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ABSTRACT Objective. To determine the 24-hour urinary sodium and potassium excretions in the Americas. Methods. A systematic review and meta-analysis were performed seeking for studies conducted between 1990 and 2021 in adults living in any sovereign state of the Americas in Medline, Embase, Scopus, SciELO, and Lilacs. The search was first run on October 26th, 2020 and was updated on December 15th, 2021. Of 3 941 abstracts reviewed, 74 studies were included from 14 countries, 72 studies reporting urinary sodium (27 387 adults), and 42 studies reporting urinary potassium (19 610 adults) carried out between 1990 and 2020. Data were pooled using a random-effects meta-analysis model. Results. Mean excretion was 157.29 mmol/24h (95% CI, 151.42-163.16) for sodium and 57.69 mmol/24h (95% CI, 53.35-62.03) for potassium. When only women were considered, mean excretion was 135.81 mmol/24h (95% CI, 130.37-141.25) for sodium and 51.73 mmol/24h (95% CI, 48.77-54.70) for potassium. In men, mean excretion was 169.39 mmol/24h (95% CI, 162.14-176.64) for sodium and 62.67 mmol/24h (95% CI, 55.41-69.93) for potassium. Mean sodium excretion was 150.09 mmol/24h (95% CI, 137.87-162.30) in the 1990s and 159.79 mmol/24h (95% CI, 151.63-167.95) in the 2010s. Mean potassium excretion was 58.64 mmol/24h (95% CI, 52.73-64.55) in the 1990s and 56.33 mmol/24/h (95% CI, 48.65-64.00) in the 2010s. Conclusions. These findings suggest that sodium excretions are almost double the maximum level recommended by the World Health Organization and potassium excretions are 35% lower than the minimum requirement; therefore, major efforts to reduce sodium and to increase potassium intakes should be implemented.
RESUMEN Objetivo. Determinar la excreción urinaria de sodio y potasio en 24 horas en la Región de las Américas. Métodos. Se realizaron una revisión sistemática y un metanálisis en busca de estudios realizados entre los años 1990 y 2021 con adultos residentes en cualquier Estado soberano de la Región publicados en Medline, Embase, Scopus, SciELO y Lilacs. La búsqueda se llevó a cabo por primera vez el 26 de octubre del 2020 y se actualizó el 15 de diciembre del 2021. De los 3941 resúmenes revisados, se incluyeron 74 estudios de 14 países, 72 estudios sobre excreción urinaria de sodio (27 387 adultos) y 42 estudios sobre excreción urinaria de potasio (19 610 adultos) realizados entre el 1990 y el 2020. Se agruparon los datos mediante un modelo de metanálisis de efectos aleatorios. Resultados. La excreción media de sodio fue de 157,29 mmol/24h (IC de 95%, 151,42-163,16); la de potasio, de 57,69 mmol/24 h (IC de 95%, 53,35-62,03). En los casos en que se consideraron únicamente mujeres, la excreción media de sodio fue de 135,81 mmol/24h (IC de 95%, 130,37-141,25); la de potasio, de 51,73 mmol/24h (IC de 95%, 48,77-54,70). En varones, la excreción media de sodio fue de 169,39 mmol/24h (IC de 95%, 162,14-176,64); la de potasio, de 62,67 mmol/24h (IC de 95%, 55,41-69,93). La excreción media de sodio fue de 150,09 mmol/24h (IC de 95%, 137,87-162,30) en la década de 1990 y de 159,79 mmol/24 h (IC de 95%, 151,63-167,95) en la década del 2010. La excreción media de potasio fue de 58,64 mmol/24h (IC de 95%, 52,73-64,55) en la década de 1990 y de 56,33 mmol/24h (IC de 95%, 48,65-64,00) en la década del 2010. Conclusiones. Estos resultados sugieren que la excreción de sodio casi duplica el nivel máximo recomendado por la Organización Mundial de la Salud y las excreción de potasio es 35% más baja que el requisito mínimo, por lo que se deben invertir grandes esfuerzos para reducir el consumo de sodio y aumentar la ingesta de potasio.
