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1.
Braz J Cardiovasc Surg ; 38(5): e2023144, 2023 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-37871254

RESUMO

OBJECTIVE: To investigate the risk factors for predicting atrial high-rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs). METHODS: A total of 140 patients with CIED in our hospital from June 2013 to June 2018 were included and were followed up to observe whether they had AHREs. AHRE are defined as atrial rate ≥ 175 times/minute, lasting > 5 minutes, and reviewed by an experienced electrophysiologist with unclear clinical diagnosis. The patients fasted for 12 hours after implantation, and blood samples were collected for biochemical, lipid, and whole blood count detection. Follow-up was regular after discharge to record follow-up data of each patient and conduct statistical analysis. RESULTS: One hundred and forty patients were implanted with dual-chamber pacemakers, their median age was 70 years old, 44.29% were male, 27 patients had AHRE within one year, and AHRE incidence rate was 19.29%. The microcytic to hypochromic (M/H) ratio was calculated for all AHRE patients and compared with the patients without AHRE; the M/H value of AHRE patients was significantly higher. Throughout the entire follow-up period, a total of 44 patients developed AHRE; when adjusted by multivariate analysis, only M/H ratio ≥ 4.5 vs. < 4.5 had statistical significance, and the adjusted hazard ratio value was 4.313 (1.675-11.105). CONCLUSION: As an indicator, M/H ratio may play an important role in the occurrence and development of atrial fibrillation and can be used as a predictor of AHRE in patients with CIED.


Assuntos
Fibrilação Atrial , Desfibriladores Implantáveis , Marca-Passo Artificial , Acidente Vascular Cerebral , Humanos , Masculino , Idoso , Feminino , Fibrilação Atrial/complicações , Monócitos , Desfibriladores Implantáveis/efeitos adversos , Átrios do Coração , Marca-Passo Artificial/efeitos adversos , Fatores de Risco , Acidente Vascular Cerebral/etiologia
2.
Front Neurol ; 14: 1241639, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37869147

RESUMO

Introduction: Stroke is the leading cause of functional disability worldwide. With the increase of the global population, motor rehabilitation of stroke survivors is of ever-increasing importance. In the last decade, virtual reality (VR) technologies for rehabilitation have been extensively studied, to be used instead of or together with conventional treatments such as physiotherapy or occupational therapy. The aim of this work was to evaluate the GestureCollection VR-based rehabilitation tool in terms of the brain changes and clinical outcomes of the patients. Methods: Two groups of chronic patients underwent a rehabilitation treatment with (experimental) or without (control) complementation with GestureCollection. Functional magnetic resonance imaging exams and clinical assessments were performed before and after the treatment. A functional connectivity graph-based analysis was used to assess differences between the connections and in the network parameters strength and clustering coefficient. Results: Patients in both groups showed improvement in clinical scales, but there were more increases in functional connectivity in the experimental group than in the control group. Discussion: The experimental group presented changes in the connections between the frontoparietal and the somatomotor networks, associative cerebellum and basal ganglia, which are regions associated with reward-based motor learning. On the other hand, the control group also had results in the somatomotor network, in its ipsilateral connections with the thalamus and with the motor cerebellum, which are regions more related to a purely mechanical activity. Thus, the use of the GestureCollection system was successfully shown to promote neuroplasticity in several motor-related areas.

3.
Sci Rep ; 13(1): 16421, 2023 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-37775531

RESUMO

Brain networks have been widely used to study the relationships between brain regions based on their dynamics using, e.g. fMRI or EEG, and to characterize their real physical connections using DTI. However, few studies have investigated brain networks derived from structural properties; and those have been based on cortical thickness or gray matter volume. The main objective of this work was to investigate the feasibility of obtaining useful information from brain networks derived from structural MRI, using texture features. We also wanted to verify if texture brain networks had any relation with established functional networks. T1-MR images were segmented using AAL and texture parameters from the gray-level co-occurrence matrix were computed for each region, for 760 subjects. Individual texture networks were used to evaluate the structural connections between regions of well-established functional networks; assess possible gender differences; investigate the dependence of texture network measures with age; and single out brain regions with different texture-network characteristics. Although around 70% of texture connections between regions belonging to the default mode, attention, and visual network were greater than the mean connection value, this effect was small (only between 7 and 15% of these connections were larger than one standard deviation), implying that texture-based morphology does not seem to subside function. This differs from cortical thickness-based morphology, which has been shown to relate to functional networks. Seventy-five out of 86 evaluated regions showed significant (ANCOVA, p < 0.05) differences between genders. Forty-four out of 86 regions showed significant (ANCOVA, p < 0.05) dependence with age; however, the R2 indicates that this is not a linear relation. Thalamus and putamen showed a very unique texture-wise structure compared to other analyzed regions. Texture networks were able to provide useful information regarding gender and age-related differences, as well as for singling out specific brain regions. We did not find a morphological texture-based subsidy for the evaluated functional brain networks. In the future, this approach will be extended to neurological patients to investigate the possibility of extracting biomarkers to help monitor disease evolution or treatment effectiveness.


