5,685 research outputs found

    Sobre-anticoagulación por warfarina ocasionada por múltiples errores de medicación

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    La warfarina es el anticoagulante más empleado en el mundo por su conveniencia y bajo costo. Sin embargo, su efectividad y seguridad están determinadas por el monitoreo paraclínico del INR, el control de la ingesta de vitamina K, las interacciones medicamentosas y el perfil farmacogenético entre otros factores, que podrían condicionar la ocurrencia de complicaciones trombóticas o hemorrágicas. Se presenta el caso de una paciente con hemorragia en el muslo secundaria a warfarina, en quien la falta de adherencia al esquema posológico prescrito, la falta de seguimiento y una posible interacción con el omeprazol fueron identificados por el servicio de Farmacia Clínica del hospital como factores determinantes de la reacción adversa a medicamento. La intervención farmacéutica consistió en sugerir la sustitución de warfarina por apixabán, medicamento de una costo-efectividad similar, que no requiere monitoreo paraclínico y carece de interacciones medicamentosas en la paciente

    Sobre-anticoagulación por warfarina ocasionada por múltiples errores de medicación

    Get PDF
    La warfarina es el anticoagulante más empleado en el mundo por su conveniencia y bajo costo. Sin embargo, su efectividad y seguridad están determinadas por el monitoreo paraclínico del INR, el control de la ingesta de vitamina K, las interacciones medicamentosas y el perfil farmacogenético entre otros factores, que podrían condicionar la ocurrencia de complicaciones trombóticas o hemorrágicas. Se presenta el caso de una paciente con hemorragia en el muslo secundaria a warfarina, en quien la falta de adherencia al esquema posológico prescrito, la falta de seguimiento y una posible interacción con el omeprazol fueron identificados por el servicio de Farmacia Clínica del hospital como factores determinantes de la reacción adversa a medicamento. La intervención farmacéutica consistió en sugerir la sustitución de warfarina por apixabán, medicamento de una costo-efectividad similar, que no requiere monitoreo paraclínico y carece de interacciones medicamentosas en la paciente

    Mechanisms of Impaired Brown Adipose Tissue Recruitment in Obesity

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    Brown adipose tissue (BAT) dissipates energy to produce heat. Thus, it has the potential to regulate body temperature by thermogenesis. For the last decade, BAT has been in the spotlight due to its rediscovery in adult humans. This is evidenced by over a hundred clinical trials that are currently registered to target BAT as a therapeutic tool in the treatment of metabolic diseases, such as obesity or diabetes. The goal of most of these trials is to activate the BAT thermogenic program via several approaches such as adrenergic stimulation, natriuretic peptides, retinoids, capsinoids, thyroid hormones, or glucocorticoids. However, the impact of BAT activation on total body energy consumption and the potential effect on weight loss is still limited. Other studies have focused on increasing the mass of thermogenic BAT. This can be relevant in obesity, where the activity and abundance of BAT have been shown to be drastically reduced. The aim of this review is to describe pathological processes associated with obesity that may influence the correct differentiation of BAT, such as catecholamine resistance, inflammation, oxidative stress, and endoplasmic reticulum stress. This will shed light on the thermogenic potential of BAT as a therapeutic approach to target obesity-induced metabolic diseases

    Walls talk: Microbial biogeography of homes spanning urbanization.

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    Westernization has propelled changes in urbanization and architecture, altering our exposure to the outdoor environment from that experienced during most of human evolution. These changes might affect the developmental exposure of infants to bacteria, immune development, and human microbiome diversity. Contemporary urban humans spend most of their time indoors, and little is known about the microbes associated with different designs of the built environment and their interaction with the human immune system. This study addresses the associations between architectural design and the microbial biogeography of households across a gradient of urbanization in South America. Urbanization was associated with households' increased isolation from outdoor environments, with additional indoor space isolation by walls. Microbes from house walls and floors segregate by location, and urban indoor walls contain human bacterial markers of space use. Urbanized spaces uniquely increase the content of human-associated microbes-which could increase transmission of potential pathogens-and decrease exposure to the environmental microbes with which humans have coevolved

    Estrategias didácticas desde las tecnologías de la información y la comunicación para el rol mediador docente

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    The objective of the article was to analyze the didactic strategy from the information and communication technologies for the teaching mediator role, for which it used a descriptive quantitative methodology, interpreting the results through percentage statistics. The main finding is that the degree of application of ICT in the classroom, as a support tool in the mediator role of the teacher, depends on the degree of appropriation of basic notions of ICT by teachers. Concluding that, the didactic process is strengthened if accompaniment strategies are implemented through an organized training program in basic ICT management skills and, in its pedagogical use within the classroom.El artículo tuvo como objetivo analizar la estrategia didáctica desde las tecnologías de la información y comunicación para el rol mediador docente, para lo cual utilizó una metodología cuantitativa descriptiva, interpretando los resultados mediante estadística porcentual. Como hallazgo principal se tiene que el grado de aplicación de las TIC en el aula, como herramienta de apoyo en el Rol mediador del docente, depende del grado de apropiación de las nociones básicas de TIC por parte de los docentes. Concluyendo que, el proceso didáctico se fortalece si se implementan estrategias de acompañamiento mediante un programa organizado de capacitación en Competencias básicas de manejo de TIC y, en su utilización pedagógica dentro del aula

    Biomarker tools to Design Clinical Vaccines Determined from a study of annual Listeriosis Incidence in Northern spain

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    Two regions of northern Spain, Gipuzkoa, and Cantabria present high annual incidence of listeriosis (1.86 and 1.71 cases per 100,000 inhabitants, respectively). We report that the high annual incidences are a consequence of infection with highly virulent Listeria monocytogenes isolates linked to fatal outcomes in elderly patients with cancer. In addition, listeriosis patients with cancer present low IL-17A/IL-6 ratios and significantly reduced levels of anti-GAPDH1?22 antibodies, identified as two novel biomarkers of poor prognosis. Analysis of these biomarkers may aid in reducing the incidence of listeriosis. Moreover, GAPDH1?22-activated monocyte-derived dendritic cells of listeriosis patients with cancer seem useful tools to prepare clinical vaccines as they produce mainly Th1 cytokines

    Congenital cytomegalovirus, parvovirus and enterovirus infection in Mozambican newborns at birth: A cross-sectional survey

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    BACKGROUND: Congenital cytomegalovirus (cCMV) infection is the most prevalent congenital infection acquired worldwide, with higher incidence in developing countries and among HIV-exposed children. Less is known regarding vertical transmission of parvovirus B19 (B19V) and enterovirus (EV). We aimed to assess the prevalence of CMV, B19V and EV vertical transmission and compare results of screening of congenital CMV obtained from two different specimens in a semirural Mozambican maternity. METHODS: A cross sectional study was conducted among pregnant mothers attending Manhica District Hospital upon delivery. Information on maternal risk factors was ascertained. Dried umbilical cord (DUC) samples were collected in filter paper for CMV, B19V and EV detection by real-time polymerase chain reaction (RT-PCR), and nasopharyngeal aspirates (NPA) to test for CMV by RT-PCR. Maternal blood samples and placental biopsy samples were also obtained to investigate CMV maternal serology, HIV status and immunopathology. RESULTS: From September 2014 to January 2015, 118 mothers/newborn pairs were recruited. Prevalence of maternal HIV infection was 31.4% (37/118). CMV RT-PCR was positive in 3/115 (2.6%) of DUC samples and in 3/96 (6.3%) of NPA samples obtained from neonates. The concordance of the RT-PCR assay through DUC with their correspondent NPA sample was moderate (Kappa = 0.42 and p<0.001. No differences on cCMV prevalence were found among HIV-exposed and unexposed. All (100%) mothers were seropositive for CMV IgG. RT-PCR of EV and B19V in DUC were both negative in all screened cases. No histological specific findings were found in placental tissues. No risk factors associated to vertical transmission of these viral infections were found. CONCLUSIONS: This study indicates the significant occurrence of vertical transmission of CMV in southern Mozambique. Larger studies are needed to evaluate the true burden, clinical relevance and consequences of congenital infections with such pathogens in resource-constrained settings

    Brown adipose tissue bioenergetics: a new methodological approach

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    The rediscovery of brown adipose tissue (BAT) in humans and its capacity to oxidize fat and dissipate energy as heat has put the spotlight on its potential as a therapeutic target in the treatment of several metabolic conditions including obesity and diabetes. To date the measurement of bioenergetics parameters has required the use of cultured cells or extracted mitochondria with the corresponding loss of information in the tissue context. Herein, we present a method to quantify mitochondrial bioenergetics directly in BAT. Based on XF Seahorse Technology, we assessed the appropriate weight of the explants, the exact concentration of each inhibitor in the reaction, and the specific incubation time to optimize bioenergetics measurements. Our results show that BAT basal oxygen consumption is mostly due to proton leak. In addition, BAT presents higher basal oxygen consumption than white adipose tissue and a positive response to b-adrenergic stimulation. Considering the whole tissue and not just subcellular populations is a direct approach that provides a realistic view of physiological respiration. In addition, it can be adapted to analyze the effect of potential activators of thermogenesis, or to assess the use of fatty acids or glucose as a source of energy
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