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1.
Br J Cancer ; 128(6): 946-957, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36476659

RESUMEN

High-quality clinical practice guidelines (CPGs) and consensus statements (CSs) are essential for evidence-based medicine. The purpose of this systematic review was to appraise the quality and reporting of colorectal cancer (CRC) screening CPGs and CSs. After prospective registration (Prospero no: CRD42021286156), a systematic review searched CRC guidances in duplicate without language restrictions in ten databases, 20 society websites, and grey literature from 2018 to 2021. We appraised quality with AGREE II (% of maximum score) and reporting with RIGHT (% of total 35 items) tools. Twenty-four CPGs and 5 CSs were analysed. The median overall quality and reporting were 54.0% (IQR 45.7-75.0) and 42.0% (IQR 31.4-68.6). The applicability had low quality (AGREE II score <50%) in 83% of guidances (24/29). Recommendations and conflict of interest were low-reported (RIGHT score <50%) in 62% guidances (18/29) and 69% (20/29). CPGs that deployed systematic reviews had better quality and reporting than CSs (AGREE: 68.5% vs. 35.5%; p = 0.001; RIGHT: 74.6% vs. 41.4%; p = 0.001). In summary, CRC screening CPGs and CSs achieved low quality and reporting. It is necessary a revision and an improvement of the current guidances. Their development should apply a robust methodology using proper guideline development tools to obtain high-quality evidence-based documents.


Asunto(s)
Neoplasias Colorrectales , Detección Precoz del Cáncer , Humanos , Estudios Prospectivos , Medicina Basada en la Evidencia , Consenso
2.
Eur J Cancer Care (Engl) ; 31(6): e13738, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36254840

RESUMEN

INTRODUCTION: We aimed to systematically evaluate quality of shared decision-making (SDM) in colorectal cancer (CRC) screening clinical practice guidelines (CPGs) and consensus statements (CSs). METHODS: Search for CRC screening guidances was from 2010 to November 2021 in EMBASE, Web of Science, MEDLINE, Scopus and CDSR, and the World Wide Web. Three independent reviewers and an arbitrator rated the quality of each guidance using a SDM quality assessment tool (maximum score: 31). Reviewer agreement was 0.88. RESULTS: SDM appeared in 41/83 (49.4%) CPGs and 9/19 (47.4%) CSs. None met all the quality criteria, and 51.0% (52/102) failed to meet any quality items. Overall compliance was low (mean 1.63, IQR 0-2). Quality was better in guidances published after 2015 (mean 1, IQR 0-3 vs. mean 0.5, IQR 0-1.5; p = 0.048) and when the term SDM was specifically reported (mean 4.5, IQR 2.5-4.5 vs. mean 0.5, IQR 0-1.5; p < 0.001). CPGs underpinned by systematic reviews showed better SDM quality than consensus (mean 1, IQR 0-3 vs. mean 0, IQR 0-2, p = 0.040). CONCLUSION: SDM quality was suboptimal and mentioned in less than half of the guidances, and recommendations were scarce. Guideline developers should incorporate evidence-based SDM recommendations in guidances to underpin the translation of evidence into practice.


Asunto(s)
Neoplasias Colorrectales , Detección Precoz del Cáncer , Humanos , Neoplasias Colorrectales/diagnóstico , Toma de Decisiones , Toma de Decisiones Conjunta , Participación del Paciente
3.
J Anim Breed Genet ; 139(4): 370-379, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35305049

