RESUMEN
We studied the two-step crystallisation process of a magnetic active 2D-granular system placed on different lens concaveness and under the action of an alternating magnetic field which controls its effective temperature. We have observed that the two-step features of the crystallisation process are more evident as the depth of the parabolic potential increases. At the initial formation of the nucleus, as a first step, in the central region of the lens an amorphous aggregate is formed. In an ulterior second step, this disordered aggregate, due to the effective temperature and the perturbations caused by the impacts of free particles moving in the surrounding region, evolves to an ordered crystalline structure. The nucleus size is larger for deeper concaveness of the parabolic potential. However, if the depth of the parabolic potential exceeds a certain value, the reordering process of the second step does not occur. The crystal growth occurs similarly; small disordered groups of particles join the nucleus, forming an amorphous shell of particles which experiments a rearranging while the aggregate grows. In the explored range of the depths of the parabolic potential, crystallisation generally occurs quicker as the deeper parabolic potential is. Also, aggregates are more clearly round-shaped as parabolic potential depth increases. On the contrary, the structures are more branched for a smaller depth of the parabolic potential. We studied the structural changes and features in the system by using the sixth orientational order parameter and the packing fraction.
RESUMEN
It has been shown that a nonvibrating magnetic granular system, when fed by an alternating magnetic field, behaves with most of the distinctive physical features of active matter systems. In this work, we focus on the simplest granular system composed of a single magnetized spherical particle allocated in a quasi-one-dimensional circular channel that receives energy from a magnetic field reservoir and transduces it into a running and tumbling motion. The theoretical analysis, based on the run-and-tumble model for a circle of radius R, forecasts the existence of a dynamical phase transition between an erratic motion (disordered phase) when the characteristic persistence length of the run-and-tumble motion, â_{c}
RESUMEN
La sangre normalmente transporta pequeñas cantidades de oxígeno (O2) disuelto en el plasma y altas cantidades combinadas en forma química con la hemoglobina. La presión parcial depende solo del oxígeno disuelto físicamente, lo que determina cuánto oxígeno se combinará con hemoglobina. La curva de disociación de la hemoglobina describe la reversibilidad de la reacción entre oxígeno y hemoglobina. Los factores habituales que aumentan o disminuyen la afinidad de la hemoglobina por el oxígeno son el pH, presión parcial de CO2, temperatura y 2,3 difosfoglicerato. La sangre también transporta grandes cantidades en forma de bicarbonato y bajas cantidades de CO2 disuelto en plasma y combinado con proteínas como compuestos carbamino. La desoxihemoglobina favorece la formación de compuestos carbamínicos y promueve el transporte del CO2 como bicarbonato uniéndose al hidrógeno proveniente de la disociación del ácido carbónico. A continuación se describe en forma detallada los mecanismos fisiológicos del transporte de gases en sangre.
Blood normally carries small amounts of oxygen dissolved in plasma and large amounts chemically combined with hemoglobin. Partial pressure of oxygen depends only on physically dissolved oxygen which determines how much oxygen will combine with hemoglobin. The oxygen-hemoglobin dissociation curve (or oxyhemoglobin dissociation curve) describes the reversibility of the reaction between oxygen and hemoglobin. The usual factors that increase or decrease the affinity of hemoglobin for oxygen are pH, CO2 partial pressure, temperature, and 2,3 diphosphoglycerate. Blood also carries large amounts of CO2 as bicarbonate and low amounts dissolved in plasma and combined with proteins as carbamino compounds. Deoxyhemoglobin favors the formation of carbamino compounds and promotes the transport of CO2 as bicarbonate by joining the hydrogen from the dissociation of carbonic acid. The physiological mechanisms of gas transport in blood are described in detail below.
