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1.
Transl Med Commun ; 6(1): 25, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34746417

RESUMO

Background: The novel SARS-CoV-2 has caused the coronavirus disease 2019 (COVID-19) pandemic. Currently, with insufficient worldwide vaccination rates, identifying treatment solutions to reduce the impact of the virus is urgently needed. Method: An adaptive, multicentric, open-label, and randomized controlled phase I/II clinical trial entitled the "SENTAD-COVID Study" was conducted by the Abu Dhabi Stem Cells Center under exceptional conditional approval by the Emirates Institutional Review Board (IRB) for COVID-19 Research Committee from April 4th to July 31st, 2020, using an autologous peripheral blood non-hematopoietic enriched stem cell cocktail (PB-NHESC-C) administered by compressor (jet) nebulization as a complement to standard care therapy. The primary endpoints include safety and efficacy assessments, adverse events, the mortality rate within 28 days, and the time to clinical improvement as measured by a 2-point reduction on a seven-category ordinal scale or discharge from the hospital whichever occurred first. Results: The study included a total of 139 randomized COVID-19 patients, with 69 in the experimental group and 70 in the control group (standard care). Overall survival was 94.20% for the cocktail-treated group vs. 90.27% for the control group. Adverse events were reported in 50 (72.46%) patients receiving PB-NHESC-C and 51 (72.85%) in the control group (p = 0.9590), with signs and symptoms commonly found in COVID-19. After the first 9 days of the intervention, 67.3% of cocktail-treated patients recovered and were released from hospitals compared to 53.1% (RR = 0.84; 95% CI, 0.56-1.28) in the control group. Improvement, i.e., at least a 2-point reduction in the severity scale, was more frequently observed in cocktail-treated patients (42.0%) than in controls (17.0%) (RR = 0.69; 95% CI, 0.56-0.88). Conclusions: Cocktail treatment improved clinical outcomes without increasing adverse events. Thus, the nebulization of PB-NHESC-C was safe and effective for treatment in most of these patients. Trial registration: ClinicalTrials.gov. NCT04473170. It was retrospectively registered on July 16th, 2020.

2.
Wellcome Open Res ; 6: 202, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34746442

RESUMO

Background: Interventions delivered in schools have been found to be effective in improving knowledge of antibiotics and antimicrobial resistance (AMR) among school-aged children, particularly those in high-income countries, but the evidence is largely lacking in low- and middle-income countries. This study aimed to design, implement and assess storytelling and picture drawing as engagement approaches for improving knowledge, attitudes and beliefs about antibiotics and AMR among schoolchildren in Ghana. Methods: Two schools with a total population of 375 schoolchildren ages 11-15 years in Tema, a city in Ghana, participated in public engagement interventions involving storytelling in one school and picture drawing in another school. The interventions included eight weeks of engagement led by science teachers and a competition held in each school. For quantitative outcome-based evaluation, some schoolchildren were randomly sampled in each school. Purposive sampling was also used to select some schoolchildren in each school for qualitative outcome-based evaluation. Respondents completed identical knowledge, attitudes and beliefs questionnaires and were interviewed at two time points (before and at most a week) after key interventions to assess changes in antibiotics and AMR knowledge, attitudes and beliefs. Results: Picture drawing had more significant effects (both positive and negative) on schoolchildren's AMR knowledge, attitudes and beliefs, whereas storytelling had a negative effect on children's AMR knowledge and no significant impact on beliefs and attitudes. Conclusions: Our project's findings suggest that public engagement interventions that use picture drawing and storytelling may influence the knowledge, attitudes and beliefs of schoolchildren regarding antibiotic misuse and AMR. However, modifications are required to make them more effective. These include making the storytelling effective by turning it into drama or plays.

3.
Haemophilia ; 2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34708896

RESUMO

INTRODUCTION: In several countries, molecular diagnosis of haemophilia A (HA) and B (HB) is hampered by a lack of resources for DNA analysis. The advent of next-generation sequencing (NGS) has enabled gene analysis at a reasonable cost. AIM: Describe a collaboration between Cuban and Spanish researchers to identify candidate variants and investigate the molecular epidemiology of 106 Cuban haemophilia patients using NGS. PATIENTS/METHODS: The molecular analysis protocol included well-established LR-PCR procedures to detect F8 inversions, NGS with a 30-gene panel to sequence F8 and F9, and multiplex ligation-dependent probe amplification to identify large structural variants. RESULTS: One-hundred and thirty-one candidate variants were identified along F8, F9, and VWF; 72 were unique and 28 (39%) had not been previously recorded. Putative variants were identified in 105/106 patients. Molecular characterization enabled confirmation and reclassification of: 90 HA (85%), 15 HB (14%), and one type 2N VWD (1%). Null variants leading to non-production of FVIII or FIX were common in severe HA (64%), moderate HA (74%), and severe HB (60%), whereas missense variants were frequent in mild HA (57%) and moderate or mild HB (83%). Additional variants in VWF were identified in 16 patients. CONCLUSION: This is the first description of the molecular epidemiology of HA and HB in Cuba. Variants identified in index cases will be of value for local implementation of familial studies and prenatal diagnosis using the molecular approaches available in Cuba. The results of this protocolled genetic study improved the accuracy of the clinical diagnosis and will facilitate management of these patients.

4.
Res Social Adm Pharm ; 2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34362688

RESUMO

As several low- and middle-income countries roll out their COVID-19 vaccination programmes, COVID-19 vaccines hesitancy could threaten the success of such programmes. But pharmacists can play a leading role in addressing COVID-19 vaccine hesitancy by using a critical mobile phone-based technology. This technology, known as caller tunes or ringback tones, is flourishing in low- and middle-income countries such as those in Africa and Asia where it is used to promote popular songs and religious messages. With this technology, callers to mobile phones hear a message or a song instead of the typical ringing sound. There is a need for pharmacists associations to collaborate with the creative arts industry and telecommunication companies to have caller tunes on COVID-19 vaccines. As pharmacists and others download COVID-19 vaccine caller tunes onto their mobile phones, their callers will hear COVID-19 vaccines messages or songs. This could help combat disinformation and hesitancy, and promote widespread vaccination as availability increases.

5.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-20236877

RESUMO

BackgroundThe COVID-19 pandemic presented an unprecedented challenge to identify effective drugs for prevention and treatment. ObjectiveTo characterize acute renal injury (AKI) in patients with COVID-19 and their relation with clinical outcomes within the framework of the SENTAD COVID clinical trial at the Abu Dhabi Stem Cells Center. MethodsAbu Dhabi Stem Cell Center (ADSCC) proposed a prospective clinical trial nebulization treatment with autologous stem cells (Non-Hematopoietic Peripheral Blood Stem Cells (NHPBSC)), at Abu Dhabi hospitals. Participants20 treated patients were compared with 23 not treated patients. Both groups received COVID 19 standard treatment. OutcomesAfter the results were collected, this study was created to determine the impact of the disease on the renal function and the efficacy of the therapy on patients outcomes. ResultsOne third of the critical patients studied suffered kidney failure. Patients in the treated group showed a favorable tendency to improve in contrast to those in the control group. Less patients from group A suffered from sepsis in comparison with the group B (25% vs 65%), HR=0.38, (95% Confidence Interval: 0.16 - 0.86), *p=0.0212. These results suggested a NNT=2.5. An improvement in lymphocyte count, CRP, and shorter hospital stay after treatment was evidenced, which led to less superinfection and sepsis in the treated group. ConclusionsThe proposed anti-inflammatory effect of the stem cells, offers a great promise for managing the illness, emerging as a crucial adjuvant tool in promoting healing and early recovery in severe COVID-19 infections and other supportive treatments. ARTICLE SUMMARYOur study had several strengths and limitation: O_LIIt was a randomized trial. C_LIO_LIThe treatment showed a positive result, providing evidence that this intervention is effective in routine practice. C_LIO_LIWe found fewer complications related to prolonged hospital stay in the treated group. C_LIO_LIThe is the small number of participants. C_LIO_LIIt was carried out in 4 different hospitals, each with different criteria for the selection of the initial empirical antimicrobials, which can cause multiple resistant germs. C_LI

6.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-20244483

RESUMO

BackgroundCOVID-19 is the defining global crisis of our time. Secondary complication such as urinary tract infections and sepsis, worsen the already established problem, creating a new challenge. ObjectiveTo characterize the features and outcomes in COVID-19 patients with sepsis and urinary tract infection. MethodsAn observational and analytical study was conducted within the framework of the SENTAD COVID clinical trial at the Abu Dhabi Stem Cells Center, were the patients received a nebulization therapy with the use of autologous stem cells (group A). Those patients were compared with a not stem cells treated control arm (group B), and both received the UAE COVID 19 standard management. An analysis of the culture samples, antimicrobial agents and the efficacy of the therapy on patients outcomes was done. ResultsA significant difference between the groups was found in the UTI incidence (p=*0.0206). Patients in group A showed a lower tendency to sepsis in comparison with group B (7% vs 21%), HR=0.35, (95% Confidence Interval: 0.13 - 0.91), p=0.0175. It was calculated a NNT=7.3. Candida albicans was the most frequently agent causing sepsis and UTI. The massive use of broad-spectrum antimicrobials was striking. ConclusionsWe found a protective factor of stem cells against secondary infection in COVID 19 cases, in terms of sepsis and UTI. The suggested immunomodulatory effect of stem cells offers a therapeutic strategy to manage the disease and avoid several complications. Antimicrobial agents can lead to increased opportunistic infections, so a rational approach to these treatments must be considered.

7.
Rev. cuba. hematol. inmunol. hemoter ; 36(2): e1133, abr.-jun. 2020.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1149903

RESUMO

La terapia celular basada en células mesenquimales/estromales se aplica ampliamente en la medicina moderna, aun cuando no todos los mecanismos de supervivencia y diferenciación están identificados. Sin embargo, hace pocos años se comenzaron a encontrar elementos extracelulares que generan nuevos paradigmas. En el presente trabajo se explican las principales características y funciones atribuidas a los exosomas, nanopartículas constituidas por microvesículas secretadas por las células con efecto en la matriz extracelular, y su repercusión como alternativa hacia una medicina regenerativa libre de células. Estas estructuras participan de forma notoria y crucial en la comunicación intercelular, lo que ha supuesto un cambio en el concepto de las funciones y el papel que desempeñan estas vesículas en los organismos vivos, en particular en la restauración de tejidos dañados y la respuesta inflamatoria e inmunológica. Se comentan algunos ejemplos de la repercusión biotecnológica de los exosomas en empresas y el mercado biofarmaceútico(AU)


Mesenchymal/stromal cell ;based therapy is widely applied in modern medicine, even though not all survival and differentiation mechanisms are identified. However, a few years ago, extracellular elements began to be found that generate new paradigms. The present work explains the main characteristics and functions attributed to exosomes, nanoparticles made up of microvesicles secreted by with an effect on the extracellular matrix, and their impact as an alternative towards cell-free regenerative medicine. These structures participate, notoriously and critically, in intercellular communication, which has led to a change in the concept of the functions and role that these vesicles play within living organisms, particularly in the restoration of damaged tissues and the inflammatory and immunological response. Some examples of the exosomes' biotechnological impact on companies and the biopharmaceutical market are discussed(AU)


Assuntos
Humanos , Medicina Regenerativa/métodos , Exossomos/fisiologia , Células-Tronco Mesenquimais/fisiologia
8.
Front Public Health ; 6: 345, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30555812

RESUMO

[This corrects the article DOI: 10.3389/fpubh.2017.00320.].

9.
Front Public Health ; 5: 320, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29234665

RESUMO

Objective: To study the best possible luteinizing hormone (LH) threshold to predict ovulation within the 24, 48, and 72 h. Design: Observational study. Setting: Multicenter collaborative study. Patients: A total of 107 women. Interventions: Women collected daily first morning urine for hormonal assessment and underwent serial ovarian ultrasound. This is a secondary analysis of 283 cycles. Main outcome measures: The sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were estimated for varying ranges of LH thresholds. Receiver operating characteristic curves and cost-benefit ratios were used to estimate the best thresholds to predict ovulation. Results: The best scenario to predict ovulation at random was within 24 h after the first single positive test. The false-positive rate was found to increase as (1) the cycle progressed or (2) two or three consecutive tests were used, or (3) ovulation was predicted within 48 or 72 h. Testing earlier in the cycle increases the predictive value of the test. The ideal thresholds to predict ovulation ranged between 25 and 30 mIU/ml with a PPV (50-60%), NPV (98%), LR+ (20-30), and LR- (0.5). At least, one day with LH ≥25 mIU/ml followed by three negatives (LH <25) occurred before ovulation in 31% of all cycles. When used throughout the cycle and evaluated together, peak-fertility type mucus with a positive LH test ≥25 mIU/ml provides a higher specificity than either mucus or LH testing alone (97-99 vs. 77-95 vs. 91%, respectively). Conclusion: We identified that beginning LH testing earlier in the cycle (day 7) with a threshold of 25-30 mIU/ml may present the best predictive value for ovulation within 24 h. However, prediction by LH testing alone may be affected negatively by several confounding factors so LH testing alone should not be used to define the end of the fertile window. Complementary markers should be further investigated to predict ovulation and identify the fertile window. The use of the peak cervical mucus along with an LH test may provide a higher specificity and predictive value than either of them alone. We recommend that manufacturers disclose their tests' threshold to the public.

10.
Environ Sci Pollut Res Int ; 24(27): 22040-22047, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28791514

RESUMO

Fluoride is an important element for humans. It inhibits initiation and progression of dental caries and stimulates bone formation. However, excessive intake may lead to the appearance of dental and/or skeletal fluorosis and a decrease in intellectual coefficient in child populations. This study evaluates exposure to fluoride in the child population of Chaco province (Argentina) by analysis of drinking water, food and its bioaccessible fraction (quantity of fluoride solubilised by gastrointestinal digestion and available for intestinal absorption) and urine as a biomarker of internal dose. The concentration of fluoride in drinking water varied between 0.050 and 4.6 mg L-1, and 80% of the samples exceeded the WHO drinking-water guideline value (1.5 mg L-1). Fluoride concentrations in food ranged between 0.80 and 3.0 mg kg-1 fresh weight (fw), being lower in bioaccessible fraction (0.43-1.9 mg kg-1, fw). On the basis of the consumption data declared for the young child population, fluoride intake varies between 4.1 and 6.5 mg day-1, greater than the level recommended for this age group. Moreover, in some cases, concentrations of fluoride found in urine (0.62-8.9 mg L-1) exceeded those reported in areas with declared fluorosis. All data obtained show the worrying situation of child population in this area of Argentina.


Assuntos
Água Potável/análise , Exposição Ambiental , Fluoretos/urina , Análise de Alimentos , Água Subterrânea/análise , Adolescente , Argentina , Disponibilidade Biológica , Biomarcadores/urina , Criança , Fluoretos/análise , Humanos , População Rural
11.
Toxicol In Vitro ; 34: 81-87, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26965474

RESUMO

Excessive fluoride intake may be harmful for health, producing dental and skeletal fluorosis, and effects upon neurobehavioral development. Studies in animals have revealed effects upon the gastrointestinal, renal and reproductive systems. Some of the disorders may be a consequence of immune system alterations. In this study, an in vitro evaluation is made of fluoride immunotoxicity using the RAW 264.7 murine macrophage line over a broad range of concentrations (2.5-75mg/L). The results show that the highest fluoride concentrations used (50-75mg/L) reduce the macrophage population in part as a consequence of the generation of reactive oxygen and/or nitrogen species and consequent redox imbalance, which in turn is accompanied by lipid peroxidation. A decrease in the expression of the antiinflammatory cytokine Il10 is observed from the lowest concentrations (5mg/L). High concentrations (50mg/L) in turn produce a significant increase in the proinflammatory cytokines Il6 and Mip2 from 4h of exposure. In addition, cell phagocytic capacity is seen to decrease at concentrations of ≥20mg/L. These data indicate that fluoride, at high concentrations, may affect macrophages and thus immune system function - particularly with regard to the inflammation autoregulatory processes, in which macrophages play a key role.


Assuntos
Macrófagos/efeitos dos fármacos , Fluoreto de Sódio/toxicidade , Animais , Peroxidação de Lipídeos/efeitos dos fármacos , Lipopolissacarídeos , Macrófagos/metabolismo , Macrófagos/fisiologia , Camundongos , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Fagocitose/efeitos dos fármacos , Células RAW 264.7 , Espécies Reativas de Nitrogênio/metabolismo , Espécies Reativas de Oxigênio/metabolismo
13.
NPJ Prim Care Respir Med ; 24: 14016, 2014 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-24965834

RESUMO

BACKGROUND: Nebulisers aid the treatment of respiratory diseases, including asthma, but they require electricity and are often cost-prohibitive for low- and middle-income countries. AIMS: The aim of this study was to compare a low-cost, human-powered nebuliser compressor with an electric nebuliser compressor for the treatment of mild to moderate asthma exacerbations in adults and children. METHODS: This was a non-blinded, parallel-group, equivalence study, with 110 subjects between 6 and 65 years of age, conducted in the emergency department of a district hospital in Ilopango, El Salvador. Participants were assigned by random allocation to receive a 2.5-mg dose of salbutamol from the experimental human-powered nebuliser or the electric nebuliser control. All assigned participants completed treatment and were included in analysis. The study was not blinded as this was clinically unfeasible; however, data analysis was blinded. RESULTS: The mean improvement in peak flow of the experimental and control groups was 37.5 (95% confidence interval (CI) 26.7-48.2) l/min and 38.7 (95% CI, 26.1-51.3) l/min, respectively, with a mean difference of 1.3 (95% CI, -15.1 to 17.7) l/min. The mean improvement in percent-expected peak flow for the experimental and control groups was 12.3% (95% CI, 9.1-15.5%) and 13.8% (95% CI, 9.8-17.9%), respectively, with a mean difference of 1.5% (95% CI, -3.6 to 6.6%). CONCLUSIONS: The human-powered nebuliser compressor is equivalent to a standard nebuliser compressor for the treatment of mild-to-moderate asthma. (Funded by the Opus Dean's Fund, Marquette University College of Engineering; ClinicalTrials.gov NCT01795742.).


Assuntos
Antiasmáticos/administração & dosagem , Asma/tratamento farmacológico , Nebulizadores e Vaporizadores , Administração por Inalação , Adolescente , Adulto , Idoso , Albuterol/administração & dosagem , Albuterol/uso terapêutico , Antiasmáticos/uso terapêutico , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nebulizadores e Vaporizadores/estatística & dados numéricos , Resultado do Tratamento , Adulto Jovem
14.
Rev. cuba. hematol. inmunol. hemoter ; 30(1): 4-10, ene.-mar. 2014.
Artigo em Espanhol | LILACS | ID: lil-705658

RESUMO

Durante los últimos 45 años, el trasplante alogénico de células progenitoras hematopoyéticas ha sido una modalidad de tratamiento cada vez más utilizada en la curación de hemopatías malignas y otras enfermedades genéticas como la drepanocitosis y algunas inmunodeficiencias primarias. Sin embargo, la falta de donantes adecuados, por carecer los pacientes de hermanos que puedan ser histocompatibles, ha hecho necesaria la búsqueda de alternativas en donantes no relacionados para garantizar la eficacia y seguridad del trasplante. Una fuente muy utilizada es la sangre de cordón umbilical (SCU); el primer trasplante con SCU se realizó en 1989 y en los últimos 25 años este tipo de trasplante se ha aplicado ampliamente en los países desarrollados. Los bancos de SCU se han convertido en una reserva de importancia para estos tratamientos y para la terapia celular regenerativa, por sus múltiples ventajas. Contar con un banco público de SCU en Cuba es una necesidad para el desarrollo del Sistema Nacional de Salud que permitiría unir nuestros esfuerzos a la comunidad científica internacional en la lucha por una salud pública mejor para nuestro pueblo y otros pueblos del mundo, en particular para la América Latina


During the last 45 years, alogenic stem cell transplant has been an every day most used form of treatment for the cure of malignant hemopathies and other genetic disorders such as sickle cell disease and some primary immunodeficiencies. Nevertheless, the lack of adequate donors caused by not having the patients possible histocompatible relatives has made it necessary to look for alternatives in non relateddonors to guarantee the efficacy and security of the transplant. A commonly used source is cord blood (CB); the first transplant was made in 1989 and in the last 25 years it has been widely applied in developed countries. CB banks have become an important reserve for these treatments and for regenerative cell therapy, due to their multiple advantages. Having a public CB bank in Cuba is a need for the development of our National Health System which will allow us to join our efforts with the international scientific community in the struggle for a better health care for our people and other countries of the world, particularly Latin America


Assuntos
Humanos , Bancos de Sangue/métodos , Transplante de Células-Tronco de Sangue do Cordão Umbilical/métodos
15.
Rev. cuba. hematol. inmunol. hemoter ; 30(1): 4-10, ene.-mar. 2014. tab
Artigo em Espanhol | CUMED | ID: cum-56350

RESUMO

Durante los últimos 45 años, el trasplante alogénico de células progenitoras hematopoyéticas ha sido una modalidad de tratamiento cada vez más utilizada en la curación de hemopatías malignas y otras enfermedades genéticas como la drepanocitosis y algunas inmunodeficiencias primarias. Sin embargo, la falta de donantes adecuados, por carecer los pacientes de hermanos que puedan ser histocompatibles, ha hecho necesaria la búsqueda de alternativas en donantes no relacionados para garantizar la eficacia y seguridad del trasplante. Una fuente muy utilizada es la sangre de cordón umbilical (SCU); el primer trasplante con SCU se realizó en 1989 y en los últimos 25 años este tipo de trasplante se ha aplicado ampliamente en los países desarrollados. Los bancos de SCU se han convertido en una reserva de importancia para estos tratamientos y para la terapia celular regenerativa, por sus múltiples ventajas. Contar con un banco público de SCU en Cuba es una necesidad para el desarrollo del Sistema Nacional de Salud que permitiría unir nuestros esfuerzos a la comunidad científica internacional en la lucha por una salud pública mejor para nuestro pueblo y otros pueblos del mundo, en particular para la América Latina(AU)


During the last 45 years, alogenic stem cell transplant has been an every day most used form of treatment for the cure of malignant hemopathies and other genetic disorders such as sickle cell disease and some primary immunodeficiencies. Nevertheless, the lack of adequate donors caused by not having the patients possible histocompatible relatives has made it necessary to look for alternatives in non relateddonors to guarantee the efficacy and security of the transplant. A commonly used source is cord blood (CB); the first transplant was made in 1989 and in the last 25 years it has been widely applied in developed countries. CB banks have become an important reserve for these treatments and for regenerative cell therapy, due to their multiple advantages. Having a public CB bank in Cuba is a need for the development of our National Health System which will allow us to join our efforts with the international scientific community in the struggle for a better health care for our people and other countries of the world, particularly Latin America(AU)


Assuntos
Humanos , Transplante de Células-Tronco de Sangue do Cordão Umbilical/métodos , Bancos de Sangue/métodos
16.
Br J Ophthalmol ; 97(5): 637-43, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23435191

RESUMO

PURPOSE: To retrospectively report a 12-month follow up for combined therapy with systemic cyclosporine A (CSA) and mycophenolate mofetil (MM) in treatment of patients with birdshot retinochoroidopathy (BSRC). PARTICIPANTS: Ninety-eight eyes of patients who received CSA and MM for the treatment of BSRC were included in the study. METHODS: All patients were followed for at least five visits during the study, or until treatment failure, or loss of follow-up. Clinical data were analysed using a Student paired t-test, Wilcoxon signed-rank test, McNemar's test, and Kaplan -Meier survival curve. Side effects related to therapy were also recorded. Main outcome measures included best-corrected logarithm of the minimum angle of resolution visual acuity, vitreous inflammation, fluorescein angiography pathologic features, and electroretinogram recordings. RESULTS: Vitreous inflammation scores at baseline and at 1 year were statistically significantly reduced in both eyes (p<0.001; p=0.001). The presence of angiographic leakage at the 1-year follow-up was significantly reduced (p=0.004). However, the presence of cystoid macular oedema (p=0.32) and comparison of electroretinogram 30-Hz amplitude revealed no significant reduction between baseline and 1-year values for either eye (p=0.61, p=0.87); nonetheless, 30-Hz implicit times were statistically significantly shorter at the end of follow-up for both eyes (p<0.001, p=0.035). Thirty-one patients (67.4%) achieved inflammation control at the 1-year endpoint. Side effects were transient, and resolved after lowering or withholding IMT for a few weeks in the majority of patients. CONCLUSIONS: These results suggest that combined IMT with CSA and MM for BSRC is well tolerated and associated with long-term control of inflammation.


Assuntos
Coriorretinite/tratamento farmacológico , Ciclosporina/uso terapêutico , Imunossupressores/uso terapêutico , Ácido Micofenólico/análogos & derivados , Adulto , Idoso , Coriorretinopatia de Birdshot , Coriorretinite/diagnóstico , Coriorretinite/fisiopatologia , Ciclosporina/efeitos adversos , Quimioterapia Combinada , Eletrorretinografia , Feminino , Angiofluoresceinografia , Seguimentos , Humanos , Imunossupressores/efeitos adversos , Masculino , Pessoa de Meia-Idade , Ácido Micofenólico/efeitos adversos , Ácido Micofenólico/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual/fisiologia
17.
Santiago de Chile; s.n; 2013. 127 p. tab.
Tese em Espanhol | LILACS, MOSAICO - Saúde integrativa | ID: biblio-947875

RESUMO

El presente estudio es una investigación que responde al paradigma interpretativo, de tipo exploratorio y metodología cualitativa, desde el enfoque fenomenológico. Esta investigación fue realizada en Santiago de Chile el año 2013 en un centro de acupuntura ubicado en la comuna de Independencia. Se realizaron siete entrevistas semi estructuradas a personas en terapia de acupuntura, obteniéndose las siguientes conclusiones: La acupuntura posee buena aceptación por parte de los usuarios, generando una opinión positiva hacia el uso de esta de terapia, debido a que se obtiene en la mayoría de los casos una resolución al problema de salud por el cual consultaron. Siendo considerada como un complemento o una alternativa, confiable y resolutiva de las patologías que presentan los entrevistados, a la medicina convencional.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Atitude Frente a Saúde , Acupuntura , Terapias Complementares , Chile
18.
Womens Health Issues ; 20(2): 139-45, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20211430

RESUMO

BACKGROUND: Breast cancer incidence and mortality have been increasing among American Indian and Alaska Native (AI/AN) women, and their survival rate is the lowest of all racial/ethnic groups. Nevertheless, knowledge of AI/AN women's breast cancer screening practices and their correlates is limited. METHODS: Using the 2003 California Health Interview Survey, we 1) compared the breast cancer screening practices of AI/AN women to other groups and 2) explored the association of several factors known or thought to influence AI/AN women's breast cancer screening practices. FINDINGS: Compared with other races, AI/AN women had the lowest rate of mammogram screening (ever and within the past 2 years). For clinical breast examination receipt, Asian women had the lowest rate, followed by AI/AN women. Factors associated with AI/AN women's breast cancer screening practices included older age, having a high school diploma or some college education, receipt of a Pap test within the past 3 years, and having visited a doctor within the past year. CONCLUSION: Significant differences in breast cancer screening practices were noted between races, with AI/AN women often having significantly lower rates. Integrating these epidemiologic findings into effective policy and practice requires additional applied research initiatives.


