RESUMO
Glutamate (Glu) is considered the most important excitatory amino acid neurotransmitter in the mammalian Central Nervous System. Zinc (Zn) is co-released with Glu during synaptic transmission and interacts with Glutamate receptors and transporters. We performed binding experiments using [3H]MK-801 (NMDA), and [3H]Fluorowillardine (AMPA) as ligands to study Zn-Glutamate interactions in rat cortical synaptic membranes. We also examined the effects of mercury and lead on NMDA or AMPA receptors. Zinc at 1 nM, significantly potentiates [3H]MK-801 binding. Lead inhibits [3H]MK-801 binding at micromolar concentrations. At millimolar concentrations, Hg also has a significant inhibitory effect. These effects are not reversed by Zn (1 nM). Zinc displaces the [3H]FW binding curve to the right. Lead (nM) and Hg (µM) inhibit [3H]FW binding. At certain concentrations, Zn reverses the effects of these metals on [3H]FW binding. These specific interactions serve to clarify the role of Zn, Hg, and Pb in physiological and pathological conditions.
Assuntos
Alanina/análogos & derivados , Maleato de Dizocilpina/metabolismo , Chumbo/farmacologia , Mercúrio/farmacologia , Pirimidinas/metabolismo , Membranas Sinápticas/metabolismo , Zinco/farmacologia , Alanina/metabolismo , Animais , Fármacos Neuroprotetores/metabolismo , Ratos , Membranas Sinápticas/efeitos dos fármacosRESUMO
INTRODUCTION: Hip fractures are considered among one of the most disabling injuries in patients older than 60 years of age. This fractures are associated with a high incidence of mortality and it is the leading cause of hospital admission that requires surgical treatment in Orthopaedic Trauma Centers. METHODS: This systematic review aimed to group, classify and report the best level of evidence of physical therapy and rehabilitation of patients that have been treated with osteostynthesis after trochanteric or subtrochanteric fracture. The outcomes of efficacy and safety were return to activities of daily living, independence and rate of complications. RESULTS: We identified 3,889 abstracts from PubMed, and 1,567 abstracts from other sources, after eliminating duplicates, and posterior to a thorough screening 378 abstracts were read. From these, 316 abstracts were excluded, and 62 articles were considered eligible. After reading for relevant outcomes 41 articles were excluded. Synthesis was based in 21 studies. CONCLUSIONS: Long term results of specialized physical therapy, appear to be crucial in the first months after surgery, and not that important after the four months after surgery. Recent literature supports that the differences of daily activities and independence of the patients that survive a hip fracture tend to be similar with no difference in the type of physical therapy.
INTRODUCCIÓN: Las fracturas de cadera se consideran entre las lesiones incapacitantes más comunes en mayores de 60 años. Se asocian a un alto índice de mortalidad y es la causa más frecuente de internamiento que requiere tratamiento quirúrgico en unidades médicas dedicadas a la traumatología. MÉTODOS: Esta revisión sistemática tiene como objetivo agrupar, clasificar y reportar el mejor nivel de evidencia en el manejo de terapia física y rehabilitación en los pacientes con fractura pertrocantérica y subtrocantérica de cadera después de la cirugía de osteosíntesis en desenlaces de actividades de la vida diaria, independencia y complicaciones. RESULTADOS: Se identificaron 3,389 resúmenes y a través de otras fuentes 1,567 resúmenes, se eliminaron duplicados en la búsqueda y posterior a un cribado se obtuvieron 378 artículos para la eliminación adicional. De los 62 ensayos restantes se incluyeron 21 y 41 fueron excluidos. CONCLUSIONES: Los resultados a largo plazo de la terapia física especializada parecen ser cruciales en los primeros meses y no tan importantes al cabo de cuatro meses. La literatura actual sostiene que las diferencias en las capacidades de la vida diaria e independencia de los pacientes que sobreviven, el tratamiento de una fractura de cadera tiende a ser similar independientemente del programa de rehabilitación que se tenga.
Assuntos
Fraturas do Quadril , Atividades Cotidianas , Idoso , Fraturas do Quadril/reabilitação , Humanos , Pessoa de Meia-IdadeRESUMO
Introducción: El incremento de la población de adultos mayores, requiere de particular atención y planeación en el área de la salud, así como considerar las actitudes hacia ellos, principalmente por parte de los estudiantes de enfermería quienes los cuidarán después de graduarse. Objetivo: Identificar la actitud que tienen los estudiantes de enfermería hacia el adulto mayor y el interés que muestran en cuidar a esta población. Material y métodos: Estudio descriptivo, cuantitativo y trasversal realizado por medio de una encuesta a una muestra representativa de 283 estudiantes de ambos sexos de la carrera de enfermería. El instrumento de investigación se aplicó para determinar la actitud que tienen los estudiantes hacia el adulto mayor con la utilización de dos escalas: el diferencial semántico de Osgood y la de Kogan. Resultados: Con base en la escala de Osgood el 37.7% de los estudiantes tienen una actitud negativa hacia el adulto mayor y con la escala de Kogan se obtuvo el 47% para esta categoría. En promedio, la actitud de los estudiantes fue valorada como regular, y es el sexo femenino quien tiene más actitudes positivas, independientemente de la escala utilizada. Al 51.9% le gustaría desempeñarse en el área gerontológica. Conclusiones: Los estudiantes de enfermería tienen más actitudes negativas relacionadas principalmente a la fragilidad y necesidades de cuidado que requiere el adulto mayor. Es necesario revisar los programas educativos en enfermería para que el aprendizaje y la comunicación orienten al estudiante desde el inicio de la carrera, para incrementar las experiencias y actitudes positivas hacia este grupo social.
Introduction: The increasing older adult population requires special health attention and planning which should include considerations on the attitudes which nursing students demonstrate while taking care of these individuals. Objective: To identify the attitudes and caring interest which nursing students have towards older adults. Material and methods: This is a descriptive, quantitative, and transversal study which used a survey on a representative sample of 283 nursing students of both sexes to determine their attitudes towards older adults in terms of two scales: the Osgood Semantic differential and the Kogan scale. Results: In terms of the Osgood's scale, 37.7% of students showed a negative attitude towards older adults, while in terms of Kogan's scale, 47% demonstrated a negative attitude. In average, the students' attitude was assessed as regular, though the female students exhibited a more positive attitude regardless of the scale. 51.9% of the sample stated they would accept working in the area of gerontology. Conclusions: Nursing students in general show more negative than positive attitudes towards caring older adults, particularly regarding issues of fragility and special needs. Strengthening the nursing education programs in terms of improving the experiences and attitudes of nursing students towards the older adult population is recommended.
Introdução: O incremento da população de idosos requer de particular atenção e planejamento na área de saúde, assim como considerar as atitudes face a eles, principalmente por parte dos estudantes de enfermagem quem os cuidaram depois de formar-se. Objetivo: Identificar a atitude que têm os estudantes de enfermagem face ao idoso e o interesse que mostram para cuidar a esta população. Material e métodos: Estudo descritivo, quantitativo e transversal realizado por meio de uma enquete a uma amostra representativa de 283 estudantes de ambos os sexos da carreira de enfermagem. O instrumento de pesquisa aplicou-se para determinar a atitude que têm os estudantes face ao idoso com a utilização de duas escalas: o diferencial semântico de Osgood e a de Kogan. Resultados: Com base na escala de Osgood o 37.7% dos estudantes têm uma atitude negativa face ao idoso e com a escala de Kogan obteve-se o 47% para esta categoria. Em média, a atitude dos estudantes foi valorizada como regular, e foi o sexo feminino quem teve mais atitudes positivas, independente da escala utilizada. O 51.9% gostaria de desenvolver-se na área gerontológica. Conclusões: Os estudantes de enfermagem têm mais atitudes negativas relacionadas, principalmente à fragilidade e necessidades de cuidado que requer o idoso. É necessário revisar os programas educativos em enfermagem para que a aprendizagem e a comunicação orientem o estudante desde o início da carreira para incrementar as experiências e atitudes positivas face a este grupo social.
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Atenção , Estudantes de Enfermagem , Idoso , AtitudeRESUMO
Resumen: Introducción: Las fracturas de cadera se consideran entre las lesiones incapacitantes más comunes en mayores de 60 años. Se asocian a un alto índice de mortalidad y es la causa más frecuente de internamiento que requiere tratamiento quirúrgico en unidades médicas dedicadas a la traumatología. Métodos: Esta revisión sistemática tiene como objetivo agrupar, clasificar y reportar el mejor nivel de evidencia en el manejo de terapia física y rehabilitación en los pacientes con fractura pertrocantérica y subtrocantérica de cadera después de la cirugía de osteosíntesis en desenlaces de actividades de la vida diaria, independencia y complicaciones. Resultados: Se identificaron 3,389 resúmenes y a través de otras fuentes 1,567 resúmenes, se eliminaron duplicados en la búsqueda y posterior a un cribado se obtuvieron 378 artículos para la eliminación adicional. De los 62 ensayos restantes se incluyeron 21 y 41 fueron excluidos. Conclusiones: Los resultados a largo plazo de la terapia física especializada parecen ser cruciales en los primeros meses y no tan importantes al cabo de cuatro meses. La literatura actual sostiene que las diferencias en las capacidades de la vida diaria e independencia de los pacientes que sobreviven, el tratamiento de una fractura de cadera tiende a ser similar independientemente del programa de rehabilitación que se tenga.
Abstract: Introduction: Hip fractures are considered among one of the most disabling injuries in patients older than 60 years of age. This fractures are associated with a high incidence of mortality and it is the leading cause of hospital admission that requires surgical treatment in Orthopaedic Trauma Centers. Methods: This systematic review aimed to group, classify and report the best level of evidence of physical therapy and rehabilitation of patients that have been treated with osteostynthesis after trochanteric or subtrochanteric fracture. The outcomes of efficacy and safety were return to activities of daily living, independence and rate of complications. Results: We identified 3,889 abstracts from PubMed, and 1,567 abstracts from other sources, after eliminating duplicates, and posterior to a thorough screening 378 abstracts were read. From these, 316 abstracts were excluded, and 62 articles were considered eligible. After reading for relevant outcomes 41 articles were excluded. Synthesis was based in 21 studies. Conclusions: Long term results of specialized physical therapy, appear to be crucial in the first months after surgery, and not that important after the four months after surgery. Recent literature supports that the differences of daily activities and independence of the patients that survive a hip fracture tend to be similar with no difference in the type of physical therapy.
Assuntos
Humanos , Idoso , Fraturas do Quadril/reabilitação , Atividades Cotidianas , Pessoa de Meia-IdadeRESUMO
SETTING: Contact investigation of tuberculosis (TB) patients in Chilean prisons. OBJECTIVE: 1) To estimate TB incidence and the prevalence of latent tuberculous infection (LTBI) among prisoners and their contacts; and 2) to determine factors associated with disease transmission. DESIGN: Cross-sectional study conducted in 46 prisons (51% of the total prison population) to assess the prevalence of and risk factors for LTBI among contacts of prisoners newly diagnosed with pulmonary TB. We used in vitro interferon-gamma release assays to establish LTBI and a questionnaire to address risk factors. RESULTS: During the 1-year follow-up, we studied 418 contacts of 33 active TB cases. We found high TB incidence (123.9 per 100,000 prisoners) and high LTBI prevalence (29.4%) among contacts. LTBI rates are significantly higher in prison inmates than in non-prisoners (33.2% vs. 15.6%). Male sex, illicit drugs, malnutrition, corticosteroid use, low educational level and sharing a cell with a case increase the risk of LTBI. Multivariate analyses showed that corticosteroid use, duration of incarceration and overcrowding are the most relevant determinants for LTBI among all contacts. CONCLUSIONS: Our results confirm that incarceration increases the risk of tuberculous infection and TB disease, and that it was associated not only with origin from vulnerable groups, but also with the prison environment. Reinforcing TB control is essential to prevent TB transmission in prisons.
Assuntos
Transmissão de Doença Infecciosa/estatística & dados numéricos , Prisioneiros , Tuberculose Pulmonar/epidemiologia , Adulto , Antituberculosos/farmacologia , Chile , Busca de Comunicante , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/genética , Prevalência , Fatores de Risco , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/transmissãoRESUMO
The crude latex of "Crown-of-Thorns" (Euphorbia milii var hislopii, syn E.splendens) is a potent plant molluscicide. For this reason, toxicological studies have been performed to evaluate the health risks posed by its use in schistosomiasis control programs. The present study is part of a more comprehensive immunotoxicological evaluation of this molluscicide. Here, we investigated the effects of E. milii latex on the proliferation of human lymphocytes in vitro. Lyophilized latex of E. milii (0, 0.5, 5, 25 and 50 µg/ml) was incubated with whole blood in the presence of proliferation stimulators, i.e. lectins (phytohemagglutinin, concanavalin A and pokeweed mitogen), as well as with human monoclonal antibody against CD3 and tetanus toxoid. Cell proliferation was measured by ³H-thymidine incorporation, and the effects of latex on mitogen-induced cell proliferation were compared to the effects of 10 ng/ml of 12-O-tetradecanoylphorbol-13-acetate (TPA). Results showed that mitogen-induced cell proliferation was markedly enhanced by E. milii latex. This synergistic effect of latex on mitogen-induced lymphocyte proliferation may be due to the presence of TPA-like phorbol esters and/or to mitogenic plant lectins.
O látexbrutoda "Coroa de Cristo" (Euphorbia miliivarhislopii, syn E.splendens) é um potente moluscicidavegetal. Neste sentido, são necessários estudos toxicológicosque visemavaliar possíveis riscos à saúdeassociados ao uso em larga escala desta espécie em áreas endêmicas para esquistossomose. O presente estudo é parte deuma avaliação mais abrangentesobre o potencial tóxico destemoluscicida. Foram investigados in vitro osefeitos dolátex da E.miliisobre a proliferação delinfócitoshumanos. O látexliofilizado (0; 0,5;5;25 e 50 µg/ml)foi incubado comsangue totalna presençade agentes mitogênicos, tais como lectinas(fitohemaglutinina, concanavalina Ae pokeweed), anticorpomonoclonalhumano anti-CD3etoxóide tetânico. A proliferação celularfoi quantificada atravésincorporaçãode ³H-timidina eos efeitos do látexnaproliferação celular induzida por agentes mitogênicosforam comparados comos efeitos de10 ng/mlde12-O-tetradecanoilforbol-13-acetato (TPA). Os resultados demonstram quea proliferação celular induzida poragentes mitogênicosfoimarcadamenteaumentada na presença do látex daE.milii.Oefeito sinérgico observado pode ser devidoà presença deésteres de forbol, como o TPA, e/oude lectinas com ação mitogênica presentes nesta espécie vegetal.
Assuntos
Humanos , Masculino , Feminino , Euphorbia/metabolismo , Látex/análise , Plantas Medicinais/classificação , Ésteres de Forbol/classificação , Linfócitos/metabolismoRESUMO
Se incrementó la conductividad iónica delelectrolito sólido polimérico (PEO)10CF3COONa medianteformación de nuevos compositos, adicionando partículasde óxido de aluminio (Al2O3) como relleno. Los compositosfueron preparados por disolución en solvente líquido y lacaracterización por espectroscopia de impedancias (EI)con configuración de electrodos Pt/electrolito/Pt. Reducciónde hasta dos órdenes de magnitud en la resistencia, seobservó en diagramas de Nyquist; combinando polióxido deetileno (PEO) con trifluoroacetato de sodio (CF3COONa).Al agregar partículas de Al2O3, la reducción en resistenciallego a ser hasta de tres órdenes de magnitud, a temperaturaambiente. Los gráficos de conductividad DC en función dela concentración, mostraron incremento de conductividadiónica a bajas concentraciones de alúmina. El compositoconductor iónico sintetizado mostró conductividadde 2.00x10-5 Scm-1 temperatura ambiente y 7.70x10-4Scm-1, temperatura de 383 K. Se presentó comportamientoArrhenius en dos regiones de diagramas de conductividadcon temperatura, indicando proceso térmicamenteactivado. Para altas concentraciones de Al2O3 se observócomportamiento Vogel-Tamman-Fulcher (VTF). Lasvariaciones de conductividad con concentración de Al2O3,están asociadas con número de sitios involucrados entrasporte iónico, a través de interacciones Lewis ácidobase,entre partículas de Al2O3 y especies iónicas del electrolito...
To increase the ionic conductivity of solid polymer electrolyte, (PEO)10CF3COONa, we formed newcomposites by adding alumina particles as a filler. We prepared these composites by dissolving them ina liquid solvent, and characterized them through impedance spectroscopy (IS), using a Pt/electrolyte/Ptelectrode configuration. The combination of polyethylene oxide (PEO) with sodium trifluoroacetate(CF3COONa) produced a reduction in resistance of up to two orders of magnitude in Nyquist plots, andup to three orders of magnitude when we added Al2O3 particles at room temperature. DC conductivityconcentration graphs show an increase in the ionic conductivity with low alumina concentrations. Thenew synthesized ionic conductor composite presented conductivity values of 2.00x10-5 Scm-1 at roomtemperature and of 7.70x10-4 Scm-1 at a temperature of 383 K. Two sections of the conductivity diagramsalso evidenced a temperature induced Arrhenius behavior, indicating a thermally activated process. Higherconcentrations of Al2O3 induced a Vogel-Tamman-Fulcher (VTF) behavior. Conductivity variationsproduced by Al2O3 concentration are linked to the number of sites involved in ion transport betweenAl2O3 ionic electrolyte species through Lewis acid-base interactions...
Foi Aumentada a condutividade iônica doeletrólito de polímero sólido (PEO)10CF3COONa, através daformação de um novo compósito, adicionando partículas deóxido de alumínio (Al2O3). Os compósitos foram preparadospor dissolução num solvente líquido e a caracterizaçãofoi feita por espectroscopia de impedância (EI) com aconfiguração utilizando eletrodo de platinum - Pt/eletrólito/Pt. A redução de até duas ordens de grandeza na resistênciaé observada em diagraamas de Nyquist quando se combinapoli (óxido de etileno) (PEO) com trifluoroacetato de sodioCF3COONa. Quando as partículas de Al2O3 são adicionadasao composição, é observado uma redução na resistênciade três ordens de grandeza à temperatura ambiente. Osgráficos do logaritmo da condutividade dc em função daconcentração, mostra um aumento da condutividade parabaixas concentrações de alumína. Do compósito condutorde íons sintetizado, apresenta valores de condutividade2.00x10-5 Scm-1 à temperatura ambiente e 7,70x10-4 Scm-1a uma temperatura de 383 K. Um comportamento do tipoArrhenius é apresentado em duas regiões dos diagramas decondutividade com a temperatura, indicando um processotermicamente ativado. Para concentrações elevadas deAl2O3, uma mudança de comportamento para Vogel-Tamman-Fulcher (VTF) foi observado. As variações nacondutividade com a concentração de Al2O3, está associadaa alteração do número dos sítios envolvidos no transportede íons através de interações do tipo ácido-base de Lewisentre partículas de Al2O3 e espécies iônicas...
Assuntos
Análise Espectral , Eletrólitos/análise , Polímeros/análiseRESUMO
OBJECTIVE: To study the incidence of MS in Chile by examining the hospitalizations across all geographical regions of the country and to examine whether there is a correlation between these rates and the latitude or ultraviolet radiation. METHODS: This is a descriptive study examining the national registry of hospitalizations because of MS (code G35 in ICD-10) from January 1, 2001, to December 31, 2006. Incidence rates were calculated by gender and geographical region and standardized to the world population estimated for 2010. RESULTS: A total of 6857 hospitalizations were analyzed. There were 935 individuals; 63.9% were women. The mean incidence rate for 2002-2006 period was 0,90 (95% CI: 0.75-1.05). The annualized incidence rates for regions from North to South were as follows: I Tarapaca 0.54 (95% CI: 0.0-1.21), II Antofagasta 0,93 (0.10-1.75), III Atacama 1.07 (0.0-2.31), IV Coquimbo 0.63 (0.01-1.24), V Valparaiso 0.83 (0.38-1.27), VI O'Higgins 0.72 (0.14-1.30), VII Maule 0.52 (0.06-0.98), VIII BIO BIO 0.81 (0.41-1.21), IX Araucanía 0.43 (0.0-0.86), X Los Lagos 0.91 (0.35-1.46), XI Aysen 0.99 (0.0-2.98), XII Magallanes 3.54 (0.57-6.51), and XIII Metropolitana 1.10 (0.84-1.36). There were no significant correlations between hospitalization rates and latitude, except for region XII. UV radiation levels showed significant differences only for region XII. CONCLUSION: There is a moderate risk of MS in Chile. The southernmost region showed significantly higher incidence rates than those in the rest of the country (a cluster zone). We did not find any correlation between incidence rates and latitude or UV radiation.
Assuntos
Esclerose Múltipla/epidemiologia , Adulto , Chile/epidemiologia , Feminino , Hospitalização , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de RiscoRESUMO
BACKGROUND: The NIH Stroke Scale (NIHSS) is used to assess acute ischemic stroke severity and outcome. High NIHSS scores are usually associated with arterial occlusion but it is unknown what the effect of time to clinical evaluation (TTCE) in this association is. We tested the NIHSS scores as an instrument to determine vessel occlusion (VO) at different time points from symptom onset. METHODS: Patients were selected from our prospective stroke database if they had admission NIHSS scores and intracranial vessel neuroimaging studies. We dichotomized patients according to VO and TTCE. Receiver operating curves, c statistics, and odds ratios were calculated to study the validity of the NIHSS score. RESULTS: Among 463 patients (mean age 70.2 years, 53.1% male, median NIHSS 4, median TTCE 3.3 hours), 22.5% had arterial occlusion. Median NIHSS scores were higher in patients with VO, 10.5 (interquartile range 5-18) vs 3 (2-7), p<0.001, and in those with TTCE<6 hours, 15 (interquartile range 7-19) vs 4 (2-8) if ≥6 hours, p<0.001. Receiver operating characteristic curves showed that the validity of NIHSS in predicting VO was higher in patients with TTCE<6 hours, p=0.03. The best cutoff point in patients evaluated before 6 hours was an NIHSS of 7 (76.2% sensitivity, specificity 70.1%), while in patients evaluated after 6 hours the best cutoff point was 4 (sensitivity 65.4%, specificity 62.0%). CONCLUSIONS: Our study shows that the validity of NIHSS scores in predicting arterial occlusion is time-dependent, decreasing with increasing time from symptom onset to clinical evaluation.
Assuntos
Arteriopatias Oclusivas/diagnóstico , Arteriopatias Oclusivas/etiologia , Infarto Cerebral/complicações , Índice de Gravidade de Doença , Idoso , Idoso de 80 Anos ou mais , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Imagem de Difusão por Ressonância Magnética/métodos , Feminino , Humanos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , National Institutes of Health (U.S.) , Exame Neurológico , Valor Preditivo dos Testes , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Estatísticas não Paramétricas , Fatores de Tempo , Tomógrafos Computadorizados , Ultrassonografia Doppler Transcraniana , Estados UnidosRESUMO
We report 189 mobilizations and 489 collections of peripheral blood stem cells (PBSC) performed in 139 autologous transplantation patients and in 28 donors for allogeneic transplantations whose ages ranged from 2-68 years. We observed a correlation (P < .001; Pearson's coefficient 0.64) between CD34-positive cells and granulocyte-macrophage colony-forming units examined to estimate PBSC. In a subset of 287 collections (97 adults and 49 children) we obtained peripheral blood (PB) CD34-positive cell counts at 2 to 4 hours before leukapheresis. We noted a correlation between PB CD34-positive cell counts before leukapheresis and the number of CD34-positive cells per kilogram of body weight collected in the whole apheresis of the day (P < .001; Pearson's coefficient 0.82). An even better correlation was obtained between PB CD34-positive cells preapheresis and the yield of each individual blood volume (BV) processed (P < .001; Pearson's coefficient 0.87). Healthy donors and patients in each age group behaved similarly. In addition, the collection yield was greater among children than adults. These findings allowed us to develop a simple predictive model to estimate the BV to process for a target dose of CD34-positive cells per kilogram, based on the level of PBSC before apheresis in children and adults.