Estudo de condutores idosos e não idosos de veículos automotores envolvidos em acidentes no Distrito Federal, no período de 2008 a 2017

Dissertação (mestrado) — Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, 2021.Introdução: Os acidentes de trânsito são causa significativa de gasto em saúde comincapacidades e mortes. Iniciativas como a “Década de Ação de Segurança no Trânsito” da Organização Mundial de Saúde preconizam intervenções para a redução no número de acidentes. O motorista é elemento chave para a ocorrência de acidentes de trânsito e o envelhecimento pode comprometer habilidades especificas para a condução veicular. Conhecer a estatística de acidentes de trânsito envolvendo motoristas idosos pode contribuirpara o adequado planejamento de ações que busquem a redução do número de acidentes. Método: Estudo epidemiológico descritivo comparativo com dados secundários do Sistema de Informações de Acidentes de Trânsito do Departamento de Trânsito do Governo do Distrito Federal, no período de 2008 a 2017. Comparação da incidência de acidentes de trânsito com vitima entre motoristas de automóveis idosos e não idosos. Resultados e Discussão: No período de 2011 a 2017 a incidência geral de acidentes de automóvel apresentou queda de 24%, sendo de 12 % nos idosos. Os motoristas idosos tem três vezes menos risco para acidentes com vitima que os não idosos. Os acidentes com maior frequência nos idosos foram os do tipo colisão no período diurno. Alguns fatores podem ter contribuindo para a menor frequência no grupo de idosos incluindo a medida de incidência utilizada que não considera a distância percorrida pelos motoristas. Estudos que consideram a distância percorrida encontram maior risco de acidentes para os motoristas idosos. Conclusão: Encontramos risco três vezes menor de motoristas idosos se envolverem em acidentes de automóveis com vitima quando comparados a não idosos. O comportamento dos motoristas idosos pode influenciar na ocorrência de acidentes.Introduction: Car crashes are a cause of health expenditure with disabilities and deaths. Initiatives such as the World Health Organization's “Decade of Action on Road Safety” advocate actions to reduce the number of accidents. Driving skills are determinants elements in car crashes. Aging can compromise specific driving skills in older drivers. The statistics of older driver's car crashes can contribute to the adequate planning of actions that reducethe accidents. Method: A descriptive study from 2008 to 2017 comparing secondary data from the Traffic Accident Information System by the Traffic Department of the Government of the Federal District, Brazil. Comparison of the incidence of car crashes with victims among older and non-older drivers. Results and Discussion: From 2011 to 2017, the number of car crashes decreased by 24%, with 12% in the older drives. Older drivers are three times less at risk for accidents with victims than non-older drivers. The most frequent accidents in the older group were those of collision during the day. Some factors may have contributed to a lower statistic in the older group, including an incidence measure thatdoes not consider the distance traveled by drivers. Studies by distance traveled are known to be a greater risk of accidents for older drivers. Conclusion: A three times lower risk of older drivers being involved in car crasheswith victims when compared to non-older people. The behavior of older drivers can influence accident occurrence

Alprostadil attenuates inflammatory aspects and leucocytes adhesion on renal ischemia and reperfusion injury in rats

PURPOSE:To evaluate the effects of alprostadil in an experimental model of ischemia and reperfusion injury (IRI) in rat renal tissue.METHODS: Adult male Wistar rats were randomized into three groups Vehicle-treated group(Veh), Alprostadil-treated(Al), and sham(Sh) group. Veh and Al groups had suprarenal aorta occluded for 30 minutes and reperfused for 60 minutes. Saline or 20 µg/kg of Alprostadil was intravenously infused immediately before declamping. Sh group animals underwent similar procedure without aortic occlusion. Left nephrectomy and blood sampling were performed after 60 minutes of reperfusion. Renal ICAM-1 expression and histological analysis were performed to estimate inflammatory response and tissue disarrangement. Serum biochemical markers for IRI were also measured. Kruskal-Wallis test was used to assess differences between the groups.RESULTS: There was lower expression of ICAM-1 in groups Veh and Sh. On histologically evaluation, inflammation and necrosis in the Veh group was significantly higher (grades III/IV) than Al group (Veh>Al=Sh; p = 0.025), as well as CPK levels (Veh>Al=Sh; p = 0.03).CONCLUSION: Alprostadil attenuates the immunohistochemical and histological repercussions in the renal tissue of rats submitted to a post-ischemic reperfusion with supra-renal aortic clamping.Federal University of São Paulo Department of SurgeryFederal University do Vale do São Francisco Faculty of NursingUniversity of São Paulo Faculty of Medicine Department of SurgeryUniversity of Health Sciences of Alagoas Faculty of MedicineUniversidade Federal de São Paulo (UNIFESP) Department of Surgery Faculty of MedicineUNIFESP, Department of SurgeryUNIFESP, Department of Surgery Faculty of MedicineSciEL

Symptoms, Ca125 And He4 For The Preoperative Prediction Of Ovarian Malignancy In Brazilian Women With Ovarian Masses.

This manuscript evaluates whether specific symptoms, a symptom index (SI), CA125 and HE4 can help identify women with malignant tumors in the group of women with adnexal masses previously diagnosed with ultrasound. This was a cross-sectional study with data collection between January 2010 and January 2012. We invited 176 women with adnexal masses of suspected ovarian origin, attending the hospital of the Department of Obstetrics and Gynecology of the Unicamp School of Medicine. A control group of 150 healthy women was also enrolled. Symptoms were assessed with a questionnaire tested previously. Women with adnexal masses were interviewed before surgery to avoid recall bias. The Ward Agglomerative Method was used to define symptom clusters. Serum measurements of CA125 and HE4 were made. The Risk of Ovarian Malignancy Algorithm (ROMA) was calculated using standard formulae. Sixty women had ovarian cancer and 116 benign ovarian tumors. Six symptom clusters were formed and three specific symptoms (back pain, leg swelling and able to feel abdominal mass) did not agglomerate. A symptom index (SI) using clusters abdomen, pain and eating was formed. The sensitivity of the SI in discriminating women with malignant from those with benign ovarian tumors was 78.3%, with a specificity of 60.3%. Positive SI was more frequent in women with malignant than in women with benign tumors (OR 5.5; 95% CI 2.7 to 11.3). Elevated CA125 (OR 11.8; 95% CI 5.6 to 24.6) or HE4 (OR 7.6; 95% CI 3.7 to 15.6) or positive ROMA (OR 9.5; 95% CI 4.4 to 20.3) were found in women with malignant tumors compared with women with benign tumors. The AUC-ROC for CA125 was not different from that for HE4 or ROMA. The best specificity and negative predictive values were obtained using CA125 in women with negative SI. Women diagnosed with an adnexal mass could benefit from a short enquiry about presence, frequency and onset of six symptoms, and CA125 measurements. Primary care physicians can be thereby assisted in deciding as to whether or not reference the woman to often busy, congested specialized oncology centers.1342

Non-classical gluconeogenesis-dependent glucose metabolism in Rhipicephalus microplus embryonic cell line BME26

In this work we evaluated several genes involved in gluconeogenesis, glycolysis and glycogen metabolism, the major pathways for carbohydrate catabolism and anabolism, in the BME26 Rhipicephalus microplus embryonic cell line. Genetic and catalytic control of the genes and enzymes associated with these pathways are modulated by alterations in energy resource availability (primarily glucose). BME26 cells in media were investigated using three different glucose concentrations, and changes in the transcription levels of target genes in response to carbohydrate utilization were assessed. The results indicate that several genes, such as glycogen synthase (GS), glycogen synthase kinase 3 (GSK3), phosphoenolpyruvate carboxykinase (PEPCK), and glucose-6 phosphatase (GP) displayed mutual regulation in response to glucose treatment. Surprisingly, the transcription of gluconeogenic enzymes was found to increase alongside that of glycolytic enzymes, especially pyruvate kinase, with high glucose treatment. In addition, RNAi data from this study revealed that the transcription of gluconeogenic genes in BME26 cells is controlled by GSK-3. Collectively, these results improve our understanding of how glucose metabolism is regulated at the genetic level in tick cells

Redox imbalance induces remodeling of glucose metabolism in Rhipicephalus microplus embryonic cell line

Carbohydrate metabolism not only functions in supplying cellular energy but also has an important role in maintaining physiological homeostasis and in preventing oxidative damage caused by reactive oxygen species. Previously, we showed that arthropod embryonic cell lines have high tolerance to H²O² exposure. Here, we describe that Rhipicephalus microplus tick embryonic cell line (BME26) employs an adaptive glucose metabolism mechanism that confers tolerance to hydrogen peroxide at concentrations too high for other organisms. This adaptive mechanism sustained by glucose metabolism remodeling promotes cell survival and redox balance in BME26 cell line after millimolar H²O² exposure. The present work shows that this tick cell line could tolerate high H²O² concentrations by initiating a carbohydrate-related adaptive response. We demonstrate that gluconeogenesis was induced as a compensation strategy that involved, among other molecules, the metabolic enzymes NADP-ICDH, G6PDH, and PEPCK. We also found that this phenomenon was coupled to glycogen accumulation and glucose uptake, supporting the pentose phosphate pathway to sustain NADPH production and leading to cell survival and proliferation. Our findings suggest that the described response is not atypical, being also observed in cancer cells, which highlights the importance of this model to all proliferative cells. We propose that these results will be useful in generating basic biological information to support the development of new strategies for disease treatment and parasite control

Experiencia de 5 años en soporte circulatorio mecánico de corta duración en pacientes posinfarto de miocardio: un reporte del registro INCORMACS

Objective. To determine the clinical and epidemiological characteristics of patients with short-term mechanical circulatory support devices (MCSD) after myocardial infarction (MI) at a national referral hospital. Materials and methods. Descriptive, retrospective study of post-MI patients in whom short-term mechanical circulatory support devices were implanted from 2015 to 2020. Results. Nine mechanical support devices were implanted, in the same number of patients due to cardiogenic shock post MI. All patients were men with ST-elevation myocardial infarction (STEMI). Eight extracorporeal membrane oxygenation devices (ECMO) and one centrifugal flow pump (in LVAD configuration) were implanted. The median time of use of the devices was eight days. The most frequent complications were non-fatal bleeding (55.6%), acute kidney injury (44.4%) and sepsis (44.4%).In-hospital mortality was 55.6 %. Conclusions. The use of short term MCSD after myocardial infarction is still limited in our institution and its main representative is the ECMO post STEMI complicated by cardiogenic shock. Despite the use of these devices, in-hospital mortality is high.Objetivo. Determinar las características clínicas y epidemiológicas de los pacientes con dispositivos de soporte mecánico circulatorio (DSMC) de corta duración, posinfarto de miocardio (IAM) en un hospital de referencia nacional. Materiales y métodos. Estudio descriptivo, retrospectivo, de pacientes post IAM en los que se implantó dispositivos de soporte mecánico circulatorio de corta duración desde el año 2015 al 2020. Resultados. Se implantaron nueve dispositivos de asistencia en igual número de pacientes debido a choque cardiogénico post-IAM. Todos los pacientes fueron varones con IAM con elevación del segmento ST (IAMCEST). Se implantaron ocho dispositivos de oxigenación por membrana extracorpórea (ECMO) y una bomba de flujo centrífugo (en configuración LVAD). La mediana de tiempo de uso del dispositivo fue de ocho días. Las complicaciones más frecuentes fueron la hemorragia no fatal (55,6%), injuria renal aguda (44,4%) y la sepsis (44,4%). La mortalidad intrahospitalaria fue de 55,6%. Conclusiones. El uso de DSMC de corta duración posinfarto de miocardio es aún limitado en nuestra institución y tiene como principal representante al ECMO post-IAMCEST complicado con choque cardiogénico. A pesar del uso de estos dispositivos la mortalidad intrahospitalaria es elevada

