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1.
Langmuir ; 33(25): 6333-6341, 2017 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-28555495

RESUMO

Colloidal Mn2+-doped ZnS quantum dots (QDs) were synthesized, surface modified, and thoroughly characterized using a pool of complementary techniques. Cap exchange of the native l-cysteine coating of the QDs with dihydrolipoic acid (DHLA) ligands is proposed as a strategy to produce nanocrystals with a strong phosphorescent-type emission and improved aqueous stability. Moreover, such a stable DHLA coating can facilitate further bioconjugation of these QDs to biomolecules using established reagents such as cross-linker molecules. First, a structural and morphological characterization of the l-cysteine QD core was performed by resorting to complementary techniques, including X-ray powder diffraction (XRD) and microscopy tools. XRD patterns provided information about the local structure of ions within the nanocrystal structure and the number of metal atoms constituting the core of a QD. The judicious combination of the data obtained from these complementary characterization tools with the analysis of the QDs using inductively coupled plasma-mass spectrometry (ICP-MS) allowed us to assess the number concentration of nanoparticles in an aqueous sample, a key parameter when such materials are going to be used in bioanalytical or toxicological studies. Asymmetric flow field-flow fractionation (AF4) coupled online to ICP-MS detection proved to be an invaluable tool to compute the number of DHLA molecules attached to the surface of a single QD, a key feature that is difficult to estimate in nanoparticles and that critically affects the behavior of nanoparticles when entering the biological media (e.g., cellular uptake, biodistribution, or protein corona formation). This hybrid technique also allowed us to demonstrate that the elemental composition of the nanoparticle core remains unaffected after the ligand exchange process. Finally, the photostability and robustness of the DHLA-capped QDs, critical parameters for bioanalytical applications, were assessed by molecular luminescence spectroscopy.

2.
Allergy Asthma Proc ; 36(5): e86-91, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26314809

RESUMO

BACKGROUND: Asthma care plans typically include complicated written instructions. Customized, audio-recorded instructions may bridge health literacy gaps and improve treatment plan understanding. OBJECTIVE: To measure the effects of a recordable greeting card-style tool (Talking Card) on asthma control and parental care of children with asthma. METHODS: Multisite randomized trial in two primary care clinics, including children 4-11 years old with uncontrolled asthma and their parents. Parent-child dyads were randomized to usual care of asthma or usual care plus the Talking Card. Dyads completed three asthma-focused visits over 3 months. At the visit, card recipients received customized instructions recorded by the pediatrician onto an audio chip in the card. Asthma control was measured by using the Childhood Asthma Control Test. Card use and parental satisfaction were measured by parental survey (card arm only). Outcomes were analyzed by using generalized estimating equations and frequency distributions. RESULTS: Sixty-four dyads participated and attended 166 clinic visits. Card use was associated with a 1.6-point increase in Childhood Asthma Control Test score (p = 0.02) and a clinic visit regardless of card use with a three-point increase (p < 0.001). Satisfaction and self-efficacy were high among the card users. The mean satisfaction score was 8.9 of 10, with 96% agreeing or strongly agreeing that the card helped them take better care of asthma. CONCLUSIONS: The Talking Card, a novel audio communication tool, was associated with improved asthma control and deemed highly desirable by parents and children struggling to control asthma. This inexpensive portable tool may be useful in other chronic disorders and in locales with low literacy and poor access to digital technology.


Assuntos
Asma/diagnóstico , Recursos Audiovisuais/estatística & dados numéricos , Adulto , Asma/prevenção & controle , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Modelos Educacionais , Pais , Educação de Pacientes como Assunto , Satisfação do Paciente , Medicina de Precisão , Inquéritos e Questionários
3.
Ann Vasc Surg ; 27(5): 672.e19-21, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23809935

RESUMO

Endoleak treatment after endovascular aneurysm repair (EVAR) can be difficult and complex. The key to success lies mostly in the accurate interpretation of imaging tests. We describe the case of a patient who was urgently operated on due to an episode of acute arterial ischemia in the left lower limb for stent-graft iliac limb thrombosis and a proximal type I endoleak. We highlight the importance of performing aneurysm sac angiography as part of an effective therapeutic strategy.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Aortografia , Endoleak/diagnóstico por imagem , Procedimentos Endovasculares , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/complicações , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Endoleak/cirurgia , Humanos , Aneurisma Ilíaco/complicações , Aneurisma Ilíaco/cirurgia , Masculino , Stents
4.
mBio ; 14(1): e0286522, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36537810

RESUMO

Faster-growing cells must synthesize proteins more quickly. Increased ribosome abundance only partly accounts for increases in total protein synthesis rates. The productivity of individual ribosomes must increase too, almost doubling by an unknown mechanism. Prior models point to diffusive transport as a limiting factor but raise a paradox: faster-growing cells are more crowded, yet crowding slows diffusion. We suspected that physical crowding, transport, and stoichiometry, considered together, might reveal a more nuanced explanation. To investigate, we built a first-principles physics-based model of Escherichia coli cytoplasm in which Brownian motion and diffusion arise directly from physical interactions between individual molecules of finite size, density, and physiological abundance. Using our microscopically detailed model, we predicted that physical transport of individual ternary complexes accounts for ~80% of translation elongation latency. We also found that volumetric crowding increases during faster growth even as cytoplasmic mass density remains relatively constant. Despite slowed diffusion, we predicted that improved proximity between ternary complexes and ribosomes wins out, illustrating a simple physics-based mechanism for how individual elongating ribosomes become more productive. We speculate that crowding imposes a physical limit on growth rate and undergirds cellular behavior more broadly. Unfitted colloidal-scale modeling offers systems biology a complementary "physics engine" for exploring how cellular-scale behaviors arise from physical transport and reactions among individual molecules. IMPORTANCE Ribosomes are the factories in cells that synthesize proteins. When cells grow faster, there are not enough ribosomes to keep up with the demand for faster protein synthesis without individual ribosomes becoming more productive. Yet, faster-growing cells are more crowded, seemingly making it harder for each ribosome to do its work. Our computational model of the physics of translation elongation reveals the underlying mechanism for how individual ribosomes become more productive: proximity and stoichiometry of translation molecules overcome crowding. Our model also suggests a universal physical limitation of cell growth rates.


Assuntos
Proteínas de Escherichia coli , Escherichia coli , Escherichia coli/metabolismo , Ribossomos/metabolismo , Biossíntese de Proteínas , Proteínas de Escherichia coli/genética , Proteínas de Escherichia coli/metabolismo , Movimento (Física)
5.
Animals (Basel) ; 14(1)2023 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-38200774

RESUMO

INTRODUCTION: Elasmobranchs currently constitute an important part of the animal collection of many aquariums worldwide. Their maintenance under human care has allowed us to describe and identify new pathogens and diseases affecting them, as well as to determine different treatments for these diseases. Great advances in elasmobranch husbandry have been developed. METHODS: A search was performed on scientific databases as PubMed and other specialized sources (IAAAM archive). RESULTS: Little information on pharmacotherapeutics is available in this taxonomic group, and treatments lack a scientific base and instead are frequently dependent on empirical knowledge. Pharmacokinetic studies are the first step to determining therapeutic protocols that are safe and effective. The available bibliography shows that a majority of the mycoses recorded in cartilaginous fish are severe, aggravated by the fact that the antifungal treatments administered, following the guidelines used for teleost species, are ineffective in elasmobranchs. Azoles appear to be a promising group of antifungals for use in treating systemic mycoses in sharks and rays. CONCLUSIONS: Based on the findings of this review, it is essential to investigate the pharmacokinetics of the different antifungals in these species in order to provide therapeutic options for fungal infections in cartilaginous fish.

6.
Am J Trop Med Hyg ; 107(6): 1261-1266, 2022 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-36375451

RESUMO

Leptospirosis represents a public health problem in Panama, with an incidence rate of 1 in 100,000 inhabitants in 2014. Despite active surveillance and reports of outbreaks in the news, publications about human leptospirosis in Panama are scarce. The objective of this study was to describe the epidemiological and clinical features of leptospirosis in a cohort of patients admitted to the national reference hospital from January 2013 to December 2018. A total of 188 patients with suspected leptospirosis were identified, but only 56.9% (107 of 188) of the medical records could be retrieved. Microagglutination assays were completed in 45% (48 of 107) of the patients, confirming leptospirosis in 29.2% (14 of 48) of the patients. The most prevalent serogroup identified was Leptospira interrogans icterohemorrhagiae (4 of 14, 28.6%). The majority of patients with confirmed disease were middle-aged (36.4 ± 15.7 years), male (11 of 14, 78.6%), and symptomatic for 6.8 ± 0.7 days before admission. The predominant clinical presentation was fever (13 of 14, 92.9%), abdominal pain (7 of 14, 50%), and jaundice (8 of 14, 57.1%). Respiratory failure (8 of 14, 57.1%), elevated creatinine levels on admission (8 of 14, 57.1%), transfusion of blood-derived products (6 of 14, 42.9%), and required use of vasopressors (4 of 14, 28.6%) were common complications. Mortality was 28.6% (4 of 14). Empiric antibiotic therapy was initiated in almost all patients (10 of 12, 83.3%), and was appropriate in 90% (9 of 10) of them. Our study highlights the high prevalence of severe disease and reveals the diagnostic challenges concealing the true burden of leptospirosis in Panama. However, the small number of confirmed patients limits the generalization of these findings.


Assuntos
Leptospira , Leptospirose , Pessoa de Meia-Idade , Humanos , Masculino , Leptospirose/diagnóstico , Leptospirose/tratamento farmacológico , Leptospirose/epidemiologia , Sorogrupo , Incidência , Hospitais
7.
JACC Case Rep ; 4(20): 1360-1362, 2022 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-36299646

RESUMO

Carcinoid heart disease (CaHD) is part of the carcinoid syndrome. Cardiac involvement is present in 20% to 60% of patients with carcinoid syndrome and is normally from liver metastasis. We report the case of a patient who presented with CaHD disease with an undiagnosed primary tumor or a possible primary liver carcinoid tumor. (Level of Difficulty: Advanced.).

8.
Anal Bioanal Chem ; 399(1): 29-42, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21052647

RESUMO

Optical labelling reagents (dyes and fluorophores) are an essential component of probe-based biomolecule detection, an approach widely employed in a variety of areas including environmental analysis, disease diagnostics, pharmaceutical screening, and proteomic and genomic studies. Recently, functional nanomaterials, as a new generation of high-value optical labels, have been applied to molecular detection. The great potential of such recent optical labels has paved the way for the development of new biomolecule assays with unprecedented analytical performance characteristics, related to sensitivity, multiplexing capability, sample throughput, cost-effectiveness and ease of use. This review aims to provide an overview of recent advances using different nanoparticles (such as quantum dots, rare earth doped nanoparticles or gold nanoparticles) for analytical genomics and proteomics, with particular emphasis on the outlook for different strategies of using nanoparticles for bioimaging and quantitative bioanalytical applications, as well as possibilities and limitations of nanoparticles in such a growing field.


Assuntos
Técnicas Biossensoriais/instrumentação , Diagnóstico por Imagem/instrumentação , Corantes Fluorescentes/química , Genômica/instrumentação , Nanopartículas/química , Proteômica/instrumentação , Animais , Técnicas Biossensoriais/métodos , Diagnóstico por Imagem/métodos , Genômica/métodos , Humanos , Proteômica/métodos
9.
Eur J Gastroenterol Hepatol ; 33(10): 1316-1321, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32868653

RESUMO

OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is associated with obesity and insulin resistance; however, there is a group of non-obese patients with NAFLD that need to be characterized. Our aim was to evaluate the factors associated with NAFLD in non-obese subjects in a third-level hospital. METHODS: A comparative cross-sectional study was performed. Participants were divided into four groups: non-obese without NAFLD (group 1), non-obese with NAFLD (group 2), obese without NAFLD (group 3), and obese with NAFLD (group 4). We evaluated the effect of clinical and biochemical characteristics with the disease by groups using a multinomial regression model and a 2K factorial analysis. RESULTS: We included 278 participants. Low platelet-lymphocyte ratio (PLR) as a novel parameter associated with NAFLD in non-obese subjects. Age, uric acid, alanine transaminase (ALT), high-density lipoprotein (HDL)-cholesterol, and neutrophil-lymphocyte ratio (NLR) were other related parameters (akaike information criterion = 557). NLR had the larger OR in groups with NAFLD (lean with NAFLD 7.12, obese with NAFLD 13.02). The 2k factorial design found inverse effect on PLR by NAFLD (effect -21.89, P < 0.001), which was higher than BMI (effect -1.33, P < 0.045). CONCLUSION: Our study found that PLR is a novel parameter with inverse correlation with NAFLD in non-obese patients. Other related parameters are age, hyperuricemia, elevation of ALT and NLR, and low HDL-cholesterol.


Assuntos
Resistência à Insulina , Hepatopatia Gordurosa não Alcoólica , Alanina Transaminase , Índice de Massa Corporal , Estudos Transversais , Humanos , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/epidemiologia
10.
J Vasc Surg Cases Innov Tech ; 7(2): 311-314, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34041418

RESUMO

Metallosis is a well-known complication at the site of total hip and knee arthroplasty. Vascular involvement of this complication is rare and generally results from vascular compression by a mass or pseudotumor. In the present report, we have described a case of lower limb acute arterial ischemia due to arterial injury as a complication of metallosis with a fatal outcome.

11.
F1000Res ; 9: 56, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32595949

RESUMO

Background: Nonalcoholic fatty liver disease (NAFLD) is a serious worldwide health problem, with an estimated global prevalence of 24%; it has a notable relationship with other metabolic disorders, like obesity and type 2 diabetes mellitus (T2DM). Nonalcoholic steatohepatitis (NASH) is one of the most important clinical entities of NAFLD, which is associated with an increased risk of progression to liver cirrhosis and hepatocellular carcinoma (HCC). Mexico is one of the countries with the highest prevalence of metabolic diseases; therefore, we sought to investigate the impact that these clinical entities have in the progression to advanced fibrosis in Mexican patients with NASH. Methods: We performed a multicenter retrospective cross-sectional study, from January 2012 to December 2017. A total of 215 patients with biopsy-proven NASH and fibrosis were enrolled. NASH was diagnosed according NAS score and liver fibrosis was staged by the Kleiner scoring system. For comparing the risk of liver fibrosis progression, we divided our sample into two groups. Those patients with stage F0-F2 liver fibrosis were included in the group with non-significant liver fibrosis (n=178) and those individuals with F3-F4 fibrosis were included in the significant fibrosis group (n=37). We carried out a multivariate analysis to find risk factors associated with liver fibrosis progression. Results: From the 215 patients included, 37 had significant liver fibrosis (F3-4). After logistic regression analysis T2DM (p=0.044), systemic arterial hypertension (p=0.014), cholesterol (p=0.041) and triglycerides (p=0.015) were the main predictor of advanced liver fibrosis. Conclusions: In a Mexican population, dyslipidemia was the most important risk factor associated with advanced liver fibrosis and cirrhosis.


Assuntos
Dislipidemias/complicações , Cirrose Hepática/epidemiologia , Hepatopatia Gordurosa não Alcoólica , Adulto , Idoso , Carcinoma Hepatocelular , Estudos Transversais , Diabetes Mellitus Tipo 2 , Feminino , Humanos , Cirrose Hepática/complicações , Neoplasias Hepáticas , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Estudos Retrospectivos , Fatores de Risco
12.
J Vasc Surg ; 49(3): 681-9, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19268773

RESUMO

OBJECTIVE: To produce a comprehensive anatomical and hemodynamic ultrasound scan mapping of the whole limb in patients with primary varicose veins (VVs). DESIGN: An analysis of venous duplex scans performed on patients referred for treatment of primary VVs. METHODS: A total of 2036 limbs were evaluated, looking for the origin of VVs in the saphenous systems and in the perforating vein (PV) systems, as well as for the presence of non-saphenous reflux. RESULTS: The sapheno-femoral junction (SFJ) of the great saphenous vein (GSV) was involved in 1330 limbs (65.3%). We have noted that finding reflux in the groin does not imply that it originates at that point necessarily, as reflux from the pelvis or abdominal wall can also cause primary VVs (SFJ reflux, 41.9% and competent SFJ with reflux from proximal veins, 35.4%). We also noted that analyzing only the presence of reflux in the SFJ of the GSV would miss 10.9% of limbs of reflux in the SFJ of the anterior accessory GSV. In 237 limbs (11.6%), reflux was observed in the popliteal fossa. In the PV system, we distinguished those PVs with retrograde flow that acted as an origin of the VVs, and other PVs that acted as re-entry points. Based on this difference, the location identified as the most frequent origin of VVs in the PV system was the thigh, specifically in the group of PVs of the medial thigh of the femoral canal, with 85 PVs with a total of 238 incompetent PVs identified. Pure non-saphenous reflux was observed in 162 limbs (8%). CONCLUSION: The assumption that the origin of VVs would be exclusively in the sapheno-femoral or sapheno-popliteal junction, is a mistaken attitude and a comprehensive duplex scan mapping is recommended.


Assuntos
Hemodinâmica , Extremidade Inferior/irrigação sanguínea , Ultrassonografia Doppler Dupla , Varizes/diagnóstico por imagem , Insuficiência Venosa/diagnóstico por imagem , Veia Femoral/diagnóstico por imagem , Veia Femoral/fisiopatologia , Humanos , Veia Poplítea/diagnóstico por imagem , Veia Poplítea/fisiopatologia , Valor Preditivo dos Testes , Fluxo Sanguíneo Regional , Estudos Retrospectivos , Veia Safena/diagnóstico por imagem , Veia Safena/fisiopatologia , Varizes/fisiopatologia , Insuficiência Venosa/fisiopatologia
13.
J Pediatr Hematol Oncol ; 31(10): 790-3, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19770681

RESUMO

BACKGROUND: L-asparaginase (L-asp) is used as part of the initial treatment in children with acute lymphoblastic leukemia (ALL), inducing remission in 83% to 95% of the treated patients. Major toxicity effects reported are hypersensitivity reactions and dysfunctions of the liver and pancreas. Acute pancreatitis (AP) induced by L-asp has been noted in 2.5% to 16% of the treated patients. The purpose of this study was to determine the frequency and outcome of AP in children with ALL treated with L-asp in a tertiary care pediatric hospital. METHODS: From January 1999 to June 2005, the charts of children with ALL admitted for L-asp treatment were reviewed. Data from children who developed AP were analyzed retrospectively. AP was defined as the presence of clinical data (nausea, vomiting, and abdominal pain), elevated pancreatic enzymes, and changes in the abdominal ultrasound and/or computed tomography (CT) scan. Clinical and biochemical data, abdominal ultrasound, and CT scan findings, complications, treatment, and outcome were analyzed retrospectively. RESULTS: During the last 6 years, 266 ALL new cases were started on chemotherapy including L-asp, of which 18 of 266 (6.7%) developed AP. Pancreatic necrosis by CT scan was found in 10 patients, peripancreatic collections and pseudocyst formation were detected in 5 and 3 cases, respectively, and resolved by cystogastrostomy or drainage. Two patients developed chronic pancreatitis and 3 diabetes. There was no relationship between number of doses and pancreatic toxicity. None of the patient died due to pancreatic toxicity. CONCLUSIONS: L-asp is an effective drug to treat ALL, the administration of L-asp requires the monitoring of pancreatic toxicity to detect AP and have treatment initiated as early as possible. Chronic complications after AP occur in almost one third of cases.


Assuntos
Asparaginase/toxicidade , Pancreatite/induzido quimicamente , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Doença Aguda , Asparaginase/uso terapêutico , Doença Hepática Induzida por Substâncias e Drogas , Criança , Pré-Escolar , Diagnóstico por Imagem , Hipersensibilidade a Drogas , Feminino , Humanos , Incidência , Masculino , Pancreatopatias/induzido quimicamente , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Estudos Retrospectivos , Resultado do Tratamento
14.
J Pediatr Gastroenterol Nutr ; 47 Suppl 1: S27-32, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18667914

RESUMO

In susceptible individuals, the adaptive response, mediated by the activation of antigen-specific T lymphocytes, drives a proinflammatory response, which ends in an immune-mediated enteropathy characterized by villous atrophy, crypt hyperplasia, and recruitment of intraepithelial lymphocytes. In addition, some gluten peptides are able to induce an innate immune response in intestinal mucosa. The molecular mechanisms and the cells involved in the initial stages of the gluten-intestinal mucosa interaction are poorly understood to date. There is evidence of a direct toxic effect of gluten peptides in several biological models. However, the failure to control the inflammatory response may be one of the factors underlying gluten intolerance in these individuals. The cytokine network involved in celiac disease is characterized by abundant interferon-gamma in the intestinal mucosa. In addition, the production of interleukin (IL)-15, IL-18, and IL-21 is linked to gluten intake, which can drive the inflammatory response probably sustained by IL-18, IL-21, and perhaps IL-27 through STAT1 and STAT5 pathways, whereas neither IL-12 nor IL-23 plays a significant role in pathogenic mechanisms. Herein we describe the involvement of these activation pathways in the context of the pathogenesis of celiac disease.


Assuntos
Doença Celíaca , Citocinas/metabolismo , Imunidade Inata , Mediadores da Inflamação/metabolismo , Mucosa Intestinal/metabolismo , Linfócitos T/metabolismo , Doença Celíaca/imunologia , Doença Celíaca/metabolismo , Doença Celíaca/patologia , Criança , Pré-Escolar , Citocinas/imunologia , Feminino , Gliadina/imunologia , Glutens/imunologia , Humanos , Imunidade Celular , Imunidade nas Mucosas , Lactente , Mediadores da Inflamação/imunologia , Mucosa Intestinal/imunologia , Mucosa Intestinal/patologia , Masculino , Linfócitos T/imunologia
15.
Nutr Hosp ; 35(3): 511-518, 2018 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-29974755

RESUMO

INTRODUCTION: home enteral nutrition (HEN) has undergone an important development; however, there is a notable lack of information with regard to its incidence and characteristics. OBJECTIVES: our aim was to assess the state of HEN in our area. METHODS: an observational, prospective study, involving all patients who had initiated HEN in the Nutrition Unit during a year. Epidemiological, functional, and nutritional evolution of the patients was described and incidence of HEN was calculated. RESULTS: HEN incidences totalled 229/100,000 inhabitants/year. The HEN population in our area was characterized by the aged and a high frequency of comorbidity and functional limitations. Neurological and oncological diseases accounted for 50% of indications. The remaining cases were malnourished patients who had received short periods of HEN after hospitalization or a hip fracture. Oral supplements (60%) with standard and hypercaloric formulas were used the most. At baseline, 75% of the patients suffered from malnutrition. During the follow-up, patients showed weight gain (1.6%), an increase in the percentage of normal weight and overweight (from 74% to 82.7%, p = 0.001) and a reduction in pressure ulcers (15.7% vs10.3%, p < 0.001). The median duration of HEN was 8.5 months. Only a quarter of the patients experienced complications (mostly mild gastrointestinal complications); 43.1% had died at the end of the follow-up. CONCLUSIONS: in our area, the HEN incidence was much higher than those described in the literature. HEN appears to be a safe therapy with few complications that improves the nutritional status of the patients, even with short periods of administration.


Assuntos
Nutrição Enteral/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Nutrição Enteral/efeitos adversos , Nutrição Enteral/mortalidade , Feminino , Serviços de Assistência Domiciliar , Humanos , Incidência , Masculino , Desnutrição/epidemiologia , Desnutrição/terapia , Pessoa de Meia-Idade , Estudos Prospectivos , Espanha/epidemiologia
16.
World J Clin Cases ; 6(15): 922-930, 2018 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-30568947

RESUMO

AIM: To investigate the main current etiologies of cirrhosis in Mexico. METHODS: We performed a cross-sectional retrospective multicenter study that included eight hospitals in different areas of Mexico. These hospitals provide health care to people of diverse social classes. The inclusion criteria were a histological, clinical, biochemical, endoscopic, or imaging diagnosis of liver cirrhosis. Data were obtained during a 5-year period (January 2012-December 2017). RESULTS: A total of 1210 patients were included. The mean age was 62.5 years (SD = 12.1), and the percentages of men and women were similar (52.0% vs 48.0%). The most frequent causes of liver cirrhosis were hepatitis C virus (HCV) (36.2%), alcoholic liver disease (ALD) (31.2%), and nonalcoholic steatohepatitis (23.2%), and the least frequent were hepatitis B virus (1.1%), autoimmune disorders (7.3%), and other conditions (1.0%). CONCLUSION: HCV and ALD are the most frequent causes of cirrhosis in Mexico. However, we note that non-alcoholic fatty liver disease (NAFLD) as an etiology of cirrhosis increased by 100% compared with the rate noted previously. We conclude that NAFLD will soon become one of the most frequent etiologies of liver cirrhosis in Mexico.

18.
Allergy Rhinol (Providence) ; 7(4): 200-206, 2016 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-28683246

RESUMO

BACKGROUND: Sensitization to Pinales (Cupressaceae and Pinaceae) has increased dramatically in recent years. The prevalence of sensitization in different geographic areas is related to exposure to specific pollens. OBJECTIVES: To investigate the prevalence of allergy to different conifer pollens, describe the characteristics of patients with such allergy, and identify the involved allergens. METHODS: Patients were recruited at five hospitals near Madrid. Extracts from conifer pollen were prepared and used in skin-prick testing. Wheal sizes were recorded, and serum samples obtained from patients with positive reactions to Cupressus arizonica and/or Pinus pinea. The specific immunoglobulin E value to C. arizonica and Cup a 1 was determined. Individual immunoblots for each patient and with a pool of sera were performed. Allergenic proteins were sequenced by using liquid chromatography-tandem mass spectrometry. RESULTS: Of 499 individuals included in the study, 17 (14%) had positive skin-prick test results to some conifer pollen extracts. Sixty-four patients had positive results to C. arizonica (prevalence 12.8%) and 11 had positive results to P. pinea (2.2%). All the patients had respiratory symptoms (61.4% during the C. arizonica pollination period), and 62.9% had asthma. Approximately 86% of the patients had positive specific immunoglobulin E results to C. arizonica and 92.3% had positive results to Cup a 1. Fourteen different bands were recognized by immunoblot; the most frequent bands were those detected at 43, 18, 16, and 14 kDa. All sequenced proteins corresponded to Cup a 1. CONCLUSION: Allergy to conifer pollen could be considered a relevant cause of respiratory allergy in central Spain. Asthma was more frequent than in other studies. We only identified Cup a 1 as involved in sensitization.

19.
Nutr Hosp ; 32(1): 215-21, 2015 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-26262720

RESUMO

INTRODUCTION: home artificial nutrition (HAN) is a growing therapy, but the absence of obligatory registries complicates the calculation of its real economic burden. The aim of this study was to assess the state and economic impact of HAN in our health area. METHODS: an observational, prospective study was designed to calculate the cost of nutritional formulas and materials in patients who initiated HAN in the nutrition unit during a year. RESULTS: we included 573 new patients with HAN during the study period, 60% of whom were treated with oral supplements. The median daily cost of oral HAN was 3.65 (IQR 18.63) euros compared to a cost of 8.86 (IQR 20.02) euros for enteral-access HAN. The daily expenditure per 1 000 kcal of diet was higher for patients on oral HAN than for patients with tubes (5.13 vs. 4.52 euros, p < 0.001). The median cost of the complete HAN treatments during the study period was also calculated (186.60 euros and 531.99 euros for oral and tube HAN, respectively). The total estimated cost for all patients who initiated HAN in the study period was around one million euros. CONCLUSIONS: HAN represented an important economic burden in our health area, but the estimated daily cost of HAN was moderate, probably because of the high frequency of oral HAN, the adjusted treatments, and the centralized dispensation by the hospital pharmacy.


Introducción: la nutrición artificial domiciliaria (NAD) es una terapia en creciente desarrollo, pero la ausencia de registros obligatorios hace difícil calcular la carga económica que implica. Nuestro objetivo es evaluar el estado y el impacto económico de la NAD en nuestra área sanitaria. Métodos: estudio observacional y prospectivo diseñado para estimar el gasto en fórmulas y materiales nutricionales en los pacientes que iniciaron NAD durante 1 año. Resultados: se incluyeron 573 pacientes que iniciaron NAD en el período de estudio. El 60% recibieron suplementos orales. La mediana de gasto diario fue de 3,65 (RIC 18,63) euros en la NAD oral y de 8,86 (RIC 20,02) euros en la NAD por acceso enteral. El gasto por 1.000 kcal de dieta fue superior en los pacientes con NAD oral respecto a los pacientes con NAD enteral (5,13 vs. 4,52 euros, p < 0.001). Asimismo se calculó la mediana de gasto completo de los tratamientos durante todo el período de estudio (186,60 euros y 531,99 euros en NAD oral y enteral, respectivamente). Considerando el gasto conjunto de todos los pacientes que iniciaron NAD en el período de estudio, el gasto estimado estaría en torno a un millón de euros. Conclusiones: la NAD representa una importante carga económica en nuestra área sanitaria. Sin embargo, el gasto diario estimado fue moderado, probablemente por la elevada proporción de NAD oral en nuestra muestra, la revisión frecuente de la indicación y la centralización de la dispensación desde el servicio de Farmacia Hospitalaria.


Assuntos
Serviços de Assistência Domiciliar/economia , Serviços de Assistência Domiciliar/estatística & dados numéricos , Apoio Nutricional/economia , Apoio Nutricional/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Análise Custo-Benefício , Feminino , Alimentos Formulados , Humanos , Masculino , Pessoa de Meia-Idade , Apoio Nutricional/métodos , Sistema de Registros , Espanha , Fatores de Tempo
20.
Rev Med Inst Mex Seguro Soc ; 52 Suppl 1: S34-41, 2014.
Artigo em Espanhol | MEDLINE | ID: mdl-24866306

RESUMO

BACKGROUND: The degree of overweight-obesity varies according to the conditions of each population and depending on geographical area, race or ethnicity, socioeconomic status, and susceptibility of each individual. The aim of this study was to determine anthropometric measures in urban child population from 6 to 12 years of Ciudad Obregón, Sonora. METHODS: We studied 684 schoolchildren from 6 to 12 years of age, of both genders in the urban area of Ciudad Obregón, Sonora. We measured weight, height, arm circumference (AC), waist, and body mass index (BMI). We used descriptive statistics (frequencies, percentages), and to compare the growth charts of this study vs. the reference standards (CDC and Ramos-Galván), we employed statistical inference (Student t test). RESULTS: On average, weight, height, AC, BMI for age by gender were higher than the reference standards at all ages. Seventy-four boys (22 %) and 51 girls (14.5 %) were above 95th percentile. With regards to size, 42 children (12.6 %) were below the 5th percentile and 37 (10.5 %) above the 95th percentile. CONCLUSION: Schoolchildren in the southern zone of Sonora showed a higher anthropometric pattern than the reference standards.


INTRODUCCIÓN: el grado de sobrepeso-obesidad tendrá variaciones de acuerdo con las condiciones de cada población, según el ámbito geográfico, la raza o etnia, el status socioeconómico y la susceptibilidad de cada individuo. El objetivo de este estudio fue determinar medidas antropométricas en la población infantil urbana de 6 a 12 años de Ciudad Obregón, Sonora. MÉTODOS: se estudiaron 684 escolares de 6 a 12 años de edad, sanos y de ambos géneros de la zona urbana de Ciudad Obregón, Sonora, en quienes se midieron peso, talla, perímetro braquial (PB), cintura e índice de masa corporal (IMC). Se realizó estadística descriptiva mediante frecuencias, porcentajes, e inferencial mediante t de Student para comparar las tablas de crecimiento de Ramos Galván y las del Centro para el Control y Prevención de Enfermedades (CDC). RESULTADOS: en promedio, peso, talla, PB, IMC por edad según el género fueron superiores a los estándares de referencia en todas las edades. Setenta y cuatro niños (22 %) y 51 niñas (14.5 %) se situaron por arriba del percentil 95. Con respecto a la talla, 42 niños (12,6 %) se encontraron por abajo del percentil 5 y 37 (10.5 %) por arriba del percentil 95. CONCLUSIÓN: los escolares de la zona sur del estado de Sonora presentaron un patrón antropométrico superior a los patrones de referencia conocidos.


Assuntos
Pesos e Medidas Corporais , Criança , Estudos Transversais , Feminino , Humanos , Masculino , México , População Urbana
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