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1.
Clinics (Sao Paulo) ; 79: 100418, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39003927

RESUMO

Systemic Lupus Erythematosus (SLE) is a chronic, autoimmune and multisystemic rheumatic disease. Patients with SLE have decreased functional and aerobic capacity, as well as increased prevalence of Cardiovascular Diseases (CVD), which are the primary causes of morbimortality in this condition. Dietary intake and physical activity are well-known modifiable cardiovascular risk factors. The aim of this study is to describe food consumption, sedentary behavior, physical activity level, and functional and aerobic capacity in a sample of SLE patients with high cardiovascular risk. This was a cross-sectional study in which patients were assessed for (i) Demographic, anthropometric, and disease-related parameters; (ii) Food consumption; (iii) Physical activity level and sedentary behavior; (iv) Functional and aerobic capacity. Patients averaged 41.7 ± 9 years, and most were classified as overweight/obese (87%). Average macronutrient intake was within recommendations; however, fiber (16 ± 9g) and calcium (391 ± 217 mg) intakes were below, and sodium intake (2.9 ± 1.3 mg) was above recommendations. Besides, food consumption assessed by the Nova system showed a predominance of unprocessed foods (43.8 ± 14.0%TEI), although ultraprocessed food intake (20.0 ± 13.9%TEI) was slightly higher than that seen in the Brazilian population. Patients also exhibited high sedentary behavior (8.2 ± 2.2h) and only eighteen participants reached the minimum recommended amount of moderate-to-vigorous physical activity. Overall, patients had a low functional and aerobic capacity compared to the general population. Data from this study may help design dedicated clinical trials aiming to investigate the effects of lifestyle intervention to mitigate CVD in SLE.


Assuntos
Doenças Cardiovasculares , Exercício Físico , Fatores de Risco de Doenças Cardíacas , Lúpus Eritematoso Sistêmico , Comportamento Sedentário , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/fisiopatologia , Feminino , Estudos Transversais , Adulto , Exercício Físico/fisiologia , Masculino , Pessoa de Meia-Idade , Doenças Cardiovasculares/etiologia , Brasil/epidemiologia , Comportamento Alimentar/fisiologia , Fatores de Risco , Ingestão de Alimentos/fisiologia , Índice de Massa Corporal
2.
Clin Rheumatol ; 43(3): 1003-1013, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38280124

RESUMO

OBJECTIVE: The aim of the present study was to investigate the effects of a lifestyle intervention on cardiometabolic risk factors in patients with systemic lupus erythematosus with a high cardiovascular risk profile. METHODS: This trial was conducted in Sao Paulo, Brazil between August 2020 and March 2023. The patients were randomly assigned to lifestyle intervention or control. The intervention was a 6-month multifaced program focused on behavioral changes through personalized recommendations for increasing physical activity (structured and non-structured) and improving eating aspects. Cardiometabolic risk score (primary outcome), anthropometry and visceral fat, aerobic capacity, blood pressure, inflammatory and oxidative stress markers, and blood flow and endothelial function were assessed before and after the intervention. RESULTS: A total of 80 patients were randomized. Twelve and 6 patients dropped out due to personal reasons in the intervention and control groups, respectively. Average adherence rate for the intervention was 56.9%. Intention-to-treat analysis showed no significant difference between groups in the cardiometabolic risk score (intervention group - Pre: 1.7 ± 3.6; Post: -1.6 ± 4.0; control group - Pre: -1.9 ± 3.6; Post: -2.0 ± 3.8; estimated mean difference between groups at post: -0.4; 95% confidence intervals: -2.7; 1.9; p = 0.96). This finding was confirmed by exploratory, per-protocol analysis. No significant differences were observed between adherents vs. non-adherent participants. Secondary outcomes did not change between groups. CONCLUSION: This 6-month, individualized, lifestyle intervention did not improve cardiovascular risk factors in SLE patients with a high cardiovascular risk profile. TRIAL REGISTRATION: clinicaltrials.gov (NCT04431167).


Assuntos
Doenças Cardiovasculares , Lúpus Eritematoso Sistêmico , Humanos , Fatores de Risco , Doenças Cardiovasculares/prevenção & controle , Brasil , Estilo de Vida , Fatores de Risco de Doenças Cardíacas , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/terapia
3.
Clinics ; 79: 100418, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1569147

RESUMO

Abstract Systemic Lupus Erythematosus (SLE) is a chronic, autoimmune and multisystemic rheumatic disease. Patients with SLE have decreased functional and aerobic capacity, as well as increased prevalence of Cardiovascular Diseases (CVD), which are the primary causes of morbimortality in this condition. Dietary intake and physical activity are well-known modifiable cardiovascular risk factors. The aim of this study is to describe food consumption, sedentary behavior, physical activity level, and functional and aerobic capacity in a sample of SLE patients with high cardiovascular risk. This was a cross-sectional study in which patients were assessed for (i) Demographic, anthropometric, and disease-related parameters; (ii) Food consumption; (iii) Physical activity level and sedentary behavior; (iv) Functional and aerobic capacity. Patients averaged 41.7 ± 9 years, and most were classified as overweight/obese (87%). Average macronutrient intake was within recommendations; however, fiber (16 ± 9g) and calcium (391 ± 217 mg) intakes were below, and sodium intake (2.9 ± 1.3 mg) was above recommendations. Besides, food consumption assessed by the Nova system showed a predominance of unprocessed foods (43.8 ± 14.0%TEI), although ultraprocessed food intake (20.0 ± 13.9%TEI) was slightly higher than that seen in the Brazilian population. Patients also exhibited high sedentary behavior (8.2 ± 2.2h) and only eighteen participants reached the minimum recommended amount of moderate-to-vigorous physical activity. Overall, patients had a low functional and aerobic capacity compared to the general population. Data from this study may help design dedicated clinical trials aiming to investigate the effects of lifestyle intervention to mitigate CVD in SLE.

4.
Lupus ; 32(11): 1287-1295, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37698181

RESUMO

Systemic lupus erythematosus (SLE) patients report worse health-related quality of life (HRQL), fatigue, anxiety, depression, and sleep quality, when compared to the general population and other chronic diseases. Furthermore, cardiometabolic diseases are highly prevalent in SLE and are also associated with these parameters. Thus, it is plausible to suggest that SLE patients with a high cardiovascular risk may report worse results for these parameters. The aim of the study is to describe HRQL, fatigue, anxiety and depression symptoms, and sleep quality in a sample of SLE patients with a high cardiovascular risk profile (i.e., BMI between 25 and 40 kg/m2 and/or dyslipidemia, hypertension, or diabetes). This was a cross-sectional study where patients were assessed for (i) demographic, anthropometric, and disease-related parameters, (ii) HRQL, (iii) fatigue, (iv) anxiety and depression symptoms, and (v) sleep quality. One-hundred patients completed the study; however, only 87 patients were assessed for sleep quality data. Patients averaged 41.7 ± 9 years, and most patients were classified as overweight/obese (87%). SF-36 scores for physical and mental components summary were 51.3 ± 9.6 and 54.2 ± 15.6, respectively, with "bodily pain" and "role emotional" presenting the lower scores. The total SLEQOL score was 105.1 ± 42.0, with lower scores reported for "self-image" and "mood." Fatigue score was 30.8 ± 8.9, and 78% and 93% reported severe symptoms of anxiety and depression, respectively. The average sleep effectiveness was 82.9 ± 6.6%. Sleep latency, total time in bed (TTiB), and total sleep time (TST) were 8.4 ± 8.9, 495.8 ± 79.7, and 409.7 ± 69.9 min, respectively. Patients reported an average of 17.8 ± 6.2 WE, with 4.5 ± 1.5 min duration and a WASO of 77.7 ± 36.6 min. Despite similar HRQL, fatigue, and sleep quality parameters to those reported by other SLE populations, SLE patients with a high cardiovascular risk had a higher prevalence of depression and anxiety. Understanding SLE patients' quality of life and psychological symptoms is of utmost importance to improve disease management. The findings of this study highlight the need for more intensive and global care regarding mental health when considering a high cardiovascular risk in SLE.

5.
Rheumatol Int ; 43(10): 1799-1810, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37354245

RESUMO

There is a paucity of studies assessing multidisciplinary interventions focused on tackling physical inactivity/sedentary behavior and poor dietary habits in SLE. The Living well with Lupus (LWWL) is a randomized controlled trial to investigate whether a six-month lifestyle change intervention will improve cardiometabolic risk factors (primary outcome) among systemic lupus erythematosus (SLE) patients with low disease activity (SLEDAI score ≤ 4) and with high cardiovascular risk. As secondary goals, we will evaluate: (1) the intervention's safety, efficacy, and feasibility in promoting lifestyle changes, and (2) the effects of the intervention on secondary outcomes (i.e., clinical parameters, functional capacity, fatigue, psychological aspects, sleep quality and health-related quality of life). Patients will be randomly allocated to either a control (i.e., standard care) or a lifestyle intervention group using a simple randomization (1:1 ratio, blocks of 20). Mixed Model analyses will be conducted for comparing groups following an intention-to-treat approach. A per protocol analysis will also be conducted. This study has the potential to generate new, clinically relevant data able to refine the multidisciplinary management of SLE patients. Protocol version number: NCT04431167 (first version).


Assuntos
Lúpus Eritematoso Sistêmico , Qualidade de Vida , Humanos , Dieta Saudável , Exercício Físico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Estilo de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Food Waterborne Parasitol ; 25: e00136, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34765755

RESUMO

Taeniosis is a neglected disease, particularly in developing countries, and is caused by infection with the adult tapeworm of either Taenia solium, Taenia saginata, and Taenia asiatica. Of these, T. solium is of primary concern due to the potential for cysticercosis should T. solium eggs be ingested. In Cuba, all cases of taeniosis are assumed to be caused by T. saginata, although some cases of cysticercosis have been documented. It is therefore important to gain further insights regarding the species causing taeniosis in Cuba, especially as diagnostic records indicate an increasing incidence, with the highest number of cases reported in 2020. In this study, we analysed 37 Taenia-positive faecal samples (or proglottids isolated from faecal samples) from the period 2001 until 2020 from all regions of the country. Genomic DNA was extracted from the samples, which had been stored in 10% formalin, using the QIAamp Tissue Kit. Species identification was carried out by duplex real-time PCR targeting the mitochondrial DNA. All cases were found to be T. saginata, and sequence analysis of three isolates confirmed the identification of this species. Our data do not provide any evidence that T. solium currently occurs in Cuba. However, given the relatively low number of samples analysed here, that the parasite may be imported with visitors or travellers who have been in endemic countries, and that taeniosis has relatively mild symptoms and thus infected patients may not seek medical attention, we recommend species determination for all taeniosis cases reported in Cuba.

7.
Biomed Pharmacother ; 144: 112310, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34678720

RESUMO

This study aims to demonstrate the applicability and importance of zebrafish (Danio rerio) model to study acute and chronic inflammatory responses induced by different stimuli: carrageenan phlogogen (nonimmune); acute infection by bacteria (immune); foreign body reaction (chronic inflammation by round glass coverslip implantation); reaction induced by xenotransplantation. In addition to the advantages of presenting low breeding cost, high prolificity, transparent embryos, high number of individuals belonging to the same spawning and high genetic similarity that favor translational responses to vertebrate organisms like humans, zebrafish proved to be an excellent tool, allowing the evaluation of edema formation, accumulation of inflammatory cells in the exudate, mediators, signaling pathways, gene expression and production of specific proteins. Our studies demonstrated the versatility of fish models to investigate the inflammatory response and its pathophysiology, essential for the successful development of studies to discover innovative pharmacological strategies.


Assuntos
Anti-Inflamatórios/farmacologia , Descoberta de Drogas , Edema/prevenção & controle , Inflamação/prevenção & controle , Animais , Modelos Animais de Doenças , Edema/etiologia , Edema/genética , Edema/metabolismo , Feminino , Regulação da Expressão Gênica , Inflamação/etiologia , Inflamação/genética , Inflamação/metabolismo , Masculino , Transdução de Sinais , Fatores de Tempo , Peixe-Zebra
8.
Pediatr Dermatol ; 38(5): 1233-1236, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34515382

RESUMO

Disseminated and recurrent infundibulofolliculitis is an uncommon non-infectious skin eruption characterized by recurrent, sometimes pruritic, follicular papules commonly seen on the trunk and proximal extremities. We describe the clinical, dermoscopic, and histopathologic characteristics of disseminated and recurrent infundibulofolliculitis in three young pediatric patients from the tropical regions of Mexico, Guerrero, and Chiapas.


Assuntos
Exantema , Foliculite , Criança , Foliculite/diagnóstico , Humanos , México/epidemiologia , Recidiva , Tronco
9.
Pharmacol Rep ; 68(6): 1095-1101, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27573715

RESUMO

INTRODUCTION: This study was conducted with the aim of evaluating whether electroacupuncture (EA) at acupoint St36 could produce antinociception through the activation of an endocannabinoid mechanism. METHODS: Male Wistar rats were divided into experimental groups. Heat was applied to the faces of rats, and the latency to withdraw the face was measured. Furthermore, the influence of electrical stimulation (100HzP) of acupoint St36, at a 0.5mA intensity, was investigated in the facial withdrawal threshold. RESULTS: The EA produced antinociception, which lasted for 180min. This effect was antagonized by the pre-injection of AM 251, a CB1 cannabinoid receptor antagonist, but not by AM 630, a CB2 cannabinoid receptor antagonist. Additionally, pretreatment with an endocannabinoid metabolizing enzyme inhibitor (MAFP) and an anandamide reuptake inhibitor (VDM11) prolonged and intensified the antinociceptive effect produced by EA. CONCLUSION: This study demonstrated for the first time that the CB1 cannabinoid receptor participates in the antinociceptive effect induced by EA.


Assuntos
Pontos de Acupuntura , Eletroacupuntura/métodos , Endocanabinoides/metabolismo , Dor Facial/metabolismo , Dor Facial/terapia , Medição da Dor/métodos , Animais , Agonistas de Receptores de Canabinoides/farmacologia , Agonistas de Receptores de Canabinoides/uso terapêutico , Antagonistas de Receptores de Canabinoides/farmacologia , Antagonistas de Receptores de Canabinoides/uso terapêutico , Relação Dose-Resposta a Droga , Indóis/farmacologia , Indóis/uso terapêutico , Masculino , Medição da Dor/efeitos dos fármacos , Piperidinas/farmacologia , Piperidinas/uso terapêutico , Pirazóis/farmacologia , Pirazóis/uso terapêutico , Ratos , Ratos Wistar
10.
Arq. ciênc. saúde ; 12(3): 138-142, jul.-set. 2005. tab
Artigo em Português | LILACS | ID: lil-450906

RESUMO

Esta pesquisa teve como objetivo identificar determinadas características de pacientes portadores de Insuficiência Renal Aguda (IRA) internados em uma Unidade de Terapia Intensiva (UTI) do Hospital de Base, bem como as causas de sua internação. Realizou-se uma análise retrospectiva de prontuários no período de 2002 a 2003. A avaliação dos resultados apontou que, 62% dos pacientes eram do sexo masculino; 42% tinham idade entre 61 e 80 anos; 21% desenvolveram IRA durante a internação; 81% das IRAs encontradas cursaram com oligúria, sendo que 84,4% eram de origem pré-renal; apenas 21% desses pacientes estudados receberam tratamento para IRA durante a internação; 33,8% permaneceram de um a cinco dias internados na UTI; 57,7% apresentaram hipertensão arterial como patologia de base; os problemas respiratórios foram prevalentes como diagnóstico inicial em 23,5% e os quadros de choque foram o principal motivo de internação em 22,9% dos pacientes e finalmente a mortalidade ocorreu em 58% dessa amostra.


Assuntos
Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Humanos , Injúria Renal Aguda , Idoso de 80 Anos ou mais , Hospitalização/estatística & dados numéricos , Unidades de Terapia Intensiva , Mortalidade
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