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Humanos , Oxígeno/sangre , Fenómenos Fisiológicos Respiratorios , Dióxido de Carbono/sangre , Transferencia de OxígenoRESUMEN
The metabolic peculiarities of felines favor an intoxication. Fifty healthy female cats were divided into five groups: PG (placebo group), G2 (cefazolin), G3 (ceftriaxone), G4 (enrofloxacin) and G5 (ampicillin) were used. The parameters evaluated were: total expired carbon dioxide (ETCO2), oxygen saturation in hemoglobin (SpO2), heart rate (HR), respiratory rate (RR), body temperature (BT), systolic, mean and diastolic blood pressure (SBP, mBP and DBP) by invasive method, at T0, 5 (T5), 10 (T10), 15 (T15), 20 (T20), 25 (T25) and 30 (T30) minutes after administration of the treatments. HR presented reduction in G2 compared to PG at all times, except T20, and in G4, T25 and T30 were lower than the T0 values (P<0.05). BT showed increase in the G3 at T0 and T5 and all groups showed reduction in the values of BT relative to T0 (P<0.05). ETCO2 increased in G2 and G5 at all times compared to PG (P<0.05) and there were no differences among the times within each group. It was concluded that ceftriaxone is safer for the prophylactic antimicrobial use in cats, however the other antimicrobials are also indicated, because all the parameters, in all groups, basically did not change over the study and when this occurs it remains in reference interval.(AU)
As peculiaridades metabólicas dos felinos favorecem quadro de intoxicação. Foram utilizadas 50 gatas saudáveis, que foram divididas em cinco grupos: GP (grupo placebo), G2 (grupo cefazolina), G3 (grupo ceftriaxona), G4 (grupo enrofloxacina) e G5 (grupo ampicilina). Os seguintes parâmetros foram avaliados: dióxido de carbono expirado (ETCO2), saturação de oxigênio na hemoglobina (SpO2), frequência cardíaca (FC), frequência respiratória (FR), temperatura corporal (T°C), pressão arterial sistólica,média e diastólica (PAS, PAM e PAD), pelo método invasivo, em 0 (T0), 5 (T5), 10 (T10), 15 (T15), 20 (T20), 25 (T25) e 30 (T30) minutos após a administração dos tratamentos. A FC apresentou redução no G2 em relação ao GP em todos os momentos, exceto no T20, e, no G4, o T25 e o T30 foram inferiores aos valores do T0 (P<0,05). A T°C apresentou aumento no G3 no T0 e no T5, e todos os grupos apresentaram redução nos valores da T°C em relação ao T0 (P<0,05). O ETCO2 apresentou aumento no G2 e no G5, em todos os momentos, em relação ao GP (P<0,05). Concluiu-se que a ceftriaxona é mais segura para uso profilático em gatos, entretanto os outros antibióticos também são recomendados, pois todos os parâmetros praticamente não se modificaram e, quando alterados, mantiveram-se dentro dos padrões de referência.(AU)
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Animales , Gatos , Ceftriaxona/administración & dosificación , Frecuencia Respiratoria/efectos de los fármacos , Frecuencia Cardíaca/efectos de los fármacos , Antiinfecciosos/administración & dosificación , Antiinfecciosos/efectos adversos , Hemodinámica , Anestesia Intravenosa/veterinariaRESUMEN
Cervical cancer is characterized by the cellular transformation caused by Human Papillomavirus (HPV), favoring cell proliferation, migration, invasion, and metastasis. Cervical cancer is conventionally treated with radiation therapy, and chemotherapy focused on the destruction of tumor cells. However, chemoresistance and low selectivity between tumor and non-tumor cells have been reported, causing side effects in patients. Metabolites of natural origin have shown selectivity against tumor cells, suggesting their use for reducing the side effects caused by drugs used in conventional therapy. Among these compounds, several natural coumarins stand out, such as auraptene, scopoletin, osthole, and praeruptorin, of which antiproliferative, anti-migratory, and anti-invasive activity have been reported. Auraptene, scopoletin, osthole, and praeruptorin show a cytotoxic or antiproliferative effect on cervical tumor cells, arresting the cell cycle by inducing the overexpression of negative regulators of the cell cycle, or inducing cell death by increasing the expression of pro-apoptotic proteins and decreasing that of anti-apoptotic proteins. On the other hand, auraptene, scopoletin, and praeruptorin inhibit the capacity for migration, invasion, and metastasis of cervical tumor cells, mainly by inhibiting the expression and activity of matrix metalloproteinase-2 and -9. The PI3K/Akt signal pathway appears to be central to the anti-tumor activity of the coumarins analyzed in this review. In addition, auraptene, osthole, and praeruptorin are useful in sensitizing tumor cells to radiotherapy or chemotherapeutic molecules, such as FOLFOX, cisplatin, or DOX. Coumarins offer an excellent possibility for developing new drugs as complementary medicine with an integrative approach against cervical cancer.
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Antineoplásicos/uso terapéutico , Cumarinas/uso terapéutico , Neoplasias del Cuello Uterino/tratamiento farmacológico , Animales , Antineoplásicos/farmacología , Terapias Complementarias , Cumarinas/farmacología , Femenino , HumanosRESUMEN
Platelet rich plasma (PRP) is used to speed up tissue repair. Despite its widespread use, the therapeutic application of PRP generates controversies in clinical results due to the variability in methods of obtaining the different preparations and differences between the components of different types of PRP, so it's recommended to mention the type of platelet preparation used. In this article, we describe technical and biologics characteristics of our platelet product, and we compare them to different commercial preparations described in order to validate their clinical use. Our results determine that the preparation can be considered a platelet rich plasma with biological activity in vivo and in vitro, which supports its use as a valid therapeutic tool, alternative to products currently available in Regenerative Medicine. (AU)
Asunto(s)
Humanos , Medicina Regenerativa/tendencias , Plasma Rico en Plaquetas , Tratamiento Basado en Trasplante de Células y TejidosRESUMEN
RESUMEN Introducción: Existen diferentes sistemas de graduación para interpretar la biopsia de glándula salival menor (BGSM) en pacientes con síntomas secos. En la actualidad la metodología recomendada (Focus Score [FS]), aunque no se emplea de forma rutinaria, conlleva discrepancias diagnósticas. Objetivo: Determinar la concordancia de la lectura histopatológica de BGSM entre las técnicas FS y Chisholm Mason (CM) para el diagnóstico de sialoadenitis linfocítica focal en el hospital de San José, entre enero de 2017 y junio de 2018. Métodos: Estudio de concordancia. Se incluyeron BGSM de pacientes con síntomas secos. Se excluyó material no apto para el estudio, o con menos de 4 lóbulos o menos de 8 mm de área. Se clasificaron utilizando las técnicas FS y CM por 2 evaluadores independientes. Se evaluó el acuerdo interobservador, intraobsevador y global entre las pruebas mediante el coeficiente de Kappa de Cohen. Resultados: Se evaluaron 130 biopsias. Los valores K intraobservador entre FS y CM fueron 0,42 para el observador 1 y 0,23 para el observador 2. Los valores K del acuerdo interobservador fueron 0,47 para FS y 0,65 para CM. La concordancia entre los 2 sistemas de puntuación fue K de 0,13. Conclusiones: Se evidencia una probable sobreestimación de focos con CM, que resalta sus debilidades, y mayor precisión con FS. Por ende, la concordancia entre las 2 pruebas es débil. Es necesario un mayor esfuerzo para el uso del método estandarizado de lectura de BGSM con el FS para una correcta interpretación y beneficio en la clasificación de pacientes con síndrome seco.