RESUMO Objetivo. Determinar as excreções urinárias de sódio e potássio em 24 horas na Região das Américas. Métodos. Revisão sistemática e metanálise de estudos realizados entre 1990 e 2021, em adultos vivendo em qualquer estado soberano da região, indexados nos bancos de dados MEDLINE, Embase, Scopus, SciELO e LILACS. A pesquisa foi realizada pela primeira vez em 26 de outubro de 2020 e foi atualizada em 15 de dezembro de 2021. Dos 3.941 resumos revisados, foram incluídos 74 estudos de 14 países, 72 estudos relatando sódio urinário (27.387 adultos) e 42 estudos relatando potássio urinário (19.610 adultos), realizados entre 1990 e 2020. Os dados foram reunidos utilizando um modelo de metanálise de efeitos aleatórios. Resultados. A excreção média foi de 157,29 mmol/24h (IC95% 151,42-163,16) para o sódio e 57,69 mmol/24h (IC95% 53,35-62,03) para o potássio. Quando somente mulheres foram consideradas, a excreção média foi de 135,81 mmol/24h (IC95% 130,37-141,25) para o sódio e 51,73 mmol/24h (IC95% 48,77-54,70) para o potássio. Nos homens, a excreção média foi de 169,39 mmol/24h (IC95% 162,14-176,64) para o sódio e 62,67 mmol/24h (IC95% 55,41-69,93) para o potássio. A excreção média de sódio foi de 150,09 mmol/24h (IC95% 137,87-162,30) na década de 1990 e 159,79 mmol/24h (IC95% 151,63-167,95) na década de 2010. A excreção média de potássio foi de 58,64 mmol/24h (IC95% 52,73-64,55) na década de 1990 e 56,33 mmol/24/h (IC95% 48,65-64,00) na década de 2010. Conclusões. Estes achados sugerem que as excreções de sódio são quase o dobro do nível máximo recomendado pela Organização Mundial da Saúde e as excreções de potássio são 35% menores do que o mínimo exigido; portanto, será necessário envidar esforços importantes para reduzir a ingestão de sódio e aumentar a de potássio.
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From 20th century, our views, understanding and treatment of pathogenic infections have drastically changed. Pathogenic organisms were discovered, classified and treatments were subsequently implemented. Candidiasis spp. was discovered and linked to the condition; Vulvovaginal Candidiasis (VVC), commonly known as yeast infection, which affects the female lower genital tract, vulva and vagina. Symtoms of such an infection include itching, burning, soreness and a creamy vaginal discharge. Given the nature, location and symptoms of such an infection, individuals are often self-conscious and hesitant to discus it or seek medical attention until symptoms become unbearable. VVC is one of the most common infections in reproductive age females with 75% of women experiencing infection at least once in their lives. Due to the qualitative gap in literature toward women affected by VVC in our country, this study aimed to highlight the knowledge, attitudes and practices towards VVC among reproductive age in Trinidad and Tobago.
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Trinidad e Tobago , Candidíase Vulvovaginal , Mulheres , Atitude , ConhecimentoRESUMO
The intestinal mucosa contributes to frontline gut defenses by forming a barrier (physical and biochemical) and preventing the entry of pathogenic microbes. One innate role of the human colonic epithelium is to secrete cathelicidin, a peptide with broad antimicrobial and immunomodulatory functions. In this study, the effect of cathelicidin in the maintenance of epithelial integrity, Toll-like receptor recognition, bacterial invasion and initiation of inflammatory response against Salmonella typhimurium is investigated in cultured human colonic epithelium. We found exogenous human cathelicidin restores the epithelial integrity in S. typhimurium-infected colonic epithelial (T84) cells by mostly post-translational effects associated with reorganization of zonula occludens (ZO)-1 tight junction proteins. Endogenous cathelicidin prevents S. typhimurium internalization as shown in colonic epithelial cells genetically deficient in the only human cathelicidin, LL-37 (shLL-37). Moreover, supplementation of shLL-37 cells with synthetic LL-37 reduces the grade of S. typhimurium internalization in a dose-dependent manner. Mechanistically, shLL-37 cells have lower gene expression of TLR4 and pro-inflammatory cytokine IL-1ß in response to S. typhimurium. Thus, human cathelicidin aids in the early colonic epithelial defenses against enteric S. typhimurium by preventing bacterial invasion and maintaining epithelial barrier integrity, likely to occur due to the production of sensing TLR4 and pro-inflammatory cytokines.
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Peptídeos Catiônicos Antimicrobianos/farmacologia , Colo/efeitos dos fármacos , Mucosa Intestinal/efeitos dos fármacos , Infecções por Salmonella/prevenção & controle , Salmonella typhimurium/efeitos dos fármacos , Peptídeos Catiônicos Antimicrobianos/uso terapêutico , Colo/imunologia , Colo/microbiologia , Células HT29 , Humanos , Interleucina-1beta/imunologia , Mucosa Intestinal/imunologia , Mucosa Intestinal/microbiologia , Receptor 4 Toll-Like/imunologia , Proteína da Zônula de Oclusão-1/metabolismo , CatelicidinasRESUMO
For more than two centuries biogeographers have attempted to explain why terrestrial or freshwater lineages have geographic distributions broken by oceans, with these disjunct distributions either attributed to vicariance associated with Gondwanan fragmentation or trans-oceanic dispersal. Stoneflies (order: Plecoptera) are a widespread order of freshwater insects whose poor dispersal ability and intolerance for salt water make them ideal candidates for Gondwanan relicts - taxa whose distribution can be explained by vicariant isolation driven by the breakup of Gondwana. Here we reconstruct the phylogenetic relationships among southern hemisphere stoneflies (5 families; 86 genera) using 2864bp of mitochondrial (COI) and nuclear (18S, H3) DNA, with a calibrated relaxed molecular clock used to estimate the chronology of diversification. Our analysis suggests that largely antitropical stonefly sub-orders, Arctoperlaria (northern hemisphere) and Antarctoperlaria (southern hemisphere), were formed approximately 121Ma (95% prior probability distribution 107-143Ma), which may reflect the vicariant rifting of the supercontinent Pangaea. Subsequently, we infer that a single Arctoperlaria lineage has dispersed into southern hemisphere 76Ma (95% range 65-98Ma). The majority of divergences between South American and Australian stonefly lineages appear to coincide with the opening of Drake Passage around 40Ma, suggesting vicariant isolation of these landmasses may be responsible for these biogeographic disjunctions. In contrast, divergences between New Zealand lineages and their sister taxa appear to post-date vicariant timeframes, implying more recent dispersal events.
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Insetos/genética , Filogenia , Animais , Austrália , Calibragem , Núcleo Celular/genética , DNA Mitocondrial/genética , Nova Zelândia , Oceanos e Mares , Filogeografia , América do Sul , Fatores de TempoRESUMO
An unusual mortality event (UME) was declared for cetaceans in the northern Gulf of Mexico (GoM) for Franklin County, Florida, west through Louisiana, USA, beginning in February 2010 and was ongoing as of September 2014. The 'Deepwater Horizon' (DWH) oil spill began on 20 April 2010 in the GoM, raising questions regarding the potential role of the oil spill in the UME. The present study reviews cetacean mortality events that occurred in the GoM prior to 2010 (n = 11), including causes, durations, and some specific test results, to provide a historical context for the current event. The average duration of GoM cetacean UMEs prior to 2010 was 6 mo, and the longest was 17 mo (2005-2006). The highest number of cetacean mortalities recorded during a previous GoM event was 344 (in 1990). In most previous events, dolphin morbillivirus or brevetoxicosis was confirmed or suspected as a causal factor. In contrast, the current northern GoM UME has lasted more than 48 mo and has had more than 1000 reported mortalities within the currently defined spatial and temporal boundaries of the event. Initial results from the current UME do not support either morbillivirus or brevetoxin as primary causes of this event. This review is the first summary of cetacean UMEs in the GoM and provides evidence that the most common causes of previous UMEs are unlikely to be associated with the current UME.
Assuntos
Cetáceos , Monitoramento Ambiental/métodos , Animais , Ecossistema , Golfo do MéxicoRESUMO
Objetivos. Estimar la frecuencia de neoplasia escamosa de la superficie ocular (NESO) no sospechada en pterigión, la precisión del diagnóstico clínico y las características demográficas y clínicas asociadas. Materiales y métodos. Se examinaron los informes histopatológicos de los pacientes con diagnóstico clínico de pterigión y/o NESO que fueron quirúrgicamente tratados entre marzo de 2009 y diciembre de 2012 en el Instituto Nacional de Oftalmología en Lima, Perú. La precisión del diagnóstico clínico para identificar la NESO se evaluó mediante la sensibilidad, especificidad y los cocientes de probabilidad. Se realizaron modelos de regresión log-log negativos para identificar las características demográficas y clínicas asociadas con un aumento de las probabilidades de diagnosticar NESO. Resultados. Se examinaron 3021 informes de histopatología. La frecuencia de NESO no sospechada en pterigión fue de 0,65%. El diagnóstico clínico presentó una sensibilidad del 85%, una especificidad del 99%, un cociente de probabilidad positiva de 111,89 y un cociente probabilidad negativa de 0,15. Las características asociadas fueron el sexo masculino (OR 1,15; IC 95%:1,01-1,30), pacientes de 61 a 80 años (OR 1,54; IC 95%: 1,28-1,85), ≥ de 81 años (OR 3,10; IC 95%: 2,09-4,58), pacientes con lesiones recurrentes (OR 1,59; IC 95%: 1,03-2,46) y lesiones en el lado temporal (OR 3,57; IC 95%: 2,63-4,85) presentaron mayor probabilidad de NESO. Conclusiones. Se encontró una baja frecuencia de NESO no sospechada, sin embargo, es recomendable realizar el estudio histopatológico de forma rutinaria para evitar diagnósticos erróneos de NESO como pterigión.
Objectives. To estimate the frequency of unsuspected ocular surface squamous neoplasia (OSSN) in pterygium, the accuracy of clinical diagnosis, and associated demographic and clinical characteristics. Materials and methods. We reviewed histopathological reports of patients with a clinical diagnosis of pterygium and/or OSSN who were surgically treated between March 2009 and December 2012 at the National Eye Institute in Lima, Peru. The accuracy of the clinical diagnosis of OSSN was assessed by sensitivity, specificity, and likelihood ratios. Models of negative log-log regression were performed to identify demographic and clinical characteristics associated with increased odds of diagnosing OSSN. Results. 3,021 histopathological reports were reviewed. The frequency of unsuspected OSSN in pterygium was 0.65%. Clinical diagnosis had a sensitivity of 85%, a specificity of 99%, a positive likelihood ratio of 111.89, and a negative likelihood ratio of 0.15. Associated characteristics were male gender (OR =1.15; 95% CI: 1.01 to 1.30), age group of 61- 80 years (OR = 1.54, 95% CI: 1.28 to 1.85) ≥ 81 years (OR = 3.10; 95% CI: 2.09 to 4.58), presence of recurrent lesions (OR = 1.59; 95% CI: 1.03 to 2.46) and temporal location lesions (OR = 3.57; 95% CI: 2.63 to 4.85). These characteristics were associated with a greater likelihood of OSSN. Conclusions. A low frequency of unsuspected OSSN was found; however, it is recommended to routinely perform histopathology studies to avoid misdiagnosis of OSSN as pterygium.
Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Diagnóstico Clínico , Neoplasias Oculares , Pterígio , PeruRESUMO
Objetivos. Estimar la frecuencia de neoplasia escamosa de la superficie ocular (NESO) no sospechada en pterigión, la precisión del diagnóstico clínico y las características demográficas y clínicas asociadas. Materiales y métodos. Se examinaron los informes histopatológicos de los pacientes con diagnóstico clínico de pterigión y/o NESO que fueron quirúrgicamente tratados entre marzo de 2009 y diciembre de 2012 en el Instituto Nacional de Oftalmología en Lima, Perú. La precisión del diagnóstico clínico para identificar la NESO se evaluó mediante la sensibilidad, especificidad y los cocientes de probabilidad. Se realizaron modelos de regresión log-log negativos para identificar las características demográficas y clínicas asociadas con un aumento de las probabilidades de diagnosticar NESO. Resultados. Se examinaron 3021 informes de histopatología. La frecuencia de NESO no sospechada en pterigión fue de 0,65%. El diagnóstico clínico presentó una sensibilidad del 85%, una especificidad del 99%, un cociente de probabilidad positiva de 111,89 y un cociente probabilidad negativa de 0,15. Las características asociadas fueron el sexo masculino (OR 1,15; IC 95%:1,01-1,30), pacientes de 61 a 80 años (OR 1,54; IC 95%: 1,28-1,85), ≥ de 81 años (OR 3,10; IC 95%: 2,09-4,58), pacientes con lesiones recurrentes (OR 1,59; IC 95%: 1,03-2,46) y lesiones en el lado temporal (OR 3,57; IC 95%: 2,63-4,85) presentaron mayor probabilidad de NESO. Conclusiones. Se encontró una baja frecuencia de NESO no sospechada, sin embargo, es recomendable realizar el estudio histopatológico de forma rutinaria para evitar diagnósticos erróneos de NESO como pterigión. (AU)
Objectives. To estimate the frequency of unsuspected ocular surface squamous neoplasia (OSSN) in pterygium, the accuracy of clinical diagnosis, and associated demographic and clinical characteristics. Materials and methods. We reviewed histopathological reports of patients with a clinical diagnosis of pterygium and/or OSSN who were surgically treated between March 2009 and December 2012 at the National Eye Institute in Lima, Peru. The accuracy of the clinical diagnosis of OSSN was assessed by sensitivity, specificity, and likelihood ratios. Models of negative log-log regression were performed to identify demographic and clinical characteristics associated with increased odds of diagnosing OSSN. Results. 3,021 histopathological reports were reviewed. The frequency of unsuspected OSSN in pterygium was 0.65%. Clinical diagnosis had a sensitivity of 85%, a specificity of 99%, a positive likelihood ratio of 111.89, and a negative likelihood ratio of 0.15. Associated characteristics were male gender (OR =1.15; 95% CI: 1.01 to 1.30), age group of 61- 80 years (OR = 1.54, 95% CI: 1.28 to 1.85) ≥ 81 years (OR = 3.10; 95% CI: 2.09 to 4.58), presence of recurrent lesions (OR = 1.59; 95% CI: 1.03 to 2.46) and temporal location lesions (OR = 3.57; 95% CI: 2.63 to 4.85). These characteristics were associated with a greater likelihood of OSSN. Conclusions. A low frequency of unsuspected OSSN was found; however, it is recommended to routinely perform histopathology studies to avoid misdiagnosis of OSSN as pterygium. (AU)
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Pterígio , Neoplasias Oculares , Diagnóstico Clínico , PeruRESUMO
PROBLEM: Guatemala is experiencing an increasing burden of cancer but lacks capacity for cancer prevention, control and research. APPROACH: In partnership with a medical school in the United States of America, a multidisciplinary Cancer Control Research Training Institute was developed at the Instituto de Cancerología (INCAN) in Guatemala City. This institute provided a year-long training programme for clinicians that focused on research methods in population health and sociocultural anthropology. The programme included didactic experiences in Guatemala and the United States as well as applied training in which participants developed research protocols responsive to Guatemala's cancer needs. LOCAL SETTING: Although INCAN is the point of referral and service for Guatemala's cancer patients, the institute's administration is also interested in increasing cancer research - with a focus on population health. INCAN is thus a resource for capacity building within the context of cancer prevention and control. RELEVANT CHANGES: Trainees increased their self-efficacy for the design and conduct of research. Value-added benefits included establishment of an annual cancer seminar and workshops in cancer pathology and qualitative analysis. INCAN has recently incorporated some of the programme's components into its residency training and established a research department. LESSONS LEARNT: A training programme for clinicians can build cancer research capacity in low- and middle-income countries. Training in population-based research methods will enable countries such as Guatemala to gather country-specific data. Once collected, such data can be used to assess the burden of cancer-related disease, guide policy for reducing it and identify priority areas for cancer prevention and treatment.
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Educação Médica/métodos , Neoplasias , Pesquisa/educação , Fortalecimento Institucional , Currículo , Países em Desenvolvimento , Guatemala , Humanos , Cooperação Internacional , Estados UnidosRESUMO
OBJECTIVES: To estimate the frequency of unsuspected ocular surface squamous neoplasia (OSSN) in pterygium, the accuracy of clinical diagnosis, and associated demographic and clinical characteristics. MATERIALS AND METHODS: We reviewed histopathological reports of patients with a clinical diagnosis of pterygium and/or OSSN who were surgically treated between March 2009 and December 2012 at the National Eye Institute in Lima, Peru. The accuracy of the clinical diagnosis of OSSN was assessed by sensitivity, specificity, and likelihood ratios. Models of negative log-log regression were performed to identify demographic and clinical characteristics associated with increased odds of diagnosing OSSN. RESULTS: 3,021 histopathological reports were reviewed. The frequency of unsuspected OSSN in pterygium was 0.65%. Clinical diagnosis had a sensitivity of 85%, a specificity of 99%, a positive likelihood ratio of 111.89, and a negative likelihood ratio of 0.15. Associated characteristics were male gender (OR =1.15; 95% CI: 1.01 to 1.30), age group of 61-80 years (OR = 1.54, 95% CI: 1.28 to 1.85) ≥ 81 years (OR = 3.10; 95% CI: 2.09 to 4.58), presence of recurrent lesions (OR = 1.59; 95% CI: 1.03 to 2.46) and temporal location lesions (OR = 3.57; 95% CI: 2.63 to 4.85). These characteristics were associated with a greater likelihood of OSSN. CONCLUSIONS: A low frequency of unsuspected OSSN was found; however, it is recommended to routinely perform histopathology studies to avoid misdiagnosis of OSSN as pterygium.
Assuntos
Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Oculares/complicações , Neoplasias Oculares/epidemiologia , Pterígio/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PeruRESUMO
OBJECTIVE: The Chronic Disease Research Fellowship Program (RFP) aims to build the research capacity of recent medical graduates to support the development of chronic disease control strategies. SETTING: Guatemala is undergoing an epidemiologic transition. However, given the way universities and the health care system are structured, it lacks an environment that fosters research careers and generates the required knowledge to implement sound public health policies and clinical strategies. The RFP was implemented at the Cardiovascular Unit of Guatemala. INTERVENTION: This 4-year Program recruited two one-year fellows and provided funding to define a research topic, write a protocol and implement the research. Strong emphasis is placed on developing skills in knowledge translation and exchange to bridge the "know-do" gap. Close mentoring relationships between the Principal Investigator and former and current fellows are fostered through the Program. OUTCOMES: The mentoring Program has generated strategic data to support the implementation of sound chronic disease control strategies, mainly related to tobacco control. Results have been presented nationally and internationally. Research training has included principles of biostatistics and epidemiology, and a journal club. The Program is increasingly generating interest among medical graduates to pursue further research training abroad and is building local research capacity. Fellows and research assistants have created a research network in Guatemala and abroad. The main obstacle the Program faces is ensuring long-term sustainability. CONCLUSIONS: A mentoring program can lead to an increase in research interest and capacity in a low-income country with little research infrastructure.
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Pesquisa Biomédica/educação , Fortalecimento Institucional/métodos , Doença Crônica/prevenção & controle , Educação de Pós-Graduação em Medicina/organização & administração , Mentores , Pesquisa Biomédica/organização & administração , Guatemala , Humanos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de SaúdeRESUMO
Although virtually all comparative research about risk perception focuses on which hazards are of concern to people in different culture groups, much can be gained by focusing on predictors of levels of risk perception in various countries and places. In this case, we examine standard and novel predictors of risk perception in seven sites among communities affected by a flood in Mexico (one site) and volcanic eruptions in Mexico (one site) and Ecuador (five sites). We conducted more than 450 interviews with questions about how people feel at the time (after the disaster) regarding what happened in the past, their current concerns, and their expectations for the future. We explore how aspects of the context in which people live have an effect on how strongly people perceive natural hazards in relationship with demographic, well-being, and social network factors. Generally, our research indicates that levels of risk perception for past, present, and future aspects of a specific hazard are similar across these two countries and seven sites. However, these contexts produced different predictors of risk perception-in other words, there was little overlap between sites in the variables that predicted the past, present, or future aspects of risk perception in each site. Generally, current stress was related to perception of past danger of an event in the Mexican sites, but not in Ecuador; network variables were mainly important for perception of past danger (rather than future or present danger), although specific network correlates varied from site to site across the countries.
Assuntos
Desastres , Inundações , Percepção , Erupções Vulcânicas , Comparação Transcultural , Equador , Nível de Saúde , Humanos , México , Características de Residência , Risco , Apoio SocialRESUMO
Adducts of a number of tertiary pnicogen ligands ER(3) (triphenyl-phosphine and -arsine (PPh(3),AsPh(3)), diphenyl,2-pyridylphosphine (PPh(2)py), tris(4-fluorophenyl)phosphine (P(C(6)H(4)-4F)(3)), tris(2-tolyl)phosphine (P(o-tol)(3)), tris(cyclohexyl)phosphine (PCy(3))), with silver(I) thiocyanate, AgSCN are structurally and spectroscopically characterized. The 1:3 AgSCN : ER(3) complexes structurally defined (for PPh(3),AsPh(3) (diversely solvated)) take the form [(R(3)E)(3)AgX], the thiocyanate X = NCS being N-bound, thus [(Ph(3)E)Ag(NCS)]. A 1:2 complex with PPh(2)py, takes the binuclear form [(pyPh(2)P)(2)Ag()Ag(PPh(2)py)(2)] with an eight-membered cyclic core. 1:1 complexes are defined with PPh(2)py, P(o-tol)(3) and PCy(3); binuclear forms [(R(3)P)Ag()Ag(PR(3))] are obtained with P(o-tol)(3) (two polymorphs), while novel isomeric tetranuclear forms, which may be envisaged as dimers of dimers, are obtained with PPh(2)py, and, as further polymorphs, with PCy(3); these latter may be considered as extensions of the 'cubane' and 'step' forms previously described for [(R(3)E)AgX](4) (X = halide) complexes. Solvent-assisted mechanochemical or solvent-assisted solid-state synthesis methods were employed in some cases, where complexes could not be obtained by conventional solution methods, or where such methods yielded a mixture of polymorphs unsuitable for solid-state spectroscopy. The wavenumbers of the ν(CN) bands in the IR spectra are in broad agreement with the empirical rule that distinguishes bridging from terminal bonding, but exceptions occur for compounds that have a double SCN bridged dimeric structure, and replacement of PPh(3) with PPh(2)py apparently causes a significant decrease in ν(CN) to well below the range expected for bridging SCN in these structures. (31)P CP MAS NMR spectra yield additional parameters that allow a correlation between the structures and spectra.
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Complexos de Coordenação/química , Fosfinas/química , Prata/química , Tiocianatos/química , Complexos de Coordenação/síntese química , Cristalografia por Raios X , Ligantes , Conformação MolecularRESUMO
There is compelling evidence that dietary salt intake is the major cause of raised blood pressure (BP) and that a reduction in salt intake from the current level of ¡Õ 9¨C12 g/day in most countries to the recommended level of < 5 g/day lowers BP. A further reduction to 3¨C4 g/day has a greater effect and there needs to be ongoing consideration of lower targets for population salt intake. Cohort studies and outcome trials have demonstrated that a lower salt intake is related to a reduced risk of cardiovascular disease. Salt reduction is one of the most costeffective measures to improve public health worldwide. In the Americas, a salt intake of > 9 g/ day is highly prevalent. Sources of salt in the diet vary hugely among countries; in developed countries, 75% of salt comes from processed foods, whereas in developing countries such as parts of Brazil, 70% comes from salt added during cooking or at the table. To reduce population salt intake, the food industry needs to implement a gradual and sustained reduction in the amount of salt added to foods in developed countries. In developing countries, a public health campaign plays a more important role in encouraging consumers to use less salt coupled with widespread replacement of salt with substitutes that are low in sodium and high in potassium. Numerous countries in the Americas have started salt reduction programs. The challenge now is to engage other countries. A reduction in population salt intake will result in a major improvement in public health along with major health-related cost savings.
Hay datos probatorios irrefutables de que la ingesta de sal alimentaria es la principal causa de hipertensión y de que una reducción del consumo de sal, del nivel actual de aproximadamente 9 a 12 g/d en la mayor parte de los países al nivel recomendado de menos de 5 g/d, disminuye la presión arterial. Una reducción adicional hasta 3 a 4 g/d tiene un mayor efecto y es necesario seguir teniendo en cuenta la posibilidad de metas de consumo de sal inferiores en la población. Los estudios de cohortes y los ensayos clínicos han demostrado que el menor consumo de sal se asocia con una reducción del riesgo de padecer enfermedades cardiovasculares. La reducción de sal es una de las medidas más rentables para mejorar la salud pública a escala mundial. En la Región de las Américas, hay una alta prevalencia de un consumo de sal superior a 9 g/d. Las fuentes de sal en el régimen alimentario varían enormemente en los diferentes países; en los países desarrollados, 75% de la sal procede de los alimentos procesados, mientras que en los países en desarrollo, como algunas zonas del Brasil, 70% de la sal se añade durante la cocción o en la mesa. Para reducir el consumo poblacional de sal en los países desarrollados, la industria alimentaria debe aplicar una reducción gradual y sostenida de la cantidad de sal añadida a los alimentos. En los países en desarrollo, las campañas de salud pública desempeñan un papel más importante al alentar a los consumidores a consumir menos sal, junto a un reemplazo generalizado de la sal por sustitutos con bajo contenido en sodio y alto contenido en potasio. Numerosos países de la Región de las Américas han iniciado programas de reducción de la sal. El reto actualmente consiste en involucrar a otros países. Una reducción del consumo de sal en la población dará lugar a una mejora importante de la salud pública además de una notable reducción de los costos relacionados con la salud.
Assuntos
Humanos , Doenças Cardiovasculares/prevenção & controle , Hipertensão/prevenção & controle , Cloreto de Sódio na Dieta/administração & dosagem , América , Países em Desenvolvimento , Promoção da Saúde , Saúde Pública/economia , Saúde GlobalAssuntos
Cloreto de Sódio na Dieta , Pressão Sanguínea , Hipertensão , Doenças Cardiovasculares , América , Cloreto de Sódio na Dieta , Pressão Arterial , Hipertensão , Doenças Cardiovasculares , América , Cloreto de Sódio na Dieta , Doenças Cardiovasculares , Hipertensão , Países em Desenvolvimento , Promoção da Saúde , Saúde Pública , Saúde GlobalRESUMO
The role of Th2 cytokines and Th2-associated chemokines in tuberculosis (TB) remains controversial, though in Mexico a polymorphism causing increased production of CCL2 is a risk factor. We studied levels of the Th2-associated chemokines CCL2 and CCL18, circulating soluble IL-4 receptors (sIL-4R), IL-4 and the inhibitory splice variant of IL-4 (IL-4δ2) in a cohort of patients with pulmonary TB and their healthy contacts. These were followed for 2 years during which time 10 contacts developed pulmonary TB. Results were compared with measurements made in renal and meningeal TB, and in disease controls with bacterial pneumonias or Dengue fever that have large Th2 components. In these disease controls both chemokines were significantly raised. They were also very significantly raised in all forms of TB, irrespective of age or disease site. Levels of CCL18 were raised least in meningeal TB, and most in pulmonary patients with long histories, when levels were similar to those in disease controls. Levels of CCL2, although also raised in all three forms of TB, were negatively correlated with CCL18. We found that levels of sIL-4R were strikingly reduced in all forms of TB, particularly meningeal. Contacts who progressed could not be distinguished from contacts who remained healthy at 2 years in terms of IL-4, sIL-4R, CCL2 or CCL18. However contacts had raised expression of IL-4δ2 as previously found. These results indicate vigorous and previously unrecorded activity within the Th2 axis, and further investigation is warranted.
Assuntos
Quimiocinas/sangue , Receptores de Interleucina-4/sangue , Tuberculose/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimiocina CCL2/sangue , Quimiocinas CC/sangue , Criança , Pré-Escolar , Progressão da Doença , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Seguimentos , Humanos , Interleucina-4/sangue , Masculino , Pessoa de Meia-Idade , Pneumonia Bacteriana/imunologia , Tuberculose Meníngea/imunologia , Tuberculose Pulmonar/imunologia , Tuberculose Pulmonar/transmissão , Tuberculose Renal/imunologia , Adulto JovemRESUMO
Litter on roadways has to be removed for hygiene and to reduce pollution, amongst other reasons. Therefore, the effective operation of street sweepers is important in the collection of solid waste. In this article, the effectiveness of gutter brushes of street sweepers in removing different debris types, namely medium-size gravel, small and fine particles, and wet thin debris is studied by means of sweeping tests using a brushing test rig. Two types of gutter brushes, cutting and F128, are tested under a variety of operating conditions. The experimental tests provide a means of identifying suitable ranges of brush penetration for the different debris types under defined operating parameters such as brush angle of attack, brush rotational speed, and sweeper velocity. These ranges may provide sufficiently high removal forces and avoid the occurrence of sweeping problems such as backward sweeping and inappropriate bristle-surface contact. Optimum operating parameters for the three debris types studied, as well as a mixture of all of them, are determined. Lastly, the results indicate that, as far as the sweeping effectiveness is concerned, the F128 brush is the preferred one for the cases studied.
Assuntos
Eliminação de Resíduos/instrumentação , Tamanho da Partícula , Eliminação de Resíduos/métodos , Rotação , ÁguaRESUMO
The environmental saprophyte Mycobacterium vaccae induces a Th1 response and cytotoxic T cells that recognize M. tuberculosis, and by subcutaneous injection, it is therapeutic for pulmonary tuberculosis (TB) induced by high-dose challenge in BALB/c mice. However, M. vaccae also drives regulatory T cells that inhibit Th2 responses, and this is seen in allergy models, not only following subcutaneous injection but also after oral administration. An oral immunotherapeutic for TB would be clinically useful, so we investigated M. vaccae given orally by gavage at 28-day intervals in the TB model. We used two different protocols: starting the oral M. vaccae either 1 day before or 32 days after infection with M. tuberculosis. Throughout the infection (until 120 days), we monitored outcome (CFU), molecules involved in the development of immunoregulation (Foxp3, hemoxygenase 1, idoleamine 2,3-dioxygenase, and transforming growth factor beta [TGF-beta]), and indicators of cytokine balance (tumor necrosis factor, inducible nitric oxide synthase, interleukin-4 [IL-4], and IL-4delta2; an inhibitory splice variant of IL-4 associated with improved outcome in human TB). Oral M. vaccae had a significant effect on CFU and led to increased expression of Th1 markers and of IL-4delta2, while suppressing IL-4, Foxp3, and TGF-beta. When administered 1 day before infection, oral M. vaccae induced a striking peak of expression of hemoxygenase 1. In conclusion, we show novel information about the expression in TB of murine IL-4delta2 and molecules involved in immunoregulation and show that these can be modulated by oral administration of a saprophytic mycobacterium. A clinical trial of oral M. vaccae in extensively drug-resistant TB might be justified.
Assuntos
Fatores Imunológicos/uso terapêutico , Imunoterapia/métodos , Mycobacterium/imunologia , Vacinas contra a Tuberculose/uso terapêutico , Tuberculose Pulmonar/imunologia , Tuberculose Pulmonar/terapia , Administração Oral , Animais , Contagem de Colônia Microbiana , Citocinas/biossíntese , Injeções Subcutâneas , Pulmão/imunologia , Pulmão/microbiologia , Masculino , Camundongos , Camundongos Endogâmicos BALB CRESUMO
OBJECTIVES: To examine whether excessive recreational Internet time, insufficient sleep, regular coffee consumption, or alcoholic beverages promote weight gain. STUDY DESIGN: A longitudinal cohort of >5000 girls (Growing Up Today Study), from all over the United States and aged 14 to 21 years, returned surveys in 2001 reporting typical past-year recreational Internet time, sleep, coffee (with caffeine), and alcohol consumption. We estimated correlations among these 4 exposures. Each girl also reported her height and weight in 2000 and again in 2001. Multivariate models investigated associations between 1-year change in body mass index and same-year exposures, adjusted for adolescent growth/development, activity, and inactivity. RESULTS: The exposures were highly (P < .0001) correlated with each other, except for coffee with Internet time (P > .50). More Internet time, more alcohol, and less sleep were all associated (P < .05) with same-year increases in body mass index. Females, aged 18+ years, who slept Assuntos
Consumo de Bebidas Alcoólicas
, Cafeína/efeitos adversos
, Café/efeitos adversos
, Internet
, Sono
, Adolescente
, Adulto
, Peso Corporal
, Estudos de Coortes
, Feminino
, Humanos
, Estilo de Vida
, Estudos Longitudinais
, Recreação
, Aumento de Peso
RESUMO
OBJECTIVES: To identify the factors which determine timely health care-seeking behaviors for childhood ARIs. METHODS: A semi-structured questionnaire was administered to a non-random purposive sample of 91 female caregivers (age 18-57 years), and was analyzed using SPSS. In addition, six focus group discussions with female caregivers and 25 in-depth interviews with members from the health care setting were conducted. RESULTS: The primary obstacles reported for timely health care-seeking among survey respondents were money for medicines (n=29, 32%), transportation fares (n=19, 21%), and restrictive hours of the health centers (n=13, 14%). The median household salary reported was $100 per month. There was an overall lack of recognition of the biomedical signs and symptoms of serious lower respiratory infections independent of socioeconomic status. CONCLUSIONS: Based on the study findings, the following recommendations are offered: (1) public health campaigns need to better address appropriate home health care management of childhood health and illness to improve maternal health-seeking behavior for ARIs; (2) provincial health authorities need to adhere to regular hours of operation, expand clinic hours and increase staff; (3) health posts should establish better policies for disbursement of antibiotics and ensure that patients follow prescribed regimens; and (4) through partnerships with economic development organizations and the private sector, there will be increased employment opportunities.