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1.
Biomed Res Int ; 2021: 6682418, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34327236

RESUMEN

Background: Soil-transmitted helminths (STHs) and Schistosoma mansoni are the main causes of morbidity among schoolchildren in the tropics. A school-based deworming program was launched to control and eliminate the infection in endemic countries including Ethiopia. Although periodic deworming is conducted in endemic areas, the prevalence of the infection is high in the country. In addition, periodic evaluation of the efficacy of the anthelminthic drug is limited. Objective: This study is aimed at checking the efficacy of mebendazole and praziquantel with the respective STHs and Schistosoma mansoni parasites. Methods: A longitudinal study was conducted from February to March 2018 among 422 schoolchildren. Stool samples were collected at baseline and at 2 and 4 weeks posttreatment and were processed using the Kato-Katz technique. Schoolchildren positive for STHs were treated with mebendazole and those positive for Schistosoma mansoni with praziquantel. After two weeks, a second round of stool was collected and examined, and then, single-dose redosing was given to each positive child. Lastly, the third stool sample was collected two weeks after the initiation of the redosing and checked for STHs and S. mansoni parasites. A close follow-up of students who were treated was done. All the data were entered and analyzed using SPSS version 20 for analysis. Descriptive statistics was used to compute the cure rate and egg reduction rate of mebendazole and praziquantel. Results: Among 422 participants, the prevalence of STHs, hookworm, Ascaris lumbricoides, and S. mansoni was 44.7%, 35.1%, 21.1%, and 13.9%, respectively. The cure rate of mebendazole against A. lumbricoides increased from 60% in the single dose to 100% in redosing after two weeks. The cure rate of mebendazole against hookworm also increased from 32.4% in the single dose to 91.0% in the redosing. The cure rate of praziquantel against S. mansoni-infected children was 91.5% in the first round and 100% in the redosing phase. There was a 98.6-100% egg reduction rate in the redosing regimen of both drugs. Conclusion: The cure and egg reduction rates of single-dose mebendazole in the treatment of hookworm and A. lumbricoides are lower at week two than at redosing, while cure and egg reduction rates of single-dose praziquantel are satisfactory to treat S. mansoni. Therefore, single-dose praziquantel to S. mansoni and redosing of single-dose mebendazole to A. lumbricoides and hookworm infections can be used for treatment purposes.


Asunto(s)
Helmintos/fisiología , Mebendazol/uso terapéutico , Praziquantel/uso terapéutico , Schistosoma mansoni/fisiología , Esquistosomiasis mansoni/tratamiento farmacológico , Instituciones Académicas , Suelo/parasitología , Estudiantes , Adolescente , Animales , Niño , Etiopía , Femenino , Geografía , Helmintiasis/tratamiento farmacológico , Helmintiasis/parasitología , Helmintos/efectos de los fármacos , Humanos , Masculino , Mebendazol/farmacología , Óvulo/citología , Praziquantel/farmacología , Schistosoma mansoni/efectos de los fármacos , Esquistosomiasis mansoni/parasitología , Resultado del Tratamiento
2.
Bioresour Technol ; 339: 125588, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34298244

RESUMEN

Adverse detrimental impacts of environmental pollution over the health regimen of people has driven a shift in lifestyle towards cleaner and natural resources, especially in the aspects of food production and consumption. Microalgae are considered a rich source of high value metabolites to be utilized as plant growth biostimulants. These organisms however, are underrated compared to other microbial counterparts, due to inappropriate knowledge on the technical, enviro-economical constrains leading to low market credibility. Thus, to avert these issues, the present review comprehensively discusses the biostimulatory potential of microalgae interactively combined with circular bio-economy perspectives. The biochemical content and intracellular action mechanism of microalgal biostimulants were described. Furthermore, detailed country-wise market trends along with the description of the existing regulatory policies are included. Enviro-techno-economic challenges are discussed, and the consensus need for shift to biorefinery and circular bio-economy concept are emphasized to achieve sustainable impacts during the commercialization of microalgal biostimulants.


Asunto(s)
Microalgas , Biocombustibles , Contaminación Ambiental , Alimentos , Humanos , Desarrollo de la Planta
3.
PLoS One ; 15(12): e0242240, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33296365

RESUMEN

INTRODUCTION: Soil transmitted helminths (STH) can affect over 50% of children in some parts of Tanzania. Control measures involve annual deworming campaigns in schools, but re-infection is rapid. This paper presents the design and baseline survey results of an ongoing school-based cluster-randomised controlled trial in Kagera region, NW Tanzania. The trial aims to determine whether the effect of routine deworming on the prevalence of Ascaris lumbricoides and Trichuris trichiura infections among school aged children can be sustained when combined with a behaviour change intervention promoting handwashing with water and soap. METHODS: As part of the trial, a total of 16 schools were randomised to receive the intervention (N = 8) or as controls (N = 8). Randomisation was stratified per district and restricted to ensure pre-trial STH prevalence was balanced between study arms. The combination intervention to be tested comprises class-room based teacher-led health education, improvement of handwash stations, coloured nudges to facilitate handwashing and parental engagement sessions. The impact evaluation involves two cross-sectional surveys conducted at baseline and endline. The objectives of the baseline survey were: (i) to confirm whether the deworming campaign was successful, and identify and treat students still infected about 2 weeks after deworming, (ii) to document any baseline differences in STH prevalence between trial arms, and (iii) to assess handwashing behaviours, and access to water and sanitation at school and home. We randomly sampled 35 students per class in Grades 1-6 (an average of 200 children per school), stratified to ensure equal representation between genders. Assenting students were interviewed using a structured questionnaire and asked to provide a stool specimen. RESULTS: Results of the baseline survey conducted about 2 weeks after deworming shows balanced demographic and STH prevalence data across trial arms. We observed a low prevalence of ascariasis (< 5%) as expected; however, the prevalence of trichuriasis was still about 35% in both arms. CONCLUSION: The randomisation procedure was successful in achieving a balanced distribution of demographic characteristics and helminth infections between trial arms. The intervention is being rolled out. The current deworming treatment regimen may need to be revised with regards to the treatment of trichuriasis.


Asunto(s)
Ascariasis/prevención & control , Higiene de las Manos/organización & administración , Control de Infecciones/organización & administración , Servicios de Salud Escolar/organización & administración , Tricuriasis/prevención & control , Animales , Antihelmínticos/administración & dosificación , Ascariasis/diagnóstico , Ascariasis/tratamiento farmacológico , Ascariasis/epidemiología , Ascaris lumbricoides/aislamiento & purificación , Terapia Conductista/métodos , Niño , Terapia Combinada/métodos , Estudios Transversales , Heces/parasitología , Femenino , Higiene de las Manos/métodos , Conductas Relacionadas con la Salud , Promoción de la Salud/métodos , Promoción de la Salud/organización & administración , Humanos , Control de Infecciones/métodos , Masculino , Prevalencia , Suelo/parasitología , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Tanzanía/epidemiología , Tricuriasis/diagnóstico , Tricuriasis/tratamiento farmacológico , Tricuriasis/epidemiología , Trichuris/aislamiento & purificación
4.
BMJ Open ; 10(8): e034582, 2020 08 05.
Artículo en Inglés | MEDLINE | ID: mdl-32759239

RESUMEN

INTRODUCTION: Neurogenic bladder dysfunction is prevalent in female patients with spinal cord injury (SCI), and previous guidelines have recommended pelvic floor muscle training (PFMT) for first-line conservative treatment. However, the actual regimen of PFMT varies widely and the single treatment does not satisfy the need of some patients. Therefore, this study aims to provide a detailed rationale and methodology for comparing the effectiveness of PFMT, biofeedback and repetitive transcranial magnetic stimulation (rTMS) as adjunct treatments for neurogenic bladder dysfunction. METHODS AND ANALYSIS: This trial is a single-centre randomised controlled trial for female patients with urinary incontinence (UI) in phase of chronic SCI. Eligible participants will be randomised to one of four arms: (1) PFMT, (2) PFMT with biofeedback, (3) PFMT and rTMS and (4) PFMT with biofeedback and rTMS. There will be 44 participants in each arm and all the subjects will undergo 20 treatment sessions, five times a week for 4 weeks. The outcomes will be evaluated at 4 weeks, 3 months and 6 months after randomisation. The primary outcome is the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, and the secondary outcomes include bladder diary, pelvic floor muscle function and the International Spinal Cord Injury Quality of Life Basic Data Set. ETHICS AND DISSEMINATION: The Clinical Research and Biomedical Ethics Committee of the West China Hospital, Sichuan University has approved this trial and the approval number is 2019-885. All participants will be provided written informed consent after verification of the eligibility criteria. The results of this study will be accessible in peer-reviewed publications and be presented at academic conferences. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry (ChiCTR1900026126).


Asunto(s)
Traumatismos de la Médula Espinal , Vejiga Urinaria Neurogénica , Incontinencia Urinaria de Esfuerzo , Biorretroalimentación Psicológica , China , Terapia por Ejercicio , Femenino , Humanos , Diafragma Pélvico , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Traumatismos de la Médula Espinal/complicaciones , Estimulación Magnética Transcraneal , Resultado del Tratamiento , Vejiga Urinaria Neurogénica/etiología , Vejiga Urinaria Neurogénica/terapia
6.
Rev. peru. biol. (Impr.) ; 27(2): 205-214, abr.-jun 2020. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1144949

RESUMEN

Abstract Ecologically-sound management plans for high-altitude grasslands of the Andes depend on an understanding the responses of plants to fire, especially the dominant tussock grasses. This study considers physiognomic responses of tussock grass in 13 sites in northern Ecuador with a known fire history, with time since fire 0.5-10 y, and a control site which had not been burned for at least 40 y. At each site, we assessed vegetation height, basal cover of the tussocks, and the ratio of dead:live leaves in tussocks. We also measured light at ground level. As recovery time increased, tussock cover and number decreased, while tussock height increased. Light levels fell sharply below the tussock canopies as recovery took place, and dead leaves accumulated quickly, reaching 60 - 70% by just two years after fire. The modification of physical tussock structure is likely to influence a much wider ecosystem response to fire, and determines directly the fuel load for future fires. Despite these clear changes in tussock characteristics, they were too variable to be used as a reliable bioindicator of time since fire. However, a better understanding of the responses of tussock grasses to fire and particularly its impact on other species should become the focus of further attention in future.


Resumen Los planes de manejo ecológicamente sólidos para los pastizales de gran altura en los Andes dependen del entendimiento de las respuestas de las plantas al fuego, en especial las respuestas de los pastos dominantes. Este estudio considera las respuestas fisionómicas de pastos en 13 sitios en el norte del Ecuador con un historial de incendios conocido, con tiempo entre 0.5 y 10 años después del incendio, más un sitio control donde al menos durante 40 años no se había producido incendio. En cada sitio, evaluamos la altura de la vegetación, la cobertura basal de las macollas y la proporción de hojas muertas:vivas en las macollas. También, medimos la luz a nivel del suelo. A medida que aumentó el tiempo de recuperación, la cobertura y el número de macollas disminuyeron, mientras que la altura de las macollas aumentó. Los niveles de luz cayeron fuertemente debajo de las copas de las macollas durante la recuperación, y las hojas muertas se acumularon rápidamente, alcanzando 60 - 70% solo dos años después del incendio. Es probable que las modificaciones en la estructura física de las macollas influyen en una respuesta mucho más amplia del ecosistema al fuego, y determinen directamente la carga de combustible para futuros incendios. A pesar de que se observaron cambios claros en las características de las macollas, estas eran demasiado variables para ser consideradas como un bioindicador confiable del tiempo transcurrido después del incendio. Sin embargo, una mejor comprensión de las respuestas de las macollas al fuego y, en particular, el impacto de esas respuestas en otras especies debería ser el enfoque de mayor atención en el futuro.

7.
Int J Nurs Stud ; 104: 103527, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32058140

RESUMEN

BACKGROUND: Stress urinary incontinence is a distressing and burdensome condition affecting approximately one third of pregnant women and pelvic floor muscle training is recommended as the first-line treatment. Convenient and cost-effective regimen of pelvic floor muscle training is required to facilitate the treatment of stress urinary incontinence and improve the adherence to treatment in pregnant women. OBJECTIVE: To determine the effectiveness of app-based audio guidance pelvic floor muscle training on the treatment of stress urinary incontinence in primiparas. DESIGN: The study was a two-arm, parallel, randomized controlled clinical trial. SETTING: The study was conducted in the obstetric clinic of a tertiary maternity hospital in Hangzhou, China. PARTICIPANTS: A total of 108 eligible primiparas were enrolled from January to April 2018. METHODS: Participants were randomly allocated (1:1) to the audio group or the control group. Primary outcomes included severity of stress urinary incontinence and adherence to pelvic floor muscle training assessed by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and the Broome Pelvic Muscle Self-Efficacy Scale, respectively. Secondary outcomes included pelvic floor muscle strength, bladder neck mobility and sexual function measured by vaginal palpation and pelvic floor muscle surface electromyography, perineal ultrasound and Female Sexual Function Index, respectively. Data analysis followed the intention-to-treat principle. Generalized estimation equation model, t-test and chi-square test were used to examine intervention effect on primary outcomes and secondary outcomes, respectively. RESULTS: Participants showed significant improvement in symptom severity across the study, which was most significant at 6 weeks postpartum (ß = -4.245, p < 0.001). No significant difference was found in symptom severity between groups (ß = -0.344, p = 0.168). The interaction effect between intervention and time on adherence was significant. Compared with the control group, greater self-efficacy was shown in the audio group at 6 weeks (ß = 4.425, p = 0.009), 3 months (ß = 3.204, p < 0.001) and 6 months (ß = 4.457, p < 0.001) postpartum. Participants in the audio group indicated less bladder neck descent (16.5 vs. 19.5, p = 0.020) at 6 weeks postpartum, better pelvic floor muscle strength (12.5% vs. 34.0%, p = 0.012; 4.2% vs. 18.0%, p = 0.030) and sexual function (22.2 vs. 17.3, p = 0.007) at 6 months postpartum. CONCLUSIONS: The app-based audio guidance pelvic floor muscle training was more effective and much easier to comply for treatment of stress urinary incontinence in primiparas than the conventional home-based pelvic floor muscle training.


Asunto(s)
Aplicaciones Móviles , Diafragma Pélvico/fisiopatología , Incontinencia Urinaria de Esfuerzo/terapia , Adulto , China , Terapia por Ejercicio , Femenino , Humanos , Periodo Posparto , Embarazo , Encuestas y Cuestionarios , Resultado del Tratamiento , Incontinencia Urinaria de Esfuerzo/fisiopatología , Adulto Joven
8.
Conserv Biol ; 34(3): 550-560, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31777984

RESUMEN

Globally, the mean abundance of terrestrial animals has fallen by 50% since 1970, and populations face ongoing threats associated with habitat loss, fragmentation, climate change, and disturbance. Climate change can influence the quality of remaining habitat directly and indirectly by precipitating increases in the extent, frequency, and severity of natural disturbances, such as fire. Species face the combined threats of habitat clearance, changing climates, and altered disturbance regimes, each of which may interact and have cascading impacts on animal populations. Typically, conservation agencies are limited in their capacity to mitigate rates of habitat clearance, habitat fragmentation, or climate change, yet fire management is increasingly used worldwide to reduce wildfire risk and achieve conservation outcomes. A popular approach to ecological fire management involves the creation of fire mosaics to promote animal diversity. However, this strategy has 2 fundamental limitations: the effect of fire on animal movement within or among habitat patches is not considered and the implications of the current fire regime for long-term population persistence are overlooked. Spatial and temporal patterns in fire history can influence animal movement, which is essential to the survival of individual animals, maintenance of genetic diversity, and persistence of populations, species, and ecosystems. We argue that there is rich potential for fire managers to manipulate animal movement patterns; enhance functional connectivity, gene flow, and genetic diversity; and increase the capacity of populations to persist under shifting environmental conditions. Recent methodological advances, such as spatiotemporal connectivity modeling, spatially explicit individual-based simulation, and fire-regime modeling can be integrated to achieve better outcomes for biodiversity in human-modified, fire-prone landscapes. Article impact statement: Land managers may conserve populations by using fire to sustain or enhance functional connectivity.


Asunto(s)
Ecosistema , Incendios , Animales , Biodiversidad , Cambio Climático , Conservación de los Recursos Naturales , Humanos
9.
Menopause ; 26(12): 1405-1414, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31479032

RESUMEN

OBJECTIVE: The aim of this study was to determine the effect of testosterone administration on trunk and pelvic floor muscle area in women with low testosterone levels. METHODS: Participants were hysterectomized women with total testosterone<31 ng/dL and/or free testosterone<3.5 pg/mL; participating in the Testosterone Dose Response in Surgically Menopausal Women (TDSM) trial. All participants received a standardized transdermal estradiol regimen during the 12-week run-in period, and were then randomized to receive weekly intramuscular injections of placebo, or 3, 6.25, 12.5, or 25 mg testosterone enanthate for 24 weeks. Muscle areas of the trunk and pelvis were measured at baseline and end of treatment using 1.5 Tesla magnetic resonance imaging. Total and free testosterone levels were measured by liquid chromatography-tandem mass spectrometry and equilibrium dialysis, respectively. Testosterone effect on muscle areas was analyzed using linear regression models. RESULTS: A total of 24 women who had available baseline and posttreatment magnetic resonance imaging were included in the analysis. Increased cross-sectional areas of the paraspinal, psoas, and abdominal wall muscles were seen after testosterone administration. The estimated mean change (95% CI; P value) between treatment groups was 4.07 cm (1.26-6.88; P = 0.007) for paraspinal, 1.60 cm (0.10-3.09; P = 0.038) for psoas major, and 7.49 cm (1.96-13.02; P = 0.011) for abdominal wall muscles. Increases in psoas muscle area were significantly associated with changes in free testosterone concentrations. No significant changes in obturator internus and pelvic floor muscle areas were observed. CONCLUSION: Short-term testosterone administration in women with low testosterone levels was associated with increased trunk muscle area.


Asunto(s)
Andrógenos/administración & dosificación , Histerectomía/efectos adversos , Fuerza Muscular/efectos de los fármacos , Testosterona/análogos & derivados , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Menopausia Prematura , Diafragma Pélvico/diagnóstico por imagen , Prueba de Estudio Conceptual , Testosterona/administración & dosificación , Testosterona/sangre , Testosterona/deficiencia , Testosterona/farmacología
10.
Acta biol. colomb ; 24(2): 372-378, May-ago. 2019. tab, graf
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1010865

RESUMEN

RESUMEN El cambio en el uso del suelo y el fuego como mecanismo utilizado para el mismo han creado perturbaciones ecológicas a grandes escalas, como lo son la fragmentación y aislamiento de ecosistemas importantes en paisajes tropicales. En el presente estudio, analizamos los cambios de uso del suelo entre los años 2012-2016 y los eventos de fuego entre los años 2016-2018, para identificar la dinámica de cambio espaciotemporal en la Serranía de la Lindosa, Guaviare, a partir de información oficial y sensores remotos. Para 2016 la cobertura boscosa se redujo en un 17 % correspondiendo con el aumento de vegetación secundaria y pastizales en el área. Los focos de fuego detectados estuvieron concentrados en el noroeste y sureste de la serranía, puntos coincidentes en zonas de bosque primario y zonas de pastizal consolidadas. Estos resultados indican que existe un proceso activo de deforestación en la serranía, que fragmenta la matriz boscosa dejando parches de bosque aislados, lo cual tendría repercusiones sobre la biodiversidad allí presente. Asimismo, la sinergia entre dicho proceso y el uso de fuego se muestra como amenaza constante, a diferentes escalas, sobre los diferentes ecosistemas. Esta información se presenta como herramienta para elaborar estrategias puntuales para evitar mayores repercusiones negativas sobre la serranía, que actualmente se encuentra en estado vulnerable.


ABSTRACT The change in land use and fire as a mechanism used for this change, have created ecological disturbances at large scales, such as the fragmentation and isolation of essential ecosystems within tropical landscapes. In the present study, we analyze the land-use changes along 2012-2016 and fire events between 2016-2018, to identify the dynamics of spatial-temporal change in the Serranía La Lindosa, Guaviare using official information and remote sensors. Forest cover was reduced by 17 %, during 2012-2016, corresponding to an increase in secondary vegetation and pastures in the area. The fire-hotspots detected were concentrated on the northwest and southeast of the mountain range, coinciding with areas of primary forest and consolidated pasture areas. These results show that there is an active process of deforestation in La Lindosa, leaving a fragmented matrix and isolated forest patches, which would have repercussions on the local biodiversity. Besides, the synergy between this process and the use of fire, represent a constant threat, at different scales, on the different ecosystems. This information is presented as a resource to elaborate punctual strategies in order to avoid greater negative repercussions on the mountain range area, which is currently in a vulnerable state.

11.
J Dairy Sci ; 102(10): 9495-9504, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31351712

RESUMEN

Through clearing and use of fertilizer and legumes, areas of southwestern Australia's unique coastal sand plains can support relatively low-cost dairies. However, the ancient, highly weathered nature of the soils in this region makes the dairies susceptible to a range of threats, including nutrient leaching and erosion. Despite this, Western Australian dairy cows typically produce up to 5,500 L of milk per head annually supported by inorganic nitrogen (N) fertilizer (commonly 50:50 urea and ammonium sulfate) at rates up to <320 kg of N/ha per year. Where hotspots exist (up to 2,000 kg of N/ha per year), total N exceeds pasture requirements. We investigated plant and soil bacteria responses to N fertilizer rates consistent with Australian legislated production practices on dairy farms for pure and mixed swards of white clover (Trifolium repens) and Italian ryegrass (Lolium multiflorum) in a long-term pasture experiment in controlled glasshouse conditions. Although the soil bacterial community structure at phylum level was similar for white clover and Italian ryegrass, relative abundances of specific subgroups of bacteria differed among plant species according to the N fertilizer regimen. Marked increases in relative abundance of some bacterial phyla and subphyla indicated potential inhibition of N cycling, especially for N hotspots in soil. Ammonium concentration in soil was less correlated with dominance of some N-cycling bacterial phyla than was nitrate concentration. Changes in bacterial community structure related to altered nutrient cycling highlight the potential for considering this area of research in policy assessment frameworks related to nutrient loads in dairy soils, especially for N.


Asunto(s)
Bacterias/efectos de los fármacos , Bovinos/metabolismo , Fertilizantes/microbiología , Lolium/crecimiento & desarrollo , Leche/metabolismo , Nitrógeno/farmacología , Microbiología del Suelo , Trifolium/crecimiento & desarrollo , Animales , Australia , Bacterias/crecimiento & desarrollo , Femenino , Italia , Nitratos/farmacología , Nitrógeno/metabolismo
12.
BMJ Open ; 9(5): e027255, 2019 05 29.
Artículo en Inglés | MEDLINE | ID: mdl-31147361

RESUMEN

INTRODUCTION: Different surgical techniques are used to cover the defect in the floor of the lesser pelvis after an 'extralevator' or 'extended' abdominoperineal excision for advanced rectal cancer. However, these operations are potentially mutilating, and the reconstruction method of the pelvic floor has been studied only sparsely. We aim to study whether a porcine-collagen implant is superior or equally beneficial to a gluteus maximus myocutaneous flap as a reconstruction method. METHODS AND ANALYSIS: This is a multicentre non-blinded randomised controlled trial with the experimental arm using a porcine-collagen implant and the control arm using a gluteus maximus muscle and skin rotation flap. Considered for inclusion are patients with rectal cancer, who are operated on with a wide abdominoperineal rectal excision including most of the levator muscles and where the muscle remnants cannot be closed in the midline with sutures. Patients with a primary or recurrent rectal cancer with an estimated survival of more than a year are eligible. The randomisation is computer generated with a concealed sequence and stratified by participating hospital and preoperative radiotherapy regimen. The main outcome is physical performance 6 months after surgery measured with the timed-stands test. Secondary outcomes are perineal wound healing, surgical complications, quality of life, ability to sit and other outcomes measured at 3, 6 and 12 months after surgery. To be able to state experimental arm non-inferiority with a 10% margin of the primary outcome with 90% statistical power and assuming 10% attrition, we aim to enrol 85 patients from May 2011 onwards. ETHICS AND DISSEMINATION: The study has been approved by the Regional Ethical Review board at Umeå University (protocol no: NEAPE-2010-335-31M). The results will be disseminated through patient associations and conventional scientific channels. TRIAL REGISTRATION NUMBER: NCT01347697; Pre-results.


Asunto(s)
Colágeno/uso terapéutico , Colgajo Miocutáneo , Proctectomía/métodos , Neoplasias del Recto/cirugía , Implantes Absorbibles , Dermis Acelular , Adolescente , Adulto , Anciano , Animales , Materiales Biocompatibles/uso terapéutico , Nalgas , Humanos , Persona de Mediana Edad , Estudios Multicéntricos como Asunto/métodos , Músculo Esquelético/trasplante , Selección de Paciente , Diafragma Pélvico/cirugía , Proctectomía/rehabilitación , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Neoplasias del Recto/rehabilitación , Porcinos , Trasplante Heterólogo/métodos , Resultado del Tratamiento , Cicatrización de Heridas/fisiología , Adulto Joven
13.
Neurourol Urodyn ; 38(5): 1363-1369, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30937969

RESUMEN

AIM: The hiatal anterior-posterior distance (APD), as measured by two-dimensional (2D) transperineal ultrasonography, is an indicator of pelvic floor muscle (PFM) contractility. The function of the pelvic floor is independently related to pelvic organ prolapse (POP) severity. However, little evidence concerning the APD for patients with POP before and after PFM training (PFMT) has been published. Therefore, we analyzed 2D transperineal ultrasonography in women with POP. METHODS: Twenty-eight women with POP completed a physiotherapist-led PFMT regimen that consisted of 4 months of one-on-one PFMT and lifestyle advice. The APD was measured using 2D transperineal ultrasonography immediately before and after the PFMT period and used to calculate ΔAPD (APD at rest-APD during contraction). Vaginal squeeze pressure during maximum voluntary contractions was also assessed using a manometer. We then analyzed the reliability and the correlation between ΔAPD as measured using 2D transperineal ultrasonography and vaginal squeeze pressure before and after PFMT. RESULTS: The APD at rest and during PFM contractions demonstrated intraclass correlation coefficients (ICCs) of 0.89 and 0.88, respectively. The ICC of maximal vaginal squeeze pressure was 0.97 during PFM contractions. Both ΔAPD (P < 0.01) and PFM strength (P < 0.05) increased significantly after PFMT. PFM strength and ΔAPD were correlated before (R = 0.53) and after (R = 0.68) PFMT (P < 0.01). CONCLUSIONS: We demonstrated that dynamic 2D transperineal ultrasonography could be used for studying functional changes in patients with POP. The ΔAPD of the levator hiatus has potential as an anatomical surrogate marker for evaluating PFM function in hospitals.


Asunto(s)
Contracción Muscular/fisiología , Músculo Esquelético/diagnóstico por imagen , Diafragma Pélvico/diagnóstico por imagen , Prolapso de Órgano Pélvico/diagnóstico por imagen , Anciano , Femenino , Humanos , Persona de Mediana Edad , Músculo Esquelético/fisiopatología , Diafragma Pélvico/fisiopatología , Prolapso de Órgano Pélvico/fisiopatología , Prolapso de Órgano Pélvico/terapia , Modalidades de Fisioterapia , Reproducibilidad de los Resultados , Ultrasonografía
14.
Acta bioquím. clín. latinoam ; 52(2): 205-211, jun. 2018. ilus, tab
Artículo en Español | LILACS | ID: biblio-949334

RESUMEN

La reacción en cadena de la polimerasa (PCR) es la técnica más importante en Biología Molecular. Su principal deficiencia es la susceptibilidad a la contaminación de la muestra, ya sea con productos de amplificación generados en reacciones previas o con material genético proveniente de otras muestras. Se entiende por contaminación a la presencia indeseada de moléculas de ADN o ARN, que pueden actuar como templados en reacciones de amplificación. El objetivo del trabajo fue demostrar la importancia de la implementación de un control de contaminación ambiental periódico monitoreando la integridad del circuito de PCR. Para ello, se hisoparon puntos correspondientes a diferentes áreas de trabajo y se investigó la presencia de amplicones mediante PCR Real Time en Lighcycler 2.0, Roche® y Ampliprep Cobas s201, Roche®. En puntos críticos del circuito (flujo laminar o la cabina de seguridad del área de pre-PCR) no se detectaron amplicones, aunque sí se hallaron en las mesadas y heladeras. En el resto del circuito, la distribución de los amplicones fue variable. De esta forma se demuestra la importancia de la realización de un control de contaminación ambiental periódico en laboratorios que realizan la técnica de PCR, pudiendo detectar contaminación de forma precoz y tomar acciones correctivas a tiempo.


Polymerase chain reaction (PCR) is the most important technique in Molecular Biology. Its main deficiency is susceptibility to contamination of the sample, either with amplification products generated in previous reactions or with genetic material from other samples. Contamination is understood as the undesired presence of DNA or RNA molecules, which may act as annealing in amplification reactions. The objective of this work is to demonstrate the importance of implementing a periodic environmental pollution control by monitoring the integrity of the PCR. To do this, different areas of work were swabbed and the presence of amplicons were investigated by Real Time PCR in Lighcycler 2.0, Roche® and Ampliprep Cobas s201, Roche®. At critical points in the circuit (laminar flow or pre-PCR area booth) no amplicons were detected, although they were found in countertops and refrigerators. In the rest of the circuit, the distribution of the amplicons was variable. Thus, the importance of conducting a periodic environmental contamination control in laboratories that perform the PCR technique is demonstrated, enabling early detection contamination and corrective actions being taken on time.


A reação em cadeia da polimerase (PCR) é a técnica mais importante em Biologia Molecular. Sua principal deficiência é a suscetibilidade à contaminação da amostra, seja com produtos de amplificação gerados em reações prévias ou com material genético em reações prévias ou com material genético proveniente de outras amostras. Entende-se por contaminação a presença não desejada de moléculas de DNA ou ARN, que podem agir como temperados em reações de amplificação. O objetivo do trabalho foi demonstrar a importância da implementação de um controle de contaminação ambiental periódico monitorando a integridade do circuito de PCR. Para isso, se fez esfregaço de pontos correspondentes a diferentes áreas de trabalho e foi investigada a presença de amplicons mediante PCR Real Time em Lighcycler 2.0, Roche® e Ampliprep Cobas s201, Roche®. Em pontos críticos do circuito (fluxo laminar ou a cabine de segurança da área de pré-PCR), não foram detectados amplicons, apesar de serem encontrados nas bancadas e refrigeradores. No resto do circuito, a distribuição dos amplicons foi variável. Assim mostra a importância da realização de um controle de contaminação ambiental periódico em laboratórios que realizam a técnica de PCR, podendo detectar a contaminação de forma precoce e tomar ações corretivas a tempo.


Asunto(s)
Gestión de la Calidad , ADN Polimerasa Dirigida por ADN , Contaminación Ambiental , Biología Molecular , Flujo Laminar , Equipos y Suministros , Distribución de Productos , Control , Laboratorios
15.
Female Pelvic Med Reconstr Surg ; 24(4): e21-e22, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29570127

RESUMEN

BACKGROUND: Paradoxical puborectalis contraction (PPC) is a syndrome of obstructed defecation associated with a cluster of complaints including rectal pain, incomplete evacuatory sensation, prolonged repetitive straining with bowel movements, and the need for digital manipulation. Traditional treatment has yielded mixed results. CASE: We present a case of PPC successfully treated with staged sacral neuromodulation and review her diagnostic features, medical regimen, and prior unsuccessful interventions tried. Symptoms were analyzed using a visual analog scale pain score (0-10). Criteria to progress to implantation of the pulse generator included a pain score less than 3 during test stimulation and/or greater than 50% decrease in the pain score compared to baseline.Our patient had a pain score of 0 (baseline 8) with stage 1 sacral neuromodulation. In addition, she had dramatic relief in her straining with bowel movements and need for digital manipulation. Her pulse generator was implanted after a 2-week trial, and she has experienced a lasting improvement at her follow-up of 2 years. CONCLUSIONS: Sacral neuromodulation is an established therapy for overactive bladder syndrome, urinary retention, and fecal incontinence. In urology, the use of sacral neuromodulation has been described to benefit some patients with pelvic floor pain. Sacral neuromodulation can be a successful treatment for PPC and functional anorectal pain with resulting improvement in quality of life without the sequelae of an invasive and irreversible surgery.


Asunto(s)
Dolor Crónico/terapia , Terapia por Estimulación Eléctrica , Neuroestimuladores Implantables , Contracción Muscular , Trastornos del Suelo Pélvico/terapia , Enfermedades del Recto/terapia , Anciano , Defecación , Femenino , Humanos , Trastornos del Suelo Pélvico/fisiopatología , Enfermedades del Recto/fisiopatología , Resultado del Tratamiento
16.
Tech Coloproctol ; 22(3): 179-190, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-29512048

RESUMEN

BACKGROUND: The aim of the present study was to assess the relationship between symptoms of obstructed defecation and findings on magnetic resonance (MR) defecography in males with obstructed defecation syndrome (ODS). METHODS: Thirty-six males with ODS who underwent MR defecography at our institution between March 2013 and February 2016 were asked in a telephone interview about their symptoms and subsequent treatment, either medical or surgical. Patients were divided into 2 groups, one with anismus (Group 1) and one with prolapse without anismus (Group 2). The interaction between ODS type and symptoms with MR findings was assessed by multivariate analysis for categorical data using a hierarchical log-linear model. MR imaging findings included lateral and/or posterior rectocele, rectal prolapse, intussusception, ballooning of levator hiatus with impingement of pelvic organs and dyskinetic puborectalis muscle. RESULTS: There were 21 males with ODS due to anismus (Group 1) and 15 with ODS due to rectal prolapse/intussusception (Group 2). Mean age of the entire group was 53.6 ± 4.1 years (range 18-77 years). Patients in Group 1 were slightly older than those in Group 2 (age peak, sixth decade in 47.6 vs 20.0%, p < 0.05). Symptoms most frequently associated with Group 1 patients included small volume and hard feces (85.0%, p < 0.01), excessive strain at stool (81.0%, p < 0.05), tenesmus and fecaloma formation (57.1 and 42.9%, p < 0.05); symptoms most frequently associated with Group 2 patients included mucous discharge, rectal bleeding and pain (86.7%, p < 0.05), prolonged toilet time (73.3%, p < 0.05), fragmented evacuation with or without digitation (66.7%, p < 0.005). Voiding outflow obstruction was more frequent in Group 1 (19.0 vs 13.3%; p < 0.05), while non-bacterial prostatitis and sexual dysfunction prevailed in Group 2 (26.7 and 46.7%, p < 0.05). At MR defecography, two major categories of findings were detected: a dyskinetic pattern (Type 1), seen in all Group 1 patients, which was characterized by non-relaxing puborectalis muscle, sand-glass configuration of the anorectum, poor emptying rate, limited pelvic floor descent and final residue ≥ 2/3; and a prolapsing pattern (Type 2), seen in all Group 2 patients, which was characterized by rectal prolapse/intussusception, ballooning of the levator hiatus with impingement of the rectal floor and prostatic base, excessive pelvic floor descent and residue ≤ 1/2. Posterolateral outpouching defined as perineal hernia was present in 28.6% of patients in Group 1 and were absent in Group 2. The average levator plate angle on straining differed significantly in the two patterns (21.3° ± 4.1 in Group 1 vs 65.6° ± 8.1 in Group 2; p < 0.05). Responses to the phone interview were obtained from 31 patients (18 of Group 1 and 13 of Group 2, response rate, 86.1%). Patients of Group 1 were always treated without surgery (i.e., biofeedback, dietary regimen, laxatives and/or enemas) which resulted in symptomatic improvement in 12/18 cases (66.6%). Of the patients in Group 2, 2/13 (15.3) underwent surgical repair, consisting of stapled transanal rectal resection (STARR) which resulted in symptom recurrence after 6 months and laparoscopic ventral rectopexy which resulted in symptom improvement. The other 11 patients of Group 2 were treated without surgery with symptoms improvement in 3 (27.3%). CONCLUSIONS: The appearance of various abnormalities at MR defecography in men with ODS shows 2 distinct patterns which may have potential relevance for treatment planning, whether conservative or surgical.


Asunto(s)
Estreñimiento/diagnóstico por imagen , Estreñimiento/fisiopatología , Defecación , Defecografía/métodos , Imagen por Resonancia Magnética , Adolescente , Adulto , Anciano , Estreñimiento/etiología , Estreñimiento/terapia , Humanos , Intususcepción/complicaciones , Intususcepción/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Trastornos del Suelo Pélvico/complicaciones , Trastornos del Suelo Pélvico/diagnóstico por imagen , Prolapso Rectal/complicaciones , Prolapso Rectal/diagnóstico por imagen , Evaluación de Síntomas , Síndrome , Adulto Joven
17.
BMJ ; 358: j4307, 2017 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-28947636

RESUMEN

Objective To evaluate efficacies of anthelmintic drugs against soil transmitted helminths in terms of cure rates and egg reduction rates.Design Systematic review and network meta-analysis.Data Sources PubMed, ISI Web of Science, Embase, ScienceDirect, the Cochrane Central Register of Clinical Trials, and the World Health Organization library database from 1960 until 31 December 2016.Study selection Randomised controlled trials evaluating the efficacy of a single dose regimen of albendazole, mebendazole, levamisole, and pyrantel pamoate against Ascaris lumbricoides, hookworm (Necator americanus and Ancylostoma duodenale) and Trichuris trichiura. The primary outcomes included cure rates analysed by network meta-analysis with mixed logistic regression models and egg reduction rates with mixed linear models.Results 55 and 46 randomised controlled trials were included in the analysis of cure rates and egg reduction rates, respectively. All drugs were highly efficacious against A lumbricoides Albendazole showed the highest efficacy against hookworm infections with a cure rate of 79.5% (95% confidence interval 71.5% to 85.6%) and an egg reduction rate of 89.6% (81.9% to 97.3%). All drugs had low efficacy against T trichiura, with mebendazole showing the highest cure rate of 42.1% (25.9% to 60.2%) and egg reduction rate of 66.0% (54.6% to 77.3%). Estimates for the years 1995 and 2015 showed significant reductions in efficacy of albendazole against T trichiura: by 2015 the egg reduction rates fell from 72.6% (53.7% to 91.5%) to 43.4% (23.5% to 63.3%; P=0.049) and the cure rates fell from 38.6% (26.2% to 52.7%) to 16.4 (7.7% to 31.3%; P=0.027).Conclusions All four currently recommended drugs show limitations in their efficacy profile. While only albendazole showed good efficacy against hookworm infection, all drugs had low efficacy against T trichiura The decrease in efficacy of albendazole against T trichiura over the past two decades is of concern. The findings indicate the need for strengthening efforts to develop new drug treatments, with a particular focus on drugs against T trichiura.


Asunto(s)
Antihelmínticos/farmacología , Helmintiasis/prevención & control , Helmintos/efectos de los fármacos , Suelo/parasitología , Animales , Femenino , Helmintiasis/transmisión , Humanos , Masculino , Metaanálisis en Red , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
18.
Integr Environ Assess Manag ; 13(2): 331-341, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27463842

RESUMEN

Veterinary drugs administered to food animals primarily enter ecosystems through the application of livestock waste to agricultural land. Although veterinary drugs are essential for protecting animal health, their entry into the environment may pose a risk for nontarget organisms. A means to predict environmental concentrations of new veterinary drug ingredients in soil is required to assess their environmental fate, distribution, and potential effects. The Canadian predicted environmental concentrations in soil (PECsoil) for new veterinary drug ingredients for use in intensively reared animals is based on the approach currently used by the European Medicines Agency for VICH Phase I environmental assessments. The calculation for the European Medicines Agency PECsoil can be adapted to account for regional animal husbandry and land use practices. Canadian agricultural practices for intensively reared cattle, pigs, and poultry differ substantially from those in the European Union. The development of PECsoil default values and livestock categories representative of typical Canadian animal production methods and nutrient management practices culminates several years of research and an extensive survey and analysis of the scientific literature, Canadian agricultural statistics, national and provincial management recommendations, veterinary product databases, and producers. A PECsoil can be used to rapidly identify new veterinary drugs intended for intensive livestock production that should undergo targeted ecotoxicity and fate testing. The Canadian PECsoil model is readily available, transparent, and requires minimal inputs to generate a screening level environmental assessment for veterinary drugs that can be refined if additional data are available. PECsoil values for a hypothetical veterinary drug dosage regimen are presented and discussed in an international context. Integr Environ Assess Manag 2017;13:331-341. © 2016 Her Majesty the Queen in Right of Canada. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of SETAC. Reproduced with the permission of the Minister of Health.


Asunto(s)
Monitoreo del Ambiente/métodos , Contaminación Ambiental/estadística & datos numéricos , Contaminantes del Suelo/análisis , Drogas Veterinarias/análisis , Crianza de Animales Domésticos , Canadá , Medición de Riesgo , Suelo
19.
An Real Acad Farm ; 83(5): 125-138, 2017. ilus, tab, graf
Artículo en Español | IBECS | ID: ibc-172272

RESUMEN

Las propiedades fisico‐químicas de los suelos que se encuentran en la parte superficial de las capas freáticas, juegan un papel muy importante en las características hidroquímicas de las aguas subyacentes, pues fenómenos como disolución, hidrolisis y procesos de oxido‐reducción de fracciones minerales y orgánicas de los suelos influyen de forma significativa en la composición de las mismas. Además, textura, estructura y materia orgánica del suelo son factores claves en la regulación del régimen hidrodinámico. En este trabajo analizamos las características edáficas de cuatro suelos muy significativos de los alrededores del Balneario de San Nicolás, ubicado en Alhama de Almería, Alpujarra Almeriense, situada a 450 msnm en la ladera norte de la Sierra de Gádor. Son suelos con escaso desarrollo, tipo AC, formados a partir de materiales sedimentarios constituidos por margas arenosas, calcarenitas, dolomías y yeso, los situados en las proximidades del Valle del Andarax, y por materiales de derrubios de ladera y pie de monte, con predominio de cuarcita, dolomías, calizas y calizas margosas, los situados en la Sierra de Gádor. Los suelos son carbonatados y están saturados, siendo el calcio el catión mayoritario. Presentan pHs básicos, bajo contenido en materia orgánica y texturas gruesas. Cuarzo, calcita, dolomita y yeso son los minerales más abundantes entre los no laminares, y son las micas los filosilicatos presentes en mayor proporción. El predominio de texturas gruesas y la perdida de estructura en los horizontes profundos son determinantes en el grado de infiltración. Se han incluido en las unidades Regosoles y Calcisoles (AU)


The physico‐chemical properties of soils adjacent to aquifers play an essential role in the hydrochemical characteristics of the underlying waters. Thus, phenomena such as dissolution, hydrolysis and oxide‐reduction processes of the mineral and organic fractions of soils may have a significant influence on the composition of these waters. Furthermore, soil texture, structure and organic matter are key factors regulating the hydrodynamic regime. In this work, the edaphic characteristics of four highly representative soils located in the thermal environment of San Nicolas in the Alhama de Almería municipality of the Alpujarra Almeriense region were analyzed. The area is part of the northern side of the Sierra de Gádor at an altitude of 450 masl. They are poorly developed soils, mainly AC profiles. Soils in the vicinity of the Andarax Valley are formed on sedimentary materials constituted by sandy marls, calcarenites, dolomites and gypsum, and those in the Sierra de Gádor developed on debris material from hillside and piedmont and mainly integrated by quartzite, dolomites, limestones and marly limestones. Soils are carbonated and saturated, with calcium being the major cation. They have basic pH values, low organic matter content and coarse textures. Quartz, calcite, dolomite and gypsum are the prominent minerals among the non‐laminar ones, and micas among the phyllosilicates. The predominance of coarse textures and the loss of structure in the deep horizons are decisive in their infiltration capacity. They were classified as Regosols and Calcisols (AU)


Asunto(s)
Análisis del Suelo , Características del Suelo/análisis , Características del Suelo/clasificación , Condición del Suelo , Aguas Termales/análisis , Aguas Termales/clasificación , Manantiales de Aguas Termales/análisis , Minería/clasificación
20.
Gig Sanit ; 95(4): 329-35, 2016.
Artículo en Ruso | MEDLINE | ID: mdl-27430061

RESUMEN

There is presented an overview of studies devoted to the assessment of 50 Hz electromagnetic the radiations in the indoor environment and their impact on the human body. The classification of household appliances depending on their location has been proposed. The levels of intensity of electric and magnetic fields generated by power-frequency (50 Hz) current from a variety of household appliances have been determined. The ranking of household appliances in dependence on the intensity of electromagnetic the radiations has been made. There was performed an estimation of the intensity of electromagnetic fields in dependence on the regimen of the usage of appliances.


Asunto(s)
Radiación Electromagnética , Exposición a Riesgos Ambientales/prevención & control , Contaminación Ambiental , Artículos Domésticos , Salud Ambiental/métodos , Salud Ambiental/normas , Contaminación Ambiental/efectos adversos , Contaminación Ambiental/análisis , Contaminación Ambiental/prevención & control , Artículos Domésticos/clasificación , Artículos Domésticos/normas , Humanos
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