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1.
Lupus ; 28(11): 1368-1377, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31558100

RESUMO

OBJECTIVE: Studies have been conducted to determine the causal factors and clinical consequences of non-adherence to treatment in systemic lupus erythematosus (SLE). However, no interventions have been performed to increase drug adherence. Our objective was to assess the effectiveness of pharmaceutical care (PC) for drug treatment adherence in lupus nephritis (LN). METHODS: This was a randomized clinical trial (pragmatic trial) in patients with LN in Rio de Janeiro, Brazil, allocated in two groups: an intervention group (Dader Method for PC) and a control group (institution's usual care). Drug treatment adherence was measured by the combination of five questions normally used in clinical practice. RESULTS: A total of 131 patients were randomized, and 122 completed the study, with a mean follow-up of 12.7 months and use of six drugs per day and 10-12 doses per day. Low adherence was observed at baseline (intervention group: 30%; control group: 29%). PC showed 27% effectiveness (95% confidence interval (CI) -6% to 50%) in the intention to treat analysis and 31% (95% CI 0-52%) in per protocol analysis, considering all drugs. As for adherence to specific drugs for SLE, effectiveness of PC was 64% (95% CI 34-80%) with intention-to-treat analysis and 62% (95% CI 32-79%) in per protocol analysis. CONCLUSIONS: PC was effective for increasing drug treatment adherence in SLE. The detailed account provided by the Dader Method of the difficulties with patients' drug therapy proved invaluable to approach non-adherence.


Assuntos
Nefrite Lúpica/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Assistência Farmacêutica/organização & administração , Adulto , Brasil , Feminino , Seguimentos , Humanos , Análise de Intenção de Tratamento , Pessoa de Meia-Idade , Inquéritos e Questionários
2.
Breast Cancer Res ; 20(1): 42, 2018 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-29778097

RESUMO

BACKGROUND: Psychiatric medications are widely prescribed in the USA. Many antipsychotics cause serum hyperprolactinemia as an adverse side effect; prolactin-Janus kinase 2 (JAK2)-signal transducer and activator of transcription 5 (STAT5) signaling both induces cell differentiation and suppresses apoptosis. It is controversial whether these antipsychotics increase breast cancer risk. METHODS: We investigated the impact of several antipsychotics on mammary tumorigenesis initiated by retrovirus-mediated delivery of either ErbB2 or HRas or by transgenic expression of Wnt-1. RESULTS: We found that the two hyperprolactinemia-inducing antipsychotics, risperidone and pimozide, prompted precancerous lesions to progress to cancer while aripiprazole, which did not cause hyperprolactinemia, did not. We observed that risperidone and pimozide (but not aripiprazole) caused precancerous cells to activate STAT5 and suppress apoptosis while exerting no impact on proliferation. Importantly, we demonstrated that these effects of antipsychotics on early lesions required the STAT5 gene function. Furthermore, we showed that only two-week treatment of mice with ruxolitinib, a JAK1/2 inhibitor, blocked STAT5 activation, restored apoptosis, and prevented early lesion progression. CONCLUSIONS: Hyperprolactinemia-inducing antipsychotics instigate precancerous cells to progress to cancer via JAK/STAT5 to suppress the apoptosis anticancer barrier, and these cancer-promoting effects can be prevented by prophylactic anti-JAK/STAT5 treatment. This preclinical work exposes a potential breast cancer risk from hyperprolactinemia-inducing antipsychotics in certain patients and suggests a chemoprevention regime that is relatively easy to implement compared to the standard 5-year anti-estrogenic treatment in women who have or likely have already developed precancerous lesions while also requiring hyperprolactinemia-inducing antipsychotics.


Assuntos
Neoplasias da Mama/genética , Janus Quinase 2/genética , Lesões Pré-Cancerosas/genética , Fator de Transcrição STAT5/genética , Animais , Antipsicóticos/efeitos adversos , Apoptose/efeitos dos fármacos , Mama/efeitos dos fármacos , Mama/patologia , Neoplasias da Mama/induzido quimicamente , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Diferenciação Celular/efeitos dos fármacos , Feminino , Humanos , Hiperprolactinemia/induzido quimicamente , Hiperprolactinemia/epidemiologia , Hiperprolactinemia/genética , Hiperprolactinemia/patologia , Camundongos , Pimozida/efeitos adversos , Lesões Pré-Cancerosas/induzido quimicamente , Lesões Pré-Cancerosas/patologia , Fatores de Risco , Risperidona/efeitos adversos , Transdução de Sinais/efeitos dos fármacos
3.
Psychol Med ; 47(14): 2472-2482, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28436341

