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1.
PLoS One ; 19(6): e0304105, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38861521

RESUMEN

BACKGROUND: The potential influence of hyperuricemia on the genesis and progression of chronic kidney disease (CKD) remains controversial. In general, the correlation between blood levels of uric acid (UA) and the rate of progression of CKD is considered to be modest, if any, and the results of relevant trials oriented to disclose the effect of urate-lowering therapies on this outcome have been disappointing. Urinary excretion rates of UA could reflect more accurately the potential consequences of urate-related kidney injury. METHOD: Using a cross-sectional design, we investigated the correlation between different estimators of the rates of urinary excretion of UA (total 24-hour excretion, mean urinary concentration, renal clearance and fractional excretion)(main study variables), on one side, and urinary levels of selected biomarkers of kidney injury and CKD progression (DKK3, KIM1, NGAL, interleukin 1b and MCP)(main outcome variables), in 120 patients with advanced CKD (mean glomerular filtration rate 21.5 mL/minute). We took into consideration essential demographic, clinical and analytic variables with a potential confounding effect on the explored correlations (control variables). Spearman's rho correlation and nonlinear generalized additive regression models (GAM) with p-splines smoothers were used for statistical analysis. MAIN RESULTS: Multivariate analysis disclosed independent correlations between urinary UA concentrations, clearances and fractional excretion rates (but not plasma UA or total 24-hour excretion rates of UA), on one side, and the scrutinized markers. These correlations were more consistent for DKK3 and NGAL than for the other biomarkers. Glomerular filtration rate, proteinuria and treatment with statins or RAA axis antagonists were other independent correlates of the main outcome variables. CONCLUSIONS: Our results support the hypothesis that urinary excretion rates of UA may represent a more accurate marker of UA-related kidney injury than plasma levels of this metabolite, in patients with advanced stages of CKD. Further, longitudinal studies will be necessary, to disclose the clinical significance of these findings.


Asunto(s)
Biomarcadores , Insuficiencia Renal Crónica , Ácido Úrico , Humanos , Ácido Úrico/sangre , Ácido Úrico/orina , Biomarcadores/orina , Biomarcadores/sangre , Masculino , Femenino , Persona de Mediana Edad , Insuficiencia Renal Crónica/orina , Insuficiencia Renal Crónica/sangre , Insuficiencia Renal Crónica/complicaciones , Anciano , Estudios Transversales , Tasa de Filtración Glomerular , Progresión de la Enfermedad , Adulto
3.
Org Lett ; 25(41): 7481-7485, 2023 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-37815231

RESUMEN

2-Halo-3-tosyl-oxanorbornadienes are able to accept two thiol molecules through an initial nucleophilic substitution, giving isolable oxabicyclic thiovinyl sulfones that, subsequently, can react with a second thiol molecule via thio-Michael addition. The resulting oxanorbornenic thioketals undergo retro-Diels-Alder (rDA) fragmentation to release a furan derivative and a ketene S,S-acetal. The substitution pattern of the oxanorbornadienic skeleton influences the rate of the rDA through electronic and steric factors examined by quantum mechanical calculations.

4.
J Org Chem ; 88(18): 13331-13338, 2023 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-37616527

RESUMEN

The use of 7-oxa/azanorbornadienes as synthetic intermediates for the preparation of 3/4-substituted (ß-substituted) furans/pyrroles is presented. The method lies in the inverse electron demand Diels-Alder (iEDDA) cycloaddition between a substituted heteronorbornadiene and an electron-poor tetrazine followed by spontaneous fragmentation of the resulting cycloadduct via two retro-Diels-Alder (rDA) reactions affording a ß-substituted furan/pyrrole. The scope of this tandem iEDDA/rDA/rDA reaction was explored in the preparation of 29 heterocycles. A one-pot procedure starting directly from the alkyne precursors of the heteronorbornadiene intermediates is also described.

5.
Nefrologia (Engl Ed) ; 43(2): 189-196, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37442712

RESUMEN

BACKGROUND: Categorization of the capacity of ultrafiltration during a peritoneal equilibration test (PET) is a usual step during the monitoring of peritoneal transport characteristics of Peritoneal Dialysis (PD) patients. Quantifying the peritoneal residual volume (Vr) after the dwell preceding the PET (Vrpre) and at the end of the test (Vrpost) could help to improve the accuracy of the estimation of this variable. METHOD: Following a prospective design, we calculated Vrpre and Vrpost in 116 patients, incident or prevalent on DP, who underwent one or two (n = 27) PET with 3,86/4,25% glucose-based PD solutions and complete drainage at 60 min. We evaluated the consistency of Vr by comparing Vrpre and Vrpost, as also these two parameters in repeated tests. We scrutinized potential associations between demographic and clinical factors, on one side, and the amount of Vr on the other, as also the impact of correcting ultrafiltration during PET for Vr on the categorization of the capacity of ultrafiltration. RESULTS: As a mean, Vrpost was larger than Vrpre. Consequently, correction of ultrafiltration for Vr resulted in significantly higher values than those obtained according to the standard procedure (494 vs. 449 mL, p < 0,0005). We disclosed marked inconsistencies for different estimations of Vr in the same patients (Vrpre vs Vrpost and repeated PET studies). Moreover, no demographic or clinical variable was able to predict the amount of Vr. We observed a significant deviation (>200 mL) between both methods of estimation of the capacity of utrafiltration in only 12,9% of the patients. However, 21,1% of the patients categorized as cases of ultrafiltration failure according to the standard procedure did not maintain this condition after correction for Vr. CONCLUSIONS: Correction for Vr of the capacity of ultrafiltration during a PET carries, as a mean, a minor impact on the categorization of this parameter. However, the results of the test can be significantly affected in 12,9% of the cases. We have been unable to detect demographic or clinical predictors of Vr, which suggests a random component for the mechanics of single peritoneal exchanges. We suggest that Vr should be estimated at the time of categorizing the capacity of ultrafiltration, whenever inconsistencies during serial PET studies are detected.


Asunto(s)
Diálisis Peritoneal , Peritoneo , Humanos , Estudios Prospectivos , Volumen Residual , Transporte Biológico , Peritoneo/metabolismo , Diálisis Peritoneal/métodos
6.
Eur J Cancer ; 188: 39-48, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37196483

RESUMEN

PURPOSE: There is an increasing interest in the role of sex and gender in cancer patients. The impact of sex differences in oncological systemic therapies is still unknown, and there is a lack of evidence specially in uncommon neoplasms like neuroendocrine tumours (NET). In the present study, we combine the differential toxicities by sex in five published clinical trials with multikinase inhibitors (MKI) in gastroenteropancreatic (GEP) NET. METHODS: We performed a pooled univariate analysis of reported toxicity in patients treated in five phase 2 and phase 3 clinical trials with MKI in the GEP NET setting: sunitinib (SU11248, SUN1111), Pazopanib (PAZONET), sorafenib-bevacizumab (GETNE0801) and Lenvatinib (TALENT). Differential toxicities between male and female patients were evaluated considering relationship with study drug and different weights of each trial by random effect adjustment. RESULTS: We found nine toxicities which were more frequent in female patients (leukopenia, alopecia, vomiting, headache, bleeding, nausea, dysgeusia, neutrophil count decreased and dry mouth) and two toxicities being more frequent in male patients (Anal Symptoms and Insomnia). Asthenia and diarrhoea were the only severe (Grade 3-4) toxicities more frequent in female patients. CONCLUSIONS: Sex-related differences in toxicity with the MKI treatment require targeted information and individualised management of patients with NET. Differential reporting of toxicity should be promoted when clinical trials are published.


Asunto(s)
Tumores Neuroendocrinos , Humanos , Femenino , Masculino , Tumores Neuroendocrinos/tratamiento farmacológico , Caracteres Sexuales , Sunitinib/uso terapéutico , Sorafenib/uso terapéutico , Bevacizumab/uso terapéutico
7.
Nefrología (Madrid) ; 43(2): 189-196, mar.-abr. 2023. tab
Artículo en Español | IBECS | ID: ibc-218127

RESUMEN

Introducción y objetivos: La categorización de la capacidad de ultrafiltración durante la prueba de equilibrio peritoneal (PEP) es parte habitual de la monitorización del funcionalismo peritoneal en pacientes tratados con diálisis peritoneal (DP). La estimación del volumen residual (Vr) tras el cambio previo (Vrpre) y el de la propia PEP (Vrpost) podría ayudar a mejorar la precisión de la prueba. Método: Siguiendo un diseño prospectivo, estimamos el Vrpre y Vrpost en 116 pacientes incidentes o prevalentes en DP que fueron sometidos a una o dos (n=27) PEP con solución de glucosa al 3,86/4,25% y drenaje completo a los 60 minutos. Valoramos la consistencia del Vr comparando Vrpre y Vrpost y también estos parámetros en PEP sucesivas. Analizamos la posible influencia de factores demográficos y clínicos en la cuantía del Vr, así como el impacto de la corrección para Vr de la ultrafiltración durante la PEP sobre la categorización de la capacidad de ultrafiltración. Resultados: El Vrpost fue mayor que el Vrpre, por lo que la ultrafiltración corregida para Vr fue signficativamente mayor que la calculada por procedimiento estándar (494 vs. 449mL, p<0,0005). Resultó notable la escasa concordancia de estimaciones sucesivas (Vrpre vs Vrpost y PEP sucesivas) del Vr. Asimismo, ningún parámetro demográfico o clínico escrutado mostró asociación con la magnitud del Vr. Tan solo un 12,9% de los pacientes presentó una desviación clínicamente significativa (>200mL) de la ultrafiltración corregida para Vr frente al valor estándar. Sin embargo, un 21,1% de los pacientes que cumplían criterio de fallo de ultrafiltración por método estándar, no lo hacían si se aplicaba la corrección para Vr. (AU)


Background: Categorization of the capacity of ultrafiltration during a peritoneal equilibration test (PET) is a usual step during the monitoring of peritoneal transport characteristics of peritoneal dialysis (PD) patients. Quantifying the peritoneal residual volume (Vr) after the dwell preceding the PET (Vrpre) and at the end of the test (Vrpost) could help to improve the accuracy of the estimation of this variable. Method: Following a prospective design, we calculated Vrpre and Vrpost in 116 patients, incident or prevalent on DP, who underwent one or two (n=27) PET with 3.86/4.25% glucose-based PD solutions and complete drainage at 60min. We evaluated the consistency of Vr by comparing Vrpre and Vrpost, as also these two parameters in repeated tests. We scrutinized potential associations between demographic and clinical factors, on one side, and the amount of Vr on the other, as also the impact of correcting ultrafiltration during PET for Vr on the categorization of the capacity of ultrafiltration. Results: As a mean, Vrpost was larger than Vrpre. Consequently, correction of ultrafiltration for Vr resulted in significantly higher values than those obtained according to the standard procedure (494 vs 449mL, p<0.0005). We disclosed marked inconsistencies for different estimations of Vr in the same patients (Vrpre vs Vrpost and repeated PET studies). Moreover, no demographic or clinical variable was able to predict the amount of Vr. We observed a significant deviation (>200mL) between both methods of estimation of the capacity of utrafiltration in only 12.9% of the patients. However, 21.1% of the patients categorized as cases of ultrafiltration failure according to the standard procedure did not maintain this condition after correction for Vr. (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Diálisis Peritoneal , Enfermedades Peritoneales , Estudios Prospectivos , Volumen Residual , Ultrafiltración
8.
Eur J Med Chem ; 250: 115170, 2023 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-36787658

RESUMEN

Cancer cells are highly dependent on Nicotinamide phosphoribosyltransferase (NAMPT) activity for proliferation, therefore NAMPT represents an interesting target for the development of anti-cancer drugs. Several compounds, such as FK866 and CHS828, were identified as potent NAMPT inhibitors with strong anti-cancer activity, although none of them reached the late stages of clinical trials. We present herein the preparation of three libraries of new inhibitors containing (pyridin-3-yl)triazole, (pyridin-3-yl)thiourea and (pyridin-3/4-yl)cyanoguanidine as cap/connecting unit and a furyl group at the tail position of the compound. Antiproliferative activity in vitro was evaluated on a panel of solid and haematological cancer cell lines and most of the synthesized compounds showed nanomolar or sub-nanomolar cytotoxic activity in MiaPaCa-2 (pancreatic cancer), ML2 (acute myeloid leukemia), JRKT (acute lymphobalistic leukemia), NMLW (Burkitt lymphoma), RPMI8226 (multiple myeloma) and NB4 (acute myeloid leukemia), with lower IC50 values than those reported for FK866. Notably, compounds 35a, 39a and 47 showed cytotoxic activity against ML2 with IC50 = 18, 46 and 49 pM, and IC50 towards MiaPaCa-2 of 0.005, 0.455 and 2.81 nM, respectively. Moreover, their role on the NAD+ synthetic pathway was demonstrated by the NAMPT inhibition assay. Finally, the intracellular NAD+ depletion was confirmed in vitro to induced ROS accumulation that cause a time-dependent mitochondrial membrane depolarization, leading to ATP loss and cell death.


Asunto(s)
Antineoplásicos , Neoplasias Hematológicas , Leucemia , Humanos , Nicotinamida Fosforribosiltransferasa/metabolismo , NAD/metabolismo , Línea Celular Tumoral , Citocinas/metabolismo , Antineoplásicos/farmacología , Leucemia/metabolismo , Relación Estructura-Actividad , Neoplasias Hematológicas/tratamiento farmacológico , Inhibidores Enzimáticos/farmacología
9.
J Org Chem ; 87(24): 16483-16491, 2022 12 16.
Artículo en Inglés | MEDLINE | ID: mdl-36455216

RESUMEN

Aminyl radicals are nitrogen-centered radicals of interest in synthetic strategies involving C-N bond formation due to their high reactivity. These intermediate radicals are generated by the reaction of an organic azide with tributyltin hydride (Bu3SnH) in the presence of substoichiometric amounts of azobisisobutyronitrile (AIBN). In this work, we report the regioselective rearrangement of azanorbornanic ([2.2.1]azabicyclic) aminyl radicals into 2,8-diazabicyclo[3.2.1]oct-2-ene systems. With the aim to establish the structural requirements for this ring expansion, we have studied the effect of different bridgehead atoms of the [2.2.1]bicyclic system and the presence of an alkyl substituent at C4. Attempts to perform this ring expansion on a monocyclic analogue have been also explored to evaluate the influence of the bicyclic skeleton on the rearrangement. A detailed mechanistic proposal supported by computational studies is reported.


Asunto(s)
Nitrógeno
10.
Antioxidants (Basel) ; 11(11)2022 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-36358557

RESUMEN

Recent studies have related mitochondrial impairment with peritoneal membrane damage during peritoneal dialysis (PD) therapy. Here, we assessed the involvement of mitochondrial dysfunction in the inflammatory response in human mesothelial cells, a hallmark in the pathogenesis of PD-related peritoneal membrane damage. Our ex vivo studies showed that IL-1ß causes a drop in the mitochondrial membrane potential in cells from peritoneal effluent. Moreover, when mitochondrial damage was induced by inhibitors of mitochondrial function, a low-grade inflammatory response was generated. Interestingly, mitochondrial damage sensitized mesothelial cells, causing a significant increase in the inflammatory response induced by cytokines, in which ROS generation and NF-κB activation appear to be involved, since inflammation was counteracted by both mitoTEMPO (mitochondrial ROS scavenger) and BAY-117085 (NF-κB inhibitor). Furthermore, the natural anti-inflammatory antioxidant resveratrol significantly attenuated the inflammatory response, by reversing the decline in mitochondrial membrane potential and decreasing the expression of IL-8, COX-2 and PGE2 caused by IL-1ß. These findings suggest that IL-1ß regulates mitochondrial function in mesothelial cells and that mitochondrial dysfunction could induce an inflammatory scenario that sensitizes these cells, causing significant amplification of the inflammatory response induced by cytokines. Resveratrol may represent a promising strategy in controlling the mesothelial inflammatory response to PD.

11.
Apuntes psicol ; 40(3): 139-149, 13 nov. 2022. tab
Artículo en Español | IBECS | ID: ibc-212678

RESUMEN

A la hora de poner en marcha procesos de innovación en los servicios de intervención familiar que supongan la incorporación de programas basadas en la evidencia (PBE), es fundamental considerar el papel que desempeñan los/as profesionales, ya que de ellos depende en gran parte la fidelidad y calidad de la implementación de los programas. Este estudio se centra en analizar las actitudes de profesionales hacia las prácticas basadas en la evidencia, así como su percepción y valoración del Programa de Intervención Familiar (PIF), desarrollado en el Ayuntamiento de Pamplona (España) dentro de la cartera de servicios de preservación familiar. Los participantes fueron los/as 27 profesionales que aplican el PIF, que cumplimentaron la escala Evidence-Based Practice Attitude Scale (EBPAS) y la de Expectativas y Valoración Inicial del PIF (EVI-PIF). Los resultados obtenidos mostraron la relación existente entre las actitudes hacia las prácticas basadas en la evidencia y algunas características de los/as profesionales. Asimismo, también se encontró relación significativa entre una alta valoración del PIF y unas actitudes positivas hacia los PBE. Estos resultados avalan la importancia de las actitudes profesionales como elementos que pueden facilitar o dificultar los procesos de innovación y mejora en los servicios de atención e intervención familiar (AU)


When implementing innovation processes in family intervention services that involve the incorporation of eviden-ce-based programmes (EBP), it is essential to take into consideration the role played by professionals, since the fidelity and quality of the implementation of the programmes largely depends on them. This study focuses on analysing the attitudes of professionals towards EBP, as well as their perception and assessment of the Family Intervention Programme (FIP), developed in the family prevention services of Pamplona City Council (Spain). The participants in the study were the 27 professionals who implement the FIP, who completed the Evidence-Based Practice Attitude Scale (EBPAS) and he Expectations and Initial Assessment of the FIP (EVI-FIP). The results obtained showed the relationship between attitudes towards evidence-based practice and some characteristics of the professionals. A significant relationship was also found between a high valuation of the FIP and positive attitudes towards EBP. These results support the importance of professional attitudes as elements that can facilitate or hinder innovation and improvement processes in family care and intervention services. (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , 36397 , Actitud del Personal de Salud , Práctica Clínica Basada en la Evidencia , Competencia Profesional
12.
Pharmaceuticals (Basel) ; 15(8)2022 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-36015178

RESUMEN

In recent years, Saturation Transfer Difference NMR (STD NMR) has been proven to be a powerful and versatile ligand-based NMR technique to elucidate crucial aspects in the investigation of protein-ligand complexes. Novel STD NMR approaches relying on "multi-frequency" irradiation have enabled us to even elucidate specific ligand-amino acid interactions and explore the binding of fragments in previously unknown binding subsites. Exploring multi-subsite protein binding pockets is especially important in Fragment Based Drug Discovery (FBDD) to design leads of increased specificity and efficacy. We hereby propose a novel multi-frequency STD NMR approach based on direct irradiation of one of the ligands in a multi-ligand binding process, to probe the vicinity and explore the relative orientation of fragments in adjacent binding sub-sites, which we called Inter-Ligand STD NMR (IL-STD NMR). We proved its applicability on (i) a standard protein-ligand system commonly used for ligand-observed NMR benchmarking: Naproxen as bound to Bovine Serum Albumin, and (ii) the biologically relevant system of Cholera Toxin Subunit B and two inhibitors adjacently bound within the GM1 binding site. Relative to Inter-Ligand NOE (ILOE), the current state-of-the-art methodology to probe relative orientations of adjacent ligands, IL-STD NMR requires about one tenth of the experimental time and protein consumption, making it a competitive methodology with the potential to be applied in the pharmaceutical industries.

13.
Eur J Med Chem ; 239: 114504, 2022 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-35724566

RESUMEN

Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal diseases for which chemotherapy has not been very successful yet. FK866 ((E)-N-(4-(1-benzoylpiperidin-4-yl)butyl)-3-(pyridin-3-yl)acrylamide) is a well-known NAMPT (nicotinamide phosphoribosyltransferase) inhibitor with anti-cancer activities, but it failed in phase II clinical trials. We found that FK866 shows anti-proliferative activity in three PDAC cell lines, as well as in Jurkat T-cell leukemia cells. More than 50 FK866 analogues were synthesized that introduce substituents on the phenyl ring of the piperidine benzamide group of FK866 and exchange its buta-1,4-diyl tether for 1-oxyprop-3-yl, (E)-but-2-en-1,4-diyl and 2- and 3-carbon tethers. The pyridin-3-yl moiety of FK866 was exchanged for chlorinated and fluorinated analogues and for pyrazin-2-yl and pyridazin-4-yl groups. Several compounds showed low nanomolar or sub-nanomolar cell growth inhibitory activity. Our best cell anti-proliferative compounds were the 2,4,6-trimethoxybenzamide analogue of FK866 ((E)-N-(4-(1-(2,4,6-trimethoxybenzoyl)piperidin-4-yl)butyl)-3-(pyridin-3-yl)acrylamide) (9), the 2,6-dimethoxybenzamide (8) and 2-methoxybenzamide (4), which exhibited an IC50 of 0.16 nM, 0.004 nM and 0.08 nM toward PDAC cells, respectively.


Asunto(s)
Acrilamidas , Antineoplásicos , Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Piperidinas , Acrilamidas/química , Acrilamidas/farmacología , Antineoplásicos/farmacología , Carcinoma Ductal Pancreático/tratamiento farmacológico , Citocinas , Humanos , Neoplasias Pancreáticas/tratamiento farmacológico , Piperidinas/química , Piperidinas/farmacología , Neoplasias Pancreáticas
14.
Bioorg Chem ; 120: 105650, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-35144103

RESUMEN

Two libraries of mono- and dimeric pyrrolidine iminosugars were synthesized by CuAAC and (thio)urea-bond-forming reactions from the respective azido/aminohexylpyrrolidine iminosugar precursors. The resulting monomeric and dimeric compounds were screened for inhibition of ß-N-acetylglucosaminidase from Jack beans, the plant ortholog of human lysosomal hexosaminidases. A selection of the best inhibitors of these libraries was then evaluated against human lysosomal ß-N-acetylhexosaminidase B (hHexB) and human nucleocytoplasmic ß-N-acetylglucosaminidase (hOGA). This evaluation identified a potent (nM) and selective monomeric inhibitor of hOGA (compound 7A) that showed a 6770-fold higher affinity for this enzyme than for hHexB. The corresponding dimeric derivative (compound 9D) further remarkably improved the selectivity in the inhibition of hOGA (2.7 × 104 times more selective for hOGA over hHexB) and the inhibition potency (by one order of magnitude). Docking studies were performed to explain the selectivity of inhibition observed in compound 7A.


Asunto(s)
Iminoazúcares , Acetilglucosaminidasa , Inhibidores Enzimáticos/farmacología , Humanos , Iminoazúcares/farmacología , Pirrolidinas/farmacología , Relación Estructura-Actividad , beta-N-Acetilhexosaminidasas
15.
Nurse Educ Pract ; 59: 103279, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34974322

RESUMEN

AIMS: To determine if a training program, aimed at home care workers, for caring for the elderly and for providing their own self-care is effective for reducing workers burden in the short and long terms and to identify the associated variables that can influence burden across 12 months. BACKGROUND: An increasing number of older adults rely on home care workers as a complement to the care received from family caregivers. However, these workers do not usually have any formal training in nursing care and occasionally suffer burden. DESIGN: A pre- and post-intervention study with a follow-up at 12 months including 86 participants. METHODS: An 85-hour training course, which included a practical module lasting 35 h, was offered on five separate occasions between 2014 and 2017 in Barcelona (Spain). The care burden was measured according the Zarit Burden Interview and care knowledge and perceived difficulty performing care tasks were assessed. We also gathered data on the physical and psychological status of the care recipients. RESULTS: The educational intervention was effective after training (-7.45% p = .020) and although the initial burden on caregivers did not worsen significantly despite spending 12 months caring for people with moderate physical and psychological dependence, the decrease in the burden was not maintained over time. Associated variables that can influence the burden over 6 months were the caregivers' baseline perception of lacking knowledge and/or having no difficulty with care tasks. The variable that could influence overburden in caregivers at 12 months was becoming ill before the intervention. CONCLUSIONS: For the first time, the effectiveness of home workers-specific training has been demonstrated: a reduction in the perceived burden was observed immediately following training completion, but this reduction was not sustained at 6/12 months. The practical interpretation is that a remedial/follow-up training course may be needed. Whether difficulty in providing care or having sufficient knowledge and having an illness influence self-care maintenance requires further verification.


Asunto(s)
Servicios de Atención de Salud a Domicilio , Calidad de Vida , Anciano , Ansiedad , Cuidadores , Humanos , Autocuidado
16.
Horiz. sanitario (en linea) ; 20(3): 417-425, sep.-dic. 2021. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1506341

RESUMEN

Resumen Objetivo: Evaluar el estado nutricional de estudiantes universitarios para proponer recomendaciones adecuadas de alimentación, con la finalidad de prevenir la COVID-19. Materiales y Métodos: Los alumnos participantes fueron evaluados mediante un estudio transversal, se diseñaron y aplicaron encuestas de frecuencia de consumo de alimentos semanal, con la finalidad de obtener información relacionada con hábitos alimenticios y sintomatología; la evaluación antropométrica y la toma de muestras sanguíneas para la realización de hemograma se realizaron bajo la normatividad ética estandarizada. Para el análisis estadístico de los datos se aplicó un modelo de regresión logística multifactorial utilizando para ello el programa EPI INFOTM. Adicionalmente, se realizó una revisión de la literatura en base de datos con relación a los nutrientes adecuados y recomendados para prevenir la COVID-19. Resultados: Se evaluó un grupo de 42 estudiantes universitarios (n=42) cuya edad oscila entre los 18 y 22 años de edad. Más del 95% de los jóvenes declararon consumir carbohidratos como su principal fuente de alimento; por otro lado, un 76% presentó un IMC dentro de los parámetros normales (19-24.9 Kg/m2). Se estimaron recuentos bajos de hemoglobina con una prevalencia del 11.90% entre el grupo participante. Conclusiones: La alimentación sigue siendo la clave para la salud y el bienestar del ser humano. Para mejorar el sistema inmunitario se recomienda el consumo variado de alimentos naturales, en lugar de alimentos con alto contenido de azúcares, harinas y grasas. Dentro de los alimentos con mayor potencial para la prevención de la COVID-19 se encuentran los frutos secos, los huevos, el pescado, los vegetales de hoja verde y los granos enteros. El consumo de fitoquímicos y nutracéuticos puede prevenir y fortalecer inmunológicamente al organismo para combatir la infección por SARS- CoV-2.


Abstract Objective: To evaluate the nutritional status of university students to propose the appropriate diet recommendations to prevent COVID-19 Materials and Methods: The participating students were evaluated using a cross- sectional study by feeding and symptoms through weekly food consumption frequency surveys; the anthropometric evaluation and the taking of blood samples were carried out under standardized ethical regulations. Statistical analysis was performed by multifactorial logistic regression analysis using the EPI INFO TM. A literature review was developed in a database where the appropriate nutrients to prevent COVID-19 are described. Results: A group of university students (n = 42) between 18 and 22 years old was evaluated. More than 95% of the young people declared consuming carbohydrates as their primary food source. On the other hand, 76% showed a BMI within normal parameters (19-24.9 Kg /m2). Low hemoglobin counts were estimated with a prevalence of 11.90% among the participating group. Conclusions: Food remains the key to human health and well-being. Consumption of phytochemicals and nutraceuticals can prevent and even treat SARS-CoV-2 infection. Among the foods with the most significant potential for preventing COVID-19 are nuts, eggs, fish, green leafy vegetables, and whole grains. The consumption of phytochemicals and nutraceuticals can prevent and even treat SARS-CoV-2 infection.

17.
Artículo en Inglés | MEDLINE | ID: mdl-34682519

RESUMEN

Being a parent is complicated in typical circumstances, with a great psychological impact as well as feelings and experiences of great intensity. This impact is greater in families in vulnerable situations, such as those with children with mental health problems, receiving treatment in a clinical setting. Due to these challenges, parenting in these circumstances is often accompanied by experiences of stress. An approach that has shown evidence of effectiveness in mitigating the negative impact of stress is mindfulness-based interventions, including the Mindfulness-Based Stress Reduction intervention program. The Mindfulness-Based Stress Reduction intervention program is designed as a psychoeducational, instructional, multimodal, and structured program whose main objective is to provide strategies for the management, coping, and awareness of stress in order to reduce it. In this paper, a protocol for the implementation and evaluation of the original Mindfulness-Based Stress Reduction intervention program with the added positive parenting component is presented, in order to systematize the incorporation of a parenting component in the Mindfulness-Based Stress Reduction intervention program, analyze its effectiveness for parents whose children have mental health problems (in terms of stress, mindfulness, emotional intelligence, general health, and parental role), explore the mechanisms of change operating in this intervention as perceived by the participants, and examine the application of acquired strategies to daily life.


