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INTRODUCTION: This review highlights the critical role of the endocannabinoid system (ECS) in regulating neuropathic pain and explores the therapeutic potential of cannabinoids. Understanding the mechanisms of the ECS, including its receptors, endogenous ligands, and enzymatic routes, can lead to innovative treatments for chronic pain, offering more effective therapies for neuropathic conditions. This review bridges the gap between preclinical studies and clinical applications by emphasizing ECS modulation for better pain management outcomes. AREAS COVERED: A review mapped the existing literature on neuropathic pain and the effects of modulating the ECS using natural and synthetic cannabinoids. This analysis examined ECS components and their alterations in neuropathic pain, highlighting the peripheral, spinal, and supraspinal mechanisms. This review aimed to provide a thorough understanding of the therapeutic potential of cannabinoids in the management of neuropathic pain. EXPERT OPINION: Advances in cannabinoid research have shown significant potential for the management of chronic neuropathic pain. The study emphasizes the need for high-quality clinical trials and collaborative efforts among researchers, clinicians, and regulatory bodies to ensure safe and effective integration of cannabinoids into pain management protocols. Understanding the mechanisms and optimizing cannabinoid formulations and delivery methods are crucial for enhancing therapeutic outcomes.
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Cannabinoides , Endocannabinoides , Neuralgia , Neuralgia/tratamiento farmacológico , Neuralgia/fisiopatología , Humanos , Endocannabinoides/metabolismo , Animales , Cannabinoides/farmacología , Dolor Crónico/tratamiento farmacológico , Dolor Crónico/fisiopatología , Analgésicos/farmacología , Terapia Molecular Dirigida , Receptores de Cannabinoides/metabolismoRESUMEN
As the world moves away from fossil fuels and embraces sustainable energy sources, the need for sustainable fuels for transportation becomes paramount. This study investigates the effects of pyrolysis oil derived from cassava peel waste (CPO), hydrogen (H), and diesel (D) blends as a partial substitute for low-displacement compression ignition engines. We tested three blends - CPO25, CPO25H5, and CPO25H10 - against neat diesel operation at engine speeds of 3400 rpm, 3600 rpm, and 3800 rpm and torques of 4 Nm, 6 Nm, and 8 Nm. Our findings reveal that while energy efficiency decreased with CPO25 compared to D100 operation, adding H2 increased energy efficiency. The highest increase was 7.8 % for CPO25H5 and 16 % for CPO25H10 compared to CPO25. Exergy efficiency also decreased with CPO25 compared to D100, but adding H2 compensated for this reduction. The highest increase was 8.0 % for CPO25H5 and 17 % for CPO25H10 compared to D100. CPO25H10 showed an increase of 8.1 % in combustion pressure and 9.9 % in heat release rate compared to CPO25. Emissions analysis also revealed that CO emissions were considerably lower with CPO and H2 than with D100, with the highest decrease of 11 % with CPO25H10. CO2 and hydrocarbon emissions followed the same trend as CO. Although NOx emissions slightly increased, the benefits of using pyrolysis oil-H2-diesel blends as a partial substitution fuel for low-displacement compression ignition engines are evident.
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BACKGROUND: Outcomes in alcohol-associated liver disease (ALD) are influenced by several race and ethnic factors, yet its natural history across the continuum of patients in different stages of the disease is unknown. METHODS: We conducted a retrospective cohort study of U.S. adults from 2011 to 2018, using three nationally representative databases to examine potential disparities in relevant outcomes among racial and ethnic groups. Our analysis included logistic and linear regressions, along with competing risk analysis. RESULTS: Black individuals had the highest daily alcohol consumption (12.6 g/day) while Hispanic participants had the largest prevalence of heavy episodic drinking (33.5%). In a multivariable-adjusted model, Hispanic and Asian participants were independently associated with a higher ALD prevalence compared to Non-Hispanic White interviewees (OR: 1.4, 95% CI: 1.1-1.8 and OR: 1.5 95% CI:1.1-2.0, respectively), while Blacks participants had a lower ALD prevalence (OR: .7 95% CI: .6-.9), and a lower risk of mortality during hospitalization due to ALD (OR: .83 95% CI: .73-.94). Finally, a multivariate competing-risk analysis showed that Hispanic ethnicity had a decreased probability of liver transplantation if waitlisted for ALD (SHR: .7, 95% CI: .6-.8) along with female Asian population (HR: .40, 95% CI: .26-.62). CONCLUSIONS: After accounting for key social and biological health determinants, the Hispanic population showed an increased risk of ALD prevalence, even with lower alcohol consumption. Additionally, Hispanic and Asian female patients had reduced access to liver transplantation compared to other enlisted patients.
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Hepatopatías Alcohólicas , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Etnicidad/estadística & datos numéricos , Disparidades en el Estado de Salud , Hepatopatías Alcohólicas/etnología , Modelos Logísticos , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Estados Unidos/epidemiología , Grupos Raciales/estadística & datos numéricosRESUMEN
UV filters in current sunscreen formulations can have negative effects on human health, such as endocrine disruption and allergic reactions, as well as on the environment, including bioaccumulation and coral health toxicity. As a result, there is a need to find alternative compounds that serve as safer and more ecofriendly active ingredients. This study successfully isolated actinomycetes from the octocoral Eunicea fusca and assessed their potential as producers of photoprotective compounds. The use of bio-based chemical agents, particularly natural products, has been a highly effective strategy for discovering bioactive compounds, especially in marine invertebrates and their associated microbiota. Eighteen bacterial isolates were obtained and subsequently employed to prepare raw methanolic extracts from seven-day submerged cultures in Zobell marine broth. The resulting extracts were screened for 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical scavenging capacity and characterized by total phenolic and flavonoid content measurements. After screening, the Gordonia hongkongensis EUFUS-Z928-derived raw extract exhibited the best antioxidant profile, i.e. DPPH and ABTS radical scavenging of 4.93 and 6.00 µmol Trolox per gram of extract, respectively, and selected for further photoprotection-related analysis. Thus, this extract demonstrated a UV-absorbing capacity of 46.33% of the in vitro sun protection factor calculated for 30 µg/mL oxybenzone but did not exhibit any cytotoxicity on human dermal fibroblasts (HDFa cell line) at concentrations up to 500 µg/mL. The liquid chromatography-mass spectrometry chemical characterization of this extract showed compounds with structural features associated with free radical scavenging and UV absorption (i.e. photoprotection-related activities). These findings highlighted the potential of the microbiota associated with E. fusca and confirmed the feasibility of exploiting its metabolites for photoprotection-related purposes.
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Antozoos , Protectores Solares , Protectores Solares/farmacología , Protectores Solares/química , Antozoos/microbiología , Animales , Actinobacteria/metabolismo , Actinobacteria/química , Humanos , Rayos Ultravioleta , Antioxidantes/farmacología , Antioxidantes/química , Fenoles/química , Fenoles/farmacología , Flavonoides/química , Flavonoides/farmacologíaRESUMEN
BACKGROUND: Oesophageal disorders and chronic liver disease are common worldwide and significantly impact quality of life. The intricate link between these conditions, including how oesophageal disorders like GERD, Barrett's oesophagus and oesophageal cancer affect and are affected by chronic liver disease, remains poorly understood. AIMS: To review the relationship between oesophageal disorders and chronic liver disease, evaluating epidemiology, pathophysiology and therapeutic factors. METHODS: We reviewed the literature on the relationship between oesophageal disorders and chronic liver disease, including cirrhosis, using the PubMed database RESULTS: Oesophageal disorders such as gastroesophageal reflux disease, Barrett's oesophagus, oesophageal cancer, oesophageal motor disorders and oesophageal candidiasis are prevalent among individuals with cirrhosis, exacerbating the burden of liver disease. These diseases have a multifaceted symptomatology and pathogenic basis, posing a significant challenge in cirrhotic patients that necessitates careful diagnosis and management. Additionally, therapies frequently used for these diseases, such as proton pump inhibitors, require careful consideration in cirrhotic patients due to potential adverse effects and altered pharmacokinetics. Managing oesophageal disorders in cirrhotic patients requires a cautious approach due to possible interactions with medications and the risk of adverse effects. Furthermore, symptoms associated with these conditions are often exacerbated by common interventions in patients with cirrhosis, such as band ligation for oesophageal varices. CONCLUSIONS: Oesophageal disorders are common in cirrhosis and increase the disease burden. These conditions require careful management due to complex symptoms and treatment risks. Proton pump inhibitors and other therapies must be used cautiously, as cirrhosis interventions can worsen symptoms.
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Enfermedades del Esófago , Hepatopatías , Humanos , Enfermedades del Esófago/fisiopatología , Enfermedades del Esófago/etiología , Enfermedades del Esófago/complicaciones , Hepatopatías/complicaciones , Hepatopatías/fisiopatología , Enfermedad Crónica , Cirrosis Hepática/complicaciones , Cirrosis Hepática/fisiopatología , Calidad de Vida , Reflujo Gastroesofágico/complicaciones , Reflujo Gastroesofágico/fisiopatología , Inhibidores de la Bomba de Protones/uso terapéuticoRESUMEN
Many studies have suggested that the encapsulation of natural antimicrobials increases their antimicrobial activity. In this sense, the objective was to study the inactivation of microorganisms with encapsulated cinnamaldehyde and vanillin (E-CIN and E-VN), in comparison with the unencapsulated antimicrobials (CIN and VN) in protein beverages. Additionally, the microbial response was quantified through mathematical modeling. Cinnamaldehyde and vanillin were encapsulated using whey protein concentrate (WPC) as the encapsulating agent. The effectiveness at inactivating Escherichia coli, Listeria innocua, and Saccharomyces cerevisiae was evaluated in a protein-apple juice beverage during storage (4 °C). Encapsulation increased the effectiveness of cinnamaldehyde, reaching reductions of 1.8, 3.3, and 5.3 log CFU/mL in E. coli, L. innocua, and S. cerevisiae, respectively, while vanillin encapsulation had little effect on antimicrobial activity, reducing by 0.5, 1.4, and 1.1 log cycles, respectively. The combined treatments (E-CIN + E-VN) had an additive effect in reducing E. coli and a synergistic effect against S. cerevisiae. The Gompertz model was more versatile and better described the biphasic curves, whereas the Weibull model complemented the information regarding the spectrum of resistances within the microbial population. In conclusion, the encapsulation of cinnamaldehyde with WPC enhanced its activity. However, further studies are necessary to improve the antimicrobial activity of vanillin.
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RESUMO Eleusine indica é uma planta daninha de difícil controle com herbicidas pós-emergentes devido ao curto intervalo entre a emergência e o perfilhamento, em que o controle é mais limitado. Ademais, o surgimento de biótipos resistentes motiva realizar trabalhos desta natureza para encontrar mais opções de controle químico. O objetivo desta investigação foi avaliar a eficiência de herbicidas pós-emergentes no controle do capim-pé-de-galinha em dois estádios fenológicos. O trabalho foi realizado em vasos a céu aberto num delineamento inteiramente casualizado, com onze herbicidas aplicados em dois experimentos: um experimento na espécie com quatro folhas (pré-perfilhamento) e outro na planta com oito folhas (em perfilhamento). Foram atribuídas notas visuais de controle aos 7, 14 e 21 dias após a aplicação, coletando a parte aérea da planta na última avaliação para obter a massa seca. Com esses dados foi realizada a análise de variância e a comparação de médias com o teste Tukey a um nível de significância de 0,05. Dos herbicidas testados, pyroxsulam, mesotrione y nicossulfuron controlaram menos do 80 % da população com quatro folhas. No perfilhamento, pyroxsulam, mesotrione, nicossulfuron y tembotrione mostraram controle menor ou igual a 65 %. Independentemente do estádio fenológico, clethodim, haloxifop, amônio-glufosinato, glyphosate, paraquat, indaziflam e ametrina foram efetivos, com mais de 88 % de controle da espécie.
ABSTRACT Eleusine indica is difficult to control with post-emergence herbicides due to the short interval between emergence and tillering, which control is more limited. Furthermore, the emergence of resistant biotypes motivates research on this type to find more options for chemical control. The objective of this work was to evaluate the efficiency of post-emergence herbicides in the goosegrass control in two phenological stages. The work was carried out in pots in a completely randomized design with eleven herbicides applied in two experiments: one with plants of four leaves (pre-tillering) and another with plants of eight leaves (in tillering). Visual control notes were assigned at 7, 14, and 21 days after application, collecting the aerial part of the plant in the last evaluation to obtain the dry weight. With these data, variance analysis and means comparison were performed using Tukey's test at a significance level of 0,05. As a principal result, pyroxsulam, mesotrione, and nicosulfuron controlled less than 80 % of the four-leaf population. At tillering, pyroxsulam, mesotrione, nicosulfuron, and tembotrione showed less than or equal to 65 % of control. Regardless of phenological stage, clethodim, haloxyfop, glufosinate ammonium, glyphosate, paraquat, indaziflam, and ametrine were effective, with more than 88 % of control of the species.
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This research assessed the feasibility of adding Cochayuyo seaweed flour (at 30, 50, and 70% levels) to rice flour-based paste to improve its 3D printing quality. The paste's rheological properties, printing quality, texture profile, thermal properties, and color of 3D-printed foods were explored. Results showed that pastes with Cochayuyo addition exhibited shear-thinning behavior, and viscosity increased with increased Cochayuyo concentration. Viscoelastic properties and a Texture Profile Analysis (TPA) revealed that Cochayuyo improved mechanical strength and made the paste easier to flow, improving printed food's extrudability, fidelity, and shape retention, which was better observed in RC50 and RC70 printed at 15 mm s-1. A differential scanning calorimetry (DSC) analysis showed a partial substitution of rice flour for Cochayuyo flour in the formulation. This increased the onset and melting peak temperatures and reduced the enthalpy of fusion. CIE color parameters a*, b*, and L* showed that Cochayuyo addition increased the color to yellow and red; however, lightness was considerably reduced. Therefore, Cochayuyo flour could have the potential to be used for the manufacture improvement of 3D-printed food with better rheological, mechanical, thermal, printing quality, and nutritional properties, making possible the exploitation of the native Cochayuyo seaweed, which is highly available in Chile.
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Only 0.1% of polyurethanes available on the market are from renewable sources. With increasing concern about climate change, the substitution of monomers derived from petrochemical sources and the application of eco-friendly synthesis processes is crucial for the development of biomaterials. Therefore, polyhydroxyurethanes have been utilized, as their synthesis route allows for the carbonation of vegetable oils with carbon dioxide and the substitution of isocyanates known for their high toxicity, carcinogenicity, and petrochemical origin. In this study, polyhydroxyurethanes were obtained from carbonated soybean oil in combination with two diamines, one that is aliphatic (1,4-butadiamine (putrescine)) and another that is cycloaliphatic (1,3-cyclohexanobis(methylamine)). Four polyhydroxyurethanes were obtained, showing stability in hydrolytic and oxidative media, thermal stability above 200 °C, tensile strength between 0.9 and 1.1 MPa, an elongation at break between 81 and 222%, a water absorption rate up 102%, and contact angles between 63.70 and 101.39. New formulations of bio-based NIPHUs can be developed with the inclusion of a cycloaliphatic diamine (CHM) for the improvement of mechanical properties, which represents a more sustainable process for obtaining NIPHUs with the physicochemical, mechanical, and thermal properties required for the preparation of wound dressings.
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There has been very limited investigation regarding the genetic diversity of Mycobacterium tuberculosis (MTb) strains isolated from human immunodeficiency virus (HIV)-infected patients in Mexico. In this study, we isolated 93 MTb strains from pulmonary and extrapulmonary samples of HIV-infected patients treated in a public hospital in Mexico City to evaluate the genetic diversity using spoligotyping and mycobacterial interspersed repetitive unit-variable-number tandem-repeat (MIRU-VNTR) typing (based on 24 loci). The cohort comprised 80 male and 13 female individuals. There was a positive correlation between a high HIV viral load (>100,000 copies) and extrapulmonary tuberculosis (TB) (r = 0.306, p = 0.008). Lineage 4 was the most frequent lineage (79 strains). In this lineage, we found the H clade (n = 24), including the Haarlem, H3, and H1 families; the T clade (n = 22), including T1 and T2; the X clade (n = 15), including X1 and X3; the LAM clade (n = 14), including LAM1, LAM2, LAM3, LAM6, and LAM9; the S clade (n = 2); Uganda (n = 1); and Ghana (n = 1). We also found 12 strains in the EAI clade belonging to lineage 1, including the EAI2-Manila and EAI5 families. Interestingly, we identified one strain belonging to the Beijing family, which is part of lineage 2. One strain could not be identified. This study reports high genetic diversity among MTb strains, highlighting the need for a molecular epidemiological surveillance system that can help to monitor the spread of these strains, leading to more appropriate measures for TB control in HIV-infected patients.
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The current emphasis within the cosmetic market on sustainable ingredients has heightened the exploration of new sources for natural, active components. Actinomycetota, recognized for producing pigments with bioactive potential, offer promising functional cosmetic ingredients. This study aimed to optimize pigment and antioxidant metabolite production from the Gordonia hongkongensis strain EUFUS-Z928 by implementing the Plackett-Burman experimental design and response surface methodology. Extracts derived from this strain exhibited no cytotoxic activity against human primary dermal fibroblast (HDFa, ATCC® PCS-201-012™, Primary Dermal Fibroblast; Normal, Human, Adult). Eight variables, including inoculum concentration, carbon and nitrogen source concentration, NaCl concentration, pH, incubation time, temperature, and stirring speed, were analyzed using the Plackett-Burman experimental design. Subsequently, factors significantly influencing pigment and antioxidant metabolite production, such as temperature, inoculum concentration, and agitation speed, were further optimized using response surface methodology and Box-Behnken design. The results demonstrated a substantial increase in absorbance (from 0.091 to 0.32), DPPH radical scavenging capacity (from 27.60% to 84.61%), and ABTS radical scavenging capacity (from 17.39% to 79.77%) compared to responses obtained in the isolation medium. The validation of the mathematical model accuracy exceeded 90% for all cases. Furthermore, liquid chromatography coupled with mass spectrometry (LC-MS) facilitated the identification of compounds potentially responsible for enhanced pigment production and antioxidant capacity in extracts derived from G. hongkongensis. Specifically, six carotenoids, red-orange pigments with inherent antioxidant capacity, were identified as the main enhanced compounds. This comprehensive approach effectively optimized the culture conditions and medium of a G. hongkongensis strain, resulting in enhanced carotenoid production and antioxidant capacity. Beyond identifying bioactive compounds and their potential cosmetic applications, this study offers insights into the broader industrial applicability of these extracts. It underscores the potential of G. hongkongensis and hints at the future utilization of other untapped sources of rare actinomycetes within the industry.
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Antioxidantes , Carotenoides , Antioxidantes/metabolismo , Antioxidantes/química , Carotenoides/metabolismo , Carotenoides/química , Humanos , Fibroblastos/metabolismo , Fibroblastos/efectos de los fármacos , Bacteria Gordonia/metabolismoRESUMEN
Introduction: Infections in patients with cirrhosis are associated with high morbidity and mortality. Rifaximin is an antibiotic used to treat and prevent hepatic encephalopathy (HE); however, it has been suggested that it may play a crucial role in reducing infections in these populations. Aim: To evaluate the role of rifaximin in preventing frequent cirrhosis-related infections [spontaneous bacterial peritonitis, pneumonia, urinary tract infection (UTI), and bacteremia], Clostridioides difficile infection, and all-cause mortality, as well as determining adverse effects and adherence to the drug. Methods: A retrospective cohort study was conducted on decompensated cirrhotic patients with history of HE between January 2017 and November 2022 at a university center. Patients with cirrhosis, regardless of their etiology and severity, were included in the study, encompassing both hospitalized and outpatient cases. The statistical analysis included adjusted general linear models, Poisson regressions, and propensity score matching. Results: We included 153 patients. The mean age in the cohort was 60.2 ± 12.3 years and 67 (43.8%) were women. The main cause of cirrhosis was metabolic dysfunction-associated steatotic liver disease 52 (38%), and the median Model of End-Stage Liver Disease sodium was 16.5 (7-32). In the cohort, 65 (45%) patients used rifaximin. The mean follow-up was 32 months. Eighty-five patients with infectious events were recorded, and a total of 164 infectious events were registered. The main infectious events were UTIs (62, 37.8%) and pneumonia (38, 23.2%). The use of rifaximin was associated with lower infection rates, displaying an incidence rate ratio (IRR) of 0.64 [95% confidence interval (CI) (0.47-0.89); p = 0.008]. However, no discernible impact on mortality outcome was observed [IRR 1.9, 95% CI (0.9-4.0); p = 0.09]. There were no reported adverse effects, and no patient discontinued the therapy due to adverse effects. Conclusion: The use of rifaximin significantly reduces infections in patients with cirrhosis and HE. Despite rifaximin was associated with a decreased all-cause mortality, this impact was not statistically significant in the adjusted analysis.
Assessing the impact of rifaximin on infections in cirrhosis This study aimed to investigate the role of rifaximin, an antibiotic commonly used to treat hepatic encephalopathy, in preventing infections and mortality in patients with cirrhosis. The retrospective cohort study included 153 decompensated cirrhotic patients with a history of hepatic encephalopathy, covering the period from January 2017 to November 2022 at a university center. Results showed that 45% of the patients in the cohort used rifaximin, and the mean follow-up duration was 32 months. A total of 164 infectious events were recorded during the study, with urinary tract infections (37.8%) and pneumonia (23.2%) being the most common. The use of rifaximin was associated with a significant reduction in infection rates, with an incidence rate ratio of 0.64 (95% CI [0.47-0.89]; p=0.008). However, there was no statistically significant impact on all-cause mortality (IRR 1.9, 95% CI [0.9-4.0]; p=0.09). Notably, no adverse effects were reported, and no patient discontinued rifaximin therapy due to adverse effects. In conclusion, rifaximin demonstrated a noteworthy reduction in infections among cirrhotic patients with hepatic encephalopathy. Although a decrease in all-cause mortality was observed with rifaximin use, this effect did not reach statistical significance in the adjusted analysis. The study supports the potential benefits of rifaximin in preventing infections in this vulnerable patient population without apparent adverse effects. Further research may provide additional insights into the long-term impact of rifaximin on mortality outcomes in cirrhotic patients.
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En el ámbito de las tecnologías no térmicas para el procesamiento de alimentos, la aplicación de plasma frío destaca por su rápido crecimiento y amplias proyecciones. El plasma frío se genera aplicando energía que ioniza un gas específico, lo que produce especies altamente reactivas como las reactivas de oxígeno y nitrógeno, además de ozono, iones, radicales libres y radiación ultravioleta. Las configuraciones más comunes para su generación incluyen la descarga de barrera dieléctrica y la descarga corona. Sus aplicaciones y efectos clave abarcan la destrucción de biofilms, inactivación de microorganismos, descontaminación de micotoxinas, degradación de pesticidas y modificación de almidones, entre otros. Los mecanismos de acción propuestos varían desde modificaciones químicas y moleculares hasta lisis celular y daño genético. Este artículo proporciona una visión general actualizada sobre los principios, generación y aplicaciones del plasma frío en la industria alimentaria.
In the field of non-thermal food processing technologies, the application of cold plasma stands out for its rapid growth and broad prospects. Cold plasma is generated by applying energy to ionize a specific gas, producing highly reactive species such as reactive oxygen and nitrogen species, as well as ozone, ions, free radicals, and ultraviolet radiation. The most common configurations for generating cold plasma include dielectric barrier discharge and corona discharge. Key applications and effects include the destruction of biofilms, inactivation of microorganisms, decontamination of mycotoxins, degradation of pesticides, and modification of starches, among others. Proposed mechanisms of action range from chemical and molecular modifications to cellular lysis and genetic damage. This article provides an updated overview of the principles, generation, and applications of cold plasma technology in the food industry.
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Alcohol-associated liver disease (ALD) represents one of the deadliest yet preventable consequences of excessive alcohol use. It represents 5.1 % of the global burden of disease, mainly involving the productive-age population (15-44 years) and leading to an increased mortality risk from traffic road injuries, suicide, violence, cardiovascular disease, neoplasms, and liver disease, among others, accounting for 5.3 % of global deaths. Daily alcohol consumption, binge drinking (BD), and heavy episodic drinking (HED) are the patterns associated with a higher risk of developing ALD. The escalating global burden of ALD, even exceeding what was predicted, is the result of a complex interaction between the lack of public policies that regulate alcohol consumption, low awareness of the scope of the disease, late referral to specialists, underuse of available medications, insufficient funds allocated to ALD research, and non-predictable events such as the COVID-19 pandemic, where increases of up to 477 % in online alcohol sales were registered in the United States. Early diagnosis, referral, and treatment are pivotal to achieving the therapeutic goal in patients with alcohol use disorder (AUD) and ALD, where complete alcohol abstinence and prevention of alcohol relapse are expected to enhance overall survival. This can be achieved through a combination of cognitive behavioral, motivational enhancement and pharmacological therapy. Furthermore, the appropriate use of available pharmacological therapy and implementation of public policies that comprehensively address this disease will make a real difference.
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COVID-19 , Salud Global , Hepatopatías Alcohólicas , Humanos , Hepatopatías Alcohólicas/epidemiología , Hepatopatías Alcohólicas/terapia , COVID-19/epidemiología , COVID-19/prevención & control , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Factores de Riesgo , Carga Global de Enfermedades , SARS-CoV-2 , Abstinencia de AlcoholAsunto(s)
Factor Estimulante de Colonias de Granulocitos , Hepatitis Alcohólica , Regeneración Hepática , Humanos , Hepatitis Alcohólica/tratamiento farmacológico , Regeneración Hepática/efectos de los fármacos , Regeneración Hepática/fisiología , Factor Estimulante de Colonias de Granulocitos/uso terapéuticoAsunto(s)
Enfermedades Cardiovasculares , Política de Salud , Hepatopatías , Neoplasias , Servicio Social , Humanos , Enfermedades Cardiovasculares/mortalidad , Enfermedades Cardiovasculares/prevención & control , Hepatopatías/mortalidad , Neoplasias/mortalidad , Servicio Social/organización & administración , Salud Pública/métodosRESUMEN
INTRODUCTION: Metabolic bone disease of premature infants is a rare complication characterized by a lower mineral content in bone tissue. OBJECTIVE: To establish the incidence of metabolic bone disease in premature infants and to determine associated risk factors. MATERIALS AND METHOD: We conducted a descriptive prospective cohort study for one year in all newborns under 32 gestational weeks, or 1,500 g, at the Hospital Universitario de Santander to determine the incidence of metabolic bone disease. We collected demographic data and prenatal histories of the selected patients, and later, we measured serum alkaline phosphatase and serum phosphorus at the third week of birth, having as reference values for diagnosis less than 5.6 mg/dl for the first one and more than 500 UI/L for the second one. We applied statistical tools for data analysis, such as average proportions, dispersion, distribution and association measures, and binomial regression. RESULTS: From a total of 58 patients, 7 had a diagnosis of metabolic bone disease, with an incidence of 12%. The weight was reported as an independent variable for the development of the disease, being significant in children under 1,160 g, as well as prolonged parenteral nutrition for more than 24 days. When performing the multivariate analysis, low weight and short time of parenteral nutrition appeared as risk factors; in the same way, maternal age below 22 years is associated with a higher relative risk, even more than a newborn weight inferior to 1,160 g. CONCLUSION: Establishing an early intervention in patients with metabolic bone disease enhancing risk factors, such as low weight and prolonged parenteral nutrition, is critical to prevent severe complications.
Introducción. La enfermedad metabólica ósea de neonatos prematuros es una complicación poco común que se caracteriza por una disminución del contenido mineral en el hueso. Objetivo. Establecer la incidencia de la enfermedad metabólica ósea en neonatos prematuros y los factores de riesgo asociados. Materiales y métodos. Durante un año, se realizó un estudio prospectivo de cohorte, descriptivo, con todos los neonatos nacidos con menos de 32 semanas de gestación o un peso menor de 1.500 g en el Hospital Universitario de Santander. Se recolectaron datos demográficos y antecedentes prenatales de los pacientes seleccionados. A la tercera semana de nacimiento, se midieron la fosfatasa alcalina y el fósforo sérico, tomando como valores de referencia diagnóstica aquellos inferiores a 5,6 mg/dl para el primero y aquellos mayores de 500 UI/L para la segunda. Para el análisis de la información, se emplearon herramientas estadísticas, como proporciones de promedios, medidas de dispersión, distribución y asociación, y regresión binomial. Resultados. De un total de 58 pacientes, 7 tuvieron diagnóstico de enfermedad metabólica ósea, con una incidencia del 12 %. De las variables estudiadas, el peso se reportó como una variable independiente para el desarrollo de la enfermedad, significativa en aquellos neonatos con peso menor de 1.160 g, al igual que la nutrición parenteral prolongada por más de 24 días. Al hacer el análisis multivariado, La edad materna menor de 22 años representó un riesgo relativo mayor, en comparación con un peso inferior a 1.160 g. Conclusión. Se estableció la importancia de una intervención temprana en pacientes con factores de riesgo para enfermedad metabólica ósea, como bajo peso (menor de 1.160 g) y nutrición parenteral prolongada (mayor de 24 días), con el fin de prevenir complicaciones graves.
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Enfermedades Óseas Metabólicas , Humanos , Colombia/epidemiología , Recién Nacido , Incidencia , Enfermedades Óseas Metabólicas/epidemiología , Estudios Prospectivos , Femenino , Masculino , Factores de Riesgo , Edad Gestacional , Nutrición Parenteral , Recien Nacido Prematuro , Fosfatasa Alcalina/sangre , Enfermedades del Prematuro/epidemiología , Enfermedades del Prematuro/sangre , Hospitales Universitarios , Fósforo/sangreRESUMEN
Introducción: La infección por SARS-CoV-2 puede presentar síndrome de distrés res-piratorio agudo con requerimiento de ventilación mecánica prolongada y retraso en la realización de traqueostomía. Esto trae como consecuencia un incremento en casos de estenosis traqueal y la necesidad de métodos menos invasivos para su abordaje. Métodos: Estudio descriptivo de corte transversal, desde marzo 2020 hasta diciem-bre 2021 en el Hospital Universitario Nacional de Colombia, en adultos con estenosis traqueal postintubación asociado SARS-CoV-2. Se realizó análisis univariado entre los grupos con infección o no por SARS-CoV-2 como control, y reintervención, grado de estenosis, uso de inyección intramucosa con dexametasona intratraqueal o múltiples estenosis como desenlaces de importancia. Se usó test exacto de Fisher, t Student y Man-Whitney según la naturaleza de variables. Se consideró p estadísticamente significativo menor a 0.05.Resultados: Se identificaron 26 pacientes, 20 tenían COVID-19 y 6 no. Se encontraron diferencias en edad (p=0,002), epilepsia (p=0,007) y estenosis múltiple (p= 0,04). En 85% de los casos se utilizó láser blue más dilatación con balón pulmonar, en 35% inyección intramucosa con dexametasona intratraqueal y reintervención en 35%, sin diferencias significativas entre grupos. Conclusiones: Se observó un incremento tres veces mayor de pacientes con estenosis múltiple en el grupo de infección por COVID-19, así mismo se encontró que el método más utilizado en este grupo para la recanalización fue el uso de láser blue más dilatación con balón pulmonar y la innovación en el uso de inyección intramucosa.
Introduction: SARS-CoV-2 infection can lead to acute respiratory distress syndrome with a prolonged need for mechanical ventilation and delayed tracheostomy, resulting in an increase in cases of tracheal stenosis and the necessity for less invasive approaches.Methods: A descriptive cross-sectional study was conducted from March 2020 to December 2021 at the Hospital Universitario Nacional de Colombia, focusing on adults with post-intubation tracheal stenosis associated with SARS-CoV-2. Univariate analysis was performed between groups with or without SARS-CoV-2 infection as a control, considering reintervention, degree of stenosis, use of intratracheal steroids, or multiple stenoses as important outcomes. Fisher's exact test, Student's t-test, and Mann-Whit-ney test were employed based on the nature of variables. A p-value less than 0.05 was considered statistically significant.Results: A total of 26 patients were included, with 20 having COVID-19 and 6 without. Significant differences were found in age (p=0.002), epilepsy (p=0.007), and multiple stenosis (p=0.04). In 85% of cases, laser blue plus balloon pulmonary dilation was used, intratracheal dexamethasone in 35%, and reintervention in 35%, with no significant differences between groups.Conclusions: A threefold increase in subglottic stenosis was observed during the SARS-CoV-2 pandemic, with more instances of multiple stenosis and predominantly the use of laser blue plus balloon pulmonary dilation as a successful recanalization technique. There was a higher use of intratracheal dexamethasone in this group compared to oth-er pathologies causing tracheal stenosis.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Síndrome de Dificultad Respiratoria del Recién Nacido , Estenosis Traqueal/complicaciones , Disnea , COVID-19/complicaciones , Respiración Artificial/métodos , Broncoscopía/métodos , Traqueostomía/métodos , Colombia , SARS-CoV-2RESUMEN
BACKGROUND: Drug-resistant tuberculosis (TB) is associated with higher mortality rates in patients with human immunodeficiency virus (HIV). In Mexico, the number of deaths due to TB among the HIV-positive population has tripled in recent years. METHODS: Ninety-three Mycobacterium tuberculosis strains isolated from the same number of HIV-infected patients treated in a public hospital in Mexico City were studied to determine the drug resistance to first- and second-line anti-TB drugs and to identify the mutations associated with the resistance. RESULTS: Of the 93 patients, 82.7% were new TB cases, 86% were male, and 73% had extrapulmonary TB. Most patients (94%) with a CD4 T-lymphocyte count <350 cells/mm3 were associated with extrapulmonary TB (p <0.0001), whilst most patients (78%) with a CD4 T-lymphocyte count >350 cells/mm3 were associated with pulmonary TB (p = 0.0011). Eighty-two strains were pan-susceptible, four mono-resistant, four poly-resistant, two multidrug-resistant, and one was extensively drug-resistant. In the rifampicin-resistant strains, rpoB S531L was the mutation most frequently identified, whereas the inhA C15T and katG S315T1 mutations were present in isoniazid-resistant strains. The extensively drug-resistant strain also contained the mutation gyrA D94A. CONCLUSIONS: These data highlight the need to promptly diagnose the drug resistance of M. tuberculosis among all HIV-infected patients by systematically offering access to first- and second-line drug susceptibility testing and to tailor the treatment regimen based on the resistance patterns to reduce the number of deaths in HIV-infected patients.