Assuntos
Encéfalo , Imageamento por Ressonância Magnética , Humanos , Masculino , Feminino , Voluntários Saudáveis , Encéfalo/diagnóstico por imagem , Encéfalo/anatomia & histologia , Imageamento por Ressonância Magnética/métodos , Substância Cinzenta/diagnóstico por imagem , Substância Cinzenta/anatomia & histologia , Mapeamento Encefálico/métodos
4.
6.
Clinics (Sao Paulo) ; 78: 100120, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37001387

RESUMO

OBJECTIVES: The incidence of cerebellar Glioblastoma Multiforme (cGBM) is rare. Database like TCGA have not distinguish cGBM from GBM, our knowledge on cGBM gene expression characteristics is limited. The expression status of Oligodendrocyte Lineage Transcription factor 2 (OLIG2) and its clinical significance in cGBM is still unclear. METHODS: The clinical data and tissue specimens of 73 cGBM patients were retrospectively studied. The association between OLIG2 expression level and the demographic characteristics of cGBM patients was identified by the Chi-Square test. The survival curves were drawn by Kaplan-Meier analysis. The independent prognostic factors was calculated according to Cox regression analysis. RESULTS: The OLIG2 high expression was observed in about 57.5% (42/73) of the cGBM patients. Patients with high OLIG2 expression levels had a higher alive ratio at the end of follow-up (alive ratio: 70.6% vs. 29.4%, p = 0.04). The median survival time was 21 months and 13 months for high and low expression of OLIG2 (p < 0 .05). Univariate analysis and Multivariate analysis indicated that EOR (HR = 3.89, 95% CI 1.23‒12.26, p = 0.02), low OLIG2 expression (HR = 5.26, 95% CI 1.13‒24.59, p = 0.04), and without adjuvant therapy (HR = 4.95, 95% CI 1.22‒20.00, p = 0.03) were independent risk factors for the OS of cGBM patients. CONCLUSION: High expression level of OLIG2 could be used as an independent favorable prognosis indicator in cGBM patients and be recognized as a characteristic biomarker of cGBM.


Assuntos
Neoplasias Encefálicas , Glioblastoma , Humanos , Prognóstico , Estudos Retrospectivos , Estimativa de Kaplan-Meier , Terapia Combinada , Fator de Transcrição 2 de Oligodendrócitos/genética
7.
Acta Cir Bras ; 37(11): e371101, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36629528

RESUMO

PURPOSE: To observe the mechanism of prepared Radix Rehmanniainon combined with Radix Astragali in treating osteoporosis. METHODS: Osteoporosis rat model was established by bilateral ovariectomy combined with low-calcium diet feeding. Bone mineral density was measured by bone densitometer. Bone metabolism markers in serum were detected by enzyme linked immunosorbent assay (ELISA), bone tissue structure was observed by hematoxylin-eosin staining, and the effect of prepared Radix Rehmanniainon combined with Radix Astragali on PI3K-AKT signaling pathway was investigated by immunohistochemistry and reverse transcription polymerase chain reaction. RESULTS: Compared with the model group, the bone tissue structure and imbalance of bone metabolism were improved, and the bone mineral density was significantly increased in the prepared Radix Rehmanniainon combined with Radix Astragali groups. After intervention with prepared Radix Rehmanniainon combined with Radix Astragali, the positive expression of PIK3CA and Akt1 in rat bone tissue was enhanced, and the expression levels of Akt1 mRNA were significantly increased. CONCLUSIONS: Prepared Radix Rehmanniainon combined with Radix Astragali may treat osteoporosis by activating PI3K/AKT pathway.


