Effectiveness of the use of non-hydrolysed type II collagen in the treatment of osteoarthritis: a systematic review and meta-analysis

Objective: To evaluate the effectiveness of treating osteoarthritis with the use of type II non-denatured collagen (UCII). Methods: This is a study of systematic review and meta-analysis based on searches for randomized controlled clinical trials carried out in the PUBMED, SciELO, ScienceDirect and Google Scholar databases. 2009 and 2020 studies that analyzed the effectiveness of UCII in the treatment of patients with osteoarthritis using clinical and / or radiographic criteria and based on WOMAC and VAS scores were included. Results: A total of 4.850 references were found in the literature. When applying the inclusion criteria, there were only 4 studies suitable for selection, and 3 of them were possible to be included in the meta-analysis. All studies were carried out in patients with knee osteoarthritis and the total sample was 202 patients. Meta-analysis of WOMAC and VAS scores was performed in the three independent studies according to the intervention adopted, and heterogeneity was not significant in both (τ² = 0.0; I² = 0%). In the WOMAC and VAS scores, the point estimate for the difference in standardized means was -0.44 (95% CI=-0.72 to -0.16; 0.002) and -0.37 (95% CI = - 0.65 to -0.09; 0.010) respectively, thus, the intervention group had positive effects and favorable results compared to the control group. There was no publication bias for the WOMAC and VAS outcomes; Conclusion: Based on the results of this study, the use of the UCII is effective in the treatment of osteoarthritis to improve parameters of pain and mobility on WOMAC and VAS parameters

O estatuto ontológico da escrita e da oralidade em duas contribuições funcionalistas: Josef Vachek e Michael Halliday

Linguistas da Escola de Praga, com destaque para Josef Vachek, chamam a atenção para a necessidade de estudar a língua escrita como uma estrutura linguística sui generis. O carácter excecional, pioneiro e sistemático do pensamento de Vachek sobre a escrita e a sagacidade das suas observações acerca da justificação funcional do que designou como norma escrita justificam trazê-lo para uma discussão sobre o estatuto ontológico da escrita e da oralidade, por relação com a visão do funcionalismo de Halliday, para quem os usos da língua escrita e os da língua oral são concebidos como variantes funcionais da língua. Se, em Vachek, a especificidade da norma escrita é essencialmente reivindicada ao nível do plano da expressão grafológica, em Halliday a especificidade dos registos da escrita e da oralidade manifesta-se nos vários estratos do sistema da língua, num movimento sistémico de reação funcional à variação ao nível do contexto. Pretende-se, neste artigo, tanto recuperar o contributo pioneiro de Vachek sobre o estatuto ontológico da escrita e da oralidade, como procurar esclarecer as relações de continuidade e de rutura que se podem estabelecer entre as visões funcionalistas de Vachek e de Halliday neste domínio teórico

Insulin analogues versus human insulin in type 1 diabetes: direct and indirect meta-analyses of efficacy and safety

All patients with Diabetes Mellitus (DM) receive insulin therapy. In this study, we evaluated the efficacy, safety and tolerability of human insulin and insulin analogues. We performed a systematic review of the literature and a meta-analysis according to the Cochrane Collaboration methodology. In the absence of clinical studies comparing insulins, we performed a mixed treatment comparison to establish the differences between the active treatments. We included studies published from 1995 to 2010. HbA1c results, episodes of hypoglycemia and nocturnal hypoglycemia data were extracted and analyzed. Thirty-five randomized clinical trials were selected after examining the abstract and a full text review. These studies included 4,206 patients who received long-acting insulin analogues and 5,733 patients who received short-acting insulin analogues. Pooled data regarding efficacy indicated no significant differences in HbA1c values between glargine or detemir (once daily) and NPH insulin. However, a twice-daily dose of detemir produced differences in HbA1c values that favored detemir (-0.14% [95% CI: -0.21 to -0.08]; p<0.0001; I2=0%). Direct and indirect comparisons are consistent and show that there were no significant differences between human insulin and insulin analogues in efficacy or safety. Our results indicate that long- and short-acting insulin analogues offer few clinical advantages over conventional human insulin

Insulin analogues versus human insulin in type 1 diabetes: direct and indirect meta-analyses of efficacy and safety

