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1.
Inj Prev ; 2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38782558

RESUMO

BACKGROUND: Restrictions of male passengers of motorcycles to prevent homicides is a long-standing policy in Cali, Colombia. For some periods of time, the policy was suspended and then put into action again. All these changes were never evaluated and there has been controversy due to the perception of citizens, specifically motorcycle users, that the law was properly implemented in some periods and poorly applied in others. Our aim was to examine the effect of the non-application of the motorcycle male passenger restriction policy on the risk of homicides in Cali, Colombia. METHODS: Ecologic study conducted using an interrupted time series analysis. The main outcome was the aggregated daily counts of homicides. Secondary outcomes were the aggregated daily counts of homicides using a motorcycle and using motorcycle and firearm. Incidence rate ratios (IRR) were obtained by comparing periods of policy implementation with periods of lack of implementation in autoregressive negative binomial regression models. RESULTS: There was an increased risk of homicides when the policy was not implemented (IRR=1.12; 1.05-1.19). There was no effect on the risk of homicides committed in motorcycles (IRR=0.98; 0.88-1.10) and when a motorcycle and firearm were used (IRR=0.99; 0.89-1.10). CONCLUSIONS: The lack of implementation of the ban of motorcycle male passengers was associated with an increased risk of homicides. Our findings support the importance of this policy to prevent homicides in Cali, Colombia. Future work should examine how this policy influences other policies related to prevent homicide and violent risk-related behaviour.

2.
Transl Androl Urol ; 12(5): 840-848, 2023 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-37305619

RESUMO

Background: Frailty is common among urology patients in general as well as among men seeking evaluation for stress urinary incontinence (SUI), with 6.1% of men undergoing artificial urinary sphincter placement considered frail. It is unclear if and how patient views on frailty and incontinence severity impact decision-making with regards to SUI treatment. Methods: We undertook a mixed methods analysis to evaluate the intersection of frailty, incontinence severity, and treatment decision-making is presented. To do so, we utilized a previously published cohort of men undergoing evaluation for SUI at the University of California, San Francisco between 2015 and 2020, selecting those who had evaluation with timed up and go test (TUGT), objective measures of incontinence, and patient-reported outcome measures (PROMs). A subset of these participants had additionally undergone semi-structured interviews, and these interviews were re-examined to thematically code them with a focus on the impact of frailty and incontinence severity on SUI treatment decision-making. Results: Among the original cohort of 130 patients, 72 had an objective measure of frailty and were included in our analysis; 18 of these individuals had corresponding qualitative interviews. Common themes identified included (I) impact of incontinence severity on decision-making; (II) the interaction between frailty and incontinence; (III) the impact of comorbidity on treatment decision-making; and (IV) age as a construct of frailty and impact on surgical choice and/or recovery. Direct quotations regarding each theme provides insight into patients' views and drivers of SUI treatment decision-making. Conclusions: The impact of frailty on treatment decision-making for patients with SUI is complex. This mixed methods study highlights the variety of patient views on frailty with regards to surgical intervention for male SUI. Urologists should make a concerted effort to personalize patient counseling for SUI management and take time to understand each patient's perspective in order to individualize SUI treatment decision-making. More research is needed to help identify factors that influence decision-making for frail male patients with SUI.

4.
Urology ; 156: e147-e149, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33774044

RESUMO

Primary hyperoxaluria 1 (PH1) is a devastating condition involving recurrent urolithiasis, early end-stage renal disease and multisystemic deposition of calcium oxalate crystals. Treatment options for PH1 are limited, inevitably requiring transplantation, usually combined kidney and liver transplant. Here we report successful compassionate use of Nedosiran, an RNA interference targeting lactate dehydrogenase, in an index patient. Monthly Nedosiran injections led to dramatically decreased plasma oxalate levels, decreased frequency of weekly hemodialysis sessions from 6 to 3, and deferral of combined kidney and liver transplant. Nedosiran represents a novel and impactful potential therapeutic for PH1 patients with end-stage renal disease.


Assuntos
Hiperoxalúria , Oxalatos , Adolescente , Feminino , Humanos , Ensaios de Uso Compassivo , Hiperoxalúria/sangue , Hiperoxalúria/tratamento farmacológico , Hiperoxalúria/terapia , Oxalatos/sangue , Diálise Renal , Resultado do Tratamento
5.
Urolithiasis ; 49(4): 309-320, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33587147

RESUMO

Ceftriaxone is a widely used antibiotic because to its broad-spectrum gram-negative coverage, safety, and biological half life (5-9 h) permit dose once-daily administration. It is specifically used in pediatric patients in developing countries. Ceftriaxone forms insoluble sludge/stone when combined with calcium in the urinary system. In this study, Ceftriaxone induced sludge/stones from pediatric patients were collected to identify its microstructure and composition to gather insights into the mechanism of Ceftriaxone induced sludge/stone formation. The results illustrated that Ceftriaxone induced stones formed rapidly following antibiotic administration. Ceftriaxone calcium salt crystals could easily be broken with minimal intervention. However, Ceftriaxone combined with calcium phosphate formed an insoluble stone aggregate.


Assuntos
Antibacterianos/efeitos adversos , Antibacterianos/química , Ceftriaxona/efeitos adversos , Ceftriaxona/química , Nefrolitíase/induzido quimicamente , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino
6.
J Pediatr Urol ; 17(2): 214.e1-214.e11, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33495102

RESUMO

OBJECTIVE: Calcium oxalate stones are the most common type among stone-forming patients and in some cases result from predisposed genetic conditions. In this work, we examined the differences in structure and chemical composition between oxalate stones from patients from three groups: 1) pediatric patients that were genetically predisposed (primary hyperoxaluria) to form stones (PPH); 2) control pediatric patients that did not have such genetic predisposition (PN-PH); 3) adult patients that formed oxalate stones without the genetic predisposition (A-CaOx). A variety of instrumental analyses were conducted to identify physicochemical properties of stones characteristic of predisposed pediatric (PPH), pediatric hyperoxaluria (PN-PH), and adult (A-CaOx) patient populations. METHODS: Genetic variants of 16 stone-forming patients were determined using whole-exome gene sequencing. Components of stones from PPH (n = 6), PN-PH (n = 5), and A-CaOx (n = 5) groups were identified using Fourier transform infrared (FTIR) spectroscopy. Stone morphology and density were evaluated using high resolution X-ray computed tomography (micro-XCT). Stone microstructure and elemental composition were mapped with scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) spectroscopy, respectively. RESULTS: Calcium oxalate bipyramidal crystals were found on stones from all groups. Stones from PPH patients with PH types I and II were composed of calcium oxalate monohydrate (COM) with relatively uniform mineral density (1224 ± 277 mg/cc) and distinct smooth surfaces. By contrast, micro-spherical calcium phosphate particles were found only on PN-PH stones, which also showed a broader range of mineral densities (1266 ± 342 mg/cc). Stones from the PN-PH group also contained phosphorus (P), which was absent in NP-PH stones. A-CaOx stones were of significantly lower mineral density (645 ± 237 mg/cc) than pediatric stones and were more heterogeneous in their elemental composition. CONCLUSION: Unique structural and compositional characteristics were identified in stones from pediatric patients with primary hyperoxaluria. These include the absence of phosphorus, a narrower mineral density distribution, and a uniform elemental composition compared to stones from pediatric patients without the genetic predisposition. Thus, characterization of stones at the macro- and micro-scales in combination with genetic testing of patients can provide insights and accurate diagnosis to develop a treatment plan for effective patient care.


Assuntos
Hiperoxalúria Primária , Cálculos Renais , Adulto , Oxalato de Cálcio , Criança , Humanos , Hiperoxalúria Primária/complicações , Hiperoxalúria Primária/genética , Cálculos Renais/diagnóstico por imagem , Cálculos Renais/genética , Tomografia Computadorizada por Raios X
7.
Front Immunol ; 12: 816930, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35111166

RESUMO

Intronic single-nucleotide polymorphisms (SNPs) in the ANKRD55 gene are associated with the risk for multiple sclerosis (MS) and rheumatoid arthritis by genome-wide association studies (GWAS). The risk alleles have been linked to higher expression levels of ANKRD55 and the neighboring IL6ST (gp130) gene in CD4+ T lymphocytes of healthy controls. The biological function of ANKRD55, its role in the immune system, and cellular sources of expression other than lymphocytes remain uncharacterized. Here, we show that monocytes gain capacity to express ANKRD55 during differentiation in immature monocyte-derived dendritic cells (moDCs) in the presence of interleukin (IL)-4/granulocyte-macrophage colony-stimulating factor (GM-CSF). ANKRD55 expression levels are further enhanced by retinoic acid agonist AM580 but downregulated following maturation with interferon (IFN)-γ and lipopolysaccharide (LPS). ANKRD55 was detected in the nucleus of moDC in nuclear speckles. We also analyzed the adjacent IL6ST, IL31RA, and SLC38A9 genes. Of note, in healthy controls, MS risk SNP genotype influenced ANKRD55 and IL6ST expression in immature moDC in opposite directions to that in CD4+ T cells. This effect was stronger for a partially correlated SNP, rs13186299, that is located, similar to the main MS risk SNPs, in an ANKRD55 intron. Upon analysis in MS patients, the main GWAS MS risk SNP rs7731626 was associated with ANKRD55 expression levels in CD4+ T cells. MoDC-specific ANKRD55 and IL6ST mRNA levels showed significant differences according to the clinical form of the disease, but, in contrast to healthy controls, were not influenced by genotype. We also measured serum sgp130 levels, which were found to be higher in homozygotes of the protective allele of rs7731626. Our study characterizes ANKRD55 expression in moDC and indicates monocyte-to-dendritic cell (Mo-DC) differentiation as a process potentially influenced by MS risk SNPs.


