RESUMEN
One of the most common respiratory chronic diseases is asthma, with 5-16 % of world prevalence. In chronic disease, prevention, diagnosis, management, and palliation are the strategies for a care model; the patient-self management is fundamental with the so-called therapeutic education (TE) to train the patient in the necessary skills. The challenge of TE grows when the patient is a child or a person with special needs, even more in public health care in low- and middle-income countries. This is a problematic human situation, that needs soft system thinking. In this research, the analytic hierarchy process was used to determine the perceived importance of the factors that affect children's asthma health care in a public health institution in Mexico. The soft systems methodology (SSM) was applied to learn about the disease self-management, in order to obtain activities models and an action plan. According to AHP, human resources and education were percived as the most important among the factors that affect children health care within the institution. The perceived importance of two main subfactors (human resources training and TE) was around 34 %, which emphasizes the need to generate strategies for the improvement of the education of patients and health care providers. In MSS, the rich vision, the CATWOE, the root definition, and an activities model were proposed, including the application of an instructional design methodology (ADDIE) for the development of learning objects of asthma for children. Desirable and feasible actions and recommendations include the update of the national clinical practice guides, the use of control measures such as the Asthma Control Test, and a daily asthma diary to register the daily status of the breathing capacity, the drug administration, and the potential trigger events. The proposed model can be used as part of a systemic patient-and-family centered approach for chronic care model (CCM), particularly in diseases unsuitable for prevention interventions.
Asunto(s)
Asma , Educación del Paciente como Asunto , Automanejo , Humanos , Asma/terapia , Niño , Educación del Paciente como Asunto/métodos , Automanejo/educación , Automanejo/métodos , México , Femenino , Masculino , AutocuidadoRESUMEN
Complementary feeding (CF) is defined as the feeding of infants that complements breastfeeding, or alternatively, feeding with a breast milk substitute, and is a process that is more than simply a guide as to what and how to introduce foods. The information provided by healthcare professionals must be up-to-date and evidence-based. Most of the recommendations that appear in the different international guidelines and position papers are widely applicable, but some must be regionalized or adapted to fit the conditions and reality of each geographic zone. The Nutrition Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) summoned a group of experts from each of the society's member countries, to develop a consensus on CF, incorporating, whenever possible, local information adapted to the reality of the region. The aim of the present document is to show the results of that endeavor. Utilizing the Delphi method, a total of 34 statements on relevant aspects of CF were evaluated, discussed, and voted upon.
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Gastroenterología , Lactante , Niño , Femenino , Humanos , Cocos , Consenso , América Latina , Fenómenos Fisiológicos Nutricionales del LactanteRESUMEN
INTRODUCTION: Health-disease processes are established and programmed in the first 1500 days of life, a period in which nutrition and the microbiota play a fundamental role. Feeding practices vary, according to regional sociocultural characteristics. The Early Nutrition Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) established the goal of identifying the main feeding practices in the first 1500 days that were recommended by health professionals in Latin America. MATERIALS AND METHODS: A survey was conducted on the aspects of maternal-infant and young child nutrition during the first 1500 days of life. An open invitation was extended to Latin American healthcare professionals to anonymously answer the online survey. RESULTS: A total of 1284 surveys from participants in 18 Latin American countries were analyzed. The mean age of the participants was 37.14⯱â¯11.1 years, 75.7% were women, 64.7% were physicians, and the rest were nutritionists/nutriologists. A total of 71.4% were familiar with the concept of the first 1000 days of life, 95% answered that exclusive breastfeeding should be carried out up to 6 months of age, and 34.3% responded that complementary feeding should be begun between 4 and 6 months of age. There was scant knowledge regarding nutrition in the pregnant woman. Adherence to traditional complementary feeding practices was evident. CONCLUSIONS: In a group of Latin American healthcare professionals, knowledge about nutrition in the first 1000-1500 days of life of an individual is still incomplete and insufficient, showing the need for continued training of healthcare professionals, with respect to those themes.
Asunto(s)
Lactancia Materna , Fenómenos Fisiológicos Nutricionales del Lactante , Lactante , Niño , Embarazo , Humanos , Femenino , Adulto , Persona de Mediana Edad , Preescolar , Masculino , América Latina , Encuestas y Cuestionarios , Atención a la SaludRESUMEN
Photoacoustic spectroscopy is applied to evaluate the impact of Moringa at different concentrations (0, 1.25, 2.5, 5 and 10%) on the elaboration, sanity, texture, and color of wheat bread. It was found that: i) Photoacoustic signal amplitude values of bread significantly increase from 37 to 90% when moringa powder concentration raises from 1.25% to 10%, at 300 nm wavelength. ii) Comparing the photoacoustic signal values at 300, 330, and 370 nm wavelengths, produced by the different bread types, there were statistically significant differences. iii) The sanitary quality of bread mixed with a 2.5% of moringa is relatively higher than the ones obtained for other concentrations, such that the number of fungal colonies were reduced by 99% in comparison with the control bread without moringa, after six days of storage. Moringa at 2.5% of concentration could thus improve the sanitary quality of wheat bread. iv) The addition of moringa for making bread slows down its textural changes (hardness, elasticity, cohesiveness, resilience, and chewiness) during storage. v) Finally, the highest correlation between the photoacoustic amplitude and the moringa concentration occurs at the wavelengths of 300 and 330 nm, which could be related to significant changes in the content of flavonoids and phenolic acids.
RESUMEN
Dietary fiber intake is one of the most influential and efficacious strategies for modulating the gut microbiota. Said fiber can be digested by the microbiota itself, producing numerous metabolites, which include the short-chain fatty acids (SCFAs). SCFAs have local and systemic functions that impact the composition and function of the gut microbiota, and consequently, human health. The aim of the present narrative review was to provide a document that serves as a frame of reference for a clear understanding of dietary fiber and its direct and indirect effects on health. The direct benefits of dietary fiber intake can be dependent on or independent of the gut microbiota. The use of dietary fiber by the gut microbiota involves several factors, including the fiber's physiochemical characteristics. Dietary fiber type influences the gut microbiota because not all bacterial species have the same capacity to produce the enzymes needed for its degradation. A low-fiber diet can affect the balance of the SCFAs produced. Dietary fiber indirectly benefits cardiometabolic health, digestive health, certain functional gastrointestinal disorders, and different diseases.
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Microbioma Gastrointestinal , Microbiota , Bacterias , Fibras de la Dieta , Ácidos Grasos Volátiles , HumanosRESUMEN
The fumigant and topical activities exhibited by 27 plant-derived essentials oils (EOs) on adult M. domestica housefly are predicted through the Quantitative Structure-Activity Relationship (QSAR) theory. These molecular structure based calculations are performed on 253 structurally diverse compounds from the EOs, where the number of constituents in each essential oil mixture varies between 2 to 24. A large number of 86,048 non-conformational mixture descriptors are derived as linear combinations of the molecular descriptors of the EO components. Two strategies are compared for the mixture descriptor formulation, which consider or avoid the use of the chemical composition. The multivariable linear regression QSAR models of the present work are useful for fumigant and topical applications, describing predictive parallelisms for the insecticidal activity of the analysed complex mixtures.
Asunto(s)
Moscas Domésticas/efectos de los fármacos , Insecticidas/farmacología , Aceites Volátiles/farmacología , Animales , Fumigación , Repelentes de Insectos/química , Repelentes de Insectos/farmacología , Insecticidas/química , Aceites Volátiles/química , Relación Estructura-Actividad CuantitativaRESUMEN
RESUMEN Introducción: Las enfermedades cardiovasculares representan la primera causa de muerte en el mundo. La estimación del Riesgo Cardiovascular (RCV) podría disminuir la carga de la enfermedad y mejorar la calidad de vida de los pacientes. Objetivo: Estimar el RCV en pacientes sin sospecha de cifras tensionales elevadas en una Clínica de Medicina Familiar en la Ciudad de México. Métodos: Estudio transversal descriptivo, participaron 101 pacientes de sexo masculino y femenino, de 40 a 69 años, sin diagnóstico previo de Hipertensión Arterial (HTA), pero que presentaron cifras tensionales altas al momento del estudio. Para diagnosticar HTA se utilizaron los criterios de la Asociación Americana del Corazón-2017. El RCV se evaluó con el ASCVD-Risk Estimator Plus. Resultados: En la muestra la HTA estuvo presente en el 55.4 %, 44.6 % manifestaron presión arterial elevada. Respecto al RCV, 54.4 % presentaron bajo riesgo, 11.8 % riesgo límite, 25.7 % intermedio y 7.9 % alto. Los factores de RCV con mayor prevalencia fueron diabetes mellitus tipo 2 (DM2), sobrepeso, obesidad y elevación de cifras tensionales. Discusión: Un porcentaje importante de participantes presentó RCV en sus diferentes categorías. Se requiere ser más estrictos en los parámetros utilizados para definir la HTA; pues sin intervenciones oportunas las enfermedades cardiovasculares continuarán incrementándose. Conclusión: Cerca de la mitad de los casos presentaron un RCV de límite a alto. Existió alta prevalencia de factores de riesgo individuales como DM2, HTA y dislipidemia. Se deben fortalecer búsquedas intencionadas de pacientes con características similares a las de este estudio para prevenir el desarrollo de enfermedades cardiovasculares.
