Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 108
Filtrar
1.
EBioMedicine ; 62: 103134, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33254027

RESUMO

BACKGROUND: Glioblastoma is the most aggressive primary brain tumour and has a very poor prognosis. Inhibition of c-Src activity in glioblastoma stem cells (GSCs, responsible for glioblastoma lethality) and primary glioblastoma cells by the peptide TAT-Cx43266-283 reduces tumorigenicity, and boosts survival in preclinical models. Because c-Src can modulate cell metabolism and several reports revealed poor clinical efficacy of various antitumoral drugs due to metabolic rewiring in cancer cells, here we explored the inhibition of advantageous GSC metabolic plasticity by the c-Src inhibitor TAT-Cx43266-283. METHODS: Metabolic impairment induced by the c-Src inhibitor TAT-Cx43266-283 in vitro was assessed by fluorometry, western blotting, immunofluorescence, qPCR, enzyme activity assays, electron microscopy, Seahorse analysis, time-lapse imaging, siRNA, and MTT assays. Protein expression in tumours from a xenograft orthotopic glioblastoma mouse model was evaluated by immunofluorescence. FINDINGS: TAT-Cx43266-283 decreased glucose uptake in human GSCs and reduced oxidative phosphorylation without a compensatory increase in glycolysis, with no effect on brain cell metabolism, including rat neurons, human and rat astrocytes, and human neural stem cells. TAT-Cx43266-283 impaired metabolic plasticity, reducing GSC growth and survival under different nutrient environments. Finally, GSCs intracranially implanted with TAT-Cx43266-283 showed decreased levels of important metabolic targets for cancer therapy, such as hexokinase-2 and GLUT-3. INTERPRETATION: The reduced ability of TAT-Cx43266-283-treated GSCs to survive in metabolically challenging settings, such as those with restricted nutrient availability or the ever-changing in vivo environment, allows us to conclude that the advantageous metabolic plasticity of GSCs can be therapeutically exploited through the specific and cell-selective inhibition of c-Src by TAT-Cx43266-283. FUNDING: Spanish Ministerio de Economía y Competitividad (FEDER BFU2015-70040-R and FEDER RTI2018-099873-B-I00), Fundación Ramón Areces. Fellowships from the Junta de Castilla y León, European Social Fund, Ministerio de Ciencia and Asociación Española Contra el Cáncer (AECC).

2.
Biomolecules ; 10(6)2020 05 28.
Artigo em Inglês | MEDLINE | ID: mdl-32481493

RESUMO

Since their first observation, understanding the biology of extracellular vesicles (EV) has been an important and challenging field of study. They play a key role in the intercellular communication and are involved in important physiological and pathological functions. Therefore, EV are considered as potential biomarkers for diagnosis, prognosis, and monitoring the response to treatment in some diseases. In addition, due to their properties, EV may be used for therapeutic purposes. In the study of EV, three major points have to be addressed: 1. How to isolate EV from cell culture supernatant/biological fluids, 2. how to detect them, and 3. how to characterize and quantify. In this review, we focus on the last two questions and provide the main analytical techniques up-to-date for detection and profiling of EV. We critically analyze the advantages and disadvantages of each one, aimed to be of relevance for all researchers working on EV biology and their potential applications.

4.
Dent Mater ; 36(4): 542-550, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32061442

RESUMO

OBJECTIVE: The use of the BisGMA as base monomer in dental composites has been questioned because of bisphenol A (BPA) is used as raw material in its synthesis, and BPA possess estrogenic potential associated to several health problems. This study describes the synthesis of the trimethacrylate tris(4-hydroxyphenyl)methane triglycidyl methacrylate (TTM) monomer and evaluate its effect when used as base monomer in the formulation of experimental photopolymerizable composite resins. METHODS: The TTM monomer was synthesized by a nucleophilic acyl substitution. Its chemical structure was confirmed via 1H and 13C NMR spectroscopy and FTIR spectroscopy. Experimental composite resins were formulated by mixing TTM, triethyleneglycol dimethacrylate (TEGDMA) and inorganic fillers. A BisGMA/TEGDMA based composite resin was prepared and used as control to compare several physicochemical properties. Cell viability assay was used for cytotoxicity evaluation. RESULTS: TTM was successfully synthesized with quantitative yields. The results showed that the TTM-based composite resin had similar values of flexural strength, elastic modulus, degree of conversion and polymerization shrinkage than the control (p > 0.05). Water sorption and solubility were statistically significantly higher than the control (p < 0.05), however they complied the requirements stablished by the ISO 4049. Finally, this study shows there were no statistically significant differences for the biocompatibility outcomes (p = 0.345). SIGNIFICANCE: TTM monomer could be potentially useful in the formulation of BisGMA free composite resins, which could mean to minimize the human exposure to BPA.


Assuntos
Resinas Compostas , Ácidos Polimetacrílicos , Bis-Fenol A-Glicidil Metacrilato , Resistência à Flexão , Humanos , Teste de Materiais , Metacrilatos , Polietilenoglicóis , Polimerização , Solubilidade
5.
Neuro Oncol ; 22(4): 493-504, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-31883012

RESUMO

BACKGROUND: Malignant gliomas are the most frequent primary brain tumors and remain among the most incurable cancers. Although the role of the gap junction protein, connexin43 (Cx43), has been deeply investigated in malignant gliomas, no compounds have been reported with the ability to recapitulate the tumor suppressor properties of this protein in in vivo glioma models. METHODS: TAT-Cx43266-283 a cell-penetrating peptide which mimics the effect of Cx43 on c-Src inhibition, was studied in orthotopic immunocompetent and immunosuppressed models of glioma. The effects of this peptide in brain cells were also analyzed. RESULTS: While glioma stem cell malignant features were strongly affected by TAT-Cx43266-283, these properties were not significantly modified in neurons and astrocytes. Intraperitoneally administered TAT-Cx43266-283 decreased the invasion of intracranial tumors generated by GL261 mouse glioma cells in immunocompetent mice. When human glioma stem cells were intracranially injected with TAT-Cx43266-283 into immunodeficient mice, there was reduced expression of the stemness markers nestin and Sox2 in human glioma cells at 7 days post-implantation. Consistent with the role of Sox2 as a transcription factor required for tumorigenicity, TAT-Cx43266-283 reduced the number and stemness of human glioma cells at 30 days post-implantation. Furthermore, TAT-Cx43266-283 enhanced the survival of immunocompetent mice bearing gliomas derived from murine glioma stem cells. CONCLUSION: TAT-Cx43266-283 reduces the growth, invasion, and progression of malignant gliomas and enhances the survival of glioma-bearing mice without exerting toxicity in endogenous brain cells, which suggests that this peptide could be considered as a new clinical therapy for high-grade gliomas.

6.
Infect Immun ; 87(8)2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31109947

RESUMO

Little is known about whether pathogen invasion of neural tissue is affected by immune-based mechanisms in endothelial cells. We examined the effects of endothelial cell CD40 on Toxoplasma gondii invasion of the retina and brain, organs seeded hematogenously. T. gondii circulates in the bloodstream within infected leukocytes (including monocytes and dendritic cells) and as extracellular tachyzoites. After T. gondii infection, mice that expressed CD40 restricted to endothelial cells exhibited diminished parasite loads and histopathology in the retina and brain. These mice also had lower parasite loads in the retina and brain after intravenous (i.v.) injection of infected monocytes or dendritic cells. The protective effect of endothelial cell CD40 was not explained by changes in cellular or humoral immunity, reduced transmigration of leukocytes into neural tissue, or reduced invasion by extracellular parasites. Circulating T. gondii-infected leukocytes (dendritic cells used as a model) led to infection of neural endothelial cells. The number of foci of infection in these cells were reduced if endothelial cells expressed CD40. Infected dendritic cells and macrophages expressed membrane-associated inducible Hsp70. Infected leukocytes triggered Hsp70-dependent autophagy in CD40+ endothelial cells and anti-T. gondii activity dependent on ULK1 and beclin 1. Reduced parasite load in the retina and brain not only required CD40 expression in endothelial cells but was also dependent on beclin 1 and the expression of inducible Hsp70 in dendritic cells. These studies suggest that during endothelial cell-leukocyte interaction, CD40 restricts T. gondii invasion of neural tissue through a mechanism that appears mediated by endothelial cell anti-parasitic activity stimulated by Hsp70.


Assuntos
Encéfalo/parasitologia , Antígenos CD40/fisiologia , Células Endoteliais/imunologia , Retina/parasitologia , Toxoplasma/patogenicidade , Animais , Autofagia , Movimento Celular , Proteínas de Choque Térmico HSP70/fisiologia , Leucócitos/fisiologia , Camundongos , Camundongos Endogâmicos C57BL
7.
Rev Saude Publica ; 53: 41, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31066819

RESUMO

OBJECTIVE: To determine the frequency of the registry of physical activity and rest recommendations made to pregnant women and to explore their associated factors in a prenatal care program of primary care public institutions in Bucaramanga, Colombia. METHODS: An observational study was conducted. The sampling frame consisted of the medical records of the pregnant women who attended at least one prenatal care program between January 1 and December 31, 2012 (n = 2.932), in 21 primary care health centers. We analyzed sociodemographic variables, prenatal and clinical antecedents, and information related to health personnel and the organization of health centers as possible factors associated with the recommendations of physical activity and rest recorded in the clinical history. Logistic regression models were applied to explore associations with α = 0.10. RESULTS: There was a frequency of 26.1% of PA recommendations and 3.6% of rest recommendation on record, issued by nutrition (97.3%) and medical (86.7%) professionals, respectively. The factors associated with the registration of physical activity recommendations were: being nulliparous pregnant (OR = 1.7), attending more than four Prenatal Care Attention Programs (OR = 2.2), having high or medium obstetric risk in the first prenatal care program (OR = 0.6), and being attended in the western (OR = 0.5) and eastern (OR = 0.2) administrative areas health centers. CONCLUSIONS: The low frequency of physical activity recommendations found in the records makes it necessary to reinforce the management strategies of health centers and strengthen the monitoring and accompaniment to comply with the care protocols. In addition, it is necessary to train health teams on the benefits of physical activity and their proper prescription, considering the multiple benefits derived from their practice on the maternal-fetal health.


Assuntos
Exercício Físico/fisiologia , Gravidez/fisiologia , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/estatística & dados numéricos , Descanso/fisiologia , Adolescente , Adulto , Antropometria , Colômbia , Feminino , Pessoal de Saúde , Humanos , Registros Médicos , Pessoa de Meia-Idade , Educação Pré-Natal/métodos , Educação Pré-Natal/estatística & dados numéricos , Valores de Referência , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
8.
Bioengineering (Basel) ; 6(1)2019 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-30658418

RESUMO

Extracellular vesicles (EV) are small membrane structures released by cells that act as potent mediators of intercellular communication. The study of EV biology is important, not only to strengthen our knowledge of their physiological roles, but also to better understand their involvement in several diseases. In the field of biomedicine they have been studied as a novel source of biomarkers and drug delivery vehicles. The most commonly used method for EV enrichment in crude pellet involves serial centrifugation and ultracentrifugation. Recently, different protocols and techniques have been developed to isolate EV that imply less time and greater purification. Here we carry out a comparative analysis of three methods to enrich EV from plasma of healthy controls: ultracentrifugation, ExoQuickTM precipitation solution (System Biosciences), and Total Exosome Isolation kit (Invitrogen). Our results show that commercial precipitation reagents are more efficient and enable higher EV enrichment factors compared with traditional ultracentrifugation, although subsequent imaging analysis is not possible with some of them. We hope that this work will contribute to the current research on isolation techniques to assist the progress of clinical applications with diagnostic or therapeutic objectives.

9.
Rev. saúde pública (Online) ; 53: 41, jan. 2019. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1004506

RESUMO

ABSTRACT OBJECTIVE To determine the frequency of the registry of physical activity and rest recommendations made to pregnant women and to explore their associated factors in a prenatal care program of primary care public institutions in Bucaramanga, Colombia. METHODS An observational study was conducted. The sampling frame consisted of the medical records of the pregnant women who attended at least one prenatal care program between January 1 and December 31, 2012 (n = 2.932), in 21 primary care health centers. We analyzed sociodemographic variables, prenatal and clinical antecedents, and information related to health personnel and the organization of health centers as possible factors associated with the recommendations of physical activity and rest recorded in the clinical history. Logistic regression models were applied to explore associations with α = 0.10. RESULTS There was a frequency of 26.1% of PA recommendations and 3.6% of rest recommendation on record, issued by nutrition (97.3%) and medical (86.7%) professionals, respectively. The factors associated with the registration of physical activity recommendations were: being nulliparous pregnant (OR = 1.7), attending more than four Prenatal Care Attention Programs (OR = 2.2), having high or medium obstetric risk in the first prenatal care program (OR = 0.6), and being attended in the western (OR = 0.5) and eastern (OR = 0.2) administrative areas health centers. CONCLUSIONS The low frequency of physical activity recommendations found in the records makes it necessary to reinforce the management strategies of health centers and strengthen the monitoring and accompaniment to comply with the care protocols. In addition, it is necessary to train health teams on the benefits of physical activity and their proper prescription, considering the multiple benefits derived from their practice on the maternal-fetal health.


RESUMEN OBJETIVO Determinar la frecuencia del registro de recomendaciones de actividad física y reposo realizadas a las gestantes y explorar sus factores asociados, en un programa de atención de control prenatal de instituciones públicas de primer nivel de atención en Bucaramanga, Colombia. MÉTODOS Se realizó un estudio observacional. El marco muestral estuvo conformado por los registros médicos de las gestantes que asistieron al menos a un programa de atención de control prenatal entre el 1º de enero y 31 de diciembre de 2012 (n = 2,932), en 21 centros de salud de primer nivel de atención. Se analizaron variables sociodemográficas, antecedentes prenatales, antecedentes clínicos, e información relacionada con el personal de salud y la organización de los centros de salud como posibles factores asociados con las recomendaciones de actividad física y reposo registrados en la historia clínica. Se aplicaron modelos de regresión logística para explorar las asociaciones con un α = 0.10. RESULTADOS Se observó una frecuencia de 26.1% de registro de recomendaciones de AF y 3.6% de reposo, emitidas por parte de profesionales de nutrición (97.3%) y medicina (86.7%), respectivamente. Los factores asociados al registro de las recomendaciones de actividad física fueron: ser gestante nulípara (OR = 1.7), asistir a más de cuatro Programas de Atención de Control Prenatal (OR = 2.2), tener riesgo obstétrico alto o medio en el primer programa de atención de control prenatal (OR = 0.6) y ser atendidas en los centros de salud de las zonas administrativas de occidente (OR = 0.5) y oriente (OR = 0.2). CONCLUSIONES La baja frecuencia del registro de recomendaciones de actividad física encontrada, genera la necesidad de reforzar las estrategias de gestión de los centros de salud y fortalecer el monitoreo y acompañamiento en el cumplimiento de los protocolos de atención. Adicionalmente, es necesario capacitar a los equipos de salud sobre los beneficios de la actividad física y su prescripción adecuada, atendiendo a los múltiples beneficios derivados de su práctica sobre la salud materno-fetal.