RESUMEN

Uniformity, understood as a similar performance in relevant livestock traits, such as birth weight within the litter, is being included as one of the selection objectives in breeding programmes, especially for polytocous livestock species. A divergent selection experiment for birth weight within-litter variability in mice during 23 generations showed that homogeneous animals were better for litter size, survival and feed efficiency but less heavy than heterogeneous animals. The aim of this study was to compare the reproductive longevity in both divergent lines as time to the end of the reproductive period. Two generations from both lines with an initial number of 43 females and 43 males were mated one to one and stayed together to have consecutive parturitions until the end of the reproductive life. Females were discarded when the time elapsed from the last parturition was longer than 63 days. The time to the end of the reproductive period between both lines was compared by fitting a Cox proportional hazard regression model adjusting for line, generation and its interaction. The rate of parturitions in both lines was also compared using a Prentice-Williams-Peterson model adjusted for the same effects. The low variability line was associated with a higher parturition rate, e.g., adjusted hazard ratio was 2.93 (95% CI 2.17-3.94). The Cox model showed that the low variability females also presented benefits of time to the end of the reproductive period, with an adjusted hazard ratio of 0.26 (95% CI 0.16-0.41). The median of reproductive days was 55.50 in the high variability line whilst the median was 252.50 days for the low variability females. The homogeneous line presented important reproductive advantages suggesting higher robustness and animal welfare. Further research should confirm whether the findings presented here of a better performance in the low variability line could be properly applied to some livestock species.


Asunto(s)
Longevidad , Reproducción , Animales , Peso al Nacer , Femenino , Tamaño de la Camada , Ganado , Masculino , Ratones , Parto , Embarazo , Selección Genética
4.
Ann Vasc Surg ; 69: 360-365, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32554200

RESUMEN

BACKGROUND: The aim of this study is to present midterm results of thoracic endovascular aortic repair (TEVAR) using scalloped or fenestrated custom-made endovascular grafts (CMEGs) in aortic arch Zones 0 and 1. METHODS: A retrospective review of prospectively collected data involving consecutive patients with aortic arch disease treated by scalloped or fenestrated Relay Plus stent grafts (Terumo Aortic, Sunrise, FL) landed in Zones 0 and 1. Patient demographics, operative details, clinical outcomes, and complications were analyzed. RESULTS: Between February 2014 and February 2020, 14 patients (9 male and 5 female) with a median age of 66 years (range 48-84) underwent scalloped or fenestrated TEVAR to preserve flow to the supra-aortic trunks (SATs). In 6 cases the landing zone was Zone 0 and in 8, Zone 1. Target vessels for the scallops were left common carotid artery in 8 cases (Zone 1) and innominate artery (IA) in 1 (Zone 0). All 5 fenestrations were designed to preserve the IA (Zone 0). Technical success was 100% with no endoleaks on completion angiography. One fatal perioperative stroke (7%) occurred in a patient with a fenestration for the IA and atherosclerotic plaques in the arch. During median follow-up of 37.5 (3-72) months, no other patient died, and all the target vessels and cervical revascularizations remained patent. There was no paraplegia, no retrograde dissection, and no other complication. Two patients (14%) with scallops in Zone 1 developed late endoleak: 1 type Ib at 6 months and 1 type Ia endoleak at 12 months. There were no endoleaks at all in the group of fenestrated endografts (Zone 0). CONCLUSIONS: When anatomy allows, endovascular treatment using scalloped or fenestrated CMEGs in Zones 0 and 1 is a feasible technique to treat patients with aortic arch disease involving the SATs.


Asunto(s)
Aorta Torácica/cirugía , Enfermedades de la Aorta/cirugía , Implantación de Prótesis Vascular/instrumentación , Prótesis Vascular , Procedimientos Endovasculares/instrumentación , Anciano , Anciano de 80 o más Años , Aorta Torácica/diagnóstico por imagen , Enfermedades de la Aorta/diagnóstico por imagen , Enfermedades de la Aorta/mortalidad , Implantación de Prótesis Vascular/efectos adversos , Implantación de Prótesis Vascular/mortalidad , Endofuga/etiología , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/mortalidad , Factores de Tiempo , Resultado del Tratamiento
5.
Int J Clin Pract ; 74(3): e13453, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31769902

RESUMEN

BACKGROUND: Insulin resistance (IR) precedes the diagnosis of many metabolic and non-metabolic illnesses, including type 2 diabetes mellitus (T2DM). Acanthosis nigricans (AN) is a clinical sign associated with IR. However, AN prevalence and diagnostic accuracy in middle-age adults before or at the time of prediabetes/diabetes diagnosis remain uncertain. METHODS: With the aim to define AN prevalence and diagnostic accuracy, adults between 40 and 60 years of age were consecutively invited to participate in the study. Participants were categorised into one of two main groups: individuals with normoglycaemia (group 1) and hyperglycaemia (group 2 [ie, prediabetes/diabetes]). Demographic, clinical, anthropometric characteristics, homeostasis model assessment of IR, homeostatic model assessment of ß-cell function, as well as the presence of AN on the neck, axillae, elbows and knuckles were assessed. RESULTS: A total of 320 consecutive participants with a mean age of 49.3 years (59.4% women) were included. Overall, AN prevalence was 46.3%, while AN in group 1 and group 2 was 36.3% and 49.6%, respectively (P = .04). The most common affected sites in group 1 (n = 80) were the knuckles (21.2%) and the neck (17.5%), while in group 2 (n = 240), the neck (29.6%) followed by the knuckles (26.7%). The specificity and positive predictive value of AN for IR were 0.85 and 0.86 in group 1 and 0.90 and 0.96 in group 2, respectively. CONCLUSIONS: In middle-age adults, within the entire spectrum of carbohydrate tolerance, AN is highly prevalent and specific. This finding supports its assessment as a reliable and convenient clinical sign of IR. The understanding of AN behaviour through different carbohydrate tolerance strata, and its different locations, could lead to early detection of individuals at high metabolic risk or help direct a more pathophysiological treatment approach in patients with T2DM.


Asunto(s)
Acantosis Nigricans/etiología , Diabetes Mellitus Tipo 2/complicaciones , Resistencia a la Insulina/fisiología , Estado Prediabético/complicaciones , Adulto , Índice de Masa Corporal , Femenino , Humanos , Hiperglucemia/complicaciones , Hiperinsulinismo/complicaciones , Masculino , Persona de Mediana Edad , Prevalencia
6.
Infect Immun ; 85(8)2017 08.
Artículo en Inglés | MEDLINE | ID: mdl-28507066

RESUMEN

The oral microbiota associated with the initiation and progression of dental caries has yet to be fully characterized. The Human Oral Microbe Identification Using Next-Generation Sequencing (HOMINGS) approach was used to analyze the microbiomes of site-specific supragingival dental plaques from children with different caries status. Fifty-five children (2 to 7 years of age) were assessed at baseline and at 12 months and grouped as caries free (CF), caries active with enamel lesions (CAE), and caries active with dentin carious lesions (CA). Plaque samples from caries-free tooth surfaces (PF) and from enamel carious lesions (PE) and dentin carious lesions (PD) were collected. 16S community profiles were obtained by HOMINGS, and 408 bacterial species and 84 genus probes were assigned. Plaque bacterial communities showed temporal stability, as there was no significant difference in beta diversity values between the baseline and 12-month samples. Irrespective of collection time points, the microbiomes of healthy tooth surfaces differed substantially from those found during caries activity. All pairwise comparisons of beta diversity values between groups were significantly different (P < 0.05), except for comparisons between the CA-PF, CAE-PE, and CA-PE groups. Streptococcus genus probe 4 and Neisseria genus probe 2 were the most frequently detected taxa across the plaque groups, followed by Streptococcus sanguinis, which was highly abundant in CF-PF. Well-known acidogenic/aciduric species such as Streptococcus mutans, Scardovia wiggsiae, Parascardovia denticolens, and Lactobacillus salivarius were found almost exclusively in CA-PD. The microbiomes of supragingival dental plaque differ substantially among tooth surfaces and children of different caries activities. In support of the ecological nature of caries etiology, a steady transition in community species composition was observed with disease progression.


Asunto(s)
Bacterias/aislamiento & purificación , Caries Dental/microbiología , Placa Dental/microbiología , Microbiota , Bacterias/clasificación , Bifidobacterium/aislamiento & purificación , Niño , Preescolar , Caries Dental/clasificación , Esmalte Dental/microbiología , Dentina/microbiología , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Masculino , ARN Ribosómico 16S , Streptococcus/clasificación , Streptococcus/aislamiento & purificación , Streptococcus mutans/aislamiento & purificación , Streptococcus sanguis/aislamiento & purificación
7.
Echocardiography ; 34(1): 44-52, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-27739100

RESUMEN

OBJECTIVES: The tricuspid annular plane systolic excursion (TAPSE) is a validated measure of right ventricular function; however, the apical echocardiographic window varies and has limitations in intensive care unit (ICU) patients receiving mechanical ventilation or those with underlying disease and air entrapment. We aimed to evaluate the subcostal echocardiographic assessment of tricuspid annular kick (SEATAK) as an alternative to TAPSE in critically ill patients. METHODS: To measure SEATAK, we obtained the subcostal inferior vena cava view and used M-mode to measure excursion of the tricuspid annulus (kick). Analysis was performed with JMP for Bland-Altman and Spearman correlations. RESULTS: We evaluated 45 patients, 26 (57.8%) of whom were women, with a mean age of 60.8 years. We were not able to obtain the apical view to measure TAPSE in 8.9% of the patients. In contrast, SEATAK was measured in all patients. The mean SEATAK and TAPSE were 1.62 cm and 1.93 cm, respectively, with a mean pairwise difference of -0.26 cm (95% CI: -0.19 to -0.35), with the SEATAK value being lower than TAPSE. The overall correlation was strong and significant (ρ = .86, P=.03). The graphical correlation was maintained between TAPSE and SEATAK and the degree of RVF. CONCLUSION: In patients presenting with RVF in the ICU (or in situations where the apical echocardiographic view is suboptimal for tricuspid annular assessment), SEATAK can be an alternative to TAPSE. Further research is needed to validate and determine the sensitivity and specificity of SEATAK for RVF prognostication.


Asunto(s)
Enfermedad Crítica , Ecocardiografía/métodos , Volumen Sistólico/fisiología , Válvula Tricúspide/diagnóstico por imagen , Función Ventricular Derecha/fisiología , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los Resultados , Sístole
8.
Ann Fam Med ; 13(1): 49-52, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25583892

RESUMEN

PURPOSE: The purpose of this study was to evaluate sensitivity, specificity, and positive and negative likelihood ratios of laryngeal height, lung function, and diagnostic questionnaires for screening and diagnosis of chronic obstructive pulmonary disease (COPD). METHODS: We undertook a cross-sectional study of 233 people aged between 40 and 75 years. Measured variables were age, sex, weight, height, body mass index, tobacco use, maximum laryngeal height, and spirometry, and we administered a COPD questionnaire and the Lung Function Questionnaire. RESULTS: For laryngeal height, we found a positive likelihood ratio of 5.21, and for the Lung Function Questionnaire, we found a negative likelihood ratio of 0.10. Combining a maximum laryngeal height of ≤4 cm with Lung Function Questionnaire findings of ≤18 yielded a positive likelihood ratio of 29.06, and a negative likelihood ratio of 0.26. CONCLUSIONS: The intrinsic validity of the lung function questionnaire makes it useful for screening. Combining Lung Function Questionnaire results and laryngeal height can help confirm or dismiss COPD.


Asunto(s)
Laringe/patología , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Pruebas de Función Respiratoria , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Funciones de Verosimilitud , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Sensibilidad y Especificidad , Encuestas y Cuestionarios
9.
Water Sci Technol ; 71(6): 885-91, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25812098

RESUMEN

Habanero pepper production was assessed with drip irrigation and plastic mulch, based on two transplanting dates. The objectives of the study were: (i) to evaluate the effect of two transplanting dates and the use of plastic mulch on water productivity and habanero pepper fruit yield under drip irrigation conditions; and (ii) to determine the profitability and economic viability of the product in the regional market. The work was conducted in the municipality of Huimanguillo, state of Tabasco, Mexico, in loam soils classified as Eutric Fluvisol. The Jaguar variety of habanero pepper, developed by INIFAP and possessing better genetic and productive characteristics, was used. Two transplanting dates were studied, (i) 30 January 2013 and (ii) 15 February 2013, with and without plastic mulch. The conclusions were: (i) application of irrigation depths based on crop evapotranspiration (ETc) and plastic mulch transplanted on 30 January increased the fruit yield of the crop and improved the benefit-cost ratio of the production system; and (ii) water use efficiency based on the 30 January transplanting date was 8.68 kg m⁻³ of water applied with plastic mulch, 6.51 kg m⁻³ without plastic mulch, and 3.65 kg m⁻³ for the 15 February transplanting date with plastic mulch.


Asunto(s)
Agricultura/métodos , Capsicum/crecimiento & desarrollo , Capsicum/metabolismo , Agua/metabolismo , Agricultura/economía , Frutas/crecimiento & desarrollo , Frutas/metabolismo , México , Estaciones del Año
11.
J Arthroplasty ; 29(10): 1950-5, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25015756

RESUMEN

Total knee arthroplasty (TKA) can be associated with substantial blood loss, leading to increased morbidity and transfusion rates. The study objective was to evaluate routine use of a thrombin-based topical hemostatic matrix in reducing blood loss and transfusion requirements in primary TKA. 108 patients were enrolled in a prospective, randomized, single-center trial. Patients receiving the hemostatic agent demonstrated a lower mean calculated blood loss (1325.2±464.8mL vs. control, 1509.3±432.8mL; P=0.02), drain output (415.6±202.0mL vs. control, 579.9±306.7mL; P=0.008), and length of stay (3.3±0.8days vs. control, 3.7±1.1days; P=0.03), without a statistically significant difference in mean hemoglobin loss or transfusion requirements. The clinical utility of this hemostatic agent to reduce transfusions after uncomplicated, primary TKA continues to remain unclear.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Pérdida de Sangre Quirúrgica/prevención & control , Esponja de Gelatina Absorbible/administración & dosificación , Hemostáticos/administración & dosificación , Hemorragia Posoperatoria/prevención & control , Trombina/administración & dosificación , Administración Tópica , Adulto , Anciano , Anciano de 80 o más Años , Artritis/cirugía , Artroplastia de Reemplazo de Rodilla/efectos adversos , Transfusión Sanguínea , Femenino , Humanos , Articulación de la Rodilla/cirugía , Masculino , Persona de Mediana Edad , Hemorragia Posoperatoria/etiología , Estudios Prospectivos , Resultado del Tratamiento
12.
Obesity (Silver Spring) ; 32(8): 1541-1550, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38932559

RESUMEN

OBJECTIVE: The objective of this study was to study how acid accumulation (lower plasma bicarbonate and higher anion gap [AG] and corrected anion gap [CAG]) correlates with metabolic parameters, food intake, and 24-h energy expenditure (EE). METHODS: Acid accumulation was measured in 286 healthy adults with estimated glomerular filtration rate > 60 mL/min/1.73 m2. Measurements included body composition by dual-energy x-ray absorptiometry scan, ad libitum energy intake by a vending machine paradigm over 3 days, and 24-h EE in a whole-room indirect calorimeter. RESULTS: Lower bicarbonate, higher AG, and higher CAG were correlated with higher waist and thigh circumferences, body fat (percentage), fat mass, triglycerides, and lower high-density lipoprotein cholesterol. Acid accumulation markers were correlated with higher total energy (CAG partial r = 0.17; p = 0.02), fat (CAG partial r = 0.17; p = 0.02), protein intake (CAG partial r = 0.20; p = 0.006), and 24-h EE (CAG partial r = 0.24; p = 0.0007). A mediation analysis of CAG and total energy intake found that 24-h EE was a partial mediator (40%), but the association remained significant (ß = 0.15; p < 0.0001). CONCLUSIONS: In healthy individuals, acid accumulation was associated with an unfavorable metabolic phenotype; higher 24-h EE; and increased total energy, fat, and protein intake. Acid accumulation markers, as putative markers of higher dietary acid load (e.g., from protein), may affect energy balance physiology promoting weight gain.


Asunto(s)
Composición Corporal , Ingestión de Energía , Metabolismo Energético , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Grasas de la Dieta/administración & dosificación , Proteínas en la Dieta/administración & dosificación , Absorciometría de Fotón , Equilibrio Ácido-Base , Triglicéridos/sangre
13.
Psychiatry Res ; 339: 115983, 2024 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-38870775

RESUMEN

Despite uncertainty about the specific molecular mechanisms driving major depressive disorder (MDD), the Wnt signaling pathway stands out as a potentially influential factor in the pathogenesis of MDD. Known for its role in intercellular communication, cell proliferation, and fate, Wnt signaling has been implicated in diverse biological phenomena associated with MDD, spanning neurodevelopmental to neurodegenerative processes. In this systematic review, we summarize the functional differences in protein and gene expression of the Wnt signaling pathway, and targeted genetic association studies, to provide an integrated synthesis of available human data examining Wnt signaling in MDD. Thirty-three studies evaluating protein expression (n = 15), gene expression (n = 9), or genetic associations (n = 9) were included. Only fifteen demonstrated a consistently low overall risk of bias in selection, comparability, and exposure. We found conflicting observations of limited and distinct Wnt signaling components across diverse tissue sources. These data do not demonstrate involvement of Wnt signaling dysregulation in MDD. Given the well-established role of Wnt signaling in antidepressant response, we propose that a more targeted and functional assessment of Wnt signaling is needed to understand its role in depression pathophysiology. Future studies should include more components, assess multiple tissues concurrently, and follow a standardized approach.

14.
Radiother Oncol ; 198: 110387, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38885905

RESUMEN

Synthetic computed tomography (sCT) generated from magnetic resonance imaging (MRI) can serve as a substitute for planning CT in radiation therapy (RT), thereby removing registration uncertainties associated with multi-modality imaging pairing, reducing costs and patient radiation exposure. CE/FDA-approved sCT solutions are nowadays available for pelvis, brain, and head and neck, while more complex deep learning (DL) algorithms are under investigation for other anatomic sites. The main challenge in achieving a widespread clinical implementation of sCT lies in the absence of consensus on sCT commissioning and quality assurance (QA), resulting in variation of sCT approaches across different hospitals. To address this issue, a group of experts gathered at the ESTRO Physics Workshop 2022 to discuss the integration of sCT solutions into clinics and report the process and its outcomes. This position paper focuses on aspects of sCT development and commissioning, outlining key elements crucial for the safe implementation of an MRI-only RT workflow.

15.
Nutrients ; 16(4)2024 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-38398850

RESUMEN

We examined whether perceived stress, anhedonia, and food insecurity were associated with dietary adherence during a 6-week intervention. Sixty participants (23 m; 53 ± 14 y) completed psychosocial measures and were provided with full meals. Individuals with obesity were randomized to a weight-maintaining energy needs (WMENs) (n = 18; BMI 33 ± 4) or a 35% calorie-reduced diet (n = 19; BMI 38 ± 9); normal-weight individuals (n = 23; BMI 23 ± 2) were assigned to a WMENs diet. Adherence scores were determined via weekly assessments and daily ecological momentary assessments (EMAs) of real-time behavior in a natural environment. Perceived stress and anhedonia were associated with % body fat (all r-values > 0.25, all p-values < 0.05), but food insecurity and adherence were not. Higher perceived stress (r = -0.31, p = 0.02), anhedonia (r = -0.34, p = 0.01), and food insecurity (r = -0.27, p = 0.04) were associated with lower adherence scores, even after adjusting for age, sex, and % body fat. In all adjusted models, % body fat was not associated with adherence. Higher measures of stress, anhedonia, and food insecurity predicted lower adherence independently of body fat, indicating that psychosocial factors are important targets for successful adherence to dietary interventions, regardless of body size.


Asunto(s)
Adiposidad , Anhedonia , Humanos , Índice de Masa Corporal , Obesidad/psicología , Dieta , Inseguridad Alimentaria , Estrés Psicológico/psicología , Abastecimiento de Alimentos
16.
Rev Panam Salud Publica ; 34(2): 121-6, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24096977

