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1.
Salud Publica Mex ; 65(1, ene-feb): 19-27, 2023 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-36750076

RESUMO

OBJECTIVE: To identify the enzyme-mediated insecticide resistance in Aedes aegypti in Tapachula, Mexico. MATERIALS AND METHODS: Biochemical assays were undertaken to determine the enzyme levels in mosquitoes from 22 sites collected in 2018 and 2020 in Tapachula. Results of 2018 were correlated with the resistance to insecticides pub-lished. RESULTS: Mosquitoes had higher levels than those of the susceptible strain in 2018 and 2020 respectively of α-esterases in 15 and 12 sites; ß-esterases in 7 and 6 sites; glutathione-S-transferases in 11 and 19 sites; ρNPA-esterases in 21 and 17 sites; and cytochromes P450 in 20 and 22 sites. In mosquitoes of 2018, there was a moderate correlation between previously documented Malathion resistance ratios and the insensitive acetylcholinesterase (r=0.459, p= 0.03). CONCLUSIONS: The elevated enzyme levels found indicate its contribution to the resistance to pyrethroids and organo-phosphates already published in mosquitoes from Tapachula. Bioassays using enzyme inhibitors resulted in greater mor-tality, confirming that metabolism contributes to resistance.


Assuntos
Aedes , Dengue , Animais , Humanos , Acetilcolinesterase , Esterases , Resistência a Inseticidas , México , Malation/farmacologia
2.
Pharm Res ; 39(8): 1823-1849, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35739369

RESUMO

A robust comprehension of phagocytosis is crucial for understanding its importance in innate immunity. A detailed description of the molecular mechanisms that lead to the uptake and clearance of endogenous and exogenous particles has helped elucidate the role of phagocytosis in health and infectious or autoimmune diseases. Furthermore, knowledge about this cellular process is important for the rational design and development of particulate systems for the administration of vaccines or therapeutics. Depending on these specific applications and the required biological responses, particles must be designed to encourage or avoid their phagocytosis and prolong their circulation time. Functionalization with specific polymers or ligands and changes in the size, shape, or surface of particles have important effects on their recognition and internalization by professional and nonprofessional phagocytes and have a major influence on their fate and safety. Here, we review the phagocytosis of particles intended to be used as carrier or delivery systems for vaccines or therapeutics, the cells involved in this process depending on the route of administration, and the strategies employed to obtain the most desirable particles for each application through the manipulation of their physicochemical characteristics. We also offer a view of the challenges and potential opportunities in the field and give some recommendations that we expect will enable the development of improved approaches for the rational design of these systems.


Assuntos
Doenças Transmissíveis , Vacinas , Humanos , Imunidade Inata , Fagocitose , Polímeros
3.
Bull Entomol Res ; : 1-13, 2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34538291

RESUMO

Male mating success depends on various traits and factors, and correctly identifying these traits can be key in the context of pest management. For tephritid pests, controlled through the sterile insect technique (SIT) traits, such as male size, can be manipulated through mass-rearing procedures. Thus, it is particularly important to understand whether male size can favor mating success. Here, we evaluated mating success of males of different sizes in Anastrepha ludens and Anastrepha obliqua, two species controlled through SIT. For both species, a morphometric analysis was performed of mated and unmated mass-reared and wild males in field cages. In both A. ludens and A. obliqua, wild females did not discriminate their mates based on male size and mated more frequently with wild males regardless of size. For mass-reared males, we found no evidence of an advantage of the large males compared to small males in mating success. However, we did find differences between the morphometric traits of mass-reared and wild males. In A. ludens, traits associated to mating success were Face Width (FW), Head Width (HW), Thorax Length (TL) and Wing Length (WL), and for A. obliqua were FW, HW, WL and WW (Wing Width). Overall, FW and TL were more consistent predictors of mating success. In conclusion, female choice seems to suggest multivariate selection, confirming that overall body size (expressed as pupal diameter, which is highly correlated with weight) is not a decisive factor in male mating success in these two species. However, morphological traits such as FW, HW, TL, WL and WW may be relevant in mating preference of wild female.

4.
Appl Environ Microbiol ; 86(16)2020 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-32503911

RESUMO

Traditional fermentations have been widely studied from the microbiological point of view, but little is known from the functional perspective. In this work, nitrogen fixation by free-living nitrogen-fixing bacteria was conclusively demonstrated in pozol, a traditional Mayan beverage prepared with nixtamalized and fermented maize dough. Three aspects of nitrogen fixation were investigated to ensure that fixation actually happens in the dough: (i) the detection of acetylene reduction activity directly in the substrate, (ii) the presence of potential diazotrophs, and (iii) an in situ increase in acetylene reduction by inoculation with one of the microorganisms isolated from the dough. Three genera were identified by sequencing the 16S rRNA and nifH genes as Kosakonia, Klebsiella, and Enterobacter, and their ability to fix nitrogen was confirmed.IMPORTANCE Nitrogen-fixing bacteria are found in different niches, as symbionts in plants, in the intestinal microbiome of several insects, and as free-living microorganisms. Their use in agriculture for plant growth promotion via biological nitrogen fixation has been extensively reported. This work demonstrates the ecological and functional importance that these bacteria can have in food fermentations, reevaluating the presence of these genera as an element that enriches the nutritional value of the dough.


Assuntos
Acetileno/metabolismo , Bactérias/metabolismo , Enterobacteriaceae/metabolismo , Alimentos Fermentados/microbiologia , Fixação de Nitrogênio , Enterobacter/isolamento & purificação , Enterobacter/metabolismo , Enterobacteriaceae/isolamento & purificação , Klebsiella/isolamento & purificação , Klebsiella/metabolismo , México , Oxirredução , Oxirredutases/análise , RNA Bacteriano/análise , RNA Ribossômico 16S/análise
5.
J Pediatr ; 219: 118-125.e5, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32037149

RESUMO

OBJECTIVES: To determine the effect of bovine lactoferrin on prevention of late-onset sepsis (LOS) and neurodevelopment delay. STUDY DESIGN: Randomized, double-blind, controlled trial in neonates with a birth weight of 500-2000 g in 3 neonatal units in Lima, Peru, comparing bovine lactoferrin 200 mg/kg/day with placebo administered for 8 weeks. The primary outcome was the first episode of culture-proven LOS or sepsis-associated death. Neurodevelopment delay was assessed by the Mullen Scales at 24 months corrected age. RESULTS: Of the 414 infants enrolled, 209 received bovine lactoferrin and 205 received placebo. LOS or sepsis-associated death occurred in 22 infants (10.5%) in the bovine lactoferrin group vs 30 (14.6%) in the placebo group; there was no difference after adjusting for hospital and birth weight; hazard ratio 0.73 (95% CI, 0.42-1.26). For infants with birth weights of <1500 g the hazard ratio was 0.69 (95% CI, 0.39-1.25). The mean age-adjusted normalized Mullen composite score at 24 months was 83.3 ± 13.6 in the bovine lactoferrin group vs 82.6 ± 13.1 in the placebo group. Growth outcomes and rehospitalization rates during the 2-year follow-up were similar in both groups, except for significantly less bronchiolitis in the bovine lactoferrin group (rate ratio, 0.34; 95% CI, 0.14-0.86). CONCLUSIONS: Supplementation with bovine lactoferrin did not decrease the incidence of sepsis in infants with birth weights of <2000 g. Growth and neurodevelopment outcomes at 24 months of age were similar. Neonatal bovine lactoferrin supplementation had no adverse effects. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01525316.


Assuntos
Lactoferrina/uso terapêutico , Transtornos do Neurodesenvolvimento/prevenção & controle , Sepse/prevenção & controle , Animais , Bovinos , Método Duplo-Cego , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Masculino
6.
Crit Rev Food Sci Nutr ; 60(5): 791-809, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30582346

RESUMO

For a long time, food microbiota has been studied using traditional microbiological techniques. With the arrival of molecular or culture-independent techniques, a strong understanding of microbiota dynamics has been achieved. However, analyzing the functional role of microbial communities is not an easy task. The application of omics sciences to the study of fermented foods would provide the metabolic and functional understanding of the microbial communities and their impact on the fermented product, including the molecules that define its aroma and flavor, as well as its nutritional properties. Until now, most omics studies have focused on commercial fermented products, such as cheese, wine, bread and beer, but traditional fermented foods have been neglected. Therefore, the information that allows to relate the present microbiota in the food and its properties remains limited. In this review, reports on the applications of omics in the study of traditional fermented foods and beverages are reviewed to propose new ways to analyze the fermentation phenomena.


