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BACKGROUND: The proportion of older people living with HIV (PLWH) has increased. Non-communicable diseases occur earlier in PLWH than in the general population. OBJECTIVE: The goal of this study was to estimate the prevalence of comorbidities in PLWH and cancer in a tertiary referral center in Mexico City. MATERIAL AND METHODS: In this retrospective study, we included PLWH > 40 years with a history of cancer, coming to Instituto Nacional de Cancerologia from 2010 through 2019. All patients needed to be on antiretrovirals for at least six months. Data collected included cancer type, comorbidities, frequency of polypharmacy, FRAX score and 10-year cardiovascular risk. Patients were evaluated for depression with the Beck Inventory Depression-II Scale. Variables associated to multimorbidity (2 or more comorbidities) were evaluated. RESULTS: Of 125 patients, 69% had at least one comorbidity; 32% had ≥ 2. Common comorbidities were dyslipidemia (54%), hypertension (19%), obesity (14%) and Diabetes (12%). In patients ≥ 50 years, 29 (62%) already undergone a densitometry and 9 (31%) had osteoporosis; 56 depression questionnaires were used: 30% had mild-to-severe depression. Being ≥ 50 years was associated with multimorbidity (aOR 2.57 (1.18-5.58), p = 0.017). CONCLUSIONS: A high prevalence of multimorbidity and poor screening of bone disease and mental health is reported in patients with PLWH and cancer. A holistic approach to the PLWH in the Infectious Diseases consultation is needed to improve the detection and management of non-communicable diseases, to go beyond viral suppression and towards an improved quality of life.
INTRODUCCIÓN: La proporción de personas mayores que viven con VIH (PVVIH) va en aumento, y las enfermedades no transmisibles ocurren antes en PVVIH comparado con la población general. OBJETIVO: El objetivo de este estudio fue estimar la prevalencia de las comorbilidades en PVVIH con cáncer de un centro de tercer nivel de la Ciudad de México. MÉTODOS: Este estudio retrospectivo incluyó todas las PVVIH > 40 años con cáncer, que acudieron al Instituto Nacional de Cancerología entre 2010 y 2019). Se incluyeron datos sobre el tipo de cáncer, comorbilidades y polifarmacia. Se calcularon la puntuación FRAX, el riesgo cardiovascular a 10 años, y se aplicó un cuestionario para evaluar depresión (Beck Inventory Depression-II Scale). RESULTADOS: De 125 pacientes, 69% tenía al menos una comorbilidad; 32% tenía ≥ 2. Las comorbilidades más comunes fueron dislipidemia (54%), hipertensión (19%), obesidad (14%) y diabetes (12%). En pacientes ≥ 50 años, 29% tenía una densitometría osea; 31% tenía osteoporosis. Se aplicaron 56 cuestionarios: 30% tenía algún grado de depresión. Tener ≥ 50 años se asoció con multimorbilidad (aOR 2.57, 1.18-5.58), p = 0.017. CONCLUSIONES: Se reporta una alta prevalencia de multimorbilidad en PVVIH y cancer, con pobre escrutinio de enfermedad ósea y salud mental. Se requiere un enfoque holístico para las PVVIH en la consulta de infectología, para mejorar el manejo de las enfermedades no transmisibles, yendo más alla de la supresión virológica.
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Infecções por HIV , Multimorbidade , Neoplasias , Humanos , México/epidemiologia , Masculino , Pessoa de Meia-Idade , Feminino , Estudos Retrospectivos , Infecções por HIV/epidemiologia , Infecções por HIV/tratamento farmacológico , Neoplasias/epidemiologia , Prevalência , Adulto , Idoso , Depressão/epidemiologia , Comorbidade , Fatores EtáriosRESUMO
This study introduces an innovative approach to the layered model, emphasizing the physical-chemical characterization of miscible liquid systems through ultrasonic techniques, with a specific focus on the water-ethanol system used in pharmaceutical formulations. Traditional characterization methods, while effective, face challenges due to the complex nature of solutions, such as the need for large pressure variations and strict temperature control. The proposed approach integrates partial molar volumes and partial propagation velocity functions into the layered model, enabling a nuanced understanding of miscibility and interactions. Ultrasonic techniques are used to calculate the isentropic compressibility coefficient for each component of the mixture as well as the total value using an additive mixing rule. Unlike conventional methods, this technique uses tabulated and experimental data to estimate the propagation velocity in the mixture, leading to a more precise computation of the isentropic compressibility coefficient. The results indicate a significant improvement in predicting the behavior of the water-ethanol system compared to the classical layered model. The methodology demonstrates the potential to provide new physicochemical insights that can be applied to other miscible systems beyond water-ethanol. This research has implications for improving the efficiency and accuracy of liquid medication formulations in the pharmaceutical industry.
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Background: Carbapenemase-producing Enterobacterales (CPE) represents a significant threat to global health. This study aimed to characterize clinically and molecularly the CPE isolated from rectal swabs of patients in the intensive care units (ICUs) of a tertiary hospital in Cali, Colombia. Methods: This was a cross-sectional observational study. Rectal swabs from patients admitted to the ICUs were collected. Bacterial identification and carbapenemase production were determined using phenotypic and molecular methods. Demographic and clinical data were extracted from electronic medical records. Results: The study included 223 patients. Thirty-six patients (36/223, 16.14 %) were found to be colonized or infected by CPE. Factors such as prolonged stay in the ICU, previous exposure to carbapenem antibiotics, use of invasive procedures, and admission due to trauma were associated with CPE. Klebsiella pneumoniae (52.5 %) was the most prevalent microorganism, and the dominant carbapenemases identified were KPC (57.8 %) and NDM (37.8 %). Conclusion: Distinguishing carbapenemase subtypes can provide crucial insights for controlling dissemination in ICUs in Cali, Colombia.
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BACKGROUND: Mortality rate estimation in small areas can be difficult due the low number of events/exposure (i.e. stochastic error). If the death records are not completed, it adds a systematic uncertainty on the mortality estimates. Previous studies in Brazil have combined demographic and statistical methods to partially overcome these issues. We estimated age- and sex-specific mortality rates for all 5,565 Brazilian municipalities in 2010 and forecasted probabilistic mortality rates and life expectancy between 2010 and 2030. METHODS: We used a combination of the Tool for Projecting Age-Specific Rates Using Linear Splines (TOPALS), Bayesian Model, Spatial Smoothing Model and an ad-hoc procedure to estimate age- and sex-specific mortality rates for all Brazilian municipalities for 2010. Then we adapted the Lee-Carter model to forecast mortality rates by age and sex in all municipalities between 2010 and 2030. RESULTS: The adjusted sex- and age-specific mortality rates for all Brazilian municipalities in 2010 reveal a distinct regional pattern, showcasing a decrease in life expectancy in less socioeconomically developed municipalities when compared to estimates without adjustments. The forecasted mortality rates indicate varying regional improvements, leading to a convergence in life expectancy at birth among small areas in Brazil. Consequently, a reduction in the variability of age at death across Brazil's municipalities was observed, with a persistent sex differential. CONCLUSION: Mortality rates at a small-area level were successfully estimated and forecasted, with associated uncertainty estimates also generated for future life tables. Our approach could be applied across countries with data quality issues to improve public policy planning.
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Teorema de Bayes , Cidades , Expectativa de Vida , Mortalidade , Humanos , Brasil/epidemiologia , Masculino , Feminino , Mortalidade/tendências , Lactente , Pré-Escolar , Idoso , Pessoa de Meia-Idade , Adolescente , Adulto , Criança , Adulto Jovem , Recém-Nascido , Idoso de 80 Anos ou mais , Fatores Sexuais , Distribuição por Idade , Fatores Etários , Distribuição por Sexo , PrevisõesRESUMO
INTRODUÇÃO: A válvula aórtica bicúspide (BAV) ocorre em até 6% dos pacientes com estenose aórtica importante. Sua presença pode refletir um desafio para TAVI uma vez que pacientes com BAV podem possuir maiores diâmetros do anel valvar, calcificação acentuada dos folhetos e dilatação da aorta ascendente. O número crescente de TAVI nessa população torna imperativo um aprofundamento na investigação de seus resultados e desfechos clínicos. MÉTODOS: Retrospectivo, unicêntrico e observacional. Realizamos uma revisão de banco de dados e selecionamos pacientes submetidos a TAVI no período de novembro de 2020 a janeiro de 2024. O objetivo deste estudo é avaliar a incidência e resultados imediatos na população com BAV comparativamente aos pacientes com valva tricúspide. Para isso, foram coletados dados clínicos e demográficos, bem como informações sobre complicações e desfechos intrahospitalares após TAVI em ambas as populações, segundo o VARC 3. A análise dos dados foi realizada utilizando estatística descritiva e comparativa (Teste T de Student), com intuito de verificar se há diferenças significativas em desfechos entre as populações. RESULTADOS: De um total de 174 pacientes, 33 deles apresentaram BAV, resultando em uma incidência de 18,96%. A análise estatística não evidenciou diferença significativa nos dados de base de ambas as populações. Média de idade entre o grupo BAV (75,84 ± 8,19 anos) e o grupo tricúspide (78,61 ± 6,32 anos), com um p-valor não significativo de p 0,243. O STS score médio foi de 3,14 ± 1,86% no grupo BAV e 3,47 ± 1,97% no grupo tricúspide; p 0,12. Em relação ao procedimento, houve diferença significativa na necessidade de pré-dilatação entre os grupos, sendo necessária em 25 dos 33 casos de bicúspide (75,75%) e 71 dos 141 casos de tricúspide (50,35%) (p 0,008). Porém, não foi evidenciada diferença significativa no gradiente ventrículo esquerdo e aorta pós-procedimento de 4,53 ± 3,04 vs 5,33 ± 4,46; p 0,233, de bicúspide e tricúspide respectivamente; nem no tempo de permanência hospitalar pós procedimento 2,63 ± 2,11 vs 3,03 ± 4,29; p 0,439. Não foi observado também diferença significativa em relação a necessidade de marcapasso definitivo, refluxo paravalvular ou complicações hemorrágicas e vasculares. CONCLUSÃO: Com base nos resultados, não foi observada diferença significativa nos desfechos entre os pacientes com BAV e tricúspide. Estes achados sugerem que a TAVI é um tratamento seguro e eficaz para pacientes com BAV. No entanto, são necessários estudos adicionais com amostras mais amplas para confirmar esses resultados.
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Humanos , Idoso , Idoso de 80 Anos ou mais , Substituição da Valva Aórtica TranscateterRESUMO
INTRODUÇÃO: As doenças cardiovasculares (DCVs) são as principais responsáveis pelas mortes no mundo desde o último século, sendo o infarto agudo do miocárdio (IAM) a causa isolada de maior dsetaque, muitas vezes em virtude da dificuldade diagnóstica. A incorporação de novas tecnologias com uso de Inteligência Artificial (AI) surge como potencial aliada neste cenário. OBJETIVO: O objetivo do presente estudo foi desenvolver um modelo de Redes Neurais Artificiais (RNAs) com a utilização de imagens de eletrocardiogramas (ECGs) e a extração dos sinais com alta sensibilidade e especificidade em relação aos laudos médicos para a identificação de casos de IAM com elevação do segmento ST (IAMCST). MÉTODOS: O modelo foi treinado com dados de 3.768 exames de janeiro a dezembro de 2022, totalizando 17.567 derivações. Do total, 820 eram exames com IAMCST e 2.948 sem IAMCST. Foram separados 90% dos dados para treino e 10% para teste. A arquitetura da rede utilizada foi baseada na ResNet de uma dimensão com uma camada de convolução inicial, quatro blocos de camadas residuais e um bloco de camada densa para classificação binária. O sinal foi filtrado, padronizado com mediana igual a 0 e desvio padrão igual a 1 e utilizado padding para padronização de tamanho dentre todas as derivações. Como forma de aumentação de dados, com objetivo de fornecer a rede mais dados para aprender sobre IAMCST, foi realizado um filtro SavGol nos sinais, o que fez com que se obtivesse o dobro de sinais originais das imagens, para entrada no modelo neural. Ainda que a IA tenha sido treinada com as derivações, a acurácia foi mensurada por exame. Resultados: O modelo obteve, ao final, uma sensibilidade de 97%, especificidade de 69% e área sob a curva ROC de 92% para a predição de IAMCST por exame. Tal resultado foi um ganho para o uso das redes neurais, visto que a tecnologia anteriormente utilizada, apenas com a extração das métricas das ondas, apresentou acurácia inferior. CONCLUSÃO: Concluímos que os modelos de RNA, que extraem sinais das imagens e os transformam em predições para auxílio na tomada de decisão de médicos, podem ser incluídos no arsenal de métodos preditivos para triagem de IAMCST, com elevada sensibilidade.
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Redes Neurais de Computação , DiagnósticoRESUMO
One challenge of the citrus industry is the treatment and disposal of its effluents due to their high toxicity, substantial organic load, and consequent resistance to conventional biotechnological processes. This study introduces a novel approach, using electrochemical oxidation with a boron-doped diamond anode to efficiently remove organic compounds from biodegraded pulp wash (treated using the fungus Pleurotus sajor-caju.) The findings reveal that employing a current density of 20 mA cm-2 achieves notable results, including a 44.1% reduction in color, a 70.0% decrease in chemical oxygen demand, an 88.0% reduction in turbidity, and an impressive 99.7% removal of total organic carbon (TOC) after 6 h of electrolysis. The energy consumption was estimated at 2.93 kWh g-1 of removed TOC. This sequential biological-electrochemical procedure not only significantly reduced the mortality rate (85%) of Danio rerio embryos but also reduced the incidence of morphologically altered parameters. Regarding acute toxicity (LC50) of the residue, the process demonstrated a mortality reduction of 6.97% for D. rerio and a 40.88% lethality decrease for Lactuca sativa seeds. The substantial reduction in toxicity and organic load observed in this study highlights the potential applicability of combined biological and electrochemical treatments for real agroindustrial residues or their effluents.
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Diamante , Poluentes Químicos da Água , Diamante/química , Poluentes Químicos da Água/análise , Eletrólise/métodos , Compostos Orgânicos , Eletrodos , OxirreduçãoRESUMO
The chiral-induced spin selectivity effect (CISS) is a breakthrough phenomenon that has revolutionized the field of electrocatalysis. We report the first study on the electron spin-dependent electrocatalysis for the oxygen reduction reaction, ORR, using iron phthalocyanine, FePc, a well-known molecular catalyst for this reaction. The FePc complex belongs to the non-precious catalysts group, whose active site, FeN4, emulates catalytic centers of biocatalysts such as Cytochrome c. This study presents an experimental platform involving FePc self-assembled to a gold electrode surface using chiral peptides (L and D enantiomers), i.e., chiro-self-assembled FePc systems (CSAFePc). The chiral peptides behave as spin filters axial ligands of the FePc. One of the main findings is that the peptides' handedness and length in CSAFePc can optimize the kinetics and thermodynamic factors governing ORR. Moreover, the D-enantiomer promotes the highest electrocatalytic activity of FePc for ORR, shifting the onset potential up to 1.01â V vs. RHE in an alkaline medium, a potential close to the reversible potential of the O2 /H2 O couple. Therefore, this work has exciting implications for developing highly efficient and bioinspired catalysts, considering that, in biological organisms, biocatalysts that promote O2 reduction to water comprise L-enantiomers.
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BACKGROUND: The development and fine-tuning of biotechnological processes for fish oil extraction constitute a very important focus to contribute to the development of a food industry based on fish consumption. This work lies in a comparative analysis of the oil extraction yield of Myliobatis goodei livers using free and immobilized enzymes. RESULTS: An immobilized biocatalyst was designed from the cell-free extract of a Bacillus sp. Mcn4. A complete factorial design was used to study the components of the bacterial culture medium and select the condition with the highest titers of extracellular enzymatic activities. Wheat bran had a significant effect on the culture medium composition for enzymatic production. The immobilized biocatalyst was designed by covalent binding of the proteins present in the cocktail retaining a percentage of different types of enzymatic activities (Mult.Enz@MgFe2 O4 ). Among the biocatalyst used, Alcalase® 2.4 L and Purazyme® AS 60 L (free commercial proteases) showed extraction yields of 87.39% and 84.25%, respectively, while Mult.Enz@MgFe2 O4 achieved a better one of 89.97%. The oils obtained did not show significant differences in their physical-chemical properties while regarding the fatty acid content, the oil extracted with Purazyme® AS 60 L showed a comparatively lower proportion of polyunsaturated fatty acids. CONCLUSIONS: Our results suggest that the use of by-products of M. goodei is a valid alternative and encourages the use of immobilized multienzyme biocatalysts for the treatment of complex substrates in the fishing industry. © 2023 Society of Chemical Industry.
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Enzimas Imobilizadas , Lipase , Hidrólise , Lipase/química , Enzimas Imobilizadas/química , Óleos de Peixe/metabolismo , Fígado/metabolismoRESUMO
Abstract In Argentina, hemolytic uremic syndrome (HUS) caused by Shiga toxin-producing Escherichia coli (STEC-HUS) infection is endemic, and reliable data about prevalence and risk factors have been available since 2000. However, information about STEC-associated bloody diarrhea (BD) is limited. A prospective study was performed during the period October Surveillance; 2018-June 2019 in seven tertiary-hospitals and 18 referral units from different regions, aiming of STEC-HUS cases in the same hospitals and during the same period were also assessed. Twenty-nine (4.1%) of the BD patients were STEC-positive, as determined by the Shiga Toxin Quik Chek (STQC) test and/or the multiplex polymerase chain reaction (mPCR) assay. The highest fre-quencies were found in the Southern region (Neuquén, 8.7%; Bahía Blanca, 7.9%), in children between 12 and 23 month of age (8.8%), during summertime. Four (13.8%) cases progressed to HUS, three to nine days after diarrhea onset. Twenty-seven STEC-HUS in children under 5 years of age (77.8%) were enrolled, 51.9% were female; 44% were Stx-positive by STQC and all by mPCR. The most common serotypes were O157:H7 and O145:H28 and the prevalent geno-types, both among BD and HUS cases, were sfx2a-only or -associated. Considering the endemic behavior of HUS and its high incidence, these data show that the rate of STEC-positive cases is low among BD patients. However, the early recognition of STEC-positive cases is important for patient monitoring and initiation of supportive treatment.
Resumen En Argentina, el síndrome urémico hemolítico asociado a Escherichia coli productor de toxina Shiga (STEC-SUH) es endémico y, desde 2000, de notificación obligatoria. Sin embargo, la información sobre diarrea sanguinolenta (DS) asociada a STEC (DS-STEC) es limitada. Se realizó un estudio prospectivo desde octubre de 2018 hasta junio de 2019 en siete hospitales de tercer nivel y 18 unidades de referencia de diferentes provincias argentinas, con el objetivo de determinar la frecuencia de casos de DS-STEC en 714 niños de 1 a 9 años que tuvieron DS (I) y la tasa de progresión de DS a SUH en dicha cohorte (II). También se evaluó el número y distribución regional de casos de STEC-SUH en los mismos hospitales en dicho período. Veintinueve casos de DS (4,1%) fueron STEC-positivos, determinados por Shiga Toxin Quik Chek (STQC) o PCR múltiple (mPCR). Las frecuencias más altas se encontraron en el sur del área relevada (Neuquén, 8,7%; Bahía Blanca, 7,9%), en niños de 12 a 23 meses (8,8%), en verano. Cuatro casos de DS-STEC (13,8%) progresaron a SUH, de tres a nueve días después del inicio de la diarrea. Se registraron 27 niños con STEC-SUH, estos fueron mayoritariamente <5 anos (77,8%) del sexo femenino (51,9%). El 44% de estos casos fueron Stx-positivos por STQC y todos por mPCR. Los serotipos más comunes fueron O157:H7y O145:H28, y el genotipo predominante fue stx2a, solo o asociado, en DS y SUH. Considerando el comportamiento endémico del SUH y su alta incidencia, estos datos muestran que la tasa de casos de DS-STEC es baja. Sin embargo, su reconocimiento temprano es importante para el seguimiento e inicio del tratamiento de sostén.
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Sulfur amino acids are essential for the proper development of broilers and are required throughout the bird's life to perform important physiological functions. Studies that seek to understand the actions of sulfur amino acids in the body of birds are essential. The present study evaluated the influence of sulfur amino acid supplementation using DL-Methionine (DL-Met) and DL-Methionine hydroxy analogue (DL-HMTBA), on the performance and expression of genes related to methionine metabolism, in the jejunum of broilers. Four hundred and fifty male broilers (Cobb-700 slow feathering) were distributed in a completely randomized design, in a factorial scheme (2x3), with two sources of methionine (DL-Met and DL-HMTBA) and three levels of methionine (deficiency, requirement and excess). The mRNA expression of the MAT1, MTR, BHMT, MTRR, CBG and GSS genes, and performance data such as feed intake, weight gain, and feed conversion were evaluated. DL-HMTBA increased the expression of BHMT (p = 0.0072) and MTRR (p = 0.0003) in the jejunum of the birds. Methionine deficiency increased the expression of BHMT (p = 0.0805) and MTRR (p = 0.0018). Higher expression of GSS was observed in birds that were supplemented with DL-HMTBA (p = 0.0672). Analyzing our results, it is preferable to supplement sulfur amino acids with DL-Met at the requirement level. Birds fed with DL-HMTBA showed worse weight gain (p = 0.0117) and higher feed conversion (p = 0.0170); methionine deficiency resulted in higher feed intake (p = 0.0214), lower weight gain (p<0.0001) and consequently higher feed conversion (p<0.0001). Based on the information found in this work, it is recommended to supplement sulfur amino acids with DL-Met at the level of compliance with the requirement.
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Galinhas , Homocisteína , Animais , Masculino , Homocisteína/metabolismo , Jejuno/metabolismo , Metionina , Dieta/veterinária , Racemetionina/metabolismo , Suplementos Nutricionais , Aumento de Peso , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição AnimalRESUMO
This study aimed to evaluate the immunity of chickens up to 35 d subjected to posthatch fasting and supplementation with conjugated linoleic acid (CLA). A total of 320 chicks were housed in a completely randomized design with a 2 × 2 factorial arrangement (0 or 12 h of fasting × 0.000 or 0.025% CLA in a prestarter diet), totaling 4 treatments (No-F-12 h; F-12 h; No-CLA; CLA) with 8 replicates of 10 birds each. The relative weights (% body weight) of the spleen and bursa were determined 12 h posthatch (Post-12 h) and then weekly. Immunoglobulin Y (IgY) titers against Newcastle disease virus (NDV) were measured by ELISA in the yolk sac contents Post-12 h and in the serum weekly. Hypersensitivity to phytohemagglutinin (PHA) inoculation was evaluated by toe-web swelling response on d 13 and 34, 4 times a day (after 3 h, 6 h, 12 h, and 24 h inoculation, respectively, PHA-3 h, PHA-6 h, PHA-12 h, and PHA-24 h). The data were subjected to analysis of variance (P < 0.05). F-12h reduced the Post-12 h relative weight of the spleen, and CLA reduced the relative weight of the bursa at this stage and at 28 d. At 13 d, F-12 h reduced PHA-3 h, whereas PHA-12 h was increased by CLA. At 34 d, CLA reduced PHA-3 h. A greater reaction was observed in the No-F-12 h-CLA chicks, for the PHA-24 h. In the Post-12 h evaluation, F-12h reduced, whereas CLA increased NDV-specific IgY titers in the yolk sac. No-F-12 h-No-CLA chicks had the lowest serum titers. At 21 d, F-12 h-CLA chicks exhibited the highest serum titers. Titers were higher in the F-12 h-No-CLA chicks, when compared to other treatments. At 28 d, fasting reduced the titers. In conclusion, F-12 h and CLA accelerated the transfer of immunoglobulins from the yolk sac to the serum. F-12 h impairs cellular immunity, whereas CLA favors it.
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Galinhas , Ácidos Linoleicos Conjugados , Animais , Galinhas/fisiologia , Ácidos Linoleicos Conjugados/farmacologia , Imunidade Humoral , Dieta/veterinária , Jejum , Ração Animal/análiseRESUMO
Renal cell carcinoma (RCC) is rarely diagnosed during pregnancy and its management represents a challenge as it necessitates considerations for the well-being of both the mother and the developing fetus. Diagnosis can be challenging and is often an incidental finding during routine imaging, which can lead to difficult decision-making. The choice of the ideal imaging study in these cases is a matter of debate. When the tumor is detected at an early stage, radical nephrectomy is indicated. However, there is still controversy regarding whether it should be performed conventionally or laparoscopically, as both techniques have their risks and benefits. In this context, our primary objective was to provide adequate surgical treatment for the patient, while safeguarding fetal health. Here, we present a patient with a history of recurrent miscarriages, in whom a renal tumor was incidentally diagnosed during pregnancy. Adding to the uniqueness of this case, the patient was diagnosed with an eosinophilic variant of chromophobe RCC through histopathological analysis. Our aim is to highlight the controversies surrounding diagnostic and treatment methodologies and to present the surgical techniques employed in this unique situation. This case underscores the importance and need for a multidisciplinary approach, which, in our instance, resulted in favorable outcomes for both maternal and neonatal health.
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Global population aging is a major challenge to health and socioeconomic policies. The prevalence of diseases progressively increases with aging, with cardiovascular disease being the major cause of mortality among elderly people. The allostatic overload imposed by the accumulation of cardiac senescent cells has been suggested to play a pivotal role in the aging-related deterioration of cardiovascular function. Senescent cells exhibit intrinsic disorders and release a senescence-associated secretory phenotype (SASP). Most of these SASP compounds and damaged molecules are released from senescent cells by extracellular vesicles (EVs). Once secreted, these EVs can be readily incorporated by recipient neighboring cells and elicit cellular damage or otherwise can promote extracellular matrix remodeling. This has been associated with the development of cardiac dysfunction, fibrosis, and vascular calcification, among others. The molecular signature of these EVs is highly variable and might provide important information for the development of aging-related biomarkers. Conversely, EVs released by the stem and progenitor cells can exert a rejuvenating effect, raising the possibility of future anti-aging therapies.
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Alostase , Vesículas Extracelulares , Coração , Transporte BiológicoRESUMO
Along with poor implant-bone integration, peri-implant diseases are the major causes of implant failure. Although such diseases are primarily triggered by biofilm accumulation, a complex inflammatory process in response to corrosive-related metallic ions/debris has also been recognized as a risk factor. In this regard, by boosting the titanium (Ti) surface with silane-based positive charges, cationic coatings have gained increasing attention due to their ability to kill pathogens and may be favorable for corrosion resistance. Nevertheless, the development of a cationic coating that combines such properties in addition to having a favorable topography for implant osseointegration is lacking. Because introducing hydroxyl (-OH) groups to Ti is essential to increase chemical bonds with silane, Ti pretreatment is of utmost importance to achieve such polarization. In this study, plasma electrolytic oxidation (PEO) was investigated as a new route to pretreat Ti with OH groups while providing favorable properties for implant application compared with traditional hydrothermal treatment (HT). To produce bactericidal and corrosion-resistant cationic coatings, after pretreatment with PEO or HT (Step 1), surface silanization was subsequently performed via immersion-based functionalization with 3-aminopropyltriethoxysilane (APTES) (Step 2). In the end, five groups were assessed: untreated Ti (Ti), HT, PEO, HT+APTES, and PEO+APTES. PEO created a porous surface with increased roughness and better mechanical and tribological properties compared with HT and Ti. The introduction of -OH groups by HT and PEO was confirmed by Fourier transform infrared spectroscopy and the increase in wettability producing superhydrophilic surfaces. After silanization, the surfaces were polarized to hydrophobic ones, and an increase in the amine functional group was observed by X-ray photoelectron spectroscopy, demonstrating a considerable amount of positive ions. Such protonation may explain the enhanced corrosion resistance and dead bacteria (Streptococcus aureus and Escherichia coli) found for PEO+APTES. All groups presented noncytotoxic properties with similar blood plasma protein adsorption capacity vs the Ti control. Our findings provide new insights into developing next-generation cationic coatings by suggesting that a tailorable porous and oxide coating produced by PEO has promise in designing enhanced cationic surfaces targeting biomedical and dental implant applications.
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Silanos , Titânio , Propriedades de Superfície , Titânio/farmacologia , Titânio/química , CátionsRESUMO
The large-conductance Ca2+-activated K+ (BK) channel is widely expressed in the pulmonary blood vessels and plays a significant role in regulating pulmonary vascular tonus. It opens under membrane depolarization, increased intracellular Ca+2 concentration, and chronic hypoxia, resulting in massive K+ efflux, membrane hyperpolarization, decreased L-type Ca+2 channel opening, and smooth muscle relaxation. Several reports have demonstrated an association between BK channel dysfunction and pulmonary hypertension (PH) development. Decreased BK channel subunit expression and impaired regulation by paracrine hormones result in decreased BK channel opening, increased pulmonary vascular resistance, and pulmonary arterial pressure being the cornerstone of PH. The resulting right ventricular pressure overload ultimately leads to ventricular remodeling and failure. Therefore, it is unsurprising that the BK channel has arisen as a potential target for treating PH. Recently, a series of selective, synthetic BK channel agonists have proven effective in attenuating the pathophysiological progression of PH without adverse effects in animal models.
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Bees play a critical role in pollination and food production, so their preservation is essential, particularly highlighting the importance of detecting diseases in bees early. The Varroa destructor mite is the primary factor contributing to increased viral infections that can lead to hive mortality. This study presents an innovative method for identifying Varroa destructors in honey bees using multichannel Legendre-Fourier moments. The descriptors derived from this approach possess distinctive characteristics, such as rotation and scale invariance, and noise resistance, allowing the representation of digital images with minimal descriptors. This characteristic is advantageous when analyzing images of living organisms that are not in a static posture. The proposal evaluates the algorithm's efficiency using different color models, and to enhance its capacity, a subdivision of the VarroaDataset is used. This enhancement allows the algorithm to process additional information about the color and shape of the bee's legs, wings, eyes, and mouth. To demonstrate the advantages of our approach, we compare it with other deep learning methods, in semantic segmentation techniques, such as DeepLabV3, and object detection techniques, such as YOLOv5. The results suggest that our proposal offers a promising means for the early detection of the Varroa destructor mite, which could be an essential pillar in the preservation of bees and, therefore, in food production.
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OBJECTIVES: Our paper presents the analysis of a nationwide survey that explored induced abortion among women using a ballot-box technique. Our objective was to determine the prevalence of abortion and the main characteristics of the procedure. STUDY DESIGN: We conducted surveys in households with 2400 women aged 18-49 from urban areas nationwide, between October 15 and 29, 2018. Data collection was overseen by the Instituto de Opinión Pública de la Universidad Católica del Perú. We performed a probabilistic, multistage, and socioeconomic level-stratified sampling. Our study used the "ballot-box technique" to ensure anonymity and reduce the risk of social desirability. RESULTS: We visited 15,433 houses nationwide. Among those households where surveys could not be conducted, it was due to abandoned or inaccessible property, unwilling to participate, absent members, out of quota, or inconclusive survey. On average, 19.0% of Peruvian women at all socioeconomic levels reported having had at least one abortion in their lifetime. Induced abortion is reported at all socioeconomic levels and reported age of the abortion is concentrated between 19 and 29 years old. In 57.7% of cases, women sought healthcare personnel for their last induced abortion. Among them, procedure abortion (45.3%) stands out over medical abortions (34.0%). Thirty-three percent of women who reported having had at least one induced abortion in their lifetime were admitted to a hospital after their last abortion. CONCLUSIONS: The illegality of abortion has not prevented its occurrence in Peru. Our results suggest that, in Peru, legal restrictions on induced abortion create an unfavorable context for women's health, exposing them to services whose safety is not guaranteed. Efforts should be made to increase awareness and education about contraception and family planning methods to prevent unwanted pregnancies and reduce the need for abortion. IMPLICATIONS: These findings should be considered in public policy discussions regarding abortion, since they might have a great impact for better decision making. They demonstrate that legal restrictions have not prevented the occurrence of abortion but has only created unsafe conditions around it.
Assuntos
Aborto Induzido , Aborto Espontâneo , Gravidez , Feminino , Humanos , Adulto Jovem , Adulto , Peru/epidemiologia , Prevalência , Anticoncepção , Serviços de Planejamento FamiliarRESUMO
In Argentina, hemolytic uremic syndrome (HUS) caused by Shiga toxin-producing Escherichia coli (STEC-HUS) infection is endemic, and reliable data about prevalence and risk factors have been available since 2000. However, information about STEC-associated bloody diarrhea (BD) is limited. A prospective study was performed during the period October 2018-June 2019 in seven tertiary-hospitals and 18 referral units from different regions, aiming to determine (i) the frequency of STEC-positive BD cases in 714 children aged 1-9 years of age and (ii) the rate of progression of bloody diarrhea to HUS. The number and regional distribution of STEC-HUS cases in the same hospitals and during the same period were also assessed. Twenty-nine (4.1%) of the BD patients were STEC-positive, as determined by the Shiga Toxin Quik Chek (STQC) test and/or the multiplex polymerase chain reaction (mPCR) assay. The highest frequencies were found in the Southern region (Neuquén, 8.7%; Bahía Blanca, 7.9%), in children between 12 and 23 month of age (8.8%), during summertime. Four (13.8%) cases progressed to HUS, three to nine days after diarrhea onset. Twenty-seven STEC-HUS in children under 5 years of age (77.8%) were enrolled, 51.9% were female; 44% were Stx-positive by STQC and all by mPCR. The most common serotypes were O157:H7 and O145:H28 and the prevalent genotypes, both among BD and HUS cases, were stx2a-only or -associated. Considering the endemic behavior of HUS and its high incidence, these data show that the rate of STEC-positive cases is low among BD patients. However, the early recognition of STEC-positive cases is important for patient monitoring and initiation of supportive treatment.