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Physico-chemical characterization of acid base disorders in patients with COVID-19:A cohort study

World Journal of Nephrology 2024年第2期13卷 16-23页

作者： Sergio Pinto de Souza Juliana R Caldas Marcelo Barreto Lopes Marcelo Augusto Duarte Silveira fernanda oliveira coelho Igor oliveira Queiroz Pedro Domingues Cury Rogério da Hora Passos Department of Nephrology Hospital São RafaelSalvadorBA 41253190Brazil Department of Nephrology D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Faculty of Medicine Escola Bahiana de Medicina e Saúde Pública-EBMSPSalvadorBA 40290000Brazil Department of Intensive Care D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Hospital São Rafael D’Or Institute for Research and Education(IDOR)SalvadorBA 41253190Brazil Department of Intensive Care Unit Hospital Israelita Albert EinsteinSao PauloSP 05652900Brazil

BACKGROUND Acid-base imbalance has been poorly described in patients with coronavirus disease 2019(COVID-19).Study by the quantitative acid-base approach may be able to account for minor changes in ion distribution that may have been over-looked using traditional acid-base analysis *** a cohort of critically ill COVID-19 patients,we looked for an association between metabolic acidosis surrogates and worse clinical outcomes,such as mortality,renal dialysis,and length of hospital *** To describe the acid-base disorders of critically ill COVID-19 patients using Stewart’s approach,associating its variables with poor *** This study pertained to a retrospective cohort comprised of adult patients who experienced an intensive care unit stay exceeding 4 days and who were diagnosed with severe acute respiratory syndrome coronavirus 2 infection through a positive polymerase chain reaction analysis of a nasal swab and typical pulmonary involvement observed in chest computed tomography *** and clinical data were obtained from electronic *** variables were compared using Fisher’s exact *** data were presented as median and interquartile *** Mann-Whitney U test was used for *** In total,211 patients were *** mortality rate was 13.7%.Overall,149 patients(70.6%)presented with alkalosis,28 patients(13.3%)had acidosis,and the remaining 34 patients(16.2%)had a normal arterial pondus *** those presenting with acidosis,most had a low apparent strong ion difference(SID)(20 patients,9.5%).Within the group with alkalosis,128 patients(61.0%)had respiratory *** non-survivors were older,had more comorbidities,and had higher Charlson’s and simplified acute physiology score *** did not find severe acid-base imbalance in this *** analyzed Stewart’s variables(effective SID,apparent SID,and strong ion gap and the effect of albumin,lactate,phosphorus,and chloride)were not d

关键词： COVID-19 Physicochemical approach Acid-base status Critically ill patients Acute respiratory syndrome

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Mindfulness training in medical education as a means to improve resilience,empathy,and mental health in the medical profession

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World Journal of Psychiatry 2024年第4期14卷 489-493页

作者： Edison Iglesias de oliveira Vidal Luiz Fernando Alvarenga Ribeiro Marco Antonio de Carvalho-Filho fernanda Bono Fukushima Internal Medicine Department Botucatu Medical SchoolSao Paulo State University(UNESP)Botucatu 18618-687SPBrazil Wenckebach Institute for Education and Training LEARN-Lifelong LearningEducation and Assessment Research NetworkUniversity Medical Center GroningenGroningen 9713AVGroningenNetherlands Assertiva Mindfulness Botucatu 18603-970SPBrazil Surgical Specialties and Anesthesiology Department Botucatu Medical SchoolSão Paulo State University(UNESP)Botucatu 18618-687SPBrazil

The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our *** contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of ***,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational ***,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their *** we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.

关键词： Mindfulness Medical education Mental capital Mental health Medical students Resilience

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Feasibility of performing the 3-minute step test with remote supervision in children and adolescents with cystic fibrosis: A comparative study

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Pediatric Investigation 2024年第2期8卷 83-90页

作者： fernanda Maria Vendrusculo Gisele Apolinario da Costa Maria Amelia Bagatini Brenda Maria Henrique Maia Lemes Carolina Aguiar Faria Larissa Carvalhaes de oliveira Evanirso da Silva Aquino Marcio Vinicius Fagundes Donadio Laboratory of Pediatric Physical Activity Infant CenterPontificia Universidade Catolica do Rio Grande do Sul(PUCRS)Porto AlegreBrazil Hospital Infantil Joao Paulo II-Fundacao Hospitalar do Estado de Minas Gerais(FHEMIG) Belo HorizonteBrazil Departament of Physiotherapy Pontificia Universidade Catolica de Minas Gerais(PUCMG)-Campus BetimBetimBrazil Department of Physiotherapy Faculty of Medicine and Health SciencesUniversitat Internacional de Catalunya(UIC)BarcelonaSpain

Importance:The 3-min step test is a simple option to monitor submaximal exercise capacity,although its use via remote video monitoring has not been investigated in children with cystic fibrosis(CF).Objective:This study aimed to assess the feasibility and reproducibility of performing the 3-min step test with remote ***:A cross-sectional study including CF patients(6-18 years)from two CF services were ***,anthropometric,clinical,and lung function data were collected and two 3-min step tests were performed:(i)in-person supervision,and(ii)remotely supervised by video *** and after the tests,heart rate(HR),oxygen saturation(SpO2),and the Borg score for dyspnea and lower limb fatigue were ***:Twenty-three patients(10.7±3.7 years)with a mean FEV1 of 89.5%±23.2%were *** were no significant differences between tests,with mean differences(95%confidence intervals)in final HR of-3.3(-8.9,2.4),change in HR of-1.9(-6.1,2.1),final SpO2 of 0.3(-0.4,1.0),and final dyspnea of 0.1(-0.8,0.9).The intraclass correlation coefficient was 0.852(final HR),0.762(final SpO2),and 0.775(final lower limb fatigue).Significant and moderate correlations were found between tests for final HR(r=0.75),change in HR(r=0.61),and final SpO2(r=0.61).The Bland-Altman analysis showed a mean difference in final SpO2 between tests of 0.3%(limit of agreement-3.0%,3.5%).Interpretation:Physiological responses between tests were similar,indicating it was feasible to perform the 3-min step test with remote supervision in CF children.

关键词： Children Cystic fibrosis Exercise test Telehealth

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Risk Stratification in Obstetrics: An Integrated Approach to Maternal Health

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Open Journal of Obstetrics and Gynecology 2024年第6期14卷 903-910页

作者： Taina Crespo Mendonca Bianca Beatriz Soares dos Reis Júlia Cruz coelho Antônio de oliveira Battistini Pestana Vitória Carolina Barreto Negri Alvaro Augusto Trigo Department of Medicine University of Franca Franca Brazil

Introduction: Prenatal care is crucial for maternal and fetal health, highlighting the importance of obstetric risk stratification. This enables personalized care, avoiding unnecessary interventions and reducing costs. Conditions such as first trimester bleeding, spontaneous abortion, gestational trophoblastic disease, and ectopic pregnancy require specific approaches. Early identification of these complications is vital, especially in urgent and emergency obstetric cases, which demand immediate hospital attention. Objective: Comprehensive review of first trimester pathologies and gestational hypertension, focusing on obstetric risks and personalized prenatal management. Methods: Literature review on bleeding and gestational hypertension. Results: The study provides a detailed analysis of pathologies associated with first trimester uterine bleeding and hypertensive disorders, focusing on obstetric risk stratification. The main causes of maternal and fetal mortality are hypertensive disorders, hemorrhages, infections, childbirth complications, and abortion. Spontaneous abortion is common, with different classifications, ranging from threatened to missed abortion. Infected abortion is a severe complication. Brazil has restrictive abortion laws, but many unsafe abortions occur, resulting in high public health costs. Pharmacological treatment with misoprostol is a safe option. Other pathologies include gestational trophoblastic disease, ectopic pregnancy, and placenta previa. Preeclampsia and eclampsia are severe conditions requiring immediate treatment to avoid complications. Conclusion: Early identification and management of obstetric risk factors, such as uterine bleeding, are essential for positive maternal and fetal outcomes. A multidisciplinary approach is fundamental.

关键词： Obstetrics Emergencies Hypertension Pregnancy-Induced Uterine Hemorrhage Pregnancy Trimester First

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Development of a Ready-to-Use PSMA-11 Kit Formulation and Biological Evaluation of Binding Affinity

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Advances in Molecular Imaging 2024年第2期13卷 7-22页

作者： Maria Renata Valente Brandão Freire Natália Marchesan Bexiga Marco Antonio Stephano João Ezequiel oliveira Carlos Roberto Jorge Soares Ana Cláudia Camargo Miranda Anna Carolina de Alcântara Barbosa Marycel Figols de Barboza Laura fernanda Garcia Luiz Felipe S. Teixeira Maria Helena Marumo Bellini Natanael Gomes da Silva Luiza Mascarenhas Balieiro Joel Mendes Elaine Bortoleti de Araújo Centro de Radiofarmcia Instituto de Pesquisas Energticas e Nucleares (IPEN) Cidade Universitria So Paulo Brasil Departamento de Tecnologia Farmacutica Faculdade de Cincias Farmacuticas (USP) Cidade Universitria So Paulo Brasil Centro de Biotecnologia Instituto de Pesquisas Energticas e Nucleares (IPEN) Cidade Universitria So Paulo Brasil Departamento de Medicina Nuclear do Hospital Israelita Albert Einstein So Paulo/SP Brasil

Introduction: 68Ga-PSMA-11 is considered the gold standard in detection of micro and oligometastases in advanced prostate cancer, being used for therapeutic planning, as well as, potentially, for evaluating response to treatment. The development of ready-to-use lyophilized kit of PSMA-11 adds quality and safety to the routine use of this radiopharmaceutical and represents a pharmacotechnical challenge as it must preserve the integrity and specificity of the ligand. Methods: PSMA-11 kit formulation was proposed, considering radiolabeling parameters and the preservation of the peptide during the lyophilization process, using mannitol as an excipient. Critical temperature characterization studies were carried out using DSC equipment and the freeze-drying process was developed. The direct radiolabeling conditions were evaluated and standardized using 68Ge/68Ga generator eluate from two different manufacturers (ITG and Eckert & Ziegler). The radiochemical purity was evaluated by TLC and HPLC. Biological evaluation was carried out with lyophilized PSMA-11 to demonstrate the integrity of the peptide and preservation of biological activity after the lyophilization process. Results: Based on critical temperature characterization studies, the freeze-drying cycle was designed to reach a freezing temperature of around −40˚C and primary drying at 2˚C. Using 20 mg of mannitol, an intact and elegant lyophilized cake was obtained. PSMA-11 lyophilized kit was directly labeled with 68Ga eluate from 68Ge/68Ga GMP generators (ITG and Eckert & Ziegler) resulting in % RP > 95% at pH 4.0 to 4.5. The results obtained from in vitro and in vivo biological competition studies confirmed the preservation of PSMA-11 affinity for the receptor after lyophilization. Conclusion: A lyophilized formulation (Kit) of PSMA-11 was successfully obtained, which preserved the integrity and biological activity of the peptide and guaranteed radiolabeling efficiency.

关键词： 68Ga-PSMA-11 Prostate-Specific Membrane Antigen (PSMA) Ready-to-Use Kit GMP-Grade Generators Metastatic Prostate Cancer PET Imaging

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Mechanisms involved in cancer stem cell resistance in head and neck squamous cell carcinoma

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Cancer Drug Resistance 2023年第1期6卷 116-137页

作者： Juliana Mota Siqueira Daniele Heguedusch Camila oliveira Rodini Fabio Daumas Nunes Maria fernanda Setúbal Destro Rodrigues Department of Stomatology Discipline of Oral and Maxillofacial PathologySchool of DentistryUniversity of São PauloSao Paulo 05508-000Brazil Department of Biological Sciences Bauru School of DentistryUniversity of Sao PauloSão Paulo 17012-230Brazil Biophotonics Applied to Health Sciences Nove de Julho UniversityUNINOVESao Paulo 01504-001Brazil

Despite scientific advances in the Oncology field,cancer remains a leading cause of death *** and cellular heterogeneity of head and neck squamous cell carcinoma(HNSCC)is a significant contributor to the unpredictability of the clinical response and failure in cancer *** stem cells(CSCs)are recognized as a subpopulation of tumor cells that can drive and maintain tumorigenesis and metastasis,leading to poor prognosis in different types of *** exhibit a high level of plasticity,quickly adapting to the tumor microenvironment changes,and are intrinsically resistant to current chemo and *** mechanisms of CSC-mediated therapy resistance are not fully ***,they include different strategies used by CSCs to overcome challenges imposed by treatment,such as activation of DNA repair system,anti-apoptotic mechanisms,acquisition of quiescent state and Epithelial-mesenchymal transition,increased drug efflux capacity,hypoxic environment,protection by the CSC niche,overexpression of stemness related genes,and immune *** elimination of CSCs seems to be the main target for achieving tumor control and improving overall survival for cancer *** review will focus on the multi-factorial mechanisms by which CSCs are resistant to radiotherapy and chemotherapy in HNSCC,supporting the use of possible strategies to overcome therapy failure.

关键词： Head and neck squamous cell carcinoma cancer stem cell chemotherapy radiotherapy therapy resistance

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Impact of SARS-CoV-2 infection during pregnancy on postnatal brain development:The potential role of glial cells

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BIOCELL 2022年第12期46卷 2517-2523页

作者： LARISSA DANIELE BOBERMIN LARA SCOPEL MEDEIROS fernanda WEBER GIANCARLO TOMAZZONI DE oliveira LUCÉLIA SANTI WALTER ORLANDO BEYS-DA-SILVA CARLOS-ALBERTO GONÇALVES ANDRÉQUINCOZES-SANTOS Programa de Pós-Graduação emNeurociências Instituto de Ciências Básicas da SaúdeUniversidade Federal do Rio Grande do SulPorto Alegre90050170Brazil Departamento de Bioquímica Instituto de Ciências Básicas da SaúdeUniversidade Federal do Rio Grande do SulPorto Alegre90035003Brazil Faculdade de Farmácia Universidade Federal do Rio Grande do SulPorto Alegre90610000Brazil Hospital de Clínicas de Porto Alegre Porto Alegre90035903Brazil Programa de Pós-Graduação emBiologia Celular eMolecular Centro de BiotecnologiaUniversidade Federal do Rio Grande do SulPorto Alegre91501970Brazil Programa de Pós-Graduação em Ciências Biológicas:Bioquímica Instituto de Ciências Básicas da SaúdeUniversidade Federal do Rio Grande do SulPorto Alegre90035003Brazil

Glial cells are crucial for maintaining central nervous system(CNS)*** actively participate in immune responses,as well as form functional barriers,such as blood-brain barrier(BBB),which restrict the entry of pathogens and inflammatory mediators into the *** general,viral infections during the gestational period can alter the embryonic and fetal environment,and the related inflammatory response may affect neurodevelopment and lead to behavioral dysfunction during later stage of life,as highlighted by our group for Zika virus *** acute respiratory syndrome coronavirus-2(SARS-CoV-2)induces a cytokine storm and,during pregnancy,may be related to a more severe form of the coronavirus disease-19(COVID-19)and also to higher preterm birth ***-CoV-2 can also affect the CNS by inducing neurochemical remodeling in neural cells,which can compromise neuronal plasticity and synaptic ***,the impact of SARS-CoV-2 infection during pregnancy on postnatal CNS,including brain development during childhood and adulthood,remains *** group has recently highlighted the impact of COVID-19 on the expression of molecular markers associated with neuropsychiatric disorders,which are strongly related to the inflammatory ***,based on these relationships,we discussed the impact of SARS-CoV-2 infection either during pregnancy or in critical periods of neurodevelopment as a risk factor for neurological consequences in the offspring later in life,focusing on the potential role of glial ***,it is important to consider future and long-term public health concerns associated with SARS-CoV-2 infection during pregnancy.

关键词： Brain development Glial cells Inflammation Pregnancy SARS-CoV-2

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Genoprotection and metabolic benefits of marine macroalgae-Insights into the concept of functional foods through direct and indirect consumption

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Food Bioscience 2022年第3期47卷 524-533页

作者： Ana Marques João Ferreira Ana Cerqueda-Pacheco Vitória Pereira Helena Abreu Rui Pereira Maria João Pires fernanda Seixas Paula oliveira Isabel Gaivão Mário Pacheco Laboratory of Physiotoxicology CESAM-Centre for Environmental and Marine StudiesDepartment of BiologyUniversity of AveiroCampus Universitário de Santiago3810-193AveiroPortugal CECAV-Animal and Veterinary Research Center AL4AnimalsUniversity of Trás-os-Montes and Alto DouroQuinta de Prados5000-801Vila RealPortugal Department of Genetics and Biotechnology University of Trás-os-Montes and Alto DouroQuinta de Prados5000-801Vila RealPortugal Department of Biology and Environment University of Trás-os-Montes and Alto DouroQuinta de Prados5000-801Vila RealPortugal CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences Inov4AgroUniversity of Trás-os-Montes and Alto DouroQuinta de Prados5000-801Vila RealPortugal Department of Veterinary Sciences University of Trás-os-Montes and Alto DouroQuinta de Prados5000-801Vila RealPortugal ALGAplus Lda.Travessa Alexandre da Conceição s/n3830-196ÍlhavoPortugal

The consumption of marine macroalgae has been linked with health benefits,albeit some actions,including genoprotection,remain ***,we evaluated the genoprotective potential of a mixture of Ulva rigida,Fucus vesiculosus and Gracilaria gracilis,through direct consumption or via indirect intake using fish(Sparus aurata)as a vector of algal ***(Mus musculus)were subjected to a 1-month dietary supplementation with 5%of macroalgae mix or 10%of fillet of fish previously fed with an algae-supplemented aquafeed(for comparison purposes,10%supplementation with fillet of fish standardly fed was also considered).Thereafter,mice were challenged by the genotoxicant methyl methanesulfonate(MMS),and the genetic damage was evaluated through the micronuclei ***,a wider evaluation was carried out encompassing the assessment of energy metabolism,haematological and histological parameters,as well as growth *** unequivocally protected against MMS-induced *** activity profile of hepatic lactate and isocitrate dehydrogenases promoted by the supplemented diets reflected an improved energy *** properties were not transferred via fish fed with the algae-supplemented aquafeed,though the transference of phytocomponents with beneficial properties(*** balance improvement)should not be ***,these findings highlighted the genoprotection afforded by marine macroalgae,likely promoted by desmutagenic factors,reinforcing their definition as functional *** possibility of using fish as an indirect source of algae-borne phytocomponents proved to be plausible and worthy of further investigations.

关键词： Antigenotoxicity Desmutagens Fish consumption Functional food Marine macroalgae consumption Metabolic benefits

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Decontamination of mobile phones and electronic devices for health care professionals using a chlorhexidine/carbomer 940■gel

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Frontiers of Chemical Science and Engineering 2019年第1期13卷 192-198页

作者： Rafael Muniz de oliveira Nereida Mello da Rosa Gioppo Jancineide oliveirade Carvalho Francilio Carvalho oliveira Thomas Jay Webster fernanda Roberta Marciano Anderson oliveira Lobo University Hospital of the West of Parana State University of West of Parana Cascavel PR Brazil University Center for Health. Humanities and Technology of Piaui (UNINOVAFAPI). Piaui Brazil Science and Technology Institute Brasil University Itaquera SP Brazil Nanomedicine Laboratory Department of Chemical Engineering Northeastern University MA 02115 USA Materials Science and Engineering graduation program Technology Center Federal University of Piaui. PI Brazil

Though they reduce microorganism growth, current hospital disinfectants also damage many of today’s modern electronic devices such as tablets and smartphones. Herein, the efficacy of a new chlorhexidine digluconate gel (CDG) was tested as a disinfectant for mobile and electronic devices in a clinical environment. Specifically, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and methicillin resistant Staphylococcus aureus were used to infect the screen of eight smartphones. The CDG was prepared at concentrations of 2%, 4% and 6%, and tested on paper disks infected with these bacteria before being tested on the smartphones. The devices were disinfected with the CDG gel (4%) at two times: immediately and after 5 min of the bacterial contamination. In all cases, the CDG gel eliminated 100% of gram-positive and gram-negative microorganisms compared to the control (without any agent). In addition, the gel did not damage the smartphones. Therefore, our study suggests that the CDG gel may be applied to disinfect a wide range of electronic devices for health care professionals in the hospital environment.

关键词： smartphones disinfection clinical environment chlorhexidine bacteria

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Respiratory muscle training with electronic devices in the postoperative period of hepatectomy:A randomized study

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World Journal of Hepatology 2023年第5期15卷 688-698页

作者： Marcelo Gustavo Pereira Aurea Maria oliveira Silva fernanda Diório Masi Galhardo Beatriz Dellamutta Miranda Almeida Railaine Lais Lopes Ilka de Fatima Santana Ferreira Boin Hospital de Clínicas Universidade Estadual de CampinasCampinas 13076-4151São PauloBrazil Faculdade de Ciências Médicas Universidade Estadual de CampinasCampinas 13083-887São PauloBrazil Hospital de Clínicas da Unicamp Universidade Estadual de CampinasCampinas 13083-888São PauloBrazil

BACKGROUND Many studies have been developed with a focus on surgical techniques and drugs,but few that address the importance of rehabilitation in the pre and postoperative period,and the specific benefits for each surgical procedure or type of neoplasm,aiming to minimize respiratory complications in the postoperative *** To compare the strength of the respiratory muscles in the pre and postoperative periods of hepatectomy by laparotomy and to verify the incidence of postoperative pulmonary complications among the groups *** Prospective,randomized,clinical trial study that compared the inspiratory muscle training group(GTMI)with the control group(CG).After the collection of sociodemographic and clinical data,in both groups,preoperatively,on the first and fifth postoperative days,vital signs and pulmonary mechanics were evaluated and *** and bilirubin values were recorded for the albumin-bilirubin(ALBI)*** randomization and allocation of participants,those in the CG underwent conventional physical therapy and those in the GTMI underwent conventional physical therapy plus inspiratory muscle,in both groups for five postoperative *** Of 76 subjects met eligibility *** collection of 41 participants was completed:20 in the CG and 21 in the *** most frequent diagnosis was 41.5%with liver metastasis,followed by 26.8%with hepatocellular *** for respiratory complications in the GTMI,there was no *** the CG,there were three respiratory *** in the CG classified as ALBI score 3 presented,statistically,a higher energy value compared to patients classified as ALBI score 1 and 2(P=0.0187).Respiratory variables,measured preoperatively and on the first postoperative day,had a significant drop in both groups from the preoperative to the first postoperative day(P≤0.0001).When comparing the preoperative period and the fifth postoperative day between the GTMI and the CG,the maximal inspira

关键词： postoperative shorter fifth

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