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1.
Endocr J ; 68(5): 573-581, 2021 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-33473070

RESUMEN

Thyroid nodules (TN) are common in the general population, and the clinical importance of diagnosing thyroid nodules is based on excluding the possibility of thyroid cancer, which occurs in 7-15% of cases. The thyroid gland, owing to its superficial location, is easily accessible via thermography, a noninvasive method of recording body temperature that measures infrared radiation emitted by the body surface. Therefore, this study aimed to evaluate the temperature differences between benign and malignant TN by using thermography. We conducted a cross-sectional study where 147 TN were divided into two groups: the first group included 120 benign nodules and the other included 27 malignant nodules. All the nodules were subjected to ultrasound, fine needle aspiration biopsy, and thermography. On analyzing the thermography results, the benign nodules had a higher temperature at the beginning of the thermography evaluation, and the malignant nodules showed a higher temperature in the middle and at the end (Ft). Using the relationships, it was observed that the temperature delta (ΔT), ΔT nodule/ΔT healthy, ΔT nodule minus ΔT healthy, and nodule Ft minus Ft of the healthy region were higher in malignant nodules. The ROC curve analysis of ΔT demonstrated a cutoff point of 2.38°C, with a sensitivity of 0.963 and specificity of 0.992. Malignant nodules have higher temperatures than benign nodules on thermographic evaluation. This finding suggests that thermography can be a useful tool in the diagnosis of thyroid nodules.


Asunto(s)
Termografía/métodos , Neoplasias de la Tiroides/diagnóstico , Nódulo Tiroideo/diagnóstico , Adulto , Estudios Transversales , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Temperatura
2.
Clin Chem Lab Med ; 55(12): 1954-1961, 2017 Oct 26.
Artículo en Inglés | MEDLINE | ID: mdl-28593924

RESUMEN

BACKGROUND: Late-night salivary cortisol (LNSC) is one of the most reliable tests to screen for endogenous Cushing syndrome. This test is simple, inexpensive and noninvasive and has high sensitivity and specificity. The aim of our study was to analyze the putative influence of age, gender and body mass index (BMI) on LNSC levels in a healthy population. METHODS: Cross-sectional study conducted in healthy adults. Midnight saliva samples were collected at home. Participants refrained from teeth brushing, eating or drinking for 2 h prior to collection. Salivary cortisol measured by electrochemiluminescence immunoassay (ECLIA). The study was approved by the Ethics Committee of the hospital (number 140073). RESULTS: We evaluated 122 nonsmoking healthy volunteers. Mean age was 35±14 years (range, 18-74 years); 63% were women. Mean BMI was 24±3 kg/m2, blood pressure 115/74 mmHg and fasting plasma glucose 4.8±0.5 mmol/L. LNSC presented a non-Gaussian distribution; the median was 3.58 (range, 0.55-8.55) nmol/L (0.13 [range, 0.02-0.31] µg/dL), and the 97.5th percentile (P97.5) was 8.3 nmol/L (0.3 µg/dL). Multiple linear regression disclosed a significant positive association between salivary cortisol levels and age (r2=0.21, p<0.001), but no association with gender (p=0.105) or BMI (p=0.119). Accordingly, participants aged >50 years had significantly higher salivary cortisol as compared to those aged <50 years (5.24 nmol/L [0.19 µg/dL] vs. 3.31 nmol/L [0.12 µg/dL], respectively, p<0.001). CONCLUSIONS: The maximum reference value (P97.5) of LNSC was set at 8.3 nmol/L (0.3 µg/dL) using ECLIA. Advanced age was associated with higher LNSC levels, with no evident influence of gender or BMI.


Asunto(s)
Índice de Masa Corporal , Hidrocortisona/análisis , Saliva/química , Adulto , Factores de Edad , Estudios Transversales , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Factores Sexuales
3.
Nutrition ; 121: 112357, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38430738

RESUMEN

OBJECTIVE: Polyunsaturated fatty acids are categorized as ω-3 or ⍵-6. Previous studies demonstrate that breast cancers display a high expression of fatty acid synthase and high fatty acid levels. Our study sought to determine if changes in plasma or red blood cell membrane fatty acid levels were associated with the response to preoperative (neoadjuvant) chemotherapy in non-metastatic breast cancer patients. METHODS: Our prospective study assessed fatty acid levels in plasma and red blood cell membrane. Response to neoadjuvant chemotherapy was evaluated by the presence or absence of pathologic complete response and/or residual cancer burden. RESULTS: A total of 28 patients were included. First, patients who achieved pathologic complete response had significantly higher neutrophil-to-lymphocyte ratio versus no pathologic complete response (P = 0.003). Second, total red blood cell membrane polyunsaturated fatty acids were higher in the absence of pathologic complete response (P = 0.0028). Third, total red blood cell membrane ⍵-6 polyunsaturated fatty acids were also higher in no pathologic complete response (P < 0.01). Among ⍵-6 polyunsaturated fatty acids, red blood cell membrane linoleic acid was higher in the absence of pathologic complete response (P < 0.01). Notably, plasma polyunsaturated fatty acid, ⍵-6, and linoleic acid levels did not have significant differences. A multivariate analysis confirmed red blood cell membrane linoleic acid was associated with no pathologic complete response; this was further confirmed by receiver operating characteristic analysis (specificity = 92.3%, sensitivity = 76.9%, and area under the curve = 0.855). CONCLUSIONS: Pending further validation, red blood cell membrane linoleic acid might serve as a predictor biomarker of poorer response to neoadjuvant chemotherapy in non-metastatic human epidermal growth factor receptor type 2-positive breast cancer. Measuring fatty acids in red blood cell membrane could offer a convenient, minimally invasive strategy to identifying patients more likely to respond or those with chemoresistance.


