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1.
Reproduction ; 168(1)2024 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-38758690

RESUMO

In brief: The endocrine disruptor, nonylphenol (NP) increases 20:4n-6 release in Sertoli cells via PKA/cPLA2 activation. Our data show that lipid metabolism could be a target of NP-induced abnormal reproductive outcomes. Abstract: Nonylphenol (NP), an endocrine-disrupting chemical, is an environmental contaminant, and many notorious effects on male fertility have been reported in animal models and wild-type species. Here, we evaluated the effects of NP in follicle-stimulating hormone (FSH) signal transduction pathways and lipid metabolism using an in vitro model of rat Sertoli cell (SC) primary culture. Results show that an acute (1 h) SC exposure to NP (10 µM) increased the intra- and extra-cellular concentrations of free fatty acids (FFAs), mainly arachidonic acid (20:4n-6). Phosphatidylinositol seemed to be the major phospholipid source of this 20:4n-6 release by activation of the protein kinase A (PKA)/cytoplasmic phospholipase A2 (cPLA2) pathway. NP also increased diacylglycerols (DAG) levels and the expression (mRNA) of cyclooxygenase 2 (Cox2) and prostaglandin E2 (PGE2) levels. It is noteworthy that accumulation of lipid droplets took place after 24 h NP exposition, which was prevented by both a PKA inhibitor and a PLA2 inhibitor. Like FSH, NP triggers the release of 20:4n-6, which is a substrate for PGE2 synthesis via PKA/PLA2 activation. In addition, NP induces the formation of DAG, which could be required as a cofactor of the PKC-mediated activation of the COX2 inflammatory pathway. Our findings suggest that NP alters lipid homeostasis in SCs by inducing the activation of pro-inflammatory pathways that may trigger adverse effects in testis physiology over time. Concomitantly, the SC enhances the acylation of surplus FFAs (including 20:4n-6) in neutral lipids as a protective mechanism to shield itself from lipotoxicity and pro-inflammatory signals.


Assuntos
Ácido Araquidônico , Proteínas Quinases Dependentes de AMP Cíclico , Disruptores Endócrinos , Fenóis , Fosfolipases A2 , Células de Sertoli , Animais , Masculino , Células de Sertoli/metabolismo , Células de Sertoli/efeitos dos fármacos , Proteínas Quinases Dependentes de AMP Cíclico/metabolismo , Fenóis/farmacologia , Ratos , Ácido Araquidônico/metabolismo , Disruptores Endócrinos/farmacologia , Fosfolipases A2/metabolismo , Células Cultivadas , Metabolismo dos Lipídeos/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Hormônio Foliculoestimulante/metabolismo
2.
Psychiatr Psychol Law ; 31(1): 47-56, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38455270

RESUMO

The high prevalence of psychiatric symptoms among juvenile delinquents is a well-replicated international finding. This study aimed to find the prevalence of mood disorders and their relationship with serious criminal acts in a population of adolescents in conflict with the law and in custody. A total of 123 male inmates aged 14 to 17 years were interviewed and assessed. Mood disorders were diagnosed in 15% of the sample for current episode and 31% for lifetime, making them third most prevalent after dependence disorders and disruptive disorders. The psychopathological profile of the adolescents who had committed violent crimes corroborates other studies reporting a high prevalence of mood disorders in this population. Several factors have been found to influence the formation of juvenile delinquency, including absence of family structure, social inequality, lack of quality school education, alcohol and drug abuse/addiction and disruptive disorders. The present results confirm mood disorders as another such factor.

3.
Heliyon ; 10(3): e25194, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38317954

RESUMO

Biodegradable biopolymers from species of the animal kingdom or their byproducts are sustainable as ecological materials due to their abundant supply and compatibility with the environment. The research aims to obtain a biodegradable active material from chitosan, gelatin, and collagen from bocachico scales (Prochilodus magdalenae). Regarding the methodology, films were developed from gelatin, chitosan, and collagen from bocachico scales (Prochilodus magdalenae) at different concentrations using glycerol as a plasticizer and citric acid as a cross-linker. The films were obtained with the hydrated mass processed by compression molding and characterized according to humidity, water solubility, contact angle, mechanical properties, and structural properties. The results of the films showed a hydrophobic characteristic. First, the chitosan-collagen (CS/CO) films showed a yellowish color, while the gelatin-collagen (Gel/CO) films were transparent and less soluble than the gelatin-collagen (Gel/CO) films. Concerning mechanical properties, gelatin films showed higher stiffness and tensile strength than chitosan films. Furthermore, in the morphological analysis, more homogeneous chitosan films were obtained by increasing the concentration of citric acid. In general, chitosan, gelatin, and collagen extracted from the scales of the bocachico (Prochilodus magdalenae) are an alternative in the application of films in the food industry.

4.
Sci Rep ; 14(1): 2395, 2024 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-38287072

RESUMO

Recently, the tiger-cat species complex was split into Leopardus tigrinus and Leopardus guttulus, along with other proposed schemes. We performed a detailed analysis integrating ecological modeling, biogeography, and phenotype of the four originally recognized subspecies-tigrinus, oncilla, pardinoides, guttulus-and presented a new multidimensional niche depiction of the species. Species distribution models used > 1400 records from museums and photographs, all checked for species accuracy. Morphological data were obtained from institutional/personal archives. Spotting patterns were established by integrating museum and photographic/camera-trap records. Principal component analysis showed three clearly distinct groups, with the Central American specimens (oncilla) clustering entirely within those of the Andes, namely the pardinoides group of the cloud forests of the southern Central-American and Andean mountain chains (clouded tiger-cat); the tigrinus group of the savannas of the Guiana Shield and central/northeastern Brazil (savanna tiger-cat); and the guttulus group in the lowland forests of the Atlantic Forest domain (Atlantic Forest tiger-cat). This scheme is supported by recent genetic analyses. All species displayed different spotting patterns, with some significant differences in body measurements/proportions. The new distribution presented alarming reductions from the historic range of - 50.4% to - 68.2%. This multidimensional approach revealed a new species of the elusive and threatened tiger-cat complex.


Assuntos
Tigres , Animais , Filogenia , Florestas , Brasil
5.
Einstein (Sao Paulo) ; 21: eRC0544, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37970955

RESUMO

Tailgut cysts are rare congenital lesions that are remnants of the embryonic hindgut. This abnormality presents with non-specific symptoms or no symptoms; therefore, misdiagnosis is common. Here, we present four cases of tailgut cysts that were successfully removed using a robotic surgical approach. A 42-year-old woman with tenesmus, pain in the right gluteal region, and discomfort in the rectal region during evacuation was referred to our medical center. Another patient was a 28-year-old woman who presented with the same symptoms to our general practitioner. Both patients underwent upper abdominal and pelvic magnetic resonance imaging that revealed a tailgut cyst. Further, a 36-year-old woman was referred with coccyx and hypogastric pain. Magnetic resonance imaging revealed two pararectal cystic formations. She underwent robot-assisted surgery, and after analysis by a pathologist, the conclusion was that the tailgut cyst was associated with scarring fibrosis. A 55-year-old woman with posterior epigastric pelvic pain associated with heartburn underwent robot-assisted surgery to resect a retroperitoneal tumor. These cases highlighted the importance of tailgut cysts in the differential diagnosis of rectal lesions. Surgical treatment is preferred because malignant transformations can occur. The difference between laparoscopic and robotic approaches is the better visualization and stability of the latter, inducing less tissue damage. Robotic resection is a safe procedure, especially in patients with a narrow pelvis, because it reduces tissue damage.


Assuntos
Cistos , Doenças Retais , Procedimentos Cirúrgicos Robóticos , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Brasil , Doenças Retais/diagnóstico por imagem , Doenças Retais/cirurgia , Cistos/diagnóstico por imagem , Cistos/cirurgia , Dor Pélvica/etiologia , Dor Pélvica/cirurgia , Dor Abdominal
6.
Health Qual Life Outcomes ; 21(1): 88, 2023 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-37580739

RESUMO

BACKGROUND: Distorted thoughts are common in Major Depressive Disorder (MDD), and can impact patients' perceptions of depression severity, and predict chronicity and treatment response. This study aimed to investigate whether distorted thoughts mediate depressive symptoms in MDD over a 6-month period. METHOD: These are secondary results from a study that followed 119 patients diagnosed with moderate to severe MDD for 6 months. Diagnoses were confirmed by the Structured Interview for DSM-IV (SCID-CV). The analysis was composed of results from the Hamilton Depression Rating Scale (HAMD-17), the Montgomery-Asberg Depression Rating Scale (MADRS), the second edition of the Beck Depression Inventory (BDI-II), and the Depression Thoughts Scale (DTS) collected at weeks 1, 8, 12 and 24. RESULTS: Results showed that the DTS mediated the relationship between depressive symptoms experienced approximately 3 months after starting antidepressant treatment. CONCLUSION: Cognitive distortions were linked as a mediator to depressive symptoms, highlighting the importance of early psychological interventions in patients with MDD who exhibit these distortions. TRIAL REGISTRATION: NCT02268487.


