A novel, simple and sensitive high-performance liquid chromatography with fluorescence detection method was developed and validated for the characterization of the preclinical pharmacokinetics of ...melatonin under pregnant conditions. Plasma samples (25 µL) were treated with 30 µL of ethanol absolute (containing the internal standard, IS). After a centrifugation process, aliquots of supernant (5 µL) were injected into the chromatographic system. Compounds were eluted on a Xbridge C18 (150 mm x 4.6 mm i.d., 5 µm particle size) maintained at 30°C. The mobile phase consisted in a mixture of aqueous solution of 0.4% phosphoric acid and acetonitrile (70:30 v/v). The wavelengths were set at 305 nm (excitation) and 408 nm (emission) and the total analysis time was 8 min/sample. All validation tests were obtained with accuracy and precision, according to FDA guidelines, over the concentration range of 0.005-20 µg/mL. Pharmacokinetic study showed that melatonin systemic exposure increased from day 14, with a significant difference at 19 days of gestation compared to the control group. Our findings suggest a decreased metabolism of melatonin as result of temporary physiological changes that occur throughout pregnancy. However, other maternal physiological changes cannot be ruled out.
Introduction
Scalp cooling (SC) aims to prevent chemotherapy‐induced alopecia. The goal of this systematic review is to tackle ethical, legal, organizational and social issues related to SC.
Methods
...A critical appraisal of the literature was carried out using a systematic review design. MEDLINE, Embase and Web of Science databases were searched up until 2 June 2021. Studies addressing these aspects in English or Spanish were considered. Representatives of both patient associations and professional scientific societies related to the topic participated in the design of the protocol and the review of the findings.
Results
A total of 17 studies were included. Articles were critically appraised using the MMAT and SANRA. Findings were organized into four categories: (1) ethical aspects focused on equal access, gender equity and doctor–patient communication supported by Patient Decision Aids (PtDAs); (2) patient perspective and acceptability; (3) professional perspective and acceptability; (4) organizational aspects focused on accessibility and feasibility.
Conclusion
Cancer patients' expectations when using SC need to be adjusted to reduce the potential distress associated with hair loss. PtDAs could help patients clarify their values and preferences regarding SC. Equal access to technology should be guaranteed.
Patient or Public Contribution
In this systematic review, the representatives of the patient associations (Ms. María Luz Amador Muñoz of the Spanish Association Against Cancer AECC and Ms. Catiana Martinez Cánovas of the Spanish Breast Cancer Federation FECMA) participated in the review of the study protocol, as well as in the results, discussion and conclusions, making their contributions. In the type of design of these studies (systematic reviews), it is not usual to have the direct participation of patients, but in this one, we have done so, as it is a systematic review that is part of a report of the Spanish Network of Health Technology Assessment Agencies (ETS).
Objective
To assess the effectiveness and tolerability of perampanel (PER) monotherapy in routine clinical practice for the treatment of focal onset and generalized tonic‐clonic seizures (GTCS).
...Methods
This multicenter, retrospective, observational study was conducted in patients aged ≥12 years treated with PER as primary monotherapy or converted to PER monotherapy by progressive reduction of background antiepileptic drugs. Outcomes included retention, responder, and seizure‐free rate after 3, 6, and 12 months and tolerability throughout the follow‐up.
Results
A total of 98 patients (mean age = 49.6 ± 21.7 years, 51% female) with focal seizures and/or GTCS were treated with PER monotherapy for a median exposure of 14 months (range = 1‐57) with a median dose of 4 mg (range = 2‐10). The retention rates at 3, 6, and 12 months and last follow‐up were 93.8%, 89.3%, 80.9%, and 71.4%, respectively. The retention rates according to the type of monotherapy (primary vs conversion) did not differ (log‐rank P value = .57). Among the 98 patients, 61.2% patients had seizures throughout the baseline period, with a median seizure frequency of 0.6 seizures per month (range = 0.3‐26). Responder rates at 3, 6, and 12 months were 79.6%, 70.1%, and 52.8%, respectively, and seizure freedom rates at the same points were 62.7%, 56.1%, and 41.5%. Regarding the 33 patients who had GTCS in the baseline period, 87.8% were seizure‐free at 3 months, 78.1% at 6 months, and 55.1% at 12 months. Over the entire follow‐up, PER monotherapy was generally well tolerated, and only 16% of patients discontinued PER due to adverse events (AEs). Female patients were found to be at a higher risk of psychiatric AEs (female vs male odds ratio = 2.85, 95% confidence interval = 1‐8.33, P = .046).
Significance
PER demonstrated good effectiveness and a good safety profile when used as primary therapy or conversion to monotherapy at relatively low doses, in a clinical setting with patients with focal seizures and GTCS.
Spontaneous bleedings occurring into joints (hemarthrosis) are the most common manifestations of hemophilia and causes severe joint damage ultimately resulting in joint disfunction known as ...hemophilic arthropathy. Among available therapeutic options for reducing recurrent hemarthrosis-associated damage, radiosynoviorthesis (RS) has proven effective in improving joint function.
To assess the impact of RS with Yttrium(90) citrate (C-Y(90)) on frequency of hemarthroses and joint function in a group of pediatric patients.
Between November 1998 and February 2017, we evaluated 27 pediatric patients with mild, moderate or severe hemophilia with haemophilic arthropathy. Overall, RS was applied in 60 joints. Some patients received more than one single intra-articular injection with C-Y(90).
During the follow-up, one patient showed joint bleeding 15 months after RS, one patient after 12 months and one patient after 45 days. The episodes of hemarthrosis were reduced and joint function significantly improved in all patients.
RS with C-Y(90) is a simple and safe treatment for reducing the frequency of hemarthroses in patients with hemophilia. It decreases the use of factor VIII / IX and improves joint function.
Partitiviruses (dsRNA viruses, family
Partitiviridae
) are ubiquitously detected in plants and fungi. Although previous surveys suggested their omnipresence in the white root rot fungus,
Rosellinia ...necatrix
, only a few of them have been molecularly and biologically characterized thus far. We report the characterization of a total of 20 partitiviruses from 16
R. necatrix
strains belonging to 15 new species, for which “
Rosellinia necatrix partitivirus 11
–
Rosellinia necatrix partitivirus 25
” were proposed, and 5 previously reported species. The newly identified partitiviruses have been taxonomically placed in two genera,
Alphapartitivirus
, and
Betapartitivirus
. Some partitiviruses were transfected into reference strains of the natural host,
R. necatrix
, and an experimental host,
Cryphonectria parasitica
, using purified virions. A comparative analysis of resultant transfectants revealed interesting differences and similarities between the RNA accumulation and symptom induction patterns of
R. necatrix
and
C. parasitica
. Other interesting findings include the identification of a probable reassortment event and a quintuple partitivirus infection of a single fungal strain. These combined results provide a foundation for further studies aimed at elucidating mechanisms that underly the differences observed.
During the COVID-19 pandemic, a considerable proportion of patients developed a severe condition that included respiratory failure, shock, or multiple organ dysfunction. Acute Kidney Injury (AKI) has ...been recognized as a possible cause of severe COVID-19 development. Given this, this study investigates the occurrence and consequences of AKI in Mexican patients to contribute to better knowledge and management of this problem. Methods: Using a retrospective observational cohort methodology, we investigated 313 cases from a cohort of 1019 patients diagnosed with COVID-19 at the IMSS Zacatecas General Hospital of Zone No. 1 in 2020. The prevalence of AKI was determined using the AKIN criteria based on serum creatinine levels and a detailed review of demographic characteristics, medical history, comorbidities, and clinical development. Results: The data showed a 25.30% prevalence of AKI among patients infected with severe COVID-19. Remarkably, these patients with AKI exhibited an advanced age (>65 years), arterial hypertension, a higher number of white blood cells during admission and the hospital stay, and elevated levels of C-reactive protein, serum creatinine, and blood urea nitrogen (BUN). Clinically, patients with AKI had signs of prostration, pneumonia, and the requirement for ventilatory assistance when compared to those without AKI. Finally, those diagnosed with AKI and COVID-19 had a 74% death rate. Relative risk analyses indicated that age (>65 years), arterial hypertension, high creatinine levels, endotracheal intubation, and pneumonia are associated with the development of AKI. On the other hand, among the protective factors against AKI, high hemoglobin levels and the consumption of statins during COVID-19 were found. Conclusions: The findings of this study underscore the significance of promptly identifying and effectively managing AKI to potentially alleviate the negative consequences of this complication within the Mexican population during COVID-19.
El objetivo del artículo es determinar el aporte de los flujos de remesas, en la lucha contra la pobreza por ingresos, pobreza por necesidades básicas insatisfechas (NBI) y su influencia en la oferta ...laboral interna, a través de la Encuesta Nacional de Empleo, Desempleo y Subempleo (ENEMDU) publicada por el Instituto Nacional de Estadísticas y Censos (INEC), en el período 2010 – 2018. La metodología empleada se fundamentó en técnicas econométricas cuasi experimentales (evaluación de impacto), que a través del emparejamiento entre los grupos examinados, beneficiarios de remesas (tratados) y no beneficiarios (control), permitió aparear correctamente el impacto de causalidad de las remesas en la pobreza y oferta laboral. Estos flujos, no parecen haber logrado solucionar los niveles de pobreza y, contrariamente, presentan un efecto negativo en la oferta laboral doméstica.
This article discusses current challenges in the field of global health and the World Health Organization’s (WHO) strategies to address them. It highlights the importance of measuring the health ...impacts of global recession and globalization and the need for human-centered approaches to sustainable development. Emphasis is placed on commitment to health equity and the use of strategic partnerships for health at global, national, and local levels. Improving the health and well-being of populations, as well as public health equity, are core principles of the 2030 Agenda for the Sustainable Development Goals (SDGs). These principles are expressed in SDG 3, which promotes universal access to health services and systems and recognizes global health as a basic human right. It highlights the importance of strategic partnerships to combat emerging health crises, improve public health indices, and address the burden of chronic disease. These partnerships are contemplated in SDG 17 and are manifested in different modalities, such as network governance, cross-sector collaboration, public–private partnership, and social participation. This diversity of alliances has played an important role in scaling up and strengthening universal health systems around the world, including in Latin America and the Caribbean. The text concludes by presenting the essential characteristics of these inter-organizational and inter-institutional alliances in the field of global health.
The presence of arboreal legumes in silvopastoral systems (SPS) may affect litter production and quality, and the characteristics and distribution of soil organic matter (OM). Senescent leaves from ...two tree legumes
Gliricidia sepium
(Jacq.) Kunth ex. Walp. (Gliricidia) and
Mimosa caesalpiniifolia
Benth. (Sabia) in SPS with
Urochloa decumbens
Stapf. R. Webster (signalgrass), and from signalgrass pasture in monoculture (Signalgrass), were collected when still attached to the plant and incubated on the ground during 0, 4, 8, 16, 32, 64, 128, and 256 days. Response variables included the disappearance of dry matter (DM), OM, C, N, lignin, acid detergent insoluble nitrogen, and C:N and lignin:N ratio. Single negative exponential models were adjusted to estimate the relative decomposition rate (
k
). The decomposition rate (
k
) of DM, OM, and C was greater for Gliricidia and Signalgrass (
P
< 0.05) compared to Sabia, incorporating 801 g kg DM
total
−1
, 850 g kg OM
total
−1
, and between 840 and 860 g kg C
total
−1
. Gliricidia showed greater N release rate compared to Sabia and Signalgrass, with an estimated disappearance of 23, 4, and 6 mg N g DM
–1
for Gliricidia, Sabia, and Signalgrass, respectively. Tree legumes showed lesser
k
for C:N ratio and greater for lignin concentration (
P
< 0.05). Gliricidia had greater release of nutrients to the soil, while Sabia had slower decomposition rates, but with the potential to form a more stable OM because of more recalcitrant compounds left behind. The
k
of Signalgrass was limited by the lesser N concentration and high C:N ratio in the litter, contributing to immobilization of N during litter decomposition.
Background: During 2020 and 2021, over 50.2 million individuals were forced to leave their homes to escape the impacts of climate-related disasters, unable to practice social isolation or ...self-quarantine. A considerable proportion of them reside in densely populated areas with a lack of basic services such as water and sanitation and limited access to essential healthcare. This study aimed to estimate the internal displacements during 2020 and 2021 due to climate-related events, and review the evidence for proposing policy recommendations. Methods: Data from the Internal Displacement Monitoring Centre were used for assessing internal displacement by disasters during 2020 and 2021. In addition, the authors conducted a bibliographic review to analyse the responses to internal displacements in climate-related disasters. Results: There were 883 severe storms and 1567 flood events resulting in 50.2 million internal displacements globally. Through the documents reviewed, the legal framework, the vulnerabilities and current challenges of internally displaced persons, and the response policy recommendations were analysed. Conclusions: The increased awareness of displacement and migration, particularly driven by climate-related factors, aligns with international agreements emphasising coordinated action. This recognition becomes even more critical in the context of the convergence of climate-related displacements and the potential for future pandemics.
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