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1.
J Clin Tuberc Other Mycobact Dis ; 36: 100446, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38708035

RESUMO

Background: Philippines is one of the top ten countries of birth among individuals with tuberculosis in New York City (NYC). The NYC Health Department (HD) screened Filipino-born New Yorkers for latent TB infection (LTBI), but few of those tested positive completed evaluation and treatment. Objective: To increase the proportion of Filipinos with a positive QuantiFeron-TB Gold Plus (QFT-Plus) complete LTBI evaluation and treatment. Methods: Nine community-based LTBI screening events were conducted during September-December 2021. Patients with positive QFT-Plus results were offered no-cost LTBI evaluation and treatment at HD Chest Clinic. The HD engaged culturally- and linguistically-competent Filipino patient navigators (PN) to facilitate LTBI evaluation and treatment. Results: Of 77 Filipinos screened, 17 (22%) tested positive. Fourteen (82%) were evaluated for LTBI; eight of the 14 (57%) completed LTBI treatment. Conclusions: Pairing patients with culturally- and linguistically- competent Filipino PNs contributed to an increase in the proportion of Filipinos with a positive QFT-Plus who completed LTBI evaluation and treatment. TB prevention programs may wish to consider PNs in LTBI patient care.

2.
Support Care Cancer ; 29(3): 1205-1212, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32607599

RESUMO

Exercise may prevent changes in body composition and provide an effective means of improving the side effects of treatment without causing lymphedema. PURPOSE: Test the effectiveness of a 12-week water aerobics program on body composition and lymphedema risk in breast cancer survivors. METHODS: Body composition analysis was completed at weeks 0, 6, and 12 weeks. RESULTS: Ten females completed all testing. Baseline subject characteristics were as follows: age (59.40 ± 8.22 years), weight (169.91 ± 41.70 lbs), body fat percent (%BF) (40.15 ± 9.84%), body fat mass (BFM) (71.27 ± 31.50 lbs), lean body mass (LBM) (98.66 ± 13.24 lbs), skeletal muscle mass (SMM) (53.17 ± 8.09 lbs), intracellular water (ICW) (44.24 ± 6.18 lbs), and extracellular water (ECW) (28.91 ± 3.62 lbs). One-way ANOVA showed no statistically significant differences over time as determined for weight (F(2.27) = 0.002, P = 0.96), %BF (F(2.27) = 0.004, P = 0.97), BFM (F(2.27) = 0.001, P = 0.97), LBM (F(2.27) = 0.013, P = 0.95), SMM (F(2.27) = 0.027, P = 0.91), ICW (F(2.27) = 0.021, P = 0.93), and ECW (F(2.27) = 0.01, P = 0.94) across the 12 weeks. CONCLUSIONS: A water aerobics program for 12 weeks was not enough to observe changes in body composition nor did it increase the risk for lymphedema and may be a safe exercise method for breast cancer survivors.


Assuntos
Composição Corporal/fisiologia , Neoplasias da Mama/terapia , Exercício Físico/fisiologia , Linfedema/prevenção & controle , Natação/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade
3.
Med Oral Patol Oral Cir Bucal ; 24(5): e588-e594, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31433390

RESUMO

BACKGROUND: Determine the behavior of the maxillofacial trauma of adults treated in 3 tertiary care centers in the central zone of Chile. MATERIAL AND METHODS: descriptive, cross-sectional, multicenter study, based on the prospective records of maxillofacial trauma cases attended between May 2016 and April 2017 by dental and maxillofacial clinical teams of Adult Emergency Units of hospitals Dr. Sótero del Río (metropolitan region), Carlos Van Buren and Dr. Gustavo Fricke (region V). Age, sex, date of occurrence, type of trauma according to ICD-10, etiology, legal medical prognosis and associated injuries were recorded, stratifying by sex and age. Chi square and unpaired Wilcoxon tests were used to compare by groups. RESULTS: 2.485 cases and 3.285 injuries were investigated. The male: female ratio was 1.7: 1 with age under 30 predominant, followed by older adults. Variability was observed in the yearly, weekly and daily presentation. The highest frequencies were in January and September, weekends and at night. The main etiologies were violence (42.3%), falls (13.1%) and road traffic crashes (12.9%) with differences by age and sex (p <0.05). 31,9% of the injuries occurred in hard tissue, being fractures in nasal bones predominant (S02.2). CONCLUSIONS: the profile of the maxillofacial trauma in Chile seems to be mixed by age, affecting young people and the elderly. The male sex predominates; the main cause, which varies by age group, is violence. Their surveillance is possible from hospital emergency records.


Assuntos
Acidentes de Trânsito , Traumatismos Maxilofaciais , Adolescente , Idoso , Chile , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Retrospectivos , Violência
4.
Mater Sci Eng C Mater Biol Appl ; 101: 404-414, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31029334

RESUMO

The synthesis of bioactive CuO/C nano composite using sucrose as a capping agent is achieved through simple green approach via Response Surface Methodology. The synthesis process was done in a green environment which prevents aggregation of sucrose and promotes nanoparticles formation. The innovative approach produces sucrose as a carbon source mediated copper oxide nanocomposites (CuO/C nanocomposite) with the particle size of 50 nm. Additionally, the produced CuO/C nanocomposite were characterized using microscopic techniques like SEM, TEM and spectroscopic techniques like UV-vis and X-ray diffraction. The antifungal activities of CuO/C nanocomposite were tested against Aspergillus niger and Aspergillus flavus species. At 1000 ppm of CuO/C nanocomposite, it showed 70% restraint on A. flavus and 90% hindrance on A. niger. The fungal inhibition mechanism of bioactive CuO/C nanocomposite was discussed in this research article. The particular high antifungal performance of CuO/C nanocomposite was found against Aspergillus niger while compare to Aspergillus flavus fungal strain.


Assuntos
Antifúngicos/farmacologia , Carbono/farmacologia , Cobre/farmacologia , Nanocompostos/química , Sacarose/farmacologia , Análise de Variância , Aspergillus/efeitos dos fármacos , Hemólise/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana , Nanocompostos/ultraestrutura , Análise de Regressão , Espectrofotometria Ultravioleta , Espectroscopia de Infravermelho com Transformada de Fourier
5.
Clin Exp Immunol ; 197(2): 250-261, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30916387

RESUMO

Previously, we found a substantial number of regulatory T cells (Tregs ) and fewer senescent and T helper type 17 (Th17) and a decrease in interstitial fibrosis (IF) in 12-month graft biopsies in belatacept versus cyclosporin (CNI)-treated patients [Belatacept Evaluation of Nephroprotection and Efficacy as First-line Immunosuppression Trial (BENEFIT) study]. Seven years after kidney transplantation (KT), mean estimated glomerular filtration rate (eGFR), patient and graft survival were significantly higher with belatacept versus CNI treatment. The aim of this study was to determine whether the immunophenotypes of inflammatory and regulatory cell subsets infiltrating the grafts contribute to the BENEFIT's clinical findings a decade after KT. Twenty-three adult patients with functionally stable KT treated with belatacept and 10 treated with CNI were enrolled. Biopsies were analyzed by histomorphometry and immunohistochemistry for proliferation, senescence, apoptosis, inflammatory and regulatory cell markers in a blinded manner. Significantly lower percentages of inflammatory/fibrogenic cells [interleukin (IL)-22+ /Th17/Th2/M1 macrophages] were observed in patients treated with belatacept than in patients treated with CNI. By contrast, remarkably higher percentages of regulatory cells [Tregs /Bregs / plasmacytoid dendritic regulatory cells (pDCregs )/M2] were found in belatacept-treated patients than in CNI-treated patients. Conspicuously lower percentages of apoptosis and senescence and higher proliferation markers were found in belatacept-treated patients than in CNI-treated patients. Consequently, there was significantly more inflammation in the microvascular compartments as well as increased tubular atrophy and IF in CNI-treated patients. These findings strongly suggest that regulatory mechanisms, along with the absence of deleterious effects of CNI, contribute to the long-term graft histology and function stability in patients treated with belatacept.


Assuntos
Abatacepte/uso terapêutico , Ciclosporinas/uso terapêutico , Sobrevivência de Enxerto/efeitos dos fármacos , Imunossupressores/uso terapêutico , Transplante de Rim/métodos , Adulto , Contagem de Linfócito CD4 , Senescência Celular/efeitos dos fármacos , Feminino , Taxa de Filtração Glomerular/fisiologia , Humanos , Imunofenotipagem , Masculino , México , Linfócitos T Reguladores/imunologia , Tacrolimo/uso terapêutico , Células Th17/imunologia
6.
Med Biol Eng Comput ; 57(3): 589-600, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30267255

RESUMO

The P300 component of event-related potentials (ERPs) is widely used in the implementation of brain computer interfaces (BCI). In this context, one of the main issues to solve is the binary classification problem that entails differentiating between electroencephalographic (EEG) signals with and without P300. Given the particularly unfavorable signal-to-noise ratio (SNR) in the single-trial detection scenario, this is a challenging problem in the pattern recognition field. To the best of our knowledge, there are no previous experimental studies comparing feature extraction and selection methods for single trial P300-based BCIs using unified criteria and data. In order to improve the performance and robustness of single-trial classifiers, we analyzed and compared different alternatives for the feature generation and feature selection blocks. We evaluated different orthogonal decompositions based on the wavelet transform for feature extraction, as well as different filter, wrapper, and embedded alternatives for feature selection. Accuracies over 75% were obtained for most of the analyzed strategies with a relatively low computational cost, making them attractive for a practical BCI implementation using inexpensive hardware. Graphical Abstract Experiments performed for P300 detection.


Assuntos
Algoritmos , Interfaces Cérebro-Computador , Potenciais Evocados P300 , Adulto , Bases de Dados Factuais , Eletroencefalografia/métodos , Humanos , Processamento de Sinais Assistido por Computador , Análise de Ondaletas
7.
Rev Chil Pediatr ; 89(5): 612-620, 2018 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-30571804

RESUMO

INTRODUCTION: The complementary feeding (CF) comprises a period in the life of the infant that starts with the introduction of foods other than breast-milk. It is determined by social and environmental factors which facilitate or limit the appropriate initiation of this practice, directly affecting the nutri tional and health status of children. OBJECTIVE: To identify barriers and facilities for the follow-up of nutritional recommendations regarding the early start of CF in children between 0 and 24 months of age belonging to a comprehensive early childhood care program. MATERIALS AND METHODS: Phenome nological, longitudinal, qualitative study in which 43 in-depth interviews and 11 focus-groups were carried out. Predefined categories were the context of the mother, representations and experiences of gestation, meanings and experiences of breastfeeding (BF), and CF. The analysis included the rela tionships between the units of meaning and predefined and emerging categories. RESULTS: The CF is a social practice which is the result of medical and popular knowledge mixture, however, the degree of influence that the latter has on mothers is higher due to the degree of support that they have from their close circle, especially from mothers, grandmothers, and women of the family. The lack of con ceptual and practical knowledge about exclusive breastfeeding (EBF) and CF prevents mothers from carrying out good practices. Most of them do not know clearly what is involved in the EBF, resulting in an early start of CF, or do not have objective criteria to assess their milk production. Despite having received specific training, CF started early in most cases, a fact in which close family influence was decisive. CONCLUSIONS: The CF experience is strongly influenced by sociocultural aspects not only of the mother but of her immediate circle, and the recommendations they received from health pro fessionals are not enough to change their practices. Therefore, it is necessary to improve CF support interventions.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Cuidado do Lactente/métodos , Fenômenos Fisiológicos da Nutrição do Lactente , Comportamento Materno/psicologia , Comportamento Social , Adolescente , Adulto , Aleitamento Materno/psicologia , Pré-Escolar , Colômbia , Relações Familiares , Feminino , Grupos Focais , Humanos , Lactente , Cuidado do Lactente/psicologia , Recém-Nascido , Entrevistas como Assunto , Estudos Longitudinais , Masculino , Pesquisa Qualitativa , Adulto Jovem
8.
Rev. chil. pediatr ; 89(5): 612-620, oct. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-978133

RESUMO

Resumen: Introducción: La alimentación complementaria (AC) comprende un periodo en la vida del lactante que inicia cuando se introducen alimentos diferentes a la leche materna. Está determinada por fac tores sociales y del medio ambiente, que facilitan o limitan el inicio adecuado de esta práctica, inci diendo directamente en el estado nutricional y de salud de los niños. Objetivo: Identificar barreras y facilidades para el seguimiento de las recomendaciones nutricionales en relación al inicio temprano de la AC en niños y niñas entre 0 y 24 meses de edad en una población perteneciente a un programa de atención integral a la primera infancia. Sujetos y métodos: Estudio cualitativo fenomenológico, longitudinal, seleccionando a través de una muestra intencionada 43 madres, a las que se les realizó entrevistas en profundidad y 11 grupos focales. Las categorías predefinidas fueron el contexto de la madre, representaciones y experiencias frente a la gestación, significados y experiencias de la lactan cia materna (LM), y la AC. El análisis comprendió las relaciones entre las unidades de significado y categorías predefinidas y emergentes. Resultados: AC es una práctica social que resulta de la mezcla de saberes médicos y populares, sin embargo, el grado de influencia que tienen estos últimos en las madres es mayor debido al grado de acompañamiento que tienen de su círculo cercano, en especial madres, abuelas y mujeres de la familia. El desconocimiento sobre lactancia materna exclusiva (LME) y AC en términos conceptuales y prácticos, impide que las madres puedan llevar a cabo prácticas ade cuadas. La gran mayoría no tiene claridad sobre lo que implica la exclusividad de la LM, resultando en un inicio temprano de la AC, o no cuentan con criterios objetivos para valorar su producción de leche. A pesar de haber recibido capacitación, la AC inició de manera temprana en la mayoría de los casos, hecho en el que la influencia familiar cercana fue decisiva. Conclusiones: La experiencia de la AC está fuertemente influenciada por el entorno cercano de la madre y las recomendaciones que reciben de profesionales de la salud no son suficientes para transformar sus prácticas. Por lo anterior se hace necesario el mejoramiento de las intervenciones de apoyo en materia de AC.


Abstract: Introduction: The complementary feeding (CF) comprises a period in the life of the infant that starts with the introduction of foods other than breast-milk. It is determined by social and environmental factors which facilitate or limit the appropriate initiation of this practice, directly affecting the nutri tional and health status of children. Objective: To identify barriers and facilities for the follow-up of nutritional recommendations regarding the early start of CF in children between 0 and 24 months of age belonging to a comprehensive early childhood care program. Materials and methods: Phenome nological, longitudinal, qualitative study in which 43 in-depth interviews and 11 focus-groups were carried out. Predefined categories were the context of the mother, representations and experiences of gestation, meanings and experiences of breastfeeding (BF), and CF. The analysis included the rela tionships between the units of meaning and predefined and emerging categories. Results: The CF is a social practice which is the result of medical and popular knowledge mixture, however, the degree of influence that the latter has on mothers is higher due to the degree of support that they have from their close circle, especially from mothers, grandmothers, and women of the family. The lack of con ceptual and practical knowledge about exclusive breastfeeding (EBF) and CF prevents mothers from carrying out good practices. Most of them do not know clearly what is involved in the EBF, resulting in an early start of CF, or do not have objective criteria to assess their milk production. Despite having received specific training, CF started early in most cases, a fact in which close family influence was decisive. Conclusions: The CF experience is strongly influenced by sociocultural aspects not only of the mother but of her immediate circle, and the recommendations they received from health pro fessionals are not enough to change their practices. Therefore, it is necessary to improve CF support interventions.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Adolescente , Adulto , Adulto Jovem , Comportamento Social , Conhecimentos, Atitudes e Prática em Saúde , Cuidado do Lactente/métodos , Fenômenos Fisiológicos da Nutrição do Lactente , Comportamento Materno/psicologia , Aleitamento Materno/psicologia , Entrevistas como Assunto , Estudos Longitudinais , Grupos Focais , Colômbia , Pesquisa Qualitativa , Relações Familiares , Cuidado do Lactente/psicologia
9.
Pediatr Transplant ; 21(1)2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27753183

RESUMO

This multicenter, open-label study evaluated the tolerability of extended prophylaxis with valganciclovir in pediatric kidney transplant recipients at risk of CMV disease. Fifty-six patients aged 4 months to 16 years received once-daily valganciclovir oral solution and/or tablets, dosed by BSA and renal function, for up to 200 days. The most common AEs on treatment were upper respiratory tract infection (33.9%), urinary tract infection (33.9%), diarrhea (32.1%), leukopenia (25.0%), neutropenia (23.2%), and headache (21.4%). There were fewer AEs during days 101-228 vs days 1-100. Twenty-seven patients (48.2%) had treatment-related AEs during valganciclovir treatment, most commonly leukopenia (21.4%), neutropenia (19.6%), anemia (7.1%), and tremor (5.4%). Treatment-related serious AEs were reported for nine patients (16.1%) and six withdrew due to AEs. Viremia was centrally confirmed in 10 patients; there was no confirmed CMV disease. One patient tested positive for a resistance mutation (UL97 L595F). Biopsy-proven acute rejection occurred in six patients (10.7%), but no graft loss or deaths occurred. In conclusion, up to 200 days of valganciclovir prophylaxis in pediatric kidney allograft recipients showed a safety profile consistent with that established in adult transplant patients.


Assuntos
Antivirais/administração & dosagem , Infecções por Citomegalovirus/prevenção & controle , Ganciclovir/análogos & derivados , Transplante de Rim/métodos , Comprimidos com Revestimento Entérico/administração & dosagem , Administração Oral , Adolescente , Biópsia , Criança , Pré-Escolar , Esquema de Medicação , Feminino , Ganciclovir/administração & dosagem , Rejeição de Enxerto/prevenção & controle , Humanos , Lactente , Masculino , Mutação , Transplantados , Resultado do Tratamento , Valganciclovir
10.
Toxicon ; 122: 103-108, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27693586

RESUMO

The scorpion Centruroides limpidus limpidus (C.l.l.) is endemic in México, producing hundreds of accidents in humans; children being one of the most susceptible targets. Few studies reported that severe envenoming by scorpion venom induces cardiac damage and electrolytes abnormalities in children, but the relationship of envenoming severity and toxic blood levels is unknown. The aim of this study was to determine the relationship among clinical status of envenoming, serum electrolyte, electrocardiographic abnormalities, and serum toxin levels in 44 children stung by scorpion over a period of 6 months in the State of Morelos, Mexico. The patients were said to be asymptomatic, when they presented just local symptoms, and were said to be symptomatic when showing local symptoms and at least one systemic symptom. The clinical status was evaluated at the admission at the emergency room of the Hospital, and 30 min after the administration of polyspecific F(ab')2 anti-scorpion therapy to symptomatic children. Forty-one percent of the children were asymptomatic and 59% symptomatic. Potassium and sodium imbalance and an elongation of the QT interval were detected; the rate of hypokalemia was higher in symptomatic than on asymptomatic children (50% and 6%, respectively). Hypokalemia persisted in 19% in symptomatic patients, whereas sodium reached normal levels 30 min after anti-venom therapy. The hypokalemia statistically correlated with elongation of the QT interval. The concentration of the toxic components of C.l.l in serum was significantly higher in symptomatic than asymptomatic children, and the serum levels of the toxic component significantly decreased to undetectable levels after the application of anti-venom therapy. Despite the small size of the sample, this study establishes that severity of envenoming was statistically related to potassium imbalance in serum, QT interval and the concentration of toxic components in serum, which decreased at undetectable levels after specific treatment with the anti-scorpion venom, correlating with clinical disappearance or greatly reduction of symptoms of envenomation.


Assuntos
Mordeduras e Picadas , Eletrólitos/metabolismo , Venenos de Escorpião/metabolismo , Escorpiões , Adolescente , Animais , Criança , Eletrocardiografia , Feminino , Humanos , Lactente , Masculino , México
11.
Parasite Immunol ; 38(8): 468-80, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27150641

RESUMO

It has been demonstrated that the allergic response can be ameliorated by the administration of pathogen derivatives that activate Toll-like receptors and induce a Th1-type immune response (IR). Cryptosporidium is a parasite that promotes an IR via Toll-like receptors and elicits the production of Th1-type cytokines, which limit cryptosporidiosis. The aim of this study was to investigate allergy-related immune markers in children naturally infected with Cryptosporidium. In a cross-sectional study, 49 children with or without clinical diagnosis of allergies, oocysts of Cryptosporidium spp. in the faeces were screened microscopically. We microscopically screened for leucocytes, examined T and B cells for allergy-related activation markers using flow cytometry and evaluated serum for total IgE using chemiluminescence. Children with allergies and Cryptosporidium in the faeces had significantly lower levels of total IgE, B cells, CD19(+) CD23(+) and CD19(+) CD124(+) cells as well as a greater percentage of interferon-gamma (IFN-γ(+) ) and IL-4(+) CD4(+) cells than children with allergies without Cryptosporidium. This is the first description of the modulation of the IR in children with allergic diseases in the setting of natural Cryptosporidium infection. Our findings suggest the involvement of CD4(+) cells producing IL-4 and IFN-γ in the IR to Cryptosporidium in naturally infected children.


Assuntos
Criptosporidiose/imunologia , Cryptosporidium/imunologia , Hipersensibilidade/imunologia , Interferon gama/imunologia , Interleucina-4/imunologia , Células Th1/imunologia , Células Th2/imunologia , Animais , Linfócitos B/imunologia , Criança , Estudos Transversais , Criptosporidiose/parasitologia , Fezes/parasitologia , Feminino , Humanos , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Ativação Linfocitária/imunologia , Masculino , Receptores Toll-Like
12.
Bol. Hosp. Viña del Mar ; 72(4): 132-136, 2016.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1397378

RESUMO

Introducción: La desnutrición y la alteración en la funcionalidad son altamente prevalentes en adultos mayores hospitalizados y se asocia a resultados adversos. El objetivo principal de este trabajo fue evaluar la relación existente entre el estado nutricional y funcionalidad en adultos mayores hospitalizados en Unidad Geriátrica de Agudos (UGA) del Hospital Naval Almirante Nef. Pacientes y Métodos: Estudio descriptivo de corte transversal, que incluyó a adultos mayores (AM) hospitalizados en UGA entre 01 de Marzo 2014 y 01 de Mayo 2015. A los pacientes se les realizó valoración geriátrica integral y valoración nutricional con MNA SF y test para evaluar la presencia de anorexia. Se analizaron los datos con software STATA 10. Para evaluar significancia estadística se ocuparon las pruebas Chi2 y de Kruskal Wallis. Resultados: 97 pacientes ingresados, 1 excluido. Promedio de edad de 84,1 años, 52% mujeres. Índice de Barthel promedio de 74,02 puntos. Prevalencia de desnutrición de 20,83%. La asociación entre un peor estado nutricional y peor funcionalidad en ABVD resultó estadísticamente significativa (p: 0,005). Discusión: Aquellos pacientes que ingresaron a UGA con peor estado nutricional presentaban peor funcionalidad basal en las ABVD. La relación entre estado nutricional y funcionalidad es compleja y probablemente bidireccional. Conclusión: La alta prevalencia de desnutrición en AM recientemente hospitalizados se acompaña de peor funcionalidad basal en actividades básicas de la vida diaria.


Background: Malnutrition and functional impairment are highly prevalent in the hospitalized elderly and can lead to unfavorable outcomes. The purpose of this study was evaluate if there is a relation between nutritional status and functionality in elderly patients hospitalized in the Acute Geriatric Unit (AGU) of Hospital Naval Almirante Nef, Viña del Mar. Patients: Cross-sectional descriptive study wich included elderly patients hospitalized in the AGU between March 1, 2014 and May 1, 2015. Patients underwent a comprehensive geriatric assessment and nutritional assessment with MNA Short Form and an anorexy test. Data were analyzed with STATA 10 software. Chi2 and Kruskal Wallis tests were used to assess statistical significance. Results: A total of 97 patients, 1 excluded. Average age of 84,1 years, 52% female. Barthel index averaged 74,02 points. The prevalence of malnutrition was 20,83%. The association between poorer nutritional status and poorer functioning in basic activities of daily living was statistically significant (p: 0.005). Conclusions: Those patients who entered AGU with worse nutritional status presented worse baseline functionality in basic activities of daily living. The relationship between nutritional status and functionality is complex and probably bidirectional. The high prevalence of malnutrition in recently hospitalized elderly is accompanied by poorer baseline functionality in basic activities of daily living.

13.
Rev. chil. cir ; 67(3): 303-305, jun. 2015. ilus
Artigo em Espanhol | LILACS | ID: lil-747505

RESUMO

Introduction: Cartilage is an uncommon component in breast lesions, most of cases it correspond to metaplasia of malignant neoplasm and its occurrence in benign tumors is exceptional. Cartilage- containing breast benign tumors has been subclassified by their majors features accord to each author, but their main composition remains to be adipose tissue, fibrous stroma and cartilage, with or without breast epithelium. Chondrolipoma of the breast was reported for the first time by Kaplan in 1977, and since then reports of this entity has been anecdotal with less than 20 cases published. Clinical case: We expose the first case diagnosed of chondrolipoma of the breast in Colombia, performed on the Pathology Department of Universidad Industrial de Santander (Bucaramanga-Colombia) along with a literature review, due to the low frequency of this diagnosis and the few information about it.


Introducción: El cartílago es un componente poco común en las lesiones de mama, la mayoría de casos corresponden a metaplasias de lesiones malignas siendo excepcional el hallazgo en lesiones benignas; estas últimas se han subclasificado de acuerdo a las características histológicas destacables para cada autor, pero globalmente se componen de tejido adiposo, estroma fibroso y cartílago, mientras que el componente epitelial mamario es de presentación variable. El condrolipoma de mama fue reportado por primera vez en 1977 por Kaplan y desde esa fecha los reportes han sido anecdóticos con menos de 20 casos publicados. Caso clínico: Se expone el primer caso diagnosticado en Colombia de condrolipoma de mama, diagnóstico efectuado en el Departamento de Patología de la Universidad Industrial de Santander (Bucaramanga-Colombia) y se hace una revisión de la literatura de esta entidad, dada la baja frecuencia de su diagnóstico y a la escasa información al respecto.


Assuntos
Humanos , Feminino , Idoso , Condroma/cirurgia , Condroma/patologia , Lipoma/cirurgia , Lipoma/patologia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/patologia
14.
Vaccine ; 32(49): 6631-8, 2014 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-25305564

RESUMO

In the recent decade, epidemic meningitis in the African meningitis belt has mostly been caused by Neisseria meningitidis of serogroups A, W and X (MenA, MenW and MenX, respectively). There is at present no licensed vaccine available to prevent MenX meningococcal disease. To explore a trivalent MenAWX vaccine concept, we have studied the immunogenicity in mice of MenX outer membrane vesicles (X-OMV) or MenX polysaccharide (X-PS) when combined with a bivalent A-OMV and W-OMV (AW-OMV) vaccine previously shown to be highly immunogenic in mice. The vaccine antigens were produced from three representative wild type strains of MenA (ST-7), MenW (ST-11) and MenX (ST-751) isolated from patients in the African meningitis belt. Groups of mice were immunized with two doses of X-OMV or X-PS combined with the AW-OMV vaccine or as individual components. All vaccine preparations were adsorbed to Al(OH)3. Sera from immunized mice were tested by ELISA and immunoblotting. Functional antibody responses were measured as serum bactericidal activity (SBA) and opsonophagocytic activity (OPA). Immunization of mice with X-OMV, alone or in combination with AW-OMV induced high levels of anti-X OMV IgG. Moreover, X-OMV alone or in combination with the AW-OMV vaccine induced high SBA and OPA titers against the MenX target strain. X-PS alone was not immunogenic in mice; however, addition of the AW-OMV vaccine to X-PS increased the immunogenicity of X-PS. Both AWX vaccine formulations induced high levels of IgG against A- and W-OMV and high SBA titers against the MenA and MenW vaccine strains. These results suggest that a trivalent AWX vaccine, either as a combination of OMV or OMV with X-PS, could potentially prevent the majority of meningococcal disease in the meningitis belt.


Assuntos
Meningite Meningocócica/microbiologia , Meningite Meningocócica/prevenção & controle , Vacinas Meningocócicas/imunologia , Vacinas Meningocócicas/isolamento & purificação , Neisseria meningitidis/imunologia , Sorogrupo , Adjuvantes Imunológicos/administração & dosagem , África , Compostos de Alúmen/administração & dosagem , Animais , Anticorpos Antibacterianos/sangue , Atividade Bactericida do Sangue , Micropartículas Derivadas de Células/imunologia , Avaliação Pré-Clínica de Medicamentos , Ensaio de Imunoadsorção Enzimática , Feminino , Immunoblotting , Meningite Meningocócica/epidemiologia , Camundongos , Neisseria meningitidis/isolamento & purificação , Proteínas Opsonizantes/sangue , Fagocitose , Polissacarídeos Bacterianos/imunologia , Vacinas Combinadas/imunologia , Vacinas Combinadas/isolamento & purificação
15.
Fish Shellfish Immunol ; 36(1): 158-63, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24188747

RESUMO

Several studies have reported that molecules extracted from invertebrates have activity against different viruses, even against those that do not infect these organisms in their environment. One of the main mechanisms against pathogens in these organisms is the production of antimicrobial peptides. The objective of this study was to determine whether the coelomic fluid (CF) of the sea urchin Tripneustes depressus has activity against Suid herpesvirus type 1 (SHV-1) and/or rabies virus (RV). We tested the antiviral activity of CF in neutralizing assays and observed 50% inhibition against SHV-1 lytic plaque formation using 33 µg of CF, whereas 21 µg CF was sufficient to obtain more than 90% inhibition for RV. Cytotoxicity to MDBK and BHK-21 cells was found with whole CF yet was eliminated by heating at 56 or 72 °C (even when using 50 µg of heat-inactivated CF supernatant [SN or thermostable fraction]), and SN retained the antiviral effect. In both cases, the antiviral effect was direct and thermostable (SN 56 and 72 °C), and the best inhibition was observed when CF + virus was incubated prior to the addition of the cells. Therefore, the coelomic fluid of T. depressus has antiviral activity against SHV-1 and RV that is direct and stable at 72 °C. We suggest that further assays should be performed using more accurate methods to characterize new molecules with antiviral activity that may result in new drugs.


Assuntos
Herpesviridae/crescimento & desenvolvimento , Proteínas/farmacologia , Vírus da Raiva/crescimento & desenvolvimento , Ouriços-do-Mar/química , Animais , Linhagem Celular , Relação Dose-Resposta a Droga , Testes de Neutralização , Replicação Viral/efeitos dos fármacos
17.
Clin Exp Immunol ; 167(2): 330-7, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22236010

RESUMO

Renal allograft survival is related directly to cell senescence. In the transplantation scenario many cellular events - participating as immunological and non-immunological factors - could contribute to accelerate this biological process, responsible for the ultimate fate of the graft. Mechanisms concerned in tolerance versus rejection are paramount in this outcome. For this reason, immunosuppressive treatment constitutes an extremely important decision to prevent organ dysfunction and, finally, graft loss. This study was conducted to document the proportion of CD4(+) /interleukin (IL)-17A(+) -, CD16(+) /indoleamine 2, 3-dioxygenase (IDO(+) )-, forkhead box protein P3 (FoxP3(+))-expressing cells, senescent cells (p16(INK) (4α)) and the percentage of interstitial fibrosis (IF) in graft biopsies of kidney transplant recipients participating in the BENEFIT (Bristol-Myers Squibb IM103008) study. CD4(+) /IL-17A(+) , CD16(+) /IDO(+), FoxP3(+) and p16(INK) (4α+) cells were evaluated by immunohistochemistry, and the percentage of IF by morphometry on graft biopsies obtained at time 0 (pre-implantation) and at 12 months post-transplant. Senescent cells and CD4(+) /IL-17A(+) cells were increased among graft biopsies in subjects receiving cyclosporin A (CsA) compared to those under belatacept treatment. Meanwhile, CD16(+) /IDO(+) and FoxP3(+) -expressing cells were lower in biopsies from CsA treatment compared to patients treated with Belatacept. Histological morphometric analyses disclosed more IF in 12-month CsA-treated patients in comparison to pre-implantation biopsy findings. Summing up, renal biopsies from patients receiving belatacept showed greater amounts of FoxP3(+) cells and lower amounts of CD4(+) /IL-17A(+) and senescent cells compared to patients under CsA treatment. Along with these findings, an increase in IF in annual CsA-treated-patients biopsies compared to pre-implantation and belatacept-treated patients were observed.


Assuntos
Senescência Celular/efeitos dos fármacos , Inibidor p16 de Quinase Dependente de Ciclina/biossíntese , Ciclosporina/farmacologia , Regulação para Baixo/efeitos dos fármacos , Fatores de Transcrição Forkhead/biossíntese , Imunoconjugados/farmacologia , Imunossupressores/farmacologia , Transplante de Rim , Rim/patologia , Nefrite Intersticial/induzido quimicamente , Abatacepte , Corticosteroides/uso terapêutico , Adulto , Anticorpos Monoclonais/uso terapêutico , Basiliximab , Ensaios Clínicos Fase III como Assunto/estatística & dados numéricos , Ciclosporina/uso terapêutico , Método Duplo-Cego , Feminino , Fatores de Transcrição Forkhead/genética , Genes p16 , Humanos , Imunoconjugados/uso terapêutico , Imunossupressores/uso terapêutico , Rim/efeitos dos fármacos , Rim/metabolismo , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto/estatística & dados numéricos , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/uso terapêutico , Nefrite Intersticial/imunologia , Nefrite Intersticial/metabolismo , Nefrite Intersticial/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Proteínas Recombinantes de Fusão/uso terapêutico
18.
Am J Transplant ; 12(1): 210-7, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21992533

RESUMO

The clinical profile of belatacept in kidney transplant recipients was evaluated to determine if earlier results in the BENEFIT study were sustained at 3 years. BENEFIT is a randomized 3 year, phase III study in adults receiving a kidney transplant from a living or standard criteria deceased donor. Patients were randomized to a more (MI) or less intensive (LI) regimen of belatacept, or cyclosporine. 471/666 patients completed ≥3 years of therapy. A total of 92% (MI), 92% (LI), and 89% (cyclosporine) of patients survived with a functioning graft. The mean calculated GFR (cGFR) was ∼21 mL/min/1.73 m(2) higher in the belatacept groups versus cyclosporine at year 3. From month 3 to month 36, the mean cGFR increased in the belatacept groups by +1.0 mL/min/1.73 m(2) /year (MI) and +1.2 mL/min/1.73 m(2) /year (LI) versus a decline of -2.0 mL/min/1.73 m(2) /year (cyclosporine). One cyclosporine-treated patient experienced acute rejection between year 2 and year 3. There were no new safety signals and no new posttransplant lymphoproliferative disorder (PTLD) cases after month 18. Belatacept-treated patients maintained a high rate of patient and graft survival that was comparable to cyclosporine-treated patients, despite an early increased occurrence of acute rejection and PTLD.


Assuntos
Ciclosporina/uso terapêutico , Imunoconjugados/uso terapêutico , Imunossupressores/uso terapêutico , Transplante de Rim , Abatacepte , Adulto , Taxa de Filtração Glomerular , Sobrevivência de Enxerto , Humanos , Resultado do Tratamento
19.
Transplant Proc ; 43(9): 3327-30, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22099790

RESUMO

BACKGROUND: The National Transplant Center in Mexico has ruled that deceased-donor kidney allocation is a function of each hospital's Internal Transplant Committee. The aim of this study was to compare and analyze results for of the traditional method and a point-score system in the allocation of deceased patient's kidneys. METHODS: The 12 major kidney transplant centers in the country having a deceased-donor program were invited to participate. Only 3 of them replied to the invitation during 2010. A point-score system was proposed to them, comprising blood group, waiting list time, HLA type, and donor and recipient ages. Once the final recipient was chosen, an explanation of reasons for the choice was requested. Thirty-eight transplants were presented. Kappa coefficient was used to measure degree of agreement in both allocation systems. Organs donated for transplantation came from patients between 4 and 54 years old, including 52% female, 52% O+ blood type, 31% A+, and 11% B+, 44% cranial-encephalic trauma, and 44% brain hemorrhage. RESULTS: Global agreement was 52.6% (kappa = 0.343), and partial agreement was 76.3% (weighted kappa = 0.204), assigning more intensity to extreme values, but with a lower correlation index. A more intense agreement, without discriminating by hospital, was found for "A" category (blood group), followed by "B" category (waiting list time). DISCUSSION: Taking into consideration the determining factors for long-term graft survival, it is indispensable to include criteria such as donor and recipient ages and HLA typife in the allocation process. This first draft of a point-score system in organ allocation included waiting list time, blood group, urgency related to vascular/peritoneal access for dialysis, clinical condition, donor/recipient age ratio, and HLA antigenic compatibility.


Assuntos
Transplante de Rim/métodos , Doadores de Tecidos , Obtenção de Tecidos e Órgãos/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Ética Médica , Feminino , Antígenos HLA/metabolismo , Humanos , Hemorragias Intracranianas/mortalidade , Masculino , México , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Obtenção de Tecidos e Órgãos/normas
20.
Fisioterapia (Madr., Ed. impr.) ; 33(4): 183-186, jul.-ago. 2011.
Artigo em Espanhol | IBECS | ID: ibc-92930

RESUMO

El objetivo de nuestro estudio se centra en describir la relación entre la presencia de os peroneum y el desarrollo de tendinopatía peronea causada por la existencia de un síndrome de fricción entre el hueso sesamoideo y el músculo peroneo lateral largo. El sujeto estudio fue un joven deportista que padece dolor difuso tipo quemazón en la parte lateral de la pierna derecha. El diagnóstico diferencial mediante radiografía oblicua y dorsoplantar confirma la presencia de os peroneum. La valoración se realiza comparativamente tras el tratamiento conservador y quirúrgico, midiendo el dolor mediante la escala visual analógica, la amplitud articular a la eversión del pie mediante goniometría manual y la funcionalidad mediante el índice de esfuerzo percibido tras realizar el test 6 minutos de marcha y la escala de valoración funcional AOFAS. Como resultados, destacamos la reducción del dolor y la readaptación a la práctica deportiva sin secuelas tras la cirugía (AU)


This study has focused on describing the relationship between the presence of Os peroneum and the development of peroneal tendinopathy caused by the existence of a friction syndrome between the sesamoid bone and the peroneus longus muscle. The subject studied was a young athlete who has diffuse burning pain in the side of the right leg. The differential diagnosis through dorsoplantar oblique radiography confirmed the presence of Os peroneum. Evaluation was made comparatively after conservative and surgical treatment through the measurement of pain with the Visual Analog Scale, the eversion range of motion of the foot using the manual goniometry and functionality using the Perceived Stress Index after the test 6 minute walking test and American Orthopedic Foot and Ankle Society (AOFAS) functional rating scale. As a result, we emphasize the reduction of pain and rehabilitation to sports activity without sequelae after surgery (AU)


Assuntos
Humanos , Traumatismos dos Tendões/terapia , Fricção , Ossos Sesamoides/lesões , Diagnóstico Diferencial , Fenômenos Biomecânicos/fisiologia , Doença de Charcot-Marie-Tooth/terapia
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