Background:
Studies have shown significant benefits of exercise therapy in heart failure (HF) with a reduced ejection fraction (HFrEF) and HF with a preserved ejection fraction (HFpEF). The ...mechanisms responsible for the beneficial effect of exercise in HFrEF and HFpEF are still unclear. We hypothesized that the effect of exercise on myocardial remodeling may explain its beneficial effect.
Methods:
IMAGING-REHAB-HF is a single-center, randomized, controlled clinical trial using cardiac magnetic resonance imaging, vasomotor endothelial function, cardiac sympathetic activity imaging and serum biomarkers to compare the effect of exercise therapy in HFpEF (LVEF ≥ 45%) and HFrEF (LVEF < 45%). Subjects will be assessed at baseline and after 4 months. The exercise program will consist of three 60-min exercise sessions/week. The primary endpoints are the effect of exercise on myocardial extracellular volume (ECV), left ventricular (LV) systolic function, LV mass, LV mass-to-volume and LV cardiomyocyte volume. Secondary endpoints include the effect of exercise on vasomotor endothelial function, cardiac sympathetic activity and plasmatic biomarkers. Patients will be allocated in a 2:1 fashion to supervised exercise program or usual care. A total sample size of 90 patients, divided into two groups according to LVEF:HFpEF group (45 patients:30 in the intervention arm and 15 in the control arm) and HFrEF group (45 patients:30 in the intervention arm and 15 in the control arm) – will be necessary to achieve adequate power.
Conclusion:
This will be the first study to evaluate the benefits of a rehabilitation program on cardiac remodeling in HF patients. The unique design of our study may provide unique data to further elucidate the mechanisms involved in reverse cardiac remodeling after exercise in HFpEF and HFrEF patients.
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•New sensors based on poly(methylene green) (PMG) and carbon nanotubes (fCNT).•Synergistic effect between PMG and fCNT lead to superior electrode platforms.•PMG/fCNT and fCNT/PMG ...modified electrodes as acetaminophen and pyridoxine sensors.•Acetaminophen and pyridoxine determined in pharmaceutical samples.
New electrode platforms have been constructed containing the redox polymer poly(methylene green) (PMG) and functionalized carbon nanotubes (fCNT) in two configurations, the first containing MG electropolymerised on a graphite composite electrode (CE) and covered with fCNT (fCNT/PMG/CE), the second having the MG electropolymerised on top of fCNT modified CE (PMG/fCNT/CE). Modified electrodes with both configurations were characterized by cyclic voltammetry and electrochemical impedance spectroscopy, and compared with PMG/CE and fCNT/CE and CE, in order to evaluate the role of each component in the modified electrode architecture. The modified electrodes were applied to the detection of acetaminophen and pyridoxine, by fixed potential amperometry and differential pulse voltammetry, the latter allowing the simultaneous detection of both analytes. The analytical properties of fCNT/PMG/CE and PMG/fCNT/CE sensors were obtained and the best analytical performance compared with recently reported acetaminophen and pyridoxine sensors. Determination of both analytes in pharmaceutical samples was successfully performed.
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Previous issue date: 2018-07
Este trabalho apresenta a síntese e caracterização de homopolímeros e copolímeros derivados do tiofeno β-substituídos visando a aplicação em janelas inteligentes (Jis). Para isso, primeiramente realizou-se a síntese química dos homopolímeros: poli(3-hexiltiofeno) (P3HT) e poli(3,4-etilenodioxitiofeno) (PEDOT); e dos copolímeros: poli(3-hexiltiofeno-co-3,4- etilenodioxitiofeno) (P3HT-co-EDOT) em proporções 1:1 e 2:1 dos monômeros 3-hexiltiofeno (3HT) e 3,4-etilenodioxitiofeno (EDOT), respectivamente. As sínteses dos materiais foram realizadas empregando-se o método de acoplamento oxidativo com cloreto férrico (FeCl₃). Os materiais obtidos foram caracterizados por técnicas físico-químicas como espectroscopia na região do infravermelho (FTIR), ressonância magnética nuclear de hidrogênio (¹H RMN), análise térmica, espectroscopia na região do ultravioleta-visível (UV-Vis). Além disso, foram empregadas técnicas de caracterização eletroquímicas e espectroeletroquímicas para estudo da aplicação destes materiais como camada ativa em JIs. Os estudos espectroeletroquímicos indicaram que o P3HT e seus copolímeros podem ser empregados como camada ativa em JIs, sendo que o P3HT-co-EDOT 2:1 apresentou melhor performance eletrocrômica e variação de cor reversível do marrom no estado reduzido para tonalidade de preto no estado oxidado. Em razão disso, este filme foi empregado na construção de uma janela inteligente, a qual, posteriormente foi caracterizada por técnicas espectroeletroquímicas.
In utero Zika virus infection resulted in many newborns with congenital defects; this public health issue was followed by unprecedented scientific productivity in this field. Many questions remain ...about congenital Zika virus infection and its maternal transmission, pathogenesis, clinical events, and the resulting neurological damage. There are few review articles that synthesize the current knowledge of congenital neurological complications as well as the gaps in the pediatric literature.
We review the full range of data on neurological complications in the newborns and infants born to Zika virus-infected women.
A research question (PCC: Population, newborns and infants of infected mothers; Concept, neurological outcomes at birth; Context, congenital Zika virus infection) was created to guide our review in searching several databases: PubMed, Lilacs, CINAHL, Cochrane Library, and OpenGrey literature. A total of 34 articles were included in the final review.
Central nervous system calcifications, mainly at the cortical-subcortical junction, were the most prevalent neurological birth defects related to Zika infection (104/112, 92.9% from seven studies). Also, microcephaly occurred in 39.7% of all infected infants (1561/3931 patients in all the studies) and ventriculomegaly and/or hydrocephalus occurred in 63.1% (157/249 patients analyzed in 12 studies). A total of 10 articles detailed ocular findings, including macular lesions, focal pigment mottling of the retina, chorioretinal atrophy, optic nerve abnormalities, cataract, microphthalmia, and strabismus, among others.
Neurological and related malformations are common lesions in individuals with congenital Zika syndrome. Long-term follow-up studies in this field are lacking.
Realizar a coleta de uma história espiritual é fundamental para se adotar, cotidianamente, práticas profissionais culturalmente sensíveis. Algumas razões para se considerar essa abordagem: religião e ...espiritualidade (R/E) são importantes para muitas pessoas, principalmente na realidade religiosa brasileira; R/E influencia desfechos de saúde, comumente por meio de associações positivas; a coleta de dados sobre a espiritualidade pode fornecer uma compreensão mais ampla da natureza e da relação entre a R/E e a sintomatologia do paciente. Já existem roteiros desenvolvidos para facilitar a obtenção de uma história espiritual pela equipe de saúde, mas também é possível ampliá-los e adaptá-los às características próprias de cada serviço de saúde. Essa identificação adequada das necessidades espirituais é central para que os profissionais possam tomar atitudes que facilitem aos pacientes a prática de suas crenças, particularmente diante de um momento de extrema vulnerabilidade, que é o adoecer.
Lung cancer patients undergoing palliative chemotherapy exhibit many symptoms related to the disease, such as adverse events and infectious complications during treatment, which impacts directly ...their health-related quality of life (HRQOL). Nutritional status is a relevant aspect among advanced cancer patients under palliative care and food supplementation has the potential to reduce treatment-related adverse effects and improve the nutritional status. The product named AferBio® is a fermented supplement that has been described as able to provide some benefits, including the capacity to potentiate the effects of anticancer drugs, by promoting the reduction of side effects and ultimately improving HRQOL.
A Phase II double-blind placebo-controlled randomized clinical trial to assess the use of food supplementation with AferBio® in Stage IIIB or IV non-small cell lung cancer (NSCLC) patients beginning a second-line palliative mono-chemotherapy. The primary goal is to compare HRQOL scores between the arms of the study over time. The ten first patients included in the present study will undergo an AferBio®toxicity-testing (non-randomized phase). If no significant toxicity is found, the study will move on to the randomized phase. All patients will be randomized in blocks at a 1:1 ratio using the online tool REDCap. ECOG-PS (0-1 versus 2) criteria will be used for stratification. All patients included in the trial will be evaluated at baseline and at each chemotherapy cycle. Each evaluation will include the following: HRQOL (EORTC QLQ-C30, LC13 and IQualiV-Lung), ECOG-PS, anthropometric measurements, clinical and laboratory toxicity assessment and response evaluation.
During palliative systemic therapy in advanced cancer patients, one of the main goals is the improvement and maintenance of HRQOL, which can be negatively affected by cancer symptoms, cancer- or treatment-related psychosocial difficulties, and chemotherapy toxicity. Thus, much research has been dedicated to the development of new and more effective and/or less toxic cancer therapies. The present study is justified by the testing of a novel food supplement that may reduce some toxicities, thus, having a potential positive impact on the HRQOL of lung cancer patients. The product in question (AferBio®) is already available for sale in Brazil, but has not yet been fully tested in cancer patients.
This Trial was registered on March 19, 2018 with ClinicalTrials.gov , NCT03469063. Protocol version: 2.0 from March 26, 2018. Trial status: Patient enrollment in the study began in April, 2018.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•Soluble mediators are valuable tools in COVID-19 diagnosis and prognosis.•sTREM-1 has been described as a predictor of inflammation severity.•sTREM-1 concentrations were markedly higher in MIS-C vs ...non-MIS-C acute patients.•High sTREM-1 concentrations had a significant association with MIS-C development.•IL-6, IL-8, and IL-10 concentrations were higher in the acute phase compared with the convalescent phase, regardless of whether the patient developed MIS-C.•sTREM-1 in pediatric patients has good predictive accuracy as an early screening biomarker to identify MIS-C cases.
The exacerbation of the inflammatory response caused by SARS-CoV-2 in adults promotes the production of soluble mediators that could act as diagnostic and prognostic biomarkers for COVID-19. Among the potential biomarkers, the soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) has been described as a predictor of inflammation severity. The aim was to evaluate sTREM-1 and cytokine serum concentrations in pediatric patients during the acute and convalescent phases of COVID-19. This was a prospective study that included 53 children/adolescents with acute COVID-19 (Acute-CoV group); 54 who recovered from COVID-19 (Post-CoV group) and 54 controls (Control group). Preexisting chronic conditions were present in the three groups, which were defined as follows: immunological diseases, neurological disorders, and renal and hepatic failures. The three groups were matched by age, sex, and similar preexisting chronic conditions. No differences in sTREM-1 levels were detected among the groups or when the groups were separately analyzed by preexisting chronic conditions. However, sTREM-1 analysis in the seven multisystemic inflammatory syndrome children (MIS-C) within the Acute-Cov group showed that sTREM-1 concentrations were higher in MIS-C vs non-MIS-C acute patients. Then, the receiver operating curve analysis (ROC) performed with MIS-C acute patients revealed a significant AUC of 0.870, and the sTREM-1 cutoff value of > 5781 pg/mL yielded a sensitivity of 71.4 % and a specificity of 91.3 % for disease severity, and patients with sTREM-1 levels above this cutoff presented an elevated risk for MIS-C development in 22.85-fold (OR = 22.85 95 % CI 1.64–317.5, p = 0.02). The cytokine analyses in the acute phase revealed that IL-6, IL-8, and IL-10 concentrations were elevated regardless of whether the patient developed MIS-C, and those levels decreased in the convalescent phase, even when compared with controls. Spearman correlation analysis generated positive indexes between sTREM-1 and IL-12 and TNF-α concentrations, only within the Acute-CoV group. Our findings revealed that sTREM-1 in pediatric patients has good predictive accuracy as an early screening tool for surveillance of MIS-C cases, even in patients with chronic underlying conditions.
Nasal disease with polyps: Need for clarity Pezato, Rogerio; Stamm, Aldo Cassol; Douglas, Richard ...
International forum of allergy & rhinology,
September 2023, Letnik:
13, Številka:
9
Journal Article
O escopo deste trabalho consistiu em compreender a satisfação dos Técnicos Administrativos em Educação com o plano de carreira oferecido aos mesmos pela instituição de trabalho – universidade pública ...federal do interior do estado de Minas Gerais. Método: realizou-se um estudo transversal, descritivo, quantitativo, com um total de 600 servidores da universidade. Foi utilizada a Escala de Satisfação no Trabalho (EST) e um Questionário Sociodemográfico elaborado pelas autoras. Resultados: constatou-se maior nível de satisfação relacionada ao trabalho entre os funcionários com baixa escolaridade, que se encontram no início e no final de suas respectivas carreiras e atuantes nas unidades acadêmicas da instituição de ensino superior. Conclusão: os resultados indicam que o plano de carreira dos servidores Técnico-Administrativos em Educação necessita ser repensado pelos dirigentes de instituições de ensino públicas federais para se tornar passível de gerar mais satisfação para os servidores.
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