Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder in primary and secondary care. It is characterised by abdominal discomfort, pain and changes in bowel habits that ca...Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder in primary and secondary care. It is characterised by abdominal discomfort, pain and changes in bowel habits that can have a serious impact on the patient’s quality of life. The pathophysiology of IBS is not yet completely clear. Genetic, immune, environmental, inflammatory, neurological and psychological factors, in addition to visceral hypersensitivity, can all play an important role, one that most likely involves the complex interactions between the gut and the brain (gut-brain axis). The diagnosis of IBS can only be made on the basis of the symptoms of the Rome III criteria. Because the probability of organic disease in patients fulfilling the IBS criteria is very low, a careful medical history is critical and should pay particular attention to the possible comorbidities. Nevertheless, the severity of the patient’s symptoms or concerns sometimes compels the physician to perform useless and/or expensive diagnostic tests, transforming IBS into a diagnosis of exclusion. The presence of alarming symptoms (fever, weight loss, rectal bleeding, significant changes in blood chemistry), the presence of palpable abdominal masses, any recent onset of symptoms in patient aged over 50 years, the presence of symptoms at night, and a familial history of celiac disease, colorectal cancer and/or inflammatory bowel diseases all warrant investigation. Treatment strategies are based on the nature and severity of the symptoms, the degree of functional impairment of the bowel habits, and the presence of psychosocial disorders. This review examines and discusses the pathophysiological aspects and the diagnostic and therapeutic approaches available for patients with symptoms possibly related to IBS, pointing out controversial issues and the strengths and weaknesses of the current knowledge.展开更多
目的评价一种可以快速定量检测疟原虫及虫种鉴别的荧光定量PCR法。方法将SYBR Green Ⅰ法与TaqMan探针法检测疟原虫进行比对,评价定量的准确性及方法的敏感度。以PCR-DNA测序法为金标准,评价SYBR Green Ⅰ法分型的准确性。结果两个方法...目的评价一种可以快速定量检测疟原虫及虫种鉴别的荧光定量PCR法。方法将SYBR Green Ⅰ法与TaqMan探针法检测疟原虫进行比对,评价定量的准确性及方法的敏感度。以PCR-DNA测序法为金标准,评价SYBR Green Ⅰ法分型的准确性。结果两个方法的定量拷贝检测数无显著性差异(P>0.05)。SYBR Green Ⅰ法检测疟原虫的最低检测下限为1×102copy/mL至5×102copy/mL之间。与PCR-DNA测序法比较,SYBR Green Ⅰ法能准确的对感染的疟原虫虫种做准确的鉴定。结论 SYBR Green I染料法定量可同时进行人体疟原虫的定量检测和虫种鉴别,且成本低廉,操作简便快速,可以在疟疾的高发地区推广使用。展开更多
Background: Skin aging is an unavoidable process aggravated by environmental agents. Among other energy devices, non-invasive radiofrequency (RF) technology is widely used for skin tightening and body contouring as it...Background: Skin aging is an unavoidable process aggravated by environmental agents. Among other energy devices, non-invasive radiofrequency (RF) technology is widely used for skin tightening and body contouring as it is simpler and more affordable than other technologies that also minimize pain and side-effects. However, most of the current RF devices do not provide automatic skin temperature control and it is difficult to achieve controlled, deep, and harmless thermal increase, so treatment performance and safety is dependent on the operator’s movements and expertise. Objective: To show the potential of numerical simulations for optimizing the design of monopolar and bipolar RF electrodes that are capable of providing homogeneous, deep and controlled heating. Materials and methods: In-silico models were developed and analyzed using Comsol Multiphysics software to simulate the RF effect produced in tissue by rotating monopolar and bipolar electrodes with different geometries from the Sculpt & Shape RF device (Sinclair, Spain), operating at frequencies of 0.5 and 1 MHz. Ex-vivo and in-vivo proof-of-concept tests were carried out to validate the simulations. Finally, treatments were performed on 16 subjects and a total of 78 body areas to assess the clinical results generated by the RF electrodes for skin tightening and body contouring. Results: In-silico studies emulated the superficial and deep dispersion of heat due to the release of RF energy into human skin tissue. The rotating electrodes (monopolar and bipolar) and the selected RF frequency (0.5 and 1 MHz) determined the homogeneity of the thermal distribution, the penetration depth (between 4.37 mm and 25.0 mm) and the heating dynamics (between 30 and 100 seconds to reach the target skin temperature), which were confirmed by ex-vivo and in-vivo tests. In addition, real treatments on facial and body areas using skin temperatures of between 43˚C and 44˚C showed consistent results with good clinical efficacy for skin tightening, circumference reduction and展开更多
Particulate organic matter(POM)is an important energy source for aquatic consumers,understanding its origin and composition is essential for understanding the energetic dynamics of aquatic environments.The aim of this...Particulate organic matter(POM)is an important energy source for aquatic consumers,understanding its origin and composition is essential for understanding the energetic dynamics of aquatic environments.The aim of this study was to analyze the relationship between POM and phytoplankton(isotopic values and chlorophyll concentration)and abiotic variables during dry and rainy seasons.Sampling was conducted in rivers and lagoons in the floodplain of the Upper ParanáRiver.We found a greater difference in ^(δ13)C values of POM between sampling points than between seasons,indicating that the composition of regional sources influences the composition of POM more than dry and rainy seasons.In addition,the concentration of chlorophyll during the dry season was positively correlated with ^(δ13)C values during that rainy period.Additionally,we found a relationship between factors limiting the growth of phytoplankton and ^(δ13)C values of POM,such as phosphate ions,indicating that variables that regulate phytoplankton growth tend to influence the composition of POM in river floodplains.Therefore,maintaining the variables that regulate the phytoplankton community is of fundamental importance for the composition of POM,an important energy source in aquatic environments.展开更多
Comparative voltammetry and differential double-layer capacitance studies were performed to evaluate interfacial interactions between cnalcopyrite（CuFeS2） and n-isopropyl xanthate（X） in the presence of ammonium bi...Comparative voltammetry and differential double-layer capacitance studies were performed to evaluate interfacial interactions between cnalcopyrite（CuFeS2） and n-isopropyl xanthate（X） in the presence of ammonium bisulfite/39wt%SO2 and caustic starch at different pH values.Raman spectroscopy,Fourier transform infrared（FTIR） spectroscopy,contact angle measurements,and microflotation tests were used to establish the type and extent of xanthate adsorption as well as the species involved under different mineral surface conditions in this study.The results demonstrate that the species that favor a greater hydrophobicity of chalcopyrite are primarily CuX and S^0,whereas oxides and hydroxides of Cu and Fe as well as an excess of starch decrease the hydrophobicity.A conditioning of the mineral surface with ammonium bisulfite/39wt%SO2 at pH 6 promotes the activation of surface and enhances the xanthate adsorption.However,this effect is diminished at pH ≥ 8,when an excess of starch is added during the preconditioning step.展开更多
Background:Serotoninergic pathways underlying delusion symptoms in Alzheimer’s disease(AD)have not been fully clarified.5-Hydroxytryptamine transporter gene-linked polymorphic region(5-HTTLPR)is a variable number tan...Background:Serotoninergic pathways underlying delusion symptoms in Alzheimer’s disease(AD)have not been fully clarified.5-Hydroxytryptamine transporter gene-linked polymorphic region(5-HTTLPR)is a variable number tandem repeats in the promoter region of serotonin transporter encoding-gene affecting transcription.Methods:We investigated the association of 5-HTTLPR with delusions in a total of 257 consecutive patients clinically diagnosed as AD according to the National Institute on Aging-Alzheimer’s Association criteria.All participants underwent a comprehensive evaluation with a standardized comprehensive geriatric assessment and Neuropsychiatric Inventory.Results:Delusion symptoms were observed in 171 patients(66.54%).In respect to AD patients without delusions,AD patients with delusions showed a low prevalence of S-plus carriers(5-HTTLPR-L/S+5-HTTLPR-S/S genotypes)[p<0.001;odds ratio(OR)=0.240,95% confidence interval(CI)=0.121–0.471].Logistic regression analysis adjusted for the apolipoprotein E polymorphism showed that in AD patients with delusions the presence of an 5-HTTLPR-S allele may reduce disease duration(p=0.005;OR=0.680,95% CI=0.522–0.886)and increase aberrant motor activity(p=0.013;OR=2.257,95% CI=1.195–4.260).The present findings suggested that 5-HTTLPR might be associated with delusions in AD.S-plus carriers might be associated with protective effect against delusions in AD.Conclusions:More studies on wider samples of high selected demented patients are needed to confirm our results.However,the present findings suggested that a genetic factor related to serotonin metabolism might exert a protective role on the clinical expression of neuropsychiatric clusters in AD with important implications regarding mechanisms underlying delusions and their possible treatment across the AD and dementia spectrum.展开更多
Pre-diabetes, which is typically defined as blood glucose concentrations higher than normal but lower than thediabetes threshold, is a high-risk state for diabetes and cardiovascular disease development. As such, it r...Pre-diabetes, which is typically defined as blood glucose concentrations higher than normal but lower than thediabetes threshold, is a high-risk state for diabetes and cardiovascular disease development. As such, it represents three groups of individuals: Those with impaired fasting glucose(IFG), those with impaired glucose tolerance(IGT) and those with a glycated haemoglobin(HbA1c) between 39-46 mmol/mol. Several clinical trials have shown the important role of IFG, IGT and HbA1c -pre-diabetes as predictive tools for the risk of developing type 2 diabetes. Moreover, with regard to cardiovascular disease, pre-diabetes is associated with more advanced vascular damage compared with normoglycaemia, independently of confounding factors. In view of these observations, diagnosis of pre-diabetes is mandatory to prevent or delay the development of the disease and its complications; however, a number of previous studies reported that the concordance between pre-diabetes diagnoses made by IFG, IGT or HbA1c is scarce and there are conflicting data as to which of these methods best predicts cardiovascular disease. This review highlights recent studies and cur-rent controversies in the field. In consideration of the expected increased use of HbA1c as a screening tool to identify individuals with alteration of glycaemic homeo-stasis, we focused on the evidence regarding the ability of HbA1c as a diagnostic tool for pre-diabetes and as a useful marker in identifying patients who have an increased risk for cardiovascular disease. Finally, we reviewed the current evidence regarding non-traditional glycaemic biomarkers and their use as alternatives to or additions to traditional ones.展开更多
This paper presents a meta-synthesis conducted to identify,compare and synthesize published qualitative data related to the Maggie’s Centres,as a paradigmatic architectural example in the provision of non-institution...This paper presents a meta-synthesis conducted to identify,compare and synthesize published qualitative data related to the Maggie’s Centres,as a paradigmatic architectural example in the provision of non-institutional cancer support.These centres are internationally renowned for their unique architecture,where the careful design of indoors and outdoors spaces plays a critical role in their agenda for supporting care.Previous research has thoroughly analysed this approach to therapeutic environments,not only confirming the importance of designed space as originally conceived in Maggie’s philosophy but also identifying precise supporting effects associated with specific elements within their design.This paper aims to provide a new reading of Maggie’s contribution to cancer support by offering an examination of all these data through the lens of biophilia,which clarifies the impact of design decisions connected to nature on cancer patients’lives.The analytic process included a systematic search strategy,extraction and classification of salient concepts using an opencoding approach,and lastly an interpretive evaluation.The systematically selected data helped to identify and rank the biophilic design parameters that appear the most critical for promoting and supporting human health and wellbeing in non-clinical therapeutic environments,from the user’s perspective.It also provided a compilation of distinctive design interventions related to biophilic parameters,which provides benchmark information for future research and design guidance in these environments.展开更多
Acinar cell carcinoma(ACC)is a rare malignant epithelial neoplasm accounting for 1%-2%of all pancreatic exocrine neoplasm,affecting more frequently man with an age between 50 and 70 years.Most patients present with no...Acinar cell carcinoma(ACC)is a rare malignant epithelial neoplasm accounting for 1%-2%of all pancreatic exocrine neoplasm,affecting more frequently man with an age between 50 and 70 years.Most patients present with nonspecific symptoms,which may give rise to difficulties in clinical diagnosis[1].ACC can manifest with diarrhea,weight loss,abdominal pain and,in up to 10%-15%,with lipase hypersecretion syndrome,characterized by elevated lipase production,diffuse subcutaneous fat necrosis and polyarthralgia[1,2].Biliary obstruction and jaundice are infre-quent clinical manifestations,unlike ductal adenocarcinoma,due to pushing rather than infiltrating growth of ACC.展开更多
This paper was made using a descriptive analysis of some indicators from the data basis of Economic Commission for Latin America （CEPAL）, CEPAL and answers the question： Have there been enough foreign trade dynamic...This paper was made using a descriptive analysis of some indicators from the data basis of Economic Commission for Latin America （CEPAL）, CEPAL and answers the question： Have there been enough foreign trade dynamics during the last years （1999-2006） in order to reduce social inequality gaps？ The results here shown correspond to the first stage of a research that relates poverty to countries＇ economic productivity. The article presents foreign trade, economic growth, and social inequality overview in the countries of the Andean Community of Nations during the years 1999-2006. In considering this period, the last international crisis is overlooked, but it takes in account the importance of the Millennium Development Goals set by the UNDP. The analysis of the basic indicators reflects that the dynamics of economic integration and foreign trade do not translate into better social equality and poverty reduction. This paper shows an economic and social contrast obtained from the results by countries of the Andean Community of Nations （CAN） during the years 1999-2006, comprised by Colombia, Peru, Ecuador, Bolivia, and Venezuela, though the last country is not currently part of CAN. These indicators are exports, imports, relative commercial balance, gross domestic product, gross domestic product per capita, unemployment, GINI index, population, urban development index, and poverty. The paper presents a succinct conceptual framework where the relationship between foreign trade and social inequality is established, from which the description and analysis of the proposed indicators is formulated, permitting the establishing of an apparent practical connection between economic behavior and social results from the CAN countries.展开更多
FAO （Food and Agriculture Organization of the United Nations） declared that 12% of the world＇s population is undernourished while in Mexico the number is around 5%. Minerals are essential for the daily diet; iron ...FAO （Food and Agriculture Organization of the United Nations） declared that 12% of the world＇s population is undernourished while in Mexico the number is around 5%. Minerals are essential for the daily diet; iron （Fe） is an important mineral on human welfare because it has a main role on the function of the immune and central nervous systems, among others. Most Mexicans fulfill their iron requirements from vegetables, which are poorly absorbed; nevertheless, in coastal populations, where seafood-rich in ironis available, it is not consumed on a regular diet. The aim of this work was to analyze minerals, focusing on the iron content of Octopus hubbsorum B （Cephalopoda： Octopodidae）, an animal of the Mexican Pacific coast. Three specimens were analyzed, two from the north and one from central Pacific Ocean. Data obtained for the central Pacific Octopus was 0.008% and data for the North Pacific were 0.008% and 0.011%, repectively. In conclusion, the supply of iron for the Mexican diet provided by Octopus hubbsorum B is significant, therefore is recommended to consume more of this resource, to diminish iron deficiency, a world-wide problem, and to improve human health.展开更多
BACKGROUND^177Lu peptide receptor radionuclide therapy(PRRT)is a recently approved therapy in Spain that has been demonstrated to be a well-tolerated therapy for positive somatostatin receptor advanced gastroenteropan...BACKGROUND^177Lu peptide receptor radionuclide therapy(PRRT)is a recently approved therapy in Spain that has been demonstrated to be a well-tolerated therapy for positive somatostatin receptor advanced gastroenteropancreatic neuroendocrine tumors.AIM To determine the impact of PRRT on quality of life,radiologic and metabolic response,overall survival,prognostic factors and toxicity.METHODS Thirty-six patients treated with^177Lu-PRRT from 2016 to 2019 were included.The most frequent location of the primary tumor was the gastrointestinal tract(52.8%),pancreas(27.8%),and nongastropancreatic neuroendocrine tumor(11.1%).The liver was the most common site of metastasis(91.7%),followed by distant nodes(50.0%),bone(27.8%),peritoneum(25.0%)and lung(11.1%).Toxicity was evaluated after the administration of each dose.Treatment efficacywas evaluated by two parameters:stable disease and disease progression in response evaluation criteria in solid tumors 1.1 criterion and prognostic factors were tested.RESULTS From 36 patients,55.6%were men,with a median age of 61.1±11.8 years.Regarding previous treatments,55.6%of patients underwent surgery of the primary tumor,100%of patients were treated with long-acting somatostatin analogues,66.7%of patients were treated with everolimus,27.8%of patients were treated with tyrosine kinase inhibitor,and 27.8%of patients were treated with interferon.One patient received radioembolization,three patients received chemoembolization,six patients received chemotherapy.Hematological toxicity was registered in 14 patients(G1-G2:55.5%and G3:3.1%).Other events presented were intestinal suboclusion in 4 cases,cholestasis in 2 cases and carcinoid crisis in 1 case.The median follow-up time was 3 years.Currently,24 patients completed treatment.Nineteen are alive with stable disease,two have disease progression,eight have died,and nine are still receiving treatment.The median overall survival was 12.5 mo(95%confidence interval range:9.8–15.2),being inversely proportional to toxicity in previous treatment展开更多
Different studies have attributed health benefits to Lactobacillus fermentum CECT 5716. However, the main problem associated with probiotics is their low resistance to environmental and technological factors. In this ...Different studies have attributed health benefits to Lactobacillus fermentum CECT 5716. However, the main problem associated with probiotics is their low resistance to environmental and technological factors. In this sense, capsules can provide a shell protection and a dosage form that is easy to swallow. For these reasons, the aim of this study was to evaluate the survival of Lactobacillusfermentum CECT 5716 in gelatin and gastro-resistant capsules during a period of 12 months at RT （room temperature） and 4 ℃. The number of encapsulated cells remained relatively constant after six months of storage, since there were no statistically significant differences compared to the initial time （p 〉 0.05）. Moreover, capsules are able to maintain a therapeutic level of bacteria （109 CFU/capsule） during the total period of storage. Gelatin capsules seem to protect worse probiotic than gastro-resistant （HPMC （hydroxy propyi methyl cellulose）） capsules. Furthermore, capsules stored at 4 ℃ show a low level of viability. These results suggest that HPMC capsules are an optimal dosage form for L. fermentum CECT 5716 and that the recommended condition of storage is room temperature rather than 4 ℃.展开更多
文摘Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder in primary and secondary care. It is characterised by abdominal discomfort, pain and changes in bowel habits that can have a serious impact on the patient’s quality of life. The pathophysiology of IBS is not yet completely clear. Genetic, immune, environmental, inflammatory, neurological and psychological factors, in addition to visceral hypersensitivity, can all play an important role, one that most likely involves the complex interactions between the gut and the brain (gut-brain axis). The diagnosis of IBS can only be made on the basis of the symptoms of the Rome III criteria. Because the probability of organic disease in patients fulfilling the IBS criteria is very low, a careful medical history is critical and should pay particular attention to the possible comorbidities. Nevertheless, the severity of the patient’s symptoms or concerns sometimes compels the physician to perform useless and/or expensive diagnostic tests, transforming IBS into a diagnosis of exclusion. The presence of alarming symptoms (fever, weight loss, rectal bleeding, significant changes in blood chemistry), the presence of palpable abdominal masses, any recent onset of symptoms in patient aged over 50 years, the presence of symptoms at night, and a familial history of celiac disease, colorectal cancer and/or inflammatory bowel diseases all warrant investigation. Treatment strategies are based on the nature and severity of the symptoms, the degree of functional impairment of the bowel habits, and the presence of psychosocial disorders. This review examines and discusses the pathophysiological aspects and the diagnostic and therapeutic approaches available for patients with symptoms possibly related to IBS, pointing out controversial issues and the strengths and weaknesses of the current knowledge.
文摘目的评价一种可以快速定量检测疟原虫及虫种鉴别的荧光定量PCR法。方法将SYBR Green Ⅰ法与TaqMan探针法检测疟原虫进行比对,评价定量的准确性及方法的敏感度。以PCR-DNA测序法为金标准,评价SYBR Green Ⅰ法分型的准确性。结果两个方法的定量拷贝检测数无显著性差异(P>0.05)。SYBR Green Ⅰ法检测疟原虫的最低检测下限为1×102copy/mL至5×102copy/mL之间。与PCR-DNA测序法比较,SYBR Green Ⅰ法能准确的对感染的疟原虫虫种做准确的鉴定。结论 SYBR Green I染料法定量可同时进行人体疟原虫的定量检测和虫种鉴别,且成本低廉,操作简便快速,可以在疟疾的高发地区推广使用。
文摘Background: Skin aging is an unavoidable process aggravated by environmental agents. Among other energy devices, non-invasive radiofrequency (RF) technology is widely used for skin tightening and body contouring as it is simpler and more affordable than other technologies that also minimize pain and side-effects. However, most of the current RF devices do not provide automatic skin temperature control and it is difficult to achieve controlled, deep, and harmless thermal increase, so treatment performance and safety is dependent on the operator’s movements and expertise. Objective: To show the potential of numerical simulations for optimizing the design of monopolar and bipolar RF electrodes that are capable of providing homogeneous, deep and controlled heating. Materials and methods: In-silico models were developed and analyzed using Comsol Multiphysics software to simulate the RF effect produced in tissue by rotating monopolar and bipolar electrodes with different geometries from the Sculpt & Shape RF device (Sinclair, Spain), operating at frequencies of 0.5 and 1 MHz. Ex-vivo and in-vivo proof-of-concept tests were carried out to validate the simulations. Finally, treatments were performed on 16 subjects and a total of 78 body areas to assess the clinical results generated by the RF electrodes for skin tightening and body contouring. Results: In-silico studies emulated the superficial and deep dispersion of heat due to the release of RF energy into human skin tissue. The rotating electrodes (monopolar and bipolar) and the selected RF frequency (0.5 and 1 MHz) determined the homogeneity of the thermal distribution, the penetration depth (between 4.37 mm and 25.0 mm) and the heating dynamics (between 30 and 100 seconds to reach the target skin temperature), which were confirmed by ex-vivo and in-vivo tests. In addition, real treatments on facial and body areas using skin temperatures of between 43˚C and 44˚C showed consistent results with good clinical efficacy for skin tightening, circumference reduction and
基金Supported by the Research Nucleus in LimnologyIchthyology and Aquaculture (NUPELIA) for logistic support+4 种基金the Laboratory of Energetic Ecology and the Long-term Ecological Research Program (PELD/CNPq)Site 6-PIAP (upper ParanáRiver floodplain)PROEXUEMand Fundação Araucária for the scholarship
文摘Particulate organic matter(POM)is an important energy source for aquatic consumers,understanding its origin and composition is essential for understanding the energetic dynamics of aquatic environments.The aim of this study was to analyze the relationship between POM and phytoplankton(isotopic values and chlorophyll concentration)and abiotic variables during dry and rainy seasons.Sampling was conducted in rivers and lagoons in the floodplain of the Upper ParanáRiver.We found a greater difference in ^(δ13)C values of POM between sampling points than between seasons,indicating that the composition of regional sources influences the composition of POM more than dry and rainy seasons.In addition,the concentration of chlorophyll during the dry season was positively correlated with ^(δ13)C values during that rainy period.Additionally,we found a relationship between factors limiting the growth of phytoplankton and ^(δ13)C values of POM,such as phosphate ions,indicating that variables that regulate phytoplankton growth tend to influence the composition of POM in river floodplains.Therefore,maintaining the variables that regulate the phytoplankton community is of fundamental importance for the composition of POM,an important energy source in aquatic environments.
基金supported by Universidad Autónoma de San Luis Potosí(No.PROMEP/UASLP/12/CA15)
文摘Comparative voltammetry and differential double-layer capacitance studies were performed to evaluate interfacial interactions between cnalcopyrite（CuFeS2） and n-isopropyl xanthate（X） in the presence of ammonium bisulfite/39wt%SO2 and caustic starch at different pH values.Raman spectroscopy,Fourier transform infrared（FTIR） spectroscopy,contact angle measurements,and microflotation tests were used to establish the type and extent of xanthate adsorption as well as the species involved under different mineral surface conditions in this study.The results demonstrate that the species that favor a greater hydrophobicity of chalcopyrite are primarily CuX and S^0,whereas oxides and hydroxides of Cu and Fe as well as an excess of starch decrease the hydrophobicity.A conditioning of the mineral surface with ammonium bisulfite/39wt%SO2 at pH 6 promotes the activation of surface and enhances the xanthate adsorption.However,this effect is diminished at pH ≥ 8,when an excess of starch is added during the preconditioning step.
基金This work was fully supported by“Ministero della Salute”,I.R.C.C.S.Research Program,Ricerca Corrente 2015–2017,Linea n.2“Malattie complesse e terapie innovative”by the“5×1000”voluntary contribution.
文摘Background:Serotoninergic pathways underlying delusion symptoms in Alzheimer’s disease(AD)have not been fully clarified.5-Hydroxytryptamine transporter gene-linked polymorphic region(5-HTTLPR)is a variable number tandem repeats in the promoter region of serotonin transporter encoding-gene affecting transcription.Methods:We investigated the association of 5-HTTLPR with delusions in a total of 257 consecutive patients clinically diagnosed as AD according to the National Institute on Aging-Alzheimer’s Association criteria.All participants underwent a comprehensive evaluation with a standardized comprehensive geriatric assessment and Neuropsychiatric Inventory.Results:Delusion symptoms were observed in 171 patients(66.54%).In respect to AD patients without delusions,AD patients with delusions showed a low prevalence of S-plus carriers(5-HTTLPR-L/S+5-HTTLPR-S/S genotypes)[p<0.001;odds ratio(OR)=0.240,95% confidence interval(CI)=0.121–0.471].Logistic regression analysis adjusted for the apolipoprotein E polymorphism showed that in AD patients with delusions the presence of an 5-HTTLPR-S allele may reduce disease duration(p=0.005;OR=0.680,95% CI=0.522–0.886)and increase aberrant motor activity(p=0.013;OR=2.257,95% CI=1.195–4.260).The present findings suggested that 5-HTTLPR might be associated with delusions in AD.S-plus carriers might be associated with protective effect against delusions in AD.Conclusions:More studies on wider samples of high selected demented patients are needed to confirm our results.However,the present findings suggested that a genetic factor related to serotonin metabolism might exert a protective role on the clinical expression of neuropsychiatric clusters in AD with important implications regarding mechanisms underlying delusions and their possible treatment across the AD and dementia spectrum.
基金Scientific Bureau of the University of Catania for language support
文摘Pre-diabetes, which is typically defined as blood glucose concentrations higher than normal but lower than thediabetes threshold, is a high-risk state for diabetes and cardiovascular disease development. As such, it represents three groups of individuals: Those with impaired fasting glucose(IFG), those with impaired glucose tolerance(IGT) and those with a glycated haemoglobin(HbA1c) between 39-46 mmol/mol. Several clinical trials have shown the important role of IFG, IGT and HbA1c -pre-diabetes as predictive tools for the risk of developing type 2 diabetes. Moreover, with regard to cardiovascular disease, pre-diabetes is associated with more advanced vascular damage compared with normoglycaemia, independently of confounding factors. In view of these observations, diagnosis of pre-diabetes is mandatory to prevent or delay the development of the disease and its complications; however, a number of previous studies reported that the concordance between pre-diabetes diagnoses made by IFG, IGT or HbA1c is scarce and there are conflicting data as to which of these methods best predicts cardiovascular disease. This review highlights recent studies and cur-rent controversies in the field. In consideration of the expected increased use of HbA1c as a screening tool to identify individuals with alteration of glycaemic homeo-stasis, we focused on the evidence regarding the ability of HbA1c as a diagnostic tool for pre-diabetes and as a useful marker in identifying patients who have an increased risk for cardiovascular disease. Finally, we reviewed the current evidence regarding non-traditional glycaemic biomarkers and their use as alternatives to or additions to traditional ones.
文摘This paper presents a meta-synthesis conducted to identify,compare and synthesize published qualitative data related to the Maggie’s Centres,as a paradigmatic architectural example in the provision of non-institutional cancer support.These centres are internationally renowned for their unique architecture,where the careful design of indoors and outdoors spaces plays a critical role in their agenda for supporting care.Previous research has thoroughly analysed this approach to therapeutic environments,not only confirming the importance of designed space as originally conceived in Maggie’s philosophy but also identifying precise supporting effects associated with specific elements within their design.This paper aims to provide a new reading of Maggie’s contribution to cancer support by offering an examination of all these data through the lens of biophilia,which clarifies the impact of design decisions connected to nature on cancer patients’lives.The analytic process included a systematic search strategy,extraction and classification of salient concepts using an opencoding approach,and lastly an interpretive evaluation.The systematically selected data helped to identify and rank the biophilic design parameters that appear the most critical for promoting and supporting human health and wellbeing in non-clinical therapeutic environments,from the user’s perspective.It also provided a compilation of distinctive design interventions related to biophilic parameters,which provides benchmark information for future research and design guidance in these environments.
文摘Acinar cell carcinoma(ACC)is a rare malignant epithelial neoplasm accounting for 1%-2%of all pancreatic exocrine neoplasm,affecting more frequently man with an age between 50 and 70 years.Most patients present with nonspecific symptoms,which may give rise to difficulties in clinical diagnosis[1].ACC can manifest with diarrhea,weight loss,abdominal pain and,in up to 10%-15%,with lipase hypersecretion syndrome,characterized by elevated lipase production,diffuse subcutaneous fat necrosis and polyarthralgia[1,2].Biliary obstruction and jaundice are infre-quent clinical manifestations,unlike ductal adenocarcinoma,due to pushing rather than infiltrating growth of ACC.
文摘This paper was made using a descriptive analysis of some indicators from the data basis of Economic Commission for Latin America （CEPAL）, CEPAL and answers the question： Have there been enough foreign trade dynamics during the last years （1999-2006） in order to reduce social inequality gaps？ The results here shown correspond to the first stage of a research that relates poverty to countries＇ economic productivity. The article presents foreign trade, economic growth, and social inequality overview in the countries of the Andean Community of Nations during the years 1999-2006. In considering this period, the last international crisis is overlooked, but it takes in account the importance of the Millennium Development Goals set by the UNDP. The analysis of the basic indicators reflects that the dynamics of economic integration and foreign trade do not translate into better social equality and poverty reduction. This paper shows an economic and social contrast obtained from the results by countries of the Andean Community of Nations （CAN） during the years 1999-2006, comprised by Colombia, Peru, Ecuador, Bolivia, and Venezuela, though the last country is not currently part of CAN. These indicators are exports, imports, relative commercial balance, gross domestic product, gross domestic product per capita, unemployment, GINI index, population, urban development index, and poverty. The paper presents a succinct conceptual framework where the relationship between foreign trade and social inequality is established, from which the description and analysis of the proposed indicators is formulated, permitting the establishing of an apparent practical connection between economic behavior and social results from the CAN countries.
文摘FAO （Food and Agriculture Organization of the United Nations） declared that 12% of the world＇s population is undernourished while in Mexico the number is around 5%. Minerals are essential for the daily diet; iron （Fe） is an important mineral on human welfare because it has a main role on the function of the immune and central nervous systems, among others. Most Mexicans fulfill their iron requirements from vegetables, which are poorly absorbed; nevertheless, in coastal populations, where seafood-rich in ironis available, it is not consumed on a regular diet. The aim of this work was to analyze minerals, focusing on the iron content of Octopus hubbsorum B （Cephalopoda： Octopodidae）, an animal of the Mexican Pacific coast. Three specimens were analyzed, two from the north and one from central Pacific Ocean. Data obtained for the central Pacific Octopus was 0.008% and data for the North Pacific were 0.008% and 0.011%, repectively. In conclusion, the supply of iron for the Mexican diet provided by Octopus hubbsorum B is significant, therefore is recommended to consume more of this resource, to diminish iron deficiency, a world-wide problem, and to improve human health.
文摘BACKGROUND^177Lu peptide receptor radionuclide therapy(PRRT)is a recently approved therapy in Spain that has been demonstrated to be a well-tolerated therapy for positive somatostatin receptor advanced gastroenteropancreatic neuroendocrine tumors.AIM To determine the impact of PRRT on quality of life,radiologic and metabolic response,overall survival,prognostic factors and toxicity.METHODS Thirty-six patients treated with^177Lu-PRRT from 2016 to 2019 were included.The most frequent location of the primary tumor was the gastrointestinal tract(52.8%),pancreas(27.8%),and nongastropancreatic neuroendocrine tumor(11.1%).The liver was the most common site of metastasis(91.7%),followed by distant nodes(50.0%),bone(27.8%),peritoneum(25.0%)and lung(11.1%).Toxicity was evaluated after the administration of each dose.Treatment efficacywas evaluated by two parameters:stable disease and disease progression in response evaluation criteria in solid tumors 1.1 criterion and prognostic factors were tested.RESULTS From 36 patients,55.6%were men,with a median age of 61.1±11.8 years.Regarding previous treatments,55.6%of patients underwent surgery of the primary tumor,100%of patients were treated with long-acting somatostatin analogues,66.7%of patients were treated with everolimus,27.8%of patients were treated with tyrosine kinase inhibitor,and 27.8%of patients were treated with interferon.One patient received radioembolization,three patients received chemoembolization,six patients received chemotherapy.Hematological toxicity was registered in 14 patients(G1-G2:55.5%and G3:3.1%).Other events presented were intestinal suboclusion in 4 cases,cholestasis in 2 cases and carcinoid crisis in 1 case.The median follow-up time was 3 years.Currently,24 patients completed treatment.Nineteen are alive with stable disease,two have disease progression,eight have died,and nine are still receiving treatment.The median overall survival was 12.5 mo(95%confidence interval range:9.8–15.2),being inversely proportional to toxicity in previous treatment
文摘Different studies have attributed health benefits to Lactobacillus fermentum CECT 5716. However, the main problem associated with probiotics is their low resistance to environmental and technological factors. In this sense, capsules can provide a shell protection and a dosage form that is easy to swallow. For these reasons, the aim of this study was to evaluate the survival of Lactobacillusfermentum CECT 5716 in gelatin and gastro-resistant capsules during a period of 12 months at RT （room temperature） and 4 ℃. The number of encapsulated cells remained relatively constant after six months of storage, since there were no statistically significant differences compared to the initial time （p 〉 0.05）. Moreover, capsules are able to maintain a therapeutic level of bacteria （109 CFU/capsule） during the total period of storage. Gelatin capsules seem to protect worse probiotic than gastro-resistant （HPMC （hydroxy propyi methyl cellulose）） capsules. Furthermore, capsules stored at 4 ℃ show a low level of viability. These results suggest that HPMC capsules are an optimal dosage form for L. fermentum CECT 5716 and that the recommended condition of storage is room temperature rather than 4 ℃.