Assuntos
Astrágalo , Medicamentos de Ervas Chinesas , Osteoporose , Feminino , Ratos , Animais , Astrágalo/química , Fosfatidilinositol 3-Quinases , Proteínas Proto-Oncogênicas c-akt , Medicamentos de Ervas Chinesas/farmacologia , Medicamentos de Ervas Chinesas/uso terapêutico , Transdução de Sinais , Osteoporose/tratamento farmacológico
8.
Ciênc. rural (Online) ; 53(6): e20220003, 2023. tab
Artigo em Inglês | LILACS-Express | VETINDEX | ID: biblio-1394281

RESUMO

ABSTRACT: With the gradual transfer of an enormous young and middle age labor force from agricultural field to non-agricultural sectors, the negative role of land fragmentation (LF), which is related to food security, is increasingly reflecting in the process of agricultural modernization. Meanwhile, the positive roles of farmers' combined-tillage in production are gradually emerging. Based on the above background, this study explained the relationship among farmers' combined-tillage, LF and agricultural production efficiency (APE). The study used survey date and the SFA-QR model to empirically investigate the effects of LF and farmers' combined-tillage on APE. Furthermore, this article analyzed the moderating effect of farmers' combined-tillage on the relationship between LF and APE. The results demonstrated that: (1) Farmers combined-tillage improves the APE significantly, especially on low and medium efficiency households; (2) LF has a negative impact on APE, especially on low and medium efficiency households; (3) Combined-tillage could alleviate the adverse effects of LF on APE. In this regard, the paper also proposed some suggestions to face the adverse effects of LF and promote farmers' combined-tillage in production.


RESUMO: Com a transferência gradual de enorme força de trabalho jovem e de meia idade do campo agrícola para os setores não agrícolas, o papel negativo da fragmentação da terra (LF), relacionada à segurança alimentar, está cada vez mais refletido no processo de modernização agrícola. Enquanto isso, os papéis positivos da lavoura combinada dos agricultores na produção estão surgindo gradualmente. Com base no histórico acima, o objetivo deste estudo é explicar a relação entre o plantio direto dos agricultores, LF e eficiência da produção agrícola (APE). O estudo usou dados do levantamento e o modelo SFA-QR para investigar empiricamente os efeitos da FL e do plantio direto dos agricultores sobre o APE. Além disso, este artigo analisou o efeito moderador do plantio combinado dos agricultores na relação entre LF e APE. Os resultados demonstram que: (1) A lavoura combinada dos agricultores melhora significativamente o APE, especialmente em domicílios de baixa e média eficiência; (2) LF tem um impacto negativo na APE, especialmente em domicílios de baixa e média eficiência; (3) A lavoura combinada pode aliviar os efeitos adversos do LF no APE. Nesse sentido, o trabalho também propõe algumas sugestões para enfrentar os efeitos adversos da FL e promover o plantio combinado dos agricultores na produção.

9.
Ciênc. rural (Online) ; 53(6): 1-10, 2023. tab
Artigo em Inglês | VETINDEX | ID: biblio-1413147

RESUMO

With the gradual transfer of an enormous young and middle age labor force from agricultural field to non-agricultural sectors, the negative role of land fragmentation (LF), which is related to food security, is increasingly reflecting in the process of agricultural modernization. Meanwhile, the positive roles of farmers' combined-tillage in production are gradually emerging. Based on the above background, this study explained the relationship among farmers' combined-tillage, LF and agricultural production efficiency (APE). The study used survey date and the SFA-QR model to empirically investigate the effects of LF and farmers' combined-tillage on APE. Furthermore, this article analyzed the moderating effect of farmers' combined-tillage on the relationship between LF and APE. The results demonstrated that: (1) Farmers combined-tillage improves the APE significantly, especially on low and medium efficiency households; (2) LF has a negative impact on APE, especially on low and medium efficiency households; (3) Combined-tillage could alleviate the adverse effects of LF on APE. In this regard, the paper also proposed some suggestions to face the adverse effects of LF and promote farmers' combined-tillage in production.


