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Camelids' semen has peculiar characteristics that differentiate it from other species, including the highly viscous aspect of seminal plasma that greatly difficult sperm manipulation and the development of techniques such as cryopreservation, artificial insemination, and/or in vitro fertilization. The presence of proteases in the seminal plasma is responsible for semen liquefaction, and sperm functionality to achieve fertilization. The enzymatic and molecular composition of the semen of llama remains unknown. Therefore, the goal of the study was to characterize the protease activity and composition of the seminal plasma and sperm of llama semen. The proteolytic activity was performed using gelatine zymography and the composition by mass-spectrometry. Metallo-proteases were the major source of gelatinolytic activity in seminal plasma, while serine-peptidases were the main enzymes of sperm cells. Matrix Metalloproteinase 2 (MMP2) was the most prominent metallo-protease of llama seminal plasma characterized under the exposure of different inhibitors (EDTA and benzamidine) and by a specific immunodetection. Moreover, the prostate and epididymis were identified as potential sites of its synthesis and secretion. Outstandingly, this metalloproteinase was undetectable in llama sperm. Regarding, the molecular composition of semen by mass-spectrometry, 4 metallo-, 9 serine-, 8 threonine-, and 1 aspartic-peptidases were identified alongside 15 regulators in the sperm cell; where 24 were directly or indirectly interacting. Whereas 6 metallo-, 12 serine-, 3 cysteine-, and 1 aspartic-peptidases were identified, besides 7 inhibitors and 5 regulators in llama seminal plasma where 30 of them were directly or indirectly interconnected. This is the first study describing a partial degradome of llama seminal plasma and spermatozoa suggesting significant differences especially the absence of MMP2 in spermatozoa in contrast to data observed in other species. The characterization of proteases in llama semen will provide a better understanding of the molecular mechanisms involved in the in vivo or in vitro fertilization process in this species.
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Camelídeos Americanos , Preservação do Sêmen , Masculino , Animais , Sêmen/química , Metaloproteinase 2 da Matriz , Peptídeo Hidrolases , Espermatozoides , Preservação do Sêmen/veterinária , Criopreservação/veterináriaRESUMO
OBJECTIVES: The aim of this study was to investigate the psychometric properties of the Spanish version of the Stigma of Occupational Stress Scale for Doctors (SOSS-D) and the factors associated with Physician Burnout in Paraguay. METHODS: Participants included 747 Paraguayan healthcare workers, aged 24-77 years old, of both sexes. SOSS-D was translated into Spanish and validated through an exploratory and confirmatory factor analysis. Participants were also scored with the Oldenburg Burnout Inventory (OLBI), the CAGE questionnaire, and the stigma subscale of the Perceived Barriers to Psychological Treatment (PBPT) measure. RESULTS: Three factors had a raw eigenvalue greater than 1, and explained 61.7% of total variance. The confirmatory analysis confirmed that the scale is three-dimensional. The model adjustment was good, according to all fit indices. OLBI results indicate clinically significant disengagement in 85.9% and clinically significant exhaustion in 91.6% of participants. Of the 747 participants, 57.6% reported alcoholic beverage consumption and among those, 19.3% had problematic alcohol consumption according to the CAGE questionnaire. The correlation between SOSS-D and the stigma subscale of the PBPT was statistically significant (r = 0.245, p < 0.001). CONCLUSIONS: The Spanish version of the SOSS-D was found to have good psychometric properties and adequately reproduces the three-dimensional model of the original English version.
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Hurricane Maria struck Puerto Rico on September 20, 2017, severely impacting the island. In order to quantify the impact of the hurricane on the indoor air quality, we evaluated the fungal levels in households (n = 20) of the Piñones community for the period of 2018 and 2019. For each dust sample collected, the 36 Environmental Relative Moldiness Index (ERMI) molds were quantified using qPCR assays, and then Shannon Diversity Index (SDI) values for the fungal populations were calculated. Homes were in five separate regions, regarding their proximity in the studied area. We found that for regions with reported least water damage, the SDI values were similar for both sampled years, but for regions that reported mid-to-high level of damage region, the SDI values were significantly higher. Households that reported remediation actions between the two sampled years showed similar values for the second year as those that did not report any major impact. Our preliminary data provides insights into the significant impacts of hurricanes into indoor fungal environment.
