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1.
Early Hum Dev ; 194: 106038, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38776727

RESUMO

BACKGROUND: The excess neonatal adiposity is considered a risk factor for the development of childhood obesity and the birth weight is a marker of health throughout life. AIMS: To evaluate the effect of a lifestyle intervention conducted among pregnant women with overweight on neonatal adiposity and birth weight. METHODS: A total of 350 pregnant women were recruited and randomly allocated into the control (CG) and intervention (IG) groups. Pregnant women in the IG were invited to participate in three nutritional counselling sessions based on encouraging the consumption of unprocessed and minimally processed foods, rather than ultra-processed foods, following the NOVA food classification system, which categorizes foods according to the extent and purpose of industrial processing, and the regular practice of physical activity. Neonatal adiposity was estimated using a previously validated anthropometric model. Adjusted linear regression models were used to measure the effect. RESULTS: Adopting the modified intention-to-treat principle, data from 256 neonates were analyzed for birth weight, and data from 163 for body composition estimation. The treatment had no effect on the proportion of fat mass [ß 0.52 (95 % CI -1.03, 2.06); p = .51], fat-free mass [ß -0.50 (95 % CI -2.45, 1.45); p = .61] or birth weight [ß 53.23 (95 % CI -87.19, 193.64); p = .46]. CONCLUSIONS: In the present study, the lifestyle counselling used had no effect on neonatal adiposity or birth weight. Future studies should investigate the effect of more intensive interventions.


Assuntos
Adiposidade , Peso ao Nascer , Sobrepeso , Humanos , Feminino , Gravidez , Recém-Nascido , Adulto , Sobrepeso/terapia , Estilo de Vida , Exercício Físico , Complicações na Gravidez/terapia
2.
Ecancermedicalscience ; 18: 1665, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38439800

RESUMO

Introduction: Communication in a doctor-patient relationship constitutes a crucial aspect in medicine, and its multiple dimensions encompass a wide variety of ethical issues. Communication is particularly relevant in oncology, because it requires continually dealing with sensitive topics in one of the most highly vulnerable situations as a human: illness and proximity to death. Sexuality is one of these topics because it constitutes an area that is frequently affected by cancer and cancer treatment, which may include causing significant distress, the reinforcement of a negative self-image, relationship conflicts and a permanent memory of having cancer. The objective of this research is to describe the perception of knowledge and communications practices used by oncology doctors with respect to sexual health in the care of their patients, as well as the barriers found when it comes to confronting the topic. Methods: An exploratory quantitative, descriptive and cross-sectional study was carried out, in which a self-administered questionnaire was given to oncology doctors who practise in Chile. This questionnaire had 41 closed questions with answers on a Likert scale and was previously validated by being reviewed and applied to a pilot group of five professionals (one medical bioethics expert and four doctors in the field of oncology). The data were analysed with the SPSS statistical program v. 20, using descriptive statistics. Results: The main results show that the surveyed doctors consider sexuality to be an important part of patients' quality of life. However, this finding does not align with the practices given for including it as part of clinical care. The professionals refer as the main barriers those that are attributed to the structural functioning of the institution, giving little value to those barriers related to personal aspects or those associated with patient characteristics and/or behaviors. Conclusion: The results of this study show that, despite oncology doctors seeing sexuality as an important aspect of the quality of life of their patients, they do not include the topic in clinical care. Given that one of the main barriers is obstacles relating to the institution, it is necessary to create political institutions that create the conditions for including this area as a relevant part of cancer patient care.

