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Few sclerophyllous plants from the central coast of Chile have been systematically studied. This work describes the phytochemical composition and antimicrobial properties of Baccharis concava Pers. (sin. B. macraei), a shrub found in the first line and near the Pacific coast. B. concava has been traditionally used by indigenous inhabitants of today's central Chile for its medicinal properties. Few reports exist regarding the phytochemistry characterization and biological activities of B. concava. A hydroalcoholic extract of B. concava was prepared from leaves and small branches. Qualitative phytochemical characterization indicated the presence of alkaloids, steroids, terpenoids, flavonoids, phenolic, and tannin compounds. The antimicrobial activity of this extract was assessed in a panel of microorganisms including Gram-positive bacteria, Gram-negative bacteria, and pathogenic yeasts. The extract displayed an important antimicrobial effect against Gram-positive bacteria, Candida albicans, and Cryptococcus neoformans but not against Gram-negatives, for which an intact Lipopolysaccharide is apparently the determinant of resistance to B. concava extracts. The hydroalcoholic extract was then fractionated through a Sephadex LH-20/methanol-ethyl acetate column. Afterward, the fractions were pooled according to a similar pattern visualized by TLC/UV analysis. Fractions obtained by this criterion were assessed for their antimicrobial activity against Staphylococcus aureus. The fraction presenting the most antimicrobial activity was HPLC-ESI-MS/MS, obtaining molecules related to caffeoylquinic acid, dicaffeoylquinic acid, and quercetin, among others. In conclusion, the extracts of B. concava showed strong antimicrobial activity, probably due to the presence of metabolites derived from phenolic acids, such as caffeoylquinic acid, and flavonoids, such as quercetin, which in turn could be responsible for helping with wound healing. In addition, the development of antimicrobial therapies based on the molecules found in B. concava could help to combat infection caused by pathogenic yeasts and Gram-positive bacteria, without affecting the Gram-negative microbiota.
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Baccharis , Quercetina , Ácido Quínico/análogos & derivados , Chile , Espectrometria de Massas em Tandem , Compostos Fitoquímicos/farmacologia , Flavonoides/farmacologia , Extratos Vegetais/farmacologiaRESUMO
Breast cancer is the most common cancer in women in the United States (U.S.) and the leading cause of cancer related death among U.S. Hispanics/Latinas (H/Ls). H/Ls have lower rates of screening and longer time to follow up after an abnormal mammogram. We developed a comprehensive community health educator (promotores)-led education and risk identification program for Spanish-speaking H/Ls in California to increase mammography screening, genetic testing, and the understanding of the impact of family history on cancer risk. Due to COVID-19, we adapted the program to a virtual platform. The experience of transforming the program to a virtual platform provided unique opportunities for collaboration between researchers, community partners, and participants. Promotores are major partners in community based participatory research and in the provision of health care services, but their voices are often excluded from scientific reports. This commentary is an effort to provide a platform for promotores to share their experiences and for the readers to understand their approach in bridging the gap between health care services and communities.
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Neoplasias da Mama , Humanos , Feminino , Estados Unidos , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/genética , Mamografia , Saúde Pública , Hispânico ou LatinoRESUMO
[This corrects the article DOI: 10.3389/fonc.2022.940162.].
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Background: Cancer is the leading cause of death among Latinos, the largest minority population in the United States (US). To address cancer challenges experienced by Latinos, we conducted a catchment area population assessment (CAPA) using validated questions from the National Cancer Institute (NCI) population health assessment supplement at our NCI-designated cancer center in California. Methods: A mixed-methods CAPA was administered by bilingual-bicultural staff, with a focus on understanding the differences between foreign-born and US-born Latinos. Results: 255 Latinos responded to the survey conducted between August 2019 and May 2020. Most respondents were foreign-born (63.9%), female (78.2%), and monolingual Spanish speakers (63.2%). Results showed that compared to US-born Latinos, foreign-born individuals were older, had lower educational attainment, were most likely to be monolingual Spanish speakers, were low-income, and were more likely to be uninsured. Foreign-born Latinos had lower levels of alcohol consumption and higher consumption of fruits and vegetables. The rate of preventive cancer screenings for breast, cervical and colorectal cancer did not differ by birthplace, although a low fraction (35.3%) of foreign-born Latinas who were up-to-date compared to US-born Latinas (83.3%) with colorectal cancer screening was observed. Time since the last routine check-up for all preventable cancers (cervical p=0.0002, breast p=0.0039, and colorectal p=0.0196) is significantly associated with being up to date with cancer screening. Individuals who had a check-up of two or more years ago are 84% less likely to be up to date with pap smears than those who had a check-up within the year (p=0.0060). Individuals without health insurance are 94% less likely to be up to date with mammograms and colonoscopy/FIT tests (p=0.0016 and p=0.0133, respectively) than those who are insured. There is no significant association between screening and nativity. Conclusions: Considerable differences in socio-economic and environmental determinants of health and colorectal cancer screening rates were observed between US-born and foreign-born Latinos. The present study represents the foundation for future targeted intervention among immigrant populations at our cancer center's catchment area.