Assuntos
Proteínas de Transporte/genética , Receptor gp130 de Citocina/genética , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Variação Genética , Esclerose Múltipla/etiologia , Esclerose Múltipla/metabolismo , Alelos , Autoimunidade/genética , Benzoatos/farmacologia , Biomarcadores , Diferenciação Celular/genética , Diferenciação Celular/imunologia , Regulação da Expressão Gênica/efeitos dos fármacos , Predisposição Genética para Doença , Humanos , Imunofenotipagem , Leucócitos Mononucleares/imunologia , Leucócitos Mononucleares/metabolismo , Linfócitos T/imunologia , Linfócitos T/metabolismo , Tetra-Hidronaftalenos/farmacologia
8.
Int J Mol Sci ; 21(24)2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33317170

RESUMO

Carotid atherosclerotic plaque rupture can lead to cerebrovascular accident (CVA). By comparing RNA-Seq data from vascular smooth muscle cells (VSMC) extracted from carotid atheroma surgically excised from a group of asymptomatic and symptomatic subjects, we identified more than 700 genomic variants associated with symptomatology (p < 0.05). From these, twelve single nucleotide polymorphisms (SNPs) were selected for further validation. Comparing genotypes of a hospital-based cohort of asymptomatic with symptomatic patients, an exonic SNP in the BIRC6 (BRUCE/Apollon) gene, rs35286811, emerged as significantly associated with CVA symptomatology (p = 0.002; OR = 2.24). Moreover, BIRC6 mRNA levels were significantly higher in symptomatic than asymptomatic subjects upon measurement by qPCR in excised carotid atherosclerotic tissue (p < 0.0001), and significantly higher in carriers of the rs35286811 risk allele (p < 0.0001). rs35286811 is a proxy of a GWAS SNP reported to be associated with red cell distribution width (RDW); RDW was increased in symptomatic patients (p < 0.03), but was not influenced by the rs35286811 genotype in our cohort. BIRC6 is a negative regulator of both apoptosis and autophagy. This work introduces BIRC6 as a novel genetic risk factor for stroke, and identifies autophagy as a genetically regulated mechanism of carotid plaque vulnerability.


Assuntos
Artérias Carótidas/metabolismo , Proteínas Inibidoras de Apoptose/genética , Placa Aterosclerótica/genética , Polimorfismo de Nucleotídeo Único , Artérias Carótidas/patologia , Humanos , Placa Aterosclerótica/metabolismo , Placa Aterosclerótica/patologia
9.
Transl Androl Urol ; 9(5): 2129-2137, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33209676

RESUMO

BACKGROUND: Kidney stone formers (SFs) are at increased risk of stroke, myocardial infarction, and atherosclerosis of the carotid and coronary arteries. These cardiovascular and urologic pathologies can result from ectopic biomineral deposition. The objectives of this study are: (I) to evaluate risk factors for ectopic biomineralization, and (II) to characterize the overall burden of ectopic minerals in known SFs compared to non-stone formers (NSFs) matched for these risk factors. METHODS: Presence and quantity of biominerals at eight anatomic locations (abdominal aorta, common iliac arteries, pelvic veins, prostate or uterus, mesentery, pancreas, and spleen) were determined in a case control study by retrospective analysis of clinical non-contrast computed tomography scans obtained from 190 SFs and 190 gender- and age-matched NSFs (renal transplant donors). Predictors of biomineralization were determined using negative binomial regression. A subgroup of 140 SFs and 140 NSFs were matched for risk factors for systemic biomineralization, and mineralization was compared between these matched SFs and NSFs using ordinal logistic regression. RESULTS: Hypertension, hyperlipidemia, diabetes mellitus, and smoking were more common amongst SFs. Risk factors for increased systemic biomineralization included history of nephrolithiasis, male gender, older age, and history of hyperlipidemia. When controlling for these comorbidities, SFs had significantly increased biomineralization systemically and at the abdominal aorta, iliac arteries, prostate, mesentery, pancreas, and spleen compared to NSFs. CONCLUSIONS: The current study provides evidence that SFs are at increased risk of biomineralization systemically, independent of common risk factors of atherosclerosis.

10.
Int J Surg Case Rep ; 72: 343-345, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32563817

RESUMO

INTRODUCTION: Hepatolithiasis (intrahepatic stones) is rare in adolescent patients and requires complex management strategies to prevent recurrent infections and progression to hepatic fibrosis. Surgical management is often required. In cases of unclear etiology, further work-up is indicated to provide insight into future management. In this report we describe an extensive stone analysis. PRESENTATION OF CASE: A 20-year-old Caucasian female presented with known hepatolithiasis and multiple prior recurrent bouts of abdominal pain requiring hospitalization. Magnetic resonance cholangiopancreatography (MRCP) demonstrated an abnormal left-sided hepatic biliary ductal system dilatation. She was treated surgically with a formal left hepatectomy and preservation of the caudate lobe. The right ductal system had no stones or evidence of inflammation, and her bile and stones cultures were negative for organism growth. An extensive analysis demonstrated stone composition primarily of cholesterol. DISCUSSION: Adolescent presentations of hepatolithiasis are rare and considerations in the differential diagnosis include primary sclerosing cholangitis, bile acid transporter defects, and other known genetic diseases. This case is unique because only the left half of the intrahepatic ductal system had evidence of stone disease and the bile was sterile. A detailed stone analysis demonstrating cholesterol supersaturation provides additional context though the etiology remains unclear in this case and will require lifelong follow-up. CONCLUSION: Early-onset hepatolithiasis is rare and requires expert management, and in some cases definitive surgical management with life-long follow-up. Extensive stone analysis and genetic testing can be performed to help identify disease etiology in unique cases.

11.
Rev. cuba. invest. bioméd ; 39(2): e226, abr.-jun. 2020. tab, graf
Artigo em Espanhol | CUMED, LILACS | ID: biblio-1126587

RESUMO

Introducción: este artículo presenta la predicción de tres tipos de movimientos básicos de la mano mediante un algoritmo inteligente para extraer características imprescindibles para el reconocimiento de patrones de movimiento a partir del análisis de señales electromiográficas superficiales adquiridas con el dispositivo Myo. Objetivo: reconocer y predecir patrones básicos de movimiento de la articulación del brazo utilizando electromiografía de superficie para aplicarlo sobre un prototipo de prótesis. Métodos: se tomaron datos de 13 estudiantes de 22 y 23 años de la Universidad Politécnica Salesiana, cada uno de los cuales ejecutó tres tipos de agarre: cilíndrico, pinza y pinza planar. Se trabajó con una frecuencia de 10 Hz y se tomaron 5 muestras por tipo de agarre durante 60 segundos. Para el análisis estadístico de los datos se utilizó la herramienta Anova, estableciendo un valor de significancia mayor a 0,65. Resultados: En ciertos voluntarios hay una mayor reacción en el electrodo 1 debido a que su antebrazo es mayor. El tiempo de respuesta para el reconocimiento varía dependiendo del número de variables que se tenga que comparar. Cuando se analiza un solo movimiento es de 2,6 segundos, en cambio, cuando se analizan los 3 movimientos el tiempo de respuesta incrementa a 7,8 segundos por la cantidad de electrodos que se quieran analizar. Conclusiones: la respuesta del sistema propuesto empieza a ser más lenta a medida que se analizan más movimientos a la vez y por tanto, es menos efectiva. El tiempo de ejecución y respuesta de nuestro sistema, en comparación al estado del arte, es más alto, debido a que se utilizan menos métodos de caracterización de la señal. Adicionalemtne, una limitante del proyecto es la frecuencia de muestreo del dispositivo Myo (200Hz)(AU)


Introduction: the paper presents the prediction of three basic hand movement types by means of a smart algorithm to draw characteristics indispensable for identification of movement patterns based on the analysis of surface electromyographic signals obtained with the Myo device. Objective: recognize and predict basic movement patterns of the arm joint using surface electromyography with a view to applying them over a prosthesis prototype. Methods: data were taken from 13 students aged 22 and 23 years from the Salesian Polytechnic University, each of whom performed three types of grasp: cylindrical, pincer and palmar pincer. A 10 Hz frequency was used and 5 samples were taken of each grasp type during 60 seconds. Statistical analysis was performed with the tool ANOVA, establishing a significance value > 0.65. Results: in certain volunteers a greater reaction was observed in electrode 1, due to their larger forearms. Response time for identification varies with the number of variables to be compared. When only one movement is analyzed, response time is 2.6 seconds, but when the three movements are examined it rises to 7.8 seconds by the number of electrodes intended to be studied. Conclusions: the response of the system proposed starts to slow down as more movements are analyzed simultaneously, which makes it less effective. The performance and response time of our system is higher than in state-of-the-art systems, since fewer signal characterization methods are used. On the other hand, a limitation of the project is the sampling frequency of the Myo device (200 Hz)(AU)


