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Rohani P, Shervin Badv R, Sohouli MH, Guimarães NS. The efficacy of low glycemic index diet on seizure frequency in pediatric patients with epilepsy: A systematic review and meta-analysis. Seizure 2024; 117:150-158. [PMID: 38422595 DOI: 10.1016/j.seizure.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Despite extensive research examining the effect of a low glycemic index (LGI) diet on the frequency of seizures in patients with epilepsy, the findings are inconclusive. Hence, we performed a systematic review and meta-analysis in order to clarify the potential effect of a low glycemic index (LGI) diet on the frequency of seizures in children. METHODS A systematic review and meta-analysis written in accordance with the PRISMA checklist was realized using a comprehensive systematic search in four electronic databases until October 2023 without time or language restrictions. A random effects model was employed to combine the data. The main outcomes were analyzed using weight mean difference (WMD) and 95 % confidence interval (95 % CI). In total, 13 studies met the eligible criteria and were included. RESULTS The publications included in this study were published between 2005 and 2021. The duration of the interventions in the studies included in this analysis ranged from 6 to 58 weeks. Our findings indicated that the pooled efficacy rate for < 50 %, ≥ 50 %, > 90 % seizure reduction in patients with epilepsy receiving a low glycemic index diet was 39 % (95 % CI: 26, 52), 34 % (95 % CI: 23, 45), and 19 % (95 % CI: 13, 25), respectively. It seems that the efficacy of this ketogenic diet in reducing seizures is greater during a shorter intervention period than 12 weeks. CONCLUSION This systematic review and meta-analysis suggests that the low glycemia index diet can be beneficial as a treatment for epilepsy in pediatric patients.
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Affiliation(s)
- Pejman Rohani
- Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shervin Badv
- Paediatrics Centre of Excellence, Department of Paediatric Neurology, Children's Medical Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Sohouli
- Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Nathalia Sernizon Guimarães
- Professor at Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais 30130-100, Brazil
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Xavier LDF, Guimarães NS, Santos ALSCD, Diniz RC, Canabrava PP, de Souza AH, de Oliveira GV. Hyperbaric oxygen therapy as an adjuvant treatment in pyoderma gangrenosum: A scoping review. J Eur Acad Dermatol Venereol 2024. [PMID: 38506565 DOI: 10.1111/jdv.19943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/20/2024] [Indexed: 03/21/2024]
Affiliation(s)
- Laura de Freitas Xavier
- Medical Sciences School of Minas Gerais, Belo Horizonte, Brazil
- Brazilian Society of Dermatology, Rio De Janeiro, Brazil
| | | | | | | | | | | | - Gisele Viana de Oliveira
- Medical Sciences School of Minas Gerais, Belo Horizonte, Brazil
- Brazilian Society of Dermatology, Rio De Janeiro, Brazil
- Hospital Luxemburgo, Belo Horizonte, Brazil
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Magno LAV, Tameirão DR, Alves LF, Guimarães NS. Effect of recreational cannabis use on bone mineral density: a systematic review. Osteoporos Int 2024; 35:391-399. [PMID: 38141142 DOI: 10.1007/s00198-023-06992-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
The recreational use of cannabis products has risen considerably worldwide over the past decade. As the cannabis legal market grows, a critical challenge has been to make substantiated claims about the benefits and adverse health problems triggered by cannabis exposure. Despite accumulating evidence from animal studies demonstrating the role of cannabinoids on bone metabolism, there are conflicting results in clinical literature regarding their effects on bone health outcomes.We undertook a systematic review to assess the evidence for the safety of cannabis use on bone health. We searched the databases MEDLINE, EMBASE, Cochrane Library, and Web of Science up to March 2023 for studies evaluating the effect of the recreational use of cannabis on the bone mineral density (BMD) of adults.Among the 2620 studies reviewed, three cross-sectional studies and one randomized controlled trial comprised 4032 participants from 18 to 60 years who met the inclusion criteria. Two studies showed that cannabis exposure decreased BMD, while the other 2 indicated no alteration. Despite the different study designs, the included studies showed a low risk of bias according to the Joanna Briggs Institute tool.Eligible studies present differences in cannabis products, administration routes, and exposure determination. Further longitudinal research is needed to establish multiple clinical predictors associated with potentially negative consequences of cannabis exposure, especially in vulnerable populations such as elderly individuals.
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Affiliation(s)
- Luiz Alexandre Viana Magno
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Faculdade Ciências Médicas de Minas Gerais (FCMMG), Alameda Ezequiel Dias, 275, Belo Horizonte, 30130-110, Brazil
| | - Diego Ribeiro Tameirão
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Faculdade Ciências Médicas de Minas Gerais (FCMMG), Alameda Ezequiel Dias, 275, Belo Horizonte, 30130-110, Brazil
- Observatório de Pesquisas E Extensão Em Nutrição E Saúde (OPeNS), Belo Horizonte, Brazil
| | - Lucas Ferreira Alves
- Curso de Medicina, Faculdade Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte, Brazil
| | - Nathalia Sernizon Guimarães
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Faculdade Ciências Médicas de Minas Gerais (FCMMG), Alameda Ezequiel Dias, 275, Belo Horizonte, 30130-110, Brazil.
- Observatório de Pesquisas E Extensão Em Nutrição E Saúde (OPeNS), Belo Horizonte, Brazil.
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Guimarães NS, Joviano-Santos JV, Reis MG, Chaves RRM. Development of search strategies for systematic reviews in health using ChatGPT: a critical analysis. J Transl Med 2024; 22:1. [PMID: 38167166 PMCID: PMC10759630 DOI: 10.1186/s12967-023-04371-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Nathalia Sernizon Guimarães
- Postgraduate Health Science, Medical Sciences College of Minas Gerais, Alameda Ezequiel Dias, 275, Belo Horizonte, Minas Gerais, 30130-110, Brazil.
| | - Julliane Vasconcelos Joviano-Santos
- Postgraduate Health Science, Medical Sciences College of Minas Gerais, Alameda Ezequiel Dias, 275, Belo Horizonte, Minas Gerais, 30130-110, Brazil
| | - Marcela Gomes Reis
- Postgraduate Health Science, Medical Sciences College of Minas Gerais, Alameda Ezequiel Dias, 275, Belo Horizonte, Minas Gerais, 30130-110, Brazil
| | - Roberta Rayra Martins Chaves
- Postgraduate Health Science, Medical Sciences College of Minas Gerais, Alameda Ezequiel Dias, 275, Belo Horizonte, Minas Gerais, 30130-110, Brazil
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Reis MG, Ferreira AJF, Sohouli MH, Taimeirão DR, Vieira RAL, Guimarães NS. Effect of cannabis and subproducts on anthropometric measures: a systematic review and meta-analysis. Int J Obes (Lond) 2024; 48:44-54. [PMID: 37935909 DOI: 10.1038/s41366-023-01399-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/18/2023] [Accepted: 10/10/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Obesity poses a significant public health challenge. Research has examined the impact of cannabis and subproducts on health but varying results have hindered a consensus. AIM This study aimed to evaluated the effects of cannabis and subproducts on body measurements. METHODS For searching randomized controlled trials evaluating cannabis and/or subproducts use and changes in anthropometric measures, a systematic search at MEDLINE, Embase, Cochrane Library and Web of Science was conducted until March 2023. The outcomes included changes in body weight, body mass index (BMI) and waist circumference (WC). Meta-analysis was realized using R software (version 4.2.1). RESULTS In general, cannabis use reduced weight by 1.87 kg (95% CI: -3.71 to -0.03) and WC (mean difference = -2.19, 95% CI: -4.44 to 0.06). When examining subgroups, longer follow-up periods were associated with a more pronounced BMI reduction (mean difference = -1.10, 95% CI: -2.23 to 0.03). Cannabinoid CB1 exhibited an increase in body fat (mean difference = 1.70, 95% CI: 0.66-2.74). CONCLUSION These findings suggest that cannabis and subproducts could be considered adjuncts in obesity treatment by helping to reduce relevant anthropometric measurements.
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Affiliation(s)
- Marcela Gomes Reis
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
- Observatório de Pesquisa em Epidemiologia, Nutrição e Saúde (OPeNS), Belo Horizonte, Brazil
| | - Andrea J F Ferreira
- Observatório de Pesquisa em Epidemiologia, Nutrição e Saúde (OPeNS), Belo Horizonte, Brazil
- The Ubuntu Center on Racism, Global Movements, and Population Health Equity, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | | | - Diego Ribeiro Taimeirão
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
- Observatório de Pesquisa em Epidemiologia, Nutrição e Saúde (OPeNS), Belo Horizonte, Brazil
| | - Renata Adrielle Lima Vieira
- Observatório de Pesquisa em Epidemiologia, Nutrição e Saúde (OPeNS), Belo Horizonte, Brazil
- Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Nathalia Sernizon Guimarães
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.
- Observatório de Pesquisa em Epidemiologia, Nutrição e Saúde (OPeNS), Belo Horizonte, Brazil.
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Guimarães NS, Magno L, Monteiro GMB, Ramos ICN, de Castro CT, Aranha-Rossi TR, Pereira M, Dourado I. Demand creation and retention strategies for oral pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women: a systematic review and meta-analysis. BMC Infect Dis 2023; 23:793. [PMID: 37964202 PMCID: PMC10644426 DOI: 10.1186/s12879-023-08693-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/11/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Men who have sex with men (MSM) and transgender women (TGW) have a disproportionately higher risk of human immunodeficiency virus (HIV) infection than other groups. Oral HIV pre-exposure prophylaxis (PrEP) is an effective prevention tool and should be offered to those at higher risk. Identifying demand creation strategies (DCS) and retention strategies (RS) to improve PrEP persistence is essential to control the HIV epidemic. AIM We aimed to identify the (DCS and RS with higher proportions among MSM and TGW. METHODS A systematic review and meta-analysis of prospective studies were conducted, with studies retrieved from five databases until November, 2022 following the Cochrane and PRISMA guidelines. The study protocol was registered in PROSPERO (CRD42022323220). The outcomes were DCS and RS for PrEP use among MSM and TGW. Strategies used for users enrolled in the PrEP-recruited (DCS) were classified as face-to-face (peer educator recruitment at social venues, nongovernmental organizations, and parties; direct referrals by health services; friends and/or sexual partners); online (chatbot or peer educator recruitment on social media [e.g., , Instagram or Facebook] or dating/hook-up apps [e.g., Grindr, Tinder, Badoo, and Scruff]); and mixed (face-to-face and online). RS was classified as provider counseling (face-to-face by a health professional; prevention of HIV risk counseling, distribution of condoms, lubricants, and testing for HIV or other sexually transmitted infections); online counseling (text messages, chatbots, telephone calls, social media, and peer educators); and mixed (all previous strategies). Subgroup analyses were conducted for each treatment strategy. Meta-analyses were performed using the R software version 4.2.1. RESULTS A total of 1, 129 studies were retrieved from the five databases. After eligibility, 46 studies were included. For MSM, most DCS and RS were online at 91% (95% CI: 0.85-0.97; I2=53%), and 83% (95% CI: 0.80-0.85; I2=17%) respectively. For TGW, mixed DCS and RS were the most frequent at85% (95% CI: 0.60-1.00; I2=91%) and online counseling at 84% (95% CI: 0.64-0.95) compared to other strategies. CONCLUSION Critical issues play. Pivotal role in increasing PrEP awareness among MSM and TGW, minimizing access gaps, and ensuring retention of PrEP services. Offering oral PrEP using online DCS and RS can reach and retain high numbers of MSM and TGW, and reduce HIV incidence in these populations.
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Affiliation(s)
- Nathalia Sernizon Guimarães
- Faculdade Ciências Médicas de Minas Gerais, R. Basílio da Gama, Canela, Salvador, Bahia, 40110-040, Brazil.
- Fundação de apoio à Fiocruz (FIOTEC) Scholarship, Avenida, Brazil.
- Departamento Ciências da Vida, Universidade do Estado da Bahia, Salvador, Brazil.
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
| | - Laio Magno
- Life Sciences Departament, Universidade do Estado da Bahia, Salvador, Bahia, Brazil
| | - Gabriel Marinho Bahia Monteiro
- Fundação de apoio à Fiocruz (FIOTEC) Scholarship, Avenida, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Izabel Cristina Neves Ramos
- Fundação de apoio à Fiocruz (FIOTEC) Scholarship, Avenida, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Caroline Tianeze de Castro
- Faculdade Ciências Médicas de Minas Gerais, R. Basílio da Gama, Canela, Salvador, Bahia, 40110-040, Brazil
| | | | - Marcos Pereira
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Inês Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
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Araújo LR, Orefice JL, Gonçalves MA, Guimarães NS, Soares AN, Salomon T, de Souza AH. Use of digital retinography to detect vascular changes in pre-diabetic patients: a cross-sectional study. Diabetol Metab Syndr 2023; 15:225. [PMID: 37926814 PMCID: PMC10626765 DOI: 10.1186/s13098-023-01154-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/22/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is a common complication of DM and may go unnoticed until irreversible damage occurs. Its screening can contribute to the early detection. Although, there are no studies which investigate the ability of digital retinography to detect vascular changes in pre-diabetic patients. OBJECTIVE Identify the prevalence and severity of RD in patients with pre-diabetes. METHODS Cross-sectionalstudy carried out in a sample of patients with pre-diabetes and weight excess characterized from January 2020 to April 2023. Sociodemographic and clinical variables were collected, in addition to lifestyle habits. Retinographic evaluation was also performed using a Digital Retinography. For the analysis of all variables, the adopted significance level was 5%. The software used for the analysis was SPSS version 25.0. RESULTS Of 108 patients selected 7.1% have alteration in the exam indicating DR. Among the participants with diabetic retinopathy, four had the moderate form (50%), three the moderate form (37%) and only one participant had the severe form (13%). CONCLUSIONS Our findings highlight the importance of preventive measures and adequate control of these conditions in pre-diabetic patients, in order to prevent or delay the progression of diabetic retinopathy and, consequently, reduce the risk of blindness and other ocular complications.
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Affiliation(s)
- Levimar Rocha Araújo
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Aleida Nazareth Soares
- Faculdade de Ciências Médicas de Minas Gerais and Faculdade de Saúde Santa Casa BH, Belo Horizonte, Brazil
| | - Tassila Salomon
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Freitas CAM, Rossi TA, Dourado I, Castellanos MEP, Guimarães NS, Magno L. Mapping evidence on health promotion in HIV testing among men who have sex with men and transgender women using the social-ecological model and the vulnerability theoretical framework: a scoping review. BMC Public Health 2023; 23:1946. [PMID: 37805484 PMCID: PMC10559455 DOI: 10.1186/s12889-023-16860-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/29/2023] [Indexed: 10/09/2023] Open
Abstract
This study aimed to map the scientific evidence on health promotion in human immunodeficiency virus) HIV testing among men who have sex with men (MSM) and transgender women (TGW) based on the social-ecological model (i.e., individual, organizational and social levels) and the theoretical framework of vulnerability (i.e., individual, social, and programmatic levels). The reviewed studies indicated several barriers to accessing HIV testing (e.g., economic, structural, and bureaucratic) and demonstrated the potential for community approaches to promote greater access to HIV testing and minimize the stigma and discrimination associated with HIV testing, primarily through community leadership and social support networks. The socio-ecological model of health promotion and the vulnerability approach have the potential to contribute to improving HIV testing services by balancing the technical and political power of health services and providers with community participation while considering the social contexts. Therefore, there is a need for reflection on health promotion policies and programs aimed at expanding access to HIV testing among MSM and TGW through interventions that consider the social contexts and cultural perspectives. Moreover, inter-sectoral strategies aimed at improving living conditions and access to fundamental resources for maintaining health and well-being should be considered.
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Affiliation(s)
- Camila Amaral Moreno Freitas
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA), Basílio da Gama Street, Salvador, BA, 40110-040, Brazil.
| | - Thais Aranha Rossi
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), 2555 Silveira Martins Street, Salvador, BA, 41150000, Brazil
| | - Inês Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA), Basílio da Gama Street, Salvador, BA, 40110-040, Brazil
| | | | - Nathalia Sernizon Guimarães
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA), Basílio da Gama Street, Salvador, BA, 40110-040, Brazil
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), 2555 Silveira Martins Street, Salvador, BA, 41150000, Brazil
| | - Laio Magno
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA), Basílio da Gama Street, Salvador, BA, 40110-040, Brazil
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), 2555 Silveira Martins Street, Salvador, BA, 41150000, Brazil
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Baichuan Y, Gomes Reis M, Tavakoli S, Khodadadi N, Sohouli MH, Sernizon Guimarães N. The effects of NAD+ precursor (nicotinic acid and nicotinamide) supplementation on weight loss and related hormones: a systematic review and meta-regression analysis of randomized controlled trials. Front Nutr 2023; 10:1208734. [PMID: 37854354 PMCID: PMC10579603 DOI: 10.3389/fnut.2023.1208734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023] Open
Abstract
Background Despite the fact that obesity and overweight are serious major health problems worldwide, fighting against them is also considered a challenging issue. Several interventional studies have evaluated the potential weight-reduction effect of nicotinamide adenine dinucleotide (NAD+) precursor. In order to obtain a better viewpoint from them, this study aimed to comprehensively investigate the effects of NAD+ precursor supplementation on weight loss, adiponectin, and leptin. Methods Scopus, PubMed/Medline, Web of Science, Cochrane, and Embase databases were searched using standard keywords to identify all controlled trials investigating the weight loss and related hormones effects of NAD+ precursor. Pooled weighted mean difference and 95% confidence intervals were achieved by random-effects model analysis for the best estimation of outcomes. Results Twenty two treatment arms with 5,144 participants' were included in this systematic review and meta-regression analysis. The pooled findings showed that NAD+ precursor supplementation has an effect on lowering BMI (weighted mean difference (WMD): -0.19 kg/m2, 95% confidence interval (CI): -0.29 to -0.09, p < 0.001) and increasing adiponectin (WMD: 1.59 μg/mL, 95% CI: 0.49 to 2.68, p = 0.004) in humans compared with control groups. However, no significant effect was observed on body weight and leptin. There was a significant relationship between doses of intervention with changes in BMI. In addition, subgroup analysis showed that BMI reduction was greater when receiving nicotinic acid (NA) supplementation than nicotinamide (NE) supplementation. Conclusion NAD+ precursor had significant effects on weight management with the reduction of BMI and increasing adiponectin.
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Affiliation(s)
- You Baichuan
- SDU-ANU Joint Science College, Shandong University, Weihai, China
| | - Marcela Gomes Reis
- Master in Health Science at Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- OPENS: Observatory of Epidemiology, Nutrition and Health Research, Faculdade Ciências Médicas de Minas Gerais/FELUMA, Belo Horizonte, Minas Gerais, Brazil
| | - Sogand Tavakoli
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Navideh Khodadadi
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Sohouli
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nathalia Sernizon Guimarães
- OPENS: Observatory of Epidemiology, Nutrition and Health Research, Faculdade Ciências Médicas de Minas Gerais/FELUMA, Belo Horizonte, Minas Gerais, Brazil
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Gontijo Garcia GS, Meira KC, de Souza AH, Guimarães NS. Anxiety and depression disorders in oncological patients under palliative care at a hospital service: a cross-sectional study. BMC Palliat Care 2023; 22:116. [PMID: 37580770 PMCID: PMC10426043 DOI: 10.1186/s12904-023-01233-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 07/25/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the risk and protective factors associated with anxiety and depression symptoms in cancer patients at an advanced stage of cancer. METHODS A cross-sectional study was conducted on patients with advanced cancer who were receiving palliative care. Cancer patients aged 18 years or older, with preserved cognitive function who completed the questionnaires were eligible. The questionnaires of Hospital Anxiety and Depression Scale (HADS) and health related of quality of life questionnaire; the European Organization for Research and Treatment of Cancer (EORTC-C30) were applied. Outcome variables were the depression and anxiety symptoms of cancer patients under palliative care, according to the answers to the 14 items that make up the HADS Scale. The analysis used the R software, version 4.2.0. RESULTS Seventy cancer patients with advanced cancer were included. The colon was the most common neoplastic diagnostic (20%), followed by breast (12.9%) and lung (10%). The prevalence of depression was 44.3%, 25.7% anxiety and 52.9% had both symptoms. Patients with a high level of functionality had a lower chance of anxiety (OR = 0.80;p = 0.025), depression (OR = 0.82; p = 0.007), and anxiety and depression (OR = 0.82p = 0.008). We observed a lower chance of depression and depression/anxiety who showed a high level of Overall Performance. Three symptoms increased the chance of depression/anxiety: nausea/vomiting (p = 0.019), fatigue (0.031), loss of appetite (0.048). CONCLUSION This study found high prevalence of anxiety and depression.Better quality of life and functionality were negatively associated with these outcomes. Examining the patient's functions will assist the clinician in alleviating symptoms of anxiety and depression, giving cancer patients in palliative care more dignity. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
| | - Karina Cardoso Meira
- Escola de Saúde, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- OPENS: Observatory of Epidemiology, Nutrition and Health Research, Faculdade Ciências Médicas de Minas Gerais/FELUMA, Belo Horizonte, Minas Gerais, Brazil
| | - Alessandra Hubner de Souza
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- OPENS: Observatory of Epidemiology, Nutrition and Health Research, Faculdade Ciências Médicas de Minas Gerais/FELUMA, Belo Horizonte, Minas Gerais, Brazil
| | - Nathalia Sernizon Guimarães
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
- OPENS: Observatory of Epidemiology, Nutrition and Health Research, Faculdade Ciências Médicas de Minas Gerais/FELUMA, Belo Horizonte, Minas Gerais, Brazil.
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Lisboa CS, Guimarães NS, Ferreira AJF, Silva KBBD, Alves FJO, Rocha ADS, Ortelan N, Texeira CSS, Falcão IR, Silva NDJ, Ribeiro-Silva RDC, Barbosa D, Barreto ML. Impact of cash transfer programs on birth and child growth outcomes: systematic review. Cien Saude Colet 2023; 28:2417-2432. [PMID: 37531548 DOI: 10.1590/1413-81232023288.14082022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/25/2023] [Indexed: 08/04/2023] Open
Abstract
To investigate the impact of cash transfer (CTs) on birth outcomes, including birth weight, low birth weight and prematurity, as well as child physical growth were included, as assessed by anthropometric indices in children under five years of age. Searching was performed using the PubMed/Medline, Embase, LILACS, Cochrane Library, Scopus and Web of Science databases. Quantitative observational, experimental and quasi-experimental. Eleven studies were included in the review. The majority (81.8%) were carried out in low-and middle-income countries and most involved conditional CTs (63.6%). Four were clinical trials and seven were observational studies. Conditional CTs were found to be associated with a reduction in height-for-age (-0.14; 95%CI -0.27, -0.02); (OR 0.85; 95%CI 0.77-0.94); (OR = 0.44; 95%CI 0.19-0.98), a significantly reduced chance of low weight-for-age (OR = 0.16; 95%CI -0.11-0.43), low weight-for-height (OR = -0.68; 95%CI -1.14, -0.21), and low weight-for-age (OR = 0.27; 95%CI 0.10; 0.71). Unconditional CTs were associated with reduced birth weight (RR = 0.71; 95%CI 0.63-0.81; p < 0.0001) and preterm births (RR = 0.76; 95%CI 0.69-0.84; p < 0.0001). Conditional CTs can positively influence birth outcomes and child growth.
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Affiliation(s)
- Cinthia Soares Lisboa
- Universidade Estadual de Feira de Santana, Programa de Pós-Graduação em Saúde Coletiva. Av. Transnordestina s/n, Novo Horizonte. 44036-900 Feira de Santana BA Brasil.
| | | | | | - Karine Brito Beck da Silva
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Flávia Jôse Oliveira Alves
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Aline Dos Santos Rocha
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Naiá Ortelan
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Camila Silveira Silva Texeira
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Ila Rocha Falcão
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | | | - Rita de Cássia Ribeiro-Silva
- Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas de Minas Gerais. Belo Horizonte MG Brasil
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
| | - Djanilson Barbosa
- Centro de Ciências da Saúde, Universidade Federal do Recôncavo da Bahia. Santo Antônio de Jesus BA Brasil
| | - Mauricio Lima Barreto
- Pós-Graduação em Ciências Médicas, Faculdade de Ciências Médicas de Minas Gerais. Belo Horizonte MG Brasil
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Instituto Gonçalo Moniz - Fiocruz Bahia. Salvador BA Brasil
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Sato HI, Costa MS, Takahashi RHC, Lourenço KL, Guimarães NS, Alves CRL, Machado EL, Tupinambás U, Fonseca FGD, Teixeira SMR. RT-qPCR-based pool testing for the diagnosis of COVID-19. Einstein (Sao Paulo) 2023; 21:eAE0115. [PMID: 37436266 DOI: 10.31744/einstein_journal/2023ae0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 02/07/2023] [Indexed: 07/13/2023] Open
Abstract
This study proposes a strategy for large-scale testing among a large number of people for the early diagnosis of COVID-19 to elucidate the epidemiological situation. Pool testing involves the analysis of pooled samples. This study aimed to discuss a reverse transcription technique followed by quantitative real-time polymerase chain reaction using pool testing to detect SARS-CoV-2 in nasopharyngeal swab samples. The study proposes an innovative diagnostic strategy that contributes to resource optimization, cost reduction, and improved agility of feedback from results. Pool testing is simultaneously performed on multiple samples to efficiently and cost-effectively detect COVID-19. Pool testing can optimize resource utilization and expand diagnostic access, and is a viable alternative for developing countries with limited access to testing. To optimize resources, the pool size was determined by estimating COVID-19 prevalence in the study population.
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Affiliation(s)
- Hugo Itaru Sato
- Vaccine Technology Center, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Murilo Soares Costa
- Postgraduate Program in Infectious Diseases and Tropical Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Karine Lima Lourenço
- Vaccine Technology Center, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Elaine Leandro Machado
- Department of Preventive and Social Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Unaí Tupinambás
- Medical Clinic Department, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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13
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Guimarães NS, Magno L, de Paula AA, Silliman M, Anderle RVR, Rasella D, Macinko J, de Souza LE, Dourado I. The effects of cash transfer programmes on HIV/AIDS prevention and care outcomes: a systematic review and meta-analysis of intervention studies. Lancet HIV 2023; 10:e394-403. [PMID: 37270225 PMCID: PMC10329870 DOI: 10.1016/s2352-3018(22)00290-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 09/02/2022] [Accepted: 09/21/2022] [Indexed: 06/05/2023]
Abstract
BACKGROUND Poverty and social inequality are risk factors for poor health outcomes in patients with HIV/AIDS. In addition to eligibility, cash transfer programmes can be divided into two categories: those with specific requirements (conditional cash transfers [CCTs]) and those without specific requirements (unconditional cash transfers). Common CCT requirements include health care (eg, undergoing an HIV test) and education (eg, children attending school). Trials assessing the effect of cash transfer programmes on HIV/AIDS outcomes have yielded divergent findings. This review aimed to summarise evidence to evaluate the effects of cash transfer programmes on HIV/AIDS prevention and care outcomes. METHODS For this systematic review and meta-analysis, we searched PubMed, EMBASE, Cochrane Library, LILACS, WHO IRIS, PAHO-IRIS, BDENF, Secretaria Estadual de Saúde SP, Localizador de Informação em Saúde, Coleciona SUS, BINACIS, IBECS, CUMED, SciELO, and Web of Science up to Nov 28, 2022. We included randomised controlled trials (RCTs) that evaluated the effects of cash transfer programmes on HIV incidence, HIV testing, retention in HIV care, and antiretroviral therapy adherence, and conducted risk of bias and quality of evidence assessments using the Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluations approach. A random-effects meta-analysis model was used to combine studies and calculate risk ratios (RRs). Subgroup analyses were performed using conditionality types (ie, school attendance or health care). The protocol was registered with PROSPERO, CRD42021274452. FINDINGS 16 RCTs, which included 5241 individuals, fulfilled the inclusion criteria. Of these, 13 studies included conditionalities for receiving cash transfer programmes. The results showed that receiving a cash transfer was associated with lowered HIV incidence among individuals who had to meet health-care conditionalities (RR 0·74, 95% CI 0·56-0·98) and with increased retention in HIV care for pregnant women (1·14, 95% CI 1·03-1·27). No significant effect was observed for HIV testing (RR 0·45, 95% CI 0·18-1·12) or antiretroviral therapy adherence (1·13, 0·73-1·75). Lower risk of bias was observed for HIV incidence and having an HIV test. The strength of available evidence can be classified as moderate. INTERPRETATION Cash transfer programmes have a positive effect on mitigating HIV incidence for individuals who have to meet health-care conditionalities and on increasing retention in HIV care for pregnant women. These results show the potential of cash transfer programmes for HIV prevention and care, especially among people in extreme poverty, and highlight that cash transfer programmes must be considered when developing policies for HIV/AIDS control, as indicated by the UNAIDS 95-95-95 target of the HIV care continuum. FUNDING National Institute of Allergy and Infectious Diseases, National Institutes of Health, USA.
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Affiliation(s)
- Nathalia Sernizon Guimarães
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil; Postgraduate Health Science, Medical Sciences College of Minas Gerais, Belo Horizonte, Brazil.
| | - Laio Magno
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil; Department of Life Sciences, State University of Bahia, Salvador, Brazil
| | | | - Miriam Silliman
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | | | - Davide Rasella
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil; Barcelona Institute for Global Health, Barcelona, Spain
| | - James Macinko
- Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | | | - Inês Dourado
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
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Dias RF, de Paula ACRB, Hasparyk UG, de Oliveira Rabelo Bassalo Coutinho M, Alderete JRA, Kanjongo JC, Silva RAM, Guimarães NS, Simões E Silva AC, Nobre V. Use of C-reactive protein to guide the antibiotic therapy in hospitalized patients: a systematic review and meta-analysis. BMC Infect Dis 2023; 23:276. [PMID: 37138222 PMCID: PMC10155296 DOI: 10.1186/s12879-023-08255-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 04/14/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND C-reactive protein (CRP) is an inflammatory protein used in clinical practice to identify and monitor inflammatory and infectious processes. Recent data suggest CRP might be useful in guiding antibiotic therapy discontinuation among critical care patients. This meta-analysis analyzed the benefits and risks of CRP-guided protocols to guide antibiotic therapy in hospitalized patients in comparison with standard treatment. METHODS Studies were searched in four databases: CENTRAL, Medline, Embase and LILACS. The search was performed until Jan 25th, 2023. The reference lists of the articles retrieved and related review studies were hand-screened to find eligible trials that might have been missed. Primary endpoints included the duration of antibiotic therapy for the index episode of infection. The secondary endpoint was the all-cause hospital mortality and infection relapses. The risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Random effects were used to pool the mean differences and odds ratio of individual studies. The protocol was registered in PROSPERO (CRD42021259977). RESULTS The search strategy retrieved 5209 titles, out of which three studies met the eligibility criteria and were included in this meta-analysis. 727 adult patients were analyzed, of whom 278 were included in the intervention group and 449 were included in the control group. 55,7% of all patients were women. Meta-analysis indicated that experimental groups (CRP-guided) had a lower duration of antibiotic therapy (days) [MMD = -1.82, 95%IC -3.23; -0.40]; with no difference in mortality [OR = 1.19 95%IC 0.67-2.12] or in the occurrence of infection relapse [OR = 3.21 95%IC 0.85-12.05]. CONCLUSION The use of CRP-guided protocol reduces the total amount of time required for antibiotic therapy when compared to standard protocols of treatment in hospitalized patients with acute bacterial infection. We did not observe statistical differences regarding mortality and infection relapse rates.
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Affiliation(s)
- Raphael Figuiredo Dias
- Laboratório Interdisciplinar de Investigação Médica (LIIM), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ana Clara Rivetti Bitencourt de Paula
- School of Medicine, Faculdade de Saúde E Ecologia Humana (FASEH), Vespasiano, MG, Brazil
- Núcleo Interdisciplinar de Investigação Em Medicina Intensiva (NIIMI), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ursula Gramiscelli Hasparyk
- Laboratório Interdisciplinar de Investigação Médica (LIIM), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - João Rafael Assis Alderete
- Laboratório Interdisciplinar de Investigação Médica (LIIM), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Renata Aguiar Menezes Silva
- Laboratório Interdisciplinar de Investigação Médica (LIIM), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Nathalia Sernizon Guimarães
- Núcleo Interdisciplinar de Investigação Em Medicina Intensiva (NIIMI), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões E Silva
- Laboratório Interdisciplinar de Investigação Médica (LIIM), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Vandack Nobre
- Núcleo Interdisciplinar de Investigação Em Medicina Intensiva (NIIMI), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
- Internal Medicine Department, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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Vilela Dos Santos P, de Toledo DNM, Guimarães NS, Perucci LO, de Andrade-Neto VF, Talvani A. Upregulation of IL-33, CCL2, and CXCL16 levels in Brazilian pregnant women infected by Toxoplasma gondii. Acta Trop 2023; 243:106931. [PMID: 37086937 DOI: 10.1016/j.actatropica.2023.106931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 04/24/2023]
Abstract
Congenital toxoplasmosis can cause neurological and eye damage, behavioral alterations, or death in fetuses or babies born to Toxoplasma gondii-infected women. Several pieces of evidence suggest that socioeconomic, environmental, and inflammatory patterns linked to the maternal immune response partly drive the pathogenesis of this disease. However, immunoregulation induced by T. gondii infection during gestation is not completely understood. The aim of this study was to assess the association between T. gondii seropositivity and concentrations of plasma markers (CCL2, CXCL16, IL-17, and IL-33) in Brazilian pregnant women. Inflammatory markers were measured by immunoassays in the plasma of 131 pregnant women (13 to 46 years old). The prevalence of T. gondii infections was 45.8% (n = 60) in this population. The concentrations of CCL2, CXCL16, and IL-33 were higher in T. gondii-seropositive than in seronegative pregnant women, while the opposite was observed for IL-17 levels. In IgG+ women, a strong correlation between IL-17 and IL-33 (r = 0.7508, p = 0.0001) and a moderate correlation between CXCL16/IL-17 (r = 0.7319, p = 0.0001) and CXCL16/CCL2 (r = 0.3519, p = 0.0098) was observed. In uninfected women, a strong correlation was found between IL-17 and CXCL16 (r = 0.6779, p = 0.0001) but moderate between IL-17 and IL-33 (r = 0.4820, p = 0.0001). In summary, our data suggest that plasma upregulation of CCL2, CXCL16, and IL-33 might exert a potential protective role in the mother/fetus/parasite axis and, in addition, multiparous women are more likely to be infected with T. gondii than primiparous women.
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Affiliation(s)
- Priscilla Vilela Dos Santos
- Immunobiology Laboratory of Inflammation, Department of Biological Sciences/ ICEB, Federal University Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Health and Nutrition, Federal University Ouro Preto, Ouro Preto, MG, Brazil
| | - Débora Nonato Miranda de Toledo
- Immunobiology Laboratory of Inflammation, Department of Biological Sciences/ ICEB, Federal University Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Health and Nutrition, Federal University Ouro Preto, Ouro Preto, MG, Brazil
| | | | - Luiza Oliveira Perucci
- Immunobiology Laboratory of Inflammation, Department of Biological Sciences/ ICEB, Federal University Ouro Preto, Ouro Preto, MG, Brazil
| | - Valter Ferreira de Andrade-Neto
- Laboratory of Malaria Biology and Toxoplasmosis, Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - André Talvani
- Immunobiology Laboratory of Inflammation, Department of Biological Sciences/ ICEB, Federal University Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Health and Nutrition, Federal University Ouro Preto, Ouro Preto, MG, Brazil; Graduate Program in Health Sciences, Infectology and Tropical Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
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Pinheiro GSMA, de Souza RC, de Oliveira Azevedo VMG, Guimarães NS, Pires LG, Lemos SMA, Alves CRL. Effects of intrauterine exposure to SARS-CoV-2 on infants' development: a rapid review and meta-analysis. Eur J Pediatr 2023; 182:2041-2055. [PMID: 36899144 PMCID: PMC10005921 DOI: 10.1007/s00431-023-04910-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/22/2023] [Accepted: 02/26/2023] [Indexed: 03/12/2023]
Abstract
Potential medium- and long-term neurodevelopmental sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy have not been ruled out. We aimed to systematically review and summarize the evidence regarding the effects of intrauterine exposure to SARS-CoV-2 on infant development and behavior. Scopus, PubMed, Web of Science, CINAHL, and PsycNet databases were searched for studies published up to February 6, 2023, investigating the effects of gestational SARS-CoV-2 on infant development and behavior. We performed narrative synthesis according to updated protocols. Studies using comparison groups and with the Ages and Stages Questionnaires-Third Edition (ASQ-3) scores available were included in a meta-analysis performed according to Cochrane protocols. We used the Newcastle-Ottawa Quality Assessment Scale to analyze the risk of bias. Heterogeneity was calculated using the I2 statistic. The search identified 2,782 studies. After removing duplicates and applying the eligibility criteria, we performed a narrative synthesis of 10 included studies and a meta-analysis of three. There was no evidence of higher developmental delay rates in infants exposed to SARS-CoV-2 during pregnancy compared to non-exposed infants. However, the exposed infants scored lower than either the non-exposed children or pre-pandemic cohorts in some domains. Pooled results from the random-effects model indicated that SARS-CoV-2-exposed infants had lower scores on fine motor (mean difference [MD] = -4.70, 95% confidence interval [CI]: -8.76; -0.63), and problem-solving (MD = -3.05, 95% CI: -5.88; -0.22) domains than non-exposed infants (heterogeneity: I2 = 69% and 88%, respectively). There was no difference between the exposed and non-exposed infants in the communication, gross motor, and personal-social ASQ-3 domains. Conclusion: We did not find evidence confirming the association between SARS-CoV-2 gestational exposure and neurodevelopmental delays. However, the meta-analysis indicated that gestational exposure negatively affected fine motor and problem-solving skills. Robust evidence on this topic is still incipient, and the available studies present methodological inconsistencies that limit the drawing of clear-cut conclusions. PROSPERO registration: #CRD42022308002; March 14, 2022. What is Known: • COVID-19 is associated with adverse pregnancy outcomes potentially linked to neurodevelopmental delays. • SARS-CoV-2 vertical transmission is rare; however, infections during pregnancy can be deleterious to the fetus, possibly mediated by maternal immune activation and other inflammatory mechanisms. What is New: • No evidence of increased developmental delay rates among SARS-CoV-2 gestational-exposed infants was found. However, a meta-analysis of three studies showed lower scores in fine motor and personal social ASQ-3 domains among exposed infants. • SARS-CoV-2 gestational exposure and the pandemic can affect child development via many mechanisms. Potential neurodevelopmental sequelae of SARS-CoV-2 exposure during gestation have not been ruled out.
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Affiliation(s)
| | - Rayany Cristina de Souza
- Postgraduate Program in Health Sciences, Medicine School, Universidade Federal de Uberlândia (UFU), Uberlândia, Brazil
| | | | | | - Laura Gregório Pires
- Medicine School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Stela Maris Aguiar Lemos
- Speech Therapy and Audiology Department, Medicine School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Claudia Regina Lindgren Alves
- Pediatrics Department, Medicine School, Universidade Federal de Minas Gerais (UFMG), Av. Alfredo Balena, 190/247, Belo Horizonte, Minas Gerais, 30130100, Brazil.
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Dos Santos PV, de Toledo DNM, de Souza DMS, Menezes TP, Perucci LO, Silva ZM, Teixeira DC, Vieira EWR, de Andrade-Neto VF, Guimarães NS, Talvani A. The imbalance in the relationship between inflammatory and regulatory cytokines during gestational toxoplasmosis can be harmful to fetuses: A systematic review. Front Immunol 2023; 14:1074760. [PMID: 36742306 PMCID: PMC9889920 DOI: 10.3389/fimmu.2023.1074760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/04/2023] [Indexed: 01/19/2023] Open
Abstract
Objective To evaluate the available information on inflammatory and regulatory plasma mediators in pregnant women (PW) diagnosed with toxoplasmosis. Source: The PubMed, Embase, Scopus, and Lilacs databases were evaluated until October 2022. Study eligibility criteria: This review was carried out following the PRISMA and registered on the PROSPERO platform (CRD42020203951). Studies that reported inflammatory mediators in PW with toxoplasmosis were considered. Evaluation methods After excluding duplicate articles, two authors independently carried out the process of title and abstract exclusion, and a third resolved disagreements when necessary. The full text was evaluated to detect related articles. The extraction table was built from the following data: Author, year of publication, journal name and impact factors, country, study design, number of gestations and maternal age (years), gestational period, diagnosis of toxoplasmosis, levels of inflammatory markers, laboratory tests, and clinical significance. Methodological quality was assessed using Joanna Briggs Institute tools. Results Of the 1,024 studies reported, only eight were included. Of the 868 PW included in this review, 20.2% were IgM+/IgG- and 50.8% were IgM-/IgG+ to T. gondii, and 29.0% uninfected. Infected PW presented higher plasma levels ofIL-5, IL-6, IL-8, IL-17, CCL5, and IL-10. Regarding the methodological quality, four studies obtained high quality. Data from this review pointed out the maintenance of the inflammatory pattern during pregnancy with a closely related to the parasite. Conclusion Immune status in PW defined the course of the T. gondii infection, where the equilibrium between inflammatory and regulatory cytokines mitigated the harmful placenta and fetus effects. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD420203951.
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Affiliation(s)
- Priscilla Vilela Dos Santos
- Laboratory of the Immunobiology of Inflammation, Department of Biological Sciences/Institute of Exact and Biological Sciences (ICEB), Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, Brazil
| | - Débora Nonato Miranda de Toledo
- Laboratory of the Immunobiology of Inflammation, Department of Biological Sciences/Institute of Exact and Biological Sciences (ICEB), Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, Brazil
| | - Débora Maria Soares de Souza
- Laboratory of the Immunobiology of Inflammation, Department of Biological Sciences/Institute of Exact and Biological Sciences (ICEB), Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, Brazil
| | - Tatiana Prata Menezes
- Laboratory of the Immunobiology of Inflammation, Department of Biological Sciences/Institute of Exact and Biological Sciences (ICEB), Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, Brazil
| | - Luiza Oliveira Perucci
- Laboratory of the Immunobiology of Inflammation, Department of Biological Sciences/Institute of Exact and Biological Sciences (ICEB), Federal University of Ouro Preto, Ouro Preto, MG, Brazil
| | - Zolder Marinho Silva
- Laboratory of the Immunobiology of Inflammation, Department of Biological Sciences/Institute of Exact and Biological Sciences (ICEB), Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, Brazil
| | | | - Ed Wilson Rodrigues Vieira
- Department of Maternal and Child Nursing and Public Health, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Valter Ferreira de Andrade-Neto
- Laboratory of Malaria and Toxoplasmosis Biology, Department of Microbiology and Parasitology, Federal University of the Rio Grande do Norte, Natal, RN, Brazil
| | - Nathalia Sernizon Guimarães
- Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, Brazil
| | - André Talvani
- Laboratory of the Immunobiology of Inflammation, Department of Biological Sciences/Institute of Exact and Biological Sciences (ICEB), Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program of Health Science, Infectiology and Tropical Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Guimarães NS, Ferreira AJF, Ribeiro Silva RDC, de Paula AA, Lisboa CS, Magno L, Ichiara MY, Barreto ML. Deduplicating records in systematic reviews: there are free, accurate automated ways to do so. J Clin Epidemiol 2022; 152:110-115. [PMID: 36241035 DOI: 10.1016/j.jclinepi.2022.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 09/27/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Here, we examined the accuracy measures of a set of automated deduplication tools to identify duplicate in the eligibility process of systematic reviews. STUDY DESIGN AND SETTING A planned search strategy was carried out on seven electronic databases until May 31, 2021. Using manual search as the reference standard, we assessed sensibility, specificity, negative predictive value, and positive predictive value (PPV). RESULTS Specificity ranged from 0.96 to 1.00. Rayyan, Mendeley, and Systematic Review Accelerator (SRA) presented high sensibility (0.98 [95% CI = 0.94-1.00]; 0.93 [95% CI = 0.88-0.97] and 0.90 [95% CI = 0.84-0.95], respectively), whereas EndNote X9 and Zotero had only fair sensitivity (0.73 [95% CI = 0.65-0.80] and 0.74 [95% CI = 0.66-0.81], respectively). Negative predictive value ranged from 0.99 to 1.00. Mendeley and SRA had good PPV (0.93 [95% CI = 0.88-0.97] and 0.99 [95% CI = 0.96-1.00], respectively). PPV was fair for EndNote X9 (0.61 [95% CI = 0.54-0.69]) and Zotero (0.62 [95% CI = 0.54-0.69]) and poor for Rayyan (0.41 [95% CI = 0.36-0.47]). CONCLUSION Choosing the most suitable tool depends on its interface's characteristics, the algorithm to identify and exclude duplicates, and the transparency of the process. Therefore, Rayyan, Mendeley, and SRA proved to be accurate enough for the systematic reviews' deduplication step.
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Affiliation(s)
| | - Andrêa J F Ferreira
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Bahia, Brazil; The Ubuntu Center on Racism, Global Movements, and Population Health Equity, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Rita de Cássia Ribeiro Silva
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Bahia, Brazil; Department of Nutrition, School of Nutrition, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Cinthia Soares Lisboa
- Pos-graduation programme of Collective Health, State University of Feira de Santana, Feira de Santana, Bahia, Brazil
| | - Laio Magno
- Institute of Collective Health. Federal University of Bahia, Salvador, Bahia, Brazil; Department of Life Sciences, State University of Bahia, Salvador, Bahia, Brazil
| | - Maria Yury Ichiara
- Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Maurício Lima Barreto
- Institute of Collective Health. Federal University of Bahia, Salvador, Bahia, Brazil; Centre for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
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de Paula W, Pereira JM, Guimarães NS, Godman B, Nascimento RCRMD, Meireles AL. Key characteristics including sex, sexual orientation and internet use associated with worse mental health among university students in Brazil and implications. J Public Health (Oxf) 2022; 44:e487-e498. [PMID: 35037058 DOI: 10.1093/pubmed/fdab406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/04/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The symptoms of anxiety and depression disorders are multifactorial and can trigger a series of problems especially among university students. The aim of this study was to assess the prevalence and associated factors with anxiety and depression symptoms among first-semester university students at a Federal University in Brazil given the paucity of such data and the first semester is the most stressfultime. METHODS Cross-sectional study with first-semester university students. The questionnaire included socio-demographic variables, lifestyles, health conditions and the Depression Anxiety Stress Scales. Descriptive analysis was performed, followed by bivariate analysis and Poisson regression analysis. RESULTS Three hundred and fifty-six students (65.2%) across a range of courses in their first semester participated. The prevalence of anxiety was 42.5% and depression 33.2%. Regarding symptoms of anxiety and depression disorders, a positive association was observed among females, non-heterosexual, non-white skin color, excessive internet use, lack of physical activity, not attending university parties, having psychological counseling, history of anxiety in first- or second-degree relatives, poor self-rated health and use of psychotropic medicines. CONCLUSIONS Due to the high prevalence of anxiety and depression symptoms, the importance of developing programs to promote mental and physical health of university students is highlighted.
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Affiliation(s)
- Waléria de Paula
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil
| | - João Marcos Pereira
- School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil
| | - Nathalia Sernizon Guimarães
- Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G1 1XQ, UK.,Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0204, South Africa
| | - Renata Cristina Rezende Macedo do Nascimento
- Department of Pharmacy, Postgraduate Program in Pharmaceutical Sciences (CiPharma), School of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil
| | - Adriana Lúcia Meireles
- Department of Clinical and Social Nutrition, Postgraduate Program in Health and Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais 35400-000, Brazil
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Souza-Silva MVR, Domingues MLDP, Chagas VS, Pereira DN, de Sá LC, Almeida MSS, Sales TLS, Raposo MC, Guimarães NS, Oliveira JADQ, Ribeiro ALP, Cardoso CS, Martins MAP, Enes TB, Soares TBDC, Baldoni AO, Marcolino MS. Implementation of a text messaging intervention to patients on warfarin therapy in Brazilian primary care units: a quasi-experimental study. BMC Prim Care 2022; 23:54. [PMID: 35321654 PMCID: PMC8942053 DOI: 10.1186/s12875-022-01647-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022]
Abstract
Background Warfarin remains the most affordable oral anticoagulant in many countries. However, it may have serious side effects, and the success of the therapy depends on the patient’s understanding of the medication and their adherence to treatment. The use of short messages services (SMS) is a strategy that can be used to educate patients, but there are no studies evaluating this intervention in patients taking warfarin. Therefore, we aimed to develop, implement, and assess the feasibility of an intervention using SMS to primary care patients taking warfarin in a medium-sized Brazilian city. Methods A bank of 79 SMS was drafted and validated by an expert panel. During 6 months, three times a week, patients received messages about anticoagulation with warfarin. At baseline and after 3 months, we assessed their knowledge and adherence with validated instruments. At the end of the follow-up, participants answered a satisfaction questionnaire. Subsequently, a scale-up phase was conducted, with another round of the intervention including 82 participants (29 from the first phase and 53 newly recruited). Seven months after the end of the scale-up, we asked the patients for their insights about the long-term effects of this program. All patients signed informed consent. The study was approved by the Research and Ethics committee of the Universidade Federal de Minas Gerais. Results In the pilot, 33 (89.2%) patients completed the follow-up. Among the participants who answered the satisfaction questionnaire (n = 29), 86.2% considered that the intervention motivated a healthy lifestyle and improved their understanding of warfarin therapy. All patients were willing to continue receiving the messages. Adherence measured by the Measure of Adherence to Treatment (MAT) test was high in the pre-intervention assessment and remained high (96.7% vs. 93.3%; p = 1.0000). The proportion of patients who achieved > 75% correct answers on the Oral Anticoagulation Knowledge (OAK) test increased from 6.5% to 25.6, p = 0.0703. In the scale-up, 23 patients answered the long-term assessment questionnaire. The main long-term knowledge reported was dietary information. Nine patients received the messages but did not remember their content. Conclusion The intervention was well-accepted and had a positive impact on patient’s knowledge about oral anticoagulation therapy. The scale-up assessment reinforced the need to constantly monitor digital interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01647-5.
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de Toledo DNM, Vilela dos Santos P, Guimarães NS, de Andrade-Neto VF, Perucci LO, Talvani A. AUMENTO NOS NÍVEIS PLASMÁTICOS DE CCL2 E CXCL16 DURANTE A INFECÇÃO POR TOXOPLASMA GONDII EM GESTANTES BRASILEIRAS. Braz J Infect Dis 2022. [DOI: 10.1016/j.bjid.2022.102423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Marcolino MS, Meira KC, Guimarães NS, Motta PP, Chagas VS, Kelles SMB, de Sá LC, Valacio RA, Ziegelmann PK. Systematic review and meta-analysis of ivermectin for treatment of COVID-19: evidence beyond the hype. BMC Infect Dis 2022; 22:639. [PMID: 35870876 PMCID: PMC9308124 DOI: 10.1186/s12879-022-07589-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 07/05/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The role of ivermectin in the treatment of COVID-19 is still under debate, yet the drug has been widely used in some parts of the world, as shown by impressive market data. The available body of evidence may have changed over the last months, as studies have been retracted and "standards of care" (SOC) used in control groups have changed with rapidly evolving knowledge on COVID-19. This review aims to summarize and critically appraise the evidence of randomized controlled trials (RCTs) of ivermectin, assessing clinical outcomes in COVID-19 patients. METHODS RCTs evaluating the effects of ivermectin in adult patients with COVID-19 were searched through June 22, 2022, in four databases, L.OVE platform, clinical trial registries and pre-prints platforms. Primary endpoints included all-cause mortality and invasive ventilation requirement. Secondary endpoint was the occurrence of adverse events. Risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Meta-analysis included only studies which compared ivermectin to placebo or SOC. Random-effects were used to pool the risk ratios (RRs) of individual trials. The quality of evidence was evaluated using GRADE. The protocol was register in PROSPERO (CRD42021257471). RESULTS Twenty-five RCTs fulfilled inclusion criteria (n = 6310). Of those, 14 compared ivermectin with placebo, in night ivermectin associated with SOC was compared to SOC and two studies compared ivermectin to an active comparator. Most RCTs had some concerns or high risk of bias, mostly due to lack of concealment of the randomization sequence and allocation, lack of blinding and high number of missing cases. Ivermectin did not show an effect in reducing mortality (RR = 0.76; 95%CI: 0.52-1.11) or mechanical ventilation (RR = 0.74; 95%CI: 0.48-1.16). This effect was consistent when comparing ivermectin vs. placebo, and ivermectin associated with SOC vs. SOC, as well as in sensitivity analysis. Additionally, there was very low quality of evidence regarding adverse effects (RR = 1.07; 95%CI: 0.84-1.35). CONCLUSIONS The evidence suggests that ivermectin does not reduce mortality risk and the risk of mechanical ventilation requirement. Although we did not observe an increase in the risk of adverse effects, the evidence is very uncertain regarding this endpoint.
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Affiliation(s)
- Milena Soriano Marcolino
- Department of Internal Medicine, Medical School and Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, sala 246, Belo Horizonte, 30130-100 Brazil
- Institute for Health Technology Assessment (IATS/CNPq), Rua Ramiro Barcelos, 2359, Prédio 21|Sala 507, Porto Alegre, Brazil
| | - Karina Cardoso Meira
- Health School, Federal University of Rio Grande do Norte, Av. Sen. Salgado Filho, s/n-Lagoa Nova, Natal, Rio Grande do Norte, Brazil
| | - Nathalia Sernizon Guimarães
- Instituto de Saúde Coletiva da Universidade Federal da Bahia, R. Basílio da Gama, s/n-Canela, Salvador, Brazil
| | - Paula Perdigão Motta
- Faculdade de Farmácia da Universidade Federal de Minas Gerais, R. Prof. Moacir Gomes de Freitas S/N-Pampulha, Belo Horizonte, Minas Gerais Brazil
| | - Victor Schulthais Chagas
- Department of Internal Medicine, Medical School and Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, sala 246, Belo Horizonte, 30130-100 Brazil
- Department of Medicine and Nursing, Universidade Federal de Viçosa, Av. Peter Henry Rolfs, University Campus, Viçosa, Brazil
| | - Silvana Márcia Bruschi Kelles
- Pontifícia Universidade Católica de Minas Gerais, R. do Rosário, 1.081 Bairro Angola, Betim, Brazil
- Unimed-BH, Belo Horizonte, MG Brazil
| | - Laura Caetano de Sá
- Department of Internal Medicine, Medical School and Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena 190, sala 246, Belo Horizonte, 30130-100 Brazil
- Faculdade Ciências Médicas de Minas Gerais-FCMMG, Alameda Ezequiel Dias, Belo Horizonte, 275 Brazil
| | | | - Patrícia Klarmann Ziegelmann
- Institute for Health Technology Assessment (IATS/CNPq), Rua Ramiro Barcelos, 2359, Prédio 21|Sala 507, Porto Alegre, Brazil
- Epidemiology e Statistics Department, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, Porto Alegre, RS 2400 Brazil
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Chaves AT, Oliveira ALGD, Guimarães NS, Magalhães IC, Menezes CADS, Rocha MODC. Galectin-3 and fibrosis intensity in Chronic Chagas Cardiomyopathy: a systematic review. Rev Inst Med Trop Sao Paulo 2022; 64:e45. [PMID: 35749417 PMCID: PMC9236203 DOI: 10.1590/s1678-9946202264045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/15/2022] [Indexed: 11/24/2022] Open
Abstract
Chronic Chagas Cardiomyopathy (CCC) is the most prevalent type of myocarditis and the main clinical form of the Chagas disease, which has peculiarities such as focal inflammation, structural derangement, hypertrophy, dilation, and intense reparative fibrosis. Many cellular compounds contribute to CCC development. Galectin-3 is a partaker in inflammation and contributes to myocardial fibrosis formation. Some studies showed the connection between Galectin-3 and fibrosis in Chagas disease but are still inconclusive on the guidance for the early implementation of pharmacological therapy. This systematic review evaluated Galectin-3 as a biomarker for fibrosis intensity in CCC. Two independent reviewers have searched five databases (PubMed, EMBASE, Cochrane Library, Scopus, and Lilacs), using the following search terms: galectin-3, biomarkers, fibrosis, Chagas cardiomyopathy, and Chagas disease. Overall, seven studies met the inclusion criteria and made up this review. There were four trials conducted through animal model experiments and three trials with humans. Experimental data in mice indicate an association between Galectin-3 expression and fibrosis in CCC (75% of studies). Data from human studies showed no direct connection between myocardial fibrosis and Galectin-3 expression (80% of studies). Thus, human findings do not provide significant evidence indicating that Galectin-3 is related to fibrosis formation in Chagas disease. Based on the analyzed studies, it is suggested that Galectin-3 might not be a good fibrosis marker in CCC.
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Affiliation(s)
- Ana Thereza Chaves
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde: Medicina Tropical e Doenças Infecciosas, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Laura Grossi de Oliveira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde: Medicina Tropical e Doenças Infecciosas, Belo Horizonte, Minas Gerais, Brazil
| | - Nathalia Sernizon Guimarães
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde: Medicina Tropical e Doenças Infecciosas, Belo Horizonte, Minas Gerais, Brazil
| | - Isabela Cristina Magalhães
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde: Medicina Tropical e Doenças Infecciosas, Belo Horizonte, Minas Gerais, Brazil
| | - Cristiane Alves da Silva Menezes
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, Minas Gerais, Brazil
| | - Manoel Otávio da Costa Rocha
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde: Medicina Tropical e Doenças Infecciosas, Belo Horizonte, Minas Gerais, Brazil
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Guimarães NS, de Paula W, de Aguiar AS, Meireles AL. Absence of religious beliefs, unhealthy eating habits, illicit drug abuse, and self-rated health is associated with alcohol and tobacco use among college students — PADu study. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01440-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Machado AM, Guimarães NS, Bocardi VB, da Silva TPR, Carmo ASD, Menezes MCD, Duarte CK. Understanding weight regain after a nutritional weight loss intervention: Systematic review and meta-analysis. Clin Nutr ESPEN 2022; 49:138-153. [PMID: 35623805 DOI: 10.1016/j.clnesp.2022.03.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/17/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND & AIMS The purpose of this systematic review was to analyze the effects of lifestyle interventions on long-term weight maintenance of weight loss. In addition, we seek to address which period is most susceptible to weight regain; and what is the time required for following-up weight maintenance after the intervention. METHODS Articles published up to August 2020 were identified using the Medline (PubMed), Embase, Web of Science, CENTRAL and Scopus. RESULTS After the selection process, 27 clinical trials involving 7236 individuals were included. The results showed that around 36 weeks after the end of the intervention, weight variation reduces, and a sign of continuous weight gain begin to occur with some patients (n = 208,209) presenting even a completely regain of the lost weight before one year (∼40-48 weeks). However, some strategies used during the weight loss intervention and maintenance period may impact the amount and when the weight regain happens, like intervention type;, intervention duration;, presence of dietitian on the care team;, and maintenance period with counseling by a health professional at least once a month. CONCLUSION This systematic review and meta-analysis showed that lifestyle interventions remained effective in maintaining the mean weight (5% lower than baseline weight) after weight loss interventions were over. However, weight regain started 36 weeks after intervention conclusion. And, it turns out, some strategies used during the weight loss intervention and maintenance period may impact the amount and when the weight regain happens. Obesity complexity and chronicity should be considered, therefore constant and lifelong monitoring and support are important.
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Affiliation(s)
| | - Nathalia Sernizon Guimarães
- Post-Doctoral Resident at Postgraduate Program in Health Science: Infectious Diseases and Tropical Medicine, Universidade Federal de Minas Gerais., Ouro Preto, Brazil
| | | | | | - Ariene Silva do Carmo
- Núcleo de Estudos Em Alimentação e Nutrição Nos Ciclos da Vida, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mariana Carvalho de Menezes
- Professor, Department of Clinical and Social Nutrition, Universidade Federal de Ouro Preto, Ouro Preto, Brazil
| | - Camila Kümmel Duarte
- Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gera, Brazil.
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de Souza MPGU, Guimarães NS, de Resende Guimarães MFB, de Souza VA, Kakehasi AM. Effect of biological disease-modifying antirheumatic drugs on body composition in patients with rheumatoid arthritis: a systematic review and meta-analysis. Adv Rheumatol 2022; 62:16. [DOI: 10.1186/s42358-022-00249-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 05/17/2022] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
Rheumatoid arthritis (RA) generates an inflammatory profile that predisposes to total and visceral fatty accumulation and reduced fat free mass (FFM). This metabolic disorder contributes to poor functionality, increased cardiovascular risk and higher mortality. This study aimed to address a systematic review with meta-analysis to determine the effect of biological and targeted synthetic disease-modifying antirheumatic drugs (bDMARDs and tsDMARDs) on body composition (BC) of patients with RA.
Methods
The search was conducted at the electronic databases PubMed, Cochrane Library, Embase, Lilacs and grey literature. This investigation was carried until July 2021. Outcomes of interest were total weight, body mass index (BMI), fat mass (FM) and FFM. A meta-analysis comparing these outcomes in RA patients under bDMARD treatment versus controls was performed.
Results
Out of 137 studies reviewed, 18 were selected: fifteen prospective cohorts, two retrospective cohorts, and one cross-sectional study. The studies comprised 1221 patients, 778 on bDMARD treatment and 443 controls, which included RA patients under conventional synthetic DMARD (csDMARD). No study addressing BC analysis in patients using tsDMARD was found. The mean age and duration of the disease was 56.7 years and 6.77 years, respectively. Ten studies demonstrated a significant increase of total weight in 88.2% of patients and 42.3% for BMI. In studies that analyzed BC by double X-ray absorptiometry (DXA), the increase in total weight and BMI correlated positively to the increase in FFM. The meta-analysis carried out in five studies showed no significant difference of the mean difference for total weight 0.12 kg (95% CI − 5.58, 5.82), BMI 0.08 kg/m2 (95% CI − 1.76, 1.92), FM − 0.08 kg (95% IC − 5.31, 5.14), and FFM − 2.08 kg (95% CI − 7.37, 3.21).
Conclusion
This systematic review suggests a possible impact of bDMARDs on BC of RA patients, even though, the meta-analysis carried out in a small part of these studies was not able to confirm significant variation in BC components.
Trial registration: PROSPERO code: CRD42020206949.
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Guimarães NS, Costa MS, Machado EL, Sato HI, Amaral EDCME, Arivabene RG, Lourenço KL, Tupinambás U, Fonseca FGD, Takahashi RHC, Teixeira SMR, Alves CRL. Autocoleta de swab nasofaríngeo e teste molecular em pool testing como estratégias para detecção de coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2): viabilidade em estudantes de medicina da Universidade Federal de Minas Gerais, 2021. Epidemiol Serv Saúde 2022; 31:e2021409. [DOI: 10.1590/s1679-49742022000100002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 12/20/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Demonstrar a viabilidade da utilização combinada da autocoleta de swab nasofaríngeo e pool testing para detecção do SARS-CoV-2 em inquéritos epidemiológicos. Métodos A experiência envolveu amostra de 154 estudantes da Universidade Federal de Minas Gerais, que realizaram a autocoleta do swab nasofaríngeo em cabines individuais e sem supervisão. O teste molecular foi realizado utilizando-se a técnica de pool testing. Resultados A obtenção de amostras durou cerca de 5 minutos por pessoa. Realizou-se análise para detecção de RNA endógeno em 40 amostras e os resultados indicaram que não houve falhas decorrentes da autocoleta. Nenhum dos pools detectou presença de RNA viral. O custo da realização do teste molecular (RT-PCR) por pool testing com amostras obtidas por autocoleta foi cerca de dez vezes menor do que nos métodos habituais. Conclusão As estratégias investigadas mostraram-se economicamente viáveis e válidas para a pesquisa de SARS-CoV-2 em inquéritos epidemiológicos.
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Guimarães NS, Raposo MA, Greco D, Tupinambás U, Premaor MO. People Living With HIV, Lean Mass, and Sarcopenia: A Systematic Review and Meta-Analysis. J Clin Densitom 2022; 25:113-123. [PMID: 33836973 DOI: 10.1016/j.jocd.2021.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/22/2022]
Abstract
This systematic review aims to estimate the prevalence of sarcopenia in people living with HIV (PLHIV) and to assess whether there is a difference between the muscle mass of PLHIV and people living without HIV. A systematic review of randomized controlled trials, cohort studies, cross-sectional and case-control studies was carried out. PLHIV over 18 years of age and that had their muscle mass evaluated by dual-energy X-ray absorptiometry were included. Overall, 4,376 studies were found, of which 118 had their full texts evaluated. A total of 5,532 people living with HIV and 2,986 people living without HIV were identified in 41 studies. The frequency of sarcopenia defined by low muscle mass (Baumgartner's operational definition) alone was 30.3% (95%CI 24.3%, 37.1%) and the frequency of sarcopenia defined by low muscle mass with low muscle strength (EWGSOP definition) was 4.5% (95%CI 1.3%, 13.9%), p-value = 0.0006. The standardized mean differences of muscle mass between PLHIV and controls was -0.211 units of standard deviation (95%CI -0.419, -0.003). In the meta-regression analysis muscle mass mean difference was associated with BMI, CD4, percentage of subjects on ART, and study design. PLHIV have a lower muscle mass when compared to people living without HIV. This difference appears to be attenuated by higher BMI, CD4 levels, and the percentage of subjects using ART. Furthermore, the frequencies of sarcopenia assessed by the operational definition of Baumgartner and the EWGSOP are not comparable and cannot be interchanged in PLHIV.
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Affiliation(s)
| | | | - Dirceu Greco
- Department of Clinical Medicine, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Unaí Tupinambás
- Department of Clinical Medicine, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Melissa Orlandin Premaor
- Department of Clinical Medicine, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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dos Santos PV, de Toledo DNM, Machado BAA, Silva ZM, de Andrade-Neto VF, Guimarães NS, Talvani A. Multiparity as a risk factor for congenital toxoplasmosis: a cross-sectional study. Journal of Global Health Reports 2021. [DOI: 10.29392/001c.29891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
| | | | | | | | | | | | - André Talvani
- Universidade Federal de Ouro Preto, Ouro Preto, Brazil
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Costa MS, Gelape GDO, Andrade ABD, Vaz-Tostes LP, Simões MDS, Oliveira RB, Guimarães NS, Tupinambás U. COVID-19 REINFECTION BETWEEN DOSES OF VACCINATION: CASE REPORT IN A CITY OF BRAZIL’S SOUTHEAST. Iniciac cient Cesumar 2021. [DOI: 10.17765/2176-9192.2021v23n2e10400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Vaccination against COVID-19 is happening worldwide, with most vaccines requiring 2 doses to reach its maximum potential. It is the most efficient measure to prevent new cases of COVID-19, both of infection and reinfection. This case reports the reinfection of a female receptionist at an urgent care facility, where the research group was testing and monitoring symptoms of patients with flu syndrome, in the city of Belo Horizonte, Minas Gerais, Brasil, where she reinfected between the two preconized doses. Her initial infection occurred in September 2020 and reinfection in February 2021, 14 days after the first dose - both confirmed by RT-PCR - with reportedly worse symptoms on the latter. We warn for the possibility of reinfection episodes even after the first dose of vaccination, differently from what literature stated so far, so that health agents can organize more effective security measures, in a context of viral mutation and of new strains.
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Costa MS, Guimarães NS, de Andrade AB, Vaz-Tostes LP, Oliveira RB, Simões MDS, Gelape GDO, Alves CRL, Machado EL, da Fonseca FG, Teixeira SMR, Sato HI, Takahashi RHC, Tupinambás U. Detection of SARS-CoV-2 through pool testing for COVID-19: an integrative review. Rev Soc Bras Med Trop 2021; 54:e0276. [PMID: 34787261 PMCID: PMC8582953 DOI: 10.1590/0037-8682-0276-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 08/19/2021] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The pool testing technique optimizes the number of tests performed and reduces the delivery time of results, which is an interesting strategy for the health crisis caused by the COVID-19 pandemic. This integrative review investigated studies in which pool testing was carried out for epidemiological or screening purposes to analyze its clinical or cost effectiveness and assessed the applicability of this method in high-, middle-, and low-income countries. METHODS This integrative review used primary studies published in the MEDLINE, EMBASE, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), and Cochrane Library databases. RESULTS A total of 435 studies were identified: 35.3% were carried out in Asia, 29.4% in Europe, 29.4% in North America, and 5.9% in Oceania. CONCLUSIONS This review suggests that pool testing in the general population may be a useful surveillance strategy to detect new variants of SARS-CoV-2 and to evaluate the period of immunogenicity and global immunity from vaccines.
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Affiliation(s)
- Murilo Soares Costa
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | - Nathalia Sernizon Guimarães
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
| | | | | | - Rhuan Braga Oliveira
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte, MG, Brasil
| | | | | | | | - Elaine Leandro Machado
- Universidade Federal de Minas Gerais, Departamento de Medicina Preventiva e Social, Belo Horizonte, MG, Brasil
| | | | | | - Hugo Itaru Sato
- Universidade Federal de Minas Gerais, Centro de Tecnologia de Vacinas, Belo Horizonte, MG, Brasil
| | | | - Unaí Tupinambás
- Universidade Federal de Minas Gerais, Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Belo Horizonte, MG, Brasil
- Universidade Federal de Minas Gerais, Departamento de Clínica Médica, Belo Horizonte , MG, Brasil
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Hassan Sohouli M, Lari A, Fatahi S, Shidfar F, Găman MA, Sernizon Guimarães N, Sindi GA, Mandili RA, Alzahrani GR, Abdulwahab RA, Almuflihi AM, Alsobyani FM, Albu Mahmud AM, Nazzal O, Alshaibani L, Elmokid S, Abu-Zaid A. Impact of soy milk consumption on cardiometabolic risk factors: A systematic review and meta-analysis of randomized controlled trials. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Paixão JC, de Oliveira FR, Guimarães NS, Machado JAN, de Souza MRCP. MICRO-CONTROLLED THERMAL STIMULATOR FOR DETECTING FINE FIBER CHANGES IN PATIENTS WITH DIABETES MELLITUS: A DIAGNOSTIC ACCURACY STUDY. Prim Care Diabetes 2021; 15:548-553. [PMID: 33541822 DOI: 10.1016/j.pcd.2021.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/27/2020] [Accepted: 01/09/2021] [Indexed: 11/22/2022]
Abstract
AIM To evaluate sensitivity and specificity of the micro-controlled thermal stimulator (MTS) for detecting pathological changes in fine fiber of neuropathy patients with DM. METHODS A diagnostic accuracy study including 84 patients, aged 15-75 years was conducted. A patient's foot was subjected to dermatological, musculoskeletal, vascular, and neurological evaluations. The latter was performed through the perception of a sharp touch with a toothpick (pinprick), thermal sensitivity (cold and hot temperature sensations measured using Diapason Handle and MTS, respectively), vibratory sensitivity (128 Hz Diapason Handle), 10 g Semmes-Weinstein monofilament, and a reflex test. Statistical analyses were performed using Stata® software version 13.0. The sensitivity, specificity, positive and negative predictive values, likelihood ratios, AUC, Kappa index, and accuracy of the diagnostic instruments were evaluated. RESULTS Of the 84 volunteers, 66.7% were female, with an average age of 54 years. We observed that 17% of the total patients were positive for pain sensations in the foot, 13% for cold-temperature sensations, and 21% for hot-temperature sensations. The MTS (hot temperature) obtained 97.6% sensitivity and 90% specificity, agreeing on 87.5% (Kappa index) with the Diapason Handle (cold temperature) (AUC > 0.937; p < 0.05). CONCLUSION MTS is an accurate, sensitive, and specific instrument for the evaluation of diabetic neuropathy as compared with the tuning fork as the standard method and, consequently, it could be of help for the early diagnosis of diabetic neuropathy.
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Borges do Nascimento IJ, Jerončić A, Arantes AJR, Brady WJ, Guimarães NS, Antunes NS, Carim Junior G, Marcolino MS. The global incidence of in-flight medical emergencies: A systematic review and meta-analysis of approximately 1.5 billion airline passengers. Am J Emerg Med 2021; 48:156-164. [PMID: 33915515 DOI: 10.1016/j.ajem.2021.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Medical emergencies during short- or long-haul commercial airline flights have become more commonplace due to the aviation industry's contemporary growth, the popularization of commercial flights, and an increased aging of air travelers with significant comorbidities. However, the precise incidence of onboard medical events on commercial airlines and the most common medical conditions is unclear. METHODS In this systematic review and meta-analysis, we explored the incidence of in-flight medical emergencies among airline passengers and estimated the incidence rate by physiological body system, or organ class/syndrome for emergencies that may be associated with different body systems. We limited our search to cohort studies published between 1945 to October 31, 2020 in MEDLINE, Embase, Cochrane Library and official reports from the Federal Aviation Administration/International Air Transport Association, regardless of the language of publication. Only studies that evaluated the overall frequency of onboard medical events on commercial air carriers (in which they also presented the total number of annual revenue passengers) and the frequency of events by physiological body systems or organ class/syndrome were included. We excluded case reports and case series, systematic or narrative reviews, and studies addressing specific health-related conditions. Two independent investigators performed first- and second-phase study screening, abstracted data, and appraised risk of bias. We rated the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Using a quality effect model, we meta-analyzed data associated with the incidence of in-flight medical emergencies, all-cause fatality, incidence of medical events by medical condition category, frequency of en-route diversion, presence of medical personnel on board, and the use of an automatic external defibrillator. We also extracted data regarding the cost of flight diversion. RESULTS Of 18 individual studies with approximately 1.5 billion passengers, 11 reported the overall incidence of in-flight medical emergencies. Low certainty of evidence suggested that the global incidence of in-flight medical emergencies was 18.2 events per million passengers (95% CI 0.5 to 53.4 per million; I2 = 100%, P < 0.001, very low certainty), and an all-cause mortality rate was 0.21 per million passengers (95% CI 0 to 0.76 per million; I2 = 99%, P < 0.001, low certainty). The four most common categories of medical conditions or syndromes during flight were syncope, gastrointestinal events, respiratory and neurological diagnostic groups. The diversion rate was 11.1 per 100,000 flights (95% CI 5.9 to17.6 per 100,000 flights; I2 = 97%, P < 0.001), with an average cost ranging from $15,000 to $893,000 per unplanned emergency landing across studies which examined this outcome. CONCLUSIONS In-flight medical events on commercial travels are extremely low with a corresponding very low in-flight mortality rate. Associated costs derived from en-route diversion might significantly influence airlines' budgetary equilibrium. Novel and modern standardized reporting systems or platforms should be internationally provided and enforced by health and aviation authorities to obtain higher quality patient-passengers datasets. Onboard volunteer medical providers must be aware of everyday life-threatening events during commercial flights and should consider the establishment of a connection between the aircraft and ground-based medical advisory services while assisting in-flight medical events.
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Affiliation(s)
- Israel Júnior Borges do Nascimento
- School of Medicine and University Hospital, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America.
| | - Ana Jerončić
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia; Cochrane Croatia, University of Split School of Medicine, Split, Croatia.
| | | | - William J Brady
- Department of Emergency Medicine, School of Medicine, University of Virginia, United States of America
| | - Nathalia Sernizon Guimarães
- Department of Clinical and Social Nutrition, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Núbia Suellen Antunes
- School of Medicine and University Hospital, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Guido Carim Junior
- School of Engineering and Built Environment/Aviation, Griffith University, Brisbane, Queensland, Australia
| | - Milena Soriano Marcolino
- School of Medicine and University Hospital, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Guimarães NS, Carvalho TML, Machado-Pinto J, Lage R, Bernardes RM, Peres ASS, Raposo MA, Carvalhais RM, Mancini RA, Shiomatsu GY, Oliveira BC, Rodrigues VDM, Melo MDCBD, Tupinambás U. Increased Home Death Due to Cardiopulmonary Arrest in Times of COVID-19 Pandemic. Arq Bras Cardiol 2021; 116:266-271. [PMID: 33656075 PMCID: PMC7909962 DOI: 10.36660/abc.20200547] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/12/2020] [Indexed: 12/21/2022] Open
Abstract
Fundamento As doenças cardiovasculares constituem um grupo importante de causas de morte no Brasil. As doenças isquêmicas do coração são as principais causas de parada cardiorrespiratória, levando a um impacto na mortalidade devido às doenças cardiovasculares no sistema de saúde. Objetivo Avaliar o número de óbitos domiciliares por parada cardiorrespiratória notificados pelo Serviço de Atendimento Móvel de Urgência (SAMU) em março de 2018, 2019 e 2020. Métodos Trata-se de um estudo observacional realizado a partir da análise de dados de mortalidade por parada cardiorrespiratória de cidadãos atendidos pelo SAMU em Belo Horizonte, Minas Gerais, Brasil. Foram analisadas as características sociais e clínicas e as informações de ocorrência. Foi avaliada a taxa de mortalidade por parada cardiorrespiratória em relação ao número total de atendimentos. Foi considerado um nível de significância de 95%. Resultados Houve um aumento nos óbitos domiciliares por parada cardiorrespiratória em março de 2020, em comparação com março de 2018 (p < 0,001) e março de 2019 (p = 0,050). Dos óbitos relatados em 2020, 63,8% dos pacientes tinham 60 anos ou mais; 63,7% das ocorrências foram à tarde e aproximadamente 87% dos casos de parada cardiorrespiratória notificados apresentavam comorbidades clínicas, com hipertensão arterial sistêmicas e parada cardíaca correspondendo a 22,87% e 13,03% dos casos relatados, respectivamente. A maioria da amostra avaliada deste estudo não teve acompanhamento médico (88,7%). Conclusão Considerando o aumento do número de óbitos, sugerimos reflexões e reajustes quanto ao monitoramento das doenças crônicas não transmissíveis durante a pandemia, bem como melhorias na vigilância dos óbitos. (Arq Bras Cardiol. 2021; 116(2):266-271)
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Affiliation(s)
| | | | | | - Roger Lage
- Prefeitura Municipal de Belo Horizonte, Belo Horizonte, MG - Brasil
| | | | | | | | | | | | | | | | | | | | - Unaí Tupinambás
- Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil
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Oliveira NA, Guimarães NS, Silva SLME, Messias AC, Lopes GF, Nascimento-Júnior IBD, Vieira-Filho SA, Caligiorne RB, Figueiredo SMD. Correlations among neck circumference and anthropometric indicators to estimate body adiposity in people living with HIV. Rev Soc Bras Med Trop 2021; 54:S0037-86822021000100629. [PMID: 33681931 PMCID: PMC8008924 DOI: 10.1590/0037-8682-0649-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/21/2020] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION: Neck circumference (NC) and anthropometric data of people living with HIV (PLWH) are correlated. METHODS: Socioeconomic, NC, body mass index (BMI), tricipital skinfold thickness (TSF), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), waist-hip ratio (WHR), waist-to-height ratio (WHtR), waist circumference (WC), and hip circumference (HC) data of 72 PLWH were correlated. RESULTS Higher adiposity was observed in NC (40.3% [n=29]) and WC (31.9% [n=23]). Correlations between NC/BMI, NC/WC, NC/HC, NC/MAC, NC/MAMC, and NC/WHtR were significant. Increased NC (40.3%[n=29]) and WC (31.9 [n=23]) were associated with higher cardiometabolic risk. CONCLUSIONS: NC correlations are adequate for estimating cardiometabolic risk.
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Affiliation(s)
- Natália Alves Oliveira
- Universidade Federal de Ouro Preto, Programa de Pós-Graduação em Saúde e Nutrição, Ouro Preto, MG, Brasil
| | | | | | - Anny Carolina Messias
- Universidade Federal de Ouro Preto, Programa de Pós-Graduação em Saúde e Nutrição, Ouro Preto, MG, Brasil
| | - Gabriela Fonseca Lopes
- Universidade Federal de Ouro Preto, Programa de Pós-Graduação em Saúde e Nutrição, Ouro Preto, MG, Brasil
| | | | | | | | - Sônia Maria de Figueiredo
- Universidade Federal de Ouro Preto, Programa de Pós-Graduação em Saúde e Nutrição, Ouro Preto, MG, Brasil.,Hospital Santa Casa de Belo Horizonte, Instituto de Ensino e Pesquisa, Belo Horizonte, MG, Brasil
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Raposo MA, Guimarães NS, Tupinambás U. Lipid Accumulation Product Index to Predict Metabolic Syndrome in People Living with HIV. Clin Med Res 2020; 18:120-125. [PMID: 32340981 PMCID: PMC7735448 DOI: 10.3121/cmr.2020.1509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 01/15/2020] [Accepted: 03/13/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Dyslipidemia and central obesity are the main components of metabolic syndrome, which represent important risk factors for cardiovascular diseases in people living with human immunodeficiency virus (HIV). The lipid accumulation product (LAP) index has been shown in studies as an efficient marker of metabolic syndrome in general adult population and its applicability in HIV-infected population is not discussed. We aimed to assess the accuracy of the LAP index to identify metabolic syndrome in people living with HIV. METHODS It is a cross-sectional study with 141 HIV-infected patients on antiretroviral therapy, conducted in a reference centre of infectious diseases in southeast Brazil. Evaluations included LAP index, anthropometric measurements and clinical and laboratorial variables. Metabolic syndrome was defined by International Diabetes Federation (IDF) criteria. RESULTS The prevalence of metabolic syndrome in our sample was 10.6%. A positive and significant correlation was found between the metabolic syndrome and LAP (r=0.401; P<0.01), metabolic syndrome and body mass index (r=0.361; P<0.01) and metabolic syndrome and waist circumference (r=0.427; P<0.01) in our sample. The analysis of the receiver-operating characteristic (ROC) curve revealed that the best cut-off value for LAP index to define metabolic syndrome was 59.4 (sensitivity 80%, specificity 79% and area under the curve (AUC) of 0.875. In female and male, analysis of the ROC curve revealed that the best cut-off value for LAP index to define metabolic syndrome was 56.3 (sensitivity 100%, specificity 82% and AUC of 0.929) and 52.0 (sensitivity 78%, specificity 74% and AUC of 0.838), respectively. CONCLUSION Despite the low prevalence of metabolic syndrome in our sample, the ROC curves analyzes demonstrated a good diagnostic accuracy as an additional screening tool of metabolic syndrome according to the IDF.
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Affiliation(s)
- Mariana Amaral Raposo
- Department of Infectology and Tropical Medicine, Faculty of Medicine - Federal University of Minas Gerais (UFMG) - Belo Horizonte, Minas Gerais - Brazil
| | - Nathalia Sernizon Guimarães
- Department of Infectology and Tropical Medicine, Faculty of Medicine - Federal University of Minas Gerais (UFMG) - Belo Horizonte, Minas Gerais - Brazil
| | - Unaí Tupinambás
- Department of Infectology and Tropical Medicine, Faculty of Medicine - Federal University of Minas Gerais (UFMG) - Belo Horizonte, Minas Gerais - Brazil
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Fatahi S, Matin SS, Sohouli MH, Găman MA, Raee P, Olang B, Kathirgamathamby V, Santos HO, Guimarães NS, Shidfar F. Association of dietary fiber and depression symptom: A systematic review and meta-analysis of observational studies. Complement Ther Med 2020; 56:102621. [PMID: 33220451 DOI: 10.1016/j.ctim.2020.102621] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND A potential relationship between depression and the intake of dietary fiber has been hypothesized in several studies. However, no meta-analysis has been conducted so far to explore the association between these two variables. Hence, we designed the present meta-analysis to elucidate the relationship between the intake of dietary fiber and depression. METHODS A comprehensive search was performed using the PubMed/Medline, Scopus, Web of Science and Google Scholar databases to identify any relevant studies published from inception to October 2019. Observational studies (cross-sectional and case-control) were included in the analysis. RESULTS Pooled analysis from the random-effects model of four case-control studies revealed that the consumption of dietary fiber in patients with depression was significantly lower versus healthy controls (WMD: -1.41 mg/dl, 95 % CI: -2.32, -0.51, P = 0.002). No significant heterogeneity was demonstrated among the analyzed studies (I2 = 4.0 %, P = 0.37). By pooling 5 effect sizes of cross-sectional studies (with a total of 97,023 subjects), we demonstrated that a higher dietary consumption of fiber was associated with significantly lower odds of depression (OR = 0.76; 95 % CI: 0.64, 0.90; P = 0.010), with a low heterogeneity seen among the retrieved studies (I2 = 43.9 %; P = 0.12). CONCLUSION An increased intake of total dietary fiber is associated with lower odds of depression. Further studies are needed to evaluate the relationship between the different types of dietary fiber and depression.
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Affiliation(s)
- Somaye Fatahi
- Student Research Committee, Faculty of Public Health Branch, Iran University of Medical Sciences, Tehran, Iran; Pediatric Gastroenterology, Hepatology, and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shakiba Shoaee Matin
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Sohouli
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mihnea-Alexandru Găman
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | - Pourya Raee
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Beheshteh Olang
- Pediatric Gastroenterology, Hepatology, and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vaani Kathirgamathamby
- Department of Medicine and Life Sciences, Kings College London, University of London, Strand, London, WC2R 2LS, United Kingdom
| | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | | | - Farzad Shidfar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
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Parreiras de Jesus AC, Grossi de Oliveira AL, Sernizon Guimarães N, Mendoza L, Toshio Fujiwara R, Alves da Silva Menezes C, Rocha Vilela RV. Serological tests using Sporothrix species antigens for the accurate diagnosis of sporotrichosis: a meta-analysis. Diagn Microbiol Infect Dis 2020; 98:115131. [PMID: 32805583 DOI: 10.1016/j.diagmicrobio.2020.115131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/02/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
Some species of the fungus Sporothrix cause a chronic granulomatous infection in humans and animals called sporotrichosis. In the last decades, some research into serological tests has been carried out by different groups for the rapid detection of this infection. We performed a systematic review of the literature with meta-analysis to evaluate studies using Sporothrix spp. antigens and to evaluate their accuracy for sporotrichosis diagnostic. We searched Scopus, MEDLINE, Web of Science, GALE, Technology Research Database, DOA, Elsevier, SciELO, and Google Scholar Databases. The united results of sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio with their corresponding 95% confidence intervals (CI) were assessed. A total of 15 assays from 8 studies using 7 different serological methods and 8 different antigens were analyzed. The studies were performed in the USA, Brazil, and Venezuela from 1973 until 2015 and presented good quality. A high heterogeneity for sensitivity [I2 = 90.7%; 87% CI = (84-89), P < 0.001] and specificity [I2 = 89.2%; 93% CI = (92-95), P < 0.001] was observed. The performance of diagnostic tests was 0.93. Enzyme-linked immunosorbent assay was the main tool used, and the ConA-binding fraction antigen of the strain 1099-18 appears as a promising diagnostic biomarker candidate.
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Affiliation(s)
- Augusto César Parreiras de Jesus
- Infectious Diseases and Tropical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte, MG, Brazil, 30130-10.
| | - Ana Laura Grossi de Oliveira
- Infectious Diseases and Tropical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte, MG, Brazil, 30130-10.
| | - Nathalia Sernizon Guimarães
- Infectious Diseases and Tropical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte, MG, Brazil, 30130-10.
| | - Leonel Mendoza
- Department of Microbiology and Molecular Genetics, 322 North Kedzie Hall, Michigan State University, East Lansing, MI, USA, 48824.
| | - Ricardo Toshio Fujiwara
- Infectious Diseases and Tropical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte, MG, Brazil, 30130-10; Department of Parasitology, Biological Sciences Institute, Federal University of Minas Gerais, Av. Antônio Carlos, 6627 Pampulha, Belo Horizonte, MG, Brazil, 31270-901.
| | - Cristiane Alves da Silva Menezes
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Av. Antônio Carlos, 6627 Pampulha, Belo Horizonte, MG, Brazil, 31270-901.
| | - Raquel Virginia Rocha Vilela
- Infectious Diseases and Tropical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190, Belo Horizonte, MG, Brazil, 30130-10; Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Av. Antônio Carlos, 6627 Pampulha, Belo Horizonte, MG, Brazil, 31270-901.
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Dias da Silva A, Matos Júnior N, Damasceno DD, Guimarães NS, Gomes JMG. Estado nutricional, fatores de risco e comorbidades em adultos portadores de diabetes mellitus tipo 2. hu rev 2020. [DOI: 10.34019/1982-8047.2020.v46.28790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introdução: A caracterização do perfil nutricional das pessoas com diabetes tipo 2 pode favorecer a adoção de medidas que reduzam as comorbidades e complicações da doença. Objetivo: Avaliar o estado nutricional, fatores de riscos e comorbidades em indivíduos adultos com diabetes tipo 2. Material e Métodos: Foi realizado um estudo transversal com 30 indivíduos com diabetes tipo 2 e idade entre 18 e 59 anos, no município de Barbacena – MG. Foram avaliadas variáveis socioeconômicas e de estilo de vida (fumo, atividade física, medicamentos, etilismo, dentre outras), do consumo alimentar (calorias totais, macronutrientes, uso de adoçantes, preparo das refeições, etc.), antropométricas e de composição corporal (perímetro da cintura, perímetro do braço, perímetro do quadril, perímetro da panturrilha, peso, altura e percentual de gordura). Resultados: A maioria da amostra foi constituída por mulheres (66,7%), as quais apresentaram maiores valores de índice de massa corporal, relação cintura-quadril, relação cintura-estatura e percentual de gordura corporal em relação aos homens. Observou-se elevada prevalência de sobrepeso e obesidade entre os participantes de ambos os sexos. Metade da amostra encontrava-se com glicemia de jejum <130 mg/dL, sendo que estes indivíduos apresentaram menores valores de índice de massa corporal (P=0.04), perímetro da cintura (P=0.05), perímetro do quadril (P=0.02), relação cintura-estatura (P=0.03) e percentual de gordura corporal (P=0.05). Os indivíduos com glicemia <130 mg/dL apresentaram menor consumo de carboidratos e lipídios em relação ao que estavam com glicemia >130 mg/dL. Conclusão: A obesidade foi uma comorbidade de elevada frequência na amostra avaliada, o que é preocupante devido à sua associação com descontrole glicêmico e risco de complicações. O consumo alimentar relacionou-se ao controle glicêmico e estado nutricional, demonstrando a necessidade de uma dieta equilibrada e diminuição gradual de peso para os indivíduos com diabetes, visando um melhor controle do diabetes e qualidade de vida.
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Pontelo BM, Greco DB, Guimarães NS, Rotsen N, Braga VAR, Pimentel PHN, Barbosa H, Barroso TM, Tupinambás U. Profile of drug-drug interactions and impact on the effectiveness of antiretroviral therapy among patients living with HIV followed at an Infectious Diseases Referral Center in Belo Horizonte, Brazil. Braz J Infect Dis 2020; 24:104-109. [PMID: 32360120 PMCID: PMC9392032 DOI: 10.1016/j.bjid.2020.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 03/12/2020] [Accepted: 03/21/2020] [Indexed: 12/02/2022] Open
Abstract
HIV infection may be considered a chronic condition for people living with HIV with access to antiretrovirals and this has effectively increased survival. Moreover, this has also facilitated the emergence of other comorbidities increasing the risk for drug–drug interactions and polypharmacy. The profile of these interactions as well as their consequences for people living with HIV are still not completely elucidated. The objectives of this study were to describe the profile of these interactions, their prevalence and their classification according to the potential for significant or non-significant drug–drug interactions. From June 2015 to July 2016, people living with HIV on follow-up at an Infectious Diseases Referral Center in Belo Horizonte, Brazil have been investigated for the presence of drug–drug interactions. A total of 304 patients were included and the majority (75%) had less than 50 years of age, male (66.4%), and 37.8% self-defined as brown skinned. Approximately 24% were on five or more medications and half of them presented with drug–drug interactions. Patients older than 50 years had a higher frequency of antiretrovirals drug–drug interactions with other drugs compared to younger patients (p = 0.002). No relationship was found between the number of drug–drug interactions and the effectiveness of antiretrovirals. As expected, the higher the number of non-HIV medications used (OR = 1.129; 95%CI 1.004–1.209; p = 0.04) was associated with an increase in drug–drug interactions. The high prevalence of drug–drug interactions found and the data collected should be useful to establish measures of quaternary prevention and to increase the medication security for people living with HIV.
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Affiliation(s)
- Betânia Maira Pontelo
- Universidade Federal de Minas Gerais (UFMG), Health Sciences: Infectology and Tropical Medicine, Faculdade de Medicina, Belo Horizonte, MG, Brazil
| | - Dirceu Bartolomeu Greco
- Universidade Federal de Minas Gerais (UFMG), Health Sciences: Infectology and Tropical Medicine, Faculdade de Medicina, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Medicina Interna, Belo Horizonte, MG, Brazil
| | - Nathalia Sernizon Guimarães
- Universidade Federal de Minas Gerais (UFMG), Health Sciences: Infectology and Tropical Medicine, Faculdade de Medicina, Belo Horizonte, MG, Brazil.
| | - Nina Rotsen
- Universidade Federal de Minas Gerais(UFMG), Faculdade de Medicina, Belo Horizonte, MG, Brazil
| | | | | | - Hugo Barbosa
- Universidade Federal de Minas Gerais(UFMG), Faculdade de Medicina, Belo Horizonte, MG, Brazil
| | - Taciane Miranda Barroso
- Universidade Federal de Minas Gerais(UFMG), Faculdade de Medicina, Belo Horizonte, MG, Brazil
| | - Unaí Tupinambás
- Universidade Federal de Minas Gerais (UFMG), Health Sciences: Infectology and Tropical Medicine, Faculdade de Medicina, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Medicina Interna, Belo Horizonte, MG, Brazil
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Teixeira DC, Diniz LMO, Guimarães NS, Moreira HMDAS, Teixeira CC, Romanelli RMDC. Risk factors associated with the outcomes of pediatric bacterial meningitis: a systematic review. Jornal de Pediatria (Versão em Português) 2020. [DOI: 10.1016/j.jpedp.2019.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Teixeira DC, Diniz LMO, Guimarães NS, Moreira HMDAS, Teixeira CC, Romanelli RMDC. Risk factors associated with the outcomes of pediatric bacterial meningitis: a systematic review. J Pediatr (Rio J) 2020; 96:159-167. [PMID: 31437421 PMCID: PMC9432045 DOI: 10.1016/j.jped.2019.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 07/19/2019] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The aim of this study was to systematically review the literature and answer the following central question: "What are the risk factors associated with worse clinical outcomes of pediatric bacterial meningitis patients?" METHODS The articles were obtained through literary search using electronic bibliographic databases: Web of Science, Scopus, MEDLINE, and LILACS; they were selected using the international guideline outlined by the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols. RESULTS The literature search identified 1,244 articles. After methodological screening, 17 studies were eligible for this systematic review. A total of 9,581 patients aged between 0 days and 18 years were evaluated in the included studies, and several plausible and important prognostic factors are proposed for prediction of poor outcomes after bacterial meningitis in childhood. Late diagnosis reduces the chances for a better evolution and reinforces the importance of a high diagnostic suspicion of meningitis, especially in febrile pictures with nonspecific symptomatology. S. pneumoniae as a causative pathogen was demonstrated to be related to clinical severity. CONCLUSIONS Early prediction of an adverse outcome may help determine which children require more intensive or longer follow-up and may provide the physician with rationale for parental counseling about their child's prognosis in an early phase of the disease.
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Affiliation(s)
- Daniela Caldas Teixeira
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Fundação Hospitalar do Estado de Minas Gerais, Hospital Infantil João Paulo II, Belo Horizonte, MG, Brazil.
| | - Lilian Martins Oliveira Diniz
- Fundação Hospitalar do Estado de Minas Gerais, Hospital Infantil João Paulo II, Belo Horizonte, MG, Brazil; Faculdade de Medicina de Barbacena, Barbacena, MG, Brazil
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Ricarte D, De Almeida Júlio BL, Folly Zocateli GA, Ferreira Barreto RL, Guimarães M, De Souza Ferreira R, Sernizon Guimarães N. Análise sensorial de preparações com batata yacon: revisão sistemática. hu rev 2020. [DOI: 10.34019/1982-8047.2019.v45.28419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introdução: A batata yacon (Polymnia sonchifolia) ou batata “diet” é considerada uma planta medicinal, nativa das regiões andinas da América do Sul que foi introduzida no Brasil no início dos anos 90. A batata yacon possui baixo valor energético e alto valor nutricional. Este alimento é considerado fonte de FOS podendo ser caracterizado como um alimento funcional, uma vez que, atua na redução dos níveis de glicose do sangue e como prebiótico equilibrando a quantidade de bactérias intestinais promovendo o crescimento de organismos probióticos. Objetivo: Verificar a aceitabilidade da batata yacon em diferentes preparações de alimentos. Materiais e métodos: Revisão sistemática realizada entre agosto e setembro de 2018 por meio das bases de dados MEDLINE, LILACS, SESSP-CTDPROD, BDENF-Enfermagem, PERNAL com a estratégia de busca: ((“Polymnia sonchifolius” OR “smallanthus sonchifolius”) OR “Yacon” OR “Yakon”)). Resultados: Dos 148 artigos encontrados, nove pesquisas foram selecionadas por meio dos critérios de exclusão empregados por três etapas de leitura: de títulos, resumos e textos. Dentre as preparações analisadas, barra de cereais, cookies e iogurtes elaborados com a batata yacon apresentaram índices iguais ou maiores do que 70%. Baixos níveis de aceitabilidade foram avaliados nas seguintes preparações bebida funcional, bolo, geleia e biscoitos diet. Conclusão: A partir dos resultados avaliados concluímos que a barra dietética, os cookies e os iogurtes podem ser inseridos no hábito alimentar da população como boas alternativas de alimentos funcionais, uma vez que possuem boas expectativas de aceitação no mercado e equilíbrio nutricional. Como principal limitação desta revisão apontamos a ausência de escala padronizada para avaliação da qualidade da evidência científica de pesquisas que envolvam análise sensorial.
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Guimarães NS, Guimarães MMM, Kakehasi AM, Paula MGPD, Caporali JFDM, Vieira ÉLM, Tanajura PR, Tupinambás U. Prevalence of low bone mass and changes in vitamin D levels in human immunodeficiency virus-infected adults unexposed to antiretrovirals. Rev Soc Bras Med Trop 2018; 51:596-602. [PMID: 30304264 DOI: 10.1590/0037-8682-0475-2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 07/30/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The prevalence of low bone mass is 3 times higher in people living with human immunodeficiency virus (PLWH) and using antiretrovirals than in the HIV-unaffected population. Changes in vitamin D levels is one of the factors associated with decreased bone mass. The objective of this study is to evaluate the low bone mass and altered vitamin D levels in PLWH who have not been exposed to antiretrovirals. METHODS A cross-sectional study was carried out with HIV-infected individuals between the ages of 18 and 55 years immediately prior to the start of antiretroviral therapy in a specialized reference center focusing on infectious and parasitic diseases. Results of clinical examination (patient's weight, height, blood pressure, and clinical history), laboratory tests, and X-ray absorptiometry, were collected. RESULTS Sixty patients were included, with a mean age of 34 years. Nine (16.7%) patients presented with low bone mass and 4 (7.1%) patients showed low total femur BMD. Analysis revealed that 23.3% and 36.7% of the patients had deficient and insufficient levels of 25-hydroxyvitamin D3, respectively. CONCLUSIONS Our study population presented with compromised bone health and with low bone mineral density and 25-(OH)-vitamin D levels.
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Affiliation(s)
- Nathalia Sernizon Guimarães
- Programa de Pós-Graduação Strictu Senso em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | - Adriana Maria Kakehasi
- Departamento de Aparelho Locomotor, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Mariana Guimarães Penido de Paula
- Programa de Pós-Graduação Strictu Senso em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Júlia Fonseca de Morais Caporali
- Programa de Pós-Graduação Strictu Senso em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.,Departamento de Clínica Médica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Érica Leandro Marciano Vieira
- Programa de Pós-Graduação Strictu Senso em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Pedro Rezende Tanajura
- Programa de Pós-Graduação Strictu Senso em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Unaí Tupinambás
- Programa de Pós-Graduação Strictu Senso em Ciências da Saúde: Infectologia e Medicina Tropical, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.,Departamento de Clínica Médica, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Carvalho PVDC, Caporali JFDM, Vieira ÉLM, Guimarães NS, Fonseca MO, Tupinambás U. Evaluation of inflammatory biomarkers, carotid intima-media thickness and cardiovascular risk in HIV-1 treatment-naive patients. Rev Soc Bras Med Trop 2018; 51:277-283. [PMID: 29972556 DOI: 10.1590/0037-8682-0472-2017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/18/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Mortality among HIV patients is 3-15 times higher than that among the general population. Currently, most deaths are due to non-infectious diseases. Chronic inflammation and adverse events due to antiretroviral therapy play crucial roles in increasing cardiovascular risk (CVR). METHODS This cross-sectional study aimed to evaluate carotid intima-media thickness (CIMT) and inflammatory biomarkers (D-dimer, ADAMTS13, GDF-15, sICAM-1, MPO, myoglobin, NGAL, SAA, sVCAM-1, and p-selectin) among naïve patients. RESULTS Sixty-seven participants were included: median age, 32 years; males, 82.1%; non-white, 61.1%; higher education level, 62.7%; and exposed to HIV through sexual relationship (men who have sex with men), 68.7%. The median viral load and LTCD4+ value were 42,033 copies/mL and 426 cells/mm³. The prevalence of arterial hypertension was 16.4%; those of diabetes mellitus and dyslipidemia were 3% and 70.1%, respectively. The CIMT was 494.08 (± 96.84mm). The mean vascular age was 33.2 ± 18.9 years, one year longer than the chronological age, without statistical significance. CONCLUSIONS The majority of participants had a low CVR (94%). After reclassification, considering the CIMT percentiles, 13 (19.4%) patients had medium/ high CVR, while 54 (80.6%) patients had low CVR. The difference between the proportions of CVR when considering the CIMT and its corresponding percentile was statistically relevant. Body mass index was the only predictor of higher CVR (p = 0.03). No biomarker was found to predict CVR. People living with HIV have a high prevalence of dyslipidemia before ARV therapy.
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Affiliation(s)
- Priscila Valéria do Carmo Carvalho
- Programa de Pós-Graduação em Ciênicas da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | - Érica Leandro Marciano Vieira
- Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Nathalia Sernizon Guimarães
- Programa de Pós-Graduação em Ciênicas da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Marise Oliveira Fonseca
- Departamento de Clinica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brasil
| | - Unai Tupinambás
- Programa de Pós-Graduação em Ciênicas da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.,Departamento de Clinica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brasil
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Guimarães MMM, Greco DB, Moreira AN, Guimarães NS, Freire CMV, Rohlfs BG, Machado LJDC. Lipid accumulation product index in HIV-infected patients: a marker of cardiovascular risk. Braz J Infect Dis 2018; 22:171-176. [PMID: 29684319 PMCID: PMC9425636 DOI: 10.1016/j.bjid.2018.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/22/2018] [Accepted: 03/26/2018] [Indexed: 11/27/2022] Open
Abstract
The lipid accumulation product (LAP) index is an emerging cardiovascular risk marker. We aimed to assess the accuracy of this index as a marker of cardiovascular risk in HIV-infected patients. A cross-sectional study of 133 HIV-infected patients on antiretroviral drugs and 20 non-infected controls was conducted at the outpatient clinic of a referral center of infectious and parasitic diseases. Evaluations included LAP index, homeostasis model assessment (HOMA) index, anthropometric measurements, blood pressure, glucose tolerance test, and cholesterol and triglyceride levels. Body mass index (BMI) was similar in both groups; however, waist circumference was greater in the HIV-infected patients. Triglyceride levels were significantly higher (p < 0.001) and HDL cholesterol levels were lower in HIV-infected patients (p < 0.001). Plasma glucose (p = 0.01) and insulin (p = 0.005) levels two hours after a glucose load, HOMA-IR index (p < 0.001) and LAP index (p < 0.001) were higher in the HIV-infected patients. A positive and significant correlation was found between HOMA-IR index and LAP (r = 0.615; p < 0.01), BMI (r = 0.334; p < 0.01) and waist circumference (r = 0.452; p < 0.01) in the HIV-infected patients. In male HIV-infected patients and controls, ROC curve analyses revealed that the best cut-off value of LAP to define the presence of insulin resistance was 64.8 (sensitivity 86%, specificity 77% and area under the curve 0.824). These results confirm that insulin resistance is more common in HIV-patients on antiretroviral drugs than in HIV-negative controls. A positive and significant correlation was found between the LAP index and the HOMA index, with LAP ≥ 64.8 constituting an additional risk factor for cardiovascular disease in male HIV patients.
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Raposo MA, Armiliato GNDA, Guimarães NS, Caram CA, Silveira RDDS, Tupinambás U. Metabolic disorders and cardiovascular risk in people living with HIV/AIDS without the use of antiretroviral therapy. Rev Soc Bras Med Trop 2017; 50:598-606. [PMID: 29160505 DOI: 10.1590/0037-8682-0258-2017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 10/05/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Metabolic disorders in people living with HIV/AIDS (PLH) have been described even before the introduction of antiretroviral (ARV) drugs in the treatment of HIV infection and are risk factors for cardiovascular diseases. Based on this, the purpose of this study was to assess metabolic disorders and cardiovascular risk in PLH before the initiation of antiretroviral treatment (ART). METHODS This was a cross-sectional descriptive study of 87 PLH without the use of ART, which was carried out between January and September 2012 at a specialized infectious diseases center in Minas Gerais, Brazil. RESULTS The main metabolic disorders in the population were low serum levels of HDL-cholesterol, hypertriglyceridemia and abdominal obesity. Dyslipidemia was prevalent in 62.6% of the study population, whereas metabolic syndrome (MS) was prevalent in 11.5% of patients assessed by the International Diabetes Federation (IDF) criteria and 10.8% assessed by the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATPIII) criteria. Regarding cardiovascular risk, 89.7% of the population presented a low coronary risk according to the Framingham Risk Score. A greater proportion of patients diagnosed with MS presented low cardiovascular risk (80% assessed by IDF criteria and 77.8% assessed by NCEP-ATPIII criteria). CONCLUSIONS Metabolic disorders in this population may be due to HIV infection or lifestyle (smoking, sedentary lifestyle and inadequate diet). The introduction of ART can enhance dyslipidemia, increasing cardiovascular risk, especially among those who have classic risks of cardiovascular disease.
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Affiliation(s)
- Mariana Amaral Raposo
- Programa de Pós-Graduação Stricto Sensu em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.,Departamento de Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Geyza Nogueira de Almeida Armiliato
- Programa de Pós-Graduação Stricto Sensu em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.,Departamento de Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Nathalia Sernizon Guimarães
- Programa de Pós-Graduação Stricto Sensu em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.,Departamento de Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Camila Abrahão Caram
- Departamento de Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | - Unaí Tupinambás
- Departamento de Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Sernizon Guimarães N, Fausto MA, Kakehasi AM, Navarro AM, Tupinambás U. Can anthropometry measure the body fat of people living with HIV/AIDS?: A systematic review. Rev Esp Nutr Hum Diet 2017. [DOI: 10.14306/renhyd.21.2.252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introducción: La evaluación de la cantidad y distribución de la grasa corporal en personas que viven con el VIH/SIDA es de gran importancia en la práctica clínica, debido a la asociación de los cambios de grasa corporal con condiciones clínicas. El objetivo de esta revisión es responder a la pregunta central: ¿Puede la antropometría medir con precisión la grasa corporal en las personas que viven con el VIH/SIDA?Material y Métodos: Revisión sistemática llevada a cabo por medio de cuatro bases de datos: Medline, LILACS, Scopus y BDTD.Resultados: De los 581 estudios encontrados, 11 cumplieron con los criterios de elegibilidad. Para evaluar la validación de la antropometría, sólo dos estudios emplearon análisis de regresión para el desarrollo de las ecuaciones de predicción de grasa corporal en las personas que viven con el VIH/SIDA y nueve estudios emplearon análisis de correlación. Este coeficiente sólo mide la fuerza de la relación entre dos variables, y no hay concordancia entre ellos y, por lo tanto, estos estudios no evaluaron con precisión si la información antropométrica mostró buena concordancia con el estándar de oro. Los otros dos estudios desarrollaron cinco ecuaciones para evaluar la grasa total y en las extremidades (brazos, piernas y tronco) en personas que viven con el VIH/SIDA y usan antirretrovirales y mostraron R2 entre 0,50 y 0,83.Conclusiones: Más investigación debe llevarse a cabo para responder a la pregunta central de esta revisión, dado el pequeño número de artículos en que se aplicó la prueba estadística correcta y la ausencia de investigaciones sobre personas que viven con el VIH/SIDA que no usan antirretrovirales.
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Oliveira ALGD, Chaves AT, Menezes CAS, Guimarães NS, Bueno LL, Fujiwara RT, Rocha MODC. Vitamin D receptor expression and hepcidin levels in the protection or severity of leprosy: a systematic review. Microbes Infect 2017; 19:311-322. [PMID: 28323068 DOI: 10.1016/j.micinf.2017.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 02/06/2017] [Accepted: 03/03/2017] [Indexed: 12/20/2022]
Abstract
Leprosy is a chronic infectious disease whose disequilibrium in the host's genetic, immunological and clinical mechanisms leads to distinct manifestations defining the type of immunological response. This review focuses its attention on the influence of the Vitamin D Receptor and hepcidin expressions that can suggest the protection or severity of leprosy.
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Affiliation(s)
- Ana Laura Grossi de Oliveira
- Post-graduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
| | - Ana Thereza Chaves
- Post-graduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | | | - Nathalia Sernizon Guimarães
- Post-graduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | | | - Ricardo Toshio Fujiwara
- Post-graduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Manoel Otávio da Costa Rocha
- Post-graduate Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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