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Severe acute respiratory syndrome coronavirus 2 has caused a global pandemic, leading to health, economic, and political crisis. The virus triggers the activation of inflammatory reactants including interleukin-6 (IL-6), ferritin, and C-reactive protein (CRP), causing multiorgan damage, particularly affecting the lungs. Tocilizumab, an IL-6 receptor blocker, has the potential to diminish the progression of the disease and reduce organ damage and long-term complications. The aim of this observational retrospective cohort study was to evaluate the efficacy of tocilizumab in decreasing CRP levels in hospitalized coronavirus disease 2019 (COVID-19) patients compared to standard care without the drug. The study included 141 patients during their Hospital Stay (HS), with 100 in the Tocilizumab group and 41 in the non-Tocilizumab group. Clinical information was collected from the electronic clinical record, analyzed using statistical software, and homogenized the CRP levels from the severe group to the levels of the less complicated group at 48 h of hospitalization. The results showed a statistically significant greater decrease in CRP levels in the Tocilizumab group at 48 h after the use of the treatment, with no differences in mortality or length of stay between the groups. In conclusion, tocilizumab accelerates the diminishing of CRP levels compared to standard treatment alone, and its use may have potential benefits in the management of severe COVID-19 patients when used alongside with follow-up quantification of CRP levels reduction.IMPORTANCESevere acute respiratory syndrome coronavirus 2 has caused a global pandemic, leading to health, economic, and political crises. International guidelines for managing coronavirus disease 2019 (COVID-19) give recommendations according to the severity of the disease and the level of oxygen therapy needed. Tocilizumab is an option for the therapeutic management of hospitalized patients with any level of oxygen therapy; IL-6 serum level is the parameter for the follow-up on the efficacy, but it is not available at many hospitals. In this study, we demonstrate that C-reactive protein determination can predict the response to tocilizumab in severe COVID-19, the target patients for treatment with this drug. The use of this affordable and extensively available biomarker supports clinical decisions for the early escalation of the therapy and for the rational use of this drug on those prone to improve with the use of it.
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Anticorpos Monoclonais Humanizados , Proteína C-Reativa , Tratamento Farmacológico da COVID-19 , COVID-19 , Hospitalização , SARS-CoV-2 , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anticorpos Monoclonais Humanizados/uso terapêutico , Proteína C-Reativa/análise , Proteína C-Reativa/metabolismo , COVID-19/mortalidade , COVID-19/sangue , Interleucina-6/sangue , Estudos Retrospectivos , SARS-CoV-2/efeitos dos fármacosRESUMO
Bladder cancer (BC) is the most common cancer of the urinary tract. Bozepinib (BZP), a purine-derived molecule, is a potential compound for the treatment of cancer. Purinergic signaling consists of the activity of nucleosides and nucleotides present in the extracellular environment, modulating a variety of biological actions. In cancer, this signaling is mainly controlled by the enzymatic cascade involving the NTPDase/E-NPP family and ecto-5'-nucleotidase/CD73, which hydrolyze extracellular adenosine triphosphate (ATP) to adenosine (ADO). The aim of this work is to evaluate the activity of BZP in the purinergic system in BC cell lines and to compare its in vitro antitumor activity with cisplatin, a chemotherapeutic drug widely used in the treatment of BC. In this study, two different BC cell lines, grade 1 RT4 and the more aggressive grade 3 T24, were used along with a human fibroblast cell line MRC-5, a cell used to predict the selectivity index (SI). BZP shows strong antitumor activity, with notable IC50 values (8.7 ± 0.9 µM for RT4; 6.7 ± 0.7 µM for T24), far from the SI for cisplatin (SI for BZP: 19.7 and 25.7 for RT4 and T24, respectively; SI for cisplatin: 1.7 for T24). BZP arrests T24 cells in the G2/M phase of the cell cycle, inducing early apoptosis. Moreover, BZP increases ATP and ADP hydrolysis and gene/protein expression of the NPP1 enzyme in the T24 cell line. In conclusion, BZP shows superior activity compared to cisplatin against BC cell lines in vitro.
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Bacteremia by non-O1/non-O139 Vibrio cholerae is a rare entity associated with high mortality rates. We report a case of non-O1/non-O139 V. cholerae bacteremia confirmed by polymerase chain reaction and agglutination tests. The clinicoepidemiological characteristics and therapeutic options for this infection are also described.
La bacteriemia por V. cholerae no-O1/no-O139 es una entidad poco frecuente que se asocia con altas tasas de mortalidad. Reportamos un caso de bacteriemia por V. cholerae no-O1/no-O139 confirmado por reacción en cadena de la polimerasa (PCR) y test de aglutinación. Se describen además las características clínico-epidemiológicas y opciones terapéuticas para esta infección.
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Bacteriemia , Vibrio cholerae não O1 , Humanos , Vibrio cholerae não O1/genética , Bacteriemia/diagnóstico , Reação em Cadeia da PolimeraseRESUMO
Bacteremia by non-O1/non-O139 Vibrio cholerae is a rare entity associated with high mortality rates. We report a case of non-O1/non-O139 V. cholerae bacteremia confirmed by polymerase chain reaction and agglutination tests. The clinicoepidemiological characteristics and therapeutic options for this infection are also described.
La bacteriemia por Vibrio cholerae no-O1/no-O139 es una entidad poco frecuente que se asocia con altas tasas de mortalidad. Se reporta un caso de bacteriemia por V. cholerae no-O1/no-O139 confirmado por reacción en cadena de la polimerasa y test de aglutinación. Se describen las características clinicoepidemiológicas y las opciones terapéuticas para esta infección.
Assuntos
Bacteriemia , Vibrio cholerae não O1 , Fatores de VirulênciaRESUMO
A novel co-encapsulation system called bicosomes (bicelles within liposomes) has been developed to overcome the limitations associated with the topical application of curcumin (cur) and α-tocopherol (α-toc). The physicochemical properties and biological activity in vitro of bicosome systems were evaluated. Bicelles were prepared with DPPC, DHPC, cur, and α-toc (cur/α-toc-bicelles). Liposomal vesicles loading cur/α-toc-bicelles were prepared with Lipoid P-100 and cholesterol-forming cur/α-toc-bicosomes. Three cur/α-toc-bicosomes were evaluated using different total lipid percentages (12, 16, and 20% w/v). The results indicated that formulations manage to solubilize cur and α-toc in homogeneous bicelles < 20 nm, while the bicosomes reaches 303-420 nm depending on the total lipid percentage in the systems. Bicosomes demonstrated high-encapsulation efficiency (EE) for cur (56-77%) and α-toc (51-65%). The loading capacity (LC) for both antioxidant compounds was 52-67%. In addition, cur/α-toc-bicosomes decreased the lipid oxidation by 52% and increased the antioxidant activity by 60% compared to unloaded bicosomes. The cell viability of these cur/α-toc-bicosomes was >85% in fibroblasts (3T3L1/CL-173™) and ≥65% in keratinocytes (Ha-CaT) and proved to be hematologically compatible. The cur/α-toc-bicelles and cur/α-toc-bicosomes inhibited the growth of C. albicans in a range between 33 and 76%. Our results propose bicosome systems as a novel carrier able to co-encapsulate, solubilize, protect, and improve the delivery performance of antioxidant molecules. The relevance of these findings is based on the synergistic antioxidant effect of its components, its biocompatibility, and its efficacy for dermal tissue treatment damaged by oxidative stress or by the presence of C. albicans. However, further studies are needed to assess the efficacy and safety of cur/α-toc bicosomes in vitro and in vivo.
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RESUMEN La enseñanza médica en Cuba constituye el escenario ideal para la formación de las competencias que garantizan la generación y socialización de resultados investigativos contextualizados a los desafíos actuales. Durante el año 2021, se realizó un estudio descriptivo con enfoque socioformativo en la Universidad de Ciencias Médicas de Camagüey, con el propósito de develar las potencialidades de la disciplina Bases Biológicas de la Medicina (BBM) para la formación de la competencia comunicación científica. A partir del mismo se determinan las causas, carencias teóricas y prácticas que repercuten en la formación de dicha competencia desde la formación inicial en el estudiante de Medicina y su incidencia en la práctica educativa. Fueron identificadas las potencialidades de esta disciplina y su implicación en la formación de una cultura para obtener, elaborar y comunicar los resultados de la actividad investigativa como elementos básicos para la socialización científica. El trabajo metodológico del colectivo de año, enfocado en las potencialidades identificadas desde un enfoque socioformativo posibilita formar y desarrollar la competencia objeto de estudio, orientada hacia la socialización de los resultados de la actividad investigativa que realiza el estudiante durante la educación en el trabajo y actividades extensionistas.
ABSTRACT Medical education in Cuba is the ideal setting for the formation of competencies that guarantee the generation and socialization of research results contextualized to current challenges. During the year 2021, a descriptive study with a socio-formative approach was carried out at the University of Medical Sciences of Camagüey, with the purpose of revealing the potentialities of the discipline Biological Bases of Medicine (BBM) for the formation of scientific communication competence. From it, the causes, theoretical and practical deficiencies that have an impact on the formation of this competence from the initial training in the medical student and its impact on educational practice are determined. The potentialities of this discipline and its involvement in the formation of a culture to obtain, elaborate and communicate the results of the research activity as basic elements for scientific socialization were identified. The methodological work of the year group, focused on the potentialities identified from a socio-formative approach, makes it possible to train and develop the competence under study, oriented towards the socialization of the results of the research activity carried out by the student during education at work and extension activities.
RESUMO A educação médica em Cuba é o cenário ideal para a formação de competências que garantam a geração e a socialização dos resultados da pesquisa contextualizados aos desafios atuais. Durante o ano de 2021, foi realizado um estudo descritivo com abordagem socioamotiva na Universidade de Ciências Médicas de Camagüey, como objetivo de revelar as potencialidades da disciplina Bases Biológicas da Medicina (BBM) para a formação de competência de comunicação científica. A partir de la, são determinadas as causas, deficiências teóricas e práticas que impactam na formação dessa competência a partir da formação inicial do estudante de medicina e seu impacto naprática educacional. Foram identificadas as potencialidades dessa disciplina e seu envolvimento na formação de uma cultura para a obtenção, elaboração e comunicação dos resultados da atividade de pesquisa como elementos básicos para a socialização científica. O grupo metodológico do ano, focado nas potencialidades identificadas a partir de uma abordagem socioamsenária, possibilita a formação e desenvolvimento da competência em estudo, orientada para a socialização dos resultados da atividade de pesquisa realizada pelo aluno durante as atividades de ensino no trabalho e extensão.
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RESUMEN Introducción: el programa de Control Sanitario Internacional implementado en Cuba permite el control y seguimiento, en todo el país, de las enfermedades endémicas y transmisibles por vectores, procedentes de otros países. Esto se realiza de forma manual, por teléfono y con el intercambio de documentos. Por ello, se decidió elaborar una herramienta informática que satisfaga las necesidades, en el Departamento de Higiene y Epidemiología del Policlínico. Objetivo: desarrollar el prototipo de una aplicación informática para el control sanitario internacional en el Departamento de Higiene y Epidemiología del Policlínico Universitario "Pedro Borrás Astorga". Métodos: la investigación obedece a un proyecto de innovación tecnológica para definir la arquitectura de la información que se gestiona durante el control sanitario internacional. Se ejecutaron las etapas de análisis y diseño de la aplicación, con el empleo de la metodología ágil para el desarrollo de software. Además, se han aplicado métodos teóricos y empíricos como el histórico-lógico, el analítico-sintético, el inductivo-deductivo, las entrevistas y el análisis documental. Resultados: se describen los primeros resultados de la investigación, a partir del estudio de las necesidades y las carencias actuales del personal del Departamento de Higiene y Epidemiología. Se desarrolló la arquitectura de la información que se gestiona para lograr el control sanitario internacional. Conclusiones: el prototipo obtenido, permitirá a los futuros programadores implementar el software necesario para apoyar al personal del departamento en la toma de decisiones, de forma significativa a la reducción de riesgos por graves epidemias, beneficiará a los profesionales con una herramienta informática que puede simplificar su trabajo, tributar a la optimización del tiempo, la gestión y la seguridad de la información.
ABSTRACT Introduction: the International Sanitary Control Program implemented in Cuba allows the control and follow-up, throughout the country, of endemic and vector-borne diseases from other countries. This is manually done, by telephone and with the exchange of documents. Therefore, it was decided to develop a computerized tool to meet the needs of the Department of Hygiene and Epidemiology of the Polyclinic. Objective: to develop the prototype of a computer application for international sanitary control in the Department of Hygiene and Epidemiology at Pedro Borras Astorga University Polyclinic. Methods: the research complies with a technological innovation project to define the architecture of the information managed during the international sanitary control. The stages of analysis and design of the application were carried out using the agile methodology for software development. In addition, theoretical and empirical methods such as historical-logical, analytical-synthetic, inductive-deductive, interviews and documentary analysis were applied. Results: the first results of the research are described, based on the study of the current needs and deficiencies found for the personnel of the Department of Hygiene and Epidemiology. The architecture of the information managed to achieve international sanitary control was developed. Conclusions: the prototype obtained, will allow future programmers to implement the necessary software to support the staff of the department in decision making, significantly reducing risks due to serious epidemics, it will benefit professionals with a computer tool that can simplify their work, contribute to the optimization of time, management and information security.
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Resumen La gestión del riesgo de desastres es un proceso social, por ello toda la comunidad debe estar incluida en ella. El objetivo del estudio fue analizar las percepciones del riesgo de desastres en habitantes del municipio de Pijao (Quindio). Para esto se siguió un enfoque cualitativo desde el diseño de la teoría fundamentada. Se realizó un muestreo no probabilístico en los barrios aledaños al recorrido del Río Lejos del municipio de Pijao (Quindío, Colombia). La muestra estuvo compuesta por un total de 60 sujetos. La teoría sustantiva producto de la investigación es la naturalización de la gestión del riesgo de desastres. Se considera que la naturalización de acciones para la mitigación del riesgo de desastres se posibilita por el nivel de conocimiento de conceptos y acciones de la gestión del riesgo, además del nivel de arraigo cultural. El estudio permitió conocer de primera mano sobre los elementos que se deben trabajar para fortalecer la gestión del riesgo a nivel comunitario.
Abstract Disaster risk management is a social process; therefore, the whole community must be included in it. The objective of the study was to analyze the perceptions of disaster risk in the inhabitants of the municipality of Pijao (Quindio). A qualitative approach was followed from the design of the grounded theory. A non‑probabilistic sampling was carried out in the neighborhoods adjacent to the course of the Lejos River in the municipality of Pijao (Quindio, Colombia). The sample was composed of a total of 60 subjects. The substantive theory resulting from the research is the naturalization of disaster risk management. It is considered that the naturalization of actions for disaster risk mitigation is made possible by the level of knowledge of risk management concepts and actions, in addition to the level of cultural rootedness. The study provided first-hand knowledge of which elements level should be worked on in the community to strengthen risk management.
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Background: Papillary cystadenoma is a rare benign neoplasm of the epididymis. It may occur sporadically or in association with von Hippel-Lindau disease (VHLD). Papillary cystadenoma of the epididymis (PCE) is a benign mimic of metastatic clear cell renal cell carcinoma (CCRCC) given their histologic similarities. Case presentation: Herein, we present the case of a 40-year-old man with a four-year history of microhematuria and a recently detected right paratesticular mass. A testicular sonogram revealed a hypoechoic, hypervascular solid mass in the right epididymal head treated by surgical excision. Histopathological examination demonstrated a 1.1 cm papillary cystadenoma of the epididymis. Genetic testing performed later showed no signs of VHLD. However, heterozygous mutations in three genes - CASR, POT1, and RAD51D - were found which have never been reported in PCE before. Conclusions: Papillary cystadenoma of the epididymis should always be considered in the differential diagnosis of epididymal lesions, especially those that are cystic. The mainstay of treatment remains surgical excision, which provides an excellent prognosis.
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ABSTRACT Background Papillary cystadenoma is a rare benign neoplasm of the epididymis. It may occur sporadically or in association with von Hippel-Lindau disease (VHLD). Papillary cystadenoma of the epididymis (PCE) is a benign mimic of metastatic clear cell renal cell carcinoma (CCRCC) given their histologic similarities. Case presentation Herein, we present the case of a 40-year-old man with a four-year history of microhematuria and a recently detected right paratesticular mass. A testicular sonogram revealed a hypoechoic, hypervascular solid mass in the right epididymal head treated by surgical excision. Histopathological examination demonstrated a 1.1 cm papillary cystadenoma of the epididymis. Genetic testing performed later showed no signs of VHLD. However, heterozygous mutations in three genes - CASR, POT1, and RAD51D - were found which have never been reported in PCE before. Conclusions Papillary cystadenoma of the epididymis should always be considered in the differential diagnosis of epididymal lesions, especially those that are cystic. The mainstay of treatment remains surgical excision, which provides an excellent prognosis.