RESUMO
In a previous correspondence, the author tried to establish the crucial relationship of the country's public health with the government officials' economic decisions and actions. Understanding such, we look at the perspective of the handling of the pandemic, in terms of economic decisions and actions, in the Philippines. In the country, complaints from the citizens surfaced because the government failed in providing an appropriate response to the economic imbalance generated by the pandemic. Thus, in this paper, we surveyed the sudden engenderment of community pantries in the Philippines as a way of filling the gaps of the government.
Assuntos
COVID-19 , COVID-19/epidemiologia , Governo , Humanos , Pandemias , Filipinas/epidemiologia , Saúde PúblicaRESUMO
The public's trust in the COVID-19 vaccination program is still a problem, especially in the Philippines. Many have suggested that the government and even healthcare workers should exhaust all their efforts to educate the public about the nature of the vaccines. However, rebuilding public trust is not only a governmental concern, but should also be taken as a personal responsibility. Thus, this paper argues that mindfulness through critical thinking is a necessary key in boosting the vaccination program.
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COVID-19 , Atenção Plena , Vacinas , Vacinas contra COVID-19 , Catolicismo , Humanos , Filipinas , SARS-CoV-2 , Confiança , VacinaçãoRESUMO
A recent correspondence pointed out that indigenous people and other ethnic communities should be included in the rollout of the COVID-19 vaccine. Indigenous communities carry a unique set of cultural beliefs and traditions that need to be preserved. This paper suggests that, aside from indigenous people, other marginalized sectors should also be included in the vaccine rollout by the government.
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Vacinas contra COVID-19 , COVID-19 , Etnicidade , Humanos , Povos Indígenas , SARS-CoV-2RESUMO
In a recent correspondence, it was explained that cultural values and beliefs must be taken into consideration in flattening the COVID-19 pandemic curve. With this, cultural awareness is suggested as a guide in coming up with more effective health strategies and policies. For this reason, we discussed the intervention made by the Philippine government and how people can make this gesture as a model for other countries in mitigating the spread of the coronavirus.
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COVID-19 , Pandemias , Humanos , Pandemias/prevenção & controle , Filipinas/epidemiologia , SARS-CoV-2RESUMO
This paper establishes that there is a need to turn to virtue ethics in dealing with the COVID-19 pandemic. It argues that the virtue of solidarity can be a companion virtue to compassion for medical frontline workers and other individuals involved. Like compassion, the virtue of solidarity is a reminder that everyone is in this crisis together and that each is responsible for all.
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COVID-19 , Pandemias , Empatia , Humanos , SARS-CoV-2 , VirtudesRESUMO
In a recent article, it was reported that the COVID-19 pandemic impacted the economic situation of some countries. It led to some people losing jobs amidst the difficult situation that the pandemic caused. Thus, this paper discusses the need to provide a program for the least advantaged citizens so that they can still experience their basic liberties. The least advantaged citizens, as Rawls deem them, are the ones who lost jobs and incomes were hit the hardest during the COVID-19 pandemic.
Assuntos
COVID-19 , Pandemias , Humanos , Pandemias/prevenção & controle , SARS-CoV-2RESUMO
Glucocorticoid signaling regulates target genes by multiple mechanisms, including the repression of transcriptional activities of nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB) though direct protein-protein interactions and subsequent O-GlcNAcylation of RNA polymerase II (pol II). Recent studies have shown that overexpression of O-linked ß-N-acetylglucosamine transferase (OGT), which adds an O-linked ß-N-acetylglucosamine (O-GlcNAc) group to the C-terminal domain of RNA pol II, increases the transrepression effects of glucocorticoids (GC). As O-GlcNAcase (OGA) is an enzyme that removes O-GlcNAc from O-GlcNAcylated proteins, we hypothesized that the potentiation of GC effects following OGT overexpression could be similarly observed via the direct inhibition of OGA, inhibiting O-GlcNAc removal from pol II. Here we show that despite pharmacological evidence of target engagement by a selective small molecule inhibitor of OGA, there is no evidence for a sensitizing effect on glucocorticoid-mediated effects on TNF-α promoter activity, or gene expression generally, in human cells. Furthermore, inhibition of OGA did not potentiate glucocorticoid-induced apoptosis in several cancer cell lines. Thus, despite evidence for O-GlcNAc modification of RNA pol II in GR-mediated transrepression, our data indicate that pharmacological inhibition of OGA does not potentiate or enhance glucocorticoid-mediated transrepression.
Assuntos
Inibidores Enzimáticos/farmacologia , N-Acetilglucosaminiltransferases/antagonistas & inibidores , Piranos/farmacologia , Receptores de Glucocorticoides/metabolismo , Tiazóis/farmacologia , Apoptose/efeitos dos fármacos , Apoptose/genética , Dexametasona/farmacologia , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Inflamação/genética , Concentração Inibidora 50 , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/metabolismo , Lipopolissacarídeos/farmacologia , N-Acetilglucosaminiltransferases/metabolismo , Prednisolona/farmacologia , Fator de Necrose Tumoral alfa/farmacologia , Células U937RESUMO
BACKGROUND: Lymphedema induced by mTOR inhibitors is a side-effect rarely reported to date. PATIENTS AND METHODS: Long-lasting bilateral lower-limb lymphedema with left predominance developed in a 71-year-old stable renal transplant recipient after 40 months of sirolimus treatment. Although no change in lymphedema was observed after 21 months despite dosage reduced, it improved markedly after changeover to tacrolimus. DISCUSSION: Regardless of the individual drug, mTOR inhibitors can cause lymphedema. This effect may be countered through substitution with tacrolimus. CONCLUSION: Physicians should be aware of lymphedema as a side-effect of mTOR inhibitors. It can be improved by substitution with tacrolimus. However, early withdrawal of mTOR inhibitors is recommended before irreversible lymphedema occurs.
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Imunossupressores/efeitos adversos , Linfedema/induzido quimicamente , Sirolimo/efeitos adversos , Tacrolimo/uso terapêutico , Idoso , Feminino , Humanos , Transplante de Rim , Sirolimo/uso terapêutico , TransplantadosRESUMO
We have previously shown that intracerebellar infusion of the neuropeptide secretin enhances the acquisition phase of eyeblink conditioning (EBC). Here, we sought to test whether endogenous secretin also regulates EBC and to test whether the effect of exogenous and endogenous secretin is specific to acquisition. In Experiment 1, rats received intracerebellar infusions of the secretin receptor antagonist 5-27 secretin or vehicle into the lobulus simplex of cerebellar cortex immediately prior to sessions 1-3 of acquisition. Antagonist-infused rats showed a reduction in the percentage of eyeblink CRs compared with vehicle-infused rats. In Experiment 2, rats received intracerebellar infusions of secretin or vehicle immediately prior to sessions 1-2 of extinction. Secretin did not significantly affect extinction performance. In Experiment 3, rats received intracerebellar infusions of 5-27 secretin or vehicle immediately prior to sessions 1-2 of extinction. The secretin antagonist did not significantly affect extinction performance. Together, our current and previous results indicate that both exogenous and endogenous cerebellar secretin modulate acquisition, but not extinction, of EBC. We have previously shown that (1) secretin reduces surface expression of the voltage-gated potassium channel α-subunit Kv1.2 in cerebellar cortex and (2) intracerebellar infusions of a Kv1.2 blocker enhance EBC acquisition, much like secretin. Kv1.2 is almost exclusively expressed in cerebellar cortex at basket cell-Purkinje cell pinceaus and Purkinje cell dendrites; we propose that EBC-induced secretin release from PCs modulates EBC acquisition by reducing surface expression of Kv1.2 at one or both of these sites.
Assuntos
Córtex Cerebelar/fisiologia , Condicionamento Palpebral/fisiologia , Receptores Acoplados a Proteínas G/metabolismo , Receptores dos Hormônios Gastrointestinais/metabolismo , Secretina/metabolismo , Animais , Cateteres de Demora , Córtex Cerebelar/efeitos dos fármacos , Condicionamento Palpebral/efeitos dos fármacos , Extinção Psicológica/efeitos dos fármacos , Extinção Psicológica/fisiologia , Canal de Potássio Kv1.2/metabolismo , Masculino , Células de Purkinje/metabolismo , Ratos Wistar , Receptores Acoplados a Proteínas G/antagonistas & inibidores , Receptores dos Hormônios Gastrointestinais/antagonistas & inibidoresRESUMO
Elevated serum CC chemokine ligand (CCL)18 reflects lung fibrosis activity in systemic sclerosis (SSc) and could be an early marker of lung function worsening. Therefore, we sought to evaluate whether serum CCL18 levels at baseline could predict worsening of lung disease in SSc. In this prospective study, 83 SSc patients were analysed longitudinally over a 4-yr observation period for the risk of occurrence of combined deleterious events, defined as a 10% decrease from baseline of total lung capacity or forced vital capacity % predicted, or death, according to serum CCL18 at inclusion. Receiver operating characteristic (ROC) curve analysis was performed for prediction of events during the first year after inclusion. The best cut-off level of serum CCL18 for prediction of a combined event within the follow-up period was 187 ng · mL(-1), with 53% sensitivity and 96% specificity (area under the ROC curve 0.86; p < 0.001). After a mean ± SD follow-up of 33.7 ± 10.8 months, a higher rate of disease progression occurred in the group with serum CCL18 levels >187 ng · mL(-1). The adjusted hazard ratio was 5.36 (95% CI 2.44-11.75; p < 0.001). In summary, serum CCL18 is an accurate predictive biomarker for the identification of patients with a higher risk of subsequent scleroderma lung disease worsening.
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Quimiocinas CC/sangue , Progressão da Doença , Pneumopatias/sangue , Escleroderma Sistêmico/sangue , Adulto , Idoso , Anticorpos Antinucleares/sangue , Autoanticorpos/sangue , Biomarcadores/sangue , DNA Topoisomerases Tipo I/imunologia , Feminino , Humanos , Estudos Longitudinais , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Curva ROC , Testes de Função Respiratória , Escleroderma Sistêmico/fisiopatologiaRESUMO
INTRODUCTION: The first manifestations of Becker's muscular dystrophy usually occur during childhood, as Duchenne's muscular dystrophy, a related disease. However, clinical presentation is usually more heterogeneous and less severe. CASE REPORT: We report a 54-year-old man who presented with a late onset of Becker's muscular dystrophy, and review 12 additional similar cases previously reported in the literature. The disease onset ranged from 30 to 65 years old. Genetic deletion involved mainly exons 45 to 55 with variable phenotype: distal muscular hypertrophy in four cases, cardiac involvement (electrocardiography, radiography or echocardiography) in six out of the 12 studied cases. Compared to the paediatric form, functional impairment was milder, as only three patients after seven to 20 years of follow-up were wheelchair bound. CONCLUSION: The first manifestations of Becker's muscular dystrophy may occur after the age of 30 with heterogeneous phenotypes. Severity and limb disability is milder in these patients.
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Distrofia Muscular de Duchenne/diagnóstico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Mycotic aneurysms are rare, remain asymptomatic for a long time, and may be life threatening by their rupture if therapy is delayed. Historically associated with Streptococcus pyogenes and Staphylococcus aureus, they now frequently involve Salmonella species in elderly or immunodeficient patients, and complicate vascular investigation or surgical procedures. Frequently located in the abdominal aorta, they can also be found rarely in other location. Therapy associates antibiotics and surgical debridement with reestablishment of vascular continuity. We report a case of ruptured popliteal aneurysm with Salmonella bredney bacteraemia.
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Aneurisma Infectado/microbiologia , Aneurisma Roto/microbiologia , Artéria Poplítea , Infecções por Salmonella/complicações , Salmonella/isolamento & purificação , Aneurisma Infectado/complicações , Aneurisma Infectado/diagnóstico , Aneurisma Infectado/terapia , Aneurisma Roto/diagnóstico , Aneurisma Roto/terapia , Antibacterianos/uso terapêutico , Bacteriemia/microbiologia , Implante de Prótese Vascular , Doença das Coronárias/complicações , Desbridamento , Complicações do Diabetes/microbiologia , Diabetes Mellitus Tipo 2/complicações , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Ruptura Espontânea , Infecções por Salmonella/diagnóstico , Infecções por Salmonella/terapia , Fumar/efeitos adversos , Resultado do TratamentoRESUMO
A peripheral neuropathy occurs rarely during the course of an inflammatory myopathy. Once the classical aetiologies of peripheral neuropathies are ruled out, the diagnosis of neuromyositis can be accepted. We report a patient with dermatomyositis who presented a peripheral neuropathy revealed by dysautonomia. The presence of associated vasculitis led us to consider that this constituted the mechanism of the neurological involvement.
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Doenças do Sistema Nervoso Autônomo/etiologia , Dermatomiosite/complicações , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Dor Abdominal/etiologia , Doenças do Íleo/diagnóstico por imagem , Obstrução Intestinal/diagnóstico por imagem , Dor Abdominal/diagnóstico por imagem , Impacção Fecal/diagnóstico por imagem , Feminino , Humanos , Doenças do Íleo/complicações , Obstrução Intestinal/complicações , Lúpus Eritematoso Sistêmico/complicações , Pessoa de Meia-Idade , Radiografia , RecidivaRESUMO
INTRODUCTION: Chronic meningococcemia is an unusual clinical presentation within the spectrum of infections due to Neisseria meningitidis. CASE REPORT: We report a 32-year-old man who presented with a 15-day history of fever and maculopapular skin rash, in the absence of meningeal irritation or severe sepsis manifestation. Blood culture identified N. meningitidis. Clinical course was uneventful after antibiotic treatment was initiated. CONCLUSION: Early diagnosis of chronic meningococcemia is crucial for optimal management of the patient and his/her contacts. Such a diagnosis should be suspected in the presence of the characteristic clinical triad (recurrent fever, skin rash and arthralgia), and this clinical presentation should be distinguished from systemic vasculitis as inadequate prescription of corticosteroids may be deleterious.