ABSTRACT Introduction: Cardiovascular diseases are the main cause of death in the world. The estimation of the Cardiovascular Risk (CVR) could both reduce the burden of the illness and improve the quality of life of the patients. Objective: To estimate the CVR in adult patients without a suspicion of having high pressure readings in a Clinic of Family Medicine in Mexico City. Methods: This is a descriptive and transversal study with a sample of 101 male and female patients in the range of 40 to 69 years old, who did not have a previous hypertension diagnosis but who, at the moment of this study, showed high tension readings. The American Heart Association 2017 criteria were used. The cardiovascular risk was assessed using the ASCVD-Risk Estimator Plus. Results: Arterial hypertension readings were found in 55.4 % of the sample. 54.4 % of the sample met the criteria for low risk, 11.8 % for limit risk, 25.7 % for medium risk, and 7.9 % for high risk. The most prevalent factors associated with cardiovascular risk were type 2 diabetes mellitus, overweight, obesity, and hypertension. Discussion: An important percentage of the sample showed cardiovascular risk to some degree, suggesting that perhaps using stricter parameters to define hypertension could prompt more timely interventions. Conclusion: Considering both the high percentage of participants who demonstrated having a cardiovascular risk of concern and the high prevalence of risk factors such as Type 2 Diabetes Mellitus, hypertension, and overweight, timely monitoring interventions should be promoted in order to prevent the development of cardiovascular diseases.
RESUMO Introdução: As doenças cardiovasculares representam a principal causa de morte a nível mundial. A estimativa do risco cardiovascular (RCV) poderia diminuir o peso da doença e melhorar a qualidade de vida dos pacientes. Objetivo: Estimar o RCV em pacientes sem suspeita de tensão arterial elevada em uma Clínica de Medicina Familiar na Cidade do México. Métodos: Um estudo descritivo transversal envolvendo 101 pacientes do sexo masculino e feminino com idades entre os 40 - 69 anos, sem diagnóstico prévio de hipertensão (HTA), mas com tensão arterial elevada no momento do estudo. Os critérios da American Heart Association-2017 foram utilizados para diagnosticar o HTA. O RCV foi avaliado utilizando o ASCVD-Risk Estimator Plus. Resultados: Na amostra, a HTA esteve presente em 55,4 %, 44,6 % reportou tensão arterial elevada. Em relação à RCV, 54,4 % apresentavam baixo risco, 11,8 % risco limite, 25,7 % risco intermédio e 7,9 % alto risco. Os fatores de RCV mais prevalentes foram a diabetes melito tipo 2 (DM2), excesso de peso, obesidade e tensão arterial elevada. Discussão: Uma percentagem significativa de participantes tinha RCV em diferentes categorias. Há necessidade de ser mais rigoroso nos parâmetros utilizados para definir a HTA; sem intervenções atempadas, as doenças cardiovasculares continuarão aumentando. Conclusão: Quase metade dos casos tinham um limite de RCV elevado. Havia uma elevada prevalência de fatores de risco individuais tais como DM2, hipertensão e dislipidemia. A procura intencional de pacientes com características semelhantes às deste estudo deve ser reforçada para prevenir o desenvolvimento de doenças cardiovasculares.