ABSTRACT Introduction: There are different grading systems for interpreting the minor salivary gland biopsy (MSGB) in patients with dry symptoms (Sicca). The recommended methodology is currently the Focus Score (FS), which, although not performed routinely, results in diagnostic discrepancies. Objective: To determine the concordance of the histopathological reading of MSGB between the FS and Chisholm Mason (CM) techniques for diagnosis of focal lymphocytic sialadenitis at the San José Hospital between January 2017 and June 2018. Methods: Concordance study. MSGB of patients with sicca symptoms were included. Material not suitable for study and / or with less than 4 lobules and / or less than 8 mm of surface area was excluded. They were classified, using the FS and CM techniques, by two independent evaluators. The inter-observer, intra-observer, and overall agreement between the tests were evaluated using Cohen's Kappa coefficient. Results: A total of 130 biopsies were evaluated. The intra-observer K values between FS and CM were 0.42 for observer 1, and 0.23 for observer 2. The K values of the inter-observer agreement were 0.47 for FS, and 0.65 for CM. The concordance between the two scoring systems was K = 0.13. Conclusions: There is evidence of a probable over-estimation of foci with CM, highlighting its weaknesses and greater precision with FS technique, resulting in the weak concordance between the two tests. A greater effort is necessary for the use of the standardised MSGB FS reading method for a correct interpretation and benefit in the classification of patients with dry syndrome.
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Humanos , Síndrome de Sjögren , Diagnóstico , Glándulas Salivales Menores , Sialadenitis , BiopsiaRESUMEN
INTRODUCTION: Aggressiveness is part of the behavioural manifestations associated with some mental disorders; it is a symptom that is difficult to manage and is often resistant to pharmacological measures. Surgery for behavioural disorders emerges as a therapeutic alternative. This procedure consists in performing interventions on different structures of the limbic system in order to correct the alteration of the circuit involved in producing the symptoms. AIM: To describe the clinical outcomes of a posterior hypothalamotomy with gamma knife to control aggressiveness in 20 patients resistant to treatment, who underwent surgery at the Imbanaco Medical Centre between 2013 and 2018. PATIENTS AND METHODS: The severity of the aggressiveness was quantified using the Overt Aggression Scale (OAS) and the Clinical Global Impression Scale (CGI-SI), and its functional impact is evaluated using the Global Assessment of Functioning scale (GAF). RESULTS: Control over aggressiveness was observed in all patients treated by posterior hypothalamotomy with gamma knife, evidenced by a decrease in the scores on the OAS and CGI-SI and an improvement in the GAF. CONCLUSIONS: Posterior hypothalamotomy gives rise to few complications, is a safe procedure and offers good results, suggesting that it could be a good alternative treatment in cases of treatment-resistant aggressiveness where it seems that all the possible pharmacological and therapeutic measures have failed.
TITLE: Hipotalamotomía en pacientes con agresividad refractaria: resultados funcionales.Introducción. La agresividad forma parte de las manifestaciones comportamentales asociadas a algunos trastornos mentales, es un síntoma de difícil manejo y, con frecuencia, es refractaria a las medidas farmacológicas. La cirugía de los trastornos del comportamiento surge como una alternativa terapéutica. Este procedimiento consiste en realizar intervenciones sobre distintas estructuras del sistema límbico, con el fin de corregir la alteración del circuito que estaría implicado en la producción de los síntomas. Objetivo. Describir los resultados clínicos de la hipotalamotomía posterior con gamma knife en el control de la agresividad en 20 pacientes refractarios al tratamiento, intervenidos en el Centro Médico Imbanaco entre 2013 y 2018. Pacientes y métodos. La gravedad de la agresividad se cuantificó mediante la escala de agresividad manifiesta (OAS) y la escala de impresión clínica global (CGI-SI), y su impacto funcional, a través de la escala de evaluación de la actividad global (EEAG). Resultados. El control de la agresividad se observó en todos los pacientes tratados con hipotalamotomía posterior con gamma knife, evidenciado por la disminución en las puntuaciones de la OAS y la CGI-SI y la mejoría en la EEAG. Conclusiones. La hipotalamotomía posterior muestra bajas complicaciones, seguridad en el procedimiento y buenos resultados, lo cual sugiere que podría ser una buena alternativa de tratamiento en los casos de agresividad refractaria donde las medidas farmacológicas y terapéuticas parecen agotarse.
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Agresión , Hipotálamo Posterior/cirugía , Psicocirugía/métodos , Radiocirugia/métodos , Adolescente , Adulto , Trastorno Autístico/complicaciones , Niño , Terapia Combinada , Resistencia a Medicamentos , Femenino , Humanos , Hiperfagia/etiología , Discapacidad Intelectual/complicaciones , Imagen por Resonancia Magnética , Masculino , Neuroimagen , Grupo de Atención al Paciente , Psicocirugía/efectos adversos , Psicotrópicos/uso terapéutico , Radiocirugia/efectos adversos , Índice de Severidad de la Enfermedad , Trastornos del Inicio y del Mantenimiento del Sueño/etiología , Resultado del Tratamiento , Adulto JovenRESUMEN
Aim: To determine prevalence, severity, and risk factors associated with Molar Incisor Hypomineralization (MIH) in schoolchildren between 6 and 15 years of age in Medellin, Colombia. Study design: We conducted a retrospective observational study including 1.075 children born and residing in Medellin, Colombia. A structured questionnaire addressing gestational period and first three years of child's life was administered to biological mothers. Two calibrated examiners established MIH diagnosis following the European Academy of Paediatric Dentistry criteria. Data were analyzed using descriptive statistics, bivariate analysis, and linear regression with a 5% significance. Results: Study population was predominantly male (70.7%), average age was 9.3±1.9 years. Prevalence of MIH was 11,2%. The majority of defects (85%) were mild. MIH was associated with alterations during last gestational trimester, type of childbirth and respiratory problems. Conclusion. MIH prevalence in schoolchildren between 6 and 15 years of age was 11.2%, being mild defects more frequently found. MIH was associated with different factors during pregnancy and the first three years of life.
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Hipoplasia del Esmalte Dental , Complicaciones del Embarazo , Enfermedades Respiratorias , Adolescente , Niño , Colombia , Hipoplasia del Esmalte Dental/complicaciones , Hipoplasia del Esmalte Dental/epidemiología , Femenino , Humanos , Incisivo , Masculino , Diente Molar , Embarazo , Complicaciones del Embarazo/epidemiología , Prevalencia , Enfermedades Respiratorias/complicaciones , Enfermedades Respiratorias/epidemiología , Estudios Retrospectivos , Factores de RiesgoRESUMEN
This work aims to study an alternative technique of cecectomy in roosters using inhalation anesthesia for subsequent use in digestibility experiments. A total of 30 adult chickens of Leghorn breed were used with an average age of 27 wk. The birds were preoxygenated, and the anesthetic induction was performed using isoflurane diluted in oxygen. After proper muscle relaxation, endotracheal intubation was performed using a Murphy catheter and kept in anesthesia under mechanical ventilation with a constant monitoring of electrocardiography variables, heart rate, oxyhemoglobin saturation, and body temperature during the surgical procedure. An incision of approximately 3 cm was made between keel and cloaca in order to expose and extirpate the cecum followed by a simple ligature. The opening of the peritoneal cavity was closed in 2 ways: Sultan suture technique was used for closing the abdominal wall and modified Cushing intradermic continuous points for closing the skin. The time for anesthesia induction and preoperational period noted to be 10 ± 2 min. Surgical procedures completed in 7 ± 1.5 min. No intraoperatively and postoperatively harm observed in animals. Water was immediately provided after the birds returned to cages and feed offered after 24 h of surgery. In remaining birds, no abnormalities were observed during and after the experimental period (3 mo). The present study describes a promising update on cecectomy technique regarding anesthesia induction and surgical procedures in roosters using potential drugs and safer surgical materials without any trans- and postoperative complications.
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Aminoácidos/fisiología , Anestésicos por Inhalación/uso terapéutico , Ciego/cirugía , Pollos/cirugía , Digestión/fisiología , Procedimientos Quirúrgicos del Sistema Digestivo/veterinaria , Isoflurano/uso terapéutico , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , MasculinoRESUMEN
RESUMEN Introducción: La otomicosis en pacientes inmunosuprimidos esta caracterizada por ser bilateral y ser causada por candida. Pocos estudios comparan las características micológicas encontradas en la microscopía directa y el cultivo. Objetivo: Identificar las características clínicas y micológicas de la otomicosis en pacientes diabéticos. Material y método: Estudio transversal en centro hospitalario de segundo nivel. Criterios de inclusión: pacientes diabéticos con diagnóstico clínico de otomicosis. Intervención: la muestra se examinó directamente bajo el microscopio y se cultivó. Resultados: Se incluyeron 17 pacientes, 10 mujeres y 7 hombres con una edad media de 47,5 años. Los síntomas predominantes fueron hipoacusia en 91,4% (n =16), prurito en 82,4% (n =14), otorrea en 76,5% (n=13)y otalgia en 70,6% (n =12). Afección bilateral se encontró en 47,1% (n =8). Estudio directo al microscopio mostró levaduras en 94,1% (n =16) y 5,9% mostró aspergillus (n =1). Cándida fue el género más comúnmente encontrado en los cultivos y en el examen directo microscópico con 94,1% (n =16) y Candida albicans la especie más común con 88,2% (n =15). Conclusión: Candida albicans es el agente etiológico más común en pacientes diabéticos con otomicosis. Su presentación clínica más frecuente es hipoacusia, prurito y otorrea. El examen directo identificó adecuadamente a los géneros fúngicos.
