Effects of Mat Pilates on quality of life, fatigue and body image in head and neck cancer survivors: a randomized clinical trial.

PURPOSE: To analyze the effect of a protocol based on the Mat Pilates method in an intervention group compared to a usual care control group, on quality of life, fatigue and body image of head and neck cancer survivors. METHODS: This was a randomized clinical trial with 30 survivors, allocated into an intervention group and a control group. The intervention group underwent a 12-week Mat Pilates, twice a week, one hour long, and the control group attended two lectures and received weekly follow-up throughout the study period. Data collection took place through individual face-to-face interviews, focusing on assessing the outcomes: quality of life (FACT-H&N); fatigue (FACT-F) and body image (BIS). RESULTS: The Mat Pilates group showed significant improvements compared to the control group in both intragroup and intergroup analyses across the variables: quality of life (in total score (p = 0.007)/(p = 0.003), family well-being (p = 0.001)/(p = 0.008) and functional well-being (p = 0.001)/(p = 0.001)); body image in the total score (p = 0.001)/(p = 0.001) and in the subscales: body image (p = 0.046)/(p = 0.010), body care (p = 0.026)/(p = 0.010) and body touch (p = 0.013)/(p = 0.022); fatigue (p = 0.006)/(p = 0.003). CONCLUSION: Based on these findings, future research could delve deeper into understanding the long-term effects of Mat Pilates interventions on quality of life, body image, and fatigue levels among survivors of head and neck cancer. CLINICAL TRIAL REGISTRATION NUMBER: RBR-3BS8XC6.

Incorporate Mat Pilates programs into rehabilitation protocols for head and neck cancer survivors to potentially improve their quality of life.Emphasize the importance of addressing body image concerns through targeted Mat Pilates exercises, focusing on body awareness and self-care.Provide ongoing support and encouragement to patients participating in Mat Pilates interventions to ensure adherence and maximize therapeutic benefits.

Tuberculosis preventive treatment in children and adolescents: an observational study of secondary data.

OBJECTIVE: To analyze the effectiveness, safety, outcomes, and associated factors of tuberculosis preventive treatment (TPT) in children and adolescents in Paraná, southern Brazil. METHOD: This was an observational cohort study with a retrospective collection of secondary data from the TPT information systems of the state of Paraná from 2009 to 2016, and tuberculosis in Brazil from 2009 to 2018. RESULTS: In total, 1,397 people were included. In 95.4% of the individuals, the indication for TPT was a history of patient-index contact with pulmonary tuberculosis. Isoniazid was used in 99.9% of the cases with TPT, and 87.7% completed the treatment. The TPT protection was 98.7%. Among the 18 people who had TB, 14 (77.8%) became ill after the second year of treatment, and four (22.2%) in the first two years (p < 0.001). Adverse events were reported in 3.3% of cases, most of them were gastrointestinal and medication was discontinued in only 2 (0.1%) patients. No risk factors associated with the illness were observed. CONCLUSIONS: The authors observed a low rate of illness in pragmatics routine conditions in TPT for children and adolescents, especially within the first two years after the end of treatment, with good tolerability and a good percentage of adherence to the treatment. TPT should be encouraged to achieve the goals of the End TB Strategy of the World Health Organization as an essential strategy to reduce the incidence rate of the disease, but studies with new schemes must continue to be carried out in real-life scenarios.

Can mat Pilates and belly dance be effective in improving body image, self-esteem, and sexual function in patients undergoing hormonal treatment for breast cancer? A randomized clinical trial.

The purpose of this study is to examine the effects of a 16-week exercise intervention (mat Pilates or belly dance) on body image, self-esteem and sexual function in breast cancer survivors receiving hormone therapy. Seventy-four breast cancer survivors were randomly allocated into mat Pilates, belly dance, or control group. The physical activity groups received a 16-week intervention, delivered 3 days a week, and 60 min a session. The control group received three education sessions. Data collection occurred at baseline, post-intervention, 6 and 12 months of follow-up with a questionnaire including body image (Body Image After Breast Cancer Questionnaire), self-esteem (Rosenberg Self-Esteem Scale), and sexual function (Female Sexual Function Index) measures. The belly dance group significantly improved body image on limitations scale in the short term and long term, the mat Pilates significantly improved body image on limitations only in the long term, and the control group significantly decreased body image on limitations in the long term. The belly dance group experienced reduced discomfort and pain during sexual relations in the short and long term. All groups showed a significant improvement in self-esteem, but orgasm sub-scale scores declined over time. No adverse events were found for any of the exercise intervention groups. Belly dance seem to be more effective than mat Pilates and control group in improving limitations of body image and sexual discomfort in the short term for breast cancer survivors. ClinicalTrials.gov (NCT03194997) - "Pilates and Dance to Breast Cancer Patients Undergoing Treatment".

Association between menopausal symptoms, sexual function, and sexual activity - a cross-sectional study.

Introduction: To analyse the possible association between menopausal symptoms (somatic-vegetative, psychological, and urogenital) and sexual function with the maintenance of the sexual activity of women in menopause. Material and methods: This cross-sectional study comprised 96 menopausal women aged 40-59 (52.88 ±4.05) years, who presented a positive score to the menopause rating scale (MRS) and had serum levels of follicle stimulating hormone ≥ 25 IU/ml. Participants who used hormone replacement therapy were excluded. Results: It was observed that participants who had an active sexual life had lower medians in the somatic-vegetative (p < 0.001) and psychological symptoms (p = 0.006), as well as in the general score (p = 0.001) at the MRS; in addition, they had better sexual function in 4 domains (p < 0.005): excitement, lubrication, orgasm, and pain, as well as in the total score of the female sexual function index questionnaire (p < 0.005). It was also found that, regardless of the type of menopause (surgical or natural), women who did not engage in sexual activity had a score of 5.651 points more in the MRS (p = 0.004), demonstrating that the practice of sexual activity predicts in 10.4% the variation in the symptom score. Conclusions: Menopausal women who maintain sexual activity had a lower score on the menopause symptom score and better sexual function compared to those who did not perform sexual activity.

Tuberculosis preventive treatment in children and adolescents: an observational study of secondary data

Abstract Objective To analyze the effectiveness, safety, outcomes, and associated factors of tuberculosis preventive treatment (TPT) in children and adolescents in Paraná, southern Brazil. Method This was an observational cohort study with a retrospective collection of secondary data from the TPT information systems of the state of Paraná from 2009 to 2016, and tuberculosis in Brazil from 2009 to 2018. Results In total, 1,397 people were included. In 95.4% of the individuals, the indication for TPT was a history of patient-index contact with pulmonary tuberculosis. Isoniazid was used in 99.9% of the cases with TPT, and 87.7% completed the treatment. The TPT protection was 98.7%. Among the 18 people who had TB, 14 (77.8%) became ill after the second year of treatment, and four (22.2%) in the first two years (p < 0.001). Adverse events were reported in 3.3% of cases, most of them were gastrointestinal and medication was discontinued in only 2 (0.1%) patients. No risk factors associated with the illness were observed. Conclusions The authors observed a low rate of illness in pragmatics routine conditions in TPT for children and adolescents, especially within the first two years after the end of treatment, with good tolerability and a good percentage of adherence to the treatment. TPT should be encouraged to achieve the goals of the End TB Strategy of the World Health Organization as an essential strategy to reduce the incidence rate of the disease, but studies with new schemes must continue to be carried out in real-life scenarios.

Força muscular respiratória e periférica, função pulmonar, ansiedade e depressão em dependentes químicos / Respiratory and peripheral muscular force, pulmonary function, anxiety and depression in chemical dependents

Introdução: Consumo de drogas no Brasil se constitui um problema de saúde pública, pois afeta não só o indivíduo no âmbito psicossocial como na sua saúde física e mental. Objetivo: Avaliar a função pulmonar, força muscular respiratória e periférica, ansiedade e depressão em dependentes químicos internados em um centro de recuperação. Métodos: Estudo transversal, realizado em um centro de recuperação para dependentes químicos. Foi analisada a função pulmonar, força muscular respiratória, força muscular periférica, qualidade de vida e depressão. Resultados: Foram avaliados 20 indivíduos internados, com idade média de 37,15 ± 11,48 anos, sexo masculino, dos quais 55% (n = 11) tinham ensino médio completo, e 27% (n = 6) apresentaram depressão grave e 75% (n = 15) apresentaram ansiedade severa. Observou-se que a correlação da força muscular periférica com a PImáx foi uma correlação moderada (r = 0,53, p < 0,05), e com a PEmáx observamos uma correlação fraca embora significante (r = 0,27, p < 0,05). Os achados com relação à função pulmonar demonstraram uma diminuição do Volume Expiratório Forçado no primeiro segundo (VEF1) em comparação com o previsto (3,60 vs. 4,06 litros, respectivamente), Capacidade Vital Forçada (CVF) (4,28 vs. 4,93 litros). Conclusão: Dependentes químicos apresentam uma redução da função pulmonar e força muscular respiratória e, ainda, aumentos dos índices de ansiedade e depressão.

Introduction: Drug use in Brazil constitutes a public health problem, since it affects not only the individual in the psychosocial environment but also physical and mental health. Objective: To assess lung function, respiratory and peripheral muscle strength, anxiety and depression in chemically dependent patients in a recovery center. Methods: Cross-sectional study, carried out at a recovery center. Pulmonary function, respiratory muscle strength, peripheral muscle strength, quality of life and depression were analyzed. Results: A total of 20 hospitalized individuals, mean age 37.15 ± 11.48 years old, were evaluated, 55% (n = 11) had completed high school, and 27% (n = 6) had major depression and 75% (n = 15) severe anxiety. The correlation of the peripheral muscle strength (PMS) with the PImax showed a moderate correlation (r = 0.53, p <0.05), and with the PEmax we observed a weak but significant correlation (r = 0.27, p <0.05). The findings regarding lung function showed a decrease in forced expiratory volume in one second (FEV1) compared to predicted (3.60 vs. 4.06 liters, respectively), Forced vital capacity (FVC) (4.28 vs. 4.93 liters). Conclusion: In chemical dependents there is a reduction of lung function and respiratory muscle strength, and also, increases in anxiety and depression rates.

Mitral annular velocity measurement with cardiac magnetic resonance imaging using a novel annular tracking algorithm: Validation against echocardiography.

BACKGROUND: Doppler based mitral annular velocities are an integral part of echocardiographic left ventricular diastolic function assessment. Although these measurements can be obtained by phase contrast cardiac magnetic resonance imaging (PC-CMR), this approach has limitations. The aims of this study were to assess the accuracy and reproducibility of a high temporal resolution steady-state free precession (SSFP) cine acquisition coupled with semi-automated mitral annular tracking to measure tissue velocity, and compare to echocardiography as the reference method. METHODS: High temporal resolution (17 ms) 4-chamber cines were acquired in 25 volunteers using retrospective and prospective gating on a 3.0 T magnet. Mitral annular early (e') and late (a') tissue velocities were derived using a novel algorithm to semi-automatically detect the mitral valve insertion points and track its motion. Additionally, PC-CMR was used to measure mitral inflow early diastolic (E) velocity. Those measurements were also obtained using echocardiography based pulsed and tissue Doppler techniques, on the same day. RESULTS: Subjects were on average 34 ±â€¯14 years-old (48% male). The lateral annulus e' measurements had the best agreement with echocardiography with a concordance correlation coefficient (CCC) of 0.76 and 0.75 for prospectively and retrospectively gated cine CMR respectively. There was no significant difference in the lateral annular tissue velocities between echocardiography (13.8 ±â€¯3.7 cm/s) and prospective (13.4 ±â€¯3.7 cm/s) or retrospective (14.0 ±â€¯3.7) acquisitions. Similarly, CMR measurement of E/e' (a surrogate marker for LV filling pressures) using the lateral e' velocity showed moderate agreement with echocardiography (CCC of 0.56 and 0.51 for prospective and retrospective acquisitions respectively) without a significant difference in ratios (5.3 ±â€¯1.6 and 5.0 ±â€¯1.3) compared to echocardiography (5.2 ±â€¯1.4). Intra- and inter-observer reproducibility of the CMR-based annular velocity measurements was good. CONCLUSION: Measurements of mitral annular tissue velocities can be obtained from SSFP 4-chamber cine images using a semi-automated annular tracking algorithm, and demonstrates moderate agreement with echocardiography. The semi-automated method can provide quantitative mitral annular velocity measurements directly from conventional cine images, thereby providing additional clinically relevant information. The accuracy of this method in patients with diastolic dysfunction remains to be determined.

Postoperative Orthognathic Surgery Edema Assessment With and Without Manual Lymphatic Drainage.

OBJECTIVE: To evaluate the effects of manual lymphatic drainage (MLD) on facial edema and pain in patients who underwent orthognathic surgery from patient and professional perspectives and clinical measures. METHODS: It is a randomized double-blind clinical trial, where 30 patients who underwent bimaxillary orthognathic surgery were divided into 2 groups (treatment and placebo). One group (treatment) received MLD from 2nd postoperative day, besides cryotherapy and postoperative medications. The other group (placebo) received cryotherapy, medications, and manual superficial sliding movements as placebo. For edema evaluation, facial measurements with tape and photographs were used. To evaluate patients' perception, visual analog scale for pain and edema was used. In statistical analysis, quantitative data were analyzed using Student t test for normally distributed variables and Mann-Whitney test for non-normal to find differences between groups; 5% significance level was adopted. RESULTS: No difference was found between groups in the amount of maximum developed edema (P = 0.290) nor on what day the edema peak occurred (P = 0.091). However, it was found that treatment group showed faster and greater regression of swelling compared with placebo (P < 0.001). Manual lymphatic drainage was not effective in relieving pain in these patients and nor in edema perception (P = 0.784 and P = 0.946, respectively). CONCLUSION: Manual lymphatic drainage was effective in reducing facial measurements in orthognathic surgery postoperatory. When considering patient's pain and swelling perception, no difference was found between groups.

Quantification of aortic stenosis diagnostic parameters: comparison of fast 3 direction and 1 direction phase contrast CMR and transthoracic echocardiography.

BACKGROUND: Aortic stenosis (AS) is a common valvular disorder, and disease severity is currently assessed by transthoracic echocardiography (TTE). However, TTE results can be inconsistent in some patients, thus other diagnostic modalities such as cardiovascular magnetic resonance (CMR) are demanded. While traditional unidirectional phase-contrast CMR (1Dir PC-CMR) underestimates velocity if the imaging plane is misaligned to the flow direction, multi-directional acquisitions are expected to improve velocity measurement accuracy. Nonetheless, clinical use of multidirectional techniques has been hindered by long acquisition times. Our goal was to quantify flow parameters in patients using 1Dir PC-CMR and a faster multi-directional technique (3Dir PC-CMR), and compare to TTE. METHODS: Twenty-three patients were prospectively assessed with TTE and CMR. Slices above the aortic valve were acquired for both PC-CMR techniques and cine SSFP images were acquired to quantify left ventricular stroke volume. 3Dir PC-CMR implementation included a variable density sampling pattern with acceleration rate of 8 and a reconstruction method called ReVEAL, to significantly accelerate acquisition. 3Dir PC-CMR reconstruction was performed offline and ReVEAL-based image recovery was performed on the three (x, y, z) encoding pairs. 1Dir PC-CMR was acquired with GRAPPA acceleration rate of 2 and reconstructed online. CMR derived flow parameters and aortic valve area estimates were compared to TTE. RESULTS: ReVEAL based 3Dir PC-CMR derived parameters correlated better with TTE than 1Dir PC-CMR. Correlations ranged from 0.61 to 0.81 between TTE and 1Dir PC-CMR and from 0.61 to 0.87 between TTE and 3Dir-PC-CMR. The correlation coefficients between TTE, 1Dir and 3Dir PC-CMR Vpeakwere 0.81 and 0.87, respectively. In comparison to ReVEAL, TTE slightly underestimates peak velocities, which is not surprising as TTE is only sensitive to flow that is parallel to the acoustic beam. CONCLUSIONS: By exploiting structure unique to PC-CMR, ReVEAL enables multi-directional flow imaging in clinically feasible acquisition times. Results support the hypothesis that ReVEAL-based 3Dir PC-CMR provides better estimation of hemodynamic parameters in AS patients in comparison to 1Dir PC-CMR. While TTE can accurately measure velocity parallel to the acoustic beam, it is not sensitive to the other directions of flow. Therefore, multi-directional flow imaging, which encodes all three components of the velocity vector, can potentially outperform TTE in patients with eccentric or multiple jets.

Fast implementation for compressive recovery of highly accelerated cardiac cine MRI using the balanced sparse model.

PURPOSE: Sparsity-promoting regularizers can enable stable recovery of highly undersampled magnetic resonance imaging (MRI), promising to improve the clinical utility of challenging applications. However, lengthy computation time limits the clinical use of these methods, especially for dynamic MRI with its large corpus of spatiotemporal data. Here, we present a holistic framework that utilizes the balanced sparse model for compressive sensing and parallel computing to reduce the computation time of cardiac MRI recovery methods. THEORY AND METHODS: We propose a fast, iterative soft-thresholding method to solve the resulting ℓ1-regularized least squares problem. In addition, our approach utilizes a parallel computing environment that is fully integrated with the MRI acquisition software. The methodology is applied to two formulations of the multichannel MRI problem: image-based recovery and k-space-based recovery. RESULTS: Using measured MRI data, we show that, for a 224 × 144 image series with 48 frames, the proposed k-space-based approach achieves a mean reconstruction time of 2.35 min, a 24-fold improvement compared a reconstruction time of 55.5 min for the nonlinear conjugate gradient method, and the proposed image-based approach achieves a mean reconstruction time of 13.8 s. CONCLUSION: Our approach can be utilized to achieve fast reconstruction of large MRI datasets, thereby increasing the clinical utility of reconstruction techniques based on compressed sensing. Magn Reson Med 77:1505-1515, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Cardiopulmonary exercise testing in the MRI environment.

Maximal oxygen consumption ([Formula: see text]max) measured by cardiopulmonary exercise testing (CPX) is the gold standard for assessment of cardiorespiratory fitness. Likewise, cardiovascular magnetic resonance (CMR) is the gold standard for quantification of cardiac function. The combination of CPX and CMR may offer unique insights into cardiopulmonary pathophysiology; however, the MRI-compatible equipment needed to combine these tests has not been available to date. We sought to determine whether CPX testing in the MRI environment, using equipment modified for MRI yields results equivalent to those obtained in standard exercise physiology (EP) lab. Ten recreationally trained subjects completed [Formula: see text]max tests in different locations; an EP laboratory and an MRI laboratory, using site specific equipment. CMR cine images of the heart were acquired before and immediately after maximal exercise to measure cardiac function. Subjects in all tests met criteria indicating that peak exercise was achieved. Despite equipment modifications for the MRI environment, [Formula: see text]max was nearly identical between tests run in the different labs (95% lower confidence limit (LCL) = 0.8182). The mean difference in [Formula: see text]max was less than 3.40 ml (kg/min)(-1), within the variability expected for tests performed on different days, in different locations, using different metabolic carts. MRI performed at rest and following peak exercise stress indicated cardiac output increased from 5.1 ± 1.0 l min(-1) to 16.4 ± 5.6 l min(-1), LVEF increased from 65.2 ± 3.3% to 78.4 ± 4.8%, while RVEF increased from 52.8 ± 5.3% to 63.4 ± 5.3%. Regression analysis revealed a significant positive correlation between [Formula: see text]max and stroke volume (R = 0.788, P = 0.006), while the correlation with cardiac output did not reach statistical significance (R = 0.505, P = 0.137). [Formula: see text]max CPX testing can be effectively performed in the MRI environment, enabling direct combination of physiological data with advanced post-exercise imaging in the same test session.

Quantification of myocardial stiffness using magnetic resonance elastography in right ventricular hypertrophy: initial feasibility in dogs.

INTRODUCTION: Myocardial stiffness is an important determinant of cardiac function and is currently invasively and indirectly assessed by catheter angiography. This study aims to demonstrate the feasibility of quantifying right ventricular (RV) stiffness noninvasively using cardiac magnetic resonance elastography (CMRE) in dogs with severe congenital pulmonary valve stenosis (PVS) causing RV hypertrophy, and compare it to remote myocardium in the left ventricle (LV). Additionally, correlations between stiffness and selected pathophysiologic indicators from transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging were explored. METHODS: In-vivo CMRE was performed on nine dogs presenting severe congenital PVS using a 1.5T MRI scanner. T1-MOLLI, T2-prepared-bSSFP, gated-cine GRE-MRE and LGE (PSIR) sequences were used to acquire a basal short-axis slice. RV and LV-free-wall (FW) stiffness measurements were compared against each other and also correlated to ventricular mass, RV and LV FW thickness, T1 and T2 relaxation times, and extracellular volume fraction (ECV). Peak transpulmonary pressure gradient and myocardial strain were also acquired on eight dogs by TTE and correlated to RV-FW systolic stiffness. Potential correlations were evaluated by Spearman's rho (rs). RESULTS: RV-FW stiffness was found to be significantly higher than the LV-FW stiffness both during end-systole (ES) (p=0.002) and end-diastole (ED) (p=0.029). Significant correlations were observed between RV-FW ES and LV-FW ED stiffness versus ECV (rs=0.75; p-value=0.05). Non-significant moderate correlations were found between LV-FW ES (rs=0.54) and RV-FW ED (rs=0.61) stiffness versus ECV. Furthermore, non-significant correlations were found between RV or LV-FW stiffness and the remaining variables (rs<0.54; p-value>0.05). CONCLUSION: This study demonstrates the feasibility of determining RV stiffness. The positive correlations between stiffness and ECV might indicate some interdependence between stiffness and myocardial extracellular matrix alterations. However, further studies are warranted to validate our initial observations.

Association Between Periodontitis and Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis.

BACKGROUND: To the best of the authors' knowledge, there is no systematic review of the potential association between periodontitis and gestational diabetes mellitus (GDM) in the current literature. The aim of the present systematic review and meta-analysis is to search for scientific evidence regarding the association between periodontitis and GDM. METHODS: The present study was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered (CRD2014010728) with PROSPERO (International prospective register for systematic reviews, University of York, York, UK). A search was conducted in three electronic databases without restrictions regarding language or date of publication. From 190 studies selected, 15 underwent full-text analysis. Eight studies were eligible (five cross-sectional and three case-control studies), and seven were entered in the meta-analysis. Meta-analysis was performed with tests for sensitivity and statistical heterogeneity. Summary effect measures were calculated by odds ratio (OR) and 95% confidence interval (CI). RESULTS: There was a significant association between periodontitis and GDM in the meta-analyses of four cross-sectional studies (OR 1.67, 95% CI 1.20 to 2.32) and two case-control studies (OR 2.66, 95% CI 1.52 to 4.65). However, sensitivity tests for case-control studies showed a lack of consistency in data; when including one case-control study, the significance was null (meta-analysis of three case-control studies: OR 1.69, 95% CI 0.68 to 4.21). CONCLUSIONS: There was substantial clinical, methodologic, and statistical heterogeneity among the studies. The scientific evidence cannot affirm a positive association between periodontitis and GDM. Future studies with different designs in distinct populations should be conducted to investigate this association.

Free-breathing myocardial T2* mapping using GRE-EPI and automatic non-rigid motion correction.

BACKGROUND: Measurement of myocardial T2* is becoming widely used in the assessment of patients at risk for cardiac iron overload. The conventional breath-hold, ECG-triggered, segmented, multi-echo gradient echo (MGRE) sequence used for myocardial T2* quantification is very sensitive to respiratory motion and may not be feasible in patients who are unable to breath-hold. We propose a free-breathing myocardial T2* mapping approach that combines a single-shot gradient-echo echo-planar imaging (GRE-EPI) sequence for T2*-weighted image acquisition with automatic non-rigid motion correction (MOCO) of respiratory motion between single-shot images. METHODS: ECG-triggered T2*-weighted images at different echo times were acquired by a black-blood, single-shot GRE-EPI sequence during free-breathing. A single image at a single TE is acquired in each heartbeat. Automatic non-rigid MOCO was applied to correct for in-plane respiratory motion before pixel-wise T2* mapping. In a total of 117 patients referred for clinical cardiac magnetic resonance exams, the free-breathing MOCO GRE-EPI sequence was compared to the breath-hold segmented MGRE approach. Image quality was scored independently by 2 experienced observers blinded to the particular image acquisition strategy. T2* measurements in the interventricular septum and in the liver were compared for the two methods in all cases with adequate image quality. RESULTS: T2* maps were acquired in all 117 patients using the breath-hold MGRE and the free-breathing MOCO GRE-EPI approaches, including 8 patients with myocardial iron overload and 25 patients with hepatic iron overload. The mean image quality of the free-breathing MOCO GRE-EPI images was scored significantly higher than that of the breath-hold MGRE images by both reviewers. Out of the 117 studies, 21 breath-hold MGRE studies (17.9% of all the patients) were scored to be less than adequate or very poor by both reviewers, while only 2 free-breathing MOCO GRE-EPI studies were scored to be less than adequate image quality. In a comparative evaluation of the images with at least adequate quality, the intra-class correlation coefficients for myocardial and liver T2* were 0.868 and 0.986 respectively (p < 0.001), indicating that the T2* measured by breath-hold MGRE and free-breathing MOCO GRE-EPI were in close agreement. The coefficient of variation between the breath-hold and free-breathing approaches for myocardial and liver T2* were 9.88% and 9.38% respectively. Bland-Altman plots demonstrated good absolute agreement of T2* in the interventricular septum and the liver from the free-breathing and breath-hold approaches (mean differences -0.03 and 0.16 ms, respectively). CONCLUSION: The free-breathing approach described for T2* mapping using MOCO GRE-EPI enables accurate myocardial and liver T2* measurements and is insensitive to respiratory motion.

Effects of preparation conditions of poly(lactide-co-glycolide) nanoparticles loaded with amphiphilic porphyrins and their photoactivities.

Three porphyrins, (5,10,15,20-tetra(3-hydroxyphenyl)porphyrin, 5-hexyl-10,20-bis(3-hydroxyphenyl)-porphyrin and 5-hexyl-10,15,20-tris(3-hydroxyphenyl)porphyrin), with different amphiphilicities and equal singlet oxygen quantum yields in ethanol, were encapsulated into 50:50 poly(lactide-co-glycolide), nanoparticles prepared by the emulsion/evaporation technique. A 22 factorial design was utilized to evaluate the influence of the porphyrin/polymer mass ratio and the percentage of ethanol in the aqueous phase on the size and zeta potential of the nanoparticles. Increasing both the amount of ethanol and the porphyrin/polymer ratio decreases the size and increases zeta potential for the photosensitizers studied, except for 5-hexyl-10,15,20-tri(3-hydroxyphenyl)porphyrin. Entrapment efficiency depended on the individual m-hydroxyphenylporphyrin and ranged from 69 to 97%. After 1.5 h incubation with m-hydroxyphenylporphyrin-loaded nanoparticles the percentages of intracellular uptake were the same for all porphyrins since the molecules are confined in the nanoparticles, hampering the interaction of the amphiphilic photosensitizers with the cellular membrane. All encapsulated porphyrins caused the same decrease of cell viability and always localized in the perinuclear region of the cells. Results show that these m-hydroxyphenylporphyrins, although with different amphiphilicities, have equal photodynamic efficacies.

[Implications of the visibility in professional nursing practices]. / Implicações da visibilidade da enfermagem no exercício profissional.

Nursing construction image is permeated by historical socioeconomic and cultural aspects. This theme aims to understand the perception of nurses regarding the visibility of nursing staff's daily work. This qualitative research is exploratory, with 30 nurses at a university hospital in southern Brazil. The data was collected from July to October 2012, through semi-structured interviews and submitted for a discursive textual analysis. The results show that nursing visibility is related to a professional historical trajectory, to an absence of recognition of the scientific aspect of Nursing, to erroneous placement in the media, to improper behavior towards the staff and also to work overload. Thus, the demystification of nursing's image includes greater media visibility, conducting personnel marketing, appropriate behavior in front of health staff and professional demonstrations of autonomy, challenges that must be overcome by nursing.