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Testicular cancer (TCa) is a rare malignancy affecting young men worldwide. Sociodemographic factors, especially socioeconomic level (SEL) and healthcare access, seem to impact TCa incidence and outcomes, particularly among Hispanic populations. However, limited research has explored these variables in Hispanic groups. This study aimed to investigate sociodemographic and clinical factors in Mexico and their role in health disparities among Hispanic TCa patients. We retrospectively analyzed 244 Mexican TCa cases between 2007 and 2020 of a representative cohort with diverse social backgrounds from a national reference cancer center. Logistic regression identified risk factors for fatality: non-seminoma histology, advanced stage, and lower education levels. Age showed a significant trend as a risk factor. Patient delay and healthcare distance lacked significant associations. Inadequate treatment response and chemotherapy resistance were more likely in advanced stages, while higher education positively impacted treatment response. Cox regression highlighted non-seminoma histology, below-median SEL, higher education, and advanced-stage survival rates. Survival disparities emerged based on tumor histology and patient SEL. This research underscores the importance of comprehensive approaches that integrate sociodemographic, biological, and environmental factors to address health disparities improving outcomes through personalized interventions in Hispanic individuals with TCa.
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Despite having a favorable response to platinum-based chemotherapies, ~15% of Testicular Germ-Cell Tumor (TGCT) patients are platinum-resistant. Mortality rates among Latin American countries have remained constant over time, which makes the study of this population of particular interest. To gain insight into this phenomenon, we conducted whole-exome sequencing, microarray-based comparative genomic hybridization, and copy number analysis of 32 tumors from a Mexican cohort, of which 18 were platinum-sensitive and 14 were platinum-resistant. We incorporated analyses of mutational burden, driver mutations, and SNV and CNV signatures. DNA breakpoints in genes were also investigated and might represent an interesting research opportunity. We observed that sensitivity to chemotherapy does not seem to be explained by any of the mutations detected. Instead, we uncovered CNVs, particularly amplifications on segment 2q11.1 as a novel variant with chemosensitivity biomarker potential. Our data shed light into understanding platinum resistance in a Latin-origin population.
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In Argentina, Chile and Ecuador, abortion at later durations of pregnancy is legally restricted. Feminist collectives in these contexts support people through self-managed medical abortion outside the healthcare system. The model of in-person abortion accompaniment represents an opportunity to examine a self-care practice that challenges and reimagines abortion provision. We formed a collaborative partnership built on a commitment to shared power and decision-making between researchers and partners. We conducted 28 key informant interviews with accompaniers in Argentina, Chile and Ecuador in 2019 about their model of in-person abortion accompaniment at later durations of pregnancy. We iteratively coded transcripts using a thematic analysis approach. Accompaniers premised their work in a feminist activist framework that understands accompaniment as addressing inequalities and expanding rights, especially for the historically marginalised. Through a detailed description of the process of in-person accompaniment, we show that the model, including the logistical considerations and security mechanisms put in place to ensure favourable abortion outcomes, emphasises peer-to-peer provision of supportive physical and emotional care of the accompanied person. In this way, it represents supported self-care through which individuals are centred as the protagonists of their own abortion, while being accompanied by feminist peers. This model of supported self-care challenges the idea that "self-care" necessarily means "solo care", or care that happens alone. The model's focus on peer-to-peer transfer of knowledge, providing emotional support, and centring the accompanied person not only expands access to abortion, but represents person-centred practices that could be scaled and replicated across contexts.
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Autocuidado , Argentina , Chile , Equador , Humanos , América LatinaRESUMO
RESUMEN Fundamento: la hipertensión arterial es una enfermedad de elevada prevalencia a nivel mundial, a menudo con graves consecuencias para la vida de las personas que la padecen. Objetivo: valorar la efectividad de un programa de intervención educativa para modificar conocimientos sobre estilos de vida saludables en pacientes hipertensos. Métodos: se realizó una investigación acción en el consultorio médico de familia 17-5 del Policlínico Universitario "Chiqui Gómez-Lubián" de Santa Clara, Villa Clara, entre enero-marzo de 2020. Se emplearon métodos teóricos: análisis-síntesis, inducción-deducción e histórico-lógico; empíricos: análisis documental y encuesta en forma de cuestionario a los pacientes antes y después de aplicado el programa; para valorar su efectividad se realizó un análisis estadístico. Resultados: el diagnóstico aplicado demostró que la mayoría de los pacientes tenían desconocimiento sobre su enfermedad y estilos de vida saludables relacionados con los beneficios de sus medicamentos para controlar la hipertensión, la educación nutricional, ingestión de bebidas alcohólicas, el hábito de fumar, el ejercicio físico, el estrés, la obesidad y el consumo de café, por lo que se aplicó una programa de intervención educativa que fue valorado por especialistas. Conclusiones: su efectividad se evidenció porque se modificaron de forma significativa los conocimientos sobre la enfermedad y las prácticas inadecuadas de estilos de vida de los pacientes muestreados.
ABSTRACT Background: hypertension is a highly prevalent disease worldwide, often with serious consequences for the live of people who suffer from it. Objective: to assess the effectiveness of an educational intervention program to modify knowledge about healthy lifestyles in hypertensive patients. Methods: an action research was carried out in the family doctor's office 17-5 of the "Chiqui Gómez-Lubián" University Polyclinic of Santa Clara, Villa Clara, from January toMarch 2020. Theoretical methods were used: analysis-synthesis, induction- deduction and historical-logical; empirical ones: documentary analysis and survey in the form of a questionnaire to patients before and after applying the program; to assess its effectiveness, a statistical analysis was carried out. Results: the applied diagnosis showed that most of the patients had ignorance about their disease and healthy lifestyles related to drug benefits to control hypertension, nutritional education, ingestion of alcoholic beverages, smoking, physical exercises, stress, obesity and coffee intake, for which an educational intervention program was applied that was assessed by specialists. Conclusions: its effectiveness was evidenced because knowledge about the disease and inappropriate lifestyle practices of the sampled patients were significantly modified.
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Projetos de Pesquisa , Fatores de Risco , Indicadores Básicos de Saúde , Estratégias de Saúde , Medição de Risco , Educação Médica , Promoção da SaúdeRESUMO
RESUMEN El presente estudio tuvo como objetivo describir los resultados materno-perinatales de gestantes con infección por SARS-CoV-2 identificadas antes del parto, en un hospital nivel III del Perú. Se evaluaron variables sociodemográficas, complicaciones obstétricas y morbilidades neonatales en los nacimientos ocurridos entre el 1 de abril y el 30 de junio de 2020, en el Instituto Nacional Materno Perinatal del Perú. Se registraron 43 recién nacidos, 93% de las madres fueron asintomáticas. Las complicaciones obstétricas más frecuentes fueron rotura prematura de membranas (18,6%) y preeclampsia (11,6%). El 65,1% de nacimientos fue por parto vaginal, solo uno de los recién nacidos presentó resultado positivo a la prueba de reacción en cadena de polimerasa con transcriptasa inversa (RT-PCR) para COVID-19, las comorbilidades de los recién nacidos fueron prematuridad (11,3%), bajo peso al nacer (9,3%), cuatro ingresaron a cuidados intermedios y dos a cuidados intensivos. Se concluye que el 2,4% de los recién nacidos hijos de madres con COVID-19 presentó prueba molecular positiva de RT-PCR, el 14% de recién nacidos presentó morbilidad como prematuridad, bajo peso al nacer, sepsis y neumonía que requirió ventilación. La morbilidad neonatal se encontró en recién nacidos cuya prueba de RT-PCR fue negativa para COVID-19.
ABSTRACT The present study aimed to describe the perinatal outcomes of newborns of mothers with 2019 coronavirus infection identified before delivery in a level III hospital in Peru. Sociodemographic variables, obstetric complications, and neonatal morbidities were evaluated in the births that occurred between April 1 and June 30, 2020, at the National Maternal Perinatal Institute of Peru. 43 newborns were registered: 93% came from asymptomatic mothers, the most frequent obstetric complications were premature rupture of membranes (18.6%) and pre-eclampsia (11.6%), 65.1% of the births were vaginally, only one of the newborns had a positive result to RT-PCR for COVID-19, the comorbidities of the newborns were prematurity (11.3%) and low birth weight (9.3%); four were admitted to intermediate care and two to intensive care. It is concluded that 2.4% of newborns born to mothers with COVID-19 presented positive molecular test of RT-PCR, 14% of newborns presented morbidity as prematurity, low birth weight, sepsis and pneumonia that required ventilation. Neonatal morbidity was found in newborns whose RT-PCR test was negative for COVID-19.
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Humanos , Feminino , Gravidez , Recém-Nascido , Peru , Gravidez , Infecções por Coronavirus , Parto , Gestantes , COVID-19 , Recém-Nascido , Pré-Escolar , Morbidade , Pandemias , HospitaisRESUMO
Introdução: as substâncias psicoativas (SPA) representam uma questão de ordem internacional. Os efeitos negativos do consumo destas incluem os elevados custos como o aumento nas taxas de acidentes de trânsito e de violência urbana. Objetivo: o presente estudo descreve as internações hospitalares por transtornos mentais e comportamentais devido ao uso de SPA na região Nordeste do Brasil em 2018. Metodologia: estudo observacional, retrospectivo, com dados agregados, do tipo ecológico. A pesquisa foi realizada nas Unidades Federativas (UF) componentes da região Nordeste do Brasil, no período do ano de 2018. Resultados: as internações totalizaram 11.250 casos, sendo que outras SPA tiveram taxas superiores na maioria das unidades federativas (UF). As maiores taxas são de pacientes de 30 a 39 anos, sexo masculino e considerados pardos. O valor médio das internações foi de R$1.274,83 e a média de permanência foi de 25,6 dias. A taxa de mortalidade total foi de 0,77, tendo o álcool como principal responsável na maioria das UF. Conclusão: os dados evidenciam a relevância da atualização dos estudos epidemiológicos para conhecimento da população exposta ao abuso de SPA. O enfrentamento do drogadição e dependência do álcool não deve excluir qualquer grupo quanto a etnia, gênero ou faixa etária, priorizando a prevenção do consumo de SPA.
Introduction: psychoactive substances (PAS) represent a matter of international order. The negative effects of the consumption of PAS include high costs, like increased rates of traffic accidents and urban violence. Objective: in order to provide a basis for new approaches, according to the reality and characteristics of the individuals affected, this study describes hospitalizations for mental and behavioral disorders due to the use of PAS in the Northeastern region of Brazil during the year of 2018. Methodology: observational, retrospective, aggregated, ecological study. The research was conducted in the Federative Units of the Northeast of Brazil, in the period of 2018. Results: hospitalizations totaled 11,250 cases, and other PAS had higher rates in most federative unities (FU). The highest rates are among patients aged 30 to 39 years, male and considered brown. The average value of hospitalizations was R$ 1,274.83 and the average length of stay is 25.6 days. The total mortality rate was 0.77, with alcohol as the main responsible in most of the FU. Conclusion: the data shows the relevance of updating epidemiological studies for a better knowledge of the population exposed to PAS abuse. Coping with drug addiction and alcohol dependence should not exclude any group regarding ethnicity, gender or age group, prioritizing the prevention of PAS consumption.
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Humanos , Masculino , Feminino , Adulto , Psicotrópicos , Epidemiologia , Mortalidade , Transtornos Relacionados ao Uso de Substâncias , Hospitalização , Transtornos Mentais , Estudos Retrospectivos , Estudo ObservacionalRESUMO
The 'red complex' is an aggregate of three oral bacteria (Tannerella forsythia, Porphyromonas gingivalis and Treponema denticola) responsible for severe clinical manifestation of periodontal disease. Here, we report the first direct evidence of ancient T.forsythia DNA in dentin and dental calculus samples from archaeological skeletal remains that span from the Pre-Hispanic to the Colonial period in Mexico. We recovered twelve partial ancient T. forsythia genomes and observed a distinct phylogenetic placement of samples, suggesting that the strains present in Pre-Hispanic individuals likely arrived with the first human migrations to the Americas and that new strains were introduced with the arrival of European and African populations in the sixteenth century. We also identified instances of the differential presence of genes between periods in the T. forsythia ancient genomes, with certain genes present in Pre-Hispanic individuals and absent in Colonial individuals, and vice versa. This study highlights the potential for studying ancient T. forsythia genomes to unveil past social interactions through analysis of disease transmission. Our results illustrate the long-standing relationship between this oral pathogen and its human host, while also unveiling key evidence to understand its evolutionary history in Pre-Hispanic and Colonial Mexico. This article is part of the theme issue 'Insights into health and disease from ancient biomolecules'.
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Genoma Bacteriano , Infecções por Bactérias Gram-Negativas/história , Periodontite/história , Tannerella forsythia/genética , Arqueologia , Genômica , Infecções por Bactérias Gram-Negativas/microbiologia , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História Antiga , História Medieval , Humanos , México , Periodontite/microbiologiaRESUMO
BACKGROUND: This paper analyzes the strategies used by activist health professionals in Argentina who justify providing abortion despite legal restrictions on the procedure. These "insider activists" make a case for abortion rights by linking pregnancy termination to a woman's ability to exert agency at a key point in her reproductive life, and argue that refusing women access to the procedure constitutes a grievous health risk. This argument frames pregnancy termination as an issue of empowerment and also as a medical necessity. METHODS: This article is based on ethnographic research conducted in Argentina in 2013 and 2015, which includes in-depth interviews with abortion activists and health professionals and ethnographic observation at activist events and in clinics. RESULTS: During the period of my field research, the medical staff in one clinic shifted from abortion counseling, based on a harm reduction model, to legal pregnancy termination, a new mode of abortion provision where they directly provided abortions based on the legal health exception. These insider activists formalized the latter approach by creating a diagnostic instrument that frames women's "bio-psycho-social" reasons for wishing to terminate a pregnancy as medically justified. CONCLUSIONS: The clinical practice analyzed in this article raises important questions about the potential for health professionals to take on an activist role by making safe abortion accessible, even in a context where the procedure is highly restricted.
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Aborto Legal/psicologia , Serviços de Planejamento Familiar/legislação & jurisprudência , Ativismo Político , Poder Psicológico , Direitos Sexuais e Reprodutivos/psicologia , Aborto Legal/legislação & jurisprudência , Argentina , Feminino , Humanos , Gravidez , Direitos Sexuais e Reprodutivos/legislação & jurisprudência , Direitos da Mulher/legislação & jurisprudênciaRESUMO
Se presenta el caso de una primigesta de 22 semanas de edad gestacional referida a nuestro servicio con el diagnóstico prenatal de espina bífida abierta. Se coordinó un equipo multidisciplinario nacional e internacional en el lapso de tres semanas para llevar a cabo la primera cirugía intrauterina de corrección de espina bífida. La operación se realizó a las 25 semanas y el parto por cesárea se produjo a las 37 semanas, obteniéndose buenos resultados a corto plazo. Demostramos que esta cirugía, altamente especializada y que involucra un gran equipo multidisciplinario, se puede realizar exitosamente en nuestro país.
We report the first successful case of fetal surgery for spina bifida repair in Peru. A pregnant woman was referred to our center at 23 weeks' gestation because of prenatal diagnosis of spina bifida. We formed a multidisciplinary international team with the goal of performing the first open intrauterine surgery in Peru. We performed a successful intrauterine surgery at 25 weeks of gestation and a healthy infant was born by cesarean section at 37 weeks of gestation. We demonstrated the feasibility of this complex intrauterine surgery in our local setting.
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Spindle poisons activate the spindle assembly checkpoint and prevent mitotic exit until cells die or override the arrest. Several studies have focused on spindle poison-mediated cell death, but less is known about consequences in cells that survive a mitotic arrest. During mitosis, proteins such as CYCLIN B, SECURIN, BUB1 and SURVIVIN are degraded in order to allow mitotic exit, and these proteins are maintained at low levels in the next interphase. In contrast, exit from a prolonged mitosis depends only on degradation of CYCLIN B; it is not known whether the levels of other proteins decrease or remain high. Here, we analyzed the levels and localization of the BUB1 and SURVIVIN proteins in cells that escaped from a paclitaxel-mediated prolonged mitosis. We compared cells with a short arrest (HCT116 cells) with cells that spent more time in mitosis (HT29 cells) after paclitaxel treatment. BUB1 and SURVIVIN were not degraded and remained localized to the nuclei of HCT116 cells after a mitotic arrest. Moreover, BUB1 nuclear foci were observed; BUB1 did not colocalize with centromere proteins. In HT29 cells, the levels of BUB1 and SURVIVIN decreased during the arrest, and these proteins were not present in cells that reached the next interphase. Using time-lapse imaging, we observed morphological heterogeneity in HCT116 cells that escaped from the arrest; this heterogeneity was due to the cytokinesis-like mechanism by which the cells exited mitosis. Thus, our results show that high levels of BUB1 and SURVIVIN can be maintained after a mitotic arrest, which may promote resistance to cell death.
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ETHNOPHARMACOLOGICAL RELEVANCE: Tecoma stans is traditionally used by several ethnical groups in Mexico and Central America to treat diabetes. This species is mentioned in the majority of the ethnopharmacological studies compiled in Mexico focused in medicinal plants used as anti-diabetic treatment. AIM OF THE STUDY: Recently, this plant was found to display a high level of pancreatic lipase inhibitory activity, in addition to the several action mechanisms already described. Here we show the phytochemical and in vitro pharmacological characterization of some of the compounds responsible for the antilipase activity. MATERIALS AND METHODS: Starting with a hydroalcoholic extract, fractions were obtained by liquid-liquid separation and successive processes of column chromatography purifications. Lipase inhibitory activity was measured employing a spectrophotometric analysis. For structural elucidation (1)H and (13)C NMR experiments were used. HPLC was used to quantify and confirm the identity of the bioactive compounds. RESULTS: Bio-guided chemical purification of the hydroalcoholic extract produced an organic fraction (ethyl acetate, TsEA), flavone fractions (TsC1F13), (TsC1F15), (TsC1F16) and isolated compounds (chrysoeriol, apigenin, luteolin, and verbascoside) with the capability to inhibit the activity of pancreatic lipase. The most active fraction (TsC2F6B) was constituted by a mixture of Chrysoeriol (5,7-dihydroxy-2-[4-hydroxy-3-methoxyphenyl]chromen-4-one, 96% ) and Apigenin (4%). This flavone mixture displayed a percentage of inhibition of 85% when it was eavaluated at 0.25mg/mL. Luteolin and chrysoeriol produced a noncompetitive and mixed inhibition with values of IC50=63 and 158µM respectively. The content of chrysoeriol was also quantified in the hydroalcoholic extract (TsHAE) and organic fraction (TsEA) as 1% and 7% respectively. All of this confirms that high proportion of both flavones produce an increase of the biological activity due to they show the highest inhibition of lipase enzyme in a concentration dependant way. CONCLUSIONS: These results evidence that the medicinal use of T. stans could be in part because of its lipase inhibitory activity allowing to adapt the administration of this plant before meals. Also this data could help to develop a novel phytopharmaceutical drug (standardized in luteolin, chrysoeriol, and apigenin) auxiliary for the Type 2 Diabetes mellitus.
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Bignoniaceae/química , Flavonas/farmacologia , Lipase/antagonistas & inibidores , Polifenóis/farmacologia , Flavonas/química , Concentração Inibidora 50 , Estrutura Molecular , Polifenóis/químicaRESUMO
Lung cancer educational programs seek the involvement of different groups in efforts to promote healthier habits and lifestyles. Women are primary agents for targeting prevention actions because of their ability to foster healthy lifestyles within their families. The purpose of this study was to develop a woman-centered educational program to strengthen knowledge and promote responsible behavior aimed at primary prevention of lung cancer. Based on identified learning needs in 133 female participants concerning lung cancer self care, healthy habits and communication skills about self care, a ten-workshop series was designed and validated by specialists and users. Before intervention, 82% of participants were highly aware of smoking-related harm, but only 26% were highly aware of healthy environmental management practices at home and 14% were knowledgeable about self care. Differences in both awareness and practice of health-promoting behaviors were observed by the end of the training: those highly aware of smoking-related harm rose to 86.5%, and those highly aware of environmental management and self care increased to 66.2% and 83.5%, respectively. The proportions reporting acceptable levels of environmental management and self-care practices increased to 86.5% (from 0%) and 91% (from 3.8%), respectively. One year later, a positive impact on families was confirmed, predominantly on children. We conclude that such a woman-centered educational program can increase awareness and promote healthy behaviors aimed at lung cancer prevention. Women's ability to communicate and share lessons learned within their families should be considered in designing community health education programs. KEYWORDS Lung cancer, health education, disease prevention, primary prevention, health promotion, Cuba.
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Promoção da Saúde/organização & administração , Neoplasias Pulmonares/prevenção & controle , Educação de Pacientes como Assunto , Prevenção Primária , Saúde da Mulher , Adulto , Cuba/epidemiologia , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Pessoa de Meia-Idade , Desenvolvimento de ProgramasRESUMO
A physio-pathological feature of diabetes mellitus is a significant reduction of ß-pancreatic cells. The growth, differentiation and function maintenance of these cells is directed by transcription factors. Nkx6.1 is a key transcription factor for the differentiation, neogenesis and maintenance of ß-pancreatic cells. We reported that silymarin restores normal morphology and endocrine function of damaged pancreatic tissue after alloxan-induced diabetes mellitus in rats. The aim of this study was to analyze the effect of silymarin on Nkx6.1 transcription factor expression and its consequence in ß cells neogenesis. Sixty male Wistar rats were partially pancreatectomized and divided into twelve groups. Six groups were treated with silymarin (200 mg/Kg p.o) for periods of 3, 7, 14, 21, 42 and 63 days. Additionally, an unpancreatectomized control group was used. Nkx6.1 and insulin gene expression were assessed by RT-PCR assay in total pancreatic RNA. ß-Cell neogenesis was determined by immunoperoxidase assay. Silymarin treated group showed an increase of Nkx6.1 and insulin genic expression. In this group, there was an increment of ß-cell neogenesis in comparison to pancreatectomized untreated group. Silymarin treatment produced a rise in serum insulin and serum glucose normalization. These results suggest that silymarin may improve the reduction of ß pancreatic cells observed in diabetes mellitus.
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Proteínas de Homeodomínio/agonistas , Células Secretoras de Insulina/efeitos dos fármacos , Insulina/agonistas , Pancreatectomia , Substâncias Protetoras/farmacologia , Silimarina/farmacologia , Animais , Glicemia/metabolismo , Contagem de Células , Proliferação de Células , Diabetes Mellitus , Modelos Animais de Doenças , Expressão Gênica , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/metabolismo , Técnicas Imunoenzimáticas , Insulina/genética , Insulina/metabolismo , Células Secretoras de Insulina/citologia , Células Secretoras de Insulina/metabolismo , Masculino , Ratos , Ratos WistarRESUMO
This work shows the inhibitory effect on glucosidase and lipase enzymes of 23 medicinal plants described as traditional treatments for diabetes in several Mexican sources. Hydroalcoholic extracts of selected plants were evaluated at 1 mg/mL for glucosidase and 0.25 mg/mL for lipase inhibitory activities, respectively. Camellia sinensis, acarbose, and orlistat were used as positive controls. Dose-response curves were done with the most active species. Sixty percent of all tested extracts inhibited more than 25% of α-glucosidase activity. C. sinensis displayed an inhibition of 85% (IC(50) = 299 µg/mL), while Ludwigia octovalvis and Iostephane heterophylla showed the highest inhibition (82.7 %, IC(50) = 202 µg/mL and 60.6%, CI(50) = 509 µg/mL, resp.). With respect to lipase activity, L. octovalvis and Tecoma stans were the most inhibiting treatments (31.4%, IC(50) = 288 µg/mL; 27.2%, IC(50) = 320 µg/mL), while C. sinensis displayed 45% inhibition (IC(50) = 310 µg/mL). These results indicate that a high proportion of plants used in Mexico as treatment for diabetes displays significant inhibition of these digestive enzymes.
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Objetivo Determinar la frecuencia de anticuerpos específicos a hantavirus en roedores del municipio de San Marcos, departamento de Sucre. Métodos Se capturaron 144 roedores con trampas Sherman® en áreas urbanas y rurales del municipio de San Marcos, desde diciembre de 2007 hasta julio de 2009. Los anticuerpos Ig G específicos contra el Virus Sin Nombre (VSN) fueron detectados en muestras de plasma mediante ELISA indirecto. Resultados La seroprevalencia de anticuerpos contra hantavirus fue del 8,3 % (12/144 capturas). Los porcentajes de seropositividad específicos por especie variaron entre 6,8 % (3/44, Zygodontomys brevicauda) y 50 % (1/2, Neacomys spinosus). No se encontró diferencia estadística en la seroprevalencia con respecto al área de muestreo, sexo y etapa reproductiva (p>0,05); sin embargo, hubo un mayor número de machos adultos seropositivos. Conclusiones Se evidenció por primera vez seropositividad a hantavirus en roedores de la subfamilia Murinae en Colombia. La detección de anticuerpos contra el virus refuerza la hipótesis que sugiere la circulación de al menos un hantavirus en roedores del norte colombiano.
Objective The main goal of this research was to determine the frequency of hantavirus-specific antibodies in rodents from the municipality of San Marcos in the Sucre department of Colombia. Methods 144 rodents were captured in San Marcos' urban and rural areas using Sherman traps between December 2007 and July 2009. "Virus sin Nombre" (SNV)-specific antibodies were detected in plasma samples by an indirect ELISA immunoassay. Results An 8.3 % (12/144) seroprevalence rate was found. Specific seropositivity rates ranged from 6.8 % (3/44, Zygodontomysbrevicauda) to 50 % (1/2, Neacomysspinosus). No significant differences were found in seroprevalence according to capture area, gender and/or reproductive stage (p>0.05); however, there were more seropositive adult males. Conclusion This is the first evidence of hanta virus seropositivity in rodents from the Murinae subfamily in Colombia. The presence of SNV antibodies in rodents in San Marcos supported the hypothesis that at least one hantavirusis circulating in rodents from northern Colombia.
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Animais , Feminino , Masculino , Anticorpos Antivirais/sangue , Reservatórios de Doenças , Infecções por Hantavirus/veterinária , Orthohantavírus/imunologia , Doenças dos Roedores/epidemiologia , Roedores/virologia , Colômbia/epidemiologia , Estudos Transversais , Infecções por Hantavirus/epidemiologia , Murinae/virologia , Doenças dos Roedores/virologia , Saúde da População Rural , Estudos Soroepidemiológicos , Sigmodontinae/virologia , Especificidade da Espécie , Saúde da População UrbanaRESUMO
OBJECTIVE: The main goal of this research was to determine the frequency of hantavirus-specific antibodies in rodents from the municipality of San Marcos in the Sucre department of Colombia. METHODS: 144 rodents were captured in San Marcos' urban and rural areas using Sherman traps between December 2007 and July 2009. "Virus sin Nombre" (SNV)-specific antibodies were detected in plasma samples by an indirect ELISA immunoassay. RESULTS: An 8.3 % (12/144) seroprevalence rate was found. Specific seropositivity rates ranged from 6.8 % (3/44, Zygodontomysbrevicauda) to 50 % (1/2, Neacomysspinosus). No significant differences were found in seroprevalence according to capture area, gender and/or reproductive stage (p>0.05); however, there were more seropositive adult males. CONCLUSION: This is the first evidence of hanta virus seropositivity in rodents from the Murinae subfamily in Colombia. The presence of SNV antibodies in rodents in San Marcos supported the hypothesis that at least one hantavirusis circulating in rodents from northern Colombia.
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Anticorpos Antivirais/sangue , Reservatórios de Doenças , Infecções por Hantavirus/veterinária , Orthohantavírus/imunologia , Doenças dos Roedores/epidemiologia , Roedores/virologia , Animais , Colômbia/epidemiologia , Estudos Transversais , Feminino , Infecções por Hantavirus/epidemiologia , Masculino , Murinae/virologia , Doenças dos Roedores/virologia , Saúde da População Rural , Estudos Soroepidemiológicos , Sigmodontinae/virologia , Especificidade da Espécie , Saúde da População UrbanaRESUMO
Introduction: Information and communication technologies were introduced in community-based polyclinics as a result of a Cuban health system policy to make information more readily accessible to health professionals and other health workers at the primary health care level. Objective: Assess phase one of the Program to Introduce Information and Communication Technologies in Primary Health Care (PICT-PHC), as implemented in Havana, and in particular to determine the aspects of structure, process and outcomes with the greatest impact on this phase's effectiveness. Methods: From May to October 2003, an assessment was carried out in all Havana community-based polyclinics where phase one of the Program was underway. Study dimensions, criteria, and standards were established through consultation with experts and considering the level of performance expected by program directors, thus providing timely analysis to the directors concerning problem areas in need of attention. This paper concentrates on the five dimensions which were thought to have the most bearing on effectiveness of information and communication technologies (ICTs) installed in the polyclinics' libraries: librarians' competencies in IT skills, training received by librarians, training received by users, Program monitoring and follow-up, and exploitation of the technologies. Six data collection instruments were devised. Participants in the study included 41 librarians and 544 users. Data were processed to obtain indicators corresponding to study criteria. Each indicator was then compared with the established standard. Validity of results was established through analysis and comparison. Results: Overall, the first phase of the PICT-PHC in Havana succeeded in making online information resources more readily available to health professionals and technicians. Some librarians had insufficient basic IT competencies, which had an impact on the quality of their work. Moreover, it was found that monitoring and follow-up activities were focused chiefly on implementation process rather than outcomes. There was consistency between the achievements and problems found for some criteria and dimensions, and their impact on related ones. Conclusion: This study furnished evidence of the need for greater emphasis on human resources training (particularly of librarians) in the use of ICTs in the primary health care system.
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Se realiza un estudio de costo por fármacos antiepilépticos (FAE) y fármacos antidepresivos (FAD) en una población de 110 pacientes con epilepsia. Se encontró que la depresión alcanzaba más del 70 por ciento de los estudiados, con un 40 por ciento que necesitaba medicación antidepresiva. Aparecía más frecuencia de crisis relacionada con la depresión de forma severa y moderada. El costo por FAE de los pacientes estudiados es totalmente bajo y solo llega a 0,25 centavos por paciente, en un año sería de 91,25 pesos. En los aproximadamente 80,000 pacientes con epilepsia que hay en todo el país tendríamos un costo anual 7 millones 300 mil pesos. El costo de la medicación por antidepresivos y antiepilépticos en cada paciente es de 0,47 centavos diarios, y en un año sería de 171,55 pesos por año. El costo actual por FAE es de 110,23 pesos en un año aproximadamenteSe hace un análisis de cómo disminuir el costo por la combinación de FAE y el uso de FAE asociados. Se sugiere el uso de medicina alternativa de forma priorizada para los pacientes que tiene aumento de la frecuencia de sus crisis de epilepsia y depresión
Assuntos
Epilepsia , Análise Custo-Benefício , DepressãoRESUMO
O artigo propõe uma discussão a respeito do Complexo Fraterno na constituição psíquica do sujeito. São salientadas as relações da fratria dentro da família e aspectos como rivalidade, competição, ciúmes, diferenciação e identificação que ocorrem entre os irmãos. Também são problematizadas as implicações da ordem de nascimento de cada filho no seu psiquismo, em relação aos papéis familiares e dentro da fratria. O olhar dos pais sobre os filhos é discutido como questão fundamental para a forma como os irmãos irão se relacionar, resolver seus conflitos e exercer seus papéis