RESUMO

BACKGROUND: Autism Spectrum Disorders (ASD) and psychosis share deficits in social cognition. The insular region has been associated with awareness of self and reality, which may be basic for proper social interactions. METHODS: Total and regional insular volume and thickness measurements were obtained from a sample of 30 children and adolescents with ASD, 29 with early onset first-episode psychosis (FEP), and 26 healthy controls (HC). Total, regional, and voxel-level volume and thickness measurements were compared between groups (with correction for multiple comparisons), and the relationship between these measurements and symptom severity was explored. RESULTS: Compared with HC, a shared volume deficit was observed for the right (but not the left) anterior insula (ASD: p = 0.007, FEP: p = 0.032), and for the bilateral posterior insula: (left, ASD: p = 0.011, FEP: p = 0.033; right, ASD: p = 0.004, FEP: p = 0.028). A voxel-based morphometry (VBM) conjunction analysis showed that ASD and FEP patients shared a gray matter volume and thickness deficit in the left posterior insula. Within patients, right anterior (r = -0.28, p = 0.041) and left posterior (r = -0.29, p = 0.030) insular volumes negatively correlated with the severity of insight deficits, and left posterior insular volume negatively correlated with the severity of 'autistic-like' symptoms (r = -0.30, p = 0.028). CONCLUSIONS: The shared reduced volume and thickness in the anterior and posterior regions of the insula in ASD and FEP provides the first tentative evidence that these conditions share structural pathology that may be linked to shared symptomatology.


Assuntos
Transtorno do Espectro Autista/patologia , Córtex Cerebral/patologia , Imageamento por Ressonância Magnética/métodos , Transtornos Psicóticos/patologia , Adolescente , Transtorno do Espectro Autista/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Criança , Feminino , Humanos , Masculino , Transtornos Psicóticos/diagnóstico por imagem
4.
J Anim Physiol Anim Nutr (Berl) ; 101(5): e154-e164, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27874218

RESUMO

Positive effects have been observed in offspring from beef cows supplemented with corn dried distillers grain with solubles (DDGS) during late gestation. The hypothesis of this study was that late gestational DDGS supplementation to beef cows would increase blood flow (BF) to the gravid uterus and mammary gland thus impacting birthweight and post-natal growth of the offspring. Experiment 1 investigated mammary gland BF in multiparous cows during late pregnancy. Beef cows were fed a control (CON1) diet of low-quality hay (n = 5) or a supplement diet (SUP1) of low-quality hay with DDGS [1.7 g/kg of body weight (BW); n = 6]. In Experiment 2, multiparous late pregnant beef cows were fed either a control (CON2) diet of a low-quality hay (n = 4) or a supplement diet (SUP2) of low-quality hay with DDGS (1.7 g/kg of BW; n = 5). Uterine and mammary gland BF were recorded every 21 days during late gestation. In Experiment 1, there were no effects of diet or day on mammary gland hemodynamics. In Experiment 2, total and ipsilateral uterine BF was less (p ≤ 0.04) in SUP2 vs. CON2 cows and similar BF to contralateral horns. Mammary gland BF was unaltered by maternal supplementation. Even when measured in two different years in two different environments, mammary gland BF remained unaltered to DDGS supplementation. Investigations on the mechanism that may impact uterine BF during late gestation remain to be known.


Assuntos
Ração Animal/análise , Bovinos/fisiologia , Dieta/veterinária , Glândulas Mamárias Animais/irrigação sanguínea , Útero/irrigação sanguínea , Fenômenos Fisiológicos da Nutrição Animal , Animais , Feminino , Gravidez
5.
J Anim Physiol Anim Nutr (Berl) ; 101(3): 589-604, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27079549

RESUMO

This study examined effects of stage of gestation and nutrient restriction with subsequent realimentation on maternal and foetal bovine pancreatic function. Dietary treatments were assigned on day 30 of pregnancy and included: control (CON; 100% requirements; n = 18) and restricted (R; 60% requirements; n = 30). On day 85, cows were slaughtered (CON, n = 6; R, n = 6), remained on control (CC; n = 12) and restricted (RR; n = 12), or realimented to control (RC; n = 11). On day 140, cows were slaughtered (CC, n = 6; RR, n = 6; RC, n = 5), remained on control (CCC, n = 6; RCC, n = 5) or realimented to control (RRC, n = 6). On day 254, the remaining cows were slaughtered and serum samples were collected from the maternal jugular vein and umbilical cord to determine insulin and glucose concentrations. Pancreases from cows and foetuses were removed, weighed, and subsampled for enzyme and histological analysis. As gestation progressed, maternal pancreatic α-amylase activity decreased and serum insulin concentrations increased (p ≤ 0.03). Foetal pancreatic trypsin activity increased (p < 0.001) with advancing gestation. Foetal pancreases subjected to realimentation (CCC vs. RCC and RRC) had increased protein and α-amylase activity at day 254 (p ≤ 0.02), while trypsin (U/g protein; p = 0.02) demonstrated the opposite effect. No treatment effects were observed for maternal or foetal pancreatic insulin-containing cell clusters. Foetal serum insulin and glucose levels were reduced with advancing gestation (p ≤ 0.03). The largest maternal insulin-containing cell cluster was not influenced by advancing gestation, while foetal clusters grew throughout (p = 0.01). These effects indicate that maternal digestive enzymes are influenced by nutrient restriction and there is a potential for programming of increased foetal digestive enzyme production resulting from previous maternal nutrient restriction.