Assuntos
Humanos , Masculino , Adulto Jovem , Próteses e Implantes/normas , Força da Mão/fisiologia , Eletrodos/normas , Eletromiografia/métodos , Mãos/fisiologia
12.
Rev. salud pública ; 22(2): e286432, mar.-abr. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1115871

RESUMO

RESUMEN Objetivo Predecir el número de casos de COVID-19 en la ciudad de Cali-Colombia mediante el desarrollo de un modelo SEIR. Métodos Se utilizó un modelo determinista compartimental SEIR considerando los estados: susceptibles (S), expuestos (E), infectados (I) y recuperados (R). Los parámetros del modelo fueron seleccionados de acuerdo a la revisión de literatura. En el caso de la tasa de letalidad, se usaron los datos de la Secretaría de Salud Municipal de Cali. Se plantearon varios escenarios teniendo en cuenta variaciones en el número básico de reproducción (R0) y en la tasa de letalidad; además, se comparó la predicción hasta el 9 de abril con los datos observados. Resultados A través del modelo SEIR se encontró que, con el número básico de reproducción más alto (2,6) y utilizando la letalidad calculada para la ciudad de 2,0%, el número máximo de casos se alcanzaría el primero de junio con 195 666 (prevalencia); sin embargo, al comparar los casos observados con los esperados, al inicio la ocurrencia observada estaba por encima de la proyectada; pero luego cambia la tendencia con una disminución marcada de la pendiente. Conclusiones Los modelos epidemiológicos SEIR son métodos muy utilizados para la proyección de casos en enfermedades infecciosas; sin embargo, se debe tener en cuenta que son modelos deterministas que pueden utilizar parámetros supuestos y podrían generar resultados imprecisos.(AU)


ABSTRACT Objective To predict the number of cases of COVID-19 in the city of Cali-Colombia through the development of a SEIR model. Methods A SEIR compartmental deterministic model was used considering the states: susceptible (S), exposed (E), infected (I) and recovered (R). The model parameters were selected according to the literature review, in the case of the case fatality rate data from the Municipal Secretary of Health were used. Several scenarios were considered taking into account variations in the basic number of reproduction (R0), and the prediction until april 9 was compared with the observed data. Results Through the SEIR model it was found that with the highest basic number of reproduction [2,6] and using the case fatality rate for the city of 2,0%, the maximum number of cases would be reached on June 1 with 195 666 (prevalence). However, when comparing the observed with the expected cases, at the beginning the observed occurrence was above the projected, but then the trend changes decreasing the slope. Conclusions SEIR epidemiological models are widely used methods for projecting cases in infectious diseases, however it must be taken into account that they are deterministic models that can use assumed parameters and could generate imprecise results.(AU)


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Número Básico de Reprodução/estatística & dados numéricos , Pandemias/estatística & dados numéricos , Colômbia/epidemiologia , Previsões
13.
Rev. salud pública ; 22(2): e286431, mar.-abr. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1115872

RESUMO

RESUMEN Objetivo Describir la distribución espacio-temporal del COVID-19 en la ciudad de Cali durante el primer mes de epidemia. Métodos Se realizó un análisis exploratorio de datos espaciales, compuesto por un análisis de densidad de Kernel y se verificó la presencia de patrones espaciales por medio de la función K de Ripley. Resultados La distribución espacial de los casos tiende a concentrarse inicialmente en el norte y sur de la ciudad, con una dinámica cambiante hacia el oriente y occidente. Conclusiones El patrón espacial identificado puede estar influenciado por las medidas de aislamiento tomadas a nivel local y nivel nacional, además no se puede descartar el efecto del poco acceso que tiene la población general a las pruebas diagnósticas, los retrasos y represamientos para conocer los resultados de las mismas y aun los posibles sesgos por dificultades en la técnica de toma de la muestra o su conservación.(AU)


ABSTRACT Objective To describe the spatio-temporal distribution of the COVID-19 in the city of Cali during the first month of the epidemic. Methods An exploratory analysis of spatial data was carried out, consisting of a kernel density analysis and the presence of spatial patterns was verified by the K-Ripley function. Results The spatial distribution of the cases tends to initially concentrate in the north and south of the city, with a changing dynamic towards the east and west. Conclusions The identified spatial pattern may be influenced by the isolation measures taken at the local and national level, but the effect of the low access of the general population to diagnostic tests, delays and restraints to know the results cannot be ruled out and even possible biases due to difficulties in the technique of taking the sample or its conservation.(AU)


Objetivo: Descrever a distribuição espaço-temporal do COVID-19 na cidade de Cali durante o primeiro mês da epidemia. Métodos: Foi realizada uma análise exploratória de dados espaciais, consistindo em uma análise de densidade de kernel e a presença de padrões espaciais foi verificada pela função K-Ripley. Resultados: A distribuição espacial dos casos tende a se concentrar inicialmente no norte e no sul da cidade, com uma dinâmica mutante para o leste e oeste. Conclusões: O padrão espacial identificado pode ser influenciado pelas medidas de isolamento tomadas a nível local e nacional, mas não se pode descartar o efeito do baixo acesso da população em geral aos exames diagnósticos, atrasos e limitações para conhecer os resultados e mesmo possíveis vieses devido às dificuldades na técnica de coleta da amostra ou na sua conservação.(AU)


Assuntos
Humanos , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/epidemiologia , Colômbia/epidemiologia , Análise Espacial , Geografia Médica/instrumentação
14.
J Cancer Res Clin Oncol ; 146(7): 1857-1865, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32219517

RESUMO

PURPOSE: Complementary and alternative medicine (CAM) use is common amongst cancer patients. However, there is growing concern about its safety and efficacy. Online crowdfunding campaigns represent a unique avenue to understand the cancer patient's perspective for using CAM or declining conventional cancer therapy (CCT). METHODS: Five hundred GoFundMe campaigns from 2012 to 2019 detailing financial need for cancer treatment were randomly selected and reviewed for endorsement of CAM use, reasons for using CAM, and reasons for declining CCT. Descriptive statistics were used to compare patient and campaign characteristics between 250 CAM users and 250 non-CAM users. RESULTS: Compared to non-CAM users, CAM users were more likely to be female (70% vs. 54%, p < 0.01), to report more stage IV cancer (54% vs. 12%, p < 0.01), and to have a history of delayed, missed, or misdiagnosis (10% vs. 4%, p < 0.01). Reasons for using CAM include endorsing curative/therapeutic effects 212 (85%), pain/stress reduction 137 (55%), and dissatisfaction with current or past medical treatment options 105 (42%). 87 (35%) CAM users that declined CCT reported that they wanted to try to fight off cancer using CAM first 57 (61%), that CCT was too "toxic" to the body 39 (42%), and cancer was already too advanced, so that CCT would be futile or too aggressive 25 (27%). CONCLUSION: Cancer patients on GoFundMe using CAM highly value quality of life, comfort, and autonomy. Physicians should educate themselves on CAM to set realistic expectations and provide comprehensive counseling of the risks and benefits of CAM usage to patients who choose to use CAM to either augment or completely replace CCT.


Assuntos
Terapias Complementares , Neoplasias/epidemiologia , Ferramenta de Busca , Terapias Complementares/economia , Terapias Complementares/métodos , Terapias Complementares/estatística & dados numéricos , Bases de Dados Factuais , Promoção da Saúde , Humanos , Motivação , Estadiamento de Neoplasias , Neoplasias/diagnóstico , Neoplasias/psicologia , Neoplasias/terapia , Ferramenta de Busca/métodos , Navegador
15.
Cells ; 9(1)2020 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-31936765

RESUMO

The IL22RA2 locus is associated with risk for multiple sclerosis (MS) but causative variants are yet to be determined. In a single nucleotide polymorphism (SNP) screen of this locus in a Basque population, rs28385692, a rare coding variant substituting Leu for Pro at position 16 emerged significantly (p = 0.02). This variant is located in the signal peptide (SP) shared by the three secreted protein isoforms produced by IL22RA2 (IL-22 binding protein-1(IL-22BPi1), IL-22BPi2 and IL-22BPi3). Genotyping was extended to a Europe-wide case-control dataset and yielded high significance in the full dataset (p = 3.17 × 10-4). Importantly, logistic regression analyses conditioning on the main known MS-associated SNP at this locus, rs17066096, revealed that this association was independent from the primary association signal in the full case-control dataset. In silico analysis predicted both disruption of the alpha helix of the H-region of the SP and decreased hydrophobicity of this region, ultimately affecting the SP cleavage site. We tested the effect of the p.Leu16Pro variant on the secretion of IL-22BPi1, IL-22BPi2 and IL-22BPi3 and observed that the Pro16 risk allele significantly lowers secretion levels of each of the isoforms to around 50%-60% in comparison to the Leu16 reference allele. Thus, our study suggests that genetically coded decreased levels of IL-22BP isoforms are associated with augmented risk for MS.


Assuntos
Predisposição Genética para Doença , Esclerose Múltipla/genética , Polimorfismo de Nucleotídeo Único/genética , Sinais Direcionadores de Proteínas/genética , Receptores de Interleucina/genética , Adulto , Sequência de Aminoácidos , Simulação por Computador , Bases de Dados Genéticas , Frequência do Gene/genética , Células HEK293 , Humanos , Pessoa de Meia-Idade , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Receptores de Interleucina/química , Fatores de Risco
16.
Rev Salud Publica (Bogota) ; 22(2): 132-137, 2020 03 01.
Artigo em Espanhol | MEDLINE | ID: mdl-36753101

RESUMO

OBJECTIVE: To predict the number of cases of COVID-19 in the city of Cali-Colombia through the development of a SEIR model. METHODS: A SEIR compartmental deterministic model was used considering the states: susceptible (S), exposed (E), infected (I) and recovered (R). The model parameters were selected according to the literature review, in the case of the case fatality rate data from the Municipal Secretary of Health were used. Several scenarios were considered taking into account variations in the basic number of reproduction (R0), and the prediction until april 9 was compared with the observed data. RESULTS: Through the SEIR model it was found that with the highest basic number of reproduction [2,6] and using the case fatality rate for the city of 2,0%, the maximum number of cases would be reached on June 1 with 195 666 (prevalence). However, when comparing the observed with the expected cases, at the beginning the observed occurrence was above the projected, but then the trend changes decreasing the slope. CONCLUSIONS: SEIR epidemiological models are widely used methods for projecting cases in infectious diseases, however it must be taken into account that they are deterministic models that can use assumed parameters and could generate imprecise results.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Colômbia/epidemiologia , Previsões , Cidades
17.
Rev Salud Publica (Bogota) ; 22(2): 138-143, 2020 03 01.
Artigo em Espanhol | MEDLINE | ID: mdl-36753102

RESUMO

OBJECTIVE: To describe the spatio-temporal distribution of the COVID-19 in the city of Cali during the first month of the epidemic. METHODS: An exploratory analysis of spatial data was carried out, consisting of a kernel density analysis and the presence of spatial patterns was verified by the K-Ripley function. RESULTS: The spatial distribution of the cases tends to initially concentrate in the north and south of the city, with a changing dynamic towards the east and west. CONCLUSIONS: The identified spatial pattern may be influenced by the isolation measures taken at the local and national level, but the effect of the low access of the general population to diagnostic tests, delays and restraints to know the results cannot be ruled out and even possible biases due to difficulties in the technique of taking the sample or its conservation.


Assuntos
COVID-19 , Epidemias , Humanos , SARS-CoV-2 , COVID-19/epidemiologia , Colômbia/epidemiologia , Análise Espaço-Temporal
18.
Front Immunol ; 10: 2067, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31620119

RESUMO

The ankyrin repeat domain-55 (ANKRD55) gene contains intronic single nucleotide polymorphisms (SNPs) associated with risk to contract multiple sclerosis, rheumatoid arthritis or other autoimmune disorders. Risk alleles of these SNPs are associated with higher levels of ANKRD55 in CD4+ T cells. The biological function of ANKRD55 is unknown, but given that ankyrin repeat domains constitute one of the most common protein-protein interaction platforms in nature, it is likely to function in complex with other proteins. Thus, identification of its protein interactomes may provide clues. We identified ANKRD55 interactomes via recombinant overexpression in HEK293 or HeLa cells and mass spectrometry. One hundred forty-eight specifically interacting proteins were found in total protein extracts and 22 in extracts of sucrose gradient-purified nuclei. Bioinformatic analysis suggested that the ANKRD55-protein partners from total protein extracts were related to nucleotide and ATP binding, enriched in nuclear transport terms and associated with cell cycle and RNA, lipid and amino acid metabolism. The enrichment analysis of the ANKRD55-protein partners from nuclear extracts is related to sumoylation, RNA binding, processes associated with cell cycle, RNA transport, nucleotide and ATP binding. The interaction between overexpressed ANKRD55 isoform 001 and endogenous RPS3, the cohesins SMC1A and SMC3, CLTC, PRKDC, VIM, ß-tubulin isoforms, and 14-3-3 isoforms were validated by western blot, reverse immunoprecipitaton and/or confocal microscopy. We also identified three phosphorylation sites in ANKRD55, with S436 exhibiting the highest score as likely 14-3-3 binding phosphosite. Our study suggests that ANKRD55 may exert function(s) in the formation or architecture of multiple protein complexes, and is regulated by (de)phosphorylation reactions. Based on interactome and subcellular localization analysis, ANKRD55 is likely transported into the nucleus by the classical nuclear import pathway and is involved in mitosis, probably via effects associated with mitotic spindle dynamics.


Assuntos
Proteínas de Transporte/imunologia , Núcleo Celular/metabolismo , Mitose/imunologia , Mapas de Interação de Proteínas/imunologia , Transporte Ativo do Núcleo Celular/genética , Transporte Ativo do Núcleo Celular/imunologia , Doenças Autoimunes/genética , Doenças Autoimunes/imunologia , Proteínas de Transporte/genética , Núcleo Celular/genética , Células HEK293 , Células HeLa , Humanos , Mitose/genética , Polimorfismo de Nucleotídeo Único
19.
J Med Internet Res ; 21(8): e13769, 2019 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-31471960

RESUMO

BACKGROUND: Predatory journals fail to fulfill the tenets of biomedical publication: peer review, circulation, and access in perpetuity. Despite increasing attention in the lay and scientific press, no studies have directly assessed the perceptions of the authors or editors involved. OBJECTIVE: Our objective was to understand the motivation of authors in sending their work to potentially predatory journals. Moreover, we aimed to understand the perspective of journal editors at journals cited as potentially predatory. METHODS: Potential online predatory journals were randomly selected among 350 publishers and their 2204 biomedical journals. Author and editor email information was valid for 2227 total potential participants. A survey for authors and editors was created in an iterative fashion and distributed. Surveys assessed attitudes and knowledge about predatory publishing. Narrative comments were invited. RESULTS: A total of 249 complete survey responses were analyzed. A total of 40% of editors (17/43) surveyed were not aware that they were listed as an editor for the particular journal in question. A total of 21.8% of authors (45/206) confirmed a lack of peer review. Whereas 77% (33/43) of all surveyed editors were at least somewhat familiar with predatory journals, only 33.0% of authors (68/206) were somewhat familiar with them (P<.001). Only 26.2% of authors (54/206) were aware of Beall's list of predatory journals versus 49% (21/43) of editors (P<.001). A total of 30.1% of authors (62/206) believed their publication was published in a predatory journal. After defining predatory publishing, 87.9% of authors (181/206) surveyed would not publish in the same journal in the future. CONCLUSIONS: Authors publishing in suspected predatory journals are alarmingly uninformed in terms of predatory journal quality and practices. Editors' increased familiarity with predatory publishing did little to prevent their unwitting listing as editors. Some suspected predatory journals did provide services akin to open access publication. Education, research mentorship, and a realignment of research incentives may decrease the impact of predatory publishing.


Assuntos
Autoria/normas , Bibliotecas Médicas/normas , Políticas Editoriais , Humanos , Inquéritos e Questionários
20.
PLoS Genet ; 15(6): e1008180, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170158

RESUMO

Multiple sclerosis (MS) is an inflammatory disease of the central nervous system characterized by myelin loss and neuronal dysfunction. Although the majority of patients do not present familial aggregation, Mendelian forms have been described. We performed whole-exome sequencing analysis in 132 patients from 34 multi-incident families, which nominated likely pathogenic variants for MS in 12 genes of the innate immune system that regulate the transcription and activation of inflammatory mediators. Rare missense or nonsense variants were identified in genes of the fibrinolysis and complement pathways (PLAU, MASP1, C2), inflammasome assembly (NLRP12), Wnt signaling (UBR2, CTNNA3, NFATC2, RNF213), nuclear receptor complexes (NCOA3), and cation channels and exchangers (KCNG4, SLC24A6, SLC8B1). These genes suggest a disruption of interconnected immunological and pro-inflammatory pathways as the initial event in the pathophysiology of familial MS, and provide the molecular and biological rationale for the chronic inflammation, demyelination and neurodegeneration observed in MS patients.


Assuntos
Predisposição Genética para Doença , Inflamação/genética , Esclerose Múltipla/genética , Transcriptoma/genética , Adulto , Códon sem Sentido , Doenças Desmielinizantes/genética , Doenças Desmielinizantes/patologia , Exoma/genética , Feminino , Humanos , Inflamação/metabolismo , Inflamação/patologia , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/metabolismo , Esclerose Múltipla/patologia , Bainha de Mielina/genética , Bainha de Mielina/patologia , Degeneração Neural/genética , Degeneração Neural/patologia , Neurônios/metabolismo , Neurônios/patologia , Linhagem , Sequenciamento do Exoma , Adulto Jovem
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