RESUMO

Bioavailability of nutrients, the scarcity of synthetic fertilisers, and the rising cost of fuel have all contributed to an increase in production costs, which has in turn reduced crop productivity and led scientists to seek out new methods to ensure high-quality output. In this context, various cytokinins dosages were tested in Peru to see whether they affected the quality of caigua, in an effort to address these issues. To mitigate these problems, a pot experiment was carried out to check the effects of various doses of cytokinin in the quality of caigua in Peru. The experiment consisted of 5 treatments including (0, 50, 100, 150 and 200 mL of cytokinin) by using (Anthesis Plus per 200 L of water) as a source, each with three replicates and placed following a randomized complete block design (RCBD). Treatment with 100 mL of cytokinins foliar analysis resulted in a caigua length of 18.9 cm, an increase in diameter of 5.65 cm, and an improvement in pulp thickness of 7.60 millimeters. Physiological parameters of caigua plants taken after 45 days of sowing were considerably improved with the same treatment. Similarly, N, K and Zn concentration in leaf was higher in case of 100 mL of cytokinins foliar analysis. Therefore, policymakers must advise using the recommended quantity of cytokinins to bring about regime transition, and formers can gain by injecting 100 mL of cytokinins to boost production and the economy. It was concluded that the adequate dose of cytokinins is in treatment T3, which raised value of potassium concentration in leaves, this influenced optimal development, strengthening against environmental stress and therefore quality. For this reason, research was carried out on the comparative study of cytokinin doses in the quality of caigua in Peru; the objective was to determine the appropriate dose to obtain higher quality fruit. Likewise, it was underlined that the objective was to employ an ecological alternative of plant origin such as the usage of phytohormone that stimulates the growth of the plant and consequently the quality of the fruit. The obtained the results were served as a recommendation for farmers in the area.

Assuntos

RESUMO

OBJECTIVES: The aims of this study were (1) to examine the differences in the mode of commuting and barriers to active commuting to university between the sexes (men and women) and in different countries (Chile and Spain); and (2) to analyse the association between the mode of commuting and the perceived barriers for male and female university students in Chile and Spain. STUDY DESIGN: This cross-sectional study took place between April 2017 and May 2018 in Chile and Spain. METHODS: The study population included 2269 university students (53.0% women). The mode of commuting and barriers to active commuting to university were assessed by a self-reported questionnaire. Multinomial logistic regression analysis was used to examine the associations. RESULTS: In both sexes, public and private transport were the main modes of commuting used in Chile and Spain, respectively, followed by active commuting in all participants, except for female students in Spain. Women perceived more environmental and psychosocial barriers compared to men (Chile: P < 0.001; Spain: P = 0.006). Perceived environmental barriers showed higher significant differences between students in Chile and Spain (P < 0.05). Private commuters reported a larger proportion of psychosocial barriers compared to active commuters (Chile: men P = 0.001, women P < 0.001; Spain: men P < 0.001, women P = 0.036). CONCLUSIONS: The study findings suggest that the mode of commuting and the barriers to active commuting to university may be influenced by sex and country.

Assuntos

RESUMO

Background: Recent data about clinical features, triggers and management of anaphylaxis in Latin America is lacking. Objective: To provide updated and extended data on anaphylaxis in this region. Method: An online questionnaire was used, with 67 allergy units involved from 12 Latin-American countries and Spain. Among data recorded, demographic information, clinical features, severity, triggering agents, and treatment were received. Results: Eight hundred and seventeen anaphylactic reactions were recorded. No difference in severity, regardless of pre-existing allergy or asthma history was found. Drug induced anaphylaxis (DIA) was most frequent (40.6%), followed by food induced anaphylaxis (FIA) (32.9%) and venom induced anaphylaxis (VIA) (12%). FIA and VIA were more common in children-adolescents. Non-steroidal anti-inflammatory drugs (NSAIDs) and beta-lactam antibiotics (BLA) were the most frequent drugs involved. Milk (61.1% of FIA) and egg (15.4% of FIA) in children, and shellfish (25.5% of FIA), fresh fruits (14.2% of FIA), and fish (11.3% of FIA) in adults were the most common FIA triggers. Fire ants were the most frequent insect triggers, and they induced more severe reactions than triggers of FIA and DIA (p < 0.0001). Epinephrine was used in 43.8% of anaphylaxis episodes. After Emergency Department treatment, epinephrine was prescribed to 13% of patients. Conclusions: Drugs (NSAIDs and BLA), foods (milk and egg in children and shellfish, fruits and fish in adults) and fire ants were the most common inducers of anaphylaxis. Epinephrine was used in less than half of the episodes emphasizing the urgent need to improve dissemination and implementation of anaphylaxis guidelines.

RESUMO

The aim of this systematic review and network meta-analysis (NMA) of randomized controlled trials was to evaluate the effectiveness of treatments for pain relief of burning mouth syndrome (BMS). Five databases and gray literature were searched. Independent reviewers selected studies, extracted data, and assessed the risk of bias. The primary outcome was pain relief or burning sensation, and the secondary outcomes were side effects, quality of life, salivary flow, and TNF-α and interleukin 6 levels. Four comparable interventions were grouped into different network geometries to ensure the transitivity assumption for pain: photobiomodulation therapy, alpha-lipoic acid, phytotherapics, and anxiolytics/antidepressants. Mean difference (MD) and 95% CI were calculated for continuous outcomes. The minimal important difference to consider a therapy beneficial against placebo was an MD of at least -1 for relief of pain. To interpret the results, the GRADE approach for NMA was used with a minimally contextualized framework and the magnitude of the effect. Forty-four trials were included (24 in the NMA). The anxiolytic (clonazepam) probably reduces the pain of BMS when compared with placebo (MD, -1.88; 95% CI, -2.61 to -1.16; moderate certainty). Photobiomodulation therapy (MD, -1.90; 95% CI, -3.58 to -0.21) and pregabalin (MD, -2.40; 95% CI, -3.49 to -1.32) achieved the minimal important difference of a beneficial effect with low or very low certainty. Among all tested treatments, only clonazepam is likely to reduce the pain of BMS when compared with placebo. The majority of the other treatments had low and very low certainty, mainly due to imprecision, indirectness, and intransitivity. More randomized controlled trials comparing treatments against placebo are encouraged to confirm the evidence and test possible alternative treatments (PROSPERO CRD42021255039).

Assuntos

RESUMO

Resumen La proteína precursora del β- Amiloide (β-APP) es una glicoproteína de membrana y un componente habitual de las neuronas. Tiene funciones en el crecimiento y la adhesión celular tras un traumatismo. Es transportada mediante transporte rápido axonal anterógrado y se acumula dentro de las neuronas cuando se daña citoesqueleto. Este proceso es activo, es decir consume energía. El β-APP no es específico de los traumatismos. Se acumula en cualquier circunstancia en la que se dañen los axones, tal como la hipoxia, alteraciones metabólicas, y cualquier otra causa de edema cerebral y aumento de la presión intracraneal que puedan conducir a un daño axonal difuso (DAI) En el presente estudio estudiamos la expresión de esta proteína en casos de traumatismo cráneo-encefálico con diferente evolución cronológica El daño del citoesqueleto producido por la proteólisis, junto con la alteración de las quinasas y las fosfatasas, aumentan la permeabilidad de la membrana, lo que provoca la entrada de calcio en la célula que, a su vez, activa la calmodulina que hace que los neurofilamentos se compacten, los microtúbulos desaparezcan y se rompa la espectrina. Esta disrupción del citoesqueleto tiene como consecuencia que las sustancias que se transportan a su través, se acumulen, sobre todo en las zonas afectadas por el DAI. Al final de todo este proceso, los axones se rompen, lo que se conoce como axotomía secundaria. El estudio de la acumulación del β-APP es útil para valorar la extensión del DAI y para determinar el tiempo de supervivencia tras el traumatismo o cualquier otro daño cerebral.

Abstract β-Amyloid Precursor Protein (β-APP) is a membrane glycoprotein and a common component of neurons. It is involved in adhesion and cell growth processes after traumatic events. It is carried by anterograde fast axonal transport, and it accumulates inside neurons when the cytoskeleton is damaged. This is a vital biochemical process that consumes energy. β-APP is not specific of traumatic events. It accumulates in any case of axonal damage, whatever its cause may be, like hypoxia, metabolic disorders, and any other circumstances that lead to brain swelling and intracranial pressure rising and in consequence to Diffuse Axonal Injury (DAI). In this study we review the expression of this protein in cases of traumatic brain injury with different chronological evolution. The damage of cytoskeleton due to proteolysis in addition to the disturbance of kinases and phosphatases increase the permeability of the membrane. Calcium gets into the cell and activates calmodulin, thus neurofilaments compact, microtubules disappear and spectrin breaks. This disruption of the cytoskeleton has as consequence that the transported substances accumulate in the most affected areas by DAI. At the end of this process axon breaks, which is known as secondary axotomy. The study of the accumulation of β-APP is useful to assess the extent of DAI and to determine the time elapsed after trauma or another insult to CNS.

Assuntos

RESUMO

El suicidio como problema de salud pública mundial muestra tasas fluctuantes con tendencia a elevarse. Las estrategias en salud pública encaminadas a la reducción del intento y del reintento suicida son la principal alternativa. Objetivo: establecer la incidencia de reintento suicida, oportunidad de atención y adherencia al seguimiento de pacientes atendidos por intento suicida en el servicio de urgencias de un hospital universitario privado. Métodos y participantes: estudio de tipo cohorte prospectiva descriptiva en pacientes ≥18 años con intento suicida de riesgo bajo asignados a tratamiento psiquiátrico ambulatorio y seguido mediante la aplicación WhatsApp durante un año después del egreso. Resultados: la prevalencia de intento suicida de los pacientes que consultaron al servicio de urgencias fue de 0,38%. De 164 pacientes con intento suicida 33 ingresaron al estudio. Tenían una mediana de edad de 23 RI (25-75): 19-33 años, el 87,8% (n: 29) fueron mujeres, 42,4% (n: 22) tenía escolaridad secundaria y 63,6% (n: 21) eran del estrato socioeconómico medio. La incidencia acumulada de reintento suicida fue del 36,3% (n: 12), más frecuente al primer mes. La atención por psiquiatría más temprana fue a las dos semanas del egreso. La adherencia al seguimiento fue del 45,4%. Conclusiones: la incidencia acumulada del reintento suicida fue elevada. La oportunidad de atención y la adherencia al seguimiento fueron bajas. A pesar de los diferentes métodos hasta ahora utilizados, el seguimiento de la conducta suicida sigue siendo difícil. Se necesitan investigaciones que exploren alternativas de intervención de tipo social y comunitario.

Suicide as a global public health issue shows fluctuating rates with a tendency to increase. Public health strategies aimed to reduce suicide attempt and retry are the main alternative. Objective: establish the incidence of suicidal retry, opportunity for care and adherence to treatment in the follow-up of patients treated for suicide attempt in the emergency room of a private University hospital. Methods and participants: a descriptive prospective cohort study in patients ≥18 years of age with a low-risk suicide attempt assigned to outpatient psychiatric treatment and followed up through WhatsApp application for one year after discharge. Results: the prevalence of suicide attempt in patients who consulted the emergency room was 0.38%. Of 164 patients with a suicide attempt, 33 were low risk. With a median age of 23 IR (25-75): 19-33 years, 87.8% (n: 29) were women, 42.4% (n: 22) with secondary school level and 63.6% (n: 21) with middle socioeconomic stratum. 24.2% (n: 8). The accumulate incidence of retry was 36,3% (n: 12), more frequently in the first month. The earlier attention by psychiatry was after two weeks of discharge. The follow-up adherence was of 45,4%. Conclusions: the accumulated incidence for retry was high. The opportunity for outpatient psychiatric care and adherence to follow up were low. Despite the different methods used until now, monitoring suicidal behavior remains difficult. It is necessary research that explore alternatives for community and social intervention.

Assuntos

RESUMO

INTRODUCTION: Major orthopedic surgery such as total hip arthroplasty (THA) is associated with an increased risk of postoperative complications. Candidates for THA are often older adults, with comorbidities that increase the risk of major bleeding, the IMPROVE scale has independent actors on the risk of bleeding according to the characteristics of the patients at hospital admission. It foresees the possibility of hemorrhage and the need for blood transfusion, being support in decision-making in the planning of a safe THA with the provision of the necessary resources. OBJECTIVE: To evaluate the sensitivity, validity and reliability of the modified IMPROVE scale in patients undergoing primary total hip arthroplasty. MATERIAL AND METHODS: Study of processes with a sample of 131 patients undergoing primary THA, in the period from January 01, 2018 to July 01, 2018. RESULTS: The scale presents good reliability, as for the performance of the scale, a good sensitivity was obtained, classifying 96.9% of the patients correctly; which is suitable for the type of scale. CONCLUSIONS: The modified IMPROVE scale is a discretely adequate and useful tool for the prognosis of bleeding risk in patients who undergo THA, compared with other assessment scales developed in other geographical areas. It is recommended to continue with the study of risk factors for major bleeding in this specific population.

INTRODUCCIÓN: La cirugía ortopédica mayor, como la artroplastía total de cadera (ATC), se asocia con mayor riesgo de complicaciones postoperatorias. Los candidatos a ATC con frecuencia son adultos mayores, con comorbilidades que aumentan el riesgo de hemorragia mayor. La escala IMPROVE tiene factores independientes sobre el riesgo de sangrado según las características de los pacientes al ingreso hospitalario, prevé la posibilidad de hemorragia y la necesidad de transfusión sanguínea, siendo apoyo en la toma de decisiones en la planeación de ATC seguras con la probabilidad de prever los recursos necesarios. OBJETIVO: Evaluar la sensibilidad, validez y confiabilidad de la escala IMPROVE modificada en los pacientes sometidos a artroplastía total de cadera primaria. MATERIAL Y MÉTODOS: Estudio de procesos con una muestra de 131 pacientes sometidos a ATC primaria, en el período del 01 de Enero al 01 de Julio de 2018. RESULTADOS: La escala presenta una buena confiabilidad, en cuanto al rendimiento se obtuvo una buena sensibilidad, clasificando al 96.9% de los pacientes correctamente, lo cual es adecuado para el tipo de escala. CONCLUSIONES: La escala IMPROVE modificada es una herramienta discretamente adecuada y útil para el pronóstico del riesgo hemorrágico en pacientes que se someten a una ATC primaria comparada con otras escalas de valoración desarrolladas en otras zonas geográficas. Se recomienda seguir con el estudio de los factores de riesgo de sangrado mayor en esta población en específico.

Assuntos

RESUMO

BACKGROUND: The Seguro Popular (SP) was launched in 2004 to increase access to healthcare and reduce catastrophic expenditures among the Mexican population. To document the evidence on its effectiveness, we conducted a systematic review of impact evaluations of the SP. METHODS: We included papers using rigorous quasi-experimental designs to assess the effectiveness of the SP. We evaluated the quality of each study and presented the statistical significance of the effects by outcome category. RESULTS: We identified 26 papers that met the inclusion criteria. Sixteen studies that evaluated the impact of SP on financial protection found consistent and statistically significant positive effects in 55% of the 65 outcomes analyzed. Nine studies evaluating utilization of health services for the general and infant populations found effectiveness on 40% of 30 outcomes analyzed. Concerning screening services for hypertension, diabetes, and cervical and prostate cancer, we found three studies evaluating 14 outcomes and finding significant effects on 50% of them. Studies looking at the impact of SP on diabetes, hypertension, and general health care and treatment evaluated 19 outcomes and found effects on 21% of them. One study assessed five diabetes monitoring services and found positive effects on four of them. The only study on morbidity and mortality found positive results on three of the four outcomes of interest. CONCLUSION: We found mixed evidence on the impact of SP on financial protection, healthcare utilization, morbidity and mortality. In the 26 studies included in this review, researchers found positive effects in roughly half of the outcomes and null results on the rest.

Assuntos

RESUMO

Resumen: Introducción: La cirugía ortopédica mayor, como la artroplastía total de cadera (ATC), se asocia con mayor riesgo de complicaciones postoperatorias. Los candidatos a ATC con frecuencia son adultos mayores, con comorbilidades que aumentan el riesgo de hemorragia mayor. La escala IMPROVE tiene factores independientes sobre el riesgo de sangrado según las características de los pacientes al ingreso hospitalario, prevé la posibilidad de hemorragia y la necesidad de transfusión sanguínea, siendo apoyo en la toma de decisiones en la planeación de ATC seguras con la probabilidad de prever los recursos necesarios. Objetivo: Evaluar la sensibilidad, validez y confiabilidad de la escala IMPROVE modificada en los pacientes sometidos a artroplastía total de cadera primaria. Material y métodos: Estudio de procesos con una muestra de 131 pacientes sometidos a ATC primaria, en el período del 01 de Enero al 01 de Julio de 2018. Resultados: La escala presenta una buena confiabilidad, en cuanto al rendimiento se obtuvo una buena sensibilidad, clasificando al 96.9% de los pacientes correctamente, lo cual es adecuado para el tipo de escala. Conclusiones: La escala IMPROVE modificada es una herramienta discretamente adecuada y útil para el pronóstico del riesgo hemorrágico en pacientes que se someten a una ATC primaria comparada con otras escalas de valoración desarrolladas en otras zonas geográficas. Se recomienda seguir con el estudio de los factores de riesgo de sangrado mayor en esta población en específico.

Abstract: Introduction: Major orthopedic surgery such as total hip arthroplasty (THA) is associated with an increased risk of postoperative complications. Candidates for THA are often older adults, with comorbidities that increase the risk of major bleeding, the IMPROVE scale has independent actors on the risk of bleeding according to the characteristics of the patients at hospital admission. It foresees the possibility of hemorrhage and the need for blood transfusion, being support in decision-making in the planning of a safe THA with the provision of the necessary resources. Objective: To evaluate the sensitivity, validity and reliability of the modified IMPROVE scale in patients undergoing primary total hip arthroplasty. Material and methods: Study of processes with a sample of 131 patients undergoing primary THA, in the period from January 01, 2018 to July 01, 2018. Results: The scale presents good reliability, as for the performance of the scale, a good sensitivity was obtained, classifying 96.9% of the patients correctly; which is suitable for the type of scale. Conclusions: The modified IMPROVE scale is a discretely adequate and useful tool for the prognosis of bleeding risk in patients who undergo THA, compared with other assessment scales developed in other geographical areas. It is recommended to continue with the study of risk factors for major bleeding in this specific population.