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INTRODUCTION: Acne keloidalis nuchae (AKN) is a primary cicatricial alopecia with mixed infiltrate. It is more common in Africans or persons of African descent. OBJECTIVES: Our objective was to describe the epidemiology and clinical and trichoscopic presentations of AKN in a large series of Hispanic patients. METHODS: This was a retrospective study from 10 different dermatological centers in Argentina, Colombia, Mexico, and Peru. Patients with a clinical diagnosis of AKN treated by 12 dermatologists experienced in trichology from 2018 to 2022 were included. The Umar classification system was used to determine severity. RESULTS: We identified 142 patients with AKN: 98% were male (n=140) with a mean age of 32 years; 108 patients had a previous history of trauma to the nuchal area (76%, P < 0.001); and 48 were positive for a history of acne (33.8%, P = 0.021). Patients with >50 months of evolution were mainly classified in classes III and IV compared to patients with an evolution of <50 months (30%, n=9 vs. 14%, n=15; P = 0.019; respectively). CONCLUSION: AKN should be considered in the differential diagnosis in the Hispanic population. Advanced stages of the disease are correlated with chronic evolution.
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BACKGROUND: Mesenchymal stromal cells (MSCs) tropism for tumours allows their use as carriers of antitumoural factors and in vitro transcribed mRNA (IVT mRNA) is a promising tool for effective transient expression without insertional mutagenesis risk. Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a cytokine with antitumor properties by stimulating the specific immune response. The aim of this work was to generate modified MSCs by IVT mRNA transfection to overexpress GM-CSF and determine their therapeutic effect alone or in combination with doxorubicin (Dox) in a murine model of hepatocellular carcinoma (HCC). METHODS: DsRed or GM-CSF IVT mRNAs were generated from a cDNA template designed with specific primers followed by reverse transcription. Lipofectamine was used to transfect MSCs with DsRed (MSC/DsRed) or GM-CSF IVT mRNA (MSC/GM-CSF). Gene expression and cell surface markers were determined by flow cytometry. GM-CSF secretion was determined by ELISA. For in vitro experiments, the J774 macrophage line and bone marrow monocytes from mice were used to test GM-CSF function. An HCC model was developed by subcutaneous inoculation (s.c.) of Hepa129 cells into C3H/HeN mice. After s.c. injection of MSC/GM-CSF, Dox, or their combination, tumour size and mouse survival were evaluated. Tumour samples were collected for mRNA analysis and flow cytometry. RESULTS: DsRed expression by MSCs was observed from 2 h to 15 days after IVT mRNA transfection. Tumour growth remained unaltered after the administration of DsRed-expressing MSCs in a murine model of HCC and MSCs expressing GM-CSF maintained their phenotypic characteristic and migration capability. GM-CSF secreted by modified MSCs induced the differentiation of murine monocytes to dendritic cells and promoted a proinflammatory phenotype in the J774 macrophage cell line. In vivo, MSC/GM-CSF in combination with Dox strongly reduced HCC tumour growth in C3H/HeN mice and extended mouse survival in comparison with individual treatments. In addition, the tumours in the MSC/GM-CSF + Dox treated group exhibited elevated expression of proinflammatory genes and increased infiltration of CD8 + T cells and macrophages. CONCLUSIONS: Our results showed that IVT mRNA transfection is a suitable strategy for obtaining modified MSCs for therapeutic purposes. MSC/GM-CSF in combination with low doses of Dox led to a synergistic effect by increasing the proinflammatory tumour microenvironment, enhancing the antitumoural response in HCC.
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Carcinoma Hepatocelular , Doxorrubicina , Fator Estimulador de Colônias de Granulócitos e Macrófagos , Neoplasias Hepáticas , Células-Tronco Mesenquimais , RNA Mensageiro , Animais , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/genética , Células-Tronco Mesenquimais/metabolismo , Camundongos , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/genética , RNA Mensageiro/metabolismo , RNA Mensageiro/genética , Doxorrubicina/farmacologia , Doxorrubicina/uso terapêutico , Fator Estimulador de Colônias de Granulócitos e Macrófagos/genética , Fator Estimulador de Colônias de Granulócitos e Macrófagos/metabolismo , Linhagem Celular Tumoral , Transplante de Células-Tronco Mesenquimais/métodos , Humanos , Camundongos Endogâmicos C3H , TransfecçãoRESUMO
Emerging evidence suggests that resistance training (RT) can mitigate respiratory muscle weakness in hemodialysis (HD) patients. However, the underlying mechanisms responsible for these beneficial effects remain unclear. The purpose of this study was to assess the impact of periodized RT on respiratory muscle strength and its relationship with handgrip strength (HGS), fat-free mass (FFM), nitric oxide (NO), and interdialytic weight gain (IWG) in HD patients. Thirty-three patients were randomly assigned to two groups: control (CTL; n=18) and RT (n=15). The RT group did not perform any additional exercise training specific to the respiratory tract. Maximal inspiratory (MIP) and expiratory (MEP) pressures, peak expiratory flow (PEF), HGS, FFM, NO, and IWG were measured before and after the intervention period. Participants in the RT group engaged in a 24-week RT program, three times per week. RT resulted in significant improvements in MIP, MEP, PEF, as well as enhancements in HGS, FFM, NO, and IWG (p<0.05). Notably, inverse correlations were observed between MIP (r=-0.37, p=0.03) and PEF (r=-0.4, p=0.02) with IWG. Thus, the amelioration of HGS and FFM coincided with a reduction in respiratory muscle weakness among HD patients. Decreased IWG and increased circulating NO are plausible mechanisms contributing to these improvements.
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INTRODUCTION: measuring the severity of traumatic injuries is crucial for predicting clinical outcomes. Whereas the Injury Severity Score (ISS) has limitations in assigning scores to injuries at the same site, the New Injury Severity Score (NISS) corrects for this problem by taking into account the three most severe injuries regardless of the region of the body. This study seeks to comprehend the clinical and epidemiological profile of trauma patients while comparing the effectiveness of scales for predicting mortality. METHODS: a descriptive, observational and retrospective study using records of patients who underwent thoracotomy at the Hospital das Clínicas of the Federal University of Triângulo Mineiro between 2000 and 2019. Demographic data, mechanisms of injury, affected organs, length of stay and mortality were analyzed. Injury severity was assessed using the ISS and NISS, and statistical analyses were conducted using MedCalc and SigmaPlot. RESULTS: 101 patients were assessed, on average 29.6 years old, 86.13% of whom were men. The average duration of hospitalization was 10.9 days and the mortality rate was 28.7%. The ROC curve analysis revealed a sensitivity of 68.97%, specificity of 80.56% and area under the curve of 0.837 for the ISS, and 58.62%, 94.44% and 0.855 for the NISS, respectively. The Youden index was 0.49 for the ISS and 0.53 for the NISS. CONCLUSION: the study demonstrated comparable efficacy of NISS and ISS in predicting mortality. These findings hold significance in the hospital setting. Professionals must be familiar with these scales to utilize them competently for each patient.
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Escala de Gravidade do Ferimento , Centros de Atenção Terciária , Traumatismos Torácicos , Humanos , Masculino , Feminino , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos , Traumatismos Torácicos/mortalidade , Traumatismos Torácicos/classificação , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Tempo de Internação/estatística & dados numéricos , Curva ROC , Brasil/epidemiologia , IdosoRESUMO
BACKGROUND: Osteosarcoma (OS) stands out as the most common bone tumor, with approximately 20% of the patients receiving a diagnosis of metastatic OS at their initial assessment. A significant challenge lies in the frequent existence of undetected metastases during the initial diagnosis. Mesenchymal stem cells (MSCs) possess unique abilities that facilitate tumor growth, and their interaction with OS cells is crucial for metastatic spread. METHODS AND RESULTS: We demonstrated that, in vitro, MSCs exhibited a heightened migration response toward the secretome of non-metastatic OS cells. When challenged to a secretome derived from lungs preloaded with OS cells, MSCs exhibited greater migration toward lungs colonized with metastatic OS cells. Moreover, in vivo, MSCs displayed preferential migratory and homing behavior toward lungs colonized by metastatic OS cells. Metastatic OS cells, in turn, demonstrated an increased migratory response to the MSCs' secretome. This behavior was associated with heightened cathepsin D (CTSD) expression and the release of active metalloproteinase 2 (MMP2) by metastatic OS cells. CONCLUSIONS: Our assessment focused on two complementary tumor capabilities crucial to metastatic spread, emphasizing the significance of inherent cell features. The findings underscore the pivotal role of signaling integration within the niche, with a complex interplay of migratory responses among established OS cells in the lungs, prometastatic OS cells in the primary tumor, and circulating MSCs. Pulmonary metastases continue to be a significant factor contributing to OS mortality. Understanding these mechanisms and identifying differentially expressed genes is essential for pinpointing markers and targets to manage metastatic spread and improve outcomes for patients with OS.
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Neoplasias Ósseas , Osteossarcoma , Animais , Humanos , Metaloproteinase 2 da Matriz/genética , Metaloproteinase 2 da Matriz/metabolismo , Proliferação de Células/genética , Pulmão/metabolismo , Osteossarcoma/genética , Osteossarcoma/patologia , Células Estromais/patologia , Neoplasias Ósseas/metabolismo , Linhagem Celular Tumoral , Microambiente TumoralRESUMO
Aging is an inevitable process that can be associated with cognitive impairment. Evidence about the simultaneous evaluation of psychosocial variables that could be associated with cognitive function is crucial. We aimed to determine the association between psychosocial characteristics and cognition in adults over 50 years in Mexico. The fifth round of the Mexican Health and Aging Study (MHAS) (2018) provides the basis for this paper. The study is part of a longitudinal analysis, for which wave pasting 2012, 2015, and 2018 were performed. The final sample comprised 6,709 individuals. Ten psychosocial variables were measured through scales or specific questions. Cognition was assessed with the Cross-Cultural Cognitive Examination (CCCE). Confounders included sociodemographics, multimorbidity, and functionality. The analysis was performed by adjusting the regression model. Of the total sample, 2,761 (41.1%) were men; 3,948 (58.8%) were women. The mean age was 68.2 years (SD = 8.1). Cognition is significantly affected in people with higher age (ß=-1.30, Cl 95% -1.54, -.1.06 p= 0.000), less schooling (ß=.559, CI 95% .498, .621 p<0.001), depressive symptoms (ß=-.066, CI 95% -.115, -.018 p=0.007), those who do not perform any volunteer service (ß=-.057, CI 95% -.102, -.102 p=0.013), or do not participate in decision making (ß=-.242, CI 95% -.295, -.189 p<0.001), low internal locus of control (ß=-.012., CI 95% -.023, -.001 p=0.023), and poor economic perception (ß=-.070., CI 95% -.115, -.024 p=0.002). When analyzing the cognitive function of older people, it is vital to consider the possible related psychosocial variables.
El envejecimiento es un proceso inevitable que puede asociarse al deterioro cognitivo. La evidencia sobre la evaluación simultánea de variables psicosociales que pudieran estar asociadas con la función cognitiva es crucial. Nuestro objetivo fue determinar la asociación entre las características psicosociales y la cognición en adultos mayores de 50 años en México. La quinta ronda del Estudio Mexicano de Salud y Envejecimiento (ENASEM) (2018) proporciona la base para este trabajo. El estudio forma parte de un análisis longitudinal, para el que se recabaron datos en 2012, 2015 y 2018. La muestra final estuvo compuesta por 6,709 individuos. Se midieron diez variables psicosociales a través de escalas o preguntas específicas. La cognición se evaluó con el Cross-Cultural Cognitive Examination (CCCE). Entre los factores de confusión se incluyeron los sociodemográficos, la multimorbilidad y la funcionalidad. El análisis se realizó ajustando un modelo de regresión. De la muestra total, 2.761 (41,1%) eran hombres; 3.948 (58,8%) eran mujeres. La edad media era de 68,2 años (DE = 8,1). La cognición se ve significativamente afectada en las personas con mayor edad (ß=-1,30, Cl 95% -1,54, -.1.06 p<0.001), menor escolaridad (ß=-.559, IC 95% .498, .621 p<0.001), síntomas depresivos (ß=-.066, IC 95% -.115, -.018 p=0.007), quienes no realizan ningún servicio voluntario (ß=-.057, IC 95% -.102, -.102 p=0. 013), o no participan en la toma de decisiones (ß=-.242, CI 95% -.295, -.189 p<0.001), presentan bajo locus de control interno (ß=-.012., CI 95% -.023, -.001 p=0.023), y pobre percepción económica (ß=-.070., CI 95% -.115, -.024 p=0.002). Al analizar la función cognitiva de las personas mayores, es vital considerar las posibles variables psicosociales relacionadas.
O envelhecimento é um processo inevitável que pode estar associado a défices cognitivos. A evidência sobre a avaliação simultânea de variáveis psicossociais que podem estar associadas à função cognitiva é crucial. O nosso objetivo foi determinar a associação entre as características psicossociais e a cognição em adultos com mais de 50 anos no México. A quinta rodada do Estudo Mexicano de Saúde e Envelhecimento (MHAS) (2018) fornece a base para este artigo. O estudo faz parte de uma análise longitudinal, para a qual foram realizadas colagens de ondas 2012, 2015 e 2018. A amostra final foi composta por 6.709 indivíduos. Dez variáveis psicossociais foram medidas por meio de escalas ou perguntas específicas. A cognição foi avaliada com o Cross-Cultural Cognitive Examination (CCCE). Os factores de confusão incluíram dados sociodemográficos, multimorbilidade e funcionalidade. A análise foi efectuada através do ajuste do modelo de regressão. Da amostra total, 2.761 (41,1%) eram homens; 3.948 (58,8%) eram mulheres. A idade média foi de 68,2 anos (DP = 8,1). A cognição é significativamente afetada nas pessoas com mais idade (ß=-1,30, Cl 95% -1,54, -.1.06 p= 0.000), menor escolaridade (ß=.559, IC 95% .498, .621 p<0.001), sintomas depressivos (ß=-.066, IC 95% -.115, -.018 p=0.007), aqueles que não realizam nenhum serviço voluntário (ß=-.057, IC 95% -.102, -.102 p=0. 013), ou não participam na tomada de decisões (ß=-.242, IC 95% -.295, -.189 p<0.001), baixo locus de controlo interno (ß=-.012., IC 95% -.023, -.001 p=0.023), e fraca perceção económica (ß=-.070., IC 95% -.115, -.024 p=0.002). Ao analisar a função cognitiva dos idosos, é vital considerar as possíveis variáveis psicossociais relacionadas.
