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1.
World J Surg ; 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38725097

RESUMEN

BACKGROUND: Gallstone-related conditions affect a significant portion of the population, with varying prevalence among different ethnic groups. Complications such as pancreatitis and cholangitis are associated with the presence of common bile duct (CBD) stones. Existing guidelines for diagnosing choledocholithiasis lack precision, leading to excessive use of invasive procedures like endoscopic retrograde cholangiopancreatography (ERCP). METHODS: A prospective study was conducted at Hospital Central "Dr. Ignacio Morones Prieto," involving 374 patients in the development cohort and 154 patients in the validation cohort. Patients meeting inclusion criteria underwent biochemical testing and ultrasonography. A predictive scoring system was developed using logistic regression and validated in an independent cohort. Clinical and laboratory variables were collected, and model performance was assessed using receiver-operator characteristic (ROC) curves. RESULTS: The predictive model incorporated variables such as age, pancreatitis, cholangitis, bilirubin levels, and CBD stone presence on ultrasound. The model demonstrated an area under the ROC curve (AUC) of 93.81% in the validation dataset. By adjusting the threshold defining high-risk probability to 40%, the model improved specificity and sensitivity compared to existing guidelines. Notably, the model reclassified patients, leading to a more accurate risk assessment. CONCLUSIONS: The developed algorithm accurately predicts choledocholithiasis non-invasively in patients with symptomatic gallstones. This tool has the potential to reduce reliance on costly or invasive procedures like magnetic resonance cholangiopancreatography and ERCP, offering a more efficient and cost-effective approach to patient management. The user-friendly calculator developed in this study could streamline diagnostic procedures, particularly in resource-limited healthcare settings, ultimately improving patient care.

2.
bioRxiv ; 2024 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-38798361

RESUMEN

ATTR amyloidosis is a systemic disease characterized by the deposition of amyloid fibrils made of transthyretin, a protein integral to transporting retinol and thyroid hormones. Transthyretin is primarily produced by the liver and circulates in blood as a tetramer. The retinal epithelium also secretes transthyretin, which is secreted to the vitreous humor of the eye. Because of mutations or aging, transthyretin can dissociate into amyloidogenic monomers triggering amyloid fibril formation. The deposition of transthyretin amyloid fibrils in the myocardium and peripheral nerves causes cardiomyopathies and neuropathies, respectively. Using cryo-electron microscopy, here we determined the structures of amyloid fibrils extracted from cardiac and nerve tissues of an ATTRv-V30M patient. We found that fibrils from both tissues share a consistent structural conformation, similar to the previously described structure of cardiac fibrils from an individual with the same genotype, but different from the fibril structure obtained from the vitreous humor. Our study hints to a uniform fibrillar architecture across different tissues within the same individual, only when the source of transthyretin is the liver. Moreover, this study provides the first description of ATTR fibrils from the nerves of a patient and enhances our understanding of the role of deposition site and protein production site in shaping the fibril structure in ATTRv-V30M amyloidosis.

3.
Sci Total Environ ; 931: 172947, 2024 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-38703837

RESUMEN

This study delves into the eco-endocrinological dynamics concerning the impact of dexamethasone (DXE) on the interrenal axis in juvenile carp, Cyprinus carpio. Through a comprehensive analysis, we investigated the effects of DXE exposure on oxidative stress, biochemical biomarkers, gene expression, and bioaccumulation within the interrenal axis. Results revealed a concentration-dependent escalation of cellular oxidation biomarkers, including 1) hydroperoxides content (HPC), 2) lipid peroxidation level (LPX), and 3) protein carbonyl content (PCC), indicative of heightened oxidative stress. Concurrently, the activity of critical antioxidant enzymes, superoxide dismutase (SOD), and catalase (CAT), significantly increased, underscoring the organism's response to oxidative insult. Notable alterations were observed in biochemical biomarkers, particularly Gamma-glutamyl-transpeptidase (GGT) and alkaline phosphatase (ALP) activity, with GGT displaying a significant decrease with increasing DXE concentrations. Gene expression analysis revealed a significant upregulation of stress and inflammation response genes, as well as those associated with sensitivity to superoxide ion presence and calcium signaling, in response to DXE exposure. Furthermore, DXE demonstrated a concentration-dependent presence in interrenal tissue, with consistent bioconcentration factors observed across all concentrations tested. These findings shed light on the physiological and molecular responses of juvenile carp to DXE exposure, emphasizing the potential ecological implications of DXE contamination in aquatic environments. Understanding these dynamics is crucial for assessing the environmental impact of glucocorticoid pollutants and developing effective management strategies to mitigate their adverse effects on aquatic ecosystems.


