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1.
Sci Total Environ ; 946: 174317, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38960189

RESUMO

Lignin is an abundant and recalcitrant biopolymer of major relevance as soil organic matter (SOM) component playing a significant role in its stabilization. In this work, a factorial field experiment was established, where three climatic treatments (W, warming; D, drought; W + D, warming + drought), mimicking future climate change scenarios were installed over five years in a Mediterranean savannah "dehesa", accounting for its landscape diversity (under the tree canopy and in open grassland). A combination of analytical pyrolysis (Py-GC/MS) and the study of biogeochemical proxies based on lignin monomers is used for the direct detection of lignin-derived phenols and to infer possible shifts in lignin dynamics in soil. A total of 27 main lignin-derived methoxyphenols were identified, exhibiting different patterns and proportions, mainly driven by the effect of habitat, hence biomass inputs to SOM. An accelerated decomposition of lignin moieties -(exhibited by higher LG/LS and Al/K + Ac ratios)- is particularly exacerbated by the effect of all climatic treatments. There is also an overall effect on increasing lignin oxidation of side chain in syringyl units, especially under the tree canopy due to the alteration in biomass degradation and potential stimulation of enzyme activities. Conversely, in open grassland these effects are slower since the microbial community is expected to be already adapted to harsher conditions. Our findings suggests that climate change-related temperature and soil moisture deviations impact soil lignin decomposition in dehesas threatening this productive Mediterranean agroecosystem and affecting the mechanism of soil carbon storage.

2.
Artigo em Inglês | MEDLINE | ID: mdl-38858538

RESUMO

The incidence of skin cancer is increasing worldwide even though its main risk factor is preventable. This study evaluated the impact of the Distintivo Soludable pilot intervention on implementation of photoprotection policies and practices in preschool and primary schools in Andalusia, Spain. We completed two rounds of a Sun Protection Policies and Practices Survey (SPPPS) nine months apart. At baseline, 67 Andalusian schools earned a median score of 3/12 points (range 0-8; IQR: 2). Ten schools involved in Distintivo Soludable intervention group significantly increased their scores from 4 to 7.5/12 points (p = 0.014). We also detected a modest positive effect in 57 control group schools, an increase from 2 to 3 points (p = 0.002). This pilot study demonstrated that the main achievement of the Distintivo Soludable intervention was implementation of organizational policies regarding sun protection, an essential starting point for establishing positive attitudes toward sun protection in school communities.

3.
Actas Dermosifiliogr ; 115(6): T533-T538, 2024 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38648931

RESUMO

BACKGROUND: Controversy has recently broken out over the potential carcinogenic risk associated with exposure to UV lamps for permanent nail polish. The new LED-based polymerization devices, and their potential biological effect has not been analyzed to this date. OBJECTIVE: To evaluate the emission power and its potential biological effects on the skin of 2 types of UV LED and fluorescent curing lamps under normal use conditions compared to doses of sunlight exposure. MATERIAL AND METHODS: The emission spectrum (290nm to 450nm) of curing lamps and the Sun at noon on an average summer day in mid-latitude Spain was analyzed. The effective biological irradiance potential for erythema, non-melanoma skin cancer, DNA damage, photoimmunosuppression and permanent pigmentation was also characterized. RESULTS: The high-energy UVA-visible irradiance emitted by these devices was similar to the one coming from the Sun in that spectral range while the effective biological doses were lower or similar to those also coming from the Sun. The total UV and high-energy visible dose per manicure session corresponded to that obtained from 3.5min to 6min exposures to the Sun at noon in the summer days at our latitudes. CONCLUSIONS: The exposure times and doses received with the common use of artificial lamp nail drying correspond to sunlight exposures of 3min to 5min in the central hours of the day. This represents a very low carcinogenic potential compared to sunlight exposure, although similar regarding immunosuppressive potential. Photoprotective measures would further minimize the risks.


Assuntos
Unhas , Neoplasias Induzidas por Radiação , Neoplasias Cutâneas , Raios Ultravioleta , Raios Ultravioleta/efeitos adversos , Humanos , Unhas/efeitos da radiação , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Induzidas por Radiação/epidemiologia , Luz Solar/efeitos adversos , Dano ao DNA , Espanha , Eritema/etiologia
4.
Actas Dermosifiliogr ; 115(6): 533-538, 2024 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38309528

RESUMO

BACKGROUND: Controversy has recently broken out over the potential carcinogenic risk associated with exposure to UV lamps for permanent nail polish. The new LED-based polymerization devices, and their potential biological effect has not been analyzed to this date. OBJECTIVE: To evaluate the emission power and its potential biological effects on the skin of 2 types of UV LED and fluorescent curing lamps under normal use conditions compared to doses of sunlight exposure. MATERIAL AND METHODS: The emission spectrum (290nm to 450nm) of curing lamps and the Sun at noon on an average summer day in mid-latitude Spain was analyzed. The effective biological irradiance potential for erythema, non-melanoma skin cancer, DNA damage, photoimmunosuppression and permanent pigmentation was also characterized. RESULTS: The high-energy UVA-visible irradiance emitted by these devices was similar to the one coming from the Sun in that spectral range while the effective biological doses were lower or similar to those also coming from the Sun. The total UV and high-energy visible dose per manicure session corresponded to that obtained from 3.5min to 6min exposures to the Sun at noon in the summer days at our latitudes. CONCLUSIONS: The exposure times and doses received with the common use of artificial lamp nail drying correspond to sunlight exposures of 3min to 5min in the central hours of the day. This represents a very low carcinogenic potential compared to sunlight exposure, although similar regarding immunosuppressive potential. Photoprotective measures would further minimize the risks.


Assuntos
Unhas , Neoplasias Induzidas por Radiação , Neoplasias Cutâneas , Raios Ultravioleta , Raios Ultravioleta/efeitos adversos , Humanos , Unhas/efeitos da radiação , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Induzidas por Radiação/epidemiologia , Luz Solar/efeitos adversos , Dano ao DNA , Espanha , Eritema/etiologia
5.
Aten. prim. (Barc., Ed. impr.) ; 56(2): [102782], Feb. 2024. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-230388

RESUMO

Objetivo: El objetivo fue desarrollar un cribado de detección de cardiopatías en atención primaria, para identificar alteraciones electrocardiográficas patológicas y cardiopatías subyacentes en adolescentes. Diseño: Durante un año se realizó el estudio mediante muestreo polietápico. Lugar: Se seleccionaron los centros asistenciales de atención primaria en un área de salud, que dispusieran de equipo de electrocardiograma (ECG) digital (12 centros). Participantes: Inicialmente, se reclutó a 718 (16,6%) adolescentes de 14 años y se excluyeron a los que tenían un diagnóstico de cardiopatía previo. Intervención: El cribado consistió en incluir en la revisión obligatoria de los 14 años un cuestionario de salud y un ECG. Principales medidas: Para el cribado se realizó cuestionario, auscultación cardíaca, ECG y ecocardiografía. Se establecieron criterios de anormalidad para remitir a una segunda valoración por un cardiólogo. Resultados: Finalmente la muestra la componen 698 adolescentes, con una edad media de 13,7± 0,5 años, de los cuales 354 (50,7%) fueron chicos. Fueron seleccionados 149 (21,3%) para la segunda revisión por cardiología: 88 (12,6%) por cuestionario positivo, 11 (2,2%) por auscultación cardíaca anormal y 66 (9,5%) por hallazgos en ECG. Los adolescentes con evidencia de cardiopatía fueron 24 (3,4%). De ellos, 14 (2,0%) tuvieron alteraciones sugestivas y se les recomendó seguimiento, 6 (0,9%) tuvieron diagnóstico definitivo de cardiopatía y 4 (0,6%) tenían otros hallazgos patológicos relacionados con el sistema cardiovascular. Conclusiones: El cribado permitió identificar un 1% de adolescentes con cardiopatía y otro 2% permanecerá en seguimiento. El ECG detectó más casos patológicos que el cuestionario.(AU)


Objective: The objective was to develop a screening for heart disease detection in primary care, to identify pathological electrocardiographic changes and underlying heart disease in adolescents. Design: The study was carried out for one year using multistage sampling. Site: Primary care centers in a health area that had digital ECG equipment (12 centers) were selected. Participants: Initially, 718 (16.6%) 14-year-old adolescents were recruited and those with a previous diagnosis of heart disease were excluded. Interventions: Screening consisted of including a health questionnaire in the mandatory 14-year-old check-up. Main measurements: Screening included a questionnaire, cardiac auscultation, ECG and echocardiography. Abnormality criteria were established to refer for a second evaluation by a cardiologist. Results: Finally, the sample was made up of 698 adolescents, with a mean age of 13.7±0.5 years, and 354 (50.7%) were boys. A total of 149 (21.3%) were selected for a second review by cardiology: 88 (12.6%) due to a positive questionnaire, 11 (2.2%) due to abnormal cardiac auscultation, and 66 (9.5%) due to ECG findings. Adolescents with evidence of heart disease were 24 (3.4%). Of these, 14 (2.0%) had suggestive alterations and follow-up was recommended, 6 (0.9%) had a definitive diagnosis of heart disease, and 4 (0.6%) had other pathological findings related to the cardiovascular system. Conclusions: The screening allowed us to identify 1% of adolescents with heart disease and another 2% will remain in follow-up. The ECG detected more pathological cases than the questionnaire.(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Cardiopatias , Atenção Primária à Saúde , Eletrocardiografia , Programas de Rastreamento , Morte Súbita Cardíaca , Estudos Prospectivos , Espanha , Inquéritos e Questionários
6.
Aten Primaria ; 56(2): 102782, 2024 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-37924621

RESUMO

OBJECTIVE: The objective was to develop a screening for heart disease detection in primary care, to identify pathological electrocardiographic changes and underlying heart disease in adolescents. DESIGN: The study was carried out for one year using multistage sampling. SITE: Primary care centers in a health area that had digital ECG equipment (12 centers) were selected. PARTICIPANTS: Initially, 718 (16.6%) 14-year-old adolescents were recruited and those with a previous diagnosis of heart disease were excluded. INTERVENTIONS: Screening consisted of including a health questionnaire in the mandatory 14-year-old check-up. MAIN MEASUREMENTS: Screening included a questionnaire, cardiac auscultation, ECG and echocardiography. Abnormality criteria were established to refer for a second evaluation by a cardiologist. RESULTS: Finally, the sample was made up of 698 adolescents, with a mean age of 13.7±0.5 years, and 354 (50.7%) were boys. A total of 149 (21.3%) were selected for a second review by cardiology: 88 (12.6%) due to a positive questionnaire, 11 (2.2%) due to abnormal cardiac auscultation, and 66 (9.5%) due to ECG findings. Adolescents with evidence of heart disease were 24 (3.4%). Of these, 14 (2.0%) had suggestive alterations and follow-up was recommended, 6 (0.9%) had a definitive diagnosis of heart disease, and 4 (0.6%) had other pathological findings related to the cardiovascular system. CONCLUSIONS: The screening allowed us to identify 1% of adolescents with heart disease and another 2% will remain in follow-up. The ECG detected more pathological cases than the questionnaire.


Assuntos
Morte Súbita Cardíaca , Cardiopatias , Masculino , Humanos , Adolescente , Feminino , Morte Súbita Cardíaca/prevenção & controle , Eletrocardiografia , Cardiopatias/diagnóstico , Ecocardiografia , Programas de Rastreamento
7.
Front Aging ; 4: 1108149, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36861136

RESUMO

Aging population is at higher risk of developing severe COVID-19, including hospitalization and death. In this work, to further understand the relationship between host age-related factors, immunosenescence/exhaustion of the immune system and the response to the virus, we characterized immune cell and cytokine responses in 58 COVID-19 patients admitted to the hospital and 40 healthy controls of different age ranges. Lymphocyte populations and inflammatory profiles were studied in blood samples, using different panels of multicolor flow cytometry. As expected, our analysis reveals differences at both the cellular and cytokine level in COVID-19 patients. Interestingly, when the age range analysis was carried out, the immunological response to the infection was found to differ with age, being especially affected in the group of 30-39 years. In this age range, an increased exhausted T cell response and a decrease of naïve T helper lymphocytes was found in patients, as well as a reduced concentration of the proinflammatory TNF, IL-1ß and IL-8 cytokines. Besides, the correlation between age and the study variables was evaluated, and multiple cell types and interleukins were found to correlate with donor age. Notably, the correlations of T helper naïve and effector memory cells, T helper 1-17 cells, TNF, IL-10, IL-1ß, IL-8, among others, showed differences between healthy controls and COVID-19 patients. Our findings, in the context of other previous studies, suggest that aging affects the behavior of the immune system in COVID-19 patients. They suggest that young individuals are able to mount an initial response to SARS-CoV-2, but some of them present an accelerated exhaustion of the cell response and an insufficient inflammatory response, resulting in a moderate to severe COVID-19. On the other hand, in older patients there is a smaller immune cell response to the virus, reflected in fewer differences in immune populations between COVID-19 patients and controls. Nevertheless, old patients show more evidence of an inflammatory phenotype, suggesting that the underlying inflammation associated with their age is exacerbated by the SARS-CoV-2 infection.

8.
Rev. int. androl. (Internet) ; 21(1): 1-7, ene.-mar. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-216608

RESUMO

Introducción: Las actitudes sexuales están relacionadas con las normas y costumbres que se consideran adecuadas según la época en la que se vive; suelen ser más restrictivas para las mujeres. Objetivo: El objetivo de este estudio es analizar de qué forma las actitudes sexuales (erotofilia-erotofobia y doble moral sexual) pueden predisponer hacia la violencia sexual (actitudes favorables a la violación). Material y métodos: La muestra está formada por 868 estudiantes de la Universidad de Huelva (723 mujeres y 145 hombres), con edades comprendidas entre los 17 y los 57 años. Se ha utilizado la Escala de Doble Moral, la Escala de Actitud Favorable a la Violación y la Encuesta Revisada de Opinión Sexual. Resultados: Las personas que se muestran más erotofílicas son las bisexuales (x̄=99,10) y las personas que se consideran de izquierda en política (x̄=96,91). Las puntuaciones más altas en doble moral las obtienen los hombres (x̄=18,50), estudiantes de máster (x̄=18,58), asexuales (x̄=20,50) y personas que se consideran de centro (x̄=18,24). En cuanto a actitudes favorables a la violación, se destacan los hombres (x̄=37,72), heterosexuales (x̄=33,29) y personas que se consideran de derecha (x̄=37,35). Las diferencias encontradas entre los grupos son estadísticamente significativas. Conclusiones: Se confirma que las actitudes sexuales pueden predisponer a la violencia sexual, lo que muestra la necesidad de seguir trabajando en esta línea para así fomentar experiencias sexuales placenteras. (AU)


Introduction: Sexual attitudes are related to the norms and customs that are considered appropriate according to the era in which one lives, usually showing themselves more restrictive for women. Objective: The aim of this study is to analyze how sexual attitudes (erotophilia-erotophobia and sexual double standards) may predispose to sexual violence (attitudes in favor of rape).Material and methods: The sample consisted of 868 students from the University of Huelva (723 women and 145 men), aged between 17 and 57 years. The Double Moral Scale, the Rape Favorable Attitude Scale and the Revised Sexual Opinion Survey were used. Results: People who are more erotophilic are bisexuals (x̄=99.10) and people who consider themselves left-wing in politics (x̄=96.91). The highest double standards scores are obtained by men (x̄=18.50), master's students (x̄=18.58), asexuals (x̄=20.50) and people who consider themselves centrist (x̄=18.24). In terms of pro-rape attitudes, men (x̄=37.72), heterosexuals (x̄=33.29) and people who consider themselves right-wing (x̄=37.35) stand out. The differences found between the groups are statistically significant. Conclusions: It is confirmed that sexual attitudes can predispose to sexual violence, which shows the need to continue working in this line in order to promote pleasurable sexual experiences. (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Estupro , Comportamento Sexual , Violência , Estudantes , Universidades
9.
Rev Int Androl ; 21(1): 100335, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-36273994

RESUMO

INTRODUCTION: Sexual attitudes are related to the norms and customs that are considered appropriate according to the era in which one lives, usually showing themselves more restrictive for women. OBJECTIVE: The aim of this study is to analyze how sexual attitudes (erotophilia-erotophobia and sexual double standards) may predispose to sexual violence (attitudes in favor of rape). MATERIAL AND METHODS: The sample consisted of 868 students from the University of Huelva (723 women and 145 men), aged between 17 and 57 years. The Double Moral Scale, the Rape Favorable Attitude Scale and the Revised Sexual Opinion Survey were used. RESULTS: People who are more erotophilic are bisexuals (x̄=99.10) and people who consider themselves left-wing in politics (x̄=96.91). The highest double standards scores are obtained by men (x̄=18.50), master's students (x̄=18.58), asexuals (x̄=20.50) and people who consider themselves centrist (x̄=18.24). In terms of pro-rape attitudes, men (x̄=37.72), heterosexuals (x̄=33.29) and people who consider themselves right-wing (x̄=37.35) stand out. The differences found between the groups are statistically significant. CONCLUSIONS: It is confirmed that sexual attitudes can predispose to sexual violence, which shows the need to continue working in this line in order to promote pleasurable sexual experiences.


Assuntos
Estupro , Violência , Masculino , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Comportamento Sexual , Atitude , Estudantes
10.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1535643

RESUMO

Introducción: Los trastornos funcionales son un reto clínico en la atención de pacientes con déficits neurológicos. Pueden generar manifestaciones clínicas típicas y gran discapacidad. Para su diagnóstico se requiere de una alta sospecha inicial asociado a una batería de examen físico completa. Hallazgos clínicos: Presentamos el caso de una paciente indígena embarazada de 19 años, con pérdida de la fuerza en sus extremidades inferiores, un nivel sensitivo y pérdida del control de los esfínteres. Luego de una evolución estacionaria con estudios imagenológicos e infectocontagiosos dentro de la normalidad. Se sospechó el diagnóstico de un trastorno neurológico funcional por lo que se realizó la prueba del Spinal Injuries Center (SIC) el cual fue positivo. Tratamiento y evolución: Realizamos una intervención multidisciplinar, incluyendo el servicio de rehabilitación, neurología, psiquiatría y psicología. Se utilizaron intervenciones con movimientos articulares, fortalecimiento muscular, estimulación eléctrica y psicoterapia. Posteriormente se obtuvo la recuperación completa de la paciente antes del alta hospitalaria, con la exigencia de seguimiento ambulatorio, además de una inserción satisfactoria en las actividades sociales y familiares. Conclusiones: Este caso refleja la importancia de un análisis neurológico detallado, el conocimiento de diferentes herramientas de semiología y el reto diagnóstico de los trastornos funcionales en neurológicos. La intervención de un equipo multidisciplinar favorece abordajes multidimensionales y resultados clínicos favorables.


Introduction: Functional disorders pose a clinical challenge in the care of patients with neurological deficits. They can generate typical clinical manifestations and great disability. Diagnosis requires a high initial suspicion together with comprehensive physical examination. Clinical Findings: We present the case of a 19-year-old pregnant indigenous patient, with loss of strength in her lower extremities, with a sensitive level and loss of sphincter control. After a stationary evolution with imaging and infectious studies within normal limits, a diagnosis of a functional neurological disorder was suspected; thus, the Spinal Injuries Center (SIC) test was performed, showing positive results. Treatment and evolution: A multidisciplinary intervention was carried out, including the neurology, psychiatry and psychology rehabilitation. Interventions amied towards joint movements, muscle strengthening, electrical stimulation and psychotherapy were used. Eventually, the patient's complete recovery was achieved before hospital discharge, in addition to a satisfactory integration into social and family activities, with a outpatient follow-up requirement. Conclusions: This case reflects the importance of a detailed neurological analysis, knowledge of different semiology tools and the diagnostic challenge of functional neurological disorders. The intervention of a multidisciplinary team favors multidimensional approaches and favorable clinical results.

11.
Arch. Soc. Esp. Oftalmol ; 97(11): 626-638, nov. 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-212044

RESUMO

Objetivo: Brolucizumab, un anti-VEGF de nueva generación, ha demostrado su eficacia y seguridad en la degeneración macular asociada a la edad neovascular exudativa (DMAEn) en los ensayos pivotales HAWK y HARRIER. Tras su comercialización, se han reportado eventos adversos relacionados con la inflamación intraocular no detectados previamente. Una revisión post hoc independiente de los ensayos pivotales cifra la tasa de inflamación intraocular (IIO) en el 4,6%. El objetivo de este trabajo es proponer una serie de recomendaciones para implementar el manejo de brolucizumab en la práctica clínica. Método: Las recomendaciones realizadas por los autores se han basado en su experiencia clínica y en la revisión crítica de: 1)los ensayos pivotales; 2)el análisis post hoc del Comité de Revisión de Seguridad, y 3)la literatura publicada. Resultados: En los ensayos pivotales, brolucizumab mostró ganancias funcionales sostenidas, resultados anatómicos superiores con intervalos entre inyecciones potencialmente más prolongados y un perfil de seguridad global bien tolerado. Los eventos adversos reportados tras la comercialización incluyen vasculitis retiniana y la oclusión vascular retiniana. De acuerdo con la información disponible, los expertos recomiendan: 1)descartar los perfiles de pacientes no recomendados (historial previo de IIO); 2)explorar al paciente antes de cada inyección para descartar la presencia de IIO activa; 3)monitorizar al paciente para detectar precozmente los signos de alerta, y 4)tratar de inmediato en el caso de que se desarrolle algún evento adverso. ConclusionesLos : eventos adversos reportados son poco frecuentes, pero pueden estar asociados con una pérdida severa e irreversible de agudeza visual. Las recomendaciones realizadas pretenden facilitar el manejo de brolucizumab en la práctica habitual de los retinólogos, garantizar la seguridad del paciente y, en caso de que se produzca alguno de los eventos adversos, minimizar su impacto sobre la visión. (AU)


Purpose: Brolucizumab, a new generation anti-VEGF, has demonstrated efficacy and safety in AMD in the pivotal HAWK and HARRIER trials. Post-marketing, previously undetected adverse events related to intraocular inflammation have been reported. An independent post hoc review of the pivotal trials puts the rate of intraocular inflammation (IOI) at 4.6%. The aim of this paper is to propose a set of recommendations for implementing the management of brolucizumab in clinical practice. Method: The recommendations made by the authors are based on their clinical experience and critical review of (i)the pivotal trials; (ii)the post-hoc analysis of the Safety Review Committee, and (iii)the published literature. Results: In the pivotal trials, brolucizumab showed sustained functional gains, superior anatomical outcomes with potentially longer intervals between injections and a well-tolerated overall safety profile. Adverse events reported post-marketing include retinal vasculitis and retinal vascular occlusion. Based on the available information, experts recommend (i)ruling out non-recommended patient profiles (prior history of ORI); (ii)screening the patient prior to each injection to rule out active IOI; (iii)monitoring the patient for early warning signs, and (iv)treating immediately should any adverse events develop. Conclusions: The adverse events reported are rare, but may be associated with severe and irreversible loss of visual acuity. The recommendations made are intended to facilitate the management of brolucizumab in the routine practice of retinologists, to ensure patient safety and, should any adverse events occur, to minimise their impact on vision. (AU)


Assuntos
Humanos , Anticorpos Monoclonais Humanizados/uso terapêutico , Degeneração Macular/tratamento farmacológico , Degeneração Macular Exsudativa/tratamento farmacológico , Medição de Risco
12.
Artigo em Inglês | MEDLINE | ID: mdl-35882576

RESUMO

PURPOSE: Brolucizumab, a new generation anti-VEGF, has demonstrated efficacy and safety in AMD in the pivotal HAWK and HARRIER trials. Post-marketing, previously undetected adverse events related to intraocular inflammation have been reported. An independent post hoc review of the pivotal trials puts the rate of IOI at 4.6%. The aim of this paper is to propose a set of recommendations for implementing the management of brolucizumab in clinical practice. METHODS: The recommendations made by the authors are based on their clinical experience, critical review of (i) the pivotal trials, the post-hoc analysis of the Safety Review Committee, (ii), and (iii) the published literature. RESULTS: In the pivotal trials, brolucizumab showed sustained functional gains, superior anatomical outcomes with potentially longer intervals between injections and a well-tolerated overall safety profile. Adverse events reported post-marketing include retinal vasculitis and retinal vascular occlusion. Based on the available information, experts recommend (i) ruling out non-recommended patient profiles (prior history of ORI), (ii) screening the patient prior to each injection to rule out active ORI, (iii) monitoring the patient for early warning signs, and (iv) treating immediately should any adverse events develop. CONCLUSIONS: The adverse events reported are rare, but may be associated with severe and irreversible loss of visual acuity. The recommendations made are intended to facilitate the management of brolucizumab in the routine practice of retinologists, to ensure patient safety and, should any adverse events occur, to minimise their impact on vision.

13.
Radiologia (Engl Ed) ; 64(3): 256-265, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35676057

RESUMO

Breast cancer is the second most common cancer in Peruvian women. Due to limitations in national breast cancer screening programs, especially in rural areas, more than 50% of cases of breast cancer in Peru are diagnosed in advanced stages. In collaboration with a local clinic registered as a nongovernmental organization (CerviCusco), RAD-AID International aims to create a sustainable diagnostic structure to improve breast cancer screening in Cuzco. With the support of local, national, and international partners that have collaborated in analyzing radiological resources, raising awareness in the population, acquiring equipment, training clinical staff, and building referral networks, our teams of radiologists, included in the RAD-AID team, have participated in training CerviCusco staff in breast ultrasound, thus enabling additional training for radiology residents through a regulated international collaboration.


Assuntos
Neoplasias da Mama , Radiologia , Neoplasias da Mama/diagnóstico por imagem , Detecção Precoce de Câncer , Feminino , Humanos , Peru , Voluntários
14.
Radiología (Madr., Ed. impr.) ; 64(3): 256-265, May-Jun 2022. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-204583

RESUMO

El cáncer de mama es el segundo cáncer más frecuente en las mujeres peruanas. Las limitaciones de los programas nacionales de detección precoz, sobre todo en las regiones rurales, propician que más del 50% de los nuevos casos de cáncer de mama en Perú se diagnostiquen en estadios avanzados. RAD-AID Internacional, en colaboración con una clínica local registrada como organización no gubernamental (CerviCusco), pretende crear una estructura diagnóstica sostenible que mejore el cribado del cáncer de mama en Cuzco. Para ello se ha contado con socios locales, nacionales e internacionales que han colaborado en el análisis de recursos radiológicos, la concienciación de la población, la adquisición de equipamiento, el entrenamiento clínico y las redes de referencia. Nuestros equipos de radiólogos, incluidos en el equipo RAD-AID, han participado en la capacitación ecográfica del personal de CerviCusco, permitiendo una formación adicional a los residentes de radiología gracias a una colaboración internacional reglada.(AU)


Breast cancer is the second most common cancer in Peruvian women. Due to limitations in national breast cancer screening programs, especially in rural areas, more than 50% of cases of breast cancer in Peru are diagnosed in advanced stages. In collaboration with a local clinic registered as a nongovernmental organization (CerviCusco), RAD-AID International aims to create a sustainable diagnostic structure to improve breast cancer screening in Cuzco. With the support of local, national, and international partners that have collaborated in analyzing radiological resources, raising awareness in the population, acquiring equipment, training clinical staff, and building referral networks, our teams of radiologists, included in the RAD-AID team, have participated in training CerviCusco staff in breast ultrasound, thus enabling additional training for radiology residents through a regulated international collaboration.(AU)


Assuntos
Humanos , Feminino , Voluntários , Peru , Neoplasias da Mama/diagnóstico por imagem , Ultrassonografia , Detecção Precoce de Câncer
15.
Photodermatol Photoimmunol Photomed ; 38(4): 365-372, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34817897

RESUMO

BACKGROUND: Transplant recipients are particularly prone to the development of skin cancer, and overexposure to UV radiation during outdoor activities increases the risk of carcinogenesis. OBJECTIVE: The aim of this study was to analyze sun-related behaviors and knowledge in transplant athletes, examine the frequency of sunburns, and explore associations with a history of skin cancer. MATERIALS AND METHODS: Cross-sectional descriptive study. Participants (n = 170) in the XXI World Transplant Games from >50 countries completed a questionnaire on sun protection habits and knowledge, type of transplant, immunosuppressive therapy, and personal history of skin cancer. RESULTS: The most common transplanted organs were the kidney (n = 79), the liver (n = 33), and the heart (n = 31). Overall, 61.3% of athletes had been doing sport for >15 years and 79.5% spent >1-2 h a day outdoors. Fifteen % of athletes had a history of skin cancer. The prevalence of sunburn in the previous year was 28.9%, higher in athletes aged <50 years (37.2%); without a primary school education (58.3%), not taking cyclosporin (32.6%), and athletes who played basketball (75%). The main sun protection measures used were sunscreen (68.9%) and sunglasses (67.3%). Use of a hat or cap was the only measure significantly associated with a reduced prevalence of sunburn. CONCLUSIONS: Despite high awareness that sun exposure increases the risk of skin cancer, sunburn was common in transplant athletes. Efforts should be made to strengthen multidisciplinary sun protection education strategies and ensure periodic dermatologic follow-up to prevent sun-induced skin cancer in this population.


Assuntos
Neoplasias Cutâneas , Queimadura Solar , Atletas , Estudos Transversais , Hábitos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/prevenção & controle , Queimadura Solar/prevenção & controle , Luz Solar/efeitos adversos , Protetores Solares/uso terapêutico , Inquéritos e Questionários
16.
Radiologia (Engl Ed) ; 2021 May 31.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34083079

RESUMO

Breast cancer is the second most common cancer in Peruvian women. Due to limitations in national breast cancer screening programs, especially in rural areas, more than 50% of cases of breast cancer in Peru are diagnosed in advanced stages. In collaboration with a local clinic registered as a nongovernmental organization (CerviCusco), RAD-AID International aims to create a sustainable diagnostic structure to improve breast cancer screening in Cuzco. With the support of local, national, and international partners that have collaborated in analyzing radiological resources, raising awareness in the population, acquiring equipment, training clinical staff, and building referral networks, our teams of radiologists, included in the RAD-AID team, have participated in training CerviCusco staff in breast ultrasound, thus enabling additional training for radiology residents through a regulated international collaboration.

17.
Arch. esp. urol. (Ed. impr.) ; 74(1): 63-70, ene.-feb. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-199437

RESUMO

INTRODUCCIÓN: La prevalencia de la patología litiásica se estima en un 5% al 15%, con una clara tendencia al aumento en los países industrializados. Los pacientes con episodios recurrentes de litiasis renal presentan un riesgo aumentado de enfermedad renal crónica que puede potencialmente limitar su expectativa de vida. OBJETIVO: Revisión y síntesis de las opciones terapéuticas recomendadas para la prevención en la recurrencia de cálculos urinarios basadas en el tipo de cálculo o alteración urinaria en orina de 24 horas, según las guías clínicas y publicaciones recientes. CONCLUSIONES: Medidas dietéticas y farmacológicas han demostrado una reducción de hasta el 60% en la recurrencia de episodios clínicos cuando son dirigidas según el tipo de cálculo y los resultados de los estudios metabólicos. El aumento en la prevalencia mundial de esta patología y el potencial riesgo de enfermedad renal crónica en pacientes recurrentes, justifican la necesidad de ampliar los conocimientos fisiopatológicos que precipitan la formación de litiasis urinarias para el desarrollo de nuevos tratamientos más eficaces en la prevención de esta enfermedad


INTRODUCTION: Prevalence of urolitiasis is estimated between 5-15% with a clear trend to increasing in the industrialized countries. Stone recurrent patients show an increased risk of chronic renal disease which can potentially limit their life expectancy. OBJECTIVE: A review and summary of the different recommended treatment options to prevent urinary stone recurrence based on the type of calculi or urinary metabolic alterations in 24 h urine, according to recent guidelines and publications. CONCLUSIONS: Dietetic and pharmacologic measures, when addressed depending on the type of stone and results of metabolic evaluation have shown a decrease up to 60% of the recurrent clinical events. The increase of prevalence worldwide and the potential risk of chronic kidney disease in these patients clearly justify the need of increasing physiopathologic knowledge leading urolithiasis formation in order to develop new and more effective drugs for its prevention


Assuntos
Humanos , Nefrolitíase/terapia , Cálculos Renais , Cálculos Urinários , Urolitíase/terapia , Recidiva , Insuficiência Renal Crônica/epidemiologia
20.
Sci Rep ; 10(1): 14757, 2020 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-32901084

RESUMO

Research has shown that warming and drought change plant phenolics. However, much of this work has centered on the effects of individual abiotic stressors on single plant species rather than the concurrent effects of multiple stressors at the plant community level. To address this gap, we manipulated rainfall and air temperature to test for their individual and interactive effects on the expression of leaf phenolics at the community level for annual plant species occurring in two habitat types (under oak tree canopies or in open grasslands) in a Mediterranean savanna. We found that augmented temperature had a significant positive effect on the community-weighted mean of total phenolics whereas reduced rainfall had no effect. In addition, we found no evidence of interactive effects between climatic stressors and these patterns remained consistent across habitat types. Overall, this study points at increasing efforts to investigate the linkages between climate change and community-level shifts in plant secondary chemistry.

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