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1.
Sensors (Basel) ; 24(5)2024 Mar 01.
Article in English | MEDLINE | ID: mdl-38475155

ABSTRACT

Designing and deploying telecommunications and broadcasting networks in the challenging terrain of the Amazon region pose significant obstacles due to its unique morphological characteristics. Within low-power wide-area networks (LPWANs), this research study introduces a comprehensive approach to modeling large-scale propagation loss channels specific to the LoRaWAN protocol operating at 915 MHz. The objective of this study is to facilitate the planning of Internet of Things (IoT) networks in riverside communities while accounting for the mobility of end nodes. We conducted extensive measurement campaigns along the banks of Universidade Federal do Pará, capturing received signal strength indication (RSSI), signal-to-noise ratio (SNR), and geolocated point data across various spreading factors. We fitted the empirical close-in (CI) and floating intercept (FI) propagation models for uplink path loss prediction and compared them with the Okumura-Hata model. We also present a new model for path loss with dense vegetation. Furthermore, we calculated received packet rate statistics between communication links to assess channel quality for the LoRa physical layer (PHY). Remarkably, both CI and FI models exhibited similar behaviors, with the newly proposed model demonstrating enhanced accuracy in estimating radio loss within densely vegetated scenarios, boasting lower root mean square error (RMSE) values than the Okumura-Hata model, particularly for spreading factor 9 (SF9). The radius coverage threshold, accounting for node mobility, was 945 m. This comprehensive analysis contributes valuable insights for the effective deployment and optimization of LoRa-based IoT networks in the intricate environmental conditions of the Amazon region.

2.
Cureus ; 15(7): e41677, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37575841

ABSTRACT

Lithium salts (lithium) is a psychotropic drug widely used as a pharmacological option in managing bipolar disorder. Regular monitoring of serum levels is necessary due to the narrow therapeutic range of lithium. Typically, the diagnosis of lithium intoxication is based on the presence of elevated plasma levels. Nevertheless, poisoning can ensue from either acute ingestion or chronic use, even in patients with normal plasma levels. The utilization of lithium has been decreasing due to its potential for multiorgan toxicity. Lithium accumulation in renal distal tubular cells is a prevalent cause of acquired arginine vasopressin resistance (AVP-R), previously known as nephrogenic diabetes insipidus (DI). Some patients might also experience neurologic persistent symptoms after plasma level normalization, a condition known as the syndrome of irreversible lithium-effectuated neurotoxicity (SILENT). We present a case report of acquired AVP-R following prolonged lithium use. This case report aims to increase awareness, particularly among those who may be unfamiliar with the use of lithium and its associated adverse reactions. In addition, it seeks to highlight the dissociation between clinical manifestations and lithium plasma levels, emphasizing the need for careful evaluation in patients receiving lithium treatment.

3.
Arch Clin Cases ; 10(1): 1-6, 2023.
Article in English | MEDLINE | ID: mdl-36814677

ABSTRACT

IgA vasculitis (IgAV) is a small-vessel vasculitis common in children but rare in adults. It is usually an auto-limited disease in children but has a more severe course and worse prognosis in adults. The classical manifestations are non-thrombocytopenic purpura, arthralgias, gastrointestinal involvement and renal involvement. Herein we report a case of a 39-year-old man with a rash of the lower limbs associated with testicular and lower abdominal pain. The initial study revealed increased inflammatory biomarkers and enlarged left testis with bilateral ischemic areas on doppler ultrasound. A cutaneous biopsy later revealed leukocytoclastic vasculitis, confirming the diagnosis of IgAV with scrotal involvement. The patient started prednisolone, with improvement in the first week and sustained remission after two years of follow-up. This case report describes an adult with IgAV and scrotal involvement, which is rarely reported in adults and appears to be different from the one in children. The prevalence of scrotal involvement is presumably underestimated. In all men with IgAV, a scrotal examination should be performed and ultrasonography accordingly since it affects the treatment and follow-up. Recommendations for IgAV diagnosis and treatment in adults are still lacking and more research is needed.

