RESUMO
INTRODUCTION: Rehabilitation is considered a key intervention in health care. Clinical registries, defined as an organized system that uses observational methods to collect information to assess specific outcomes in a defined population, can contribute to assessing the impact of the rehabilitation intervention. This review aims to identify and describe rehabilitation-specific registry systems with an emphasis on identifying outcomes that enable the assessment of vital areas and activities of daily living. EVIDENCE ACQUISITION: A systematic scoping review was conducted. A systematic search was conducted up to August 2022 in MEDLINE/PubMed, Embase, Cochrane Library, Epistemonikos, and other search resources. Studies related to rehabilitation registries presented data on people with health problems that could limit their functioning were selected. The inclusion of studies/clinical registries was not limited by methodological design, year of publication, country, or language. The unit of analysis was rehabilitation registries. The measurement instruments used to assess the outcomes were explored to estimate the domain assessed from the vital areas related to functioning and disability as described by the International Classification of Functioning, Disability and Health (ICF). The vital areas were classified according to activities of daily living (ADLs). EVIDENCE SYNTHESIS: Seventy-one registries in rehabilitation were identified. The registries included a median of 3 (IQR 2-5) assessment instruments designed to assess the impact of different rehabilitation programs. In total, 137 different assessment scales or instruments were identified. Each rehabilitation registry assessed 6 (IQR 2-8) domains of the ICF, and 15.4% of registries assessed all domains. The most assessed domain was "Mobility" (89.7%), and the least assessed was "General Tasks and Demands" (25.6%). In addition, 92.3% of rehabilitation registries assessed basic ADLs, 76.9% advanced ADLs, and 71.8% instrumental ADLs. CONCLUSIONS: Although clinical registries do not claim to directly assess the impact of rehabilitation programs on people's functioning according to the ICF framework, it was identified that a low percentage of them assessed the nine vital areas through different outcome assessment instruments. However, most rehabilitation registries directly or indirectly assess some basic, instrumental, and advanced ADLs. The findings of this review highlight the need to improve the design of clinical registries focused on assessing the impact of rehabilitation programs to assess people in all areas of their lives.
Assuntos
Atividades Cotidianas , Pessoas com Deficiência , Humanos , Avaliação de Resultados em Cuidados de SaúdeRESUMO
OBJECTIVE: The purpose of this article was to summarize the available evidence from systematic reviews on telerehabilitation in physical therapy. METHODS: We searched Medline/PubMed, EMBASE, and Cochrane Library databases. In addition, the records in PROSPERO and Epistemonikos and PEDro were consulted. Systematic reviews of different conditions, populations, and contexts-where the intervention to be evaluated is telerehabilitation by physical therapy-were included. The outcomes were clinical effectiveness depending on specific condition, functionality, quality of life, satisfaction, adherence, and safety. Data extraction and risk of bias assessment were carried out by a reviewer with non-independent verification by a second reviewer. The findings are reported qualitatively in the tables and figures. RESULTS: Fifty-three systematic reviews were included, of which 17 were assessed as having low risk of bias. Fifteen reviews were on cardiorespiratory rehabilitation, 14 on musculoskeletal conditions, and 13 on neurorehabilitation. The other 11 reviews addressed other types of conditions and rehabilitation. Thirteen reviews evaluated with low risk of bias showed results in favor of telerehabilitation versus in-person rehabilitation or no rehabilitation, while 17 reported no differences between the groups. Thirty-five reviews with unclear or high risk of bias showed mixed results. CONCLUSIONS: Despite the contradictory results, telerehabilitation in physical therapy could be comparable with in-person rehabilitation or better than no rehabilitation for conditions such as osteoarthritis, low-back pain, hip and knee replacement, and multiple sclerosis and also in the context of cardiac and pulmonary rehabilitation. It is imperative to conduct better quality clinical trials and systematic reviews. IMPACT: Providing the best available evidence on the effectiveness of telerehabilitation to professionals, mainly physical therapists, will impact the decision-making process and therefore yield better clinical outcomes for patients, both in these times of the COVID-19 pandemic and in the future. The identification of research gaps will also contribute to the generation of relevant and novel research questions.
Assuntos
COVID-19/epidemiologia , Doenças Musculoesqueléticas/reabilitação , Satisfação do Paciente/estatística & dados numéricos , Modalidades de Fisioterapia/organização & administração , Qualidade de Vida/psicologia , Telerreabilitação/métodos , Humanos , Avaliação de Processos e Resultados em Cuidados de Saúde , Projetos de Pesquisa , Resultado do TratamentoRESUMO
The structure of the title compound, C29H26N4O6, exhibits a folded conformation with the three arms all on the same side of the tertiary N atom. The two phthalimide units make a dihedral angle of 12.18â (12)° and the dihedral angles between the benzyl plane and the phthalimide units are 68.08â (7) and 67.71â (7)°. The crystal packing features π-π inter-actions.
RESUMO
The production and demand of nanoparticles in the manufacturing sector and personal care products, release a large number of engineered nanoparticles (ENPs) into the atmosphere, aquatic ecosystems, and terrestrial environments. The intentional or involuntary incorporation of ENPs into the environment is carried out through different processes. The ENPs are combined with other compounds and release into the atmosphere, settling on the ground due to the water cycle or other atmospheric phenomena. In the case of aquatic ecosystems, the ENPs undergo hetero-aggregation and sedimentation, reaching different living organisms and flora, as well as groundwater. Accordingly, the high mobility of ENPs in diverse ecosystems is strongly related to physical, chemical, and biological processes. Recent studies have been focused on the toxicological effects of a wide variety of ENPs using different validated biological models. This literature review emphasizes the study of toxicological effects related to using the most common ENPs, specifically metal and metal/oxides-based nanoparticles, addressing different synthesis methodologies, applications, and toxicological evaluations. The results suggest negative impacts on biological models, such as oxidative stress, metabolic and locomotive toxicity, DNA replication dysfunction, and bioaccumulation. Finally, it was consulted the protocols for the control of risks, following the assessment and management process, as well as the classification system for technological alternatives and risk management measures of ENPs, which are useful for the transfer of technology and nanoparticles commercialization.
Assuntos
Nanopartículas Metálicas , Nanopartículas , Nanoestruturas , Ecossistema , Nanopartículas Metálicas/toxicidade , Metais , Nanoestruturas/toxicidade , ÓxidosRESUMO
Cardiac glycosides (CGs), inhibitors of Na+/K+-ATPase (NKA), used clinically to treat heart failure, have garnered recent attention as potential anti-cancer and anti-viral agents. A high-throughput phenotypic screen designed to identify modulators of promyelocytic leukemia protein (PML) nuclear body (NB) formation revealed the CG gitoxigenin as a potent activator of PML. We demonstrate that multiple structurally distinct CGs activate the formation of PML NBs and induce PML protein SUMOylation in an NKA-dependent fashion. CG effects on PML occur at the post-transcriptional level, mechanistically distinct from previously described PML activators and are mediated through signaling events downstream of NKA. Curiously, genomic deletion of PML in human cancer cells failed to abrogate the cytotoxic effects of CGs and other apoptotic stimuli such as ceramide and arsenic trioxide that were previously shown to function through PML in mice. These findings suggest that alternative pathways can compensate for PML loss to mediate apoptosis in response to CGs and other apoptotic stimuli.
Assuntos
Glicosídeos Cardíacos/farmacologia , Proteínas Nucleares/metabolismo , Sumoilação/efeitos dos fármacos , Fatores de Transcrição/metabolismo , Proteínas Supressoras de Tumor/metabolismo , Animais , Apoptose/efeitos dos fármacos , Glicosídeos Cardíacos/química , Chlorocebus aethiops , Deleção de Genes , Células HEK293 , Células HeLa , Humanos , Proteínas Nucleares/genética , Proteína da Leucemia Promielocítica , ATPase Trocadora de Sódio-Potássio/antagonistas & inibidores , ATPase Trocadora de Sódio-Potássio/metabolismo , Fatores de Transcrição/genética , Proteínas Supressoras de Tumor/genética , Células VeroRESUMO
In 1920, the German botanist Hans Winkler coined the concept of the 'genome'. This paper explores the history of a concept that has developed in parallel with advances in biology and supports novel and powerful heuristic biological research in the 21st century. From a structural interpretation (the genome as the haploid number of chromosomes), it has changed to keep pace with technological progress and new interpretations of the material of heredity. In the first place, the 'genome' was extended to include all the material in the nucleus, then the sum of all genes, and (with the discovery of the structure of DNA) the sum of the nucleotide base sequences. In the early 21st century, it has become a much more complex and central concept that has spawned the growing field of studies referred to as the 'omics'.
Assuntos
DNA/história , Genoma , Genômica/história , Pesquisa em Genética/história , História do Século XX , História do Século XXI , HumanosRESUMO
An important historical relation that has hardly been addressed is the influence of Prosper Lucas's Treatise on Natural Inheritance on the development of Charles Darwin's concepts related to inheritance. In this article we trace this historical connection. Darwin read Lucas's Treatise in 1856. His reading coincided with many changes concerning his prior ideas on the transmission and expression of characters. We consider that this reading led him to propose a group of principles regarding prepotency, hereditary diseases, morbid tendencies and atavism; following Lucas, he called these principles: laws of inheritance.
Assuntos
Predisposição Genética para Doença/história , Hereditariedade , Inglaterra , França , Doenças Genéticas Inatas/genética , Variação Genética , História do Século XIX , Humanos , Transtornos Mentais/genéticaRESUMO
La hipótesis provisional de la pangénesis se ha interpretado como una explicación materialista y mecanicista de la herencia, seguramente porque Darwin mismo consideraba que las gémulas eran partículas corporales; sin embargo, analizando los principios en los que descansan las conjeturas de la pangénesis podemos ver cómo están entretejidas con nociones del vitalismo científico, principalmente el principio vitalista del nisus formativus de Blumembach
The provisional hipothesis of the pangenesis has been interpreted as a materialist and mechanistic explanation of heritance, surely because Darwin himself considered that the gemmules were corporal praticles; neverthless, analyzing the principles in which these suppositions on pangenesis rest we can aopreciate how they are interlocked with notions of scientific vitalism, mainly Blumenbach´s vitalist principle nisus formativus
Assuntos
Evolução Biológica , Hereditariedade , Vitalismo/história , História da Medicina , Genética/educação , Genética/história , Força Vital/história , Força Vital/tendências , Genética/tendênciasRESUMO
Se hizo la determinación de marcadores de hepatitis B en personal hospitalario comprendiendo a 165 trabajadores del Hospital Central de la Sanidad de la Policía Nacional, quienes laboran en áreas con alto riesgo potencial para dicho agente. Se investigó la presencia del antígeno de superficie B (HBsAg), anticuerpo central B (Anti HBc total) y anticuerpo de superficie (Anti Hbs) por el método de enzimo-inmuno ensayo (Elisa). El estudio comprendió a 70 personas del sexo masculino y 95 personas del sexo femenino. El personal laborando en áreas de alto riesgo, presenta incidencia baja de positividad para los marcadores estudiados. Se comprobó la existencia de algún marcador B en 11 personas (6.6%), 8 (4.8%) fueron positivas para el anti HBc, y 1 para el HBs Ag (0.6%). El antiHBs se detectó en 9 personas (5.4%), 8 de ellos también positivos para el AntiHBc. Los grupos con más alta positividad de marcadores serológicos del virus B ocurrieron en los Departamentos de Laborotorio Clínico, Odontología, Nefrología, Cirugía General y Anatomía Patológica. Se encontró mayor incidencia de marcadores de la hepatitis B en el sexo masculino, 9 personas (5.4%) que en el sexo femenino 2(1.2%)
Assuntos
Humanos , Adulto , Masculino , Feminino , Hepatite B/epidemiologia , Anticorpos , Antígenos da Hepatite B , Antígenos de Superfície da Hepatite B , Antígenos do Núcleo do Vírus da Hepatite BRESUMO
Presenta el primer caso detectado de anticuerpos al VIH en el banco de sangre del Hospital Central del Servicio de la Sanidad de las Fuerzas Policiales. Se trata de un hemodonador civil sin síntomas ni signos de enfermedad clínica y con factores de alto riesgo. El test de látex para VIH,el método ELISA y las pruebas confirmatorias de Inmunofluorescencia Indirecta(IFI) y la prueba Western Blot resultaron positivas. El cultivo de linfocitos para confirmar la presencia del virus resultó negativo. Recomienda el despistaje obligatorio del VIH en todo hemodonador y el uso de una ficha de datos epidemiológicos
Assuntos
Bancos de Sangue , Doadores de Sangue , Sorodiagnóstico da AIDS , Síndrome da Imunodeficiência Adquirida , PeruRESUMO
Se revisaron 2,452 fichas de hemodonadores aparentemente sanos, que concurrieron a la sección de Hemoterapia del Hospital Central de la Sanidad de las Fuerzas Policiales, en un lapso de diez meses hasta octubre de 1988.Se determinó el Antígeno de Superficie de la Hepatitits B (HBsAG) empleándose los métodos de la Inmuno-absorción enzimática (ELISA) y el de la hemaglutinación pasiva inversa (HAPI); pruebas de tercera generación clasificadas por la Food and Drug Administration (FDA), las cuales poseen una alta sensibilidad y especificidad. Se encontró con el método de la Inmuno-absorción enzimática (ELISA) 39 Hemodonadores positivos al HBsAG que representa el 1.6% y con el método de la Hemaglutinación pasiva inversa (HAPI) 12 Hemodonadores positivos al HBsAG que representa el 1.4%. Estos resultados, se comparan con los encontrados por otros autores a nivel mundial y se hace hincapié de la importancia y la obligatoriedad de detectarlo en todos los Bancos de Sangre, para prevenir su trasmisión
Assuntos
Humanos , Masculino , Feminino , Ensaio de Imunoadsorção Enzimática , Antígenos da Hepatite B/imunologia , Doadores de Sangue , Hepatite B/imunologiaRESUMO
Se revisaron 16,765 fichas de hemodonadores en el Archivo de la Sección Hemoterapia HCSFP en un lapso de cinco años 1980 a 1984; endontrándose 1,067 Rh negativos (6.3) de éstos, 20 fueron variante Du (1.8%). El estudio demuestra la importancia de hacer la determinación correcta del antígeno Du en los Rh negativos puesto que produce peligrosas sensibilizaciones al usarse en las transfusiones