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OBJECTIVE: To examine associations of vibration sensitivity and pressure pain sensitivity with knee osteoarthritis (OA) outcomes across sex and race, which may relate to known sex and race disparities in clinical outcomes. DESIGN: Data were from the 2013-2015 visit of the Johnston County Osteoarthritis Project. Exposures were vibration perception threshold (VPT) measured at the bilateral medial femoral condyle (MFC) and first metatarsophalangeal joint (MTP), and pressure pain threshold (PPT) measured at the bilateral upper trapezius. Outcomes were knee pain severity and presence of knee symptoms, radiographic knee OA, and symptomatic knee OA in each knee. Cross-sectional associations of the exposures with the outcomes were examined using logistic regression models, overall and separately by sex and race. RESULTS: In the VPT and PPT analyses, 851 and 862 participants (mean age 71 years, 68% female, 33% Black, body mass index 31 kg/m2) and 1585 and 1660 knees were included, respectively. Higher VPT (lower vibration sensitivity) at the MFC and first MTP joint was associated with all outcomes. Lower PPT (greater pressure pain sensitivity) was associated with greater knee pain severity. Associations of VPT and PPT with all outcomes were similar among females and males and Black and White individuals. CONCLUSIONS: Diminished vibration perception and greater pressure pain sensitivity were cross-sectionally associated with worse knee OA outcomes. Despite differences in VPT and PPT among females and males and Black and White adults, associations with knee OA outcomes did not differ by sex or race, suggesting neurophysiological differences do not relate to established disparities.
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Osteoartritis de la Rodilla , Umbral del Dolor , Presión , Vibración , Humanos , Osteoartritis de la Rodilla/fisiopatología , Masculino , Femenino , Anciano , Umbral del Dolor/fisiología , Estudios Transversales , Persona de Mediana Edad , Factores Sexuales , Índice de Severidad de la Enfermedad , Dimensión del Dolor , Artralgia/fisiopatología , Artralgia/etiologíaRESUMEN
Sex inequities in liver transplantation (LT) have been documented in several, mostly US-based, studies. Our aim was to describe sex-related differences in access to LT in a system with short waiting times. All adult patients registered in the RETH-Spanish Liver Transplant Registry (2000-2022) for LT were included. Baseline demographics, presence of hepatocellular carcinoma, cause and severity of liver disease, time on the waiting list (WL), access to transplantation, and reasons for removal from the WL were assessed. 14,385 patients were analysed (77% men, 56.2 ± 8.7 years). Model for end-stage liver disease (MELD) score was reported for 5,475 patients (mean value: 16.6 ± 5.7). Women were less likely to receive a transplant than men (OR 0.78, 95% CI 0.63, 0.97) with a trend to a higher risk of exclusion for deterioration (HR 1.17, 95% CI 0.99, 1.38), despite similar disease severity. Women waited longer on the WL (198.6 ± 338.9 vs. 173.3 ± 285.5 days, p < 0.001). Recently, women's risk of dropout has reduced, concomitantly with shorter WL times. Even in countries with short waiting times, women are disadvantaged in LT. Policies directed at optimizing the whole LT network should be encouraged to guarantee a fair and equal access of all patients to this life saving resource.
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Accesibilidad a los Servicios de Salud , Trasplante de Hígado , Sistema de Registros , Listas de Espera , Humanos , Femenino , Trasplante de Hígado/estadística & datos numéricos , Persona de Mediana Edad , Masculino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Anciano , España , Enfermedad Hepática en Estado Terminal/cirugía , Disparidades en Atención de Salud/estadística & datos numéricos , Factores Sexuales , Adulto , Estados Unidos , Índice de Severidad de la Enfermedad , Carcinoma Hepatocelular/cirugía , Neoplasias Hepáticas/cirugíaRESUMEN
INTRODUCTION: To examine the incidence and progression of foot osteoarthritis (OA), as well as associated factors, in a community-based cohort. METHODS: Baseline (2013-2015) and follow-up (2016-2018) foot radiographs were available for 541 participants (71% women, mean age 69 years; 35% Black, 53% with obesity). The LaTrobe Foot Atlas was used to examine osteophytes (OP, score 0-3) and joint space narrowing (JSN, score 0-3) at 5 joint sites. Incident foot radiographic OA (rOA) was a baseline score <2 OP and JSN in all 5 joints with ≥2 OP or JSN at follow-up in any of the joints. Progression was a worsening OP or JSN score in a joint with baseline foot rOA. At baseline and follow-up, participants reported presence/absence of foot symptoms and completed the Foot and Ankle Outcome Score (FAOS) for each foot. Joint-based logistic regression models with generalized estimating equations were used to examine associations (adjusted odds ratio [aOR], 95% confidence interval [CI]) of foot rOA incidence and progression and with covariates. RESULTS: Among 928 feet without baseline rOA, 4% developed incident foot rOA (2% of those developed symptoms). Among 154 feet with baseline foot rOA, 55% had radiographic progression (16% of those had symptoms). Women and those with higher body mass index (BMI) were more likely to have incident foot rOA (aOR [95% CI] = 4.10 [1.22, 13.8] and 1.60 [1.31, 1.97], respectively); history of gout was associated with incidence or progression of foot rOA (2.75 [1.24, 6.07]. BMI was associated with worse scores on all FAOS subscale (aORs range 1.21-1.40). CONCLUSION: Progression of foot rOA is common but not necessarily related to worsening symptoms. BMI may be a modifiable risk factor for foot OA.
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BACKGROUND: Shoulder pain is a leading cause of disability. Occupations requiring high upper extremity demands may put workers at greater risk of shoulder injury and resulting pain. We examined associations of occupation with shoulder pain and upper extremity disability in the Johnston County Osteoarthritis Project. METHODS: Work industry and occupational tasks for the longest job held were collected from participants. At follow-up ranging from 4-10 years later, participants were asked about shoulder symptoms (pain, aching, or stiffness occurring most days of 1 month in the last year) and given a 9-item, modified Disabilities Arm Shoulder and Hand (DASH) questionnaire to categorize disability from 0-4 (none-worst). Logistic regression and cumulative logit regression models were used to estimate associations with prevalent shoulder symptoms and with worse disability category, respectively. Models were adjusted for cohort, age, sex, race, education and time to follow-up. Sex- and race-stratified associations were evaluated. RESULTS: Among 1560 included participants, mean age was 62 years (standard deviation ± 9 years); 32% were men, and 31% were Black. Compared to the managerial/professional industry, higher odds of both shoulder symptoms and worse upper extremity disability were seen for most industrial groups with physically demanding jobs, particularly the service industry. Work that often or always required lifting/moving > 10 lbs. was associated with higher odds of shoulder symptoms. Work that sometimes or always required heavy work while standing was associated with higher odds of shoulder symptoms, and this association was stronger among men and White workers. CONCLUSION: Physically demanding occupations were associated with increased occurrence of shoulder pain and disability. Mitigating specific physical work demands may reduce shoulder-related disability.
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Evaluación de la Discapacidad , Enfermedades Profesionales , Osteoartritis , Dolor de Hombro , Extremidad Superior , Humanos , Masculino , Femenino , Persona de Mediana Edad , Estudios Transversales , Dolor de Hombro/epidemiología , Dolor de Hombro/etiología , Dolor de Hombro/diagnóstico , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/etiología , Extremidad Superior/fisiopatología , Anciano , Osteoartritis/epidemiología , Estudios de Seguimiento , Encuestas y CuestionariosRESUMEN
Through collaborative efforts, One Health partners have responded to outbreaks of COVID-19 among animals, including those in human care at zoos. Zoos have been faced with numerous challenges, including the susceptibility of many mammalian species, and therefore the need to heighten biosecurity measures rapidly. Robust One Health collaborations already exist in Arizona to address endemic and emerging zoonoses, but these have rarely included zoos. The pandemic shed light on this, and Arizona subsequently expanded its SARS-CoV-2 surveillance efforts to include zoo animals. Testing and epidemiologic support was provided to expedite the detection of and response to zoonotic SARS-CoV-2 infection in zoo animals, as well as to understand possible transmission events. Resulting from this program, SARS-CoV-2 was detected from a rectal swab collected from an 8-yr-old squirrel monkey (Saimiri sciureus) from a zoo in Southern Arizona. The animal had rapidly become ill with nonrespiratory symptoms and died in July 2022. Genomic sequencing from the swab revealed mutations consistent with the Omicron (BA.2) lineage. An epidemiologic investigation identified an animal caretaker in close proximity to the affected squirrel monkey who tested positive for COVID-19 the same day the squirrel monkey died. Critical One Health partners provided support to the zoo through engagement of local, state, and federal agencies. Necropsy and pathologic evaluation showed significant necrotizing colitis; the overall clinical and histopathological findings did not implicate SARS-CoV-2 infection alone as a causal or contributing factor in the squirrel monkey's illness and death. This report documents the first identification of SARS-CoV-2 in a squirrel monkey and highlights a successful and timely One Health investigation conducted through multisectoral collaboration.
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Animales de Zoológico , COVID-19 , Enfermedades de los Monos , Salud Única , SARS-CoV-2 , Saimiri , Animales , Saimiri/virología , COVID-19/veterinaria , COVID-19/epidemiología , COVID-19/virología , COVID-19/diagnóstico , Arizona/epidemiología , SARS-CoV-2/aislamiento & purificación , Enfermedades de los Monos/virología , Enfermedades de los Monos/epidemiología , Enfermedades de los Monos/diagnósticoRESUMEN
Pathogenic variants in CWF19L1 lead to a rare autosomal recessive form of hereditary ataxia with only seven cases reported to date. Here, we describe four additional unrelated patients with biallelic variants in CWF19L1 (age range: 6-22 years) and provide a comprehensive review of the literature. The clinical spectrum was broad, including mild to profound global developmental delay; global or motor regression in infancy or adolescence; childhood-onset ataxia and cerebellar atrophy; and early-onset epilepsy. Since only two previously reported patients were adults, our cohort expands our understanding of the evolution of symptoms from childhood into early adulthood. Taken together, we describe that CWF19L1-related disorder presents with developmental and epileptic encephalopathy with treatment-resistant seizures and intellectual disability in childhood followed by progressive ataxia and other extrapyramidal movement disorders in adolescence.
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Ataxia Cerebelosa , Enfermedades Cerebelosas , Malformaciones del Sistema Nervioso , Degeneraciones Espinocerebelosas , Adolescente , Adulto , Niño , Humanos , Adulto Joven , Ataxia Cerebelosa/genética , Ataxia Cerebelosa/diagnóstico , Mutación , ConvulsionesRESUMEN
OBJECTIVE: To evaluate knee osteoarthritis (KOA) and multijoint osteoarthritis (MJOA), and to compare features by sex and race and ethnicity in a population-based cohort. METHODS: Participants (n = 544) enrolled in the Johnston County Health Study (JoCoHS) as of January 2023 were categorized by radiographic and symptomatic KOA and MJOA phenotypes, and frequencies were compared by sex and race and ethnicity. Symptoms were assessed according to the Knee Injury and Osteoarthritis Outcome Score (KOOS) and pain, aching, and stiffness (PAS) scores at various joints. Models produced estimates (odds ratio [OR] or mean ratios [MR] and 95% CI) adjusted for age, BMI (kg/m2), and education. RESULTS: Men had twice the odds of having MJOA-6 (≥ 3 lower extremity joints affected); there were no significant differences in MJOA phenotypes by race and ethnicity. Women had 50% higher odds of having KOA or having various features of KOA. Women reported significantly worse KOOS Symptoms scores (MR 1.25). Black participants had higher odds of more severe KOA (OR 1.47), subchondral sclerosis (OR 2.06), and medial tibial osteophytes (OR 1.50). Black participants reported worse KOOS Symptoms than White participants (MR 1.18). Although not statistically significant, Hispanic participants (vs non-Hispanic participants) appeared to have lower odds of radiographic changes but reported worse symptoms. CONCLUSION: Preliminary findings in the diverse JoCoHS cohort suggest more lower extremity- predominant MJOA in men compared to women. Women and Black participants had more KOA features and more severe symptoms. Hispanic participants appear to have higher pain and symptoms scores despite having fewer structural changes. Studies in diverse populations are needed to understand the burden of OA.
RESUMEN
DRESS syndrome is a multisystem disorder that appears in the context of an adverse drug reaction, characterized by fever, rash and peripheral eosinophilia with involvement of other organs such as the liver. The typical liver involvement is acute toxic hepatitis (DILI), showing improvement and a tendency to resolution when corticotherapy is started. We must not forget this manifestation in the clinical context of a DRESS syndrome.
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Síndrome de Hipersensibilidad a Medicamentos , Eosinofilia , Exantema , Humanos , Síndrome de Hipersensibilidad a Medicamentos/etiología , Síndrome de Hipersensibilidad a Medicamentos/tratamiento farmacológico , Anticonvulsivantes/efectos adversos , Carbamazepina/efectos adversos , Exantema/inducido químicamente , Exantema/tratamiento farmacológico , Eosinofilia/inducido químicamente , Eosinofilia/tratamiento farmacológico , BenzodiazepinasRESUMEN
This study analyzed total mercury (THg), and selenium (Se) in edible tissues of white shrimp (Litopenaeus vannamei), blue shrimp (L. stylirostris) and brown shrimp (F. californiensis), from three states of the Northwest of Mexico in September and October 2017. Concentrations of THg and Se in the muscle were between 0.026 and 0.829 and 0.126-1.741 µg/g dry weight (dw), respectively. Significant differences were observed among Hg concentration of Sonora and Nayarit and among Se concentration of Sinaloa and Nayarit. In addition, the health risk assessment (HQ) in the three species of shrimp was between 0.550 and 0.607. All Se:Hg molar ratios were > 1 and positive HBVSe values that showed that shrimp from Northwest of Mexico does not represent a risk to human health.
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Mercurio , Penaeidae , Selenio , Contaminantes Químicos del Agua , Humanos , Animales , Mercurio/análisis , Selenio/toxicidad , Selenio/análisis , México , Contaminantes Químicos del Agua/toxicidad , Contaminantes Químicos del Agua/análisis , Medición de Riesgo , Monitoreo del AmbienteRESUMEN
Spin coating is a common method for fabricating polymer thin films on flat substrates. The well-established Meyerhofer relationship between film thickness (h) and spin rate (ω), h â ω-1/2, enables the preparation of thin films with desired thickness by adjusting the spin rate and other experimental parameters. The 1/2 exponent has been verified by previous studies involving organic thin films prepared on silicon wafers. In this study, 88% and >99% hydrolyzed poly(vinyl alcohol) (PVOH) polymers were adsorbed and spin-coated from an aqueous solution onto four different substrates. The substrates were prepared by covalently attaching poly(dimethylsiloxane) (PDMS) of different molecular weights onto silicon wafers (SiO2). Atomic force microscopy images indicate that the PVOH films transitioned from stable on SiO2, to metastable, and then to unstable as PDMS molecular weight was increased. Notably, none of the polymer-substrate systems studied here exhibited the thickness-spin rate profile predicted by the Meyerhofer model. Based on the experimental results, a more general adsorption-deposition model is proposed that decouples the total spin-coated thickness into two componentsâthe adsorbed thickness (h1) and the spin-deposited thickness (h2). The former accounts for polymer-substrate interactions, and the latter depends on polymer concentration and spin rate. In unstable systems, the exponents were found to be â¼0 because slip takes place at the solution-substrate interface during spin and the spin-deposited thickness is 0. In metastable and stable systems, a universal relationship between spin-deposited thickness and spin rate emerged, independent of the substrate type and polymer concentration for each polymer examined. Our findings indicate the importance of film stability and polymer-substrate interactions in the application of spin coating.
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BACKGROUND: In a previous work, we identified nine founder mutations present in close to 80% of BRCA1 and BRCA2 mutation carriers, and distributed across the country. The presence of founder mutations constitutes a valuable opportunity to develop new strategies for genetic screening. Genetic tests are primarily performed by NGS sequencing, which requires sophisticated and expensive equipment, and it takes 2-3 weeks for the results to be informed to the patient. In addition, genetic tests are not covered by insurance companies in Latin American countries. In this work, we present the standardization and technical validation of a real-time PCR based methodology for allelic discrimination in order to identify the nine Chilean founder mutations in BRCA1 and BRCA2 genes. METHODS AND RESULTS: We designed nine pairs of probes and nine pairs of primers to amplify synchronically nine regions of the BRCA1/BRCA2 genes by real-time PCR, in order to identify the nine founder mutations through allelic discrimination analyses. Technical validation was performed using 90 positive and 90 negative samples for each mutation. The methodology was tested in a second group of 60 patients. Our method correctly classified carriers and non-carriers of one of the nine Chilean founder mutations with a 100% specificity and 100% sensitivity, compared with Sanger sequencing performance. CONCLUSIONS: We develop an inexpensive, simple, and fast mutation detection method that could be implemented locally in Hospitals from the Private to Public health system. This methodology may be useful for the screening of BRCA1 and BRCA2 mutations in other populations.
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Neoplasias de la Mama , Neoplasias Ováricas , Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias de la Mama/genética , Carcinoma Epitelial de Ovario/genética , Chile , Detección Precoz del Cáncer , Femenino , Efecto Fundador , Genes BRCA2 , Predisposición Genética a la Enfermedad , Humanos , Mutación/genética , Neoplasias Ováricas/genética , Reacción en Cadena en Tiempo Real de la PolimerasaRESUMEN
BACKGROUND: During the COVID-19 pandemic, the shift to virtual care became essential for the continued care of patients. Individuals with rheumatic and musculoskeletal diseases (RMDs) especially require frequent provider visits and close monitoring. To date, there have been limited studies examining inequities in health technology use among patients with RMDs. OBJECTIVE: Our goal was to identify characteristics associated with patient portal use before and after the COVID-19 pandemic in a convenience sample of patients with RMDs from a large academic medical center. METHODS: In this cross-sectional study, Epic electronic medical record data were queried to identify established patients of the University of North Carolina Hospitals adult rheumatology clinic between November 1, 2017, through November 30, 2019. Demographic and clinical data were collected to compare MyChart (Epic's patient portal) users with nonusers before and after the COVID-19 pandemic. MyChart activation and use were modeled using logistic regression and adjusted odds ratios, and confidence intervals were estimated. RESULTS: We identified 5075 established patients with RMDs who met the inclusion criteria. Prior to the pandemic, we found that younger age (P<.001), suburban residence (P=.05), commercial/state insurance (P<.001), military insurance (P=.05), and median income >US $50,000 (P<.001) were associated with significantly higher odds of MyChart activation. Male sex (P<.001), being of Black or African American (P<.001) or "other" race (P<.001), Spanish as a primary language (P<.001), rural residence (P=.007), Medicaid insurance (P<.001), and median income of Asunto(s)
COVID-19
, Enfermedades Musculoesqueléticas
, Portales del Paciente
, Adulto
, COVID-19/epidemiología
, Estudios Transversales
, Humanos
, Masculino
, Enfermedades Musculoesqueléticas/epidemiología
, Pandemias
, Estudios Retrospectivos
, Estados Unidos
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We present an uncommon cause of liver transplant in a patient with a particular personal situation, who suffered loss of follow-up during his antitubercular treatment. He presented a dress syndrome with fulminant liver failure that required a liver transplant. This case demonstrates the importance of close monitoring of liver function during this treatment.
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Fallo Hepático Agudo , Trasplante de Hígado , Tuberculosis , Antituberculosos/efectos adversos , Estudios de Seguimiento , Humanos , Fallo Hepático Agudo/inducido químicamente , Fallo Hepático Agudo/cirugía , Trasplante de Hígado/efectos adversos , Masculino , Tuberculosis/complicacionesRESUMEN
BACKGROUND AND AIMS: Transjugular intrahepatic portosystemic shunts (TIPS) are successfully used in the management of portal hypertension (PH)-related complications. Debate surrounds the diameter of the dilation. The aim was to analyse the outcomes of and complications deriving from TIPS in patients with cirrhosis and identify predictors of survival. METHODS: This was a retrospective single-centre study, which included patients with cirrhosis who had a TIPS procedure for PH from 2009 to October 2018. Demographic, clinical and radiological data were collected. The Kaplan-Meier method was used to measure survival and predictors of survival were identified with the Cox regression model. RESULTS: A total of 98 patients were included (78.6% male), mean age was 58.5 (SD±/-9.9) and the median MELD was 13.3 (IQR 9.5-16). The indications were refractory ascites (RA), variceal bleeding (VB) and hepatic hydrothorax (HH). Median survival was 72 months (RA 46.4, VB 68.5 and HH 64.7) and transplant-free survival was 26 months. Clinical and technical success rates were 70.5% and 92.9% respectively. Age (HR 1.05), clinical success (HR 0.33), sodium (HR 0.92), renal failure (HR 2.46) and albumin (HR 0.35) were predictors of survival. Hepatic encephalopathy occurred in 28.6% of patients and TIPS dysfunction occurred in 16.3%. CONCLUSIONS: TIPS with 10-mm PTFE-covered stent is an effective and safe treatment for PH-related complications in patients with cirrhosis. Age, renal failure, sodium, albumin and clinical success are independent predictors of long-term survival.
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Hipertensión Portal/complicaciones , Cirrosis Hepática/complicaciones , Derivación Portosistémica Intrahepática Transyugular/métodos , Stents , Adulto , Anciano , Anciano de 80 o más Años , Ascitis/mortalidad , Ascitis/cirugía , Várices Esofágicas y Gástricas/complicaciones , Várices Esofágicas y Gástricas/mortalidad , Várices Esofágicas y Gástricas/cirugía , Femenino , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/mortalidad , Hemorragia Gastrointestinal/cirugía , Encefalopatía Hepática/epidemiología , Encefalopatía Hepática/mortalidad , Encefalopatía Hepática/prevención & control , Venas Hepáticas/diagnóstico por imagen , Venas Hepáticas/cirugía , Humanos , Hidrotórax/mortalidad , Hidrotórax/cirugía , Hipertensión Portal/mortalidad , Estimación de Kaplan-Meier , Cirrosis Hepática/mortalidad , Masculino , Persona de Mediana Edad , Politetrafluoroetileno , Derivación Portosistémica Intrahepática Transyugular/efectos adversos , Derivación Portosistémica Intrahepática Transyugular/mortalidad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/mortalidad , Modelos de Riesgos Proporcionales , Diseño de Prótesis , Insuficiencia Renal/mortalidad , Estudios Retrospectivos , Albúmina Sérica , Sodio/sangre , Resultado del TratamientoRESUMEN
BACKGROUND: The BRCA1 c.3331_3334delCAAG founder mutation has been reported in hereditary breast and ovarian cancer families from multiple Hispanic groups. We aimed to evaluate BRCA1 c.3331_3334delCAAG haplotype diversity in cases of European, African, and Latin American ancestry. METHODS: BC mutation carrier cases from Colombia (n = 32), Spain (n = 13), Portugal (n = 2), Chile (n = 10), Africa (n = 1), and Brazil (n = 2) were genotyped with the genome-wide single nucleotide polymorphism (SNP) arrays to evaluate haplotype diversity around BRCA1 c.3331_3334delCAAG. Additional Portuguese (n = 13) and Brazilian (n = 18) BC mutation carriers were genotyped for 15 informative SNPs surrounding BRCA1. Data were phased using SHAPEIT2, and identical by descent regions were determined using BEAGLE and GERMLINE. DMLE+ was used to date the mutation in Colombia and Iberia. RESULTS: The haplotype reconstruction revealed a shared 264.4-kb region among carriers from all six countries. The estimated mutation age was ~ 100 generations in Iberia and that it was introduced to South America early during the European colonization period. CONCLUSIONS: Our results suggest that this mutation originated in Iberia and later introduced to Colombia and South America at the time of Spanish colonization during the early 1500s. We also found that the Colombian mutation carriers had higher European ancestry, at the BRCA1 gene harboring chromosome 17, than controls, which further supported the European origin of the mutation. Understanding founder mutations in diverse populations has implications in implementing cost-effective, ancestry-informed screening.
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Proteína BRCA1/genética , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/genética , Predisposición Genética a la Enfermedad , Mutación de Línea Germinal , Haplotipos , Polimorfismo de Nucleótido Simple , África/epidemiología , Brasil/epidemiología , Chile/epidemiología , Cromosomas Humanos Par 17/genética , Colombia/epidemiología , Femenino , Efecto Fundador , Estudio de Asociación del Genoma Completo/métodos , Humanos , Portugal/epidemiología , España/epidemiologíaRESUMEN
Astaxanthin is a powerful antioxidant, because it neutralizes free radicals and plays a vital role in the prevention of human diseases. The objective of this work was to develop an isotonic beverage (IB) of orange-red color, using an astaxanthin oleoresin emulsion (AOE) that is dispersible in water. This was carried out in order to simulate the color of commercial isotonic beverages (CIB) prepared from artificial pigments. The size of the AOE micelles ranged from 0.15 to 7.60 µm2. The color difference (ΔE) was similar for the samples exposed to dark as well as light conditions. The samples subjected to light stress showed pigment degradation after seven days, followed by a decrease in the concentration of astaxanthin; whereas, the samples exposed to dark conditions remained stable for seven days and then showed a decrease in the concentration of astaxanthin (this decrease ranged from 65% to 76% when compared to the initial content) after a period of 91 days. For the astaxanthin oleoresin (AO) and AOE, the oxygen radical absorbance capacity (ORAC) values reached 5224 and 1968 µmol of trolox equivalents (TE)/100 g, respectively. When exposed to light conditions, the addition of AOE in the IB led to its rapid degradation, while it remained stable in the samples exposed to the dark conditions.
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Bebidas/análisis , Extractos Vegetales/farmacología , Agua/química , Antioxidantes/química , Antioxidantes/farmacología , Color , Emulsiones/química , Radicales Libres/química , Humanos , Extractos Vegetales/química , Xantófilas/química , Xantófilas/farmacologíaRESUMEN
Haematococcus pluvialis is the largest producer of natural astaxanthin in the world. Astaxanthin is a bioactive compound used in food, feed, nutraceutics, and cosmetics. In this study, astaxanthin extraction from H. pluvialis by supercritical fluid extraction was evaluated. The effects of temperature (40 and 50 °C), pressure (40 and 50 MPa), and CO2 flow rate (2 and 4 L/min) were investigated. The results showed that the highest astaxanthin recovery was obtained at 50 °C/50 MPa and the CO2 flow rates evaluated had no significant effect. It was possible to achieve astaxanthin recoveries of 95% after 175 min for a CO2 flow rate of 2 L/min, and 95 min for CO2 flow rate of 4 L/min. The ω-6/ω-3 ratios obtained were similar in all conditions, reaching 0.87, demonstrating that the extracts from H. pluvialis by SFE are rich in unsaturated fatty acids (UFA) which increases their positive effects when used as a functional ingredient in food.
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Dióxido de Carbono/química , Chlorophyceae/química , Cromatografía con Fluido Supercrítico/métodos , Ácidos Grasos/química , Microalgas/química , Tecnología/métodos , Xantófilas/químicaRESUMEN
BACKGROUND: satisfaction with healthcare is focused on the patient and is known as "patient-centered care". However, user satisfaction is not always synonymous with good care. Healthcare practitioners should determine and understand what patients need and expect in order to improve the quality of care. AIMS: the main objective of this study was to determine the perceived quality of care of patients diagnosed with colorectal cancer in our unit. METHODS: a cross-sectional study was performed in all patients diagnosed with colorectal cancer (CRC) that underwent staging studies and were hospitalized in the Gastroenterology Department from May 2013 to October 2013. Furthermore, outpatients with rapid consultations for CRC staging from November 2013 to November 2014 were also included. Two questionnaires were administered: a) a survey of 20 questions with closed responses regarding the competence of treating physicians and nurses, the information received and the waiting time; b) the European Organization for Research and Treatment of Cancer (EORTC) QLQ-INFO25: information on the disease, medical tests, treatment and other services, with eight single items. RESULTS: there were no differences in the perceived healthcare quality, delays in starting treatment, the tumor stage, symptoms (performance status) or the time spent studying the disease. In-patients and those with advanced disease started treatment earlier than outpatients and those with disease stage I or II. Likewise, outpatients perceived a better psychological support. CONCLUSIONS: outpatient study did not reduce the quality of care and did not delay treatment.
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Atención Ambulatoria/normas , Neoplasias Colorrectales/terapia , Hospitalización , Satisfacción del Paciente , Calidad de la Atención de Salud , Adulto , Anciano , Anciano de 80 o más Años , Atención Ambulatoria/psicología , Cuidadores/psicología , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/psicología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Grupo de Atención al Paciente , Calidad de Vida , Encuestas y Cuestionarios , Factores de Tiempo , Listas de EsperaRESUMEN
The present study shows the human health risk of Cd, Cu, Hg and Zn by consumption of clams Megapitaria squalida from Northwest Mexico, collected in 2013. The mean concentration for each metal in the soft tissue was: Zn > Cu > Cd > Hg; and mean values of 68.89 ± 37.59-30.36 ± 27.19, 8.77 ± 1.35-6.80 ± 0.36, 4.47 ± 0.21-3.18 ± 0.63 and 0.99 ± 0.81-0.52 ± 0.16 µg/g, respectively. Clam age was significantly negatively correlated (p < 0.05) with soft tissue Zn concentrations. For all metals there is a low level of human health risk associated with the consumption of M. squalida, but it is necessary to determine the specific characteristics of the human population of the study site.
Asunto(s)
Envejecimiento/metabolismo , Bivalvos/química , Monitoreo del Ambiente/métodos , Metales Pesados/análisis , Contaminantes Químicos del Agua/análisis , Animales , Bioacumulación , Bivalvos/crecimiento & desarrollo , Humanos , Metales Pesados/metabolismo , México , Medición de Riesgo , Contaminantes Químicos del Agua/metabolismoRESUMEN
[Purpose] This study aims to evaluate the synergistic effects of laser therapy and vacuum therapy in the rehabilitation of some disorders of the osteomuscular articular system (shoulder bursitis, low back pain, hip dysfunction after long-term impact of femoral endoprosthesis). [Participants and Methods] Three case reports were described. A vacuum laser system was used, which is a device that contains 1 handpiece with 3 red lasers (660â nm) and 3 infrared lasers (808â nm). This device contains 6 laser beams that are arranged around the vacuum chamber bore which generate negative pressure. Two weekly sessions were held, totalling 10 treatment sessions. Active goniometry was performed to assess range of motion (ROM) of the shoulder, lumbar spine and hip, and visual analogue scale (VAS) was used to evaluate pain in the pre and posttreatment period. [Results] There was a pain reduction and an increase in ROM in the different clinical cases. [Conclusion] Potentiating laser therapy through suctioning during the rehabilitation process leads to pain relief and increased functionality.