Com a transferência gradual de enorme força de trabalho jovem e de meia idade do campo agrícola para os setores não agrícolas, o papel negativo da fragmentação da terra (LF), relacionada à segurança alimentar, está cada vez mais refletido no processo de modernização agrícola. Enquanto isso, os papéis positivos da lavoura combinada dos agricultores na produção estão surgindo gradualmente. Com base no histórico acima, o objetivo deste estudo é explicar a relação entre o plantio direto dos agricultores, LF e eficiência da produção agrícola (APE). O estudo usou dados do levantamento e o modelo SFA-QR para investigar empiricamente os efeitos da FL e do plantio direto dos agricultores sobre o APE. Além disso, este artigo analisou o efeito moderador do plantio combinado dos agricultores na relação entre LF e APE. Os resultados demonstram que: (1) A lavoura combinada dos agricultores melhora significativamente o APE, especialmente em domicílios de baixa e média eficiência; (2) LF tem um impacto negativo na APE, especialmente em domicílios de baixa e média eficiência; (3) A lavoura combinada pode aliviar os efeitos adversos do LF no APE. Nesse sentido, o trabalho também propõe algumas sugestões para enfrentar os efeitos adversos da FL e promover o plantio combinado dos agricultores na produção.


Assuntos
Privação do Sono , 24444 , Produção Agrícola , Fazendeiros
10.
Clinics ; Clinics;78: 100120, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1439908

RESUMO

Abstract Objectives: The incidence of cerebellar Glioblastoma Multiforme (cGBM) is rare. Database like TCGA have not distinguish cGBM from GBM, our knowledge on cGBM gene expression characteristics is limited. The expression status of Oligodendrocyte Lineage Transcription factor 2 (OLIG2) and its clinical significance in cGBM is still unclear. Methods: The clinical data and tissue specimens of 73 cGBM patients were retrospectively studied. The association between OLIG2 expression level and the demographic characteristics of cGBM patients was identified by the Chi-Square test. The survival curves were drawn by Kaplan-Meier analysis. The independent prognostic factors was calculated according to Cox regression analysis. Results: The OLIG2 high expression was observed in about 57.5% (42/73) of the cGBM patients. Patients with high OLIG2 expression levels had a higher alive ratio at the end of follow-up (alive ratio: 70.6% vs. 29.4%, p = 0.04). The median survival time was 21 months and 13 months for high and low expression of OLIG2 (p < 0 .05). Univariate analysis and Multivariate analysis indicated that EOR (HR = 3.89, 95% CI 1.23−12.26, p = 0.02), low OLIG2 expression (HR = 5.26, 95% CI 1.13−24.59, p = 0.04), and without adjuvant therapy (HR = 4.95, 95% CI 1.22−20.00, p = 0.03) were independent risk factors for the OS of cGBM patients. Conclusion: High expression level of OLIG2 could be used as an independent favorable prognosis indicator in cGBM patients and be recognized as a characteristic biomarker of cGBM.

11.
Rev. bras. cir. cardiovasc ; Rev. bras. cir. cardiovasc;38(5): e2023144, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1521662

RESUMO

ABSTRACT Objective: To investigate the risk factors for predicting atrial high-rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs). Methods: A total of 140 patients with CIED in our hospital from June 2013 to June 2018 were included and were followed up to observe whether they had AHREs. AHRE are defined as atrial rate ≥ 175 times/minute, lasting > 5 minutes, and reviewed by an experienced electrophysiologist with unclear clinical diagnosis. The patients fasted for 12 hours after implantation, and blood samples were collected for biochemical, lipid, and whole blood count detection. Follow-up was regular after discharge to record follow-up data of each patient and conduct statistical analysis. Results: One hundred and forty patients were implanted with dual-chamber pacemakers, their median age was 70 years old, 44.29% were male, 27 patients had AHRE within one year, and AHRE incidence rate was 19.29%. The microcytic to hypochromic (M/H) ratio was calculated for all AHRE patients and compared with the patients without AHRE; the M/H value of AHRE patients was significantly higher. Throughout the entire follow-up period, a total of 44 patients developed AHRE; when adjusted by multivariate analysis, only M/H ratio ≥ 4.5 vs. < 4.5 had statistical significance, and the adjusted hazard ratio value was 4.313 (1.675-11.105). Conclusion: As an indicator, M/H ratio may play an important role in the occurrence and development of atrial fibrillation and can be used as a predictor of AHRE in patients with CIED.

