Variations in Function and Vocal Acoustic Characteristics After Orthognathic Surgery: Preliminary Results

Objective: To determine the effects of orthognathic surgery on oral function and vocal quality in order to assess the need for speech therapy after surgery. Material and Methods: Thirty-seven patients scheduled for mono-jaw surgery, specifically maxillary (G1:15 patients), mandibular advancement (G2:10 patients) or mandibular set-back (G3:12 patients), were recruited for this prospective cohort study. Evaluation of oral functions, video recordings of speech articulation and audio recordings of voice were obtained before surgery (T0), and at 1 (T1) and 6 months (T2) after surgery. Spectrographic analysis and self-evaluation questionnaire regarding the vocal performance (VAPP) were performed. Both qualitative and quantitative statistical analysis was performed, mainly using generalized linear models for dichotomous data (p<0.05). Results: The formant frequencies (F1 and F2) of the main vowels vary after orthognathic surgery according to the type of surgery. Before surgery, 84% of patients analyzed showed difficulties in breathing and positioning the tongue both at rest and swallowing. Thanks to surgical correction of the malocclusion, the major part of these issues were resolved within 6 months. In 25% of cases, a change in the voice and/or articulation had occurred. Conclusion: Vocality improves after orthognathic surgery and it changes in relation to the type of surgery. However, vocality did not normalize completely. Speech assessment should be considered after surgery in order to offer adequate speech therapy if necessary

Effect of a Pharmaceutical Care Program on quality of life and satisfaction with pharmacy services in patients with type 2 diabetes mellitus

The aim is to evaluate the humanistic outcomes in type 2 diabetic patients by the adoption of pharmacotherapy follow-up in community pharmacies. Controlled, non-randomized, 12-months trial; n=161 patients distributed into control and intervention groups; 6 community pharmacies involved, all in the Curitiba city region, in the state of Paraná were used. The health-related quality of life (HRQoL) and the satisfaction index were determined using both the DQOL assessment tool, which measures HRQoL, and the satisfaction evaluation tool (QSSF). Interventions on 119 negative therapeutic outcomes were done (2.3/patient [SD=1.6]); the most commonly found problems were related to ineffectiveness of pharmacotherapy (68.1%). The Intervention-Group showed a significant improvement in HRQoL compared with the Control Group (0.08 vs -0.01, respectively; p=0.036). Satisfaction and impact domains presented the most significant improvement (0.13 vs 0.00 [p=0.030] and 0.07 vs -0.04 [p=0.033], respectively). After adjusting for baseline variables, the difference in improvement scores between groups on the QSSF was attributed to the allocation of patients in the intervention group. Pharmacotherapy follow-up of type 2 diabetic patients in community pharmacies can improve the HRQoL and satisfaction of patients.O objetivo foi avaliar os resultados humanísticos de pacientes com diabetes tipo 2, por meio da adoção de acompanhamento farmacoterapêutico nas farmácias comunitárias. Utilizaram-se: ensaio controlado, não-randomizado, de 12 meses; n=161 pacientes, distribuídos entre Grupo Controle e de Intervenção, e 6 farmácias comunitárias, todas na região da cidade de Curitiba, Estado do Paraná. A qualidade de vida relacionada à saúde (HRQoL) e o índice de satisfação foram determinados utilizando a ferramenta de avaliação DQOL, que mede a HRQoL, e a ferramenta de avaliação da satisfação (QSSF). Intervenções em 119 resultados terapêuticos foram efetuadas (2,3/paciente [SD=1,6]. Os problemas mais comumente encontrados foram aqueles relacionados à ineficácia da farmacoterapia (68,1%). O Grupo de Intervenção mostrou melhoria significativa da HRQoL em comparação ao Grupo Controle (0,08 versus 0,00 [p=0,030 e 0,07 versus -0,04 [p=0,033], respectivamente). Após o ajuste da linha base das variáveis, a diferença na contagem de melhoramento entre os grupos no QSSF foi atribuída à alocação de pacientes no Grupo de Intervenção. O acompanhamento farmacoterapêutico em pacientes de diabetes tipo 2 em farmácias comunitárias pode melhorar a HRQoL e a satisfação dos pacientes

Systematic review and evidence gap mapping of biomarkers associated with neurological manifestations in patients with COVID-19

Objective: This study aimed to synthesize the existing evidence on biomarkers related to coronavirus disease 2019 (COVID-19) patients who presented neurological events. Methods: A systematic review of observational studies (any design) following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Collaboration recommendations was performed (PROSPERO: CRD42021266995). Searches were conducted in PubMed and Scopus (updated April 2023). The methodological quality of nonrandomized studies was assessed using the Newcastle‒Ottawa Scale (NOS). An evidence gap map was built considering the reported biomarkers and NOS results. Results: Nine specific markers of glial activation and neuronal injury were mapped from 35 studies published between 2020 and 2023. A total of 2,237 adult patients were evaluated in the included studies, especially during the acute phase of COVID-19. Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) biomarkers were the most frequently assessed (n = 27 studies, 77%, and n = 14 studies, 40%, respectively). Although these biomarkers were found to be correlated with disease severity and worse outcomes in the acute phase in several studies (p < 0.05), they were not necessarily associated with neurological events. Overall, 12 studies (34%) were judged as having low methodological quality, 9 (26%) had moderate quality, and 9 (26%) had high quality. Conclusions: Different neurological biomarkers in neurosymptomatic COVID-19 patients were identified in observational studies. Although the evidence is still scarce and conflicting for some biomarkers, well-designed longitudinal studies should further explore the pathophysiological role of NfL, GFAP, and tau protein and their potential use for COVID-19 diagnosis and management.info:eu-repo/semantics/publishedVersio

