We assessed plasma malondialdehyde (MDA) levels as a biomarker of lipid peroxidation in type 2 diabetic patients on insulin therapy. Associations among MDA levels and some risk factors for the ...development of chronic complications of diabetes were also evaluated.
MDA, fasting glucose, fructosamine, urinary albumin, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, creatinine, uric acid, serum albumin, lactate, high sensitive C reactive protein (hsCRP), and vitamin E were measured in 53 type 2 diabetic patients and 26 healthy subjects.
MDA levels were higher in type 2 diabetes insulin users (12.8 +/- 3.0 micromol/L) and type 2 diabetes no insulin users (10.3 +/- 2.1 micromol/L) compared to control subjects (8.2 +/- 2.1 micromol/L). Fasting glucose, fructosamine, urinary albumin, and hsCRP were higher in all type 2 diabetic patients compared to controls. Significant correlations were observed between MDA and fasting glucose (r = 0.685, p < 0.001), fructosamine (r = 0.526, p < 0.001), urinary albumin (r = 0.516, p < 0.001), and the duration of type 2 diabetes (r = 0.401, p = 0.005).
MDA levels increased in type 2 diabetes, especially in patients on insulin therapy. Chronic hyperglycemia and other biomarkers, such as urinary albumin, were correlated with MDA levels, suggesting the involvement of lipid peroxidation in the pathogenesis of diabetes complications.
Purpose
Patients with hypotension in emergency clinical situations require the administration of vasopressor drugs for a fast and correct return of the mean arterial pressure, done by either manual ...or automated administration which can be done by either manual or automated administration. The proportional-integral-derivative (PID) algorithm has been used for several years as one of the most understandable and easily implemented automatic control techniques. However, in situations where there is variability in the parameters of the process you want to control, as in the case of the mean arterial pressure (MAP) response in patients undergoing vasopressor infusion, the automatic control system can become challenging. This paper describes the development of a controller, considering the real-time identification of several types of patients.
Methods
The MAP response for phenylephrine (PHP) drug infusion and the controller were modeled by the MATLAB/Simulink computational tool and embedded each one on simple hardware platforms based on the low-cost microcontroller. The controller was designed considering a time for patient identification, allowing its adjustment according to the patient. To validate the feasibility of the controller, tests were conducted verifying the performance both in a computer simulation environment and in hardware-in-the-loop (HIL) simulation. In these tests, three tuning methods were used for control, based on the consolidated methods developed by Ziegler-Nichols and Skogestad.
Results
The results obtained show that the patient identification occurs in 200 s. The MAP control was obtained with a steady-state error of less than 0.31 mmHg, settling time with a maximum of 240.5 s, and peak overshoot of desired MAP value on the order of 5.5 mmHg in its worst case, considering all tuning methods.
Conclusion
The developed control system can identify the patient’s response type. The results obtained indicated that the controller demonstrated to be suitable for low peak overshoot and steady-state error values, allowing a smoother MAP control.
Considering the likely need for the development of novel effective vaccines adapted to emerging relevant CoV-2 variants, the increasing knowledge of epitope recognition profile among convalescents ...and afterwards vaccinated with identification of immunodominant regions may provide important information.
We used an RBD peptide microarray to identify IgG and IgA binding regions in serum of 71 COVID-19 convalescents and 18 vaccinated individuals.
We found a set of immunodominant RBD antibody epitopes, each recognized by more than 30% of the tested cohort, that differ among the two different groups and are within conserved regions among betacoronavirus. Of those, only one peptide, P44 (S415-429), recognized by 68% of convalescents, presented IgG and IgA antibody reactivity that positively correlated with nAb titers, suggesting that this is a relevant RBD region and a potential target of IgG/IgA neutralizing activity.
This peptide is localized within the area of contact with ACE-2 and harbors the mutation hotspot site K417 present in gamma (K417T), beta (K417N), and omicron (K417N) variants of concern. The epitope profile of vaccinated individuals differed from convalescents, with a more diverse repertoire of immunodominant peptides, recognized by more than 30% of the cohort. Noteworthy, immunodominant regions of recognition by vaccinated coincide with mutation sites at Omicron BA.1, an important variant emerging after massive vaccination. Together, our data show that immune pressure induced by dominant antibody responses may favor hotspot mutation sites and the selection of variants capable of evading humoral response.
Radiotherapy and cisplatin lead to cell killing in head and neck squamous cell carcinoma patients, but adverse events and response to treatment are not the same in patients with similar ...clinicopathological aspects. The aim of this prospective study was to evaluate the roles of TP53 c.215G > C, FAS c.-671A > G, FAS c.-1378G > A, FASL c.-844 C > T, CASP3 c.-1191A > G, and CASP3 c.-182-247G > T single nucleotide variants in toxicity, response rate, and survival of cisplatin chemoradiation-treated head and neck squamous cell carcinoma patients. Genomic DNA was analyzed by polymerase chain reaction for genotyping. Differences between groups of patients were analyzed by chi-square test or Fisher’s exact test, multiple logistic regression analysis, and Cox hazards model. One hundred nine patients with head and neck squamous cell carcinoma were enrolled in study. All patients were smokers and/or alcoholics. Patients with FAS c.-671GG genotype, FAS c.-671AG or GG genotype, and FASL c.-844CC genotype had 5.52 (95% confidence interval (CI): 1.42–21.43), 4.03 (95% CI: 1.51–10.79), and 5.77 (95% CI: 1.23–27.04) more chances of presenting chemoradiation-related anemia of grades 2–4, lymphopenia of grade 3 or 4, and ototoxicity of all grades, respectively, than those with the remaining genotypes. FAS c.-671GG genotype was also seen as an independent predictor of shorter event-free survival (hazard ratio (HR): 2.05; P = 0.007) and overall survival (HR: 1.83; P = 0.02) in our head and neck squamous cell carcinoma patients. These findings present, for the first time, preliminary evidence that inherited abnormalities in apoptosis pathway, related to FAS c.-671A > G and FASL c.-844 C > T single nucleotide variants, can alter toxicity and survival of tobacco- and alcohol-related head and neck squamous cell carcinoma patients homogeneously treated with cisplatin chemoradiation.
The consumer demand for a reduction in the use of synthetic additives in food has been providing a greater search and incentive for the food industries to use new alternatives for food preservation. ...Among them, there is the initiative to use essential oils (EOs) due to their antimicrobial properties, coming from specific compounds in their compositions. However, in view of limitations related to the use of EOs, as well as their susceptibility to oxidation and degradation, the possibility arises of employing protection methods such as microencapsulation to minimize the impairment of the benefits associated with the application of EOs. This study aimed to examine the antimicrobial effect of turmeric and nutmeg EOs against microbial strains of Staphylococcus aureus, Listeria monocytogenes, Escherichia coli, and Salmonella spp., as well as the microparticles of the EOs involved. Analyses of the minimum inhibitory concentration (MIC), the minimum bactericidal concentration (MBC), and the developed microparticles, as well as the verification of the synergistic inhibitory action between these oils, were carried out. For free oils, antimicrobial action was evidenced against the vast majority of microorganisms tested, with free nutmeg EO having a better antimicrobial effect than free turmeric oil. In contrast, for encapsulated oils, only antimicrobial action was noted against strains of Listeria. Furthermore, the synergism of free oils did not potentiate the antimicrobial action. Regarding the alternative of microencapsulation of EOs, it was obtained that the results in which chitosan was used as wall material were more promising than when gelatin was used as wall material.
Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 ...and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population.
This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay.
Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity.
AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes.
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Resumo O presente estudo analisa a relação entre a implementação de práticas de transição do contexto familiar para a creche e o bem-estar emocional dos bebês durante o primeiro de mês de frequência ...neste contexto extrafamiliar. Foram recolhidos dados, antes e após a entrada do bebê na creche, junto das mães e das educadoras de 90 bebês.Os resultados indicaram que o número de práticas de transição reportadas pelas educadoras se revela positivamente associado ao bem-estar emocional dos bebês durante o primeiro mês de frequência da creche. Estes resultados recomendam a implementação de um conjunto diversificado de práticas de transição, antes e após a entrada na creche, no sentido de facilitar a adaptação dos bebês ao novo contexto desenvolvimental.