RESUMEN
Translation engineering and bioinformatics have accelerated the rate at which gene sequences can be improved to generate multi-epitope proteins. Strong antigenic proteins for tuberculosis diagnosis include individual ESAT6 and CFP10 proteins or derived peptides. Obtention of heterologous multi-component antigens in E. coli without forming inclusion bodies remain a biotechnological challenge. The gene sequence for ESAT6-CFP10 fusion antigen was optimized by codon bias adjust for high-level expression as a soluble protein. The obtained fusion protein of 23.7 kDa was observed by SDS-PAGE and Western blot analysis after Ni-affinity chromatography and the yield of expressed soluble protein reached a concentration of approximately 67 mg/L in shake flask culture after IPTG induction. Antigenicity was evaluated at 4 µg/mL in whole blood cultures from bovines, and protein stimuli were assessed using a specific in vitro IFN-γ release assay. The hybrid protein was able to stimulate T-cell specific responses of bovine TB suspects. The results indicate that improved E. coli codon usage is a good and cost-effective strategy to potentialize large scale production of multi-epitope proteins with sustained antigenic properties for diagnostic purposes.
Asunto(s)
Antígenos Bacterianos/genética , Proteínas Bacterianas/genética , Mycobacterium bovis/inmunología , Fragmentos de Péptidos/genética , Proteínas Recombinantes de Fusión/administración & dosificación , Vacunas contra la Tuberculosis/administración & dosificación , Tuberculosis Bovina/prevención & control , Secuencia de Aminoácidos , Animales , Antígenos Bacterianos/inmunología , Proteínas Bacterianas/inmunología , Bovinos , Clonación Molecular , Codón , Escherichia coli/genética , Escherichia coli/metabolismo , Expresión Génica , Vectores Genéticos/química , Vectores Genéticos/metabolismo , Histidina/genética , Histidina/metabolismo , Inmunogenicidad Vacunal , Interferón gamma/biosíntesis , Mycobacterium bovis/química , Mycobacterium bovis/genética , Mycobacterium tuberculosis/química , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/inmunología , Oligopéptidos/genética , Oligopéptidos/metabolismo , Fragmentos de Péptidos/inmunología , Proteínas Recombinantes de Fusión/química , Proteínas Recombinantes de Fusión/genética , Proteínas Recombinantes de Fusión/inmunología , Alineación de Secuencia , Vacunas contra la Tuberculosis/genética , Vacunas contra la Tuberculosis/inmunología , Tuberculosis Bovina/inmunología , Tuberculosis Bovina/microbiología , Vacunación/métodosRESUMEN
Aiming to provide cardiovascular morphophysiology information on the Cuniculus paca, an important neotropical rodent, eight healthy adult females of this species were evaluated three times by echocardiography under general anesthesia with isoflurane every 15 days. The exams were performed by a single experienced evaluator with the animals positioned in right and left decubitus. Posteriorly, two expert evaluators measured the cardiac chambers, walls and flow patterns, by B-mode, M-mode, and Doppler ultrasonography. The resulting values were compared among evaluators and periods by the Bland-Altman agreement test and several descriptive statistics were presented for each parameter. Echocardiographic images were obtained between the second and fifth left and right intercostal spaces, enabling the measurement of heart chambers and walls, mitral, tricuspid, aortic and pulmonary valves blood flows, and the ejection and shortening fractions calculation. None of the studied variables showed inter-observers or inter-periods variations. This study provided some normal echocardiographic variables, applicable to epidemiological, pathophysiological or case studies in the Cuniculus paca and phylogenetically close species.(AU)
Com o objetivo de fornecer informações da morfofisiologia cardiovascular da Cuniculus paca, um importante roedor neotropical, oito fêmeas adultas saudáveis dessa espécie foram avaliadas três vezes pela ecocardiografia, sob anestesia geral com isoflurano, a cada 15 dias. Os exames foram realizados por um único avaliador experiente, com os animais posicionados em decúbito direito e esquerdo. Posteriormente, dois avaliadores experientes mediram as câmaras cardíacas, as paredes e os padrões de fluxo, por meio do modo B, do modo M e da ultrassonografia Doppler. Os valores resultantes foram comparados entre avaliadores e períodos pelo teste de concordância de Bland-Altman, e várias estatísticas descritivas foram apresentadas para cada parâmetro. As imagens ecocardiográficas foram obtidas entre o segundo e o quinto espaços intercostais esquerdo e direito, o que permitiu a medição das câmaras e paredes cardíacas, do fluxo sanguíneo pelas válvulas mitral, tricúspide, aórtica e pulmonar e o cálculo das frações de ejeção e encurtamento. Nenhuma das variáveis estudadas mostrou variações entre os avaliadores ou entre os períodos. Este estudo fornece algumas variáveis ecocardiográficas normais, aplicáveis a estudos epidemiológicos, fisiopatológicos ou de casos na Cuniculus paca e em espécies filogeneticamente próximas.(AU)
Asunto(s)
Animales , Femenino , Ecocardiografía/veterinaria , Sistema Cardiovascular , Cuniculidae/anatomía & histologíaRESUMEN