Asunto(s)
Carpas , Dexametasona , Estrés Oxidativo , Contaminantes Químicos del Agua , Animales , Carpas/metabolismo , Carpas/fisiología , Contaminantes Químicos del Agua/toxicidad , Biomarcadores/metabolismo , Peroxidación de Lípido/efectos de los fármacos , Riñón/metabolismo , Riñón/efectos de los fármacos
4.
Cancer Lett ; 591: 216879, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38636895

RESUMEN

Galectin-3 (Gal-3) is a multifunctional protein that plays a pivotal role in the initiation and progression of various central nervous system diseases, including cancer. Although the involvement of Gal-3 in tumour progression, resistance to treatment and immunosuppression has long been studied in different cancer types, mainly outside the central nervous system, its elevated expression in myeloid and glial cells underscores its profound impact on the brain's immune response. In this context, microglia and infiltrating macrophages, the predominant non-cancerous cells within the tumour microenvironment, play critical roles in establishing an immunosuppressive milieu in diverse brain tumours. Through the utilisation of primary cell cultures and immortalised microglial cell lines, we have elucidated the central role of Gal-3 in promoting cancer cell migration, invasion, and an immunosuppressive microglial phenotypic activation. Furthermore, employing two distinct in vivo models encompassing primary (glioblastoma) and secondary brain tumours (breast cancer brain metastasis), our histological and transcriptomic analysis show that Gal-3 depletion triggers a robust pro-inflammatory response within the tumour microenvironment, notably based on interferon-related pathways. Interestingly, this response is prominently observed in tumour-associated microglia and macrophages (TAMs), resulting in the suppression of cancer cells growth.


Asunto(s)
Neoplasias Encefálicas , Movimiento Celular , Proliferación Celular , Galectina 3 , Glioblastoma , Microglía , Microambiente Tumoral , Microglía/metabolismo , Microglía/patología , Galectina 3/metabolismo , Galectina 3/genética , Humanos , Animales , Glioblastoma/patología , Glioblastoma/metabolismo , Glioblastoma/genética , Glioblastoma/inmunología , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/inmunología , Línea Celular Tumoral , Femenino , Neoplasias de la Mama/patología , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/genética , Neoplasias de la Mama/inmunología , Macrófagos Asociados a Tumores/metabolismo , Macrófagos Asociados a Tumores/inmunología , Macrófagos/metabolismo , Macrófagos/inmunología , Invasividad Neoplásica , Proteínas Sanguíneas/metabolismo , Galectinas/metabolismo , Galectinas/genética , Transducción de Señal , Ratones , Regulación Neoplásica de la Expresión Génica
5.
Plants (Basel) ; 13(7)2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-38611579

RESUMEN

The assessment of constructed wetlands (CWs) has gained interest in the last 20 years for wastewater treatment in Latin American regions. However, the effects of culture systems with different ornamental species in CWs for phytoremediation are little known. In this study, some chemical parameters such as total suspended solids (TSS), chemical oxygen demand (COD), phosphate (PO4-P), and ammonium (NH4-N) were analyzed in order to prove the removal of pollutants by phytoremediation in CWs. The environmental impact index based on eutrophication reduction (EI-E) was also calculated to estimate the cause-effect relationship using CWs in different culture conditions. C. hybrids and Dieffenbachia seguine were used in monoculture and polyculture (both species mixed) mesocosm CWs. One hundred eighty days of the study showed that CWs with plants in monoculture/polyculture conditions removed significant amounts of organic matter (TSS and COD) (p > 0.05; 40-55% TSS and 80-90% COD). Nitrogen and phosphorous compounds were significantly lower in the monoculture of D. seguine (p < 0.05) than in monocultures of C. hybrids, and polyculture systems. EI-E indicator was inversely proportional to the phosphorous removed, showing a smaller environmental impact with the polyculture systems (0.006 kg PO43- eq removed) than monocultures, identifying the influence of polyculture systems on the potential environmental impacts compared with the phytoremediation function in monocultures (0.011-0.014 kg PO43- eq removed). Future research is required to determine other types of categories of environmental impact index and compare them with other wastewater treatment systems and plants. Phytoremediation with the ornamental plants studied in CWs is a good option for wastewater treatment using a plant-based cleanup technology.

6.
Sci Rep ; 14(1): 9096, 2024 04 20.
Artículo en Inglés | MEDLINE | ID: mdl-38643289

RESUMEN

The objective of this study was to evaluate the association of maternal cardiometabolic markers trajectories (glucose, triglycerides (TG), total cholesterol, systolic blood pressure (SBP) and diastolic blood pressure (DBP)) with estimated fetal weight trajectories and birth weight in Mexican pregnant women without medical complications. Cardiometabolic marker trajectories were characterized using group-based trajectory models. Mixed-effect and linear regression models were estimated to assess the association of maternal trajectories with estimated fetal weight and birth weight. The final sample comprised 606 mother-child dyads. Two trajectory groups of maternal cardiometabolic risk indicators during pregnancy were identified (high and low). Fetuses from women with higher values of TG had higher weight gain during pregnancy ( ß ^ = 24.00 g; 95%CI: 12.9, 35.3), were heavier at the sixth month ( ß ^ =48.24 g; 95%CI: 7.2, 89.7) and had higher birth weight ( ß ^ = 89.08 g; 95%CI: 20.8, 157.4) than fetuses in the low values trajectory. Fetuses from mothers with high SBP and DBP had less weight in the sixth month of pregnancy ( ß ^ = - 42.4 g; 95%CI: - 82.7, - 2.1 and ß ^ = - 50.35 g; 95%CI: - 94.2, - 6.4), and a higher DBP trajectory was associated with lower birth weight ( ß ^ = - 101.48 g; 95%CI: - 176.5, - 26.4). In conclusion, a longitudinal exposition to high values of TG and BP was associated with potentially adverse effects on fetal growth. These findings support the potential modulation of children's phenotype by maternal cardiometabolic conditions in pregnancies without medical complications.


Asunto(s)
Enfermedades Cardiovasculares , Desarrollo Fetal , Humanos , Femenino , Embarazo , Peso al Nacer , Aumento de Peso , Triglicéridos , Enfermedades Cardiovasculares/etiología
7.
Environ Res ; 252(Pt 3): 118913, 2024 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-38643821

RESUMEN

Exposome studies are advancing in high-income countries to understand how multiple environmental exposures impact health. However, there is a significant research gap in low- and middle-income and tropical countries. We aimed to describe the spatiotemporal variation of the external exposome, its correlation structure between and within exposure groups, and its dimensionality. A one-year follow-up cohort study of 506 children under 5 in two cities in Colombia was conducted to evaluate asthma, acute respiratory infections, and DNA damage. We examined 48 environmental exposures during pregnancy and 168 during childhood in eight exposure groups, including atmospheric pollutants, natural spaces, meteorology, built environment, traffic, indoor exposure, and socioeconomic capital. The exposome was estimated using geographic information systems, remote sensing, spatiotemporal modeling, and questionnaires. The median age of children at study entry was 3.7 years (interquartile range: 2.9-4.3). Air pollution and natural spaces exposure decreased from pregnancy to childhood, while socioeconomic capital increased. The highest median correlations within exposure groups were observed in meteorology (r = 0.85), traffic (r = 0.83), and atmospheric pollutants (r = 0.64). Important correlations between variables from different exposure groups were found, such as atmospheric pollutants and meteorology (r = 0.76), natural spaces (r = -0.34), and the built environment (r = 0.53). Twenty principal components explained 70%, and 57 explained 95% of the total variance in the childhood exposome. Our findings show that there is an important spatiotemporal variation in the exposome of children under 5. This is the first characterization of the external exposome in urban areas of Latin America and highlights its complexity, but also the need to better characterize and understand the exposome in order to optimize its analysis and applications in local interventions aimed at improving the health conditions and well-being of the child population and contributing to environmental health decision-making.

8.
J Public Health Dent ; 2024 Apr 28.
Artículo en Inglés | MEDLINE | ID: mdl-38679565

RESUMEN

BACKGROUND: Patient safety climate constitutes an important element for quality improvement. Its current evidence base has been generated in hospital settings in developed countries. Studies in dentistry are limited. OBJECTIVE: To systematically explore the evidence regarding assessing patient safety climate in dentistry. METHODS: We developed a search strategy to explore MEDLINE, SCOPUS, and Web of Science databases from January 1st, 2002, to December 31st, 2022, to include observational studies on patient safety culture or patient safety climate assessment. Methodological features and item data concerning the dimensions employed for assessment were extracted and thematically analyzed. Reported scores were also collected. RESULTS: Nine articles out of 5584 were included in this study. Most studies were generated from high-income economies. Our analysis revealed methodological variations. Non-randomized samples were employed (ranging from 139 to 656 participants), and response rates varied from 28% to 93.7%. Three types of measurement instruments have been adapted to assess patient safety climate. These mainly consisted of replacing words or rewording sentences. Only one study employed an instrument previously validated through psychometric methods. In general, patient safety climate levels were either low or neutral. Only one study reported scores equal to or greater than 75. DISCUSSION: Despite diverse assessment tools, our two-decade analysis reveals a lag compared with medicine, resulting in methodological variations for assessing patient safety climate. Collaboration is vital to elevate standards, prioritize patient safety across oral healthcare services, and advocate for integrating safety climate into local and national quality and patient safety strategies.

9.
Surg Neurol Int ; 15: 96, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38628542

RESUMEN

Background: Pituitary neuroendocrine tumors (PitNETs) are a diverse group of benign neoplasms that account for a significant proportion of intracranial tumors (13%). The coexistence of PitNET with other intracranial lesions, such as meningiomas and intracranial aneurysms, has been constantly reported in the literature; yet, the pathophysiological mechanisms remain unknown, and the appropriate management is controversial. This study aims to describe the clinical characteristics, surgical treatment, and outcomes of patients with PitNET with coexisting intracranial lesions in a single healthcare center. Methods: A retrospective analysis was conducted on 12 patients who underwent surgical treatment for PitNET and another intracranial lesion at our single tertiary referral center over 15 years from January 2008 to May 2023. Results: Among these coexisting lesions, aneurysms were the most commonly found (41.67%), followed by meningiomas (33.33%). Surgical intervention for both lesions was performed in a single-stage procedure for most cases (75%), employing transcranial, endoscopic endonasal, and combined approaches. We found low preoperative Karnofsky Performance Scale scores in three patients, with significant differences in functional outcomes. Conclusion: These findings contribute to the limited knowledge about PitNET coexisting with other intracranial lesions and emphasize the importance of patient-tailored, multidisciplinary management in these unusual scenarios.

10.
Agric For Entomol ; 26(1): 126-134, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38516031

RESUMEN

In the Colombian Amazon, there has been long-term and sustained loss of primary forest threatening biodiversity and climate change mitigation. Silvopastoral practices that integrate trees into livestock production could help address both local economic and wider environmental challenges.We aimed to assess the effects of silvopastoral practices on invertebrate communities on smallholder farms in Caquetá, Colombia. Using sweep nets and malaise trapping, invertebrate communities were compared between traditional pasture, silvopasture and forest edge habitats.Invertebrate communities collected using sweep nets were contrasting among habitat types, communities were significantly different between traditional pasture and forest edge habitats and diversity and evenness were greatest in forest edges compared to traditional pastures. It appears that silvopasture areas, by supporting similar invertebrate assemblages to both traditional pasture and forest edges, may be acting as an intermediate habitat.When individual invertebrate orders were compared, Lepidoptera and Coleoptera were found in greater abundance in the forest edge habitats, while Hemiptera were more abundant in traditional pasture. Hemipterans are often pests of forage plants in pasture systems and these differences in abundance may have implications for ecosystem services and disservices.Silvopastoral approaches cannot replace the unique biodiversity supported by native forests but could deliver benefits for invertebrate conservation and ecosystem services if integrated into landscapes.


Resumen: En la Amazonía colombiana ha habido una pérdida sostenida y a largo plazo de bosque primario que amenaza la biodiversidad y la mitigación del cambio climático. Las prácticas silvopastoriles que integran los árboles en la producción ganadera podrían ayudar a abordar tanto los desafíos económicos locales como los ambientales.Nuestro objetivo fue evaluar los efectos de las prácticas silvopastoriles en comunidades de invertebrados en pequeñas fincas en Caquetá, Colombia. Las comunidades de invertebrados se compararon entre las pasturas nativas, el sistema silvopastoril y los hábitats del borde del bosque mediante el uso redes entomológicas de barrido y trampas Malaise.Las comunidades de invertebrados recolectadas usando redes entomológicas de barrido contrastaban entre los tipos de hábitat. Las comunidades eran significativamente diferentes entre las pasturas nativas y el borde de bosque. Pareciera que las áreas de silvopastoreo, al soportar conjuntos de invertebrados similares tanto a las pasturas nativas como a los bordes del bosque, pueden estar actuando como un hábitat intermedio.Cuando se compararon los órdenes individuales de invertebrados, los lepidópteros y los coleópteros se encontraron en mayor abundancia en los hábitats del borde del bosque, mientras que los hemípteros eran más abundantes en las pasturas nativas. Los hemípteros son a menudo plagas de plantas forrajeras en sistemas de pastoreo y estas diferencias en abundancia pueden tener implicaciones y perjuicios para los servicios ecosistémicos.Los sistemas silvopastoriles no pueden reemplazar la biodiversidad única apoyada por los bosques nativos, pero podrían ofrecer beneficios para la conservación de invertebrados y los servicios ecosistémicos si se integran en los paisajes.

11.
Animals (Basel) ; 14(6)2024 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-38540069

RESUMEN

Animal welfare is inherited in each society, shaped by the surrounding environment and upbringing of each individual. This influence becomes particularly significant during adolescence. Due to its cultural context, Spain is among the European Union nations with the highest number of cases of animal abuse. The Canary Islands, the scenario of this study, show the highest rates of intentional poisoning of wildlife and pets' abandonment. The aim of the present study was to explore the perception of animal welfare among adolescents, studying the influence of the main socio-demographic factors that may condition it. A validated questionnaire on animal abuse was used and distributed to adolescents aged 14-18 years in two public study centers. Animal abuse rates were correlated with socio-demographic variables. In total, 302 subjects answered the questionnaire. The perception of animal welfare was influenced by socio-demographic variables, gender being the most important. The demographic profile of the least responsive adolescent to animal abuse was a male engaged in sports, not owning a dog, and hailing from a family involved in hunting. Awareness should be raised at an early age, promoting artistic activities, encouraging contact with animals and sporting practices that do not generate a lack of empathy for animals.

12.
World Neurosurg X ; 23: 100319, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38511160

RESUMEN

Background: Tuberculum sellae meningiomas (TSM) account for 3-10% of intracranial meningiomas. Visual loss is the presenting symptom in up to 80% of cases. Surgical management poses a great challenge due to tumor proximity to neurovascular structures such as the optic nerve and the internal carotid artery (ICA); hence, there is controversy regarding the optimal approach. The aim of this study is to determine differences in visual outcomes between transcranial (TCA) and endoscopic endonasal (EEA) approaches. Methods: A retrospective study including 29 patients with TSM surgically treated by TCA or EEA between 2011 and 2023 in a single referral center was conducted. Pre-and post-operative neuro-ophthalmologic evaluations, focusing on visual acuity and campimetry, were evaluated. Results: Sixteen (55.16%) patients were intervened through a TCA and the remaining 13 (44.84%) via an EEA. The lesions in each group were similar in terms of pre- operative volume (15.12 vs 12.9 cm3, p = 0.497) and neurovascular invasion (optic canal invasion 48.26 vs 41.37%, p = 0.664; ICA 44.81 vs 31.03%, p = 0.797). There were no significant differences in visual outcomes between both approaches; TCA presented an improvement of 5.18 points in visual fields (p = 0.140), whereas EEA had an improvement of 17.39 points in visual acuity (p = 0.114). Conclusion: EEA seems to offer greater improvement in visual acuity than TCA. However, the ideal approach should be individualized; taking into account the tumor's volume and invasiveness, as well as the patient's visual complaints.

13.
JMIR Form Res ; 8: e52462, 2024 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-38517457

RESUMEN

BACKGROUND: In this paper, we present an automated method for article classification, leveraging the power of large language models (LLMs). OBJECTIVE: The aim of this study is to evaluate the applicability of various LLMs based on textual content of scientific ophthalmology papers. METHODS: We developed a model based on natural language processing techniques, including advanced LLMs, to process and analyze the textual content of scientific papers. Specifically, we used zero-shot learning LLMs and compared Bidirectional and Auto-Regressive Transformers (BART) and its variants with Bidirectional Encoder Representations from Transformers (BERT) and its variants, such as distilBERT, SciBERT, PubmedBERT, and BioBERT. To evaluate the LLMs, we compiled a data set (retinal diseases [RenD] ) of 1000 ocular disease-related articles, which were expertly annotated by a panel of 6 specialists into 19 distinct categories. In addition to the classification of articles, we also performed analysis on different classified groups to find the patterns and trends in the field. RESULTS: The classification results demonstrate the effectiveness of LLMs in categorizing a large number of ophthalmology papers without human intervention. The model achieved a mean accuracy of 0.86 and a mean F1-score of 0.85 based on the RenD data set. CONCLUSIONS: The proposed framework achieves notable improvements in both accuracy and efficiency. Its application in the domain of ophthalmology showcases its potential for knowledge organization and retrieval. We performed a trend analysis that enables researchers and clinicians to easily categorize and retrieve relevant papers, saving time and effort in literature review and information gathering as well as identification of emerging scientific trends within different disciplines. Moreover, the extendibility of the model to other scientific fields broadens its impact in facilitating research and trend analysis across diverse disciplines.

14.
J Cosmet Dermatol ; 23(6): 2001-2006, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38514912

RESUMEN

BACKGROUND: Eyelid ptosis is characterized by an inferior displacement of the upper eyelid when the eye assumes its primary position. Besides its aesthetic implications, ptosis can also adversely affect visual acuity. OBJECTIVE: This study aimed to evaluate the simultaneous administration of IncobotulinumtoxinA (IncoBonTA) and hyaluronic acid effect in eyelid ptosis and ocular rejuvenation. METHODS: A novel, non-surgical technique for eyelid ptosis management involving IncoBonTA and hyaluronic acid the co-administration within a single syringe, and applied using a cannula. RESULTS: The dual action of IncoBonTA and hyaluronic acid in conjunction with the exact injection sites approaches improves overall aesthetic outcomes but also optimizes the restoration of eyelid functionality in palpebral ptosis. CONCLUSIONS: The functional balance achieved among the contributory muscles-primarily the orbicularis oculi (OO) and its antagonists, the frontal muscle and levator palpebrae superioris (LPS), yields to both, cosmetic and functional.


Asunto(s)
Blefaroptosis , Toxinas Botulínicas Tipo A , Cánula , Párpados , Ácido Hialurónico , Rejuvenecimiento , Humanos , Ácido Hialurónico/administración & dosificación , Toxinas Botulínicas Tipo A/administración & dosificación , Femenino , Técnicas Cosméticas/instrumentación , Persona de Mediana Edad , Adulto , Resultado del Tratamiento , Músculos Oculomotores/efectos de los fármacos , Masculino , Fármacos Neuromusculares/administración & dosificación
15.
Pharmacoeconomics ; 42(5): 527-568, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38489077

RESUMEN

BACKGROUND: Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, with up to 32% of patients with NSCLC harboring an epidermal growth factor receptor (EGFR) mutation. NSCLC harboring an EGFR mutation has a dedicated treatment pathway, with EGFR tyrosine kinase inhibitors and platinum-based chemotherapy often being the therapy of choice. OBJECTIVE: The aim of this study was to systemically review and summarize economic models of first-line treatments used for locally advanced or metastatic NSCLC harboring EGFR mutations, as well as to identify areas for improvement for future models. METHODS: Literature searches were conducted via Ovid in PubMed, MEDLINE, MEDLINE In-Process, Embase, Evidence-Based Medicine Reviews: Health Technology Assessment, Evidence-Based Medicine Reviews: National Health Service Economic Evaluation Database, and EconLit. An initial search was conducted on 19 December 2022 and updated on 11 April 2023. Studies were selected according to predefined criteria using the Population, Intervention, Comparator, Outcome and Study design (PICOS) framework. RESULTS: Sixty-seven articles were included in the review, representing 59 unique studies. The majority of included models were cost-utility analyses (n = 52), with the remaining studies being cost-effectiveness analyses (n = 4) and a cost-minimization analysis (n = 1). Two studies incorporated both a cost-utility and cost-minimization analysis. Although the model structure across studies was consistently reported, justification for this choice was often lacking. CONCLUSIONS: Although the reporting of economic models in NSCLC harboring EGFR mutations is generally good, many of these studies lacked sufficient reporting of justification for structural choices, performing extensive sensitivity analyses and validation in economic evaluations. In resolving such gaps, the validity of future models can be increased to guide healthcare decision making in rare indications.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Análisis Costo-Beneficio , Receptores ErbB , Neoplasias Pulmonares , Modelos Económicos , Humanos , Antineoplásicos/economía , Antineoplásicos/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/economía , Receptores ErbB/genética , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/economía , Neoplasias Pulmonares/genética , Mutación , Inhibidores de Proteínas Quinasas/economía , Inhibidores de Proteínas Quinasas/uso terapéutico
16.
Math Biosci Eng ; 21(1): 237-252, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38303421

RESUMEN

In this work, we propose a mathematical model that describes liver evolution and concentrations of alanine aminotransferase and aspartate aminotransferase in a group of rats damaged with carbon tetrachloride. Carbon tetrachloride was employed to induce cirrhosis. A second groups damaged with carbon tetrachloride was exposed simultaneously a plant extract as hepatoprotective agent. The model reproduces the data obtained in the experiment reported in [Rev. Cub. Plant. Med. 22(1), 2017], and predicts that using the plants extract helps to get a better natural recovery after the treatment. Computer simulations show that the extract reduces the damage velocity but does not avoid it entirely. The present paper is the first report in the literature in which a mathematical model reliably predicts the protective effect of a plant extract mixture in rats with cirrhosis disease. The results reported in this manuscript could be used in the future to help in fighting cirrhotic conditions in humans, though more experimental and mathematical work is required in that case.


Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas , Extractos Vegetales , Humanos , Ratas , Animales , Extractos Vegetales/farmacología , Extractos Vegetales/uso terapéutico , Tetracloruro de Carbono/toxicidad , Enfermedad Hepática Inducida por Sustancias y Drogas/tratamiento farmacológico , Enfermedad Hepática Inducida por Sustancias y Drogas/prevención & control , Enfermedad Hepática Inducida por Sustancias y Drogas/patología , Hígado/patología , Cirrosis Hepática/tratamiento farmacológico , Cirrosis Hepática/patología , Modelos Teóricos
17.
ChemMedChem ; 19(10): e202300651, 2024 May 17.
Artículo en Inglés | MEDLINE | ID: mdl-38354370

RESUMEN

In this research work, a series of 16 quinazoline derivatives bearing ibuprofen and an amino acid were designed as inhibitors of epidermal growth factor receptor tyrosine kinase domain (EGFR-TKD) and cyclooxygenase-2 (COX-2) with the intention of presenting dual action in their biological behavior. The designed compounds were synthesized and assessed for cytotoxicity on epithelial cancer cells lines (AGS, A-431, MCF-7, MDA-MB-231) and epithelial non-tumorigenic cell line (HaCaT). From this evaluation, derivative 6 was observed to exhibit higher cytotoxic potency (IC50) than gefitinib (reference drug) on three cancer cell lines (0.034 µM in A-431, 2.67 µM in MCF-7, and 3.64 µM in AGS) without showing activity on the non-tumorigenic cell line (>100 µM). Furthermore, assessment of EGFR-TKD inhibition by 6 showed a discreet difference compared to gefitinib. Additionally, 6 was used to conduct an in vivo anti-inflammatory assay using the 12-O-tetradecanoylphorbol-3-acetate (TPA) method, and it was shown to be 5 times more potent than ibuprofen. Molecular dynamics studies of EGFR-TKD revealed interactions between compound 6 and M793. On the other hand, one significant interaction was observed for COX-2, involving S531. The RMSD graph indicated that the ligand remained stable in 50 ns.


Asunto(s)
Aminoácidos , Antineoplásicos , Ciclooxigenasa 2 , Ensayos de Selección de Medicamentos Antitumorales , Receptores ErbB , Ibuprofeno , Quinazolinas , Ibuprofeno/farmacología , Ibuprofeno/química , Ibuprofeno/síntesis química , Humanos , Quinazolinas/farmacología , Quinazolinas/química , Quinazolinas/síntesis química , Ciclooxigenasa 2/metabolismo , Receptores ErbB/antagonistas & inhibidores , Receptores ErbB/metabolismo , Antineoplásicos/farmacología , Antineoplásicos/química , Antineoplásicos/síntesis química , Relación Estructura-Actividad , Aminoácidos/química , Aminoácidos/farmacología , Aminoácidos/síntesis química , Estructura Molecular , Línea Celular Tumoral , Antiinflamatorios no Esteroideos/farmacología , Antiinflamatorios no Esteroideos/química , Antiinflamatorios no Esteroideos/síntesis química , Acetato de Tetradecanoilforbol/farmacología , Proliferación Celular/efectos de los fármacos , Animales , Relación Dosis-Respuesta a Droga , Inhibidores de Proteínas Quinasas/farmacología , Inhibidores de Proteínas Quinasas/química , Inhibidores de Proteínas Quinasas/síntesis química , Simulación del Acoplamiento Molecular , Antiinflamatorios/farmacología , Antiinflamatorios/química , Antiinflamatorios/síntesis química , Supervivencia Celular/efectos de los fármacos
18.
Cad Saude Publica ; 40(1): e00058123, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38324861

RESUMEN

The association between community violence and mental health has been studied by reports of individual experiences, particularly in adolescents and youths, but little is known about the effect of living in disordered and violent communities. This study aims to determine the possible relation between living in disordered and violent community environments and psychological distress in Mexican adolescents and youths regardless of their individual experience of victimization and to assess the potential modifying effect of sex and age on this association. Data come from a cross-sectional survey with a representative sample of adolescents and youths living in Mexican municipalities, including 39,639 participants aged from 12 to 29 years. Disordered and violent community environments were assessed using reports from a secondary sample of adults who lived in the same communities as participants. Using exploratory factor analysis, three contextual variables related to disordered and violent community environment were created: social disorder, vandalism, and criminality. Multilevel linear regression models with random intercept were estimated. Adolescents and youths who lived in environments with higher social disorder had more psychological distress. Men in environments with greater vandalism had a higher level of psychological distress. Unexpectedly, women from communities with higher levels of crime had fewer symptoms. It is necessary to address the violence that exists in these communities, creating strategies that reduce not only crime, but also the social disorder and vandalism that could contribute to developing negative effects on mental health.


Asunto(s)
Víctimas de Crimen , Exposición a la Violencia , Pueblos de América del Norte , Adolescente , Adulto , Femenino , Humanos , Masculino , Víctimas de Crimen/psicología , Estudios Transversales , Violencia , Niño , Adulto Joven
19.
Surg Neurol Int ; 15: 24, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38344098

RESUMEN

Background: Postsurgical spinal infections are a severe complication and a challenge to the neurosurgeon due to their complex management. Revision surgeries and the removal of hardware are usually necessary. Recently, advances in nuclear medicine have made it possible to employ radiotracers to identify infections. The radiolabeled antimicrobial peptide technetium-99m-ubiquicidin (99mTc-UBI) (29-41) has been demonstrated to detect bacterial infections. UBI 29-41 is a peptide sequence with selective binding to the anionic cell membrane of bacteria, which has recently been used to differentiate between infection and inflammation. Here, we describe the clinical utility of 99mTc-UBI 29-41 single-photon emission computed tomography-computed tomography (SPECT-CT) in a patient suspected of a postoperative infection. Case description: A 54-year-old male who presented with conus medullaris syndrome secondary to T12 spondylodiscitis and multiple abscess collections was initially managed with debridement, corpectomy, and minimally invasive lateral instrumentation. The patient developed postsurgical empyema near the surgical site. The image study avoided the need for a second surgery and hardware removal. Conclusion: The use of 99mTc-UBI 29-41 SPECT-CT served as a tool to avoid a second invasive procedure; instead, conservative management with antibiotics was performed with an effective outcome after two weeks. This radiotracer has utility in cases in which infection is suspected, but the location is not entirely clear, and information is needed to guide the therapeutic approach.

20.
Sensors (Basel) ; 24(4)2024 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-38400500

RESUMEN

One of the main lines of research in distributed learning in recent years is the one related to Federated Learning (FL). In this work, a decentralized Federated Learning algorithm based on consensus (CoL) is applied to Wireless Ad-hoc Networks (WANETs), where the agents communicate with other agents to share their learning model as they are available to the wireless connection range. When deploying a set of agents, it is essential to study whether all the WANET agents will be reachable before the deployment. The paper proposes to explore it by generating a simulation close to the real world using a framework (FIVE) that allows the easy development and modification of simulations based on Unity and SPADE agents. A fruit orchard with autonomous tractors is presented as a case study. The paper also presents how and why the concept of artifact has been included in the above-mentioned framework as a way to highlight the importance of some devices used in the environment that have to be located in specific places to ensure the full connection of the system. This inclusion is the first step to allow Digital Twins to be modeled with this framework, now allowing a Digital Shadow of those devices.

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