Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 101
Filtrar
1.
J Perinat Med ; 48(5): 446-449, 2020 Jun 25.
Artigo em Inglês | MEDLINE | ID: covidwho-260592

RESUMO

The novel coronavirus disease 2019 (COVID-19) has caused a rapid and massive transition to online education. We describe the response of our Office of Faculty Development at Texas Tech University Health Sciences Center El Paso (TTUHSC EP) to this unprecedented challenge during and after this post-pandemic crisis. The initiatives for emergency transition to eLearning and faculty development described in this paper may serve as a model for other academic health centers, schools, colleges and universities.

2.
J Perinat Med ; 48(5): 446-449, 2020 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-32401229

RESUMO

The novel coronavirus disease 2019 (COVID-19) has caused a rapid and massive transition to online education. We describe the response of our Office of Faculty Development at Texas Tech University Health Sciences Center El Paso (TTUHSC EP) to this unprecedented challenge during and after this post-pandemic crisis. The initiatives for emergency transition to eLearning and faculty development described in this paper may serve as a model for other academic health centers, schools, colleges and universities.


Assuntos
Betacoronavirus , Instrução por Computador/métodos , Infecções por Coronavirus , Educação Profissionalizante/métodos , Docentes/organização & administração , Internet , Pandemias , Pneumonia Viral , Desenvolvimento de Pessoal/organização & administração , Educação Profissionalizante/organização & administração , Humanos , Desenvolvimento de Pessoal/métodos , Texas
3.
Iran J Kidney Dis ; 14(2): 81-94, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32165592

RESUMO

Diabetic nephropathy (ND) is the leading cause of end-stage renal disease and oxidative stress (OS) has been recognized as a key factor in the pathogenesis and progression. Hyperglycemia, reactive oxygen species, advanced glycation end products, arterial pressure, insulin resistance, decrease in nitric oxide, inflammatory markers, and cytokines, among others; are involved in the presence of OS on ND. This revision focus on diverse studies in experimental and human models with diabetes and DN that has been demonstrated beneficial effects of different dietary antioxidant as resveratrol, curcumin, selenium, soy, catechins, α-lipoic acid, coenzyme Q10, omega-3 fatty acids, zinc, vitamins E and C, on OS and the capacity for antioxidant response. Therefore, this interventions could have a positive clinical impact on DN.

4.
Lupus Sci Med ; 6(1): e000343, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31478011

RESUMO

Objective: To compare the clinical, laboratory and outcome features of SLE patients with and without Jaccoud's arthropathy (JA) from the Grupo Latino Americano De Estudio del Lupus (GLADEL) cohort. Methods: 1480 patients with SLE [(34 centres, 9 Latin American countries with a recent diagnosis (≤2 years)] constitute the GLADEL cohort. JA was defined as reducible deformity of the metacarpophalangeal axis, without radiographic erosions at any time. Within this cohort, a nested case-control study was carried out. Control was matched for age, gender and centre in a 1:3 proportion. The variables included were: sociodemographic, clinical and immunological features, disease activity, damage and mortality. Comparisons were performed with Wilcoxon and χ2 tests for continuous and categorical variables, respectively. ORs and 95% CIs and Kaplan-Meier survival curve were estimated. Results: Of 1480 patients, 17 (1.1%) JA patients were identified; 16 (94.1%) of them were women, mean age: 31.0 years (SD 12.0). Five (29.4%) patients presented JA at SLE diagnosis and 12 (70.6%) after. The median follow-up time and all disease features were comparable in both groups except for a higher frequency of pneumonitis in the patients with JA [4 (23.5) vs 1 (2.0); p=0.012; (OR: 15.4; 95% CI 1.6 to 149.6)]. The SLE disease activity index, Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage Index and the Kaplan-Meier survival curve were similar in both groups. Conclusion: JA may tend to appear early in the course of SLE; it seems not to have an impact on disease activity, damage accrual or in survival.

5.
IEEE Trans Neural Syst Rehabil Eng ; 27(9): 1883-1892, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31403437

RESUMO

Brain-computer interface (BCI) spellers based on event related potentials (ERPs) are intrinsically synchronous systems. Therefore, selections are constantly made, even when users are not paying attention to the stimuli. This poses a major limitation in real-life applications, in which an asynchronous control is required. The aim of this study is to design, develop and test a novel method to discriminate whether the user is controlling the system (i.e., control state) or is engaged in other task (i.e., non-control state). To achieve such an asynchronous control, our method detects the steady-state visual evoked potentials (SSVEPs) elicited by peripheral stimuli of ERP-based spellers. A characterization experiment was conducted with 5 subjects to investigate general aspects of this phenomenon. Then, the proposed method was validated with 15 subjects in offline and online sessions. Results show that the proposed method provides a reliable asynchronous control, achieving an average accuracy of 95.5% for control state detection during the online sessions. Furthermore, our approach is independent of the ERP classification stage, and to the best of our knowledge, is the first procedure that does not need to extend the duration of the calibration sessions to acquire non-control observations.

6.
Org Biomol Chem ; 17(6): 1423-1435, 2019 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-30672562

RESUMO

A collection of fourteen diphenylamine macrocyclic derivatives containing a peptide chain with different substituents was synthesized using a protocol of two Ugi four component reactions (Ugi-4CR) and a Buchwald-Hartwig macrocyclization. Their anti-inflammatory effects were assayed with an ear edema model using 12-O-tetradecanoylphorbol-13-acetate, while the activity of myeloperoxidase was determined to evaluate the index of leukocyte infiltration. Compound 5e had an ID50 of 0.18 µM per ear with a potency higher than that of the reference drugs indomethacin and celecoxib (0.24 and 0.91 µM per ear, respectively). Moreover, the cytotoxicity of the macrocycles was determined in two healthy cell lines, showing a low percentage of toxicity.


Assuntos
Anti-Inflamatórios/síntese química , Anti-Inflamatórios/farmacologia , Difenilamina/química , Compostos Macrocíclicos/síntese química , Compostos Macrocíclicos/farmacologia , Animais , Anti-Inflamatórios/química , Anti-Inflamatórios/uso terapêutico , Técnicas de Química Sintética , Ciclização , Relação Dose-Resposta a Droga , Edema/tratamento farmacológico , Concentração Inibidora 50 , Leucócitos/efeitos dos fármacos , Leucócitos/imunologia , Compostos Macrocíclicos/química , Compostos Macrocíclicos/uso terapêutico , Camundongos , Modelos Moleculares , Conformação Molecular , Células RAW 264.7
7.
Brain Topogr ; 32(4): 599-624, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-27026168

RESUMO

The curtain of technical limitations impeding rat multichannel non-invasive electroencephalography (EEG) has risen. Given the importance of this preclinical model, development and validation of EEG source imaging (ESI) is essential. We investigate the validity of well-known human ESI methodologies in rats which individual tissue geometries have been approximated by those extracted from an MRI template, leading also to imprecision in electrode localizations. With the half and fifth sensitivity volumes we determine both the theoretical minimum electrode separation for non-redundant scalp EEG measurements and the electrode sensitivity resolution, which vary over the scalp because of the head geometry. According to our results, electrodes should be at least ~3 to 3.5 mm apart for an optimal configuration. The sensitivity resolution is generally worse for electrodes at the boundaries of the scalp measured region, though, by analogy with human montages, concentrates the sensitivity enough to localize sources. Cramér-Rao lower bounds of source localization errors indicate it is theoretically possible to achieve ESI accuracy at the level of anatomical structures, such as the stimulus-specific somatosensory areas, using the template. More validation for this approximation is provided through the comparison between the template and the individual lead field matrices, for several rats. Finally, using well-accepted inverse methods, we demonstrate that somatosensory ESI is not only expected but also allows exploring unknown phenomena related to global sensory integration. Inheriting the advantages and pitfalls of human ESI, rat ESI will boost the understanding of brain pathophysiological mechanisms and the evaluation of ESI methodologies, new pharmacological treatments and ESI-based biomarkers.


Assuntos
Mapeamento Encefálico/métodos , Eletroencefalografia/métodos , Animais , Encéfalo/fisiologia , Encefalopatias , Eletrodos , Humanos , Imagem por Ressonância Magnética , Masculino , Ratos , Couro Cabeludo
8.
ChemMedChem ; 14(1): 132-146, 2019 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-30430749

RESUMO

Inflammation is widely reported as a main factor for the development of chronic diseases such as cancer, diabetes, and even metabolic syndrome. Thus, the search for novel anti-inflammatory compounds is required. Herein we describe the synthesis of a collection of peptidic pyrazinones by a convenient approach involving a multicomponent isocyanide-based reaction followed by a tandem deprotection/oxidative cyclization step. This series of compounds were tested for their potential anti-inflammatory capacity in an in vivo murine model, and four compounds were identified to inhibit tetradecanoylphorbol acetate (TPA)-induced edema by more than 75 %. The two most active compounds, N-benzyl-2-(4-hydroxy-3,5-dimethoxyphenyl)-2-[2-oxopyrazin-1(2H)-yl]acetamide (10 o) and N-cyclohexyl-2-[2-oxopyrazin-1(2H)-yl]-2-[4-(trifluoromethyl)phenyl]acetamide (10 x), with methyl and trifluoromethyl groups, were also able to decrease myeloperoxidase activity and leukocyte infiltration. Moreover, 10 x decreased the thickness of TPA-treated mouse ears, as observed in histological analysis of the tissues.


Assuntos
Anti-Inflamatórios não Esteroides/síntese química , Anti-Inflamatórios não Esteroides/farmacologia , Inflamação/tratamento farmacológico , Pirazinas/síntese química , Pirazinas/farmacologia , Animais , Anti-Inflamatórios não Esteroides/química , Células COS , Proliferação de Células/efeitos dos fármacos , Chlorocebus aethiops , Relação Dose-Resposta a Droga , Orelha , Edema/tratamento farmacológico , Masculino , Camundongos , Estrutura Molecular , Pirazinas/química , Relação Estrutura-Atividade
9.
Conf Proc IEEE Eng Med Biol Soc ; 2019: 4807-4810, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31946937

RESUMO

In this study, a new automated noise rejection algorithm, the SOurce-estimate-Utilizing Noise-Discarding algorithm (SOUND), was evaluated on magnetoencephalographic (MEG) resting-state signals in order to select its optimal configuration parameters. Different values of the epoch length and the regularization parameter λ0 were assessed in three scenarios with ascending noise levels. Results show that it is possible to remarkably improve the Signal-to-Noise Ratio, without overly altering the signal of interest. An optimal λ0 value of 0.1 was obtained. However, the epoch length should be adapted to the specific problem. In conclusion, our results suggest that the SOUND algorithm is an appropriate and useful tool to be applied in a preprocessing pipeline for MEG restingstate signals.


Assuntos
Algoritmos , Artefatos , Magnetoencefalografia , Processamento de Sinais Assistido por Computador , Humanos , Razão Sinal-Ruído
11.
BMC Nephrol ; 19(1): 324, 2018 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-30428841

RESUMO

BACKGROUND: Acyclovir is one of the most common prescribed antiviral drugs. Acyclovir nephrotoxicity occurs in approximately 12-48% of cases. It can present in clinical practice as acute kidney injury (AKI), crystal-induced nephropathy, acute tubulointerstitial nephritis, and rarely, as tubular dysfunction. Electrolytes abnormalities like hypokalemia, were previously described only when given intravenously. CASE PRESENTATION: A 54 year-old female presented with weakness and lower extremities paresis, nausea and vomiting after receiving oral acyclovir. Physical examination disclosed a decrease in the patellar osteotendinous reflexes (++ / ++++). Laboratory data showed a serum creatinine level of 2.1 mg/dL; serum potassium 2.1 mmol/L. Kidney biopsy was obtained; histological findings were consistent with acute tubular necrosis and acute tubulointerstitial nephritis. The patient was advised to stop the medications and to start with oral and intravenous potassium supplement, symptoms improved and continued until serum potassium levels were > 3.5 meq/L. CONCLUSIONS: The case reported in this vignette is unique since it is the first one to describe hypokalemia associated to acute tubular necrosis induced by oral acyclovir.


Assuntos
Aciclovir/efeitos adversos , Antivirais/efeitos adversos , Hipopotassemia/induzido quimicamente , Hipopotassemia/patologia , Necrose Tubular Aguda/induzido quimicamente , Necrose Tubular Aguda/patologia , Aciclovir/administração & dosagem , Administração Oral , Antivirais/administração & dosagem , Feminino , Humanos , Hipopotassemia/sangue , Necrose Tubular Aguda/sangue , Pessoa de Meia-Idade
12.
Gac Med Mex ; 154(4): 427-431, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30250329

RESUMO

Introducción: La hiperuricemia es común en pacientes con psoriasis. Se ha sugerido que la elevación de ácido úrico en psoriasis está fuertemente asociada con morbilidad cardiovascular. Objetivo: Determinar la relación entre niveles de ácido úrico, gravedad clínica medida por Psoriasis Area Severity Index (PASI), Body Surface Area (BSA) y static Physician's Global Assessment (sPGA) en pacientes con psoriasis en placas y comorbilidades ungueales y artritis psoriásica. Método: Determinación de ácido úrico sérico en 45 pacientes con psoriasis en placas y 45 controles pareados por sexo, edad e índice de masa corporal; medición de índices de gravedad clínica en pacientes y presencia de manifestaciones ungueales y articulares. Resultados: Los pacientes con psoriasis presentaron niveles más elevados de ácido úrico (7.03 ± 1.47 versus 5.32 ± 1.17, p < 0.01) y mayor prevalencia de hiperuricemia asintomática (68 versus 17.8 %, p < 0.01) que los controles. Existió correlación proporcional significativa entre gravedad determinada por PASI y ácido úrico (r2 = 0.70) y entre manifestaciones articulares e hiperuricemia en pacientes con psoriasis en placas (p < 0.01; RM = 2.85, IC 95 % = 1.52-5.33). Conclusiones: Los niveles séricos de ácido úrico tuvieron correlación proporcional con PASI y se asociaron con manifestaciones articulares en pacientes con psoriasis en placas. Introduction: Hyperuricemia is common in patients with psoriasis. Uric acid elevation in psoriasis has been suggested to be strongly associated with cardiovascular morbidity. Objective: To determine the relationship between uric acid levels and clinical severity as measured by the Psoriasis Area Severity Index (PASI), body surface area (BSA) and static Physician's Global Assessment (sPGA) in patients with plaque psoriasis and nail comorbidities and psoriatic arthritis. Method: Determination of serum uric acid in 45 patients with plaque psoriasis and 45 controls matched by gender, age and body mass index; measurement of patient clinical severity indices and presence of nail and joint manifestations. Results: Patients with psoriasis had higher levels of uric acid (7.03 ± 1.47 versus 5.32 ± 1.17, p < 0.01), and higher prevalence of asymptomatic hyperuricemia than controls (68% versus 17.8%, p < 0.01). There was significant proportional correlation between PASI-determined severity and uric acid (r2 = 0.70), and between joint manifestations and hyperuricemia in patients with plaque psoriasis (p < 0.01; OR = 2.85, 95% CI = 1.52-5.33). Conclusions: Serum uric acid levels had a proportional correlation with PASI and were associated with joint manifestations in patients with plaque psoriasis.


