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1.
Immunity ; 57(5): 1019-1036.e9, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38677292

RESUMO

Group 3 innate lymphoid cells (ILC3) are the major subset of gut-resident ILC with essential roles in infections and tissue repair, but how they adapt to the gut environment to maintain tissue residency is unclear. We report that Tox2 is critical for gut ILC3 maintenance and function. Gut ILC3 highly expressed Tox2, and depletion of Tox2 markedly decreased ILC3 in gut but not at central sites, resulting in defective control of Citrobacter rodentium infection. Single-cell transcriptional profiling revealed decreased expression of Hexokinase-2 in Tox2-deficient gut ILC3. Consistent with the requirement for hexokinases in glycolysis, Tox2-/- ILC3 displayed decreased ability to utilize glycolysis for protein translation. Ectopic expression of Hexokinase-2 rescued Tox2-/- gut ILC3 defects. Hypoxia and interleukin (IL)-17A each induced Tox2 expression in ILC3, suggesting a mechanism by which ILC3 adjusts to fluctuating environments by programming glycolytic metabolism. Our results reveal the requirement for Tox2 to support the metabolic adaptation of ILC3 within the gastrointestinal tract.


Assuntos
Citrobacter rodentium , Infecções por Enterobacteriaceae , Glicólise , Proteínas HMGB , Imunidade Inata , Linfócitos , Camundongos Knockout , Animais , Camundongos , Adaptação Fisiológica/imunologia , Citrobacter rodentium/imunologia , Infecções por Enterobacteriaceae/imunologia , Trato Gastrointestinal/imunologia , Trato Gastrointestinal/metabolismo , Hexoquinase/metabolismo , Hexoquinase/genética , Interleucina-17/metabolismo , Linfócitos/imunologia , Linfócitos/metabolismo , Camundongos Endogâmicos C57BL , Transativadores/metabolismo , Transativadores/genética , Proteínas HMGB/genética , Proteínas HMGB/imunologia , Proteínas HMGB/metabolismo
2.
Biochem Soc Trans ; 52(1): 231-239, 2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38288760

RESUMO

Totipotency is the ability of a single cell to develop into a full organism and, in mammals, is strictly associated with the early stages of development following fertilization. This unlimited developmental potential becomes quickly restricted as embryonic cells transition into a pluripotent state. The loss of totipotency seems a consequence of the zygotic genome activation (ZGA), a process that determines the switch from maternal to embryonic transcription, which in mice takes place following the first cleavage. ZGA confers to the totipotent cell a transient transcriptional profile characterized by the expression of stage-specific genes and a set of transposable elements that prepares the embryo for subsequent development. The timely silencing of this transcriptional program during the exit from totipotency is required to ensure proper development. Importantly, the molecular mechanisms regulating the transition from totipotency to pluripotency have remained elusive due to the scarcity of embryonic material. However, the development of new in vitro totipotent-like models together with advances in low-input genome-wide technologies, are providing a better mechanistic understanding of how this important transition is achieved. This review summarizes the current knowledge on the molecular determinants that regulate the exit from totipotency.


Assuntos
Embrião de Mamíferos , Zigoto , Camundongos , Animais , Zigoto/metabolismo , Desenvolvimento Embrionário/genética , Regulação da Expressão Gênica no Desenvolvimento , Mamíferos/genética
3.
Macromol Rapid Commun ; : e2400242, 2024 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-39116442

RESUMO

Reconfigurability within hydrogels has emerged as an attractive functionality that can be used in information encryption, cargo/delivery, environmental remediation, soft robotics, and medicine. Here micro-patterned polymer hydrogels capable of temperature-dependent reconfigurability are fabricated. For this, the hydrogels are provided with micron-sized Pickering emulsion droplets stabilized by magnetic particles, which are capable of harnessing energy from external force fields. The droplets can both migrate under magnetic field gradients and heat the environment when laser irradiated. These functions not only affect a single compartment but have higher-order effects on the mesoscale, thanks to the temperature-responsiveness of the polymeric network. This double responsiveness is exploited to control the spatial organization of hundreds of droplets within the hydrogel matrix and form predesigned and sophisticated patterns. Furthermore, pattern self-reconfiguration driven by the droplets themselves upon laser irradiation is induced. Finally, we show that due to their internal liquid phase, the droplets can be used as reservoirs of hydrophobic nutrients for living cells (i.e., Yarrowia lipolytica yeast) in the solid-like environment of the polymeric network, and demonstrate communication between the droplets and the cells to facilitate nutrient uptake. Altogether, the results provide opportunities for the development of stimuli-sensitive polymer hydrogels with post-synthesis reprogrammable response using micro-compartments as building blocks.