RESUMEN

OBJECTIVE: To describe knowledge and perceptions regarding the use of oral rehydration solution (ORS) for the management of diarrheal diseases among formal and informal health care providers and community caregivers in the Guatemalan department of Santa Rosa, and to recommend strategies to increase ORS use for management of diarrhea in children. METHODS: From July to September 2008, in-depth, semi-structured interviews were conducted with formal health care providers; open-ended interviews were conducted with informal health care providers; and focus group discussions and pile sorting were carried out with community caregivers. RESULT: The study participants attributed episodes of diarrhea in children to culturally recognized or folk ailments (empacho, cuajo, and varillas) that are primarily treated by traditional healers. There were knowledge deficits about 1) dehydration as a manifestation of diarrhea, and 2) management of dehydration, including the use of ORS and the need to continue feedings during diarrheal episodes. Caregivers perceived bottled/ready-made ORS products and the more expensive over-the-counter antidiarrheal medications as superior to ORS packets in the treatment of diarrhea. CONCLUSIONS: In Guatemala, folk etiologies of disease differ from those of the biomedical establishment and influence the decisions made by caregivers when treating ill children, including those related to the use of ORS. Public health campaigns addressing the treatment and management of diarrheal diseases in Santa Rosa should recognize the ailments known as empacho, cuajo, and varillas and target them for ORS use by community caregivers as well as health care providers in both the formal and informal health sectors.


Asunto(s)
Actitud del Personal de Salud , Actitud Frente a la Salud , Cuidadores/psicología , Deshidratación/terapia , Diarrea/terapia , Fluidoterapia/psicología , Personal de Salud/psicología , Soluciones para Rehidratación/uso terapéutico , Adolescente , Adulto , Antidiarreicos/uso terapéutico , Preescolar , Cultura , Deshidratación/tratamiento farmacológico , Deshidratación/etiología , Deshidratación/mortalidad , Diarrea/complicaciones , Diarrea/mortalidad , Diarrea Infantil/complicaciones , Diarrea Infantil/mortalidad , Diarrea Infantil/terapia , Escolaridad , Femenino , Grupos Focales , Guatemala/epidemiología , Promoción de la Salud , Humanos , Lactante , Masculino , Medicina Tradicional/psicología , Persona de Mediana Edad , Medicamentos sin Prescripción , Fitoterapia/psicología , Fitoterapia/estadística & datos numéricos , Investigación Cualitativa , Muestreo , Terminología como Asunto , Adulto Joven
17.
Healthcare (Basel) ; 11(15)2023 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-37570400

RESUMEN

In recent years, there has been a lack of healthy lifestyle habits in the population, including hydration, with negative consequences for health. At the same time, advances in technology have changed the process of teaching and learning since elementary school, highlighting the incorporation of educational robots as innovative resources in recent years. This study analyzes the state of the scientific knowledge presented by university students doing a university degree in Primary Education after a robotics-based educational intervention. The study adopted a quasi-experimental design with a qualitative approach, using category systems and a quantitative approach with descriptive and inferential (Chi-square and Contingency Coefficient) statistics. The results of the study show that the level of scientific knowledge has improved in the different scientific contents involved, highlighting the excellent level presented for the recommended daily volume of hydration. Innovative interventions, through digital resources such as Educational Robotics, are presented as possible alternatives to promoting the healthy habit of hydration, due the effective learning of biosanitary knowledge in the young population.

18.
Cancer J ; 29(6): 323-327, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37963366

RESUMEN

ABSTRACT: Because of diversities and disparities, lung cancer incidence and mortality rates among minorities are disproportionate compared with non-Hispanic White (NHW) populations. This review focuses on the disparities in lung cancer screening, diagnosis, treatment, and outcomes that minorities, mainly Hispanic and Black, experience compared with NHW populations. Despite efforts such as improving the eligibility criteria for screening to improve lung cancer survival rates, disparities persist, particularly among minority populations. However, the "Hispanic Paradox" describes the lower incidence and better survival rates observed in Hispanics compared with other ethnic groups best explained by possible contributions such as genetics and other factors such as dietary habits. Disparities in screening, particularly among underrepresented populations, are frequently explained by cultural, socioeconomic, and health care access barriers. There are also disparities in receiving appropriate treatment, such as surgical treatment, with fewer Hispanics and Blacks undergoing surgery than NHW individuals, resulting in lower overall survival rates. In addition, the prevalence of biomarker testing varies by racial and ethnic groups, influencing personalized treatment plans and outcomes. Finally, because of genetic and social determinants of health, the clinical outcomes of targeted therapy and immunotherapy may differ among minority populations. Identifying and addressing social determinants of health in real time are a "must" to have a significant impact in reducing lung cancer disparities. A comprehensive and multifaceted strategy is required to rectify disparities in cancer treatment. This strategy includes increasing levels of awareness and education, reducing financial and access barriers, and promoting increased diversity in clinical trial recruitment. By effectively addressing these complex challenges, the objective of providing equitable cancer care to all patients, regardless of race or ethnicity, can be achieved. To identify and address disparities, heightened awareness and education are essential. Access to health care is ensured by reducing financial and access barriers. Finally, increased diversity in clinical trial recruitment advances the generalizability of findings and promotes equitable representation of all racial and ethnic groups, resulting in improved outcomes for all patients.


