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1.
Rev Med Chil ; 150(8): 1036-1045, 2022 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-37358151

RESUMO

BACKGROUND: Suicidal behavior is a public health problem, and adolescents are one of the main risk groups. AIM: To analyze the association among suicidal behavior, consumption of psychoactive substances, and Health Related Quality of Life (HRQoL) in adolescents attending schools in Valparaiso, Chile. MATERIAL AND METHODS: Five hundred-fifty adolescents enrolled in a public school participated in the study. HRQoL was evaluated through KIDSCREEN-27, while suicidal behavior and the consumption of psychoactive substances were measured with the Global School-based Student Health Survey (GSHS). RESULTS: The prevalence of suicidal behavior was higher in women and in those who used tobacco or marijuana in the last month. Respondents with a bad perception of physical well-being reported a higher frequency of suicidal ideation than those with a good perception (Odds ratio (OR): 2.24; 95% confidence: 1.49-3.36). Likewise the frequency of suicidal ideation was higher in those with a bad perception of psychological well-being (OR: 3.87; 95%CI: 2.09-7.71), and a bad perception of autonomy and relation with parents (OR:2.46; 95%CI: 1.34-4.54). Suicide planning was also associated with dimensions of autonomy and relation with parents (OR: 2.32; 95% CI: 1.23-4.38) and dimensions of friends and social support (OR: 1.86; 95%CI:1.05-3.28). Suicide attempt was associated with the dimensions of friendship and social support (OR: 1.83; 95%CI: 1.02-3.28) and school environment (OR: 1,92; 95%CI: 1,23-3,01). CONCLUSIONS: Suicide ideation is associated with worse physical and psychological well-being. Suicide planning and suicide attempt is associated with a worse perception about the relation with parents or friends, social support, and school environment.


Assuntos
Comportamento do Adolescente , Ideação Suicida , Humanos , Adolescente , Feminino , Chile/epidemiologia , Qualidade de Vida , Tentativa de Suicídio/psicologia , Fatores de Risco , Prevalência , Comportamento do Adolescente/psicologia
2.
Rev Med Chil ; 150(5): 584-596, 2022 May.
Artigo em Espanhol | MEDLINE | ID: mdl-37906758

RESUMO

BACKGROUND: Adolescents are more prone to develop health risk behaviors. Among these, early consumption of psychoactive drugs is relevant. AIM: To assess the association between early consumption of illicit drugs, tobacco and alcohol, suicide behaviors, risky sexual behaviors, eating habits and physical activity in school age adolescents from Valparaiso, Chile. MATERIAL AND METHODS: The online world survey of scholar health to identify the health risk behaviors was answered by 550 adolescents aged 15 to 18 years, from a public educational institution at Valparaiso, Chile. RESULTS: Early consumption of alcohol, smoking and illicit drug use was reported by 59, 57 and 44% of respondents, respectively. The frequency of psychoactive drug consumption during the last month, risky sexual behaviors and missing breakfast was higher among those with an early onset of alcohol and illicit drug consumption and smoking. The frequency of suicidal risk behaviors and low consumption of fruits and vegetables was higher among those with an early onset of illicit drug use and smoking. A low physical activity level was associated with early smoking onset. Health risk behaviors were associated with early onset of alcohol and illicit drug consumption and smoking. CONCLUSIONS: Early onset of alcohol and illicit drug consumption and smoking is associated with health risk behaviors in Chilean adolescents.


Assuntos
Drogas Ilícitas , Transtornos Relacionados ao Uso de Substâncias , Humanos , Adolescente , Comportamentos de Risco à Saúde , Chile/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Psicotrópicos , Consumo de Bebidas Alcoólicas/epidemiologia
3.
Rev Med Chil ; 148(7): 921-929, 2020 Jul.
Artigo em Espanhol | MEDLINE | ID: mdl-33399676

RESUMO

BACKGROUND: Adolescence is considered a nutritionally vulnerable period of life, since their eating habits are influenced by factors that can promote the consumption of non-nutritious food. AIM: To analyze the relation between eating habits, obesity, and the perception of Health-Related Quality of Life in school-aged adolescents. MATERIAL AND METHODS: A cross-sectional study of 550 adolescents aged 16 ± 1 years (60% women) attending a public education institution in Valparaíso, Chile. The Global School-based Student Health Survey (GSHS) for eating habits and the KIDSCREEN-27 survey for health-related quality of life were self-administered online. The answers were anonymous. A logistic regression analysis was conducted to evaluate the relationship between the variables, which was adjusted for age and sex. RESULTS: Ten percent of men and 6% of women were obese. Those with an inadequate consumption of fruits had a worst perception of their physical well-being, autonomy and relationship with their parents. Psychological well-being and school environment were perceived worst among those that did not consume breakfast. Obese respondents also reported a poorest physical health. CONCLUSIONS: Inadequate eating habits and obesity have a negative effect of health-related quality of life among adolescents.


Assuntos
Comportamento Alimentar , Qualidade de Vida , Adolescente , Chile/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Obesidade Infantil/epidemiologia , Instituições Acadêmicas
4.
Contemp Oncol (Pozn) ; 23(4): 239-246, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31992957

RESUMO

INTRODUCTION: The useof immunotherapy in Mexico has been used since 2012 with ipilimumab and since 2015 with nivolumab and pembrolizumab, so it is a matter of necessity to know the experience of these drugs. MATERIAL AND METHODS: An observational, descriptive, cross-sectional, and retrospective study was performed in Médica Sur Hospital, where with dossiers from 2012 to June 2018 patients with metastatic cancer who received immunotherapy with ipilimumab, nivolumab, and pembrolizumab for six months were evaluated, searching as principal outcomes the adverse effects of those drugs and as secondary outcomes the response to treatment. RESULTS: Seventy subjects fulfilled the inclusion criteria for the study, and 42 (60%) were women with an average age of 60.73 ±13.64 years (16-82 years). The pathologies that received immunotherapy were the following: melanoma and lung cancer. The most frequent clinical and laboratory adverse effects were as follows: fatigue - 32 (45.71%), asthaenia - 30 (42%), nausea - 8 (11.4%), diarrhoea - 8 (11.4%), and rash - 7 (10%). The worst adverse effects were respiratory and endocrinological: pneumonitis - 10 (14.28%), hypothyroidism - 4 (5.71%), hyperglycaemia - 1 (1.4%), and hypophysitis - 2 (2.9%). With respect to treatment response: complete response - 8 (11.4%), partial response - 11 (15.71%), stable disease - 33 (47.14%), and disease progression - 19 (27.14%). CONCLUSIONS: The most common adverse effects did not condition the suspension of treatment or increase in intra-hospital stay, but there were some adverse effects that actually had an impact on evolution, hospital stay, and mortality.

5.
Rev Med Chil ; 145(12): 1525-1534, 2017 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-29652948

RESUMO

Background The use of psychoactive substances among adolescents is a major social and public health concern. Aim To analyze association of substance abuse and multiple drug use with health-related quality of life (HRQOL) in adolescents attending a high school in Valparaiso, Chile. Material and Methods Analytical cross-sectional study conducted in a sample of adolescents attending high school. HRQOL was assessed using KIDSCREEN-52 questionnaire and substance use was measured using the Global school-based student health survey. Participants had to complete online, self-administered, anonymous questionnaires. Multiple logistic regression analyses were conducted to calculate Odd ratios. Results A total of 550 adolescents aged 16 ± 1 years old completed the questionnaires. Thirty nine percent consumed alcohol during the last month, 31% smoked, 33% used marijuana and 33% admitted the use of multiple drugs. High-risk alcohol consumption was associated with a lower perception of psychological well-being, self-perception and school environment. This last dimension was affected in those who admitted marijuana use during the last month. Multiple drug use (three substances) was associated with a lower perception of physical and psychological well-being, self-perception, relationship with parents, family life and school environment. Conclusions High-risk alcohol consumption and multiple drug use (three substances) have a negative impact on the HRQOL of school age adolescents.


Assuntos
Transtornos Relacionados ao Uso de Álcool/epidemiologia , Abuso de Maconha/epidemiologia , Qualidade de Vida/psicologia , Tabagismo/epidemiologia , Adolescente , Comportamento do Adolescente/psicologia , Distribuição por Idade , Fatores Etários , Transtornos Relacionados ao Uso de Álcool/psicologia , Chile/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Modelos Logísticos , Masculino , Abuso de Maconha/psicologia , Medição de Risco , Fatores de Risco , Autorrelato , Distribuição por Sexo , Fatores Sexuais , Tabagismo/psicologia
6.
Nucleic Acids Res ; 42(12): 7807-18, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24838560

RESUMO

The DNA unwinding element (DUE) is a sequence rich in adenine and thymine residues present within the origin region of both prokaryotic and eukaryotic replicons. Recently, it has been shown that this is the site where bacterial DnaA proteins, the chromosomal replication initiators, form a specific nucleoprotein filament. DnaA proteins contain a DNA binding domain (DBD) and belong to the family of origin binding proteins (OBPs). To date there has been no data on whether OBPs structurally different from DnaA can form nucleoprotein complexes within the DUE. In this work we demonstrate that plasmid Rep proteins, composed of two Winged Helix domains, distinct from the DBD, specifically bind to one of the strands of ssDNA within the DUE. We observed nucleoprotein complexes formed by these Rep proteins, involving both dsDNA containing the Rep-binding sites (iterons) and the strand-specific ssDNA of the DUE. Formation of these complexes required the presence of all repeated sequence elements located within the DUE. Any changes in these repeated sequences resulted in the disturbance in Rep-ssDNA DUE complex formation and the lack of origin replication activity in vivo or in vitro.


Assuntos
Proteínas de Bactérias/metabolismo , DNA Bacteriano/metabolismo , DNA de Cadeia Simples/metabolismo , Proteínas de Ligação a DNA/metabolismo , Plasmídeos/genética , Origem de Replicação , Sequência Rica em At , Sequência de Bases , Sítios de Ligação , DNA Bacteriano/química , DNA de Cadeia Simples/química
7.
Methods ; 60(2): 113-21, 2013 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-23454289

RESUMO

The atomic force microscope overestimates lateral dimensions and underestimates heights of nanometer size objects such as proteins and nucleic acids. This has made researchers cautious of AFM measurements, even though there is no other technique capable of measuring topography with sub-nanometer precision. Nevertheless, several approaches for determining the stoichiometry of protein and protein-DNA complexes have been developed which show that, although the absolute values may be incorrect, the AFM volume is essentially proportional to the mass. This has allowed the determination of the mass of protein complexes with the help of a calibration curve. Here we review the main techniques for AFM volume measurements and detail a methodology that significantly reduces the associated errors. This method uses a fragment of DNA as a fiducial marker by which the volume of a protein is normalized. The use of fiducial markers co-adsorbed together with the protein of interest minimizes the contribution of tip-induced artifacts as they affect both the object of interest and the marker. Finally, we apply this method to the measurement of the length of single-stranded DNA. A linear relationship between length and volume was obtained, opening the door to studies of ssDNA intermediates formed during complex DNA transactions such as replication, recombination and repair.


Assuntos
DNA de Cadeia Simples/ultraestrutura , Microscopia de Força Atômica/normas , Proteínas/ultraestrutura , Algoritmos , Reparo do DNA , Replicação do DNA , DNA de Cadeia Simples/química , Interpretação Estatística de Dados , Marcadores Fiduciais , Conformação de Ácido Nucleico , Tamanho da Partícula , Conformação Proteica , Proteínas/química
8.
J Evid Based Soc Work (2019) ; 21(1): 75-89, 2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-37766623

RESUMO

PURPOSE: This study used secondary data from a randomized controlled trial of a Brief Motivational Intervention (BMI) to examine whether Non-White participants had different treatment results compared to White participants. METHODS: The outcome variables of this study were divided into primary outcomes (heavy drinking and consequences associated with alcohol use) and secondary outcomes (cognitive variables such as motivation to change alcohol use, and behavioral variables, including protective behavioral strategies). Linear regression analyses were conducted with the PROCESS macro for SPSS, to test if race or ethnicity moderated the relationship between BMI and each treatment outcome. Data was collected at two time points, six weeks and three months after treatment. RESULTS: This study showed that race or ethnicity did not moderate treatment results for the four outcome variables. Additional within-group effect sizes were calculated for all racial and ethnic categories, showing that Hispanic/Latine and Black participants had larger effect sizes in all the outcome variables. DISCUSSION: The discussion examines the potential strength of Motivational Interviewing due to its client-centered spirit, which naturally allows for incorporating values and identity-based factors, such as culture, into the session. CONCLUSION: The results suggest similar BMI outcomes among White and Non-White emerging adults who engage in heavy drinking, potentially due to its client-centered approach. This is a preliminary study, and the results are therefore tentative.


Assuntos
Alcoolismo , Minorias Étnicas e Raciais , Motivação , Humanos , Etnicidade , Grupos Minoritários , População Branca , Alcoolismo/prevenção & controle , Grupos Raciais , Adulto Jovem
9.
J Am Chem Soc ; 135(1): 122-31, 2013 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-23214411

RESUMO

Double-stranded (ds) RNA is the genetic material of a variety of viruses and has been recently recognized as a relevant molecule in cells for its regulatory role. Despite that the elastic response of dsDNA has been thoroughly characterized in recent years in single-molecule stretching experiments, an equivalent study with dsRNA is still lacking. Here, we have engineered long dsRNA molecules for their individual characterization contrasting information with dsDNA molecules of the same sequence. It is known that dsRNA is an A-form molecule unlike dsDNA, which exhibits B-form in physiological conditions. These structural types are distinguished at the single-molecule level with atomic force microscopy (AFM) and are the basis to understand their different elastic response. Force-extension curves of dsRNA with optical and magnetic tweezers manifest two main regimes of elasticity, an entropic regime whose end is marked by the A-form contour-length and an intrinsic regime that ends in a low-cooperative overstretching transition in which the molecule extends to 1.7 times its A-form contour-length. DsRNA does not switch between the A and B conformations in the presence of force. Finally, dsRNA presents both a lower stretch modulus and overstretching transition force than dsDNA, whereas the electrostatic and intrinsic contributions to the persistence length are larger.


Assuntos
DNA/química , RNA/química , Microscopia de Força Atômica
10.
Glob Public Health ; 18(1): 2236705, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-37519155

RESUMO

Structural competency is used to train health professionals on how social, political, and economic dynamics create conditions that negatively impact a population's health. In the Global South, this approach has historical roots in social movements, popular education, social medicine, and human rights. In 1982, during a time of extreme poverty, inequality, and violence under the Chilean military dictatorship, Educación Popular en Salud (EPES), developed a programme for training community health promoters to address common illnesses and analyse the underlying causes of poor health. In 2010, EPES began using the same model to train international and Chilean health professionals. The approach advanced four competencies. Evaluations show that training contributes to transforming health professionals' mindsets and leads them to question their practices. However, educating practitioners does not change the underlying structures that generate poor health. This article examines the intersection between EPES' competencies and the structural competency framework, highlighting two major contributions of EPES to structural competency: a methodology that narrows the gap between a theoretical analysis of social determinants of health and implementing action plans; and organic long-term links with social movements that strengthen collective action in poor neighbourhoods to advance social justice.


Assuntos
Pobreza , Humanos , Chile , Escolaridade
11.
Artigo em Inglês | MEDLINE | ID: mdl-36674160

RESUMO

In recent years, smart city projects and initiatives have surged around the globe. Yet, a wide range of factors determine the success or failure of such initiatives and there is still a long road ahead in terms of effective governance and innovation management. In such a context, this study explores the specific case of PCT Cartuja (science and technology park in Seville, Spain)-analyzing several smart-mobility and smart-climate solutions from a Triple Helix Model standpoint. The authors tap into multiple information sources to describe the case and key implications of smart initiatives for both theory and management are discussed. This paper shows the current progress as well as the remaining challenges to illustrate how public-private partnerships and conflict can be effectively managed.


Assuntos
Clima , Tecnologia , Espanha , Cidades
12.
J Evid Based Soc Work (2019) ; 20(4): 508-519, 2023 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-37330687

RESUMO

PURPOSE: Epidemiological studies show that depressive and substance use disorders are salient risk factors for suicidal behavior. In residential centers in Mexico City, 75.72% of the patients are diagnosed with comorbidity of substance use and psychiatric disorders; however, the specific prevalence of depression and suicidal behavior in this population has not been reported. This study aims to inform the comorbidity of depression and suicidal behavior in crystal users in residential centers in the state of Aguascalientes, Mexico. METHOD: A brief survey was applied to measure substance use patterns, suicidal behavior, and depression symptoms using the Depression Scale of the Center of Epidemiological Studies (CES-D-R). The sample included 343 participants. RESULTS: The results show that of the 23.3% of participants who reported depressive symptoms, 65% showed suicidal ideation, 46% suicide planning, and 43% suicidal attempt. DISCUSSIONS: These results show the importance of implementing components that address depression and suicidal behavior in interventions for substance use. CONCLUSIONS: Currently, no specialized interventions are developed to treat substance use disorders with crystal methamphetamine and, at the same time, treat others mental problems like depression and suicidal behavior. We conclude that the development of this intervention is necessary and urgent.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Ideação Suicida , Humanos , Depressão/epidemiologia , Depressão/terapia , México/epidemiologia , Tratamento Domiciliar , Comorbidade , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapia
13.
Addict Behav ; 145: 107759, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37276788

RESUMO

The age cohort referred to as emerging adults (ages 18-29 years old) demonstrates the most hazardous alcohol use in the United States (U.S.) Approximately one-third of emerging adults regularly engage in heavy episodic drinking (4/5 drinks in two hours females/males). Compared to their non-Latine White peers, Latine emerging adults in the U.S. report lower rates of heavy episodic drinking (HED) yet are at greater risk of developing a substance use disorder and experience more severe negative consequences from drinking alcohol. Despite their high-risk status, Latine emerging adults are less likely to seek treatment and have less access to innovative health-promoting resources, further exacerbating health inequities. Research has shown that practicing mindfulness can interrupt habituated cognitions, intrusive thinking, and automatic behaviors associated with hazardous drinking. However, Latine representation in MBI trials is minimal. This mini-review explores the potential value of mindfulness as an early intervention for hazardous alcohol use among Latine emerging adults. The review provides future directions for research, highlighting the need to design culturally and developmentally tailored MBIs that can provide a respectful, non-judgmental, and discrimination-free environment that appeals to Latine emerging adults. Additionally, conclusions are drawn regarding the possible benefits of pairing MBI with contingency management strategies to decrease attrition rates in MBI trials.


Assuntos
Atenção Plena , Masculino , Feminino , Adulto , Humanos , Estados Unidos , Adolescente , Adulto Jovem , Consumo de Bebidas Alcoólicas/terapia , Etanol , Inquéritos e Questionários , Grupo Associado
14.
Cannabis ; 6(3): 127-138, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38035169

RESUMO

Guided Self-Change (GSC) is a Motivational Interviewing (MI)-based early intervention program, infused with Cognitive Behavioral Therapy (CBT), for individuals with substance use problems. In this study, we implemented a 4-session GSC program with the innovative addition of mindfulness-based techniques at a minority-serving institution to reduce substance use and negative consequences among self-referred university students. We investigated processes that may be associated with behavior change, including perceived risk of use and self-efficacy ratings among university students who reported their primary substance of choice was cannabis (n = 18) or alcohol (n = 18). The sample of 36 participants (Mage = 24.4, SDage = 5, range 18-37) mostly identified as female (58.3%), then male (41.7%); 52.8% identified as Hispanic/Latine, 22.2% as Black or African American, and 19.5% as a sexual minority. Among cannabis primary using students, results indicated that the perceived risk of weekly cannabis use, confidence to change, and readiness to change showed statistically significant increases from pre- to post-assessment. Among alcohol primary using students, confidence to change and readiness to change showed statistically significant increases from pre- to post-assessments. All results yielded large effect sizes, which may be inflated due to the small sample size. Findings suggest that over the course of participation in a brief, 4-session targeted GSC program, there were significant increases in perceived risk and self-efficacy among minority university students who engage in primary cannabis or primary alcohol use.

15.
Health Equity ; 7(1): 166-177, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36942313

RESUMO

Racial and ethnic health disparities are more conspicuous in the United States since the start of the coronavirus disease 2019 (COVID-19) pandemic. While the urgency of these disparities was already alarming, the pandemic has exacerbated longstanding issues in health equity, disproportionate impacts, and social determinants of health. Vaccine hesitancy was a crucial factor during the U.S. COVID-19 vaccination campaign. We conducted a qualitative exploration of vaccine hesitancy through thematic analysis of four focus groups with Hispanic/Latine and African American/Black adults and senior citizens (N=23). The focus groups were conducted between February and April of 2021, in both English and Spanish. All participants (mean age=66.2, female 78.3%) were recruited by community-based organizations in the South Florida area. We explored six categories: (1) barriers to prevention and preventive behaviors, (2) barriers to vaccination against COVID-19, (3) facilitators of prevention and preventative behaviors, (4) facilitators of vaccination against COVID-19, (5) trusted sources of information, and (6) suggested macrolevel measures. These categories are discussed vis-à-vis COVID-19 disparities among racial and ethnic minorities. Implications for public health policy and future vaccination campaigns are outlined and discussed.

16.
Artigo em Inglês | MEDLINE | ID: mdl-36293803

RESUMO

This study explored barriers, motivators, and trusted sources of information regarding COVID-19 vaccination among Hispanic/Latine individuals. Hispanic/Latine is a broad social construct that encompasses people from heterogeneous countries and cultures. In the U.S., foreign-born Hispanics/Latines tend to have better health outcomes than U.S.-born individuals. Thus, the study examined whether nativity is a significant factor in COVID-19 vaccine hesitancy. Binary logistic regression and linear regression analyses were employed and revealed that, regardless of nativity, Hispanic/Latine participants face similar barriers and find similar sources of information trustworthy. Controlling for age and race, vaccination rates or perceived likelihood of getting vaccinated did not differ between the two groups. The two groups significantly differed in specific motivators for vaccination: foreign-born Hispanic/Latine individuals were more motivated to get the vaccine to keep themselves, their families, and their community safe, and more often believed vaccination is needed for life to return to normal. Study results provide important insights into similarities and differences in barriers, motivators, and trusted sources of information regarding COVID-19 vaccination among native and foreign-born Hispanic/Latine individuals.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Adulto , Feminino , Humanos , Florida , COVID-19/prevenção & controle , Hispânico ou Latino , Vacinação
17.
Vaccines (Basel) ; 10(4)2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35455294

RESUMO

By the spring of 2021, most of the adult U.S. population became eligible to receive a COVID-19 vaccine. Yet, by the summer of 2021, the vaccination rate stagnated. Given the immense impact COVID-19 has had on society and individuals, and the surge of new variant strains of the virus, it remains urgent to better understand barriers to vaccination, including the impact of variations in trusted sources of COVID-19 information. The goal of the present study was to conduct a cross-sectional, community-engaged, and person-centered study of trusted sources of COVID-19 information using latent profile analysis (LPA). The aims were to (1) identify the number and nature of profiles of trusted sources of COVID-19 information, and (2) determine whether the trust profiles were predictive of COVID-19 vaccination attitudes and various demographic categories. Participants included mostly racial and ethnic minority individuals (82.4%) recruited by various community-based agencies in South Florida. The LPA evidenced an optimal 3-class solution characterized by low (n = 80)-, medium (n = 147)-, and high (n = 52)-trust profiles, with high trust statistically significantly predictive of vaccination willingness. The profiles identified could be important targets for public health dissemination efforts to reduce vaccine hesitancy and increase COVID-19 vaccination uptake. The general level of trust in COVID-19 information sources was found to be an important factor in predicting COVID-19 vaccination willingness.

18.
Case Rep Oncol ; 14(1): 112-122, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33776692

RESUMO

Calcitonin-negative neuroendocrine tumor (CNNET) of the thyroid is an extremely rare entity. In some of the previously reported cases within the literature, the terms "atypical medullary thyroid carcinoma," "calcitonin-free oat cell carcinoma," and "a distinct clinical entity" were applied to NETs without definitive evidence of calcitonin production. In the English-language literature, not only are there only few reported cases of CNNET, but the criteria for diagnosis in these cases are also controversial. Most of the current published cases were also treated surgically for local disease. We describe a case of NET of the thyroid with calcitonin, chromogranin A and thyroglobulin negativity, synaptophysin and TTF-1 positivity, and a high Ki-67 proliferation index with metastases in the cervical region as well as mediastinal adenopathies. This case was considered an unresectable thyroid carcinoma, and chemotherapy including cisplatin and etoposide was started as neoadjuvant treatment at the department of medical oncology. Total thyroidectomy plus bilateral and central cervical dissection was performed, and the patient underwent 2 cycles of adjuvant radiotherapy. Currently, the patient's 18F-FDG-PET/CT findings show a complete response 17 months after diagnosis. In conclusion, CNNET of the thyroid is very rare and there is limited evidence regarding treatment in patients with metastases. Chemotherapy including cisplatin and etoposide as well as early aggressive surgical resection appears to positively impact patients' survival.

19.
Rev Esp Geriatr Gerontol ; 54(5): 251-256, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31324404

RESUMO

INTRODUCTION: Progressive supranuclear palsy (PSP) is a syndrome characterized by progressive parkinsonism with early falls due to postural instability, typically vertical gaze supranuclear ophthalmoplegia, pseudobulbar dysfunction, neck dystonia and upper trunk rigidity as well as mild cognitive dysfunction. Progressive supranuclear palsy must be differentiated from Parkinson's disease taking into account several so-called red flags. MATERIALS AND METHODS: We report a case series hallmarked by gait abnormalities, falls and bradykinesia in which Parkinson's disease was the initial diagnosis. RESULTS: Due to a torpid clinical course, magnetic resonance imaging (MRI) was performed demonstrating midbrain atrophy, highly suggestive of progressive supranuclear palsy. CONCLUSION: The neuroradiological exams (magnetic resonance imaging, single photon emission computer tomography, and positron emission tomography) can be useful for diagnosis of PSP. Treatment with levodopa should be considered, especially in patients with a more parkinsonian phenotype.


Assuntos
Doença de Parkinson/diagnóstico , Paralisia Supranuclear Progressiva/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Masculino
20.
Rev. chil. infectol ; 40(3): 270-288, jun. 2023. ilus, tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1515134

RESUMO

INTRODUCCIÓN: El tratamiento de la tuberculosis (TB) ocular es un tema que genera controversia en el mundo. Para el correcto manejo de estos pacientes, es necesario el desarrollo de guías que consideren la epidemiología de la TB ocular en cada nación. El objetivo de este consenso fue discutir de forma interdisciplinaria la epidemiología, fisiopatología, clínica, diagnóstico, estudio y tratamiento de los pacientes con TB ocular, para establecer un algoritmo de tratamiento y proponer qué pacientes deben ser tratados en Chile y con qué tratamiento. Además, se establecieron acuerdos para efectuar quimioprofilaxis de los pacientes con TB latente que tienen indicación de tratamiento inmunosupresor por enfermedades inflamatorias oculares.


The treatment of ocular tuberculosis (TB) remains controversial worldwide. The development of guidelines for ocular TB can facilitate the approach and management of these patients. These guidelines should be developed regionally, considering the local TB epidemiology. The objectives of this consensus are: to initiate an interdisciplinary discussion about the epidemiology, pathophysiology, clinical presentation, diagnosis, workup and treatment of patients with ocular TB, to establish a treatment algorithm and define which patients should be treated in Chile and how and, to analyze and discuss the published data regarding chemoprophylaxis for patients with latent TB who need to start immunosuppressive treatment due to inflammatory ocular conditions.


Assuntos
Humanos , Tuberculose Ocular/diagnóstico , Tuberculose Ocular/terapia , Tuberculose Ocular/epidemiologia , Fenótipo , Uveíte/diagnóstico , Chile/epidemiologia , Esclerite/diagnóstico , Tuberculose Ocular/fisiopatologia , Fatores de Risco , Quimioprevenção , Vasculite Retiniana/diagnóstico , Consenso , Diagnóstico Diferencial
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