Universidade de Pernambuco

About: Universidade de Pernambuco is a education organization based out in Recife, Brazil. It is known for research contribution in the topics: Population & Medicine. The organization has 6147 authors who have published 6948 publications receiving 73648 citations.

Metabolic surgery, weight regain and diabetes re-emergence.

Abstract: INTRODUCTION: The poor success of clinical treatment of Type 2 Diabetes Mellitus (T2DM2) increased interest in metabolic surgery, which has been considered a promising alternative for the control of obese or non-obese diabetics. However, there is still no long-term follow-up to evaluate the duration of diabetes remission, and if weight regain would be associated to recurrence. AIM: 1) To describe the results of diabetic patients with a BMI < 30 and < 35 kg/m2 submitted to the following types of metabolic surgery: ileal interposition and sleeve gastrectomy, Roux-en-Y gastric bypass (RYGB), adjustable gastric banding, duodeno-jejunal exclusion and duodeno-jejunal bypass; 2) to evaluate the possible relapse of diabetes after occurrence of weight regain on long-term after bariatric surgery. METHOD: An expositive and historical literature review about metabolic surgery in diabetic patients with BMI < 30 and < 35 kg/m2 was conducted, and systematic review of the association between disease relapse and weight regain after bariatric surgery. RESULTS: After analysis of 188 published papers on Medline until 2010, three papers were selected, which included 269 patients who underwent RYGB. Pre-operatory BMI was between 37 and 60 kg/m2 and follow-up of three to 16 years. CONCLUSIONS: 1) Two studies showed association between weight regain and recurrence of type 2 diabetes, while the third did not show this association when comparing groups with and without weight regain; 2) metabolic surgery has shown adequate control of T2DM2 in class I obese subjects; however, the non-obese group still need a long-term evaluation, considering the risk of diabetes recurrence when after weight regain.

Protocol for evaluating the effects of a foot-ankle therapeutic exercise program on daily activity, foot-ankle functionality, and biomechanics in people with diabetic polyneuropathy: a randomized controlled trial

Abstract: Diabetic polyneuropathy (DPN) negatively affects foot and ankle function (strength and flexibility), which itself affects the daily physical activity and quality of life of patients. A physical therapy protocol aiming to strengthen the intrinsic and extrinsic foot muscles and increase flexibility may be a promising approach to improve lower-extremity function, prevent further complications, and improve autonomy for daily living activities in these patients. Thus, the inclusion of a specific foot-related exercises focused on the main musculoskeletal impairments may have additional effects to the conventional interventions in the diabetic foot. A prospective, parallel-group, outcome-assessor blinded, randomized controlled trial (RCT) will be conducted in 77 patients with DPN who will be randomly allocated to usual care (control arm) or usual care with supervised foot-ankle exercises aiming to increase strengh and flexibility twice a week for 12 weeks and remotely supervised foot-ankle exercises for a year through a web software. Patients will be evaluated 5 times in a 1 year period regarding daily physical activity level, self-selected and fast gait speeds (primary outcomes), foot ulcer incidence, ulcer risk classification, neuropathy testing, passive ankle range of motion, quality of life, foot health and functionality, foot muscle strength, plantar pressure, and foot-ankle kinematics and kinetics during gait. This study aims to assess the effect of a foot-ankle strength and flexibility program on a wide range of musculoskeletal, activity-related, biomechanical, and clinical outcomes in DPN patients. We intend to demonstrate evidence that the year-long training program is effective in increasing gait speed and daily physical activity level and in improving quality of life; foot strength, functionality, and mobility; and biomechanics while walking. The results will be published as soon as they are available. This study has been registered at ClinicalTrials.gov as NCT02790931 (June 6, 2016) under the name “Effects of foot muscle strengthening in daily activity in diabetic neuropathic patients”.

Expression of transforming growth factor-beta 1, -beta 2, and -beta 3 in human developing teeth: Immunolocalization according to the odontogenesis phases

Abstract: Transforming growth factor-beta (TGF-beta) is a multifunctional growth factor that has several biological effects in vivo, including control of cell growth and differentiation, cell migration, lineage determination, motility, adhesion, apoptosis, and synthesis and degradation of extracellular matrix, and TGF-beta plays an important role in regulating tissue repair and regeneration. Our study analyzed the participation of TGF-beta 1, -beta 2, and -beta 3 in the different stages of morphogenesis and differentiation of human developing dental organ using immunohistochemistry. The maxillae and mandibles of 10 human embryos ranging from 8 to 23 weeks of gestation were employed, according to the approval of the ethical committee. Our study revealed that the TGF-beta subunits-beta 1, beta 2, and beta 3-were present in the various stages of tooth development, but the expression varied according to the differentiation stage, tissue, and TGF-beta subunit. Our results indicated that TGF-beta 1 is closely related to differentiation of enamel organ and initiation of matrix secretion, TGF-beta 2 to cellular differentiation, and TGF-beta 3 to mineral maturation matrix.

Evaluation of tissue-equivalent materials to be used as human brain tissue substitute in dosimetry for diagnostic radiology

Abstract: Tissue-equivalent materials to be used as substitutes for human brain tissue in dosimetry for diagnostic radiology have been investigated in terms of calculated total mass attenuation coefficient (μ/ρ), calculated mass energy-absorption coefficient (μen/ρ) and absorbed dose. Measured linear attenuation coefficients (μ) have been used for benchmarking the calculated total mass attenuation coefficient (μ/ρ). The materials examined were bolus, nylon®, orange articulation wax, red articulation wax, PMMA (polymethylmethacrylate), bees wax, paraffin I, paraffin II, pitch and water. The results show that water is the best substitute for brain among the materials investigated. The average percentage differences between the calculated μ/ρ and μen/ρ coefficients for water and those for brain were 1.0% and 2.5%, respectively. Absorbed doses determined by Monte Carlo methods confirm water as being the best brain substitute to be used in dosimetry for diagnostic radiology, showing maximum difference of 0.01%. Additionally this study showed that PMMA, a material often used for the manufacturing of head phantoms for computed tomography, cannot be considered to be a suitable substitute for human brain tissue in dosimetry.

The risk of headache attributed to surgical treatment of intracranial aneurysms: a cohort study.

Abstract: Objectives The aim of this study was to assess the risk of headache in patients undergoing surgical treatment of intracranial aneurysms. Background The risk of the post-craniotomy headache has never been studied. Methods Patients with intracranial aneurysm, who were consecutively admitted to the Hospital da Restauracao, Brazil, from May 2009 to October 2010, were interviewed before they underwent surgical or non-surgical treatment of the aneurysms. The patients were followed for 4 months after intervention. The International Headache Society criteria for post-craniotomy headache were used after surgery and adapted for headache after embolization (maximum intensity of pain on the same side of the aneurysm). We also used the Headache Impact Test, the Hospital Anxiety and Depression Scale, and the Epworth Sleepiness Scale. Results Of 101 patients enrolled, 53 patients underwent craniotomy and 48 patients embolization. The surgery group was younger and had fewer women. The incidence of headache was 28/51 cases (54.9%) after surgery and 12/47 cases (25.5%) after embolization (relative risk = 2.15; 95% confidence interval [CI] 1.24-3.72). The incidence of persistent headache was not different between the 2 groups. The only risk factor for headache after the intervention was craniotomy (odds ratio = 2.6; 95% CI 1.1-6.7) and for persistent headache was anxiety prior to treatment (odds ratio = 8.5; 95% CI 1.7-42.3). The headache after treatment was not associated with the risk of anxiety or depression after the intervention. Conclusions Patients who underwent craniotomy had an increased risk of headache after treatment of intracranial aneurysms. The incidence of persistent headache after 3 months was higher among patients who had anxiety before the intervention.