4.
Cureus ; 15(1): e34029, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36814727

ABSTRACT

Whipple's disease (WD) is a rare multisystemic infectious disease caused by Tropheryma whipplei. The pathogenesis of Whipple's disease remains unknown and clinical experience relies solely on various case reports published in the literature. The disease may occur at any age, with most studies describing patients in their fifth decade. Classic WD mainly affects the gastrointestinal tract, but extraintestinal commitment can occur, with the most common manifestations being arthralgias, lymphadenopathy, fever, and neurological symptoms. We present a case of a 69-year-old woman who presented with fever, macular rash, abdominal pain, lymphadenopathy, pleural and pericardial effusion, weight loss, and severely altered mental status over seven days. Initial workup tests only revealed leucopenia, thrombocytopenia, and hyperferritinemia. Since the fever persisted despite antibiotic treatment, an extensive workup was required until the final diagnosis of classic WD through histological examination of duodenal biopsies. Treatment with ceftriaxone was implemented for two weeks, followed by trimethoprim-sulfamethoxazole 160/800mg bid for 12 months. The patient presented full recovery and no recurrence after three years of follow-up. Even though WD was first described more than a century ago, WD is an elusive disease with a wide variety of clinical findings, leading to a still significant delay in diagnosis. WD should be considered in the differential diagnosis of rheumatologic disorders, chronic abdominal pain or diarrhea, neurological manifestations not suggestive of any other specific disease, non-caseating granulomatous diseases, and cases of lymphadenopathies. The authors aim to add additional clinical data and raise awareness for a rare condition that can be lethal if not timely treated. More studies and recommendations are needed concerning screening patients and treatment, with an urgent need to improve the delay in diagnosis.

5.
Thorax ; 78(2): 169-175, 2023 02.
Article in English | MEDLINE | ID: mdl-35321941

ABSTRACT

BACKGROUND: The potential influence of thoracic ultrasound on clinical decision-making by physiotherapists has never been studied. The aim of this study was to assess the impact of thoracic ultrasound on clinical decision-making by physiotherapists for critical care patients. METHODS: This prospective, observational multicentre study was conducted between May 2017 and November 2020 in four intensive care units in France and Australia. All hypoxemic patients consecutively admitted were enrolled. The primary outcome was the net reclassification improvement (NRI), quantifying how well the new model (physiotherapist's clinical decision-making including thoracic ultrasound) reclassifies subjects as compared with an old model (clinical assessment). Secondary outcomes were the factors associated with diagnostic concordance and physiotherapy treatment modification. RESULTS: A total of 151 patients were included in the analysis. The NRI for the modification of physiotherapist's clinical decisions was-40% (95% CI (-56 to -22%), p=0.02). Among the cases in which treatment was changed after ultrasound, 41% of changes were major (n=38). Using a multivariate analysis, the physiotherapist's confidence in their clinical diagnosis was associated with diagnostic concordance (adjusted OR=3.28 95% CI (1.30 to 8.71); p=0.014). Clinical diagnosis involving non-parenchymal conditions and clinical signs reflecting abolished lung ventilation were associated with diagnostic discordance (adjusted OR=0.06 95% CI (0.01 to 0.26), p<0.001; adjusted OR=0.26 95% CI (0.09 to 0.69), p=0.008; respectively). CONCLUSION: Thoracic ultrasound has a high impact on the clinical decision-making process by physiotherapists for critical care patients. TRIAL REGISTRATION NUMBER: NCT02881814; https://clinicaltrials.gov.


Subject(s)
Physical Therapists , Humans , Prospective Studies , Critical Care , Physical Therapy Modalities , Clinical Decision-Making
6.
Eur J Case Rep Intern Med ; 9(11): 003637, 2022.
Article in English | MEDLINE | ID: mdl-36506733

ABSTRACT

A 71-year-old female presented with 5 days of diarrhoea and asthenia. Past medical history of rheumatoid arthritis, arterial hypertension, hypertrophic cardiomyopathy and chronic gastritis was treated with leflunomide, deflazacort, esomeprazole, carvedilol and spironolactone. At admission, the patient's physical examination showed signs of dehydration. Lab results revealed leucocytosis, increased C-reactive protein, hypomagnesaemia, hypocalcaemia and hypokalaemia. A presumption of acute infectious diarrhoea causing hypomagnesaemia with hypocalcaemia and hypokalaemia was made. She was started on ciprofloxacin, IV hydration and electrolyte supplementation with an adequate response. However, magnesium levels fell repeatedly. After excluding other causes for hypomagnesaemia, chronic use of proton pump inhibitors (PPIs) was considered a plausible cause therefore PPI was discontinued, with normalisation of magnesium levels. Hypomagnesaemia is a common disturbance, mainly caused by diarrhoea, gastrointestinal malabsorption, medications, alcoholism and volume expansion. Clinical manifestations include neuromuscular symptoms, cardiovascular manifestations, hypokalaemia and changes in calcium metabolism. PPI-related hypomagnesaemia has been described in later years particularly in chronic use cases, with a medium prevalence of 27%, but further studies remain necessary to clarify its pathophysiologic mechanism. Since PPIs are widely used, it is essential to be aware of hypomagnesaemia as a possible side effect, particularly in refractory cases and after excluding other common causes. LEARNING POINTS: PPIs-related hypomagnesaemia should be a concern, especially in cases with refractory hypomagnesaemia and after excluding other common causes.Formal indication for PPIs use should be revised in most patients.

9.
Eur J Immunol ; 52(1): 149-160, 2022 01.
Article in English | MEDLINE | ID: mdl-34695227

ABSTRACT

During the COVID-19 pandemic, Portugal has experienced three distinct SARS-CoV-2 infection waves. We previously documented the prevalence of SARS-CoV-2 immunity, measured by specific antibodies, in September 2020, 6 months after the initial moderate wave. Here, we show the seroprevalence changes 6 months later, up to the second week of March 2021, shortly following the third wave, which was one of the most severe in the world, and 2 months following the start of the vaccination campaign. A longitudinal epidemiological study was conducted, with a stratified quota sample of the Portuguese population. Serological testing was performed, including ELISA determination of antibody class and titers. The proportion of seropositives, which was 2.2% in September 2020, rose sharply to 17.3% (95% CI: 15.8-18.8%) in March 2021. Importantly, circulating IgG and IgA antibody levels were very stable 6 months after the initial determination and up to a year after initial infection, indicating long-lasting infection immunity against SARS-CoV-2. Moreover, vaccinated people had higher IgG levels from 3 weeks post-vaccination when compared with previously infected people at the same time post-infection.


Subject(s)
Antibodies, Viral/immunology , COVID-19 Serological Testing , COVID-19 , Immunoglobulin A/immunology , Immunoglobulin G/immunology , SARS-CoV-2/immunology , Adolescent , Adult , COVID-19/epidemiology , COVID-19/immunology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Portugal/epidemiology , Prevalence , Time Factors
10.
Mol Syst Biol ; 16(9): e9828, 2020 09.
Article in English | MEDLINE | ID: mdl-32939983

ABSTRACT

Essential genes tend to be highly conserved across eukaryotes, but, in some cases, their critical roles can be bypassed through genetic rewiring. From a systematic analysis of 728 different essential yeast genes, we discovered that 124 (17%) were dispensable essential genes. Through whole-genome sequencing and detailed genetic analysis, we investigated the genetic interactions and genome alterations underlying bypass suppression. Dispensable essential genes often had paralogs, were enriched for genes encoding membrane-associated proteins, and were depleted for members of protein complexes. Functionally related genes frequently drove the bypass suppression interactions. These gene properties were predictive of essential gene dispensability and of specific suppressors among hundreds of genes on aneuploid chromosomes. Our findings identify yeast's core essential gene set and reveal that the properties of dispensable essential genes are conserved from yeast to human cells, correlating with human genes that display cell line-specific essentiality in the Cancer Dependency Map (DepMap) project.


Subject(s)
Genes, Essential , Genes, Fungal , Saccharomyces cerevisiae/genetics , Suppression, Genetic , Aneuploidy , Evolution, Molecular , Gene Deletion , Gene Duplication , Gene Regulatory Networks , Genes, Suppressor , Multiprotein Complexes/metabolism
11.
Inorg Chem ; 59(17): 12722-12732, 2020 Sep 08.
Article in English | MEDLINE | ID: mdl-32838513

ABSTRACT

A small library of "half-sandwich" cyclopentadienylruthenium(II) compounds of the general formula [(η5-C5R5)Ru(PPh3)(N-N)][PF6], a scaffold hitherto absent from the toolbox of antiplasmodials, was screened for activity against the blood stage of CQ-sensitive 3D7-GFP, CQ-resistant Dd2, and artemisinin-resistant IPC5202 Plasmodium falciparum strains and the liver stage of Plasmodium berghei. The best-performing compounds displayed dual-stage activity, with single-digit nanomolar IC50 values against blood-stage malaria parasites, nanomolar activity against liver-stage parasites, and residual cytotoxicity against HepG2 and Huh7 mammalian cells. The parasitic absorption/distribution of 7-nitrobenzoxadiazole-appended fluorescent compounds Ru4 and Ru5 was investigated by confocal fluorescence microscopy, revealing parasite-selective absorption in infected erythrocytes and nuclear accumulation of both compounds. The lead compound Ru2 impaired asexual parasite differentiation, exhibiting fast parasiticidal activity against both ring and trophozoite stages of a synchronized culture of the P. falciparum 3D7 strain. These results point to cyclopentadienylruthenium(II) complexes as a highly promising chemotype for the development of dual-stage antiplasmodials.


Subject(s)
Antimalarials/chemistry , Antimalarials/pharmacology , Coordination Complexes/chemistry , Coordination Complexes/pharmacology , Cyclopentanes/chemistry , Ruthenium/chemistry , Drug Resistance/drug effects , Erythrocytes/drug effects , Hep G2 Cells , Humans , Oxadiazoles/chemistry , Plasmodium berghei/drug effects , Plasmodium falciparum/drug effects
13.
Pharm Biol ; 55(1): 1348-1357, 2017 Dec.
Article in English | MEDLINE | ID: mdl-28301958

ABSTRACT

CONTEXT: Several Polygonum species (Polygonaceae) are used in traditional medicine in Asia, Europe and Africa to treat inflammation and diabetes. OBJECTIVE: Evaluate the in vitro antioxidant, anti-inflammatory and antidiabetic potential of methanol and dichloromethane extracts of leaves and roots of the halophyte Polygonum maritimum L. MATERIAL AND METHODS: Antioxidant activity was determined (up to 1 mg/mL) as radical-scavenging activity (RSA) of 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS), copper (CCA) and iron (ICA) chelating activities and iron reducing power (FRAP). NO production was measured in lipopolysaccharide (LPS)-stimulated macrophages for 24 h at concentrations up to 100 µg/mL and antidiabetic potential was assessed by α-amylase and α-glucosidase inhibition (up to 10 mg/mL) assays. The phytochemical composition of the extracts was determined by gas chromatography-mass spectrometry (GC-MS). RESULTS: The methanol leaf extract had the highest activity against DPPH• (IC50 = 26 µg/mL) and ABTS+• (IC50 = 140 µg/mL), FRAP (IC50 = 48 µg/mL) and CCA (IC50 = 770 µg/mL). Only the dichloromethane leaf extract (LDCM) showed anti-inflammatory activity (IC50 = 48 µg/mL). The methanol root (IC50 = 19 µg/mL) and leaf (IC50 = 29 µg/mL) extracts strongly inhibited baker's yeast α-glucosidase, but LDCM had higher rat's α-glucosidase inhibition (IC50 = 2527 µg/mL) than acarbose (IC50 = 4638 µg/mL). GC-MS analysis identified ß-sitosterol, stigmasterol, 1-octacosanol and linolenic acid as possible molecules responsible for the observed bioactivities. CONCLUSIONS: Our findings suggest P. maritimum as a source of high-value health promoting commodities for alleviating symptoms associated with oxidative and inflammatory diseases, including diabetes.


Subject(s)
Anti-Inflammatory Agents/pharmacology , Hypoglycemic Agents/pharmacology , Plant Extracts/pharmacology , Polygonum , Animals , Antioxidants/pharmacology , Cell Survival/drug effects , Cells, Cultured , Gas Chromatography-Mass Spectrometry , Mice , Phytochemicals/analysis , Polygonum/chemistry , Rats
14.
Med Microbiol Immunol ; 206(2): 111-123, 2017 Apr.
Article in English | MEDLINE | ID: mdl-27987042

ABSTRACT

Infection with Burkholderia cepacia complex (Bcc) bacteria is a threat to cystic fibrosis (CF) patients, commonly leading to a fatal pneumonia, the cepacia syndrome. It causes a massive production of pro-inflammatory cytokines and leucocyte recruitment to airway epithelium without resolving infection and contributing to tissue lesion. To dissect how Bcc bacteria subvert the immune response, we developed a co-culture model with human dendritic cells (DCs) and B. cenocepacia clonal variants isolated from a chronically infected CF patient, who died with cepacia syndrome. We demonstrated that the two late variants were sevenfold and 17-fold (respectively) more internalized by DCs than the variant that initiated infection. The late variants showed improved survival within DCs (60.29 and 52.82 CFU/DC) compared to the initial variant (0.38 CFU/DC). All clonal isolates induced high expression of inflammatory cytokines IL-8, IL-6, IL-1ß, IL-12, IL-23, TNF-α and IL-1ß. This pro-inflammatory trait was significantly more pronounced in DCs infected with the late variants than in DCs infected with the variant that initiated patient's infection. All infected DCs failed to upregulate maturation markers, HLA-DR, CD80, CD86 and CD83. Nevertheless, these infected DCs activated approximately twice more T cells than non-infected DCs. Similar T cell activation was observable with respective conditioned media, suggesting a non-antigen-specific activation. Our data indicate that during prolonged infection, B. cenocepacia acquires ability to survive intracellularly, inducing inflammation, while refraining DC's maturation and stimulating non-antigen-specific T cell responses. The co-culture model here developed may be broadly applied to study B. cenocepacia-induced immunomodulation.


Subject(s)
Burkholderia Infections/etiology , Burkholderia cenocepacia , Cystic Fibrosis/complications , Cystic Fibrosis/immunology , Dendritic Cells/immunology , Opportunistic Infections , Biomarkers , Burkholderia Infections/diagnosis , Burkholderia Infections/microbiology , Burkholderia cenocepacia/immunology , Burkholderia cenocepacia/isolation & purification , Cell Differentiation/immunology , Cell Survival/immunology , Cystic Fibrosis/metabolism , Cytokines/biosynthesis , Cytokines/genetics , Dendritic Cells/cytology , Dendritic Cells/metabolism , Gene Expression , Humans , Immunophenotyping , Microbial Viability/immunology , Phagocytosis/immunology , Phenotype , T-Lymphocyte Subsets/immunology , T-Lymphocyte Subsets/metabolism
15.
Int J Biochem Cell Biol ; 69: 183-95, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26515125

ABSTRACT

Around 60-80% of all breast tumors are estrogen receptor-positive. One of the several therapeutic approaches used for this type of cancers is the use of aromatase inhibitors. Exemestane is a third-generation steroidal aromatase inhibitor that undergoes a complex and extensive metabolism, being catalytically converted into chemically active metabolites. Recently, our group showed that the major exemestane metabolites, 17ß-hydroxy-6-methylenandrosta-1,4-dien-3-one and 6-(hydroxymethyl)androsta-1,4,6-triene-3,17-dione, as well as, the intermediary metabolite 6ß-Spirooxiranandrosta-1,4-diene-3,17-dione, are potent aromatase inhibitors in breast cancer cells. In this work, in order to better understand the biological mechanisms of exemestane in breast cancer and the effectiveness of its metabolites, it was investigated their effects in sensitive and acquired-resistant estrogen receptor-positive breast cancer cells. Our results indicate that metabolites induced, in sensitive breast cancer cells, cell cycle arrest and apoptosis via mitochondrial pathway, involving caspase-8 activation. Moreover, metabolites also induced autophagy as a promoter mechanism of apoptosis. In addition, it was demonstrated that metabolites can sensitize aromatase inhibitors-resistant cancer cells, by inducing apoptosis. Therefore, this study indicates that exemestane after metabolization originates active metabolites that suppress the growth of sensitive and resistant breast cancer cells. It was also concluded that, in both cell lines, the biological effects of metabolites are different from the ones of exemestane, which suggests that exemestane efficacy in breast cancer treatment may also be dependent on its metabolites.


Subject(s)
Androstadienes/pharmacology , Antineoplastic Agents/pharmacology , Apoptosis/drug effects , Autophagy/drug effects , Receptors, Estrogen/metabolism , Breast Neoplasms , Cell Proliferation , Cell Shape/drug effects , Cell Survival , Drug Screening Assays, Antitumor , Female , Humans , MCF-7 Cells , Membrane Potential, Mitochondrial/drug effects , Testosterone/pharmacology
16.
Life Sci ; 137: 133-41, 2015 Sep 15.
Article in English | MEDLINE | ID: mdl-26231695

ABSTRACT

AIMS: It is well known that in the aging process a variety of physiological functions such as cardiac physiology and energy metabolism decline. Imbalance in production and elimination of reactive oxygen species (ROS) may induce oxidative stress. Research shows that oxidative stress is an important factor in the aging process. Studies suggest that É·-3 polyunsaturated fatty acids (PUFAs) and moderate physical exercise modulate the ROS system. Therefore, the present study aimed to investigate whether É·-3 present in fish oil supplementation coupled with moderate physical training could improve antioxidant and metabolic enzymes in the hearts of adult and aged rats and, if these effects could be associated to glycemia, plasma lipid profile or murinometric parameters. MAIN METHODS: Adult (weighing 315.1±9.3g) and aged rats (weighing 444.5±11.8g) exercised and receive fish oil supplementation for 4weeks. Then they were used to evaluate murinometric parameters, fasting glucose and lipid profile. After this, their hearts were collected to measure the levels of malondialdehyde (MDA), antioxidant enzyme activity (superoxide dismutase-SOD, catalase-CAT, glutathione peroxidase-GPx) and oxidative metabolism marker (citrate synthase-CS activity). KEY FINDINGS: Fish oil supplementation increases HDL concentration and activity of CAT and CS. Moreover, physical training coupled with fish oil supplementation induces additional effects on SOD, GPx and CS activity mainly in aged rats. SIGNIFICANCE: Our data suggest that combined treatment in aged rat hearts improves the antioxidant capacities and metabolic enzyme that can prevent the deleterious effects of aging.


Subject(s)
Aging , Dietary Supplements , Fish Oils/pharmacology , Heart/drug effects , Myocardium/metabolism , Oxidative Stress/drug effects , Physical Conditioning, Animal/physiology , Aging/drug effects , Animals , Antioxidants/pharmacology , Blood Glucose/metabolism , Body Weight , Catalase/metabolism , Citrate (si)-Synthase/metabolism , Glutathione Peroxidase/metabolism , Lipids/blood , Male , Malondialdehyde/metabolism , Rats , Superoxide Dismutase/metabolism
17.
Saúde Soc ; 24(2): 486-500, Apr-Jun/2015.
Article in Portuguese | LILACS | ID: lil-749044

ABSTRACT

A partir da análise da literatura sobre a abordagem do empoderamento do paciente no campo da diabetologia, discute-se o impacto dessa perspectiva sobre os significados das transformações nas relações de cuidado, explorando as implicações para a posição ocupada por profissionais da saúde e pacientes. Consideram-se as dificuldades e os incômodos apontados pelos profissionais da saúde frente às mudanças requeridas pelo empoderamento do paciente. Esses dados são problematizados por meio de um enfoque antropológico, apoiando-se nas elaborações sobre o contraste entre a lógica da escolha e a lógica do cuidado, e considerando a diferença entre as representações dos agentes da biomedicina e dos pacientes a partir da oposição entre os modelos indivíduo/pessoa. O percurso analítico é concluído com a constatação da necessidade de relativizar a ideia de que o empoderamento do paciente representa o incremento do individualismo nas relações de assistência à saúde, o que contribui para matizar as reflexões que os cientistas sociais têm desenvolvido acerca da tendência atual de atribuir ao indivíduo a responsabilidade pela própria saúde.


Based on an analysis of the literature on patient empowerment in the field of diabetology, I discuss the impact of this perspective on the meanings of changes in the relations of care, and explore implications to the position occupied by health professionals and patients. The analysis considers the difficulties and embarrassments mentioned by health professionals regarding the changes that are required by patient empowerment. Through an anthropological approach, the analysis is supported by theoretical conceptions about the contrast between the logic of choice and the logic of care, and problematizes the difference among the representations of biomedicine agents and patients, based on the opposition between the individual/person models. The analytical course allows to conclude that it is necessary to relativize the idea that patient empowerment represents an increase in individualism in health care relationships. This contributes to include other nuances in the social scientists' reflections on the current tendency of attributing to individuals the responsibility for their own health.


