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ABSTRACT BACKGROUDS: Child and Adolescent Psychosocial Care Centers (Centros de Atenção Psicossocial, CAPSI) are dedicated centers for persistent psychiatric disorders, which provide an individualized therapeutic approach based on extra-hospital services. OBJECTIVES: We aimed to describe the clinico-epidemiological profiles of the patients seeking interventions at the CAPSIs. DESIGN AND SETTING: A cross-sectional study was conducted in two CAPSI in São Bernardo do Campo, SP, Brazil. One CAPSI is dedicated to the treatment of alcohol- and drug-related disorders, and the other to the treatment of other mental disorders. METHODS: In July 2017, we reviewed all active medical records of these two CAPSI, and collected the patients information including sex, race, education, type of referral, initial complaints, psychiatric diagnoses, and medication utilization. RESULTS: Of the 233 patients, 69.5% were male and 42.5% lived with their immediate family. Most of the patients were referred from other health services. Complaints on admission included agitation and aggressive behavior (30.9%). Autism spectrum disorder (ASD) was the most prevalent diagnosis (46.8%), followed by depressive disorder (13.8%). Of the patients, 81.5% were on regular medical follow-up and 70.3% were on a single medication only. CONCLUSION: Aggression complaints are the most prevalent in CAPSI, and diagnoses of ASD and psychotic disorders are more common. This situation differs from most CAPSI that present school complaints as the most prevalent, in which diagnoses of attention-deficit/hyperactivity disorder and conduct disorders are likely to be more frequent. The epidemiological profile of each CAPSI should guide the implementation of human and structural resources targeting the most prevalent complaints and diagnoses.
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BACKGROUDS: Child and Adolescent Psychosocial Care Centers (Centros de Atenção Psicossocial, CAPSI) are dedicated centers for persistent psychiatric disorders, which provide an individualized therapeutic approach based on extra-hospital services. OBJECTIVES: We aimed to describe the clinico-epidemiological profiles of the patients seeking interventions at the CAPSIs. DESIGN AND SETTING: A cross-sectional study was conducted in two CAPSI in São Bernardo do Campo, SP, Brazil. One CAPSI is dedicated to the treatment of alcohol- and drug-related disorders, and the other to the treatment of other mental disorders. METHODS: In July 2017, we reviewed all active medical records of these two CAPSI, and collected the patients information including sex, race, education, type of referral, initial complaints, psychiatric diagnoses, and medication utilization. RESULTS: Of the 233 patients, 69.5% were male and 42.5% lived with their immediate family. Most of the patients were referred from other health services. Complaints on admission included agitation and aggressive behavior (30.9%). Autism spectrum disorder (ASD) was the most prevalent diagnosis (46.8%), followed by depressive disorder (13.8%). Of the patients, 81.5% were on regular medical follow-up and 70.3% were on a single medication only. CONCLUSION: Aggression complaints are the most prevalent in CAPSI, and diagnoses of ASD and psychotic disorders are more common. This situation differs from most CAPSI that present school complaints as the most prevalent, in which diagnoses of attention-deficit/hyperactivity disorder and conduct disorders are likely to be more frequent. The epidemiological profile of each CAPSI should guide the implementation of human and structural resources targeting the most prevalent complaints and diagnoses.
