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1.
Arch Physiother ; 13(1): 7, 2023 Mar 27.
Article in English | MEDLINE | ID: mdl-36967380

ABSTRACT

BACKGROUND: To translate and cross-culturally adapt into Brazilian-Portuguese, and to test the measurement properties of the following items of implementation outcome measures: Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM) and Feasibility of Intervention Measure (FIM). METHODS: This was a measurement properties study in accordance with the Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN). We conducted a translation and cross-cultural adaptation of three implementation measures according to guidelines for translation and cross-cultural adaptation, then we collected information from patients who had participated in remotely delivered physical therapy treatment for musculoskeletal condition. The patients answered the translated versions of the implementation outcome measures. The measurement properties of the three implementation outcome measures were collected in a test-retest assessment, with an interval of 7 to 14 days.. The measurement properties evaluated in this study were interpretability, measured using Ceiling and Floor Effects, reliability in test-retest evaluation, measured using Cronbach's Alpha Coefficient, internal consistency, measured using Intraclass Correlation Coefficient and construct validity, measured using Pearson Correlation. RESULTS: We included 104 participants (76 female). The average age of the sample was 56.8 (SD 14.8) years old. The items of implementation outcome measures (AIM, IAM, and FIM) showed 66.39%, 63.11%, and 63.93% of ceiling effects. The items of implementation outcome measures showed adequate internal consistency measured using Cronbach's Alpha Coefficient (AIM: 0.89, IAM: 0.91, FIM: 0.93) and values of Standard Error of Measurement between 5 and 10%, showing good measurement error. The results of AIM and IAM was classified as moderate reliability and the FIM as substantial reliability. In a total 96 correlations, > 75% of correlations met our prior hypothesis. CONCLUSION: The three Brazilian-Portuguese versions of items of implementation outcome measures had adequate internal consistency, measurement error and construct validity. The three implementation outcome measures showed moderate to substantial reliability values. The Ceiling Effect was observed in the three measures, showing maximum values ​​in more than 15% of the evaluations.

2.
Article in Portuguese | CONASS, Coleciona SUS, Sec. Est. Saúde SP, SESSP-CTDPROD, Sec. Est. Saúde SP | ID: biblio-1509705

ABSTRACT

Objetivo: Analisar o perfil dos profissionais atuantes na Atenção Primária em Saúde (APS) no cuidado a pacientes com depressão pós-parto (DPP) e as principais dificuldades na realização do diagnóstico precoce. Método: Por meio de uma pesquisa observacional, de caráter exploratório, abordagem quantitativa descritiva, com delineamento transversal, das informações colhidas através de questionário enviados por meio do aplicativo Google Forms, aplicada aos profissionais da APS, da região do Departamento Regional de Saúde de Araçatuba (DRSII). Resultado:Observa-se que 22,62% dos Agentes Comunitários de Saúde (ACS) permanecem na APS por 3 anos ou mais, enquanto 3,16% dos médicos, de 1 a 3 anos. Dos profissionais, 93,2% trabalham com protocolos de pré-natal, e destes, somente 33% são atualizados anualmente. Avaliando as consultas de pré-natal, 44,44% das gestantes com mais de 5 consultas retornam à Unidade Básica de Saúde (UBS) no puerpério. Dentre todas as categorias profissionais, 73,00% dos médicos se sentem aptos a realizarem orientações sobre a DPP. Cerca de 85% dos participantes da pesquisa identificaram os sintomas da doença e 18% o período do diagnóstico precoce corretamente. Atendimentos individuais e orientações às gestantes são realizados em 14,48% das práticas desenvolvidas pelos profissionais. Ademais, 91% dos profissionais nunca receberam capacitação a respeito do tema. Conclusão:Observou-se no estudo que há alta rotatividade dos profissionais da atenção primária de saúde, ausência do uso de protocolos de pré-natal atualizados e falta de conhecimento para a realização do diagnóstico precoce e preciso da DPP.


Objective: To analyze the profile of professionals working in Primary Health Care (PHC) in the care of patients with Postpartum Depression (PPD) and the main difficulties in carrying out an early diagnosis.Method:Through an observational, applied, exploratory research, descriptive quantitative approach, with a cross-sectional design, the information collected through a questionnaire sent through the Google Forms application, to PHC professionals, in the region of the Regional Department of Health of Araçatuba (DRSII), for the elaboration of effective strategies, aiming at the prevention, diagnosis and treatment of this pathology. Result: It is observed that 22.62% of Community Health Agents (ACS) remain in PHC for 3 years or more, while 3.16% of physicians, from 1 to 3 years. Of the professionals, 93.2% work with prenatal protocols, and of these, only 33% are updated annually. Evaluating prenatal consultations, 44.44% of pregnant women with more than 5 consultations return to the Basic Health Unit (UBS) in the puerperium. Among all professional categories, 73.00% of physicians feel able to provide guidance on PPD. About 85% of the survey participants correctly identified the symptoms of the disease and 18% the period of early diagnosis. Individual consultations and guidance for pregnant women are carried out in 14.48% of the practices developed by professionals. Furthermore, 91% of professionals have never received training on the subject. Conclusion: It was observed in the study that there is a high turnover of primary health care professionals, absence of the use of updated prenatal protocols and lack of knowledge to carry out an early and accurate diagnosis of PPD