Assuntos
Bebidas/microbiologia , Alimentos Fermentados/microbiologia , Análise de Alimentos , Microbiota , Verduras/microbiologia , Fermentação
7.
J Chem Ecol ; 43(10): 945-954, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28918495

RESUMO

Stingless bees foraging for food improve recruitment by depositing chemical cues on valuable food sites or pheromone marks on vegetation. Using gas chromatography/mass spectrometry and bioassays, we showed that Melipona solani foragers leave a mixture composed mostly of long chain hydrocarbons from their abdominal cuticle plus methyl oleate from the labial gland as a scent mark on rich food sites. The composition of hydrocarbons was highly variable among individuals and varied in proportions, depending on the body part. A wide ratio of compounds present in different body parts of the bees elicited electroantennogram responses from foragers and these responses were dose dependent. Generally, in bioassays, these bees prefer to visit previously visited feeders and feeders marked with extracts from any body part of conspecifics. The mean number of visits to a feeder was enhanced when synthetic methyl oleate was added. We propose that this could be a case of multi-source odor marking, in which hydrocarbons, found in large abundance, act as a signature mixture with attraction enhanced through deposition of methyl oleate, which may indicate a rich food source.


Assuntos
Comportamento Apetitivo , Antenas de Artrópodes/fisiologia , Abelhas/fisiologia , Hidrocarbonetos/metabolismo , Ácidos Oleicos/metabolismo , Comunicação Animal , Animais , Alimentos , Odorantes/análise , Feromônios/metabolismo
8.
Polymers (Basel) ; 15(7)2023 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-37050229

RESUMO

Mucus is a viscoelastic gel that acts as a protective barrier for epithelial surfaces. The mucosal vehicles and adjuvants need to pass through the mucus layer to make drugs and vaccine delivery by mucosal routes possible. The mucoadhesion of polymer particle adjuvants significantly increases the contact time between vaccine formulations and the mucosa; then, the particles can penetrate the mucus layer and epithelium to reach mucosa-associated lymphoid tissues. This review presents the key findings that have aided in understanding mucoadhesion and mucopenetration while exploring the influence of physicochemical characteristics on mucus-polymer interactions. We describe polymer-based particles designed with mucoadhesive or mucopenetrating properties and discuss the impact of mucoadhesive polymers on local and systemic immune responses after mucosal immunization. In future research, more attention paid to the design and development of mucosal adjuvants could lead to more effective vaccines.

9.
Arthropod Struct Dev ; 77: 101314, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37925773

RESUMO

The morphology of the immature stages of Utetes anastrephae (Hymenoptera: Braconidae), a native parasitoid of larvae of flies of the Neotropical genus Anastrepha (Diptera: Tephritidae), is shown. This study aimed to characterize the immature stages and morphological changes in the development of the koinobiont endoparasitoid in two species of larval hosts, Anastrepha obliqua and Anastrepha ludens. The definition of structures and morphological changes during development was made through daily microscopic observations and photographs of dissected hosts. The immature development of the parasitoid corresponds to a holometabolous insect with three well-defined stages: egg (two days), larva with three larval instars (approximately eight days), and pupa (six days). Similar development times were obtained in the two host species. Males and females completed their cycle in 17 and 18 days, respectively. During egg-first instar development, host antagonistic activity through melanization and encapsulation as mortality factors was evident and frequent only in A. obliqua. These results serve as basic knowledge for the use of this parasitoid in the biological control of fruit flies.


Assuntos
Himenópteros , Tephritidae , Feminino , Masculino , Animais , Larva , Pupa
10.
Eur J Pharm Biopharm ; 187: 96-106, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37094693

RESUMO

Raw starch microparticles (SMPs) proved efficient antigen carriers with adjuvant properties when administered via the mucosal route; however, the underlying mechanisms associated with this bioactivity are unknown. In the present study, we explored the mucoadhesion properties, fate, and toxicity of starch microparticles after mucosal administration. Nasally administered microparticles were mainly retained in nasal turbinates, reaching the nasal-associated lymphoid tissue; this step is facilitated by the ability of the microparticles to penetrate through the mucous epithelium. Likewise, we found intraduodenally administered SMPs on the small intestinal villi, follicle-associated epithelium, and Peyer's patches. Furthermore, under simulated gastric and intestinal pH conditions, we detected mucoadhesion between the SMPs and mucins, regardless of microparticle swelling. SMPs' mucoadhesion and translocation to mucosal immune responses induction sites explain the previously reported role of these microparticles as vaccine adjuvants and immunostimulants.


Assuntos
Imunização , Amido , Amido/química , Adjuvantes Imunológicos , Imunidade nas Mucosas , Administração através da Mucosa
11.
PLoS One ; 18(11): e0294894, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38033047

RESUMO

The objective of the study is to present a systematic review and meta-analysis protocol for evaluating the effects of health education gamification-based interventions, on health parameters (food consumption, sleep quality and physical activity) of adolescent students. This protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022373833). The search will be performed in the following databases: MEDLINE, Embase, Scopus, ERIC, ScienceDirect, Web of Science, Cochrane, LILACS, APA, and ADOLEC. Intervention studies (clinical trials - randomized or non-randomized) and quasi-experimental studies will be included. The risk of bias will be assessed using the Risk of Bias in Non-randomized Studies of Interventions tool for randomized controlled trials, non- randomized controlled trials and quasi-experimental trials. Two independent researchers will conduct all assessments, and any disagreements will be consulted with a third reviewer. Data analysis and synthesis will be analyzed using RevMan 5.4.1 software. We will conduct the study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guideline. The review will summarize the current evidence on gamification health education changes in parameters related to the health of adolescents. Gamification has been used to verify the increase in adherence to healthy habits or the development of health-related skills, but there are still few results for the adolescent population. We expect that the systematic review could indicate strategies with gamification interventions and also determine how these strategies can improve health parameters of adolescent students, and they will be available as a reference for these interventions.


Assuntos
Gamificação , Educação em Saúde , Adolescente , Humanos , Revisões Sistemáticas como Assunto , Metanálise como Assunto , Instituições Acadêmicas
12.
Insects ; 14(6)2023 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-37367381

RESUMO

Tapachula, Mexico, a tropical city, is an endemic area for dengue, in addition to several outbreaks in the last decade with chikungunya and zika. As part of the migratory corridor from Central to North America and the risks of scattered infectious diseases that this implies, the identification and distribution of potential disease vectors in and around residential areas are essential in terms of entomological surveillance for the prevention of disease outbreaks. The identification of mosquito species of medical importance coexisting in houses and cemeteries in Tapachula and two semiurban sites in southern Chiapas was investigated. Adult mosquitoes were collected from May to December 2018, resting inside and outside houses and in the tombstones and fallen tree leaves in cemeteries. A total of 10,883 mosquitoes belonging to three vector species were collected across 20 sites; 6738 were from neighborhood houses, of which 55.4% were Culex quinquefasciatus, 41.6% Aedes aegypti, and 2.9% Ae. albopictus. Aedes aegypti was the most common mosquito resting inside houses (56.7%), while Ae. albopictus and Cx. quinquefasciatus were mostly found resting outside houses (75.7%). In the cemeteries, Cx. quinquefasciatus (60.8%) and Ae. albopictus (37.3%) were the most abundant, while Ae. aegypti (1.9%) was the least abundant. This is the first report to identify adults of three major disease vector species coexisting in the domestic environment of urban and semiurban sites and Ae. albopictus adult resting inside of urban houses in Mexico. It would be opportune to consider comprehensive strategies that can be applied in this region to control the three species at the same time and avoid outbreaks of the diseases they transmit.

13.
Front Nutr ; 8: 714814, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34490328

RESUMO

Pozol is an acidic, refreshing, and non-alcoholic traditional Mayan beverage made with nixtamalized corn dough that is fermented spontaneously. The extensive analysis of the microbiology, biochemistry and metaproteomics of pozol allowed the construction of a comprehensive image of the fermentation system. The main changes in both the substrate and the microbiota occurred in the first 9 h of fermentation. The increase in microorganisms correlated with the drop in pH and with the decrease in the contents of carbohydrates, lipids, and nitrogen, which shows that this stage has the highest metabolic activity. Bacterial proteins were mainly represented by those of lactic acid bacteria, and among them, the proteins from genus Streptococcus was overwhelmingly the most abundant. Yeast proteins were present in all the analyzed samples, while proteins from filamentous fungi increased up to 48 h. The metaproteomic approach allowed us to identify several previously unknown enzyme complexes in the system. Additionally, enzymes for hydrolysis of starch, hemicellulose and cellulose were found, indicating that all these substrates can be used as a carbon source by the microbiota. Finally, enzymes related to the production of essential intermediates involved in the synthesis of organic acids, acetoin, butanediol, fatty acids and amino acids important for the generation of compounds that contribute to the sensorial quality of pozol, were found.

14.
Appl Microbiol Biotechnol ; 85(5): 1241-9, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19908036

RESUMO

Insoluble polysaccharides can be degraded by a set of hydrolytic enzymes formed by catalytic modules appended to one or more non-catalytic carbohydrate-binding modules (CBM). The most recognized function of these auxiliary domains is to bind polysaccharides, bringing the biocatalyst into close and prolonged vicinity with its substrate, allowing carbohydrate hydrolysis. Examples of insoluble polysaccharides recognized by these enzymes include cellulose, chitin, beta-glucans, starch, glycogen, inulin, pullulan, and xylan. Based on their amino acid similarity, CBMs are grouped into 55 families that show notable variation in substrate specificity; as a result, their biological functions are miscellaneous. Carbohydrate or polysaccharide recognition by CBMs is an important event for processes related to metabolism, pathogen defense, polysaccharide biosynthesis, virulence, plant development, etc. Understanding of the CBMs properties and mechanisms in ligand binding is of vital significance for the development of new carbohydrate-recognition technologies and provide the basis for fine manipulation of the carbohydrate-CBM interactions.


Assuntos
Glicosídeo Hidrolases/química , Polissacarídeos/metabolismo , Proteínas/química , Proteínas de Bactérias/química , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Sítios de Ligação , Glicosídeo Hidrolases/metabolismo , Cinética , Modelos Moleculares , Polissacarídeos/química , Ligação Proteica , Dobramento de Proteína , Estrutura Terciária de Proteína , Proteínas/metabolismo , Relação Estrutura-Atividade , Especificidade por Substrato
15.
Heliyon ; 6(6): e04247, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32613121

RESUMO

INTRODUCTION: Polymerase chain reaction (PCR) testing of cerebrospinal fluid (CSF) is a sensitive and specific method in diagnosing herpes simplex virus (HSV) encephalitis. However there are increasing reports of false negative HSV PCR. CASE DESCRIPTION: We present a patient in the 9th decade of life with abnormal behavior and focal seizures with MRI showing a right temporal T2 hyperintense non-enhancing lesion with electrographic evidence of right lateralized periodic discharges. CSF analysis and PCR for HSV-1 and 2 yielded negative results twice, and therefore acyclovir was discontinued. Patient initially improved following correction of hyponatremia. Patient however deteriorated and imaging revealed a new right parietal lesion. Third CSF sample showed lymphocytic pleocytosis with positive HSV-1 PCR. Patient improved following antiviral treatment. DISCUSSION: Acyclovir treatment should continue in high clinical suspicion scenarios despite negative HSV PCR. We further discuss causes of PCR false negatives and challenges it poses for patient care.

16.
Carbohydr Polym ; 165: 103-114, 2017 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-28363529

RESUMO

α-Glucans are present in virtually all domains of life, and these glucose chains linked by α-1,4- and α-1,6-linked branches form the most important storage carbohydrates in cells. It is likely for this reason that α-glucans are not generally considered as bioactive molecules as ß-glucans are. Nevertheless, it is known that depending on their source, many α-glucans play important roles as modulators of immune response. Recent efforts have attempted to elucidate the mechanisms through which α-glucans exert their immunostimulant effects; however, the main challenge is the accurate identification of the receptors of immune cells involved in their recognition. Here, we review the adjuvant properties reported for some polysaccharides and ultimately focus on α-glucans and how their structural characteristics, such as molecular weight, solubility and derivatization, influence their immunostimulatory properties. As a final point, we discuss the potential and associated challenges of using these polysaccharides as adjuvants, particularly in mucosal vaccination.


