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Objetivo: identificar o local e os cuidados diretos recebidos por pessoas com úlceras da perna por doença falciforme nos serviços de atenção à saúde. Método: estudo transversal, realizado em 11 centros, no período de agosto de 2019 a abril de 2020. Fizeram parte do estudo 72 pessoas com úlcera da perna ativa. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultado: apresentavam anemia falciforme 91,7% dos participantes, com mediana de três anos de existência da úlcera; 77,8% eram redicivantes; 40,3% compravam os insumos; 66,7% trocavam o próprio curativo no domicílio; 52,8% realizavam uma ou mais trocas diárias; 45,8% dos tratamentos foram prescritos pelo médico; 37,5% eram pomada (colagenase ou antibiótico); 89% não utilizavam compressão para o manejo do edema. Conclusão: a maioria dos participantes não estava inserida na Rede de Atenção à Saúde para o tratamento da úlcera, e não recebia assistência sistematizada e nem insumos apropriados.
Objective: to identify the location and direct care received by people with leg ulcers due to sickle cell disease in health care services. Method: a cross-sectional study carried out in 11 centers from August 2019 to April 2020. The study included 72 people with active leg ulcers. The study was approved by the Research Ethics Committee. Results: a total of 91.7% of the participants had sickle cell anemia, with a median of three years of ulcer existence; 77.8% were recurrent; 40.3% bought the supplies; 66.7% changed their own dressings at home; 52.8% did one or more changes a day; 45.8% of the treatments were prescribed by physician; 37.5% were ointments (collagenase or antibiotics); and 89% did not use compression to manage edema. Conclusion: most of the participants were not included in the Health Care Network for ulcer treatment and did not receive systematized care or appropriate supplies.
Objetivo: identificar el lugar y los cuidados directos recibidos por personas con úlceras de pierna por enfermedad falciforme en los servicios de atención a la salud. Método: estudio transversal, realizado en 11 centros, en el período de agosto de 2019 a abril de 2020. Participaron 72 personas con úlcera de pierna activa. El estudio fue aprobado por el Comité de Ética en Investigación. Resultado: presentaban anemia falciforme 91,7% de los participantes, con una mediana de tres años de existencia de la úlcera; 77,8% eran recidivantes; 40,3% compraban los insumos; 66,7% cambiaban su propio vendaje en el domicilio; 52,8% realizaban uno o más cambios diarios; 45,8% de los tratamientos fueron prescritos por el médico; 37,5% eran pomada (colagenasa o antibiótico); y 89% no utilizaban compresión para el manejo del edema. Conclusión: la mayoría de los participantes no estaba integrada en la Red de Atención a la Salud para el tratamiento de la úlcera, y no recibía asistencia sistematizada ni insumos apropiados.
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Gelidium sesquipedale is valued in the Spanish agar industry, but its production generates substantial waste, often discarded despite its nutritional and bioactive content. Subcritical water extraction (SWE) at 175 °C and 50 bar for 130 min was performed on this waste after agar extraction, comparing it to conventional ethanol extraction. The SWE extract exhibited superior nutritional profile, including proteins (170.6 ± 1.0 mg/gfreeze-dried-extract), essential amino acids (18.1%), carbohydrates (148.1 ± 0.3 mg/gfreeze-dried-extract), total phenolic content (57 ± 7 mg-EqGA/gfreeze-dried-extract), and also containing Maillard reaction compounds, such as 5-hydroxymethylfurfural, furfural, 2-furanmethanol, 1-(2-furanyl)-ethanone, and 5-methyl-2-furfural, influencing color, aroma and flavor. This extract showed better antioxidant and anti-inflammatory properties than the conventional extract, and higher xanthine oxidase, tyrosinase, and acetylcholinesterase inhibition activities. Toxicological assessment on human cells indicated the safety of the SWE extract. Therefore, SWE technology offers a promising method to valorize G. sesquipedale residue, yielding a bioactive and nutrient-rich extract suitable for food and nutraceutical applications.
