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BACKGROUND: Adolescent girls and young woman (AGYW) comprise a significant proportion of new HIV infections and unintended pregnancies in sub-Saharan Africa yet face many barriers to accessing family planning and reproductive health (FPRH) information and services. Developed via human-centered design, the Malkia Klabu ("Queen Club") program aimed to facilitate access to HIV self-testing (HIVST) and FPRH information and products at privately-owned drug shops. We sought to understand barriers and facilitators to program implementation in a 4-month pilot in Tanzania. METHODS: Forty semi-structured interviews were conducted with participants in a cluster randomized trial of the Malkia Klabu program from November 2019 through March 2020, including 11 with AGYW, 26 with drug shopkeepers, and three with counselors at health facilities to whom AGYW were referred. Interviews were audio-recorded, transcribed, coded, and analyzed to identify key themes. The Consolidated Framework for Implementation Research (CFIR) was used to assess barriers and facilitators to program implementation at multiple levels. CFIR considers the outer setting (e.g., culture and systemic conditions), the inner setting where the intervention is implemented (e.g., incentives, relationships, and available resources), the individuals involved, the innovation as it relates to stakeholder needs, and the implementation process. RESULTS: The Malkia Klabu program reshaped and directed the role of drug shopkeepers as providers of information and resources rather than FPRH gatekeepers. Key implementation facilitators included the program's adaptability to a wide range of needs and stages of readiness among AGYW, ability to capitalize on AGYW social networks for driving membership, responsiveness to AGYW's need for privacy, and positive contributions to the income and community standing of drug shopkeepers. Components such as HIVST were highly acceptable to both AGYW and shopkeepers, and the introduction of the loyalty program and HIVST kits in shops opened doors to the provision of FPRH products and information, which was further facilitated by program tools such as videos, product displays, and symbol cards. Although some shopkeepers maintained beliefs that certain contraceptive methods were inappropriate for AGYW, most appeared to provide the products as part of the program. CONCLUSIONS: The Malkia Klabu intervention's success was due in part to its ability to address key motivations of both AGYW and drug shopkeepers, such as maintaining privacy and increasing access to FPRH products for AGYW and increasing business for shops. Better understanding these implementation barriers and facilitators can inform the program's future adaptation and scale-up. TRIAL REGISTRATION: clinicaltrials.gov #NCT04045912.
Adolescent girls and young women (AGYW) in sub-Saharan Africa have limited access to family planning and reproductive health products and information even though they are at greater risk of pregnancy and HIV infection. The Malkia Klabu intervention was designed with AGYW and shopkeepers from private drug shops to facilitate access to products and information through a loyalty program that included free products, prizes for purchases, educational videos, and a non-verbal system of requesting products through symbols. Qualitive interviews with AGYW, drug shop staff, and health system counselors suggested that the program helped provide greater privacy and confidence to AGYW while bringing new business to drug shops. These findings can help as the study team charts a pathway for scaling up the intervention.
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Infecciones por VIH , Adolescente , Femenino , Humanos , Anticoncepción , VIH , Autoevaluación , TanzaníaRESUMEN
Adolescent girls and young women (AGYW; ages 15-24) in sub-Saharan Africa face many barriers to accessing preventive sexual and reproductive health (SRH) services. We drew upon the strengths of two complementary approaches, human-centered design and behavioral economics, to craft a holistic, highly-tailored, and empathetic intervention to motivate AGYW to seek contraception and HIV self-test kits at community drug shops. To encourage engagement, we embedded "nudge" strategies at different opportunity points (uncovered during our design research) along the care-seeking and service delivery journey. Our Malkia Klabu intervention is a loyalty program designed to enhance drug shops' role as SRH providers through which AGYW earned punches for shop purchases redeemable for small prizes; free SRH products could be requested at any time. From our 4-month pilot in Shinyanga, Tanzania, we assess the extent to which different behavioral nudge strategies motivated behaviors as predicted by synthesizing findings from (1) in-depth interviews with AGYW and shopkeepers, (2) shop program records, (3) shop observations, and (4) customer exit surveys. Overall, we find that AGYW and shopkeepers were motivated by many intervention features as intended and consistent with hypothesized mechanisms. We found strong evidence of social norms for helping to spread awareness of Malkia Klabu among peers, prize incentives for drawing AGYW back to shops, and the opt-out default membership gift of an HIV self-test kit for encouraging testing uptake and exploration of contraceptives. Shopkeepers in both arms noted increased community status from distributing HIV self-testing kits (ego). Malkia Klabu shopkeepers experienced increased customer traffic and business revenues (incentives), which reduced shopkeepers' gatekeeping tendencies and earned them additional recognition as champions of AGYW well-being. Integrating human-centered design and behavioral economics was effective for developing an innovative and effective intervention that simultaneously met the different needs of economic actors in support of public health priorities.
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Infecciones por VIH , Servicios de Salud Reproductiva , Adolescente , Humanos , Femenino , Adulto Joven , Adulto , Tanzanía , Conducta Sexual , Anticoncepción , Infecciones por VIH/prevención & controlRESUMEN
BACKGROUND: Protocol kidney biopsy (PKB) in kidney transplant is a useful tool for graft monitoring because the subclinical detection of histologic lesions helps to modulate immunosuppression. We analyze our experience. METHODS: We performed a descriptive study that analyzed the PKB results at the fourth to sixth month and the first year post transplant of patients with kidney transplant followed in our hospital between January 2015 and June 2021. RESULTS: A total of 100 patients and 134 biopsy results were included, of which 71 were obtained between the fourth and sixth month and 63 at the first year. The mean age was 57.8 years, and 66% were men. Unknown etiology was the most common underlying kidney disease (31%), followed by diabetes mellitus (15%) and polycystic kidney disease (14%). A total of 80% had panel-reactive antibody < 50%. Induction therapy consisted of thymoglobulin (51%) and basiliximab (49%), and maintenance therapy consisted of corticosteroids and tacrolimus (100%), mycophenolate mofetil (82%), and mammalian target of rapamycin inhibitor (18%). Of the total of the PKB results (n = 134), 19 episodes of subclinical rejection (14%) and 10 with borderline changes (7.4%) were observed. Regarding other findings, there were cases of nephrocalcinosis (4.4%), immunoglobulin A nephropathy (2.2%), and BK nephropathy (1.5%). The PKB brought about a change in the therapeutic attitude in 45 cases (33%) of the total number of biopsies, the most frequent change being the administration of boluses of methylprednisolone (12.6%) and the change to mammalian target of rapamycin inhibitor (8.9%). CONCLUSIONS: In our experience, PKB is a useful tool for monitoring and evaluating histologic changes without clinical expression in the kidney graft, allowing us to adapt the treatment during the first year of kidney transplant.
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Enfermedades Renales , Trasplante de Riñón , Masculino , Humanos , Persona de Mediana Edad , Femenino , Trasplante de Riñón/efectos adversos , Rechazo de Injerto , Inmunosupresores/uso terapéutico , Tacrolimus/uso terapéutico , Ácido Micofenólico/uso terapéutico , Riñón/patología , Enfermedades Renales/patología , Biopsia , Sirolimus , Serina-Treonina Quinasas TORRESUMEN
Background: Budd-Chiari syndrome (BCS) is considered a rare condition in cats that is characterized by the obstruction of the hepatic venous outflow tract from the level of the small hepatic veins to the level of the termination of the inferior vena cava into the right atrium in the absence of cardiac or pericardial disease, or sinusoidal obstruction syndrome. Case description: This report presents a 13-year-old cat with a two-week history of progressive lethargy, inappetence, weight loss, and abdominal distension. Findings/treatment and outcome: The radiological study was consistent with pleural effusion, as well as alveolar and interstitial pulmonary patterns. Ultrasonography confirmed hepatic venin congestion and ascites. Abdominocentesis revealed a modified transudate. A computed tomography (CT) angiography showed a mass at the level of the caudal mediastinum that compressed the caudal vena cava (CVC). Mediastinal lymphoma was considered the most likely differential diagnosis. These findings were interpreted as Budd-Chiari-like syndrome (BCLS) secondary to a mediastinal mass although, unfortunately, no further diagnostic or treatment procedures were accepted by the owners. BCLS is a rare condition in cats, where most of the reported cases occurred as a result of obstruction of the caudal vena cava. In this report, BCLS was caused by a mass located in the caudal mediastinum oppressing the caudal vena cava. Conclusion: This is the first report of BCLS in cats diagnosed by CT angiography, and it shows the value of this technique to define the origin and extent of the mass and to evaluate the presence or absence of metastatic lesions.
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Surface water samples from the Yucatan shelf presented Cd concentrations similar to those reported internationally for non-polluted coastal and marine waters. V concentrations, on the other hand, fall within the range of anthropogenically polluted waters (25% of the sampling sites). In the study area, the probable sources of V could be: (1) carbonate sediments leaching V into the water column and co-transported with fine sediments resuspending as a result of the complex hydrodynamics in the area or, (2) accidental spills from cargo ships transporting oil between the Atlantic and the Gulf of Mexico. Significant spatial and temporal differences were found for both metals; therefore, a regional interval concentration is suggested for V from 1.28 to 1.84 µg L-1 and Cd from 0.003 to 0.09 µg L-1. These differences could primarily be the result of the observed hydrology and hydrodynamics created by the Yucatan current, submarine groundwater discharges and upwelling.
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Metales Pesados , Contaminantes Químicos del Agua , Cadmio , Monitoreo del Ambiente , Sedimentos Geológicos , Metales Pesados/análisis , México , Vanadio , Agua , Contaminantes Químicos del Agua/análisisRESUMEN
Surface water samples from the Perdido study area presented Cd and V concentrations similar to those reported internationally for waters with: (1) fossil fuel extraction, processing and burning, and (2) sites polluted by anthropogenic wastewater. Results showed an order of magnitude increase in time for Cd, therefore, no general average value was established. For V, however, results of this study suggest a general average value of 1.4 µg L-1 for the area. The observed spatial variation of concentrations could be the result of: (1) temporal variation of external inputs to the area, and coincide with previously reported hydrodynamic patterns of dispersion related to significant river contributions and accumulation areas indicative of eddy circulation or fronts. The Perdido area showed Cd and V concentrations in surface water reflective of anthropogenic impacts, while its spatial and temporal variation could depend significantly on the hydrodynamics of the area.
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Cadmio , Contaminantes Químicos del Agua , Cadmio/análisis , Monitoreo del Ambiente , Golfo de México , Vanadio/análisis , Agua , Contaminantes Químicos del Agua/análisisRESUMEN
This study analyzed 27 surface sediment samples from the Tamaulipas Continental shelf to determine the spatial-temporal distribution of V and Cd (spring-summer 2016; summer 2017). Average V concentrations (99 ± 18 mg g-1) were similar to that previously reported values for the area, while average Cd concentrations reflect uncontaminated sediments at surface level of the shelf. Inputs of V and Cd may be related to hydrocarbon and anthropogenic contributions from South and North of the Gulf of Mexico. The variability shown by both elements results from the hydrodynamics and hydrology of the area produced by local currents, eddies of the Loop Current, resuspension of fine sediments and contribution of terrigenous material. Considering that both metals showed significant differences (Shapiro-Wilk, p = 0), baseline concentrations could not be established, instead a reference interval of 79-122 µg g-1 for V and 0.121-0.258 µg g-1 for Cd in sediments from the Tamaulipas platform is suggested.