12.
Metabolites ; 12(11)2022 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-36422296

RESUMO

Carotid artery stenosis (CAS) is a common vascular disease with long-term consequences for the brain. Although CAS is strongly associated with impaired cerebral hemodynamics and neurodegeneration, the mechanisms underlying hemodynamic impairment in the microvasculature remain unknown. In this work, we employed functional near-infrared spectroscopy (fNIRS) to introduce a methodological approach for quantifying the temporal delay of the evoked hemodynamic response. The method was validated during a vasodilatory task (breath-holding) in 50 CAS patients and 20 controls. Our results suggest that the hemodynamic response to breath-holding can be delayed by up to 6 s in the most severe patients, a significant increase from the median 4 s measured for the control group (p = 0.01). In addition, the fraction of brain regions that responded to the task decreased as the CAS severity increased, from a median of 90% in controls to 73% in the most severe CAS group (p = 0.04). The presence of collateral circulation increases the response to breath-holding and decreases the average time delays across the brain, although the number of communicating arteries alone cannot predict these fNIRS-based hemodynamic variables (p > 0.09). Overall, this work proposes a method to quantitatively assess impaired cerebral hemodynamics in CAS patients.

13.
J Bras Pneumol ; 48(1): e20210337, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35293487

RESUMO

OBJECTIVE: VEGF-D is a potential biomarker for lymphangioleiomyomatosis (LAM); however, its diagnostic performance has yet to be systematically studied. METHODS: We searched PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library to identify primary studies on VEGF-D in relation to the diagnosis of LAM. The quality of the studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Summary estimates of diagnostic accuracy were pooled using a bivariate random effects model. Subgroup and sensitivity analyses were performed to explore possible heterogeneity. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was applied to rate the quality of evidence and indicate the strength of recommendations. RESULTS: Ten studies involving 945 patients were of high risk in quality, as assessed using the QUADAS-2. The pooled diagnostic parameters were indicated as follows: sensitivity = 0.82 (95% CI, 0.71-0.90); specificity = 0.98 (95% CI, 0.94-0.99); and diagnostic OR = 197 (95% CI, 66-587). The AUC of summary ROC analysis was 0.98. The subgroup and sensitivity analyses revealed that the overall performance was not substantially affected by the composition of the control group, prespecified cutoff value, the country of origin, or different cutoff values (p > 0.05 for all). A strong recommendation for serum VEGF-D determination to aid in the diagnosis of LAM was made according to the GRADE. CONCLUSIONS: VEGF-D seems to have great potential implications for the diagnosis of LAM in clinical practice due to its excellent specificity and suboptimal sensitivity.


Assuntos
Linfangioleiomiomatose , Biomarcadores , Humanos , Linfangioleiomiomatose/diagnóstico , Curva ROC , Sensibilidade e Especificidade , Fator D de Crescimento do Endotélio Vascular
14.
Acta cir. bras ; 37(11): e371101, 2022. tab, ilus, graf
Artigo em Inglês | VETINDEX | ID: biblio-1415444

RESUMO

Purpose: To observe the mechanism of prepared Radix Rehmanniainon combined with Radix Astragali in treating osteoporosis. Methods: Osteoporosis rat model was established by bilateral ovariectomy combined with low-calcium diet feeding. Bone mineral density was measured by bone densitometer. Bone metabolism markers in serum were detected by enzyme linked immunosorbent assay (ELISA), bone tissue structure was observed by hematoxylin-eosin staining, and the effect of prepared Radix Rehmanniainon combined with Radix Astragali on PI3K-AKT signaling pathway was investigated by immunohistochemistry and reverse transcription polymerase chain reaction. Results: Compared with the model group, the bone tissue structure and imbalance of bone metabolism were improved, and the bone mineral density was significantly increased in the prepared Radix Rehmanniainon combined with Radix Astragali groups. After intervention with prepared Radix Rehmanniainon combined with Radix Astragali, the positive expression of PIK3CA and Akt1 in rat bone tissue was enhanced, and the expression levels of Akt1 mRNA were significantly increased. Conclusions: Prepared Radix Rehmanniainon combined with Radix Astragali may treat osteoporosis by activating PI3K/AKT pathway.


Assuntos
Animais , Ratos , Osteoporose/terapia , Plantas Medicinais , Osso e Ossos , Astrágalo , Rehmannia
15.
J. bras. pneumol ; J. bras. pneumol;48(1): e20210337, 2022. tab, graf
Artigo em Inglês, Português | LILACS | ID: biblio-1365042

RESUMO

ABSTRACT Objective: VEGF-D is a potential biomarker for lymphangioleiomyomatosis (LAM); however, its diagnostic performance has yet to be systematically studied. Methods: We searched PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library to identify primary studies on VEGF-D in relation to the diagnosis of LAM. The quality of the studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Summary estimates of diagnostic accuracy were pooled using a bivariate random effects model. Subgroup and sensitivity analyses were performed to explore possible heterogeneity. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was applied to rate the quality of evidence and indicate the strength of recommendations. Results: Ten studies involving 945 patients were of high risk in quality, as assessed using the QUADAS-2. The pooled diagnostic parameters were indicated as follows: sensitivity = 0.82 (95% CI, 0.71-0.90); specificity = 0.98 (95% CI, 0.94-0.99); and diagnostic OR = 197 (95% CI, 66-587). The AUC of summary ROC analysis was 0.98. The subgroup and sensitivity analyses revealed that the overall performance was not substantially affected by the composition of the control group, prespecified cutoff value, the country of origin, or different cutoff values (p > 0.05 for all). A strong recommendation for serum VEGF-D determination to aid in the diagnosis of LAM was made according to the GRADE. Conclusions: VEGF-D seems to have great potential implications for the diagnosis of LAM in clinical practice due to its excellent specificity and suboptimal sensitivity.


RESUMO Objetivo: O VEGF-D é um potencial biomarcador para linfangioleiomiomatose (LAM); entretanto, seu desempenho diagnóstico ainda não foi sistematicamente estudado. Métodos: Foram realizadas buscas nos bancos de dados PubMed, EMBASE, Scopus, Web of Science e Cochrane Library para identificar estudos primários sobre o VEGF-D com relação ao diagnóstico de LAM. A qualidade dos estudos foi avaliada por meio da ferramenta Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). As estimativas sumárias de acurácia diagnóstica foram combinadas utilizando um modelo bivariado de efeitos aleatórios. Análises de subgrupo e de sensibilidade foram realizadas para explorar possíveis heterogeneidades. O sistema Grading of Recommendations Assessment, Development, and Evaluation (GRADE) foi aplicado para avaliar a qualidade das evidências e indicar a força das recomendações. Resultados: Dez estudos envolvendo 945 pacientes eram de alto risco em qualidade, segundo a ferramenta QUADAS-2. Os parâmetros diagnósticos combinados foram indicados da seguinte forma: sensibilidade = 0,82 (IC95%: 0,71-0,90); especificidade = 0,98 (IC95%: 0,94-0,99); e OR diagnóstica = 197 (IC95%: 66-587). A ASC da análise summary ROC foi de 0,98. As análises de subgrupo e de sensibilidade revelaram que o desempenho global não foi substancialmente afetado pela composição do grupo controle, valor de corte pré-especificado, país de origem ou diferentes valores de corte (p > 0,05 para todos). Uma forte recomendação para a dosagem de VEGF-D sérico para auxiliar no diagnóstico de LAM foi feita de acordo com o sistema GRADE. Conclusões: O VEGF-D parece ter grandes implicações potenciais para o diagnóstico de LAM na prática clínica em virtude da excelente especificidade e sensibilidade subótima.


Assuntos
Humanos , Linfangioleiomiomatose/diagnóstico , Biomarcadores , Curva ROC , Sensibilidade e Especificidade , Fator D de Crescimento do Endotélio Vascular
16.
Sci Rep ; 11(1): 13911, 2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34230503

RESUMO

Transcranial direct current stimulation (tDCS) has been used aiming to boost exercise performance and inconsistent findings have been reported. One possible explanation is related to the limitations of the so-called "conventional" tDCS, which uses large rectangular electrodes, resulting in a diffuse electric field. A new tDCS technique called high-definition tDCS (HD-tDCS) has been recently developed. HD-tDCS uses small ring electrodes and produces improved focality and greater magnitude of its aftereffects. This study tested whether HD-tDCS would improve exercise performance to a greater extent than conventional tDCS. Twelve endurance athletes (29.4 ± 7.3 years; 60.15 ± 5.09 ml kg-1 min-1) were enrolled in this single-center, randomized, crossover, and sham-controlled trial. To test reliability, participants performed two time to exhaustion (TTE) tests (control conditions) on a cycle simulator with 80% of peak power until volitional exhaustion. Next, they randomly received HD-tDCS (2.4 mA), conventional (2.0 mA), or active sham tDCS (2.0 mA) over the motor cortex for 20-min before performing the TTE test. TTE, heart rate (HR), associative thoughts, peripheral (lower limbs), and whole-body ratings of perceived exertion (RPE) were recorded every minute. Outcome measures were reliable. There was no difference in TTE between HD-tDCS (853.1 ± 288.6 s), simulated conventional (827.8 ± 278.7 s), sham (794.3 ± 271.2 s), or control conditions (TTE1 = 751.1 ± 261.6 s or TTE2 = 770.8 ± 250.6 s) [F(1.95; 21.4) = 1.537; P = 0.24; η2p = 0.123]. There was no effect on peripheral or whole-body RPE and associative thoughts (P > 0.05). No serious adverse effect was reported. A single session of neither HD-tDCS nor conventional tDCS changed exercise performance and psychophysiological responses in athletes, suggesting that a ceiling effect may exist.


