Management of Procedural Pain in Children Páramo-Cano, Tatjana; Ortiz, Mario I; Gómez-Busto, Federico J ...
Current pediatric reviews,
01/2021, Letnik:
17, Številka:
4
Journal Article
Recenzirano
In recent years, there has been increased interest in the study of pain in children and its treatment. It is known that when facing diagnostic and therapeutic procedures similar to those performed on ...adults, children either do not receive specific pain treatment or receive it on a significantly lower scale. However, recent research suggests a change in attitude and an improvement in the current treatment of children's pain. Although current knowledge demonstrates the falsity of many preconceived ideas about pain and its management, our results suggest that attitudinal change towards childhood pain remains slow and that real improvement in the training and practical application of the pediatrician who has to treat childhood pain is urgently needed. In this context, this manuscript has prepared standards and guidelines to improve pain management practices in a large number of national and international professional settings.
OBJECTIVEPrimary dysmenorrhea has a high prevalence among the student population. The objective of this study was to determine the prevalence of dysmenorrhea, its severity and its impact on academic ...performance in Mexican university students. METHODSCross-sectional study. An anonymous multiple-choice questionnaire was applied in class hours in the classrooms. The visual pain scale (VAS) was used for the measurement of pain. A descriptive and inferential analysis of the variables studied was carried out using the program SPSS® IBM. RESULTSA total of 2154 (n=2154) students were surveyed. The average age of the women was 20.4 ±1.9years. The general prevalence of dysmenorrhea was 78.9%, with psychology students having the highest value (83.7%). The VAS mean pain score was of 64.0. The severity of menstrual pain in students was reported as mild in 9.0%, and moderate-severe in 91.0%. The VAS mean pain scores and intensity of pain of gerontology students were significantly higher than those reported by dentistry and medicine students (P<.05). Limitation of daily activities was reported in 90.4% of women, with medical students reporting the highest percentage (93.3%). Women reported school absenteeism in 37.0%, with medical students presenting the highest percentage (41.4%). The severity of menstrual pain as a risk factor (independent variable) positively influenced various dependent variables involved in students' academic performance (P<.05), including: stop doing their activities due to pain in 1 to 6 menstruations a year, minor concentration, absenteeism, low school performance, and lower grades during dysmenorrhea. CONCLUSIONA high prevalence of dysmenorrhea was observed and it is concluded that the severity of the symptomatology significantly interferes with the academic performance of the participants.
Pioglitazone (PGZ) is a peroxisome proliferator-activated receptor agonist. Its role in the inflammatory response modulation paves the way for additional therapeutic applications. The purpose of this ...study was to develop a pioglitazone nanoemulsion (PGZ-NE) in order to investigate its anti-inflammatory efficacy on the skin. To that end, an NE vehicle developed for skin delivery was optimized and characterized. The resulting PGZ-NE showed good anti-inflammatory efficacy by decreasing the expression of inflammatory cytokines IL-6, IL-1β and TNF-α. The properties of the developed nanocarrier allowed achievement of a high permeation flux of PGZ through the skin as well as a high retained amount in the skin, likely due to the depot effect of ingredients, which assured a prolonged local action, with good skin tolerability among participating individuals. Consequently, these results suggest that PGZ-NE may be used as an alternative treatment for inflammatory skin diseases such as rosacea, atopic dermatitis or psoriasis.
The reported anti-inflammatory efficacy of pioglitazone, a peroxisome proliferator-activated receptor agonist was exploited for the elaboration of a therapeutic agent aimed for the treatment of skin inflammatory diseases. A nanoemulsion system was specifically developed and characterized for the skin delivery of pioglitazone. This nanoemulsion provided enhanced flux of the drug through the skin and its retention. This fact promoted a decrease of the expression of adipose inflammatory cytokines IL-6, IL-1β and TNF-α, which reinforced the anti-inflammatory efficacy of the drug. The tolerance study in humans guaranteed its safety maintaining biomechanical skin properties in the site of action. Display omitted
Background and Objectives
Nutritional benefits of amaranth addition to maize products have been documented. However, studies of the effect on the final product's rheological and textural properties ...are scarce. The objective was to study the effect of amaranth addition on masa's rheological properties and the tortilla texture of maize nixtamalized flours obtained by extrusion technology.
Findings
Composite flours of maize with 0%, 15%, 30%, or 45% amaranth were extruded, and masa and tortillas were obtained. Masa properties were evaluated with dynamic rheology and tortilla firmness with the texture profile analysis. The amaranth addition effect was not linear. Fifteen percent addition increased frequency sweep values for G′ and G″, while 30% and 45% addition decreased them. Tortilla firmness decreased at 2 storage hours for 15% addition compared with maize‐only samples (5440 and 7190 (g‐f)/mm). The effects can be partially explained by differences in starch characteristics.
Conclusions
Amaranth (15% addition) improved masa viscoelastic behavior and reduced firmness during storage. Besides the nutritional effects, amaranth use at the tested level will be helpful in improving the texture of maize tortillas produced with extruded flour.
Significance and Novelty
The texture of tortillas obtained by extruded flours has not been reported to be completely satisfactory; therefore, the use of amaranth has the potential to improve the final product quality.
Abstract Climate change is an environmental emergency threatening species and ecosystems globally. Oceans have absorbed about 90% of anthropogenic heat and 20%–30% of the carbon emissions, resulting ...in ocean warming, acidification, deoxygenation, changes in ocean stratification and nutrient availability, and more severe extreme events. Given predictions of further changes, there is a critical need to understand how marine species will be affected. Here, we used an integrated risk assessment framework to evaluate the vulnerability of 132 chondrichthyans in the Eastern Tropical Pacific (ETP) to the impacts of climate change. Taking a precautionary view, we found that almost a quarter (23%) of the ETP chondrichthyan species evaluated were highly vulnerable to climate change, and much of the rest (76%) were moderately vulnerable. Most of the highly vulnerable species are batoids (77%), and a large proportion (90%) are coastal or pelagic species that use coastal habitats as nurseries. Six species of batoids were highly vulnerable in all three components of the assessment (exposure, sensitivity and adaptive capacity). This assessment indicates that coastal species, particularly those relying on inshore nursery areas are the most vulnerable to climate change. Ocean warming, in combination with acidification and potential deoxygenation, will likely have widespread effects on ETP chondrichthyan species, but coastal species may also contend with changes in freshwater inputs, salinity, and sea level rise. This climate‐related vulnerability is compounded by other anthropogenic factors, such as overfishing and habitat degradation already occurring in the region. Mitigating the impacts of climate change on ETP chondrichthyans involves a range of approaches that include addressing habitat degradation, sustainability of exploitation, and species‐specific actions may be required for species at higher risk. The assessment also highlighted the need to further understand climate change's impacts on key ETP habitats and processes and identified knowledge gaps on ETP chondrichthyan species.
Abstracta El cambio climático es una emergencia medioambiental que amenaza a especies y ecosistemas en todo el mundo. Los océanos han absorbido alrededor del 90% del calor antropogénico y entre el 20% y el 30% de las emisiones de carbono, lo que ha provocado su calentamiento, acidificación, desoxigenación, cambios en la estratificación de los océanos y en la disponibilidad de nutrientes, así como fenómenos extremos más pronunciados. Dadas las predicciones de cambios, hay una importante necesidad de entender cómo las especies marinas se verán afectadas. En este estudio utilizamos una Evaluación Integrada de Riesgos para evaluar la vulnerabilidad de 132 condrictios del Pacífico Tropical Oriental (PTO) a los impactos del cambio climático. Adoptando un enfoque preventivo, estimamos que la vulnerabilidad general al cambio climático es Alta para casi una cuarta parte (23%) de las especies de condrictios del PTO evaluadas y Moderada para gran parte del resto (76%). La mayoría de las especies altamente vulnerables son batoideos (77%), y una gran proporción de éstas (90%) son especies costeras o especies pelágicas que utilizan los hábitats costeros como áreas de crianza. Seis especies de batoideos tuvieron una vulnerabilidad Alta en los tres componentes de la evaluación. Esta evaluación indica que las especies costeras, en particular las que dependen de áreas de crianza costeras, son las más vulnerables al cambio climático. Es probable que el calentamiento de los océanos, junto con la acidificación y la posible desoxigenación, tenga efectos generalizados sobre las especies de condrictios del PTO, pero las especies costeras se verán también afectadas por los cambios en los aportes de agua dulce, la salinidad y el aumento del nivel del mar. Esta vulnerabilidad relacionada con el clima se ve agravada por otros factores antropogénicos que ya se están produciendo en la región, como la sobrepesca y la degradación del hábitat. La mitigación de los impactos del cambio climático sobre los condrictios del PTO implica medidas que incluyan abordar la degradación del hábitat y la sostenibilidad de la explotación pesquera, y acciones para las especies de mayor riesgo son necesarias. Esta evaluación también destaca la necesidad de comprender mejor los impactos del cambio climático en los hábitats y procesos clave del PTO y las lagunas de conocimiento identificadas en relación con las especies de condrictios del PTO.
Recently, the number of people acquiring tattoos has increased, with tattoos gaining significant popularity in people between 20 and 40 years old. Inflammation is a common reaction associated with ...tattooing. The purpose of this study was to evaluate a nanostructured lipid carrier loading pranoprofen (PRA-NLC) as a tattoo aftercare formulation to reduce the inflammation associated with tattooing. In this context, the in vitro drug release and the ex vivo permeation-through-human-skin tests using Franz cells were appraised. The tolerance of our formulation on the skin was evaluated by studying the skin's biomechanical properties. In addition, an in vivo anti-inflammatory study was conducted on mice skin to evaluate the efficacy of the formulation applied topically after tattooing the animals. PRA-NLC showed a sustained release up to 72 h, and the amount of pranoprofen retained in the skin was found to be 33.48 µg/g/cm
. The formulation proved to be well tolerated; it increased stratum corneum hydration, and no signs of skin irritation were observed. Furthermore, it was demonstrated to be non-cytotoxic since the cell viability was greater than 80%. Based on these results, we concluded that PRA-NLC represents a suitable drug delivery carrier for the transdermal delivery of pranoprofen to alleviate the local skin inflammation associated with tattooing.
Allergic diseases are under-investigated and overlooked health conditions in developing countries. We measured the prevalence of food allergy (FA), airborne allergic disease, and allergic ...sensitisation among adolescents living in 2 socio-demographically disparate regions in Ecuador. We investigated which risk factors are associated with these conditions.
A cross-sectional study involved 1338 students (mean age: 13 ± 0.9 years old) living in Cuenca (n = 876) and Santa Isabel (n = 462). History of allergic symptoms (noted by parents or doctor) to food, house dust mites (HDM), pollen, and pets were recorded. Sociodemographic characteristics, environmental exposures, and parental history of allergic disorders data were collected. Sensitisation to 19 food and 20 aeroallergens was measured by skin-prick testing (SPT). FA and airborne allergic diseases (to HDM, pollen, cat, or dog) were defined as a report of allergic symptoms noted by doctor, together with a positive SPT (wheal size ≥3 mm). Logistic regression models were used to identify environmental and parental factors associated with allergic conditions.
FA was prevalent among 0.4% (95% CI 0.2%–0.9%), and food sensitisation among 19.1% of the adolescents. Shrimp was the most frequent food linked with FA and food sensitisation. Risk factors associated with FA could not be evaluated due to the low prevalence. Food sensitisation was higher among adolescents exposed to family smoking (OR 1.63, 95% CI 1.14–2.34, p = 0.008) and those with parental history of allergic disorders (OR 1.68, 95% CI 1.13–2.49, p = 0.01), but less common among adolescents owning dogs (OR 0.59, 95% CI 0.41–0.84, p = 0.003).
Airborne allergic diseases were prevalent amongst 12.0% of the adolescents (95% CI: 10.4–13.9, n = 1321), with HDM as the primary allergen (11.2%). Airborne allergic diseases were less common among adolescents with more siblings (OR 0.79, 95% CI 0.65–0.96, p = 0.02) and those who lived with farm animals in the first year of life (OR 0.47, 95% CI 0.23–0.95, p = 0.04), but, most common among adolescents with a smoking family (OR 1.67, 95% CI 1.04–2.70, p = 0.03) and with a parental history of allergic disorders (OR self-perceived: 2.62, 95% CI 1.46–4.71, p = 0.001; OR diagnosed by a doctor: 4.07, 95% CI 2.44–6.80, p < 0.001).
FA and airborne allergies are less prevalent in Ecuador than in developed regions; there is a great dissociation between the prevalence of allergic disease and allergic sensitisation. Shrimp and HDM were the most prevalent allergens. Risk factors identified in this study to be related to allergic diseases should be considered by physicians, health practitioners, and epidemiologists in Ecuador.
Latin American countries have a high diversity of sharks, rays, and chimaeras, yet many species are at high risk of extinction due to numerous threats. The conservation of chondrichthyans is key to ...achieving healthy and productive aquatic ecosystems, and countries in Latin America are increasingly recognizing the need for aligning conservation strategies across jurisdictions with similar ecological and socioeconomic challenges. Reflecting on the current state of knowledge and providing consensus expert opinion on research priorities are critical steps to ensure sound management and conservation strategies for chondrichthyans. The present study is a multinational collaboration by leading researchers in Latin America to identify the top-ten research priorities for the conservation of chondrichthyans within this region. Our results were highlighted from a total of 20 broader relevant topics including taxonomy and biology, ecological function, climate change and other stressors, contribution to local economies, and international collaboration. This constitutes the first comprehensive academic perspective on research priorities for chondrichthyans in Latin America which considers the varied perceptions and perspectives related to the management of sharks, rays, and chimaeras across the region and beyond. The main conservation implications highlighted by our study relate to the urgent need to implement, evaluate and/or improve management regulations based on scientific evidence and interdisciplinary research, especially in areas with little progress on the subject and/or where species threatened by extinction are distributed.
Display omitted
•Chondrichthyans conservation in Latin America requires regulations based on research under an interdisciplinary approach.•We provide an academic perspective on chondrichthyan research top-ten priorities in the region.•Obtaining evidence is urgently needed to develop, apply, and improve successful sustainable management.•These priorities are related to previous and novel knowledge in taxonomy, biology, fisheries, and sociology.•Conservation can be compromised by mitigable factors such as pollution and climate change.
In the present study, the inhibitory effect of chlorogenic acid (CGA), a phenolic compound with potential antitumor effects, on circulating microRNA 31 (miR-31), was evaluated in RKO colon cancer ...cells. The capacity of gold nanoparticles (AuNPs) to enhance miR-31 quantification after treatment with CGA was assessed. RKO cells were treated with different concentrations of CGA for 24, 48 and 72 h, after which AuNPs coupled to CD81 were added to the supernatants. Total RNA was extracted, and miR-31 was quantified by reverse transcription-quantitative PCR. The results revealed an 85% decrease in miR-31 level following treatment with 1,000 microM CGA for 72 h, and the highest capacity to detect miR-31 (after treatment and isolation with AuNPs + CD81) was observed at 24 h. Furthermore, CGA decreased the expression of the miR-31 oncogene in an in vitro colon cancer model, and the use of AuNPs enhanced the levels of miRNA detection. The results suggest that miR-31 inhibition is one mechanism by which CGA decreases colon cancer cell proliferation. Moreover, AuNPs can increase the capacity of miR-31 quantification, representing a new strategy to develop non-invasive tools for the molecular diagnosis and monitoring of colon cancer. Key words: microRNA 31, chlorogenic acid, gold nanoparticles, oncogene inhibitor, colon cancer
PDF
