77 results on '"Nunes RA"'
Search Results
2. P39 Meat, fruit and vegetable consumption in sub-saharan africa: a systematic review and meta-regression
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Mensah, DO, primary, Oyebode, O, additional, Nunes, RA, additional, and Lillywhyte, R, additional
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- 2019
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3. Characterizing the Interaction Between Root-knot Nematodes and Soil-borne Fungi which are Pathogenic to Passion Fruit (Passiflora edulis)
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Mangeiro Mariana Z., Nunes Rafael A., Vieira José O.L., Mussi-Dias Vicente, Viana Alexandre P., and Souza Ricardo M.
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disease complex ,fusarium ,interaction ,meloidogyne incognita ,meloidogyne javanica ,neocosmospora ,passiflora edulis ,passion fruit ,root-knot nematodes ,soilborne fungi ,synergistic interaction ,Biology (General) ,QH301-705.5 - Abstract
For decades there have been anecdotal claims of synergistic interactions between plant-parasitic nematodes and soil-borne fungi causing decline of productivity of passion fruit (Passiflora edulis) orchards. An empirical confirmation of these disease complexes would impact disease management and plant breeding for resistance. To test those claims, we subjected passion fruit plants to single or concomitant parasitism by Meloidogyne javanica or M. incognita and Fusarium nirenbergiae or Neocosmospora sp. under controlled conditions. Non-inoculated plants served as control for the assays. The severity of shoot symptoms and variables related to plant growth, the extent of fungal lesions, and nematode reproduction were assessed to characterize the interactions. The shoot symptoms and effect on plant growth induced by the pathogens varied, but no synergy between the pathogens was observed. Moreover, the volume of tissue lesioned by the fungi was not affected by co-parasitism of the nematodes. Conversely, plant resistance to the nematodes was not affected by co-parasitism of the fungi. The interactions M. incognita-F. nirenbergiae, M. incognita-Neocosmospora sp., M. javanica-F. nirenbergiae, and M. javanica-Neocosmospora sp. were not synergistic as previously claimed, but instead neutral.
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- 2022
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4. CYP2A6/2A7 and CYP2E1 expression in human oesophageal mucosa: regional andinter-individual variation in expression and relevance to nitrosaminemetabolism.
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Godoy, W, Albano, RM, Moraes, EG, Pinho, PR, Nunes, RA, Saito, EH, Higa, C, Filho, IM, Kruel, CD, Schirmer, CC, Gurski, R, Lang, MA, Pinto, LF, Godoy, W, Albano, RM, Moraes, EG, Pinho, PR, Nunes, RA, Saito, EH, Higa, C, Filho, IM, Kruel, CD, Schirmer, CC, Gurski, R, Lang, MA, and Pinto, LF
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- 2002
5. Influence of demographic and metabolic variables on forearm blood flow and vascular conductance in individuals without overt heart disease.
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Sartori TE, Nunes RA, da Silva GT, da Silva SC, Rondon MU, Negrao CE, Mansur AJ, Sartori, Thiago E, Nunes, Rafael A B, da Silva, Gisela T, da Silva, Sandra C, Rondon, Maria U P B, Negrão, Carlos E, and Mansur, Alfredo J
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- 2010
6. Prediction VO2max during cycle ergometry based on submaximal ventilatory indicators.
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Nunes RA, Vale RG, Simão R, de Salles BF, Reis VM, Novaes JS, Miranda H, Rhea MR, and Medeiros AC
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There are several equations to predict maximum oxygen consumption (VO2max) from ergometric test variables on different ergometers. However, a similar equation using ventilatory thresholds of ergospirometry in a submaximal test on a cycle ergometer is unavailable. The aim of the present study was to assess the accuracy of VO2max prediction models based on indicators of submaximal effort. Accordingly, 4,640 healthy, nonathlete women ages 20 years and older volunteered to be tested on a cycle ergometer using a maximum incremental protocol. The subjects were randomly assigned to 2 groups: group A (estimation) and group B (validation). From the independent variables of weight in kilograms, the second workload threshold (WT2), and heart rate of the second threshold (HRT2), it was possible to build a multiple linear regression model to predict maximal oxygen consumption (VO2max = 40.302 - 0.497 [Weight] - 0.001 [HRT2] + 0.239 [WT2] in mL O2/kg/min(-1); r = 0.995 and standard error of the estimate [SEE] = 0.68 mL O2/kg/min(-1)). The cross-validation method was used in group B with group A serving as the basis for building the model and the validation dataset. The results showed that, in healthy nonathlete women, it is possible to predict VO2max with a minimum of error (SEE = 1.00%) from submaximal indicators obtained in an incremental test. [ABSTRACT FROM AUTHOR]
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- 2009
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7. Physical property distributions and seasonal trends in Spencer Gulf, South Australia: an inverse estuary
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Nunes, RA and Lennon, GW
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Results are described from the first long-term, systematic program of oceanographic measurements in Spencer Gulf, South Australia. The gulf belongs to a subset of semi-enclosed seas that are characterized by a net fluid loss, in this case induced by excess evaporation, and a resulting circulation that is the reverse of that found in a classical estuary. In Spencer Gulf, this inverse estuary character involves the production of salinities as high as 48 at the head in late summer. The seasonal variations of temperature and salinity, from both large-scale CTD surveys and time-series observations at a fixed station, reveal the manner in which the gulf responds to seasonal influences. From such information, the gulf's dispersive capabilities are quantitatively assessed, and the implications of thermohaline processes for gulf-ocean exchange are discussed.
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- 1986
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8. Effect of the carbohydrate counting method on glycemic control in patients with type 1 diabetes
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Dias Viviane M, Pandini Juliana A, Nunes Raquel R, Sperandei Sandro LM, Portella Emilson S, Cobas Roberta A, and Gomes Marília de B
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Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
Abstract Background The importance of achieving and maintaining an appropriate metabolic control in patients with type 1 diabetes mellitus (DM1) has been established in many studies aiming to prevent the development of chronic complications. The carbohydrate counting method can be recommended as an additional tool in the nutritional treatment of diabetes, allowing patients with DM1 to have more flexible food choices. This study aimed to evaluate the influence of nutrition intervention and the use of multiple short-acting insulin according to the carbohydrate counting method on clinical and metabolic control in patients with DM1. Methods Our sample consisted of 51 patients with DM1, 32 females, aged 25.3 ± 1.55 years. A protocol of nutritional status evaluation was applied and laboratory analysis was performed at baseline and after a three-month intervention. After the analysis of the food records, a balanced diet was prescribed using the carbohydrate counting method, and short-acting insulin was prescribed based on the total amount of carbohydrate per meal (1 unit per 15 g of carbohydrate). Results A significant decrease in A1c levels was observed from baseline to the three-month evaluation after the intervention (10.40 ± 0.33% and 9.52 ± 0.32%, respectively, p = 0.000). It was observed an increase in daily insulin dose after the intervention (0.99 ± 0.65 IU/Kg and 1.05 ± 0.05 IU/Kg, respectively, p = 0.003). No significant differences were found regarding anthropometric evaluation (BMI, waist, hip or abdominal circumferences and waist to hip ratio) after the intervention period. Conclusions The use of short-acting insulin based on the carbohydrate counting method after a short period of time resulted in a significant improvement of the glycemic control in patients with DM1 with no changes in body weight despite increases in the total daily insulin doses.
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- 2010
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9. Low-level expression of HER2 and CK19 in normal peripheral blood mononuclear cells: relevance for detection of circulating tumor cells
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You Fanglei, Roberts Lisa A, Kang S Peter, Nunes Raquel A, Dias Cinara, Iglehart J Dirk, Solomon Natalie A, Friedman Paula N, and Harris Lyndsay N
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Diseases of the blood and blood-forming organs ,RC633-647.5 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Detection of circulating tumor cells (CTC) in the blood of cancer patients may have prognostic and predictive significance. However, background expression of 'tumor specific markers' in peripheral blood mononuclear cells (PBMC) may confound these studies. The goal of this study was to identify the origin of Cytokeratin 19 (CK19) and HER-2 signal in PBMC and suggest an approach to enhance techniques involved in detection of CTC in breast cancer patients. Methods PBMC from healthy donors were isolated and fractionated into monocytes, lymphocytes, natural killer cells/granulocytes and epithelial populations using immunomagnetic selection and fluorescent cell-sorting for each cell type. RNA isolated from each fraction was analyzed for CK19, HER2 and Beta 2 microglobulin (B2M) using real-time qRT-PCR. Positive selection for epithelial cells and negative selection for NK/granulocytes were used in an attempt to reduce background expression of CK19 and HER2 markers. Results In normal PBMC, CK19 was expressed in the lymphocyte population while HER-2 expression was highest in the NK/granulocyte population. Immunomagnetic selection for epithelial cells reduced background CK19 signal to a frequency of Conclusion We present a novel method to improve the specificity of the traditional method of detecting CTC by identifying the source of the background signals and reducing them by negative immunoselection. Further studies are warranted to improve sensitivity and specificity of methods of detecting CTC will prove to be useful tools for clinicians in determining prognosis and monitoring treatment responses of breast cancer patients.
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- 2008
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10. NaF films: Growth properties and electron beam induced defects
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Stefano Martelli, M. H. Do Pinho Mauricio, L. C. Scavarda Do Carmo, Rosa Maria Montereali, R. A. Nunes, Fabrizia Somma, Marco Cremona, A. P. Sotero, Cremona, M, Sotero, Ap, Nunes, Ra, Mauricio, Mhd, Docarmo, Lc, Montereali, Rm, Martelli, S, and Somma, Fabrizia
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Nuclear and High Energy Physics ,Radiation ,Absorption spectroscopy ,Scanning electron microscope ,Photoemission spectroscopy ,Chemistry ,Analytical chemistry ,Condensed Matter Physics ,Evaporation (deposition) ,Electron beam physical vapor deposition ,Crystallography ,General Materials Science ,Crystallite ,Texture (crystalline) ,Thin film - Abstract
Polycrystalline NaF films were grown by e-beam assisted physical evaporation on amorphous silica substrates kept, during film growth, at constant temperatures ranging from 40 degrees C to 400 degrees C. The structural characterization of the films was performed by X-ray diffraction and by scanning electron microscopy. Irradiating the films with a 15 keV electron beam induced the formation of F and F-aggregate colour centres stable at room temperature. Absorption and photoemission measurements were performed and indicated a dependence of coloration on the deposition conditions.