Aiming to provide cardiovascular morphophysiology information on the Cuniculus paca, an important neotropical rodent, eight healthy adult females of this species were evaluated three times by echocardiography under general anesthesia with isoflurane every 15 days. The exams were performed by a single experienced evaluator with the animals positioned in right and left decubitus. Posteriorly, two expert evaluators measured the cardiac chambers, walls and flow patterns, by B-mode, M-mode, and Doppler ultrasonography. The resulting values were compared among evaluators and periods by the Bland-Altman agreement test and several descriptive statistics were presented for each parameter. Echocardiographic images were obtained between the second and fifth left and right intercostal spaces, enabling the measurement of heart chambers and walls, mitral, tricuspid, aortic and pulmonary valves blood flows, and the ejection and shortening fractions calculation. None of the studied variables showed inter-observers or inter-periods variations. This study provided some normal echocardiographic variables, applicable to epidemiological, pathophysiological or case studies in the Cuniculus paca and phylogenetically close species.(AU)
Com o objetivo de fornecer informações da morfofisiologia cardiovascular da Cuniculus paca, um importante roedor neotropical, oito fêmeas adultas saudáveis dessa espécie foram avaliadas três vezes pela ecocardiografia, sob anestesia geral com isoflurano, a cada 15 dias. Os exames foram realizados por um único avaliador experiente, com os animais posicionados em decúbito direito e esquerdo. Posteriormente, dois avaliadores experientes mediram as câmaras cardíacas, as paredes e os padrões de fluxo, por meio do modo B, do modo M e da ultrassonografia Doppler. Os valores resultantes foram comparados entre avaliadores e períodos pelo teste de concordância de Bland-Altman, e várias estatísticas descritivas foram apresentadas para cada parâmetro. As imagens ecocardiográficas foram obtidas entre o segundo e o quinto espaços intercostais esquerdo e direito, o que permitiu a medição das câmaras e paredes cardíacas, do fluxo sanguíneo pelas válvulas mitral, tricúspide, aórtica e pulmonar e o cálculo das frações de ejeção e encurtamento. Nenhuma das variáveis estudadas mostrou variações entre os avaliadores ou entre os períodos. Este estudo fornece algumas variáveis ecocardiográficas normais, aplicáveis a estudos epidemiológicos, fisiopatológicos ou de casos na Cuniculus paca e em espécies filogeneticamente próximas.(AU)
Asunto(s)
Animales , Femenino , Ecocardiografía/veterinaria , Sistema Cardiovascular , Cuniculidae/anatomía & histologíaRESUMEN
Introducción La obesidad materna y una ganancia de peso gestacional superior a lo recomendado pueden colocar a las mujeres y a sus bebés en riesgo de malos resultados de salud, tanto a corto como a largo plazo. Para los profesionales de enfermería es un reto prevenir problemas nutricionales en las gestantes a nivel primario. Resulta indispensable contar con teorías de rango medio propias de enfermería que guíen el cuidado diario. Desarrollo Este artículo presenta el desarrollo de la Teoría de Rango Medio Estado nutricio saludable en la mujer durante la Gestación, desarrollada mediante el método de derivación teórica de Fawcett, sustentado en el Modelo de Promoción de la Salud de Pender y la revisión de la literatura sobre obesidad materna. Esta teoría de rango medio tiene como objetivo explicar como factores personales, cognitivos y conductuales influyen en la mujer para que adopten conductas necesarias que promuevan un estado nutricio saludable durante la gestación. Se ilustran los vínculos entre los conceptos de modelo, los conceptos de la teoría de rango medio y los indicadores empíricos. Conclusiones La teoría de rango medio propuesta puede ayudar a proporcionar atención basada en evidencia y a proponer intervenciones para mejorar el estado nutricio, en particular al personal de enfermería materno infantil debido que tiene un rol importante en el control y seguimiento prenatal
Introduction Maternal obesity and a higher than recommended gestational weight gain can place women and their babies at risk of developing adverse health outcomes both in the short, and in the long term. Because of this, nursing professionals are challenged to within primary level, prevent nutritional unbalances among pregnant women. Therefore, it is necessary to have nursing-own medium range theories which address this type of daily care. Development This article presents the development of a Healthy Nutritional Status Medium Range Theory for women during gestation based on the Fawcett theoretical derivation method, and sustained by Pender's Health Promotion Model and the corresponding maternal obesity literature review. This theory aims to explain how personal, cognitive, and behavioral factors can exert an influence on women so that they adopt conducts which promote a healthy nutritional status during their pregnancy. Links among model related concepts, medium range theory concepts, and empirical indicators are all illustrated. Conclusions The proposed medium range theory can help obstetric nursing staff in the provision of evidence-based attention and corresponding interventions to improve the nutritional status of pregnant women.
