Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 82
Filtrar
1.
Nutr Metab Cardiovasc Dis ; 34(6): 1427-1437, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38503617

RESUMO

BACKGROUND AND AIM: Increased consumption of ultra-processed foods has been linked to both mortality and cardiovascular risk. Copeptin levels may serve as potential risk markers for cardiovascular death and events. This cross-sectional analysis seeks to assess the potential correlation between the intake of ultra-processed foods and copeptin levels in outpatients diagnosed with type 2 diabetes, based on estimates of cardiovascular risk. METHODS AND RESULTS: Outpatients underwent clinical and nutritional assessments. Dietary information was gathered using a validated quantitative food frequency questionnaire, and the consumption of all foods, beverages, and food products was assessed according to the NOVA food classification system. Fasting plasma-EDTA samples were collected and preserved at -80 °C. Plasma copeptin measurements were analyzed using an enzyme-linked immunosorbent assay based on the competition principle. Participants were categorized into two groups: high risk and very high risk, based on cardiovascular risk calculated by the HEARTS calculator. A total of 190 participants were included in the evaluation, with an average age of 60 ± 9 years, glycated hemoglobin of 8.4 ± 1.4%, and a diabetes duration of 11 (5-19) years. Patients at a very high cardiovascular risk exhibited higher plasma copeptin levels compared to those at high cardiovascular risk. Notably, 92.1% of patients reported consuming more than 10% of total energy intake from ultra-processed foods, although this proportion did not differ between the two groups. CONCLUSION: This patient sample reported elevated consumption of ultra-processed foods; nevertheless, the correlation between ultra-processed foods and plasma copeptin has not been substantiated.


Assuntos
Biomarcadores , Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Glicopeptídeos , Fatores de Risco de Doenças Cardíacas , Humanos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Estudos Transversais , Glicopeptídeos/sangue , Pessoa de Meia-Idade , Masculino , Feminino , Idoso , Biomarcadores/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Medição de Risco , Fast Foods/efeitos adversos , Avaliação Nutricional , Fatores de Risco , Ingestão de Alimentos
3.
J Clin Virol ; 169: 105610, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37837869

RESUMO

BACKGROUND: Chikungunya can cause persistent chronic joint pain. Knowledge of the risk factors for disease progression is important for preventing and controlling complications. This study aimed to identify factors associated with chronic joint pain. METHODS: This prospective cohort study was conducted at a reference center in Rio de Janeiro. Men and women (aged ≥ 18 years) in the acute phase of Chikungunya were included. Clinical data and samples were collected over three months. Risk factors were evaluated using multivariate and logistic regression analyses. RESULTS: A total of 107 patients were followed up. The incidence rate of joint tenderness was 61.7 %. Female sex (adjusted odds ratio [AOR] 3.24, 95 % confidence interval [CI]:1.07-9.77), diarrhea (AOR 5.08, 95 % CI:1.55-16.67), severe joint pain (AOR 4.26, 95 % CI:1.06-17.06), and CHIKV real-time reverse transcription polymerase chain reaction positivity up to 5 days after the onset of symptoms in urine or saliva (AOR 4.56, 95 % CI:1.41-14.77) were identified as predictors of persistent chronic pain. CONCLUSIONS: In a predominantly female population, musculoskeletal symptoms are not the sole determinant of chronic pain, and careful evaluation of CHIKV detection in alternative body fluids (such as saliva and urine) during the early phase of the disease is warranted.


Assuntos
Febre de Chikungunya , Vírus Chikungunya , Dor Crônica , Masculino , Humanos , Feminino , Febre de Chikungunya/complicações , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/diagnóstico , Vírus Chikungunya/genética , Dor Crônica/etiologia , Dor Crônica/complicações , Estudos Prospectivos , Brasil/epidemiologia , Artralgia/epidemiologia , Artralgia/etiologia
4.
Sci Adv ; 9(35): eadg9204, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37656782

RESUMO

Despite the considerable morbidity and mortality of yellow fever virus (YFV) infections in Brazil, our understanding of disease outbreaks is hampered by limited viral genomic data. Here, through a combination of phylogenetic and epidemiological models, we reconstructed the recent transmission history of YFV within different epidemic seasons in Brazil. A suitability index based on the highly domesticated Aedes aegypti was able to capture the seasonality of reported human infections. Spatial modeling revealed spatial hotspots with both past reporting and low vaccination coverage, which coincided with many of the largest urban centers in the Southeast. Phylodynamic analysis unraveled the circulation of three distinct lineages and provided proof of the directionality of a known spatial corridor that connects the endemic North with the extra-Amazonian basin. This study illustrates that genomics linked with eco-epidemiology can provide new insights into the landscape of YFV transmission, augmenting traditional approaches to infectious disease surveillance and control.


