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1.
Health Expect ; 27(5): e70004, 2024 10.
Artículo en Inglés | MEDLINE | ID: mdl-39207250

RESUMEN

BACKGROUND AND OBJECTIVE: Mental health treatment for psychosexual problems is effective, but treatment rates are low. Metaverse-based therapy offers one solution to increase overall treatment rates. Understanding attitudes towards this novel approach could lead to wider adoption of metaverse-based therapy, resulting in higher treatment rates for psychosexual problems. METHODS: Twenty-one participants across three focus groups of different ages shared their perceptions and attitudes about metaverse-based therapy broadly and for treating sexual disorders. A content analysis of the transcribed text from the focus groups using qualitative data analysis software was conducted. RESULTS: Participants identified several perceived benefits of metaverse-based intervention, including avoiding the perceived embarrassment of going to a clinic and accessing patients (a) with diverse physical or mental functionality, (b) living in remote areas and/or (c) balancing different family/work obligations or duties. The two main concerns with metaverse-based therapy were the fear of online therapy being less personal than traditional therapy and the technological fluency needed. Clarifying their acceptance of the therapy, participants reported that they would be more likely to engage in metaverse-based therapy if they trusted their therapist. Also, although it might be effective for mild and moderate disorders, participants were more reluctant about its use for severe mental illness. CONCLUSIONS: Results suggest that attitudes towards metaverse-based intervention are mainly positive, since it removes some barriers that hinder access to psychological treatment in general and, specifically, for problems of a sexual nature. PATIENT AND PUBLIC CONTRIBUTION: During the design stage, a person with sexual difficulties was consulted to understand the patient's perspective. Members of the public advised the implementation of the focus groups. Three potential service users were involved in the coding of the text during the content analysis.


Asunto(s)
Grupos Focales , Investigación Cualitativa , Humanos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Disfunciones Sexuales Psicológicas/terapia , Disfunciones Sexuales Psicológicas/psicología , Anciano , Adulto Joven , Psicoterapia/métodos
2.
Arch Toxicol ; 2024 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-39162819

RESUMEN

Developmental exposure to carbamates, organophosphates, and pyrethroids has been associated with impaired neurodevelopmental outcomes. Sex-specific differences following chronic insecticide exposure are rather common in vivo. Therefore, we assessed the chronic effects of in vitro exposure to different carbamates (carbaryl, methomyl and aldicarb), organophosphates [chlorpyrifos (CPF), chlorpyrifos-oxon (CPO), and 3,5,6,trichloropyridinol (TCP)], and pyrethroids [permethrin, alpha-cypermethrin and 3-phenoxy benzoic acid (3-PBA)] on neuronal network development in sex-separated rat primary cortical cultures using micro-electrode array (MEA) recordings. Our results indicate that exposure for 1 week to carbaryl inhibited neurodevelopment in male cultures, while a hyperexcitation was observed in female cultures. Methomyl and aldicarb evoked a hyperexcitation after 2 weeks of exposure, which was more pronounced in female cultures. In contrast to acute MEA results, exposure to ≥ 10 µM CPF caused hyperexcitation in both sexes after 10 days. Interestingly, exposure to 10 µM CPO induced a clear hyperexcitation after 10 days of exposure in male but not female cultures. Exposure to 100 µM CPO strongly inhibited neuronal development. Exposure to the type I pyrethroid permethrin resulted in a hyperexcitation at 10 µM and a decrease in neuronal development at 100 µM. In comparison, exposure to ≥ 10 µM of the type II pyrethroid alpha-cypermethrin decreased neuronal development. In female but not in male cultures, exposure to 1 and 10 µM permethrin changed (network) burst patterns, with female cultures having shorter (network) bursts with fewer spikes per (network) burst. Together, these results show that MEA recordings are suitable for measuring sex-specific developmental neurotoxicity in vitro. Additionally, pyrethroid exposure induced effects on neuronal network development at human-relevant concentrations. Finally, chronic exposure has different effects on neuronal functioning compared to acute exposure, highlighting the value of both exposure paradigms.

3.
Microbiol Spectr ; : e0025424, 2024 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-39194291

RESUMEN

Klebsiella pneumoniae is one of the most threatening multi-drug-resistant pathogens today, with phage therapy being a promising alternative for personalized treatments. However, the intrinsic capsule diversity in Klebsiella spp. poses a substantial barrier to the phage host range, complicating the development of broad-spectrum phage-based treatments. Here, we have isolated and genomically characterized phages capable of infecting each of the acquired 77 reference serotypes of Klebsiella spp., including capsular types widespread among high-risk K. pneumoniae clones causing nosocomial infections. We demonstrated the possibility of isolating phages for all capsular types in the collection, revealing high capsular specificity among taxonomically related phages, in contrast to a few phages that exhibited broad-spectrum infection capabilities. To decipher the determinants of the specificity of these phages, we focused on their receptor-binding proteins, with particular attention to depolymerases. We also explored the possibility of designing a broad-spectrum phage cocktail based on phages isolated in reference capsular-type strains and determining the ability to lyse relevant clinical isolates. A combination of 12 phages capable of infecting 55% of the reference Klebsiella spp. serotypes was tested on a panel of carbapenem-resistant K. pneumoniae clinical isolates. Thirty-one percent of isolates were susceptible to the phage cocktail. However, our results suggest that in a highly variable encapsulated bacterial host, phage hunting must be directed to the specific Klebsiella isolates. This work is a step forward in the understanding of the complexity of phage-host interactions and highlights the importance of implementing precise and phage-specific strategies to treat K. pneumoniae infections worldwide.IMPORTANCEThe emergence of resistant bacteria is a serious global health problem. In the absence of effective treatments, phages are a personalized and effective therapeutic alternative. However, little is still known about phage-host interactions, which are key to implementing effective strategies. Here, we focus on the study of Klebsiella pneumoniae, a highly pathogenic encapsulated bacterium. The complexity and variability of the capsule, where in most cases phage receptors are found, make it difficult for phage-based treatments. Here, we isolated a large collection of Klebsiella phages against all the reference strains and in a cohort of clinical isolates. Our results suggest that clinical isolates represent a challenge, especially high-risk clones. Thus, we propose targeted phage hunting as an effective strategy to implement phage-derived therapies. Our results are a step forward for new phage-based strategies to control K. pneumoniae infections, highlighting the importance of understanding phage-host interactions to design personalized treatments against Klebsiella spp.

4.
Nat Commun ; 15(1): 4355, 2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38778023

RESUMEN

Phages are increasingly considered promising alternatives to target drug-resistant bacterial pathogens. However, their often-narrow host range can make it challenging to find matching phages against bacteria of interest. Current computational tools do not accurately predict interactions at the strain level in a way that is relevant and properly evaluated for practical use. We present PhageHostLearn, a machine learning system that predicts strain-level interactions between receptor-binding proteins and bacterial receptors for Klebsiella phage-bacteria pairs. We evaluate this system both in silico and in the laboratory, in the clinically relevant setting of finding matching phages against bacterial strains. PhageHostLearn reaches a cross-validated ROC AUC of up to 81.8% in silico and maintains this performance in laboratory validation. Our approach provides a framework for developing and evaluating phage-host prediction methods that are useful in practice, which we believe to be a meaningful contribution to the machine-learning-guided development of phage therapeutics and diagnostics.


Asunto(s)
Bacteriófagos , Especificidad del Huésped , Klebsiella , Aprendizaje Automático , Bacteriófagos/fisiología , Klebsiella/virología , Simulación por Computador
5.
Cir Cir ; 92(1): 28-32, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38537239

RESUMEN

OBJECTIVE: The aim of this study is to describe the effectiveness and safety of a magistral formulation of diltiazem 2% rectal gel as a treatment for chronic anal fissure. MATERIAL AND METHODS: A retrospective observational study of all patients that began treatment with diltiazem 2% gel during 2019. The primary endpoint of the study was anal fissure healing. We also looked for differences in effectiveness between those initiating treatment and those who had been previously treated, long-term effectiveness through a 2-year follow-up and frequency of adverse effects. RESULTS: Of the 166 patients included in the study, anal fissure healed in 72.9%. We detected adverse effects in 12 patients, the most common was local irritation. After 2 years of follow-up, 88% of patients did not relapse. CONCLUSION: In this study, use of topical diltiazem 2% has been shown to be effective and safe in the treatment of anal fissure and should be considered as the first line of therapy.


OBJETIVO: El objetivo de este estudio es describir la efectividad y la seguridad de una fórmula magistral de diltiazem 2% gel rectal, como tratamiento de la fisura anal crónica. MATERIAL Y MÉTODOS: Un studio observacional retrospectivo de todos los pacientes que comenzaron a ser tratados con diltiazem 2% gel durante el año 2019. La variable principal del estudio fue la cicatrización de la fisura anal. También se buscaron diferencias de efectividad entre aquellos que iniciaban el tratamiento y los que ya habían sido tratados previamente, efectividad a largo plazo mediante un seguimiento de 2 años y frecuencia de aparición de efectos adversos. RESULTADOS: De los 166 pacientes incluidos en el estudio, el 72,9% cicatrizaron la fisura anal. No detectamos diferencias estadísticamente significativas de efectividad entre los pacientes naive y aquellos que ya habían sido tratados. Detectamos efectos adversos en 12 pacientes, siendo el más frecuente la irritación local. Tras 2 años de seguimiento, el 88% de los pacientes no presentaron ninguna recaída. CONCLUSIÓN: En este estudio, el uso de diltiazem 2% tópico ha mostrado ser efectivo y seguro en el tratamiento de la fisura anal y debería considerarse como primera línea terapéutica.


Asunto(s)
Diltiazem , Fisura Anal , Humanos , Diltiazem/uso terapéutico , Diltiazem/efectos adversos , Fisura Anal/tratamiento farmacológico , Fisura Anal/inducido químicamente , Administración Tópica , Enfermedad Crónica , Cicatrización de Heridas , Resultado del Tratamiento
6.
PLoS One ; 18(12): e0291094, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38100408

RESUMEN

Forest management modifies tree cover, directly influencing various ecosystem services, such as water regulation. Evapotranspiration, water interception, surface runoff, stemflow, and throughfall are among those processes that depend on tree cover. The objective of this study was to evaluate the changes in water yield, defined as the difference between precipitation and evapotranspiration, after the application of silvicultural treatments in a temperate forest ecosystem in northern Mexico. Fifteen experimental plots were established in which the following treatments were applied: intensive management (clearcutting), semi-intensive management (selection, tree cutting of 59-61% of basal area), conservative management (selection, tree cutting of 29-31% of basal area), and no treatment (control group). Incident precipitation, throughfall, stemflow, net precipitation, interception, and surface runoff were analyzed. Results show that conservative management treatments increase water yield between 2 to 3.6 mm per m-2 ha-1 of tree basal area removed. Water flow distribution, in relation to the incident precipitation, ranged from 72.3 to 91.8% for throughfall, 0.2 to 0.4% for stemflow, 72.7 to 91.8% for net precipitation, 8.19 to 27.42% for interception or evaporation, and 0.54 to 1.93% for surface runoff. The conservative management treatment was the most viable alternative for increasing water yield without compromising timber harvesting and loss of soil due to hydric erosion.


Asunto(s)
Ecosistema , Agua , Agua/análisis , México , Lluvia , Bosques , Árboles/fisiología , Suelo
7.
Protein Sci ; 32(8): e4723, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37409874

RESUMEN

PADI4 is one of the human isoforms of a family of enzymes implicated in the conversion of arginine to citrulline. MDM2 is an E3 ubiquitin ligase which is crucial for down-regulation of degradation of the tumor suppressor gene p53. Given the relationship between both PADI4 and MDM2 with p53-signaling pathways, we hypothesized they may interact directly, and this interaction could be relevant in the context of cancer. Here, we showed their association in the nucleus and cytosol in several cancer cell lines. Furthermore, binding was hampered in the presence of GSK484, an enzymatic PADI4 inhibitor, suggesting that MDM2 could bind to the active site of PADI4, as confirmed by in silico experiments. In vitro and in silico studies showed that the isolated N-terminal region of MDM2, N-MDM2, interacted with PADI4, and residues Thr26, Val28, Phe91 and Lys98 were more affected by the presence of the enzyme. Moreover, the dissociation constant between N-MDM2 and PADI4 was comparable to the IC50 of GSK484 from in cellulo experiments. The interaction between MDM2 and PADI4 might imply MDM2 citrullination, with potential therapeutic relevance for improving cancer treatment, due to the generation of new antigens.


Asunto(s)
Neoplasias , Proteína p53 Supresora de Tumor , Humanos , Proteína p53 Supresora de Tumor/química , Ubiquitina-Proteína Ligasas/química , Desiminasas de la Arginina Proteica/metabolismo , Línea Celular , Unión Proteica , Proteínas Proto-Oncogénicas c-mdm2/metabolismo
8.
Ann Hematol ; 102(8): 2069-2075, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37171598

RESUMEN

Acquired thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder. N-Acetylcysteine (NAC) rapidly degrades ultra-large von Willebrand factor multimers by disrupting the disulfide bonds. We report a series of twelve consecutive patients diagnosed with acquired TTP successfully treated with high-dose NAC (150 mg/kg/day) in combination with plasma exchange and steroids. Eight patients also received rituximab. Two patients presented refractory TTP. All patients achieved a quick clinical response in a median time of 5.5 days after starting NAC and are alive after a median follow-up of 29 months. The treatment was feasible and well tolerated. These data provide further evidence of the potential benefit and safety of adding NAC to the standard of care.


Asunto(s)
Púrpura Trombocitopénica Trombótica , Humanos , Púrpura Trombocitopénica Trombótica/diagnóstico , Púrpura Trombocitopénica Trombótica/tratamiento farmacológico , Proteína ADAMTS13 , Rituximab/uso terapéutico , Intercambio Plasmático , Acetilcisteína/uso terapéutico
9.
Chembiochem ; 24(13): e202300229, 2023 07 03.
Artículo en Inglés | MEDLINE | ID: mdl-37171138

RESUMEN

Macrocyclization of peptides is typically used to fix specific bioactive conformations and improve their pharmacological properties. Recently, macrobicyclic peptides have received special attention owing to their capacity to mimic protein structures or be key components of peptide-drug conjugates. Here, we describe the development of novel synthetic strategies for two distinctive types of peptide macrobicycles. A multicomponent macrocyclo-dimerization approach is introduced for the production of interconnected ß-turns, allowing two macrocyclic rings to be formed and dimerized in one pot. Also, an on-resin double stapling strategy is described for the assembly of lactam-bridged macrobicycles with stable tertiary folds.


Asunto(s)
Péptidos Cíclicos , Péptidos , Péptidos Cíclicos/química , Ciclización , Péptidos/química , Lactamas , Conformación Molecular
10.
PLoS One ; 17(12): e0278386, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36454915

RESUMEN

BACKGROUND: Between October 2018, and February 2020, the United States saw an unprecedented increase in the number of asylum seekers and refugees arriving unexpectedly at international crossings along the US-Mexico Border. Many of these migrants needed proper medical attention, and consequently created significant pressure on local health systems. In El Paso, Texas, volunteer clinicians, collaborating closely with religious organizations and non-governmental organizations, provided outpatient medical care for the new arrivals; the county hospital provided in-patient care at local tax payers' expense. The objective of this study was to estimate costs of healthcare services offered by these volunteers in order to formulate sustainable and appropriate healthcare policies to address the needs of refugees and asylum seekers in the United States. METHODS: A mixed methods approach was used including personal interviews with stakeholders, and follow up surveys with volunteer clinicians. The cost analysis was done from the payer perspective using Medicaid reimbursement rates. RESULTS: Total costs of care provided to asylum seekers and refugees varied between $1.9MM to $4.4MM during the study period. The number of patient visits was estimated at 15,736 to 19,236, and cost per patient ranged between $99 and $281. Most common conditions treated by volunteer providers were abdominal pain, dermatological conditions, headaches, dehydration and hypertension. CONCLUSIONS: This is the first study looking at the cost of healthcare for refugees and asylum seekers provided by volunteer clinicians, in a binational context. The resources invested by volunteer providers were significant, and essential to meet medical needs of migrant populations. Without appropriate financial support, a strategy relying on volunteer and local community resources will prove unsustainable in the long term. Findings from this study will help formulate federal and local policies to support local health systems along the US-Mexico Border in providing care to future migrations into the United States.


Asunto(s)
Refugiados , Estados Unidos , Humanos , Texas , Voluntarios , Asistencia Médica , Política de Salud
11.
Rev. inf. cient ; 101(2)abr. 2022.
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1409524

RESUMEN

RESUMEN Introducción: La enfermedad pulmonar obstructiva crónica (epoc) es una entidad inflamatoria crónica caracterizada por una limitación, parcialmente reversible, del flujo aéreo. Su principal factor de riesgo es el tabaquismo y existen múltiples factores asociados a su elevada letalidad. Objetivo: Identificar los factores asociados con la muerte en pacientes con epoc pertenecientes al Hospital Clínico Quirúrgico Docente "Dr. Salvador Allende", La Habana, Cuba, en el periodo comprendido desde el 1 de enero al 31 de diciembre de 2019. Método: Se realizó un estudio epidemiológico observacional analítico de casos y controles. Los casos fueron los fallecimientos (n=34) con diagnóstico de epoc y los controles fueron los pacientes vivos (n=59) con este diagnóstico confirmado al egreso. Fueron consideradas las variables: edad, sexo, tabaquismo, hipertensión arterial, diabetes mellitus, cor pulmonale crónico, cáncer, grado de epoc, causa de hospitalización, sitio de hospitalización y necesidad de ventilación mecánica invasiva. Se emplearon métodos estadísticos descriptivos, análisis univariado y multivariado para calcular el riesgo, y la regresión logística para valorar los factores de confusión. Resultados: Hubo predominio de pacientes con edad superior a los 65 años y del sexo femenino. Las variables asociadas con la muerte por epoc fueron: comorbilidad por cáncer (OR: 5,1; IC 95 %: 1,2-22,4; p=0,032) y necesidad de ventilación mecánica invasiva (OR: 6,5; IC 95 %: 1,1-38,3; p=0,04). Conclusiones: La comorbilidad por cáncer y la necesidad de ventilación mecánica invasiva se comportaron como factores de riesgo para la mortalidad en pacientes con epoc.


ABSTRACT Introduction: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory entity characterized by a partially reversible limitation of airflow. Its main risk factor is smoking and there are multiple factors associated with its high mortality. Objective: To identify the factors associated with death in COPD patients belonging to the Hospital Clínico Quirúrgico Docente "Dr. Salvador Allende", in the period from January 1 to December 31, 2019. Method: An analytical observational epidemiological study of cases and controls was carried out. The cases were deaths (n=34) with a diagnosis of COPD, and the controls were living patients (n=59) with this diagnosis confirmed at discharge. Demographic and clinical variables were considered. The variables were considered: age, sex, smoking, arterial hypertension, diabetes mellitus, chronic cor pulmonale, cancer, degree of COPD, cause of hospitalization, site of hospitalization and need for invasive mechanical ventilation. Descriptive statistical methods, univariate and multivariate analysis were used to calculate risk, and logistic regression to assess confounding factors. Results: There was a predominance of patients over 65 years of age, and females. The variables associated with death from COPD were: cancer comorbidity (OR: 5.1; 95% CI: 1.2-22.4; p=0.032) and need for invasive mechanical ventilation (OR: 6.5; CI 95%: 1.1-38.3; p=0.04). Conclusions: Cancer comorbidity and the need for invasive mechanical ventilation behaved as risk factors for mortality in patients with COPD.


RESUMO Introdução: A doença pulmonar obstrutiva crônica (DPOC) é uma entidade inflamatória crônica caracterizada por uma limitação parcialmente reversível do fluxo aéreo. Seu principal fator de risco é o tabagismo e existem múltiplos fatores associados à sua alta letalidade. Objetivo: Identificar os fatores associados ao óbito em pacientes com DPOC pertencentes ao grupo "Dr. Salvador Allende", Havana, Cuba, no período de 1º de janeiro a 31 de dezembro de 2019. Método: Foi realizado um estudo epidemiológico observacional analítico de casos e controles. Os casos eram óbitos (n=34) com diagnóstico de DPOC e os controles eram pacientes vivos (n=59) com esse diagnóstico confirmado na alta. Foram consideradas as variáveis: idade, sexo, tabagismo, hipertensão arterial, diabetes mellitus, cor pulmonale crônico, câncer, grau da DPOC, causa da internação, local da internação e necessidade de ventilação mecânica invasiva. Métodos estatísticos descritivos, análise univariada e multivariada foram usados para calcular o risco e regressão logística para avaliar os fatores de confusão. Resultados: Houve predomínio de pacientes com mais de 65 anos e do sexo feminino. As variáveis associadas ao óbito por DPOC foram: comorbidade por câncer (OR: 5,1; IC 95%: 1,2-22,4; p=0,032) e necessidade de ventilação mecânica invasiva (OR: 6,5; IC 95%: 1,1-38,3; p=0,04). Conclusões: A comorbidade oncológica e a necessidade de ventilação mecânica invasiva se comportaram como fatores de risco para mortalidade em pacientes com DPOC.

12.
Materials (Basel) ; 14(16)2021 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-34443047

RESUMEN

The effects of the density and thickness of samples made from used cigarette butts on acoustic characteristics were analyzed in this study. All the analyzed samples showed high acoustic performance, indicating that the fabrication of acoustic absorbing material may be a good use for this problematic waste (due to its toxicity, continuous generation, lack of recycling method, etc.). An increase in either density or thickness shifted the absorption characteristics of the samples to lower frequencies and increased the overall absorption. The relationships of the frequency and value of the maximum absorption coefficient with thickness and/or density were analyzed. The shift of the maximum absorption coefficient value due to varying thickness is in good agreement with previous studies.

13.
Materials (Basel) ; 14(15)2021 Jul 27.
Artículo en Inglés | MEDLINE | ID: mdl-34361354

RESUMEN

Used cigarette butts represent a major and problematic form of waste, due to their abundance, toxicity, and durability. Moreover, the few proposals for their recycling are clearly insufficient, and new ones are welcome. For a new proposal regarding the reuse of used cigarette butts as acoustical absorbers in building construction, previous conditioning of the used butts is performed. This conditioning includes the elimination of moisture and toxic products accumulated in the filter of the cigarettes. Thus, in this work, the moisture content effect in acoustical absorption was analyzed, and a proposal for elimination is made. Moreover, a chemical cleaning procedure is proposed, and its influence on the acoustical behavior of the samples was also analyzed.

14.
Rev Med Inst Mex Seguro Soc ; 59(3): 216-223, 2021 Aug 13.
Artículo en Español | MEDLINE | ID: mdl-34369942

RESUMEN

BACKGROUND: Early onset neonatal sepsis (EOS) is a public health problem; antibiotic treatment is often unnecessary and can increase morbimortality. EOS risk calculator are available that allows limiting the use of antibiotics. OBJECTIVE: To compare the patterns of antibiotic use and hospitalization time in infant newborns (NB) ≥ 34 weeks of gestational age (GA) in a historical cohort attended from November 2017 to April 2018 vs. a prospective cohort from November 2018 to April 2019, before and after implementing the use of an EOS risk calculator, respectively. MATERIAL AND METHODS: Ambispective, observational, longitudinal, analytical study in infants NB ≥ 34 GA attended before and after implementing the use of an EOS risk calculator. The patterns of antibiotic´s use were compared. Simple frequencies and proportions, means and standard deviations or medians with ranges, Mann-Whitney U Test and Chi square test with SPSS V. 20.0 statistical package were used; considering significant values of p < 0.05. RESULTS: Thirty patients were included, 15 NB for each period, the gestational age average was 36.8 ± 2.3 GA. there was no statistically significant difference in the frequency of diagnosis of EOS with blood culture or days of hospital stay. Antibiotics were beginning in all the infants attended before the implementation of the EOS risk calculator, unlike 46.7% of the infants after its implementation (p = 0.001). CONCLUSIONS: The EOS risk calculator is an easy tool to use, and demonstrated to be useful in decreasing unnecessary use of antibiotics.


INTRODUCCIÓN: la sepsis neonatal temprana (SNT) es un problema de salud pública. El tratamiento con antibióticos frecuentemente es innecesario y no inocuo. El uso de calculadoras de riesgo de SNT permite disminuir el uso injustificado de antibióticos. OBJETIVO: comparar el uso de antibióticos y tiempo de hospitalización en recién nacidos (RN) ≥ 34 semanas de gestación (SDG) en una cohorte histórica atendida de noviembre de 2017 a abril de 2018 frente a una cohorte prospectiva de noviembre de 2018 a abril del 2019, antes y después de la implementación del uso de una calculadora de riesgo de SNT. MATERIAL Y MÉTODOS: estudio ambispectivo, observacional, analítico en RN ≥ 34 SDG atendidos antes y después de implementar una calculadora de riesgo de SNT. Se comparó el uso de antibióticos así como el tiempo de hospitalización. Se usaron frecuencias, proporciones, medidas de tendencia central y dispersión, U de Mann-Whitney y Chi cuadrada, con el paquete estadístico SPSS V. 20.0; siendo significativos los valores de p < 0.05. RESULTADOS: se incluyeron 30 pacientes, 15 para cada grupo, de 36.8 ± 2.3 SDG. No hubo diferencia significativa en la frecuencia de diagnóstico de SNT con hemocultivo ni en los días de estancia intrahospitalaria. Se usó antibióticos en el 100% de los RN antes frente al 46.7% después del uso de la calculadora (p = 0.001). CONCLUSIONES: la calculadora de riesgo de SNT es una herramienta de uso sencillo y que demostró ser útil para disminuir el uso innecesario de antibióticos.


Asunto(s)
Sepsis Neonatal , Sepsis , Antibacterianos/uso terapéutico , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Sepsis Neonatal/diagnóstico , Sepsis Neonatal/tratamiento farmacológico , Estudios Prospectivos , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Sepsis/diagnóstico , Sepsis/tratamiento farmacológico
15.
Antibiotics (Basel) ; 10(5)2021 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-34064754

RESUMEN

The irrational use of antibiotics has led to a high emergence of multi-drug resistant (MDR) bacteria. The traditional overuse of antibiotics in the animal feed industry plays a crucial role in the emergence of these pathogens that pose both economic and health problems. In addition, antibiotics have also recently experienced an increase to treat companion animal infections, promoting the emergence of MDR bacteria in pets, which can reach humans. Phages have been proposed as an alternative for antibiotics for the treatment of livestock and companion animal infections due to their multiple advantages as adaptative drugs, such as their ability to evolve, to multiply at the site of infections, and their high specificity. Moreover, phage-derived enzymes may also be an interesting approach. However, the lack of regulation for this type of pharmaceutical hinders its potential commercialization. In this review, we summarize the main recent studies on phage therapy in livestock and companion animals, providing an insight into current advances in this area and the future of treatments for bacterial infections.

16.
Genome Biol ; 21(1): 284, 2020 11 23.
Artículo en Inglés | MEDLINE | ID: mdl-33225950

RESUMEN

BACKGROUND: Adult T cell acute lymphoblastic leukemia (T-ALL) is a rare disease that affects less than 10 individuals in one million. It has been less studied than its cognate pediatric malignancy, which is more prevalent. A higher percentage of the adult patients relapse, compared to children. It is thus essential to study the mechanisms of relapse of adult T-ALL cases. RESULTS: We profile whole-genome somatic mutations of 19 primary T-ALLs from adult patients and the corresponding relapse malignancies and analyze their evolution upon treatment in comparison with 238 pediatric and young adult ALL cases. We compare the mutational processes and driver mutations active in primary and relapse adult T-ALLs with those of pediatric patients. A precise estimation of clock-like mutations in leukemic cells shows that the emergence of the relapse clone occurs several months before the diagnosis of the primary T-ALL. Specifically, through the doubling time of the leukemic population, we find that in at least 14 out of the 19 patients, the population of relapse leukemia present at the moment of diagnosis comprises more than one but fewer than 108 blasts. Using simulations, we show that in all patients the relapse appears to be driven by genetic mutations. CONCLUSIONS: The early appearance of a population of leukemic cells with genetic mechanisms of resistance across adult T-ALL cases constitutes a challenge for treatment. Improving early detection of the malignancy is thus key to prevent its relapse.


Asunto(s)
Leucemia-Linfoma Linfoblástico de Células T Precursoras/genética , Niño , ADN Helicasas/genética , Femenino , Humanos , Modelos Genéticos , Mutación , Proteínas Nucleares/genética , Leucemia-Linfoma Linfoblástico de Células T Precursoras/diagnóstico , Recurrencia , Linfocitos T , Factores de Transcripción/genética , Secuenciación Completa del Genoma , Adulto Joven
17.
Ecol Evol ; 10(11): 4928-4943, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32551071

RESUMEN

Bat acoustic libraries are important tools that assemble echolocation calls to allow the comparison and discrimination to confirm species identifications. The Sonozotz project represents the first nation-wide library of bat echolocation calls for a megadiverse country. It was assembled following a standardized recording protocol that aimed to cover different recording habitats, recording techniques, and call variation inherent to individuals. The Sonozotz project included 69 species of echolocating bats, a high species richness that represents 50% of bat species found in the country. We include recommendations on how the database can be used and how the sampling methods can be potentially replicated in countries with similar environmental and geographic conditions. To our knowledge, this represents the most exhaustive effort to date to document and compile the diversity of bat echolocation calls for a megadiverse country. This database will be useful to address a range of ecological questions including the effects of anthropogenic activities on bat communities through the analysis of bat sound.

18.
Antibiotics (Basel) ; 9(5)2020 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-32455536

RESUMEN

Biofilms are clusters of bacteria that live in association with surfaces. Their main characteristic is that the bacteria inside the biofilms are attached to other bacterial cells and to the surface by an extracellular polymeric matrix. Biofilms are capable of adhering to a wide variety of surfaces, both biotic and abiotic, including human tissues, medical devices, and other materials. On these surfaces, biofilms represent a major threat causing infectious diseases and economic losses. In addition, current antibiotics and common disinfectants have shown limited ability to remove biofilms adequately, and phage-based treatments are proposed as promising alternatives for biofilm eradication. This review analyzes the main advantages and challenges that phages can offer for the elimination of biofilms, as well as the most important factors to be taken into account in order to design effective phage-based treatments.

19.
An. pediatr. (2003. Ed. impr.) ; 91(3): 205.e1-205.e7, sept. 2019. tab
Artículo en Español | IBECS | ID: ibc-186734

RESUMEN

El rotavirus (RV) es la causa principal de diarrea infantil grave en todo el mundo e infecta prácticamente a todos los niños en los primeros 5 años de vida, sobre todo en los primeros 2años. Existen dos vacunas atenuadas de administración oral frente al RV disponibles en nuestro medio que han demostrado ser seguras y eficaces frente a la enfermedad. El objetivo principal de estas vacunas ha sido reproducir la historia natural de la infección y proteger frente a la enfermedad grave en los primeros meses de vida. Los recién nacidos prematuros son especialmente vulnerables a la enfermedad por RV, no solo por tener más riesgo de adquirir la infección, sino también por sus complicaciones. La vacunación frente al RV en niños prematuros ha mostrado resultados de eficacia y seguridad similares a los comunicados en niños a término, y los datos existentes sugieren un riesgo bajo de diseminación e infección nosocomial cuando la vacunación se realiza durante la hospitalización. Dado que un porcentaje estimable de recién nacidos prematuros permanecen ingresados en las unidades neonatales más allá de las 12semanas de vida, se considera que estos, siempre que su condición clínica lo permita, deben recibir la vacunación frente al RV sin retrasos, incluso durante la hospitalización si así fuese necesario


Rotavirus (RV) is the leading cause of severe acute gastroenteritis in infants worldwide. Most children are infected by RV by the age of 5 years, and especially in the first 2 years. Two oral attenuated vaccines against RV are licensed in industrialised countries, which have proven to be safe and effective against the disease. The main objective of these vaccines has been to reproduce the natural history of infection and protect against severe disease in the first months of life. Preterm infants are at higher risk of severe RV infection compared to full-term infants and infants with normal birth weight. Data collected on RV vaccination in preterm infants demonstrated that RV vaccines are effective and safe, compared with full-term infants, with a marginal risk of horizontal viral transmission and dissemination when vaccination is performed during hospitalisation. Preterm infants frequently require admission to hospital after the beginning of the 12 th week of life, which suggests that they should receive RV vaccines during admission according to the official immunisation schedule


Asunto(s)
Humanos , Recién Nacido , Infecciones por Rotavirus/prevención & control , Vacunas contra Rotavirus/administración & dosificación , Vacunación/métodos , Gastroenteritis/prevención & control , Gastroenteritis/virología , Esquemas de Inmunización , Recien Nacido Prematuro , Vacunas contra Rotavirus/efectos adversos , Vacunas Atenuadas
20.
Sci Rep ; 9(1): 10372, 2019 07 17.
Artículo en Inglés | MEDLINE | ID: mdl-31316123

RESUMEN

The impact of nanotechnology in the field of agricultural sciences creates the need to study in greater detail the effect of products offering nanoparticles for application in plant species of agricultural interest. The objective of this study was to determine the response of stevia (Stevia rebaudiana B.) in vitro to different concentrations of AgNPs (silver nanoparticles), as well as to characterize and identify their absorption, translocation and accumulation mechanisms. Nodal segments of stevia grown in MS medium supplemented with AgNPs (0,12.5, 25, 50,100 and 200 mg L-1) were used. After 30 days of in vitro shoot proliferation, the number of shoots per explant, shoot length, chlorophyll content, dry matter content and the metallic silver (Ag) content of the plants were quantified. In addition, characterization, transport and accumulation of silver nanoparticles were performed by microscopic analysis. AgNPs were shown to be present in epidermal stem cells, within vascular bundles and in intermembrane spaces. In leaves, they were observed in ribs and stomata. The current and future use of AgNPs in agricultural sciences opens up the possibility of studying their effects on different plant species.


Asunto(s)
Nanopartículas del Metal , Plata/farmacología , Stevia/metabolismo , Transporte Biológico , Clorofila/metabolismo , Relación Dosis-Respuesta a Droga , Hierro/metabolismo , Magnesio/metabolismo , Microscopía Electrónica , Microscopía Fluorescente , Nitrógeno/metabolismo , Tamaño de la Partícula , Hojas de la Planta/efectos de los fármacos , Hojas de la Planta/metabolismo , Hojas de la Planta/ultraestructura , Brotes de la Planta/efectos de los fármacos , Brotes de la Planta/crecimiento & desarrollo , Brotes de la Planta/metabolismo , Brotes de la Planta/ultraestructura , Plata/administración & dosificación , Plata/metabolismo , Stevia/efectos de los fármacos , Stevia/ultraestructura , Técnicas de Cultivo de Tejidos
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