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Percutaneous closure of patent ductus arteriosus versus surgical treatment in low-birth-weight preterms: a systematic review and meta-analysis
- Camila Dos Santos Melchior, Gabriel Rezende Neves, Bruna Letícia de Oliveira, Ana Carolina Toguchi, Jesana Costa Lopes, Marcos Alves Pavione, Shirley Katherine Tinajero Enríquez
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- Cardiology in the Young / Volume 34 / Issue 4 / April 2024
- Published online by Cambridge University Press:
- 08 February 2024, pp. 705-712
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Introduction:
The optimal management of a patent ductus arteriosus in a population of preterm infants is controversial. Traditionally, when the patent ductus arteriosus does not close either with conservative treatment or in response to pharmacological therapy, the only option is surgical closure. However, transcatheter occlusion might provide a therapeutic alternative.
Methods:We searched PubMed, Embase, and Cochrane databases for non-randomised and randomised controlled trials that compared transcatheter percutaneous closure of patent ductus arteriosus with surgical ligation in low-birth-weight preterm infants (<2,500 g). A random-effects model was used for outcomes with high heterogeneity.
Results:We included twelve studies comprising 4,668 low-birth-weight preterm infants, of whom 966 (20.7%) were in the transcatheter percutaneous closure group, and 3,702 (79.3%) patients were included in the surgical group. All-cause mortality (OR 0.28; 95% confidence interval 0.18–0.423; p < 0.00001; I2 = 0%) and haemodynamic instability (OR 0.10; 95% confidence interval 0.05–0.21; p < 0.001; I2 = 14%) were significantly lower in the transcatheter percutaneous closure group. There was no significant difference between transcatheter and surgical patent ductus arteriosus closure for the outcomes of bronchopulmonary dysplasia (0.93; 95% confidence interval 0.46–1.87; p = 0.83; I2 = 0%) and major complications (OR 0.76; 95% confidence interval 0.34–1.69; p = 0.51; I2 = 43%).
Conclusion:These findings suggest that transcatheter patent ductus arteriosus closure in preterm infants under 2,500 g is a safe and effective alternative to surgical treatment. There was a substantial reduction in all-cause mortality and haemodynamic instability with transcatheter intervention compared to surgical closure.
P135: Electroencephalography-Based Neuro-emotional Responses during interactive scenario therapy in the person with dementia – case study
- Marlene C. Neves Rosa, Sr., Dara Pincegher, Emanuel Silva, Susana L. Lopes, Natalia Martins Martins, Filipa Ribeiro, Mariline Ferreira, Duarte Fernandes, Mariana Moreira, Rui Martins, Rui Pedro Jesus, Sr., Alice Gabriel, Rafael Pinheiro
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, p. 136
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Background:
Immersive technologies have the potential to control cognitive and behavioural symptoms in people with dementia. A safe environment can be designed through a specific interactive scenario, according to the preferences and experiences of each user.
Objective:Mapping neuro-emotional responses during the interactive scenario therapy experience in a case study, with dementia, using electroencephalography (EEG).
Methods:A participant, 78 years old and diagnosed with moderate to severe Alzheimer's disease (female; Mini Mental State Examination score of 17 points; frontal assessment battery score of 8 points), underwent EEG analysis (EMOTIV EPOC X) using a protocol with interactive scenarios tailored to the participant's needs and preferences, the scenarios were designed from reminiscence strategies. The protocol included a stimulus that alternated between motor and cognitive activities (3 minutes), and breath-centered relaxation (1 minute). The scenarios used in this study were: setting up a living room; composing a cake recipe; shopping in the market to make a cake; looking for objects in the park; organizing a birthday party. These variables are provided, on a scale of 0 to 100, after processing by the algorithms of the EmotivPRO v3.0 software.
Results:The values found in the EEG analysis will be described without stimulus and with stimulus respectively. Thus, engagement (68.57 to 71.86); arousal (57.86 to 49.86), focus (61.57 to 57.00), interest (54.86 to 49.57), relaxation (33.86 to 30.86), and stress (53.71 to 43.00). The EEG data showed an increase in engagement when the patient was stimulated (68.57 to 71.86). Relaxation also increased (30.86 to 33.86) when the stimulus was removed. The stress level, as analysed by the EEG, was also higher in the period without stimulus and reduced in the period with the stimulus (53.71 to 43).
Conclusion:During a stimulus period in interactive therapy, there was an increase in engagement, which was related to an increasing focus during the stimulus. Lower values were observed compared to the period without stimulus, indicating a period of recovery after a period of concentration/arousal. Therefore, therapy with an interactive and familiar scenario, using a circuit of stimulus-breathing exercises, promotes a positive and adequate neuro-emotional response in a person with dementia.
Braiding Public Health and Human Rights: AIDS, Activism, and International Agencies in Brazil, 1987–1996
- Marcos Cueto, Gabriel Lopes
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- Latin American Research Review / Volume 58 / Issue 1 / March 2023
- Published online by Cambridge University Press:
- 02 November 2022, pp. 144-160
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This article examines the emergence of a synergy that allowed the early development of what was once considered the best anti-AIDS program in the developing world. Initial responses to AIDS in Brazil during the 1980s and early 1990s were marked by a confrontation between activists concerned with human rights, and a government focusing on biomedical management of the epidemic. After 1992, activists, medical researchers, government officials, international donors like the Ford Foundation, health officers, and multilateral agencies like the World Bank were galvanized to cooperate. This was a complex process of braiding knowledge and practices related to activism, science, public health, governance and philanthropy in which each constituency maintained its independence. The result was a complex, holistic, and nuanced AIDS program. The process helped bridge the gap between knowledge and advocacy, generated public awareness, and was instrumental to reducing AIDS mortality developing local human resources and comprehensive policies.
Potential advantages of ketamine over electroconvulsive therapy in the treatment of nonrefractory severe depression in older patients with multiple medical comorbidities
- Fábio Lopes Rocha, Ulisses Gabriel V. Cunha, Débora B. Duarte, Cláudia Hara
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- CNS Spectrums / Volume 28 / Issue 3 / June 2023
- Published online by Cambridge University Press:
- 02 May 2022, pp. 313-318
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Depression in older adults with multiple medical comorbidities can contribute to clinical deterioration, and increased mortality. Electroconvulsive therapy (ECT) is the first-line treatment for these patients. This study aimed to evaluate the effectiveness and safety of subcutaneous (SC) ketamine as an alternative to ECT. We reviewed the medical records of all consecutive older inpatients with severe depression and multiple medical comorbidities who were referred for ECT but treated with SC ketamine over 1 year in our institution. Demographic data, DSM-5 diagnosis, MÅDRS score, and CGI score were analyzed. Twelve patients aged 67–94 years were included. All patients were rated as severely ill, 83% were women, with a mean of 12.6 (SD, 1.4) medical comorbidities. Remission was achieved in 75% of the intention-to-treat population and 100% of treatment completers. The number of sessions ranged from 1 to 6, and days until remission from 1 to 16. Patients remained without relapse for 8–28 months. SC ketamine was safe and well tolerated, and most adverse events were mild and transient. Although limited by the retrospective open-label design of the study and small sample size, our findings provide a potential new indication for ketamine: treatment of severe depression, not necessarily resistant to antidepressants, in older patients with multiple medical comorbidities, at risk of clinical deterioration, and referral for ECT. SC ketamine was highly effective in this population, with no relapse and good tolerance. Randomized controlled trials are needed to adequately test the use of ketamine in this specific group.
Early postnatal overnutrition impairs VO2max gains with moderate exercise and increase post-exercise muscle damage in adult male rats
- Douglas Lopes Almeida, Gabriel Sergio Fabricio, Laize Peron Tófolo, Tatiane Aparecida Ribeiro, Camila Cristina Ianoni Matiusso, Maiara Vanusa Guedes Ribeiro, Anna Rebeka Oliveira Ferreira, Audrei Pavanello, Ananda Malta, Kesia Palma-Rigo, Paulo Cezar de Freitas Mathias
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- Journal of Developmental Origins of Health and Disease / Volume 13 / Issue 3 / June 2022
- Published online by Cambridge University Press:
- 21 July 2021, pp. 406-410
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Exercise counteracts obesity effects, but information on how early-life obesity may affect long-term adaptation to exercise is lacking. This study investigates the impact of early-life postnatal overfeeding (PO) on animals’ adaptation to exercise. Only male Wistar rats were used. On postnatal day (PN) 30, rats from control (NL-9 pups) or PO (SL-3 pups) litters were separated into four groups: NL-sedentary (NL-Se), NL-exercised (NL-Ex), SL-sedentary (SL-Se), and SL-exercised (SL-Ex). Exercised groups performed moderate-intensity exercise, running on a treadmill, from PN30 to PN90. Further experiments were carried out between PN90 and PN92. PO promoted obesity in SL versus NL rats (P < 0.05). Exercise reduced body weight (P < 0.001), body fat (P < 0.01), and improved glucose homeostasis in SL-Ex versus SL-Se. SL-Ex presented lower VO2max (P < 0.01) and higher post-exercise LDH (P < 0.05) compared to NL-Ex rats. Although moderate exercise counteracted obesity in SL rats, early-life overnutrition restricts fitness gains in adulthood, indicating that early obesity may impair animals’ adaptation to exercise.
Automated Risk Analysis of Surgical Site Infection in Hip Arthroplasty Surgeries
- Flávio Souza, Braulio Couto, Felipe Leandro Andrade da Conceição, Gabriel Henrique Silvestre da Silva, Igor Gonçalves Dias, Rafael Vieira Magno Rigueira, Gustavo Maciel Pimenta, Maurilio Martins, Julio Cesar Mendes, Ana Flavia Viana Quintão, Camila Vieira Brandão, Débora Martins Borges, Eduarda Muzzi Torres Lage, Luiza da Conceição Sabadini, Sabrina de Almeida Lopes
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 02 November 2020, pp. s135-s136
- Print publication:
- October 2020
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Background: In 7 hospitals in Belo Horizonte, a city with >3,000,000 inhabitants, a survey was conducted between July 2016 and June 2018, focused on surgical site infection (SSI) in patients undergoing arthroplasty surgery procedures. The main objective is to statistically evaluate such incidences and enable a study of the prediction power of SSI through pattern recognition algorithms, the MLPs (multilayer perceptron). Methods: Data were collected on SSI by the hospital infection control committees (CCIHs) of the hospitals involved in the research. All data used in the analysis during their routine SSI surveillance procedures were collected. The information was forwarded to the NOIS (Nosocomial Infection Study) Project, which used SACIH automated hospital infection control system software to collect data from a sample of hospitals participating voluntarily in the project. After data collection, 3 procedures were performed: (1) a treatment of the database collected for the use of intact samples; (2) a statistical analysis on the profile of the hospitals collected; and (3) an assessment of the predictive power of 5 types of MLP (backpropagation standard, momentum, resilient propagation, weight decay, and quick propagation) for SSI prediction. MLPs were tested with 3, 5, 7, and 10 hidden layer neurons and a database split for the resampling process (65% or 75% for testing and 35% or 25% for validation). The results were compared by measuring AUC (area under the curve; range, 0–1) presented for each of the configurations. Results: Of 1,246 records, 535 were intact for analysis. We obtained the following statistics: the average surgery time was 190 minutes (range, 145–217 minutes); the average age of the patients was 67 years (range, 9–103); the prosthetic implant index was 98.13%; the SSI rate was 1.49%, and the death rate was 1.21%. Regarding the prediction power, the maximum prediction power was 0.744. Conclusions: Despite the considerable loss rate of almost 60% of the database samples due to the presence of noise, it was possible to perform relevant sampling for the profile evaluation of hospitals in Belo Horizonte. For the predictive process, some configurations have results that reached 0.744, which indicates the usefulness of the structure for automated SSI monitoring for patients undergoing hip arthroplasty surgery. To optimize data collection and to enable other hospitals to use the SSI prediction tool (available in www.sacihweb.com ), a mobile application was developed.
Funding: None
Disclosures: None
Epidemiological and molecular identification of Trypanosoma vivax diagnosed in cattle during outbreaks in central Brazil
- Thiago Souza Azeredo Bastos, Adriana Marques Faria, Luiz Fellipe Monteiro Couto, João Eduardo Nicaretta, Alliny Souza de Assis Cavalcante, Dina Maria Beltrán Zapa, Lorena Lopes Ferreira, Luciana Maffini Heller, Darling Mélany de Carvalho Madrid, Leonardo Bueno Cruvinel, Gabriel Augusto Marques Rossi, Vando Edésio Soares, Fabiano Antônio Cadioli, Welber Daniel Zanetti Lopes
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- Parasitology / Volume 147 / Issue 12 / October 2020
- Published online by Cambridge University Press:
- 22 June 2020, pp. 1313-1319
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Bovine trypanosomosis has been spreading in Brazil. In the present study, we evaluated the spatial distribution, prevalence and risk factors of this disease in the state of Goiás, Brazil, and performed both molecular and phylogenetical analyses of Trypanosoma vivax. A total of 4049 blood samples were collected from cattle for a period of 2 years. The parasitological diagnosis was performed using the Woo method and a questionnaire was administered to the farmers to document risk factors associated with the disease in the herd. Positive samples were DNA sequenced and compared to GenBank codes. The prevalence of T. vivax was 8.84%, occurring on 24 ranches only in dairy cattle and mainly in the central and southern portions of the state. The acquisition of new animals infected with T. vivax and the administration of exogenous oxytocin to cows using the same syringe and needle were the main associated factors (P ≤ 0.05). After an outbreak, milk production decreased by 39.62%. The presence of biting flies (tabanids, Haematobia irritans and Stomoxys calcitrans) was not a risk factor (P > 0.05) for the occurrence of T. vivax. The epidemiological data demonstrate the importance of restricting the practice of auctions as well as eliminating the use of exogenous oxytocin in animals during milking. The samples tested by polymerase chain reaction were positive for T. vivax and were genetically homologous with T. vivax found in different states of Brazil and west Africa based on the 18S rRNA gene.
Relationship between childhood maltreatment and geriatric depression: the mediator effect of personality traits
- Gabriel Behr Gomes Jardim, Armin von Gunten, Irenio Gomes da Silva Filho, Patricia Klarmann Ziegelmann, Daniela Benzano Bumaguin, Eduardo Lopes Nogueira, Paula Engroff, Alfredo Cataldo Neto
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- International Psychogeriatrics / Volume 31 / Issue 12 / December 2019
- Published online by Cambridge University Press:
- 04 March 2019, pp. 1759-1767
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Background:
Childhood maltreatment is an important factor associated with adverse mental health outcomes including geriatric depression and the “big five” personality characteristics. The objective of this study was to evaluate a model where personality characteristics mediate the relationship between childhood maltreatment and geriatric depression.
Method:In this cross-sectional study, elderly subjects from socioeconomically disadvantaged neighborhoods of Porto Alegre, Brazil (n = 260) completed the Childhood Trauma Questionnaire (CTQ), NEO-Five Factor Inventory (NEO-FFI), and Mini International Neuropsychiatric Interview 5.0 (MINI plus). We used structural equation modeling (SEM) to evaluate the mediation hypothesis.
Results:The five personality factors (neuroticism, extraversion, agreeableness, openness, and conscientiousness) were related to childhood maltreatment and depression. Mediation analysis revealed that neuroticism and extraversion are complete mediators, agreeableness and conscientiousness are partial mediators, and openness is not a mediator.
Conclusions:These findings support the hypothesis in which childhood maltreatment is associated with geriatric depression and mediated by personality factors. These results suggest that reducing the maladaptive personality trait in elderly people who suffered childhood maltreatment could prevent geriatric depression.
Food intake of women with gestational diabetes mellitus, in accordance with two methods of dietary guidance: a randomised controlled clinical trial
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- Letícia Barbosa Gabriel da Silva, Eliane Lopes Rosado, Patricia de Carvalho Padilha, Juliana Rebelo Dias, Tainá Marques Moreira, Tatiana Pereira de Paula, Denise Cavalcante de Barros, Cláudia Saunders
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- Journal:
- British Journal of Nutrition / Volume 121 / Issue 1 / 14 January 2019
- Published online by Cambridge University Press:
- 05 November 2018, pp. 82-92
- Print publication:
- 14 January 2019
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The aim of the study was to evaluate the food intake of pregnant women with gestational diabetes mellitus (GDM) according to two methods of dietary guidance. A randomised controlled clinical trial was conducted by appointment with a nutritionist and by using data from hospital records (2011–2014). The study population comprised adult women diagnosed with GDM treated in a public maternity hospital in Rio de Janeiro, Brazil. The control group (CG) received nutritional advice by the traditional method and the intervention group (IG) were instructed on carbohydrate counting. The analysis of food intake and the consumption of processed foods (PF) and ultra-processed foods (UPF) were evaluated in the second and third trimester. A total of 286 pregnant women were initially assessed (145 in the CG and 141 in the IG). It was observed that 89/120 (74·2 %) and 183/229 (79·9 %) consumed PF daily in the second and third trimesters, respectively, whereas 117/120 (97·5 %) and 225/231 (97·4 %) consumed UPF daily in the second and third trimesters, respectively. When analysing the intake of macronutrients (%) by quartiles, women who had fat intake in the third quartile had the highest average postprandial blood glucose compared with those who consumed fat in the second quartile (P=0·02). The consumption of PF and UPF was high and dietary intake was similar in both groups, regardless of dietary guidance method deployed, suggesting that both methods tested in the study can be used for monitoring the nutritional status of pregnant women with GDM.
Gilberto Hochman, The Sanitation of Brazil: Nation, State, and Public Health, 1889–1930 (Urbana, IL, Chicago, and Springfield, IL: University of Illinois Press, 2016), pp. xiv+152, $25.00, paperback, ISBN: 978-0-252-08211-5.
- Gabriel Lopes
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- Medical History / Volume 62 / Issue 1 / January 2018
- Published online by Cambridge University Press:
- 04 December 2017, pp. 141-142
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Analysis of bovine cysticercosis in the state of Goiás, Brazil and economical losses for beef farms
- FERNANDA MARTINS DE AQUINO, VANDO EDÉSIO SOARES, GABRIEL AUGUSTO MARQUES ROSSI, LUIZ ANTÔNIO CARDOSO DANIN, JOÃO EDUARDO NICARETTA, THIAGO DE SOUZA AZEREDO BASTOS, LEONARDO BUENO CRUVINEL, GUSTAVO FELIPPELLI, BRENO CAYEIRO CRUZ, WILLIAN GIQUELIM MACIEL, LUCAS VINICIUS COSTA GOMES, WELBER DANIEL ZANETTI LOPES
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- Parasitology Open / Volume 3 / 2017
- Published online by Cambridge University Press:
- 15 August 2017, e12
- Print publication:
- 2017
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This study aimed to assess the prevalence and spatial distribution of bovine cysticercosis in the state of Goiás, Brazil; to verify its association with epidemiological variables, and to establish the economical losses for beef farms. A set of 23 255 979 bovines from 246 municipalities were slaughtered from 2007 through 2014. The prevalence of bovine cysticercosis was 0·53% [95% confidence interval (95% CI) 0·5295–0·5354]. The Central mesoregion showed a higher risk [odds ratio (OR) = 4·44; 95% CI 4·2936–4·5895] for detecting infected animals with cysticerci compared with those raised at North and Northeast mesoregion (OR = 1·02 and OR = 1·02). The microregion of Goiânia had a higher risk for bovine cysticercosis occurrence (OR = 11·05, 95% CI 10·6933–11·4099) compared with the microregion of São Miguel do Araguaia (OR = 1). None of the epidemiological variables evaluated in this study was significantly associated (P > 0·05) with bovine cysticercosis prevalence.
In conclusion, the prevalence of bovine cysticercosis in the state of Goiás, Brazil, was 0·53% and some mesoregions and microregions presented a higher risk for its occurrence. The economical losses due to its occurrence during the period ranged from US$9 260 728·57 to 11 313 816·67. These results highlighted the needs of adopting prophylactic measures and the development of political strategies in specific regions in order to control this zoonose and reduce the economical losses for beef production chain and the costs for public health.
Experimental infection by Haemonchus contortus in lambs: influence of disease on purine levels in serum
- LUCAS T. GRESSLER, ALEKSANDRO S. DA SILVA, CAMILA B. OLIVEIRA, ANDRESSA S. SCHAFER, ADELINA R. AIRES, JOSÉ F. X. ROCHA, ALEXANDRE A. TONIN, GABRIEL H. SCHIRMBECK, EMERSON A. CASALI, SONIA T. A. LOPES, MARTA L. R. LEAL, SILVIA G. MONTEIRO
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- Parasitology / Volume 141 / Issue 7 / June 2014
- Published online by Cambridge University Press:
- 17 February 2014, pp. 898-903
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The aim of this study was to evaluate the purine levels of lambs experimentally infected with Haemonchus contortus. A total of 12 healthy lambs were divided into two groups, composed of 6 animals each: Group A represented the healthy animals (uninfected), while in Group B the animals were infected with 15 000 larvae of H. contortus. Blood was drawn on days 15, 45 and 75 post-infection (PI) in order to perform the purine analysis (ATP, ADP, AMP, adenosine, inosine, hypoxanthine, xanthine and uric acid) by high pressure liquid chromatography (HPLC) in serum. On day 15 PI a significant (P<0·05) increase in the levels of ATP and inosine was observed in the infected animals, unlike the levels of ADP, adenosine, xanthine and uric acid which were reduced. On day 45 PI a significant (P<0·05) increase in the ATP and xanthine levels in infected animals was observed, contrasting with reduced levels of ADP and uric acid. Finally, on day 75 PI an increase occurred in the levels of ATP, adenosine and hypoxanthine in infected lambs, concomitant with a reduction in the levels of ADP and uric acid (P<0·05). These changes in purine levels may influence the inflammatory process and the pathological events.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. 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Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. 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Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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Evaluation of body development, fat mass and lipid profile in rats fed with high-PUFA and -MUFA diets, after neonatal malnutrition
- Carlos Alberto Soares da Costa, Erika Gomes Alves, Gabrielle de Paula Lopes Gonzalez, Thais Barcellos Côrtes Barbosa, Aluana Santana Carlos, Verônica Demarco Lima, Renata Nascimento, Egberto Gaspar de Moura, Celly Cristina Alves do Nascimento-Saba
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- British Journal of Nutrition / Volume 101 / Issue 11 / 14 June 2009
- Published online by Cambridge University Press:
- 25 November 2008, pp. 1639-1644
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- 14 June 2009
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Neonatal malnutrition is associated with several features of the metabolic syndrome, later in life. Although the recovery of malnutrition was studied with different high-fat diets, few studies compare the effects of enriched vegetable oil diets, containing PUFA and MUFA, after weaning. Our aim was to evaluate the recovery with soya oil- or rapeseed oil-enriched diet, after malnutrition in rats whose mothers were food restricted (FR) during lactation. Dams were 50 % FR and compared to standard diet-fed dams (control, C). At 21 d, FR offspring had a lower body mass and length. After weaning C and FR offspring were fed a diet containing 7 % soya oil (7 %sC and 7 %sFR), or supplemented with 19 % soya oil (19 %sC or 19 %sFR) or 19 % rapeseed oil (19 %cC or 19 %cFR). The normal animals fed enriched vegetable oil diets had more visceral fat mass, but lower serum TAG and higher HDL-cholesterol. The 19 %FR groups showed significantly less food intake and body development compared to the 7 %sFR, and the same pattern was observed when this group was compared to the C groups. Absolute and relative mass of vital organs and body were lower in the FR groups. Visceral fat depot was lower in 19 %FR than 7 %FR and C groups. Serum glucose, albumin, TAG, cholesterol, leptin and triiodothyronine did not show significant changes. However, 19 %FR groups showed higher HDL-cholesterol and the 19 %sFR group showed lower serum thyroxine. The data suggest that a higher vegetable oil diet in the recovery of neonatal malnutrition ameliorates some features of the metabolic syndrome later in life.
Comparison of an intravenous pulse of methylprednisolone versus oral corticosteroid in severe acute rheumatic carditis: a randomized clinical trial
- Edmundo José Nassri Câmara, Júlio César Vieira Braga, Luiz Sérgio Alves-Silva, Gabriel Ferreira Câmara, Antonio Alberto da Silva Lopes
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- Cardiology in the Young / Volume 12 / Issue 2 / March 2002
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- 15 August 2006, pp. 119-124
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Objectives: To compare the short-term prognosis of patients with severe acute rheumatic carditis when treated with an intravenous pulse of methylprednisolone in comparison with conventional treatment using oral prednisone. Methods: We designed a randomized clinical trial in the setting of a university general hospital in Brazil. We randomly allocated 18 patients with the diagnosis of severe acute rheumatic carditis and congestive heart failure to receive an intravenous pulse as opposed to oral prednisolone. Methylprednisolone was administered in a dose of 1 g intravenously for 3 consecutive days in the first and second weeks, for two days in the third, and one day in the fourth week. Prednisone was administered in a dose of 1.5 mg/kg/day over the period of 4 weeks. Results: The mean age of the patients was 11.1 ± 3.7 years, with a median of 12 years. Patients on oral treatment showed a more pronounced decrease in the heart rate, sedimentation rate, and in the titres of C-reactive protein than those receiving intravenous therapy. At the end of treatment, a mild decrease in the left ventricular end-systolic dimension was found in those having oral treatment, compared to an increase in the group having intravenous treatment (p = 0.036). The ejection fraction showed a median increase of 5% in those undergoing oral treatment, and a median decrease of 6% in the group with intravenous therapy (p = 0.009). There were 5 therapeutic failures in those receiving intravenous therapy (56%), including 1 death. Therapeutic failures were not observed in those treated orally (p = 0.03). Conclusion: Intravenous treatment of methylprednisolone, as a single anti-inflammatory agent, was inferior to conventional treatment with oral prednisone in the control of severe rheumatic carditis.
Mechanisms of mitral valvar insufficiency in children and adolescents with severe rheumatic heart disease: an echocardiographic study with clinical and epidemiological correlations
- Edmundo J. Nassri Câmara, Christiane Neubauer, Gabriel Ferreira Câmara, Antonio Alberto Lopes
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- Cardiology in the Young / Volume 14 / Issue 5 / October 2004
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- 21 January 2005, pp. 527-532
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We carried out a detailed clinical, epidemiological, and echocardiographic study in 41 patients ≤14 years of age who were admitted in a public hospital in Salvador, Brazil, with severe rheumatic heart disease.
Mitral insufficiency was severe in 90%, and moderate in 10%, of the patients. A posteriorly directed jet was seen in 93% of the patients. We identified three mechanisms producing the regurgitation: prolapse of the aortic leaflet of the mitral valve in 13 (32%) patients, rupture of tendinous cords in 14 (34%), and a retracted, non-coapting mural leaflet in 14 (34%). The mean ages, with standard deviations, for these three groups were 7.0 (1.6) years, 7.9 (2.2) years, and 10.5 (2.4) years, respectively (p < 0.001). Rheumatic activity was diagnosed in 58.5% of them. Evidence of previous rheumatic fever was present in 54% of patients with prolapse, in all patients with rupture, and in 93% of those with non-coapting leaflets (p = 0.002).
Prolapse of the aortic leaflet, rupture of tendinous cords, and a retracted, non-coapting mural leaflet are the mechanisms responsible for mitral valvar insufficiency in children and adolescents with severe rheumatic heart disease. Prolapse seems to be an early phenomenon in the natural history of rheumatic heart disease, while rupture and non-coaption of the leaflets were associated with older age and signs of chronic rheumatic disease.
Vitamin B12 Deficiency and Dementia
- Ulisses Gabriel de Vasconcelos Cunha, Fábio Lopes Rocha, Josecy Maria de Souza Peixoto, Maria Flávia de Morão Motta, Maira Tonidandel Barbosa
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- International Psychogeriatrics / Volume 7 / Issue 1 / March 1995
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- 07 January 2005, pp. 85-88
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We set out to investigate the possible beneficial effects on cognitive function of demented patients with cobalamin deficiency after cobalamin replacement. A total of 181 consecutive, demented (DSM-III or DSM-III-R criteria and score below 24 on the Mini-Mental State Examination [MMSE] outpatients (mean age 77.5 years) were prospectively evaluated and had their vitamin B12 level measured by radioimmunoassay. The frequency of vitamin B12 deficiency (less than 200 pg/mL) was 25% (46 patients). Treatment outcome was obtained in 19 patients (19 of 46). Despite cobalamin replacement, 16 of 19 patients persisted in showing progressive decline during follow-up visits (3 to 24 months). The nonresponse to vitamin B12 replacement in most cases seems to reflect the presence of associated irreversible dementia or a follow-up of shorter duration in a few patients. All of the patients who showed some improvement (MMSE returned to normal values) had mild dementia with a history of less than 2 years. Thus, screening for B12 deficiency should be considered in patients with recent onset of mild mental status changes.