RESUMEN
OBJECTIVE: To identify culturally appropriate psychological screening measures for children and adolescents with type 1 diabetes in Qatar, determine rates of depressive and anxiety symptoms in a clinical sample, and examine associations between screening measures, demographic variables, medical characteristics, and diabetes treatment outcomes, specifically HbA1c. METHODS: A total of 150 participants with type 1 diabetes aged 10-17 were recruited. Participants were Arabic or English speaking and of Qatari and non-Qatari nationality. Participants completed the Mood and Feelings Questionnaire (child and parent proxy form), the Spence Children's Anxiety Scale, and the Pediatric Quality of Life, Diabetes version (child and parent proxy form). Glycosylated hemoglobin (HbA1c) on the date of the testing was recorded. RESULTS: Approximately ten percent (10.2%) of children and adolescents scored above the cutoff score of 27 indicating clinically significant depressive symptoms, and 12.8% of parents rated their child above the respective cutoff score of 21 for the parent proxy form. Further, 36% of the sample reported clinically significant anxiety symptoms, scoring above the cutoff score of 50. Parent report on their child's quality of life predicted HbA1c (F[6, 140] = 5.42, p = 0.000); B = -0.05, p = 0.002). CONCLUSIONS: Rates of depressive and anxiety symptoms are comparable to those observed in western countries. Thus, systematic screening for depression and anxiety in children and adolescents with type 1 diabetes should be implemented in Qatar. This will help inform decisions to refer to mental health services and thus provide more integrated care, possibly improving treatment outcomes.
Asunto(s)
Instituciones de Atención Ambulatoria , Ansiedad/diagnóstico , Depresión/diagnóstico , Diabetes Mellitus Tipo 1/psicología , Adolescente , Ansiedad/epidemiología , Niño , Depresión/epidemiología , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/terapia , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Masculino , Tamizaje Masivo , Qatar , Calidad de Vida , Encuestas y CuestionariosRESUMEN
Microbial biofilms have gathered interest in recent years as they have become the major cause of nosocomial infections. The abuse and misuse of antibiotics have created a selective pressure that results in widespread formation of resistant bacterial strains and a need to devise novel plant based antimicrobials. In this study, antimicrobial peptides were isolated from Peganum harmala and their effect was examined on biofilm related colonization genes of Pseudomonas aeruginosa and Staphylococcus aureus isolated from burn and surgical wounds. Results showed that in P. aeruginosa isolated from burn wound, the expression of flagellar gene (flgK), pilin gene (pilA) and fimbriae gene (cupA1) was significantly down-regulated indicating that Peganum harmala antimicrobial peptides (PhAMP) damage locomotors of planktonic cells by affecting the gene expression while in resistant biofilm cells, the expression of flgK, cupA1 and polysaccharide synthesis gene (pslA) was enhanced in the presence of PhAMP. In P. aeruginosa isolated from surgical wounds which was more sensitive; the expression of flgK, pilA, cupA1 and pslA was significantly down-regulated in biofilms and planktonic cells in the presence of PhAMP thus disrupting locomotors of planktonic as well as biofilm cells. In S. aureus isolated from burn wounds; the expression of capsular polysaccharide synthesis gene (CPS5) and inter cellular adhesion gene (icaA) was significantly up-regulated in biofilms as well as in planktonic cells in response to PhAMP stress showing resistance mechanism. Thus these genes can be used as efficient resistance markers for bacterial pathogens against antimicrobial agents.
Asunto(s)
Antibacterianos/farmacología , Biopelículas/efectos de los fármacos , Peganum , Péptidos/farmacología , Pseudomonas aeruginosa/efectos de los fármacos , Staphylococcus aureus/efectos de los fármacos , Proteínas Bacterianas/genética , Proteínas Fimbrias/genética , Regulación Bacteriana de la Expresión Génica/efectos de los fármacos , Humanos , Plancton/efectos de los fármacos , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/fisiología , Staphylococcus aureus/genética , Staphylococcus aureus/fisiologíaRESUMEN
Proteins encoded by the Pseudomonas aeruginosa pvcA-D operon synthesize a novel isonitrile functionalized cumarin termed paerucumarin. The pvcA-D operon enhances the expression of the P. aeruginosa fimbrial chaperone/usher pathway (cup) genes and this effect is mediated through paerucumarin. Whether pvcA-D and/or paerucumarin affect the expression of other P. aeruginosa genes is not known. In this study, we examined the effect of a mutation in pvcA-D operon the global transcriptome of the P. aeruginosa strain PAO1-UW. The mutation reduced the expression of several ironcontrolled genes including pvdS, which is essential for the expression of the pyoverdine genes. Additional transcriptional studies showed that the pvcA-D operon is not regulated by iron. Exogenously added paerucumarin enhanced pyoverdine production and pvdS expression in PAO1-UW. Iron-chelation experiments revealed that purified paerucumarin chelates iron. However, exogenously added paerucumarin significantly reduced the growth of a P. aeruginosa mutant defective in pyoverdine and pyochelin production. In contrast to other secondary metabolite, Pseudomonas quinolone signal (PQS), paerucumarin is not localized to the P. aeruginosa membrane vesicles. These results suggest that paerucumarin enhances the expression of iron-controlled genes by chelating iron within the P. aeruginosa extracellular environment. Although paerucumarin chelates iron, it does not function as a siderophore. Unlike PQS, paerucumarin is not associated with the P. aeruginosa cell envelope.