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The NHEPACHA Iberoamerican Network, founded on the initiative of a group of researchers from Latin American countries and Spain, aims to establish a research framework for Chagas disease that encompasses diagnosis and treatment. For this purpose, the network has created a questionnaire to gather relevant data on epidemiological, clinical, diagnostic, and therapeutic aspects of the disease. This questionnaire was developed based on a consensus of expert members of the network, with the intention of collecting high-quality standardized data, which can be used interchangeably by the different research centers that make up the NHEPACHA network. Furthermore, the network intends to offer a clinical protocol that can be embraced by other researchers, facilitating comparability among published studies, as well as the development of therapeutic response and progression markers.
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Doença de Chagas , Doença de Chagas/epidemiologia , Doença de Chagas/tratamento farmacológico , Humanos , América Latina/epidemiologia , Inquéritos e Questionários , Espanha/epidemiologia , Bases de Dados Factuais , Pesquisa Biomédica/normasRESUMO
The dinoflagellate Alexandrium catenella is a well-known paralytic shellfish toxin producer that forms harmful algal blooms, repeatedly causing damage to Chilean coastal waters. The causes and behavior of algal blooms are complex and vary across different regions. As bacterial interactions with algal species are increasingly recognized as a key factor driving algal blooms, the present study identifies several bacterial candidates potentially associated with Chilean Alexandrium catenella. This research narrowed down the selection of bacteria from the Chilean A. catenella culture using antibiotic treatment and 16S rRNA metabarcoding analysis. Subsequently, seawater from two Chilean coastal stations, Isla Julia and Isla San Pedro, was monitored for two years to detect Alexandrium species and the selected bacteria, utilizing 16S and 18S rRNA gene metabarcoding analyses. The results suggested a potential association between Alexandrium species and Spongiibacteraceae at both stations. The proposed candidate bacteria within the Spongiibacteraceae family, potentially engaging in mutualistic relationships with Alexandrium species, included the genus of BD1-7 clade, Spongiibbacter, and Zhongshania.
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Dinoflagellida , RNA Ribossômico 16S , Simbiose , Dinoflagellida/genética , Dinoflagellida/fisiologia , Chile , RNA Ribossômico 16S/genética , Bactérias/genética , Bactérias/classificação , Proliferação Nociva de Algas , Água do Mar/microbiologia , Filogenia , RNA Ribossômico 18S/genéticaRESUMO
The Reloncaví estuary in southern Chile is famous for its aquaculture. However, recurring harmful algal blooms have adversely affected mussel production. Therefore, regular monitoring of algal toxins is urgently needed to better understand the contamination status of the estuary. In this study, we quantified 15 types of lipophilic shellfish toxins in Metri Bay in the Reloncaví estuary on a biweekly basis for 4 years. We identified algal species using microscopy and metabarcoding analysis. We also measured water temperature, salinity, chlorophyll-a, and dissolved oxygen to determine the potential relationships of these parameters with algal toxin production. Our results revealed the presence of a trace amount of pectenotoxin and the causal phytoplankton Dinophysis, as well as yessotoxin and the causal phytoplankton Protoceratium. Statistical analysis indicated that fluctuations in water temperature affected the detection of these toxins. Additionally, metabarcoding analysis detected the highly toxic phytoplankton Alexandrium spp. in some samples. Although our results suggest that the level of lipophilic shellfish toxins in Metri Bay during the study period was insignificantly low using our current LC-MS method, the confirmed presence of highly toxic algae in Metri Bay raises concerns, given that favorable environmental conditions could cause blooms.
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Monitoramento Ambiental , Estuários , Proliferação Nociva de Algas , Toxinas Marinhas , Fitoplâncton , Chile , Toxinas Marinhas/análise , Animais , DinoflagellidaRESUMO
Biosynthesized silver nanoparticles (AgNPs) are widely used in varied applications, which are morphology dependent. Consequently, a morphology-controlled synthesis is mandatory. Although there are several studies focused on the plant extract-based biosynthesis of metallic nanoparticles, the use of extracts obtained from agro-wastes is scant. Furthermore, information regarding morphology modification through the use of additional agents is even more scarce. Thus, in this study, AgNPs were synthesized using a malt extract (ME) obtained from an artisanal beer brewing process residue. Additionally, sodium chloride (NaCl), gum arabic (GA), and talc (T) were used in an attempt to modify the morphology of AgNPs. XRD, DLS, SEM, and TEM results demonstrate that stable AgNPs of different sizes and shapes were synthesized. FTIR, HPLC analysis, and the quantification of total proteins, free amino acids, reducing sugars, and total polyphenols before and after AgNPs synthesis showed that ME biomolecules allowed them to act as a source of reducing and stabilizing agents. Therefore, this study provides evidence that ME can be successfully used to biosynthesize AgNPs. Additionally, the antibacterial activity of AgNPs against Gram-negative and Gram-positive bacteria was evaluated. Results indicate that AgNPs show a higher antibacterial activity against Gram-positive bacteria.
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Acacia , Nanopartículas Metálicas , Cerveja , Prata , Antibacterianos/farmacologia , Cloreto de SódioRESUMO
The study of marine toxins in shellfish is of the utmost importance to ensure people's food safety. Marine toxins in shellfish and microalgae in the water column off the south-central coast of Chile (36°â43° S) were studied in a network of 64 stations over a 14-month period. The relative abundance of harmful species Alexandrium catenella, Alexandrium ostenfeldii, Protoceratium reticulatum, Dinophysis acuminata, Dinophysis acuta, Pseudo-nitzschia seriata group and P. delicatissima group was analyzed. The detection and quantification of lipophilic toxins and domoic acid (DA) in shellfish was determined by UHPLC-MS/MS, and for Paralytic Shellfish Toxins (PSTs) by HPLC-FD with post-column oxidation, while for a culture of A. ostenfeldii a Hylic-UHPLC-MS/MS was used. Results showed that DA, gonyautoxin (GTX)-2, GTX-3 and pectenotoxin (PTX)-2 were detected below the permitted limits, while Gymnodimine (GYM)-A and 13-desmethylespirolide C (SPX-1) were below the limit of quantitation. According to the distribution and abundance record of microalgae, DA would be associated to P. seriata and P. delicatissima-groups, PTX-2 to D. acuminata, and GTX-2, GTX-3, GYM-A, and SPX-1 to A. ostenfeldii. However, the toxin analysis of an A. ostenfeldii culture from the Biobío region only showed the presence of the paralytic toxins C2, GTX-2, GTX-3, GTX-5 and saxitoxin, therefore, the source of production of GYM and SPX is still undetermined.
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Dinoflagellida , Compostos Heterocíclicos com 3 Anéis , Hidrocarbonetos Cíclicos , Iminas , Microalgas , Humanos , Espectrometria de Massas em Tandem , Chile , Toxinas Marinhas/análise , Frutos do Mar/análise , Alimentos Marinhos/análiseRESUMO
Background: Tridimensional medical knowledge of human anatomy is a key step in the undergraduate and postgraduate medical education, especially in surgical fields. Training simulation before real surgical procedures is necessary to develop clinical competences and to minimize surgical complications. Methods: Latex injection of vascular system in brain and in head-neck segment is made after washing out of the vascular system and fixation of the specimen before and after latex injection. Results: Using this latex injection technique, the vascular system of 90% of brains and 80% of head-neck segments are well-perfused. Latex-injected vessels maintain real appearance compared to silicone, and more flexible vessels compared to resins. Besides, latex makes possible a better perfusion of small vessels. Conclusions: Latex vascular injection technique of the brain and head-neck segment is a simulation model for neurosurgical training based on real experiencing to improve surgical skills and surgical results.
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Here we report a case of septic arthritis associated with a genetically divergent Francisella philomiragia strain in a patient with chronic rheumatoid arthritis and Adult-onset Still's disease (AOSD) in Maldonado, Uruguay. In this study mass spectrometry together with whole-genome sequencing using Oxford Nanopore technology allowed for the correct identification of the etiologic agent.
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Inertial kinetics and kinematics have substantial influences on human biomechanical function. A new algorithm for Inertial Measurement Unit (IMU)-based motion tracking is presented in this work. The primary aims of this paper are to combine recent developments in improved biosensor technology with mainstream motion-tracking hardware to measure the overall performance of human movement based on joint axis-angle representations of limb rotation. This work describes an alternative approach to representing three-dimensional rotations using a normalized vector around which an identified joint angle defines the overall rotation, rather than a traditional Euler angle approach. Furthermore, IMUs allow for the direct measurement of joint angular velocities, offering the opportunity to increase the accuracy of instantaneous axis of rotation estimations. Although the axis-angle representation requires vector quotient algebra (quaternions) to define rotation, this approach may be preferred for many graphics, vision, and virtual reality software applications. The analytical method was validated with laboratory data gathered from an infant dummy leg's flexion and extension knee movements and applied to a living subject's upper limb movement. The results showed that the novel approach could reasonably handle a simple case and provide a detailed analysis of axis-angle migration. The described algorithm could play a notable role in the biomechanical analysis of human joints and offers a harbinger of IMU-based biosensors that may detect pathological patterns of joint disease and injury.
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Harmful Algal Blooms (HABs) have caused damage to the marine environment in Isla San Pedro in the Gulf of Corcovado, Chile. While rising water temperature and artificial eutrophication are the most discussed topics as a cause, marine bacteria is a recent attractive parameter as an algal bloom driver. This study monitored algal and bacterial compositions in the water of Isla San Pedro for one year using microscopy and 16S rRNA metabarcoding analysis, along with physicochemical parameters. The collected data were analyzed with various statistical tools to understand how the particle-associated bacteria (PA) and the free-living (FL) bacteria were possibly involved in algal blooms. Both FL and PA fractions maintained a stable bacterial composition: the FL fraction was dominated by Proteobacteria (α-Proteobacteria and γ-Proteobacteria), and Cyanobacteria dominated the PA fraction. The two fractions contained equivalent bacterial taxonomic richness (c.a. 8,000 Operational Taxonomic Units) and shared more than 50% of OTU; however, roughly 20% was exclusive to each fraction. The four most abundant algal genera in the Isla San Pedro water were Thalassiosira, Skeletonema, Chaetoceros, and Pseudo-nitzchia. Statistical analysis identified that the bacterial species Polycyclovorans algicola was correlated with Pseudo-nitzschia spp., and our monitoring data recorded a sudden increase of particle-associated Polycyclovorans algicola shortly after the increase of Pseudo-nitzschia, suggesting that P. algicola may have regression effect on Pseudo-nitzschia spp. The study also investigated the physicochemical parameter effect on algal-bacterial interactions. Oxygen concentration and chlorophyll-a showed a strong correlation with both FL and PA bacteria despite their assemblage differences, suggesting that the two groups had different mechanisms for interacting with algal species.
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Butyrate is a microbiota-produced metabolite, sensed by host short-chain fatty acid receptors FFAR2 (Gpr43), FFAR3 (Gpr41), HCAR2 (Gpr109A), and Histone deacetylase (HDAC) that promotes microbiota-host crosstalk. Butyrate influences energy uptake, developmental and immune response in mammals. This microbial metabolite is produced by around 79 anaerobic genera present in the mammalian gut, yet little is known about the role of butyrate in the host-microbiota interaction in salmonid fish. To further our knowledge of this interaction, we analyzed the intestinal microbiota and genome of Atlantic salmon (Salmo salar), searching for butyrate-producing genera and host butyrate receptors. We identified Firmicutes, Proteobacteria, and Actinobacteria as the main butyrate-producing bacteria in the salmon gut microbiota. In the Atlantic salmon genome, we identified an expansion of genes orthologous to FFAR2 and HCAR2 receptors, and class I and IIa HDACs that are sensitive to butyrate. In addition, we determined the expression levels of orthologous of HCAR2 in the gut, spleen, and head-kidney, and FFAR2 in RTgutGC cells. The effect of butyrate on the Atlantic salmon immune response was evaluated by analyzing the pro and anti-inflammatory cytokines response in vitro in SHK-1 cells by RT-qPCR. Butyrate decreased the expression of the pro-inflammatory cytokine IL-1ß and increased anti-inflammatory IL-10 and TGF-ß cytokines. Butyrate also reduced the expression of interferon-alpha, Mx, and PKR, and decreased the viral load at a higher concentration (4 mM) in cells treated with this molecule before the infection with Infectious Pancreatic Necrosis Virus (IPNV) by mechanisms independent of FFAR2, FFAR3 and HCAR2 expression that probably inhibit HDAC. Moreover, butyrate modified phosphorylation of cytoplasmic proteins in RTgutGC cells. Our data allow us to infer that Atlantic salmon have the ability to sense butyrate produced by their gut microbiota via different specific targets, through which butyrate modulates the immune response of pro and anti-inflammatory cytokines and the antiviral response.
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BACKGROUND: Although the cavernous sinus (CS) has been studied since 1695, its anatomy and name are still under discussion. METHOD: Anatomy and histology of 40 CS from human cadavers were studied, included both from a newborn specimen. RESULTS: Two walls limit the CS, an inferior medial one composed only of the dura's outer layer and a superior lateral one consisting of both dura's layers. Sinusoidal veins pass through the lateral wall of the CS as a transition between venous tributaries and the CS. An endothelial layer covers the inner surface of the CS and the outer surface of the internal carotid artery. The space within the CS shows trabeculae, which are rarer in adults compared to the newborn. The loss of trabeculae in the CS may be a natural process along with life. CONCLUSIONS: In conclusion, the CS is a real sinus, and the term "cavernous sinus" is appropriately applied.
ANTECEDENTES: Si bien el seno cavernoso (SC) ha sido estudiado desde 1695, su anatomía y nombre aún están bajo discusión. MÉTODOS: Se estudiaron la anatomía y la histología de 40 SC de cadáveres humanos, incluyendo los dos de un recién nacido. RESULTADOS: El SC está limitado por dos paredes, una inferomedial compuesta solo por la capa más externa de la duramadre y otra superolateral compuesta por ambas capas de la duramadre. Hay venas sinusoidales que atraviesan la pared lateral del SC formando una transición entre venas tributarias y el SC. Una capa endotelial recubre la superficie interna del SC y la superficie externa de la arteria carótida interna. El espacio dentro del SC presenta trabéculas, las cuales son escasas en el adulto en comparación con el recién nacido. La pérdida de trabéculas en el SC puede ser un proceso natural a lo largo de la vida. CONCLUSIONES: En conclusión, el SC es un verdadero seno, por lo que el término «seno cavernoso¼ se aplica de forma correcta.
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Artéria Carótida Interna , Seio Cavernoso , Adulto , Recém-Nascido , Humanos , Seio Cavernoso/anatomia & histologia , CadáverRESUMO
One of the most relevant and differentiating aspects provided by the 2021 European Society of Cardiology guidelines for the diagnosis and treatment of acute and chronic heart failure is the retraction of the historical stepped and vertical pharmacological treatment scheme for heart failure with reduced ejection fraction (HFrEF). Subsequently, it was replaced by an updated algorithm that places four therapeutic families in the same initial horizontal step with an equally high degree of recommendation (class I). In this context, these four pillars, which have demonstrated a significant reduction in mortality and hospitalizations in patients with HFrEF, include (1) angiotensin-converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB)/angiotensin II receptor-neprilysin inhibitors (ARNi), (2) beta blockers, (3) mineralocorticoid receptor antagonists (MRA) and (4) sodium-glucose cotransporter 2 inhibitors (SGLT2is) as the main novelty. This manuscript reviews the current therapeutic algorithm with a special focus on the therapeutic value of adding an MRA (still underused in both clinical trials and real world), changing an ACEi/ARB for an ARNi and incorporating an SGLT2i in patients with HFrEF. This article is part of the Emerging concepts in heart failure management and treatment Special Issue: https://www.drugsincontext.com/special_issues/emerging-concepts-in-heart-failure-management-and-treatment.
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BACKGROUND: Malaria-endemic areas are not spared from the impact of coronavirus disease 2019 (COVID-19), leading to co-infection scenarios where overlapping symptoms impose serious diagnostic challenges. Current knowledge on Plasmodium spp. and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infection in pregnant women remains limited, especially in Latin America, where Plasmodium vivax infection is highly prevalent. METHODS: This is a case series of five pregnant women with P. vivax and SARS-CoV-2 co-infection hospitalized in two main malaria referral centers of the Capital District and Bolivar state, Venezuela between March 13, 2020 and December 31, 2021. RESULTS: Clinical and laboratory data from five pregnant women with a mean age of 22 years were analyzed; three of them were in the third trimester of pregnancy. Comorbidities included obesity in two cases, hypertension in one, and asthma in one. Three out of five patients had severe to critical COVID-19 disease. Dry cough, fever, chills, and headache were the most frequent symptoms reported. Laboratory analyses showed elevated aspartate/alanine aminotransferase and creatinine levels, thrombocytopenia, and severe anemia as the most relevant abnormalities. The mean period between symptom onset and a positive molecular test for SARS-CoV-2 infection or positive microscopy for Plasmodium spp. was 4.8 ± 2.5 days and 2.8 ± 1.6 days, respectively. The mean hospital stay was 5.4 ± 7 days. Three women recovered and were discharged from the hospital. Two women died, one from cerebral malaria and one from respiratory failure. Three adverse fetal outcomes were registered, two miscarriages and one stillbirth. CONCLUSION: This study documented a predominance of severe/critical COVID-19 disease and a high proportion of adverse maternal-fetal outcomes among pregnant women with malaria and COVID-19 co-infection. More comprehensive prospective cohort studies are warranted to explore the risk factors, management challenges, and clinical outcomes of pregnant women with this co-infection.
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Aborto Espontâneo , COVID-19 , Coinfecção , Malária Vivax , Malária , Complicações Infecciosas na Gravidez , Feminino , Humanos , Gravidez , Adulto Jovem , Coinfecção/diagnóstico , Coinfecção/epidemiologia , COVID-19/diagnóstico , COVID-19/epidemiologia , Malária Vivax/diagnóstico , Malária Vivax/epidemiologia , Plasmodium vivax , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Gestantes , Estudos Prospectivos , SARS-CoV-2 , Venezuela/epidemiologiaRESUMO
Kinetic and probabilistic (Time-to-Failure, TTF) models were used to predict the color (L*, a*, b* total color differences (ΔE), Hue and Chroma) stability of Justicia spicigera leaves pigments subjected to different temperatures (40 - 80 °C) and pHs (2 - 12). The change in pH caused different hues (from 60° = orange red to 268° = deep-blue) due to the shift effect of anthocyanins in the extract. Temperatures higher than 60 °C increased the color degradation. High heat sensitivity was observed at pH 4 (Ea = 90.27) and 10 (Ea = 154.99 kJ/mol). The Time-to-Failure model for both ΔE and Hue describes the effect of pH and temperature in the J. spicigera extracts. High pHs and temperatures applied to the extracts increased the probability of showing ΔEs > 4 or Hue changes over 20 %. Nearby the neutral region of pH, pigments of J. spicigera were more stable. The TTF model might be a useful tool to describe and predict the behavior of pigments added to foods.
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Introducción: La fibrosis quística (FQ), afecta el epitelio exocrino, formando una mucosidad espesa que obstruye los conductos de los diferentes órganos, siendo el pulmón y páncreas los más afectados. El objetivo del presente estudio fue determinar la asociación entre los factores clínicos y las complicaciones, así como la supervivencia de pacientes con FQ atendidos en un centro de referencia pediátrica en México. Métodos: El presente estudio observacional, longitudinal, fue realizado en el Instituto Nacional de Pediatría en México, de abril del 2012, a abril del 2022. Con una muestra no probabilística ingresaron al estudio niños con fibrosis quística. Las variables fueron: demográficas, complicaciones pulmonares, extrapulmonares y mortalidad. Se realiza la asociación con chi-cuadrado y la supervivencia con Kaplan-Meir. Resultados: Se analizan 71 pacientes, lactantes menores 41 casos (62%), pre-escolares 12 casos (16.9%). Fueron 40 hom-bres (56.3%). 57 casos (80.3%) tuvieron exacerbación infecciosa, 11 casos (15.5%) aspergi-losis broncopulmonar, 9 casos (12.7%) con hipertensión pulmonar, 5 casos (7%) con neumotórax, 12 casos (16.9%) con ventilación mecánica, 70 casos (98.5) con insuficiencia pancreática, 10 casos (14%) con enfermedad hepatobiliar. Hubo asociación de complica-ciones extrapulmonares con el fenotipo F508. La supervivencia global fue de 150 meses. En pacientes con ventilación mecánica invasiva la supervivencia fue de 55 meses (P<0.001), en pacientes con ventilación mecánica no invasiva fue de 106 meses (P<0.001), en pacientes con neumotórax fue de 25 meses P<0.001, en pacientes con aspergilosis bronco-pulmonar alérgica fue de 125 meses P<0.01. Conclusión: la mayor compli-cación extrapulmonar de pa-cientes con FQ es la insuficien-cia pancreática. La presencia de neumotórax disminuye la supervivencia.
Introduction: Cystic fibrosis (CF) affects the exocrine epithelium, forming a thick mucus that obstructs the ducts of the different organs, with the lungs and pancreas being the most affected. This study aimed to determine the association between clinical factors and complications, as well as the survival of CF patients treated at a pediatric reference center in Mexico. Methods: This observational, longitudinal study was conducted at the National Institute of Pediatrics in Mexico from April 2012 to April 2022. Children with cystic fibrosis were entered into the study with a nonprobabilistic sample. The variables were demographic, pulmonary and extrapulmonary complications and mortality. The association was made with chi-square and survival with Kaplan- Meir. Results: Seventy-one patients were analyzed, including 41 infants (62%) and 12 preschoolers (16.9%). There were 40 men (56.3%). Fifty-seven cases (80.3%) had an infectious exacerbation, 11 cases (15.5%) had allergic bronchopulmonary aspergillosis, 9 cases (12.7%) had pulmonary hypertension, 5 cases (7%) had pneumothorax, 12 cases (16.9%) had mechanical ventilation, 70 cases (98.5%) had pancreatic insufficiency, and 10 cases (14%) had hepatobiliary disease. There was an association of extrapulmonary complications with the F508 phenotype. Overall survival was 150 months. In patients with invasive mechanical ventilation, survival was 55 months (P<0.001); in patients with noninvasive mechanical ventilation, it was 106 months (P<0.001); in patients with pneumothorax, it was 25 months (P<0.001); and in patients with allergic bronchopulmonary aspergillosis, it was 125 months (P<0.01). Conclusion: The most significant extrapulmonary complication in CF patients is pancreatic insufficiency. The presence of pneumothorax markedly decreases survival.
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Humanos , Lactente , Pré-Escolar , Criança , Criança , Taxa de Sobrevida , Fibrose Cística , Insuficiência Pancreática Exócrina , PneumotóraxRESUMO
Abstract Introduction/Objective: The resilience and emotional intelligence of teachers are crucial in order to face the daily educational challenges. To determine the association between teacher's emotional intelligence and resilience during Emergency Remote Learning. Method: A quantitative approach and a cross-sectional predictive non-experimental design were used. Participants were 1329 teachers from Chilean schools. The WLEIS Emotional Intelligence Scale and the RS-14 resilience scale were used. Spearman correlation analyses and Yuen's test were used for the comparative analysis by sex, and in the case of comparison by specialty the one-way ANOVA test was used; multiple regressions were performed. Results: High levels of resilience and between medium to high emotional intelligence; significant, positive and high relationship between emotional intelligence and resilience. Both in the emotional regulation variable and in the emotional intelligence variable significant differences were found regarding sex and specialty. The results of the predictive model with all emotional intelligence variables as predictors explained 43.5% of the observed variability of resilience. Conclusion: During the pandemic, teachers' emotional intelligence and resilience are essential for facing the educational adversities and challenges that arise as a consequence of a context susceptible to constant and deregulatory change.
Resumen Introducción/Objetivo: La resiliencia y la inteligencia emocional de los profesores son cruciales para afrontar los retos educativos diarios. Determinar la asociación entre la inteligencia emocional de los profesores y la resiliencia durante la enseñanza remota de emergencia. Método: Se utilizó un enfoque cuantitativo y un diseño no experimental predictivo transversal. Los participantes fueron 1329 profesores de escuelas chilenas. Se utilizó la escala de inteligencia emocional WLEIS y la escala de resiliencia RS-14. Se utilizaron análisis de correlación de Spearman y la prueba de Yuen para el análisis comparativo por sexo, y en el caso de la comparación por especialidad se utilizó la prueba ANOVA de una vía; se realizaron regresiones múltiples. Resultados: Los resultados mostraron niveles altos de resiliencia y entre media y alta inteligencia emocional; relación significativa, positiva y alta entre inteligencia emocional y resiliencia; tanto en la variable de regulación emocional como en la inteligencia emocional se encontraron diferencias significativas respecto al sexo y la especialidad. Los resultados del modelo predictivo con todas las variables de inteligencia emocional como predictores explicaron el 43,5% de la variabilidad observada de la resiliencia. Conclusión: Durante la pandemia, la inteligencia emocional y la resiliencia de los profesores son esenciales para afrontar las adversidades y los retos educativos que surgen como consecuencia de un contexto susceptible de cambios constantes y desreguladores.
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En algunos estudios se ha asociado a la terapia de reemplazo hormonal (TRH) con estrógenos y progestinas a un mayor riesgo de cáncer de mama que la terapia con estrógenos solos. Sin embargo, dependiendo de su naturaleza algunas progestinas serían más seguras que otras. Se buscaron y analizaron artículos atingentes al tema en las bases de datos Google Scholar, PubMed, Science, SciELO y Cochrane, introduciendo los siguientes términos: terapia de reemplazo hormonal y cáncer de mama, progestinas y cáncer de mama, receptor de progesterona. Específicamente se ha asociado a las progestinas sintéticas acetato de medroxiprogesterona, noretisterona y levonorgestrel con un mayor riesgo de cáncer de mama, no así a la progesterona natural, a la progesterona oral micronizada ni a la didrogesterona. La progesterona natural, progesterona micronizada y didrogesterona serían más seguras en TRH para evitar el desarrollo de cáncer de mama, lo que estaría dado por la mayor especificidad en su acción.
In some studies, hormone replacement therapy (HRT) with estrogens and progestins has been associated with a higher risk of breast cancer than therapy with estrogens alone. However, depending on their nature, some progestins may be safer than others. This article analyzes the mode of action of progesterone in breast tissue and also the role of some progestins in the development of this pathology. Articles related to the subject were searched for and analyzed in Google Scholar, PubMed, Science, SciELO and Cochrane databases, introducing the following terms: hormone replacement therapy and breast cancer, progestins and breast cancer, progesterone receptor. Specifically, synthetic progestins medroxyprogesterone acetate, norethisterone, and levonorgestrel have been associated with an increased risk of breast cancer, but not natural progesterone, micronized oral progesterone, or dydrogesterone. Natural progesterone, micronized progesterone and dydrogesterone would be safer in HRT to prevent the development of breast cancer, which would be due to the greater specificity of their action.
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Humanos , Feminino , Progestinas/efeitos adversos , Neoplasias da Mama/induzido quimicamente , Progestinas/classificação , Progestinas/fisiologia , Receptores de Progesterona , Medição de Risco , Terapia de Reposição Hormonal/efeitos adversos , Estrogênios/efeitos adversosRESUMO
BACKGROUND: Panama is one of eight countries in Mesoamerica that aims to eliminate malaria by 2022. Malaria is concentrated in indigenous and remote regions like Guna Yala, a politically autonomous region where access to health services is limited and cases are predominately detected through intermittent active surveillance. To improve routine access to care, a joint effort was made by Guna Yala authorities and the Ministry of Health to pilot a network of community health workers (CHWs) equipped with rapid diagnostic tests and treatment. The impact of this pilot is described. METHODS: Access to care was measured using the proportion of villages targeted by the effort with active CHWs. Epidemiological impact was evaluated through standard surveillance and case management measures. Tests for differences in proportions or rates were used to compare measures prior to (October 2014-September 2016) and during the pilot (October 2016-September 2018). RESULTS: An active CHW was placed in 39 (95%) of 41 target communities. During the pilot, CHWs detected 61% of all reported cases from the region. Test positivity in the population tested by CHWs (22%) was higher than in those tested through active surveillance, both before (3.8%) and during the pilot (2.9%). From the pre-pilot to the pilot period, annual blood examination rates decreased (9.8 per 100 vs. 8.0 per 100), test positivity increased (4.2% to 8.5%, Χ2 = 126.3, p < 0.001) and reported incidence increased (4.1 cases per 1000 to 6.9 cases per 1000 [Incidence Rate Ratio = 1.83, 95% CI 1.52, 2.21]). The percent of cases tested on the day of symptom onset increased from 8 to 27% and those treated on the day of their test increased from 26 to 84%. CONCLUSIONS: The CHW network allowed for replacement of routine active surveillance with strong passive case detection leading to more targeted and timely testing and treatment. The higher test positivity among those tested by CHWs compared to active surveillance suggests that they detected cases in a high-risk population that had not previously benefited from access to diagnosis and treatment. Surveillance data acquired through this CHW network can be used to better target active case detection to populations at highest risk.
Assuntos
Agentes Comunitários de Saúde , Malária , Humanos , Administração de Caso , Malária/diagnóstico , Malária/epidemiologia , Malária/prevenção & controle , Incidência , Panamá/epidemiologiaRESUMO
This work aimed to evaluate the effect of the addition 5°Bx Mexican honeysuckle (Justicia spicigera) extract (JSE) in spray dried encapsulates of whole and skimmed unfermented and fermented cow's milk with Lacticaseibacillus rhamnosus (LR). All samples were spray dried at 160 °C. Samples were analyzed in physical properties (moisture content, water activity (a w ), L∗, a∗, b∗, Hue, Chroma color parameters, particle size), LR content, and bioactive compounds (total anthocyanins (TA), total phenolic content (TPC), and antioxidant capacity (AC) using the DPPH assay). Results showed that the load of LR was in the range 6.79-7.44 Log10 (CFU/mL) cycles after fermentation, lower values were obtained when JSE was added before fermentation. In addition, LR remains after drying in fermented samples but decrease about 1 Log10 (CFU/mL) cycle. LR was 4.46 Log10 (CFU/mL) in the fermented skimmed milk-J. spicigera extract powder. All powders had a w and moisture content below 0.295 and 6.51%, respectively. Color of powders depended on the moment of addition of JSE and fermentation. Powders from fermented milk were pale brownish/orangey/red (Hue = 44.91-59.7) and unfermented and J. spicigera extract-maltodextrin solution (12% w/v) powders were purple (Hue = 314.52-326.68). Higher particle sizes (52.3-104.7 µm) were obtained with whole milk fermented and unfermented powders. On the contrary, skimmed milk and JSE without milk protein had values in the range 15.56-44.0 µm. TPC in powders were higher (16.96-33.81 mg GAE/g powder db) compared with TA (0.27-0.64 mg Peonidin-3,5-diglucoside/g powder db). TPC increased with fermentation and remain after spray drying. The AC and TPCs were highly correlated and had antioxidant capacity of 10.18 mg TE/g powder db. The principal component analysis showed that the type of milk and fermentation separate the powders in four groups, depending on their physical and antioxidant properties. Encapsulated pigments could be used in formulations in the food industry to increase bioactive compounds and pigments in foods.