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1.
Front Psychol ; 14: 1133583, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37179851

RESUMO

Based on the framework of the self-determination theory, the present study aimed to test a predictive model in the Ecuadorian sports context by using autonomy support as a trigger, which was mediated by basic psychological needs and later by autonomous motivation. This procedure was used to predict the intention to be physically active and was carried out on 280 athletes from the province of Azuay (Ecuador) aged between 12 and 20 years (M = 15.28; SD = 1.71). Different scales were used to measure the perception of the interpersonal style of autonomy supported by the coach. The scales employed included the degree of satisfaction of basic psychological needs, motivation to practice sports, and intention to be physically active. A structural equation analysis revealed that perceived autonomy support positively predicted basic psychological needs, which in turn positively predicted autonomous motivation and, as a result, the athletes' intentions to be physically active. It was concluded that coaches' support for the interpersonal style of autonomy can benefit the development of basic psychological needs as well as autonomous motivation, which in turn can increase young athletes' intentions to be physically active. Future research is also recommended to verify this predictive model and to encourage further experimental studies in which coaches promote autonomy support for athletes intending to increase their adherence to practising sports.

2.
Sci Rep ; 13(1): 5664, 2023 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-37024656

RESUMO

The advent of quantum computing threatens blockchain protocols and networks because they utilize non-quantum resistant cryptographic algorithms. When quantum computers become robust enough to run Shor's algorithm on a large scale, the most used asymmetric algorithms, utilized for digital signatures and message encryption, such as RSA, (EC)DSA, and (EC)DH, will be no longer secure. Quantum computers will be able to break them within a short period of time. Similarly, Grover's algorithm concedes a quadratic advantage for mining blocks in certain consensus protocols such as proof of work. Today, there are hundreds of billions of dollars denominated in cryptocurrencies and other digital assets that rely on blockchain ledgers as well as thousands of blockchain-based applications storing value in blockchain networks. Cryptocurrencies and blockchain-based applications require solutions that guarantee quantum resistance in order to preserve the integrity of data and assets in these public and immutable ledgers. The quantum threat and some potential solutions are well understood and presented in the literature. However, most proposals are theoretical, require large QKD networks, or propose new quantum-resistant blockchain networks to be built from scratch. Our work, which is presented in this paper, is pioneer in proposing an end-to-end framework for post-quantum blockchain networks that can be applied to existing blockchain to achieve quantum-resistance. We have developed an open-source implementation in an Ethereum-based (i.e., EVM compatible) network that can be extended to other existing blockchains. For the implementation we have (i) used quantum entropy to generate post-quantum key pairs, (ii) established post-quantum TLS connections and X.509 certificates to secure the exchange of information between blockchain nodes over the internet without needing a large QKD network, (iii) introduced a post-quantum second signature in transactions using Falcon-512 post-quantum keys, and (iv) developed the first on-chain verification of post-quantum signatures using three different mechanisms that are compared and analyzed: Solidity smart-contracts run by the validators for each transaction, modified EVM Opcode, and precompiled smart contracts.

3.
Children (Basel) ; 10(1)2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36670662

RESUMO

The objective of this study was to analyze the motivational profiles of Physical Education (PE) students and assess differences based on the perception of the support of autonomy, the intention to be physically active, satisfaction with classes, gender, age, and extracurricular sports activities. A cross-sectional descriptive study was carried out with a sample of 2621 students, aged 8 to 18 years (M = 14.16, SD = 2.28). An analysis of profiles was implemented, taking into account the motivation and the index of psychological mediators. The result of the cluster analysis gave a solution to four motivational profiles: high quality (n = 1094), low quantity (n = 292), low quality (n = 555), and high quantity (n = 680). Students grouped in the high quantity and quality profile presented higher levels of autonomy support, physical activity intention, enjoyment, and lower levels of boredom. Male participants, younger students, and those who participated in extracurricular activity were associated with self-determined profiles. In conclusion, the importance of promoting the satisfaction of basic psychological needs and autonomous motivation in PE classes is highlighted, in order to achieve higher values in terms of autonomy support, the intention to be physically active, enjoyment, and to reduce boredom levels in students.

4.
Artigo em Inglês | MEDLINE | ID: mdl-36231627

RESUMO

The objective of the study was to identify the profiles of support for autonomy perceived by athletes and compare them with motivation, basic psychological needs, and the intention to be physically active. A cross-sectional descriptive study was carried out with 280 athletes (M = 15.28; SD = 1.71). The results reveal the existence of two profiles using the perception of support for autonomy as a grouping variable. A profile of "High perception of support for autonomy" (group 1, n = 190, M = 4.38, SD = 0.32) and a profile of "Low support for autonomy" (group 2, n = 90, M = 3.40, SD = 0.86). The data show statistically significant differences in favour of group 1 with higher values in the Self-Determination Index (p = 0.009) and three basic psychological needs measured with the Index of Psychological Mediators (p = 0.000), but no significant differences in intention to be physically active were found. In conclusion, the importance of the support of autonomy granted by coaches is demonstrated, thus favouring more adaptive motivational climates and the greater satisfaction of basic psychological needs. The intention to be physically active was not found in federated athletes. New studies are required to clarify this fact and improve the contribution of sustainable development to the social dimension.


Assuntos
Intenção , Motivação , Estudos Transversais , Humanos , Autonomia Pessoal , Satisfação Pessoal , Desenvolvimento Sustentável
5.
iScience ; 23(3): 100932, 2020 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-32151975

RESUMO

Pathogenic bacteria secrete virulence factors that interact with the human host to establish infections. The human immune system evolved multiple mechanisms to fight bacterial invaders, including immune proteases that were demonstrated to contribute crucially to antibacterial defense. Here we show that granzyme B degrades multiple secreted virulence mediators from Listeria monocytogenes, Salmonella typhimurium, and Mycobacteria tuberculosis. Pathogenic bacteria, when infected in the presence of granzyme B or granzyme-secreting killer cells, fail to grow in human macrophages and epithelial cells owing to their crippled virulence. A granzyme B-uncleavable mutant form of the major Listeria virulence factor, listeriolysin O, rescued the virulence defect in response to granzyme treatment. Hence, we link the degradation of a single factor with the observed decrease in virulent bacteria growth. Overall, we reveal here an innate immune barrier function of granzyme B by disrupting bacterial virulence to facilitate bacteria clearance by bystander immune and non-immune cells.

6.
Acta Biomater ; 109: 254-266, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32194263

RESUMO

The architectural features of synthetic bone grafts are key parameters for regulating cell functions and tissue formation for the successful repair of bone defects. In this regard, macroporous structures based on triply-periodic minimal surfaces (TPMS) are considered to have untapped potential. In the present study, custom-made implants based on a gyroid structure, with (GPRC) and without (GP) a cortical-like reinforcement, were specifically designed to fit an intended bone defect in rat femurs. Sintered hydroxyapatite implants were produced using a dedicated additive manufacturing technology and their morphological, physico-chemical and mechanical features were characterized. The implants' integrity and ability to support bone ingrowth were assessed after 4, 6 and 8 weeks of implantation in a 3-mm-long, femoral defect in Lewis rats. GP and GPRC implants were manufactured with comparable macro- to nano-architectures. Cortical-like reinforcement significantly improved implant effective stiffness and resistance to fracture after implantation. This cortical-like reinforcement also concentrated new bone formation in the core of the GPRC implants, without affecting newly formed bone quantity or maturity. This study showed, for the first time, that custom-made TPMS-based bioceramic implants could be produced and successfully implanted in load-bearing sites. Adding a cortical-like reinforcement (GPRC implants) was a relevant solution to improve implant mechanical resistance, and changed osteogenic mechanism compared to the GP implants. STATEMENT OF SIGNIFICANCE: Architectural features are known to be key parameters for successful bone repair using synthetic bioceramic bone graft. So far, conventional manufacturing techniques, lacking reproducibility and complete control of the implant macro-architecture, impeded the exploration of complex architectures, such as triply periodic minimal surfaces (TPMS), which are foreseen to have an unrivaled potential for bone repair. Using a new additive manufacturing process, macroporous TPMS-based bioceramics implants were produced in calcium phosphate, characterized and implanted in a femoral defect in rats. The results showed, for the first time, that such macroporous implants can be successfully implanted in anatomical load-bearing sites when a cortical-like outer shell is added. This outer shell also concentrated new bone formation in the implant center, without affecting new bone quantity or maturity.


Assuntos
Osso e Ossos/fisiologia , Cerâmica/química , Durapatita/química , Próteses e Implantes , Animais , Força Compressiva , Feminino , Teste de Materiais , Osseointegração/fisiologia , Osteogênese/fisiologia , Porosidade , Ratos Endogâmicos Lew
7.
J Org Chem ; 84(20): 12809-12834, 2019 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-31385503

RESUMO

The development of a novel protocol for the fast introduction of the picolinamide directing group in aliphatic ketones by using the ammonia-Ugi 4-CR reaction and the subsequent evaluation of the Pd-mediated γ-C(sp3)-H bond activation is described. The methodology allows the efficient construction of a series of γ-arylated α-aminoamides bearing a congested carbon in two steps.

8.
Methods Mol Biol ; 1535: 275-284, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27914086

RESUMO

Bacterial pathogens represent a constant threat to human health that was exacerbated in recent years by a dramatic increase of strains resistant to last resort antibiotics. The immune system of higher vertebrates generally evolved several efficient innate and adaptive mechanisms to fight ubiquitous bacterial pathogens. Among those mechanisms, immune proteases were recognized to contribute essentially to antibacterial immune defense. The effector serine proteases of the adaptive immune system, the granzymes, exert potent antimicrobial activity when they are delivered into the bacterial cytosol by prokaryotic membrane disrupting proteins, such as granulysin.In this chapter, we are detailing experimental protocols to study the synergistic cytotoxic effects of human granzymes and granulysin on extracellular as well as on intracellular bacterial pathogens in vitro. In addition, we provide a simple and fast-forward method to biochemically purify native cytotoxic effector molecules necessary to perform this kind of investigations.


Assuntos
Antibacterianos/farmacologia , Antígenos de Diferenciação de Linfócitos T/farmacologia , Bactérias/efeitos dos fármacos , Bactérias/imunologia , Citotoxicidade Imunológica , Granzimas/farmacologia , Perforina/farmacologia , Linhagem Celular , Relação Dose-Resposta a Droga , Espaço Extracelular/imunologia , Espaço Extracelular/microbiologia , Humanos , Espaço Intracelular/imunologia , Espaço Intracelular/microbiologia , Células Matadoras Naturais/imunologia , Células Matadoras Naturais/metabolismo , Linfócitos T Citotóxicos/imunologia , Linfócitos T Citotóxicos/metabolismo
9.
Arch Oral Biol ; 65: 44-51, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26854620

RESUMO

OBJECTIVE: The focus of the current study was to identify if a possible association between NLRP3 (rs4612666) and IL-1B (rs1143634) single-nucleotide polymorphisms (SNPs) may be implicated in the etiopathogenesis of chronic periodontitis (CP) in a Colombian population. DESIGN: One hundred and twenty-four CP subjects and 81 periodontally healthy controls (HC) were recruited. Periodontal status was assessed by criteria based on probing depth, clinical attachment level, extent, and severity of periodontal breakdown. Human genomic DNA was obtained from saliva samples of the study subjects. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to identify the NLRP3 (rs4612666) and IL-1B (rs1143634) SNPs. The association of polymorphisms with CP was assessed individually and adjusted for confounding using a multivariate binary logistic regression model. RESULTS: Bivariate analysis showed a weak association between CT genotype of NLRP3 (rs4612666) SNP and CP, however after logistic regression analysis, neither NLRP3 (rs4612666) nor IL-1B (rs1143634) polymorphisms were strongly/independently associated with disease status. Even so, an interaction effect was significantly detected not only among CT/CC genotypes of NLRP3 gene regarding to the age stratum ≥ 48 years, but also between CC genotype of the same gene and smoking habit. CONCLUSION: Although the present results do not support that IL-1B (rs1143634) SNP could be identified as a risk predictor for CP in the present population, the synergistic interaction of the CT/CC genotypes of NLRP3 (rs4612666) SNP with ageing and/or smoking habit potentially might play a significant role in the pathogenic pathways of periodontal disease.


Assuntos
Periodontite Crônica/genética , Interleucina-1beta/genética , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Adulto , Feminino , Frequência do Gene , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/genética , Bolsa Periodontal/genética , Reação em Cadeia da Polimerase/métodos , Polimorfismo de Fragmento de Restrição , Polimorfismo de Nucleotídeo Único , Fatores de Risco
10.
Nat Commun ; 5: 5326, 2014 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-25351925

RESUMO

Mutations in different genes encoding sarcomeric proteins are responsible for 50-60% of familial cases of hypertrophic cardiomyopathy (HCM); however, the genetic alterations causing the disease in one-third of patients are currently unknown. Here we describe a case with familial HCM of unknown cause. Whole-exome sequencing reveals a variant in the gene encoding the sarcomeric protein filamin C (p.A1539T) that segregates with the disease in this family. Sequencing of 92 HCM cases identifies seven additional variants segregating with the disease in eight families. Patients with FLNC mutations show marked sarcomeric abnormalities in cardiac muscle, and functional analysis reveals that expression of these FLNC variants resulted in the formation of large filamin C aggregates. Clinical studies indicate that FLNC-mutated patients have higher incidence of sudden cardiac death. On the basis of these findings, we conclude that mutations in the gene encoding the sarcomeric protein filamin C cause a new form of familial HMC.


Assuntos
Cardiomiopatia Hipertrófica Familiar/genética , Filaminas/genética , Mutação/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Exoma/genética , Feminino , Filaminas/química , Humanos , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Miocárdio/patologia , Miocárdio/ultraestrutura , Miócitos Cardíacos/metabolismo , Miócitos Cardíacos/patologia , Linhagem , Ratos , Análise de Sequência de DNA , Adulto Jovem
11.
Arch. cardiol. Méx ; 84(2): 100-101, abr.-jun. 2014. ilus
Artigo em Inglês | LILACS | ID: lil-732013

RESUMO

Caseous calcification of the mitral annulus is an infrequent echocardiographic finding. The differential diagnosis includes other entities like tumors, abscess or thrombus. Both cardiac CT and cardiac MRI may be useful for its definitive diagnosis.


La calcificación caseosa del anillo mitral es un hallazgo ecocardiográfico poco frecuente. Debe hacerse el diagnóstico diferencial con otras entidades tales como tumores, abscesos o trombos. Para su diagnóstico definitivo además del ecocardiograma tanto el TC cardiaco como la Cardio RM pueden ser de utilidad.


Assuntos
Idoso , Feminino , Humanos , Calcinose , Endocardite Bacteriana , Doenças das Valvas Cardíacas , Valva Mitral , Ecocardiografia , Endocardite Bacteriana/microbiologia , Streptococcus agalactiae , Infecções Estreptocócicas
12.
Arch Cardiol Mex ; 84(2): 100-1, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24780164

RESUMO

Caseous calcification of the mitral annulus is an infrequent echocardiographic finding. The differential diagnosis includes other entities like tumors, abscess or thrombus. Both cardiac CT and cardiac MRI may be useful for its definitive diagnosis.


Assuntos
Calcinose/diagnóstico por imagem , Endocardite Bacteriana/diagnóstico por imagem , Doenças das Valvas Cardíacas/diagnóstico por imagem , Valva Mitral/diagnóstico por imagem , Idoso , Ecocardiografia , Endocardite Bacteriana/microbiologia , Feminino , Humanos , Infecções Estreptocócicas/diagnóstico por imagem , Streptococcus agalactiae
14.
Arch. cardiol. Méx ; 83(1): 35-39, ene.-mar. 2013. ilus
Artigo em Inglês | LILACS | ID: lil-685351

RESUMO

Left ventricle non-compaction cardiomyopathy is currently considered as a well-defined individual entity. However, it includes a broad spectrum of clinical, radiological and pathophysiological findings. In this review we describe 3 different scenarios of this entity: an isolated case with severe left ventricle dysfunction, an "associated" case in a patient with previous atrial septum defect and pulmonary stenosis and finally, as a finding in a patient with a transient cerebrovascular ischemic attack. In the 2 last cases, both asymptomatic, morphological criteria of left ventricle non-compaction were found but, ventricular function was normal and cardiac-MRI showed no late gadolinium hyperenhancement. Periodical follow-up and familial screening were recommended. Natural history and prognosis factors of this disease are still not well known. Further and longer series of patients with this diagnosis are needed to completely define radiological criteria, clinical presentation and evolution.


La miocardiopatía no compactada está considerada actualmente como una entidad independiente y bien definida. Sin embargo, presenta un espectro amplio de hallazgos clínicos, radiológicos y fisiopatológicos. En la presente revisión describimos 3 escenarios clínicos diferentes de dicha entidad: un caso con disfunción ventricular severa, un caso como entidad «asociada¼ a una cardiopatía congènita en un pacientes con un defecto del septo interauricular previo y estenosis pulmonar, y finalmente, como un hallazgo casual en un paciente con un accidente cerebrovascular transitorio. En estos 2 últimos casos se encontraron criterios morfológicos de miocardiopatía no compactada con función ventricular normal y sin presencia de realce tardío de gadolinio en el estudio de cardio-RM. En todos ellos se recomendó estudio familiar. La historia natural y el pronóstico de esta anatomía patológica no son todavía del todo conocidos. Series mayores y seguimiento más largos son necesarios para definir completamente los criterios radiológicos, la presentación clínica y la evolución de esta fascinante entidad.


Assuntos
Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Técnicas de Imagem Cardíaca , Miocárdio Ventricular não Compactado Isolado/diagnóstico , Imageamento por Ressonância Magnética
15.
Arch Cardiol Mex ; 83(1): 35-9, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23428354

RESUMO

Left ventricle non-compaction cardiomyopathy is currently considered as a well-defined individual entity. However, it includes a broad spectrum of clinical, radiological and pathophysiological findings. In this review we describe 3 different scenarios of this entity: an isolated case with severe left ventricle dysfunction, an "associated" case in a patient with previous atrial septum defect and pulmonary stenosis and finally, as a finding in a patient with a transient cerebrovascular ischemic attack. In the 2 last cases, both asymptomatic, morphological criteria of left ventricle non-compaction were found but, ventricular function was normal and cardiac-MRI showed no late gadolinium hyperenhancement. Periodical follow-up and familial screening were recommended. Natural history and prognosis factors of this disease are still not well known. Further and longer series of patients with this diagnosis are needed to completely define radiological criteria, clinical presentation and evolution.


Assuntos
Técnicas de Imagem Cardíaca , Miocárdio Ventricular não Compactado Isolado/diagnóstico , Imageamento por Ressonância Magnética , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
16.
J Med Econ ; 16(1): 125-33, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-22587385

RESUMO

OBJECTIVE: Tyrosine kinase inhibitors (TKI), the standard of care for patients with chronic myeloid leukemia (CML) patients, may in some cases lead to the development of pleural effusion (PE). The purpose of this study is to compare healthcare resource utilization and costs associated with PE among CML patients treated with a TKI therapy. METHODS: Two large retrospective claims databases (1999-2009) were combined to identify adult CML patients who received ≥1 TKI prescription before the index date, which was defined as 30 days before the first PE diagnosis for patients with PE and a randomly selected date for PE-free patients. Patients were followed for 6 months after the index date. PE and PE-free patients were matched on a 1:1 ratio. PE-related resource utilization and costs (measured in 2009 US dollars) were estimated for PE patients. All-cause and CML-related resource utilization and costs were compared between PE and PE-free patients. Multivariate regression models were used to control for confounding factors. RESULTS: The study included 186 matched pairs. PE-free and PE patients were on average 65.4 and 63.6 years old and 39.8% and 48.9% were female, respectively. PE patients had a significantly higher number of inpatient (IP) days, IP admissions, outpatient (OP) visits and emergency room (ER) visits than PE-free patients (all p < 0.01). All-cause medical services costs were $88,526 and $30,434 for PE and PE-free patients, respectively. After adjusting for confounding factors, the PE-related total medical costs were $47,288 (p < 0.01), which was mostly accounted for by higher IP (difference: $34,123, p < 0.01) and OP (difference: $9563, p < 0.05) costs. PE patients also incurred higher CML-related medical costs compared to PE-free patients (difference: $39,599; p < 0.01). CONCLUSION: PE presents a substantial economic burden for CML patients treated with TKI.


Assuntos
Serviços de Saúde/estatística & dados numéricos , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Derrame Pleural/induzido quimicamente , Derrame Pleural/economia , Proteínas Tirosina Quinases/antagonistas & inibidores , Fatores Etários , Idoso , Custos e Análise de Custo , Feminino , Gastos em Saúde/estatística & dados numéricos , Serviços de Saúde/economia , Humanos , Revisão da Utilização de Seguros/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais
17.
Rev. chil. neuropsicol. (En línea) ; 7(3): 108-114, dic. 2012. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-722451

RESUMO

El objetivo del presente escrito es proponer un modelo teórico desde la neurociencia afectiva para abordar el problema del origen y función de experiencia consciente, para ello se parte de una pequeña discusión acerca del problema epistemológico, ontológico y metodológico que implica construir una explicación de la subjetividad, entendida esta como el atributo central y básico de la consciencia. Se continúa con la presentación de algunos de los fundamentos de la neurociencia afectiva, en especial se explora la propuesta de Jaak Panksepp, desde este punto de vista, la neurociencia afectiva resulta ser un marco conceptual relevante y actualizado para el abordaje de la naturaleza de la experiencia consciente. En este modelo se resalta el papel primordial, básico y biológico de los procesos afectivos, los cuales permiten una autoorganización de los parámetros neurodinámicos, a partir de la cual van emergiendo nuevos patrones de actividad orgánica que dan lugar a los diferentes tipos de subjetividades, estas experiencias subjetiva le permiten al organismo sentir los valores biológicos de su actuar en relación con las exigencias medioambientales. En el último apartado, se presentan algunas consideraciones, se discute sobre el uso desafortunado del concepto de inconsciente, el aporte a problemas de la bioética, y las implicaciones que esta aproximación podría tener para la sociedad en general y para la psicología en particular.


The paper aims is to propose a theoretical model from affective neuroscience to treat the problem of roots and functions of the conscious experience, the paper begins with a short discussion about the epistemological, ontological and methodological problem that implies to build a subjectivity explanation, understood this as the core and basic characteristic of the consciousness. It is continued with the presentation of some affective neuroscience principles, in especial is explored the Jaak Panksepp approach, from this point of view, the affective neuroscience result to be a relevant and updated conceptual framework to treat with the nature of conscious experience. The paper remarks the primordial, basic and biologic role of the affective process, which lets the autoorganization of the neurodynamics parameters, from which goes emerging new patrons of organic activity that result in the different subjectivities feelings, this subjective experiences lets to organism fell the biological values of its action in relation with the environmental challenges. In the last part, are presented some considerations, is discussed about the fortuneless use of unconsciousness concept, the contribution to bioethical problems, and the implications of this approximation on the society in general and the psychology in particular.


Assuntos
Humanos , Afeto/fisiologia , Consciência , Psicofisiologia , Emoções , Modelos Neurológicos , Neurociências
18.
Rev. gastroenterol. Perú ; 32(4): 418-422, oct.-dic. 2012. ilus, tab
Artigo em Espanhol | LILACS, LIPECS | ID: lil-692412

RESUMO

El Linfoma no Hodgkin (LNH) extraganglionar es una neoplasia maligna que corresponde al 40% de los casos de LNH, siendo el tracto gastrointestintal (TGI) la localización más común. Dentro del TGI es el estómago el órgano más afectado (60%). Presentamos el caso de un hombre de 52 años trabajador en empresa minera por más de 10 años, el cual es derivado al Servicio de Gastroenterología por presentar un cuadro de epigastralgia, náuseas y baja de peso. La endoscopía digestiva mostró una lesión ulcerada en cuerpo gástrico a la cual se le tomaron múltiples biopsias. El estudio histológico y el posterior análisis inmunohistoquímico permitieron realizar el diagnóstico de LNH B difuso de células grandes. Asimismo, el paciente presentó compromiso de múltiples órganos en relación a exposición crónica de metales pesados, lo cual fue comprobado en el mineralograma, siendo las de mayor concentración el uranio, talio, arsénico, plomo y mercurio. En la literatura se ha descrito la asociación de exposición laboral crónica a Uranio y Arsénico con la presentación de LNH de compromiso gastrointestinal. Por tal motivo, el compromiso gástrico no se puede considerar como un daño aislado, sino más bien parte del compromiso sistémico asociado a concentraciones elevadas de metales. La minería constituye el principal motor de ingresos económicos para el Perú, sin embargo, no existen reportes hasta la fecha de la asociación de LNH de compromiso gastrointestinal en relación a exposición laboral a metales pesados.


Primary extranodal Non-Hodgkin lymphoma (NHL) is a non epithelial tumours that accounts for 40% of cases of NHL. Spread of nodal lymphomas to the gastrointestinal tract (GIT) is the most common location. Within the GIT is the stomach the most affected organ (60%). We report the case of 52-year- old man, mining company worker for over 10 years, which is derived to the Service of Gastroenterology with history of epigastric pain, nausea, vomiting and weight loss. Upper gastrointestinal endoscopic examination revealed an ulcerated lesion on greater curve of stomach and histopathological examination and subsequent immunohistochemical analysis showed diffuse large B cell gastric NHL. Also, the patient had multiple organ involvement in relation to chronic exposure to heavy metals, which was found in the mineralograma, with the highest concentration of uranium, thallium, arsenic, lead and mercury. The literature has described the association of chronic occupational exposure to uranium and arsenic with NHL presenting gastrointestinal involvement. Therefore, gastric commitment can not be considered as an isolated injury, but rather part of systemic involvement associated with elevated concentrations of metals. Mining is a key driver of income for Peru; however, there are no reports to date of the association of gastrointestinal NHL commitment regarding occupational exposure to heavy metals.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Carcinógenos Ambientais/efeitos adversos , Linfoma Difuso de Grandes Células B/diagnóstico , Metais Pesados/efeitos adversos , Doenças Profissionais/diagnóstico , Exposição Ocupacional/efeitos adversos , Neoplasias Gástricas/diagnóstico , Linfoma Difuso de Grandes Células B/induzido quimicamente , Mineração , Doenças Profissionais/induzido quimicamente , Neoplasias Gástricas/induzido quimicamente
20.
Curr Med Res Opin ; 28(7): 1155-62, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22738777

RESUMO

OBJECTIVES: To compare adherence to second-generation tyrosine kinase inhibitors (TKIs) dasatinib and nilotinib in patients with imatinib resistant or intolerant chronic myeloid leukemia (CML) receiving second-line therapies. METHODS: Two U.S. administrative claims databases were reviewed (January 1997 to March 2011) for CML patients previously treated with imatinib, who received ≥1 prescription of dasatinib or nilotinib and had continuous enrollment ≥1 month before and after the index date (first dasatinib or nilotinib prescription date). Medication possession ratios (MPRs) and proportion of days covered (PDCs) were evaluated between the treatment initiation date until the end of continuous eligibility, for a maximum of 12 months. Sensitivity analyses were conducted to compare patients initiated on nilotinib to patients who initiated dasatinib 100 mg/day and 140 mg/day separately. This study provides updated results of a previously published study. RESULTS: In total, 878 CML patients who received second-line treatment with either dasatinib (n = 550) or nilotinib (n = 328) were studied. Dasatinib users were less adherent compared to nilotinib users; mean MPR was 0.739 (standard deviation [SD] 0.246) for dasatinib and 0.800 (SD 0.246) for nilotinib (adjusted difference = 0.061; P = 0.002). Subgroup analyses of patients who initiated dasatinib 100 mg/day and 140 mg/day separately presented similar trends; after multivariate adjustment, adherence was 0.039 points lower in the 100 mg/day group (P = 0.034) and 0.120 points lower in the 140 mg/day group (P < 0.001). CONCLUSIONS: Among patients treated in the second-line CML setting, those treated with nilotinib had significantly higher adherence compared to patients treated with dasatinib, regardless of dasatinib dose (100 mg/day and 140 mg/day). LIMITATIONS: The study was subject to common limitations of claims data, which lack clinical information, may contain inaccuracies in diagnosis and procedure coding, and may not truly reflect actual drug consumption. Moreover, daily doses calculated based on refill records may not reflect accurate dosing regimens.


Assuntos
Antineoplásicos/uso terapêutico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Cooperação do Paciente/estatística & dados numéricos , Piperazinas/uso terapêutico , Pirimidinas/uso terapêutico , Tiazóis/uso terapêutico , Benzamidas , Dasatinibe , Resistencia a Medicamentos Antineoplásicos , Feminino , Humanos , Mesilato de Imatinib , Masculino , Pessoa de Meia-Idade , Piperazinas/efeitos adversos , Proteínas Tirosina Quinases/antagonistas & inibidores , Pirimidinas/efeitos adversos , Estudos Retrospectivos
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