4.
Int J Mol Sci ; 25(10)2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38791376

RESUMO

Inflammatory bowel disease (IBD) is a chronic inflammatory condition involving dysregulated immune responses and imbalances in the gut microbiota in genetically susceptible individuals. Current therapies for IBD often have significant side-effects and limited success, prompting the search for novel therapeutic strategies. Microbiome-based approaches aim to restore the gut microbiota balance towards anti-inflammatory and mucosa-healing profiles. Extracellular vesicles (EVs) from beneficial gut microbes are emerging as potential postbiotics. Serotonin plays a crucial role in intestinal homeostasis, and its dysregulation is associated with IBD severity. Our study investigated the impact of EVs from the probiotic Nissle 1917 (EcN) and commensal E. coli on intestinal serotonin metabolism under inflammatory conditions using an IL-1ß-induced inflammation model in Caco-2 cells. We found strain-specific effects. Specifically, EcN EVs reduced free serotonin levels by upregulating SERT expression through the downregulation of miR-24, miR-200a, TLR4, and NOD1. Additionally, EcN EVs mitigated IL-1ß-induced changes in tight junction proteins and oxidative stress markers. These findings underscore the potential of postbiotic interventions as a therapeutic approach for IBD and related pathologies, with EcN EVs exhibiting promise in modulating serotonin metabolism and preserving intestinal barrier integrity. This study is the first to demonstrate the regulation of miR-24 and miR-200a by probiotic-derived EVs.


Assuntos
Escherichia coli , Vesículas Extracelulares , Inflamação , Interleucina-1beta , Mucosa Intestinal , MicroRNAs , Probióticos , Serotonina , Humanos , Interleucina-1beta/metabolismo , Interleucina-1beta/genética , Vesículas Extracelulares/metabolismo , Probióticos/farmacologia , Serotonina/metabolismo , MicroRNAs/genética , MicroRNAs/metabolismo , Células CACO-2 , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Mucosa Intestinal/patologia , Inflamação/metabolismo , Receptor 4 Toll-Like/metabolismo , Receptor 4 Toll-Like/genética , Doenças Inflamatórias Intestinais/metabolismo , Doenças Inflamatórias Intestinais/induzido quimicamente , Doenças Inflamatórias Intestinais/terapia , Proteína Adaptadora de Sinalização NOD1/metabolismo , Proteína Adaptadora de Sinalização NOD1/genética , Células Epiteliais/metabolismo , Proteínas da Membrana Plasmática de Transporte de Serotonina/metabolismo , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética , Estresse Oxidativo , Regulação da Expressão Gênica
5.
Int J Mol Sci ; 25(2)2024 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-38256253

RESUMO

Rotavirus (RV) infection is a major cause of acute gastroenteritis in children under 5 years old, resulting in elevated mortality rates in low-income countries. The efficacy of anti-RV vaccines is limited in underdeveloped countries, emphasizing the need for novel strategies to boost immunity and alleviate RV-induced diarrhea. This study explores the effectiveness of interventions involving extracellular vesicles (EVs) from probiotic and commensal E. coli in mitigating diarrhea and enhancing immunity in a preclinical model of RV infection in suckling rats. On days 8 and 16 of life, variables related to humoral and cellular immunity and intestinal function/architecture were assessed. Both interventions enhanced humoral (serum immunoglobulins) and cellular (splenic natural killer (NK), cytotoxic T (Tc) and positive T-cell receptor γδ (TCRγδ) cells) immunity against viral infections and downregulated the intestinal serotonin receptor-3 (HTR3). However, certain effects were strain-specific. EcoR12 EVs activated intestinal CD68, TLR2 and IL-12 expression, whereas EcN EVs improved intestinal maturation, barrier properties (goblet cell numbers/mucin 2 expression) and absorptive function (villus length). In conclusion, interventions involving probiotic/microbiota EVs may serve as a safe postbiotic strategy to improve clinical symptoms and immune responses during RV infection in the neonatal period. Furthermore, they could be used as adjuvants to enhance the immunogenicity and efficacy of anti-RV vaccines.


Assuntos
Vesículas Extracelulares , Microbiota , Infecções por Rotavirus , Rotavirus , Vacinas , Criança , Humanos , Animais , Ratos , Pré-Escolar , Animais Recém-Nascidos , Escherichia coli , Diarreia/terapia , Infecções por Rotavirus/terapia
6.
Med Biol Eng Comput ; 62(8): 2371-2388, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38584206

RESUMO

The precise segmentation of white blood cells (WBCs) within blood smear images is a significant challenge with implications for both medical research and image processing. Of particular importance is the often neglected task of accurately segmenting WBC nuclei, an aspect that currently lacks dedicated methodologies. This paper introduces a straightforward and efficient method designed to fill this critical gap, providing an effective solution for the efficient segmentation of WBC nuclei. In blood smear imagery, the distinctive coloration of WBCs contrasts with the hues of other blood components. The inherent obscurity of WBCs prompts their segmentation by isolating pixels with minimal intensities. To streamline this process, our proposed method employs the Laplacian pyramid technique to decorrelate pixels in blood smear images, thereby amplifying the contrast. Subsequently, the intensities of pixels constituting blood cells, encompassing WBCs and the background, are modeled using three Gaussian random variables. Capitalizing on this feature, we implement the Gaussian mixture model (GMM) clustering method to determine the optimal threshold value, facilitating a highly precise segmentation of WBC nuclei. The proposed method demonstrates the capability to process images containing a single WBC as well as effectively functioning with images containing multiple cells of this type. Evaluation of the method on the ALL-IDB, ALL-IDB2, CellaVision, and JTSC datasets yielded accuracy values of 0.9802, 0.9725, 0.9772, and 0.9730, respectively. Comparative analysis with state-of-the-art methods revealed a notably comparable performance, underscoring the effectiveness of the proposed approach. The method presented in this article is highly competitive for segmenting the nuclei of WBCs compared to state-of-the-art methods. The three main advantages of our method are its ability to process images containing one or more WBCs, the automatic calculation of threshold values for each processed image, eliminating the need for manual parameter adjustments. Lastly, the method is efficient, as its algorithmic complexity is approximately O ( n m ) .


Assuntos
Algoritmos , Núcleo Celular , Processamento de Imagem Assistida por Computador , Leucócitos , Humanos , Leucócitos/citologia , Distribuição Normal , Processamento de Imagem Assistida por Computador/métodos , Análise por Conglomerados
7.
Brain Sci ; 14(7)2024 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-39061384

RESUMO

Motor intention is a high-level brain function related to planning for movement. Although studies have shown that motor intentions can be decoded from brain signals before movement execution, it is unclear whether intentions relating to mental imagery of movement can be decoded. Here, we investigated whether differences in spatial and temporal patterns of brain activation were elicited by intentions to perform different types of motor imagery and whether the patterns could be used by a multivariate pattern classifier to detect such differential intentions. The results showed that it is possible to decode intentions before the onset of different types of motor imagery from functional MR signals obtained from fronto-parietal brain regions, such as the premotor cortex and posterior parietal cortex, while controlling for eye movements and for muscular activity of the hands. These results highlight the critical role played by the aforementioned brain regions in covert motor intentions. Moreover, they have substantial implications for rehabilitating patients with motor disabilities.

8.
Open Forum Infect Dis ; 11(1): ofad635, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38173846

RESUMO

Background: Our objective was to assess the health impact of coronavirus disease 2019 (COVID-19) during 2020-2022 in the Madrid region. Methods: We included all individuals registered in the Madrid Health System Registry as of 31 December 2019, and followed them until 31 December 2022. Using a unique personal identifier, we linked the databases of primary care, hospitals, pharmacies, certified laboratories performing diagnostic tests, vaccines, and mortality. Results: Of 6 833 423 individuals, 21.4% had a confirmed COVID-19 diagnosis, and 1.5% had a COVID-19 hospitalization (primary diagnosis). Thirty-day mortality was 1.6% for confirmed COVID-19 (from 11.4% in first semester 2020 to 0.4% in first semester 2022). Thirty-day mortality was 10.8% for COVID-19 hospitalizations (from 14.0% in first semester 2020 to 6.0% in second semester 2022). There were 24 073 deaths within 30 days of a confirmed COVID-19 diagnosis. Advanced age, male sex, higher socioeconomic deprivation, and comorbidities were associated with higher mortality. Conclusions: By linking administrative and clinical databases, we characterized the burden of the COVID-19 pandemic in Madrid over 3 years. Our analysis proposes a high-level framework for comparisons of the burden of COVID-19 across areas worldwide.

9.
Nat Genet ; 56(4): 697-709, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38509386

RESUMO

In mice, exit from the totipotent two-cell (2C) stage embryo requires silencing of the 2C-associated transcriptional program. However, the molecular mechanisms involved in this process remain poorly understood. Here we demonstrate that the 2C-specific transcription factor double homeobox protein (DUX) mediates an essential negative feedback loop by inducing the expression of DUXBL to promote this silencing. We show that DUXBL gains accessibility to DUX-bound regions specifically upon DUX expression. Furthermore, we determine that DUXBL interacts with TRIM24 and TRIM33, members of the TRIM superfamily involved in gene silencing, and colocalizes with them in nuclear foci upon DUX expression. Importantly, DUXBL overexpression impairs 2C-associated transcription, whereas Duxbl inactivation in mouse embryonic stem cells increases DUX-dependent induction of the 2C-transcriptional program. Consequently, DUXBL deficiency in embryos results in sustained expression of 2C-associated transcripts leading to early developmental arrest. Our study identifies DUXBL as an essential regulator of totipotency exit enabling the first divergence of cell fates.


Assuntos
Genes Homeobox , Proteínas de Homeodomínio , Células-Tronco Embrionárias Murinas , Fatores de Transcrição , Animais , Camundongos , Diferenciação Celular , Regulação da Expressão Gênica , Regulação da Expressão Gênica no Desenvolvimento/genética , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Células-Tronco Embrionárias Murinas/metabolismo
10.
Biomolecules ; 14(6)2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38927060

RESUMO

Plasmacytoid dendritic cells (pDCs) are vital players in antiviral immune responses because of their high levels of IFN-α secretion. However, this attribute has also implicated them as critical factors behind the immunopathogenesis of inflammatory diseases, and no currently available therapy can efficiently inhibit pDCs' aberrant activation. Mesenchymal stromal cells (MSCs) possess stromal immunomodulatory functionality, regulating immune cell activation through several mechanisms, including the adenosinergic (CD39/CD73/adenosine) pathway. The IFN-γ preconditioning of bone marrow MSCs improves their inhibitory properties for therapy applications; however, isolating human gingival tissue-derived MSCs (hGMSCs) is more accessible. These cells have shown better immunomodulatory effects, yet the outcome of IFN-γ preconditioning and its impact on the adenosinergic pathway has not been evaluated. This study first validated the immunoregulatory properties of primary-cultured hGMSCs, and the results showed that IFN-γ preconditioning strengthens CD39/CD73 coexpression, adenosine production, and the regulatory properties of hGMSC, which were confirmed by describing for the first time their ability to reduce pDC activation and their IFN-α secretion and to increase the frequency of CD73+ pDC. In addition, when CD73's enzymatic activity was neutralized in hGMSCs, adenosine production and the IFN-γ preconditioning effect were restrained. This evidence might be applied to design hGMSCs- and adenosine-based immunotherapeutic strategies for treating inflammatory disorders that are associated with pDC overactivation.


Assuntos
5'-Nucleotidase , Adenosina , Células Dendríticas , Gengiva , Interferon gama , Células-Tronco Mesenquimais , Humanos , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/imunologia , Células-Tronco Mesenquimais/citologia , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Adenosina/metabolismo , Interferon gama/metabolismo , Gengiva/citologia , 5'-Nucleotidase/metabolismo , Células Cultivadas , Apirase/metabolismo , Proteínas Ligadas por GPI
11.
Anemia ; 2024: 4940760, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38716363

RESUMO

Sickle cell anemia has been classified as a noninfectious neglected tropical disease and, although not exclusively, affects African descendants more frequently. This study aimed to detect asymptomatic sickle cell hemoglobin carriers (HbAS) in marginalized and vulnerable populations during a public health screening in African descendants from Oaxaca, Mexico, and to validate an amplification refractory mutation system (ARMS)-PCR methodology to detect fetal-hemoglobin (HbF)-regulating genetic variants in BCL11A toward affordable routine association of single nucleotide variants (SNVs) with HbF concentrations. To this aim, hemoglobin variants were detected by acidic citrate agar and alkaline cellulose acetate electrophoreses. SNVs in the hemoglobin subunit beta gene (HBB) were identified by the ß-globin mutation detection assay (ß-GMDA) and ARMS-PCR, respectively, and validated by Sanger sequencing. The association between genotypes and HbF concentrations was evaluated using Spearman's correlation coefficient. The results obtained during a directed screening in 140 self-identified African descendants revealed 42 HbS-carriers (30%), of which 39 showed normal total hemoglobin concentrations (92.8%), only 3 presented anemia (7.2%), and 9 showed quantifiable HbF concentration (21.4%). As validated by Sanger sequencing, the designed ARMS-PCR efficiently detected homozygous and heterozygous variants in BCL11A. In a cohort of 42 heterozygous (HbAS) and 27 healthy (HbAA) individuals from the same population, only one SNV (rs766432) showed statistically significant association with increasing HbF concentration, and two new unrelated homozygous silent variants were identified. This study reveals the need to raise coverage of HbS screening in vulnerable populations and shows a feasible low-cost ARMS-PCR methodology to determine the presence of SNVs in quantitative trait loci affecting HbF.

12.
Ann Intensive Care ; 14(1): 108, 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38980442

RESUMO

BACKGROUND: Dynamic arterial elastance (Eadyn) has been investigated for its ability to predict hypotension during the weaning of vasopressors. Our study focused on assessing Eadyn's performance in the context of critically ill adult patients admitted to the intensive care unit, regardless of diagnosis. MAIN BODY: Our study was conducted in accordance with the Preferred Reported Items for Systematic Reviews and Meta-Analysis checklist. The protocol was registered in PROSPERO (CRD42023421462) on May 26, 2023. We included prospective observational studies from the MEDLINE and Embase databases through May 2023. Five studies involving 183 patients were included in the quantitative analysis. We extracted data related to patient clinical characteristics, and information about Eadyn measurement methods, results, and norepinephrine dose. Most patients (76%) were diagnosed with septic shock, while the remaining patients required norepinephrine for other reasons. The average pressure responsiveness rate was 36.20%. The synthesized results yielded an area under the curve of 0.85, with a sensitivity of 0.87 (95% CI 0.74-0.93), specificity of 0.76 (95% CI 0.68-0.83), and diagnostic odds ratio of 19.07 (95% CI 8.47-42.92). Subgroup analyses indicated no variations in the Eadyn based on norepinephrine dosage, the Eadyn measurement device, or the Eadyn diagnostic cutoff to predict cessation of vasopressor support. CONCLUSIONS: Eadyn, evaluated through subgroup analyses, demonstrated good predictive ability for the discontinuation of vasopressor support in critically ill patients.

13.
Healthcare (Basel) ; 11(24)2023 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-38132081

RESUMO

BACKGROUND: Pain in hospitalized adults is underestimated and undervalued. The aim of this study was to evaluate pain prevalence and satisfaction with the hospital's pain management among patients attending a tertiary university hospital. Predictor factors of pain were also studied. METHODS: A prospective, cross-sectional study was carried out through a structured questionnaire given on one day to all hospitalized patients in a university hospital. Clinical data, such as personal history and analgesic treatment, were collected from medical records. Other variables related to pain (including intensity rated by the visual analogue scale as well as location and patient satisfaction measured by the numerical rating scale) were also obtained. RESULTS: Of the 274 surveyed patients, pain prevalence was 52.9%, with an average intensity of 5.3 ± 2.8 according to VAS. The overall satisfaction was 87.2%, and 72.6% had already been prescribed at least one analgesic. Patients receiving analgesics showed higher pain intensity (VAS 3.6 ± 3.4) than those without treatment (VAS 1.1 ± 2.1) (p < 0.001). However, patients with treatment showed more satisfaction (NRS 7.8 ± 2 vs. 5.3 ± 1.4, p < 0.001). CONCLUSIONS: The prevalence of pain in hospitalized patients was high, despite the fact that patient satisfaction was also very high.

14.
Pharmaceutics ; 15(12)2023 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-38140093

RESUMO

Flavanones are natural compounds that display anti-inflammatory activity. The aim of this work was to prepare PLGA nanoparticles (NPs) containing natural flavanones I ((2S)-5,7-dihydroxy-6-methyl-8-(3-methyl-2-buten-1-il)-2-phenyl-2,3-dihydro-4H-1-Benzopyran-4-one) and II (2S)-5,7-dihydroxy-2-(4'-methoxyphenyl)-6-methyl-8-(3-methyl-2-buten-1-yl)-2,3-dihydro-4H-1-Benzopyran-4-one) (NP I and NP II, respectively) so as to evaluate their potential for topical anti-inflammatory ocular therapy. An in silico study was carried out using the Molinspiration® and PASS Online web platforms before evaluating the in vitro release study and the ex vivo porcine cornea and sclera permeation. The HPLC analytical method was also established and validated. Finally, the in vitro anti-inflammatory efficacy of NPs was studied in the HCE-2 model. The flavanones I and II could be released following a kinetic hyperbolic model. Neither of the two NPs was able to permeate through the tissues. NP I and NP II were found to be respectful of any changes in the tissues' morphology, as evidenced by histological studies. In HCE-2 cells, NP I and NP II were not cytotoxic at concentrations up to 25 µM. NP I showed higher anti-inflammatory activity than NP II, being able to significantly reduce IL-8 production in LPS-treated HCE-2 cells. In summary, ocular treatment with NP I and NP II could be used as a promising therapy for the inhibition of ocular inflammation.

15.
Rev. esp. podol ; 34(1): 39-46, 2023. ilus
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-226672

RESUMO

Los procesos de no-unión postquirúrgicos en pie y tobillo no son infrecuentes debido a la gran cantidad de procedimientos quirúrgicos mediante osteotomías o artrodesis que se realizan anualmente. Ocasionalmente, estos procedimientos no tienen una estabilización óptima del foco de fractura y pueden acabar degenerando en un proceso de no-unión. Presentamos el caso de una paciente a la que se le realizaron osteotomías en la base de los metatarsianos menores por cirugía mínimamente invasiva para el tratamiento de metatarsalgia, que derivó en el desarrollo de pseudoartrosis dolorosa en la base del segundo metatarsiano y de no-unión en el 4.º metatarsiano. Se realizó tratamiento quirúrgico consistente en la utilización de autoinjerto corticoesponjoso de calcáneo y estabilización con placa de bloqueo dorsal para 2.º metatarsiano y estabilización con placa dorsal de bloqueo para el 4.º metatarsiano. La radiología mostró integración del injerto a las 8 semanas y los resultados clínicos fueron muy satisfactorios tras 5 años de seguimiento. El autoinjerto de calcáneo con estabilización rígida por medio de placa de bloqueo dorsal puede ser un tratamiento efectivo para el tratamiento de la no unión y pseudoartrosis en la base de los metatarsianos.(AU)


Postsurgical nonunions of the foot and ankle are not uncommon because of the large number of procedures by means of osteotomies and arthrodesis that are performed annually. We present a clinical case of a patient who developed a painful nonunion in the base of the second metatarsal after a minimally invasive surgical procedure for metatarsalgia within a base osteotomy that developed a painful pseudoartrhosis of the 2nd metatarsal and also a nonunion of the 4th metatarsal. The patient was treated with the use of an autograft of corticocancellous bone from ipsilateral calcaneus that was fixated with a dorsal locking plate for the 3rd metatarsal and also with stabilization by means of a dorsal locking plate of the 4th metatarsal. Radiology showed good integration of the graft at 8 weeks and clinical results were excellent after 5 years of followup. Autograft from calcaneus fixed with a locking dorsal plate can be an effective treatment of nonunions in the base of the metatarsals.(AU)


Assuntos
Humanos , Ossos do Metatarso/efeitos dos fármacos , Calcâneo/cirurgia , Transplante Ósseo , Pseudoartrose/tratamento farmacológico , Osteotomia , Pacientes Internados , Exame Físico , Podiatria , Pé/cirurgia , Tornozelo/cirurgia , Antepé Humano/cirurgia
16.
Arch. argent. pediatr ; 121(4): e202202775, ago. 2023. ilus
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1443050

RESUMO

La hemocromatosis es una enfermedad caracterizada por el excesivo depósito de hierro en múltiples órganos, entre ellos hígado, páncreas, piel y corazón. La infiltración de este último es un importante factor en morbilidad y mortalidad. Presentamos un caso de un paciente pediátrico con insuficiencia cardíaca terminal que ameritó trasplante cardíaco, que resultó sin complicaciones. Posterior a la cirugía, mostró mejoría bioquímica y clínica, lo que influyó positivamente en su calidad de vida y prolongó su supervivencia.


Hemochromatosis is a disease characterized by excess iron stores in multiple organs, including the liver, pancreas, skin, and heart. The infiltration of the heart is an important factor in morbidity and mortality. Here we describe the case of a pediatric patient with end-stage heart failure who required a heart transplantation, with no complications. After the surgery, she showed biochemical and clinical improvement, with a positive impact on her quality of life and a prolonged survival.


Assuntos
Humanos , Feminino , Criança , Transplante de Coração , Sobrecarga de Ferro/complicações , Hemocromatose/complicações , Hemocromatose/diagnóstico , Qualidade de Vida , Fígado
17.
Ginecol. obstet. Méx ; 91(2): 85-91, ene. 2023. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1448318

RESUMO

Resumen OBJETIVO: Describir la prevalencia de diabetes gestacional e hipertensión arterial en pacientes embarazadas con obesidad pregestacional. MATERIALES Y MÉTODOS: Estudio retrospectivo, transversal y descriptivo llevado a cabo en mujeres embarazadas con diagnóstico previo de obesidad (índice de masa corporal superior a 29.99) y con control prenatal. Parámetros evaluados: estilo de vida (alimentación, actividad física, consumo de alcohol, tabaco o alguna toxicomanía) y características físicas, clínicas y bioquímicas durante el embarazo actual por trimestre (índice de masa corporal, glucosa, presión arterial sistólica y diastólica). El diagnóstico de diabetes gestacional se estableció mediante una prueba de tolerancia a la glucosa entre las semanas 24 y 28 de embarazo. La hipertensión gestacional se diagnosticó por cifras de presión arterial mayores e iguales a 140-90 mmHg a partir de la semana 20 de embarazo y en ausencia de proteinuria. El análisis estadístico incluyó porcentajes, promedios e intervalos de confianza. RESULTADOS: La prevalencia de diabetes gestacional en embarazadas con obesidad fue 13.7% (IC95%: 9.6 a 17.9) y la de hipertensión gestacional en embarazadas con obesidad 7.4% (IC95%: 4.3 a 10.6). CONCLUSIÓN: La obesidad es un factor conocido de riesgos, en particular de diabetes e hipertensión en el embarazo. Su alta prevalencia hace necesario implementar campañas de prevención que favorezcan su reducción.