Assuntos
Atitude Frente a Saúde/etnologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/etnologia , Índios Norte-Americanos/estatística & dados numéricos , Inuítes/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Adulto , Idoso , California/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Humanos , Incidência , Mamografia , Pessoa de Meia-Idade , Fatores Socioeconômicos , Saúde da Mulher/etnologia
19.
Environ Health ; 9: 10, 2010 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-20170520

RESUMO

BACKGROUND: Multiple N-nitroso compounds have been observed in animal studies to be both mutagenic and teratogenic. Human exposure to N-nitroso compounds and their precursors, nitrates and nitrites, can occur through exogenous sources, such as diet, drinking water, occupation, or environmental exposures, and through endogenous exposures resulting from the formation of N-nitroso compounds in the body. Very little information is available on intake of nitrates, nitrites, and nitrosamines and factors related to increased consumption of these compounds. METHODS: Using survey and dietary intake information from control women (with deliveries of live births without major congenital malformations during 1997-2004) who participated in the National Birth Defects Prevention Study (NBDPS), we examined the relation between various maternal characteristics and intake of nitrates, nitrites, and nitrosamines from dietary sources. Estimated intake of these compounds was obtained from the Willet Food Frequency Questionnaire as adapted for the NBDPS. Multinomial logistic regression models were used to estimate odds ratios and 95% confidence intervals for the consumption of these compounds by self-reported race/ethnicity and other maternal characteristics. RESULTS: Median intake per day for nitrates, nitrites, total nitrites (nitrites + 5% nitrates), and nitrosamines was estimated at 40.48 mg, 1.53 mg, 3.69 mg, and 0.472 microg respectively. With the lowest quartile of intake as the referent category and controlling for daily caloric intake, factors predicting intake of these compounds included maternal race/ethnicity, education, body mass index, household income, area of residence, folate intake, and percent of daily calories from dietary fat. Non-Hispanic White participants were less likely to consume nitrates, nitrites, and total nitrites per day, but more likely to consume dietary nitrosamines than other participants that participated in the NBDPS. Primary food sources of these compounds also varied by maternal race/ethnicity. CONCLUSIONS: Results of this study indicate that intake of nitrates, nitrites, and nitrosamines vary considerably by race/ethnicity, education, body mass index, and other characteristics. Further research is needed regarding how consumption of foods high in nitrosamines and N-nitroso precursors might relate to risk of adverse pregnancy outcomes and chronic diseases.


Assuntos
Dieta , Nitratos/administração & dosagem , Nitritos/administração & dosagem , Nitrosaminas/administração & dosagem , Adulto , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Gravidez , Estados Unidos , Adulto Jovem
20.
Nutr J ; 8: 16, 2009 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-19348679

RESUMO

BACKGROUND: Studies have suggested that nitrates, nitrites, and nitrosamines have an etiologic role in adverse pregnancy outcomes and chronic diseases such as cancer. Although an extensive body of literature exists on estimates of these compounds in foods, the extant data varies in quality, quantified estimates, and relevance. METHODS: We developed estimates of nitrates, nitrites, and nitrosamines for food items listed in the Short Willet Food Frequency Questionnaire (WFFQ) as adapted for use in the National Birth Defects Prevention Study. Multiple reference databases were searched for published literature reflecting nitrate, nitrite, and nitrosamine values in foods. Relevant published literature was reviewed; only publications reporting results for items listed on the WFFQ were selected for inclusion. The references selected were prioritized according to relevance to the U.S. population. RESULTS: Based on our estimates, vegetable products contain the highest levels of nitrate, contributing as much as 189 mg/serving. Meat and bean products contain the highest levels of nitrites with values up to 1.84 mg/serving. Alcohol, meat and dairy products contain the highest values of nitrosamines with a maximum value of 0.531 microg/serving. The estimates of dietary nitrates, nitrites, and nitrosamines generated in this study are based on the published values currently available. CONCLUSION: To our knowledge, these are the only estimates specifically designed for use with the adapted WFFQ and generated to represent food items available to the U.S. population. The estimates provided may be useful in other research studies, specifically in those exploring the relation between exposure to these compounds in foods and adverse health outcomes.


Assuntos
Nitratos/análise , Nitritos/análise , Nitrosaminas/análise , Inquéritos e Questionários , Anormalidades Induzidas por Medicamentos/etiologia , Feminino , Humanos , Carne , Gravidez , Verduras/química
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