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1.
BMC Nurs ; 22(1): 192, 2023 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-37286976

RESUMO

BACKGROUND: The World Health Organisation (WHO) calls on stakeholders to give Higher Education a key educational importance for the future of Europe. Within the content of the training programmes at university, sexuality emerges as a relevant topic in the nursing degree, to promote integral health from a holistic perspective. However, research on the presence of sexuality at the curricular level in Higher Education suggests that it is incomplete and underdeveloped. METHODS: This is a protocol for a long-term, multi-centre, exploratory, descriptive, and cross-sectional study with a quantitative and qualitative approach lasting two years. The research will be carried out in the educational community, including, on the one hand, students, and professors and health professionals of nursing programmes from five universities in different parts of the world (Portugal, Spain, Italy, and the United States), and on the other hand, women, young people, and immigrants from these communities. The study will have several target populations. Firstly, the target is nursing students, with whom the aim is to define their perspective on the sexuality content taught at the university, and their level of knowledge. Secondly university professors and health professionals, with whom we will check their perspective on sexuality in the classroom, as well as their level of knowledge in this field. And finally, we will work with the community (women, young people, and immigrants) to whom we will try to bring sexuality from a useful and enjoyable perspective. In order to measure these variables in the protocol, instruments such as questionnaires and semi-structured interviews will be used. During data collection, ethical principles will be guaranteed and informed consent will be requested from the participants. DISCUSSION: The results of the research will have a high curricular impact on the educational community, and will last over time, since the tools generated in the project will be included as part of nursing training programmes. In addition, participation in the project will improve health education for health professionals and at the community level on sexuality in both urban and rural populations.

2.
Cell Tissue Bank ; 2022 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-35059955

RESUMO

Deep second and third degree burns treatment requires fibroblasts, keratinocytes and other skin cells in order to grow new dermis and epidermis. Cells can proliferate, secrete growth factors and extracellular matrix required to repair the damaged tissue. Radiosterilized human amnion and radiosterilized pig skin have been used as natural origin skin dressings for burned patients. Adipose-derived mesenchymal stem cells can differentiate into fibroblasts and keratinocytes and improve wound-healing progress. These cells can stimulate vascular tissue formation, release growth factors, synthetize new extracellular matrix and immunoregulate other cells. In this study, we developed mesenchymal stem cells-cellularized skin substitutes based from radiosterilized human amnion or pig skin. Third-degree burns were induced in mice animal models to evaluate the effect of cellularized skin substitutes on burn wound healing. Mesenchymal phenotype was immunophenotypically confirmed by flow cytometry and cell viability was close to 100%. Skin recovery was evaluated in burned mice after seven and fourteen days post-coverage with cellularized and non-cellularized sustitutes. Histological techniques and immunofluorescence were used to evaluate re-epithelization and type I collagen deposition. We determined that cellularized-human amnion or cellularized-pig skin in combination with mesenchymal stem cells improve extracellular matrix deposition. Both cellularized constructs increase detection of type I collagen in newly formed mouse skin and can be potentially used as skin coverage for further clinical treatment of burned patients.

3.
Artigo em Inglês | MEDLINE | ID: mdl-33318012

RESUMO

Ganciclovir is indicated for curative or preventive treatment of cytomegalovirus (CMV) infections. This study aimed to characterize ganciclovir pharmacokinetics, following intravenous ganciclovir and oral valganciclovir administration, to optimize dosing schemes. All children aged <18 years receiving ganciclovir or valganciclovir were included in this study. Pharmacokinetics were described using nonlinear mixed-effect modeling. Monte Carlo simulations were used to optimize the dosing regimen to maintain the area under the concentration-time curve (AUC) in the preventive or therapeutic target. Among the 105 children (374 concentration-time observations) included, 78 received intravenous (i.v.) ganciclovir, 19 received oral valganciclovir, and 6 received both drugs. A two-compartment model with first-order absorption for valganciclovir and first-order elimination best described the data. An allometric model was used to describe the bodyweight (BW) effect. Estimated glomerular filtration rate (eGFR) and medical status of critically ill children were significantly associated with ganciclovir elimination. Recommended doses were adapted for prophylactic treatment. To obtain a therapeutic exposure, doses should be increased to 40 mg/kg of body weight/day oral or 15 to 20 mg/kg/day i.v. in children with normal eGFR and to 56 mg/kg/day oral or 20 to 25 mg/kg/day i.v. in children with augmented eGFR. These doses should be prospectively confirmed, and therapeutic drug monitoring could be used to refine them individually. (This study has been registered at ClinicalTrials.gov under identifier NCT02539407.).


Assuntos
Infecções por Citomegalovirus , Ganciclovir , Administração Oral , Antivirais/uso terapêutico , Criança , Infecções por Citomegalovirus/tratamento farmacológico , Ganciclovir/uso terapêutico , Humanos , Valganciclovir/uso terapêutico
4.
Crit Care ; 25(1): 42, 2021 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-33514414

RESUMO

BACKGROUND: Sleep amongst intensive care patients is reduced and highly fragmented which may adversely impact on recovery. The current challenge for Intensive Care clinicians is identifying feasible and accurate assessments of sleep that can be widely implemented. The objective of this study was to investigate the feasibility and reliability of a minimally invasive sleep monitoring technique compared to the gold standard, polysomnography, for sleep monitoring. METHODS: Prospective observational study employing a within subject design in adult patients admitted to an Intensive Care Unit. Sleep monitoring was undertaken amongst minimally sedated patients via concurrent polysomnography and actigraphy monitoring over a 24-h duration to assess agreement between the two methods; total sleep time and wake time. RESULTS: We recruited 80 patients who were mechanically ventilated (24%) and non-ventilated (76%) within the intensive care unit. Sleep was found to be highly fragmented, composed of numerous sleep bouts and characterized by abnormal sleep architecture. Actigraphy was found to have a moderate level of overall agreement in identifying sleep and wake states with polysomnography (69.4%; K = 0.386, p < 0.05) in an epoch by epoch analysis, with a moderate level of sensitivity (65.5%) and specificity (76.1%). Monitoring accuracy via actigraphy was improved amongst non-ventilated patients (specificity 83.7%; sensitivity 56.7%). Actigraphy was found to have a moderate correlation with polysomnography reported total sleep time (r = 0.359, p < 0.05) and wakefulness (r = 0.371, p < 0.05). Bland-Altman plots indicated that sleep was underestimated by actigraphy, with wakeful states overestimated. CONCLUSIONS: Actigraphy was easy and safe to use, provided moderate level of agreement with polysomnography in distinguishing between sleep and wakeful states, and may be a reasonable alternative to measure sleep in intensive care patients. Clinical Trial Registration number ACTRN12615000945527 (Registered 9/9/2015).


Assuntos
Actigrafia/métodos , Actigrafia/normas , Polissonografia/normas , Actigrafia/estatística & dados numéricos , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Polissonografia/métodos , Polissonografia/estatística & dados numéricos , Estudos Prospectivos , Reprodutibilidade dos Testes
5.
Eur J Clin Pharmacol ; 77(11): 1687-1695, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34160669

RESUMO

PURPOSE: This study aimed to characterize pharmacokinetics of intravenous and oral ciprofloxacin in children to optimize dosing scheme. METHODS: Children treated with ciprofloxacin were included. Pharmacokinetics were described using non-linear mixed-effect modelling and validated with an external dataset. Monte Carlo simulations investigated dosing regimens to achieve a target AUC0-24 h/MIC ratio ≥ 125. RESULTS: A total of 189 children (492 concentrations) were included. A two-compartment model with first-order absorption and elimination best described the data. An allometric model was used to describe bodyweight (BW) influence, and effects of estimated glomerular filtration rate (eGFR) and age were significant on ciprofloxacin clearance. CONCLUSION: The recommended IV dose of 10 mg/kg q8h, not exceeding 400 mg q8h, would achieve AUC0-24 h to successfully treat bacteria with MICs ≤ 0.25 (e.g. Salmonella, Escherichia coli, Proteus, Haemophilus, Enterobacter, and Klebsiella). A dose increase to 600 mg q8h in children > 40 kg and to 15 mg/kg q8h (max 400 mg q8h, max 600 mg q8h if augmented renal clearance, i.e., eGFR > 200 mL/min/1.73 m2) in children < 40 kg would be needed for the strains with highest MIC (16% of Pseudomonas aeruginosa and 47% of Staphylococcus aureus). The oral recommended dose of 20 mg/kg q12h (not exceeding 750 mg) would cover bacteria with MICs ≤ 0.125 but may be insufficient for bacteria with higher MIC and a dose increase according bodyweight and eGFR would be needed. These doses should be prospectively confirmed, and a therapeutic drug monitoring could be used to refine them individually.


Assuntos
Antibacterianos/administração & dosagem , Antibacterianos/farmacocinética , Bacteriemia/tratamento farmacológico , Ciprofloxacina/administração & dosagem , Ciprofloxacina/farmacocinética , Administração Intravenosa , Adolescente , Fatores Etários , Área Sob a Curva , Estatura , Peso Corporal , Criança , Pré-Escolar , Creatinina/sangue , Relação Dose-Resposta a Droga , Feminino , Taxa de Filtração Glomerular , Humanos , Lactente , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Modelos Biológicos , Método de Monte Carlo , Estudos Prospectivos , Fatores Sexuais
6.
BMC Public Health ; 19(1): 90, 2019 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-30660198

RESUMO

BACKGROUND: Globally, diarrhea is a leading cause of child morbidity and mortality. Although latrines are integral for reducing enteric pathogen transmission, several studies have shown no evidence that latrine ownership improved child health. There are a number of explanations for these results. One explanation is that latrine access does not equate to latrine use. Latrine use, however, is difficult to accurately ascertain, as defecation behavior is often stigmatized. To address this measurement issue, we measure latrine use as a latent variable, indicated by a suite of psychosocial variables. METHODS: We administered a survey of 16 defecation-related psychosocial questions to 251 individuals living in rural Ecuador. We applied latent class analysis (LCA) to these data to model the probability of latrine use as a latent variable. To account for uncertainty in predicted latent class membership, we used a pseudo-class approach to impute five different probabilities of latrine use for each respondent. Via regression modeling, we tested the association between household sanitation and each imputed latrine use variable. RESULTS: The optimal model presented strong evidence of two latent classes (entropy = 0.86): consistent users (78%) and inconsistent users (22%), predicted by 5 of our 16 psychosocial variables. There was no evidence of an association between the probability of latrine use, predicted from the LCA, and household access to basic sanitation (OR = 1.1, 95% CI = 0.6-2.1). This suggests that home access to a sanitation facility may not ensure the use of the facility for every family member at all times. CONCLUSION: Effective implementation and evaluation of sanitation programs requires accurate measurement of latrine use. Psychosocial variables, such as norms, perceptions, and attitudes may provide robust proxy-measures. Future longitudinal studies will help to strengthen the use of these surrogate measures, as many of these factors may be subject to secular trends. Additionally, subgroup analyses will elucidate how our  proxy indicators of latrine defecation vary by individual-level characteristics.


Assuntos
Análise de Classes Latentes , Propriedade/estatística & dados numéricos , Saneamento/estatística & dados numéricos , Banheiros/estatística & dados numéricos , Adulto , Criança , Saúde da Criança/estatística & dados numéricos , Defecação , Equador , Características da Família , Feminino , Humanos , Masculino , Probabilidade , População Rural/estatística & dados numéricos , Estereotipagem , Inquéritos e Questionários , Adulto Jovem
7.
Environ Monit Assess ; 191(8): 498, 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31317335

RESUMO

The fate of highly hazardous or persistent pesticides in soils and their potential for environmental and health risks depends on the physical and chemical properties of the pesticide, soil properties including biological health and climatic conditions. Assessing the fate and impact of pesticides in soil is complicated in the Caribbean due to the high diversity of soils and duality of climate. The FAO supported national competent authorities from 11 countries in the Caribbean in the assessment of obsolete stocks and potentially contaminated soil. The Environmental Management Tool Kit (EMKT) prioritised Fond Cole and Camden Base as the only critical sites. Preliminary site investigations that utilised the rapid environmental assessment (REA) methodology identified that contamination was restricted to an impervious layer at the Camden site. Pesticide properties varied across groups, with the organochlorides exhibiting greater sorptive capacity and lower leaching potential relative to the organophosphates. All tested soils were non-saline with alkaline pH and notably sandy in texture with low adsorptive capacity. Analysis of pesticide levels revealed low to undetected quantities across contaminated sites. Traces of Endrin and Dieldrin were found in Marienburg, Suriname. Overall, assessment of soil contamination from stored obsolete pesticides revealed minimal contamination, however, detailed assessment considering contamination gradients should be performed where pesticides were identified.


Assuntos
Monitoramento Ambiental/métodos , Resíduos de Praguicidas/análise , Praguicidas/análise , Poluentes do Solo/análise , Solo/química , Região do Caribe , Suriname
8.
J Viral Hepat ; 25(1): 19-27, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28692182

RESUMO

GSK2878175 is a potent, pan-genotypic, non-nucleoside, nonstructural protein 5B palm polymerase inhibitor being developed for the treatment of chronic hepatitis C (CHC). A first-in-human, randomized, placebo-controlled, dose escalation study, evaluated the safety and pharmacokinetics of GSK2878175 administered as single and repeat oral doses (once daily for 14 days) to healthy volunteers. A separate proof-of-concept, placebo-controlled, repeat dose (once daily for 2 days) study evaluated the safety, pharmacokinetics and antiviral activity of GSK2878175 monotherapy in treatment-naïve, noncirrhotic, subjects with hepatitis C virus (HCV) genotype 1 [1a and 1b], 2, or 3. No deaths or SAEs were reported in either study, and treatment was well-tolerated. Across all the HCV genotypes, GSK2878175 monotherapy at doses of 10, 30 or 60 mg once daily for 2 days produced a statistically significant multilog reduction (P<.001) in plasma HCV RNA log10 IU/mL from Baseline to 24, 48 and 72 hours after the first dose of GSK2878175 compared to placebo. The reduction in HCV RNA was sustained for a prolonged period across all of the active treatment groups, consistent with the long apparent half-life of GSK2878175 that was observed (mean t1/2 range: 60-63 hours in the CHC subjects). In summary, GSK2878175, when administered to healthy subjects and subjects with CHC, did not reveal any safety concerns that would limit or preclude further clinical development. GSK2878175 monotherapy across a wide dose range produced substantial reduction in HCV RNA, irrespective of HCV genotype. The results from these studies support further evaluation of GSK2878175-based regimens.


Assuntos
Antivirais/administração & dosagem , Inibidores Enzimáticos/administração & dosagem , Hepatite C Crônica/tratamento farmacológico , Adulto , Antivirais/farmacocinética , Antivirais/farmacologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Inibidores Enzimáticos/efeitos adversos , Inibidores Enzimáticos/farmacocinética , Inibidores Enzimáticos/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Placebos/administração & dosagem , RNA Viral/sangue , Resposta Viral Sustentada , Resultado do Tratamento , Carga Viral , Proteínas não Estruturais Virais/antagonistas & inibidores
9.
J Eur Acad Dermatol Venereol ; 32(1): 117-124, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28776770

RESUMO

BACKGROUND: Cutaneous leishmaniasis (CL) is underestimated in Spain as in other European countries due to the polymorphism of its clinical manifestations and histopathological features discouraging doctors from suspecting leishmaniasis. Mucosal manifestations (ML) are misdiagnosed due to the fact that they often mimic cancer. OBJECTIVES: Given that leishmaniasis may be masked as different granulomatous diseases in Leishmania infantum endemic areas, the aim of this study was to verify this misdiagnosing and contributes to the improvement of CL/ML diagnosis. METHODS: A retrospective study involving formalin-fixed paraffin-embedded tissue biopsies with histopathological features of granulomatous lesions of unknown origin (GLUO) detected in 17 patients. This study included 13 patients with CL that was used as positive controls, nine patients with other confirmed diseases used as negative controls and seven patients with histological features suggestive of CL or ML without confirmation. Molecular analysis was blindly performed using two different PCR techniques. RESULTS: The PCR detected 15 CL cases in which the diagnosis was neither clinically nor histologically suspected. Leishmaniasis was confirmed in seven suspected patients in whom the classical techniques failed to detect the parasite. L. infantum was identified in all cases. A systematic review of CL cases in GLUO patients from European countries identified 45 reported cases. CONCLUSIONS: In L. infantum endemic areas, a high percentage of GLUO are due to Leishmania infection. The main consequences are delayed diagnosis and underestimation of the real incidence. PCR performed on paraffin-embedded tissue proved to be a reliable tool for diagnosis of CL/ML and must be performed routinely in any granulomatous dermatitis, even when the morphological features are no stereotypical of leishmaniasis.


Assuntos
Granuloma/parasitologia , Leishmania infantum/isolamento & purificação , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/parasitologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Leishmania infantum/genética , Masculino , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular , Doenças da Boca/diagnóstico , Doenças da Boca/parasitologia , Mucosa Bucal/parasitologia , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Adulto Jovem
10.
J Eur Acad Dermatol Venereol ; 32(11): 1999-2003, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29704265

RESUMO

BACKGROUND: Cutaneous leishmaniasis (CL) is a disfiguring and stigmatising disease occurring in more than 70 countries across the world including Spain and Morocco. The use of sensitive tests that can differentiate Leishmania species is advised. OBJECTIVE: To evaluate the influence of the epidemiological scenario on the reliability of the PCR techniques and contribute to the selection of the most efficient one for CL diagnosis. METHODS: The sensitivities of parasitological methods and four PCRs were compared in cutaneous samples from 77 patients from Spanish (PSH) and Moroccan hospitals (PMH). Exudates and fresh or paraffin-embedded tissue biopsies were used. RESULTS: None of the PCRs used in this study allowed the diagnosis of all CL cases, showing also some drawbacks. Lmj4/Uni21-PCR displayed the best sensitivity with PMH, but it did not provide positive results in PSH with CL confirmed by other PCRs. Conversely, JW13/JW14-PCR and L. infantum-PCR-ELISA displayed good sensitivities with PSH that were not achieved with PMH. Nested-ITS-1-PCR did not show enough sensitivity with paraffin-embedded tissue biopsies. False-negative results were obtained in 19% of PSH due to unspecific hybridizations of ITS-1 primers with human chromosome1. CONCLUSIONS: PCR should be routinely used in patients with cutaneous lesions compatible with CL and furthermore, the combination of two PCR techniques is advisable. The selection of these PCRs will be influenced by the epidemiological scenario: In areas where L. infantum is endemic, the use of the PCR-ELISA joint with JW13/JW14-PCR seems an appropriate choice, whereas in areas such as Morocco, Lmj4/Uni21 and ITS-1 provide satisfactory results.


Assuntos
Leishmania/patogenicidade , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/epidemiologia , Reação em Cadeia da Polimerase/métodos , Adulto , Fatores Etários , Idoso , Estudos de Coortes , Primers do DNA/genética , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Prevalência , Estudos Retrospectivos , Medição de Risco , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Fatores Sexuais , Espanha/epidemiologia , Adulto Jovem
11.
Parasitol Res ; 117(4): 1105-1113, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29404748

RESUMO

Burrows of the wild rabbit, Oryctolagus cuniculus, a lagomorph that has been recently suggested as a Leishmania infantum reservoir, constitute an unspoilt biotope in phlebotomine studies in Europe. We hypothesize that Phlebotomus langeroni, a proven vector of L. infantum in North Africa, is associated with rabbits and may have been overlooked in Europe. Sandfly captures were carried out with CDC light traps in an L. infantum endemic area of southern Spain with a high density of lagomorphs and a large numbers of burrows. The stable, permanent, and highly abundant presence of P. langeroni was assessed. After morphological identification, this sandfly species was characterized by comparing it with P. perniciosus and other P. langeroni populations from North Africa through molecular techniques. P. langeroni had not been found in southern Spain to date, despite being a highly investigated area, except for this particular biotope. Its activity period turned out to begin in mid-July, ending in late October, accounting for a maximum activity during this month. This study shows that P. langeroni is associated with the existence of rabbit burrows and has been overlooked in Europe. L. infantum DNA was found in almost half of the female specimens (47.6%) captured inside a biotope where wild rabbits are infected as well.


Assuntos
Leishmania infantum/fisiologia , Leishmaniose Visceral/transmissão , Phlebotomus/parasitologia , Animais , DNA de Protozoário/genética , Feminino , Leishmania infantum/genética , Leishmaniose Visceral/parasitologia , Masculino , Coelhos , Espanha/epidemiologia
12.
Int Nurs Rev ; 65(3): 459-466, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29517143

RESUMO

AIM: To give an overview of the level of resilience among nurses in Singapore and to examine associations between various demographics variables and resilience level. BACKGROUND: The World Health Organization reported a global needs-based shortage of over 9 million nurses and midwives in 2013. Building resilience among nurses has been postulated as one of the ways to support and retain nurses in the profession. METHOD: A self-reported questionnaire consisting of questions on demographics and the Connor-Davidson Resilience Scale CD-RISC 10 was used. RESULTS: Univariate analysis identified marital status, age group, years of experience in nursing, highest education qualification and job grade to have significant associations with resilience. During multivariate analysis, only marital status, age group, highest educational qualification and job grade remained significant. A strong association was found between highest educational qualification and resilience level; nurses with bachelor's or postgraduate degree were about three times more likely than nurses with only a general nursing certificate to be of moderate/high resilience. CONCLUSION: The experience of life events (as exemplified by marital status, age and working experience) was associated with higher resilience levels. IMPLICATIONS FOR NURSING POLICY: There is a need for healthcare organizations and nurse leaders to develop programmes focusing on building resilience among younger and less experienced nurses. Nurses should also be supported in their pursuits for higher education, which will in turn lead to higher resilience, and consequently, retention of nurses within the profession and institution.


Assuntos
Adaptação Psicológica , Satisfação no Emprego , Recursos Humanos de Enfermagem/psicologia , Resiliência Psicológica , Estresse Psicológico , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Singapura , Fatores Socioeconômicos , Inquéritos e Questionários
13.
Ann Oncol ; 28(10): 2552-2558, 2017 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-28961835

RESUMO

Background: To assess the supportive care needs, quality of life (QoL) and symptoms of patients with cancer after the end of first-line treatments and into survivorship in Asian countries using Australian data as benchmark. Patients and methods: A cross-sectional survey was carried out in Australia and eight high-income (HICs) and low-/middle-income (LMICs) Asian countries (China, Japan, Hong Kong SAR, South Korea, Myanmar, Thailand, India, Philippines) using validated scales (Cancer Survivors Unmet Needs scale), physical-symptom concerns (Cancer Survivors Survey of Needs subscale) and a single-item measure of global QoL perception. Results: Data were collected from 1873 patients. QoL was highest in Australia and all other countries had significantly lower QoL than Australia (all P < 0.001). One-quarter of the patients reported low QoL (scores 1-3/10). The most frequently reported symptoms were fatigue (66.6%), loss of strength (61.8%), pain (61.6%), sleep disturbance (60.1%), and weight changes (57.7%), with no difference in symptom experience between Australian data and all other countries, or between HICs and LMICs. Unmet needs of moderate/strong level were particularly high in all aspects assessed, particularly in the area of existential survivorship (psychosocial care) and receiving comprehensive cancer care. Australia and HICs were similar in terms of unmet needs (all low), but LMICs had a significantly higher number of needs both compared with Australia and HICs (all P < 0.001). Conclusion: Health care systems in Asian countries need to re-think and prioritize survivorship cancer care and put action plans in place to overcome some of the challenges surrounding the delivery of optimal supportive cancer care, use available resource-stratified guidelines for supportive care and test efficient and cost-effective models of survivorship care.


Assuntos
Sobreviventes de Câncer/psicologia , Necessidades e Demandas de Serviços de Saúde , Avaliação das Necessidades , Neoplasias/psicologia , Neoplasias/terapia , Ásia , Austrália , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Qualidade de Vida
14.
Osteoarthritis Cartilage ; 25(7): 1172-1178, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28185846

RESUMO

OBJECTIVE: Lipocalin-2 (LCN2) is an adipokine that was first identified in neutrophil granules. In the last years it was recognized as a factor that could impair chondrocyte phenotype, cartilage homeostasis as well as growth plate development. Both pro-inflammatory cytokines and glucocorticoids (GCs) modulate LCN2 expression. Actually, GCs were found to be LCN2 inducers, suggesting that part of the negative actions exerted by these anti-inflammatory drugs at cartilage level could be mediated by this adipokine. So, in this study we wanted to investigate whether corticoids were able to act in synergy with IL-1 in the induction of LCN2 and the signaling pathway involved in this process. MATERIALS AND METHODS: For the realization of this work, ATDC5 mouse chondrogenic cell line was used. We determined the mRNA and protein expression of LCN2 by real-time reverse transcription-polymerase chain reaction (RT-qPCR) and western blot respectively, after GC or mineralcorticoid treatment. Different signaling pathways inhibitors were also used. RESULTS: GC and mineralcorticoid were able to induce the expression of LCN2 in ATDC5 cells. Interestingly, both corticoids synergized with IL-1 in the induction of LCN2. The effect of these corticoids on the expression of LCN2 occurred through GC or mineralcorticoid receptors and the kinases PI3K, ERK1/2 and JAK2. CONCLUSIONS: Prolonged use of corticoids may have detrimental effects on cartilage homeostasis. Based on our results, we conclude that corticoids could increase the negative actions exerted by IL-1 by increasing the expression of LCN2.


Assuntos
Corticosteroides/farmacologia , Anti-Inflamatórios/farmacologia , Interleucina-1alfa/farmacologia , Lipocalina-2/metabolismo , Mineralocorticoides/farmacocinética , Animais , Linhagem Celular , Relação Dose-Resposta a Droga , Sinergismo Farmacológico , Camundongos , Transdução de Sinais
15.
J Environ Manage ; 186(Pt 2): 301-313, 2017 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-27817970

RESUMO

(Aided) phytostabilisation has been proposed as a suitable technique to decrease the environmental risks associated with metal(loid)-enriched mine tailings. Field scale evaluations are needed for demonstrating their effectiveness in the medium- to long-term. A field trial was implemented in spring 2011 in Cu-rich mine tailings in the NW of Spain. The tailings were amended with composted municipal solid wastes and planted with Salix spp., Populus nigra L. or Agrostis capillaris L. cv. Highland. Plant growth, nutritive status and metal accumulation, and soil physico- and bio-chemical properties, were monitored over three years (four years for plant growth). The total bacterial community, α- and ß-Proteobacteria, Actinobacteria and Streptomycetaceae were studied by DGGE of 16s rDNA fragments. Compost amendment improved soil properties such as pH, CEC and fertility, and decreased soil Cu availability, leading to the establishment of a healthy vegetation cover. Both compost-amendment and plant root activity stimulated soil enzyme activities and induced important shifts in the bacterial community structure over time. The woody plant, S. viminalis, and the grassy species, A. capillaris, showed the best results in terms of plant growth and biomass production. The beneficial effects of the phytostabilisation process were maintained at least three years after treatment.


Assuntos
Biodegradação Ambiental , Cobre/toxicidade , Microbiologia do Solo , Poluentes do Solo/toxicidade , Solo/química , Agrostis/crescimento & desenvolvimento , Bactérias/genética , Biomassa , Cobre/farmacocinética , Consórcios Microbianos/genética , Mineração , Raízes de Plantas/química , Raízes de Plantas/microbiologia , Populus/crescimento & desenvolvimento , Salix/crescimento & desenvolvimento , Poluentes do Solo/análise , Poluentes do Solo/farmacocinética , Resíduos Sólidos , Espanha , Especificidade da Espécie
16.
Bull Environ Contam Toxicol ; 98(2): 204-211, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28039530

RESUMO

A simple and rapid focused ultrasound extraction method was developed for the determination of Persistent Organic Pollutants (POPs) in liver tissue obtained of giant toad (Rhinella marina) using a gas chromatography coupled to a mass detector with electron impact ionization. The performed method for POPs, was validated in fortified matrix, showing linearity from the LOQ up to 100 ng/mL; LODs and LOQs for each compound were between 1.7 and 4.8 and 3.5-7.5 ng/mL, respectively. Recovery rates were among 79%-116% for POPs determined. Finally, the method was applied in liver samples of giant toads found in a malarial area in Mexico. The sensitivity of the proposed method was good enough to ensure reliable determination of target analytes at concentration levels commonly found in this kind of samples.


Assuntos
Bufo marinus/metabolismo , Poluentes Ambientais/metabolismo , Animais , Poluição Ambiental , Cromatografia Gasosa-Espectrometria de Massas , Limite de Detecção , Fígado/metabolismo , México
17.
Apoptosis ; 21(10): 1071-81, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27539477

RESUMO

Cutaneous leishmaniasis treatment remains challenging due to the absence of a satisfactory treatment. The screening of natural compounds is a valuable strategy in the search of new drugs against leishmaniasis. The sesquiterpene (-)-α-bisabolol is effective in vivo against visceral leishmaniasis due to Leishmania infantum, but its mechanism of action remains elusive. The aim of this study is to validate this promising compound against the causative species of Old World cutaneous leishmaniasis and to get an insight into its antileishmanial mode of action. The compound was evaluated on L. tropica promastigotes and intracellular amastigotes using bone marrow-derived macrophages and its cytotoxicity was evaluated on L929 fibroblasts. The reactive oxygen species generation was evaluated using a sensitive probe. Mitochondrial depolarization was assessed evaluating the fluorescence due to rhodamine 123 in a flow cytometer. Apoptosis was investigated by measuring the fluorescence due to annexin V and propidium iodide in a flow cytometer. The ultrastructure of treated promastigotes and intracellular amastigotes was analysed through transmission electron microscopy. (-)-α-Bisabolol was active against L. tropica intracellular amastigotes displaying an inhibitory concentration 50 % of 25.2 µM and showing low cytotoxicity. This compound induced time and dose-dependent oxidative stress, mitochondrial depolarization and phosphatidilserine externalization (a marker of apoptosis). These effects were noticed at a low concentration and short exposure time. In the ultrastructural analyses, the treated parasites showed mitochondrial disruption, presence of electron-dense structures and chromatin condensation. These results suggest that this natural compound induces oxidative stress and mitochondrial-dependent apoptosis on Leishmania without disturbing the plasma membrane.


Assuntos
Antiprotozoários/farmacologia , Apoptose/efeitos dos fármacos , Leishmania infantum/efeitos dos fármacos , Leishmaniose Cutânea/parasitologia , Mitocôndrias/efeitos dos fármacos , Sesquiterpenos/farmacologia , Animais , Antiprotozoários/química , Linhagem Celular , Humanos , Leishmania infantum/citologia , Leishmania infantum/metabolismo , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Camundongos , Mitocôndrias/metabolismo , Sesquiterpenos Monocíclicos , Estresse Oxidativo/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismo , Sesquiterpenos/química
19.
Trop Med Int Health ; 21(5): 630-41, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26921209

RESUMO

OBJECTIVES: The introduction of leishmaniasis in a new area requires a well-established population of the sandfly vector species of the parasite. No autochthonous cases of anthroponotic cutaneous leishmaniasis have been detected in southwestern Europe, and Leishmania infantum is the only causative agent of leishmaniasis in this area. Phlebotomus sergenti, the main vector of Leishmania tropica, is commonly found in the Iberian Peninsula at sufficient densities to be able to act as a vector. It is characterised by high genetic diversity and classified in four mitochondrial lineages. Our aim was to analyse the composition and distribution of P. sergenti mitochondrial lineages in southwestern Europe given the possibility of phenotypic differences of biomedical importance between them. METHODS: Sandflies were captured in the Iberian Peninsula and on the Canary and Balearic Islands. Mitochondrial lineage identification of 137 P. sergenti was performed using a novel PCR-RFLP that avoids the necessity of gene sequencing. RESULTS: Two lineages were evidenced, the typical Iberian one (lineage I) and another, held in common with North Africa (lineage III), that show a distinctive distribution. P. sergenti lineage I shows a better correlation to the bioclimatic diversity in southwestern Europe. Conversely, P. sergenti lineage III prefers warmer temperatures and less precipitation, which are typical of the Mediterranean. CONCLUSION: Lineage I seems to have adaptive advantages given its wider tolerance to temperature and altitude than lineage III, and it would seem more suitable to lead a potential geographical expansion towards the rest of Europe.


Assuntos
Mudança Climática , Doenças Transmissíveis Emergentes/parasitologia , Ecossistema , Insetos Vetores/parasitologia , Leishmaniose/parasitologia , Psychodidae/genética , Animais , Doenças Transmissíveis Emergentes/epidemiologia , Geografia , Humanos , Leishmaniose/epidemiologia , Modelos Logísticos , Reação em Cadeia da Polimerase , Densidade Demográfica , Psychodidae/parasitologia , Análise de Sequência de DNA , Espanha/epidemiologia
20.
J Appl Microbiol ; 120(6): 1492-500, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26972682

RESUMO

AIMS: The aim of this study was to evaluate which of the three mathematical models (Weibull, Geeraerd and Logistic) makes the best approximation for Hypericin-based photosensitization bacterial inactivation. METHODS AND RESULTS: The inactivation of common food-borne pathogens Listeria monocytogenes and Bacillus cereus has been analysed. Three models, Weibull, Logistic and Geeraerd, have been used for different treatment conditions (10(-7 ) mol l(-1) and 10(-8)  mol l(-1) Hypericin concentrations and 2 and 60 min incubation time). The Logistic method showed better correspondence (estimated R(2)  ≥ 0·98, RMSE ≤ 0·41), than the Weibull (estimated R(2)  ≥ 0·91, RMSE ≤ 0·90) and the Geeraerd model (R(2)  ≥ 0·83, RMSE ≤ 1·27). After evaluation of best fitting model for the dependence of bacterial population reduction on irradiation time, the parameters describing treatment efficiency have been calculated. CONCLUSIONS: Our results indicate that the Logistic model described in the best way the inactivation of B. cereus and L. monocytogenes by Hypericin-based photosensitization. SIGNIFICANCE AND IMPACT OF THE STUDY: This study identified a best model for describing bacterial inactivation by hypericin-based photosensitization, which provides a way to evaluate the efficacy of different treatment conditions for this novel decontamination technique.


Assuntos
Bacillus cereus/efeitos da radiação , Descontaminação/métodos , Microbiologia de Alimentos , Listeria monocytogenes/efeitos da radiação , Modelos Biológicos , Perileno/análogos & derivados , Radiossensibilizantes/farmacologia , Antracenos , Bacillus cereus/fisiologia , Luz , Listeria monocytogenes/fisiologia , Perileno/farmacologia
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