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HIV transmitted through cosmetic injection services via contaminated blood has not been previously documented. During summer 2018, the New Mexico Department of Health (NMDOH) was notified of a diagnosis of HIV infection in a woman with no known HIV risk factors who reported exposure to needles from cosmetic platelet-rich plasma microneedling facials (vampire facials) received at a spa in spring 2018. An investigation of the spa's services began in summer 2018, and NMDOH and CDC identified four former spa clients, and one sexual partner of a spa client, all of whom received HIV infection diagnoses during 2018-2023, despite low reported behavioral risks associated with HIV acquisition. Nucleotide sequence analysis revealed highly similar HIV strains among all cases. Although transmission of HIV via unsterile injection practices is a known risk, determining novel routes of HIV transmission among persons with no known HIV risk factors is important. This investigation identified an HIV cluster associated with receipt of cosmetic injection services at an unlicensed facility that did not follow recommended infection control procedures or maintain client records. Requiring adequate infection control practices and maintenance of client records at spa facilities offering cosmetic injection services can help prevent the transmission of HIV and other bloodborne pathogens and ensure adequate traceback and notification in the event of adverse clinical outcomes, respectively.
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Infecções por HIV , Plasma Rico em Plaquetas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas Cosméticas , Face , Infecções por HIV/transmissão , Infecções por HIV/epidemiologia , Agulhas , New Mexico/epidemiologiaRESUMO
The efficiency of a thermoelectric generator model under maximum conditions is presented for two optimization criteria proposed under the context of finite-time thermodynamics, namely, the efficient power criterion and the Omega function, where this last function represents a trade-off between useful and lost energy. The results are compared with the performance of the device at maximum power output. A macroscopic thermoelectric generator (TEG) model with three possible sources of irreversibilities is considered: (i) the electric resistance R for the Joule heating, (ii) the thermal conductances Kh and Kc of the heat exchangers between the thermal baths and the TEG, and (iii) the internal thermal conductance K for heat leakage. In particular, two configurations of the macroscopic TEG are studied: the so-called exoreversible case and the endoreversible limit. It shows that for both TEG configurations, the efficiency at maximum Omega function is always greater than that obtained in conditions of maximum efficient power, and this in turn is greater than that of the maximum power regime.
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This study sought to evaluate the roles of and interactions between cognitive processes that have been shown to exhibit impact from socioeconomic status (SES) and living conditions in predicting social adaptation (SA) in a population of adults living in socially vulnerable conditions. Participants included 226 people between the ages of 18 and 60 who have been living in vulnerable contexts throughout life in Santiago, Chile. Data was collected through a battery of psychological assessments. A structural equation model (SEM) was implemented to examine the interrelationships among cognitive and social variables. Results indicate a significant relationship between executive function (EF) and SA through both social cognition (SC) and intelligence. Theory of Mind (ToM), a component of SC, was shown to exhibit a significant relationship with affective empathy; interestingly, this was negatively related to SA. Moreover, fluid intelligence (FI) was found to exhibit a positive, indirect relationship with SA through crystallized intelligence (CI). Evaluation of these results in the context of research on the impacts of SES and vulnerable living conditions on psychological function may allow for the development of more effective clinical, political, and social interventions to support psychosocial health among socially vulnerable populations.
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Função Executiva , Cognição Social , Adulto , Humanos , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Testes Neuropsicológicos , Populações Vulneráveis , Inteligência , CogniçãoRESUMO
Transarterial radioembolization (TARE) with yttrium-90 (Y90) is a promising alternative strategy to treat liver tumors and liver metastasis from colorectal cancer (CRC), as it selectively delivers radioactive isotopes to the tumor via the hepatic artery, sparring surrounding liver tissue. The landscape of TARE indications is constantly evolving. This strategy is considered for patients with hepatocellular carcinoma (HCC) with liver-confined disease and preserved liver function in whom neither TACE nor systemic therapy is possible. In patients with liver metastases from CRC, TARE is advised when other chemotherapeutic options have failed. Recent phase III trials have not succeeded to prove benefit in overall survival; however, it has helped to better understand the patients that may benefit from TARE based on subgroup analysis. New strategies and treatment combinations are being investigated in ongoing clinical trials. The aim of this review is to summarize the clinical applications of TARE in patients with gastrointestinal malignancies.
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Braquiterapia , Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Gastrointestinais , Neoplasias Hepáticas , Carcinoma Hepatocelular/radioterapia , Neoplasias Gastrointestinais/tratamento farmacológico , Neoplasias Gastrointestinais/radioterapia , Humanos , Neoplasias Hepáticas/radioterapia , Radioisótopos de Ítrio/uso terapêuticoRESUMO
BACKGROUND: The prognostic value of neutrophil-to-lymphocyte ratio (NLR) has been extensively studied in cancer patients. However, the performance of NLR as an early marker of efficacy of immune checkpoint inhibitors (ICI) is still understudied. We studied the utility of NLR at baseline (bNLR), before the second dose of immunotherapy (NLR2) and the NLR trend for predicting efficacy outcomes. METHODS: We included all patients with advanced cancer treated with ICI from June 2013 to April 2019 at La Paz University Hospital, Madrid (Spain). We examined bNLR, NLR2 and NLR trend and explored the association with progression-free survival (PFS) at 6 months, median PFS and overall survival (OS). RESULTS: We included 211 patients. PFS and OS were significantly longer in the low bNLR group than in the high bNLR group [HR 0.71 (95% CI 0.60-0.84) and HR: 0.66 (95% CI 0.55-0.79), respectively]. Regarding NLR2, patients with low NLR2 had significantly longer PFS and OS than patients with high NLR2 [HR 0.67 (95% CI 0.57-0.79) and HR: 0.60 (95% CI 0.50-0.72), respectively]. Finally, for NLR trend, PFS and OS for patients with NLR trend < 1 were significantly longer than those patients with NLR trend ≥ 1 [HR 0.59 (95% CI 0.43-0.82) and HR 0.63 (95% CI 0.44-0.90), respectively]. At the multivariate analysis for PFS and OS, bNLR, NLR2 and NLR trend were all independent prognostic factors for PFS and OS. CONCLUSIONS: bNLR, NLR2 and NLR trends are independent prognostic factors for survival in patients on immunotherapy. The dynamics of NLR in patients on immunotherapy is a promising marker that needs further investigation.
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Imunoterapia , Linfócitos , Neoplasias/sangue , Neoplasias/terapia , Neutrófilos , Idoso , Feminino , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do TratamentoRESUMO
BACKGROUND: Capectiabine is an oral antineoplastic drug used in multiple malignancies. Proton pump inhibitors (PPI) have been proven to interact with other oral antineoplastic agents. In this systematic review we will summarize the clinical evidence on the efficacy of capecitabine when used concomitantly with PPI. MATERIALS AND METHODS: We performed a systematic literature search on the main databases up to November 2019. RESULTS: Nine studies met our inclusion criteria: 8 retrospective studies and 1 phase II clinical trial. Patients with colorectal, breast and gastroesophageal were represented. Four out of the 9 studies reported a shorter efficacy outcome in uni- or multivariate analysis when capecitabine was taken concomitantly with PPI than alone. CONCLUSIONS: Up to date, the clinical evidence reported on the use of capecitabine concomitantly with PPI is scarce and shows conflicting results. While awaiting further data, avoiding misuse of PPI in cancer patients taking capecitabine is recommended.
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Antimetabólitos Antineoplásicos/uso terapêutico , Capecitabina/uso terapêutico , Neoplasias/tratamento farmacológico , Inibidores da Bomba de Prótons/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Ensaios Clínicos Fase II como Assunto , Neoplasias Colorretais/tratamento farmacológico , Quimioterapia Combinada/métodos , Neoplasias Esofágicas/tratamento farmacológico , Feminino , Neoplasias Gastrointestinais/tratamento farmacológico , Humanos , Masculino , Estudos Retrospectivos , Neoplasias Gástricas/tratamento farmacológicoRESUMO
The introduction of invasive species is one of the greatest threats currently faced by natural ecosystems, causing ecological imbalances between native populations and transmission of a variety of diseases. We reported the interaction between two exotic species given by the parasitic infestation of the copepod Lernaea cyprinacea in the early stages of the development of the American bullfrog Lithobates catesbeianus in the central area of Argentina. In this paper we analysed the leukocyte profile of parasitized and non-parasitized tadpoles of L. catesbeianus with L. cyprinacea and their body condition (BC) as biomarkers of the health status of organisms. A total of 27 tadpoles of L. catesbeianus were analysed (12 non-parasitized and 15 parasitized). The lower BC recorded in parasitized organisms show a lower health status in these tadpoles, which could be affecting the metamorphosis and therefore impact at the population level. Leukocyte response of L. catesbeianus tadpoles to the parasitism of L. cyprinacea was found. Mature and immature lymphocyte frequencies and hematocrit were higher in parasitized compared to non-parasitized tadpoles, which is a typical response to the presence of parasites. However, eosinophils and monocytes were recorded at high frequencies in not parasitized tadpoles, which could be due to the important role played by these leucocytes in the metamorphosis of frogs. The results of this study constitute a first antecedent on leukocyte profile in aquatic stages of anurans during an ectoparasitosis and its possible implications for environmental health. The parasitism of L. cyprinacea influences the biology of the American bullfrog at both the individual and population levels. Parasitized individuals are not killed directly by the parasite, but they can create conditions for secondary infections, growth retardation, behavioral changes and, ultimately, reduce populations.
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Hepatocellular carcinoma (HCC) represents the second leading cause of cancer-related death worldwide. Surveillance with abdominal ultrasound every 6 months should be offered to patients with a high risk of developing HCC: Child-Pugh A-B cirrhotic patients, all cirrhotic patients on the waiting list for liver transplantation, high-risk HBV chronic hepatitis patients (higher viral load, viral genotype or Asian or African ancestry) and patients with chronic hepatitis C and bridging fibrosis. Accurate diagnosis, staging and functional hepatic reserve are crucial for the optimal therapeutic approach. Characteristic findings on dynamic CT/MR of arterial hyperenhancement with "washout" in the portal venous or delayed phase are highly specific and sensitive for a diagnosis of HCC in patients with previous cirrhosis, but a confirmed histopathologic diagnosis should be done in patients without previous evidence of chronic hepatic disease. BCLC classification is the most common staging system used in Western countries. Surgical procedures, local therapies and systemic treatments should be discussed and planned for each patient by a multidisciplinary team according to the stage, performance status, liver function and comorbidities. Surgical interventions remain as the only curative procedures but both local and systemic approaches may increase survival and should be offered to patients without contraindications.
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Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/terapia , Guias de Prática Clínica como Assunto/normas , Terapia Combinada , Gerenciamento Clínico , Detecção Precoce de Câncer , Humanos , Oncologia , Estadiamento de Neoplasias , Prognóstico , Sociedades MédicasRESUMO
The efficiency of four different and representative models of heat engines under maximum conditions for a figure of merit representing a compromise between useful energy and lost energy (the Ω criterion) is investigated and compared with previous results for the same models where the efficiency is considered at maximum power conditions. It is shown that the maximum Ω regime is more efficient and, additionally, that the resulting efficiencies present a similar behavior. For each performance regime we obtain explicit equations accounting for lower and upper bounds. The optimization of refrigeration devices is far from being as clear as heat engines, and some remarks on it are finally considered.
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mRNA and protein presence of Na+/H+ exchanger (NHE) 1 (NHE1) and 5 (NHE5) in dorsal root ganglion (DRG) and dorsal spinal cord as well as its possible role in three inflammatory nociception tests were determined. Local peripheral ipsilateral, but not contralateral, administration of NHE inhibitors 5-(N,N-dimethyl)amiloride hydrochloride (DMA, 0.3-30 microM/paw), 5-(N-ethyl-N-isopropyl)amiloride (EIPA, 0.3-30 microM/paw) and amiloride (0.1-10 microM/paw) significantly increased flinching but not licking behavior in the capsaicin and 5-HT tests. Moreover, DMA and EIPA (0.03-30 microM/paw) as well as amiloride (0.1-1 microM/paw) augmented, in a dose-dependent manner, 0.5% formalin-induced flinching behavior during phase II but not during phase I. Reverse transcription-polymerase chain reaction showed the expression of NHE1 and NHE5 in DRG and dorsal spinal cord. Western blot analysis confirmed the presence of NHE1 in DRG and spinal cord. Moreover, NHE5 was expressed in dorsal spinal cord, but not in DRG where a 45 kDa truncated isoform of NHE5 was identified. Collectively, these data suggest that NHE1, but not NHE5, plays an important role reducing inflammatory pain in rats.