The phenomenon of chemsex has emerged as an essential public health issue in recent years. This systematic review aimed to investigate currently available harm reduction strategies and to evaluate ...the efficacy of the corresponding interventions. Methods: A systematic review of the scientific literature related to harm and risk reduction strategies and the effectiveness of chemsex interventions. Between January 2024 and May 2024, the articles were retrieved from the electronic databases Pubmed, Web of Science, Scopus, PsycInfo, Cochrane, Dialnet, CUIDEN, and SciELO. The review protocol was registered in the PROSPERO database (registration number CRD42024508953). The inclusion criteria were as follows: (I) original studies published in peer-reviewed journals, (II) studies exploring harm reduction interventions for chemsex, and (III) studies reflecting the efficacy of harm reduction interventions for chemsex. Two reviewers independently selected articles by title, abstract, and full paper review and extracted data. Two authors described the selected studies and assessed their methodological quality. Results: The systematic review comprised six scientific papers that met the selection criteria and were obtained from five countries. Although a limited number of studies were included, it was observed that they presented a medium–high methodological quality. Programs evaluated interventions to reduce harm from chemsex, such as a web-based intervention that improved self-efficacy to refuse risky behaviors and accept HIV testing. The studies suggested that peer-led programs can be effective, especially with facilitators who have experienced chemsex dependence. Conclusion: Harm reduction strategies in chemsex are effective and should be promoted by health professionals. Interventions should be accessible, personalized, and non-judgmental to provide appropriate care and support, ensuring a comprehensive and effective public health response.
To assess changes in aqueous humor levels of different interleukins (IL), tumor necrosis factor (TNF)-α and vascular endothelial growth factor (VEGF) in patients with uveitis treated with adalimumab.
...In this study, 24 aqueous humor samples including 12 pre- and post-treatment samples from 6 patients with uveitis treated with subcutaneous adalimumab and 12 samples from patients with cataracts (serving as controls) were evaluated. The levels of IL-1β, IL-2, IL-6, IL-10, TNF-α and VEGF were measured using a Luminex(®) 200™ flow cytometer (Merckmillipore, Merck KGaA, Darmstadt, Alemania) and a highly sensitive ELISA system.
The levels of IL-1β, IL-2, IL-6 and IL-10 in the aqueous humor before and after treatment with adalimumab did not show significant differences. Aqueous VEGF levels significantly reduced after treatment with adalimumab (P = 0.028). Aqueous TNF-α levels did not significantly change after treatment with adalimumab, however the post-treatment level was significantly higher in patients as compared to control subjects (P = 0.032). IL-2 showed significantly higher levels in uveitis patients before treatment as compared to controls (P = 0.024), while its post-treatment levels were almost normalized.
Decrease in the aqueous humor levels of VEGF and IL-2 after treatment with systemic adalimumab indicates that anti-TNF-α therapy induces modifications of some inflammatory mediators involved in the pathogenesis of uveitis. Aqueous humor samples may be useful to assess the effect of adalimumab on intraocular inflammation through measurement of cytokines.
Direct cost analysis of hemodialysis units Durán-Arenas, Luis; Avila-Palomares, Paula D; Zendejas-Villanueva, Rodrigo ...
Salud pública de México,
2011, Letnik:
53 Suppl 4
Journal Article
Recenzirano
Odprti dostop
To estimate and compare direct costs per hemodialysis session in public and private units in Mexico City.
PAATI, a microcosting strategy, was used to determine total costs of four public and two ...private health hospitals in Mexico City. A "shadow study" approach was employed to collect the needed data. Charts containing the "PAATI" information for each session were developed in Microsoft Excel.
The average annual cost per patient undergoing hemodialysis in public units is $158 964.00 MX. The estimated cost for the care of all population estimated in need of renal replacement therapy (via hemodialysis) was estimated to be $10 921 788 072.00 MX.
Human resources and infrastructure availability in México are very limited for nephrology, and in consequence for offering hemodialysis services.
Objetivo. Obtener estimaciones para el tamaño óptimo de unidades de hemodiálisis considerando los factores en la producción de este servicio. Material y métodos. Se realizó un estudio en México en ...2009. Se analizan algunos métodos para calcular el tamaño óptimo de una unidad de hemodiálisis bajo diferentes condiciones: mercado monopolístico, en competencia perfecta y maximización de producción. Resultados. Una unidad óptima con base en los supuestos de este ejercicio de estimación debería de contar con: 16 dializadores (15 activos, uno de reserva) y una purificadora de agua que pueda abastecerlos. Además son necesarios un médico nefrólogo y cinco enfermeras por cada dos turnos, con cuatro turnos por día. Conclusión. Comparando lo óptimo con lo observado en estudios recientes de México, se observan ineficiencias en la operación, particularmente por desaprovechar tanto el potencial del equipo de filtrado de agua como el equipo de salud
OBJETIVO. Estimar y comparar el costo por sesión de hemodiálisis dentro del sector público y privado en la Ciudad de México. MATERIAL Y MÉTODOS. Se calcularon los costos de los insumos utilizados en ...las hemodiálisis de cuatro hospitales públicos y dos privados de la Ciudad de México, mediante la estrategia de micro-costeo denominada PAATI. Para la obtención de los datos se utilizó el método de sombra; además, se empleó Excel para elaborar cédulas en las que se determina el PAATI para cada sesión. RESULTADOS. El costo anual promedio directo en el sector público por el tratamiento de un individuo en hemodiálisis es de $158 964.00 M. N., y el costo de atender a la población que podría demandar terapia de reemplazo renal se estima en $10 921 788 072.00 M. N. CONCLUSIÓN. La disponibilidad de recursos humanos e infraestructura en el país es muy limitada para el campo de la nefrología en general y, en particular, para ofrecer servicios de hemodiálisis, por lo que sería necesario inyectar más recursos para poder responder ante la demanda por insuficiencia renal terminal.
Purpose: To assess changes in aqueous humor levels of different interleukins (IL), tumor necrosis factor (TNF)-α and vascular endothelial growth factor (VEGF) in patients with uveitis treated with ...adalimumab. Methods: In this study, 24 aqueous humor samples including 12 pre- and post-treatment samples from 6 patients with uveitis treated with subcutaneous adalimumab and 12 samples from patients with cataracts (serving as controls) were evaluated. The levels of IL-1β, IL-2, IL-6, IL-10, TNF-α and VEGF were measured using a Luminex ® 200(TM) flow cytometer (Merckmillipore, Merck KGaA, Darmstadt, Alemania) and a highly sensitive ELISA system. Results: The levels of IL-1β, IL-2, IL-6 and IL-10 in the aqueous humor before and after treatment with adalimumab did not show significant differences. Aqueous VEGF levels significantly reduced after treatment with adalimumab (P = 0.028). Aqueous TNF-α levels did not significantly change after treatment with adalimumab, however the post-treatment level was significantly higher in patients as compared to control subjects (P = 0.032). IL-2 showed significantly higher levels in uveitis patients before treatment as compared to controls (P = 0.024), while its post-treatment levels were almost normalized. Conclusion: Decrease in the aqueous humor levels of VEGF and IL-2 after treatment with systemic adalimumab indicates that anti-TNF-α therapy induces modifications of some inflammatory mediators involved in the pathogenesis of uveitis. Aqueous humor samples may be useful to assess the effect of adalimumab on intraocular inflammation through measurement of cytokines.
Prevalence of neurological involvement in Behçet's disease (BD) varies between studies and is associated with high morbimortality. Neurological involvement is classified as parenchymal and ...non-parenchymal involvement (vascular involvement). Treatment of neurological involvement consists of immunosuppressants. Evidence regarding presentation and outcomes in neuro-Behçet's (NB) is scarce.
Observational retrospective study that included consecutive patients diagnosed with BD between 2006 and 2019 in a tertiary hospital of Madrid.
Fifty-seven patients were included with a mean follow-up of 7.83 (±6.98) years. The mean age at diagnosis of BD and first NB episode was 34.7 (± 12.1) and 31.03 (±9.9) years, respectively. Fifty-six NB episodes were registered in 25 patients. Fever (OR 3.39, CI 95% 1.14-10.15) and pseudofolliculitis (OR 4.06, CI 95% 1.11-14.80) were associated to NB. Trigeminal neuralgia was found in 16% (4/25) of patients.
The prevalence of NB in patients with BD was higher than previously described. Fever and pseudofolliculitis were more frequently associated with NB, with low mortality during follow-up.
Objetivo. Obtener estimaciones para el tamaño óptimo de unidades de hemodiálisis considerando los factores en la producción de este servicio. Material y métodos. Se realizó un estudio en México en ...2009. Se analizan algunos métodos para calcular el tamaño óptimo de una unidad de hemodiálisis bajo diferentes condiciones: mercado monopolístico, en competencia perfecta y maximización de producción. Resultados. Una unidad óptima con base en los supuestos de este ejercicio de estimación debería de contar con: 16 dializadores (15 activos, uno de reserva) y una purificadora de agua que pueda abastecerlos. Además son necesarios un médico nefrólogo y cinco enfermeras por cada dos turnos, con cuatro turnos por día. Conclusión. Comparando lo óptimo con lo observado en estudios recientes de México, se observan ineficiencias en la operación, particularmente por desaprovechar tanto el potencial del equipo de filtrado de agua como el equipo de salud.Objective. To estimate the optimum size for hemodialysis units to maximize production given capital constraints. Materials and Methods. A national study in Mexico was conducted in 2009. Three possible methods for estimating a unit's optimum size were analyzed: hemodialysis services production under monopolistic market, under a perfect competitive market and production maximization given capital constraints. Results. The third method was considered best based on the assumptions made in this paper; an optimal size unit should have 16 dialyzers (15 active and one back up dialyzer) and a purifier system able to supply all. It also requires one nephrologist, five nurses per shift, considering four shifts per day. Conclusion. Empirical evidence shows serious inefficiencies in the operation of units throughout the country. Most units fail to maximize production due to not fully utilizing equipment and personnel, particularly their water purifier potential which happens to be the most expensive asset for these units.
Prevalence of neurological involvement in Behçet's disease (BD) varies between studies and is associated with high morbimortality. Neurological involvement is classified as parenchymal and ...non-parenchymal involvement (vascular involvement). Treatment of neurological involvement consists of immunosuppressants. Evidence regarding presentation and outcomes in neuro-Behçet's (NB) is scarce.
Observational retrospective study that included consecutive patients diagnosed with BD between 2006 and 2019 in a tertiary hospital of Madrid.
Fifty-seven patients were included with a mean follow-up of 7.83 (±6.98) years. The mean age at diagnosis of BD and first NB episode was 34.7 (±12.1) and 31.03 (±9.9) years, respectively. Fifty-six NB episodes were registered in 25 patients. Fever (OR 3.39, 95% CI: 1.14–10.15) and pseudofolliculitis (OR 4.06, 95% CI: 1.11–14.80) were associated to NB. Trigeminal neuralgia was found in 16% (4/25) of patients.
The prevalence of NB in patients with BD was higher than previously described. Fever and pseudofolliculitis were more frequently associated with NB, with low mortality during follow-up.
Las manifestaciones neurológicas en la enfermedad de Behçet (EB) presentan una prevalencia variable en la literatura y asocian una mayor morbimortalidad. Se distingue la afectación parenquimatosa y la no parenquimatosa (vascular). El tratamiento de estas manifestaciones se basa en la inmunosupresión. La evidencia sobre la presentación y evolución del neurobehçet (NB) es escasa.
Estudio observacional retrospectivo que incluyó a pacientes consecutivos con diagnóstico de EB entre 2006 y 2019 en un hospital terciario de Madrid.
Se incluyó a 57 pacientes con EB, con un seguimiento medio de 7,83 (±6,98) años. La edad media al diagnóstico de EB y del primer episodio de NB fue 34,7 (±12,1) años y 31 (±9,9) años, respectivamente. Se registraron 56 episodios de NB en 25 pacientes. La fiebre (OR 3,39; IC 95%: 1,14-10,15) y la pseudofoliculitis (OR 4,06; IC 95%: 1,11-14,80) se asociaron a NB. La neuralgia del trigémino se encontró en el 16% (4/25) de los pacientes.
La prevalencia de NB fue mayor que la descrita previamente. La fiebre y la pseudofoliculitis se asociaron a NB y la mortalidad fue baja durante el seguimiento.
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