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INTRODUCTION: Dance Medicine is a growing discipline, and healthcare for dancers requires appreciating particularities of their artistic craft. Manual therapists (MTs) are often dancers' first choice when seeking care. Whilst dancers' experiences of injury and healthcare have been extensively researched, little is known of MTs' perspectives of caring for them. AIM: This study aimed to gain an understanding of MTs' perspectives of caring for dancers. Communication, treatment strategies and obstacles to a successful therapeutic alliance were examined to broaden knowledge and improve care. METHODS: This was a qualitative study using Grounded Theory as a framework for data collection and analysis. A purposive sample of 8 participants was recruited-physiotherapists, chiropractors, and osteopaths with 2+ years' experience of treating dancers. Data collection was conducted via semi-structured interviews, which were transcribed verbatim, anonymized, member checked, and later analyzed. RESULTS: Data analysis constructed 3 categories which described the range of participants' experiences. Two categories were identified-(i) A Strangled Industry and (ii) Be-all End-all Patients-and found to culminate in a core category: (iii) Beyond Hands-on, which exemplified MTs' attempts to address clinical challenges. CONCLUSIONS: MTs experience several challenges when providing healthcare to dancers. These encompass psychosocial aspects relating to dancers' internal world and the dance industry environment. It suggests that caring for dancers demands comprehensive, collaborative, and psychologically informed approaches. Emphasis should also be given to developing and implementing dance-specific pain science for all stakeholders.
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The inadequate vascularization seen in fast-growing solid tumors gives rise to hypoxic areas, fostering specific changes in gene expression that bolster tumor cell survival and metastasis, ultimately leading to unfavorable clinical prognoses across different cancer types. Hypoxia-inducible factors (HIF-1 and HIF-2) emerge as druggable pivotal players orchestrating tumor metastasis and angiogenesis, thus positioning them as prime targets for cancer treatment. A range of HIF inhibitors, notably natural compounds originating from marine organisms, exhibit encouraging anticancer properties, underscoring their significance as promising therapeutic options. Bioprospection of the marine environment is now a well-settled approach to the discovery and development of anticancer agents that might have their medicinal chemistry developed into clinical candidates. However, despite the massive increase in the number of marine natural products classified as 'anticancer leads,' most of which correspond to general cytotoxic agents, and only a few have been characterized regarding their molecular targets and mechanisms of action. The current review presents a critical analysis of inhibitors of HIF-1 and HIF-2 and hypoxia-selective compounds that have been sourced from marine organisms and that might act as new chemotherapeutic candidates or serve as templates for the development of structurally similar derivatives with improved anticancer efficacy.
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Antineoplásicos , Organismos Acuáticos , Productos Biológicos , Factor 1 Inducible por Hipoxia , Neoplasias , Animales , Humanos , Antineoplásicos/farmacología , Antineoplásicos/uso terapéutico , Organismos Acuáticos/química , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/metabolismo , Factores de Transcripción con Motivo Hélice-Asa-Hélice Básico/antagonistas & inhibidores , Productos Biológicos/farmacología , Productos Biológicos/química , Productos Biológicos/uso terapéutico , Factor 1 Inducible por Hipoxia/antagonistas & inhibidores , Neoplasias/tratamiento farmacológico , Neoplasias/patología , Transducción de Señal/efectos de los fármacosRESUMEN
OBJECTIVES: Nutritional recommendations, a core component of cardiovascular rehabilitation, play a vital role in managing cardiovascular diseases. However, adherence to these recommendations is complex, particularly in low-resource settings. This study explored the barriers and facilitators influencing adherence to nutritional recommendations among participants in a low-resource cardiovascular rehabilitation program in Brazil. METHODS: A mixed-methods approach was employed. Sociodemographic data, the Mediterranean diet score, scale for assessing nutrition, and open-ended questions on adherence were collected. Those who completed the questionnaires (phase 1) were invited to participate in one focus group session (phase 2). The participants were characterized according to the responses provided in phase 1 (Mediterranean diet score and scale for assessing nutrition) in low adherence or high adherence to dietary practice. Descriptive statistics and thematic content analysis within the context of the theory of planned behavior were employed. RESULTS: Seventy-four participants completed phase 1, with 41.9% classified into low adherence and 27.0% in high adherence; of those, 17 participated in phase 2. Focus group findings revealed 9 themes/29 subthemes. Barriers included food prices, income, knowledge, routine, food access, family patterns, disease, work, anxiety, eating habits, and food planning. Facilitators included affordable food, health considerations, taste preferences, knowledge, family/professional support, government assistance, personal willpower, income stability, easy food access, media influence, and a quiet eating place. CONCLUSIONS: The study findings underscore the need for targeted interventions, including individualized meal planning, community engagement, and enhanced access to healthcare professionals, to optimize dietary adherence and improve cardiovascular outcomes.
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Grupos Focales , Cooperación del Paciente , Humanos , Brasil , Masculino , Femenino , Persona de Mediana Edad , Cooperación del Paciente/estadística & datos numéricos , Anciano , Encuestas y Cuestionarios , Rehabilitación Cardiaca/métodos , Enfermedades Cardiovasculares/prevención & control , Conducta Alimentaria/psicología , Dieta Mediterránea/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , AdultoRESUMEN
Objective: To explore the experiences that significantly impact the professional quality of life of people providing palliative care (PC) in Ecuador. Design: Observational cross-sectional qualitative research. Methods: In September 2022, 10 focus groups were carried out in four cities in Ecuador; each group lasted from 1 to 2 h, was audio recorded, and transcribed verbatim. Recruitment was conducted through convenience sampling, and a total of 71 individuals (15 students, 50 professionals, and 6 volunteers) linked to PC participated. Content analysis with a phenomenological and inductive approach was used to analyze the data. Results: People recognized their experiences in PC as having positive and negative impacts on their professional quality of life. Experiences were mapped as affecting them at individual, relational, and contextual levels. These experiences included personal growth, opportunity to provide care, teamwork, death-related issues, inability to deal with work-related stress, social acceptance of PC, and dealing with inefficient health systems, among others. Conclusion: Despite the positive emotions that arise with caring for others, individuals working and volunteering in PC experience situations that influence their professional quality of life. Addressing these factors to increase satisfaction and ease the burden of PC work is essential. Undergraduate education, continuous professional training, and PC teams should incorporate actions to address these factors at all levels, such as teaching coping skills, fostering social support, and increasing awareness of PC.
How experiences shape professional quality of life in palliative care This study explored how working in palliative care impacts the professional quality of life of people providing palliative care in Ecuador. The research team conducted 10 focus groups in four cities in Ecuador with 71 participants. The results show that people's experiences impact their professional quality of life in positive and negative ways. These experiences also affect people at individual, relational, and contextual levels. This study has identified common experiences that should be addressed to increase satisfaction and ease the burden of working in palliative care. These should be considered in undergraduate education, continuous professional training, and within palliative care teams.
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BACKGROUND: The increasing prevalence of alcohol use disorder (AUD) and the parallel surge in alcohol-associated liver disease (ALD) emphasize the urgent need for comprehensive alcohol management strategies. Low-dose ondansetron (AD04, a 5-HT3 antagonist) was shown recently to be a promising treatment for AUD with a specific genotypic profile (5-marker). The liver safety of AD04 has never been evaluated in subjects with AUD. The aim of the present study was to assess the liver safety profile of AD04 compared with placebo in subjects with AUD. METHODS: Liver biochemical parameters were assessed in subjects with AUD with a 5-marker genetic profile who participated in a Phase 3 randomized controlled trial and received either twice-daily, low-dose AD04 (ondansetron 0.33 mg twice daily) or matching placebo, combined with brief psychosocial counseling. ALT, AST, GGT, Serum Bilirubin, MCV, and Prothrombin were evaluated at weeks 0, 12, and 24. Adverse cardiac events, general well-being, and study completion were also assessed. RESULTS: Low-dose AD04 did not significantly change biochemical markers of liver injury, such as ALT, AST, and Serum Bilirubin. While patients with AUD displayed elevated GGT levels, typically associated with increased alcohol consumption, this parameter remained unaffected by low-dose AD04. Notably, no significant adverse effects were observed due to oral low-dose AD04 treatment. CONCLUSIONS: Low-dose AD04 has the potential to be a safe treatment option for subjects with AUD and ALD, indicating the need for an RCT for this specific cohort. Such a trial would pave the way for the design of a precision treatment for combined AUD with ALD.
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Onion skin waste (OSW), the primary non-edible byproduct from onion processing, offers a renewable source of bioactive compounds. This study aims to valorize OSW through subcritical water extraction (SWE), aligning with a circular economy and biorefinery principles. SWE was carried out at 145 °C and 50 bar for 50 min in a discontinuous reactor, producing a phenolic-rich extract (32.3 ± 2.6 mg/g) dominated by protocatechuic acid (20.3 ± 2.5 mg/g), quercetin-4'-O-glucoside (7.5 ± 0.2 mg/g), and quercetin (3.2 ± 0.6 mg/g). Additionally, the extract contains sugars (207.1 ± 20.3 mg sucrose-Eq/g), proteins (22.8 ± 1.6 mg BSA-Eq/g), and free amino acids (20.4 ± 1.2 mg arginine-Eq/g). Its phenolic richness determines its scavenging activity against âNO and O2â- radicals and its α-glucosidase and aldose-reductase inhibition without affecting α-amylase. Notably, the extract demonstrates significant α-glucosidase inhibition (IC50 = 75.6 ± 43.5 µg/mL), surpassing acarbose (IC50 = 129.5 ± 1.0 µg/mL) in both pure enzyme and cell culture tests without showing cytotoxicity to AGS, HepG2, and Caco-2 human cell lines. The extract's bioactivity and nutritional content make it suitable for developing antioxidant and antidiabetic nutraceutical/food components, highlighting SWE's potential for OSW valorization without using organic solvents.
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The aim of this study was to evaluate the influence of the type of etchant on the shear bond strength (SBS) of metallic brackets to enamel and the Adhesive Remnant Index (ARI) after debonding. A total of 30 mandibular and maxillary premolars were randomly distributed into groups (n = 10) treated with 1 of 3 enamel surface-conditioning agents: 35% phosphoric acid (PA), 35% glycolic acid (GA), or 35% ferulic acid (FA). The designated acid was applied to the buccal enamel surface of the tooth for 20 seconds, and the tooth was then rinsed with distilled water for 20 seconds and air dried for 5 seconds. A metal bracket was bonded to the prepared surface with light-cured orthodontic resin. After 24 hours, the bracket-tooth interface was submitted to SBS testing in a universal testing machine at a speed of 0.5 mm/min. After debonding, the enamel surface was observed under a stereomicroscope (×20 magnification) to determine the ARI. The generalized linear models showed that the PA and GA groups presented significantly higher SBSs than the FA group (P = 0.0003). The ARI was significantly higher in specimens treated with PA than with the other acids (P < 0.05; Kruskal-Wallis and Dunn tests), with a larger quantity of adhesive remaining adhered to the tooth. Both PA and GA are effective for bonding brackets, but GA resulted in a lower percentage of adhesive remnant adhered to the enamel.
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Ácidos Cumáricos , Glicolatos , Soportes Ortodóncicos , Humanos , Esmalte Dental , Ácidos FosfóricosRESUMEN
This scoping review aimed to provide an overview of the current landscape of pediatric palliative care in Latin America, including policies, regulations, available resources, challenges, barriers, and evidence-based recommendations. We conducted a comprehensive search for peer-reviewed articles related to pediatric palliative care in Latin America, considering both review and empirical articles published in English, Portuguese, or Spanish within the last decade. Our review initially identified 30 publications, which were subjected to a full-text assessment. The majority of these articles originated from Brazil, Mexico, and Chile, highlighting a regional concentration of research efforts. Notably, we observed a scarcity of comprehensive research and specific studies on pediatric palliative care in Latin America. Our findings revealed significant challenges, including resource limitations, the absence of dedicated policies, and the critical need for interdisciplinary teams to address the multifaceted aspects of pediatric palliative care. In light of our review, we emphasise the necessity for more extensive and representative research efforts, as well as the continuous updating of scientific evidence in the field of pediatric palliative care within the Latin American context. The recommendations derived from this review aim to contribute to the enhancement of pediatric palliative care services and accessibility throughout Latin America.
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Cuidados Paliativos , Humanos , Niño , América Latina , México , BrasilRESUMEN
The development of new therapeutic options for Parkinson's disease (PD) requires formulations able to mitigate both brain degeneration and motor dysfunctions. SC-Nanophytosomes, an oral mitochondria-targeted formulation developed with Codium tomentosum membrane polar lipids and elderberry anthocyanin-enriched extract, promote significant brain benefits on a rotenone-induced rat model of PD. In the present work, the effects of SC-Nanophytosome treatment on the skeletal muscle tissues are disclosed. It is unveiled that the rotenone-induced PD rat model exhibits motor disabilities and skeletal muscle tissues with deficient activity of mitochondrial complexes I and II along with small changes in antioxidant enzyme activity and skeletal muscle lipidome. SC-Nanophytosome treatment mitigates the impairment of complexes I and II activity, improving the mitochondrial respiratory chain performance at levels that surpass the control. Therefore, SC-Nanophytosome competence to overcome the PD-related motor disabilities should be also associated with its positive outcomes on skeletal muscle mitochondria. Providing a cellular environment with more reduced redox potential, SC-Nanophytosome treatment improves the skeletal muscle tissue's ability to deal with oxidative stress stimuli. The PD-related small changes on skeletal muscle lipidome were also counteracted by SC-Nanophytosome treatment. Thus, the present results reinforces the concept of SC-Nanophytosomes as a mitochondria-targeted therapy to address the neurodegeneration challenge.
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Enfermedades Mitocondriales , Fármacos Neuroprotectores , Enfermedad de Parkinson , Ratas , Animales , Enfermedad de Parkinson/tratamiento farmacológico , Enfermedad de Parkinson/etiología , Rotenona/farmacología , Antioxidantes/farmacología , Estrés Oxidativo , Músculo Esquelético , Fármacos Neuroprotectores/farmacologíaRESUMEN
With the onset of the COVID-19 pandemic, the rapid spread of the SARS-CoV-2 virus became a global health threat affecting people's mental and physical health, as well as working conditions and modalities. The reorganization of the work environment also affected work engagement and psychological distress levels. This manuscript assesses how work engagement and distress vary according to gender and age across three working modalities. We used a voluntary response sampling strategy to collect data on psychological distress and work engagement between August 2021 and January 2022. Results are from 542 people working in Ecuador during the COVID-19 pandemic. Overall, participants experienced psychological distress; women and younger participants presented higher psychological distress. Regarding engagement, the sample showed average levels of total engagement, average levels of vigor, and high levels of dedication and absorption. Men presented higher levels of total work engagement and vigor. Psychological distress was significantly and negatively correlated with total work engagement scores and its three factors. There were no differences in work engagement according to the different modalities. However, teleworkers reported significantly higher levels of psychological distress than hybrid workers. Findings are discussed considering ideas for decision-makers to explore the benefits of flexible working practices.
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COVID-19 , Distrés Psicológico , Masculino , Humanos , Femenino , COVID-19/epidemiología , SARS-CoV-2 , Pandemias , Compromiso LaboralRESUMEN
Objetivo: avaliar os efeitos de um grupo educativo nas práticas parentais promotoras do desenvolvimento infantil adotadas por familiares de lactentes. Métodos: ensaio clínico randomizado de abordagem quantitativa conduzido em serviço de atenção básica com familiares de lactentes. O grupo controle recebeu acompanhamento de saúde usual, e o grupo experimental foi convidado para interagir com o grupo educativo. As práticas parentais foram avaliadas utilizando o instrumento da Organização Mundial da Saúde (OMS) e do Fundo das Nações Unidas para a Infância (Unicef) para avaliação do cuidado promotor do desenvolvimento infantil. Resultados: participaram do estudo 21 familiares de lactentes. Após a intervenção, houve um aumento de práticas parentais no grupo experimental, como brincar com objetos domésticos (46,1% versus 12,5% no grupo controle), brincar com brinquedos feitos em casa (38,5% versus 12,5% no grupo controle) e contar histórias com livros infantis (38,4% versus 12,5% no grupo controle). Conclusão: os grupos educativos apoiaram práticas parentais de promoção do desenvolvimento de lactentes
Objective: to evaluate an educative group in the parental practices promoting child development adopted by the family members of infants. Methods: quantitative randomized clinical essay carried out in a primary care service with families of infants. The control group received usual health follow up, and the experimental group was invited to interact with the educational group. The parental practices were evaluated by using the instrument from the World Health Organization (WHO) and United Nations International Children's Emergency Fund (UNICEF) to evaluate care promoting child development. Results: a group of 21 family members of infants participated in the study. After the intervention, parental practices in the experimental group, such as playing with domestic objects (46.1% versus 12.5% in the control group), playing with house-made toys (38.5% versus 12.5% in the control group), and telling stories with child books (38.4% versus 12.5% in the control group), increased. Conclusion: the educational groups supported parental practices of promoting child development of infants.
Objetivo: evaluar los efectos de un grupo educativo sobre las prácticas parentales impulsoras del desarrollo infantil que son adoptadas por la familia de los lactantes. Métodos: ensayo clínico aleatorizado con enfoque cuantitativo realizado en un servicio de atención primaria con la familia de los de lactantes. El grupo de control recibió el seguimiento de salud habitual, y el grupo experimental se invitó a interactuar con el grupo educativo. Las prácticas parentales se evaluaron mediante instrumentos de la Organización Mundial de la Salud (OMS) y el Fondo de las Naciones Unidas para la infancia (UNICEF) para evaluar la atención impulsora del desarrollo infantil. Resultados: participaron en el estudio 21 familiares de los lactantes. Después de la intervención, hubo un aumento en las prácticas parentales en el grupo experimental, como jugar con objetos domésticos (46,1% versus 12,5% en el grupo control), jugar con juguetes caseros (38,5% versus 12,5% en el grupo control) y narrar historias con libros infantiles (38,4% versus 12,5% en el grupo de control). Conclusión: los grupos educativos permitieron apoyar prácticas parentales para promover el desarrollo de los lactantes
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Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Enfermería Pediátrica , Atención Primaria de Salud , Desarrollo Infantil , Educación en Salud , Responsabilidad ParentalRESUMEN
Pest resistance against fungicides is a widespread and increasing problem, with impact on crop production and public health, making the development of new fungicides an urgent need. Chemical analyses of a crude methanol extract (CME) of Guiera senegalensis leaves revealed the presence of sugars, phospholipids, phytosterols, guieranone A, porphyrin-containing compounds, and phenolics. To connect chemical composition with biological effects, solid-phase extraction was used to discard water-soluble compounds with low affinity for the C18 matrix and obtain an ethyl acetate fraction (EAF) that concentrates guieranone A and chlorophylls, and a methanol fraction (MF) dominated by phenolics. While the CME and MF exhibited poor antifungal activity against Aspergillus fumigatus, Fusarium oxysporum and Colletotrichum gloeosporioides, the EAF demonstrated antifungal activity against these filamentous fungi, particularly against C. gloeosporioides. Studies with yeasts revealed that the EAF has strong effectiveness against Saccharomyces cerevisiae, Cryptococcus neoformans and Candida krusei with MICs of 8, 8 and 16 µg/mL, respectively. A combination of in vivo and in vitro studies shows that the EAF can function as a mitochondrial toxin, compromising complexes I and II activities, and as a strong inhibitor of fungal tyrosinase (Ki = 14.40 ± 4.49 µg/mL). Thus, EAF appears to be a promising candidate for the development of new multi-target fungicides.
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Background: Ecuador is facing increasing health-related suffering due to cancer; however, the distributed opioid analgesic in the country is below the global average. Aim: This study explores the access to cancer pain management (CPM) from the healthcare professionals' perspective in a middle-income country. Methods: Thirty problem-centered interviews with healthcare providers were conducted in six cancer facilities and were analyzed thematically. Results: Limited and unequal access to opioid analgesics was reported. Structural weaknesses of the healthcare system restrain access for the poorest, at the primary care level, and for people living in remote areas. The lack of education among the healthcare personnel, patients, and society was identified as the main barrier. Conclusion: Access barriers were interrelated; therefore multisectoral strategies must be considered to improve access to CPM.
The number of patients with cancer in Ecuador is growing. It is known that people with a cancer diagnosis often experience severe pain, which requires opioid analgesics. In this study, we explore the opinion of healthcare providers regarding access to opioid analgesics to alleviate cancer pain in Ecuador. We interviewed 30 healthcare professionals working at six cancer centers in different cities, who deal daily with patients with a cancer diagnosis. We found that it is difficult for cancer patients in the country to access adequate pain therapy and this generates avoidable severe health-related suffering. The structure of the healthcare system makes it difficult to be supplied with the medication they need. That is worst for the country's poor and people in rural areas. The main problem is the lack of knowledge on the subject among health workers, patients and society. We conclude that the obstacles in providing patients access to cancer pain relief lie in different areas, including the healthcare system, the healthcare professionals and the patients and society, all of which are interrelated. All areas must work together to improve the situation.
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Neoplasias , Manejo del Dolor , Humanos , Ecuador , Personal de Salud , Analgésicos Opioides/uso terapéutico , Neoplasias/complicacionesRESUMEN
Kitul (Caryota urens L.) inflorescences are broadly used for sweet sap production in Asian countries and Kitul food products are known as being suitable for diabetic patients. Considering the strong ability to inhibit α-glucosidase, we hypothesize that kitul antidiabetic properties might also involve the modulation of inflammatory pathways and hyperglycaemia-induced oxidative damage. Hence, the effects of an inflorescence's methanol extract were investigated in glucose-stimulated pancreatic cells (RIN-5F) and LPS-stimulated RAW 264.7 macrophages. The extract reduced the overproduction of intracellular reactive species in pancreatic cells and also NO, L-citrulline and IL-6 levels in LPS-stimulated RAW 264.7 macrophages. Inhibition of 5-lipoxygenase (IC50 = 166.1 µg/mL) through an uncompetitive manner was also recorded upon treatment with C. urens inflorescences extract. The phenolic profile of the inflorescences was characterized by HPLC-DAD, six hydroxycinnamic acids being identified and quantified. Overall, our data provide additional evidence on the pleiotropic mechanisms of Kitul inflorescences as an antidiabetic agent.
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Glucosa , Extractos Vegetales , Humanos , Ratones , Animales , Células RAW 264.7 , Extractos Vegetales/farmacología , Extractos Vegetales/metabolismo , Glucosa/metabolismo , Hipoglucemiantes/farmacología , Hipoglucemiantes/metabolismo , Mediadores de Inflamación/metabolismo , Lipopolisacáridos/farmacología , Antiinflamatorios/farmacología , Antiinflamatorios/metabolismo , Macrófagos , Plantas Comestibles/metabolismoRESUMEN
In Brazil, blood donation is regulated by the Brazilian Ministry of Health, and all States follow the same protocol for clinical and laboratory screening. Brazil is an endemic country for Chagas disease (CD), caused by Trypanosoma cruzi, and for leishmaniasis, caused by a species of Leishmania spp. Screening for leishmaniosis is not routinely performed by blood banks. Given the antigenic similarity between T. cruzi and Leishmania spp., cross-reactions in serological tests can occur, and inconclusive results for CD have been found. The objective of this study was to apply molecular techniques, e.g., nPCR, PCR, and qPCR, to clarify cases of blood donation candidates with non-negative serology for CD and to analyze the difference between the melting temperature during real-time PCR using SYBR Green. Thirty-seven cases that showed non-negative results for CD using chemiluminescent microparticle immunoassay (CMIA) tests from blood banks in Campo Grande, MS, and Campinas, SP, were analyzed. In the serum samples, 35 samples were evaluated by ELISA, and 24.3% (9/35) showed positive results for CD. nPCR was able to detect 12 positive results in 35 samples (34.28%). qPCR for T. cruzi was quantifiable in the samples that showed a value ≥0.002 par eq/mL (parasite equivalents per milliliter), and in 35 samples, 11 (31.42%) were positive. Of all evaluated samples using the described tests (CMIA, ELISA, nPCR, and qPCR), 18 (48.6%) were positive for CD. For MCA by qPCR, the melting temperature was 82.06 °C ± 0.46 for T. cruzi and 81.9 °C ± 0.24 for Leishmania infantum. The Mann-Whitney test showed a significant value of p < 0.0001. However, the differentiation between T. cruzi and L. infantum could not be considered due to temperature overlap. For leishmaniasis, of the 35 samples with non-negative serology for CD tested by the indirect fluorescent antibody test (IFAT), only one sample (2.85%) was positive (1:80). The PCR for Leishmania spp. was performed on 36 blood samples from donation candidates, and all were negative. qPCR for L. infantum showed 37 negative results for the 37 analyzed samples. The data presented here show the importance of performing two different tests in CD screening at blood banks. Molecular tests should be used for confirmation, thereby improving the blood donation system.
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Mitochondrial dysfunction and cytosolic oxidative stress are pathological biomarkers interlinked in several chronic diseases and cellular toxicity promoted by high-energy radiation or xenobiotics. Thus, assessing the activities of the mitochondrial redox chain complexes and the cytosolic antioxidant enzymes in the same cell culture system is a valuable approach to addressing the challenge of chronic diseases or unveiling the molecular mechanisms underlying the toxicity of physical and chemical stress agents. The present article gathers the experimental procedures to obtain, from isolated cells, a mitochondria-free cytosolic fraction and a mitochondria-rich fraction. Furthermore, we describe the methodologies to evaluate the activity of the main antioxidant enzymes in the mitochondria-free cytosolic fraction (superoxide dismutase, catalase, glutathione reductase and glutathione peroxidase), and the activity of the individual mitochondrial complexes I, II and IV, as well as the conjugated activity of complexes I-III and complexes II-III in the mitochondria-rich fraction. The protocol to test the citrate synthase activity was also considered and used to normalize complexes. The procedures were optimized within an experimental setup to allow that each condition to be tested only requires sampling of one T-25 flask of cells 2D cultured, as the typical results presented and discussed here.
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Por meio de um método ensaístico, sustentado pela teoria psicanalítica e seus enlaces com as teorias decoloniais e sociais críticas, este artigo reflete sobre as disputas pela memória e as possibilidades de elaboração de traumas coloniais, analisando os simbolismos de duas experiências ocorridas na cena pública brasileira: a quebra da placa em homenagem à memória de Marielle Franco e a queima da estátua em homenagem à Borba Gato. Apontamos que a aparição destas duas figuras no espaço público, bem como o atentado a elas, instauram diferentes possibilidades de compreensão da história e de elaboração de traumas psicossociais. Concluímos que o atentado à placa de Marielle se trata de uma tentativa de apagar sua memória, bem como dos diversos grupos oprimidos (mulheres, LGBTQIA+, pessoas negras) simbolizados por ela, mantendo, assim, as repetições mórbidas oriundas dos traumas coloniais. Já o atentado à estátua de Borba, simbolismo da expansão bandeirante no país, tensiona uma história oficial que oblitera as violentas ações perpetradas pelo Estado e segmentos da sociedade civil.
RESUMEN
Since 1997, Ecuador has undergone a series of changes to ensure family rights to sexual minorities. However, there is still limited research regarding attitudes toward them. This study focused on the attitudes toward lesbians (L), gay men (G), and their rights. A sample of 318 cisgender Ecuadorians who responded to an online survey was recruited. Analyses indicated that men, heterosexuals, who practice their religion, attend more frequently to religious services, and identify as conservative showed higher levels of prejudice against LG as well as less support toward their rights. Further, participants who did not have LG acquaintances, friends, family members, and those who did not know any LG parented family showed less support toward these populations. Multiple regression analyses indicated that believing that a person's sexual orientation is learned significantly predicted the attitudes measured in our study. Implications of these findings to help reduce prejudice against LG individuals are discussed.