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1.
J Sci Food Agric ; 2023 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-37406186

RESUMO

BACKGROUND: The consumption of foods such as sweet potato and cassava with high levels of carotenoids is a possible solution to reduce vitamin A deficiency. In this study, we evaluated the kinetics of thermal degradation of carotenoids. The content of carotenoids was quantified by high-performance liquid chromatography, first in fresh material, then in flour and finally in bakery products using mixtures of wheat, sweet potato and cassava. The degree of acceptance of the bakery products by children was also assessed through a sensory acceptance test. RESULTS: The study found that the degradation of carotenoid compounds in sweet potato followed first-order kinetics and fitted the Arrhenius equation with correlations of R2 > 0.9. The retention rates of all-trans-ß-carotene were 77%, 56% and 48% at cooking temperatures of 75, 85 and 95 °C respectively, during a cooking time of 20 min. The concentrations of all-trans-ß-carotene, after baking, for bread, cookies and cake were 15, 19 and 14 µg g-1 db, respectively. In a sensory acceptance test carried out in a school, 47.6% of the boys and 79.2% of the girls rated the cookies made from a mixture of cassava, sweet potato and wheat flour with the indicator I like it a lot. CONCLUSION: The content of carotenoid compounds was reduced by exposure to high temperatures and long cooking times. The combinations of cooking time and temperature which minimized degradation of all-trans-ß-carotene occurred at 75 °C-20 min and 95 °C-10 min. All-trans-ß-carotene retentions for bread, cookies and cake were 25%, 15% and 11% respectively. The mixture of wheat, sweet potato and cassava flour can be considered in the development of cookies with positive contributions of all-trans-ß-carotenes and with a good acceptance by children between 9 and 13 years old. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

2.
Rev Esp Enferm Dig ; 107(6): 347-53, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26031862

RESUMO

BACKGROUND: Microscopic colitis has now emerged as a common cause of chronic diarrhoea, but its aetiology remains unknown. Some studies suggest that commonly prescribed drugs and other additional risk factors may be triggers. AIMS: To evaluate the effects of drug intake and other risk factors on microscopic colitis patients. METHODS: A prospective, case-control study with all consecutive adult patients referred to the Hospital General de Tomelloso (Ciudad Real, Spain) for chronic watery diarrhoea (from 2008 to 2011) was performed. Microscopic colitis was diagnosed following the commonly accepted histopathological criteria. RESULTS: 46 consecutive new cases of microscopic colitis and 317 chronic diarrhoea controls were recruited. Five independent risk factors significantly associated with microscopic colitis were identified: Abdominal pain (OR 3.25; 95%CI, 1.49-7.08), weight loss (OR 2.67; 95%CI, 1.16-6.15), celiac disease (OR 15.3; 95%CI, 3.70-63.5), topiramate intake (OR 13.6; 95%CI, 1.84- 100.8), and older age at diagnosis (OR 1 year increase 1.022; 95%CI, 1.002-1.042). Use of non-steroidal anti-inflammatory drugs was associated with microscopic colitis in the subgroup of patients who fulfilled irritable bowel syndrome criteria (38.5% vs. 10.8%; p < 0.017). CONCLUSIONS: Microscopic colitis is associated with autoimmune disease, an increased age at diagnosis, topiramate intake and only in a sub-group of irritable bowel disease patients with non-steroidal anti-inflammatory drugs.


Assuntos
Colite Microscópica/etiologia , Adulto , Idoso , Anti-Inflamatórios não Esteroides/efeitos adversos , Doenças Autoimunes/complicações , Estudos de Casos e Controles , Colite Microscópica/induzido quimicamente , Colite Microscópica/diagnóstico , Feminino , Frutose/efeitos adversos , Frutose/análogos & derivados , Humanos , Síndrome do Intestino Irritável/complicações , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fármacos Neuroprotetores/efeitos adversos , Estudos Prospectivos , Fatores de Risco , Topiramato
3.
Medicina (B Aires) ; 75(3): 163-8, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-26117607

RESUMO

Surveillance of primary drug resistance is critical to optimize antiretroviral therapy (ART) for HIV. Mutations to be monitored are defined in a reference list of the World Health Organization (WHO), which does not include mutations for new drugs, such as rilpivirine. We undertook a retrospective analysis of medical records of ART naive patients treated at a specialized HIV/AIDS center, evaluating the prevalence of WHO mutations and mutations specific for rilpivirine. Ninety-one patients were included during 2011-2013, being male 71 (78.0%), and men who have sex with men 46 (50.5%). The median values for age, viral load, and CD4 counts were 33 years, 62 100 copies/mL, and 548 cells/µl, retrospectively; 34 (37.3%) had early infection and 60 (65.9%) were asymptomatic. WHO mutations were found in 11 (12.1%) patients, two of whom presented multiple mutations. Seven mutations corresponded to non-nucleoside reverse transcriptase inhibitors, four to nucleoside analogues, and two to protease inhibitors. The most frequent mutations were K103N and M41L. No differences in mutation frequencies were found when compared by time post-infection, gender, sexual orientation, or CD4 count. Mutations conferring low-level resistance to rilpivirine were found in 3 (3.3%) patients; such mutations were E138A and E138G. The overall moderate primary resistance levels found in this study highlight the value of performing a resistance test before ART initiation in the served population. The observed prevalence of primary resistance to rilpivirine was low.


Assuntos
Fármacos Anti-HIV , Farmacorresistência Viral/genética , Infecções por HIV/virologia , HIV-1/efeitos dos fármacos , Mutação , Adulto , Contagem de Linfócito CD4 , Feminino , HIV-1/genética , Humanos , Masculino , Prevalência , Estudos Retrospectivos , População Urbana , Carga Viral
4.
J Allergy Clin Immunol ; 131(3): 797-804, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23375693

RESUMO

BACKGROUND: Although empiric exclusion from the diet of the 6 food groups most likely to trigger allergies achieves eosinophilic esophagitis (EoE) remission in children, data on its prolonged efficacy and effects on adults are lacking. OBJECTIVE: We sought to evaluate the efficacy of a 6-food elimination diet in inducing and maintaining prolonged remission in patients with adult EoE. METHODS: Sixty-seven consecutive patients with adult EoE were prospectively recruited and treated exclusively with a diet avoiding cereals, milk, eggs, fish/seafood, legumes/peanuts, and soy for 6 weeks. Subsequent challenge was undertaken by sequentially reintroducing all excluded single foods, followed by endoscopy and biopsies, which were developed every 6 weeks in case of response (eosinophil peak count reduction to <15/high-power field [hpf]). A food was considered a trigger for EoE and removed from the diet if pathologic eosinophilic infiltration (≥15 eosinophils/hpf) reappeared. Food-specific serum IgE measurements and skin prick tests were performed before initiating the diet. RESULTS: Forty-nine (73.1%) patients exhibited significantly reduced eosinophil peak counts (<15 eosinophils/hpf) before sequential single-food reintroduction. A single offending food antigen was identified in 35.71% of patients, 2 food triggers were identified in 30.95%, and 3 or more food triggers were identified in 33.3%. Cow's milk was the most common food antigen (61.9%), followed by wheat (28.6%), eggs (26.2%), and legumes (23.8%). Prior allergy tests showed no concordance with food-reintroduction challenge results. All patients who continued to avoid the offending foods maintained histopathologic and clinical EoE remission for up to 3 years. CONCLUSIONS: An empiric 6-food elimination diet effectively induced remission of active adult EoE, which was maintained for up to 3 years with individually tailored, limited exclusion diets.


Assuntos
Esofagite Eosinofílica/dietoterapia , Hipersensibilidade Alimentar/complicações , Adolescente , Adulto , Alérgenos , Esofagite Eosinofílica/imunologia , Esofagite Eosinofílica/patologia , Feminino , Alimentos , Hipersensibilidade Alimentar/imunologia , Humanos , Imunoglobulina E/sangue , Mucosa Intestinal/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Testes Cutâneos , Adulto Jovem
5.
POCUS J ; 9(1): 11-13, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38681150

RESUMO

The tissue diagnosis and staging of all types of lung cancer is foundational for prognosis and establishing the optimal treatment plan. In order to appropriately stage lung cancer, the highest stage should be established using the 8th edition TNM criteria, where tumor size (T), nodal involvement (N), and metastasis (M) are all taken into account. Establishing a tissue diagnosis may involve the use of CT guided biopsy, navigational bronchoscopy, endobronchial biopsy, EBUS, percutaneous lymph node biopsy and/or excisional biopsy of supraclavicular nodes. It is recommended to proceed with the method that is considered least invasive and provides the highest staging. We present a case of recurrent lung adenocarcinoma diagnosed with real time ultrasound-guided fine needle aspiration of a neck lymph node.

6.
Sci Total Environ ; 905: 167178, 2023 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-37730028

RESUMO

High-altitude mountain areas are sentinel ecosystems for global environmental changes such as anthropogenic pollution. In this study, we report a source apportionment of particulate material with an aerodynamic diameter smaller than 10 µm (PM10) in a high-altitude site in southern Europe (Sierra Nevada Station; SNS (2500 m a.s.l.)) during summer 2021. The emission sources and atmospheric secondary processes that determine the composition of aerosol particles in Sierra Nevada National Park (Spain) are identified from the concentrations of organic carbon (OC), elemental carbon (EC), 12 major inorganic compounds, 18 trace elements and 44 organic molecular tracer compounds in PM10 filter samples collected during day- and nighttime. The multivariate analysis of the joint dataset resolved five main PM10 sources: 1) Saharan dust, 2) advection from the urbanized valley, 3) local combustion, 4) smoke from a fire-event, and 5) aerosol from regional recirculation with high contribution of particles from secondary inorganic and organic aerosol formation processes. PM sources were clearly associated with synoptic meteorological conditions, and day- and nighttime circulation patterns typical of mountainous areas. Although a local pollution source was identified, the contribution of this source to PM10, OC and EC was small. Our results evidence the strong influence of middle- and long-range transport of aerosols, mainly from anthropogenic origin, on the aerosol chemical composition at this remote site.

7.
J Allergy Clin Immunol ; 128(5): 1037-46, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21880354

RESUMO

BACKGROUND: Recent research shows that both pediatric and adult patients with eosinophilic esophagitis (EoE) experience esophageal remodeling marked by increased collagen deposition in which TGF-ß plays an important role. However, limited data are available on the intensity and reversibility of fibrous remodeling in adults with EoE. OBJECTIVE: We sought to analyze differences in collagen deposition in the lamina propria (LP) and profibrogenic cytokine gene expression along with other changes induced by prolonged treatment with fluticasone propionate in adults with EoE. METHODS: Ten adults given consecutive diagnoses of EoE were studied prospectively. Deep esophageal biopsy specimens were obtained before and after 1 year of treatment with fluticasone propionate. Collagen deposition in the LP was assessed in tissue sections with the aid of the Masson trichrome technique. IL5, TGFB1, fibroblast growth factor 9 (FGF9), and CCL18 gene expression was quantified through real-time PCR. EoE results were compared among samples from 10 adult patients with gastroesophageal reflux disease and 10 control subjects with healthy esophagi. RESULTS: Patients with EoE showed a significant increase in subepithelial collagen deposition; this correlated positively with eosinophil density in the LP and the patient's age. Prolonged steroid treatment induced a nonsignificant reduction in subepithelial fibrosis, which remained significantly higher than in control subjects. Profibrogenic cytokine gene expression also increased in patients with EoE, with IL5 (P < .001), FGF9 (P = .005), and CCL18 (P = .008) all significantly upregulated. After 1 year of treatment, a reduction was observed in gene expression; for CCL18 expression, this decrease was statistically significant (P < .001). CONCLUSIONS: Esophageal remodeling is associated with upregulated gene expression of profibrogenic cytokines in adults with EoE. Prolonged treatment with fluticasone propionate leads to a nonsignificant reduction in subepithelial collagen deposition accompanied by downregulation of profibrogenic cytokine gene expression, with that of CCL18 being especially significant.


Assuntos
Androstadienos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Colágeno/metabolismo , Citocinas/genética , Esofagite Eosinofílica/tratamento farmacológico , Esofagite Eosinofílica/patologia , Expressão Gênica/efeitos dos fármacos , Adolescente , Adulto , Citocinas/biossíntese , Esofagite Eosinofílica/genética , Feminino , Fibrose/tratamento farmacológico , Fibrose/patologia , Fluticasona , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real , Adulto Jovem
8.
Rev Esp Enferm Dig ; 104(9): 479-88, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23130856

RESUMO

BACKGROUND AND AIMS: enteral (EN) and parenteral (TPN) nutrition exert variable therapeutic effects on the induction and maintenance of remission in inflammatory bowel disease (IBD). This review aims to provide an updated discussion on the complex relationship between diet and IBD. METHODS: medline, Cochrane and Scopus database searches were conducted. Sources cited in the articles obtained were also searched to identify other potential sources of information. RESULTS: nutritional status is significantly compromised in IBD patients, especially those with Crohn's disease (CD). Apart from restoring malnourishment, dietary components contribute to modulate intestinal immune responses. Nutritional treatment is divided into support therapy and primary therapy to induce and maintain remission through TPN and EN. EN is considered a first-line therapy in children with active CD whereas it is usually used in adult CD patients when corticosteroid therapy is not possible. TPN has limited effects on IBD.En formula composition, in terms of carbohydrates, nitrogen source and bioactive molecules supplementation, differentially influence on IBD treatment outcomes. Other dietary components, such as poorly absorbed short-chain carbohydrate, polyols, and exogenous microparticles, also participate in the etiopathogenesis of IBD. Finally, new approaches to understanding the complex relationship between IBD and diet are provided by nutrigenenomic. CONCLUSION: further long-term, well-powered studies are required to accurately assess the usefulness of nutrition in treating IBD. In future research, the potential role of nutrient-gene interaction in drug trials and specific dietary formula compositions should be investigated in order to incorporate new knowledge about the etiopathology of IBD into nutritional intervention.


Assuntos
Nutrição Enteral , Doenças Inflamatórias Intestinais/dietoterapia , Nutrição Parenteral , Adulto , Fatores Etários , Deficiência de Vitaminas/dietoterapia , Deficiência de Vitaminas/etiologia , Criança , Carboidratos da Dieta/efeitos adversos , Carboidratos da Dieta/farmacocinética , Fermentação , Glutamina/uso terapêutico , Humanos , Imunomodulação , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/imunologia , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Mucosa Intestinal/metabolismo , Micronutrientes/deficiência , Nutrigenômica , Apoio Nutricional , Permeabilidade , Desnutrição Proteico-Calórica/dietoterapia , Desnutrição Proteico-Calórica/epidemiologia , Desnutrição Proteico-Calórica/etiologia , Indução de Remissão
9.
Dig Dis Sci ; 56(12): 3551-8, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21674173

RESUMO

BACKGROUND AND AIMS: Leukotriene D4 is produced by and functions as a chemotactic factor for eosinophils. Eosinophilic esophagitis (EoE) is characterized by esophageal eosinophilic infiltration, determining structural changes and dismotility symptoms. Montelukast, a selective leukotriene D4 receptor antagonist, has gained increasing consideration as a therapeutic agent for EoE. However, limited available information has shown that montelukast is not effective in reducing eosinophilic infiltration. Our paper aims at evaluating whether montelukast could be consider as a steroid-sparing therapy by assessing its efficacy in maintaining both clinical and histopathological remission achieved after topical corticosteroids in adult EoE patients. METHODS: Eleven consecutively diagnosed adult EoE patients were prospectively studied. Esophageal biopsies were obtained before and after a 6-month treatment with fluticasone propionate 400 µg/twice a day. Immediately after that, montelukast 10 mg/day was instituted. A new endoscopy was foreseen after a new 3-month period, or as soon as the patients presented esophageal symptoms. Symptoms were assessed by using a questionnaire before and after fluticasone propionate treatment and after montelukast therapy. RESULTS: Eosinophils density into the esophageal epithelium and lamina propria was significantly reduced after a 6-month treatment with topical steroids (P = 0.003) and increased to levels similar to baseline level into the first 3 months after treatment with montelukast. Baseline symptom scores significantly decreased after treatment with topical steroids (P = 0.003) and increased again after montelukast therapy, but baseline levels improved. CONCLUSIONS: Montelukast was not efficient in maintaining the histopathological or clinical response achieved by topical steroids in adult EoE patients.


Assuntos
Acetatos/uso terapêutico , Androstadienos/uso terapêutico , Esofagite Eosinofílica/tratamento farmacológico , Antagonistas de Leucotrienos/uso terapêutico , Quinolinas/uso terapêutico , Acetatos/administração & dosagem , Adulto , Androstadienos/administração & dosagem , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Biópsia , Ciclopropanos , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Endoscopia Gastrointestinal , Esofagite Eosinofílica/metabolismo , Esofagite Eosinofílica/patologia , Feminino , Fluticasona , Seguimentos , Humanos , Antagonistas de Leucotrienos/administração & dosagem , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Prospectivos , Quinolinas/administração & dosagem , Indução de Remissão/métodos , Sulfetos , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
10.
Dig Dis Sci ; 56(4): 1107-11, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20725783

RESUMO

BACKGROUND: Recent articles have described patients that share eosinophilic esophagitis (EoE) and celiac disease (CD) suggesting a true relationship between both diseases. AIMS: The purpose of this study was to investigate whether HLA DQ2 and DQ8 predisposing to CD are increased in adult patients with EoE. METHODS: HLA alleles conferring risk for CD was assessed in 75 adult EoE patients attended at two hospitals located in different Spanish regions over the past 2 years. We compared the frequencies to the registered data of 421 healthy kidney and bone marrow donors from our hospitals for the following alleles: (a) DR3-DQ2 haplotype; (b) the combination of DR3-DQ2 and DR4-DQ8; (c) DR4-DQ8 haplotype; (d) the simultaneous presence of the DR5-DQ7 and DR7-DQ2 haplotypes; and lastly (e) any combination of haplotypes not conferring risk for the development of CD. RESULTS: The HLA DQ2 and DQ8 alleles were analyzed in 58 adult EoE patients from hospital #1 and in 20 patients from hospital #2, and they were compared to recorded HLA genotyping data from 298 and 123 healthy donors, respectively. No differences were found between the distribution of the HLA frequencies of the patients and controls at both hospitals and the data could be combined. EoE patients did not show increased frequencies of DQ2 and DQ8 alleles compared to controls. CONCLUSIONS: Our work does not allow us to establish a common genetic basis for EoE and CD because an increased frequency of the HLA DQ2 and DQ8 alleles predisposing to CD was not observed in adult EoE patients compared to controls.


Assuntos
Doença Celíaca/genética , Esofagite Eosinofílica/genética , Predisposição Genética para Doença/genética , Antígenos HLA-DQ/genética , Adolescente , Adulto , Feminino , Frequência do Gene , Estudos de Associação Genética , Haplótipos/genética , Humanos , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia , Adulto Jovem
11.
Fed Pract ; 38(Suppl 2): S30-S34, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34177239

RESUMO

OBJECTIVES: Stereotactic ablative radiotherapy (SABR) has become the standard of care for inoperable early-stage non-small cell lung cancer (NSCLC). Many patients cannot safely undergo a biopsy because of poor pulmonary function and are empirically treated with radiotherapy. This study aimed to evaluate factors associated with radiation toxicity in patients receiving empiric SABR. METHODS: We performed a retrospective review of 69 patients. Patients and tumor characteristics, radiation doses, pulmonary function tests, and toxicity (acute ≤ 90 days and late > 90 days) were analyzed to find associations with overall survival on Kaplan-Meier curves and differences in patient populations with χ2 and Mann-Whitney U tests. RESULTS: Median age was 71 years. Tumors were classified as peripheral in 62 patients (89.9%). After a median follow-up of 18 months, 39 patients (56.5%) were alive with 4 local recurrences (5.7%), 10 regional failures (14.3%), and 15 distant metastases (21.4%). Nineteen of 67 (26.3%) patients had acute toxicity of which 9 had acute grade ≥ 2 toxicity. There were differences in overall survival based on operability status (P = .031) and acute toxicity (P < .001). Pretreatment oxygen dependence (P = .003), central location (P < .001), and new oxygen requirement (P = .02) were significantly associated with acute grade ≥ 2 toxicity. No association was found with performance on pulmonary function tests. CONCLUSION: Empiric SABR in presumed early-stage NSCLC appears to be safe and may increase overall survival. Acute grade ≥ 2 toxicity was significantly associated with pretreatment oxygen dependence, central location, and new oxygen requirement. No association was found with poor pulmonary function.

12.
Curr Res Food Sci ; 4: 279-286, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33997794

RESUMO

High kernel-zinc maize varieties are available to consumers in several countries in Latin America to contribute to increase the zinc intake of their populations. Minerals, phytic acid and amino acids retention were measured after processing six maize varieties including three high kernel-zinc, one quality protein maize and two conventional maize. Grain for each variety was processed into tortillas, arepas and mazamorra, common maize dishes in the region. To evaluate the effect of processing kernel-zinc maize varieties on zinc retention, varieties were grouped in zinc biofortified maize (ZBM) and non-ZBM. Iron, zinc, phytic acid, tryptophan and lysine concentrations in non-processed maize were 17.1-19.1 â€‹µg/g DW, 23.9-33.0 â€‹µg/g DW, 9.9-10.0 â€‹mg/g DW, 0.06-0.08% and 0.27-0.37%, respectively. In tortillas, the iron, zinc, phytic acid and lysine content did not change (p â€‹< â€‹0.05) compared to raw grain, while tryptophan decreased by 32%. True retention of iron in arepas and mazamorra was 43.9 and 60.0%, for zinc 36.8 and 41.3%, and for phytic acid 19.3 and 25.1%. Tortillas had higher zinc retention than arepas and mazamorra due to use of whole grain in the nixtamalization process. Therefore, to contribute to higher zinc intake, nixtamalized tortilla prepared with biofortified zinc maize is recommended. Additionally, promotion of whole grain flour to prepare arepas should be explored to enhance the intake of minerals that are usually confined to aleurone layers and germ.

13.
Sci Total Environ ; 762: 143100, 2021 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-33121775

RESUMO

Understanding the activation properties of aerosol particles as cloud condensation nuclei (CCN) is important for the climate and hydrological cycle, but their properties are not fully understood. In this study, the CCN activation properties of aerosols are investigated at two different sites in southern Spain: an urban background station in Granada and a high altitude mountain station in the Sierra Nevada National Park, with a horizontal separation of 21 km and vertical separation of 1820 m. CCN activity at the urban environment is driven by primary sources, mainly road traffic. Maximum CCN concentrations occurred during traffic rush hours, although this is also when the activation fraction is lowest. This is due to the characteristics of the rush hour aerosol consisting of ultrafine and less hygroscopic particles. In contrast, the mountain site exhibited larger and more hygroscopic particles, with CCN activity driven by the joint effect of new particle formation (NPF) and vertical transport of anthropogenic particles from Granada urban area by orographic buoyant upward flow. This led to the maximum concentrations of CCN and aerosol particles occurring at midday at the mountain site. Clear differences in the diurnal evolution of CCN between NPF events and non-event days were observed at the Sierra Nevada station, demonstrating the large contribution of NPF to CCN concentrations, especially at high supersaturations. The isolated contribution of NPF to CCN concentration has been estimated to be 175% higher at SS = 0.5% relative to what it would be without NPF. We conclude that NPF could be the major source of CCN at this mountain site. Finally, two empirical models were used to parameterize CCN concentration in terms of aerosol optical or physical parameters. The models can explain measurements satisfactorily at the urban station. At the mountain site both models cannot reproduce satisfactorily the observations at low SS.

14.
Rev Esp Cardiol (Engl Ed) ; 74(5): 438-448, 2021 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33712348

RESUMO

Both cancer treatment and survival have significantly improved, but these advances have highlighted the deleterious effects of vascular complications associated with anticancer therapy. This consensus document aims to provide a coordinated, multidisciplinary and practical approach to the stratification, monitoring and treatment of cardiovascular risk in cancer patients. The document is promoted by the Working Group on Cardio Oncology of the Spanish Society of Cardiology (SEC) and was drafted in collaboration with experts from distinct areas of expertise of the SEC and the Spanish Society of Hematology and Hemotherapy (SEHH), the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Radiation Oncology (SEOR), the Spanish Society of General and Family Physicians (SEMG), the Spanish Association of Specialists in Occupational Medicine (AEEMT), the Spanish Association of Cardiovascular Nursing (AEEC), the Spanish Heart Foundation (FEC), and the Spanish Cancer Association (AECC).


Assuntos
Cardiologia , Doenças Cardiovasculares , Hematologia , Neoplasias , Radioterapia (Especialidade) , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/terapia , Consenso , Fatores de Risco de Doenças Cardíacas , Humanos , Oncologia , Neoplasias/complicações , Neoplasias/epidemiologia , Neoplasias/terapia , Fatores de Risco
15.
J Clin Gastroenterol ; 44(10): 663-71, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20838233

RESUMO

Eosinophilic esophagitis (EE) is a chronic clinicopathologic syndrome and is the latest inflammatory disease of the esophagus described in literature. It seems to have a multifactorial etiology. Its causes include exposure to food or airborne allergens that affect individuals who may be genetically predisposed and exposure to the acid could also modulate the inflammatory response at esophageal level. However, we currently do not know how each of these possible etiologic factors contribute to the development of the disease that is essential to define specific treatment. We have used 3 different therapeutic approaches that were effective in patients with EE: various antiinflammatory drugs that are useful in treating asthma, controlling the exposure to allergens, particularly with respect to dietary changes and dilation of the esophagus. Although none of these treatments have absolute advantages, they can efficiently control the symptoms and inflammation in a large number of patients. Each treatment option should be assessed on a case-by-case basis in accordance with the experience of each center, the patients' characteristics, their sensitivity to allergens and their preferences. This article provides the latest information on the different treatment options for patients with EE, analyzing the advantages and disadvantages of each pathology and it offers practical recommendations on how to manage these patients who are being more frequently diagnosed.


Assuntos
Anti-Inflamatórios/uso terapêutico , Dieta , Esofagite Eosinofílica/terapia , Esofagoscopia , Fármacos Gastrointestinais/uso terapêutico , Comportamento de Redução do Risco , Dieta/efeitos adversos , Esofagite Eosinofílica/diagnóstico , Esofagite Eosinofílica/etiologia , Humanos , Seleção de Pacientes , Guias de Prática Clínica como Assunto , Fatores de Risco , Resultado do Tratamento
16.
Cureus ; 12(4): e7875, 2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-32489729

RESUMO

Background Interstitial lung disease (ILD) is a common pathologic consequence of the idiopathic inflammatory myopathies, and it may be the initial presentation of autoimmune disease in many cases. There are no well-established guidelines to direct the evaluation of this disease in these cases. This study looked at the utility of four common serologic tests to screen for a myositis-associated ILD. Methods This is a single institution retrospective analysis of four common serologic tests (antinuclear antibody [ANA], creatine kinase [CK], aldolase, and anti-Sjögren's syndrome A [anti-SSA]) to detect a positive antibody on an extended myositis antibody panel. Results The serum aldolase was the most sensitive test to detect the presence of a positive antibody on an extended myositis antibody panel with a sensitivity of 54.5%. The anti-SSA was the least sensitive at 21.4%. A positive result for anti-SSA antibodies was associated with a 100% positive predictive value when all other screening tests (ANA, aldolase, and CK) were also positive.  Conclusion No single screening test was sufficient for the evaluation of a myositis-associated ILD. A positive serum aldolase had higher sensitivity, and a positive SSA had a high positive predictive value when other screening markers were also elevated, but clinicians still need to maintain a high index of suspicion for myositis-associated ILD.

17.
Cureus ; 12(2): e7078, 2020 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-32226679

RESUMO

Active learning improves self-reported engagement and satisfaction in medical education. Audience response systems are one mechanism of encouraging participation, especially in a setting in which learners in varying educational levels are present. Three fellowships participated in this educational quality improvement project where Poll Everywhere® was incorporated into didactics. Attendees were invited to complete a 4-question retrospective pre-post satisfaction survey. Incorporation of the Poll Everywhere® audience response system resulted in a shift in more favorable satisfaction scores and self-perceived attentiveness compared to the pre-intervention responses.

18.
PLoS One ; 15(11): e0242202, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33175890

RESUMO

Zinc deficiency is a major public health problem in vulnerable populations of Latin America and the Caribbean. Biofortification of rice (Oryza sativa L.) with zinc has the potential to alleviate zinc deficiencies. However, as plant breeding processes can alter grain culinary quality and favorable sensory attributes, grain quality and consumer acceptability need to be assessed prior to releasing a variety to the public. A grain quality characterization and a sensory acceptability analysis were carried out with two varieties of zinc biofortified rice and a local control both in Bolivia and Colombia. The aim of this study was to evaluate the physicochemical parameters that are significant in consumer acceptance and to determine the acceptability of zinc biofortified rice by consumers. Results of physicochemical parameters were analyzed using ANOVA. The sensory acceptability was evaluated in 243 adults utilizing a 7-point hedonic scale and a Wilcoxon's signed rank test was used to determine the overall acceptability of the varieties. Biofortified rice variety T2-11 and MAC-18 -control 1- were equally accepted by consumers in Bolivia with no significant differences (p<0.05). The grain quality analysis reported that both presented long and slender rice grains (L>7.5 mm and L/B>3), an intermediate to high amylose content (>25%) and a similar level of chalkiness. In Colombia, the biofortified variety 035 presented a higher score in overall acceptance in comparison to biofortified variety 021 and the local variety CICA4 -control 2-. However, no significant differences were observed (p<0.05). Conversely to the other two varieties, the biofortified variety 035 presented the largest size grain (L/B = 2.97), a lower chalkiness and an amylose content above 25%. This study shows that the grain quality properties of rice have an influence on acceptability and that zinc biofortified rice varieties are accepted by consumers.


Assuntos
Biofortificação , Comportamento do Consumidor , Grão Comestível/normas , Oryza/química , Percepção Gustatória , Zinco/análise , Adolescente , Adulto , Atitude , Bolívia , Colômbia , Grão Comestível/química , Feminino , Alimentos Fortificados/normas , Humanos , Masculino , Pessoa de Meia-Idade
19.
Sci Total Environ ; 744: 140745, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-32727660

RESUMO

This article presents the results of atmospheric deposition from a 15-sites network which cover remote, agricultural, urban and industrial areas in the Iberian Peninsula and the Balearic Islands, with the aim of exploring geographical, climatic and natural vs anthropogenic gradients. Annual average fluxes of global deposition, discriminating insoluble (3,5-20,7 g m-2 year-1) and soluble-inorganic (7,1-45,5 g m-2 year-1) aerosols are discussed, seasonal patterns are regarded, and an attempt to estimate the impact of the main sources is presented. The wide range of atmospheric deposition fluxes (DF) regarding soluble (DFSOL) and insoluble (DFINS) has been investigated taking into consideration the contribution from nearby to long-distance sources, such as African dust, or regional-to-nearby ones, which include agricultural dust in the Ebro Valley, industrial emissions at different parts, urban dust at all cities, or saline dust resuspension from a dissicated lake bed. DFSOL is made up of marine aerosols, prevailing in coastal areas, with few exceptions in the Ebro Valley; nitrogen-species, homogeneously distributed across the network, with few exceptions due to agricultural sources; mineral dust, enhanced in the Ebro Valley owing to regional and agricultural emissions; and phospathe, displaying comparable values to other studies in general, but three hotspots at regional background environments have been identified. DFINS particles followed the aridity pattern, especially where anthropogenic emissions take place. Our estimates indicate that the regional dust to DFINS in the Ebro Valley represented 23-30%, overpassing 50% at intensive agricultural areas. Similarly, urban-metropolitan contributions accounted for 37-45% at the four cities, and 55% at the industrial one. African dust deposition was enhanced in the Central Pyrenees (75-80%) as a result of the magnification of atmospheric washout processes, and in south-eastern Iberia (69%) owing to the higher frequency of dust outbreaks.

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