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ABSTRACT Introduction: measuring the severity of traumatic injuries is crucial for predicting clinical outcomes. Whereas the Injury Severity Score (ISS) has limitations in assigning scores to injuries at the same site, the New Injury Severity Score (NISS) corrects for this problem by taking into account the three most severe injuries regardless of the region of the body. This study seeks to comprehend the clinical and epidemiological profile of trauma patients while comparing the effectiveness of scales for predicting mortality. Methods: a descriptive, observational and retrospective study using records of patients who underwent thoracotomy at the Hospital das Clínicas of the Federal University of Triângulo Mineiro between 2000 and 2019. Demographic data, mechanisms of injury, affected organs, length of stay and mortality were analyzed. Injury severity was assessed using the ISS and NISS, and statistical analyses were conducted using MedCalc and SigmaPlot. Results: 101 patients were assessed, on average 29.6 years old, 86.13% of whom were men. The average duration of hospitalization was 10.9 days and the mortality rate was 28.7%. The ROC curve analysis revealed a sensitivity of 68.97%, specificity of 80.56% and area under the curve of 0.837 for the ISS, and 58.62%, 94.44% and 0.855 for the NISS, respectively. The Youden index was 0.49 for the ISS and 0.53 for the NISS. Conclusion: the study demonstrated comparable efficacy of NISS and ISS in predicting mortality. These findings hold significance in the hospital setting. Professionals must be familiar with these scales to utilize them competently for each patient.
RESUMO Introdução: a medição da gravidade das lesões traumáticas é essencial para prever os desfechos clínicos. Enquanto o Injury Severity Score (ISS) tem limitações ao atribuir pontuações às lesões no mesmo local, o New Injury Severity Score (NISS) corrige esse problema ao considerar as três lesões mais graves independentemente da região corporal. Este estudo visa entender o perfil clínico-epidemiológico dos pacientes traumatizados, comparando a eficácia das escalas para prever mortalidade. Métodos: estudo descritivo, observacional e retrospectivo utilizando registros de pacientes submetidos à toracotomia no Hospital das Clínicas da Universidade Federal do Triângulo Mineiro entre 2000 e 2019. Dados demográficos, mecanismos de lesão, órgãos afetados, tempo de internação e mortalidade foram analisados. A gravidade das lesões foi avaliada usando o ISS e NISS, e as análises estatísticas foram conduzidas no MedCalc e SigmaPlot. Resultados: Foram avaliados 101 pacientes, em média com 29,6 anos, sendo 86,13% homens. A média da internação foi de 10,9 dias e a taxa de mortalidade foi de 28,7%. A análise da curva ROC revelou uma sensibilidade de 68,97%, especificidade de 80,56% e área sob a curva de 0,837 para o ISS, e 58,62%, 94,44% e 0,855 para o NISS, respectivamente. O índice de Youden indicou 0,49 para o ISS e 0,53 para o NISS. Conclusão: o estudo demonstrou semelhante eficácia entre o NISS e o ISS na previsão de mortalidade. Esses resultados geram implicações importantes na aplicação dessas escalas no ambiente hospitalar. É essencial que os profissionais conheçam tais escalas para aplica-las adequadamente no contexto de cada paciente.
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A alimentação contemporânea, principalmente no espaço urbano, é marcada por uma desconexão entre os indivíduos, os alimentos e o próprio ato de comer. Como consequência do processo de industrialização da alimentação há um distanciamento do ciclo de vida dos alimentos e uma padronização dos alimentos consumidos, além de uma perda de sentido sobre o que se come e como se come. Neste contexto, as hortas surgem como espaços estratégicos para promover a saúde no território. Elas propiciam a troca de saberes e o fortalecimento de uma concepção holística de saúde, estimulando a autonomia, o autocuidado e a participação social. As hortas revelam ainda um valioso potencial de aprendizagem e podem ser usadas como um instrumento para apoiar a conexão entre o cultivo de alimentos e hábitos alimentares saudáveis. Além disso, unem e fortalecem o trabalho sobre temas ambientais, alimentares e dietéticos em uma mesma atividade.
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Abastecimento de Alimentos , Promoção da Saúde , Agricultura Urbana , Sistema Alimentar SustentávelRESUMO
The severity of non-alcoholic fatty liver disease (NAFLD) ranges from simple steatosis to steatohepatitis, and it is not yet clearly understood which patients will progress to liver fibrosis or cirrhosis. SPARC (Secreted Protein Acidic and Rich in Cysteine) has been involved in NAFLD pathogenesis in mice and humans. The aim of this study was to investigate the role of SPARC in inflammasome activation, and to evaluate the relationship between the hepatic expression of inflammasome genes and the biochemical and histological characteristics of NAFLD in obese patients. In vitro studies were conducted in a macrophage cell line and primary hepatocyte cultures to assess the effect of SPARC on inflammasome. A NAFLD model was established in SPARC knockout (SPARC-/-) and SPARC+/+ mice to explore inflammasome activation. A hepatic RNAseq database from NAFLD patients was analyzed to identify genes associated with SPARC expression. The results were validated in a prospective cohort of 59 morbidly obese patients with NAFLD undergoing bariatric surgery. Our results reveal that SPARC alone or in combination with saturated fatty acids promoted IL-1ß expression in cell cultures. SPARC-/- mice had reduced hepatic inflammasome activation during the progression of NAFLD. NAFLD patients showed increased expression of SPARC, NLRP3, CASP1, and IL-1ß. Gene ontology analysis revealed that genes positively correlated with SPARC are linked to inflammasome-related pathways during the progression of the disease, enabling the differentiation of patients between steatosis and steatohepatitis. In conclusion, SPARC may play a role in hepatic inflammasome activation in NAFLD.
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Hepatopatia Gordurosa não Alcoólica , Obesidade Mórbida , Animais , Humanos , Camundongos , Inflamassomos/metabolismo , Fígado/metabolismo , Cirrose Hepática/metabolismo , Hepatopatia Gordurosa não Alcoólica/genética , Hepatopatia Gordurosa não Alcoólica/complicações , Obesidade Mórbida/metabolismo , Osteonectina/genética , Osteonectina/metabolismo , Estudos ProspectivosRESUMO
Natural pigments from haloarchaea are of great interest; bacterioruberin is the major pigment, it shows higher antioxidant power when compared with ß-carotene. However, characterization of bacterioruberin and its isomers along with its antioxidant and the matrix metallopeptidase 9 (MMP-9) inhibition activities in extracts from Natronoccoccus sp. TC6 and Halorubrum tebenquichense SU10 was not previously described, being the aim of this work. The carotenoids profile was performed by UV-Vis spectrophotometry, thin-layer chromatography, nuclear magnetic resonance spectroscopy, and high-resolution mass spectrometry (UPLC-ESI-MS/MS). Antioxidant capacity was determined for DPPH, ABTS, and FRAP. In addition, MMP-9 inhibition was studied using docking simulations. The carotenoid profile of studied strains was composed of bacterioruberin, some derivatives like mono, bis, and tris anhydrobacterioruberin, and also some bacterioruberin cis isomers. The carotenoid pools showed antioxidant capacity for DPPH > ABTS > FRAP; Natronococcus sp. TC6 carotenoid pool was better for ABTS and DPPH, while Halorubrum tebenquichense SU10 carotenoid pool was better for FRAP. Additionally, docking and molecular dynamics suggest that bacterioruberin inhibits MMP-9 through hydrophobic interactions near the catalytic site. Bacterioruberin shows the higher binding energy of -8.3 (kcal/mol). The carotenoids profile of both strains was elucidated, their antioxidant activity and singular participation of each carotenoid on MMP-9 in silico inhibition were evaluated.
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Introduction: Piura, located in a seismic zone, faces challenges related to food security. The aim of this study was to analyze aspects related to food insecurity in the region following the 6.1-magnitude earthquake that occurred in 2021, within the context of the COVID-19 pandemic. Methods: A secondary analysis was performed in 177 people exposed to the earthquake in Piura. Food insecurity was assessed with the Household Food Insecurity Access Scale. Its association with insomnia, resilience, anxiety/depressive symptoms, and general variables were determined using generalized linear models. Results: Food insecurity was observed in 31.1% (95% CI: 24.3-38.4) of participants. This prevalence was higher in people with mild (PR: 1.73, 95% CI: 1.12-2.70) and moderate (PR: 1.55, 95% CI: 1.09-2.22) anxiety symptoms, severe depressive symptoms (PR: 2.74, 95% CI: 1.24-6.03), and previous exposure to the El Niño Phenomenon (PR: 1.72; 95% CI: 1.06-2.81). An income higher than 5000 Peruvian soles (approximately 1300 US dollars) was associated with a lower prevalence of food insecurity (PR: 0.22, 95% CI: 0.13-0.40). Conclusions: Overall, three out of 10 individuals experienced food insecurity after the 2021 earthquake in Piura. Food insecurity may be aggravated by mental disorders, previous exposure to the El Niño phenomenon, and the COVID-19 pandemic. Our study contributes to the field by exploring a range of variables related to food insecurity in a unique context: post-earthquake and during the COVID-19 health emergency in Peru. These findings enhance our understanding of food insecurity at the regional level and highlight the need for preventive food security programs in seismic events.
