Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 31
Filtrar
Filtros adicionais











Intervalo de ano
1.
Artigo em Inglês | PAHO-IRIS | ID: phr-49457

RESUMO

[ABSTRACT]. Objectives. To estimate adult (15–49 years old) prevalence and incidence of active syphilis, gonorrhea, and chlamydia, and incidence of congenital syphilis (CS) and adverse birth outcomes (ABOs) in Colombia, over 1995–2016. Methods. The Spectrum-STI epidemiological model tool estimated gonorrhea and chlamydia prevalences as moving averages across prevalences observed in representative general population surveys. For adult syphilis, Spectrum-STI applied segmented polynomial regression through prevalence data from antenatal care (ANC) surveys, routine ANC-based screening, and general population surveys. CS cases and ABOs were estimated from Spectrum’s maternal syphilis estimates and proportions of women screened and treated for syphilis, applying World Health Organization case definitions and risk probabilities. Results. The Spectrum model estimated prevalences in 2016 of 0.70% (95% confidence interval (CI): 0.15%-1.9%) in women and 0.60% (0.1%-1.9%) in men for gonorrhea and of 9.2% (4.4%-15.4%) in women and 7.4% (3.5%-14.7%) in men for chlamydia, without evidence for trends over 1995–2016. The prevalence of active syphilis in 2016 was 1.25% (1.22–1.29%) in women and 1.25% (1.1%-1.4%) in men, decreasing from 2.6% (2.1%-3.2%) in women in 1995. Corresponding CS cases in 2016 (including cases without clinical symptoms) totaled 3 851, of which 2 245 were ABOs. Annual CS and ABO estimates decreased over 2008–2016, reflecting decreasing maternal prevalence and increasing cases averted through ANC-based screening and treatment. Conclusions. The available surveillance and monitoring data synthesized in Spectrum-STI—and the resulting first-ever national STI estimates for Colombia—highlighted Colombia’s persistently high STI burden. Adult syphilis and congenital syphilis are estimated to be falling, reflecting improving screening efforts. Strengthened surveillance, including with periodic screening in low-risk populations and future refined Spectrum estimations, should support planning and implementation of STI prevention and control, including CS elimination.


[RESUMEN]. Objetivos. Estimar la prevalencia e incidencia en los adultos (de 15 a 49 años de edad) de sífilis activa, gonorrea y clamidiasis, así como la incidencia de sífilis congénita y resultados adversos del embarazo en Colombia durante el período de 1995 al 2016. Métodos. Usando las herramientas del modelo epidemiológico Spectrum-STI se estimó la prevalencia de gonorrea y clamidiasis como promedios móviles entre las distintas prevalencias observadas en encuestas representativas de la población general. En cuanto a la sífilis en los adultos, Spectrum-STI aplicó la regresión polinomial segmentada a los datos sobre prevalencia recopilados en encuestas de atención prenatal, el tamizaje sistemático en la atención prenatal y encuestas a la población general. Los casos de sífilis congénita y de resultados adversos del embarazo se estimaron a partir de las cifras de Spectrum sobre sífilis materna y proporciones de mujeres examinadas y tratadas por sífilis, aplicando las definiciones de casos y probabilidades de riesgo de la Organización Mundial de la Salud. Resultados. El modelo Spectrum estimó que en el 2016 la prevalencia de la gonorrea fue de 0,70% (intervalo de confianza de 95% [IC]: 0,15%-1,9%) en las mujeres y de 0,60% (0,1%-1,9%) en los hombres, y que la prevalencia de la clamidiasis fue de 9,2% (4,4%-15,4%) en las mujeres y de 7,4% (3,5%-14,7%) en los hombres, sin datos científicos acerca de las tendencias durante el período 1995-2016. La prevalencia de la sífilis activa en el 2016 fue de 1,25% (1,22-1,29%) en las mujeres y de 1,25% (1,1%-1,4%) en los hombres, con una reducción de 2,6% (2,1%-3,2%) en las mujeres con respecto a 1995. Los casos correspondientes de sífilis congénita en el 2016 (incluidos los asintomáticos) sumaron en total 3 851, de los cuales 2 245 fueron resultados adversos del embarazo. Las cifras anuales estimadas de sífilis congénita y resultados adversos del embarazo disminuyeron entre el 2008 y el 2016, lo que reflejó un descenso en la prevalencia materna y un aumento de casos evitados mediante el tamizaje y el tratamiento durante la atención prenatal. Conclusiones. Los datos disponibles sobre vigilancia y seguimiento sintetizados en Spectrum‑STI, así como los consiguientes estimados nacionales de infecciones de transmisión sexual (ITS) hechos por primera vez en Colombia, pusieron de relieve la carga de morbilidad por ITS persistentemente alta en ese país. Se estima que la sífilis en los adultos y la sífilis congénita van en descenso, lo que refleja mejoras en las actividades de tamizaje. Un fortalecimiento de la vigilancia, incluso con tamizaje periódico en las poblaciones de bajo riesgo, y estimaciones más refinadas con Spectrum en el futuro deberían brindar apoyo a la planificación y la ejecución de medidas para la prevención y el control de las infecciones de transmisión sexual, incluida la eliminación de la sífilis congénita.


[RESUMO]. Objetivos. Estimar a incidência e a prevalência na população adulta (com idade de 15–49 anos) de sífilis ativa, gonorreia e clamídia e a incidência de sífilis congênita (SC) e desfechos adversos congênitos na Colômbia no período de 1995 a 2016. Métodos. O modelo epidemiológico Spectrum-STI foi o instrumento usado para estimar a prevalência de gonorreia e clamídia como médias móveis nas prevalências observadas em pesquisas representativas da população geral. A sífilis em adultos foi estimada com a regressão polinomial segmentada aplicada ao modelo Spectrum-STI com dados de prevalência obtidos de pesquisas da atenção pré-natal, exames pré-natais de rotina de detecção precoce e pesquisas da população geral. Casos de SC e desfechos adversos congênitos foram estimados a partir das estimativas de sífilis materna do modelo Spectrum e percentuais de mulheres que fizeram testes de detecção e foram tratadas para sífilis, segundo as definições de casos da Organização Mundial da Saúde (OMS) e probabilidades de risco. Resultados. O modelo Spectrum estimou, para 2016, uma prevalência de gonorreia de 0,70% (intervalo de confiança de 95% [IC 95%] 0,15%–1,9%) no sexo feminino e 0,60% (0,1%–1,9%) no sexo masculino e uma prevalência de clamídia de 9,2% (4,4%–15,4%) no sexo feminino e 7,4% (3,5%–14.7%) no sexo masculino, sem evidência de tendências no período 1995–2016. A prevalência de sífilis ativa em 2016 foi de 1,25% (1,22–1,29%) no sexo feminino e 1,25% (1,1%–1,4%) no sexo masculino, demonstrando um declínio da prevalência de 2,6% (2,1%–3,2%) observada em 1995 para o sexo feminino. Houve, ao todo, 3.851 casos correspondentes de SC em 2016 (incluindo casos assintomáticos), dos quais 2.245 foram desfechos adversos congênitos. Observou-se uma redução nas estimativas anuais de SC e desfechos adversos congênitos em 2008–2016, refletindo a diminuição da prevalência materna e o número crescente de casos evitados com exames pré-natais de detecção e tratamento. Conclusões. Os dados disponíveis de vigilância e monitoramento condensados no modelo Spectrum-STI, e as resultantes estimativas nacionais de infeções sexualmente transmissíveis (IST) obtidas pela primeira vez na Colômbia, evidenciam a alta carga persistente de IST no país. Estima-se que a ocorrência de sífilis do adulto e sífilis congénita esteja diminuindo em decorrência da melhoria nos esforços de detecção precoce. A vigilância reforçada, consistindo também de exames periódicos de detecção precoce nas populações de baixo risco e estimavas futuras aprimoradas do instrumento Spectrum, deve sustentar o planejamento e a implementação de controle e prevenção de IST e a eliminação da SC.


Assuntos
Doenças Sexualmente Transmissíveis , Sífilis , Gonorreia , Chlamydia , Vigilância , Colômbia , Doenças Sexualmente Transmissíveis , Sífilis , Gonorreia , Vigilância , Doenças Sexualmente Transmissíveis , Gonorreia , Vigilância , Colômbia
2.
Rev. panam. salud pública ; 42: e118, 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-961812

RESUMO

ABSTRACT Objectives To estimate adult (15-49 years old) prevalence and incidence of active syphilis, gonorrhea, and chlamydia, and incidence of congenital syphilis (CS) and adverse birth outcomes (ABOs) in Colombia, over 1995-2016. Methods The Spectrum-STI epidemiological model tool estimated gonorrhea and chlamydia prevalences as moving averages across prevalences observed in representative general population surveys. For adult syphilis, Spectrum-STI applied segmented polynomial regression through prevalence data from antenatal care (ANC) surveys, routine ANC-based screening, and general population surveys. CS cases and ABOs were estimated from Spectrum's maternal syphilis estimates and proportions of women screened and treated for syphilis, applying World Health Organization case definitions and risk probabilities. Results The Spectrum model estimated prevalences in 2016 of 0.70% (95% confidence interval (CI): 0.15%-1.9%) in women and 0.60% (0.1%-1.9%) in men for gonorrhea and of 9.2% (4.4%-15.4%) in women and 7.4% (3.5%-14.7%) in men for chlamydia, without evidence for trends over 1995-2016. The prevalence of active syphilis in 2016 was 1.25% (1.22-1.29%) in women and 1.25% (1.1%-1.4%) in men, decreasing from 2.6% (2.1%-3.2%) in women in 1995. Corresponding CS cases in 2016 (including cases without clinical symptoms) totaled 3 851, of which 2 245 were ABOs. Annual CS and ABO estimates decreased over 2008-2016, reflecting decreasing maternal prevalence and increasing cases averted through ANC-based screening and treatment. Conclusions The available surveillance and monitoring data synthesized in Spectrum-STI— and the resulting first-ever national STI estimates for Colombia—highlighted Colombia's persistently high STI burden. Adult syphilis and congenital syphilis are estimated to be falling, reflecting improving screening efforts. Strengthened surveillance, including with periodic screening in low-risk populations and future refined Spectrum estimations, should support planning and implementation of STI prevention and control, including CS elimination.


resumen está disponible en el texto completo


RESUMO Objetivos Estimar a incidência e a prevalência na população adulta (com idade de 15-49 anos) de sífilis ativa, gonorreia e clamídia e a incidência de sífilis congênita (SC) e desfechos adversos congênitos na Colômbia no período de 1995 a 2016. Métodos O modelo epidemiológico Spectrum-STI foi o instrumento usado para estimar a prevalência de gonorreia e clamídia como médias móveis nas prevalências observadas em pesquisas representativas da população geral. A sífilis em adultos foi estimada com a regressão polinomial segmentada aplicada ao modelo Spectrum-STI com dados de prevalência obtidos de pesquisas da atenção pré-natal, exames pré-natais de rotina de detecção precoce e pesquisas da população geral. Casos de SC e desfechos adversos congênitos foram estimados a partir das estimativas de sífilis materna do modelo Spectrum e percentuais de mulheres que fizeram testes de detecção e foram tratadas para sífilis, segundo as definições de casos da Organização Mundial da Saúde (OMS) e probabilidades de risco. Resultados O modelo Spectrum estimou, para 2016, uma prevalência de gonorreia de 0,70% (intervalo de confiança de 95% [IC 95%] 0,15%-1,9%) no sexo feminino e 0,60% (0,1%-1,9%) no sexo masculino e uma prevalência de clamídia de 9,2% (4,4%-15,4%) no sexo feminino e 7,4% (3,5%-14.7%) no sexo masculino, sem evidência de tendências no período 1995-2016. A prevalência de sífilis ativa em 2016 foi de 1,25% (1,22-1,29%) no sexo feminino e 1,25% (1,1%-1,4%) no sexo masculino, demonstrando um declínio da prevalência de 2,6% (2,1%-3,2%) observada em 1995 para o sexo feminino. Houve, ao todo, 3.851 casos correspondentes de SC em 2016 (incluindo casos assintomáticos), dos quais 2.245 foram desfechos adversos congênitos. Observou-se uma redução nas estimativas anuais de SC e desfechos adversos congênitos em 2008-2016, refletindo a diminuição da prevalência materna e o número crescente de casos evitados com exames pré-natais de detecção e tratamento. Conclusões Os dados disponíveis de vigilância e monitoramento condensados no modelo Spectrum-STI, e as resultantes estimativas nacionais de infeções sexualmente transmissíveis (IST) obtidas pela primeira vez na Colômbia, evidenciam a alta carga persistente de IST no país. Estima-se que a ocorrência de sífilis do adulto e sífilis congênita esteja diminuindo em decorrência da melhoria nos esforços de detecção precoce. A vigilância reforçada, consistindo também de exames periódicos de detecção precoce nas populações de baixo risco e estimavas futuras aprimoradas do instrumento Spectrum, deve sustentar o planejamento e a implementação de controle e prevenção de IST e a eliminação da SC.


Assuntos
Humanos , Infecções por Chlamydia/diagnóstico , Doenças Sexualmente Transmissíveis/prevenção & controle , Gonorreia , Sífilis/diagnóstico , Colômbia/epidemiologia , Vigilância
3.
Rev. colomb. obstet. ginecol ; 68(3): 193-201, July-Sept. 2017. graf
Artigo em Inglês | LILACS | ID: biblio-900755

RESUMO

ABSTRACT Curable and incurable sexually transmitted infections (STI) are acquired by hundreds of millions of people worldwide each year. Undiagnosed and untreated STIs cause a range of negative health outcomes including adverse birth outcomes, infertility and other long term sequelae such as cervical cancer. In 2016, the World Health Organization (WHO) launched the Global STI Strategy (20162021). The WHO Global STI Strategy's public health approach focuses on three causative organisms of STIs that need immediate action and for which cost-effective interventions exist: (a) Neisseria gonorrhoeae as a cause of infertility, a risk factor for coinfection with other STIs and because of increasing bacterial resistance to antibiotic treatment, (b) Treponema pallidum given the contribution of syphilis to adverse birth outcomes including stillbirth and neonatal death and (c) Human papillomavirus due to its link to cervical cancer. The range of actions recommended for countries includes: (a) strengthening surveillance, with program monitoring and progress evaluation, (b) STI prevention, (c) early diagnosis of STIs, (d) patient and partner management, and (e) approaches to reach the most vulnerable populations. This summary describes the WHO Global STI Strategy alongside findings from a STI surveillance workshop held in Colombia in May of 2017. Observations related to the Global STI Strategy and findings from the STI estimation workshop are described here for stakeholders in Colombia to consider as they identify opportunities to improve STI services and surveillance.


RESUMEN En el mundo, cientos de millones de personas adquieren anualmente infecciones de transmisión sexual (ITS), algunas de ellas curables y otras incurables. Las ITS que no se diagnostican y no se tratan producen una serie de desenlaces negativos para la salud, entre los cuales se cuentan malos resultados perinatales, infertilidad y otras secuelas crónicas, además del cáncer de cuello uterino. En 2016, la Organización Mundial de la Salud (OMS) lanzó la Estrategia Mundial contras las ITS (2016-2021). El enfoque de salud pública contemplado en la Estrategia Global de la OMS se centra en tres microorganismos causantes de las ITS que requieren acciones inmediatas y para los cuales existen intervenciones costo-efectivas: (a) Neisseria gonorrhoea como causa de infertilidad y factor de riesgo para coinfección con otras ITS, y por su mayor resistencia al tratamiento con antibióticos; (b) Treponema pallidum por la contribución de la sífilis a resultados adversos al nacimiento, entre ellos muerte fetal y muerte neonatal; y (c) virus del papiloma humano debido a su relación con el cáncer de cuello uterino. Entre las acciones recomendadas para los países están las siguientes: (a) fortalecer la vigilancia, el monitoreo y la evaluación de los programas y los avances logrados; (b) prevención de las ITS; (c) diagnóstico temprano de las ITS; (d) manejo del paciente y la pareja; (e) mecanismos para llegar a las poblaciones más vulnerables. Esta síntesis de la política resume la Estrategia Mundial de la OMS contra las ITS, además de los hallazgos de un taller de vigilancia llevado a cabo en Colombia en mayo de 2017. Aquí se describen las observaciones relacionadas con la Estrategia, y los hallazgos del taller a fin de que los distintos grupos de interés en Colombia, los tomen en consideración a la hora de identificar las oportunidades de mejorar los servicios y la vigilancia en lo que atañe a las ITS.


Assuntos
Feminino , Adulto , Doenças Sexualmente Transmissíveis , Organização Mundial da Saúde
4.
Rev. Fac. Med. UNAM ; 60(4): 7-18, jul.-ago. 2017. tab, graf
Artigo em Espanhol | LILACS-Express | ID: biblio-957125

RESUMO

Resumen En la actualidad, México ocupa el primer lugar con obesidad infantil y el segundo con obesidad en el adulto. Este fenómeno ya ha alcanzado niveles de pandemia, por lo que de no evitar que continúe aumentando el número de pacientes obesos, en pocos años la cantidad de discapacitados a causa de alteraciones metabólicas será alarmante. En esta revisión se pretenden establecer las causas del síndrome metabólico, los mecanismos que se alteran para conducirá diabetes mellitus, y se mencionan los mecanismos fisiológicos que se alteran en la condición de hiperglucemia. Y dentro de las consecuencias que resultan de esta enfermedad, analizar una de las que más cuesta al paciente y a la familia como lo es el pie diabético.


Abstract Mexico currently occupies the first place with childhood obesity and the second with adult obesity. This phenomenon has already reached pandemic levels so if the increasing number of obese patients is not prevented, in a fewyears the number of patients with disabilities resulting from metabolic alterations will be alarming. This review aims to establish the causes of the metabolic syndrome, the mechanisms that are altered and lead to diabetes mellitus, also we will mention the physiological mechanisms altered in hyperglycemia and its consequences. We will analyze one of the diseases with the highest costs for the patient and their family: the diabetic foot.

5.
Cytokine ; 91: 13-29, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27951455

RESUMO

Aging is considered a systemic, chronic and low-grade inflammatory state, called "inflammaging", which has been contemplated as a risk factor for cancer development and progression in the elderly population. Cellular senescence is a multifactorial phenomenon of growth arrest and distorted function, which has been recognized as a contributor to aging. Senescent cells have an altered secretion pattern called Senescent Associated Secretory Phenotype (SASP), that comprise a complex mix of factors including cytokines, growth factors, chemokines and matrix metalloproteinases among others. The SASP secreted by accumulated senescent cells during old age has been related to local inflammation that leads to cellular transformation and therefore may be supporting the inflammaging process. Here, we evaluated if the pro-inflammatory profile within the serum obtained from elderly patients (EPS) was able to induce cellular proliferation in the breast cancer transformed cell line (MCF-7), in a similar way to the proliferation stimulated by the SASP obtained from WI-38 primary cells prematurely induced to senescence by oxidative stress (SIPS). At the same time, the participation of IL-6/IL-8 ratio was determined. Our results showed that not all the EPS increased MCF-7 proliferation. However, there was an interesting relationship between IL-6 and IL-8 concentrations, when the IL-6 was higher than IL-8. Similar results were found with SASP from SIPS-WI-38 on the MCF-7 proliferation. Although it is known that those cytokines are fundamental factors to induce proliferation; the occurrence of other components in the cellular microenvironment is necessary to carry out this effect.


Assuntos
Neoplasias da Mama/metabolismo , Interleucina-6/metabolismo , Interleucina-8/metabolismo , Proteínas de Neoplasias/metabolismo , Idoso de 80 Anos ou mais , Neoplasias da Mama/patologia , Feminino , Humanos , Inflamação/sangue , Inflamação/patologia , Células MCF-7
6.
Rev. chil. dermatol ; 33(2): 62-64, 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-964927

RESUMO

La lepra es una infección crónica, granulomatosa, producida por Mycobacterium leprae, que afecta piel y nervios periféricos. Se describen dos tipos de reacciones leprosas: tipo I y tipo II, las que corresponden a cuadros agudos que exacerban la enfermedad. Estas leproreacciones pueden ocurrir antes, durante o después del tratamiento. Se presenta el caso de un paciente masculino que acude a consultar con lesiones cutáneas y resultado de biopsia de piel con diagnóstico de lepra. Se inicia tratamiento multidroga OMS-MB1. Posteriormente presenta una leproreacción tipo I, por lo que se le realiza tratamiento con prednisona.


Leprosy is a chronic granulomatous infection of the skin and peripheral nervous system produced by Mycobacterium leprae. Two types of acute leprosy reactions have been described: type I and type II. These reactions can occur before, during or after treatment. We present the case of an adult male patient presenting with skin lesions and skin biopsy diagnostic for leprosy. A multidrug WHO-MB 1 treatment was initiated, after which he presents with type I lepra reaction requiring corticosteroids.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/tratamento farmacológico , Clofazimina/efeitos adversos , Quimioterapia Combinada/efeitos adversos , Eritema Nodoso/induzido quimicamente , Rifampina/efeitos adversos , Biópsia , Dapsona/efeitos adversos , Hanseníase Multibacilar/patologia , Hansenostáticos/efeitos adversos
7.
Rev. panam. salud pública ; 40(6): 455-461, Dec. 2016. tab, graf
Artigo em Inglês | LILACS | ID: biblio-845673

RESUMO

ABSTRACT Objective To assess the effectiveness of a dual rapid test compared to a single rapid test for syphilis and HIV screening. Methods A cluster-randomized open-label clinical trial was performed in 12 public antenatal care (ANC) centers in the cities of Bogotá and Cali, Colombia. Pregnant women who were over 14 years of age at their first antenatal visit and who had not been previously tested for HIV and syphilis during the current pregnancy were included. Pregnant women were randomized to single HIV and single syphilis rapid diagnostic tests (Arm A) or to dual HIV and syphilis rapid diagnostic tests (Arm B). The four main outcomes measured were: (1) acceptability of the test, (2) uptake in testing, (3) treatment on the same day (that is, timely treatment), and (4) treatment at any time for positive rapid test cases. Bivariate and multivariate analyses were calculated to adjust for the clustering effect and the period. Results A total of 1 048 patients were analyzed in Arm A, and 1 166 in Arm B. Acceptability of the rapid tests was 99.8% in Arm A and 99.6% in Arm B. The prevalence of positive rapid tests was 2.21% for syphilis and 0.36% for HIV. Timely treatment was provided to 20 of 29 patients (69%) in Arm A and 16 of 20 patients (80%) in Arm B (relative risk (RR), 1.10; 95% confidence interval (CI): (1.00 −1.20). Treatment at any time was given to 24 of 29 patients (83%) in Arm A and to 20 of 20 (100%) in Arm B (RR, 1.11; 95% CI: 1.01−1.22). Conclusions There were no differences in patient acceptability, testing and timely treatment between dual rapid tests and single rapid tests for HIV and syphilis screening in the ANC centers. Same-day treatment depends also on the interpretation of and confidence in the results by the health providers.


RESUMEN Objetivo Evaluar la eficacia de la prueba rápida dual en comparación con la prueba rápida individual para la detección sistemática de la sífilis y la infección por el VIH. Métodos Se realizó un ensayo clínico sin enmascaramiento y aleatorizado por grupos en 12 centros públicos de atención prenatal en las ciudades de Bogotá y Cali (Colombia). Se incluyó a las mujeres embarazadas de 14 o más años de edad que asistían a su primera consulta prenatal y no se habían realizado pruebas en este embarazo. Las embarazadas se dividieron de forma aleatoria para realizarles las pruebas rápidas individuales para el diagnóstico de sífilis y de infección por el VIH (Grupo A) o la prueba rápida dual para el diagnóstico de la sífilis y la infección por el VIH (Grupo B). Se midieron principalmente cuatro resultados: (1) aceptabilidad de la prueba, (2) uso de los servicios de prueba, (3) tratamiento el mismo día (es decir, tratamiento oportuno) y (4) tratamiento en cualquier momento en los casos con resultados positivos en las pruebas rápidas. Se realizaron análisis bifactoriales y multifactoriales para hacer los ajustes pertinentes por el efecto de la división en grupos y el período. Resultados Se estudió a 1 048 pacientes en el Grupo A y a 1 166 en el Grupo B. La aceptabilidad de las pruebas rápidas fue de 99,8% en el Grupo A y 99,6% en el Grupo B. La prevalencia de resultados positivos en las pruebas rápidas fue de 2,21% para la sífilis y 0,36% para la infección por el VIH. Se administró tratamiento oportuno a 20 de 29 pacientes (69%) del Grupo A y a 16 de 20 pacientes (80%) del Grupo B (riesgo relativo, 1,10; intervalo de confianza de 95% (IC): 1,00-1,20). Se administró tratamiento en cualquier momento a 24 de 29 pacientes (83%) del Grupo A y a 20 de 20 (100%) del Grupo B (riesgo relativo, 1,11; IC de 95%: 1,01-1,22). Conclusiones No hubo diferencias en cuanto a la aceptabilidad por parte de los pacientes, y el uso de los servicios de cribaje y el tratamiento oportuno entre las pruebas rápidas duales y las pruebas rápidas individuales para la detección sistemática de la sífilis y la infección por el VIH en los centros de atención prenatal. El tratamiento el mismo día depende también de la interpretación y la confianza en los resultados del trabajador de salud.


Assuntos
Complicações Infecciosas na Gravidez/diagnóstico , Aceitação pelo Paciente de Cuidados de Saúde , Infecções por HIV/diagnóstico , Testes Diagnósticos de Rotina , Colômbia
8.
Rev Panam Salud Publica ; 40(6), dic. 2016
Artigo em Inglês | PAHO-IRIS | ID: phr-33672

RESUMO

Objective. To assess the effectiveness of a dual rapid test compared to a single rapid test for syphilis and HIV screening. Methods. A cluster-randomized open-label clinical trial was performed in 12 public antenatal care (ANC) centers in the cities of Bogotá and Cali, Colombia. Pregnant women who were over 14 years of age at their first antenatal visit and who had not been previously tested for HIV and syphilis during the current pregnancy were included. Pregnant women were randomized to single HIV and single syphilis rapid diagnostic tests (Arm A) or to dual HIV and syphilis rapid diagnostic tests (Arm B). The four main outcomes measured were: (1) acceptability of the test, (2) uptake in testing, (3) treatment on the same day (that is, timely treatment), and (4) treatment at any time for positive rapid test cases. Bivariate and multivariate analyses were calculated to adjust for the clustering effect and the period. Results. A total of 1 048 patients were analyzed in Arm A, and 1 166 in Arm B. Acceptability of the rapid tests was 99.8% in Arm A and 99.6% in Arm B. The prevalence of positive rapid tests was 2.21% for syphilis and 0.36% for HIV. Timely treatment was provided to 20 of 29 patients (69%) in Arm A and 16 of 20 patients (80%) in Arm B (relative risk (RR), 1.10; 95% confidence interval (CI): (1.00 −1.20). Treatment at any time was given to 24 of 29 patients (83%) in Arm A and to 20 of 20 (100%) in Arm B (RR, 1.11; 95% CI: 1.01−1.22). Conclusions. There were no differences in patient acceptability, testing and timely treatment between dual rapid tests and single rapid tests for HIV and syphilis screening in the ANC centers. Same-day treatment depends also on the interpretation of and confidence in the results by the health providers.


Objetivo. Evaluar la eficacia de la prueba rápida dual en comparación con la prueba rápida individual para la detección sistemática de la sífilis y la infección por el VIH. Métodos. Se realizó un ensayo clínico sin enmascaramiento y aleatorizado por grupos en 12 centros públicos de atención prenatal en las ciudades de Bogotá y Cali (Colombia). Se incluyó a las mujeres embarazadas de 14 o más años de edad que asistían a su primera consulta prenatal y no se habían realizado pruebas en este embarazo. Las embarazadas se dividieron de forma aleatoria para realizarles las pruebas rápidas individuales para el diagnóstico de sífilis y de infección por el VIH (Grupo A) o la prueba rápida dual para el diagnóstico de la sífilis y la infección por el VIH (Grupo B). Se midieron principalmente cuatro resultados: (1) aceptabilidad de la prueba, (2) uso de los servicios de prueba, (3) tratamiento el mismo día (es decir, tratamiento oportuno) y (4) tratamiento en cualquier momento en los casos con resultados positivos en las pruebas rápidas. Se realizaron análisis bifactoriales y multifactoriales para hacer los ajustes pertinentes por el efecto de la división en grupos y el período. Resultados. Se estudió a 1 048 pacientes en el Grupo A y a 1 166 en el Grupo B. La aceptabilidad de las pruebas rápidas fue de 99,8% en el Grupo A y 99,6% en el Grupo B. La prevalencia de resultados positivos en las pruebas rápidas fue de 2,21% para la sífilis y 0,36% para la infección por el VIH. Se administró tratamiento oportuno a 20 de 29 pacientes (69%) del Grupo A y a 16 de 20 pacientes (80%) del Grupo B (riesgo relativo, 1,10; intervalo de confianza de 95% (IC): 1,00-1,20). Se administró tratamiento en cualquier momento a 24 de 29 pacientes (83%) del Grupo A y a 20 de 20 (100%) del Grupo B (riesgo relativo, 1,11; IC de 95%: 1,01-1,22). Conclusiones. No hubo diferencias en cuanto a la aceptabilidad por parte de los pacientes, y el uso de los servicios de cribaje y el tratamiento oportuno entre las pruebas rápidas duales y las pruebas rápidas individuales para la detección sistemática de la sífilis y la infección por el VIH en los centros de atención prenatal. El tratamiento el mismo día depende también de la interpretación y la confianza en los resultados del trabajador de salud.


Assuntos
HIV , Sífilis , Gestantes , Testes Imediatos , Efetividade , Aceitação pelo Paciente de Cuidados de Saúde , HIV , Sífilis , Gestantes , Testes Imediatos , Efetividade , Aceitação pelo Paciente de Cuidados de Saúde , Colômbia
9.
Rev Panam Salud Publica ; 40(6): 455-461, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28718495

RESUMO

Objective: To assess the effectiveness of a dual rapid test compared to a single rapid test for syphilis and HIV screening. Methods: A cluster-randomized open-label clinical trial was performed in 12 public antenatal care (ANC) centers in the cities of Bogotá and Cali, Colombia. Pregnant women who were over 14 years of age at their first antenatal visit and who had not been previously tested for HIV and syphilis during the current pregnancy were included. Pregnant women were randomized to single HIV and single syphilis rapid diagnostic tests (Arm A) or to dual HIV and syphilis rapid diagnostic tests (Arm B). The four main outcomes measured were: (1) acceptability of the test, (2) uptake in testing, (3) treatment on the same day (that is, timely treatment), and (4) treatment at any time for positive rapid test cases. Bivariate and multivariate analyses were calculated to adjust for the clustering effect and the period. Results: A total of 1 048 patients were analyzed in Arm A, and 1 166 in Arm B. Acceptability of the rapid tests was 99.8% in Arm A and 99.6% in Arm B. The prevalence of positive rapid tests was 2.21% for syphilis and 0.36% for HIV. Timely treatment was provided to 20 of 29 patients (69%) in Arm A and 16 of 20 patients (80%) in Arm B (relative risk (RR), 1.10; 95% confidence interval (CI): (1.00 -1.20). Treatment at any time was given to 24 of 29 patients (83%) in Arm A and to 20 of 20 (100%) in Arm B (RR, 1.11; 95% CI: 1.01-1.22). Conclusions: There were no differences in patient acceptability, testing and timely treatment between dual rapid tests and single rapid tests for HIV and syphilis screening in the ANC centers. Same-day treatment depends also on the interpretation of and confidence in the results by the health providers.


Assuntos
Infecções por HIV/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Cuidado Pré-Natal , Sífilis/diagnóstico , Adolescente , Adulto , Análise de Variância , Colômbia , Testes Diagnósticos de Rotina , Feminino , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Gravidez , Adulto Jovem
10.
BMC Public Health ; 15: 1260, 2015 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-26686850

RESUMO

BACKGROUND: The Pan American Health Organization provides technical cooperation to countries in Latin America and the Caribbean for the scale-up of HIV care and treatment based on the Treatment 2.0 initiative. Fourteen Joint Review Missions (JRMs) were conducted between March 2012 and October 2014. Evaluating the degree of implementation of the recommendations of the JRMs and their impact on health policies, would help countries identify their gaps and areas for priority interventions. METHODS: A descriptive analysis of the JRM recommendations was conducted for eight countries. An in-depth cross-sectional retrospective analysis of the degree of implementation of these recommendations in Ecuador, Venezuela, Bolivia, and El Salvador was performed through a standardized self-administered questionnaire applied to key informants. A comparative quantitative analysis on the optimization of antiretroviral regimens 'before/after' JRMs was conducted in three of the latter four countries, using data reported in 2013 and 2014. RESULTS: The priority areas with most recommendations were the optimization of antiretroviral treatment (ART) regimens (n = 57), the rational and efficient use of resources (n = 27) and the provision of point-of-care diagnostics and monitoring tools (n = 26), followed by community mobilization (n = 23), strategic information (n = 17) and the adaptation of delivery services (n = 15). The in-depth analysis in four countries showed that the two priority areas where most progress was observed were the rational and efficient use of resources (62%) and the optimization of ART regimens (60%). Adaptation of delivery services, community mobilization and strategic information were rated at 52% and the provision of point-of-care diagnostics and monitoring tools 38%. The quantitative analysis on optimization evidenced a 36% reduction in the number of first-line and second-line ART regimens, a 5.4% increase in the proportion of patients on WHO-recommended first-line regimens, a 19.4% increase in the use of the WHO preferred first-line regimen, 51% increase in the use of WHO-recommended second-line regimens, and a significant reduction in the use of obsolete drugs in first- and second-line regimens (respectively 1 and 9% of regimens in 2013). CONCLUSIONS: A relatively good level of progress was perceived in the recommendations related to optimization of ART regimens. Challenges remain on the improvement of recommendations related to health system strengthening and the promotion and support aimed at community-based organizations as part of the response to HIV/AIDS in Latin America. The JRMs are a useful mechanism for providing coherent technical support to guide countries in the pursuit of a comprehensive response to HIV/AIDS in the Latin American region.


Assuntos
Infecções por HIV/prevenção & controle , Infecções por HIV/terapia , Implementação de Plano de Saúde/organização & administração , Acesso aos Serviços de Saúde/organização & administração , Sistemas Automatizados de Assistência Junto ao Leito/organização & administração , Antirretrovirais/administração & dosagem , Estudos Transversais , Infecções por HIV/tratamento farmacológico , Política de Saúde , Humanos , América Latina , Programas de Rastreamento/organização & administração , Guias de Prática Clínica como Assunto , Estudos Retrospectivos
11.
Gac Med Mex ; 151(4): 491-500, 2015 Jul-Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-26290026

RESUMO

Cellular senescence is defined as the physiological program of terminal growth arrest; in mammals it is an important tumor-suppressor mechanism since it stops premalignant cell proliferation. However, senescence also contributes to the decline associated to aging and the development of several diseases. This is explained by the fact that senescent cells secrete diverse molecules, which compromise the cellular microenvironment, and altogether are referred as senescent-associated secretory phenotype (SASP). The SASP is composed by cytokines, chemokines, growth factors, proteases, etc., whose function is to maintain the antiproliferative state and promote senescent cell clearance by the immune system. Nevertheless, over time, and particularly during old age, SASP might stimulate proliferation and premalignant cell transformation. The multifunctional roles of SASP would depend on the cell type and their physiological nature. Therefore, relying on the biological context, SASP could be beneficial and participate in the repair and regeneration processes, or detrimental and induce degenerative pathologies and cancer.


Assuntos
Envelhecimento/genética , Senescência Celular/genética , Neoplasias/genética , Humanos , Fenótipo
12.
AIDS Behav ; 18(1): 88-98, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23620242

RESUMO

This study characterized the HIV epidemic among men who have sex with men (MSM) in Quito, Ecuador and contrasted risk patterns with other STI's. 416 MSM ages 15 years and older were recruited using respondent-driven sampling in 2010-2011. Biological testing and a self-interview survey assessed HIV and STI infections and risk behaviors. Analysis incorporated recruiter-level variables and clustering adjustments to control for recruitment patterns. We identify high levels of HIV (11 %), HSV-2 (14 %) and active syphilis (5.5 %) infections, low levels of lifetime HIV testing (57 %), limited knowledge of HIV and STI's (<48 %) and limited consistent condom use independent of partner type (<40 %). Sex work was associated with all infections while associations with residential location, how casual partners are met and other variables, varied. Scale-up of behavioral prevention and HIV testing is urgently needed. Interventions should target male sex workers and exploit differential patterns of HIV-STI risk to stay ahead of the epidemic.


Assuntos
Infecções por HIV/epidemiologia , Necessidades e Demandas de Serviços de Saúde , Homossexualidade Masculina/estatística & dados numéricos , Prevenção Primária/organização & administração , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Equador/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/psicologia , Hepatite B/epidemiologia , Herpes Genital/epidemiologia , Herpes Simples/epidemiologia , Herpesvirus Humano 2 , Humanos , Masculino , Prevenção Primária/normas , Assunção de Riscos , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/prevenção & controle , Doenças Sexualmente Transmissíveis/psicologia , Sífilis/epidemiologia , Adulto Jovem
13.
Photosynth Res ; 114(1): 43-58, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22965313

RESUMO

Tolypothrix PCC 7601 and Fremyella diplosiphon UTEX B590 can produce two alternative phycobilisome (PBS) rods. PE-PBSs with one phycocyanin (PC) disk and multiple phycoerythrin (PE) disks are found in cells grown under green light (GL). PC-PBSs with only PC disks are obtained from cells grown under red light (RL). In this manuscript, we show the localization of the linker proteins and ferredoxin-NADP(+) oxidoreductase (FNR) in the PC-PBS and of PE-PBS rods using visible spectroscopy and mass spectrometry. PE-PBSs with different [PE]/[PC] ratios and PC-PBSs with different [PC]/[AP] (AP, allophycocyanin) ratios were isolated. CpeC was the primary rod linker protein found in the PBSs with a [PE]/[PC] ratio of 1.1, which indicates that this is the rod linker at the interphase PC-PE. CpeC and CpeD were identified in the PBSs with a [PE]/[PC] ratio of 1.6, which indicates that CpcD is the linker between the first and the second PE hexamers. Finally, CpeC, CpeD, and CpeE were found in the PBSs with a [PE]/[PC] ratio of 2.9, indicating the position of CpeE between the second and third PE moieties. CpcI2 was identified in the two PC-PBSs obtained from cells grown under RL, which indicates that CpcI2 is the linker between the first and second PC hexamers. CpcH2 was identified only in the PC-PBSs from Tolypothrix with a high [PC]/[AP] ratio of 1.92, which indicates that CpcH2 is the linker between the second and third PC hexamers. The PC-PBSs contained the rod cap protein L(R)(10) (CpcD), but this protein was absent in the PE-PBSs. PE-PBSs (lacking L(R)(10)) incorporated exogenous rFNR in a stoichiometry of up to five FNRs per PBS. A maximum of two FNRs per PBS were found in PC-PBSs (with L(R)(10)). These observations support the hypothesis that FNR binds at the distal ends of the PBS rods in the vacant site of CpcD L(R)(10). Finally, the molecular mass of the core membrane linker (L(CM)) was determined to be 102 kDa from a mass spectrometry analysis.


Assuntos
Adaptação Fisiológica/fisiologia , Proteínas de Algas/isolamento & purificação , Cianobactérias/metabolismo , Ficobilissomas/metabolismo , Proteômica , Proteínas de Algas/química , Proteínas de Algas/metabolismo , Sequência de Aminoácidos , Western Blotting , Cianobactérias/fisiologia , Eletroforese em Gel de Poliacrilamida , Dados de Sequência Molecular , Ficobilissomas/análise , Estrutura Terciária de Proteína , Proteínas Recombinantes , Alinhamento de Sequência
14.
Pharmacol Biochem Behav ; 101(4): 544-52, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22386964

RESUMO

In mammals, there is an underlying mechanism that dictates the organism's biological functions and daily activity schedule, known as circadian rhythms, which play a major role in maintaining steady metabolism, homeostasis, and immunity. Limited research has been done investigating the effects of continuous opiate administration on the circadian rhythm activity pattern. A change in circadian activity pattern is suggested as an experimental model to demonstrate long-term effect of the drug. The objective of this study was to investigate the effects of morphine treatment on the long term activity (24 h) of the animal as well as the activity after abrupt removal, since prescribed medication containing morphine is widely used and abused and its long term effects are not known. Male Sprague-Dawley rats were contained in stable conditions with a standard light/dark cycle recordings taken before, during and after morphine pellet implantation. Cosinor analysis was used to fit a 24-hour curve to the activity pattern. Results indicate that morphine pellet administration alters the mesor, amplitude, the day-time and night-time activity levels, and demonstrates a remarkable change in the maximal circadian rhythm timing during the withdrawal period. The question whether morphine changes the circadian rhythm or a change in circadian rhythm results in tolerance and withdrawal is discussed.


Assuntos
Ritmo Circadiano/efeitos dos fármacos , Morfina/administração & dosagem , Atividade Motora/efeitos dos fármacos , Animais , Comportamento Animal/efeitos dos fármacos , Comportamento Animal/fisiologia , Ritmo Circadiano/fisiologia , Implantes de Medicamento/administração & dosagem , Tolerância a Medicamentos/fisiologia , Masculino , Dependência de Morfina/fisiopatologia , Atividade Motora/fisiologia , Entorpecentes/administração & dosagem , Ratos , Ratos Sprague-Dawley , Síndrome de Abstinência a Substâncias/fisiopatologia
15.
Brain Res ; 1442: 76-89, 2012 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-22322149

RESUMO

The interferons (IFNs) are an endogenous pleiotropic family of cytokines that perform fundamental physiological functions as well as protecting host organisms from disease and in maintaining homeostasis. This review covers the effects of endogenous IFN on the nervous system. It starts with the description of its receptors, followed how it modulate neuronal activity, mood, sleep, temperature, the endocrine system, the opioid system and how it regulate food consumption and the immune system. Similar to other multifunctional cytokines, an excessive or inappropriate activity of IFNs can cause toxicity and even death. Furthermore, IFNs are currently the major treatment modality for several malignant and non-malignant diseases such as chronic hepatitis C and B, multiple sclerosis, hematological malignancies, malignant melanoma, renal cell carcinoma, etc.


Assuntos
Encéfalo/fisiologia , Interferons/fisiologia , Neurônios/fisiologia , Animais , Regulação do Apetite , Regulação da Temperatura Corporal , Encéfalo/metabolismo , Depressão/induzido quimicamente , Depressão/fisiopatologia , Sistema Endócrino/fisiologia , Humanos , Sistema Imunitário/fisiologia , Interferons/efeitos adversos , Interferons/uso terapêutico , Transtornos Relacionados ao Uso de Opioides/metabolismo , Receptores de Interferon/metabolismo , Sono
16.
Artigo em Inglês | LILACS | ID: lil-612967

RESUMO

By the end of 2010, Latin America and the Caribbean (LAC) achieved 63% antiretroviral treatment (ART) coverage. Measures to control HIV drug resistance (HIVDR) at the countrylevel are recommended to maximize the efficacy and sustainability of ART programs. Since 2006, the Pan American Health Organization has supported implementation of the WorldHealth Organization (WHO) strategy for HIVDR prevention and assessment through regional capacity-building activities and direct technical cooperation in 30 LAC countries. By 2010, 85 sites in 19 countries reported early warning indicators, providing information about the extent of potential drivers of drug resistance at the ART site. In 2009, 41.9% of sites did notachieve the WHO target of 100% appropriate first-line prescriptions; 6.3% still experienced high rates (> 20%) of loss to follow-up, and 16.2% had low retention of patients (< 70%) on first-line prescriptions in the first year of treatment. Stock-outs of antiretroviral drugs occurred at 22.7% of sites. Haiti, Guyana, and the Mesoamerican region are planning and implementing WHO HIVDR monitoring surveys or threshold surveys. New HIVDR surveillance tools for concentrated epidemics would promote further scale-up. Extending the WHO HIVDR lab network in Latin America is key to strengthening regional lab capacity to support quality assuredHIVDR surveillance. The WHO HIVDR control strategy is feasible and can be rolled out in LAC. Integrating HIVDR activities in national HIV care and treatment plans is key to ensuring the sustainability of this strategy.


Hacia fines del 2010, América Latina y el Caribe lograron una cobertura de tratamiento antirretroviral de 63%. Se recomienda la ejecución de medidas para controlar la farmacorresistencia del VIH a nivel de país para potenciar al máximo la eficacia y la sostenibilidad de los programas de tratamiento antirretroviral. Desde el 2006, la Organización Panamericana de la Salud ha apoyado la aplicación de la estrategia de la Organización Mundial de la Salud (OMS) para la prevención y la evaluación de la farmacorresistenciadel VIH mediante actividades regionales de formación de capacidad y de cooperación técnica directa en 30 países de América Latina y el Caribe. En 2010, 85 centros en 19 países notificaron indicadores de alerta temprana y suministraron información acerca del alcance de los posibles impulsores de la farmacorresistencia enlos centros de tratamiento antirretroviral. En el 2009, 41,9% de los centros no lograron la meta de la OMS de 100% de prescripción de medicamentos de primera línea apropiados; 6,3% todavía tenían tasas elevadas (> 20%) de pérdida de seguimiento y 16,2% tenían una baja retención de pacientes (< 70%) en tratamiento con antirretrovirales deprimera línea en el primer año de tratamiento. Se registraron desabastecimientos de medicamentos antirretrovirales en 22,7% de los centros. Haiti, Guyana y la zona mesoamericana están planificando y ejecutando estudios de vigilancia de la farmacorresistencia del VIH o estudios del umbral de la OMS. Las nuevas herramientas para la vigilancia de la farmacorresistencia del VIH en las epidemias concentradas permitiránuna mejor vigilancia. La ampliación de la red de laboratorios de farmacorresistenciadel VIH acreditados por la OMS en América Latina es fundamental para el fortalecimientode la capacidad de los laboratorios regionales, a fin de de efectuar una vigilancia de la farmacorresistencia del VIH de calidad garantizada...


Assuntos
Humanos , Fármacos Anti-HIV/farmacologia , Farmacorresistência Viral , HIV-1 , Vigilância da População , Organização Mundial da Saúde/organização & administração , Fármacos Anti-HIV/provisão & distribução , Região do Caribe/epidemiologia , Farmacorresistência Viral/genética , Estudos de Viabilidade , Saúde Global , Implementação de Plano de Saúde , Inquéritos Epidemiológicos , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , América Latina/epidemiologia , Fatores de Tempo
17.
Rev. Fac. Med. UNAM ; 54(4): 24-33, jul.-ago. 2011. ilus, tab
Artigo em Espanhol | LILACS-Express | ID: biblio-956882

RESUMO

La melatonina en algunos países se usa desde hace mucho tiempo para reducir los síntomas de algunas enfermedades neuropsiquiátricas infantiles. En adultos se toma primordialmente para combatir problemas de trastornos del sueño. Por sus propiedades antioxidantes también ha sido utilizada como coadyuvante para contrarrestar algunos tipos de cáncer. Esta hormona es usada en cremas y bloqueadores solares para la piel que prometen el antienvejecimiento celular. Los efectos secundarios producidos por el uso prologado de la melatonina no están del todo claros. Con el propósito de conocer si el uso crónico de esta hormona altera la reproducción y los eventos que a ésta subyacen (como lo es la fertilidad), se propuso revisar la influencia que tiene sobre el eje reproductor de mamíferos masculinos, incluyendo al ser humano.


In some countries melatonin is chronically used to reduce the symptoms of certain neuropsychiatric diseases in children. Adults consume it mainly to treat sleep disorders. Due to its antioxidant properties, it has also been used in the treatment of some types of cancer. This hormone is used in dermal creams and sunscreens, which promise an antiaging effect on cells. Side effects provoked by long-term use of melatonin are not completely clear. In order to know whether the chronic use of this hormone alters reproduction and the events underlying it, fertility for instance, a review of the influence that melatonin has on the reproductive axis of male mammals, including humans, was proposed.

18.
Rev Panam Salud Publica ; 30(6): 657-62, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22358418

RESUMO

By the end of 2010, Latin America and the Caribbean (LAC) achieved 63% antiretroviral treatment (ART) coverage. Measures to control HIV drug resistance (HIVDR) at the country level are recommended to maximize the efficacy and sustainability of ART programs. Since 2006, the Pan American Health Organization has supported implementation of the World Health Organization (WHO) strategy for HIVDR prevention and assessment through regional capacity-building activities and direct technical cooperation in 30 LAC countries. By 2010, 85 sites in 19 countries reported early warning indicators, providing information about the extent of potential drivers of drug resistance at the ART site. In 2009, 41.9% of sites did not achieve the WHO target of 100% appropriate first-line prescriptions; 6.3% still experienced high rates (> 20%) of loss to follow-up, and 16.2% had low retention of patients (< 70%) on first-line prescriptions in the first year of treatment. Stock-outs of antiretroviral drugs occurred at 22.7% of sites. Haiti, Guyana, and the Mesoamerican region are planning and implementing WHO HIVDR monitoring surveys or threshold surveys. New HIVDR surveillance tools for concentrated epidemics would promote further scale-up. Extending the WHO HIVDR lab network in Latin America is key to strengthening regional lab capacity to support quality assured HIVDR surveillance. The WHO HIVDR control strategy is feasible and can be rolled out in LAC. Integrating HIVDR activities in national HIV care and treatment plans is key to ensuring the sustainability of this strategy.


Assuntos
Fármacos Anti-HIV/farmacologia , Farmacorresistência Viral , HIV-1/efeitos dos fármacos , Vigilância da População , Organização Mundial da Saúde/organização & administração , Fármacos Anti-HIV/provisão & distribução , Região do Caribe/epidemiologia , Farmacorresistência Viral/genética , Estudos de Viabilidade , Saúde Global , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Implementação de Plano de Saúde , Inquéritos Epidemiológicos , Humanos , América Latina/epidemiologia , Fatores de Tempo
20.
Photosynth Res ; 106(3): 247-61, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21136295

RESUMO

Gloeobacter violaceus PCC 7421 is a unicellular oxygenic photosynthetic organism, which precedes the diversification of cyanobacteria in the phylogenetic tree. It is the only cyanobacterium that does not contain internal membranes. The unique structure of the rods of the phycobilisome (PBS), grouped as one bundle of six parallel rods, distinguishes G. violaceus from the other PBS-containing cyanobacteria. It has been proposed that unique multidomain rod-linkers are responsible for this peculiarly organized shape. However, the localization of the multidomain linkers Glr1262 and Glr2806 in the PBS-rods remains controversial (Koyama et al. 2006, FEBS Lett 580:3457-3461; Krogmann et al. 2007, Photosynth Res 93:27-43). To further increase our understanding of the structure of the G. violaceus PBS, the identification of the proteins present in fractions obtained from sucrose gradient centrifugation and from native electrophoresis of partially dissociated PBS was conducted. The identification of the proteins, after electrophoresis, was done by spectrophotometry and mass spectrometry. The results support the localization of the multidomain linkers as previously proposed by us. The Glr1262 (92 kDa) linker protein was found to be the rod-core linker L(RC) (92), and Glr2806 (81 kDa), a special rod linker L(R) (81) that joins six disks of hexameric PC. Consequently, we propose to designate glr1262 as gene cpcGm (encoding L(RC) (92)) and glr2806 as gene cpcJm (encoding L(R) (81)). We also propose that the cpeC (glr1263) gene encoding L(R) (31.8) forms the interface that binds PC to PE.


Assuntos
Proteínas de Bactérias/metabolismo , Cianobactérias/metabolismo , Ficobiliproteínas/química , Ficobiliproteínas/metabolismo , Proteínas de Bactérias/química , Extratos Celulares , Centrifugação com Gradiente de Concentração , Eletroforese em Gel de Poliacrilamida , Espectrometria de Massas , Modelos Moleculares , Peptídeos/química , Peptídeos/metabolismo , Estrutura Terciária de Proteína , Proteômica , Espectrometria de Fluorescência , Frações Subcelulares/metabolismo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA