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1.
bioRxiv ; 2024 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-38895335

RESUMO

Hematopoietic stem cells (HSCs) with multilineage potential are critical for effective T cell reconstitution and restoration of the adaptive immune system after allogeneic Hematopoietic Cell Transplantation (allo-HCT). Our current understanding of lymphoid-poised HSC subsets is limited due to a lack of reliable markers. Through comprehensive molecular profiling of HSCs, we identify Kit lo HSCs-a subset with enhanced lymphoid potential, which declines with age. Using a preclinical allo-HCT model, we demonstrate that Kit lo HSCs exhibit superior lymphoid progenitor output, enhanced thymic recovery, and T-cell reconstitution resulting in improved T cell responses to infection post-HCT. Furthermore, Kit lo HSCs with augmented BM lymphopoiesis mitigate age-associated thymic alterations, thus enhancing T-cell recovery in middle-aged hosts. Chromatin profiling revealed that Kit lo HSCs exhibit higher activity of lymphoid-specifying transcription factors (TFs), including Zbtb1 . Deletion of Zbtb1 in Kit lo HSCs, diminished their T-cell potential, while reinstating Zbtb1 in megakaryocytic-biased Kit hi HSCs rescued T-cell potential, in vitro and in vivo . Finally, we discover an analogous Kit lo HSC subset with enhanced lymphoid potential in human bone marrow. Our results demonstrate that Kit lo HSCs identify HSC subsets with enhanced lymphoid potential mediated by an underlying epigenetic program.

2.
Acta Trop ; 256: 107267, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38777256

RESUMO

Chagas disease (CD), caused by the protozoan Trypanosoma cruzi (T. cruzi), is a neglected disease endemic to some Latin American countries, including Brazil. Soon after infection, individuals develop an acute phase, which in most cases is asymptomatic and may go undetected. However, when CD is detected early, notification in the Notifiable Diseases Information System (SINAN), is mandatory. This study aimed to evaluate the information registered in the SINAN database and to determine the epidemiological profile of acute CD in Northeast Brazil, an endemic region, from 2001 to 2021. According to this survey, 1,444 cases of acute CD were reported in the Northeastern region of Brazil during this period. During the first six years, referred to as period 1, 90.24% of the notifications were registered, while the number of notifications significantly decreased in the subsequent years, referred to as period 2. Most individuals diagnosed with acute CD were Afro-Brazilian adults. All known routes of infection by the parasite were reported. Vector-borne transmission was predominant during period 1 (73.29%) and oral transmission during period 2 (58.87%). All nine states in Northeast Brazil reported cases in both periods. A higher incidence of disease was reported in Rio Grande do Norte (RN) during period 1, and in Maranhão (MA) during period 2. Our results show that CD remains a significant public health challenge.


Assuntos
Doença de Chagas , Doença de Chagas/epidemiologia , Doença de Chagas/transmissão , Brasil/epidemiologia , Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Adolescente , Criança , Pré-Escolar , Adulto Jovem , Notificação de Doenças/estatística & dados numéricos , Lactente , Idoso , Incidência , Trypanosoma cruzi , Doença Aguda/epidemiologia , Recém-Nascido , Idoso de 80 Anos ou mais
3.
Artigo em Inglês | MEDLINE | ID: mdl-38712373

RESUMO

BACKGROUND: In response to inflammation and other stressors, tryptophan is catalyzed by Tryptophan 2,3-Dioxygenase (TDO), which leads to activation of the kynurenine pathway. Sepsis is a serious condition in which the body responds improperly to an infection, and the brain is the inflammation target in this condition. OBJECTIVE: This study aimed to determine if the induction of TDO contributes to the permeability of the Blood-Brain Barrier (BBB), mortality, neuroinflammation, oxidative stress, and mitochondrial dysfunction, besides long-term behavioral alterations in a preclinical model of sepsis. METHODS: Male Wistar rats with two months of age were submitted to the sepsis model using Cecal Ligation and Perforation (CLP). The rats received allopurinol (Allo, 20 mg/kg, gavage), a TDO inhibitor, or a vehicle once a day for seven days. RESULTS: Sepsis induction increased BBB permeability, IL-6 level, neutrophil infiltrate, nitric oxide formation, and oxidative stress, resulting in energy impairment in 24h after CLP and Allo administration restored these parameters. Regarding memory, Allo restored short-term memory impairment and decreased depressive behavior. However, no change in survival rate was verified. CONCLUSION: In summary, TDO inhibition effectively prevented depressive behavior and memory impairment 10 days after CLP by reducing acute BBB permeability, neuroinflammation, oxidative stress, and mitochondrial alteration.

