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Recently, the role of trace elements in the pathophysiology of obesity, insulin resistance (IR), and metabolic diseases has been explored. In this cross-sectional study, we aimed to assess the association of overweight, obesity, and cardiometabolic traits with serum copper (Cu) levels in 346 Mexican adults. Serum Cu level was measured by inductively coupled plasma mass spectrometry (ICP-MS). Anthropometrical data were collected, and biochemical parameters were measured. The triglyceride-glucose (TyG) index was used as a surrogate marker to evaluate IR. Overweight and obesity status was positively associated with the serum Cu level (ß = 19.434 ± 7.309, p = 0.008). Serum Cu level was observed to have a positive association with serum triglycerides level (ß = 0.160 ± 0.045, p < 0.001) and TyG (ß = 0.001 ± 0.001, p < 0.001). Additionally, high serum Cu level was positively associated with overweight and obesity status (odds ratio [OR] = 1.9, 95% confidence interval [95% CI] 1.1-3.4, p = 0.014), hypertriglyceridemia (OR = 3.0, 95% CI 1.7-5.3, p < 0.001), and IR (OR = 2.6, 95% CI 1.4-4.6, p = 0.001). In conclusion, our results suggest that overweight, obesity, hypertriglyceridemia, and IR are positively associated with serum Cu levels in Mexican adults.
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BACKGROUND: An imbalance between adipokines and micronutrient concentrations, such as those of copper (Cu), has been linked to dysregulation of energy homeostasis leading to weight gain and the development of other comorbidities; however, information on this issue remains limited. Our aim was to investigate the correlation between Cu status and serum adipokine levels and their relationship in normal-weight, overweight, and obese adult women. METHODS: Sixty patients were evaluated and classified according to their body mass index (BMI) and biochemical parameters; adipokines and Cu were measured at fasting. RESULTS: Leptin (Lep) and resistin (Res) levels were elevated, whereas adiponectin (Adpn) and ghrelin (Ghr) values were decreased in overweight and obese women (p = 0.001). The mean Adpn/Lep ratio was <0.5 in overweight and obese subjects, while the Lep/Ghr ratio increased significantly in relation to weight gain, suggesting an inverse link between the ratios of these hormones in the regulation of obesity. The analysis revealed a positive association between BMI and Cu levels in obese women. Moreover, a negative association between Cu and Res in normal-weight subjects was found. CONCLUSIONS: Circulating fasting Res levels are negatively associated with serum Cu concentration in normal-weight adult women. We also observed a close relationship between Adpn/Lep and Lep/Ghr ratios with obesity. However, more observational studies are required to confirm these results in future research.
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Adipocinas , Sobrepeso , Adulto , Humanos , Feminino , Cobre , Obesidade , Leptina , Adiponectina , Índice de Massa Corporal , Anti-Inflamatórios , Aumento de PesoRESUMO
Resumen El trabajo intersectorial en la promoción de la salud es ampliamente reconocido; sin embargo, la literatura consultada evidenció ausencia de instrumentos válidos y confiables en esta área. Objetivo: diseñar y validar un instrumento para medir el trabajo intersectorial en funcionarios públicos que participaron en una Estrategia Nacional de Prevención del Embarazo en la Adolescencia (EPEA). Metodología: 1. Diseño del instrumento a partir de revisión de literatura, antecedentes de trabajo intersectorial en Colombia y experiencia del equipo investigador; 2. Validación facial para medir precisión, pertinencia, claridad y comprensión de los ítems con muestra por conveniencia de 12 personas; 3. Validación del constructo mediante modelo Rasch, sobre muestra de 132 funcionarios públicos. Resultados: el instrumento final conformado por 21 ítems, presentó buenas propiedades de validez facial y de constructo. La consistencia interna fue de 0,92; en el análisis Rasch se excluyeron personas e ítems que no se ajustaron al modelo, logrando correlaciones positivas entre ítems y medidas mayores a 0,47, unidimensionalidad con una varianza explicada por las medidas de 44,6 %; la varianza explicada en el primer contraste de los residuales fue de 5,7 %, la separación de personas fue de 2,07 y de ítems de 4,51 y la dificultad de los ítems estuvo entre -3,14 y 3,69 lógitos. Ninguno de los ítems presentó funcionamiento diferencial. Conclusiones: se cuenta con un instrumento válido y confiable con 21 ítems para la evaluación de competencias en trabajo intersectorial de funcionarios públicos que trabajan en prevención del embarazo en la adolescencia.
Abstract Even though intersectoral work in health promotion is widely recognized, the literature consulted showed an absence of valid and reliable instruments in this area. Objective: to design and validate an instrument to measure intersectoral work in public officials who participated in a National Strategy for the Prevention of Pregnancy in Adolescence (EPEA in Spanish). Materials and methods: 1. Design of the instrument based on a literature review, history of intersectoral work in Colombia and experience of the research team; 2. Facial validation to measure precision, relevance, clarity and understanding of the items with a convenience sample of 12 people; 3. Validation of the construct using the Rasch model, on a sample of 132 public officials. Results: The final instrument, made up of 21 Items, presented good facial and construct validity properties. The internal consistency was 0.92. In the Rasch analysis, people and items that did not fit the model were excluded, achieving positive correlations between items and linearity measures greater than 0.47 with a variance explained by the measures of 44.6%. The variance explained in the first contrast of the residuals was 5.7%, the separation of people was 2.07 and of items was 4.51 and the difficulty of the items was between -3.14 and 3.69 logits. None of the items presented differential functioning. Conclusions: there is a valid and reliable instrument with 21 items, for the evaluation of competencies in intersectoral work of public officials who work in prevention of pregnancy in adolescence.
Resumo O trabalho intersetorial na promoção da saúde é amplamente reconhecido; porém, a literatura consultada evidenciou ausência de instrumentos válidos e confiáveis nesta área. Objetivo: desenhar e validar um instrumento para medir o trabalho intersetorial em funcionários públicos que participaram em uma Estratégia Nacional de Prevenção da Gravidez na Adolescência (EPEA). Metodologia: 1. Desenho do instrumento a partir de revisão de literatura, antecedentes de trabalho intersetorial na Colômbia e experiência da equipe investigador; 2. Validação facial para medir precisão, pertinência, claridade e compreensão dos itens com amostra por conveniência de 12 pessoas; 3. Validação do constructo mediante modelo Rasch, sobre amostra de 132 funcionários públicos. Resultados: o instrumento final conformado por 21 itens, apresentou boas propriedades de validez facial e de constructo. A consistência interna foi de 0,92; na análise Rasch se excluíram pessoas e itens que não se ajustaram ao modelo, logrando correlações positivas entre itens e medidas maiores a 0,47, unidimensionalidade com uma variância explicada pelas medidas de 44,6 %; a variância explicada no primer contraste dos residuais foi de 5,7 %, a separação de pessoas foi de 2,07 e de itens de 4,51 e a dificuldade dos itens esteve entre -3,14 e 3,69 lógitos. Nenhum dos itens apresentou funcionamento diferencial. Conclusões: conta-se com um instrumento válido e confiável com 21 itens para a avaliação de competências em trabalho intersetorial de funcionários públicos que trabalham em prevenção da gravidez na adolescência.
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Quinoxalines are heterocyclic compounds that contain a benzene ring and a pyrazine ring. The oxidation of both nitrogen of the pyrazine ring results in quinoxaline derivatives (QdNO), which exhibit a variety of biological properties, including antiparasitic activity. However, its activity against Entamoeba histolytica, the protozoan that causes human amebiasis, is poorly understood. Recently, our group reported that various QdNOs produce morphological changes in E. histolytica trophozoites, increase reactive oxygen species, and inhibit thioredoxin reductase activity. Notably, T-001 and T-017 derivatives were among the QdNOs with the best activity. In order to contribute to the characterization of the antiamebic effect of QdNOs, in this work we analyzed the proteomic profile of E. histolytica trophozoites treated with the QdNOs T-001 and T-017, and the results were correlated with functional assays. A total number of 163 deregulated proteins were found in trophozoites treated with T-001, and 131 in those treated with T-017. A set of 21 overexpressed and 24 under-expressed proteins was identified, which were mainly related to cytoskeleton and intracellular traffic, nucleic acid transcription, translation and binding, and redox homeostasis. Furthermore, T-001 and T-017 modified the virulence of trophozoites, since they altered their erythrophagocytosis, migration, adhesion and cytolytic capacity. Our results show that in addition to alter reactive oxygen species, and thioredoxin reductase activity, T-001 and T-017 affect essential functions related to the actin cytoskeleton, which eventually affects E. histolytica virulence and survival.
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Entamoeba histolytica , Animais , Entamoeba histolytica/metabolismo , Humanos , Proteômica , Pirazinas , Quinoxalinas/farmacologia , Espécies Reativas de Oxigênio/metabolismo , Tiorredoxina Dissulfeto Redutase/metabolismo , Tiorredoxina Dissulfeto Redutase/farmacologia , Trofozoítos/metabolismoRESUMO
BACKGROUND: Leishmaniasis and trypanosomiasis are diseases that affect public health worldwide due to their high incidence, morbidity, and mortality. Available treatments are costly, prolonged, and toxic, not to mention the problem of parasite resistance. The development of alternative treatments is justified and polyphenols show promising activity. OBJECTIVE: The main aim of this mini-review was to analyze the most promising phenolic compounds with reported antileishmanial and antitrypanosomal activity as well as their mechanisms of action. RESULTS: We found that the mode of action of these natural compounds, mainly lignans, neolignans, and flavonoids depends on the organism they act on and includes macrophage activation, induction of morphological changes such as chromatin condensation, DNA fragmentation, accumulation of acidocalcisomes, and glycosomes, Golgi damage and mitochondrial dysfunction as well as negative regulation of mitochondrial enzymes and other essential enzymes for parasite survival such as arginase. This gives a wide scope for future research toward the rational development of anti-kinetoplastid drugs. CONCLUSION: Although the specific molecular targets, bioavailability, route of administration, and dosages of some of these natural compounds need to be determined, polyphenols and their combinations represent a very promising and safe strategy to be considered for use against Leishmania spp and Trypanosoma spp. In addition, these compounds may provide a scaffold for developing new, more potent, and more selective antiprotozoal agents.
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Antiprotozoários , Leishmaniose , Lignanas , Antiparasitários/farmacologia , Antiparasitários/uso terapêutico , Antiprotozoários/química , Arginase/uso terapêutico , Cromatina , Flavonoides/química , Humanos , Leishmaniose/tratamento farmacológico , Lignanas/uso terapêutico , Polifenóis/farmacologia , Polifenóis/uso terapêuticoRESUMO
BACKGROUND: Invasive pneumococcal disease (IPD) leads to thousands of pediatric deaths annually. Pneumococcal colonization precedes IPD. In 2013, the Dominican Republic introduced the 13-valent pneumococcal conjugate vaccine (PCV13) into its routine infant immunization program, with doses at ages 2, 4, and 12 months. Prevalence of pneumococcal nasopharyngeal colonization was evaluated post-PCV13 introduction. METHODS: A prospective cohort study of 125 children aged 2-35 months was conducted in a rural Dominican Republic community November 2016 through July 2017. Nasopharyngeal swabs and clinical and vaccination data were collected at enrollment and 4-6 months later. Serotypes included in PCV13 were defined as vaccine-type. Colonization rates and serotype distribution were compared at baseline and follow-up, and the association between colonization and vaccination status among the entire cohort was evaluated at each time point. RESULTS: Of 125 children enrolled, 118 (94%) completed follow-up. Overall and vaccine-type pneumococcal colonization rates were 62% and 25%, respectively, at baseline and 60% and 28% at follow-up. Among children age-eligible for 3 doses, 50% and 51% were fully vaccinated at baseline and follow-up, respectively. At baseline assessment, children up-to-date for age for PCV13 were less likely to be colonized with vaccine-type pneumococci than children not up-to-date, and the same was found for fully vaccinated children (3 doses) compared to those not fully vaccinated (odds ratios [ORs], 0.38 [95% confidence interval {CI}, .18-.79], and 0.14 [95% CI, .04-.45], respectively). The same associations were not found at follow-up assessment. CONCLUSIONS: Three years post -PCV13 introduction, vaccine-type colonization rates remained high. Low vaccination coverage for 3 PCV13 doses may have contributed. The protective effect of PCV13 on vaccine-type carriage suggests an increase in PCV13 coverage could lead to substantial declines in pneumococcal vaccine-type carriage.
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Nasofaringe/microbiologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/administração & dosagem , Vacinas Pneumocócicas/imunologia , Streptococcus pneumoniae/imunologia , Vacinas Conjugadas/imunologia , Portador Sadio/epidemiologia , República Dominicana/epidemiologia , Feminino , Humanos , Lactente , Masculino , Infecções Pneumocócicas/epidemiologia , Estudos Prospectivos , População Rural , Sorogrupo , Vacinas Conjugadas/administração & dosagemRESUMO
BACKGROUND: In 2013, the Dominican Republic introduced 13-valent pneumococcal conjugate vaccine (PCV13) using a 3-dose schedule (at 2, 4 and 12 months of age). We evaluated the impact of PCV13 on serotypes causing pneumococcal pneumonia with pleural effusion. METHODS: Surveillance data after PCV13 introduction (July 2014 to June 2016) were compared with data before PCV13 introduction (July 2009 to June 2011). Cases were defined as radiologic evidence of pneumonia with pleural effusion in a child aged <15 years. Pneumococcus was detected in pleural fluid by either culture or polymerase chain reaction, and serotyping was performed. The Ministry of Health's PCV13 uptake data for 2014-2016 were obtained. RESULTS: The prevalence of pneumococcus among cases was similar before and after PCV13 introduction (56.4% and 52.8%, respectively). The proportion of pneumococcal cases caused by vaccine serotypes was 86% for children <2 years old both before and PCV13 introduction. Compared with before PCV13, serotype 14 accounted for a smaller (28% vs 13%, respectively; P = .02) and serotype 1 for a larger (23% vs 37%; P = .09) proportion of pneumococcal cases after PCV13 introduction. National uptake for the first, second, and third PCV13 doses was 94%, 81%, and 28%, respectively, in 2014 and 75%, 61%, and 26% in 2015. DISCUSSION: While the decrease in pneumococcal pneumonia with pleural effusion caused by serotype 14 may reflect an early effect of PCV13 implementation, other vaccine serotypes, including serotype 1, are not well controlled. Better PCV13 coverage for all 3 doses is needed.
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Infecções Pneumocócicas/epidemiologia , Vacinas Pneumocócicas/administração & dosagem , Vacinas Pneumocócicas/efeitos adversos , Pneumonia Pneumocócica/epidemiologia , Vacinas Conjugadas/efeitos adversos , Criança , Pré-Escolar , República Dominicana/epidemiologia , Feminino , Humanos , Lactente , Masculino , Derrame Pleural/epidemiologia , Derrame Pleural/etiologia , Infecções Pneumocócicas/complicações , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/imunologia , Pneumonia Pneumocócica/complicações , Pneumonia Pneumocócica/prevenção & controle , Complicações Pós-Operatórias , Prevalência , Sorogrupo , Streptococcus pneumoniae/imunologia , Streptococcus pneumoniae/isolamento & purificação , Vacinação , Vacinas Conjugadas/administração & dosagem , Vacinas Conjugadas/imunologiaRESUMO
BACKGROUND: Streptococcus pneumoniae isolated from patients with invasive pneumococcal disease has been subjected to laboratory-based surveillance in Latin American and Caribbean countries since 1993. Invasive pneumococcal diseases remain a major cause of death and disability worldwide, particularly in children. We therefore aimed to assess the direct effect of pneumococcal conjugate vaccines (PCVs) on the distribution of pneumococcal serotypes causing invasive pneumococcal disease in children younger than 5 years before and after PCV introduction. METHODS: We did a multicentre, retrospective observational study in eight countries that had introduced PCV (ie, PCV countries) in the Latin American and Caribbean region: Argentina, Brazil, Chile, Colombia, Dominican Republic, Mexico, Paraguay, and Uruguay. Cuba and Venezuela were also included as non-PCV countries. Isolate data for Streptococcus pneumoniae were obtained between 2006 and 2017 from children younger than 5 years with an invasive pneumococcal disease from local laboratories or hospitals. Species' confirmation and capsular serotyping were done by the respective national reference laboratories. Databases from the Sistema Regional de Vacunas (SIREVA) participating countries were managed and cleaned in a unified database using Microsoft Excel 2016 and the program R (version 3.6.1). Analysis involved percentage change in vaccine serotypes between pre-PCV and post-PCV periods and the annual reporting rate of invasive pneumococcal diseases per 100â000 children younger than 5 years, which was used as a population reference to calculate percentage vaccine type reduction. FINDINGS: Between 2006 and 2017, 12â269 isolates of invasive pneumococcal disease were collected from children younger than 5 years in the ten Latin American and Caribbean countries. The ten serotypes included in ten-valent pneumococcal conjugate vaccine (PCV10) decreased significantly (p<0·0001) after any PCV introduction, except for the Dominican Republic. The percentage change for the ten vaccine serotypes in PCV10 countries was -91·6% in Brazil (530 [72·9%] of 727 before, 27 [6·1%] of 441 after); -85·0% in Chile (613 [72·6%] of 844 before, 44 [10·9%] of 404] after); -84·7% in Colombia (231 [63·1%] of 366 before, 34 [9·7%] of 352 after); and -73·8% in Paraguay (127 [77·0%] of 165 before, 22 [20·2%] of 109 after). In the 13-valent pneumococcal conjugate vaccine (PCV13) countries, the percentage change for the 13 vaccine serotypes was -59·6% in Argentina (853 [85·0%] of 1003 before, 149 [34·3%] of 434 after); -16·5% in the Dominican Republic (95 [80·5%] of 118 before, 39 [67·2%] of 58 after); -43·7% in Mexico (202 [73·2%] of 276 before, 63 [41·2%] of 153 after); and -45·9% in Uruguay (138 [80·7%] of 171 before, 38 [43·7%] of 87 after). Annual reporting rates showed a reduction from -82·5% (6·21 before vs 1·09 after per 100â000, 95% CI -61·6 to -92·0) to -94·7% (1·15 vs 0·06 per 100â000, -89·7 to -97·3) for PCV10 countries, and -58·8% (2·98 vs 1·23 per 100â000, -21·4 to -78·4) to -82·9% (7·80 vs 1·33 per 100â000, -76·9 to -87·4) for PCV13 countries. An increase in the amount of non-vaccine types was observed in the eight countries after PCV introduction together with an increase in their percentage in relation to total invasive strains in the post-PCV period. INTERPRETATION: SIREVA laboratory surveillance was able to confirm the effect of PCV vaccine on serotypes causing invasive pneumococcal disease in the eight PCV countries. Improved monitoring of the effect and trends in vaccine type as well as in non-vaccine type isolates is needed, as this information will be relevant for future decisions associated with new PCVs. FUNDING: None. TRANSLATIONS: For the Portuguese and Spanish translations of the abstract see Supplementary Materials section.
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Infecções Pneumocócicas/microbiologia , Sorotipagem , Streptococcus pneumoniae/classificação , Vacinas Conjugadas , Região do Caribe , Pré-Escolar , Feminino , Vacina Pneumocócica Conjugada Heptavalente/administração & dosagem , Humanos , América Latina , Masculino , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/administração & dosagem , Estudos Retrospectivos , Streptococcus pneumoniae/isolamento & purificaçãoRESUMO
Survival rates for pediatric acute leukemia vary dramatically worldwide. Infections are a leading cause of morbidity and mortality, and the impact is amplified in low and middle-income countries. Defining the epidemiology of infection in a specific health care setting is paramount to developing effective interventions. This study aimed to define the epidemiology of and outcomes from infection in children with acute leukemia treated in a large public pediatric hospital in the Dominican Republic. A retrospective cohort was assembled of children newly diagnosed with acute leukemia between July 1, 2015 to June 30, 2017 at Hospital Infantil Dr. Robert Reid Cabral in Santo Domingo. Patients were identified from the Pediatric Oncology Network Database (PONDTM) and hospital admissions from the Oncology admissions logbook. Medical records and microbiology results were reviewed to identify all inpatient invasive infections. Distance from a child's home to the hospital was determined using ArcGIS by Esri. Infection rates were described in discrete time periods after diagnosis and risk factors for invasive infection were explored using negative binomial regression. Overall, invasive infections were common and a prominent source of death in this cohort. Rates were highest in the first 60 days after diagnosis. Gastroenteritis/colitis, cellulitis, and pneumonia were most frequent, with bacteremia common early on. Multidrug resistant bacteria were prevalent among a small number of positive cultures. In a multivariate negative binomial regression model, age ≥ 10 years and distance from the hospital > 100 km were each protective against invasive infection in the first 180 days after diagnosis, findings that were unexpected and warrant further investigation. Over one-third of patient deaths were related to infection. Interventions aimed at reducing infection should target the first 60 days after diagnosis, improved supportive care inside and outside the hospital, and increased antimicrobial stewardship and infection prevention and control measures.
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Hospitais Pediátricos/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Infecções/complicações , Pacientes Internados/estatística & dados numéricos , Leucemia Mieloide Aguda/complicações , Adolescente , Criança , Pré-Escolar , República Dominicana , Feminino , Humanos , Lactente , Infecções/diagnóstico , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/tratamento farmacológico , Masculino , Prognóstico , Estudos RetrospectivosRESUMO
RESUMEN Los problemas de degradación del suelo que se presentan actualmente permiten que los fijadores biológicos de nitrógeno libre (FBNL), tengan potencial como microorganismos regeneradores de este recurso. Con el objetivo de evaluar su capacidad como grupo funcional, se buscó el aislamiento en medios selectivos Ashby y FBN. Luego de su caracterización morfológica y bioquímica; se inocularon dos tipos de semillas, Zea mays y Brachiaria decumbens; sembradas en un suelo degradado (predio La Ortega de la Universidad de Medellín). Se realizaron 4 tratamientos con 5 repeticiones, durante 36 días en invernadero. Los resultados más destacados los presentó la Brachiaria decumbens al incrementar el peso seco y la longitud de sus raíces gracias a un aislado FBNL (AshAssm4); lo que sugiere su potencial utilización para mejorar los procesos de revegetalización.
ABSTRACT Due to the problems of soil degradation that currently occur, the free nitrogen biological fixers (FNBF), have potential as regenerating microorganisms of this resource. With the objective of evaluating its capacity as a functional group, isolation was sought in selective media Ashby and FBN; after its morphological and biochemical characterization; two types of seeds were inoculated, Zea mays and Brachiaria decumbens; planted in degraded soil (La Ortega property of the Universidad de Medellín). Four treatments were performed with 5 repetitions, during 36 days in the greenhouse. The most outstanding results are those described by Brachiaria decumbens by increasing the dry weight and the length of its roots thanks to a FNBF isolate (AshAssm4); which suggests its potential use to improve revegetalization processes.
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Amoebiasis is caused by the protozoan Entamoeba histolytica that affects millions of people throughout the world. The standard treatment is metronidazole, however, this drug causes several side effects, and is also mutagenic and carcinogenic. Therefore, the search for therapeutic alternatives is necessary. Quinoxaline 1,4-di-N-oxides (QdNOs) derivatives have been shown to exhibit activity against different protozoan. In the present study, the effects of esters of quinoxaline-7-carboxylate 1,4-di-N-oxide (7-carboxylate QdNOs) derivatives on E. histolytica proliferation, morphology, ultrastructure, and oxidative stress were evaluated, also their potential as E. histolytica thioredoxin reductase (EhTrxR) inhibitors was analyzed. In vitro tests showed that 12 compounds from n-propyl and isopropyl series, were more active (IC50 = 0.331 to 3.56 µM) than metronidazole (IC50 = 4.5 µM). The compounds with better biological activity have a bulky, trifluoromethyl and isopropyl group at R1-, R2-, and R3-position, respectively. The main alterations found in trophozoites treated with some of these compounds included changes in chromatin, cell granularity, redistribution of vacuoles with cellular debris, and an increase in reactive oxygen species. Interestingly, docking studies suggested that 7-carboxylate QdNOs derivatives could interact with amino acid residues of the NADPH-binding domain and/or the redox-active site of EhTrxR. Enzymatic assays demonstrated that selected 7-carboxylate QdNOs inhibits EhTrxR disulfide reductase activity, and diaphorase activity shows that these compounds could act as electron acceptor substrates for the enzyme. Taken together, these data indicate that among the mechanisms involved in the antiamoebic effect of the 7-carboxylate QdNOs derivatives studied, is the induction of oxidative stress and the inhibition of EhTrxR activity.
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Entamoeba histolytica/efeitos dos fármacos , Quinoxalinas/farmacologia , Tiorredoxina Dissulfeto Redutase/antagonistas & inibidores , Óxidos N-Cíclicos , Entamoeba histolytica/enzimologia , Ésteres , Humanos , Metronidazol/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Quinolinas , Espécies Reativas de Oxigênio/metabolismoRESUMO
In humans, mRNA polyadenylation involves the participation of about 20 factors in four main complexes that recognize specific RNA sequences. Notably, CFIm25, CPSF73, and PAP have essential roles for poly(A) site selection, mRNA cleavage, and adenosine residues polymerization. Besides the relevance of polyadenylation for gene expression, information is scarce in intestinal protozoan parasites that threaten human health. To better understand polyadenylation in Entamoeba histolytica, Giardia lamblia, and Cryptosporidium parvum, which represent leading causes of diarrhea worldwide, genomes were screened for orthologs of human factors. Results showed that Entamoeba histolytica and C. parvum have 16 and 12 proteins out of the 19 human proteins used as queries, respectively, while G. lamblia seems to have the smallest polyadenylation machinery with only six factors. Remarkably, CPSF30, CPSF73, CstF77, PABP2, and PAP, which were found in all parasites, could represent the core polyadenylation machinery. Multiple genes were detected for several proteins in Entamoeba, while gene redundancy is lower in Giardia and Cryptosporidium. Congruently with their relevance in the polyadenylation process, CPSF73 and PAP are present in all parasites, and CFIm25 is only missing in Giardia. They conserve the functional domains and predicted folding of human proteins, suggesting they may have the same roles in polyadenylation.
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Fator de Especificidade de Clivagem e Poliadenilação/genética , Cryptosporidium parvum/genética , Entamoeba histolytica/genética , Giardia lamblia/genética , Intestinos/parasitologia , RNA Mensageiro/genética , Fator de Especificidade de Clivagem e Poliadenilação/química , Fator de Especificidade de Clivagem e Poliadenilação/metabolismo , Cryptosporidium parvum/metabolismo , Bases de Dados Genéticas , Entamoeba histolytica/metabolismo , Giardia lamblia/metabolismo , Humanos , Modelos Moleculares , Fases de Leitura Aberta , Poli A/química , Domínios Proteicos , Estrutura Terciária de Proteína , Proteínas de Protozoários/química , Proteínas de Protozoários/genética , Proteínas de Protozoários/metabolismo , RNA Mensageiro/química , RNA de Protozoário/química , RNA de Protozoário/genética , Alinhamento de Sequência , Análise de Sequência de ProteínaRESUMO
Introducción: Analizar las perspectivas teóricas y prácticas que muestran las publicaciones científicas a nivel mundial, con respecto al síndrome de burnout, en el personal de enfermería que ofrece cuidado a la población adulta mayor. Metodología: Se realizó una revisión de literatura en el contexto mundial de artículos publicados en inglés y español, en las bases de datos de ScienceDirect, Biblioteca Virtual en Salud-BVS, Dialnet y Redalyc, en el período de 2013 a 2018. Resultados: 15 publicaciones que cumplían con los criterios de inclusión. La mayoría de los artículos originales tenían como objetivo identificar la correlación entre el síndrome de quemarse por el trabajo o estresores laborales; solamente un artículo reporta la evaluación de una intervención. En ninguno de los artículos se hace referencia a la enfermería geriátrica, como parte del constructo en el que se basa el estudio; pero la mayoría sí definen el burnout. Conclusiones: La evidencia científica revisada sobre el burnout en enfermería geriátrica es escasa, lo cual reta a investigar más, así como a publicar. También es necesario hacer explícitos estos dos constructos. Los resultados sugieren mejoras para futuros estudios en relación con los objetivos, la metodología y las intervenciones.
Introduction: Analyze the theoretical and practical perspectives shown in global scientific publications, regarding the burnout syndrome in the nursing staff that provide care to the elderly population. Methodology: A review of the literature was made for the global context of published articles in English and Spanish, from the databases of ScienceDirect, the Virtual Health Library (VHL), Dialnet and Redalyc, during the period from 2013 to 2018. Results: 15 publications met the selection criterion. The majority of the original articles had as their objective to identify the correlation between the burnout syndrome and the workload or work stress; only one article reports the evaluation of an intervention. None of the articles refer to gerontological nursing as part of the construct from which their studies are based on; but the majority do define the term burnout. Conclusions: The reviewed scientific evidence about burnout in gerontological nursing is scarce, which encourages to investigate more about the subject, as well as publishing. Also, it is necessary to make these constructs explicit. The results suggest future improvements for studies related to their objectives, the methodology used and the interventions.
Introdução: Analisar as perspectivas teóricas e práticas evidenciadas na literatura científica mundial, relacionada com a síndrome de Burnout no pessoal da enfermagem que presta cuidados na populaçao idosa. Métodos: Realizou-se uma revisão de literatura internacional de artigos publicados em inglês e espanhol disponíveis em ScienceDirect, Biblioteca Virtual em Saúde-BVS, Dialnet e Redalyc, no período de 2013 ao 2018. Resultados: 15 artigos cumpriram os critérios de elegibilidade. A maioria desses tinham como objetivo identificar a correlação entre o Burnout e situações estressoras no trabalho; somente um artigo reportou a avaliação de uma intervenção. Nenhum fazia referência à enfermagem geriátrica, que a variável de interesse do presente estudo; entretanto a maioria definia o Burnout. Conclusões: A evidência científica revisada relacionada com o Burnout na enfermagem geriátrica é escassa, evidenciando uma área que precisa de pesquisa e de publicação de resultados na mesma. Também precisa-se fazer maior ênfase nessas duas variáveis. Os resultados sugerem melhoras para futuros estudos relacionados com os objetivos, a metodologia e as intervenções.
Assuntos
Enfermagem Geriátrica , Esgotamento Profissional , Instituição de Longa Permanência para IdososRESUMO
Resumen Introducción: Desde hace muchos años se ha reconocido que uno de los escenarios más importantes para promover la salud es el entorno escolar. Objetivo: Se analizaron las tendencias teóricas y prácticas de la promoción de la salud en el ámbito escolar en Latinoamérica. Metodología: Revisión narrativa a partir de literatura científica publicada en el período 2007 a 2017 y vinculada en las bases de datos Scielo, Redalyc, Lilacs y Ebsco. Resultados: La búsqueda arrojó un total de 182 artículos, fueron seleccionados 75 estudios que cumplían con los criterios de inclusión y se analizaron. Existe una visión de la escuela como lugar propicio para el cuidado de la salud de los escolares, el trabajo intersectorial, desarrollo de políticas, conocimientos y ambientes, así como una relación con la educación para el autocuidado y el fomento de estilos de vida. La tendencia en cuanto a prácticas es a actuar en los estilos de vida desde el sector salud con enfoque biologicista e higienista. Conclusiones: Existe una brecha entre la teoría y la práctica pues si bien se mencionan perspectivas amplias de la promoción de la salud en el ámbito escolar las intervenciones están enmarcadas en el modelo biomédico, con enfoque de riesgo y con incipiente participación del sector educación.
Abstract Introduction: For many years it has been recognized that one of the most important scenarios to promote health is the school environment. Objective: To analyze the theoretical and practical trends of health promotion in the school environment in Latin America. Methods: Narrative review based on scientific literature published between 2007 and 2017 and linked in the databases Scielo, Redalyc, Lilacs and Ebsco. Results: The search yielded a total of 182 articles and 75 studies were selected that met the inclusion criteria and were analyzed. There is a vision of the school as a favorable place for health care for schoolchildren, intersectoral work, policy development, knowledge and environments, as well as a relationship with education for self-care and the promotion of lifestyles. The tendency in terms of practices is to act in lifestyles from the health sector with a biologicist and hygienist approach. Conclusions: There is a gap between theory and practice because although broad perspectives of health promotion in the school setting are mentioned, the interventions are framed in the biomedical model, with a focus on risk and with incipient participation of the education sector.
Assuntos
Humanos , Promoção da Saúde , Serviços de Saúde Escolar , Estudantes , Planos e Programas de Saúde , EducaçãoRESUMO
Aptamers are single-stranded DNA or RNA sequences with a unique three-dimensional structure that allows them to recognize a particular target with high affinity. Although their specific recognition activity could make them similar to monoclonal antibodies, their ability to bind to a large range of non-immunogenic targets greatly expands their potential as tools for diagnosis, therapeutic agents, detection of food risks, biosensors, detection of toxins, drug carriers, and nanoparticle markers, among others. One aptamer named Pegaptanib is currently used for treating macular degeneration associated with age, and many other aptamers are in different clinical stages of development of evaluation for various human diseases. In the area of parasitology, research on aptamers has been growing rapidly in the past few years. Here we describe the development of aptamers raised against the main protozoan parasites that affect hundreds of millions of people in underdeveloped and developing countries, remaining a major health concern worldwide, i.e. Trypanosoma spp., Plasmodium spp., Leishmania spp., Entamoeba histolytica, and Cryptosporidium parvuum. The latest progress made in this area confirmed that DNA and RNA aptamers represent attractive alternative molecules in the search for new tools to detect and treat these parasitic infections that affect human health worldwide.
RESUMO
BACKGROUND: Limited data are available on the effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13) in resource-poor settings and PCV naïve populations. The Dominican Republic introduced PCV13 in September 2013 using a 2 + 1 schedule (2, 4, and 12 months) without a catch-up campaign. We evaluated PCV13 effectiveness against vaccine-type (VT) invasive pneumococcal disease (IPD) among children in the Dominican Republic. METHODS: We conducted a matched case-control study. A case-patient was defined as VT-IPD identified by culture or polymerase chain reaction (PCR) from a normally sterile-site in a hospitalized child who was age-eligible to have received ≥1 PCV13 dose. Four age- and neighborhood-matched controls were enrolled for each case-patient. We collected demographic, vaccination history, and risk factor data. Conditional logistic regression was performed. Vaccine effectiveness was calculated as (1- adjusted matched odds ratio for vaccination) X 100%. RESULTS: We enrolled 39 case-patients and 149 matched-controls. Most case-patients had pneumonia with pleural effusion (64%), followed by meningitis (28%) and septicemia (13%). The most common pneumococcal serotypes identified included 14 (18%), 3 (13%), 19A (10%), and 1 (8%). Fewer case-patients had ≥1 PCV13 dose as compared to controls (61.5% vs. 80.0%; p = 0.006). Adjusting for malnutrition and socioeconomic status, VE of ≥1 PCV13 dose compared to no doses was 67.2% (95% CI: 2.3% to 90.0%). Only 44% of controls were up-to-date for PCV13, suggesting low vaccine coverage in the population. CONCLUSIONS: We found that PCV13 provided individual protection against VT-IPD in this resource-poor setting with a PCV-naïve population, despite low PCV13 coverage. Expanding vaccination coverage might increase PCV13 impact.
Assuntos
Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/uso terapêutico , Vacinas Conjugadas/uso terapêutico , Estudos de Casos e Controles , Criança Hospitalizada , República Dominicana/epidemiologia , Feminino , Humanos , Lactente , Masculino , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/patologia , Sepse/epidemiologia , Sepse/prevenção & controle , Classe Social , Resultado do Tratamento , Vacinação/estatística & dados numéricosRESUMO
The 25 kDa subunit of the Clevage Factor Im (CFIm25) is an essential factor for messenger RNA polyadenylation in human cells. Therefore, here we investigated whether the homologous protein of Entamoeba histolytica, the protozoan responsible for human amoebiasis, might be considered as a biochemical target for parasite control. Trophozoites were cultured with bacterial double-stranded RNA molecules targeting the EhCFIm25 gene, and inhibition of mRNA and protein expression was confirmed by RT-PCR and Western blot assays, respectively. EhCFIm25 silencing was associated with a significant acceleration of cell proliferation and cell death. Moreover, trophozoites appeared as larger and multinucleated cells. These morphological changes were accompanied by a reduced mobility, and erythrophagocytosis was significantly diminished. Lastly, the knockdown of EhCFIm25 affected the poly(A) site selection in two reporter genes and revealed that EhCFIm25 stimulates the utilization of downstream poly(A) sites in E. histolytica mRNA. Overall, our data confirm that targeting the polyadenylation process represents an interesting strategy for controlling parasites, including E. histolytica. To our best knowledge, the present study is the first to have revealed the relevance of the cleavage factor CFIm25 as a biochemical target in parasites.
Assuntos
Entamoeba histolytica/genética , Entamoeba histolytica/metabolismo , Genes de Protozoários/genética , Proteínas de Protozoários/genética , Proteínas de Protozoários/metabolismo , Morte Celular , Movimento Celular , Proliferação de Células , Sobrevivência Celular , Entamoeba histolytica/patogenicidade , Entamebíase/parasitologia , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Técnicas de Silenciamento de Genes , Inativação Gênica , Genes Reporter , Humanos , Fagocitose , RNA Mensageiro/metabolismo , RNA de Protozoário/metabolismo , Trofozoítos/citologia , Trofozoítos/metabolismo , Fatores de Virulência/genética , Fatores de Poliadenilação e Clivagem de mRNA/genética , Fatores de Poliadenilação e Clivagem de mRNA/metabolismoRESUMO
We report the genome of a novel human triple-recombinant G4P[6-8_R] mono-reassortant strain identified in a stool sample from the Dominican Republic during routine facility-based rotavirus strain surveillance. The strain was designated as RVA/Human-wt/DOM/2013840364/2013/G4P[6-8_R], with a genomic constellation of G4-P[6-8_R]-I1-R1-C1-M1-(A1-A8_R)-N1-(T1-T7_R)-E1-H1. Recombinant gene segments NSP1 and NSP3 were generated as a result of recombination between genogroup 1 rotavirus A1 human strain and a genotype A8 porcine strain and between genogroup 1 rotavirus T1 human strain and a genotype T7 bovine strain, respectively. Analyses of the RNA secondary structures of gene segment VP4, NSP1 and NSP3 showed that all the recombinant regions appear to start in a loop (single-stranded) region and terminate in a stem (double-stranded) structure. Also, the VP7 gene occupied lineage VII within the G4 genotypes consisting of mostly porcine or porcine-like G4 strains, suggesting the occurrence of reassortment. The remaining gene segments clustered phylogenetically with genogroup 1 strains. This exchange of whole or partial genetic materials between rotaviruses by recombination and reassortment contributes directly to their diversification, adaptation and evolution.
Assuntos
Gastroenterite/virologia , Genoma Viral , Vírus Reordenados/genética , Recombinação Genética , Infecções por Rotavirus/virologia , Rotavirus/genética , Adaptação Fisiológica/genética , Animais , Bovinos/virologia , República Dominicana , Monitoramento Epidemiológico , Evolução Molecular , Fezes/virologia , Gastroenterite/veterinária , Variação Genética , Genômica , Genótipo , Humanos , Família Multigênica , Conformação de Ácido Nucleico , Filogenia , RNA Viral/química , RNA Viral/genética , Vírus Reordenados/classificação , Rotavirus/classificação , Rotavirus/isolamento & purificação , Análise de Sequência de DNA , Suínos/virologia , Proteínas não Estruturais Virais/genéticaRESUMO
Introducción: La educación para la salud es una herramienta fundamental en salud pública, donde los fisioterapeutas cumplen un rol importante; fomentando comportamientos que protegen la salud o previniendo aquellos que la ponen en riesgo. Objetivo: Identificar las características de experiencias en educación para la salud que llevan a cabo fisioterapeutas a nivel mundial. Materiales y métodos:Estudio descriptivo, mediante revisión documental de experiencias divulgadas en artículos publicados entre 1995 y 2014. Resultados: Se identificaron 30 experiencias de fisioterapeutas como educadores para la salud, reportadas en artículos científicos. Las áreas de aplicación fueron, musculo-esquelética (20; 66,6%) y actividad física o ejercicio físico (6; 20%). Existen debilidades en las bases teóricas; además, se utilizan principalmente estrategias metodológicas tradicionales como la consejería (24,2%), la educación individual (21,2%) y la combinación de consejería con material de educación y comunicación (9,1%); los impresos son ampliamente usados. Las evaluaciones que se realizan son principalmente de tipo cuantitativo. Conclusiones: Son escasas las publicaciones científicas sobre intervenciones de educación para la salud realizadas por fisioterapeutas. Las reportadas en este artículo se desarrollan principalmente en el área músculo-esquelética, pero no se encuentra una clara fundamentación teórica; existiendo confusión y uso indiscriminado del término educación para la salud y promoción de la salud. Se plantean retos normativos y formativos para los fisioterapeutas como educadores para la salud, así como problemas para ser resueltos en futuras investigaciones.
Introduction: Health education is a fundamental tool in public health, where the physiotherapists play an important role by either promoting behaviors that protect the health or preventing those that put it at risk. Objective:To identify the characteristics of experiences of HE that physiotherapists carry out worldwide. Materials and methods:A descriptive study was performed by using documentary review of experiences reported in articles published from 1995 to 2014. Results:30 experiences of physiotherapists as health educators were identified, which were reported in scientific papers. The areas of application were musculoskeletal (20; 69%) and physical activity or exercise (6; 20.6%). There are weaknesses in the theoretical foundations; in addition, traditional methodological strategies such as counseling (24.2%), individual education (21.2%) and the combination of counseling with educational material (9.1%) are used. Printed materials are also widely used. Evaluations carried out are mainly quantitative. Conclusions: There are few scientific publications of experiences about Health education in physiotherapy. Those reported in this article are mainly developed in the muscle-skeletal area. However, there is not a clear theoretical foundation; there is confusion and an indiscriminate use of the term Health education and health promotion. There are normative and training challenges for physiotherapists as health educators; as well as problems to be solved in future research.
Assuntos
Educação , Promoção da Saúde , Especialidade de Fisioterapia , Estilo de Vida SaudávelRESUMO
Se describe el caso de una niña de 2 años 3 meses de edad, con diagnóstico de parálisis cerebral espástica causada por hipoxia perinatal, quien fue referida a la Clínica Odontológica de la Universidad de San Martín de Porres (USMP), para su respectivo tratamiento. Se evaluó a la paciente de manera integral, utilizando el sistema internacional de registro y diagnóstico de caries (ICDAS) que permite determinar la severidad de la lesión y la evolución de la enfermedad, estableciéndose un plan de tratamiento restaurador con procedimientos odontológicos no convencionales, teniendo en cuenta la edad y condición sistémica de la paciente, buscando brindarle una mejor salud bucal acorde a sus necesidades de atención especial.
The case of a girl of 2 years and 3 months old is described, with a diagnosis of spastic cerebral palsy caused by perinatal hypoxia,who was referred to the Dental Clinic of the San Martin de Porres University (SMPU), for her treatment. The patient was assessed integrally, using the international system of caries detection and assessment (ICDAS) which allows to determine the severity of thecaries lesions and the evolution of the disease, establishing a plan for dental restorative treatment with non-conventional procedures,taking into account the age and the systemic condition of the patient, looking to provide the best oral health approach for her special needs.