ABSTRACT Introduction: Otomycosis in immunocompromised patients is characterize by its bilateral course and the predominant etiologic agent is Candida. Few studies compare the mycological features between microscopic direct exam and culture. Aim: To identify the clinical and mycological characteristics of otomycosis in diabetic patients. Material and method: Transversal study. Secondary care center. Inclusion criteria: diabetic patients with clinical diagnosis of otomycosis. Intervention: Direct examination under a microscope of the ear sample and culture. Results: We included 17 patients, 10 women, 7 men with a mean age of 47.5 years. Symptoms were hearing loss 94.1% (n = 16), pruritus 82.4% (n =14) otorrhoea 76.5% (n =13) and otalgia 70.6% (n =12). Bilateral involvement was found in 47.1% (n =8). Direct microscopic study found 94.1% of yeast (n =16) and 5.9% of Aspergillus (n =1). Candida was the most common fungal genus in culture and microscopic exam with 94.1% (n =16) of cases and Candida albicans was the most common species in 88.2% (n =15) cases. Conclusion: Candida albicans is the most common etiologic agent in diabetic patients with otomycosis. Main symptoms were hearing loss, itching and otorrhea. Direct exam correctly identified the fungal genus.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Complicaciones de la Diabetes/microbiología , Otomicosis/microbiología , Aspergillus fumigatus/aislamiento & purificación , Estaciones del Año , Factores de Tiempo , Infecciones Oportunistas , Candida albicans/aislamiento & purificación , Evolución Clínica , Estudios Transversales , Candida glabrata/aislamiento & purificación , Complicaciones de la Diabetes/epidemiología , Otomicosis/epidemiologíaRESUMEN
A atresia anal com fístula retovaginal, é considerada uma afecção congênita rara nos ovinos. Em virtude disso, buscou-se descrever o reparo cirúrgico e cuidados pós-operatórios em uma borrega que apresentava essa afecção. Nesse sentido, uma borrega, sem raça definida, de 25 dias de idade e pesando 7,2kg, apresentou sinais de distensão abdominal e defecação pela vulva. A afecção foi diagnosticada por meio do exame clínico e confirmada radiograficamente, constatando-se atresia anal do tipo III em associação com a fístula.(AU)
Atresia ani associated with rectovaginal fistula is considered a rare congenital anomaly in sheep. Therefore, the surgical correction and post-operative care of a lamb presenting atresia ani with rectovaginal fistula has been detailed in this case report. A 25-days old, mixed breed lamb, weighing 7.2 kg, showing signs of abdominal bloating, and stool passage through the vulva was admitted at our hospital. An atresia ani type III condition associated with rectovaginal fistula was diagnosed by clinical examination and confirmed by radiographic examination.(AU)
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Animales , Femenino , Fístula Rectovaginal/veterinaria , Ano Imperforado/veterinaria , Ovinos , Anomalías Congénitas/veterinaria , Procedimientos de Cirugía Plástica/veterinariaRESUMEN
A atresia anal com fístula retovaginal, é considerada uma afecção congênita rara nos ovinos. Em virtude disso, buscou-se descrever o reparo cirúrgico e cuidados pós-operatórios em uma borrega que apresentava essa afecção. Nesse sentido, uma borrega, sem raça definida, de 25 dias de idade e pesando 7,2kg, apresentou sinais de distensão abdominal e defecação pela vulva. A afecção foi diagnosticada por meio do exame clínico e confirmada radiograficamente, constatando-se atresia anal do tipo III em associação com a fístula.(AU)
Atresia ani associated with rectovaginal fistula is considered a rare congenital anomaly in sheep. Therefore, the surgical correction and post-operative care of a lamb presenting atresia ani with rectovaginal fistula has been detailed in this case report. A 25-days old, mixed breed lamb, weighing 7.2 kg, showing signs of abdominal bloating, and stool passage through the vulva was admitted at our hospital. An atresia ani type III condition associated with rectovaginal fistula was diagnosed by clinical examination and confirmed by radiographic examination.(AU)
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Animales , Femenino , Ano Imperforado/cirugía , Ano Imperforado/veterinaria , Anomalías Congénitas/veterinaria , Fístula Rectovaginal/veterinaria , Ovinos , Procedimientos de Cirugía Plástica/veterinariaRESUMEN
Resumen Introducción: El principal microorganismo implicado en las infecciones de piel y tejidos blandos (IPTB) es Staphylococcus aureus, con incremento en las cepas resistentes a meticilina en los últimos años. Objetivo: Identificar la frecuencia de S. aureus resistente a meticilina (SARM) en IPTB en niños que consultaron a un hospital de cuarto nivel en la ciudad de Medellín. Métodos: Estudio descriptivo, retrospectivo, a partir de la revisión de historias clínicas. Se incluyeron pacientes menores de 18 años con IPTB causadas por S. aureus que no cumplieran con criterios de enfermedad invasora. Resultados: La prevalencia de SARM en esta población fue de 31%. El principal diagnóstico fue absceso cutáneo (68%), seguido por infección de sitio quirúrgico (15%) y celulitis no purulenta (6%). Tenían alguna co-morbilidad 85% de los pacientes. Todos los aislados fueron sensibles a rifampicina y cotrimoxazol. Ocho por ciento de los aislados fueron resistentes a clindamicina. Se encontró mayor prevalencia de SARM en lactantes comparado con los mayores de 2 años (60 vs 23%, p = 0,0109). Conclusión: Ante la alta prevalencia de SARM en IPTB se recomienda incluir en el tratamiento empírico antimicrobianos con cobertura para estas cepas, principalmente para lactantes.
Background: Skin and soft tissue infections (SSTI) are very common in children and Staphylococcus aureus is the main agent, with an increase of methicillin resistant strains (MRSA) in recent years. Aim: To identify the frequency of MRSA in skin and soft tissue infections (SSTI) in children from a high complex hospital in Medellin, Colombia. Methods: This is a descriptive, retrospective study, information was obtained from medical records. We included patients younger than 18 years with SSTI due to S. aureus who did not meet criteria for invasive disease. Results: The prevalence of MRSA in this population was 31%. The main diagnosis was cutaneous abscess (68%), followed by surgical site infection (15%) and non-purulent cellulitis (6%). Eighty five percent of the patients had at least 1 comorbidity. All isolates were sensitive to rifampicin and cotrimoxazole and 8% of the isolates were resistant to clindamycin. There was a higher prevalence of MRSA in patients under 2 years compared to older (60 vs 23%, p = 0,0109). Conclusion: In view of the high prevalence of MRSA in SSTI, empirical treatment with adequate coverage for MRSA is recommended, especially for patients under 2 years of age.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación , Infecciones Cutáneas Estafilocócicas/epidemiología , Infecciones de los Tejidos Blandos/epidemiología , Piel/microbiología , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/tratamiento farmacológico , Staphylococcus aureus/efectos de los fármacos , Infecciones Cutáneas Estafilocócicas/microbiología , Infecciones Cutáneas Estafilocócicas/tratamiento farmacológico , Prevalencia , Estudios Retrospectivos , Resistencia a la Meticilina/efectos de los fármacos , Factores de Edad , Distribución por Sexo , Colombia/epidemiología , Infecciones de los Tejidos Blandos/microbiología , Infecciones de los Tejidos Blandos/tratamiento farmacológico , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Hospitales , Antibacterianos/uso terapéuticoRESUMEN
BACKGROUND: Skin and soft tissue infections (SSTI) are very common in children and Staphylococcus aureus is the main agent, with an increase of methicillin resistant strains (MRSA) in recent years. AIM: To identify the frequency of MRSA in skin and soft tissue infections (SSTI) in children from a high complex hospital in Medellin, Colombia. METHODS: This is a descriptive, retrospective study, information was obtained from medical records. We included patients younger than 18 years with SSTI due to S. aureus who did not meet criteria for invasive disease. RESULTS: The prevalence of MRSA in this population was 31%. The main diagnosis was cutaneous abscess (68%), followed by surgical site infection (15%) and non-purulent cellulitis (6%). Eighty five percent of the patients had at least 1 comorbidity. All isolates were sensitive to rifampicin and cotrimoxazole and 8% of the isolates were resistant to clindamycin. There was a higher prevalence of MRSA in patients under 2 years compared to older (60 vs 23%, p = 0,0109). CONCLUSION: In view of the high prevalence of MRSA in SSTI, empirical treatment with adequate coverage for MRSA is recommended, especially for patients under 2 years of age.
Asunto(s)
Infecciones de los Tejidos Blandos/epidemiología , Infecciones Estafilocócicas/epidemiología , Infecciones Cutáneas Estafilocócicas/epidemiología , Staphylococcus aureus/aislamiento & purificación , Factores de Edad , Antibacterianos/uso terapéutico , Niño , Preescolar , Colombia/epidemiología , Femenino , Hospitales , Humanos , Masculino , Resistencia a la Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Prevalencia , Estudios Retrospectivos , Distribución por Sexo , Piel/microbiología , Infecciones de los Tejidos Blandos/tratamiento farmacológico , Infecciones de los Tejidos Blandos/microbiología , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/microbiología , Infecciones Cutáneas Estafilocócicas/tratamiento farmacológico , Infecciones Cutáneas Estafilocócicas/microbiología , Staphylococcus aureus/efectos de los fármacosRESUMEN
During periodontitis, alveolar bone resorption is associated with activation of T helper type 17 (Th17) lymphocytes and receptor activator of nuclear factor-κB ligand (RANKL) -induced osteoclasts. We previously reported that serotype b of Aggregatibacter actinomycetemcomitans has a higher capacity to trigger Th17-type differentiation and function in activated T lymphocytes and its lipopolysaccharide is a more potent immunogen compared with the other serotypes. This study aimed to investigate whether serotype b of A. actinomycetemcomitans induces higher Th17-associated RANKL production, RANKL-induced osteoclast activation, and antigen-specific memory T lymphocyte proliferation. On naive CD4(+) T lymphocytes stimulated with autologous dendritic cells primed with different A. actinomycetemcomitans serotypes, RANKL production, T-bet, GATA-3, RORC2 and Foxp3 expression, RORC2/RANKL intracellular double-expression, TRAP(+) osteoclast activation, and bone resorption were quantified. The frequency of proliferating memory T lymphocytes in response to A. actinomycetemcomitans serotypes was determined in periodontitis and healthy subjects. Naive CD4(+) T lymphocytes stimulated by serotype b-primed dendritic cells elicited higher levels of RANKL, RORC2, TRAP(+) osteoclasts, and bone resorption than the same cells stimulated with the other serotypes. RANKL positively correlated and co-expressed with RORC2. Memory T lymphocytes responding to serotype b were more frequently detected in periodontitis patients than healthy subjects. These results indicate that serotype b of A. actinomycetemcomitans is associated with higher production of RANKL and these increased levels are associated with Th17 lymphocyte induction, osteoclast activation, and bone resorption.
Asunto(s)
Aggregatibacter actinomycetemcomitans/inmunología , Osteoclastos/inmunología , Linfocitos T/inmunología , Antígenos Bacterianos/inmunología , Antígenos Bacterianos/farmacología , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD4-Positivos/microbiología , Diferenciación Celular/inmunología , Periodontitis Crónica/inmunología , Periodontitis Crónica/microbiología , Células Dendríticas/inmunología , Factores de Transcripción Forkhead/biosíntesis , Factor de Transcripción GATA3/biosíntesis , Humanos , Memoria Inmunológica/inmunología , Lipopolisacáridos/farmacología , Activación de Linfocitos , Miembro 3 del Grupo F de la Subfamilia 1 de Receptores Nucleares/biosíntesis , Ligando RANK/inmunología , Serogrupo , Linfocitos T/microbiologíaRESUMEN
BACKGROUND AND OBJECTIVE: Based on lipopolysaccharide (LPS) antigenicity, different Aggregatibacter actinomycetemcomitans serotypes have been described. Serotype b strains have demonstrated a stronger capacity to trigger cytokine production on dendritic cells (DCs). As DCs regulate the development of T-lymphocyte lineages, the objective of this investigation was to study the response of T lymphocytes after being stimulated with autologous DCs primed with different bacterial strains belonging to the most prevalent serotypes of A. actinomycetemcomitans in humans: a-c. MATERIAL AND METHODS: Human DCs were primed with increasing multiplicity of infection (10(-1) -10(2) ) or the purified LPS (10-50 ng/mL) of A. actinomycetemcomitans serotypes a-c and then used to stimulate autologous naïve CD4(+) T lymphocytes. The T-helper (Th) type 1, Th2, Th17 and T-regulatory transcription factors T-bet, GATA-3, RORC2 and Foxp3, which are the master-switch genes implied in their specific differentiation, as well as T-cell phenotype-specific cytokine patterns were quantified by real-time reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay. In addition, the intracellular expression of T-bet/interferon-γ, GATA-3/interleukin-4, RORC2/interleukin-17A and Foxp3/transforming growth factor-ß1 was analysed by double staining and flow cytometry. RESULTS: All the A. actinomycetemcomitans serotypes led to T-lymphocyte activation; however, when T lymphocytes were stimulated with DCs primed with the A. actinomycetemcomitans serotype b strain or their purified LPS, higher levels of Th1- and Th17-associated transcription factors and cytokines were detected compared with similar experiments with the other serotypes. CONCLUSION: These results demonstrate that serotype b of A. actinomycetemcomitans has a higher capacity of trigger Th1 and Th17 phenotype and function and it was demonstrated that their LPS is a more potent immunogen compared with the other serotypes.
Asunto(s)
Aggregatibacter actinomycetemcomitans/inmunología , Fenotipo , Serogrupo , Linfocitos T/inmunología , Aggregatibacter actinomycetemcomitans/clasificación , Células Cultivadas , Citocinas/análisis , Ensayo de Inmunoadsorción Enzimática , Citometría de Flujo , Perfilación de la Expresión Génica , Humanos , Inmunofenotipificación , Lipopolisacáridos/inmunología , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factores de Transcripción/análisisRESUMEN
La deshidratación es una de las principales causas de mortalidad en la población pediátrica en países en vía de desarrollo. Por ello, se han estudiado alternativas de manejo para la rehidratación oral, intravenosa e intraósea, de fácil aplicación y bajo costo. La hipodermoclisis es la técnica para la administración subcutánea de líquidos con el fin de prevenir o tratar la deshidratación leve o moderada; olvidada por muchos años debido a la falta de experiencia y protocolos bien estructurados. Recientemente resurge el interés en investigar e implementar esta técnica gracias a sus beneficios y menores riesgos frente a las otras opciones, entre las que se encuentran facilidad de aplicación, mantenimiento de la vía, comodidad del paciente y disminución de complicaciones por daño endotelial, demostrados en diferentes estudios como es el caso del Infuse Peds 1 y 2. Para favorecer la absorción subcutánea se puede implementar la hialuronidasa recombinante humana, enzima encargada de disolver el ácido hialurónico para alterar, temporalmente, la permeabilidad del tejido, que es el objeto de análisis dentro de estos estudios. En Colombia esta técnica aún no ha sido completamente difundida para aplicarla en la población pediátrica. Es imperativo divulgar opciones de manejo que sean efectivas y de bajo costo para la atención de las enfermedades más prevalentes. La hipodermoclisis cumple con estos objetivos y cuenta, además, con beneficios como la satisfacción de los padres y mejora índices de morbimortalidad infantil.
Dehydration is one of the main causes of mortality in pediatric population in developing countries. Thus, we have studied alternative measures that are low-cost and easy to administer for oral, intravenous, and intraosseuos rehydration. Hypodermoclysis is the technique for subcutaneous administration of liquids in order to prevent or treat mild or moderate dehydration. This method has been forgotten for many years due to the lack of experience and well-structured protocols. Recently, there has been increasing interest in researching and implementing this technique due to the benefits and lower risks compared to other options, including easy administration, pathway maintenance, patient comfort, and reduced complications due to endothelial damage, demonstrated in different studies, such as INFUSE-Peds I and II. Human recombinant hyaluronidase can be implemented in order to favor subcutaneous absorption; this enzyme is in charge of dissolving hyaluronic acid to temporarily alter the permeability of the tissue, which is the object of analysis of these studies. This technique has not been completely disseminated in Colombia to administer in pediatric population. It is imperative to divulge treatment options that are effective and low-cost to treat the most prevalent diseases. Hypodermoclysis meets these objectives and also has benefits such as parent satisfaction and improves indexes of infant morbidity and mortality.
A desidratação é uma das principais causas de mortalidade na população pediátrica em países em via de desenvolvimento. Por isso, se estudaram alternativas de manejo para a reidratação oral, intravenosa e intraóssea, de fácil aplicação e baixo custo. A hipodermóclise é a técnica para a administração subcutânea de líquidos com o fim de prevenir ou tratar a desidratação leve ou moderada; esquecida por muitos anos devido à falta de experiência e protocolos bem estruturados. Recentemente ressurge o interesse em investigar e implementar esta técnica graças a seus benefícios e menores riscos frente às outras opções, entre as que se encontram facilidade de aplicação, manutenção da via, comodidade do paciente e diminuição de complicações por dano endotelial, demostrados em diferentes estudos como é o caso do Infuse Peds 1 e 2. Para favorecer a absorção subcutânea se pode implementar a hialuronidase recombinante humana, enzima encargada de dissolver o ácido hialurônico para alterar, temporalmente, a permeabilidade do tecido, que é o objeto de análise dentro destes estudos. Na Colômbia esta técnica ainda não há sido completamente difundida para aplicá-la na população pediátrica. É imperativo divulgar opções de manejo que sejam efetivas e de baixo custo para a atenção das doenças mais prevalentes. A hipodermóclise cumpre com estes objetivos e conta, ademais, com benefícios como a satisfação dos pais e melhora índices de morbimortalidade infantil.
Asunto(s)
Humanos , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Hipodermoclisis , Soluciones para Rehidratación , Deshidratación , Países en Desarrollo , FluidoterapiaRESUMEN
Epidemiological studies on benign lesions related to human papillomavirus (HPV) infection are scarce in Latin America. We enrolled 342 consecutive patients with lesions suspected of being genital warts (GW). All patients underwent confirmatory biopsy and GP5+/GP6+/- Reverse Line Blot HPV testing on frozen tissue. In 261 (81%) cases, the diagnosis was confirmed by histopathology and HPV was detected in 90.6% of men and 87.7% of women. HPV 6 was by far the most common type in both women (62%) and men (56%), followed by HPV 11 (â¼20%). Co-infection with these two types occurred in 7% and 12% of women and men, respectively. HPV16 ranked third in prevalence, with 16% of patients testing positive. Twenty-five percent of cases tested positive for multiple HPV genotypes. Although HPV 6 and HPV 11 were the main types detected and no differences between men and women were observed, we found HPV 11 contributed more to GW aetiology compared with previous reports, showing a variability of HPV type distribution in GW across populations. This information is valuable baseline data in Latin America for future estimations of the burden of GW in men and women and shows the potential benefit obtainable by prophylactic vaccination against HPV types 6 and 11.