RESUMO
BACKGROUND: Violence against women (VAW) severely impacts their physical and mental health. In some cultures, women can normalize certain types of violence if they were linked to home models in childhood and, eventually, do not seek for help in adulthood. We aimed to determine, in Peruvian women, (1) the association between witnessing violence in their family of origin and VAW experienced in adulthood, (2) the extent to which women who have experienced VAW seek some help, and (3) identify VAW prevalence by Peruvian region. METHODS: Cross-sectional study of secondary data obtained from the 2019 National Demographic and Family Health Survey (ENDES). The outcome was VAW (psychological, physical and sexual violence), whereas the exposure was witnessing violence in the home of origin. Help-seeking behavior was a secondary outcome, for which VAW was the exposure. Prevalence ratios (PR) were estimated to assess both associations, unadjusted and adjusted for covariates (aPR). RESULTS: Data from 14,256 women aged 15 to 49 years were analysed. 51.5% reported having experienced VAW and 43.8% witnessed violence in the home of origin during childhood. Witnessing inter-parental violence in childhood was associated with psychological violence aPR = 1.25 (95% CI: 1.17-1.33), physical aPR = 1.52 (95% CI: 1.38-1.67), and sexual aPR = 1.99 (95% CI: 1.57-2.52). Women who have experienced both types of violence (physical and sexual) were more likely to help-seeking (aPR = 1.30, 95% CI: 1.14-1.50) than women suffering only one type of violence. CONCLUSION: Women who reported having witnessed home violence in their childhood are more likely to experience Violence Against Women (VAW) by their current partner. Physical and sexual violence with a current partner was more associated with witnessing inter-parental violence in childhood, and when physical and sexual violence jointly occurred women were more help-seeking. The southern region of Peru is identified as an area of high vulnerability for women. It is crucial to promote educative and community-based programs aimed at the prevention and early recognition of VAW.
Assuntos
Comportamento de Busca de Ajuda , Humanos , Feminino , Peru/epidemiologia , Estudos Transversais , Pais , ViolênciaRESUMO
We studied the effect of exercise-induced body fluid redistribution on dual-energy x-ray absorptiometry (DXA) body composition scores. Thirty males completed 30-min of upper-body exercise (UBE), lower-body exercise, and seated non-exercise control (NEC). ANOVA determined interactions between experimental conditions and measurements on body composition variables. For UBE, mean pre to post differences were found on tissue fat (M = 0.35 ± 0.12%; CI95%diff = 0.10 to 0.59%; p = 0.007), region fat (M = 0.32 ± 0.11%; CI95%diff = 0.09 to 0.55%; p = 0.008), lean mass (M = 0.27 ± 0.01 kg; CI95%diff = 0.18 to 0.37 kg; p ≤ 0.0001), and total mass (M = 0.27 ± 0.05 kg; CI95%diff = 0.17 to 0.36 kg; p ≤ 0.0001). Mean tissue pre to post differences were found for the total body in the NEC (M = 0.10 ± 0.04 kg; CI95%diff = 0.03 to 0.18 kg; p = 0.008), UBE (M = 0.19 ± 0.03 kg; CI95%diff = 0.14 to 0.24 kg; p ≤ 0.0001), and LBE (M = 0.31 ± 0.04 kg; CI95%diff = 0.24 to 0.39 kg; p ≤ 0.0001) conditions. High absolute reliability was found within experimental conditions. These findings have practical implications for technicians, since acute exercise elicited small changes in body composition scores using DXA.
Assuntos
Absorciometria de Fóton , Composição Corporal , Exercício Físico , Humanos , Masculino , Exercício Físico/fisiologia , Composição Corporal/fisiologia , Adulto Jovem , Adulto , Líquidos Corporais/fisiologiaRESUMO
BACKGROUND: In the Americas, the Pan American Health Organization (PAHO) has promoted initiatives that aim at the elimination of mother-to-child transmitted diseases for over two decades. Although Guatemala has assumed the commitment to improve access and coverage of reproductive and perinatal services, the goals have not yet been reached. Often, the implementation of these efforts is hampered by complexities rooted in social, cultural, and environmental intersections. The objective of this work is to share our experience applying gender intersectionality as a methodological and analytical tool in a participatory research project that aims to improve access to maternal and child health screening services. The study shows the novel strategy that incorporates intersectionality contributing to evidence on how it can be applied to strengthen public health efforts around the implementation of the EMTCT Plus (Elimination of mother-to-child transmission of HIV, Syphilis, Hepatitis B, and Chagas disease) framework, in the mostly rural municipality of Comapa, in Guatemala. METHODS: We applied a participatory methodology, integrating theoretical and methodological frameworks to have an intersectional understanding of health services delivered by both, midwives, and the public health institution, for the prevention, diagnosis, treatment, and follow-up of HIV, Syphilis, Hepatitis B, and Chagas. The data was collected by conducting interviews, focus groups, workshops, and reviewing laboratory databases, guided by five strategies from a cultural appropriateness framework. RESULTS: The intersectional analysis shed light on the synergies and gaps of the current efforts and protocols implemented by both the midwives and the Ministry of Health. The services offered for the four diseases were often delivered independently from each other, and a comprehensive educational and communication material strategy was absent. However, our findings will be used to inform consistent, locally relevant, and culturally appropriate educational content for the local population, also following the national policy guidelines. CONCLUSIONS: Using intersectionality as a method and as an analytical tool allowed us to understand the (1) interrelation of diverse social, cultural, and environmental determinants which influence the delivery of health services, as well as (2) the dynamics between the traditional and institutional health systems. (3) Community engagement and the participation of different stakeholders in a consultative process have been fundamental for the conceptual and methodological tenets of this research. (4) Finally, giving a more prominent role to midwives can strengthen sustainability and cultural appropriateness, which is complementary to the delivery of institutional health services.
RESUMEN: ANTECEDENTES: La Organización Panamericana de la Salud (OPS) ha impulsado iniciativas que buscan la eliminación de las enfermedades de transmisión materno infantil en las Américas desde hace más de dos décadas. Si bien Guatemala ha asumido el compromiso de mejorar el acceso y la cobertura de los servicios reproductivos y perinatales, las metas aún no se han alcanzado. Muchas veces, la implementación de estos esfuerzos se ve obstaculizada por complejidades arraigadas en intersecciones sociales, culturales y ambientales. Este estudio muestra una estrategia novedosa que incorpora la interseccionalidad como un componente metodológico y analítico. Esto contribuye a evidenciar la manera en que la interseccionalidad y la participación comunitaria pueden ser aplicadas para fortalecer los esfuerzos de salud pública en torno a la implementación de la estrategia ETMI Plus (Eliminación de la transmisión materno infantil del VIH, sífilis, hepatitis B y enfermedad de Chagas), en el municipio de Comapa, en Guatemala, el cual es mayoritariamente rural. MéTODOS: Implementamos una metodología participativa, integrando marcos teóricos y metodológicos para comprender la prestación de servicios de salud, tanto por parte de comadronas como de la institución de salud pública, desde una perspectiva interseccional para la prevención, diagnóstico, tratamiento y seguimiento de VIH, sífilis, hepatitis B y Chagas. Los datos fueron recolectados a través de entrevistas, grupos focales, talleres y tras la revisión de bases de datos de laboratorio, y nos guiamos por cinco estrategias propuestas en un marco para pertinencia cultural. RESULTADOS: El análisis interseccional permitió entender las sinergias y brechas de los esfuerzos y los protocolos que se implementan actualmente, tanto por parte de las comadronas como por el Ministerio de Salud. Encontramos que los servicios que actualmente se prestan para las cuatro enfermedades son en su mayoría independientes entre sí, y no se contaba con una estrategia integral de material educativo y de comunicación. Sin embargo, nuestros resultados se utilizarán como base para una estrategia de comunicación que sea coherente, localmente relevante y culturalmente apropiada para la población local, y también siga las regulaciones de las políticas nacionales. CONCLUSIONES: El uso de la interseccionalidad como método y como herramienta analítica nos permitió comprender (1) la interrelación de diversos determinantes sociales, culturales y ambientales que influyen en la prestación de servicios de salud, así como (2) la dinámica entre los sistemas de salud tradicional e institucional. (3) El compromiso de la comunidad y la participación de las diferentes partes interesadas en un proceso consultivo han sido fundamentales para los principios conceptuales y metodológicos de esta investigación. (4) Por último, otorgar un papel más destacado a las matronas puede reforzar la sostenibilidad y la adecuación cultural, que es complementaria a la prestación de servicios de salud institucionales.
Assuntos
Infecções por HIV , Hepatite B , Sífilis , Gravidez , Criança , Humanos , Feminino , Saúde da Criança , Enquadramento Interseccional , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Infecções por HIV/epidemiologia , Hepatite B/prevenção & controleRESUMO
BACKGROUND: Dual-energy X-ray absorptiometry (DXA) measures are affected by the noise produced by external factors such as textile compression found in loose clothing. The study aimed to determine the effect of a compression bandage (CB) on body composition (BC) assessed by DXA. METHODS: Sixty volunteers (age=21.4±4.7yr.) underwent full-body DXA scans on a control (CTRL) condition and after wearing a 30-mmHg CB on the trunk, legs, and arms. ANOVA (2 genders by 2 experimental conditions) determined mean interactions in BC variables tissue body fat% (BF%), region body fat% (RBF%), body tissue (BT), fat mass (FM), lean mass (LM), bone mineral content (BMC), and total mass (TM). Absolute reliability in BC scores was studied by the typical error of the measurement (TEM), the coefficient of variability (CV), and Bland-Altman plots. RESULTS: ANOVA interactions were found on tissue total BF% (p=0.049), RBF% (p=0.048), android lean mass (p=0.004), and android total mass (p=0.019). The CV was small for tissue BF% (2.61±0.93%, CI95%=0.79, 4.43%), RBF% (2.66±1.78%, CI95%=-0.83, 6.15%), BT (4.82±2.19%, CI95%=0.54, 9.10kg), FM (4.17±2.25%, CI95%=-0.24, 8.58kg), LM (3.25±2.44%, CI95%=-1.53, 8.04kg), BMC (4.81±2.96%, CI95%=-0.99, 10.62kg), and TM (2.84±2.80%, CI95%=-2.65, 8.33kg). Bland-Altman plots showed random error for BF%, LM, and BMC. A bias of 0.5% was observed on BF% in males. CONCLUSION: A CB worn during a full-body DXA scan elicited similar BC scores than not wearing it. The variation in scores was <10% for most BC variables, and a trivial bias of 0.5% in BF% was detected in male scores.
Assuntos
Tecido Adiposo , Composição Corporal , Masculino , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Absorciometria de Fóton , Reprodutibilidade dos Testes , Densidade ÓsseaRESUMO
Community engagement strategies provide tools for sustainable vector-borne disease control. A previous cluster randomized control trial engaged nine intervention communities in seven participatory activities to promote management of the domestic and peri-domestic environment to reduce risk factors for vector-borne Chagas disease. This study aims to assess the adoption of this innovative community-based strategy, which included chickens' management, indoor cleaning practices, and domestic rodent infestation control, using concepts from the Diffusion of Innovations Theory. We used questionnaires and semi-structured interviews to understand perceptions of knowledge gained, intervention adoption level, innovation attributes, and limiting or facilitating factors for adoption. The analysis process focused on five innovation attributes proposed by the Diffusion of Innovations Theory: relative advantage, compatibility, complexity, trialability, and observability. Rodent management was highly adopted by participants, as it had a relative advantage regarding the use of poison and was compatible with local practices. The higher complexity was reduced by offering several types of trapping systems and having practical workshops allowed trialability. Observability was limited because the traps were indoors, but information and traps were shared with neighbors. Chicken management was not as widely adopted due to the higher complexity of the method, and lower compatibility with local practices. Using the concepts proposed by the Diffusion of Innovations Theory helped us to identify the enablers and constraints in the implementation of the Chagas vector control strategy. Based on this experience, community engagement and intersectoral collaboration improve the acceptance and adoption of novel and integrated strategies to improve the prevention and control of neglected diseases.
Assuntos
Galinhas , Colaboração Intersetorial , Animais , Humanos , Conhecimento , Doenças Negligenciadas , Fatores de RiscoRESUMO
Importance: The potential role of living alone in either facilitating or hampering access to and use of services for older adults with cognitive impairment is largely unknown. Specifically, it is critical to understand directly from health care and social services professionals how living alone creates barriers to the access and use of supportive health care and social services for racially and ethnically diverse patients with cognitive impairment. Objective: To identify the potential role of living alone in the access and use of health care and social services for diverse patients with cognitive impairment by investigating professionals' perceptions of caring for such patients who live alone in comparison with counterparts living with others. Design, Setting, and Participants: This qualitative study of 76 clinicians, social workers, and other professionals used semistructured interviews conducted between February 8, 2021, and June 8, 2022, with purposively sampled professionals providing services to diverse patients with cognitive impairment in Michigan, California, and Texas. Main Outcomes and Measures: Clinicians, social workers, and other professionals compared serving patients with cognitive impairment and living alone vs counterparts living with others. An inductive content analysis was used to analyze the interview transcripts. Results: A total of 76 professionals were interviewed (mean [SD] age, 49.3 [12.7] years); 59 were female (77.6%), 8 were Black or African American (11%), and 35 were White (46%). Participants included physicians, nurses, social workers, and home-care aides, for a total of 20 professions. Participants elucidated specific factors that made serving older adults living alone with cognitive impairment more challenging than serving counterparts living with others (eg, lacking an advocate, incomplete medical history, requiring difficult interventions), as well as factors associated with increased concerns when caring for older adults living alone with cognitive impairment, such as isolation and a crisis-dominated health care system. Participants also identified reasons for systematic unmet needs of older adults living alone with cognitive impairment for essential health care and social services, including policies limiting access and use to public home-care aides. Conclusions and Relevance: In this qualitative study of professionals' perspectives, findings suggest that living alone is a social determinant of health among patients with cognitive impairment owing to substantial barriers in access to services. Results raised considerable concerns about safety because the US health care system is not well equipped to address the unique needs of older adults living alone with cognitive impairment.
Assuntos
Disfunção Cognitiva , Utilização de Instalações e Serviços , Acessibilidade aos Serviços de Saúde , Ambiente Domiciliar , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , População Negra , Disfunção Cognitiva/terapia , Serviço Social , Assistentes Sociais , Atenção à Saúde , Estados Unidos , Adulto , Atitude do Pessoal de Saúde , BrancosRESUMO
Jiménez-Díaz, J., Chaves-Castro, K. y Carpio-Rivera, E. (2023). Relación entre el desempeño motor real evaluado con pruebas orientadas al proceso y el desempeño motor real evaluado con pruebas orientadas al producto: un metaanálisis. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-17. El desempeño motor suele ser evaluado de dos formas; la primera se enfoca en cómo se realiza la destreza, mientras que la segunda registra el resultado obtenido después de la ejecución; ambas son ampliamente usadas, sin embargo, la relación entre ellas no está clara. El objetivo del presente estudio fue determinar la relación entre los resultados de las pruebas orientadas al proceso o al producto utilizadas para medir el desempeño motor real y examinar posibles variables moderadoras por medio de la técnica meta-analítica. Para resumir los resultados, se utilizó el modelo de efectos aleatorios (REML) y se calculó el tamaño de efecto (TE) de correlación. Un total de siete estudios cumplieron con los criterios de elegibilidad, se obtuvo un total de 37 TE. Se encontró que existe una relación significativa y positiva entre el desempeño evaluado por medio de proceso y producto (TE = 0.466; IC95% = 0.391,0.541; p < .001; n = 37; Q = 78.68; p < .001; I2 = 60.17%). Como posibles variables moderadoras se analizó la edad y el tipo de destreza. Los resultados sugieren que existe una relación entre el desempeño motor real evaluado por medio de pruebas orientadas al proceso y al producto, la edad y el tipo de destreza no influyen en dicha relación.
Jiménez-Díaz, J., Chaves-Castro, K. y Carpio-Rivera, E. (2023). Relationship between process- and product-oriented assessments of actual motor performance: a meta-analysis. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-17. Motor performance is often assessed in two different ways. The first of them focuses on how the skill is carried out, whereas the second records the product obtained after execution. While both are widely used, the relationship between them is not clear. The objective of the present study is to determine the relationship between the results of process- or product-oriented tests that are used to measure actual motor performance, and to examine possible moderating variables through the meta-analytic technique. In order to sum up the products, the random effect model (REML) was used and the effect size (TE) of the correlation was calculated. A total seven studies met the criteria for eligibility, and a total 37 TE were obtained. It was found that a significant and positive relationship exists between process- and product-evaluated performance (TE = 0.466; IC95% = 0.391, 0.541; p < .001; n = 37; Q = 78.68; p < .001; I2 = 60.17%). Age and skill type were analyzed as possible moderating variables. The results suggest that a relationship exists between process- and product-oriented assessments of actual motor performance, while age and the type of skill have no influence on that relationship.
Jiménez-Díaz, J., Chaves-Castro, K. y Carpio-Rivera, E. (2023). Relação entre o desempenho motor real, avaliado por testes orientados a processos e a produtos: uma metanálise. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-17. O desempenho motor é geralmente avaliado de duas maneiras; a primeira se concentra em como a destreza é realizada, enquanto a segunda registra o resultado obtido após a execução; ambas são amplamente utilizadas, no entanto, a relação entre elas não é clara. O objetivo do presente estudo foi determinar a relação entre os resultados de testes orientados a processos ou a produtos usados para medir o desempenho motor real e examinar possíveis variáveis moderadoras por meio da técnica metanalítica. Para resumir os resultados, foi utilizado o modelo de efeitos aleatórios (REML) e calculado o tamanho do efeito (TDE) da correlação. Um total de sete estudos cumpriram os critérios de elegibilidade, resultando em um total de 37 TDEs. Foi encontrada uma relação significativa e positiva entre o desempenho avaliado por processo e produto (TDE = 0,466; IC95% = 0,391, 0,541; p < 0,001; n = 37; Q = 78,68; p < 0,001; I2 = 60,17%). A idade e o tipo de habilidade foram analisados como possíveis variáveis moderadoras. Os resultados sugerem que existe uma relação entre o desempenho motor real, avaliado por testes orientados a processos e a produtos, idade e tipo de habilidade não influenciam esta relação.
Assuntos
Humanos , Desenvolvimento Muscular , Condicionamento Físico Humano , Desempenho Físico FuncionalRESUMO
ABSTRACT: Briceño-Torres, JM, Carpio-Rivera, E, Solera-Herrera, A, Forsse, J, Grandjean, PW, and Moncada-Jiménez, J. Low-intensity resistance training improves flow-mediated dilation in young hispanic adults. J Strength Cond Res 37(2): 298-304, 2023-The purpose of this study was to compare the effects of 2 resistance exercise training (RET) intensities on brachial artery flow-mediated dilatation (FMD) in sedentary males. Thirty-four men (age = 20.6 ± 1.8 years, height = 171.3 ± 5.2 cm, body mass = 65.2 ± 10.6 kg, and DXA fat mass = 22.3 ± 7.4%) were randomly assigned to a control group (no exercise CTRL, n = 12), RET at 50% of 1 repetition maximum (1RM) (RET50%, n = 12), and RET at 80% 1RM (RET80%, n = 10). The RET program was performed twice per week for 8 weeks; subjects performed the same RET exercises at similar total workloads (1920 arbitrary units [AUs] for the RET80% and 1950 AUs for the RET50%). The FMD% was measured before and after 8 weeks by ultrasound. Mixed factorial analysis of variance (3 groups × 2 measurements), effect size (ES), and 95% confidence intervals (95% CIs) were computed for FMD%. The level of significance was set at p ≤ 0.05. A significant increase ( p = 0.001) was found on post-test FMD% in RET50% (mean = 9.9 ± 3.7%, ES = 1.9, and 95% CIs = 2.8-0.9) compared with CTRL (mean = 5.7 ± 1.7%, ES = 0.2, and 95% CIs = -0.4 to 0.8), and there were no significant differences found between RET50% and RET80% and between RET80% and CTRL. Results support the concept of training specificity and provide preliminary evidence that lower resistance and higher repetition RET elicit greater short-term reduced endothelium dysfunction than higher intensity RET at similar training volume.
Assuntos
Treinamento Resistido , Masculino , Humanos , Adulto , Adolescente , Adulto Jovem , Treinamento Resistido/métodos , Dilatação , Terapia por Exercício , Exercício Físico , Hispânico ou Latino , Força Muscular , Músculo EsqueléticoRESUMO
Purpose: To determine the acute and chronic effects of exercise on Paraoxonase-1 (PON1) concentration and activity. Methods: A literature search was performed using 16 electronic databases. Effect sizes (ES) were computed and two-tailed α values < .05 and non-overlapping 95% confidence intervals (95%CI) were considered statistically significant. Heterogeneity, inconsistency (I2), and small-study effects using the LFK index were examined. Results: Eighteen studies (n = 377 participants) met the criteria for inclusion. The acute effects of exercise on PON1 concentration were trivial and non-significant (ES = -.03, 95%CI = -.39 to .34, p > .05), heterogeneous (p = .05), moderately inconsistent (I2 = 48%), with minor asymmetry (LFK index = 1.34). The chronic effects of exercise on PON1 concentration were also trivial and non-significant (ES = -.04, 95%CI = -.53 to.45, p > .05), homogenous (p = .65), displayed low inconsistency (I2 = 0%), and minor asymmetry (LFK index = -1.14). The acute effects of exercise on PON1 activity were trivial and non-significant (ES = .11, 95%CI = -.02 to.24, p > .05), homogenous (p = .85), showed low inconsistency (I2 = 0%), and no asymmetry (LFK index = .82). The chronic effects of exercise on PON1 activity were trivial and non-significant (ES = .31, 95%CI = -.03 to.65, p > .05), homogenous (p = .17), moderately inconsistent (I2 = 36%), with no asymmetry (LFK index = .60). Conclusion: Acute and chronic exercise training, overall, exerted a trivial effect on PON1 concentration and activity.
Assuntos
Arildialquilfosfatase , Exercício Físico , Arildialquilfosfatase/metabolismo , Arildialquilfosfatase/fisiologia , Exercício Físico/fisiologia , HumanosRESUMO
BACKGROUND AND OBJECTIVES: Even before the COVID-19 pandemic, older adults with cognitive impairment living alone (an estimated 4.3 million individuals in the United States) were at high risk for negative health outcomes. There is an urgent need to learn how this population is managing during the pandemic. RESEARCH DESIGN AND METHODS: This is a qualitative study of 24 adults aged 55 and older living alone with cognitive impairment from diverse racial/ethnic backgrounds. Participants' lived experiences during the pandemic were elicited via 59 ethnographic interviews conducted over the phone either in English, Spanish, or Cantonese. Using a qualitative content analysis approach, interview transcripts were analyzed to identify codes and themes. RESULTS: Qualitative analysis of transcripts revealed 5 themes: (a) fear generated by the pandemic, (b) distress stemming from feeling extremely isolated, (c) belief in misinformation, (d) strategies for coping during the pandemic, and (e) the importance of access to essential services. DISCUSSION AND IMPLICATIONS: This pandemic put a spotlight on the precarity and unmet needs of older adults living alone with cognitive impairment. Findings underscore the need to expand access to home care aides and mental health services for this population.
Assuntos
COVID-19 , Disfunção Cognitiva , Adaptação Psicológica , Idoso , Disfunção Cognitiva/epidemiologia , Humanos , Pandemias , SARS-CoV-2 , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: In our country, transplantation centers differ in the age limit for allogeneic hematopoietic transplantation (ALOHT). In our program, transplants with age- adjusted conditioning are performed in patients until 70 years old. Currently more than 60% of ALOHT reported to the Center for International Bone Marrow Transplantation Research (CIBMTR) are performed in patients older than 40 years. AIM: To report our experience with ALOHT in acute myelogenous leukemia (AML), analyzing patient age at transplantation in different periods and transplant results in different age groups. MATERIAL AND METHODS: A retrospective analysis of the database of adult hematopoietic transplants in AML patients was performed. Demographic data, disease characteristics, transplant data, survival and relapse times, and mortality were collected. RESULTS: In our program, 1030 transplants were performed in adults and 119 ALOHT were performed in AML patients, between 1990 and 2020. The median age of patients in all periods was 41 years, (range 16-69). The median age was 33 and 45 years, in the periods 1990-2000 and 2000-2020 respectively (p < 0.01). Seventy-eight patients received myeloablative conditioning (median age 44 years) and 41 reduced intensity conditioning (median age 53 years). Five-year overall survival was 44.6% (confidence intervals (CI) 41-48). Non relapse mortality of all periods was 19% (CI 17 - 40%) and relapse rate was 17 % (CI 16-22). No difference in five years overall survival among patients younger than 40, 41 to 50 and over 51 years was observed. Conclusions: Overall Survival, non-relapse mortality and relapse rate were similar in younger and older patients in our program and similar to those previously reported in other centers.
Assuntos
Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Leucemia Mieloide Aguda/terapia , Transplante de Células-Tronco Hematopoéticas , Doença Enxerto-Hospedeiro , Transplante Homólogo , Estudos Retrospectivos , Resultado do Tratamento , Condicionamento Pré-TransplanteRESUMO
Resumen Actualmente, se recomienda el ejercicio contra resistencia (ECR) como una de las estrategias no farmacológicas para el control y tratamiento de la presión arterial (PA). Sin embargo, es necesario profundizar esta línea de investigación. El propósito del estudio fue comparar el efecto del tipo de descanso al realizar ECR sobre la PA de participantes normotensos. Participaron nueve hombres; siguiendo un diseño de investigación de medidas repetidas, realizaron tres condiciones experimentales en orden aleatorio: a) Descanso Activo (DA), b) Descanso Pasivo (DP), c) Sesión Control. En las 3 sesiones, se midió la PA y la frecuencia cardíaca (FC) pre-tratamiento, 1 minuto post-sesión y cada 10 minutos post-tratamiento durante 120 minutos. Las sesiones experimentales estuvieron precedidas por: mediciones antropométricas, familiarización y aplicación del test de 1RM. En el análisis estadístico se aplicó ANOVA de 2 vías para medidas repetidas, análisis de efectos simples y post hoc de Tukey. Entre los principales resultados, se encontró que, en comparación con la sesión control, los valores de PA disminuyen de forma significativa (p < .05): 1) al realizar ECR utilizando DP y DA a los 50, 100, 110 minutos post-ejercicio; 2) posterior a ejecutar ECR utilizando DA a los 20, 30, 70, 80,100, 120 minutos; 3) después de finalizada la sesión ECR con DP a los 10, 40 y 120 minutos. Respecto a la medición pre-test, los valores de PA disminuyeron de forma significativa (p < .05) a los 10, 20, 40, 50, 60, 100 y 120 minutos post ECR utilizando DP. En conclusión, al comparar con los valores de PA mostrados en un día de control, la ejecución de ECR aplicando DP y DA es funcional en el control de la PA de hombres jóvenes normotensos. En relación al pre-test, se podría indicar que el DP es el que promueve el efecto hipotensivo del ECR.
Abstract Resistance exercise is currently recommended as a non-pharmacological strategy to control and treat blood pressure, but further research is necessary concerning this topic. The purpose of this paper is to compare the effect of types of rest on the blood pressure of normotensive individuals while performing resistance exercise. Following a random methodological design with repeated measurements, nine men performed three experimental conditions on different days: a) Active Rest, b) Passive Rest, and c) Control Session. During the three sessions, blood pressure and heart rate measurements were taken pre-treatment, one-minute post-session, and every 10 minutes post-treatment for 120 minutes. Experimental sessions were preceded by anthropometric measurements, familiarization, and taking the 1RM test. The statistical analysis was conducted using two-way ANOVA with repeated measurements and Tukey post-hoc analysis. One of the main results indicated that, compared to the control session, blood pressure decreased significantly (p<0.05): 1) When performing resistance exercise with active and passive rest at 50, 100, 110 minutes post-exercise; 2) After executing resistance exercise with active rest at 20, 30, 70, 80,100, and 120 minutes; 3) After performing resistance exercise session with passive rest at 10, 40, and 120 minutes. With respect to pre-test levels, blood pressure decreased significantly (p<0.05) at 10, 20, 40, 50, 60, 100, and 120 minutes after performing resistance exercise with passive rest. In conclusion, compared with a control day, in the case of young normotensive males, the inclusion of both passive and active rest is functional for controlling blood pressure. In relation to the pre-test, passive rest promotes a hypotensive effect in the study population.
Resumo Recomenda-se, atualmente, o exercício contrarresistência (ECR) como uma das estratégias não farmacológicas para o controle e tratamento da pressão arterial (PA). Não obstante, é preciso aprofundamento nesta linha de pesquisa. O propósito do estudo foi comparar o efeito do tipo de descanso ao realizar ECR sobre a PA de participantes normotensos. Participaram nove homens; seguindo um desenho de pesquisa de medidas repetidas, realizaram três condições experimentais em ordem aleatória: a) Descanso Ativo (DA), b) Descanso Passivo (DP) e c) Sessão Controle. Nas 3 sessões, foram solicitadas a PA e a frequência cardíaca (FC) pré-tratamento, 1 minuto pós-sessão e a cada 10 minutos pós-tratamento durante 120 minutos. As sessões experimentais foram precedidas por: medições antropométricas, familiarização e aplicação do teste de 1RM. Na análise estatística aplicou-se a ANOVA de 2 vias com medidas repetidas, a análise de efeitos simples e o teste pós-hoc de Tukey. Entre os principais resultados, observou-se que, em comparação com a sessão controle, os valores de PA diminuíram de maneira significativa (p < 0,05): 1) ao realizar ECR, usando DP e DA nos 50, 100, 110 minutos pós-exercício; 2) posterior à execução do ECR usando DA nos 20, 30, 70, 80,100, 120 minutos; 3) depois de finalizar a sessão ECR com DP nos 10, 40 e 120 minutos. Com relação à medição pré-teste, os valores de PA diminuíram de maneira significativa (p < 0,05) nos 10, 20, 40, 50, 60, 100 e 120 minutos pós-ECR usando DP. Em conclusão, ao fazer a comparação com os valores de PA mostrados em um dia de controle, a execução de ECR aplicando DP e DA é funcional no controle da PA de homens jovens normotensos. Com relação ao pré-teste, poderia indicar-se que o DP é o promotor do efeito hipotensivo do ECR.
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Humanos , Adulto , Pressão Arterial , Treino Aeróbico , DescansoRESUMO
[This corrects the article DOI: 10.1021/acsmedchemlett.8b00344.].
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Receptor Interacting Protein 2 (RIP2) kinase inhibitors have been reported for therapeutic opportunities in inflammatory bowel diseases such as Ulcerative Colitis and Crohn's disease. During lead optimization, team identified 4-aminoquinoline series and several compounds from this series were investigated in rat and dog pharmacokinetic studies. While compounds such as GSKA and GSKB demonstrated acceptable pharmacokinetics in rat and dog, further progression of these compounds was halted due to adverse findings in advanced safety studies. Structurally similar analogues incorporating polarity at C-7 position of 4-aminoquinoline resulted in identification of GSKC - GSKF. Interestingly, following oral administration to rat at similar low dose, GSKC - GSKF demonstrated significantly low systemic drug exposure compared to GSKA and GSKB (3-17-fold difference). However, in dog, dose normalized oral systemic exposure for GSKC - GSKF was comparable to GSKA and GSKB (within 2-fold). A series of studies were conducted to understand the disconnect which highlighted that an intrinsic reduction in permeability and high P-glycoprotein (P-gp) efflux ratio for C-7 substituted analogues were driving pharmacokinetic disconnect between rat and dog. Oral absorption was minimally impacted in dog by P-gp mediated efflux compared to rat because the leakier gastrointestinal tract in dog likely overcomes this effect.
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Subfamília B de Transportador de Cassetes de Ligação de ATP/metabolismo , Aminoquinolinas/farmacocinética , Administração Oral , Animais , Transporte Biológico , Cães , Permeabilidade , RatosRESUMO
Resumen El propósito fue determinar el efecto del calentamiento activo con diferentes intervalos de recuperación en el rendimiento deportivo, en las pruebas de 50 y 200 metros libre. El estudio contó con la participación de 17 atletas (edad 13.5 ± 2.18 años), inscritos ante la Federación Costarricense de Deportes Acuáticos, con experiencia de entrenamiento y competición de 4.47 ± 1.28 años. Previo a la ejecución de las pruebas 50 y 200 metros libre, se realizaron 4 condiciones experimentales: Control (sin realizar calentamiento); Calentamiento (960 m) + descanso 20 min; Calentamiento (960 m) + descanso 10 min; Calentamiento (960 m) sin descanso. El orden de ejecución de las pruebas (50 y 200 metros libre) y la ejecución de las condiciones experimentales fueron asignadas de forma aleatoria. El análisis estadístico se realizó mediante ANOVA de una vía de medidas repetidas, p < 0.05. Los resultados indicaron que no existió diferencia significativa en el rendimiento en una prueba de 50 m libre (F = 0.83, p = 0.48) ni en la prueba de 200 m libre (F = 0.88, p = 0.46), al realizar un calentamiento activo respecto a no realizarlo. No hubo influencia de los diferentes tiempos de recuperación en el rendimiento en ambas pruebas. Se observaron diferentes patrones de respuesta individual a las condiciones experimentales. Se concluye que, de manera grupal, en nadadores jóvenes con poca experiencia, ejecutar un calentamiento activo previo a las pruebas de 50 y 200 metros libre, no mejora el rendimiento. Se recomienda que el entrenador ponga atención a la respuesta individualizada, para que elija el mejor protocolo (calentamiento o no) para mejorar el rendimiento deportivo de sus atletas.
Abstract The purpose of the paper was to determine the effect of active warm-ups with different recovery intervals in sport performance in 50m and 200m freestyle swimming. Seventeen athletes (13.5 ± 2.18 years old) registered with the Costa Rican Federation of Water Sports, with training and competition experience of 4.47 ± 1.28 years participated in this study. Before the 50m and 200m freestyle swimming tests, four experimental conditions were conducted: Control (without warm-up), Warm-up (960m) + 20 min rest, Warm-up (960m) + 10 min rest, Warm-up (960m) without rest. The order of the tests (50m and 200m freestyle) and the experimental conditions were randomly assigned. The statistical analysis used a one-way ANOVA of repeated measures, p < .05. No significant difference was found in performance in 50m or 200m freestyle swimming tests (F = 0.83, p = .48) (F = 0.88, p = .46), respectively, when using active warm-ups or not. Neither was there an effect of the different recovery times on performance in both swimming tests. Different patterns of individual responses were observed in the experimental conditions. It is concluded that, as a group, an active warm-up before 50m and 200m freestyle swimming tests does not improve the performance of young inexperienced swimmers. However, the coach is recommended to pay attention to individualized responses to select the best protocol (having warm-up or not) to improve athletes' performance.
Resumo O propósito foi determinar o efeito do aquecimento ativo com diferentes intervalos de recuperação no desempenho esportivo, nas provas de 50 e 200 metros livres. O estudo contou com a participação de 17 atletas (idade 13,5 ± 2,18 anos), inscritos na Federação Costarriquenha de Esportes Aquáticos, com experiência de treinamento e competição de 4,47 ± 1,28 anos. Previamente à execução das provas de 50 e 200 metros livres, foram realizados 4 condicionamentos experimentais: controle (sem aquecimento); aquecimento (960 m) mais descanso de 20 min; aquecimento (960 m) mais descanso de 10 min; aquecimento (960 m) sem descanso. A ordem de execução das provas (50 e 200 metros livres) e a execução dos condicionamentos experimentais foram atribuídas de maneira aleatória. A análise estatística foi realizada por meio da ANOVA de uma via de medidas repetidas, p < 0,05. Os resultados indicaram que não existiu diferença significativa no desempenho em uma prova de 50 m livres (F = 0,83, p = 0,48) e, tampouco, na prova de 200 m livres (F = 0,88, p= 0,46) ao realizar um aquecimento ativo em comparação a não o realizar. Não houve influência dos diferentes tempos de recuperação no desempenho em ambas as provas. Foram observados diferentes padrões de resposta individual aos condicionamentos experimentais. Conclui-se que, de modo grupal, em nadadores jovens com pouca experiência, realizar um aquecimento ativo prévio às provas de 50 e 200 metros livres, não melhora o desempenho. Recomenda-se que o treinador preste atenção na resposta individualizada para escolher o melhor protocolo (aquecimento ou não), buscando o aperfeiçoamento do desempenho esportivo de seus atletas.
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Humanos , Adolescente , Natação , Desempenho Atlético , Exercício de AquecimentoRESUMO
The delivery of Cytochrome c (Cyt c) to the cytosol stimulates apoptosis in cells where its release from mitochondria and apoptotic induction is inhibited. We developed a drug delivery system consisting of Cyt c nanoparticles decorated with folate-poly(ethylene glycol)-poly(lactic-co-glycolic acid)-thiol (FA-PEG-PLGA-SH) to deliver Cyt c into cancer cells and tested their targeting in the Lewis Lung Carcinoma (LLC) mouse model. Cyt c-PLGA-PEG-FA nanoparticles (NPs) of 253 ± 55 and 354 ± 11 nm were obtained by Cyt c nanoprecipitation, followed by surface decoration with the co-polymer SH-PLGA-PEG-FA. The internalization of Cyt c-PLGA-PEG-FA nanoparticles (NPs) in LLC cells was confirmed by confocal microscopy. NP caspase activation was more efficient than the NP-free formulation. Caspase activity assays showed NPs retained 88-96% Cyt c activity. The NP formulations were more effective in decreasing LLC cell viability than NP-free formulation, with IC50 49.2 to 70.1 µg/mL versus 129.5 µg/mL, respectively. Our NP system proved to be thrice as selective towards cancerous than normal cells. In vivo studies using near infrared-tagged nanoparticles show accumulation in mouse LLC tumor 5 min post-injection. In conclusion, our NP delivery system for Cyt c shows superiority over the NP-free formulation and reaches a folic acid-overexpressing tumor in an immune-competent animal model.
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BACKGROUND: Tumor-infiltrating lymphocytes are an important component of the tumor microenvironment (TME) in breast cancer. They have been linked with tumor pathogenesis in advanced stages. However, little is known about their contribution in early phases. In this study, we analyzed the infiltration of leukocytes and cancer stem cells (CSC) in tumors from patients with early breast cancer. METHODS: Samples of blood and tumor tissue from 30 patients with breast cancer were collected, and the number of dendritic cells (DC), T cells, and CSC were analyzed by flow cytometry. RESULTS: Tumor-infiltrating CD4 and CD8 T cells expressed higher levels of cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) compared with peripheral T cells. Regulatory T cells (Treg) were enriched in tumors and overexpressed glucocorticoid-induced TNFR-related protein and CTLA-4. Tumor Treg had a positive correlation with the amount of myeloid DC (mDC) and disease progression. The CD8/Treg ratio was associated with lymph node metastasis and tumor stages. The main subset of DC in early breast tumors was mDC, while plasmacytoid DC were almost absent. CSC were present in most tumors with higher frequencies in patients with lymph node metastasis. CSC were also associated with the amount of tumor-infiltrating Treg. CONCLUSION: Early breast cancer has an inflammatory milieu characterized by mDC, Treg, and CSC infiltration. The frequencies of Treg, CSC and CD8/Treg ratio were associated with disease progression. The composition of leukocytes and the presence of CSC in early breast tumors should be considered for the development of new therapeutic approaches.
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Neoplasias da Mama/patologia , Linfócitos T CD8-Positivos/imunologia , Metástase Linfática/imunologia , Células-Tronco Neoplásicas/imunologia , Linfócitos T Reguladores/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Mama/imunologia , Mama/patologia , Neoplasias da Mama/sangue , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/imunologia , Relação CD4-CD8 , Células Dendríticas/imunologia , Feminino , Humanos , Linfonodos/imunologia , Linfonodos/patologia , Linfócitos do Interstício Tumoral , Pessoa de Meia-Idade , Gradação de Tumores , Microambiente Tumoral/imunologiaRESUMO
Abstract Introduction Patients with benign or malignant blood disorders, who require allogeneic stem cell transplantation and lack an identical human leukocyte antigen HLA identicalHL sibling donor, could be transplanted with hematopoietic stem cells from unrelated adult or umbilical cord donors. However, in our country, both approaches are costly and time-consuming options. Methods Over the last few years, haploidentical modalities have been investigated as an alternative donor source, showing similar results to those obtained with identical HLA donors. We started using T-cell-replete haploidentical with post-transplant cyclophosphamide in 2012 and we presented our experience with patients undergoing haploidentical ransplantation compared to SIB. Results Since January 2012 to date, 91 allogeneic transplants have been performed, of which 49 were haploidentical and 42 were HLA identical. The mean age of the patients was 35 years (range: 17-62). The mean CD34/kg × 106 infused per group was 5.93 and 5.89, respectively. Time to granulocyte and platelet engraftment was 11 and 15 days, respectively, for haploidentical, and 12 and 14 days, respectively, for HLA identical (p = 0.10). The 100-day cumulative incidence of global acute GVHD was 34% for haploidentical and 29% for SIHLA identical (p = 0.9). The 2-year overall global graft-versus-host disease was 43% for haploidentical and 41% for HLA identical (p = 0.8). Overall survival, relapse, and transplant and relapse-related mortality were similar between both groups. Conclusion Our experience showed that haploidentical has similar outcomes to those obtained with HLA idential and can be performed in our country safely.
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Humanos , Masculino , Feminino , Adulto , Leucemia , Transplante Haploidêntico , Linfoma , Polyomavirus , Doença Enxerto-HospedeiroRESUMO
INTRODUCTION: Patients with benign or malignant blood disorders, who require allogeneic stem cell transplantation and lack an identical human leukocyte antigen HLA identicalHL sibling donor, could be transplanted with hematopoietic stem cells from unrelated adult or umbilical cord donors. However, in our country, both approaches are costly and time-consuming options. METHODS: Over the last few years, haploidentical modalities have been investigated as an alternative donor source, showing similar results to those obtained with identical HLA donors. We started using T-cell-replete haploidentical with post-transplant cyclophosphamide in 2012 and we presented our experience with patients undergoing haploidentical ransplantation compared to SIB. RESULTS: Since January 2012 to date, 91 allogeneic transplants have been performed, of which 49 were haploidentical and 42 were HLA identical. The mean age of the patients was 35 years (range: 17-62). The mean CD34/kg×106 infused per group was 5.93 and 5.89, respectively. Time to granulocyte and platelet engraftment was 11 and 15 days, respectively, for haploidentical, and 12 and 14 days, respectively, for HLA identical (p=0.10). The 100-day cumulative incidence of global acute GVHD was 34% for haploidentical and 29% for SIHLA identical (p=0.9). The 2-year overall global graft-versus-host disease was 43% for haploidentical and 41% for HLA identical (p=0.8). Overall survival, relapse, and transplant and relapse-related mortality were similar between both groups. CONCLUSION: Our experience showed that haploidentical has similar outcomes to those obtained with HLA idential and can be performed in our country safely.