4.
Life (Basel) ; 14(4)2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38672706

RESUMO

Animal models have been essential for advancing research of fetal alcohol spectrum disorder (FASD) in humans, but few animal species effectively replicate the behavioural and clinical signs of FASD. The honey bee (Apis mellifera) is a previously unexplored research model for FASD that offers the distinct benefit of highly social behaviour. In this study, we chronically exposed honey bee larvae to incremental concentrations of 0, 3, 6, and 10% ethanol in the larval diet using an in vitro rearing protocol and measured developmental time and survival to adult eclosion, as well as body weight and motor activity of newly emerged adult bees. Larvae reared on 6 and 10% dietary ethanol demonstrated significant, dose-responsive delays to pupation and decreased survival and adult body weight. All ethanol-reared adults showed significantly decreased motor activity. These results suggest that honey bees may be a suitable social animal model for future FASD research.

5.
Dent Traumatol ; 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38576382

RESUMO

BACKGROUND/AIM: This study assessed the epidemiology of luxation injuries with or without dental fractures in patients attending the outpatient clinic of a Brazilian dental school over the past decade. MATERIAL AND METHODS: We reviewed clinical records from a specialized center for dental trauma care in Brazil, focusing on patients who experienced at least one traumatic dental injury (TDI) in a permanent tooth between 2012 and 2022. The extracted data included sex, age, etiology, time between trauma occurrence and the search for initial care, TDI classification, and the need for endodontic treatment. The statistical analysis involved Pearson's chi-squared and Fisher's exact tests at a 5% significance level. RESULTS: The 366 analyzed clinical records included 166 patients (350 teeth) with luxation injuries. Men (n = 102) showed a higher prevalence of luxation injuries than women (n = 64). Extrusive luxation prevailed (n = 99 patients and 208 teeth). Patients with luxation injuries sought care promptly after dental trauma incidents (p = .02) and demonstrated a higher incidence of endodontic treatment (p < .0001) than those without luxation injuries. Lateral luxation was notably associated with traffic accidents (p < .0001). The combination of luxation injuries and tooth fractures did not correlate with a higher need for endodontic treatment (p > .05). CONCLUSIONS: Age and trauma etiology seemed to have influenced the epidemiological profile of luxation injuries. Additionally, these injuries affected the time to seek initial care and the need for endodontic treatment.

6.
Cell Death Dis ; 15(4): 264, 2024 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-38615035

RESUMO

Cognitive dysfunction and dementia are critical symptoms of Lewy Body dementias (LBD). Specifically, alpha-synuclein (αSyn) accumulation in the hippocampus leading to synaptic dysfunction is linked to cognitive deficits in LBD. Here, we investigated the pathological impact of αSyn on hippocampal neurons. We report that either αSyn overexpression or αSyn pre-formed fibrils (PFFs) treatment triggers the formation of cofilin-actin rods, synapse disruptors, in cultured hippocampal neurons and in the hippocampus of synucleinopathy mouse models and of LBD patients. In vivo, cofilin pathology is present concomitantly with synaptic impairment and cognitive dysfunction. Rods generation prompted by αSyn involves the co-action of the cellular prion protein (PrPC) and the chemokine receptor 5 (CCR5). Importantly, we show that CCR5 inhibition, with a clinically relevant peptide antagonist, reverts dendritic spine impairment promoted by αSyn. Collectively, we detail the cellular and molecular mechanism through which αSyn disrupts hippocampal synaptic structure and we identify CCR5 as a novel therapeutic target to prevent synaptic impairment and cognitive dysfunction in LBD.


Assuntos
Transtornos Cognitivos , Doença por Corpos de Lewy , Animais , Camundongos , Humanos , alfa-Sinucleína , Espinhas Dendríticas , Fatores de Despolimerização de Actina , Receptores CCR5/genética
7.
Nat Microbiol ; 9(3): 614-630, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38429422

RESUMO

Microbial transformation of bile acids affects intestinal immune homoeostasis but its impact on inflammatory pathologies remains largely unknown. Using a mouse model of graft-versus-host disease (GVHD), we found that T cell-driven inflammation decreased the abundance of microbiome-encoded bile salt hydrolase (BSH) genes and reduced the levels of unconjugated and microbe-derived bile acids. Several microbe-derived bile acids attenuated farnesoid X receptor (FXR) activation, suggesting that loss of these metabolites during inflammation may increase FXR activity and exacerbate the course of disease. Indeed, mortality increased with pharmacological activation of FXR and decreased with its genetic ablation in donor T cells during mouse GVHD. Furthermore, patients with GVHD after allogeneic hematopoietic cell transplantation showed similar loss of BSH and the associated reduction in unconjugated and microbe-derived bile acids. In addition, the FXR antagonist ursodeoxycholic acid reduced the proliferation of human T cells and was associated with a lower risk of GVHD-related mortality in patients. We propose that dysbiosis and loss of microbe-derived bile acids during inflammation may be an important mechanism to amplify T cell-mediated diseases.


Assuntos
Doença Enxerto-Hospedeiro , Linfócitos T , Humanos , Intestinos , Inflamação , Ácidos e Sais Biliares
8.
Life (Basel) ; 14(3)2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38541698

RESUMO

(1) Background: Microsporidiosis (nosemosis) is an intestinal disorder of adult honey bees caused by the microsporidian pathogens Vairimorpha apis and Vairimorpha ceranae. In Canada, fumagillin is an approved antibiotic used to treat this disease. However, the recommended dosage is based on efficacy studies for V. apis, the native pathogen in European honey bees. Since the detection of V. ceranae in Apis mellifera, V. ceranae became more prevalent in managed European honey bees and seems to have replaced V. apis due to yet unknown reasons. (2) Methods: This colony study investigated the efficacy of fumagillin administered in the fall to colonies infected with both V. apis and V. ceranae and its effects on the Vairimorpha species' prevalence overwinter. Spore loads in control and fumagillin-treated colonies were analysed by microscopy; Vairimorpha species prevalence was determined molecularly and infection and treatment effects on colony productivity were assessed. (3) Results: Fall fumagillin treatment was associated with a temporary reduction in spore load, but there was no difference in spore loads between treated and control colonies the following spring. Interestingly, fumagillin-treated colonies had a significantly greater prevalence of V. ceranae relative to V. apis the following spring, suggesting fumagillin is less effective in controlling V. ceranae.

9.
World J Clin Oncol ; 15(2): 195-207, 2024 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-38455133

RESUMO

Interferon-gamma (IFN-γ) plays a dual role in cancer; it is both a pro- and an antitumorigenic cytokine, depending on the type of cancer. The deregulation of the IFN-γ canonic pathway is associated with several disorders, including vulnerability to viral infections, inflammation, and cancer progression. In particular, the interplay between lung adenocarcinoma (LUAD) and viral infections appears to exist in association with the deregulation of IFN-γ signaling. In this mini-review, we investigated the status of the IFN-γ signaling pathway and the expression level of its components in LUAD. Interestingly, a reduction in IFNGR1 expression seems to be associated with LUAD progression, affecting defenses against viruses such as severe acute respiratory syndrome coronavirus 2. In addition, alterations in the expression of IFNGR1 may inhibit the antiproliferative action of IFN-γ signaling in LUAD.

10.
Metab Brain Dis ; 39(4): 635-648, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38429463

RESUMO

Obesity results from an energy imbalance and has been considered an epidemic due to its increasing rates worldwide. It is classified as a low-grade chronic inflammatory disease and has associated comorbidities. Different nutritional strategies are used for the purpose of weight loss, highlighting low-carbohydrate (LC) diets, ketogenic diets, and intermittent fasting (IF). These strategies can lead to metabolic and behavioral changes as they stimulate different biochemical pathways. Therefore, this study evaluated memory, energy metabolism, neuroinflammation, oxidative stress, and antioxidant defense parameters in mice subjected to an LC diet, ketogenic diet (KD), or IF. Eighty male Swiss mice, 60 days old, were divided into 4 groups: control, LC, KD, or IF. Body weight was measured weekly, and food intake every 48 h. After 15 days of nutritional interventions, the animals were subjected to the behavioral object recognition test and subsequently euthanized. Then, visceral fat was removed and weighed, and the brain was isolated for inflammatory and biochemical analysis. We concluded from this study that the LC and KD strategies could damage memory, IF improves the production of adenosine triphosphate (ATP), and the LC, KD, and IF strategies do not lead to neuroinflammatory damage but present damage at the level of oxidative stress.


Assuntos
Dieta Cetogênica , Estresse Oxidativo , Animais , Masculino , Camundongos , Estresse Oxidativo/fisiologia , Transtornos da Memória/metabolismo , Transtornos da Memória/etiologia , Doenças Neuroinflamatórias/metabolismo , Dieta com Restrição de Carboidratos , Jejum/metabolismo , Metabolismo Energético/fisiologia , Encéfalo/metabolismo
11.
Craniomaxillofac Trauma Reconstr ; 17(1): 34-39, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38371218

RESUMO

Study Design: Retrospective cohort study. Objective: Malnutrition has been found to have negative effects on the immune system and inflammatory responses, impairing the wound healing process. Free flap failure is a serious complication in patients undergoing microvascular reconstruction, as it increases patient morbidity, length of stay in the hospital, patient, and hospital costs, as well as causes the need for further surgical interventions1. Malnutrition is estimated to be present in 35-50% of head and neck cancer patients with higher rates in those experiencing hypo-oropharyngeal disease. This is often caused by functional and pain limitations from due to disease burden causing odynophagia and dysphagia. The Malnutrition Universal Screening Tool (MUST) is recommended for risk screening and provides three scores for risk classification: high, intermediate, and low2. We argue that the use of MUST as a preoperative assessment tool is useful to predict postoperative surgical site infection and delayed wound healing in patients that will undergo reconstruction with free flaps for head and neck defects. Methods: A retrospective cohort study was designed to include all subjects who underwent head and neck microvascular free tissue transfer at a single institution between 2013 and 2019. Primary and secondary reconstructions were included, for benign or malignant pathology, osteonecrosis, osteomyelitis, congenital defects, and trauma. The nutritional risk was evaluated using MUST, which analyzes body mass index, weight loss, and acute disease effect, to classify patients as low, intermediate, and high risk. We further divided the subjects into two comparison groups- low-intermediate and high risk. The primary outcome was surgical site complications and delayed wound healing. Data was analyzed as frequencies and means with standard deviations, as well as Fisher's exact test and t-test. P-values <0.05 were considered statistically significant. Analyses were done utilizing IBM SPSS Statistics Version 29. Results: 131 subjects were included for data analysis, with 54 being considered low MUST risk, 12 intermediate risk (66 low-intermediate), and 65 were high risk. The mean BMI overall was 25.5 ±5.3, and 27.2 in the low-intermediate group, and 23.7 in the high-risk group. Eighty-two subjects experienced <5-pound weight loss in the preceding 6 months to surgery, while 17 lost between 5-10 pounds, and 23 lost 10< pounds. Cancer/osteonecrosis was the etiology for 54 (82%) subjects of the low-intermediate group, and 61 (92%) of the high-risk group (P = .089). The subjects classified in High-risk group according to the MUST score had 11% more surgical site complications (P = .120) and 13.7% more delayed wound healing and dehiscence(P = .09); only 3 subjects in the study presented total flap loss and they were all in the High-risk group. Surgical site complication, delayed wound healing rates and partial or total flap loss were not increased by any specific medical comorbidity or history such as radiation or chemotherapy. Conclusions: In conclusion, Subjects with high MUST score had increased complications and poor wound healing, and subjects with acute disease effect that induces a phase of nil per os for > 5 day have higher risk of total flap loss and surgical site complication.

12.
Environ Res ; 247: 118220, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38242422

RESUMO

The work investigates the potential of peanut shells, an abundant agro-industrial waste, to serve as an adsorbent precursor for the effective and simple treatment of effluents loaded with cadmium and nickel ions. Among the adsorbents prepared, carbonized peanut shell (CCarb), due to its higher adsorption capacity, proved to be the most effective compared to carbonized and activated peanut shell (CATQ). The carbonization process led to structural changes, which resulted in an increase in surface area (around 6 times more in CATQ) and pore volume (around 3 times more in CATQ). Even so, the amount of H+ acid sites due to acid activation produced unfavorable effects for adsorption. Hydroxyl, carboxyl and carbonyl groups were identified on the adsorbent surface which presented favorable charges for metal adsorption. This improvement propels the carbonized variant to the forefront, demonstrating the highest adsorption capacity and reaching equilibrium in less than 90 and 60 min for cadmium and nickel ions, respectively. In both monocomponent and bicomponent systems concentrations greater than 40 ppm signify an increase in adsorption capacity for Ni2+. The experimental data best fit the Freundlich model, showing maximum adsorption capacities of 17.04 mg g-1 for cadmium and 31.28 mg g-1 for nickel. Despite the antagonistic effect observed in the bicomponent system, this study concludes by underlining the promise of activated carbon from peanut shells to harmonize technical and environmental concerns.


Assuntos
Níquel , Poluentes Químicos da Água , Cádmio , Arachis , Adsorção , Bismuto , Íons , Cinética , Poluentes Químicos da Água/análise , Concentração de Íons de Hidrogênio
13.
Mol Biol Rep ; 51(1): 64, 2024 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-38170343

RESUMO

BACKGROUND: Glioblastoma is a brain malignant tumor grade IV, highly invasive. Alterations in several signaling pathways are involved in glioblastoma development. In this work, we evaluated the IFN-γ canonical signaling pathway in glioblastoma cells and its effect on cell viability and migration. METHODS: The levels of STAT1/pSTAT1, IRF1, and PD-L1 in LN-18 glioblastoma cells were analyzed using western blotting. Cell viability was evaluated by calcein-AM/propidium iodide assays, and a wound healing assay was used to study the migration of glioblastoma cells treated with IFN-γ. Our aim was to determine the expression of IFN-γ signaling elements in cell lines and tissue from glioblastoma samples and examine the relationship between these elements and the survival of glioblastoma patients. The following platforms were utilized for analysis: the CCLE (Cancer Cell Line Encyclopedia), UALCAN (University of Alabama at Birmingham Cancer data analysis Portal), GEPIA (Gene Expression Profiling Interactive Analysis), and GENT2 (Gene Expression patterns across Normal and Tumor tissues). RESULTS: Our results evidenced that IFN-γ signaling increases non-phosphorylated and phosphorylated STAT1 levels and promotes the upregulation of IRF1 and PD-L1 in glioblastoma cells. The activation of IFN-γ signaling increased cell migration without affecting the viability of glioblastoma cells. Furthermore, in silico analysis showed that the elements of IFN-γ signaling pathways (IFNGR1/IFNGR2/STAT1/IRF1) are upregulated in human glioblastoma samples. The upregulation of IFN-γ signaling was associated with shorter survival in glioblastoma patients. CONCLUSION: IFN-γ signaling pathway is upregulated in glioblastoma, displaying pro-tumor activity. Thus, IFN-γ signaling elements may be potential biomarkers and targets for treating glioblastoma.


Assuntos
Glioblastoma , Interferon gama , Humanos , Interferon gama/metabolismo , Glioblastoma/genética , Antígeno B7-H1/metabolismo , Regulação para Cima , Transdução de Sinais , Linhagem Celular Tumoral
14.
Commun Biol ; 7(1): 14, 2024 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-38212558

RESUMO

Ancient DNA is a valuable tool for investigating genetic and evolutionary history that can also provide detailed profiles of the lives of ancient individuals. In this study, we develop a generalised computational approach to detect aneuploidies (atypical autosomal and sex chromosome karyotypes) in the ancient genetic record and distinguish such karyotypes from contamination. We confirm that aneuploidies can be detected even in low-coverage genomes ( ~ 0.0001-fold), common in ancient DNA. We apply this method to ancient skeletal remains from Britain to document the first instance of mosaic Turner syndrome (45,X0/46,XX) in the ancient genetic record in an Iron Age individual sequenced to average 9-fold coverage, the earliest known incidence of an individual with a 47,XYY karyotype from the Early Medieval period, as well as individuals with Klinefelter (47,XXY) and Down syndrome (47,XY, + 21). Overall, our approach provides an accessible and automated framework allowing for the detection of individuals with aneuploidies, which extends previous binary approaches. This tool can facilitate the interpretation of burial context and living conditions, as well as elucidate past perceptions of biological sex and people with diverse biological traits.


Assuntos
Síndrome de Down , Síndrome de Klinefelter , Masculino , Humanos , Síndrome de Klinefelter/diagnóstico , Síndrome de Klinefelter/genética , DNA Antigo , Aneuploidia , Cromossomos Sexuais
15.
Gut Microbes ; 16(1): 2297872, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38165200

RESUMO

Hyperbaric oxygen (HBO) therapy is a well-established method for improving tissue oxygenation and is typically used for the treatment of various inflammatory conditions, including infectious diseases. However, its effect on the intestinal mucosa, a microenvironment known to be physiologically hypoxic, remains unclear. Here, we demonstrated that daily treatment with hyperbaric oxygen affects gut microbiome composition, worsening antibiotic-induced dysbiosis. Accordingly, HBO-treated mice were more susceptible to Clostridioides difficile infection (CDI), an enteric pathogen highly associated with antibiotic-induced colitis. These observations were closely linked with a decline in the level of microbiota-derived short-chain fatty acids (SCFAs). Butyrate, a SCFA produced primarily by anaerobic microbial species, mitigated HBO-induced susceptibility to CDI and increased epithelial barrier integrity by improving group 3 innate lymphoid cell (ILC3) responses. Mice displaying tissue-specific deletion of HIF-1 in RORγt-positive cells exhibited no protective effect of butyrate during CDI. In contrast, the reinforcement of HIF-1 signaling in RORγt-positive cells through the conditional deletion of VHL mitigated disease outcome, even after HBO therapy. Taken together, we conclude that HBO induces intestinal dysbiosis and impairs the production of SCFAs affecting the HIF-1α-IL-22 axis in ILC3 and worsening the response of mice to subsequent C. difficile infection.


Assuntos
Clostridioides difficile , Infecções por Clostridium , Microbioma Gastrointestinal , Oxigenoterapia Hiperbárica , Camundongos , Animais , Membro 3 do Grupo F da Subfamília 1 de Receptores Nucleares , Imunidade Inata , Oxigenoterapia Hiperbárica/efeitos adversos , Interleucina 22 , Disbiose/terapia , Linfócitos , Butiratos/farmacologia , Ácidos Graxos Voláteis/farmacologia , Antibacterianos/farmacologia
16.
Rev. Bras. Cancerol. (Online) ; 70(1)Jan-Mar. 2024.
Artigo em Inglês, Português | LILACS, Sec. Est. Saúde SP | ID: biblio-1537378

RESUMO

A assistência nutricional em cuidados paliativos possui papel preventivo e visa assegurar as necessidades nutricionais do paciente na tentativa de auxiliar o controle dos sintomas, manter a hidratação satisfatória, ressignificar a alimentação, reduzir a ansiedade, retardar o desenvolvimento da caquexia, preservar o peso e a composição nutricional. Objetivo: Desenvolver e validar o mnemônico NUTRIFICO como abordagem de assistência nutricional e comunicação de notícias difíceis em cuidados paliativos. Método: Pesquisa de desenvolvimento e validação de conteúdo que utilizou a técnica Delphi com a aplicação do delineamento misto com abordagens qualitativas e quantitativas para a coleta e análise dos dados. Os participantes, nutricionistas com atuação em cuidados paliativos e/ou formação na área, foram recrutados por amostragem do tipo bola de neve. O percentual de concordância mínimo definido para validação foi de 80% pela escala Likert de cinco pontos. Resultados: Quarenta participantes, incluindo oito "sementes", foram convidados a participar do estudo. Destes, 16 assinaram o Termo de Consentimento Livre e Esclarecido (TCLE). A análise de conteúdo seguiu duas rodadas Delphi e foi obtida uma taxa de concordância superior a 80% entre os participantes para todos os componentes. A versão final do mnemônico NUTRIFICO resultou em dois princípios-chave, oito componentes e 12 recomendações. Conclusão: O mnemônico NUTRIFICO foi considerado válido quanto ao conteúdo e, portanto, pertinente à aplicação na abordagem nutricional e comunicação de notícias difíceis em cuidados paliativos.


Nutritional assistance in palliative care has a preventive role and seeks to ensure the patient's nutritional needs in an attempt to help to control the symptoms, maintain satisfactory hydration, reframe food, reduce anxiety, delay the development of cachexia, preserve weight and nutritional composition. Objective: To develop and validate the NUTRIFICO mnemonic as an approach to nutritional assistance and communication of dismal news in palliative care. Method: Research development and validation of content utilizing the Delphi technique with the application of a mixed design with qualitative and quantitative approaches for data collection and analysis. The participants, nutritionists with experience in palliative care and/or training in the area, were recruited by sampling using the snowball method. The minimum agreement percentage defined for validation was 80% on the five-point Likert scale. Results: Forty participants were invited to participate in the study, including eight "seeds" and 16 signed the Informed Consent Form (ICF). The content analysis followed two Delphi rounds, an agreement rate greater than 80% was obtained among participants for all the components. The final version of the NUTRIFICO mnemonic presented two key principles, eight components and twelve recommendations. Conclusion: The mnemonic NUTRIFICO was validated in terms of content and relevant for the application in the nutritional approach and communication of dismal news in palliative care


Assuntos
Cuidados Paliativos , Alimentos , Técnica Delphi , Comunicação , Estudo de Validação , Alimentos, Dieta e Nutrição
17.
Curr Biol ; 34(1): 204-212.e6, 2024 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-38118448

RESUMO

In the second century CE the Roman Empire had increasing contact with Sarmatians, nomadic Iranian speakers occupying an area stretching from the Pontic-Caspian steppe to the Carpathian mountains, both in the Caucasus and in the Danubian borders of the empire.1,2,3 In 175 CE, following their defeat in the Marcomannic Wars, emperor Marcus Aurelius drafted Sarmatian cavalry into Roman legions and deployed 5,500 Sarmatian soldiers to Britain, as recorded by contemporary historian Cassius Dio.4,5 Little is known about where the Sarmatian cavalry were stationed, and no individuals connected with this historically attested event have been identified to date, leaving its impact on Britain largely unknown. Here we document Caucasus- and Sarmatian-related ancestry in the whole genome of a Roman-period individual (126-228 calibrated [cal.] CE)-an outlier without traceable ancestry related to local populations in Britain-recovered from a farmstead site in present-day Cambridgeshire, UK. Stable isotopes support a life history of mobility during childhood. Although several scenarios are possible, the historical deployment of Sarmatians to Britain provides a parsimonious explanation for this individual's extraordinary life history. Regardless of the factors behind his migrations, these results highlight how long-range mobility facilitated by the Roman Empire impacted provincial locations outside of urban centers.


Assuntos
Isótopos , Mundo Romano , Humanos , Reino Unido , Irã (Geográfico) , Mundo Romano/história
18.
Sci Total Environ ; 909: 168377, 2024 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-37956847

RESUMO

BACKGROUND AND OBJECTIVE: While impact of heat exposure on human health is well-documented, limited research exists on its effect on kidney disease hospital admissions especially in Texas, a state with diverse demographics and a high heat-related death rate. We aimed to explore the link between high temperatures and emergency kidney disease hospital admissions across 12 Texas Metropolitan Statistical Areas (MSAs) from 2004 to 2013, considering causes, age groups, and ethnic populations. METHODS: To investigate the correlation between high temperatures and emergency hospital admissions, we utilized MSA-level hospital admission and weather data. We employed a Generalized Additive Model to calculate the association specific to each MSA, and then performed a random effects meta-analysis to estimate the overall correlation. Analyses were stratified by age groups, admission causes, and racial/ethnic disparities. Sensitivity analysis involved lag modifications and ozone inclusion in the model. RESULTS: Our analysis found that each 1 °C increase in temperature was associated with a 1.73 % (95 % CI [1.43, 2.03]) increase in hospital admissions related to all types of kidney diseases. Besides, the effect estimates varied across different age groups and specific types of kidney diseases. We observed statistically significant associations between high temperatures and emergency hospital admissions for Acute Kidney Injury (AKI) (3.34 % (95 % CI [2.86, 3.82])), Kidney Stone (1.76 % (95 % CI [0.94, 2.60])), and Urinary Tract Infections (UTI) (1.06 % (95 % CI [0.61, 1.51])). Our research findings indicate disparities in certain Metropolitan Statistical Areas (MSAs). In Austin, Houston, San Antonio, and Dallas metropolitan areas, the estimated effects are more pronounced for African Americans when compared to the White population. Additionally, in Dallas, Houston, El Paso, and San Antonio, the estimated effects are greater for the Hispanic group compared to the Non-Hispanic group. CONCLUSIONS: This study finds a strong link between higher temperatures and kidney disease-related hospital admissions in Texas, especially for AKI. Public health actions are necessary to address these temperature-related health risks, including targeted kidney health initiatives. More research is needed to understand the mechanisms and address health disparities among racial/ethnic groups.


Assuntos
Injúria Renal Aguda , Temperatura Alta , Humanos , Texas/epidemiologia , Hospitalização , Hospitais , Injúria Renal Aguda/epidemiologia
19.
PLoS One ; 18(12): e0295832, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38150452

RESUMO

AIMS: Evaluate the impact of an intervention program in non-adherent patients with ulcerative colitis. METHODS: Parallel controlled randomized clinical trial (1:1), approved by the ethics committee (No. 3.068.511/2018) and registered at The Brazilian Clinical Trials Registry (No. RBR-79dn4k). Non-adherent ulcerative colitis patients according to the Morisky-Green-Levine-test were included. Recruitment began in August 2019 until August 2020, with 6-month follow-up. All participants received standard usual care, and additionally the intervention group received educational (video, educational leaflet, verbal guidance) and behavioral interventions (therapeutic scheme, motivational and reminder type short message services). Researchers were blinded for allocation prior to data collection at Visits 1 and 2 (0 and 6 months). Primary outcome: 180-day adherence rate, with relative risk 95%CI. Secondary outcome: 180-day quality of life according to SF-36 domains, using Student's t test. Variables with p<0.20 were selected for regression. Analysis included data from August/2019 to May/2021. RESULTS: Forty-six and 49 participants were allocated in control and intervention groups, respectively. Two were excluded due to intervention refusal, and 4 and 6 were lost to follow-up in control and intervention groups. There was no post-intervention adherence rate difference, even after adjustment for type of non-adherence (unintentional/both/intentional) as confounder, or if considered as adherent the intervention group participants lost in follow-up. Interventions promoted better quality of life scores even after multivariate analysis for "Pain", when adjusted for ulcerative colitis severity, sex, and marital status (ß = 18.352, p = 0.004), "Vitality", when adjusted for ulcerative colitis severity (ß = 10.568, p = 0.015) and "Emotional Aspects", when adjusted for disease severity, income, and education (ß = 24.907, p = 0.041). CONCLUSIONS: The intervention program was not able to produce a significant medication adherence rate difference between comparative groups, however, there was a significant improvement in quality of life. Study limitations may include: sample size calculated to identify differences of 30%, leading to a possible insufficient power; non blinded participants, exposing the results to the risk of performance bias; outcomes based on self-reported data.


Assuntos
Colite Ulcerativa , Envio de Mensagens de Texto , Humanos , Colite Ulcerativa/tratamento farmacológico , Qualidade de Vida , Adesão à Medicação , Terapia Comportamental
20.
Rev Enferm UFPI ; 12(1): e4078, 2023-12-12. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1523664

RESUMO

Objetivo: Testar uma intervenção educativa para professores de creche sobre primeiros socorros, quanto aos desfechos de conhecimento e habilidade. Métodos: Estudo quase-experimental do tipo antes e depois, realizado em dez creches municipais públicas no Piauí, no período de setembro a outubro de 2019. A amostra foi composta de 36 professores e a coleta de dados foi realizada em três etapas: pré-teste acerca do conhecimento e habilidades em primeiros socorros; aplicação de atividade educativa teórico-prática; e pós-teste. Os dados foram analisados a partir do teste de Wilcoxon. Resultados:97,2% são do sexo feminino, a média de idade é de 41,47 (± 9,48) anos, 86,1% são apenas graduados e 13,9% têm pós-graduação. Ademais, 97,2% não realizaram curso de primeiros socorros e 58,3% já haviam presenciado alguma necessidade desse tipo de atendimento. Os participantes apresentaram aumento do conhecimento após a intervenção nos seguintes itens: acionamento de socorro (p=0,000); detecção e conduta na parada cardiorrespiratória (p=0,000; p=0,002); e conduta em hemorragias (p=0,001). A habilidade técnica dos profissionais apresentou aumento em todos os passos do atendimento em vítimas de parada cardiorrespiratória com p<0,05 na totalidade de itens avaliados. Conclusão: Após a intervenção, observou-se aumento do conhecimento e habilidade dos professores sobre situações de primeiros socorros. Descritores: Primeiros Socorros; Educação em Saúde; Professores Escolares; Capacitação de Professores.


Objective: To test an educational intervention for kindergarten teachers on first aid, regarding the outcomes of knowledge and skill. Methods:Quasi-experimental study of the before and after type, carried out in ten public municipal kindergarten centers in Piauí, during September to October 2019. The sample consisted of 36 teachers and data collection was carried out in three stages: pre-test on knowledge and skills in first aid; application of theoretical-practical educational activity; and post-test. Data were analyzed using the Wilcoxon test. Results:97.2% were female, the average age was 41.47 (± 9.48) years, 86.1% were only graduates and 13.9% had graduate degrees. 97.2% did not take a first aid course and 58.3% had already witnessed some need for this type of care. Participants showed an increase in knowledge after the intervention in the following items: emergency response (p=0.000); detection and management of cardiorespiratory arrest (p=0.000; p=0.002); and management of bleeding (p=0.001). The technical ability of professionals showed an increase in all stages of care in victims of cardiorespiratory arrest with p<0.05 in all items evaluated. Conclusion:After the intervention, there was an increase in teachers' knowledge and skill about first aid situations. Descriptors: First aid; Health education; School teachers; Teacher training.


Assuntos
Educação em Saúde , Primeiros Socorros , Capacitação de Professores , Professores Escolares
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