Assuntos
Adjuvantes Imunológicos/farmacologia , Glucanos/farmacologia , Vacinas
17.
Injury ; 48 Suppl 6: S12-S25, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29162237

RESUMO

Continuing tissue destruction in osteoarthrosis is maintained by molecular pathways related to an unbalanced chondrocyte metabolism, the loss of reactive oxygen species (ROS) homeostasis, increase catabolism in a degraded matrix and the limited response to growth factors due to cell aging. Rare deleterious gene variants driving relevant molecular pathways may play a key role in the pathogenesis and genetic control of common diseases and may also influence the common gene variants observed in GWAS. We use molecular profiling technologies based on massive sequencing of genes to interrogate clinical samples for a variety of molecules involved in the pathogenesis pathways of OA and also to derive new insights for drug targeting discovery at an early stage of the disease. By whole-exome sequencing performed in OA patients with extreme phenotypes and in non-related individuals without clinical evidence of OA, the most predominant of the rare gene variants found were non-synonymous single-nucleotide variants (SNV) from exonic DNA regions and with missense functional effects predicting a moderate impact on protein function. A total of 629, 577, and 639 gene variants for the TPF, COA, and ANHNF patients, respectively, were found not to be shared with the 20 non-disease-related individuals. After subtraction of the 306 variants shared among the OA patients, we obtained the individual profiles of 323, 271, and 333 gene variants, for the TPF, COA, and ANHNF patients, respectively. After filtering by the bioinformatics, genetic, and biological criteria established to assess the clinical consequences, comparative analysis of trio sequences using integrative genome visualization tool clearly demonstrate the differences between patients. Analysis of the collagen gene variants identified 78, 20, and 43 genetic collagen variants for the three extreme phenotypes. Rare gene variants encoding for proteins that are less abundant in the trabecular bone matrix, together with those responsible for the control and regulation of bone turnover and plasticity of subchondral trabecular bone, play important roles in OA and help to define the clinical phenotype.


Assuntos
Matriz Óssea/patologia , Osso Esponjoso/patologia , Exoma/fisiologia , Fraturas do Colo Femoral/genética , Genômica , Osteoartrite/genética , Osteonecrose/genética , Adulto , Idoso , Colágeno Tipo I/metabolismo , Biologia Computacional , Fraturas do Colo Femoral/fisiopatologia , Frequência do Gene , Humanos , Masculino , Osteoartrite/fisiopatologia , Osteogênese/genética , Polimorfismo de Nucleotídeo Único , Sequenciamento do Exoma
18.
Rev Peru Med Exp Salud Publica ; 33(4): 719-724, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-28327842

RESUMO

The aim of this study was to describe the neurological consultation and baseline characteristics of children with cerebral palsy (CP). The clinical records of children with CP attending an external consultation of the Neuropediatric department of Hospital Nacional Cayetano Heredia between 2011 and 2012 were assessed in this retrospective descriptive study. A total of 81 children were included: 53.1% were boys. Spastic CP was the most frequent (72.8%), hypoxic-isquemic encephalopathy (28.1%) and cerebral malformations (28.1%) were the main causes in term newborn. The average age at the time of diagnosis was 4.1 ± 3.2 years; epilepsy was the most frequent reason for neuropediatric consultation, and 58% were admitted to the hospital at least once. The waiting period to be seen by a physical therapist was around 2 months (interquartile range = 0.8-9). We reached the conclusion that CP was delayed, and the waiting period to access specialized care was prolonged. Protocols and increased efficiency are required to provide adequate medical care to children with CP.


Assuntos
Paralisia Cerebral/fisiopatologia , Paralisia Cerebral/diagnóstico , Criança , Pré-Escolar , Diagnóstico Tardio , Epilepsia/diagnóstico , Epilepsia/fisiopatologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Peru , Encaminhamento e Consulta , Estudos Retrospectivos
20.
Sleep Sci ; 8(3): 115-20, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26779317

RESUMO

We aimed to evaluate the impact in sleep quality and musculoskeletal pain of a Medium-Firm Mattress (MFM), and their relationship with objective sleep parameters in a group of institutionalized elders. The sample size included forty older adults with musculoskeletal pain. We did a clinical assessment at baseline and weekly trough the study period of four weeks. We employed the Pittsburgh Sleep Quality Index (PSQI) and Pain Visual Analog Scale (P-VAS). Additionally a sub-group of good sleepers, selected from PSQI baseline evaluation, were studied with actigraphy and randomized to MFM or High Firm Mattress (HFM), in two consecutive nights. We found a significant reduction of cervical, dorsal and lumbar pain. PSQI results did not change. The actigraphy evaluation found a significant shorter sleep onset latency with MFM, and a slightly better, but not statistically significant, sleep efficiency. The medium firmness mattress improved musculoskeletal pain and modified the sleep latency.

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