4.
Eur J Nutr ; 62(1): 443-454, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36087136

RESUMO

PURPOSE: This study aimed at evaluating the effectiveness of a nutritional counselling intervention based on encouraging the consumption of unprocessed and minimally processed foods, rather than ultra-processed products, and the practice of physical activities to prevent excessive gestational weight gain in overweight pregnant women. METHODS: This was a two-armed, parallel, randomized controlled trial conducted in primary health units of a Brazilian municipality from 2018 to 2021. Overweight, adult pregnant women (n = 350) were randomly assigned to control (CG) or intervention groups (IG). The intervention consisted of three individualized nutritional counselling sessions based on encouraging the consumption of unprocessed and minimally processed foods rather than ultra-processed products, following the NOVA food classification system, and the practice of physical activities. The primary outcome was the proportion of women whose weekly gestational weight gain (GWG) exceeded the Institute of Medicine guidelines. Adjusted logistic regression models were employed. RESULTS: Complete data on weight gain were available for 121 women of the IG and 139 of the CG. In modified intention-to-treat analysis, there was a lower chance of the IG women having excessive GWG [OR 0.56 (95% CI 0.32, 0.98), p = .04], when compared to the CG. No between-group differences were observed for the other maternal outcomes investigated. CONCLUSION: The present study was unprecedented in demonstrating that nutritional counselling based on the NOVA food classification system, together with encouraging the practice of physical activity, is effective in preventing excessive weight gain in overweight pregnant women. TRIAL REGISTRATION: Registered on July 30th 2018 at Brazilian Registry of Clinical Trials (RBR-2w9bhc).


Assuntos
Ganho de Peso na Gestação , Complicações na Gravidez , Adulto , Feminino , Gravidez , Humanos , Sobrepeso/prevenção & controle , Gestantes , Alimento Processado , Aumento de Peso , Aconselhamento , Complicações na Gravidez/prevenção & controle
5.
Int J Public Health ; 67: 1604548, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36339661

RESUMO

Objective: We aimed to quantify SARS-CoV-2 specific antibodies' seroprevalence among university students in Porto. Methods: A rapid point of care testing for SARS-CoV-2 specific immunoglobulin (Ig) M and IgG antibodies was performed, and a questionnaire was applied to 6512 voluntary students from September to December 2020. We computed the apparent IgM, IgG, and IgM or IgG prevalence, and the true prevalence and 95% credible intervals (95% CI) using Bayesian inference. Results: We found an apparent prevalence (IgM or IgG) of 9.7%, the true prevalence being 7.9% (95% CI 4.9-11.1). Prevalence was significantly higher among males (10.9% vs. 9.2%), international students (18.1% vs. 10.4% local vs. 8.8% nationally displaced), and increased with age. Those with a known risk contact, that experienced quarantine, had symptoms, or a previous negative molecular test had a higher seroprevalence. Of the 91 (1.4%) students who reported a molecular diagnosis, 86.8% were reactive for IgM or IgG. Conclusion: Based on immunological evidence infection was 5.6-fold the reported molecular diagnosis. The higher seroprevalence among male, older, and international students emphasizes the importance of identifying particular groups.


Assuntos
COVID-19 , Masculino , Humanos , COVID-19/epidemiologia , Estudos Soroepidemiológicos , SARS-CoV-2 , Estudos Transversais , Imunoglobulina M , Teorema de Bayes , Anticorpos Antivirais , Imunoglobulina G , Estudantes
6.
BMJ Open ; 12(11): e066585, 2022 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-36385019

RESUMO

INTRODUCTION: Our community-based participatory research partnership aims to expand understanding of the social, ethical and behavioural implications of COVID-19 testing and vaccination to inform the development of an integrated intervention that harnesses community-based peer navigation and mHealth strategies to improve COVID-19 testing and vaccination; test the intervention; and develop and disseminate practice, research and policy recommendations to further increase COVID-19 testing and vaccination among Spanish-speaking Latine communities in the USA. METHODS AND ANALYSIS: We will conduct 50 individual in-depth interviews with health providers, who have conducted COVID-19 testing and/or vaccination activities within Spanish-speaking communities, and with representatives from Latine-serving community-based organisations. We will also conduct six focus groups with 8-12 Spanish-speaking Latine community member participants each for a total number of about 60 focus group participants. Next, we will develop the Nuestra Comunidad Saludable intervention based on findings from interviews and focus groups and use a longitudinal group-randomised trial design with two arms (intervention and delayed intervention) to evaluate the impact of the intervention. We will recruit, enrol and collect baseline data from 20 community-based peer navigators (Navegantes) and their social network members (n=8 unique social network members per Navegante). Navegantes (coupled with their social networks) will be randomised to intervention or delayed intervention groups (10 Navegantes and 80 social network members per group). ETHICS AND DISSEMINATION: Ethical approval for data collection was granted by the Wake Forest University School of Medicine Institutional Review Board. Following the description of study procedures, we will obtain consent from all study participants. Study findings will be disseminated through an empowerment theory-based community forum, peer-reviewed publications and presentations at scientific meetings, and reports and briefs for lay, community and practitioner audiences. TRIAL REGISTRATION NUMBER: NCT05302908.


Assuntos
Teste para COVID-19 , COVID-19 , Humanos , Estados Unidos , COVID-19/prevenção & controle , Hispânico ou Latino , Vacinação , Rede Social , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
Am J Community Psychol ; 69(3-4): 318-330, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35285953

RESUMO

Community-based participatory research (CBPR) approaches to promoting justice focus on working from the ground up and giving a voice to marginalized communities regarding their concerns, potential solutions, and how to address social justice issues that matter to them. The pursuit of justice is often related to efforts to attain personal as well as collective well-being. In this paper, we illustrate three exemplars of community psychologists' efforts to promote justice. Within each case study, we discuss the social and community context and examine how the researchers built partnerships and solidarity, developed ways of doing, and approached challenges and solutions. First, we present an example to promote economic justice through an entrepreneurship initiative developed in collaboration with young Black youth with disabilities in the United States. The second case illustrates an effort to promote reproductive justice in collaboration with Roma women and girls in Spain. The third exemplar depicts the use of life stories as a method to raise the voices of displaced, marginalized indigenous women in Peru. Based on these three case studies, we present a synthesis model of social justice. We also discuss implications for future studies emphasizing the importance of engaging community participants in research meaningful ways, developing sustainable partnerships, and decolonizing research.


Assuntos
Roma (Grupo Étnico) , Justiça Social , Adolescente , Pesquisa Participativa Baseada na Comunidade/métodos , Feminino , Humanos , Peru , Espanha , Estados Unidos
8.
Nutr Res ; 100: 47-57, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35220081

RESUMO

A pro-inflammatory diet in pregnant women is associated with an increased risk of harmful maternal and fetal health outcomes. The present study aimed to investigate the relationship between the maternal energy-adjusted dietary inflammatory index (E-DII) and the classification of birth weight of newborns. We hypothesized that a maternal pro-inflammatory diet would be associated with a higher chance of inadequate birth weight infants. A prospective cohort study was conducted among 600 mother-infant pairs in Brazil. The E-DII was calculated through 24-hour dietary recalls on 2 occassions, using 36 of its 45 components. Secondary data on birth weight, sex of the newborns, and gestational age at birth were obtained. Adjusted logistic regression models were used to investigate the relationship between the maternal E-DII (in tertiles) and birth weight categories. The mothers' mean (standard deviation [SD]) age was 27 (5) years, 32.2% were overweight, and 21.5% had prepregnancy obesity. In total, 62 (10.3%) cases of small-for-gestational-age newborns and 79 (13.2%) of large-for-gestational-age (LGA) newborns were identified. The mean (SD) of the E-DII was 1.6 (1.5), ranging from -2.6 to 6.0. In adjusted logistic regression models, it was found that women classified in the third tertile of the E-DII had higher odds of having LGA infants (odds ratio, 2.07 [95% confidence interval, 1.07-4.02], P =.03), when compared with the women classified in the first tertile. A maternal pro-inflammatory diet was associated with a higher chance of LGA infants, reinforcing the relevance of the consumption of foods naturally rich in antioxidants during pregnancy.


Assuntos
Dieta , Retardo do Crescimento Fetal , Adulto , Peso ao Nascer , Índice de Massa Corporal , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Gravidez , Estudos Prospectivos
9.
Am J Community Psychol ; 70(1-2): 89-101, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-34963017

RESUMO

Asset mapping is a participatory methodology that engages community members in identifying services and settings that promote health and well-being. This study aimed to identify community assets from the perspective of Latinx immigrant families with youth with disabilities. Latinx immigrant families (n = 21) participated in the mapping, followed by a reflection session and an open forum (n = 30). The findings revealed that families identified faith-based organizations and social service agencies as some of the main assets in their communities, while they identified mental health services as the most needed. The results also showed that participants preferred to utilize services and resources that are within walking distance of their homes, provide safe spaces, treat them well, offer bilingual services, do not require documentation, and are affordable. This study has important implications for community scholars and practitioners interested in implementing asset-based methodologies that focus on participants as experts of their own realities and agents of change and that promote advocacy and empowerment actions.


Assuntos
Pessoas com Deficiência , Emigrantes e Imigrantes , Adolescente , Promoção da Saúde/métodos , Humanos
10.
Gac Sanit ; 36(2): 118-126, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-33234337

RESUMO

OBJECTIVE: The objective of this study is to build advocacy capacity among a group of gipsy Roma neighbours living in contexts of risk of social exclusion. METHODS: A Community Based Participatory Action Research design was used, in which 4 members of the community participated in the process of collecting evidence by photo-voice, analysing it using the ReACT method and disseminating the results. RESULTS: A total of 96 pieces of evidence were collected and analysed for qualitative data analysis. These were categorised according to (a) the type of unhealthy conditions and (b) the area of the neighbourhood where they were located. The subsequent thematic grouping made it possible to identify the causes: (a) the abandonment of public services; (b) discrimination; and (c) the lack of Roma presence in community spaces. The consequences identified were (a) mental and physical health problems and (b) the normalisation of undignified living conditions. The plan was designed to advocate for the presence of Roma in community spaces. CONCLUSIONS: Our study highlighted the relevance of the photo-voice to transcend the biomedical perspective and develop advocacy actions based on the knowledge created by the community. Future research should look more deeply into the impact of health advocacy on reducing inequalities and consider the importance of involving researchers, public health professionals and the community in addressing it.


Assuntos
Roma (Grupo Étnico) , Pesquisa Participativa Baseada na Comunidade/métodos , Humanos , Saúde Pública , Características de Residência
11.
J Community Psychol ; 48(8): 2773-2788, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33016345

RESUMO

Individuals migrate to improve their wellbeing and quality of life, and often experience adverse situations, both during the process of migration and once within the host country. The purpose of this paper is to unpack the barriers to and facilitators of community participation, among Latinx immigrants with disabilities in the United States and Latinx migrant workers in Canada, following the Social Ecological Model. The authors draw from an appraisal of existing literature and their own participatory research with Latinx immigrants. Based on this integrative literature review, Latinx experience individual issues such as language barriers and lack of knowledge of the services available to them. At the community level they experience discrimination, limited opportunities for community participation, and lack of opportunities for meaningful employment. At the systemic and policy level in the United States, the antimigrant political environment keeps Latinx immigrants with disabilities from participating in their communities due to fear of deportation. In Canada, Latinx workers experience the paradox of migration and discrimination. The discussion of barriers and facilitators is followed by recommendations for community research and action.


Assuntos
Participação da Comunidade , Pessoas com Deficiência , Emigrantes e Imigrantes , Migrantes , Canadá/epidemiologia , Feminino , Hispânico ou Latino , Humanos , América Latina/etnologia , Masculino , Estados Unidos/epidemiologia
12.
Rev. MVZ Córdoba ; 25(2): 81-89, mayo-ago. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1340776

RESUMO

RESUMEN Objetivo. Evaluar el estado actual de Melongena melongena en la bahía de Cispatá, Caribe Colombiano a través de los aspectos poblacionales de la especie. Materiales y métodos. Se establecieron tres sectores de muestreo, conforme con la zonificación de los manglares en la bahía. Para la recolección del material biológico se ubicó un transecto lineal de 4 x 20 m perpendicular al área del manglar con dos replicas a una distancia de 50 m. Para la determinación del sexo, se tomó una submuestra de 10 individuos con tallas superiores a la estimada para la madurez sexual de la especie. A las conchas se les midió la longitud total, con el fin de diferenciar las tallas de hembras y machos. En cada sector, la temperatura del agua y salinidad fueron registradas in situ, empleando un medidor multiparámetro Extech EC170, mientras la trasparencia del agua se calculó mediante el disco Secchi. Resultados. Se registraron un total de 1.149 individuos de M. melongena, obteniendo la mayor abundancia el sector Caño Salado (522), seguido de Las Cagás (458) y finalmente Amaya (169). El 63% de los individuos se encontraron en un intervalo de talla entre 41-61 mm. La proporción sexual fue 1:1.2 (H:M). Las tallas registradas en hembras fueron de 55 a 92 mm y en machos de 54 a 77 mm. Conclusiones. M. melongena en la bahía de Cispatá está presentando signos evidentes de recuperación en la última década, debido a que la mayoría de los individuos registrados han alcanzado la talla media de madurez sexual.


ABSTRACT Objective. Evaluate the current status of Melongena melongena in Cispata Bay, Colombian Caribbean through the population aspects of the species. Materials and methods. Three sampling sectors were established, according to the zoning of the mangrove in the bay. For the collection of the biological material a linear transect of 4 x 20 m was located perpendicular to the area of the mangrove with two replicas at a distance of 50 m. For the determination of sex, a subsample of 10 individuals with sizes greater than that estimated for the sexual maturity of the species was taken. The shells were measured in total length, in order to differentiate the sizes of females and males. In each sector, the water temperature and salinity were measured in situ using an Extech EC170 multiparameter while water transparency is calculated using the Secchi disk. Results. A total of 1,149 individuals of M. melongena were recorded, obtaining the highest abundance in the Caño Salado sector (522), followed by Las Cagás (458) and finally Amaya (169). 63% of the individuals were in a size range between 41-61 mm. The sex ratio was 1:1.2 (H:M). The sizes recorded in females were from 55 to 92 mm and in males from 54 to 77 mm. Conclusions. M. melongena in Cispatá Bay is showing evident signs of recovery in the last decade, because most of the registered individuals have reached the average size of sexual maturity.


Assuntos
Animais , Caramujos , Áreas Alagadas , Moluscos , Estuários
13.
Am J Community Psychol ; 66(3-4): 347-357, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32696550

RESUMO

The pervasive failure of policies aimed at overcoming health inequities suffered by European Roma reflects the oppressive and impoverished living conditions of many ethnic minorities in the Western world. The multiple social inequities that Roma experience and the cumulative effect on their health prove that the failure of health policies that impact Roma must be attributed to their ameliorative nature. These policies legitimize the mechanisms of oppression that sustain inequities, fueling fatalistic attitudes toward minorities, while these minorities internalize the stigma and attempt to survive on the margins of society. This paper presents the RoAd4Health project, a community initiative in which academic researchers partnered with Roma communities to overcome health inequities. We present the multiple methods utilized for building meaningful advocacy, such as photovoice and asset mapping led by Roma agents of change. These methods provided the capacity to develop a local narrative of disparities, build alliances to gain capacity to respond to injustices, and take actions to promote social change. The results of effectively involving all significant stakeholders (i.e., community agents of change, residents, health and social care providers, Roma community grassroots organizations, and institutional actors) are discussed along with lessons learned.


Assuntos
Relações Comunidade-Instituição , Etnicidade , Equidade em Saúde , Adolescente , Adulto , Serviços de Saúde Comunitária , Feminino , Política de Saúde , Acessibilidade aos Serviços de Saúde , Disparidades nos Níveis de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários , Narração , Fotografação , Roma (Grupo Étnico) , Estigma Social , Espanha , Adulto Jovem
14.
Gac Sanit ; 34(4): 411-414, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-31767201

RESUMO

This article describes a workshop whose objective was to build Roma health advocacy capacity among a group of health professionals. Health advocacy is recommended by international organizations and public health experts to overcome the health inequities that Roma populations suffer. Sixteen professionals from three health centres located in neighbourhoods with a high Roma population participated. The workshop was organized in three sessions aimed at raising awareness, sharing an advocacy framework and methodology and designing an advocacy plan. We highlight the utility of spaces for reflection and analysis, the need to advocate for Roma health with Roma leaders and community sectors, identification of opportunities and utilization of community resources. Future research should strengthen the development of intersectoral advocacy plans, disseminate them and facilitate their implementation in other contexts with similar characteristics.


Assuntos
Roma (Grupo Étnico) , Humanos , Saúde Pública
15.
Artigo em Inglês | MEDLINE | ID: mdl-31581695

RESUMO

Addressing health disparities and promoting health equity for Roma has been a challenge. The Roma are the largest disadvantaged ethnic minority population in Europe and have been the victims of deep social and economic injustices, institutional discrimination, and structural antigypsyism over many centuries. This has resulted in a much worse health status than their non-Roma counterparts. Current strategies based on ameliorative and top-down approaches to service delivery have resulted in paradoxical effects that solidify health disparities, since they do not effectively address the problems of vulnerable Roma groups. Following a health justice approach, we present a community-based participatory action research case study generated by a community and university partnership intended to address power imbalances and build collaboration among local stakeholders. This case study involved a group of health providers, Roma residents, researchers, Roma community organizations, and other stakeholders in the Poligono Sur, a neighborhood of Seville, Spain. The case study comprises four phases: (1) identifying Roma health assets, (2) empowering Roma community through sociopolitical awareness, (3) promoting alliances between Roma and community resources/institutions, and (4) building a common agenda for promoting Roma health justice. We highlighted best practices for developing processes to influence Roma health equity in local health policy agendas.


Assuntos
Pesquisa Participativa Baseada na Comunidade/métodos , Equidade em Saúde , Política de Saúde , Disparidades em Assistência à Saúde , Roma (Grupo Étnico)/psicologia , Roma (Grupo Étnico)/estatística & dados numéricos , Justiça Social , Etnicidade/psicologia , Etnicidade/estatística & dados numéricos , Promoção da Saúde/métodos , Humanos , Grupos Minoritários/psicologia , Grupos Minoritários/estatística & dados numéricos , Estigma Social , Espanha
16.
Cancer Med ; 8(6): 2942-2949, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31050162

RESUMO

To determine potential predictors of long-term survival in a large set of Hispanic (Mexican) patients with chronic myeloid leukemia (CML) treated with imatinib. We conducted an analysis with data from 411 patients with CML treated at the National Cancer Institute - Mexico, between January 2000 and December 2016. We found a median age at diagnosis of 40 years (range: 18-84 years). The survival rate at 150 months was 82.02%, and we found that phase at diagnosis (ß: 0.447, 95% Confidence Interval [95% CI]: 0.088, 0.806; P = 0.015), prognostic scales (Sokal [P = 0.021] and Hasford [ß: 0.369, 95% CI: 0.049, 0.688; P = 0.024]) and hematological response at 3 months (ß: 0.717, 95% CI: 0.443, 0.991; P < 0.001), but not molecular response (P = 0.834 for 6 months, P = 0.927 for 12 months, P = 0.250 for 18 months), were independently associated with overall survival. Survival analysis in subsets, according to the initial phase (chronic, accelerated and blastic phase) did not show any effect according to prognostic scales (P > 0.05). Mexican patients with CML have repeatedly been diagnosed at earlier ages. Prognostic factors in CML may differ according to the ethnic or geographical context. We found that phase at diagnosis, prognostic scale and hematological response at 3 months were independent predictors of survival.


Assuntos
Antineoplásicos/uso terapêutico , Mesilato de Imatinib/uso terapêutico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/farmacologia , Feminino , História do Século XXI , Humanos , Mesilato de Imatinib/farmacologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/mortalidade , Masculino , México , Pessoa de Meia-Idade , National Cancer Institute (U.S.) , Prognóstico , Análise de Sobrevida , Resultado do Tratamento , Estados Unidos , Adulto Jovem
17.
Org Biomol Chem ; 17(11): 2906-2912, 2019 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-30672956

RESUMO

Herein, we report the design and synthesis of two novel bifunctional dendrons bearing multiple amine termini at the periphery and an azide at the focal point. Copper-catalyzed alkyne-azide cycloaddition enabled modular dendritic scaffold assembly resulting in a first generation dendron carrying six amines and a second generation dendron carrying eighteen amines. Peripheral amines were labeled with multiple copies of a metal isotope, whereas the azide functionality at the focal point was employed in conjugation to a single anti-human CD4 antibody. We demonstrated that the highly monomeric first generation dendron-antibody conjugate selectively detected CD4+ T cells in the PMBC culture.


Assuntos
Aminas/química , Anticorpos/química , Azidas/química , Dendrímeros/química , Aminas/imunologia , Anticorpos/imunologia , Reações Antígeno-Anticorpo , Azidas/imunologia , Antígenos CD4/química , Antígenos CD4/imunologia , Linfócitos T CD4-Positivos/citologia , Linfócitos T CD4-Positivos/imunologia , Catálise , Células Cultivadas , Cobre/química , Dendrímeros/síntese química , Humanos , Estrutura Molecular
18.
Eur J Med Chem ; 149: 69-78, 2018 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-29499488

RESUMO

Hybrid compounds may play a critical role in the context of the malaria eradication agenda, which will benefit from therapeutic tools active against the symptomatic erythrocytic stage of Plasmodium infection, and also capable of eliminating liver stage parasites. To address the need for efficient multistage antiplasmodial compounds, a small library of 1,2,4,5-tetraoxane-8- aminoquinoline hybrids, with the metabolically labile C-5 position of the 8-aminoquinoline moiety blocked with aryl groups, was synthesized and screened for antiplasmodial activity and metabolic stability. The hybrid compounds inhibited development of intra-erythrocytic forms of the multidrug-resistant Plasmodium falciparum W2 strain, with EC50 values in the nM range, and with low cytotoxicity against mammalian cells. The compounds also inhibited the development of P. berghei liver stage parasites, with the most potent compounds displaying EC50 values in the low µM range. SAR analysis revealed that unbranched linkers between the endoperoxide and 8-aminoquinoline pharmacophores are most beneficial for dual antiplasmodial activity. Importantly, hybrids were significantly more potent than a 1:1 mixture of 8-aminoquinoline-tetraoxane, highlighting the superiority of the hybrid approach over the combination therapy. Furthermore, aryl substituents at C-5 of the 8-aminoquinoline moiety improve the compounds' metabolic stability when compared with their primaquine (i.e. C-5 unsubstituted) counterparts. Overall, this study reveals that blocking the quinoline C-5 position does not result in loss of dual-stage antimalarial activity, and that tetraoxane-8- aminoquinoline hybrids are an attractive approach to achieve elimination of exo- and intraerythrocytic parasites, thus with the potential to be used in malaria eradication campaigns.


Assuntos
Aminoquinolinas/química , Aminoquinolinas/uso terapêutico , Antimaláricos/síntese química , Aminoquinolinas/metabolismo , Animais , Antimaláricos/metabolismo , Antimaláricos/farmacologia , Avaliação Pré-Clínica de Medicamentos , Estabilidade de Medicamentos , Eritrócitos/parasitologia , Humanos , Fígado/parasitologia , Peróxidos/química , Peróxidos/metabolismo , Plasmodium berghei/efeitos dos fármacos , Plasmodium falciparum/efeitos dos fármacos , Bibliotecas de Moléculas Pequenas/síntese química , Relação Estrutura-Atividade
19.
J Prev Interv Community ; 46(1): 84-99, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29281603

RESUMO

The health inequities suffered by the Roma population in Europe represent an alarming and unacceptable source of injustice. As the main ethnic minority in Europe, the gap between the health conditions of the Roma and the rest of the population poses a challenge to human rights and public health. Many political efforts have been deployed in Europe to tackle these inequities. However, they have fallen short, even causing paradoxical consequences. In this paper, we argue that previous political efforts have failed because they were developed from a neoliberal perspective, which perceives Roma health inequities as isolated ethnic problems for which there is no political accountability. Hence, there is a need for transformative political change that results in the protection of rights and self-governance to address health inequities experienced by Roma people. We propose a framework of health governance guided by the following principles: (a) effective involvement of multiple stakeholders by building collaborative capacity; (b) infusion of health perspectives in all policies and multisectoral actions;


Assuntos
Política de Saúde , Disparidades nos Níveis de Saúde , Política , Roma (Grupo Étnico) , Bulgária , Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Hungria , Roma (Grupo Étnico)/psicologia , Romênia , Justiça Social
20.
Prev Vet Med ; 143: 30-38, 2017 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-28622789

RESUMO

Rabies is a zoonotic disease of great impact to public health. According to the World Health Organization, the country of Chile is currently declared free from human rabies transmitted by dogs. An epidemiological characterization and description was conducted using rabies data from 2003 to 2013 held by the National Program for Prevention and Control of Rabies from the Ministry of Health, consisting of bats samples reported as suspect and samples taken by active surveillance (bats brain tissue). Spatial autocorrelation analysis was performed using Local Indicators of Spatial Association (LISA) statistics, particularly Moran's I index, for the detection of spatial clusters. Temporal descriptive analysis was also carried out. Nine hundred and twenty-seven positive cases were reported, presenting an average of 84 cases per year, mainly originated from passive surveillance (98.5%), whilst only 1.5% of cases were reported by active surveillance. Global positivity for the study period was 7.02% and 0.1% in passive and active surveillance respectively. Most of the cases were reported in the central zone of Chile (88.1%), followed by south zone (9.1%) and north zone (2.8%). At a regional level, Metropolitana (40.6%), Valparaíso (19.1%) and Maule (11.8%) regions reported the majority of the cases. Tadarida brasiliensis (92%) presented the majority of the cases reported, with viral variant 4 (82%) being most commonly diagnosed. Only two cases were detected in companion animals. The central zone presented a positive spatial autocorrelation (Moran's I index=0.1537, 95% CI=0.1141-0.1933; p-value=0.02); north and south zones returned non-significant results (Moran's I index=0.0517 and -0.0117, 95% CI=-0.0358-0.1392 and -0.0780-0.0546, and p-values=0.21 and 0.34 respectively). The number of rabies cases decreased between May and August (late fall and winter) and tended to increase during the hot season (December to March), confirmed with the evidence from Autocorrelation analysis and the Ljun-Box test (X2=234.85 and p-value<0.0001). Knowledge of animal rabies epidemiologic behaviour becomes relevant when designing prevention and control measures and surveillance programs. This is especially important considering the high impact to Public Health of this disease and that wildlife rabies in bats remains endemic in Chile.


Assuntos
Quirópteros/virologia , Doenças do Cão/epidemiologia , Raiva/transmissão , Raiva/veterinária , Zoonoses , Animais , Animais Selvagens , Chile/epidemiologia , Doenças do Cão/transmissão , Cães , Humanos , Raiva/epidemiologia , Vírus da Raiva
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