Assuntos
Atletas/psicologia , Resistência Física/fisiologia , Psicofisiologia , Estimulação Transcraniana por Corrente Contínua , Adulto , Frequência Cardíaca/fisiologia , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Consumo de Oxigênio/fisiologia , Esforço Físico/fisiologia , Reprodutibilidade dos Testes , Sensação/fisiologia , Adulto Jovem
17.
Mol Pharm ; 18(7): 2634-2646, 2021 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-34134485

RESUMO

Breast cancer was the leading cause of newly diagnosed cases of tumors in 2020, ranking as the second highest cause of female death. Chemotherapy remains the conventional treatment of choice for breast tumors in most clinical cases. However, it is often accompanied by a poor prognosis and severe side effects, resulting from an insufficient accumulation of the drug at tumor sites and an unsystematic distribution of the drug across the body. Inspired by the fact that breast tumor cells overexpress integrin α2ß1 on the surface, we designed and constructed an integrin α2ß1 targeting DGEA-modified liposomal doxorubicin (DGEA-Lipo-DOX) platform for application in breast cancer therapy. The DGEA-Lipo-DOX was stable with a uniform particle size of 121.1 ± 3.8 nm and satisfactory drug encapsulation. Demonstrated in vitro and in vivo, the constructed platform exhibited improved antitumor ability. The DGEA-Lipo-DOX showed 4-fold enhanced blood circulation and 6-fold increased accumulation of DOX at the tumor sites compared to those of free DOX, resulting in a significantly enhanced antitumor efficacy in tumor-bearing mice. A preliminary safety evaluation suggested that the systemic toxicity of DOX was relieved by DGEA-Lipo delivery. Collectively, binding integrin α2ß1 by DGEA may represent an alternative therapeutic strategy for potentially safer breast cancer treatment.


Assuntos
Antibióticos Antineoplásicos/farmacologia , Neoplasias da Mama/prevenção & controle , Doxorrubicina/análogos & derivados , Sistemas de Liberação de Medicamentos , Integrina alfa2beta1/antagonistas & inibidores , Oligopeptídeos/química , Animais , Antibióticos Antineoplásicos/química , Apoptose , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Proliferação de Células , Doxorrubicina/química , Doxorrubicina/farmacologia , Feminino , Humanos , Integrina alfa2beta1/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Polietilenoglicóis/química , Polietilenoglicóis/farmacologia , Ratos Sprague-Dawley , Células Tumorais Cultivadas , Ensaios Antitumorais Modelo de Xenoenxerto
18.
Acta Cir Bras ; 36(4): e360403, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34008744

RESUMO

PURPOSE: To study effects of Rehmannia glutinosa polysaccharides (RGP) on bone tissue structure and skeletal muscle atrophy in rats with disuse. METHODS: A rat model of disuse osteoporosis combined with muscle atrophy was established by removing the bilateral ovaries of rats and fixing their hind limbs for a long time. Forty SD rats were administered intragastrically for 12 weeks. The bone histomorphometry parameters and the level of oxidative stress were measured. In addition, the changes of muscle atrophy F-box (MAFbx), muscle RING-finger protein-1 (MuRF1), forkhead box O1 (FOXO1) mRNA expression in skeletal muscle of rats were observed. RESULTS: RGP significantly increased the percentage of fluorescence perimeter and bone mineralization deposition rate of the second lumbar vertebrae of rats. It also significantly increased the wet weight ratio and muscle fiber cross-sectional area of the gastrocnemius muscle of rats. At the same time, RGP significantly increased the levels of super oxide dismutase (SOD) and catalase (CAT) in the skeletal muscle of rats, and reduced the content of malondialdehyde (MDA). Rehmannia glutinosa polysaccharides also significantly reduced the expression levels of FOXO1, MAFbx and MuRF1 mRNA in rat skeletal muscle. CONCLUSIONS: RGP could improve the bone structure of osteoporotic rats. It could also improve muscle that atrophy may be related to the inhibition of FOXO1-mediated ubiquitin-proteasome pathway.


Assuntos
Rehmannia , Animais , Osso e Ossos , Músculo Esquelético/patologia , Atrofia Muscular/patologia , Polissacarídeos/farmacologia , Ratos , Ratos Sprague-Dawley
19.
Neuroimage Clin ; 29: 102538, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33385880

RESUMO

BACKGROUND AND PURPOSE: Cognitive impairment is a common consequence of stroke, and the rewiring of the surviving brain circuits might contribute to cognitive recovery. Studies investigating how the functional connectivity of networks change across time and whether their remapping relates to cognitive recovery in stroke patients are scarce. We aimed to investigate whether resting-state functional connectivity was associated with cognitive performance in stroke patients and if any alterations in these networks were correlated with cognitive recovery. METHODS: Using an fMRI ROI-ROI approach, we compared the ipsilesional, contralesional and interhemispheric functional connectivity of three resting-state networks involved in cognition - the Default Mode (DMN), Salience (SN) and Central Executive Networks (CEN), in subacute ischemic stroke patients (time 1, n = 37, stroke onset: 24.32 ± 7.44 days, NIHSS: 2.66 ± 3.45) with cognitively healthy controls (n = 20). Patients were reassessed six months after the stroke event (time 2, n = 20, stroke onset: 182.05 ± 8.17 days) to verify the subsequent reorganization of functional connections and whether such reorganization was associated with cognitive recovery. RESULTS: At time 1, patients had weaker interhemispheric connectivity in the DMN than controls; better cognitive performance at time 1 was associated with stronger interhemispheric and ipsilesional DMN connectivity, and weaker contralesional SN connectivity. At time 2, there were no changes in functional connectivity in stroke patients, compared to time 1. Better cognitive recovery measured at time 2 (time 2 - time 1) was associated with stronger functional connectivity in the DMN, and weaker interhemispheric subacute connectivity in the SN, both from time 1. CONCLUSIONS: Stroke disrupts the functional connectivity of the DMN, not only at the lesioned hemisphere but also between hemispheres. Six months after the stroke event, we could not detect the remapping of networks. Cognitive recovery was associated with the connectivity of both the DMN and SN of time 1. Our findings may be helpful for facilitating further understanding of the potential mechanisms underlying post-stroke cognitive performance.


Assuntos
Encéfalo , Acidente Vascular Cerebral , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Cognição , Humanos , Imageamento por Ressonância Magnética , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico por imagem
20.
Rev. bras. pesqui. méd. biol ; Braz. j. med. biol. res;54(2): e9542, 2021. tab
Artigo em Inglês | LILACS, Coleciona SUS | ID: biblio-1142580

RESUMO

Influenza viruses exacerbate chronic obstructive pulmonary disease (COPD) with considerable morbidity and mortality. Zanamivir and oseltamivir are effective in treating influenza. However, their efficacy in relieving influenza symptoms in COPD patients remains unknown, with the lack of controlled trials in this subject. Therefore, we conducted this randomized controlled trial to investigate the clinical efficacy of both interventions in this population. Patients were allocated to two groups (80 patients each): oseltamivir (OSELTA) and zanamivir (ZANA) groups. Oseltamivir (75 mg) was orally administered twice daily for 5 days, while zanamivir (10 mg) was inhaled twice daily for 5 days. Clinical parameters including body temperature, influenza symptoms (i.e., sore throat, cough, etc.), and serial blood tests were recorded on days 1, 3, and 7. We analyzed primary (changes in body temperature) and secondary outcomes (changes in non-specific symptoms) using the pre-protocol and intention-to-treat analyses. Differences between groups were assessed using t-test. Oseltamivir and zanamivir significantly reduced body temperature on the 3rd day after treatment; however, the number of patients who reported clinical improvement in influenza-like symptoms was significantly higher in the OSELTA group compared to the ZANA group on days 3 (85 vs 68.8%, P=0.015) and 7 (97.5 vs 83.8%, P=0.003). However, no significant changes in hematological (white blood cells and its subtypes) and inflammatory (C-reactive protein) parameters were noted (P>0.05). Our results suggested that oseltamivir and zanamivir are effective in reducing body temperature, while oseltamivir led to better clinical improvement regarding influenza-like symptoms in patients with COPD.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Antivirais/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Influenza Humana/tratamento farmacológico , Oseltamivir/uso terapêutico , Zanamivir/uso terapêutico , Inibidores Enzimáticos/uso terapêutico , Neuraminidase
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