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Corporate Social Responsibility is a voluntary strategy by companies, which integrates a set of actions that contribute to sustainable development. This study analyzes the degree of involvement of marine tourism companies in human resource management, adaptation to change, environmental management, local community development and collaboration with public and private agents. These areas configure companies' Corporate Social Responsibility strategies. Information was collected from marine tourism companies on the island of Tenerife using quantitative and qualitative methodologies. A binary logistic regression analysis was applied. The results indicate that, in general, marine tourism companies are socio-environmentally responsible. Environmental aspects and adaptation to change through innovation have the greatest weight in these companies' Corporate Social Responsibility strategies. Actions for local community development and collaboration with private agents are also important. However, human resource management influences negatively since marine tourism is a highly regulated sector in this regard. Thus, actions are mandatory and not voluntary, affecting all companies equally whether they have high levels of Corporate Social Responsibility implementation or not. Regarding relations with public authorities, the results indicate that improvement is urgently required, given the low participation of marine tourism companies in policy making.
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ETHNOPHARMACOLOGICAL RELEVANCE: Litsea glaucescens K. (Lauraceae) is a small tree from the Mexican and Central American temperate forests, named as "Laurel". Its aromatic leaves are ordinarily consumed as condiments, but also are important in Mexican Traditional Medicine, and among the most important non wood forest products in this area. The leaves are currently used in a decoction for the relief of sadness by the Mazahua ethnic group. Interestingly, "Laurel" has a long history. It was named as "Ehecapahtli" (wind medicine) in pre-Columbian times and applied to heal maladies correlated to the Central Nervous System, among them depression, according to botanical texts written in the American Continent almost five centuries ago. AIM OF THE STUDY: Depression is the first cause of incapacity in the world, and society demands alternative treatments, including aromatherapy. We have previously demonstrated the antidepressant-like activity of L. glaucescens leaves' essential oil (LEO), as well as their monoterpenes linalool, and beta-pinene by intraperitoneal route in a mice behavioral model. Here we now examined if LEO and linalool exhibit this property and anxiolytic activity when administered to mice by inhalation. We also investigated if these effects occur by BDNF pathway activation in the brain. MATERIALS AND METHODS: The LEO was prepared by distillation with water steam and analyzed by gas chromatography-mass spectrometry (GC-MS). The monoterpenes linalool, eucalyptol and ß-pinene were identified and quantified. Antidepressant type properties were determined with the Forced Swim Test (FST) on mice previously exposed to LEO or linalool in an inhalation chamber. The spontaneous locomotor activity and the sedative effect were assessed with the Open Field Test (OFT), and the Exploratory Cylinder (EC), respectively. The anxiolytic properties were investigated with the Elevated Plus Maze Apparatus (EPM) and the Hole Board Test (HBT). All experiments were video documented. The mice were subjected to euthanasia, and the brain hippocampus and prefrontal cortex were dissected. RESULTS: The L. glaucescens essential oil (LEO) contains 31 compounds according to GC/MS, including eucalyptol, linalool and beta-pinene. The LEO has anxiolytic effect by inhalation in mice, as well as linalool, and ß-pinene, as indicated by OFT and EC tests. The LEO and imipramine have antidepressant like activity in mice as revealed by the FST; however, linalool and ketamine treatments didn't modify the time of immobility. The BDNF was increased in FST in mice treated with LEO in both areas of the brain as revealed by Western blot; but did not decrease the level of corticosterone in plasma. The OFT indicated that LEO and imipramine didn't reduce the spontaneous motor activity, while linalool and ketamine caused a significant decrease. CONCLUSION: Here we report by the first time that L. glaucescens leaves essential oil has anxiolytic effect by inhalation in mice, as well as linalool, and ß-pinene. This oil also maintains its antidepressant-like activity by this administration way, similarly to the previously determined intraperitoneally. Since inhalation is a common administration route for humans, our results suggest L. glaucescens essential oil deserve future investigation due to its potential application in aromatherapy.