Todos os pacientes com Diabetes Mellitus (DM) tipo 1 recebem insulina. Neste estudo, avaliaram-se eficácia, segurança e tolerabilidade de insulinas humanas e análogas. Realizou-se uma revisão sistemática e meta-análise, de acordo com o preconizado pela Colaboração Cochrane. Na ausência de estudos clínicos comparando insulinas entre si, realizaram-se meta-análises de comparações indiretas a fim de estabelecer diferenças entre tratamentos ativos. Incluíram-se estudos de 1995 a 2010. Resultados de HbA1c, episódios de hipoglicemia e hipoglicemia noturna foram extraídos e analisados. Após leitura de resumos e, posteriormente, de artigos na íntegra, selecionaram-se 35 ensaios clínicos randomizados, totalizando 4206 pacientes utilizando insulina análoga de longa duração e 5733 pacientes insulina análoga de curta duração. Os resultados não demonstraram diferença estatisticamente significativa para redução de HbA1c entre glargina e detemir (uma vez ao dia) comparados a NPH. No entanto, insulina detemir utilizada duas vezes ao dia reduz a HbA1c (-0.14% [95% CI: -0.21 to -0.08]; pAll patients with Diabetes Mellitus (DM) receive insulin therapy. In this study, we evaluated the efficacy, safety and tolerability of human insulin and insulin analogues. We performed a systematic review of the literature and a meta-analysis according to the Cochrane Collaboration methodology. In the absence of clinical studies comparing insulins, we performed a mixed treatment comparison to establish the differences between the active treatments. We included studies published from 1995 to 2010. HbA1c results, episodes of hypoglycemia and nocturnal hypoglycemia data were extracted and analyzed. Thirty-five randomized clinical trials were selected after examining the abstract and a full text review. These studies included 4,206 patients who received long-acting insulin analogues and 5,733 patients who received short-acting insulin analogues. Pooled data regarding efficacy indicated no significant differences in HbA1c values between glargine or detemir (once daily) and NPH insulin. However, a twice-daily dose of detemir produced differences in HbA1c values that favored detemir (-0.14% [95% CI: -0.21 to -0.08];

Influenza seroprotection correlates with predominant circulating viruses during 2014/15 and 2015/16 seasons in Portugal

Rede Portuguesa de Laboratórios para o Diagnóstico da GripeBACKGROUND: Population immune profile for influenza is highly affected by circulating influenza viruses, thus changing the risk of infection for influenza. This study aims to assess influenza immunity in the Portuguese population by age groups, during 2014 and 2015 and establish a relationship between seroprotection and circulating influenza viruses in 2014/15 and 2015/16 seasons. METHODS: Two cross-sectional studies were developed based on a convenience serum sample collected in June 2014 (n=626) and July 2015 (n=675) in hospitals from mainland and Azores and Madeira.Serums equally represent all age groups. Antibody titers were evaluated by HI assay for strains recommended for seasonal influenza vaccine northern hemisphere,2014/15 and 2015/2016. Seroprevalences were estimated for each strain by age group and the association with seasonal cumulative influenza-like illness (ILI) rates for influenza virus during both seasons was analised. RESULTS: In June 2014 the highest seroprotection was observed for influenza A(H3) (39.0%; 95% CI: 36.2-43.8%) and A(H1)pdm09 (29.7; 95% CI: 26.3-33.4%), with higher levels in children 5-14 years old. In 2014/2015 a dominant circulation of influenza B/Yamagata was observed with high incidence rates in individuals under 65 years old, the ones that had lower seroprotection. Although before the start of the season high protection for A(H3) was observed, the circulation of the new drift A(H3) strains had gained an immunological advantage,in accordance with A(H3) elevated incidence rates observed during 2014/15. In July 2015 the highest seroprotection was observed for influenza B/ Yamagata (55.1%; 95% CI: 51.4-58.9%), 2.4 times the estimated 2014.This increase was even more pronounced in younger (≤ 4 years old), 6.3 times increase in 2015.This fact is in agreement with the predominant influenza B virus detected and the high ILI incidence rate observed in children during 2014/2015 epidemic. Seroprotection levels for influenza A in July 2015 were not significantly different from 2014.During 2015/16 season, influenza A(H1N1)pdm09 was predominant, with high incidence rate in < 65 year old. Influenza B/Victoria lineage,although detected at low levels increased in frequency, in agreement with the lowest level of seroprotection detected in the general population before the start of 2015/2016 season (21.8%; 95% CI: 18.7-24.0%). CONCLUSIONS There was a correlation between virus circulation, incidence rates for each age group and the previous seroprotection for seasonal influenza viruses.Our study highlights the value of measuring the serological profile for influenza to establishe risk groups for infection for which an increase preventive measures, including vaccination, should be fostered.info:eu-repo/semantics/publishedVersio

Influenza severe cases in hospitals, between 2014 and 2016 in Portugal

Rede Portuguesa de Laboratórios para o Diagnóstico da GripeBackground: Since 2009, the Portuguese Laboratory Network (PLNID) for Influenza Diagnosis has integrated 15 Laboratories in mainland and Atlantic Islands of Azores and Madeira. This PLNID added an important contribute to the National Influenza Surveillance Program regarding severe and hospitalized influenza cases. The present study aims to describe influenza viruses detected in influenza like illness (ILI) cases: outpatients (Outp), hospitalized (Hosp), and intensive care units (ICU), between 2014 and 2016. Methods: The PLNID performs influenza virus diagnosis by biomolecular methodologies. Weekly reports to the National Influenza Reference Laboratory ILI cases tested for influenza. Reports include data on detecting viruses, hospital assistance, antiviral therapeutics, and information on death outcome. Were reported during two winter seasons 8059 ILI cases,being 3560 cases in 2014/15 (1024 in Outp, 1750 Hosp, and 606 in ICU) and 4499 cases in 2015/2016 (1933 in Outp, 1826 Hosp, and 740 in ICU). Results: The higher percentage of influenza positive cases were detected in Outp in both seasons, 18% during 2014/15 and 20% in 2015/16. In 2014/15,influenza cases were more frequent in individuals older than 65 years old and these required more hospitalizations,even in ICU. In 2015/16,the influenza cases were mainly detected in individuals between 15-64 years old. A higher proportion of influenza positive cases with hospitalization in ICU were observed in adults between 45-64 years old.During the study period,the predominant circulating influenza viruses were different in the two seasons: influenza B and A(H3) co-circulated in 2014/15,and influenza A(H1)pdm09 was predominant during 2015/16. Even when influenza A is notthe dominant virus, A(H3) and A(H1)pdm09 subtypes correlate with higher detection rate in hospitalized cases (Hosp and UCI), with higher frequencies in adults older than 45. Influenza B,detected in higher proportion in outpatients, was frequently relatedwith influenza cases in younger age groups: 0-4 and 5-14 years old. Conclusions: This study highlights the correlation of theinfluenza virus type/subtype that circulates in each season with the possible need for hospitalization and intensive care in special groups of the population. Circulation of influenza A subtypes can cause more frequentdisease in individuals older than 45, with need of hospitalization including intensive care. On the other hand, influenza B is more frequently associated with less severe cases and with infection in children and younger adults. Influenza B circulation might predict lower number of hospitalizations.The identification of influenza type in circulation,byPLNID ineach season, could guide action planning measures in population health care.info:eu-repo/semantics/publishedVersio

The inventory of geological heritage of the state of São Paulo, Brazil: Methodological basis, results and perspectives

An inventory of geological sites based on solid and clear criteria is a first step for any geoconservation strategy. This paper describes the method used in the geoheritage inventory of the State of São Paulo, Brazil, and presents its main results. This inventory developed by the geoscientific community aimed to identify geosites with scientific value in the whole state, using a systematic approach. All 142 geosites representative of 11 geological frameworks were characterised and quantitatively evaluated according to their scientific value and risk of degradation, in order to establish priorities for their future management. An online database of the inventory is under construction, which will be available to be easily consulted and updated by the geoscientific community. All data were made available to the State Geological Institute as the backbone for the implementation of a future state geoconservation strategy.The authors acknowledge the Science Without Borders Programme, Process 075/2012, which supported this study and the São Paulo Research Foundation (FAPESP), Process 2011/17261-6. We also thanks C. Mazoca for his help with maps and figures.info:eu-repo/semantics/acceptedVersio

Divergent Anthropological Views in Scientific Articles on Bioethics in Brazil

20 páginasEl objeto del estudio es caracterizar de forma antropológica las producciones brasileñas en bioética, en específico artículos científicos. La cuestión orientadora de la investigación es: ¿cuál la caracterización antropológica presente en los artículos científicos en bioética en Brasil? Las teorías bioéticas prominentes presentan indicadores de antropología restrictiva, es decir, que atribuyen dignidad solo a miembros de la especie humana que sean detentores de algunos atributos, entre ellos, conciencia y autoconciencia, en contraposición con indicadores de antropología integral en relación con los seres humanos, o sea, que atribuyen igual dignidad a todos los miembros de la especie Homo sapiens. Se concluye la prominencia de indicadores de antropología integral y la divergencia teórica en las temáticas relacionadas con el inicio de la vida, sobre todo entre utilitarismo y personalismo

Visões antropológicas divergentes em artigos científicos de bioética no Brasil

Visiones antropológicas divergentes en artículos científicos de bioética en BrasilDivergent Anthropological Views in Scientific Articles on Bioethics in BrazilThe aim of the study is to characterize Brazilian bioethics outputs anthropologically, specifically scientific articles. The guiding question of this research is: What is the anthropological characterization present in scientific articles on bioethics in Brazil? Prominent bioethical theories show restrictive anthropology indicators; i.e., dignity is given only to members of the human species that have certain attributes, including conscience and self-consciousness, as opposed to comprehensive anthropology indicators in relation to human beings; i.e., dignity is equally assigned to all members of the Homo sapiens species. In conclusion, comprehensive anthropology indicators and theoretical divergence in relation to the origin of life, especially between utilitarianism and personalism, prevail.Para citar este artículo / To reference this article / Para citar este artigoSanches MA, Monteiro TM. Visões antropológicas divergentes em artigos científicos de bioética no Brasil. Pers Bioet. 2019; 23(1): 64-83. DOI: https://doi.org/10.5294/pebi.2019.23.1.5Recibido: 09/10/2018Aceptado: 20/03/2019Visiones antropológicas divergentes en artículos científicos de bioética en BrasilDivergent Anthropological Views in Scientific Articles on Bioethics in BrazilO objetivo deste estudo é caracterizar de forma antropológica as produções brasileiras em bioética, em específico artigos científicos. A questão norteadora da pesquisa é: qual a caracterização antropológica presente nos artigos científicos em bioética no Brasil? As teorias bioéticas proeminentes apresentam indicadores de antropologia restritiva, isto é, que atribuem dignidade apenas a membros da espécie humana que sejam detentores de alguns atributos, dentre eles, consciência e autoconsciência, em contraponto com indicadores de antropologia integral em relação com os seres humanos, ou seja, que atribuem igual dignidade a todos os membros da espécie Homo sapiens. Conclui-se a proeminência de indicadores de antropologia integral e a divergência teórica nas temáticas relacionadas ao início da vida, principalmente entre utilitarismo e personalismo.Para citar este artículo / To reference this article / Para citar este artigoSanches MA, Monteiro TM. Visões antropológicas divergentes em artigos científicos de bioética no Brasil. Pers Bioet. 2019; 23(1): 64-83. DOI: https://doi.org/10.5294/pebi.2019.23.1.5Recibido: 09/10/2018Aceptado: 20/03/2019Visiones antropológicas divergentes en artículos científicos de bioética en BrasilDivergent Anthropological Views in Scientific Articles on Bioethics in BrazilEl objeto del estudio es caracterizar de forma antropológica las producciones brasileñas en bioética, en específico artículos científicos. La cuestión orientadora de la investigación es: ¿cuál la caracterización antropológica presente en los artículos científicos en bioética en Brasil? Las teorías bioéticas prominentes presentan indicadores de antropología restrictiva, es decir, que atribuyen dignidad solo a miembros de la especie humana que sean detentores de algunos atributos, entre ellos, conciencia y autoconciencia, en contraposición con indicadores de antropología integral en relación con los seres humanos, o sea, que atribuyen igual dignidad a todos los miembros de la especie Homo sapiens. Se concluye la prominencia de indicadores de antropología integral y la divergencia teórica en las temáticas relacionadas con el inicio de la vida, sobre todo entre utilitarismo y personalismo.Para citar este artículo / To reference this article / Para citar este artigoSanches MA, Monteiro TM. Visões antropológicas divergentes em artigos científicos de bioética no Brasil. Pers Bioet. 2019; 23(1): 64-83. DOI: https://doi.org/10.5294/pebi.2019.23.1.5Recibido: 09/10/2018Aceptado: 20/03/201