El Eco de Santiago : diario independiente: Año XIV Número 8662 - 1909 Septiembre 16

A previsão de demanda de energia elétrica é componente fundamental para planejar e operar corretamente um sistema de energia elétrica. Para poder entender a dimensão de sua importância, é apresentado o funcionamento do sistema elétrico brasileiro e gaúcho. Para entender a previsão de energia elétrica a curto prazo, são apresentados vários conceitos e técnicas integrantes de sua execução. Por fim, é apresentada uma modelagem da previsão de energia elétrica através de técnicas de redes neurais, comparando temperatura intradiária, intensidade de uso da luminosidade artificial e uma aproximação em modelo autoregressivo para obter um resulta-do de previsão de demanda de energia elétrica para as próximas vinte e quatro ho-ras. O estudo de caso ilustra a aplicação do método proposto ao Estado federado brasileiro do Rio Grande do Sul.The demand forecast for electricity is a key component to plan and operate correctly an electric power system. To understand the magnitude of its importance, it is shown the functioning of the Brazilian and Gaucho electrical system. Several con-cepts and technics of power demand forecast are presented. Finally, a short term demand forecasting is presented using techniques of neural networks, comparing intraday temperature, intensity of use of artificial light and an approach for AR model for a qualified result of demand forecasting for the next twenty four hours. The case study illustrates the application of the proposed method on the federated Brazilian state of Rio Grande do Sul

Lower risk of car crashes among older drivers compared with younger drivers: analysis of 10 years of data

OBJECTIVE: Traffic crashes are a significant cause of health expenditure, mainly considering disability and death. Driving skills are key when it comes to traffic crashes, and older drivers may be unfit to drive. The statistics of traffic crashes involving older drivers can contribute to planning actions that reduce accidents. This study aimed to present statistical data on traffic crashes among older adults in a Brazilian state. METHODS: This is an epidemiological study performed with data from the Traffic Accident Information System of the Federal District Traffic Department, Brazil, ranging from 2008 to 2017 and comparing the incidence of injury crashes between older drivers and adult drivers. RESULTS: Although the system recorded 60 705 drivers involved in injury crashes, a 24% reduction was seen in the overall crash incidence during the studied period (2008 – 2017); within the older drivers group, this reduction was two times smaller (12%). Despite the smaller drop in incidence, older car drivers presented around three times less risk of crashes when compared to adult drivers, along with a lower risk of accidents on urban, low-speed streets, and were mostly involved in collisions during the day. CONCLUSION: We found that the risk of older drivers being involved in injury crashes was three times smaller than that of adult drivers. The behavior of older drivers can influence the occurrence of accidents.</p

Lower risk of car crashes among older drivers compared with younger drivers: analysis of 10 years of data

Objective: Traffic crashes are a significant cause of health expenditure, mainly considering disability and death. Driving skills are key when it comes to traffic crashes, and older drivers may be unfit to drive. The statistics of traffic crashes involving older drivers can contribute to planning actions that reduce accidents. This study aimed to present statistical data on traffic crashes among older adults in a Brazilian state. Methods: This is an epidemiological study performed with data from the Traffic Accident Information System of the Federal District Traffic Department, Brazil, ranging from 2008 to 2017 and comparing the incidence of injury crashes between older drivers and adult drivers. Results: Although the system recorded 60 705 drivers involved in injury crashes, a 24% reduction was seen in the overall crash incidence during the studied period (2008 - 2017); within the older drivers group, this reduction was two times smaller (12%). Despite the smaller drop in incidence, older car drivers presented around three times less risk of crashes when compared to adult drivers, along with a lower risk of accidents on urban, low-speed streets, and were mostly involved in collisions during the day. Conclusion: We found that the risk of older drivers being involved in injury crashes was three times smaller than that of adult drivers. The behavior of older drivers can influence the occurrence of accidents