Patient satisfaction with pharmacy services: translation and validation of the Pharmacy Services Questionnaire for Brazil

The aim of this study was to translate into Portuguese and validate the Pharmacy Services Questionnaire (PSQ). The instrument includes 20 questions that measure user satisfaction with pharmacy services, and is organized according to two factors. It uses a Likert scale of answers from 1 (poor) to 5 (excellent). The PSQ-Brazil was applied to 137 diabetics from 31 to 89 years of age (60.6% women), clients of private pharmacies, mostly users of public health services (65.7%), with low education (67.9% elementary schooling or less), and who used an average of 4.3 medicines per person. Overall score in the sample was 3.6 (SD = 1.1 [95%CI 3.4-3.8]). After factor analysis, “pleasant exposure” and “treatment management” included 8 and 12 items, respectively, and were significantly correlated with each other (r = 0.92, p < 0.001) and with the overall score. The instrument obtained a Cronbach's alpha of 0.98 for the overall score. The pleasant exposure and treatment management variables showed alphas of 0.94 and 0.98. PSQBrazil shows adequate reliability and validity for use in the country

Simultaneous determination of the tuberculostatic drugs rifampicin, isoniazid, and pyrazinamide by CZE

A simple and cost-effective method by capillary zone electrophoresis (CZE) was developed and validated for the simultaneous determination of the antituberculosis drugs isoniazid (INH), pyrazinamide (PYR), and rifampicin (RIF) in tablets. A 40 mmol L-1 sodium tetraborate background electrolyte (BGE) solution (pH 9.0) was found to be suitable for separation of all the analytes. An uncoated fused-silica capillary of 64.5 cm length (effective length 56 cm) was used for chromatography separation. All analytes were completely separated within 5 min at an applied voltage of 20 kV (max. 50 µA), and detection was performed at 269.5 nm with an UV detector. The method was validated in terms of linearity, accuracy, precision, and robustness. The linearities of the calibration curves for INH, PYR, and RIF were 40-120 µg/mL (r2 = 0.9994), 20-100 µg/mL (r2 = 0.9997), and 40-100 µg/mL (r2 = 0.9999), respectively. The proposed method was successfully applied for the simultaneous determination of the tuberculostatic drugs RIF, INH, and PYR in tablets. Thus, the proposed CZE method is a potential alternative to the HPLC methods described by the US Pharmacopoeia for the quality control of tuberculostatic drugs.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Degradabilidade e cinética ruminal de alimentos energéticos utilizados em dietas para ruminantes

Objetivou-se neste trabalho avaliar alimentos energéticos quanto a composição química, degradabilidade ruminal in situ da matéria seca (DMS), cinética ruminal e taxa de desaparecimento ruminal da matéria seca. Foram avaliados sete alimentos (tratamentos): grão de milho moído, grão de aveia moído, grão de cevada moído, farelo de trigo, casca de soja, radícula de malte e gérmen de milho, num delineamento inteiramente casualizado com quatro repetições cada. Para a incubação dos materiais foram utilizados dois bovinos com cânula ruminal, e cada tratamento foi submetido a sete períodos de exposição ao rúmen (0, 3, 6, 9, 12, 18 e 24 horas). Dentre os alimentos avaliados, a casca de soja teve o maior teor de fibra em detergente neutro (68,91%) e apresentou a menor DMS em 24 h (64,91%). O grão de cevada moído e o grão de milho moído tiveram os menores níveis de fração solúvel (FS) (26,34% e 28,7%, respectivamente), porém o grão de cevada moído apresentou a maior DMS em 24 h (90,48%), que por conciliar estes parâmetros teve a maior taxa de desaparecimento ruminal (2,50%.h-1), enquanto o grão de aveia moído teve a maior FS (47,75%) e a menor taxa de desaparecimento ruminal (1,09%.h-1). Palavras-chave: composição química; grãos e derivados industriais; taxa de desaparecimento rumina

Increased Incidence of Choroid Plexus Carcinoma Due to the Germline TP53 R337H Mutation in Southern Brazil

International audienceBACKGROUND: Choroid plexus carcinomas (CPC) are rare tumors predominantly found in children. Given the high frequency of the germline R337H mutation in the TP53 gene in southern Brazil, we have evaluated the frequency of the R337H mutation in families with CPC in children. METHODOLOGY/PRINCIPAL FINDINGS: The present series included 29 patients that were admitted to the same institution from 1992 to 2010, including 22 children with CPC (0.08-13.6 years of age at diagnosis) and 7 children with papilloma of the choroid plexus (Pp; 0.5-9.8 years of age). Surgical resection was possible in 28 children. Blood and/or tumor DNA was extracted and analyzed using PCR-RFLP and results were confirmed by sequencing 240 bp of the TP53 exon 10. The patients, all parents, and some relatives submitted samples for blood DNA analysis. In addition, we have also examined the presence of the mutation in DNA from paraffin-embedded tumor samples to evaluate loss of heterozygosity. We found 63.3% (14/22) of the CPC patients positive for the germline R337H mutation; CPC samples were either heterozygous (n = 7), lost only the wild-type (n = 4), or only the R337H copy (n = 2). One CPC sample was not available. All Pp cases (7/7, 100%) were negative for R337H. Cure (>5 years survival free of disease) was observed in 18.1% of the CPC cases with the R337H mutation (2/11), 71.4% of the Pp (5/7), and 25% of CPC cases negative for the R337H mutation (2/8). Family history of cancer (with 2 or more cancer cases) was exclusively identified on the parental side segregating the R337H mutation, and 50% (7/14) of them were compatible with Li-Fraumeni-like syndrome. SIGNIFICANCE: Our results show for the first time that the R337H TP53 mutation is responsible for 63% of the CPC cases in children, suggesting a higher incidence of CPC in southern Brazil