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1.
Sci Rep ; 11(1): 7098, 2021 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-33782506

RESUMO

Hexokinases (HXKs) and fructokinases (FRKs) are the only two families of enzymes in plants that have been identified as able to phosphorylate Glucose (Glc) and Fructose (Fru). Glc can only be phosphorylated in plants by HXKs, while Fru can be phosphorylated by either HXKs or FRKs. The various subcellular localizations of HXKs in plants indicate that they are involved in diverse functions, including anther dehiscence and pollen germination, stomatal closure in response to sugar levels, stomatal aperture and reducing transpiration. Its association with modulating programmed cell death, and responses to oxidative stress and pathogen infection (abiotic and biotic stresses) also have been reported. To extend our understanding about the function of HXK-like genes in the response of Prunus rootstocks to abiotic stress, we performed a detailed bioinformatic and functional analysis of hexokinase 3-like genes (HXK3s) from two Prunus rootstock genotypes, 'M.2624' (Prunus cerasifera Ehrh × P. munsoniana W.Wight & Hedrick) and 'M.F12/1' (P. avium L.), which are tolerant and sensitive to hypoxia stress, respectively. A previous large-scale transcriptome sequencing of roots of these rootstocks, showed that this HXK3-like gene that was highly induced in the tolerant genotype under hypoxia conditions. In silico analysis of gene promoters from M.2624 and M.F12/1 genotypes revealed regulatory elements that could explain differential transcriptional profiles of HXK3 genes. Subcellular localization was determinates by both bioinformatic prediction and expression of their protein fused to the green fluorescent protein (GFP) in protoplasts and transgenic plants of Arabidopsis. Both approaches showed that they are expressed in plastids. Metabolomics analysis of Arabidopsis plants ectopically expressing Prunus HXK3 genes revealed that content of several metabolites including phosphorylated sugars (G6P), starch and some metabolites associated with the TCA cycle were affected. These transgenic Arabidopsis plants showed improved tolerance to salt and drought stress under growth chamber conditions. Our results suggest that Prunus HXK3 is a potential candidate for enhancing tolerance to salt and drought stresses in stone fruit trees and other plants.

3.
Artigo em Inglês | MEDLINE | ID: mdl-33287409

RESUMO

Neuromuscular electrostimulation (NMES) has been used mainly as a method to promote muscle strength, but its effects on improving blood flow are less well known. The aim of this study is to deepen the knowledge about the local and contralateral effects of the application of symmetric biphasic square currents on skin temperature (Tsk). An experimental pilot study was developed with a single study group consisting of 45 healthy subjects. Thermographic evaluations were recorded following the application of NMES to the anterior region of the thigh. The results showed an increase in the maximal Tsk of 0.67% in the anterior region of the thigh where the NMES was applied (p < 0.001) and an increase of 0.54% (p < 0.01) due to cross-education effects, which was higher when the NMES was applied on the dominant side (0.79%; p < 0.01). The duration of the effect was 20 min in the dominant leg and 10 min in the nondominant one. The application of a symmetrical biphasic current (8 Hz and 400 µs) creates an increase in the maximal Tsk at the local level. A temperature cross-education effect is produced, which is greater when the NMES is applied on the dominant side. This could be a useful noninvasive measurement tool in NMES treatments.

4.
PLoS One ; 15(12): e0243816, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33332408

RESUMO

The active cervical range of motion (aROM) is assessed by clinicians to inform their decision-making. Even with the ability of neck motion to discriminate injured from non-injured subjects, the mechanisms to explain recovery or persistence of WAD remain unclear. There are few studies of ROM examinations with precision tools using kinematics as predictive factors of recovery rate. The present paper will evaluate the performance of an artificial neural network (ANN) using kinematic variables to predict the overall change of aROM after a period of rehabilitation in WAD patients. To achieve this goal the neck kinematics of a cohort of 1082 WAD patients (55.1% females), with mean age 37.68 (SD 12.88) years old, from across Spain were used. Prediction variables were the kinematics recorded by the EBI® 5 in routine biomechanical assessments of these patients. These include normalized ROM, speed to peak and ROM coefficient of variation. The improvement of aROM was represented by the Neck Functional Holistic Analysis Score (NFHAS). A supervised multi-layer feed-forward ANN was created to predict the change in NFHAS. The selected architecture of the ANN showed a mean squared error of 308.07-272.75 confidence interval for a 95% in the Monte Carlo cross validation. The performance of the ANN was tested with a subsample of patients not used in the training. This comparison resulted in a medium correlation with R = 0.5. The trained neural network to predict the expected difference in NFHAS between baseline and follow up showed modest results. While the overall performance is moderately correlated, the error of this prediction is still too large to use the method in clinical practice. The addition of other clinically relevant factors could further improve prediction performance.


Assuntos
Inteligência Artificial , Traumatismos em Chicotada/reabilitação , Adulto , Feminino , Humanos , Masculino , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Resultado do Tratamento , Traumatismos em Chicotada/fisiopatologia
5.
PLoS One ; 15(9): e0237515, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32898138

RESUMO

BACKGROUND: Regional variations in gastric cancer incidence are not explained by prevalence of Helicobacter pylori, the main cause of the disease, with several areas presenting high H. pylori prevalence but low gastric cancer incidence. The IARC worldwide H. pylori prevalence surveys (ENIGMA) aim at systematically describing age and sex-specific prevalence of H. pylori infection around the world and generating hypotheses to explain regional variations in gastric cancer risk. METHODS: We selected age- and sex-stratified population samples in two areas with different gastric cancer incidence and mortality in Chile: Antofagasta (lower rate) and Valdivia (higher rate). Participants were 1-69 years old and provided interviews and blood for anti-H. pylori antibodies (IgG, VacA, CagA, others) and atrophy biomarkers (pepsinogens). RESULTS: H. pylori seroprevalence (Age-standardized to world population) and antibodies against CagA and VacA were similar in both sites. H. pylori seroprevalence was 20% among children <10 years old, 40% among 10-19 year olds, 60% in the 20-29 year olds and close to or above 80% in those 30+ years. The comparison of the prevalence of known and potential H. pylori cofactors in gastric carcinogenesis between the high and the low risk area showed that consumption of chili products was significantly higher in Valdivia and daily non-green vegetable consumption was more common in Antofagasta. Pepsinogen levels suggestive of gastric atrophy were significantly more common and occurred at earlier ages in Valdivia, the higher risk area. In a multivariate model combining both study sites, age, chili consumption and CagA were the main risk factors for gastric atrophy. CONCLUSIONS: The prevalence of H. pylori infection and its virulence factors was similar in the high and the low risk area, but atrophy was more common and occurred at younger ages in the higher risk area. Dietary factors could partly explain higher rates of atrophy and gastric cancer in Valdivia. IMPACT: The ENIGMA study in Chile contributes to better understanding regional variations in gastric cancer incidence and provides essential information for public health interventions.


Assuntos
Infecções por Helicobacter/complicações , Helicobacter pylori/isolamento & purificação , Neoplasias Gástricas/etiologia , Estômago/patologia , Adolescente , Adulto , Idoso , Atrofia/etiologia , Atrofia/microbiologia , Atrofia/patologia , Criança , Pré-Escolar , Chile/epidemiologia , Feminino , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/patologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Estômago/microbiologia , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/patologia , Adulto Jovem
6.
Cureus ; 12(7): e9350, 2020 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-32850222

RESUMO

Unclassified mixed germ cell-sex cord-stromal tumor (UMGC-SCST) is a rare ovarian neoplasm composed of germ cells and sex cord elements, which occurs in genetically and phenotypically normal women without the usual histological features seen in gonadoblastoma. Few cases have been reported in the literature so far. The age of presentation is more frequent in girls younger than 10 years of age, although it can also occur in adult women. It can be associated with isosexual pseudoprecocity. The preferred management is the resection of the gonad that contains the tumor and the conservation of the opposite ovary and tube. This is a case of a 14-year-old patient, with precocious puberty and normal phenotype, diagnosed with this kind of ovarian tumor. A fertility preserving surgery with the resection of the right ovarian tumor and tube was performed. The patient was classified as stage IA according to the 2014 International Federation of Gynecology and Obstetrics (FIGO). She received adjuvant chemotherapy with bleomycin-etoposide-cisplatin for three cycles. After a follow-up of 24 months, she was found to be asymptomatic and free of relapse.

7.
Reumatol. clín. (Barc.) ; 16(2,pt.1): 71-86, mar.-abr. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194324

RESUMO

OBJETIVO: La dificultad para el diagnóstico y la variedad de manifestaciones clínicas que pueden determinar la elección del tratamiento del síndrome antifosfolípido (SAF) primario ha impulsado a la Sociedad Española de Reumatología (SER) en la elaboración de recomendaciones basadas en la mejor evidencia posible. Estas recomendaciones pueden servir de referencia para reumatólogos y otros profesionales implicados en el manejo de pacientes con SAF. MÉTODOS: Se creó un panel formado por cuatro reumatólogos, una ginecóloga y una hematóloga, expertos en SAF, previamente seleccionados mediante una convocatoria abierta o por méritos profesionales. Las fases del trabajo fueron: identificación de las áreas claves para la elaboración del documento, análisis y síntesis de la evidencia científica (utilizando los niveles de evidencia del Scottish Intercollegiate Guidelines Network [SIGN]) y formulación de recomendaciones a partir de esta evidencia y de técnicas de «evaluación formal» o «juicio razonado». RESULTADOS: Se han elaborado 46 recomendaciones que abordan cinco áreas principales: diagnóstico y evaluación, medidas de tromboprofilaxis primaria, tratamiento del SAF primario o tromboprofilaxis secundaria, tratamiento del SAF obstétrico y situaciones especiales. Se incluye también el papel de los nuevos anticoagulantes orales, el problema de las recurrencias o los principales factores de riesgo identificados en estos individuos. En este documento se reflejan las 21 primeras recomendaciones, referidas a las áreas de diagnóstico, evaluación y tratamiento del SAF primario. El documento contiene una tabla de recomendaciones y algoritmos de tratamiento. CONCLUSIONES: Se presentan las recomendaciones de la SER sobre SAF primario. Este documento corresponde a la parte I, relacionada con el diagnóstico, la evaluación y el tratamiento. Estas recomendaciones se consideran herramientas en la toma de decisiones para los clínicos, teniendo en consideración tanto la decisión del médico experto en SAF como la opinión compartida con el paciente. Se ha elaborado también una parte II, que aborda aspectos relacionados con el SAF obstétrico y situaciones especiales


OBJECTIVE: The difficulty in diagnosis and the spectrum of clinical manifestations that can determine the choice of treatment for primary antiphospholipid syndrome (APS) has fostered the development of recommendations by the Spanish Society of Rheumatology (SER), based on the best possible evidence. These recommendations can serve as a reference for rheumatologists and other specialists involved in the management of APS. METHODS: A panel of four rheumatologists, a gynaecologist and a haematologist with expertise in APS was created, previously selected by the SER through an open call or based on professional merits. The stages of the work were: identification of the key areas for drafting the document, analysis and synthesis of the scientific evidence (using the Scottish Intercollegiate Guidelines Network [SIGN] levels of evidence) and formulation of recommendations based on this evidence and formal assessment or reasoned judgement techniques (consensus techniques). RESULTS: 46 recommendations were drawn up, addressing five main areas: diagnosis and evaluation, measurement of primary thromboprophylaxis, treatment for APS or secondary thromboprophylaxis, treatment for obstetric APS and special situations. These recommendations also include the role of novel oral anticoagulants, the problem of recurrences or the key risk factors identified in these subjects. This document reflects the first 21, referring to the areas of: diagnosis, evaluation and treatment of primary APS. The document provides a table of recommendations and treatment algorithms. CONCLUSIONS: An update of the SER recommendations on APS is presented. This document corresponds to part I, related to diagnosis, evaluation and treatment. These recommendations are considered tools for decision-making for clinicians, taking into consideration both the decision of the physician experienced in APS and the patient. A part II has also been prepared, which addresses aspects related to obstetric SAF and special situations


Assuntos
Humanos , Síndrome Antifosfolipídica/diagnóstico , Síndrome Antifosfolipídica/terapia , Sociedades Médicas/normas , Reumatologia/normas , Síndrome Antifosfolipídica/epidemiologia , Síndrome Antifosfolipídica/classificação , Medicina Baseada em Evidências/normas , Consenso
8.
Reumatol. clín. (Barc.) ; 16(2,pt.2): 133-148, mar.-abr. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194337

RESUMO

OBJETIVO: La dificultad para el diagnóstico y la variedad de manifestaciones clínicas que pueden determinar la elección del tratamiento del síndrome antifosfolípido (SAF) primario ha impulsado a la Sociedad Española de Reumatología (SER) en la elaboración de recomendaciones basadas en la mejor evidencia posible. Estas recomendaciones pueden servir de referencia para reumatólogos y otros profesionales implicados en el manejo de pacientes con SAF. MÉTODOS: Se creó un panel formado por 4 reumatólogos, una ginecóloga y una hematóloga, expertos en SAF, previamente seleccionados mediante una convocatoria abierta o por méritos profesionales. Las fases del trabajo fueron: identificación de las áreas claves para la elaboración del documento, análisis y síntesis de la evidencia científica (utilizando los niveles de evidencia de SIGN, Scottish Intercollegiate Guidelines Network) y formulación de recomendaciones a partir de esta evidencia y de técnicas de «evaluación formal» o «juicio razonado». RESULTADOS: Se han elaborado 46 recomendaciones que abordan 5áreas principales: diagnóstico y evaluación, medidas de tromboprofilaxis primaria, tratamiento del SAF o tromboprofilaxis secundaria, tratamiento del síndrome antifosfolípido obstétrico y situaciones especiales. Está incluido también el papel de los nuevos anticoagulantes orales, el problema de las recurrencias o los principales factores de riesgo identificados en estos individuos. En este documento se reflejan las últimas 25, referidas a las áreas de: SAF obstétrico y situaciones especiales. El documento contiene una tabla de recomendaciones y algoritmos de tratamiento. CONCLUSIONES: Se presentan las recomendaciones de la SER sobre SAF. Este documento corresponde a la parte 2.ª relacionada con el SAF obstétrico y las situaciones especiales. Estas recomendaciones se consideran herramientas en la toma de decisiones para los clínicos, teniendo en consideración tanto la decisión del médico experto en SAF como la opinión compartida con el paciente. Se ha elaborado también una parte I que aborda aspectos relacionados con el diagnóstico, evaluación y tratamiento


OBJECTIVE: The difficulty in diagnosis and the spectrum of clinical manifestations that can determine the choice of treatment for antiphospholipid syndrome (APS) has fostered the development of recommendations by the Spanish Society of Rheumatology (SER), based on the best possible evidence. These recommendations can serve as a reference for rheumatologists and other specialists involved in the management of APS. METHODS: A panel of 4rheumatologists, a gynaecologist and a haematologist with expertise in APS was created, previously selected by the SER through an open call or based on professional merits. The stages of the work were: identification of the key areas for the document elaboration, analysis and synthesis of the scientific evidence (using the Scottish Intercollegiate Guidelines Network, SIGN levels of evidence) and formulation of recommendations based on this evidence and formal assessment or reasoned judgement techniques (consensus techniques). RESULTS: Forty-six recommendations were drawn up, addressing 5 main areas: diagnosis and evaluation, measurement of primary thromboprophylaxis, treatment for APS or secondary thromboprophylaxis, treatment for obstetric APS and special situations. These recommendations also include the role of novel oral anticoagulants, the problem of recurrences or the key risk factors identified in these subjects. This document reflects the last 25, referring to the areas of: obstetric APS and special situations. The document provides a table of recommendations and treatment algorithms. CONCLUSIONS: Update of SER recommendations on APS is presented. This document corresponds to part II, related to obstetric SAF and special situations. These recommendations are considered tools for decision-making for clinicians, taking into consideration both the decision of the physician experienced in APS and the patient. A part I has also been prepared, which addresses aspects related to diagnosis, evaluation and treatment


Assuntos
Humanos , Feminino , Síndrome Antifosfolipídica/epidemiologia , Sociedades Médicas/normas , Medicina Baseada em Evidências/normas , Complicações na Gravidez/epidemiologia , Anticoagulantes/normas , Tomada de Decisões , Unidade Hospitalar de Ginecologia e Obstetrícia/normas , Período Pós-Parto
9.
Reumatol Clin ; 16(2 Pt 2): 133-148, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30686569

RESUMO

OBJECTIVE: The difficulty in diagnosis and the spectrum of clinical manifestations that can determine the choice of treatment for antiphospholipid syndrome (APS) has fostered the development of recommendations by the Spanish Society of Rheumatology (SER), based on the best possible evidence. These recommendations can serve as a reference for rheumatologists and other specialists involved in the management of APS. METHODS: A panel of 4rheumatologists, a gynaecologist and a haematologist with expertise in APS was created, previously selected by the SER through an open call or based on professional merits. The stages of the work were: identification of the key areas for the document elaboration, analysis and synthesis of the scientific evidence (using the Scottish Intercollegiate Guidelines Network, SIGN levels of evidence) and formulation of recommendations based on this evidence and formal assessment or reasoned judgement techniques (consensus techniques). RESULTS: Forty-six recommendations were drawn up, addressing 5main areas: diagnosis and evaluation, measurement of primary thromboprophylaxis, treatment for APS or secondary thromboprophylaxis, treatment for obstetric APS and special situations. These recommendations also include the role of novel oral anticoagulants, the problem of recurrences or the key risk factors identified in these subjects. This document reflects the last 25, referring to the areas of: obstetric APS and special situations. The document provides a table of recommendations and treatment algorithms. CONCLUSIONS: Update of SER recommendations on APS is presented. This document corresponds to part II, related to obstetric SAF and special situations. These recommendations are considered tools for decision-making for clinicians, taking into consideration both the decision of the physician experienced in APS and the patient. A part I has also been prepared, which addresses aspects related to diagnosis, evaluation and treatment.

10.
Reumatol Clin ; 16(2 Pt 1): 71-86, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30713012

RESUMO

OBJECTIVE: The difficulty in diagnosis and the spectrum of clinical manifestations that can determine the choice of treatment for primary antiphospholipid syndrome (APS) has fostered the development of recommendations by the Spanish Society of Rheumatology (SER), based on the best possible evidence. These recommendations can serve as a reference for rheumatologists and other specialists involved in the management of APS. METHODS: A panel of four rheumatologists, a gynaecologist and a haematologist with expertise in APS was created, previously selected by the SER through an open call or based on professional merits. The stages of the work were: identification of the key areas for drafting the document, analysis and synthesis of the scientific evidence (using the Scottish Intercollegiate Guidelines Network [SIGN] levels of evidence) and formulation of recommendations based on this evidence and formal assessment or reasoned judgement techniques (consensus techniques). RESULTS: 46 recommendations were drawn up, addressing five main areas: diagnosis and evaluation, measurement of primary thromboprophylaxis, treatment for APS or secondary thromboprophylaxis, treatment for obstetric APS and special situations. These recommendations also include the role of novel oral anticoagulants, the problem of recurrences or the key risk factors identified in these subjects. This document reflects the first 21, referring to the areas of: diagnosis, evaluation and treatment of primary APS. The document provides a table of recommendations and treatment algorithms. CONCLUSIONS: An update of the SER recommendations on APS is presented. This document corresponds to partI, related to diagnosis, evaluation and treatment. These recommendations are considered tools for decision-making for clinicians, taking into consideration both the decision of the physician experienced in APS and the patient. A partII has also been prepared, which addresses aspects related to obstetric SAF and special situations.

11.
Prog. obstet. ginecol. (Ed. impr.) ; 62(6): 567-569, nov.-dic. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-192144

RESUMO

El parto vaginal después de una cesárea segmentaria transversa anterior es considerado una alternativa segura y efectiva a la cesárea electiva si las condiciones obstétricas lo permiten. Una de las complicaciones más graves es la rotura uterina, la cual se asocia de forma inusual a rotura de vejiga urinaria. Se reporta un caso clínico de un parto vaginal acompañado de rotura uterina y de vejiga urinaria en tercigesta con cesárea anterior. En conclusión, en gestantes con cesárea anterior, con o sin sintomatología intraparto, se ha de considerar la asociación de rotura de la vejiga urinaria y uterina debida a la existencia de mayor riesgo de adherencias entre la pared anterior uterina y la vejiga urinaria. Ante hematuria posparto, siempre descartar rotura vesical. Se considera de alta importancia el consejo prenatal para recordar los riesgos implicados en gestantes que optan por un parto vaginal con cesárea anterior


Vaginal birth after a caesarean section is considered a safe and effective alternative to elective caesarean if obstetric conditions allow it. One of the most serious complications is uterine rupture, which is infrequently associated with bladder rupture. A clinical case of a vaginal birth associated to uterine and bladder rupture is reported in a multiparous with a previous caesarean section. In conclusion, in pregnant women with a previous caesarean section, with or without intrapartum symptoms, it has to be considered the association with bladder rupture and uterine rupture due to the mayor risk of adherences between the anterior uterine wall and the bladder. Against hematuria postpartum, always discard bladder rupture. It is considered of high importance the prenatal advice to remember the implicated risks in pregnant women who choose a vaginal birth with a previous caesarean


Assuntos
Humanos , Feminino , Adulto , Complicações do Trabalho de Parto , Nascimento Vaginal Após Cesárea/efeitos adversos , Fístula Vesicovaginal/etiologia , Fístula Vesicovaginal/terapia , Cateteres Urinários
12.
BMC Psychiatry ; 19(1): 301, 2019 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619196

RESUMO

BACKGROUND: Depressive symptoms are quite prevalent in Primary Care (PC) settings. The treatment as usual (TAU) in PC is pharmacotherapy, despite the high relapse rates it produces. Many patients would prefer psychotherapy, but specialized services are overloaded. Studies that apply Mindfulness-Based Interventions (MBIs) for the treatment of depression have obtained significant improvements. Brief low-intensity approaches delivered from PC could be a promising approach. This study aims to compare a low-intensity mindfulness intervention for the treatment of depression in PC using different intervention formats - a face-to-face MBI delivered in a group and the same MBI individually applied on the Internet - to a control group that will receive PC medical treatment as usual. METHODS: A randomized controlled clinical trial will be conducted in PC, with about 120 depressed patients allocated (1:1:1) to three groups: "face-to-face MBI + TAU", "Internet-delivered MBI + TAU", and "TAU alone". The MBI programs will be composed of four modules. The primary outcome will be depressive symptoms, measured through the Beck Depression Inventory, assessed at pre- and post-treatment and 6- and 12-month follow-ups. Other outcomes will be mindfulness, happiness, affectivity, quality of life, and the use of healthcare services. Intention-to-treat analysis using linear mixed models adjusted for baseline scores and routine sociodemographic analysis that could show baseline differences will be conducted. Per-protocol secondary outcome analyses will also be performed. DISCUSSION: This is the first Spanish RCT to apply a low-intensity face-to-face MBI (plus TAU) to treat depression in PC settings compared to TAU (alone). Moreover, this study will also make it possible to evaluate the same MBI program (plus TAU), but Internet-delivered, considering their cost-effectiveness. Positive results from this RCT might have an important impact on mental health settings, helping to decrease the overload of the system and offering treatment alternatives beyond antidepressant medication through high-quality, flexible PC interventions. TRIAL REGISTRATION: Clinical Trials.gov NCT03034343 . Trial Registration date 24 January 2017, retrospectively registered.


Assuntos
Depressão/terapia , Transtorno Depressivo/terapia , Atenção Plena/métodos , Atenção Primária à Saúde/métodos , Psicoterapia Breve/métodos , Adulto , Análise Custo-Benefício , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
13.
Micron ; 125: 102731, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31415982

RESUMO

The morphology and elemental composition of crystals in embryos, seedlings and adult plants of the globose cacti Mammillaria uncinata were studied. Samples of mature fruits and adult plants were collected. To obtain embryos and seedlings, seeds from mature fruits were germinated under laboratory conditions. Both embryos and seedlings as well as stem and root of the adult plants were processed by conventional microtechniques and tissue macerations to isolate the individual crystals. The crystal morphology was evaluated by light and scanning electron microscopy while its chemical composition was analyzed by energy dispersive spectroscopy, IR and Raman spectroscopy. The results demonstrated the occurrence of calcium oxalate crystals in the three stages of plant growth. Solitary and small crystals are present in embryos and seedlings in contrast crystals are aggregates or conglomerates in the adult plants. The compositional analysis showed that seedling crystals contain carbon (50.37%), oxygen (45.29%) and calcium (3.36%) while in adult plants the percentage has changed to carbon (12.54%), oxygen (53.06%) and calcium (34.38%). In the IR spectrum, the vibration bands around 1321 and 1621 cm-1 are attributed to the calcium oxalate in the dihydrate state (weddellite), the Raman peak at 1475 cm-1 shows also that crystals correspond to the pure state of calcium oxalate dihydrate state. The crystal size was also different for seedlings and adult plants, mean values varied from 12.11 to 13.38 µm for width and length, respectively in seedlings and from 65.10 to 73.90 µm, in adult plants. It is concluded that the elemental composition, size and morphology of crystals in M. uncinata depend on the growth stage, as it happens in other plant species.

14.
PLoS One ; 14(5): e0215764, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31071105

RESUMO

BACKGROUND: Patients with HIV infection suffer from accelerated aging. In this context, frailty could be a relevant problem that aggravates the quality of life (QoL) and morbi-mortality of these patients. Our objective was to determine the prevalence of frailty and pre-frailty in HIV-infected patients in our cohort as well as their risk factors and QoL. METHODS: This was a prospective cross-sectional study of HIV-infected people aged ≥18 years on a stable antiretroviral regimen (ART) ≥1 year. Frailty was defined by ≥3 of 5 Fried's criteria: weight loss, low physical activity, exhaustion, weak grip strength and slow walking time. Variables related to sociodemographics, HIV infection, comorbidities, polypharmacy, and QoL were evaluated. Independent predictors of frailty were evaluated using collinearity in a multivariate logistic regression analyses (backward stepwise elimination). RESULTS: The 248 people studied has a mean age of 49 years, 63.7% were male, and 81% were Caucasian. The prevalence of pre-frailty and fragility was 39.1% and 4.4%, respectively. The main route of HIV acquisition was heterosexual (47.2%). At the inclusion time 26.6% of the patients had AIDS events, 60.9% were anti-HCV negative, and 91.5% had HIV RNA <50 copies/mL (84.3% for ≥1 year); 10.9% had >2 comorbidities, and 13.3% were receiving >5 non-HIV drugs. Frailty patients had a higher age (p 0.006), more sensitive deficits (visual or auditory) (p 0.002), a greater number of falls during the previous year (p 0.0001), a higher Charlson comorbidity index (p 0.001), and a higher VACS index (p 0.001). All comorbidities, excluding bone and liver, were significantly more frequent in fragile patients. The presence of >2 comorbidities and treatment with >5 drugs not related to HIV they were also more frequent in frail patienst (p 0.0001 and p 0.004, respectively). Independent predictors of pre-frailty/frailty in the multivariable analysis differ in men (VACS index, C-reactive protein [CRP], and falls) and women (CRP, AIDS, and menopause). Patients with pre-frailty/frailty had some indicator of a lower QoL. CONCLUSION: Factors associated with pre-frailty/frailty in HIV-infected patients differ by gender, which should be considered when establishing measures for prevention. The role of menopause in the risk of pre-frailty/frailty warrants further investigations.


Assuntos
Fármacos Anti-HIV/farmacologia , Fragilidade/complicações , Fragilidade/fisiopatologia , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Caracteres Sexuais , Carga Viral/efeitos dos fármacos , Fármacos Anti-HIV/uso terapêutico , Estudos Transversais , Feminino , Infecções por HIV/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Prevalência , Qualidade de Vida , Fatores de Risco , Resultado do Tratamento
15.
Cureus ; 11(2): e4148, 2019 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-31058031

RESUMO

Metastases of squamous cell carcinoma of the cervix to atypical locations may occur in approximately 12% of patients diagnosed with distant metastases, with the kidney and paraspinal muscle as one of the rarest sites of spread. A 34-year-old woman with a diagnosis of squamous cell carcinoma of the cervix stage IIIB, treated with chemotherapy and radiation, presented 21 months after completion of therapy, with two sites of simultaneous metastases (kidney and paraspinal muscle). No other evidence of disease was noted. She underwent right nephrectomy and radiotherapy to the para-spinal mass. She did not accept chemotherapy. The patient then had progression of disease in the right nephrectomy bed and a new left renal lesion. The paraspinal lesion presents a partial response. The patient declined further chemotherapy and died five months after the relapse. Simultaneous metastases of squamous cell carcinoma of the cervix to the kidney and paraspinal region is a rare entity, and there is currently no standard recommendation for treatment.

16.
Front Cell Neurosci ; 13: 107, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30941020

RESUMO

Antiphospholipid syndrome (APS) is characterized by arterial and venous thrombosis, pregnancy morbidity and fetal loss caused by pathogenic autoantibodies directed against phospholipids (PL) and PL-cofactors. Isolated neurological APS may represent a significant diagnostic challenge, as epidemiological, clinical and neuroimaging features may overlap with those of multiple sclerosis (MS). In an open view, MS could be considered as an organ-specific anti-lipid (phospholipid and glycosphingolipid associated proteins) disease, in which autoreactive B cells and CD8+ T cells play a dominant role in its pathophysiology. In MS, diverse autoantibodies against the lipid-protein cofactors of the myelin sheath have been described, whose pathophysiologic role has not been fully elucidated. We carried out a review to select clinical studies addressing the prevalence of antiphospholipid (aPL) autoantibodies in the so-called MS-like syndrome. The reported prevalence ranged between 2% and 88%, particularly aCL and aß2GPI, with predominant IgM isotype and suggesting worse MS prognosis. Secondarily, an updated summary of current knowledge on the pathophysiological mechanisms and events responsible for these conditions is presented. We draw attention to the clinical relevance of diagnosing isolated neurological APS. Prompt and accurate diagnosis and antiaggregant and anticoagulant treatment of APS could be vital to prevent or at least reduce APS-related morbidity and mortality.

17.
Gait Posture ; 70: 116-121, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30849606

RESUMO

BACKGROUND: Most human movements are executed while in a state of postural instability. For this reason, instability training is a highly-specific method that is intended to improve balance and postural control. This research aimed to determine the effect of instability training on the balance of individuals with similar baseline abilities, who initiated training within different stability conditions. RESEARCH QUESTION: Does the level of difficulty with which instability training is performed determine improvements in balance? METHOD: A two-arm randomized trial was undertaken, for which 22 and 21 participants were included in the experimental and control groups, respectively. The experimental group performed balance training on unstable surfaces and the control group implemented the same training on stable ground. The primary outcome was the Y-Balance Test (YBT); the Emery test, Functional Reach test, and platform measures were the secondary outcomes. Confidence intervals were set at 95% and Cohen's f statistic was used to estimate effect size. RESULTS: Dynamic balance, as measured by the YBT, showed significant Time improvements in both groups for right (p < 0.001, f = 0.53) and left (p = 0.005, f=0.33) limbs. Similar results were found in the Emery test and Functional Reach test. No statistical Group and Time*Group interactions were found. None of the proposals modified the center of pressure excursions. SIGNIFICANCE: Instability training is a safe and effective approach to enhance balance. However, the findings deduced that the level of difficulty (instability) with which participants with similar abilities initiate the training is not a determining factor in the balance improvements achieved. It follows that instability training may be either used as an alternative or as an additional method to train for balance on a stable ground.


Assuntos
Modalidades de Fisioterapia , Equilíbrio Postural/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos , Método Simples-Cego , Adulto Jovem
18.
PLoS Negl Trop Dis ; 13(3): e0007250, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30856180

RESUMO

Coral snakes of the genus Micrurus have a high diversity and wide distribution in the Americas. Despite envenomings by these animals being uncommon, accidents are often severe and may result in death. Producing an antivenom to treat these envenomings has been challenging since coral snakes are difficult to catch, produce small amounts of venom, and the antivenoms produced have shown limited cross neutralization. Here we present data of cross neutralization among monovalent antivenoms raised against M. dumerilii, M. isozonus, M. mipartitus and M. surinamensis and the development of a new polyvalent coral snake antivenom, resulting from the mix of monovalent antivenoms. Our results, show that this coral snake antivenom has high neutralizing potency and wide taxonomic coverage, constituting a possible alternative for a long sought Pan-American coral snake antivenom.


Assuntos
Antivenenos/farmacologia , Cobras Corais , Reações Cruzadas , Fatores Imunológicos/farmacologia , América , Animais , Antivenenos/isolamento & purificação , Fatores Imunológicos/isolamento & purificação , Testes de Neutralização
19.
Psicol. conoc. Soc ; 8(2): 25-38, nov. 2018.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1091805

RESUMO

Resumen: El artículo presenta y discute la intervención de la psiquiatría en el abordaje de los niños difíciles, entendidos como aquellos que mostraban conductas desviadas: eran inquietos, distraídos, apáticos o indisciplinados. Preocupada por la infancia como futuro de la nación, la psiquiatría intentó detectar estos niños mediante la aplicación de test e implementar medidas correctivas para encauzarlos. Estos acontecimientos se analizan a partir de la noción de medicalización, entendida como la expansión del saber médico a otros campos no médicos así como la definición de problemas como desviaciones. Este proceso se debió a la consolidación de la psiquiatría en el período y por una demanda sociopolítica para atender comportamientos que podrían atentar contra el progreso social.


Resumo: O artigo apresenta e discute a intervenção da psiquiatria na abordagem das crianças difíceis, sendo aqueles que mostravam condutas desviadas tais como desassossego, apatia ou falta de disciplina. Preocupada pela infância como futuro da nação, a psiquiatria tentou caracterizar essas crianças por meio do uso de testes e desenvolver medidas corretivas para canalizá-los. Estes acontecimentos analisam-se a partir da noção de medicalização, entendida como a expansão do saber médico a diversos campos não médicos bem como a definição de problemas como desvios. Este processo ocorreu pela consolidação da psiquiatria nesse período e por uma demanda sociopolítica de atender comportamentos que poderiam atentar contra o progresso social.


Abstract: The article presents and discusses the intervention of psychiatry in the approach of difficult children, understood as those that showed deviant behaviors: they were restless, distracted, apathetic or undisciplined. Concerned about childhood as the future of the nation, psychiatry tried to detect these children through the application of tests and implement corrective measures to channel them. These events will be analyzed from the notion of medicalization, understood as the expansion of medical knowledge to various non-medical fields as well as the definition of problems as deviations. This process was due to the consolidation of psychiatry in the period and a sociopolitical demand to address behaviors that could threaten social progress.

20.
Saúde Soc ; 27(2): 354-366, abr.-jun. 2018.
Artigo em Espanhol | LILACS | ID: biblio-962589

RESUMO

Resumen El artículo analiza las relaciones entre eugenesia y medicalización del crimen en Uruguay hacia fines del siglo XIXy primeras tres décadas del siglo XX. La perspectiva adoptada parte de la consideración de la conversión del crimen y de otros comportamientos socialmente problemáticos en objeto de la medicina psiquiátrica como parte de procesos más amplios de gestión biopolítica de la vida social en contextos urbanos. En ese sentido, se examinan algunas peculiaridades del caso uruguayo en lo que concierne a las relaciones entre eugenesia y medicalización del crimen, destacándose la inexpresiva alusión al factor racial y la importancia superlativa atribuida a los «vicios sociales¼ y, en particular, al consumo de alcohol como elemento disgenésico y criminogénico susceptible de poner en riesgo la composición y calidad de la población.


Abstract The article analyzes the relationship between eugenics and medicalization of crime in Uruguay between the end of the 19th century and the first three decades of the 20th century. The perspective adopted starts from the consideration of the conversion of crime and other socially problematic behaviors in a psychiatric matter, as part of broader processes of biopolitical management of social life in urban contexts. In that sense, some peculiarities of the Uruguayan case are examined concerning the relationship between eugenics and medicalization of crime, standing out the inexpressive allusion to the racial factor and the extreme importance attributed to the "social addictions" and, in particular, to the alcohol consumption as a reproductive and criminogenic element susceptible to put at risk the composition and quality of the population.


Assuntos
Humanos , Masculino , Feminino , Saúde Mental , Psiquiatria Comunitária , Crime , Alcoolismo , Eugenia (Ciência) , Medicalização
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