RESUMO
This article examines the short-term effects of the COVID-19 lockdown on food security and nutrition in rural Guatemala. We rely on a comprehensive panel dataset of 1,824 small agricultural households collected over two survey rounds, on November-December 2019 and May-June 2020. We place special emphasis on changes in agricultural and nonagricultural income sources, including remittances, and changes in dietary diversity, including consumption of animal source foods (ASF) and fruits and vegetables (F&V). We find that COVID-19 affected the incomes, food security, and dietary patterns of households, with a decrease in ASF diversity and an increase in F&V diversity, and an overall net decrease in dietary diversity across all food groups. Dietary diversity among women in reproductive age, however, remained unchanged, and increased among children under 2 years old. Interestingly, households with relatively higher incomes appear to have reduced their dietary diversity to a larger extent than lower income ones, as well as households located in communities with more severe access restrictions. The focus of the study in a region with a high prevalence of poverty and chronic malnutrition provides an important perspective into the consequences of the lockdown in complex rural contexts with vulnerable populations and contributes to inform eventual recovery measures.
RESUMO
Delivery is a stressful and risky event menacing the newborn. The mother-dependent respiration has to be replaced by autonomous pulmonary breathing immediately after delivery. If delayed, it may lead to deficient oxygen supply compromising survival and development of the central nervous system. Lack of oxygen availability gives rise to depletion of NAD(+) tissue stores, decrease of ATP formation, weakening of the electron transport pump and anaerobic metabolism and acidosis, leading necessarily to death if oxygenation is not promptly re-established. Re-oxygenation triggers a cascade of compensatory biochemical events to restore function, which may be accompanied by improper homeostasis and oxidative stress. Consequences may be incomplete recovery, or excess reactions that worsen the biological outcome by disturbed metabolism and/or imbalance produced by over-expression of alternative metabolic pathways. Perinatal asphyxia has been associated with severe neurological and psychiatric sequelae with delayed clinical onset. No specific treatments have yet been established. In the clinical setting, after resuscitation of an infant with birth asphyxia, the emphasis is on supportive therapy. Several interventions have been proposed to attenuate secondary neuronal injuries elicited by asphyxia, including hypothermia. Although promising, the clinical efficacy of hypothermia has not been fully demonstrated. It is evident that new approaches are warranted. The purpose of this review is to discuss the concept of sentinel proteins as targets for neuroprotection. Several sentinel proteins have been described to protect the integrity of the genome (e.g. PARP-1; XRCC1; DNA ligase IIIα; DNA polymerase ß, ERCC2, DNA-dependent protein kinases). They act by eliciting metabolic cascades leading to (i) activation of cell survival and neurotrophic pathways; (ii) early and delayed programmed cell death, and (iii) promotion of cell proliferation, differentiation, neuritogenesis and synaptogenesis. It is proposed that sentinel proteins can be used as markers for characterising long-term effects of perinatal asphyxia, and as targets for novel therapeutic development and innovative strategies for neonatal care.
Assuntos
Asfixia Neonatal/metabolismo , Asfixia Neonatal/prevenção & controle , Regulação da Expressão Gênica no Desenvolvimento , Proteínas do Tecido Nervoso/biossíntese , Fármacos Neuroprotetores/uso terapêutico , Animais , Sistemas de Liberação de Medicamentos , Humanos , Recém-Nascido , Proteínas do Tecido Nervoso/metabolismo , Fármacos Neuroprotetores/metabolismo , Poli(ADP-Ribose) Polimerase-1 , Poli(ADP-Ribose) Polimerases/biossíntese , Proteína Grupo D do Xeroderma Pigmentoso/biossínteseRESUMO
Perinatal asphyxia occurs still with great incidence whenever delivery is prolonged, despite improvements in perinatal care. After asphyxia, infants can suffer from short- to long-term neurological sequelae, their severity depend upon the extent of the insult, the metabolic imbalance during the re-oxygenation period and the developmental state of the affected regions. Significant progresses in understanding of perinatal asphyxia pathophysiology have achieved. However, predictive diagnostics and personalised therapeutic interventions are still under initial development. Now the emphasis is on early non-invasive diagnosis approach, as well as, in identifying new therapeutic targets to improve individual outcomes. In this review we discuss (i) specific biomarkers for early prediction of perinatal asphyxia outcome; (ii) short and long term sequelae; (iii) neurocircuitries involved; (iv) molecular pathways; (v) neuroinflammation systems; (vi) endogenous brain rescue systems, including activation of sentinel proteins and neurogenesis; and (vii) therapeutic targets for preventing or mitigating the effects produced by asphyxia.
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2,5-Dimethoxy-4-substituted phenylisopropylamines and phenethylamines are 5-hydroxytryptamine (serotonin) (5-HT)(2A/2C) agonists. The former are partial to full agonists, whereas the latter are partial to weak agonists. However, most data come from studies analyzing phospholipase C (PLC)-mediated responses, although additional effectors [e.g., phospholipase A(2) (PLA(2))] are associated with these receptors. We compared two homologous series of phenylisopropylamines and phenethylamines measuring both PLA(2) and PLC responses in Chinese hamster ovary-K1 cells expressing human 5-HT(2A) or 5-HT(2C) receptors. In addition, we assayed both groups of compounds as head shake inducers in rats. At the 5-HT(2C) receptor, most compounds were partial agonists for both pathways. Relative efficacy of some phenylisopropylamines was higher for both responses compared with their phenethylamine counterparts, whereas for others, no differences were found. At the 5-HT(2A) receptor, most compounds behaved as partial agonists, but unlike findings at 5-HT(2C) receptors, all phenylisopropylamines were more efficacious than their phenethylamine counterparts. 2,5-Dimethoxyphenylisopropylamine activated only the PLC pathway at both receptor subtypes, 2,5-dimethoxyphenethylamine was selective for PLC at the 5-HT(2C) receptor, and 2,5-dimethoxy-4-nitrophenethylamine was PLA(2)-specific at the 5-HT(2A) receptor. For both receptors, the rank order of efficacy of compounds differed depending upon which response was measured. The phenylisopropylamines were strong head shake inducers, whereas their phenethylamine congeners were not, in agreement with in vitro results and the involvement of 5-HT(2A) receptors in the head shake response. Our results support the concept of functional selectivity and indicate that subtle changes in ligand structure can result in significant differences in the cellular signaling profile.
Assuntos
Anfetaminas/farmacologia , Alucinógenos/farmacologia , Fenetilaminas/farmacologia , Agonistas do Receptor 5-HT2 de Serotonina , 2,5-Dimetoxi-4-Metilanfetamina/análogos & derivados , 2,5-Dimetoxi-4-Metilanfetamina/farmacologia , Animais , Ácido Araquidônico/metabolismo , Comportamento Animal/efeitos dos fármacos , Células CHO , Cricetinae , Cricetulus , Humanos , Fosfatos de Inositol/metabolismo , Masculino , Mescalina/análogos & derivados , Mescalina/farmacologia , Atividade Motora/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Receptor 5-HT2A de Serotonina/genética , Receptor 5-HT2A de Serotonina/fisiologia , Receptor 5-HT2C de Serotonina/genética , Receptor 5-HT2C de Serotonina/fisiologia , Transdução de Sinais/efeitos dos fármacos , TransfecçãoRESUMO
Autoimmune diseases are characterized by immune response against self antigens. One of the current research interests in this field is oriented toward development of tolerance. One of the newest options in the search for tolerance is autologous bone marrow transplantation: a variant of bone marrow transplant in which the patient's own hematopoietic stem cells are reinfused after myeloablative therapy. The idea of using bone marrow transplant in treatment of autoimmune diseases derived from observing remission in autoimmune diseases in patients transplanted due to coexisting neoplastic disease. Although an isolated initial report of bone marrow transplant as treatment for autoimmune disease questioned the utility of this procedure, over all, results are encouraging. To compile information in a programmed and systematic manner, it is necessary to send more patients in all stages of immune diseases to specialized centers to be included in large multicenter randomized trials. In time, the role for this procedure in autoimmune diseases will become clear.
Assuntos
Doenças Autoimunes/cirurgia , Transplante de Medula Óssea , Artrite Juvenil/cirurgia , Artrite Reumatoide/cirurgia , Humanos , Lúpus Eritematoso Sistêmico/cirurgia , Esclerose Múltipla/cirurgia , Escleroderma Sistêmico/cirurgia , Resultado do TratamentoRESUMO
Las enfermedades autoinmunes se caracterizan por una respuesta del sistema inmune del individuo hacia tejidos propios. Una línea de investigación actual es el tratamiento de estas enfermedades y el desarrollo de tolerancia. Una de las opciones en la búsqueda del desarrollo de tolerancia es el trasplante autólogo de médula ósea: la variantes del trasplante de médula ósea que hace uso de células progenitoras hematopoyéticas propias. La posibilidad de usar este tipo de trasplante como tratamiento de enfermedades autoinmunes se originó en los hallazgos de remisiones de enfermedades autoinmunes coexistentes, en pacientes que eran trasplantados por enfermedades oncológicas. En esta revisión presentemos el fundamento teórico de este tratamiento, así como una recopilación de los estudios preclínicos y clínicos más relevantes en esta materia. Aunque algún reporte inicial puso en duda la utilidad de dicho procedimiento, en general, los resultados son alentadores. Es necesario que más pacientes en diversos estadios de las enfermedades autoinmunes sean referidos a centros especializados de manera que sea posible recopilar la información de manera ordenada y sistemática, y se pueda arribar a un conocimiento sobre el papel que juega este tipo de tratamiento en las enfermedades autoinmunes.
Autoimmune diseases are characterized by immune response against self antigens. One of the current research interests in this field is oriented toward development of tolerance. One of the newest options in the search for tolerance is autologous bone marrow transpiantation: a variant of bone marrow transplant in which the patient's own hematopoietic stem cells are reinfused after myeloablative therapy. The idea of using bone marrow transplant in treatment of autoimmune diseases derived from observing remission in autoinmune diseases in patients transplanted due to coexisting neoplastic disease. Although an isolated initial report of bone marrow transplant as treatment for autoimmune disease questioned the utility of this procedure, over all, results are encouraging. To compile information in a programmed and systematic manner, it is necessary to send more patients in all stages of immune diseases to specialized centers to be included in large multicenter randomized trials. In time, the role for this procedure in autoimmune diseases will become clear.
Assuntos
Humanos , Doenças Autoimunes/cirurgia , Transplante de Medula Óssea , Artrite Juvenil/cirurgia , Artrite Reumatoide/cirurgia , Lúpus Eritematoso Sistêmico/cirurgia , Esclerose Múltipla/cirurgia , Escleroderma Sistêmico/cirurgia , Resultado do TratamentoRESUMO
Objetivo. Comparar la eficacia y eficiencia de la pefloxacina vs la amika-cina-ceftazidima, seguidas de vancomicina, como terapia empírica en episodios de infección y neutropenia. Material y métodos. El estudio fue prospectivo. Se incluyeron pacientes mayores de 15 años, con temperatura superior a 38ºC y concentración de neutrófilos menor de 1 x 10 a la 9/L. La asignación a la ramas de tratamiento se hizo al azar. Un grupo recibió pefloxacina, el otro amikacina y ceftazidima. En ambas rama, si la fiebre persistió por 72 h se agregó vancomicina; si la fiebre persistió por 10 días, se agregó anfotericina B. Resultados. 38 pacientes evaluables (17/21) en ambas ramas fueron comparables en patología básica, aplicación de quimioterapia, neutrófilos iniciales, neutropenia máxima, neutrófilos finales, focos infecciosos y gérmenes aislados. La curación se observó en 87 y 89 por ciento de los casos, respectivamente (p=0.52). La duración promedio de la fiebre fue de 6.1 y 5.8 días (p=0.84). Conclusión. La pefloxacina y la amikacina-ceftazidima tienen eficacia y eficiencia comparables como antibióticos iniciales en episodios de infección y neutropenia, usados como tratamiento antimicrobiana empírica
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Humanos , Adolescente , Amicacina/uso terapêutico , Anemia Aplástica/tratamento farmacológico , Ceftazidima/uso terapêutico , Infecções/etiologia , Infecções/tratamento farmacológico , Leucemia/tratamento farmacológico , Neutropenia , Pefloxacina/uso terapêutico , Vancomicina/uso terapêutico , Doença Aguda , Anti-Infecciosos/uso terapêutico , Quimioterapia Combinada , Febre/etiologiaRESUMO
El objetivo de este trabajo fue evaluar el beneficio de la plasmaféresis en la preparación para timectomía de los enfermos con miastenia gravis generalizada (MGG). Se evaluaron 21 pacientes de enero de 1988 a enero de 1995, con diagnóstico confirmado de MGG, quienes fueron sometidos a timectomía y se les realizó plasmaféresis previa al procemiento; se compararon con un grupo control histórico de 21 enfermos; ambos grupos eran comparables en sexo, edad, tiempo de enfermedades, en el manejo prequirúrgico y posoperatorio; la diferencia entre ellos fue la realización de plasmaféresis. El grupo tratado mostró diferencias significativas en una reducción del tiempo de asistencia ventilatoria (p < 0.008), menor requerimiento de piridostigmina (p< 0.0006) y mejores condiciones clínicas evaluadas a través de la clasificación de Osserman (p < 0.0075) durante el posoperatorio. Concluimos que el grupo tratado tuvo morbilidad en el posoperatorio inmediato y mediato, por lo que deberá realizarse este procedimiento en el manejo preoperatorio a timectomía en pacientes con MGG cuando sea posible