Subject(s)
Humans , Male , Female , Delivery of Health Care , Diabetes Mellitus , Health Personnel , Power, Psychological , Health Promotion , Professional-Patient Relations , Anthropology, Medical , Life Style
18.
Eur J Med Chem ; 87: 336-45, 2014 Nov 24.
Article in English | MEDLINE | ID: mdl-25277066

ABSTRACT

Exemestane is a third-generation steroidal aromatase inhibitor that has been used in clinic for hormone-dependent breast cancer treatment in post-menopausal women. It is known that exemestane undergoes a complex metabolization, giving rise to some already identified metabolites, the 17ß-hydroxy-6-methylenandrosta-1,4-dien-3-one (17-ßHE) and the 6-(hydroxymethyl)androsta-1,4,6-triene-3,17-dione (6-HME). In this study, four metabolites of exemestane have been analyzed, three of them were synthesized (6ß-spirooxiranandrosta-1,4-diene-3,17-dione (2), 1α,2α-epoxy-6-methylenandrost-4-ene-3,17-dione (3) and 17-ßHE (4)) while one was acquired, the 6-HME (6). The stereochemistry of the epoxide group of 2 and 3 has been unequivocally elucidated for the first time on the basis of NOESY experiments. New structure-activity relationships (SAR) have been established through the observation that the substitution of the double bonds by epoxide groups led to less potent derivatives in microsomes. However, the reduction of the C-17 carbonyl group to a hydroxyl group originating 17-ßHE (4) resulted in a significant increase in activity in MCF-7aro cells when compared to exemestane (IC50 0.25 µM vs 0.90 µM, respectively). All the studied metabolites reduced MCF-7aro cells viability in a dose and time-dependent manner, and metabolite 3 was the most potent one. Altogether our results showed that not only exemestane but also its main metabolites are potent aromatase inhibitors and reduce breast cancer cells viability. This suggests that exemestane efficacy may also be due to the active metabolites that result from its metabolic transformation. Our results emphasize the importance of performing further studies to expand our understanding of exemestane actions in breast cancer cells.


Subject(s)
Androstadienes/chemical synthesis , Androstadienes/pharmacology , Aromatase Inhibitors/chemical synthesis , Aromatase Inhibitors/pharmacology , Breast Neoplasms/pathology , Receptors, Estrogen/metabolism , Androstadienes/chemistry , Aromatase Inhibitors/chemistry , Breast Neoplasms/metabolism , Cell Proliferation/drug effects , Cell Survival/drug effects , Chemistry Techniques, Synthetic , Dose-Response Relationship, Drug , Estradiol/pharmacology , Humans , MCF-7 Cells , Stereoisomerism , Structure-Activity Relationship , Time Factors
19.
Psicol. soc. (Online) ; 26(2): 483-495, maio-ago. 2014.
Article in Portuguese | LILACS | ID: lil-720925

ABSTRACT

Investigamos a produção de identidades no contexto autogestionário, visando as relações entre a inserção nesse contexto e a construção da identidade de cidadão. A pesquisa foi realizada com sócios de uma cooperativa de reciclagem situada em Joinville. Foram realizadas entrevistas individuais semiestruturadas acerca da história de vida dos participantes e de conceitos como cidadania, política, participação e cooperativismo. Os dados foram analisados a partir da categorização das falas. Buscou-se, através da identificação dos sentidos atribuídos, levantar indícios da influência da inserção na cooperativa sobre a construção da cidadania enquanto constituinte da identidade dos cooperados. Observou-se que a inserção na cooperativa promoveu a participação nos espaços de luta política e o aprofundamento do vínculo com a comunidade. Contudo, esta luta mostrou-se significativa somente quando os interesses da cooperativa estavam em jogo. Acredita-se que isto ocorre porque a cooperativa é investida de afeto pelos cooperados, tornando-se parte de suas identidades.


Investigamos la producción de identidades en el contexto de autogestión, buscando relaciones entre inserción en este contexto y construcción de identidad. Se realizaron entrevistas individuales semiestructuradas sobre historia de vida y conceptos como ciudadanía, política, participación y cooperación con los miembros de una cooperativa de reciclaje ubicada en Joinville. Se analizaron los datos en base a la categorización de expresiones. Se buscó, mediante la identificación de los sentidos asignados, recaudar evidencias de la influencia de su inclusión en la cooperativa y la construcción de la ciudadanía como un constituyente de la identidad. Se observó que la inclusión promovió la participación en espacios de lucha política y profundizó el vínculo con la comunidad. Sin embargo, esta lucha fue significativa sólo cuando los intereses de la cooperativa estaban en juego. Se cree que esto se debe a que la cooperativa es investida de afecto, pasando a formar parte de la identidad.


We study on the production of identities in the context of self-managed, aiming to analyze the correlations between the insertion in this context and the building of the citizen identity. The survey was conducted with members of a cooperative recycling in Joinville. Semi-structured interviews about the life history of the participants were performed, discussing concepts such as citizenship, politics, participation and cooperative. From the categorization of speeches we sought to raise evidence of the influence of inclusion in the cooperative on the construction of citizenship as a constituent of the identity of members. It was observed that the inclusion in the cooperative promoted the participation in the spaces of political struggle, deepening the bond with the community. However, this fight was significant only when the cooperative's interests were at stake. We believed that this occurs because the cooperative is vested with affection for the members, becoming part of their identities.


Subject(s)
Humans , Male , Female , Community Participation , Self-Management , Social Identification , Cooperative Behavior , Economics , Recycling/economics
20.
Psicol. soc. (online) ; 26(2): 483-495, maio-ago. 2014.
Article in Portuguese | Index Psychology - journals | ID: psi-66788

ABSTRACT

Investigamos a produção de identidades no contexto autogestionário, visando as relações entre a inserção nesse contexto e a construção da identidade de cidadão. A pesquisa foi realizada com sócios de uma cooperativa de reciclagem situada em Joinville. Foram realizadas entrevistas individuais semiestruturadas acerca da história de vida dos participantes e de conceitos como cidadania, política, participação e cooperativismo. Os dados foram analisados a partir da categorização das falas. Buscou-se, através da identificação dos sentidos atribuídos, levantar indícios da influência da inserção na cooperativa sobre a construção da cidadania enquanto constituinte da identidade dos cooperados. Observou-se que a inserção na cooperativa promoveu a participação nos espaços de luta política e o aprofundamento do vínculo com a comunidade. Contudo, esta luta mostrou-se significativa somente quando os interesses da cooperativa estavam em jogo. Acredita-se que isto ocorre porque a cooperativa é investida de afeto pelos cooperados, tornando-se parte de suas identidades.(AU)


Investigamos la producción de identidades en el contexto de autogestión, buscando relaciones entre inserción en este contexto y construcción de identidad. Se realizaron entrevistas individuales semiestructuradas sobre historia de vida y conceptos como ciudadanía, política, participación y cooperación con los miembros de una cooperativa de reciclaje ubicada en Joinville. Se analizaron los datos en base a la categorización de expresiones. Se buscó, mediante la identificación de los sentidos asignados, recaudar evidencias de la influencia de su inclusión en la cooperativa y la construcción de la ciudadanía como un constituyente de la identidad. Se observó que la inclusión promovió la participación en espacios de lucha política y profundizó el vínculo con la comunidad. Sin embargo, esta lucha fue significativa sólo cuando los intereses de la cooperativa estaban en juego. Se cree que esto se debe a que la cooperativa es investida de afecto, pasando a formar parte de la identidad.(AU)


We study on the production of identities in the context of self-managed, aiming to analyze the correlations between the insertion in this context and the building of the citizen identity. The survey was conducted with members of a cooperative recycling in Joinville. Semi-structured interviews about the life history of the participants were performed, discussing concepts such as citizenship, politics, participation and cooperative. From the categorization of speeches we sought to raise evidence of the influence of inclusion in the cooperative on the construction of citizenship as a constituent of the identity of members. It was observed that the inclusion in the cooperative promoted the participation in the spaces of political struggle, deepening the bond with the community. However, this fight was significant only when the cooperative's interests were at stake. We believed that this occurs because the cooperative is vested with affection for the members, becoming part of their identities.(AU)


Subject(s)
Community Participation , Cooperative Behavior , Recycling
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