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1.
Brain Sci ; 14(6)2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38928592

RESUMO

The endocannabinoid system has been linked to various physiological and pathological processes, because it plays a neuromodulator role in the central nervous system. In this sense, cannabinoids have been used off-label for neurodevelopmental disorders, such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHA), as well as in Alzheimer's disease (AD), a more prevalent neurodegenerative disease. Thus, this study aims, through a comprehensive literature review, to arrive at a better understanding of the impact of cannabinoids in the therapeutic treatment of patients with ASD, ADHD, and Alzheimer's disease (AD). Overall, cannabis products rich in CBD displayed a higher therapeutic potential for ASD children, while cannabis products rich in THC have been tested more for AD therapy. For ADHD, the clinical studies are incipient and inconclusive, but promising. In general, the main limitations of the clinical studies are the lack of standardization of the cannabis-based products consumed by the participants, a lack of scientific rigor, and the small number of participants.

2.
Ann Phys Rehabil Med ; 67(4): 101826, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38479250

RESUMO

BACKGROUND: Chikungunya virus (CHIKV) is a globally prevalent pathogen, with outbreaks occurring in tropical regions. Chronic pain is the main symptom reported and is associated with decreased mobility and disability. Transcranial direct current stimulation (tDCS) is emerging as a new therapeutic tool for chronic arthralgia. OBJECTIVE: To evaluate the effectiveness of 10 consecutive sessions of anodal tDCS on pain (primary outcome) in participants with chronic CHIKV arthralgia. Secondary outcomes included functional status, quality of life, and mood. METHODS: In this randomized, double-blind, placebo-controlled trial, 30 participants with chronic CHIKV arthralgia were randomly assigned to receive either active (n = 15) or sham (n = 15) tDCS. The active group received 10 consecutive sessions of tDCS over M1 using the C3/Fp2 montage (2 mA for 20 min). Visual analog scale of pain (VAS), health assessment questionnaire (HAQ), short-form 36 health survey (SF-36), pain catastrophizing scale, Hamilton anxiety scale (HAS), timed up and go (TUG) test, lumbar dynamometry, 30-s arm curl and 2-min step test were assessed at baseline, day 10 and at 2 follow-up visits. RESULTS: There was a significant interaction between group and time on pain (p = 0.03; effect size 95 % CI 0.9 (-1.67 to -0.16), with a significant time interaction (p = 0.0001). There was no interaction between time and group for the 2-minute step test (p = 0.18), but the groups differed significantly at day 10 (p = 0.01), first follow-up (p = 0.01) and second follow-up (p = 0.03). HAQ and SF-36 improved but not significantly. There was no significant improvement in mental health, and physical tests. CONCLUSION: tDCS appears to be a promising intervention for reducing pain in participants with chronic CHIKV arthralgia, although further research is needed to confirm these findings and explore potential long-term benefits. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC): RBR-245rh7.


Assuntos
Febre de Chikungunya , Dor Crônica , Córtex Motor , Qualidade de Vida , Estimulação Transcraniana por Corrente Contínua , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estimulação Transcraniana por Corrente Contínua/métodos , Febre de Chikungunya/complicações , Febre de Chikungunya/terapia , Método Duplo-Cego , Adulto , Dor Crônica/terapia , Dor Crônica/etiologia , Dor Crônica/psicologia , Córtex Motor/fisiopatologia , Artralgia/terapia , Artralgia/etiologia , Resultado do Tratamento , Medição da Dor , Doença Crônica
3.
Lasers Med Sci ; 39(1): 17, 2023 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-38150056

RESUMO

The aim of this study is to assess the effect of photobiomodulation therapy (PBMT) on functional performance concerning strength, fatigue, and functional capacity in healthy individuals. This systematic review with meta-analysis involved searches on data platforms and active searches of randomized clinical trials, focusing on PBMT as the sole intervention. Primary outcomes assessed included strength, fatigue, and functional capacity. Three reviewers screened studies by title and abstract using Rayyan, and data were extracted using a specific form. Bias risk was assessed using RoB2, and confidence in the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The RevMan was used for meta-analysis. Sixteen studies were included, totaling 340 individuals (183 males and 157 women). Most articles presented a low risk of bias. Variability was observed in device types and application domains, including wavelengths (655-905 nm), power (10-200 nW), energy (0.6-30 J per point), and time (30-100 s per point). PBMT improved fatigue recovery (mean difference: 5.87; 95% CI 3.83, 7.91). There was no enhancement in strength (peak torque: mean difference 12.40; 95% CI -5.55, 30.55; one-repetition maximum test: mean difference 39.97, 95% CI -2.44, 82.38; isometric and isokinetic strength: mean difference 2.77, 95% CI -14.90, 20.44) nor improvement in short-term (mean difference 0.67, 95% CI -0.58, 1.91) and long-term (mean difference 18.44, 95% CI -55.65, 92.54) functional capacity. PBMT may aid in favoring fatigue recovery in healthy individuals; however, there's no evidence to support PBMT enhancing strength or improving functional capacity.


Assuntos
Terapia com Luz de Baixa Intensidade , Desempenho Físico Funcional , Feminino , Humanos , Masculino , Fadiga/radioterapia , Força Muscular
4.
Cancers (Basel) ; 15(17)2023 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-37686683

RESUMO

Cancer is a leading cause of death, and the fibrinolytic system shows cooperative effects that facilitate the growth of tumors and the appearance of metastases. This prospective study aimed to evaluate the fibrinolytic potential in cancer patients and its association with mortality outcomes using the fluorometric method of simultaneous thrombin and plasmin generation. The study included 323 cancer patients and 148 healthy individuals. During the 12-month follow-up, 68 patients died. Compared to the control group, cancer patients showed alterations in thrombin production consistent with a hypercoagulability profile, and an increase in plasmin generation. Mortality risk was associated with two parameters of thrombin in both univariate and multivariable analysis: maximum amplitude (Wald 11.78, p < 0.001) and area under the curve (Wald 8.0, p < 0.005), while such associations were not observed for plasmin. In conclusion, this was the first study able to demonstrate the simultaneous evaluation of thrombin and plasmin generation in newly diagnosed untreated cancer patients. Patients with cancer have been observed to exhibit a hypercoagulable profile. During the study, two parameters linked to thrombin generation, MA and AUC, were identified and found to have a potential association with mortality risk. However, no associations were found with parameters related to plasmin generation.

5.
Acta fisiátrica ; 30(3): 173-179, set. 2023.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1531042

RESUMO

Objective: To analyze the effect of the Mobilization With Movement (MWM) of the Mulligan's concept in the perception of nociceptive and neuropathic pain, range of motion (ROM) and joint mobility of individuals with low back pain. Method: This is a randomized and controlled clinical trial, with 30 volunteers with nonspecific low back pain, divided into: Intervention Group (INTG), that received sustained natural apophyseal glides (SNAG) type MWM of the Mulligan's concept; Control Group (CONTG), which received a similar intervention to INTG. Volunteers were assessed using the Numeric Rating Scale for Pain (NRS Pain); the Modified Schober Test (MST) and ROM by goniometry for lumbar spine mobility and Douleur Neuropatique 4 (DN4) questionnaire for assessment of neuropathic and nociceptive pain. Results: INTG showed an increase in lumbar flexion (pre-intervention= 81.21±15.23°; post-intervention= 90.00±19.62°, p< 0.05), mobility of the lumbar spine in MST (pre= 15.33±1.05 post= 16.08±1.02, p< 0.05) and reduction of pain perception by NRS Pain (pre= 5.33±2.26; post= 1.47±2.61 p< 0.05) and in CONTG (pre= 4.07±2.34; post= 2.20±1.93, p< 0.05). Conclusion: The intervention with MWM - SNAGs promoted improved ROM and mobility in flexion of the lumbar spine, associated with reduction from the nociceptive pain in INTG and CONTG.


Objetivo: Analisar o efeito da Mobilization Whith Movement (MWM) do conceito Mulligan na percepção de dor nociceptiva e neuropática, na amplitude e na mobilidade articular de indivíduos com dor lombar. Métodos: Trata-se de um ensaio clínico randomizado e controlado, de 30 voluntários com dor lombar inespecífica, divididos em: Grupo Intervenção (GINT) que recebeu a mobilização articular com deslizamentos apofisários naturais mantidos (MWM - SNAGs); Grupo Controle (GCONT), que recebeu uma mobilização articular placebo. Os voluntários foram avaliados pela escala numérica de dor (EVN); pelo teste modificado de Schober (TMS) para a mobilidade da coluna lombar e pelo DN4 para avaliação da dor neuropática e nociceptiva. Resultados: GINT apresentou aumento da flexão lombar (pré intervenção= 81,21±15,23°; pós-intervenção= 90,00±19,62°, p= <0,05), da mobilidade da coluna lombar no TMS (pré= 15,33±1,05 pós= 16,08±1,02, p= <0,05) e redução da percepção de dor pela EVN (pré= 5,33±2,26; pós= 1,47±2,61= p< 0,05) e no GCONT (pré= 4,07±2,34; pós= 2,20±1,93, p < 0,05). Conclusão: A intervenção com MWM - SNAGs promoveu melhora da ADM e da mobilidade na flexão da coluna lombar, associada com redução da dor nociceptiva no GINT e no GCONT.

6.
J Med Genet ; 61(1): 61-68, 2023 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-37536918

RESUMO

BACKGROUND: Sarcomas are a rare and diverse group of cancers occurring mainly in young individuals for which an underlying germline genetic cause remains unclear in most cases. METHODS: Germline DNA from 177 children, adolescents and young adults with soft tissue or bone sarcomas was tested using multigene panels with 113 or 126 cancer predisposing genes (CPGs) to describe the prevalence of germline pathogenic/likely pathogenic variants (GPVs). Subsequent testing of a subset of tumours for loss of heterozygosity (LOH) evaluation was performed to investigate the clinical and molecular significance of these variants. RESULTS: GPVs were detected in 21.5% (38/177) of the patients (15.8% in children and 21.6% in adolescents and young adults), with dominant CPGs being altered in 15.2% overall. These variants were found in genes previously associated with the risk of developing sarcomas (TP53, RB1, NF1, EXT1/2) but also in genes where that risk is still emerging/limited (ERCC2, TSC2 and BRCA2) or unknown (PALB2, RAD50, FANCM and others). The detection rates of GPVs varied from 0% to 33% across sarcoma subtypes and GPV carriers were more likely to present more than one primary tumour than non-carriers (21.1%×6.5%; p=0.012). Loss of the wild-type allele was detected in 48% of tumours from GPV carriers, mostly in genes definitively associated with sarcoma risk. CONCLUSION: Our findings reveal that a high proportion of young patients with sarcomas presented a GPV in a CPG, underscoring the urgency of establishing appropriate genetic screening strategies for these individuals and their families.


Assuntos
Predisposição Genética para Doença , Sarcoma , Criança , Adulto Jovem , Adolescente , Humanos , Prevalência , Mutação em Linhagem Germinativa/genética , Sarcoma/epidemiologia , Sarcoma/genética , Células Germinativas , Proteína Grupo D do Xeroderma Pigmentoso/genética , DNA Helicases/genética
7.
Biomedicines ; 11(7)2023 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-37509489

RESUMO

The prevalence of partial rotator cuff tears (PRCTs) is high in the general population. Our hypothesis is that barbotage, when associated with platelet-rich plasma (PRP), is an effective method for healing these tears. The aim of this study was to compare the effects of barbotage with or without PRP on the healing of partial supraspinatus tendon tears (PSTTs). This study assessed the Western Ontario Rotator Cuff Index score and ultrasound (US) images at 6 weeks and 6 months after treatment. Patients in both groups showed clinical improvement, with no significant difference in scores at 6 weeks. However, at 6 months, the PRP group exhibited significant improvement (p = 0.019). Both groups experienced a reduction in ST tear size, but the PRP group demonstrated a significant enhancement at 6 weeks and 6 months. In conclusion, the US-guided barbotage technique, whether associated with PRP or saline solution, proved to be an effective treatment for clinical improvement and reduction in the size of PSTT. Better clinical improvement results were observed with PRP at 6 months. The combination of PRP with barbotage was superior in reducing the size of the ST tear at both 6 weeks and 6 months, resulting in complete healing in 79.3% of the tears.

8.
Clin Appl Thromb Hemost ; 29: 10760296231175656, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37203167

RESUMO

Thrombosis occurrence in coronavirus disease 2019 (COVID-19) has been mostly compared to historical cohorts of patients with other respiratory infections. We retrospectively evaluated the thrombotic events that occurred in a contemporary cohort of patients hospitalized between March and July 2020 for acute respiratory distress syndrome (ARDS) according to the Berlin Definition and compared those with positive and negative real-time polymerase chain reaction results for wild-type severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) using descriptive analysis. The association between COVID-19 and thrombotic risk was evaluated using logistic regression. 264 COVID-19-positive (56.8% male, 59.0 years [IQR 48.6-69.7], Padua score on admission 3.0 [2.0-3.0]) and 88 COVID-19-negative patients (58.0% male, 63.7 years [51.2-73.5], Padua score 3.0 [2.0-5.0]) were included. 10.2% of non-COVID-19 and 8.7% of COVID-19 patients presented ≥ 1 clinically relevant thrombotic event confirmed by imaging exam. After adjustment for sex, Padua score, intensive care unit stay, thromboprophylaxis, and hospitalization length, the odds ratio for thrombosis in COVID-19 was 0.69 (95% CI, 0.30-1.64). We, therefore, conclude that infection-induced ARDS carries an inherent thrombotic risk, which was comparable between patients with COVID-19 and other respiratory infections in our contemporary cohort.


Assuntos
COVID-19 , Síndrome do Desconforto Respiratório , Trombose , Tromboembolia Venosa , Humanos , Masculino , Feminino , COVID-19/complicações , SARS-CoV-2 , Anticoagulantes/uso terapêutico , Estudos Retrospectivos , Tromboembolia Venosa/tratamento farmacológico , Trombose/tratamento farmacológico , Síndrome do Desconforto Respiratório/etiologia
9.
Toxicol Appl Pharmacol ; 467: 116496, 2023 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-37001608

RESUMO

Glyphosate is a nonselective and postemergent herbicide used to combat weeds in several crops, which raises concerns about risks to human health since residues are detected in urine, human milk, surface water and several types of food. Feces and urine are the major routes of elimination of glyphosate, making the kidney a sensitive target for the development of toxicity. In fact, farmers are at high risk of developing chronic kidney disease. In this sense, this study aims to investigate kidney function by measuring the serum levels of urea and creatinine, examining the histological morphology, and analyzing the mRNA expression of genes related to tubular transport of ions, urea and urates and the biomarker of kidney disease Kim1, and the levels of lead in the kidney in male Wistar rats orally exposed to low levels of glyphosate-based herbicide (GBH: 0, 0.5 or 5 mg/kg) from weaning to adult life by gavage. GBH0.5 showed reduced serum urea concentration, presence of tubulointerstitial swelling and mononuclear cell infiltration into the interstitium, increased gene expression of Kim1 and reduced gene expression of Slc14a1. GBH5 showed reduced serum urea and increased serum creatinine concentrations, tubulointerstitial swelling, interstitial fibrosis, and reduced expression of Trpm6 and Trpv5. Exposure to GBH did not affect the levels of Pb in the kidneys of animals. In conclusion, glyphosate at low doses may cause mild kidney damage. It is necessary to evaluate whether the long-term effects of this constant injury may contribute to the development of chronic kidney disease of uncertain etiology.


Assuntos
Herbicidas , Canais de Cátion TRPM , Ratos , Animais , Humanos , Masculino , Ratos Wistar , Herbicidas/toxicidade , Rim , Ureia , Biomarcadores , Glifosato
10.
Front Oncol ; 13: 1133277, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36969061

RESUMO

Background: Endometrial cancer is of increasing concern in several countries, including Brazil, in part because of an ageing population, declines in fertility, and the increasing prevalence of obesity. Although endometrial tumors had lagged behind other cancer types in terms of treatment improvements, molecular characterization of these tumors is paving the way for novel therapies and an expansion of the therapeutic arsenal. We aimed to help medical oncologists who manage patients with recurrent or metastatic endometrial cancer in the Brazilian healthcare setting. Methods: The panel, composed of 20 medical oncologists, convened in November 2021 to address 50 multiple-choice questions on molecular testing and treatment choices. We classified the level of agreement among panelists as (1) consensus (≥75% choosing the same answer), (2) majority vote (50% to <75%), or (3) less than majority vote (<50%). Results: Consensus was present for 25 of the 50 questions, whereas majority vote was present for an additional 23 questions. Key recommendations include molecular testing for every patient with recurrent/metastatic endometrial cancer; choice of first-line treatment according to microsatellite instability and HER2, with the addition of programmed death ligand 1 (PD-L1) and hormone receptors (HRs) for second-line therapy; carboplatin and paclitaxel as the preferred option in first-line treatment of HER2-negative disease, with the addition of trastuzumab in HER2-positive disease; pembrolizumab plus lenvatinib as a key option in second line, regardless of HER2, PD-L1 or HRs; and various recommendations regarding treatment choice for patients with distinct comorbidities. Conclusion: Despite the existing gaps in the current literature, the vast majority of issues addressed by the panel provided a level of agreement sufficient to inform clinical practice in Brazil and in other countries with similar healthcare environments.

11.
Child Adolesc Ment Health ; 28(2): 299-306, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-35614029

RESUMO

BACKGROUND: Patient-reported outcome measures place the patient at the centre of his/her care. There are calls to introduce child-reported outcome measures to mental health services. We aimed to (a) develop an age-appropriate patient-reported outcome measure for children's mental health, and (b) validate this in a primary school and Child and Adolescent Mental Health Service (CAMHS). METHODS: A list of items to measure children's mental health was proposed (Draft 1) and revised to 14 items following focus group and user consultation (Draft 2). A colourful, cartoon and emoji version was created in consultation with children (Draft 3); a professional cartoon artist created the final 'My Feelings Form' (MFF), with usability feedback (Draft 4). The MFF was tested by 317 children aged 4-13 years from one mixed-gender primary school at two time points in 1 day, and 25 children aged 4-13 years from CAMHS. Results were analysed using test-retest reliability and exploratory factor analysis; a receiver operator characteristic curve was constructed. RESULTS: The CAMHS group scored significantly higher than the school group for the mean total score (23.5 ± 11.3 vs. 16.1 ± 6.2) and for 10 items. Test-retest reliability was acceptable (correlation = 0.74, p < .001). Exploratory factor analysis using 10 informative items identified two factors - emotional factor (Cronbach's alpha = 0.74) and function factor (Cronbach's alpha = 0.59). The revised 10-item form has a Cronbach's alpha of 0.77; a cut-off of 12 has a sensitivity of 80% and specificity of 60%, indicating that it correctly identified 80% of those who were attending CAMHS and gave 60% of the schoolchildren a negative result. CONCLUSIONS: The colourful MFF was co-produced with children, and preliminary data suggest that it is a useful patient-reported outcome measure for children's mental health.


Assuntos
Serviços de Saúde Mental , Humanos , Adolescente , Masculino , Feminino , Criança , Pré-Escolar , Autorrelato , Reprodutibilidade dos Testes , Inquéritos e Questionários , Emoções , Excipientes
13.
Obes Surg ; 33(1): 263-267, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36460942

RESUMO

PURPOSE: The purpose of this study is to determine the incidence of gastric tube abnormalities after SG and its relationship with esophagitis progression. METHODS: Retrospective study which included 459 patients in the postoperative period of SG who underwent an esophagogastroduodenoscopy in both pre- and postoperative periods. The main studied variables were presence of gastric tube abnormalities (dilation, neofundus, twist, and hiatal hernia) and esophagitis progression. RESULTS: Among the 459 patients who underwent SG, 393 (85.6%) were women, and 66 (14.4%) men, with mean age of 40.4 years. Mean preoperative BMI was 39.70 kg/m2. In total, 20.3% of the sample presented progression of esophagitis after surgery. Among the whole sample, 130 (28.3%) presented with an abnormality of the remnant gastric tube. The most common alteration was gastric dilation, which occurred in 16.1% of the patients, followed by gastric twist (10.7%), neofundus (7.4%), and hiatal hernia (0.2%). Patients who presented with any abnormality of the gastric tube were significantly prone to presenting esophagitis progression (p = 0.013). When analyzing each morphological abnormality isolated, there was no statistically significant correlation. CONCLUSION: Abnormalities of the gastric tube are not uncommon after SG and seems to contribute partially to the relevant rates of GERD and esophagitis after this surgery.


Assuntos
Esofagite , Refluxo Gastroesofágico , Hérnia Hiatal , Laparoscopia , Obesidade Mórbida , Masculino , Humanos , Feminino , Adulto , Hérnia Hiatal/cirurgia , Refluxo Gastroesofágico/etiologia , Estudos Retrospectivos , Incidência , Obesidade Mórbida/cirurgia , Esofagite/epidemiologia , Esofagite/etiologia , Esofagite/cirurgia , Gastrectomia/efeitos adversos , Laparoscopia/efeitos adversos
14.
Nat Commun ; 13(1): 5722, 2022 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-36175400

RESUMO

Visceral adiposity is a risk factor for severe COVID-19, and a link between adipose tissue infection and disease progression has been proposed. Here we demonstrate that SARS-CoV-2 infects human adipose tissue and undergoes productive infection in fat cells. However, susceptibility to infection and the cellular response depends on the anatomical origin of the cells and the viral lineage. Visceral fat cells express more ACE2 and are more susceptible to SARS-CoV-2 infection than their subcutaneous counterparts. SARS-CoV-2 infection leads to inhibition of lipolysis in subcutaneous fat cells, while in visceral fat cells, it results in higher expression of pro-inflammatory cytokines. Viral load and cellular response are attenuated when visceral fat cells are infected with the SARS-CoV-2 gamma variant. A similar degree of cell death occurs 4-days after SARS-CoV-2 infection, regardless of the cell origin or viral lineage. Hence, SARS-CoV-2 infects human fat cells, replicating and altering cell function and viability in a depot- and viral lineage-dependent fashion.


Assuntos
COVID-19 , SARS-CoV-2 , Tecido Adiposo , Enzima de Conversão de Angiotensina 2 , Citocinas , Humanos
15.
J Food Sci ; 87(9): 4056-4067, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35986622

RESUMO

Spent coffee grounds (SCG) are a coproduct that causes environmental impacts worldwide. Thus, consciously reusing the SCG is an eminent need. This work aimed to encapsulate phenolic compounds and antioxidants obtained from SCG extracts through spray- and freeze-drying techniques using different isolated and combined wall materials. The dried powders produced were evaluated for moisture content, water activity, bulk density, hygroscopicity, color, content of phenolic compounds and antioxidants, and the results were compared. The results showed that all evaluated treatments resulted in a powdered product with low values of bulk density, moisture and water activity, especially for freeze-drying. The freeze-dried product also showed higher hygroscopicity. Regarding the content of phenolic compounds and antioxidants, both drying methods showed high levels of these compounds in the dried product and good encapsulation efficiency, reaching 83.43%. In most cases, spray-drying and freeze-drying did not differ statistically (p > 0.05) in relation to bioactive compound content and encapsulation efficiency. In relation to wall materials, albumin showed the worst performance in the retention of bioactive compounds. On the other hand, pure gum arabic combined with maltodextrin led to better preservation of these compounds. PRACTICAL APPLICATION: Spent coffee grounds are a coproduct generated in large quantities in the world. The encapsulation of phenolic and antioxidant compounds protects and enables their application in different food matrices. Therefore, the evaluation of different encapsulation methods and wall materials is important to define good process conditions.


Assuntos
Antioxidantes , Café , Albuminas , Antioxidantes/análise , Goma Arábica , Fenóis/análise , Pós , Água
16.
Perspect Health Inf Manag ; 19(Spring): 1f, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35692850

RESUMO

With the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, hospitals and physician practices across the country converted from a system of paper recordkeeping to fully integrated electronic health records (EHR).1, 2 With financial incentives in hand, there was a rush to market to acquire and implement these systems. Fast-forward 10 years, and it is apparent that the EHR space has significantly evolved in technology, processes, and policies.3 These changes should make organizations examine their EHR and organizational models and consider if they are using the best EHR to meet their organizational needs for the next 20 years. The National Institutes of Health (NIH) Clinical Center (CC) implemented its EHR in 2004 and, recognizing all of the new participants, technologies, and the advancement of clinical research needs since then, made the decision to embark on a comprehensive business case analysis to evaluate the best solution to meet the CC's and NIH's needs over the next 20 years. The goal was to answer this question: "Given the evolution of the EHR market, is the CC on the best platform to meet its needs now and in the future?"


Assuntos
Informática Médica , Médicos , Registros Eletrônicos de Saúde , Humanos , Motivação
17.
Thromb Res ; 214: 132-137, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35561448

RESUMO

BACKGROUND: The release of neutrophil extracellular traps (NETs) is the basis of immune-mediated thrombosis. Data on the clinical relevance of NETs in antiphospholipid syndrome-related thrombosis are scarce. OBJECTIVE: The aim of this study was to evaluate whether the NET regulator proteins PADI4, ELANE, and MPO are associated with thrombosis in APS. METHODS: A total of 152 thrombotic APS (t-APS) patients and 123 individuals without thrombosis (controls) were included. The following markers of NETs were evaluated: PADI4, ELANE, and MPO gene expression by qPCR and circulating levels of citrullinated histone H3 (H3cit) and myeloperoxidase-DNA complexes (MPO-DNA) by ELISA. RESULTS: The levels of circulating MPO-DNA and MPO mRNA expression and PADI4 mRNA expression were higher in t-APS patients than in controls. The mean differences were 0.05 OD (95% CI 0.01 to 0.09) in MPO-DNA levels, 1.07 AU (95% CI 0.20 to 1.93) for MPO mRNA and 0.20 AU (95% CI 0.03 to 0.36) in PADI4 mRNA fold-change. These differences were more pronounced in triple-positive patients, who had 56% increased levels of MPO-DNA, 44% increased MPO mRNA expression and 69% increased PADI4 mRNA expression compared to controls. Additionally, circulating MPO-DNA levels and MPO mRNA expression were higher in patients with recurrent thrombosis than in patients with incident thrombosis and controls. In recurrent thrombosis, levels of MPO-DNA were 43.8% higher and MPO mRNA expression was 2-fold higher than in controls. Levels of circulating MPO-DNA and PADI4 mRNA expression did not differ substantially between primary and secondary APS. CONCLUSION: Thrombotic APS was associated with increased NET formation, which was more pronounced among patients with poorer prognosis, such as those with triple antiphospholipid positivity and recurrent thrombosis. Our results provide evidence on the association of NETs and the severity of APS-related thrombosis.


Assuntos
Síndrome Antifosfolipídica , Armadilhas Extracelulares , Trombose , Síndrome Antifosfolipídica/complicações , Síndrome Antifosfolipídica/metabolismo , DNA , Armadilhas Extracelulares/metabolismo , Humanos , Neutrófilos/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Trombose/metabolismo
18.
Regen Med ; 17(5): 259-270, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35291812

RESUMO

Background: Platelet-rich plasma (PRP) has a high concentration of growth factors (GFs), which present a therapeutic wound healing effect. Despite having been correlated with an immunomodulatory function, the administration of PRP has not yet been investigated in atherosclerosis models. Aim: Evaluate the effect of lyophilized PRP on atherosclerosis in mice models through serum analysis. Methods: Animals received a high-fat diet for disease induction and a weekly PRP retro-orbital application. Effectiveness was evaluated by measuring inflammatory markers in plasma following the treatment of mice with either PRP or saline solution. Results: PRP was well characterized for platelet and GF concentrations; the atherosclerotic profile was established. Cytokine concentrations were altered after PRP applications. Conclusion: PRP could modulate the inflammatory pattern in the early stages of atherosclerosis.


Platelet-rich plasma (PRP) contains growth factors, which stimulate normal wound healing. This product seems to be a good modulator of white blood cells and has not been investigated in atherosclerosis. This study aimed to evaluate PRP in atherosclerosis using mice models. The PRP was produced from animals and preserved using the lyophilization technique; the product was then applied weekly in the vein. For atherosclerosis induction, genetically modified animals were fed a high-fat diet. The effectiveness was evaluated by measuring plasma inflammatory markers after treatment, and PRP seemed to alter cell-signaling molecules (cytokines). This study concluded that PRP was capable of modulating the inflammatory pattern during the early stages of atherosclerosis.


Assuntos
Aterosclerose , Plasma Rico em Plaquetas , Animais , Aterosclerose/terapia , Citocinas/farmacologia , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Camundongos , Cicatrização
19.
J Food Sci Technol ; 59(2): 805-814, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35185192

RESUMO

Safflower oil (SO) is mainly rich in linoleic acid (ω-6), oleic acid (ω-9), and other bioactives with potential antioxidant, antidiabetic, thermogenic, anti-inflammatory, cardioprotective and anticancer activities. The reduced aqueous solubility and high susceptibility to oxidative degradation are undesirable for food applications and can be overcome by incorporation in lipid nanoparticles. Thus, the main goal was to develop and characterize SO-loaded nanostructured lipid carriers (NLC-SO) and to evaluate their potential for protection of the antioxidant activity of the bioactive. NLC-SO showed average size of 222 ± 2.0 nm, zeta potential of  43 ± 3.5 mV and the encapsulation efficiency was 49.0 ± 2.8%, combined with high thermal compatibility (up to 228 °C) and physical stability for up to 60 days in aqueous dispersion. Besides, the NLC-SO showed threefold reduction in the DPPH radical scavenge activity after encapsulation, indicating protection of the antioxidant components of the SO and preservation of the bioactives. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13197-021-05078-5.

20.
J Thromb Thrombolysis ; 53(2): 390-398, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34417945

RESUMO

Although dyslipidemia is associated with poorer prognosis in antiphospholipid syndrome (APS), the management of lipid disorders can be challenging. While statins may increase the bleeding risk associated with anticoagulation, the effectiveness of hypolipid diet (HD) has not yet been established in patients with autoimmune disorders. In this study, we evaluated whether HD is associated with decreases in cholesterol levels in patients with thrombotic primary APS (t-PAPS) and dyslipidemia. Nutritional and lipid profiles were assessed before HD was initiated (baseline) and after 3 and 6 months with HD. A 24-h dietary recall was applied to assess the adherence to the diet. Forty-four patients were included, mean age was 43 years (± 12.93) and 65% were female. After HD was started, the intake of carbohydrates, lipids, saturated fats and cholesterol decreased, whereas dietary fiber intake increased. Levels of total cholesterol (TC) and non-high density lipoprotein cholesterol (non-HDL-C) decreased after 3 and 6 months of HD, as compared to baseline (P = 0.007 and P = 0.008). Low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) values did not change during the study period. The mean body mass index (BMI) decreased from 28.4 to 27.8 kg/m2 after six months of HD (p < 0.0001). In subgroup analysis, the effects of HD were more pronounced in patients with high TC, LDL-C or non-HDL-C levels at baseline and in those without obesity or hypertension. Nutritional intervention is feasible among t-PAPS and could be an alternative therapy to modulate lipid metabolism in this population.


Assuntos
Síndrome Antifosfolipídica , Dislipidemias , Adulto , HDL-Colesterol , Dieta , Feminino , Humanos , Lipídeos , Estudos Prospectivos
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