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In the quest to uncover biological cues that help explain organic changes brought on by an external stimulus, like stress, new technologies have become necessary. The Laser Speckle Contrast Analysis (LASCA) approach is one of these technologies that may be used to analyze biological data, including respiratory rate (RR) intervals, and then use the results to determine heart rate variability (HRV Thus, to evaluate the stress brought on by physical activity, this study used the LASCA approach. A stress induction procedure involving physical exertion was employed, and the results were compared to other established techniques (cortisol analysis and ECG signal) to verify the LASCA methodology as a tool for measuring HRV and stress. The study sample comprised 27 willing participants. The technique involving LASCA allowed for the non-invasive (non-contact) acquisition of HRV and the study of stress. Furthermore, it made it possible to gather pertinent data, such as recognizing modifications to the thermoregulation, peripheral vasomotor tonus, and renin-angiotensin-aldosterone systems that were brought on by elevated stress and, as a result, variations in HRV readings.
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Frequência Cardíaca , Estresse Fisiológico , Humanos , Frequência Cardíaca/fisiologia , Projetos Piloto , Masculino , Adulto , Feminino , Estresse Fisiológico/fisiologia , Adulto Jovem , Eletrocardiografia/métodos , Lasers , Hidrocortisona , Taxa Respiratória/fisiologiaRESUMO
OBJECTIVE: The impact of responsive neurostimulation (RNS) on neuropsychiatric and psychosocial outcomes has not been extensively evaluated outside of the original clinical trials and post-approval studies. The goal of this study was to ascertain the potential real-world effects of RNS on cognitive, psychiatric, and quality of life (QOL) outcomes in relation to seizure outcomes by examining 50 patients undergoing RNS implantation for drug-resistant epilepsy (DRE). METHODS: We performed a retrospective review of all patients treated at our institution with RNS for DRE with at least 12 months of follow-up. In addition to baseline demographic and disease-related characteristics, we collected cognitive (Full-Scale Intelligence Quotient, Verbal Comprehension, and Perceptual Reasoning Index), psychiatric (Beck Depression and Anxiety Inventory Scores), and QOL (QOLIE-31) outcomes at 6 and 12 months after RNS implantation and correlated them with seizure outcomes. RESULTS: Fifty patients (median age 39.5 years, 64% female) were treated with RNS for DRE in our institution from 2005 to 2020. Of the 37 of them who had well-documented pre and post-implantation seizure diaries, the 6-month median seizure frequency reduction was 88%, the response rate (50% or greater seizure frequency reduction) was 78%, and 32% of patients were free of disabling seizures in this timeframe. There was no statistically significant difference at a group level in any of the evaluated cognitive, psychiatric, and QOL outcomes at 6 and 12 months post-implantation compared to the pre-implantation baseline, irrespective of seizure outcomes, although a subset of patients experienced a decline in mood or cognitive variables. SIGNIFICANCE: Responsive neurostimulation does not appear to have a statistically significant negative or positive impact on neuropsychiatric and psychosocial status at the group level. We observed significant variability in outcome, with a minority of patients experiencing worse behavioral outcomes, which seemed related to RNS implantation. Careful outcome monitoring is required to identify the subset of patients experiencing a poor response and to make appropriate adjustments in care.
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Epilepsia Resistente a Medicamentos , Qualidade de Vida , Humanos , Feminino , Adulto , Masculino , Epilepsia Resistente a Medicamentos/terapia , Estudos Retrospectivos , Convulsões , Resultado do TratamentoRESUMO
AIMS: To explore the perceptions of women with lived experience of domestic and family violence on accessing healthcare and to identify how nurses can facilitate and support women experiencing domestic and family violence to receive the care they need. DESIGN: A qualitative single site study. METHODS: As part of an evaluation of a nurse-led domestic and family violence service, a 2-h focus group was conducted with four women with lived experience of domestic and family violence on 14 December 2021. The Levesque Framework provided a novel approach to identify barriers and facilitators to healthcare access. The focus group guide included eight open-ended questions. The audio recording was transcribed and analysed using Braun and Clark's thematic analysis process. RESULTS: The Levesque Framework helped highlight individual and structural challenges in accessing healthcare faced by women experiencing domestic and family violence. Dominant themes were first contact, comprehensiveness of services and domestic violence awareness. CONCLUSION: The growing incidences of domestic and family violence are confounding communities worldwide. Despite the high profile of domestic and family violence in Australia, access to healthcare remains problematic. These preliminary findings suggest that nurses have opportunities to facilitate access in relation to the approachability, acceptability and appropriateness of services. Realizing these opportunities requires education that enables nurses' capacity to provide an effective first contact and facilitate comprehensive care by embodying a no wrong door culture. We intend to explore these concepts in future focus groups. IMPACT: This study explored the factors impacting access to healthcare for women experiencing domestic and family violence. Accessing healthcare when experiencing domestic and family violence in Australia is problematic. Findings suggest that nursing has opportunities to facilitate the approachability, acceptability and appropriateness of services. These findings will be valuable to nurses across all healthcare settings, nursing education providers and health workforce planners.
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Violência Doméstica , Acessibilidade aos Serviços de Saúde , Feminino , Humanos , Austrália , Violência Doméstica/psicologia , Grupos Focais , Acessibilidade aos Serviços de Saúde/organização & administração , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Pesquisa Qualitativa , Relações Enfermeiro-Paciente , Pesquisa em Avaliação de Enfermagem , Adolescente , AdultoRESUMO
The diagnosis of epilepsy is primarily based on the history and the verbal description of the events in question. Smartphone videos are increasingly used to assist in the diagnosis. The purpose of this study is to evaluate their value for the diagnosis of seizures. We prospectively collected smartphone videos from patients who presented to our epilepsy center over two years. The video-based diagnosis was then compared to the eventual diagnosis based on video-electroencephalographic (EEG) monitoring with recorded episodes. Video-EEG studies and smartphone videos were reviewed by two separate physicians, each blinded to the other's interpretation. Fifty-four patients were included in the final analysis (mean age = 34.7 years, SD = 17 years). Data (either smartphone video or video-EEG monitoring) were inconclusive in 18 patients. Of the 36 patients with conclusive data, 34 (94%) were in agreement. Smartphone video interpretation can be a useful adjunctive tool in the diagnosis of seizure-like events.
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Epilepsia , Convulsões , Smartphone , Adolescente , Adulto , Eletroencefalografia , Epilepsia/diagnóstico , Humanos , Pessoa de Meia-Idade , Monitorização Fisiológica , Convulsões/diagnóstico , Gravação em Vídeo , Adulto JovemRESUMO
BACKGROUND: Phosphate-solubilizing bacteria (PSB) can be an environment-friendly strategy to improve crop production in low-phosphorus (P) or P-deficient soils. The effect of indigenous mixed inocula of PSB on Agave angustifolia Haw. growth was assessed. The four treatments evaluated were T1 (Pseudomonas luteola + Enterobacter sp.), T2 (Pseudomonas luteola + Bacillus sp.), T3 (Pseudomonas luteola + Acinetobacter sp.), and T4 (control); each was replicated 25 times using a completely randomized design during 12 months under rain-fed conditions. Additionally, P solubilization in vitro of the mixed inocula with three different sources of inorganic P was tested. RESULTS: The mixed inocula were able to solubilize more P from tricalcium phosphate Ca3 (PO4 )2 than from aluminum phosphate (AlPO4 ) and iron phosphate (FePO4 ). Relative to the control, T2 increased plant height by 22.9%, leaf dry weight by 391.4%, plant stem diameter by 49.6%, and root dry weight by 193.9%. The stem solid soluble content increased 50.0% with T1. Plant-available soil P increased 94.6% with T3 and 77.3% with T1. Soil alkaline phosphatase activity increased 85.9% with T1. CONCLUSION: T2 was the mixed inoculum that most improved Agave angustifolia plant growth. The indigenous mixed inocula of PSB evaluated appears to be a practical and efficient option for promoting field growth of Agave angustifolia plants. However, further research is necessary to achieve a deeper understanding of the relationships between different PSB species and their effects on agave, which may reveal some of the mechanisms of the synergistic interactions that are involved in the promotion of plant growth. © 2019 Society of Chemical Industry.
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Acinetobacter/metabolismo , Agave/crescimento & desenvolvimento , Agave/microbiologia , Inoculantes Agrícolas/metabolismo , Bacillus/metabolismo , Enterobacter/metabolismo , Fosfatos/metabolismo , Pseudomonas/metabolismo , Agave/metabolismo , Fosfatos/química , Microbiologia do Solo , SolubilidadeRESUMO
This review provides insights into cellulolytic bacteria present in global forest and agricultural soils over a period of 11 years. It delves into the study of soil-dwelling cellulolytic bacteria and the enzymes they produce, cellulases, which are crucial in both soil formation and the carbon cycle. Forests and agricultural activities are significant contributors to the production of lignocellulosic biomass. Forest ecosystems, which are key carbon sinks, contain 20-30% cellulose in their leaf litter. Concurrently, the agricultural sector generates approximately 998 million tons of lignocellulosic waste annually. Predominant genera include Bacillus, Pseudomonas, Stenotrophomonas, and Streptomyces in forests and Bacillus, Streptomyces, Pseudomonas, and Arthrobacter in agricultural soils. Selection of cellulolytic bacteria is based on their hydrolysis ability, using artificial cellulose media and dyes like Congo red or iodine for detection. Some studies also measure cellulolytic activity in vitro. Notably, bacterial cellulose hydrolysis capability may not align with their cellulolytic enzyme production. Enzymes such as GH1, GH3, GH5, GH6, GH8, GH9, GH10, GH12, GH26, GH44, GH45, GH48, GH51, GH74, GH124, and GH148 are crucial, particularly GH48 for crystalline cellulose degradation. Conversely, bacteria with GH5 and GH9 often fail to degrade crystalline cellulose. Accurate identification of cellulolytic bacteria necessitates comprehensive genomic analysis, supplemented by additional proteomic and transcriptomic techniques. Cellulases, known for degrading cellulose, are also significant in healthcare, food, textiles, bio-washing, bleaching, paper production, ink removal, and biotechnology, emphasizing the importance of discovering novel cellulolytic strains in soil.
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INTRODUCTION: the indigenous population is vulnerable and there is limited understanding of their somatometric indicators and APGAR score at birth. AIM: the objective of the study was to explore the association of the condition of indigenous newborn (INB) on somatometric parameters and APGAR score at birth. METHODS: this study employed an exploratory cross-sectional design, utilizing the registry of newborns (NB) from a private clinic. The APGAR score at one minute after birth, as well as nutritional indicators derived from measurements of weight, height, and perimeters, were taken into consideration. The statistical analysis involved the use of logistic regressions. RESULTS: the analysis included 7413 NB (1.8 % INB), 52 % were male and 8.1 % were born preterm (gestational age < 37 weeks). In comparison to non-indigenous NB, the INB group showed a higher risk of malnutrition (8 % vs. 6.3 %; p < 0.001), a greater prevalence of excess weight (7.3 % vs. 1.8 %; p < 0.001), smaller head circumference (33.6 cm vs. 34.1 cm; p = 0.017), smaller abdominal circumference (30.9 cm vs. 31.5 cm; p = 0.011), and a higher occurrence of low APGAR scores (< 7) (8.7 % vs. 1.2 %; p < 0.001). Furthermore, the indigenous condition was independently associated with low birth weight (< 2.500 g) (OR, 0.4; 95 % CI, 0.2; 0.9), excess head circumference (OR, 2.7; 95 % CI, 1.5; 4.7), and APGAR score < 7 points (OR, 8.3; 95 % CI, 4.2; 16.5). CONCLUSIONS: the indigenous condition was associated with factors that have adverse effects on the health of NB, including reduced head circumference and suboptimal performance on the APGAR scale. These results emphasize the importance of improving access to and quality of prenatal healthcare services for indigenous communities.
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Background and Objectives: The purpose of this study was to assess the likelihood of capturing a patient's typical event in question on ambulatory video-EEG monitoring (AVEM) based on certain baseline patient or event characteristics. Methods: We retrospectively reviewed 300 studies that resulted between June 2021 and August 2022 ordered by adult epileptologists. Patients were included in event analysis if the study was ordered for the purpose of capturing an event (and excluded for all other purposes). Results: A total of 149 studies were included in event analysis. Sixty-eight patients (46%) had their typical events captured on AVEM. Diagnosis was an epileptic seizure in 17 patients (25%), psychogenic nonepileptic seizure in 7 (10%), and other nonepileptic events in 44 (65%). Regarding event frequency, for patients who on average had daily events, 84% had events captured, which corresponds to a significantly increased odds ratio (OR 17.90, 95% CI 7.55-42.44, p < 0.001). For those who had events <1 per week to ≥1 per month, only 9% had events captured (OR 0.06, 95% CI 0.02-0.19, p < 0.001). No patients who had events less frequently than once per month had a diagnostic AVEM. Regarding the number of antiseizure medications (ASMs), the odds ratio was increased for those not on ASMs (OR 2.65, 95% CI 1.17 -6.03, p = 0.02) and decreased for those on 1 ASM (OR 0.28, 95% CI 0.13 -0.60, p = 0.001). There was no statistical significance based on event type (motor vs nonmotor), prior seizure diagnosis, history of psychiatric comorbidity, or presence of a focal brain lesion. Discussion: Certain baseline characteristics can increase or decrease the pretest probability of capturing a typical event on AVEM, particularly the frequency of events and number of ASMs. This can be useful information for clinicians before ordering a study so that resources can be properly allocated.
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The contamination of the environment by domestic and industrial discharges is a relevant and persistent problem that needs novel solutions. Innovations in the detection, adsorption, and removal or in-situ degradation of toxic components are urgently required. Various effective techniques and materials have been proposed to address this problem, in which carbon dots (CDs) stand out because of their unique properties and low-cost and abundant nature. Their combination with different metals results in the enhancement of their innate properties. Metal-doped CDs have shown excellent results and competitive advantages in recent times. Considering the above useful critiques and CDs notable potentialities, this review discusses different approaches in detail to sense, adsorb, and photodegrade different pollutants in water samples. It was found that altering the electronic structure of CDs via metal doping has a great potential to enhance the optical, electrical, chemical, and magnetic capabilities of CDs, which in turn is beneficial for wastewater treatment.
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Nanoestruturas , Pontos Quânticos , Poluentes da Água , Purificação da Água , Carbono/química , Purificação da Água/métodos , Metais , Pontos Quânticos/químicaRESUMO
Background: Domestic and family violence is a significant and growing public health concern in many communities around the world. Nurses are often the first and sometimes only point of contact for people seeking healthcare following DFV incidents and are therefore well placed to identify and support these vulnerable people. The aim of this scoping review is to examine the English language studies of healthcare provided by nurses in primary healthcare settings to people experiencing domestic and family violence. Methods: A scoping review of the following databases was undertaken between March-June 2021: CINAHL, Medline, and PubMed. Primary studies were included if written in English, published from 2000 onwards, and focused on the care provided by primary healthcare nurses to people experiencing DFV. A critical appraisal of included studies was conducted using the Mixed Methods Appraisal Tool (MMAT). Results were synthesised narratively. Results: Six studies were included, from the United States (n = 2), United Kingdom (n = 1), Sweden (n = 2), and Brazil (n = 1). Five studies were quantitative and one qualitative. A fundamental aspect of the healthcare provided by nurses, reported by all studies, was the screening of DFV. Other healthcare provided includes physical and mental health assessment and referral to other services, including sexual assault clinics, social supports, and law enforcement agencies. Findings suggest the level of DFV screening conducted by nurses is limited. Nurses' knowledge of how to support people experiencing DFV was also reportedly limited. Two studies reported that nurses were unfamiliar with DFV practice guidelines and the existence and availability of support networks for people experiencing DFV. Conclusion: Findings suggest inconsistency in primary healthcare nurses' level of education, skill and knowledge, and detection of people experiencing DFV. As the largest healthcare professional discipline, nurses have frequent contact with people experiencing DFV. There is an urgent need for nurses to be better educationally prepared and more organisationally supported in order to adequately respond and provide healthcare to people experiencing DFV. Given that the number of people experiencing DFV has increased due to the COVID-19 pandemic, it is ever more important for nurses to be well equipped to identify and respond appropriately.
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Carbon-based materials are among the most biosynthesized nanocomposites with excellent tunability and multifunctionality features, that other materials fail to demonstrate. Naturally occurring materials, such as alginate (Alg), can be combined and modified by linking the active moieties of various carbon-based materials of interest, such as graphene oxide (GO), carbon nanotubes (CNTs), and mesoporous silica nanocomposite (MSN), among others. Thus, several types of robust nanocomposites have been fabricated and deployed for environmental remediation of emerging pollutants, such as pharmaceutical compounds, toxic dyes, and other environmentally hazardous contaminants of emerging concern. Considering the above critiques and added features of carbon-based nanocomposites, herein, an effort has been made to spotlight the synergies of GO, CNTs, and MSN with Alg and their role in mitigating emerging pollutants. From the information presented in this work, it can be concluded that Alg is a material that has excellent potential. However, its use still requires further tests in different areas and other materials to carry out a holistic investigation that exploits its versatility for environmental remediation purposes.
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Poluentes Ambientais , Recuperação e Remediação Ambiental , Nanocompostos , Nanotubos de Carbono , Poluentes Químicos da Água , Adsorção , Alginatos , Nanocompostos/toxicidade , Nanotubos de Carbono/toxicidade , Dióxido de Silício , Poluentes Químicos da Água/análiseRESUMO
BACKGROUND: Determining the type and source of cells involved in regenerative processes has been one of the most important goals of researchers in the field of regeneration biology. We have previously used several cellular markers to characterize the cells involved in the regeneration of the intestine in the sea cucumber Holothuria glaberrima. RESULTS: We have now obtained a monoclonal antibody that labels the mesothelium; the outer layer of the gut wall composed of peritoneocytes and myocytes. Using this antibody we studied the role of this tissue layer in the early stages of intestinal regeneration. We have now shown that the mesothelial cells of the mesentery, specifically the muscle component, undergo dedifferentiation from very early on in the regeneration process. Cell proliferation, on the other hand, increases much later, and mainly takes place in the mesothelium or coelomic epithelium of the regenerating intestinal rudiment. Moreover, we have found that the formation of the intestinal rudiment involves a novel regenerative mechanism where epithelial cells ingress into the connective tissue and acquire mesenchymal phenotypes. CONCLUSIONS: Our results strongly suggest that the dedifferentiating mesothelium provides the initial source of cells for the formation of the intestinal rudiment. At later stages, cell proliferation supplies additional cells necessary for the increase in size of the regenerate. Our data also shows that the mechanism of epithelial to mesenchymal transition provides many of the connective tissue cells found in the regenerating intestine. These results present some new and important information as to the cellular basis of organ regeneration and in particular to the process of regeneration of visceral organs.
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Desdiferenciação Celular/fisiologia , Transição Epitelial-Mesenquimal/fisiologia , Holothuria/fisiologia , Mucosa Intestinal/metabolismo , Regeneração/fisiologia , Animais , Anticorpos Monoclonais , Proliferação de Células , Epitélio/imunologia , Holothuria/citologia , Intestinos/crescimento & desenvolvimento , Mesentério/citologia , Mesentério/fisiologia , Células Musculares/imunologia , Regeneração/genéticaRESUMO
Shark fishery is one of the most important activities in the Mexican Pacific coast, nevertheless, there is few data available about the specific captures done by the fleet along the coast. This study describes fishery biology aspects of the shark species catched by the semi-industrial long-line fleet of Manzanillo. Monthly samplings were made on board of these vessels during an annual period from April 2006 to April 2007. Captured species composition (n = 1 962 organisms) was represented by nine species. The one that sustains this fishery was Carcharhinus falciformis (88.12%), followed by Prionace glauca (8.21%). Low frequency species were represented by Sphyrna zygaena (1.78%), Alopias pelagicus (0.82%), Carcharhinus longimanus (0.45%). Furthermore, rare species were Alopias superciliosus (0.35%), Carcharhinus leucas (0.1%), Carcharhinus limbatus (0.1%) and Isurus oxyrinchus (0.05%). Fishery activity affected principally (60-92.70%) young males of C. falciformis, S. zygaena, C. longimanus and I. oxyrinchus; adult males (56-75%) of A. pelagicus, A. superciliosus, and C. limbatus; for P. glauca there were primarily female adults. For all the species found, females showed the bigger sizes when compared to males (with the exception of S. zygaena, that showed sexual dimorphism). Considering the lineal regressions made between precaudal length and total length, and, fork length and total length for C. falciformis, P. glauca, S. zygaena and A. pelagicus, the determination coefficients (r2) showed that both lengths can be useful to obtain the total length of fish with some damage or absence of its caudal fin. The estimated fecundity for C. falciformis was of 3-7 offspring/female of 30-45 cm LT (average of 40.57 +/- 2.03 cm LT); and for P. glauca 5-52 offspring/female of 5-18.6 cm LT (average of 11.61 +/- 0.21 cm LT). In the case of C. longimanus only one female was captured with a total of eight embryos, with an average of 45 cm LT each; for this reason we assumed that the fishery areas do not coincide with the nursery oness for this species. According to the information obtained, we concluded that C. falciformis has a concurrent cycle and P. glauca a consecutive biannual one.
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Pesqueiros , Tubarões/classificação , Animais , Feminino , Fertilidade , Pesqueiros/estatística & dados numéricos , Masculino , México , Densidade Demográfica , Estações do Ano , Tubarões/anatomia & histologia , Tubarões/fisiologiaRESUMO
INTRODUCTION: The availability of ambulatory EEG-video monitoring gives an alternative to traditional inpatient EEG-video, but its yield and diagnostic value are not well known. This study evaluates the yield of ambulatory EEG-video for the diagnosis of epilepsy. METHODS: We retrospectively reviewed the ambulatory EEG-video monitoring data from 200 consecutive and unselected patients aged 12 years and older performed by a single company (RSC Diagnostic Services) between January 2018 and May 2018. Studies were processed by two senior certified long-term monitoring EEG technologists and interpreted by neurologists. RESULTS: Of the 200 patients, 130 (65%) were women, mean age was 45 years. Mean duration of studies were 76.6 hours (range 23-175 hours). There were 110 studies (55%) with events recorded and 101 (92%) were captured on video. Epileptic events accounted for 17.8% (18/101) of the events captured and 9% (18/200) of our total cohort. Nonepileptic diagnosis accounted for 38% of the total number of patients in study (76/200). CONCLUSION: Ambulatory EEG-video monitoring may be a useful alternative to inpatient epilepsy monitoring unit, particularly with high clinical suspicion for nonepileptic events.
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Eletroencefalografia , Epilepsia , Adolescente , Adulto , Criança , Estudos de Coortes , Epilepsia/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Ambulatorial , Monitorização Fisiológica , Estudos RetrospectivosRESUMO
BACKGROUND: The available evidence regarding the clinical characteristics, treatment patterns, adverse events (AEs), and costs of treating patients with stage IV non-small cell lung cancer (NSCLC) in Mexico is scarce. OBJECTIVE: Our objective was to describe the clinical characteristics, treatment patterns, and direct costs associated with Mexican patients diagnosed with stage IV NSCLC who had completed two or more lines of systemic antineoplastic treatment. METHODS: A multicenter retrospective cohort study was designed to collect data from the medical records of patients treated at tertiary-level public hospitals in Mexico (multicenter chart review). We calculated costs from the viewpoint of payers based on data regarding therapy and service utilization. RESULTS: A total of 115 patients were included. Median patient age was 61 years (interquartile range [IQR] 52.4-68.5), and 51.3% were female. The most common NSCLC type was non-squamous (92.2%), and the typical histology was adenocarcinoma (88.7%). All patients received first- and second-line therapy: 54.78% completed a third-line, 27.82% a fourth-line, 7.82% a fifth-line, 2.6% a sixth-line, and 1.7% a seventh-line active therapy. Carboplatin was the most frequently used therapy (28.6%) followed by docetaxel (23.3%), nivolumab (16.7%), and irinotecan (13.3%). AEs occurred in 53% of the patients and none was fatal. In total, 59 patients (51.3%) required hospitalization during the observation period. The median cost per patient was $US7039.40, with a minimum of $US628.30 and a maximum of $US3,557,364.20. Median overall survival of the cohort was 12 months (95% confidence interval 9.8-14.1). CONCLUSIONS: In Mexico, NSCLC is usually diagnosed at stage IV. This study shows considerable variation in chemotherapy regimens, leading to a wide range in treatment cost. The understanding of NSCLC treatment patterns in Mexico will help to identify and address unmet needs.
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The spastic Han Wistar (sHW) rat serves as a model for human ataxia presenting symptoms of motor deterioration, weight loss, shortened lifespan, and Purkinje neuron loss. Past studies revealed that human neural progenitor cells (NPCs) improved ataxic symptoms at 20 d posttransplantation in sHW rats. In this study, we investigated the fate and longer-term effectiveness of these transplanted NPCs. Rats were placed into four treatment groups: an untreated normal control group (n = 10), an untreated mutant rat control (n = 10), a mutant group that received an injection of dead NPCs (n = 9), and a mutant group that received live NPCs (n = 10). Bilateral cerebellar injections containing 500,000 of either live or dead NPCs were performed on mutant sHW rats at 40 d of age. Motor activity for all mutant rats started to decline in open field testing around day 35. However, at day 45, the live NPC-treated mutants exhibited significant improvements in open field activity. Similar improvements were observed during rotarod testing and weight gain through the completion of the experiments (100 d). Immunohistochemistry revealed few surviving human NPCs in the cerebella of 80- and 100-d-old NPC-treated mutants; while cresyl violet staining revealed that live NPC-treated mutants had significantly more surviving Purkinje neurons compared to mutants that were untreated or received dead NPCs. Direct stereotactic implantation of NPCs alleviated the symptoms of ataxia, acting as a neuroprotectant, supporting future clinical applications of these NPCs in the areas of ataxia as well as other neurodegenerative diseases.
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Ataxia/genética , Músculo Esquelético/fisiopatologia , Doenças Neurodegenerativas/genética , Células-Tronco/metabolismo , Animais , Ataxia/patologia , Modelos Animais de Doenças , Humanos , Longevidade , Masculino , Doenças Neurodegenerativas/patologia , Ratos , Ratos WistarRESUMO
Nesta Tribuna, os autores discutem as transformações da sociedade e seu impacto na construção dos sistemas de saúde e a comprovada importância da Atenção Primária à Saúde, com a abordagem do processo de saúde-doença de modo singular e articulado ao contexto social por meio do trabalho em equipe interprofissional. A criação dos Núcleos de Apoio à Saúde da Família, recentemente rebatizados como Núcleos Ampliados de Saúde da Família e Atenção Básica, é um bom exemplo da imperiosa importância dessa abordagem interprofissional no âmbito da atenção primária. Contudo, nessa interlocução, também emergem desafios e fragilidades. Esses aspectos são suscitados na reflexão proposta.
In this forum, the authors discuss the transformations in society and their impact on the construction of health systems and the proven importance of Primary Health Care, with a unique approach to the health-disease process that is articulated with the social context through interprofessional teamwork. The creation of Family Health Support Centers, recently renamed Expanded Family Health and Primary Care Centers, is a good example of the imperative importance of this interprofessional approach in the context of primary care. However, in this dialogue, challenges and weaknesses also emerge. These aspects are raised in the proposed reflection.
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Educação ContinuadaRESUMO
BACKGROUND: Osteoporosis is a major healthcare concern in Latin America. Factors such as changing demographics, fragmented healthcare systems, and financial considerations may result in a huge increase in the burden of osteoporosis in this region. The aim of this article is to describe the baseline clinical characteristics and fracture history of patients who are prescribed teriparatide in normal clinical practice in Latin America. METHODS: We conducted a prospective, multinational, observational study (the Asia and Latin America Fracture Observational Study [ALAFOS]) in 20 countries worldwide to assess the incidence of fractures in postmenopausal women with osteoporosis receiving teriparatide as a part of routine clinical practice in a real-world setting. In this subregional analysis of the ALAFOS study, we report the clinical characteristics, fracture history, risk factors for osteoporosis, comorbidities, previous osteoporosis therapies and health-related quality of life measures at baseline for patients from the four participant Latin American countries: Argentina, Brazil, Colombia, and Mexico. RESULTS: The Latin America subregional cohort included 546 postmenopausal women (mean [SD] age: 71.0 [10.1] years; range: 40-94 years), constituting 18% of the ALAFOS total population. The baseline mean (SD) bone mineral density T-scores were - 3.02 (1.23) at the lumbar spine and - 2.31 (0.96) at the femoral neck; 62.8% of patients had a history of low trauma fracture after the age of 40 years and 39.7% of patients had experienced ≥1 fall in the past year. Osteoporosis medications were used by 70.9% of patients before initiating teriparatide. The median (Q1, Q3) EQ-5D-5 L Visual Analog Scale (VAS) scores for perceived health status at baseline was 70 (50, 80). The mean (SD) worst back pain numeric rating scale score for the overall Latin American cohort was 4.3 (3.4) at baseline. CONCLUSIONS: This baseline analysis of the Latin America subregion of the ALAFOS study indicates that patients who are prescribed teriparatide in the four participant countries had severe osteoporosis and high prevalence of fractures. They also had back pain and poor health-related quality of life. The proportions of patients with severe or extreme problems on the EQ-5D-5 L individual domains were lower than those in the overall ALAFOS study population.
Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Osteoporose/tratamento farmacológico , Fraturas por Osteoporose/epidemiologia , Pós-Menopausa , Teriparatida/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Dor nas Costas/tratamento farmacológico , Densidade Óssea , Brasil/epidemiologia , Colômbia/epidemiologia , Comorbidade , Feminino , Glucocorticoides/uso terapêutico , Humanos , América Latina , México/epidemiologia , Pessoa de Meia-Idade , Osteoporose/epidemiologia , Osteoporose/etiologia , Fraturas por Osteoporose/etiologia , Medição da Dor , Prevalência , Estudos Prospectivos , Qualidade de Vida , História Reprodutiva , Fatores de Risco , Fraturas da Coluna Vertebral/epidemiologia , Fraturas da Coluna Vertebral/etiologia , Escala Visual AnalógicaRESUMO
The aim of this study was to synthesize chitosan hydrogels, in macro- and nano-size, grafted with N-vinylcaprolactam (NVCL) using gamma radiation, and evaluate their potential application as a drug delivery system, using 5-fluorouracil (5-FU) as a model drug. The effect of dose and monomer concentration in the grafting process was studied, and the materials were characterized by FTIR, TGA, DLS, SEM and AFM. Higher grafting percentages were observed for the nanogels system. Although both the grafted macro- and nanogels, (net-CS)-g-NVCL, showed a response to pH (4.75) and temperature (31-33°C), the nanogels showed a better swelling response to both stimuli because of their higher surface area. Both systems were able to load 5-FU in small amounts (2-3.5mgg-1) and the release was sustained for more than 12h, showing that the modified macro and nanogels can be a potential alternative for the administration of drugs.
RESUMO
Introducción: la población indígena es vulnerable y poco se conoce sobre sus indicadores somatométricos y APGAR al nacimiento. Objetivo: explorar la asociación de la condición de recién nacido indígena (RNI) sobre parámetros somatométricos y APGAR al nacimiento. Métodos: estudio transversal exploratorio que empleó el registro de recién nacidos (RN) de una clínica privada. La condición de RNI se determinó por la condición indígena materna. Se consideraron la puntuación APGAR al primer minuto y los indicadores nutricionales derivados del peso, la talla y los perímetros. El análisis estadístico empleó regresiones logísticas. Resultados: el análisis exploratorio involucró a 7413 RN (1,8 % de RNI). El 52 % de los RN eran de sexo masculino y el 8,1 % fueron pretérmino (< 37 semanas). Los RNI, respecto a los RN no indígenas, presentaron mayor riesgo de desnutrición (8 % vs. 6,3 %; p < 0,001), mayor exceso de peso (7,3 % vs. 1,8 %; p < 0,001), menor perímetro cefálico (33,6 cm vs. 34,1 cm; p = 0,017), menor perímetro abdominal (30,9 cm vs. 31,5 cm; p = 0,011) y bajo puntaje APGAR < 7 (8,7 % vs. 1,2 %). La condición de indígena se asoció de manera independiente con el bajo peso (< 2500 g) al nacimiento (OR: 0,4; IC 95 %: 0,2; 0,9), perímetro cefálico en exceso (OR: 2,7; IC 95 %: 1,5; 4,7) y puntaje de APGAR < 7 puntos (OR: 8,3; IC 95 %: 4,2; 16,5). Conclusiones: la condición de indígena se asocia con indicadores que impactan negativamente en la salud de los recién nacidos, como son el perímetro cefálico y el bajo desempeño en la escala APGAR. Estos resultados deben tomarse como un llamado para mejorar la atención prenatal de la población indígena.(AU)
Introduction: the indigenous population is vulnerable and there is limited understanding of their somatometric indicators and APGAR score at birth. Aim: the objective of the study was to explore the association of the condition of indigenous newborn (INB) on somatometric parameters and APGAR score at birth. Methods: this study employed an exploratory cross-sectional design, utilizing the registry of newborns (NB) from a private clinic. The APGAR score at one minute after birth, as well as nutritional indicators derived from measurements of weight, height, and perimeters, were taken into consideration. The statistical analysis involved the use of logistic regressions. Results: the analysis included 7413 NB (1.8 % INB), 52 % were male and 8.1 % were born preterm (gestational age < 37 weeks). In comparison to non-indigenous NB, the INB group showed a higher risk of malnutrition (8 % vs. 6.3 %; p < 0.001), a greater prevalence of excess weight (7.3 % vs. 1.8 %; p < 0.001), smaller head circumference (33.6 cm vs. 34.1 cm; p = 0.017), smaller abdominal circumference (30.9 cm vs. 31.5 cm; p = 0.011), and a higher occurrence of low APGAR scores (< 7) (8.7 % vs. 1.2 %; p < 0.001). Furthermore, the indigenous condition was independently associated with low birth weight (< 2.500 g) (OR, 0.4; 95 % CI, 0.2; 0.9), excess head circumference (OR, 2.7; 95 % CI, 1.5; 4.7), and APGAR score < 7 points (OR, 8.3; 95 % CI, 4.2; 16.5). Conclusions: the indigenous condition was associated with factors that have adverse effects on the health of NB, including reduced head circumference and suboptimal performance on the APGAR scale. These results emphasize the importance of improving access to and quality of prenatal healthcare services for indigenous communities.(AU)