Ineficacy of portable device accutrend plus in equine internal medicine

Comparou-se nesse estudo a determinação de quatro constituintes sanguíneos (glicose, lactato, triglicérides e colesterol), entre um aparelho portátil e métodos laboratoriais convencionais. Foram analisados o sangue de 20 equinos (11 machos e 9 fêmeas), de diversas raças com idades variando entre 8 +-5 anos e peso corpóreo de 327,60 +-64,02 Kg. Após exame clínico completo de cada animal realizou-se punção da veia jugular externa para coleta de amostra sanguínea, de maneira que a mesma amostra, foi utilizada para determinação no aparelho portátil e no laboratório. Na comparação entre as metodologias, em relação a glicose, não foi notada diferença entre as médias (teste T de Student), a correlação de Pearson revelou-se fraca e não houve concordância segundo o método de Bland-Altman. Para o lactato também não se observou concordância entre os dois métodos. Quanto aos triglicérides e colesterol foi possível apenas a análise descritiva dos resultados, devido as concentrações dos padrões fisiológicos de equinos em repouso, se apresentarem inferiores ao intervalo de leitura do aparelho portátil. Este trabalho demonstrou que o uso do referido aparelho para determinação de glicose, lactato, triglícerides e colesterol não é adequado na clínica médica equina. _________________________________________________________________________________ ABSTRACTFour blood components (glucose, lactate, triglycerides and cholesterol) were determined and compared using a portable device (Accutrend® Plus, ROCHE) and laboratory methods. Blood samples from 20 horses were analyzed (11 geldings and 9 mares, from various breeds with age and weight varying between 8 +- 5 years and 327,60 +-64,02 Kg, respectively. After complete clinical examination, blood was withdrawn through venipunction of the external jugular and these samples were analyzed using a portable device and compared to laboratory results. Statistical analysis were used to compare both methodologies. The results showed that glucose data were not different with a weak Pearson.s correlation and no agreement according to Bland.Altman method. The results obtained for lactate according to both methods were also not in agreement. Triglycerides and cholesterol data could not be compared due to the fact that reference values for resting horses lie below the reading range of the portable device. The present study showed that the use of Accutrend® Plus to determine glucose, lactate, triglycerides, and cholesterol levels , is not adequate in equine internal medicine

Investigação em sistemas e serviços de saúde: novos problemas e objetos, abordagens e estratégias

O artigo discute as tendências atuais das políticas e da organização dos sistemas e serviços de saúde, identificando os problemas que estão a exigir o desenvolvimento de investigações cujos resultados venham a subsidiar a formulação e implementação de propostas de mudança na formação de pessoal e nas práticas de saúde. Identifica áreas temáticas e discute os novos objetos de investigação que estão sendo constituidos, destacando a problemática dos sujeitos políticos em saúde, a redefinição do papel do Estado e a questão dos mercados em saúde, assim como a preocupação com o impacto das políticas, programas e serviços de saúde no contexto do ajuste estrutural das economias latinoamericanas e brasileira, em particular. Analisando as tendências atuais da produção científica no campo dos sistemas e serviços de saúde, aponta o crescimento do interesse pela pesquisa avaliativa e discute as estratégias de articulação entre as instituições de ensino-pesquisa e os serviços, notadamente o estabelecimento de "parcerias" para o desenvolvimento de atividades de cooperação técnica, o que vem colocando novos desafios e oportunidades para a consolidação de núcleos de investigação e da própria Rede de investigações em sistemas e serviços de saúde.The article discusses the present trends of the policies and health system organizations and services. It identifies the problems that at the moment demand the development of investigations with results that may support the formulation and implementation of proposal of changes in the personnel qualification and health practices. The paper also identifies the thematic areas and discusses the new objects of investigation being constituted highlighting the predicament of the political subjects in health, the redefinition of the role of the state and the issues of the health markets another concern is the impact of the policies, programs and health services in the context of economic structural adjustment of Latin America and in special Brazil. Having analyzed the present trends of scientific production in the field of health systems and services it points to the growing interest for the evaluative research. Next it discusses the articulation strategies among the teaching research institutions and the services, notably the establishment of partnerships for the development of activities of technical cooperation. Such strategies have placed new challenges and opportunities for the consolidation of not only the investigation nuclei but also the very Investigation Net system and services

Long-term Melatonin Treatment Reduces Ovarian Mass And Enhances Tissue Antioxidant Defenses During Ovulation In The Rat.

Melatonin regulates the reproductive cycle, energy metabolism and may also act as a potential antioxidant indoleamine. The present study was undertaken to investigate whether long-term melatonin treatment can induce reproductive alterations and if it can protect ovarian tissue against lipid peroxidation during ovulation. Twenty-four adult female Wistar rats, 60 days old (± 250-260 g), were randomly divided into two equal groups. The control group received 0.3 mL 0.9% NaCl + 0.04 mL 95% ethanol as vehicle, and the melatonin-treated group received vehicle + melatonin (100 µg·100 g body weight(-1)·day(-1)) both intraperitoneally daily for 60 days. All animals were killed by decapitation during the morning estrus at 4:00 am. Body weight gain and body mass index were reduced by melatonin after 10 days of treatment (P < 0.05). Also, a marked loss of appetite was observed with a fall in food intake, energy intake (melatonin 51.41 ± 1.28 vs control 57.35 ± 1.34 kcal/day) and glucose levels (melatonin 80.3 ± 4.49 vs control 103.5 ± 5.47 mg/dL) towards the end of treatment. Melatonin itself and changes in energy balance promoted reductions in ovarian mass (20.2%) and estrous cycle remained extensive (26.7%), arresting at diestrus. Regarding the oxidative profile, lipid hydroperoxide levels decreased after melatonin treatment (6.9%) and total antioxidant substances were enhanced within the ovaries (23.9%). Additionally, melatonin increased superoxide dismutase (21.3%), catalase (23.6%) and glutathione-reductase (14.8%) activities and the reducing power (10.2% GSH/GSSG ratio). We suggest that melatonin alters ovarian mass and estrous cyclicity and protects the ovaries by increasing superoxide dismutase, catalase and glutathione-reductase activities.44217-2

Clear-PEM: A PET imaging system dedicated to breast cancer diagnostics

The Clear-PEM scanner for positron emission mammography under development is described. The detector is based on pixelized LYSO crystals optically coupled to avalanche photodiodes and readout by a fast low-noise electronic system. A dedicated digital trigger (TGR) and data acquisition (DAQ) system is used for on-line selection of coincidence events with high efficiency, large bandwidth and small dead-time. A specialized gantry allows to perform exams of the breast and of the axilla. In this paper we present results of the measurement of detector modules that integrate the system under construction as well as the imaging performance estimated from Monte Carlo simulated data.http://www.sciencedirect.com/science/article/B6TJM-4M942B5-D/1/e8aea93baa1aeae3538ea200a5a5466

Efficacy and Safety of Upadacitinib Treatment in Adolescents With Moderate-to-Severe Atopic Dermatitis

Importance: Atopic dermatitis onset usually occurs in childhood. Persistence of disease into adolescence and adulthood is common. It is important to evaluate new treatment options in adolescents because of the high unmet need in this population. Objective: To assess the efficacy and safety of upadacitinib to treat moderate-to-severe atopic dermatitis in adolescents. Design, setting, and participants: Prespecified analysis of adolescents enrolled in 3 randomized, double-blind, placebo-controlled phase 3 clinical trials in more than 20 countries across Europe, North and South America, Oceania, the Middle East, and the Asia-Pacific region from July 2018 through December 2020. Participants were adolescents aged 12 to 17 years with moderate-to-severe atopic dermatitis. Data analysis was performed from April to August 2021. Interventions: Patients were randomized (1:1:1) to once-daily oral upadacitinib 15 mg, upadacitinib 30 mg, or placebo alone (Measure Up 1 and Measure Up 2) or with topical corticosteroids (AD Up). Main outcomes and measures: Safety and efficacy, including at least a 75% improvement in the Eczema Area and Severity Index from baseline and validated Investigator Global Assessment for Atopic Dermatitis score of 0 (clear) or 1 (almost clear) at week 16 (coprimary end points). Results: A total of 552 adolescents (290 female; 262 male) were randomized. Mean (SD) age was 15.4 (1.8), 15.5 (1.7), and 15.3 (1.8) years for adolescents in Measure Up 1, Measure Up 2, and AD Up, respectively. In Measure Up 1, Measure Up 2, and AD Up, respectively, a greater proportion of adolescents (% [95% CI]) achieved at least 75% improvement in the Eczema Area and Severity Index at week 16 with upadacitinib 15 mg (73% [63%-84%], 69% [57%-81%], 63% [51%-76%]), and upadacitinib 30 mg (78% [68%-88%], 73% [62%-85%], 84% [75%-94%]), than with placebo (12% [4%-20%], 13% [5%-22%], 30% [19%-42%]; nominal P < .001 for all comparisons vs placebo). Similarly, a greater proportion of adolescents treated with upadacitinib achieved a validated Investigator Global Assessment for Atopic Dermatitis score of 0 or 1 at week 16 and improvements in quality of life with upadacitinib than with placebo. Upadacitinib was generally well tolerated in adolescents. Acne was the most common adverse event, and all acne events were mild or moderate. Conclusions and relevance: In this analysis of 3 randomized clinical trials, upadacitinib was an effective treatment for adolescents with moderate-to-severe atopic dermatitis, with an acceptable safety profile.info:eu-repo/semantics/publishedVersio

Drug Survival of IL-12/23, IL-17 and IL-23 Inhibitors&nbsp;for Psoriasis Treatment: A Retrospective Multi-Country, Multicentric Cohort Study

Background: Drug survival analysis of biologic agents in psoriasis is of extreme importance, as it allows not only the evaluation of objective clinical outcomes (such as effectiveness and safety) but also of factors that are associated with patients’ adherence to treatment. The aim of this study was to evaluate and compare the drug survival of the most recent biologic agents approved for the treatment of moderate-to-severe psoriasis—ustekinumab, secukinumab, ixekizumab, brodalumab, guselkumab, and risankizumab—and to identify clinical predictors that can influence the drug survival of these drugs. Methods: This retrospective multicentric cohort study from 16 dermatology centers in Portugal, Spain, Italy, Switzerland, Czech Republic, Canada, and the United States included patients that started IL-12/23, IL-17 (IL-17A and IL-17R) and IL-23 inhibitors for the treatment of psoriasis between January 1, 2012 and December 31, 2019. Survival analysis was performed using a Kaplan-Meier estimator, to obtain descriptive survival curves, and proportional hazard Cox regression models. Results: A total of 3312 treatment courses (total patients: 3145) were included in the study; 1118 (33.8%) with an IL-12/23 inhibitor (ustekinumab), 1678 (50.7%) with an IL-17 inhibitor [911 (27.5%) on secukinumab, 651 (19.7%) on ixekizumab, 116 (3.5%) on brodalumab], and 516 (15.5%) with an IL-23 inhibitor [398 (12.0%) on guselkumab, 118 (3.5%) on risankizumab]. At 18 months, the cumulative probability of survival was 96.4% for risankizumab, 91.1% for guselkumab, 86.3% for brodalumab, 86.1% for ustekinumab, 82.0% for ixekizumab, and 79.9% for secukinumab. Using ustekinumab as reference, drug survival of guselkumab was higher (HR 0.609; 95% CI 0.418–0.887) and that of secukinumab was lower (HR 1.490; 95% CI 1.257–1.766). In the final multivariable model, secukinumab, female sex, higher BMI, and prior exposure to biologic agents significantly increased the risk of drug discontinuation, whereas risankizumab was protective. Conclusion: In this multinational cohort with 8439 patient-years of follow-up, the cumulative probability of drug survival for all drugs was &gt;79% at 18 months. Prescribed biologic, female sex, higher BMI, and previous exposure to biologic agents were predictors of drug discontinuation. Drug survival of guselkumab and risankizumab was higher than that of ustekinumab, and secukinumab was lower