Asunto(s)
Neoplasias de la Mama , Humanos , Femenino , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/metabolismo , Ácido Linoleico , Terapia Neoadyuvante , Estudios Prospectivos , Ácidos Grasos Insaturados , Ácidos Grasos , Eritrocitos/metabolismo , Receptores ErbB/uso terapéutico
4.
Nutrients ; 15(15)2023 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-37571256

RESUMEN

Docosahexaenoic acid (C22:6n-3, DHA) is the precursor of specialized pro-resolving lipid mediators (SPMs), such as resolvin, protectin, and maresin families which have been considered therapeutic bioactive compounds for human health. Growing evidence indicates that DHA and SPMs are beneficial strategies in the amelioration, regulation, and duration of inflammatory processes through different biological actions. The present review discusses the reported therapeutic benefits of SPMs on various diseases and their potential clinical applications.


Asunto(s)
Ácidos Docosahexaenoicos , Eicosanoides , Humanos , Inflamación/tratamiento farmacológico , Mediadores de Inflamación
5.
Arq Bras Cardiol ; 120(5): e20220597, 2023.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-37255128

RESUMEN

Hydatidosis is a zoonosis caused by Echinococcus granulosus, leading to the formation of cysts on involved organs. Cardiac involvement is rare and can cause a wide range of complications secondary to rupture, embolization, or compression. Its diagnosis is challenging, and is generally confirmed through data related to clinical manifestations, environmental exposure, and laboratory and imaging exams. Surgical removal is necessary in most cases, in which an association with antiparasite therapy is recommended. The present article describes a case of a cardiac hydatid cyst associated with a complete atrioventricular block (AVB) in a young adult patient, with the need for a pacemaker implant, an atypical presentation, and scarce reports in the literature.


A hidatidose é uma zoonose causada pelo Echinococcus granulosus, levando à formação de cistos nos órgãos acometidos. O envolvimento cardíaco é raro e pode causar diversas complicações secundárias à ruptura, embolização ou compressão. Seu diagnóstico é desafiador, sendo confirmado por meio de dados relacionados a manifestações clínicas, exposição ambiental, exames laboratoriais e de imagem. A ressecção cirúrgica é necessária na maioria dos casos, sendo indicada a associação com terapia antiparasitária. No presente artigo, descreve-se um caso de cisto hidático cardíaco associado a bloqueio atrioventricular total em paciente jovem, com necessidade de implante de marcapasso, uma apresentação atípica e pouco relatada na literatura.


Asunto(s)
Bloqueo Atrioventricular , Equinococosis , Adulto Joven , Humanos , Bloqueo Atrioventricular/diagnóstico por imagen , Bloqueo Atrioventricular/etiología , Bloqueo Atrioventricular/terapia , Equinococosis/complicaciones , Equinococosis/diagnóstico por imagen , Diagnóstico por Imagen , Corazón
6.
Nutrients ; 15(22)2023 Nov 18.
Artículo en Inglés | MEDLINE | ID: mdl-38004223

RESUMEN

Nonalcoholic fatty liver disease (NAFLD) is pediatrics' most common chronic liver disease. The incidence is high in children and adolescents with obesity, which is associated with an increased risk of disease progression. Currently, there is no effective drug therapy in pediatrics; therefore, lifestyle interventions remain the first line of treatment. This review aims to present an updated compilation of the scientific evidence for treating this pathology, including lifestyle modifications, such as exercise and dietary changes, highlighting specific nutritional strategies. The bibliographic review was carried out in different databases, including studies within the pediatric population where dietary and/or nutritional interventions were used to treat NAFLD. Main interventions include diets low in carbohydrates, free sugars, fructose, and lipids, in addition to healthy eating patterns and possible nutritional interventions with n-3 polyunsaturated fatty acids (EPA and DHA), amino acids (cysteine, L-carnitine), cysteamine, vitamins, and probiotics (one strain or multi-strain). Lifestyle changes remain the main recommendation for children with NAFLD. Nevertheless, more studies are required to elucidate the effectiveness of specific nutrients and bioactive compounds in this population.


Asunto(s)
Enfermedad del Hígado Graso no Alcohólico , Adolescente , Niño , Humanos , Enfermedad del Hígado Graso no Alcohólico/tratamiento farmacológico , Dieta , Obesidad/complicaciones , Vitaminas/uso terapéutico , Ejercicio Físico
7.
Artículo en Inglés | MEDLINE | ID: mdl-37544056

RESUMEN

INTRODUCTION: There is a growing interest in vegetarian and vegan diets, but both can potentially affect tissue fatty acids (FA) composition. We aimed to evaluate the effect of vegetarian diets on plasma, erythrocytes, and sperm n-3 polyunsaturated fatty acids (n-3 PUFA) status in healthy young men. METHODS: Four groups were studied: i) men consuming a regular omnivore diet (OMV-1, n = 35); ii) men consuming an omnivore diet but excluding fish and seafood (OMV-2, n = 34); iii) men consuming a pescetarian diet (including dairy, eggs, fish, and seafood) (PESC, n = 36); and iv) men following a strict vegan diet (VEG, n = 35). Participants in each group should follow their diet for at least the previous 12 months. Diet evaluation used a structured validated food frequency questionnaire. FA composition was measured in plasma, erythrocyte phospho-lipids, and spermatozoa by gas-liquid chromatography, expressed as a mole percentage of the total FA content. RESULTS: Main findings showed higher alpha-linolenic fatty acid (ALA) and total n-3 PUFA dietary intake in the VEG group. In plasma, arachidonic and eicosapentaenoic acids were higher in OMV and PESC groups, whereas docosahexaenoic acid (DHA) level was lower in VEG. Higher ALA, but reduced DHA and total n-3 PUFA levels were found in erythrocytes and spermatozoa in the VEG group. CONCLUSION: Higher dietary ALA intake was found in pescetarians and vegan men. However, the higher ALA intake was not reflected in higher DHA content in the evaluated tissues. PUFA assessment, with particular emphasis in DHA, are necessary to improve PUFA status in vegan men.


Asunto(s)
Ácidos Grasos Omega-3 , Ácidos Grasos , Animales , Masculino , Dieta Vegana , Semen , Dieta , Ácidos Docosahexaenoicos , Ácido Eicosapentaenoico , Ácido alfa-Linolénico , Ácidos Grasos Insaturados
8.
IJID Reg ; 7: 52-62, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36536932

RESUMEN

Background: In 2020, Brazil became the epicentre of the coronavirus disease (COVID-19) pandemic in Latin America, resulting in an unparalleled health catastrophe. Nevertheless, comprehensive clinical reports in Brazilian children are not available. Methods: This retrospective, hospital-based, active surveillance study was performed to identify paediatric patients with COVID-19 who presented at a private academic medical centre in a large urban area between March 2020 and March 2021. Clinical and demographic information was analysed for those requiring hospitalization, those with severe illness and those with clinical syndromes. Results: In total, 964 symptomatic cases were evaluated; of these, 17.7% required hospitalization, and 27.5% of hospitalized cases were classified as severe/critical. Acute bronchiolitis and pneumonia were the most common causes of hospitalization among the severe cases. Twenty-seven hospitalized children fulfilled the diagnostic criteria for multi-system inflammatory syndrome (median age 29 months; 85.2% cases were non-severe). A significant co-existing condition was present in 29% of hospitalized children. The risk of hospitalization was higher in children with at least one comorbidity, children aged <2 years and obese children. Increased risk of severe disease was described among those with leukopenia, leukocytosis or any significant comorbidity. No deaths occurred among the study population. Conclusion: Although most children with COVID-19 experienced mild disease, and no deaths occurred among the study population, a significant proportion of cases required hospitalization and developed severe illness. Obesity, young age, underlying comorbidity, leukopenia and leukocytosis were risk factors for hospitalization or severe disease.

9.
Pediatr Infect Dis J ; 2023 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-37991363

RESUMEN

BACKGROUND: Brazil´s case fatality rate (CFR) of pediatric multisystem inflammatory syndrome in children and adolescents (MIS-C) is among the highest worldwide. Despite these concerns, limited hospital-based and comprehensive pediatric data have been published on MIS-C in Brazilian children. METHODS: We performed a descriptive analysis of the MIS-C scores in 16 public and private hospitals providing secondary and tertiary care in the metropolitan area of São Paulo, Brazil. Clinical and demographic information were systematically extracted from the electronic medical records of each patient. Logistic regression analysis was performed to identify the combined effects of MIS-C phenotype, disease severity and comorbidity as dependent variables. RESULTS: A total of 101 patients met the MIS-C criteria and were evaluated. The median age was 67 months, 60% were male, 28.7% were black or afrodescendant and 62.3% were admitted to public hospitals. Underlying medical conditions were observed in 16.8% of patients and were associated with a longer duration of hospitalization. A Kawasaki disease-like phenotype was observed in 43.5% of patients, and they demonstrated a trend of lower median age. Children with severe MIS-C were older (median age 91 months vs. 36 months) and had a nonspecific phenotype, more cardiovascular and respiratory involvement and kidney injury; 73.3% required intensive care, 20.8% required mechanical ventilation and 35.6% required inotropic support. Four deaths occurred (CFR = 3.9%), three of which were in healthy participants. CONCLUSION: We identified a lower median age, particularly among children with Kawasaki disease-like phenotypes, those with a significant need for intensive care, and a high CFR in MIS-C. Our findings confirmed the increased severity of the disease in the selected Brazilian population.

10.
JAMA Pediatr ; 177(10): 1073-1084, 2023 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-37603343

RESUMEN

Importance: Multiple SARS-CoV-2 variants have emerged over the COVID-19 pandemic. The implications for COVID-19 severity in children worldwide are unclear. Objective: To determine whether the dominant circulating SARS-CoV-2 variants of concern (VOCs) were associated with differences in COVID-19 severity among hospitalized children. Design, Setting, and Participants: Clinical data from hospitalized children and adolescents (younger than 18 years) who were SARS-CoV-2 positive were obtained from 9 countries (Australia, Brazil, Italy, Portugal, South Africa, Switzerland, Thailand, UK, and the US) during 3 different time frames. Time frames 1 (T1), 2 (T2), and 3 (T3) were defined to represent periods of dominance by the ancestral virus, pre-Omicron VOCs, and Omicron, respectively. Age groups for analysis were younger than 6 months, 6 months to younger than 5 years, and 5 to younger than 18 years. Children with an incidental positive test result for SARS-CoV-2 were excluded. Exposures: SARS-CoV-2 hospitalization during the stipulated time frame. Main Outcomes and Measures: The severity of disease was assessed by admission to intensive care unit (ICU), the need for ventilatory support, or oxygen therapy. Results: Among 31 785 hospitalized children and adolescents, the median age was 4 (IQR 1-12) years and 16 639 were male (52.3%). In children younger than 5 years, across successive SARS-CoV-2 waves, there was a reduction in ICU admission (T3 vs T1: risk ratio [RR], 0.56; 95% CI, 0.42-0.75 [younger than 6 months]; RR, 0.61, 95% CI; 0.47-0.79 [6 months to younger than 5 years]), but not ventilatory support or oxygen therapy. In contrast, ICU admission (T3 vs T1: RR, 0.39, 95% CI, 0.32-0.48), ventilatory support (T3 vs T1: RR, 0.37; 95% CI, 0.27-0.51), and oxygen therapy (T3 vs T1: RR, 0.47; 95% CI, 0.32-0.70) decreased across SARS-CoV-2 waves in children 5 years to younger than 18 years old. The results were consistent when data were restricted to unvaccinated children. Conclusions and Relevance: This study provides valuable insights into the impact of SARS-CoV-2 VOCs on the severity of COVID-19 in hospitalized children across different age groups and countries, suggesting that while ICU admissions decreased across the pandemic in all age groups, ventilatory and oxygen support generally did not decrease over time in children aged younger than 5 years. These findings highlight the importance of considering different pediatric age groups when assessing disease severity in COVID-19.


Asunto(s)
COVID-19 , Adolescente , Humanos , Niño , Masculino , Lactante , Preescolar , Femenino , COVID-19/epidemiología , SARS-CoV-2 , Pandemias , Oxígeno
11.
Can J Diabetes ; 45(4): 334-340, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33277195

RESUMEN

OBJECTIVES: Achieving glycated hemoglobin (A1C) and blood pressure targets is an important strategy for preventing chronic vascular complications in diabetes. Our aim in this study was to determine the proportion of type 2 diabetes patients who meet the recommended A1C and arterial blood pressure targets and to identify the determinants of failure to do so. METHODS: A cross-sectional study was conducted in an outpatient endocrine clinic at a university hospital. The A1C goal was 7% in general and 8% for patients with advanced chronic complications. Regarding blood pressure, the overall expected target was 140/90 mmHg. RESULTS: A total of 602 type 2 diabetes patients were analyzed: 62% were female, 14% self-reported as black, mean age was 63±11 years, mean diabetes duration was 17±9 years and median A1C was 8.0% (interquartile range, 7.0% to 9.5%). Macrovascular disease was present in 33% of the patients, diabetic retinopathy in 47%, peripheral neuropathy in 43% and diabetic kidney disease in 56%. Regarding metabolic control, 403 (67%) patients were not at the adjusted target A1C level, and being female, black, young and an insulin user were the main determinants of poor glycemic control. Regarding blood pressure, 348 (58%) patients were not at the recommended targets, and a more advanced age was the main associated factor. CONCLUSIONS: Because more than half of type 2 diabetes outpatients do not meet the recommended A1C and blood pressure target values, there is a major call to overcome the therapeutic inertia and target treatment of patients on an individual basis.


Asunto(s)
Presión Sanguínea/fisiología , Diabetes Mellitus Tipo 2/terapia , Hemoglobina Glucada/análisis , Adulto , Anciano , Estudios Transversales , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad
12.
Funct Plant Biol ; 48(11): 1113-1123, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34585660

RESUMEN

Silver nanoparticle (AgNPs) toxicity is related to nanoparticle interaction with the cell wall of microorganisms and plants. This interaction alters cell wall conformation with increased reactive oxygen species (ROS) in the cell. With the increase of ROS in the cell, the dissolution of zero silver (Ag0) to ionic silver (Ag+) occurs, which is a strong oxidant agent to the cellular wall. AgNP interaction was evaluated by transmission electron microscopy (TEM) on Lactuca sativa roots, and the mechanism of passage through the outer cell wall (OCW) was also proposed. The results suggest that Ag+ binds to the hydroxyls (OH) present in the cellulose structure, thus causing the breakdown of the hydrogen bonds. Changes in cell wall structure facilitate the passage of AgNPs, reaching the plasma membrane. According to the literature, silver nanoparticles with an average diameter of 15nm are transported across the membrane into the cells by caveolines. This work describes the interaction between AgNPs and the cell wall and proposes a transport model through the outer cell wall.


Asunto(s)
Asteraceae , Nanopartículas del Metal , Pared Celular , Lactuca , Nanopartículas del Metal/toxicidad , Plata
13.
Chemosphere ; 261: 128107, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33113668

RESUMEN

Although fluorescent lamps (FL) are extensively used worldwide, recycling rates in some countries are still low. If disposed of inappropriately and broken, FL can cause soil contamination. Hg toxicity in FL is extensively discussed in the literature; however, few studies address the other toxic metals present in the phosphorous powder of FL (PPFL). This paper presents a characterization of the environmental mobility with sequential extraction scheme (SES) of Cd, Cu, Hg, Mn, Ni, Pb, and Zn in PPFL, and modeling the potential risks to human health, in case of direct disposal in soils. An after thermal treatment waste was used for safety reasons. The SES method included five fractions, and the quantification was performed by flame atomic absorption spectrometry (FAAS). Human health risk assessment (HHRA) was conducted using RISC4® software. The PPFL showed the following mobility sequence: Cu (85%) > Ni (81%) > Hg (80%) > Zn (77%) > Cd (75%) > Mn (6%) > Pb (2%), which suggests that Cu, Ni, Zn, and Cd, besides Hg, could be of environmental concern in terms of availability. HHRA showed the potential hazard of Cd, for both children and adults, in the hypothetical scenario of vegetable ingestion, considering vegetables grown in soils contaminated with FL waste. The thermal treatment does not completely remove Hg from the matrix, and the residual Hg still poses a risk to children. These results show that Hg and Cd can be hazardous to humans and reinforce the importance of the correct disposal and treatment of PPFL.


Asunto(s)
Cadmio/toxicidad , Equipos y Suministros Eléctricos , Monitoreo del Ambiente/métodos , Mercurio/toxicidad , Contaminantes del Suelo/toxicidad , Residuos Sólidos , Adulto , Cadmio/análisis , Niño , Humanos , Mercurio/análisis , Fósforo/química , Medición de Riesgo , Suelo/química , Contaminantes del Suelo/análisis , Verduras/química
14.
Cad. Ibero-Am. Direito Sanit. (Online) ; 13(1): 69-82, jan.-mar.2024.
Artículo en Portugués | LILACS | ID: biblio-1538385

RESUMEN

Objetivo: identificar se a situação pandêmica interferiu na extensão e no modo como as questões referentes ao direito à saúde foram apreciadas pelo Supremo Tribunal Federal. Metodologia: foi realizada pesquisa documental, que, após consulta na base de dados do Supremo Tribunal Federal, com o filtro pelo termo "saúde", retornou um total de 1.178 acórdãos, sendo 447 do período pré-pandêmico e 731 do período pandêmico, os quais foram analisados e classificados conforme a pertinência temática. Após os descartes da etapa de classificação, identificaram-se 70 acórdãos no período pré-pandêmico e 167 acórdãos no pandêmico que versam efetivamente sobre o direito à saúde. Resultados: a pandemia impôs inúmeros desafios ao sistema de saúde, de modo que o Poder Judiciário foi instado a se manifestar ante às controvérsias ora instauradas. Nessas manifestações, identificou-se que houve aumento nas demandas de controle concentrado e no quantitativo absoluto de decisões envolvendo o direito à saúde, bem como que qualitativamente, em geral, o padrão decisório anterior foi mantido, embora novos temas tenham surgido. Conclusão: o estudo concluiu que a tendência da Suprema Corte permanece favorável ao reconhecimento de direitos sanitários, tendo, para tal, argumentos como a não ofensa à separação de poderes e a impossibilidade de arguir a reserva do possível para impedir sua concessão.


Objective: to identify whether the pandemic situation interfered with the extent and way in which issues relating to the right to health were assessed by the Federal Supreme Court. Methodology: documentary research was carried out, which, after consulting the Federal Supreme Court database, with the filter using the term "health", returned a total of 1,178 rulings, 447 from the pre-pandemic period and 731 from the pandemic period, which were analyzed and classified according to thematic relevance. After the classification stage discards, 70 rulings were identified in the pre-pandemic period and 167 rulings in the pandemic that effectively deal with the right to health. Results: the pandemic imposed numerous challenges on the health system, so that the Judiciary was urged to speak out in the face of the now established controversies. In these manifestations, it was identified that there was an increase in demands for concentrated control and in the absolute quantity of decisions involving the right to health, as well as that qualitatively, in general, the previous decision-making pattern was maintained, although new themes have emerged. Conclusion: the study concluded that the Supreme Court's tendency remains in favor of the recognition of health rights, using arguments such as the non-offense of the separation of powers and the impossibility of arguing on the possible reservation to prevent their granting.


Objetivo: identificar si la situación de pandemia interfirió en el alcance y la forma en que las cuestiones relativas al derecho a la salud fueron evaluadas por el Supremo Tribunal Federal. Metodología: se realizó una investigación documental que, consultada la base de datos del Supremo Tribunal Federal, con el filtro del término "salud", arrojó un total de 1.178 sentencias, 447 del período prepandemia y 731 del período pandémico, que fueron analizados y clasificados según relevancia temática. Descartada la etapa de clasificación, se identificaron 70 sentencias en el período prepandemia y 167 sentencias en la pandemia que abordan efectivamente el derecho a la salud. Resultados: la pandemia impuso numerosos desafíos al sistema de salud, por lo que se instó al Poder Judicial a pronunciarse ante las controversias ahora establecidas. En estas manifestaciones se identificó que hubo un aumento en las demandas de control concentrado y en la cantidad absoluta de decisiones que abordan el derecho a la salud, así como que cualitativamente, en general, se mantuvo el patrón de toma de decisiones anterior, aunque han surgido nuevos temas. Conclusión: el estudio concluyó que se mantiene la tendencia de la Corte Suprema a favor del reconocimiento de los derechos a la salud, utilizando argumentos como la no infracción de la separación de poderes y la imposibilidad de argumentar la reserva de lo posible para impedir su otorgamiento.


Asunto(s)
Derecho Sanitario
15.
PLoS One ; 14(5): e0216323, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31083656

RESUMEN

The highly interactive nature of predator-prey relationship is essential for ecosystem conservation; predators have been extirpated, however, from entire ecosystems all over the Earth. Reintroductions comprise a management technique to reverse this trend. Species Distribution Models (SDM) are preemptive tools for release-site selection, and can define levels of habitat quality over the species distribution. The Atlantic Forest of South America has lost most of its apex predators, and Harpy Eagles Harpia harpyja-Earth's largest eagle-are now limited to few forest pockets in this domain. Harpy Eagles are supposedly widespread in the Amazon Forest, however, where habitat loss and degradation is advancing at a rapid pace. We aim to describe the suitability of threatened Amazonian landscapes for this eagle. We also aim to assess the suitability of remaining Atlantic Forest sites for Harpy Eagle reintroductions. Here we show that that considerable eagle habitat has already been lost in Amazonia due to the expansion of the "Arc of Deforestation", and that Amazonian forests currently represent 93% of the current distribution of the species. We also show that the Serra do Mar protected areas in southeastern Brazil is the most promising region for Harpy Eagle reintroductions in the Atlantic Forest. Reintroduction and captive breeding programs have been undertaken for Harpy Eagles, building the technical and biological basis for a successful restoration framework. Our distribution range for this species represents a 41% reduction of what is currently proposed by IUCN. Furthermore, habitat loss in Amazonia, combined with industrial logging and hunting suggest that the conservation status of this species should be reassessed. We suggest researchers and conservation practitioners can use this work to help expand efforts to conserve Harpy Eagles and their natural habitats.


Asunto(s)
Águilas , Ecosistema , Especies en Peligro de Extinción , Animales , Brasil , Conservación de los Recursos Naturales/tendencias , Bosques , Conducta Predatoria
16.
Sci Rep ; 9(1): 16850, 2019 11 14.
Artículo en Inglés | MEDLINE | ID: mdl-31727948

RESUMEN

Recombinant protein expression for structural and therapeutic applications requires the use of systems with high expression yields. Escherichia coli is considered the workhorse for this purpose, given its fast growth rate and feasible manipulation. However, bacterial inclusion body formation remains a challenge for further protein purification. We analyzed and optimized the expression conditions for three different proteins: an anti-MICA scFv, MICA, and p19 subunit of IL-23. We used a response surface methodology based on a three-level Box-Behnken design, which included three factors: post-induction temperature, post-induction time and IPTG concentration. Comparing this information with soluble protein data in a principal component analysis revealed that insoluble and soluble proteins have different optimal conditions for post-induction temperature, post-induction time, IPTG concentration and in amino acid sequence features. Finally, we optimized the refolding conditions of the least expressed protein, anti-MICA scFv, using a fast dilution protocol with different additives, obtaining soluble and active scFv for binding assays. These results allowed us to obtain higher yields of proteins expressed in inclusion bodies. Further studies using the system proposed in this study may lead to the identification of optimal environmental factors for a given protein sequence, favoring the acceleration of bioprocess development and structural studies.


Asunto(s)
Clonación Molecular/métodos , Escherichia coli/genética , Antígenos de Histocompatibilidad Clase I/genética , Interleucina-23/genética , Anticuerpos de Cadena Única/genética , Secuencia de Aminoácidos , Escherichia coli/efectos de los fármacos , Escherichia coli/metabolismo , Análisis Factorial , Expresión Génica/efectos de los fármacos , Vectores Genéticos/química , Vectores Genéticos/metabolismo , Antígenos de Histocompatibilidad Clase I/química , Antígenos de Histocompatibilidad Clase I/aislamiento & purificación , Humanos , Cuerpos de Inclusión/química , Interleucina-23/química , Interleucina-23/aislamiento & purificación , Isopropil Tiogalactósido/farmacología , Análisis de Componente Principal , Replegamiento Proteico , Subunidades de Proteína/química , Subunidades de Proteína/genética , Subunidades de Proteína/aislamiento & purificación , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/aislamiento & purificación , Anticuerpos de Cadena Única/química , Anticuerpos de Cadena Única/aislamiento & purificación , Solubilidad
17.
Rev. chil. nutr ; 51(1)feb. 2024.
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1550798

RESUMEN

The consumption of vegetable oils is common in our daily diet. Rapeseed oil (canola oil) is the third most consumed edible oil in the world, followed by palm and soybean oils in terms of production. Rapeseed oil has a low proportion of saturated fatty acids, while it is rich in unsaturated fatty acids, as well as in healthy compounds such as phenols, tocopherols, phytosterols, carotenoids, and fat-soluble vitamins. However, processing technologies affect the content and functional activities of bioactive compounds in the oil. Aim: To assess any potential effect of hot or cold pressing and a refining process on the nutritional value and the profile of several bioactive compounds in canola oils produced in Chile. Methods: Canola oils were characterized regarding their fatty acid profile, phytosterol and tocopherol composition, total phenol content, and antioxidant activity, according to the mode of extraction (cold or hot pressed) and before and after bWeing subjected to a refining process. Results: Fatty acid profiles were not significantly different in any of the analyzed canola oils. Refining but not temperature extraction led to a sharp decrease of phytosterols and tocopherols. Hot pressing significantly increased the amount of total phenols (3.1 times) and the antioxidant activity measured by ORAC (3.1 times) and DPPH (8.3 times) compared to the cold extraction. However, phenolic concentration and antioxidant capacity decreased after refining. Conclusions: Refining processes should be adjusted to reduce the loss of bioactive compounds in the oil.


El consumo de aceites vegetales es habitual en nuestra dieta diaria. El aceite de colza (aceite de canola) es el tercer aceite comestible más consumido en el mundo, seguido por los aceites de palma y soja en términos de producción. El aceite de colza tiene una baja proporción de ácidos grasos saturados, mientras que es rico en ácidos grasos insaturados, así como en compuestos liposolubles saludables como fenoles, tocoferoles, fitoesteroles, carotenoides y vitaminas. Sin embargo, las tecnologías de procesamiento afectan el contenido y las actividades funcionales de los compuestos bioactivos en el aceite. Objetivo: Evaluar cualquier efecto potencial del prensado en caliente o en frío y un proceso de refinación sobre el valor nutricional y el perfil de varios compuestos bioactivos en los aceites de canola producidos en Chile. Métodos: Los aceites de canola se caracterizaron en cuanto a su perfil de ácidos grasos, composición de fitoesteroles y tocoferoles, contenido de fenoles totales y actividad antioxidante, según el modo de extracción (prensado en frío o en caliente) y antes y después de ser sometidos a un proceso de refinación. Resultados: Los perfiles de ácidos grasos no fueron significativamente diferentes en ninguno de los aceites de canola analizados. La refinación, pero no la extracción en caliente, condujo a una fuerte disminución de los fitoesteroles y tocoferoles. El prensado en caliente aumentó significativamente la cantidad de fenoles totales (3,1 veces) y la actividad antioxidante medida por ORAC (3,1 veces) y DPPH (8,3 veces) en comparación con la extracción en frío. Sin embargo, la concentración de fenoles y la capacidad antioxidante disminuyeron después del refinado. Conclusión: Los procesos de refinación deben ajustarse para reducir la pérdida de compuestos bioactivos en el aceite.

18.
Arq. bras. cardiol ; 120(5): e20220597, 2023. tab, graf
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1439340

RESUMEN

Resumo A hidatidose é uma zoonose causada pelo Echinococcus granulosus, levando à formação de cistos nos órgãos acometidos. O envolvimento cardíaco é raro e pode causar diversas complicações secundárias à ruptura, embolização ou compressão. Seu diagnóstico é desafiador, sendo confirmado por meio de dados relacionados a manifestações clínicas, exposição ambiental, exames laboratoriais e de imagem. A ressecção cirúrgica é necessária na maioria dos casos, sendo indicada a associação com terapia antiparasitária. No presente artigo, descreve-se um caso de cisto hidático cardíaco associado a bloqueio atrioventricular total em paciente jovem, com necessidade de implante de marcapasso, uma apresentação atípica e pouco relatada na literatura.


Abstract Hydatidosis is a zoonosis caused by Echinococcus granulosus, leading to the formation of cysts on involved organs. Cardiac involvement is rare and can cause a wide range of complications secondary to rupture, embolization, or compression. Its diagnosis is challenging, and is generally confirmed through data related to clinical manifestations, environmental exposure, and laboratory and imaging exams. Surgical removal is necessary in most cases, in which an association with antiparasite therapy is recommended. The present article describes a case of a cardiac hydatid cyst associated with a complete atrioventricular block (AVB) in a young adult patient, with the need for a pacemaker implant, an atypical presentation, and scarce reports in the literature.

19.
Psicol. Estud. (Online) ; 28: e54292, 2023.
Artículo en Portugués | LILACS, Index Psi Revistas Técnico-Científicas | ID: biblio-1521383

RESUMEN

RESUMO. No setor de oncologia das instituições hospitalares, visando o cuidado humanizado, tem sido desejável a atuação de profissionais de diferentes áreas. Esse estudo teve o objetivo de investigar a experiência subjetiva dos diferentes profissionais que atuam nesse setor. A pesquisa contou com a participação de 23 profissionais da área de oncologia de um hospital público situado no interior do Rio Grande do Sul. Nesse estudo qualitativo, os participantes foram entrevistados individualmente, sendo tais entrevistas mediadas pela apresentação de uma narrativa interativa, a qual eles eram convidados a inventarem um desfecho e a associarem livremente. Foram identificadas, após consideração psicanalítica, duas categorias intituladas 'Aos outros eu devolvo a dor' e 'Dança da solidão'. A partir delas foi possível identificar, respectivamente, como os profissionais experienciam, em seu cotidiano de trabalho, suas relações com os pacientes e com os seus colegas de equipe. Observou-se que, para os participantes, o cotidiano de trabalho é atravessado por sofrimento por terem de lidar com o mal-estar de seus pacientes, bem como as perdas frequentes, sofrimento esse que fica acentuado por não terem condições de compartilhá-lo com os seus pares no trabalho. Conclui-se que se faz necessário o desenvolvimento de ações, em especial a constituição de um enquadre clínico em que os profissionais possam ter trocas afetivas entre si, o que poderia, num só tempo, tanto ajudá-los a lidar com o sofrimento despertado no setor de oncologia quanto ajudá-los a se sentirem pertencentes a essa equipe composta por diferentes áreas de especialidade.


RESUMEN. En el sector de Oncología de las instituciones hospitalarias, con miras a la atención humanizada, ha sido deseable la actuación de profesionales de diferentes áreas. Este estudio tuvo como objetivo investigar la experiencia subjetiva de los diferentes profesionales que laboran en este sector. La investigación contó con la participación de 23 profesionales del área de Oncología de un hospital público ubicado en el interior de Rio Grande do Sul. En este estudio cualitativo, los participantes fueron entrevistados individualmente, siendo dichas entrevistas mediadas por la presentación de una narrativa interactiva, a la que fueron invitados a inventar un desenlace y asociarse libremente. Se identificaron dos categorías, después de una consideración psicoanalítica, tituladas 'Devuelvo el dolor a los demás' y 'Danza de la soledad'. A partir de ellos, fue posible identificar, respectivamente, cómo los profesionales viven, en su trabajo diario, sus relaciones con los pacientes y con sus compañeros de equipo. Se observó que, para los participantes, el trabajo diario está atravesado por el sufrimiento porque tienen que convivir con el malestar de sus pacientes, así como con las frecuentes pérdidas, sufrimiento que se acentúa al no poder compartirlo con los demás compañeros de trabajo. Se concluye que es necesario desarrollar acciones, especialmente la constitución de un entorno clínico en el que los profesionales puedan tener intercambios afectivos entre sí, que puedan, en un solo tiempo, ayudarles a afrontar el sufrimiento suscitado en el sector de Oncología, además de ayudarles a sentirse parte de este equipo formado por diferentes áreas de especialidad.


ABSTRACT. In the Oncology Ward of hospital institutions, aiming humanized care, the performance of professionals from different areas has been desirable. This study aimed to investigate the subjective experience of the different professionals who work in this sector. The research was developed with the participation of 23 professionals from the Oncology area of ​​a public hospital located in Rio Grande do Sul. In this qualitative study, they were interviewed individually. Those interviews were mediated by the presentation of an interactive narrative, with the participants being asked to create an outcome and to freely associate. Two categories were identified, after psychoanalytic consideration, entitled 'I return the pain to others' and 'Dance of solitude'. From those categories, it was possible to identify, respectively, how professionals experience, in their daily work, their relations with patients and with their teammates. It was observed that, for the participants, the daily work is crossed by suffering because they have to deal with the discomfort of their patients, as well as the frequent losses, a suffering that is accentuated by not being able to share it with their peers at work. It is concluded that it is necessary to develop actions, especially the constitution of a clinical setting in which professionals can have affective exchanges with each other, which could, in just one time, help them to deal with the suffering aroused in the Oncology sector as well as help them to feel that they belong to this team made up of different areas of specialty.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Dolor/psicología , Servicio de Oncología en Hospital/organización & administración , Distrés Psicológico , Soledad/psicología , Grupo de Atención al Paciente/ética , Psicoanálisis/métodos , Cuidadores/psicología , Capacitación Profesional , Hospitales Públicos
20.
Rev. chil. nutr ; 49(5)oct. 2022.
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1407836

RESUMEN

RESUMEN La chía (Salvia hispanica L.) es una semilla originaria de la zona sur de México y Guatemala, que se ha expandido a otros países de latinoamérica. Esta semilla ha sido utilizada con diferentes fines a lo largo de la historia, donde se destaca como producto alimentario debido a su gran versatilidad, ya que puede ser utilizada como semilla, harina integral, fracciones de fibra y/o proteína y aceite. En la actualidad, la investigación de nuevas fuentes alimentarias que otorguen beneficios a la salud ha logrado recopilar información sobre la composición química y valor nutricional de esta semilla y sus derivados (harina y aceite), donde se encuentra principalmente el contenido de ácidos grasos poli-insaturados n-3, destacando el ácido alfa linolénico (C18:3n-3, ALA), que se propone como fuente alternativa de este nutriente a alimentos de otros orígenes, además el contenido de fibra de la chía, principalmente fibra insoluble. En cuanto a los beneficios que se asocian al consumo de chía, se ha visto que tiene estrecha relación con enfermedades crónicas no transmisibles como dislipidemia, diabetes, hipertensión, cáncer, entre otras, logrando captar la atención de investigadores para controlar y prevenir estas patologías que van en aumento en la población mundial. Por lo tanto, se hace relevante profundizar en los conocimientos disponibles sobre esta semilla y sus subproductos para poder establecer los posibles mecanismos moleculares que están involucrados en la generación de beneficios para la salud. El objetivo de esta revisión es presentar una actualización de los beneficios asociados al consumo de semilla de chía y sus derivados.


ABSTRACT Chia (Salvia hispanica L.) is a seed native to the southern part of Mexico and Guatemala, which has spread to other Latin American countries. This seed has been used for different purposes throughout history, where it stands out as a food product due to its great versatility, since it can be used as a seed, whole meal flour, fiber and/or protein fractions and oil. Currently, the investigation of new food sources that provide health benefits has managed to collect information on the chemical composition and nutritional value of this seed and its derivatives (flour and oil). For polyunsaturated fatty acid content, n-3 is found, highlighting alpha linolenic acid (C18:3n-3, ALA), which is proposed as an alternative source of this nutrient to foods of other origins. In addition, the fiber content of chia, is mainly insoluble fiber. Regarding the benefits associated with chia consumption, it is closely related to chronic non-communicable diseases such as dyslipidemia, diabetes, type II, hypertension, cancer, among others, managing to attract the attention of researchers to control and prevent these pathologies that are increasing in world population. Therefore, it is relevant to deepen the knowledge available about this seed and its by-products in order to establish the possible molecular mechanisms that are involved in generating health benefits. The objective of this review is to present an update on the benefits associated with consumption of chia seed and its derivatives.

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