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1.
BMC Med Educ ; 24(1): 384, 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38589880

RESUMO

BACKGROUND: Role-emerging settings - those where occupational therapy (OT) services have not traditionally been provided - are common sites for practice placements of entry-level occupational therapy students. A growing body of literature has attempted to determine the value and drawbacks of such practice placements on the professional preparedness of OT students with mixed findings. Benefits have been identified, including increased cultural understanding, advocacy, creativity, initiative, and problem-solving skills. However, OT students have been reported to perceive such placement as limiting their professional growth and preparedness to practice compared to traditional placements. METHODS: A phenomenological study was conducted seeking the perceptions of OT students (n = 14) about their clinical placement at a role-emerging site. Recorded semi-structured interviews were conducted by trained interviewers within two weeks of the end of clinical placement. The recordings were transcribed verbatim and then coded using an iterative multi-coder inductive approach. Inter-coder agreement, reflectivity, and audit trail were maintained. RESULTS: Three themes emerged from the analysis: (1) integrating independence and support, (2) becoming occupational therapists, and (3) filling a gap. These themes reflect students' positive perceptions of their role-emerging clinical placement. They felt that this placement allowed them to develop self-confidence and professional identity as occupational therapists and learn new skills while simultaneously filling a gap in services for clients. Most importantly, they felt that this placement prepared them for their future OT practice. CONCLUSION: This finding and their resounding support of the experience suggest that OT students can perceive role-emerging placement as a solid foundation for clinical practice. Factors, included in this placement, that may have contributed to their experience include the level of support provided, time available for learning including space to make mistakes, and freedom from productivity and payor requirements.


Assuntos
Terapia Ocupacional , Humanos , Terapia Ocupacional/educação , Pesquisa Qualitativa , Estudantes , Aprendizagem
2.
Int J Obes (Lond) ; 44(11): 2303-2312, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32826973

RESUMO

BACKGROUND: Infection by Adenovirus 36 (Ad-36) has been associated with adipogenesis using cell and animal models, and a high risk of developing obesity has been reported in Ad-36-seropositive individuals. However, molecular mechanisms involved in the maintenance over the years of adipogenesis associated with Ad-36 has not been investigated in human adipose tissue. Epigenetic mechanisms, such as micro-RNAs (miRNAs) that regulate gene expression at the post-transcriptional level, have shown an important role in the development and maintenance of metabolic diseases. AIM: This study investigated the expression of miRNA associated with the adipogenic process in visceral adipose tissue from obese individuals according to Ad-36 serology. METHODS: Obese individuals were separated according to their status of Ad-36 serology in seropositive (Ad-36 (+); n = 29) and seronegative (Ad-36 (-); n = 28) groups. Additionally, a group of lean controls (n = 17) was selected to compare with obese individuals. Biopsies of visceral adipose tissue were obtained to evaluate miRNA and gene expression. The study of Ad-36 serology was carried out by ELISA. The expression of pro-adipogenic (miR-17 and miR-210) and anti-adipogenic (miR-155, miR-130 and miR-27a) miRNAs was evaluated using Taqman advanced miRNA assays by qPCR. The expression of adipogenes encoding LEP, ADIPOQ, and PPARγ was evaluated by Taqman predesigned assays through qPCR. RESULTS: The obese group had higher LEP (p < 0.001) and PPARγ (p = 0.016) expression and lower ADIPOQ expression (p = 0.017), and also had higher expression of miR-210 (p = 0.039), whereas lower expression of miR-155 (p = 0.019) and miR-27a (p = 0.028) as compared to lean controls. Higher PPARγ expression (p = 0.008), but no influence on LEP or ADIPOQ expression was observed in Ad-36 (+) group. Those seropositive individuals also had higher expression of the miR-17 (p = 0.028) and lower levels of miR-155 (p = 0.031) in adipose tissue as compared to seronegative subjects. CONCLUSIONS: Individuals with previous infection by Ad-36 had higher expression of the pro-adipogenic miR-17 and lower expression of the anti-adipogenic miR-155, which could lead to an increased adipogenic status by positively modulating PPARγ expression in adipose tissue from obese subjects.


Assuntos
Adenoviridae/classificação , Gordura Intra-Abdominal/metabolismo , MicroRNAs/genética , Obesidade Mórbida/genética , Adulto , Estudos de Casos e Controles , Chile , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/virologia , PPAR gama/metabolismo
3.
Alcohol Treat Q ; 42(1): 95-114, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38352063

RESUMO

Despite growing research on peer recovery specialists and community health workers (CHWs) in fields such as substance use disorder (SUD) treatment and recovery support, their workplace experiences are little understood. Through semi-structured interviews with 21 CHWs and peer recovery specialists working within substance use disorder treatment and/or traditional health care settings, we identified six prevalent themes: Benefits/Pleasures of the Role; Reciprocity; Challenges; Duality of Lived Experience; Relationships with Medical Professionals and Supervisors; and Defining Metrics. These themes reveal a complex narrative of system failures, organizational hierarchies, and experiential realities in which shared experiences and personal connections with clients undergird both positive and negative aspects of the role. In the words of one study participant: "We have not taken a vow of poverty, we need to get paid for our value."

4.
Science ; 384(6700): eadk0850, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38843329

RESUMO

To delineate the mechanisms by which the ERK1 and ERK2 mitogen-activated protein kinases support mutant KRAS-driven cancer growth, we determined the ERK-dependent phosphoproteome in KRAS-mutant pancreatic cancer. We determined that ERK1 and ERK2 share near-identical signaling and transforming outputs and that the KRAS-regulated phosphoproteome is driven nearly completely by ERK. We identified 4666 ERK-dependent phosphosites on 2123 proteins, of which 79 and 66%, respectively, were not previously associated with ERK, substantially expanding the depth and breadth of ERK-dependent phosphorylation events and revealing a considerably more complex function for ERK in cancer. We established that ERK controls a highly dynamic and complex phosphoproteome that converges on cyclin-dependent kinase regulation and RAS homolog guanosine triphosphatase function (RHO GTPase). Our findings establish the most comprehensive molecular portrait and mechanisms by which ERK drives KRAS-dependent pancreatic cancer growth.


Assuntos
Proteína Quinase 1 Ativada por Mitógeno , Proteína Quinase 3 Ativada por Mitógeno , Neoplasias Pancreáticas , Fosfoproteínas , Proteoma , Proteínas Proto-Oncogênicas p21(ras) , Animais , Humanos , Camundongos , Linhagem Celular Tumoral , Quinases Ciclina-Dependentes/metabolismo , Quinases Ciclina-Dependentes/genética , Sistema de Sinalização das MAP Quinases , Proteína Quinase 1 Ativada por Mitógeno/metabolismo , Proteína Quinase 3 Ativada por Mitógeno/metabolismo , Mutação , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/metabolismo , Fosfoproteínas/metabolismo , Fosfoproteínas/genética , Fosforilação , Proteínas Proto-Oncogênicas p21(ras)/genética , Proteínas Proto-Oncogênicas p21(ras)/metabolismo , Células HEK293
5.
Science ; 384(6700): eadk0775, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38843331

RESUMO

How the KRAS oncogene drives cancer growth remains poorly understood. Therefore, we established a systemwide portrait of KRAS- and extracellular signal-regulated kinase (ERK)-dependent gene transcription in KRAS-mutant cancer to delineate the molecular mechanisms of growth and of inhibitor resistance. Unexpectedly, our KRAS-dependent gene signature diverges substantially from the frequently cited Hallmark KRAS signaling gene signature, is driven predominantly through the ERK mitogen-activated protein kinase (MAPK) cascade, and accurately reflects KRAS- and ERK-regulated gene transcription in KRAS-mutant cancer patients. Integration with our ERK-regulated phospho- and total proteome highlights ERK deregulation of the anaphase promoting complex/cyclosome (APC/C) and other components of the cell cycle machinery as key processes that drive pancreatic ductal adenocarcinoma (PDAC) growth. Our findings elucidate mechanistically the critical role of ERK in driving KRAS-mutant tumor growth and in resistance to KRAS-ERK MAPK targeted therapies.


Assuntos
Carcinoma Ductal Pancreático , MAP Quinases Reguladas por Sinal Extracelular , Regulação Neoplásica da Expressão Gênica , Sistema de Sinalização das MAP Quinases , Mutação , Neoplasias Pancreáticas , Proteínas Proto-Oncogênicas p21(ras) , Transcriptoma , Animais , Humanos , Camundongos , Carcinoma Ductal Pancreático/genética , Carcinoma Ductal Pancreático/patologia , Carcinoma Ductal Pancreático/metabolismo , Linhagem Celular Tumoral , Resistencia a Medicamentos Antineoplásicos/genética , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/patologia , Proteínas Proto-Oncogênicas p21(ras)/genética , Proteínas Proto-Oncogênicas p21(ras)/metabolismo , Células HEK293
6.
Int J Drug Policy ; 118: 104118, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37422985