Assuntos
Febre Amarela , Vírus da Febre Amarela , Humanos , Vírus da Febre Amarela/genética , Filogenia , Brasil/epidemiologia , Febre Amarela/epidemiologia , Surtos de Doenças , Genômica
5.
J Ren Nutr ; 33(2): 261-268, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36270481

RESUMO

OBJECTIVE: The aim of this cross-sectional study was to evaluate the relationship between eating patterns and diabetic kidney disease in patients with type 2 diabetes. METHODS: Outpatients underwent clinical and nutritional evaluation. Dietary information was obtained through a validated quantitative food frequency questionnaire, and eating patterns were identified by cluster analysis. Diabetic kidney disease was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 and/or persistently elevated urinary albumin concentration (albuminuria ≥ 14 mg/L). Procedures involving patients were approved by the Hospital's Ethics Committee. Patients with type 2 diabetes treated at university hospital and tertiary referral center, southern Brazil. RESULTS: A total of 329 patients were evaluated: mean age 62 ± 10 years, body mass index 30.9 ± 4.2 kg/m2, glycated hemoglobin 8.7% ± 2.0, and 10 (5 to 19) years of diabetes duration. Four eating patterns were identified based on cluster analysis: healthy= dairy products, fruits, and vegetables; snacks= dairy products, whole breads, vegetables, and low-calorie products; processed foods= refined carbohydrates and processed meat, and red meat= red meat. Poisson regression models confirmed that snack eaters (PR = 1.48, 95% CI 1.10, 1.99; P = .010) and red meat eaters (PR = 1.93, 95% CI 1.29, 2.89; P = .001) were associated with diabetic kidney disease. CONCLUSION: In this sample of outpatients with type 2 diabetes, the patterns of snacks and red meat were associated with diabetic kidney disease as compared to a healthy pattern.


Assuntos
Diabetes Mellitus Tipo 2 , Nefropatias Diabéticas , Humanos , Pessoa de Meia-Idade , Idoso , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Estudos Transversais , Fatores de Risco , Nefropatias Diabéticas/epidemiologia , Dieta
6.
Viruses ; 14(11)2022 11 06.
Artigo em Inglês | MEDLINE | ID: mdl-36366557

RESUMO

Infections with arboviruses are reported worldwide. Saint Louis encephalitis (SLEV) and West Nile (WNV) viruses are closely related flaviviruses affecting humans and animals. SLEV has been sporadically detected in humans, and corresponding antibodies have been frequently detected in horses throughout Brazil. WNV was first reported in western Brazil over a decade ago, has been associated with neurological disorders in humans and equines and its prevalence is increasing nationwide. Herein, we investigated by molecular and serological methods the presence of SLEV and WNV in equines from Rio de Janeiro. A total of 435 serum samples were collected from healthy horses and tested for specific neutralizing antibodies by plaque reduction neutralization test (PRNT90). Additionally, samples (serum, cerebrospinal fluid, central nervous system tissue) from 72 horses, including horses with neurological disorders resulting in a fatal outcome or horses which had contact with them, were tested by real-time reverse transcription-polymerase chain reaction (RT-qPCR) for both viruses. Adopting the criterion of four-fold antibody titer difference, 165 horses (38%) presented neutralizing antibodies for flaviviruses, 89 (20.4%) for SLEV and five (1.1%) for WNV. No evidence of SLEV and WNV infection was detected by RT-qPCR and, thus, such infection could not be confirmed in the additional samples. Our findings indicate horses of Rio de Janeiro were exposed to SLEV and WNV, contributing to the current knowledge on the distribution of these viruses in Brazil.


Assuntos
Encefalite de St. Louis , Flavivirus , Doenças dos Cavalos , Febre do Nilo Ocidental , Vírus do Nilo Ocidental , Animais , Humanos , Cavalos , Vírus do Nilo Ocidental/genética , Encefalite de St. Louis/epidemiologia , Encefalite de St. Louis/veterinária , Brasil/epidemiologia , Anticorpos Antivirais , Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/veterinária , Anticorpos Neutralizantes , Doenças dos Cavalos/epidemiologia
7.
Mol Cell Endocrinol ; 558: 111756, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36084853

RESUMO

This study compared the effects of aerobic physical training and estradiol (E2) replacement on central pathways involved with thermoregulation in ovariectomized rats. Rats were assigned to untrained ovariectomized treated with placebo (UN-OVX), untrained ovariectomized treated with E2 (E2-OVX), and trained ovariectomized (TR-OVX) groups. Tail skin temperature (TST), internal temperature (Tint), and basal oxygen consumption (VO2) were recorded. Neuronal activity, brain expression of Kiss1, NKB and Prodyn, and central norepinephrine (NE) levels were measured. UN-OVX had the highest TST. Compared to UN-OVX rats, TR-OVX and E2-OVX had lower Fos expression in the paraventricular and arcuate (ARC) nuclei, and lower double labeling for Tyrosine Hydroxylase and Fos in the brainstem. Compared to UN-OVX, only TR-OVX group exhibited lower kisspeptin (Kiss1), neurokinin B (NKB), and prodynorphin expression in the ARC and higher central NE levels. Aerobic physical training before menopause may prevent the heat dissipation imbalance induced by reduction of E2, through central NE release, modulation of Kiss1, NKB and prodynorphin expression in neurons from ARC nucleus.