Introdução A obesidade materna e um ganho de peso gestacional superior ao aconselhado, podem colocar às mulheres e aos seus bebês em risco de resultados adversos de saúde, tanto a curto quanto a longo prazo. Para os profissionais de enfermagem é um desafio prevenir problemas nutricionais nas gestantes a nível primário. Resulta indispensável contar com teorias de rango médio próprias de enfermagem que orientem o cuidado diário. Desenvolvimento Este artigo apresenta o desenvolvimento da Teoria de Rango Médio Estado nutrício saudável na mulher durante a Gestação, desenvolvida mediante o método de derivação teórica de Fawcett, sustentado no Modelo de Promoção da Saúde de Pender e a revisão da literatura sobre obesidade materna. Esta teoria de rango médio tem como objetivo explicar como fatores pessoais, cognitivos e comportamentais influem na mulher para que adoptem condutas necessárias que promovam um estado nutrício saudável durante a gestação. Ilustram-se as ligações entre os conceitos de modelo, os conceitos da teoria de rango médio e os indicadores empíricos. Conclusões A teoria de rango médio proposta pode ajudar a proporcionar atenção baseada em evidencia e a propor intervenções para melhorar o estado nutrício, no particular ao pessoal de enfermagem materno infantil devido a que tem um papel importante no controle e seguimento pré-natal.
Asunto(s)
Humanos , Femenino , Embarazo , Embarazo , Nutrición, Alimentación y Dieta , Obesidad MaternaRESUMEN
OBJECTIVE: Our goal was to develop a tele-colposcopy platform for primary-care clinics to improve screening sensitivity and access. Specifically, we developed a low-cost, portable Pocket colposcope and evaluated its performance in a tertiary healthcare centre in Peru. DESIGN AND SETTING: Images of the cervix were captured with a standard-of-care and Pocket colposcope at la Liga Contra el Cáncer in Lima, Peru. POPULATION: Two hundred Peruvian women with abnormal cytology and/or human papillomavirus positivity were enrolled. METHODS: Images were collected using acetic acid and Lugol's iodine as contrast agents. Biopsies were taken as per standard-of-care procedures. MAIN OUTCOME MEASURES: After passing quality review, images from 129 women were sent to four physicians who provided a diagnosis for each image. RESULTS: Physician interpretation of images from the two colposcopes agreed 83.1% of the time. The average sensitivity and specificity of physician interpretation compared with pathology was similar for the Pocket (sensitivity = 71.2%, specificity = 57.5%) and standard-of-care (sensitivity = 79.8%, specificity = 56.6%) colposcopes. When compared with a previous study where only acetic acid was applied to the cervix, results indicated that adding Lugol's iodine as a secondary contrast agent improved the percent agreement between colposcopes for all pathological categories by up to 8.9% and the sensitivity and specificity of physician interpretation compared with pathology by over 6.0 and 9.0%, respectively. CONCLUSIONS: The Pocket colposcope performance was similar to that of a standard-of-care colposcope when used to identify precancerous and cancerous lesions using acetic acid and Lugol's iodine during colposcopy examinations in Peru. TWEETABLE ABSTRACT: The Pocket colposcope performance was similar to that of a standard-of-care colposcope when identifying cervical lesions.
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Ácido Acético/farmacología , Colposcopios , Colposcopía , Detección Precoz del Cáncer/métodos , Yoduros/farmacología , Enfermedades del Cuello del Útero/diagnóstico , Adulto , Biopsia/métodos , Colposcopía/instrumentación , Colposcopía/métodos , Medios de Contraste/farmacología , Diseño de Equipo , Femenino , Humanos , Aumento de la Imagen/métodos , Persona de Mediana Edad , Perú/epidemiología , Sistemas de Atención de Punto , Atención Primaria de Salud/métodos , Enfermedades del Cuello del Útero/clasificación , Enfermedades del Cuello del Útero/epidemiologíaRESUMEN
This manuscript describes the design of plasmids containing the genes coding for four main mammalian toxins of scorpions from the genus Centruroides (C.) of Mexico. The genes that code for toxin 2 of C. noxius (Cn2), toxin 2 from C. suffusus (Css2) and toxins 1 and 2 from C. limpidus (Cll1 and Cll2) were included into individual plasmids carrying the genetic construction for expression of fusion proteins containing a leader peptide (pelB) that directs the expressed protein to the bacterial periplasm, a carrier protein (thioredoxin), the cleavage site for enterokinase, the chosen toxin and a poly-histidine tag (6xHis-tag) for purification of the hybrid protein by immobilized metal ion affinity chromatography after expression in Escherichia coli strain BL21 (DE3). The purified hybrid proteins containing the recombinant toxins (abbreviated Thio-EK-Toxin) were used for immunization of three independent groups of ten mice and four rabbits. Challenging the first group of mice, immunized with recombinant Thio-EK-Css2, with three median lethal doses (LD50) of C. suffusus soluble venom resulted in the survival of all the test animals without showing intoxication symptoms. All control mice (none immunized) died. Similar results were obtained with mice previously immunized with Thio-EK-Cn2 and challenged with C. noxius venom. The third group of mice immunized with both Thio-EK-Cll1 and Thio-EK-Cll2 showed an 80% survival ratio when challenged with only one LD50 of C. limpidus venom, all showing symptoms of intoxication. The sera from rabbits immunized with a combination of the four recombinant toxins were collected separately and used to assess their neutralization capacity in vitro (pre-incubating the serum with the respective scorpion venom and injecting the mixture into mice), using six mice for each serum/venom combination tested. The venoms from the six most dangerous scorpion species of Mexico were assayed: C. noxius, C. suffusus, C. limpidus, C. elegans, C. tecomanus and C. sculpturatus. Two hundred and 50 µL of serum from any of the immunized rabbits were enough to neutralize three LD50 of any of the tested venoms, with mice showing no symptoms of intoxication. These results confirm that the recombinant forms of the main toxins from the most dangerous scorpions of Mexico are excellent immunogens for the production of antivenoms to treat scorpion intoxications.
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Antivenenos/química , Proteínas Recombinantes/química , Venenos de Escorpión/química , Escorpiones/química , Secuencia de Aminoácidos , Animales , Antivenenos/genética , Antivenenos/farmacología , Secuencia de Bases , Clonación Molecular , Escherichia coli/genética , Femenino , Inmunización , Dosificación Letal Mediana , México , Ratones , Conejos , Proteínas Recombinantes/genética , Proteínas Recombinantes/farmacología , Venenos de Escorpión/genética , Venenos de Escorpión/farmacología , Alineación de SecuenciaRESUMEN
The aim of this research was to quantify some POPs, such as p,p' DDT, p,p' DDE, and PCBs in agricultural soils of Tlaxcala, Mexico and evaluate their capacity for eliciting DNA damage, using Vicia faba as bioindicator. The values of ΣDDTs and ΣPCBs ranged from 8-24 to 118-26,983 µg/kg, respectively. The samples T1 (HQ = 9.3) and T2 (HQ = 53.9) showed concentrations of ΣPCBs higher than Canadian guidelines (SQGE = 500 µg/kg). The genotoxicity testing produced percentages of DNA fragmentation higher than negative control and statistically significant (p < 0.05), both in agricultural soils and organic extracts. The soils T2, T3, N4, and N5 showed a DICA from 2.6 to 3.1 times, statistically higher (p < 0.05) than negative control. In general, the agricultural soils have greater genotoxic capacity than the organic extracts, suggesting a potential risk to biota that depends upon this ecosystem.
Asunto(s)
DDT/toxicidad , Bifenilos Policlorados/toxicidad , Contaminantes del Suelo/toxicidad , Vicia faba/efectos de los fármacos , Agricultura , DDT/análisis , Fragmentación del ADN/efectos de los fármacos , Monitoreo del Ambiente/métodos , México , Bifenilos Policlorados/análisis , Suelo , Contaminantes del Suelo/análisisRESUMEN
La dermatitis atópica (DA) es una enfermedad inflamatoria crónica de la piel, afecta entre el 1 y el 3% de la población adulta. Se presenta el caso de una mujer de 23 años con antecedentes de asma, rinitis alérgica y dermatitis atópica severa (DAS), con mala respuesta previa a múltiples tratamientos sistémicos, que consultó por exacerbación de su dermatitis y por lesiones papulares progresivas, compatibles con moluscos contagiosos. Destacaba una hiper-eosinofilia y niveles de IgE > 20.000. Por la severidad del cuadro y el estado de inmunosupresión asociado a infección viral extensa, se decide inicio de inmunoglobulina intravenosa (IgIV), con buena respuesta del cuadro cutáneo. Las terapias estándares para la DA se centran en el alivio sintomático y su eficacia clínica, es frecuentemente insuficiente. La IgIV es un tratamiento eficaz en algunas condiciones auto-inflamatorias dermatológicas; existen reportes limitados en el tratamiento de la DAS, principalmente en niños. Otros tratamientos utilizados para estos casos son interferón-gamma y el omalizumab; sin embargo, la evidencia actual es insuficiente y se requieren de más estudios, que demuestren su efectividad en el manejo de la DAS.
Background: atopic dermatitis (AD) is a chronic inflammatory skin disease that affects between 1 to 3% of adults. Case: we report a case of a 23-years old woman with history of asthma, allergic rhinitis and severe atopic dermatitis (SAD), with poor previous response to four systemic treatments. She consulted due to exacerbation of her AD and a four month-course of progressive papular lesions, compatible with molluscum contagiosum. Laboratory evaluation showed hypereosinophilia and IgE levels > 20.000. Because of the severity of the clinical condition and taking in consideration the patient´s immunosupression state, intravenous immunoglobulin (IVIg) 0,4 mg/kg/day was started for five days and three cycles, with good response of her cutaneous lesions. Discussion: the standard therapies for AD are mainly focused on symptomatic relief and its clinical efficacy is often insufficient. The treatment with IVIg is effective in some dermatological autoinflammatory diseases and there are few reports in this matter, especially in children. Other treatments available for these cases are interferon-gamma and omalizumab, but the actual evidence is insufficient and it is required more prospective studies to support their use.
RESUMEN
In this study we assessed the influence of three different environmental salinities (5, 15 and 31 psu during 90 days) on growth, osmoregulation, energy metabolism and digestive capacity in juveniles of the Notothenioid fish Eleginops maclovinus. At the end of experimental time samples of plasma, liver, gill, intestine, kidney, skeletal muscle, stomach and pyloric caeca were obtained. Growth, weight gain, hepatosomatic index and specific growth rate increased at 15 and 31 psu and were lower at 5 psu salinity. Gill Na(+), K(+)-ATPase (NKA) activity presented a "U-shaped" relationship respect to salinity, with its minimum rates at 15 psu, while this activity correlated negatively with salinity at both anterior and posterior intestinal portions. No significant changes in NKA activity were observed in kidney or mid intestine. Large changes in plasma, metabolite levels and enzymatic activities related to energy metabolism in liver, gill, intestine, kidney and muscle were generally found in the groups exposed to 5 and 31 psu compared to the 15 psu group. Only the pepsin activity (digestive enzymes) assessed enhanced with environmental salinity, while pyloric caeca trypsin/chymotrypsin ratio decreased. This study suggests that juvenile of E. maclovinus presents greater growth near its iso-osmotic point (15 psu) and hyperosmotic environment (31 psu). Acclimation to low salinity increased the osmoregulatory expenditure as seen by the gill and anterior intestine results, while at high salinity, branchial osmoregulatory activity was also enhanced. This requires the mobilization of lipid stores and amino acids, thereby holding the growth of fish back. The subsequent reallocation of energy sources was not sufficient to maintain the growth rate of fish exposed to 5 psu. Thus, E. maclovinus juveniles present better growth efficiencies in salinities above the iso-osmotic point and hyperosmotic environment of this species, showing their best performance at 15 psu as seen by the main osmoregulatory and energy metabolism enzymatic activities.