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1.
Sci Rep ; 14(1): 7479, 2024 Mar 29.
Article in English | MEDLINE | ID: mdl-38553528

ABSTRACT

Maneuvering a spacecraft in the cislunar space is a complex problem, since it is highly perturbed by the gravitational influence of both the Earth and the Moon, and possibly also the Sun. Trajectories minimizing the needed fuel are generally preferred in order to decrease the mass of the payload. A classical method to constrain maneuvers is mathematically modeling them using the Two Point Boundary Value Problem (TPBVP), defining spacecraft positions at the start and end of the trajectory. Solutions to this problem can then be obtained with optimization techniques like the nonlinear least squares conjugated with the Theory of Functional Connections (TFC) to embed the constraints, which recently became an effective method for deducing orbit transfers. In this paper, we propose a tangential velocity (TV) type of constraints to design orbital maneuvers. We show that the technique presented in this paper can be used to transfer a spacecraft (e.g. from the Earth to the Moon) and perform gravity assist maneuvers (e.g. a swing-by with the Moon). In comparison with the TPBVP, solving the TV constraints via TFC offers several advantages, leading to a significant reduction in computational time. Hence, it proves to be an efficient technique to design these maneuvers.

2.
Sci Rep ; 13(1): 18269, 2023 10 25.
Article in English | MEDLINE | ID: mdl-37880377

ABSTRACT

Angiotensin II receptor 1(AT1) antagonists are beneficial in focal ischemia/reperfusion (I/R). However, in cases of global I/R, such as cardiac arrest (CA), AT1 blocker's potential benefits are still unknown. Wistar male rats were allocated into four groups: Control group (CG)-animals submitted to CA by ventricular fibrillation induced by direct electrical stimulation for 3 min, and anoxia for 5 min; Group AT1 (GAT1)-animals subjected to CA and treated with 0.2 mg/kg of candesartan diluted in dimethylsulfoxide (DMSO) (0.1%); Vehicle Group (VG): animals subjected to CA and treated with 0.2 ml/kg of DMSO and Sham group (SG)-animals submitted to surgical interventions, without CA. Cardiopulmonary resuscitation consisted of group medications, chest compressions, ventilation, epinephrine (20 mcg/kg) and defibrillation. The animals were observed up to 4 h after spontaneous circulation (ROSC) return, and survival rates, hemodynamic variables, histopathology, and markers of tissue injury were analyzed. GAT1 group had a higher rate of ROSC (62.5% vs. 42.1%, p < 0.0001), survival (100% vs. 62.5%, p = 0.027), lower incidence of arrhythmia after 10 min of ROSC (10% vs. 62.5%, p = 0.000), and lower neuronal and cardiac injury scores on histology evaluation (p = 0.025 and p = 0.0052, respectively) than GC group. The groups did not differ regarding CA duration, number of adrenaline doses, or number of defibrillations. AT1 receptor blockade with candesartan yielded higher rates of ROSC and survival, in addition to neuronal and myocardial protection.


Subject(s)
Cardiopulmonary Resuscitation , Heart Arrest , Male , Rats , Animals , Receptor, Angiotensin, Type 1 , Dimethyl Sulfoxide , Rats, Wistar , Heart Arrest/therapy , Epinephrine , Disease Models, Animal
3.
J Pediatr Surg ; 58(6): 1178-1184, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37030979

ABSTRACT

BACKGROUND: The objective was to explore the hospital-level relationship between routine pre-discharge WBC utilization (RPD-WBC) and outcomes in children with complicated appendicitis. METHODS: Multicenter analysis of NSQIP-Pediatric data from 14 consortium hospitals augmented with RPD-WBC data. WBC were considered routine if obtained within one day of discharge in children who did not develop an organ space infection (OSI) or fever during the index admission. Hospital-level observed-to-expected ratios (O/E) for 30-day outcomes (antibiotic days, imaging utilization, healthcare days, and OSI) were calculated after adjusting for appendicitis severity and patient characteristics. Spearman correlation was used to explore the relationship between hospital-level RPD-WBC utilization and O/E's for each outcome. RESULTS: 1528 children were included. Significant variation was found across hospitals in RPD-WBC use (range: 0.7-100%; p < 0.01) and all outcomes (mean antibiotic days: 9.9 [O/E range: 0.56-1.44, p < 0.01]; imaging: 21.9% [O/E range: 0.40-2.75, p < 0.01]; mean healthcare visit days: 5.7 [O/E 0.74-1.27, p < 0.01]); OSI: 14.1% [O/E range: 0.43-3.64, p < 0.01]). No correlation was found between RPD-WBC use and antibiotic days (r = +0.14, p = 0.64), imaging (r = -0.07, p = 0.82), healthcare days (r = +0.35, p = 0.23) or OSI (r = -0.13, p = 0.65). CONCLUSIONS: Increased RPD-WBC utilization in pediatric complicated appendicitis did not correlate with improved outcomes or resource utilization at the hospital level. LEVEL OF EVIDENCE: III. TYPE OF STUDY: Clinical Research.


Subject(s)
Appendicitis , Child , Humans , Appendicitis/complications , Appendicitis/surgery , Patient Discharge , Leukocyte Count , Anti-Bacterial Agents/therapeutic use , Appendectomy/methods , Clinical Decision-Making , Hospitals , Retrospective Studies
4.
Ann Surg ; 278(4): e863-e869, 2023 10 01.
Article in English | MEDLINE | ID: mdl-36317528

ABSTRACT

OBJECTIVE: To evaluate whether redosing antibiotics within an hour of incision is associated with a reduction in incisional surgical site infection (iSSI) in children with appendicitis. BACKGROUND: Existing data remain conflicting as to whether children with appendicitis receiving antibiotics at diagnosis benefit from antibiotic redosing before incision. METHODS: This was a multicenter retrospective cohort study using data from the Pediatric National Surgical Quality Improvement Program augmented with antibiotic utilization and operative report data obtained though supplemental chart review. Children undergoing appendectomy at 14 hospitals participating in the Eastern Pediatric Surgery Network from July 2016 to June 2020 who received antibiotics upon diagnosis of appendicitis between 1 and 6 hours before incision were included. Multivariable logistic regression was used to compare odds of iSSI in those who were and were not redosed with antibiotics within 1 hour of incision, adjusting for patient demographics, disease severity, antibiotic agents, and hospital-level clustering of events. RESULTS: A total of 3533 children from 14 hospitals were included. Overall, 46.5% were redosed (hospital range: 1.8%-94.4%, P <0.001) and iSSI rates were similar between groups [redosed: 1.2% vs non-redosed: 1.3%; odds ratio (OR) 0.84, (95%,CI, 0.39-1.83)]. In subgroup analyses, redosing was associated with lower iSSI rates when cefoxitin was used as the initial antibiotic (redosed: 1.0% vs nonredosed: 2.5%; OR: 0.38, (95% CI, 0.17-0.84)], but no benefit was found with other antibiotic regimens, longer periods between initial antibiotic administration and incision, or with increased disease severity. CONCLUSIONS: Redosing of antibiotics within 1 hour of incision in children who received their initial dose within 6 hours of incision was not associated with reduction in risk of incisional site infection unless cefoxitin was used as the initial antibiotic.


Subject(s)
Anti-Bacterial Agents , Appendicitis , Child , Humans , Anti-Bacterial Agents/therapeutic use , Surgical Wound Infection/epidemiology , Surgical Wound Infection/etiology , Surgical Wound Infection/prevention & control , Cefoxitin , Retrospective Studies , Appendicitis/complications , Treatment Outcome , Appendectomy/adverse effects
5.
Braz J Anesthesiol ; 73(4): 446-454, 2023.
Article in English | MEDLINE | ID: mdl-34118261

ABSTRACT

BACKGROUND: Sepsis and septic shock still represent great challenges in critical care medicine. Sildenafil has been largely used in the treatment of pulmonary arterial hypertension, but its effects in sepsis are unknown. The aim of this study was to investigate the hypothesis that sildenafil can attenuate endotoxin-induced pulmonary hypertension in a porcine model of endotoxemia. METHODS: Twenty pigs were randomly assigned to Control group (n.ß=.ß10), which received saline solution; or to Sildenafil group (n.ß=.ß10), which received sildenafil orally (100.ßmg). After 30.ßminutes, both groups were submitted to endotoxemia with intravenous bacterial lipopolysaccharide endotoxin (LPS) infusion (4.ß..g.kg-1.h-1) for 180.ßminutes. We evaluated hemodynamic and oxygenation functions, and also lung histology and plasma cytokine (TNF.., IL-1.., IL6, and IL10) and troponin I response. RESULTS: Significant hemodynamic alterations were observed after 30.ßminutes of LPS continuous infusion, mainly in pulmonary arterial pressure (from Baseline 19.ß...ß2.ßmmHg to LPS30 52.ß...ß4.ßmmHg, p.ß<.ß0.05). There was also a significant decrease in PaO2/FiO2 (from Baseline 411.ß...ß29 to LPS180 334.ß...ß49, p.ß<.ß0.05). Pulmonary arterial pressure was significantly lower in the Sildenafil group (35.ß...ß4.ßmmHg at LPS30, p.ß<.ß0.05). The Sildenafil group also presented lower values of systemic arterial pressure. Sildenafil maintained oxygenation with higher PaO2/FiO2 and lower oxygen extraction rate than Control group but had no effect on intrapulmonary shunt. All cytokines and troponin increased after LPS infusion in both groups similarly. CONCLUSION: Sildenafil attenuated endotoxin-induced pulmonary hypertension preserving the correct heart function without improving lung lesions or inflammation.


Subject(s)
Endotoxemia , Hypertension, Pulmonary , Animals , Swine , Sildenafil Citrate/pharmacology , Hypertension, Pulmonary/chemically induced , Hypertension, Pulmonary/drug therapy , Endotoxins/pharmacology , Lipopolysaccharides/pharmacology , Hemodynamics
6.
JAMA Surg ; 157(8): 685-692, 2022 08 01.
Article in English | MEDLINE | ID: mdl-35648410

ABSTRACT

Importance: The clinical significance of gangrenous, suppurative, or exudative (GSE) findings is poorly characterized in children with nonperforated appendicitis. Objective: To evaluate whether GSE findings in children with nonperforated appendicitis are associated with increased risk of surgical site infections and resource utilization. Design, Setting, and Participants: This multicenter cohort study used data from the Appendectomy Targeted Database of the American College of Surgeons Pediatric National Surgical Quality Improvement Program, which were augmented with operative report data obtained by supplemental medical record review. Data were obtained from 15 hospitals participating in the Eastern Pediatric Surgery Network (EPSN) research consortium. The study cohort comprised children (aged ≤18 years) with nonperforated appendicitis who underwent appendectomy from July 1, 2015, to June 30, 2020. Exposures: The presence of GSE findings was established through standardized, keyword-based audits of operative reports by EPSN surgeons. Interrater agreement for the presence or absence of GSE findings was evaluated in a random sample of 900 operative reports. Main Outcomes and Measures: The primary outcome was 30-day postoperative surgical site infections (incisional and organ space infections). Secondary outcomes included rates of hospital revisits, postoperative abdominal imaging, and postoperative length of stay. Multivariable mixed-effects regression was used to adjust measures of association for patient characteristics and clustering within hospitals. Results: Among 6133 children with nonperforated appendicitis, 867 (14.1%) had GSE findings identified from operative report review (hospital range, 4.2%-30.2%; P < .001). Reviewers agreed on presence or absence of GSE findings in 93.3% of cases (weighted κ, 0.89; 95% CI, 0.86-0.92). In multivariable analysis, GSE findings were associated with increased odds of any surgical site infection (4.3% vs 2.2%; odds ratio [OR], 1.91; 95% CI, 1.35-2.71; P < .001), organ space infection (2.8% vs 1.1%; OR, 2.18; 95% CI, 1.30-3.67; P = .003), postoperative imaging (5.8% vs 3.7%; OR, 1.70; 95% CI, 1.23-2.36; P = .002), and prolonged mean postoperative length of stay (1.6 vs 0.9 days; rate ratio, 1.43; 95% CI, 1.32-1.54; P < .001). Conclusions and Relevance: In children with nonperforated appendicitis, findings of gangrene, suppuration, or exudate are associated with increased surgical site infections and resource utilization. Further investigation is needed to establish the role and duration of postoperative antibiotics and inpatient management to optimize outcomes in this cohort of children.


Subject(s)
Appendicitis , Appendectomy/adverse effects , Appendectomy/methods , Appendicitis/complications , Appendicitis/surgery , Child , Cohort Studies , Gangrene/complications , Humans , Length of Stay , Retrospective Studies , Suppuration/complications , Surgical Wound Infection/epidemiology , Surgical Wound Infection/etiology , Treatment Outcome
7.
9.
Evolution ; 74(9): 1988-2004, 2020 09.
Article in English | MEDLINE | ID: mdl-32307697

ABSTRACT

Traditionally focused on Amazonian and Atlantic rainforests, studies on the origins of high Neotropical biodiversity have recently shifted to also investigate biodiversity processes in the South American dry diagonal, encompassing Chaco, Cerrado savannas, and Caatinga seasonally dry tropical forests. The plateau/depression hypothesis states that riparian forests in the Brazilian Shield in central Brazil are inhabited by Pleistocene lineages, with shallow divergences and signatures of population expansion. Moreover, riparian forests may have acted as a vegetation network in the Pleistocene, allowing gene/species flow across the South American dry diagonal. We tested these hypotheses using Colobosaura modesta, a small gymnophthalmid lizard from forested habitats in the Cerrado savannas and montane/submontane forests in the Caatinga. We conducted phylogeographic analyses using a multi-locus dataset, tested alternative demographic scenarios with Approximate Bayesian Computation, and also employed species delimitation tests. We recovered a history of recent colonization and expansion along riparian forests, associated with Pleistocene climate shifts, and the existence of a new species of Colobosaura restricted to the Serra do Cachimbo region. We also present evidence that riparian forests have provided an interconnected network for forest organisms within the South American dry diagonal and that Pleistocene events played an important role in their evolutionary history.


Subject(s)
Animal Distribution , Forests , Lizards , Animals , Biological Evolution , Brazil , Phylogeography , Tropical Climate
10.
Rev Assoc Med Bras (1992) ; 65(11): 1343-1348, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31800894

ABSTRACT

OBJECTIVE: To evaluate chronological age as a limiting factor to perform the bronchodilator test, determine significant adverse effects of short-acting beta 2 agonists with clinical repercussions, and assess bronchodilator response in extreme-old-age patients who undergo the spirometry test. METHODS: This is a cross-sectional and retrospective study. The sample was extracted from the database (spirometer and respiratory questionnaire) of a pulmonary function service. Patients over 90 years old were included in the research, and we evaluated their bronchodilator response and its significant adverse effects that may have clinical repercussions related to the bronchodilator. RESULTS: A sample of 25 patients aged 92.12 ± 2.22 years (95% CI, 91.20 - 93.04), with a minimum age of 90 years and a maximum of 97 years and a predominance of females with 72% (18/25). The bronchodilator test was performed in 84% (21/25) of the patients. The bronchodilator response was evaluated in 19 of the 21 patients (90.47%) who underwent the bronchodilator test. Two tests did not meet the criteria of acceptability and reproducibility. No clinical adverse effects were observed with the bronchodilator medication (salbutamol) during or after the exam. CONCLUSIONS: Chronological age is not a limiting factor for the bronchodilator test, short-acting beta-2 agonists did not present adverse effects with significant clinical repercussion and were useful in the diagnosis and therapeutic guidance of extreme-old-age patients.


Subject(s)
Adrenergic beta-Agonists/administration & dosage , Aging , Bronchial Provocation Tests/methods , Bronchodilator Agents/administration & dosage , Spirometry/methods , Adrenergic beta-Agonists/adverse effects , Aged, 80 and over , Bronchial Provocation Tests/adverse effects , Bronchodilator Agents/adverse effects , Cross-Sectional Studies , Female , Humans , Male , Reproducibility of Results , Retrospective Studies , Spirometry/adverse effects
11.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 65(11): 1343-1348, Nov. 2019. tab
Article in English | LILACS | ID: biblio-1057074

ABSTRACT

SUMMARY OBJECTIVE: To evaluate chronological age as a limiting factor to perform the bronchodilator test, determine significant adverse effects of short-acting beta 2 agonists with clinical repercussions, and assess bronchodilator response in extreme-old-age patients who undergo the spirometry test. METHODS: This is a cross-sectional and retrospective study. The sample was extracted from the database (spirometer and respiratory questionnaire) of a pulmonary function service. Patients over 90 years old were included in the research, and we evaluated their bronchodilator response and its significant adverse effects that may have clinical repercussions related to the bronchodilator. RESULTS: A sample of 25 patients aged 92.12 ± 2.22 years (95% CI, 91.20 - 93.04), with a minimum age of 90 years and a maximum of 97 years and a predominance of females with 72% (18/25). The bronchodilator test was performed in 84% (21/25) of the patients. The bronchodilator response was evaluated in 19 of the 21 patients (90.47%) who underwent the bronchodilator test. Two tests did not meet the criteria of acceptability and reproducibility. No clinical adverse effects were observed with the bronchodilator medication (salbutamol) during or after the exam. CONCLUSIONS: Chronological age is not a limiting factor for the bronchodilator test, short-acting beta-2 agonists did not present adverse effects with significant clinical repercussion and were useful in the diagnosis and therapeutic guidance of extreme-old-age patients.


RESUMO OBJETIVOS: Avaliar se idade cronológica é um fator limitante para realizar prova broncodilatadora, determinar efeitos adversos significativos com repercussão clínica dos beta-2 agonistas de curta ação e avaliar a resposta broncodilatadora na espirometria, na velhice extrema. MÉTODOS: Estudo transversal, retrospectivo. Amostra extraída do banco de dados (espirômetro e questionário respiratório) de um serviço de função pulmonar. Incluídos na pesquisa pacientes com ≥90 anos, sendo avaliados a resposta broncodilatadora e efeitos adversos significativos com repercussão clínica ao broncodilatador. RESULTADOS: Amostra de 25 pacientes com idade de 92,12 ± 2,22 anos (IC 95%; 91,20 - 93,04), idade mínima de 90 anos e máxima de 97 anos, predominando o sexo feminino, com 72% (18/25). A prova broncodilatadora foi realizada em 84% (21/25) dos pacientes. A avaliação da resposta ao broncodilatador foi feita em 19 dos 21 pacientes (90,47%) que realizaram a prova broncodilatadora, uma vez que dois desses exames não preencheram os critérios de aceitabilidade e reprodutibilidade. A resposta broncodilatadora foi significativa em 10,52% (2/19) dos pacientes, ambos portadores de pneumopatia obstrutiva. Não foram observados efeitos adversos com repercussão clínica da medicação broncodilatadora (salbutamol) durante ou após sua realização. CONCLUSÕES: A idade cronológica não é um fator limitante para a realização da prova broncodilatadora, os beta-2 agonistas de curta ação não apresentaram efeitos adversos com repercussão clínica significativa e foram bastante úteis para auxiliar no diagnóstico e orientação terapêutica na velhice extrema.


Subject(s)
Humans , Male , Female , Aged, 80 and over , Spirometry/methods , Bronchial Provocation Tests/methods , Bronchodilator Agents/administration & dosage , Aging , Adrenergic beta-Agonists/administration & dosage , Spirometry/adverse effects , Bronchial Provocation Tests/adverse effects , Bronchodilator Agents/adverse effects , Cross-Sectional Studies , Reproducibility of Results , Retrospective Studies , Adrenergic beta-Agonists/adverse effects
12.
J Bras Pneumol ; 45(4): e20180232, 2019 Jul 29.
Article in English, Portuguese | MEDLINE | ID: mdl-31365683

ABSTRACT

OBJECTIVE: To determine the frequency of spirometry in elderly people, by age group, at a pulmonary function clinic, to assess the quality of spirometry in the extremely elderly, and to determine whether chronological age influences the quality of spirometry. METHODS: This was a cross-sectional retrospective study evaluating information (spirometry findings and respiratory questionnaire results) obtained from the database of a pulmonary function clinic in the city of Aracaju, Brazil, for the period from January of 2012 to April of 2017. In the sample as a whole, we determined the total number of spirometry tests performed, and the frequency of the tests in individuals ≥ 60 years of age, ≥ 65 years of age, and by decade of age, from age 60 onward. In the extremely elderly, we evaluated the quality of spirometry using criteria of acceptability and reproducibility, as well as examining the variables that can influence that quality, such a cognitive deficit. RESULTS: The sample comprised a total of 4,126 spirometry tests. Of those, 961 (23.30%), 864 (20.94%), 102 (2.47%), and 26 (0.63%) were performed in individuals ≥ 60, ≥ 65, ≥ 86, and ≥ 90 years of age (defined as extreme old age), respectively. In the extremely elderly, the criteria for acceptability and reproducibility were met in 88% and 60% of the spirometry tests (95% CI: 75.26-100.00 and 40.80-79.20), respectively. The cognitive deficit had a negative effect on acceptability and reproducibility (p ≤ 0.015 and p ≤ 0.007, respectively). CONCLUSIONS: A significant number of elderly individuals undergo spirometry, especially at ≥ 85 years of age, and the majority of such individuals are able to perform the test in a satisfactory manner, despite their advanced age. However, a cognitive deficit could have a negative effect on the quality of spirometry.


Subject(s)
Lung/physiopathology , Respiratory Tract Diseases/diagnosis , Respiratory Tract Diseases/physiopathology , Spirometry/standards , Age Factors , Aged , Aged, 80 and over , Aging/physiology , Cognitive Dysfunction , Comorbidity , Cross-Sectional Studies , Female , Forced Expiratory Volume/physiology , Humans , Male , Middle Aged , Peak Expiratory Flow Rate , Reproducibility of Results , Respiratory Tract Diseases/psychology , Retrospective Studies , Sex Factors , Spirometry/methods , Spirometry/psychology , Vital Capacity/physiology
13.
J. bras. pneumol ; 45(4): e20180232, 2019. tab, graf
Article in English | LILACS | ID: biblio-1012565

ABSTRACT

ABSTRACT Objective: To determine the frequency of spirometry in elderly people, by age group, at a pulmonary function clinic, to assess the quality of spirometry in the extremely elderly, and to determine whether chronological age influences the quality of spirometry. Methods: This was a cross-sectional retrospective study evaluating information (spirometry findings and respiratory questionnaire results) obtained from the database of a pulmonary function clinic in the city of Aracaju, Brazil, for the period from January of 2012 to April of 2017. In the sample as a whole, we determined the total number of spirometry tests performed, and the frequency of the tests in individuals ≥ 60 years of age, ≥ 65 years of age, and by decade of age, from age 60 onward. In the extremely elderly, we evaluated the quality of spirometry using criteria of acceptability and reproducibility, as well as examining the variables that can influence that quality, such a cognitive deficit. Results: The sample comprised a total of 4,126 spirometry tests. Of those, 961 (23.30%), 864 (20.94%), 102 (2.47%), and 26 (0.63%) were performed in individuals ≥ 60, ≥ 65, ≥ 86, and ≥ 90 years of age (defined as extreme old age), respectively. In the extremely elderly, the criteria for acceptability and reproducibility were met in 88% and 60% of the spirometry tests (95% CI: 75.26-100.00 and 40.80-79.20), respectively. The cognitive deficit had a negative effect on acceptability and reproducibility (p ≤ 0.015 and p ≤ 0.007, respectively). Conclusions: A significant number of elderly individuals undergo spirometry, especially at ≥ 85 years of age, and the majority of such individuals are able to perform the test in a satisfactory manner, despite their advanced age. However, a cognitive deficit could have a negative effect on the quality of spirometry.


RESUMO Objetivo: Determinar a frequência de idosos que realizaram espirometria num serviço de função pulmonar, e avaliar a qualidade da realização do exame na velhice extrema e se a idade cronológica influencia essa qualidade. Métodos: Estudo transversal retrospectivo utilizando informações (espirometria e questionário respiratório) de um banco de dados de um serviço de função pulmonar em Aracaju (SE) entre janeiro de 2012 e abril de 2017. Com base na amostra geral, determinou-se o número total de espirometrias realizadas em todas as idades, em idosos ≥ 60 anos, ≥ 65 anos, e por década de idade a partir da sexta década. Na velhice extrema, avaliou-se a qualidade da espirometria utilizando critérios de aceitabilidade e reprodutibilidade, e investigaram-se variáveis que influenciam essa qualidade, tal como déficit cognitivo. Resultados: A amostra geral foi composta por 4.126 espirometrias. Dessas, 961 (23,30%), 864 (20,94%), 102 (2,47%) e 26 (0,63%) foram realizadas em idosos com ≥ 60 anos de idade, ≥ 65 anos, ≥ 86 anos e ≥ 90 anos (velhice extrema), respectivamente. Na velhice extrema, os critérios de aceitabilidade e reprodutibilidade foram preenchidos em 88% (IC95%: 75,26-100,00) e 60% (IC95%: 40,80-79,20) das espirometrias, respectivamente. O déficit cognitivo influenciou negativamente a aceitabilidade e a reprodutibilidade (p ≤ 0,015; e p ≤ 0,007, respectivamente). Conclusões: Idosos na velhice extrema são uma realidade atual nos serviços de função pulmonar, e a maioria deles é capaz de realizar espirometrias adequadamente, apesar da idade avançada. O déficit cognitivo influencia negativamente a qualidade da espirometria.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Respiratory Tract Diseases/diagnosis , Respiratory Tract Diseases/physiopathology , Spirometry/methods , Spirometry/standards , Lung/physiopathology , Respiratory Tract Diseases/psychology , Spirometry/psychology , Aging/physiology , Comorbidity , Peak Expiratory Flow Rate , Sex Factors , Vital Capacity/physiology , Forced Expiratory Volume/physiology , Cross-Sectional Studies , Reproducibility of Results , Retrospective Studies , Age Factors , Cognitive Dysfunction
14.
Pulmonology ; 24 Suppl 1: 1-21, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30473034

ABSTRACT

Alpha-1-antitrypsin deficiency (AATD) is a genetic autosomal codominant disorder caused by mutations in SERPINA1 gene. It is one of the most prevalent genetic disorders, although it remains underdiagnosed. Whereas at international level there are several areas of consensus on this disorder, in Portugal, inter-hospital heterogeneity in clinical practice and resources available have been adding difficulties in reaching a diagnosis and in making therapeutic decisions in this group of patients. This raised a need to draft a document expressing a national consensus for AATD. To this end, a group of experts in this field was created within the Portuguese Pulmonology Society - Study group on AATD, in order to elaborate the current manuscript. The authors reviewed the existing literature and provide here general guidance and extensive recommendations for the diagnosis and management of AATD that can be adopted by Portuguese clinicians from different areas of Medicine. This article is part of a supplement entitled "Portuguese consensus document for the management of alpha-1-antitrypsin deficiency" which is sponsored by Sociedade Portuguesa de Pneumologia.


Subject(s)
Lung Diseases/diagnosis , Lung Diseases/therapy , alpha 1-Antitrypsin Deficiency/diagnosis , alpha 1-Antitrypsin Deficiency/therapy , Algorithms , Humans , Lung Diseases/etiology , Patient Selection , Portugal , Practice Guidelines as Topic , alpha 1-Antitrypsin Deficiency/complications
15.
Genetica ; 146(6): 505-515, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30361962

ABSTRACT

We assessed the presence of independent evolving lineages of the trahira, Hoplias malabaricus, one of the few freshwater fish species having wide distribution in the Neotropics which is the region with the highest global diversity of freshwater fish. To achieve that goal, 58 mitochondrial sequences of cytochrome c oxidase subunit I (COI; DNA barcoding) were generated from collected samples and 85 obtained from public databases, which were analyzed in comparison to chromosomal and geological data. The magnitude of genetic diversity found among different sampling sites was greater than 2%. Molecular species delimitation methods indicated the existence of a least four distinct lineages. The recognised cytotypes did not form monophyletic groups, suggesting that the karyotypic macrostructure could be a homoplastic character. The haplotype relationships suggested secondary contacts between the ecoregions of Northern and Northeastern Brazil that were shaped by coastal routes between adjacent watersheds during the Pleistocene epoch and probable exchanges of their ichthyofaunas. Our results indicated that multiple factors have driven the diversification of H. malabaricus, from ancient geological events linked to the reactivation of tectonic faults to more recent occurrences related to eustatic changes in ocean levels. Ultimately, the magnitude of its genetic diversity suggests the necessity of revising its taxonomic status.


Subject(s)
Characiformes/genetics , Evolution, Molecular , Phylogeny , Animals , Characiformes/classification , DNA Barcoding, Taxonomic , Electron Transport Complex IV/genetics , Fish Proteins/genetics , Haplotypes , Karyotype , Phylogeography
16.
J Med Entomol ; 54(2): 485-488, 2017 03 01.
Article in English | MEDLINE | ID: mdl-28011729

ABSTRACT

Culex (Melanoconion) pedroiSirivanakarn & Belkin 1980 and Culex (Melanoconion) ribeirensisForattini & Sallum 1985 are two morphologically very similar species of the Pedroi subgroup of mosquitoes in the Spissipes section of the subgenus Melanoconion of the genus Culex L. 1758. We carried out an analysis of the mitochondrial cytochrome c oxidase I (COI) DNA variation between these two species. The recent observation of sympatric coexistence in a forested area of Rio de Janeiro State (Brazil) triggered the need to validate these two species previously identified based on morphology. We concluded that the COI is a useful tool for identification of Cx. pedroi and Cx. ribeirensis.


Subject(s)
Culex/classification , Electron Transport Complex IV/genetics , Insect Proteins/genetics , Mitochondria/genetics , Animals , Brazil , Culex/enzymology , Culex/genetics , DNA, Mitochondrial/genetics , Genetic Variation , Mitochondria/enzymology
17.
Rev Port Pneumol (2006) ; 22(5): 283-6, 2016.
Article in English | MEDLINE | ID: mdl-27185409

ABSTRACT

Tracheal tumors are rare, representing only 0.2% of the respiratory tract malignancies. Chondrosarcoma arising in the trachea was first described in 1959 by Jackson et al. and since then only 20 cases have been described. We report the second documented case of malignant transformation from an endotracheal chondroma, in a 75-year-old woman, and review the literature.


Subject(s)
Chondroma/pathology , Tracheal Neoplasms/pathology , Aged , Cell Transformation, Neoplastic , Female , Humans
18.
Vet Parasitol ; 218: 102-5, 2016 Mar 15.
Article in English | MEDLINE | ID: mdl-26872936

ABSTRACT

With the aim of validating the FAMACHA(©) as a method for phenotypic selection of sheep resistant/resilient to gastrointestinal nematodes, 27 Suffolk ewes with known FAMACHA(©) score histories were experimentally infected with 25,000 larvae of Haemonchus contortus. From the day of infection (day 0) to 60 days post-infection, at intervals of 7-15 days, ewes were evaluated for packed cell volume (PCV) and fecal egg counts (FEC). A statistically significant increase (p<0.05) in FEC occurred between day 0 and day 60. PCV values showed a decrease (p<0.05) starting from day 21, compared to day 0. Based on the changes in FEC and PCV values from day 0 to day 60, 15 ewes (55.56%) were classified as susceptible (S) and 12 ewes (44.44%) as resistant/resilient (RR). A comparison of the average FEC after infection between susceptible (4487.6 eggs per gram-epg) and resistant/resilient (1317.9epg) ewes showed a significant difference (p<0.05) between the two groups. The difference in average PCV values after infection (24.8% and 30.3% for S and RR, respectively) was also significant (p<0.05). Data from 980 previous evaluations of FAMACHA(©) scores from the 27 ewes showed that 58.33% of the ewes classified as RR and 46.67% of the S group had a history of only F1 and F2 scores. In the RR group, only one animal (8.33%) had an F4 score, occurring one time out of the 61 evaluations of this ewe. In contrast, 40.0% of S group ewes had F4 and/or F5 scores. During the period of FAMACHA(©) score history that was evaluated, 69.56% of the total number of anthelmintic treatments in the flock were administered to ewes from group S. Since ewes with F4 and/or F5 scores during the FAMACHA(©) score time period were classified as susceptible during the experimental infection (with the exception of one ewe), we conclude that the FAMACHA(©) score history is a useful tool for the selection of ewes that are resistant/resilient, as well as for the identification of susceptible animals that should be culled.


Subject(s)
Animal Husbandry/methods , Disease Susceptibility/veterinary , Haemonchiasis/veterinary , Sheep Diseases/parasitology , Animals , Disease Susceptibility/diagnosis , Feces/parasitology , Female , Haemonchiasis/diagnosis , Haemonchiasis/parasitology , Haemonchus/physiology , Hematocrit/veterinary , Parasite Egg Count/veterinary , Sheep
19.
J Dev Orig Health Dis ; 7(3): 282-289, 2016 Jun.
Article in English | MEDLINE | ID: mdl-26818798

ABSTRACT

This study aimed to evaluate the systemic and renal renin-angiotensin-aldosterone system (RAAS) at birth in male and female offspring and in mothers fed a high sodium diet (HSD) before and during gestation. Female Wistar rats were fed a HSD (8.0% NaCl) or a normal sodium diet (1.3% NaCl) from 8 weeks of age until delivery of their first litter. Maternal body weight, tail blood pressure, and food and water intake were evaluated. The litter sizes were assessed, and the body and kidney weights of the offspring were measured. Both mothers and offspring were euthanized immediately following the birth of the pups to evaluate plasma renin activity (PRA), renal renin content (RRC), renal angiotensin-converting enzyme (ACE) activity, renal angiotensin (Ang) II content, serum aldosterone (ALDO) levels, and renal cortical and medullary renin messenger RNA expression. In mothers in the HSD group, water intake and kidney mass were higher, whereas renal ACE activity, Ang II, PRA, ALDO and RRC were decreased. In the offspring of HSD-fed dams, the body and kidney mass were lower in both genders, renal ACE activity was lower in females and renal Ang II was lower in males. PRA, RRC, renin gene expression and ALDO levels did not differ between the groups of offspring. The data presented herein showed that a maternal HSD during pregnancy induces low birth weight and a sex-specific response in the RAAS in offspring.

20.
Eur Neurol ; 74(5-6): 310-4, 2015.
Article in English | MEDLINE | ID: mdl-26674657

ABSTRACT

The aim of this study was to evaluate the pulmonary condition in a large family with Charcot-Marie-Tooth disease type 2 (CMT2). Eighteen participants diagnosed with CMT2 and 20 healthy individuals were evaluated by spirometry and maximal expiratory and maximal inspiratory pressures (MEP and MIP, respectively). Clinical disability was measured with CMT neuropathy score (CMTNS; range 0-36). One control group (CG) comprising 20 individuals, matched for age, sex and body mass index, were used for comparison. Eight patients were female (44.5%) and 10 patients were male (55.5%); mean age was 31.8 years (range 11-79) and CMTNS range was 6-26. Differences between CMT2 and CG in the spirometry and respiratory muscle strength were statistically significant for all dimensions. There were significant correlations between CMTNS and MIP (Pearson = -0.581) and MEP (Pearson = -0.5090). The results of this study show that patients with CMT, in spite of not showing clinical signs of advanced respiratory impairment, may present subclinical respiratory changes. The respiratory comprise in the CMT disease can be silent and insidious without presenting characteristic clinical signals.


Subject(s)
Charcot-Marie-Tooth Disease/physiopathology , Respiratory Insufficiency/physiopathology , Respiratory Muscles/physiopathology , Respiratory Paralysis/physiopathology , Adult , Brazil , Charcot-Marie-Tooth Disease/diagnosis , Charcot-Marie-Tooth Disease/genetics , Chromosome Aberrations , Female , Genes, Dominant , Humans , Male , Middle Aged , Muscle Strength/physiology , Respiratory Function Tests , Respiratory Insufficiency/diagnosis , Respiratory Insufficiency/genetics , Respiratory Paralysis/diagnosis , Respiratory Paralysis/genetics , Young Adult
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