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Sea turtles are vulnerable to climate change since their reproductive output is influenced by incubating temperatures, with warmer temperatures causing lower hatching success and increased feminization of embryos. Their ability to cope with projected increases in ambient temperatures will depend on their capacity to adapt to shifts in climatic regimes. Here, we assessed the extent to which phenological shifts could mitigate impacts from increases in ambient temperatures (from 1.5 to 3°C in air temperatures and from 1.4 to 2.3°C in sea surface temperatures by 2100 at our sites) on four species of sea turtles, under a "middle of the road" scenario (SSP2-4.5). Sand temperatures at sea turtle nesting sites are projected to increase from 0.58 to 4.17°C by 2100 and expected shifts in nesting of 26-43 days earlier will not be sufficient to maintain current incubation temperatures at 7 (29%) of our sites, hatching success rates at 10 (42%) of our sites, with current trends in hatchling sex ratio being able to be maintained at half of the sites. We also calculated the phenological shifts that would be required (both backward for an earlier shift in nesting and forward for a later shift) to keep up with present-day incubation temperatures, hatching success rates, and sex ratios. The required shifts backward in nesting for incubation temperatures ranged from -20 to -191 days, whereas the required shifts forward ranged from +54 to +180 days. However, for half of the sites, no matter the shift the median incubation temperature will always be warmer than the 75th percentile of current ranges. Given that phenological shifts will not be able to ameliorate predicted changes in temperature, hatching success and sex ratio at most sites, turtles may need to use other adaptive responses and/or there is the need to enhance sea turtle resilience to climate warming.
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Tortugas , Animales , Tortugas/fisiología , Temperatura , Cambio Climático , Reproducción , Razón de MasculinidadRESUMEN
As the construction industry moves towards greater sustainability, the application of more durable and environmentally friendly materials, capable of providing comfort in buildings and infrastructure, is a key element to consider. In this context, the use of alkali-activated binders (AAB) and geopolymers (GP), which have a lower carbon footprint than ordinary Portland cement (OPC), has emerged as an important alternative. Moreover, the addition of waste-based lightweight aggregates (LWA) to AAB and GP matrices produces lightweight composites that offer enhanced mechanical performance and improved comfort as building materials, while offering an alternative use to the increasing number of waste materials from diverse sources. This paper presents a comprehensive review of the literature on the above-mentioned topics (waste LWA in an AAB/GP matrix) published between 2012 and 2023, mainly indexed in the Scopus database. The waste-based LWA reported in the literature were categorized, and their properties and morphology presented. Then, the influence of the size, quantity, and nature of the LWA on the composite's properties and performance was analyzed. Fresh state performance, mechanical performance, density, and thermal and acoustic insulation were considered. This review is complemented by a bibliometric analysis, where keyword correlation and co-authorship networks on this field are established. The review highlights the potential of cementitious composites including waste-based LWA as a sustainable building material for structural and non-structural applications. However, more studies are required to further understand the behaviour of these composites under innovative manufacturing processes, such as extrusion and 3D printing.
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Networks of excitable systems provide a flexible and tractable model for various phenomena in biology, social sciences, and physics. A large class of such models undergo a continuous phase transition as the excitability of the nodes is increased. However, models of excitability that result in this continuous phase transition are based implicitly on the assumption that the probability that a node gets excited, its transfer function, is linear for small inputs. In this paper, we consider the effect of cooperative excitations, and more generally the case of a nonlinear transfer function, on the collective dynamics of networks of excitable systems. We find that the introduction of any amount of nonlinearity changes qualitatively the dynamical properties of the system, inducing a discontinuous phase transition and hysteresis. We develop a mean-field theory that allows us to understand the features of the dynamics with a one-dimensional map. We also study theoretically and numerically finite-size effects by examining the fate of initial conditions where only one node is excited in large but finite networks. Our results show that nonlinear transfer functions result in a rich effective phase diagram for finite networks, and that one should be careful when interpreting predictions of models that assume noncooperative excitations.
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INTRODUCTION: The massive vaccination against the SARS-CoV-2 virus has demonstrated to be one of the major measures for the reduction of the morbidity and mortality that this virus causes. However, during the last months the administration of the vaccine has been also associated with some rare, but life-threatening, adverse effects. CASE REPORT: In this article we describe the case of a patient that developed a Guillain-Barre syndrome and an Idiopathic thrombocytopenic purpura nine days after the vaccination with the third dose for the SARS-CoV-2 virus (Moderna). He had received previously two doses of the AstraZeneca vaccine. Moreover, the patient was positive for auto-antibodies anti-SSA/Ro60 and auto-antibodies IgG anti-GM1 and IgG anti-GM3. DISCUSSION: Even though it is not possible to stablish a clear relation of causality between the administration of the vaccine booster for SARS-CoV-2 and the diseases developed by the patient, the association of two concomitant autoimmune processes is remarkable. As well as the positivity for the auto-antibodies anti-SSA/Ro60, which have been described in the bibliography in cases of SARS-CoV-2 infection.
TITLE: Síndrome de Guillain-Barré y trombocitopenia tras la vacunación contra el SARS-CoV-2 con Moderna. Descripción de un caso.Introducción. La vacunación masiva contra el virus SARS-CoV-2 constituye una de las principales estrategias en la reducción de la morbimortalidad que presenta dicho virus. No obstante, a lo largo de los últimos meses, su administración también se ha relacionado con diversos efectos adversos raros, pero potencialmente graves. Caso clínico. En el presente artículo describimos el caso de un paciente que desarrolló un síndrome de Guillain-Barré y una púrpura trombocitopénica idiopática nueve días después de la vacunación con la tercera dosis contra el virus SARS-CoV-2 (Moderna), con dos dosis previas de AstraZeneca. Adicionalmente, destaca la presencia de positividad para autoanticuerpos anti-SSA/Ro60 y para anticuerpos inmunoglobulina G anti-GM1 e inmunoglobulina G anti-GM3. Conclusión. Aunque no es posible establecer una relación de causalidad entre la administración del booster de la vacuna y el desarrollo de la enfermedad, es destacable la asociación de dos procesos autoinmunes concomitantes, junto con la positividad en los autoanticuerpos anti-SSA/Ro60, lo cual se ha descrito en la bibliografía en casos de infección del virus SARS-CoV-2.
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Vacunas contra la COVID-19 , COVID-19 , Síndrome de Guillain-Barré , Trombocitopenia , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Síndrome de Guillain-Barré/etiología , Humanos , Inmunoglobulina G , Masculino , SARS-CoV-2 , Trombocitopenia/etiología , Vacunación/efectos adversos , Vacunas ViralesRESUMEN
BACKGROUND: Neonatal acute kidney injury (AKI) has been associated with unfavorable outcomes, including increased mortality. We aimed to describe the clinical course and outcomes during the first 7 days after diagnosis in newborns with AKI in three neonatal intensive care units in Popayán-Colombia. METHODS: Multi-center prospective cohort study conducted between June 2019 and December 2020 in three NICUs after ethical approval. We included newborns between 2 and 28 days of life, first diagnosed with AKI using the KDIGO classification modified for newborns which consider increased serum creatinine values over baseline values as well as urine output over time in hours or both. Patients with chromosomal abnormalities, major kidney malformations, and complex congenital heart disease were excluded. Patients were followed for up to 7 days after diagnosis and the maximum KDIGO stage, recovery of kidney function, need for renal replacement therapy and cumulative incidence of death were evaluated. RESULTS: Over the 18 months of the study, 4132 newborns were admitted to the NICUs, and 93 patients (2.25, 95% CI 1.82-2.75%) developed neonatal AKI. 59.1% of the newborns were premature and there were no differences in severity according to gestational age. During follow-up, the maximum KDIGO was 64.5% for AKI-stage 1, 11.8% for AKI-stage 2, and 23.7% for AKI-stage 3. Kidney function recovery was higher in AKI-stage 1 patients vs. AKI-severe (AKI-stage 2 and 3) (95% vs. 48.5%). Five patients (5.4%) received renal replacement therapy and 15 died (16.1%), four in AKI-stage 1 vs. 11 in AKI-severe (6.7% vs 33.3%). CONCLUSIONS: Newborns admitted to the NICUs can develop AKI regardless of gestational age, and it is more frequent between the second and ninth days of life. More patients whit AKI-stage 1 recover and die less than those in a severe stage.
