ABSTRACT
This study investigated the antitumoral, anti-inflammatory and oxidative effects of polysaccharides from tucum (Bactris setosa, TUC) using the Ehrlich carcinoma as a tumor model. Additionally, the glycogen content, cytochrome P levels, and gluconeogenesis from lactate were assessed in the liver of healthy animals. Tumor-bearing female mice were orally treated with 50 and 100 mg.kg-1 of TUC or vehicle, once a day, or with 1.5 mg.kg-1 methotrexate via i.p., every 3 days, along 21 days. Both doses of TUC reduced the tumor weight and volume. In the tumor tissue, it decreased GSH and IL-1ß levels, and increased LPO, NAG, NO and TNF-α levels. The tumor histology showed necrosis and leukocytes infiltration. The metabolic effects of TUC were investigated by measurement of total cytochrome P (CYP) and glycogen in tumor-bearing mice, and by ex vivo liver perfusion on non-bearing tumor male mice, using lactate as gluconeogenic precursor. Metabolically, the hepatic glucose and pyruvate productions, oxygen uptake, and the total CYP concentration were not modified by TUC. Thus, tucum-do-cerrado polysaccharides have antitumor effects through the modulation of oxidative stress and inflammation, without impairing glucose production from lactate in the liver, the main organ responsible for the metabolism of organic and xenobiotic compounds.
Subject(s)
Gluconeogenesis , Liver , Polysaccharides , Animals , Polysaccharides/pharmacology , Polysaccharides/chemistry , Mice , Liver/drug effects , Liver/metabolism , Liver/pathology , Gluconeogenesis/drug effects , Female , Male , Antineoplastic Agents/pharmacology , Antineoplastic Agents/chemistry , Oxidative Stress/drug effects , Fruit/chemistry , Glycogen/metabolism , Carcinoma, Ehrlich Tumor/drug therapy , Carcinoma, Ehrlich Tumor/pathology , Carcinoma, Ehrlich Tumor/metabolism , Plant Extracts/pharmacology , Plant Extracts/chemistryABSTRACT
O estudo tem como objetivo analisar os fatores associados ao uso adequado dos Equipamentos de Proteção Individual (EPI) pelos trabalhadores da Atenção Primária à Saúde (APS). Estudo transversal, realizado no Brasil, em ambiente virtual entre os meses de agosto/2020 e março/2021. Para a coleta de dados utilizou-se o instrumento validado "E.P.I. - APS COVID-19". Foram utilizados testes qui-quadrado ou exato de Fisher, razão de prevalência, Intervalo de Confiança de 95% e regressão de Poisson com significância p≤0,005. Pesquisa aprovada pelo Comitê de Ética em Pesquisa com Seres Humanos. Participaram da pesquisa 455 trabalhadores. Os trabalhadores com 37 anos ou mais apresentaram prevalência de 1,59 vezes maior para uso adequado de óculos/protetor facial, 1,39 vezes maior para máscara N95 e 1,23 vezes maior para a higienização correta das mãos. O uso de luvas apresentou uma prevalência 35% maior para os trabalhadores com carga horária ≤ 40 horas. A faixa etária 37 anos ou mais foi associada ao uso de máscara N95 (RP=1,107) e a higiene das mãos (RP=1,075). A carga horária ≤ 40 horas foi associada ao uso de luvas (RP=0,846). Conclui-se que são fatores associados ao uso adequado de EPI a faixa etária 37 anos ou mais e a carga horária ≤ 40 horas.
This study aims to analyze the factors associated with the proper use of Personal Protective Equipment (PPE) by Primary Health Care (PHC) workers. Cross-sectional study, carried out in Brazil, in a virtual environment between August/2020 and March/2021. For data collection, the validated instrument "P.P.E. - PHC COVID-19" was used. Chi-square or Fisher's exact tests, prevalence ratio, 95% confidence interval, and Poisson regression with p≤0.005 significance were used. The research was approved by the Ethics Committee for Research with Human Beings and 455 workers participated in the survey. Workers aged 37 years or older had a prevalence of 1.59 times higher for proper use of glasses/face shields, 1.39 times higher for N95 masks, and 1.23 times higher for correct hand hygiene. The use of gloves showed a 35% higher prevalence for workers with working hours of ≤ 40 hours. The age group 37 years or older was associated with the use of N95 masks (PR=1.107) and hand hygiene (PR=1.075). Working hours of ≤ 40 hours were associated with the use of gloves (PR=0.846). It is concluded that the factors associated with the proper use of PPE are age group 37 years or older and working hours of ≤ 40 hours.
Subject(s)
Primary Health Care , Personal Protective Equipment , COVID-19ABSTRACT
Objetivo: analisar os fatores associados ao uso e a adesão aos equipamentos de proteção individual pelos profissionais pós-graduandos vinculados a programas de residência em saúde. Método: transversal com 227 residentes. Avaliadas variáveis relacionadas à adesão e uso adequado de equipamentos de proteção individual por meio de instrumento validado "E.P.I. covid-19 Brasil-versão adaptada para residentes". Realizou-se análise bivariada, teste qui-quadrado/exato de Fisher e cálculo da razão de prevalência. Pesquisa foi aprovada pelo Comitê de Ética em Pesquisa com Seres Humanos. Resultados: realizaram atividades de capacitação sobre EPIs (59,9%).Associação entre uso de máscara cirúrgica(p≤0,01) e idade; área de concentração do programa e uso de gorro (p≤0,01) e máscara cirúrgica (p=0,04); realização de atividades de capacitação e uso de máscara cirúrgica (p=0,02) e N95 (p≤0,01). A adesão variou de 0% a 67%. Conclusão: fatores associados ao uso adequado, idade, área de concentração do programa e realização de atividades de capacitação. Houve fragilidades na adesão. Sugere-se o fortalecimento do tema biossegurança na residência.
Objective: to analyze the factors associated with the use and adherence to personal protective equipment by graduate professionals linked to residency programs in health. Method: cross-sectional study with 227 residents. E.P.I.covid-19 Brasil-adapted version for residents". Bivariate analysis, Fisher chi-square/exact test and calculation of the prevalence ratio were performed. Research was approved by the Ethics Committee for Research with Human Beings. Results: they carried out training activities on PPE (59.9%). Association between use of surgical mask (p≤0.01) and age; program concentration area and use of cap (p≤0.01) and surgical mask (p=0.04); performance of training activities and use of surgical mask (p=0.02) and N95 (p≤0.01). Adherence to PPE ranged from 0% to 67%. Conclusion: factors associated with the proper use of personal protective equipment were age, area of program concentration, and performance of training activities. There were weaknesses in adherence. It is suggested to strengthen the theme of biosafety in the residence.
Objetivos:analizar los factores asociados al uso y la adherencia a los equipos de protección personal (EPP) por parte de profesionales graduados vinculados a programas de residencia en salud. Método: estudio transversal con 227 residentes. Se utilizó la versión adaptada para residentes del «Cuestionario sobre EPI en la atención primaria de salud (EPS-APS) en el contexto de la COVID-19 en Brasil. Se realizaron análisis bivariados, prueba chi-cuadrado de Fisher/prueba exacta y cálculo de la razón de prevalencia. La investigación fue aprobada por el Comité de Ética para la Investigación con Seres Humanos. Resultados: se realizaron actividades de capacitación sobre EPI (59,9%). Se observó asociación entre el uso de mascarilla quirúrgica (p≤0,01) y la edad; área de concentración del programa y uso de cofia (p≤0,01) y mascarilla quirúrgica (p=0,04); realización de actividades de capacitación y uso de mascarilla quirúrgica (p=0,02) y N95 (p≤0,01). La adherencia a los EPI osciló entre el 0% y el 67%. Conclusión: los factores asociados al uso correcto de los EPI fueron la edad, el área de concentración del programa y la realización de actividades de capacitación. Se observaron debilidades en la adherencia. Se sugiere fortalecer el tema de la bioseguridad en la residencia.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Personal Protective Equipment/statistics & numerical data , COVID-19/prevention & control , Internship and Residency/statistics & numerical data , Internship, Nonmedical/statistics & numerical data , Containment of Biohazards/statistics & numerical dataABSTRACT
INTRODUCTION: Migraine is a disease that affects the overall performance of the patient, especially attention and executive functions (EF), with a direct impact on the person's functionality, highlighting the importance of studies in order to minimize its damage. OBJECTIVE: The objective of this study was to evaluate if there is a link between migraine and executive and attentional functions. METHODOLOGY: Observational study (44 subjects; 29 migraineurs and 15 non-migraineurs) on attentional and executive functioning changes in migraine. Subjects over 18 years of age were included in the study, regardless of gender, recruited for convenience at CAM FAME, FAME and Centro AMA, primary recruitment centers, following the criteria of the International Classification of Headache Disorders (ICHD-3). The participants underwent neuropsychological tests that estimated executive and attentional functioning. For attention, the Psychological Attention the Assessment Battery (AAB) was used, and for EF, the Five-Digit Test (FDT) was used. Student's t test, ANOVA, Mann-Whitney and/or Kruskal-Wallis U test were used, whose analyzes fixed the type I error at 0.05. RESULTS: All AAB subtests pointed to a reduction in the attentional potential in migraineurs when compared to the control group. The FDT showed lowering in the migraineurs group subjects, when compared with the non- migraineurs group. Multivariate analysis identified a relationship between EF, Attention and migraine (p<0.05). CONCLUSION: migraineurs present a decrease in executive functioning and attentional skills and an increase in execution time when compared to non-migraineurs individuals
INTRODUÇÃO: A enxaqueca é uma doença que afeta o desempenho global do paciente, principalmente a atenção e as funções executivas (FE), com impacto direto na funcionalidade da pessoa, destacando a importância de estudos a fim de minimizar seus danos. OBJETIVO: O objetivo deste estudo foi avaliar se existe ligação entre enxaqueca e funções executivas e atencionais. METODOLOGIA: Estudo observacional (44 indivíduos; 29 com enxaqueca e 15 sem enxaqueca) sobre alterações de atenção e funcionamento executivo na enxaqueca. Foram incluídos no estudo indivíduos maiores de 18 anos, independente do sexo, recrutados por conveniência no CAM FAME, FAME e Centro AMA, centros primários de recrutamento, seguindo os critérios da Classificação Internacional de Cefaleias (ICHD-3). Os participantes foram submetidos a testes neuropsicológicos que estimaram o funcionamento executivo e atencional. Para atenção foi utilizada a Bateria de Avaliação da Atenção Psicológica (AAB) e para FE foi utilizado o Teste de Cinco Dígitos (FDT). Foram utilizados teste t de Student, ANOVA, Mann-Whitney e/ou teste U de Kruskal-Wallis, cujas análises fixaram o erro tipo I em 0,05. RESULTADOS: Todos os subtestes da AAB apontaram redução do potencial atencional em enxaquecosos quando comparados ao grupo controle. O FDT apresentou redução nos indivíduos do grupo com enxaqueca, quando comparado com o grupo sem enxaqueca. A análise multivariada identificou relação entre FE, Atenção e enxaqueca (p<0,05). CONCLUSÃO: enxaquecosos apresentam diminuição do funcionamento executivo e das habilidades de atenção e aumento no tempo de execução quando comparados a indivíduos não enxaquecosos
Subject(s)
Humans , Male , Female , Patients/statistics & numerical data , Executive Function/classification , Migraine Disorders/complicationsABSTRACT
Mitotane is a chiral drug used to treat adrenocortical carcinoma, being metabolized to the o,p'-dichlorodiphenyl acetic acid (o,p'-DDA), also a chiral compound. Despite of its therapeutic significance, the overall ratios and enantiomers have not been known. In this study, we analyzed the enantiomers of mitotane and o,p'-DDA in the plasma of patients by a newly developed chiral-phase method employed in two-dimensional chromatography. Important differences were observed in the ratio of (S)/(R)-mitotane, which varied substantially from 1:1.2 to 1:10 whereas the (S)/(R)-o,p'-DDA ratio was relatively conserved, at approximately 2:1. These findings provide evidence for the enantioselective metabolism and provide a method for further analyses of mitotane and metabolites, which can explain the variation in the therapeutic response.
Subject(s)
Adrenal Cortex Neoplasms , Adrenocortical Carcinoma , Humans , Mitotane/therapeutic use , Mitotane/metabolism , Adrenocortical Carcinoma/drug therapy , Stereoisomerism , Chromatography, High Pressure Liquid/methods , Adrenal Cortex Neoplasms/drug therapy , Adrenal Cortex Neoplasms/metabolismABSTRACT
RESUMO Objetivo: Validar o instrumento de medida que avalia o uso e a adesão de equipamentos de proteção individual entre os residentes de saúde. Método: Estudo metodológico desenvolvido em ambiente virtual entre agosto de 2020 e março de 2021 com residentes da atenção primária e hospitalar das cinco regiões do Brasil. Os participantes responderam a versão adaptada para residentes do "E.P.I.-APS". Utilizou-se a análise fatorial confirmatória para validação do instrumento. Resultados: Participaram 227 residentes, sendo maioria mulher cis (82,8%), atuavam na região Sudeste (58,1%) e em atenção hospitalar (47,6%). A estrutura em oito domínios (gorro/touca; luvas; comportamento de segurança; máscara N95; higienização das mãos; avental/capote; máscara cirúrgica; óculos de proteção/protetor facial) foi confirmada. Apenas dois itens com carga fatorial inferior a 0,5 foram mantidos. Conclusão: O instrumento é válido para mensurar o uso e adesão aos equipamentos de proteção individual entre residentes, o que contribui para direcionar a formação e a segurança laboral.
ABSTRACT Objective: To validate the measuring instrument that assesses healthcare residents' use and adherence to personal protective equipment. Method: Methodological study developed in a virtual environment between August 2020 and March 2021 with primary care and hospital residents from the five regions of Brazil. The participants answered the adapted version of the "P.P.E.-PHC" for residents. Confirmatory factor analysis was used to validate the instrument. Results: 227 residents took part, the majority of whom were cis women (82.8%), worked in the Southeast region (58.1%), and in-hospital care (47.6%). The structure in eight domains (cap, gloves, safety behavior, N95 mask, hand hygiene, apron/coat, surgical mask, goggles/face shield) was confirmed. Only two items with a factor load of less than 0.5 were kept. Conclusion: The tool is valid for measuring residents' use of and adherence to personal protective equipment, which helps to guide training and occupational safety.
RESUMEN Objetivo: Validar el instrumento de medición que evalúa el uso y la adhesión de los equipos de protección individual entre los residentes de salud. Método: Estudio metodológico desarrollado en un entorno virtual entre agosto de 2020 y marzo de 2021 con residentes de atención primaria y hospitalaria de las cinco regiones de Brasil. Los participantes respondieron a la versión adaptada del "E.P.I.-APS" para residentes. Se utilizó un análisis factorial confirmatorio para validar el instrumento. Resultados: Participaron 227 residentes, en su mayoría mujeres cis (82,8%), que trabajaban en el sureste (58,1%) y en cuidados hospitalarios (47,6%). Se confirmó la estructura en ocho dominios (gorro; guantes; comportamiento de seguridad; mascarilla N95; higiene de las manos; delantal/abrigo; mascarilla quirúrgica; gafas/protector facial). Sólo se mantuvieron dos ítems con una carga factorial inferior a 0,5. Conclusión: La herramienta es válida para medir el uso y la adhesión de los equipos de protección individual entre los residentes, lo que ayuda a orientar la formación y la seguridad laboral.
ABSTRACT
OBJECTIVES: Diet can play a role in caries disease and the consumption of ultra-processed foods has increased over the years. The purpose was to propose predictive models on the relation between caries experience, diet, sex, and oral health aspects. METHODS: This cross-sectional study included 5213 schoolchildren aged 2-11 years and a questionnaire based on WHO Oral Health Survey was applied to assess the intake of sugary foods, oral hygiene practices, access to health services and parents' perception; dmft/DMFT index, biofilm accumulation and orthodontic treatment need were assessed by 6 calibrated dentists. RESULTS: The logistic model showed that female sex and presence of biofilm increased the chance of having early childhood caries; besides, this chance increased by 17% for each additional day of sweetened drink intake. In children aged 6-11 years, a negative binomial regression model showed that the absence of biofilm and frequency of toothbrushing were related to lower caries index, while male sex and the consumption of salty snacks and cake/cookies were related to higher dmft+DMFT index. Disagreement or weak agreement between caregivers' perception of the presence of dental caries and children's need for dental treatment was found. CONCLUSION: Early childhood caries was dependent on the consumption of sweetened drinks and the presence of biofilm, while in older children the caries experience was predicted by the consumption of snacks, cakes and biscuits, biofilm accumulation and toothbrushing frequency, emphasizing the need of health education to encourage healthy eating habits and oral care with an approach to parents/caregivers to prevent dental caries development.
Subject(s)
Dental Caries , Sugar-Sweetened Beverages , Humans , Male , Child , Child, Preschool , Female , Dental Caries/epidemiology , Dental Caries/etiology , Dental Caries/prevention & control , Food, Processed , Cross-Sectional Studies , Dental Caries Susceptibility , Feeding Behavior , DMF Index , PrevalenceABSTRACT
OBJECTIVES: to reflect on the daily life of family members dependent on psychoactive substances and the role of health professionals in Primary Care. METHODS: a descriptive investigation outlined in Maffesoli's phenomenological approach, carried out at a Basic Health Unit in Minas Gerais with eight family members dependent on psychoactive substances. Sociodemographic characterization data and in-depth interviews were collected and analyzed with support of NVivo Pro11® software. All ethical and legal aspects were met. RESULTS: physicians were the professionals most mentioned in participants' statements, who took on a dubious role with other health professionals: welcoming (positive perceptions about care received) and neglect (negative perceptions). FINAL CONSIDERATIONS: dependence on psychoactive substances imposes a burden on persons, their family members and health professionals. The role of establishing good relationships in the triad professionals-users-family members of primary care is inseparable in favor of treatment and preservation of their mental health.
Subject(s)
Codependency, Psychological , Family Relations , Brazil , Family , Health Personnel , HumansABSTRACT
PURPOSE: Circadian misalignment has been associated with an increased risk of overweight and obesity, as well as changes in metabolic parameters. This study evaluated the association between social jet lag (SJL), a measure of circadian misalignment, and anthropometric, metabolic and food intake outcomes 6 months after bariatric surgery. MATERIALS AND METHODS: A total of 122 bariatric patients were included (77% female, aged 33 years (range 28-41); 79.5% underwent Roux-en-Y gastric bypass). Anthropometric, food consumption and SJL were evaluated in the preoperative evaluation and in the third and sixth months after surgery. SJL was calculated based on the absolute difference between the mid-sleep time on weekends and weekdays. Generalised estimating equations and linear regression were performed to evaluate the associations between mean SJL exposure and the outcomes. RESULTS: The interaction between SJL and follow-up time negatively influenced the evolution of weight (p = 0.01), BMI (p = 0.04) and insulin levels (p = 0.01). SJL had an effect on intake of calories (p = 0.001), carbohydrate (p = 0.005) and total (p = 0.007), monounsaturated (p = 0.03) and polyunsaturated fat (p < 0.001). Linear regression showed a negative association between mean SJL exposure over the 6 months and the percentage of weight loss (coefficient = - 0.30, p = 0.006), body weight loss (kg) (coefficient = - 0.17, p = 0.03) and the reduction of BMI (coefficient = - 0.24, p = 0.007). CONCLUSIONS: SJL was negatively associated with anthropometric, metabolic and food consumption outcomes 6 months after bariatric surgery. Future studies with longer follow-up are needed to confirm these findings. TRIAL REGISTRATION: Clinical Trials.gov : NCT03485352.
Subject(s)
Bariatric Surgery , Gastric Bypass , Obesity, Morbid , Adult , Eating , Female , Humans , Male , Obesity, Morbid/surgery , Weight LossABSTRACT
Being a product with a high market value, olive oil undergoes adulterations. Therefore, studies that make the verification of the authenticity of olive oil more efficient are necessary. The aim of this study was to develop a robust model using FT-NIR and PLS-DA to discriminate extra virgin olive oil samples and build individual models to differentiate adulterated extra virgin olive oil samples. The best PLS-DA-OPS classification model for olive oils showed specificity (Spe) and accuracy (Acc) values higher than 99.7% and 99.9%. For the classification of adulterants, PLS-DA-OPS models presented values of Spe at 96.0% and Acc above 95.5% for varieties. For the blend, the best PLS-DA-GA model presented Acc and Spe values greater than 98.2% and 98.8%. Reliable and robust models have been built, allowing differentiation from seven adulterants to genuine extra virgin olive oils.
Subject(s)
Models, Statistical , Olive Oil/analysis , Spectroscopy, Fourier Transform Infrared , Discriminant Analysis , Food Contamination/analysis , Least-Squares AnalysisABSTRACT
ABSTRACT Objectives: to reflect on the daily life of family members dependent on psychoactive substances and the role of health professionals in Primary Care. Methods: a descriptive investigation outlined in Maffesoli's phenomenological approach, carried out at a Basic Health Unit in Minas Gerais with eight family members dependent on psychoactive substances. Sociodemographic characterization data and in-depth interviews were collected and analyzed with support of NVivo Pro11® software. All ethical and legal aspects were met. Results: physicians were the professionals most mentioned in participants' statements, who took on a dubious role with other health professionals: welcoming (positive perceptions about care received) and neglect (negative perceptions). Final Considerations: dependence on psychoactive substances imposes a burden on persons, their family members and health professionals. The role of establishing good relationships in the triad professionals-users-family members of primary care is inseparable in favor of treatment and preservation of their mental health.
RESUMEN Objetivos: reflexionar sobre el día a día de los familiares dependientes de sustancias psicoactivas y el papel de los profesionales sanitarios en Atención Primaria. Métodos: investigación descriptiva perfilada en el abordaje fenomenológico de Maffesoli, realizada en una Unidad Básica de Salud en Minas Gerais con ocho familiares dependientes de sustancias psicoactivas. Se recolectaron datos de caracterización sociodemográfica y entrevistas en profundidad, que fueron analizadas con el apoyo del software NVivo Pro11®. Se cumplieron los aspectos éticos y legales. Resultados: el profesional más mencionado en el discurso de los participantes fue el médico, quien asumió un rol dudoso con el resto de profesionales de la salud: acogida (percepciones positivas sobre la asistencia recibida) y desatención (percepciones negativas). Consideraciones Finales: la dependencia de sustancias psicoactivas supone una carga para la persona, sus familiares y los profesionales sanitarios. El papel del establecimiento de buenas relaciones en la tríada profesionales-usuarios-familiares de Atención Primaria es inseparable a favor del tratamiento y preservación de la salud mental de los implicados.
RESUMO Objetivos: refletir sobre o cotidiano dos familiares codependentes de substâncias psicoativas e o papel dos profissionais de saúde na Atenção Básica. Métodos: investigação descritiva delineada na abordagem fenomenológica de Maffesoli, realizada em uma Unidade Básica de Saúde mineira com oito familiares codependentes de substâncias psicoativas. Foram coletados dados de caracterização sociodemográfica e entrevistas em profundidade, que foram analisadas com apoio do software NVivo Pro11®. Atenderam-se os aspectos ético-legais. Resultados: o profissional mais mencionado no discurso das participantes foi o médico, que assumiu uma dubiedade de papéis junto aos demais profissionais de saúde: de acolhimento (percepções positivas sobre a assistência recebida) e de descaso (percepções negativas). Considerações Finais: a dependência de substâncias psicoativas acarreta ônus à pessoa, aos seus familiares e aos profissionais de saúde. É indissociável o papel do estabelecimento de boas relações na tríade profissionais-usuários-familiares da Atenção Básica em prol do tratamento e preservação da saúde mental dos envolvidos.
Subject(s)
Humans , Codependency, Psychological , Family Relations , Brazil , Family , Health PersonnelABSTRACT
OBJECTIVES: The primary objective is to test if heparin added to a standard regional anticoagulation protocol based on citrate is able to reduce dialysis circuit losses by clotting without increasing the risk of thrombocytopenia or bleeding, in patients with COVID-19 with acute kidney injury requiring dialysis. TRIAL DESIGN: Randomized, parallel-group, open-label trial, with two arms (ratio 1:1) comparing different continuous renal replacement therapy anticoagulation strategies. PARTICIPANTS: Eligibility conditions: All ICU patients of University of Sao Paulo General Hospital (Hospital das Clínicas), Brazil will be screened for eligibility conditions. Adults (> 18 years old) with confirmed COVID-19 and acute kidney injury requiring dialysis with agreement between ICU and nephrology teams for the introduction of renal continuous replacement therapy in daily ICU rounds. Continuous renal replacement therapy will be prescribed by consulting nephrologists based on standard clinical guidelines, including acute kidney injury with hemodynamic instability plus hyperkalemia, severe acidosis, volume overload, respiratory distress, multiorgan failure or some combination of these factors. DATA COLLECTION: Patients demographics and associated clinical data and comorbidities will be recorded at ICU entry. Demographic information will include the patient's age, sex, and admission dates. Clinical data comprise comorbidities, APACHE 2, SAPS 3, need for mechanical ventilation, and use of vasopressor drugs. Physiological data collected by the day of CRRT start will be vital signs, the arterial oxygen tension/fraction of inspired oxygen (PaO2/FiO2) index, and serum creatinine, blood urea nitrogen, bilirubin, hemoglobin, hematocrit, platelets, white blood cell count levels and Peak D-dimer levels. Patients will be analyzed for the first 72h of CRRT, and they will be evaluated regarding clinical variables, filter patency and any adverse events that could be related to the anticoagulation choice, as bleeding (mild or major) or low platelets counts (<100.000 ui/uL) during treatment period. Mild and major bleeding will be defined by hemorrhagic event without clinical impact or hemoglobin (Hb) fall lesser than 1g/dL and hemorrhagic event with clinical impact or Hb fall higher than 1g/dL, respectively. EXCLUSION CRITERIA: Hypersensitivity to any of the substances going to be used in the study (Citric acid dextrosol 2.2% and unfractionated heparin); Previous diagnosis of coagulopathy or thrombophilia; Contraindication to the use of unfractionated heparin; Risk of citrate poisoning - (Lactate> 30 mg/dL, international normalized ratio > 2.5, Total bilirubin> 15 mg/dL); Pregnancy; Patients unlikely to survive for more than 24 hours. The trial is being undertaken at the University of Sao Paulo General Hospital (Hospital das Clinicas), Brazil. INTERVENTION AND COMPARATOR: Group A (control) - Patients on continuous renal replacement therapy (blood flow 150 ml/min, dose of 30 mL/Kg/h) receiving anticoagulation with sodium citrate at 4 mmol/L Group B (experiment): Patients on continuous hemodialysis (blood flow 150 mL/min, dose of 30 mL/Kg/h) receiving anticoagulation with sodium citrate at 4 mmol/L associated with unfractionated heparin at 10 U/Kg/h. MAIN OUTCOMES: The percentage of clotted dialyzers within 72 hours in each of the studied groups (Primary outcome) Secondary outcomes: Number of dialyzers used in the first 72 hours of dialysis protocol, Mortality in the first 72 h of dialysis protocol, Bleeding events (Major or minor) in the first 72 h of dialysis protocol, Thrombocytopenia (less than 50.000 platelets) proportion in the first 72 h of dialysis protocol, Dialysis efficiency (Urea sieving) - variation in urea sieving between the first, second and third days of dialysis protocol, Continuous renal replacement therapy pressures (Arterial, Venous, dialysate and pre-filter pressure) in the first 72 h of dialysis protocol, in-hospital mortality. RANDOMIZATION: RedCapâ randomization - 2 blocks randomization by D-dimer level (5000ng/dL cut-off) and catheter site (Right Internal Jugular versus other sites) with 1:1 allocation ratio. BLINDING (MASKING): No blinding - Open label format NUMBERS TO BE RANDOMIZED (SAMPLE SIZE): Total number of patients 90 (45 per group) TRIAL STATUS: Trial version 2.0 - ongoing recruitment. First recruitment: June 29, 2020 Estimated date for last recruitment: December 31, 2020 TRIAL REGISTRATION: Responsible Party: University of Sao Paulo General Hospital (Hospital das Clinicas) ClinicalTrials.gov Identifier: NCT04487990 , registered July 27, 2020, ReBec www.ensaiosclinicos.gov.br/rg/RBR-45kf9p/ Other Study ID Numbers: U1111-1252-0194 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1) In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
Subject(s)
Acute Kidney Injury , Coronavirus Infections , Drug Monitoring/methods , Heparin , Pandemics , Pneumonia, Viral , Renal Dialysis , Thrombosis/prevention & control , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Adult , Anticoagulants/administration & dosage , Anticoagulants/adverse effects , Blood Coagulation/drug effects , COVID-19 , Coronavirus Infections/blood , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Female , Fibrin Fibrinogen Degradation Products/analysis , Hemoglobins/analysis , Hemorrhage/etiology , Hemorrhage/prevention & control , Heparin/administration & dosage , Heparin/adverse effects , Humans , Male , Outcome Assessment, Health Care , Pneumonia, Viral/blood , Pneumonia, Viral/complications , Pneumonia, Viral/drug therapy , Randomized Controlled Trials as Topic , Renal Dialysis/adverse effects , Renal Dialysis/methods , Risk Adjustment/methods , Thrombocytopenia/etiology , Thrombocytopenia/prevention & control , Thrombosis/complicationsABSTRACT
This article aims to develop and validate a multivariate model for quantifying Robusta-Arabica coffee blends by combining near infrared spectroscopy (NIRS) and total reflection X-ray fluorescence (TXRF). For this aim, 80 coffee blends (0.0-33.0%) were formulated. NIR spectra were obtained in the wavenumber range 11100-4950 cm-1 and 14 elements were determined by TXRF. Partial least squares models were built using data fusion at low and medium levels. In addition, selection of predictive variables based on their importance indices (SVPII) improved results. The best model reduced the number of variables from 1114 to 75 and root mean square error of prediction from 4.1% to 1.7%. SVPII selected NIR regions correlated with coffee components, and the following elements were chosen: Ti, Mn, Fe, Cu, Zn, Br, Rb, Sr. The model interpretation took advantage of the data fusion between atomic and molecular spectra in order to characterize the differences between these coffee varieties.
ABSTRACT
Abstract Solvents play important and critical role in natural product chemistry and could generate artefacts during the extraction and purification of metabolites from a biological matrix. This study aimed to correlate the chromatographic profile with biological activity of Ipomoea pes-caprae (L.) R. Br., Convolvulaceae, extracts obtained with hydroethanolic extraction. Thus, aerial parts of I. pes-caprae were extracted with different concentration of ethanol (50, 70 and 90°GL) and the obtained extracts were analysed by HPLC-UV. HPLC data were studied employing chemometrics to discriminate the samples. Moreover these samples were further characterized by using UPLC-QTOF/MS data. The extracts were also biomonitored through the paw-oedema and spontaneous nociception induced by trypsin in mice. Different chromatographic profiles were obtained and the exploratory analysis clearly revealed higher level of ethyl caffeate in extracts of lower strength of ethanol (50°GL). This compound was suggested to be an artefact formed by transesterification of caffeoylquinic acid derivatives present in the plant, once it was not observed when other solvents were employed. During the biological assay, only the extract obtained with ethanol 50°GL presented significant inhibition of inflammation (45 ± 9%) and nociception (24 ± 3%). Ethyl caffeate seems to be linked to the anti-inflammatory effect since it reduced 86 ± 5% of paw-oedema induced by trypsin. Artefacts could contribute to the biological activity of herbal preparations and consequently lead to misinterpretation of the results.
ABSTRACT
This paper describes a robust multivariate model for quantifying and characterizing blends of Robusta and Arabica coffees. At different degrees of roasting, 120 ground coffee blends (0.0-33.0%) were formulated. Spectra were obtained by two different techniques, attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy and paper spray mass spectrometry (PS-MS). Partial least squares (PLS) models were built individually with the two types of spectra. Nevertheless, better predictions were obtained by low and medium-level data fusion, taking advantage from the synergy between these two data sets. Data fusion models were improved by variable selection, using genetic algorithms (GA) and ordered predictors selection (OPS). The smallest prediction errors were provided by OPS low-level data fusion model. The number of variables used for regression was reduced from 2145 (full spectra) to 230. Model interpretation was performed by assigning some of the selected variables to specific coffee components, such as trigonelline and chlorogenic acids.
Subject(s)
Coffee/chemistry , Spectrophotometry, Infrared , Coffea/chemistry , Food Analysis , Food Handling , Reproducibility of Results , Spectroscopy, Fourier Transform InfraredABSTRACT
Grape, orange, peach and passion fruit nectars were formulated and adulterated by dilution with syrup, apple and cashew juices at 10 levels for each adulterant. Attenuated total reflectance Fourier transform mid infrared (ATR-FTIR) spectra were obtained. Partial least squares (PLS) multivariate calibration models allied to different variable selection methods, such as interval partial least squares (iPLS), ordered predictors selection (OPS) and genetic algorithm (GA), were used to quantify the main fruits. PLS improved by iPLS-OPS variable selection showed the highest predictive capacity to quantify the main fruit contents. The selected variables in the final models varied from 72 to 100; the root mean square errors of prediction were estimated from 0.5 to 2.6%; the correlation coefficients of prediction ranged from 0.948 to 0.990; and, the mean relative errors of prediction varied from 3.0 to 6.7%. All of the developed models were validated.
Subject(s)
Food Contamination/analysis , Plant Nectar/analysis , Spectroscopy, Fourier Transform Infrared/methods , Brazil , Calibration , Citrus sinensis , Fruit/chemistry , Least-Squares Analysis , Plant Nectar/chemistry , Prunus persica , Spectrophotometry, Infrared , Spectroscopy, Fourier Transform Infrared/statistics & numerical data , VitisABSTRACT
The building of multivariate calibration models using near-infrared spectroscopy (NIR) and partial least squares (PLS) to estimate the lignin content in different parts of sugarcane genotypes is presented. Laboratory analyses were performed to determine the lignin content using the Klason method. The independent variables were obtained from different materials: dry bagasse, bagasse-with-juice, leaf, and stalk. The NIR spectra in the range of 10 000-4000 cm-1 were obtained directly for each material. The models were built using PLS regression, and different algorithms for variable selection were tested and compared: iPLS, biPLS, genetic algorithm (GA), and the ordered predictors selection method (OPS). The best models were obtained by feature selection with the OPS algorithm. The values of the root mean square error prediction (RMSEP), correlation of prediction ( RP), and ratio of performance to deviation (RPD) were, respectively, for dry bagasse equal to 0.85, 0.97, and 2.87; for bagasse-with-juice equal to 0.65, 0.94, and 2.77; for leaf equal to 0.58, 0.96, and 2.56; for the middle stalk equal to 0.61, 0.95, and 3.24; and for the top stalk equal to 0.58, 0.96, and 2.34. The OPS algorithm selected fewer variables, with greater predictive capacity. All the models are reliable, with high accuracy for predicting lignin in sugarcane, and significantly reduce the time to perform the analysis, the cost and the chemical reagent consumption, thus optimizing the entire process. In general, the future application of these models will have a positive impact on the biofuels industry, where there is a need for rapid decision-making regarding clone production and genetic breeding program.
Subject(s)
Lignin/analysis , Lignin/chemistry , Saccharum/chemistry , Spectroscopy, Near-Infrared/methods , Algorithms , Cellulose , Least-Squares Analysis , Limit of Detection , Linear Models , Reproducibility of ResultsABSTRACT
Introdução: A violência doméstica, de maneira geral, é definida como sendo o uso da força que resulta em ferimento, sofrimento, tortura ou morte, bem como o uso de palavras ou ações que possam machucar os indivíduos. Entre as mulheres atendidas pelo Sistema Único de Saúde (SUS) em 2011, a violência física é a preponderante, englobando 44,2% dos casos, caracterizados a partir de algumas ações descritas a seguir: tapas, empurrões, chutes, puxões de cabelo, ameaças com faca, queimaduras, dentre outras. A lesão por queimadura é reconhecida como um dos traumatismos que mais incapacitam e desfiguram sua vítima, levando-a a um prolongado período de cuidados médicos. Método: Revisão de literatura, nas bases de dados: Lilacs e PubMed, versando sobre a temática da violência doméstica, especificamente a violência física, caracterizada pela queimadura contra a mulher, no período temporal que compreendeu os anos de 2002 a 2012. Após exclusão de artigos por repetição de conteúdo e inadequação de temática, restaram 10 artigos a serem analisados. Resultados: Observa-se que o fenômeno da violência doméstica é amplamente estudado na sociedade brasileira e que a violência de gênero, caracterizada como física, pertence a esse cenário, o que não ocorre com o fenômeno da queimadura, visto, embora seja estudado, existe uma lacuna em relação a sua existência dentro do cenário de violência física contra a mulher. Conclusão: Adequada relação entre a díade (mulher vítima de queimadura por violência física e equipe de enfermagem) facilita a conscientização sobre a extensão e a gravidade da queimadura, a adesão ao tratamento e a confiança entre todos os envolvidos.
Introduction: Domestic violence is generally defined as the use of force that results in injury, suffering, torture or death, as well as the use of words or actions that might hurt individuals. Of the women served by the Unified Health System (SUS) in 2011, physical violence is prevalent, comprising 44.2% of cases, characterized from some actions described below: slapping, shoving, kicking, hair pulling, threats with knife, burns, among others. A burn injury is recognized as one of the most disabling injuries and disfiguring his victim, leading to a prolonged period of medical care. Methods: Thus, we chose the literature review, the following databases: PubMed and LILACS, dealing with the issue of domestic violence, especially physical violence, characterized by burning against women in the time period that encompassed the years 2002 to 2012. After excluding articles because repetition of content and theme of inadequacy, left a total of 10 articles to be analyzed. Results: We observe that the phenomenon of domestic violence is widely studied in Brazilian society and gender violence, characterized as physical, belongs to this scenario, which does not occur with the phenomenon of burning seen, although it is studied, there is a gap regarding its existence within the scenario of physical violence against women. Conclusion: An appropriate relationship between the dyad (female burn victim by physical violence and nursing staff) facilitates awareness of the extent and severity of the burn, treatment adherence and trust between all involved.
Subject(s)
Humans , Burns , Domestic Violence , Violence Against WomenABSTRACT
As periodontites são doenças infecto-inflamatórias que têm como agente desencadeador do processo de destruição dos tecidos de inserção o biofilme bacteriano agindo sobre um hospedeiro susceptível. O início e progressão da doença podem ser modificados por fatores de risco de ordem biológica, ambiental e comportamental. O estudo dos fatores de risco às doenças periodontais tem recebido grande ênfase na periodontia e tem sido um importante fundamento para abordagens preventivas e terapêuticas tanto individuais quanto coletivas. Nesse contexto, a obesidade emerge como um possível fator modificador do curso da periodontite. A plausibilidade da associação sustenta-se em diversas alterações imunológicas desencadeadas pelo acúmulo de gordura nos tecidos. Recentes estudos epidemiológicos mostraram esta associação. No entanto, há ainda um longo caminho, dentro de um contexto de uma Odontologia baseada em evidências científicas, com estudos clínicos controlados randomizados, com amostras representativas e longo tempo de acompanhamento, para que se possa assegurar que a relação é causal e não apenas casual.
The periodontitis are infectious- inflammatory diseases that have agent triggering the process of tissue destruction from entering the biofilm by acting on a susceptible host. The beginning and progression can be modified by the biological, environmental and/or behavior risk factors. The study of risk factors for periodontal diseases has received great emphasis on Periodontics and has been an important basis for preventive and therapeutic approaches to both individual and collective. In this context obesity comes as a possible modifying factor of the course of periodontitis. The plausibility of association is based on the immunological changes due to the accumulation of adiposity on the tissues. Recent epidemiological studies show this association. However, there is still a long way, within a context of Dentistry based on scientific evidence, to be run through randomized controlled clinical trials based on representative samples and long follow-up time, in order to investigate if the association is cause or occasional.
ABSTRACT
A necessidade da introdução de novos agentes quimioterápicos é uma realidade no controle de doenças infecciosas. O Brasil é o país mais rico em biodiversidade, e o Laboratório de Extração da Universidade Paulista tem coletado plantas na Amazônia e Mata Atlântica com a finalidade de identificar extratos vegetais antibacterianos e antitumorais. Estudos prévios demonstraram que a fração etanólica obtida do extrato bruto orgânico do caule de Tabernaemontana angulata Mart. ex Müll. Arg. apresentou atividade antimicrobiana significante contra Staphylococcus aureus ATCC6538, no ensaio de diluição em caldo. Verificou-se por cromatografia em camada delgada que os compostos majoritários presentes na fração ativa eram alcalóides. No presente trabalho, foi obtida a fração de alcalóides totais a partir do extrato bruto, da qual os compostos majoritários foram isolados por sucessivas cromatografias e, posteriormente, identificados por CG-EM e ¹H-RMN como os alcalóides indólicos coronaridina e voacangina. As frações obtidas do isolamento foram testadas no ensaio biológico, porém não demonstraram atividade antimicrobiana.
Introducing new chemotherapeutic agents is a great demand in the control of infectious diseases. Brazil is one of the richest countries in biodiversity and the Laboratório de Extração at UNIP has been collecting plants from the Amazon and Atlantic Rain Forests with the aim of screening for new antibacterial and antitumor plant extracts. Previous studies demonstrated that the ethanol fraction obtained from the crude extract of Tabernaemontana angulata stems showed an antibacterial activity against Staphylococcus aureus (ATCC 6538) in the microdilution broth assay. Two alkaloids were the major compounds in the active fraction, verified by thin layer chromatography analysis. In the present study, the total alkaloids were obtained from the crude extract and were fractionated by preparative thin layer chromatography for the isolation of the main components. The isolated compounds were identified by GC/MS and ¹H-NMR as coronaridine and voacangine. The alkaloid fractions obtained from the isolation procedure were tested for antibacterial activity, but no activity was detected.