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INTRODUCTION: Although a well-established component of bone metabolism, the efficacy and safety of vitamin D supplementation for the prevention of fractures in elderly healthy individuals is still unclear. PURPOSE: To perform a meta-analysis comparing vitamin D supplementation with placebo and its contributions on fracture incidence. METHODS: This meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO), under protocol CRD42023484979. We systematically searched PubMed, Embase, and Cochrane Central databases from inception to November 2023 for randomized controlled trials (RCTs) comparing vitamin D supplementation versus placebo in individuals with 60 years of age or more and without bone related medical conditions such as cancer and osteoporosis. RESULTS: Seven RCTs with 71,899 patients were included, of whom 36,822 (51.2%) were women. There was no significant difference in total fracture incidence (RR 1.03; 95% CI 0.93-1.14; p = 0.56; I2 = 58%) between groups or subgroups. However, women had an increased risk for hip fractures (164 vs. 121 events; RR 1.34; 95% CI 1.06-1.70; p = 0.01; I2 = 0%). There was no significant difference in non-vertebral fractures, osteoporotic fractures development, or falls (RR 1.02; 95% CI 0.94-1.12; p = 0.6; I2 = 47%; RR 0.97; 95% CI 0.87-1.08; p = 0.63; I2 = 0%; RR 1.01; 95% CI 0.97-1.04; p = 0.66; I2 = 55%, respectively). CONCLUSION: Vitamin D supplementation does not reduce the total fracture development rate in the elderly healthy population, and it may increase the incidence of hip fractures among elderly healthy women. This finding suggests refraining from prescribing high intermittent doses of vitamin D, without calcium, to individuals aged 60 or older with unknown vitamin D serum concentration or osteoporosis status and inadequate calcium intake.
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The present study aimed to assess the effectiveness and functional adverse effects of a single and multiple injections of botulinum toxin A (BoNT-A) for masseter hypertrophy (MH). Twenty-six women complaining about lower third facial enlargement due to MH, received 75 U of BoNT-A (abobotulinum toxin) in each masseter muscles. After 3 months, patients were randomly assigned to receive a second treatment session of Saline Solution: (G1; n = 11) or BoNT-A: (G2; n = 12). Muscle thickness (ultrasound), electrical activity (electromyography; EMG), masticatory performance, and subjective perception of MH were evaluated. Follow-up was performed at 1, 3 and 6 months. Muscle thickness, EMG activity, and masticatory performance were analyzed using ANOVA two-way and Sidak test as post-hoc. Masticatory performance was analyzed by the Friedman's test and Mann-Whitney test. Regarding inter-groups comparisons, there was a significant decrease in the left masseter muscle thickness in the G2 group at the 6 month follow-up (p < 0.02). For EMG, significant differences were evident at the 6 month assessment, with higher masseter activity for G1 (p < 0.05). For masticatory performance, no significant differences were observed throughout the study (p > 0.05) and a higher improvement in subjective perception of MH was observed in the 1 month follow-up for G2 (p < 0.05). In conclusion, BoNT-A is effective for MH, however multiple injections cause functional adverse effects in masseter muscle.
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Toxinas Botulínicas Tipo A , Eletromiografia , Hipertrofia , Músculo Masseter , Humanos , Músculo Masseter/efeitos dos fármacos , Músculo Masseter/patologia , Músculo Masseter/anormalidades , Feminino , Hipertrofia/tratamento farmacológico , Toxinas Botulínicas Tipo A/administração & dosagem , Toxinas Botulínicas Tipo A/uso terapêutico , Toxinas Botulínicas Tipo A/efeitos adversos , Adulto , Mastigação/efeitos dos fármacos , Pessoa de Meia-Idade , Resultado do Tratamento , Fármacos Neuromusculares/uso terapêutico , Fármacos Neuromusculares/administração & dosagem , Injeções IntramuscularesRESUMO
This study introduces further insights from the hit-to-lead optimization process involving a series of benzimidazole derivatives acting as inhibitors of the cruzain enzyme, which targets Trypanosoma cruzi, the causative parasite of Chagas disease. Here, we present the design, synthesis and biological evaluation of 30 new compounds as a third generation of benzimidazole analogues with trypanocidal activity, aiming to enhance our understanding of their pharmacokinetic profiles and establish a structure-metabolism relationships within the series. The design of these new analogues was guided by the analysis of previous pharmacokinetic results, considering identified metabolic sites and biotransformation studies. This optimization resulted in the discovery of two compounds (42 e and 49 b) exhibiting enhanced metabolic stability, anti-Trypanosoma cruzi activity compared to benznidazole (the reference drug for Chagas disease), as well as being non-cruzain inhibitors, and demonstrating a satisfactory inâ vitro pharmacokinetic profile. These findings unveil a new subclass of aminobenzimidazole and rigid compounds, which offer potential for further exploration in the quest for discovering novel classes of antichagasic compounds.
