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1.
Nutr Health ; : 2601060241276918, 2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39215529

RESUMEN

Background: Proteins are essential for the maintenance, repair, and growth of muscle mass. This is particularly important for master athletes because aging has been associated with loss of muscle mass, function, and strength. Moreover, the timing of intake has been shown important for the best protein utilization. Aim: To analyze timing, quantity, and source of dietary protein in competitive master athletes according to current recommendations. Methods: Twenty-one male master swimmers (47.9 ± 10.0 years; 79.2 ± 6.5 kg; 179.1 ± 5.5 cm; 23.5 ± 4.9% body fat; 73.3 ± 4.2% lean mass) participated in this cross-sectional study. Protein intake was analyzed based on 7-day food records, regarding quantity, timing, and sources of intake. Protein intake was evaluated according to current international sports nutrition guidelines, including the International Society of Sports Nutrition Position Stand. Body fat (%) and lean mass (%) were evaluated using dual-energy X-ray absorptiometry. Results: Participants' mean protein intakes were 1.9 ± 0.5 g/kg/day, 0.6 ± 0.2 g/kg/meal post-training, and 33.5 ± 23.9 g during the pre-sleep period. Daily intake was within the recommended values of 1.4 and 2.0 g/kg/day (p = 0.01 and 0.147, respectively). Mean pre-sleep intake was within the recommendation values of 30-40 g (p = 0.28 and 0.147, respectively). Most of the daily protein intake was consumed at lunch (66.7 ± 6.9 g) and dinner (48.0 ± 4.5 g). Regarding protein sources, intakes from animal, vegetal, and supplements were, respectively, 65.7%, 29.2%, and 5.1%. Conclusion: Master swimmers presented a total protein intake within the recommendations for a daily basis, but the majority of intake was at lunch and dinner. Protein intake could be better distributed throughout the day to optimize protein synthesis. Guidance on daily protein intake distribution should be reinforced in clinical practice.

2.
J Law Med ; 30(1): 166-178, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-37271957

RESUMEN

This article examines the United Kingdom Supreme Court decision in Whittington Hospital NHS Trust v XX [2020] UKSC 14. The case centred on whether damages could be awarded for the cost of a commercial surrogacy arrangement in California, following clinical negligence by the hospital that left the plaintiff unable to carry her own children. After examination of this case, the article outlines and compares the United Kingdom and Australian surrogacy laws. It then discusses how a similar case would be decided in Australia and argues that the result would be the same in some Australian States. It also discusses the concept of reproductive autonomy and the importance of this concept when considering cases involving the loss of fertility.


Asunto(s)
Mala Praxis , Madres Sustitutas , Madres Sustitutas/legislación & jurisprudencia , Humanos , Infertilidad , Autonomía Personal , Derechos Sexuales y Reproductivos , Reino Unido , Australia
3.
Exp Brain Res ; 240(10): 2525-2567, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36063192

RESUMEN

Intellectual disability (ID) and autism spectrum disorder (ASD) are neurodevelopmental disorders that have become a primary clinical and social concern, with a prevalence of 2-3% in the population. Neuronal function and behaviour undergo significant malleability during the critical period of development that is found to be impaired in ID/ASD. Human genome sequencing studies have revealed many genetic variations associated with ASD/ID that are further verified by many approaches, including many mouse and other models. These models have facilitated the identification of fundamental mechanisms underlying the pathogenesis of ASD/ID, and several studies have proposed converging molecular pathways in ASD/ID. However, linking the mechanisms of the pathogenic genes and their molecular characteristics that lead to ID/ASD has progressed slowly, hampering the development of potential therapeutic strategies. This review discusses the possibility of recognising the common molecular causes for most ASD/ID based on studies from the available models that may enable a better therapeutic strategy to treat ID/ASD. We also reviewed the potential biomarkers to detect ASD/ID at early stages that may aid in diagnosis and initiating medical treatment, the concerns with drug failure in clinical trials, and developing therapeutic strategies that can be applied beyond a particular mutation associated with ASD/ID.


Asunto(s)
Trastorno del Espectro Autista , Discapacidad Intelectual , Animales , Trastorno del Espectro Autista/complicaciones , Trastorno del Espectro Autista/genética , Humanos , Discapacidad Intelectual/complicaciones , Ratones , Neuronas , Transducción de Señal/genética
4.
Adv Neonatal Care ; 22(2): 119-124, 2022 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33783387

RESUMEN

BACKGROUND: Traditionally, the provision of comfort care and support during the dying process for infants born with life-limiting diagnoses has occurred in the neonatal intensive care unit (NICU). A major goal for the families of these infants is often the opportunity to spend as much time as possible with their infant in order to make memories and parent their infant. PURPOSE: The objective of the Mother Baby Comfort Care Pathway is to implement a program of family-centered care with logistically flexible care delivery, allowing mothers and their families to share as normal a postpartum care experience as possible with a focus on quality of life, memory making, and time spent together. METHODS: The program was developed with the nucleus of care coordination and provision on the Mother Baby Unit (postpartum unit), with involvement from the labor and delivery room, NICU, and other units as necessary to provide the postpartum mother, her dying infant, as well as possible additional siblings (in the case of multiple gestation), postpartum care while rooming-in. The program was rolled out with training workshops for postpartum nurses. FINDINGS: Nurses who took part in the workshops and the patient care program rated both highly. IMPLICATIONS FOR PRACTICE: The Mother Baby Comfort Care Pathway aims to offer a framework for providing multidisciplinary family-centered comfort care to newborns during the postpartum period in a compassionate, evidence-based, and individualized manner in order to maximize quality time together for families with a dying infant.


Asunto(s)
Madres , Cuidados Paliativos , Niño , Vías Clínicas , Femenino , Humanos , Lactante , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Comodidad del Paciente , Embarazo , Calidad de Vida
5.
Circulation ; 141(18): 1452-1462, 2020 05 05.
Artículo en Inglés | MEDLINE | ID: mdl-32174130

RESUMEN

BACKGROUND: The future risk of myocardial infarction is commonly assessed using cardiovascular risk scores, coronary artery calcium score, or coronary artery stenosis severity. We assessed whether noncalcified low-attenuation plaque burden on coronary CT angiography (CCTA) might be a better predictor of the future risk of myocardial infarction. METHODS: In a post hoc analysis of a multicenter randomized controlled trial of CCTA in patients with stable chest pain, we investigated the association between the future risk of fatal or nonfatal myocardial infarction and low-attenuation plaque burden (% plaque to vessel volume), cardiovascular risk score, coronary artery calcium score or obstructive coronary artery stenoses. RESULTS: In 1769 patients (56% male; 58±10 years) followed up for a median 4.7 (interquartile interval, 4.0-5.7) years, low-attenuation plaque burden correlated weakly with cardiovascular risk score (r=0.34; P<0.001), strongly with coronary artery calcium score (r=0.62; P<0.001), and very strongly with the severity of luminal coronary stenosis (area stenosis, r=0.83; P<0.001). Low-attenuation plaque burden (7.5% [4.8-9.2] versus 4.1% [0-6.8]; P<0.001), coronary artery calcium score (336 [62-1064] versus 19 [0-217] Agatston units; P<0.001), and the presence of obstructive coronary artery disease (54% versus 25%; P<0.001) were all higher in the 41 patients who had fatal or nonfatal myocardial infarction. Low-attenuation plaque burden was the strongest predictor of myocardial infarction (adjusted hazard ratio, 1.60 (95% CI, 1.10-2.34) per doubling; P=0.014), irrespective of cardiovascular risk score, coronary artery calcium score, or coronary artery area stenosis. Patients with low-attenuation plaque burden greater than 4% were nearly 5 times more likely to have subsequent myocardial infarction (hazard ratio, 4.65; 95% CI, 2.06-10.5; P<0.001). CONCLUSIONS: In patients presenting with stable chest pain, low-attenuation plaque burden is the strongest predictor of fatal or nonfatal myocardial infarction. These findings challenge the current perception of the supremacy of current classical risk predictors for myocardial infarction, including stenosis severity. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01149590.


Asunto(s)
Angina Estable/etiología , Angiografía por Tomografía Computarizada , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Estenosis Coronaria/diagnóstico por imagen , Infarto del Miocardio/etiología , Placa Aterosclerótica , Calcificación Vascular/diagnóstico por imagen , Anciano , Angina Estable/diagnóstico , Angina Estable/mortalidad , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/mortalidad , Estenosis Coronaria/complicaciones , Estenosis Coronaria/mortalidad , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/mortalidad , Valor Predictivo de las Pruebas , Pronóstico , Medición de Riesgo , Escocia , Factores de Tiempo , Calcificación Vascular/complicaciones , Calcificación Vascular/mortalidad
6.
Ann Surg Oncol ; 27(9): 3156-3162, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32285282

RESUMEN

BACKGROUND: Current rates of opioid prescribing and consumption in the United States have resulted in deleterious consequences for both patients and society. There has been a focus on opioid consumption and overprescribing, but the utility of patient education in reducing opioid consumption has only recently been explored. This randomized trial aimed to evaluate the effectiveness of a brief patient educational intervention in reducing pain and opioid consumption in patients undergoing mastectomy and breast reconstruction. METHODS: A parallel, randomized, single-center trial of women undergoing mastectomy with immediate, implant-based breast reconstruction was completed to evaluate the utility of a patient educational instrument with information on multi-modal pain control. A questionnaire was administered postoperatively to collect data on pain control and opioid consumption. RESULTS: Fifty participants were randomized to each group preoperatively; 46 control (92%) and 39 intervention (78%) participants completed the postoperative questionnaire. Active tobacco use was more common in the control group (p = 0.04). There was a trend towards lower pain scores in the intervention group (3.0/10, SD 1.8 vs 3.6/10, SD 1.6, p = 0.06). Both groups were prescribed a median of 32.0 5-mg oxycodone tablets postoperatively. Participants in the intervention group consumed 33% fewer opioids than the control group (16.2 tablets, SD 16.4 vs 24.3 tablets, SD 21.8, p = 0.05). CONCLUSIONS: The use of a brief educational intervention provided at a preoperative appointment can reduce opioid consumption. We recommend the use of an educational intervention to decrease opioid consumption among breast surgery patients.


Asunto(s)
Analgésicos Opioides , Neoplasias de la Mama , Educación del Paciente como Asunto , Analgésicos Opioides/uso terapéutico , Implantes de Mama , Neoplasias de la Mama/cirugía , Femenino , Humanos , Mamoplastia/efectos adversos , Mamoplastia/métodos , Mastectomía/efectos adversos , Mastectomía/métodos , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/etiología , Dolor Postoperatorio/prevención & control , Dolor Postoperatorio/psicología , Pautas de la Práctica en Medicina
7.
Breast J ; 26(9): 1712-1716, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32497361

RESUMEN

Although there has been a recent focus on decreasing opioid prescribing through alternative pain medication protocols, the patient's perception of pain related to breast reconstructive surgeries has not been well described. We sought to evaluate patient perception of pain control as it influences opioid use. We hypothesize that modifiable factors may influence patterns in pain perception and postoperative opioid use. Patients undergoing consultation for mastectomy with immediate, implant-based breast reconstruction were enrolled in a prospective, cohort survey study. A survey was administered at preoperative and postoperative appointments to collect data on pain expectations and pain control. Of 100 patients enrolled, 85% completed the postoperative survey. Over half of patients (52%) reported feeling anxious about pain control after surgery. Patients with preoperative opioid use were more likely to expect complete relief of pain postoperatively (P = .038). Patients with psychiatric comorbidity were more likely to report feeling anxious about postoperative pain (P = .012; 70% vs 42%; OR 3.0 CI 1.2-7.4). Patients who reported feeling anxious about pain control preoperatively were more likely to report trying opioids (P = .047; 67% vs 44%; OR 2.5 CI 1.0-6.1) and benzodiazepines (P = .020; 80% vs 56%; OR 3.0 CI 1.2-8.0) postoperatively. Anxiety related to pain control is common and results in an increased likelihood of trying opioid and benzodiazepine medications postoperatively. This presents an opportunity to educate patients preoperatively by addressing anxiety related to pain control to decrease controlled substance use.


Asunto(s)
Neoplasias de la Mama , Mamoplastia , Analgésicos Opioides , Femenino , Humanos , Mamoplastia/efectos adversos , Mastectomía , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/etiología , Percepción , Pautas de la Práctica en Medicina , Estudios Prospectivos
8.
J Microencapsul ; 37(3): 230-241, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31996059

RESUMEN

Aim: Optimum conditions of umbu juice spray drying were selected using inlet air temperature (T), feed flow rate (F) and 10-DE maltodextrin concentration (CMD) as independent variables, and water activity, moisture content, hygroscopicity and phenolic compounds retention as responses.Methods: Powders water activity was determined with a water activity metre, moisture content and hygroscopicity gravimetrically, total phenolics spectrophotometrically, apparent and absolute density, porosity and solubility by standard methods, particle size by laser diffraction, and morphology by Scanning Electron Microscopy. Nectars sensory analysis was based on acceptance, purchase intention and multiple comparison preference tests. Powder stability was checked at 25 °C varying water activity and storage time in the ranges 0.1-0.3 and 30-90 days, respectively.Results: Powders prepared at T = 110 °C, F = 0.84 L/h, CMD=10% and T = 140 °C, F = 0.60 L/h, CMD=10% gave the best microparticles and sensory results. The former showed properties suitable for industrial production.Conclusion: These findings may promote umbu powder industrial exploitation.


Asunto(s)
Anacardiaceae/química , Jugos de Frutas y Vegetales , Tamaño de la Partícula , Polvos
9.
Circulation ; 135(17): 1586-1596, 2017 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-28034899

RESUMEN

BACKGROUND: High-sensitivity cardiac troponin assays enable myocardial infarction to be ruled out earlier, but the optimal approach is uncertain. We compared the European Society of Cardiology rule-out pathway with a pathway that incorporates lower cardiac troponin concentrations to risk stratify patients. METHODS: Patients with suspected acute coronary syndrome (n=1218) underwent high-sensitivity cardiac troponin I measurement at presentation and 3 and 6 or 12 hours. We compared the European Society of Cardiology pathway (<99th centile at presentation or at 3 hours if symptoms <6 hours) with a pathway developed in the High-STEACS study (High-Sensitivity Troponin in the Evaluation of Patients With Acute Coronary Syndrome) population (<5 ng/L at presentation or change <3 ng/L and <99th centile at 3 hours). The primary outcome was a comparison of the negative predictive value of both pathways for index type 1 myocardial infarction or type 1 myocardial infarction or cardiac death at 30 days. We evaluated the primary outcome in prespecified subgroups stratified by age, sex, time of symptom onset, and known ischemic heart disease. RESULTS: The primary outcome occurred in 15.7% (191 of 1218) patients. In those less than the 99th centile at presentation, the European Society of Cardiology pathway ruled out myocardial infarction in 28.1% (342 of 1218) and 78.9% (961 of 1218) at presentation and 3 hours, respectively, missing 18 index and two 30-day events (negative predictive value, 97.9%; 95% confidence interval, 96.9-98.7). The High-STEACS pathway ruled out 40.7% (496 of 1218) and 74.2% (904 of 1218) at presentation and 3 hours, missing 2 index and two 30-day events (negative predictive value, 99.5%; 95% confidence interval, 99.0-99.9; P<0.001 for comparison). The negative predictive value of the High-STEACS pathway was greater than the European Society of Cardiology pathway overall (P<0.001) and in all subgroups, including those presenting early or known to have ischemic heart disease. CONCLUSIONS: Use of the High-STEACS pathway incorporating low high-sensitivity cardiac troponin concentrations rules out myocardial infarction in more patients at presentation and misses 5-fold fewer index myocardial infarctions than guideline-approved pathways based exclusively on the 99th centile. CLINICAL TRIAL REGISTRATION: URL: http://clinicaltrials.gov. Unique identifier: NCT01852123.


Asunto(s)
Síndrome Coronario Agudo/diagnóstico , Técnicas de Apoyo para la Decisión , Infarto del Miocardio/diagnóstico , Troponina I/sangre , Síndrome Coronario Agudo/sangre , Síndrome Coronario Agudo/mortalidad , Factores de Edad , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Femenino , Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/sangre , Infarto del Miocardio/mortalidad , Valor Predictivo de las Pruebas , Pronóstico , Medición de Riesgo , Factores de Riesgo , Escocia , Factores Sexuales , Factores de Tiempo , Regulación hacia Arriba
10.
Mol Ecol ; 27(10): 2447-2460, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29676034

RESUMEN

While the high species diversity of tropical arthropod communities has often been linked to marked spatial heterogeneity, their temporal dynamics have received little attention. This study addresses this gap by examining spatio-temporal variation in the arthropod communities of a tropical montane forest in Honduras. By employing DNA barcode analysis and Malaise trap sampling across 4 years and five sites, 51,596 specimens were assigned to 8,193 presumptive species. High beta diversity was linked more strongly to elevation than geographic distance, decreasing by 12% when only the dominant species were considered. When sampling effort was increased by deploying more traps at a site, beta diversity only decreased by 2%, but extending sampling across years decreased beta diversity by 27%. Species inconsistently detected among years, likely transients from other settings, drove the low similarity in species composition among traps only a few metres apart. The dominant, temporally persistent species substantially influenced the cyclic pattern of change in community composition among years. This pattern likely results from divergence-convergence dynamics, suggesting a stable baseline of temporal turnover in each community. The overall results establish that large sample sizes are necessary to reveal species richness, but are not essential for quantifying beta diversity. This study further highlights the need for standardized methods of sampling and species identification to generate the comparative data required to evaluate biodiversity change in space and time.


Asunto(s)
Artrópodos/genética , Ambiente , Variación Genética , Animales , Código de Barras del ADN Taxonómico/ética , Honduras , Modelos Lineales , Clima Tropical
11.
Int J Equity Health ; 16(1): 24, 2017 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-28109194

RESUMEN

BACKGROUND: Prenatal care coverage is still not universal or adequately provided in many low and middle income countries. One of the main barriers regards the presence of socioeconomic inequalities in prenatal care utilization. In Brazil, prenatal care is supplied for the entire population at the community level as part of the Family Health Strategy (FHS), which is the main source of primary care provided by the public health system. Brazil has some of the greatest income inequalities in the world, and little research has been conducted to investigate prenatal care utilization of FHS across socioeconomic groups. This paper addresses this gap investigating the socioeconomic and regional differences in the utilization of prenatal care supplied by the FHS in the state of Minas Gerais, Brazil. METHODS: Data comes from a probabilistic household survey carried out in 2012 representative of the population living in urban areas in the state of Minas Gerais. The sample size comprises 1,420 women aged between 13 and 45 years old who had completed a pregnancy with a live born in the last five years prior to the survey. The outcome variables are received prenatal care, number of antenatal visits, late prenatal care, antenatal tests, tetanus immunization and low birthweight. A descriptive analysis and logistic models were estimated for the outcome variables. RESULTS: The coverage of prenatal care is almost universal in catchment urban areas of FHT of Minas Gerais state including both antenatal visits and diagnostic procedures. Due to this high level of coverage, socioeconomic inequalities were not observed. FHS supplied care for around 80% of the women without private insurance and 90% for women belonging to lower socioeconomic classes. Women belonging to lower socioeconomic classes were at least five times more likely to receive antenatal visits and any of the antenatal tests by the FHS compared to those belonging to the highest classes. Moreover, FHS was effective in reducing low birthweight. Women who had prenatal care through FHS were 40% less likely to have a child with low birthweight. CONCLUSION: This paper presents strong evidence that FHS promotes equity in antenatal care in Minas Gerais, Brazil.


Asunto(s)
Salud de la Familia , Equidad en Salud/estadística & datos numéricos , Atención Prenatal/estadística & datos numéricos , Adolescente , Adulto , Brasil , Estudios Transversales , Femenino , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Persona de Mediana Edad , Embarazo , Atención Primaria de Salud , Factores Socioeconómicos , Adulto Joven
12.
Int J Paediatr Dent ; 27(1): 30-36, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26774559

RESUMEN

OBJECTIVE: To assess parental reports of changes in oral health-related quality of life (OHRQoL) of young children in the UK with early childhood caries (ECC) following dental treatment under general anaesthesia (DGA). To compare the impact of oral rehabilitation (OR) and extraction-only (Exo) treatment approaches on this. METHODS: Data were collected using the proxy reported components of the Child Oral Health-Related Quality of Life (COHRQoL® ) questionnaire: the Parent-Caregivers Perceptions questionnaire (P-CPQ) and Family Impact Scale (FIS), from a convenience sample of parents of children receiving DGA at a UK Paediatric Dental Department. Mean scores and prevalence impacts were compared pre- and postoperatively with mean change score and effect sizes calculations. RESULTS: Seventy-eight parents were recruited (51 children undergoing OR, 27 Exo) with 6 lost to follow-up (92.3%). Following treatment, changes in mean P-CPQ and FIS scores were statistically significant (P < 0.0001) with medium to large effect sizes (0.45-1.39). The differences in change scores between the two treatment approaches were not statistically different. CONCLUSION: DGA for young children with early childhood caries resulted in substantial improvements in parent's ratings of their child's OHRQoL and of the impact on their families. Larger cohort studies are needed to validate these preliminary findings.


Asunto(s)
Anestesia Dental , Anestesia General , Atención Dental para Niños , Caries Dental/terapia , Salud Bucal , Calidad de Vida , Preescolar , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Extracción Dental , Reino Unido
13.
J Nanosci Nanotechnol ; 15(8): 5628-36, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-26369129

RESUMEN

The controlled-release of natural plant oils such as linalool is of interest in therapeutics, cosmetics, and antimicrobial and larvicidal products. The present study reports the release characteristics of linalool encapsulated at three concentrations (10, 15 and 20 wt.%) in poly(lactic acid) nanofibrous membranes produced by electrospinning and solution blow spinning (SBS) as well as the effect of linalool on fiber morphology and structural properties. PLA nanofibrous membranes were characterized by Scanning Electron Microscopy (SEM), differential scanning calorimetry (DSC), X-ray diffraction (XRD) and contact angle measurements. The average diameters of the electrospun and solution blow spun nanofibers were similar, ranging from 176 to 240 nm. Linalool behaved as a plasticizer to PLA decreasing the glass transition temperature (Tg), melting point (Tm) and crystallization temperature (TC) of PLA. Curves of the release of linalool at 35 °C were non-linear, showing a clear biphasic pattern consistent with one or more Fickian release components. The time required to release 50% of linalool (t1/2) decreased with increasing linalool concentration. The range in t1/2 values for SBS nanofibers was higher (291-1645s) than the t1/2 values for electrospun fibers (76-575s).


Asunto(s)
Preparaciones de Acción Retardada/síntesis química , Galvanoplastia/métodos , Membranas Artificiales , Monoterpenos/química , Nanocápsulas/química , Nanofibras/química , Monoterpenos Acíclicos , Cristalización/métodos , Difusión , Insecticidas/administración & dosificación , Insecticidas/química , Ácido Láctico , Ensayo de Materiales , Monoterpenos/administración & dosificación , Nanocápsulas/administración & dosificación , Nanocápsulas/ultraestructura , Nanofibras/ultraestructura , Tamaño de la Partícula , Poliésteres , Polímeros , Rotación , Propiedades de Superficie
14.
J Law Med ; 22(4): 915-33, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26349387

RESUMEN

Preimplantation genetic diagnosis (PGD) is the process by which an early in vitro embryo is screened for a genetic condition. As the name suggests, the procedure is undertaken prior to the embryo being implanted into a woman and therefore affected embryos can be discarded. This article argues that the objections previously put forward opposing the use of PGD to select against disability are flawed. It also argues that permitting parents to act in a procreatively beneficent manner and to preserve their child's right to an open future are good reasons for parents to have the freedom to select against disability. In light of this, are there any sound reasons to limit the use of PGD to selection against serious disabilities?


Asunto(s)
Conducta de Elección , Regulación Gubernamental , Padres/psicología , Diagnóstico Preimplantación , Australia , Femenino , Humanos , Modelos Teóricos , Embarazo
15.
Dent Update ; 42(8): 735-6, 738-40, 743, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26685472

RESUMEN

Topical silver nitrate may be used in oral and maxillofacial clinical settings owing to its astringent, caustic and disinfectant properties. Uses of the toughened silver nitrate pencil stick include haemostasis at bleeding points and for the management of aphthous ulcers, hypergranulation tissue, warts and verrucas. We present an interesting case of apparent silver nitrate-induced, bisphosphonate-related osteonecrosis of the hard palate following mucosal lesion biopsy in a multiple myeloma patient receiving zoledronic acid intravenous infusions. Our review of the literature indicates that this is the first report of such a scenario. CPD/Clinical Relevance: Clinicians must consider all potential sources of chemical and mechanical trauma to the bone and overlying mucosa when managing patients at risk of developing bisphosphonate-related osteonecrosis of the jaw.


Asunto(s)
Osteonecrosis de los Maxilares Asociada a Difosfonatos/etiología , Nitrato de Plata/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo
16.
Br Dent J ; 236(4): 261-267, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-38388595

RESUMEN

Oral mucosal and other head and neck conditions in children have a variety of presentations. The joint oral medicine and paediatric (JOMP) dental clinic is a specialised unit within a London teaching hospital, developed to manage a wide range of oral conditions with an absolute commitment to a child-centred care approach. The authors present eight cases from the JOMP clinic experience at Guy's and St Thomas' NHS Foundation trust, over a nine-year period. Each case is unique in its presentation, diagnosis and bespoke management, tailored to the nuance of each individual patient and their unique position. The eight clinical cases demonstrate the success of the JOMP team in achieving good patient outcomes, in terms of providing accurate diagnoses for their oral conditions and for appropriately tailored management/ treatment. The cases also serve to raise awareness of some of the more unusual oral conditions affecting paediatric patients among our professional colleagues.


Asunto(s)
Enfermedades de la Boca , Medicina Oral , Humanos , Niño , Odontología Pediátrica , Enfermedades de la Boca/diagnóstico , Enfermedades de la Boca/terapia , Londres , Hospitales de Enseñanza
17.
Rev Esc Enferm USP ; 58: e20230326, 2024.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-38875500

RESUMEN

OBJECTIVE: To identify and analyze the features and quality of self-management support of mobile applications available in Brazil for chronic low back pain in adults. METHOD: A systematic review on the Apple Store® and Google Play® digital platforms. The Self-Management Support Assessment Tool scale was used to assess self-management support and the Institute for Healthcare Informatics Functionality Score scale was used to assess functionality. RESULTS: Seventeen applications were selected, which included around seven self-management skills. The applications that met the majority of self-management support skills were Pathways, Branch, Pancea, Pain Navigator, and Curable. The Curable, Branch and MoovButh applications had the highest scores, with ten features on the functionality scale. CONCLUSION: Some applications have the potential to complement in-person treatment in terms of validity, acceptability and clinical usefulness in pain management. However, barriers such as lack of partnership between healthcare providers and patients, limited evidence-based content, social support, cultural relevance, cost, language, security and privacy can limit their sustained use. PROSPERO Registration: CRD42022382686.


Asunto(s)
Dolor de la Región Lumbar , Aplicaciones Móviles , Automanejo , Dolor de la Región Lumbar/terapia , Humanos , Automanejo/métodos , Brasil , Adulto , Dolor Crónico/terapia
18.
Clinics (Sao Paulo) ; 79: 100419, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38981306

RESUMEN

BACKGROUND: HIV Pre-Exposure Pophylaxis (PrEP) is provided free of charge by the Brazilian national health system. Though effective in preventing HIV infection, little is known about its impact on the health-related Quality of Life (QoL) of users. OBJECTIVE: The present study aimed at assessing the impact of PrEP on the QoL of its users. METHODS: Prospective cohort study with 114 HIV-negative participants aged 18 years or older. Participants' QoL was assessed before starting PrEP and after 7 months of use, using the self-responsive WHOQOL-bref questionnaire. Sociodemographic and behavioral aspects were described and the Wilcoxon signed-rank test with p ≤ 0.05 was considered statistically significant. RESULTS: Improvement was seen in QoL scores for the environment domain (p = 0.02), which addresses feeling of physical safety, access to information and health services, and participation in leisure activities. Furthermore, participants reported improved satisfaction with their sex life, when questioned about the social relationships domain. There was no statistically significant change in the global QoL score, in the global health score, in the physical and psychological domains, nor in the total score for the social relationships domain. As for their socio-demographic profile, most participants were white and highly educated young cisgender men who have sex with men. 76.3% had unprotected sex in the 3 months before starting PrEP. 60.5% had reported substance use: marijuana (42.1%), club drugs (35.1%), and poppers (20.2%). CONCLUSIONS: This study unveiled that PrEP benefited our cohort beyond its effectiveness in preventing HIV infection, having improved environmental aspects of QoL and self-satisfaction with sex life.


Asunto(s)
Infecciones por VIH , Profilaxis Pre-Exposición , Calidad de Vida , Factores Socioeconómicos , Humanos , Masculino , Adulto , Femenino , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Brasil , Estudios Prospectivos , Profilaxis Pre-Exposición/métodos , Encuestas y Cuestionarios , Adulto Joven , Fármacos Anti-VIH/uso terapéutico , Fármacos Anti-VIH/administración & dosificación , Persona de Mediana Edad , Conducta Sexual/psicología , Adolescente , Factores Sociodemográficos , Estadísticas no Paramétricas
19.
iScience ; 27(8): 110565, 2024 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-39184442

RESUMEN

Astroglia play crucial neuroprotective roles by internalizing pathogenic aggregates and facilitating their degradation. Here, we show that α-SYN protofibril-induced organelle toxicities and reactive oxygen species (ROS) cause premature cellular senescence in astrocytes and astrocyte-derived cancer cells, resulting in a transient increase in the biogenesis of tunneling nanotubes (TNTs). TNT-biogenesis and TNT-mediated cell-to-cell transfer lead to clearance of α-SYN-induced organelle toxicities, reduction in cellular ROS levels, and reversal of cellular senescence. Enhanced cell proliferation is seen in the post-recovered cells after recovering from α-SYN-induced organelle toxicities. Further, we show that α-SYN-induced senescence promotes the transient localization of focal adhesion kinase (FAK) in the nucleus. FAK-mediated regulation of Rho-associated kinases plays a significant role in the biogenesis of TNTs and their subsequent proliferation. Our study emphasizes that TNT biogenesis has a potential role in the clearance of α-SYN-induced cellular toxicities, the consequences of which cause enhanced proliferation in the post-recovered astroglia cells.

20.
Commun Biol ; 7(1): 552, 2024 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-38720028

RESUMEN

Global biodiversity gradients are generally expected to reflect greater species replacement closer to the equator. However, empirical validation of global biodiversity gradients largely relies on vertebrates, plants, and other less diverse taxa. Here we assess the temporal and spatial dynamics of global arthropod biodiversity dynamics using a beta-diversity framework. Sampling includes 129 sampling sites whereby malaise traps are deployed to monitor temporal changes in arthropod communities. Overall, we encountered more than 150,000 unique barcode index numbers (BINs) (i.e. species proxies). We assess between site differences in community diversity using beta-diversity and the partitioned components of species replacement and richness difference. Global total beta-diversity (dissimilarity) increases with decreasing latitude, greater spatial distance and greater temporal distance. Species replacement and richness difference patterns vary across biogeographic regions. Our findings support long-standing, general expectations of global biodiversity patterns. However, we also show that the underlying processes driving patterns may be regionally linked.


Asunto(s)
Artrópodos , Biodiversidad , Animales , Artrópodos/clasificación , Artrópodos/fisiología , Geografía , Análisis Espacio-Temporal
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