RESUMO

BACKGROUND: The North American overdose crisis has continued at unprecedented rates with more than 100,000 overdose deaths estimated to have occurred in the United States in 2022. Regional variations in overdose rates signify differences in local drug supplies. State-level drug supply surveillance systems have been limited in their ability to document and communicate the rapidly changing drug supplies which can hinder harm reduction efforts at the community level. We sought to address by piloting a two-year, community-engaged local drug supply surveillance program in Rhode Island (RI). METHODS: The first set of samples (n = 125) were collected from May 2022 to January 2023 across RI and included used paraphernalia (e.g., cookers), refuse (e.g., baggies), and product. Samples were tested using comprehensive toxicology testing approaches via liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS). Results were disseminated to participants and the broader public across platforms. RESULTS: Fentanyl was detected in 67.2% of all samples tested. 39.2% (n = 49) of samples were expected to be fentanyl. Xylazine was detected in 41.6% of all samples-always in combination with fentanyl-and no samples were expected to contain xylazine. In expected stimulant samples (n = 39), 10% contained fentanyl and/or analogues as major substances and 30.8% contained trace amounts of fentanyl and/or analogues. In expected stimulant samples, 15.4% contained xylazine with fentanyl. No opioids or benzodiazepines were detected in expected hallucinogen or dissociative samples (n = 7). In expected benzodiazepine samples (n = 8), no opioids were detected. CONCLUSIONS: Our results describe part of the local drug supply in Rhode Island, including a presence of NPS and adulterants (e.g., designer benzodiazepines, xylazine). Importantly, our findings underscore the feasibility of developing a community-driven drug supply surveillance database. Expanding drug supply surveillance initiatives is imperative for improving the health and safety of people who use drugs and informing public health approaches to addressing the overdose crisis.


Assuntos
Overdose de Drogas , Xilazina , Humanos , Estados Unidos , Rhode Island/epidemiologia , Xilazina/uso terapêutico , Analgésicos Opioides/uso terapêutico , Fentanila/análise , Overdose de Drogas/epidemiologia
7.
Drug Alcohol Depend ; 253: 111028, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38000322

RESUMO

BACKGROUND: Drug checking is a harm reduction strategy that provides greater awareness and information about the drug supply to the community. While fentanyl test strips are low-cost and available in most parts of the U.S., community-based organizations are considering using more sophisticated technologies, such as Fourier-transform infrared (FTIR) spectroscopy to test drugs. FTIR can detect multiple substances in a non-destructive manner that can be rapidly communicated to the program client by a trained technician, however implementation costs in community-based settings have not been assessed. METHODS: We conducted a costing analysis of a new pilot drug checking service that employed an FTIR spectrometer, fentanyl test strips and confirmatory testing in Rhode Island from January 2023-May 2023. We used microcosting methods to determine the overall cost during this period and cost per drug checked, reflecting realistic service capacity. RESULTS: Among 101 drug samples that were voluntarily submitted and tested, 53% tested positive for fentanyl, 39% for cocaine, 9% for methamphetamine and 13% for xylazine, a powerful sedative. The total cost during this period was $71,044 and the cost per drug checked was $474, though sensitivity analyses indicated that the cost would rise to $78,058 - $83,058 or $544 - $593 for programs needing to pay for specialized training. CONCLUSIONS: These findings demonstrate feasibility and inform the resources needed to scale-up drug checking services to reduce overdose risk.


Assuntos
Analgésicos Opioides , Overdose de Drogas , Humanos , Analgésicos Opioides/análise , Rhode Island , Sistemas Automatizados de Assistência Junto ao Leito , Fentanila/análise , Redução do Dano
8.
Cancer Res ; 83(24): 4112-4129, 2023 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-37934103

RESUMO

Primary/intrinsic and treatment-induced acquired resistance limit the initial response rate to and long-term efficacy of direct inhibitors of the KRASG12C mutant in cancer. To identify potential mechanisms of resistance, we applied a CRISPR/Cas9 loss-of-function screen and observed loss of multiple components of the Hippo tumor suppressor pathway, which acts to suppress YAP1/TAZ-regulated gene transcription. YAP1/TAZ activation impaired the antiproliferative and proapoptotic effects of KRASG12C inhibitor (G12Ci) treatment in KRASG12C-mutant cancer cell lines. Conversely, genetic suppression of YAP1/WWTR1 (TAZ) enhanced G12Ci sensitivity. YAP1/TAZ activity overcame KRAS dependency through two distinct TEAD transcription factor-dependent mechanisms, which phenocopy KRAS effector signaling. First, TEAD stimulated ERK-independent transcription of genes normally regulated by ERK (BIRC5, CDC20, ECT2, FOSL1, and MYC) to promote progression through the cell cycle. Second, TEAD caused activation of PI3K-AKT-mTOR signaling to overcome apoptosis. G12Ci treatment-induced acquired resistance was also caused by YAP1/TAZ-TEAD activation. Accordingly, concurrent treatment with pharmacologic inhibitors of TEAD synergistically enhanced KRASG12C inhibitor antitumor activity in vitro and prolonged tumor suppression in vivo. In summary, these observations reveal YAP1/TAZ-TEAD signaling as a crucial driver of primary and acquired resistance to KRAS inhibition and support the use of TEAD inhibitors to enhance the antitumor efficacy of KRAS-targeted therapies. SIGNIFICANCE: YAP1/TAZ-TEAD activation compensates for loss of KRAS effector signaling, establishing a mechanistic basis for concurrent inhibition of TEAD to enhance the efficacy of KRASG12C-selective inhibitor treatment of KRASG12C-mutant cancers. See related commentary by Johnson and Haigis, p. 4005.


Assuntos
Resistencia a Medicamentos Antineoplásicos , Neoplasias , Fatores de Transcrição de Domínio TEA , Humanos , Proteínas Adaptadoras de Transdução de Sinal/genética , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas p21(ras)/genética , Proteínas Proto-Oncogênicas p21(ras)/metabolismo , Transativadores/metabolismo , Proteínas de Sinalização YAP , Fatores de Transcrição de Domínio TEA/antagonistas & inibidores
9.
Front Pharmacol ; 14: 1175737, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37251329

RESUMO

Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC. Next, we conducted a regional structured survey that evaluated a list of 14 potential barriers to the clinical implementation of biomarkers based on their importance. In addition, a paired list of 54 genes/drugs was analyzed to determine an association between biomarkers and response to genomic medicine. This survey was compared to a previous survey performed in 2014 to assess progress in the region. The search results indicated that Latin American and Caribbean countries have contributed 3.44% of the total publications and 2.45% of the PGx-related clinical trials worldwide thus far. A total of 106 professionals from 17 countries answered the survey. Six major groups of barriers were identified. Despite the region's continuous efforts in the last decade, the primary barrier to PGx implementation in LAC remains the same, the "need for guidelines, processes, and protocols for the clinical application of pharmacogenetics/pharmacogenomics". Cost-effectiveness issues are considered critical factors in the region. Items related to the reluctance of clinicians are currently less relevant. Based on the survey results, the highest ranked (96%-99%) gene/drug pairs perceived as important were CYP2D6/tamoxifen, CYP3A5/tacrolimus, CYP2D6/opioids, DPYD/fluoropyrimidines, TMPT/thiopurines, CYP2D6/tricyclic antidepressants, CYP2C19/tricyclic antidepressants, NUDT15/thiopurines, CYP2B6/efavirenz, and CYP2C19/clopidogrel. In conclusion, although the global contribution of LAC countries remains low in the PGx field, a relevant improvement has been observed in the region. The perception of the usefulness of PGx tests in biomedical community has drastically changed, raising awareness among physicians, which suggests a promising future in the clinical applications of PGx in LAC.

10.
Occup Ther Int ; 2022: 2266326, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36312841

RESUMO

Coaching, an evidence-based approach in other fields, is relatively novel within occupational therapy (OT) and is not yet widely taught in OT programs. In recent studies, experienced occupational therapists have reported that coaching added value to their practice, but OT students' perspectives are missing from the literature. This phenomenological study explored OT students' (n = 14) perceptions of the value of learning to coach while in fieldwork. Three themes emerged from the inductive qualitative analysis: Coaching Requires a Mindset Shift, Change is a Journey, and Impact on Clients. Occupational therapy students perceived that coaching required a different way of thinking and reimagining their role, saw the value of learning to coach in the clients' outcomes, and recognized the potential for their future practice regardless of settings. The study findings suggest that incorporating coaching skills into OT education could be beneficial to students when they enter the profession.


Assuntos
Tutoria , Terapia Ocupacional , Humanos , Terapia Ocupacional/educação , Aprendizagem , Terapeutas Ocupacionais , Estudantes
11.
J Organomet Chem ; 696(13): 2519-2527, 2011 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-21709809

RESUMO

The possible inclusion complexes of Cp(2)NbCl(2) into calixarenes hosts have been investigated. The existence of a true inclusion complex in the solid state was confirmed by a combination of NMR, ab-initio calculations, thermogravimetric analysis, FTIR, Raman and PXRD. Ab-initio calculations, (1)H NMR solution and solid state (13)C CP MAS NMR results demonstrated that p-sulfonic calix[6]arene does form an inclusion complex with Cp(2)NbCl(2). Raman spectroscopy showed, for the inclusion compound of p-sulfonic calix[6]arene-Cp(2)NbCl(2), a band between 500-850 cm(-1) characteristic of Nb-O vibration. This result suggests that Nb(V) may engage in coordination with the oxygen of the sulfonate group, as part of the host-guest interaction. However, it is important to mention that the niobocene dichloride (Cp(2)NbCl(2)) dissolves in water and undergoes oxidation and hydrolysis processes to yield Cp(2)NbCl(2)(OH) species. For that reason this band does not exclude that the Nb-O band belongs to Cp(2)NbCl(2)(OH). Solid State (13)C CP MAS NMR and solution (1)H NMR spectroscopies together with ab-initio results showed that Cp(2)NbCl(2) is included in the p-sulfonic calix[6]arene cavity, with both Cp rings inside the cavity. In contrast, the solution (1)H NMR results demonstrated that calix[6]arene does not form inclusion complex with Cp(2)NbCl(2) in CDCl(3) solution. Cp(2)NbCl(2) is not included in the calix[6]arene cavity, possibly due to the lack of sulfonate heads which promote Nb-O interactions and assist the inclusion of Cp(2)NbCl(2) into the cavity.

12.
Diagn Interv Radiol ; 26(6): 541-545, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33032979

RESUMO

The liver has a complex vascularization and is subjected to a high metabolic demand, making it vulnerable to hemodynamic changes. As a result, several pathologies can develop, one of which is congestive hepatopathy. This disease occurs secondary to various cardiovascular conditions that generate a persistent passive venous congestion in the liver, which in the long term can culminate in fibrosis and cirrhosis, which in turn increases the risk of developing hepatocellular carcinoma. In order to avoid this outcome, early diagnosis is crucial; however, both the clinical presentation and laboratory tests are unspecific, and they are only altered in advanced stages of the disease. One form of early detection is through imaging findings, there being various useful modalities such as Doppler ultrasonography (US), computed tomography, and magnetic resonance imaging. The purpose of this article is to detail the imaging findings of congestive hepatopathy in the different available modalities, with special emphasis on Doppler US, highlighting the role of the radiologist in the suspicion of this disease. We summarize the pathophysiologic mechanisms of congestive hepatopathy, clinical findings, and provide description of its main differential diagnoses.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Cirrose Hepática , Imageamento por Ressonância Magnética , Radiologistas
13.
Invest Clin ; 47(1): 65-9, 2006 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-16562645

RESUMO

Carbamazepine (CBZ) is an oral anticonvulsant drug, structurally similar to tricyclic antidepressants. It is preferred over other drugs because it has fewer adverse effects on behavior and alertness. However, hematologic toxicity is possible during therapy with CBZ. Patients should undergo routine monitoring of hematologic function. CBZ can make the skin more sensitive to the sun or ultraviolet light, therefore, dermatological effects of this drug also can happen such as, skin rash, urticaria, and erythema multiforme. The present study reports the case of a female patient that presented hyperchromic-concentric-pruriginous- spots on the skin of her hands after six months of treatment with CBZ. She came to the physicians of the Clinical Pharmacokinetic Service (Laboratory of Toxicology of IAHULA, Mérida-Venezuela) requesting a drug monitoring. The results showed a level of 8.51 microg x. mL(-1), which was found within the therapeutic range (4-12 microg x mL(-1)). Subsequently, the dermatologist diagnosed fixed pigmented erythema related to the ingestion of a specific medication which began disappearing after 15 days of CBZ free-treatment and with the aid of a dermatologic formulation.


Assuntos
Anticonvulsivantes/efeitos adversos , Carbamazepina/efeitos adversos , Toxidermias/etiologia , Eritema/induzido quimicamente , Dermatoses da Mão/induzido quimicamente , Transtornos da Pigmentação/induzido quimicamente , Administração Oral , Adolescente , Anticonvulsivantes/administração & dosagem , Carbamazepina/administração & dosagem , Feminino , Humanos
15.
Rev. Méd. Clín. Condes ; 31(2): 197-203, mar.-abr. 2020. tab
Artigo em Espanhol | LILACS | ID: biblio-1223696

RESUMO

INTRODUCCIÓN La fenitoína es usada con mucha frecuencia en nuestro medio, por lo que se requiere hacer estudios de monitorización terapéutica, que contribuya a minimizar los efectos adversos y optimizar la terapia farmacológica. En ese contexto, nuestro objetivo ha sido determinar el índice nivel/dosis de la fenitoína en pacientes epilépticos voluntarios de Mérida. MÉTODOS Se realizó un estudio descriptivo, observacional y por reclutamiento consecutivo concurrente, conformado por 30 pacientes voluntarios con diagnóstico de epilepsia. Las muestras de suero se obtuvieron en niveles mínimos de pacientes que estaban en tratamiento con fenitoína durante 1 mes. Los niveles del fármaco se cuantificaron por el método de Inmunoensayo de enzima donante clonada en el equipo Indiko Thermo Scientific. RESULTADOS El índice nivel/dosis fue de 1,4 y 1,6, la concentración plasmática de 4,8mg/l y 8,0mg/l, la capacidad metabólica de 388,4 y 462,9mg/día, respectivamente en mujeres y hombres. Mientras que el nivel de la concentración plasmática en el estado estacionario fue de 6,5mg/l y 5,5mg/l, la dosis de carga máxima de 237,3mg y de 395,6mg, respectivamente en mujeres y hombres con epilepsia de la ciudad de Mérida. CONCLUSIONES Nuestros resultados sugieren que se debe individualizar la dosis en base al índice nivel/dosis de cada paciente, ya que no se puede extrapolar para todos los pacientes con epilepsia, debido a diversos factores como al fenotipo metabólico y al uso de fármacos inductores e inhibidores enzimáticos.


INTRODUCTION Phenytoin is used very frequently in our environment, so it is necessary to do studies of therapeutic monitoring, which helps to minimize adverse drug reaction and optimize pharmacological therapy. In this context, our objective was to determine the level/dose index of phenytoin in volunteer epileptic patients from Mérida. METHODS A descriptive, observational and consecutive concurrent recruitment study was carried out, consisting of 30 volunteer patients with a diagnosis of epilepsy. The serum samples were obtained in minimum levels from patients who were in treatment with phenytoin for 1 month. The levels of the drug were quantified by the method of donor enzyme immunoassay cloned in the Indiko Thermo Scientific equipment. RESULTS The level/dose index was 1,4 and 1,6, the plasma concentration of 4,8mg/l and 8,0mg/l, the metabolic capacity of 388,4 and 462,9mg/day, respectively in women and men. While the level of plasma concentration at steady state was 6,5mg/l and 5,5mg/l, the maximum loading dose of 237,3mg and 395,6mg, respectively in women and men with epilepsy of the city of Mérida. CONCLUSIONS Our results suggest that the dose should be individualized based on the level/dose index of each patient, since it can not be extrapolated for all patients with epilepsy, due to various factors such as the metabolic phenotype and the use of enzyme-inducing drugs and inhibitors.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Fenitoína/administração & dosagem , Epilepsia/tratamento farmacológico , Anticonvulsivantes/administração & dosagem , Fenitoína/sangue , Fenitoína/farmacocinética , Estudos Transversais , Monitoramento de Medicamentos , Anticonvulsivantes/sangue , Anticonvulsivantes/farmacocinética
16.
Rev. ANACEM (Impresa) ; 13(1): 52-60, 2019. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1121694

RESUMO

INTRODUCCIÓN: Desde diciembre de 2019 la neumonía por SARS-CoV-2 ha experimentado un fuerte avance presentando a la fecha más de nueve millones de casos a nivel mundial. El objetivo de esta revisión es describir las principales características de la neumonía por COVID-19 en la tomografía computada (TC) de tórax en pacientes adultos. MATERIALES Y MÉTODOS: Se buscaron en PubMed artículos que se centraran en las características de la infección por COVID-19 en la tomografía computada de tórax en adultos durante el último año, en inglés y español. Las palabras clave fueron: "COVID-19", "chest CT manifestations" "chest CT findings" y "chest CT features", excluyendo estudios en población pediátrica, cartas al editor y casos clínicos. Se examinaron títulos y resúmenes de artículos obtenidos y se descartaron estudios no atingentes al objetivo de la investigación. RESULTADOS: Se obtuvieron 21 artículos. Una gran variedad de hallazgos en la TC de tórax han sido reportados en los distintos artículos revisados, siendo los más característicos las opacidades en "vidrio esmerilado" de predominio periférico y bilateral; con o sin consolidaciones, que además pueden asociarse a engrosamiento septal interlobulillar, conformando un patrón en empedrado (crazy paving) y a engrosamiento perivascular. Menos frecuentes son el compromiso central, la presencia de nódulos, quistes y derrame pleural. CONCLUSIONES: La tomografía computada de tórax tiene un papel fundamental en la evaluación y manejo de los pacientes con COVID-19, con un evidente rol diagnóstico en ciertas situaciones. El conocimiento de sus características imagenológicas resulta de suma importancia en el contexto actual


Introduction: The new Coronavirus Disease 2019 (COVID-19) has become an unprecedented global health emergency. The World Health Organization estimates global mortality from COVID-19 at 3.4%, however it will be higher in patients with comorbidities such as Cancer (5.6%), High Blood Pressure (6.0%), Chronic respiratory disease (6.3%), Diabetes (7.3%) and Cardiovascular Disease (10.5%). These diseases are among the most prevalent in the world, for this reason we pretend to synthesize their pathophysiology and role in COVID-19, in order to identify effective measures that decrease morbidity and mortality in these high risk groups. Methodology: A review was performed using the databases MEDLINE, PubMed and Google Scholar. Original articles and bibliographic review articles were considered, prioritizing the articles published this year. Results: SARS-CoV-2 uses the enzyme ACE2 as a functional receptor, which allows its entry into the host cell. Eventually, regulates its expression downward, with Angiotensin-II prevailing with its profibrotic, prothrombotic and proinflammatory functions, leading to the deleterious effects of the disease. Chronic non-transmissible diseases (NTCD) would have baseline alteration in ACE2 levels, dysregulation of the immune system, endothelial dysfunction, and chronic inflammation, which would be associated with increased susceptibility and severity in COVID-19. Conclusion: Prevention and identification of risk patients remains the main measure against COVID-19. It is necessary to emphasize efforts in the prevention of NTCD and the promotion of healthy lifestyles. The negative effects of prolonged confinement and suspension of health care services must be considered.


Assuntos
Humanos , Radiografia Torácica , SARS-CoV-2 , COVID-19/diagnóstico por imagem , Tomografia Computadorizada por Raios X
17.
Appl Organomet Chem ; 22(8): 440-450, 2008 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-19881887

RESUMO

Host-guest interactions between α-, ß-, and γ-cyclodextrins and vanadocene dichloride (Cp(2)VCl(2)) have been investigated by a combination of thermogravimetric analysis, differential scanning calorimeters, PXRD and solid state and solution EPR spectroscopy. The solid state results demonstrated that only ß- and γ-cyclodextrins form 1:1 inclusion complexes, while α-cyclodextrin does not form an inclusion complex with Cp(2)VCl(2). The ß- and γ-CD-Cp(2)VCl(2) inclusion complexes exhibited anisotropic electron-(51)V (I = 7/2) hyperfine coupling constants whereas the α-CD- Cp(2)VCl(2) system showed only an asymmetric peak with no anisotropic hyperfine constant. On the other hand, solution EPR spectroscopy showed that α-CD may be involved in weak host-guest interactions in equilibrium with free vanadocene species.

18.
Rev. Inst. Nac. Hig ; 44(2): 56-64, dic. 2013. tab, graf
Artigo em Espanhol | LILACS, LIVECS | ID: lil-746327

RESUMO

El objetivo de esta investigación fue evaluar los efectos fisiológicos y neuroquímicos en 60 ratones machos cepas Naval Medical Research Institute (NMRI) en edad adulto-joven con pesos promedios de 25,45 ± 3,05 g, sometidos durante seis semanas a dosis del principio psicoactivo de la marihuana el Δ-9-tetrahidrocannabinol en concentraciones entre 4 - 20%. Se realizaron tomas de sangre retroorbital para evaluar parámetros hematológicos y bioquímicos antes, durante y post experiencia. Se monitorearon medidas tales como: peso, ingesta de agua, alimentos, actividad locomotora horizontal y vertical, entre otros. Al final de la experiencia se realizo autopsia y toma de muestras de regiones cerebrales, para medir niveles de neurotransmisores aminoacidicos y dopamina. Estos resultados permiten concluir que altas concentraciones del principio psicoactivo de la marihuana hacen más dependiente al consumidor con los consecuentes daños fisiológicos y neurológicos. Esto lleva a que cada vez se necesite más droga para producir el mismo efecto.


The objective of this research was to evaluate the physiological and neurochemical effects in 60 (Naval Medical Research Institute) NMRI male mice strains in young adult - age average weight 25.45 ± 3.05 g, underwent six weeks at doses of the psychoactive ingredient in marijuana the Δ -9-tetrahydrocannabinol in concentrations between 4-20 %. Retroorbital blood shots were conducted to evaluate hematological and biochemical parameters before, during and post experience. Weight, water intake, food, horizontal and vertical locomotors activity include: measures such as monitored. At the end of the experience autopsy was conducted and sampling of brain regions to measure levels of amino acid neurotransmitters and dopamine. These results suggest that high concentrations of the psychoactive ingredient in marijuana consumers become more dependent with consequent physiological and neurological damage. This leads to more and more drugs is needed to produce the same effect.


Assuntos
Humanos , Masculino , Feminino , Adulto , Camundongos , Bioquímica/classificação , Cannabis/efeitos dos fármacos , Dopamina/fisiologia , Neurotransmissores , Dronabinol/análise , Saúde Pública , Pesquisa Científica e Desenvolvimento Tecnológico , Hematologia , Camundongos/anormalidades
19.
Rev. salud pública (Córdoba) ; 16(2): 46-56, 2012. tab
Artigo em Espanhol | LILACS | ID: lil-671201

RESUMO

El Trastorno de Desatención e Hiperactividad (TDHA) esposiblemente la patología infantil que más auge ha adquiridoen las dos últimas décadas. Este trastorno es considerado,en muchos casos, una problemática social, tanto por sucada vez mayor prevalencia, como por el involucramientode distintos sectores en la misma. Ello ha llevado a queexista una fuerte presión desde la institución escolar y enalgunos casos también de la familia para que esta patologíainfantil encuentre una rápida resolución mediante el usode psicofármacos. En la actualidad, sin embargo, se hapuesto en duda los fundamentos científicos que muestranuna prevalencia elevada para este trastorno hasta alcanzar,en algunos casos, el 20% del total de población infantil.Ello conlleva a la discusión acerca de si es posible sosteneral TDHA como una entidad diagnóstica independiente, osi solo se trata de un conjunto de síntomas relativamenteindependientes entre sí


The disorder of inattention and hyperactivity is arguablythe child pathology more boom has acquired in the past twodecades, considered in many cases a real social problem, its increasing prevalence, both sectors that are involved with regard to the same. This hasled to that there is strong pressure from the school and in some cases also the family sothat this child pathology find a quick resolution through the use of psychoactive drugs.However, it should be questioned about the scientific foundations who claim a high andbelief so high prevalence for this pathology, reaching almost, in some cases, 20 per cent.Alternatively, if it is possible to hold to the TDHA as an independent diagnosed entity, orif it is only a relatively independent symptoms set with each other


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/classificação , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade
20.
Rev. Inst. Nac. Hig ; 42(1): 16-26, jun. 2011. ilus, graf, tab
Artigo em Espanhol | LILACS, LIVECS | ID: lil-631789

RESUMO

Con el fin de detectar la presencia de benzoilecgonina en orina de consumidores de té de coca, se realizó un estudio piloto analizando muestras de orina a 10 voluntarios sanos, no consumidores de cocaína, antes de ingerir la infusión de té de coca (Nasa Esh´s Coca Nasa), y las recolectadas hasta las 48 horas después de la ingestión, de una toma única de 100 mL el mismo día. El análisis se realizó por métodos de inmunoensayo, cualitativo, mediante pruebas rápidas Acu-check, y semicuantitativo AxSYM Cocaine Metabolite, basado en In munoensayo de Fluorescencia Polarizada (FPIA). Antes de la ingestión de la infusión por los métodos cualitativos y semicuantitativos las muestras recolectadas resultaron negativas, después de haber ingerido la infusión, por ambos métodos se detectó concentraciones de benzoilecgonina desde la primera hasta las 48 horas con diversas variaciones entre las muestras, observándose excelente concordancia entre los métodos para la determinación de benzoilecgonina en orina. En este estudio, se concluyó que existe la presencia de benzoilecgonina en muestras de orina de consumidores de té de coca. Los métodos utilizados sólo proporcionan resultados preliminares, se recomienda utilizar unos más específicos a fin de encontrar parámetros que permitan discriminar individuos que hayan ingerido infusión de té de coca, de aquellos que son adictos a la cocaína. Además, es importante prevenir a los consumidores de té de coca sobre el riesgo de detección de benzoilecgonina en orina dentro de las primeras 24 a 48 horas y las implicaciones que trae consigo tales hallazgos de laboratorio.


In order to detect the presence of benzoylecgonine in urine of consumers of coca tea, a pilot study was conducted by analyzing urine samples from 10 volunteers not cocaine users, be fore drinking the coca tea infusion, and collected until 48 hours after ingestión of a single shot (100 mL) the same day, The analysis was performed by immunoassay qualitative methods, using fast Acu-check tests, and semi quantitative automated equipment Abbott Axsym System, based on fluorescence polarization immunoassay (FPIA). Before ingestion of the infusion for qualitative and semiquantitative methods for samples collected were negative, and after drinking the tea, for both methods, concentrations of benzoylecgonine was detected from the first to 48 hours with several variations between samples, observed excellent agreement between the methods for the determination of benzoilecgonine in urine. In this study, we concluded that there is the presence of benzoylecgonine in urine samples from consumers of coca tea. According to the methods used provide only preliminary results, we recommend using a more specific in order to find parameters to discriminate individuals who have ingested coca tea infusions of dose that are cocaine addicts, In turn, it is important to prevent cosumers coca tea on the risk of detection of benzoylecgonine in urine within the first 24 to 48 hours and the implications it brings such laboratory findings.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Coca/química , Cocaína/metabolismo , Cocaína/síntese química , Cocaína/toxicidade , Saúde Pública , Chás de Ervas/classificação
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