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Background: Breast cancer is the most common cancer among women in the U.S. and the leading cause of cancer death among Hispanics/Latinas (H/L). H/L are less likely than Non-H/L White (NHW) women to be diagnosed in the early stages of this disease. Approximately 5-10% of breast cancer can be attributed to inherited genetic mutations in high penetrance genes such as BRCA1/2. Women with pathogenic variants in these genes have a 40-80% lifetime risk of breast cancer. Past studies have shown that genetic counseling can help women and their families make informed decisions about genetic testing and early cancer detection or risk-reduction strategies. However, H/L are 3.9-4.8 times less likely to undergo genetic testing than NHW women. We developed a program to outreach and educate the H/L community about hereditary breast cancer, targeting monolingual Spanish-speaking individuals in California. Through this program, we have assessed cancer screening behavior and identified women who might benefit from genetic counseling in a population that is usually excluded from cancer research and care. Materials and Methods: The "Tu Historia Cuenta" program is a promotores-based virtual outreach and education program including the cities of San Francisco, Sacramento, and Los Angeles. Participants responded to three surveys: a demographic survey, a breast cancer family history survey, and a feedback survey. Survey responses were described for participants and compared by area where the program took place using chi-square, Fisher exact tests, and t tests. Multinomial logistic regression models were used for multivariate analyses. Results and Conclusion: We enrolled 1042 women, 892 completed the cancer family history survey and 62 (7%) provided responses compatible with referral to genetic counseling. We identified 272 women (42.8% ages 40 to 74 years) who were due for mammograms, 250 women (24.7% ages 25 to 65 years) due for Papanicolaou test, and 189 women (71.6% ages 50+) due for colorectal cancer screening. These results highlight the need of additional support for programs that spread awareness about cancer risk and facilitate access to resources, specifically within the H/L community.
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COVID-19 pandemic is one of the most devastating worldwide crises in recent years. During this pandemic, people have been exposed to products that have not been proven to be safe and effective against COVID-19. We present an adult chronic consumer of chlorine dioxide, in which a fatal outcome is described. This case demonstrates that for people searching products to protect themselves from COVID-19, unregulated access to industrial disinfectants represents a dangerous alternative. To date, there is no scientific evidence to uphold the use of chlorine dioxide or chlorine derivatives as preventive or therapeutic agents against COVID-19. Researchers and general population must take into consideration the fatal possible consequences of not following communications and warnings from health authorities and government institutions.
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Compostos Clorados/intoxicação , Desinfetantes/intoxicação , Perfuração Intestinal , Óxidos/intoxicação , Adulto , COVID-19/prevenção & controle , Evolução Fatal , Humanos , Perfuração Intestinal/induzido quimicamente , PandemiasRESUMO
INTRODUCTION: Gastrointestinal stromal tumors (GISTs) represent <1% of all gastrointestinal (GI) tumors. Extra-gastrointestinal stromal tumors (EGISTs) are mesenchymal tissue neoplasm arising outside the GI tract. This rare group comprises only 5% of all GISTs. This case demonstrates a rare entity in a patient with non-specific symptoms, a large tumor size and unremarkable past personal and family history. PRESENTATION OF CASE: We present a 45-year old man with non-specific symptoms who was diagnosed with a primary EGIST arising in the small bowel mesentery after surgery. The tumor was not compromising the GI tract and it was completely resected. The tumor was sent for pathological examination that confirmed the diagnosis. Histological examination revealed a 15 cm in diameter mass, comprised of spindle cells and high mitotic activity. Treatment with imatinib mesylate was initiated. DISCUSSION: There have been only a few previous reports of EGISTs arising from the small bowel mesentery. It is believed that EGISTs originate from cells with similar pathological characteristics and biological behaviour as the intestinal cells of Cajal. Such tumors are associated with poorer prognosis, lager tumor size and younger presentation than their GI counterparts. The preferred treatment is complete surgical resection. The addition of specific tyrosine kinase inhibitors such as imatinib mesylate is recommended for high risk patients. Even though morphological and immunohistochemical similarities between GISTs and EGISTs are described, their pathogenesis, incidence, genetic background, complications and prognosis are not completely known because they are extremely rare. CONCLUSION: EGISTs are very rare tumors which originate from cells outside the GI tract and are associated with a more aggressive biological behavior than their GI counterparts. These tumors may grow without any clinical implications and should be kept in mind in the differential diagnosis for patients presenting with an abdominal mass. Further studies are needed due to lack of large patient cohort studies and long-term follow-up regarding the prognosis and management of this rare pathology.
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Resumen Introducción: El ruido es un sonido desagradable que afecta la salud y que es factor de riesgo para hipertensión y cardiopatía isquémica. La aviación genera ruido y contaminación del aire que daña la audición y es un problema a nivel mundial y para la población en general y para quienes trabajan en los aeropuertos, por lo que debe ser analizado. Sobre el tema se han publicado trabajos diversos, más sin embargo son pocos los estudios hechos en zonas aledañas a bases aéreas y brindándose poca atención preventiva a la población que labora dentro de ellas. Objetivo: Determinar la existencia de niveles de ruido ambiental dañino en instalaciones de trabajo no operativas de bases aéreas militares. Material y métodos: Se midió el ruido ambiental en turnos laborales por 7 días, en las bases aéreas de Santa Lucía, y Zapopan, con sonómetro ambiental Extech® Mod. 407732, clase 2, normas ANSI y IEC 651 Type 2 y calibrador 407744 de 94 ó 114 dB., en áreas expuestas al ruido cercanas a la pista de aterrizaje en horas de máxima actividad aérea. Resultados: Se encontró ruido dañino no satisfactorio y peligroso entre los 68 dB y 82.06 dB de nivel equivalente sonoro de ruido (LEQ), fuera de norma para ruido ambiental. Conclusiones: Los niveles de ruido encontrado se salen de los parámetros aceptables de exposición al ruido ambiental en la comunidad, por tanto resulta nocivo y se debe contar con medios de protección y programas preventivos para evitar la pérdida de la audición.
Abstract Introduction: Noise is an unpleasant sound that affects health and is a risk factor for hypertension and ischemic heart disease. Aviation generates noise and air pollution that damages hearing and is a problem worldwide and for the general population and for those who work in airports, so it must be analyzed. Various works have been published on the subject, however, there are few studies carried out in areas surrounding air bases and little preventive care is provided to the population that works within them. Objective: Determine the existence of harmful environmental noise levels in non-operational work installations of military air bases. Material and Methods: Ambient noise was measured in work shifts for 7 days, at the air bases of Santa Lucía and Zapopan, with Extech® Mod. 407732, class 2 environmental sound level meter, ANSI and IEC 651 Type 2 standards and 407766 gauge of 94 or 114 dB, in áreas exposed to noise near the runway at peak hours air activit Results: No satisfactory and dangerous harmful noise was found between 68 dB and 82.06 dB of noise equivalent noise level (LEQ), out of the norm for ambient noise. Conclusions: The noise found does not meet what is established for the levels of exposure of environmental noise in the community, it must have means of protection and preventive programs to prevent hearing loss.
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Resumen Objetivo: Revisar en la literatura las diferentes posturas de las agencias reguladoras de la aviación sobre la implantación de lentes intraoculares multifocales (MIOLs) en pilotos aviadores civiles que han desarrollado catarata, además de evidencia científica que podría generar una revisión de los lineamientos vigentes. Resultados: Se encontraron el 50% (3 de 6) de agencias revisadas con postura en contra de los MIOLs. Además, se revisaron dos estudios a favor de los MIOLs, en el que implantarlos brinda una mayor independencia de lentes respecto a los monofocales para las tareas visuales dentro y fuera de la cabina, así como un rendimiento sin diferencias en simuladores de vuelo versus los pilotos con lentes intraoculares monofocales. Limitaciones: Existen pocos estudios de MIOLs en pilotos aviadores. Originalidad: No se ha reportado ninguna revisión de las agencias reguladoras respecto a la prohibición o permisión de los MIOLs en pilotos aviadores, tocando evidencia que pudiera consolidar una postura unánime respecto a este tema, como en su momento fue la cirugía refractiva con láser excimer que actualmente no está restringida.
Abstract Objective: To review the literature on the different stands of aviation regulatory agencies on the implantation of multifocal intraocular lenses (MIOLs) in civilian aviators who have developed cataract, as well as scientific evidence that could generate a revision of the current guidelines. Results: 50% (3 of 6) of agencies reviewed were found to be against MIOLs. In addition, two studies were reviewed in favour of MIOLs, in which implanting MIOLs provides greater lens independence from monofocals for visual tasks in and out of the cockpit, as well as no difference in performance in flight simulators versus pilots with monofocal intraocular lenses. Limitations: There are few studies of MIOLs in aviator pilots. Originality: No review of regulatory agencies regarding the prohibition or permission of MIOLs in airline pilots has been reported, touching on evidence that could consolidate a unanimous position on this issue, as was once the case with excimer laser refractive surgery, which is currently unrestricted.
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El objetivo de esta investigación es proponer una nueva metodología en la gestión logística de los aprovisionamientos para las industrias biotecnológicas cubanas que funcionan esencialmente con un ciclo completo de desempeño empresarial, desde la investigación básica de nuevos biofármacos, hasta llegar a la fabricación y comercialización de sus productos, donde la amplia y compleja gama de surtidos a suministrar en un contexto adverso para el país, conlleva a utilizar diferentes métodos de gestión de los aprovisionamientos en correspondencia con su destino y frecuencia de uso. De esta manera, se propone dividir las materias primas y materiales a proveer en: 1) insumos de proyectos, que emplean de forma esporádica pequeñas, pero múltiples variedades de mercancías 2) insumos de procesos, que se caracterizan por consumir altos volúmenes de productos, pero poco diversos, como sucede en las actividades de producción. Finalmente, se evalúa la implementación de este procedimiento en una de las entidades biotecnológicas de mayor prestigio en Cuba, el Centro de Inmunología Molecular, demostrando las ventajas y alcance de esta propuesta que permitió elevar la efectividad en la gestión de los aprovisionamientos, y de esta manera la eficiencia empresarial(AU)
The objective of this work is to propose a new methodology for the logistics management of supplies in Cuban biotechnological industries. They work essentially on a full cycle of enterprise performance, from basic research to the manufacture and marketing of new biopharmaceuticals products. The wide and complex range of supply requirements, in an adverse country-wide context, leads to the use of different methods for managing supplies, in accordance with their destination and frequency of use. We propose to divide the supplies and materials into two categories: 1) supplies for projects, for those that are highly varied, used sporadically and in small quantities, 2) process supplies, for those that are regularly used in large volumes -such as manufacture process-, and a relatively small variety of supply types. The implementation of this methodology is assessed in one of the most prestigious biotechnological entities in Cuba, the Molecular Immunology Center. The effectiveness in the management of supplies was increased, and therefore, business efficiency(AU)
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Tecnologia Farmacêutica/métodos , Insumos Farmacêuticos , Organização e Administração , CubaRESUMO
El surgimiento del sector biotecnológico inició una revolución en las bases tradicionales de competencia en la industria farmacéutica en términos de desarrollo y fabricación de productos, orientados principalmente a salud humana. La gestión de inventarios en esta industria es muy compleja, con grandes volúmenes y variedad de inventario, dado por la complejidad de mantener dos procesos que tienen efecto en la gestión de inventarios, relacionados con la investigación y desarrollo, y producción. La complejidad de estos procesos exige de un sistema logístico con capacidad y flexibilidad suficiente para adaptarse a las distintas regulaciones existentes y la variación en los planes de ventas, además de un sistema informático que permita integrar las partes del sistema. El presente artículo tiene el propósito de evaluar la situación de la Gestión de Inventarios en el Centro de Inmunología Molecular a partir de la implementación de los conceptos de Insumo Proyecto e Insumo Proceso. Para el desarrollo de la investigación se emplearon diferentes métodos y herramientas como: análisis bibliográfico, entrevistas a expertos, consultas de registros, tormenta de ideas, entre otros. Entre las herramientas utilizadas se encuentran: Modelo de Referencia para la Evaluación de la Gestión de Inventarios, Microsoft Excel y Diagrama Causa-Efecto. Los resultados demuestran el impacto positivo alcanzado por la diferenciación entre los insumos utilizados en procesos productivos e investigación, por el alcance dado en distintos procesos de la Gestión de Inventarios en el orden organizativo y financiero, logrando la mejora de indicadores como rotación de inventarios, ciclo de importación y satisfacción del cliente(AU)
The emergence of the biotechnological sector started a revolution in the traditional competitive basis of the pharmaceutical industries, in terms of development and manufacture of products, especially those aimed at human health. Inventory management in this industry is very complex, with varied, high-volume inventories, given the complexity of executing two processes that have an effect on inventory management: production, and R&D. The complexity of these processes demands a logistical system with the capacity and flexibility to adapt to the many different regulations in existence and changes in sales plans, and an informatics solution that allows integration of the different parts of the system. The current article aims to evaluate the situation of Inventory Management at the Molecular Immunology Center from the implementation of the concepts of Project Input and Process Input. The research was carried out through diverse methods and tools including bibliographic analysis, expert interviews, record querying, and brainstorming. The tools used included: Reference Model for Inventory Management Evaluation, Microsoft Excel, and cause-effect diagrams. The results show a positive impact achieved by differentiating inputs used for production and inputs used for R&D, and its reach into the process of Inventory Management at the organization level, improving indicators like inventory rotation, importing cycle, and client satisfaction(AU)
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Humanos , Tecnologia Farmacêutica/métodos , Biotecnologia , Insumos Farmacêuticos , Avaliação de Programas e Projetos de Saúde/normas , Técnicas de PlanejamentoRESUMO
El objetivo de esta investigación es proponer una nueva metodología en la gestión logística de los aprovisionamientos para las industrias biotecnológicas cubanas que funcionan esencialmente con un ciclo completo de desempeño empresarial, desde la investigación básica de nuevos biofármacos, hasta llegar a la fabricación y comercialización de sus productos, donde la amplia y compleja gama de surtidos a suministrar en un contexto adverso para el país, conlleva a utilizar diferentes métodos de gestión de los aprovisionamientos en correspondencia con su destino y frecuencia de uso. De esta manera, se propone dividir las materias primas y materiales a proveer en: 1) insumos de proyectos, que emplean de forma esporádica pequeñas, pero múltiples variedades de mercancías 2) insumos de procesos, que se caracterizan por consumir altos volúmenes de productos, pero poco diversos, como sucede en las actividades de producción. Finalmente, se evalúa la implementación de este procedimiento en una de las entidades biotecnológicas de mayor prestigio en Cuba, el Centro de Inmunología Molecular, demostrando las ventajas y alcance de esta propuesta que permitió elevar la efectividad en la gestión de los aprovisionamientos, y de esta manera la eficiencia empresarial(AU)
The objective of this work is to propose a new methodology for the logistics management of supplies in Cuban biotechnological industries. They work essentially on a full cycle of enterprise performance, from basic research to the manufacture and marketing of new biopharmaceuticals products. The wide and complex range of supply requirements, in an adverse country-wide context, leads to the use of different methods for managing supplies, in accordance with their destination and frequency of use. We propose to divide the supplies and materials into two categories: 1) supplies for projects, for those that are highly varied, used sporadically and in small quantities, 2) process supplies, for those that are regularly used in large volumes -such as manufacture process-, and a relatively small variety of supply types. The implementation of this methodology is assessed in one of the most prestigious biotechnological entities in Cuba, the Molecular Immunology Center. The effectiveness in the management of supplies was increased, and therefore, business efficiency(AU)
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Tomada de Decisões Gerenciais , Biofarmácia/organização & administração , Projetos Industriais , Organização e AdministraçãoRESUMO
El surgimiento del sector biotecnológico inició una revolución en las bases tradicionales de competencia en la industria farmacéutica en términos de desarrollo y fabricación de productos, orientados principalmente a salud humana. La gestión de inventarios en esta industria es muy compleja, con grandes volúmenes y variedad de inventario, dado por la complejidad de mantener dos procesos que tienen efecto en la gestión de inventarios, relacionados con la investigación y desarrollo, y producción. La complejidad de estos procesos exige de un sistema logístico con capacidad y flexibilidad suficiente para adaptarse a las distintas regulaciones existentes y la variación en los planes de ventas, además de un sistema informático que permita integrar las partes del sistema. El presente artículo tiene el propósito de evaluar la situación de la Gestión de Inventarios en el Centro de Inmunología Molecular a partir de la implementación de los conceptos de Insumo Proyecto e Insumo Proceso. Para el desarrollo de la investigación se emplearon diferentes métodos y herramientas como: análisis bibliográfico, entrevistas a expertos, consultas de registros, tormenta de ideas, entre otros. Entre las herramientas utilizadas se encuentran: Modelo de Referencia para la Evaluación de la Gestión de Inventarios, Microsoft Excel y Diagrama Causa-Efecto. Los resultados demuestran el impacto positivo alcanzado por la diferenciación entre los insumos utilizados en procesos productivos e investigación, por el alcance dado en distintos procesos de la Gestión de Inventarios en el orden organizativo y financiero, logrando la mejora de indicadores como rotación de inventarios, ciclo de importación y satisfacción del cliente(AU)
The emergence of the biotechnological sector started a revolution in the traditional competitive basis of the pharmaceutical industries, in terms of development and manufacture of products, especially those aimed at human health. Inventory management in this industry is very complex, with varied, high-volume inventories, given the complexity of executing two processes that have an effect on inventory management: production, and R&D. The complexity of these processes demands a logistical system with the capacity and flexibility to adapt to the many different regulations in existence and changes in sales plans, and an informatics solution that allows integration of the different parts of the system. The current article aims to evaluate the situation of Inventory Management at the Molecular Immunology Center from the implementation of the concepts of Project Input and Process Input. The research was carried out through diverse methods and tools including bibliographic analysis, expert interviews, record querying, and brainstorming. The tools used included: Reference Model for Inventory Management Evaluation, Microsoft Excel, and cause-effect diagrams. The results show a positive impact achieved by differentiating inputs used for production and inputs used for R&D, and its reach into the process of Inventory Management at the organization level, improving indicators like inventory rotation, importing cycle, and client satisfaction(AU)
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Humanos , Tomada de Decisões Gerenciais , Produtos Biológicos/provisão & distribuição , Equipamentos e Provisões , Insumos Farmacêuticos , CubaRESUMO
The polymorphism of Pvs25 and Pvs28 ookinete surface proteins, their association to circumsporozoite protein repeat (CSPr) genotypes (Vk210 and Vk247) and their infectivity to local Anopheles albimanus and Anopheles pseudopunctipennis were investigated in Plasmodium vivax-infected blood samples obtained from patients in Southern Mexico. The pvs25 and pvs28 complete genes were amplified, cloned and sequenced; and the CSPr genotype was determined by PCR amplification and hybridization. The amino acid Pvs25 and Pvs28 polymorphisms were mapped to their corresponding protein structure. Infected blood samples were simultaneously provided through artificial feeders to both mosquito species; the ratio of infected mosquitoes and oocyst numbers were recorded. The polymorphism of pvs25 and pvs28 was limited to few nucleotide positions, and produced three haplotypes: type A/A parasites presented Pvs25 and Pvs28 amino acid sequences identical to that of Sal I reference strain; parasites type B1 presented a mutation 130 Ile-->Thr in Pvs25, while type B2 presented 87 Gln-->Lys/130 Ile-->Thr in the same molecule. Both types B1 and B2 parasites presented changes in Pvs28 at 87 Asn-->Asp, 110 Tyr-->Asn and five GSGGE/D repeat sequences between the fourth EGF-like domain and the GPI. Most P. vivaxparasites from the coastal plains and the overlapping region were Pvs25/28 A/A, CSPrVk210 and were infective only to An. albimanus (p< or =0.0001). Parasites originating in foothills were Pvs25/28 type B1/B or B2/B and CSPrVk210 or Vk247, and were more infective to An. pseudopunctipennis than to An. albimanus (p< or =0.001). These results and the analysis of Pvs25/28 from other parts of the world indicated that non-synonymous variations in these proteins occur in amino acid residues exposed on the surface of the proteins, and are likely to interact with midgut mosquito ligands. We hypothesize that these molecules have been shaped by co-evolutionary adaptations of parasites to their susceptible vectors.
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Anopheles/parasitologia , Antígenos de Protozoários/genética , Antígenos de Superfície/genética , Insetos Vetores/parasitologia , Vacinas Antimaláricas/genética , Plasmodium vivax , Polimorfismo Genético , Sequência de Aminoácidos , Animais , Antígenos de Protozoários/química , Antígenos de Superfície/química , Sequência de Bases , Evolução Molecular , Genótipo , Haplótipos , Humanos , Vacinas Antimaláricas/química , Malária Vivax/transmissão , México , Modelos Moleculares , Dados de Sequência Molecular , Plasmodium vivax/genética , Plasmodium vivax/patogenicidade , Estrutura Terciária de ProteínaRESUMO
Background Depression is associated with an increased use of medical resources and reduced quality of life, cognitive functions, functionality and general health. The treatment of depression is limited by the scarcity of mental health professionals, as reflected in the mental health atlas of the World Health Organization. Method A randomised controlled trial that was not blinded was conducted. Family doctors referred patients older than 60 years who were suspected to have depression to the screening module. The PHQ-9 questionnaire, the Six-Item Screener, and previous diagnosis for psychiatric disorders were collected. Major depression was excluded. Those with a score from two to six on the PHQ-9 and with no comorbidities were referred to the Baseline Phase. A simple random process without blocking was applied. Groups of 7-10 participants engaged in weekly sessions over the course of three months. The control group was referred to their family physician. Reduction in depression score of the PHQ-9 was the main outcome. Results and discussion There were 40 patients in the control group (CG) and 41 in the intervention group (IG). 84% were women, 41% married and 41% reported at least primary education. The mean age for the GC was 69.7 years vs. 71.3 in the GI. The baseline mean MMSE score was 23.7 in the GC and 24.1 in the IG. No significant baseline differences between groups were reported. In the IG, 56% of the participants (n=23) displayed a decrease that was greater than or equal to 5 points on the PHQ-9 compared with 30% (n=12) in the control group. The CT group evidenced a marginal improvement.
Antecedentes La depresión se asocia con un aumento en el uso de los recursos médicos y reducción de la calidad de vida, funciones cognitivas, funcionalidad y la salud general. El tratamiento de la depresión está limitado por la escasez de profesionales en salud mental, como se refleja en el atlas de salud mental de la Organización Mundial de la Salud. Método Se realizó un ensayo controlado aleatorio no cegado. Los médicos familiares referían a los pacientes mayores de 60 años con sospecha de depresión al módulo de detección. Se aplicó el cuestionario PHQ-9, la prueba de escrutinio de seis ítems, y el diagnóstico previo de trastornos psiquiátricos. Se excluyó a pacientes con depresión mayor. Aquellos con una puntuación de dos a seis en el PHQ-9 y sin comorbilidades fueron remitidos a la fase basal. Se aplicó un proceso aleatorio simple sin bloquear. Se integraron grupos de 7-10 participantes en sesiones semanales durante el transcurso de tres meses. El grupo control fue remitido a su médico familiar. El resultado principal fue la reducción en la puntuación de la depresión del PHQ-9 Resultados y discusión Se estudiaron a 40 pacientes en el grupo control (GC) y 41 en el grupo intervención (GI). 84% eran mujeres, 41% casados y el 41% informó de al menos la educación primaria. La edad media para el GC fue 69.7 años vs. 71.3 en el GI. La puntuación media del MMSE fue de 23.7 en el GC y el 24.1 en el IG. No se registraron diferencias iniciales significativas entre los grupos. El 56% de los participantes del GI mostró una disminución que fue mayor que o igual a cinco puntos en el PHQ-9 en comparación con 30% del GC. El grupo CT demuestra una mejora marginal.