Resumen En el presente estudio se analiza la relación entre la implementación de prácticas de transición del contexto familiar a la guardería y el bienestar emocional de los bebés, durante el primer mes de frecuencia de este contexto extra-familiar. Se recolectaron datos, antes y tras la entrada del bebé en la guardería, por intermedio de las madres y de las educadoras de 90 bebés. Los resultados indicaron que el número de prácticas de transición reportadas por las educadoras se revela positivamente asociado al bienestar emocional de los bebés durante el primer mes de frecuencia a la guardería. Estos resultados recomiendan la implementación de un conjunto diversificado de prácticas de transición, antes y tras la entrada en la guardería, en el sentido de facilitar la adaptación de los bebés al nuevo contexto de desarrollo.
Abstract The present study analyzes the relationship between the implementation of transition practices from home to day care center and the emotional well-being of the infants during the first month of attendance in this extrafamiliar environment. Data were collected, before and after the infant entered the day care center, with the mothers and teachers of 90 infants. The results indicated that the number of transition practices reported by teachers is positively associated with the emotional well-being of infants during the first month of day care attendance. These results recommend the implementation of a diversified set of transition practices, before and after entry into the day care center, to facilitate the infants' adaptation to the new developmental setting.
Este artigo descreve a frequência relativa de comportamentos de risco e de proteção para doenças crônicas não transmissíveis (DCNT) em adultos de Viçosa, Brasil. Foi realizado um estudo transversal ...de base populacional, incluindo 1226 adultos residentes do município. Utilizou-se um questionário estruturado, contendo questões sociodemográficas e comportamentais. Os fatores de risco/proteção avaliados foram: tabagismo, prática de atividade física, consumo abusivo de bebida alcóolica e consumo alimentar. A proporção dos fatores de risco/proteção foi calculada na população total, de acordo com sexo, escolaridade e nível socioeconômico. A população avaliada apresenta elevada frequência de fatores de risco para DCNT, como consumo abusivo de bebidas alcoólicas, hábito de consumir leite integral, ingerir carnes com gorduras visíveis, consumo regular de refrigerantes e 78,5% não atingiram a recomendação mínima para atividade física no lazer. Em relação aos fatores de proteção, 86,2% da população relataram consumir regularmente frutas e vegetais, e 73%, feijões. Verificou-se a maior frequência de fatores de riscos no sexo masculino, em indivíduos de menor idade e nível socioeconômico intermediário. Nesta população há urgência nas políticas públicas de planejamento municipal para mudar o atual cenário.
Gastrointestinal (GI) symptoms are frequent complaints from individuals with nonalcoholic fatty liver disease (NAFLD). Dyspepsia is a universal clinical symptom and is among the most common GI ...complaints observed in the general population, but its prevalence in the population with NAFLD has not been previously investigated.
To compare the prevalence of functional dyspepsia (FD) between patients with NAFLD and controls without liver disease.
Cross-sectional study at the Outpatient Liver Clinic, University Hospital, Belo Horizonte, Brazil.
We included 96 NAFLD patients and 105 controls without liver disease. All participants were assessed for GI symptoms in accordance with the Rome III criteria. Evaluation methods included a questionnaire for FD (validated in Brazil), laboratory tests and upper GI endoscopy.
Mean age and sex were similar between the groups. The NAFLD group presented higher frequency of proton-pump inhibitor usage (31.3% vs 4.8%; P < 0.001) and prevalence of FD (25.0% versus 12.4%; P = 0.021). The symptom frequencies were as follows: postprandial distress, 22.9% versus 11.4% (P = 0.030); postprandial fullness, 18.8% versus 10.5% (P = 0.095); early satiation, 8.3% versus 5.7% (P = 0.466); and epigastric pain or burning, 18.8% versus 5.7% (P = 0.004), in NAFLD patients and controls, respectively. Multivariate analysis demonstrated that female sex (odds ratio, OR 6.97; 95% confidence interval, CI: 1.51-32.12; P = 0.013) and NAFLD diagnosis (OR 2.45; 95% CI: 1.14-5.27; P = 0.021) were independently associated with FD occurrence.
FD occurs more frequently in individuals with NAFLD than in controls without hepatic disease.
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