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Aging is characterized by a functional decline in several physiological systems. α-Klotho-hypomorphic mice (Kl-/-) exhibit accelerated aging and cognitive decline. We evaluated whether male and female α-Klotho-hypomorphic mice show changes in the expression of synaptic proteins, N-methyl-d-aspartate receptor (NMDAR) and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) subunits, postsynaptic density protein 95 (PSD-95), synaptophysin and synapsin, and the activity of Na+, K+-ATPase (NaK) isoforms in the cerebellum and hippocampus. In this study, we demonstrated that in the cerebellum, Kl-/- male mice have reduced expression of GluA1 (AMPA) compared to wild-type (Kl+/+) males and Kl-/- females. Also, Kl-/- male and female mice show reduced É2/É3-NaK and Mg2+-ATPase activities in the cerebellum, respectively, and sex-based differences in NaK and Mg2+-ATPase activities in both the regions. Our findings suggest that α-Klotho could influence the expression of AMPAR and the activity of NaK isoforms in the cerebellum in a sex-dependent manner, and these changes may contribute, in part, to cognitive decline.
Assuntos
Cerebelo , Hipocampo , Proteínas Klotho , Receptores de AMPA , Caracteres Sexuais , ATPase Trocadora de Sódio-Potássio , Animais , Feminino , Masculino , Camundongos , Cerebelo/metabolismo , Proteína 4 Homóloga a Disks-Large/metabolismo , Proteína 4 Homóloga a Disks-Large/genética , Hipocampo/metabolismo , Proteínas Klotho/metabolismo , Camundongos Endogâmicos C57BL , Camundongos Knockout , Receptores de AMPA/metabolismo , Receptores de AMPA/genética , Receptores de N-Metil-D-Aspartato/metabolismo , Receptores de N-Metil-D-Aspartato/genética , ATPase Trocadora de Sódio-Potássio/metabolismo , ATPase Trocadora de Sódio-Potássio/genética , Sinapsinas/metabolismo , Sinapsinas/genética , Sinaptofisina/metabolismoRESUMO
PURPOSE: To evaluate the prognostic value of C-reactive protein (CRP), albumin, CRP/albumin ratio (CAR), and modified Glasgow Prognostic Score (mGPS) at different thresholds in patients with advanced cancer in palliative care. METHODS: Prospective cohort study with patients evaluated at a palliative care unit in Brazil between July 2016 and March 2020. We included patients ≥ 20 years old, both sexes, able to provide the necessary information or accompanied by someone able to do so, and Karnofsky Performance Status ≥ 30 %. The exclusion criteria were the absence of laboratory data and previous diagnosis of autoimmune and infectious diseases. The thresholds analyzed were: CRP < 5 vs. 5-10 vs. > 10 mg/L, albumin < 2.4 vs. 2.4-2.9 vs. 3.0-3.5 vs. > 3.5 g/dL; CAR <1.2 vs. 1.2-2.0 vs. > 2.0, and mGPS equal to 0 vs. 1 vs. 2. Kaplan-Meier curves and Cox regression models (with hazard ratios [HR] and 95% confidence interval [CI]) were used to evaluate prognostic value, and the concordance statistic (C-statistic) was used to evaluate the predictive accuracy of these thresholds to predict death within 90 days. RESULTS: A total of 1,877 patients were included. Median overall survival was 51 (19;124) days and decreased in line with the deterioration of the inflammatory biomarkers. According to the Cox regression models, HR increased as the thresholds worsened (CRP: 1.74 [95% CI, 1.50-2.02] to 2.30 [95% CI, 2.00-2.64]; albumin: 1.77 [95% CI, 1.52-2.07] to 2.60 [95% CI, 2.15-3.14]; CAR: 1.47 [95% CI, 1.21-1.77] to 2.35 [95% CI, 2.05-2.69]; mGPS: 1.78 [95% CI, 1.40-2.23] to 1.89 [95% CI, 1.65-2.15]). All the inflammatory biomarkers evaluated showed discriminatory accuracy for predicting death (C-statistic >0.70), with CAR as the best parameter (C-statistic: 0.80). CONCLUSION: Our results suggest that CRP, albumin, CAR, and mGPS can be used as clinically meaningful biomarkers to stratify patients with advanced cancer in palliative care according to the severity of these indicators.
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Proteína C-Reativa , Neoplasias , Cuidados Paliativos , Humanos , Proteína C-Reativa/análise , Proteína C-Reativa/metabolismo , Masculino , Feminino , Neoplasias/sangue , Neoplasias/mortalidade , Neoplasias/patologia , Prognóstico , Estudos Prospectivos , Pessoa de Meia-Idade , Idoso , Medição de Risco/métodos , Biomarcadores Tumorais/sangue , Inflamação/sangue , Albumina Sérica/análise , Albumina Sérica/metabolismo , Brasil/epidemiologia , Seguimentos , Albumina Sérica Humana/análise , Adulto , Taxa de SobrevidaRESUMO
OBJECTIVE: Investigate individual and contextual determinants associated with traumatic dental injuries in schoolchildren. METHODS: A cross-sectional study with 739 pairs of parents and children. Parents answered a sociodemographic questionnaire, the Family Adaptability and Cohesion Evaluation Scale and a questionnaire on the child's use of electronic devices. Examinations of the children were conducted at the school by calibrated examiners using the diagnostic criteria proposed by Andreasen. Contextual variables of the school were also collected. Multilevel Poisson regression for complex samples was performed (p < 0.05). RESULTS: The individual factors associated with the outcome were children of single parents (PR = 2.33; 95% CI: 1.79-2.66), practice of sports (PR = 2.46; 95% CI: 1.70-3.22), the daily use of electronic devices (PR = 1.78; 95% CI: 1.31-1.81), more than 2 h per day of screen time (PR = 3.84; 95% CI: 1.94-4.28) and chaotic family adaptability (PR = 4.22; 95% CI: 3.44-4.99). The contextual variables were studying at a public school (PR = 1.77; 95% CI: 1.02-3.05) and the presence of rigid floor in the school courtyard (PR = 1.99; 95% CI: 1.15-3.15). CONCLUSION: Individual determinants, studying at a public school and the presence of rigid floor in the school courtyard were associated with traumatic dental.
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Análise Multinível , Traumatismos Dentários , Humanos , Criança , Estudos Transversais , Feminino , Masculino , Inquéritos e Questionários , Fatores de RiscoRESUMO
This study aimed to evaluate the ability of biofilm formation by L. monocytogenes from the meat processing industry environment, as well as the use of different combinations of detergents, sanitizers, and UV-A radiation in the control of this microorganism in the planktonic and sessile forms. Four L. monocytogenes isolates were evaluated and showed moderate ability to form biofilm, as well as carried genes related to biofilm production (agrB, agrD, prfA, actA, cheA, cheY, flaA, sigB), and genes related to tolerance to sanitizers (lde and qacH). The biofilm-forming isolates of L. monocytogenes were susceptible to quaternary ammonium compound (QAC) and peracetic acid (PA) in planktonic form, with minimum inhibitory concentrations of 125 and 75 ppm, respectively, for contact times of 10 and 5 min. These concentrations are lower than those recommended by the manufacturers, which are at least 200 and 300 ppm for QAC and PA, respectively. Biofilms of L. monocytogenes formed from a pool of isolates on stainless steel and polyurethane coupons were subjected to 14 treatments involving acid and enzymatic detergents, QAC and PA sanitizers, and UV-A radiation at varying concentrations and contact times. All treatments reduced L. monocytogenes counts in the biofilm, indicating that the tested detergents, sanitizers, and UV-A radiation exhibited antimicrobial activity against biofilms on both surface types. Notably, the biofilm formed on polyurethane showed greater tolerance to the evaluated compounds than the biofilm on stainless steel, likely due to the material's surface facilitating faster microbial colonization and the development of a more complex structure, as observed by scanning electron microscopy. Listeria monocytogenes isolates from the meat processing industry carry genes associated with biofilm production and can form biofilms on both stainless steel and polyurethane surfaces, which may contribute to their persistence within meat processing lines. Despite carrying sanitizer tolerance genes, QAC and PA effectively controlled these microorganisms in their planktonic form. However, combinations of detergent (AC and ENZ) with sanitizers (QAC and PA) at minimum concentrations of 125 ppm and 300 ppm, respectively, were the most effective.
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Biofilmes , Detergentes , Desinfetantes , Listeria monocytogenes , Raios Ultravioleta , Biofilmes/efeitos dos fármacos , Biofilmes/efeitos da radiação , Biofilmes/crescimento & desenvolvimento , Listeria monocytogenes/efeitos dos fármacos , Listeria monocytogenes/efeitos da radiação , Listeria monocytogenes/crescimento & desenvolvimento , Listeria monocytogenes/fisiologia , Detergentes/farmacologia , Desinfetantes/farmacologia , Testes de Sensibilidade Microbiana , Indústria de Processamento de Alimentos , Aço Inoxidável , Microbiologia de Alimentos , Ácido Peracético/farmacologiaRESUMO
The present study aimed to investigate associations between the self-perceived dental treatment need and clinical factors, familial characteristics, and school context in adolescents. A cross-sectional study was conducted with a representative sample of 746 students aged 15 to 19 years in a medium-sized city in Brazil. Data collection involved the use of a sociodemographic questionnaire, an oral health questionnaire, and the Family Adaptability and Cohesion Scales (FACES III) instrument. Clinical examinations were performed by two trained and calibrated examiners (Kappa > 0.80) using the Nyvad criteria. A robust logistic regression analysis for complex samples was performed using a multilevel approach (α = 5%). The individual factors associated with the self-perceived treatment need were dental pain (OR = 1.08; 95% CI: 1.01-1.16), the loss of the first molars (OR = 1.09; 95% CI: 1.03-1.15), and disengaged family cohesion (OR = 1.15; 95% CI: 1.01-1.31). In terms of context, attending a public school was associated with the self-perceived treatment need (OR = 1.17; 95% CI: 1.02-1.33). Thus, the individual factors of toothache, tooth loss, and a disengaged family, as well as the school context, exerted an influence on the self-perceived treatment need.
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Autoimagem , Humanos , Adolescente , Masculino , Feminino , Brasil , Estudos Transversais , Adulto Jovem , Inquéritos e Questionários , Saúde Bucal , Odontalgia/psicologiaRESUMO
O alopurinol, de uso contínuo oral, é o tratamento de escolha para os distúrbios hereditários do glicogênio. Apesar de não ser comum, a reação de hipersensibilidade ao alopurinol se torna um problema quando esta é a única medicação disponível para o controle da doença de base. Nestes casos, a dessensibilização é uma alternativa viável. No presente relato, descrevemos o caso de um paciente com diagnóstico de doença de depósito de glicogênio tipo I, com exantema pruriginoso generalizado ao alopurinol, tratado com um protocolo de dessensibilização oral acelerado. Este tratamento permitiu o uso contínuo deste medicamento sem novas reações em longo prazo.
Continuous oral allopurinol use is the first-line treatment for hereditary glycogen disorders. While hypersensitivity reactions to allopurinol are uncommon, they can pose challenges when this medication is the only available option for the long-term treatment of the underlying disorder. In such cases, desensitization emerges as a viable alternative. We report the case of a patient with glycogen storage disease type I who developed a generalized pruritic rash due to allopurinol. Drug intolerance was successfully managed using a rapid oral desensitization protocol, which allowed an uneventful long-term use of allopurinol.
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Humanos , Masculino , AdultoRESUMO
OBJECTIVE: To determine the effective dose and therapeutic potential of maropitant using through expression of mediators of oxidative stress, inflammatory and of the unfolded protein response (UPR) (bio) markers on spinal cord using a model of neuropathic pain induced through chronic constriction injury (CCI) in rats. STUDY DESIGN: Randomized, blinded, prospective experimental study. ANIMALS: 98 male Wistar rats. METHODS: Rats were anesthetized with sevoflurane and after CCI, they were randomly assigned to the following groups that received: vehicle, 3, 6, 15, 30 e 50 mg/kg/24q of maropitant. The effect on inflammatory mediators (IL10, TNFα), oxidative stress (GPx, CAT, SOD), microglial (IBA-1) and neuronal (NeuN, TACR1) markers was evaluated though immunohistochemistry and expression levels of markers of hypoxia (HIF1α, Nrf2), antioxidant enzymes (Catalse, Sod1 and GPx1), and endoplasmic reticulum stress mediators (GRP78, CHOP and PERK) through qRT-PCR. RESULTS: Intraperitoneal injection (IP) of maropitant inhibited nociception with ID50 values of 4,1 mg/kg (5,85-19,36) in a neuropathic pain model through CCI. A dose of 30 mg/kg/24q was significantly effective in reducing mechanical allodynia 1 to 4h after treatment with nociception inhibition (145,83%). A reduction in the expression of hypoxia factors (HIF1α, Nrf2) was observed, along with an increase in antioxidant activity (CAT, SOD and GPX). Additionally, there was a reduction in inflammatory markes (IL10, TNFα), microglial (IBA-1), and neuronal markers (NeuN, TACR1). CONCLUSION AND CLINICAL RELEVANCE: These findings demonstrate that the determined dose, administered daily for seven days, had an antinociceptive effect, as well as anti-inflammatory and antioxidant activity.
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Neuralgia , Traumatismos dos Nervos Periféricos , Quinuclidinas , Ratos , Masculino , Animais , Antioxidantes/metabolismo , Ratos Wistar , Doenças Neuroinflamatórias , Traumatismos dos Nervos Periféricos/tratamento farmacológico , Fator de Necrose Tumoral alfa/metabolismo , Interleucina-10/metabolismo , Fator 2 Relacionado a NF-E2/metabolismo , Estudos Prospectivos , Estresse Oxidativo , Hiperalgesia/tratamento farmacológico , Estresse do Retículo Endoplasmático , Neuralgia/tratamento farmacológico , Neuralgia/metabolismo , Superóxido Dismutase/metabolismo , Hipóxia/tratamento farmacológicoRESUMO
A comunicação entre pais e seus filhos no período da adolescência é fundamental para propor uma estrutura psicológica, na qual pode-se permitir que o adolescente desenvolva uma autoestima forte e independente. Objetivo: identificar por meio de literatura o comportamento autodestrutivo em adolescentes que utilizam redes sociais e jogos digitais de modo demasiado. Método: Trata-se de um estudo de cunho exploratório com intuito caracterizado por meio de revisão bibliográfica, realizada através do Google Acadêmico, Fio Cruz (Fundação Oswaldo Cruz), Biblioteca Virtual em Saúde (BVS), utilizando os uni termos: "COMPORTAMENTOS AUTODESTRUTIVOS NA ADOLESCENCIA", pesquisado apenas no idioma português," ordenado por "data" de 2002 até maio de 2023. Resultado: Mediante as bases pesquisadas forem elegíveis (22) artigos, (2) revistas e (1) livro após os critérios estabelecidos ficaram apenas 05 artigos. Conclusão: Cabe aos profissionais da saúde bem como a equipe de enfermagem, seja na atenção primaria ou dentro do ambiente hospitalar estarem preparados e capacitados para prestar uma assistência de qualidade, realizar o acolhimento e uma escuta terapêutica de forma mais positiva.(AU)
Communication between parents and their children during adolescence is fundamental to propose a psychological structure in which adolescents can develop a strong and independent self-esteem. Objective: to identify, through literature, self-destructive behavior in adolescents who use social networks and digital games too much. Method: This is an exploratory study with a purpose characterized by a bibliographical review, carried out through Google Scholar, Fio Cruz (Oswaldo Cruz Foundation), Virtual Health Library (VHL), using the uni terms: "SELF-DESTRUCTIVE BEHAVIORS NA ADOLESCENCIA", searched only in Portuguese," sorted by "date" from 2002 to May 2023. Result: According to the searched databases, (22) articles, (2) magazines and (1) book were eligible after the established criteria. only 05 articles. Conclusion: It is up to health professionals, as well as the nursing team, whether in primary care or within the hospital environment, to be prepared and qualified to provide quality care, embracement and therapeutic listening in a more positive way.(AU)
La comunicación entre padres e hijos durante la adolescencia es fundamental para proponer una estructura psicológica en la que los adolescentes puedan desarrollar una autoestima fuerte e independiente. Objetivo: identificar, a través de la literatura, conductas autodestructivas en adolescentes que utilizan demasiado las redes sociales y los juegos digitales. Método: Se trata de un estudio exploratorio con finalidad caracterizada por una revisión bibliográfica, realizada a través de Google Scholar, Fio Cruz (Fundación Oswaldo Cruz), Biblioteca Virtual en Salud (BVS), utilizando los términos uni: "CONDUCTAS AUTODESTRUCTIVAS EN LA ADOLESCENCIA" , buscado solo en portugués", ordenados por "fecha" de 2002 a mayo de 2023. Resultado: De acuerdo con las bases de datos buscadas, (22) artículos, (2) revistas y (1) libro fueron elegibles después de los criterios establecidos. sólo 05 artículos. Conclusión: Corresponde a los profesionales de la salud, así como al equipo de enfermería, ya sea en la atención primaria o en el ámbito hospitalario, estar preparados y calificados para brindar un cuidado de calidad, acogida y escucha terapéutica de forma más positiva.(AU)
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Masculino , Feminino , Adolescente , Comportamento , Adolescente , Comportamento Autodestrutivo , Redes Sociais OnlineRESUMO
OBJECTIVE: To evaluate the presence of sleep disorders, obesity and anxiety associated with cavitated carious lesions in children aged 8 to 10 years. MATERIALS AND METHODS: A cross-sectional study was carried out in the Northeast of Brazil. The sample was comprised of 793 schoolchildren randomly selected from public and private schools. Calibrated examiners (Kappa >0.80) performed the clinical examination of dental caries using the International Caries Detection and Assessment System and applied the Revised Children's Manifest Anxiety Scale and the Sleep Disturbance Scale for Children questionnaires. The anthropometric variables evaluated were weight and height. Negative binomial regressions (α ≤ 0.05) were performed. A Directed Acyclic Graph was prepared using DAGitty software (version 3.0), to select the co-variables for the statistical fits. RESULTS: The prevalence of tooth decay was 52.8%. The mean number of tooth surfaces with cavitated caries was 2.2(2.8), 58.9% of the schoolchildren had some type of sleep disorder, while 20.2% were anxious and 29.1% were obese. Sleep disturbance (RR = 1.38; 95% CI: 1.05-1.83), general anxiety (RR = 1.71; 95% CI: 1.32-2.21), obesity (RR = 1.48; 95% CI: 1.17-1.86) were associated with dental caries in the final model. CONCLUSION: The presence of carious lesions was higher in children with sleep disorders, anxiety, obesity, and those who experienced dry mouth.
Assuntos
Cárie Dentária , Criança , Humanos , Cárie Dentária/complicações , Cárie Dentária/epidemiologia , Cárie Dentária/diagnóstico , Estudos Transversais , Obesidade , Prevalência , Ansiedade , Transtornos de Ansiedade , SonoRESUMO
OBJECTIVES: To develop and validate a new prognostic model to predict 90-day mortality in patients with incurable cancer. METHODS: In this prospective cohort study, patients with incurable cancer receiving palliative care (n = 1322) were randomly divided into two groups: development (n = 926, 70%) and validation (n = 396, 30%). A decision tree algorithm was used to develop a prognostic model with clinical variables. The accuracy and applicability of the proposed model were assessed by the C-statistic, calibration and receiver operating characteristic (ROC) curve. RESULTS: Albumin (75.2%), C reactive protein (CRP) (47.7%) and Karnofsky Performance Status (KPS) ≥50% (26.5%) were the variables that most contributed to the classification power of the prognostic model, named Simple decision Tree algorithm for predicting mortality in patients with Incurable Cancer (acromion STIC). This was used to identify three groups of increasing risk of 90-day mortality: STIC-1 - low risk (probability of death: 0.30): albumin ≥3.6 g/dL, CRP <7.8 mg/dL and KPS ≥50%; STIC-2 - medium risk (probability of death: 0.66 to 0.69): albumin ≥3.6 g/dL, CRP <7.8 mg/dL and KPS <50%, or albumin ≥3.6 g/dL and CRP ≥7.8 mg/dL; STIC-3 - high risk (probability of death: 0.79): albumin <3.6 g/dL. In the validation dataset, good accuracy (C-statistic ≥0.71), Hosmer-Lemeshow p=0.12 and area under the ROC curve=0.707 were found. CONCLUSIONS: STIC is a valid, practical tool for stratifying patients with incurable cancer into three risk groups for 90-day mortality.
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The aim of the present study was to investigate predictors of malocclusion in Brazilian schoolchildren eight to ten years of age based on a causal directed acyclic graph model. A cross-sectional study was conducted with 739 schoolchildren eight to ten years of age. Parents/guardians provided information on sleep disorders of the child (Sleep Disturbance Scale for Children) and family characteristics (Family Adaptability and Cohesion Evaluation Scale). The diagnosis of malocclusion was performed by four trained examiners using the Dental Aesthetic Index. Control variables were selected using a directed acyclic graph. Descriptive analysis was performed, followed by robust logistic regression analysis for complex samples (α = 5%). The following variables were associated with malocclusion in the final model: sleep disorders (OR = 2.61; 95%CI: 2.43-2.86), mouth breathing (OR = 1.04; 95%CI: 1.02-1.99), non-nutritive sucking habits (OR = 2.45; 95%CI: 2.37-4.85), and obesity (OR = 1.54; 95%CI: 1.02-2.33). Sociodemographic characteristics, family functioning, and premature tooth loss did not remain associated with malocclusion. Sleep disorders, mouth breathing, sucking habits, and obesity are predictors of malocclusion in schoolchildren eight to ten years of age.
Assuntos
Má Oclusão , Transtornos do Sono-Vigília , Criança , Humanos , Estudos Transversais , Sucção de Dedo , Respiração Bucal/complicações , Má Oclusão/complicações , Má Oclusão/epidemiologia , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/epidemiologia , Obesidade/complicaçõesRESUMO
To investigate individual and contextual factors associated with seeking treatment for traumatic dental injuries. A cross-sectional study was conducted with 739 pairs of guardians and children. Guardians answered a questionnaire addressing sociodemographic characteristics, seeking treatment for a tooth injury in the child, and the Oral Health Literacy-Adult Questionnaire. Descriptive analysis and unadjusted and adjusted multilevel Poisson regression analysis (p<0.05). The prevalence of seeking treatment for traumatic dental injury was 44.7%. Sociodemographic variables associated were white skin of the child (PR = 1.30; 95% CI: 1.08-1.76), mother's age older than 35 years (PR = 1.70; 95% CI: 1.50-1.90), married parents (PR = 1.93; 95% CI: 1.70-2.23), guardians with more than eight years of schooling (PR = 2.00; 95% CI: 1.76-2.23), with adequate oral health literacy (PR = 3.33; 95% CI: 3.01-3.62) and the daily use of electronic devices by the child (PR = 1.26; 95% CI: 1.02-1.50). On the contextual level, attending a private school (PR = 1.77; 95% CI: 1.02-3.05) and the number of primary care units with oral health teams in the school district (PR = 1.78; 95% CI: 1.12-2.38) remained associated. Among the children who suffered TDI, adequate oral health literacy on the part of the parents stood out among the factors associated with seeking treatment.
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Cárie Dentária , Traumatismos Dentários , Criança , Adulto , Humanos , Estudos Transversais , Análise Multinível , Traumatismos Dentários/terapia , Traumatismos Dentários/epidemiologia , Saúde Bucal , Pais , Brasil/epidemiologia , Cárie Dentária/epidemiologia , PrevalênciaRESUMO
BACKGROUND: Next-generation sequencing has had a significant impact on genetic disease diagnosis, but the interpretation of the vast amount of genomic data it generates can be challenging. To address this, the American College of Medical Genetics and Genomics and the Association for Molecular Pathology have established guidelines for standardized variant interpretation. In this manuscript, we present the updated Hospital Israelita Albert Einstein Standards for Constitutional Sequence Variants Classification, incorporating modifications from leading genetics societies and the ClinGen initiative. RESULTS: First, we standardized the scientific publications, documents, and other reliable sources for this document to ensure an evidence-based approach. Next, we defined the databases that would provide variant information for the classification process, established the terminology for molecular findings, set standards for disease-gene associations, and determined the nomenclature for classification criteria. Subsequently, we defined the general rules for variant classification and the Bayesian statistical reasoning principles to enhance this process. We also defined bioinformatics standards for automated classification. Our workgroup adhered to gene-specific rules and workflows curated by the ClinGen Variant Curation Expert Panels whenever available. Additionally, a distinct set of specifications for criteria modulation was created for cancer genes, recognizing their unique characteristics. CONCLUSIONS: The development of an internal consensus and standards for constitutional sequence variant classification, specifically adapted to the Brazilian population, further contributes to the continuous refinement of variant classification practices. The aim of these efforts from the workgroup is to enhance the reliability and uniformity of variant classification.
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Testes Genéticos , Variação Genética , Humanos , Estados Unidos , Mutação , Reprodutibilidade dos Testes , Teorema de Bayes , Genoma HumanoRESUMO
BACKGROUND/AIM: Traumatic dental injuries (TDI) constitute a public health problem. The aim of the present study was to investigate whether sleep disorders, school jet lag, and anxiety are associated with TDI in schoolchildren 8-10 years of age. METHODS: An analytical, cross-sectional study was conducted with 739 pairs of parents/guardians and children enrolled in public and private schools. The parents/guardians answered a socioeconomic questionnaire, the Sleep Disturbance Scale for Children, Circadian Energy Scale, and Revised Children's Manifest Anxiety Scale. Four examiners underwent calibration exercises for the diagnosis of TDI (K > 0.80) using the criteria proposed by Andreasen (2007). A directed acyclic graph was used for the formulation of the theoretical model and statistical adjustments. Unadjusted and adjusted robust binary logistic regression analyses were performed (α = 5%). RESULTS: The prevalence of TDI was 16.2%. The following variables remained associated with the outcome in the final model: family income less than or equal to the minimum monthly wage (OR = 1.77; 95% CI: 1.09-2.88; p = .02), child's height >137.6 cm (OR = 1.68; 95% CI: 1.06-2.64; p = .02), the occurrence of school jet lag (OR = 2.12; 95% CI: 1.27-3.53; p = .004), anxiety (OR = 1.77; 95% CI: 1.04-3.00; p = .04) and sleep disorders (OR = 1.63; 95% CI: 1.38-1.93; p = .05). CONCLUSION: Children from families with a lower income, taller children, those with school jet lag, those with anxiety and those with sleep disorders had a greater occurrence of TDI.
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BACKGROUND: Nutritional support (NS) offered through oral nutritional supplements (ONS) or enteral nutrition (EN) and its impact on quality of life (QoL) is a controversial topic in patients with cancer receiving palliative care (PC). AIMS: To compare the QoL of patients without and with use of NS, including ONS or EN in patients with incurable cancer receiving PC. METHODS: Cross-sectional analysis with patients that were evaluated at PC Unit between June 2021 and February 2023. QoL was assessed using the Quality of Life Questionnaire Core 15. Patients were classified into three groups according to the NS: ONS (n=72; 33%), EN (n=61; 28%) and control group (CG) (n=87; 39%), the last one being formed by patients not using NS. Adjusted logistic regression models were used to verify the association of the domains of QoL with the type of NS. RESULTS: A total of 220 patients were included, with a median age of 64 (58-70) years, predominantly male (54.1%). The EN group had worse scores in physical function when compared with the ONS group (p=0.037) and appetite loss when compared with the CG (p=0.013). The ONS (OR: 2.70; 95% CI 1.32 to 5.49) and EN groups (OR: 2.61; 95% CI 1.24 to 5.49) were independently associated with a higher chance of presenting appetite loss in relation to the CG. CONCLUSION: In general, there was no difference in the QoL of patients using NS when compared with patients not using NS. However, patients using NS have more chance of having appetite loss.
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Competition is an important biological filter that can define crucial features of species' natural history, like survival and reproduction success. We evaluated in the Brazilian tropical savanna whether two sympatric and congenereric species, Qualea multiflora Mart. and Q. parviflora Mart. (Vochysiaceae), compete for pollinator services, testing whether there is a better competitor or whether plants present any anti-competitive mechanism. Additionally, we investigated the breeding system, pollinators, and flowering phenology of both species. The results showed that Q. multiflora and Q. parviflora are dependent on pollinators for fruit formation, as they exhibited a self-incompatible and non-agamospermic breeding system. These plants shared the same guild of pollinators, which was formed by bees and hummingbirds, and an overlap in the flower visitation time was observed. Each plant species had different pollinator attraction strategies: Q. multiflora invested in floral resource quality, while Q. parviflora invested in resource quantity. The blooming time showed a temporal flowering partition, with highly sequential flowering and no overlap. Qualea parviflora bloomed intensely from September to October, while Q. multiflora bloomed from November to January, with the flowering peak occurring in December. The two Qualea species have morphologically similar flowers, are sympatric, and share the same pollinator community, with overlapping foraging activity during the day. However, they do not compete for pollinator services as they exhibit an anti-competitive mechanism mediated by temporal flowering partition.
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ABSTRACT To investigate individual and contextual factors associated with seeking treatment for traumatic dental injuries. A cross-sectional study was conducted with 739 pairs of guardians and children. Guardians answered a questionnaire addressing sociodemographic characteristics, seeking treatment for a tooth injury in the child, and the Oral Health Literacy-Adult Questionnaire. Descriptive analysis and unadjusted and adjusted multilevel Poisson regression analysis (p<0.05). The prevalence of seeking treatment for traumatic dental injury was 44.7%. Sociodemographic variables associated were white skin of the child (PR = 1.30; 95% CI: 1.08-1.76), mother's age older than 35 years (PR = 1.70; 95% CI: 1.50-1.90), married parents (PR = 1.93; 95% CI: 1.70-2.23), guardians with more than eight years of schooling (PR = 2.00; 95% CI: 1.76-2.23), with adequate oral health literacy (PR = 3.33; 95% CI: 3.01-3.62) and the daily use of electronic devices by the child (PR = 1.26; 95% CI: 1.02-1.50). On the contextual level, attending a private school (PR = 1.77; 95% CI: 1.02-3.05) and the number of primary care units with oral health teams in the school district (PR = 1.78; 95% CI: 1.12-2.38) remained associated. Among the children who suffered TDI, adequate oral health literacy on the part of the parents stood out among the factors associated with seeking treatment.
Resumo Investigar fatores individuais e contextuais associados à busca de tratamento para lesões dentárias traumáticas. Foi realizado um estudo transversal com 739 pares de responsáveis e crianças. Os responsáveis responderam a um questionário abordando características sociodemográficas, busca por tratamento para traumatismo dentário na criança e o Questionário de alfabetização em saúde bucal para adulto. Análise descritiva e análise de regressão de Poisson multinível não ajustada e ajustada (p<0,05) foram realizadas. A prevalência de busca de tratamento para lesão dentária traumática foi de 44,7%. As variáveis sociodemográficas associadas foram a pele branca da criança (RP = 1,30; IC 95%: 1,08-1,76), idade da mãe maior que 35 anos (RP = 1,70; IC 95%: 1,50-1,90), os responsáveis casados (RP = 1,93; IC 95%: 1,70-2,23), com mais de oito anos de estudo (RP = 2,00; IC 95%: 1,76-2,23), com alfabetização adequada em saúde bucal (RP = 2,00; IC 95%: 1,76-2,23) e uso diário de dispositivos eletrônicos pela criança (RP = 1,26; IC 95%: 1,02-1,50). No nível contextual, frequentar uma escola particular (PR = 1,77; IC 95%: 1,02-3,05) e a quantidade de unidades básicas de saúde com equipes de saúde bucal no distrito sanitário da escola (PR = 1,78; IC 95%: 1,12-2,38) permaneceram associados. Entre as crianças que sofreram TDI, a alfabetização em saúde bucal adequada dos pais foi um fator que se destacou na busca por tratamento.
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Klotho is an antiaging protein, and its levels decline with age and chronic stress. The exogenous administration of Klotho can enhance cognitive performance in mice and negatively modulate the Insulin/IGF1/PI3K/AKT pathway in terms of metabolism. In humans, insulin sensitivity is a hallmark of healthy longevity. Therefore, this study aimed to determine if exogenous Klotho, when added to neuronal and astrocytic cell cultures, could reduce the phosphorylation levels of certain insulin signaling effectors and enhance antioxidant strategies in these cells. Primary cell cultures of cortical astrocytes and neurons from mice were exposed to 1 nM Klotho for 24 h, with or without glucose. Klotho decreased pAKT and mTOR levels. However, in astrocytes, Klotho increased FOXO-3a activity and catalase levels, shielding them from intermediate oxidative stress. In neurons, Klotho did not alter FOXO-3 phosphorylation levels but increased proteasome activity, maintaining lower levels of PFKFB3. This study offers new insights into the roles of Klotho in regulating energy metabolism and the redox state in the brain.
Assuntos
Antioxidantes , Complexo de Endopeptidases do Proteassoma , Animais , Humanos , Camundongos , Astrócitos , Insulina , Neurônios , Fosfatidilinositol 3-Quinases , UbiquitinaRESUMO
Liver transplantation has come a long way and is now regarded as the gold standard treatment for end-stage liver failure. The great majority of livers utilized in transplantation come from brain-dead donors. A broad inflammatory response characterizes BD, resulting in multiorgan damage. This process is primarily mediated by cytokines, which increase the immunogenicity of the graft. In male Lewis rats, we evaluated the immune response in a BD liver donor and compared it to that of a control group. We studied two groups: Control and BD (rats subjected to BD by increasing intracranial pressure). After the induction of BD, there was an intense rise in blood pressure followed by a fall. There were no significant differences observed between the groups. Blood tissue and hepatic tissue analyzes showed an increase in plasma concentrations of liver enzymes (AST, ALT, LDH and ALP), in addition to pro-inflammatory cytokines and macrophages in liver tissue in animals submitted to BD. The current study found that BD is a multifaceted process that elicits both a systemic immune response and a local inflammatory response in liver tissue. Our findings strongly suggested that the immunogenicity of plasma and liver increased with time following BD.