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2.
Vaccine ; 42(9): 2414-2420, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38458869

RESUMO

BACKGROUND: Cervical cancer eradication is one of the main goals for 2030 by the World Health Organization, which can only be achieved with high vaccination rates against Human Papilloma Virus. In Colombia, more and better scientific evidence is required to increase confidence in vaccination. The objective of this study is to evaluate the safety profile of the quadrivalent vaccine against HPV in the risk of developing autoimmune, neurological, and hematological diseases in adolescent women in Colombia. METHODS: We designed a cohort study based on national HPV vaccination records and incident diagnostic data for the diseases of special interest during 2012 and 2021. We included adolescent women between 9 and 19 years old and compared vaccinated and non-vaccinated cohorts using an Inverse Probability of Treatment Weighting (IPWT) method for each scenario disease and follow-up period (180 and 360 days). FINDINGS: The Odds Ratio (OR) of developing diseases of interest was estimated during two follow up periods, 180 and 360 days after the follow-up index date (Vaccination Day). The OR for developing rheumatoid arthritis was 4·4; CI95% (1·74 - 11·14), juvenile idiopathic arthritis was 2·76 IC95% (1·50 - 5·11), idiopathic thrombocytopenic purpura was 2·54 IC95% (1·28 - 5·02) and thyrotoxicosis was 2·86 IC95% (1·03 - 7·95), when comparing the vaccinated versus unvaccinated population. However, the temporal distribution of cases incident did not reveal a clear difference between the cohorts, since the rate of appearance of new cases has a constant linear behavior for the two groups. INTERPRETATION: For rheumatoid arthritis, juvenile idiopathic arthritis, idiopathic thrombocytopenic purpura, and thyrotoxicosis; the application of the vaccine had an effect on the development of the disease. Nevertheless, our results should be interpreted with caution and be further studied, considering that the biological plausibility of the events occurred without a clear temporal pattern in relation to the exposure to the vaccine.


Assuntos
Artrite Juvenil , Artrite Reumatoide , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Púrpura Trombocitopênica Idiopática , Tireotoxicose , Neoplasias do Colo do Útero , Adolescente , Criança , Feminino , Humanos , Adulto Jovem , Estudos de Coortes , Colômbia/epidemiologia , Papillomavirus Humano , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Vacinação/efeitos adversos , Vacinação/métodos , Vacinas Combinadas
3.
Mol Biol Evol ; 41(2)2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38364113

RESUMO

Evolutionary analyses have estimated that ∼60% of nucleotides in intergenic regions of the Drosophila melanogaster genome are functionally relevant, suggesting that regulatory information may be encoded more densely in intergenic regions than has been revealed by most functional dissections of regulatory DNA. Here, we approached this issue through a functional dissection of the regulatory region of the gene shavenbaby (svb). Most of the ∼90 kb of this large regulatory region is highly conserved in the genus Drosophila, though characterized enhancers occupy a small fraction of this region. By analyzing the regulation of svb in different contexts of Drosophila development, we found that the regulatory information that drives svb expression in the abdominal pupal epidermis is organized in a different way than the elements that drive svb expression in the embryonic epidermis. While in the embryonic epidermis svb is activated by compact enhancers separated by large inactive DNA regions, svb expression in the pupal epidermis is driven by regulatory information distributed over broader regions of svb cis-regulatory DNA. In the same vein, we observed that other developmental genes also display a dense distribution of putative regulatory elements in their regulatory regions. Furthermore, we found that a large percentage of conserved noncoding DNA of the Drosophila genome is contained within regions of open chromatin. These results suggest that part of the evolutionary constraint on noncoding DNA of Drosophila is explained by the density of regulatory information, which may be greater than previously appreciated.


Assuntos
Proteínas de Drosophila , Drosophila , Animais , Drosophila/metabolismo , Fatores de Transcrição/metabolismo , Drosophila melanogaster/genética , Drosophila melanogaster/metabolismo , Proteínas de Ligação a DNA/genética , Proteínas de Drosophila/genética , Proteínas de Drosophila/metabolismo , Regulação da Expressão Gênica no Desenvolvimento , DNA , DNA Intergênico/genética , DNA Intergênico/metabolismo , Elementos Facilitadores Genéticos
6.
Int J Gynaecol Obstet ; 164(2): 763-769, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37872710

RESUMO

OBJECTIVE: To evaluate the users' opinion on internal manual aortic compression (IMAC) training, using a low-cost simulation model. METHODS: An educational strategy was designed to teach IMAC, which included: (1) guided reading of educational material and viewing an explanatory video of IMAC; (2) an introductory lecture with the anatomical considerations, documentation of the cessation of femoral arterial flow during IMAC, and real clinical cases in which this procedure was used; and (3) simulated practice of IMAC with a new low-cost manikin. The educational strategy was applied during three postpartum hemorrhage workshops in three Latin American countries and the opinions of the participants were measured with a survey. RESULTS: Almost all of the participants in the IMAC workshop, including the simulation with the low-cost mannikin, highlighted the usefulness of the strategy (scores of 4/5 and 5/5 on the Likert scale) and would recommend it to colleagues. CONCLUSION: We present a low-cost simulation model for IMAC as the basis of an educational strategy perceived as very useful by most participants. The execution of this strategy in other populations and its impact on postpartum hemorrhage management should be evaluated in further studies.


Assuntos
Hemorragia Pós-Parto , Gravidez , Feminino , Humanos , Hemorragia Pós-Parto/terapia , Manequins , Inquéritos e Questionários , Escolaridade , Ensino
7.
Eur J Contracept Reprod Health Care ; 28(6): 295-300, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37910020

RESUMO

OBJECTIVE: To describe the knowledge, attitudes, and perceptions of healthcare providers in a region in southwestern Colombia regarding the recommendation and use of long-acting reversible contraceptive (LARC) methods for adolescents. STUDY DESIGN: This was a cross-sectional study. An online exploratory survey was designed to assess healthcare providers' knowledge, attitudes, and perceptions of Valle del Cauca hospitals. For the development of this the questionnaire, a literature search and validation of the instrument's appearance were conducted. RESULTS: The survey was completed by 115 people. Knowledge: 62.6% and 33% of the participants did not consider themselves capable of correctly placing an intrauterine device (IUD) or a subdermal implant, respectively. However, 73.9% of the participants had adequate theoretical knowledge. Attitudes: 64.3% of the participants considered that adolescents can acquire contraceptive methods without limitations. Short-acting reversible methods were the least recommended. Perceptions: For IUDs, 40.8% and 16.5% of the participants imposed a minimum age and minimum parity requirement for their use, respectively. Side effects were the main reason for not recommending in health institutions with a lower level of complexity. CONCLUSION: Healthcare providers had positive attitudes and adequate theoretical knowledge concerning to the effectiveness of LARCs. The main areas for improvement were practical knowledge about the insertion and proper use of the devices, indications for referral to gynaecologists for the insertion procedure, and concerns about side effects.


Our research explores healthcare providers' knowledge, attitudes, and perceptions regarding long-acting reversible contraceptives for adolescents. While attitudes were positive, practical knowledge gaps on device, placement and referral indications emerged. Read the full findings to uncover more about LARCs in adolescent healthcare.


Assuntos
Anticoncepcionais Femininos , Dispositivos Intrauterinos , Gravidez , Feminino , Humanos , Adolescente , Conhecimentos, Atitudes e Prática em Saúde , Estudos Transversais , Anticoncepção/métodos , Pessoal de Saúde
8.
Acta neurol. colomb ; 39(3)sept. 2023.
Artigo em Espanhol | LILACS | ID: biblio-1533501

RESUMO

Introducción: Con la experiencia de los registros electroencefalográficos invasivos y el fracaso quirúrgico después de la cirugía, se ha hecho evidente que la epilepsia del lóbulo temporal es mucho más compleja de lo que se creía, y en la actualidad es considerada una enfermedad de redes anatomofuncionales y no de lesiones estructurales. Contenido: La información neurofisiológica e imagenológica actual permite concluir que en esta epilepsia están involucradas varias redes neuronales temporales y extratemporales que contribuyen a la extensión de la zona epileptógena. Una forma de entender el concepto de red epiléptica en la epilepsia del lóbulo temporal es a partir del conocimiento de la corteza piriforme. Varios estudios clínicos han mostrado que en pacientes con epilepsia del lóbulo temporal asociada a esclerosis hipocampal existe una disfunción interictal del procesamiento olfatorio que es más significativa, en comparación con pacientes con epilepsia focal extrahipocampal y controles sanos. Esta alteración es, probablemente, la consecuencia de una red neuronal disfuncional que se extiende más allá del hipocampo y que afecta a otras estructuras cercanas, incluida la corteza piriforme. Conclusión: En este artículo llevamos a cabo una revisión narrativa de la literatura con el objetivo de establecer un vínculo entre la corteza piriforme y la epileptogénesis del lóbulo temporal, y demostramos que esta enfermedad es la consecuencia de una disfunción de redes neuronales que no depende exclusivamente de una anormalidad estructural en el hipocampo o en estructuras cercanas.


Introduction: With the experience of invasive EEG recordings and surgical failure after surgery, it has become clear that temporal lobe epilepsy is much more complex than previously thought, and currently, is conceptualized as a disease of anatomical networks instead of structural lesions. Content: The current neurophysiological and imaging information allows us to conclude that several temporal and extratemporal anatomical networks are involved in this type of epilepsy. One way of understanding the concept of the epileptic network in temporal lobe epilepsy is from the knowledge of the piriform cortex. Several clinical studies have shown that in patients with temporal lobe epilepsy associated with hippocampal sclerosis exists an interictal dysfunction of olfactory processing that is more significant compared to patients with focal extra-hippocampal epilepsy and healthy controls. This alteration is probably the consequence of a dysfunctional neural network that extends beyond the hippocampus and affects other nearby structures, including the piriform cortex. Conclusion: In this article, we carry out a narrative review of the literature with the aim of establishing a link between the piriform cortex and temporal lobe epileptogenesis, demonstrating that this disease is the consequence of a dysfunctional network that does not depend exclusively of a hippocampal structural abnormality.


Assuntos
Olfato , Lobo Temporal , Córtex Piriforme , Hipocampo , Epilepsias Parciais
9.
Bioengineering (Basel) ; 10(4)2023 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-37106624

RESUMO

In this study, green chemistry was used as a tool to obtain gold nanoparticles using Amphipterygium adstringens extracts as a synthesis medium. Green ethanolic and aqueous extracts were obtained using ultrasound and shock wave-assisted extraction. Gold nanoparticles with sizes ranging between 100 and 150 nm were obtained with ultrasound aqueous extract. Interestingly, homogeneous quasi-spherical gold nanoparticles with sizes between 50 and 100 nm were achieved with shock wave aqueous-ethanolic extracts. Furthermore, 10 nm gold nanoparticles were obtained by the traditional methanolic macerate extraction method. The physicochemical characteristics, morphology, size, stability, and Z potential of the nanoparticles were determined using microscopic and spectroscopic techniques. The viability assay in leukemia cells (Jurkat) was performed using two different sets of gold nanoparticles, with final IC50 values of 87 µM and 94.7 µM, reaching a maximum cell viability decrease of 80% The results do not indicate a significant difference between the cytotoxic effects produced by the gold nanoparticles synthesized in this study and vincristine on normal lymphoblasts (CRL-1991).

10.
Rev Colomb Obstet Ginecol ; 74(1): 28-36, 2023 03 30.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37093943

RESUMO

Objectives: To describe the frequency of maternal complications in pregnant women with major or minor placenta previa (PP), and to assess a potential association between PP type and the presence of severe maternal bleeding and other associated outcomes. Materials and methods: Retrospective descriptive cohort. The study included pregnant women with 20 weeks of gestation or more and a confirmed diagnosis of placenta previa who were seen in a high complexity hospital in Cali (Colombia), between January 2011 and December 2020. Women with a diagnosis of placenta previa and concomitant placenta accreta were excluded. The collected variables were maternal age, body mass index, smoking, obesity, parity, presence of bleeding, postpartum hemorrhage, management of postpartum hemorrhage, transfusion, and maternal ICU admission. A descriptive analysis was performed. The protocol was approved by the ethics committee of Fundaciónn Valle de Lili. Results: A total of 146 patients met the inclusion criteria. The population consisted of women with a mean age of 32 years, with no history of prior surgery, with a prenatal diagnosis of placente previa at week 22; 70 % were major placenta previa cases. The most frequent complications were postpartum hemorrhage (37.9 % vs. 16.3 % for patients with major and minor placenta previa, respectively), transfusion requirement (23.3 and 9.3 %, respectively), and maternal ICU admission (40.8 % vs. 18.6 %, respectively). There were no cases of maternal death. Conclusions: There is a high frequency of complications in women with placenta previa, and it is probably higher in cases of major placenta previa. Further studies are needed to compare the frequency of maternal complications according to the type of placenta previa.


Objetivos: describir la frecuencia de complicaciones maternas en mujeres gestantes con placenta previa (PP) mayor o menor y evaluar una posible asociación entre tipo de PP y la presencia de hemorragia materna severa y otros resultados maternos asociados. Materiales y métodos: cohorte retrospectiva, descriptiva. Se incluyeron gestantes con 20 semanas o más de embarazo, con diagnóstico confirmado de placenta previa, quienes fueron atendidas en un hospital de alto nivel de complejidad localizado en Cali (Colombia), entre enero de 2011 y diciembre de 2020. Se excluyeron las gestantes con diagnóstico de placenta previa y acretismo placentario concomitante. Las variables recolectadas fueron: edad materna, índice de masa corporal, tabaquismo, obesidad, paridad, presencia de sangrado, hemorragia posparto, manejo de la hemorragia posparto, transfusión y admisión a UCI de la gestante. Se realizó análisis descriptivo. El protocolo fue aprobado por el comité de ética de la Fundación Valle de Lili. Resultados: 146 pacientes cumplieron con los criterios de inclusión. La población estuvo constituida por mujeres con una mediana de edad de 32 años, sin antecedente quirúrgico, con diagnóstico prenatal de placenta previa a la semana 22. En el 70,5 % de los casos se trató de pacientes con placenta previa mayor. Las complicaciones más frecuentes fueron hemorragia posparto (37,9 % vs. 16,3 % para pacientes con placenta previa mayor y menor, respectivamente), requerimiento de transfusión (23,3 y 9,3 %, respectivamente) y el ingreso materno a la UCI (40,8 % vs. 18,6 %, respectivamente). No se registraron muertes maternas. Conclusiones: las mujeres con placenta previa experimentan una frecuencia elevada de complicaciones; probablemente, dicha frecuencia es más alta cuando se documenta placenta previa mayor. Se requieren más estudios que comparen la frecuencia de complicaciones maternas según el tipo de placenta previa.


Assuntos
Placenta Prévia , Gravidez , Feminino , Humanos , Estudos Retrospectivos , Colômbia , Hospitais , Família
11.
Rev. colomb. obstet. ginecol ; 74(1): 28-36, ene.-mar. 2023. ilus, tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1536051

RESUMO

Objetivos: Describir la frecuencia de complicaciones maternas en mujeres gestantes con placenta previa (PP) mayor o menor y evaluar una posible asociación entre tipo de PP y la presencia de hemorragia materna severa y otros resultados maternos asociados. Materiales y métodos: Cohorte retrospectiva, descriptiva. Se incluyeron gestantes con 20 semanas o más de embarazo, con diagnóstico confirmado de placenta previa, quienes fueron atendidas en un hospital de alto nivel de complejidad localizado en Cali (Colombia), entre enero de 2011 y diciembre de 2020. Se excluyeron las gestantes con diagnóstico de placenta previa y acretismo placentario concomitante. Las variables recolectadas fueron: edad materna, índice de masa corporal, tabaquismo, obesidad, paridad, presencia de sangrado, hemorragia posparto, manejo de la hemorragia posparto, transfusión y admisión a UCI de la gestante. Se realizó análisis descriptivo. El protocolo fue aprobado por el comité de ética de la Fundación Valle de Lili. Resultados: 146 pacientes cumplieron con los criterios de inclusión. La población estuvo constituida por mujeres con una mediana de edad de 32 años, sin antecedente quirúrgico, con diagnóstico prenatal de placenta previa a la semana 22. En el 70,5 % de los casos se trató de pacientes con placenta previa mayor. Las complicaciones más frecuentes fueron hemorragia posparto (37,9 % vs. 16,3 % para pacientes con placenta previa mayor y menor, respectivamente), requerimiento de transfusión (23,3 y 9,3 %, respectivamente) y el ingreso materno a la UCI (40,8 % vs. 18,6 %, respectivamente). No se registraron muertes maternas. Conclusiones: Las mujeres con placenta previa experimentan una frecuencia elevada de complicaciones; probablemente, dicha frecuencia es más alta cuando se documenta placenta previa mayor. Se requieren más estudios que comparen la frecuencia de complicaciones maternas según el tipo de placenta previa.


Objectives: To describe the frequency of maternal complications in pregnant women with major or minor placenta previa (PP), and to assess a potential association between PP type and the presence of severe maternal bleeding and other associated outcomes. Material and methods: Retrospective descriptive cohort. The study included pregnant women with 20 weeks of gestation or more and a confirmed diagnosis of placenta previa who were seen in a high complexity hospital in Cali (Colombia), between January 2011 and December 2020. Women with a diagnosis of placenta previa and concomitant placenta accreta were excluded. The collected variables were maternal age, body mass index, smoking, obesity, parity, presence of bleeding, postpartum hemorrhage, management of postpartum hemorrhage, transfusion, and maternal ICU admission. A descriptive analysis was performed. The protocol was approved by the ethics committee of Fundaciónn Valle de Lili. Results: A total of 146 patients met the inclusion criteria. The population consisted of women with a mean age of 32 years, with no history of prior surgery, with a prenatal diagnosis of placente previa at week 22; 70% were major placenta previa cases. The most frequent complications were postpartum hemorrhage (37.9 % vs. 16.3 % for patients with major and minor placenta previa, respectively), transfusion requirement (23.3 and 9.3 %, respectively), and maternal ICU admission (40.8 % vs. 18.6 %, respectively). There were no cases of maternal death. Conclusions: There is a high frequency of complications in women with placenta previa, and it is probably higher in cases of major placenta previa. Further studies are needed to compare the frequency of maternal complications according to the type of placenta previa.


Assuntos
Humanos , Feminino , Gravidez , Colômbia
12.
West J Emerg Med ; 24(2): 193-200, 2022 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-36602481

RESUMO

INTRODUCTION: Few studies have examined the impact of emergency department (ED) social interventions on patient outcomes and revisits, especially in underserved populations. Our objective in this study was to characterize a volunteer initiative that provided community medical and social resources at ED discharge and its effect on ED revisit rates and adherence to follow-up appointments at a large, county hospital ED. METHODS: We performed a cross-sectional analysis of ED patients who received medical and social resources and an educational intervention at discharge between September 2017-June 2018. Demographic information, the number of ED return visits, and outpatient follow-up appointment adherence within 30 and 90 days of ED discharge were obtained from electronic health records. We obtained data regarding patient utilization of resources via telephone follow-up communication. We used logistic regression analyses to evaluate associations between patient characteristics, reported resource utilization, and revisit outcomes. RESULTS: Most patients (55.3% of 494 participants) identified as Latino/Hispanic, and 49.4% received healthcare assistance through a local governmental program. A majority of patients (83.6%) received at least one medical or social resource, with most requesting more than one. Patients provided with a medical or social resource were associated with a higher 90-day follow-up appointment adherence (odds ratio [OR] 2.56; 95% confidence interval [CI] 1.05-6.25, and OR 4.75; 95% CI 1.49-15.20], respectively), and the provision of both resources was associated with lower odds of ED revisit within 30 days (OR 0.50; 95% CI 0.27-0.95). Males and those enrolled in the healthcare assistance program had higher odds of ED revisits, while Hispanic/Latino and Spanish-speaking patients had lower odds of revisits. CONCLUSION: An ED discharge intervention providing medical and social resources may be associated with improved follow-up adherence and reduced ED revisit rates in underserved populations.


Assuntos
Serviço Hospitalar de Emergência , Readmissão do Paciente , Masculino , Humanos , Estudos Transversais , Alta do Paciente , Assistência Centrada no Paciente
13.
Food Res Int ; 145: 110423, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34112425

RESUMO

Insects have potential to become food ingredients, but it is necessary to improve the sensory properties of insects to help them to be better accepted by the population. The purpose of this study was to produce and characterize house fly larval meal (FLM) converted to a micro-encapsulated powder to improve appearance and other organoleptic characteristics. FLM showed high protein (54%) and lipid (22%) content, with a microbiological activity compatible for food purposes. Moreover, the high content of essentials amino acids (lysine, cysteine and leucine) and unsaturated fatty acids (oleic, linoleic and palmitoleic) make FLM a valuable nutritional source. Spray drying was selected to encapsulate FLM (0.5-2% w/v) using maltodextrin (20% w/v) and alginate (0.5% w/v). Encapsulation improved the appearance of FLM, creating a white-beige, monodispersed micro-powder (9 µm in size). Micro-powder with 2% FLM is considered a good source of protein (5.1%). Microencapsulation also dramatically reduced the volatile emissions of FLM. In conclusion, novel FLM micro-powders were developed using a simple and scalable encapsulation technique. The micro-powder with 2% FLM is a good source of protein, has a pleasant appearance similar to vegetable meals and has improved odor compared to typical insect meals. Thus, insect-based food ingredients in micro-powders could become more accepted by the general population.


Assuntos
Moscas Domésticas , Animais , Humanos , Larva , Refeições , Valor Nutritivo , Sensação
14.
Vet Res ; 52(1): 64, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33933136

RESUMO

Salmonid Rickettsial Septicaemia (SRS), caused by Piscirickettsia salmonis, is the most important infectious disease in the Chilean salmon farming industry. An opportunity to control this disease is to use functional micronutrients to modulate host mechanisms of response to the infection. Since P. salmonis may affect the host antioxidant system in salmonids, particularly that dependent on selenium (Se), we hypothesized that fish's dietary selenium supplementation could improve the response to the bacterial infection. To address this, we defined a non-antibiotic, non-cytotoxic concentration of selenium to evaluate its effect on the response to in vitro infections of SHK-1 cells with P. salmonis. The results indicated that selenium supplementation reduced the cytopathic effect, intracellular bacterial load, and cellular mortality of SHK-1 by increasing the abundance and activity of host glutathione peroxidase. We then prepared diets supplemented with selenium up to 1, 5, and 10 mg/kg to feed juvenile trout for 8 weeks. At the end of this feeding period, we obtained their blood plasma and evaluated its ability to protect SHK-1 cells from infection with P. salmonis in ex vivo assays. These results recapitulated the observed ability of selenium to protect against infection with P. salmonis by increasing the concentration of selenium and the antioxidant capacity in fish's plasma. To the best of our knowledge, this is the first report of the protective capacity of selenium against P. salmonis infection in salmonids, becoming a potential effective host-directed dietary therapy for SRS and other infectious diseases in animals at a non-antibiotic concentration.


Assuntos
Antioxidantes/metabolismo , Resistência à Doença , Doenças dos Peixes/microbiologia , Oncorhynchus mykiss/imunologia , Infecções por Piscirickettsiaceae/veterinária , Selênio/metabolismo , Ração Animal/análise , Animais , Dieta/veterinária , Suplementos Nutricionais/análise , Relação Dose-Resposta a Droga , Piscirickettsia/fisiologia , Infecções por Piscirickettsiaceae/microbiologia , Plasma/química , Distribuição Aleatória , Selênio/administração & dosagem
15.
PLoS One ; 15(10): e0241434, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33119705

RESUMO

PURPOSE: To systematically review the literature in order to evaluate the effects of health coaching on patients' reduction of opioid usage and opioid discontinuation. In addition, this systematic review investigated the effects of health coaching on pain intensity, physical function, and quality of life. METHODS: Four electronic databases (PubMed, Embase, Scopus, and PsychINFO) were searched from inception to December 2019. Randomized controlled trials assessing the effects of health coaching interventions in adult patients currently using opioids were included. We considered trials if they included any of the four defined key constructs of health coaching adopted in this review: motivational interviewing, positive psychology, the transtheoretical model, and self-determination theory Independent reviewers screened and selected studies, extracted data, and assessed risk of bias using Revised Cochrane risk-of-bias tool for randomized trials (RoB2) and quality of evidence using Grading, Recommendation, Assessment, Development, and Evaluation (GRADE). The review is registered in the International Prospective Register of Systematic Reviews (PROSPERO) databased as CRD42019136201. It was not possible to perform a meta-analysis due to heterogeneity between included trials. RESULTS: Eleven studies met our inclusion criteria (n = 4,516 participants). No study assessed all four constructs of health coaching. All eleven studies utilized only one of the constructs, brief motivational interviewing. Thus, we reported our results in terms of motivational interviewing. There is conflicting and very low quality of evidence that brief motivational interviewing may or may not be more effective than education to reduce opioid usage. There is very low quality of evidence that brief motivational interviewing is more effective than educational monthly diaries to reduce opioid use. There is very low to low quality of evidence that brief motivational interviewing is not more effective than no behavioral intervention to reduce opioid use at 6 months follow-up, treatment as usual (TAU) to improve overdose risk behaviors, and TAU to improve physical and psychological health. CONCLUSION: There is no direct evidence related to the effect of health coaching on opioid reduction. There is limited, low quality evidence to conclude brief motivational interviewing reduces opioid usage in opioid-dependent patients. Future research should focus on the impact of high theoretical health coaching interventions on opioid usage.


Assuntos
Analgésicos Opioides , Promoção da Saúde/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos
16.
Vet Res ; 51(1): 134, 2020 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-33115510

RESUMO

Salmonid Rickettsial Septicaemia (SRS), caused by Piscirickettsia salmonis, is a severe bacterial disease in the Chilean salmon farming industry. Vaccines and antibiotics are the current strategies to fight SRS; however, the high frequency of new epizootic events confirms the need to develop new strategies to combat this disease. An innovative opportunity is perturbing the host pathways used by the microorganisms to replicate inside host cells through host-directed antimicrobial drugs (HDAD). Iron is a critical nutrient for P. salmonis infection; hence, the use of iron-chelators becomes an excellent alternative to be used as HDAD. The aim of this work was to use the iron chelator Deferiprone (DFP) as HDAD to treat SRS. Here, we describe the protective effect of the iron chelator DFP over P. salmonis infections at non-antibiotic concentrations, in bacterial challenges both in vitro and in vivo. At the cellular level, our results indicate that DFP reduced the intracellular iron content by 33.1% and P. salmonis relative load during bacterial infections by 78%. These findings were recapitulated in fish, where DFP reduced the mortality of rainbow trout challenged with P. salmonis in 34.9% compared to the non-treated group. This is the first report of the protective capacity of an iron chelator against infection in fish, becoming a potential effective host-directed therapy for SRS and other animals against ferrophilic pathogens.


Assuntos
Doenças dos Peixes/prevenção & controle , Ferro/farmacologia , Oncorhynchus mykiss , Piscirickettsia/fisiologia , Infecções por Piscirickettsiaceae/veterinária , Salmo salar , Sepse/veterinária , Fenômenos Fisiológicos da Nutrição Animal , Animais , Linhagem Celular , Doenças dos Peixes/imunologia , Doenças dos Peixes/microbiologia , Ferro/química , Infecções por Piscirickettsiaceae/imunologia , Infecções por Piscirickettsiaceae/microbiologia , Infecções por Piscirickettsiaceae/prevenção & controle , Sepse/imunologia , Sepse/microbiologia , Sepse/prevenção & controle
17.
Nat Prod Res ; 34(24): 3522-3525, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30864868

RESUMO

The vasorelaxing effect of the methanol extract of the flowers of Crataegus gracilior, a Mexican medicinal plant used to treat some cardiovascular diseases, was assessed, and its possible chemical markers identified. The extract produced a potent vasodilator effect on isolated rat aortic rings (EC50 = 1.83 ± 1.39 µg/mL; Emax = 100 ± 3.4%). Vitexin, the most commonly identified flavonoid in the flowers and used to standardise some Crataegus species, was not found at all in this plant sample. Instead, daucosterol, and corosolic and euscapic acids were purified. The two triterpene acids have been reported to possess beneficial effects on cardiovascular diseases. These results indicate that the vasodilator effect might induce the hypotensive effect claimed by users, and that euscapic and corosolic acids may be the main vasodilator compounds, and can then be employed as the chemical markers towards the future standardisation of the extract.


Assuntos
Crataegus/química , Flores/química , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Vasodilatadores/farmacologia , Animais , Aorta/efeitos dos fármacos , Apigenina/análise , Relação Dose-Resposta a Droga , Flavonoides/análise , Masculino , Metanol , México , Plantas Medicinais/química , Ratos Wistar , Triterpenos/análise , Triterpenos/farmacologia , Vasodilatadores/análise , Vasodilatadores/química
18.
Rev Alerg Mex ; 66(4): 388-393, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-32105422

RESUMO

BACKGROUND: Allergic rhinitis is the most common allergic disease worldwide and it is caused by a reaction of hypersensitivity to aeroallergens. To our knowledge, there aren't any previous studies of aeroallergenic sensitization in Aguascalientes, Mexico. OBJECTIVE: To describe the sensitization to aeroallergens in patients with allergic rhinitis who have been treated at a private clinic in Aguascalientes, Mexico. METHODS: A descriptive, cross-sectional and retrospective study was done in which patients diagnosed with allergic rhinitis were included. Skin prick tests with 32 allergenic extracts were carried out and the frequencies at each were determined. RESULTS: In total, 350 patients were analyzed. The most frequent aeroallergens were grass pollens (74.8%), followed by tree pollens (64.8%) and dust mites Dermatophagoides pteronyssinus (64%). The group of patients under 20 years of age was predominant (67.1%), followed by the group of 21 to 40 years old (22.5%). CONCLUSIONS: This research provides information about regional patterns of sensitization, which shall facilitate diagnostic tests in the region and the best practices of specific immunotherapy.


Antecedentes: La rinitis alérgica es la enfermedad alérgica más común en el mundo y es causada por hipersensibilidad a los aeroalérgenos. Hasta donde sabemos, no hay estudios previos de sensibilización aeroalergénica en Aguascalientes, México. Objetivo: Describir la sensibilización a aeroalérgenos en pacientes con rinitis alérgica tratados en una clínica privada en Aguascalientes, México. Métodos: Estudio descriptivo, transversal y retrospectivo; se incluyeron pacientes diagnosticados con rinitis alérgica. Se realizaron pruebas cutáneas con 32 extractos alergénicos y se determinaron las frecuencia de reacción a cada uno. Resultados: En total se analizaron 350 pacientes. Los aeroalérgenos más frecuentes fueron los pólenes de pastos (74.8%), seguidos por los pólenes de árboles (64.8%) y Dermatophagoides pteronyssinus (64%). El grupo de edad predominante fue el menor de 20 años (67.1%), seguido del grupo de 21 a 40 años (22.5%). Conclusión: La investigación proporciona información sobre los patrones regionales de sensibilización, que facilitará las pruebas de diagnóstico en la región y las mejores prácticas de inmunoterapia específica.


Assuntos
Poluentes Atmosféricos/imunologia , Alérgenos/imunologia , Rinite Alérgica/imunologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , México , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
19.
Poiésis (En línea) ; 37(Jul.-Dic): 65-84, 2019.
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1047952

RESUMO

El presente trabajo investigativo parte de la postura de que ahondar sobre el conflicto armado y sus efectos en la población colombiana, es referirse a un tema que durante años ha evolucionado en diferentes periodos trascendentales generando diversas posturas, pero que indudablemente solo se puede describir de manera particular por quien ha vivido el rigor de la lucha por el poder económico y político, teniendo en cuenta esto, se desarrolla un estudio mediante un paradigma explicativo e interpretativo que contempla una metodología mixta, dirigida a indagar la relación entre el nivel de resiliencia y los constructos personales de aquellos individuos vulnerados por el conflicto armado, evidenciándose una disonancia entre el análisis de los resultados, al hallarse habilidades resilientes en los sujetos desde lo cuantitativo, las cuales no estaban representadas, desde un foco cualitativo, en el discurso de la mayoría de individuos, pues su subjetividad refería constructos poco ligados a la resiliencia. En tanto, se devela la relevancia de ejecutar acciones no solo inclinadas en hacer una reparación desde lo legal, sino que traigan a colación las significaciones individuales de las víctimas, para que estas puedan trascender y superar las secuelas que dificultan el desarrollo en las dimensiones psicológicas, sociales y emocionales que de alguna manera prolongan el flagelo y perpetúan el asistencialismo.


This paper is part of an effort to try to go deeper into the armed conflict and its effect on the Colombian people, it refers to a topic that has evolved into transcendental periods creating diverse postures that can only be described by those who have lived the political and economic struggle. Taking this perspective into account, this study was carried out under an explanatory and interpretative paradigm using a mixed methodo- logy looking to analyze the relationship between the level of resilience and the personal construction of those individuals victims of the armed conflict, displaying a dissonance between the result analysis of the results in finding the resilient abilities in subjects using a quantitative perspective, since their subjectivity referred constructions that were not very resilient. Therefore, there is the relevance of carrying out actions not only meant to repair forma legal perspective but that bring meaning to individual victims so that they may transcend and overcome the aftermath that hinder the development of psychological, social and emotional dimensions that in some way or another elongate the pain and extend assistance.


Assuntos
Humanos , Resiliência Psicológica , Teoria da Construção Pessoal , Vítimas de Crime/psicologia , Conflitos Armados/psicologia
20.
Cell Rep ; 22(11): 3021-3031, 2018 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-29539428

RESUMO

Developmental genes can have complex cis-regulatory regions with multiple enhancers. Early work revealed remarkable modularity of enhancers, whereby distinct DNA regions drive gene expression in defined spatiotemporal domains. Nevertheless, a few reports have shown that enhancers function in multiple developmental stages, implying that enhancers can be pleiotropic. Here, we have studied the activity of the enhancers of the shavenbaby gene throughout D. melanogaster development. We found that all seven shavenbaby enhancers drive expression in multiple tissues and developmental stages. We explored how enhancer pleiotropy is encoded in two of these enhancers. In one enhancer, the same transcription factor binding sites contribute to embryonic and pupal expression, revealing site pleiotropy, whereas for a second enhancer, these roles are encoded by distinct sites. Enhancer pleiotropy may be a common feature of cis-regulatory regions of developmental genes, and site pleiotropy may constrain enhancer evolution in some cases.


Assuntos
Elementos Facilitadores Genéticos/genética , Regulação da Expressão Gênica no Desenvolvimento/genética , Pleiotropia Genética/genética , Fatores de Transcrição/metabolismo , Humanos
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