Revisión
URI permanente para esta colección
Examinar
Examinando Revisión por Materia "Medicine"
Mostrando 1 - 6 de 6
Resultados por página
Opciones de ordenación
Ítem Acceso Abierto Carotid body chemoreceptors, sympathetic neural activation, and cardiometabolic disease(2016) Iturriaga, R.; Del Rio, R.; Idiaquez, J.; Somers, V.K.The carotid body (CB) is the main peripheral chemoreceptor that senses the arterial PO2, PCO2 and pH. In response to hypoxemia, hypercapnia and acidosis, carotid chemosensory discharge elicits reflex respiratory, autonomic and cardiovascular adjustments. The classical construct considers the CB as the main peripheral oxygen sensor, triggering reflex physiological responses to acute hypoxemia and facilitating the ventilatory acclimation to chronic hypoxemia at high altitude. However, a growing body of experimental evidence supports the novel concept that an abnormally enhanced CB chemosensory input to the brainstem contributes to overactivation of the sympathetic nervous system, and consequent pathology. Indeed, the CB has been implicated in several diseases associated with increases in central sympathetic outflow. These include hypertension, heart failure, sleep apnea, chronic obstructive pulmonary disease and metabolic syndrome. Indeed, ablation of the CB has been proposed for the treatment of severe and resistant hypertension in humans. In this review, we will analyze and discuss new evidence supporting an important role for the CB chemoreceptor in the progression of autonomic and cardiorespiratory alterations induced by heart failure, obstructive sleep apnea, chronic obstructive pulmonary disease and metabolic syndrome.Ítem Acceso Abierto Extensively drug-resistant tuberculosis: Report and literature review on two cases requiring prolonged treatment(Medical Science International, 2016) Matos-Tocasca, M.; de La Cruz-Ku, G.; Auccacusi, E.; Fernandez-Salas, D.; García-Ahuanari, T.; Valcarcel-Valdivia, B.Objective: Unusual clinical course Background: Extensively drug-resistant tuberculosis (XDR-TB) is a global problem due to the high morbidity and mortality it causes. Peru is one of the countries with the highest numbers of cases of XDR-TB, which increase every year. Case Report: We present the case of two siblings who developed XDR-TB, underwent surgery twice, and were in individualized treatment for more than 6 years. Finally they achieved remission of symptoms, despite not having standardized treatment schemes during their diagnosis period. Conclusions: Extensively drug-resistant tuberculosis can be cured with a treatment that involves both medical care and patient actions to achieve remission of the disease. © Am J Case Rep.Ítem Acceso Abierto Factores sociolaborales asociados al riesgo cardiovascular según el score de Framingham en trabajadores de Lima, 2015 [Social-occupational factors associated with cardiovascular risk according to Framingham score in workers in Lima, 2015](Sociedad Argentina de Endocrinologia y Metabolismo, 2016) Mejia, C.R.; Chacón, J.I.; Cavero, M.; Orihuela, R.; Orihuela, E.Objective: To determine the social-occupational factors associated with cardiovascular risk in a population of workers of healthy private health insurance company in Lima, Peru. Methods: A cross-sectional study of secondary data from the data of workers who were seen in an institution as part of their occupational examinations. The Framingham score was used to determine the risk of having a cardiovascular event at 10 years. This score was also analysed along with other social and occupational variables were taken and shown in two populations (< 30 years or ≥30 years, according to score criteria). Statistical association was determined using generalised linear models. Results: Of the 4,134 workers examined, 71.4% (2,950) were men, and the median age was 35 years (range 18-73 years old). More than two-thirds (39%, 1,613) of workers had a low risk to minimum risk. In the multivariate statistics on those < 30 years: Male gender (adjusted prevalence ratio [aPR]: 7.53; 95% CI: 7.01-8.09) and body mass index (aPR: 1.02; 95% CI: 1.01- 1.04) increased the frequency of cardiovascular risk. For workers ≥ 30 years: Male gender (aPR: 2.78; 95% CI: 2.41-3.20), the body mass index (aPR: 1.01; 95% CI: 1.001-1.014), the notsingle marital status (aPR: 1.14; 95% CI: 1.08-1.21) and being an administrative worker (aPR: 1.06; 95% CI: 1.01-1.13) increased the frequency of cardiovascular risk. Conclusions: There are some social-occupational factors that influence cardiovascular risk. These results can be used for occupational medicine, proper monitoring, and improving lifestyles in the workers. © 2016 Sociedad Argentina de Endocrinología y Metabolismo.Ítem Acceso Abierto Ingesta de arsénico: el impacto en la alimentación y la salud humana [Arsenic intake: impact in human nutrition and health](Instituto Nacional de Salud, 2018) Medina-Pizzali, M.L.; Robles, P.; Mendoza, M.; Torres, C.Arsenic is an element that is widely distributed throughout the environment. Its compounds are mainly in the state of pentavalent and trivalent oxidation; and in inorganic and organic forms. Arsenical species vary in their degree of toxicity, with inorganic compounds being more toxic than organic and trivalent compounds more toxic than pentavalent compounds. There would be interconversion between the less toxic species and other more toxic species and the cooking and processing methods could affect it. Arsenic is a carcinogenic agent and causes multiple negative effects on human health in the short and long term. Non-occupational human exposure to arsenic occurs mainly through water and food. The regulation is variable for each country and is based on WHO standards, the Codex Alimentarius, and the European Union. Many studies focus on determining the total arsenic content but do not identify arsenical species in foods. Globally, fish and seafood, chicken, meat, rice, and seaweed have high levels of arsenic. In Peru, there are few studies on total arsenic content and arsenical species in food despite the fact that we have areas with high levels of environmental contamination. The objective of this review is to discuss exposure to arsenic through food and water intake, related regulations, toxicity, consequences on human health and main foods that contribute to its intake. © 2018, Instituto Nacional de Salud. All rights reserved.Ítem Acceso Abierto Systemic lupus erythematosus: a therapeutic challenge for the XXI century(Springer-Verlag London Ltd, 2014) Ugarte-Gil, M.F.; Alarcón, G.S.Despite significant advances in our understanding of the pathogenesis of systemic lupus erythematosus (SLE), there are only a few drugs approved by the regulatory agencies across the world for the treatment of these patients; in fact, many of the compounds subjected to clinical trials have failed in achieving their primary endpoints. Current therapeutic options include antimalarials which should be used in all SLE patients unless they are strongly contraindicated, glucocorticoids which should be used at the lowest possible dose and for the shortest possible time, and immunosuppressive drugs which should be used judiciously, mainly in patients with severe organ involvements or receiving high doses of steroids to control their disease. Despite improvement on the survival of SLE patients, damage accrual has not varied over the last few decades, reflecting a gap between these therapeutic options and the expectations of these patients and their treating physicians. Biologic compounds can be used in some refractory cases. However, their cost is of great concern for both the patients and the health system. Cost is of special importance in low-income countries, because low-income SLE patients tend to experience a more severe disease having an overall worse prognosis which is compounded by their limited access to the health system. Although a treatment to target based on defined molecular pathways for specific disease subsets is appealing, this is not yet a reality. This review addressed current therapeutic options for SLE patients and the state of the art of investigational drugs targeting pathogenic pathways identified in these patients. © 2014 Clinical Rheumatology.Ítem Acceso Abierto Therapeutic actions of the thiazolidinediones in Alzheimer's disease(Hindawi Publishing Corporation, 2015) Pérez, M.J.; Quintanilla, R.A.Alzheimer's disease (AD) is a multifactorial metabolic brain disorder characterized by protein aggregates, synaptic failure, and cognitive impairment. In the AD brain is common to observe the accumulation of senile plaques formed by amyloid-beta (Aβ) peptide and the neurofibrillary tangles composed of modified tau protein, which both lead to cellular damage and progressive neurodegeneration. Currently, there is no effective therapy for AD; however several studies have shown that the treatments with the peroxisome proliferators activated receptor-gamma (PPARγ) agonists known as thiazolidinedione drugs (TZDs), like rosiglitazone and pioglitazone, attenuate neurodegeneration and improve cognition in mouse models and patients with mild-to-moderate AD. Furthermore, studies on animal models have shown that TZDs inhibit neuroinflammation, facilitate amyloid-β plaque clearance, enhance mitochondrial function, improve synaptic plasticity, and, more recently, attenuate tau hyperphosphorylation. How TZDs may improve or reduce these pathologic signs of AD and what the mechanisms and the implicated pathways in which these drugs work are are questions that remain to be answered. However, in this review, we will discuss several cellular targets, in which TZDs can be acting against the neurodegeneration. © 2015 María José Pérez and Rodrigo A. Quintanilla.