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With a vision to meet the changing trends and recent developments in the field of pharmacology and therapeutics, the postgraduate medical education board of the national medical commission has put forth amendments to the existing guidelines for the MD pharmacology course. Major changes include introducing a district residency-based program for 3 months apart from the clinical postings and more focus is given to the areas of rational prescribing, pharmacovigilance, and ethical aspects of research. These amendments come as a new ray of hope in developing the postgraduate student as a complete professional equipped to meet the increasing standards in the workplace be it a hospital or a research arena. Including the simulation-based approaches for training as a lesson learned from the pandemic and adopting patient-oriented learning during the course are some of the key changes in the new guidelines. This review focuses on highlighting these amendments and correlating the same with the current scenario and discusses the future areas that can be improved for comprehensive development in the pharmacology curriculum.
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Tapinarof is a novel topical formulation approved recently, in May 2022, by the United States Food and Drug Administration to treat plaque psoriasis. Existing topical therapies for psoriasis are limited by systemic and local adverse effects, medication cost and repeated administration, thus significantly hampering the compliance of patients to therapy. These limitations can be resolved by tapinarof owing to its better efficacy and favourable safety profile in psoriasis management. Tapinarof was developed with a unique mechanism targeting the aryl hydrocarbon receptor (AhR) involved in inflammation and modulation of skin barrier integrity in inflammatory dermatological disorders such as psoriasis and atopic dermatitis. The efficacy and safety outcomes of tapinarof in psoriasis were justified through the two pivotal clinical trials, namely, PSOARING 1 and PSOARING 2. The common adverse effects observed with tapinarof are folliculitis, contact dermatitis and headache. The literature search was conducted for efficacy and safety of tapinarof in the electronic databases of PubMed and Cochrane using a combination of keywords such as tapinarof, psoriasis and AhR. This review will delineate the molecular mechanisms underlying the action of tapinarof and also summarise the trial data supporting the claim that tapinarof is replacing the existing standard of care in psoriasis management.
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Lymphatic filariasis (LF) is a vector-borne neglected tropical disease, causing permanent disability. The disease is debilitating and widespread, leading to tremendous productivity and economic loss. The Government of India (GOI) prioritized the elimination of LF through the annual mass drug administration (MDA) programme in 2004 and continued with a single dose of diethylcarbamazine citrate (DEC), 6 mg/kg of body weight, plus albendazole annually over a period of 5-6 years. The GOI had set the target to achieve LF elimination by 2015 and now by 2030. The progress so far has been suboptimal. Much remains to be done as about 84 per cent of the total 328 endemic districts are still under MDA. The major challenge in implementing MDA is poor compliance. It is necessary to have a feasible alternative strategy addressing the above challenge to achieve the desired goal of LF elimination. At this juncture, a well-researched approach, i.e. the use of DEC-fortified salt, also advocated by the World Health Organization, as a unique form of MDA, is proposed. As per this strategy, a low dose of DEC (0.2% w/w) is added to the cooking salt at the manufacturing facility of iodized salt and consumed by the LF-endemic communities for about two years. Many examples of successful use of this strategy for LF elimination in small- and large-scale trials have been documented in India and several other endemic countries in the world. Implementing DEC–iodine-fortified salt is a safe, less expensive, more efficient and prompt approach for achieving the elimination of LF in India. Adverse effects are none or minor and self-limiting. The DEC-fortified salt strategy can easily piggyback on the existing countrywide deployment of iodized salt under the National Iodine Deficiency Disorders Control Programme (NIDDCP), which has achieved a great success in reducing iodine-deficiency disorders such as hypothyroidism. This existing robust programme can be leveraged to launch DEC-fortified salt for the community. If implemented appropriately, this strategy will ensure the complete cessation of LF transmission within two years from its introduction. If the said strategy is implemented in 2022, it is expected that India will be able to achieve the LF elimination by 2024, much before the global target of 2030.
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Abstract: This study aims (1) to test the association between access to basic sanitation/hygiene services in Brazilian households with their householders' socioeconomic and demographic characteristics; (2) to analyze the distribution of urban health-relevant elements in the census tracts according to their income, education and race/color composition. The information come from the 2010 Brazilian Demographic Census, which collected data regarding both household conditions and urban structure of the census tracts. Prevalence ratios were calculated using crude and adjusted Poisson regression models. The proportional distribution of the census-tract urban structure was performed, according to the deciles of the exploratory variables, and the ratios and the absolute differences between the extreme deciles were calculated. Around 4.8% of the households had no piped water, 34.7% had no sewage collection system, 9.8% had no garbage collection and 39% were considered inadequate. Families whose householders were black, indigenous or brown had lower income and educational level, and lived in the North, Northeast, and Central West regions. They were more likely to be considered inappropriate for not having piped water, sewage collection system, and garbage collection. Moreover, sectors where the majority of the population was black, had lower educational levels and lower income had significantly poor paving, street lighting, afforestation, storm drain, sidewalk and wheelchair ramp. This study analyzed national data from 2010 and provides a baseline for future studies and government planning. The relevant social inequalities reported in this study need to be addressed by effective public policies.
Resumo: Os objetivos do estudo foram: (1) testar a associação entre os serviços de saneamento básico/higiene nos domicílios brasileiros e as características socioeconômicas e demográficas dos/das chefes de família e (2) analisar a distribuição dos elementos urbanos relacionados à saúde nos distritos sanitários de acordo com a composição de renda, escolaridade e raça/cor. Os dados foram obtidos do Censo Demográfico de 2010, que coletou informações sobre as condições do domicílio e a infraestrutura urbana dos distritos censitários. Foram calculadas as razões de prevalência, usando modelos de regressão Poisson simples e ajustada. Foi avaliada a distribuição proporcional da infraestrutura urbana nos distritos censitários de acordo com os decis das variáveis exploratórias, e foram calculadas as razões e diferenças absolutas entre os decis extremos. Cerca de 4,8% dos domicílios não dispunham de água encanada, 34,7% faltavam esgotamento sanitário, 9,8% não tinham coleta de lixo e 39% das moradias eram consideradas inadequadas. Os domicílios chefiados por pretos/as, pardos/as ou indígenas apresentavam níveis mais baixos de renda e escolaridade, e aqueles localizados no Norte, Nordeste e Centro-oeste tinham níveis maiores de moradia inadequada e falta de água encanada, esgotamento sanitário e coleta de lixo. Além disso, os distritos com maioria negra e com menores níveis de escolaridade e renda apresentavam menores coberturas de pavimentação, iluminação e arborização de ruas, galerias pluviais, calçadas e rampas para cadeira de rodas. O estudo analisou os dados de 2010 e estabeleceu uma linha de base para estudos futuros e planejamento de políticas de governo. As desigualdades sociais relevantes relatadas no estudo devem ser enfrentadas com políticas públicas efetivas.
Resumen: Los objetivos de este estudio son: (1) probar la asociación entre el acceso a servicios básicos de higiene y saneamiento en los hogares brasileños con sus principales características socioeconómicas y demográficas; (2) analizar la distribución de elementos urbanos relevantes para la salud en secciones censales, según la composición de sus ingresos, educación y raza/color. Los datos provienen del Censo Demográfico de 2010, que recogió datos, tanto respecto a las condiciones de los hogares, como al entorno urbano de las secciones censales. Las ratios de prevalencia se calcularon usando modelos de regresión crudos y ajustados de Poisson. Se realizó una distribución proporcional de las secciones censales relacionadas con el entorno urbano, según deciles de las variables exploratorias y las ratios, y se calcularon las diferencias absolutas entre los deciles extremos. Alrededor de un 4,8% de los hogares no contaban con agua canalizada, 34,7% no tenían un sistema de alcantarillado, un 9,8% no tenían recogida de basuras y un 39% de los hogares fueron considerados inadecuados. Hogares, cuyas cabezas de familia eran negros, indígenas o mulatos/mestizos, tenían bajos ingresos, educación, y vivían en el Norte, Noreste, y Centro-oeste tuvieron más probabilidad de ser considerados inapropiados, no contar con agua canalizada, sistema de alcantarillado y recogida de basuras. Además, los sectores donde la mayoría de la población era negra, con bajos niveles educativos e ingresos más bajos tenían significativamente menos cobertura de pavimentación, iluminación de calles, forestación, alcantarillado pluvial, aceras y rampas de acceso para sillas de ruedas. Este estudio analizó los datos nacionales desde 2010 y proporciona una base de referencia para futuros estudios y planificación gubernamental. Las inequidades relevantes sociales reflejadas en este estudio necesitan que ser tratadas mediante políticas públicas eficientes.
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Humans , Censuses , Housing , Socioeconomic Factors , Urban Population , Brazil , SanitationABSTRACT
Background: Sexual behavior is an important determinant of sexually transmitted diseases transmission. It is essential to understand the HIV-related high-risk behavior among high-risk groups like migrants to design evidence-based intervention. Objectives: This study was undertaken to assess HIV-related high-risk behavior and awareness among male construction workers. Materials and Methods: A total of 404 male workers were enrolled in a cross-sectional study at a construction area in Karnataka. Behavioral Surveillance Survey questionnaire was used to collect information regarding sexual behavior and their knowledge regarding HIV/AIDS. Results: The mean age of workers was 25.6 ± 7.3 years. Among workers, 82.2% of them heard about AIDS and 66.8% (270) could tell at least two correct mode of transmission of HIV. Mean age of first sexual intercourse was 22 ± 9.4 years among married and 18.9 ± 2.8 years among unmarried. Nearly 25% and 56% had their first sexual intercourse <18 years among married and unmarried, respectively. Among married workers, 21.9% used condoms during last sexual intercourse with spouse and 10.8% used condoms with other partners. About 15.7% of them had multiple sexual partners. Among unmarried workers, 27.9% of them ever had sex and 22.2% of them used condom during last sexual intercourse. Nearly 30% of them had multiple sexual partners. Higher age, educational status, and high-income associated with better awareness. Conclusion: Knowledge regarding AIDS and sexual transmission was good. However, condom usage was found to be poor among the workers. In addition to that, multiple sexual partners which included commercial sex workers among both married and unmarried workers are an important risk factor for HIV. Adequate interventions should be done in this group to address this issue.
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Background: There is dearth of studies in India on the management of paediatric septic shock. So it is prudent to do a study on paediatric septic shock management. The objective of the study is to determine the correlation between Paediatric Assessment Triangle and serum lactate levels., to determine the role Paediatric Assessment Triangle in predicting mortality in septic shock and to the determine the role of elevated lactate levels in predicting mortality in septic shock.Methods: Descriptive study of 100 children from 31 days to 12 years of age who are admitted with septic shock in a tertiary care hospital are assessed with paediatric assessment triangle and clinical score and serum lactate was tested along with other standard tests and the children are managed as per the standard protocols. Outcome is analysed.Results: In this study, septic shock children with total clinical score >22 are having statistically significant low levels of diastolic blood pressure and low mean arterial pressure. There was a significant difference in median serum lactate levels between the survivors (28.08 mg/dl) and non-survivors (40.92 mg/dl).Conclusions: Paediatric assessment triangle and clinical scoring based on it more than 22 and serum lactate levels of more than 2mmol/L or 18mg/dl predict the mortality.
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Background: Whole-grain consumption is associated with several health benefits. Little is known, however, about whole-grain consumption patterns in medical students in Malaysia. Objectives: The study was conducted to assess whole-grain intake pattern and factors influencing intake among Malaysian medical students. Methods: A cross-sectional study investigating whole-grain intake among 151 medical students in a private medical university in Malaysia was conducted from January to June 2018. A self-administered questionnaire was used to assess sociodemographic variables, the whole-grain intake pattern and the knowledge and attitudes toward whole-grain intake. Data were analyzed using IBM SPSS software. Chi-square test and multivariable logistic regression were used. Results: The prevalence of reported whole-grain intake in the past 3 months was 51%. Chinese ethnicity, readiness to adhere to Malaysian food pyramid, and self-preparation of food, and eating at home were significantly associated with whole-grain consumption. However, the primary determinants of food choice such as education, knowledge, and affordability did not seem to influence whole-grain consumption. Whole-grain consumption is relatively low among Malaysian medical students. Cultural background and self-belief influence this practice despite being from the medical fraternity. Conclusions: Efforts are needed to bridge the knowledge–practice gap by assessing the barriers to whole-grain consumption to design effective initiatives to promote an increase in whole-grain consumption.
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Abstract: This study aims to quantify the overall importance of schools in explaining the individual variance of tobacco use and to test the association between characteristics of the school environment and its vicinity with the experimentation and current use of cigarettes. We analyzed data from 102,072 Brazilian adolescents interviewed in the 2015 National School Health Survey (PeNSE). Multilevel logistic regression models were performed to estimate the between-schools variance and to test the association between school-level variables and the use of tobacco. Violence in the vicinity of the school and presence of teachers or students smoking on school premises were the school-level characteristics. The analyses were adjusted by individual covariates and stratified by gender. Around 12.5% of the individual variance in ever smoking was explained by between-school variation among girls (9.2% among boys). The figures were even higher for current smoking (14.9% girls; 12.2% boys) and current use of other tobacco products (27.7% girls; 17.8% boys). In general, the use of tobacco was associated with the existence of violence in the vicinity of the schools and was higher among students whose schools reported that students and teachers (teachers only for use of other tobacco products among girls) smoke on school premises. Tobacco use on school premises and the safety of the neighborhood where the school is located are associated with some smoking behaviors among adolescents. Such findings reinforce the necessity to effectively consider interventions in the school environment and neighborhood to fight smoking among adolescents.
Resumo: O estudo tem como objetivos quantificar a importância global da escola na explicação da variância individual no uso de tabaco e testar a associação entre as características do ambiente escolar e o entorno e a experimentação e o uso atual de cigarros. Analisamos os dados de 102.072 adolescentes brasileiros entrevistados na Pesquisa Nacional de Saúde Escolar (PeNSE) de 2015. Foram utilizados modelos de regressão logística multinível para estimar a variância entre escolas e testar a associação entre variáveis escolares e o tabagismo. As características da escola foram a violência no entorno e a presença de professores e alunos fumando no ambiente escolar. As análises foram ajustadas para covariáveis individuais e estratificadas por sexo. Cerca de 12,5% da variância individual no tabagismo pregresso ou atual foram explicados pela variação entre escolas, no sexo feminino (9,2% no sexo masculino). As proporções foram ainda mais altas para o tabagismo atual (14,9% no sexo feminino; 12,2% no sexo masculino) e para o uso atual de outros produtos de tabaco (27,7% no sexo feminino; 17,8% no sexo masculino). Em geral, o uso de tabaco mostrou estar associado à existência de violência no entorno da escola, sendo mais frequente entre alunos cujas escolas relatavam que alunos e professores fumavam no ambiente escolar (para professores, apenas para o uso de outros produtos de tabaco, entre alunas). O uso de tabaco no ambiente escolar e a segurança no entorno da escola estão associados a alguns comportamentos relacionados ao tabaco entre adolescentes. Os achados reforçam a necessidade de considerar intervenções no ambiente escolar e no entorno para combater o tabagismo entre adolescentes
Resumen: Este estudio tiene como objetivo cuantificar la importancia global de las escuelas a la hora de explicar la variancia individual del consumo de tabaco, así como probar la asociación entre las características del entorno de la escuela y sus inmediaciones con probar por primera vez y consumir cigarrillos habitualmente. Analizamos los datos de 102.072 brasileños adolescentes, entrevistados en la Encuesta Nacional de Salud Escolar (PeNSE) 2015. Se usaron modelos de regresión logística multinivel para estimar la variancia entre escuelas y para probar la asociación entre las variables de nivel escolar y consumo de tabaco. La violencia en las inmediaciones de la escuela y la presencia de profesores o estudiantes fumando en las instalaciones de la escuela fueron características del nivel escolar. Los análisis fueron ajustados por covariables individuales y estratificadas por género. Alrededor de un 12,5% de la variancia individual entre quienes habían fumado se explicó mediante la variación interescolar entre chicas (9,2% entre chicos). Las cifras fueron incluso superiores para los fumadores en la actualidad (14,9% chicas; 12,2% chicos) y el consumo actual de otros productos derivados del tabaco (27,7% chicas; 17,8% chicos). En general, el consumo de tabaco estuvo asociado con la existencia de violencia en las inmediaciones de las escuelas y fue superior entre estudiantes en cuyas escuelas se informó que estudiantes y profesores (profesores solo por el consumo de otros productos del tabaco entre chicas) fuman en dependencias escolares. El consumo de tabaco y la seguridad del vecindario donde estaba ubicada la escuela están asociados con algunos hábitos de consumo de tabaco entre adolescentes. Tales resultados refuerzan la necesidad de considerar efectivamente intervenciones en el entorno escolar y en el vecindario para luchar contra el tabaquismo entre adolescentes
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Humans , Male , Female , Child , Adolescent , Adult , Young Adult , Students/statistics & numerical data , Violence/statistics & numerical data , Smoking/psychology , Smoking/epidemiology , Tobacco Use/epidemiology , Peer Group , Schools/statistics & numerical data , Students/psychology , Teaching , Brazil , Multilevel Analysis , Health Risk BehaviorsABSTRACT
Background: Tuberculosis is a leading infectious killer disease worldwide. Early diagnosis and prompt treatment on the part of the health care providers is essential for TB control. Their knowledge, attitude and practice have an impact on the tuberculosis patients regarding compliance to treatment and follow up. There are limited studies in India assessing the knowledge of nursing professionals regarding TB transmission, prevention and control. This study seeks to assess the same. Materials and methods: A cross-sectional study was conducted at SRM Medical College and Research Centre, Potheri, Kanchipuram district. A pre-tested self-administered questionnaire was given to 224 nursing staff. The responses were then analyzed. Results: A high proportion (71.80%) of awareness was found regarding the causation of TB by bacterium, air-borne method of spread and over-crowding being a significant risk factor. A lesser proportion of the participants were aware that TB does not spread by breast feeding (54.9%) or hand shaking (33%) and that ATT should be continued during pregnancy. Levels of knowledge on the preventable nature of TB infection (56%) and the availability of ATT were also found to be low. Conclusions: This study indicates the need for addressing the gaps regarding the knowledge and transmission of TB among the nursing care professionals. Nursing professionals still are in need of continuing educational programs regarding treatment and control of TB. Improved knowledge on TB will thus contribute to effective TB control and in the long term, will help India achieve the goal of End TB.
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Notwithstanding the significant improvements in child survival in recent decades [1], India accounts for the largest share of the global burden of under-five mortality with an estimated 1.2-5.9 million child deaths [2]. Consequently, scientific efforts continue to identify factors and interventions that can help improve child survival [3]. An overwhelming majority of studies are informed, almost exclusively, by a ‘maternal perspective’, such that factors and interventions have largely focused on mothers [3,4]. For instance, increasing educational attainment among women has been identified and targeted as a means to achieve rapid progress towards fourth millennium development goal (MDG-4) [4]. Other maternal specific interventions that have received considerable attention in the literature include family planning and care targeted to mothers in the pre-conception period along with micronutrient and folic acid supplementation and early initiation of breastfeeding during pregnancy and in the postnatal period [5]. In this issue, Sinha, et al. [6] consider maternal age at childbirth (hereafter referred to as maternal age) as a potentially modifiable social determinant of child survival within a large prospectively followed cohort. They report that young motherhood is associated with an increase in child mortality, leading to a conclusion that delaying age at pregnancy would confer important survival benefits in this population.
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Background & objectives: One of the major strategies being pursued for malaria control by the National Vector Borne Disease Control Programme is the distribution of long lasting insecticidal nets (LLINs) in endemic areas since 2009. Information on durability of insecticidal efficacy and physical integrity of LLINs and community usage at different time intervals of their use is essential to plan net replacements to maintain universal coverage for an effective and sustainable malaria control strategy. Therefore, a study was undertaken to assess these parameters in two malaria endemic districts of the Odisha State. Methods: A total of 309 households were selected in 15 villages of two community health centres (CHCs) (Borigumma and Laxmipur) from Koraput district and one (Khairput) from Malkangiri district. Data on net usage were collected during March to July 2014 using semi-structured questionnaires. PermaNet 2.0 were sampled from all households, replaced with new ones, and bioassays were carried out to determine the insecticidal efficacy of LLINs after four and half, four and two years of field use following the standard procedure of World Health Organization. Results: LLIN use rate varied from 57.9 to 90.2 per cent in the study CHCs. The annual washing rate per net in Borigumma, Khairput and Laxmipur was 6.6, 3.2 and 4.8, respectively. The LLINs used two years in the field caused 100 per cent mortality and four to four and half years caused below 80 per cent mortality, except one net. Interpretation & conclusions: Nearly 20 per cent of the people were out of net coverage and hence the Programme to ensure 100 per cent coverage. The community should adequately be educated so as to increase the net use rate and avoid incorrect washing practices.
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Individuos de diferentes orígenes, grupos sociales y países gozan de diferentes niveles de salud. En este artículo se define y se distingue entre desigualdades en salud inevitables y desigualdades en salud injustas y prevenibles. Se describen las dimensiones por las cuales se examina comúnmente las desigualdades en salud, incluyendo a nivel de toda la población, entre países o estados y dentro de geografías, por agrupamientos socialmente relevantes como raza/etnicidad, género, educación, casta, ingreso, ocupación y otros. Distintas teorías intentan explicar las diferencias en salud a nivel de grupo, incluyendo explicaciones psicosociales, medioambientales, de privación material, de conducta en salud y de selección. Conceptos como relativo versus absoluto, dosis-respuesta versus umbral, composición versus contexto, lugar versus espacio, la perspectiva del curso de vida sobre la salud; las vías causales hacia la salud; los efectos en salud condicionales y las diferencias de nivel grupal versus individual son fundamentales para entender las desigualdades en salud. Se concluye con una reflexión sobre qué condiciones hacen injustas a las desigualdades en salud y una consideración sobre los méritos de las políticas que priorizan la eliminación de las desigualdades en salud respecto a aquellas que se centran en elevar el estándar general de salud de una población.
Individuals from different backgrounds, social groups, and countries enjoy different levels of health. This article defines and distinguishes between unavoidable health inequalities and unjust and preventable health inequities. We describe the dimensions along which health inequalities are commonly examined, including across the global population, between countries or states, and within geographies, by socially relevant groupings such as race/ethnicity, gender, education, caste, income, occupation, and more. Different theories attempt to explain group-level differences in health, including psychosocial, material deprivation, health behavior, environmental, and selection explanations. Concepts of relative versus absolute; dose response versus threshold; composition versus context; place versus space; the life course perspective on health; causal pathways to health; conditional health effects; and group-level versus individual differences are vital in understanding health inequalities. We close by reflecting on what conditions make health inequalities unjust, and to consider the merits of policies that prioritize the elimination of health disparities versus those that focus on raising the overall standard of health in a population.
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Health Status Disparities , /policies , Public Health/methodsABSTRACT
Background & objectives: Selection of an insecticide and its appropriate formulation is a prerequisite of formulating any chemical control strategy against vectors. A hut scale field trial was carried out to study the effectiveness of house spraying with capsule suspension (CS) formulation of lambdacyhalothrin in comparison with its wettable powder (WP) formulation on mortality, density and behaviour of malaria vector in Malkangiri district, Odisha, India. Methods: The two formulations were tested at 20 and 30 mg (a.i.)/m2 for their effectiveness in terms of deterrence, excito-repellency, blood-feeding success, mortality and residual activity against Anopheles fluviatilis, the major malaria vector, in experimental huts in Malkangiri district, Odisha State, India. Results: Both CS and WP formulations prevented the entry of An. fluviatilis in to the sprayed huts by >90 per cent for >6 months, the entire peak malaria transmission season in the area. The exit rate increased (90-99%) with different treatments and the feeding rate was reduced (91-97%). There was no significant difference between WP 30, CS 20 and CS 30 mg/m2 in these respects. However, WP 20 mg/m2 caused a lesser effect than the other three groups. The formulations or the dosages differed only in causing vector mortalities. Overall, the total mortality rate of An. fluviatilis was higher in the huts sprayed with CS 30 (58%) than the huts sprayed with CS 20 (48%), WP 20 (37%) and WP 30 mg/m2 (47%). Interpretation & conclusions: Considering the duration of residual action and the effect on entry, exit, feeding and mortality of An. fluviatilis, the dosage 20 mg/m2 of CS formulation of lambdacyhalothrin could be considered for further use.
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A bacteriologically proven case of brain abscess, due to Streptococcus oralis is being reported in a 12‑year‑old girl who is a known case of congenital heart disease. The patient presented with fever, headache and vomiting. Pus cultures yielded S. oralis.
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To study the potential of chemically modified tetracycline-3 [COL-3], a potent matrix metalloproteinase [MMP] inhibitor, to protect against the development of paclitaxel-induced painful neuropathy and its immunomodulatory effects. The reaction latency to thermal stimuli [hot plate test] of female BALB/c mice was recorded before and after treatment with paclitaxel [2 mg/kg i.p.], paclitaxel plus COL-3 [4, 20 or 40 mg/kg p.o.] or their vehicles for 5 consecutive days. Gene transcripts of CD11b [marker for microglia], 5 cytokines [IFN-gamma, IL-1 beta, IL-6, IL-10 and TNF- alpha] and 3 chemokines [CCL2, CXCL10 and CX3CL1] were quantified by real-time PCR in the brains, spinal cords and spleens of mice sacrificed on day 7 after treatment. Treatment with paclitaxel reduced the reaction latency time to thermal stimuli [thermal hyperalgesia] for 4 weeks, with maximum effect on days 7 and 10. The coadministration of paclitaxel with COL-3 40 mg/kg, but not lower doses, prevented the development of paclitaxel-induced thermal hyperalgesia. Treatment with paclitaxel alone or coadministration with COL-3 increased CD11b transcript levels in the brain but not in the spinal cord. Treatment with paclitaxel reduced IL-6 transcript levels in the spinal cord but did not alter the transcript levels of other cytokines or chemokines in the brain, spinal cord or spleen. The coadministration of COL-3 with paclitaxel significantly increased the transcript levels of IL-6 in the spleen and decreased CX3CL1 transcripts in the brain in comparison to treatment with paclitaxel alone. Our results indicate that the MMP inhibitor COL-3 protected against paclitaxel-induced thermal hyperalgesia and, thus, could be useful in the prevention of chemotherapy-induced painful neuropathy
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Animals, Laboratory , Matrix Metalloproteinase Inhibitors , Mice , Hyperalgesia/prevention & control , Hyperalgesia/etiology , Cytokines , ChemokinesSubject(s)
Cohort Studies , Female , Health Status , Humans , India/epidemiology , Infant Mortality , Infant, Newborn , Life Expectancy , Male , Models, Theoretical , Public Health Practice , Sex Factors , Socioeconomic FactorsSubject(s)
Adult , Body Weight , Female , Humans , India , Life Style , Male , Overweight , Risk Factors , Social ClassABSTRACT
As we have seen a global increase in asthma in the past three decades it has also become clear that it is a socially patterned disease, based on demographic and socioeconomic indicators clustered by areas of residence. This trend is not readily explained by traditional genetic paradigms or physical environmental exposures when considered alone. This has led to consideration of the interplay among physical and psychosocial environmental hazards and the molecular and genetic determinants of risk (i.e., biomedical framing) within the broader socioenvironmental context including socioeconomic position as an upstream "cause of the causes" (i.e., ecological framing). Transdisciplinary research strategies or programs that embrace this complexity through a shared conceptual framework that integrates diverse discipline-specific theories, models, measures, and analytical methods into ongoing asthma research may contribute most significantly toward furthering our understanding of socially patterned disease. This paper provides an overview of a multilevel, multimethod longitudinal study, the Asthma Coalition on Community, Environment and Social Stress (ACCESS), as a case study to exemplify both the opportunities and challenges of transdisciplinary research on urban asthma expression in the United States.
Com o aumento da asma observado em nível mundial nas últimas três décadas, também ficou claro que se trata de uma doença social, conforme evidenciado por indicadores demográficos e socioeconômicos agrupados por áreas residenciais. Esta tendência não pode ser explicada apenas por paradigmas genéticos tradicionais ou influência física do ambiente, quando considerados isoladamente. Por isso passou-se a considerar a interação entre riscos ambientais físicos e psicológicos e os determinantes de risco moleculares e genéticos (i.e. enquadramento biomédico) no âmbito de um contexto socioambiental mais amplo, incluindo a posição socioeconômica como "causa das causas" (i.e. enquadramento ecológico). Estratégias de pesquisa transdisciplinares ou programas que acolhem esta complexidade por meio de uma estrutura conceitual comum integrando teorias, modelos, medidas e métodos analíticos específicos das diversas disciplinas à pesquisa atual da asma podem representar contribuições particularmente significantes a uma melhor compreensão de uma doença social. Este artigo em forma de relato de caso pretende dar uma visão geral de um estudo longitudinal usando vários níveis e métodos - o Asthma Coalition on Community, Environment and Social Stress (ACCESS) -, para mostrar as oportunidades e desafios de um estudo transdisciplinar investigando a expressão urbana da asma nos Estados Unidos.