RESUMO
Artificial Intelligence (AI) represents a significant milestone in health care's digital transformation. However, traditional health care education and training often lack digital competencies. To promote safe and effective AI implementation, health care professionals must acquire basic knowledge of machine learning and neural networks, critical evaluation of data sets, integration within clinical workflows, bias control, and human-machine interaction in clinical settings. Additionally, they should understand the legal and ethical aspects of digital health care and the impact of AI adoption. Misconceptions and fears about AI systems could jeopardize its real-life implementation. However, there are multiple barriers to promoting electronic health literacy, including time constraints, overburdened curricula, and the shortage of capacitated professionals. To overcome these challenges, partnerships among developers, professional societies, and academia are essential. Integrating specialists from different backgrounds, including data specialists, lawyers, and social scientists, can significantly contribute to combating digital illiteracy and promoting safe AI implementation in health care.
Assuntos
Inteligência Artificial , Currículo , Humanos , Escolaridade , Redes Neurais de Computação , Aprendizado de MáquinaRESUMO
BACKGROUND/AIM: Renin-angiotensin system (RAS) is present in a diverse type of cells and plays an important role in lung physiology and pathophysiology. Angiotensin converting enzymes (ACE) are part of the RAS system. There are still controversies about the association of I/D polymorphisms of ACE1 with COVID-19 severity. The goal of the study was to determine whether there is an association of the I/D polymorphism with severity of COVID-19 in Mexican patients. PATIENTS AND METHODS: The study included voluntary participants: 53 healthy individuals negative to RT-PCR COVID-19 (control), and 165 patients positive to COVID-19. Severity was defined by the need of hospitalization, invasive ventilation, shock, or multiple organ failure. The patient group consisted of 28 asymptomatic, 82 with mild, and 55 with severe COVID-19. I/D polymorphism was determined by PCR. Rutinary laboratory tests were performed in all the participants. RESULTS: DD polymorphism was significantly associated with severe COVID-19, independently of comorbidities, or any other variable. Receiver operator characteristic curves demonstrated association of low total cholesterol, low high-density lipoproteins, and high c-reactive protein with severity of COVID-19. CONCLUSION: The DD polymorphism was associated with the course of the infection and severity of COVID-19 in a sample of Mexican patients.
Assuntos
COVID-19 , Humanos , COVID-19/genética , Lipídeos/sangue , Polimorfismo Genético , Sistema Renina-Angiotensina/genéticaRESUMO
BACKGROUND: Surgically induced adhesions complicate up to 100% of abdominal surgeries. Food and Drug Administration-approved treatments are generally not only less effective than desired but they also have major contraindications. Oxychlorine species, including chlorine dioxide (ClO2), suppress scar formation in infected wounds without affecting keratinocytes while reducing fibroblast proliferation. The aim of the present study was to evaluate the effect of oxychlorine solutions containing ClO2 on adhesion formation. METHODS: Male Wistar rats were subjected to Buckenmaier model of surgical adhesions and treated with either oxychlorine solutions containing ClO2 (40-150 ppm) or isotonic saline solution. To increase the severity of adhesions, peritonitis was produced by intraperitoneal administration of a diluted nonlethal dose of feces (50 mg/kg). Wound strength of the healed wound was measured to evaluate the effects of oxychlorine solutions. In addition, an oxychlorine solution of lesser efficacy (at 100 ppm) was compared with three available anti-adhesion materials. RESULTS: Reproducibility of the model was validated in 26 rats. Oxychlorine solutions containing ClO2 (40-110 ppm) significantly reduced postsurgical adhesion formation without affecting the strength of the healed wound. Higher concentrations (120 and 150 ppm) had no effect. Fecal peritonitis significantly increased, and solutions with ClO2 at 110 ppm significantly reduced adhesion formation. The effect of the oxychlorine solution was significantly greater than that of Interceed, Guardix, Seprafilm, and isotonic saline solution. CONCLUSIONS: ClO2-containing oxychlorine solutions could be an innovative strategy for the suppression of surgical adhesion formation, with the additional advantage of contributing antiseptic properties.
Assuntos
Compostos Clorados/farmacologia , Óxidos/farmacologia , Aderências Teciduais/prevenção & controle , Animais , Relação Dose-Resposta a Droga , Hipóxia/complicações , Masculino , Ratos , Ratos Wistar , Reprodutibilidade dos Testes , Aderências Teciduais/etiologiaRESUMO
Oxidative stress (OS) induced by acute exercise is reduced by chronic exercise. Ozone (O(3)) exposure produces OS. The aim of this study was to determine if aerobic exercise (AE) reduced OS produced by O(3). A pilot experiment was performed with male Wistar rats submitted to AE (trained to swim 90 min/day). Adaptation to exercise was demonstrated three weeks after training by means of changes in reduced nitrates (NO(x)) in plasma. Therefore, two-week training was chosen for the following experiments. Six of twelve trained rats were exposed to O(3) (0.5 ppm, 4 h/day, one hour before exercise). Two groups of sedentary animals (n = 6 each) were used as controls, one of which was exposed to O(3). At the end of the experiments NO(x), 8-isoprostane (8-IP), malondialdehyde (MDA), superoxide dismutase (SOD) activity, and carbonyls (CBs) were measured in plasma. CBs did not change in any group. O(3)-induced OS was manifested by reduced NO(x) and SOD activity, as well as increased 8-IP and MDA. Exercise significantly blocked O(3) effects although SOD was also decreased by exercise (a greater drop occurring in the O(3) group). It is concluded that AE protects against OS produced by O(3) and the effect is independent of SOD.
Assuntos
Estresse Oxidativo/efeitos dos fármacos , Ozônio/farmacologia , Condicionamento Físico Animal , Animais , Dinoprosta/análogos & derivados , Dinoprosta/metabolismo , Masculino , Malondialdeído/metabolismo , Óxido Nítrico/metabolismo , Ratos , Ratos Wistar , Superóxido Dismutase/metabolismoRESUMO
Antioxidants are among the most popular health-protecting products, sold worldwide without prescription. Indeed, there are many reports showing the benefits of antioxidants but only a few questioning the possible harmful effects of these "drugs". The normal balance between antioxidants and free radicals in the body is offset when either of these forces prevails. The available evidence on the harmful effects of antioxidants is analyzed in this review. In summary, a hypothesis is presented that "antioxidant-induced stress" results when antioxidants overwhelm the body's free radicals.
Assuntos
Antioxidantes/efeitos adversos , Estresse Oxidativo/efeitos dos fármacos , Ensaios Clínicos como Assunto , Progressão da Doença , Exercício Físico/fisiologia , Radicais Livres/metabolismo , Humanos , Espécies Reativas de Oxigênio/metabolismo , Espécies Reativas de Oxigênio/farmacologia , Superóxidos/metabolismoRESUMO
Pain is a symptom associated with alterations of the musculoskeletal system and frequently needs to be treated by the orthopedist. The purpose of this review is to analyze the mechanisms involved in the pain sensation and the various treatments that have been applied in orthopedics to control pain. Since it is known that the analgesic response is not the same in all patients, aspects that affect the pain sensation were assessed, such as the placebo effect, patients sex and genomic factors. The treatment varieties analyzed included drug therapy, considering the drugs, their pharmaceutical presentations and the route of administration most frequently used in orthopedics; and acupuncture, which has proven to be effective in special cases.
Assuntos
Analgesia , Doenças Musculoesqueléticas/complicações , Manejo da Dor , Analgesia por Acupuntura , Analgésicos/uso terapêutico , Humanos , Dor/etiologiaRESUMO
Larrea tridentata also known as Creosote bush, Larrea, chaparral, greasewood or gobernadora has been used in the folk medicine for the treatment of several illnesses. The primary product that is present at high concentrations in the leaves from this plant is nordihydroguaiaretic acid (NDGA) which is a powerful antioxidant. On the other hand, potassium dichromate (K(2)Cr(2)O(7))-induced nephrotoxicity is associated with oxidative stress. The aim of this work was to study the effect of NDGA on K(2)Cr(2)O(7)-induced nephrotoxicity and oxidative stress. Nephrotoxicity was induced by a single injection of K(2)Cr(2)O(7) (15 mg/Kg). A group of K(2)Cr(2)O(7)-treated rats was administered NDGA by mini osmotic pumps (17 mg/Kg/day). The results show that NDGA was able to ameliorate the structural and functional renal damage evaluated by histopathological analysis and by measuring proteinuria, urinary excretion of N-acetyl-beta-d-glucosaminidase, serum creatinine, and serum glutathione peroxidase activity. In addition, immunostaining of 4-hydroxy-2-nonenal and 3-nitrotyrosine, markers of oxidative and nitrosative stress, respectively, was ameliorated by the NDGA treatment. These data strongly suggest that the antioxidant properties of NDGA are involved in its renoprotective effect in K(2)Cr(2)O(7)-treated rats.
Assuntos
Rim/efeitos dos fármacos , Masoprocol/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Dicromato de Potássio/toxicidade , Animais , Feminino , Imuno-Histoquímica , Ratos , Ratos WistarRESUMO
The ability of estradiol to affect phenylephrine-induced contraction and the subsequent increase in resting tone, associated with capacitative Ca(2+) entry across the plasma membrane, was evaluated in rat aortic rings incubated in Ca(2+)-free solution. The incubation with estradiol (1-100 nM, 5 min) inhibited both the phenylephrine-induced contraction and the IRT. Neither cycloheximide (1 microM; inhibitor of protein synthesis) nor tamoxifen (1 microM; blocker of estrogenic receptors) modified the effects of estradiol. Estradiol (100 microM) also blocked the contractile response to serotonin (10 microM) but not to caffeine (10 mM). In addition, estradiol (100 microM) inhibited the contractile responses to cyclopiazonic acid (1 microM; selective Ca(2+)-ATPase inhibitor) associated with capacitative Ca(2+) influx through non-L-type Ca(2+) channels. Finally, estradiol inhibited the Ca(2+)-induced increases in intracellular free Ca(2+) (after pretreatment with phenylephrine) in cultured rat aorta smooth muscle cells incubated in Ca(2+)-free solution. In conclusion, estradiol interfered in a concentration-dependent manner with Ca(2+)-dependent contractile effects mediated by the stimuli of alpha(1)-adrenergic and serotonergic receptors and inhibited the capacitative Ca(2+) influx through both L-type and non-L-type Ca(2+) channels. Such effects are in essence nongenomic and not mediated by the intracellular estrogenic receptor.
Assuntos
Aorta/efeitos dos fármacos , Cálcio/metabolismo , Estradiol/farmacologia , Fenilefrina/farmacologia , Vasoconstritores/farmacologia , Vasodilatação/fisiologia , Animais , Aorta/anatomia & histologia , Aorta/metabolismo , Cafeína/farmacologia , Células Cultivadas , Cicloeximida/farmacologia , Relação Dose-Resposta a Droga , Estradiol/análogos & derivados , Antagonistas de Estrogênios/farmacologia , Feminino , Fulvestranto , Indóis/farmacologia , Masculino , Músculo Liso Vascular/citologia , Músculo Liso Vascular/efeitos dos fármacos , Músculo Liso Vascular/metabolismo , Miócitos de Músculo Liso/citologia , Miócitos de Músculo Liso/metabolismo , Inibidores de Fosfodiesterase/farmacologia , Bloqueadores dos Canais de Potássio/farmacologia , Progesterona/farmacologia , Inibidores da Síntese de Proteínas/farmacologia , Ratos , Ratos Wistar , Serotonina/farmacologia , Tamoxifeno/farmacologia , Testosterona/farmacologia , Tetraetilamônio/farmacologia , Vasodilatadores/farmacologiaRESUMO
The aim was to study whether ozone affects vascular endothelium by causing inducible nitric oxide synthase (iNOS) expression and tyrosine nitration. We also studied biomarkers of endothelial function. Male Wistar rats were exposed to ozone (0.25ppm, 4h/day) or filtered air (control, ozone <0.05ppm). After ozone exposure, blood samples were taken to measure 6-keto prostaglandin F1α (6-keto PGF1α), dehydro-thromboxane B(2) (DH-TxB(2)), endothelin-1 and NO(2)(-)/NO(3)(-) (NO(x)(-)). iNOS and nitrotyrosine were detected in aorta by immunohistochemistry. Nitrotyrosine was also detected by immunoelectromicroscopy. Control aortae failed to show either iNOS or nitrotyrosine. Time-dependent positive iNOS and nitrotyrosine cells were observed in exposed animals. Except for NO(x)(-), endothelial markers decreased after 14 days of ozone exposure (P<0.05). After 28 days of ozone, 6-keto PGF1α remained low (P<0.05) while DH-TxB(2) increased (P<0.05). It is concluded that ozone causes endothelial dysfunction manifested early with peroxynitrite formation and lately with changes in endothelial markers.
RESUMO
This work evaluates the feasibility of monitoring ischemic injury in the gastrointestinal mucosa by impedance spectroscopy, using a minimally invasive intestinal catheter. The disruption of the intestinal mucosa plays a key role in the evolution of shock and is the 'motor of multiple organ failure'. Different technologies have been developed to monitor mucosal perfusion, oxygenation and/or ischemia, but no practical method exists to assess tissue damage, which may be crucial for preventing multiple organ failure. The experimental protocol of this study relied on an isobaric model of hypovolemic shock in 16 anaesthetized rabbits assigned to three groups: sham (n = 6), ischemia (n = 5) and ischemia + reperfusion (n = 5). Complex impedance spectra were recorded in the range of 0.05 to 300 kHz, with simultaneous measurements of tonometric pHi in the ileum every 30 min for 4 h. Impedance spectra were reproducible, and those of tissue under prolonged ischemia were clearly differentiable from those of normally perfused tissue. The dynamic changes in impedance did not correlate directly with either tissue perfusion or pHi, but instead correlated well with the duration of ischemia. It is concluded that impedance spectroscopy does indeed measure changes in tissue injury, and could be a very useful tool to guide therapy of patients in shock.