ABSTRACT
The prevalence of obesity has increased in recent years worldwide. In this context, strategies for management obesity in primary care are essential. The first step in the treatment of obesity are lifestyle intervention programs. The three pillars of these programs, ideally of high intensity (high frequency of visits), are dietary intervention, exercise and behavioral therapy. There is no universal model of care for patients with obesity, but it must take into account key aspects, such as facilitating the access and adherence of the patient and a multidisciplinary and coordinated care among professionals at different levels of healthcare. The components of the model of care and its format should be defined according to the resources available and the characteristics of the population to be treated.
ABSTRACT
In this letter, we report on the optical and structural properties of supported and suspended MoS2/Graphene/MoS2 vertical heterostructures using Raman and photoluminescence (PL) spectroscopies. Vertical heterostructures (VH) are formed by multiple wet transfers on micro-sized holes in SiO2/Si substrates, resulting in VH with different configurations. The strong interlayer coupling is confirmed by Raman spectroscopy. Additionally, we observe an enhancement of the PL emission in the three-layer VH (either support or suspended) compared with bare MoS2 or MoS2/Graphene. This suggests the formation of a spatial type-II band alignment assisted by the graphene layer and thus, the operation of the VH as a n++/metal/n junction.
ABSTRACT
BACKGROUND: In Mexico, combined chloroquine (CQ) and primaquine (PQ) treatment has been used since the late 1950s to treat Plasmodium vivax infections. Although malaria transmission has declined, current treatment strategies must be evaluated to advance towards malaria elimination. METHODS: The clinical and parasitological outcome of treating symptomatic P. vivax with the 14-day (T14) treatment or intermittent single dose (ISD) regimen was evaluated in southern Mexico between February 2008 and September 2010. Patients over 12 months old with P. vivax mono-infection and asexual parasitaemia ≥500 parasites/µl were treated under supervision. After diagnosis (day 0), treatment began immediately. T14 patients received CQ for 3 days (10, 10 and 5 mg/kg) and PQ daily for 14 days (0.25 mg/kg), while ISD patients received a single dose of CQ (10 mg/kg) and PQ (0.75 mg/kg) on days 0, 30, 60, 180, 210, and 240. Follow-up was done by observing clinical and laboratory (by microscopy, serology and PCR) outcome, considering two endpoints: primary blood infection clearance and clinical response at ~28 days, and the incidence of recurrent blood infection during 12 months. Parasite genotypes of primary/recurrent blood infections were analysed. RESULTS: During the first 28 days, no differences in parasite clearance or clinical outcome were observed between T14 (86 patients) and ISD (67 patients). On day 3, 95 % of patients in both groups showed no blood parasites, and no recurrences were detected on days 7-28. Contrarily, the therapeutic effectiveness (absence of recurrent parasitaemia) was distinct for T14 versus ISD at 12 months: 83.7 versus 50 %, respectively (p = 0.000). Symptomatic and asymptomatic infections were recorded on days 31-352. Some parasite recurrences were detected by PCR and/or serological testing. CONCLUSIONS: T14 was effective for opportune elimination of the primary blood infection and preventing relapse episodes. The first single dose of CQ-PQ eliminated primary blood infection as efficiently as the initial three-dose scheme of T14, but the ISD regimen should be abandoned. A single combined dose administered to symptomatic patients in remote areas while awaiting parasitological diagnosis may contribute to halting P. vivax transmission. Alternatives for meeting the challenge of T14 supervision are discussed. TRIAL REGISTRATION: NIH-USA, ClinicalTrial.gov Identifier: NCT02394197.
Subject(s)
Antimalarials/administration & dosage , Chloroquine/administration & dosage , Malaria, Vivax/drug therapy , Primaquine/administration & dosage , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Diagnostic Tests, Routine , Drug Therapy, Combination/methods , Female , Genotype , Humans , Infant , Malaria, Vivax/parasitology , Malaria, Vivax/pathology , Male , Mexico , Middle Aged , Plasmodium vivax/classification , Plasmodium vivax/genetics , Plasmodium vivax/isolation & purification , Recurrence , Treatment Outcome , Young AdultABSTRACT
El cáncer de mama tiene una alta incidencia en las mujeres de la provincia de Granma. Se realizó la presente investigación con el objetivo de identificar las características de la incidencia de esta enfermedad. Se diseñó un estudio observacional descriptivo, se seleccionaron para tal fin las pacientes con diagnóstico de cáncer de mama incluidas en el Registro Nacional de Cáncer (1997-2006). La información fue resumida en números absolutos, razones, porcentajes y tasas. Para el análisis de la tendencia temporal de las tasa de incidencia se utilizó el método de regresión segmentada y para la distribución geográfica el método descriptivo de la representación cartográfica de la medida del riesgo. El mayor riesgo de enfermar por cáncer de mama se observó en la sexta década de la vida, un 30 por cientoa de las mujeres eran menores de 50 años, con una tendencia creciente. Se encontraron diferencias geográficas en la incidencia, un porciento importante de las pacientes se diagnosticaron tardíamente, sin etapa clínica, sin verificación histológica o citológica y solo por certificado de defunción. Se concluye que la edad, factores de riesgo y los estilos de vida juegan un papel importante en la incidencia de esta enfermedad y la calidad de la atención médica(AU)
Breast cancer has a high incidence in women from Granma province. It was performed the present research with the objective to identify the characteristics of its incidence. It was designed an observational descriptive study, for that purpose there were selected the patients with breast cancer included in the National Cancer Record (1997- 2006). The information was gathered in absolute numbers, percentages and rates. For the analysis of the temporary tendency of the incidence rate it was used the segment regression method and for the geographic distribution it was used the descriptive method of cartographic representation of the risk measure. The greatest risk to get ill was observed in the sixth decade of life, a 30 percent of women were under 50 years, with a growing tendency. There were found geographic differences in the incidence, an important percent of patients were belately diagnosed, without a clinical stage, without the histological or cytological verification and only with a death certificate. It was concluded that the age, risk factors, and life styles play an important role in the incidence of this disease and the quality of medical care(EU)