Assuntos
Artrite Psoriásica/fisiopatologia , Hiperuricemia/epidemiologia , Psoríase/fisiopatologia , Ácido Úrico/sangue , Adulto , Idoso , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Índice de Gravidade de Doença
13.
ChemMedChem ; 13(12): 1193-1209, 2018 06 20.
Artigo em Inglês | MEDLINE | ID: mdl-29771004

RESUMO

Cancer continues to be a worldwide health problem. Certain macrocyclic molecules have become attractive therapeutic alternatives for this disease because of their efficacy and, frequently, their novel mechanisms of action. Herein, we report the synthesis of a series of 20-, 21-, and 22-membered macrocycles containing triazole and bis(aryl ether) moieties. The compounds were prepared by a multicomponent approach from readily available commercial substrates. Notably, some of the compounds displayed interesting cytotoxicity against cancer (PC-3) and breast (MCF-7) cell lines, especially those bearing an aliphatic or a trifluoromethyl substituent on the N-phenyl moiety (IC50 <13 µm). Additionally, some of the compounds were able to induce apoptosis relative to the solvent control; in particular, (Z)-N-cyclohexyl-7-oxo-6-[4-(trifluoromethyl)phenyl]-11 H-3,10-dioxa-6-aza-1(4,1)-triazola-4(1,3),9(1,4)-dibenzenacyclotridecaphane-5-carboxamide (12 f) was the most potent in this regard (22.7 % of apoptosis).


Assuntos
Antineoplásicos/farmacologia , Éteres/farmacologia , Compostos Macrocíclicos/farmacologia , Triazóis/farmacologia , Antineoplásicos/síntese química , Antineoplásicos/química , Apoptose/efeitos dos fármacos , Linhagem Celular Tumoral , Relação Dose-Resposta a Droga , Ensaios de Seleção de Medicamentos Antitumorais , Éteres/síntese química , Éteres/química , Humanos , Compostos Macrocíclicos/síntese química , Compostos Macrocíclicos/química , Estrutura Molecular , Relação Estrutura-Atividade , Triazóis/síntese química , Triazóis/química
14.
J Pharm Pharmacol ; 70(8): 1031-1039, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29774523

RESUMO

OBJECTIVES: To explore the antihyperglycaemic and antidiabetic effects and to determine the acute toxicity of 5-(4-chlorophenyl)-1-(2,4-dichloro-phenyl)-4-methyl-N-(piperidin-1-yl)-1H-pyrazole-3-carboxamide (ENP-9). METHODS: The antihyperglycaemic effect of ENP-9 (50 mg/kg) was determined by oral glucose tolerance test (OGTT). Also, the acute (16, 50 and 160 mg/kg) and subacute (50 mg/kg/day for 10 days) antidiabetic effects of ENP-9 were determined. After subacute treatment, blood samples were analysed to determine glucose and lipid profiles. Also, an acute toxicity determination of ENP-9 was conducted followed the OECD recommendation. Molecular docking was performed using AutoDock 4.2.6 at human cannabinoid receptor 1 (PDB code 5TGZ). KEY FINDINGS: Acute Administration of ENP-9 showed significant antidiabetic effect and decreased the maximum OGTT peak, compared to the control group (P < 0.05). Moreover, the 10 days treatment induced a decrease in plasma glucose levels, being significant at the end of the experiments (P < 0.05); however, triacylglycerols and cholesterol were not modified. Finally, LD50 of ENP-9 was estimated to be greater than 2000 mg/kg. Molecular docking suggests that ENP-9 may act as rimonabant does. CONCLUSIONS: ENP-9 showed significant antihyperglycaemic and antidiabetic properties and also was demonstrated to be safety in the studied doses, which might allow future studies for its potential development as antidiabetic agent.


Assuntos
Diabetes Mellitus Experimental/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Pirazóis/uso terapêutico , Animais , Glicemia/análise , Colesterol/sangue , Diabetes Mellitus Experimental/sangue , Relação Dose-Resposta a Droga , Esquema de Medicação , Teste de Tolerância a Glucose , Humanos , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/química , Camundongos Endogâmicos , Simulação de Acoplamento Molecular , Piperidinas/química , Piperidinas/farmacologia , Ligação Proteica , Pirazóis/administração & dosagem , Pirazóis/química , Pirazóis/farmacologia , Receptor CB1 de Canabinoide/metabolismo , Rimonabanto , Relação Estrutura-Atividade , Testes de Toxicidade Aguda , Triglicerídeos/sangue
16.
Arch. cardiol. Méx ; 87(2): 155-166, Apr.-Jun. 2017. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-887509

RESUMO

Abstract: Objective: Rationale for non-routine use of inferior venous cava filters (IVCF) in pulmonary embolism (PE) patients. Methods: Thrombosis mechanisms involved with IVCF placement and removal, the blood-contacting medical device inducing clotting, and the inorganic polyphosphate in the contact activation pathway were analyzed. In addition, we analyzed clinical evidence from randomized trials, including patients with and without cancer. Furthermore, we estimated the absolute risk reduction (ARR), the relative risk reduction (RRR), and the number needed to treat (NNT) based on the results of each study using a frequency table. Finally, we analyzed the outcome of our PE patients that were submitted to thrombolysis with short and long term follow-up. Results: IVCF induces thrombosis by several mechanisms including placement and removal, rapid protein adsorption, and simultaneous surface-induced activation via the contact activation pathway. Also, inorganic polyphosphate has an important role as a procoagulant, reversing the effect of anticoagulants. Randomized control trials included 904 cancer and non-cancer PE patients. In terms of ARR, RRR, and NNT, there is no evidence for routine use of IVCF. In 290 patients with proved PE, extensive thrombotic burden and right ventricular dysfunction under thrombolysis and oral anticoagulation, we observed a favorable outcome in a short- and long-term follow-up; additionally, IVCF was only used in 5% of these patients. Conclusion: Considering the complex mechanisms of thrombosis related with IVCF, the evidence from randomized control trials and ARR, RRR, and NNT obtained from venous thromboembolism patients with and without cancer, non-routine use of IVCF is recommended.


Resumen: Objetivo: Racionalidad para no utilizar en forma rutinaria filtros de vena cava inferior (FVCI) en pacientes con tromboembolia pulmonar (TEP). Métodos: Analizamos mecanismos de trombosis relacionados con la colocación o retiro de estos dispositivos médicos, incluyendo la importancia del polifosfato inorgánico en la vía de activación de contacto. Analizamos evidencia clínica de estudios aleatorizados controlados en pacientes con y sin cáncer. Mediante tablas de frecuencia estimamos de cada estudio reducción del riesgo absoluto (RRA) y relativo (RRR) y el número necesario a tratar (NNT). Finalmente, examinamos la evolución de nuestros pacientes con TEP llevados a trombolisis con seguimientos a corto y largo plazo. Resultados: FVCI inducen trombosis por diferentes mecanismos: colocación y retiro, adsorción rápida de proteínas y activación de superficie inducida en la vía de activación de contacto. El polifosfato inorgánico es un procoagulante importante para la anticoagulación. Estudios aleatorizados controlados incluyeron 904 pacientes con TEP con y sin cáncer. En términos de RRA, RRR y NNT no existe evidencia para el uso rutinario. En 290 pacientes con TEP probada, importante carga de trombo y disfunción del ventrículo derecho llevados a trombolisis y anticoagulación observamos una evolución favorable en seguimientos a corto y largo plazo. En estos pacientes los FVCI se utilizaron solo en el 5%. Conclusión: Considerando los mecanismos complejos de trombosis relacionados con los FVCI, la evidencia obtenida de los estudios aleatorizados y controlados, así como la RRA, RRR y NNT en pacientes con tromboembolismo venoso con y sin cáncer, no recomendamos el uso rutinario de FVCI.

17.
Biomedica ; 37(0): 92-103, 2017 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-28527271

RESUMO

INTRODUCTION: Self-rated health is an individual and subjective conceptualization involving the intersection of biological, social and psychological factors. It provides an invaluable and unique evaluation of a person's general health status. OBJECTIVE: To propose and evaluate a simple conceptual model to understand self-rated health and its relationship to multimorbidity, disability and depressive symptoms in Mexican older adults. MATERIALS AND METHODS: We conducted a cross-sectional study based on a national representative sample of 8,874 adults of 60 years of age and older. Self-perception of a positive health status was determined according to a Likert-type scale based on the question: "What do you think is your current health status?" Intermediate variables included multimorbidity, disability and depressive symptoms, as well as dichotomous exogenous variables (sex, having a partner, participation in decision-making and poverty). The proposed conceptual model was validated using a general structural equation model with a logit link function for positive self-rated health. RESULTS: A direct association was found between multimorbidity and positive self-rated health (OR=0.48; 95% CI: 0.42-0.55), disability and positive self-rated health (OR=0.35; 95% CI: 0.30-0.40), depressive symptoms and positive self-rated health (OR=0.38; 95% CI: 0.34-0.43). The model also validated indirect associations between disability and depressive symptoms (OR=2.25; 95% CI: 2.01- 2.52), multimorbidity and depressive symptoms (OR=1.79; 95% CI: 1.61-2.00) and multimorbidity and disability (OR=1.98; 95% CI: 1.78-2.20). CONCLUSIONS: A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.


Assuntos
Depressão/epidemiologia , Multimorbidade , Estudos Transversais , Nível de Saúde , Humanos , México/epidemiologia , Autorrelato
18.
CEN Case Rep ; 6(1): 91-97, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28509134

RESUMO

Atypical hemolytic uremic syndrome (aHUS) is a rare disease characterized by hemolysis, thrombocytopenia, and renal failure. It is related to genetic mutations of the alternative complement pathway and is difficult to differentiate from other prothrombotic microangiopathies. Eosinophilic granulomatosis with polyangiitis (EGPA) (Churg-Strauss syndrome, CSS) is a systemic ANCA-associated vasculitis and a hypereosinophilic disorder where eosinophils seem to induce cell apoptosis and necrosis and therefore, vasculitis. Here, we report the case of two CSS patients with a genetic complement disorder consistent with aHUS diagnosis. Both patients showed histologic features that supported the diagnosis of CSS, and a genetic complement study confirmed the suspected aHUS diagnosis. In the case where eculizumab was administered, the global response was excellent. There is very limited understanding of the genetics and epidemiology of both, atypical HUS and EGPA, but considering our two patients we suggest that an etiopathogenic link exists among patients diagnosed with both entities.

19.
J Cardiovasc Pharmacol ; 69(4): 192-197, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28375903

RESUMO

BACKGROUND: The risk-benefit of antithrombotic treatment (ATT) has not been established in patients on dialysis. Our objective was to determine the influence of ATT on the risk of hemorrhage in patients on hemodialysis. METHODS: We included patients who began dialysis between 2003 and 2007. We determined the rates of fatal bleeding or bleeding leading to hospitalization or transfusion. RESULTS: Two hundred twenty-one patients were included. Over the follow-up period (45.5 ± 34 months), there were 76 hemorrhages in 52 patients. There were 10 fatal bleedings. The annual incidence of patients presenting with hemorrhagia was 6.2%. Bleeding occurred in 5.2% of those being treated with aspirin, 7% with acenocumarol, 12.3% with clopidogrel, 15.2% with aspirin + clopidogrel, 45.9% with anticoagulants + antiplatelets, 49.6% with low-molecular-weight heparin, and 3.9% without ATT. On multivariate analysis, masculine gender [hazard ratio (HR): 2.421; 95% confidence interval (CI), 1.261-4.650; P = 0.003], treatment with dicumarins (HR: 2.406; 95% CI, 1.013-5.718; P = 0.047), treatment with clopidogrel (HR: 2.697; 95% CI, 1.440-5.051; P = 0.002), and treatment with low-molecular-weight heparin (HR: 21.463; 95% CI, 9.067-50.806; P = 0.001) were independent predictors of bleeding. CONCLUSIONS: ATT increases the risk of bleeding in patients on hemodialysis. The incidence of hemorrhage varies with the type of antithrombotics used.


Assuntos
Fibrinolíticos/efeitos adversos , Hemorragia/induzido quimicamente , Falência Renal Crônica/terapia , Diálise Renal/efeitos adversos , Diálise Renal/tendências , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/efeitos adversos , Feminino , Seguimentos , Hemorragia/diagnóstico , Humanos , Falência Renal Crônica/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Adulto Jovem
20.
Biomédica (Bogotá) ; 37(supl.1): 92-103, abr. 2017. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-888515

RESUMO

Resumen Introducción. La autopercepción de la salud es una concepción individual y subjetiva que resulta de la intersección entre factores biológicos, sociales y psicológicos, y proporciona una evaluación única e inestimable del estado general de salud de una persona. Objetivo. Proponer y evaluar un modelo conceptual simple para entender la autopercepción de la salud y su relación con la presencia de comorbilidades, discapacidad y síntomas depresivos en adultos mayores mexicanos. Materiales y métodos. Se hizo un estudio transversal basado en una muestra representativa nacional de 8.874 adultos de 60 y más años. Se determinó la autopercepción positiva de la salud mediante una escala de tipo Likert con la pregunta: "¿Cómo considera que es su estado actual de salud?", así como de las variables intermedias de presencia de comorbilidades, discapacidad y síntomas depresivos, y variables exógenas dicotómicas (sexo, tener pareja, percepción de la participación en las decisiones del hogar y pobreza). Para validar el modelo conceptual propuesto, se diseñó un modelo generalizado de ecuaciones estructurales con función de enlace logit para la autopercepción positiva de la salud. Resultados. Se encontró una asociación de vías directas entre la presencia de comorbilidades y la autopercepción positiva de la salud (odds ratio, OR=0,48; IC95% 0,42-0,55), entre la discapacidad y la autopercepción positiva de la salud (OR=0,35; IC95% 0,30-0,40), y entre los síntomas depresivos y la autopercepción positiva de la salud (OR=0,38; IC95% 0,34-0,43). El modelo también validó asociaciones indirectas entre discapacidad y síntomas depresivos (OR=2,25; IC95% 2,01-2,52), presencia de comorbilidades y síntomas depresivos (OR=1,79; IC95% 1,61-2,00), y presencia de comorbilidades y discapacidad (OR=1,98; IC95% 1,78-2,20). Conclusiones. Se hizo la evaluación empírica de un modelo teórico parsimonioso, lo cual permitió determinar asociaciones directas e indirectas con la autopercepción positiva de la salud.


Abstract Introduction: Self-rated health is an individual and subjective conceptualization involving the intersection of biological, social and psychological factors. It provides an invaluable and unique evaluation of a person's general health status. Objective: To propose and evaluate a simple conceptual model to understand self-rated health and its relationship to multimorbidity, disability and depressive symptoms in Mexican older adults. Materials and methods: We conducted a cross-sectional study based on a national representative sample of 8,874 adults of 60 years of age and older. Self-perception of a positive health status was determined according to a Likert-type scale based on the question: "What do you think is your current health status?" Intermediate variables included multimorbidity, disability and depressive symptoms, as well as dichotomous exogenous variables (sex, having a partner, participation in decision-making and poverty). The proposed conceptual model was validated using a general structural equation model with a logit link function for positive self-rated health. Results: A direct association was found between multimorbidity and positive self-rated health (OR=0.48; 95% CI: 0.42-0.55), disability and positive self-rated health (OR=0.35; 95% CI: 0.30-0.40), depressive symptoms and positive self-rated health (OR=0.38; 95% CI: 0.34-0.43). The model also validated indirect associations between disability and depressive symptoms (OR=2.25; 95% CI: 2.01-2.52), multimorbidity and depressive symptoms (OR=1.79; 95% CI: 1.61-2.00) and multimorbidity and disability (OR=1.98; 95% CI: 1.78-2.20). Conclusions: A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA