RESUMO
A glioblastoma is an aggressive form of a malignant glial-derived tumor with a poor prognosis despite multimodal therapy approaches. Lactate has a preponderant role in the tumor microenvironment, playing an immunoregulatory role as well as being a carbon source for tumor growth. Lactate homeostasis depends on the proper functioning of intracellular lactate regulation systems, such as transporters and enzymes involved in its synthesis and degradation, with evidence that an intracellular lactate overload generates metabolic stress on tumor cells and tumor cell death. We propose that the delivery of a lactate overload carried in nanoparticles, allowing the intracellular release of lactate, would compromise the survival of tumor cells. We synthesized and characterized silica and titania nanoparticles loaded with lactate to evaluate the cellular uptake, metabolic activity, pH modification, and cytotoxicity on C6 cells under normoxia and chemical hypoxia, and, finally, determined the survival of an orthotopic malignant glioma model after in situ administration. A dose-dependent reduction in metabolic activity of treated cells under normoxia was found, but not under hypoxia, independent of glucose concentration. Lactated-loaded silica nanoparticles were highly cytotoxic (58.1% of dead cells) and generated significant supernatant acidification. In vivo, lactate-loaded silica nanoparticles significantly increased the median survival time of malignant glioma-bearing rats (p = 0.005) when administered in situ. These findings indicate that lactate-loaded silica nanoparticles are cytotoxic on glioma cells in vitro and in vivo.
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The frequency of central nervous system infections due to herpesvirus have been studied in various populations; however, studies in Mexican mestizo patients are scant. This paper documents the frequency of herpesvirus encephalitis in Mexican mestizo patients from the National Institute of Neurology and Neurosurgery (NINN) of Mexico. To study the frequency of herpetic viral encephalitis at the NINN in the period from 2004 to 2009. We reviewed clinical records from patients with clinically suspected encephalitis; polymerase chain reaction assays were done for detection of herpesviruses in cerebrospinal fluid (CSF) samples. The total number of patients studied was 502; in 59 (12%), the diagnosis of herpetic encephalitis was confirmed by PCR-based testing of CSF. Of them, 21 (36%) were positive for herpes simplex virus type 1, 15 (25%) for Epstein-Barr virus, 10 (17%) for varicella zoster virus, 8 (14%) for cytomegalovirus, 3 (5%) for human herpesvirus 6, and 2 (3%) for herpes simplex virus 2. Our results show a varied frequency of viral encephalitis in mestizo patients due to herpesviruses in a tertiary neurological center and point out the importance of modern molecular technology to reach the etiological diagnosis in cases of encephalitis.
Assuntos
Infecções por Citomegalovirus/diagnóstico , Encefalite por Varicela Zoster/diagnóstico , Encefalite Viral/diagnóstico , Infecções por Vírus Epstein-Barr/diagnóstico , Herpes Genital/diagnóstico , Herpes Simples/diagnóstico , Infecções por Roseolovirus/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Citomegalovirus/genética , Citomegalovirus/patogenicidade , Infecções por Citomegalovirus/epidemiologia , Infecções por Citomegalovirus/etnologia , Infecções por Citomegalovirus/virologia , Encefalite por Varicela Zoster/epidemiologia , Encefalite por Varicela Zoster/etnologia , Encefalite por Varicela Zoster/virologia , Encefalite Viral/epidemiologia , Encefalite Viral/etnologia , Encefalite Viral/virologia , Infecções por Vírus Epstein-Barr/epidemiologia , Infecções por Vírus Epstein-Barr/etnologia , Infecções por Vírus Epstein-Barr/virologia , Etnicidade , Feminino , Herpes Genital/epidemiologia , Herpes Genital/etnologia , Herpes Genital/virologia , Herpes Simples/epidemiologia , Herpes Simples/etnologia , Herpes Simples/virologia , Herpesvirus Humano 1/genética , Herpesvirus Humano 1/patogenicidade , Herpesvirus Humano 2/genética , Herpesvirus Humano 2/patogenicidade , Herpesvirus Humano 3/genética , Herpesvirus Humano 3/patogenicidade , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/patogenicidade , Herpesvirus Humano 6/genética , Herpesvirus Humano 6/patogenicidade , Humanos , Incidência , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase/métodos , Estudos Retrospectivos , Infecções por Roseolovirus/epidemiologia , Infecções por Roseolovirus/etnologia , Infecções por Roseolovirus/virologiaRESUMO
OBJECTIVE: The aim of the study was to evaluate the impact of maintenance on performance of cryosurgical equipment used in El Salvador primary health clinics. MATERIALS AND METHODS: Nine gynecological cryotherapy devices used in El Salvador were bench tested against a new machine of the same make and model. The devices were run for five successive double-freeze cycles. The El Salvador machines then received maintenance by a specialized engineer and another double-freeze cycle was performed. Temperature at the device probe tip was recorded throughout each cycle and ballistic gelatin was used as the tissue analogue to measure freeze ball dimensions achieved by the devices. Outcome measures were mean lowest-sustained temperatures and freeze ball mean weight, depth, and diameter. Paired and unpaired t tests were used to compare results premaintenance versus postmaintenance and postmaintenance versus the reference, respectively. RESULTS: Premaintenance versus postmaintenance freeze ball dimensions were significantly different (mean differences in weight = 2.31 g, p = .01; depth = 2.29 mm, p = .03; diameter = 3.51 mm, p = .02). However, postmaintenance dimensions were not significantly different than those of the reference (weight = 7.44 g vs. 8.39 g, p = .07; depth = 10.71 vs. 11.24 mm, p = .1; diameter = 31.38 mm vs. 32.05 mm, p = .3). Postmaintenance, minimum, and lowest-sustained temperatures were within the recommended clinical range. CONCLUSIONS: Specialized maintenance was necessary for heavily used cryotherapy devices to perform adequately, highlighting the challenges of gas-based cryotherapy in low- and middle-income countries.
Assuntos
Crioterapia/instrumentação , Crioterapia/métodos , Lesões Pré-Cancerosas/terapia , Doenças do Colo do Útero/terapia , El Salvador , Feminino , Humanos , Manutenção , Qualidade da Assistência à SaúdeRESUMO
OBJECTIVE: To establish the feasibility and acceptability of home-based HPV self-sampling among women who did not attend screening appointments in rural El Salvador. METHODS: In a cross-sectional study, data were collected from May 2015 to January 2016 among 60 women aged 30-59 years who were not pregnant, provided informed consent, had not been screened in 2 years, had no history of pre-cancer treatment, and did not attend a scheduled HPV screening. Participants completed questionnaires and received educational information before being given an opportunity to self-sample with the Hybrid Capture 2 High Risk HPV DNA Test. RESULTS: Self-sampling was accepted by 41 (68%) participants. Almost all women chose to self-sample because the process was easy (40/41, 98%), could be performed at home (40/41, 98%), and saved time (38/41, 93%), and because they felt less embarrassed (33/41, 80%). The most common reason for declining the test was not wanting to be screened (8/19, 42%). The prevalence of high-risk HPV types among women who accepted self-sampling was 17% (7/41). CONCLUSION: For most women, community-based self-sampling was an acceptable way to participate in a cervical cancer screening program. In low-resource countries, incorporating community-based self-sampling into screening programs might improve coverage of high-risk women.
Assuntos
Detecção Precoce de Câncer/métodos , Papillomaviridae , Infecções por Papillomavirus/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Adulto , Serviços de Saúde Comunitária , Estudos Transversais , El Salvador , Estudos de Viabilidade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Infecções por Papillomavirus/virologia , Aceitação pelo Paciente de Cuidados de Saúde , Projetos Piloto , População Rural , Autocuidado , Inquéritos e QuestionáriosRESUMO
Objetivo: evaluar los cambios en la demanda de servicios en salud, luego de la actualización del plan de beneficios de Colombia, entre los años 2010 y 2012. Métodos: estudio tipo descriptivo y explicativo, donde se evalúa el uso de tecnologías sanitarias antes y después de la actualización del Plan Obligatorio de Salud. Se tomaron las dispensaciones de medicamentos entre el 2010 y el 2012 del Sistema de Información de Precios de Medicamentos. Para valorar los cambios se construyó una escala de valoración de cambios porcentuales. Resultados: se evidenciaron cambios en el comportamiento de la demanda de servicios. Como se esperaba, la actualización del Plan de Beneficios representa para los pacientes mayor acceso a las nuevas tecnologías, medido a través del mayor uso de tecnologías nuevas. Conclusión: la actualización del plan de beneficios mejoró el acceso de los pacientes a una gran parte de los servicios de salud.
Objective: Assessing the changes in the demand of health services after the update of the benefit plan in Colombia, during 2010 and 2012. Methods: Descriptive and Explanatory type study, where the use of healthcare technologies before and after the update of the Compulsory Health Plan is assessed. We took the drug dispensations between 2010 and 2012 from the Drug Price Information System. To assess the changes, we made an evaluation scale of percentage changes. Results: We found evidence of changes in the behavior of the demand of services. As expected, the update of the Benefits Plan represents greater access to new technologies, measured through a greater use of new technologies. Conclusion: The update of the Benefits Plan improved access for patients to a large part of the health services.
Objetivo: avaliar as mudancas na demanda de servicos em saúde, após atualizacao do plano de beneficios da Colombia, entre os anos 2010 e 2012. Métodos: estudo tipo descritivo e explicativo, onde avalia-se o uso de tecnologias sanitarias antes e depois da atualizacao do Plano Obrigatório de Saúde. Tomaram-se as dispensares de medicamentos entre o 2010 e 2012 do Sistema de Informacao de Precos de Medicamentos. Para avaliar as mudancas foi construída uma escala de valoracao de mudancas porcentuais. Resultados: evidenciaram-se mudancas no comportamento da demanda de servicos. Como esperado, a atualizacao do Plano de Beneficios representa para os pacientes maior acesso as novas tecnologias, medido a través do maior uso de tecnologia nova. Conclusao: a atualizacao do plano de beneficios melhorou o acesso dos pacientes a uma grande parte dos servicos de saúde.
RESUMO
Técnicas de laboratorio en el diagnóstico de las ETV [Enfermedades transmitidas por vectores].- Toma, preparación y embalaje de las muestras.- Morfología de los parásitos, causantes de las ETV.- Red de control de calidad registro y notificación