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1.
J Mater Chem B ; 8(1): 88-99, 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31769463

RESUMO

We synthesized an anthracene derivative with solvatochromic properties to be used as a molecular probe for membrane dynamics and supramolecular organization. A nine carbon atom acyl chain and a dimethylamino substitution were introduced at positions 2 and 6 of the anthracene ring, respectively. This derivative, 2-nonanoyl-6-(dimethylamino)anthracene (termed CAPRYDAA), is a molecular probe designed to mimic the well-known membrane probe LAURDAN's location and response in the lipid membranes. Due to the larger distance between the electron donor and acceptor groups, its absorption and emission bands are red-shifted according to the polarity of the media. The photophysical behavior of CAPRYDAA was measured in homogeneous media, synthetic bilayer and cells, both in a cuvette and in a fluorescence microscope, using one and two-photon excitation. Our results show a comparable physicochemical behavior of CAPRYDAA with LAURDAN, but with the advantage of using visible light (488 nm) as an excitation source. CAPRYDAA was also excitable by two-photon laser sources, making it easy to combine CAPRYDAA with either blue or red emission probes. In GUVs or cells, CAPRYDAA can discriminate the lipid phases and liquid-liquid phase heterogeneity. This new membrane probe shows the bathochromic properties of the PRODAN-based probes designed by Weber, overcoming the need for UV or two-photon excitation and facilitating the studies on the membrane properties using regular confocal microscopes.

2.
Eur J Intern Med ; 70: 24-32, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31451322

RESUMO

OBJECTIVE: To investigate the relationship between length of hospitalisation (LOH) and post-discharge outcomes in acute heart failure (AHF) patients and to ascertain whether there are different patterns according to department of initial hospitalisation. METHODS: Consecutive AHF patients hospitalised in 41 Spanish centres were grouped based on the LOH (<6/6-10/11-15/>15 days). Outcomes were defined as 90-day post-discharge all-cause mortality, AHF readmissions, and the combination of both. Hazard ratios (HRs), adjusted by chronic conditions and severity of decompensation, were calculated for groups with LOH >6 days vs. LOH <6 days (reference), and stratified by hospitalisation in cardiology, internal medicine, geriatrics, or short-stay units. RESULTS: We included 8563 patients (mean age: 80 (SD = 10) years, 55.5% women), with a median LOH of 7 days (IQR 4-11): 2934 (34.3%) had a LOH <6 days, 3184 (37.2%) 6-10 days, 1287 (15.0%) 11-15 days, and 1158 (13.5%) >15 days. The 90-day post-discharge mortality was 11.4%, readmission 32.2%, and combined endpoint 37.4%. Mortality was increased by 36.5% (95%CI = 13.0-64.9) when LOH was 11-15 days, and by 72.0% (95%CI = 42.6-107.5) when >15 days. Conversely, no differences were found in readmission risk, and the combined endpoint only increased 21.6% (95%CI = 8.4-36.4) for LOH >15 days. Stratified analysis by hospitalisation departments rendered similar post-discharge outcomes, with all exhibiting increased mortality for LOH >15 days and no significant increments in readmission risk. CONCLUSIONS: Short hospitalisations are not associated with worse outcomes. While post-discharge readmissions are not affected by LOH, mortality risk increases as the LOH lengthens. These findings were similar across hospitalisation departments.

3.
Emergencias (Sant Vicenç dels Horts) ; 31(4): 227-233, ago. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182762

RESUMO

Objetivos: Este estudio analiza el control del ritmo en los servicios de urgencias (SUH) y sus resultados en pacientes con fibrilación auricular (FA) de reciente comienzo, para identificar áreas de mejora en el manejo. Método: Estudio multicéntrico, observacional, prospectivo y transversal desarrollado en 124 SUH representativos del sistema sanitario español basado en el registro HERMES-AF (estrategias de manejo en el servicio de urgencias hospitalario de la FA) del 23 de mayo al 5 de junio de 2011. Se incluyeron pacientes con FA sintomática con menos de 48 h de evolución en los cuales se tomó la decisión de restaurar el ritmo sinusal. Resultados: Se incluyeron 337 pacientes, se optó por cardioversión farmacológica en 311 pacientes (92,3%), y por cardioversión eléctrica en 52 (15%), la mitad de los casos tras fracaso de los fármacos. Se obtuvo ritmo sinusal (RS) en 278 pacientes (82,5%) y el alivio de los síntomas en 297 (94%), con una tasa de efectos adversos del 0,9%, ninguno grave. Amiodarona se asoció de manera independiente a una menor tasa de RS al alta (OR = 0,442; IC 95% 0,238-0,823; p = 0,01), al contrario que la cardioversión eléctrica (OR = 4,0; IC 95% 1,2-13,3; p = 0,024). Los fármacos I-C se asociaron con una mayor proporción de altas en < 6 h (OR 2,6; IC 95% 1,6-4,3; p < 0,001) y amiodarona con más estancias prolongadas de > 24 h (OR 2,7, IC 95% 1,5-4,8; p < 0,003). Conclusiones: En los SUH, la restauración del RS en la FA de reciente comienzo es segura, efectiva y asocia beneficios clínicos para los pacientes. Reemplazar amiodarona por técnicas más efectivas y rápidas como la cardioversión eléctrica o los fármacos I-C es un área de mejora de la calidad asistencial


Objectives: To analyze heart rate control in hospital emergency departments and outcomes in patients with recent onset atrial fibrillation (AF) so that targets for improvement can be identified. Methods: Multicenter, prospective observational cross-sectional study in a representative sample of 124 hospitals of the Spanish health services, based on records in the HERMES-AF database (Hospital Emergency Department Management Strategies for AF) for May 23 to June 5, 2011. Patients with symptomatic AF within 48 hours of onset were enrolled when the decision was made to attempt restoration of sinus rhythm. Results: We included 337 patients. Chemical cardioversion was used in 311 (92.3%) and electrical cardioversion in 52 (15%), after drugs had failed in half the cases. Sinus rhythm was restored in 278 patients (82.5%), and symptoms resolved in 94%. Adverse effects were recorded in 0.9% but none were serious. Amiodarone was independently associated with a lower rate of restored sinus rhythm (odds ratio [OR], 0.442; 95% CI, 0.238-0.823; P=.01) than electrical cardioversion (OR, 4.0; 95% CI, 1.2-13.3; P=.024). The use of class Ic antiarrhythmic agents was associated with a higher percentage of discharges in less than 6 hours (OR, 2.6; 95% CI, 1.6-4.3; P<.001), and amiodarone was associated with hospital stays longer than 24 hours (OR, 2.7; 95% CI, 1.5-4.8; P<.003). Conclusions: Emergency department restoration of sinus rhythm in patients with AF is safe, effective, and associated with clinical benefits. Quality of care could be improved by replacing the use of amiodarone with faster and more effective treatments such as electrical cardioversion or the use of class Ic agents


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Cardioversão Elétrica/métodos , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/terapia , Serviços Médicos de Emergência , Ritmo Circadiano/efeitos dos fármacos , Sistema de Registros/normas , Cardioversão Elétrica/tendências , Estudos Prospectivos , Estudos Transversais , Espanha , Antiarrítmicos/administração & dosagem , Sistemas de Saúde/organização & administração
4.
Emergencias ; 31(4): 227-233, 2019.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-31347801

RESUMO

OBJECTIVES: To analyze heart rate control in hospital emergency departments and outcomes in patients with recent onset atrial fibrillation (AF) so that targets for improvement can be identified. MATERIAL AND METHODS: Multicenter, prospective observational cross-sectional study in a representative sample of 124 hospitals of the Spanish health services, based on records in the HERMES-AF database (Hospital Emergency Department Management Strategies for AF) for May 23 to June 5, 2011. Patients with symptomatic AF within 48 hours of onset were enrolled when the decision was made to attempt restoration of sinus rhythm. RESULTS: We included 337 patients. Chemical cardioversion was used in 311 (92.3%) and electrical cardioversion in 52 (15%), after drugs had failed in half the cases. Sinus rhythm was restored in 278 patients (82.5%), and symptoms resolved in 94%. Adverse effects were recorded in 0.9% but none were serious. Amiodarone was independently associated with a lower rate of restored sinus rhythm (odds ratio [OR], 0.442; 95% CI, 0.238-0.823; P=.01) than electrical cardioversion (OR, 4.0; 95% CI, 1.2-13.3; P=.024). The use of class Ic antiarrhythmic agents was associated with a higher percentage of discharges in less than 6 hours (OR, 2.6; 95% CI, 1.6-4.3; P< .001), and amiodarone was associated with hospital stays longer than 24 hours (OR, 2.7; 95% CI, 1.5-4.8; P< .003). CONCLUSION: Emergency department restoration of sinus rhythm in patients with AF is safe, effective, and associated with clinical benefits. Quality of care could be improved by replacing the use of amiodarone with faster and more effective treatments such as electrical cardioversion or the use of class Ic agents.

5.
EMBO Rep ; 20(9): e47097, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31321879

RESUMO

Protein homeostasis is essential to cell function, and a compromised ability to reduce the load of misfolded and aggregated proteins is linked to numerous age-related diseases, including hearing loss. Here, we show that altered proteostasis consequent to Elongator complex deficiency also impacts the proper development of the cochlea and results in deafness. In the absence of the catalytic subunit Elp3, differentiating spiral ganglion neurons display large aggresome-like structures and undergo apoptosis before birth. The cochlear mechanosensory cells are able to survive proteostasis disruption but suffer defects in polarity and stereociliary bundle morphogenesis. We demonstrate that protein aggregates accumulate at the apical surface of hair cells, where they cause a local slowdown of microtubular trafficking, altering the distribution of intrinsic polarity proteins and affecting kinocilium position and length. Alleviation of protein misfolding using the chemical chaperone 4-phenylbutyric acid during embryonic development ameliorates hair cell polarity in Elp3-deficient animals. Our study highlights the importance of developmental proteostasis in the cochlea and unveils an unexpected link between proteome integrity and polarized organization of cellular components.

6.
Metas enferm ; 22(6): 5-11, jul. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184042

RESUMO

Objetivo: determinar la evolución de la tasa de vacunación antigripal y antineumocócica (23 valencias) entre los años 2010 y 2014 en pacientes reumáticos en tratamiento con inmunosupresores y evaluar la magnitud de infecciones respiratorias documentadas en el año posterior a la vacunación. Método: estudio descriptivo longitudinal retrospectivo. Se reclutaron por conveniencia 200 pacientes con artritis reumatoide o espondiloartropatías en tratamiento con fármacos antirreumáticos modificadores de la enfermedad (FAME) sintético, FAME biológico o corticoides. Se conformaron dos grupos de 100 pacientes (2010 y 2014) en los que se revisaron historias clínicas para recoger variables demográficas, comorbilidades, hábitos tóxicos, diagnóstico reumatológico y años de evolución de este, tratamiento, administración de la vacuna antigripal y antineumocócica 23v y número de infecciones respiratorias en el año posterior. Resultados: en la muestra un 66% fue mujer, la edad media fue de 66 años y 12 de evolución de la enfermedad. El 43,5% había recibido vacunación antigripal y el 30% vacunación neumocócica 23v. El 21,5% presentó infección respiratoria en el tiempo de seguimiento. Hubo una mayor tasa de vacunación antigripal y antineumocócica en 2014 frente a 2010 (49 y 29% vs. 38% y 21%, respectivamente), siendo solo estadísticamente significativo el aumento en la cobertura antineumocócica. Los pacientes mayores de 65 años y alguna comorbilidad o hábito tóxico son más vacunados (p< 0,05). No hubo diferencias en las vacunaciones ni en el número de infecciones respiratorias, ni en función del diagnóstico reumatológico, ni del tratamiento recibido por el paciente. Conclusiones: la tasa de vacunación mejoró en 2014 respecto a 2010. No obstante, el profesional enfermero ha de intervenir en mejorar la tasa de vacunación en estos pacientes


Objective: to determine the evolution in the rate of influenza and pneumococcal (23-valent) vaccination between the years 2010 and 2014 in rheumatic patients on treatment with immunosuppressants, and to evaluate the extent of documented respiratory infections within the year after vaccination. Method: a retrospective cross-sectional descriptive study. Two hundred (200) patients were recruited by convenience sampling, with rheumatoid arthritis or spondyloarthropathy, on treatment with synthetic disease modifying antirheumatic drugs (DMARDs), biologic DMARDs or corticosteroids. Two arms of 100 patients were formed (2010 and 2014), and clinical records were reviewed in order to collect demographical variables, comorbidities, toxic habits, rheumatology diagnosis and years of disease evolution, treatment, administration of the influenza and the pneumococcal 23 vaccine, and number of respiratory infections during the following year. Results: in the sample, 66% were women, their mean age was 66 years, with 12 years of disease evolution; 43.5% had received influenza vaccination, and 30% pneumococcal 23v vaccination; 21.5% presented respiratory infection within the time of follow-up. There was a higher rate of influenza and pneumococcal vaccination in 2014 vs. 2010 (49 and 29% vs. 38% and 21%, respectively); only the increase in pneumococcal coverage was statistically significant. Patients >65-year-old and with some comorbidity or toxic habit were more vaccinated (p< 0.05). There were no differences in vaccinations or in the number of respiratory infections based on the rheumatology diagnosis or the treatment received by the patient. Conclusions: the vaccination rate improved in 2014 vs. 2010. However, the nursing professional must be involved in the improvement of the vaccination rate for these patients


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Vacinas contra Influenza/administração & dosagem , Vacinas Pneumocócicas/administração & dosagem , Doenças Reumáticas/tratamento farmacológico , Doenças Reumáticas/imunologia , Imunossupressores/administração & dosagem , Cobertura Vacinal , Estudos Transversais , Estudos Longitudinais , Estudos Retrospectivos , Prednisona
7.
Rev. salud pública Parag ; 9(1): [P33-P40], jun. 2019.
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1047015

RESUMO

Introducción: Las enfermedades transmitidas por alimentos (ETA) son consideradas como un problema de salud pública por el daño físico y económico que genera. Objetivo: Describir las características epidemiológicas y clínicas de los brotes de ETA en el Paraguay entre el 2015 y 2016. Metodología: Estudio descriptivo de corte transversal, con datos secundarios de la Dirección General de Vigilancia de la Salud. MSPyBS. Se calcularon frecuencias, medidas de tendencia central y proporción. Resultados: 14 brotes involucraron a 231personas, 56% mujeres (2015: 47%; 2016: 64%), 52% entre 5-14 años (2015: 57%; 2016: 47,5%). Las regiones sanitarias afectadas en 2015: Asunción (73%) y Central (19,8%), en tanto que en 2016: Caaguazú (42,5%) y Asunción (34,2%). En ambos años, se registran brotes en domicilios (2015: 14,4%; 2016: 5,8%) e instituciones educativas (2015: 4,5%; 2016: 35%). En un 62,8% (2015-2016) no se identifica el alimento sospechoso ingerido. El vómito fue síntoma más referido en 2015 (54,1%); en 2016 fue dolor abdominal (67,9%). El 44% de los casos se registraron en la semana epidemiológica (SE) 49 (2015) y el 42% en la SE 32 (2016). Conclusión: Para ambos periodos fueron similares las características de edad y sexo. Asunción se encuentra entre los primeros sitios de mayor notificación, identificándose como lugar de ingesta el domicilio o institución educativa en ambos periodos. Se observa deficiencias en cuanto al registro del alimento sospechoso y variaciones en cuanto a las manifestaciones clínicas y el periodo de tiempo en el que registraron el mayor número de casos (2015: verano; 2016: invierno) Palabras-clave: brote; enfermedades transmitidas por alimentos; vigilancia; Paraguay.


Introduction: Food borne diseases (ETA) is considered a public health problem due to the physical and economic damage it causes. Objective: To describe the epidemiological and clinical characteristics of ETA outbreaks in Paraguay between 2015 and 2016. Methodology: Cross-section descriptive study, with secondary data from the General Directorate of Health Surveillance. MSPyBS. Frequencies, measures of central tendency and proportion were calculated. Results: 14 outbreaks involved 231 people, 56% women (2015: 47%, 2016: 64%), 52% between 5-14 years (2015: 57%, 2016: 47.5%). The health regions affected in 2015: Asunción (73%) and Central (19.8%), while in 2016: Caaguazú (42.5%) and Asunción (34.2%). In both years, outbreaks were recorded in homes (2015: 14.4%, 2016: 5.8%) and educational institutions (2015: 4.5%, 2016: 35%). In 62.8% (2015-2016) the suspected ingested food is not identified. Vomiting was the most referred symptom in 2015 (54.1%); in 2016 it was abdominal pain (67.9%). 44% of the cases were registered in the epidemiological week (SE) 49 (2015) and 42% in EW 32 (2016). Conclusion: For both periods, the characteristics of age and sex were similar. Asunción is among the first sites of greater notification, identifying as place of intake the address or educational institution in both periods. Deficiencies are observed in the registration of suspect food and variations in clinical manifestations and the period of time in which they recorded the highest number of cases (2015: summer, 2016: winter) Key words: outbreak; foodborne diseases; surveillance; Paraguay


Assuntos
Humanos , Masculino , Feminino , Adolescente , Surtos de Doenças , Epidemiologia Nutricional , Alimentos Preparados
8.
Adv Exp Med Biol ; 1117: 111-129, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30980356

RESUMO

Antimicrobial peptides (AMPs) are in the focus of scientific research since the 1990s. In most cases, the main aim was laid on the design of AMP to kill bacteria effectively, with particular emphasis on broadband action and independency on antibiotic resistance. However, so far no approved drug on the basis of AMP has entered the market.Our approach of constructing AMP, called synthetic anti-lipopolysaccharide peptides (SALPs), on the basis of inhibiting the inflammatory action of lipopolysaccharide (LPS, endotoxin) from Gram-negative bacteria was focused on the neutralization of the decisive toxins. These are, beside LPS from Gram-negative bacteria, the lipoproteins (LP) from Gram-positive origin. Although some of the SALPs have an antibacterial action, the most important property is the high-affinity binding to LPS and LP, whether as constituent of the bacteria or in free form which prevents the damaging inflammation, that could otherwise lead to life-threatening septic shock. Most importantly, the SALP may inhibit inflammation independently of the resistance status of the bacteria, and so far the repeated use of the peptides apparently does not cause resistance of the attacking pathogens.In this chapter, an overview is given over the variety of possible applications in the field of fighting against severe bacterial infections, from the use in systemic infection/inflammation up to various topical applications such as anti-biofilm action and severe skin and soft tissue infections.


Assuntos
Antibacterianos/química , Padrões Moleculares Associados a Patógenos/antagonistas & inibidores , Peptídeos/química , Infecções Bacterianas/tratamento farmacológico , Endotoxinas , Bactérias Gram-Negativas , Humanos , Lipopolissacarídeos
9.
Enferm. glob ; 18(54): 124-133, abr. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-183479

RESUMO

Los Trastornos de la Alimentación (TA), la Anorexia Nerviosa (AN), Bulimia nerviosa (BN) y trastorno por atracón son trastornos de gran preocupación en el mundo occidental. Sus tendencias crecientes han llevado a los investigadores a tratar de explicar los factores implicados, sus causas y sus efectos, como una forma de contribuir a los esfuerzos para detener las tendencias de crecimiento.Nuestro proyecto de investigación se centra en el estudio del riesgo de padecer TA entre una muestra de 600 estudiantes de la Universidad de Extremadura (España). Dichos estudiantes están matriculados en doce de los grados ofertados por dicha Universidad.Los instrumentos de evaluación utilizados para los fines de esta investigación están el inventario-3 trastorno del RF (RF de EDI-3) y el cuestionario en español, IMAGEN (evaluación de la insatisfacción con la imagen corporal).Los resultados más significativos demuestran la existencia de un alto porcentaje de estudiantes en riesgo de sufrir TA. En las jóvenes alumnas se evidencia mayores tasas de insatisfacción corporal y de delgadez que sus compañeros masculinos que, por el contrario, demuestran más características de bulimia. Además quienes estudian grados de educación presentan tasas más altas de los factores de riesgo para sufrir tales como TC, la unidad de la delgadez y la insatisfacción de su propio cuerpo, en la situación opuesta se encuentran los grados de ciencias de la salud en particular los estudiantes de enfermería, probablemente como consecuencia de un mayor conocimiento biosanitario


Eating disorders (ED), anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder are disorders of great concern in western world countries. Their rising tendencies have led researchers to try to explain the factors involved, their causes, and their effects, as a way of contributing to the efforts to stop the growing trends. Our research project focuses on the study of the risk of suffering ED amongst a sample of 600 students from the University of Extremadura (Spain). Said students are enrolled in twelve of the degrees offered by the University. The assessment tools used for the purposes of this research are the Eating Disorder Inventory-3 RF (EDI-3 RF) and the Spanish questionnaire, IMAGEN (Evaluation of Dissatisfaction with Body Image). The most significant results show the existence of a high percentage of students at risk of suffering ED. Young female students evidence higher rates of body dissatisfaction and drive for thinness than their male classmates who, conversely, demonstrate more characteristics of bulimia. Those studying education present higher rates of risk factors for suffering ED, such as the drive for thinness and their own body dissatisfaction, in the opposite situation are the health degrees in particular the nursing students, as a result of a greater bio health knowledge caused


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Imagem Corporal/psicologia , Transtornos Dismórficos Corporais/psicologia , Autoimagem , Fatores de Risco , Estudantes/psicologia , Somatotipos/psicologia , Índice de Massa Corporal , Manutenção do Peso Corporal , Estudos Transversais
10.
Acad Emerg Med ; 26(9): 1034-1043, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30703274

RESUMO

BACKGROUND: Although rhythm control has failed to demonstrate long-term benefits over rate control in longstanding episodes of atrial fibrillation (AF), there is little evidence concerning recent-onset ones. We analyzed the benefits of rhythm and rate control in terms of symptoms alleviation and need for hospital admission in patients with recent-onset AF. METHODS: This was a multicenter, observational, cross-sectional study with prospective standardized data collection carried out in 124 emergency departments (EDs). Clinical variables, treatment effectiveness, and outcomes (control of symptoms, final disposition) were analyzed in stable patients with recent-onset AF consulting for AF-related symptoms. RESULTS: Of 421 patients included, rhythm control was chosen in 352 patients (83.6%), a global effectiveness of 84%. Rate control was performed in 69 patients (16.4%) and was achieved in 67 (97%) of them. Control of symptoms was achieved in 396 (94.1%) patients and was associated with a heart rate after treatment ≤ 110 beats/min (odds ratio [OR] = 14.346, 95% confidence interval [CI] = 3.90 to 52.70, p < 0.001) and a rhythm control strategy (OR = 2.78, 95% CI = 1.02 to 7.61, p = 0.046). Sixty patients (14.2%) were admitted: discharge was associated with a rhythm control strategy (OR = 2.22, 95% CI = 1.20-4.60, p = 0.031) and admission was associated with a heart rate > 110 beats/min after treatment (OR = 29.71, 95% CI = 7.19 to 123.07, p < 0.001) and acute heart failure (OR = 9.45, 95% CI = 2.91 to 30.65, p < 0.001). CONCLUSION: In our study, recent-onset AF patients in whom rhythm control was attempted in the ED had a high rate of symptoms' alleviation and a reduced rate of hospital admissions.

12.
BMC Geriatr ; 19(1): 19, 2019 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-30674284

RESUMO

BACKGROUND: The increasing use of smartphones by older adults also increases their potential for improving different aspects of health in this population. Some studies have shown promising results in the improvement of cognitive performance through lifestyle modification. All this may have a broad impact on the quality of life and carrying out daily living activities. The objective of this study is to evaluate the effectiveness of combining the use of smartphone and smartband technology for 3 months with brief counseling on life habits, as opposed to providing counseling only, in increasing physical activity and improving adherence to the Mediterranean diet. Secondary objectives are to assess the effect of the intervention on body composition, quality of life, independence in daily living activities and cognitive performance. METHODS: This study is a two-arm cluster-randomized trial that will be carried out in urban health centers in Spain. We will recruit 160 people aged between 65 and 80 without cardiovascular disease or cognitive impairment (score in the Mini-mental State Examination ≥24). On a visit to their center, intervention group participants will be instructed to use a smartphone application for a period of 3 months. This application integrates information on physical activity received from a fitness bracelet and self-reported information on the patient's daily nutritional composition. The primary outcome will be the change in the number of steps measured by accelerometer. Secondary variables will be adherence to the Mediterranean diet, sitting time, body composition, quality of life, independence in daily living activities and cognitive performance. All variables will be measured at baseline and on the assessment visit after 3 months. A telephone follow-up will be carried out at 6 months to collect self-reported data regarding physical activity and adherence to the Mediterranean diet. DISCUSSION: Preventive healthy aging programs should include health education with training in nutrition and lifestyles, while stressing the importance of and enhancing physical activity; the inclusion of new technologies can facilitate these goals. The EVIDENT-AGE study will incorporate a simple, accessible intervention with potential implementation in the care of older adults. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03574480 . Date of trial Registration July 2, 2018.


Assuntos
/métodos , Exercício/fisiologia , Estilo de Vida Saudável , Smartphone , Dispositivos Eletrônicos Vestíveis , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Aconselhamento/métodos , Feminino , Humanos , Masculino , Qualidade de Vida , Smartphone/tendências , Espanha/epidemiologia , Dispositivos Eletrônicos Vestíveis/tendências
13.
Pediatr Nephrol ; 34(6): 1077-1086, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30607568

RESUMO

OBJECTIVE: To find out if cardiovascular alterations are present in pediatric patients with X-linked hypophosphatemia (XLH). STUDY DESIGN: Multicentre prospective clinical study on pediatric patients included in the RenalTube database ( www.renaltube.com ) with genetically confirmed diagnosis of XLH by mutations in the PHEX gene. The study's protocol consisted of biochemical work-up, 24-h ambulatory blood pressure monitoring (ABPM), carotid ultrasonography, and echocardiogram. All patients were on chronic treatment with phosphate supplements and 1-hydroxy vitamin D metabolites. RESULTS: Twenty-four patients (17 females, from 1 to 17 years of age) were studied. Serum concentrations (X ± SD) of phosphate and intact parathyroid hormone were 2.66 ± 0.60 mg/dl and 58.3 ± 26.8 pg/ml, respectively. Serum fibroblast growth factor 23 (FGF23) concentration was 278.18 ± 294.45 pg/ml (normal < 60 pg/ml). Abnormally high carotid intima media thickness was found in one patient, who was obese and hypertensive as revealed by ABPM, which disclosed arterial hypertension in two other patients. Z scores for echocardiographic interventricular septum end diastole and left ventricular posterior wall end diastole were + 0.77 ± 0.77 and + 0.94 ± 0.86, respectively. Left ventricular mass index (LVMI) was 44.93 ± 19.18 g/m2.7, and four patients, in addition to the obese one, had values greater than 51 g/m2.7, indicative of left ventricular hypertrophy. There was no correlation between these echocardiographic parameters and serum FGF23 concentrations. CONCLUSIONS: XLH pediatric patients receiving conventional treatment have echocardiographic measurements of ventricular mass within normal reference values, but above the mean, and 18% have LVMI suggestive of left ventricular hypertrophy without correlation with serum FGF23 concentrations. This might indicate an increased risk of cardiovascular involvement in XLH.

14.
Int J Mol Sci ; 19(12)2018 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-30544863

RESUMO

An immunophenotyping analysis was performed in peripheral blood samples from seven patients with lung cancer unfit for surgery treated with stereotactic body radiotherapy (SBRT). The objective was to characterize the effect of SBRT on the host immune system. Four patients received 60 Gy (7.5 Gy × 8) and three 50 Gy (12.5 Gy × 4). Analyses were performed before SBRT, 72 h after SBRT, and at one, three, and six months after the end of SBRT. Of note, there was a specific increase of the immunoactive component of the immune system, with elevation of CD56+highCD16+ natural killer (NK) cells (0.95% at baseline to 1.38% at six months), and a decrease of the immunosuppressive component of the immune system, with decreases of CD4+CD25+Foxp3+CDA5RA- regulatory T cells (4.97% at baseline to 4.46% at six months), granulocytic myeloid-derived suppressor cells (G-MDSCs) (from 66.1% at baseline to 62.6% at six months) and monocytic (Mo-MDSCs) (8.2% at baseline to 6.2% at six months). These changes were already apparent at 72 h and persisted over six months. SBRT showed an effect on systemic immune cell populations, which is a relevant finding for supporting future combinations of SBRT with immunotherapy for treating lung cancer patients.


Assuntos
Sistema Imunitário/patologia , Imunofenotipagem , Neoplasias Pulmonares/imunologia , Neoplasias Pulmonares/radioterapia , Radiocirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Pulmonares/cirurgia , Masculino , Células Supressoras Mieloides/imunologia , Linfócitos T Citotóxicos/imunologia , Linfócitos T Reguladores/imunologia
15.
Front Aging Neurosci ; 10: 226, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30123122

RESUMO

Background: The beta-amyloid peptide (Aß) involved in Alzheimer's disease (AD) has been described to associate/aggregate on the cell surface disrupting the membrane through pore formation and breakage. However, molecular determinants involved for this interaction (e.g., some physicochemical properties of the cell membrane) are largely unknown. Since cholesterol is an important molecule for membrane structure and fluidity, we examined the effect of varying cholesterol content with the association and membrane perforation by Aß in cultured hippocampal neurons. Methods: To decrease or increase the levels of cholesterol in the membrane we used methyl-ß-cyclodextrin (MßCD) and MßCD/cholesterol, respectively. We analyzed if membrane fluidity was affected using generalized polarization (GP) imaging and the fluorescent dye di-4-ANEPPDHQ. Additionally membrane association and perforation was assessed using immunocytochemistry and electrophysiological techniques, respectively. Results: The results showed that cholesterol removal decreased the macroscopic association of Aß to neuronal membranes (fluorescent-puncta/20 µm: control = 18 ± 2 vs. MßCD = 10 ± 1, p < 0.05) and induced a facilitation of the membrane perforation by Aß with respect to control cells (half-time for maximal charge transferred: control = 7.2 vs. MßCD = 4.4). Under this condition, we found an increase in membrane fluidity (46 ± 3.3% decrease in GP value, p < 0.001). On the contrary, increasing cholesterol levels incremented membrane rigidity (38 ± 2.7% increase in GP value, p < 0.001) and enhanced the association and clustering of Aß (fluorescent-puncta/20 µm: control = 18 ± 2 vs. MßCD = 10 ± 1, p < 0.01), but inhibited membrane disruption. Conclusion: Our results strongly support the significance of plasma membrane organization in the toxic effects of Aß in hippocampal neurons, since fluidity can regulate distribution and insertion of the Aß peptide in the neuronal membrane.

16.
Sensors (Basel) ; 18(6)2018 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-29865271

RESUMO

In recent years, there have been many advances in vehicle technologies based on the efficient use of real-time data provided by embedded sensors. Some of these technologies can help you avoid or reduce the severity of a crash such as the Roll Stability Control (RSC) systems for commercial vehicles. In RSC, several critical variables to consider such as sideslip or roll angle can only be directly measured using expensive equipment. These kind of devices would increase the price of commercial vehicles. Nevertheless, sideslip or roll angle or values can be estimated using MEMS sensors in combination with data fusion algorithms. The objectives stated for this research work consist of integrating roll angle estimators based on Linear and Unscented Kalman filters to evaluate the precision of the results obtained and determining the fulfillment of the hard real-time processing constraints to embed this kind of estimators in IoT architectures based on low-cost equipment able to be deployed in commercial vehicles. An experimental testbed composed of a van with two sets of low-cost kits was set up, the first one including a Raspberry Pi 3 Model B, and the other having an Intel Edison System on Chip. This experimental environment was tested under different conditions for comparison. The results obtained from low-cost experimental kits, based on IoT architectures and including estimators based on Kalman filters, provide accurate roll angle estimation. Also, these results show that the processing time to get the data and execute the estimations based on Kalman Filters fulfill hard real time constraints.

17.
Methods ; 140-141: 52-61, 2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29408224

RESUMO

In this article, we review the application of fluorescence correlation spectroscopy (FCS) methods to studies on live cells. We begin with a brief overview of the theory underlying FCS, highlighting the type of information obtainable. We then focus on circular scanning FCS. Specifically, we discuss instrumentation and data analysis and offer some considerations regarding sample preparation. Two examples from the literature are discussed in detail. First, we show how this method, coupled with the photon counting histogram analysis, can provide information on yeast ribosomal structures in live cells. The combination of scanning FCS with dual channel detection in the study of lipid domains in live cells is also illustrated.


Assuntos
2-Naftilamina/análogos & derivados , Fluorescência , Microscopia Intravital/métodos , Lauratos/química , Espectrometria de Fluorescência/métodos , 2-Naftilamina/química , Difusão , Microscopia Intravital/instrumentação , Microdomínios da Membrana/metabolismo , Microscopia Confocal/instrumentação , Microscopia Confocal/métodos , Espectrometria de Fluorescência/instrumentação
18.
Colloids Surf B Biointerfaces ; 161: 375-385, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29102849

RESUMO

The study of surfactant and bio membranes interaction is particularly complex due to the diversity in lipid composition and the presence of proteins in natural membranes. Even more difficult is the study of this interaction in vivo since cellular damage may complicate the interpretation of the results, therefore for most of the studies in this field either artificial or model systems are used. One of the model system most used to study biomembranes are erythrocytes due to their relatively simple structure (they lack nuclei and organelles having only the plasma membrane), their convenient experimental manipulation and availability. In this context, we used rabbit erythrocytes as a model membrane and Laurdan (6-lauroyl-2-dimethylaminonaphthalene) as the fluorescent probe to study changes promoted in the membrane by the interaction with the sucrose monoester of myristic acid, ß-d-fructofuranosyl-6-O-myristoyl-α-d-glucopyranoside (MMS). Surfactant and erythrocytes interaction was studied by measuring hemoglobin release and the changes in water content in the membrane sensed by Laurdan. Using two-photon excitation, three types of measurements were performed: Generalized Polarization (analyzed as average GP values), Fluorescence Lifetime Imaging, FLIM (analyzed using phasor plots) and Spectral imaging (analyzed using spectral phasor). Our data indicate that at sublytical concentration of surfactant (20µM MMS), there is a decrease of about 35% in erythrocytes size, without changes in Laurdan lifetime or emission spectra. We also demonstrate that as hemolysis progress, Laurdan lifetime increased due to the decrease in hemoglobin (strong quencher of Laurdan emission) content inside the erythrocytes. Under these conditions, Laurdan spectral phasor analyses can extract the information on the water content in the membrane in the presence of hemoglobin. Our results indicate an increase in membrane fluidity in presence of MMS.


Assuntos
2-Naftilamina/análogos & derivados , Membrana Eritrocítica/metabolismo , Eritrócitos/metabolismo , Lauratos/metabolismo , Ácido Mirístico/metabolismo , Sacarose/metabolismo , 2-Naftilamina/química , 2-Naftilamina/metabolismo , Animais , Membrana Eritrocítica/química , Membrana Eritrocítica/efeitos dos fármacos , Eritrócitos/efeitos dos fármacos , Corantes Fluorescentes/química , Corantes Fluorescentes/metabolismo , Hemoglobinas/metabolismo , Hemólise , Lauratos/química , Fluidez de Membrana/efeitos dos fármacos , Surfactantes Pulmonares/farmacologia , Coelhos , Solubilidade , Água/metabolismo
19.
Farm Hosp ; 41(5): 589-600, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28847248

RESUMO

OBJECTIVE: Complementary and alternative medicine (CAM) use has grown considerably, although there is little research on the topic in Spain. The aim of this study was to determine the prevalence of complementary medicine use in adult cancer patients at the same time as they were receiving conventional treatment in a Spanish referral cancer centre. METHOD: An observational, descriptive, cross-sectional study was conducted in the Ambulatory Treatment Unit during 2 consecutive weeks in March 2015. Adult patients who were receiving intravenous chemotherapy were included. Study variables were obtained from a questionnaire and medical records. RESULTS: 316 patients were included. 32.3% of the patients reported complementary medicine use during this period and 89% were ingesting products by mouth, herbs and natural products being the most commonly used. 81% of patients started to use complementary medicine after diagnosis, and family/friends were the main source of information. 65% of the patients reported improvements, especially in their physical and psychological well-being. Significant predictors of CAM use were female gender (P=0.028), younger age (P<0.001), and secondary education (P=0.009). CONCLUSIONS: A large proportion of cancer patients receiving intravenous chemotherapy also use complementary medicine, which they mainly take by mouth. Due to the risk of chemotherapy-CAM interactions, it is important for health-professionals to keep abreast of research on this issue, in order to provide advice on its potential benefit and risks.


Assuntos
Antineoplásicos/administração & dosagem , Antineoplásicos/uso terapêutico , Terapias Complementares , Neoplasias/terapia , Administração Intravenosa , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Espanha , Inquéritos e Questionários , Adulto Jovem
20.
Colloids Surf B Biointerfaces ; 158: 539-546, 2017 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-28743089

RESUMO

The specificity of carbohydrate-protein interaction is a key factor in many biological processes and it is the foundation of technologies using glycoliposomes in drug delivery. The incorporation of glycolipids in vesicles is expected to increase their specificity toward particular targets such as lectins; however, the degree of exposure of the carbohydrate moiety at the liposome surface is a crucial parameter to be considered in the interaction. Herein we report the synthesis of mannose derivatives with one or two hydrophobic chains of different length, designed with the purpose of modifying the degree of exposure of the mannose when they were incorporated into liposomes. The interaction of glycovesicles with Con A was studied using: (i) agglutination assays; measured by dynamic laser light scattering (DLS); (ii) time resolved fluorescence methods and (iii) surface plasmon resonance (SPR) kinetic measurements. DLS data showed that an increase in hydrophobic chain length promotes a decrease of liposomes hydrodynamic radius. A longer hydrocarbon chain favors a deeper insertion into the bilayer and mannose moiety results less exposed at the surface to interact with lectin. Fluorescence experiments showed changes in the structure of glycovesicles due to the interaction with the protein. From SPR measurements the kinetic and equilibrium constants associated to the interaction of ConA with the different glycolipid synthetized were determined. The combination of SPR and fluorescence techniques allowed to study the interaction of Con A with mannosyl glycovesicles at three levels: at the surface, at the interface and deeper into the bilayer.


Assuntos
Concanavalina A/química , Lipossomos/química , Aglutinação , Anisotropia , Cinética , Manose/química , Ressonância de Plasmônio de Superfície
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