Assuntos
Glicemia , Privação de Alimentos , Insulina/sangue , Fenômenos Fisiológicos da Nutrição Materna , Pâncreas/enzimologia , Animais , Bovinos , Feminino , Pâncreas/citologia , Pâncreas/metabolismo , Gravidez
6.
Psychol Med ; 45(9): 1851-60, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25524365

RESUMO

BACKGROUND: Maternal depression and unhealthy diet are well-known risk factors for adverse child emotional-behavioural outcomes, but their developmental relationships during the prenatal and postnatal periods are largely uncharted. This study sought to examine the inter-relationships between maternal depression symptoms and unhealthy diet (assessed during pregnancy and postnatal periods) in relation to child emotional-behavioural dysregulation (assessed at the ages of 2, 4 and 7 years). METHOD: In a large prospective birth cohort of 7814 mother-child pairs, path analysis was used to examine the independent and inter-related associations of maternal depression symptoms and unhealthy diet with child dysregulation. RESULTS: Higher prenatal maternal depression symptoms were prospectively associated with higher unhealthy diet, both during pregnancy and the postnatal period, which, in turn, was associated with higher child dysregulation up to the age of 7 years. In addition, during pregnancy, higher maternal depression symptoms and unhealthy diet were each independently associated with higher child dysregulation up to the age of 7 years. These results were robust to other prenatal, perinatal and postnatal confounders (such as parity and birth complications, poverty, maternal education, etc.). CONCLUSIONS: Maternal depression symptoms and unhealthy diet show important developmental associations, but are also independent risk factors for abnormal child development.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Depressão Pós-Parto/epidemiologia , Depressão/epidemiologia , Dieta/estatística & dados numéricos , Emoções , Complicações na Gravidez/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Autocontrole , Adulto , Criança , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Estudos de Coortes , Depressão/psicologia , Depressão Pós-Parto/psicologia , Inglaterra/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Período Pós-Parto , Gravidez , Complicações na Gravidez/psicologia , Efeitos Tardios da Exposição Pré-Natal/psicologia , Estudos Prospectivos , Análise de Regressão , Adulto Jovem
7.
Oecologia ; 177(2): 379-87, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25424156

RESUMO

Reversed sexual dimorphism (RSD), which occurs when the female of a species is larger than the male, is the rule for most birds of prey but the exception among other bird and mammal species. The selective pressures that favour RSD are an intriguing issue in animal ecology. Despite the large number of hypotheses proposed to explain the evolution of RSD, there is still no consensus about the mechanisms involved and whether they act on one or both sexes, mainly because few intrapopulation studies have been undertaken and few raptor species have been investigated. Using the strongly size-dimorphic northern goshawk (Accipiter gentilis L.) as a model, we studied a population with one of the highest densities of breeding pairs reported in the literature in order to understand selective pressures that may favour RSD. We evaluated life-history processes, including recruitment of adult breeders and reproductive success, and we explored the mechanisms thought to act on each sex, including hunting efficiency, diet, body condition and mate choice. We found that smaller males produced more fledglings than larger ones, but there was no relationship between size and reproductive success for females. The mean body size of female breeders was larger than that of female fledglings, but male fledglings and breeders did not differ in size. Male body size was related to the type but not to the amount of prey captured during the nestling stage. We conclude that RSD may be favoured in this goshawk population because small males tend to enjoy higher reproductive success and large females greater recruitment. Our results do not support the hypotheses that evolutionary reduction in male size is driven by hunting efficiency, at least during the nestling stage, or the hypotheses that it is driven by greater recruitment. Our findings also suggest that increase in female size is driven by recruitment, rather than by reproductive success as previously postulated.


