49 research outputs found
Decisiones razonables y razonadas sobre medicamentos convencionales y de uso tradicional. El Seguimiento Farmacoterapéutico, integrador de la perspectiva del paciente.
Se presenta un caso de una paciente con síndrome metabólico y comorbilidades asociadas que acude a un consultorio farmacéutico del nivel primario de Atención en Salud en Bogotá (Colombia), donde recibe seguimiento farmacoterapéutico. La paciente usa tratamientos prescritos por sus médicos y se automedica con productos naturales, como son el extracto de balsamina para regular niveles de glucosa, el extracto de arándano azul europeo para problemas oculares y el uso de lecitina de soja para control de triglicéridos.
Para la evaluación de la farmacoterapia, se localizó evidencia científica sobre el uso y conveniencia de cada producto en el tratamiento de sus problemas de salud, realizándose las siguientes intervenciones: continuar
con la toma de la balsamina, el Bilberry y la lecitina de soja, ya que existen reportes de su utilidad como coadyuvantes en el control de las enfermedades que presenta y la elaboración de un plan de medicación para reforzar la adherencia a los tratamientos. Cuando se evalúan las intervenciones, encontramos que las cifras de glicemia, presión arterial y función hepática se encuentran dentro de objetivos terapéuticos. En este caso, el químico farmacéutico tiene una labor integradora de las terapias de los pacientes, basados en la valoración del riesgo-beneficio y a través del seguimiento farmacoterapéutico obtiene información clínica que permite tomar decisiones sustentadas para el futuro, más aún en el contexto de Latinoamérica, donde los productos naturales son ampliamente usados en la población
Decisiones razonables y razonadas sobre medicamentos convencionales y de uso tradicional. El Seguimiento Farmacoterapéutico, integrador de la perspectiva del paciente.
Se presenta un caso de una paciente con síndrome metabólico y comorbilidades asociadas que acude a un consultorio farmacéutico del nivel primario de Atención en Salud en Bogotá (Colombia), donde recibe seguimiento farmacoterapéutico. La paciente usa tratamientos prescritos por sus médicos y se automedica con productos naturales, como son el extracto de balsamina para regular niveles de glucosa, el extracto de arándano azul europeo para problemas oculares y el uso de lecitina de soja para control de triglicéridos.
Para la evaluación de la farmacoterapia, se localizó evidencia científica sobre el uso y conveniencia de cada producto en el tratamiento de sus problemas de salud, realizándose las siguientes intervenciones: continuar
con la toma de la balsamina, el Bilberry y la lecitina de soja, ya que existen reportes de su utilidad como coadyuvantes en el control de las enfermedades que presenta y la elaboración de un plan de medicación para reforzar la adherencia a los tratamientos. Cuando se evalúan las intervenciones, encontramos que las cifras de glicemia, presión arterial y función hepática se encuentran dentro de objetivos terapéuticos. En este caso, el químico farmacéutico tiene una labor integradora de las terapias de los pacientes, basados en la valoración del riesgo-beneficio y a través del seguimiento farmacoterapéutico obtiene información clínica que permite tomar decisiones sustentadas para el futuro, más aún en el contexto de Latinoamérica, donde los productos naturales son ampliamente usados en la población
Absence of system xc⁻ on immune cells invading the central nervous system alleviates experimental autoimmune encephalitis
Background: Multiple sclerosis (MS) is an autoimmune demyelinating disease that affects the central nervous system (CNS), leading to neurodegeneration and chronic disability. Accumulating evidence points to a key role for neuroinflammation, oxidative stress, and excitotoxicity in this degenerative process. System x(c)- or the cystine/glutamate antiporter could tie these pathological mechanisms together: its activity is enhanced by reactive oxygen species and inflammatory stimuli, and its enhancement might lead to the release of toxic amounts of glutamate, thereby triggering excitotoxicity and neurodegeneration.
Methods: Semi-quantitative Western blotting served to study protein expression of xCT, the specific subunit of system x(c)-, as well as of regulators of xCT transcription, in the normal appearing white matter (NAWM) of MS patients and in the CNS and spleen of mice exposed to experimental autoimmune encephalomyelitis (EAE), an accepted mouse model of MS. We next compared the clinical course of the EAE disease, the extent of demyelination, the infiltration of immune cells and microglial activation in xCT-knockout (xCT(-/-)) mice and irradiated mice reconstituted in xCT(-/-) bone marrow (BM), to their proper wild type (xCT(+/+)) controls.
Results: xCT protein expression levels were upregulated in the NAWM of MS patients and in the brain, spinal cord, and spleen of EAE mice. The pathways involved in this upregulation in NAWM of MS patients remain unresolved. Compared to xCT(+/+) mice, xCT(-/-) mice were equally susceptible to EAE, whereas mice transplanted with xCT(-/-) BM, and as such only exhibiting loss of xCT in their immune cells, were less susceptible to EAE. In none of the above-described conditions, demyelination, microglial activation, or infiltration of immune cells were affected.
Conclusions: Our findings demonstrate enhancement of xCT protein expression in MS pathology and suggest that system x(c)- on immune cells invading the CNS participates to EAE. Since a total loss of system x(c)- had no net beneficial effects, these results have important implications for targeting system x(c)- for treatment of MS
Integral strategy to supportive care in breast cancer survivors through occupational therapy and a m-health system: design of a randomized clinical trial
Background: Technological support using e-health mobile applications (m-health) is a promising strategy to improve
the adherence to healthy lifestyles in breast cancer survivors (excess in energy intake or low physical activity are
determinants of the risk of recurrence, second cancers and cancer mortality). Moreover, cancer rehabilitation
programs supervised by health professionals are needed due to the inherent characteristics of these breast cancer
patients. Our main objective is to compare the clinical efficacy of a m-health lifestyle intervention system alone versus
an integral strategy to improve Quality of Life in breast cancer survivors.
Methods: This therapeutic superiority study will use a two-arm, assessor blinded parallel RCT design. Women will be
eligible if: they are diagnosed of stage I, II or III-A breast cancer; are between 25 and 75 years old; have a Body Mass
Index > 25 kg/m2; they have basic ability to use mobile apps; they had completed adjuvant therapy except for
hormone therapy; and they have some functional shoulder limitations. Participants will be randomized to one of
the following groups: integral group will use a mobile application (BENECA APP) and will receive a face-to-face
rehabilitation (8-weeks); m-health group will use the BENECA app for 2-months and will received usual care
information. Study endpoints will be assessed after 8 weeks and 6 months. The primary outcome will be Quality
of Life measured by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core
and breast module. The secondary outcomes: body composition; upper-body functionality (handgrip, Disability of the
Arm, Shoulder and Hand questionnaire, goniometry); cognitive function (Wechsler Adult Intelligence Scale, Trail Making
Test); anxiety and depression (Hospital Anxiety and Depression Scale); physical fitness (Short version of the Minnesota
Leisure Time Physical Activity Questionnaire, Self-Efficacy Scale for Physical Activity); accelerometry and lymphedema.
Discussion: This study has been designed to seek to address the new needs for support and treatment of breast cancer
survivors, reflecting the emerging need to merge new low cost treatment options with much-needed involvement of
health professionals in this type of patients.
Trial registration: ClinicalTrials.gov Identifier: NCT02817724 (date of registration: 22/06/2016).The study was funded by the Spanish Ministry of Economy and Competitiveness
(Plan Estatal de I + D + I 2013-2016), Fondo de Investigación Sanitaria del Instituto
de Salud Carlos III (PI14/01627), Fondos Estructurales de la Unión Europea (FEDER)
and by the Spanish Ministry of Education (FPU14/01069). This is part of a Ph.D.
Thesis conducted in the Clinical Medicine and Public Health Doctoral Studies of
the University of Granada, Spain
Low-mass and sub-stellar eclipsing binaries in stellar clusters
We highlight the importance of eclipsing double-line binaries in our
understanding on star formation and evolution. We review the recent discoveries
of low-mass and sub-stellar eclipsing binaries belonging to star-forming
regions, open clusters, and globular clusters identified by ground-based
surveys and space missions with high-resolution spectroscopic follow-up. These
discoveries provide benchmark systems with known distances, metallicities, and
ages to calibrate masses and radii predicted by state-of-the-art evolutionary
models to a few percent. We report their density and discuss current
limitations on the accuracy of the physical parameters. We discuss future
opportunities and highlight future guidelines to fill gaps in age and
metallicity to improve further our knowledge of low-mass stars and brown
dwarfs.Comment: 30 pages, 5 figures, no table. Review pape
A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)
Meeting abstrac
Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.
In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field
Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies
Background: Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains un- known.
Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n = 168,287) and non-fatal (13 cohorts, n = 27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor.
Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 10 0,0 0 0 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana.
Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those esti- mated from cohorts in high-income countries