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Benzimidazóis , Doença de Chagas , Tripanossomicidas , Trypanosoma cruzi , Trypanosoma cruzi/efeitos dos fármacos , Benzimidazóis/química , Benzimidazóis/farmacologia , Benzimidazóis/síntese química , Relação Estrutura-Atividade , Tripanossomicidas/farmacologia , Tripanossomicidas/química , Tripanossomicidas/síntese química , Doença de Chagas/tratamento farmacológico , Estrutura Molecular , Testes de Sensibilidade Parasitária , Humanos , Animais , Relação Dose-Resposta a DrogaRESUMO
Background: Resistance training with instability (REI) emerged as a promising training modality for older adults aiming to counteract age-related changes. Objectives: We compared the effects of 12 weeks of REI and traditional resistance exercise (RE) on muscle strength in older adults with cognitive impairment. We further explored if total training volume (TTV) significantly differs among training groups. Methods: This is a secondary analysis of the REI study. Participants were randomly assigned to REI (n=22) or RE (n=23). RE protocol involved moderate-intensity, free-weight, and machines-based resistance exercises (3 sets, 10-15 repetitions). REI received a similar training protocol, in which exercises were simultaneously performed with instability/unstable devices (e.g., squat exercise under a foam pad or Bosu® ball). Maximal isometric strength and isokinetic parameters were assessed at baseline and after completion of a 12-week intervention through a hydraulic handgrip and isokinetic dynamometer, respectively. TTV (sets × repetitions × load) was computed based on external training load over the 12 weeks. Results: No differences were observed between groups (p=.35) after the intervention. Over 12 weeks, REI and RE improved isometric handgrip strength (p<.001) and isokinetic performance (p=.04). We also did not find differences in the TTV between training groups (p=.28). Conclusion: We demonstrated that both REI and RE training induced similar gains in muscle strength. Combining unstable surfaces/instability devices did not hamper TTV, which may have clinical applications in the context of exercise for older adults.
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BACKGROUND: This study aimed to elucidate the effects of botulinum toxin A (BoNT-A) treatment for patients diagnosed with masseter hypertrophy on the temporalis muscle, with a particular focus on assessing alterations in muscle thickness, electromyographic (EMG) activity, and the development of muscle pain. METHODS: The present randomized triple-blinded clinical trial enrolled 26 female participants aged between 25 and 50 years complaining about masseter hypertrophy. Participants received 75U of BoNT-A (abobotulinumtoxinA) in both masseter muscles and after three months were randomized to receive a second treatment session of saline solution (S-BoNT-A) or BoNT-A (M-BoNT-A). Longitudinal assessments included temporalis muscle thickness through ultrasound, EMG activity, subjective pain, and masseter prominence severity after one, three, and six months of the first injection session. Muscle thickness, EMG, and subjective pain were analysed using two-way ANOVA with repeated measures and post hoc Sidak test, and for masseter prominence severity, Friedman and Mann-Whitney tests were used. RESULTS: Regarding inter-group comparisons, a higher muscle thickness (p < 0.02) and a higher EMG activity (p < 0.01) were found in the M-BoNT-A group at the 6-month follow-up. For subjective pain assessments, inter-group comparisons showed a higher prevalence of painful regions in M-BoNT-A group at the 6-month follow-up (p < 0.02). No significant differences were found in masseter prominence severity at the 6 months assessment between groups. CONCLUSION: BoNT-A treatment for masseter hypertrophy lead to structural and functional changes in the temporalis muscle, presenting higher changes after multiple injections of this treatment. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Ochratoxin A (OTA) is a toxin produced by several Aspergillus species, mainly those belonging to section Circumdati and section Nigri. The presence of OTA in cheese has been reported recently in cave cheese in Italy. As artisanal cheese production in Brazil has increased, the aim of this study was to investigate the presence of ochratoxin A and related fungi in artisanal cheese consumed in Brazil. A total of 130 samples of artisanal cheeses with natural moldy rind at different periods of maturation were collected. Of this total, 79 samples were collected from 6 producers from Canastra region in the state of Minas Gerais, since this is the largest artisanal cheese producer region; 13 samples from one producer in the Amparo region in the state of São Paulo and 36 samples from markets located in these 2 states. Aspergillus section Circumdati occurred in samples of three producers and some samples from the markets. A. section Circumdati colony counts varied from 102 to 106 CFU/g. Molecular analysis revealed Aspergillus westerdijkiae (67 %) as the most frequent species, followed by Aspergillus ostianus (22 %), and Aspergillus steynii (11 %). All of these isolates of A. section Circumdati were able to produce OTA in Yeast Extract Sucrose Agar (YESA) at 25 °C/7 days. OTA was found in 22 % of the artisanal cheese samples, ranging from 1.0 to above 1000 µg/kg, but only five samples had OTA higher than 1000 µg/kg. These findings emphasize the significance of ongoing monitoring and quality control in the artisanal cheese production process to minimize potential health risks linked to OTA contamination.
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Aspergillus , Queijo , Contaminação de Alimentos , Microbiologia de Alimentos , Ocratoxinas , Ocratoxinas/biossíntese , Ocratoxinas/análise , Queijo/microbiologia , Queijo/análise , Brasil , Aspergillus/metabolismo , Contaminação de Alimentos/análise , Contagem de Colônia MicrobianaRESUMO
Introduction: Glycemia is an important factor among critically ill patients in the intensive care unit (ICU). There is conflicting evidence on the preferred strategy of blood glucose control among patients with diabetes in the ICU. We aimed to conduct a meta-analysis comparing tight with liberal blood glucose in critically ill patients with diabetes in the ICU. Methods: We systematically searched PubMed, Embase, and Cochrane Central for randomized controlled trials (RCTs) comparing tight versus liberal blood glucose control in critically ill patients with diabetes from inception to December 2023. We pooled odds-ratios (OR) and 95% confidence intervals (CI) with a random-effects model for binary endpoints. We used the Review Manager 5.17 and R version 4.3.2 for statistical analyses. Risk of bias assessment was performed with the Cochrane tool for randomized trials (RoB2). Results: Eight RCTs with 4474 patients were included. There was no statistically significant difference in all-cause mortality (OR 1.11; 95% CI 0.95-1.28; P = .18; I² = 0%) between a tight and liberal blood glucose control. RoB2 identified all studies at low risk of bias and funnel plot suggested no evidence of publication bias. Conclusion: In patients with diabetes in the ICU, there was no statistically significant difference in all-cause mortality between a tight and liberal blood glucose control. PROSPERO registration: CRD42023485032.
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INTRODUCTION: Benznidazole, the drug of choice for treating Chagas Disease (CD), has significant limitations, such as poor cure efficacy, mainly in the chronic phase of CD, association with side effects, and parasite resistance. Understanding parasite resistance to benznidazole is crucial for developing new drugs to treat CD. AREAS COVERED: Here, the authors review the current understanding of the molecular basis of benznidazole resistance. Furthermore, they discuss the state-of-the-art methods and critical outcomes employed to evaluate the efficacy of potential drugs against T. cruzi, aiming to select better compounds likely to succeed in the clinic. Finally, the authors describe the different strategies employed to overcome resistance to benznidazole and find effective new treatments for CD. EXPERT OPINION: Resistance to benznidazole is a complex phenomenon that occurs naturally among T. cruzi strains. The combination of compounds that inhibit different metabolic pathways of the parasite is an important strategy for developing a new chemotherapeutic protocol.
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Doença de Chagas , Descoberta de Drogas , Resistência a Medicamentos , Nitroimidazóis , Tripanossomicidas , Trypanosoma cruzi , Trypanosoma cruzi/efeitos dos fármacos , Nitroimidazóis/farmacologia , Doença de Chagas/tratamento farmacológico , Doença de Chagas/parasitologia , Tripanossomicidas/farmacologia , Humanos , Animais , Descoberta de Drogas/métodos , Desenvolvimento de MedicamentosRESUMO
Bacterial meningitis is still a significant public health concern, with high morbidity and mortality rates. Despite this, it is still a rare event that requires the bacterial invasion of the meninges. However, some predisposing factors can trigger recurrent episodes of meningitis. This study is aimed at determining the clinical characteristics and the molecular epidemiology of episodes of recurrent community-acquired meningitis with and without predisposing factors. For this purpose, we performed a retrospective study of our laboratory database during the period of 2010 to 2020. Additionally, using molecular tools developed in our previous works, the epidemiology of the pathogens causing these episodes was analyzed using cerebrospinal fluid samples, especially in the absence of isolated strains. We observed a total of 1,779 meningitis cases and 230 were caused by Streptococcus pneumoniae. Of those, 16 were recurrent meningitis episodes (16/1,779; 0.9%) from seven patients. Pneumococcus was the main agent responsible in these recurrent episodes and only two episodes were caused by Haemophilus influenzae. The mean age of these patients was 20 years old and three had predisposing factors which could have led to contracting meningitis. The samples presented different pneumococcal serotypes. Most of them were non-vaccine-covered serotypes and antibiotic susceptible strains. Therefore, it was demonstrated how the practical employment of molecular tools, developed for research, when applied in the routine of diagnosis, can provide important information for epidemiological surveillance. Furthermore, it was shown how pneumococcus was the leading cause of recurrent community-acquired meningitis without predisposing factors, suggesting that pneumococcal vaccination may be necessary, even in those groups of individuals considered to be less susceptible.
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Infecções Comunitárias Adquiridas , Meningite Pneumocócica , Recidiva , Streptococcus pneumoniae , Humanos , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/epidemiologia , Meningite Pneumocócica/epidemiologia , Meningite Pneumocócica/microbiologia , Adulto , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/isolamento & purificação , Streptococcus pneumoniae/classificação , Estudos Retrospectivos , Feminino , Masculino , Adulto Jovem , Pessoa de Meia-Idade , Adolescente , Fatores de Risco , Sorogrupo , Antibacterianos , Haemophilus influenzae/genética , Haemophilus influenzae/isolamento & purificação , Haemophilus influenzae/classificaçãoRESUMO
BACKGROUND: Awake Bruxism (AB) management includes cognitive and behavioural changes. Digital and analogic tools can be used to remind the individual to control/avoid AB behaviours. However, no study addressed both tools together. OBJECTIVE: To compare the efficacy of the combination of digital (smartphone application) and analogic (adhesive reminders) tools versus digital tool alone for AB management. METHODS: Seventy-two individuals diagnosed with probable AB were divided into 3 groups: Group 1 (n = 24), used both digital and analogic tools during 30 days; Group 2 (n = 24), used only a digital tool during 30 days and Group 3 (n = 24), used only a digital tool for the first 15 days and then added the analogic tool for 15 days. The AB frequency was measured in real-time with a smartphone app, which sent alerts asking the individuals if they were doing any AB behaviours (bracing, teeth contact, clenching or grinding). Groups were compared using one-way ANOVA and before-after adding an analogic tool (group 3) by paired t-test, considering α = 0.05. RESULTS: All groups showed a decrease in AB behaviours at the end of the evaluation period. Group 1 (digital and analogic tools) showed the lowest average of AB behaviours among all groups; however, statistically significant differences were found only for the comparison between groups 1 and 2. In group 3, a significantly greater reduction in AB behaviours was found after combining both approaches. CONCLUSION: The combination of digital and analogic tools showed the greatest reduction of AB frequency and can be recommended for AB control.
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Bruxismo , Aplicativos Móveis , Smartphone , Humanos , Feminino , Masculino , Bruxismo/terapia , Adulto , Adulto Jovem , Resultado do Tratamento , Vigília/fisiologia , Pessoa de Meia-IdadeRESUMO
The occurrence and severity of osteonecrosis in sickle cell anaemia (SCA) vary due to risk factors, including genetic modifiers. Bone morphogenetic proteins (BMPs), particularly BMP6, and the vitamin D receptor (VDR) play key roles in cartilage and bone metabolism, making them potential contributors to orthopaedic outcomes in SCA. Here, we evaluated the association of polymorphisms in BMP6 (rs3812163, rs270393 and rs449853) and VDR (FokI rs2228570 and Cdx2 rs11568820) genes with osteonecrosis risk in a Brazilian SCA cohort. A total of 177 unrelated SCA patients were selected. The AA genotype of BMP6 rs3812163 was independently associated with a lower osteonecrosis risk (p = 0.015; odds ratio (OR): 0.38; 95% confidence interval (CI): 0.18-0.83) and with the long-term cumulative incidence of osteonecrosis (p = 0.029; hazard ratio: 0.56, 95% CI: 0.34-0.94). The VDR rs2228570 TT genotype was independently associated with a lower osteonecrosis risk (p = 0.039; OR: 0.14; 95% CI: 0.02-0.90). In summary, our results provide evidence that BMP6 rs3812163 and the VDR rs2228570 might be implicated in osteonecrosis pathophysiology in SCA and might help identify individuals at high risk.
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Anemia Falciforme , Osteonecrose , Humanos , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Osteonecrose/genética , Anemia Falciforme/complicações , Anemia Falciforme/genética , Genótipo , Estudos de Casos e Controles , Proteína Morfogenética Óssea 6/genética , Receptores de Calcitriol/genéticaRESUMO
Background: Chagas disease is caused by the parasite Trypanosoma cruzi, and the lack of effective and safe treatments makes identifying new classes of compounds with anti-T. cruzi activity of paramount importance. Methods: Hit-to-lead exploration of a metabolically stable N-imidazoylpiperazine was performed. Results: Compound 2, a piperazine derivative active against T. cruzi, was selected to perform the hit-to-lead exploration, which involved the design, synthesis and biological evaluation of 39 new derivatives. Conclusion: Compounds 6e and 10a were identified as optimized compounds with low micromolar in vitro activity, low cytotoxicity and suitable preliminary absorption, distribution, metabolism and excretion and physicochemical properties. Both compounds reduced parasitemia in mouse models of Chagas disease, providing a promising opportunity for further exploration of new antichagasic compounds.
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Doença de Chagas , Tripanossomicidas , Trypanosoma cruzi , Animais , Camundongos , Tripanossomicidas/farmacologia , Tripanossomicidas/química , Doença de Chagas/tratamento farmacológico , Doença de Chagas/parasitologia , Relação Estrutura-Atividade , Parasitemia/tratamento farmacológicoRESUMO
BACKGROUND: Breast cancer (BC) is one of the most incident types of cancer among women in the world. Although chemotherapy is an effective way to treat several types of cancer, it may also cause serious complications, including cardiotoxicity. This study aimed to identify the impact of chemotherapy on functional capacity, muscle strength and autonomic function. METHODS: Ten breast cancer patients in therapeutic follow-up (TG) and ten women without comorbidities (CG) participated in the study (46±8.87 years old). Both groups were evaluated at two time points, before and 20 weeks after the start of chemotherapy. Functional capacity and muscle strength were assessed by 6-minute walk test (6MWT) and handgrip test, respectively. Autonomic function was assessed by heart rate variability analysis. RESULTS: TG presented greater reductions in the handgrip test for the non-dominant hand (TG ↓15.2%; CG: ↑1.1%, p<0.05) compared to GC. However, no significant differences were found regarding VO2max (p>0.05) and 6MWT total distance (p>0.05). Regarding the heart rate variability variables before and after follow-up period, rMSSD (CG= 39.15±37.66; TG= 14.89±8.28, p= 0.01) and SDNN (CG= 55.77±40.03; TG= 26.30±10.37, p= 0.02) showed effect in the group and time interaction, whereas the LF/HF ratio presented significant difference only in the time analysis (CG= 2.24±2.30; TG= 2.84±1.82, p= 0.04). CONCLUSION: Chemotherapy used in the treatment of breast cancer patients resulted in decreased muscle strength and autonomic imbalance. The data suggests that chemotherapy may carry the risk of developing cardiovascular disease. TRIAL REGISTRATION: Registration not required.
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To reduce the speed of selection of populations resistant to chemical insecticides, photodynamic inactivation (PDI) against Aedes aegypti is a hot-topic and promising alternative technique to vector control. Temperature is an important factor in the survival of Ae. aegypti larvae and mosquitoes as it influences physiology, behavior, and ecology. This work aimed to evaluate parameters of the biological cycle of Ae. aegypti such as: hatching rate, larval development, adult mosquito longevity, sex ratio, weight, and lethal concentration of larval mortality (LC) through the combination of PDI with different temperatures. The number of larvae found after 48 h suggests that temperature affects hatching rate. Additionally, results showed a delay in development of surviving larvae after PDI when compared to control groups, and there was a reduction in the longevity of mosquitoes that undertook photodynamic action. PDI also led to a predominance of male insects, and observed weight indicates that the inactivation method may have also interfered in mosquito size. The results point to a satisfactory performance of PDI at all tested temperatures. Experimental conditions that were not lethal to all larvae implied that PDI impacts the mosquitoes' biological cycle. Though metabolism and development are improved at higher temperatures, so is PDI action, thus maintaining the net benefit. Therefore, it is assumed that the proposed photolarvicide can be useful in reducing arbovirus transmission, and results invite for future research in different abiotic conditions.
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Aedes , Fotoquimioterapia , Animais , Masculino , Feminino , Aedes/fisiologia , Temperatura , Mosquitos Vetores/fisiologia , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/farmacologia , LarvaRESUMO
BACKGROUND: Forehead aesthetic injections are a well-known source of discomfort, and many analgesic non-invasive techniques have been proposed to ameliorate pain. However, no study has compared all these techniques for aesthetic purposes. Therefore, this study aimed to compare the effectiveness of topical cream anesthesia, vibratory stimulus, cryotherapy, pressure, and even no intervention, on pain during and immediately after injection, when considering aesthetic injections in the forehead. METHODS: Seventy patients were selected and had their foreheads divided into 5 parts, which received four different analgesic techniques, and one control zone was added. A numeric rating scale was used to assess pain, two direct questions were asked to evaluate patients' preference and discomfort with the techniques, and the adverse events were quantified. The injections were performed in the same sequence, with three minutes of rest between them and in a single session. Comparisons among analgesic methods for pain relief were performed by the one-way analysis of variance (ANOVA), considering a significance level of 5%. RESULTS: No significant differences were found among the analgesic methods, and between the methods and the control zone, both during and immediately after the injections (p > 0.05). The preferred method for pain relief was the use of topical anesthetic cream (47%), while the most uncomfortable technique was manual distraction (pressure) (36%). Only one patient reported an adverse event. CONCLUSIONS: No analgesic method to diminish pain was superior to the others or was better than no method. Nevertheless, the topical anesthetic cream was the preferred technique, causing less discomfort. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Anestésicos Locais , Dor , Humanos , Anestesia Local , Músculo Esquelético , AnalgésicosRESUMO
BACKGROUND: Diabetic neuropathy (DN) causes neuropathic pain, and current treatments are unsatisfactory. Recently studies have demonstrated an assertive correlation between gut microbiota and pain modulation. OBJECTIVE: Considering the emerging search for new therapies for the control of DN and the growing commercial interest in the probiotics market, this study aimed to provide patents on the use of probiotics in the control of DN. METHODS: This is a patent prospection performed in the Espacenet Patent database, using the association of keywords and IPC related to probiotics in medical preparations and foods, from 2009 to December 2022. RESULTS: Results have shown that in 2020, there was a boom in patent filing in the area. Asian countries accounted for more than 50% of all 48 inventions (n = 48), with Japan as the only applicant in 2021. Products being developed in recent years point to effects that may represent an advancement in DN treatment, such as reduced concentration of pro-inflammatory mediators, metabolites and neurotransmitters release, and hypoglycemic potential. All effects were more related to the Lactobacillus and Bifidobacterium genera, associated with more than one property mentioned. CONCLUSION: The mechanisms attributed to the microorganisms suggest the therapeutic potential of probiotics in the non-pharmacological treatment of pain. New applications for probiotics have resulted from great research interest by academia, but also reflect commercial interests despite the paucity of clinical trials. Thus, the present work supports the evolution of research to explore the benefits of probiotics and their clinical use in DN.
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Diabetes Mellitus , Neuropatias Diabéticas , Microbioma Gastrointestinal , Probióticos , Humanos , Neuropatias Diabéticas/terapia , Probióticos/uso terapêutico , Lactobacillus , DorRESUMO
This study aimed to propose and evaluate a drug susceptibility testing (DST) using the 2,3,5-triphenyl tetrazolium chloride (TTC) as a colorimetric indicator against Mycobacterium abscessus complex (MABC), M. avium complex (MAC), and M. kansasii strains, main nontuberculous mycobacteria (NTM) of clinical relevance. Our results demonstrated that the assay using TTC and the broth microdilution method recommended by the Clinical and Laboratory Standards Institute had essential agreement above 91%, 92%, and 100%, for drugs tested against MABC, MAC, and M. kansasii strains, respectively. Categorical agreement above 91% was obtained for most drugs tested against MABC, except to cefoxitin (76.5%). For drugs tested against MAC and M. kansasii, categorical agreement above 92% and 100% was observed, respectively. TTC showed to be a promising colorimetric indicator of growth to be used in DST for NTM, allowing an easier reading of results.
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Infecções por Mycobacterium não Tuberculosas , Mycobacterium abscessus , Mycobacterium tuberculosis , Humanos , Micobactérias não Tuberculosas , Infecções por Mycobacterium não Tuberculosas/microbiologia , Antibacterianos/uso terapêutico , Cloretos , Colorimetria , Testes de Sensibilidade MicrobianaRESUMO
Objetivo: Analisar as práticas assistenciais de saúde no processo do abortamento tipificadas como violência obstétrica. Metodologia: Estudo qualitativo e descritivo, realizado em um hospital público no Brasil com 15 profissionais de saúde de nível médio e superior. Os dados foram coletados presencialmente, através de um roteiro de entrevista semiestruturada. O perfil foi analisado pela estatística descritiva simples e as questões abertas pela técnica de conteúdo temática proposta por Bardin. Resultados: Evidenciou-se que as práticas que denotam violência obstétrica relacionam-se a alocação das mulheres em processo de abortamento no mesmo ambiente que gestantes e puérperas e ao emitirem juízos de valor no momento da assistência às mulheres. Conclusão: Há necessidade de educação permanente para que as/os profissionais possam assistir de maneira humanizada e qualificada.
Objetivo: Analizar las prácticas de atención a la salud en el proceso de aborto tipificadas como violencia obstétrica. Metodología: Estudio cualitativo y descriptivo, realizado en un hospital público en Brasil con 15 profesionales de salud de nivel medio y superior. Los datos fueron recogidos presencialmente, a través de un guion de entrevista semiestructurada. El perfil fue analizado por la estadística descriptiva simple y las cuestiones abiertas por la técnica de contenido temática propuesta por Bardin. Resultados: Se evidenció que los profesionales de salud presentaron conocimiento insuficiente sobre violencia obstétrica en el momento en que la restringieron al parto o aborto, a la tipificación física/verbal e identificaron solo a los médicos y enfermeras como los principales perpetradores. Las prácticas que denotan violencia obstétrica se relacionan a la asignación de las mujeres en proceso de aborto en el mismo ambiente que gestantes y puérperas, y al emitir juicios de valor en el momento de la asistencia. Conclusión: Hay necesidad de educación permanente para que los profesionales puedan asistir de manera humanizada y cualificada.
Objective: To analyze health care practices in the abortion process typified as obstetric violence. Methodology: Qualitative and descriptive study, conducted in a public hospital in Brazil with 15 health professionals of medium and higher education. The data were collected in person, through a semi-structured interview script. The profile was analyzed by simple descriptive statistics and the questions opened by the thematic content technique proposed by Bardin. Results: It was evidenced that health professionals had insufficient knowledge about obstetric violence at the time they restricted it to childbirth or abortion, physical/verbal typing and identified only doctors and nurses as the main perpetrators. The practices that denote obstetric violence are related to the allocation of women in the process of abortion in the same environment as pregnant women and puerperal women and when issuing value judgments at the time of care. Conclusion: There is a need for permanent education so that the professionals can assist in a humanized and qualified way.
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The COVID-19 pandemic has severely affected global health, leading to the suspension of numerous routine healthcare services and posing challenges in efforts to control other diseases, such as HIV/AIDS. This study aimed to assess the impact of the COVID-19 pandemic on HIV/AIDS diagnoses and mortality rates in Brazil during 2020 and 2021. The percentage change was calculated to determine whether there was an increase or decrease in HIV/AIDS diagnoses and mortality, considering the average numbers from the last 5 years. Additionally, a Joinpoint regression model and an interrupted time series analysis were applied to assess time trends before and after the onset of the pandemic. Lastly, choropleth maps were prepared. We observed a reduction of 22.4% (2020) and 9.8% (2021) in the diagnosis of HIV/AIDS in Brazil. Conversely, there was a significant increase in the percentage change of late diagnosis of AIDS deaths in 2020 (6.9%) and 2021 (13.9%), with some states showing an increase of over 87%. Decreasing time trends in the diagnosis of HIV/AIDS were identified before the pandemic in Brazil, especially in the Southeast and South regions, and then time trends stabilized after including the pandemic years. Along with the dissemination of COVID-19, there was a reduction in the diagnosis of HIV/AIDS and an increase in late diagnosis AIDS deaths, signaling a serious impact of the pandemic on HIV/AIDS control strategies in Brazil. Therefore, we highlight the need for continuous efforts to control both diseases, that is, maintaining regular health services even in crisis situations.
Assuntos
Síndrome da Imunodeficiência Adquirida , COVID-19 , Infecções por HIV , Humanos , Síndrome da Imunodeficiência Adquirida/diagnóstico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Pandemias , Diagnóstico Tardio , Brasil/epidemiologia , COVID-19/diagnóstico , COVID-19/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Teste para COVID-19RESUMO
Objetivos: Traçar as características biopsicossociais das mulheres no ciclo grávido-puerperal e analisar as representações sociais dessas mulheres sobre a violência obstétrica. Metodologia: Estudo descritivo, de abordagem qualitativa, norteado pela Teoria das Representações Sociais, realizado no período de setembro de 2021 a abril de 2022, com 40 mulheres atendidas em uma maternidade de Minas Gerais, no Brasil. Os dados foram coletados por meio de um roteiro de entrevista semiestruturada e da técnica de associação livre de palavras. A caracterização foi analisada pela estatística descritiva simples, a entrevista semiestruturada pela técnica de conteúdo temática proposta por Bardin e a técnica de associação livre de palavras pelo software Iramuteq. Resultados: 82,5 % das participantes possuíam faixa de 18 e 29 anos, 77,5 % intitularam-se pardas, 25 % tinham ensino médio completo e 65 % referiram renda de 1 a 3 salários-mínimos. Quanto à história obstétrica, 52 % possuíam idade gestacional entre 37 e 41 semanas, 70 % não haviam planejado a gravidez, 42,5 % haviam sido admitidas em trabalho de parto e 87,5 % estavam acompanhadas. A violência obstétrica é representada pelas mulheres de maneira superficial com enfoque na dimensão física e emocional, sendo em alguns momentos naturalizada. Conclusão: A violência obstétrica é uma grave problemática vivenciada pelo público feminino e a falta de conhecimento pode levar à naturalização, deixando-as em posição de ampla vulnerabilidade.
Objetivos: Trazar las características biopsicosociales de mujeres en el ciclo gravídico-puerperal y analizar las representaciones sociales de estas mujeres sobre violencia obstétrica Metodología: Estudio descriptivo, de abordaje cualitativo, guiado por la teoría de las representaciones sociales, realizado en el período de septiembre de 2021 a abril de 2022, con 40 mujeres atendidas en una maternidad de Minas Gerais, en Brasil. Los datos fueron recogidos a través de un guion de entrevista semiestructurada y de la técnica de asociación libre de palabras. La caracterización fue analizada por la estadística descriptiva simple, la entrevista semiestructurada por la técnica de contenido temático propuesta por Bardin, y la técnica de asociación libre de palabras por el software Iramuteq. Resultados: 82.5 % de las participantes poseían rango de 18 y 29 años, 77.5 % se identificaron como pardas, 25 % poseían enseñanza media completa y 65 % refirieron renta de 1 a 3 salarios mínimos. En cuanto a la historia obstétrica, 52 % poseían edad gestacional entre 37 y 41 semanas, 70 % no habían planeado el embarazo, 42.5 % habían sido admitidas en trabajo de parto y 87.5 % estaban acompañadas. La violencia obstétrica es representada por las mujeres de manera superficial, con enfoque en la dimensión física y emocional, a veces naturalizada. Conclusión: La violencia obstétrica es una grave problemática vivida por el público femenino y la falta de conocimiento puede llevar a la naturalización, dejándolas en posición de amplia vulnerabilidad
Objectives: To trace the biopsychosocial characteristics of women in the pregnancy-puerperal cycle and to analyze the social representations of these women on obstetric violence. Methodology: Descriptive study, qualitative approach, guided by the Theory of Social Representations conducted in the period from September 2021 to April 2022, with 40 women assisted in a maternity hospital in Minas Gerais, Brazil. The data was collected through a script of semi-structured interview and the technique of free association of words. The characterization was analyzed by simple descriptive statistics, the semi-structured interview by the thematic content technique proposed by Bardin and the free word association technique by Iramuteq software. Results: 82.5 % of the participants had a range of 18 and 29 years, 77.5% self-identified as pardas (mixed race), 25 % had completed high school and 65 % reported income from 1 to 3 minimum wages. Regarding obstetric history, 52,0% had gestational age between 37 and 41 weeks, 70.0% had not planned pregnancy, 42.5% had been admitted for labor and 87.5% were monitored. Obstetric violence is represented by women in a superficial way with a focus on the physical and emotional dimension, being in some moments naturalized. Conclusion: Obstetric violence is a serious problem experienced by the female public and the lack of knowledge can lead to naturalization, leaving them in a position of broad vulnerability