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- 1995
11. Photoluminescence of LiF : NaF films at room temperature
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A.P. da Silva Sotero, Marco Cremona, Fabrizia Somma, R. A. Nunes, L. C. Scavarda Do Carmo, Marco Rossi, Rosa Maria Montereali, Nunes, Ra, Sotero, Apd, Docarmo, Lc, Cremona, M, Montereali, Rm, Roosi, M, and Somma, Fabrizia
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Photoluminescence ,Chemistry ,business.industry ,Biophysics ,Physics::Optics ,New materials ,General Chemistry ,Dielectric ,Electron ,Condensed Matter Physics ,Biochemistry ,Atomic and Molecular Physics, and Optics ,Spectral line ,Condensed Matter::Materials Science ,Low energy ,Optoelectronics ,business ,Nuclear chemistry - Abstract
In this paper we present the results of the photoluminescence spectra of multilayer LiF : NaF films colored by low energy (3 keV) electron beams. We show that dielectric multilayered films can be used in the design of new materials with optical properties that cannot be matched by bulk materials.
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- 1994
12. Structural and optical properties of alkali halide multilayer LiF:NaF films
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Marco Cremona, Ra Nunes, Rm Montereali, Fabrizia Somma, Maurizio Passacantando, Luca Lozzi, Mhp Mauricio, Sandro Santucci, Somma, Fabrizia, Montereali, Rm, Santucci, S, Lozzi, L, Passacantando, M, Cremona, M, Mauricio, Mhp, and Nunes, Ra
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Argon ,Photoluminescence ,Materials science ,Photoemission spectroscopy ,Scanning electron microscope ,Analytical chemistry ,chemistry.chemical_element ,Halide ,Physics::Optics ,Surfaces and Interfaces ,Condensed Matter Physics ,Evaporation (deposition) ,Surfaces, Coatings and Films ,Characterization (materials science) ,Condensed Matter::Materials Science ,chemistry ,X-ray crystallography - Abstract
Alkali halide multilayer films containing a large concentration of color centers created by low energy (3-12 keV) electron beams in a thin dielectric layer of controlled depth, represent a good and simple way to obtain new optically active materials. This work presents a study of multilayer LiF:NaF films, grown by physical evaporation. The structural and morphological characterization of the samples have been performed using x-ray diffraction, scanning electron microscopy, atomic force microscopy, and x-ray photoemission spectroscopy depth profile techniques. The visible photoluminescence of optically active defects was measured by excitation with an Argon laser. Controlling the deposition and coloration parameters it is possible to obtain new photoluminescent materials with predesigned optical features. (C) 1997 American Vacuum Society.
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- 1997
13. F-AGGREGATE CENTERS IN KCL FILMS
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Rosa Maria Montereali, A. Scacco, Stefano Martelli, G. Petrocco, L. C. Scavarda Do Carmo, A. Ercoli, L. Scopa, R. A. Nunes, Fabrizia Somma, Marco Cremona, Ercoli, A, Scacco, A, Somma, Fabrizia, Cremona, M, Montereali, Rm, Martelli, S, Petrocco, G, Scopa, L, Nunes, Ra, and Docarmo, Lcs
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Nuclear and High Energy Physics ,Radiation ,Photoluminescence ,genetic structures ,Absorption spectroscopy ,business.industry ,Chemistry ,Analytical chemistry ,Condensed Matter Physics ,Amorphous solid ,Optics ,Electron beam processing ,General Materials Science ,Thin film ,business ,Luminescence ,Absorption (electromagnetic radiation) ,Deposition (law) - Abstract
The optical behaviour of colour centres is studied in thin films of KCl obtained by thermal evaporation onto amorphous substrates. Deposition conditions are optimized in order to minimize chemical and thermal effects on films. Concentration of colour centres even higher than in bulk crystals can be induced by low energy electron irradiation. Thermal bleaching of F centres is observed at room temperature and its kinetics, deduced from absorption measurements, consists of two exponential processes with very different time constants. Luminescence is obtained for the first time from aggregate colour centres in KCl films, and typical emissions of F2, F3, F4 defects (but not of F centres because of concentration quenching) are revealed.
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- 1994
14. Alcohol Use Disorder and Chronic Pain: An Overlooked Epidemic.
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De Aquino JP, Sloan ME, Nunes JC, Costa GPA, Katz JL, de Oliveira D, Ra J, Tang VM, and Petrakis IL
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- Humans, Substance Withdrawal Syndrome epidemiology, Chronic Pain epidemiology, Alcoholism epidemiology, Comorbidity
- Abstract
Alcohol use disorder (AUD) and chronic pain disorders are pervasive, multifaceted medical conditions that often co-occur. However, their comorbidity is often overlooked, despite its prevalence and clinical relevance. Individuals with AUD are more likely to experience chronic pain than the general population. Conversely, individuals with chronic pain commonly alleviate their pain with alcohol, which may escalate into AUD. This narrative review discusses the intricate relationship between AUD and chronic pain. Based on the literature available, the authors present a theoretical model explaining the reciprocal relationship between AUD and chronic pain across alcohol intoxication and withdrawal. They propose that the use of alcohol for analgesia rapidly gives way to acute tolerance, triggering the need for higher levels of alcohol consumption. Attempts at abstinence lead to alcohol withdrawal syndrome and hyperalgesia, increasing the risk of relapse. Chronic neurobiological changes lead to preoccupation with pain and cravings for alcohol, further entrenching both conditions. To stimulate research in this area, the authors review methodologies to improve the assessment of pain in AUD studies, including self-report and psychophysical methods. Further, they discuss pharmacotherapies and psychotherapies that may target both conditions, potentially improving both AUD and chronic pain outcomes simultaneously. Finally, the authors emphasize the need to manage both conditions concurrently, and encourage both the scientific community and clinicians to ensure that these intertwined conditions are not overlooked given their clinical significance., Competing Interests: Dr. De Aquino has received in-kind medication support for clinical trials from Jazz Pharmaceuticals and has served as a consultant for Boehringer Ingelheim. Dr. Petrakis has received in-kind medication support for research studies from Alkermes and BioXcel Therapeutics and is co-editor of the Journal of Addiction Medicine. Dr. Petrakis has received royalties from McGraw Hill and is named on provisional patent applications for methods to treat addiction (U.S. 61/973/961) and for methods for treating or preventing depression and other diseases (U.S. 62/444,552). The other authors report no financial relationships with commercial interests.
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- 2024
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15. Microbiological Analysis of Surgeons' Hands in a Public Hospital in São Luis, Maranhão State, Brazil: A Cross-Sectional Study.
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Serra Neto A, Marques SG, Bomfim MRQ, Monteiro SG, de Souza RC, and Nunes RA
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Antisepsis of the hands of medical personnel is one of the most important steps in the process of patient care, since direct contact can cause the cross-transfer of potentially pathogenic microorganisms at surgical sites. This study aimed to analyze the prevalence of microorganisms on the hands of 131 surgeons in a university hospital before the surgical procedure. Swabs were collected from each clinician's hands before and after handwashing. The samples were placed in a transport medium and immediately delivered to a private clinical analysis laboratory from São Luis-Maranhão. The microorganisms were identified by ionization source mass spectrometry and matrix-assisted laser desorption (MALDI-TOF), and antibiotic susceptibility tests (AST) were performed using the Vitek2 and Phoenix-BD automated system. The results showed a high frequency (100%) of microorganisms before handwashing, but after surgical antisepsis, the rate dropped significantly ( p < 0.05) to 27.5%. The gram-positive species most detected were Staphylococcus spp. and Micrococcus luteus , representing 83.9%, followed by gram-negative species, Stenotrophomonas maltophilia , Acinetobacter baumanii , Pseudomonas aeruginosa , Pseudomonas gessardi , Pantoea septica , Serratia marcescens , and Burkholderia lata. The effectiveness of hand antisepsis was 72.5%, demonstrating that surgeons' hands are an important source of microorganisms that can cause infections in hospitalized patients in different care settings.
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- 2023
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16. The importance of endobag use with incision-protective devices in VATS lung resection: a preliminary study.
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Noguera CAL, Lopes AJ, Mathias Filho I, Higa C, Nunes RA, Lima CET, and Saito EH
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- Humans, Lung pathology, Protective Devices, Retrospective Studies, Thoracic Surgery, Video-Assisted methods, Carcinoma, Non-Small-Cell Lung pathology, Lung Neoplasms pathology, Lung Neoplasms surgery
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Objective: The advent of new techniques such as video-assisted thoracoscopic surgery (VATS) for the removal of lung segments leads to compression of the surgical specimen, with the possible dissemination of neoplastic cells. The sheer volume of surgeries performed using these techniques has caused many institutions to stop removing the surgical specimen using an endobag, even when retractors/protectors are used in the instrumentalization incision. This study aimed to collect data from patients undergoing lung resection by VATS and analyze the cytopathological results of the collected material., Results: A total of 47 endobag fluid samples were collected from patients who underwent VATS. The surgical specimen was subjected to histopathological analysis, and all patients underwent pathological TNM staging. In the cytopathological analyses, only 2 (4.3%) specimens of endobag fluid aspirate were positive for neoplastic cells. In these two cases, the tumors were peripheral, both with diagnoses of moderately differentiated adenocarcinoma and with classifications of T1bN0M0 and T3N0M0. These results indicate that although there is a low incidence of tumor cells in endobag fluid, it is always better to perform surgery using all available protective measures to avoid tumor implantation in the thoracic cavity to the greatest extent possible., (© 2022. The Author(s).)
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- 2022
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17. Effects of Pilates with and without elastic resistance on health variables in postmenopausal women with low back pain.
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Castro JB, Lima VP, Mello DB, Lopes GC, Peixoto JC, Santos AOD, Nunes RA, and Souza Vale RG
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- Exercise Therapy, Female, Humans, Lumbosacral Region, Pain Measurement, Postmenopause, Exercise Movement Techniques, Low Back Pain therapy
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Aim: To compare the effects of Pilates with and without accessories on biochemical markers, pain intensity, functional disability and muscle strength in postmenopausal women with nonspecific chronic low back pain. Materials & methods: Twenty-two participants were randomized to a group of Pilates without (PG; n = 11) and with elastic resistance (PAG; n = 11) for 8 weeks, twice a week. We analyzed IGF-1, IGF-binding protein-3 (IGFBP-3), cortisol, creatine kinase, pain intensity, functional disability, abdominal and back strengths. Results: Both groups had lower pain intensity and functional disability and increased lumbar strength postinterventions. PAG exhibited an increase in IGF-1/IGFBP-3 ratio and reduction in creatine kinase compared with PG. Conclusion: Both interventions were effective in the treatment of low back pain. However, PAG presented better responses than PG. Clinical Trial Registration: Brazilian Clinical Trials Registry: ReBEC (RBR-9jwcykc), www.ensaiosclinicos.gov.br/rg/RBR-9jwcykc.
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- 2022
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18. Automatic method for classifying COVID-19 patients based on chest X-ray images, using deep features and PSO-optimized XGBoost.
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Dias Júnior DA, da Cruz LB, Bandeira Diniz JO, França da Silva GL, Junior GB, Silva AC, de Paiva AC, Nunes RA, and Gattass M
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The COVID-19 pandemic, which originated in December 2019 in the city of Wuhan, China, continues to have a devastating effect on the health and well-being of the global population. Currently, approximately 8.8 million people have already been infected and more than 465,740 people have died worldwide. An important step in combating COVID-19 is the screening of infected patients using chest X-ray (CXR) images. However, this task is extremely time-consuming and prone to variability among specialists owing to its heterogeneity. Therefore, the present study aims to assist specialists in identifying COVID-19 patients from their chest radiographs, using automated computational techniques. The proposed method has four main steps: (1) the acquisition of the dataset, from two public databases; (2) the standardization of images through preprocessing; (3) the extraction of features using a deep features-based approach implemented through the networks VGG19, Inception-v3, and ResNet50; (4) the classifying of images into COVID-19 groups, using eXtreme Gradient Boosting (XGBoost) optimized by particle swarm optimization (PSO). In the best-case scenario, the proposed method achieved an accuracy of 98.71%, a precision of 98.89%, a recall of 99.63%, and an F1-score of 99.25%. In our study, we demonstrated that the problem of classifying CXR images of patients under COVID-19 and non-COVID-19 conditions can be solved efficiently by combining a deep features-based approach with a robust classifier (XGBoost) optimized by an evolutionary algorithm (PSO). The proposed method offers considerable advantages for clinicians seeking to tackle the current COVID-19 pandemic., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 Elsevier Ltd. All rights reserved.)
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- 2021
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19. An emergency system for monitoring pulse oximetry, peak expiratory flow, and body temperature of patients with COVID-19 at home: Development and preliminary application.
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Motta LP, Silva PPFD, Borguezan BM, Amaral JLMD, Milagres LG, Bóia MN, Ferraz MR, Mogami R, Nunes RA, and Melo PL
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- Adult, Asymptomatic Diseases nursing, Body Temperature, COVID-19 virology, Case-Control Studies, Female, Heart Rate, Humans, Male, Middle Aged, Mobile Applications, Oximetry, Peak Expiratory Flow Rate physiology, SARS-CoV-2 isolation & purification, COVID-19 pathology, Home Care Services, Monitoring, Physiologic methods
- Abstract
Background: COVID-19 is characterized by a rapid change in the patient's condition, with major changes occurring over a few days. We aimed to develop and evaluate an emergency system for monitoring patients with COVID-19, which may be useful in hospitals where more severe patients stay in their homes., Methodology/principal Findings: The system consists of the home-based patient unit, which is set up around the patient and the hospital unit, which enables the medical staff to telemonitor the patient's condition and help to send medical recommendations. The home unit allows the data transmission from the patient to the hospital, which is performed using a cell phone application. The hospital unit includes a virtual instrument developed in LabVIEW® environment that can provide a real-time monitoring of the oxygen saturation (SpO2), beats per minute (BPM), body temperature (BT), and peak expiratory flow (PEF). Abnormal events may be fast and automatically identified. After the design details are described, the system is validated by a 30-day home monitoring study in 12 controls and 12 patients with COVID-19 presenting asymptomatic to mild disease. Patients presented reduced SpO2 (p<0.0001) and increased BPM values (p<0.0001). Three patients (25%) presented PEF values between 50 and 80% of the predicted. Three of the 12 monitored patients presented events of desaturation (SpO2<92%). The experimental results were in close agreement with the involved pathophysiology, providing clear evidence that the proposed system can be a useful tool for the remote monitoring of patients with COVID-19., Conclusions: An emergency system for home monitoring of patients with COVID-19 was developed in the current study. The proposed system allowed us to quickly respond to early abnormalities in these patients. This system may contribute to conserving hospital resources for those most in need while simultaneously enabling early recognition of patients under acute deterioration, requiring urgent assessment., Competing Interests: The authors have declared that no competing interests exist.
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- 2021
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20. Segmentation and quantification of COVID-19 infections in CT using pulmonary vessels extraction and deep learning.
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Diniz JOB, Quintanilha DBP, Santos Neto AC, da Silva GLF, Ferreira JL, Netto SMB, Araújo JDL, Da Cruz LB, Silva TFB, da S Martins CM, Ferreira MM, Rego VG, Boaro JMC, Cipriano CLS, Silva AC, de Paiva AC, Junior GB, de Almeida JDS, Nunes RA, Mogami R, and Gattass M
- Abstract
At the end of 2019, the World Health Organization (WHO) reported pneumonia that started in Wuhan, China, as a global emergency problem. Researchers quickly advanced in research to try to understand this COVID-19 and sough solutions for the front-line professionals fighting this fatal disease. One of the tools to aid in the detection, diagnosis, treatment, and prevention of this disease is computed tomography (CT). CT images provide valuable information on how this new disease affects the lungs of patients. However, the analysis of these images is not trivial, especially when researchers are searching for quick solutions. Detecting and evaluating this disease can be tiring, time-consuming, and susceptible to errors. Thus, in this study, we aim to automatically segment infections caused by COVID19 and provide quantitative measures of these infections to specialists, thus serving as a support tool. We use a database of real clinical cases from Pedro Ernesto University Hospital of the State of Rio de Janeiro, Brazil. The method involves five steps: lung segmentation, segmentation and extraction of pulmonary vessels, infection segmentation, infection classification, and infection quantification. For the lung segmentation and infection segmentation tasks, we propose modifications to the traditional U-Net, including batch normalization, leaky ReLU, dropout, and residual block techniques, and name it as Residual U-Net. The proposed method yields an average Dice value of 77.1% and an average specificity of 99.76%. For quantification of infectious findings, the proposed method achieves results like that of specialists, and no measure presented a value of ρ < 0.05 in the paired t-test. The results demonstrate the potential of the proposed method as a tool to help medical professionals combat COVID-19. fight the COVID-19., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.)
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- 2021
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21. Solid Indeterminate Nodules with a Radiological Stability Suggesting Benignity: A Texture Analysis of Computed Tomography Images Based on the Kurtosis and Skewness of the Nodule Volume Density Histogram.
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Borguezan BM, Lopes AJ, Saito EH, Higa C, Silva AC, and Nunes RA
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- Diagnosis, Differential, Humans, Image Processing, Computer-Assisted, Lung Neoplasms diagnostic imaging, Models, Statistical, Retrospective Studies, Sensitivity and Specificity, Solitary Pulmonary Nodule diagnostic imaging, Tomography, X-Ray Computed
- Abstract
Background: The number of incidental findings of pulmonary nodules using imaging methods to diagnose other thoracic or extrathoracic conditions has increased, suggesting the need for in-depth radiological image analyses to identify nodule type and avoid unnecessary invasive procedures., Objectives: The present study evaluated solid indeterminate nodules with a radiological stability suggesting benignity (SINRSBs) through a texture analysis of computed tomography (CT) images., Methods: A total of 100 chest CT scans were evaluated, including 50 cases of SINRSBs and 50 cases of malignant nodules. SINRSB CT scans were performed using the same noncontrast enhanced CT protocol and equipment; the malignant nodule data were acquired from several databases. The kurtosis (KUR) and skewness (SKW) values of these tests were determined for the whole volume of each nodule, and the histograms were classified into two basic patterns: peaks or plateaus., Results: The mean (MEN) KUR values of the SINRSBs and malignant nodules were 3.37 ± 3.88 and 5.88 ± 5.11, respectively. The receiver operating characteristic (ROC) curve showed that the sensitivity and specificity for distinguishing SINRSBs from malignant nodules were 65% and 66% for KUR values >6, respectively, with an area under the curve (AUC) of 0.709 ( p < 0.0001). The MEN SKW values of the SINRSBs and malignant nodules were 1.73 ± 0.94 and 2.07 ± 1.01, respectively. The ROC curve showed that the sensitivity and specificity for distinguishing malignant nodules from SINRSBs were 65% and 66% for SKW values >3.1, respectively, with an AUC of 0.709 ( p < 0.0001). An analysis of the peak and plateau histograms revealed sensitivity, specificity, and accuracy values of 84%, 74%, and 79%, respectively., Conclusions: KUR, SKW, and histogram shape can help to noninvasively diagnose SINRSBs but should not be used alone or without considering clinical data., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2019 Bruno Max Borguezan et al.)
- Published
- 2019
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22. Modified Quality Threshold Clustering for Temporal Analysis and Classification of Lung Lesions.
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Netto SMB, Bandeira Diniz JO, Silva AC, de Paiva AC, Nunes RA, and Gattass M
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- Algorithms, Cluster Analysis, Databases, Factual, Humans, Lung diagnostic imaging, Time Factors, Tomography, X-Ray Computed, Image Interpretation, Computer-Assisted methods, Lung Neoplasms diagnostic imaging
- Abstract
Lung cancer is the type of cancer that most often kills after the initial diagnosis. To aid the specialist in its diagnosis, temporal evaluation is a potential tool for analyzing indeterminate lesions, which may be benign or malignant, during treatment. With this goal in mind, a methodology is herein proposed for the analysis, quantification, and visualization of changes in lung lesions. This methodology uses a modified version of the quality threshold clustering algorithm to associate each voxel of the lesion to a cluster, and changes in the lesion over time are defined in terms of voxel moves to another cluster. In addition, statistical features are extracted for classification of the lesion as benign or malignant. To develop the proposed methodology, two databases of pulmonary lesions were used, one for malignant lesions in treatment (public) and the other for indeterminate cases (private). We determined that the density change percentage varied from 6.22% to 36.93% of lesion volume in the public database of malignant lesions under treatment and from 19.98% to 38.81% in the private database of lung nodules. Additionally, other inter-cluster density change measures were obtained. These measures indicate the degree of change in the clusters and how each of them is abundant in relation to volume. From the statistical analysis of regions in which the density changes occurred, we were able to discriminate lung lesions with an accuracy of 98.41%, demonstrating that these changes can indicate the true nature of the lesion. In addition to visualizing the density changes occurring in lesions over time, we quantified these changes and analyzed the entire set through volumetry, which is the technique most commonly used to analyze changes in pulmonary lesions.
- Published
- 2019
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23. Strong SOD2 expression and HPV-16/18 positivity are independent events in cervical cancer.
- Author
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Rabelo-Santos SH, Termini L, Boccardo E, Derchain S, Longatto-Filho A, Andreoli MA, Costa MC, Lima Nunes RA, Lucci Ângelo-Andrade LA, Villa LL, and Zeferino LC
- Abstract
It is well known that persistent infection with high-risk HPV (hr-HPV), mostly HPV-16 and 18, is the main cause of cervical cancer development. Manganese superoxide dismutase (MnSOD or SOD2) are highly expressed in different neoplasia. The present study investigated SOD2 protein expression and the presence of hr-HPV types in 297 cervical samples including non-neoplastic tissue, cervical intraepithelial neoplasia grade 3 (CIN3), squamous cell carcinoma (SCC) and adenocarcinoma (ADC). Strong SOD2 expression was significantly higher in ADC (82%) than CIN3 (52%) or SCC (64%). There was no association between SOD2 expression and HPV 16 and/or 18 detection for every lesion analyzed. Binary Logist Regression revealed that strong SOD2 expression (OR: 27.50, 6.16-122.81) and HPV 16 and/or HPV 18 (OR: 12.67, 4.04-39.74) were independently more associated with CIN3 than non-neoplastic cervix. Strong SOD2 expression (OR: 3.30, 1.23-8.86) and HPV 16 and/or HPV 18 (OR: 3.51, 1.03-11.87) were independently more associated with ADC than SCC. Similar findings for SOD2 expression were observed by the Cochran Mantel-Haenszel test, controlling for HPV-16 and/or HPV 18. In conclusion, the expression of SOD2 was increased in CIN3 and SCC, and more increased in cervical ADC than in SCC. Strong SOD2 expression was statistically independent of the presence of HPV 16 and/or 18. These findings suggest that the mitochondrial antioxidant system and HPV infection could follow independent pathways in the carcinogenesis of cervical epithelium and in the differentiation to SCC or ADC of the cervix., Competing Interests: CONFLICTS OF INTEREST L.L Villa is a consultant/advisory board member for Merck. No potential conflicts of interest were disclosed by the other authors.
- Published
- 2018
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24. Computer-Aided Diagnosis of Lung Nodules in Computed Tomography by Using Phylogenetic Diversity, Genetic Algorithm, and SVM.
- Author
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de Carvalho Filho AO, Silva AC, Cardoso de Paiva A, Nunes RA, and Gattass M
- Subjects
- Genetic Variation genetics, Humans, Image Processing, Computer-Assisted methods, Lung diagnostic imaging, Pattern Recognition, Automated methods, Phylogeny, Reproducibility of Results, Sensitivity and Specificity, Diagnosis, Computer-Assisted methods, Lung Neoplasms diagnostic imaging, Lung Neoplasms genetics, Solitary Pulmonary Nodule diagnostic imaging, Support Vector Machine, Tomography, X-Ray Computed methods
- Abstract
Lung cancer is pointed as the major cause of death among patients with cancer throughout the world. This work is intended to develop a methodology for diagnosis of lung nodules using images from the Image Database Consortium and Image Database Resource Initiative (LIDC-IDRI). The proposed methodology uses image processing and pattern recognition techniques. In order to differentiate between the patterns of malignant and benign nodules, we used phylogenetic diversity by means of particular indexes, that are: intensive quadratic entropy, extensive quadratic entropy, average taxonomic distinctness, total taxonomic distinctness, and pure diversity indexes. After that, we applied the genetic algorithm for selection of the best model. In the tests' stage, we applied the proposed methodology to 1405 (394 malignant and 1011 benign) nodules. The proposed work presents promising results at the classification into malignant and benign, achieving accuracy of 92.52%, sensitivity of 93.1% and specificity of 92.26%. The results demonstrated a good rate of correct detections using texture features. Since a precocious detection allows a faster therapeutic intervention, thus a more favorable prognostic to the patient, we propose herein a methodology that contributes to the area in this aspect.
- Published
- 2017
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25. Computer-aided diagnosis system for lung nodules based on computed tomography using shape analysis, a genetic algorithm, and SVM.
- Author
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de Carvalho Filho AO, Silva AC, de Paiva AC, Nunes RA, and Gattass M
- Subjects
- Female, Humans, Male, Middle Aged, Models, Genetic, Radiographic Image Enhancement methods, Reproducibility of Results, Sensitivity and Specificity, Algorithms, Pattern Recognition, Automated methods, Radiographic Image Interpretation, Computer-Assisted methods, Solitary Pulmonary Nodule diagnostic imaging, Solitary Pulmonary Nodule pathology, Support Vector Machine, Tomography, X-Ray Computed methods
- Abstract
Lung cancer is the major cause of death among patients with cancer worldwide. This work is intended to develop a methodology for the diagnosis of lung nodules using images from the Image Database Consortium and Image Database Resource Initiative (LIDC-IDRI). The proposed methodology uses image processing and pattern recognition techniques. To differentiate the patterns of malignant and benign forms, we used a Minkowski functional, distance measures, representation of the vector of points measures, triangulation measures, and Feret diameters. Finally, we applied a genetic algorithm to select the best model and a support vector machine for classification. In the test stage, we applied the proposed methodology to 1405 (394 malignant and 1011 benign) nodules from the LIDC-IDRI database. The proposed methodology shows promising results for diagnosis of malignant and benign forms, achieving accuracy of 93.19 %, sensitivity of 92.75 %, and specificity of 93.33 %. The results are promising and demonstrate a good rate of correct detections using the shape features. Because early detection allows faster therapeutic intervention, and thus a more favorable prognosis for the patient, herein we propose a methodology that contributes to the area.
- Published
- 2017
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26. 3D shape analysis to reduce false positives for lung nodule detection systems.
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Filho AOC, Silva AC, de Paiva AC, Nunes RA, and Gattass M
- Subjects
- False Positive Reactions, Female, Humans, Machine Learning, Male, Middle Aged, Radiographic Image Enhancement methods, Reproducibility of Results, Sensitivity and Specificity, Algorithms, Imaging, Three-Dimensional methods, Pattern Recognition, Automated methods, Radiographic Image Interpretation, Computer-Assisted methods, Solitary Pulmonary Nodule diagnostic imaging, Solitary Pulmonary Nodule pathology, Tomography, X-Ray Computed methods
- Abstract
Using images from the Image Database Consortium and Image Database Resource Initiative (LIDC-IDRI), we developed a methodology for classifying lung nodules. The proposed methodology uses image processing and pattern recognition techniques. To classify volumes of interest into nodules and non-nodules, we used shape measurements only, analyzing their shape using shape diagrams, proportion measurements, and a cylinder-based analysis. In addition, we use the support vector machine classifier. To test the proposed methodology, it was applied to 833 images from the LIDC-IDRI database, and cross-validation with k-fold, where [Formula: see text], was used to validate the results. The proposed methodology for the classification of nodules and non-nodules achieved a mean accuracy of 95.33 %. Lung cancer causes more deaths than any other cancer worldwide. Therefore, precocious detection allows for faster therapeutic intervention and a more favorable prognosis for the patient. Our proposed methodology contributes to the classification of lung nodules and should help in the diagnosis of lung cancer.
- Published
- 2017
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27. Effect of strength training with blood flow restriction on muscle power and submaximal strength in eumenorrheic women.
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Gil AL, Neto GR, Sousa MS, Dias I, Vianna J, Nunes RA, and Novaes JS
- Subjects
- Adolescent, Adult, Blood Flow Velocity, Female, Humans, Lower Extremity, Regional Blood Flow, Time Factors, Treatment Outcome, Ultrasonography, Doppler, Upper Extremity, Young Adult, Menstrual Cycle, Muscle Strength, Muscle, Skeletal blood supply, Resistance Training methods, Tourniquets
- Abstract
Blood flow restriction (BFR) training stimulates muscle size and strength by increasing muscle activation, accumulation of metabolites and muscle swelling. This method has been used in different populations, but no studies have evaluated the effects of training on muscle power and submaximal strength (SS) in accounted for the menstrual cycle. The aim of this study was to analyse the effect of strength training (ST) with BFR on the muscle power and SS of upper and lower limbs in eumenorrheic women. Forty untrained women (18-40 years) were divided randomly and proportionally into four groups: (i) high-intensity ST at 80% of 1RM (HI), (ii) low-intensity ST at 20% of 1RM combined with partial blood flow restriction (LI + BFR), (iii) low-intensity ST at 20% of 1RM (LI) and d) control group (CG). Each training group performed eight training sessions. Tests with a medicine ball (MB), horizontal jump (HJ), vertical jump (VJ), biceps curls (BC) and knee extension (KE) were performed during the 1st day follicular phase (FP), 14th day (ovulatory phase) and 26-28th days (luteal phase) of the menstrual cycle. There was no significant difference among groups in terms of the MB, HJ, VJ or BC results at any time point (P>0·05). SS in the KE exercise was significantly greater in the LI + BFR group compared to the CG group (P = 0·014) during the LP. Therefore, ST with BFR does not appear to improve the power of upper and lower limbs and may be an alternative to improve the SS of lower limbs of eumenorrheic women., (© 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)
- Published
- 2017
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28. Voxel-based comparative analysis of lung lesions in CT for therapeutic purposes.
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Netto SM, Silva AC, Nunes RA, and Gattass M
- Subjects
- Databases, Factual, Fuzzy Logic, Humans, Lung Neoplasms pathology, Image Processing, Computer-Assisted methods, Lung diagnostic imaging, Lung pathology, Lung Neoplasms diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
Lung cancer remains as one of the most incident types of cancer throughout the world. Temporal evaluation has become a very useful tool when one wishes to analyze some malignancy-indicating behavior. The objective of the present work is to detect changes in the local densities of lung lesions over time (follow-up analysis). From the detected changes, local information as well as extent region of changes can complement the studies regarding the malignant or benign nature of the lesion. Based on this idea, we attempt to use techniques that allow the observation of changes in the lesion over time, based on remote sensing techniques which highlight changes occurring in the environment. The techniques used were the image differencing, image rationing, median filtering, image regression and the fuzzy XOR operator. Based on the global measurement of change percentage in the density, we found density variations which were considered significant in a range from 2.22 to 36.57 % of the volume of the lesion. The results achieved are promising since, besides the visual aspects of the changes in density of the lung lesion over time, we managed to quantify these changes and compare them by volumetric analysis, a more commonly used technique for analysis of changes in lung lesions.
- Published
- 2017
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29. The association between caffeine consumption and objective sleep variables is dependent on ADORA2A c.1083T>C genotypes.
- Author
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Nunes RA, Mazzotti DR, Hirotsu C, Andersen ML, Tufik S, and Bittencourt L
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Genetic Predisposition to Disease genetics, Genotype, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide, Young Adult, Caffeine pharmacology, Central Nervous System Stimulants pharmacology, Receptor, Adenosine A2A genetics, Sleep drug effects, Sleep genetics
- Abstract
Objective: To verify the association between c.1083T>C polymorphism in the adenosine receptor A
2A gene (ADORA2A) and objective sleep, as well as the correlation between caffeine consumption, sleep parameters, and electroencephalographic spectral power in a large, population-based sample from São Paulo, Brazil., Methods: This study was conducted in participants of the São Paulo Epidemiologic Sleep Study (EPISONO), a large, population-based survey consisting of a representative sample of the inhabitants of the city from São Paulo, Brazil, according to sex, age (20-80 years), and socioeconomic status in the year 2007. Questionnaires, polysomnography, spectral analysis of sleep electroencephalogram, and c.1083T>C polymorphism genotyping were performed in this study., Results: We found that caffeine consumption was positively correlated with sleep latency and α spectral power, as well as negatively correlated with percentage of N3 stage and δ spectral power in this stage. However, this association was identified only in T allele carriers and not in CC genotype., Conclusion: Our data support an important aspect of this polymorphism in ADORA2A gene, showing that the variant affects the association between caffeine consumption and objective sleep parameters in a large population-based cohort., Clinical Trial Information: Name: Epidemiology of sleep disturbances among adult population of the Sao Paulo City. URL: http://www.clinicaltrials.gov/ct2/show/NCT00596713?term = NCT00596713&rank = 1. Number: NCT00596713., (Copyright © 2016 Elsevier B.V. All rights reserved.)- Published
- 2017
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30. Increased Activation Amplitude Levels of Gluteus Medius in Women During Isometric and Dynamic Conditions Following a 4-week Protocol of Low-load Eccentric Exercises.
- Author
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Barbosa AC, Carvalho RA, Bonifácio DN, Martins FL, and Barbosa MC
- Subjects
- Adult, Buttocks, Electromyography methods, Female, Follow-Up Studies, Hip Joint physiopathology, Humans, Muscle, Skeletal physiopathology, Risk Assessment, Sampling Studies, Treatment Outcome, Young Adult, Exercise Therapy methods, Isometric Contraction physiology, Joint Instability rehabilitation, Muscle Strength physiology, Muscle Weakness diagnosis, Muscle Weakness rehabilitation
- Abstract
Background: The dysfunction of gluteus medius (GMed) has been implicated in other musculoskeletal disorders including low back pain and lower limb injuries. The purpose of this study was to use a protocol involving low-load eccentric exercises to observe the effects on the three subdivisions of GMed activation through surface electromyography (sEMG) and digital dynamometry., Methods: Eleven female subjects having femoral instability participated in a 4-week protocol (three sessions per week/non-consecutive days). At each session, two low-load eccentric exercises (12% of maximal isometric voluntary contraction [MVIC]) in abduction, extension and external rotation were applied to the hip joint. The sEMG of the GMed subdivisions (anterior, mid and posterior) during a squat and MVIC were assessed. The digital dynamometry was also assessed during MVIC. Parametric paired t-test was used to compare the results before and after treatment with α = 0.05., Results: The results showed an increased sEMG activity of GMed (middle and posterior portions) during isometric voluntary contraction and squat after the protocol. No difference was noted to the anterior subdivision of GMed. Another finding was the significant difference to the dynamometry results, showing improvements to generate strength to the GMed as a whole muscle in abduction., Conclusion: The 4-week exercise protocol was effective to increase the activation of the GMed middle and posterior subdivisions, improving also the capacity to generate strength as a whole muscle during the proposed tasks. Copyright © 2015 John Wiley & Sons, Ltd., (Copyright © 2015 John Wiley & Sons, Ltd.)
- Published
- 2016
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31. Genomic profiling of breast cancer in African-American women using MammaPrint.
- Author
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Nunes RA, Wray L, Mete M, Herbolsheimer P, Smith KL, Bijelic L, Boisvert ME, and Swain SM
- Subjects
- Adult, Aged, Aged, 80 and over, Breast Neoplasms pathology, Female, Genetic Heterogeneity, Humans, Middle Aged, Neoplasm Staging, Prognosis, United States ethnology, Young Adult, Black or African American genetics, Breast Neoplasms genetics, Gene Expression Profiling instrumentation, Receptor, ErbB-2 genetics, Receptors, Estrogen genetics, Receptors, Progesterone genetics
- Abstract
Breast cancer in African-American females (AAF) has a less favorable outcome than that in Caucasians. More information is needed regarding its biology. We evaluated gene expression in tumors from AAF presenting with early stage or locally advanced breast cancer using MammaPrint(®), BluePrint (®) (molecular subtype) and TargetPrint (®) [estrogen receptor (ER), progesterone receptor, and Human Epidermal Growth Factor Receptor 2 (HER2) mRNA levels]. Genomic information was correlated with clinical and pathologic characteristics and Oncotype DX(®) Recurrence Score(®) (RS). One hundred Patients were enrolled, 1 not evaluable by BluePrint. The median age was 60 years (range 22-98), and eighty-four (84 %) patients had stage I or II disease. High Risk MammaPrint was present in 66 % of patients and in 52 % of patients with stage I disease. High Risk MammaPrint was associated with young age (p = 0.02), high grade (p < 0.0001), HER2 expression (p = 0.016), and triple-negative phenotype (p < 0.001). Sixty-four tumors (65 %) were Luminal type (47 % of these were classified as High Risk), 26 (26 %) were Basal type, and 9 (9 %) HER2 type. Twenty-two cancers were triple negative (TN) by IHC and 19 (90 %) Basal type. Among the 15 tumors HER2 positive by IHC/FISH, 8 (53 %) were HER2 type by BluePrint. Eleven tumors with ER expression of 1-9 % were ER negative by TargetPrint and none of these was Luminal type. None of the seven tumors HER2 positive by IHC/FISH but negative by TargetPrint was HER type. RS results were available in 29 patients: two had High Risk both by RS and MammaPrint; eight had intermediate RS, with four High Risk by MammaPrint; 19 had a low RS, with eight High Risk by MammaPrint. AAF with stage I to III breast cancer often present with High Risk disease. Molecular heterogeneity is present within TN, HER2-positive, and ER-positive breast cancer. RS and MammaPrint offer different prognostic information.
- Published
- 2016
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32. Asthma prevalence in Portuguese preschool children: The latest scientific evidence.
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Branco PT, Nunes RA, Alvim-Ferraz MC, Martins FG, Ferraz C, Vaz LG, and Sousa SI
- Subjects
- Child, Preschool, Female, Humans, Male, Portugal epidemiology, Prevalence, Asthma epidemiology
- Published
- 2016
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33. Brain stimulation used as biofeedback in neuronal activation of the temporal lobe area in autistic children.
- Author
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Silva VF, Calomeni MR, Nunes RA, Pimentel CE, Martins GP, Oliveira Pda C, Silva PB, and Silva AP
- Subjects
- Brain Mapping, Case-Control Studies, Child, Electroencephalography, Facial Expression, Humans, Autistic Disorder physiopathology, Biofeedback, Psychology physiology, Emotions physiology, Mirror Neurons physiology, Photic Stimulation methods, Temporal Lobe physiopathology
- Abstract
This study focused upon the functional capacity of mirror neurons in autistic children. 30 individuals, 10 carriers of the autistic syndrome (GCA), 10 with intellectual impairments (GDI), and 10 non-autistics (GCN) had registered eletroencephalogram from the brain area theoretically related to mirror neurons. Data collection procedure occurred prior to brain stimulation and after the stimulation session. During the second session, participants had to alternately process figures evoking neutral, happy, and/or sorrowful feelings. Results proved that, for all groups, the stimulation process in fact produced additional activation in the neural area under study. The level of activation was related to the format of emotional stimuli and the likelihood of boosting such stimuli. Since the increase of activation occurred in a model similar to the one observed for the control group, we may suggest that the difficulty people with autism have at expressing emotions is not due to nonexistence of mirror neurons.
- Published
- 2016
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34. Asthma prevalence and risk factors in early childhood at Northern Portugal.
- Author
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Branco PT, Nunes RA, Alvim-Ferraz MC, Martins FG, Ferraz C, Vaz LG, and Sousa SI
- Subjects
- Child, Child, Preschool, Cross-Sectional Studies, Humans, Infant, Portugal epidemiology, Prevalence, Risk Factors, Asthma epidemiology
- Abstract
Asthma is the commonest and most important chronic non-infectious disease in childhood and it has become more prevalent in recent years. There is a shortage of studies in relation to early childhood and so, as part of the INAIRCHILD project, this cross-sectional study aimed to assess the prevalence of asthma and its associated risk factors, namely demographic, environmental, psychosocial and clinical factors for infants and preschoolers living in Northern Portugal. Data concerning asthma prevalence were collected through questionnaires based on those from the International Study of Asthma and Allergies in Childhood (ISAAC-derived), the questionnaires were distributed to 1042 children attending the 17 nurseries involved in the INAIRCHILD project (10 in urban and suburban context, and 7 in rural context). The response rate was 48%. Prevalence of asthma based on symptomatology and odds ratio was calculated. Around 52% of the studied children presented at least one of the respiratory symptoms investigated (wheeze, dyspnea and cough) in the absence of upper respiratory infections. The prevalence of asthma was 10.7%, comparable to the figures for Portuguese schoolchildren (6-7 years old) reported by the national Directorate-General of Health, thus showing that an early diagnosis might be possible and helpful for the mitigation of childhood asthma. Environmental context (urban, suburban or rural), gender and family asthma history showed clear associations with asthma prevalence, namely non-rural location, male gender, and having an asthmatic parent were found to be risk factors., (Copyright © 2015 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2016
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35. Case 2/2016 - 76-Year-Old Male with Hypertensive Heart Disease, Renal Tumor and Shock.
- Author
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Benetti MA, Nunes RA, and Benvenuti LA
- Subjects
- Aged, Electrocardiography, Fatal Outcome, Humans, Hypertension complications, Male, Myocardium pathology, Shock, Septic etiology, Carcinoma, Renal Cell pathology, Kidney Neoplasms pathology
- Published
- 2016
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36. Children's Exposure to Radon in Nursery and Primary Schools.
- Author
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Branco PT, Nunes RA, Alvim-Ferraz MC, Martins FG, and Sousa SI
- Subjects
- Child, Environmental Exposure analysis, Humans, Infant, Portugal, Air Pollutants, Radioactive analysis, Air Pollution, Indoor analysis, Nurseries, Infant statistics & numerical data, Radon analysis, Schools statistics & numerical data
- Abstract
The literature proves an evident association between indoor radon exposure and lung cancer, even at low doses. This study brings a new approach to the study of children's exposure to radon by aiming to evaluate exposure to indoor radon concentrations in nursery and primary schools from two districts in Portugal (Porto and Bragança), considering different influencing factors (occupation patterns, classroom floor level, year of the buildings' construction and soil composition of the building site), as well as the comparison with IAQ standard values for health protection. Fifteen nursery and primary schools in the Porto and Bragança districts were considered: five nursery schools for infants and twelve for pre-schoolers (seven different buildings), as well as eight primary schools. Radon measurements were performed continuously. The measured concentrations depended on the building occupation, classroom floor level and year of the buildings' construction. Although they were in general within the Portuguese legislation for IAQ, exceedances to international standards were found. These results point out the need of assessing indoor radon concentrations not only in primary schools, but also in nursery schools, never performed in Portugal before this study. It is important to extend the study to other microenvironments like homes, and in time to estimate the annual effective dose and to assess lifetime health risks.
- Published
- 2016
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37. Cardiac function in BRCA1/2 mutation carriers with history of breast cancer treated with anthracyclines.
- Author
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Barac A, Lynce F, Smith KL, Mete M, Shara NM, Asch FM, Nardacci MP, Wray L, Herbolsheimer P, Nunes RA, Swain SM, Warren R, Peshkin BN, and Isaacs C
- Subjects
- Adult, Breast Neoplasms genetics, Doxorubicin therapeutic use, Female, Humans, Middle Aged, Mutation genetics, Prospective Studies, Stroke Volume drug effects, Anthracyclines adverse effects, Anthracyclines therapeutic use, BRCA1 Protein genetics, BRCA2 Protein genetics, Breast Neoplasms drug therapy, Breast Neoplasms pathology, Ventricular Function, Left drug effects
- Abstract
Animal data suggest that defects in BRCA1/2 genes significantly increase the risk of heart failure and mortality in mice exposed to doxorubicine. Women with BRCA1/2 mutations who develop breast cancer (BC) may receive anthracyclines but their risk of cardiac dysfunction has not been investigated. Our study tested the hypothesis that women with history of BRCA1/2 mutation-associated BC treated with anthracyclines have impaired parameters of cardiac function compared to similarly treated women with history of sporadic BC. Women with history of BC and anthracycline treatment underwent an echocardiographic exam for assessment of primary outcomes, left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). The sample size of 81 provided 79 % power with two-sided two-sample t test and alpha of 0.05 to detect a clinically meaningful difference in cardiac function of absolute 5 % points difference for LVEF and 2 % points difference for GLS. Of 81 normotensive participants, 39 were BRCA1/2 mutation carriers and 42 in the sporadic group. Mean age was 50 ± 9 years in both groups (P = 0.99) but BRCA1/2 mutation carriers had longer anthracycline treatment-to-enrollment time (7.5 ± 5.3 vs. 4.2 ± 3.3 years, P = 0.001). There were no significant differences in LVEF (P = 0.227) or GLS (P = 0.53) between the groups. LVEF was normal in 91 % of women and subclinical cardiac dysfunction defined as absolute GLS value <18.9 % was seen in 4 (10 %) BRCA1/2 mutation carriers and 7 (17 %) sporadic participants. In this first prospective examination of cardiac function in BRCA1/2 mutation carriers, we found no significant differences in sensitive echocardiographic parameters of cardiac function between BRCA1/2 mutation carriers and women with history of sporadic BC who received anthracycline treatment. In contrast to laboratory animal data, our findings indicate lack of elevated cardiac risk with the use of standard-doses of adjuvant anthracyclines in treatment of BRCA1/2 mutation carriers with early stage BC.
- Published
- 2016
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38. Children's exposure to indoor air in urban nurseries--Part II: Gaseous pollutants' assessment.
- Author
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Branco PT, Nunes RA, Alvim-Ferraz MC, Martins FG, and Sousa SI
- Subjects
- Child, Preschool, Humans, Air Pollution, Indoor, Environmental Exposure, Schools, Nursery, Urban Population
- Abstract
This study, Part II of the larger study "Children's exposure to indoor air in urban nurseries", aimed to: (i) evaluate nursery schools' indoor concentrations of several air pollutants in class and lunch rooms; and (ii) analyse them according to guidelines and references. Indoor continuous measurements were performed, and outdoor concentrations were obtained to determine indoor/outdoor ratios. The influence of outdoor air seemed to be determinant on carbon monoxide (CO), nitrogen dioxide (NO2) and ozone (O3) indoor concentrations. The peak concentrations of formaldehyde and volatile organic compounds (VOC) registered (highest concentrations of 204 and 2320 µg m(-3) respectively), indicated the presence of specific indoor sources of these pollutants, namely materials emitting formaldehyde and products emitting VOC associated to cleaning and children's specific activities (like paints and glues). For formaldehyde, baseline constant concentrations along the day were also found in some of the studied rooms, which enhances the importance of detailing the study of children's short and long-term exposure to this indoor air pollutant. While CO, NO2 and O3 never exceeded the national and international reference values for IAQ and health protection, exceedances were found for formaldehyde and VOC. For this reason, a health risk assessment approach could be interesting for future research to assess children's health risks of exposure to formaldehyde and to VOC concentrations in nursery schools. Changing cleaning schedules and materials emitting formaldehyde, and more efficient ventilation while using products emitting VOC, with the correct amount and distribution of fresh air, would decrease children's exposure., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
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39. The assessment of telemedicine to support outpatient palliative care in advanced cancer.
- Author
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Hennemann-Krause L, Lopes AJ, Araújo JA, Petersen EM, and Nunes RA
- Subjects
- Aged, Aged, 80 and over, Ambulatory Care methods, Fatigue diagnosis, Female, Humans, Longitudinal Studies, Male, Middle Aged, Pain diagnosis, Qualitative Research, Ambulatory Care standards, Neoplasms therapy, Palliative Care methods, Telemedicine standards
- Abstract
Objective: We aimed to examine telemedicine as a form of home and additional support for traditional outpatient care as a way to remotely monitor and manage the symptoms of patients with advanced cancer., Method: In total, 12 patients were monitored through monthly consultations with a multidisciplinary healthcare team and weekly web conferences. To evaluate and treat pain and other symptoms, the Edmonton Symptom Assessment System (ESAS) was applied during all remote or in-person interviews., Results: During monitoring, the team contacted the patients on 305 occasions: there were 89 consultations at the hospital, 19 in-person assistances to the family (without the patient), 77 web conferences, 38 telephone calls, 80 emails, and 2 home visits. The mean monitoring time until death was 195 ± 175.1 days. Eight patients who completed the ESAS in all interviews had lower mean distress symptom scores according to web conferences than in person., Significance of Results: Telemedicine allowed greater access to the healthcare system, reduced the need to employ emergency services, improved assessment/control of symptoms, and provided greater orientation and confidence in the care given by family members through early and proactive interventions. Web conferencing proved to be a good adjuvant to home monitoring of symptoms, complementing in-person assistance.
- Published
- 2015
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40. Particulate matter in rural and urban nursery schools in Portugal.
- Author
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Nunes RA, Branco PT, Alvim-Ferraz MC, Martins FG, and Sousa SI
- Subjects
- Child, Child, Preschool, Environmental Monitoring legislation & jurisprudence, Government Regulation, Humans, Male, Particle Size, Portugal, Air Pollution, Indoor analysis, Environmental Monitoring methods, Particulate Matter analysis, Rural Population, Schools, Nursery, Urban Population
- Abstract
Studies have been showing strong associations between exposures to indoor particulate matter (PM) and health effects on children. Urban and rural nursery schools have different known environmental and social differences which make their study relevant. Thus, this study aimed to evaluate indoor PM concentrations on different microenvironments of three rural nursery schools and one urban nursery school, being the only study comparing urban and rural nursery schools considering the PM1, PM2.5 and PM10 fractions (measured continuously and in terms of mass). Outdoor PM2.5 and PM10 were also obtained and I/O ratios have been determined. Indoor PM mean concentrations were higher in the urban nursery than in rural ones, which might have been related to traffic emissions. However, I/O ratios allowed concluding that the recorded concentrations depended more significantly of indoor sources. WHO guidelines and Portuguese legislation exceedances for PM2.5 and PM10 were observed mainly in the urban nursery school., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2015
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41. Lymphocyte count and prognosis in patients with heart failure.
- Author
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Marçula M, de Souza Buto MF, Madaloso BA, Nunes RA, Cuoco MA, de Paula RS, Yamada AT, Sandoval MC, Botter DA, and Mansur AJ
- Subjects
- Aged, Biomarkers blood, Cohort Studies, Confidence Intervals, Databases, Factual, Female, Heart Failure therapy, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Prognosis, Proportional Hazards Models, Retrospective Studies, Severity of Illness Index, Survival Analysis, Heart Failure blood, Heart Failure mortality, Lymphocyte Count methods
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- 2015
- Full Text
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42. Radon Levels in Nurseries and Primary Schools in Bragança District-Preliminary Assessment.
- Author
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Sousa SI, Branco PT, Nunes RA, Alvim-Ferraz MC, and Martins FG
- Subjects
- Child, Preschool, Circadian Rhythm, Humans, Infant, Infant, Newborn, Nurseries, Infant, Portugal, Radiation Monitoring, Schools, Air Pollutants, Radioactive analysis, Air Pollution, Indoor analysis, Environmental Exposure, Radon analysis
- Abstract
Lung cancer has been associated with radon concentration even at low levels such as those found in dwellings. This study aimed to (i) determine radon diurnal variations in three nurseries and one primary school in the Bragança district (north of Portugal) and (ii) compare radon concentrations with legislated standards and assess the legislated procedures. Radon was measured in three nurseries and a primary school in a rural area with nongranite soil. Measurements were performed continuously to examine differences between occupation and nonoccupation periods. Indoor temperature and relative humidity were also measured continuously. A great variability was found in radon concentrations between the microenvironments examined. Radon concentrations surpassed by severalfold the recommended guidelines and thresholds, and excessive levels of health concern were sporadically found (361.5-753.5 Bq m(-3)). Thus, it is of importance to perform a national campaign on radon measurements and to reduce exposure.
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- 2015
- Full Text
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43. Gender-related associations of genetic polymorphisms of α-adrenergic receptors, endothelial nitric oxide synthase and bradykinin B2 receptor with treadmill exercise test responses.
- Author
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Nunes RA, Barroso LP, Pereira Ada C, Krieger JE, and Mansur AJ
- Abstract
Background: Treadmill exercise test responses have been associated with cardiovascular prognosis in individuals without overt heart disease. Neurohumoral and nitric oxide responses may influence cardiovascular performance during exercise testing. Therefore, we evaluated associations between functional genetic polymorphisms of α-adrenergic receptors, endothelial nitric oxide synthase, bradykinin receptor B2 and treadmill exercise test responses in men and women without overt heart disease., Methods: We enrolled 766 (417 women; 349 men) individuals without established heart disease from a check-up programme at the Heart Institute, University of São Paulo Medical School. Exercise capacity, chronotropic reserve, maximum heart-rate achieved, heart-rate recovery, exercise systolic blood pressure (SBP), exercise diastolic blood pressure (DBP) and SBP recovery were assessed during exercise testing. Genotypes for the α-adrenergic receptors ADRA1A Arg347Cys (rs1048101), ADRA2A 1780 C>T (rs553668), ADRA2B Del 301-303 (rs28365031), endothelial nitric synthase (eNOS) 786 T>C (rs2070744), eNOS Glu298Asp (rs1799983) and BK2R (rs5810761) polymorphisms were assessed by PCR and high-resolution melting analysis., Results: Maximum SBP was associated with ADRA1A rs1048101 (p=0.008) and BK2R rs5810761 (p=0.008) polymorphisms in men and ADRA2A rs553668 (p=0.008) and ADRA2B rs28365031 (p=0.022) in women. Maximum DBP pressure was associated with ADRA2A rs553668 (p=0.002) and eNOS rs1799983 (p=0.015) polymorphisms in women. Exercise capacity was associated with eNOS rs2070744 polymorphisms in women (p=0.01) and with eNOS rs1799983 in men and women (p=0.038 and p=0.024)., Conclusions: The findings suggest that genetic variants of α-adrenergic receptors and bradykinin B2 receptor may be involved with blood pressure responses during exercise tests. Genetic variants of endothelial nitric oxide synthase may be involved with exercise capacity and blood pressure responses during exercise tests. These responses may be gender-related.
- Published
- 2014
- Full Text
- View/download PDF
44. Spontaneous closure of post-intervention left anterior descending coronary pseudoaneurysm.
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Nunes RA, Cade JR, Silva RC, Brito Júnior FS, and Freitas HF
- Subjects
- Coronary Vessels injuries, Humans, Male, Middle Aged, Remission, Spontaneous, Aneurysm, False etiology, Coronary Aneurysm etiology
- Abstract
Coronary pseudoaneurysms are an unusual finding during coronary angiography and there are very little data on their prognosis in the literature. We report the case of a 62-year-old man admitted with an anterior myocardial infarction who developed a pseudoaneurysm in the mid left anterior descending artery some days after a type I coronary perforation during coronary angioplasty. Spontaneous closure of the pseudoaneurysm was observed during hospital follow-up. Spontaneous closure of coronary pseudoaneurysms may be more common in clinical practice than previously thought, but few cases have been reported. As the natural history of post-intervention coronary pseudoaneurysms has been little investigated, reports of their occurrence may help to clarify their evolution., (Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
45. Lung cancer with chest wall invasion: retrospective analysis comparing en-bloc resection and 'resection in bird cage'.
- Author
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Santos HT, Lopes AJ, Higa C, Nunes RA, and Saito EH
- Subjects
- Adult, Aged, Female, Humans, Lung Neoplasms pathology, Male, Middle Aged, Retrospective Studies, Thoracic Wall pathology, Lung Neoplasms surgery, Pulmonary Surgical Procedures methods, Thoracic Wall surgery
- Abstract
Background: Invasion of the chest wall per se is not a contraindication for tumor resection in non-small cell lung cancer (NSCLC), provided there is no mediastinal lymph node or vital structure involvement. Although widely known to Brazilian surgeons, the 'resection in bird cage' technique has never been widely studied in terms of patient survival. Thus, the objective of this study was to evaluate the postoperative consequences and overall survival of extra-musculoperiosteal resection compared with en-bloc resection in NSCLC patients with invasion of the endothoracic fascia., Methods: Between January 1990 and December 2009, 33 NSCLC patients with invasion of the thoracic wall who underwent pulmonary resection were retrospectively analyzed. Of the 33 patients evaluated, 20 patients underwent en-bloc resection and 13 underwent 'resection in bird cage.' For each patient, a retrospective case note review was made., Results: The median age at surgery, gender, indication, rate of comorbidities, tumor size and the degree of uptake in the costal margin were similar for both groups. The rate of postoperative complications and the duration of hospitalization did not differ between the groups. Regarding the outcome variables, the disease-free interval, rate of local recurrence, metastasis-free time after surgery, overall mortality rate, mortality rate related to metastatic disease, duration following surgery in which deaths occurred, and overall survival were also similar between groups. The cumulative survival curves between the 'resection in bird cage' and en-bloc resection and between stages Ia + Ib and IIb + IIIa + IV were not significantly different (p = 0.68 and p = 0.64, respectively). The cumulative metastasis-free survival curves were not significantly different between the two types of surgery (p = 0.38)., Conclusions: In NSCLC patients with invasion of the endothoracic fascia, 'resection in bird cage' is a less aggressive procedure that yields similar results in terms of morbidity and mortality compared with en-bloc resection. Thus, 'resection in bird cage' meets the oncologic principles of resection and does not adversely affect the patients in terms of cure.
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- 2014
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- View/download PDF
46. Left ventricular hypertrophy in asymptomatic individuals without overt heart disease.
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Correia GF, Gonçalves TC, Madaloso BA, Nunes RA, Uemura RT, Justo RC, Tanaka NI, and Mansur AJ
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- Adult, Electrocardiography, Female, Humans, Male, Middle Aged, Asymptomatic Diseases, Echocardiography, Hypertrophy, Left Ventricular diagnostic imaging
- Published
- 2014
- Full Text
- View/download PDF
47. Automatic detection of solitary lung nodules using quality threshold clustering, genetic algorithm and diversity index.
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de Carvalho Filho AO, de Sampaio WB, Silva AC, de Paiva AC, Nunes RA, and Gattass M
- Subjects
- Algorithms, Artificial Intelligence, Cluster Analysis, Humans, Image Processing, Computer-Assisted, Pattern Recognition, Automated, Sensitivity and Specificity, Lung diagnostic imaging, Lung Neoplasms diagnosis, Radiographic Image Interpretation, Computer-Assisted methods, Solitary Pulmonary Nodule diagnosis, Tomography, X-Ray Computed methods
- Abstract
Objective: The present work has the objective of developing an automatic methodology for the detection of lung nodules., Methodology: The proposed methodology is based on image processing and pattern recognition techniques and can be summarized in three stages. In the first stage, the extraction and reconstruction of the pulmonary parenchyma is carried out and then enhanced to highlight its structures. In the second stage, nodule candidates are segmented. Finally, in the third stage, shape and texture features are extracted, selected and then classified using a support vector machine., Results: In the testing stage, with 140 new exams from the Lung Image Database Consortium image collection, 80% of which are for training and 20% are for testing, good results were achieved, as indicated by a sensitivity of 85.91%, a specificity of 97.70% and an accuracy of 97.55%, with a false positive rate of 1.82 per exam and 0.008 per slice and an area under the free response operating characteristic of 0.8062., Conclusion: Lung cancer presents the highest mortality rate in addition to one of the smallest survival rates after diagnosis. An early diagnosis considerably increases the survival chance of patients. The methodology proposed herein contributes to this diagnosis by being a useful tool for specialists who are attempting to detect nodules., (Copyright © 2013 Elsevier B.V. All rights reserved.)
- Published
- 2014
- Full Text
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48. Use of insulin-like growth factor in the healing of open wounds in diabetic and non-diabetic rats.
- Author
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Achar RA, Silva TC, Achar E, Martines RB, and Machado JL
- Subjects
- Actins analysis, Administration, Topical, Alloxan, Animals, Cell Proliferation, Diabetes Mellitus, Experimental chemically induced, Disease Models, Animal, Immunohistochemistry, Male, Rats, Wistar, Reproducibility of Results, Skin Cream therapeutic use, Time Factors, Treatment Outcome, Wound Healing physiology, Diabetes Mellitus, Experimental physiopathology, Insulin-Like Growth Factor I therapeutic use, Myofibroblasts drug effects, Wound Healing drug effects
- Abstract
Purpose: To analyze the effects of application of 1% and 3% insulin-like growth factor I (IGF-1) cream on the process of wound healing in induced skin lesions in diabetic and non-diabetic rats and evaluate its effect on expression of myofibroblasts., Methods: Ninety-six Wistar adult male rats were divided into six groups, with 16 rats in each group, as follows: group 1: non-diabetic, untreated; group 2: non-diabetic, treated with 1% IGF-1 cream; group 3: non-diabetic, treated with 3% IGF-1 cream; group 4: diabetic, untreated; group 5: diabetic, treated with 1% IGF-1 cream; and group 6: diabetic, treated with 3% IGF-1 cream. In groups 4, 5, and 6, diabetes was induced by intravenous injection of alloxan. After diabetes had been induced, animals were mantained for 3 months. The experimental procedure consisted of the creation of a circular incision of 0.9 mm in diameter using a metal punch. Following this, wounds were treated daily according to the assigned treatment regimen. Groups 2 and 5 were treated with 1% IGF-1 cream, groups 3 and 6 with 3% IGF-1 cream, and groups 1 and 4 and the untreated groups with 0.9% saline solution. From each group, samples from 4 rats were taken at three, seven, 14, and 21 days after the injury. Samples were fixed in 10% formalin to prepare slides for histological analysis. Slides stained with hematoxylin-eosin (H&E) and Masson were observed vascular proliferation, mononuclear cells, polymorphonuclear cells, fibroblast proliferation, re-epithelialization, and collagen fibers. This study analyzed the expression of α-smooth muscle actin using specific antibodies to correlate the temporal expression of α-smooth muscle-specific actin (α-SM actin), a molecular marker for myofibroblast transformation., Results: Macroscopic observation of wounds showed a more rapid re-epithelialization of wounds treated with IGF. Regarding acute inflammatory reactions, the results of the analysis of vascular proliferation and polymorphonuclear and mononuclear cells showed no statistically significant differences in any of the periods studied (according to the results of a Mann-Whitney test). The initial immunohistochemical analysis of tissue samples conducted to compare the expression of α-smooth muscle actin between groups showed a relevant response in the expression of myofibroblasts. Data were analyzed using ANOVA and were found to be statistically significant., Conclusion: The topical application of 1% and 3% IGF-1 creams increases the expression of myofibroblasts in the process of wound healing in rats.
- Published
- 2014
- Full Text
- View/download PDF
49. Exercise-induced muscle vasodilatation and treadmill exercise test responses in individuals without overt heart disease.
- Author
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Nunes RA, Giampaoli V, de Freitas HF, da Costa Pereira A, Araújo F, Correia GF, Rondon MU, Negrão CE, and Mansur AJ
- Subjects
- Adolescent, Adult, Aged, Blood Flow Velocity, Exercise Test, Female, Forearm blood supply, Hand Strength physiology, Humans, Male, Middle Aged, Young Adult, Exercise physiology, Heart Diseases physiopathology, Muscle, Skeletal blood supply, Vasodilation physiology
- Abstract
Background: The beneficial effects of exercise on cardiovascular health may be related to the improvement in several physiologic pathways, including peripheral vascular function. The aim of this study was to evaluate the relationship between cardiovascular responses during the treadmill exercise test and exercise-induced muscle vasodilatation in individuals without overt heart disease., Methods: The study included 796 asymptomatic subjects (431 females and 365 males) without overt heart disease. We evaluated the heart rate (chronotropic reserve and heart rate recovery), blood pressure (maximum systolic and diastolic blood pressure as well as systolic blood pressure recovery) and exercise capacity during symptom-limited treadmill exercise testing. Exercise-induced muscle vasodilatation was studied with venous occlusion plethysmography and estimated by forearm blood flow and vascular conductance responses during a 3-min handgrip maneuver., Results: Forearm blood flow increase during the handgrip exercise was positively associated with heart rate recovery during treadmill exercise testing (p < 0.001). Forearm vascular conductance increase during the handgrip exercise was inversely associated with exercise diastolic blood pressure during exercise treadmill testing (p = 0.038). No significant association was found between exercise capacity and exercise-induced muscle vasodilation., Conclusion: In a sample of individuals without overt heart disease, exercise-induced muscle vasodilatation was associated with heart rate and blood pressure responses during treadmill exercise testing, but was not associated with exercise capacity. These findings suggest that favorable hemodynamic and chronotropic responses are associated with better vasodilator capacity, but exercise capacity does not predict muscle vasodilatation.
- Published
- 2014
- Full Text
- View/download PDF
50. High-sensitivity C-reactive protein levels and treadmill exercise test responses in men and women without overt heart disease.
- Author
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Nunes RA, Araújo F, Correia GF, da Silva GT, and Mansur AJ
- Abstract
Background: C-reactive protein (CRP) is a marker of systemic inflammatory activity and may be modulated by physical fitness. Treadmill exercise testing is used to evaluate cardiovascular health through different variables including exercise capacity, heart rate and blood pressure responses. It was hypothesized that CRP levels are associated with these variables in men and women without overt heart disease., Methods: A total of 584 asymptomatic subjects (317 [54.3%] women and 267 [45.7%] men) were enrolled in the present study and underwent clinical evaluation. CRP levels in men and women were examined relative to clinical characteristics and to variables of treadmill exercise testing: peak heart rate, exercise systolic blood pressure, exercise time, chronotropic reserve and heart rate recovery at the first and second minutes after exercise. Multivariate analysis was performed using a log-linear regression model., Results: In women, exercise time on the treadmill exercise test (P=0.009) and high-density lipoprotein cholesterol levels (P=0.002) were inversely associated with CRP levels. Body mass index (P<0.001) and total cholesterol levels (P=0.005) were positively associated with CRP levels. In men, exercise time on the treadmill exercise test was inversely associated with CRP levels (P=0.015). Body mass index (P=0.001) and leukocyte count (P=0.002) were positively associated with CRP levels. CRP levels were not associated with peak heart rate, chronotropic reserve, heart rate recovery at the first and second minutes, or exercise systolic blood pressure., Conclusions: These findings contribute to the evidence that CRP is lower in individuals with better exercise capacity and demonstrate that this relationship is also apparent in individuals without overt heart disease undergoing cardiovascular evaluation through the treadmill exercise test. Lowering inflammatory markers may be an additional reason to stimulate sedentary individuals with low exercise capacity in the treadmill exercise test to improve physical conditioning through regular exercise.
- Published
- 2013
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