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Trastorno por Déficit de Atención con Hiperactividad , Trastorno del Espectro Autista , Rehabilitación Psiquiátrica , Niño , Adolescente , Humanos , Masculino , Femenino , Estudios Transversales , Trastorno del Espectro Autista/terapia , Brasil/epidemiologíaRESUMEN
BACKGROUND: The ewe lamb nutritional and physiological state interfere with the ovarian environment and fertility. The lack or excess of circulating nutrients reaching the ovary can change its gene expression. A protein deficiency in the blood caused by an Haemonchus contortus abomasal infection is detrimental to the organism's development during puberty. The peripubertal period is a time of intensive growth that requires a high level of nutrients. An essential feature controlling pubertal arousal and female reproductive potential is ovarian follicle growth activation. Protein supplementation improves the sheep's immune response to helminthic infections. We aimed to determine if supplementing protein in infected ewe lambs' diet would impact the ovarian environment leading to earlier ovarian follicle activation than in infected not supplemented animals. METHODS: We fed 18 Santa Ines ewe lambs (Ovis aries) - bred by the same ram - with either 12% protein (Control groups) or 19% protein (Supplemented groups) in their diets. After 35 days of the diet, they were each artificially infected or not with 10,000 Haemonchus contortus L3 larvae. Following 77 days of the diet and 42 days of infection, we surgically collected their left ovaries and examined their genes expression through RNA sequencing. RESULTS: We found that protein supplementation in infected animals led to an up-regulation of genes (FDR p-values < 0.05) and biological processes (p-value cut-off = 0.01) linked to meiotic activation in pre-ovulatory follicles and primordial follicle activation, among others. The supplemented not infected animals also up-regulated genes and processes linked to meiosis and others, such as circadian behaviour. The not supplemented animals had these same processes down-regulated while up-regulated processes related to tissue morphogenesis, inflammation and immune response. CONCLUSION: Diet's protein supplementation of peripubertal infected animals allowed them to express genes related to a more mature ovarian follicle stage than their half-sisters that were not supplemented. These results could be modelling potential effects of the interaction between environmental factors, nutrition and infection on reproductive health. When ovarian activation is achieved in a timely fashion, the ewe may generate more lambs during its reproductive life, increasing sheep breeders' productivity.
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Dieta/veterinaria , Hemoncosis/veterinaria , Ovario/crecimiento & desarrollo , Enfermedades de las Ovejas/parasitología , Animales , Proteínas en la Dieta , Femenino , Expresión Génica , Haemonchus , Ovario/metabolismo , Ovinos , Oveja DomésticaRESUMEN
BACKGROUND/AIMS: Understanding the risk factors for dental injuries is essential to develop prevention strategies. The aim of this study was to perform a systematic review and meta-analysis to determine whether people with special needs (SN) have a higher incidence of traumatic dental injury (TDI). MATERIALS AND METHODS: Electronic searches were performed with no language or date restrictions in the following databases: PubMed, Lilacs, BBO, Scopus, Web of Science, Cochrane Library and Open Gray. According to the PECOS strategy, observational studies that investigated subjects with and without SN and its association with TDI episodes were included. Quality assessment and bias control were carried out according to Fowkes and Fulton guidelines. A meta-analysis was performed by sub-grouping studies according to the type of SN, with the odds ratio (OR) also being calculated (P ≤ .05). The evidence was quality tested using the GRADE approach. RESULTS: After titles and abstracts were examined, and full texts were read, 28 studies were included in the qualitative synthesis and 27 in the meta-analysis. Three studies were classified with high methodological quality and the others had methodological problems. No associations were determined between TDI and autism spectrum disorder, epilepsy and mental disability (OR 1.12 [0.70, 1.78], OR 1.28 [0.13, 12.27] and OR 1.04 [0.20, 5.35], respectively, P > .05). A positive association (P < .05) was found between TDI and hyperactivity disorder, cerebral palsy, 21 trisomy, various conditions of SN and in pooled results (OR 2.67 [1.22, 5.87], OR 1.89 [1.06, 3.37], OR 6.18 [2.24, 17.05], OR 1.69 [1.18, 2.41], OR 1.61 [1.16; 2.22], respectively).The certainty of evidence ranged from very low to low. CONCLUSIONS: In general, people with SN had a higher chance of having TDI with very low certainty of evidence. People with ADHD and cerebral palsy had a higher chance of TDI.
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Trastorno por Déficit de Atención con Hiperactividad , Trastorno del Espectro Autista , Parálisis Cerebral , Traumatismos de los Dientes/epidemiología , Humanos , Factores de RiesgoRESUMEN
The early pregnancy diagnosis allows optimizing production and timely management correction, with a greater reproductive output of livestock. The Idexx Rapid Visual Pregnancy Test® consists of an ELISA for visual reading which does not require the use of readers in the laboratory, with satisfactory pregnancy diagnoses at 28 days of pregnancy in cattle. Therefore, the aim of this study was to evaluate this rapid test and to verify the most appropriate day for the diagnosis of pregnancy in the ovine species. For this purpose, 98 serum samples from pregnant sheep and 36 from non-pregnant were used, with duplicate samples, and diagnosis was confirmed by ultrasound examination, used as the gold standard. The numbers of positive samples obtained at 26, 28, and 30 days of pregnancy were 26, 27, and 45, respectively. The Rapid Visual Pregnancy Test correctly identified 100% of the samples as positive at pregnancy of days 26, 28, and 30. The sensitivity and specificity of the test were also 100%. The Idexx Rapid Visual Pregnancy Test, initially indicated for cattle, is effective for the detection of pregnancy in the ovine species, enabling diagnosis of pregnant sheep from the 26th day of pregnancy.
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Pruebas Diagnósticas de Rutina/veterinaria , Pruebas de Embarazo/veterinaria , Preñez/fisiología , Ovinos , Animales , Pruebas Diagnósticas de Rutina/métodos , Femenino , Embarazo , Pruebas de Embarazo/métodos , Sensibilidad y EspecificidadRESUMEN
The association between subclinical thyroid dysfunctions and autonomic modulation changes has been described by many studies with conflicting results. We aimed to analyze the association between subclinical hyperthyroidism (SCHyper), subclinical hypothyroidism (SCHypo), and heart rate variability (HRV) using the baseline from ELSA-Brasil. SCHyper and SCHypo were classified by use of medication to treat thyroid disorders, thyrotropin levels respectively above and under the reference range, and normal free thyroxine levels. For HRV, the participants underwent 10 min in supine position and the R-R intervals of the final 5 min were selected for analysis. We first used linear regression models to report crude data and then, multivariate adjustment for sociodemographic (age, sex, and race) and cardiovascular risk factors (hypertension, dyslipidemia, diabetes, smoking, body mass index, use of alcohol, and leisure physical activity) using the euthyroid group as reference. From 9270 subjects (median age, 50; interquartile range: 44-56), 8623 (93.0%) were classified as euthyroid, 136 (1.5%) as SCHyper, and 511 (5.5%) as SCHypo. Compared to euthyroid subjects, SCHyper participants presented significantly higher heart rate (68.8 vs 66.5 for euthyroidism, P=0.007) and shorter R-R intervals (871.4 vs 901.6, P=0.007). Although SCHyper was associated with lower standard deviation of NN interval (SDNN) (ß: -0.070; 95% confidence interval (95%CI): -0.014 to -0.009) and low-frequency (LF) (ß: -0.242, 95%CI: -0.426 to -0.058) compared to the euthyroid group, these differences lost significance after multivariate adjustment for confounders. No significant differences were found for HRV in SCHypo. No association was found between HRV and SCHyper or SCHypo compared to euthyroid subjects in this sample of apparently healthy subjects.
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Frecuencia Cardíaca/fisiología , Enfermedades de la Tiroides/fisiopatología , Adulto , Anciano , Sistema Nervioso Autónomo/fisiología , Femenino , Humanos , Hipertiroidismo/complicaciones , Hipotiroidismo/complicaciones , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Factores de Riesgo , Tirotropina/sangreRESUMEN
Data on the association between subclinical thyroid dysfunction and coronary artery disease (CAD) is scarce. We aimed to analyze the association between thyroid function and CAD using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We included subjects with normal thyroid function (0.4-4.0 mIU/L, and normal free thyroxine, FT4, or 0.8 to 1.9 ng/dL), subclinical hypothyroidism (SCHypo; TSH>4.0 mIU/L and normal FT4), and subclinical hyperthyroidism (SCHyper; TSH<0.4 mIU/L and normal FT4) evaluated by coronary computed tomography angiography. We excluded individuals using medications that interfere in thyroid function or with past medical history of cardiovascular disease. Logistic regression models evaluated the presence of CAD, segment involvement score (SIS) >4, and segment severity score (SSS) >4 of coronary arteries as the dependent variables, and quintiles of TSH and FT4 as the independent variables, adjusted for demographical data and cardiovascular risk factors. We included 767 subjects, median age 58 years (IQR=55-63), 378 (49.3%) women, 697 euthyroid (90.9%), 57 (7.4%) with SCHypo, and 13 (1.7%) with SCHyper. No association between TSH and FT4 quintiles and CAD prevalence was noted. Similarly, no association between TSH levels and the extent or severity of CAD, represented by SIS>4 and SSS>4 were seen. Restricting analysis to euthyroid subjects did not alter the results. TSH levels were not significantly associated with the presence, extent, or severity of CAD in a middle-aged healthy population.
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Enfermedad de la Arteria Coronaria/sangre , Enfermedades de la Tiroides/sangre , Tirotropina/sangre , Tiroxina/sangre , Adulto , Anciano , Biomarcadores/sangre , Brasil , Angiografía por Tomografía Computarizada , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Estudios Transversales , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Factores de Riesgo , Enfermedades de la Tiroides/complicaciones , Enfermedades de la Tiroides/diagnóstico por imagen , Pruebas de Función de la TiroidesRESUMEN
The association between subclinical thyroid dysfunctions and autonomic modulation changes has been described by many studies with conflicting results. We aimed to analyze the association between subclinical hyperthyroidism (SCHyper), subclinical hypothyroidism (SCHypo), and heart rate variability (HRV) using the baseline from ELSA-Brasil. SCHyper and SCHypo were classified by use of medication to treat thyroid disorders, thyrotropin levels respectively above and under the reference range, and normal free thyroxine levels. For HRV, the participants underwent 10 min in supine position and the R-R intervals of the final 5 min were selected for analysis. We first used linear regression models to report crude data and then, multivariate adjustment for sociodemographic (age, sex, and race) and cardiovascular risk factors (hypertension, dyslipidemia, diabetes, smoking, body mass index, use of alcohol, and leisure physical activity) using the euthyroid group as reference. From 9270 subjects (median age, 50; interquartile range: 44-56), 8623 (93.0%) were classified as euthyroid, 136 (1.5%) as SCHyper, and 511 (5.5%) as SCHypo. Compared to euthyroid subjects, SCHyper participants presented significantly higher heart rate (68.8 vs 66.5 for euthyroidism, P=0.007) and shorter R-R intervals (871.4 vs 901.6, P=0.007). Although SCHyper was associated with lower standard deviation of NN interval (SDNN) (β: -0.070; 95% confidence interval (95%CI): -0.014 to -0.009) and low-frequency (LF) (β: -0.242, 95%CI: -0.426 to -0.058) compared to the euthyroid group, these differences lost significance after multivariate adjustment for confounders. No significant differences were found for HRV in SCHypo. No association was found between HRV and SCHyper or SCHypo compared to euthyroid subjects in this sample of apparently healthy subjects.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Enfermedades de la Tiroides/fisiopatología , Frecuencia Cardíaca/fisiología , Sistema Nervioso Autónomo/fisiología , Tirotropina/sangre , Factores de Riesgo , Estudios Longitudinales , Hipertiroidismo/complicaciones , Hipotiroidismo/complicacionesRESUMEN
BACKGROUND: Tuberculous and cryptococcal meningitis (TBM and CM) are the most common causes of opportunistic meningitis in HIVinfected patients from resource-limited settings, and the differential diagnosis is challenging. OBJECTIVE: To compare clinical and basic cerebrospinal fluid (CSF) characteristics between TBM and CM in HIV-infected patients. METHODS: A retrospective analysis was conducted of clinical, radiological and laboratory records of 108 and 98 HIV-infected patients with culture-proven diagnosis of TBM and CM, respectively. The patients were admitted at a tertiary centre in São Paulo, Brazil. A logistic regression model was used to distinguish TBM from CM and derive a diagnostic index based on the adjusted odds ratio (OR) to differentiate these two diseases. RESULTS: In multivariate analysis, TBM was independently associated with: CSF with neutrophil predominance (odds ratio (OR) 35.81, 95% confidence interval (CI) 3.80 - 341.30, p=0.002), CSF pleocytosis (OR 9.43, 95% CI 1.30 - 68.70, p=0.027), CSF protein >1.0 g/L (OR 5.13, 95% CI 1.38 - 19.04, p=0.032) and Glasgow Coma Scale <15 (OR 3.10, 95% CI 1.03 - 9.34, p=0.044). Nausea and vomiting (OR 0.27, 95% CI 0.08 - 0.90, p=0.033) were associated with CM. Algorithm-related area under the receiver operating characteristics curve was 0.815 (95% CI 0.758 - 0.873, p<0.0001), but an accurate cut-off was not derived. CONCLUSION: Although some clinical and basic CSF characteristics appear useful in the differential diagnosis of TBM and CM in HIVinfected patients, an accurate algorithm was not identified. Optimised access to rapid, sensitive and specific laboratory tests is essential.
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BACKGROUND AND AIM: Although subclinical hypothyroidism (SCH) is associated with cardiovascular risk, there is scarce data about subclinical atherosclerosis in subjects with SCH. We aimed to analyze the association between SCH and carotid intima-media thickness (IMT) using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS AND RESULTS: We included subjects with normal thyroid function (TSH: 0.4-4.0 mIU/l, and normal free thyroxine (FT4): 0.8-1.9 ng/dl) and SCH (TSH ≥ 4.0 mIU/l and normal FT4) evaluated for IMT in a cross-sectional analysis. We excluded individuals using medications that affect thyroid function and those with a history of cardiovascular disease. We performed logistic and linear regression models to evaluate the association with IMT (mean values and categorized at the 75th percentile) as a dependent variable and SCH as an independent variable, adjusted for other cardiovascular risk factors. From 8623 subjects (median age of 50 years; interquartile range: 44-57), 4624 (53.6%) were women, 8095 (93.9%) were euthyroid, and 528 (6.1%) had SCH. Groups varied in age, body mass index, Framingham risk score, Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), C-reactive protein, as well as, IMT, that were all higher in SCH compared to euthyroid participants. SCH is associated with IMT as a continuous variable (ß = 0.010, P = 0.036) and IMT >75th percentile: OR = 1.30 (95% CI = 1.06-1.59) in logistic models. CONCLUSION: Individuals with SCH presented higher IMT compared with euthyroid subjects, even after adjustment for potential confounders. IMT was independently associated with SCH in the baseline of the ELSA-Brasil study.
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Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Enfermedades de las Arterias Carótidas/etiología , Grosor Intima-Media Carotídeo , Hipotiroidismo/complicaciones , Adulto , Anciano , Enfermedades Asintomáticas , Biomarcadores/sangre , Brasil , Distribución de Chi-Cuadrado , Estudios Transversales , Femenino , Humanos , Hipotiroidismo/sangre , Hipotiroidismo/diagnóstico , Modelos Lineales , Modelos Logísticos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Valor Predictivo de las Pruebas , Estudios Prospectivos , Factores de Riesgo , Pruebas de Función de la Tiroides , Hormonas Tiroideas/sangreRESUMEN
Native sheep breeds have satisfactory reproductive activity throughout the year, but nutritional and climatic factors such as high temperature during the dry period can affect the semen quality, causing a decrease in sperm motility and an increase in the percentage of morphologically abnormal sperm. To protect itself against the deleterious effect of high temperature, the testicle has a complex mechanism of thermoregulation sites. The scrotal skin has an important function in the maintenance of testicular temperature, since it is thin, poor in subcutaneous fat, relatively hairless and has a well-developed blood and lymphatic system, facilitating thermal loss by radiation and evaporation. This study aimed to evaluate the effect of scrotal temperature on sperm quality in Morada Nova sheep. Temperature was measured with a laser thermometer and three classes of average testicular temperature were established: class 1 = 28ºC to 31ºC, class 2 = 31.01ºC to 33ºC and class 3 = >33ºC. The ejaculate of each animal was collected using an artificial vagina for further evaluation of volume, aspect, whirling, motility and sperm vigor. Then the sperm concentration and morphology were determined by examination of moist slides. Means were compared by the t-test and chi-square test using the SAS software (SAS Inst., Inc., Cary, NC). There was no difference (P>0.05) for whirling (3.42±1.08%)
O artigo não possui resumo em português.
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The success of reproductive management in the sheep industry depends on several factors. Among them, early pregnancy diagnosis stands to improve the rates of exploration of sheep livestock, allowing the identification of fertility problems, disposal of infertile animals, food supplementation of pregnant females and maximizing production and profits. Therefore, this work aimed to develop an Enzyme Linked Immunosorbent Assay (ELISA) for detection of progesterone in peripheral blood samples from sheep of Santa Inês breed. A calibration curve was made on the test plate at which a fraction of 100 L of diluted antigen was deposited in the wells. The antigen (P4) was diluted sample in methanol/water and incubated at 37ºC for one hour; then 200 L were deposited from the PBS-BSA 1% and was followed by incubation overnight at 10ºC. 100 L of anti-P4 serum produced in rabbits were added and another incubation at 37ºC for one hour was performed, followed by two washes with PBS-T-G. Then it was added 100 L of the conjugate anti rabbit peroxidase labeled, followed by another incubation at 37ºC for one hour; two washing were done with PBS-T-G and drying the plate; revelation with TMB (Sure Blue) was performed using 100 L of Sure Blue for 10 minutes and the reaction stopped, the plate was read at 595 nm; another revelation was done with PNPP and the plate reading was done at 450 nm. The r
O artigo não possui resumo em português.
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Toxoplasmosis is one of the most frequent zoonosis around the world and occurs by the contact of host to Toxoplasma gondii parasite. In humans, the transmission can be congenital, when pregnant woman are exposed to the parasite and the fetus can develop micro and macro encephalitis, mental retardation, abortion, etc. In animals, transmition can be congenital or can be done by saliva, milk or semen containing Toxoplasma gondii. Ovine are potential transmitters, where the parasite cists are found in animal tissue for long periods of time. Disease diagnoses are needed to avoid economic losses and human health problems. Despite immunofluorescence is the most used test to diagnose T. gondii, ELISA tests were used in this study to screen animals in ovine herd, at IZ. For those, 134 animals from Morada Nova and Santa Inês breeds were tested using the IDEXX Toxoplasma gondii test kit, using sera as biological sample. Blood was taken from jugular vein and centrifugation was performed. Sera were separated and kept frozen. Presence of T. gondii was verified in ELISA test and reading at Biotech microplate reader, analyzed by Xchek 3.3 software. O.D. showed 27 animals with the presence of T. gondii. Only one animal was diagnosed suspect and new sample will be run. ELISA test showed to be fast, easy and reliable in the farm. Once the amount of sera used is minimum (1 ul), same blood sample
ês.
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Animales , Ensayo de Inmunoadsorción Enzimática , Embarazo , Ovinos , Progesterona/análisisAsunto(s)
Animales , Ovinos , Progesterona/análisis , Ensayo de Inmunoadsorción Enzimática , EmbarazoRESUMEN
Toxoplasmosis is one of the most frequent zoonosis around the world and occurs by the contact of host to Toxoplasma gondii parasite. In humans, the transmission can be congenital, when pregnant woman are exposed to the parasite and the fetus can develop micro and macro encephalitis, mental retardation, abortion, etc. In animals, transmition can be congenital or can be done by saliva, milk or semen containing Toxoplasma gondii. Ovine are potential transmitters, where the parasite cists are found in animal tissue for long periods of time. Disease diagnoses are needed to avoid economic losses and human health problems. Despite immunofluorescence is the most used test to diagnose T. gondii, ELISA tests were used in this study to screen animals in ovine herd, at IZ. For those, 134 animals from Morada Nova and Santa Inês breeds were tested using the IDEXX Toxoplasma gondii test kit, using sera as biological sample. Blood was taken from jugular vein and centrifugation was performed. Sera were separated and kept frozen. Presence of T. gondii was verified in ELISA test and reading at Biotech microplate reader, analyzed by Xchek 3.3 software. O.D. showed 27 animals with the presence of T. gondii. Only one animal was diagnosed suspect and new sample will be run. ELISA test showed to be fast, easy and reliable in the farm. Once the amount of sera used is minimum (1 ul), same blood sample
ês.