Assuntos
Evolução Biológica , Tamanho Corporal/genética , Falconiformes/genética , Fenótipo , Reprodução , Seleção Genética , Caracteres Sexuais , Animais , Cruzamento , Falconiformes/anatomia & histologia , Falconiformes/fisiologia , Feminino , Masculino
8.
Ann Oncol ; 25(7): 1416-1421, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24737778

RESUMO

BACKGROUND: Tivantinib (ARQ 197) is an orally available, non-adenosine triphosphate competitive, selective c-MET inhibitor. The primary objective of this study was to evaluate the safety, tolerability and to establish the recommended phase II dose (RP2D) of tivantinib and gemcitabine combination. PATIENTS AND METHODS: Patients with advanced or metastatic solid tumors were treated with escalating doses of tivantinib (120-360 mg capsules) in combination with gemcitabine (1000 mg/m(2) weekly for 3 of 4 weeks). Different schedules of administration were tested and modified based on emerging preclinical data. Tivantinib was given continuously, twice a day (b.i.d.) for 2, 3 or 4 weeks of a 28-day cycle or on a 5-day on, 2-day off schedule (the day before and day of gemcitabine administration). RESULTS: Twenty-nine patients were treated with gemcitabine and escalating doses of tivantinib: 120 mg b.i.d. (n = 4), 240 mg b.i.d. (n = 6) and 360 mg b.i.d. (n = 19). No dose-limiting toxicities were observed in escalation. The RP2D was 360 mg b.i.d. daily, and 45 additional patients were enrolled in the expansion cohort. Grade ≥3 treatment-related toxicities were observed in 54 of 74 (73%) patients with the most common being neutropenia (43%), anemia (30%), thrombocytopenia (28%) and fatigue (15%). There was one treatment-related death due to neutropenia. Administration of gemcitabine did not affect tivantinib concentration. Fifty-six patients were assessable for response. Eleven (20%) patients achieved a partial response and 26 (46%) had stable disease (SD), including 15 (27%) who achieved SD for over 4 months. Ten of 37 patients with clinical benefit had prior exposure to gemcitabine. CONCLUSION: The combination of tivantinib at its monotherapy dose and standard dose gemcitabine was safe and tolerable. Early signs of antitumor activity may warrant further development of this combination in nonsmall-cell lung cancer, ovarian, pancreatic and cholangiocarcinoma. CLINICALTRIALSGOV IDENTIFIER: NCT00874042.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias/tratamento farmacológico , Proteínas Proto-Oncogênicas c-met/antagonistas & inibidores , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/farmacocinética , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pirrolidinonas/administração & dosagem , Quinolinas/administração & dosagem , Gencitabina
9.
Vet Pathol ; 51(4): 737-48, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24048323

RESUMO

Human inflammatory breast carcinoma (IBC) and canine inflammatory mammary carcinoma (IMC) are considered the most malignant types of breast cancer. IMC has similar characteristics to IBC; hence, IMC has been suggested as a model to study the human disease. To compare the angiogenic and angioinvasive features of IMC with non-IMC, 3 canine mammary tumor xenograft models in female SCID mice were developed: IMC, comedocarcinoma, and osteosarcoma. Histopathological and immunohistochemical characterization of both primary canine tumors and xenografts using cellular markers pancytokeratin, cytokeratin 14, vimentin, and α-smooth muscle actin and vascular factors (VEGF-A, VEGF-D, VEGFR-3, and COX-2) was performed. Tumor cell proliferation index was measured by the Ki-67 marker. The xenograft models reproduced histological features found in the primary canine tumor and preserved the original immunophenotype. IMC xenografts showed a high invasive character with tumor emboli in the dermis, edema, and occasional observations of ulceration. In addition, compared with osteosarcoma and comedocarcinoma, the IMC model showed the highest vascular factor expression associated with a high proliferation index. Likewise, IMC xenografts showed higher COX-2 expression associated with VEGF-D and VEGFR-3, as well as a higher presence of dermal lymphatic tumor emboli, suggesting COX-2 participation in IMC lymphangiogenesis. These results provide additional evidence to consider vascular factors, their receptors, and COX-2 as therapeutic targets for IBC.


Assuntos
Modelos Animais de Doenças , Doenças do Cão/metabolismo , Doenças do Cão/fisiopatologia , Regulação Neoplásica da Expressão Gênica/fisiologia , Neoplasias Mamárias Animais/metabolismo , Neoplasias Mamárias Animais/fisiopatologia , Peptídeos/metabolismo , Animais , Ciclo-Oxigenase 2/metabolismo , Cães , Feminino , Xenoenxertos/patologia , Xenoenxertos/transplante , Imuno-Histoquímica/veterinária , Peptídeos e Proteínas de Sinalização Intercelular , Camundongos , Camundongos SCID
10.
J Anim Physiol Anim Nutr (Berl) ; 98(4): 797-807, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25180375

RESUMO

To determine how nutrient restriction and melatonin supplementation influence ewe and foetal hepatic and small intestinal energy use, 32 primiparous ewes on d 50 of gestation were fed 60% (RES) or 100% (ADQ) of NRC recommendations with 0 (CON) or 5 mg/d (MEL) of dietary melatonin. On d 130 of gestation, small intestine and liver were weighed and collected. Data were analysed as a completely randomized design with a 2 × 2 factorial arrangement of treatments. Liver weight (g/kg EBW) decreased (p = 0.02) in RES ewes. Jejunum weight (g/kg BW) increased (interaction p = 0.04) in ADQ-MEL ewes compared with all other treatments. Total in vitro O2 consumption (mol/min/tissue) and total citrate synthase activity (mol/min/tissue and mol/min/kg EBW) in liver decreased (p ≤ 0.03) in RES ewes. Oxygen consumption (mol/min/kg EBW) increased (interaction p = 0.02) in jejunum of ADQ-CON versus RES-MEL and ADQ-CON. Citrate synthase activity (mol/min/kg of EBW) increased (interaction p = 0.03) in jejunum of ADQ-MEL compared with RES-MEL and ADQ-CON. Foetal liver weight (g/kg BW) decreased (p = 0.02) in RES versus ADQ. Foetal small intestine weight (g/kg BW) decreased (interaction p = 0.05) in RES-MEL versus ADQ-MEL. Total O2 consumption (mol/min/tissue) and total citrate synthase activity (mol/min/kg of BW) in foetal liver decreased (p ≤ 0.05) in RES versus ADQ. Foetal small intestinal O2 consumption (mol/min/kg of BW) was greater (interaction p = 0.03) in RES-CON and ADQ-MEL than RES-MEL and ADQ-CON. Maternal nutrient restriction had a greater effect than melatonin supplementation on liver and jejunum mass and energy utilization in dams and foetuses. Because intestinal mass and energy utilization were more responsive to melatonin supplementation in ewes fed adequate nutrition compared with restricted ewes, melatonin may have limited use as a therapeutic supplement to help overcome potential negative effects of nutrient restriction.


Assuntos
Suplementos Nutricionais , Intestino Delgado/embriologia , Fígado/embriologia , Melatonina/farmacologia , Ovinos/embriologia , Ovinos/metabolismo , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Dieta/veterinária , Feminino , Privação de Alimentos , Intestino Delgado/metabolismo , Fígado/metabolismo , Melatonina/administração & dosagem , Consumo de Oxigênio , Gravidez
11.
Br J Cancer ; 108(1): 21-4, 2013 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-23287988

RESUMO

BACKGROUND: The mesenchymal-epithelial transition factor (MET) receptor is dysregulated in hepatocellular carcinoma (HCC), and tivantinib (ARQ 197) is an oral, selective, MET inhibitor. METHODS: This Phase-1b study assessed tivantinib safety as primary objective in patients with previously treated HCC and Child-Pugh A or B liver cirrhosis. Patients received oral tivantinib 360 mg twice daily until disease progression or unacceptable toxicity. RESULTS: Among 21 HCC patients, common drug-related adverse events (AEs) were neutropaenia, anaemia, asthenia, leucopaenia, anorexia, diarrhoea, and fatigue. No drug-related worsening of liver function or performance status occurred, but one Child-Pugh B patient experienced drug-related bilirubin increase. Four patients had drug-related serious AEs, including one neutropaenia-related death. Haematologic toxicities were more frequent than in previous tivantinib studies but were manageable with prompt therapy. Best response was stable disease (median, 5.3 months) in 9 of 16 evaluable patients (56%). Median time to progression was 3.3 months. CONCLUSION: Tivantinib demonstrated a manageable safety profile and preliminary antitumour activity in patients with HCC and Child-Pugh A or B cirrhosis.


Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Hepatocelular/tratamento farmacológico , Cirrose Hepática/complicações , Neoplasias Hepáticas/tratamento farmacológico , Pirrolidinonas/uso terapêutico , Quinolinas/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/complicações , Feminino , Humanos , Neoplasias Hepáticas/complicações , Masculino , Pessoa de Meia-Idade , Proteínas Proto-Oncogênicas c-met/antagonistas & inibidores , Pirrolidinonas/efeitos adversos , Quinolinas/efeitos adversos , Retratamento
12.
Cranio ; 41(4): 368-379, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33357146

RESUMO

OBJECTIVE: To evaluate whether there is a relationship between occlusion and body posture evaluated using a stabilometric platform. METHODS: Observational studies that analyzed the relationship between dental occlusion (changes in mandibular position and/or dental malocclusion) and body posture evaluated with a stabilometric platform in patients older than 13 years without orthodontic or orthopedic intervention and systemically healthy were considered eligible for inclusion. PubMed, EMBASE, Science Direct, LILACS, and Google Scholar databases were searched to obtain articles published from September 2019 up to March 2020. RESULTS: Twelve articles met the inclusion criteria, of which 66.7% showed a relationship between dental occlusion and body posture, and 33.3% found no relationship. The marked heterogeneity between studies did not allow data to be combined for meta-analyses. CONCLUSION: For the mandibular positions, the postural changes were mainly in the mediolateral direction, while in the malocclusions, they were in the anteroposterior direction.


Assuntos
Má Oclusão , Humanos , Postura , Mandíbula , Estudos Observacionais como Assunto
13.
BMC Psychol ; 11(1): 46, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36793136

RESUMO

PURPOSE: Depression is inadequately recognized and managed, and physicians' attitudes toward this condition and its treatment may play a part in this. This study aimed to assess Ecuadorian physicians' attitudes toward depression. METHODS: This was a cross-sectional study conducted using the validated Revised Depression Attitude Questionnaire (R-DAQ). The questionnaire was delivered to Ecuadorian physicians, and the response rate was 88.8%. RESULTS: 76.4% of participants had never received previous training in depression, and 52.1% of them indicated neutral or limited professional confidence when dealing with depressed patients. More than two-thirds of the participants reported an optimistic attitude toward the generalist perspective of depression. CONCLUSION: Overall, physicians in Ecuador's healthcare settings were optimistic and held positive attitudes toward patients with depression. However, a lack of confidence in the management of depression and a need for ongoing training were found, especially among medical professionals who are not in daily contact with patients with depression.


Assuntos
Depressão , Médicos , Humanos , Depressão/terapia , Equador , Atitude do Pessoal de Saúde , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos e Questionários
14.
Ann Oncol ; 23(4): 1037-44, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21828377

RESUMO

BACKGROUND: Satraplatin is an oral platinum analog with demonstrated activity in a range of malignancies. The current study was designed to evaluate the effect of varying degrees of renal impairment on the safety and pharmacokinetics (PKs) of satraplatin. PATIENTS AND METHODS: Patients with advanced solid tumors, refractory to standard therapies, were eligible. The study included four cohorts of patients with varying levels of renal function, and eight patients per cohort: Group 1 (G1) = normal renal function; G2 = mild renal impairment [creatinine clearance (CrCl) 50-80 ml/min]; G3 = moderate impairment (CrCl 30 to <50 ml/min); G4 = severe impairment (CrCl <30 ml/min). Satraplatin was administered orally at 80 mg/m(2)/day on days 1-5 every 35 days. RESULTS: A total of 32 patients were enrolled, 8 patients in each renal function group. Each group tolerated the dose of 80 mg/m(2)/day on days 1-5 every 35 days without the need for dose deescalation. The most common adverse events were fatigue (63%), nausea (56%), diarrhea (53%), anorexia (47%), constipation (38%), vomiting (28%), anemia, dyspnea, and thrombocytopenia (25%). There were no dose-limiting toxic effects in any study group. There was increased exposure to plasma platinum and plasma ultrafiltrate platinum in patients with moderate to severe renal impairment. CONCLUSIONS: Satraplatin PKs was altered in patients with renal impairment. However, a corresponding increase in satraplatin-related toxic effects was not observed.


Assuntos
Antineoplásicos/farmacocinética , Antineoplásicos/uso terapêutico , Neoplasias/tratamento farmacológico , Compostos Organoplatínicos/farmacocinética , Compostos Organoplatínicos/uso terapêutico , Insuficiência Renal/metabolismo , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/metabolismo , Compostos Organoplatínicos/efeitos adversos , Análise de Regressão , Insuficiência Renal/complicações , Resultado do Tratamento
15.
Epidemiol Infect ; 140(10): 1853-61, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22313725

RESUMO

Aimed at assessing the circulation of Mycobacterium tuberculosis in a highly endemic prison, this 13-month prospective study was performed on strains isolated from tuberculosis (TB) cases detected passively and actively. We used X-ray screening of newly admitted inmates and mass screening at the beginning of the study and again 1 year later. Of the 94 strains genotyped by restriction fragment-length polymorphism, 79 (84·0%) belonged to one of the 12 identified clusters (2-21 strains each), including two main clusters (18 and 21 cases, respectively). A history of TB treatment was reported in 22/79 (27·8%) clustered cases. Time-space distribution of clustered cases was predominantly consistent with transmission, in micro-epidemics. Given the dominant pattern of exogenous infection and the extensive strain circulation, effective TB control should emphasize reduction of overcrowding and improvement of environmental measures as a complement to detection and treatment of cases.


Assuntos
Doenças Endêmicas , Controle de Infecções/métodos , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose/epidemiologia , Adulto , Análise por Conglomerados , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Tipagem Molecular , Mycobacterium tuberculosis/classificação , Mycobacterium tuberculosis/genética , Polimorfismo de Fragmento de Restrição , Prisões , Estudos Prospectivos , Radiografia Torácica
16.
Theriogenology ; 191: 109-121, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-35981410

RESUMO

Our hypothesis was that maternal nutrient restriction would negatively impact the endocrine and metabolic status of the pregnant cow, therefore influencing the mammary gland in preparation for lactation. We further hypothesized that earlier timing of realimentation could prevent negative impacts of nutrient restriction. The objectives were to investigate the influence of nutrient restriction and realimentation during early to late gestation on endocrine profile, umbilical hemodynamics, and mammary gland development and hemodynamics in pregnant beef cows. In Experiment 1, on d 30 of pregnancy cows (initial BW = 667.5 ± 13.4 kg, BCS = 6.2 ± 0.1) were randomly assigned to one of 3 treatments: 1) 100% NRC requirements from d 30 to 254 of gestation (CCC; n = 6); 2) 60% NRC from d 30 to 85, thereafter being re-alimented to 100% NRC to d 254 (RCC; n = 5); 3) or receive 60% NRC from d 30 to 140, thereafter being re-alimented to 100% NRC to d 254 (RRC; n = 6). Cows were returned to a common outdoor facility for calving thereafter and were fed ad libitum. In Experiment 2, on d 30 of pregnancy, cows (initial BW = 620.5 ± 11.3 kg, BCS = 5.1 ± 0.1) were randomly assigned to dietary treatments including: control (CON; 100% NRC; n = 18) and nutrient restriction (RES; 60% NRC; n = 30). On d 85 of pregnancy, cows were either slaughtered (CON, n = 6 and RES, n = 6), remained on control (CC; n = 12) and restricted (RR; n = 12) treatments, or were realimented to control (RC; n = 11). On d 140 of pregnancy, cows were either slaughtered (CC, n = 6; RR, n = 6; RC, n = 5), remained on control (CCC, n = 6; RCC, n = 5), or were realimented to control (RRC, n = 6). On d 254 of pregnancy, all remaining cows were slaughtered (CCC, n = 6; RCC, n = 5; RRC, n = 6). Mammary hemodynamics and endocrine profile were measured. Serum urea nitrogen, NEFA, as well as fetal parameters were measured in Experiment 1; whereas in Experiment 2, mammary gland development was recorded. In Experiment 1, RRC cows had lower dry matter intake (P = 0.001) and consequently lower BW change (P = 0.06). However, maternal nutrition did not alter mammary hemodynamics, hormonal patterns, and fetal characteristics (P > 0.11). In Experiment 2, CCC cows had increased (P = 0.02) mammary gland blood flow ipsilateral to the gravid horn as well as greater (P = 0.02) mammary gland fat on d 254. Nevertheless, plane of nutrition did not alter hormonal concentrations nor mammary gland characteristics (P > 0.15). These data indicate that nutrient restriction did not alter mammary hemodynamics nor endocrine profile throughout gestation.


Assuntos
Carcinoma de Células Renais , Doenças dos Bovinos , Neoplasias Renais , Ração Animal/análise , Animais , Carcinoma de Células Renais/veterinária , Bovinos , Dieta/veterinária , Feminino , Hemodinâmica , Neoplasias Renais/veterinária , Nutrientes , Gravidez
17.
Cureus ; 14(2): e22300, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35350529

RESUMO

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. The global surge in migration to high-income countries, especially Canada, highlights the importance of studies evaluating the risk factors and the disparities in the rate of incidence of CVD among immigrants. Canada is home to a diverse group of immigrants, each presenting with a risk profile that is unique to their ethnicity and country of birth. A variety of cardiac risk factors, such as dietary habits, physical activity, smoking, cultural traditions as well as preponderance to certain diseases like type II diabetes mellitus, hypertension, and high lipid levels act in concert and impact CVD risk and overall incidence. This narrative review focuses on CVD risks and how it is related to the immigration status among various ethnic groups in Canada.

18.
World J Biol Psychiatry ; 23(3): 208-218, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34338147

RESUMO

BACKGROUND: Schizophrenia-spectrum disorders (SSD) and Autism spectrum disorders (ASD) are neurodevelopmental disorders that share clinical, cognitive, and genetic characteristics, as well as particular white matter (WM) abnormalities. In this study, we aimed to investigate the role of a set of oligodendrocyte/myelin-related (OMR) genes and their epistatic effect on the risk for SSD and ASD. METHODS: We examined 108 SNPs in a set of 22 OMR genes in 1749 subjects divided into three independent samples (187 SSD trios, 915 SSD cases/control, and 91 ASD trios). Genetic association and gene-gene interaction analyses were conducted with PLINK and MB-MDR, and permutation procedures were implemented in both. RESULTS: Some OMR genes showed an association trend with SSD, while after correction, the ones that remained significantly associated were MBP, ERBB3, and AKT1. Significant gene-gene interactions were found between (i) NRG1*MBP (perm p-value = 0.002) in the SSD trios sample, (ii) ERBB3*AKT1 (perm p-value = 0.001) in the SSD case-control sample, and (iii) ERBB3*QKI (perm p-value = 0.0006) in the ASD trios sample. DISCUSSION: Our results suggest the implication of OMR genes in the risk for both SSD and ASD and highlight the role of NRG1 and ERBB genes. These findings are in line with the previous evidence and may suggest pathophysiological mechanisms related to NRG1/ERBBs signalling in these disorders.


Assuntos
Transtorno do Espectro Autista , Esquizofrenia , Substância Branca , Humanos , Esquizofrenia/genética , Transtorno do Espectro Autista/genética , Polimorfismo de Nucleotídeo Único , Genes erbB , Neuregulina-1/genética
19.
Chemosphere ; 275: 130030, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33662730

RESUMO

In this work the ability of Zn2-xCuxCr-CO3 layered double hydroxides (LDHs) as highly efficient DeNOx photocatalysts was studied. LDHs with x = 0, 0.2 and 0.4 were prepared using a coprecipitation method. The samples were characterized by different techniques such as XRD, XPS, FT-IR, ICP-MS, TG, SBET, SEM and Diffuse reflectance (DR). The increased amount of copper ions in the LDH layers gave rise to slight changes in the structure and morphology and an important variation of the optical properties of the LDHs. The prepared ZnCuCr-CO3 photocatalysts exhibited favourable conversion efficiency (51%) and an extraordinary selectivity (97%) for the photochemical NO abatement. The photochemical mechanism was elucidated from DOS, EPR, Femtosecond transient absorption and in-situ DRIFTS studies. The results suggested that the presence of Cu2+ ions in the LDH framework introduced new states in the valence band states, thus favouring the production and mobility of e-/h+ charge carriers and a greater production of ⋅O2- and ⋅OH.


Assuntos
Cobre , Hidróxidos , Espectroscopia de Infravermelho com Transformada de Fourier , Zinco
20.
Braz J Infect Dis ; 25(6): 101652, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34793713

RESUMO

Meningococcal disease by serogroup B has been a public health problem in Brazil in the last decades. The Brazilian Oswaldo Cruz Foundation has been working to develop a vaccine with detergent-treated outer membrane vesicles (OMV) and detoxified endotoxin (dLOS) from Neisseria meningitidis serogroup B prevalent strains. A phase I study, enrolling 26 adults (18-44 years of age) was performed using experimental vaccines combining B components and aluminum hydroxide as adjuvant. It was a dose escalation study testing vaccines made of 25, 50, and 100 µg OMV protein/mL (sum of both strains) and dLOS in half amount of total protein concentration, with three doses given two months apart. Adverse events were mild/moderate with frequency increasing with the amount of antigens. Pain in the site of injection was the most frequent reaction in all doses, reported in more than the 85% across vaccine groups. Considering all injections, cephalea was the most common systemic adverse event, detected in 11.1%, 17.2% and 32.1%, respectively with doses of 12.5 µg, 25 µg and 50 µg. High titers of total IgG (ELISA) were observed for the vaccine components before vaccination. Protective levels of bactericidal antibodies (titer ≥1:4) for both vaccine strains were also present. Considering a 4-fold increase of IgG titers compared to pre-immune values (seroconversion), 50%-70% of those who received intermediate and highest doses of antigens presented satisfactory response for OMV of N44/89 strain. The lowest dose vaccine induced no seroconversion for strain N44/89, and 11% for strain N603/95. For the three vaccines doses, 25% of seroconversion, in total IgG against LOS, was observed. Increased antibody bactericidal activity was observed for both strains in higher antigen concentrations. For IgG against LOS, all vaccine formulations showed 25% of seroconversion. In conclusion, MenB-Bio experimental vaccines were well tolerated and immunogenic, thus allowing phase II studies.


Assuntos
Infecções Meningocócicas , Vacinas Meningocócicas , Neisseria meningitidis Sorogrupo B , Adulto , Anticorpos Antibacterianos , Brasil , Humanos , Vacinas Meningocócicas/efeitos adversos , Sorogrupo
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