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1.
Community Dent Health ; 39(2): 86-91, 2022 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-35020280

RESUMO

OBJECTIVE: To assess the experience, prevalence, need for treatment and economic impact of caries among students 6-12 years old in four cities in Mexico. BASIC RESEARCH DESIGN: Cross-sectional clinical study. SETTING: Elementary public schools. PARTICIPANTS: 500 schoolchildren aged 6 to 12 years. METHOD: Oral clinical examinations using WHO criteria for caries in the primary (dmft) and permanent (DMFT) dentitions. MAIN OUTCOME MEASURES: Indicators of caries in the primary and permanent dentitions: experience, prevalence, severity and the Significant Caries Index. In addition, we calculated the treatment needs, dental care rate and cost of care. RESULTS: dmft in the primary dentition was 2.59±2.83, and DMFT was 0.82±1.44 in the permanent dentition. Caries prevalence reached 67.7% in the primary and 34.1% in permanent dentition. The treatment needs index was 85.9% and 91.3% in the primary and permanent dentitions, respectively; the dental care index was 13.9% and 8.5%, respectively. The cost of care for caries in the primary dentition was estimated at $22.087 millions of international dollars (PPP US$) when amalgam was the restorative material used, and PPP US$19.107 millions for glass ionomer. For the permanent dentition, the cost was PPP US$7.431 millions when amalgam was used and PPP US$7.985 millions when resin/composite was used as restorative material. CONCLUSIONS: The prevalence and experience of caries in the primary dentition were 50% greater than those of other studies carried out in Mexico. In the permanent dentition they were less. There is considerable need for the treatment of caries and minimal experience with restorative care. The cost of care for caries may be assumed to be high for a health system such as Mexico's.


Assuntos
Suscetibilidade à Cárie Dentária , Cárie Dentária , Criança , Estudos Transversais , Índice CPO , Amálgama Dentário , Cárie Dentária/epidemiologia , Cárie Dentária/terapia , Países em Desenvolvimento , Humanos , Prevalência , Dente Decíduo
2.
Mater Sci Eng C Mater Biol Appl ; 122: 111933, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33641924

RESUMO

The most pressing need in cartilage tissue engineering (CTE) is the creation of a biomaterial capable to tailor the complex extracellular matrix of the tissue. Despite the standardized used of polycaprolactone (PCL) for osteochondral scaffolds, the pronounced stiffness mismatch between PCL scaffold and the tissue it replaces remarks the biomechanical incompatibility as main limitation. To overcome it, the present work was focused in the design and analysis of several geometries and pore sizes and how they affect cell adhesion and proliferation of infrapatellar fat pad-derived mesenchymal stem cells (IPFP-MSCs) loaded in biofabricated 3D thermoplastic scaffolds. A novel biomaterial for CTE, the 1,4-butanediol thermoplastic polyurethane (b-TPUe) together PCL were studied to compare their mechanical properties. Three different geometrical patterns were included: hexagonal (H), square (S), and, triangular (T); each one was printed with three different pore sizes (PS): 1, 1.5 and 2 mm. Results showed differences in cell adhesion, cell proliferation and mechanical properties depending on the geometry, porosity and type of biomaterial used. Finally, the microstructure of the two optimal geometries (T1.5 and T2) was deeply analyzed using multiaxial mechanical tests, with and without perimeters, µCT for microstructure analysis, DNA quantification and degradation assays. In conclusion, our results evidenced that IPFP-MSCs-loaded b-TPUe scaffolds had higher similarity with cartilage mechanics and T1.5 was the best adapted morphology for CTE.


Assuntos
Células-Tronco Mesenquimais , Engenharia Tecidual , Cartilagem , Adesão Celular , Proliferação de Células , Poliésteres , Porosidade , Tecidos Suporte
4.
Br J Surg ; 107(4): 364-372, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31846067

RESUMO

BACKGROUND: Several non-randomized and retrospective studies have suggested that intracorporeal anastomosis (IA) has advantages over extracorporeal anastomosis (EA) in laparoscopic right colectomy, but scientific evidence is lacking. The aim was to compare short-term outcomes and to define the possible benefits of IA compared with EA in elective laparoscopic right colectomy. METHODS: An RCT was conducted from May 2015 to June 2018. The primary endpoint was duration of hospital stay. Secondary endpoints were intraoperative technical events and postoperative clinical outcomes. RESULTS: A total of 140 patients were randomized. Duration of surgery was longer for procedures with an IA than in those with an EA (median 149 (range 95-215) versus 123 (60-240) min; P < 0·001). Wound length was shorter in the IA group (median 6·7 (4-9·5) versus 8·7 (5-13) cm; P < 0·001). Digestive function recovered earlier in patients with an IA (median 2·3 versus 3·3 days; P = 0·003) and the incidence of paralytic ileus was lower (13 versus 30 per cent; P = 0·022). Less postoperative analgesia was needed in the IA group (mean(s.d.) weighted analgesia requirement 39(24) versus 53(26); P = 0·001) and the pain score was also lower (P = 0·035). The postoperative decrease in haemoglobin level was smaller (mean(s.d.) 8·8(1·7) versus 17·1(1·7) mg/dl; P = 0·001) and there was less lower gastrointestinal bleeding (3 versus 14 per cent; P = 0·031) in the IA group. IA was associated with a significantly better rate of grade I and II complications (P = 0·016 and P = 0·037 respectively). The duration of hospital stay was slightly shorter in the IA group (median 5·7 (range 2-19) versus 6·6 (2-23) days; P = 0·194). CONCLUSION: Duration of hospital stay was similar, but IA was associated with less pain and fewer complications. Registration number: NCT02667860 ( http://www.clinicaltrials.gov).


ANTECEDENTES: Varios estudios no aleatorizados y retrospectivos sugieren que la anastomosis intracorpórea (intracorporeal anastomosis, IA) tiene ventajas sobre la anastomosis extracorpórea (extracorporeal anastomosis, EA) en la colectomía laparoscópica derecha, pero no hay suficientes evidencias científicas. El objetivo del estudio fue comparar los resultados a corto plazo y definir los posibles beneficios de la anastomosis intracorpórea versus extracorpórea en la colectomía derecha laparoscópica electiva. MÉTODOS: Se realizó un ensayo clínico prospectivo y aleatorizado de mayo de 2015 a junio de 2018. El criterio de valoración principal fue la duración de la estancia hospitalaria. Los criterios de valoración secundarios fueron los eventos técnicos intraoperatorios y los resultados clínicos postoperatorios. RESULTADOS: Se aleatorizaron 140 pacientes. El tiempo quirúrgico fue más largo para la IA que para la EA (149,49 ± 27,24 versus 123,35 ± 36,56 min; P = 0,001). La longitud de la herida fue más corta en la IA (6,65 ± 1,21 versus 8,72 ± 1,44 cm; P < 0,001). La función digestiva se recuperó antes en la IA que en la EA (2,3 versus 3,3 días, P = 0,003) y la incidencia de íleo paralítico fue menor (13% versus 30%, P = 0,022). Los requisitos de analgesia postoperatoria fueron menores con la IA (39 ± 24,3 versus 53 ± 26; P < 0,001) y la puntuación de dolor (EVA) también fue menor (P < 0,035). El descenso de la hemoglobina en el postoperatorio y la hemorragia gastrointestinal baja fueron menores en la IA que en la EA (-8,83 ± 1,7 versus -17,07 ± 1,7 mg/dl; P = 0,001) y (2,8% versus 14%; P = 0,031), respectivamente. La clasificación de Clavien-Dindo mostró que la IA se asoció con resultados significativamente mejores que la EA: grado I (10% versus 27% P = 0,016); grado II (18% versus 35%, P = 0,0369). La puntuación del índice de complicación integral (comprehensive complication index, CCI) fue menor en el grupo IA (5,33 ± 9,2 versus 11,15 ± 14,34; P = 0,006). La estancia hospitalaria fue más corta en el grupo de IA pero sin diferencia significativa (5,65 ± 3,75 versus 6,58 ± 4,63 días; P = 0,194). CONCLUSIÓN: La IA presenta ventajas clínicas sobre la EA en la colectomía derecha laparoscópica.


Assuntos
Anastomose Cirúrgica/métodos , Colectomia/métodos , Laparoscopia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Colo/cirurgia , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Dor Pós-Operatória/epidemiologia , Assistência Perioperatória , Método Simples-Cego , Resultado do Tratamento
5.
J Vector Borne Dis ; 57(1): 71-77, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33818459

RESUMO

BACKGROUND & OBJECTIVES: Cutaneous leishmaniasis (CL) in Marrakesh-Safi region located in the central-south part of Morocco is a public health problem. This study assessed the efficiency of a microscopic examination method in establishing the diagnosis of CL and PCR for the characterization and identification of the circulating Leishmania strains in different CL foci of the study area. METHODS: A total of 297 smears obtained from cutaneous lesions of suspected patients with CL were stained with May-Grünwald Giemsa (MGG) for microscopic examination. For each positive smear, genomic DNA was extracted and PCR-analysed, targeting the small subunit ribosomal ribonucleic acid (ssu rRNA) gene to detect Leishmania DNA. Then, the internal transcribed spacer 1 (ITS1) was amplified and sequenced in order to identify the Leishmania species. The sensitivity and specificity of the conventional microscopy with ssu rRNA gene were compared by Leishmania nested PCR (LnPCR) and ITS1 gene by ITS-PCR. RESULTS: A total of 257 smears were positive in the microscopic examination, i.e. the detection rate of amastigotes by optical microscopy was 86.53% (257/297). The LnPCR was found to have a specificity and a sensitivity of 100%, each. Interestingly, the sequencing results showed that 99.61% (256/257) of the isolates had Leishmania tropica and 0.39% (1/257) had L. infantum infection. INTERPRETATION & CONCLUSION: Though, classical microscopic examination is useful and economical, it is not sensitive enough, especially in endemic regions where several Leishmania species coexist. In such situations, PCR constitutes a complementary method for the identification of the causal species. The results indicate that both the L. tropica (dominant) and L. infantum are the causative agents of CL in the Marrakesh-Safi region. The rate of CL infection is high in Imintanout, and Chichaoua provinces. Hence, early diagnosis and prompt treatment of CL patients is necessary to prevent its extension to neighboring localities.


Assuntos
DNA de Protozoário/genética , Leishmania infantum/genética , Leishmania tropica/genética , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/parasitologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Leishmania infantum/isolamento & purificação , Leishmania tropica/isolamento & purificação , Leishmaniose Cutânea/epidemiologia , Masculino , Microscopia/métodos , Microscopia/normas , Pessoa de Meia-Idade , Marrocos/epidemiologia , Patologia Molecular/métodos , Patologia Molecular/normas , Sensibilidade e Especificidade , Adulto Jovem
6.
Int J Colorectal Dis ; 33(11): 1635-1641, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30191370

RESUMO

BACKGROUND: Colorectal cancer (CRC) is the third most frequent cancer diagnosed in men and the second in women. Laparoscopic surgery has been a technical revolution in colorectal surgery, facilitating a better recovery of patients with lower morbidity and better esthetic results, compared to traditional surgery via laparotomy, without compromising safety and long-term oncological results. PURPOSE: The trial is a randomized controlled trial indented to evaluate the two interventions with thorough measurements of the postoperative variables and complications to improve the evaluation of the surgical technique. The primary endpoint is to compare the hospital stay, which will be measured in days between both groups. The purpose of the study at secondary endpoints is to compare intraoperative and postoperative events between both groups in terms of operating time, anastomotic performance time, intraoperative complications, number of harvested lymph nodes, need for blood transfusion, length of the surgical wound, start and tolerance of oral intake, beginning of digestive functionality, postoperative pain, need for analgesic administration, surgical wound infection, paralytic ileus, anastomosis leakage or dehiscence, need for surgical reintervention, and hospital readmission within the first 30 days after surgery. METHODS: This trial is a prospective, randomized, single-blind, and single-center clinical trial comparing intracorporeal anastomosis versus extracorporeal anastomosis for right laparoscopic hemicolectomy. CONCLUSIONS: Nowadays, there are several retrospective trials comparing the benefits for extracorporeal anastomosis versus intracorporeal anastomosis in right colon cancer patients. Considering the impact for laparoscopic surgery, we think it is necessary to do a randomized trial comparing extracorporeal versus intracorporeal anastomosis modalities. TRIAL REGISTRATION: www.clinicaltrials.gov No. NCT02667860 and Hospital de la Santa Creu i Sant Pau Research Institute No. IIBSP-AIE-2015-01.


Assuntos
Colectomia , Laparoscopia , Anastomose Cirúrgica/efeitos adversos , Auditoria Clínica , Colectomia/efeitos adversos , Determinação de Ponto Final , Humanos , Laparoscopia/efeitos adversos , Reprodutibilidade dos Testes , Tamanho da Amostra
7.
Eur Cell Mater ; 35: 209-224, 2018 04 13.
Artigo em Inglês | MEDLINE | ID: mdl-29652075

RESUMO

The success of cell-based approaches for the treatment of cartilage defects requires an optimal autologous cell source with chondrogenic differentiation ability that maintains its differentiated properties and stability following implantation. The objective of this study was to compare the chondrogenic capacity of mesenchymal stem cells (MSCs) isolated from lipoaspirates (ASCs) and the infrapatellar fat pad (IFPSCs) of osteoarthritic patients and treated with transforming growth factor (TGF)-ß family-related growth factors. Cells were cultured for 6 weeks in a 3D pellet culture system with the chimeric activin A/bone morphogenic protein (BMP)-2 ligand (AB235), the chimeric nodal/BMP-2 ligand (NB260) or BMP-2. To investigate the stability of the new cartilage, ASCs-treated pellets were transplanted subcutaneously into severe combined immunodeficiency (SCID) mice. Histological and immunohistochemical assessment confirmed that the growth factors induced cartilage differentiation in both isolated cell types. However, reverse transcription-quantitative PCR results showed that ASCs presented a higher chondrogenic potential than IFPSCs. In vivo results revealed that AB235-treated ASCs pellets were larger in size and could form stable cartilage-like tissue as compared to NB260-treated pellets, while BMP-2-treated pellets underwent calcification. The chondrogenic induction of ASCs by AB235 treatment was mediated by SMAD2/3 activation, as proved by immunofluorescence analysis. The results of this study indicated that the combination of ASCs and AB235 might lead to a cell-based cartilage regeneration treatment.