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5-Fluorouracil (5-FU) and oral fluoropyrimidines, such as capecitabine, are widely used in the treatment of cancer, especially gastrointestinal tumors and breast cancer, but their administration can produce serious and even lethal toxicity. This toxicity is often related to the partial or complete deficiency of the dihydropyrimidine dehydrogenase (DPD) enzyme, which causes a reduction in clearance and a longer half-life of 5-FU. It is advisable to determine if a DPD deficiency exists before administering these drugs by genotyping DPYD gene polymorphisms. The objective of this consensus of experts, in which representatives from the Spanish Pharmacogenetics and Pharmacogenomics Society and the Spanish Society of Medical Oncology participated, is to establish clear recommendations for the implementation of genotype and/or phenotype testing for DPD deficiency in patients who are candidates to receive fluoropyrimidines. The genotyping of DPYD previous to treatment classifies individuals as normal, intermediate, or poor metabolizers. Normal metabolizers do not require changes in the initial dose, intermediate metabolizers should start treatment with fluoropyrimidines at doses reduced to 50%, and poor metabolizers are contraindicated for fluoropyrimidines.
Assuntos
Capecitabina/uso terapêutico , Di-Hidrouracila Desidrogenase (NADP)/genética , Fluoruracila/uso terapêutico , Técnicas de Genotipagem/normas , Neoplasias/tratamento farmacológico , Neoplasias/genética , Seleção de Pacientes , Humanos , Polimorfismo de Nucleotídeo ÚnicoRESUMO
Organ donation currently is an extremely important issue in public health. Proper information about the details of this topic is extremely important, but is not yet widespread among the public. This study was carried out with the aim to determine the level of knowledge about organ donation among medical students in Paraguay and associated socio-academic factors influencing their level of knowledge. This was an analytical cross-sectional study, based on a multicenter survey among university medical students. About 68.7% (235) of the respondents were preclinical students doing basic sciences. Two aspects were evaluated, the knowledge regarding the donation of the organs and the socio-academic factors, then both the aspects were evaluated through bivariate and multivariate analyses. There were 342 respondents with a median age of 22 years (interquartile range: 20-23 years) of which 263 (77%) were women. One hundred and eighty-eight (55%) reported not knowing the law that protects and regulates the activities of organ and tissue donation in Paraguay. In the multivariate analysis, the highest frequency of a good level of knowledge of organ donation occurred in those who were older [RPA: 1.07, 95% confidence interval (CI): 1.02-1.12, P = 0.007] and in two of the universities evaluated (both with values P <0.012). On the contrary, those who were preclinical students, in general, had a lower level of knowledge of organ donation (RPa: 0.61, 95% CI: 0.46-0.79; value P <0.001). Our findings denote relatively a poor knowledge of organ donation in some socio-academic subsets. Therefore, it is important to develop strategies to increase the knowledge about the subject, by creating opportunities by way of discussions and debates among the students at all academic levels and also by conducting academic conferences on the subject.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Estudantes de Medicina , Obtenção de Tecidos e Órgãos , Estudos Transversais , Feminino , Humanos , Masculino , Paraguai , Fatores Sociais , Adulto JovemRESUMO
Introducción Un modelo centrado en la enseñanza-aprendizaje supone un cambio en la docencia universitaria, esto implica el uso de metodologías activas con enfoque en el desarrollo de habilidades como el pensamiento crítico (PC) y sentido ético (SE). Objetivo Evaluar el impacto de la implementación del estudio de caso (EC) en el desarrollo de habilidades de PC y SE en estudiantes de enfermería. Métodos Se realizó una intervención longitudinal en una muestra de 103 estudiantes, se aplicó la prueba estadística ANOVA. Resultados Se evaluó el desarrollo de PC al comparar los resultados obtenidos por los estudiantes en tres evaluaciones, se logró evidenciar un progreso en el desarrollo de las habilidades de PC, y SE. Con el análisis de varianza se estableció que el valor del estadístico F fue mayor al crítico (valor p < 0,05), para un nivel de confianza del 95%, se puede rechazar la hipótesis nula. Discusión La implementación de la metodología contribuyó favorablemente en el desarrollo de las habilidades PC y SE en los estudiantes, lo que les permitió identificar y resolver problemas, al fundamentar sus decisiones. Además, fomentó el aprendizaje colaborativo y el respeto, entre pares. Conclusiones La metodología EC promovió un aprendizaje activo y un cambio en la cultura del aula. Si bien, implementar la metodología de EC favoreció el desarrollo de habilidades de PC y SE en los estudiantes de enfermería, es necesario seguir investigando sobre factores que mejoren el proceso de enseñanza-aprendizaje con un enfoque activo.
Introduction A teaching-learning centered university model implies an evolution characterized by using active methodologies with a focus on the development of skills such as critical thinking (CT), and ethical sense (ES). Objective To assess the impact from the implementation of the Study Case (SC) in the development of critical thinking and ethical sense among nursing students. Methods A longitudinal intervention was conducted on a sample of 103 nursing students. ANOVA tests were performed. Results Critical thinking was assessed by comparing the corresponding results of the students in three evaluations. A progress is development of critical thinking and ethical sense was evidenced. From the ANOVA, it was shown that the F value was higher than the critical reference (p < 0.05) within a 95% confidence interval, and thus, the nil hypothesis was rejected. Discussion The implementation of this methodology favorably contributed for the development of critical thinking and ethical sense skills among the students, an improvement which allowed them to identify and solve problems based on their decision arguments. Moreover, the methodology fostered collaborative learning and respect among colleagues. Conclusions Although the Case Study methodology promoted active learning and a change in the culture of the classroom, it is necessary to continue studying the factors which could improve the teaching-learning processes under an active approach.
Introdução Um modelo centrado no ensino-aprendizagem supõe um câmbio na docência universitária, isto envolve o uso de metodologias ativas com enfoque no desenvolvimento de habilidades como o pensamento crítico (PC) e sentido ético (SE). Objetivo Avaliar o impacto da implementação do estudo de caso (EC) no desenvolvimento de habilidades de PC e SE em estudantes de enfermagem. Métodos Realizou-se uma intervenção longitudinal em uma mostra de 103 estudantes, aplicou-se a proba estatística ANOVA. Resultados Avaliou-se o desenvolvimento de PC ao comparar os resultados obtidos pelos estudantes em três avaliações, atingiu-se evidenciar um progresso no desenvolvimento das habilidades de PC, e SE. Com a análise de variância estabeleceu-se que o valor do estatístico F foi maior ao crítico (valor p < 0,05), para um nível de confiança do 95%, pode se rejeitar a hipótese nula. Discussão A implementação da metodologia contribuiu favoravelmente no desenvolvimento das habilidades PC e SE nos estudantes, o que lhes permitiu identificar e resolver problemas, ao fundamentar suas decisões. Além disso, fomentou a aprendizagem colaborativa e o respeito entre pares. Conclusões A metodologia EC promoveu uma aprendizagem ativa e um câmbio na cultura de aula. Embora, implementar a metodologia de EC favoreça o desenvolvimento de habilidades de PC e SE nos estudantes de enfermagem, é necessário seguir pesquisando sobre fatores que melhorem o processo de ensino-aprendizagem com um enfoque ativo.
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Humanos , Masculino , Feminino , Estudantes de Enfermagem , Pensamento , Relatos de CasosRESUMO
BACKGROUND: The purpose of this study was to analyze the clinical and radiological evolution of the total knee revision arthroplasty with cemented stems in patients over 75 years. MATERIAL AND METHODS: A retrospective analysis was performed in all the subjects who underwent revision of total knee arthroplasty with cemented stems between 2008 and 2014 in our center. Twenty-seven individuals over 75 years met the inclusion criteria. We assessed the Knee Society Score and range of motion for clinical outcome. We evaluated the implant stability with radiographs through radiolucent lines according to the modified radiological scale of the Knee Society; we registered the complications and prosthetic survival. RESULTS: With an average age of our participants of 82.6 ± 4.4 years and a follow-up of 43 ± 14.4 months, we did not find any mechanical failure of the components. The functional average score was 115 ± 32 in the total KSS, of which 77 ± 17.5 points were in the KSS knee and 42 ± 24 in the KSS function. The average range of motion was 98º ± 17. Radiologically, 18 patients presented radiolucent lines, but only three needed follow-up using the modified Knee Society radiographic scoring system. CONCLUSIONS: The results revealed that cemented stems are a good method for fixation in the revision of total knee arthroplasty in people over 75 years. We observed acceptable medium-term clinical results with a low risk of radiological failure, despite the high number of radiolucencies.
Analizar la evolución funcional y radiológica de los pacientes mayores de 75 años intervenidos de cirugía de revisión de rodilla con vástagos cementados.
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Artroplastia do Joelho , Reoperação , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Humanos , Prótese do Joelho , Falha de Prótese , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Resumen: Antecedentes: Analizar la evolución funcional y radiológica de los pacientes mayores de 75 años intervenidos de cirugía de revisión de rodilla con vástagos cementados. Material y métodos: Mediante análisis retrospectivo, hemos revisado a 27 individuos mayores de 75 años a quienes se les ha implantado una prótesis total de rodilla de revisión con vástagos cementados en nuestro centro entre 2008-2014. Durante el seguimiento, se realizó un análisis clínico mediante la escala Knee Society Score y de movilidad de la rodilla, un análisis radiológico de la estabilidad de los implantes por medio de la escala radiológica modificada de la Knee Society, el registro de las complicaciones y la supervivencia protésica. Resultados: Con una edad media de los participantes de 82.6 ± 4.4 años y un seguimiento medio de 43 ± 14.4 meses, no hemos observado ningún caso de aflojamiento mecánico de los componentes. La valoración funcional ha sido de 115 ± 32 puntos en la escala total KSS, de los cuales 77 ± 17.5 puntos pertenecen al KSS rodilla y 42 ± 24 puntos al KSS función. El rango medio de movilidad fue de 98o ± 17. A nivel radiológico, 18 sujetos mostraron radiolucencias periprotésicas; según los criterios de la escala radiológica de la Knee Society, solo tres requirieron seguimiento clínico-radiológico estricto. Conclusiones: La cementación de los vástagos en prótesis totales de rodilla de revisión se trata de un buen sistema de fijación en personas mayores de 75 años, con elevada supervivencia del implante, buen resultado funcional y bajo porcentaje de aflojamiento radiológico a pesar de la aparición frecuente de radiolucencias.
Abstract: Background: The purpose of this study was to analyze the clinical and radiological evolution of the total knee revision arthroplasty with cemented stems in patients over 75 years. Material and methods: A retrospective analysis was performed in all the subjects who underwent revision of total knee arthroplasty with cemented stems between 2008 and 2014 in our center. Twenty-seven individuals over 75 years met the inclusion criteria. We assessed the Knee Society Score and range of motion for clinical outcome. We evaluated the implant stability with radiographs through radiolucent lines according to the modified radiological scale of the Knee Society; we registered the complications and prosthetic survival. Results: With an average age of our participants of 82.6 ± 4.4 years and a follow-up of 43 ± 14.4 months, we did not find any mechanical failure of the components. The functional average score was 115 ± 32 in the total KSS, of which 77 ± 17.5 points were in the KSS knee and 42 ± 24 in the KSS function. The average range of motion was 98o ± 17. Radiologically, 18 patients presented radiolucent lines, but only three needed follow-up using the modified Knee Society radiographic scoring system. Conclusions: The results revealed that cemented stems are a good method for fixation in the revision of total knee arthroplasty in people over 75 years. We observed acceptable medium-term clinical results with a low risk of radiological failure, despite the high number of radiolucencies.
Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Reoperação , Artroplastia do Joelho , Falha de Prótese , Estudos Retrospectivos , Seguimentos , Resultado do Tratamento , Prótese do JoelhoRESUMO
STUDY DESIGN: Case control study. OBJECTIVE: To determine the main risk factors for pressure ulcer (PU) in ambulatory spinal cord injury (SCI) patients. SETTING: Hospital del Trabajador, Santiago, (ACHS (Chilean Security Association), Chile. METHODS: We studied 41 patients for traumatic SCI, from Santiago, Chile, cared for in our hospital. The clinical histories were reviewed from first discharge to 1996. The patients were categorized into two groups: 18 cases with a previous history of PU, and 23 patients with no history of PU were considered as controls. Univariate analysis was performed, 18 variables per case, 10 of which were psychosocial factors. RESULTS: There were 37 men and four women. Average age was 41.7 years. Duration of SCI on average was 6.7 years. The distribution was complete paraplegia (CPP) 22 patients (54%), complete tetraplegia three patients (7%), incomplete paraplegia 11 patients (27%) and incomplete tetraplegia, five patients (12%). Four variables of the univariate analysis were significant: duration of cord injury (SCI time) >5 years, completeness of cord injury, paraplegia and not able to practice regular standing. There was a significant association in body morphology (endo or ectomorphic), being able to practice regular standing and personality disorder in CPP. CONCLUSIONS: The risk for developing PU was 4.3 times greater in CPP patients than is any other type of SCI. CPP patients who do not practice standing periodically, who have a personality disorder and have an ecto/endomorphic corporal morphology have a greater risk of suffering PU.
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Úlcera por Pressão/etiologia , Traumatismos da Medula Espinal/complicações , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paraplegia , Úlcera por Pressão/prevenção & controle , Análise de Regressão , Medição de Risco , Fatores de RiscoRESUMO
BACKGROUND: Twenty to twenty two percent of work related accidents have a direct or indirect relationship with recent alcohol use. AIM: To detect recent alcohol or drug use in patients who required hospitalization for severe work related accidents. PATIENTS AND METHODS: Blood and urine samples were obtained from patients admitted to a hospital within 6 hours of an accident severe enough to require hospitalization. Blood alcohol and urinary metabolites of cocaine, marijuana, amphetamines and benzodiazepines were measured. Patient identity was kept confidential throughout the study. Once patients were stabilized, they were interviewed by a psychologist that was blind to laboratory results. RESULTS: Two hundred thirty men and 18 women were studied and 29% (30% of men and 17% of women) had recent use of alcohol or drugs. The most common substances were alcohol in 15% and benzodiazepines in 13%. Use of alcohol or drugs was found in 21% of professionals, in 33% of other occupational levels, half of agricultural workers and 25% of commerce workers. Only two of 60 positive cases, admitted substance use during the interview. Most of negative cases admitted the use of alcohol or other drugs during the month prior to the accident. CONCLUSIONS: Recent use of alcohol and drugs is frequent among severe work related accident victims. Probably, a high proportion of these subjects are problem drinkers. The combination of alcohol and benzodiazepines is an additional risk factor.
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Acidentes de Trabalho , Consumo de Bebidas Alcoólicas/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias , Feminino , Hospitalização , Humanos , Escala de Gravidade do Ferimento , Masculino , Fatores de TempoRESUMO
This is a preliminary study of psychological symptoms, prior psychosocial adjustment and severity of injury in 25 consecutive burn patients. All had suffered burns in work-related accidents and were evaluated by the psychiatric consulation-liaison team during their initial hospitalization in the Burn Unit of the Hospital del Trabajador, Santiago. All patients were clinically evaluated and the following instruments were applied: Hamilton Scales of Anxiety (HAM-A) and Depression (HAM-D), Goldberg's General Health Questionnaire (GHQ-28), Cloninger's Tridimensional Personality Questionnaire (TPQ) and a modified version of a Schooler's Adjustment Scale. No significant correlation was found between extent and severity of burns and anxious or depressive symptoms. However, all patients had burns that varied from mild to moderate; there were no severe and extensive injuries. A significant correlation was found between anxiety and the harm avoidance dimension in the TPQ, as would be expected. Patients with poor psychosocial adjustment presented with greater anxiety symptoms. A significant negative correlation was also found between degree of anxiety symptoms and income level. The main findings are in agreement with current literature. They emphasize the relevance of prior psychosocial adjustment and personality as probable factors of psychological symptoms. The need to control pain as a variable is also pointed out.
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Queimaduras/psicologia , Emoções , Hospitalização , Acidentes de Trabalho/psicologia , Adulto , Ansiedade/psicologia , Atitude Frente a Saúde , Superfície Corporal , Queimaduras/classificação , Queimaduras/patologia , Chile , Depressão/psicologia , Escolaridade , Feminino , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Dor/prevenção & controle , Dor/psicologia , Personalidade , Índice de Gravidade de Doença , Ajustamento Social , Inquéritos e QuestionáriosRESUMO
Splenic pseudocysts represent 70 to 80% of the non parasitic cysts of this organ. Malaria, infectious mononucleosis, tuberculosis and t. pallidum infection are predisposing factors. Cystic characteristics are determined by CT-SCAN and ultrasound. Final diagnosis is achieved by hystological examination. This is a case report.
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Cistos , Esplenopatias , Adulto , Cistos/diagnóstico , Feminino , Humanos , Esplenopatias/diagnósticoRESUMO
The purpose of this study was to adapt and apply a battery of neuropsychological tests administered by computer. The study comprised three phases: 1) An existing system (NES-2) was revised and adapted (mainly in its Spanish version, since the structure and time intervals were the same). 2) A pilot group of 18 subjects was administered the five selected tests. 3) A comparative study of 36 exposed workers with 40 unexposed controls was undertaken. It was concluded that computer-administered tests are acceptable and economic. No significant differences were found between exposed. The possible reasons for the negative findings are discussed, as well as the types of future studies that need to be carried out.
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Diagnóstico por Computador/métodos , Exposição Ambiental/efeitos adversos , Doenças Profissionais/induzido quimicamente , Estirenos/efeitos adversos , Adolescente , Adulto , Fatores Etários , Criança , Humanos , Doenças do Sistema Nervoso/induzido quimicamente , Doenças do Sistema Nervoso/diagnóstico , Doenças Profissionais/diagnóstico , Testes Psicológicos , Fatores de RiscoRESUMO
La rehabilitación sexual ocupa un lugar importante en el manejo del lesionado medular. Se describe el método y resultados del tratamiento de 62 casos (60 hombres y 2 mujeres) con lesión medular. En 29 pacientes (47%) bastó con una entrevista destinada a aclarar dudas, todos los hombres (27 de los 29 casos) tenían erecciones útiles y no necesitaron tratamiento específico. Otros 27 hombres se trataron sin inyección de Papaverina, consiguiendo erección eficiente en 23 (85% de eficiencia). Sólo 2 de los 60 pacientes de sexo masculino (3%) han requerido prótesis. En total se ha obtenido rehabilitación satisfactoria en 53 de 63 pacientes (85,5%)
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Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Disfunções Sexuais Fisiológicas/reabilitação , Traumatismos da Medula Espinal/complicações , Papaverina/uso terapêuticoRESUMO
Episodes of hepatic sequestration were seen in four patients with sickle cell anaemia (SCA). One case presented a severe and fatal sequestration crisis whereas the others showed mild episodes associated with less striking haematological and clinical changes. These clinical pictures are similar to those seen in the splenic sequestration crises of children with SCA. Different causes of liver enlargement in SCA suggest that the clinical spectrum representing intrahepatic trapping of blood could range from the acute sequestration crisis to chronic sequestration events which very probably should play any role in the pathogenesis of the hepatomegaly frequently found in these patients.