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1.
Rev. ADM ; 78(5): 258-263, sept.-oct. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1344709

ABSTRACT

Introducción: La displasia epitelial oral (DEO) es la presencia de alteraciones celulares y tisulares, lo que puede significar una etapa anterior al desarrollo del cáncer. Múltiples marcadores han sido considerados para estimar su potencial neoplásico y evolución a carcinoma, incluyendo a la molécula p53, se considera como participe de diversos fenómenos de la homeostasis celular. Objetivo: Determinar la relación entre la inmunoexpresión de p53 DO-7 y PAb 240 con el grado de severidad de la displasia epitelial oral. Material y métodos: Se analizaron nueve muestras de DEO (tres para cada grado de severidad). La inmunoexpresión de p53 tipo silvestre (DO-7) y forma mutada (PAb 240), fue determinada a través de ensayo de inmunohistoquímica por peroxidasa. Se obtuvieron la media y desviación estándar y se realizó la prueba χ2 (p < 0.05). Resultados: La edad media fue de 65.7 ± 11.4 años, la zona anatómica con mayor presencia de DEO es el borde lateral de la lengua. Ocho de nueve muestras fueron positivas para DO-7 y solo dos para PAb 240. Conclusiones: Nuestros resultados indican que, aunque la expresión de p53 DO-7 podría estar relacionada parcialmente con la patogénesis de la displasia epitelial, no todas las displasias presentaron la forma mutada de p53 (PAb 240). Lo cual coincide con el comportamiento biológico incierto de las displasias al poder permanecer sin cambios, involucionar o transformarse


Introduction: Oral epithelial dysplasia (OED) is the presence of cellular and tissue alterations, which may mean a stage prior to the development of cancer. Multiple markers have been considered to estimate its pathogenic potential and evolution to neoplasms, including the p53 molecule, considered as participating in various phenomena of cellular homeostasis. Objective: To determine the relationship between the immunoexpression of p53 DO-7 and PAb 240 with the degree of severity of oral epithelial dysplasia. Material and methods: Nine OED samples were analyzed (three for each degree of severity). The immunoexpression of wild-type p53 (DO-7) and mutated form (PAb 240) was determined through a peroxidase immunohistochemical assay. The mean and standard deviation were obtained, and χ2 test (p < 0.05) were performed. Results: The mean age was 65.7 ± 11.4 years, with a greater presence of OED in the anatomical area of the lateral side of the tongue. Eight out of nine samples were positive for DO-7 and only two for PAb 240. Conclusions: Our results indicate that, although the expression of p53 DO-7 could be partially related to the pathogenesis of epithelial dysplasia, not all dysplasias presented the mutated form of p53 (PAb 240), which coincides that not all dysplasias have a potential for malignant transformation and that could be related to other oncogenic mechanisms (AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Aged , Precancerous Conditions , Immunohistochemistry , Genes, p53 , Gingival Neoplasms , Tongue Neoplasms , Pilot Projects , Statistical Analysis , Carcinogenesis , Observational Study , Mexico
2.
Aval. psicol ; 20(3): 274-288, jul.-set. 2021. ilus, tab
Article in English | LILACS, INDEXPSI | ID: biblio-1345363

ABSTRACT

The objective of this cross-sectional study was to develop and validate an Assessment Scale for Perceived Influences in Sport and Study (EIPE). The validation process was carried out with specialists and athletes of both sexes, from team and individual sports, aged between 13 and 18 years old and who attended secondary and high school Education in Santa Catarina/Brazil. Five steps were taken in order to validate the instrument: content validity; clarity of language; pilot test; construct validity; internal consistency; and reliability. Results showed that the final version of the EIPE (two factors and 49 items) showed satisfactory adjustment indices (χ2/gl = 1.751; GFI = .85; AGFI = .82; CFI = .90; SRMR = .059; RMR = .046; RMSEA = .042; CFI = .90; TLI = .89), high internal consistency (α > .70) and reliability (α > .91). It is concluded that the EIPE has satisfactory psychometric properties that provide evidence of scientific validity and reliability. (AU)


O objetivo desse estudo foi desenvolver e validar uma Escala de Avaliação de Influências Percebidas no Esporte e no Estudo (EIPE). O processo de validação foi realizado com especialistas e atletas de ambos os sexos, com idade entre 13 e 18 anos e que cursavam a Educação Básica em Santa Catarina/Brasil. Cinco etapas foram realizadas para validar o instrumento: validade de conteúdo; clareza de linguagem; teste de piloto; validade do construto; consistência interna; e fidedignidade. Os resultados mostraram que a versão final da EIPE (dois fatores e 49 itens) apresentou índices de ajuste satisfatórios (χ2/gl = 1,751; GFI = 0,85; AGFI = 0,82; CFI = 0,90; SRMR = 0,059 ; RMR = 0,046; RMSEA = 0,042; CFI = 0,90; TLI = 0,89), alta consistência interna (α > 0,70) e fidedignidade (α > 0.91). Conclui-se que a EIPE possui propriedades psicométricas aceitáveis que fornecem evidências de validade e confiabilidade científica. (AU)


El objetivo de este estudio fue desarrollar y validar una Escala de evaluación de las influencias percibidas en el deporte y el estudio (EIPE). El proceso de validación se llevó a cabo con especialistas y atletas de ambos sexos, con edades entre 13 y 18 años, que estudiaban Educación Básica en Santa Catarina/Brasil. Se dieron cinco pasos para validar el instrumento: validez de contenido; claridad del lenguaje; prueba piloto; validez de constructo; consistencia interna; y fiabilidad. Los resultados mostraron que la versión final del EIPE (dos factores y 49 ítems) mostró índices de ajuste satisfactorios (χ2/gl = 1.751; GFI = .85; AGFI = .82; CFI = .90; SRMR = .059; RMR = .046; RMSEA = .042; CFI = .90; TLI = .89), alta consistencia interna (α > .70) y fiabilidad (α > .91). Se concluye que el EIPE tiene propiedades psicométricas aceptables que proporcionan evidencia de validez y confiabilidad científica. (AU)


Subject(s)
Humans , Male , Female , Adolescent , Students/psychology , Education, Primary and Secondary , Athletes/psychology , Peer Influence , Psychometrics , Pilot Projects , Reproducibility of Results , Factor Analysis, Statistical
3.
Rev. bras. ortop ; 56(3): 326-332, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1288672

ABSTRACT

Abstract Objective The aim of the present study was to quantify the urinary concentration of the C-terminal cross-linked telopeptide of type-II collagen (CTX-II) biomarker in patients who suffered an isolated ACL injury, and to compare the concentrations found in this population with a control group of patients with no metabolic changes in the knee that could lead to cartilage degeneration. Methods A cross-sectional pilot study was performed in two groups: patients with ACL tears and a control group (each group with 10 male subjects, with an age range between 18 and 35 years, and body mass index below 30 kg/m2). In both groups, urine concentrations of a biomarker related to the degradation of type-II collagen (CTX-II) was measured. For the group with ACL tears, a temporal relationship between the time after the injury and the amount of the biomarker was also examined. Results There were significant differences in the concentrations of urinary CTX-II between the ACL group and the control group (p = 0.009). No significant relationship was observed between the time after the injury and the quantity of the biomarker. Conclusions Patients with ACL injury had higher concentrations of urinary CTX-II biomarker than those with no ACL injury (p = 0.009). However, there was no correlation between the concentration of this biomarker and the elapsed time after the injury (p≥ 0.05).


Resumo Objetivo Quantificar a concentração urinária do biomarcador telopeptídeo C de ligação cruzada de colágeno de tipo II (C-terminal cross-linked telopeptide of type-II collagen, CTX-II) em casos de lesão isolada do ligamento cruzado anterior (LCA), e comparar as concentrações observadas nessa população com um grupo controle composto por pacientes sem alterações metabólicas no joelho que possam levar à degeneração da cartilagem. Métodos Este é um estudo piloto transversal com dois grupos: pacientes com ruptura do LCA e grupo controle (cada grupo era composto por 10 indivíduos do sexo masculino, com 18 a 35 anos de idade, e índice de massa corporal inferior a 30 kg/m2). Nos dois grupos, as concentrações urinárias de um biomarcador relacionado à degradação do colágeno de tipo II (CTX-II) foram medidas. No grupo com ruptura do LCA, a relação entre o tempo pós-lesão e a quantidade do biomarcador também foi analisada. Resultados Houve diferenças significativas nas concentrações urinárias de CTX-II entre o grupo LCA e o grupo controle (p = 0,009). Não foi observada relação significativa entre o tempo de lesão e a quantidade do biomarcador. Conclusões Pacientes com lesão do LCA apresentaram maiores concentrações urinárias do biomarcador CTX-II do que aqueles sem lesão do LCA (p = 0,009). No entanto, não houve correlação entre a concentração desse biomarcador e o tempo decorrido após a lesão (p≥ 0,05).


Subject(s)
Humans , Osteoarthritis , Patients , Biomarkers , Cartilage , Pilot Projects , Anterior Cruciate Ligament Injuries
4.
Rev. argent. radiol ; 85(2): 33-40, abr. 2021. tab, graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1288197

ABSTRACT

Resumen Objetivo: Evaluar la diferencia del trazado cefalométrico manual con el digital en radiografías laterales de cráneo. Materiales y métodos: Inicialmente se realizó un piloto para calibrar al investigador principal, en donde se analizaron 10 radiografías pertenecientes a cinco pacientes del Servicio de Radiología del Centro Odontológico de nuestra institución para evaluar la concordancia entre los dos evaluadores y establecer el tamaño de la muestra. Finalmente, se analizaron 78 radiografías cefalométricas de 39 pacientes, en las que se realizó el trazado cefalométrico de Steiner manual y digital. Esas radiografías se analizaron en una escala 1:1 y posteriormente se evaluó la diferencia de las mediciones mediante el análisis univariado, se determinó en mediana e intervalo intercuartil por separado. En el análisis bivariado, se aplicó la prueba de signo de rangos de Wilcoxon y muestras pareadas para determinar la diferencia de las mediciones cefalométricas de Steiner entre el tipo del análisis cefalométrico. El nivel de significancia se fijó en p < 0,05 y confiabilidad al 95%, respectivamente. Resultados: No hubo diferencia significativa en la mayoría de las mediciones hechas de manera manual y digital, siendo el ángulo interincisal la única medición angular en la cual hubo diferencia significativa al obtener un resultado de p = 0,002. Mientras tanto, en las mediciones lineales, la única medición en la que hubo diferencia significativa fue en el segmento incisivo inferior - NB con p = 0,005. Conclusión: No se encuentran diferencias significativas entre el trazado cefalométrico manual y el digital. No obstante, es importante tener en cuenta que la muestra o población evaluada es reducida para definir conclusiones.


Abstract Objective: To evaluate the difference of the manual cephalometric tracing with the digital tracing on lateral cranial radiographs. Materials and Methods: Initially, a pilot study was carried out to calibrate the principal investigator, where 10 radiographs belonging to 5 patients of the Radiology Service of the Dental Center, were analyzed to evaluate the intraclass concordance between the two evaluators. To establish the size of the sample, finally, 78 cephalometric radiographs of 39 patients were analyzed, in which the manual and digital Steiner cephalometric tracing was performed. These radiographs were analyzed on a 1: 1 scale and then the difference of the measurements was evaluated using the univariate analysis, which was determined in the median and interquartile range, separately. In the bivariate analysis, the Wilcoxon rank sign test and paired samples were applied to determine the difference of Steiner's cephalometric measurements between the cephalometric analysis type. The level of significance was set at p < 0.05 and 95% reliability, respectively. Results: There was no significant difference in most of the measurements made manually and digitally. The interincisal angle the only angular measurement in which there was a significant difference when obtaining a result of p = 0.002, while, in the linear measurements, the only measurement in which there was significant difference was in the lower incisor segment - NB with p = 0.005. Conclusion: There is no significant difference between manual and digital cephalometric tracing, nevertheless it is important to keep in mind that the simple or population evaluated is reduced to define conclusions.


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Cephalometry , Radiography, Dental, Digital , Patients , Population , Radiology , Research Personnel , Skull , Measurements, Methods and Theories , Radiography, Dental , Pilot Projects , Organizations , Sample Size , Materials , Incisor , Methods
5.
Aval. psicol ; 20(1): 100-110, jan.-mar. 2021. ilus, tab
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1249049

ABSTRACT

Funções executivas (FE) são habilidades que permitem o autocontrole comportamental e cognitivo e estão relacionadas a diversos desfechos ao longo da vida. O uso de testes informatizados para avaliar as FE pode facilitar a precisão dos registros, a padronização e a análise dos dados. Este estudo objetivou desenvolver um instrumento informatizado para avaliar FE em crianças de 4 a 10 anos e analisar características psicométricas. Foram conduzidas cinco etapas: 1) Definição teórica e metodológica; 2) Construção dos itens; 3) Estudo piloto; 4) Análise de juízes; e 5) Estudos psicométricos de validade e fidedignidade. As tarefas informatizadas mostraram-se adequadas para o público-alvo, conforme avaliação dos juízes. As diferentes tarefas de memória de trabalho, inibição e flexibilidade cognitiva apresentaram correlações significativas entre si e a maioria das medidas no teste-reteste evidenciou estabilidade na mensuração. Portanto, os resultados sugerem viabilidade para uso do instrumento no contexto brasileiro. (AU)


Executive functions (EF) are skills linked to behavioral and cognitive self-control and are related to various outcomes throughout life. The use of computerized tests to evaluate EFs can facilitate the accuracy of records, standardization and data analysis. This study aimed to develop a computerized instrument for the EF assessment of children aged 4 to 10 years, and to seek psychometric evidence. Five steps were carried out: 1) Theoretical and methodological definition; 2) Construction of the items; 3) Pilot study; 4) Analysis of experts; and 5) Psychometric studies of validity and reliability. The computerized tasks proved to be suitable for the target audience according to the expert's evaluation. The results between the different tasks of working memory, inhibition and cognitive flexibility showed significant correlations and most test-retest measures showed stability in the measurement. Therefore, the results indicate the feasibility of using the instrument in the Brazilian context. (AU)


Funciones ejecutivas (FE) son habilidades que permiten el autocontrol conductual y cognitivo y están relacionadas con diversos resultados a lo largo de la vida. El uso de tests informatizados para evaluar las FE puede facilitar la precisión de los registros, la estandarización y el análisis de datos. Este estudio tuvo como objetivo desarrollar un instrumento informatizado para la FE para niños de 4 a 10 años, y analizar evidencias psicométricas. Fueron ejecutados cinco pasos: 1) Definición teórica y metodológica; 2) Construcción de los ítems; 3) Estudio piloto; 4) Análisis de jueces; y 5) Estudios psicométricos de validez y fiabilidad. Las tareas informatizadas demostraron ser adecuadas para el público objetivo según la evaluación de los jueces. Las diferentes tareas de memoria de trabajo, inhibición y flexibilidad cognitiva mostraron correlaciones significativas entre sí y la mayoría de las medidas test-retest presentaron estabilidad en la medición. Por lo tanto, los resultados sugieren la viabilidad del instrumento para el contexto brasileño. AU)


Subject(s)
Humans , Child, Preschool , Child , Diagnosis, Computer-Assisted/psychology , Executive Function , Pilot Projects , Reproducibility of Results
6.
Aval. psicol ; 20(1): 89-99, jan.-mar. 2021. tab
Article in Spanish | LILACS, INDEXPSI | ID: biblio-1249048

ABSTRACT

El objetivo del estudio fue adaptar y validar una batería de instrumentos para evaluar subdominios de la cognición social con población forense en Colombia y México a partir de una selección de instrumentos utilizados en neuropsicología clínica. Se revisó la pertinencia de los subdominios que componen la cognición social como evidencia de validez de contenido mediante la evaluación de diferentes expertos en psicología forense, neuropsicología y medición y evaluación; utilizando el método ANGOFF modificado y un análisis de confiabilidad según el modelo Rasch y el coeficiente Alfa de Cronbach. Posteriormente fue sometido a pilotaje con 20 personas condenadas en cárceles colombianas y mexicanas con privación de libertad. Se encontraron calibraciones INFIT 1.17 y 1.04, OUTFIT 1.08 y 1.18, con índices de separación de 2.66 y 1.63, y fiabilidad de .88 en colombianos y .73 en mexicanos; estos datos proporcionaron evidencias de validez de la batería adaptada. (AU)


O objetivo do estudo foi adaptar e validar uma bateria para avaliar subdomínios da cognição social com população forense na Colômbia e no México a partir de uma seleção de instrumentos usados ​​em neuropsicologia clínica. Revisou-se a relevância dos subdomínios que compõem a cognição social como evidência de validade de conteúdo por meio da avaliação de diferentes psicólogos especialistas em psicologia forense, neuropsicologia e medição e avaliação, usando o método ANGOFF modificado e uma análise de confiabilidade de acordo com o modelo de Rasch e coeficiente alfa de Cronbach. Posteriormente, ele foi submetido a pilotar com 20 pessoas privadas de liberdade sentenciadas em prisões colombianas e mexicanas. Calibrações INFIT 1,17 e 1,04, OUTFIT 1,08 e 1,18 foram encontradas, com taxas de separação de 2,66 e 1,63, uma confiabilidade de 0,88 em colombianos e 0,73 em mexicanos; esses dados forneceram evidências da validade da bateria adaptada. (AU)


The aim of the study was to adapt and validate a battery for the evaluation of subdomains of social cognition with the forensic population in Colombia and Mexico from a selection of instruments used in clinical neuropsychology. We reviewed the relevance of the subdomains that compose social cognition as evidence of content validity through the assessment of different psychologists, experts in forensic psychology, neuropsychology and measurement and evaluation, using the modified ANGOFF method and a reliability analysis according to the Rasch model and Cronbach's Alpha coefficient. Subsequently, a pilot study was performed with 20 people deprived of liberty in Colombian and Mexican prisons. INFIT calibrations of 1.17 and 1.04, and OUTFIT calibrations of 1.08 and 1.18, with separation rates of 2.66 and 1.63, and reliability of .88 and .73 were found in Colombians and Mexicans respectively; these data provide evidence of the validity of the adapted battery. (AU)


Subject(s)
Humans , Female , Adult , Prisoners/psychology , Social Cognition , Neuropsychological Tests , Pilot Projects , Reproducibility of Results , Forensic Psychology
7.
Aval. psicol ; 20(1): 11-22, jan.-mar. 2021. graf, tab
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1249040

ABSTRACT

Esta pesquisa teve por objetivo adaptar para o contexto brasileiro a Escala do Nível de Satisfação com o Relacionamento Amoroso (ENSRA, Rusbult, Martz, & Agnew, 1998). No primeiro estudo (N = 269), buscaram-se evidências de validade baseadas na estrutura unifatorial do instrumento e analisaram-se as propriedades dos itens de acordo com a Teoria de Resposta ao Item. No segundo estudo (N = 1.498), propôs-se uma versão revisada da escala (ENSRA-R), incluindo-se novos itens com parâmetros mais elevados de dificuldade. Análises fatoriais exploratórias e confirmatórias indicaram uma estrutura unifatorial também para ENSRA-R. Conforme esperado teoricamente, ENSRA e ENSRA-R correlacionaram-se positivamente com outra medida de satisfação com o relacionamento e com amor romântico, e negativamente com intenção de terminar o relacionamento. Ambas as versões do instrumento apresentam satisfatórias evidências de validade e adequados índices de precisão, contudo, a ENSRA-R mostrou-se mais informativa, cobrindo uma maior porção do traço latente, comparada à ENSRA. (AU)


This study aimed to adapt the Investment Model of Commitment Processes Scale (Escala do Nível de Satisfação com o Relacionamento Amoroso - ENSRA - Rusbult, Martz, & Agnew, 1988) to the Brazilian context. In the first study (N = 269), we sought evidence of validity based on the unifactorial structure of the instrument and analyzed the properties of the items according to the item response theory. In the second study (N = 1498), a revised version of the scale (ENSRA-R) was proposed, including new items with higher difficulty parameters. Exploratory and confirmatory factor analyses indicated a single-factor structure for both the ENSRA and ENSRA-R. As theoretically expected the ENSRA and ENSRA-R correlated positively with another instrument that assesses relationship satisfaction and with romantic love, and negatively with the intention to break-up. Both versions of the instrument provide satisfactory evidence of validity and adequate accuracy, however, the ENSRA-R was more informative, covering a larger portion of the latent trait compared to the ENSRA. (AU)


Esta investigación tuvo como objetivo adaptar la Escala de Satisfacción en la Pareja (ENSRA, Rusbult, Martz, & Agnew, 1988) al contexto brasileño. En el primer estudio (N = 269), se buscaron evidencias de validez basadas en la estructura unifactorial del instrumento y, de acuerdo con la teoría de respuesta al ítem, se analizaron las propiedades de los ítems. En el segundo estudio (N = 1498) fue propuesta una versión revisada de la escala (ENSRA-R), que incluye nuevos ítems con parámetros de dificultad más estrictos. Los análisis factoriales exploratorios y confirmatorios también indicaron la estructura de un factor para la ENSRA-R. Como resultado esperado, ENSRA y ENSRA-R se correlacionaron positivamente con otra medida de satisfacción con la relación y con el amor romántico; y negativamente con la intención de terminar la relación. Ambas versiones del instrumento presentan evidencias de validez satisfactorias e índices de precisión adecuados. Sin embargo, la ENSRA-R se demostró más informativa, cubriendo el rasgo latente en mayor medida, en comparación con la ENSRA. (AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Personal Satisfaction , Marriage/psychology , Pilot Projects , Surveys and Questionnaires , Reproducibility of Results , Factor Analysis, Statistical
9.
Rev. CEFAC ; 23(3): e9820, 2021. tab
Article in English | LILACS | ID: biblio-1155338

ABSTRACT

ABSTRACT Purpose: to investigate the effectiveness of an early identification screening based on the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) test, 6th edition, to early identify first graders at risk of dyslexia. Methods: the sample comprised 34 children assessed at two moments - the screening was conducted while they were in the first grade, while a word dictation was used when they were in the second grade. The data were analyzed with Pearson's correlation test, linear regression analysis, and ANOVA, with a p-value ≤ 0.05. Results: the results provide evidence that agrees with other studies in that children with signs of risk of dyslexia differ from children with typical development in terms of less phonological skills and that these differences are already present at the beginning of the literacy process. Conclusion: the early screening allows for the identification of the risk factors for dyslexia, making it possible to implement preventive and personalized phonological skills training to make the literacy process easier.


RESUMO Objetivo: investigar a eficácia de uma triagem de identificação precoce baseada no teste Dibels 6th Edition, a fim de identificar precocemente crianças do primeiro ano escolar com risco para Dislexia. Métodos: a amostra foi constituída por 34 crianças avaliadas em dois momentos, sendo a triagem realizada enquanto estavam no primeiro ano do ensino fundamental e um ditado de palavras quando estavam no segundo ano. Para a análise dos dados foram aplicados os testes de Correlação de Pearson, Análise de Regressão Linear e ANOVA com valor de p≤0,05. Resultados: os resultados forneceram evidências convergentes com outros estudos de que crianças com sinais de risco para Dislexia diferem das crianças com desenvolvimento típico em termos de reduzida habilidade fonológica e que essas diferenças já estão presentes no início do processo de alfabetização. Conclusão: a triagem de identificação precoce permite a identificação dos fatores de risco para Dislexia, tornando possível implementar treino preventivo e personalizado de habilidades fonológicas que facilitará o processo de alfabetização.


Subject(s)
Humans , Male , Female , Child , Early Diagnosis , Dyslexia/diagnosis , Pilot Projects , Cross-Sectional Studies , Triage , Education, Primary and Secondary
10.
Cad. Saúde Pública (Online) ; 37(11): e00152021, 2021. tab, graf
Article in English | LILACS | ID: biblio-1350409

ABSTRACT

Abstract: Evolving evidence shows that ultra-processed food consumption may increase exposure to chemicals used in food packaging and production, such as per- and poly-fluoroalkyl substances, phthalates, and bisphenols. Studies suggested that these contaminants may be transferred from mother to child through placenta, increasing concerns for both maternal and child health. This study aimed to investigate the association of maternal consumption of ultra-processed foods with newborn exposure to perfluoroalkyl substances (PFAS) in the PIPA Project (The Rio Birth Cohort Study on Environmental Exposure and Childhood Development). The pilot cohort study conducted with 131 pregnant women-child pairs in a public maternity school in Rio de Janeiro, Brazil, was assessed. Maternal dietary intake in the third trimester of pregnancy was evaluated using a qualitative food frequency questionnaire. Food items were classified as non-ultra-processed food and ultra-processed food using the NOVA system and regular consumption of ultra-processed foods was estimated. Newborns of pregnant women who weekly consumed three or more subgroups of ultra-processed food presented the highest level of PFAS (2.47ng/mL; 95%CI: 1.22; 3.72), compared to non-consumption of ultra-processed food investigated (0 ultra-processed food = 1.86ng/mL; 95%CI: 1.38; 2.50). Additionally, cluster analysis grouped ultra-processed food, fish, and PFAS levels. In conclusion, we found increased levels of PFAS in newborns whose mothers were higher consumers of ultra-processed foods.


Resumo: Evidências crescentes demonstram que o consumo de alimentos ultraprocessados pode aumentar a exposição a substâncias químicas utilizadas na produção e embalagem desses alimentos, como os compostos per- e polifluoroalquil, ftalatos e bisfenóis. Os estudos sugerem que esses contaminantes podem ser transferidos da mãe para o feto pela via transplacentária, o que aumenta as preocupações em relação à saúde tanto materna quanto infantil. O estudo buscou investigar a associação entre o consumo materno de alimentos ultraprocessados e a exposição intrauterina aos compostos perfluoroalquil (PFAS) no Projeto PIPA Rio - Projeto Infância e Poluentes Ambientais. Foi avaliada a coorte-piloto com 131 pares gestante-feto em uma maternidade-escola pública no Rio de Janeiro. A ingestão materna no terceiro trimestre da gestação foi avaliada com um questionário qualitativo de frequência alimentar. Os itens alimentares foram classificados entre não ultraprocessados e ultraprocessados, usando o sistema NOVA, e foi estimado o consumo regular de ultraprocessados. Os PFAS foram medidos no sangue do cordão umbilical. Os recém-nascidos de mães que haviam consumido três ou mais subgrupos de ultraprocessados por semana apresentaram os níveis séricos mais elevados de PFAS (2,47ng/mL; IC95%: 1,22; 3,72), comparado com nenhum consumo dos subgrupos de alimentos ultraprocessados (0 alimento ultraprocessado = 1,86ng/mL; IC95%: 1,38; 2,50). Além disso, a análise de clusters agrupou ultraprocessados, peixe e níveis de PFAS. Em conclusão, o estudo mostrou níveis elevados de PFAS em neonatos de gestantes com maior consumo de alimentos ultraprocessados.


Resumen: Evidencias recientes han mostrado que el consumo de comida ultraprocesada puede incrementar la exposición a sustancias químicas usadas en el empaquetado de comida y producción, tales como las sustancias per- y poli- fluoroalquílicas, ftalatos, y bisfenoles. Los estudios han sugerido que estos contaminantes pueden transmitirse de la madre al niño, a través de la placenta, incrementando los problemas de salud de la madre y el niño. El objetivo de este estudio fue investigar la asociación del consumo materno de comidas ultraprocesadas con la exposición de los recién nacidos a las sustancias perfluoroalquílicas (PFAS) en el Proyecto PIPA (Estudio de Cohorte de Nacimiento en Río sobre la Exposición Ambiental y Desarrollo en la Infancia). El estudio de la cohorte piloto evaluó a parejas constituidas por 131 mujeres embarazadas y sus hijo/as en una escuela de maternidad pública en Río de Janeiro, Brasil. Se evaluó la ingesta alimentaria materna en el tercer trimestre de embarazo, usando un cuestionario de calidad de frecuencia de la comida. Los ítems alimentarios fueron clasificados como no-comida ultraprocesada y comida ultraprocesada usando el sistema NOVA y se estimó el consumo regular de comidas ultraprocesadas. Las PFAS se determinaron en la sangre del cordón umbilical. Los recién nacidos de mujeres embarazadas que consumieron tres o más subgrupos de comidas ultraprocesada semanalmente presentaron el nivel más alto de PFAS (2,47ng/mL; IC95%: 1,22; 3,72), comparado con ninguno consumo de comida ultraprocesada (0 comida ultraprocesada = 1,86ng/mL; IC95%: 1,38; 2,50). Asimismo, el análisis de conglomerados agrupó comida ultraprocesada, pescado y niveles de PFAS. En conclusión, se encontraron niveles elevados de PFAS en recién nacidos, cuyas madres eran grandes consumidoras de comidas ultraprocesadas.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Child , Fluorocarbons , Brazil , Energy Intake , Pilot Projects , Cohort Studies , Infectious Disease Transmission, Vertical , Diet , Food Handling
11.
Braz. arch. biol. technol ; 64: e21200736, 2021. graf
Article in English | LILACS | ID: biblio-1345489

ABSTRACT

Abstract The effects of fluorodeoxyglucose conjugated iron oxide magnetic nanoparticles (FDGMNP) on macrophages are presented using a yeast substrate. Iron oxide magnetic nanoparticles (MNP) were synthesized by partially reducing FeCl3, then conjugated with (3-aminopropyl) triethoxysilane (APTES) after silication with tetraethyl orthosilicate. Silanated MMP nanoparticles were combined with fluorodeoxyglucose (FDG). Fluorodeoxyglucose iron oxide magnetic nanoparticles (FDGMNP) and its unconjugated control (MNP) were added (1mL) to the cells from the murine macrophage-like, Abelson murine leukemia virus transformed cell line RAW 264.7 (American Type Culture Collection number TIB-71) cell culture wells at different concentrations from 90-3.6 μg/mL. Cells were placed on the magnet plate for 30 min before incubating at 37°C, 5% CO2 overnight. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide tetrazolium) assay was performed to measure cell viability. Our results demonstrate that iron based nanoparticles can be linked to macrophages (elements of the immune system that attack bacteria) without the function of the macrophages being affected, ie no detrimental effects to the macrophages were evident in these experiments. We conclude that neither FDGMNP nor MNP had a detrimental effect on macrophage function.


Subject(s)
Urologic Diseases , Fluorodeoxyglucose F18 , Magnetic Iron Oxide Nanoparticles , Pilot Projects , Macrophages
12.
Braz. j. med. biol. res ; 54(6): e10577, 2021. tab, graf
Article in English | LILACS | ID: biblio-1285665

ABSTRACT

Endothelial dysfunction is a well-known component of the pathophysiology of heart failure (HF), with proven prognostic value. Dietary supplementation with whey protein (WP) has been widely used to increase skeletal muscle mass, but it also has vascular effects, which are less understood. This study aimed to evaluate the effects of WP supplementation on the systemic microvascular function of HF patients. This was a blinded, randomized, placebo-controlled clinical trial that evaluated the effects of 12-week WP dietary supplementation on systemic microvascular function, in patients with HF New York Heart Association (NYHA) classes I/II. Cutaneous microvascular flow and reactivity were assessed using laser speckle contrast imaging, coupled with pharmacological local vasodilator stimuli. Fifteen patients (aged 64.5±6.2 years, 11 males) received WP supplementation and ten patients (aged 68.2±8.8 years, 8 males) received placebo (maltodextrin). The increase in endothelial-dependent microvascular vasodilation, induced by skin iontophoresis of acetylcholine, was improved after WP (P=0.03) but not placebo (P=0.37) supplementation. Moreover, endothelial-independent microvascular vasodilation induced by skin iontophoresis of sodium nitroprusside, was also enhanced after WP (P=0.04) but not placebo (P=0.42) supplementation. The results suggested that dietary supplementation with WP improved systemic microvascular function in patients with HF.


Subject(s)
Humans , Male , Middle Aged , Aged , Vasodilation , Heart Failure/drug therapy , Skin , Vasodilator Agents/pharmacology , Endothelium, Vascular , Pilot Projects , Dietary Supplements , Whey Proteins/pharmacology , Microcirculation
13.
Braz. j. med. biol. res ; 54(6): e10794, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249304

ABSTRACT

The aim of this study was to investigate the effects of multicomponent training on baroreflex sensitivity (BRS) and heart rate (HR) complexity of prefrail older adults. Twenty-one prefrail community-dwelling older adults were randomized and divided into multicomponent training intervention group (MulTI) and control group (CG). MulTI performed multicomponent exercise training over 16 weeks and CG was oriented to follow their own daily activities. The RR interval (RRi) and blood pressure (BP) series were recorded for 15 min in supine and 15 min in orthostatic positions, and calculation of BRS (phase, coherence, and gain) and HR complexity (sample entropy) were performed. A linear mixed model was applied for group, assessments, and their interaction effects in supine position. The same test was used to assess the active postural maneuver and it was applied separately to each group considering assessments (baseline and post-intervention) and positions (supine and orthostatic). The significance level established was 5%. Cardiovascular control was impaired in prefrail older adults in supine position. Significant interactions were not observed between groups or assessments in terms of cardiovascular parameters. A 16-week multicomponent exercise training did not improve HR complexity or BRS in supine rest or in active postural maneuver in prefrail older adults.


Subject(s)
Humans , Aged , Exercise , Baroreflex , Blood Pressure , Pilot Projects , Heart Rate
14.
CoDAS ; 33(4): e20200019, 2021. graf
Article in English | LILACS | ID: biblio-1286107

ABSTRACT

ABSTRACT Purpose Aphasia is a common and debilitating manifestation of stroke. Transcranial electrical stimulation uses low-intensity electric currents to induce changes in neuronal activity. Recent evidence suggests that noninvasive techniques can be a valuable rehabilitation tool for patients with aphasia. However, it is difficult to recruit patients with aphasia for trials, and the reasons for this are not well understood. This study aimed to elucidate the main difficulties involved in patient's recruitment and inclusion in a randomized clinical study of neuromodulation in aphasia. Methods We evaluated the reasons for the exclusion of patients in a pilot, randomized, double-blinded clinical trial in which patients diagnosed with motor aphasia after stroke were recruited from March to November 2018. A descriptive statistical analysis was performed. Results Only 12.9% (4) of patients with ischemic stroke were included in the clinical trial. A total of 87.1% (27) of the 31 recruited patients were excluded for various reasons including: sensory aphasia (32.2%), dysarthria (25.8%), spontaneous clinical recovery (16.1%), previous stroke (6.4%), and death or mutism (3.2%). Conclusion The presence of other types of aphasia, dysarthria, spontaneous recovery, deaths, and mutism were barriers to recruiting patients evidenced in this neuromodulation study.


RESUMO Objetivo A afasia é uma manifestação comum e debilitante do acidente vascular cerebral (AVC). A estimulação elétrica transcraniana por corrente contínua oferece uma corrente elétrica de baixa intensidade que induz alterações na atividade neuronal e evidências recentes sugerem que técnicas não invasivas podem servir como uma ferramenta benéfica para a reabilitação de pacientes afásicos. No entanto, é muito difícil recrutar esses pacientes para estudos clínicos e as razões não são claras. O objetivo do estudo foi identificar as principais dificuldades envolvidas no recrutamento e inclusão de pacientes em ensaio clínico piloto randomizado sobre neuromodulação em pacientes com afasia. Método Foram avaliadas as razões para a exclusão e não inclusão de pacientes em um ensaio clínico piloto, randomizado, duplo-cego no qual foram incluídos pacientes diagnosticados com afasia motora após AVC no período de março a novembro de 2018. Análise estatística descritiva foi realizada. Resultados Apenas 12,9% (4) dos pacientes com AVC isquêmico foram incluídos no estudo. Um total de 87,1% (27) dos 31 pacientes recrutados foram excluídos por apresentarem afasia sensorial (32,2%), disartria (25,8%), recuperação clínica espontânea (16,1%), AVC prévio (6,4%) e óbito ou mutismo (3,2%). Conclusão A presença de outros tipos de afasia, disartria, recuperação espontânea, óbitos e mutismo foram as principais barreiras ao recrutamento de pacientes evidenciadas nesse estudo de neuromodulação.


Subject(s)
Humans , Stroke/complications , Transcranial Direct Current Stimulation , Stroke Rehabilitation , Aphasia, Broca , Randomized Controlled Trials as Topic , Pilot Projects
15.
CoDAS ; 33(2): e20190154, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1249606

ABSTRACT

RESUMO Objetivo descrever o desempenho em vocabulário expressivo e receptivo de crianças entre três e sete anos de idade em um instrumento de triagem. Método a amostra foi composta por 133 crianças entre três e sete anos de idade, sem diagnósticos de deficiências ou transtornos do neurodesenvolvimento. Para a triagem, foi utilizado o instrumento TRILHAR, que inclui as habilidades de vocabulário receptivo e expressivo. Os dados foram analisados pelos testes Kruskal-Wallis, Mann-Whitney e Correlação de Spearman. Resultado houve diferença no desempenho dos grupos, além de correlação positiva entre a faixa etária e a pontuação na triagem. Ainda, verificou-se diferença nos desempenhos das provas de vocabulário receptivo e expressivo. Conclusão Foi verificada diferença no desempenho dos grupos nas tarefas de vocabulário receptivo, expressivo e no resultado final, com melhores resultados para o grupo de sete anos. Além disso, observou-se correlação positiva entre a idade e o desempenho na triagem, ou seja, quanto maior a idade, melhor o desempenho.


ABSTRACT Purpose to describe the performance of children between three and seven years of age in using an expressive and receptive screening instrument. Methods the sample consisted of 133 children between 3 and 7 years of age, without diagnoses of neurodevelopmental disabilities or disorders. The screening was performed with the TRILHAR instrument, which includes receptive and expressive vocabulary skills. The data were analyzed by the Kruskal-Wallis, Mann-Whitney, and Spearman Correlation tests. Results we observed a statistical difference in the groups' performance, in addition to a positive correlation between the age group and the final score in the screening. There was statistical difference in the performance on the receptive and expressive vocabulary subtests. Conclusion We observed difference in the performance of the groups in receptive and expressive tasks, and in the final score, with better performance for the children with 7 years. In addition, age and performance on the screening test were positively correlated, that is, the older the age, the better the performance.


Subject(s)
Humans , Child, Preschool , Child , Vocabulary , Mass Screening , Pilot Projects , Language Tests
16.
Clinics ; 76: 2550, 2021. graf, tab
Article in English | LILACS, SES-SP, CONASS, SESSP-IDPCPROD, SES-SP | ID: biblio-1278931

ABSTRACT

OBJECTIVES: We aimed to compare the effects of home-and center-based exercise training programs on functional capacity, inspiratory muscle strength, daily physical activity level, and quality of life (QoL) in patients with chronic heart failure (CHF) over a 12-week period. METHODS: This study included 23 patients with CHF (left ventricular ejection fraction 31±6%) randomized to a home-based (n=11) or center-based (n=12) program. Patients underwent 12 weeks of aerobic training (60%-70% heart rate reserve): walking for the home-based and supervised cycling for the center-based group, both combined with resistance training (50% of 1 maximum repetition). At baseline and after 12 weeks of training, we assessed cardiopulmonary test variables, 6-min walk test distance (6 MWD), steps/day with accelerometry, and QoL (Minnesota Living with Heart Failure questionnaire). Maximal inspiratory pressure and handgrip strength were measured at baseline and after 4, 8, and 12 weeks of training. ClinicalTrials.gov: NCT03615157. RESULTS: There were no adverse events during training in either group. The home- and center-based training groups obtained similar improvements in peak oxygen uptake, maximal ventilation, and 6 MWD. However, there were significant between-group differences: center-based training was more effective in improving maximal inspiratory pressure (p=0.042), number of steps/day (p=0.001), and QoL (p=0.039). CONCLUSIONS: Home-based training is safe and can be an alternative to improve the exercise capacity of patients with stable CHF. However, center-based training was superior in improving inspiratory muscle strength, QoL, and daily physical activity.


Subject(s)
Humans , Quality of Life , Heart Failure/therapy , Stroke Volume , Pilot Projects , Ventricular Function, Left , Exercise Tolerance , Hand Strength , Exercise Therapy
17.
Clinics ; 76: e2604, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249585

ABSTRACT

OBJECTIVES: The coronavirus disease (COVID-19) outbreak has catastrophically threatened public health worldwide and presented great challenges for clinicians. To date, no specific drugs are available against severe acute respiratory syndrome coronavirus 2. Mesenchymal stem cells (MSCs) appear to be a promising cell therapy owing to their potent modulatory effects on reducing and healing inflammation-induced lung and other tissue injuries. The present pilot study aimed to explore the therapeutic potential and safety of MSCs isolated from healthy cord tissues in the treatment of patients with COVID-19. METHODS: Twelve patients with COVID-19 treated with MSCs plus conventional therapy and 13 treated with conventional therapy alone (control) were included. The efficacy of MSC infusion was evaluated by changes in oxygenation index, clinical chemistry and hematology tests, immunoglobulin (Ig) levels, and pulmonary computerized tomography (CT) imaging. The safety of MSC infusion was evaluated based on the occurrence of allergic reactions and serious adverse events. RESULTS: The MSC-treated group demonstrated significantly improved oxygenation index. The area of pulmonary inflammation decreased significantly, and the CT number in the inflammatory area tended to be restored. Decreased IgM levels were also observed after MSC therapy. Laboratory biomarker levels at baseline and after therapy showed no significant changes in either the MSC-treated or control group. CONCLUSION: Intravenous infusion of MSCs in patients with COVID-19 was effective and well tolerated. Further studies involving a large cohort or randomized controlled trials are warranted.


Subject(s)
Humans , Coronavirus Infections , Mesenchymal Stem Cell Transplantation , Mesenchymal Stem Cells , Umbilical Cord , Pilot Projects , Betacoronavirus
18.
Clinics ; 76: e2567, 2021. graf
Article in English | LILACS | ID: biblio-1153942

ABSTRACT

OBJECTIVES: To assess the clinical response to and the histomorphometric effects of microablative fractional radiofrequency (MFR) in women with symptomatic vulvar lichen sclerosus (VLS). METHODS: This was a pilot study on the use of MFR for the treatment of VLS. Upon recruitment and at each treatment session, all participants were examined and each of their symptoms were rated on a visual analog scale. After the procedure, the participants completed a satisfaction questionnaire. We compared the morphometric findings of vulvar biopsies performed at enrollment and after the last treatment session. The participants were divided into three groups according to previous treatment with corticosteroids: G1, no previous treatment; G2, treated for up to 5 years; and G3, treated for >5 years. RESULTS: This study included 26 women. After two to three sessions, most participants in all groups became either "asymptomatic" or "much better" than before treatment and were "very satisfied" or "satisfied" with the intervention. Pruritus and burning sensation were the most frequently reported symptoms. Nearly 40% of the participants in all groups reported complete remission of symptoms. The improvement was rated as moderate or higher by 80%, 76%, and 66% of the women in groups 1, 2, and 3, respectively. The improvement of symptoms persisted for 11 months (range, 7-16 months), on average, after the treatment. Type III collagen concentration significantly increased and was associated with important symptom improvement. Tissue trophism and vascularization also increased but did not reach statistical significance, probably because of the small number of cases. CONCLUSIONS: MFR may be an effective and safe treatment for symptomatic VLS.


Subject(s)
Humans , Female , Lichen Sclerosus et Atrophicus , Vulvar Lichen Sclerosus/therapy , Pilot Projects
19.
Rev. bras. educ. méd ; 45(supl.1): e127, 2021.
Article in Portuguese | LILACS | ID: biblio-1279883

ABSTRACT

Resumo: Introdução: Com a interrupção das aulas presenciais nas escolas médicas ocasionada pela pandemia da doença pelo novo coronavírus, verificou-se que os alunos ingressantes no primeiro ano de Medicina de uma faculdade pública brasileira apresentavam maior vulnerabilidade social e psicológica devido aos vínculos pouco consolidados com colegas e com o ambiente acadêmico. Observou-se que os fatores de estresse relacionados às adaptações ao contexto universitário se intensificaram, tornando essa turma prioritária para o desenvolvimento de intervenções emergenciais de suporte e acolhimento. Este trabalho relata um projeto-piloto de mentoria entre professores e alunos em ambiente virtual, visando à sua posterior institucionalização como atividade regular. Descreve etapas de implantação, desenvolvimento, resultados iniciais e perspectivas. Relato de experiência: Foi desenvolvida uma mentoria on-line entre alunos e professores, em que utilizou a dinâmica de grupos de reflexão como estratégia metodológica. Por meio de redes sociais e reuniões on-line, alunos e professores foram convidados a participar do projeto, que contou com seis docentes, um preceptor e 29 alunos, além da equipe coordenadora. Realizou-se uma capacitação on-line de professores com conteúdos teóricos e simulações, objetivando delimitar o papel deles, os objetivos, o enquadre e as especificidades de uma mentoria remota. A avaliação final da atividade foi feita por professores e alunos. Discussão: As medidas de distanciamento social evidenciaram a necessidade de oferecer oportunidades de aprendizagem e de convívio mediadas por plataformas digitais. Comprovou-se a adesão de alunos e professores à mentoria na modalidade on-line, e observou-se a sua potencialidade para fomentar uma relação aluno-professor baseada na troca de ideias, reflexão e suporte social. Constatou-se também um incremento da motivação para a adesão ao curso. Conclusão: A mentoria on-line proporcionou benefícios aos participantes, corroborando resultados de experiências no modelo tradicional presencial, e instigou a realização de pesquisas que aprofundem a investigação sobre a sua eficácia e relevância para a formação médica.


Abstract: Introduction: With the interruption of face-to-face classes in medical schools caused by the Covid-19 pandemic, new first-year medical students at a Brazilian public university showed greater social and psychologic vulnerability due to poorly consolidated ties with colleagues and the academic environment. Intensified stress factors related to adapting to the university environment have been observed, making this group a priority for emergency support and reception interventions. This article reports on a pilot online mentoring project, between teachers and students in a virtual environment, with a view to its subsequent institutionalization as a regular activity. The stages of implementation, development, initial results, and perspectives are described. Experience report: The pilot project aimed to operationalize online mentoring between teachers and students, using reflection group dynamics as a methodological strategy. Through social networks and online meetings, students and teachers were invited to participate in the project, which included six teachers, one preceptor, and twenty-nine students, in addition to the coordination team. Online teacher training with theoretical content and simulations was conducted to outline the teacher's role in the activity, task objectives, framework, and specific characteristics of online mentoring. The final evaluation was performed by teachers and students. Discussion: Social distancing measures have evinced the need for online learning and socializing opportunities. Gathering students and teachers in an online mentoring activity has proven to be feasible and its potential to foster a student-teacher relationship based on exchange of ideas, reflection and social support was observed. Increased motivation to join the course was observed. Conclusion: Online mentoring has brought benefits to the participants, corroborating the results of experiences in the traditional face-to-face model, and has instigated research that deepens investigation into its effectiveness and relevance for medical training.


Subject(s)
Humans , Education, Distance/methods , Education, Medical/methods , Mentoring/methods , COVID-19 , Schools, Medical , Students, Medical , Pilot Projects , Teacher Training
20.
Einstein (Säo Paulo) ; 19: eAO5859, 2021. tab
Article in English | LILACS | ID: biblio-1286287

ABSTRACT

ABSTRACT Objective To compare the effectiveness of oral progestins and injectable gonadotropin-releasing hormone antagonist medication in cancer fertility preservation in patients with breast cancer. Methods A cross-sectional study with 40 breast cancer patients submitted to cancer fertility preservation, who were divided into two groups according to histochemical analysis of progesterone receptors to define luteinizing hormone block: if positive, use of gonadotropin-releasing hormone antagonist, if negative, use of oral progestins. The mean age, medication days, antral follicle count, number of oocytes in metaphase II and the occurrence of ovarian hyperstimulation syndrome were compared. Results A total of 20 patients both in the group using gonadotropin-releasing hormone antagonist, and in the group with oral progestins, respectively, had a mean age of 33.9 (32-35.8) and 33.8 (32-35.6) years; days of medications of 11 (9.7-12.3) and 12.8 (11.6-13.9), p=0.037; antral follicle count of 9 (7.11-12) and 8.5 (6-11.9), p=0.370; metaphase II oocyte number of 4 (2.1-9.8) and 7.5 (3.1-10), p=0.348; and ovarian hyperstimulation syndrome of 2 (10%) and 5 (25%) cases, p=0.212. Conclusion The use of oral progestins, in spite of requiring longer treatment time, is effective in relation to the protocol with gonadotropin-releasing hormone antagonist, and offers greater comfort at a lower cost in breast cancer patients with negative progesterone receptors, submitted to cancer fertility preservation.


RESUMO Objetivo Comparar a efetividade dos progestágenos orais em relação à medicação injetável antagonista de hormônio liberador de gonadotrofina na preservação da fertilidade oncológica de pacientes com câncer de mama. Métodos Estudo transversal com 40 pacientes com câncer de mama submetidas à preservação da fertilidade oncológica, que foram divididas em dois grupos, conforme análise histoquímica dos receptores de progesterona, para definir o bloqueio de hormônio luteinizante: se positivos, uso de antagonista de hormônio liberador de gonadotrofina; se negativos, uso de progestágenos orais. Comparou-se média de idade, dias de medicações, contagem de folículos antrais, número de oócitos em metáfase II e ocorrência de síndrome do hiperestímulo ovariano. Resultados Vinte pacientes, tanto no grupo com uso de antagonista de hormônio liberador de gonadotrofina, quanto no grupo com progestágenos orais, respectivamente, apresentaram média de idade de 33,9 (32-35,8) e 33,8 (32-35,6) anos; 11 (9,7-12,3) e 12,8 (11,6-13,9) de dias de medicações com p=0,037; contagem de folículos antrais de 9 (7,11-12) e 8,5 (6-11,9), com p=0,370; número de oócitos metáfase II de 4 (2,1-9,8) e 7,5 (3,1-10), com p=0,348, e síndrome do hiperestímulo ovariano de 2 casos (10%) e 5 casos (25%), com p=0,212. Conclusão O uso de progestágenos orais, apesar de necessitar de maior tempo de tratamento, é efetivo em relação ao protocolo com antagonista de hormônio liberador de gonadotrofina e oferece maior conforto com menor custo em pacientes com câncer de mama com receptores de progesterona negativos, submetidas à preservação da fertilidade oncológica.


Subject(s)
Humans , Female , Breast Neoplasms/drug therapy , Fertility Preservation , Ovulation Induction , Progestins , Pilot Projects , Cross-Sectional Studies , Gonadotropin-Releasing Hormone
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