RESUMO
OBJECTIVES: The aim of this study was to investigate the longitudinal association of sleep with physical performance in a representative sample of non-institutionalised older adults residing in the municipality of São Paulo, Brazil. STUDY DESIGN: Prospective cohort study. METHODS: The current longitudinal study used data extracted from the Health, Well-being, and Aging Study (Estudo Saúde Bem-Estar e Envelhecimento [SABE]). The study population consisted of individuals aged ≥60 years who participated in the study in 2010 or 2015. Dependent variables included the Short Physical Performance Battery (SPPB) and gait speed. Independent variables of interest were self-reported sleep difficulty, daytime sleepiness and sleep quality. The longitudinal association between sleep variables and the outcomes was evaluated using Generalised Estimating Equations (GEE) Models adjusted for covariates. All the variables, except age, sex and schooling, were assessed at baseline and follow-up visits (2010 and 2015). RESULTS: The analyses included 2205 observations from 1559 individuals. The population mean age was 72 years in 2010 and 71 years in 2015, with a higher prevalence of women in both years. Between 2010 and 2015, there was a decline in the SPPB score and gait speed. Daytime sleepiness was negatively associated with the SPPB score [Coef.: -0.38 (95% confidence interval {CI}: -0.56, -0.21)] and gait speed [Coef.: -0.03 (95% CI: -0.05, -0.01)]. Poor sleep quality was negatively associated with the SPPB score [Coef.: -0.29 (95% CI: -0.57, -0.01)] and gait speed [Coef.: -0.03 (95% CI: -0.06, -0.00)]. CONCLUSIONS: Daytime sleepiness and poor sleep quality are associated with compromised physical performance in non-institutionalised older adults, and this association remained consistent over time.
Assuntos
Desempenho Físico Funcional , Qualidade do Sono , Humanos , Feminino , Masculino , Brasil/epidemiologia , Idoso , Estudos Longitudinais , Estudos Prospectivos , Pessoa de Meia-Idade , Velocidade de Caminhada , Idoso de 80 Anos ou maisRESUMO
Fundamentos: Idosos que vivem na comunidade são propensos a desenvolver fragilidade, considerada como um estado clinicamente identificável que aumenta a vulnerabilidade a resultados adversos e prediz incapacidade e mortalidade na população idosa. Objetivo: Identificar a prevalência e fatores associados à fragilidade em idosos que vivem em uma comunidade. Método: Trata-se de um inquérito domiciliar transversal e analítico, de abordagem quantitativa realizado com 854 idosos que vivem na comunidade. A fragilidade foi mensurada pela Edmonton Frail Scale (EFS). A associação entre fragilidade e variáveis sociodemográficas e de condições clínicas foi mensurada pela análise múltipla por regressão logística. Resultados: A prevalência de fragilidade encontrada neste estudo foi de 12,3% (IC95%: 10,1 a 14,5). O modelo de regressão logística mostrou que as variáveis estatisticamente associadas à fragilidade foram: queda recorrente, uso de dispositivo para auxílio à marcha, polifarmácia, autopercepção ruim de saúde, dependência nas atividades básicas e instrumentais de vida diária. Conclusão: A prevalência de fragilidade em idosos foi baixa em comparação a outros estudos nacionais que empregaram a EFS. Os resultados indicaram múltiplos fatores associados à fragilidade modificáveis. Assim, a investigação da síndrome da fragilidade bem como dos seus fatores relacionados passíveis de prevenção são ações a serem incluídas na prática clínica. (AU)
Foundations: Elderly people living in the community are prone to developing frailty, considered as a clinically identifiable state that increases vulnerability to adverse events and predicts disability and mortality in the elderly population. Objective: To identify the prevalence and factors associated with frailty in the elderly living in the community. Materials and method: This is a cross-sectional and analytical household survey with a quantitative approach conducted with 854 elderly people living in the community. Frailty was measured by Edmonton Frail Scale (EFS). The association between frailty and sociodemographic and clinical condition variables was measured by multiple analysis using logistic regression. Results: The prevalence of frailty found in this study was 12.3% (95% CI: 10.1 to 14.5). The logistic regression model showed that the variables statistically associated with frailty were: recurrent fall, use of walking aids, polypharmacy, poor self-rated health, dependence on basic and instrumental activities of daily living. Conclusion: The prevalence of frailty in the elderly was low compared to other national studies that employed the SAI. Results indicated potentially modifiable factors associated with frailty. Thus, the investigation of frailty syndrome and its related preventable factors are actions to be included in clinical practice. (AU)
Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Atividades Cotidianas , Prevalência , Idoso Fragilizado , Prevenção de Doenças , Vulnerabilidade em Saúde , Fragilidade , Marcha , Instituição de Longa Permanência para Idosos , MétodosRESUMO
OBJECTIVES: This study assessed the moderating role of education on the relationship between multimorbidity and mortality among older adults in Brazil. STUDY DESIGN: This was a cohort study. METHODS: This study used data from 1768 participants of the Health, Well-Being and Ageing Cohort Study (SABE) who were assessed between 2006 and 2015. The Cox Proportional Risks Model was used to evaluate the association between multimorbidity (two or more chronic diseases) and mortality. An interaction term between education and multimorbidity was included to test the moderating role of education in this association. RESULTS: The average follow-up time was 4.5 years, with a total of 589 deaths in the period. Multimorbidity increased the risk of mortality (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.27-1.91), and this association was not moderated by education (HR 1.06, 95% CI 1.00-1.13; P value = 0.07). CONCLUSIONS: The impact of education and multimorbidity on mortality emphasises the need for an integrated approach directed towards the social determinants of health to prevent multimorbidity and its burden among older adults.
Assuntos
Envelhecimento , Multimorbidade , Idoso , Doença Crônica , Estudos de Coortes , Humanos , Modelos de Riscos ProporcionaisRESUMO
Knowledge about the needs of psychiatric patients is essential for mental health care planning. However, research on met and unmet needs is still scarce, particularly in low- and middle-income countries. This study aimed to describe the patients' needs (met and unmet) at least four years after their first psychiatric hospitalization and to verify the role of demographic and clinical features as possible predictors of these needs. Patients who had their first psychiatric admission between January 1, 2006 and December 31, 2007 at an inpatient unit in the city of Ribeirão Preto, Brazil, were eligible to participate in the study. Patients were contacted and face-to-face interviews were conducted by psychologists using the Camberwell Assessment of Need. Data were analyzed using zero-inflated negative binomial regression model. Of 933 eligible patients, 333 were interviewed. The highest level of needs was related to welfare benefits (32.4%, unmet=25.5%), followed by household skills (30.3%, unmet=3.0%), psychotic symptoms (29.4%, unmet=9.0%), psychological distress (27.6%, unmet=8.4%), physical health (24.3%, unmet=5.4%), daytime activities (19.5%, unmet=16.5%), and money (16.8%, unmet=9.0%). Fewer years of schooling, living with relatives, and unemployment at the moment of the first admission were significantly associated with a higher number of both met and unmet needs in the follow-up. Unmet needs were also more often reported by patients living alone. In conclusion, socioeconomic indicators were the best predictors of needs. The unmet needs related to welfare benefits point to the need for specific social and health policies.
Assuntos
Hospitalização , Pacientes Internados , Brasil , Estudos de Coortes , Humanos , Avaliação das NecessidadesAssuntos
Craniofaringioma/diagnóstico por imagem , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Teratoma/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Craniofaringioma/embriologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Ilustração Médica , Nasofaringe/anormalidades , Nasofaringe/diagnóstico por imagem , Nasofaringe/embriologia , Gravidez , Teratoma/embriologiaRESUMO
Melanoma is a type of skin cancer with increasing incidence worldwide and high lethality. Conventional forms of treatment are not effective in advanced cancer stages. Hence, immunotherapeutic approaches have been tested to modulate immune response against tumor cells. Some vaccine models using tumor-associated antigens (TAAs) such as glycoprotein 100 (gp100) have been studied, but their expected effectiveness has not been shown until now. Antigen immunogenicity is a crucial point to improve the immune response, and therefore mutations are inserted in peptide sequences. It is possible to understand the interactions which occur between peptides and immune system molecules through computer simulation, and this is essential in order to guide efficient vaccine models. In this work, we have calculated the interaction binding energies of crystallographic data based on modified gp100 peptides and HLA-A*0201 using density functional theory (DFT) and the molecular fractionation with conjugated caps (MFCC) approach. Our results show the most relevant residue-residue interactions, the impact of three mutations in their binding sites, and the main HLA-A*0201 amino acids for peptide-HLA binding.
Assuntos
Antígeno HLA-A2/metabolismo , Antígeno gp100 de Melanoma/metabolismo , Simulação por Computador , Teoria da Densidade Funcional , Antígeno HLA-A2/química , Humanos , Modelos Químicos , Mutação , Fragmentos de Peptídeos , Ligação Proteica , Termodinâmica , Antígeno gp100 de Melanoma/química , Antígeno gp100 de Melanoma/genéticaRESUMO
Knowledge about the needs of psychiatric patients is essential for mental health care planning. However, research on met and unmet needs is still scarce, particularly in low- and middle-income countries. This study aimed to describe the patients' needs (met and unmet) at least four years after their first psychiatric hospitalization and to verify the role of demographic and clinical features as possible predictors of these needs. Patients who had their first psychiatric admission between January 1, 2006 and December 31, 2007 at an inpatient unit in the city of Ribeirão Preto, Brazil, were eligible to participate in the study. Patients were contacted and face-to-face interviews were conducted by psychologists using the Camberwell Assessment of Need. Data were analyzed using zero-inflated negative binomial regression model. Of 933 eligible patients, 333 were interviewed. The highest level of needs was related to welfare benefits (32.4%, unmet=25.5%), followed by household skills (30.3%, unmet=3.0%), psychotic symptoms (29.4%, unmet=9.0%), psychological distress (27.6%, unmet=8.4%), physical health (24.3%, unmet=5.4%), daytime activities (19.5%, unmet=16.5%), and money (16.8%, unmet=9.0%). Fewer years of schooling, living with relatives, and unemployment at the moment of the first admission were significantly associated with a higher number of both met and unmet needs in the follow-up. Unmet needs were also more often reported by patients living alone. In conclusion, socioeconomic indicators were the best predictors of needs. The unmet needs related to welfare benefits point to the need for specific social and health policies.
Assuntos
Humanos , Hospitalização , Pacientes Internados , Brasil , Estudos de Coortes , Avaliação das NecessidadesRESUMO
OBJECTIVES: The most recent survey conducted by the World Health Organization described Tuberculosis (TB) as one of the top 10 causes of death and the leading cause of death from a single infectious agent. The increasing number of TB-resistant cases has contributed to this scenario. In light of this, new strategies to control and treat the disease are necessary. Our research group has previously described furoxan derivatives as promising scaffolds to be explored as new antitubercular drugs. RESULTS: Two of these furoxan derivatives, (14b) and (14c), demonstrated a high selectivity against Mycobacterium tuberculosis. The compounds (14b) and (14c) were also active against a latent M. tuberculosis strain, with MIC90 values of 6.67 µM and 9.84 µM, respectively; they were also active against monoresistant strains (MIC90 values ranging from 0.61 to 20.42 µM) and clinical MDR strains (MIC90 values ranging from 3.09 to 42.95 µM). Time-kill experiments with compound (14c) showed early bactericidal effects that were superior to those of the first- and second-line anti-tuberculosis drugs currently used in therapy. The safety of compounds (14b) and (14c) was demonstrated by the Ames test because these molecules were not mutagenic under the tested conditions. Finally, we confirmed the safety, and high efficacy of compounds (14b) and (14c), which reduced M. tuberculosis to undetectable levels in a mouse aerosol model of infection. CONCLUSION: Altogether, we have identified two advanced lead compounds, (14b) and (14c), as novel promising candidates for the treatment of TB infection.
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Antituberculosos/uso terapêutico , Oxidiazóis/uso terapêutico , Tuberculose/tratamento farmacológico , Animais , Antituberculosos/farmacologia , Antituberculosos/toxicidade , Bactérias/efeitos dos fármacos , Farmacorresistência Bacteriana , Feminino , Camundongos , Camundongos Endogâmicos BALB C , Testes de Sensibilidade Microbiana , Testes de Mutagenicidade , Mycobacterium tuberculosis/efeitos dos fármacos , Oxidiazóis/farmacologia , Oxidiazóis/toxicidade , Tuberculose/microbiologiaRESUMO
PURPOSE: Meningiomas are common brain tumors, the majority of which are considered benign. Despite surgery and/or radiation therapy, recurrence rates are approximately 8-10%. One likely cause is the dysregulation of cyclin D-cyclin-dependent kinases 4 and 6 (CDK4/6)-retinoblastoma (Rb) pathway, which controls the cell cycle restriction point. This pathway is commonly dysregulated in anaplastic meningioma cell lines (AM) and radiation-induced meningioma cells (RIM), making it a rational target for anti-meningioma therapy. In this study, we investigate the effect of a CDK4/6 inhibitor, palbociclib, with radiation in relevant pre-clinical models. METHODS: In vitro cell culture, ex vivo slice culture and in vivo cell line-derived orthotopic xenograft animal models of AM/RIM were utilized to assess treatment efficacy with palbociclib plus radiation. Treatment effects were examined by immunoblot, cell viability, apoptosis, and cell cycle progression. RESULTS: The in vitro and ex vivo studies demonstrate that palbociclib plus radiation treatment reduced proliferation and has additional effects on cell cycling, including induction of an RB-associated G (1) arrest in Rb+ AM and RIM cells, but not in Rb- cells. Our results also demonstrated reduced CDK4 and CDK6 expression as well as reduced E2F target gene expression (CCNA2 and CCNE2) with the combination therapy. MRI results in vivo demonstrated reduced tumor size at 5 weeks when treated with 14 days palbociclib (10 mg/kg) plus 6 Gy radiation compared to saline-treated tumors. Finally, no hepatic toxicity was found after treatments. CONCLUSION: A pre-clinical murine model provides preclinical evidence for use of palbociclib plus radiation as a therapeutic agent for Rb+ meningiomas.
Assuntos
Antineoplásicos/uso terapêutico , Neoplasias Meníngeas/terapia , Meningioma/terapia , Neoplasias Induzidas por Radiação/terapia , Piperazinas/uso terapêutico , Piridinas/uso terapêutico , Animais , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Terapia Combinada , Quinase 4 Dependente de Ciclina/antagonistas & inibidores , Quinase 6 Dependente de Ciclina/antagonistas & inibidores , Humanos , Masculino , Camundongos , Proteína do Retinoblastoma/metabolismoRESUMO
PURPOSE: N-myc downstream-regulated gene 2 (NDRG2) is down-regulated in grade-III meningioma [anaplastic meningioma (AM)] and associated with clinically aggressive behavior. Current therapies in the treatment of high-grade meningioma are lacking with limited success. This study aims to validate the effect of NDRG2-targeted therapy using structurally related bioactive triterpene compounds derived from the edible mushroom Ganoderma lucidum (ganoderic acid A:GA-A/ganoderic acid DM:GA-DM) in human AM in relevant pre-clinical models. METHODS: Tissue samples from the AM tumor regions of three human patients and control non-tumor samples were used to analyze the expression pattern of NDRG2. In vitro cell culture and in vivo cell-line-derived orthotopic xenograft animal models of AM were utilized to assess efficacy of treatment with GA-A/DM. RESULTS: Downregulation of NDRG2 expression was observed in surgically resected high-grade meningiomas compared to normal brain. These results prompt us to use NDRG2-targeting agents GA-A/DM. In vitro results showed that 72-h treatments of 25 µM GA-A/DM induced AM cell death, upregulate NDRG2 protein expression, downregulate NDRG2 promoter methylation in meningioma cells as compared to azacitidine and decitabine, the most commonly used demethylating agents. Our results also demonstrated that GA-A/DM does not have any detrimental effect on normal human neurons and arachnoid cells. GA-A/DM promoted apoptotic factors (Bax) while suppressing MMP-9, p-P13K, p-AKT, p-mTOR, and Wnt-2 protein expression. RNAi-mediated knockdown of NDRG2 protein expression increased tumor proliferation, while forced expression of wt-NDRG2 decreased proliferation in an in vitro model. Magnetic resonance (MR) imaging and Hematoxylin (H&E) staining demonstrated gross reduction of tumor volume in GA-A/DM treated mice at 5 weeks when compared with saline-treated orthotopic AM xenografted controls. There was an overall decrease in tumor cell proliferation with increased survival in GA-A/DM-treated animals. Enzyme assays showed that GA-A/DM did not negatively impact hepatic function. CONCLUSION: GA-A/DM may be a promising natural therapeutic reagent in the treatment of AM by suppressing growth via NDRG2 modulation and altering of intracellular signal pathways. We have shown it could potentially be an effective treatment for AM with decreased cellular proliferation in vitro, decreased tumor volume and increased survival in vivo.
Assuntos
Ácidos Heptanoicos/farmacologia , Lanosterol/análogos & derivados , Neoplasias Meníngeas/metabolismo , Meningioma/metabolismo , Triterpenos/farmacologia , Proteínas Supressoras de Tumor/efeitos dos fármacos , Idoso , Anaplasia , Animais , Antimetabólitos Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Azacitidina/farmacologia , Morte Celular/efeitos dos fármacos , Metilação de DNA/efeitos dos fármacos , Decitabina/farmacologia , Regulação para Baixo , Técnicas de Silenciamento de Genes , Humanos , Técnicas In Vitro , Lanosterol/farmacologia , Metaloproteinase 9 da Matriz/efeitos dos fármacos , Metaloproteinase 9 da Matriz/metabolismo , Neoplasias Meníngeas/patologia , Meningioma/patologia , Camundongos , Camundongos SCID , Pessoa de Meia-Idade , Terapia de Alvo Molecular , Gradação de Tumores , Fosfatidilinositol 3-Quinases/efeitos dos fármacos , Fosfatidilinositol 3-Quinases/metabolismo , Fosforilação , Regiões Promotoras Genéticas , Proteínas Proto-Oncogênicas c-akt/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-akt/metabolismo , Serina-Treonina Quinases TOR/efeitos dos fármacos , Serina-Treonina Quinases TOR/metabolismo , Proteínas Supressoras de Tumor/metabolismo , Proteína Wnt2/efeitos dos fármacos , Proteína Wnt2/metabolismo , Ensaios Antitumorais Modelo de Xenoenxerto , Proteína X Associada a bcl-2/efeitos dos fármacos , Proteína X Associada a bcl-2/metabolismoRESUMO
BACKGROUND: While the genetic contribution to obesity is well established, few studies have examined how genetic variants influence standardized body mass index Z-score (BMIz) in Hispanics/Latinos, especially across childhood and adolescence. OBJECTIVES: We estimated the effect of established BMIz loci in Chilean children of the Santiago Longitudinal Study (SLS). METHODS: We examined associations with BMIz at age 10 for 15 loci previously identified in European children. For significant loci, we performed association analyses at ages 5 and 16 years, for which we have smaller sample sizes. We tested associations of unweighted genetic risk scores (GRSs) for previously identified tag variants (GRS_EUR) and from the most significant variants in SLS at each locus (GRS_SLS). RESULTS: We generalized five variants at age 10 (P < 0.05 and directionally consistent), including rs543874 that reached Bonferroni-corrected significance. The effect on BMIz was greatest at age 10 for all significant loci, except FTO, which exhibited an increase in effect from ages 5 to 16. Both GRSs were associated with BMIz (P < 0.0001), but GRS_SLS explained a much greater proportion of the variation (13.63%). CONCLUSION: Our results underscore the importance of conducting genetic investigations across life stages and selecting ancestry appropriate tag variants in future studies for disease prediction and clinical evaluation.
Assuntos
Índice de Massa Corporal , Obesidade Infantil/genética , Adolescente , Criança , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Chile , Estudos de Coortes , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Estudos Longitudinais , Masculino , Polimorfismo de Nucleotídeo Único , Fatores de RiscoRESUMO
BACKGROUND/OBJECTIVE: There is little epidemiological evidence demonstrating that dynapenic abdominal obesity has higher mortality risk than dynapenia and abdominal obesity alone. Our main aim was to investigate whether dynapenia combined with abdominal obesity increases mortality risk among English and Brazilian older adults over ten-year follow-up. DESIGN: Cohort study. SETTING: United Kingdom and Brazil. PARTICIPANTS: Data came from 4,683 individuals from the English Longitudinal Study of Ageing (ELSA) and 1,490 from the Brazilian Health, Well-being and Aging study (SABE), hence the final sample of this study was 6,173 older adults. MEASUREMENTS: The study population was categorized into the following groups: non-dynapenic/non-abdominal obese, abdominal obese, dynapenic, and dynapenic abdominal obese according to their handgrip strength (< 26 kg for men and < 16 kg for women) and waist circumference (> 102 cm for men and > 88 cm for women). The outcome was all-cause mortality over a ten-year follow-up. Adjusted hazard ratios by sociodemographic, behavioural and clinical characteristics were estimated using Cox proportional hazards models. RESULTS: The fully adjusted model showed that dynapenic abdominal obesity has a higher mortality risk among the groups. The hazard ratios (HR) were 1.37 for dynapenic abdominal obesity (95% CI = 1.12 - 1.68), 1.15 for abdominal obesity (95% CI = 0.98 - 1.35), and 1.23 for dynapenia (95% CI = 1.04 - 1.45). CONCLUSIONS: Dynapenia is an important risk factor for mortality but dynapenic abdominal obesity has the highest mortality risk among English and Brazilian older adults.
Assuntos
Obesidade Abdominal/complicações , Circunferência da Cintura/fisiologia , Idoso , Envelhecimento , Brasil , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Obesidade Abdominal/mortalidade , Obesidade Abdominal/patologia , Fatores de Risco , Análise de Sobrevida , Reino UnidoRESUMO
Recent evidence suggests that cell-derived circulating miRNAs may serve as biomarkers of cardiovascular diseases. However, a few studies have investigated the potential of circulating miRNAs as biomarkers for left ventricular hypertrophy (LVH). In this study, we aimed to characterize the miRNA profiles that could distinguish hypertensive patients with LHV, hypertensive patients without LVH and control subjects, and identify potential miRNAs as biomarkers of LVH. LVH was defined by left ventricular mass indexed to body surface area >125 g/m2 in men and >110 g/m2 in women and patients were classified as hypertensive when presenting a systolic blood pressure of 140 mmHg or more, or a diastolic blood pressure of 90 mmHg or more. We employed miRNA PCR array to screen serum miRNAs profiles of patients with LVH, essential hypertension and healthy subjects. We identified 75 differentially expressed miRNAs, including 49 upregulated miRNAs and 26 downregulated miRNAs between LVH and control patients. We chose 2 miRNAs with significant differences for further testing in 59 patients. RT-PCR analysis of serum samples confirmed that miR-7-5p and miR-26b-5p were upregulated in the serum of LVH hypertensive patients compared with healthy subjects. Our findings suggest that these miRNAs may play a role in the pathogenesis of hypertensive LVH and may represent novel biomarkers for this disease.
Assuntos
Perfilação da Expressão Gênica/métodos , Hipertensão/sangue , Hipertrofia Ventricular Esquerda/sangue , MicroRNAs/sangue , Adulto , Idoso , Análise de Variância , Biomarcadores/sangue , Estudos de Casos e Controles , Regulação para Baixo , Feminino , Humanos , Hipertensão/genética , Hipertrofia Ventricular Esquerda/genética , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reação em Cadeia da Polimerase em Tempo Real , Padrões de Referência , Valores de Referência , Fatores de Risco , Regulação para CimaRESUMO
We consider interacting electrons moving in a nonlinear Morse lattice. We set the initial conditions as follows: electrons were initially localized at the center of the chain and a solitonic deformation was produced by an impulse excitation on the center of the chain. By solving quantum and classical equations for this system numerically, we found that a fraction of electronic wave function was trapped by the solitonic excitation, and trapping specificities depend on the degree of interaction among electrons. Also, there is evidence that the effective electron velocity depends on Coulomb interaction and electron-phonon coupling in a nontrivial way. This association is explained in detail along this work. In addition, we briefly discuss the dependence of our results with the type of initial condition we choose for the electrons and lattice.
RESUMO
BACKGROUND: Pain is a stressful experience that can have a negative impact on child development. The aim of this crossover study was to examine the efficacy of audiovisual distraction for acute pain relief in paediatric inpatients. METHOD: The sample comprised 40 inpatients (6-11 years) who underwent painful puncture procedures. The participants were randomized into two groups, and all children received the intervention and served as their own controls. Stress and pain-catastrophizing assessments were initially performed using the Child Stress Scale and Pain Catastrophizing Scale for Children, with the aim of controlling these variables. The pain assessment was performed using a Visual Analog Scale and the Faces Pain Scale-Revised after the painful procedures. Group 1 received audiovisual distraction before and during the puncture procedure, which was performed again without intervention on another day. The procedure was reversed in Group 2. Audiovisual distraction used animated short films. A 2 × 2 × 2 analysis of variance for 2 × 2 crossover study was performed, with a 5% level of statistical significance. RESULTS: The two groups had similar baseline measures of stress and pain catastrophizing. A significant difference was found between periods with and without distraction in both groups, in which scores on both pain scales were lower during distraction compared with no intervention. The sequence of exposure to the distraction intervention in both groups and first versus second painful procedure during which the distraction was performed also significantly influenced the efficacy of the distraction intervention. CONCLUSION: Audiovisual distraction effectively reduced the intensity of pain perception in paediatric inpatients. SIGNIFICANCE: The crossover study design provides a better understanding of the power effects of distraction for acute pain management. Audiovisual distraction was a powerful and effective non-pharmacological intervention for pain relief in paediatric inpatients. The effects were detected in subsequent acute painful procedures.
Assuntos
Dor Aguda/prevenção & controle , Manejo da Dor/métodos , Dor Processual/prevenção & controle , Dor Aguda/diagnóstico , Dor Aguda/psicologia , Atenção , Catastrofização , Criança , Estudos Cross-Over , Feminino , Hospitalização , Humanos , Masculino , Medição da Dor , Dor Processual/diagnóstico , Dor Processual/psicologia , FlebotomiaRESUMO
Studies conducted in monozygotic and dizygotic twins have established a strong genetic component in eating behavior. Rare mutations and common variants of the melanocortin 4 receptor (MC4R) gene have been linked to obesity and eating behavior scores. However, few studies have assessed common variants in MC4R gene with the rewarding value of food in children. The objective of the study was to evaluate the association between the MC4R rs17782313 polymorphism with homeostatic and non-homeostatic eating behavior patterns in Chileans children. This is a cross-sectional study in 258 Chilean children (44 % female, 8-14 years old) showing a wide variation in BMI. Anthropometric measurements (weight, height, Z-score of BMI and waist circumference) were performed by standard procedures. Eating behavior was assessed using the Eating in Absence of Hunger Questionnaire (EAHQ), the Child Eating Behavior Questionnaire (CEBQ), the Three-Factor Eating Questionnaire (TFEQ), and the Food Reinforcement Value Questionnaire (FRVQ). Genotype of the rs17782313 nearby MC4R was determined by a Taqman assay. Association of the rs17782313 C allele with eating behavior was assessed using non-parametric tests. We found that children carrying the CC genotype have higher scores of food responsiveness (p value = 0.02). In obese girls, carriers of the C allele showed lower scores of satiety responsiveness (p value = 0.02) and higher scores of uncontrolled eating (p value = 0.01). Obese boys carrying the C allele showed lower rewarding value of food in relation to non-carriers. The rs17782313 C allele is associated with eating behavior traits that may predispose obese children to increased energy intake and obesity.
Assuntos
Regiões 3' não Traduzidas , Predisposição Genética para Doença , Hiperfagia/genética , Sobrepeso/etiologia , Obesidade Infantil/etiologia , Polimorfismo Genético , Receptor Tipo 4 de Melanocortina/genética , Adolescente , Alelos , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Chile , Estudos Transversais , Comportamento Alimentar , Feminino , Estudos de Associação Genética , Humanos , Hiperfagia/metabolismo , Hiperfagia/fisiopatologia , Masculino , Receptor Tipo 4 de Melanocortina/metabolismo , Reforço Psicológico , Recompensa , Circunferência da CinturaRESUMO
High circulating nonesterified fatty acids (NEFAs) concentration, often reported in diabetes, leads to impaired glucose-stimulated insulin secretion (GSIS) through not yet well-defined mechanisms. Serotonin and dopamine might contribute to NEFA-dependent ß-cell dysfunction, since extracellular signal of these monoamines decreases GSIS. Moreover, palmitate-treated ß-cells may enhance the expression of the serotonin receptor Htr2c, affecting insulin secretion. Additionally, the expression of monoamine-oxidase type B (Maob) seems to be lower in islets from humans and mice with diabetes compared to nondiabetic islets, which may lead to increased monoamine concentrations. We assessed the expression of serotonin- and dopamine-related genes in islets from db/db and wild-type (WT) mice. In addition, the effect of palmitate and oleate on the expression of such genes, 5HT content, and GSIS in MIN6 ß-cell was determined. Lower Maob expression was found in islets from db/db versus WT mice and in MIN6 ß-cells in response to palmitate and oleate treatment compared to vehicle. Reduced 5HT content and impaired GSIS in response to palmitate (-25%; p < 0.0001) and oleate (-43%; p < 0.0001) were detected in MIN6 ß-cells. In conclusion, known defects of GSIS in islets from db/db mice and MIN6 ß-cells treated with NEFAs are accompanied by reduced Maob expression and reduced 5HT content.
Assuntos
Células Secretoras de Insulina/efeitos dos fármacos , Ilhotas Pancreáticas/metabolismo , Transcriptoma/genética , Acetilserotonina O-Metiltransferasa/efeitos dos fármacos , Acetilserotonina O-Metiltransferasa/genética , Animais , Arilalquilamina N-Acetiltransferase/efeitos dos fármacos , Arilalquilamina N-Acetiltransferase/genética , Catecol O-Metiltransferase/efeitos dos fármacos , Catecol O-Metiltransferase/genética , Linhagem Celular , Dopa Descarboxilase/efeitos dos fármacos , Dopa Descarboxilase/genética , Proteínas da Membrana Plasmática de Transporte de Dopamina/efeitos dos fármacos , Proteínas da Membrana Plasmática de Transporte de Dopamina/genética , Dopamina beta-Hidroxilase/efeitos dos fármacos , Dopamina beta-Hidroxilase/genética , Insulina/metabolismo , Secreção de Insulina , Células Secretoras de Insulina/metabolismo , Camundongos , Monoaminoxidase/efeitos dos fármacos , Monoaminoxidase/genética , Ácido Oleico/farmacologia , Ácido Palmítico/farmacologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Serotonina/metabolismo , Proteínas da Membrana Plasmática de Transporte de Serotonina/efeitos dos fármacos , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética , Transcriptoma/efeitos dos fármacos , Triptofano Hidroxilase/efeitos dos fármacos , Triptofano Hidroxilase/genética , Tirosina 3-Mono-Oxigenase/efeitos dos fármacos , Tirosina 3-Mono-Oxigenase/genéticaRESUMO
BACKGROUND/OBJECTIVE: In Chile, approximately one in three children under 6 years of age reported overweight/obese, while one in four children in elementary school suffer from obesity. There is a paucity of population-based information on the influence of childhood eating behavior on anthropometric measures related to obesity. To assess the association between eating behavior scores and Body Mass Index (BMI) z-scores in 7-10-year-old Chilean children. SUBJECTS/METHODS: We conducted a cross-sectional study in 1058 children aged 7-10 (51% girls) from the 'Growth and Obesity Chilean Cohort Study' (GOCS). Direct measures of weight and height were used to compute BMI z-scores according to World Health Organization (WHO) curves. Children were classified as normal weight (-1<1 s.d.), overweight (1<2 s.d.) and obese (⩾2 s.d.). Eating behavior scores were measured through the Child Eating Behavior Questionnaire (CEBQ), previously adapted and validated for Chilean children. Multiple linear regressions were carried out using BMI z-score as the outcome and eating behavior scores as explanatory variables. All models were adjusted by age and gender. RESULTS: BMI z-scores were positively associated with pro-intake scores in the subscales 'enjoyment of food', 'emotional overeating' and 'food responsiveness' (P<0.0001). Contrary to other studies, 'desire for drinks' scores were also associated with BMI z-scores (P<0.0001). In contrast, food-avoidant 'satiety responsiveness', 'slowness in eating' and 'food-fussiness' scores were negatively associated with BMI z-scores (P<0.0001). CONCLUSION: We found a significant relationship between eating behavior scores and BMI z-scores in Chilean children, showing that BMI in 7-10-year-old Chilean children is positively associated with pro-intake eating behavior scores and negatively associated with anti-intake eating behavior scores. The identification of specific eating behaviors patterns related to obesity will provide important information for the implementation of prevention programs for this disease.