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Lesión Renal Aguda , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/etiología , Lesión Renal Aguda/terapia , Humanos , Incidencia , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Estudios Prospectivos , Terapia de Reemplazo Renal , Estudios Retrospectivos , Factores de RiesgoRESUMEN
RESUMEN La tiña capitis es una enfermedad que afecta con mayor frecuencia a la población pediátrica; es ocasionada por hongos dermatofitos y es el querión su forma inflamatoria severa. Su diagnóstico e intervención temprana evita posibles secuelas estéticas y psicológicas en quienes lo padecen. Se presenta caso de paciente masculino de 4 años quien consultó al servicio de dermatología por cuadro de 4 meses de placa eritemato-descamativa con pústulas que progresó a única placa de predominio alopécica y adenopatías cervicales. El reporte microbiológico confirmó su diagnóstico, y el ultrasonido contribuyó al pronóstico y conducta terapéutica.
ABSTRACT Tinea capitis is a disease that most frequently affects the pediatric population caused by dermatophyte fungi, of which kerion is the severe inflammatory form of it. Its early diagnosis and intervention avoids possible aesthetic and psychological consequences in those who suffer from it. The case of a 4-year-old male patient is presented, who attend the dermatology service for 4 months of erythematous-desquamative plaque with pustules that evolved to a single plaque of predominantly alopecia and cervical lymphadenopathy. Microbiological report confirmed its diagnosis, and ultrasound contributed to the prognosis and therapeutic behavior.
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We have investigated the equilibrium states of ferromagnetic single wall nanotubes by means of atomistic Monte Carlo simulations of a zig-zag lattice of Heisenberg spins on the surface of a cylinder. The main focus of our study is to determine how the competition between short-range exchange (J) and long-range dipolar (D) interactions influences the low temperature magnetic order of the nanotubes as well as the thermal-driven transitions involved. Apart from the uniform and vortex states occurring for dominant J or D, we find that helical states become stable for a range of intermediate values of γ = D/J that depends on the radius and length of the nanotube. Introducing a vorticity order parameter to better characterize helical and vortex states, we find the pseudo-critical temperatures for the transitions between these states and we establish the magnetic phase diagrams of their stability regions as a function of the nanotube aspect ratio. Comparison of the energy of the states obtained by simulation with those of simpler theoretical structures that interpolate continuously between them, reveals a high degree of metastability of the helical structures that might be relevant for their reversal modes.
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Purpose The purpose of this paper is to determine the factors predictive of flares in systemic lupus erythematosus (SLE) patients. Methods A case-control study nested within the Grupo Latino Americano De Estudio de Lupus (GLADEL) cohort was conducted. Flare was defined as an increase ≥4 points in the SLEDAI. Cases were defined as patients with at least one flare. Controls were selected by matching cases by length of follow-up. Demographic and clinical manifestations were systematically recorded by a common protocol. Glucocorticoid use was recorded as average daily dose of prednisone and antimalarial use as percentage of time on antimalarial and categorized as never (0%), rarely (>0-25%), occasionally (>25%-50%), commonly (Ë50%-75%) and frequently (Ë75%). Immunosuppressive drugs were recorded as used or not used. The association between demographic, clinical manifestations, therapy and flares was examined using univariable and multivariable conditional logistic regression models. Results A total of 465 cases and controls were included. Mean age at diagnosis among cases and controls was 27.5 vs 29.9 years, p = 0.003; gender and ethnic distributions were comparable among both groups and so was the baseline SLEDAI. Independent factors protective of flares identified by multivariable analysis were older age at diagnosis (OR = 0.929 per every five years, 95% CI 0.869-0.975; p = 0.004) and antimalarial use (frequently vs never, OR = 0.722, 95% CI 0.522-0.998; p = 0.049) whereas azathioprine use (OR = 1.820, 95% CI 1.309-2.531; p < 0.001) and SLEDAI post-baseline were predictive of them (OR = 1.034, 95% CI 1.005-1.064; p = 0.022). Conclusions In this large, longitudinal Latin American cohort, older age at diagnosis and more frequent antimalarial use were protective whereas azathioprine use and higher disease activity were predictive of flares.
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Antimaláricos/uso terapéutico , Glucocorticoides/uso terapéutico , Inmunosupresores/uso terapéutico , Lupus Eritematoso Sistémico/tratamiento farmacológico , Adolescente , Adulto , Factores de Edad , Antimaláricos/efectos adversos , Estudios de Casos y Controles , Femenino , Glucocorticoides/efectos adversos , Humanos , Inmunosupresores/efectos adversos , América Latina/epidemiología , Modelos Logísticos , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/etnología , Masculino , Análisis Multivariante , Oportunidad Relativa , Factores Protectores , Inducción de Remisión , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND AIMS: Stem cell transplantation is an excellent option for regenerative or replacement therapy. However, deleterious microenvironmental and endogenous factors (e.g., oxidative stress) compromise ongoing graft survival and longevity. Therefore, (transient or stable) genetically modified cells may be reasonably thought to resist oxidative stress-induced damage. Genetic engineering of mesenchymal stromal cells (MSCs) obtained from Wharton's jelly tissue may offer some therapeutic potential. PARKIN is a multifunctional ubiquitin ligase able to protect dopaminergic cells against stress-related signaling. We, therefore, evaluated the effect of the neurotoxicant 6-hydroxydopamine (6-OHDA) on regulated cell death signaling in MSCs and investigated whether overexpression of PARKIN in MSCs was capable of modulating the effect of 6-OHDA. METHODS: We transiently transfected Wharton's jelly-derived MSCs with an mCherry-PARKIN vector using the Lipofectamine LTX method. Naïve MSCs and MSCs overexpressing PARKIN were exposed to increasing concentrations of 6-OHDA. We used light and fluorescence microscopy, flow cytometry, immunocytochemistry staining, in-cell Western and Western blot analysis. RESULTS: After 12-24 h of 6-OHDA exposure, we detected dichlorofluorescein (DCF)-positive cells (80%) indicative of reactive oxygen species (H2O2) production, reduced cell viability (40-50%), decreased mitochondrial membrane potential (ΔΨm, ~35-45%), DNA fragmentation (18-30%), and G1-arrested cell cycle in the MSCs. 6-OHDA exposure increased the expression of the transcription factor c-JUN, increased the expression of the mitochondria maintenance Phosphatase and tensin homologue-induced putative kinase 1 (PINK1) protein and increased the expression of pro-apoptotic PUMA, caspase-3 and apoptosis-inducing factor (AIF). 6-OHDA exposure also significantly augmented the oxidation of the oxidative stress sensor, DJ-1. Overexpression of PARKIN in MSCs not only significantly reduced the expression of cell death and oxidative stress markers but also significantly reduced DCF-positive cells (~50% reduction). DISCUSSION: 6-OHDA induced apoptosis in MSCs via generation of H2O2, activation of c-JUN and PUMA, mitochondrial depolarization and nuclei fragmentation. Our findings suggest that PARKIN protects MSCs against 6-OHDA toxicity by partly interacting with H2O2, reducing the expression of c-JUN, PUMA, AIF and caspase-3, and maintaining the mitochondrial ΔΨm.
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Apoptosis , Células Madre Mesenquimatosas/metabolismo , Enfermedad de Parkinson/patología , Enfermedad de Parkinson/terapia , Ubiquitina-Proteína Ligasas/metabolismo , Gelatina de Wharton/citología , Apoptosis/efectos de los fármacos , Caspasa 3 , Supervivencia Celular , Humanos , Peróxido de Hidrógeno/farmacología , Potencial de la Membrana Mitocondrial , Trasplante de Células Madre Mesenquimatosas , Mitocondrias/metabolismo , Estrés Oxidativo , Oxidopamina , Fenotipo , Especies Reactivas de Oxígeno/metabolismo , Transducción de SeñalRESUMEN
A 9-valent HPV (9vHPV) vaccine has been developed to protect against HPV type 6/11/16/18/31/33/45/52/58-related infection and disease. Previous safety analyses from 7 clinical trials conducted in 9vHPV vaccine recipients 9-26 years of age, including comparisons of 9vHPV and quadrivalent HPV (qHPV) vaccines in girls and women 16-26 years of age, showed that the 9vHPV vaccine was generally well tolerated. Additional safety analyses were conducted to include the results of new clinical studies. The safety profile of the 9vHPV vaccine in prior qHPV vaccine recipients (n = 3756 from 1 randomized controlled trial and 2 open-label extension studies) and young men (n = 248 9vHPV and n = 248 qHPV vaccine recipients from 1 randomized controlled trial) was evaluated. Vaccine was administered as a 3-dose regimen (at Day 1 and Months 2 and 6), and adverse events (AEs) were monitored. The most common AEs were injection-site events (91.1% and 79.0% in prior qHPV vaccine recipients and young men, respectively), the majority of which were mild. Discontinuations due to an AE were rare (0.2% and 0.0% among prior qHPV vaccine recipients and young men, respectively). In young men, the AE profile of the 9vHPV vaccine was generally similar to that of the qHPV vaccine. Overall, the 9vHPV vaccine was generally well tolerated in prior qHPV vaccine recipients and in young men, with an AE profile generally consistent with that previously reported with the broader clinical program.
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Vacunas contra Papillomavirus/efectos adversos , Vacunas contra Papillomavirus/inmunología , Adolescente , Adulto , Niño , Método Doble Ciego , Femenino , Humanos , Masculino , Infecciones por Papillomavirus/prevención & control , Vacunación/efectos adversos , Adulto JovenRESUMEN
Common variable immunodeficiency (CVID) is a syndrome with predominantly defective B cell function. However, abnormalities in the number and function of other lymphocyte subpopulations in peripheral blood (PB) have been described in most patients. We have analysed the distribution of iNKT cell subpopulations in the PB of CVID patients and the ability of these cells to provide in vitro cognate B cell help. The total of iNKT cells was reduced in the PB of CVID patients, especially CD4+, CD4-/CD8- and CCR5+/CXCR3+. These findings were associated with an enrichment of memory-like and a tendency towards a reduction in TNF-α-expressing effector iNKT cells in the peripheral blood mononuclear cells (PBMC) of CVID patients. Moreover, an accumulation of follicular helper iNKT cells in the PB of CVID patients was demonstrated. CVID αGalCer-pulsed iNKT cells are not able to induce autologous B cell proliferation although they do induce proliferation to healthy donor B cells. Interestingly, autologous and heterologous co-cultures did not differ in the amount of immunoglobulin secreted by B cells in vitro. Finally, reduced intracellular SAP expression in iNKT cells and other lymphocytes in the blood from CVID patients was observed. These results provide further insights into the immunological mechanisms underlying the iNKT cell defects and the potential targets to improve B cell help in CVID.
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Linfocitos B/inmunología , Comunicación Celular , Inmunodeficiencia Variable Común/inmunología , Células T Asesinas Naturales/inmunología , Saposinas/metabolismo , Adolescente , Adulto , Antígenos CD4/metabolismo , Antígenos CD8/metabolismo , Proliferación Celular , Células Cultivadas , Técnicas de Cocultivo , Femenino , Galactosilceramidas/inmunología , Humanos , Inmunoglobulinas/metabolismo , Memoria Inmunológica , Activación de Linfocitos , Masculino , Persona de Mediana Edad , Receptores CCR5/metabolismo , Receptores CXCR3/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Adulto JovenRESUMEN
Trypanosoma equiperdum is the causative agent of dourine, a venereal disease in horses and donkeys. This parasite has a widely distribution, is found in Africa, Asia, Southern and Eastern Europe, Russia, Mexico and Venezuela. The T. equiperdum is morphologically indistinguishable to other Trypanozoon species, however differs from other mammalian trypanosomes due to the fact that it is primarily a tissue parasite, generating cutaneous plaques, swelling of genitalia and neurological signs. The aim of this study was to evaluate the trypanocidal effectiveness of a set of derivatives of thiosemicarbazones on a T. equiperdum ex vivo culture. All compounds appeared to have trypanocidal activity, however one of them shown better solubility and a dose-dependent effect. The median inhibitory concentration (IC50) was 1.2µM. The selected compound exhibits a greater inhibitory activity than diminazene aceturate, a common drug for animal trypanosomosis treatment.
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Tiosemicarbazonas/farmacología , Tripanocidas/farmacología , Trypanosoma/efectos de los fármacos , Estructura Molecular , Tiosemicarbazonas/química , Tripanocidas/síntesis químicaRESUMEN
INTRODUCTION: Ritscher-Schinzel syndrome (also known as cranio-cerebello-cardiac dysplasia or 3C syndrome) is a rare genetic syndrome that is mainly characterised by the association of cardiac and craniofacial anomalies together with others affecting the posterior fossa. PATIENTS AND METHODS: We report on 26 patients with Ritscher-Schinzel syndrome at a hospital in Medellin, in the Department of Antioquia, Colombia. RESULTS: Males account for 69% of this cohort. The mean age of the cohort was 30 months, and 42% were under the age of one year at the time of diagnosis. All of them presented ocular disorders, and megalocornea was the most frequent ocular manifestation (69%), whereas low-set ears (80.7%) and septal heart defects (68.7%) were the most common facial and cardiac malformations, respectively. The most frequent malformations of the posterior fossa were megacisterna magna (31.8%) and Dandy-Walker malformation (27%). 84% of the cases had delayed neurodevelopment or intellectual disability. Skeletal manifestations were frequent: the group consisting of camptodactyly, single palmar crease, overlapping fingers, vertical talus and nail hypoplasia were found in hands and feet in 96% of the cases. CONCLUSIONS: Ritscher-Schinzel syndrome is a heterogeneous syndrome from the genetic and clinical point of view. These results suggest that the skeletal and ocular abnormalities that were observed can facilitate the phenotypic diagnosis. However, it is necessary to conduct further studies that allow us to gain a deeper knowledge of its prevalence and help identify other genes involved in this syndrome.
TITLE: Descripcion fenotipica de 26 pacientes con sindrome de Ritscher-Schinzel (displasia craneo-cerebelo-cardiaca o sindrome 3C).Introduccion. El sindrome de Ritscher-Schinzel (tambien conocido como displasia craneo-cerebelo-cardiaca o sindrome 3C) es un sindrome genetico raro que se caracteriza principalmente por la asociacion de anomalias cardiacas, craneofaciales y de la fosa posterior. Pacientes y metodos. Se describen 26 pacientes con sindrome de Ritscher-Schinzel pertenecientes a un hospital de Medellin en el departamento de Antioquia, Colombia. Resultados. La presente cohorte esta compuesta en un 69% por hombres. La mediana de edad de la cohorte fue de 30 meses y el 42% tenia menos de 1 año de edad en el momento del diagnostico. Todos presentaban afectacion ocular, y la megalocornea fue la manifestacion ocular mas frecuente (69%), mientras que las orejas de implantacion baja (80,7%) y los defectos cardiacos septales (68,7%) fueron las malformaciones faciales y cardiacas mas comunes, respectivamente. Las malformaciones de la fosa posterior mas frecuentes fueron megacisterna magna (31,8%) y malformacion de Dandy-Walker (27%). El 84% tenia retraso del neurodesarrollo o discapacidad intelectual. Las manifestaciones esqueleticas fueron frecuentes: el conjunto de camptodactilia, pliegue palmar unico, dedos sobrelapados, astragalo vertical e hipoplasia ungueal en las manos y los pies se hallo en el 96% de los casos. Conclusiones. El sindrome de Ritscher-Schinzel es heterogeneo desde el punto de vista genetico y clinico. Estos resultados sugieren que las anormalidades esqueleticas y oculares observadas pueden facilitar el diagnostico fenotipico. No obstante, es necesario realizar estudios adicionales que permitan conocer mejor su prevalencia y facilitar la identificacion de otros genes implicados en este sindrome.
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Anomalías Múltiples/genética , Cerebelo/anomalías , Fosa Craneal Posterior/anomalías , Anomalías Craneofaciales/genética , Síndrome de Dandy-Walker/genética , Discapacidades del Desarrollo/genética , Anomalías del Ojo/genética , Defectos del Tabique Interatrial/genética , Discapacidad Intelectual/genética , Anomalías Múltiples/patología , Adolescente , Adulto , Niño , Preescolar , Colombia , Córnea/anomalías , Anomalías Craneofaciales/patología , Síndrome de Dandy-Walker/patología , Femenino , Deformidades Congénitas del Pie/genética , Deformidades Congénitas de la Mano/genética , Defectos del Tabique Interatrial/patología , Humanos , Lactante , Recién Nacido , Masculino , Fenotipo , Estudios Retrospectivos , SíndromeRESUMEN
Comprehensive psychiatric rehabilitation programs in Latin America have been designed across several countries in the region without yet achieving full implementation. Facing an increasing burden of disease due to mental disorders, including alcohol and substance use disorders, the region has responded unevenly to the challenge. Moreover, low priority for mental health in national policies and insufficient funding for mental health services are common barriers for the much-needed mental health services reforms. Reestablishing a primary care community-based model of care has been a shared aspiration for most countries during the last two decades. Comprehensive models of psychiatric rehabilitation developed predominantly in high-income countries need to be culturally adapted to local contexts, while strengthening health systems research will provide evidence on the efficiency of locally designed interventions and on the critical milestones to succeed in the scaling up strategies. Increasing participation of patients and their families in the mental health delivery system is another key factor in order to ensure comprehensive patient-centred psychosocial rehabilitation programs in Latin America.
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Servicios Comunitarios de Salud Mental/organización & administración , Trastornos Mentales/diagnóstico , Trastornos Mentales/terapia , Atención Primaria de Salud/métodos , Rehabilitación Psiquiátrica , Humanos , América Latina/epidemiología , Trastornos Mentales/psicologíaRESUMEN
The objective of the study is to find predictors of remission, radiographic progression (RP), and erosive disease in a cohort of patients with early onset rheumatoid arthritis (EORA) that followed a therapeutic protocol aiming at remission, in a real world tight-control setting. EORA patients were enrolled in a 3-year follow-up study. Clinical, biological, immunogenetic, and radiographical data were analyzed. Radiographs were scored according to Sharp-van der Heijde (SvdH) method. RP was defined by an increase of 3 units in 36 months. Remission was defined as DAS28 <2.6. A stepwise multiple logistic regression model was used to identify independent predictors of the three target outcomes. One hundred twenty-nine patients were included. Baseline disease activity was high. Significant overall improvement was observed, but only 33.3 % achieved remission. At 36 month, 50.4 % (65) of patients showed erosions. RP was observed in 62.7 % (81) of cases. Statistical analysis showed that baseline SvdH score was the only predictive factor associated with the three outcomes evaluated. Lower HAQ-DI and absence of autoantibodies were predictive of remission. Higher levels of ESR and presence of erosions at entry were predictive of RP. Independent baseline predictors of incident erosive disease were anti-CCP and RF positivity, symptom duration at baseline >3 months, and presence of HLA-DRB1 shared epitope. Radiographic damage at baseline was the main predictor of outcomes. Autoantibodies, HAQ and ESR at baseline, symptom duration before diagnosis, and HLA-DRB1 status had influence on clinical course and development of structural joint damage in Colombian RA patients.
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Artritis Reumatoide/diagnóstico por imagen , Artritis Reumatoide/patología , Adulto , Antirreumáticos/administración & dosificación , Artritis Reumatoide/tratamiento farmacológico , Autoanticuerpos/sangre , Colombia , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Cadenas HLA-DRB1/genética , Humanos , Modelos Logísticos , Masculino , Metotrexato/administración & dosificación , Persona de Mediana Edad , Péptidos Cíclicos/inmunología , Estudios Prospectivos , Radiografía , Inducción de Remisión , Factor Reumatoide/inmunología , Índice de Severidad de la EnfermedadRESUMEN
AIM: To evaluate the ability of a calcium silicate-based sealer (iRoot SP) and an epoxy resin-based sealer (Topseal) using two gutta-percha filling techniques to fill artificial lateral canals (ALCs). METHODOLOGY: Seventy single-rooted human teeth were selected. Ten of these were used to obtain pilot data. Three ALCs were produced on mesial and distal surfaces of each root, one in each third, using size 10 engine reamers. The roots were randomly assigned to four experimental groups according to the filling technique and sealer used: 1, cold gutta-percha (single-point technique) with iRoot SP (SP-iR); 2, cold gutta-percha (single-point technique) with Topseal (SP-T); 3, continuous wave of condensation technique with iRoot SP (CWC-iR); and 4, continuous wave of condensation technique with Topseal (CWC-T). Digital periapical radiographs were taken. After the sealer had set, the roots were demineralized, cleared in methyl-salicylate and examined under a stereomicroscope. The depth of penetration of sealer and/or gutta-percha into the ALC was scored using a 5-point system, conducting an analysis on four surfaces. Filling scores of 0-1 were considered not acceptable, whilst scores of 2-4 were considered acceptable. Pearson's chi-square test was used to compare the experimental groups (P < 0.05). RESULTS: CWC-T was associated with the highest acceptable filling (57.8%), followed by CWC-iR (53.3%), SP-T (48.9%) and SP-iR (36.7%). Only when SP-iR was compared to the other groups, was the difference significant (P < 0.05). The apical third was associated with the lowest acceptable filling (37.5%). It was followed, in ascending order, by the middle (51.6%) and coronal thirds (58.3%). These differences were significant only when the apical thirds were compared to the other root thirds (P < 0.05). CONCLUSION: The calcium silicate-based sealer with continuous wave of condensation was more effective in artificial filling lateral canals than the single-point technique. The epoxy resin-based sealer with both filling techniques was effective in artificial filling lateral canals.
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Compuestos de Calcio/química , Resinas Epoxi/química , Gutapercha/química , Materiales de Obturación del Conducto Radicular/química , Obturación del Conducto Radicular/métodos , Silicatos/química , Humanos , Técnicas In Vitro , Microscopía Electrónica de Rastreo , Proyectos Piloto , Distribución Aleatoria , Preparación del Conducto Radicular/métodosRESUMEN
Understanding the demographic history and genetic make-up of colonizing species is critical for inferring population sources and colonization routes. This is of main interest for designing accurate control measures in areas newly colonized by vector species of economically important pathogens. The biting midge Culicoides imicola is a major vector of orbiviruses to livestock. Historically, the distribution of this species was limited to the Afrotropical region. Entomological surveys first revealed the presence of C. imicola in the south of the Mediterranean basin by the 1970s. Following recurrent reports of massive bluetongue outbreaks since the 1990s, the presence of the species was confirmed in northern areas. In this study, we addressed the chronology and processes of C. imicola colonization in the Mediterranean basin. We characterized the genetic structure of its populations across Mediterranean and African regions using both mitochondrial and nuclear markers, and combined phylogeographical analyses with population genetics and approximate Bayesian computation. We found a west/east genetic differentiation between populations, occurring both within Africa and within the Mediterranean basin. We demonstrated that three of these groups had experienced demographic expansions in the Pleistocene, probably because of climate changes during this period. Finally, we showed that C. imicola could have colonized the Mediterranean basin in the Late Pleistocene or Early Holocene through a single event of introduction; however, we cannot exclude the hypothesis involving two routes of colonization. Thus, the recent bluetongue outbreaks are not linked to C. imicola colonization event, but rather to biological changes in the vector or the virus.