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1.
Theranostics ; 14(6): 2464-2488, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38646648

RESUMO

Cancer has remained a formidable challenge in medicine and has claimed an enormous number of lives worldwide. Theranostics, combining diagnostic methods with personalized therapeutic approaches, shows huge potential to advance the battle against cancer. This review aims to provide an overview of theranostics in oncology: exploring its history, current advances, challenges, and prospects. We present the fundamental evolution of theranostics from radiotherapeutics, cellular therapeutics, and nanotherapeutics, showcasing critical milestones in the last decade. From the early concept of targeted drug delivery to the emergence of personalized medicine, theranostics has benefited from advances in imaging technologies, molecular biology, and nanomedicine. Furthermore, we emphasize pertinent illustrations showcasing that revolutionary strategies in cancer management enhance diagnostic accuracy and provide targeted therapies customized for individual patients, thereby facilitating the implementation of personalized medicine. Finally, we describe future perspectives on current challenges, emerging topics, and advances in the field.


Assuntos
Neoplasias , Medicina de Precisão , Nanomedicina Teranóstica , Humanos , Neoplasias/terapia , Neoplasias/diagnóstico , Nanomedicina Teranóstica/métodos , Medicina de Precisão/métodos , Sistemas de Liberação de Medicamentos/métodos , Nanomedicina/métodos , História do Século XX , Animais , História do Século XXI
2.
Open Biol ; 13(11): 230019, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37989224

RESUMO

Studies at the cellular and molecular level of magnetoreception-sensing and responding to magnetic fields-are a relatively new research area. It appears that different mechanisms of magnetoreception in animals evolved from different origins, and, therefore, many questions about its mechanisms remain left open. Here we present new information regarding the Electromagnetic Perceptive Gene (EPG) from Kryptopterus vitreolus that may serve as part of the foundation to understanding and applying magnetoreception. Using HaloTag coupled with fluorescent ligands and phosphatidylinositol specific phospholipase C we show that EPG is associated with the membrane via glycosylphosphatidylinositol anchor. EPG's function of increasing intracellular calcium was also used to generate an assay using GCaMP6m to observe the function of EPG and to compare its function with that of homologous proteins. It was also revealed that EPG relies on a motif of three phenylalanine residues to function-stably swapping these residues using site directed mutagenesis resulted in a loss of function in EPG. This information not only expands upon our current understanding of magnetoreception but may provide a foundation and template to continue characterizing and discovering more within the emerging field.


Assuntos
Glicosilfosfatidilinositóis , Fenilalanina , Animais , Fosfatidilinositol Diacilglicerol-Liase , Fosfoinositídeo Fosfolipase C , Glicosilfosfatidilinositóis/metabolismo , Peixes , Mamíferos
3.
Ann Oncol ; 34(1): 111-120, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36208697

RESUMO

BACKGROUND: Genomic analysis of circulating tumor DNA (ctDNA) is increasingly incorporated into the clinical management of patients with advanced cancer. Beyond tumor profiling, ctDNA analysis also can enable calculation of circulating tumor fraction (TF), which has previously been found to be prognostic. While most prognostic models in metastatic cancer are tumor type specific and require significant patient-level data, quantification of TF in ctDNA has the potential to serve as a pragmatic, tumor-agnostic prognostic tool. PATIENTS AND METHODS: This study utilized a cohort of patients in a nationwide de-identified clinico-genomic database with metastatic castration-resistant prostate cancer (mCRPC), metastatic breast cancer (mBC), advanced non-small-cell lung cancer (aNSCLC), or metastatic colorectal cancer (mCRC) undergoing liquid biopsy testing as part of routine care. TF was calculated based on single-nucleotide polymorphism aneuploidy across the genome. Clinical, disease, laboratory, and treatment data were captured from the electronic health record. Overall survival (OS) was evaluated by TF level while controlling for relevant covariables. RESULTS: A total of 1725 patients were included: 198 mCRPC, 402 mBC, 902 aNSCLC, and 223 mCRC. TF ≥10% was highly correlated with OS in univariable analyses for all cancer types: mCRPC [hazard ratio (HR) 3.3, 95% confidence interval (CI) 2.04-5.34, P < 0.001], mBC (HR 2.4, 95% CI 1.71-3.37, P < 0.001), aNSCLC (HR 1.68, 95% CI 1.34-2.1, P < 0.001), and mCRC (HR 2.11, 95% CI 1.39-3.2, P < 0.001). Multivariable assessments of TF had similar point estimates and CIs, suggesting a consistent and independent association with survival. Exploratory analysis showed that TF remained consistently prognostic across a wide range of cutpoints. CONCLUSIONS: Plasma ctDNA TF is a pragmatic, independent prognostic biomarker across four advanced cancers with potential to guide clinical conversations around expected treatment outcomes. With further prospective validation, ctDNA TF could be incorporated into care paradigms to enable precision escalation and de-escalation of cancer therapy based on patient-level tumor biology.


