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Objetivo: una tecnología médica es el conjunto de técnicas, medicamentos, equipos y procedimientos utilizados por los profesionales de la salud en la atención médica. Este estudio busca identificar los criterios de evaluación de nuevas tecnologías en salud que utilizan algunos hospitales. Metodología: estudio observacional de corte transversal. Se incluyeron todos los directores de hospitales y clínicas del departamento de Antioquia que estuvieran interesados en participar en la investigación. Se aplicó una encuesta de 21 preguntas. Resultados: el 60 % de los encuestados dio la máxima importancia a la capacidad de producción de daños en la atención de los pacientes; el 90 % tiene en cuenta el criterio de seguridad clínica (éticos y jurídicos) y el 100 % lo hace con la evaluación de costo efectividad. En cuanto al orden de relevancia para la toma de decisiones en la adquisición de nuevas tecnologías, el perfil epidemiológico institucional tuvo mayor calificación. Conclusiones: las instituciones de salud encuestadas tienen protocolos establecidos para la evaluación de tecnologías. Se identificaron los temas a los que se les da mayor priorización, como son la producción de daños a la atención de pacientes, la seguridad clínica, aspectos éticos y jurídicos, y la evaluación de costo efectividad
Introduction: A medical technology is the set of techniques, drugs, equipment, and procedures used by health professionals in the delivery of medical care. Objective: to identify the criteria for evaluating new health technologies used by some hospitals. Methodology: An observational cross-sectional study was carried out. All the directors of Hospitals and Clinics of the department of Antioquia who belonged to one and who were interested in participating in the research were included. A survey of 21 questions was applied. Results: 60 % of the respondents gave the maximum importance to the capacity to produce damages in the care of patients, 90 % consider the criteria of clinical, ethical, and legal safety; and 100 % do it with the evaluation of cost effectiveness. In relation to the order of relevance for decision-making in the acquisition of new health technologies, it was evidenced that the institutional epidemiological profile had a higher rating. Conclusions: The surveyed health institutions have established protocols in the evaluation of new health technologies. Likewise, the issues that are given the highest priority were identified, such as the issue of harm to patient care, clinical safety, ethical and legal aspects, and cost-effectiveness evaluation.
Objetivo: uma tecnologia médica é o conjunto de técnicas, medicamentos, equipamentose procedimentos utilizados pelos profissionais da saúde na atenção médica. Este estudobusca identificar os critérios de avaliação de novas tecnologias na saúde que utilizam alguns hospitais. Metodologia: estudo observacional de corte transversal. Se incluíram todos os diretoresde hospitais e clínicas do Departamento de Antioquia que estiveram interessados em participar na investigação. Se aplicou uma enquete de 21 perguntas. Resultados: 60 % dos entrevistados deram a máxima importância na capacidade de produção de danos na atenção dos pacientes; 90% têm em conta o critério de segurançaclínica (éticos e jurídicos) e 100% o fazem com a avaliação de custo efetividade. Enquantoà ordem de relevância para a toma de decisões na aquisição de novas tecnologias, o perfil epidemiológico institucional teve maior qualificação. Conclusões: as instituições de saúde entrevistadas têm protocolos estabelecidos para a avaliação de tecnologias. Se identificaram os temas aos quais se deve dar maior priorização, como são a produção de danos à atenção de pacientes, a segurança clínica, aspectos éticos jurídicos, a avaliação de custo efetividade.
Assuntos
Humanos , Análise Custo-Benefício , Avaliação da Tecnologia Biomédica , Organização Mundial da Saúde , Custos e Análise de Custo , Economia , Equipamentos e ProvisõesRESUMO
Exosomes are lipid membrane-enclosed vesicles released by all cell types that act at the paracrine or endocrine level to favor cell differentiation, tissue homeostasis, organ remodeling and immune regulation. Their biosynthesis begins with a cell membrane invagination which generates an early endosome that matures to a late endosome. By inward budding of the late endosome membrane, a multivesicular body (MVB) with intraluminal vesicles (ILVs) is generated. The fusion of MVBs with the plasma membrane releases ILVs into the extracellular space as exosomes, ranging in size from 30 to 100 nm in diameter. The bilipid exosome membrane is rich in cholesterol, ceramides and phosphatidylserine and can be loaded with DNA, RNA, microRNAs, proteins and lipids. It has been demonstrated that exosome secretion is a common mechanism used by the tumor to generate an immunosuppressive microenvironment that favors cancer development and progression, allowing tumor escape from immune control. Due to their ability to transport proteins, lipids and nucleic acids from the cell that gave rise to them, exosomes can be used as a source of biomarkers with great potential for clinical applications in diagnostic, prognostic or therapeutic areas. This article will review the latest research findings on exosomes and their contribution to cancer development.
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Saccharomyces yeasts are able to ferment simple sugars to generate levels of ethanol that are toxic to other yeasts and bacteria. The tolerance to ethanol of different yeasts depends also on the incubation temperature. In this study, the ethanol stress responses of S. cerevisiae and the probiotic yeast S. boulardii CNCM I-745 were evaluated at two temperatures. The growth kinetics parameters were obtained by fitting the Baranyi and Roberts model to the experimental data. The four-parameter logistic Hill equation was used to describe the ethanol tolerance of the yeasts at the temperatures of 28 and 37 °C. Adequate determination coefficients were obtained (R2 > 0.91) in all cases. S. boulardii grown at 28 °C was selected as the yeast with the best ethanol tolerance (6-8%) for use in the elaboration of functional craft beers.
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Cerveja/microbiologia , Etanol/metabolismo , Modelos Biológicos , Probióticos , Saccharomyces cerevisiae/metabolismoRESUMO
En Colombia el cultivo de plátano ocupa uno de los principales renglones de la economía; hace parte de la canasta familiar y es una fuente de empleo en las zonas donde se cultiva. La producción de este frutal se ve amenazada por el ataque de nematodos fitoparásitos que afectan el sistema radical, disminuyen la absorción de nutrientes y sirven como puerta de entrada a patógenos. Debido a esto, se requieren manejos que permitan la regulación de las poblaciones mediante estrategias que no atenten contra el equilibrio del ecosistema y que presenten una ventaja competitiva frente a los tratamientos tradicionales. En este estudio se evaluó la respuesta poblacional de fitonematodos del plátano Dominico Hartón, la presencia de hongos micorrícicoarbusculares (HMA) y la actividad de lombrices a la inoculación con HMA, lixiviado de compost de raquis de plátano y lombricompost. Los resultados obtenidos en la investigación sugieren que la respuesta de la población de fitonematodos a los tratamientos evaluados, mostró gran dependencia de las características parasíticas de cada género y que la aplicación de lombricompost, HMA y lixiviado de raquis de plátano pueden tener potencial en la regulación de las poblaciones de fitonematodos en el cultivo.
Plantain cultivation in Colombia occupies one of the main areas of the economy: plantain is part of the shopping basket and is a source of employment in the areas where it is cultivated. The production of this fruit is threatened by the attack of phytoparasitic nematodes affecting the root system, reducing the absorption of nutrients and serving as a gateway to pathogens. Because of this, maneuvers which allow the regulation of populations through strategies that do not threaten the balance of the ecosystem and that show a competitive advantage over traditional treatments. The phytonematodes population response of Dominico-Harton plantain, the presence of arbuscular mycorrhizal fungi (AMF) and earthworm activity to HMA inoculation, leachate from plantain compost rachis and earthworm compost were evaluated in this study. The results obtained from this research suggest that the phytonematodes population response to the treatments evaluated, showed strong dependence on parasitic characteristics of each gender and than the application of earthworm compost, AMF and leachate from plantain compost rachis may have a potential in the regulation of phytonematodes populations in cultivation.
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Cationic antimicrobial peptides (AMPs) have attracted a great interest as novel class of antibiotics that might help in the treatment of infectious diseases caused by pathogenic bacteria. However, some AMPs with high antimicrobial activities are also highly hemolytic and subject to proteolytic degradation from human and bacterial proteases that limit their pharmaceutical uses. In this work a D-diastereomer of Pandinin 2, D-Pin2, was constructed to observe if it maintained antimicrobial activity in the same range as the parental one, but with the purpose of reducing its hemolytic activity to human erythrocytes and improving its ability to resist proteolytic cleavage. Although, the hydrophobic and secondary structure characteristics of L- and D-Pin2 were to some extent similar, an important reduction in D-Pin2 hemolytic activity (30-40 %) was achieved compared to that of L-Pin2 over human erythrocytes. Furthermore, D-Pin2 had an antimicrobial activity with a MIC value of 12.5 µM towards Staphylococcus aureus, Escherichia coli, Streptococcus agalactiae and two strains of Pseudomonas aeruginosa in agar diffusion assays, but it was half less potent than that of L-Pin2. Nevertheless, the antimicrobial activity of D-Pin2 was equally effective as that of L-Pin2 in microdilution assays. Yet, when D- and L-Pin2 were incubated with trypsin, elastase and whole human serum, only D-Pin2 kept its antimicrobial activity towards all bacteria, but in diluted human serum, L- and D-Pin2 maintained similar peptide stability. Finally, when L- and D-Pin2 were incubated with proteases from P. aeruginosa DFU3 culture, a clinical isolated strain, D-Pin2 kept its antibiotic activity while L-Pin2 was not effective.
Assuntos
Antibacterianos/química , Peptídeos Catiônicos Antimicrobianos/química , Peptídeos/química , Sequência de Aminoácidos , Antibacterianos/farmacologia , Peptídeos Catiônicos Antimicrobianos/farmacologia , Bactérias/efeitos dos fármacos , Estabilidade Enzimática , Eritrócitos/efeitos dos fármacos , Hemólise , Humanos , Dados de Sequência Molecular , Elastase Pancreática/química , Peptídeos/farmacologia , Conformação Proteica , Estabilidade Proteica , Estereoisomerismo , Tripsina/químicaRESUMO
OBJECTIVE: To evaluate the acceptance and long-term use of insecticide-treated (IT) materials for dengue vector control. METHODS: In 2007, IT jar covers and/or curtains (PermaNet®) were distributed under routine conditions to 4101 households (10 clusters) in Venezuela and to 2032 households (22 clusters) in Thailand. The use of IT tools was measured at distribution (uptake), at 5/6 months (short-term use) and at 18/22 months (continued use) after distribution. Determinants of use were assessed with logistic regression analysis. RESULTS: The uptake of IT curtains was 76.7% in Venezuela and 92.3% in Thailand. It was associated with being a resident for >5 years (OR Venezuela 3.0 95% CI 2.0-4.4; OR Thailand 3.5 95% CI 1.7-7.3) and with pre-intervention use of ordinary curtains (OR Venezuela 2.2 95% CI 1.4-3.6). The continued use decreased significantly to 38.4% of households in Venezuela and 59.7% in Thailand and was, conditional on short-term use, only determined by the perceived effectiveness of IT curtains (OR Venezuela 13.0 95%CI 8.7-19.5; OR Thailand 4.9 95% CI 3.1-7.8). Disease knowledge and pre-intervention perception of mosquito nuisance were not associated with IT curtains' uptake or use. The uptake of IT jar covers in Venezuela was 21.5% and essentially determined by the presence of uncovered jars in the household (OR 32.5 95% CI 14.5-72.6). Their continued use, conditional on short-time use, was positively associated with the household use of Abate® (OR 7.8 95% CI 2.1-28.9). CONCLUSION: The use of IT curtains rapidly declines over time. Continued use is mainly determined by the perceived effectiveness of the tool. This poses a real challenge if IT curtains are to be introduced in dengue control programmes.
Assuntos
Dengue/prevenção & controle , Utensílios Domésticos , Inseticidas/administração & dosagem , Controle de Mosquitos/métodos , Aedes , Animais , Serviços de Saúde Comunitária/métodos , Serviços de Saúde Comunitária/estatística & dados numéricos , Dengue/transmissão , Seguimentos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Insetos Vetores , Decoração de Interiores e Mobiliário , Aceitação pelo Paciente de Cuidados de Saúde , Fatores Socioeconômicos , Tailândia , Venezuela , Abastecimento de ÁguaRESUMO
Four variants of the highly hemolytic antimicrobial peptide Pin2 were chemically synthesized with the aim to investigate the role of the proline residue in this peptide, by replacing it with the motif glycine-valine-glycine [GVG], which was found to confer low hemolytic activity in a spider antimicrobial peptide. The proline residue in position 14 of Pin2 was substituted by [V], [GV], [VG] and [GVG]. Only the peptide variant with the proline substituted for [GVG] was less hemolytic compared to that of all other variants. The peptide variant [GVG] kept its antimicrobial activity in Muller-Hilton agar diffusion assays, whereas the other three variants were less effective. However, all Pin2 antimicrobial peptide variants, were active when challenged against a Gram-positive bacteria in Muller-Hilton broth assays suggesting that chemical properties of the antimicrobial peptides such as hydrophobicity is an important indication for antimicrobial activity in semi-solid environments.
Assuntos
Substituição de Aminoácidos , Antibacterianos/química , Antibacterianos/farmacologia , Bactérias Gram-Positivas/efeitos dos fármacos , Peptídeos/química , Peptídeos/farmacologia , Sequência de Aminoácidos , Animais , Antibacterianos/síntese química , Humanos , Interações Hidrofóbicas e Hidrofílicas , Testes de Sensibilidade Microbiana , Dados de Sequência Molecular , Peptídeos/síntese química , Peptídeos/genética , Estrutura Secundária de Proteína , Escorpiões/química , Escorpiões/metabolismo , Relação Estrutura-AtividadeRESUMO
El crecimiento de la cepa jumbo de Lentinula edodes Pegler se evaluó en diferentes medios agarizados y en diferentes sustratos de crecimiento para la formación de semilla. El crecimiento del micelio se valoró en tres medios de cultivo (MYA, OMYA, PDYA), en dos pH diferentes (5 y 5,5), y en dos porcentajes de aserrín de eucalipto (0,3 y 0,2 por cien), hallándose diferencias significativas en el crecimiento radial en los medios de cultivos (P < 0,05) mas no en el pH y el porcentaje de aserrín.La obtención de semilla se evaluó con la técnica de inoculación líquida en cinco diferentes combinacionesde viruta de eucalipto y semillas de trigo, hallando diferencias significativas entre los tratamientos, y arrojando como mejor combinación 80 por cien trigo y 20 por cien viruta de eucalipto.
Assuntos
MicélioRESUMO
As dengue continues to emerge as a major public-health problem world-wide, efforts to control the dengue vector Aedes aegypti must become more effective and efficient. Results from larval and pupal surveys applied in Venezuela illustrate the uniqueness of the information gained from pupal surveys; information that is lost when traditional Stegomyia indices are calculated. As most Ae. aegypti pupae will emerge to become adults, controlling the containers that produce the most pupae could have the greatest impact on the adult population. Pupal-survey results in Venezuela showed that large (150- to 200-litre) water drums produce the greatest number of pupae throughout the year. In the rainy season, approximately 70% of all pupae are found in these drums or in tyres, buckets and tanks. Over 80% of pupae in the dry season are found in drums and tanks alone. By targeting only those domestic breeding containers that produce the greatest number of pupae, control efforts may be streamlined to have the greatest impact on reducing the local adult Ae. aegypti population.
Assuntos
Aedes , Dengue , Insetos Vetores , Controle de Mosquitos , Animais , Estudos Transversais , Dengue/epidemiologia , Dengue/transmissão , Doenças Endêmicas , Utensílios Domésticos , Humanos , Estudos Longitudinais , Vigilância da População/métodos , Pupa , Estações do Ano , Saúde da População Urbana , Venezuela/epidemiologia , Abastecimento de ÁguaRESUMO
El propósito de este estudio fue utilizar una adaptación de la técnica descrita por la Food and Drug Administration (FDA) para evaluar el FPS de dos protectores solares en 20 voluntarios sanos. Se determinó previamente la Dosis Eritematosa Mínima (DEM) en los voluntarios con y sin protector y posteriormente el FPS de los protectores solares. La DEM promedio de los voluntarios en piel sin protección y con protector solar A y B fue de 9,7 mJ/cm2, 271,7 mJ/cm2 y 429,9 mJ/cm2, respectivamente. Los valores de FPS promedio para los voluntarios con el protector solar A y B fueron de 26,5 (rango: 25,5-27,6) y de 44,5 (rango: 43,0-45,9), respectivamente, valores inferiores a los señalados por el fabricante.
Assuntos
Masculino , Humanos , Feminino , Protetores Solares/administração & dosagem , Eficácia , Eritema/prevenção & controle , Pele/efeitos da radiação , Relação Dose-Resposta à RadiaçãoRESUMO
Utilizando tres técnicas serológicas anti-Trypanosoma cruzi se ha estudiado la seroprevalencia para la enfermedad de chagas en ocho comunidades rurales del área endémica del estado Trujillo, Venezuela. De 647 personas investigadas, que representan el 41 por ciento de la población residente en viviendas no colonizadas por Rhodnius prolixus, 124 (19,2 por ciento) resultaron reactivas con al menos dos de las tres técnicas utilizadas. La seropositividad en niños menores de 10 años fue del 2,8 por ciento (7/244). Estos resultados revelan que actualmente persiste la transmisión de la enfermedad de chagas en regiones controladas y en viviendas no localizadas por triatominos, ello plantea la necesidad de revaluar la situación epidemiológica del estado Trujillo
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Humanos , Doença de Chagas , Microbiologia , VenezuelaRESUMO
OBJECTIVE: To establish the prevalence of vitamin A deficiency during pregnancy and lactation in a group of urban Mexican women. MATERIAL AND METHODS: A group of pregnant women who attended a prenatal care program were invited to participate. Subjects had no added pathologies and were less than 20 weeks pregnant. Evaluations were performed 3 times during pregnancy until 24 weeks post-partum. Vitamin A levels were determined in serum by high performance liquid chromatography (HPLC). The cut-off point to consider retinol deficiency was < 1.05 mumol/L. RESULTS: During the 3 gestational evaluations, vitamin A levels were 2.34 +/- 0.70, 2.41 +/- 1.03 and 1.86 +/- 0.66 mumol/L, respectively, which shows a significant decrease. However, only 1/30 was situated below the accepted cut-off point to consider risk of deficiency, and none for deficiency. During post-partum, concentrations remained relatively constant, approximately 2.10 mumol/L. Lactation had no impact on serum retinol levels, while weight loss did. CONCLUSIONS: No cases of vitamin A deficiency were found in the studied population during the perinatal period. Maternal weight loss affects post-partum retinol levels.
Assuntos
Período Pós-Parto/sangue , Gravidez/sangue , População Urbana , Vitamina A/sangue , Adulto , Análise de Variância , Cromatografia Líquida de Alta Pressão/estatística & dados numéricos , Feminino , Humanos , México/epidemiologia , Complicações na Gravidez/sangue , Complicações na Gravidez/epidemiologia , Prevalência , Transtornos Puerperais/sangue , Transtornos Puerperais/epidemiologia , Fatores de Tempo , População Urbana/estatística & dados numéricos , Deficiência de Vitamina A/sangue , Deficiência de Vitamina A/epidemiologiaRESUMO
The measurement of pressure drop(DeltaP) across an aerated fermentation bed is proposed as alternative on-line sensor for the qualitative and, in some cases, quantitative, macroscopic changes in a static solid state fermentor. An increase in the DeltaP is correlated with the evolution of the different phases of Aspergillus niger growth: germination, vegetative growth, limitation, and sporulation, we observed in the microscope. For the case where the support is not modified during the fermentation and the water content remains constant, i.e., a synthetic resin (Amberlite IRA-900), the gas phase permeability of the bed is directly related to the biomass content. For example, the permeability of the bed is reduced to 5% of the initial value when biomass attains 21 mg dry biomass/g dry support. Biomass was appropriately predicted from the DeltaP measurements in an independent test. Experiments with different initial sucrose solution concentrations showed that biomass could not be produced beyond a certain level (21.5 mg dry biomass/g dry support) which suggests steric limitations. For the case of wheat bran and cane bagasse, the increase in DeltaP was related qualitatively to the evolution in the growth and the morphology of the mold.
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Se estudiaron 84 pacientes con diagnóstico de herpes zoster, ingresados en el Servicio de Dermatología del Hospital Provincial Clíninico Quirúrgico Docente "Dr. Gustavo Aldereguía Lima" de Cienfuegos, en el período 1983-1987. Fueron divididos en dos grupos de 42 enfermos. En un grupo se empleó como tratamiento el interferpon alfa leucocitario (IFN * leu) y en el otro la terapia convencional con vitaminoterapia y analgésicos. En todos los enfermos predominaron las edades de 55 años y más, el sexo femenino y el zoster intercostal. La desaparición del dolor y la curación clínica de la afección fue más rápida en los casos tratados con IFN, observándose resultados estadísticamente significativos. No se observaron efectos secundarios de importancia en el curso del tratamiento con interferón
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Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Herpes Zoster/terapia , Interferon Tipo I/uso terapêuticoRESUMO
To evaluate the surface (12 derivations) electrocardiogram in its possibility to predict left ventricular hypertrophy, the diastolic thickness of the posterior wall of the left ventricle was determined by M mode echocardiography in 12 normal persons and 47 hypertensive patients. In all cases the echocardiographic findings concerning diastolic thickness of the free wall of the left ventricle were studied as well as their relation ship to several electrocardiographic criteria mentioned in literature as indicative of left ventricle hypertrophy. The sensitivity, specificity and precision were calculated for each EKG criterion. The electrocardiographic criteria in general are little sensitive, highly specific and very variable in its accuracy. The most sensitive criteria found as indicative of left ventricle hypertrophy were the T positive wave in V1 higher than the T in V6 and the intrinsecoid deflection time inscription higher than 0.04 sec.
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Cardiomegalia/diagnóstico , Ecocardiografia , Eletrocardiografia , Hipertensão/complicações , Cardiomegalia/etiologia , Humanos , Sensibilidade e EspecificidadeRESUMO
El carcinoma epidermoide primario de mama es una entidad clínica muy rara, y tal hecho nos animó a revisar la literatura y reportarlo. Además, se discuten los criterios para definirlo como tal
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Pessoa de Meia-Idade , Humanos , Feminino , Neoplasias da Mama/patologia , Carcinoma de Células Escamosas/patologiaRESUMO
The concept, physiopathology, epidemiology, diagnostic procedures, prognosis and treatment of asymptomatic myocardial ischemia are reviewed. Hypotheses given to explain the absence of pain in the presence of myocardial ischemia are analyzed; Cohn's classification of asymptomatic myocardial ischemia is described and complemented with other clinical entities of painless myocardial ischemia. Prevalence of asymptomatic myocardial ischemia in different groups of patients is also discussed as well as the most important characteristics of diagnostic procedures. Finally the prognosis of asymptomatic myocardial ischemia is analyzed and the present therapeutic possibilities are discussed.
Assuntos
Doença das Coronárias , Doença das Coronárias/diagnóstico , Doença das Coronárias/epidemiologia , Doença das Coronárias/fisiopatologia , Doença das Coronárias/terapia , Humanos , PrognósticoRESUMO
Se hace un estudio clínico, citológico e histológico de once casos de A.D.C. del cuello uterino encontrados en los archivos del Servicio de Anatomía Patológica de la Maternidad "Concepción Palacios", entre los años 1979 y 1983, ambos inclusive. Se constata que un 5,21% de los carcinomas de cuello uterino corresponden a este tipo y de los cuales el más frecuente fue el A.D.C. tipo células culumnares endocervicales, bien diferenciado. La edad promedio de las pacientes fue de 40,18 años y el motivo de consulta en el 72,7% de los casos fue sangramiento genital