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1.
Artigo em Inglês | MEDLINE | ID: mdl-39277444

RESUMO

OBJECTIVE: To investigate the stimulated salivary flow (SSF) and unstimulated salivary flow (USF) in adults with acromegaly and to identify possible clinical factors associated with salivary flow. STUDY DESIGN: A case-control study was conducted with a group composed of adults diagnosed with acromegaly (n = 29, mean age = 50.2 years) and a control group (n = 29, mean age = 54.3 years). Variables for socio-demographic characterization, lifestyle habits, and diabetes diagnosis, body mass index (BMI), cervical circumference (CC) and abdominal circumference (AC) were collected. USF and SSF variables were analyzed as outcomes. Unpaired t-test, Pearson's correlation, and multivariate regression models were used for statistical analysis. RESULTS: Both groups were 44.8% male and 55.2% female. Diabetes was present in 55.2% of the acromegaly group and in 51.7% of the controls (P = .792). The acromegaly group had a higher USF than the control group (0.50 mL/min versus 0.22 mL/min). SSF showed a direct correlation with CC (r = 0.470, P = .010). Acromegaly was associated with higher USF (standardized coefficient = 0.780, P = .039), and age was inversely related to USF (standardized coefficient = -0.333, P = .013). CONCLUSIONS: The findings suggest that adults with acromegaly have an increased USF and that being older is associated with a decrease in USF.

2.
Chem Asian J ; : e202400734, 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-39278839

RESUMO

This study aims to describe the synthesis of a new class of selanylfullerene derivatives in a convergent strategy route, affording the desired products in a few steps and in good yields. C60 compounds were evaluated as photosensitizers to be used in photodynamic therapy (PDT) via the generation of singlet oxygen (1O2), using the chemical trapping method. The photooxidation of the chemical probe1,3-diphenylisobenzofuran (DPBF) sensitized by selanylfullerenes followed a first-order kinetic and the values of singlet oxygen quantum yields (ΦΔ) are appropriate for its use in PDT. The electronic absorption spectra, and the intersystem crossing tax rates for the most prominent synthesized compounds were calculated using the density functional theory and the Marcus electron transfer theory, with the theoretical results confirming the experimental findings.

3.
Phys Rev E ; 110(2-1): 024206, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39295058

RESUMO

Isochronous islands in phase space emerge in twist Hamiltonian systems as a response to multiple resonant perturbations. According to the Poincaré-Birkhoff theorem, the number of islands depends on the system characteristics and the perturbation. We analyze, for the two-parameter standard map, also called two-harmonic standard map, how the island chains are modified as the perturbation amplitude increases. We identified three routes for the transition from one chain, associated with one harmonic, to the chain associated with the other harmonic, based on a combination of pitchfork and saddle-node bifurcations. These routes can present intermediate island chains configurations. Otherwise, the destruction of the islands always occurs through the pitchfork bifurcation.

4.
medRxiv ; 2024 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-39252933

RESUMO

Tuberculosis (TB) treatment is highly effective, but response to therapy can vary by geography, race, and ethnicity. We assessed for differences in TB treatment response in a representative and heterogeneous Brazilian population. We estimated genetic ancestry proportion according to major ancestry groups (African, European, and Amerindian ancestry) in the Regional Prospective Observational Research in Tuberculosis (RePORT)-Brazil cohort. RePORT-Brazil is an observational prospective cohort study of individuals with newly-diagnosed, culture-confirmed, pulmonary TB. TB treatment outcomes that were attributed to TB treatment included Grade 2 or higher adverse drug reaction (ADR), Grade 3 or higher ADR, hepatic ADR, and failure/recurrence. Ancestry proportion was the main predictor in logistic regression for each outcome, with adjustments for candidate confounders. There were 941 pulmonary TB patients included in this study. We observed a decreased risk of Grade 2+ ADR when African ancestry proportion increased by 10% (Odds Ratio [OR] 0.41, 95% Confidence Interval [CI] 0.20 -0.85) and an increased risk for Grade 2+ ADR with increasing European ancestry (OR 2.84, 95% CI 1.47 - 5.48). We then performed the same analysis adding HIV status as an interaction term. The decreased risk for Grade 2+ ADR seen for African ancestry proportion did not hold for persons living with HIV; we observed increased risk for Grade 2+ ADR with increasing African ancestry proportion. There were no associations with Amerindian ancestry or for other treatment outcomes. In this Brazilian TB cohort, toxicity risk was associated with African and European ancestry, divergent, and affected by HIV. #RePORT-Brazil Consortium members include: Aline Benjamin and Flavia M. Sant'Anna Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil Jamile Garcia de Oliveira and João Marine Clínica de Saúde Rinaldo Delmare, Rio de Janeiro, Brazil Adriana Rezende and Anna Cristina Carvalho Secretaria de Saúde de Duque de Caxias, Rio de Janeiro, Brazil Michael Rocha and Betânia Nogueira Instituto Brasileiro para Investigação da Tuberculose, Fundação José Silveira, Salvador, Brazil Alexandra Brito and Renata Spener Fundação Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil Megan Turner Vanderbilt University Medical Center, Nashville, USA.

5.
Vet Med Int ; 2024: 4714077, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39220466

RESUMO

The genetic diversity of Breton horses in Brazil is a critical concern, mainly due to the small population size and low number of births per year. Given that the inbreeding was overlooked by breeders for multiple generations, we estimated the genetic diversity of this population utilizing pedigree-based measures of population diversity. A total of 1394 six-generation pedigrees representing the full population of registered Breton horses in Brazil defined a total population (TP, N = 2679), with horses born between 2000 and 2022, reproductively active and alive, as reported by the breed association, representing the reference population (RP, N = 731). Using the R package PurgeR, we estimated inbreeding coefficient (F ped ), maternal inbreeding coefficient (F da m ), paternal inbreeding coefficient (F sire ), individual reproductive values, number of equivalents to complete generations (t), and unbiased ancestral inbreeding coefficient (Fa). We established the equivalent complete generations (ECG), effective population size (Ne), total number of founders (Nf), effective number of founders (Nfe), total number of ancestors (Na), effective number of ancestors (Nae), founder genomes (Ng), and the inbreeding coefficient estimated with effective population size (Ne) and generation numbers (t) (F Ne:t ), as well as Nfe/Nae and Nfe/Ng ratios for the RP. The RP inbreeding levels have stabilized, although they are still significantly rising by generation (t), and the Nfe/Ng ratio strongly suggests genetic drift. Pedigree-based analysis demonstrates that only five stallions have sired 52.83% of the RP individuals, which along with the Nae value of 36.73 implies that the observed inbreeding can be arising from patrilines. Our results suggest that observed inbreeding is due to Popular Sire Effect, highlighting the importance of monitoring breeding schemes and genetic diversity to maintain health.

6.
Open Forum Infect Dis ; 11(8): ofae416, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39100532

RESUMO

Background: Adherence to anti-tuberculosis treatment (ATT) in Brazil remains a challenge in achieving the goals set by the World Health Organization (WHO). Patients who are lost to follow-up during treatment pose a significant public health problem. This study aimed to investigate the factors associated with unfavorable ATT outcomes among those undergoing retreatment in Brazil. Methods: We conducted an observational study of patients aged ≥18 years with tuberculosis (TB) reported to the Brazilian National Notifiable Disease Information System between 2015 and 2022. Clinical and epidemiologic variables were compared between the study groups (new cases and retreatment). Regression models identified variables associated with unfavorable outcomes. Results: Among 743 823 reported TB cases in the study period, 555 632 cases were eligible, consisting of 462 061 new cases and 93 571 undergoing retreatments (44 642 recurrent and 48 929 retreatments after loss to follow-up [RLTFU]). RLTFU (odds ratio [OR], 3.96 [95% confidence interval {CI}, 3.83-4.1]) was a significant risk factor for any type of unfavorable ATT. Furthermore, RLTFU (OR, 4.93 [95% CI, 4.76-5.11]) was the main risk factor for subsequent LTFU. For death, aside from advanced age, living with HIV (OR, 6.28 [95% CI, 6.03-6.54]) was the top risk factor. Conclusions: Retreatment is a substantial risk factor for unfavorable ATT outcomes, especially after LTFU. The rates of treatment success in RLTFU are distant from the WHO End TB Strategy targets throughout Brazil. These findings underscore the need for targeted interventions to improve treatment adherence and outcomes in persons who experience RLTFU.

7.
An Acad Bras Cienc ; 96(suppl 1): e20231333, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39046058

RESUMO

This study was conducted to determine the best combination of protein sources in diets for jundiá, based on growth, metabolism, and nutrient deposition. Five protein combinations were tested: casein + fish meal (control), casein + gelatin, casein + albumin, casein + albumin + fish meal, and albumin + fish meal, in diets containing 370 g Kg-1 of crude protein and 13.4 MJ Kg-1 of digestible energy. The fish (9.38 ± 0.12 g) were allocated in a water recirculation system at a density of 3.35 g L-1 per experimental unit and fed until apparent satiety for 40 days with the diets. The fish fed with the control diet had the highest final weight, specific growth rate, protein and feed efficiency ratio, protein retention, and best apparent feed conversion. On the other hand, fish that received casein + albumin and albumin + fish meal diets showed worse results in growth and body protein retention, low trypsin and chymotrypsin activity, and high intestinal amylase activity. Therefore, the combination referred to as control (casein + fish meal) conclusively provides the best rhythm for nutrient digestion and metabolism processes, enabling fish to reach greater growth and retention of body protein with low whole-fish fat content.


Assuntos
Ração Animal , Proteínas Alimentares , Animais , Ração Animal/análise , Proteínas Alimentares/administração & dosagem , Proteínas Alimentares/metabolismo , Caseínas/administração & dosagem , Caseínas/metabolismo , Digestão/fisiologia , Digestão/efeitos dos fármacos , Fenômenos Fisiológicos da Nutrição Animal
8.
Sci Rep ; 14(1): 17569, 2024 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-39080451

RESUMO

Projected to impact 310 million children by the next decade, childhood obesity is linked to serious health issues like metabolic disturbance and cardiovascular diseases. This study introduces a novel approach for the integrated assessment of inflammatory, glycemic and lipid disorders in obese children in resources-limited settings and also identifies key factors contributing to these changes. Conducting a cross-sectional analysis of 231 children aged 5-12 years from public schools in Brazil's semi-arid region, the research involved collecting medical history, anthropometric measurements, and blood samples to analyze glycemic and lipid profiles, along with C-reactive protein levels. We used an adapted the Molecular Degree of Perturbation model to analyze deviations in metabolic markers from a healthy control group. Statistical analyses included Mann-Whitney and Fisher exact tests, backward logistic regression, and hierarchical cluster analysis. The study identified a direct and independent association between elevated Metabolic Disturbance Degree and both overweight and obesity in children, with significant differences in CRP, Triglycerides, and HDL levels noted between obese and healthy-weight groups. The findings highlight the critical need for early detection and comprehensive understanding of obesity-related changes to mitigate the severe health risks associated with childhood obesity.


Assuntos
Obesidade Infantil , Humanos , Criança , Obesidade Infantil/sangue , Obesidade Infantil/epidemiologia , Brasil/epidemiologia , Masculino , Feminino , Pré-Escolar , Estudos Transversais , Proteína C-Reativa/metabolismo , Proteína C-Reativa/análise , Doenças Metabólicas/sangue , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/etiologia , Biomarcadores/sangue , Triglicerídeos/sangue
9.
Front Immunol ; 15: 1357360, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38994357

RESUMO

Background: The impact of previous SARS-CoV-2 infection on the systemic immune response during tuberculosis (TB) disease has not been explored. Methods: An observational, cross-sectional cohort was established to evaluate the systemic immune response in persons with pulmonary tuberculosis with or without previous SARS-CoV-2 infection. Those participants were recruited in an outpatient referral clinic in Rio de Janeiro, Brazil. TB was defined as a positive Xpert-MTB/RIF Ultra and/or a positive culture of Mycobacterium tuberculosis from sputum. Stored plasma was used to perform specific serology to identify previous SARS-CoV-2 infection (TB/Prex-SCoV-2 group) and confirm the non- infection of the tuberculosis group (TB group). Plasmatic cytokine/chemokine/growth factor profiling was performed using Luminex technology. Tuberculosis severity was assessed by clinical and laboratory parameters. Participants from TB group (4.55%) and TB/Prex-SCoV-2 (0.00%) received the complete COVID-19 vaccination. Results: Among 35 participants with pulmonary TB, 22 were classified as TB/Prex-SCoV-2. The parameters associated with TB severity, together with hematologic and biochemical data were similar between the TB and TB/Prex-SCoV-2 groups. Among the signs and symptoms, fever and dyspnea were significantly more frequent in the TB group than the TB/Prex-SCoV-2 group (p < 0,05). A signature based on lower amount of plasma EGF, G-CSF, GM-CSF, IFN-α2, IL-12(p70), IL-13, IL-15, IL-17, IL-1ß, IL-5, IL-7, and TNF-ß was observed in the TB/Prex-SCoV-2 group. In contrast, MIP-1ß was significantly higher in the TB/Prex-SCoV-2 group than the TB group. Conclusion: TB patients previously infected with SARS-CoV-2 had an immunomodulation that was associated with lower plasma concentrations of soluble factors associated with systemic inflammation. This signature was associated with a lower frequency of symptoms such as fever and dyspnea but did not reflect significant differences in TB severity parameters observed at baseline.


Assuntos
COVID-19 , Citocinas , SARS-CoV-2 , Tuberculose Pulmonar , Humanos , COVID-19/imunologia , COVID-19/sangue , Masculino , Feminino , Estudos Transversais , Adulto , Pessoa de Meia-Idade , SARS-CoV-2/imunologia , Tuberculose Pulmonar/imunologia , Tuberculose Pulmonar/sangue , Citocinas/sangue , Citocinas/imunologia , Brasil/epidemiologia
10.
J Fish Biol ; 105(4): 1151-1162, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39022856

RESUMO

Reproductive traits co-evolve and form successful life-history strategies adapted to the biology and environment of a particular taxon, maximizing offspring and species survival chances, therefore studies investigating differences in adaptive traits across different environments can enhance our understanding of the natural selection process and evolution. Herein, we address whether the reproductive strategies of phylogenetically closely related fishes are influenced by habitat predictability, using three species of the Lebiasinidae family as models. The predominance of larger and mature individuals during the flood season, with high waters characterized by smaller immature individuals, suggests a seasonal reproductive strategy for Nannostomus trifasciatus. Copella callolepis, which inhabits both habitats, also showed a single reproductive peak. However, compared to N. trifasciatus, this species displayed late spawning, restricted to the flood season, as indicated by the higher abundance of larger and mature individuals during this period and the presence of smaller (juveniles) and spawned individuals in the following season. The reproductive tactics observed in N. marginatus differed significantly from the single reproductive peak of the other species, as two reproductive peaks were observed: one during the flood season and another during the low water season. In conclusion, our study demonstrates that the environment strongly influences reproductive strategies for lebiasinids. N. marginatus, restricted to small water bodies, exhibited an opportunistic reproductive strategy, whereas the species inhabiting main rivers, N. trifasciatus and C. callolepis, exhibited a more seasonal strategy.


Assuntos
Caraciformes , Características de História de Vida , Reprodução , Rios , Estações do Ano , Animais , Brasil , Caraciformes/fisiologia , Ecossistema , Masculino , Feminino
11.
Lancet Reg Health Am ; 36: 100804, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38912329

RESUMO

Background: Since 2014, Brazil has gradually implemented the Xpert MTB/RIF (Xpert) test to enhance early tuberculosis (TB) and drug-resistant (DR-TB) detection and control, yet its nationwide impact remains underexplored. Our study conducts an intervention time-series analysis (ITSA) to evaluate how the Xpert's implementation has improved TB and DR-TB detection nationwide. Methods: 1,061,776 cases from Brazil's National TB Registry (2011-2022) were reviewed and ITSA (2011-2019) was used to gauge the impact of the Xpert's adoption on TB and DR-TB notification. Granger Causality and dynamic regression modelling determined if incorporating Xpert testing as an external regressor enhanced forecasting accuracy for Brazil's future TB trends. Findings: Xpert implementation resulted in a 9.7% increase in TB notification and substantial improvements in DR-TB (63.6%) and drug-susceptible TB (92.1%) detection compared to expected notifications if it had not been implemented. Xpert testing counts also presented a time-dependent relationship with DR-TB detection post-implementation, and improved predictions in forecasting models, which depicted a potential increase in TB and DR-TB detection in the next six years. Interpretation: This study underscores the critical role of Xpert's adoption in boosting TB and DR-TB detection in Brazil, reinforcing the case for its widespread use in disease control. Improvements in prediction accuracy resulting from integrating Xpert data are crucial for allocating resources and reducing the incidence of TB. By acknowledging Xpert's role in both disease control and improving predictions, we advocate for its expanded use and further research into advanced molecular diagnostics for effective TB and DR-TB control. Funding: FIOCRUZ.

12.
BMC Public Health ; 24(1): 1385, 2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38783264

RESUMO

BACKGROUND: Identifying patients at increased risk of loss to follow-up (LTFU) is key to developing strategies to optimize the clinical management of tuberculosis (TB). The use of national registry data in prediction models may be a useful tool to inform healthcare workers about risk of LTFU. Here we developed a score to predict the risk of LTFU during anti-TB treatment (ATT) in a nationwide cohort of cases using clinical data reported to the Brazilian Notifiable Disease Information System (SINAN). METHODS: We performed a retrospective study of all TB cases reported to SINAN between 2015 and 2022; excluding children (< 18 years-old), vulnerable groups or drug-resistant TB. For the score, data before treatment initiation were used. We trained and internally validated three different prediction scoring systems, based on Logistic Regression, Random Forest, and Light Gradient Boosting. Before applying our models we splitted our data into training (~ 80% data) and test (~ 20%) sets, and then compared the model metrics using the test data set. RESULTS: Of the 243,726 cases included, 41,373 experienced LTFU whereas 202,353 were successfully treated. The groups were different with regards to several clinical and sociodemographic characteristics. The directly observed treatment (DOT) was unbalanced between the groups with lower prevalence in those who were LTFU. Three models were developed to predict LTFU using 8 features (prior TB, drug use, age, sex, HIV infection and schooling level) with different score composition approaches. Those prediction scoring systems exhibited an area under the curve (AUC) ranging between 0.71 and 0.72. The Light Gradient Boosting technique resulted in the best prediction performance, weighting specificity and sensitivity. A user-friendly web calculator app was developed ( https://tbprediction.herokuapp.com/ ) to facilitate implementation. CONCLUSIONS: Our nationwide risk score predicts the risk of LTFU during ATT in Brazilian adults prior to treatment commencement utilizing schooling level, sex, age, prior TB status, and substance use (drug, alcohol, and/or tobacco). This is a potential tool to assist in decision-making strategies to guide resource allocation, DOT indications, and improve TB treatment adherence.


Assuntos
Perda de Seguimento , Aprendizado de Máquina , Sistema de Registros , Tuberculose , Humanos , Masculino , Feminino , Estudos Retrospectivos , Adulto , Brasil/epidemiologia , Pessoa de Meia-Idade , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia , Adulto Jovem , Antituberculosos/uso terapêutico , Adolescente , Algoritmos
13.
J Infect Dis ; 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38709708

RESUMO

BACKGROUND: Approximately 5% of people infected with Mycobacterium tuberculosis progress to tuberculosis (TB) disease without preventive therapy. There is a need for a prognostic test to identify those at highest risk of incident TB, so that therapy can be targeted. We evaluated host blood transcriptomic signatures for progression to TB disease. METHODS: Close contacts (≥4 hours exposure per week) of adult patients with culture-confirmed pulmonary TB were enrolled in Brazil. Investigation for incident, microbiologically-confirmed or clinically-diagnosed pulmonary or extra-pulmonary TB disease through 24 months of follow-up was symptom-triggered. Twenty previously validated blood TB transcriptomic signatures were measured at baseline by real-time quantitative PCR. Prognostic performance for incident TB was tested using receiver operating characteristic curve (ROC) analysis at 6, 9, 12, and 24 months of follow-up. RESULTS: Between June 2015 and June 2019, 1,854 close contacts were enrolled; Twenty-five progressed to incident TB, of whom 13 had microbiologically-confirmed disease. Baseline transcriptomic signature scores were measured in 1,789 close contacts. Prognostic performance for all signatures was best within 6 months of diagnosis. Seven signatures (Gliddon4, Suliman4, Roe3, Roe1, Penn-Nicholson6, Francisco2, and Rajan5) met the minimum World Health Organization target product profile (TPP) for a prognostic test through 6 months; three (Gliddon4, Rajan5, and Duffy9) through 9 months. None met the TPP threshold through 12 or more months of follow-up. CONCLUSIONS: Blood transcriptomic signatures may be useful for predicting TB risk within 9 months of measurement among TB-exposed contacts, to target preventive therapy administration.

14.
J Pediatr (Rio J) ; 100(6): 565-585, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38636551

RESUMO

OBJECTIVE: Empirical evidence underscores an association between parental stress and emotional and behavioral problems in offspring. However, a comprehensive systematic review or meta-analysis on this topic is lacking. Thus, this study aims to address the scientific inquiry: Is there a relationship between parental stress and emotional/behavioral problems in children? SOURCES: This systematic review with a meta-analysis surveyed PubMed, PsycINFO, and the Biblioteca Virtual em Saúde between August and September 2021. The present search combined terms (school-age children) AND (parental stress OR parenting stress OR family stress) AND (emotional and behavioral problems OR internalizing and externalizing problems). Eligibility criteria encompassed cross-sectional, cohort, and case-control studies published within the last five years, exploring the association between parental stress (stressful life events and parenthood-related stress disorders) and emotional/behavioral problems in school-age children. PROSPERO ID CRD42022274034. SUMMARY OF THE FINDINGS: Of the 24 studies meeting all inclusion criteria (n = 31,183) for the systematic review, nine were eligible for inclusion in the meta-analysis. The meta-analysis revealed an association between parental stress and emotional problems (COR: 0.46 [95 % CI: 0.27 - 0.61], p < 0.001, Heterogeneity = 89 %) as well as behavioral problems (COR: 0.37 [95 % CI: 0.27 - 0.46], p < 0.001, Heterogeneity = 76 %). CONCLUSIONS: These findings indicate that parental stress predicts emotional/behavioral problems in school-age children. Since these problems are related to long-term negative effects in adulthood, these results are crucial for preventing mental health problems in offspring and for screening and managing parental stress.


Assuntos
Transtornos do Comportamento Infantil , Pais , Estresse Psicológico , Criança , Humanos , Transtornos do Comportamento Infantil/etiologia , Transtornos do Comportamento Infantil/psicologia , Pais/psicologia , Estresse Psicológico/psicologia
15.
J Clin Sleep Med ; 20(8): 1321-1330, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38557332

RESUMO

STUDY OBJECTIVES: We assessed whether critical pathophysiological phenotypes predict treatment response in patients with obstructive sleep apnea using a mandibular advancement device (MAD). METHODS: Thirty-one patients with obstructive sleep apnea were treated with a MAD. Individuals were categorized and graded into 4 pathophysiological phenotypes based on polysomnographic features (anatomical, ventilatory control, arousal threshold, and muscle responsiveness). Morpho-anthropometric data were additionally assessed. Patients were classified as responders or nonresponders. Associations between polysomnographic phenotypes and treatment response were documented, as were morpho-anthropometric data and their impact on therapeutic success. RESULTS: There was a male predominance (64.5%), with a median age of 49 years (25th percentile: 40; 75th percentile: 55), body mass index = 27.4 kg/m2 (25th percentile: 26; 75th percentile: 28.8), and apnea-hypopnea index of 18.2 events/h (25th percentile: 11.7; 75th percentile: 27.6). The majority of patients treated with a MAD (58%) were good responders (68.0% mild and moderate vs 16.7% severe). Treatment response was associated with shorter intermolar and interpremolar distances in the lower arch (P = .0092 and .0129). Rapid eye movement sleep apnea-hypopnea index and MAD-related treatment response were inversely correlated (P = .0013). Favorable anatomical (P = .0339) and low muscle response (P = .0447) phenotypes were correlated with outcomes. CONCLUSIONS: According to our results, a favorable response occurred in a better "anatomical phenotype" and in the worse "muscular responsiveness phenotype" according to polysomnographic data. Furthermore, other favorable predictors, such as a rapid eye movement sleep apnea-hypopnea index < 16 events/h and a smaller distance between lower molars and premolars, were found. These findings indicate that clinical and polysomnographic aspects can discriminate phenotypes that may guide decisions on MAD treatment for obstructive sleep apnea. CITATION: Manetta IP, Duarte BB, Nucci LB, Enes CC. Relationship between OSA pathophysiological phenotypes and treatment response to mandibular advancement devices: a pilot study. J Clin Sleep Med. 2024;20(8):1321-1330.


Assuntos
Avanço Mandibular , Fenótipo , Polissonografia , Apneia Obstrutiva do Sono , Humanos , Masculino , Projetos Piloto , Apneia Obstrutiva do Sono/terapia , Apneia Obstrutiva do Sono/fisiopatologia , Avanço Mandibular/instrumentação , Avanço Mandibular/métodos , Feminino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto
16.
Front Immunol ; 15: 1383098, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38633252

RESUMO

Despite major global efforts to eliminate tuberculosis, which is caused by Mycobacterium tuberculosis (Mtb), this disease remains as a major plague of humanity. Several factors associated with the host and Mtb interaction favor the infection establishment and/or determine disease progression. The Early Secreted Antigenic Target 6 kDa (ESAT-6) is one of the most important and well-studied mycobacterial virulence factors. This molecule has been described to play an important role in the development of tuberculosis-associated pathology by subverting crucial components of the host immune responses. This review highlights the main effector mechanisms by which ESAT-6 modulates the immune system, directly impacting cell fate and disease progression.


Assuntos
Mycobacterium tuberculosis , Tuberculose , Humanos , Antígenos de Bactérias , Proteínas de Bactérias , Progressão da Doença
19.
iScience ; 27(3): 109135, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38380250

RESUMO

Tuberculosis-diabetes mellitus (TB-DM) is linked to a distinct inflammatory profile, which can be assessed using multi-omics analyses. Here, a machine learning algorithm was applied to multi-platform data, including cytokines and gene expression in peripheral blood and eicosanoids in urine, in a Brazilian multi-center TB cohort. There were four clinical groups: TB-DM(n = 24), TB only(n = 28), DM(HbA1c ≥ 6.5%) only(n = 11), and a control group of close TB contacts who did not have TB or DM(n = 13). After cross-validation, baseline expression or abundance of MMP-28, LTE-4, 11-dTxB2, PGDM, FBXO6, SECTM1, and LINCO2009 differentiated the four patient groups. A distinct multi-omic-derived, dimensionally reduced, signature was associated with TB, regardless of glycemic status. SECTM1 and FBXO6 mRNA levels were positively correlated with sputum acid-fast bacilli grade in TB-DM. Values of the biomarkers decreased during the course of anti-TB therapy. Our study identified several markers associated with the pathophysiology of TB-DM that could be evaluated in future mechanistic investigations.

20.
An Acad Bras Cienc ; 96(1): e20190556, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38359283

RESUMO

A 45-day feeding assay was carried out to evaluate the effects of crescent levels of dephytinized rice bran protein concentrate (DRBPC) on growth performance, nutrient deposition, plasma and liver parameters of jundiá Rhamdia quelen. Five experimental diets were formulated with inclusion of 0 (control), 10, 15, 20, and 30% of DRBPC. In total 500 jundiás (initial body weight 6.28 ± 0.12 g) were allocated in 20 tanks (230 L) to give four groups for each treatment. Fish were fed to apparent satiation for 45 days. Weight gain and specific growth rate were evaluated by cubic regression analysis (P < 0.05) and displayed maximal growth on the inclusion level of 25% of DRBPC. The results indicated that fish fed DRBPC15 and DRBPC30 had lower body protein deposition and hepatosomatic index compared to CONTROL diet, respectively. No significant differences (P > 0.05) were assessed in plasma parameters. The alanine aminotransferase activity was higher in fish fed DRBPC30 compared to CONTROL group. The present study has demonstrated that DRBPC displayed significant nutritional quality for the jundiá. Thus, this new ingredient could be included as a protein source in fish for minimizing the use of fish meal.


Assuntos
Peixes-Gato , Oryza , Animais , Fígado/metabolismo , Aumento de Peso , Dieta , Ração Animal/análise
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