Asunto(s)
Disparidades en Atención de Salud , Neoplasias Pulmonares , Humanos , Detección Precoz del Cáncer , Etnicidad , Accesibilidad a los Servicios de Salud , Hispánicos o Latinos , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/terapia , Estados Unidos , Negro o Afroamericano
19.
Chemosphere ; 315: 137606, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36574787

RESUMEN

This work aimed to study NiO/F-TiO2 composites in the photocatalytic degradation of 4-chlorophenol. F-TiO2 support was prepared by in-situ fluorination of TiO2 using the sol-gel method. The heterostructured materials were prepared by wet impregnation method, varying NiO content (0.5, 1.0, and 2.0% wt). The solids were characterized by X-ray fluorescence, X-ray diffraction, nitrogen physisorption, diffuse reflectance UV-Vis spectrophotometry, infrared spectroscopy, and X-ray photoelectron spectroscopy. The characterization studies showed that the coupling of TiO2 with fluoride ions promoted the generation of ≡Ti-F surface species that could be responsible for the decrease in the recombination frequency of charge carriers and the increased photoactivity. In addition, it was found that the coupling of NiO/F-TiO2 semiconductors improved the photocatalytic properties of the fluorinated support, obtaining higher percentages of degradation and mineralization of the phenolic contaminant. These results are possibly a consequence of factors such as the formation of larger crystallites, lower band gap energies, and the generation of p-n type interfacial heterojunctions that potentiate the proper separation of electron-hole pairs. An effect of NiO content on photoactivity was observed, being a percentage of 1.0% wt the optimum in this photocatalytic treatment.


Asunto(s)
Luz , Nanocompuestos , Fotólisis , Titanio/química , Nanocompuestos/química , Catálisis
20.
Heliyon ; 9(4): e15367, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37101642

RESUMEN

Model organisms are fundamental in cancer research given that they rise the possibility to characterize in a quantitative-objective fashion the organisms as a whole in ways that are infeasible in humans. From this perspective, model organisms with short generation times and established protocols for genetic manipulation allow the understanding of basic biology principles that might guide carcinogenic onset. The cancer-hallmarks (CHs) approach, a modular perspective for cancer understanding, stands that underlying the variability among different cancer types, critical events support the carcinogenic origin and progression. Thus, CHs as interconnected genetic circuitry, have a causal effect over cancer biogenesis and might represent a comparison scaffold among model organisms to identify and characterize evolutionarily conserved modules to understand cancer. Nevertheless, the identification of novel cancer regulators by comparative genomics approaches relies on selecting specific biological processes or related signaling cascades that limit the type of detected regulators, even more, holistic analysis from a systemic perspective is absent. Similarly, although the plant Arabidopsis thaliana has been used as a model organism to dissect specific disease-associated mechanisms, given the evolutionary distance between plants and humans, a general concern about the utility of using A. thaliana as a cancer model persists. In the present research, we take advantage of the CHs paradigm as a framework to establish a functional systemic comparison between plants and humans, that allowed the identification not only of specific novel key genetic regulators, but also, biological processes, metabolic systems, and genetic modules that might contribute to the neoplastic transformation. We propose five cancer-hallmarks that overlapped in conserved mechanisms and processes between Arabidopsis and human and thus, represent mechanisms which study can be prioritized in A. thaliana as an alternative model for cancer research. Additionally, derived from network analyses and machine learning strategies, a new set of potential candidate genes that might contribute to neoplastic transformation is described. These findings postulate A. thaliana as a suitable model to dissect, not all, but specific cancer properties, highlighting the importance of using alternative complementary models to understand carcinogenesis.

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