Assuntos
Transtorno Depressivo Maior , Humanos , Antidepressivos/uso terapêutico , Depressão , Transtorno Depressivo Maior/diagnóstico , Estudos Longitudinais , Escalas de Graduação Psiquiátrica , Qualidade de Vida
7.
J Biomech Eng ; 145(10)2023 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-37382599

RESUMO

Everyday, we interact with screens, sensors, and many other devices through contact with the skin. Experimental efforts have increased our knowledge of skin tribology but are challenged by the fact that skin has a complex structure, undergoes finite deformations, has nonlinear material response, and has properties that vary with anatomical location, age, sex, and environmental conditions. Computational models are powerful tools to dissect the individual contribution of these variables to the overall frictional response. Here, we present a three-dimensional high-fidelity multilayer skin computational model including a detailed surface topography or skin microrelief. Four variables are explored: local coefficient of friction (COF), indenter size, mechanical properties of the stratum corneum, and displacement direction. The results indicate that the global COF depends nonlinearly on the local COF, implying a role for skin deformation on the friction response. The global COF is also influenced by the ratio of the indenter size to the microrelief features, with larger indenters smoothing out the role of skin topography. Changes in stiffness of the uppermost layer of skin associated with humidity have a substantial effect on both the contact area and the reaction forces, but the overall changes in the COF are small. Finally, for the microrelief tested, the response can be considered isotropic. We anticipate that this model and results will enable the design of materials and devices for a desired interaction against skin.


Assuntos
Pele , Humanos , Anisotropia , Pele/química , Fricção
8.
WIREs Mech Dis ; 15(2): e1589, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36493758

RESUMO

The mammalian acrosome is a secretory vesicle attached to the sperm nucleus whose fusion with the overlying plasma membrane is required to achieve fertilization. Acrosome biogenesis starts during meiosis, but it lasts through the entire process of haploid cell differentiation (spermiogenesis). Acrosome biogenesis is a stepwise process that involves membrane traffic from the Golgi apparatus, but it also seems that the lysosome/endosome system participates in this process. Defective sperm head morphology is accompanied by defective acrosome shape and function, and patients with these characteristics are infertile or subfertile. The most extreme case of acrosome biogenesis failure is globozoospermia syndrome, which is primarily characterized by the presence of round-headed spermatozoa without acrosomes with cytoskeleton defects around the nucleus and infertility. Several genes participating in acrosome biogenesis have been uncovered using genetic deletions in mice, but only a few of them have been found to be deleted or modified in patients with globozoospermia. Understanding acrosome biogenesis is crucial to uncovering the molecular basis of male infertility and developing new diagnostic tools and assisted reproductive technologies that may help infertile patients through more effective treatment techniques. This article is categorized under: Reproductive System Diseases > Environmental Factors Infectious Diseases > Stem Cells and Development Reproductive System Diseases > Molecular and Cellular Physiology.


Assuntos
Acrossomo , Teratozoospermia , Humanos , Masculino , Camundongos , Animais , Acrossomo/metabolismo , Espermatozoides/metabolismo , Teratozoospermia/genética , Sêmen/metabolismo , Espermatogênese/genética , Mamíferos
9.
Anat Histol Embryol ; 52(2): 336-340, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36345659

RESUMO

This is the first morpho-histological comparison of guanaco ovaries between reproductive (long-days) and non-reproductive (short-days) seasons, and oestrogen receptor-alpha (ERα) and beta (ERß) detection. Different stages of follicle development were found in the cortical area, but no corpus luteum was detected. The size and frequency of antral follicles and large atretic follicles were higher in long-day ovaries than short-days, consistent with ovarian activity in this season. Differential expression of ERα and ERß was observed in follicles at different stages of development between short and long days. These data reveal histological and molecular differences between reproductive and non-reproductive seasons of guanaco ovaries.


Assuntos
Camelídeos Americanos , Ovário , Feminino , Animais , Ovário/anatomia & histologia , Receptor alfa de Estrogênio , Receptor beta de Estrogênio , Folículo Ovariano
10.
Einstein (São Paulo, Online) ; 21: eRC0544, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1520846

RESUMO

ABSTRACT Tailgut cysts are rare congenital lesions that are remnants of the embryonic hindgut. This abnormality presents with non-specific symptoms or no symptoms; therefore, misdiagnosis is common. Here, we present four cases of tailgut cysts that were successfully removed using a robotic surgical approach. A 42-year-old woman with tenesmus, pain in the right gluteal region, and discomfort in the rectal region during evacuation was referred to our medical center. Another patient was a 28-year-old woman who presented with the same symptoms to our general practitioner. Both patients underwent upper abdominal and pelvic magnetic resonance imaging that revealed a tailgut cyst. Further, a 36-year-old woman was referred with coccyx and hypogastric pain. Magnetic resonance imaging revealed two pararectal cystic formations. She underwent robot-assisted surgery, and after analysis by a pathologist, the conclusion was that the tailgut cyst was associated with scarring fibrosis. A 55-year-old woman with posterior epigastric pelvic pain associated with heartburn underwent robot-assisted surgery to resect a retroperitoneal tumor. These cases highlighted the importance of tailgut cysts in the differential diagnosis of rectal lesions. Surgical treatment is preferred because malignant transformations can occur. The difference between laparoscopic and robotic approaches is the better visualization and stability of the latter, inducing less tissue damage. Robotic resection is a safe procedure, especially in patients with a narrow pelvis, because it reduces tissue damage.

11.
Artigo em Inglês | MEDLINE | ID: mdl-38592432

RESUMO

Despite the abundance of literature on treatment-resistant depression (TRD), there is no universally accepted definition of TRD, and available treatment pathways for the management of TRD vary across the Latin American region, highlighting the need for a uniform definition and treatment principles to optimize the management of TRD in Latin America. METHODS: Following a thematic literature review and pre-meeting survey, a Latin America expert panel comprising 14 psychiatrists with clinical experience in managing patients with TRD convened and utilized the RAND/UCLA appropriateness method to develop consensus-based recommendations on the appropriate definition of TRD and principles for its management. RESULTS: The expert panel agreed that 'treatment-resistant depression' (TRD) is defined as 'failure of two drug treatments of adequate doses, for 4-8 weeks duration with adequate adherence, during a major depressive episode'. A stepwise treatment approach should be employed for the management of TRD - treatment strategies can include maximizing dose, switching to a different class, and augmenting or combining treatments. Nonpharmacological treatments, such as electroconvulsive therapy, are also appropriate options for patients with TRD. CONCLUSION: These consensus recommendations on the operational definition of TRD and approved treatments for its management can be adapted to local contexts in the Latin American countries but should not replace clinical judgement. Individual circumstances and benefit-risk balance should be carefully considered while determining the most appropriate treatment option for patients with TRD.

12.
Braz J Psychiatry ; 44(6): 576-583, 2022 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-36580584

RESUMO

OBJECTIVE: To explore whether there is an association between distractibility, anxiety, irritability, and agitation (DAIA) symptoms and the severity of depressive and manic symptoms. METHODS: Patients with unipolar and bipolar disorder (I and II) and mixed depression were evaluated. DAIA symptoms were assessed using previously described definitions. RESULTS: The full analysis set comprised 100 patients. The severity of depressive symptoms in mixed depression, assessed by Montgomery-Åsberg Depression Rating Scale (MADRS), was significantly associated with the presence of two or more DAIA symptoms in the bipolar sample, influenced mainly by anxiety. The severity of manic symptoms in mixed depression, assessed by Young Mania Rating Scale (YMRS), was significantly associated with the presence of two or more DAIA symptoms in the bipolar sample and three or four DAIA symptoms in the unipolar sample. CONCLUSION: DAIA symptoms were associated with greater severity of manic symptoms in mixed depression. DAIA symptoms must be evaluated in all patients with mixed features and are associated with the severity of depressive and manic symptoms in mixed depression.


Assuntos
Transtorno Bipolar , Depressão , Humanos , Depressão/diagnóstico , Transtorno Bipolar/diagnóstico , Ansiedade/diagnóstico , Humor Irritável , Agitação Psicomotora
13.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; Braz. J. Psychiatry (São Paulo, 1999, Impr.);44(6): 576-583, Nov.-Dec. 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1420530

RESUMO

Objective: To explore whether there is an association between distractibility, anxiety, irritability, and agitation (DAIA) symptoms and the severity of depressive and manic symptoms. Methods: Patients with unipolar and bipolar disorder (I and II) and mixed depression were evaluated. DAIA symptoms were assessed using previously described definitions. Results: The full analysis set comprised 100 patients. The severity of depressive symptoms in mixed depression, assessed by Montgomery-Åsberg Depression Rating Scale (MADRS), was significantly associated with the presence of two or more DAIA symptoms in the bipolar sample, influenced mainly by anxiety. The severity of manic symptoms in mixed depression, assessed by Young Mania Rating Scale (YMRS), was significantly associated with the presence of two or more DAIA symptoms in the bipolar sample and three or four DAIA symptoms in the unipolar sample. Conclusion: DAIA symptoms were associated with greater severity of manic symptoms in mixed depression. DAIA symptoms must be evaluated in all patients with mixed features and are associated with the severity of depressive and manic symptoms in mixed depression. Clinical trial registration: ClinicalTrials.gov (NCT04123301).

14.
Rev. méd. Panamá ; 42(3): 64-68, dic 2022.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1413300

RESUMO

Introducción: Las vasculitis asociadas a anticuerpos anti citoplasma de neutrófilos (ANCA) son entidades clínicas poco frecuentes con manifestaciones amplias que se asocian a retos diagnósticos. El tratamiento oportuno se asocia a mejoría pronóstica significativa. Caso clínico: Femenina de 45 años que acude con síntomas constitucionales de 2 meses de evolución, asociado en las últimas 2 semanas a hipoacusia progresiva. Se evidencia lesión renal aguda asociada a datos de sedimento urinario activo. El perfil inmune solicitado resultó positivo para ANCA PR-3, y la biopsia renal confirma el diagnóstico de Granulomatosis con Poliangeitis. Se inicia tratamiento inmunosupresor con ciclofosfamida, con poca mejoría de la función renal y requerimiento de hemodiálisis crónica.  La amplia variedad de manifestaciones clínicas asociadas a las vasculitis ANCA conducen a la incapacidad de diagnosticarlas tempranamente y la hipoacusia, aunque descrita, es una manifestación inicial poco frecuente. Conclusión: Las VAA son entidades clínicas poco frecuentes y cuando se presentan con manifestaciones atípicas, suelen ser un reto diagnóstico. Resulta imperativo considerarla en casos de síntomas constitucionales, asociados a manifestaciones renales, otorrinolaringológicas y pulmonares. (provisto por Infomedic International)


Introduction: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides are rare clinical entities with broad manifestations that are associated with diagnostic challenges. Prompt treatment is associated with significant prognostic improvement. Case report: 45-year-old female presenting with constitutional symptoms of 2 months of evolution, associated in the last 2 weeks with progressive hypoacusis. Acute renal lesion associated with active urinary sediment data was evidenced. The requested immune profile was positive for ANCA PR-3, and the renal biopsy confirmed the diagnosis of Granulomatosis with Polyangiitis. Immunosuppressive treatment with cyclophosphamide was started, with little improvement in renal function and requiring chronic hemodialysis. The wide variety of clinical manifestations associated with ANCA vasculitis lead to the inability to diagnose them early and hypoacusis, although described, is a rare initial manifestation. Conclusion: AAV are rare clinical entities and when they present with atypical manifestations, they are often a diagnostic challenge. It is imperative to consider it in cases of constitutional symptoms, associated with renal, otorhinolaryngologic and pulmonary manifestations. (provided by Infomedic International)

15.
Arq Bras Cir Dig ; 35: e1673, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36102484

RESUMO

BACKGROUND: Incisional hernia is characterized by a bulging of the abdominal wall caused by the prolapse of intracavitary structures, such as a segment of the small intestine, through the trocar orifice. Ultrasonography and physical examination are used in the diagnosis of incisional hernia. AIMS: This study aimed to evaluate the difference between physical examination and abdominal ultrasonography at the diagnosis of incisional hernia in patients who underwent laparoscopic bariatric surgery. METHODS: A total of 123 patients who underwent Roux-en-Y gastric bypass type bariatric surgery performed by laparoscopy were analyzed for the presence or absence of hernia by physical and ultrasonography examination at each trocar incision site. RESULTS: In our results, a total of 7 hernias were detected by physical examination, while ultrasonography detected a total of 56 hernias in at least one of the incision sites. Lin's concordance analysis showed that the tests are not concordant. The association between body mass index and hernia detection (p=0.04 for physical examination and p=0.052 for ultrasonography) was observed. Ultrasonography detected more incisional hernias in 10-mm or larger trocars than in 5-mm trocars (p<0.0001, p<0.05). No differences were noted among the trocar types that were used. CONCLUSIONS: Abdominal ultrasonography showed to have a higher accuracy than physical examination, resulting in a substantial increase in incisional hernia detection at the trocar sites.


Assuntos
Cirurgia Bariátrica , Derivação Gástrica , Hérnia Incisional , Laparoscopia , Humanos , Hérnia Incisional/diagnóstico por imagem , Hérnia Incisional/etiologia , Exame Físico
16.
Front Psychiatry ; 13: 830301, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935445

RESUMO

Objective: Ketamine, an N-methyl D-aspartate (NMDA) receptor antagonist, can promote rapid action in the management of individuals with treatment-resistant depression (TRD) at sub-anesthetic doses. However, few studies have investigated the long-term use of ketamine administered intravenously (IV) and intranasally (IN). We report the design and rationale of a therapeutic trial for assessing the efficacy, safety, and tolerability of repeated-dose intramuscular (IM) ketamine vs. active treatment (escitalopram and aripiprazole) in TRD patients. Methods: A comparative, parallel-group, randomized double-blind trial assessing the efficacy, safety, and tolerability of acute (4 weeks) and maintenance (24 weeks) use of IM ketamine (0.75 mg/kg) vs. active control (escitalopram 15 mg and aripiprazole 5 mg) in individuals with moderate-severe intensity TRD (no psychotic symptoms) with or without suicide risk will be conducted. Patients with TRD (18-40 years) will be randomized and blinded to receive ketamine IM or active treatment at a 1:1 ratio for 4 weeks (active treatment) and 24 weeks (maintenance treatment). Subjects will be assessed using clinical scales, monitored for vital signs (VS) after application of injectable medication, and undergo neuropsychological tests. The primary outcome will be changed on the Montgomery-Åsberg Depression Rating Scale (MADRS) during the course of the trial. The study is in running. Results: This study can potentially yield evidence on the use of IM ketamine in the treatment of depressive disorders as an ultra-rapid low-cost therapy associated with less patient discomfort and reduced use of medical resources, and can elucidate long-term effects on different outcomes, such as neuropsychological aspects. Conclusions: The trial can help promote the introduction of a novel accessible approach for the treatment of complex disease (TRD) and also allow refinement of its long-term use. Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT04234776, identifier: NCT04234776.

17.
Rev. colomb. cardiol ; 29(2): 155-161, ene.-abr. 2022. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1376873

RESUMO

Resumen Introducción: La ecocardiografía bidimensional es la técnica más efectiva para el diagnóstico del derrame pericárdico, gracias a sus altas sensibilidad y especificidad. Objetivo: Analizar la superioridad del método de suma de discos comparado con el método bidimensional en la estimación del derrame pericárdico por medio de ecocardiografía, tomando como referencia el volumen de líquido pericárdico extraído por pericardiocentesis o cirugía abierta. Método: Estudio retrospectivo de seguimiento de una cohorte basado en registros médicos y archivos de ecocardiografía. Se empleó un diseño pareado en el que cada imagen fue leída por el método bidimensional y por el método de suma de discos. Se incluyeron derrames pericárdicos graves, definidos clínicamente o por parámetros ecocardiográficos, que requirieran drenaje. El desempeño de los métodos de estimación bidimensional y de suma de discos, tomando como referencia la extracción por intervención, se cuantificó mediante áreas bajo la curva operador-receptor (auROC). Resultados: Se analizaron 40 registros, tomando como referencia el volumen obtenido por extracción; con un auROC de 0.81 (intervalo de confianza del 95% [IC95%]: 0.73-0.89), el desempeño diagnóstico del método de suma de discos fue significativamente mayor (p = 0.0335) que el del método bidimensional (auROC: 0.73; IC95%: 0.63-0.83). La estimación realizada por el método de suma de discos subestimó en promedio 51.3 ml (IC95%: −156.2-53.5). Conclusiones: En pacientes con derrame pericárdico e indicación de drenaje o taponamiento cardíaco, el método de suma de discos es superior en comparación con el método bidimensional en el estudio ecocardiográfico para la estimación cuantitativa del derrame pericárdico, ya que discrimina mejor respecto al método bidimensional.


Abstract Introduction: Two-dimensional echocardiography is the most effective technique for diagnosing pericardial effusion due to its high sensitivity and specificity. Objective: The superiority of the method of disks was compared with the bidimensional method in the estimation of pericardial effusion by echocardiography, taking as reference the volume of pericardial fluid removed by pericardiocentesis or open surgery. Method: Retrospective follow-up study of a cohort, based on medical records and echocardiography files. A paired design was used, each image was read by the bidimensional method and by the method of disks. Severe pericardial effusions defined clinically or by echocardiographic parameters, that required drainage were included. The performance of the bidimensional and disks estimation methods, taking the volume removed as a reference, was quantified using areas under the receiver operating characteristic curve (auROC). Results: 40 records were analyzed, taking as a reference the volume obtained by extraction, with an auROC of 0.81 (95% CI: 0.73-0.89) the diagnostic performance of the disks method was significantly higher (p = 0.0335) than the bidimensional method (auROC 0.73, 95% CI: 0.63-0.83). The estimate made by the disks method underestimated an average of 51.3 ml (95% CI: -156.2-53.5). Conclusions: In patients with pericardial effusion with indication of cardiac drainage or tamponade, the disks method is superior in comparison with the bidimensional method in the echocardiographic study of the quantitative estimation of pericardial effusion, discriminating better than the bidimensional method.

18.
Animals (Basel) ; 12(6)2022 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-35327117

RESUMO

The buoyancy of eggs and embryos is associated with successful development in pelagic fish. Buoyancy is the result of oocyte hydration, which depends on the osmotic force exerted by free amino acids (FAA) generated by yolk proteolysis, and cathepsins are the main enzymes involved in this process. Seriola lalandi is a pelagic fish whose farming has been hampered by development failure that have been partially attributed to decreased buoyancy of embryos. Therefore, the aim of this study was to compare the mRNA expression and activity of cathepsins B, D, and L, as well as the FAA content in floating and low-floating embryos at different developmental stages. The chosen stages were eggs, morula, blastula, gastrula and 24 h embryos. Complementary assessments showed that there were no differences attributed to buoyancy status in embryo and oil droplet diameters, as well as the transcriptional status at any developmental stage. Cathepsin B did not show differences in mRNA expression or activity related to buoyancy at any stage. Cathepsin D displayed higher transcript and activity levels only in low-floating eggs compared with those floating. Cathepsin L showed higher expression in floating eggs and 24 h embryos compared with that of low-floating, but the activity of this enzyme was higher in floating eggs and morula. Total FAA content constantly decreased throughout development in floating embryos, but it was always higher than low-floating embryos until gastrula stage. In 24 h embryos floating and low-floating embryos share similar quantities of FAA. In summary, differences in the expression and activity of cathepsins between floating and low-floating embryos could be revealed at specific embryonic stages, suggesting different functions of these enzymes throughout development. Besides 24 h embryos, FAA content seems to be a decisive factor for buoyancy of embryos during early development of S. lalandi. Overall, considering the main role of cathepsins and FAA in buoyancy acquisition process and therefore in both embryo quality and viability, our study identifies good marker candidates to evaluate embryo quality in the farming of this species.

19.
ABCD (São Paulo, Online) ; 35: e1673, 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1402866

RESUMO

ABSTRACT BACKGROUND: Incisional hernia is characterized by a bulging of the abdominal wall caused by the prolapse of intracavitary structures, such as a segment of the small intestine, through the trocar orifice. Ultrasonography and physical examination are used in the diagnosis of incisional hernia. AIMS: This study aimed to evaluate the difference between physical examination and abdominal ultrasonography at the diagnosis of incisional hernia in patients who underwent laparoscopic bariatric surgery. METHODS: A total of 123 patients who underwent Roux-en-Y gastric bypass type bariatric surgery performed by laparoscopy were analyzed for the presence or absence of hernia by physical and ultrasonography examination at each trocar incision site. RESULTS: In our results, a total of 7 hernias were detected by physical examination, while ultrasonography detected a total of 56 hernias in at least one of the incision sites. Lin's concordance analysis showed that the tests are not concordant. The association between body mass index and hernia detection (p=0.04 for physical examination and p=0.052 for ultrasonography) was observed. Ultrasonography detected more incisional hernias in 10-mm or larger trocars than in 5-mm trocars (p<0.0001, p<0.05). No differences were noted among the trocar types that were used. CONCLUSIONS: Abdominal ultrasonography showed to have a higher accuracy than physical examination, resulting in a substantial increase in incisional hernia detection at the trocar sites.


RESUMO RACIONAL: A hérnia incisional é caracterizada por um abaulamento da parede abdominal causada por um prolapso das estruturas intracavitárias, como um segmento do intestino delgado, através de um orifício de trocarte. A ultrassonografia e o exame físico são usados no diagnóstico da hérnia incisional. OBJETIVOS: Avaliar a diferença entre o exame físico e a ultrassonografia abdominal no diagnóstico da hérnia incisional em pacientes submetidos a cirurgia bariátrica por videolaparoscopia. MÉTODOS: O total de 123 pacientes submetidos à cirurgia bariátrica, tipo derivação gástrica em Y de Roux, foram avaliados para a presença ou ausência de hérnia incisional por exame físico e ultrassonografia, nos sítios incisionais de cada trocarte. RESULTADOS: O total de sete hérnias foram detectados por exame físico, enquanto a ultrassonografia detectou um total de 56 hérnias em pelo menos um sítio incisional. A análise de concordância de Lin mostrou que os testes empregados não são concordantes. A associação entre o Índice de Massa Corpórea e a detecção de hérnia foi observada (p=0.04, para exame físico, p=0.052 para ultrassonografia). A ultrassonografia detectou mais hérnias incisionais em trocartes de 10 mm ou mais do que em trocartes de 5 mm (p<0,0001, p<0.05). Não foi observada diferença entre os tipos de trocartes empregados. CONCLUSÕES: A ultrassonografia abdominal demonstrou ter acurácia mais elevada que o exame físico, resultando em um aumento substancial na detecção de hérnia incisional nos locais de inserção dos trocartes.

20.
Diversitas perspectiv. psicol ; 17(2): 97-121, jul.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1384706

RESUMO

Resumen Se realizó una revisión de literatura acerca de los aportes investigativos de la resiliencia en el deporte entre los años de 2010 y 2020 en una muestra de 239 artículos que respondieron a criterios de inclusión como: artículos originales, de revisión de literatura, estudios cualitativos, cuantitativos o mixtos publicados; tesis o trabajos de grado y capítulos de libro. La búsqueda se realizó en las bases de datos de PubMed, Ebsco Host, Science Direct, Scopus, PsyINFO. Se encontró que la investigación y aportes de la resiliencia en el deporte son numerosos y aplicados a una gran diversidad de modalidades deportivas y a nivel de actividad física, deporte formativo y competitivo. Se encontraron predominantemente estudios cuantitativo-descriptivos; sin embargo se destacan diversos enfoques metodológicos. Se observó además que los estudios se orientaron hacia las poblaciones de adultos y adolescentes, y un tercer foco de interés son las revisiones de literatura. Los campos en los que se exploró la resiliencia en el deporte se asociaron al desempeño en competencia, afrontamiento de la adversidad, situaciones estresantes, o de burn out, como dimensión motivacional. Se concluye con la necesidad de realizar estudios específicos por práctica deportiva, tipos de deporte y fenómenos psico-sociales relacionados como la influencia de la recuperación de lesiones, estados anímicos y situaciones adversas extradeportivas y extra-competición.


Abstract A literature review was conducted on the research contributions on resilience in sports between 2010 and 2020 in a sample of 239 articles, which responded to inclusion criteria such as original articles; literature reviews; qualitative, quantitative, or mixed published studies; thesis or degree works; and book chapters. The search was carried out in PubMed, Ebsco Host, Science Direct, Scopus, and PsycINFO databases. It was found that research and contributions on resilience in sports are numerous and applied to a great diversity of sports modalities and at the level of physical activity and formative and competitive sports. Quantitative-descriptive studies were predominantly found; however, different methodological approaches are highlighted. It was also observed that the studies were oriented towards adult and adolescent populations, and a third focus of interest is literature reviews. The fields in which resilience in sports was explored were associated with performance in competition, coping with adversity, stressful situations, or burnout, as a motivational dimension. It is concluded that it is necessary to carry out specific studies by sports practice and types of sports, and the related psycho-social phenomena, such as the influence of injury recovery, moods, and adverse extra-sports and extra-competition situations.

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