ABSTRACT
Type 2 diabetes mellitus (T2DM) and sarcopenia (low skeletal muscle mass and function) share a bidirectional relationship. The prevalence of these diseases increases with age and they share common risk factors. Skeletal muscle fat infiltration, commonly referred to as myosteatosis, may be a major contributor to both T2DM and sarcopenia in older adults via independent effects on insulin resistance and muscle health. Many strategies to manage T2DM result in energy restriction and subsequent weight loss, and this can lead to significant declines in muscle mass in the absence of resistance exercise, which is also a first-line treatment for sarcopenia. In this review, we highlight recent evidence on established treatments and emerging therapies targeting weight loss and muscle mass and function improvements in older adults with, or at risk of, T2DM and/or sarcopenia. This includes dietary, physical activity and exercise interventions, new generation incretin-based agonists and myostatin-based antagonists, and endoscopic bariatric therapies. We also highlight how digital health technologies and health literacy interventions can increase uptake of, and adherence to, established and emerging treatments and therapies in older adults with T2DM and/or sarcopenia.
ABSTRACT
Abstract Sarcocystis neurona and Neospora hughesi are coccidian protozoa that can cause neurological illness in horses in America. In this study we report seroprevalence of Neospora spp. andS. neurona in sera of 333 donkeys from the northeastern region of Brazil. Antibodies to Neospora spp. were detected in 2% (7 donkeys) of 333 sera tested by the indirect fluorescent antibody test (IFAT) with a cut-off dilution of 1:40. Antibodies to S. neurona were found in 3% (10 donkeys) of the samples tested by IFAT (cut-off ≥50) and 21% (69 donkeys) by the direct agglutination test (SAT ≥50). The SAT and IFAT results for S. neurona showed a poor concordance (value of Kappa=0.051). This is the first report ofNeospora spp. antibodies in Brazilian donkeys and the first detection of antibodies against S. neurona in this animal species.
Resumo Sarcocystis neurona e Neospora hughesi são protozoários coccídios que infectam equídeos e são responsáveis por doenças neurológicas nessas espécies. Neste estudo, a soroprevalência de infecção porS. neurona e Neospora spp. foi determinada em amostras de 333 soros de jumentos da Região Nordeste do Brasil. Anticorpos contra Neospora spp. foram detectados em 2% (7 jumentos) dos 333 animais examinados pela reação de imunofluorescência indireta (RIFI), com ponto de corte de 40. Anticorpos contra S. neurona foram detectados em 3% (10 jumentos) das amostras pela RIFI (ponto de corte de 50) e em 21% (69 jumentos) pela técnica de aglutinação direta (SAT - ponto de corte de 50). SAT e RIFI, para diagnóstico de S. neurona, apresentaram uma baixa concordância (Kappa = 0,051). Essa é a primeira observação de anticorpos anti-N. caninum em jumentos brasileiros e a primeira detecção de anticorpos contra S. neurona nessa espécie.
Subject(s)
Animals , Antibodies, Protozoan/blood , Sarcocystis/immunology , Sarcocystosis/veterinary , Coccidiosis/veterinary , Neospora/immunology , Equidae/immunology , Brazil/epidemiology , Seroepidemiologic Studies , Prevalence , Sarcocystosis/immunology , Sarcocystosis/epidemiology , Coccidiosis/immunology , Coccidiosis/epidemiology , Hyperbilirubinemia, Neonatal/veterinaryABSTRACT
South American opossums are the definitive hosts of Sarcocystis neurona, Sarcocystis falcatula, Sarcocystis speeri and Sarcocystis lindsayi. The sporocysts of these species of Sarcocystis are morphologically similar and methods like infectivity and pathogenicity for intermediate hosts (immunodeficient mice and psittacine birds) and molecular tools are used for identification. Opossums are synanthropic wild animals, and widely distributed in Brazilian territory. Previous studies have shown high environmental contamination with S. neurona sporocysts in several Brazilian regions. This paper reviews information on Sarcocystis spp. shed by various opossum species and its occurrence in Brazil.(AU)
Os gambás Sul-americanos são os hospedeiros definitivos de Sarcocystis falcatula, Sarcocystis neurona, Sarcocystis speeri e Sarcocystis lindsayi. Estas espécies de Sarcocystis são morfologicamente similares, mas podem ser distinguidas por sua patogenicidade e infectividade em hospedeiros intermediários (aves e camundongos imunodeficientes) e técnicas moleculares. Os gambás são animais silvestres e sinantrópicos e amplamente distribuídos no território nacional. Estudos anteriores demonstraram uma alta contaminação ambiental com esporocistos de S. neurona em diversas regiões brasileiras. Este artigo revisa informações sobre Sarcocystis spp. excretados por gambás e sua ocorrência no Brasil.(AU)
Subject(s)
Animals , Didelphis/parasitology , Opossums/parasitology , Parasite Egg Count/veterinary , Sarcocystis/parasitology , Sarcocystis/pathogenicity , BrazilABSTRACT
Sarcocystis neurona is the major agent of equine protozoal myeloencephalitis. It infects several mammalian species in the Americas, where the definitive hosts, marsupials of the genus Didelphis (D. virginiana and D. albiventris) are found. Domestic cats are one of the confirmed intermediate hosts of the parasite; however, antibodies against S. neurona had never before been demonstrated in Brazilian cats. The aim of this study was to determine whether cats in Bahia, Brazil, are exposed to the parasite. A total of 272 feline serum samples (134 from feral and 138 from house cats) were subjected to an indirect fluorescent antibody test using cultured merozoites of S. neurona as antigen. Positivity was detected in 4.0% (11/272) of the tested samples, with titers ranging from 25 to 800. The feline sera were also tested for antibodies against the protozoan Neospora caninum, with an observed antibody frequency of 2.9%. To the author's knowledge, this is the first study to report antibodies against S. neurona in Brazilian cats. We conclude that cats are exposed to the parasite in the region of this study. Further investigations are needed to confirm the role of cats in the transmission cycle of S. neurona in Brazil.
Sarcocystis neurona é o principal agente da mieloencefalite protozoária equina. Esse parasito infecta várias espécies de mamíferos nas Américas, onde são encontrados os hospedeiros definitivos, os marsupiais do gênero Didelphis (D. virginiana and D. albiventris). O gato doméstico é um dos hospedeiros intermediários do parasito. Contudo, anticorpos contra S. neurona ainda não tinham sido demonstrados em gatos brasileiros. O objetivo deste trabalho foi determinar se gatos da Bahia, Brasil, são expostos ao parasito. Amostras séricas de 272 felinos (134 de gatos errantes e 138 de gatos domiciliados) foram testadas pelo teste de imunofluorescência indireta, utilizando-se como antígeno, merozoítos produzidos em cultura celular. Entre as amostras testadas, 4,0% (11/272) foram positivas com títulos entre 25 e 800. Os soros dos felinos foram também testados para anticorpos contra o protozoário Neospora caninum, cuja frequência de anticorpos foi de 2,9%. Esse é o primeiro relato de anticorpos contra S. neurona em gatos brasileiros. Conclui-se que os gatos da região estudada são expostos a S. neurona. Estudos futuros são necessários, a fim de se confirmar o papel dos gatos no ciclo de transmissão de S. neurona no Brasil.
Subject(s)
Animals , Antimalarials/pharmacology , Cysteine Proteinase Inhibitors/pharmacology , Leucine/analogs & derivatives , Plasmodium falciparum/drug effects , Plasmodium falciparum/enzymology , Cysteine Endopeptidases/biosynthesis , Cysteine Endopeptidases/pharmacology , Electrophoresis, Polyacrylamide Gel , Erythrocytes/parasitology , Gene Expression Regulation, Developmental , Hydrolysis , Hemoglobins/metabolism , Leucine/pharmacology , Leupeptins/pharmacology , Plasmodium falciparum/growth & development , Time FactorsABSTRACT
The Gynecologic Oncology Group (GOG) has conducted multiple trials related to malignancies of the uterine corpus. Recently, several of these trials have been presented and/or published. Areas of focus included the feasibility of laparoscopic staging for endometrial cancer, the adjuvant management of locally advanced endometrial cancer, whole abdominal irradiation in maximally resected advanced endometrial carcinoma, and combination chemotherapy regimens for stage I and II carcinosarcoma after primary surgery and for advanced or recurrent carcinosarcoma. This article will discuss the background and details of each of these important advances.
Subject(s)
Female , Carcinosarcoma , Drug Therapy, Combination , Endometrial NeoplasmsABSTRACT
The Gynecologic Oncology Group (GOG) has conducted multiple trials related to malignancies of the uterine corpus. Recently, several of these trials have been presented and/or published. Areas of focus included the feasibility of laparoscopic staging for endometrial cancer, the adjuvant management of locally advanced endometrial cancer, whole abdominal irradiation in maximally resected advanced endometrial carcinoma, and combination chemotherapy regimens for stage I and II carcinosarcoma after primary surgery and for advanced or recurrent carcinosarcoma. This article will discuss the background and details of each of these important advances.
Subject(s)
Female , Carcinosarcoma , Drug Therapy, Combination , Endometrial NeoplasmsABSTRACT
La tuberculosis (TBC) es una enfermedad infecciosa, crónica, causada por Mycobacterium tuberculosis y M. bovis. Reemerge como enfermedad epidémica en 1986, considerandose la epidemia concomitante de SIDA como factor contributivo importante. En la actualidad ha infectado a 1,7 millores de personas, con 8 millones de casos nuevos y 3 millones de muertes por año, siendo la principal causa de muerte en SIDA (más del 30 porciento). En Colombia, se notifican aproximadamente 10.000 casos nuevos/año, 8-30 porciento relacionados con VIH. El número de personas coinfectadas en toda el mundo se calcula en 5, 6 millones. EL VIH ataca directamente el mecanismo de defenza contra la TBC, lo que favorece la diseminación de la enfermedad. El riesgo de progresar la Tbc activa en los coinfectados es de 8 porciento por año, contra 0.2 porciento/año en los infectados solo por TBC. Este riesgo aumenta en pacientes PPD >5 mm, anérgicos o con CD4+ <200/ul. Las características clínicas de los pacientes coinfectados varía con el grado de inmunosupresión y tiempo de adquisición del M. tuberculosis. La PPD, radiografía de tórax y BK de esputo siguen siendo los pilares diagnosticos. Los pacientes coinfectados deben recibir el mejor tratamiento antituberculoso disponible. El esquema debe ser corto, supervisado estrictamente y basarse en: rinfanpicina, isoniazida, pirazinamida y estreptomicina o ethambutol. Se recomienda la profilaxis en áreas con alta prevalencia de TBC. La coinfección por VIH agrava la situación epidemiológica de la TBC, especialmente en paises en desarrollo. Existen pruebas de que la TBC agrava el curso de la infección por VIH
Subject(s)
Humans , Tuberculosis/diagnosis , Tuberculosis/etiology , Tuberculosis/therapy , Tuberculosis/epidemiology , AIDS-Related Opportunistic Infections/etiology , AIDS-Related Opportunistic Infections/physiopathology , AIDS-Related Opportunistic Infections/epidemiologyABSTRACT
Señala la existencia de crisis de valores con repercusiones y consecuencias a todos los niveles, incluyendo la formulación y ejecución de políticas de desarrollo urbano. La crisis de conciencia se manifiesta de diferentes formas: acciones de miembros de todos los sectores basadas en posiciones interesadas; para colaboración, intercambio y confianza; enfasis en desarrollo material, tangible y cuantitativo; afán de lucro; poco respeto para los derechos humanos; poco respeto para bienestar de biósfera y seres vivientes; falta de visión globalista de la vida, despreocupación por la calidad y condición de vida y otros aspectos que se manifiestan diariamente