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1.
J Neuroeng Rehabil ; 17(1): 98, 2020 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-32680539

RESUMO

BACKGROUND: In the last decades, several powered ankle-foot orthoses have been developed to assist the ankle joint of their users during walking. Recent studies have shown that the effects of the assistance provided by powered ankle-foot orthoses depend on the assistive profile. In compliant actuators, the stiffness level influences the actuator's performance. However, the effects of this parameter on the users has not been yet evaluated. The goal of this study is to assess the effects of the assistance provided by a variable stiffness ankle actuator on healthy young users. More specifically, the effect of different onset times of the push-off torque and different actuator's stiffness levels has been investigated. METHODS: Eight healthy subjects walked with a unilateral powered ankle-foot orthosis in several assisted walking trials. The powered orthosis was actuated in the sagittal plane by a variable stiffness actuator. During the assisted walking trials, three different onset times of the push-off assistance and three different actuator's stiffness levels were used. The metabolic cost of walking, lower limb muscles activation, joint kinematics, and gait parameters measured during different assisted walking trials were compared to the ones measured during normal walking and walking with the powered orthosis not providing assistance. RESULTS: This study found trends for more compliant settings of the ankle actuator resulting in bigger reductions of the metabolic cost of walking and soleus muscle activation in the stance phase during assisted walking as compared to the unassisted walking trial. In addition to this, the study found that, among the tested onset times, the earlier ones showed a trend for bigger reductions of the activation of the soleus muscle during stance, while the later ones led to a bigger reduction in the metabolic cost of walking in the assisted walking trials as compared to the unassisted condition. CONCLUSIONS: This study presents a first attempt to show that, together with the assistive torque profile, also the stiffness level of a compliant ankle actuator can influence the assistive performance of a powered ankle-foot orthosis.

2.
Biomedica ; 40(2): 362-381, 2020 06 15.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32673463

RESUMO

INTRODUCTION: Cancer is the second leading cause of death in the United States, surpassed only by cardiovascular disease. However, cancer has now overtaken cardiovascular disease as the main cause of death in 12 countries in Western Europe. The burden of cancer is posing a major challenge to health care systems worldwide and demanding improvements in methods for cancer prevention, diagnosis, and treatment. Alternative and complementary strategies for orthodox surgery, radiotherapy, and chemotherapy need to be developed. OBJECTIVE: To determine the oncolytic potential of tumor cell-adapted rotavirus in terms of their ability to infect and lysate murine myeloma Sp2/0-Ag14 cells. MATERIALS AND METHODS: We inoculated rotaviruses Wt1-5, WWM, TRUYO, ECwt-O, and WTEW in Sp2/0-Ag14 cells and we examined their infectious effects by immunocytochemistry, immunofluorescence, flow cytometry, and DNA fragmentation assays. RESULTS: Rotavirus infection involved the participation of some heat shock proteins, of protein disulfide isomerase (PDI), and integrin ß3. We detected the accumulation of viral antigens within the virus-inoculated cells and in the culture medium in all the rotavirus isolates examined. The rotavirus-induced cell death mechanism in Sp2/0-Ag14 cells involved changes in cell membrane permeability, chromatin condensation, and DNA fragmentation, which were compatible with cytotoxicity and apoptosis. CONCLUSIONS: The ability of the rotavirus isolates Wt1-5, WWM, TRUYO, ECwt-O, and WTEW to infect and cause cell death of Sp2/0-Ag14 cells through mechanisms that are compatible with virus-induced apoptosis makes them potential candidates as oncolytic agents.

3.
J Biomech ; 105: 109795, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32423541

RESUMO

The number one cause of disability in the world is low-back pain, with mechanical loading as one of the major risk factors. To reduce mechanical loading, exoskeletons have been introduced in the workplace. Substantial reductions in back muscle activity were found when using the exoskeleton during static bending and manual materials handling. However, most exoskeletons only have one joint at hip level, resulting in loss of range of motion and shifting of the exoskeleton relative to the body. To address these issues, a new exoskeleton design has been developed and tested. The present study investigated the effect of the SPEXOR passive exoskeleton on compression forces, moments, muscle activity and kinematics during static bending at six hand heights and during lifting of a box of 10 kg from around ankle height using three techniques: Free, Squat and Stoop. For static bending, the exoskeleton reduced the compression force by 13-21% depending on bending angle. Another effect of the exoskeleton was that participants substantially reduced lumbar flexion. While lifting, the exoskeleton reduced the peak compression force, on average, by 14%. Lifting technique did not modify the effect of the exoskeleton such that the reduction in compression force was similar. In conclusion, substantial reductions in compression forces were found as a result of the support generated by the exoskeleton and changes in behavior when wearing the exoskeleton. For static bending, lumbar flexion was reduced with the exoskeleton, indicating reduced passive tissue strain. In addition, the reduced peak compression force could reduce the risk of compression induced tissue failure during lifting.

4.
Environ Sci Pollut Res Int ; 27(23): 28607-28622, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32285389

RESUMO

In this article, the geographical location and availability of the most important crop residues generated in Mexico over the last 10 years (2008-2017) were determined. This study estimates the gross number of residues for the four most important cultivars in Mexico named conventional residues (CRs) such as corn, wheat, sorghum, and barley, and estimates were also made for regionally important crops identified as nonconventional residues (NCRs) such as coffee, sugarcane, and beans. The total and sustainable energy potentials (TEP and SEP) for agricultural residues were calculated, in similar way the butanol and electricity production potentials were also calculated if these residues were processed under a nonconventional biorefinery scheme; the calculated availability of crop residues was 59,059,666 t/year, thus demonstrating that Mexico could have great potential for bioenergy production. The estimated TEP was 1,787,241,249 PJ/year, and the SEP was 78,724,689 PJ/year. The production of butanol and its production cost were calculated for the main crop residues; the butanol volume ranged from 7348 to 161,610 t/day, and the volume of crops of regional importance ranged from 6461.9 to 151,389 t/day. The minimum butanol production cost was 2000 t/day of feedstock. The surplus electricity was determined for all crop residues.


Assuntos
Agricultura , Produtos Agrícolas , Biomassa , Butanóis , Eletricidade , México
5.
Nanoscale ; 12(16): 9133-9143, 2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-32293616

RESUMO

Mechanobiology aims to establish functional relationships between the mechanical state of a living a cell and its physiology. The acquisition of force-distance curves with an AFM is by far the dominant method to characterize the nanomechanical properties of living cells. However, theoretical simulations have shown that the contact mechanics models used to determine the Young's modulus from a force-distance curve could be off by a factor 5 from its expected value. The semi-quantitative character arises from the lack of a theory that integrates the AFM data, a realistic viscoelastic model of a cell and its finite-thickness. Here, we develop a method to determine the mechanical response of a cell from a force-distance curve. The method incorporates bottom-effect corrections, a power-law rheology model and the deformation history of the cell. It transforms the experimental data into viscoelastic parameters of the cell as a function of the indentation frequency. The quantitative agreement obtained between the experiments performed on living fibroblast cells and the analytical theory supports the use of force-distance curves to measure the nanorheological properties of cells.

6.
IEEE Trans Neural Syst Rehabil Eng ; 28(5): 1109-1116, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32286990

RESUMO

Serious games and immersive virtual reality promote emotional engagement during learning tasks, mostly by providing (1) skill-adapted challenges with performance feedback (for trial and error learning) and (2) enhanced presence (further reactions to multimodal stimuli), respectively. However, it is still unclear how each of these two strategies independently influence emotional states to engage subjects to a task. This study assessed the dimensions of emotion (valence-arousal-dominance) of 87 healthy subjects in a virtual game, assigned to 2 groups that were exposed to a different set of 5 trials: Group A experienced game variations by virtual factors affecting user's presence, whereas group B experienced levels of difficulty, affecting challenge. Emotional reports and 26 features extracted from physiological signals were statistically analyzed. Results showed that presence-based experimental conditions were able to modify the sense of arousal, whereas valence and dominance responded to challenge variation, i.e. were positively correlated with game score. Arousal is likely to increase with low sense of coexistence (social presence) and decrease with low scenario realism (physical presence). Faster breathing and higher skin conductance (SC) were detected at high challenge, whereas heart rate variability and SC increased with higher arousal. The evidence from this study suggests that both strategies can be used to separately influence dimensions of emotion, pointing out the customization of presence-based factors as a promising method to adjust emotional engagement by impacting arousal. Further research should be undertaken to identify the independent effect of single presence factors on emotional states.

7.
IEEE Trans Neural Syst Rehabil Eng ; 28(1): 221-227, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31765315

RESUMO

This study aimed to investigate: 1) the effect of optic flow speed manipulation on active participation during robot-assisted treadmill walking (RATW), 2) the influence of the type of virtual environment, and 3) the level of motion sickness and enjoyment. Twenty-eight healthy older adults were randomized in two groups: "stimulus rich" Park group (50% male, 61± 6 year) and "stimulus poor" Hallway group (43% male, 62± 5 year). Subjects walked in the Lokomat with immersive virtual reality (VR) with a matched, slow and fast optic flow speed, each lasting 7 minutes. Active participation was measured by continuously assessing the human-machine interaction torques at the hip and knee joints and muscle activity of the Vastus Medialis and Biceps Femoris. Motion sickness and enjoyment were assessed with the Simulator Sickness Questionnaire (SSQ) and Physical Activity Enjoyment Scale (PACES) respectively. In both groups optic flow speed manipulation in both directions led to a decrease in bilateral hip interaction torques towards flexion at the end of the stance phase compared to matched speed. In the Hallway group, walking with slow optic flow elicited 32% more muscle activity of the Vastus Medialis. There were no significant differences between both groups for the SSQ and PACES. Optic flow speed manipulation appears to have only a small effect on the active participation of healthy people during RATW. The type of virtual environment did not affect their activity, motion sickness or enjoyment. However, the addition of immersive VR during RATW was well tolerated and enjoyable. Further research with patients is necessary.

8.
J Cell Physiol ; 235(4): 3320-3328, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31549393

RESUMO

Ovarian cancer is the fifth leading cause of cancer-related deaths. It causes approximately 125,000 deaths per year worldwide; its diagnosis is made in advanced stages resulting in a high mortality rate. The objective of the study was optimizing the isolation of cells obtained from the solid tumor and ascitic fluid of patients with ovarian cancer and the phenotype with markers related to the epithelial-mesenchymal transition. For this, the solid tumor tissue was disaggregated and cultivated with different methodologies. As a result, cell growth was obtained and epi-immunofluorescence was performed using antibodies against E-cadherin, EpCAM, N-cadherin, vimentin, CD133, and CD44. The primary culture from the solid tumor was obtained using Dispase II and DMEM/F12. Finally, heterogeneity was detected in terms of the expression of mesenchymal and epithelial type markers in the two types of isolated cells. Additionally, CD133 and CD44 expression was detected, proteins associated with the tumor stem cells phenotype.

9.
Org Lett ; 21(22): 9198-9202, 2019 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-31647672

RESUMO

This communication highlights the use of chiral sulfinamides as nitrogen nucleophiles in intermolecular aza-Michael reactions. When chiral sulfinamides are coupled to a chloroethyl group, the corresponding novel annulating reagents can be used to streamline the stereoselective synthesis of complex pyrrolidine-containing molecules. As a result, it has enabled a medicinal chemistry campaign for the synthesis of biologically active RORγt inverse agonists.

10.
Ann Transplant ; 24: 584-587, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31636248

RESUMO

BACKGROUND High-dose chemotherapy followed by autologous hematopoietic stem cell transplant has proven useful in relapsed or refractory cases of Hodgkin and non-Hodgkin lymphoma. BEAM (carmustine, etoposide, cytarabine, melphalan) is frequently used as a conditioning regimen; however, the high cost and limited availability of BCNU hinders its use in Mexico. MATERIAL AND METHODS Between January 2013 and February 2019, refractory or relapsing HL and NHL patients were treated with an autologous HSCT conditioned with cisplatin+dexamethasone as substitution for BCNU in BEAM. RESULTS Four HL patients and 6 NHL patients were included; 60% were male, the average age was 34.5±15.2 years, the median follow-up was 19.1 months, and 70% had a complete response after transplant. OS at 12 months was 63% for NHL and 100% for HL. Time to hematological recovery was 17.6±2.8 days; all patients developed grade III/IV neutropenia and thrombocytopenia, and 8 patients had transplant-related infections. CONCLUSIONS This retrospective study based on real-world data introduces the option of substituting carmustine with cisplatin+dexamethasone, with a similar response, expected lower cost, and better accessibility in developing nations.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Transplante de Células-Tronco Hematopoéticas , Doença de Hodgkin/terapia , Linfoma não Hodgkin/terapia , Condicionamento Pré-Transplante/métodos , Adulto , Carmustina/administração & dosagem , Cisplatino/administração & dosagem , Terapia Combinada , Citarabina/administração & dosagem , Dexametasona/administração & dosagem , Feminino , Humanos , Masculino , Melfalan/administração & dosagem , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/terapia , Projetos Piloto , Podofilotoxina/administração & dosagem , Estudos Retrospectivos , Transplante Autólogo , Adulto Jovem
11.
Rev. colomb. cardiol ; 26(5): 256-263, sep.-oct. 2019. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1092935

RESUMO

Resumen Introducción: el ultrasonido cardiaco enfocado ha sido propuesto como una aproximación útil para mejorar la toma de decisiones clínicas, permitiendo identificar rápidamente signos ultrasonográficos de una lista específica de diagnósticos potenciales. Objetivo: evaluar un programa de entrenamiento para médicos sin experiencia en ecocardiografía a fin de realizar ultrasonido cardiaco enfocado por medio de un dispositivo portátil (ecoscopio). Materiales y métodos: se compararon los resultados obtenidos mediante ecoscopia realizada por los médicos que recibieron el entrenamiento, con los obtenidos mediante ecocardiografía convencional realizada por cardiólogos expertos. Métodos: un total de 5 médicos no cardiólogos incluyendo un estudiante de Medicina de último año, 2 residentes de Medicina Interna y 2 Intensivistas participaron en un curso de entrenamiento de cuatro semanas, dirigido por un Cardiólogo experto de nivel III así: Primera semana: teoría y bases de ecocardiografía (3 horas diarias) Segunda semana: teoría de la adquisición de imágenes. Hallazgos normales y anormales (50 estudios). Tercera semana: manejo del ecoscopio (50 estudios). Cuarta semana: recolección de datos. Se incluyeron pacientes programados para ecocardiografía convencional en el Laboratorio de métodos no invasivos. A cada paciente se le realizaron dos exámenes. El primero consistió en una ecoscopia hecha por médico que recibió el entrenamiento y el segundo consistió en un ecocardiograma realizado por un cardiólogo experto. Los parámetros ecocardiográficos evaluados fueron: fracción de eyección del ventrículo izquierdo, disfunción ventricular derecha, crecimiento auricular izquierdo, hipertensión pulmonar, enfermedad valvular cardiaca y derrame pericárdico. Por medio de análisis de concordancia (índice Kappa) se compararon los resultados encontrados en ecoscopia versus ecocardiografía. Resultados: de 221 estudios se obtuvo concordancia moderada en fracción de eyección del ventrículo izquierdo (к =0,541, p<0,000), función ventricular derecha (к =0,403, p<0,001), dilatación de la aurícula izquierda (к =0,413, p<0,001), valvulopatía mitral (к =0,466, p<0,001) y tricuspídea (к =0,437, p<0,001). La valvulopatía aórtica mostró un acuerdo débil. El derrame pericárdico y la hipertensión pulmonar tuvieron concordancia pobre y débil, respectivamente. Conclusiones: con un tiempo limitado de formación, los participantes sin experiencia previa en técnicas de ultrasonido y utilizando ecoscopia, alcanzaron un acuerdo moderado en la mayoría de las mediciones cuando se comparó con ecocardiografía convencional practicada por ecocardiografistas expertos. Es necesario un estudio con mayor número de participantes que determine el tiempo de formación ideal para obtener resultados comparables con ecocardiografía.


Abstract Introduction: Focused cardiac ultrasound has been proposed as a useful approach for improving clinical decision making, as well as to be able to rapidly identify the ultrasound signs of a specific list of potential diagnoses. Objective: To evaluate a training program for physicians with no experience in cardiac ultrasound with the aim performing focused cardiac ultrasound using a portable device (echoscopy). Materials and methods: The results obtained from echoscopy performed by the physicians that received training were compared with those obtained with conventional cardiac ultrasound carried out by expert cardiologists. A total of 5 non-cardiologist doctors, including 1 medical student, 2 Internal Medicine residents, and 2 from Intensive Medicine, took part in a four-week training course given by a Level III Cardiology specialist. The course included: First week: Theory and basis of cardiac ultrasound (3 hours daily) Second week: Theory of acquiring images. Normal and abnormal findings (50 studies). Third week: handling of the echoscope (50 studies). Fourth week: Data collection. The study included patients scheduled for conventional cardiac ultrasound in the Non-Invasive Methods Laboratory. Two examinations were carried out on each patient. The first consisted of an echoscopy performed by a doctor that had received the training, and the second consisted of a cardiac ultrasound carried out by an expert cardiologist. The ultrasound parameters evaluated were: left ventricular ejection fraction, right ventricular dysfunction, left atrial enlargement, pulmonary hypertension, cardiac valve disease, and pericardial effusion. The results found in echoscopy versus cardiac ultrasound were compared using concordance analysis (Kappa Index). Results: The following results were obtained on the 221 studies performed: moderate agreement in left ventricular ejection fraction (к =0.541, P<.000), right ventricular function (к =0.403, P<.001), left atrial enlargement (к =0.413, P<.001), mitral valve and tricuspid valve disease (к =0.437, P<.001 and (к =0.466, P<.001, respectively). There was weak agreement with aortic valve disease. Pericardiac effusion and the presence of pulmonary hypertension had a poor and week agreement, respectively. Conclusions: With a limited training period, the participants with no previous experience in ultrasound techniques and using echoscopy achieved a moderate agreement in the majority of measurements when compared with conventional cardiac ultrasound performed by experts in the technique. A study with a larger number of participants is required in order to determine the ideal training period to obtain results comparable with cardiac ultrasound.

12.
Rev. esp. med. legal ; 45(3): 98-107, jul.-sept. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-188610

RESUMO

Introducción: En este artículo se analizan los datos del equipo técnico (psicólogo, trabajador social y educador) del juzgado de menores de Toledo (España) desde el año 2001 a 2012. Metodología: Estudio descriptivo de la serie anual de una muestra de 3.333 menores infractores y de sus características psicosociales, educativas y delictivas. Resultados: En los últimos años de la serie se tiende a infracciones de mayor gravedad cometidas por chicos de mayor edad. Conclusiones: La delincuencia de menores en esta provincia desde el año 2001 se mantuvo constante hasta el año 2009, en el que se observa un destacado repunte para volver a bajar durante los años 2011 y 2012. Sin embargo, en los últimos años de la serie (a partir de 2008) se constata un aumento de la gravedad de los hechos, al ser significativamente más numerosos los delitos que las faltas. También se ha detectado que probablemente el sistema infradiagnostica a los menores infractores, tanto en problemas de salud mental como en consumo de alcohol y otras drogas. Por lo tanto, estos menores no se beneficiarían adecuadamente de las medidas impuestas por el sistema de justicia juvenil


Introduction: This paper presents an analysis of the data of the technical team (psychologist, social worker and educator) of the juvenile court of Toledo (Spain) from 2001 to 2012. Methodology: Descriptive study of the annual series of a sample of 3,333 juvenile offenders and their psychosocial, educational and criminal characteristics. Results: In the latter years of the series there tends to be infractions of greater gravity committed by older boys. Conclusions: Juvenile delinquency in the province of Toledo remained constant from 2001 until 2009, when a sharp increase was observed, which lowered again during the years 2011 and 2012. However, in the latter years of the series (starting 2008) an increase in the gravity of the acts is noted, with the number of crimes increasing more significantly than the misdemeanours. The team has also detected that perhaps institutions underestimate the diagnosis of the juvenile misdemeanours, even in mental health issues, such as abuse of alcohol and other substances. Therefore, these minors may not achieve the benefits of the justice youth system


Assuntos
Humanos , Masculino , Feminino , Adolescente , Delinquência Juvenil/estatística & dados numéricos , Impacto Psicossocial , Crime/classificação , Crime/estatística & dados numéricos , Espanha/epidemiologia , Fatores Socioeconômicos
13.
ACS Nano ; 13(8): 9629-9637, 2019 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-31356042

RESUMO

The development of high-resolution, label-free, noninvasive, and subsurface microscopy methods of living cells remains a formidable problem. Force-microscopy-based stiffness measurements contribute to our understanding of single-cell nanomechanics. The elastic properties of the cell's outer structures, such as the plasma membrane and actin cytoskeleton, dominate stiffness measurements, which in turns prevents the imaging of intracellular structures. We propose that the above limitation could be overcome by combining 2D sections of the cell's viscoelastic properties. We show the simultaneous imaging of the outer cell's cytoskeleton and the organelles inside the nucleus. The elastic component of interaction force carries information on the cell's outer elements as the cortex and the actin cytoskeleton. The inelastic component is sensitive to the hydrodynamic drag of the inner structures such the nucleoli.

14.
Nutrients ; 11(7)2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31319484

RESUMO

This study analyzes an oral supplement of molecular iodine (I2), alone and in combination with the neoadjuvant therapy 5-fluorouracil/epirubicin/cyclophosphamide or taxotere/epirubicin (FEC/TE) in women with Early (stage II) and Advanced (stage III) breast cancer. In the Early group, 30 women were treated with I2 (5 mg/day) or placebo (colored water) for 7-35 days before surgery. For the Advanced group, 30 patients received I2 or placebo, along with FEC/TE treatment. After surgery, all patients received FEC/TE + I2 for 170 days. I2 supplementation showed a significant attenuation of the side effects and an absence of tumor chemoresistance. The control, I2, FEC/TE, and FEC/TE + I2 groups exhibited response rates of 0, 33%, 73%, and 100%, respectively, and a pathologic complete response of 18%, and 36% in the last two groups. Five-year disease-free survival rate was significantly higher in patients treated with the I2 supplement before and after surgery compared to those receiving the supplement only after surgery (82% versus 46%). I2-treated tumors exhibit less invasive potential, and significant increases in apoptosis, estrogen receptor expression, and immune cell infiltration. Transcriptomic analysis indicated activation of the antitumoral immune response. The results led us to register a phase III clinical trial to analyze chemotherapy + I2 treatment for advanced breast cancer.


Assuntos
Antineoplásicos/administração & dosagem , Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Iodo/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/cirurgia , Intervalo Livre de Doença , Feminino , Humanos , Pessoa de Meia-Idade , Terapia Neoadjuvante , Projetos Piloto , Oligoelementos/administração & dosagem
15.
16.
Hematology ; 24(1): 399-404, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30890036

RESUMO

BACKGROUND: Pancytopenia is a frequent entity in clinical practice as a feature of a myriad of conditions, ranging from benign to malignant diseases. Since the cause of pancytopenia depends on environmental factors, it is important to know the common etiologies of pancytopenia, however, few studies address this. OBJECTIVES: To identify the etiology of pancytopenia in our population and compare them with what is reported elsewhere. METHODS: We conducted an observational study of patients with pancytopenia in a Mexican Tertiary Care Center. Clinical, hematological and bone marrow studies were performed in all patients. RESULTS: Of 109 cases included, the mean age at diagnosis was 49.4 years, with a slightly higher female incidence (53.2%). The most common causes of pancytopenia were: MDS (20.2%), megaloblastic anemia (18.3%) and AML (12.8%). DISCUSSION: We found a complex picture of pancytopenia in Mexico and compared it with what is reported elsewhere in the literature. CONCLUSION: The sociocultural context in which the patients develop helps narrowing the possible etiology of pancytopenia, and therefore hasten the diagnostic process. Of all the studies available, bone marrow aspiration seems the most useful.


Assuntos
Pancitopenia , Adolescente , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Pancitopenia/sangue , Pancitopenia/epidemiologia , Pancitopenia/etiologia , Fatores Sexuais , Centros de Atenção Terciária
17.
Pain Rep ; 4(1): e692, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30801041

RESUMO

Introduction: Chronic pain (CP) is highly prevalent and generally undertreated health condition. Noninvasive brain stimulation may contribute to decrease pain intensity and influence other aspects related to CP. Objective: To provide consensus-based recommendations for the use of noninvasive brain stimulation in clinical practice. Methods: Systematic review of the literature searching for randomized clinical trials followed by consensus panel. Recommendations also involved a cost-estimation study. Results: The systematic review wielded 24 transcranial direct current stimulation (tDCS) and 22 repetitive transcranial magnetic stimulation (rTMS) studies. The following recommendations were provided: (1) Level A for anodal tDCS over the primary motor cortex (M1) in fibromyalgia, and level B for peripheral neuropathic pain, abdominal pain, and migraine; bifrontal (F3/F4) tDCS and M1 high-definition (HD)-tDCS for fibromyalgia; Oz/Cz tDCS for migraine and for secondary benefits such as improvement in quality of life, decrease in anxiety, and increase in pressure pain threshold; (2) level A recommendation for high-frequency (HF) rTMS over M1 for fibromyalgia and neuropathic pain, and level B for myofascial or musculoskeletal pain, complex regional pain syndrome, and migraine; (3) level A recommendation against the use of anodal M1 tDCS for low back pain; and (4) level B recommendation against the use of HF rTMS over the left dorsolateral prefrontal cortex in the control of pain. Conclusion: Transcranial DCS and rTMS are recommended techniques to be used in the control of CP conditions, with low to moderate analgesic effects, and no severe adverse events. These recommendations are based on a systematic review of the literature and a consensus made by experts in the field. Readers should use it as part of the resources available to decision-making.

18.
Biomaterials ; 192: 461-474, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30502723

RESUMO

Neural diseases at the central nervous system including spinal cord injury (SCI) remain therapeutic challenges. Graphene materials are being delineated as alternative tools for neural repair. Herein, the regenerative ability of reduced graphene oxide (rGO) scaffolds to support pivotal features of neural repair at 4 months after SCI is assessed by an interdisciplinary approach. 3D randomly porous foams have been prepared in mechanical compliance with neural cells and tissues (Young's modulus of 1.3 ±â€¯1.0 kPa) as demonstrated by atomic force microscopy techniques applied ex vivo. After implantation, the significant increase in Young's modulus caused by massive cell/protein infiltration does not alter the mechanical performance of the contralateral spinal cord but provides mechanical stability to the lesion. These aerogels appear fully vascularized and populated with neurites, some of them being myelinated excitatory axons. Clinically-inspired magnetic resonance imaging studies demonstrate that the scaffolds significantly reduce perilesional damage with respect to rats without implants and cause no compressive damage in the contralateral hemicord and rostral/caudal regions. The rGO implants do not either alter the rat spontaneous behaviour or induce toxicity in major organs. Finally, preliminary data suggest hints of rGO sheets dissociation and eventual degradation at the injured spinal cord for the first time. In summary, these 3D porous rGO scaffolds are able to induce, without any further biological functionalization, a compilation of positive effects that have been rarely described before, if ever, for any other material implanted in the injured spinal cord.


Assuntos
Materiais Biocompatíveis/uso terapêutico , Grafite/uso terapêutico , Regeneração Nervosa , Traumatismos da Medula Espinal/terapia , Animais , Axônios/patologia , Materiais Biocompatíveis/química , Grafite/química , Masculino , Neovascularização Fisiológica , Ratos , Ratos Wistar , Traumatismos da Medula Espinal/patologia , Traumatismos da Medula Espinal/fisiopatologia , Tecidos Suporte/química
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