Search Results (17)

Background: The comparison of left ventricular mass (LVM) at different BP levels and the effects of antihypertensive drug treatment on LVM are unknown. Objective: To compare the LVM of individuals with prehypertension and Stage 1 hypertension and assess the effects of treatment on LVM at these stages of hypertension. Methods: We estimated LVM in the PREVER-Prevention trial using Sokolow–Lyon and Cornell voltage and voltage–duration products before and after randomization to 18 months of treatment with low doses of chlorthalidone and amiloride or placebo in adults with JNC 7 “prehypertension” (systolic BP [SBP] of 120–139 mm Hg and diastolic BP [DBP] of 80–89 mm Hg). Similarly, in the PREVER-Treatment trial, we assessed these indices before and after randomization to 18 months of treatment with the chlorthalidone/amiloride combination or losartan in adults with JNC 7 “stage 1” hypertension (140–159 mm Hg or DBP of 90–99 mm Hg). Results: At baseline, the participants in the stage I hypertension trial exhibited higher mean LVM indices than those in the prehypertension trial. In the PREVER-Prevention trial, those randomized to the chlorthalidone/amiloride combination experienced a significant reduction in Sokolow–Lyon LVM indices compared to placebo (p = 0.02). In the PREVER-Treatment trial, those randomized to the chlorthalidone/amiloride combination or losartan experienced a similar reduction in electrocardiographic LVM during the 18 months of treatment (p < 0.01). Conclusions: The institution of low-dose antihypertensive drug therapy in prehypertension and treatment of patients with stage 1 hypertension has the potential to interrupt the progress of hypertensive cardiomyopathy. Full article

Delayed initiation of effective antifibrotic therapy in patients with interstitial lung diseases (ILD) may influence the progression and outcome of the disease. This study analyzes the differences in the journey of patients with ILD in the Brazilian and Mexican health systems. An evaluative study was conducted in reference centers for interstitial lung diseases in Brazil and Mexico with a panel of four specialists. The patient’s journey in both countries begins when the patient seeks medical care after observing a chronic respiratory symptom. In both countries, due to diagnostic complexity, these patients arrive at ILD referral centers at an advanced stage of the disease. Once diagnosis is established, the treatment onset differs between Mexico and Brazil. In Brazil, access to antifibrotic drugs through the public health system has been a significant challenge, and their cost makes them unaffordable for most people. This situation forces medical specialists to provide only supportive care to patients until these drugs can be accessed. In Mexico, antifibrotics have been available in health sectors since 2018. Brazil and Mexico have several similarities regarding the initial journey of the patient due to diagnosis difficulties. Still, the outcome tends to be different due to a difference in access to treatment with antifibrotics. For this reason, advancing health policies that ensure proper treatment for patients with ILD is crucial for the sustainability and reliability of the health system. Full article

Background: Adopting advanced digital technologies as diagnostic support tools in healthcare is an unquestionable trend accelerated by the COVID-19 pandemic. However, their accuracy in suggesting diagnoses remains controversial and needs to be explored. We aimed to evaluate and compare the diagnostic accuracy of two free accessible internet search tools: Google and ChatGPT 3.5. Methods: To assess the effectiveness of both medical platforms, we conducted evaluations using a sample of 60 clinical cases related to urological pathologies. We organized the urological cases into two distinct categories for our analysis: (i) prevalent conditions, which were compiled using the most common symptoms, as outlined by EAU and UpToDate guidelines, and (ii) unusual disorders, identified through case reports published in the ‘Urology Case Reports’ journal from 2022 to 2023. The outcomes were meticulously classified into three categories to determine the accuracy of each platform: “correct diagnosis”, “likely differential diagnosis”, and “incorrect diagnosis”. A group of experts evaluated the responses blindly and randomly. Results: For commonly encountered urological conditions, Google’s accuracy was 53.3%, with an additional 23.3% of its results falling within a plausible range of differential diagnoses, and the remaining outcomes were incorrect. ChatGPT 3.5 outperformed Google with an accuracy of 86.6%, provided a likely differential diagnosis in 13.3% of cases, and made no unsuitable diagnosis. In evaluating unusual disorders, Google failed to deliver any correct diagnoses but proposed a likely differential diagnosis in 20% of cases. ChatGPT 3.5 identified the proper diagnosis in 16.6% of rare cases and offered a reasonable differential diagnosis in half of the cases. Conclusion: ChatGPT 3.5 demonstrated higher diagnostic accuracy than Google in both contexts. The platform showed satisfactory accuracy when diagnosing common cases, yet its performance in identifying rare conditions remains limited. Full article

Cartographic resources play a crucial role in facilitating communication across various sectors, including research projects focused on low-income communities. Despite this, some researchers still adhere to colonialist and exploitative approaches. This study aims to promote equitable university–community interaction though cartographic resources, aid academic and vulnerable community users in choosing a better platform for their work, and provide insights to developers for improving the platforms to better serve the user profiles of community members. To achieve this, we examined the use of cartographic resources in five projects within low-income communities (commonly referred to as favelas or so-called “slums”) in three Brazilian cities, all guided by equitable principles. The study unfolds in four stages: (i) data collection from documents and interviews; (ii) systematization into seven analytical categories—cartographic resources, data, personnel, processes, equipment, general objectives, and specific objectives; (iii) analysis of eight cartographic resources; and (iv) a critical examination of the outcomes. The synthesis of the collected information identified 65 characteristics/demands, with 17 common to all projects, including vector feature creation, thematic map design, printed map usage, and satellite imagery. We also identified 53 geographic information system (GIS) functionalities required for the projects, predominantly related to vector data generation and editing. The outcomes demonstrate the benefits of project methodologies, contributing to a decolonial university–community praxis. Additionally, they underscore the potential of digital cartographic resources, functioning not solely as data collection tools but also as powerful instruments that empower slum residents to advocate for improvements and foster local development. Full article

The retina is the sensory tissue responsible for the first stages of visual processing, with a conserved anatomy and functional architecture among vertebrates. To date, retinal eye diseases, such as diabetic retinopathy, age-related macular degeneration, retinitis pigmentosa, glaucoma, and others, affect nearly 170 million people worldwide, resulting in vision loss and blindness. To tackle retinal disorders, the developing retina has been explored as a versatile model to study intercellular signaling, as it presents a broad neurochemical repertoire that has been approached in the last decades in terms of signaling and diseases. Retina, dissociated and arranged as typical cultures, as mixed or neuron- and glia-enriched, and/or organized as neurospheres and/or as organoids, are valuable to understand both neuronal and glial compartments, which have contributed to revealing roles and mechanisms between transmitter systems as well as antioxidants, trophic factors, and extracellular matrix proteins. Overall, contributions in understanding neurogenesis, tissue development, differentiation, connectivity, plasticity, and cell death are widely described. A complete access to the genome of several vertebrates, as well as the recent transcriptome at the single cell level at different stages of development, also anticipates future advances in providing cues to target blinding diseases or retinal dysfunctions. Full article

Brachyspira hyodysenteriae and Lawsonia intracellularis coinfection has been observed in the diagnostic routine; however, no studies have evaluated their interaction. This study aimed to characterize lesions and possible synergisms in experimentally infected pigs. Four groups of piglets, coinfection (CO), B. hyodysenteriae (BRA), L. intracellularis (LAW), and negative control (NEG), were used. Clinical signals were evaluated, and fecal samples were collected for qPCR. At 21 days post infection (dpi), all animals were euthanized. Gross lesions, bacterial isolation, histopathology, immunohistochemistry, and fecal microbiome analyses were performed. Diarrhea started at 12 dpi, affecting 11/12 pigs in the CO group and 5/11 pigs in the BRA group. Histopathological lesions were significantly more severe in the CO than the other groups. B. hyodysenteriae was isolated from 11/12 pigs in CO and 5/11 BRA groups. Pigs started shedding L. intracellularis at 3 dpi, and all inoculated pigs tested positive on day 21. A total of 10/12 CO and 7/11 BRA animals tested positive for B. hyodysenteriae by qPCR. A relatively low abundance of microbiota was observed in the CO group. Clinical signs and macroscopic and microscopic lesions were significantly more severe in the CO group compared to the other groups. The presence of L. intracellularis in the CO group increased the severity of swine dysentery. Full article

Crotalus venom has broad biological activity, including neurotoxic, myotoxic, hematologic, and cytotoxic compounds that induce severe systemic repercussions. We evaluated the pathophysiological and clinical significance of Crotalus durissus cascavella (Cdc) venom-induced pulmonary impairment in mice. We conducted a randomized experimental study, involving 72 animals intraperitoneally inoculated with saline solution in the control group (CG), as well as venom in the experimental group (EG). The animals were euthanized at predetermined intervals (1 h, 3 h, 6 h, 12 h, 24 h, and 48 h), and lung fragments were collected for H&E and Masson histological analysis. The CG did not present inflammatory alterations in pulmonary parenchyma. In the EG, interstitial and alveolar swelling, necrosis, septal losses followed by alveolar distensions, and areas of atelectasis in the pulmonary parenchyma were observed after three hours. The EG morphometric analysis presented pulmonary inflammatory infiltrates at all time intervals, being more significant at three and six (p = 0.035) and six and 12 h (p = 0.006). The necrosis zones were significant at intervals of one and 24 h (p = 0.001), one and 48 h (p = 0.001), and three and 48 h (p = 0.035). Crotalus durissus cascavella venom induces a diffuse, heterogeneous, and acute inflammatory injury in the pulmonary parenchyma, with potential clinical implications for respiratory mechanics and gas exchange. The early recognition and prompt treatment of this condition are essential to prevent further lung injury and to improve outcomes. Full article

Despite significant advances in pharmacological treatment over the last few decades, COPD remains a heavy burden on the health systems around the world, affecting approximately 210 million people, with elevated morbimortality and socioeconomic impact. Barriers to healthcare access were even more evident during the coronavirus disease 19 (COVID-19) pandemic and increased patients’ vulnerability to physical deconditioning, depression, and social isolation. Home-based respiratory care in patients with COPD provides a valuable contribution to effective disease management, with potential advantages for monitoring, treatment adherence, and cost reduction. Technological innovation allows clinical markers of interest, such as respiratory frequency, pulmonary function, and oxygen saturation, to be tracked remotely from the patients’ homes, providing a better understanding of their real needs. Home-based telerehabilitation can also be a viable alternative to hospital-based programs. Here, we highlight the full extent of health benefits of HRC in COPD, particularly for patients with a higher risk of exacerbations, multiple comorbidities, and limited access to health services. Full article

Chronic obstructive pulmonary disease (COPD) is a global public health burden that stands out as a leading cause of mortality around the world, especially in less developed countries. COPD treatment should be centered on the individual necessities of each patient, integrating pharmacological therapy, immunization, nutritional support, pulmonary rehabilitation and control of comorbidities. Combining a long-acting antimuscarinic (LAMA) with a long-acting beta2-agonist (LABA) bronchodilator has proven to be more effective than monotherapy with LABA or LAMA, in terms of the functional improvement of forced expiratory volume (FEV1), symptoms and life quality and may be helpful in patients with progressive dyspnea. The eosinophil blood count is a simple biomarker that could guide personalized treatment strategies by identifying patients with greater clinical benefits of inhaled corticosteroid (ICS) treatment. However, one critical concern is the increased risk of pneumonia in individuals treated with ICS. Full article

In this work, recycled poly(ethylene terephthalate) (PETR) was blended with virgin high-density polyethylene (HDPE) in an internal mixer in an attempt to obtain a material with improved properties. A compatibilizer (PE-g-MA) and a chain extender (Joncryl) were added to the PETR/HDPE blend and the rheological and thermal properties of the modified and unmodified blends as well as those of virgin PET with virgin HDPE (PETV/HDPE). All the blends were characterized by torque rheometry, differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). The data obtained indicate that the incorporation of either the chain extender or the compatibilizer agent led to increases in torque (and hence in viscosity) of the blend compared to that of the neat polymers. The joint incorporation of the chain extender and compatibilizer further increased the viscosity of the systems. Their effect on the crystallinity parameters of HDPE was minimal, but they reduced the crystallinity and crystallization temperature of virgin and recycled PET in the blends. The thermal stability of the PETR/HDPE blend was similar to that of the PETV/HDPE blend, and it was not affected by the incorporation of the chain extender and/or compatibilizer. Full article

Altered smell is one of the most prevalent symptoms in acute COVID-19 infection. Although most patients recover normal neurosensory function in a few weeks, approximately one-tenth of patients report long-term smell dysfunction, including anosmia, hyposmia, parosmia and phantosmia, with a particularly notable impact on quality of life. In this complex scenario, inflammation and cellular damage may play a key role in the pathogenesis of olfactory dysfunctions and may affect olfactory signaling from the peripheral to the central nervous system. Appropriate management of smell disturbances in COVID-19 patients must focus on the underlying mechanisms and the assessment of neurosensorial pathways. This article aims to review the aspects of olfactory impairment, including its pathophysiology, epidemiology, and clinical management in post-acute COVID-19 syndrome (PACS). Full article

This study sought to examine the variations of internal and external load measures in soccer players when performing different types of 4 vs. 4 small-sided games (SSGs). Ten U-23 professional and sub-elite soccer players, eight outfield players (age: 20.1 ± 1.5 years old; height: 1.83 ± 0.04 m; total body mass: 76.1 ± 3.6 kg) and two goalkeepers (GK) (age: 20.5 ± 2.1 years old; height: 1.91 ± 0.04 m; total body mass: 77.0 ± 1.4 kg) participated in the study. Five SSGs were performed with 3 min duration and 3 min rest interval. SSG1, SSG2 and SSG4 aimed for ball possession play, while in SSG3 and SSG5, two GK were added, defending regular-size goals. The pitch size changed from SSG1 (16 × 24 m) to SSG2 and SSG3 (both 20 × 30 m) and SSG4 and SSG5 (both 24 × 36 m). All players were monitored using WIMU Pro device during the tasks. Anova One-Way and the post hoc Tukey honestly significant difference were used for analysis of statistically significant differences (p < 0.05) and effect sizes were determined by calculating partial eta-squared. The framework was associated with relevant but steady state internal load fatigue and induce a considerable external load stimulus. GK participation in SSGs should be carefully considered as it seems to have a greater impact on physical load measures when compared to the pitch size manipulation. Full article

Vegetable fibers have inspired studies in academia and industry, because of their good characteristics appropriated for many technological applications. Sisal fibers (Agave sisalana variety), when extracted from the leaf, are wet and must be dried to reduce moisture content, minimizing deterioration and degradation for long time. The control of the drying process plays an important role to guarantee maximum quality of the fibers related to mechanical strength and color. In this sense, this research aims to evaluate the drying of sisal fibers in an oven with mechanical air circulation. For this purpose, a transient and 3D mathematical model has been developed to predict moisture removal and heating of a fiber porous bed, and drying experiments were carried out at different drying conditions. The advanced model considers bed porosity, fiber and bed moisture, simultaneous heat and mass transfer, and heat transport due to conduction, convection and evaporation. Simulated drying and heating curves and the hygroscopic equilibrium moisture content of the sisal fibers are presented and compared with the experimental data, and good concordance was obtained. Results of moisture content and temperature distribution within the fiber porous bed are presented and discussed in details. It was observed that the moisture removal and temperature kinetics of the sisal fibers were affected by the temperature and relative humidity of the drying air, being more accentuated at higher temperature and lower relative humidity, and the drying process occurred in a falling rate period. Full article

Severe asthma is a multifactorial disorder with marked phenotypic heterogeneity and complex interactions between genetics and environmental risk factors, which could, at least in part, explain why during standard pharmacologic treatment, many patients remain poorly controlled and at an increased risk of airway remodeling and disease progression. The concept of “precision medicine” to better suit individual unique needs is an emerging trend in the management of chronic respiratory diseases. Over the past few years, Genome-Wide Association Studies (GWAS) have revealed novel pharmacogenetic variants related to responses to inhaled corticosteroids and the clinical efficacy of bronchodilators. Optimal clinical response to treatment may vary between racial/ethnic groups or individuals due to genetic differences. It is also plausible to assume that epigenetic factors play a key role in the modulation of gene expression patterns and inflammatory cytokines. Remarkably, specific genetic variants related to treatment effectiveness may indicate promising pathways for novel therapies in severe asthma. In this review, we provide a concise update of genetic determinants of poor response to treatment in severe asthma and future directions in the field. Full article

This research aims to study the process of separating water contaminated with oil using a hydrocyclone with a porous wall (membrane), containing two tangential inlets and two concentric outlets (concentrate and permeate), at the base of the equipment. For the study, the computational fluid dynamics technique was used in a Eulerian–Eulerian approach to solve the mass and linear momentum conservation equations and the turbulence model. The effects of the concentration polarization layer thickness and membrane rejection coefficient on the permeate flow, hydrodynamic behavior of the fluids inside the hydrocyclone, and equipment performance were evaluated. Results of the velocity, transmembrane pressure and oil concentration profiles along the equipment, and hydrocyclone performance are presented and analyzed. The results confirmed the effect of the membrane rejection coefficient on the equipment performance and the high potential of the hydrocyclone with a porous wall to be used in the oil–water mixture separation. Full article