RESUMO
Periapical lesions are common pathologies affecting the alveolar bone, often initiated by intraradicular lesions resulting from microbial exposure to dental pulp. These microorganisms trigger inflammatory and immune responses. When endodontic treatment fails to eliminate the infection, periapical lesions persist, leading to bone loss. The RANK/RANKL/OPG pathway plays a crucial role in both the formation and the destruction of the bone. In this study, the objective was to inhibit the RANK/RANKL pathway in vitro within exposed Thp-1 macrophages to endodontic microorganisms, specifically Enterococcus faecalis, which was isolated from root canals of 20 patients with endodontic secondary/persistent infection, symptomatic and asymptomatic, and utilizing an α-IRAK-4 inhibitor, we introduced endodontic microorganisms and/or lipoteichoic acid from Streptococcus spp. to cellular cultures in a culture plate, containing thp-1 cells and/or PBMC from patients with apical periodontitis. Subsequently, we assessed the percentages of RANK+, RANKL+, and OPG+ cells through flow cytometry and measured the levels of several inflammatory cytokines (IL-1ß, TNF-α, IL-6, IL-8, IL-10, and IL-12p70) in the cellular culture supernatant through a CBA kit and performed analysis by flow cytometry. A significant difference was observed in the percentages of RANK+RANKL+, OPG+ RANKL+ cells in thp-1 cells and PBMCs from patients with apical periodontitis. The findings revealed significant differences in the percentages of the evaluated cells, highlighting the novel role of the IRAK-4 inhibitor in addressing this oral pathology, apical periodontitis, where bone destruction is observed.
Assuntos
Macrófagos , Periodontite Periapical , Ligante RANK , Receptor Ativador de Fator Nuclear kappa-B , Transdução de Sinais , Humanos , Ligante RANK/metabolismo , Macrófagos/metabolismo , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Células THP-1 , Receptor Ativador de Fator Nuclear kappa-B/metabolismo , Periodontite Periapical/metabolismo , Periodontite Periapical/microbiologia , Periodontite Periapical/patologia , Citocinas/metabolismo , Enterococcus faecalis , Lipopolissacarídeos , Cavidade Pulpar/microbiologia , Cavidade Pulpar/metabolismo , Masculino , Osteoprotegerina/metabolismo , Adulto , Ácidos Teicoicos/farmacologiaRESUMO
RESUMEN El eritema fijo pigmentado es una toxicodermia que puede afectar la piel o las mucosas. Tiende a recurrir en las mismas localizaciones tras la administración repetida del agente desencadenante. Los principales grupos farmacológicos asociados han sidoanalgésicos, antiepilépticos y AINES. Clínicamente, hayaparición de placaseritemato-edematosas redondas u ovaladas, definidas. Existen diferentes variantes;la generalizada es una de las menos frecuentes. Se reporta el caso de un paciente de mediana edad, quien presentó un cuadro deeritema fijo pigmentadogeneralizado, asociado al uso de ARA II. Es el primer caso reportado de esta patología secundaria al uso de dicho grupo farmacológico.
SUMMARY Pigmented fixed erythema is a toxicoderma, it can affect the skin or mucous membranes. It tends to recur in the same locations after repeated administration of the triggering agent.1 The main associated pharmacological groups have been: analgesics, antiepileptics and NSAIDs. Clinically, there is the appearance of defined round or oval erythematous-edematous plaques. There are different variants, the generalized is one of the least frequent. The case of a middle-aged patient is reported, who presented a generalized fixed pigmented erythema, associated with ARBS, it is the first reported case of this pathology secondary to the use of said pharmacological group.
RESUMO
Protected areas are of paramount relevance to conserving wildlife and ecosystem contributions to people. Yet, their conservation success is increasingly threatened by human activities including habitat loss, climate change, pollution, and species overexploitation. Thus, understanding the underlying and proximate drivers of anthropogenic threats is urgently needed to improve protected areas' effectiveness, especially in the biodiversity-rich tropics. We addressed this issue by analyzing expert-provided data on long-term biodiversity change (last three decades) over 14 biosphere reserves from the Mesoamerican Biodiversity Hotspot. Using multivariate analyses and structural equation modeling, we tested the influence of major socioeconomic drivers (demographic, economic, and political factors), spatial indicators of human activities (agriculture expansion and road extension), and forest landscape modifications (forest loss and isolation) as drivers of biodiversity change. We uncovered a significant proliferation of disturbance-tolerant guilds and the loss or decline of disturbance-sensitive guilds within reserves causing a "winner and loser" species replacement over time. Guild change was directly related to forest spatial changes promoted by the expansion of agriculture and roads within reserves. High human population density and low nonfarming occupation were identified as the main underlying drivers of biodiversity change. Our findings suggest that to mitigate anthropogenic threats to biodiversity within biosphere reserves, fostering human population well-being via sustainable, nonfarming livelihood opportunities around reserves is imperative.
Assuntos
Biodiversidade , Ecossistema , Humanos , Animais , Agricultura , Animais Selvagens , Mudança ClimáticaRESUMO
Oral protein delivery holds significant promise as an effective therapeutic strategy for treating a wide range of diseases. However, effective absorption of proteins faces challenges due to biological barriers such as harsh conditions of the stomach and the low permeability of mucous membranes. To address these challenges, this article presents a novel nano-in-nano platform designed for enteric protein delivery. This platform, obtained by electrospinning, involves a coaxial arrangement comprising poly(N-vinylcaprolactam) nanogels (NGs) enclosed within nanofibers of Eudragit® L100-55 (EU), a pH-responsive polymer. The pH-selective solubility of EU ensures the protection of NGs during their passage through the stomach, where the fibers remain intact at low pH, and releases them in the intestine where EU dissolves. The switchable characteristic of this nano-in-nano platform is confirmed by using NGs loaded with a model protein (ovalbumin), which is selectively released when the intestinal pH is achieved. The versatility of this nano-in-nano delivery platform is demonstrated by the ability to modify the fibers dissolution profile simply by adjusting the concentration of EU used in the electrospinning process. Furthermore, by tuning the properties of NGs, the potential applications of this platform can be further extended, paving the way for diverse therapeutic possibilities.
Assuntos
Caprolactama/análogos & derivados , Sistemas de Liberação de Fármacos por Nanopartículas , Polímeros , Ácidos Polimetacrílicos , Nanogéis , Ácidos Polimetacrílicos/química , Concentração de Íons de HidrogênioRESUMO
We sought to evaluate the effect of endodontic-causative microorganisms of primary infections on mononuclear cells such as CD14+, CD4+, CD8+, CD19+ and Tregs Foxp3+. Facultative anaerobic microorganisms were isolated from radicular conducts and peripheral blood samples, which were taken from patients with primary infections. Cellular cultures were performed with peripheral blood mononuclear cells (PBMC) with and without Actinomyces spp. and Streptococcus spp. during 48, 72, and 96 h of contact in culture (concentration 5 × 105 cells/well) in a round plate bound with 48 wells. Later, PBMC was collected for analysis by flow cytometry, with the monoclonal antibodies αCD14, αCD4, αCD8, αCD19 and αFoxp3, and acquired using an FACSCanto II cytometer. The supernatant of cellular cultures was analyzed for the quantification of inflammatory cytokines. Data analysis was performed in FlowJo v10.8.2 and FCAPArray software, and statistical analysis was performed using GraphPad v5.0. software. We observed an increase in the percentage of CD14+ cells in patients at different hours of cellular culture in the presence of both Actinomyces spp. and Streptococcus spp. microorganisms, compared to healthy controls. This study demonstrates the role played by the innate immune system in the pathogeny of endodontic primary infections, explaining the effects that generate the more common microorganisms in this oral pathology.
Assuntos
Leucócitos Mononucleares , Monócitos , Humanos , Actinomyces , Citocinas/metabolismo , Interleucina-12/metabolismo , Interleucina-8/metabolismo , Leucócitos Mononucleares/metabolismo , Monócitos/metabolismo , Streptococcus/metabolismoRESUMO
Abstract Avoidant or Restrictive Food Intake Disorder (ARFID) is an eating disorder (ED) not common in adults. In this article we present a clinical case of ARFID in a 37-year-old male patient treated in an ED center in Medellin, Colombia; displaying anxious symptoms that began a year earlier and concomitant weight loss, following a traumatic event causing an overall impairment with that patient. Several medical evaluations/examinations looking for organic causes, were excluded. Interventions were implemented by a psychiatry, a psychotherapist using cognitive-behavior therapy (CBT), and a nutritionist, all in face-to-face modality, which were carried out weekly for the first three months, then biweekly and subsequently quarterly. each lasting approximately 40-60 minutes. After the set of pharmacological interventions and psychotherapy, a great improvement in the functionality of the patient was observed. Improvement was found with respect to eating in public, food variation and panic attacks. In the absence of guidelines, it is important to use standardized and replicable treatments in this population.
Resumen El trastorno evitativo restrictivo de la ingesta (TERIA) es un trastorno alimentario (TCA) raro en adultos. Se presenta el caso de un hombre de 37 años con TERIA y trastorno de pánico atendido en un centro para TCA en Medellín, Colombia, quien presentó un año de síntomas ansiosos y pérdida de peso después de evento traumático, generando disfuncionalidad. Fue evaluada y excluida organicidad. Se realizaron intervenciones por parte de psiquiatría, psicoterapia con enfoque cognitivo conductual y nutrición, todas en modalidad presencial, las cuales se realizaron semanalmente los primeros tres meses, luego quincenalmente y posteriormente trimestralmente. Cada una con una duración de 40-60 minutos aproximadamente por sesión. Posterior al conjunto de intervenciones farmacológicas y psicoterapia, se observó una gran mejoría la funcionalidad del paciente, se encontró mejoría con respecto a comer en público, variación en los alimentos y ataques de panico. Ante la ausencia de guías de manejo de TERIA en adultos es relevante realizar tratamientos estandarizados que puedan ser replicados.
RESUMO
Abstract Osteomyelitis is defined as the inflammation of the either medullary, cortical, or cancellous bone, including nerves and blood vessels, causing necrosis and bone sequestrum formation; this condition has become a rare pathology, and odontogenic infections are considered the most frequent causal factor. This case shows a patient with bi-maxillary osteomyelitis caused by Actinomyces spp, which was worsened for severe COVID-19 infection. Patient was submitted at surgery as, amplified total bilateral maxillectomy through the surgical technique Weber-Fergusson, and prolonged use of combination of antibiotics, achieved a good recovery. Two years later follow- up, the patient no show imaging or clinical evidence of the infection of osteomyelitis. The present case shows an interesting relationship between a rare infection and its association with COVID-19.
Resumen La osteomielitis se define como la inflamación del hueso medular, cortical o esponjoso, incluyendo nervios y vasos sanguíneos, causando necrosis y formación de secuestro óseo; esta condición es una patología rara, y las infecciones odontogénicas son consideradas como el factor causal más frecuente. En este caso, se muestra un paciente con osteomielitis bi-maxilar causada por Actinomyces spp, la cual empeoró por la infección de COVID-19 severo. El paciente fue sometido a una cirugía, maxilectomía bilateral total amplificada, a través de la técnica quirúrgica de Weber- Fergusson, y el uso prolongado de una combinación de antibióticos, logrando una buena recuperación. A los 2 años de seguimiento, el paciente no mostró evidencia clínica o imagenológica de la infección de osteomielitis. El presente caso muestra una interesante relación entre una infección rara y su asociación con COVID-19.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Osteomielite/diagnóstico por imagem , Actinomicose/tratamento farmacológico , Cirurgia Bucal , COVID-19RESUMO
The global increase in solid waste pollution due to economic growth and population growth has led to severe ecological deterioration. This situation is exacerbated by the ongoing coronavirus disease (COVID-19) pandemic, which has significantly impacted consumer behavior and consumption habits. Proper management of solid waste has thus become critical in mitigating environmental degradation. In this study, we aim to examine the relationship between the outbreak of COVID-19, environmental attitudes (EATT), social norms (SN), environmental knowledge (EK), technological innovation (TI), and solid waste management (SWM) in Ecuadorian households during the pandemic. We collected data from 426 households in Ecuador using an online questionnaire and analyzed it using the Partial Least Squares Structural Equation Model method to test the hypotheses. Likewise, we validated the measurement and structural model. The results are novel about SWM, considering a developing country severely affected during the pandemic. Our findings suggest that COVID-19 has a negative impact on SWM, while EATT, SN, and TI have a positive influence on SWM. However, we found that EK does not significantly affect SWM.
Assuntos
COVID-19 , Gerenciamento de Resíduos , Humanos , Resíduos Sólidos , COVID-19/epidemiologia , Gerenciamento de Resíduos/métodos , Inquéritos e Questionários , PandemiasRESUMO
La situación de Multiempleo (ME) en Argentina, entendido como la combinación de la práctica clínica en una o más instituciones con la realización de otras actividades, es reconocida por diversos autores(MTEySS, 2021, OPS, 2013) y se ve favorecida por las características de un sistema de salud descentralizado y de tipología mixta.La pandemia COVID-19 incrementó la carga de trabajo y expuso la situación delME en los profesionales de salud. Para ahondar en su caracterización, se propuso un estudio en el ámbito de la PBA, que combinó diversas técnicas metodológicas. El presente trabajo incluye los resultados obtenidos en la fase cualitativa del estudio, que tuvo lugar en 2021.
The multi-employment (ME) situation in Argentina, understood as the clinical practice in one or more institutions combined with other activities, is recognized by various authors (MTEySS, 2021, OPS, 2013) and it is facilitated by the characteristics of a decentralized and mixed healthcare system. The COVID-19 pandemic increased workload and revealed the ME situation health professionals undergo. To delve deeper into this scenario, a study was conducted in the Buenos Aires province that combined different methodological techniques. This article includes the results obtained during the qualitative phase of the study, which took place in 2021.
Assuntos
Argentina , Condições de Trabalho , Mão de Obra em SaúdeRESUMO
Multiempleo (ME) y pluriempleo describen profesionales que combinan la práctica clínica con otras actividades, relacionadas o no con la atención de la salud. Entre los motivos que refieren para elegirlo se destacan la necesidad de aumentar los ingresos, la estabilidad y seguridad laboral, la búsqueda de prestigio, aprendizaje y diversificación de tareas. También influyen género, profesión o tipo de trabajo. La extensa jornada laboral resultante, el tiempo de traslado entre trabajos y las responsabilidades familiares dificultan la práctica e incrementan el cansancio de los profesionales.
Multi-employment (ME) and multiple employment describe professionals who combine clinical practice with other activities, whether related to healthcare or not. Among the reasons cited for this election are the need to increase income, job stability and security, the pursuit of prestige, learning, and diversification of tasks. Gender, profession, or type of job also influence this choice. The resulting extended workday, the time spent commuting between jobs, and family responsibilities hinder the practice and contribute to the professionals' fatigue