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Ansiolíticos , Ketamina , Lauraceae , Litsea , Óleos Voláteis , Humanos , Camundongos , Animais , Ansiolíticos/farmacologia , Ansiolíticos/uso terapêutico , Óleos Voláteis/química , Fator Neurotrófico Derivado do Encéfalo , Imipramina/farmacologia , Eucaliptol/farmacologia , Ketamina/farmacologia , Antidepressivos/farmacologia , Antidepressivos/uso terapêutico , Antidepressivos/química , Monoterpenos/farmacologia , Comportamento AnimalRESUMO
AIMS/HYPOTHESIS: To assess the feasibility and effectiveness of an active real-life primary care lifestyle intervention in preventing type 2 diabetes within a high-risk Mediterranean population. METHODS: A prospective cohort study was performed in the setting of Spanish primary care. White-European individuals without diabetes aged 45-75 years (n = 2,054) were screened using the Finnish Diabetes Risk Score (FINDRISC) and a subsequent 2 h OGTT. Where feasible, high-risk individuals who were identified were allocated sequentially to standard care, a group-based or an individual level intervention (intensive reinforced DE-PLAN [Diabetes in Europe-Prevention using Lifestyle, Physical Activity and Nutritional] intervention). The primary outcome was the development of diabetes according to WHO criteria. Analyses after 4-year follow-up were performed based on the intention-to-treat principle with comparison of standard care and the combined intervention groups. RESULTS: The standard care (n = 219) and intensive intervention (n = 333) groups were comparable in age (62.0/62.2 years), sex (64.4/68.2% women), BMI (31.3/31.2 kg/m(2)), FINDRISC score (16.2/15.8 points), fasting (5.3/5.2 mmol/l), 2 h plasma glucose (7.1/6.9 mmol/l) and self-reported interest to make lifestyle changes at baseline. Diabetes was diagnosed in 124 individuals: 63 (28.8%) in the standard care group and 61 (18.3%) in the intensive intervention group. During a 4.2-year median follow-up, the incidences of diabetes were 7.2 and 4.6 cases per 100 person-years, respectively (36.5% relative risk reduction, p < 0.005). The number of participants needed to be treated by intensive intervention for 4 years to reduce one case of diabetes was 9.5. CONCLUSIONS/INTERPRETATION: Intensive lifestyle intervention is feasible in a primary care setting and substantially reduces diabetes incidence among high-risk individuals. CLINICAL TRIAL REGISTRATION: ClinicalTrial.gov NCT01519505. FUNDING: Commission of the European Communities, Institute of Health Carlos III, Spanish Ministry of Health and Department of Health, Generalitat de Catalunya.
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Diabetes Mellitus Tipo 2/prevenção & controle , Atenção Primária à Saúde/métodos , Comportamento de Redução do Risco , Idoso , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etnologia , Progressão da Doença , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Risco , Espanha/epidemiologia , População Branca/estatística & dados numéricosRESUMO
Materials in nature have fascinating properties that serve as a continuous source of inspiration for materials scientists. Accordingly, bio-mimetic and bio-inspired approaches have yielded remarkable structural and functional materials for a plethora of applications. Despite these advances, many properties of natural materials remain challenging or yet impossible to incorporate into synthetic materials. Natural materials are produced by living cells, which sense and process environmental cues and conditions by means of signaling and genetic programs, thereby controlling the biosynthesis, remodeling, functionalization, or degradation of the natural material. In this context, synthetic biology offers unique opportunities in materials sciences by providing direct access to the rational engineering of how a cell senses and processes environmental information and translates them into the properties and functions of materials. Here, we identify and review two main directions by which synthetic biology can be harnessed to provide new impulses for the biologization of the materials sciences: first, the engineering of cells to produce precursors for the subsequent synthesis of materials. This includes materials that are otherwise produced from petrochemical resources, but also materials where the bio-produced substances contribute unique properties and functions not existing in traditional materials. Second, engineered living materials that are formed or assembled by cells or in which cells contribute specific functions while remaining an integral part of the living composite material. We finally provide a perspective of future scientific directions of this promising area of research and discuss science policy that would be required to support research and development in this field.
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INTRODUCTION: Epiblepharon is a congenital eyelid malposition due to a horizontal skin fold and a redundant orbicular muscle, resulting in the inward positioning of the eyelashes. OBJECTIVE: Personal experience is presented of the non-surgical correction of symptomatic epiblepharon using a pretarsal injection of 5 IU of botulinum toxin type A (BoNT-A) into the orbicular muscle. MATERIAL AND METHODS: Patients with epiblepharon younger than 2 year were included in the study. A review was made of their clinical charts and the symptoms and signs of epiblepharon were evaluated before and after treatment with BoNT-A. RESULTS: A total of 40 patients were included (28 girls [70%]). The mean age at treatment was 11 months (range, 4-24 months). A total of 76 eyelids were treated with BoNT-A. A statistically significant improvement in symptoms, lash-corneal touch, and punctate corneal epitheliopathy were reported after the treatment with 5IU BoNT-A. The mean final follow-up was 25.5 weeks (range, 4-92 months). CONCLUSIONS: The present study provides evidence that a pretarsal BoNT-A injection is an effective and safe treatment for the correction of symptomatic epiblepharon in patients younger than 2 years of age.
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Toxinas Botulínicas Tipo A/uso terapêutico , Doenças Palpebrais/congênito , Pálpebras/anormalidades , Fármacos Neuromusculares/uso terapêutico , Toxinas Botulínicas Tipo A/administração & dosagem , Avaliação de Medicamentos , Doenças Palpebrais/tratamento farmacológico , Feminino , Seguimentos , Humanos , Lactente , Injeções Intramusculares , Masculino , Fármacos Neuromusculares/administração & dosagem , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Immune response failure during HCV infection has been associated with the activity of regulatory T cells. Hepatitis C-related cirrhosis is the main reason for liver transplantation. However, 80% of transplanted patients present an accelerated recurrence of the disease. This study assessed the involvement of regulatory T-cell subsets (CD4+CD25+ cells: 'Treg' and CD49b+CD18+ cells: 'T regulatory-1' cells), in the recurrence of HCV after liver transplantation, using transcriptomic analysis, ELISA assays on serum samples and immunohistochemistry on liver biopsies from liver recipients 1 and 5 years after transplantation. Three groups of patients were included: stable HCV-negative recipients and those with mild and severe hepatitis C recurrence. At 5 years, Treg markers were overexpressed in all HCV+ recipients. By contrast, Tr1 markers were only overexpressed in patients with severe recurrence. At 1 year, a trend toward the overexpression of Tr1 was noted in patients evolving toward severe recurrence. IL-10 production, a characteristic of the Tr1 subset, was enhanced in severe recurrence at both 1 and 5 years. These results suggest that Tr1 are enhanced during severe HCV recurrence after liver transplantation and could be predictive of HCV recurrence. High levels of IL-10 at 1 year could be predictive of severe recurrence, and high IL-10 producers might warrant more intensive management.
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Regulação Viral da Expressão Gênica , Hepatite C/imunologia , Transplante de Fígado/métodos , Linfócitos T Reguladores/imunologia , Linfócitos T Reguladores/metabolismo , Adulto , Antígenos CD18/biossíntese , Linfócitos T CD4-Positivos/imunologia , Feminino , Hepatite C/metabolismo , Humanos , Integrina alfa2/biossíntese , Interleucina-10/biossíntese , Subunidade alfa de Receptor de Interleucina-2/biossíntese , Masculino , Pessoa de Meia-Idade , RecidivaRESUMO
BACKGROUND: Immune response failure against hepatitis C virus (HCV) has been associated with an increased regulatory T cell (Treg) activity. After liver transplantation (LT), 80% of patients experience an accelerated progression of hepatitis C recurrence. The aim of this work was to assess the involvement of Tregs, T helper (Th) 1, 2 and 17 cells in recurrent hepatitis C. METHODS: Peripheral blood cells obtained before and one month after LT from 22 recipients were analysed. Forty-four key molecules related to Treg, Th1, 2 and 17 responses, were evaluated using qRT-PCR. Liver recipients were classified in two groups according to graft fibrosis evaluated by the METAVIR score on the biopsy performed one year after LT (mild: F ≤ 1, n = 13; severe: F > 1, n = 9). Patients developing a severe recurrence were compared with patients with a mild recurrence. RESULTS: mRNA levels of Treg markers obtained one month after LT were significantly increased in patients with a severe disease course when compared to patients with a mild recurrence. Markers of the Th1 response were elevated in the same group. No differences in the markers determined before LT were observed. CONCLUSION: These findings suggest that Treg, induced by a multifactorial process, which could include a strong Th1 response itself, may play a role in suppressing the early antiviral response, leading to a severe recurrence of hepatitis C.
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Hepatite C Crônica/diagnóstico , Transplante de Fígado , Linfócitos T Auxiliares-Indutores/metabolismo , Linfócitos T Reguladores/metabolismo , Idoso , Biomarcadores/metabolismo , Antígenos CD28/genética , Antígenos CD28/metabolismo , Ligante de CD40/genética , Ligante de CD40/metabolismo , Antígeno CTLA-4/genética , Antígeno CTLA-4/metabolismo , Progressão da Doença , Feminino , Humanos , Interferon gama/genética , Interferon gama/metabolismo , Subunidade alfa de Receptor de Interleucina-10/genética , Subunidade alfa de Receptor de Interleucina-10/metabolismo , Subunidade beta de Receptor de Interleucina-10/genética , Subunidade beta de Receptor de Interleucina-10/metabolismo , Interleucina-2/genética , Interleucina-2/metabolismo , Subunidade alfa de Receptor de Interleucina-2/genética , Subunidade alfa de Receptor de Interleucina-2/metabolismo , Interleucina-23/genética , Interleucina-23/metabolismo , Masculino , Pessoa de Meia-Idade , RNA Mensageiro/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Recidiva , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Proteínas com Domínio T/genética , Proteínas com Domínio T/metabolismo , Fator de Crescimento Transformador beta/genética , Fator de Crescimento Transformador beta/metabolismo , Membro 7 da Superfamília de Receptores de Fatores de Necrose Tumoral/genética , Membro 7 da Superfamília de Receptores de Fatores de Necrose Tumoral/metabolismoRESUMO
Neuroprotective effects of short prolactin (PRL) pre-treatment against kainic acid (KA)-induced damage include neuron loss avoidance in all hippocampal regions and attenuation of seizures. Recent evidence points PRL receptor (PRL-R) as mediator of such neuroprotective effects and seizures as regulators of neuronal marker transcript expression in the hippocampus. Here, we investigated if a daily PRL dose of 100 µg or vehicle for 14 days in ovariectomized rats (OVX) prevents neuron loss induced by KA administered on the third day of PRL treatment in a systemic single dose of 7.5 mg/kg or vehicle, and promotes PRL-R, vesicular glutamate transporter 1 (VGLUT1) and glutamic acid decarboxylase 65 (GAD65) expression changes in the hippocampus of sacrificed rats 27 days after the KA administration. Immunostaining for Neu-N and PRL-R revealed significant neuron number and PRL-R expression reduction induced by KA that was prevented and turned into overexpression respectively in all hippocampal regions when PRL was added; while VGLUT1,and GAD65 immunostaining displayed expression decrease in the CA1 of injured rats, prevented in the last case and turned into VGLUT1, overexpression when administered PRL. These data indicate that chronic PRL administration before damage induces hippocampal neuroprotection associated with PRL-R and VGLUT1 overexpression, the latter in a regiondependent way.
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Hipocampo/efeitos dos fármacos , Ácido Caínico/toxicidade , Neurônios/efeitos dos fármacos , Fármacos Neuroprotetores/administração & dosagem , Prolactina/administração & dosagem , Receptores da Prolactina/metabolismo , Proteína Vesicular 1 de Transporte de Glutamato/metabolismo , Animais , Agonistas de Aminoácidos Excitatórios/toxicidade , Feminino , Glutamato Descarboxilase/metabolismo , Hipocampo/metabolismo , Hipocampo/patologia , Neurônios/metabolismo , RatosRESUMO
INTRODUCTION: The HAISS (Herramienta de Aprendizaje ISS) program was created to enhance the feasibility and learning of trauma severity scores AIS (Abbreviated Injury Score) and ISS (Injury Severity Score). OBJECTIVE: Get a computer tool that promotes learning and facilitate proper use of AIS and ISS. MATERIAL AND METHODS: A sample of 40 orthopedic residents from 1st to 4th grade from 4 hospitals of the Ministry of Health was taken. A prospective longitudinal study was conducted with analytical statistics. 10 clinical cases for obtaining ISS by AIS score were delivered, this was done with the AIS Manual 2005 update 2008, two questions were conducted to evaluate the feasibility and ease of use, the time to perform was measured. The process was repeated a month later with the HAISS program. RESULTS: Using the HAISS program reduced the time to resolve the 10 cases by more than 50%, acceptance by the user of the AIS scale also improved. Reliability to obtain the codification of lesions with AIS did not improve, but it did not affected ISS. CONCLUSIONS: The HAISS computer program is useful for orthopedic residents to accept the AIS score and ISS score mainly because it improved the ease of use and makes it more user-friendly, it also takes less time to use it.
INTRODUCCIÓN: Se creó el programa HAISS (Herramienta de Aprendizaje ISS) para mejorar la factibilidad y aprendizaje de las escalas de gravedad en trauma AIS (Abbreviated Injury Score) e ISS (Injury Severity Score). OBJETIVO: Obtener una herramienta de computación que promueva el aprendizaje y facilite el uso adecuado de las escalas AIS e ISS. MATERIAL Y MÉTODOS: Se toma una muestra de 40 residentes de primero a cuarto grado de ortopedia de cuatro hospitales de la Secretaría de Salud. Se realizó un estudio longitudinal prospectivo con estadística analítica. Se entregaron 10 casos clínicos para obtención de ISS mediante la escala AIS, se utilizó el manual AIS 2005 actualización 2008, se plantearon dos preguntas para evaluar facilidad de uso y factibilidad, se midió el tiempo de realización. Se repitió el proceso al mes con el programa HAISS. RESULTADOS: Con ayuda del programa HAISS se redujo el tiempo para resolver los 10 casos en más de 50%, la aceptación por parte del usuario de la escala AIS también mejoró. La fiabilidad de obtener la codificación de las lesiones con AIS no mejoró, pero no se ve afectada la obtención del ISS. CONCLUSIONES: El programa HAISS mostró aceptación en un grupo de residentes de ortopedia, mejoró en forma subjetiva su uso y además ocupa poco tiempo.
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Serviço Hospitalar de Emergência , Software , Ferimentos e Lesões , Escala Resumida de Ferimentos , Humanos , Escala de Gravidade do Ferimento , Estudos Longitudinais , México , Estudos Prospectivos , Reprodutibilidade dos Testes , Ferimentos e Lesões/diagnósticoRESUMO
The most common complications after surgical extraction of the third mandibular molar are trismus, oedema or swelling, local pain, dysphagia and infection. The aim of this comparative, double-blind, randomized clinical trial was to evaluate the efficacy of two sustained release amoxicillin/clavulanate regimens in the reduction of infection after third molar extractive surgery. A total of 225 patients were randomized into three equal groups: placebo, prophylaxis with single pre-surgical dose of two tablets amoxicillin/clavulanate 1000/62.5 mg, and pre-emptive post-surgery therapy with two tablets amoxicillin/clavulanate 1000/62.5 mg BID for 5 days. A higher rate of infection (P=0.006) was found among patients receiving placebo (16%) than those receiving single-dose prophylaxis (5.3%) or 5-day pre-emptive therapy (2.7%). A relationship between both the duration (13.8% for long versus 7.4% for medium versus 1.6% for short) and difficulty (12.7% with ostectomy versus 3.5% without ostectomy; P=0.011) of surgical procedure and incidence of subsequent infection was also observed. Both prophylactic and therapeutic regimens versus placebo achieved greater reduction of pain after surgery on day 3 (P=0.001). Logistic regression analysis revealed a risk of infection of 24%, 9% and 4% for ostectomy with placebo, prophylaxis and pre-emptive treatment, respectively, whereas it was 7%, 2% and 1% if ostectomy was not performed. Pre-emptive therapy with the oral sustained release amoxicillin/clavulanate formulation reduced the rate of subsequent infection in patients undergoing ostectomy. Prophylaxis was beneficial in simpler procedures and may be indicated in cases where ostectomy is not performed.
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Combinação Amoxicilina e Clavulanato de Potássio/administração & dosagem , Antibacterianos/administração & dosagem , Antibioticoprofilaxia , Dente Serotino/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Extração Dentária , Adulto , Idoso , Estudos de Casos e Controles , Transtornos de Deglutição/prevenção & controle , Preparações de Ação Retardada , Método Duplo-Cego , Edema/prevenção & controle , Feminino , Febre/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Osteotomia , Dor Pós-Operatória/prevenção & controle , Placebos , Fatores de Risco , Infecção da Ferida Cirúrgica/prevenção & controle , Resultado do Tratamento , Trismo/prevenção & controleRESUMO
INTRODUCTION: Evisceration is currently becoming the technique of choice in the treatment of certain eye diseases, including, among others, painful blind eye and endophthalmitis. The most widely used implants are currently the hydroxyapatite and porous polyethylene for the rehabilitation of the anophthalmic socket. OBJECTIVE: To describe the indications, type of implant material used, and complications in evisceration surgery. METHODS: A retrospective, observational, descriptive study based on clinical records of patients that underwent evisceration between 2008 and 2015 in the Instituto Fundación Conde de Valenciana, Mexico. RESULTS: A total of 186 evisceration surgeries were performed, of which 52.7% of the patients were men. The mean age was 54 years. The right eye was eviscerated in 53% of cases, and 79.2% had a vision of no light perception. Most patients had preoperative pain. The most common diagnosis for which evisceration was performed was endophthalmitis. Phthisis bulbi was reported in 20 eyes. A primary implant was inserted in 86.81% of the cases, with 34.81% of the implants being made of porous polyethylene. Four cases showed extrusion of the implant, with 2 cases of porous polyethylene. The ocular prosthesis was tolerated in 91% of cases. There were no cases of sympathetic ophthalmia. CONCLUSION: Evisceration is shown to be a good alternative to enucleation in cases where the sclera can be preserved, showing a low incidence of sympathetic ophthalmia.
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Evisceração do Olho/estatística & dados numéricos , Academias e Institutos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Materiais Biocompatíveis , Criança , Pré-Escolar , Úlcera da Córnea/cirurgia , Durapatita , Endoftalmite/cirurgia , Traumatismos Oculares/cirurgia , Olho Artificial , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Implantes Orbitários , Polietileno , Implantação de Prótese , Estudos Retrospectivos , Adulto JovemRESUMO
CLINICAL CASE: A 43 year-old woman consulted due to 2 months of swelling on the superolateral side of the left orbit, with pain and erythema. An excisional biopsy was performed that revealed vasculitis with polyangiitis of the lacrimal gland. A systemic study showed that no other system was compromised. DISCUSSION: Orbital involvement occurs in up to 60% of patients with granulomatosis with polyangiitis. The involvement of the lacrimal gland is rare and often unilateral. Serological tests are generally negative, both in initial stages, as in localized forms of the disease.
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Granulomatose com Poliangiite , Doenças do Aparelho Lacrimal , Adulto , Feminino , Granulomatose com Poliangiite/diagnóstico , Granulomatose com Poliangiite/cirurgia , Humanos , Doenças do Aparelho Lacrimal/diagnóstico , Doenças do Aparelho Lacrimal/cirurgiaRESUMO
Resumen Objetivo: Revisar la incidencia de esta enfermedad en pacientes sometidos a mamoplastías en una clínicaprivada en el período de 11 años, con el fin de describir sus síntomas y signos, diagnóstico, tratamiento y evolución. Materiales y Método: Se estudiaron 355 mujeres que se sometieron a mamoplastías estéticas. Se excluyó aquellas cirugías reconstructivas secundarias a cáncer de mama y aquellas con otros antecedentes oncológicos previos. La información fue recolectada de las fichas clínicas. Resultado: Se analizan 710 mamas operadas en el período 2008-2018, de las cuales seis mamas (6/710) evolucionaron con enfermedad de Mondor (0,8%). El diagnóstico se realizó clínicamente. Todos los casos recibieron terapia antiinflamatoria oral y local, respondiendo favorablemente. Discusión: Existe poca literatura publicada al respecto. Casos bilaterales son menos reportados. Pareciera asociarse con cirugías del surco submamario y no está claro que requiera curación terapéutica. Conclusiones: La enfermedad de Mondor es infrecuente, puede presentarse secundario a mamoplastías, es de diagnóstico clínico y sólo tratamiento sintomático con evolución satisfactoria sin secuelas.
Aim: Review the disease incidence in patients who had mammoplasties in a private clinic on a 11 year-period. The purpose is to describe their symptoms and signs, diagnosis, treatment and evolution. Materials and Method: 355 women who underwent cosmetic mammoplasties were studied. Those reconstructive surgeries secondary to breast cancer and those with other previous oncological history were excluded. The information was collected from clinical files. Results: 710 breasts operated between 2008-2018 are analyzed, six of them (6/710) evolved Mondor disease (0.8%). The diagnosis was made clinically. All cases received oral and local antiinflammatory therapy, responding favorably. Discussion: There is a few published literature about it. Bilateral cases are less reported. It appears to be associated with surgeries of the submammary sulcus and it is not clear that it requires therapeutic cure. Conclusions: Mondor's disease is infrequent, can occur secondary to mammoplasty, diagnosis is clinical, treatment is symptomatic, all cases had satisfactory evolution without sequelae.
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Humanos , Feminino , Tromboflebite/diagnóstico , Tromboflebite/terapia , Veias/patologia , Mama/cirurgia , Complicações Pós-Operatórias , Período Pós-Operatório , Parede Abdominal/patologia , Tratamento ConservadorRESUMO
BACKGROUND: The prevalence of anemia in children from Santander (Colombia), is nearly 28 %. Economic conditions make it difficult to perform the hemoglobin test in all children with suspected anemia. The palmar pallor sign has been recommended by the World Health Organization (WHO) and the Pan-American Health Organization for the diagnosis of anemia in children aged less than 5 years old; however, the yield of the test has not been established in Colombian communities. The aims of the present study were to establish the efficiency of the test and to determine its reproducibility. METHODS: The palmar pallor sign was evaluated in a sample of 167 children attending a low complexity hospital located in a deprived area of Bucaramanga city. Two pediatricians determined the presence of the sign, according to criteria from the "Integrated Management of Childhood Illness" strategy of the WHO and the Pan-American Health Organization. A hospital laboratory determined the concentration of hemoglobin in each of the children. Based on these data, the sensitivity, specificity, positive predictive value and negative predictive value were determined and the agreement between observers was established. RESULTS: The prevalence of anemia in the sample evaluated was 28.74 %. Sensitivity was 33.33 %, specificity was 79.83 %, the positive predictive value was 40 % and the negative predictive value was 74.8 %. The reproducibility of the test was low. The yield of the test substantially improved when the hemoglobin cut-off point was reduced from 11 g/dl, which is the value proposed by the WHO, to 10.5 g/dl. CONCLUSIONS: Anemia is frequent in children aged less than 5 years old in Bucaramanga city. The Palmar pallor sign is a valuable tool for the diagnosis of severe anemia, but is much less useful in mild or moderate anemia. If the hemoglobin level proposed by the WHO were lower, the palmar pallor sign would be more useful.
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Anemia/diagnóstico , Pré-Escolar , Colômbia , Humanos , Lactente , Palidez , Exame Físico , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
It has been demonstrated that the aqueous extract of Tagetes lucida Cav. shows an antidepressant-like effect on the forced swimming test (FST) in rats. The aim of this study was to analyze the participation of the serotoninergic system in the antidepressant-like effect of the aqueous extract of T. lucida. Different doses of the extract of T. lucida were administered at 72, 48, 24, 18 and 1 h before FST. The animals were pretreated with a 5-HT1A receptor antagonist (WAY-100635, 0.5 mg/kg), a 5-HT2A receptor antagonist (ketanserin, 5 mg/kg), a ß-noradrenergic receptor antagonist (propranolol, 200 mg/kg), and with a α2-noradrenergic receptor antagonist (yohimbine, 1 mg/kg) alone or combined with the extract and pretreated with a serotonin synthesis inhibitor (PCPA) before treatment with 8-OH-DPAT + the extract of T. lucida. In addition, suboptimal doses of the 5-HT1A agonist (8-OH-DPAT) + non-effective dose of extract was analyzed in the FST. To determine the presence of flavonoids, the aqueous extract of T. lucida (20 µl, 4 mg/ml) was injected in HPLC; however, a quercetin concentration of 7.72 mg/g of extract weight was detected. A suboptimal dose of 8-OH-DPAT + extract of T. lucida decreased immobility and increased swimming and climbing. An antidepressant-like effect with the aqueous extract of T. lucida at doses of 100 and 200 mg/kg was observed on the FST with decreased immobility behavior and increased swimming; however, this effect was blocked by WAY-100635, ketanserin and PCPA but not by yohimbine and propranolol, suggesting that the extract of T. lucida could be modulating the release/reuptake of serotonin.
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Antidepressivos/metabolismo , Produtos Biológicos/uso terapêutico , Depressão/tratamento farmacológico , Receptor 5-HT1A de Serotonina/metabolismo , Receptor 5-HT2A de Serotonina/metabolismo , Natação/fisiologia , Tagetes/química , 8-Hidroxi-2-(di-n-propilamino)tetralina , Animais , Antidepressivos/farmacologia , Masculino , Ratos , Ratos Wistar , Fatores de RiscoRESUMO
Resumen Introducción: El tinnitus se define como la percepción consciente de un sonido, en ausencia de un estímulo acústico externo correspondiente. Se ha relacionado a múltiples comorbilidades como hipertensión arterial (HTA), diabetes mellitus (DM) e hipoacusia, sin evidencia sólida en la actualidad. Hay diversas formas de experimentar el tinnitus, ya sea de comienzo unilateral o bilateral, intermitente o persistente, con deterioro de la calidad de vida, leve hasta formas invalidantes. El conocer las diversas patologías presentes en el tinnitus, en especial la hipoacusia, toma relevancia al momento de enfrentar a pacientes con dicha patología. Objetivo: Caracterizar el tinnitus y sus principales hallazgos audiométricos en pacientes atendidos en el Servicio de Otorrinolaringología del Hospital Clínico Herminda Martín de Chillán, Chile. Material y Método: Estudio retrospectivo. Se incluyeron pacientes mayores de 18 años con diagnóstico de tinnitus entre los años 2015-2017. Se obtuvo información epidemiológica, comorbilidades, presentación clínica del tinnitus en función de lateralidad y frecuencia, hipoacusia asociada y hallazgos audiométricos. Resultados: Se incluyeron en el estudio a 249 pacientes, la mayoría mujeres (70%) con una edad promedio de inicio de su tinnitus entre 60-79 años (52%). Entre las principales comorbilidades se encuentran la hipertensión arterial, diabetes mellitus y patologías autoinmunes; los síntomas otorrinolaringológicos acompañantes estuvieron en menos del 10% de los casos. En relación a la caracterización del tinnitus, el 52% fue de inicio unilateral y el 66% de forma continua. La hipoacusia objetivada en el audiograma estuvo presente en el 43% de los pacientes con tinnitus. Conclusión: El tinnitus es una patología compleja y multifactorial, en este sentido, la presencia de hipoacusia objetiva en la audiometría estuvo presente en un 43% de los pacientes, siendo una de las principales causas a descartar por el médico en el primer enfrentamiento del paciente.
Abstract Introduction: tinnitus is defined as the conscious perception of a sound, in the absence of a corresponding external acoustic stimulus. It has been related to multiple comorbidities such as high blood pressure, diabetes mellitus, hearing loss, with no solid evidence at present. There are various ways to experience tinnitus, whether it is unilateral or bilateral, intermittent or persistent onset, from mild quality of life deterioration to disabling forms. Knowing the various pathologies present in tinnitus, especially hearing loss, becomes relevant when confronting patients with this pathology. Aim: To characterize tinnitus and its main audiometric findings in patients treated at the Otorhinolaryngology Service of the Herminda Martin of Chillán Clinical Hospital in Chile. Material and Method: Retrospective study. Patients older than 18 years with a diagnosis of tinnitus between the years 2015-2017 were included. Epidemiological information, comorbidities, clinical presentation of tinnitus according to laterality and frequency, associated hearing loss and audiometric findings were obtained. Results: 249 patients were included. Most were women (70%), with an onset average age of tinnitus between 60 to 79 years (52%). The accompanying otorhinolaryngological symptoms were in less than 10% of the cases. The main comorbidities were high blood pressure, diabetes mellitus and autoimmune pathologies. 52% of tinnitus was unilateral presentation and in 66% it was continuous. 43% had hypoacusis objectified on the audiogram, regardless of whether they had the sensation of hearing loss. Conclusion: Tinnitus is a complex and multifactorial pathology, in this sense, the presence of objective hearing loss in audiometry was present in 43% of patients, being one of the main causes to be ruled out by the doctor in the patient's first confrontation.
RESUMO
Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) are important growth factors for postnatal longitudinal bone growth. Although many effects of GH on bone growth are mediated by IGF-1, GH can directly influence bone cells. Limited knowledge exists regarding specific intracellular signaling pathways and genes activated by GH in bone cells. GH is known to activate several intracellular signaling pathways, among them the Janus kinase (JAK)/signal transducers and activators of transcription (STAT) pathway. GH mainly activates JAK2 and both isoforms of STAT5, A and B. STAT5 gene deletion experiments have shown the importance of these transcription factors for growth. To understand the molecular mechanism(s) behind this, different experimental models are needed. The UMR 106 cell line is a rat clonal osteosarcoma cell line with osteoblast-like phenotypic properties, one is the endogenous expression of GH receptor (GHR). The present study focused on whether these cells express a functional GH-responsive JAK2/STAT5 pathway. Analysis of cell extracts by immunoprecipitation and Western blot showed that physiological concentrations of GH activated JAK2. Western blot analysis of nuclear extracts from GH-stimulated UMR 106 cells showed that physiological concentrations of GH induced nuclear translocation of both STAT5 isoforms, but with STAT5A being predominant. Both isoforms displayed similar nuclear turnover after GH stimulation of cells. Gel electrophoretic mobility shift assay (GEMSA) of nuclear extract revealed that both STAT5A and STAT5B obtained DNA-binding capacity after GH stimulation. Thus, we have shown, for the first time, the expression and GH-induced activation of JAK2 and STAT5A/B in UMR 106 osteoblast-like cells. This study also shows that this cell line is a suitable experimental model to study unique GH effects in osteoblasts mediated by STAT5.
Assuntos
Hormônio do Crescimento/metabolismo , Proteínas do Leite , Osteoblastos/metabolismo , Proteínas Proto-Oncogênicas , Transdução de Sinais , Animais , Neoplasias Ósseas/metabolismo , Extratos Celulares , Núcleo Celular/efeitos dos fármacos , Núcleo Celular/metabolismo , DNA/metabolismo , Proteínas de Ligação a DNA/metabolismo , Ativação Enzimática/efeitos dos fármacos , Hormônio do Crescimento/farmacologia , Janus Quinase 2 , Osteoblastos/efeitos dos fármacos , Osteossarcoma/metabolismo , Transporte Proteico , Proteínas Tirosina Quinases/metabolismo , Ratos , Fator de Transcrição STAT5 , Transativadores/metabolismo , Células Tumorais CultivadasRESUMO
The efficacy of systemic chemotherapy in the treatment of primary and secondary liver cancer is poor. Intra-arterial delivery of fluoropyrimidines resulted in a significantly higher tumor response, but survival was prolonged by only a few months. Obviously, there is still a great need for improved therapeutic strategies. As the regional blood flow is of importance for the advantage of intra-arterial administration of cytotoxic drugs, degradable starch microspheres (DSMs) have been developed specifically to achieve temporary vascular occlusion during coadministration of cytotoxic drugs. Peak plasma concentrations, as well as the area under the concentration-time curve (AUC) of mitomycin C in plasma have been found to be significantly reduced following intra-arterial coadministration with DSMs. Similar results were also obtained with other drugs, such as nitrosoureas, doxorubicin, and 5-fluorouracil. The temporary vascular occlusion induced by DSMs enables a coadministered drug to be lodged in the target area for a prolonged period of time, resulting in a selectively increased uptake of labeled low molecular weight markers and several cytotoxic drugs into liver tumors compared with normal liver tissue. Vascular occlusion induced by DSMs has been demonstrated to redistribute the blood flow to hypovascular areas, which might be of particular importance for improving the efficacy of intra-arterial chemotherapy of hypovascular liver tumors. Passage through arteriovenous shunts was generally increased after DSM injection. However, this was without clinical significance as respiratory distress symptoms were found in only 1% of the sessions and were not considered to be serious in any of these patients. To take advantage of the pharmacokinetic modulation of coinjected drugs and, in addition, the redistribution of blood flow to hypovascular tumor areas, the goal is to achieve an almost complete vascular occlusion by injection of DSMs. Therefore, due to the wide variation between patients in the size and vascularity of liver tumors, the dose of DSMs has to be individualized. Degradable starch microspheres have been shown to enhance the antitumor efficacy of several cytotoxic drugs in animal experimental models and in noncomparative and randomized clinical studies.
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Antineoplásicos/administração & dosagem , Neoplasias Hepáticas/terapia , Amido/administração & dosagem , Animais , Antineoplásicos/farmacocinética , Biodegradação Ambiental , Humanos , Injeções Intra-Arteriais , Neoplasias Hepáticas/irrigação sanguínea , Microesferas , Fluxo Sanguíneo RegionalRESUMO
We studied a group of 12 hypertensive patients (seven men, five women) with unilateral renal arterial stenosis, and evaluated the morphological criteria on renal angiography for the significance of the stenosis and compared them with the prostaglandin-E2 (PGE2), plasma renin activity (PRA), and angiotensin II (ANG II) concentrations in both renal veins. PGE2 and PRA concentrations were significantly higher in renal veins of kidneys with arterial stenosis with patients supine and after sitting up for 15 min, but the ANG II concentration was raised only with the patient sitting. Assuming that a PRA ratio greater than 2 signifies stenosis of haemodynamic importance, correlation to the angiographic classification was seen in 11 of the 12 patients. The PGE2 ratios were better correlated to PRA ratios than to the angiographic findings. ANG II ratios showed an inconstant and variable pattern in relation to the morphological picture. Our results confirm that PGE2 concentrations in renal venous blood increase in parallel to PRA, and may be interpreted as a means of preserving the blood flow in a kidney with arterial stenosis. However, it is unclear whether this increase is the result of dilution factors or of increased net production of PGE2. Determination of PGE2 in renal vein blood apparently gives no additional information about the functional significance of renal arterial stenosis, and PRA determinations remain the best guide in the management of renovascular hypertension.