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Metales Pesados , Contaminantes Químicos del Agua , Cadmio , Monitoreo del Ambiente , Sedimentos Geológicos , Golfo de México , Metales Pesados/análisis , México , Vanadio , Contaminantes Químicos del Agua/análisisRESUMEN
We investigated the spatial and temporal distribution of V and Cd in surface sediments of the Yucatan Shelf to establish current average values for the area. V and Cd concentrations are similar to those reported internationally for limestone rocks and surface marine sediments. The observed variability of V concentrations between cruises may be the result of changes in ocean current direction in summer (SW-S) and strong prevailing winds in autumn (N-NE). In addition to the hydrodynamics described above, Cd variations may also be associated with inputs of particulate material by upwelling events and subsequent transport and distribution to the shelf by the Yucatan Channel current (autumn). Considering that both metals showed significant spatial and temporal differences, a range of values for V (0.4-1.5 µg g-1) and Cd (0.05-0.2 µg g-1) are proposed as baseline reference for sediments of the Yucatan Shelf.
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Metales Pesados , Contaminantes Químicos del Agua , Monitoreo del Ambiente , Sedimentos Geológicos , Golfo de México , Metales Pesados/análisis , México , Contaminantes Químicos del Agua/análisisRESUMEN
Incisional wound closure is a key surgical step to facilitate tissue healing, reduce the risk of infection and obtain esthetic and functional recovery. Cyanoacrylates such as Histoacryl® have become a popular choice in surgical veterinary practice. However, how Histoacryl® is affecting tissue regeneration and bacterial load in the wound in comparison to poliglecaprone (Monocryl®) traditional suture methods remains to be determined. This work aimed to evaluate how wounded tissue responds to traditional suture with Monocryl® (poliglecaprone 25/4-0) and Histoacryl®, as well as provide evidence of their effects on wound healing in mice. Fortyeight hours after the incisional procedure, wound tissue biopsies were prepared for histological and microbiological analysis. Biopsies were fixed and colored with Mallory's trichrome and hematoxylin-eosin stains. For microbiological assays, biopsies were suspended in tryptic soy broth (TSB) and 1/10 diluted to evaluate the number of CFU in nutrient agar plates. Our results show no differences between Histoacryl® and Monocryl® traditional suture suggesting that both methods could be used to treat wounds in small animals such as rodents.
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High surface water-groundwater connectivity characterizes watersheds underlain by karsts, increasing contaminant transport risks. However, karsts are highly complex, making research necessary to understand the transport of contaminants from the surface, through the aquifer, to discharge areas. In Yucatan, the lack of waste water treatment raises the risk of groundwater contamination. We monitored stable isotopes (δ18 O-NO3 and δ15 N-NO3 ), cadmium, and lead to document waste water contamination and transport during the rainy and dry seasons, using water samples collected along the Ring of Cenotes during each season. Specific conductance and pH showed no consistent seasonality, with conductance ranging from 0.5 to 55 mS/cm and pH ranging from 6.6 to 8.6 for most samples. Nitrate concentrations in the cenotes averaged 205 ± 260 µM and no seasonal pattern was observed. Cd and Pb concentrations were 0.1 to 37.9 µg/L and 0.2 to 243.2 µg/L, respectively. Nitrate stable isotope values were 2.6 to 27.2 for δ18 O and 1.2 to 20.7 for δ15 N. The statistical relationship between δ15 N and δ18 O, in dry season samples, indicated that denitrification was occurring. A scale measure for waste water recognition showed: (1) high variability among sites probably related with dry/rainy seasons and/or diverse anthropogenic activities; and (2) specific water quality variables that contribute to contamination at each site during each season. Importantly, our analyses indicate that in the area surrounding the Ring of Cenotes, waste water exhibits spatial and temporal patterns related to complex transport and dilution processes, as is the case in karsts in general.
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Agua Subterránea , Contaminantes Químicos del Agua , Monitoreo del Ambiente , Isótopos , México , Nitratos/análisis , Isótopos de Nitrógeno/análisis , Contaminantes Químicos del Agua/análisisRESUMEN
Resumen: Introducción: El pie caído es una condición que suele manejarse con ortesis cortas, normalmente fabricadas en polipropileno. Se ha descrito también su tratamiento con ortesis de silicón, poco estudiadas pero que parecen mejorar el patrón cinemático de la marcha y, dada su comodidad, ser más aceptadas por los pacientes. Nuestro estudio describe cuáles son las características cinemáticas de la marcha y la satisfacción referida por los pacientes al usar una ortesis tobillo pie de silicón y compara dicho patrón con el no uso de la ortesis en casos con pie caído. Material y métodos: Estudio seudoexperimental descriptivo en pacientes con pie caído desde el año 2010 al 2012, en el que se evaluaron las variables cinemáticas del patrón de marcha a partir de laboratorios de marcha y además de la satisfacción de los sujetos con las ortesis de silicón y con el no uso de las mismas. Resultados: Cinco casos con pie caído fueron objeto del estudio. El análisis de marcha de los pacientes que usaron la ortesis constató una mejora de la posición del tobillo en el contacto inicial, en la velocidad promedio de marcha y en la longitud del paso, así como un aumento de la cadencia. Sin embargo, en términos de comodidad en comparación con el no uso de la ortesis, el resultado fue exiguo. Conclusiones: Las ortesis tobillo pie de silicón mejoran la posición del tobillo en el contacto inicial, así como los parámetros temporoespaciales de la marcha.
Abstract: Introduction: The Drop foot is a condition that is usually handled with short orthosis, usually made of polypropylene. It has also been described as being treated with silicon orthosis, little studied but which seem to improve the kinematic pattern of gait and, given its comfort, be more accepted by patients. Our study describes the kinematic characteristics of gait and patient satisfaction when using a silicon foot ankle orthosis, and compares this pattern to the non-use of the orthosis, in patients with a drop foot. Material and methods: Pseudo-experimental descriptive study in patients with dropped feet from 2010 to 2012, in which the kinematic variables of the gait pattern were evaluated from gait laboratories and in addition to the satisfaction of subjects with silicon orthosis and non-use of them. Results: Five patients with a drop foot were the subject of the study. Gait analysis of patients using the orthosis found an improvement in ankle position at initial contact, average walking speed and step length, as well as increased cadence. However, in terms of comfort compared to the non-use of the orthosis, the result was meager. Conclusions: Silicon foot ankle orthosis improve the position of the ankle in the initial contact, as well as the temporo-spatial parameters of the gait.
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Humanos , Siliconas , Tobillo , Fenómenos Biomecánicos , Rango del Movimiento Articular , Diseño de Equipo , Marcha , Articulación del TobilloRESUMEN
INTRODUCCIÓN: La resistencia antibiótica y una inadecuada adherencia terapéutica son fenómenos que favorecen la proliferación de la tuberculosis. Los cambios sociodemográficos nos desafían a conocer la realidad actual de la enfermedad a través de antecedentes que nos permitan contextualizar un nuevo escenario. OBJETIVO: Caracterizar el perfil biopsicosocial del paciente con tuberculosis y su relación con la adherencia terapéutica. MATERIAL Y MÉTODO: Estudio descriptivo, transversal, correlacional. Muestra de 90 pacientes tratados en 35 Centros de Salud Familiar de los Servicios de Salud de Iquique, Metropolitano Norte, Concepción y Reloncaví. RESULTADOS: los componentes biopsicosociales como edad, antecedentes de enfermedad mental, autoestima, situación sentimental, pertenencia a grupos de riesgo, alcoholismo, drogadicción y situación de calle presentaron una relación estadísticamente significación con la adherencia terapéutica. CONCLUSIONES: La caracterización biopsicosocial del paciente con tuberculosis visibiliza nuevos factores relacionados con la adherencia que deben ser considerados para una atención interdisciplinaria.
BACKGROUND: Antibiotic resistance and inadequate therapeutic adherence are phenomena that promote the proliferation of tuberculosis. Sociodemographic changes challenge us to know the real situation of the disease and allows us to contextualize a new scenario. OBJECTIVE: To characterize the biopsychosocial profile of the patient with tuberculosis and its relationship to therapeutic adherence. MATERIAL AND METHOD: Descriptive, cross-sectional, correlational study. Sample of 90 patients treated at 35 Family Health Centers from the following Chilean Public Health Services: Iquique, Metropolitan northern (Santiago), Concepción and Reloncaví. RESULTS: Biopsychosocial components such as age, history of mental illness, self-esteem, sentimental status, belonging to risk groups, alcoholism, drug addiction and homeless situation presented a statistically significant relationship with therapeutic adherence. CONCLUSIONS: The biopsychosocial characterization of the TB patient evidence a new adherence-related factors that should be considered for interdisciplinary care.
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Humanos , Masculino , Femenino , Adulto , Tuberculosis/psicología , Tuberculosis/tratamiento farmacológico , Cumplimiento de la Medicación/psicología , Cumplimiento y Adherencia al Tratamiento/psicología , Autoimagen , Factores Socioeconómicos , Grupos de Riesgo , Personas con Mala Vivienda , Chile , Salud de la Familia , Estudios Transversales , Encuestas y Cuestionarios , Trastornos Relacionados con Sustancias/psicología , Farmacorresistencia Bacteriana , Alcoholismo/psicología , Cumplimiento de la Medicación/estadística & datos numéricos , Cumplimiento y Adherencia al Tratamiento/estadística & datos numéricos , Correlación de Datos , Antituberculosos/uso terapéuticoRESUMEN
Hemicellulose hydrolysates (HH), which could be an interesting carbon source to feed mixed microbial cultures (MMC) able to accumulate high value-added compounds. This research focused on the evaluation of a culture strategy to achieve the simultaneous biological production of Levulinic Acid (LA) and Polyhydroxyalcanoates (PHA) by MMC fed with a synthetic HH (SHH). The culture strategy involves the use of sequential batch reactors (SBR) to select microorganisms capable of producing LA and PHA. This work proved that the cultivation strategy used allowed the biological production of LA, reaching 37%w/w when the SHH was composed of 85% pentoses. In addition, the simultaneous biological production of LA and PHB was possible when the SHH was enriched with acetate (45% pentoses - 50% acetate). Finally, this study showed that the composition of the SHH impacts directly on the selected microorganism genus and the type and quantity of the value-added compounds obtained.
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Polihidroxialcanoatos , Reactores Biológicos , Ácidos Levulínicos , PolisacáridosRESUMEN
Water quality degradation by organochlorine pesticides and potentially toxic elements is of worldwide concern. This research explores groundwater conditions, regarding organochlorine pesticides and potentially toxic elements, in Hopelchen, Campeche, which is located in the buffer zone of the Calakmul Biosphere Reserve. Unfortunately, agriculture is allowed and agrochemical use is not monitored and sanctioned. Results show that Heptachlor, Endosulfan, and Dieldrin, all recognized carcinogens, had concentrations above the Mexican normative recommended values. Conversely, Cd and Ni concentrations were below recommended values. These results demonstrate that government intervention involving immediate control over agrochemical use is mandatory. Also, the results underscore the contamination of groundwater in several of the Calakmul Biosphere Reserve's buffer zones by organochlorine pesticides concentrations, posing a probable threat for local inhabitants who consume this water and use it for recreation.
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Monitoreo del Ambiente/métodos , Agua Subterránea/química , Sustancias Peligrosas/análisis , Hidrocarburos Clorados/análisis , Plaguicidas/análisis , Agricultura , Dieldrín/análisis , Endosulfano/análisis , Heptacloro/análisis , México , Recursos Hídricos/provisión & distribuciónRESUMEN
INTRODUCTION: The Drop foot is a condition that is usually handled with short orthosis, usually made of polypropylene. It has also been described as being treated with silicon orthosis, little studied but which seem to improve the kinematic pattern of gait and, given its comfort, be more accepted by patients. Our study describes the kinematic characteristics of gait and patient satisfaction when using a silicon foot ankle orthosis, and compares this pattern to the non-use of the orthosis, in patients with a drop foot. MATERIAL AND METHODS: Pseudo-experimental descriptive study in patients with dropped feet from 2010 to 2012, in which the kinematic variables of the gait pattern were evaluated from gait laboratories and in addition to the satisfaction of subjects with silicon orthosis and non-use of them. RESULTS: Five patients with a drop foot were the subject of the study. Gait analysis of patients using the orthosis found an improvement in ankle position at initial contact, average walking speed and step length, as well as increased cadence. However, in terms of comfort compared to the non-use of the orthosis, the result was meager. CONCLUSIONS: Silicon foot ankle orthosis improve the position of the ankle in the initial contact, as well as the temporo-spatial parameters of the gait.
INTRODUCCIÓN: El pie caído es una condición que suele manejarse con ortesis cortas, normalmente fabricadas en polipropileno. Se ha descrito también su tratamiento con ortesis de silicón, poco estudiadas pero que parecen mejorar el patrón cinemático de la marcha y, dada su comodidad, ser más aceptadas por los pacientes. Nuestro estudio describe cuáles son las características cinemáticas de la marcha y la satisfacción referida por los pacientes al usar una ortesis tobillo pie de silicón y compara dicho patrón con el no uso de la ortesis en casos con pie caído. MATERIAL Y MÉTODOS: Estudio seudoexperimental descriptivo en pacientes con pie caído desde el año 2010 al 2012, en el que se evaluaron las variables cinemáticas del patrón de marcha a partir de laboratorios de marcha y además de la satisfacción de los sujetos con las ortesis de silicón y con el no uso de las mismas. RESULTADOS: Cinco casos con pie caído fueron objeto del estudio. El análisis de marcha de los pacientes que usaron la ortesis constató una mejora de la posición del tobillo en el contacto inicial, en la velocidad promedio de marcha y en la longitud del paso, así como un aumento de la cadencia. Sin embargo, en términos de comodidad en comparación con el no uso de la ortesis, el resultado fue exiguo. CONCLUSIONES: Las ortesis tobillo pie de silicón mejoran la posición del tobillo en el contacto inicial, así como los parámetros temporoespaciales de la marcha.
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Tobillo , Siliconas , Articulación del Tobillo , Fenómenos Biomecánicos , Diseño de Equipo , Marcha , Humanos , Rango del Movimiento ArticularRESUMEN
Synthetic osteoinductive materials that mimic the human osteogenic niche have emerged as ideal candidates to address this area of unmet clinical need. In this study, we evaluated the osteoinductive potential in a rabbit orthotopic model of a magnesium-doped hydroxyapatite/type I collagen â(MHA/Coll) composite. The composite was fabricated to exhibit a highly fibrous structure of carbonated MHA with 70% (±2.1) porosity and a Ca/P ratio of 1.5 (±0.03) as well as a diverse range of elasticity separated to two distinct stiffness peaks of low (2.35 â± â1.16 âMPa) and higher (9.52 â± â2.10 âMPa) Young's Modulus. Data suggested that these specific compositional and nanomechanical material properties induced the deposition of de novo mineral phase, while modulating the expression of early and late osteogenic marker genes, in a 3D in vitro model using human bone marrow-derived mesenchymal stem cells (hBM-MSCs). When tested in the rabbit orthotopic model, MHA/Col1 scaffold induction of new trabecular bone mass was observed by DynaCT scan, only 2 weeks after implantation. Bone histomorphometry at 6 weeks revealed a significant amount of de novo bone matrix formation. qPCR demonstrated MHA/Coll scaffold full cellularization in vivo and the expression of both osteogenesis-associated genes (Spp1, Sparc, Col1a1, Runx2, Dlx5) as well as hematopoietic (Vcam1, Cd38, Sele, Kdr) and bone marrow stromal cell marker genes (Vim, Itgb1, Alcam). Altogether, these data provide âevidence of the solid osteoinductive potential of MHA/Coll and its suitability for multiple approaches of bone regeneration.
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Merida is the largest urban center in the Mexican State of Yucatan. Here domestic sewage is deposited in poorly built septic tanks and is not adequately treated. Because of contamination from such waste, water from the top 20 m of the aquifer is unsuitable for human consumption. Given this situation and because children are highly vulnerable to environmental pollution, including exposure to toxic trace elements, this study focused on evaluating the exposure of children to arsenic (As), chromium (Cr), and mercury (Hg) in water. It also evaluated the relationship between the levels of these elements in water and their concentrations in urine and blood. Among the 33 children monitored in the study, arsenic surpassed WHO limits for blood in 37% of the cases, which could result from the ingestion of poultry contaminated with organoarsenic compounds. In the case of WHO limits for Mercury, 65% of the water samples analyzed, 28% of urine samples, and 12% of blood samples exceeded them. Mercury exposure was correlated with biological sex, some lifestyle factors, and the zone in Merida in which children live. These data suggest that the levels of some toxic metals in children may be affected by water source, socioeconomic factors, and individual behavior.
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Exposición a Riesgos Ambientales/estadística & datos numéricos , Contaminantes Ambientales/metabolismo , Oligoelementos/metabolismo , Animales , Arsénico/análisis , Arsénico/sangre , Arsénico/metabolismo , Arsénico/orina , Niño , Cromo/análisis , Cromo/metabolismo , Exposición a Riesgos Ambientales/análisis , Monitoreo del Ambiente , Contaminantes Ambientales/análisis , Agua Subterránea/química , Humanos , Mercurio/análisis , Mercurio/sangre , Mercurio/metabolismo , México , Aguas del Alcantarillado , Porcinos , Oligoelementos/análisis , Contaminantes Químicos del Agua/análisisRESUMEN
The influence of coastal submarine groundwater discharges (SGD) on the distribution and abundance of seagrass meadows was investigated. In 2012, hydrological variability, nutrient variability in sediments and the biotic characteristics of two seagrass beds, one with SGD present and one without, were studied. Findings showed that SGD inputs were related with one dominant seagrass species. To further understand this, a generalized additive model (GAM) was used to explore the relationship between seagrass biomass and environment conditions (water and sediment variables). Salinity range (21-35.5 PSU) was the most influential variable (85%), explaining why H. wrightii was the sole plant species present at the SGD site. At the site without SGD, GAM could not be performed since environmental variables could not explain a total variance of > 60%. This research shows the relevance of monitoring SGD inputs in coastal karstic areas since they significantly affect biotic characteristics of seagrass beds.
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Ecosistema , Monitoreo del Ambiente , Agua Subterránea/química , Salinidad , Agua de Mar/química , Ambiente , NavíosRESUMEN
Studies investigating the correlation between metal content in water and metal levels in children are scarce worldwide, but especially in developing nations. Therefore, this study investigates the correlation between arsenic, chromium, and mercury concentrations in drinking and cooking water and in blood and urine samples collected from healthy and supposedly non-exposed children from a rural area in Yucatan, Mexico. Mercury in water shows concentrations above the recommended World Health Organization (WHO) value for drinking and cooking water. Also, 25% of the children show mercury in urine above the WHO recommended value. Multivariate analyses show a significant role for drinking and cooking water as a vector of exposure in children. Also, the factor analysis shows chronic exposure in the case of arsenic, as well as an ongoing detoxification process through urine in the case of mercury. Further studies should be done in order to determine other potential metal exposure pathways among children.