Assuntos
Tecido Adiposo/patologia , Diferenciação Celular/efeitos dos fármacos , Separação Celular , Condrogênese/efeitos dos fármacos , Lipectomia , Osteoartrite/patologia , Células-Tronco/patologia , Fator de Crescimento Transformador beta/farmacologia , Idoso , Animais , Feminino , Humanos , Masculino , Camundongos SCID , Pessoa de Meia-Idade , Fenótipo , Proteínas Smad/metabolismo , Transplante de Células-Tronco
8.
Parasitol Res ; 117(4): 1237-1244, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29478175

RESUMO

In Morocco, visceral leishmaniasis (VL) is a parasitic disease caused by the flagellated protozoan parasite Leishmania infantum. L. infantum is transmitted by the bite of female phlebotomine sandflies, and its main reservoir hosts are domestic dogs. Asymptomatic infection with L. infantum is more frequent than clinically apparent disease. In HIV-infected patients, the risk of clinical VL is increased due to immunosuppression that may reactivate latent infections. However, coinfected subjects do not necessarily develop VL and may remain as asymptomatic carriers depending on their immune status. The present study investigates the asymptomatic carriers of L. infantum in HIV-infected patients in central Morocco, where human cases of visceral leishmaniasis by L. infantum have been reported. A total of 200 HIV-infected patients attending the Infectious Diseases Unit of the Ibn Zohar Hospital of Marrakech participated in the study. Parasitological and serological blood analyses included a direct microscopic examination (DME), culture in Novy-McNeal-Nicolle (NNN) medium, and serology by indirect immunofluorescence (IFI). We found prevalence rates of 5% (10/200) by IFI, 3% (6/200) by DME, and 2.5% (5/200) by culture. The parasite was identified as L. infantum by PCR from positive cultures.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por HIV/epidemiologia , Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/epidemiologia , Adulto , Animais , Coinfecção , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Infecções por HIV/complicações , Humanos , Leishmaniose Visceral/complicações , Leishmaniose Visceral/diagnóstico , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Reação em Cadeia da Polimerase , Prevalência , Psychodidae/parasitologia
9.
Int J Biometeorol ; 62(4): 493-500, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28986694

RESUMO

This study aimed to investigate the effect of heat stress and month of birth on growth performance, pelleted starter intake, and stress-related hormones in Holstein calves. Birth weight and growth records, representing 4735 Holstein calves from a large commercial dairy herd in northern Mexico (25° N; 22.3 °C mean annual temperature) from 2013 to 2015, were analyzed. Temperature-humidity index (THI) at calving, season of birth, and month of birth were the independent variables, whereas growth traits were the dependent variables. Increased THI at birth from < 65 to > 85 units was associated with a decrease in birth weight from 39.3 to 38.7 kg. Calves subjected to high THI (> 75 units) at calving showed lesser (P < 0.01) pre-weaning gains (405 ± 97 g/calf/day), whereas those calves born with THI < 70 units presented the highest gains (466 ± 112 g/calf/day). Birth during the fall months reduced (P < 0.01) weaning weight by about 5 kg compared with winter months. Also, the pre-weaning average daily gain for calves born in the fall was about 70 g less (P < 0.01) than calves delivered in winter months. Plasma triiodothyronine and tetraiodothyronine levels were lower (1.02 ± 0.21 and 48 ± 7.9 ng/mL, respectively; P < 0.01) in summer and highest in winter (1.64 ± 0.48 and 66 ± 11 ng/mL, respectively). Mean plasma cortisol concentration was higher in heat-stressed calves born in summer (59 ± 40 ng/mL) than calves born in winter (20 ± 28 ng/mL). Pelleted starter intake 1 week before weaning was lowest (P < 0.01) in the fall (0.82 ± 0.26 kg/calf/day; mean ± SD) and highest in spring (1.26 ± 0.43 kg/calf/day). It was concluded that in this particular environment, heat stress affects birth weight and growth rate of Holstein calves. Thus, environmental management of the newborn calf during hot spring and summer months is warranted to optimize pelleted starter intake and calf growth rates.


Assuntos
Doenças dos Bovinos , Transtornos de Estresse por Calor , Ração Animal , Animais , Peso Corporal , Bovinos/sangue , Bovinos/crescimento & desenvolvimento , Doenças dos Bovinos/sangue , Ingestão de Alimentos , Feminino , Transtornos de Estresse por Calor/sangue , Transtornos de Estresse por Calor/veterinária , Umidade , Hidrocortisona/sangue , Temperatura , Desmame
10.
Sci Rep ; 7(1): 17266, 2017 12 08.
Artigo em Inglês | MEDLINE | ID: mdl-29222521

RESUMO

Whole blood stimulation with soluble Leishmania antigen (SLA), followed by plasma cytokine and chemokine determination, provides means of detecting subjects with asymptomatic Leishmania infection. This work examines the potential of Protein Saver 903 cards for the storage and transport of SLA-stimulated dried plasma spot samples. Blood was collected from asymptomatic and negative control subjects living in a Leishmania infantum- (Spain) and Leishmania donovani-endemic area (Bangladesh). After SLA-stimulation, three types of sample were prepared: frozen liquid plasma (-20 °C), and plasma dropped onto Protein Saver cards kept at -20 °C (DPS-FZ), and at ambient temperature (DPS-AT). The concentrations of IFN-γ, IL-2, CXCL10, CXCL9, CCL2 and CXCL8 in the thawed liquid plasma (TLP), DPS-FZ and DPS-AT samples were then determined. Strong correlations were seen between the TLP and DPS-FZ/AT samples for all the studied cytokines/chemokines in both the L. infantum and L. donovani areas. Protein Saver 903 cards would therefore appear to allow for the transport of SLA-stimulated plasma samples by courier at ambient temperature. The CXCL10 and CXCL9 detectable in these plasma spots provided robust markers for identifying asymptomatic subjects from both endemic areas. This easy procedure opens up new possibilities for field studies in resource-limited settings, which could help in Leishmania control.


Assuntos
Antígenos de Protozoários/farmacologia , Doenças Assintomáticas , Quimiocinas/sangue , Teste em Amostras de Sangue Seco , Leishmania donovani/fisiologia , Leishmania infantum/fisiologia , Leishmaniose Visceral/sangue , Antígenos de Protozoários/química , Feminino , Humanos , Leishmania donovani/imunologia , Leishmania infantum/imunologia , Masculino , Solubilidade
11.
Enferm. intensiva (Ed. impr.) ; 28(4): 178-186, oct.-dic. 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-168092

RESUMO

Objetivo: Analizar si el cumplimiento de las medidas no farmacológicas para la prevención de la neumonía asociada a la ventilación mecánica (NAV) se asocia a la carga de trabajo de las enfermeras. Método: Estudio observacional prospectivo llevado a cabo en una UCI médico-quirúrgica. Se evaluó a las enfermeras a cargo de pacientes con soporte ventilatorio. Variables: cuestionario de conocimiento, aplicación de las medidas no farmacológicas de prevención de la NAV, carga de trabajo medida mediante el Nine Equivalents of Nursing Manpower Use Score. Fases: 1) las enfermeras realizaron un programa educativo, basado en conferencias de 60 min sobre medidas no farmacológicas para la prevención de NAV, completando al finalizar un cuestionario de conocimiento; 2) periodo de observaciones; 3) cuestionario de conocimiento. Resultados: De un total de 67 enfermeras de UCI, 54 completaron el programa formativo y fueron incluidos en el estudio. Se llevaron a cabo un total de 160 observaciones de 49 enfermeros/as. El correcto conocimiento de las medidas de prevención se confirmó tanto en el cuestionario inicial como final. La aplicación de las medidas de prevención varió desde el 11% para el lavado de manos preaspiración hasta el 97% para el uso de sonda de aspiración estéril. La puntuación del Nine Equivalents of Nursing Manpower Use Score fue de 50±13. No se observaron asociaciones significativas entre el grado de conocimiento y la aplicación de medidas de prevención, ni entre la carga de trabajo y la aplicación de dichas medidas. Conclusiones: El conocimiento de las enfermeras de las medidas de prevención de la NAV no se traslada necesariamente a la práctica diaria. En la población estudiada, la falta de aplicación de estas medidas no está sujeta a la falta de conocimiento ni a la carga de trabajo, sino probablemente a los factores contextuales (AU)


Objective: To analyse whether adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia (VAP) is associated with nursing workload. Methods: A prospective observational study performed in a single medical-surgical ICU. Nurses in charge of patients under ventilator support were assessed. Variables: knowledge questionnaire, application of non-pharmacological VAP prevention measures, and workload (Nine Equivalents of Nursing Manpower Use Score). Phases: 1) the nurses carried out a educational programme, consisting of 60-minute lectures on non-pharmacological measures for VAP prevention, and at the end completed a questionnaire knowledge; 2) observation period; 3) knowledge questionnaire. Results: Among 67 ICU-staff nurses, 54 completed the educational programme and were observed. A total of 160 observations of 49 nurses were made. Adequate knowledge was confirmed in both the initial and final questionnaires. Application of preventive measures ranged from 11% for hand washing pre-aspiration to 97% for the use of a sterile aspiration probe. The Nine Equivalents of Nursing Manpower Use Score was 50±13. No significant differences were observed between the association of the nurses' knowledge and the application of preventive measures or between workload and the application of preventive measures. Conclusions: Nurses' knowledge of VAP prevention measures is not necessarily applied in daily practice. Failure to follow these measures is not subject to lack of knowledge or to increased workload, but presumably to contextual factors (AU)


Assuntos
Humanos , Enfermagem de Cuidados Críticos/normas , Carga de Trabalho/normas , Pneumonia/enfermagem , Pneumonia/prevenção & controle , Respiração Artificial/métodos , Respiração Artificial/enfermagem , Projetos Piloto , Pneumonia/complicações , Pneumonia Aspirativa/enfermagem , Sucção/enfermagem , Respiração Artificial/efeitos adversos
12.
Enferm Intensiva ; 28(4): 178-186, 2017.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28890209

RESUMO

OBJECTIVE: To analyse whether adherence to non-pharmacological measures in the prevention of ventilator-associated pneumonia (VAP) is associated with nursing workload. METHODS: A prospective observational study performed in a single medical-surgical ICU. Nurses in charge of patients under ventilator support were assessed. VARIABLES: knowledge questionnaire, application of non-pharmacological VAP prevention measures, and workload (Nine Equivalents of Nursing Manpower Use Score). Phases: 1) the nurses carried out a educational programme, consisting of 60-minute lectures on non-pharmacological measures for VAP prevention, and at the end completed a questionnaire knowledge; 2) observation period; 3) knowledge questionnaire. RESULTS: Among 67 ICU-staff nurses, 54 completed the educational programme and were observed. A total of 160 observations of 49 nurses were made. Adequate knowledge was confirmed in both the initial and final questionnaires. Application of preventive measures ranged from 11% for hand washing pre-aspiration to 97% for the use of a sterile aspiration probe. The Nine Equivalents of Nursing Manpower Use Score was 50±13. No significant differences were observed between the association of the nurses' knowledge and the application of preventive measures or between workload and the application of preventive measures. CONCLUSIONS: Nurses' knowledge of VAP prevention measures is not necessarily applied in daily practice. Failure to follow these measures is not subject to lack of knowledge or to increased workload, but presumably to contextual factors.


Assuntos
Enfermagem de Cuidados Críticos , Fidelidade a Diretrizes/estatística & dados numéricos , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Carga de Trabalho , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos
13.
Expert Rev Mol Med ; 19: e9, 2017 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-28724458

RESUMO

The protein kinase R (PKR, also called EIF2AK2) is an interferon-inducible double-stranded RNA protein kinase with multiple effects on cells that plays an active part in the cellular response to numerous types of stress. PKR has been extensively studied and documented for its relevance as an antiviral agent and a cell growth regulator. Recently, the role of PKR related to metabolism, inflammatory processes, cancer and neurodegenerative diseases has gained interest. In this review, we summarise and discuss the involvement of PKR in several cancer signalling pathways and the dual role that this kinase plays in cancer disease. We emphasise the importance of PKR as a molecular target for both conventional chemotherapeutics and emerging treatments based on novel drugs, and its potential as a biomarker and therapeutic target for several pathologies. Finally, we discuss the impact that the recent knowledge regarding PKR involvement in metabolism has in our understanding of the complex processes of cancer and metabolism pathologies, highlighting the translational research establishing the clinical and therapeutic potential of this pleiotropic kinase.


Assuntos
Metabolismo Energético , Neoplasias/metabolismo , eIF-2 Quinase/metabolismo , Animais , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Apoptose/genética , Biomarcadores , Metabolismo Energético/efeitos dos fármacos , Humanos , Neoplasias/tratamento farmacológico , Neoplasias/genética , Inibidores de Proteínas Quinases/farmacologia , Inibidores de Proteínas Quinases/uso terapêutico , Transdução de Sinais/efeitos dos fármacos , eIF-2 Quinase/antagonistas & inibidores , eIF-2 Quinase/genética
14.
Gene Ther ; 24(8): 453-461, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28553929

RESUMO

RNA interference (RNAi) is a sequence-specific gene silencing mechanism that is triggered by the expression of a short hairpin RNA (shRNA). shRNA molecules enter the RNAi pathway at the Dicer processing step. Recent studies indicated that the cellular microRNA miR-451 is not recognized by Dicer, but that it is processed instead by the Argonaute 2 (Ago2) protein. Subsequently, Dicer-independent shRNAs were described that rely on Ago2 for processing, as well as the subsequent silencing step. We called these AgoshRNA molecules because they depend on Ago2 both for maturation and activation. Processing of an AgoshRNA yields only a single active RNA strand, thus reducing the chance of adverse off-target effects induced by the passenger strand of regular shRNAs. In this study, we converted several anti-HIV-1 shRNAs into AgoshRNAs. Seven of the 21 designed AgoshRNAs were potent anti-HIV molecules, although their RNAi activity is generally somewhat reduced compared with the matching shRNAs. The AgoshRNA candidates revealed no cellular toxicity. This may relate to the absence of passenger strand expression, which was verified for these AgoshRNA candidates. Furthermore, we demonstrate that a toxic shRNA can be converted into a non-toxic AgoshRNA.


Assuntos
Proteínas Argonautas/genética , HIV-1/genética , Interferência de RNA , RNA Interferente Pequeno/genética , Proteínas Argonautas/metabolismo , Células HEK293 , Humanos , RNA Interferente Pequeno/metabolismo
15.
Clin Microbiol Infect ; 22(8): 739.e1-4, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27265372

RESUMO

No field method exists for identifying asymptomatic individuals in areas where Leishmania infantum is endemic. This work reports that, 24 h after stimulating whole blood with soluble Leishmania antigen (SLA), plasma interferon-γ (IFN-γ) and interleukin-2 (IL-2) become significantly elevated in samples from asymptomatic individuals (n=47) compared with those from negative controls (n=50), all of them recruited from a blood bank. When compared with the reference test SLA-lymphoproliferative assay, IL-2 appears as a new, 100% sensitive and specific marker for asymptomatic individuals with a positive cellular response (compared with 100% and 84.78%, respectively, for IFN-γ). Further studies in other transmission areas and in other cohorts of exposed people need to be performed to confirm these results. Once validated, IFN-γ and IL-2 levels in SLA-stimulated whole blood could be reliably used in the field to estimate the prevalence of those asymptomatic individuals with Leishmania-specific cellular immune responses.


Assuntos
Doenças Assintomáticas , Interleucina-2/sangue , Leishmania infantum , Leishmaniose Visceral/sangue , Leishmaniose Visceral/parasitologia , Adulto , Biomarcadores , Citocinas/sangue , Feminino , Humanos , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/epidemiologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
16.
Anim Reprod Sci ; 167: 133-8, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26944772

RESUMO

This study aimed to determine the possible effects of a single injection of human chorionic gonadotropin (hCG) as a means for estrus induction in acyclic French-Alpine goats during the reproductive transition period at 25°N, 103°W. The potential effects of hCG upon ovarian function and reproductive performance of goats were also assessed. Multiparous acyclic French-Alpine goats (n = 39; 37.4 ± 8 .5 kg) were primed with 20mg progesterone (P4) 1 day prior to hCG administration. Thereafter, does were treated either with saline (hCG-0; n = 10), 50 (hCG-50; n = 9), 100 (hCG-100; n = 10), or 300 IU of hCG (hCG-300; n = 10). Ovarian structures and pregnancy were monitored by transrectal ultrasonography. In addition, after hCG application, goats were monitored twice daily (0800 and 1800 h) to detect estrus signs, with the use of aproned, sexually active bucks treated with testosterone. Goats were bred 12h after the onset of estrus. Two days after hCG administration, the number of large follicles was higher (P < 0.05) in the hCG-50 and hCG-300 groups (1.7 ± 0.1 and 1.8 ± 0.2, respectively) compared with the hCG-100 and hCG-0 groups (1.4 ± 0.2 and 1.1 ± 0.1, respectively). Although none of the hCG-0-goats depicted estrus, the estrus response from the hCG-50, hCG-100, and hCG-300 groups over the 7-d breeding period was 67%, 100%, and 90%, respectively (P > 0.05), being always accompanied by ovulation. Pregnancy rate (67, 100, and 70%), kidding rate (55%, 80%, and 70%), and litter size (1.6 ± 0.5, 1.5 ± 0.5, and 1.5 ± 0.5) for hCG-50, hCG-100, and hCG-300, respectively, did not differ among the hCG-treated does. Therefore, the combined use of P4-priming plus a 100-IU hCG injection is an effective protocol for inducing estrus in non-cycling Alpine goats during the anestrus-to-estrus transition period, which is of key importance for both goat producers and industrializers.


Assuntos
Gonadotropina Coriônica/farmacologia , Ciclo Estral/efeitos dos fármacos , Cabras/fisiologia , Progesterona/farmacologia , Substâncias para o Controle da Reprodução/farmacologia , Animais , Feminino , Gravidez
17.
Phys Rev E ; 94(6-1): 062116, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28085445

RESUMO

In the configuration in which two-level atoms with an initial thermal distribution of their states are sent in succession to a cavity sustaining a single mode of electromagnetic radiation, one atom leaving the cavity as the next one enters it (as in the one-atom maser), Jaynes and Cummings showed that the steady state of the field, when many atoms have traversed the cavity, is thermal with a temperature different than that of the atoms in the off-resonant situation. Having an interaction between two subsystems which maintains them at different temperatures was then understood as leading to an apparent violation of energy conservation. Here we show, by calculating the quantum entropy production in the system, that this difference of temperatures is consistent with having the subsystems adiabatically insulated from each other as the steady state is approached. At resonance the insulation is removed and equilibration of the temperatures is achieved.

18.
Artigo em Inglês | MEDLINE | ID: mdl-26565225

RESUMO

It is well-known that a dilute one-dimensional (1D) gas of bosons with infinitely strong repulsive interactions behaves like a gas of free fermions. Just as with conduction electrons in metals, we consider a single-particle picture of the resulting dynamics, when the gas is isolated by enclosing it into a box with hard walls and preparing it in a special initial state. We show, by solving the nonstationary problem of a free particle in a 1D hard-wall box, that the single-particle state recurs in time, signaling the intuitively expected back-and-forth motion of a free particle moving in a confined space. Under suitable conditions, the state of the whole gas can then be made to recur if all the particles are put in the same initial momentum superposition. We introduce this problem here as a modern instance of the discussions giving rise to the famous recurrence paradox in statistical mechanics: on one hand, our results may be used to develop a poor man's interpretation of the recurrence of the initial state observed [T. Kinoshita et al., Nature 440, 900 (2006)] in trapped 1D Bose gases of cold atoms, for which our estimated recurrence time is in fair agreement with the period of the oscillations observed; but this experiment, on the other hand, has been substantially influential on the belief that an isolated quantum many-body system can equilibrate as a consequence of its own unitary nonequilibrium dynamics. Some ideas regarding the latter are discussed.

19.
Sci Rep ; 5: 16400, 2015 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-26563344

RESUMO

Autologous chondrocyte implantation (ACI) depends on the quality and quantity of implanted cells and is hindered by the fact that chondrocytes cultured for long periods of time undergo dedifferentiation. Here we have developed a reproducible and efficient chondrogenic protocol to redifferentiate chondrocytes isolated from osteoarthritis (OA) patients. We used morphological, histological and immunological analysis together with a RT-PCR detection of collagen I and collagen II gene expression to show that chondrocytes isolated from articular cartilage biopsies of patients and subjected to long-term culture undergo dedifferentiation and that these cells can be redifferentiated following treatment with the chimeric Activin A/BMP2 ligand AB235. Examination of AB235-treated cell pellets in both in vitro and in vivo experiments revealed that redifferentiated chondrocytes synthesized a cartilage-specific extracellular matrix (ECM), primarily consisting of vertically-orientated collagen fibres and cartilage-specific proteoglycans. AB235-treated cell pellets also integrated into the surrounding subcutaneous tissue following transplantation in mice as demonstrated by their dramatic increase in size while non-treated control pellets disintegrated upon transplantation. Thus, our findings describe an effective protocol for the promotion of redifferentiation of autologous chondrocytes obtained from OA patients and the formation of a cartilage-like ECM that can integrate into the surrounding tissue in vivo.


Assuntos
Ativinas/metabolismo , Proteína Morfogenética Óssea 2/metabolismo , Diferenciação Celular , Condrócitos/patologia , Ativinas/genética , Idoso , Animais , Proteína Morfogenética Óssea 2/genética , Cartilagem Articular/metabolismo , Cartilagem Articular/patologia , Condrócitos/transplante , Colágeno/genética , Colágeno/metabolismo , Matriz Extracelular/metabolismo , Feminino , Expressão Gênica , Humanos , Imuno-Histoquímica , Ligantes , Masculino , Camundongos , Camundongos Endogâmicos NOD , Camundongos SCID , Pessoa de Meia-Idade , Osteoartrite/patologia , Osteoartrite/terapia , Proteoglicanas/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Tempo , Transplante Autólogo , Transplante Heterólogo
20.
J Anim Sci ; 93(8): 4153-60, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26440195

RESUMO

This study evaluated the effects of peripartum feed supplementation on doe and kid BW and BCS, milk yield and composition, serum metabolites, and maternal-neonatal behavior under rangeland conditions in northern Mexico. Adult does ( = 23) were randomly assigned to 3 nutritional plane groups: 1) goats supplemented (500 g of concentrate [18% CP/kg DM, 2.7 Mcal/kg DM, and 2% salt]) from 15 d prepartum to 7 d postpartum (G15; = 8), 2) the same supplementation as G15 but from 35 d before until 7 d after kidding (G35; = 8), and 3) nonsupplemented does (GC; = 7). Supplemented goats differed from GC goats in BW (48 ± 1.8, 46.1 ± 2.5, and 44.9 ± 2.3 kg; < 0.05), milk yield (1.8 ± 0.1, 1.9 ± 0.2, and 1.2 ± 0.1 kg at d 15 postpartum; < 0.01), kid birth weights (3.8 ± 0.2, 3.6 ± 0.2, and 3.4 ± 0.2 kg; < 0.05), and kid BW at 15 d after birth (6.9 ± 0.2, 6.6 ± 0.2, and 5.6 ± 0.2 kg; < 0.05) for the G35, G15, and GC, respectively. Serum concentrations for total protein, glucose, and cholesterol were not affected ( > 0.05) by treatments. Milk of GC goats showed increased ( < 0.05) percentages for fat, protein, lactose, and nonfat milk solids, whereas total quantities of these variables where higher ( < 0.05) in the G15 and G35 groups. Furthermore, GC dams spent more time seeking their offspring and emitted more low-pitched bleats 4 h postpartum ( < 0.05) in a 2-choice test compared with the G15 and G35 groups. In general, peripartum supplementation promoted a closer dam-kid relationship at 8 h postpartum. Goat performance may be improved in this semiarid region of Mexico with marginal production through supplementation in late gestation.


Assuntos
Ração Animal/análise , Comportamento Animal , Cabras/fisiologia , Lactação/fisiologia , Leite/fisiologia , Criação de Animais Domésticos , Fenômenos Fisiológicos da Nutrição Animal , Animais , Peso ao Nascer , Glicemia , Proteínas Sanguíneas , Peso Corporal , Colesterol/sangue , Suplementos Nutricionais , Feminino , Leite/química , Período Periparto , Gravidez
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