3.
Front Hum Neurosci ; 16: 870103, 2022.
Article in English | MEDLINE | ID: mdl-35992955

ABSTRACT

Therapeutic strategies capable of inducing and enhancing prosthesis embodiment are a key point for better adaptation to and acceptance of prosthetic limbs. In this study, we developed a training protocol using an EMG-based human-machine interface (HMI) that was applied in the preprosthetic rehabilitation phase of people with amputation. This is a case series with the objective of evaluating the induction and enhancement of the embodiment of a virtual prosthesis. Six men and a woman with unilateral transfemoral traumatic amputation without previous use of prostheses participated in the study. Participants performed a training protocol with the EMG-based HMI, composed of six sessions held twice a week, each lasting 30 mins. This system consisted of myoelectric control of the movements of a virtual prosthesis immersed in a 3D virtual environment. Additionally, vibrotactile stimuli were provided on the participant's back corresponding to the movements performed. Embodiment was investigated from the following set of measurements: skin conductance response (affective measurement), crossmodal congruency effect (spatial perception measurement), ability to control the virtual prosthesis (motor measurement), and reports before and after the training. The increase in the skin conductance response in conditions where the virtual prosthesis was threatened, recalibration of the peripersonal space perception identified by the crossmodal congruency effect, ability to control the virtual prosthesis, and participant reports consistently showed the induction and enhancement of virtual prosthesis embodiment. Therefore, this protocol using EMG-based HMI was shown to be a viable option to achieve and enhance the embodiment of a virtual prosthetic limb.

4.
Rural Remote Health ; 21(3): 6568, 2021 09.
Article in English | MEDLINE | ID: mdl-34482699

ABSTRACT

INTRODUCTION: While Brazil has achieved a significantly higher coverage through primary care and improved health outcomes through the Family Health Strategy, rural areas still have worse indicators and several barriers to access primary healthcare units, which sometimes condition users to seek alternative answers outside the formal circuit. From the framework of medical anthropology, Arthur Kleinman indicates that the sociohistorical-cultural context also determines the search for health care, and not only by the conditions of access and availability of formal services. From this perspective, each health system would consist of three interrelated subsystems: the informal, the popular, and the professional subsystem, widely used in an overlapping and non-exclusive way, interacting according to an individual's needs. This study analyzes how informal and popular health subsystems are featured in a remote rural municipality in the Brazilian Amazon region. METHODS: This is a single, exploratory, qualitative case study conducted in the remote rural municipality of Assis Brasil, in the state of Acre, Brazil. Data were collected with onsite visits to the municipality through semi-structured interviews with users, managers, and health professionals. Data thematic analysis was guided by categories inspired by Arthur Kleinman's framework and emerging in the field, focusing on the dimensions of the informal and popular subsystems. RESULTS: In the informal system, family, friends, and community seem to have broader roles in the field of care, underpinning the social support network to allow using health services. Also included in the informal system are NGOs, armed forces, and the church, acting complementarily to the Unified Health System (Sistema Único de Saúde). Two patterns of relationship with the popular system were identified: in complementarity with the formal system, with the specific or longitudinal use of its resources, and replacing formal practices. In the popular system, secular healing agents such as shamans, healers, prayers, and midwives, and the use of medicinal herbs and other natural resources, are part of the care scenario, especially among the traditional populations of the territory. Popular resources are sometimes activated mainly due to geographic and economic barriers, which prevent timely access to health services and contribute to the deterioration of conditions. The level of resistance of health professionals varied according to the substitutive or complementary nature that such care assumes in users' therapeutic trajectories. CONCLUSION: Complex policies and processes such as health care have been implemented nationwide, in general, with a poor understanding of the context and culture of rural communities. In this sense, understanding the dynamics between the subsystems can help identify more appropriate and sensitive strategies for the organization of health services, which respond to the population's needs from a broader perspective, especially in the context of rurality.


Subject(s)
Health Services Accessibility , Rural Population , Brazil , Health Personnel , Humans , Primary Health Care
5.
An Acad Bras Cienc ; 93(1): e20191338, 2021.
Article in English | MEDLINE | ID: mdl-33825791

ABSTRACT

To achieve a better SDI system design, the emitters' hydraulic characteristics and the flowrate uniformity along lateral lines under backpressure influence must be known. The objective of this study was to evaluate the effect of backpressure on the maximum length of irrigation laterals using two types of emitters (pressure-compensating and nonpressure-compensating) in different situations. Data from a field experiment combined with information obtained from a previously published paper was used, that tested driplines hydraulics behavior influenced by backpressure. The lateral dripline design technique based on statistical approach developed by Anyoji & Wu 1987 was used to calculate the maximum length. The variables that most influenced the maximum length of the laterals were the terrain slope and permissible flowrate variation. For nonpressure-compensating emitters, the maximum length of the irrigation laterals is up to 5% greater in subsurface applications than in surface applications. For pressure-compensating emitters operating under the influence of backpressure, there is an increase in the discharge exponent due to the small difference in flowrate between the surface and subsurface conditions, which also increases the influence of pressure variations on the flowrate thus, the surface laterals are up to 8% longer than the subsurface ones.

6.
Mol Cell Endocrinol ; 521: 111116, 2021 02 05.
Article in English | MEDLINE | ID: mdl-33321116

ABSTRACT

Alzheimer's disease (AD) is a neurodegenerative disorder and the major cause of dementia. According to predictions of the World Health Organization, more than 150 million people worldwide will suffer from dementia by 2050. An increasing number of studies have associated AD with type 2 diabetes mellitus (T2DM), since most of the features found in T2DM are also observed in AD, such as insulin resistance and glucose intolerance. In this sense, some bile acids have emerged as new therapeutic targets to treat AD and metabolic disorders. The taurine conjugated bile acid, tauroursodeoxycholic (TUDCA), reduces amyloid oligomer accumulation and improves cognition in APP/PS1 mice model of AD, and also improves glucose-insulin homeostasis in obese and type 2 diabetic mice. Herein, we investigated the effect of TUDCA upon glucose metabolism in streptozotocin-induced AD mice model (Stz). The Stz mice that received 300 mg/kg TUDCA during 10 days (Stz + TUDCA), showed improvement in glucose tolerance and insulin sensitivity, reduced fasted and fed glycemia, increased islet mass and ß-cell area, as well as increased glucose-stimulated insulin secretion, compared with Stz mice that received only PBS. Stz + TUDCA mice also displayed lower neuroinflammation, reduced protein content of amyloid oligomer in the hippocampus, improved memory test and increased protein content of insulin receptor ß-subunit in the hippocampus. In conclusion, TUDCA treatment enhanced glucose homeostasis in the streptozotocin-induced Alzheimer's disease mice model, pointing this bile acid as a good strategy to counteract glucose homeostasis disturbance in AD pathology.


Subject(s)
Alzheimer Disease/drug therapy , Amyloid beta-Peptides/metabolism , Bile Acids and Salts/metabolism , Blood Glucose/drug effects , Hippocampus/drug effects , Insulin-Secreting Cells/drug effects , Taurochenodeoxycholic Acid/pharmacology , Alzheimer Disease/chemically induced , Alzheimer Disease/metabolism , Alzheimer Disease/pathology , Animals , Cytokines/genetics , Cytokines/metabolism , Disease Models, Animal , Glucose/metabolism , Glucose/pharmacology , Hippocampus/metabolism , Hippocampus/pathology , Inflammation/drug therapy , Insulin/blood , Insulin/metabolism , Insulin-Secreting Cells/metabolism , Insulin-Secreting Cells/pathology , Male , Memory and Learning Tests , Mice , Mice, Inbred C57BL , Real-Time Polymerase Chain Reaction , Streptozocin/toxicity , Taurochenodeoxycholic Acid/administration & dosage
7.
Saúde debate ; 45(131): 998-1016, 2021. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1352230

ABSTRACT

RESUMO O objetivo do artigo foi caracterizar a organização da Atenção Primária à Saúde (APS) e suas interfaces com os demais serviços da rede assistencial em um Município Rural Remoto (MRR). Foi realizado estudo de caso único em Assis Brasil (AC), por meio de entrevistas com usuários, gestores e profissionais de saúde. Os resultados indicaram distribuição desigual de estabelecimentos de saúde com áreas descobertas; dificuldades de acesso por condições climáticas; barreiras econômicas para custeio de transporte; promoção de ações itinerantes na zona rural; descontinuidade e insuficiência de medicamentos; dificuldades para a fixação de profissionais; escassez de recursos tecnológicos; falta de acesso à internet; necessidade de adaptação cultural; concentração de serviços especializados do SUS na capital. Foram identificados esforços da gestão local para manutenção da Estratégia Saúde da Família (ESF) e adequação dos processos de trabalho para atendimento ao grande fluxo de demanda espontânea, estrangeiros e população indígena. Argumenta-se que o MRR e suas populações somam vulnerabilidades econômicas, sociais e de acesso aos serviços de saúde, parcialmente atendidas pelas políticas nacionais, e que o ente municipal, sem o suficiente apoio e aporte de recursos estadual e federal, mantém arranjos possíveis para a provisão de APS, nem sempre afeitos aos princípios abrangentes da ESF.


ABSTRACT The aim of the article was to characterize the organization of Primary Health Care (APS) and its interfaces with other services in the healthcare network in a Remote Rural Municipality (MRR). A single case study was carried out in Assis Brasil (AC), through interviews with users, managers and health professionals. The results indicated an unequal distribution of health facilities with uncovered areas; access difficulties due to weather conditions; economic barriers to costing transport; promotion of itinerant actions in rural areas; discontinuity and insufficiency of medications; difficulties in retaining professionals; scarcity of technological resources; lack of internet access; need for cultural adaptation; concentration of specialized services of the Unified Health System (SUS) in the capital. Local management efforts were identified to maintain the Family Health Strategy (ESF) and the adequacy of work processes to meet the large flow of spontaneous demand, foreigners and the indigenous population. It is argued that the MRR and its populations add economic, social and access to health services vulnerabilities, partially covered by national policies, and that the municipal entity, without sufficient support and allocation of state and federal resources, maintains possible arrangements for the provision of APS, not always bound by the comprehensive principles of the ESF.

10.
Rev. adm. pública (Online) ; 54(4): 614-634, jul.-ago. 2020. graf
Article in Portuguese | LILACS | ID: biblio-1136994

ABSTRACT

Resumo Como a crise em saúde pública causada pela pandemia da COVID-19 ajuda a compreender o funcionamento do Sistema Nacional de Proteção e Defesa Civil (SINPDEC) nas fases de preparação e resposta a desastres em saúde no Brasil? A resposta a essa pergunta se dará por meio do seguinte objetivo geral: compreender o funcionamento do SINPDEC no enfrentamento à COVID-19, com ênfase na atuação do Ministério da Saúde (MS), órgão gestor de combate às ameaças em saúde. Para tanto, três objetivos específicos serão explorados: caracterizar a (doença) COVID-19 como evento em saúde pública com potencial causador de desastre, situar os conceitos de preparação e resposta na literatura de governança de desastres e identificar previsões legais e funcionamento da gestão de desastres no Brasil. A despeito das tensões decisórias no âmbito político, a burocracia profissional brasileira conseguiu garantir a ativação do sistema de governança de desastres relativa às fases de preparação e resposta. Contudo, sua ativação não foi suficiente para aplacar a crise, cujo agravamento expõe falhas nas fases de prevenção e mitigação de desastres, bem como a falta de uma resposta ao desastre em âmbito federativo.


Resumen ¿Cómo la crisis de salud pública causada por la pandemia de COVID-19 ayuda a comprender el funcionamiento del Sistema Nacional de Protección y Defensa Civil (SINPDEC) en las fases de preparación y respuesta a desastres de salud en Brasil? La respuesta a esta pregunta se dará mediante el siguiente objetivo general de investigación: comprender el funcionamiento del SINPDEC en el afrontamiento a la COVID-19, con énfasis en el trabajo del Ministerio de Salud, organismo gestor del combate contra las amenazas a la salud. Con este fin, se explorarán tres objetivos específicos: caracterizar la COVID-19 como un evento de salud pública con el potencial de causar un desastre; situar los conceptos de preparación y respuesta en la literatura sobre gestión de desastres; e identificar las predicciones legales y el funcionamiento de la gestión de desastres en Brasil. Se argumenta que, a pesar de las tensiones políticas en la toma de decisiones, la burocracia profesional brasileña logró garantizar la activación del sistema de gestión de desastres relacionado con las fases de preparación y respuesta. Sin embargo, su activación no fue suficiente para aplacar la crisis, cuyo empeoramiento expone fallas en las fases de prevención y mitigación de desastres, así como la falta ‒e importancia‒ de una respuesta al desastre en ámbito federativo.


Abstract This article aims to understand how the National System of Protection and Civil Defense functions in response to COVID-19, with emphasis on the work of the Ministry of Health, which is the body responsible for tackling health threats. Three specific objectives were used: the first characterizes COVID-19 as a public health event that can represent a disaster; the second situates the concepts of preparedness and response in the disaster governance literature; the third identifies the jurisprudence and the functioning of disaster management in Brazil. The findings show that, despite the political decision-making tensions, the Brazilian professional bureaucracy managed to guarantee the activation of the disaster governance system related to the preparation and response phases. However, its activation was not enough to allay the crisis. The severity of the pandemic exposed flaws in the phases of disaster prevention and mitigation, as well as the lack of coordinated government response.


Subject(s)
Humans , Male , Female , Public Health , Civil Defense , Coronavirus Infections , Disaster Medicine , Health Governance
11.
Rev. adm. pública (Online) ; 54(1): 142-161, jan.-fev. 2020. graf
Article in Portuguese | LILACS | ID: biblio-1092379

ABSTRACT

Resumo Como as diversas iniciativas legislativas sobre acesso à informação no Brasil culminaram na aprovação da Lei n. 12.527 (Lei de Acesso à Informação [LAI], 2011)? A partir da abordagem de coalizões de defesa (advocacy coalitions framework - ACF), este artigo analisa a formação de agenda e a atuação de diferentes coalizões, por meio da análise de amplo clipping de notícias, entrevistas, leis e documentos publicados entre 2001 e 2012. Foram identificadas duas coalizões: a) uma a favor de mudanças na legislação, composta por setores do Poder Executivo, do Poder Legislativo, da mídia e da sociedade civil; e b) outra a favor da manutenção de regras restritivas de acesso à informação, composta por Forças Armadas, Itamaraty e Comissão de Relações Exteriores e Defesa Nacional (CRE) do Senado. Identificou-se, também, a superposição de dois subsistemas de políticas públicas: a) o de transparência; e b) o de reconciliação. Este último monopolizou o debate público sobre o tema, contribuindo para a morosidade na aprovação da LAI (2011). O Itamaraty também emerge como autor de forte lobby contra modificações nas regras de classificação de documentos, por motivos ainda a explorar em profundidade.


Resumen ¿Cómo las diversas iniciativas legislativas sobre acceso a la información en Brasil culminaron en la aprobación de la ley n.o 12.527 [Ley de Acceso a la Información (LAI), 2011)]? Utilizando el marco de coaliciones de causa (advocacy coalitions framework - ACF), este artículo analiza la formación de agenda y la actuación de diferentes coaliciones por medio del análisis de amplio clipping de noticias, entrevistas, leyes y documentos entre 2001 y 2012. Se identificaron dos coaliciones: una a favor de cambios en la legislación, compuesta por sectores del Ejecutivo, Legislativo, medios de comunicación y sociedad civil; y otra a favor del mantenimiento de reglas restrictivas de acceso a la información, compuesta por las Fuerzas Armadas, Itamaraty (Ministerio de Relaciones Exteriores de Brasil) y la Comisión de Relaciones Exteriores y Defensa Nacional del Senado. Se identificó también la superposición de dos subsistemas de políticas públicas, el de transparencia y el de reconciliación. Este último monopolizó el debate público sobre el tema, contribuyendo a la morosidad en la aprobación de la Ley de Acceso a la Información. El Itamaraty también emerge como autor de fuerte lobby contra modificaciones en las reglas de clasificación de documentos, por motivaciones aún por investigar.


Abstract How did the various legislative initiatives on access to information in Brazil culminate in the 12.527/11 federal law? Using the Advocacy Coalition Framework, this article analyzes the agenda setting and strategies of different coalitions, analyzing a broad array of news, interviews, laws, and official documents between 2001 and 2012. Two coalitions were identified: one in favor of changes in legislation, comprised of sectors of the Executive, legislative, the media and civil society; and another in favor of the maintenance of restrictive rules of access to information, composed of Armed Forces, Itamaraty (Brazil's diplomatic corps) and the Senate's Legislative Commission on Defense and Foreign Affairs. The article also identifies an overlap of two public policy subsystems: the transparency subsystem and the reconciliation one. The latter monopolized the public debate on the subject, contributing to the slowness in approving a transparency law. Itamaraty also emerges as the author of a strong lobby against changes in the rules for document classification, for reasons yet to be studied.


Subject(s)
Humans , Male , Female , Policy Making , Public Policy , Access to Information , Executive , Legislative , Civil Society
12.
Foot (Edinb) ; 40: 98-104, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31229793

ABSTRACT

Ankle sprain in plantarflexion and inversion is one of the most common injuries occurring in daily activities and sports. Although acute symptoms may resolve quickly, many individuals have reported persistent pain and instability. Thus, understanding the factors that contribute to the occurrence of this type of injury is extremely important. Although sprains are multifactorial, a relationship can be established between sprain and fatigue. Therefore, the present study examined the latency and intensity of activation of the peroneus longus and brevis muscles under conditions of fatigue. Twenty-three women participated in the study, including 12 with functional instability of the ankle and 11 without a history of sprain. To induce fatigue, the volunteers maintained the force of eversion and plantarflexion at 70% of the maximum voluntary isometric contraction for as long as possible until a 10% decline in the rated force occurred. Ten simulations of ankle sprains were performed before and after fatigue at random for each side, with simultaneous recordings of the electromyographic signals, using a simulator platform for inversion sprain and plantarflexion. As a result, after fatigue, no change in latency was observed. However, a reduction in the intensity of contraction of the muscles analyzed in both groups was observed. Neuromuscular control was concluded to be compromised in situations of fatigue, while differences in muscle behavior were not observed between stable and unstable ankles.


Subject(s)
Ankle Injuries/physiopathology , Joint Instability/physiopathology , Muscle Fatigue/physiology , Sprains and Strains/physiopathology , Adult , Female , Humans , Surveys and Questionnaires
13.
Spec Care Dentist ; 38(2): 95-98, 2018 Mar.
Article in English | MEDLINE | ID: mdl-29509314

ABSTRACT

AIM: To report a case of a pediatric patient carrier of myelodysplastic syndrome (MDS) with severe oral infectious disease, in which antimicrobial photodynamic therapy (aPDT) was used as a therapeutic choice to support systemic treatment. METHODS AND RESULTS: This case report refers to a 1-year-old male patient with MDS and hospitalized for investigation and treatment of complications at a Pediatric Oncology and Hematology Center in Recife/PE, Brazil. The intraoral examination revealed a violaceous lesion surrounding the lower incisor teeth, which progressed with alteration of color to milky yellowish white, compromising the entire lower gingival border, leading to tooth mobility and consequent loss of teeth 71 and 81. The patient was treated under systemic antimicrobial therapy and aPDT was also performed, using a photosensitizing agent (methylene blue, 0.01%) and a low-intensity laser in the visible red spectrum. Oral clinical improvement was observed, but the patient died after 45 days of hospitalization in the Pediatric ICU due to other systemic complications. CONCLUSION: MDS may present limiting oral repercussions interfering in patients' quality of life. The aPDT is presented as an adjuvant therapeutic modality in oral infections with satisfactory results.


Subject(s)
Bacterial Infections/drug therapy , Bacterial Infections/microbiology , Gingival Diseases/drug therapy , Gingival Diseases/microbiology , Methylene Blue/therapeutic use , Myelodysplastic Syndromes/complications , Photochemotherapy/methods , Photosensitizing Agents/therapeutic use , Anti-Bacterial Agents/therapeutic use , Fatal Outcome , Humans , Infant , Male
14.
Methods Mol Biol ; 1730: 305-313, 2018.
Article in English | MEDLINE | ID: mdl-29363084

ABSTRACT

Amino acids play an important role in clinical analysis. Capillary electrophoresis-electrospray ionization-mass spectrometry (CE-ESI-MS) has proven to possess several characteristics that make it a powerful and useful tool for the analysis of amino acids in clinical studies. Here we present a method for the separation and quantitative analysis of 27 amino acids in urine based on CE-ESI-MS. The method presents an improved resolution between the isomers Leu, Ile, and aIle, in comparison to other CE-ESI-MS methods in the literature. This method is fast, selective, and simple and has improved sensitivity by applying a pH-mediated stacking strategy, showing that it can be successfully used for amino acid analysis and probably for other small cationic metabolites.


Subject(s)
Amino Acids/urine , Electrophoresis, Capillary/methods , Spectrometry, Mass, Electrospray Ionization/methods , Humans , Hydrogen-Ion Concentration , Isoleucine/urine , Leucine/urine
15.
Adv Exp Med Biol ; 965: 99-141, 2017.
Article in English | MEDLINE | ID: mdl-28132178

ABSTRACT

This chapter focuses on the important contribution of CE-MS in metabolomics, describing the nature of CE-MS coupling and the technical improvements that have led to the interfaces used in modern instrumentation. Moreover, it will discourse how the variety of electrolyte compositions and additives, which has conferred CE the exceptional selectivity of its multiple separation modes, has been handled to allow interfacing with MS without compromising ionization efficiency and the spectrometer integrity. Finally, the methodologies of CE-MS in current use for metabolomics will be discussed in detail. To verify the scope of CE-MS in clinical metabolomics, a myriad of representative applications has been compiled.