Assuntos
Neoplasias da Mama , Carcinoma Pulmonar de Células não Pequenas , DNA Tumoral Circulante , Neoplasias Pulmonares , Neoplasias de Próstata Resistentes à Castração , Humanos , Masculino , Biomarcadores Tumorais , Prognóstico , Neoplasias de Próstata Resistentes à Castração/terapia , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Feminino
4.
Neurología (Barc., Ed. impr.) ; 36(4): 305-323, mayo 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-219748

RESUMO

Objetivo: Actualizar las recomendaciones de la Sociedad Española de Neurología para la prevención del ictus en pacientes con DM-2 o prediabetes, analizando las evidencias disponibles sobre el efecto del control metabólico y el posible beneficio de los antidiabéticos con beneficio vascular añadidos al tratamiento antidiabético estándar en la prevención de ictus.DesarrolloSe han elaborado preguntas tipo PICO (Patient, Intervention, Comparison, Outcome) para identificar cuestiones prácticas para el manejo de pacientes con ictus y poder realizar recomendaciones específicas en cada una de ellas. Posteriormente se han realizado revisiones sistemáticas en Pubmed y se han seleccionado los ensayos clínicos aleatorizados que han evaluado ictus como variable independiente (principal o secundaria). Finalmente se ha elaborado metaanálisis para cada una de las preguntas PICO y se han redactado unas recomendaciones en respuesta a cada una de ellas.ConclusionesAunque no hay evidencia de que un mejor control metabólico reduzca el riesgo de ictus, algunas familias de antidiabéticos con beneficio vascular han mostrado reducción en el riesgo de ictus cuando se añaden al tratamiento convencional, tanto en el ámbito de prevención primaria en pacientes con DM-2 de alto riesgo vascular o con enfermedad vascular aterosclerosa establecida (agonistas GLP-1) como en prevención secundaria de ictus en pacientes con DM-2 y prediabetes (pioglitazona). (AU)


Objective: To update the Spanish Society of Neurology's guidelines for stroke prevention in patients with type 2 diabetes or prediabetes, analysing the available evidence on the effect of metabolic control and the potential benefit of antidiabetic drugs with known vascular benefits in addition to conventional antidiabetic treatments in stroke prevention.DevelopmentPICO-type questions (Patient, Intervention, Comparison, Outcome) were developed to identify practical issues in the management of stroke patients and to establish specific recommendations for each of them. Subsequently, we conducted systematic reviews of the PubMed database and selected those randomised clinical trials evaluating stroke as an independent variable (primary or secondary). Finally, for each of the PICO questions we developed a meta-analysis to support the final recommendations.ConclusionsWhile there is no evidence that metabolic control reduces the risk of stroke, some families of antidiabetic drugs with vascular benefits have been shown to reduce these effects when added to conventional treatments, both in the field of primary prevention in patients presenting type 2 diabetes and high vascular risk or established atherosclerosis (GLP-1 agonists) and in secondary stroke prevention in patients with type 2 diabetes or prediabetes (pioglitazone). (AU)


Assuntos
Humanos , Diabetes Mellitus Tipo 2/complicações , Neurologia , Pioglitazona , Estado Pré-Diabético/complicações , Acidente Vascular Cerebral/prevenção & controle
5.
Leuk Lymphoma ; 62(7): 1609-1618, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33627023

RESUMO

Classic Hodgkin lymphoma (cHL) in young children (ages 0-6) is rare in high income countries (HICs) but is more prevalent in low- and middle-income countries (LMICs) like Guatemala. Given that the majority of cHL studies have evaluated adolescent/adults, and the immune system changes with age, we sought to characterize Epstein-Barr virus (EBV) expression, immune regulatory pathway markers and the tumor microenvironment in 42 children ages 0-6 with cHL from Guatemala. We found a very high frequency of EBV expression (97.5%). Hodgkin cells showed increased expression of PD1 ligands and CD137, indicative of shared immune regulatory mechanisms with adult cHL. Pediatric cHL also showed an increase in CD8+ tumor infiltrating lymphocytes and tumor associated macrophages within the tumor microenvironment. Despite 25 having high risk disease, only 4 patients died from progressive disease, relapse or infection.


Assuntos
Infecções por Vírus Epstein-Barr , Doença de Hodgkin , Adolescente , Adulto , Criança , Pré-Escolar , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/epidemiologia , Herpesvirus Humano 4 , Doença de Hodgkin/epidemiologia , Humanos , Lactente , Recém-Nascido , Recidiva Local de Neoplasia , Microambiente Tumoral
6.
Materials (Basel) ; 13(3)2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32033379

RESUMO

The effect of α-Al2O3 nanoparticles (up to 5 wt.%) on the physical, mechanical, and thermal properties, as well as on the microstructural evolution of a dense magnesia refractory is studied. Sintering temperatures at 1300, 1500, and 1600 °C are used. The physical properties of interest were bulk density and apparent porosity, which were evaluated by the Archimedes method. Thermal properties were examined by differential scanning calorimetry. The mechanical behavior was studied by cold crushing strength and microhardness tests. Finally, the microstructure and mineralogical qualitative characteristics were studied by scanning electron microscopy and X-ray diffraction, respectively. Increasing the sintering temperature resulted in improved density and reduced apparent porosity. However, as the α-Al2O3 nanoparticle content increased, the density and microhardness decreased. Microstructural observations showed that the presence of α-Al2O3 nanoparticles in the magnesia matrix induced the magnesium-aluminate spinel formation (MgAl2O4), which improved the mechanical resistance most significantly at 1500 °C.

7.
Oper Dent ; 44(1): E12-E22, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30444694

RESUMO

OBJECTIVE:: The aim of this retrospective case-control study was to evaluate the influence of different occlusal characteristics and self-referred bruxism in the presence of noncarious cervical lesions (NCCLs). METHODS AND MATERIALS:: The participants were 280 students (140 cases and 140 controls), with an average age of 24.5 years, from six schools of dentistry in Spain. Clinical examination was carried out to record the NCCLs and the static and dynamic occlusal characteristics. The side of mastication and bruxism was collected by questionnaire. Data variables were analyzed by means of univariate and multivariate logistic regression. Odds ratios and the respective 95% confidence intervals were calculated ( p<0.05). RESULTS:: The presence of NCCLs was significantly more likely in subjects with protrusive interferences (odds ratio [OR]=1.82); with lateral interferences, especially on the nonworking side (OR= 1.77); or who were self-reported bruxists (OR=1.72). In the multivariate analysis, protrusive interferences, bruxism, age, and the presence of attrition were risk factors for the development of NCCLs. These factors resulted in a model with an area under the receiver-operating characteristic curve of 0.667 and a positive predictive value of 61.43%. CONCLUSIONS:: There was no significant relationship between most occlusal factors and the presence of NCCLs. Only bruxism, protrusive interferences, age, and occlusal wear were risk factors. The predictive model was not sufficiently explanatory. Occlusal factors alone do not appear to be sufficient to explain the presence of NCCLs.


Assuntos
Oclusão Dentária , Desgaste dos Dentes/etiologia , Fatores Etários , Bruxismo , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Mastigação , Estudos Retrospectivos , Fatores de Risco , Espanha , Inquéritos e Questionários , Adulto Jovem
8.
Oper Dent ; 44(4): 396-404, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30517069

RESUMO

OBJECTIVE: To evaluate the effect of different photoinitiator systems on photopolymerizing resin cements through ceramic veneers with different thickness on microshear bond strength (µSBS), flexural strength (FS), and ultimate tensile strength (UTS) and verify the light attenuation through these ceramic veneers. METHODS AND MATERIALS: Four photopolymerizing experimental resin cements were produced with the same resin matrix and associated with four different photoinitiator systems: camphorquinone (CQ), diphenyl(2,4,6-trimethylbenzoyl)phosphine oxide (TPO), Ivocerin, and TPO + Ivocerin. Eighty disc-shaped ceramic veneers (IPS Empress Esthetic, Ivoclar Vivadent) were fabricated (10-mm diameter) in two different thicknesses: 0.7 and 1.5 mm. A previously characterized multiwave LED (Bluephase G2, Ivoclar Vivadent) was standardized for 40 seconds of photoactivation. Light transmittance through each ceramic veneer thickness (n=5) was measured using a spectrometer (USB 2000, Ocean Optics). The µSBS of each resin cement (n=15) to the ceramic veneer was evaluated using 0.5-mm cylinders with 0.7-mm diameters photoactivated through the different ceramic veneer thicknesses. Samples for FS and UTS tests were made either with or without ceramics veneers (0.7 and 1.5 mm) fixed to the light-curing tip. Data were submitted to two-way analysis of variance and the Tukey test (α=0.05). RESULTS: The multiwave LED emitted higher irradiance into the blue wavelength spectra than into the violet wavelength spectra (p=0.0001). Light transmittance through the ceramic veneers was reduced in a systematic manner based on thickness regardless of the wavelength spectra emitted from the multiwave LED (p=0.00037). The µSBS was reduced in a systematic manner based on thickness regardless of the photoinitiator system (p<0.05). However, resin cements with CQ and Ivocerin showed higher bond strength values in comparison to the resin cement with TPO regardless of the ceramic veneer thickness (p<0.05). The FS and UTS means decreased (p<0.05) with the interposition of 0.7- and 1.5-mm ceramic veneers for all resin cements. The resin cement containing only TPO showed the lowest FS and UTS means (p<0.05) for all ceramic veneers. CONCLUSIONS: The thickness of the ceramic veneers reduced the irradiance of the multiwave LED in all wavelength spectra. Ivocerin alone or associated with TPO showed to be an effective alternative photoinitiator to substitute for CQ. The resin cement containing only TPO had lower bond strength values in comparison to resin cements with CQ, Ivocerin, and Ivocerin + TPO.


