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2.
Eur J Endocrinol ; 190(6): 421-433, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38701338

RESUMO

INTRODUCTION: Growth hormone (GH)-secreting pituitary tumors (GHomas) are the most common acromegaly cause. At diagnosis, most of them are macroadenomas, and up to 56% display cavernous sinus invasion. Biomarker assessment associated with tumor growth and invasion is important to optimize their management. OBJECTIVES: The study aims to identify clinical/hormonal/molecular biomarkers associated with tumor size and invasiveness in GHomas and to analyze the influence of pre-treatment with somatostatin analogs (SSAs) or dopamine agonists (DAs) in key molecular biomarker expression. METHODS: Clinical/analytical/radiological variables were evaluated in 192 patients from the REMAH study (ambispective multicenter post-surgery study of the Spanish Society of Endocrinology and Nutrition). The expression of somatostatin/ghrelin/dopamine system components and key pituitary/proliferation markers was evaluated in GHomas after the first surgery. Univariate/multivariate regression studies were performed to identify association between variables. RESULTS: Eighty percent of patients harbor macroadenomas (63.8% with extrasellar growth). Associations between larger and more invasive GHomas with younger age, visual abnormalities, higher IGF1 levels, extrasellar/suprasellar growth, and/or cavernous sinus invasion were found. Higher GH1 and lower PRL/POMC/CGA/AVPR1B/DRD2T/DRD2L expression levels (P < .05) were associated with tumor invasiveness. Least Absolute Shrinkage and Selection Operator's penalized regression identified combinations of clinical and molecular features with areas under the curve between 0.67 and 0.82. Pre-operative therapy with DA or SSAs did not alter the expression of any of the markers analyzed except for DRD1/AVPR1B (up-regulated with DA) and FSHB/CRHR1 (down-regulated with SSAs). CONCLUSIONS: A specific combination of clinical/analytical/molecular variables was found to be associated with tumor invasiveness and growth capacity in GHomas. Pre-treatment with first-line drugs for acromegaly did not significantly modify the expression of the most relevant biomarkers in our association model. These findings provide valuable insights for risk stratification and personalized management of GHomas.


Assuntos
Acromegalia , Adenoma , Adenoma Hipofisário Secretor de Hormônio do Crescimento , Invasividade Neoplásica , Humanos , Masculino , Feminino , Acromegalia/metabolismo , Pessoa de Meia-Idade , Adulto , Adenoma Hipofisário Secretor de Hormônio do Crescimento/patologia , Adenoma Hipofisário Secretor de Hormônio do Crescimento/metabolismo , Adenoma/metabolismo , Adenoma/patologia , Idoso , Agonistas de Dopamina/uso terapêutico , Biomarcadores Tumorais/metabolismo , Somatostatina/análogos & derivados , Somatostatina/uso terapêutico , Hormônio do Crescimento Humano/metabolismo
3.
Nat Commun ; 15(1): 3736, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38744818

RESUMO

The E3 SUMO ligase PIAS2 is expressed at high levels in differentiated papillary thyroid carcinomas but at low levels in anaplastic thyroid carcinomas (ATC), an undifferentiated cancer with high mortality. We show here that depletion of the PIAS2 beta isoform with a transcribed double-stranded RNA-directed RNA interference (PIAS2b-dsRNAi) specifically inhibits growth of ATC cell lines and patient primary cultures in vitro and of orthotopic patient-derived xenografts (oPDX) in vivo. Critically, PIAS2b-dsRNAi does not affect growth of normal or non-anaplastic thyroid tumor cultures (differentiated carcinoma, benign lesions) or cell lines. PIAS2b-dsRNAi also has an anti-cancer effect on other anaplastic human cancers (pancreas, lung, and gastric). Mechanistically, PIAS2b is required for proper mitotic spindle and centrosome assembly, and it is a dosage-sensitive protein in ATC. PIAS2b depletion promotes mitotic catastrophe at prophase. High-throughput proteomics reveals the proteasome (PSMC5) and spindle cytoskeleton (TUBB3) to be direct targets of PIAS2b SUMOylation at mitotic initiation. These results identify PIAS2b-dsRNAi as a promising therapy for ATC and other aggressive anaplastic carcinomas.


Assuntos
Mitose , Proteínas Inibidoras de STAT Ativados , Humanos , Proteínas Inibidoras de STAT Ativados/metabolismo , Proteínas Inibidoras de STAT Ativados/genética , Animais , Linhagem Celular Tumoral , Camundongos , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/metabolismo , Interferência de RNA , Fuso Acromático/metabolismo , Chaperonas Moleculares/metabolismo , Chaperonas Moleculares/genética , Ensaios Antitumorais Modelo de Xenoenxerto , Complexo de Endopeptidases do Proteassoma/metabolismo , Sumoilação , Carcinoma/genética , Carcinoma/metabolismo , Carcinoma/patologia , Feminino
4.
Mar Pollut Bull ; 201: 116271, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38513604

RESUMO

The Eastern Tropical and South-Eastern Pacific region is of global biodiversity importance. At COP26, the governments of Costa Rica, Panama, Colombia, and Ecuador committed to the expansion of existing MPAs to create a new Mega MPA, safeguarding the Eastern Tropical Pacific Marine Corridor. It offers a profound step forward in conservation efforts but is not specifically designed to protect against the more diffuse anthropogenic threats, such as plastic pollution. We combine published data with our own unpublished records to assess the abundance and distribution of plastic pollution in the region. Macro- and microplastic concentrations varied markedly and were not significantly different when comparing areas inside and outside existing MPA boundaries. These findings highlight the diffuse and complex nature of plastic pollution and its ubiquitous presence across MPA boundaries. Understanding the sources and drivers of plastic pollution in the region is key to developing effective solutions.


Assuntos
Conservação dos Recursos Naturais , Plásticos , Biodiversidade , Poluição Ambiental , Microplásticos
5.
Waste Manag Res ; 42(4): 344-351, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37277997

RESUMO

Marine litter is a growing environmental problem for which fisheries-sourced waste remains poorly understood. In Peru, there is an ongoing challenge of waste management from the small-scale fisheries fleet given the lack of facilities to receive the variety of debris produced by fishers, which includes hazardous wastes such as batteries. In this study, onboard solid waste production was monitored daily by land-based observers upon landing at the port of Salaverry, Peru, from March to September 2017. The analysed small-scale gillnet and longline fishing fleets produced annually an estimated 11,260 kg of solid waste. Of particular concern is the production of single use plastics (3427 kg) and batteries (861 kg) due to their potential long-lasting impacts on the environment and challenges related to their proper disposal. A management plan for solid waste has been developed for Salaverry; therefore, a subsequent assessment was conducted in 2021-2022 of the behaviours and perceptions of fishers regarding the implementation of this plan. Most fishers (96%) reported disposing of their waste on land, except organic waste which is disposed of at sea. While fishers in Salaverry have become more conscious of the issues surrounding at-sea waste disposal and have an interest in better segregating and managing their waste, there remains a need for improved waste management and recycling protocols and procedures at the port to make this possible.


Assuntos
Eliminação de Resíduos , Resíduos Sólidos , Pesqueiros , Peru , Resíduos Perigosos , Plásticos , Resíduos
6.
Endocrine ; 83(3): 585-593, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38001324

RESUMO

Although thyroid cancer (TC) is generally associated with a favourable prognosis, there are certain high-risk groups with a clear unmet therapeutic need. Unravelling the genomic landscape of TC has recently led to the development of novel effective targeted treatments. To date, these treatments have mostly been evaluated in non-randomised single-arm phase II clinical trials and are consequently non-reimbursed in several countries. Furthermore, most of these agents must be tailored to individual patient molecular characteristics, a context known as personalised cancer medicine, necessitating a requirement for predictive molecular biomarker testing. Existing guidelines, both in Europe and internationally, entail mostly therapeutic rather than molecular testing recommendations. This may reflect ambiguity among experts due to lack of evidence and also practical barriers in availability of the preferred molecular somatic screening and/or targeted treatments. This article reviews existing European recommendations regarding advanced/metastatic TC management with a special focus on molecular testing, and compares findings with real-world practice based on a recent survey involving TC experts from 18 European countries. Significant disparities are highlighted between theory and practice related to variable access to infrastructure, therapies and expertise, together with the insufficient availability of multidisciplinary tumour boards. In particular, practitioners' choice of what, how and when to test is shown to be influenced by the expertise of the available laboratory, the financing source and the existence of potential facilitators, such as clinical trial access. Overall, the need of a collaborative initiative among European stakeholders to develop standardised, accessible molecular genotyping approaches in TC is underscored.


Assuntos
Medicina , Neoplasias da Glândula Tireoide , Humanos , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/terapia , Europa (Continente)
8.
Int J Mol Sci ; 24(18)2023 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-37762349

RESUMO

This study aims to determine the predictive value of the soluble suppression of tumorigenicity 2 (sST2) biomarker in atrial fibrillation (AF) recurrence. This prospective, observational study included patients with AF referred for electrical cardioversion (ECV) or pulmonary vein isolation (PVI) procedures. Baseline characteristics were collected, and sST2 was determined at baseline and at 3 and 6 months of follow-up. sST2 was determined at baseline in a matched control group. Left atrial voltage mapping was performed in patients undergoing PVI. The sST2 maximal predictive capacity of AF recurrence was at the 3-month FU in the cohort of patients undergoing ECV with respect to 6-month AF recurrence with an AUC of 0.669, a cut-off point of 15,511 pg/mL, a sensitivity of 60.97%, and a specificity of 69.81%. The ROC curve of the sST2 biomarker at baseline and 3 months in the cohort of patients undergoing PVI showed AUCs of 0.539 and 0.490, respectively. The logistic regression model identified the rhythm (AF) and the sST2 biomarker at 3 months as independent factors for recurrence at 6 months in the ECV cohort. In the logistic regression model, sST2 was not an independent factor for recurrence at 6 months of follow-up in the PVI cohort. In patients who underwent ECV, sST2 values at 3 months may provide utility to predict AF recurrence at 6 months of follow-up. In patients who underwent PVI, sST2 had no value in predicting AF recurrence at 6 months of follow-up.


Assuntos
Fibrilação Atrial , Veias Pulmonares , Humanos , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/terapia , Cardioversão Elétrica , Proteína 1 Semelhante a Receptor de Interleucina-1 , Veias Pulmonares/cirurgia , Estudos Prospectivos , Biomarcadores
9.
Front Psychol ; 14: 1109561, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37113122

RESUMO

Introduction: Adults with autism and adults with schizophrenia show difficulties in adaptive skills, especially those related to daily functioning. Some studies suggest that adaptive skills are associated with deficits in executive functions (EF), while others indicate that intelligence quotient (IQ) might also play a role. Literature suggests that autistic symptoms further affect adaptive skills. The interest of the current study, therefore, was to explore to what extent IQ, EFs as well as core autistic symptoms predict adaptive skills. Methods: To do this, 25 controls, 24 adults with autism, and 12 with schizophrenia were assessed on IQ (Wechsler Adult Intelligence Scale), and executive functioning. The EF was measured with neuropsychological tasks (inhibition, updating, and task switching) and with the Dysexecutive-Spanish Questionnaire (DEX-Sp) which assessed everyday life EF problems. Core ASD symptoms were measured using the Autism Diagnostic Observation Schedule, the Autism Spectrum Quotient-Short version (AQ-S), and the Repetitive Behavior Questionnaire - 3 (RBQ-3). Results: The results indicated EF difficulties in both, autism and schizophrenia. The IQ explained a high percentage of the variance found in adaptive skills, but only in the autism group. We can conclude, therefore, that high IQ is associated with low adaptive skills levels and EFs affect adaptive functioning in people with autism; however, this does not explain the difficulties in adaptive functioning in the schizophrenia group. Core features of autism assessed with self-report questionnaires (but not the ADOS-2) predicted low scores on the adaptive skills, only in the autism group. Discussion: Both EF measures predicted adaptive skills scores in autism, but not in schizophrenia. Our results suggest that different factors affect the adaptive functioning in each disorder. For instance, the EFs should be a central focus for improvement, especially for individuals with autism.

10.
Plants (Basel) ; 12(3)2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36771723

RESUMO

The Mi-1 gene of tomato (Solanum lycopersicum) confers resistance against some nematodes and insects, but the resistance mechanisms differ depending on the harmful organism, as a hypersensitive reaction (HR) occurs only in the case of nematodes. The gene Rme1 is required for Mi-1-mediated resistance to nematodes, aphids, and whiteflies, and several additional proteins also play a role in this resistance. Among them, the involvement of the chaperone HSP90 has been demonstrated in Mi-1-mediated resistance for aphids and nematodes, but not for whiteflies. In this work, we studied the implication of the Hsp90 gene in the Mi-1 resistance against the whitefly Bemisia tabaci by means of Tobacco rattle virus (TRV)-based virus-induced gene silencing (VIGS). The silencing of the Hsp90 gene in tomato Motelle plants carrying the Mi-1 gene resulted in a decrease in resistance to whiteflies, as oviposition values were significantly higher than those on non-silenced plants. This decrease in resistance was equivalent to that caused by the silencing of the Mi-1 gene itself. Infiltration with the control TRV vector did not alter Mi-1 mediated resistance to B. tabaci. Similar to the Mi-1 gene, silencing of Hsp90-1 occurs partially, as silenced plants showed a significant but not complete suppression of gene expression. Thus, our results demonstrate the requirement of Hsp90 in the Mi-1-mediated resistance to B. tabaci and reinforce the hypothesis of a common model for this resistance to nematodes and insects.

11.
Neurol Ther ; 12(2): 479-503, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36692706

RESUMO

INTRODUCTION: Experts agree that there is a need for protocols to guide health professionals on how to best manage psychiatric comorbidities in patients with epilepsy (PWE). We aimed to develop practical recommendations for key issues in the management of depression in PWE. METHODS: This was a qualitative study conducted in four steps: (1) development of a questionnaire on the management of depression in PWE to be answered; (2) literature review and, if evidence from guidelines/consensus or systematic reviews was available, drafting initial recommendations; (3) a nominal group methodology for reviewing initial recommendations and formulating new recommendations on those issues without available evidence; and (4) drafting and approving the final recommendations. A scientific committee (one neurologist and one psychiatrist) was responsible for the development of the project and its scientific integrity. The scientific committee selected a panel of experts (nine neurologists and nine psychiatrists with experience in this field) to be involved in the nominal group meetings and to formulate final recommendations. RESULTS: Fifteen recommendations were formulated. Four on the screening and diagnosis: screening and diagnosis of depression, evaluation of the risk of suicide, and diagnosis of depression secondary to epilepsy; nine on the management of depression: referral to a psychiatrist, selection of the antiseizure medication, change of antiseizure medication, antidepressant treatment initiation, selection of antidepressant, use of antidepressants during pregnancy, use of psychotherapy, antidepressant treatment duration, and discontinuation of antidepressant treatment; two on the follow-up: duration of the follow-up under usual conditions, and follow-up of patients at risk of suicide. CONCLUSION: We provide recommendations based on expert opinion consensus to help healthcare professionals assess depression in PWE. The detection and treatment of major depressive disorders are key factors in improving epilepsy outcomes and avoiding suicide risk.

12.
Healthcare (Basel) ; 10(9)2022 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-36141235

RESUMO

Thyroid cancer (TC) is the most common malignancy of the endocrine system that affects the thyroid gland. It is usually treatable and, in most cases, curable. The central issues are how to improve knowledge on TC, to accurately identify cases at an early stage that can benefit from effective intervention, optimise therapy, and reduce the risk of overdiagnosis and unnecessary treatment. Questions remain about management, about treating all patients in referral centres, and about which treatment should be proposed to any individual patient and how this can be optimised. The European Alliance for Personalised Medicine (EAPM) hosted an expert panel discussion to elucidate some of the challenges, and to identify possible steps towards effective responses at the EU and member state level, particularly in the context of the opportunities in the European Union's evolving initiatives-notably its Beating Cancer Plan, its Cancer Mission, and its research funding programmes. Recommendations emerging from the panel focus on improved infrastructure and funding, and on promoting multi-stakeholder collaboration between national and European initiatives to complement, support, and mutually reinforce efforts to improve patient care.

13.
Case Rep Psychiatry ; 2022: 1223292, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35966042

RESUMO

Posttraumatic stress disorder (PTSD) is a debilitating stress disorder occurring in the context of a traumatic event and is characterized by intrusive and avoidance symptoms, negative alterations in cognition and mood, and arousal and reactivity changes. Despite its representation throughout literature, the pathophysiology of PTSD remains incompletely understood, thus contributing to broad, variable, and at times, experimental treatment options. The authors present the first documented case of the rapid and successful management of PTSD using valproic acid and twice daily dosing of prazosin aimed at targeting symptoms of hyperarousal and both daily and nightly intrusive symptoms of flashbacks and nightmares, respectively. The authors also discuss postulations of the underlying mechanisms of action responsible for such symptom alleviation. Further investigation is needed to expand upon our knowledge of the use of such agents in the treatment of PTSD to improve upon existing clinical guidelines, especially in the acute setting, thus providing better overall prognosis.

14.
Sci Rep ; 12(1): 8979, 2022 05 28.
Artigo em Inglês | MEDLINE | ID: mdl-35643771

RESUMO

Predicting which acromegaly patients could benefit from somatostatin receptor ligands (SRL) is a must for personalized medicine. Although many biomarkers linked to SRL response have been identified, there is no consensus criterion on how to assign this pharmacologic treatment according to biomarker levels. Our aim is to provide better predictive tools for an accurate acromegaly patient stratification regarding the ability to respond to SRL. We took advantage of a multicenter study of 71 acromegaly patients and we used advanced mathematical modelling to predict SRL response combining molecular and clinical information. Different models of patient stratification were obtained, with a much higher accuracy when the studied cohort is fragmented according to relevant clinical characteristics. Considering all the models, a patient stratification based on the extrasellar growth of the tumor, sex, age and the expression of E-cadherin, GHRL, IN1-GHRL, DRD2, SSTR5 and PEBP1 is proposed, with accuracies that stand between 71 to 95%. In conclusion, the use of data mining could be very useful for implementation of personalized medicine in acromegaly through an interdisciplinary work between computer science, mathematics, biology and medicine. This new methodology opens a door to more precise and personalized medicine for acromegaly patients.


Assuntos
Acromegalia , Neoplasias , Acromegalia/tratamento farmacológico , Acromegalia/terapia , Biomarcadores , Análise de Dados , Mineração de Dados , Humanos , Neoplasias/terapia , Medicina de Precisão
15.
Rev. salud pública ; 24(3)mayo-jun. 2022.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1536727

RESUMO

Objetivo Mapear la forma de uso y el efecto de las tecnologías m-Health en intervenciones a fin de incrementar el uso de anticonceptivos en adolescentes latinas. Métodos Se realizó una revisión de alcance a partir de Peters M en octubre de 2021; se recuperaron artículos del 2015 a 2021 en EBSCO Host, PubMed y BVS, LILACS, SciELO, Web of Science y Scopus, en inglés, español y portugués. Resultados Se identificaron ocho artículos que emplearon las m-Health como potencializadoras. La forma de uso fue ampliamente heterogénea en dosis, intervalo e interacción. El efecto significativo para el uso de anticonceptivos fue reportado en tres diseños experimentales, con una buena aceptabilidad y viabilidad para futuros experimentos. Discusión Las m-Health ofrecen una oportunidad de incrementar el uso de anticonceptivos en adolescentes. Al momento, su efecto es controversial debido a la escasez de intervenciones de este tipo. Por lo tanto, se requieren estudios rigurosos que consideren procesos de adaptación a contextos latinos.


Objective To map the use and effect of m-Health technologies on interventions to increase contraceptive use in Latino adolescents. Methods A low scope review was performed from Peters M in October 2021; articles from 2015 to 2021 were recovered in EBSCO Host, PubMed and BVS, LILACS, SciELO, Web of Science and Scopus, in English, Spanish, and Portuguese. Results We identified eight articles that used m-Health as potentiators. The form of use was widely heterogeneous in dose, interval, and interaction. The significant effect on contraceptive use was reported in three experimental designs with good acceptability and feasibility for future experiments. Discussion m-Health offers an opportunity to increase contraceptive use in adolescents. At the moment its effect is controversial due to the scarcity of interventions of this type. Therefore, rigorous studies that consider processes of adaptation to Latino contexts are required.

16.
Mar Pollut Bull ; 178: 113632, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35405486

RESUMO

Peru has a large small-scale fishing fleet upon which many coastal communities depend for their food and livelihoods. Nonetheless, no thorough assessments have been conducted of solid waste production and management of small-scale fisheries (SSF) and associated communities. We aimed to assess gillnet SSF and household solid waste generation in San Jose, north Peru. A solid waste generation assessment was conducted by monitoring solid waste production during 22 fishing trips and interviewing 70 families. Daily waste generation and recycling per capita, were calculated applying separate Generalized Linear Mixed-Effect Models. Organic waste is the most frequently produced during fishing activities (38%) and at home (83%), followed by plastic and metal. Glass, paper/cardboard, and fishing nets were solely produced during fishing trips. Daily waste per capita was estimated on 0.14 kg∗(day)-1 onboard, and 0.33 kg∗(day)-1 at home. Additionally, perception interviews showed that the population of San Jose perceived solid waste as a threat to public health and marine ecosystems. This study provides a first attempt to assess solid waste production in a Peruvian fishing community, showing the need for an integrated management plan embracing vessel and land-based solid waste generation.


Assuntos
Eliminação de Resíduos , Resíduos Sólidos , Ecossistema , Humanos , Caça , Peru , Resíduos Sólidos/análise
17.
Artigo em Espanhol | LILACS, BDENF - Enfermagem | ID: biblio-1378894

RESUMO

Introducción: México se encuentra en los primeros lugares de embarazo en la adolescencia entre los países de la Organización para la Cooperación y el Desarrollo Económico. Por lo tanto, el embarazo de primera vez y subsecuente representa un problema sanitario con impacto negativo en el desarrollo de la adolescente y su hijo, por lo que es necesario estudiar el fenómeno a fin de prevenirlo y contribuir al mejoramiento de las condiciones de salud y vida de dos grupos vulnerables (adolescentes e hijos). Desarrollo: las causas del embarazo subsecuente son diversas, implican aspectos relacionados con el entorno familiar y comunitario, el acceso a los servicios de salud y el nivel educativo. Aunque no es exclusivo de un estrato social, se presenta con mayor frecuencia en adolescentes de bajos recursos. Las consecuencias son de índole físico, psicológico, económico y social, y agudizan las condiciones negativas de salud y las mencionadas como causas, con riesgo de que se repita y se perpetue el problema. Conclusiones: las intervenciones basadas en la atención centrada en la persona han mostrado efectos positivos en la conducta anticonceptiva de las adolescentes. Su adopción e implementación en países en desarrollo amerita la suma de esfuerzos interinstitucionales e interdisciplinares de forma vertical y transversal, con sentido bidireccional, a fin de hacer cambios significativos en la prevención de este fenómeno.


Introduction: Mexico ranks in the first places of teenage pregnancy among the countries of the Organisation for Economic Co-operation and Development. For this reason, the first and subsequent pregnancy represents a health problem with a negative impact on the development of the adolescent girl and her child, which is why it is necessary to study the phenomenon, in order to prevent it and to contribute to the improvement of health and living conditions of two vulnerable groups (adolescents and children). Development: The causes of subsequent pregnancy are diverse, involving aspects related to the family and community environment, as well as access to health services, and the educational level. Although it is not exclusive to a social stratum, it occurs more often in low-income adolescents. The consequences are of a physical, psychological, economic and social nature, and they exacerbate the negative health conditions and those mentioned as causes, with the risk of repeating and perpetuating the problem. Conclusions: Person-centered interventions have demonstrated positive effects on the contraceptive behavior of adolescents. Its adoption and implementation in developing countries deserve the sum of inter-agency and interdisciplinary efforts in a vertical and cross-cutting manner with a two-way sense of making significant changes in the prevention of this phenomenon.


Assuntos
Humanos , Feminino , Gravidez , Gravidez na Adolescência/prevenção & controle , Condições Sociais/estatística & dados numéricos , Gravidez/estatística & dados numéricos , Assistência Centrada no Paciente/estatística & dados numéricos , Fatores Sociodemográficos , Acessibilidade aos Serviços de Saúde
18.
Autism ; 26(8): 2136-2150, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35261293

RESUMO

LAY ABSTRACT: Professional guidance and support in response to first concerns appears to be an important predictor of the level of satisfaction with the detection process of autism in young children. In this study, we analyzed the views of 1342 family members, including 1278 parents, who completed an online survey form collecting information about their experience and satisfaction with the early detection of autism in their child. Specifically, we were interested in how specific experiences with the detection process relate to the satisfaction with it and whether we could identify important predictors of satisfaction. The detection process is an emotionally charged period for parents, often described as painful, chaotic, and lengthy. A better understanding of their experiences is important to take appropriate action to improve the detection process. In our sample, the level of satisfaction with the detection process varied greatly from one respondent to another. Among the different experiences we considered, whether or not respondents received professional guidance and support in response to first concerns explained most of this variation. We also found that difficulty finding information about detection services, lack of professional guidance and support in response to first concerns, having to find a diagnostic service on one's own, and longer delays between confirmation of concerns and first appointment with a specialist were experiences associated with a greater likelihood of being unsatisfied. The findings of this study highlight the importance of the parent-professional relationship in the detection process and have important practical implications for health administrations to improve the detection process.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Criança , Humanos , Pré-Escolar , Transtorno Autístico/diagnóstico , Transtorno Autístico/psicologia , Satisfação Pessoal , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Pais/psicologia , Família
19.
Biomedicines ; 10(2)2022 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-35203700

RESUMO

Background: Vascular inflammation plays a crucial role in peripheral arterial disease (PAD), although the role of the mediators involved has not yet been properly defined. The aim of this work is to investigate gene expression and plasma biomarkers in chronic limb-threating ischemia (CLTI). Methods: Using patients from the GHAS trial, both blood and ischemic muscle samples were obtained to analyze plasma markers and mRNA expression, respectively. Statistical analysis was performed by using univariate (Spearman, t-Student, and X2) and multivariate (multiple logistic regression) tests. Results: A total of 35 patients were available at baseline (29 for mRNA expression). Baseline characteristics (mean): Age: 71.4 ± 12.4 years (79.4% male); TNF-α: 10.7 ± 4.9 pg/mL; hsCRP:1.6 ± 2.2 mg/dL; and neutrophil-to-lymphocyte ratio (NLR): 3.5 ± 2.8. Plasma TNF-α was found elevated (≥8.1) in 68.6% of patients, while high hsCRP (≥0.5) was found in 60.5%. Diabetic patients with a high level of inflammation showed significantly higher levels of NOX4 expression at baseline (p = 0.0346). Plasma TNF-α had a negative correlation with NOS3 (eNOS) expression (-0.5, p = 0.015) and plasma hsCRP with VEGFA (-0.63, p = 0.005). The expression of NOX4 was parallel to that of plasma TNF-α (0.305, p = 0.037), especially in DM. Cumulative mortality at 12 months was related to NLR ≥ 3 (p = 0.019) and TNF-α ≥ 8.1 (p = 0.048). The best cutoff point for NLR to predict mortality was 3.4. Conclusions: NOX4 and TNF-α are crucial for the development and complications of lower limb ischemia, especially in DM. hsCRP could have a negative influence on angiogenesis too. NLR and TNF-α represent suitable markers of mortality in CLTI. These results are novel because they connect muscle gene expression and plasma information in patients with advanced PAD, deepening the search for new and accurate targets for this condition.

20.
Cells ; 11(3)2022 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-35159134

RESUMO

Data gleaned recently shows that ghrelin, a stomach derived peptide, and liver-expressed-antimicrobial peptide 2 (LEAP-2) play opposite roles on food intake. However, the data available with LEAP-2 in relation to in vivo studies are still very scanty and some key questions regarding the interplay among ghrelin and LEAP-2 remain to be answered. In this work, using rats and mice, we study fasting-induced food intake as well as testing the effect of diet exposure, e.g., standard diet and high fat diet, in terms of ghrelin-induced food intake. The anorexigenic effect of LEAP-2 on fasting induced food intake appears to be dependent on energy stores, being more evident in ob/ob than in wild type mice and also in animals exposed to high fat diet. On the other hand, LEAP-2 administration markedly inhibited ghrelin-induced food intake in lean, obese (ob/ob and DIO) mice, aged rats and GH-deficient dwarf rats. In contrast, the inhibitory effect on glucose levels can only be observed in some specific experimental models indicating that the mechanisms involved are likely to be quite different. Taken together from these data, LEAP-2 emerged as a potential candidate to be therapeutically useful in obesity.


Assuntos
Peptídeos Catiônicos Antimicrobianos , Ingestão de Alimentos , Grelina , Hormônio do Crescimento , Animais , Peptídeos Catiônicos Antimicrobianos/metabolismo , Grelina/farmacologia , Camundongos , Nutrientes , Obesidade , Ratos
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