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COVID-19 , Terremotos , Humanos , COVID-19/epidemiologia , Peru/epidemiologia , Pandemias , Abastecimento de Alimentos , Insegurança AlimentarRESUMO
Resumen Introducción: la diabetes mellitus tipo 2 (DM2) tiene gran importancia para la salud pública mundial, porque es una de las enfermedades no transmisibles más frecuentes, por la severidad y diversidad de sus complicaciones crónicas. Objetivo: el objetivo fue determinar el riesgo de desarrollar DM2 en personal de enfermería del Hospital T. J. Schestakow, San Rafael. Materiales y método: se realizó un estudio descriptivo de tipo transversal, se tomó una muestra no probabilística, que incluyó 109 enfermeros. Se evaluó el estado nutricional a través del índice de masa corporal (IMC) y la circunferencia de cintura (CC). Los datos personales y los obtenidos del cuestionario FINDRISC fueron adquiridos a través de un cuestionario realizado a los enfermeros. Resultados: el riesgo de desarrollar DM2 según las categorías de FINDRISC fue bajo en un 35,6% (n=41), ligeramente aumentado en un 39,4% (n=43), moderado en un 10,1% (n=11), alto y muy alto riesgo en un 12,9% (n=14). Esto está fuertemente influenciado por los antecedentes familiares de primer grado, la actividad física, la medicación antihipertensiva recibida, la glucemia elevada, el IMC, la circunferencia de cintura y la edad. El consumo de frutas y verduras no fue un factor determinante del riesgo de diabetes en la muestra estudiada (p>0,05). En cuanto a la CC y el IMC, ambos se correlacionaron de manera moderada-alta con el puntaje de FINDRISC, por lo cual estos indicadores fueron mejores predictores del riesgo para desarrollar diabetes. Conclusión: el riesgo de padecer DM2 es latente y constante, por lo que el uso de instrumentos fáciles y rápidos para su detección, como lo es el cuestionario FINDRISC, pueden ayudar en la prevención y toma de conciencia del autocuidado.
Abstract Introduction: type 2 diabetes mellitus (T2DM) has a great importance for global public health, because it is one of the most frequent non-communicable diseases, due to the severity and diversity of its chronic complications. Objective: the objective of this study was to determine the risk of developing T2DM in nursing staff of the T. J. Schestakow Hospital, San Rafael. Material and methods: a descriptive cross-sectional study was carried out, a non-probabilistic sample was taken, which included 109 nurses. Nutritional status was assessed through body mass index (BMI) and waist circumference (WC). Personal data and data obtained from the FINDRISC test were acquired through a questionnaire administered to nurses. Results: the risk of developing T2DM according to the Findrisc categories was low in 35.6% (n=41), slightly increased in 39.4% (n=43), moderate in 10.1% (n=11), high and very high risk in 12.9% (n=14). This is strongly influenced by first-degree family history, physical activity, antihypertensive medication, elevated blood glucose, BMI, waist circumference, and age. The consumption of fruits and vegetables was not a determinant of diabetes risk in the studied sample (p>0.05). Regarding WC and BMI, both were moderately to high correlated with the Findrisc score so these indicators were better predictors of the risk of developing diabetes. Conclusion: the risk of suffering from T2DM is latent and constant, so the use of quick and easy tools for its detection, such as the FINDRISC questionnaire, can help in the prevention and awareness of self-care.
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Diabetes Mellitus Tipo 2 , Métodos de Análise Laboratorial e de Campo , EnfermeirosRESUMO
New therapeutic options for liver cirrhosis are needed. Mesenchymal stem cell (MSC)-derived extracellular vesicles (EVs) have emerged as a promising tool for delivering therapeutic factors in regenerative medicine. Our aim is to establish a new therapeutic tool that employs EVs derived from MSCs to deliver therapeutic factors for liver fibrosis. EVs were isolated from supernatants of adipose tissue MSCs, induced-pluripotent-stem-cell-derived MSCs, and umbilical cord perivascular cells (HUCPVC-EVs) by ion exchange chromatography (IEC). To produce engineered EVs, HUCPVCs were transduced with adenoviruses that code for insulin-like growth factor 1 (AdhIGF-I-HUCPVC-EVs) or green fluorescent protein. EVs were characterized by electron microscopy, flow cytometry, ELISA, and proteomic analysis. We evaluated EVs' antifibrotic effect in thioacetamide-induced liver fibrosis in mice and on hepatic stellate cells in vitro. We found that IEC-isolated HUCPVC-EVs have an analogous phenotype and antifibrotic activity to those isolated by ultracentrifugation. EVs derived from the three MSCs sources showed a similar phenotype and antifibrotic potential. EVs derived from AdhIGF-I-HUCPVC carried IGF-1 and showed a higher therapeutic effect in vitro and in vivo. Remarkably, proteomic analysis revealed that HUCPVC-EVs carry key proteins involved in their antifibrotic process. This scalable MSC-derived EV manufacturing strategy is a promising therapeutic tool for liver fibrosis.
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Vesículas Extracelulares , Células-Tronco Mesenquimais , Camundongos , Animais , Proteômica , Cirrose Hepática/induzido quimicamente , Cirrose Hepática/terapia , Cirrose Hepática/metabolismo , Células Estreladas do Fígado/metabolismo , Células-Tronco Mesenquimais/metabolismo , Vesículas Extracelulares/metabolismoRESUMO
The chemical diversity of sphingolipids in plants allows the assignment of specific roles to special molecular species. These roles include NaCl receptors for glycosylinositolphosphoceramides or second messengers for long-chain bases (LCBs), free or in their acylated forms. Such signaling function has been associated with plant immunity, with an apparent connection to mitogen-activated protein kinase 6 (MPK6) and reactive oxygen species (ROS). This work used in planta assays with mutants and fumonisin B1 (FB1) to generate varying levels of endogenous sphingolipids. This was complemented with in planta pathogenicity tests using virulent and avirulent Pseudomonas syringae strains. Our results indicate that the surge of specific free LCBs and ceramides induced by FB1 or an avirulent strain trigger a biphasic ROS production. The first transient phase is partially produced by NADPH oxidase, and the second is sustained and is related to programmed cell death. MPK6 acts downstream of LCB buildup and upstream of late ROS and is required to selectively inhibit the growth of the avirulent but not the virulent strain. Altogether, these results provide evidence that a LCB- MPK6- ROS signaling pathway contributes differentially to the two forms of immunity described in plants, upregulating the defense scheme of a non-compatible interaction.
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Proteínas de Arabidopsis , Arabidopsis , Arabidopsis/metabolismo , Proteínas de Arabidopsis/genética , Espécies Reativas de Oxigênio/metabolismo , Morte Celular , Transdução de Sinais , Esfingolipídeos/metabolismo , Regulação da Expressão Gênica de PlantasRESUMO
Introducción: La funcionalidad familiar influye en el proceso salud-enfermedad, es por ello que se destaca su importancia en el primer nivel de atención. No existe evidencia concluyente sobre los factores que influyen en la disfunción familiar en pacientes atendidos en el primer nivel de atención. Objetivo: Determinar la prevalencia y factores asociados a disfunción familiar en pacientes atendidos en el primer nivel de atención. Métodos: Estudio transversal de análisis secundario de datos en pacientes atendidos en 7 establecimientos del primer nivel de atención de Lima, Perú, en 2019. Se utilizó el cuestionario Apgar Familiar y se indagó su asociación con factores demográficos-socioeconómicos. Se estimaron razones de prevalencia (RP) a través de modelos de regresión simple y múltiple. Resultados: De 150 pacientes, la mayoría fueron mujeres (81,3 %) y la mediana de edad fue de 32 años. El 14 % presentó disfunción familiar. Los pacientes con acceso a servicio de agua tenían menor prevalencia de disfunción familiar (RP: 0,04; IC95 %: 0,001 - 0,47). Residir entre 1 a 10 años en Lima representó menor prevalencia de disfunción familiar; en comparación con pacientes recién llegados a la capital (menos de 1 año) (RP: 0,15; IC95 %: 0,04 - 0,62). Conclusiones: La prevalencia de disfunción familiar en pacientes atendidos en primer nivel de atención es baja. Tener acceso a servicio de agua y residir entre 1 a 10 años en la capital influyó en una menor prevalencia de disfunción familiar.
Introduction: Family functionality influences the health-disease process, which is why its importance in the first level of care is highlighted. There is no conclusive evidence on the factors that influence family dysfunction in patients treated at the First Level of Care. Objective: To determine the prevalence and factors associated with family dysfunction in patients treated at the First Level of Care. Methods: Cross-sectional study of secondary data analysis in patients treated in 7 primary care establishments in Lima, Peru in 2019. The Family Apgar questionnaire was used, and its association with demographic-socioeconomic factors was investigated. Prevalence ratios (PR) were estimated through simple and multiple regression models. Results: Of 150 patients, the majority were women (81.3%) and the median age was 32 years. 14% presented family dysfunction. Patients with access to water service had a lower prevalence of family dysfunction (PR: 0.04; 95% CI: 0.001-0.47). Living between 1 and 10 years in Lima represented a lower prevalence of family dysfunction; compared with patients recently arrived in the capital (less than 1 year) (PR: 0.15; 95% CI: 0.04- 0.62). Conclusions: The prevalence of family dysfunction in patients treated at the primary care level was low. Having access to water service and residing between 1 and 10 years in the capital influenced a lower prevalence of family dysfunction.
RESUMO
Post-incisional ventral hernia is estimated at 5-30%, when the content of the abdominal cavity migrates to the hernial sac (HSV), with a HSV/abdominal cavity volume ratio > 25%, conditioning systemic changes defined as "loss of domain". A 27-year-old male presented with ventral hernia with loss of domain that required pre-operative preparation techniques, using application of botulinum toxin A (IncobotulinumtoxinA) and pneumoperitoneum, both guided by image. A ventral plasty was performed with adequate return of the viscera to the abdominal cavity. The combination of both techniques seems to be a safe procedure to carry out a tension-free repair.
La hernia ventral postincisional se estima en 5 al 30%, cuando el contenido de la cavidad abdominal migra al saco herniario, con una relación VSH/VCA > 25% condicionando cambios sistémicos se define como "pérdida de dominio". Masculino de 27 años con hernia ventral con pérdida de dominio que ameritó técnicas de preparación preoperatoria, utilizando toxina botulínica A (IncobotulinumtoxinA) y neumoperitoneo, ambos guíados por imagen. Se realizó una plastia ventral con adecuado regreso de las vísceras a la cavidad abdominal. La combinación de ambas técnicas es un procedimiento seguro para realizar una reparación libre de tensión.
Assuntos
Parede Abdominal , Toxinas Botulínicas Tipo A , Hérnia Ventral , Pneumoperitônio , Masculino , Humanos , Adulto , Toxinas Botulínicas Tipo A/uso terapêutico , Pneumoperitônio/etiologia , Herniorrafia/métodos , Pneumoperitônio Artificial/métodos , Hérnia Ventral/complicações , Hérnia Ventral/tratamento farmacológico , Hérnia Ventral/cirurgia , Cuidados Pré-Operatórios/métodos , Telas Cirúrgicas , Parede Abdominal/cirurgiaRESUMO
OBJECTIVE: Opioids (except for tramadol) have not been shown to be effective in patients with fibromyalgia, but they can increase the risk of adverse drug reactions. The aim was to determine the treatment patterns of a group of patients with fibromyalgia and to identify the factors associated with the use of opioids in Colombia. METHODS: This was a cross-sectional study of a group of patients with fibromyalgia from a pain clinic in Colombia. Sociodemographic, clinical and pharmacological variables were identified. Descriptive, bivariate, and multivariate analyses were performed. RESULTS: A total of 559 patients were analysed, 88.6% of whom were women, and the mean age was 53.4 ± 12.6 years. A total of 40.6% received nonpharmacological management, and the majority were treated with acetaminophen (96.1%) and pregabalin (62.8%). A total of 69.6% received opioids, the most common of which was hydrocodone (36.3%). The average morphine equivalent milligrammes was 36.9 ± 91.2 (range: 2.3-750 mg), and 43.8% had intermediate/high doses. Being male (OR: 3.12; 95% CI: 1.40-6.91), having arterial hypertension (OR: 1.67; 95% CI: 1.04-2.69), obesity (OR: 2.23; 95% CI: 1.18-4.24), degenerative disease of vertebral discs (OR: 2.32; 95% CI: 1.10-4.88) and comedication with gabapentinoids (OR: 1.75; 95% CI: 1,15-2.65) were associated with a higher probability of receiving opioids, while patients treated with muscle relaxants had a lower risk of opioid treatment (OR: 0.64; 95% CI: 0.41-0.98). CONCLUSIONS: A significant proportion of patients were treated with opioids, the most common of which was hydrocodone, which goes against the recommendations of clinical practice guidelines.
Assuntos
Analgésicos Opioides , Fibromialgia , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Analgésicos Opioides/efeitos adversos , Hidrocodona/uso terapêutico , Estudos Transversais , Acetaminofen/uso terapêutico , Padrões de Prática MédicaRESUMO
Nota científica que apresenta as principais estratégias desenvolvidas na Atenção Primária à Saúde para o atendimento das demandas referentes à Covid-19, no Estado de São Paulo.
Assuntos
Atenção Primária à Saúde , COVID-19 , Integralidade em SaúdeRESUMO
Nota científica sistematizando dados referentes à organização da gestão da Atenção Primária à Saúde no Estado de São Paulo, a partir de dados fornecidos por gestores municipais.
Assuntos
Atenção Primária à Saúde , Modelos de Assistência à Saúde , Gestão em Saúde , COVID-19RESUMO
Nota científica sistematizando dados referentes à continuidade do cuidado de áreas essenciais da Atenção Primária à Saúde, durante a pandemia por Covid-19, no Estado de São Paulo.