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PURPOSE: Interleukin-6 (IL-6) is a proinflammatory cytokine with pleiotropic effects which has been related to primary open angle glaucoma (POAG) due to its particular effect of protecting the retinal ganglion cells (RGc) from the apoptosis. Different single nucleotide polymorphisms (SNP) have been associated with POAG. The aim of this study was to determine whether an association between IL-6 rs1800795 (-174 G>C) SNP and a higher risk for POAG is present in western Mexican population. METHODS: One hundred and sixty-five unrelated Mexican mestizo patients with POAG and 108 control subjects were included. Genomic DNA was extracted from leukocytes and purified, followed by genotyping and amplification by polymerase chain reaction (PCR) with Taqman Biosystem probes. Allelic and genotypic diversity was evaluated between cases and control subjects. RESULTS: There was no statistically significant association between allele and genotype frequencies, neither with dominant nor recessive genetic association models (pâ¯>â¯0.05). CONCLUSION: Even though there is a role of IL6 in the pathophysiology of POAG, our results ruled out the association between IL-6 and the rs1800795 SNP showing not to be an index of higher risk for POAG in Mexican population.
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Glaucoma de Ângulo Aberto , Interleucina-6 , Polimorfismo de Nucleotídeo Único , Frequência do Gene , Genótipo , Glaucoma de Ângulo Aberto/genética , Humanos , Interleucina-6/genética , México/epidemiologiaRESUMO
El presente trabajo tiene el objetivo de explorar el desarrollo de las tecnologías de la información y comunicación (componentes de eSalud) en servicios de salud públicos de México, así como indagar sobre los facilitadores y barreras para su implementación. Se realizó un estudio de caso en el Instituto de Servicios de Salud del Estado de Aguascalientes utilizando un abordaje mixto de tipo concurrente y de predominancia cualitativa que incluyó observación no participante, entrevistas semiestructuradas y un cuestionario dirigido al personal médico. A través del estudio, se identifican diversas oportunidades de mejora en cuanto al acceso y desarrollo de las tecnologías de la información y comunicación; también se identifican diversas barreras para su implementación factibles de superarse. En cuanto a las limitaciones del estudio, se reconoce la exploración de perspectivas sólo desde la oferta de servicios. En lo que respecta a la originalidad, destaca la investigación integral de diferentes componentes de eSalud. Se concluye que es necesario fortalecer las políticas de las tecnologías de información y comunicación dirigidas al sector salud con el fin de optimizar su desarrollo e implementación
The purpose of this work is to explore the development of the Information and Communication Technologies (e-Health components) in public health services of Mexico, as well as to inquire into the enablers and barriers to its implementation. A case study was conducted at the Instituto de Servicios de Salud del Estado de Aguascalientes using a mixed approach of concurrent type and qualitative predominance that included non-participant observation, semi-structured interviews and a questionnaire addressed to medical staff. Through the study, diverse improvement opportunities for the access and development of the Information and Communication Technologies were identified; diverse barriers to its implementation were also. The study has the limitation of taking only the services offer perspectives. The originality of this study is the comprehensive research of e-Health components. It is concluded that it is necessary to strengthen the Information and Communication Technologies policies focused to the health sector in order to optimize its development and implementation
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Telemedicina , Estratégias de eSaúdeRESUMO
PURPOSE: This study aims to evaluate the association between composition of tumor-infiltrating lymphocytes (TIL) and expression of p16 in acral lentiginous melanoma (ALM), and their impact on prognosis. MATERIALS AND METHODS: A cohort of 148 surgical pathology specimens of ALM was studied. TIL were evaluated by immunohistochemical detection of CD3 and CD8, along with CD20, CD4, CD68, and CD163 in a subset of 43 cases. p16 protein expression was also investigated in all the cases. RESULTS: The median age was 66 years, median Breslow thickness was 6.0 mm, grade III TIL was found in 28.4% and lymph nodes were involved in 54.2%. Breslow thickness (p < 0.001), stage I-II (p < 0.001), negative lymph nodes (p < 0.001) and < 10% p16 (p = 0.01) were associated with longer survival. Grade III of TIL was associated with thinner Breslow thickness (p = 0.008) and lower mitosis (p = 0.047). A higher density of CD3 TIL was associated with male gender (p = 0.008), thinner Breslow thickness (p = 0.047), negative lymph node (p = 0.031), early stage (p = 0.046), and p16 nuclear expression of > 10% (p = 0.045). Higher CD8 TIL was associated with > p16 (p = 0.03). Survival analysis found that longer survival had a trend to be associated with high TIL (p = 0.090). Levels of CD3+ and CD8+ cells were correlated with those of CD4+, CD20+, CD68+ and CD163+ immune cells. CONCLUSIONS: Higher levels of TIL tend to be associated with better overall survival in ALM. Loss of expression of p16 is associated with lower levels of CD3+ and CD8+ TIL, indicating a probable relationship between p16 and TIL immune response in ALM .
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Biomarcadores Tumorais/análise , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Lentigo/patologia , Linfócitos do Interstício Tumoral/imunologia , Melanoma/patologia , Neoplasias Cutâneas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Seguimentos , Humanos , Lentigo/imunologia , Lentigo/metabolismo , Masculino , Melanoma/imunologia , Melanoma/metabolismo , Pessoa de Meia-Idade , Prognóstico , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/metabolismo , Taxa de Sobrevida , Melanoma Maligno CutâneoRESUMO
BACKGROUND: For primary triple-negative breast cancer (TNBC) treated with neoadjuvant chemotherapy (NAC), higher pretreatment tumor-infiltrating lymphocytes (TILs) correlates with increased pathologic complete response (pCR) rates, and improved survival. We evaluated the added prognostic value of residual disease (RD) TILs to residual cancer burden (RCB) in predicting survival post-NAC. PATIENTS AND METHODS: We combined four TNBC NAC patient cohorts who did not achieve pCR. RD TILs were investigated for associations with recurrence-free survival (RFS), and overall survival (OS) using Cox models with stromal TILs as a continuous variable (per 10% increment). The likelihood ratio test was used to evaluate added prognostic value of RD TILs. RESULTS: A total of 375 RD TNBC samples were evaluable for TILs and RCB. The median age was 50 years, with 62% receiving anthracycline/taxane chemotherapy. The RCB class after NAC was 11%, 50%, and 39% for I, II, and III, respectively. The median RD TIL level was 20% (IQR 10-40). There was a positive correlation between RD TIL levels and CD8+ T-cell density (ρ = 0.41). TIL levels were significantly lower with increasing post-NAC tumor (P = 0.005), nodal stage (P = 0.032), but did not differ by RCB class (P = 0.84). Higher RD TILs were significantly associated with improved RFS (HR: 0.86; 95% CI 0.79-0.92; P < 0.001), and improved OS (HR: 0.87; 95% CI 0.80-0.94; P < 0.001), and remained significant predictors in multivariate analysis (RFS P = 0.032; OS P = 0.038 for OS). RD TILs added significant prognostic value to multivariate models including RCB class (P < 0.001 for RFS; P = 0.021 for OS). The positive prognostic effect of RD TILs significantly differed by RCB class for RFS (PInt=0.003) and OS (PInt=0.008) with a greater magnitude of positive effect observed for RCB class II than class III. CONCLUSIONS: TIL levels in TNBC RD are significantly associated with improved RFS and OS and add further prognostic information to RCB class, particularly in RCB class II.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfócitos do Interstício Tumoral/imunologia , Terapia Neoadjuvante/mortalidade , Neoplasia Residual/patologia , Neoplasias de Mama Triplo Negativas/patologia , Idoso , Linfócitos T CD8-Positivos/imunologia , Progressão da Doença , Feminino , Seguimentos , Humanos , Neoplasia Residual/tratamento farmacológico , Neoplasia Residual/imunologia , Prognóstico , Receptor ErbB-2/metabolismo , Taxa de Sobrevida , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Neoplasias de Mama Triplo Negativas/imunologiaRESUMO
PURPOSE: Acral lentiginous melanoma (ALM) is a poor prognosis subtype and is the most prevalent in non-Caucasian populations. The presence of tumor infiltrating lymphocytes (TILs) has been associated with poor prognosis in melanoma. A large cohort of ALM cases was studied to determine status of TIL and its association with outcome. METHODS: All patients with cutaneous melanoma presenting from 2005 to 2012 at Instituto Nacional de Enfermedades Neoplasicas in Peru were retrospectively identified. Clinicopathological information was obtained from the medical charts. A prospective evaluation of TIL was performed. Analysis of association between ALM and clinicopathological features including TIL as well as survival analysis compared the outcome of ALM to whole group and extremity NALM was performed. RESULTS: 537 ALM from a total of 824 cutaneous melanoma cases were studied. Older age (p = 0.022), higher Breslow (p = 0.008) and ulceration (p < 0.001) were found to be more frequent in ALM. Acral had worse overall survival (OS) compared with the whole group (p = 0.04). Clinical stage (CS) I-II patients had a median OS of 5.3 (95% CI 4.3-6.2) for ALM and 9.2 (95% CI 5.0-7.0) for extremity NALM (p = 0.016). Grade 0 (absence of TIL), I, II and III were found in 7.5, 34.5, 32.1, and 25.9%, respectively. Lower TIL grade was associated with larger tumor size (p = 0.003), higher Breslow (p = 0.001), higher Clark level (p = 0.007), higher CS (p = 0.002), extremity location (p = 0.048), histological subtype ALM (p = 0.024) and better OS (p = 0.001). CONCLUSIONS: ALM is highly prevalent in Peru and carries poor outcome. Lower TIL levels were associated with poor outcome and ALM.
Assuntos
Extremidades/patologia , Linfócitos do Interstício Tumoral/patologia , Melanoma/patologia , Neoplasias Cutâneas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Extremidades/cirurgia , Feminino , Seguimentos , Humanos , América Latina , Masculino , Melanoma/cirurgia , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Neoplasias Cutâneas/cirurgia , Taxa de Sobrevida , Adulto Jovem , Melanoma Maligno CutâneoRESUMO
We report the synthesis of two novel pyrrole-imidazole polyamides with N-terminal guanidinium or tetramethylguanidinium groups and evaluate their antiviral activity against three cancer-causing human papillomavirus strains. Introduction of guanidinium improves antiviral activity when compared to an unsubstituted analog, especially in IC90 values. These substitutions change DNA-binding preferences, while binding affinity remains unchanged.
RESUMO
Objetivo: Determinar la presencia de plomo en los lápices labiales de diferentes marcas que se expenden en la ciudad de Lima. Material y Método: Se utilizó 24 lápices labiales de cinco marcas comerciales operantes en Perú, procedentes del centro comercial Capón en Lima. La presencia de plomo se determinó por el método de espectrofotometría de absorción atómica con horno de grafito. Para la validación estadística, se determinó la media y la desviación estándar. Resultados: Se encontró mayor contenido de plomo en las marcas LAL-04-YHBC (3,02 ppm), LAL-05-BALOE (2,10 ppm), LAL- 02-RW (1,55 ppm) y LAL-03-VCYH (1,22 ppm); contrastada con una marca poco conocida,de código LAL-01-CHOCO PLUSII en la que no se detectó plomo. Conclusiones: De los lápices labiales estudiados, cuatro de ellos superaron los valores permisibles de plomo (0,1 ppm), que es un valor referencial para caramelos.
Objective: To determine the presence of lead in lipsticks from different brands that are sold in the city of Lima. Material and Methods: 24 lipsticks of five different trademarks were used, from the shopping center in Lima Capon. The presence of lead was determined by the method of atomic absorption spectrophotometry with graphite furnace. For statistical validation, the mean and standard deviation was determined. Results: The highest lead content was found in the LAL -04 - YHBC (3.02 ppm) , LAL -05 - BALOE (2.10 ppm) , LAL -02 -RW (1.55 ppm) and LAL -03 marks - VCYH (1.22 ppm ) ; contrasted with a little known brand , LAL -01- CHOCO PLUSII code where no lead was detected. Conclusions: Of the studied lipsticks, four exceeded the permissible values of lead (0.1 ppm), which is a reference value for candy.
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Peru , Chumbo/análise , Produtos para LábiosRESUMO
Increased iron in subcortical gray matter (GM) structures of patients with Huntington's disease (HD) has been suggested as a causal factor in neuronal degeneration. But how iron content is related to white matter (WM) changes in HD is still unknown. For example, it is not clear whether WM changes share the same physiopathology (i.e. iron accumulation) with GM or whether there is a different mechanism. The present study used MRI to examine iron content in premanifest gene carriers (PreHD, n = 25) and in early HD patients (n = 25) compared with healthy controls (n = 50). 3T MRI acquisitions included high resolution 3D T1, EPI sequences for diffusion tensor imaging (DTI) as an indirect measure of tissue integrity, and T2*-weighted gradient echo-planar imaging for MR-based relaxometry (R2*), which provides an indirect measure of ferritin/iron deposition in the brain. Myelin breakdown starts in the PreHD stage, but there is no difference in iron content values. Iron content reduction manifests later, in the early HD stage, in which we found a lower R2* parameter value in the isthmus. The WM iron reduction in HD is temporally well-defined (no iron differences in PreHD subjects and iron differences only in early HD patients). Iron level in callosal WM may be regarded as a marker of disease state, as iron does not differentiate PreHD subjects from controls but distinguishes between PreHD and HD.
Assuntos
Corpo Caloso/metabolismo , Doença de Huntington/patologia , Ferro/metabolismo , Bainha de Mielina/patologia , Adulto , Feminino , Humanos , Doença de Huntington/metabolismo , Imageamento Tridimensional , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Escalas de Graduação PsiquiátricaRESUMO
Objetivo: Evaluar la composición química, la toxicidad aguda y los efectos antiulceroso y antitumoral de tres extractos de Capsicum pubescens (ROCOTO) en estudios preclínicos. Materiales y métodos: Estudio experimental preclínico, analítico. Utilizamos 50 ratas albinas machos para evaluar el efecto antiulceroso y 86 ratones albinos para evaluar el efecto antitumoral y la toxicidad aguda. El tamizado fitoquímico se realizó con el método de Ciulei. Para producir las úlceras gástricas usamos Indometacina como agente ulcerígeno. El efecto antitumoral de Capsicum pubescens, fue evaluado frente al sarcoma-180. La toxicidad aguda (DL-50) fue evaluada con dosis de 500, 1000, 2000, 10000 y 12000 mg/kg de peso de rocoto. Resultados: En el estudio fitoquímico, detectamos grasas, aceites, alcaloides, lactonas, coumarinas, triterpenos, esteroides, catequinas, resinas, azúcares reductores, fenoles y taninos, entre otros. Apreciamos reducción de las lesiones gástricas macroscópicas producidas por indometacina con los extractos acuoso y etanólico de rocoto, superiores a los de la ranitidina. No observamos mortalidad en los ratones hasta la dosis de 12,000 mg/kg de peso, del extracto metanólico de rocoto. El extracto metanólico de rocoto, mejoró la sobrevida de los ratones inoculados con sarcoma, cuando se administró preventivamente, siendo mayor el efecto a la dosis de 750 mg/kg. Conclusiones: Los extractos acuoso y etanólico de rocoto, presentaron propiedades gastroprotectoras, dosis dependiente, superiores a Ranitidina, y el extracto metanólico presentó efecto antitumoral frente al sarcoma-180, administrado preventivamente y es, prácticamente, atóxico según los criterios de Williams.
Assuntos
Animais , Ratos , Capsicum/toxicidade , Extratos Vegetais , Antiulcerosos , Compostos FitoquímicosRESUMO
El síndrome metabólico es un grupo de factores de riesgo para desarrollar evento coronario; alteración del metabolismo de la glucosa, diabetes, obesidad abdominal, dislipidemia e hipertensión forman parte de él. Seestima que una cuarta parte de la población adulta lo presenta, tienen dos veces de riesgo de morir y tresveces más riesgo de padecer algún evento coronario o evento Cerebrovascular comparado a quienes no lopresentan. También las personas tienen cinco veces más posibilidad de desarrollar diabetes tipo 2. Laspatologías que lo conforman, parecen tener una interrelación fisiopatológica, que las va uniendo. Laspoblaciones latinoamericanas presentan características que las hacen especialmente susceptibles a padecerestas patologías cardio-metabólicas. El reconocimiento de estas características en los pacientes tiene unaimportancia especial debido a que indica la necesidad de aplicar medidas activas para reducir el riesgo cardiovascular.
Metabolic syndrome is a group of the most dangerous risk factors for coronary event, alteration in glucosemetabolism; diabetes, abdominal obesity, dyslipidemia and hypertension are components of this. It isestimated that a quarter of the adult population has it, they have twice probabilities to die, three times as likelyto coronary event or Cerebrovascular event compared to those do not have it. Also people are five times morelikely at risk for type 2 Diabetes. The pathologies that comprise it seem to have a pathophysiologicalinterrelationship, which puts together. Latin American populations have characteristics that make themespecially susceptible to these cardiometabolic diseases. Recognition of these characteristics in patients isparticularly important because it indicates the need for active measures to reduce cardiovascular risk.
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Humanos , /complicações , Doenças Cardiovasculares/diagnóstico , Obesidade Abdominal/etiologia , Síndrome Metabólica/complicações , Triglicerídeos/efeitos adversosRESUMO
Introducción: La infección no complicada del tracto urinario bajo y la bacteriuria asintomática son causas frecuentes de consulta médica ambulatoria y en el servicio de urgencias en Colombia y el mundo. La falta de pautas y consenso para el manejo, así como la emergencia de resistencia a las múltiples opciones terapéuticas disponibles en los uropatógenos provenientes de la comunidad, hacen necesario elaborar unas recomendaciones que orienten al clínico sobre el abordaje óptimo de estas entidades. Objetivo: Definir un consenso sobre el manejo empírico de la bacteriuria asintomática y la infección del tracto urinario (ITU) bajo en adultos y mujeres embarazadas en Colombia. Metodología: Se lleva a cabo una metodología de consenso con expertos en urología, infectología, medicina interna, ginecología y microbiología basada en la revisión de las referencias bibliográficas disponibles en los términos de búsqueda relacionados, haciendo énfasis en estudios locales. Resultados: Se elaboró un algoritmo de manejo para el tratamiento empírico de la ITU baja no complicada en adultos con antisépticos urinarios como nitrofurantoína y fosfomicina trometamol como primera línea, con recomendaciones terapéuticas específicas para el tratamiento de la bacteriuria asintomática en mujeres embarazadas. Adicionalmente, se formuló un algoritmo de decisión para el procesamiento de cultivos de orina. La recurrencia o recaída frecuente justifica remisión a urología e infectología. Conclusiones: Se generan recomendaciones prácticas de fácil implementación en el diagnóstico y manejo de la ITU bajo en adultos y embarazadas, y de los casos donde es necesario tratar la bacteriuria asintomática, con opciones terapéuticas efectivas y de espectro reducido.
Background: Uncomplicated infection of the lower urinary tract and asymptomatic bacteriuria are frequent causes of visits to outpatient clinics and emergency departments in Colombia and worldwide. The lack of guidelines and a consensus for their management, and the emergence of resistance of community-based uropathogens to the available therapeutic options, make it necessary to develop recommendations to guide clinicians on the optimal approach to these entities. Objective: Define a consensus for the empiric management of asymptomatic bacteriuria and Urinary Tract Infection (UTI) in adults and pregnant women in Colombia. Methods: We carried out a consensus methodology with experts in urology, infectious diseases, internal medicine, gynecology and clinical microbiology; based on reviewing the available literature on the related terms, and emphasizing local studies. Results: We developed a management algorithm for the empirical treatment of uncomplicated lower UTI in adults with urinary antiseptics such as nitrofurantoin and fosfomycin trometamol as first line, with specific therapeutic recommendations for the treatment of asymptomatic bacteriuria in pregnant women. Additionally, we created a decision algorithm for processing urine cultures. Frequent recurrence or relapse justifies referral to urology and infectious disease professionals. Conclusions: We generated straightforward and easy-to-implement recommendations for the diagnosis and management of UTI in adults and pregnant women, and in cases where it is necessary to treat asymptomatic bacteriuria, with effective therapeutic and narrow spectrum options.
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Humanos , Feminino , Gravidez , Infecções Urinárias , Cistite , Infecções do Sistema Genital , Bacteriúria , Infecções Urinárias/tratamento farmacológico , Doenças Urológicas/virologia , Serviço Hospitalar de EmergênciaRESUMO
En ésta experiencia se trata de aportar datos exitosos sobre la insulinización en un grupo de pacientes en una población Guatemalteca. El universo de pacientes a quienes se les ofreció insulinización fue de 326 personas con diabetes tipo 2 (DM2), los pacientes fueron tomados de la casuística diaria del Patronato del Diabético, cede central, Guatemala, a partir del 15 diciembre del 2011 hasta 04 de diciembre del 2012. Los datos fueron tomados directamente durante la entrevista y plasmados tanto en la historia clínica, que es llevada en el centro, así como en un formato llevado a parte para tener una copia de los datos clínicos de los pacientes incluidos. De las 326 pacientes, 3 rechazaron la insulinización y 45 no regresaron para seguimiento...
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Humanos , /diagnóstico , /prevenção & controle , Insulina/administração & dosagemRESUMO
Men living at high altitudes in Peru compared to sea level counterparts have erythrocytosis (hemoglobin 16-21 g/dl) or excessive erythrocytosis (hemoglobin>21 g/dl). High testosterone (T) levels in men at high altitude (HA) were associated with excessive erythrocytosis. High androgen levels could be due to a low aromatase activity or to an elevated rate of conversion from precursors to testosterone. The aim of this study was to evaluate aromatase activity and rate of conversion from precursors to testosterone before and after administration of the aromatase enzyme inhibitor letrozole (5 mg/day) for a 5-day period to men at HA and at sea level (SL). The response to short term aromatase inhibition was assessed in 30 adult men living at sea level, 31 native men at HA with erythrocytosis (Hb 16-21 g/dl), and 35 men at HA with excessive erythrocytosis (Hb>21 g/dl). Serum hormone levels, estradiol/testosterone, testosterone/androstenedione, and testosterone/dehydroepiandrosterone sulfate (DHEAS) ratios were measured. Men with erythrocytosis had lower basal serum T/androstenedione ratios than men with excessive erythrocytosis at HA and men at sea level. Men at HA with excessive erythrocytosis had higher T/DHEAS ratios than men with erythrocytosis and than those at sea level before and after letrozole administration. After letrozole administration, both groups of men at high altitude (with erythrocytosis or with excessive erythrocytosis) showed lower aromatase activities than those at sea level. In conclusion, higher serum testosterone levels in men with excessive erythrocytosis were associated with an increased rate of conversion from DHEAS to testosterone rather than to a lower aromatase activity.
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Altitude , Inibidores da Aromatase/farmacologia , Aromatase/sangue , Sulfato de Desidroepiandrosterona/sangue , Nitrilas/farmacologia , Policitemia/sangue , Testosterona/sangue , Triazóis/farmacologia , Adulto , Androstenodiona/sangue , Estudos de Coortes , Estradiol/sangue , Hemoglobinas/metabolismo , Humanos , Letrozol , Masculino , Pessoa de Meia-Idade , Oximetria , Peru , Policitemia/enzimologia , Estudos Prospectivos , Estatísticas não ParamétricasRESUMO
Gene signatures can provide prognostic and predictive information to help in the treatment of early-stage breast cancer. Although many of these signatures have been described, only a few have been properly validated. MammaPrint and OncoType offer prognostic information and identify low-risk patients who do not benefit from adjuvant chemotherapy. With regard to prediction of response, molecular subtypes of breast cancer differ in their sensitivity to chemotherapy, although further studies are needed in this field. Cost, small sample size, and the need to use central laboratories are common limitations to the widespread use of these tools.
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Neoplasias da Mama/genética , Perfilação da Expressão Gênica , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Quimioterapia Adjuvante , Feminino , Humanos , Prognóstico , Reprodutibilidade dos TestesRESUMO
Objetivo general: describir y analizar, desde una perspectiva cualitativa, las vivencias de un grupo de mujeres gestantes con diagnóstico de embarazo de alto riesgo con el fin de contar con criterios para construir intervenciones de enfermería que puedan responder a sus necesidades de cuidado. Materiales y métodos: se realizó una entrevista a profundidad, partiendo del marco teórico, a 10 mujeres de 17 a 39 años con embarazo de alto riesgo, atendidas por la Red Distrital de Salud. El análisis fue apoyado por el Atlas ti 6, basado en la Teoría Fundamentada. Resultados: las situaciones asociadas al alto riesgo en el embarazo encontradas en este grupo son: intervalo intergenésico riesgo más frecuente, hipertensión inducida por el embarazo, anemia, complicaciones obstétricas del embarazo anterior, antecedente de aborto a repetición, obesidad, bajo peso, placenta previa, tuberculosis, isoinmunización Rh, infección urinaria a repetición y consumo de sustancias psicoactivas (SPA). Se destacan los embarazos no planeados; la mitad de las participantes no cuentan con apoyo económico de su pareja; 7 perdieron su trabajo; 5 viven con parientes. La violencia de género y la pobreza limitan la toma de decisiones y afectan su salud. Se visualizan estrés y sentimientos de ambivalencia: por un lado, entusiasmo con su embarazo y, por otro, cambios que producen desequilibrio y afectan la calidad de vida. Conclusiones: las mujeres de este grupo social requieren de atención integral y oportuna, evitando demoras, y educación sexual y reproductiva. Enfermería debe brindar cuidado transcultural y actividades educativas para minimizar temores y empoderar en derechos.
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Complicações na Gravidez , Educação Sexual , Gravidez de Alto Risco , Pesquisa Qualitativa , Saúde ReprodutivaRESUMO
OBJETIVO: Realizamos el estudio botánico (taxonómico e histológico) y fitoquímico de las hojas de maca que se cultivan en la Meseta de Bombón del Departamento de Junín, con el OBJETIVO de determinar la especie a la que pertenece. MATERIAL Y MÉTODOS: Las muestras fueron colectadas entre diciembre-2007 y agosto-2008, siguiendo el método de Cerrate E y Ramagosa et. al. El estudio taxonómico se fundamentó en el sistema de clasificación de Cronquist (1981), claves nacionales e internacionales, descripciones originales fototipos y dibujos. Utilizamos reactivos de grado analítico y un estándar certificado de quercetina. La determinación de la quercetina se realizó por espectrofotometría UV/Vis, en un extracto metanólico hidrolizado, siguiendo la metodología de Sharapin modificada; y por HPLC (método de Piacente modificado). La identificación de los ácidos grasos poliinsaturados se realizó por cromatografía de gases acoplado a espectrofotometría de masa (GC-EM). RESULTADOS: La morfología de las hojas demostró que la planta es anual, pubescente, herbaceae-sufrútice; hojas pinnasectas, sépalos persistentes; raíz globosa tuberosa, características propias del Lepidiun peruvianum Chacón. La histología mostró tricomas unicelulares cónicos y tricomas pluricelulares; la epidermis y el mesófilo contienen cristales de oxalato de calcio. En el extracto metanólico hidrolizado ôBõ encontramos una cantidad significativa de flavonoides, expresados como quercetina (3,55-3,95 mg/ gramo de muestra), tanto por el método espectrofotométrico, como por el de cromatografía líquida de alta precisión. Por CG-EM identificamos ácidos grasos poliinsaturados (palmítico; linoleato, linolenato y palmitato de etilo). CONCLUSIONES: La muestra vegetal colectada proveniente de la Meseta del Bombón del Departamento de Junín corresponde a la especie Lepidium peruvianum Chacón y contiene flavonoides (quercetina) y ácidos grasos poliinsaturados).
ABSTRACT We make a botanic (taxonomic and hystologic) and phytochemic study of the ômacaõ from the Meseta de Bombom-Junìn with the OBJETIVE to deteremine the species to which it belong MATERIALS AND METHOD The samples were collected between December-2007 and Augost-2008 according with the Cerrate E and Ramagosa et al. Method. The taxonomic study was based on the Cronquist clasification system (1981), national and international keys, original descriptions and fototypes and draws. We used reactives of analytic grades and certifayed standars of Quercetine. The test of quercetin was made by spectrophotometry UV/Vis in the methanolic hydrolyzed extract, following the Sharapin modified method and by HPLC following the Piacente modified method. The identification of the insatureted fat acids was made by gas cromatography acopled to mass spectrometry (GC-EM). RESULTS The morphology of the leaves showed tha the plant is annual, pubescent, hebaceae-sufrútice; pinnasectas leaves, permanent sepals; globous tuberous roots. All o these are characteristics of the Lepidiun peruvianum Chacon. The histology showed that the plant has unicelular conic tricomes and pluricelular tricomes; the epidermis and the mesophil has calcium oxalate chystals. In the methanolic hydrolysed ôBõ we found a significant amount of flavonoids, expresed as Quercetine (3,55-3,95 mg/g of sample) tested by spectrophotomety as by HPLC. By CG-EM we found poliinsaturated fat acids such: palimitc acid, etilo linolated, etilo linolenated and etilo palmitated. CONCLUSIONS The sample of ôMacaõ colected in the Meseta de Bombon Department of Junín belongs to the Lepidiun peruvianun Chacon species and has flavonoids (quercetin) and polyunsaturated fat acids.
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Humanos , Botânica , Espectrometria de FluorescênciaRESUMO
Camu-camu, es un árbol frutal, oriundo de la amazonía sudamericana que crece en las orillas anegables de ríos amazónicos. Pertenece al género Myrciaria, especie dubia. Presenta gran importancia nutritiva. Su alto contenido en ácido ascórbico (2780 mg/100 g de pulpa) le confieren propiedades antioxidantes. Objetivo: Evaluar la toxicidad subaguda (30 días) del Camu-camu. Material y método: Utilizamos 33 ratas albinas, macho, Holtzman, distribuidas en 3 grupos equitativos: Grupo I (grupo control), se le administró agua destilada, Grupo II y Grupo III, se les administró por vía oral el extracto seco de Camu-camu a las dosis de 100 y 200mg/Kg, respectivamente. Al inicio del experimento (basal), a las 15 y a los 30 días, se determinó: hemoglobina, WBC, urea, albúmina, creatinina, proteínas GGT, TGP, TGO, en sangre, y peso corporal; además, se realizó el examen histológico de hígado, riñones, bazo y estómago al finalizar el estudio (30 días). Resultados: Los valores de hemoglobina, albúmina y proteínas, fueron mayores que las del grupo control (p<0.05); a su vez, los valores de GGT fueron menores que los del grupo control (p<0.05). No encontramos evidencias de toxicidad sub-aguda, en ninguno de los 2 grupos expuestos, en el examen histopatológico. Conclusión: El Camu-camu, a las dosis y formas de administración, del presente trabajo, carece de efectos tóxicos para las ratas.
Camu-camu, is a native fruit tree of the South American jungle and grows at the borders of amazonian rivers. It belongs to Myrciaria generous and dubia specie and has a great nutritional importance. Contains a high amounts of ascorbic acid, (2780mg/100g of pulp), that is why it is good antioxidant. Objective: To evaluate the subacute toxicity of the atomized Camu-camu. Material and method: We used 33 Holtzman albino male rats, distributed in 3 equitable groups: Group I, the control group, only received distilled water, Groups II and III received 100 and 200 mg/Kg of Camu-camu, respectively. Blood samples were taken for biochemical analysis at the beginning, 15th and 30th days (at the end), to determinate Hb, WBC, urea, albumin, total proteins, creatinine, GGT, TGP, TGO and the weight of the animals; we also do the histological examination of liver, kidneys, spleen and stomach at the end of the experiments (day 30th). Results: The values of albumin, total proteins and hemoglobin were higher than the control group (p<0.05) while the values of GGT were lower that control group (p<0.05). We didnÆt find evidences of subacute toxicity in any of the 2 groups exposed to Camu-camu in the histopathological examination. Conclusion: Camu camu hadn´t toxic effect, in rats, with oral administration during 30 days.
Assuntos
Animais , Ratos , Administração Oral , Antioxidantes , Citrus , Técnicas In Vitro , Myrtaceae , Myrtaceae/toxicidade , Ácido AscórbicoAssuntos
Encefalopatias/complicações , Encefalopatias/diagnóstico , Encéfalo/patologia , Demência/diagnóstico , Imageamento por Ressonância Magnética , Idade de Início , Encefalopatias/patologia , Demência/etiologia , Demência/patologia , Feminino , Humanos , Leucoencefalopatia Multifocal Progressiva/complicações , Leucoencefalopatia Multifocal Progressiva/diagnóstico , Pessoa de Meia-IdadeRESUMO
El Smallanthus sonchifolius, oriundo de los Andes y llamado vulgarmente yacón, es conocido por su uso como normoglicemiante e hipolipemiante así como por su utilidad como antioxidante. En la presente investigación evaluamos la toxicidad subcrónica del extracto acuoso de sus hojas, luego de su administración oral en ratas albinas Holtzman. Objetivo: Evaluar la toxicidad del extracto acuoso de las hojas de yacón en ratas albinas sanas. Material y método: Se realizó un estudio experimental en 40 ratas Holtzman, distribuidas en dos grupos (hembras y machos), a las cuales se administró, por vía oral, durante 90 días, dosis de 100, 200 y 500 mg/Kg/día, del extracto acuoso de hojas de yacón. Se tomaron muestras de sangre del plexo orbital del ojo a los 0, 45 y 90 días para llevar a cabo análisis bioquímicos y hermatológicos. Se realizaron, además exámenes histopatológicos de cerebro, hígado y riñones. Resultados: No se encontraron variaciones significativas en ninguno de los exámenes en comparación con las ratas controles (p ø 0.05). Conclusión: El consumo del extracto de hojas de yacón, durante 90 días, no produjo signos de toxicidad en los órganos estudiados.
The Smallanthus sonchifolius, vulgarly known as yacon, an Ades's species is well known for its use as by it's normoglycemic, hipolipemic and antioxidant effects. There are only few studies on this plant. At present we have investigations about it's chemical composition, harverts process, and medical use. In this paper we evaluated the toxicity of the aqueous extract of the organic leaves of Smallanthus sonchifolius on Holtzman albin rats subcronic oral administration of the extract during 90 days. Objective: To evaluate the subchronic toxicity of aqueous extract of the yacon leaves on healthy albina rats. Material and method: An experimental study has been performed on 40 Holtzman rats. Male a female rats were grouped separately. They received oral daily doses of 100, 200 y 500 mg/Kg/ yaconÆs leaves aqueous extract. Blood samples were taken from the rat orbital plexus of the rats at 0,45 and 90 days of treatment for biochemical and haematologic analysis. Histological examination of brain, liver and kigneys was also done. Results: Non significant differences were found in the examinations of the three groups in comparison with control (p ø 0.05). Conclusion: The Smallanthus sonchifolius aqueous extract consumption during 90 days did not produce toxicity signs in the organs studied.
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Masculino , Animais , Feminino , Aster/toxicidade , Asteraceae/toxicidade , RatosRESUMO
La evaluación de plantas medicinales usando parámetros de genotoxicidad, nos permite indicar si alguno de sus componentes puede provocar daño al material genético, a niveles génico o cromosómico. Este daño puede estimarse y determinará si el uso de la planta es conveniente o si por el contrario, el efecto benéfico aludido, se ve opacado por el probable efecto genotóxico. De forma alternativa, esta misma metodología permitiría detectar el efecto protector de una planta frente a la acción de mutágenos, lo cual redundaría en beneficio de los usuarios. Objetivo: Evaluar, in vitro, el efecto genotóxico del extractos de Abuta grandifolia, ôAbutaõ y Alchornea castaneifolia, ôHiporuroõ. Materiales y método: se realizaron cultivos de linfocitos obtenidos de sangre periférica, agregando los extractos de Abuta grandifolia, ôAbutaõ y Alchornea castaneifolia, ôHiporuroõ a diferentes concentraciones. Posteriormente, se realizó la evaluación citológica de aberraciones cromosómicas. Resultados: Se encontró un número elevado de aberraciones cromosómicas, tanto para el cultivo con Abuta como para el de Hiporuro. Este efecto se observó a diferentes concentraciones de extracto. Conclusiones: Las aberraciones cromosómicas encontradas en el presente trabajo, implicarían un efecto genotóxico de ambas plantas medicinales en el sistema in vitro empleado. Se requiere más estudios a diferentes niveles de organización que complementen los resultados reportados de este trabajo.
The evaluation of plants used in traditional medicine base don genotoxic parameters, allows researchers to determinate if some component could promote, genetic or chromosomal damage. This damage can be measured and, allow to determine the convenience of its use or, on the contrary, if its beneficial effect in undermined by the genotoxic effect. Moreover, this method would make it possible to detect the protective effect of the plant as opposed to a mutagen, which would enhance the benefit of its use. Objective: To evaluate the genotoxic effect of extracts of Abuta grandifolia, ôAbutaõ and Alchornea castaneifolia, ôHiporuroõ, using an in vitro test. Materials and method: Lymphocytes were cultured from peripheral blood, adding Abuta or Hiporuro extracts in different doses. Cytological evaluation of chromosome aberration was performed and registered. Results: An increased number of chromosome aberrations in Abuta and Hiporuro culture were found for different doses of extract. Conclusions: Chromosome aberrations found in the present work, would implicate a genotoxic effect in both plants in the system used. More studies are needed to complement the results of this research.