11.
Rev Saude Publica ; 52: 77, 2018 Jul 26.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30066814

RESUMO

OBJECTIVE: To analyze the impacts of the care to the population displaced by violence on the health system and the challenges that this entails. METHODS: This is a narrative review of the national and international literature in PubMed, SciELO, WHO/PAHO, and Bireme. Inclusion criteria were date of publication (from 2000), relation with the subject, and language (Spanish or English). We found 292 documents, of which 91 met the inclusion criteria. RESULTS: The main challenges are the intersectoral, participatory, and integral approach (with emphasis on mental health and sexual and reproductive health), ensured accessibility to health services, the need for a reliable registration and information system of the population displaced by violence and its characteristics, and the addressing of the biopsychosocial problems of the different groups, especially women, persons with disabilities or infectious diseases, adolescents, children, ethnic minorities, older adults and the lesbian, gay, bisexual, transsexual, and intersexual population. CONCLUSIONS: The lack of political will to accept and see the internal displacement by violence and its importance as a humanitarian and public health problem is an obstacle to the adequate and timely care of the population displaced by violence in Mexico.


Assuntos
Assistência à Saúde , Exposição à Violência , Serviços de Saúde , Refugiados , Populações Vulneráveis , Assistência à Saúde/tendências , Feminino , Serviços de Saúde/tendências , Humanos , Masculino , México , Grupos Minoritários , Minorias Sexuais e de Gênero , Migrantes
12.
J Nanobiotechnology ; 16(1): 47, 2018 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-29720199

RESUMO

BACKGROUND: Tumour-derived exosomes can be released to serum and provide information on the features of the malignancy, however, in order to perform systematic studies in biological samples, faster diagnostic techniques are needed, especially for detection of low abundance proteins. Most human cancer cells are positive for at least one ligand for the activating immune receptor NKG2D and the presence in plasma of NKG2D-ligands can be associated with prognosis. METHODS: Using MICA as example of a tumour-derived antigen, endogenously expressed in metastatic melanoma and recruited to exosomes, we have developed two immunocapture-based assays for detection of different epitopes in nanovesicles. Although both techniques, enzyme-linked immunosorbent assay (ELISA) and Lateral flow immunoassays (LFIA) have the same theoretical basis, that is, using capture and detection antibodies for a colorimetric read-out, analysis of exosome-bound proteins poses methodological problems that do not occur when these techniques are used for detection of soluble molecules, due to the presence of multiple epitopes on the vesicle. RESULTS: Here we demonstrate that, in ELISA, the signal obtained was directly proportional to the amount of epitopes per exosome. In LFIA, the amount of detection antibody immobilized in Au-nanoparticles needs to be low for efficient detection, otherwise steric hindrance results in lower signal. We describe the conditions for detection of MICA in exosomes and prove, for the first time using both techniques, the co-existence in one vesicle of exosomal markers (the tetraspanins CD9, CD63 and CD81) and an endogenously expressed tumour-derived antigen. The study also reveals that scarce proteins can be used as targets for detection antibody in LFIA with a better result than very abundant proteins and that the conditions can be optimized for detection of the protein in plasma. CONCLUSIONS: These results open the possibility of analyzing biological samples for the presence of tumour-derived exosomes using high throughput techniques.


Assuntos
Antígenos de Neoplasias/sangue , Exossomos/química , Antígenos de Histocompatibilidade Classe I/sangue , Imunoensaio/métodos , Melanoma/sangue , Linhagem Celular Tumoral , Humanos , Subfamília K de Receptores Semelhantes a Lectina de Células NK , Nanopartículas/química , Tetraspaninas/sangue
13.
J Extracell Vesicles ; 7(1): 1453730, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29696075

RESUMO

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME) is an acquired, complex and multisystem condition of unknown etiology, no established diagnostic lab tests and no universally FDA-approved drugs for treatment. CFS/ME is characterised by unexplicable disabling fatigue and is often also associated with numerous core symptoms. A growing body of evidence suggests that extracellular vesicles (EVs) play a role in cell-to-cell communication, and are involved in both physiological and pathological processes. To date, no data on EV biology in CFS/ME are as yet available. The aim of this study was to isolate and characterise blood-derived EVs in CFS/ME. Blood samples were collected from 10 Spanish CFS/ME patients and 5 matched healthy controls (HCs), and EVs were isolated from the serum using a polymer-based method. Their protein cargo, size distribution and concentration were measured by Western blot and nanoparticle tracking analysis. Furthermore, EVs were detected using a lateral flow immunoassay based on biomarkers CD9 and CD63. We found that the amount of EV-enriched fraction was significantly higher in CFS/ME subjects than in HCs (p = 0.007) and that EVs were significantly smaller in CFS/ME patients (p = 0.014). Circulating EVs could be an emerging tool for biomedical research in CFS/ME. These findings provide preliminary evidence that blood-derived EVs may distinguish CFS/ME patients from HCs. This will allow offer new opportunities and also may open a new door to identifying novel potential biomarkers and therapeutic approaches for the condition.

14.
Rev. colomb. obstet. ginecol ; 69(1): 22-31, jan.-Mar. 2018. tab
Artigo em Inglês | LILACS | ID: biblio-960073

RESUMO

ABSTRACT Objective: To describe the prevalence of late initiation of prenatal care and assess its association with the socioeconomic level of the pregnant woman. Materials and methods: Cross-sectional study. Pregnant women from the urban area of Bucaramanga were included using sampling based on proportional affixation quotas according to the socioeconomic classification of the neighbourhood where they lived. Late initiation was considered to occur when prenatal care was started at 12 weeks or more of gestation. The association between late initiation and socioeconomic bracket was assessed, controlling by sociodemographic and clinical variables of the pregnant woman, and a multivariate log-binomial regression model was developed to estimate prevalence ratios and their 95% confidence intervals (95% CI). Results: Overall, 391 pregnant women between 18 and 43 years of age (median 23) were included. Median for schooling was 11 years, with a range between 0 and 25 years. Late initiation was found in 29.7% (95% CI: 25.2-34.5) of the women. Association was found with low income brackets (prevalence ratio [PR] = 1.57; 95% CI: 1.082.56), no affiliation to social security at the start of pregnancy (PR = 2.73; 95% CI: 2.04-3.67), and low schooling (PR = 1.46; 95% CI: 1.02-2.16), and age between 18 and 24 years (PR = 1.53; 95% CI: 1.12-1.70). Remembering the date of the last menstruation (PR = 0.48; 95% CI: 0.32-0.71) and being in a stable relationship (PR = 0.82; 95% CI: 0.64-0.98) were protective factors. Conclusions: Late initiation of prenatal care is found to occur in approximately one out of every three pregnant women. Late initiation is associated with living in a low socioeconomic bracket. Early identification of pregnant women in this population affected by health inequity must be improved.


RESUMEN Objetivo: Describir la prevalência del inicio tardío de la atención prenatal y evaluar su asociación con el estrato socioeconómico donde habita la gestante. Materiales y métodos: Estudio de corte transversal. Se incluyeron gestantes procedentes del área urbana de Bucaramanga, seleccionadas por muestreo por cuotas con afijación proporcional por estrato socioeconómico, según la clasificación socioeconómica del barrio donde habitan. Se consideró inicio tardío haber comenzado atención prenatal (APN) a las 12 semanas o más de gestación. Se evaluó asociación del inicio tardío con el estrato socioeconómico, controlando por variables sociodemográficas y clínicas de la gestante, y se elaboró un modelo de regresión log-binomial multivariada para estimar las razones de prevalencia con sus intervalos de confianza del 95 % (IC 95 %). Resultados: Se incluyeron 391 gestantes, con edades entre 18 y 43 años, mediana 23 años; respecto a la escolaridad la mediana fue de 11 años con un rango entre 0 y 25 años. El inicio tardío se dio en el 29,7 % (IC 95 %: 25,2-34,5) de las gestantes. Estuvo asociado con estrato bajo. Razón de prevalencias ([RP] = 1,57; IC 95 %: 1,08-2,56), falta de afiliación a la seguridad social al inicio del embarazo (RP = 2,73; IC 95 %: 2,04-3,67), la baja escolaridad (RP = 1,46; IC 95 %: 1,02-2,16) y la edad entre 18 y 24 años (RP= 1,53; IC 95 %: 1,12-1,70). Fueron factores protectores el recordar la fecha de la última regla (RP = 0,48; IC 95 %: 0,32-0,71) y tener pareja estable (RP = 0,82; IC 95 %: 0,64-0,98). Conclusiones: Cerca de una de cada tres gestantes inicia tarde su APN. El inicio tardío está asociado con vivir en estrato socioeconómico bajo. Se requiere mejorar la captación temprana de las gestantes en esta población que presenta condiciones de inequidad en salud.


Assuntos
Feminino , Gravidez , Cuidado Pré-Natal , Previdência Social , Fatores Socioeconômicos , Idade Gestacional , Colômbia , Assistência à Saúde , Gestantes
15.
Rev. saúde pública (Online) ; 52: 77, 2018. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-962263

RESUMO

ABSTRACT OBJECTIVE To analyze the impacts of the care to the population displaced by violence on the health system and the challenges that this entails. METHODS This is a narrative review of the national and international literature in PubMed, SciELO, WHO/PAHO, and Bireme. Inclusion criteria were date of publication (from 2000), relation with the subject, and language (Spanish or English). We found 292 documents, of which 91 met the inclusion criteria. RESULTS The main challenges are the intersectoral, participatory, and integral approach (with emphasis on mental health and sexual and reproductive health), ensured accessibility to health services, the need for a reliable registration and information system of the population displaced by violence and its characteristics, and the addressing of the biopsychosocial problems of the different groups, especially women, persons with disabilities or infectious diseases, adolescents, children, ethnic minorities, older adults and the lesbian, gay, bisexual, transsexual, and intersexual population. CONCLUSIONS The lack of political will to accept and see the internal displacement by violence and its importance as a humanitarian and public health problem is an obstacle to the adequate and timely care of the population displaced by violence in Mexico.


RESUMEN OBJETIVO Analizar las implicaciones de la atención de la población desplazada por violencia para el sistema de salud y los retos que le implica. MÉTODOS Revisión narrativa de literatura nacional e internacional en PubMed, SciELO, WHO/OPS, y Bireme. Los criterios de inclusión fueron, la fecha de publicación (a partir de 2000), la relación con el tema, y el idioma (español o inglés). Se encontraron 292 documentos, de los cuales 91 cumplían con los criterios de inclusión. RESULTADOS Los principales retos se referirán: al enfoque integral (con énfasis en la salud mental y la salud sexual y reproductiva), intersectorial, y participativo; a la garantía de la accesibilidad a los servicios de salud; a la necesidad de un sistema de información y registro confiable de la población desplazada por violencia y sus características; y al abordaje de las problemáticas biopsicosociales de los diferentes grupos, especialmente mujeres, personas con discapacidad o con enfermedades infecciosas, de adolescentes, niños y niñas, minorías étnicas, población adulta mayor y la población lésbica, gay, transexual, bisexual y intersexual. CONCLUSIONES La ausencia de voluntad política para la aceptación y visibilización del desplazamiento interno por violencia y de su importancia como problema humanitario y de salud pública, constituye un obstáculo para atender a la población desplazada por violencia de forma adecuada y oportuna en México.

16.
MedUNAB ; 21(1): 130-137, 2018.
Artigo em Espanhol | LILACS | ID: biblio-994747

RESUMO

Introducción. Los aneurismas de arterias viscerales son entidades raras, su incidencia es del 0.01 al 0.2% y su prevalencia de 1%; afectan, además, en un 2% la arteria gastroduodenal. Su complicación más frecuente es la ruptura, por lo cual es importante realizar un diagnóstico precoz, debido a su alto índice de mortalidad, que llega hasta el 70%. Por consiguiente, el manejo endovascular puede ser una opción segura y eficaz, pues presenta un excelente resultado y una disminución de las complicaciones asociadas. Objetivo. Describir las características clínicas e imaginológicas y el abordaje terapéutico endovascular en un caso de aneurisma de la arteria gastroduodenal. Presentación del caso. Hombre de 62 años de edad, sin antecedentes previos, quien consulta al servicio de urgencias por cuadro clínico de inicio súbito, caracterizado por un episodio sincopal asociado a náuseas, dolor abdominal, deposiciones diarreicas y malestar general. Al examen físico se evidencia paciente en regulares condiciones generales, deshidratación leve, palidez generalizada y leve dolor a la palpación superficial de hemiabdomen derecho. Se solicita tomografía axial computarizada de abdomen con contraste, evidenciando hematoma secundario a ruptura de la arteria gastroduodenal. Se realiza manejo endovascular mediante punción en la arteria braquial derecha y, posteriormente, https://doi.org/1029375/01237047.2781Vol 21(1): 130-137, abril - julio 2018 131se emboliza con coils, controlando el sangrado. Luego de la intervención, el paciente evolucionó favorablemente y es dado de alta a los dos días. Conclusiones. El manejo endovascular mediante embolización con coils es un abordaje quirúrgico reciente y efectivo que disminuye la mortalidad en los pacientes con ruptura de aneurisma de origen gastrointestinal. [Galvis-Méndez M, Sánchez-Rodríguez ML, Cepeda-Bareño DF, Santander-Landazabal JD. Hematoma encapsulado por ruptura de aneurisma sacular de la arteria gastroduodenal manejado con técnica endovascular tipo coils: reporte de caso. MedUNAB. 2018;21(1):130-137doi:10.29375/01237047.2781].


Introduction. Visceral artery aneurysms are rarely spotted entities. Their incidence rate is from 0.01 to 0.2% and their prevalence rate is of 1%. Also, these kinds of entities affect 2% to the gastroduodenal artery. Its riskiest complication is the aneurysmal rupture, and it is vital to run an early diagnosis due to the high mortality rates this complication might have (rupture mortality rates are up to 70%). For this reason, endovascular coiling might be an effective and safe technique for managing visceral aneurysms, as this technique has proved excellent results and remarkable diminishments in complications associated with the entity control. Objective. To describe clinical and imaging characteristics, and endovascular therapeutics deployment within a gastroduodenal artery aneurysm study case. Case presentation. A 62-year-old man, with no previous clinical history of the condition, enters to the emergency room because of a sudden syncopal episode accompanied by nausea, abdominal pain, diarrheal stools and malaise. When the patient is examined, the medical team noticed that in spite he was in an overall good health condition, he was mildly dehydrated, showed generalized paleness, and complained about mild pain in the right hemiabdomen area when performing superficial abdominal palpation. Consequently, a high-contrast computerized axial tomography (High-Contrast CAT scan) revealed the rupture of a secondary hematoma located on the gastroduodenal arteria. Endovascular management is performed using arterial puncture techniques in the right brachial artery. After this procedure, arterial bleeding was managed using endovascular coil embolization. When the physical intervention concluded, the patient evolved favorably and was discharged two days later. Conclusions. Endovascular management using coiling embolization techniques is one of the most recent and effective surgical approaches. It has proved to reduce mortality rates among patients with aneurysms located within the gastrointestinal area. [Galvis-Méndez M, Sánchez-Rodríguez ML, Cepeda-Bareño DF, Santander-Landazabal JD. A case report: encapsulated hematoma, caused by gastroduodenal artery saccular aneurism rupture, and managed using endovascular coiling technique. MedUNAB. 2018;21(1):130-137doi:10.29375/01237047.2781].


Introdução. Os aneurismas das artérias viscerais são entidades raras, sua incidência é de 0.01 a 0.2% e sua prevalência é de 1%; além, afetam em 2% a artéria gastroduodenal. Sua complicação mais frequente é a ruptura, por isso é importante fazer um diagnóstico precoce, devido a que sua taxa de mortalidade chega até 70%. Portanto, o tratamento endovascular pode ser uma opção segura e eficaz, pois apresenta excelente resultado e diminuição das complicações associadas. Objetivo. Descrever as características clínicas e de imagem e a abordagem terapêutico endovascular em um caso de aneurisma da artéria gastroduodenal. Apresentação do caso. Homem de 62 anos, sem história prévia consultou o pronto-socorro por início repentino dos sintomas, caracterizado por um episódio de síncope associado a náusea, dor abdominal, fezes diarréicas e mal-estar. O exame físico revelou um paciente com condições gerais regulares, desidratação leve, palidez generalizada e dor leve na palpação superficial do hemiabdome direito. É solicitada uma tomografia axial computadorizada do abdome com contraste, evidenciando hematoma secundário à ruptura da artéria gastroduodenal. O tratamento endovascular é feito por punção da artéria braquial direita e, subsequentemente, embolizada com uso de molas, para controlar o sangramento. Após a intervenção, o paciente evoluiu favoravelmente e recebeu alta após dois dias. Conclusões. O tratamento endovascular por embolização com molas é uma abordagem cirúrgica recente e eficaz que diminui a mortalidade em pacientes com ruptura aneurismática de origem gastrointestinal. [Galvis-Méndez M, Sánchez-Rodríguez ML, Cepeda-Bareño DF, Santander-Landazabal JD. Hematoma encapsulado por ruptura de aneurisma sacular da artéria gastroduodenal tratado com a técnica endovascular de mola: relato de caso. MedUNAB. 2018;21(1):130-137doi:10.29375/01237047.2781].


Assuntos
Aneurisma , Ruptura , Angiografia , Embolização Terapêutica , Hematoma
17.
J Vis Exp ; (130)2017 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-29286477

RESUMO

Here we present a protocol to study intracellular protein-protein interactions that is based on the widely used biotin-avidin pull-down system. The modification presented includes the combination of this technique with cell-penetrating sequences. We propose to design cell-penetrating baits that can be incubated with living cells instead of cell lysates and therefore the interactions found will reflect those that occur within the intracellular context. Connexin43 (Cx43), a protein that forms gap junction channels and hemichannels is down-regulated in high-grade gliomas. The Cx43 region comprising amino acids 266-283 is responsible for the inhibition of the oncogenic activity of c-Src in glioma cells. Here we use TAT as the cell-penetrating sequence, biotin as the pull-down tag and the region of Cx43 comprised between amino acids 266-283 as the target to find intracellular interactions in the hard-to-transfect human glioma stem cells. One of the limitations of the proposed method is that the molecule used as bait could fail to fold properly and, consequently, the interactions found could not be associated with the effect. However, this method can be especially interesting for the interactions involved in signal transduction pathways because they are usually carried out by intrinsically disordered regions and, therefore, they do not require an ordered folding. In addition, one of the advantages of the proposed method is that the relevance of each residue on the interaction can be easily studied. This is a modular system; therefore, other cell-penetrating sequences, other tags, and other intracellular targets can be employed. Finally, the scope of this protocol is far beyond protein-protein interaction because this system can be applied to other bioactive cargoes such as RNA sequences, nanoparticles, viruses or any molecule that can be transduced with cell-penetrating sequences and fused to pull-down tags to study their intracellular mechanism of action.


Assuntos
Biotina/química , Peptídeos Penetradores de Células/química , Peptídeos Penetradores de Células/metabolismo , Avidina/química , Avidina/metabolismo , Biotina/metabolismo , Conexina 43/química , Conexina 43/metabolismo , Produtos do Gene tat/química , Produtos do Gene tat/metabolismo , Glioma/metabolismo , Glioma/patologia , Humanos , Células-Tronco Neoplásicas/metabolismo , Células-Tronco Neoplásicas/patologia , Fragmentos de Peptídeos/química , Ligação Proteica , Domínios e Motivos de Interação entre Proteínas
18.
PLoS One ; 12(8): e0180857, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28854236

RESUMO

OBJECTIVE: To generate and evaluate an indicator of the health system's performance in the area of maternal and reproductive health in Colombia. MATERIALS AND METHODS: An indicator was constructed based on variables related to the coverage and utilization of healthcare services for pregnant and reproductive-age women. A factor analysis was performed using a polychoric correlation matrix and the states were classified according to the indicator's score. A path analysis was used to evaluate the relationship between the indicator and social determinants, with the maternal mortality ratio as the response variable. RESULTS: The factor analysis indicates that only one principal factor exists, namely "coverage and utilization of maternal healthcare services" (eigenvalue 4.35). The indicator performed best in the states of Atlantic, Bogota, Boyaca, Cundinamarca, Huila, Risaralda and Santander (Q4). The poorest performance (Q1) occurred in Caqueta, Choco, La Guajira, Vichada, Guainia, Amazonas and Vaupes. The indicator's behavior was found to have an association with the unsatisfied basic needs index and women's education (ß = -0.021; 95%CI -0031 to -0.01 and ß 0.554; 95%CI 0.39 to 0.72, respectively). According to the path analysis, an inverse relationship exists between the proposed indicator and the behavior of the maternal mortality ratio (ß = -49.34; 95%CI -77.7 to -20.9); performance was a mediating variable. DISCUSSION: The performance of the health system with respect to its management of access and coverage for maternal and reproductive health appears to function as a mediating variable between social determinants and maternal mortality in Colombia.


Assuntos
Serviços de Saúde Materna , Saúde Reprodutiva , Adulto , Colômbia , Feminino , Humanos , Serviços de Saúde Materna/estatística & dados numéricos , Mortalidade Materna , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Gravidez , Saúde Reprodutiva/estatística & dados numéricos , Fatores Socioeconômicos , Adulto Jovem
19.
Stem Cell Reports ; 9(2): 451-463, 2017 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-28712848

RESUMO

Connexin43 (CX43), a protein that forms gap junction channels and hemichannels in astrocytes, is downregulated in high-grade gliomas. Its relevance for glioma therapy has been thoroughly explored; however, its positive effects on proliferation are counterbalanced by its effects on migration and invasion. Here, we show that a cell-penetrating peptide based on CX43 (TAT-Cx43266-283) inhibited c-Src and focal adhesion kinase (FAK) and upregulated phosphatase and tensin homolog in glioma stem cells (GSCs) derived from patients. Consequently, TAT-Cx43266-283 reduced GSC motility, as analyzed by time-lapse microscopy, and strongly reduced their invasive ability. Interestingly, we investigated the effects of TAT-Cx43266-283 on freshly removed surgical specimens as undissociated glioblastoma blocks, which revealed a dramatic reduction in the growth, migration, and survival of these cells. In conclusion, a region of CX43 (amino acids 266-283) exerts an important anti-tumor effect in patient-derived glioblastoma models that includes impairment of GSC migration and invasion.


Assuntos
Conexina 43/metabolismo , Proteína-Tirosina Quinases de Adesão Focal/metabolismo , Glioma/metabolismo , Células-Tronco Neoplásicas/metabolismo , PTEN Fosfo-Hidrolase/metabolismo , Quinases da Família src/metabolismo , Proteína Tirosina Quinase CSK , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Movimento Celular/genética , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/genética , Conexina 43/química , Conexina 43/genética , Conexina 43/farmacologia , Glioma/genética , Humanos , Modelos Biológicos , Fragmentos de Peptídeos/farmacologia , Proteínas Recombinantes de Fusão/farmacologia
20.
Rev. Univ. Ind. Santander, Salud ; 49(2): 320-329, abr.-jun. 2017.
Artigo em Espanhol | LILACS | ID: biblio-897103

RESUMO

Resumen Introducción: En Colombia, a partir del año 2011 ha resurgido el interés por la incorporación de la Estrategia de Atención Primaria en Salud (APS) en los servicios de salud y en los debates académicos. A partir de la promulgación del nuevo Modelo Integral de Atención en Salud en el año 2016, este interés es explícito por los distintos actores del Sistema General de Seguridad Social en Salud. En el marco de la Alianza por la Atención Primaria en Salud para Colombia, se promovieron encuentros regionales que permitieran identificar potencialidades y limitaciones para la implementación de la estrategia de APS en el marco de la nueva política de atención. Objetivo: Socializar las reflexiones que tomadores de decisiones y representantes de la academia realizaron frente a la implementación de la nueva política de atención en el oriente del país. Metodología: Se realizaron tres mesas de trabajo con 30 actores de 11 Instituciones de Educación Superior y 17 tomadores de decisiones de cuatro departamentos del oriente del país. Se utilizó la estrategia de investigación de grupos de discusión. Resultados: Tanto la academia como los tomadores de decisiones identificaron desafíos relacionados con la comprensión de los aspectos conceptuales del enfoque poblacional del modelo, así como la necesidad de hacer una mirada crítica a las competencias y currículos de los nuevos profesionales. Conclusión: Los distintos temas que emergieron del debate incluyen aspectos estructurales y de funcionamiento del sistema de seguridad social en Salud que le plantean a la autoridad sanitaria retos que superan la mera instrumentalización del modelo.


Abstract Introduction: Since 2011, there has been an increasing interest to re-incorporate primary health care (PHC) strategy in healthcare services and academic debates. After the promulgation of the new healthcare model (MIAS) in 2016, this interest has been made explicit by all actors involved in the health benefits program of the Social Security System (SGSSS). According to the guidelines proposed by the Colombian PHC Alliance, regional meetings have been held to identify potentialities and limitations for implementing the PHC strategy within the framework of the new healthcare policy. Objective: To socialize the analysis carried out by decision-makers and academics related to the implementation of the new healthcare policy in the east of the country. Methodology: Three workshops were held with the participation of 30 representatives of 11 higher-education institutions and 17 decision makers from four departments of the east of the country. Qualitative research methodology based on focus groups was applied. Results: Academics and decision-makers identified challenges related to understanding the conceptual aspects of the Model's population focus and raised awareness about the need of a critical assessment of curricula and professional competencies of health professionals. Conclusion: The discussion topics emerged from the debate included structural and functional aspects of the Health System that represent challenges to health authorities beyond the mere operationalization of the model.


Assuntos
Atenção Primária à Saúde , Sistemas de Saúde , Colômbia , Reforma dos Serviços de Saúde , Governo Local
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA