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Soil contamination by Pb can result from different anthropogenic sources such as lead-based paints, gasoline, pesticides, coal burning, mining, among others. This work aimed to evaluate the potential of P-loaded biochar (Biochar-based slow-release P fertilizer) to remediate a Pb-contaminated soil. In addition, we aim to propose a biomonitoring alternative after soil remediation. First, rice husk-derived biochar was obtained at different temperatures (450, 500, 550, and 600 °C) (raw biochars). Then, part of the resulting material was activated. Later, the raw biochars and activated biochars were immersed in a saturated KH2PO4 solution to produce P-loaded biochars. The ability of materials to immobilize Pb and increase the bioavailability of P in the soil was evaluated by an incubation test. The materials were incorporated into doses of 0.5, 1.0, and 2.0%. After 45 days, soil samples were taken to biomonitor the remediation process using two bioindicators: a phytotoxicity test and enzyme soil activity. Activated P-loaded biochar produced at 500 °C has been found to present the best conditions for soil Pb remediation. This material significantly reduced the bioavailability of Pb and increased the bioavailability of P. The phytotoxicity test and the soil enzymatic activity were significantly correlated with the decrease in bioavailable Pb but not with the increase in bioavailable P. Biomonitoring using the phytotoxicity test is a promising alternative for the evaluation of soils after remediation processes.
Assuntos
Biomarcadores Ambientais , Poluentes do Solo , Fertilizantes , Chumbo/toxicidade , Monitoramento Biológico , Poluentes do Solo/toxicidade , Poluentes do Solo/análise , Solo , Carvão VegetalRESUMO
We conducted a pilot randomized controlled trial of a social network-based intervention to promote PrEP adherence among transgender women (TW) in Lima, Peru. We enrolled 89 TW from six social networks and cluster-randomized them 1:1 to standard of care (n = 44) or the TransPrEP intervention (n = 45). Core workshops discussed strategies to support PrEP adherence and defined group adherence objectives. Maintenance workshops discussed participants' experiences taking PrEP and collective adherence goals. At 3-month follow-up, we evaluated 40 participants and obtained 29 hair samples for tenofovir level measurements. Though no significant differences were observed, 36.4% (4/11) of participants of TransPrEP participants and 10.0% (1/10) of control participants had tenofovir levels > 0.023 ng/mg, consistent with ≥ 4 doses per week. 81.8% (9/11) of intervention and 40.0% (4/10) of control participants had any detectable tenofovir in their hair. Pilot assessment of our network-based intervention suggested a trend towards improved PrEP adherence, measured objectively, for TW in Peru.
RESUMEN: Realizamos un estudio piloto controlado y aleatorizado de una intervención basada en redes sociales para promover la adherencia al PrEP en mujeres transgénero (MT) de Lima, Perú. Enrolamos a 89 MT de 6 redes sociales y las aleatorizamos por grupos a razón 1:1 al estándar de atención como control (n = 44) o a la intervención TransPrEP (n = 45). En los talleres centrales se discutieron estrategias para respaldar la adherencia al PrEP y se definieron los objetivos de adherencia del grupo. En los talleres de mantenimiento se discutieron las experiencias de los participantes al tomar PrEP y los objetivos de adherencia colectiva. A los 3 meses de seguimiento, evaluamos a 40 participantes y obtuvimos 29 muestras de cabello para medir el nivel de tenofovir. Aunque no se observaron diferencias significativas, el 36.4% (4/11) de los participantes de TransPrEP y el 10.0% (1/10) de los participantes del grupo control tenían niveles de tenofovir> 0.023 ng/mg, congruente con 4 o más dosis por semana. El 81.8% (9/11) del grupo de intervención y el 40.0% (4/10) de los participantes de control tenían tenofovir detectable en el cabello. La evaluación piloto de nuestra intervención basada en redes sugiere una tendencia hacia una mejor adherencia al PrEP, medida objetivamente, para las MT en Perú.
Assuntos
Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Pessoas Transgênero , Fármacos Anti-HIV/uso terapêutico , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Masculino , Adesão à Medicação , Peru , Projetos Piloto , Rede SocialRESUMO
Lithium activates Wnt/ß-catenin signaling leading to stabilization of free cytosolic ß-catenin. The aim of the present study is to evaluate the in vivo effect of acute and chronic lithium treatment on the expression of ß-catenin target genes, addressing its transcripts HIG2, Bcl-xL, Cyclin D1, c-myc, in cortical and hippocampal tissue from adult mice. Lithium doses were established to yield therapeutic working concentrations. In acute treatment, mice received a 300µL of a 350 mg/kg solution of LiCl by gavage, and were euthanized after 2 h, 6 h and 12 h. To determine the effect of chronic treatment, animals were continuously fed either with chow supplemented with 2 g/kg Li2CO3, or regular chow (controls), being euthanized after 30 days. All animals had access to drinking water and 0.9% saline ad libitum. After acute and chronic treatments samples of peripheral blood were obtained from the tail vein for each animal, and serum concentrations of lithium were determined. All transcripts were up-regulated in cortical and hippocampal tissues of lithium-treated mice, both under acute and chronic treatments. There was a positive correlation between serum lithium concentrations and the increment in the expression of all transcripts. This effect was observed in all time points of the acute treatment (i.e., 2, 6 and 12 hours) and also after 30 days. We conclude that Wnt/ß-catenin transcriptional response (HIG2, Bcl-xL, Cyclin D1 and c-myc) is up-regulated in the mouse brain in response to acute and chronic lithium treatment at therapeutic concentrations.
Assuntos
Antimaníacos/farmacologia , Córtex Cerebral/efeitos dos fármacos , Hipocampo/efeitos dos fármacos , Cloreto de Lítio/farmacologia , Proteínas Wnt/metabolismo , beta Catenina/metabolismo , Animais , Córtex Cerebral/metabolismo , Hipocampo/metabolismo , Camundongos , Via de Sinalização Wnt/efeitos dos fármacosRESUMO
Introducción.Desde un punto de vista integral, la sexualidad comprende aspectos de orden biopsicosocial. Los prejuiciosy el desconocimiento llevan a evitar hablar sobre este tema en la consulta con el adulto mayor (AM).Objetivo.Profundizar en la vivencia de la sexualidad del AM.Metodología.Estudio cualitativo, fenomenológico, realizado en dos centros de actividades recreativas para AM en SanMiguel de Tucumán, que incluyó 13 entrevistas semiestructuradas en profundidad a pacientes mayores de 60 años, 11 desexo femenino, seleccionados en forma intencional y por conveniencia en Agosto de 2018.Resultados.Existe una dicotomía entre quienes hablan del tema y quienes no; sin embargo, todos expresan el deseode naturalizarlo tanto en su círculo social como en la consulta médica. Los AM aceptan el proceso de envejecimiento,tienen una autopercepción positiva de su imagen y pese a los prejuicios, experiencias, comorbilidades y adversidades, seadaptan buscando formas para sentirse bien y disfrutar de una sexualidad plena.Conclusión.El envejecimiento y la sexualidad son conceptos dinámicos que confluyen con las experiencias de vida.Creemos que como médicos de familia es importante brindar una atención integral, abordando las diferentes dimensionesdel ser humano, incluyendo su sexualidad. (AU)
Introduction.Sexuality from an integral point of view includes aspects of biopsychosocial order. Prejudice and ignorancelead to avoid talking about this topic in the medical consultation with the Eldery.Objective.To deepen the experience of the sexuality of the Eldery.Methodology.Qualitative, phenomenological study, conducted in two centres of recreational activities for Senior Citizensin San Miguel de Tucumán, which included 13 in-depth semi-structured interviews to patients over 60 years of age, 11female, selected intentionally and for convenience in August 2018.Results.There is a dichotomy between those who talk about the subject and those who do not; however, all of themexpress the desire to naturalize it in both, their social circle and the medical consultation. The eldery patients acceptthe ageing process, have a positive self-perception of their image and despite prejudices, experiences, comorbidities andadversities, they adapt looking for ways to feel good and enjoy a full sexuality.Conclusion.Aging and sexuality are dynamic concepts that converge with life experiences. We believe that, as familydoctors, it is important to provide comprehensive care, addressing the different dimensions of the human being, wheresexuality is included. (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/psicologia , Saúde do Idoso , Assistência Integral à Saúde/tendências , Sexualidade/psicologia , Autoimagem , Envelhecimento/metabolismo , Sexualidade/fisiologia , Características Culturais , Medicina de Família e Comunidade/tendênciasRESUMO
CD100 or Sema4D is a protein from the semaphorin family with important roles in the vascular, nervous and immune systems. It may be found as a membrane bound dimer or as a soluble molecule originated by proteolytic cleavage. Produced by the majority of hematopoietic cells including B and T lymphocytes, natural killer and myeloid cells, as well as endothelial cells, CD100 exerts its actions by binding to different receptors depending on the cell type and on the organism. Cell-to-cell adhesion, angiogenesis, phagocytosis, T cell priming, and antibody production are examples of the many functions of this molecule. Of note, high CD100 serum levels has been found in inflammatory as well as in infectious diseases, but the roles of the protein in the pathogenesis of these diseases has still to be clarified. Macrophages are highly heterogeneous cells present in almost all tissues, which may change their functions in response to microenvironmental conditions. They are key players in the innate and adaptive immune responses and have decisive roles in sterile conditions but also in several diseases such as atherosclerosis, autoimmunity, tumorigenesis, and antitumor responses, among others. Although it is known that macrophages express CD100 and its receptors, few studies have focused on the role of this semaphorin in this cell type or in macrophage-associated diseases. The aim of this review is to critically revise the available data about CD100 and atherosclerosis, with special emphasis on its roles in macrophages and monocytes. We will also describe the few available data on treatments with anti-CD100 antibodies in different diseases. We hope that this review stimulates future studies on the effects of such an important molecule in a cell type with decisive roles in inflammatory diseases such as atherosclerosis.
RESUMO
El Hatha yoga es una práctica ancestral que ha surgido en Occidente como un antídoto para el estrés (Field, 2011). Esta técnica involucra la práctica de ejercicios físicos, técnicas de respiración y meditación (Riley, 2004). Objetivos: El presente estudio buscó conocer los efectos de un programa de Hatha yoga en el estrés percibido de estudiantes universitarios de una universidad privada de Lima Metropolitana. Metodología: Se optó por realizar un estudio piloto de corte cuasi experimental, con dos grupos (control y experimental) medidos antes, durante y después del programa. Luego de medir en una primera instancia el estrés percibido en los participantes de ambos grupos, el grupo experimental inició un programa de hatha yoga mientras que el grupo control fue sometido a un programa de imaginería guiada. Al finalizar la aplicación de ambos programas, los datos fueron analizados con los estadísticos ANOVA de medidas repetidas y t de student. Resultados: Los resultados demostraron que tras el programa de Hatha yoga el estrés percibido de los estudiantes universitarios disminuyó de manera significativa. (AU)
Assuntos
Humanos , Estresse Psicológico/terapia , Estudantes , Yoga , Peru , Terapias ComplementaresRESUMO
Human relationship with dogs associates with numerous and varied benefits on human health; however, it also presents significant risks. The goal of this study was to describe demographic parameters and characteristics of dog ownership with possible implications on human health and to evaluate the prevalence of dog bites and traffic accidents due to dogs. Interviews were conducted in the neighborhoods of Nuestras Malvinas and Nahuel Hue in San Carlos de Bariloche. The percentage of homes with at least one dog, the average number of dogs per home, the prevalence of dog bites and traffic accidents due to dogs and the general awareness of the population on dog transmitted zoonoses were estimated. Regarding ownership characteristics, the degree of sterilization, vaccination and parasite control and the percentage of dogs allowed to roam freely in public places were evaluated. A total of 141 interviews were conducted; 87% of the households had at least one dog, with an average of 2.2 dogs. In 26% of the households someone had suffered a traffic accident caused by dogs and in 41% someone had been bitten. Antiparasite treatment was administered to 83% of the dogs in the last 12 months, on average 1.4 times (recommended 6 times), 51% were sterilized, 55% were allowed to roam freely. This study shows a disturbing situation regarding the canine population of the evaluated neighborhoods. The number of dogs allowed to roam freely and the low level of parasite control and sterilization provide suitable conditions for the spread of zoonoses.
Assuntos
Bem-Estar do Animal , Mordeduras e Picadas/epidemiologia , Cães , Propriedade , Acidentes de Trânsito/estatística & dados numéricos , Animais , Argentina/epidemiologia , Doenças do Cão/parasitologia , Doenças do Cão/prevenção & controle , Humanos , Entrevistas como Assunto , Propriedade/estatística & dados numéricos , Responsabilidade SocialRESUMO
La relación entre el hombre y el perro se asocia a numerosos y variados beneficios sobre la salud humana; sin embargo también presenta importantes riesgos. El objetivo de este trabajo es describir parámetros demográficos y características de la tenencia de perros con implicancias sobre la salud humana y evaluar la prevalencia de mordeduras y accidentes de tránsito causados por perros. Se realizó una encuesta en los barrios Nuestras Malvinas y Nahuel Hue de San Carlos de Bariloche. Se estimó el porcentaje de viviendas con al menos un perro, la media de perros por vivienda, la prevalencia de mordeduras de perro y de accidentes de tránsito causados por perros y el conocimiento de la población sobre zoonosis transmitidas por perros. Respecto de la tenencia, se evaluó el grado de esterilización, vacunación y desparasitación y el porcentaje de perros con libre acceso a la calle. Se realizaron 141 entrevistas. En 87% de las viviendas había al menos un perro (promedio 2.2 perros/vivienda). En 26% de las viviendas alguien había sufrido un accidente de tránsito causado por perros y en 41% alguien había sido mordido. El 83% de los perros fueron desparasitados en los últimos 12 meses, en promedio 1.4 veces (óptimo: 6 veces/año), 51% estaban esterilizados, 55% tenían libre acceso a la calle. Este estudio muestra una situación preocupante respecto de la población canina de los barrios evaluados. El número de perros sueltos en la calle y el bajo nivel de desparasitación y esterilización proveen condiciones ideales para que se propaguen zoonosis.
Human relationship with dogs associates with numerous and varied benefits on human health; however, it also presents significant risks. The goal of this study was to describe demographic parameters and characteristics of dog ownership with possible implications on human health and to evaluate the prevalence of dog bites and traffic accidents due to dogs. Interviews were conducted in the neighborhoods of Nuestras Malvinas and Nahuel Hue in San Carlos de Bariloche. The percentage of homes with at least one dog, the average number of dogs per home, the prevalence of dog bites and traffic accidents due to dogs and the general awareness of the population on dog transmitted zoonoses were estimated. Regarding ownership characteristics, the degree of sterilization, vaccination and parasite control and the percentage of dogs allowed to roam freely in public places were evaluated. A total of 141 interviews were conducted; 87% of the households had at least one dog, with an average of 2.2 dogs. In 26% of the households someone had suffered a traffic accident caused by dogs and in 41% someone had been bitten. Antiparasite treatment was administered to 83% of the dogs in the last 12 months, on average 1.4 times (recommended 6 times), 51% were sterilized, 55% were allowed to roam freely. This study shows a disturbing situation regarding the canine population of the evaluated neighborhoods. The number of dogs allowed to roam freely and the low level of parasite control and sterilization provide suitable conditions for the spread of zoonoses.
Assuntos
Humanos , Animais , Cães , Propriedade/estatística & dados numéricos , Mordeduras e Picadas/epidemiologia , Bem-Estar do Animal , Argentina/epidemiologia , Responsabilidade Social , Acidentes de Trânsito/estatística & dados numéricos , Entrevistas como Assunto , Doenças do Cão/parasitologia , Doenças do Cão/prevenção & controleRESUMO
Objective To describe the benefits obtained through South-South and triangular cooperation as a potential tool for strengthening medicine quality control in official medicines control laboratories (OMCLs) of the Region of the Americas. Methods Descriptive study of the project for strengthening drug quality control in OMCLs of the Caribbean community (CARICOM). Results Staff members of Argentina's National Administration for Drugs, Food, and Medical Technology (ANMAT) provided training to professionals from Guyana, Jamaica, Suriname, and Trinidad and Tobago. The project was funded by the Argentine Fund for South-South and Triangular Cooperation (FO.AR) and coordinated by the Pan American Health Organization (PAHO). Documents on good laboratory practice (GLP) developed by the World Health Organization (WHO) and the Pan American Network for Drug Regulatory Harmonization (PANDRH) were reviewed, and the area of physical and chemical controls was strengthened, primarily for drugs to treat tuberculosis, malaria, and HIV/AIDS, all of which are strategically important to those countries. Conclusion This type of collaboration makes it possible to share experiences, optimize resources, harmonize procedures and regulations, and strengthen human resource capacities. In addition, it is a valuable tool for reducing asymmetries in various areas among the different countries of our Region.
Assuntos
Cooperação Internacional , Laboratórios/normas , Preparações Farmacêuticas/normas , Controle de Qualidade , Argentina , Região do Caribe , Guias como Assunto/normas , Guiana , Humanos , Jamaica , Desenvolvimento de Pessoal , Suriname , Trinidad e TobagoRESUMO
Objetivo. Describir los beneficios obtenidos a través de la cooperación Sur-Sur y Triangular, como una potencial herramienta para el fortalecimiento en el control de la calidad de los medicamentos en los Laboratorios Oficiales de Control de Medicamentos (LOCM) de la Región de las Américas. Métodos. Estudio descriptivo del proyecto para el fortalecimiento en el control de la calidad de los medicamentos en los LOCM de la Comunidad del Caribe (CARICOM). Resultados. La capacitación fue desarrollada por profesionales de la Administración Nacional de Medicamentos, Alimentos y Tecnología Médica (ANMAT) de Argentina, a profesionales de Guyana, Jamaica, Surinam y Trinidad y Tobago. El proyecto contó con financiamiento del Fondo Argentino de Cooperación Sur-Sur y Triangular (FO.AR) y coordinación de la Organización Panamericana de la Salud (OPS). Se revisaron los documentos de Buenas Prácticas de Laboratorio (BPL) de la Organización Mundial de la Salud (OMS) y de la Red Panamericana para la Armonización de la Reglamentación Farmacéutica (Red-PARF) y se fortaleció el área de controles físicos químicos, principalmente en relación a medicamentos para el tratamiento de la tuberculosis, la malaria y el VIH/sida, todos de importancia estratégica para esos países. Conclusión. Este tipo de colaboraciones permiten transferir experiencia, optimizar los recursos, armonizar procedimientos y regulaciones y reforzar capacidades en término de recursos humanos, y constituyen una herramienta valiosa en la reducción de las asimetrías que pudieron establecerse en diferentes áreas entre diferentes países de nuestra región.
Objective. To describe the benefits obtained through South-South and triangular cooperation as a potential tool for strengthening medicine quality control in official medicines control laboratories (OMCLs) of the Region of the Americas. Methods. Descriptive study of the project for strengthening drug quality control in OMCLs of the Caribbean community (CARICOM). Results. Staff members of Argentina’s National Administration for Drugs, Food, and Medical Technology (ANMAT) provided training to professionals from Guyana, Jamaica, Suriname, and Trinidad and Tobago. The project was funded by the Argentine Fund for South-South and Triangular Cooperation (FO.AR) and coordinated by the Pan American Health Organization (PAHO). Documents on good laboratory practice (GLP) developed by the World Health Organization (WHO) and the Pan American Network for Drug Regulatory Harmonization (PANDRH) were reviewed, and the area of physical and chemical controls was strengthened, primarily for drugs to treat tuberculosis, malaria, and HIV/AIDS, all of which are strategically important to those countries. Conclusion. This type of collaboration makes it possible to share experiences, optimize resources, harmonize procedures and regulations, and strengthen human resource capacities. In addition, it is a valuable tool for reducing asymmetries in various areas among the different countries of our Region.
Assuntos
Laboratório Oficial , Região do Caribe , Cooperação Técnica , Laboratório Oficial , Região do Caribe , Cooperação InternacionalRESUMO
Leukocyte migration is essential for the function of the immune system. Their recruitment from the vessels to the tissues involves sequential molecular interactions between leukocytes and endothelial cells (ECs). Many adhesion molecules involved in this process have already been described. However, additional molecules may be important in this interaction, and here we explore the potential role for CD100 and plexins in monocyte-EC binding. CD100 was shown to be involved in platelet-endothelial cell interaction, an important step in atherogenesis and thrombus formation. In a recent work we have described CD100 expression in monocytes and in macrophages and foam cells of human atherosclerotic plaques. In the present work, we have identified plexin B2 as a putative CD100 receptor in these cells. We have detected CD100 expression in the endothelium as well as in in vitro cultured endothelial cells. Blocking of CD100, plexin B1 and/or B2 in adhesion experiments have shown that both CD100 and plexins act as adhesion molecules involved in monocyte-endothelial cell binding. This effect may be mediated by CD100 expressed in both cell types, probably coupled to the receptors endothelial plexin B1 and monocytic plexin B2. These results can bring new insights about a possible biological activity of CD100 in monocyte adhesion and atherosclerosis, as well as a future candidate for targeting therapeutics.
Assuntos
Antígenos CD/metabolismo , Aterosclerose/metabolismo , Aterosclerose/patologia , Moléculas de Adesão Celular/metabolismo , Células Endoteliais da Veia Umbilical Humana/citologia , Monócitos/citologia , Proteínas do Tecido Nervoso/metabolismo , Receptores de Superfície Celular/metabolismo , Semaforinas/metabolismo , Animais , Antígenos CD/genética , Artérias Carótidas/metabolismo , Artérias Carótidas/patologia , Adesão Celular , Diferenciação Celular , Células Cultivadas , Células Espumosas/metabolismo , Regulação da Expressão Gênica , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Camundongos , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Semaforinas/genéticaRESUMO
La tuberculosis (TB) es una enfermedad infecto-contagiosa cuya transmisión se produce de persona a persona. La forma más eficaz de cortar la cadena de transmisión es tratando a todos los casos de TB de la comunidad. La TB sigue siendo un problema de salud que más casos, muertes y empeoramiento de la condición social de las personas causa en el mundo. El objetivo general de este estudio fue analizar espacialmente la accesibilidad geográfica y el abandono del tratamiento de los casos notificados de TB en los Establecimientos de salud de las Ciudades de Santa Fe y Rosario Provincia de Santa Fe - Argentina. Es un estudio de caso y control con componente espacial teniendo como variable dependiente el abandono o no del tratamiento de los casos de TB notificados en las Ciudades de Santa Fe y Rosario durante el período 2008 2012. Los casos fueron definidos como aquellos pacientes que abandonaron el tratamiento. Los controles fueron definidos como aquellos pacientes que no abandonaron el tratamiento. Se realizó un análisis exploratorio y espacial con el fin de investigar los factores asociados con el abandono de tratamiento en las dos Ciudades. Las variables que se asociaron fueron individuales, socio económicas y del Establecimiento de Salud donde el paciente realizó el tratamiento. En ambas Ciudades, el espacio contribuyó al abandono del tratamiento con una distancia superior a 7 km en Rosario y 6 km en Santa Fe. Para cada Ciudad, las variables se ajustaron a Modelos Aditivos Generalizados (GAMs), donde hubo una mayor contribución de las variables: personas por vivienda, sexo masculino, Establecimiento de tratamiento Hospital y Condición VIH/SIDA. Conociendo los factores de riesgo en las distintas Ciudades, es necesario tomar medidas específicas para reducir el abandono de tratamiento de los casos de TB en estos lugares.
Tuberculosis (TB) is an infectious disease whose transmission occurs from person to person. The most effective way to break the chain of transmission is treating all cases of TB in the community. TB remains a health problem most cases, deaths and worsening social conditions of people in the world cause. The overall objective of this study was to spatially analyze the geographic accessibility and treatment drop in reported cases of TB in health establishments of the cities of Santa Fe and Rosario - Province of Santa Fe - Argentina. It is a case study and control spatial component having as dependent variable the abandonment or treatment of TB cases reported in the cities of Santa Fe and Rosario during the period 2008-2012. Cases were defined as those patients who discontinue treatment. Controls were defined as those patients who did not drop out of treatment. An exploratory spatial analysis and to investigate factors associated with the abandonment of treatment in the two cities was conducted. The variables associated were individual, socioeconomic and health facility where the patient underwent treatment. In both cities, the space contributes to the abandonment of treatment with a distance greater than 7 km in Rosario and 6 km in Santa Fe. For each city, the variables fit Generalized Additive Models (GAMs), where there was a greater contribution of the variables: people per household, male sex, Hospital Treatment Facility and Condition and HIV/AIDS. Knowing the risk factors in different cities, it is necessary to take specific measures to reduce the abandonment of treatment of TB cases in these places.
Assuntos
Humanos , Acessibilidade aos Serviços de Saúde , Pacientes Desistentes do Tratamento , Análise Espacial , Tuberculose/mortalidade , Tuberculose/prevenção & controle , Tuberculose/terapia , Argentina , Notificação de DoençasRESUMO
Long-term non-progressors (LTNP) represent a minority (1-5%) of HIV-infected individuals characterized by documented infection for more than 7-10 years, a stable CD4+ T cell count over 500/mm(3) and low viremia in the absence of antiretroviral treatment. Protective factors described so far such as the CCR5delta32 deletion, protective HLA alleles, or defective viruses fail to fully explain the partial protection phenotype. The existence of additional host resistance mechanisms in LTNP patients was investigated here using a whole human genome microarray study comparing gene expression profiles of unstimulated peripheral blood mononuclear cells from LTNP patients, HIV-1 infected patients under antiretroviral therapy with CD4+ T cell levels above 500/mm(3) (ST), as well as healthy individuals. Genes that were up- or downregulated exclusively in LTNP, ST or in both groups in comparison to controls were identified and classified in functional categories using Ingenuity Pathway Analysis. ST and LTNP patient groups revealed distinct genetic profiles, regarding gene number in each category and up- or downregulation of specific genes, which could have a bearing on the outcome of each group. We selected some relevant genes to validate the differential expression using quantitative real-time qRT-PCR. Among others, we found several genes related to the canonical Wnt/beta-catenin signaling pathway. Our results identify new possible host genes and molecules that could be involved in the mechanisms leading to the slower progression to AIDS and sustained CD4+ T cell counts that is peculiar to LTNP patients.
Assuntos
Resistência à Doença/genética , Infecções por HIV/genética , Infecções por HIV/imunologia , Sobreviventes de Longo Prazo ao HIV , Transcriptoma , Contagem de Linfócito CD4 , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD4-Positivos/virologia , Estudos de Casos e Controles , Progressão da Doença , Feminino , Infecções por HIV/virologia , HIV-1/imunologia , Humanos , Masculino , Análise em Microsséries , Carga ViralRESUMO
Atherosclerosis is a complex disease in which vessels develop plaques comprising dysfunctional endothelium, monocyte derived lipid laden foam cells and activated lymphocytes. Considering that humans and animal models of the disease develop quite distinct plaques, we used human plaques to search for proteins that could be used as markers of human atheromas. Phage display peptide libraries were probed to fresh human carotid plaques, and a bound phage homologous to plexin B1, a high affinity receptor for CD100, was identified. CD100 is a member of the semaphorin family expressed by most hematopoietic cells and particularly by activated T cells. CD100 expression was analyzed in human plaques and normal samples. CD100 mRNA and protein were analyzed in cultured monocytes, macrophages and foam cells. The effects of CD100 in oxLDL-induced foam cell formation and in CD36 mRNA abundance were evaluated. Human atherosclerotic plaques showed strong labeling of CD100/SEMA4D. CD100 expression was further demonstrated in peripheral blood monocytes and in in vitro differentiated macrophages and foam cells, with diminished CD100 transcript along the differentiation of these cells. Incubation of macrophages with CD100 led to a reduction in oxLDL-induced foam cell formation probably through a decrease of CD36 expression, suggesting for the first time an atheroprotective role for CD100 in the human disease. Given its differential expression in the numerous foam cells and macrophages of the plaques and its capacity to decrease oxLDL engulfment by macrophages we propose that CD100 may have a role in atherosclerotic plaque development, and may possibly be employed in targeted treatments of these atheromas.
Assuntos
Antígenos CD/metabolismo , Biomarcadores/metabolismo , Células Espumosas/metabolismo , Macrófagos/metabolismo , Placa Aterosclerótica/química , Semaforinas/metabolismo , Análise de Variância , Western Blotting , Antígenos CD36/metabolismo , Técnicas de Visualização da Superfície Celular , Células Cultivadas , Primers do DNA/genética , Imunofluorescência , Humanos , Imuno-Histoquímica , Proteínas do Tecido Nervoso/metabolismo , Placa Aterosclerótica/metabolismo , RNA Mensageiro/metabolismo , Receptores de Superfície Celular/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
OBJECTIVES: To develop a prediction model for hospital length of stay (LOS) in very low birth weight (VLBW) infants and to compare this outcome among 20 centers within a neonatal network. METHODS: Data from 7,599 infants with birth weights of 500-1,500 g born between the years 2001-2008 were prospectively collected. The Cox regression model was employed to develop two prediction models: an early model based upon variables present at birth, and a late one that adds relevant morbidities for the first 30 days of life. RESULTS: Median adjusted estimated LOS from birth was 59 days - 28 days after 30-day point of survival. There was a high correlation between models (r = 0.92). Expected/observed LOS varied widely among centers, even after correction for relevant morbidity after 30 days. Median observed LOS (range: 45-70 days), and postmenstrual age at discharge (range: 36.4-39.9 weeks) reflect high inter-center variability. CONCLUSION: A simple model, with factors present at birth, can predict a VLBW infant's LOS in a neonatal network. Significant variability in LOS was observed among neonatal intensive care units. We speculate that the results originate in differences in inter-center practices.
Assuntos
Hospitalização/estatística & dados numéricos , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Feminino , Humanos , Mortalidade Infantil , Recém-Nascido , Tempo de Internação/estatística & dados numéricos , Masculino , Alta do Paciente/estatística & dados numéricos , Estudos Prospectivos , Fatores de Risco , América do SulRESUMO
OBJETIVOS: Desenvolver um modelo de predição para o tempo de permanência hospitalar (TPH) em lactentes de muito baixo peso ao nascer (MBPN) e comparar esse resultado entre 20 centros de uma rede neonatal, visto que o TPH é utilizado como uma medida da qualidade da assistência em lactentes de MBPN. MÉTODOS: Utilizamos dados coletados prospectivamente de 7.599 lactentes com peso ao nascer entre 500 e 1.500 g no período entre os anos de 2001 a 2008. O modelo de regressão de Cox foi empregado para desenvolver dois modelos de predição: um modelo prévio com dados do nascimento e outro posterior, que acrescenta morbidades relevantes dos primeiros 30 dias de vida. RESULTADOS: A mediana do TPH estimado e ajustado a partir do nascimento foi de 59 dias; 28 dias depois do tempo de sobrevida de 30 dias. Houve uma alta correlação entre os modelos (r = 0,92). O TPH esperado e o TPH observado variaram bastante entre os centros, mesmo depois de correção para as morbidades relevantes após 30 dias. O TPH mediano (variação: 45-70 dias) e a idade concepcional na alta hospitalar (variação: 36,4-39,9 semanas) refletem uma variabilidade alta entre centros. CONCLUSÃO: Um modelo simples, com fatores apresentados no nascimento, pode predizer o TPH de um lactente de MBPN em uma rede neonatal. Observou-se uma variabilidade nos TPHs considerável entre unidades de terapia intensiva neonatal. Especulamos que os resultados sejam provenientes das diferenças entre as práticas dos centros.
OBJECTIVES: To develop a prediction model for hospital length of stay (LOS) in very low birth weight (VLBW) infants and to compare this outcome among 20 centers within a neonatal network. METHODS: Data from 7,599 infants with birth weights of 500-1,500 g born between the years 2001-2008 were prospectively collected. The Cox regression model was employed to develop two prediction models: an early model based upon variables present at birth, and a late one that adds relevant morbidities for the first 30 days of life. RESULTS: Median adjusted estimated LOS from birth was 59 days ‒ 28 days after 30-day point of survival. There was a high correlation between models (r = 0.92). Expected/observed LOS varied widely among centers, even after correction for relevant morbidity after 30 days. Median observed LOS (range: 45-70 days), and postmenstrual age at discharge (range: 36.4-39.9 weeks) reflect high inter-center variability. CONCLUSION: A simple model, with factors present at birth, can predict a VLBW infant's LOS in a neonatal network. Significant variability in LOS was observed among neonatal intensive care units. We speculate that the results originate in differences in inter-center practices.
Assuntos
Feminino , Humanos , Recém-Nascido , Masculino , Hospitalização/estatística & dados numéricos , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Mortalidade Infantil , Tempo de Internação/estatística & dados numéricos , Estudos Prospectivos , Alta do Paciente/estatística & dados numéricos , Fatores de Risco , América do SulRESUMO
INTRODUCCIÓN La tuberculosis (TB) infantil es un problema de salud pública en Argentina. Su estudio es importante para controlar aquellos grupos que se consideran vulnerables por el entorno familiar o comunitario. OBJETIVOS Describir características, magnitud, tendencia y tratamiento de la notificación de casos de TB en menores de 15 años, así como la tendencia de la mortalidad en Argentina durante el período 1990-2010. MÉTODOS Se realizó un estudio descriptivo retrospectivo, que analizó una serie cronológica de información secundaria de mortalidad y notificación de casos de TB durante el período 1990-2010. Quedaron excluidas las provincias con menos de 100.000 habitantes y los departamentos en los que no se notificó por lo menos un caso de TB anual. RESULTADOS En 1990-2010 se notificaron 40.102 casos de TB en menores de 15 años en Argentina (tasa de 18,8 por 100.000 habitantes). Se observaron diferencias entre las jurisdicciones, pero las diferencias por departamento fueron mayores. La tasa de mortalidad por TB pediátrica en Argentina se redujo en un 91,3% entre 1990 y 2010. Tanto el éxito como el abandono del tratamiento de los casos pediátricos registraron una tendencia estable. DISCUSIÓN La persistencia del problema se refleja en el número de casos anuales en menores de 15 años, que son producto de una infección primaria a partir de casos en el entorno familiar o comunitario. Las acciones de control disponible pueden contribuir a la prevención de la TB pediátrica.
Assuntos
Tuberculose , Epidemiologia , Sistema Nacional de Vigilância em SaúdeRESUMO
INTRODUCTION: For nearly the past two decades, cytokines (CKs) have been the only systemic treatment option available for advanced renal cell carcinoma (RCC). In recent years, tyrosine kinase inhibitors (TKIs) have demonstrated clinical activity on this tumour. Our purpose is to describe one centre's experience with the use of CKs and TKIs in the treatment of patients with advanced RCC. MATERIALS AND METHODS: This study was designed as a retrospective chart review of RCC patients who were treated with CKs and/or TKIs in our department between July 1996 and June 2008. Efficacy and toxicity were assessed using World Health Organization (WHO) criteria. The Kaplan-Meier method was used to estimate progression-free (PFS) and overall (OS) survival. RESULTS: Ninety-four patients were classified into three groups depending on the modality of treatment administered: 46 were treated with CKs alone and/or chemotherapy (27 with immunotherapy, one with chemotherapy and 18 with both), 28 with TKIs alone (25 with sunitinib and 13 with sorafenib) and 20 with TKIs in second-line treatment following failure with CKs (17 with sunitinib, eight with sorafenib, four with bevacizumab and one with lapatinib). The median age was 60 years in the CK group and 65 and 62, respectively, in TKI in first and second-line treatment groups. Eighty-five percent of patients treated with CKs and 75% in the TKI group in first-line treatment and 80% in second-line treatment were men. Overall, 89% of patients had favourable risk, and 11% had intermediate risk. All patients were considered evaluable for toxicity. The main grade 3-4 (%) toxicity was asthenia for both groups, (ten in TKIs and 15 in CKs). Other grade 1-2 toxicities were mucositis (39), bleeding (8), hypertension (19), skin toxicity (33) and hypothyroidism (12.5) associated with TKIs; and anaemia (33), cough (29), asthenia (39) and emesis (14) associated with CKs. The objective response rate among 80 patients evaluable for activity was 10.6% with CKs and 46.5% and 35%, respectively, with TKIs in first- and second-line treatments. Disease stabilisation with CKs was recorded at 59% of patients and with TKIs 25% and 50% in first- and second-line treatment groups, respectively. The median progression-free survival (PFS) with CKs was 122 days [95% confidence interval (CI) 82-162] and with TKIs 201 days (65-337) in the first and 346 days (256-436) in second-line treatment groups. The median overall survival (OS) was 229 days (142-316) and 2,074 days (1,152-2,996) for patients treated with CKs and TKIs. CONCLUSIONS: Our results are in line with the activity and survival rates previously reported in the literature regarding the use of TKIs for patients with advanced RCC in first- and second-line treatment, which has demonstrated an acceptable toxicity level.
Assuntos
Antineoplásicos/uso terapêutico , Carcinoma de Células Renais/tratamento farmacológico , Neoplasias Renais/tratamento farmacológico , Inibidores de Proteínas Quinases/uso terapêutico , Adulto , Idoso , Inibidores da Angiogênese/administração & dosagem , Inibidores da Angiogênese/efeitos adversos , Inibidores da Angiogênese/uso terapêutico , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Benzenossulfonatos/administração & dosagem , Benzenossulfonatos/efeitos adversos , Benzenossulfonatos/uso terapêutico , Bevacizumab , Carcinoma de Células Renais/mortalidade , Intervalo Livre de Doença , Quimioterapia Combinada/efeitos adversos , Feminino , Humanos , Fatores Imunológicos/administração & dosagem , Fatores Imunológicos/efeitos adversos , Fatores Imunológicos/uso terapêutico , Indóis/administração & dosagem , Indóis/efeitos adversos , Indóis/uso terapêutico , Interferon-alfa/administração & dosagem , Interferon-alfa/efeitos adversos , Interferon-alfa/uso terapêutico , Interleucina-2/administração & dosagem , Interleucina-2/efeitos adversos , Interleucina-2/uso terapêutico , Estimativa de Kaplan-Meier , Neoplasias Renais/mortalidade , Lapatinib , Masculino , Pessoa de Meia-Idade , Niacinamida/análogos & derivados , Compostos de Fenilureia , Inibidores de Proteínas Quinases/administração & dosagem , Piridinas/administração & dosagem , Piridinas/efeitos adversos , Piridinas/uso terapêutico , Pirróis/administração & dosagem , Pirróis/efeitos adversos , Pirróis/uso terapêutico , Quinazolinas/administração & dosagem , Quinazolinas/efeitos adversos , Quinazolinas/uso terapêutico , Estudos RetrospectivosRESUMO
A aterosclerose é uma doença degenerativa crônica dos vasos, com conseqüências clínicas agudas que incluem o infarto do miocárdio e o acidente vascular cerebral, resultantes geralmente da ruptura da placa e trombose. É atualmente reconhecida como de característica inflamatória, iniciada e propagada no contexto da hipercolesterolemia. Um trabalho de nosso grupo utilizou técnicas de phage display para comparar placas ateroscleróticas e carótidas normais objetivando a busca de proteínas alteradas potencialmente envolvidas na patogênese da doença. Diversas semaforinas e plexinas (receptores de semaforinas) foram identificadas dentre elas a plexina B1, que possui alta afinidade por CD100, sugerindo assim uma concentração aumentada de CD100 na placa aterosclerótica. CD100 foi a primeira semaforina descrita no sistema imune e a única até hoje descrita como possuidora de duas formas de funcionalidades distintas, sendo uma de membrana (mCD100) e outra solúvel (sCD100). Neste trabalho demonstramos a expressão da semaforina CD100 em macrófagos e células espumosas em placas ateroscleróticas humanas, assim como seu padrão de expressão ao longo da diferenciação monócito-macrófago-célula espumosa, e sob estímulos distintos. Além disso, identificamos pela primeira vez o receptor que medeia suas atividades nessas células, a plexina B2. Adicionalmente, detectamos também pela primeira vez detectamos a expressão de CD100 em células endoteliais teciduais e cultivadas in vitro, o que sugere um papel significativo da semaforina em fenômenos vasculares. Com base nessas observações e nos resultados de experimentos de bloqueio de adesão constatamos que CD100 pode atuar na fase mais precoce da aterosclerose, como uma molécula de adesão envolvida na ligação entre monócitos e células endoteliais. Verificamos ainda que CD100 diminui a captação de LDLox em macrófagos e células espumosas. Poucos estudos relatam a presença ou possível atividade biológica de CD100 tanto na aterosclerose...
Atherosclerosis is a chronic degenerative disease affecting vessels, with acute clinical consequences that include myocardium infarction or stroke, generally resulting from plaque rupture and thrombosis. It is now recognized as an inflammatory disease, initiated and developed in a hipercholesterolemic context. A work in our lab has used phage display techniques to compare atherosclerotic plaques and normal carotids, searching for altered proteins potentially involved in the pathogenesis of the disease. Many semaphorins and plexins (semaphorin receptors) have been identified, among which plexin B1, a high affinity receptor for CD100, suggesting an augmented level of CD100 in the atherosclerotic plaques. CD100 is the first semaphorin described in the immune system, and the only to possess two forms with distinct functionalities, being one associated to the membrane, mCD100, and another soluble form, sCD100. In the present work we have demonstrated CD100 expression in macrophages and foam cells of human atherosclerotic plaques, as well as its pattern of expression along monocyte-macrophage-foam cell differentiation and under distinct stimuli. Furthermore, we have identified for the first time the receptor involved in CD100 activities in these cells, namely plexin B2. Aditionally, we have detected CD100 expression in tissue as well as in in vitro cultured endothelial cells, also for the first time. According to these informations and adhesion blockage experiments we have shown that CD100 may act in the earliest phase of the establishment of atherosclerosis, as an adhesion molecule involved in monocyte-endothelial cell association. We have also verified that CD100 diminishes the intake of oxLDL in macrophages and foam cells. Only a few studies describe the presence or possible biological activity of CD100 in atherosclerosis or macrophages. Since the molecule has been shown to participate in the immune system, we believe that the differential expression of...
Assuntos
Humanos , Aterosclerose , Moléculas de Adesão Celular , Células EspumosasRESUMO
The ultrastructure of normal, ejaculated spermatozoa of Bos indicus was studied by means of electron microscopy, being evaluated in two principal parts, the head and the tail. The head is flat, oval or paddle-shaped with a square base, which provides a concave recess for the insertion of the tail. The acrosome tightly covers the anterior two thirds of the nucleus. A distinct unilateral acrosomal bulge was observed along the apical edge of the head. The equatorial region demarcates the acrosome from the post-equatorial region that covers the caudal one third of the nucleus. The classical 9+9+2 fiber pattern which composes the axoneme was observed along three segments of the tail, namely middle, principal and terminal pieces. The axoneme is anteriorly bound by the mitochondrial helix (middle piece) and posteriorly by the fibrous helix (principal piece), except at the terminal piece. The border between the middle piece and principal piece was well defined due to the termination of the thick mitochondrial helix and the presence of the annulus. Some of the spermatozoa presented cytoplasmatic droplets, which appeared as stalk-like appendages.