Subject(s)
Electrophoresis, Capillary/methods , Mass Spectrometry/methods , Metabolomics/methods , Humans
16.
Neotrop. ichthyol ; 15(2): e160127, 2017. tab, graf
Article in English | LILACS-Express | LILACS, VETINDEX | ID: biblio-1485605

ABSTRACT

The reproductive potential of red porgy in coastal waters of Buenos Aires Province (Argentina) and Uruguay (34º-39ºS) was studied by means of a macroscopic and histological analysis of the gonads. Length and age at first maturity were determined, and fecundity, spawning frequency and egg quality were estimated. The spawning season extended from spring through summer between October and January with a peak of spawning in December. Length and age at maturity for sexes combined was 24.5 cm TL and 1.54 years, respectively. Batch fecundity ranged from 6,974 (25 cm TL) to 110,725 (39 cm TL) hydrated oocytes and showed significant linear relationships with total length and ovary-free weight. Relative fecundity ranged from 16 to 172 oocytes per female gram (ovary free). Spawning frequency was 58.5% during January 2011, indicating that females spawned once every 1-2 days at the peak of the spawning season. The life history of red porgy in Argentina and Uruguay was characterized by a young age at first maturity and partial, almost daily, spawning in a bounded time period, a life history strategy that would facilitate population expansion or colonization of new areas, and high population recovery rates or growth (r).


Se analizó el potencial reproductivo del besugo en aguas costeras de la provincia de Buenos Aires (Argentina) y Uruguay sobre la base del análisis macroscópico e histológico de las gónadas. Se determinó la talla y edad de primera madurez sexual y se estimaron la fecundidad, frecuencia de puesta y calidad ovocitaria. Se pudo establecer que la actividad reproductiva del besugo acontece durante primavera-verano, entre octubre y enero, con un pico de desove principal en diciembre. La estimación de la talla y edad de primera madurez para ambos sexos fue de 24,5 cm LT y 1,54 años respectivamente. La fecundidad parcial presentó un ajuste lineal con la talla y el peso de la hembra y varió entre 6.974 (25 cm LT) y 110.725 (39 cm LT) ovocitos hidratados. La fecundidad relativa osciló entre 16 y 172 ovocitos hidratados g-1. Los valores de ambos parámetros presentaron diferencias interanuales. La frecuencia reproductiva, determinada mediante el uso de los porcentajes de hembras con folículos post ovulatorios, fue de 58,5% durante enero de 2011, lo que indica que los desoves ocurren una vez cada 1-2 días. Los resultados hallados indican que el besugo se caracteriza por presentar una edad de primera madurez baja (entre 1 y 2 años), desoves parciales casi diarios pero en un período de tiempo acotado. Este tipo de estrategia podría explicar tasas de recuperación o de crecimiento poblacional (r) altas como así también la ampliación de su área de distribución o la colonización de nuevas áreas.

17.
Neotrop. ichthyol ; 15(2): e160127, 2017. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-955178

ABSTRACT

The reproductive potential of red porgy in coastal waters of Buenos Aires Province (Argentina) and Uruguay (34º-39ºS) was studied by means of a macroscopic and histological analysis of the gonads. Length and age at first maturity were determined, and fecundity, spawning frequency and egg quality were estimated. The spawning season extended from spring through summer between October and January with a peak of spawning in December. Length and age at maturity for sexes combined was 24.5 cm TL and 1.54 years, respectively. Batch fecundity ranged from 6,974 (25 cm TL) to 110,725 (39 cm TL) hydrated oocytes and showed significant linear relationships with total length and ovary-free weight. Relative fecundity ranged from 16 to 172 oocytes per female gram (ovary free). Spawning frequency was 58.5% during January 2011, indicating that females spawned once every 1-2 days at the peak of the spawning season. The life history of red porgy in Argentina and Uruguay was characterized by a young age at first maturity and partial, almost daily, spawning in a bounded time period, a life history strategy that would facilitate population expansion or colonization of new areas, and high population recovery rates or growth (r).(AU)


Se analizó el potencial reproductivo del besugo en aguas costeras de la provincia de Buenos Aires (Argentina) y Uruguay sobre la base del análisis macroscópico e histológico de las gónadas. Se determinó la talla y edad de primera madurez sexual y se estimaron la fecundidad, frecuencia de puesta y calidad ovocitaria. Se pudo establecer que la actividad reproductiva del besugo acontece durante primavera-verano, entre octubre y enero, con un pico de desove principal en diciembre. La estimación de la talla y edad de primera madurez para ambos sexos fue de 24,5 cm LT y 1,54 años respectivamente. La fecundidad parcial presentó un ajuste lineal con la talla y el peso de la hembra y varió entre 6.974 (25 cm LT) y 110.725 (39 cm LT) ovocitos hidratados. La fecundidad relativa osciló entre 16 y 172 ovocitos hidratados g-1. Los valores de ambos parámetros presentaron diferencias interanuales. La frecuencia reproductiva, determinada mediante el uso de los porcentajes de hembras con folículos post ovulatorios, fue de 58,5% durante enero de 2011, lo que indica que los desoves ocurren una vez cada 1-2 días. Los resultados hallados indican que el besugo se caracteriza por presentar una edad de primera madurez baja (entre 1 y 2 años), desoves parciales casi diarios pero en un período de tiempo acotado. Este tipo de estrategia podría explicar tasas de recuperación o de crecimiento poblacional (r) altas como así también la ampliación de su área de distribución o la colonización de nuevas áreas.(AU)


Subject(s)
Animals , Perciformes/anatomy & histology , Ecosystem , Reproductive Behavior , Fecundity Rate
18.
São Paulo; s.n; s.n; 2017. 146p tab, graf.
Thesis in Portuguese | LILACS | ID: biblio-876618

ABSTRACT

O refluxo vésico-ureteral (RVU) é uma das condições urológicas comumente diagnosticada entre crianças. Altos graus dessa condição podem causar cicatrização renal, insuficiência renal e hipertensão arterial. A uretrocistografia miccional é o método mais comumente utilizado para o diagnóstico, no entanto, esse procedimento envolve sedação, cateterismo vesical e expõe a criança a uma quantidade significativa de radiação. A investigação metabolômica pode fornecer novos entendimentos sobre a doença e visa a descoberta de metabólitos específicos associados a ela. Assim, existe um potencial considerável para a implementação de perfil metabólico em análises clínicas. Dessa forma, buscou-se estabelecer uma alternativa não invasiva para identificar crianças com o RVU através da metabolômica. Para a investigação metabolômica alvo um método por eletroforese capilar acoplada ao espectrômetro de massas (CE-MS) com analisador to tipo ion trap foi desenvolvido e validado para a determinação de 27 aminoácidos em urina. Os parâmetros experimentais relacionados às configurações da interface CE-MS, eletrólito (BGE) e espectrômetro de de massas (MS) foram otimizados, proporcionando uma boa separação dos 27 aminoácidos, incluindo os isômeros L-leucina, L-isoleucina e L-alloisoleucina, em menos de 30 min. O líquido auxiliar (SHL) foi composto de 0,5% (v/v) ácido fórmico em 60% (v/v) água/metanol à uma vazão de 5 µL min-1. O BGE consistiu de 0,80 mol L-1 de ácido fórmico e 15% (v/v) de metanol. Um procedimento de stacking por pH foi implementado para aumentar a detectabilidade (uma solução de NH4OH a 12,5% (v/v) foi injetada a 0,5 psi/9 s antes das amostras). O método foi validado de acordo com os protocolos FDA e ICH, exibindo parâmetros aceitáveis. A quantificação bem sucedida dos aminoácidos em amostras de urina de um estudo piloto do RVU foi alcançada. A avaliação estatística dos resultados mostrou que alguns dos aminoácidos avaliados podem carregar informações que possibilitam discriminar as amostras de urina entre os grupos teste e controle. Para a análise metabolômica global urinária, métodos por RPLC-MS e HILIC-MS foram otimizados. Cinco colunas com diferentes propriedades foram investigadas para RPLC e quatro colunas para HILIC; adicionalmente, foram investigados a influência dos aditivos e pH da fase móvel. As condições ótimas foram determinadas avaliando o formato de pico, a relação sinal-ruído, o tempo de retenção, o número de molecular features detectados e sua distribuição durante o gradiente de eluição. A melhor condição obtida para RPLC utiliza a coluna CSH C18 e fase móvel composta por 0,1% (v/v) ácido fórmico em água (A) e 0,1% (v/v) ácido fórmico em acetonitrila (B). Para HILIC, o melhor desempenho foi obtido com a coluna zwitteriônica ZIC-HILIC e fase móvel composta por 10 mmol L-1 acetato de amônio pH 6,8 (B) e 95% (v/v) acetonitrila e 5% 200 mmol L-1 acetato de amônio pH 6,8 (A). As amostras de urina dos grupos controle e teste foram submetidas à análise metabolômica global por RPLC-MS usando o método otimizado e por CESI-MS. Os resultados indicaram que diversas rotas metabólicas podem ter sido alteradas pelo RVU. Alteração dos níveis de carnitinas e acilcarnitinas, aminoácidos e derivados, purinas e outros foi observada. Ainda, a presença de acilcarnitinas na urina podem indicar danos mitocondriais e a diminuição de triptofano e aumento do ácido quinurênico indicam uma alteração no metabolismo do triptofano


Vesicoureteral reflux (VUR) is one of the most commonly urologic conditions diagnosed among children. A high degree of this condition can cause kidney scarring, kidney failure and high blood pressure. Voiding cystourethrography is the standard method for diagnosis; however, this procedure involves sedation, bladder catheterization and exposes the child to a significant amount of radiation. Metabolomics has provided new insights about the disease and aims to discover specific metabolites associated with it. Thus, there is a considerable potential for the implementation of metabolic profile in clinical analyses. Thus, we attempted to establish a noninvasive alternative to identify children with VUR through metabolomics approach. For target metabolomics, a CE-MS method was developed and validated for the separation and quantitative analysis of 27 amino acids in urine. Experimental parameters related to the CE-MS interface (based on co-axial sheath liquid, SHL), background electrolyte (BGE) and mass spectrometer (MS) settings were optimized providing a good separation of 27 amino acids, including the isomers L-leucine, L-isoleucine and L-alloisoleucine, in less than 30 min. The SHL was composed of 0.50% (v/v) formic acid in 60% (v/v) methanol-water delivered at a flow rate of 5 µL min-1. The BGE consisted of 0.80 mol L-1 formic acid and 15% (v/v) methanol. A pH stacking procedure was implemented to enhance sensitivity (a 12.5% (v/v) NH4OH solution was injected at 0.5 psi/9 s prior to samples). The proposed method was thoroughly validated according to FDA and ICH protocols exhibiting acceptable parameters. A successful quantification of amino acids in urine samples from the VUR cohort was achieved. The statistical evaluation of the results showed that some of the amino acids may carry information for the discrimination of the urine samples between the test and control groups. For untargeted metabolomics analysis, methods by RPLC-MS and HILIC-MS were optimized. Five columns with different properties were investigated for RPLC and four columns for HILIC; additionally, the influence of additives and pH of the mobile phase were investigated. The optimum conditions were determined assessing the peak shape, signal-to-noise ratio, retention time, number of molecular features detected and their distribution during the elution gradient. The best condition obtained for RPLC uses CSH C18 column and mobile phase composed by 0.1% (v/v) formic acid in water (A) and 0.1% (v/v) formic acid in acetonitrile (B). For HILIC, the best performance was obtained with the zwitterionic ZIC-HILIC column and mobile phase composed by 10 mmol L-1 ammonium acetate pH 6.8 (B) and 95% (v/v) acetonitrile and 5% (v/v) 200 mmol L-1 ammonium acetate pH 6.8 (A). Urine samples from the control and test groups were submitted to global metabolomics analysis by RPLC-MS using the optimized method and by CESI-MS. The results indicated that several metabolic pathways may have been altered by VUR. Changes of carnitine and acylcarnitine levels, amino acids and derivatives, purines and others was observed. Furthermore, the presence of acylcarnitines in the urine may indicate mitochondrial damage and the decrease of tryptophan and increase of the kynurenic acid indicate a change in the metabolism of tryptophan


Subject(s)
Urine/chemistry , Vesico-Ureteral Reflux/physiopathology , Metabolomics/instrumentation , Mass Spectrometry/methods , Electrophoresis, Capillary/methods
19.
Exp Toxicol Pathol ; 68(6): 307-14, 2016 Jun.
Article in English | MEDLINE | ID: mdl-27020045

ABSTRACT

Exhumation is required for the investigation of suspicions deaths when a body is buried and is usually performed under court order. Exhumation of animals is not a routine practice in forensic pathology. In this study, 30 male 70-day-old Wistar rats were experimentally exposed to the carbamate pesticides aldicarb and carbofuran. Toxicological, macroscopic and microscopic examinations were performed. Groups of 3 animals (2 exposed and 1 control) were evaluated at 24h, 3days, 5days, 7days and 10days post-mortem. In histopathological examination, the brain, liver, lungs and kidneys were assessed, and for toxicological analysis, the gastric contents, liver, vitreous humor, skeletal muscle and larvae (when available) were collected. The pesticides were detected by HPLC and quantified in the analyzed matrices, and a possible delay in tissue putrefaction due to the pesticides was observed. This study has revealed that it is possible to exhume animals for investigations of possible poisoning by carbamates and has demonstrated that the exhumation of an animal in a suspected case of poisoning should not be ruled out. The increasing demand for investigations of suspicious animal deaths, e.g., in cases of poisoning, will likely lead to an increase in the use of this type of procedure in veterinary pathology.


Subject(s)
Aldicarb/poisoning , Carbofuran/poisoning , Exhumation/methods , Insecticides/poisoning , Neurotoxicity Syndromes/veterinary , Aldicarb/analysis , Animals , Carbofuran/analysis , Chromatography, High Pressure Liquid , Insecticides/analysis , Male , Rats , Rats, Wistar
20.
Electrophoresis ; 37(7-8): 1039-47, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26826549

ABSTRACT

A CE-ESI-MS method was developed and validated for the separation and quantitative analysis of amino acids (AA) in urine. Experimental parameters related to the CE-MS interface, BGE, and mass spectrometer (MS) settings were optimized providing a good separation of 27 AA, including the isomers L-leucine, L-isoleucine, and L-alloisoleucine, in less than 30 min. The sheath liquid was composed by 0.50% formic acid in 60% (v,v) methanol-water delivered at a flow rate of 5 µL/min. The BGE consisted of 0.80 mol/L formic acid at pH 1.96 and 15% methanol. A pH stacking procedure was implemented to enhance sensitivity (a 12.5% NH4 OH solution was injected at 0.5 psi/9 s prior to samples injected at 0.6 psi/20 s). The proposed method was validated according to FDA and ICH protocols exhibiting acceptable parameters. Analytical curves presented coefficients of determination from 0.996 to 0.9997 (with large F statistics and low p-values). LODs and quantification ranged from 0.63 to 29 µmol/L and from 1.9 to 86 µmol/L, respectively. Practical repeatability was obtained for all AA with coefficients of variation better than 0.55% CV (migration time) and 1.7% CV (peak area ratios; methionine sulfone as internal standard). Recoveries of AA in spiked urine ranged from 92.0 to 123% with few exceptions. Moreover, a successful quantification of AA in pooled control and test urine samples, which compose a vesicoureteral reflux cohort, was achieved showing the potential applicability of the proposed method for targeted metabolomics studies using CE-ESI-MS with an Ion Trap as mass analyzer.


Subject(s)
Amino Acids/urine , Electrophoresis, Capillary/methods , Spectrometry, Mass, Electrospray Ionization/methods , Child , Humans , Limit of Detection , Linear Models , Metabolomics/methods , Reproducibility of Results
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