Abstract OBJECTIVE: To describe the prevalence of gestational diabetes and arterial hypertension in pregnant patients with pre-pregnancy obesity. MATERIALS AND METHODS: Retrospective, cross-sectional and descriptive study in pregnant women with a diagnosis of obesity prior to pregnancy (body mass index greater than 29.99) and with prenatal care. The sample size was 269 pregnant women. Lifestyle (diet, physical activity, alcohol, tobacco or drug addiction) and physical, clinical and biochemical characteristics during the current pregnancy were evaluated by gestational trimester (body mass index, glucose, systolic and diastolic blood pressure). The diagnosis of gestational diabetes was established by a glucose tolerance test between the 24th and 28th week of gestation and gestational hypertension was diagnosed by blood pressure figures greater than or equal to 140/90 mmHg from the 20th week of gestation and in the absence of proteinuria. Statistical analysis included percentages, means, and confidence intervals. RESULTS: The prevalence of gestational diabetes in obese pregnant women was 13.7% (95%CI: 9.6-17.9) and the prevalence of gestational hypertension in obese pregnant women was 7.4% (95%CI: 4.3-10.6). CONCLUSION: Obesity is a known risk factor, particularly for diabetes and hypertension in pregnancy. Its high prevalence makes it necessary to implement prevention campaigns to reduce it.

18.
Apuntes psicol ; 41(1): 5-10, 9 feb. 2023. tab
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-215642

RESUMO

El uso de instrumentos informatizados y en línea se ha incrementado notablemente en las últimas décadas. Sucesos como la COVID-19 han influido en la consolidación de su uso, siendo herramientas de trabajo muy útiles para evaluación e investigación. El objetivo del presente trabajo fue analizar una plataforma de evaluación online denominada MenPas 1.0, explorando sus áreas de trabajo y el flujo de datos de los últimos años. Se ha seguido una estrategia descriptiva para analizar las posibilidades que ofrece la plataforma, así como el tráfico de datos que posee y número de usuarios. Los resultados muestran que esta plataforma ofrece herramientas vinculadas a las siguientes áreas: ansiedad, atención, autoconcepto, autorregistros, burnout, búsqueda de talentos, calidad de vida, dinámica grupal, entrenamiento mental, inteligencia emocional, estrés, generalizabilidad, hipnosis, liderazgo, motivación, observación, organizaciones/calidad, socialización, toma de decisiones o visualización. Actualmente, tiene más de 16 mil usuarios registrados y acumula más de un millón trescientos mil sucesos. Algunos de los cuestionarios alojados han sido respondidos más de 60.000 veces. Además, sus usuarios proceden de múltiples países europeos y asiáticos, americanos o de Oceanía. Los resultados ponen de relieve el amplio espectro de uso que tiene la plataforma, las posibilidades de almacenamiento y procesamiento de datos que permite y la universalización de los recursos informatizados. (AU)


Computerized online instruments use has been increased significantly in recent decades. Influenced by events as COVID-19, consolidating its use in assessment and research. Present work main goal is to analyze the online assessment platform named MenPas 1.0, by exploring its working areas as well as the traffic communication data in the last years. A descriptive strategy has been followed in order to analyze the several possibilities offered by the platform as well as its data traffic and number of users. The results show that this platform offers a set of for the following areas: anxiety, attention, self-concept, self-registers, burnout, talent search, quality of life, group dynamics, mental training, emotional intelligence, stress, generalizability, hypnosis, leadership, motivation, observation, organizations/quality, socialization, decision making or visualization. Currently, it has more than 16 thousand registered users and accumulates more than 1.3 million events. Some of the hosted questionnaires have been run more than 60,000 times. In addition, users come from many European, Asian, American, and Oceanian countries. The results highlight the wide using spectrum of the platform joined to the data storing and processing possibilities what allows the computerized resources universalization. (AU)


Assuntos
Humanos , 51890 , Psicologia Social , Autoavaliação (Psicologia) , Testes Psicológicos
19.
Rev. chil. neuro-psiquiatr ; 60(1): 75-91, mar. 2022. tab
Artigo em Espanhol | LILACS | ID: biblio-1388422

RESUMO

Resumen Introducción: la resiliencia ha sido definida como la resistencia frente a experiencias psicosociales adversas. Tiene un rol importante en varios trastornos mentales, asociándose, por ejemplo, a la severidad en el trastorno depresivo mayor y a la calidad de vida en el trastorno afectivo bipolar. La esquizofrenia es un trastorno mental severo que destaca por producir dificultades en múltiples dominios de la vida y una alta morbimortalidad. El objetivo de esta revisión fue sintetizar la evidencia disponible acerca de la importancia de la resiliencia en la esquizofrenia. Métodos: se realizó una búsqueda en las bases de datos PubMed, LILACS y SciELO, seleccionando artículos en inglés y español, que incluyeran personas con esquizofrenia y midieran la resiliencia. Veinticinco artículos cumplieron los criterios de inclusión. Resultados: las personas con esquizofrenia tenían una menor resiliencia que sujetos sanos (9 estudios). El nivel de resiliencia se asoció inversamente con los síntomas negativos (3 estudios), síntomas positivos (1 estudio), depresión (4 estudios), desesperanza (3 estudios) y suicidio (1 estudio). Por otro lado, la resiliencia se asoció positivamente con la calidad de vida (5 estudios), funcionalidad (4 estudios) y salud física (2 estudios). En dos estudios se evaluaron intervenciones orientadas a potenciar la resiliencia de pacientes con esquizofrenia, mostrando resultados poco concluyentes. Discusión: es llamativa la escasa literatura que aborda el tema de la resiliencia en esquizofrenia. Los hallazgos de la presente revisión sitúan a la resiliencia como un factor determinante de la evolución y expresión clínica de esta enfermedad.


Introduction: resilience has been defined as the resistance to adverse psychosocial experiences. It has an important role in various mental disorders, being associated, for example, with the severity in major depressive disorder and the quality of life in bipolar affective disorder. Schizophrenia is a severe mental disorder that stands out for causing difficulties in multiple domains of life and high morbidity and mortality. The objective of this review was to synthesize the available evidence about the importance of resilience in schizophrenia. Methods: a search of the PubMed, LILACS and SciELO databases was performed, selecting articles in English and Spanish that included patients with schizophrenia and measured resilience. Twenty-five articles met the inclusion criteria. Results: patient with schizophrenia had less resilience than healthy subjects (9 studies). Resilience levels were inversely associated with negative symptoms (3 studies), positive symptoms (1 study), depression (4 studies), hopelessness (3 studies), and suicide (1 study). On the other hand, resilience was positively associated with quality of life (5 studies), functionality (4 studies) and physical health (2 studies). In two studies, interventions aimed at enhancing the resilience of patients with schizophrenia were evaluated, showing inconclusive results. Discussion: there is a striking limited literature that address the topic of resilience in schizophrenia. The findings of the present review place resilience as a determining factor in the evolution and clinical expression of this disease.


Assuntos
Humanos , Psicologia do Esquizofrênico , Resiliência Psicológica , Qualidade de Vida , Pesquisa Qualitativa
20.
Rev. enferm. Inst. Mex. Seguro Soc ; 29(3): 136-134, 04-oct-2021. tab
Artigo em Espanhol | LILACS, BDENF - enfermagem (Brasil) | ID: biblio-1357685

RESUMO

Introducción: en la actualidad, el cáncer gástrico sigue ocupando un lugar importante entre las causas de muerte a nivel mundial. Objetivo: determinar las características sociodemográficas, ambientales y clínicas de los pacientes con cáncer gástrico en el municipio de San Gil, Colombia. Metodología: estudio descriptivo transversal. La muestra estuvo conformada por 13 casos de personas con diagnóstico clínico e histopatológico de cáncer gástrico del municipio de San Gil, Santander, residentes del área rural y urbana. El análisis estadístico fue realizado con el programa Statistical Product and Service Solutions, versión 24.0 Resultados: el género con mayor afectación fue el masculino con un 62%. La mediana de edad de los participantes fue de 51 años con una edad mínima de 36 años y una edad máxima de 87 años. En el 61.5% el nivel de escolaridad fue la educación primaria. En cuanto a los factores ambientales, se encontró que el 69.2% consumieron alimentos salados y condimentados. Conclusiones: se encontró que una gran proporción de los participantes fueron del género masculino y residentes del casco urbano. Entre las ocupaciones, las más frecuentes fueron amas de casa y conductores de transporte pesado. Los síntomas que presentaron los participantes en el momento del diagnóstico fueron: pérdida de peso, hematemesis, dolor epigástrico y sensación de plenitud abdominal


Introduction: At present, gastric cancer continues to occupy an important place among the causes of death worldwide. Objective: To determine the sociodemographic, environmental, and clinical characteristics of patients with gastric cancer in the municipality of San Gil, Colombia. Methods: Descriptive cross-sectional study. The sample consisted of 13 cases of people with clinical and histopathological diagnosis of gastric cancer from the municipality of San Gil, Santander, who were residents of rural and urban areas. Statistical analysis was carried out with the program Statistical Product and Service Solutions (SPSS), version 24.0. Results: Men were the most affected, with 61.5%. The median age of the participants was 51 years with a minimum age of 36 years and a maximum of 87 years. In 61.5% the level of education was primary education. Regarding environmental factors, it was found that 69.2% consumed salty and spicy foods. Conclusions: It was found that a large proportion of the participants were male, urban residents. Concerning occupations, the most frequent were housewives and heavy truck drivers. Symptoms that participants presented at the time of diagnosis were weight loss, hematemesis, epigastric pain and fullness in upper abdomen.


Assuntos
Humanos , Masculino , Feminino , Neoplasias Gástricas , Fatores Epidemiológicos , Estudos Transversais , Saúde Pública , Causas de Morte , Colômbia
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