Assuntos
Kisspeptinas , Neurocinina B , Feminino , Humanos , Ratos , Animais , Kisspeptinas/metabolismo , Neurocinina B/metabolismo , Tirosina 3-Mono-Oxigenase/metabolismo , Ovariectomia , Estradiol/farmacologia , Norepinefrina/metabolismo , Regulação da Temperatura Corporal
8.
Viruses ; 14(9)2022 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-36146686

RESUMO

BACKGROUND: Chikungunya is a viral disease that is transmitted by mosquitoes. It is characterized by an acute onset of fever and severe arthralgia. METHODS: We describe six cases of acute and post-acute chikungunya in which viral RNA was detected in semen. CONCLUSIONS: The most prolonged detection period was 56 days after illness onset. We attempted to cultivate positive semen samples, but virus isolation was unsuccessful in all cases.


Assuntos
Febre de Chikungunya , Vírus Chikungunya , Animais , Vírus Chikungunya/genética , Humanos , RNA Viral/genética , Sêmen , Eliminação de Partículas Virais
9.
Sci Rep ; 12(1): 8764, 2022 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-35610295

RESUMO

Previous studies have highlighted the positive effects of Estradiol (E2) replacement therapy and physical exercise on skeletal muscle during menopause. However, the comparison effects of exercise training (ET) and estradiol replacement therapy during menopause on skeletal muscle have not been investigated to date. This study aimed to compare the effects of endurance exercise training versus E2 replacement therapy on mitochondrial density, redox status, and inflammatory biomarkers in the skeletal muscle of ovariectomized rats. Thirty female Wistar rats (12-week-old) were randomly assigned into three groups: Untrained ovariectomized rats (UN-OVX, n = 10); untrained ovariectomized rats treated with estradiol replacement therapy (E2-OVX); and, trained ovariectomized rats (TR-OVX). After ovariectomy, the E2-OVX rats were treated subcutaneously with E2 (implanted Silastic® capsule containing 360 µg of 17ß-estradiol/mL) while the TR-OVX group performed an exercise training protocol (50-70% of maximal running speed on a treadmill, 60 min/day, 5 days/week for 8 weeks). After euthanasia, the soleus muscle was processed for histological and biochemical evaluations. Only exercise prevented the reduction of maximal oxygen consumption and increased mechanical efficiency (ME). While mitochondrial muscle density, total antioxidant capacity (FRAP), catalase (CAT) activity, and interleukin 10 levels were higher in TR-OVX, only OVX-E2 presented higher CAT activity and lower interleukin 6 levels. Endurance exercise training compared with E2 replacement therapy maintains the aerobic capacity improving the ME of OVX rats. In addition, only endurance exercise training raises the skeletal muscle mitochondrial content and tends to balance the redox and inflammatory status in the skeletal muscle of OVX rats.


Assuntos
Condicionamento Físico Animal , Animais , Estradiol/farmacologia , Feminino , Terapia de Reposição Hormonal , Humanos , Músculo Esquelético , Ovariectomia , Condicionamento Físico Animal/fisiologia , Ratos , Ratos Wistar
10.
Front Nutr ; 9: 804121, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35479734

RESUMO

The American Heart Association (AHA) has developed the concept of "ideal cardiovascular health" (ICH), a seven-component score, which includes health dietary metrics. Higher ultra-processed foods intake is related with several cardiometabolic and cardiovascular diseases. We propose to develop and validate the Cardiovascular Health Diet Index (CHDI), a diet quality index that combines the AHA's recommendations of a healthy diet for cardiovascular health and ultra-processed foods. We used dietary data obtained through a 114-item FFQ from 14,779 participants of the Brazilian Longitudinal Study of Adults Health (ELSA-Brasil). The CHDI had 11 components and a total score ranging from 0 to 110 points. Validation and reliability analyses were performed, including principal component analyses, association with selected nutrients, means differences between groups (for example, smokers vs. non-smokers), Cronbach's alpha, and linear regression analyses between CHDI and overall dietary quality. The mean CHDI was 57.1 points (95% CI 47.9:66.0). The CHDI had four dimensions; in addition, it was associated with nutrients related to cardiovascular health, and the points were significantly (p < 0.001) lower in smokers (52.1) than in non-smokers (57.8). Cronbach's alpha value was 0.50. After age and sex adjustment, the CHDI score remained associated with a higher overall dietary quality (ß 0.87, 95%CI 0.84:0.89, p < 0.001). The CHDI proved to be valid and reliable for use, in addition to being associated with higher overall dietary quality. The use of CHDI is expected to assess the population's compliance with dietary recommendations for promoting cardiovascular health and preventing cardiovascular disease.

11.
PLoS Negl Trop Dis ; 16(3): e0010242, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35255099

RESUMO

BACKGROUND: Chikungunya is a widely distributed, re-emerging tropical disease caused by the chikungunya virus (CHIKV). Little is known about the duration for which CHIK RNA are detectable in bodily fluids, especially genital secretions, and current evidence is based on small series or case reports. An understanding of viral dynamics across different body compartments can inform diagnostic testing algorithms and public health prevention interventions. METHODOLOGY: A prospective cohort study was conducted to assess the presence and duration of detectable levels of CHIKV RNA in blood, urine, saliva, semen, and vaginal secretions. Men and women (≥ 18 years) with a positive reverse transcriptase-polymerase chain reaction (RT-PCR) test for CHIKV in the acute phase (1-14 days) of the disease were included. After enrollment, clinical data and samples were collected every 15 days over the first 2 months, and a final collection was performed 3 months after recruitment. The Kaplan-Meier interval-censoring method and the parametric Weibull model were fitted to estimate the median time of viral persistence until the lack of CHIKV RNA detection among all body fluids. Punctual estimates of the median time of CHIKV RNA persistence for each fluid were estimated using a 95% confidence interval (CI). RESULTS: From April to December 2019, 170 participants were screened. Of these, 152 (100 women) were enrolled in the study. The median and interquartile range (IQR) ages for men and women were 39.3 (IQR: 26.9, 50.7) and 43.5 (IQR: 33.8, 53.6) years, respectively. CHIKV RNA was detected in 80.3% (122/152) of serum samples, 23.0% (35/152) of urine samples, 30.3% (46/152) of saliva samples, 14.3% (6/42) of semen samples, and 20.2% (20/99) of vaginal secretion samples. The median time until the loss of CHIKV RNA detection was 19.6 days (95% CI, 17.5-21.7) in serum, 25.3 days (95% CI, 17.8-32.8) in urine, 23.1 days (95% CI, 17.9-28.4) in saliva, and 25.8 days (95% CI, 20.6-31.1) in vaginal secretion. The number of semen samples available was too small to make statistical estimates, but a last positive sample was obtained from a participant 56 days after the onset of symptoms. CONCLUSIONS: CHIKV RNA could be detected in all bodily fluids studied, including genital secretions during the acute and convalescent phases and additional studies on viral infectivity in semen and vaginal secretions are warranted.


Assuntos
Febre de Chikungunya , Vírus Chikungunya , Febre de Chikungunya/diagnóstico , Vírus Chikungunya/genética , Estudos de Coortes , Feminino , Humanos , Masculino , Estudos Prospectivos , RNA , RNA Viral/genética
12.
Nursing (Ed. bras., Impr.) ; 25(285): 7263-7272, fev.2022.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1371984

RESUMO

Objetivo: Entender a situação da COVID-19 em Guaratinguetá e suas repercussões na saúde física e mental da população local. Método: Estudo quantitativo descritivo, com coleta de dados por meio de um questionário aplicado aos pacientes atendidos durante a Jornada da Saúde em Guaratinguetá, realizado em outubro de 2020. Resultados: 2% dos entrevistados responderam que tiveram COVID-19 e 44% relataram conhecer alguém que teve a infecção. 82% relataram concordar com as medidas de prevenção. 51% dos entrevistados responderam que se sentiram mais ansiosos ou deprimidos durante este mesmo período. Conclusão: as repercussões da pandemia não se restringem aos casos de infecção, destacando a necessidade de cuidado com a saúde física e mental da população, um grande desafio para o sistema de saúde brasileiro, com repercussões a longo prazo(AU)


Objective: To understand the situation of COVID-19 in Guaratinguetá and the repercussions of the pandemic in the local population's physical and mental health. Method: Quantitative descriptive study, with data collected by a questionnaire applied to patients attending the Jornada da Saúde in Guaratinguetá held in October 2020. Results: 2% of interviewed answered that they had COVID-19 and 44% reported knowing someone who had the infection, 82% reported agreeing with the preventive measures, 51% replied that they felt more anxious or depressed during this same period. Conclusion: the repercussions of the pandemic are not restricted to cases of infection, emphasizing the need to care for the physical and mental health of the population, a major challenge for the Brazilian health system, with long term repercussions(AU)


Objetivo: Conocer la situación del COVID-19 en Guaratinguetá y su impacto en la salud física y mental de la población local. Método: Estudio descriptivo cuantitativo, con recolección de datos mediante cuestionario aplicado en pacientes atendidos durante la Jornada da Saúde en Guaratinguetá realizado en octubre de 2020. Resultados: 2% de los entrevistados ya havian tenido COVID-19 y 44% conocer a alguien que ya la havia tenido. El 82% informó estar de acuerdo con las medidas de prevención para la misma y 51% respondió sentirse más ansioso o deprimido durante la pandemia. Conclusión: las repercusiones de la pandemia no se limitan a los casos de infección, destacando la necesidad de cuidar la salud física y mental de la población, un gran desafío para el sistema de salud brasileño, con repercusiones a largo plazo(AU)


Assuntos
Transtornos Somatoformes , Saúde Pública , Inquéritos e Questionários , Pandemias , COVID-19
13.
Braz J Microbiol ; 53(1): 213-220, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34993920

RESUMO

INTRODUCTION: Understanding the different transmission routes of SARS-CoV-2 is crucial in planning effective interventions in healthcare institutions. This study aimed to evaluate the presence of SARS-Cov-2 genome on inanimate surfaces in COVID-19 intensive care unit and emergency care cohorts. METHODS: This is a prospective cross-sectional study. Samples of the environmental surface of objects and furniture were collected between July 15 and October 15, 2020, at COVID-19 intensive and emergency care units. The presence of SARS-CoV-2 genome was determined by quantitative RT-qPCR. The positivity rate for SARS-Cov-2 genome is presented as the arithmetic mean of the sum of the values obtained in each collection. Values of 1.0, 0.5, and 0.0 were assigned for positive, indeterminate, and negative events, respectively. RESULTS: In the intensive care unit, 86% of samples collected at the stethoscope and bed rail surfaces were positive. In the emergency care unit, 43% of bathroom tap, bed rails, and bedside table samples were positive. SARS-CoV-2 genome was not detected at the computer mouse and keyboard. At the emergency care unit, 14.3% of the samples from the collection room armchair were positive. CONCLUSIONS: SARS-CoV-2 genome can be found at the environmental surface of objects and furniture at COVID-19 care units. They can represent a potential source of indirect transmission pathway for COVID-19, especially within health service institutions.


Assuntos
COVID-19 , Serviços Médicos de Emergência , Estudos Transversais , Humanos , Unidades de Terapia Intensiva , Estudos Prospectivos , RNA Viral/genética , SARS-CoV-2/genética
14.
J Relig Health ; 61(1): 467-478, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33226573

RESUMO

Cardiovascular diseases are the main cause of mortality in the world, generating important socioeconomic and cultural impacts. Spirituality has been associated with the main risk factors for acute myocardial infarction, influencing lifestyle, and drug treatment compliance. Estimate the level of spiritual well-being and its association with coronary artery disease. We conducted a case-control study with 88 adults (42 cases and 46 controls) individually interviewed. Using a spiritual well-being scale and collecting socioeconomic and demographic information. We compared groups by Chi-square and Mann-Whitney tests. Friedman's analysis of variance was used to evaluate the differences between the values assigned to the scale items in each group. Statistically, there was no significant difference between categories and levels of spiritual well-being in any of the groups. Both had high rates, driven by the high level of religious well-being. There was no difference between the rates attributed to the items on the subscale of religious well-being, in the case or control groups (p = 0.959 and p = 0.817). However, the existential well-being subscale revealed variability between the scores attributed to each item in both groups (p < 0.001). The results revealed a high level of spiritual well-being in the analyzed sample. There was no correlation between the levels of spiritual, religious, and existential well-being with coronary artery disease, possibly due to the reduced ability of the religious well-being subscale to discriminate between groups.


Assuntos
Doença da Artéria Coronariana , Terapias Espirituais , Adulto , Estudos de Casos e Controles , Existencialismo , Humanos , Espiritualidade
15.
Rev. bras. educ. méd ; 46(supl.1): e155, 2022. graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1407403

RESUMO

Resumo: Introdução: O Teste de Progresso no curso de Medicina (TPMed) tem sido utilizado pelas escolas médicas que implantaram mudanças curriculares, com currículos baseados/orientados na comunidade, aprendizagem baseada em problemas e currículos orientados por competências, entre outros, além de alguns programas de pós-graduação ou disciplinas isoladas. Baseado nessa premissa, o presente relato se propõe a descrever a experiência no processo de implantação do TPMed em nossa instituição e a participação estudantil nele. Relato de experiência: Dada a importância do TPMed, o curso de Medicina da Universidade Santo Amaro (Unisa) se filiou ao Consórcio São Paulo I (SP1), composto pelas seguintes escolas de Medicina: ABC, Jundiaí, Catanduva, PUC Sorocaba, PUC Goiás e Unoeste, iniciando nossa experiência em 2018. A inserção da Unisa no TPMed foi estimulada a partir da participação no Congresso Brasileiro de Educação Médica (Cobem), com a subsequente associação ao Consórcio SP1. Inúmeras iniciativas de sensibilização do corpo docente e do corpo discente da instituição, com a colaboração da diretoria da Regional São Paulo da Associação Brasileira de Educação Médica (Abem), resultaram em 96,74% de participação discente no TPMed em 2018, 97,12% em 2019, 98,85%, em 2020 e 86,10% em 2021. Em relação ao desempenho dos estudantes, encontramos um aumento progressivo de acertos ao longo dos seis anos de graduação: 32,63% como média de acerto no primeiro semestre, e 62,87%, no 12º semestre. Discussão: A influência positiva do TPMed na aprendizagem do aluno foi a motivação da Unisa para vencer os desafios e mobilizar os estudantes no primeiro ano em que aplicamos a prova, corroborando a grande participação deles. Houve uma queda da adesão ao Teste de Progresso Nacional da Abem - 2021 dos alunos da Unisa, tendo como possível causa os problemas técnicos ocorridos na aplicação dele, que foi on-line. Conclusão: O efeito positivo do TPMed foi observado de forma clara na Unisa. O trabalho direcionado, enfatizando a relevância do TPMed, faz-se mister no seu reconhecimento, resultando em uma forte adesão dos nossos acadêmicos a essa avaliação.


Abstract: Introduction: The Medical Course Progress Test (TPMed) has been used by medical schools that have implemented curricular changes, with, for example, community-based/oriented curricula, problem-based learning and competency-oriented curricula, in addition to some graduate programs or isolated disciplines. Based on this premise, the present report proposes to describe the experience in the TPMed implementation process in our Institution and student participation in it. Experience report: Given the importance of the TPMed, the Medicine course at Universidade Santo Amaro (UNISA) joined the SP1 Consortium, with our experience beginning in 2018. The inclusion of UNISA in the TPMed was driven by the school's participation in the Brazilian Congress of Medical Education (COBEM), and its subsequent association with the Consortium (SP1). Numerous initiatives to raise awareness of the institution's faculty and students, with the collaboration of the São Paulo Regional Board of the Brazilian Association of Medical Education (ABEM) resulted in 96.74% student participating in the TPMed in 2018, 97.12% in 2019, 98.85% in 2020 and 86.10% in 2021. Regarding student performance, we found a progressive increase in correct answers over the six years of the undergraduate course, 32.63% as an average score in the first semester and 62.87% in the twelfth semester. Discussion: The positive influence of the TPMed on student learning was UNISA's motivation to overcome the challenges and mobilize the students in the first year in which the test was applied, corroborating their substantial participation. There was a drop in adherence to the ABEM National Progress Test - 2021 by UNISA students, possibly due to technical problems that occurred in its online application. Conclusion: The positive effect of the TPMed was clearly observed in UNISA. This directed work, which emphasized the relevance of the TPMed, is essential for its recognition, and resulted in a strong adhesion of our academics in this evaluation.

16.
Med. leg. Costa Rica ; 38(2)dic. 2021.
Artigo em Inglês | SaludCR, LILACS | ID: biblio-1386287

RESUMO

Abstract Introduction : Homicides are important causes of mortality in the world, especially in Brazil, which represents approximately two thirds of deaths from external causes and the third place among the causes of death in the country. Methods: Retrospective study on the occurrence of causes of violent deaths occurring in different regions of the city of São Paulo from 2000 to 2014 according to the Mortality Information System of the Municipal Health Secretariat. The standardized coefficient (CP) for the occurrence of homicides and risk rates according to population and male gender were calculated. Results: The PC showed that the south and east regions had increased homicide occurrence between 2000 and 2005 when compared to the years 2010 and 2014. Considering the sum of the PC over the 15 years can be observed the highest occurrence of homicide. in the southern and eastern regions of São Paulo, however, with a reduction in occurrence between 2010 and 2014. Regarding the relative risk rate for homicide, the northern region presented higher rates between 2000 and 2005. When considering gender male population, the western region showed an increase in the risk rate between 2000 and 2005. For 2010, the risk rate remained higher for the northern (1.14) and eastern (1.15) regions, while for the male gender. For men, the risk rate (0.91) remained high for the southern region. In 2014 the highest risk rate (1.18) moved to the western region while for males the highest risk rate was directed to the central region (0.92). Conclusions: High homicide rates have remained in the southern and eastern regions of the city of São Paulo over the past 15 years. The risk rate differs between the regions of the city of São Paulo, highlighting the northern region between 2000, 2005 and 2010 and the western region in 2014. The male gender influences the risk rates between the regions, especially the western region between 2000 and 2005, the southern region in 2010 and the central region in 2014, showing their influence on homicide.


Resumen Introducción: Los homicidios son causas importantes de mortalidad en el mundo, especialmente en Brasil, que representa aproximadamente dos tercios de las muertes por causas externas y el tercer lugar entre las causas de muerte en el país. Materiales Y métodos: Estudio retrospectivo sobre la ocurrencia de causas de muertes violentas ocurridas en diferentes regiones de Municipio de São Paulo de 2000 a 2014 según el Sistema de Información de Mortalidad de la Secretaría de Salud Municipal. Se calculó el coeficiente estandarizado (CP) para la ocurrencia de homicidios y las tasas de riesgo según la población y el sexo masculino. Resultados: De 11.981 casos, el CP mostró que las regiones sur y este mostraron un aumento en la ocurrencia de homicidios entre los años 2000 y 2005 en comparación con los años 2010 y 2014. Considerando la suma del CP en los 15 años, Es posible observar la mayor ocurrencia de homicidios en las regiones sur y oriente de la ciudad de São Paulo, sin embargo, con una reducción entre los años 2010 y 2014. En cuanto a la tasa de riesgo relativo de homicidio, la región norte tuvo tasas más altas entre 2000 y 2005. Al considerar el género masculino, la región oeste mostró un aumento en la tasa de riesgo entre 2000 y 2005. Para los años 2010 la tasa de riesgo se mantuvo elevada para las regiones: norte (1,14) y este (1,15), mientras que para los hombres la tasa de riesgo (0,91) se mantuvo alta para la región sur. En 2014, la tasa de riesgo más alta (1,18) se trasladó a la región occidental, mientras que para los hombres la tasa de riesgo más alta se dirigió a la región central (0,92). Conclusiones: Se mantuvieron altas tasas de ocurrencia de homicidios para las regiones sur y oriente de la ciudad de São Paulo durante los últimos 15 años. La tasa de riesgo difiere entre las regiones de la ciudad de São Paulo, destacando la región norte entre los años 2000, 2005 y 2010 y la región occidental en 2014. El género masculino influye en las tasas de riesgo entre regiones, especialmente la región occidental entre 2000 y 2005, la región sur en 2010 y la región central en 2014, mostrando su influencia en la ocurrencia de homicidios.


Assuntos
Humanos , Masculino , Homicídio/estatística & dados numéricos , Brasil
17.
Exp Gerontol ; 155: 111556, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34537279

RESUMO

BACKGROUND: Endurance training prevents cardiac dysfunction induced by menopause, but to date, no studies compared the effects of endurance training prior to menopause versus estrogen replacement therapy during menopause on heart function of rats. METHODS: Female Wistar rats aged three months were randomly assigned into three groups: Untrained ovariectomized rats (UN-OVX), untrained ovariectomized rats treated with estradiol (UN-OVX-E2), and ovariectomized rats previously exercised (EX-OVX). The endurance training protocol consisted of running on a treadmill at 60-70% of maximal aerobic capacity, 60 min per day, five days per week, for eight weeks. Estradiol replacement therapy consisted of silastic capsules containing the hormone for twelve days. After euthanasia, hearts were harvested, weighed and cardiac function was evaluated by the Langendorff technique. RESULTS: Both cardiac contractility and relaxation indexes improved similarly in the EX-OVX and UN-OVX-E2 rats compared to UN-OVX. CONCLUSION: Our findings reveal similar beneficial effects between endurance training previously to menopause and estradiol replacement therapy during menopause on cardiac function of rats.


Assuntos
Treino Aeróbico , Condicionamento Físico Animal , Animais , Estradiol/farmacologia , Feminino , Humanos , Ovariectomia , Ratos , Ratos Wistar
18.
Viruses ; 13(2)2021 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-33672226

RESUMO

Intrahost genetic diversity is thought to facilitate arbovirus adaptation to changing environments and hosts, and it might also be linked to viral pathogenesis. Dengue virus serotype 2 (DENV-2) has circulated in Brazil since 1990 and is associated with severe disease and explosive outbreaks. Intending to shed light on the viral determinants for severe dengue pathogenesis, we sought to analyze the DENV-2 intrahost genetic diversity in 68 patient cases clinically classified as dengue fever (n = 31), dengue with warning signs (n = 19), and severe dengue (n = 18). Unlike previous DENV intrahost diversity studies whose approaches employed PCR, here we performed viral whole-genome deep sequencing from clinical samples with an amplicon-free approach, representing the real intrahost diversity scenario. Striking differences were detected in the viral population structure between the three clinical categories, which appear to be driven mainly by different infection times and selection pressures, rather than being linked with the clinical outcome itself. Diversity in the NS2B gene, however, showed to be constrained, irrespective of clinical outcome and infection time. Finally, 385 non-synonymous intrahost single-nucleotide variants located along the viral polyprotein, plus variants located in the untranslated regions, were consistently identified among the samples. Of them, 124 were exclusively or highly detected among cases with warning signs and among severe cases. However, there was no variant that by itself appeared to characterize the cases of greater severity, either due to its low intrahost frequency or the conservative effect on amino acid substitution. Although further studies are necessary to determine their real effect on viral proteins, this heightens the possibility of epistatic interactions. The present analysis represents an initial effort to correlate DENV-2 genetic diversity to its pathogenic potential and thus contribute to understanding the virus's dynamics within its human host.


Assuntos
Vírus da Dengue/genética , Vírus da Dengue/isolamento & purificação , Dengue/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Criança , Pré-Escolar , Dengue/imunologia , Vírus da Dengue/classificação , Vírus da Dengue/fisiologia , Feminino , Variação Genética , Genoma Viral , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Filogenia , Sorogrupo , Proteínas não Estruturais Virais/genética , Adulto Jovem
19.
Life Sci ; 275: 119411, 2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-33774029

RESUMO

AIMS: Menopause is a female condition induced by a reduction of ovarian hormone and is related to an increase in cardiovascular diseases in women. We have shown that severe calorie restriction (SCR) from birth reduces the cardiometabolic risk in adult male Wistar rats. In this study, we investigated the effects of SCR from birth to adulthood on cardiovascular function of ovariectomized rats. MAIN METHODS: From birth to adulthood, rats were daily fed ad libitum (control group - C) or with 50% of the amount consumed by the control group (calorie-restricted group - R). At 90 days, half of the rats in each group underwent bilateral ovariectomy (OVX), totaling 4 groups: C-Sham, C-OVX, R-Sham, R-OVX. Systolic blood pressure (SBP), heart rate (HR) and, double product (DP) index were recorded by tail-cuff plethysmography. Cardiac function was analyzed by the Langendorff technique and cardiomyocyte diameter was accessed by histologic analysis. Additionally, cardiac SERCA2 content and redox status were evaluated. KEY FINDINGS: C-OVX rats exhibited reduced cardiac function and cardiac non-enzymatic total antioxidant capacity (TAC). R-Sham animals showed reduced SBP, DP, HR, improved cardiac function, reduced cardiac protein carbonyl derivatives and increased TAC, catalase, and superoxide dismutase activities. R-OVX rats maintained reduced SBP, DP, HR, and increased contractility and relaxation indexes. R-Sham and R-OVX rats exhibited preserved heart mass and reduced cardiomyocyte diameter. Cardiac SERCA2 content did not differ between the groups. SIGNIFICANCE: Taken together, our findings show cardioprotective effects of SCR from birth in adult ovariectomized rats.


Assuntos
Restrição Calórica , Doenças Cardiovasculares/prevenção & controle , Ovariectomia , Animais , Pressão Sanguínea , Western Blotting , Feminino , Frequência Cardíaca , Oxirredução , Ratos , Ratos Wistar
20.
Metab Brain Dis ; 36(1): 85-95, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33095371

RESUMO

Several animal studies have showed the beneficial effects of physical exercise (PE) on brain function and health. Alzheimer's Disease (AD) is the most common type of dementia, characterized by the presence of aggregated extracellular amyloid-beta (Aß) and neurofibrillary tangles, with progressive cognitive decline. Therapeutic approaches such as PE showed to be effective in halting AD progression. Here, we present a systematic review about PE and AD. The search was carried out using the PubMed and LILACS databases. The following keywords were used: Alzheimer; PE; animal model. All found studies adopted aerobic exercise training as the PE protocol (100%). We identified running on treadmill as the most commonly used PE routine (62.5%). The duration of each session, intensity, frequency, and period of training most used were 60 min/day (62.5%), moderate intensity (87.5%), 5 days/week (62.5%), and 4 (37.5%) or 12 (37.5%) weeks, respectively. The AD animal models most used were the Tg APP/PS1ΔE9 (25%), models based on i.c.v. infusion of AßOs (25%) and streptozotocin (25%). All protocols used rodents to their experiments (100%), but mice were the most common (62.5%). Finally, the main results presented in all studies were capable to reduce significantly AD consequences, such as reducing Aß or pro-inflammatory proteins levels (100%). The lack of resistance training protocols in animal models of AD indicates a huge gap that should be investigated in future studies. We suggest that PE protocols must be adapted according to the specie, lineage and life span of the animal.


Assuntos
Doença de Alzheimer/terapia , Encéfalo/patologia , Condicionamento Físico Animal/fisiologia , Doença de Alzheimer/patologia , Doença de Alzheimer/fisiopatologia , Animais , Encéfalo/fisiopatologia , Modelos Animais de Doenças , Inflamação/patologia , Inflamação/fisiopatologia , Inflamação/terapia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA