Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.569
Filtrar
1.
Neural Regen Res ; 20(4): 1031-1041, 2025 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38845231

RESUMO

Astrocytes are the most abundant type of glial cell in the central nervous system. Upon injury and inflammation, astrocytes become reactive and undergo morphological and functional changes. Depending on their phenotypic classification as A1 or A2, reactive astrocytes contribute to both neurotoxic and neuroprotective responses, respectively. However, this binary classification does not fully capture the diversity of astrocyte responses observed across different diseases and injuries. Transcriptomic analysis has revealed that reactive astrocytes have a complex landscape of gene expression profiles, which emphasizes the heterogeneous nature of their reactivity. Astrocytes actively participate in regulating central nervous system inflammation by interacting with microglia and other cell types, releasing cytokines, and influencing the immune response. The phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway is a central player in astrocyte reactivity and impacts various aspects of astrocyte behavior, as evidenced by in silico , in vitro , and in vivo results. In astrocytes, inflammatory cues trigger a cascade of molecular events, where nuclear factor-κB serves as a central mediator of the pro-inflammatory responses. Here, we review the heterogeneity of reactive astrocytes and the molecular mechanisms underlying their activation. We highlight the involvement of various signaling pathways that regulate astrocyte reactivity, including the PI3K/AKT/mammalian target of rapamycin (mTOR), α v ß 3 integrin/PI3K/AKT/connexin 43, and Notch/PI3K/AKT pathways. While targeting the inactivation of the PI3K/AKT cellular signaling pathway to control reactive astrocytes and prevent central nervous system damage, evidence suggests that activating this pathway could also yield beneficial outcomes. This dual function of the PI3K/AKT pathway underscores its complexity in astrocyte reactivity and brain function modulation. The review emphasizes the importance of employing astrocyte-exclusive models to understand their functions accurately and these models are essential for clarifying astrocyte behavior. The findings should then be validated using in vivo models to ensure real-life relevance. The review also highlights the significance of PI3K/AKT pathway modulation in preventing central nervous system damage, although further studies are required to fully comprehend its role due to varying factors such as different cell types, astrocyte responses to inflammation, and disease contexts. Specific strategies are clearly necessary to address these variables effectively.

2.
Rev. med. Risaralda ; 30(1): 81-87, jul.-dic. 2024.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1576520

RESUMO

Resumen Introducción: los fisioterapeutas y fonoaudiólogos como profesionales de la salud generan impacto en el rol educativo realizando acciones dentro de sus competencias de detección temprana y oportuna de las alteraciones que se presentan frecuentemente en educación inicial y preescolar a nivel de los procesos motores y comunicativos. Objetivo: realizar una reflexión sobre el rol del fisioterapeuta y el fonoaudiólogo en la educación inicial y preescolar de niños en Colombia. Reflexión: es necesaria la inclusión de los fisioterapeutas y los fonoaudiólogos en el sector educativo, formando grupos interdisciplinares en conjunto con los docentes, familias, e instituciones educativas con el fin de impactar positivamente en el bienestar comunicativo y desarrollo motor de la población que se encuentra en educación inicial y preescolar. Conclusión: se resalta la importancia de incluir a los fisioterapeutas y fonoaudiólogos en el equipo interdisciplinar en el sector educativo, con el fin de abordar de manera temprana las dificultades que puedan generarse a nivel comunicativo y en el desarrollo motor.


Abstract Introduction: Health professionals such as physiotherapists and speech therapists, within their competences, generate an impact on the educational role by carrying out early and opportune detection actions of the alterations that frequently occur in initial and preschool education at the level of motor and communication processes. Objective: To make a reflection on the role of the physiotherapist and speech therapist in the initial and preschool education of children in Colombia. Reflection: It is important to highlight and recognize the importance of including physiotherapists and speech therapists in the education sector in such a way that it can impact the population that is in initial and preschool education, forming interdisciplinary groups together with teachers, families, and schools, to impact the communicative well-being and motor development. Conclusion: When making the reflection, the importance of including physiotherapists and speech therapists in the interdisciplinary team of the educational sector is highlighted, to approach the difficulties that may be generated at the communicative level and in motor development in an early stage.

3.
Geroscience ; 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39354239

RESUMO

This study explored how adherence to the DASH diet relates to electrophysiological measures in individuals at varying Alzheimer's disease (AD) risk due to family history (FH). There were 179 dementia-free subjects. DASH index was calculated, and participants were classified into different DASH adherence groups. Tertiles of relative alpha power in default mode network (DMN) regions were calculated. Multivariate logistic regression models were used to examine the association. Lower DASH adherence was associated with decreased odds of higher relative alpha power in the DMN, observed across the entire sample and specifically among those without a FH of AD. Logistic regression models indicated that participants with poorer DASH adherence had a reduced likelihood of elevated DMN alpha power, potentially influenced by vascular and amyloid-beta mechanisms. These findings underscore the dietary pattern's potential role in neural activity modulation, particularly in individuals not genetically predisposed to AD.

4.
Rev Esp Salud Publica ; 982024 Sep 24.
Artigo em Espanhol | MEDLINE | ID: mdl-39355948

RESUMO

OBJECTIVE: It is necessary to facilitate the implementation of evidence-based practice in clinical practice to improve patients' health results. Sumamos Excelencia® is an implementation project led by nurses that aims to improve the evidence-based practice uptake. Building on the first edition, we have improved the project design and proposed new intervention topics. The objective is to evaluate the effects of the implementation of evidence-based recommendations through a multifaceted implementation strategy. METHODS: This study is an implementation research with a quasi-experimental, multicentre, before-and-after design and audits for data collection at baseline, 3, 6, and 12 months. It will be developed in hospital units, primary care centres, and nursing homes. Units choose to implement recommendations of one of these topics: assessment and management of pain, conservative management of urinary incontinence, prevention of childhood obesity, or breastfeeding promotion. All units will implement recommendations about hand hygiene. Audits will assess changes in process and patient outcomes, barriers and strategies, and evidence-based practice competencies through specific questionnaires and clinical records data. Analysis will be descriptive and inferential. CONCLUSIONS: Sumamos Excelencia® will aim to improve the use of evidence-based practice in the Spanish National Health System and to advance implementation science. This study will also provide important insight into the barriers that nurses face to implementing evidence-based practice in clinical practice and the strategies that they can use to overcome them. This generated knowledge can be used in other evidence-based practice implementation projects in a similar context to enhance adherence to evidence-based recommendations.


OBJECTIVE: Es necesario facilitar la implantación de la evidencia científica en la práctica clínica para mejorar los resultados de salud de los pacientes. Sumamos Excelencia® es un proyecto de implantación liderado por enfermeras para aumentar el uso de prácticas basadas en la evidencia en la práctica clínica. En base a la primera edición, se ha mejorado el diseño del proyecto y desarrollado nuevos paquetes de intervención clínica. El objetivo es evaluar los efectos de la implantación de recomendaciones basadas en evidencia en la práctica clínica mediante una estrategia de implantación multifacética. METHODS: Investigación en implantación con diseño cuasi-experimental multicéntrico antes-después sin grupo control, auditorías a los 0, 3, 6 y 12 meses. Realizado en unidades hospitalarias, centros de atención primaria y centros sociosanitarios. Las unidades eligen buenas prácticas sobre una intervención clínica: evaluación y manejo del dolor, manejo conservador de la incontinencia urinaria, prevención de la obesidad infantil o promoción de la lactancia materna. Todas implantarán recomendaciones sobre higiene de manos. Las auditorías evaluarán cambios en procesos y resultados, barreras y estrategias, y competencias de práctica basada en evidencia mediante cuestionarios específicos y registros clínicos. Análisis descriptivo e inferencial. CONCLUSIONS: Sumamos Excelencia® pretende mejorar el uso de la práctica basada en evidencia y aportar conocimiento a la ciencia de la implantación. Proporcionará información sobre las barreras para implantar prácticas basadas en evidencia en la práctica clínica y las estrategias para superarlas. El conocimiento generado puede utilizarse en otros proyectos de implantación para mejorar la adherencia a las recomendaciones basadas en evidencia.


Assuntos
Enfermagem Baseada em Evidências , Espanha , Humanos , Enfermagem Baseada em Evidências/organização & administração , Guias de Prática Clínica como Assunto
5.
Eye (Lond) ; 2024 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-39379522

RESUMO

Patients with glaucoma often experience chronic ocular surface diseases, potentially underestimated in frequency and severity. To provide updated estimates of ocular surface diseases linked to prostaglandin analogue antiglaucoma eye medication, a systematic review was conducted. Twenty-seven publications were selected from databases like PubMed, Scopus, and Web of Science, following a search strategy targeting glaucoma and prostaglandins while excluding certain medications '(Glaucoma AND prostaglandins OR 'prostaglandin analogues')('eye drops' OR 'artificial tears' OR 'ocular surface' OR 'dry eye' OR 'dry eye syndrome' OR 'ocular surface disease' OR 'tear film') NOT ('beta blockers' OR 'alpha adrenergic agonists' OR 'carbonic anhydrase inhibitors' OR 'rho-quinase')'. The review revealed a correlation between prostaglandin analogue use and ocular surface damage, assessing parameters such as tear break-up time, Schirmer test value, ocular surface staining, hyperaemia score, and meibomian gland characteristics. Some studies explored switching patients to alternative glaucoma medications, noting varied effects on ocular surface parameters. Comparisons suggested better tolerance and outcomes with preservative-free options over prostaglandins. Additionally, the impact of treatment duration and diquafosol on ocular health, including meibomian gland loss, was examined across different formulations. Although a link between prostaglandin analogues (with or without preservatives) and ocular surface damage was established, inconsistencies in methodologies and assessment across studies were noted. This comprehensive review, spanning a decade of glaucoma research, underscores the need for re-evaluation of treatment strategies in ophthalmology. It stresses the significance of informed decision-making for enhanced glaucoma care, taking into account the observed effects of various medications on eye health.

6.
Artigo em Inglês | MEDLINE | ID: mdl-39457281

RESUMO

The chemical components of the e-liquids and aerosols contained in electronic nicotine delivery systems (ENDSs), better known as vapes, were evaluated. The analytical technique used was gas chromatography-mass spectrometry, where the extraction and injection methods were established in this study. The work consisted of the analysis of twenty samples of disposable electronic cigarettes prefilled with new e-liquid, of a known brand, flavor, volume, and, in some of them, the percentage of nicotine and the number of puffs per device were indicated on the label. We detected the presence of many substances (at a qualitative and semi-quantitative level), and we achieved the quantification of benzene, toluene, and xylenes (BTX), dangerous substances that cause severe damage to health. Several of the e-liquids and aerosols present BTX concentrations above the permissible exposure limit (PEL), recommended by the Occupational Safety and Health Administration (OSHA): benzene in aerosol samples 80% > PEL, and toluene in aerosol samples 45% > PEL. The number of chemical compounds found in the samples increases from 13 to 167, the average being 52 compounds for the water extraction method, 42 compounds for the methanol extraction method of e-liquids, and 107 compounds for the direct aerosol analysis. It is a fact that many of those compounds, especially BTX, can cause serious effects on human health, affecting the respiratory, digestive, cardiovascular, pulmonary, and immune systems, as well as the brain. Therefore, the use of these devices should be considered with caution, since the substances and their chemical nature may pose significant health risks to both users and those exposed to secondhand emissions.


Assuntos
Aerossóis , Benzeno , Sistemas Eletrônicos de Liberação de Nicotina , Cromatografia Gasosa-Espectrometria de Massas , Tolueno , Xilenos , Cromatografia Gasosa-Espectrometria de Massas/métodos , Aerossóis/análise , México , Xilenos/análise , Tolueno/análise , Benzeno/análise
7.
Biomed Res Int ; 2024: 5560866, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39445210

RESUMO

A biomarker is defined as a characteristic that is measured as an indicator of a normal biological or pathological process, a response to an exposure or intervention. Biomarkers with a diagnostic approach must identify not only the presence but also the absence of the disease with high precision, so having the biological source of the said marker is of vital importance to ensure precision and accuracy; the aim was to carry out a review of its diagnostic potential. The search strategy was carried out in three databases: PubMed, ScienceDirect, and Scopus. The keywords that were used were as follows: "gingival crevicular fluid", "Biomarker", and "Diagnosis", using the Boolean operator "AND". The filter was used at 10 years. Within the type of molecules most studied, the cytokine family was the most abundant with 25.42% of the studies, followed by metalloproteinases and proteins with 16.9% each one. Studies that included RNA-type genetic material were less frequently found. As has been demonstrated, the use of GCF as a source of biomolecules for diagnostic use has been increasing, both for oral diseases, which reflects the local conditions of the disease; it also has the ability to reflect the development of distant diseases; and this is because GCF is a blood ultrafiltrate.


Assuntos
Biomarcadores , Líquido do Sulco Gengival , Líquido do Sulco Gengival/metabolismo , Humanos , Biomarcadores/metabolismo , Técnicas de Diagnóstico Molecular/métodos , Citocinas/metabolismo
8.
Artigo em Inglês | MEDLINE | ID: mdl-39453385

RESUMO

STUDY DESIGN: Heterogeneous data collection via a mix of prospective, retrospective, and ambispective methods. OBJECTIVE: To evaluate the effect of biological sex on patient-reported outcomes after spinal fusion surgery for lumbar degenerative disease. SUMMARY OF BACKGROUND DATA: Current literature suggests sex differences regarding clinical outcome after spine surgery may exist. Substantial methodological heterogeneity and limited comparability of studies warrants further investigation of sex-related differences in treatment outcomes. METHODS: We analyzed patients who underwent spinal fusion with or without pedicle screw insertion for lumbar degenerative disease included within a multinational study, comprising patients from 11 centers in 7 countries. Absolute values and change scores (change from pe-operative baseline to post-operative follow-up) for 12-month functional impairment (Oswestry disability index [ODI]) and back and leg pain severity (numeric rating scale [NRS]) were compared between male and female patients. Minimum clinically important difference (MCID) was defined as > 30% improvement. RESULTS: Six-hundred-sixty (59%) of 1115 included patients were female. Female patients presented with significantly baseline ODI (51.5 ± 17.2 vs. 47.8 ± 17.9, P<0.001) and back pain (6.96 ± 2.32 vs. 6.60 ± 2.30, P=0.010) and leg pain (6.49 ± 2.76 vs. 6.01 ± 2.76, P=0.005). At 12-months, female patients still reported significantly higher ODI (22.76 ± 16.97 vs. 20.50 ± 16.10, P=0.025), but not higher back (3.13 ± 2.38 vs. 3.00 ± 2.40, P=0.355) or leg pain (2.62 ± 2.55 vs. .34 ± 2.43, P=0.060). Change scores at 12 months did not differ significantly among male and female patients in ODI (∆ 1.31, 95% CI -3.88-1.25, P=0.315), back (∆ 0.22, 95% CI -0.57-0.12, P=0.197) and leg pain (∆ 0.16, 95% CI -0.56-0.24, P=0.439). MCID at 12-months was achieved in 330 (77.5%) male patients and 481 (76.3%) female patients (P=0.729) for ODI. CONCLUSION: Both sexes experienced a similar benefit from surgery in terms of relative improvement in scores for functional impairment and pain. Although female patients reported a higher degree of functional impairment and pain preoperatively, at 12 months only their average scores for functional impairment remained higher than those for their male counterparts, while absolute pain scores were similar for female and male patients.

9.
Crit Care Sci ; 36: e20240065en, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39442133

RESUMO

OBJECTIVE: To compare the effectiveness of the awake-prone position on relevant clinical outcomes in patients with COVID-19-related acute respiratory failure requiring high-flow nasal oxygen between different waves in Argentina. METHODS: This multicenter, prospective cohort study included adult patients with COVID-19-related acute respiratory failure requiring high-flow nasal oxygen. The main exposure position was the awake-prone position (≥ 6 hours/day) compared to the non-prone position. The primary outcome was endotracheal intubation, and the secondary outcome was in-hospital mortality. The inverse probability weighting-propensity score was used to adjust the conditional probability of treatment assignment. We then adjusted for contextual variables that varied over time and compared the effectiveness between the first and second waves. RESULTS: A total of 728 patients were included: 360 during the first wave and 368 during the second wave, of whom 195 (54%) and 227 (62%) remained awake-prone for a median (p25 - 75) of 12 (10 - 16) and 14 (8 - 17) hours/day, respectively (Awake-Prone Position Group). The ORs (95%CIs) for endotracheal intubation in the Awake-Prone Position Group were 0.25 (0.13 - 0.46) and 0.19 (0.09 - 0.31) for the first and second waves, respectively (p = 0.41 for comparison between waves). The ORs for in-hospital mortality in the awake-prone position were 0.35 (0.17 - 0.65) and 0.22 (0.12 - 0.43), respectively (p = 0.44 for comparison between waves). CONCLUSION: The awake-prone position was associated with a reduction in the risk of endotracheal intubation and in-hospital mortality. These effects were independent of the context in which the intervention was applied, and no differences were observed between the different waves.


Assuntos
COVID-19 , Mortalidade Hospitalar , Intubação Intratraqueal , Oxigenoterapia , Humanos , COVID-19/terapia , COVID-19/complicações , COVID-19/mortalidade , Masculino , Feminino , Decúbito Ventral/fisiologia , Estudos Prospectivos , Pessoa de Meia-Idade , Oxigenoterapia/métodos , Argentina/epidemiologia , Idoso , Posicionamento do Paciente/métodos , Vigília/fisiologia , Insuficiência Respiratória/terapia , Insuficiência Respiratória/mortalidade , SARS-CoV-2
10.
Nat Commun ; 15(1): 8706, 2024 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-39433735

RESUMO

After traumatic events, simple cue-threat associative memories strengthen while episodic memories become incoherent. However, how the brain prioritises cue associations over episodic coding of traumatic events remains unclear. Here, we developed an original episodic threat conditioning paradigm in which participants concurrently form two memory representations: cue associations and episodic cue sequence. We discovered that these two distinct memories compete for physiological fear expression, reorganising overnight from an overgeneralised cue-based to a precise sequence-based expression. With multivariate fMRI, we track inter-area communication of the memory representations to reveal that a rebalancing between hippocampal- and prefrontal control of the fear regulatory circuit governs this memory maturation. Critically, this overnight re-organisation is altered with heightened trait anxiety. Together, we show the brain prioritises generalisable associative memories under recent traumatic stress but resorts to selective episodic memories 24 h later. Time-dependent memory competition may provide a unifying account for memory dysfunctions in post-traumatic stress disorders.


Assuntos
Sinais (Psicologia) , Medo , Hipocampo , Imageamento por Ressonância Magnética , Memória Episódica , Córtex Pré-Frontal , Humanos , Medo/fisiologia , Medo/psicologia , Masculino , Feminino , Adulto Jovem , Adulto , Hipocampo/fisiologia , Córtex Pré-Frontal/fisiologia , Córtex Pré-Frontal/diagnóstico por imagem , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Fatores de Tempo , Ansiedade/fisiopatologia , Ansiedade/psicologia , Encéfalo/fisiologia , Encéfalo/diagnóstico por imagem , Condicionamento Clássico/fisiologia , Mapeamento Encefálico
11.
Sci Rep ; 14(1): 25440, 2024 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-39455600

RESUMO

PIK3CA-related overgrowth spectrum (PROS) disorders are caused by somatic mosaic variants that result in constitutive activation of the phosphatidylinositol-3-kinase/AKT/mTOR pathway. Promising responses to molecularly targeted therapy have been reported, although identification of an appropriate agent can be hampered by the mosaic nature and corresponding low variant allele frequency of the causal variant. Moreover, our understanding of the molecular consequences of these variants-for example how they affect gene expression profiles-remains limited. Here we describe in vitro expansion of a human capillary malformation followed by molecular characterization using exome sequencing, single cell gene expression, and targeted long-read single cell RNA-sequencing in a patient with clinical features consistent with Megalencephaly-Capillary Malformation Syndrome (MCAP, a PROS condition). These approaches identified a targetable PIK3CA variant with expression restricted to PAX3+ fibroblast and undifferentiated keratinocyte populations. This study highlights the innovative combination of next-generation single cell sequencing methods to better understand unique transcriptomic profiles and cell types associated with MCAP, revealing molecular intricacies of this genetic syndrome.


Assuntos
Classe I de Fosfatidilinositol 3-Quinases , Análise de Célula Única , Transcriptoma , Malformações Vasculares , Humanos , Classe I de Fosfatidilinositol 3-Quinases/genética , Análise de Célula Única/métodos , Malformações Vasculares/genética , Malformações Vasculares/patologia , Capilares/patologia , Capilares/anormalidades , Megalencefalia/genética , Megalencefalia/patologia , Fator de Transcrição PAX3/genética , Fator de Transcrição PAX3/metabolismo , Fibroblastos/metabolismo , Mancha Vinho do Porto/genética , Mancha Vinho do Porto/patologia , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Mutação , Feminino , Masculino , Anormalidades Múltiplas , Telangiectasia/congênito , Dermatopatias Vasculares
12.
Nurs Rep ; 14(4): 3126-3137, 2024 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-39449464

RESUMO

COVID-19 affects the respiratory system, reducing the oxygen saturation level, leading to hypoxemia and increasing the metabolic oxygenation need. OBJECTIVE: To describe the nursing interventions related to the need for oxygenation in hospitalized adults with severe COVID-19 disease in the Intensive Care Unit. METHOD: This was an observational, retrospective and descriptive study in a population of 2205 patients with a convenience sample of n = 430 and based on the North American Nursing Diagnosis Association (NANDA), the Nursing Interventions Classification (NIC) and the Nursing Outcomes Classification (NOC). The analysis was performed with a non-parametric test to determine the association between the nursing interventions and the need for oxygenation. RESULTS: The findings are aimed at improving nursing interventions with statistical associations as follow: oxygen therapy (p < 0.000), airway suctioning (p < 0.000), airway management (p = 0.029), invasive mechanical ventilation (p < 0.000) and non-invasive mechanical ventilation (p = 0.022). NOC taxonomy expected outcomes in ventilation, 34% (146), alteration in gas exchange, 33.7% (145), and respiratory status, 558.9% (253), were severely compromised. CONCLUSIONS: The nursing interventions to maintain the respiratory status are focused on airway care and oxygen therapy in order to increase the oxygen saturation level and decrease the severity of the need for oxygenation.

13.
J Fungi (Basel) ; 10(10)2024 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-39452633

RESUMO

This study presents data on the concentration of Alternaria spores in the atmosphere of the northwestern Iberian Peninsula. A non-viable volumetric method was used to collect the samples, resulting in a database of 70 annual. When the annual averages for each locality are calculated, Ourense stands out with 2152 spores/m3, followed by Vigo and Lugo, while Santiago de Compostela recorded the lowest concentrations. Focusing on the total data for each locality, the main sporulation period started in May and ended in October in all localities, centered on a single phase, with an earlier onset and longer duration in Ourense and Vigo. The number of days with concentrations in excess of 100 spores/m3 was very low in Santiago de Compostela, Ourense, and Vigo and null in Lugo. Temperature was the meteorological parameter for which the highest statistical correlation was obtained in all locations, being favorable to the concentration of spores in the air. Temperature ranges favorable to the presence of airborne spores in the study area ranged from 25.5 to 31.2 °C. Based on the analysis of the data collected, it is concluded that Alternaria spore concentrations are low throughout most of the year.

14.
Gynecol Oncol ; 191: 233-239, 2024 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-39454227

RESUMO

BACKGROUND: Granulosa cell ovarian tumors (GCT) are orphan disease with limited treatments. Hormone therapy is a potential treatment, due to the overexpression of hormone receptors in most tumors. This study explores the activity of the antiandrogen, enzalutamide, in metastatic cases. METHODS: We designed a phase II clinical trial under the Spanish Collaborative Group for Transversal Oncology and Rare and Orphan Tumors (GETTHI). Eligible participants were adult women with advanced GCT. Primary endpoint was objective response rate. Secondary endpoints included clinical benefit rate, progression-free survival, overall survival, and safety profile. Patients received enzalutamide 160 mg once daily. RESULTS: From April 2018 to March 2020, eighteen patients were screened, and sixteen were included across nine institutions. Median age was 56.4 years (range 45-71), and most were Caucasian (14 cases), one Arabian and one Latin. ECOG performance status was zero in 13 cases (81 %) and one in three (19 %). Six patients (38 %) had previously received hormone therapy as adjuvant treatment or for advanced disease, and 15 (94 %) chemotherapy. Median time from metastasis to study entry was 96 months (range 4.5-198). No objective response was observed, but the clinical benefit rate reached 68.8 % (95 % CI [46 %-91.5 %]). Median progression-free survival was 3.8 months (95 % CI [1.36-6.14]). Median overall survival was not reached, with a median follow-up of 6 months (range 2.2-19). At the time of database closure, 14 patients had discontinued treatment, 13 due to disease progression and one by personal choice. Two deaths attributed to disease progression were recorded. Five grade 3 adverse events were reported, with only one (asthenia) deemed related to the therapy. CONCLUSIONS: Although enzalutamide demonstrated modest activity in GCT, durable stabilization was observed in some cases. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03464201.

15.
ChemSusChem ; : e202402067, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39352793

RESUMO

The development of recyclable crosslinked thermosetting fibres is a challenging research topic. In the present work, we have designed and synthesized polyurethane fibres from fructose-derived 5-chloromethylfurfural (CMF) and lignin-derived monomeric phenols. The greenhouse gas emissions associated with the production of CMF showed comparable results to that of 5-hydroxymethylfurfural (HMF), a high potential sugar-based platform molecule. The wet-spun biobased polyurethane fibres produced could be conveniently crosslinked using Diels-Alder chemistry to effectively enhance the glass transition temperature and mechanical properties. At a mildly elevated temperature (140 °C), the chemically crosslinked fibres could be effectively de-crosslinked, which enabled complete separation from a mixture with poly(ethylene terephthalate) (PET) and cotton fibres. These results outline a potential strategy to design and fabricate new biobased fibres with reversible crosslinking, which may enable fibre-to-fibre recycling.

16.
Digit Health ; 10: 20552076241288311, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39421311

RESUMO

Background: Helping people recover from aphasia is among the top 10 research priorities relating to life after stroke. Objective: We aimed to evaluate the feasibility of dubbing techniques (using newly developed software) for post-stroke aphasia therapy and explore its potential efficacy. Methods: Randomised, crossover, interventional, feasibility trial that included patients with chronic post-stroke non-fluent aphasia. The intervention consisted of an individualised programme (16 sessions; 8 weeks) based on dubbing words and sentences progressively adapted to the severity of the aphasia. Patients were allocated to groups that underwent therapy within the first 3 months, or between 3 and 6 months from inclusion, each group serving as the control during the non-therapy periods. Outcomes were the pre-post differences in the Communicative Activity Log, the Boston Diagnostic Aphasia Examination, the General Health Questionnaire-12, the Stroke Aphasia Quality of Life Scale, and the Western Aphasia Battery Revised, administered by psychologists blinded to the patients' allocation. Results: Recruitment was limited due to COVID-19 and prematurely stopped because of funding coming to an end. A total of 23 patients were randomised, 20 of whom completed the study (1 withdrew consent, and 2 dropped out). The adherence rate to the allocated group was 95.3%. No statistically significant differences were found in any of the outcomes; however, 17 (85%) patients reported subjective improvements in communication skills. Conclusions: This trial shows the feasibility of dubbing therapy (using dedicated software) for patients with post-stroke non-fluent aphasia. Although it lacks statistical power, certain effects on language and communication cannot be ignored.

17.
Open Forum Infect Dis ; 11(10): ofae550, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39416992

RESUMO

Background: People with HIV-1 (PWH) age differently than the general population. Blood telomere length (BTL) attrition is a surrogate biomarker of immunosenescence and aging in PWH. BTL is reduced immediately after HIV-1 infection and recovers in PWH with long-term virologic suppression, but the extent of this recovery is unknown. Methods: This prospective 6-year observational study assessed the evolution of BTL in PWH who were virologically suppressed. A cross-sectional analysis additionally compared BTL with age- and sex-matched blood donors and sex-matched persons older than 60 years from a general population cohort. DNA from whole blood was isolated, and relative BTL was determined by monochrome quantitative multiplex polymerase chain reaction assay and expressed as the ratio of telomere to single-copy gene (T/S). Results: A total of 128 PWH were included in the prospective 6-year observational study. These same 128 PWH (median age, 55 years; 27.3% women) were compared cross-sectionally at 6-year follow-up with 128 age- and gender-matched blood donors (median age, 55 years) and 128 gender-matched individuals older than 60 years from a general population cohort (median age, 70 years). An inverse correlation between age and BTL was observed. The median BTL of PWH was shorter than their matched blood donors (T/S, 1.07 [IQR, 0.95-1.17] vs 1.28 [IQR, 1.12-1.48]; P < .001) but longer than the elderly population (T/S, 0.89 [IQR, 0.77-0.98], P < .001). PWH experienced a BTL increase at 6 years of 2.9% (T/S, 1.04 vs 1.07; P = .002). In PWH, age was associated with a shorter BTL (coefficient, -0.007 45, SE = 0.002 04, P = .002) and baseline lower CD4 count with a gain in BTL (coefficient, -0.000 06, SE = 0.000 02, P = .004). Shorter baseline BTL (odds ratio, 0.91 [95% CI, .87-.94]; P < .001) and higher glucose levels (odds ratio, 1.04 [95% CI, 1.02-1.07]; P = .003) were associated with a greater similarity of BTL to the elderly population. Conclusions: PWH with long-term virologic suppression experience a trend toward an increased BTL after 6 years of follow-up. Middle-aged people with long-term controlled HIV-1 have a shorter BTL than expected for their chronologic age but longer than that of people 15 years older in the general population.

18.
Clin Gerontol ; : 1-10, 2024 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-39360340

RESUMO

OBJECTIVES: To implement a transcultural adaptation of the Caregiver Guilt Questionnaire (CGQ) for the Brazilian population. METHODS: Five stages were involved in the adaptation: two independent translations by Brazilian nationals fluent in Spanish; summary of translations produced; back-translation; evaluation by expert panel of judges (n = 5); and lastly, assessment by family caregivers (n = 30). RESULTS: semantic changes were made to render the items more relevant to Brazilian culture and replicate the five factors of guilt proposed by the original questionnaire. CONCLUSIONS: A Brazilian version of the questionnaire was produced and transculturally adapted for use in Brazil, allowing future validation and application. CLINICAL IMPLICATIONS: The CGQ allows healthcare professionals to quantify feelings of guilt. Clinicians and clinical researcher can use the scale to obtain more precise interventions.

20.
Sci Data ; 11(1): 1082, 2024 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-39362896

RESUMO

The dataset presents a 43 year-long reanalysis of pollen seasons for three major allergenic genera of trees in Europe: alder (Alnus), birch (Betula), and olive (Olea). Driven by the meteorological reanalysis ERA5, the atmospheric composition model SILAM predicted the flowering period and calculated the Europe-wide dispersion pattern of pollen for the years 1980-2022. The model applied an extended 4-dimensional variational data assimilation of in-situ observations of aerobiological networks in 34 European countries to reproduce the inter-annual variability and trends of pollen production and distribution. The control variable of the assimilation procedure was the total pollen release during each flowering season, implemented as an annual correction factor to the mean pollen production. The dataset was designed as an input to studies on climate-induced and anthropogenically driven changes in the European vegetation, biodiversity monitoring, bioaerosol modelling and assessment, as well as, in combination with intra-seasonal observations, for health-related applications.


Assuntos
Alnus , Betula , Olea , Pólen , Estações do Ano , Europa (Continente) , Alérgenos , Monitoramento Ambiental
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA