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This study presents a novel conservative technique to increase oral opening and overcome rigor mortis during medicolegal autopsy (MLA). The method proposes a myotomy of the temporalis and masseter muscles, taking advantage of the incisions of the cranial opening procedures, to achieve a significant oral opening (≥ 30 mm) in fresh cadavers with established rigor mortis without altering facial aesthetics. The study was performed on 48 individuals aged between 18 and 66 years (20 males and 28 females) who were autopsied at the Instituto Nacional de Patología Forense Dr. Sergio Sarita Valdez (Santo Domingo, Dominican Republic). The proposed technique not only allowed the oral access to all autopsied cadavers but also complied with current ethical standards for preserving facial aesthetics, taking into account the concerns of family members by allowing respectful viewing of the cadaver. This advancement not only contributes to the efficiency of oral autopsies but also influences public perception of forensic procedures and highlights the importance of ethical and aesthetic considerations in the context of MLAs. The proposed technique represents a significant step towards more respectful and ethical forensic practices, and offers practical advantages for a more complete and accurate assessment during MLA.
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Access to comprehensive sexual and reproductive health (SRH) services remains a challenge worldwide. Describing community pharmacists' SRH services in countries with different scopes of practice will aid in understanding how pharmacists view their roles and how to support them in providing needed services. A cross-sectional web-based survey was administered to pharmacists working in community pharmacies in Japan, Thailand, and Canada. The survey covered 7 SRH categories: pregnancy tests, ovulation tests, contraception, emergency contraception, sexually transmitted and blood-borne infections, maternal and perinatal health, and general sexual health. Descriptive statistics were used to analyze the data. A total of 922 eligible responses were included in the analysis (Japan = 534, Thailand = 85, and Canada = 303). Most Thai and Canadian participants reported dispensing hormonal contraceptives (Thailand = 99%, Canada = 98%) and emergency contraceptive pills (Thailand = 98%, Canada = 97%). Most Japanese participants provided patient education on barrier contraceptives for men (56%) and information on the safety of medications in pregnancy (74%) and breastfeeding (76%). The majority of participants expressed interest in additional training and expanding their roles in SRH. Sharing international experiences can guide challenges faced by the evolution of pharmacists' practice in SRH. Providing pharmacists support could help their readiness for this role.
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Background: Pharmacists in many countries have long been involved in some aspect of assisted dying. Since 2016, when Canada enacted legislation permitting medical assistance in dying (MAiD), the number of patients seeking the procedure has increased yearly. Despite the global nature of pharmacists' involvement, little is known about how they experience MAiD practice. Objective: To study how pharmacists experience the practice of caring for patients who seek MAiD. Methods: This qualitative study used semistructured interviews with pharmacists who had cared for patients seeking MAiD. Interviews, conducted between June 2019 and October 2020, were audio-recorded and transcribed verbatim. Data were examined using a modified framework analysis approach. Data were coded and sorted using Quirkos and Microsoft Excel software. Themes were defined through an iterative process involving constant comparison. Results: Nineteen hospital pharmacists representing a range of practice settings in Alberta participated in the study. The experience of caring for patients seeking assistance in dying brought to light 3 themes: finding a place in the process, serving in a caring role, and bearing emotional burdens. Pharmacists' experiences were personal, relational, emotional, and dynamic. Conclusions: Each of the pharmacists experienced MAiD practice in a unique way. Although their roles in MAiD were primarily medication-focused, their experiences highlighted the centrality of patient choices, autonomy, and needs. The results of this study will inform pharmacists (including those not yet engaged in MAiD practice) about the role, and will also be valuable for pharmacy organizations and educators seeking to support pharmacists and the profession, as well as policy-makers seeking to expand pharmacists' roles in MAiD.
Contexte: Les pharmaciens de nombreux pays participent depuis longtemps à certains aspects de l'aide médicale à mourir (AMM). Depuis que le Canada a adopté une loi l'autorisant en 2016, le nombre de patients qui demandent l'intervention a augmenté chaque année. Malgré la nature mondiale de l'implication des pharmaciens, on sait peu de choses sur la façon dont ils vivent la pratique de l'AMM. Objectif: Étudier comment les pharmaciens vivent la pratique de la prise en charge des patients qui sollicitent l'AMM. Méthodes: Cette étude qualitative a utilisé des entretiens semi-structurés avec des pharmaciens qui avaient pris en charge des patients ayant fait une demande d'AMM. Un enregistrement sonore des entretiens, menés entre juin 2019 et octobre 2020, a été effectué et ils ont été transcrits mot à mot. Les données ont été examinées en adoptant une approche d'analyse du cadre modifié. Les données ont été codées et triées à l'aide des logiciels Quirkos et Microsoft Excel. Les thèmes ont été définis par un processus itératif impliquant une comparaison constante. Résultats: Dix-neuf pharmaciens d'hôpitaux représentant un éventail de milieux de pratique en Alberta ont participé à l'étude. L'expérience de la prise en charge de patients cherchant à recevoir l'aide médicale à mourir a mis en lumière 3 thèmes : trouver sa place dans le processus; jouer un rôle de proche aidant; et supporter des charges émotionnelles. Les expériences des pharmaciens étaient personnelles, relationnelles, émotionnelles et dynamiques. Conclusions: Chaque pharmacien a vécu la pratique de l'AMM d'une manière unique. Bien que leurs rôles dans l'AMM étaient principalement axés sur la médication, leurs expériences ont mis en évidence la centralité des choix, de l'autonomie et des besoins des patients. Les résultats de cette étude informeront les pharmaciens (y compris ceux qui ne sont pas encore engagés dans la pratique de l'AMM) sur le rôle. Ils seront également précieux pour les organismes pharmaceutiques et les éducateurs cherchant à soutenir les pharmaciens et la profession, ainsi que pour les décideurs politiques qui cherchent à élargir les rôles de pharmaciens dans l'AMM.
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La investigación tuvo por objetivo identificar, analizar y sistematizar las experiencias teóricas con respecto al estudio de casos como metodología investigativa. El objetivo primario fue evidenciar el estigma y el estereotipo sobre los adultos mayores contrastado con la realidad actual. Para esto se realizó una serie de estudios de casos a adultos mayores de manera remota y presencial debido a la reciente pandemia de COVID-19 donde fueron seleccionados los más destacados. Los resultados obtenidos fueron utilizados para comparar con la estigmatización social atribuida a este grupo etario. Se considera que mediante la entrega de herramientas necesarias para el desarrollo social a las personas mayores para que logren manejar su salud y su estilo de vida, un adulto mayor puede ser capaz de gestionar su autonomía e incluirse en la sociedad de forma eficaz y placentera[AU]
The objective of the research w as to identify, analyze and systematize the theoretical experiences regarding the case study as a research methodology. The primary objective was to demonstrate the stigma and stereotype about the elderly over reality. For this, a series of case studies were carried out on elderly people remotely and in person due to the recent COVID-19 pandemic, where the most prominent were selected. The results obtained were used to contrast the social stigmatization attributed to this age group. We believe that by providing the necessary tools for social development to older people so that they can manage their health and lifestyle, an older adult may be able to manage their autonomy and include themselves in society in an effective and pleasant way[AU]
A pesquisa teve como objetivo identificar, analisar e sistematizar as experiências teóricas sobre o estudo de caso como metodologia de pesquisa. O objetivo principal foi destacar o estigma e estereótipo sobre os idosos sobre a realidade. Para isso, foi realizada uma série de estudos de caso em idosos de forma remota e presencial devido à recente pandemia de COVID-19, onde foram selecionados os mais destacados. Os resultados obtidos foram utilizados para contrastar com a estigmatização social atribuída a essa faixa etária. Em conclusão, propomos que, ao fornecer as ferramentas necessárias para o desenvolvimento social dos idosos, para que eles possam gerenciar sua saúde e estilo de vida, o idoso poderá gerenciar sua autonomia e se incluir na sociedade de maneira eficaz e agradável[AU]
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Anciano , Cambio Social , Estereotipo , Enseñanza , Anciano , Informes de Casos , Autonomía Personal , Teleenfermería , Aprendizaje , Estilo de VidaRESUMEN
BACKGROUND: In many countries, pharmacists' scope of practice enables the delivery of professional pharmacy services related to sexual and reproductive health (SRH). Studies exploring practices and perspectives regarding a wide range of SRH professional pharmacy services and the extent to which pharmacists are involved in prescribing or administering injections are limited. OBJECTIVES: This study aimed to explore SRH professional pharmacy services provided by pharmacists, evaluate pharmacists' self-reported confidence in providing SRH education and determine preferences for additional training. METHODS: A cross-sectional Web-based survey was administered to pharmacists working in community pharmacies in Alberta, Canada. The survey was sent via e-mail and was open for 8 weeks between June and August 2020. Descriptive statistics were used to analyze the data. RESULTS: Most of the 303 participants were female (66%) and received their first pharmacy degree in Canada (69%). Approximately two-thirds had additional prescribing authorization (APA), and 97% had injections authorization; 90% and 94% of participants reported administering injectable contraceptives and human papillomavirus vaccine, respectively, and more than 95% renewed prescriptions for oral contraceptives. Of the participants with APA, approximately 40% reported providing initial prescribing services for contraceptive products. Overall, participants reported confidence in providing SRH education for most topics. Most selected topics for additional training were related to sexually transmitted and blood-borne infections; sexual health concerns of lesbian, gay, bisexual, transgender, queer or questioning; and abortion medications. CONCLUSION: Pharmacists in Alberta reported providing a wide range of SRH services and are interested in expanding their SRH role. These findings highlight opportunities to improve access and reduce inequities in the delivery of SRH services through community pharmacies. However, pharmacists' training needs should be considered.
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Servicios Comunitarios de Farmacia , Servicios de Salud Reproductiva , Alberta , Estudios Transversales , Femenino , Humanos , Masculino , Farmacéuticos , Embarazo , Rol ProfesionalRESUMEN
The provision of sexual and reproductive health (SRH) services is an important part of a community pharmacist's role in many countries. However, such services are not traditionally provided by pharmacists in Japan. We surveyed the practice and attitudes regarding the provision of SRH services among Japanese community pharmacists with a focus on reproductive health (RH) topics. The participants were asked about the provision of RH services, attitudes toward their role as SRH providers, and self-reported confidence in providing education to patients on RH topics. We obtained 534 effective responses. About half of the participants reported providing RH services, and only 21% were involved in dispensing emergency contraception pills. Although the proportion of pharmacists providing education on these topics was considerably lower, about 80% recognized the importance of their role as SRH advisors. Confidence in providing patient education about RH topics depended on their experience in providing such services. Most participants were interested in additional SRH training (80%). Our results suggest that training programs could help to expand Japanese community pharmacists' roles as SRH providers and increase their confidence in the education of patients. This study provides useful insights to expand pharmacists' roles in Japan as providers of comprehensive SRH services.
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OBJECTIVES: Pharmacists are increasingly providing patient-focused services in community pharmacies, including in the area of sexual and reproductive health (SRH). Specific SRH areas have been the focus of research, but a broader perspective is needed to position pharmacists as SRH providers. This review explored research that described and evaluated professional pharmacy services across a broad range of SRH areas. DESIGN: Scoping review DATA SOURCES: Medline, EMBASE, CINAHL, Web of Science, Scopus and Cochrane Library (January 2007-July 2020). STUDY SELECTION: Studies reporting on the description and evaluation of professional pharmacy SRH services provided by community pharmacists. DATA EXTRACTION: Two investigators screened studies for eligibility, and one investigator extracted the data. Data were analysed to primarily describe professional pharmacy services and intervention outcomes. RESULTS: Forty-one studies were included. The main SRH areas and professional pharmacy services reported were sexually transmitted and bloodborne infections (63%) and screening (39%), respectively. Findings showed that pharmacists' delivery of SRH services was feasible, able to reach vulnerable and high-risk groups, and interventions were highly accepted and valued by users. However, integration into daily workflow, pharmacist remuneration, cost and reimbursement for patients, and policy regulations were some of the barriers identified to implementing SRH services. Studies were primarily in specific areas such as chlamydia screening or hormonal contraception prescribing, while studies in other areas (ie, medical abortion provision, long-acting reversible contraception prescribing and vaccine delivery in pregnant women) were lacking. CONCLUSION: This scoping review highlights the expansion of pharmacists' roles beyond traditional product-focused services in a number of SRH areas. Given the potential feasibility, users' acceptability and reach, pharmacists are ideally situated to enhance SRH care access. Future research describing implementation and evaluation of professional pharmacy services in all SRH areas is needed to promote access to these services through community pharmacies and position pharmacists as SRH providers worldwide.
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Servicios Comunitarios de Farmacia , Farmacias , Servicios de Salud Reproductiva , Salud Sexual , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Farmacéuticos , Embarazo , Rol ProfesionalRESUMEN
El ratón (Mus musculus) es un buen modelo animal de experimentación, donde sus glándulas salivales han sido utilizadas en estudios, especialmente de tipo preclínico. Sin embargo, las diferencias en la morfología de estas glándulas y, en particular de las submandibulares, entre humanos y roedores no son de conocimiento común. Por lo anterior, el objetivo de este estudio fue conocer las características morfocuantitativos de la glándula submandibular del ratón macho C57BL/6. Se utilizaron cinco ratones macho, cepa C57BL/ 6, de 11 a 13 semanas de nacidos, con un peso promedio de 30 g. Luego de su ambientación, los ratones fueron eutanasiados. Para el análisis histológico, las glándulas fueron extraídas y fijadas en formalina tamponada por 48 horas, procesada para su inclusión en paraplast y teñidas con hematoxilina y eosina, azul alcián pH 2,5, ácido peryódico de Schiff y Picrosirius Red. Se determinaron las características estereológicas de densidad de longitud (LVcond), de volumen (VVcond) y de superficie (SVcond) de los conductos. En las células acinares se evaluó la densidad de número (NVcel) y la densidad de volumen (VVcel). Para cada variable se obtuvo la media ± desviación estándar. La glándula submandibular se encontraba organizada de manera lobulada, cuyo parénquima era de tipo túbuloacinar mixto con predominio seroso, que se conectaba a través de conductos. Las células acinares presentaban reacción positiva para azul alcián y ácido peryódico de Schiff. El estroma de la glándula contenía principalmente colágeno tipo 1. Los resultados de las mediciones estereológicas fueron: LVcond = 220,02 ± 50,51 mm/mm3; VVcond = 50,48 ± 9,55 %; SVcond = 26,39 ± 5,45 mm2/mm3; NVcel = 16,85 x 104 ± 9,13 × 104/mm3; VVcel = 24,98 ± 6,22 %. Con los análisis presentados es posible realizar investigaciones experimentales, considerando las similitudes y diferencias morfocuantitativas que presenta la glándula submandibular de ratón macho, cepa C57BL/6 con la del humano.
The mouse (Mus musculus) is a good experimental animal model, where murine salivary glands have been widely used in research by their similarities with human glands. Stereology is a tool that has to demonstrated to be valuable in biomedical researc h. Therefore, the objective was to realize an analogy between morphology, function and morpho-quantitative characteristics of the C57BL/6 mouse submandibular gland. Five male mice, C57BL/6, from 11 to 13 weeks old were used, with an average weight of 30 g. After seven days, the mice were euthanized and the samples were extracted. Then, these were processed following the conventional histological processing protocol and stained with H&E, Picrosirius Red, AA and PAS. Finally, the histological and stereological analysis of the samples was performed. In the glandular ducts the length density (LVcond), volume density (VVcond) and surface density (SVcond) were determined; whereas, in the acinar cells the density of number (NVcel) and the density of volume (VVcel) were evaluated. For each stereological variable the mean ± standard deviation was obtained. The histological study revealed no discrepancies as previously described. Descriptive statistical analysis revealed the following: LVcond = 220.02 ± 50.51 mm/mm3; VVcond = 50.48 ± 9.55 %; SVcond = 26.39 ± 5.45 mm2/mm3; NVcel = 168467.38 ± 91288.67 /mm3 and VVcel = 24.98 ± 6.22 %. From this study, it will be possible to conduct comparative experimental research analyzing quantitative results from those presented in this research. From this study, it will be possible to carry out comparative experimental research, analyzing quantitative results from those presented in this investigation.
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Animales , Masculino , Ratones , Glándula Submandibular/anatomía & histología , Ratones Endogámicos C57BL/anatomía & histología , Glándulas Salivales/anatomía & histología , Modelos AnimalesRESUMEN
Para la enseñanza y aprendizaje de cualquier disciplina es clave el uso de una terminología clara y definida. Particularmente en el caso de Morfología, el rol de Programa Federativo Internacional de Terminología Anatómica (FIPAT) ha permitido avanzar a lograr la máxima unificación de la terminología asociada a esta disciplina, que considera múltiples variaciones lingüísticas en sus términos, dificultando su comprensión y difusión. Para que esta labor tenga un impacto más profundo en el uso correcto de la terminología internacional se debe articular un trabajo con los procesos de formación profesional que incorporan esta disciplina. El objetivo principal del presente estudio fue analizar la correcta utilización de Terminologia Histologica en los textos de estudios de Histología Oral, disponibles en Chile. Para este trabajo, se realizó un análisis de 4 textos de Histología Oral, dentro de los cuales se encontraban los 2 más utilizados por los estudiantes según las bases de datos de biblioteca de tres Universidades chilenas tanto públicas como privadas, además de 2 textos del área en idioma distinto al español (inglés y portugués). El análisis consistió, comparar el uso de los términos histológicos del capítulo "Esmalte" con los términos incluidos en Terminologia Histologica. Además de registrar errores en la denominación de términos tales como, eponimias, sinonimias y comparar con dos idiomas distintos al español, con el fin de descartar la traducción como problema principal. De los textos analizados el 100 % presentaba una mayor cantidad de términos histológicos en comparación con los 14 descritos por Terminologia Histologica, de los cuales solo 7 son nombrados en la totalidad de los textos. Se encontraron 59 términos para las distintas estructuras del esmalte entre todos los textos, de éstos, solo 15 son nombrados conjuntamente en los cuatro textos y 7 poseen un término asignado en FIPAT. Además son descritas múltiples estructuras que no están construidas bajo las consideraciones de la FIPAT, presentando eponímias y sinonimias. Llama la atención que la mayoría de los términos extraídos no poseen representación en Terminologia Histologica además del uso predominante de epónimos y sinónimos tanto entre los textos de estudio como dentro de los mismos encontrándose veinte términos con más de un nombre. A partir de estos resultados se sugiere realizar las modificaciones pertinentes además de proponer focos para mejorar el uso de Terminologia Histologica en la formación de los futuros profesionales.
For the teaching and learning of any discipline the use of a clear and defined terminology is key. Particularly in the case of Morphology, the role of the International Federative Program of Anatomical Terminology (FIPAT) has made it possible to advance towards the maximum unification of the terminology associated with this discipline, which considers multiple linguistic variations in its terms, hindering its understanding and dissemination. For this work to have a more profound impact on the correct use of international terminology, work must be articulated with the vocational training processes that incorporate this discipline. The main objective of the present study was to analyze the correct use of Terminologia Histologica in the texts of Oral Histology studies, available in Chile. For this work, an analysis of 4 texts of Oral Histology was carried out, among which were the 2 most used by students according to the library databases of three Chilean universities, both public and private, as well as 2 texts from the area. in a language other than Spanish (English and Portuguese). The analysis consisted in comparing the use of the histological terms of the "Enamel" chapter with the terms included in Terminologia Histologica. In addition to registering errors in the denomination of terms such as, eponymias, synonimies and compare with two languages ??other than Spanish, in order to rule out translation as the main problem. Of the texts analyzed, 100 % had a greater number of histological terms compared to the 14 described by Terminologia Histologica, of which only 7 are named in all the texts. 59 terms were found for the different enamel structures among all the texts, of these, only 15 are named together in the four texts and 7 have a term assigned in FIPAT. In addition, multiple structures are described that are not constructed under the considerations of the FIPAT, presenting eponyms and synonyms. It is noteworthy that most of the extracted terms do not have representation in Terminologia Histologica besides the predominant use of eponyms and synonyms either, between the various texts or within them, and twenty terms can be found with more than one name. From these results it is suggested that pertinent modifications be made, in addition to proposing foci to improve the use of Terminologia Histologica in the training of future professionals.
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Histología , Boca/anatomía & histología , Terminología como Asunto , Esmalte Dental/anatomía & histología , EpónimosRESUMEN
According to the information provided by the World Health Organization (WHO), overweight and obesity are the fifth leading causes of death in the world. Due to the alarming increase of this disorder in recent years, studies have been carried out to evidence harmful effects on human or animal tissues. Our objective was to evaluate the morphological and physiological changes of C57BL/6 mice adrenal glands (AGs), associated with high fat diets (HFDs), we used 14 male mice, 5 months old, fed for 14 weeks according to two diets. The standard chow group (SC) was fed AIN-93M and the high fat group (HF) was fed AIN-93M-HF. At the end of the experiment, biometric analysis was performed and euthanasia was performed. Blood was then extracted for biochemical analysis and AGs were processed for mesoscopic, histological, morphometric and stereological studies. We used Student's t-test (p<0.05) for statistical analysis. SC group showed a lower weight (29.67±1.28 g) with respect to the HF group (38.46±4.68 g, p=0.002). COL-T, HDL-C, TG and CORT analysis revealed differences between SC group and HF (p≤0.001). Focally, in the fasciculate area, there was an increase in the core-cytoplasm ratio and a greater lipid vacuole presence and size. There was a significant reduction (p=0.001) in Vvfas=7.365±3.326 % of the HF group fasciculate area compared to SC group (Vvfas=9.619±4.548 %). Obesity induced by HF diets affects adrenal gland physiology and morphology of mice. Our results suggest that both the percentage of fat as well as the time of administration of the diet, produce a diurnal reduction of corticosterone, which could be due to an increase in the metabolic clearance of this hormone and not to the inhibition of the Hypothalamus-Pituitary-Adrenal (HPA) axis.
De acuerdo a la información entregada por la OMS, el sobrepeso y la obesidad son el quinto factor principal de riesgo de muerte en el mundo. Debido al aumento alarmante de este trastorno en los últimos años, estudios evidencian efectos perjudiciales sobre tejidos humanos y animales. Por lo tanto, nuestro objetivo fue evaluar los cambios morfo-fisiológicos de la glándula suprarrenal de ratones C57BL/6 asociado a dietas altas en grasas. Utilizamos 14 ratones machos, de 5 meses, alimentados por 14 semanas con dos dietas. Grupo dieta estándar (SC), alimentados con AIN-93M y grupo alto en grasa (HF), alimentado con AIN- 93M-HF. Al finalizar el experimento, se realizó el análisis biométrico y se efectuó la eutanasia. Posteriormente, se extrajo sangre para el análisis bioquímico y cada glándula suprarrenal fue procesada para el estudio mesoscópico, histológico, morfométrico y estereológico. Para el análisis estadístico se utilizó la prueba t de Student (p<0,05). El grupo SC mostró un menor peso (29,67±1,28 g) respecto al grupo HF (38,46±4,68 g; p=0,002). El análisis del COL-T, HDL-C, TG y CORT reveló diferencias entre el grupo SC y HF (p≤0,001). En la zona fasciculada, focalmente, se observó aumento en la relación núcleo-citoplasma y, mayor presencia y tamaño de vacuolas lipídicas. Hubo una reducción significativa (p=0,001) en VVfas=7,365±3,326 % de la zona fasciculada del grupo HF, en comparación al grupo SC (VVfas=9,619±4,548 %). La obesidad inducida por la dieta HF afecta la fisiología y morfología de la glándula suprarrenal de ratones alimentados con dietas altas en grasas. Nuestros resultados sugieren que tanto el porcentaje de grasa, así como el tiempo de administración de la dieta, producen una reducción diurna de la corticosterona, lo que podría ser debido a un aumento en el aclaramiento metabólico de esta hormona y no a la inhibición del eje Hipotálamo-Hipófisis-Adrenal.
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Animales , Masculino , Ratas , Grasas de la Dieta/administración & dosificación , Glándulas Suprarrenales/patología , Dieta Alta en Grasa , Ratones Endogámicos C57BLRESUMEN
El objetivo de esta revisión fue exponer el conocimiento actual sobre la relación existente entre dietas altas en grasa (DAG), alteraciones morfológicas de la mucosa intestinal, efectos inflamatorios y cáncer intestinal. Las DAG inicialmente producen aumento de la microbiota patógena, lo que reduce la cantidad y calidad de la secreción de los exocrinocitos caliciformes, disminuyendo la efectividad de la barrera intestinal. Las bacterias y sus lipopolisacaridos (LPS) promueven la secreción de citoquinas proinflamatorias activando vías de inflamación, que a su vez afectan la integridad de las uniones intercelulares alterando la barrera intestinal. Lo anterior, permite que los LPS ingresen a la lámina propia y circulación sanguínea produciendo inflamación local y sistémica. Así mismo, las DAG generan efectos nocivos en la morfología y función de la mucosa gastrointestinal lo que podría favorecer el desarrollo de cáncer. Lo anterior, podría deberse a que el consumo de DAG es capaz de aumentar la proliferación de células de la mucosa y el número y proliferación de células madres tumorales en el intestino.
The aim of this review was to present current knowledge about the relationship between high fat diets (HFD), morphological alterations of intestinal mucosa, inflammatory effects and intestinal cancer. The HFD initially produces an increase in the pathogenic microbiota, which reduces quantity and quality of secretion of goblet cells, decreasing the effectiveness of intestinal barrier. Bacteria and their lipopolysaccharides (LPS) stimulate the secretion of proinflammatory cytokines by activating inflammation pathways, which in turn affect the integrity of intercellular junctions by changing intestinal barrier. The above allows the LPS enter to lamina propria and blood circulation producing local and systemic inflammation. Likewise, HFD generate deleterious effects on morphology and function of gastrointestinal mucosa, which could favor the development of cancer. This could be due to the fact that consumption of HFD is capable of increasing proliferation of mucosal cells and number and proliferation of tumor stem cells in the intestine.
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Humanos , Grasas de la Dieta/efectos adversos , Dieta Alta en Grasa/efectos adversos , Microbioma Gastrointestinal/efectos de los fármacos , Inflamación/etiología , Mucosa Intestinal/efectos de los fármacos , Ácidos y Sales Biliares/metabolismo , Citocinas/metabolismo , Uniones Estrechas/efectos de los fármacos , Tracto Gastrointestinal/microbiología , Inflamación/metabolismo , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologíaRESUMEN
Due to the increase in overweight and obesity in humans, various studies have been conducted in recent years that demonstrate the detrimental effects on tissues and organs. The aim of this study was to assess the morphoquantitative changes produced in the ileum of mice, associated with high-fat diets. Fourteen male C57BL/6 mice, 5 months old, were fed two types of diets for 14 weeks. The control group (C) was fed a standard diet (10% fat, AIN-93M) and the experimental group (E) was fed a high-fat diet (42% fat, AIN-93M-AG). The assessments included: body weight, calorie consumption, food efficiency, biochemical analysis of plasma lipids, diameter, total wall thickness, thickness of the tunica mucosa and tunica muscularis, length and width of the intestinal villi, depth of the intestinal crypts and number of goblet cells per mm(-2) (NA). For the statistical analysis the Student's t-test was used, considering a P value less than 0.05. The mice in the E group presented greater weight gain (P = 0.028), higher levels of total and LDL cholesterol (P = 0.03 and P = 0.01, respectively), and length of the intestinal villi (P = 0.000). The width of the intestinal villi and the NA of PAS-positive goblet cells presented significantly lower values (P = 0.037 and P = 0.039, respectively) than the C group. The observed changes could be related to the higher demand for fat absorption and to possible alterations in the intestinal microflora and inflammation by action of high-fat diets.
Asunto(s)
Dieta Alta en Grasa/efectos adversos , Íleon/patología , Animales , Lípidos/sangre , Masculino , Ratones , Ratones Endogámicos C57BLRESUMEN
El presente artículo describe una intervención educativa que fomenta la participación activa de la comunidad como protagonista de su aprendizaje, con el propósito de empoderarla en el manejo de su salud en relación a crisis hipertensiva y diabética. MÉTODOS: se utilizó el Proceso de Enfermería y el modelo de Comunidad como Socio de Anderson y McFarlane, con los cuales se realizó la valoración, levantamiento de necesidades y análisis. Además, se utilizaron metodologías participativas, establecidas en el modelo de educación descrito por Jane Vella, para las intervenciones. En la valoración, se empleó un instrumento diseñado para recolectar datos del núcleo y los subsistemas educación y recreación. La población estuvo conformada por un grupo de diez mujeres, nueve de ellas adultos mayores, pertenecientes a la comuna de Puente Alto, seleccionadas por el programa de adultos mayores de la Municipalidad de dicha comuna. Los encuentros con la comunidad se iniciaron el día jueves 12 de marzo de 2015 y finalizaron el día martes 31 de marzo del mismo año, completando un total de cinco sesiones. RESULTADOS: en el primer encuentro, se identificó la necesidad de aprender acerca del manejo de enfermedades crónicas en situaciones de crisis, tales como Diabetes Mellitus tipo II e Hipertensión Arterial. Conjuntamente, resultó que toda la comunidad fue capaz de reconocer el manejo correcto de una emergencia diabética e hipertensiva. CONCLUSIÓN: las metodologías participativas logran el empoderamiento de la comunidad para actuar frente a situaciones de descompensación de diabéticos tipo II e hipertensos.
OBJECTIVE: The present arcticle describes an educational intervention that encourages active communitary participation, ensuring to make them the main character of their learning, with the purpose of empowering their health management regarding hypertensive and diabetic crisis. METHODS: the method used was based on the Nursing process, and the Community-as-partner model by Anderson and McFarlane, with this approach a valuation, a list of needs, and an analysis were carried out. Furthermore, Jane Vella's participative methodology was used for the development of the interventions. For the assessment, an instrument was designed to collect the data. The data consisted of the core, the education subsistem and the recreation subsistem. The community consisted of a ten women group; nine of them were elderly, and all of them lived in the area of Puente Alto. They were selected by the Municipality's elderly program. The communitary meetings began on Thursday March 12, 2015, and ended on Tuesday March 31, of the same year. There were a total of five sessions. RESULTS: on the first meeting, the need to learn about the management of crisis situations in chronic diseases, such as Diabetes and Hypertension, was identified. All the community's members were able to recognize by themselves the right diabetic and hypertensive crisis management. CONCLUSION: the participative methodology achieves the community's empowering to face the diabetic and hypertensive decompensations.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Participación de la Comunidad , Diabetes Mellitus/prevención & control , Tutoría , Hipertensión/prevención & control , Envejecimiento , ChileRESUMEN
Ultrasound therapy is used to treat injuries in joints, nerves and tendons. Part of the radiation generated is absorbed by nearby undamaged tissues, such as muscles. The aim was to evaluate histomorphological changes in the healthy gastrocnemius muscle in rats irradiated with continuous ultrasound (CUS) and pulsed ultrasound (PUS). Healthy adult rats were used, separated into two groups: CUS and PUS. Both were irradiated in the gastrocnemius muscle for 10 days: the CUS group in continuous mode (3 MHz, 1.0 W/cm(2), 1 min/session) and the PUS group in pulsed mode (3 MHz, 1.0 W/cm(2), 100 Hz, 50% duty cycle, 1 min/session). The contralateral muscles were used as a control. Their histological characteristics were analyzed, and the area and perimeter of the muscle fibers were measured. The connective tissue showed no histological changes. The area of muscle fibers of the irradiated groups was significantly greater (CUS 1325.2 ± 182.1 µm(2), p=0.0278 and PUS 1019.4 ± 125.3 µm(2), p=0.0398) than the control, and the CUS area was greater than the PUS (p=0.0383). The perimeter of muscle fibers showed significant differences between the irradiated groups (CUS 148 ± 11.12 µm, p=0.0178 and PUS 129.3 ± 8.83 µm, p=0.0236) compared to the control, as well as differences between CUS and PUS (p=0.0319). The application of ultrasound on healthy muscle produces hypertrophy of the muscle fibers, greater when continuous mode is used. It is advisable to apply pulsed, focused ultrasound therapies with sound heads sufficient for the tissue or zone to be treated, thereby reducing the risk of altering the adjacent healthy tissue.
Asunto(s)
Fibras Musculares Esqueléticas/patología , Terapia por Ultrasonido/métodos , Animales , Hipertrofia , Masculino , Ratas , Ratas Sprague-Dawley , Factores de Tiempo , Terapia por Ultrasonido/efectos adversosRESUMEN
El comportamiento reproductivo de los ovinos varía entre las diferentes razas. Dentro de los factores que inciden en la capacidad reproductiva, el nivel de expresión de receptores de estrógenos y progesterona en su tracto genital parece tener un rol relevante. En el endometrio, oviducto y ovario los estrógenos y progesterona, regulan la expresión de numerosas proteínas comprometidas en su desarrollo morfofuncional. Factores genéticos como la raza estarian relacionados con los niveles de expresión de estos receptores. Las ovejas de raza Texel tienen elevados índices de fertilidad, son muy prolíficas y presentan un alto porcentaje de gestación múltiple lo cual podría tener relación con la expresión de estos receptores en el tracto reproductivo. El objetivo del presente estudio fue evaluar la expresión de receptores de estrógenos y progesterona en tracto genital de ovejas de raza Texel de alta prolificidad. La expresión de la proteína receptora de ambos receptores se detectó mediante análisis inmunohistoquímico y el nivel de expresión de los transcritos por RT-PCR en Tiempo Real Cuantitativo. Los resultados muestran expresión inmunohistoquímica del receptor de estrógeno principalmente en zonas glandulares y carunculares del endometrio. Se destaca además una menor expresión de ambos receptores en ovario, epitelio del oviducto y cervix. La expresión del receptor de progesterona a nivel inmunohistoquímico es bastante menor en cuanto a la señal destacándose marcas débiles en endometrio y ovarios. El nivel de expresión de los transcritos mantiene la misma distribución que las señales inmunohistoquimicas para ambos receptores. Concluimos que ambos receptores son expresados en el sistema reproductivo de ovejas de raza Texel en una distribución similar a lo encontrado en otras razas de ovejas quedando por definir si los niveles de expresión son similares en las distintas razas.
Reproductive performance of sheep varies between different races. Among the factors that affect the reproductive capacity, the level of expression of estrogen and progesterone receptors in the genital tract appears to have a relevant role. In the endometrium, oviduct and ovarian estrogen and progesterone regulate the expression of numerous proteins involved in morphofunctional development. Genetic factors such as race would be related to expression levels of these receptors. The Texel ewes have high fertility rates, are very prolific and have a high percentage of multiple births which could be related to the expression of these receptors in the reproductive tract. The aim of this study was to evaluate the expression of estrogen and progesterone receptors in the genital tract of ewes and Texel high prolificacy. The expression of the receptor protein of both receptors was detected by immunohistochemistry and the level of expression of the transcripts by Quantitative RT-PCR Real-Time. The results showed immunohistochemical expression of estrogen receptor mainly in areas of glandular and caruncular endometrium. It also highlights a lower expression of both receptors in ovarian tissue, epithelium of the oviduct and cervix. Expression of progesterone receptor immunohistochemical level is much lower with weaker signal in endometrium and ovaries. The expression level of transcripts remains the same distribution as immunohistochemical signals for both receptors. We conclude that both receptors are expressed in the reproductive system Texel ewes in a distribution similar to that found in other breeds of sheep, must be defined if the levels of expression are similar in different races.