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1.
Cad. Ibero-Am. Direito Sanit. (Online) ; 13(3): 26-41, jul.-set.2024.
Artículo en Portugués | LILACS | ID: biblio-1571906

RESUMEN

Objetivo: O presente estudo visa a compreender como a judicialização da saúde se desenvolve como um fenômeno global, com ênfase particular nos contextos da América Latina, considerando Brasil e Colômbia. Metodologia: Adotou-se uma metodologia de revisão de literatura apoiada pela ferramenta Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A pesquisa foi conduzida com descritores específicos e as estratégias de busca foram realizadas nas bases de dados PubMed, MEDLINE, Lilacs, SciELO, CRD, CDSR, BVS e BIREME. Foram selecionados artigos publicados entre 2010 e 2024 que discutem a judicialização da saúde, considerando os idiomas português, espanhol ou inglês. Resultados: A busca resultou em 455 artigos e, destes, 18 artigos atenderam aos critérios de inclusão. A análise dos artigos selecionados revela a necessidade de soluções equilibradas que respeitem os direitos individuais sem comprometer a acessibilidade e qualidade dos cuidados de saúde coletivos. São destacados os desafios impostos pela judicialização, como questões de equidade, sustentabilidade financeira dos sistemas de saúde e priorização de recursos. Conclusão: Conclui-se pela importância de uma abordagem multidisciplinar envolvendo ajustes legislativos, melhorias na gestão dos sistemas de saúde, educação para a saúde e a promoção de políticas públicas equitativas.


Objective: The present study aims to understand how the judicialization of health develops as a global phenomenon, with particular emphasis on Latin American contexts, considering Brazil, and Colombia. Methodology: A literature review methodology supported by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses tool was adopted. The research was conducted using specific descriptors, and search strategies were carried out in the PubMed, MEDLINE, Lilacs, SciELO, CRD, CDSR, BVS, and BIREME databases. Articles published between 2010 and 2024 that discuss the judicialization of health, considering Portuguese, Spanish, or English languages, were selected. Results: The search resulted in 455 articles, of which 18 met the inclusion criteria. The analysis of the selected articles reveals the need for balanced solutions that respect individual rights without compromising the accessibility and quality of collective healthcare. The challenges imposed by judicialization are highlighted, such as issues of equity, financial sustainability of health systems, and resource prioritization. Conclusion: It concludes by emphasizing the importance of a multidisciplinary approach involving legislative adjustments, improvements in health system management, health education, and the promotion of equitable public policies.


Objetivo: El presente estudio tiene como objetivo comprender cómo se desarrolla la judicialización de la salud como un fenómeno global, con un énfasis particular en los contextos de América Latina, considerando Brasil y Colombia. Metodología: Se adoptó una metodología de revisión de literatura respaldada por la herramienta Preferred Reporting Items for Systematic Reviews and Meta-Analyses. La investigación se realizó utilizando descriptores específicos y las estrategias de búsqueda se llevaron a cabo en las bases de datos PubMed, MEDLINE, Lilacs, SciELO, CRD, CDSR, BVS y BIREME. Se seleccionaron artículos publicados entre 2010 y 2024 que discuten la judicialización de la salud, considerando los idiomas portugués, español o inglés. Resultados: La búsqueda resultó en 455 artículos, de los cuales 18 cumplieron con los criterios de inclusión. El análisis de los artículos seleccionados revela la necesidad de soluciones equilibradas que respeten los derechos individuales sin comprometer la accesibilidad y la calidad de la atención sanitaria colectiva. Se destacan los desafíos impuestos por la judicialización, como cuestiones de equidad, sostenibilidad financiera de los sistemas de salud y priorización de recursos. Conclusión: Se concluye sobre la importancia de un enfoque multidisciplinario que involucre ajustes legislativos, mejoras en la gestión de los sistemas de salud, educación para la salud y la promoción de políticas públicas equitativas.


Asunto(s)
Derecho Sanitario
2.
Bioelectrochemistry ; 160: 108795, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-39146929

RESUMEN

E6 and E7 oncogenes are pivotal in the carcinogenic transformation in HPV infections and efficient diagnostic methods can ensure the detection and differentiation of HPV genotype. This study describes the development and validation of an electrochemical, label-free genosensor coupled with a microfluidic system for detecting the E6 and E7 oncogenes in cervical scraping samples. The nanostructuring employed was based on a cysteine and graphene quantum dots layer that provides functional groups, surface area, and interesting electrochemical properties. Biorecognition tests with cervical scraping samples showed differentiation in the voltammetric response. Low-risk HPV exhibited a lower biorecognition response, reflected in ΔI% values of 82.33 % ± 0.29 for HPV06 and 80.65 % ± 0.68 for HPV11 at a dilution of 1:100. Meanwhile, high-risk, HPV16 and HPV18, demonstrated ΔI% values of 96.65 % ± 1.27 and 93 % ± 0.026, respectively, at the same dilution. Therefore, the biorecognition intensity followed the order: HPV16 >HPV18 >HPV06 >HPV11. The limit of detection and the limit of quantification of E6E7 microfluidic LOC-Genosensor was 26 fM, and 79.6 fM. Consequently, the E6E7 biosensor is a valuable alternative for clinical HPV diagnosis, capable of detecting the potential for oncogenic progression even in the early stages of infection.


Asunto(s)
Técnicas Biosensibles , Proteínas Oncogénicas Virales , Técnicas Biosensibles/métodos , Humanos , Proteínas Oncogénicas Virales/genética , Femenino , Límite de Detección , Proteínas E7 de Papillomavirus/genética , Cuello del Útero/virología , Grafito/química , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/virología , Técnicas Electroquímicas/métodos , Proteínas Represoras/genética , Técnicas Analíticas Microfluídicas/métodos , Técnicas Analíticas Microfluídicas/instrumentación , Puntos Cuánticos/química , Dispositivos Laboratorio en un Chip , Papillomaviridae/genética , Papillomaviridae/aislamiento & purificación
3.
Anal Methods ; 16(22): 3539-3550, 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38780022

RESUMEN

Dengue virus (DENV) is the most prevalent global arbovirus, exhibiting a high worldwide incidence with intensified severity of symptoms and alarming mortality rates. Faced with the limitations of diagnostic methods, an optical and electrochemical biosystem was developed for the detection of DENV genotypes 1 and 2, using cysteine (Cys), cadmium telluride (CdTe) quantum dots, and anti-DENV antibodies. Cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), surface plasmon resonance (SPR), atomic force microscopy (AFM), and Fourier transform infrared spectroscopy (FTIR) were employed to characterize the immunosensor. The AFM and SPR results demonstrated discernible topographic and angular changes confirming the biomolecular recognition. Different concentrations of DENV-1 and DENV-2 were evaluated (0.05 × 106 to 2.0 × 106 PFU mL-1), resulting in a maximum anodic shift (ΔI%) of 263.67% ± 12.54 for DENV-1 and 63.36% ± 3.68 for DENV-2. The detection strategies exhibited a linear response to the increase in viral concentration. Excellent linear correlations, with R2 values of 0.95391 for DENV-1 and 0.97773 for DENV-2, were obtained across a broad concentration range. Data analysis demonstrated high reproducibility, displaying relative standard deviation values of 3.42% and 3.62% for Cys-CdTe-antibodyDENV-1-BSA and Cys-CdTe-antibodyDENV-2-BSA systems. The detection limits were 0.34 × 106 PFU mL-1 and 0.02 × 106 PFU mL-1, while the quantification limits were set at 1.49 × 106 PFU mL-1 and 0.06 × 106 PFU mL-1 for DENV-1 and DENV-2, respectively. Therefore, the biosensing apparatus demonstrates analytical effectiveness in viral screening and can be considered an innovative solution for early dengue diagnosis, contributing to global public health.


Asunto(s)
Técnicas Biosensibles , Virus del Dengue , Dengue , Telurio , Virus del Dengue/aislamiento & purificación , Virus del Dengue/inmunología , Técnicas Biosensibles/métodos , Telurio/química , Humanos , Dengue/diagnóstico , Técnicas Electroquímicas/métodos , Técnicas Electroquímicas/instrumentación , Puntos Cuánticos/química , Resonancia por Plasmón de Superficie/métodos , Cisteína/química , Compuestos de Cadmio/química , Anticuerpos Antivirales/inmunología , Anticuerpos Antivirales/análisis , Inmunoensayo/métodos , Inmunoensayo/instrumentación , Límite de Detección , Microscopía de Fuerza Atómica
4.
Diagn Microbiol Infect Dis ; 109(2): 116227, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38503028

RESUMEN

The objective of this systematic review is to analyze the diagnostic accuracy of rapid dengue diagnostic tests. The search was conducted in the following databases: LILACS, Medline (Pubmed), CRD, The Cochrane Library, Trip Medical Database and Google Scholar. ELISA and PCR assays were adopted as reference methods. Thirty-four articles were included in this systematic review. Receiver operating characteristic (ROC) and Forest Plot were performed to evaluate sensitivity and specificity for each parameter analyzed (NS1, IgM and IgG). The results revealed that the combined analysis of the IgM antibody with the NS1 antigen resulted in greater sensitivity than the isolated analysis of IgM. The three analytes together showed the best performance, with a combined sensitivity of 90 % (95 % CI: 89-92 %) using ELISA as a comparator. Thus, the present review provides relevant knowledge for decision-making between the available rapid diagnostic tests.


Asunto(s)
Anticuerpos Antivirales , Dengue , Inmunoglobulina M , Sensibilidad y Especificidad , Humanos , Anticuerpos Antivirales/sangre , Cromatografía de Afinidad/métodos , Dengue/diagnóstico , Virus del Dengue/inmunología , Pruebas Diagnósticas de Rutina/métodos , Pruebas Diagnósticas de Rutina/normas , Ensayo de Inmunoadsorción Enzimática/métodos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Curva ROC , Proteínas no Estructurales Virales/inmunología , Proteínas no Estructurales Virales/sangre
5.
Adv Med Sci ; 69(1): 153-159, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38490331

RESUMEN

PURPOSE: New-onset diabetes after transplantation (NODAT) is a frequent metabolic complication associated with podocyte damage and renal allograft dysfunction. Thus, Wilm's tumor-1 (WT-1) protein, as a podocyte marker, holds promise as an option to evaluate renal allograft dysfunction in NODAT. Therefore, the study aimed to investigate urinary WT-1 levels in NODAT patients during the first year after kidney transplantation (KTx). MATERIALS AND METHODS: KTx patients were categorized into non-NODAT and NODAT groups. Fasting blood glucose, glycated hemoglobin (HbA1c), urinary albumin/creatinine ratio (ACR), serum creatinine, estimated glomerular filtration rate (eGFR), and urinary WT-1 were measured at 3, 6, 9, and 12-months post-KTx. RESULTS: The NODAT group manifested elevated levels of blood glucose and HbA1c during the first year post-KTx. Also, exhibited elevations in ACR and serum creatinine levels at 6, 9, and 12-months post-KTx when compared to non-NODAT group. Conversely, eGFR values in the NODAT group demonstrated significant declines at 3, 6, and 9-months post-KTx relative to non-NODAT. Furthermore, NODAT group exhibited a median annual eGFR of 47 â€‹mL/min/1.73 â€‹m2. Urinary WT-1 levels at 3, 6, 9, and 12-months post-KTx were significantly higher in the NODAT group compared to non-NODAT. Additionally, noteworthy positive correlations were identified between urinary WT-1 and HbA1c levels, along with significant negative correlations between urinary WT-1 and eGFR at the 3, 6, 9, and 12-months post-KTx. CONCLUSION: The increased urinary WT-1 levels from 3-months post-KTx in NODAT patients may indicate the first sign of podocyte injury, predicting a renal allograft dysfunction in these patients.


Asunto(s)
Diabetes Mellitus , Tasa de Filtración Glomerular , Trasplante de Riñón , Proteínas WT1 , Humanos , Trasplante de Riñón/efectos adversos , Masculino , Femenino , Persona de Mediana Edad , Adulto , Proteínas WT1/orina , Diabetes Mellitus/orina , Biomarcadores/orina , Biomarcadores/sangre , Aloinjertos , Pronóstico , Estudios de Seguimiento , Hemoglobina Glucada/metabolismo
6.
Data Brief ; 52: 109999, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38226035

RESUMEN

In the pursuit of advancing research in continuous user authentication, we introduce COUNT-OS-I and COUNT-OS-II, two distinct performance counter datasets from Windows operating systems, crafted to bolster research in continuous user authentication. Encompassing data from 63 computers and users, the datasets offer rich, real-world insights for developing and evaluating authentication models. COUNT-OS-I spans 26 users in an IT department, capturing 159 attributes across diverse hardware and software environments over 26 h on average per user. COUNT-OS-II, on the other hand, encompasses 37 users with identical system configurations, recording 218 attributes per sample over a 48-hour period. Both datasets utilize pseudonymization to safeguard user identities while maintaining data integrity and statistical accuracy. The well-balanced nature of the data, confirmed by comprehensive statistical analysis, positions these datasets as reliable benchmarks for the continuous user authentication domain. Through their release, we aim to empower the development of robust, real-world applicable authentication models, contributing to enhanced system security and user trust.

7.
J Pharm Biomed Anal ; 235: 115606, 2023 Oct 25.
Artículo en Inglés | MEDLINE | ID: mdl-37544275

RESUMEN

Acute promyelocytic leukemia (APL) in children is associated with a favorable initial prognosis. However, minimal residual disease (MRD) follow-up remains poorly defined, and relapse cases are concerning due to their recurrent nature. Thus, we report two electrochemical flexible genosensors based on polypyrrole (PPy) and graphene quantum dots (GQDs) for label-free PML-RARα oncogene detection. Atomic force microscopy (AFM), scanning electron microscope (SEM), cyclic voltammetry (CV), and electrochemical impedance spectroscopy (EIS) were used to characterize the technological biosensor development. M7 and APLB oligonucleotide sequences were used as bioreceptors to detect oncogenic segments on chromosomes 15 and 17, respectively. AFM characterization revealed heterogeneous topographical surfaces with maximum height peaks for sensor layers when tested with positive patient samples. APLB/Genosensor exhibited a percentage change in anode peak current (ΔI) of 423 %. M7/Genosensor exhibited a ΔI of 61.44 % for more concentrated cDNA samples. The described behavior is associated with the biospecific recognition of the proposed biosensors. Limits of detection (LOD) of 0.214 pM and 0.677 pM were obtained for APLB/Genosensor and M7/Genosensor, respectively. The limits of quantification (LOQ) of 0.648 pM and 2.05 pM were estimated for APLB/Genosensor and M7/Genosensor, respectively. The genosensors showed reproducibility with a relative standard deviation of 7.12 % for APLB and 1.18 % for M7 and high repeatability (9.89 % for APLB and 1.51 % for M7). In addition, genetic tools could identify the PML-RARα oncogene in purified samples, plasmids, and clinical specimens from pediatric patients diagnosed with APL with high bioanalytical performance. Therefore, biosensors represent a valuable alternative for the clinical diagnosis of APL and monitoring of MRD with an impact on public health.


Asunto(s)
Grafito , Leucemia Promielocítica Aguda , Puntos Cuánticos , Humanos , Niño , Leucemia Promielocítica Aguda/diagnóstico , Leucemia Promielocítica Aguda/genética , Polímeros , Pirroles , Reproducibilidad de los Resultados
8.
Rev Col Bras Cir ; 50: e20233536, 2023.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-37222383

RESUMEN

Chronic ulcers of the lower limbs are common and recurrent, especially in the elderly population, they are disabling injuries that generate a great socioeconomic burden. This scenario encourages the development of new, low-cost therapeutic alternatives. The present study aims to describe the use of bacterial cellulose in the treatment of lower limb ulcers. This is an integrative literature review, carried out in the PubMed and Science Direct databases by associating the descriptors, with the inclusion criteria being clinical studies in the last 5 years, available in full in English, Portuguese and Spanish. Five clinical trials were analyzed and the main therapeutic effects obtained in the experimental groups that used bacterial cellulose dressings were a reduction in the area of the wounds, one of the studies showed a reduction of 44.18cm2 in the area of the wound, the initial lesions measured on average 89.46cm2 and at the end of the follow-up, they had an average of 45.28cm2, since the reduction in pain and the decrease in the number of exchanges were advantages described in all groups that used the BS. It is concluded that BC dressings are an alternative for the treatment of lower limb ulcers, their use also reduces operational costs related to the treatment of ulcers.


Asunto(s)
Úlcera de la Pierna , Úlcera , Anciano , Humanos , Extremidad Inferior , Materiales Biocompatibles , Celulosa
9.
Biotechnol Prog ; 39(3): e3334, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36795023

RESUMEN

This article developed a novel electrochemical immunosensor for the specific detection of aflatoxin B1 (AFB1). Amino-functionalized iron oxide nanoparticles (Fe3 O4 -NH2 ) were synthesized. Fe3 O4 -NH2 were chemically bound on self-assembly monolayers (SAMs) of mercaptobenzoic acid (MBA). Finally, polyclonal antibodies (pAb) were immobilized on Fe3 O4 -NH2 -MBA. The sensor system was evaluated through atomic force microscopy (AFM), cyclic voltammetry (CV), and electrochemical impedance spectroscopy (EIS). A reduction in the anodic and cathodic peak currents was observed after the assembly of the sensor platform. The charge transfer resistance (Rct ) was increased due to the electrically insulating bioconjugates. Then, the specific interaction between the sensor platform and AFB1 blocks the electron transfer of the [Fe(CN)6 ]3-/4- redox pair. The nanoimmunosensor showed a linear response range estimated from 0.5 to 30 µg/mL with a limit of detection (LOD) of 9.47 µg/mL and a limit of quantification (LOQ) of 28.72 µg/mL for AFB1 identification in a purified sample. In addition, a LOD of 3.79 µg/mL, a LOQ of 11.48 µg/mL, and a regression coefficient of 0.9891 were estimated for biodetection tests on peanut samples. The proposed immunosensor represents a simple alternative, successfully applied in detecting AFB1 in peanuts, and therefore, represents a valuable tool for ensuring food safety.


Asunto(s)
Arachis , Técnicas Biosensibles , Aflatoxina B1/análisis , Aflatoxina B1/química , Técnicas Biosensibles/métodos , Técnicas Electroquímicas/métodos , Inmunoensayo , Límite de Detección , Oro/química
10.
Talanta ; 256: 124285, 2023 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-36706502

RESUMEN

Systemic sclerosis (SSc) is a chronic, autoimmune disease that primarily affects connective tissue. SSc can be classified into limited cutaneous (lSSc) and diffuse cutaneous (dSSc). Oncostatin M receptor (sOSMR) is an important inflammatory biomarker expressed in the serum of patients with autoimmune diseases. A nanoengineered immunosensor surface was developed. The biosensor was composed of a conductive layer of polypyrrole, electrodeposited gold nanoparticles, and sOSMR protein for anti-human OSMR monoclonal antibody biorecognition. The electrochemical response evaluated by cyclic voltammetry and electrochemical impedance spectroscopy indicated the detection of the target analyte present in clinical samples from lSSc and dSSc patients. The voltammetric anodic shift for lSSc specimens was 82.7% ± 0.9-93.6% ± 3.2, and dSSc specimens was 118.7 ± 2.6 to 379.6 ± 2.6, revealing a differential diagnostic character for SSc subtypes. The sensor platform was adapted for identifying sOSMR, using anti-OSMR antibodies as bioreceptors. With a linear response range estimated from 0.005 to 500 pg mL-1 and a limit of detection of 0.42 pg mL-1, the sensing strategy demonstrated high sensitivity in identifying the human OSMR protein in clinical samples. The proposed biosensor is a promising and innovative tool for SSc-related biomarker research.


Asunto(s)
Técnicas Biosensibles , Nanopartículas del Metal , Esclerodermia Sistémica , Humanos , Autoanticuerpos , Biomarcadores , Oro , Inmunoensayo , Polímeros , Pirroles , Receptores de Oncostatina M , Esclerodermia Sistémica/diagnóstico , Técnicas Electroquímicas
11.
Braz. J. Pharm. Sci. (Online) ; 59: e22430, 2023. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1439530

RESUMEN

Abstract Lipoprotein monitoring is desirable in the management of medical conditions such as atherosclerotic cardiovascular disease and coronary artery disease, in which controlling the concentration of these chylomicrons is crucial. Current clinical methods are complex and present poor reproducibility between laboratories. For these reasons, recent guidelines discard the assessment of low-density lipoprotein cholesterol (LDL-C) as a routine analysis during lipid-lowering therapies. Concerning the importance of monitoring this parameter, the authors present an electrochemical immunosensor constructed from a simple and easy-to-reproduce platform that allows detecting and quantifying LDL nanoparticles directly from human serum samples. The performance of the biosensor was studied by scanning electron microscopy, cyclic voltammetry, and electrochemical impedance spectroscopy. The biosensing platform displays good stability and linearity between 30 mg dL-1 and 135 mg dL-1 with a detection limit of 20 mg dL-1. The proposed biosensor can be easily employed for monitoring LDL concentration in clinical treatments.


Asunto(s)
Transición de Fase , Lipoproteínas LDL/análisis , Microscopía Electrónica de Rastreo/métodos , Electroquímica/instrumentación , Espectroscopía Dieléctrica/métodos , Hipercolesterolemia/clasificación
12.
Braz. J. Pharm. Sci. (Online) ; 59: e22009, 2023. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1447565

RESUMEN

Abstract Oxazolidine derivatives (OxD) have been described as third-line antibiotics and antitumoral agents. The inclusion complexes based on cyclodextrin could improve the solubility and bioavailability of these compounds. A novel synthetic OxD was used, and its inclusion complexes were based on 2-hydroxy-beta-cyclodextrin (2-HPßCD). We conducted an in silico study to evaluate the interaction capacity between OxD and 2-HPßCD. Characterization studies were performed through scanning electron microscopy (SEM), Fourier-transformed infrared (FTIR), nuclear magnetic resonance spectroscopy (1H-NMR), X-ray diffraction (XRD), and thermal analyses. A kinetic study of the OxD was performed, including a cytotoxicity assay using peripheral blood mononuclear cells (PBMCs). The maximum increment of solubility was obtained at 70 mM OxD using 400 mM 2-HPßCD. SEM analyses and FTIR spectra indicated the formation of inclusion complexes. 1H-NMR presented chemical shifts that indicated 1:1 stoichiometry. Different thermal behaviors were obtained. The pharmacokinetic profile showed a short release time. Pure OxD and its inclusion complex did not exhibit cytotoxicity in PBMCs. In silico studies provided a foremost insight into the interactions between OxD and 2-HPßCD, including a higher solubility in water and an average releasing profile without toxicity in normal cells


Asunto(s)
Solubilidad/efectos de los fármacos , Ciclodextrinas/agonistas , Microscopía Electrónica de Rastreo/métodos , Espectroscopía de Resonancia Magnética/métodos , Espectroscopía Infrarroja por Transformada de Fourier/métodos , Espectroscopía de Protones por Resonancia Magnética/métodos , Antibacterianos/análisis
13.
Rev. bioét. (Impr.) ; 31: e3293PT, 2023. tab
Artículo en Portugués | LILACS | ID: biblio-1449533

RESUMEN

Resumo O objetivo deste artigo é analisar o perfil clínico-epidemiológico de crianças acompanhadas por um serviço de cuidados paliativos em um hospital pediátrico de referência no Ceará. Trata-se de estudo de coorte retrospectivo, quantitativo, do tipo série de casos, realizado com 56 pacientes de até 2 anos, 11 meses e 29 dias de idade. As doenças mais comuns foram as do sistema nervoso, circulatório, malformações congênitas, deformidades e anomalias cromossômicas. As condições incapacitantes graves e não progressivas foram o principal critério para inclusão na paliação. Na conferência familiar, a mãe esteve presente em 94,6% das ocasiões. O desfecho predominante foi óbito (58,9%), apresentando associação significativa com as doenças do aparelho circulatório, sistema nervoso, uso de dispositivo respiratório e ventilação mecânica, setor solicitante e cuidados paliativos. Conclui-se que os cuidados paliativos pediátricos não relacionados a crianças com câncer têm gerado uma nova demanda a nível hospitalar, exigindo uma equipe capacitada e sensível a essa nova realidade.


Abstract This study analyzes the clinical-epidemiological profile of children assisted by the palliative care services of a reference hospital in Ceará, Brazil. A retrospective, quantitative, case series cohort study was conducted with 56 patients aged up to 2 years, 11 months and 29 days. Nervous system and circulatory system diseases, congenital malformations, deformities, and chromosomal anomalies were the most common illnesses. Severe and non-progressive disabling conditions were the main criteria for inclusion in palliative care. As for family conference, the mother was present in 94.6% of the cases. Death (58.9%) was the main outcome, being associated with circulatory system and nervous system diseases, use of respiratory device and mechanical ventilation, requesting sector and palliative care. In conclusion, pediatric palliative care aimed at non-cancer patients has generated new hospital demands, requiring a trained team sensitive to this new reality.


Resumen Este artículo pretende analizar el perfil clínico-epidemiológico de los niños bajo cuidados paliativos en un hospital pediátrico de referencia en Ceará (Brasil). Este es un estudio de cohorte retrospectivo, cuantitativo, de tipo serie de casos, realizado con 56 pacientes de hasta 2 años, 11 meses y 29 días de edad. Las enfermedades más prevalentes fueron las del sistema nervioso y circulatorio, malformaciones congénitas, malformaciones y anomalías cromosómicas. Las condiciones incapacitantes severas y no progresivas fueron el criterio principal para incluir en paliación. En la conferencia familiar, la madre estuvo presente en el 94,6% de las ocasiones. El desenlace predominante fue la muerte (58,9%) asociada significativamente con enfermedades del sistema circulatorio, sistema nervioso, uso de aparato respiratorio y ventilación mecánica, sector demandante y cuidados paliativos. Los cuidados paliativos pediátricos no relacionados con niños con cáncer generan una nueva demanda a nivel hospitalario, requiriendo un equipo capacitado y sensible a esta nueva realidad.


Asunto(s)
Masculino , Femenino , Lactante , Lactante
14.
Rev. Col. Bras. Cir ; 50: e20233536, 2023. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1440934

RESUMEN

ABSTRACT Chronic ulcers of the lower limbs are common and recurrent, especially in the elderly population, they are disabling injuries that generate a great socioeconomic burden. This scenario encourages the development of new, low-cost therapeutic alternatives. The present study aims to describe the use of bacterial cellulose in the treatment of lower limb ulcers. This is an integrative literature review, carried out in the PubMed and Science Direct databases by associating the descriptors, with the inclusion criteria being clinical studies in the last 5 years, available in full in English, Portuguese and Spanish. Five clinical trials were analyzed and the main therapeutic effects obtained in the experimental groups that used bacterial cellulose dressings were a reduction in the area of the wounds, one of the studies showed a reduction of 44.18cm2 in the area of the wound, the initial lesions measured on average 89.46cm2 and at the end of the follow-up, they had an average of 45.28cm2, since the reduction in pain and the decrease in the number of exchanges were advantages described in all groups that used the BS. It is concluded that BC dressings are an alternative for the treatment of lower limb ulcers, their use also reduces operational costs related to the treatment of ulcers.


RESUMO As úlceras crônicas de membros inferiores são comuns e recorrentes principalmente na população idosa, são lesões incapacitantes e que geram grande ônus socioeconômico. Tal cenário incentiva o desenvolvimento de novas alternativas terapêuticas e de baixo custo. O presente estudo tem como objetivo descrever o uso da celulose bacteriana no tratamento de úlceras de membros inferiores. Trata-se de uma revisão integrativa da literatura, realizada nas bases de dados PubMed e Science Direct por meio da associação dos descritores, tendo como critério de inclusão estudos clínicos nos últimos 5 anos, disponíveis na integra em inglês, português e espanhol. Cinco ensaios clínicos foram analisados e os principais efeitos terapêuticos obtidos nos grupos experimentais que utilizaram os curativos de celulose bacteriana foram redução da área das feridas, um dos estudos apontou uma redução de 44,18cm2 da área da ferida, as lesões iniciais mediam em média 89,46cm2 e ao término do acompanhamento apresentaram uma média de 45,28cm2, já a redução da dor e diminuição do número de trocas foram vantagens descritas em todos os grupos que utilizaram a CB. Conclui-se que os curativos de CB são uma alternativa para o tratamento das úlceras de MMII, sua utilização reduz também os custos operacionais relacionados ao tratamento de úlceras.

15.
Arq. bras. neurocir ; 42(4): 282-287, 2023.
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1570909

RESUMEN

Background Animal models are commonly used to assess the efficacy of new materials to be employed in the surgical repair of a nerve injury. However, there is no published surgical repair protocol for sciatic nerve neurotmesis in rats. Objective To produce and evaluate a protocol for the tubing technique using a polyvinyl alcohol biofilm after sciatic nerve neurotmesis. Methods Eighteen rats were randomized into 3 groups (n » 6 per group): control group - CG, neurotmesis group - NG, and neurotmesis biofilm group - NBG. The NG and NBGanimals were submitted to neurotmesis of the sciatic nerve at 60 days of life, followed by suture of the nerve stumps; in the NBG, the animals had the suture involved by polyvinyl alcohol biofilm. A descriptive evaluation of the surgical technique was performed after the experimental period. The Shapiro-Wilk normality test was used for body weight, and analysis of variance (ANOVA) with Bonferroni posthoc (p < 0.05) was applied. Results All groups showed good repair of the skin and muscle sutures; however, 33.30% of the CG presented disruption of skin points. Furthermore, 16.70% of the stumps were not structurally aligned and 33.30% had neuromas in the NG, while in the NBG, all stumps were aligned and none of them had neuroma. Conclusions The present study was able to produce a protocol with high reproducibility in view of the mechanical stability, targeting of the nerve stumps, muscle healing, the low frequency of skin breakage and the low complexity level of the technique, and it can be used in future studies that aim to evaluate other biomaterials for nerve repair in rats.


Introdução Modelos animais são comumente utilizados para avaliar a eficácia de novos materiais a ser empregados no reparo cirúrgico de lesões nervosas. No entanto, não há protocolo de reparo cirúrgico publicado para neurotmese do nervo ciático em ratos. Objetivo Produzir e avaliar um protocolo para a técnica de tubulização usando um biofilme de álcool polivinílico após uma neurotmese do nervo ciático. Métodos Dezoito ratos foram randomizados em três grupos (n » 6 por grupo): grupo controle - GC, grupo neurotmese - GN e grupo neurotmese biofilme - GNB. Os animais do GN e do GNB foram submetidos à neurotmese do nervo ciático aos 60 dias de vida, seguida de sutura dos cotos do nervo; no GNB, os animais tiveram a sutura envolvida por biofilme de álcool polivinílico. Após o período experimental, foi realizada avaliação descritiva da técnica cirúrgica. Para o peso corporal, foi utilizado o teste de normalidade Shapiro-Wilk e aplicada a análise de variância (ANOVA) com posthoc de Bonferroni (p < 0,05). Resultados Todos os grupos apresentaram bom reparo de suturas de pele e musculares; porém, 33,30% do GC apresentou rompimento dos pontos da pele. Além disso, 16,70% dos cotos não estavam estruturalmente alinhados e 33,30% apresentavam neuromas no GN, enquanto todos os cotos estavam alinhados e nenhum apresentava neuroma no GNB. Conclusões O presente estudo foi capaz de produzir um protocolo com alta reprodutibilidade tendo em vista a estabilidade mecânica, direcionamento dos cotos nervosos, cicatrização muscular, a baixa frequência de rompimento da pele e o baixo nível de complexidade da técnica, podendo ser utilizado em estudos futuros que avaliem outros biomateriais para reparo de nervo em ratos.

16.
Eur J Clin Microbiol Infect Dis ; 41(9): 1191-1201, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35988010

RESUMEN

Rapid immunochromatographic tests are frequently used to diagnose dengue due to their easy use, low cost, and fast response. A high level of accuracy is essential for rapid diagnostic tests to support their large-scale use. Thus, this systematic review aims to evaluate the accuracy of rapid dengue diagnostic tests. The investigation was run through the following databases: LILACS, Medline (Pubmed), CRD, The Cochrane Library, Trip Medical Database, and Google Scholar. To solve difficulties, two independent reviewers performed document screening and selection. ELISA assay was adopted as a reference test because of several methodologic advantages. Seventeen articles were included accordingly, reckoning 6837 participating individuals. The receiver operating characteristic (ROC) and Forest Plot were conducted to evaluate the sensitivity and specificity for each analyzed parameter (anti-dengue IgM, IgG, and NS1 antigen). The risk of bias and quality of evidence were assessed as moderate using QUADAS-2 and Grading of Recommendations Assessment, Development, and Evaluation (GRADE), respectively. The sensitivity of IgM concerning the studied tests ranged from 13.8 to 90%, while that of NS1 ranged from 14.7 to 100% (95% CI). The antibodies with NS1 presented increased sensitivity; pooled data show that the association of the three analytes bestows the best result, with a combined sensitivity of 90% (CI 95%: 87-92%) and a pooled specificity of 89% (CI 95%: 87-92%). Thus, the present review provides relevant knowledge for decision-making between available rapid diagnostic tests.


Asunto(s)
Pruebas Diagnósticas de Rutina , Pruebas Diagnósticas de Rutina/métodos , Ensayo de Inmunoadsorción Enzimática/métodos , Humanos , Inmunoglobulina M , Curva ROC , Sensibilidad y Especificidad
17.
Bioelectrochemistry ; 147: 108176, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35779517

RESUMEN

The present research refers to elaborating a new label-free electrochemical biosensor used to detect the BCR/ABL fusion gene. We used a hybrid nanocomposite composed of chitosan and zinc oxide nanoparticles (Chit-ZnONP) immobilized on a polypyrrole (PPy) film. DNA segments were covalently immobilized, allowing biomolecular recognition. Atomic force microscopy (AFM), cyclic voltammetry (CV), and electrochemical impedance spectroscopy (EIS) were used to evaluate the assembly stages of the biosensor. The biosensor's analytical performance was investigated using recombinant plasmids containing the target oncogene and clinical samples from patients with chronic myeloid leukemia (CML). A limit of detection (LOD) of 1.34 fM, limit of quantification (LOQ) of 4.08 fM, and sensitivity of 34.03 µA fM-1 cm2 were calculated for the BCR/ABL fusion oncogene. The sensing system exhibited high specificity, selectivity, and reproducibility with a standard deviation (SD) of 4.21%. Additionally, a linear response range was observed between 138.80 aM to 13.88 pM with a regression coefficient of 0.96. Also, the biosensor shows easy operationalization and fast analytical response, contributing to the early cancer diagnosis. The proposed nanostructured device is an alternative for the genetic identification BCR/ABL fusion gene.


Asunto(s)
Técnicas Biosensibles , Leucemia Mielógena Crónica BCR-ABL Positiva , Nanocompuestos , Técnicas Biosensibles/métodos , ADN/genética , Técnicas Electroquímicas/métodos , Humanos , Leucemia Mielógena Crónica BCR-ABL Positiva/diagnóstico , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , Nanocompuestos/química , Polímeros/química , Pirroles , Reproducibilidad de los Resultados
18.
Molecules ; 27(14)2022 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-35889418

RESUMEN

The fungus Aspergillus flavus causes serious damage to maize grains and its by-products, such as tortilla. Currently, animal and plant derivatives, such as chitosan and propolis, and plant extract residues, respectively, are employed as alternatives of synthetic fungicides. The objective of this research was to evaluate the efficacy of several formulations based on propolis-chitosan-pine resin extract on the in vitro growth of A. flavus, the growth of maize grain plantlets and the quality of stored tortillas at 4 and 28 °C. The most outstanding formulation was that based on 59.7% chitosan + 20% propolis nanoparticles + 20% pine resin extract nanoparticles; since the in vitro conidia germination of A. flavus did not occur, disease incidence on grains was 25-30% and in tortillas, 0% infection was recorded, along with low aflatoxin production (1.0 ppb). The grain germination and seedling growth were markedly reduced by the nanocoating application. The percentage weight loss and color of tortillas were more affected by this coating compared to the control, and the rollability fell within the scale of non-ruptured at 4 °C and partially ruptured at 28 °C. The next step is to evaluate the toxicity of this formulation.


Asunto(s)
Aflatoxinas , Quitosano , Própolis , Aflatoxinas/análisis , Aspergillus flavus , Quitosano/análisis , Quitosano/farmacología , Grano Comestible/química , Extractos Vegetales/farmacología , Própolis/farmacología , Zea mays/química
19.
Enzyme Microb Technol ; 160: 110088, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35777193

RESUMEN

The increasing number of multidrug resistance microorganisms is an alarming threat, and their rapid detection is essential to prevent nosocomial, foodborne, or waterborne infections. Many peptides derived from the venom of wasp Synoeca surinama have antimicrobial activity against Gram-positive and Gram-negative bacteria. Synoeca-MP, an antimicrobial peptide (AMP) from mastoparan family, seems to increase bacterial membrane permeability, promoting cytotoxicity and membrane disruption. Here Synoeca-MP was evaluated as biorecognition element tethered over chitosan-coated magnetic nanoparticles (Fe3O4-Chit). The transducing layer of the biosensor was developed from the self-assembling of 4-mercaptobenzoic acid (4-MBA) monolayer onto gold substrate. Atomic force microscopy (AFM) analyses confirmed the biointeraction between AMP and different pathogens membranes. The fabrication and performance of the biosensing assembly were characterized by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). Detection of Enterococcus faecalis (G+), Klebsiella pneumoniae (G-), Pseudomonas aeruginosa (G-), and Candida tropicalis was assessed in a recognition range from 101 to 105 CFU.mL-1. An instrumental limit of detection of 10 CFU.mL-1 was obtained for each specimen. However, the device presented a preferential selectivity towards Gram-negative bacteria. The proposed biosensor is a sensitive, fast, and straightforward platform for microbial detection in aqueous samples, envisaged for environmental monitoring applications.


Asunto(s)
Técnicas Biosensibles , Nanopartículas de Magnetita , Antibacterianos/farmacología , Técnicas Biosensibles/métodos , Técnicas Electroquímicas/métodos , Oro/química , Bacterias Gramnegativas , Bacterias Grampositivas , Péptidos y Proteínas de Señalización Intercelular , Nanopartículas de Magnetita/química , Venenos de Avispas
20.
J Pharm Biomed Anal ; 216: 114788, 2022 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-35525110

RESUMEN

Bacterial and fungal infections are challenging due to their low susceptibility and resistance to antimicrobial drugs. For this reason, antimicrobial peptides (AMP) emerge as excellent alternatives to overcome these problems. At the same time, their active insertion into the cell wall of microorganisms can be availed for biorecognition applications in biosensing platforms. Temporin-PTA (T-PTA) is an AMP found in the skin secretions of the Malaysian fire frog Hylarana picturata, which presents antibacterial activity against MRSA, Escherichia coli, and Bacillus subtilis. In this work, T-PTA was explored as an innovative sensing layer aiming for the electrochemical differentiation of Klebsiella pneumoniae, Acinetobacter baumannii, Bacillus subtilis, Enterococcus faecalis, Candida albicans, and C. tropicalis based on the structural differences of their membranes. The biosensor was analyzed through electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV). In this approach, the different structural features of each microorganism resulted in different adherence degrees and, therefore, different electrochemical responses. The transducing layer was fabricated by the self-assembling of a 4-mercaptobenzoic acid (MBA) monolayer and gold-capped magnetic nanoparticles (Fe3O4@Au) implemented to improve the electrical signal of the biointeraction. We found that each interaction, expressed in variations of electron transfer resistance and anodic peak current, demonstrated a singular response from which the platform can discriminate all different microorganisms. We found expressive sensitivity towards Gram-negative species, especially K. pneumoniae. A detection limit of 101 CFU.mL-1 and a linear range of 101 to 105 CFU.mL-1 were obtained. The T-PTA biosensor platform is a promising and effective tool for microbial identification.


Asunto(s)
Técnicas Biosensibles , Péptidos Catiónicos Antimicrobianos/química , Técnicas Biosensibles/métodos , Electrodos , Oro/química
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