Assuntos
Facetas Dentárias , Cimentos de Resina , Cerâmica , Cor , Porcelana Dentária , Teste de Materiais
9.
Artigo em Espanhol | BINACIS | ID: biblio-1099579

RESUMO

INTRODUCCIÓN: La miopía patológica es una causa importante de pérdida de visión irreversible y es la cuarta a novena causa más frecuente de ceguera en el mundo. Es también conocida como miopía alta, degenerativa o maligna; condición en la que los individuos tienen una longitud axial superior a 25,5 - 26,5mm, y/o un error de refracción de por lo menos -5.0 dioptrías, acompañado por cambios patológicos. La neovascularización coroidea (NVC) asociada a miopía patológica puede resultar en la pérdida significativa de la visión y/o la ceguera. La NVC suele ser subfoveal y es una importante complicación, desarrollándose en aproximadamente 5-10% de ojos con miopía patológica. De manera similar que en otras enfermedades maculares asociadas a NVC, se ha encontrado un aumento del nivel del factor de crecimiento de endotelial (VEGF) en NVC miópicas, y por lo tanto, la terapia anti-VEGF sería útil. Desde la introducción en oftalmología de agentes anti factor de crecimiento de endotelial (anti-VEGF), el tratamiento anti-angiogénico con antiVEGF intravítreo se ha convertido en el tratamiento de primera línea para la NVC miópica. El bevacizumab es un anticuerpo monoclonal humano, anti factor de crecimiento endotelial (anti-VEGF), que inhibe la proliferación de nuevas células endoteliales produciendo un bloqueo de la fosforilación de las uniones estrechas (tight junctions) de las mismas. Este mecanismo produciría una mejoría anatómica-funcional en los pacientes e impediría una de las complicaciones más importantes de esta patología como lo es la neovascularización. OBJETIVO: Evaluar la eficacia de bevacizumab intravítreo (Avastin ®™) como tratamiento de la neovascularización coroidea (NVC) en miopías patológicas. PACIENTES Y MÉTODOS: Se evaluaron retrospectivamente 22 pacientes con diagnóstico de maculopatía miópica neovascular tratados mediante inyección intravítrea de bevacizumab, con un seguimiento mínimo de 12 meses. La agudeza visual se evaluó mediante tabla de Snellen y se convirtió en unidades LogMAR. El espesor macular se evaluó mediante tomografía de coherencia óptica (OCT). Las variables cuantitativas se analizaron mediante medidas de tendencia central, dispersión y forma. Los cambios en la agudeza visual se calcularon utilizando la prueba de Wilcoxon para variables apareadas y con la prueba de Mann Whitney para comparar variables independientes. Las diferencias entre variables continuas con distribución normal y de muestras independientes fueron calculadas mediante la prueba T de Student. RESULTADO: Se estudiaron 22 pacientes con diagnóstico de maculopatía miópica neovascular, cuya edad promedio fue de 59,68 (de 11,75; rango 34,00 ­ 85,00), de los cuales 7 (31,8%) fueron hombres y 15 (68,2%) fueron mujeres. El tiempo de seguimiento fue de 12 meses. El tiempo promedio transcurrido entre el comienzo de los síntomas y el inicio del tratamiento fue 38,68 (de 34,63) días. El 68,2% (15) de los pacientes consultaron por disminución brusca de la agudeza visual del ojo afectado y 31,8% (7) consultaron por metamorfopsias. Todos los pacientes presentaron miopía patológica (> 5.0 dioptrías). La cantidad total de inyecciones durante el seguimiento tuvo una media de 4,27 (DE 1.86; Rango 2,00 ­ 9,00), con un máximo de 9 inyecciones y un mínimo de 2 inyecciones. Durante los primeros 6 meses se realizaron la mayor parte de las inyecciones con una media de 3,36 (DE 1,22; Rango 1,00 ­ 6,00). La mediana de la AV al momento del tratamiento fue de 1,00 (P25-75=0,40-1,00). Al analizar la totalidad de los pacientes se encontró que existe una diferencia significativa al comparar las agudezas visuales previas al tratamiento y a los 12 meses de tratamiento (p=<0.0001). La mejoría franca de la AV se observó entre el primer mes (mediana= 1.00 RIQ= 0,6) y los 3 meses de tratamiento (mediana= 0,60 RIQ= 0,6) (p= 0,0002), mientras que no hubo diferencias significativas en la variación de la AV más allá de los 3 meses de seguimiento (p= 0,09). Al estudiar los espesores maculares antes del tratamiento, encontramos una mediana de 290 (RIQ=105); mientras que a los 12 meses de seguimiento fue de 269,50 (RIQ= 91). Teniendo en cuenta el total de los pacientes estudiados, no hubo diferencias significativas en el análisis del espesor macular medido por OCT antes y después del tratamiento (p=0,8812). CONCLUSIONES: El bevacizumab fue eficaz en el tratamiento de la maculopatía miópica, si bien no se encontraron diferencias significativas en la variación del espesor macular. En nuestra serie no hubo complicaciones oculares ni sistémicas vinculadas al tratamiento. (AU)


BACKGROUND: Pathological myopia is observed in about 2% of the general population. Submacular choroidal neovascularization is a leading cause of severe visual loss and blindness in eyes with pathological myopia, affecting 4-11% of those eyes. PURPOSE: Our aim is to evaluate the efficacy and safety of intravitreal bevacizumab in the treatment of neovascular myopic maculopathy (NMM). PATIENTS AND METHODS: 22 nonpreviously treated eyes of 22 consecutive patients with NMM. were reated with monthly intravitreal injections of bevacizumab and followed up for 12 months. Changes in BCVA and central macular thickness were evaluated at 12 months of follow-up. Snellen best-corrected visual acuity (BCVA) was converted into LogMAR units. Mean central macular thickness was obtained by means of spectral domain optical coherence tomography (SP-OCT). Quantitative variables were analyzed with central tendency, dispersion and shape. Changes in BCVA were calculated with Wilcoxon test in paired variables. Mann Whitney test was used to compare independent variables. Differences between continuous variables with normal distribution and independent samples were calculated with the Student T test. Main outcome measures: Changes in BCVA and central macular thickness at12 months of follow-up. RESULTS: Mean age was 54.45 (SD 12.30; r= 28.00 ­ 79.00); 7 patients (31.8%) were male and 15 (68.2%) female. Mean spherical equivalent refractive error was -10.89±4.13 (r= 7.00 to -21,00) Mean time elapsed between initial symptoms and the beginning of treatment was 38.68 (SD34.63) days. Patients received a mean of 4.27 (SD 1.86; r=2.00 to 9.00) injections. Most injections were performed during the first 6 months of treatment (mean 3.36 months; SD 1.22; r=1.00 to 6.00). Median BCVA at baseline was 1.00 (P25-75=0.40-1.00) and at 12 months 0.45 (P25-75=0.30- 0.70) (p<0.0001). Significant visual improvement was observed between the first (median=1.00, IQR= 0.6) and the third month of treatment (median=0.60, IQR=0.6) (p=0.0002), with no further significant improvement (p=0.09). No ocular or systemic side effects attributable to treatment were observed. When comparing patients 55 years old or younger with those older, and between both genders, all individuals improved, although not significantly (Mann Whitney for age P=0.1765; gender P=3454). No significant improvement in macular thickness was observed (pretreatment median thickness 290 microns, IQR=105; month 12 post-treatment median thickness 269.5 microns, IQR=91) (P=0.8812). CONCLUSIONS: Bevacizumab was effective and safe in our series of myopic patients with neovascular maculopathy, and visual gain remained stable during follow-up. (AU)


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Bevacizumab/efeitos dos fármacos , Degeneração Macular/tratamento farmacológico , Miopia Degenerativa
10.
Ginecol. obstet. Méx ; 85(6): 355-363, mar. 2017. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-953716

RESUMO

Resumen ANTECEDENTES: los cuidados centrados en el desarrollo tienen por objeto favorecer el desarrollo neurosensorial y emocional del recién nacido, disminuir el estrés asociado con la atención neonatal, el dolor relacionado con pruebas diagnósticas y los tratamientos invasores. OBJETIVO: describir el grado de implementación de los cuidados centrados en el desarrollo en las unidades de cuidados intensivos neonatales de México. MATERIALES Y MÉTODOS: estudio transversal, observacional y descriptivo. Por medios electrónicos se envió a personal que labora en unidades de cuidados intensivos neonatales, que atienden a más de 50 menores de 1500 g cada año, un cuestionario enfocado a los cuidados centrados en el desarrollo. RESULTADOS: de las 39 unidades de cuidados intensivos neonatales incluidas: 31% usó cobertores para proteger a las incubadoras de la luz, 10% recurrió a algún método de medición del ruido y 36% aplicó escalas del dolor. El tiempo de acceso de los padres a la unidad fue de 2-3 horas al día (56%). El 13% disponía de sala para padres dentro de la unidad, 36% permitían el método canguro. CONCLUSIONES: se observó falta de estrategias para elevar la cobertura de cuidados centrados en el desarrollo en las UCIN, mejorar la educación de los padres respecto a las medidas utilizadas en este programa y lograr que los cuidados centrados en el desarrollo sean aplicados en todas las regiones debido a su bajo costo y gran beneficio.


Abstract BACKGROUND: The objective of Developmental Centered Care (DCC) is to favor the neurosensorial and emotional development of the newborn and to decrease the stress associated to neonatal care and the pain related to diagnostic tests and invasive treatments. OBJECTIVE: To describe the implementation extent of the DCC in the Neonatal Intensive Care Units (NICU) in Mexico. MATERIALS AND METHODS: Cross sectional, observational and descriptive study. A questionnaire focused on DCC was sent via online to personnel working in NICUs that attend more than 50 children weighting less than 1.500 gr every year. RESULTS: A total of 39 NICUs were studied: 31% use covers as a mean of protection from light, 10% use methods of noise measurement, 36% employ pain assessment scales. The access of the parents to the units is 2-3 hours per day (56%); 13% of the units have a room exclusively for parents available inside the unit, and 36% allow the Kangaroo Care Method to be performed. CONCLUSION: A lack of strategies is noted to raise the coverage of these care methods in the NICUs, to improve the education of the parents respecting the measures used in this program, and to achieve that the DCC is applied in every region due to its low cost and great benefit.

11.
Pediatr Blood Cancer ; 61(6): 997-1002, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24347509

RESUMO

BACKGROUND: AHOPCA is a collaborative group that designs uniform treatment regimens (protocols) for children diagnosed with cancer in Central America. Based on a preliminary report from one of the AHOPCA centers, AHOPCA adopted a treatment regimen to maintain a good event-free survival (EFS) as well as eliminate radiation therapy from the treatment of children with Hodgkin lymphoma. PROCEDURE: Newly diagnosed patients with histologically proven Hodgkin lymphoma were staged according to the Ann Arbor classification and divided into favorable (stage I, stage IIA, and IIIA) and unfavorable (stage IIB, IIIB, and IV) groups. Subjects classified as group 1 (favorable) were treated with six 28-day cycles of chemotherapy (COPP/COPP ± ABV). Subjects classified as group 2 (unfavorable) were treated with eight 28-day cycles of COPP/ABV chemotherapy. RESULTS: Of 269 patients registered, 216 were eligible for evaluation. The mean age at diagnosis was 7.5 years with a male to female ratio of 3.7-1. The predominant histology was nodular sclerosis (44%) but with a relatively high proportion of mixed cellularity (35.2%) The EFS at 5 and 10 years was 71% and 68%, respectively. There was a 14% rate of abandonment of therapy. CONCLUSION: This treatment regimen for children with Hodgkin lymphoma, when applied as a multi-institutional regimen, had poorer outcome than our previously reported preliminary data and was inferior to the EFS reported in high-income countries. The major contributor adversely affecting EFS in this report is abandonment of therapy. Given these results, AHOPCA initiated a concerted effort to decrease abandonment of therapy.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doença de Hodgkin/tratamento farmacológico , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Bleomicina/administração & dosagem , Criança , Pré-Escolar , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Feminino , Seguimentos , Doença de Hodgkin/patologia , Humanos , Masculino , Estadiamento de Neoplasias , Pacientes Desistentes do Tratamento , Prednisona/administração & dosagem , Procarbazina/administração & dosagem , Indução de Remissão , Resultado do Tratamento , Vimblastina/administração & dosagem , Vincristina/administração & dosagem
14.
Epidemiol Infect ; 139(1): 143-8, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20653991

RESUMO

Mycobacterium avium subsp. hominissuis (MAH) infection in swine may cause granulomatous lesions in lymph nodes that must undergo differential diagnosis with those caused by M. tuberculosis complex members. Moreover, MAH outbreaks can lead to severe economic losses due to condemnation of carcasses. A number of potential sources of infection for animals can usually be identified in contaminated farms. This report describes the application of several molecular characterization techniques in order to identify the possible environmental sources of MAH infection in an outbreak involving four breeding farms and six fattening farms. Molecular profiles obtained from MAH strains suggested a likely epidemiological link between clinical and environmental isolates cultured from sawdust and cooling systems from one breeding farm. These results highlight the potential risk posed by these environmental elements in the spread of infection and the need for implementation of adequate management practices in order to minimize this risk.


Assuntos
Surtos de Doenças/veterinária , Mycobacterium avium/classificação , Doenças dos Suínos/epidemiologia , Tuberculose/veterinária , Matadouros , Animais , Linfonodos/microbiologia , Linfonodos/patologia , Mycobacterium avium/genética , Mycobacterium avium/isolamento & purificação , Espanha/epidemiologia , Suínos , Doenças dos Suínos/microbiologia , Tuberculose/epidemiologia , Tuberculose/microbiologia
15.
Vet J ; 190(1): 131-5, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21050783

RESUMO

The interferon-gamma (IFN-γ) assay is an effective tool for the diagnosis of tuberculosis (Tb) in goats. The objectives of this study were to evaluate factors that might affect assay performance: (1) the phenol concentration of the purified protein derivative (PPD, tuberculin) used; (2) dialysis of PPD; and (3) delaying antigenic stimulation of blood samples for 8, 16 and 24h after collection. The assay was performed in duplicate with two cut-off points. Dialysis of PPD reduced test sensitivity, whereas the concentration of phenol did not significantly affect test outcome. Delaying antigenic stimulation of samples >8h resulted in a reduction in test sensitivity, compromising the capacity of the assay to detect infected animals. Performing the assay in duplicate was unnecessary, which has implications for reducing assay costs. These findings will facilitate the effective application of the IFN-γ assay as an ancillary test in Tb eradication programmes in goats.


Assuntos
Doenças das Cabras/diagnóstico , Interferon gama/sangue , Mycobacterium/imunologia , Teste Tuberculínico/métodos , Tuberculina , Tuberculose Pulmonar/veterinária , Animais , Sangue/microbiologia , Diálise/métodos , Diálise/veterinária , Ensaio de Imunoadsorção Enzimática/veterinária , Doenças das Cabras/imunologia , Doenças das Cabras/microbiologia , Cabras , Pulmão/imunologia , Linfonodos/imunologia , Fenol/química , Sensibilidade e Especificidade , Espanha , Tuberculina/química , Teste Tuberculínico/instrumentação , Teste Tuberculínico/veterinária , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/imunologia
16.
Clin Microbiol Infect ; 16(11): 1658-62, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20167007

RESUMO

Some of the members of the Mycobacterium avium­intracellulare (MAI) complex are recognized as human pathogens in both immunocompromised and immunocompetent patients. The current molecular methods that are available for genotyping the MAI complex members can be both expensive and technically demanding. In this report, we describe for the first time the application of a real-time PCR and high-resolution melt approach to differentiate between the complex members by targeting a member of the Pro- Pro-Glu gene family, MACPPE24. To this end, reference strains of the M. avium subspecies and Mycobacterium intracellulare were used to optimize the technique. Then, this real-time PCR­high-resolution melt approach was used to distinguish ten M. avium ssp. hominissuis field isolates from the M. intracellulare reference strain.


Assuntos
Impressões Digitais de DNA/métodos , Complexo Mycobacterium avium/classificação , Complexo Mycobacterium avium/genética , Infecção por Mycobacterium avium-intracellulare/microbiologia , Reação em Cadeia da Polimerase/métodos , Polimorfismo de Nucleotídeo Único , Proteínas de Bactérias/genética , Sequência de Bases , DNA Bacteriano/genética , Genótipo , Humanos , Dados de Sequência Molecular , Complexo Mycobacterium avium/isolamento & purificação , Desnaturação de Ácido Nucleico , Alinhamento de Sequência
17.
Int J Obes (Lond) ; 33(9): 1063-73, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19621020

RESUMO

BACKGROUND: The major aim of this study was to investigate whether the motivational salience of food cues (as reflected by their attention-grabbing properties) differs between obese and normal-weight subjects in a manner consistent with altered reward system function in obesity. METHODOLOGY/PRINCIPAL FINDINGS: A total of 18 obese and 18 normal-weight, otherwise healthy, adult women between the ages of 18 and 35 participated in an eye-tracking paradigm in combination with a visual probe task. Eye movements and reaction time to food and non-food images were recorded during both fasted and fed conditions in a counterbalanced design. Eating behavior and hunger level were assessed by self-report measures. Obese individuals had higher scores than normal-weight individuals on self-report measures of responsiveness to external food cues and vulnerability to disruptions in control of eating behavior. Both obese and normal-weight individuals demonstrated increased gaze duration for food compared to non-food images in the fasted condition. In the fed condition, however, despite reduced hunger in both groups, obese individuals maintained the increased attention to food images, whereas normal-weight individuals had similar gaze duration for food and non-food images. Additionally, obese individuals had preferential orienting toward food images at the onset of each image. Obese and normal-weight individuals did not differ in reaction time measures in the fasted or fed condition. CONCLUSIONS/SIGNIFICANCE: Food cue incentive salience is elevated equally in normal-weight and obese individuals during fasting. Obese individuals retain incentive salience for food cues despite feeding and decreased self-report of hunger. Sensitization to food cues in the environment and their dysregulation in obese individuals may play a role in the development and/or maintenance of obesity.


Assuntos
Sinais (Psicologia) , Comportamento Alimentar/psicologia , Alimentos , Fome/fisiologia , Obesidade/psicologia , Adolescente , Adulto , Potenciais Evocados/fisiologia , Jejum/psicologia , Comportamento Alimentar/fisiologia , Feminino , Humanos , Obesidade/fisiopatologia , Recompensa , Inquéritos e Questionários , Adulto Jovem
18.
Av. odontoestomatol ; 24(6): 365-368, nov.-dic. 2008.
Artigo em Es | IBECS | ID: ibc-70144

RESUMO

La relación céntrica ha sido objeto de disparidad de criterios en la odontología durante más de un siglo. A lo largo de este trabajo, vamos a exponer diferentes métodos usados tanto para obtener el registro, como para comprobar su certeza y corroborar la posición condilar. Dado que no existe evidencia científica en el tema, en este trabajo, revisaremos los estudios experimentales que aparecen en la literatura. Los hemos divididos en dos partes, la primera relacionada con la definición de relación céntrica y la segunda parte relacionada con técnicas de registro, posición condilar y la discrepancia entre relación céntrica y oclusión céntrica (AU)


The centric relation has been controversial on dentistry during more of one century. Along of this work, we are going to expose different methods to recording as checking the accuracy and condilar position. Given that there aren’t scientific evidence, in this work, we review the researches publicated. We have divided them into two parts; the first is related with the definition of centric relation and the second part is related with recording techniques, condilar position and centric relation- centric occlusion discrepancy (AU)


Assuntos
Oclusão Dentária Central , Relação Central , Prostodontia/métodos , Prostodontia/normas , Terminologia , Côndilo Mandibular/anatomia & histologia , Côndilo Mandibular/irrigação sanguínea , Côndilo Mandibular/inervação , Prostodontia/instrumentação , Prostodontia/organização & administração , Prostodontia/tendências
19.
Av. odontoestomatol ; 24(6): 369-376, nov.-dic. 2008.
Artigo em Es | IBECS | ID: ibc-70145

RESUMO

La relación céntrica ha sido objeto de disparidad de criterios en la odontología durante más de un siglo. A lo largo de este trabajo, vamos a exponer diferentes métodos usados tanto para obtener el registro, como para comprobar su certeza y corroborar la posición condilar. Dado que no existe evidencia científica en el tema, en este trabajo, revisaremos los estudios experimentales que aparecen en la literatura. Los hemos divididos en dos partes, la primera relacionada con la definición de relación céntrica y la segunda parte relacionada con técnicas de registro, posición condilar y la discrepancia entre relación céntrica y oclusión céntrica (AU)


The centric relation has been controversial on dentistry during more of one century. Along of this work, we are going to expose different methods to recording as checking the accuracy and condilar position. Given that there aren’t scientific evidence, in this work, we review the researches publicated. We have divided them into two parts; the first is related with the definition of centric relation and the second part is related with recording techniques, condilar position and centric relation- centric occlusion discrepancy (AU)


Assuntos
Métodos , Oclusão Dentária , Relação Central , Mandíbula/anatomia & histologia , Mandíbula/irrigação sanguínea , Mandíbula/inervação , Mandíbula/fisiologia
20.
J Clin Microbiol ; 45(10): 3439-42, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17670925

RESUMO

The analysis of the gyrA and gyrB genes of a panel of Mycobacterium avium subsp. paratuberculosis isolates from types I, II, and III detected type-specific single nucleotide polymorphisms. Based on these results, we developed a PCR and restriction enzyme analysis to discriminate type I and III isolates. The application of this technique would be the unique strategy to characterize these strains when there is not enough bacterial growth to perform pulsed-field gel electrophoresis and IS900 restriction fragment length polymorphism.


Assuntos
DNA Girase/genética , Mycobacterium avium subsp. paratuberculosis/genética , Polimorfismo de Nucleotídeo Único , Sequência de Bases , Humanos , Dados de Sequência Molecular , Mycobacterium avium subsp. paratuberculosis/classificação , Reação em Cadeia da Polimerase , Mapeamento por Restrição
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