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1.
Value Health Reg Issues ; 44: 101014, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39368195

RESUMO

OBJECTIVE: This study aimed to evaluate the cost-effectiveness (CE) of minimally invasive interventions for pain associated with articular temporomandibular dysfunction from the Brazilian Public Health System (SUS) perspective. METHODS: This is a CE study with a 1-year time horizon. Effectiveness data were extracted from a network meta-analysis, and 2 treatments with moderate levels of evidence certainty were evaluated: arthrocentesis (ARTRO) plus intra-articular corticosteroid (CO) injection and ARTRO plus intra-articular injection of sodium hyaluronate (SH). For CE analysis, the costs of 2 types of SH (low and high molecular weight) and 4 COs (betamethasone [B], dexamethasone acetate [D], methylprednisolone sodium succinate [M], or triamcinolone hexacetonide [T]) were considered. Modeling was conducted using TreeAge Pro Healthcare software, with the construction of a decision tree representing a hypothetical cohort of adults with articular temporomandibular dysfunction. Deterministic and probabilistic sensitivity analyses were performed. In addition, an acceptability curve was developed. RESULTS: The total costs per joint for ARTRO plus low- and high-molecular-weight SH and ARTRO plus COs B, D, M, and T were, respectively, R$583.32, R$763.85, R$164.39, R$133.93, R$138.57, and R$159.86. ARTRO plus dexamethasone acetate was considered cost-effective, with lower cost and higher net monetary benefit than other technologies. In all sensitivity analysis scenarios, it remained cost-effective. It also showed greater acceptability. CONCLUSION: ARTRO plus dexamethasone acetate was considered the cost-effective technology, exhibiting higher net monetary benefit and higher acceptability from the SUS perspective.


Assuntos
Análise Custo-Benefício , Humanos , Análise Custo-Benefício/métodos , Análise Custo-Benefício/estatística & dados numéricos , Brasil , Injeções Intra-Articulares/economia , Artrocentese/métodos , Artrocentese/economia , Transtornos da Articulação Temporomandibular/tratamento farmacológico , Transtornos da Articulação Temporomandibular/terapia , Transtornos da Articulação Temporomandibular/economia , Ácido Hialurônico/economia , Ácido Hialurônico/administração & dosagem , Ácido Hialurônico/uso terapêutico , Ácido Hialurônico/análogos & derivados , Corticosteroides/uso terapêutico , Corticosteroides/economia
2.
Clin Exp Rheumatol ; 2024 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-39360368

RESUMO

OBJECTIVES: N-acetylcysteine (NAC) is used in Sjögren's disease (SjD) based on limited evidence. The aim of this study was to assess the efficacy of NAC for relieving dryness symptoms in SjD. METHODS: In this placebo-controlled double-blind trial, 60 adult SjD females (with low disease activity) were randomised to receive NAC (1,200 mg/day orally) or placebo. At baseline (D0), 30 days (D30) and 90 days (D90), all participants underwent the following evaluations: EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), Ocular Surface Disease Index (OSDI), Xerostomia Inventory (XI), Leicester Cough Questionnaire (LCQ), unstimulated/stimulated salivary flow, Schirmer's test, and plasma levels of thiobarbituric acid reactive substances (TBARS), glutathione and NAC. RESULTS: At inclusion, both groups were balanced for age, ethnicity, disease duration, ESSPRI, OSDI, XI, Schirmer's test, salivary flow, ESSDAI and topical/systemic treatments (p>0.05). No significant differences were observed between NAC and placebo groups on D30 and D90 regarding ESSPRI, XI, OSDI, LCQ, Schirmer's test, stimulated salivary flow, ESSDAI and topical/systemic treatments (p>0.05). Unstimulated salivary flow was significantly higher in the placebo group on D90 (p=0.018). NAC blood concentrations were significantly higher in the NAC group on D30 (p=0.018) and D90 (p<0.001), however, no differences were found in TBARS and glutathione. Further analysis showed decrease≥1 in ESSPRI in the NAC compared with placebo group on D30 (p=0.045), a result not found on D90 (p=0.696). CONCLUSIONS: NAC is recommended as a rescue therapy for SjD. However, our well-designed study provides novel evidence demonstrating its inefficacy for improving dryness symptoms or reducing oxidative stress. CLINICALTRIALS: gov-NCT04793646.

3.
Artigo em Inglês | MEDLINE | ID: mdl-39290156

RESUMO

INTRODUCTION: Levothyroxine (L-T4) monotherapy is the standard of care for the treatment of hypothyroidism. A minority of the L-T4-treated patients remain symptomatic and report better outcomes with combination therapy that contains liothyronine (L-T3) or with desiccated thyroid extract (DTE). GOAL: To assess patient preferences in the treatment of hypothyroidism. METHODS: A systematic review, meta-analysis, meta-regression, and network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing treatments for adults with hypothyroidism (L-T4 vs. L-T4+L-T3 or DTE). Searches were conducted in PubMed, Embase, and Cochrane databases up to April 10, 2024. Data extraction and quality assessment were independently performed by four researchers. RESULTS: Eleven RCTs (eight cross-over studies) with a total of 1,135 patients were considered. Overall, 24% of patients preferred L-T4 versus 52 % who preferred L-T4+L-T3 or DTE; 24% had no preference. The meta-analysis confirmed the preference for combination therapy over L-T4 monotherapy (RR: 2.20, 95% CI: 1.38 to 3.52; p = 0.0009). Excluding four studies reduced the high heterogeneity (I2 = 81%) without affecting the results (RR: 1.97, 95% CI: 1.52 to 2.54; p < 0.00001; I2 = 24%). This preference profile remained when only crossover studies were considered (RR: 2.84, 95% CI: 1.50 to 5.39; p < 0.00001). Network meta-analysis confirmed the preference for DTE and L-T3+L-T4 versus L-T4 alone. CONCLUSION: Patients with hypothyroidism prefer combination therapy (L-T3+L-T4 or DTE) over L-T4 monotherapy. The strength of these findings justifies considering patient preferences in the setting of shared decision-making in the treatment of hypothyroidism.

4.
MethodsX ; 13: 102924, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39263359

RESUMO

In an island power system, optimizing energy management is fundamental since there are renewable sources with their limitations. This management includes the allocation and capacity of energy sources to supply the loads. In this context, optimizing losses in the system contributes to improve the efficiency of this management. This paper proposes the losses optimization and energy management in the island power system. The authors propose the Natural Logarithm Particle Swarm Optimization to solve the problem and compare it with the Attractor Point Algorithm and Evolutionary Particle Swarm Optimization. And with that, we also propose a particle initialization for the studied particle-based algorithms to guarantee convergence in radial power systems. This is because the system configuration influences the response of the algorithm convergence. These techniques were applied to the IEEE-34 unbalanced radial island system.•Natural Logarithm Particle Swarm Optimization differs from classical PSO in that it does not calculate the velocity of the particles. Therefore, the method considers a cloud of particles with a natural logarithmic trajectory to solve the reduction of losses in a power system with a radial topology.•Natural Logarithmic Particle Swarm Optimization uses an initialization equation to minimize the initial estimation process, which is relevant to the convergence process.

5.
Chem Asian J ; : e202400931, 2024 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-39240095

RESUMO

We report herein a reexamination of the reactions between sulfoxonium ylides and acetylenic esters. Continuing our previous study of conjugate additions using α-carbonyl sulfoxonium ylides, we came across an interesting transformation when dimethyl acetylenedicarboxylate (DMAD) was employed as a Michael acceptor. Trisubstituted electron-deficient 1,3-dienes and α-carbonyl vinyl sulfoxides were obtained for the first time from these sulfur ylides, in a stereoselective manner (exclusively forming the E-isomer), achieving yields of up to 70 % and 83 %, respectively. Selected dienes were subsequently utilized in the synthesis of novel nitrogen heterocycles. Interestingly, when di-tert-butyl acetylenedicarboxylate (DtBAD) or alkyl propiolates were evaluated, the isolated product arose from the classical Michael addition, yielding α-carbonyl vinyl sulfoxonium ylides in yields of up to 89 %.

6.
Heliyon ; 10(15): e34622, 2024 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-39144992

RESUMO

Protein compartmentalization in the frame of a liquid-liquid phase separation is a key mechanism to optimize spatiotemporal control of biological systems. Such a compartmentalization process reduces the intrinsic noise in protein concentration due to stochasticity in gene expression. Employing Flory-Huggins solution theory, Avramov/Casalini's model, and the Grüneisen parameter, we unprecedentedly propose a cellular Griffiths-like phase (CGLP), which can impact its functionality and self-organization. The here-proposed CGLP is key ranging from the understanding of primary organisms' evolution to the treatment of diseases. Our findings pave the way for an alternative Biophysics approach to investigate coacervation processes.

7.
An Acad Bras Cienc ; 96(3): e20230662, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39166651

RESUMO

This study evaluated the digestibility of whole mango (Mangifera indica) meal (WMM) and determined the growth performance, intestinal enzyme activity, and metabolic and hematologic responses of tambaqui (Colossoma macropomum) juveniles fed diets containing different proportions of corn meal (CM) substitution by WMM. Fish fed with graded levels of WMM (0 (control), 80, 160, 240, and 320 g kg diet-1), replacing part of the dietary CM. The apparent digestibility coefficients of WMM were above 96%. Diets with WMM did not affect growth performance or intestinal enzyme activity. However, they showed a positive linear effect on plasma glucose, amino acids, and albumin levels and a negative linear effect on hepatic aspartate aminotransferase activity and hepatic glycogen, plasma cholesterol, and hemoglobin levels. Increased erythrocyte values and decreased plasma triglyceride levels were verified in fish fed 80 and 160 g WMM kg diet-1. In conclusion, the WMM may be a viable alternative to the tambaqui juveniles' diet, and WMM could replace up to 16% of CM without harming the growth and health of tambaqui juveniles.


Assuntos
Ração Animal , Mangifera , Zea mays , Animais , Ração Animal/análise , Digestão/fisiologia , Dieta/veterinária , Fenômenos Fisiológicos da Nutrição Animal/fisiologia , Caraciformes/fisiologia , Caraciformes/crescimento & desenvolvimento , Caraciformes/sangue , Glicemia/análise , Fígado/metabolismo
8.
J Adv Res ; 2024 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-39163906

RESUMO

BACKGROUND: Soybean is a worldwide-cultivated crop due to its applications in the food, feed, and biodiesel industries. Genome editing in soybean began with ZFN and TALEN technologies; however, CRISPR/Cas has emerged and shortly became the preferable approach for soybean genome manipulation since it is more precise, easy to handle, and cost-effective. Recent reports have focused on the conventional Cas9 nuclease, Cas9 nickase (nCas9) derived base editors, and Cas12a (formally Cpf1) as the most commonly used genome editors in soybean. Nonetheless, several challenges in the complex plant genetic engineering pipeline need to be overcome to effectively edit the genome of an elite soybean cultivar. These challenges include (1) optimizing CRISPR cassette design (i.e., gRNA and Cas promoters, gRNA design and testing, number of gRNAs, and binary vector), (2) improving transformation frequency, (3) increasing the editing efficiency ratio of targeted plant cells, and (4) improving soybean crop production. AIM OF REVIEW: This review provides an overview of soybean genome editing using CRISPR/Cas technology, discusses current challenges, and highlights theoretical (insights) and practical suggestions to overcome the existing bottlenecks. KEY SCIENTIFIC CONCEPTS OF REVIEW: The CRISPR/Cas system was discovered as part of the bacterial innate immune system. It has been used as a biotechnological tool for genome editing and efficiently applied in soybean to unveil gene function, improve agronomic traits such as yield and nutritional grain quality, and enhance biotic and abiotic stress tolerance. To date, the efficiency of gRNAs has been validated using protoplasts and hairy root assays, while stable plant transformation relies on Agrobacterium-mediated and particle bombardment methods. Nevertheless, most steps of the CRISPR/Cas workflow require optimizations to achieve a more effective genome editing in soybean plants.

9.
Membranes (Basel) ; 14(8)2024 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-39195423

RESUMO

A conventional hydrocyclones is a versatile equipment with a high processing capacity and low maintenance cost. Currently, several studies aim to alter the typical structure of the conventional hydrocyclone in order to modify its performance and purpose. For this, filtering hydrocyclones have emerged, where a porous membrane replaces the conic or cylindrical wall. During the operation of this equipment, in addition to the traditionally observed streams (feed, underflow, and overflow), there is a liquid stream resulting from the filtration process, commonly referred to as filtrate. This work proposes to numerically investigate the solid particle/liquid water separation process in a filtering hydrocyclone using the commercial software Ansys CFX® 15.0. The proposed mathematical model for the study considers three-dimensional, steady state and turbulent flow, using the Eulerian-Eulerian approach and the Shear Stress Transport (SST) turbulence model. This study presents and analyzes the volume fraction, velocity, and pressure fields, along with flowlines and velocity profiles. The results indicate that the proposed model effectively captures the fluid dynamic behavior within the filtering hydrocyclone, highlighting higher pressures near the porous membrane and a higher concentration of solid particles in the conical region, with water being more concentrated in the cylindrical part of the hydrocyclone. Additionally, the findings show that the volumetric flow rate of the filtrate significantly influences the internal flow dynamics, with conventional hydrocyclones demonstrating higher pressure gradients compared to the proposed filtering hydrocyclone.

10.
Heliyon ; 10(12): e32808, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38975186

RESUMO

For decades, animal models have been the standard approach in drug research and development, as they are required by regulations in the transition from preclinical to clinical trials. However, there is growing ethical and scientific concern regarding these trials, as 80 % of the therapeutic potential observed in pre-clinical studies are often unable to be replicated, despite demonstrating efficacy and safety. In response to this, Tissue Engineering has emerged as a promising alternative that enables the treatment of various diseases through the production of biological models for advanced biological assays or through the direct development of tissue repairs or replacements. One of the promising applications of Tissue Engineering is the development of three-dimensional (3D) models for in vitro tests, replacing the need for in vivo animal models. In this study, 3D skin equivalents (TSE) were produced and used as an in vitro model to test photobiostimulation using curcumin-loaded nanocapsules. Photodynamic biostimulation therapy uses photodynamic processes to generate small amounts of reactive oxygen species (ROS), which can activate important biological effects such as cell differentiation, modulation of inflammatory processes and contribution to cell regeneration. The PLGA nanocapsules (NC) used in the study were synthesized through a preformed polymer deposition method, exhibiting particle size <200 nm, Zeta potential >|30| and polydispersity index between 0.5 and 0.3. Atomic force microscopy analyzes confirmed that the particle size was <200 nm, with a spherical morphology and a predominantly smooth and uniform surface. The NC biocompatibility assay did not demonstrate cytotoxicity for the concentrations tested (2.5-25 µg mL-1).The in vitro release assay showed a slow and sustained release characteristic of the nanocapsules, and cellular uptake assays indicated a significant increase in cellular internalization of the curcumin-loaded nanostructure. Monolayer photobiostimulation studies revealed an increase in cell viability of the HDFn cell line (viability 134 %-228 %) for all LED fluences employed at λ = 450 nm (150, 300, and 450 mJ cm-2). Additionally, the scratch assays, monitoring in vitro scar injury, demonstrated more effective effects on cell proliferation with the fluence of 300 mJ cm-2. Staining of TSE with hematoxylin and eosin showed the presence of cells with different morphologies, confirming the presence of fibroblasts and keratinocytes. Immunohistochemistry using KI-67 revealed the presence of proliferating cells in TSE after irradiation with LED λ = 450 nm (150, 300, and 450 mJ cm-2).

11.
J Mol Model ; 30(7): 237, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38951316

RESUMO

CONTEXT: Due to advances in synthesizing lower-dimensional materials, there is the challenge of finding the wave equation that effectively describes quantum particles moving on 1D and 2D domains. Jensen and Koppe and Da Costa independently introduced a confining potential formalism showing that the effective constrained dynamics is subjected to a scalar geometry-induced potential; for the confinement to a curve, the potential depends on the curve's curvature function. METHOD: To characterize the π electrons in polyenes, we follow two approaches. First, we utilize a weakened Coulomb potential associated with a spiral curve. The solution to the Schrödinger equation with Dirichlet boundary conditions yields Bessel functions, and the spectrum is obtained analytically. We employ the particle-in-a-box model in the second approach, incorporating effective mass corrections. The π - π ∗ transitions of polyenes were calculated in good experimental agreement with both approaches, although with different wave functions.

12.
Tree Physiol ; 44(8)2024 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-38952005

RESUMO

Forest ecosystems face increasing drought exposure due to climate change, necessitating accurate measurements of vegetation water content to assess drought stress and tree mortality risks. Although Frequency Domain Reflectometry offers a viable method for monitoring stem water content by measuring dielectric permittivity, challenges arise from uncertainties in sensor calibration linked to wood properties and species variability, impeding its wider usage. We sampled tropical forest trees and palms in eastern Amazônia to evaluate how sensor output differences are controlled by wood density, temperature and taxonomic identity. Three individuals per species were felled and cut into segments within a diverse dataset comprising five dicotyledonous tree and three monocotyledonous palm species on a wide range of wood densities. Water content was estimated gravimetrically for each segment using a temporally explicit wet-up/dry-down approach and the relationship with the dielectric permittivity was examined. Woody tissue density had no significant impact on the calibration, but species identity and temperature significantly affected sensor readings. The temperature artefact was quantitatively important at large temperature differences, which may have led to significant bias of daily and seasonal water content dynamics in previous studies. We established the first tropical tree and palm calibration equation which performed well for estimating water content. Notably, we demonstrated that the sensitivity remained consistent across species, enabling the creation of a simplified one-slope calibration for accurate, species-independent measurements of relative water content. Our one-slope calibration serves as a general, species-independent standard calibration for assessing relative water content in woody tissue, offering a valuable tool for quantifying drought responses and stress in trees and forest ecosystems.


Assuntos
Florestas , Árvores , Clima Tropical , Água , Madeira , Madeira/química , Água/metabolismo , Árvores/fisiologia , Ecossistema , Secas , Arecaceae/fisiologia , Arecaceae/metabolismo , Brasil
13.
J Exp Biol ; 227(16)2024 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-39054944

RESUMO

Understanding the intricate relationship between temperature and physiological processes in ectotherm vertebrates is crucial for predicting how these animals respond to environmental changes, including those associated with climate change. This is particularly relevant for the anurans, given their limited capacity for thermoregulation, particularly in larval stages. Herein, we investigated the capacity for thermal acclimatization in Thoropa taophora tadpoles, an endemic species in the Atlantic rainforest of Southeast Brazil, inhabiting distinct thermal environments. These semi-terrestrial tadpoles develop on rocky surfaces, with some populations inhabiting exposed regions near the marine coast where temperatures may reach up to 30°C in sunny conditions, while other populations occupy forested areas near waterfalls that maintain lower temperatures. We aimed to understand the effects of temperature on locomotor performance and on the activity of metabolic enzymes that support performance in tadpoles sampled in four different populations. Moreover, we measured several aspects of thermoregulation, including the critical thermal maximum (CTmax), the body temperature of activity (Tb), the preferred temperature (Tpref) and the effectiveness of thermoregulation (E). Despite differences in body size, tadpoles from warmer environments consistently demonstrated higher locomotor performance, with minimal or no acclimatization seen in other variables. Correlations between habitat temperature and biological endpoints underscore the significance of maximum locomotor performance in shaping physiological responses. Our results show how temperature can impact tadpole behavior and performance, without changes in many organismal measures of thermal acclimatization, providing insights into potential ecological implications, particularly in the context of climate change.


Assuntos
Aclimatação , Anuros , Regulação da Temperatura Corporal , Larva , Locomoção , Animais , Larva/fisiologia , Larva/crescimento & desenvolvimento , Anuros/fisiologia , Brasil , Temperatura Alta , Mudança Climática
14.
Nat Prod Res ; : 1-8, 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38902957

RESUMO

Two unusual phorbol esters, namely 20-deoxyphorbol-3,4,12-triacetate-13-phenylacetate (1) and phorbol-3,4,12,13-tetraacetate-20-phenylacetate (2) plus ingol-3,8,12-triacetate-7-phenylacetate (3) were isolated from the latex of Euphorbia umbellata and identified by HRESIMS and 2D NMR. Compound 1 is herein described for the first time. Assignment of the phenylacetyl group at C-7 in compound 3 was suggested by the HMBC and NOESY spectra obtained in pyridine-d5. In addition to the latex and its distinct terpenoid fractions, the isolated compounds were tested as latent reversal agents against HIV-1-infected J-Lat cells, with reference to phorbol-12-myristate-13-acetate and ingenol-B. Compound 2 reverted 75-80% the viral latency on the GFP-positive cells, resulting EC50 3.70 µg/mL (SI 6.7), while 1 induced 34-40% reactivation at the same concentration range (4-20 µg/mL). The ingol derivative 3 was ineffective. Phorbol esters were confirmed as effective constituents in the latex since the fraction containing them was 2.4-fold more active than the lyophilised latex at the lowest concentration assayed.

15.
Eur Thyroid J ; 13(4)2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38869458

RESUMO

Introduction: The type 2 deiodinase and its Thr92Ala-DIO2 polymorphism have been linked to clinical outcomes in acute lung injury and coronavirus disease 2019 (COVID-19). Objective: The objective was to identify a potential association between Thr92Ala-DIO2 polymorphism and body composition (appendicular muscle mass, myosteatosis, and fat distribution) and to determine whether they reflect the severity or mortality associated with the disease. Methods: In this prospective cohort study (June-August 2020), 181 patients hospitalized with moderate-to-severe COVID-19 underwent a non-contrast-enhanced computed tomography (CT) of the thorax to assess body composition, laboratory tests, and genotyping for the Thr92Ala-DIO2 polymorphism. Results: In total, 181 consecutive patients were stratified into three subgroups according to the genotype: Thr/Thr (n = 64), Thr/Ala (n = 96), and Ala/Ala (n = 21). The prevalence of low muscle area (MA) (< 92 cm²) was 52.5%. Low MA was less frequent in Ala/Thr patients (44.8%) than in Thr/Thr (60.9%) or Ala/Ala patients (61.9%) (P = 0.027). Multivariate logistic regression analysis confirmed that the Thr/Ala allele was associated with a reduced risk of low MA (41% to 69%) and myosteatosis (62% to 72%) compared with Thr/Thr + Ala/Ala (overdominant model). Kaplan-Meier curves showed that patients with low muscle mass and homozygosity had lower survival rates than the other groups. Notably, the heterozygotes with MA ≥92 cm² exhibited the best survival rate. Conclusion: Thr92Ala-DIO2 heterozygosity is associated with increased skeletal MA and less myosteatosis in patients with COVID-19. The protective effect of Thr92Ala-DIO2 heterozygosity on COVID-19 mortality is restricted to patients with reduced MA.


Assuntos
COVID-19 , Músculo Esquelético , SARS-CoV-2 , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Composição Corporal/genética , COVID-19/genética , COVID-19/diagnóstico por imagem , Genótipo , Heterozigoto , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/patologia , Estudos Prospectivos , Tomografia Computadorizada por Raios X
16.
Artigo em Inglês | MEDLINE | ID: mdl-38780968

RESUMO

CONTEXT: Thyroid-stimulating hormone (TSH) trajectory classification represents a novel approach to defining the adequacy of levothyroxine (LT4) treatment for hypothyroidism over time. OBJECTIVE: This is a proof of principle study that uses longitudinal clinical data, including thyroid hormone levels from a large prospective study to define classes of TSH trajectories and examine changes in cardiovascular (CV) health markers over the study period. METHODS: Growth mixture modeling (GMM), including latent class growth analysis (LCGA), was used to classify LT4-treated individuals participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) based on serial TSH levels. Repeated measure analyses were then utilized to assess within-class changes in blood pressure, lipid levels, hemoglobin A1c, and CV-related medication utilization. RESULTS: From the 621 LT4-treated study participants, the best-fit GMM approach identified 4 TSH trajectory classes, as defined by their relationship to the normal TSH range: (1) high-high normal TSH, (2) normal TSH, (3) normal to low TSH, and (4) low to normal TSH. Notably, the average baseline LT4 dose was lowest in the high-high normal TSH group (77.7 µg, P < .001). There were no significant differences in CV health markers between the classes at baseline. At least 1 significant difference in CV markers occurred in all classes, highlighted by the low to normal class, in which total and high-density lipoprotein cholesterol, triglycerides, and A1c all increased significantly (P = .049, P < .001, P < .001, and P = .001, respectively). Utilization of antihypertensive, antihyperlipidemic, and antidiabetes medications increased in all classes. CONCLUSION: GMM/LCGA represents a viable approach to define and examine LT4 treatment by TSH trajectory. More comprehensive datasets should allow for more complex trajectory modeling and analysis of clinical outcome differences between trajectory classes.

17.
Fitoterapia ; 176: 105987, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38703916

RESUMO

In Brazil, latex from Euphorbia umbellata (African milk tree) has been increasingly used in folk medicine to treat several types of cancer, including melanoma. The effect of lyophilized latex (LL), its hydroethanolic extract (E80), triterpene (F-TRI)- and diterpene (F-DIT)-enriched fractions, along with six isolated phorbol esters from LL and phorbol 12-myristate 13-acetate (PMA) on J774A.1, THP-1, SK-MEL-28, and B16-F10 cell line viability were evaluated by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) method. The compounds were identified by 2D-NMR and HRESIMS. The effect of the LL, extract and fractions on cell viability was also assessed through a resazurin reduction assay. At 100 µg/ml, LL, and its fractions moderately inhibited J774A.1 (37.5-59.5%) and THP-1 (12.6-43.6%) metabolism. LL (IC50 70 µg/ml) and F-TRI (IC50 68 µg/ml) were barely more effective against B16-F10 cells, and only F-TRI exerted an inhibitory effect on SK-MEL-28 cells (IC50 66-75 µg/ml). The samples did not effectively inhibit THP-1 growth (IC50 69-87 µg/ml, assessed by MTT). B16-F10 was susceptible to PMA (IC50 53 µM) and two 12-phenylacetate esters (IC50 56-60 µM), while SK-MEL-28 growth was inhibited (IC50 58 µM) by one of these kinds of esters with an additional 4ß-deoxy structure. Synagrantol A (IC50 39 µM) was as effective as PMA (IC50 47 µM) in inhibiting J774A.1 growth in a dose-dependent manner. Furthermore, an in silico study with target receptors indicated a high interaction of the compounds with the PKC proteins. These results provide useful knowledge on the effect of tigliane-type diterpenes on tumor cell from the perspective of medicinal chemistry.


Assuntos
Euphorbia , Látex , Ésteres de Forbol , Euphorbia/química , Látex/química , Ésteres de Forbol/farmacologia , Humanos , Camundongos , Animais , Linhagem Celular Tumoral , Estrutura Molecular , Extratos Vegetais/farmacologia , Extratos Vegetais/química , Brasil , Monócitos/efeitos dos fármacos , Compostos Fitoquímicos/farmacologia , Compostos Fitoquímicos/isolamento & purificação , Sobrevivência Celular/efeitos dos fármacos , Diterpenos/farmacologia , Diterpenos/isolamento & purificação , Terpenos/farmacologia , Terpenos/isolamento & purificação , Antineoplásicos Fitogênicos/farmacologia , Antineoplásicos Fitogênicos/isolamento & purificação , Acetato de Tetradecanoilforbol , Melanoma/tratamento farmacológico
18.
J Low Genit Tract Dis ; 28(3): 264-275, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38697126

RESUMO

OBJECTIVES: We set out to identify the psychosocial factors associated with vulvodynia and the effects on sexuality, mental health, and quality of life. MATERIALS AND METHODS: PubMed, LILACS, Embase, CINAHL, Web of Science, Scopus, and PsycINFO were searched in August 2023. Two authors selected and extracted the data independently. The risk of bias was assessed using the Newcastle-Ottawa Scale for Observational Studies. To rank the strength of evidence, the Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE) approach was utilized. RESULTS: A total of 3,182 articles were identified. Twenty-two observational studies (8 cohorts and 14 case-controls) met the eligibility criteria and were included, comprising 2,624 patients. Vulvodynia has been associated with psychological factors (anxiety and depression) and social factors (childhood exposure to physical and sexual abuse, posttraumatic stress, and domestic abuse). Concerning sexual function, the most frequent outcomes were dyspareunia and sexual dysfunction. Only one study assessed quality of life, which showed that women with chronic vulvar pain had greater difficulty performing physical activities and experienced negative moods and feelings. The assessment of the risk of bias showed that the average quality of studies was good to excellent. However, the studies failed to select the nonexposed cohort or control group to describe the results, and often, the study population was rather small, which made it impossible to carry out a meta-analysis. CONCLUSIONS: The certainty of evidence for the associations between anxiety and depression, vulvodynia, and sexual functioning suggests that combating these factors could improve overall quality of life in vulvodynia patients.


Assuntos
Qualidade de Vida , Vulvodinia , Humanos , Vulvodinia/psicologia , Feminino , Qualidade de Vida/psicologia , Adulto , Pessoa de Meia-Idade , Depressão/psicologia , Ansiedade/psicologia
19.
Brain Sci ; 14(5)2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38790479

RESUMO

The sensorimotor gating is a nervous system function that modulates the acoustic startle response (ASR). Prepulse inhibition (PPI) phenomenon is an operational measure of sensorimotor gating, defined as the reduction of ASR when a high intensity sound (pulse) is preceded in milliseconds by a weaker stimulus (prepulse). Brainstem nuclei are associated with the mediation of ASR and PPI, whereas cortical and subcortical regions are associated with their modulation. However, it is still unclear how the modulatory units can influence PPI. In the present work, we developed a computational model of a neural circuit involved in the mediation (brainstem units) and modulation (cortical and subcortical units) of ASR and PPI. The activities of all units were modeled by the leaky-integrator formalism for neural population. The model reproduces basic features of PPI observed in experiments, such as the effects of changes in interstimulus interval, prepulse intensity, and habituation of ASR. The simulation of GABAergic and dopaminergic drugs impaired PPI by their effects over subcortical units activity. The results show that subcortical units constitute a central hub for PPI modulation. The presented computational model offers a valuable tool to investigate the neurobiology associated with disorder-related impairments in PPI.

20.
J Clin Endocrinol Metab ; 109(10): 2504-2512, 2024 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-38506164

RESUMO

CONTEXT: The effectiveness of levothyroxine (LT4) in restoring thyroid hormone (TH) homeostasis, particularly serum thyroxine (T4) and triiodothyronine (T3) levels, remains debatable. OBJECTIVE: This work aimed to assess TH homeostasis in LT4-treated individuals using data from the Longitudinal Study of Adult Health in Brazil (ELSA-Brasil) study. METHODS: The ELSA-Brasil study follows 15 105 adult Brazilians (aged 35-74 years) over 8.2 years (2008-2019) with 3 observation points assessing health parameters including serum thyrotropin (TSH), free T4 (FT4), and free T3 (FT3) levels. We analyzed 186 participants that initiated treatment with LT4 during the study, and 243 individuals continuously treated with LT4 therapy. RESULTS: Initiation of therapy with LT4 resulted in an 11% to 19% decrease in TSH, an approximately 19% increase in FT4, and a 7% reduction in FT3 serum levels (FT3 dropped >10% in ∼40% of the LT4-treated patients). This was associated with an increase in triglyceride levels and utilization of hypolipidemic and antidiabetic medications. Participants continuously treated with LT4 exhibited a stable elevation in serum FT4 and a reduction in serum FT3 and TSH levels. While 115 participants (47.3%) had at least 1 serum FT4 levels above the control reference range (>1.52 ng/dL), 38 participants (15.6%) had at least 1 serum FT3 below the reference range (<0.23 ng/dL). CONCLUSION: The present results challenge the dogma that treatment with LT4 for hypothyroidism restores TH homeostasis in all patients. A substantial number of LT4-treated patients exhibit repeated FT4 and FT3 levels outside the normal reference range, despite normal TSH levels. Further studies are needed to define the clinical implications of these findings.


Assuntos
Homeostase , Hipotireoidismo , Tiroxina , Humanos , Pessoa de Meia-Idade , Tiroxina/uso terapêutico , Tiroxina/sangue , Tiroxina/administração & dosagem , Feminino , Masculino , Adulto , Homeostase/efeitos dos fármacos , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/sangue , Estudos Longitudinais , Idoso , Brasil , Hormônios Tireóideos/sangue , Tri-Iodotironina/sangue , Tireotropina/sangue , Testes de Função Tireóidea , Terapia de Reposição Hormonal/métodos
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