Asunto(s)
Trastornos Mentales , Atención Plena , Adaptación Psicológica , Cuidadores , Niño , Humanos , Trastornos Mentales/terapia , Responsabilidad Parental , Estrés Psicológico/prevención & control
18.
Antioxidants (Basel) ; 10(3)2021 Mar 13.
Artículo en Inglés | MEDLINE | ID: mdl-33805753

RESUMEN

Preservation of the peritoneal membrane is an essential determinant of the long-term outcome of peritoneal dialysis (PD). Epithelial-to-mesenchymal transition (EMT) plays a central role in the pathogenesis of PD-related peritoneal membrane injury. We hypothesized that mitochondria may be implicated in the mechanisms that initiate and sustain peritoneal membrane damage in this setting. Hence, we carried out ex vivo studies of effluent-derived human mesothelial cells, which disclosed a significant increase in mitochondrial reactive oxygen species (mtROS) production and a loss of mitochondrial membrane potential in mesothelial cells with a fibroblast phenotype, compared to those preserving an epithelial morphology. In addition, in vitro studies of omentum-derived mesothelial cells identified mtROS as mediators of the EMT process as mitoTEMPO, a selective mtROS scavenger, reduced fibronectin protein expression induced by TGF-ß1. Moreover, we quantified mitochondrial DNA (mtDNA) levels in the supernatant of effluent PD solutions, disclosing a direct correlation with small solute transport characteristics (as estimated from the ratio dialysate/plasma of creatinine at 240 min), and an inverse correlation with peritoneal ultrafiltration. These results suggest that mitochondria are involved in the EMT that human peritoneal mesothelial cells suffer in the course of PD therapy. The level of mtDNA in the effluent dialysate of PD patients could perform as a biomarker of PD-induced damage to the peritoneal membrane.

19.
3 Biotech ; 11(2): 41, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33457170

RESUMEN

The emerging SARS-CoV-2 viral disease (COVID-19) has caused a global health alert due to its high rate of infection and mortality in individuals with chronic cardiovascular comorbidities, in addition to generating complex clinical conditions. This has forced the scientific community to explore different strategies that allow combating this viral infection as well as treating life-threatening systemic effect of the infection on the individual. In this work, we have reviewed the most recent scientific evidence to provide a comprehensive panorama regarding the biotechnological strategies that have been proposed to combat this new viral infection. We have focused our analysis on vaccine production, nanotechnology applications, repurposing of know drugs for unrelated pathologies, and the search for bioactive molecules obtained from natural products. The goals include safely use as potential prophylactic or therapeutic treatments, based on in silico and in vivo studies, including clinical trials around the world for the correct and timely diagnosis of the infection. This review aims to highlight the development of new ideas that can decrease the time lines for research output and improve research quality while at the same time, keeping in mind the efficacy and safety aspects of these potential biotechnological strategies.

20.
Blood Purif ; 50(3): 328-335, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33091904

RESUMEN

INTRODUCTION: Prior abdominal surgery may result in peritoneal membrane adhesions and fibrosis, compromising the success of peritoneal dialysis (PD). The impact of this factor on peritoneal membrane function and PD technique survival has not been adequately investigated. METHODS: Following an observational, retrospective design, we studied 171 incident PD patients, with the main objective of analyzing the influence of prior abdominal surgical procedures (main study variable) on baseline and evolutionary peritoneal transport characteristics (main outcome) and PD patient and technique survival (secondary outcomes). Abdominal surgeries were categorized according to the degree of presumed injury to the peritoneal membrane. We also considered the additive effect of aggressions to the membrane during the first year on PD therapy. RESULTS: All patients had a baseline peritoneal equilibration test with complete drainage at 60', and 113 patients had a second study at the end of the first year. Sixty-one patients (35.7%) had a record of prior abdominal surgery, including 29 patients with at least one major intraperitoneal surgery, 22 having undergone minor intraperitoneal procedures, and 21 with a background of major abdominopelvic extraperitoneal surgery. We did not observe differences, at baseline or after 1 year, among patients with or without previous abdominal procedures regarding small solute transport, overall capacity of ultrafiltration, free water transport, small pore ultrafiltration, or peritoneal protein excretion. Stratified analysis, considering prior and first-year-on-PD peritoneal aggressions, did not reveal any differences, although in this case our analysis was hampered by a limited statistical power. Abdominal surgical events did not influence patient or PD technique survival. CONCLUSION: Prior abdominal surgical procedures do not appear to compromise peritoneal membrane function or technique survival in patients successfully started on PD.


Asunto(s)
Abdomen/cirugía , Diálisis Peritoneal/métodos , Peritoneo/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Transporte Biológico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Peritoneo/cirugía , Estudios Retrospectivos , Adulto Joven
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