RESUMO
BACKGROUND: Conflict and violence can impact on the mental health of children and young people, who are in a crucial stage of their personal growth. Not much is known about the provision of mental health care to young people in conflict-affected areas. Community-based care can be essential, as state-led services are often scarce in conflict contexts, like Colombia's Pacific region where this research was conducted. According to the WHO, such care is ideally provided in the form of a network of interconnected services, offered by different actors beyond the formal health sector. This article describes the relationship between the formal and community mental health systems in Colombia's Pacific region, and identifies ways of improving their interaction. METHODS: Qualitative data were collected through 98 semi-structured interviews with community organisations, schools, international organisations and state institutions. These interviews aimed to identify the strategies used to promote young people's mental health and the interactions between the different providers. Boundary spanning theory was used to analyse how different actors and forms of mental health care provision could coordinate better. RESULTS: Community organisations and schools use a wide array of strategies to attend to the mental health of children and young people, often of a collective and psychosocial nature. State institutions offer more clinically focused strategies, which are however limited in terms of accessibility and continuity. International organisations aim to strengthen state capacity, but often struggle due to high staff turnover. Although mental health care pathways exist, their effectiveness is limited due to ineffective coordination between actors. CONCLUSIONS: To make sure that the variety of strategies to improve young people's mental health effectively reach their beneficiaries, better coordination is needed between the different actors. Mental health care pathways should therefore integrate community organisations, while community connectors can help to manage the coordination between different actors and forms of clinical and psychosocial support.
RESUMO
Carbapenem-resistant Gram-negative bacilli (CR-GNB) are a major public health concern. We aimed to evaluate the prevalence of CR-GNB and the frequency of carbapenemase-encoding genes in a tertiary referral center from El Bajio, Mexico. A cross-sectional study was conducted between January and October 2022; Gram-negative bacilli (GNB) were screened for in vitro resistance to at least one carbapenem. CR-GNB were further analyzed for carbapenemase-production through phenotypical methods and by real-time PCR for the following genes: blaKPC, blaGES, blaNDM, blaVIM, blaIMP, and blaOXA-48. In total, 37 out of 508 GNB were carbapenem-resistant (7.3%, 95% CI 5.2-9.9). Non-fermenters had higher rates of carbapenem resistance than Enterobacterales (32.5% vs. 2.6%; OR 18.3, 95% CI 8.5-39, p < 0.0001), and Enterobacter cloacae showed higher carbapenem resistance than other Enterobacterales (27% vs. 1.4%; OR 25.9, 95% CI 6.9-95, p < 0.0001). Only 15 (40.5%) CR-GNB had a carbapenemase-encoding gene; Enterobacterales were more likely to have a carbapenemase-encoding gene than non-fermenters (63.6% vs. 30.8%, p = 0.08); blaNDM-1 and blaNDM-5 were the main genes found in Enterobacterales; and blaIMP-75 was the most common for Pseudomonas aeruginosa. The mcr-2 gene was harbored in one polymyxin-resistant E. cloacae. In our setting, NDM was the most common carbapenemase; however, less than half of the CR-GNB showed a carbapenemase-encoding gene.
RESUMO
Resumen: Se presenta un caso de una mujer de 28 años, primera gesta, embarazo normoevolutivo, quien acudió a atención de parto, se realizó cesárea por falta de progresión. Durante el perioperatorio desarrolló atonía uterina y sangrado (2,000 mL), por lo que se le realizó histerectomía subtotal abdominal, embolización selectiva de vasos pélvicos, transfusión masiva y empaquetamiento pélvico. Evolucionó con vasoplejía y perfil hemodinámico compatible con choque cardiogénico, ecocardiograma transtorácico con disfunción sistólica severa, fracción de eyección de ventrículo izquierdo (FEVI) 18%, contractilidad normal en los tercios basales de la pared lateral. El resto de los segmentos con hipocinesia severa, NT-pro BNP 9,226 pg/mL, troponina de alta sensibilidad 490 pg/mL, electrocardiograma con taquicardia sinusal sin datos de lesión. Se estableció el diagnóstico de Takotsubo (miocardiopatía por estrés). Se colocó membrana de oxigenación extracorpórea (ECMO) V-A y balón de contrapulsación intraaórtica. Desarrolló lesión renal aguda y sobrecarga hídrica, por lo que se inició terapia de sustitución renal. La terapia ECMO se mantuvo durante nueve días, y se egresó a domicilio a los 18 días. El ECMO es una estrategia terapéutica para el soporte hemodinámico del choque cardiogénico incluyendo la cardiomiopatía por estrés; este caso ilustra su utilidad en el puerperio.
Abstract: We present a case of a 28-year-old woman currently in her first pregnancy, normal evolution, who attended delivery care, a cesarean section was performed due to lack of progression. During the perioperative period, she developed uterine atony and bleeding of 2,000 mL, for which she underwent a subtotal abdominal hysterectomy, selective embolization of the pelvic vessels, massive transfusion, and pelvic packing. She evolved with vasoplegia and hemodynamic profile compatible with cardiogenic shock, transthoracic echocardiogram exposes severe systolic dysfunction, LVEF 18%, normal contractility in the basal thirds of the lateral wall, the rest of the segments with severe hypokinesia, NT-pro BNP 9,226 pg/mL, high-sensitivity troponin 490 pg/mL, electrocardiogram whit sinus tachycardia with no evidence of injury, the diagnosis of Takotsubo (stress cardiomyopathy) was established. Extracorporeal membrane oxygenation (ECMO) V-A and intra-aortic balloon counterpulsation were placed. Acute kidney injury developed, and fluid overload, for which renal replacement therapy was started. ECMO therapy was maintained for nine days, and she was discharged home after 18 days. ECMO is an innovative therapeutic strategy for hemodynamic support of cardiogenic shock, including stress cardiomyopathy, and this case illustrates its potential utility in the postpartum period.
Resumo: Apresenta-se o caso de uma mulher de 28 anos, primigesta, gravidez evolução normal, que assistiu ao parto, tendo sido submetida a cesariana por falta de evolução. No período perioperatório, apresentou atonia uterina e sangramento (2,000 mL), sendo submetida a histerectomia abdominal subtotal, embolização seletiva de vasos pélvicos, transfusão maciça e tamponamento pélvico. Evoluiu com vasoplegia e quadro hemodinâmico compatível com choque cardiogênico, ecocardiograma transtorácico com disfunção sistólica grave, FEVE 18%, contratilidade normal nos terços basais da parede lateral, restante dos segmentos com hipocinesia grave, NT-pro BNP 9,226 pg/mL, troponina de alta sensibilidade 490 pg/mL, eletrocardiograma com taquicardia sinusal sem evidência de lesão, foi estabelecido o diagnóstico de Takotsubo (cardiomiopatia de estresse). Colocou-se uma oxigenação por membrana extracorpórea (ECMO) V-A e um balão de contrapulsação intra-aórtico. Evoluiu com lesão renal aguda e sobrecarga hídrica, sendo iniciada terapia renal substitutiva. A terapia com ECMO foi mantida por 9 dias e ele recebeu alta após 18 dias. A ECMO é uma estratégia terapêutica para suporte hemodinâmico do choque cardiogênico, incluindo a cardiomiopatia de estresse, e este caso ilustra sua utilidade no puerpério.
RESUMO
Resumen: La optimización del esfuerzo espontáneo en la ventilación mecánica tiene un lugar central en la Unidad de Cuidados Intensivos; aporta beneficios a los pacientes como la mejoría en el intercambio de gases, ayuda a recuperar la función del diafragma y el mantenimiento de los músculos periféricos. Por otro lado, también puede estar asociado al deterioro de la oxigenación y la lesión pulmonar. El incremento del impulso respiratorio neural aumenta el esfuerzo muscular inspiratorio, lo que condiciona presiones de distensión pulmonar lesivas, que en el contexto del síndrome de insuficiencia respiratoria aguda es de vital relevancia, ya que puede provocar el colapso y la sobredistensión regional alveolar de forma cíclica, con distribución heterogénea del estrés y tensión pulmonar. Existen tres mecanismos de lesión pulmonar por esfuerzo espontáneo: sobredistensión, aumento de la perfusión pulmonar y asincronía paciente-ventilador. La lesión pulmonar causa fuga capilar, edema pulmonar y alteración del intercambio de gases. Esto conduce a un aumento del impulso respiratorio y mayores volúmenes corrientes de las propias respiraciones espontáneas del paciente, que provocan fuga capilar y mayor daño pulmonar de forma similar a la lesión pulmonar inducida por ventilador.
Abstract: The optimization of spontaneous effort in mechanical ventilation has a central place in the intensive care unit; provides benefits to patients such as improved gas exchange, helps to regain function of the diaphragm and maintenance of peripheral muscles. On the other hand, it can also be associated with impaired oxygenation and lung injury. The increase in the neural respiratory drive increases the inspiratory muscular effort, conditioning damaging pulmonary distension pressures, which in the context of acute respiratory distress syndrome is of vital importance, since it can cause collapse and regional alveolar overdistention in a cyclical way. with heterogeneous distribution of pulmonary stress and strain. There are three mechanisms of lung injury due to spontaneous effort: overdistention, increased pulmonary perfusion, and patient-ventilator asynchrony. Lung injury causes capillary leakage, pulmonary edema, and impaired gas exchange. This leads to increased respiratory drive and higher tidal volumes of the patient's own spontaneous breaths, causing capillary leakage and increased lung damage like ventilator-induced lung injury.
Resumo: A otimização do esforço espontâneo na ventilação mecânica tem lugar central na unidade de terapia intensiva; Proporciona benefícios aos pacientes como melhora nas trocas gasosas, auxilia na recuperação da função do diafragma e na manutenção da musculatura periférica. Por outro lado, também pode estar associada ao deterioro da oxigenação e lesão pulmonar. O incremento do impulso respiratório neural aumenta o esforço muscular inspiratório, condicionando pressões de distensão pulmonar prejudiciais, o que no contexto da síndrome de insuficiência respiratória aguda é de vital relevância, pois pode causar colapso e hiperdistensão alveolar regional de forma cíclica, com distribuição heterogênea do estresse e tensão pulmonar. Existem três mecanismos de lesão pulmonar espontânea por esforço: hiperdistensão, aumento da perfusão pulmonar e assincronia paciente-ventilador. A lesão pulmonar causa vazamento capilar, edema pulmonar e troca gasosa prejudicada. Isso leva ao aumento do impulso respiratório e aos volumes correntes mais altos das próprias respirações espontâneas do paciente, causando vazamento capilar e danos pulmonares adicionais semelhantes aos danos pulmonares induzidos pelo ventilador.
RESUMO
Poly(amide-triazole) and poly(ester-triazole) synthesized from d-galactose as a renewable resource were applied for the synthesis of nanoparticles (NPs) by the emulsification/solvent evaporation method. The NPs were characterized as stable, spherical particles, and none of their components, including the stabilizer poly(vinyl alcohol), were cytotoxic for normal rat kidney cells. These NPs proved to be useful for the efficient encapsulation of cilostazol (CLZ), an antiplatelet and vasodilator drug currently used for the treatment of intermittent claudication, which is associated with undesired side-effects. In this context, the nanoencapsulation of CLZ was expected to improve its therapeutic administration. The carbohydrate-derived polymeric NPs were designed taking into account that the triazole rings of the polymer backbone could have attractive interactions with the tetrazole ring of CLZ. The activity of the nanoencapsulated CLZ was measured using a matrix metalloproteinase model in a lipopolysaccharide-induced inflammation system. Interestingly, the encapsulated drug exhibited enhanced anti-inflammatory activity in comparison with the free drug. The results are very promising since the stable, noncytotoxic NP systems efficiently reduced the inflammation response at low CLZ doses. In summary, the NPs were obtained through an innovative methodology that combines a carbohydrate-derived synthetic polymer, designed to interact with the drug, ease of preparation, adequate biological performance, and environmentally friendly production.
RESUMO
Resumen: Introducción: el retraso en el inicio de la nutrición enteral (NE), a diferencia de la NE precoz, está asociado a resultados adversos en los pacientes críticos. Objetivos: correlacionar el tiempo de inicio de la nutrición con la mortalidad, días de ventilación mecánica, estancia en la unidad de cuidados intensivos (UCI) y estancia hospitalaria. Material y métodos: se realizó un estudio tipo cohorte, retrospectivo, comparativo de los pacientes hospitalizados durante un periodo de enero a julio de 2022 en la Unidad de Cuidados Intensivos del Hospital Centro Médico ABC Campus Observatorio. Se incluyeron todos los pacientes ingresados que recibieron nutrición enteral. Resultados: de 242 pacientes, 62.8% son masculinos, con una mediana de edad de 65 (62.8-67.7) años, de los cuales 22% de la población requirió ventilación mecánica, encontrando una mortalidad global de 6.3%. Se observó diferencia significativa con p = 0.001, con un OR 0.210 (0.087-0.509) en la mortalidad de los pacientes con nutrición temprana 5.5 versus 13.2% nutrición tardía, sin diferencia en días de ventilación, estancia en la unidad de cuidados intensivos adultos (UCIA) ni hospitalización. Conclusiones: el retraso en la NE se asoció significativamente con menos días libres de UCI, estancia más prolongada en la UCI, hospitalizaciones más largas y mortalidad en comparación con la NE temprana.
Abstract: Introduction: the delay in the start of enteral nutrition (EN) or late EN, unlike early EN, is associated with adverse outcomes in critically ill patients. Objectives: to correlate the start time of nutrition with mortality, days of mechanical ventilation, Intensive Care Unit (ICU) and hospital length of stay. Material and methods: a retrospective, comparative, cohort study of hospitalized patients during the period from January to July 2022 in the ICU of the ABC Medical Center Observatory Campus was carried out. All hospitalized patients who received enteral nutrition were included. Results: of 242 patients, 62.8% were male, with a median age of 65 (62.8-67.7) years, 22% of the population required mechanical ventilation, finding an overall mortality of 6.3%. A significant difference was found with p = 0.001, with an OR 0.210 (0.087-0.509) in the mortality of patients with early nutrition 5.5 vs 13.2% late nutrition, without difference in days of mechanical ventilation, ICU or hospitalization length of stay. Conclusions: delayed EN was significantly associated with less ICU-free days, longer intrahospital length of stay and mortality, compared with early EN.
Resumo: Introdução: o atraso no início da nutrição enteral (NE) ou NE tardia, ao contrário da NE precoce, está associado a desfechos adversos em pacientes críticos. Objetivos: correlacionar o tempo de início da nutrição com mortalidade, dias de ventilação mecânica, internação na UTI e internação. Material e métodos: realizou-se um estudo de coorte, retrospectivo e comparativo de pacientes internados no período de janeiro a julho de 2022 na UTI do Hospital Centro Médico ABC Campus Observatorio. Todos os pacientes admitidos que receberam nutrição enteral foram incluídos. Resultados: dos 242 pacientes, 62.8% são do sexo masculino, com idade média de 65 (62.8-67.7) anos, dos quais 22% da população necessitou de ventilação mecânica, encontrando-se uma mortalidade geral de 6.3%. Uma diferença significativa foi encontrada com p = 0.001, com OR 0.210 (0.087-0.509) na mortalidade de pacientes com nutrição precoce 5.5 vs 13.2% nutrição tardia, sem diferença em dias de ventilação, permanência na UTI ou hospitalização. Conclusões: o atraso da NE foi significativamente associada a menos dias livres de UTI, estadias mais longas na UTI, internações mais longas e mortalidade, em comparação com NE precoce.
RESUMO
Given the non-linearity of many protein properties with a short range of concentration which cannot be predicted a priori, and due to the lack of references in the food industry, we proceeded to analyze the foaming ones. The existing bibliography belongs to other fields of research but it is scarcely found for this area. For the food industry, ultrasound is considered one of the most environment-friendly processing. In addition, heating combination would alter their results considerably by synergistic or additive phenomena. Native soy protein isolate was obtained in our laboratory to use it as starting material; ultrasound with temperature was applied at 2, 4 and 6%w/w protein concentrations. Therefore, the objective of this paper was to determine the effect of ultrasound+temperature (50 or 90 °C) simultaneously applied, on the foamability by relating with the relative viscoelasticity, aggregates particle size distribution and their surface charge by zeta potential. The results indicated that treatments promoted changes on the functional parameters depending on the protein concentration. The analysis showed that at 4%wt/wt was adequate to improve foam formation and stability at same time. Dynamic rheology of continuous phase was relation with foamability showing the higher relative viscoelasticity at 4% of concentration after the combined treatment. Light scattering studies could partially explain this observation, taking into account both, the bulk viscosity and the low number of large particles formed after treating. Surface charge was increased for all concentrations equally leading to the aggregates formation of greater colloidal stability for all concentration and treatment conditions investigated. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at (10.1007/s13197-020-04954-w).
RESUMO
Activation of T cells triggers the expression of regulatory molecules like the programmed cell death 1 (PD1) protein. The association of PD1 with the natural ligands PDL1 and PDL2 induces an inhibitory signal that prevents T cells from proliferating and exerting effector functions. However, little is known about how the binding of the ligands induce the PD1 inhibitory signal over T cells effector functions. Here, we explore the dynamics of PD1 free, and in complex with different PDL1 variants as well as the therapeutic antibodies nivolumab and pembrolizumab in order to assess the conformational changes in PD1 related to the signaling process. Our simulations suggest a pre-conformational selection mechanism for the binding of the different PDL1 variants, while an induced-fit model fits better for the molecular recognition process of the therapeutic antibodies. A deep analysis of the changes on PD1 movement upon the binding to different ligands revealed that as larger is the difference in the conformation adopted by loop C'D with respect to the complex with PDL1 is higher the ligand ability to reduce the PD1 inhibitory signaling. This behavior suggests that targeting specific conformations of this loop can be useful for designing therapies able to recover T cells effector functions.
Assuntos
Anticorpos Monoclonais Humanizados/química , Antígeno B7-H1/química , Nivolumabe/química , Receptor de Morte Celular Programada 1/química , Anticorpos Monoclonais Humanizados/imunologia , Anticorpos Monoclonais Humanizados/metabolismo , Antineoplásicos Imunológicos , Antígeno B7-H1/genética , Antígeno B7-H1/imunologia , Sítios de Ligação , Expressão Gênica , Humanos , Ligantes , Simulação de Dinâmica Molecular , Nivolumabe/imunologia , Nivolumabe/metabolismo , Análise de Componente Principal , Receptor de Morte Celular Programada 1/genética , Receptor de Morte Celular Programada 1/imunologia , Ligação Proteica , Domínios e Motivos de Interação entre Proteínas , Estrutura Secundária de Proteína , Transdução de SinaisRESUMO
Hydrogels obtained by acidification with glucono-δ-lactone (GDL), starting from nanoemulsions formulated with different concentrations of sodium caseinate (1-4 wt%) or 4 wt% sodium caseinate and sucrose (2-8 wt%), were prepared with the aim of quantifying structural parameters of both, initial nanoemulsions and hydrogels after 2.5 h of GDL addition, using the Guinier-Porod (GP) or the generalized GP models. Gelation process was followed by performing in situ temperature-controlled X-ray small angle scattering experiments (SAXS) using synchrotron radiation. In nanoemulsions, the calculated radius of gyration for oil nanodroplets (Rg oil ) decreased with increasing protein concentration and for the 4 wt% protein nanoemulsion, with increasing sucrose content. Calculated values of Rg oil were validated correlating them with experimental Z-average values as measured by dynamic light scattering (DLS). For hydrogels, radii of gyration for the sphere equivalent to the hydrogel scattering object (R gsph ) were close to 3 nm while correlation distances among building blocks (R g2 ) were dependent on formulation. They increased with increasing contents of sodium caseinate and sucrose. R g2 parameter linearly correlated with hydrogel strength (G' ∞ ): a more connected nanostructure led to a stronger hydrogel.
RESUMO
We present a female patient, 13 years old, with diagnosis of hepatocellular carcinoma of fibrolamellar type, which was rapidly evolving. The fibrolamellar hepatocellular carcinoma invaded more than 80% of the hepatic parenchyma without surgical possibility or liver transplantation. Measures applied corresponded to chemotherapy of 1 cycle of cisplatin 40 mg/s/5 days + vincristine 1.5 mg/m2/day, 5-fluorouracil, doxorubicin, and dexrazoxane. The case presented aggressive evolution of hepatocellular carcinoma, which led to acute liver failure, with hyperammonemia, sepsis, pulmonary focus plus septic shock, grade III-IV encephalopathy, portal hypertension, and ascites with intra-abdominal hypertension. Death occurred due to multiple organ failure, which involved respiratory failure type KDIGO 1 and 2, acute liver failure, severe pneumonia, pericardial effusion, AKIN 2 acute kidney injury, carcinoma, and pulmonary metastasis. This type of ailment is infrequent in children and adolescents, and the first symptoms are crucial to achieve treatment possibilities.
RESUMO
BACKGROUND: Gamma-Decanolactone (GD) is a monoterpene compound that presents anticonvulsant effect in acute and chronic models of epilepsy and it acts as a noncompetitive glutamate antagonist. OBJECTIVE: This study evaluated the anticonvulsant profile and the possible mechanism of action of GD in seizures induced by isoniazid (INH; 250 mg/kg), picrotoxin (PCT; 5 mg/kg) and 4- aminopyridine (4-AP; 13 mg/kg) in male mice. METHOD: Thirty minutes before the convulsants administration, animals received a single administration of saline, GD (100 or 300 mg/kg) or the positive control diazepam (DZP; 2 mg/kg). The parameters evaluated were the latency to the first seizure and the occurrence of clonic forelimb seizures. The rotarod performance test was used to evaluate the neurotoxicity of GD (300 mg/kg). Also, the DZPinduced sleep test was used. RESULTS: DZP increased the latency to the first seizure on all used models and decreased the percentage of seizures in two of the three behavioral models. GD was able to prolong the latency to the first seizure and decreased the percentage of seizures induced by INH and 4-AP, but not by PCT. It reduced the latency to fall off the rotarod test only at the time of 30 min. In the DZP-induced sleep test, GD shortened the onset and prolonged the time of sleep. CONCLUSION: Our findings suggested that GD reduced the convulsive behavior in the seizure models used here and it could modulate GABA pathways and affect potassium channels directly or indirectly, involving more than one cellular target in the central nervous system.
RESUMO
Electrochemical treatment has been suggested as an effective alternative to local cancer therapy. Nevertheless, its effectiveness decreases when highly aggressive primary tumors are treated. The aim of this research was to understand the growth kinetics of the highly aggressive and metastatic primary F3II tumor growing in male and female BALB/c/Cenp mice under electrochemical treatment. Different amounts of electric charge (6, 9, and 18 C) were used. Two electrodes were inserted into the base, perpendicular to the tumor's long axis, keeping about 1 cm distance between them. Results have shown that the F3II tumor is highly sensitive to direct current. The overall effectiveness (complete response + partial response) of this physical agent was ≥75.0% and observed in 59.3% (16/27) of treated F3II tumors. Complete remission of treated tumors was observed in 22.2% (6/27). An unexpected result was the death of 11 direct current-treated animals (eight females and three males). It is concluded that direct current may be addressed to significantly affect highly aggressive and metastatic primary tumor growth kinetics, including the tumor complete response. Bioelectromagnetics. 39:460-475, 2018. © 2018 Wiley Periodicals, Inc.
Assuntos
Neoplasias da Mama/terapia , Carcinoma/terapia , Terapia por Estimulação Elétrica , Animais , Linhagem Celular Tumoral , Terapia por Estimulação Elétrica/efeitos adversos , Terapia por Estimulação Elétrica/métodos , Feminino , Masculino , Camundongos Endogâmicos BALB C , Transplante de Neoplasias , Distribuição Aleatória , Análise de Sobrevida , Carga TumoralRESUMO
Gastric ulcers are a worldwide health problem and their poor healing is one of the most important causes for their recurrence. We have previously reported the remarkable gastroprotective and anti-Helicobacter pylori activities of the methanolic extract (CpMet) of Cyrtocarpa procera bark. This work investigates, in a murine model, the CpMet gastroprotective mechanism and establishes its preclinical efficacy in the resolution of ethanol-induced gastric ulcers. The results showed that the gastroprotective activity of CpMet is mainly associated with endogenous NO and prostaglandins, followed by sulfhydryl groups and KATP channels. Furthermore, CpMet (300 mg/kg, twice a day) orally administered during 20 consecutive days promoted an ulcer area reduction of 62.65% at the 20th day of the treatment. The effect was confirmed macroscopically by the alleviation of gastric mucosal erosions and microscopically by an increase in mucin content and a reduction in the inflammatory infiltration at the site of the ulcer. No clinical symptoms or signs of toxicity were observed in the treated animals. The results indicate the safety and efficacy of CpMet in promoting high quality of ulcer healing by different mechanisms, but mostly through cytoprotective and anti-inflammatory effects, making it a promising phytodrug for ulcer treatment.
RESUMO
Resumen Desde hace décadas, el ritmo de la vida moderna ha generado múltiples cambios en nuestra conducta y hábitos. Especialmente, los hábitos alimenticios y de ejercicio se han modificado de manera importante, pero uno de los cambios más evidentes ha ocurrido en el sueño. En la actualidad, el tiempo dedicado a este ha disminuido drásticamente, pero no solo se trata de la cantidad, sino también de la calidad del sueño que se ha visto afectada de forma relevante en todos los grupos de edad, en especial en la población joven. Desde hace algunos años se sabe que el sueño juega un papel muy importante para el óptimo funcionamiento físico y mental del ser humano, pero solo recientemente hemos comenzado a conocer y entender las consecuencias que una mala calidad del sueño puede tener sobre la salud a mediano y largo plazo. En esta revisión se incluyen los trastornos del sueño más comunes o representativos, los estudios que se utilizan para su diagnóstico y, finalmente, se da un panorama general sobre las consecuencias de estos trastornos en la salud a largo plazo.
Abstract For decades, the rhythm of modern life has generated multiple changes in our behavior and habits. Especially, the way we eat and our exercise habits have changed significantly but one of the most evident effects is regarding sleep behavior. Nowadays, sleep has decreased dramatically, but not only in quantity. The quality of sleep has been affected in a significant way on all age groups, especially in the young population. For several years, we've known that sleep plays an essential role for an optimal physical and mental performance in the human being. Only recently we've begun to discover and understand the consequences that sleep disturbances can have on health in the long term. In the present article we include a general review of the most common or representative sleep disorders, the studies used for their diagnosis and finally we made an overview of the consequences of these disorders on health.
RESUMO
Isolated 7S and 11S globulins obtained from defeated soy flour were complexated with folic acid (FA) in order to generate nano-carriers for this important vitamin in human nutrition. Fluorescence spectroscopy and dynamic light scattering were applied to follow the nano-complexes formation and for their characterization. Fluorescence experimental data were modeled by the Stern-Volmer and a modified double logarithm approach. The results obtained confirmed static quenching. The number of binding sites on the protein molecule was ~1. The values obtained for the binding constants suggest a high affinity between proteins and FA. Particle size distribution allowed to study the protein aggregation phenomenon induced by FA bound to the native proteins. Z-average manifested a clear trend to protein aggregation. 11S-FA nano-complexes resulted in more polydispersity. ζ-potential of FA nano-complexes did not show a remarkable change after FA complexation. The biological activity of nano-complexes loaded with FA was explored in terms of their capacity to enhance the biomass formation of Lactobacillus casei BL23. The results concerning to nano-complexes inclusion in culture media showed higher bacterial growth. Such a result was attributed to the entry of the acid by the specific receptors concomitantly by the peptide receptors. These findings have technological impact for the use of globulins-FA based nano-complexes in nutraceutical, pharmaceutical and food industries.
RESUMO
AIM: To describe the demographic characteristics, ocular comorbidities, and clinical outcomes of patients with neovascular glaucoma (NVG) and to determine the number of patients who returned for a follow-up eye examination. MATERIALS AND METHODS: We examined the clinical data of patients with NVG, who attended a glaucoma clinic between July 2010 and November 2014. We collected information on the demographic characteristics of the patients to include the level of education, ocular comorbidities, NVG stage, visual acuity, glaucoma medications, intraocular pressure (IOP), and the number of patients who had a follow-up ocular examination at month 1, 3, 6, and 12. RESULTS: Data from 350 patients (473 eyes) with NVG were collected. We found 91% of the cohort had proliferative diabetic retinopathy (PDR). We found blindness in both or one eye in 14% and 31% of the cohort respectively. Low vision was found in both or one eye in 14% and 32% of the eyes respectively. By 6 months follow-up, only 32% of the patients were seen at our clinic and by 12 months follow-up, this number decreased to 15%. Around 60% of the patients were on no IOP lowering drugs at the first visit. We found 53% of the cohort had an incomplete elementary school education. CONCLUSION: The results suggest that advanced NVG is a significant ocular problem for patients referred to our clinic with just over half of the patients presenting as blind. We also found that several socioeconomic factors that had an important role in the development of PDR and NVG, specifically, educational status. CLINICAL SIGNIFICANCE: We described the characteristics of a large cohort of patients with very advanced NVG, reflecting the fact that the strict control of the underlying disease must be the main goal of the Mexican national health system. HOW TO CITE THIS ARTICLE: Lazcano-Gomez G, Soohoo JR, Lynch A, Bonell LN, Martinez K, Turati M, González-Salinas R, Jimenez-Roman J, Kahook MY. Neovascular Glaucoma: A Retrospective Review from a Tertiary Eye Care Center in Mexico. J Curr Glaucoma Pract 2017;11(2):48-51.
RESUMO
Resumen La exploración neurológica (EN) es la herramienta clínica más importante con que se cuenta en medicina para la detección y diagnóstico de las enfermedades del sistema nervioso. Como en muchas áreas de la medicina, la integración de los datos clínicos obtenidos mediante la EN con los conocimientos neuroanatómicos y neurofisiológicos resulta de vital importancia para la correcta interpretación de la EN. Para el estudiante de medicina, con frecuencia la EN, y en general las materias relacionadas con las neurociencias, son conceptualizadas como muy extensas, difíciles y áridas, por lo que resulta importante realizar de manera sencilla la enseñanza de las distintas disciplinas neurocientíficas al estudiante de medicina y al médico en general. En este sentido, el objetivo del presente artículo es proponer un esquema para la realización de una exploración neurológica básica (ENB) que le permita al médico de primer contacto identificar eficazmente posibles alteraciones neurológicas (sobre todo las más frecuentes o graves), para así poder brindar un tratamiento inicial adecuado o establecer criterios de referencia oportuna a otro nivel de atención.
Abstract The neurological examination (NE) is the most important clinical tool in medicine for the detection and diagnosis of nervous system diseases. In several medical areas, the integration of clinical data with neuroanatomical and neurophysiological knowledge is of vital importance for the correct utilization and interpretation of NE. Frequently for the medical students, the NE and other subjects related to neuroscience are conceptualized as lengthy, difficult and boring; so it is important to teach these subjects to the medical students and general practitioners in a simple and comprehensive manner. Hence, the main objective of this paper is to propose a scheme for performing a basic neurological examination (BNE) that will allow the primary care physician to readily identify possible neurological disorders (especially the most frequent or severe), in order to provide adequate initial treatment or establish opportune reference criteria to another level of medical assistance.
RESUMO
Interleukin-2 (IL2) is a growth factor for several immune cells and its function depends on its binding to IL2Rs in the cell membrane. The most accepted model for the assembling of IL2-IL2R complexes in the cell membrane is the Affinity Conversion Model (ACM). This model postulates that IL2R receptor association is sequential and dependent on ligand binding. Most likely free IL2 binds first to IL2Rα, and then this complex binds to IL2Rß, and finally to IL2Rγ (γc). However, in previous mathematical models representing this process, the binding of γc has not been taken into account. In this work, the quantitative contribution of the number of IL2Rγ chain to the IL2-IL2R apparent binding affinity and signaling is studied. A mathematical model of the affinity conversion process including the γ chain in the dynamic, has been formulated. The model was calibrated by fitting it to experimental data, specifically, Scatchard plots obtained using human cell lines. This paper demonstrates how the model correctly explains available experimental observations. It was estimated, for the first time, the value of the kinetic coefficients of IL2-IL2R complexes interaction in the cell membrane. Moreover, the number of IL2R components in different cell lines was also estimated. It was obtained a variable distribution in the number of IL2R components depending on the cell type and the activation state. Of most significance, the study predicts that not only the number of IL2Rα and IL2Rß, but also the number of γc determine the capacity of the cell to capture and retain IL2 in signalling complexes. Moreover, it is also showed that different cells might use different pathways to bind IL2 as consequence of its IL2R components distribution in the membrane.
Assuntos
Subunidade gama Comum de Receptores de Interleucina/metabolismo , Interleucina-2/metabolismo , Algoritmos , Calibragem , Linhagem Celular , Membrana Celular/metabolismo , Humanos , Cinética , Ligantes , Modelos Estatísticos , Modelos Teóricos , Ligação Proteica , Multimerização Proteica , Transdução de SinaisRESUMO
The effect of high intensity ultrasound (HIUS) may produce structural modifications on proteins through a friendly environmental process. Thus, it can be possible to obtain aggregates with a determined particle size, and altering a defined functional property at the same time. The objective of this work was to explore the impact of HIUS on the functionality of a denatured soy protein isolate (SPI) on foaming and interfacial properties. SPI solutions at pH 6.9 were treated with HIUS for 20 min, in an ultrasonic processor at room temperature, at 75, 80 and 85°C. The operating conditions were: 20 kHz, 4.27 ± 0.71 W and 20% of amplitude. It was determined the size of the protein particles, before and after the HIUS treatment, by dynamic light scattering. It was also analyzed the interfacial behavior of the different systems as well as their foaming properties, by applying the whipping method. The HIUS treatment and HIUS with temperature improved the foaming capacity by alteration of particle size whereas stability was not modified significantly. The temperature of HIUS treatment (80 and 85°C) showed a synergistic effect on foaming capacity. It was found that the reduction of particle size was related to the increase of foaming capacity of SPI. On the other hand, the invariable elasticity of the interfacial films could explain the stability of foams over time.