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Rhizobium etli CFN42 proteome-transcriptome mixed data of exponential growth and nitrogen-fixing bacteroids, as well as Sinorhizobium meliloti 1021 transcriptome data of growth and nitrogen-fixing bacteroids, were integrated into transcriptional regulatory networks (TRNs). The one-step construction network consisted of a matrix-clustering analysis of matrices of the gene profile and all matrices of the transcription factors (TFs) of their genome. The networks were constructed with the prediction of regulatory network application of the RhizoBindingSites database (http://rhizobindingsites.ccg.unam.mx/). The deduced free-living Rhizobium etli network contained 1,146 genes, including 380 TFs and 12 sigma factors. In addition, the bacteroid R. etli CFN42 network contained 884 genes, where 364 were TFs, and 12 were sigma factors, whereas the deduced free-living Sinorhizobium meliloti 1021 network contained 643 genes, where 259 were TFs and seven were sigma factors, and the bacteroid Sinorhizobium meliloti 1021 network contained 357 genes, where 210 were TFs and six were sigma factors. The similarity of these deduced condition-dependent networks and the biological E. coli and B. subtilis independent condition networks segregates from the random Erdös-Rényi networks. Deduced networks showed a low average clustering coefficient. They were not scale-free, showing a gradually diminishing hierarchy of TFs in contrast to the hierarchy role of the sigma factor rpoD in the E. coli K12 network. For rhizobia networks, partitioning the genome in the chromosome, chromids, and plasmids, where essential genes are distributed, and the symbiotic ability that is mostly coded in plasmids, may alter the structure of these deduced condition-dependent networks. It provides potential TF gen-target relationship data for constructing regulons, which are the basic units of a TRN.
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Valganciclovir (VGC) was used in a randomized clinical trial in patients with disseminated Kaposi Sarcoma/human immunodeficiency virus (DKS/HIV) as add-on therapy to evaluate the proinflammatory axis tumor necrosis factor (TNF) and its receptors (TNFRs) in T cells. Two treatment schedules were used: an experimental regime (ER) and a conventional treatment (CT). Mononuclear cells from patients with DKS/HIV were obtained at baseline (W0), 4 (W4), and 12 weeks (W12). Ten DKS/HIV patients received CT (antiretroviral therapy [cART]) and 10 ER (valganciclovir [VGC] initially, plus cART at the fourth week). HIV+ without KS and HIV- patient groups were included as controls. Correlation between T-cell subsets and HHV-8 viral load (VL) and a multivariate linear regression was performed. Data showed that DKS/HIV patients have an increased frequency of CD8+ T cells, which display a high density of CD8 expression. The ER scheme increases naïve and central memory CD4+ T cells at W4 and W12 of follow-up and induces a balanced distribution of activated CD4+ T-cell subsets. Moreover, ER decreases solTNFR2 since W4 and CT decreased the transmembrane forms of TNF axis molecules. Although CT induces a positive correlation between HHV-8 VL and TNFRs, the use of ER positively correlates with TNF and TNFRs levels through follow-up and a moderate correlation with HHV-8 VL and TNF soluble levels. In conclusion, VGC, as an add-on therapy in DKS/HIV patients, gradually modulates the activation of CD4+ T-cell subsets and the TNF/TNFRs axis, suggesting a better regulation of the inflammatory status.
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Infecciones por VIH , Sarcoma de Kaposi , Sulfonamidas , Humanos , Sarcoma de Kaposi/tratamiento farmacológico , Sarcoma de Kaposi/metabolismo , Infecciones por VIH/metabolismo , Valganciclovir/metabolismo , Valganciclovir/uso terapéutico , Linfocitos T CD4-Positivos/metabolismo , Subgrupos de Linfocitos T , Linfocitos T CD8-positivos/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Carga ViralRESUMEN
OBJECTIVES: We investigated the expression of toll-like receptor (TLR)-4 on the cell surface of innate and adaptive cells from patients with COVID-19 carrying the rs4986790 GG genotype in the TLR4 gene and the functional profile of these cells. METHODS: We included 1169 hospitalized patients with COVID-19. The rs4986790 in TLR4 was identified by real-time polymerase chain reaction. Peripheral blood mononuclear cells were isolated and cultured to evaluate TLR-4 expression on immune cells. Supernatants recovered culture assays were stored, and we measured cytokines and cytotoxic molecules. RESULTS: We showed that the rs4986790 (GG) was significantly associated (P = 0.0310) with severe COVID-19. Cells of patients with COVID-19 carrying the GG genotype have increased the frequency of monocytes and activated naïve and non-switched B cells positive to TLR-4 when cells are stimulated with lipopolysaccharide and with spike protein of SARS-CoV-2. Also, cells from patients with GG COVID-19 cannot produce pro-inflammatory cytokines after lipopolysaccharide stimulus, but they are high producers of cytotoxic molecules at baseline. CONCLUSIONS: The rs4986790 GG genotype of the TLR4 is associated with the risk of COVID-19 and acute respiratory distress syndrome. Peripheral blood mononuclear cells of patients carrying the rs4986790 (TLR4) GG genotype had a limited delivery of pro-inflammatory cytokines compared to the AA and AG genotypes in which TLR-4 stimulation induces IL-10, IL-6, tumor necrosis factor-α, and Fas ligand production.
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COVID-19 , Receptor Toll-Like 4 , Humanos , COVID-19/genética , Citocinas/genética , Citocinas/metabolismo , Leucocitos Mononucleares/metabolismo , Lipopolisacáridos , SARS-CoV-2/metabolismo , Receptor Toll-Like 4/genética , Genotipo , Índice de Severidad de la EnfermedadRESUMEN
Introduction: Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis (M.tb). B cells are the central mediator of the humoral response; they are responsible for producing antibodies in addition to mediating other functions. The role of the cellular response during the TB spectrum by B cells is still controversial. Methods: In this study, we evaluated the distribution of the circulating B cell subsets in patients with active and latent TB (ATB and LTB, respectively) and how they respond to stimuli of protein or lipid from M.tb. Results: Here, we show that ATB patients show an immune fingerprinting. However, patients with drug-sensitive- (DS-TB) or drug-resistant- (DR-TB) TB have altered frequencies of circulating B cells. DS-TB and DR-TB display a unique profile characterized by high systemic levels of IFN-γ, IL-10, IgG, IgG/IgM ratio, and total B cells. Moreover, B cells from DR-TB are less efficient in producing IL-10, and both DS-TB and DR-TB produce less IFN-γ in response to M.tb antigens. Conclusion: These results provide new insights into the population dynamics of the cellular immune response by B cells against M.tb and suggest a fingerprinting to characterize the B-cell response on DR-TB.
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Tuberculosis Latente , Mycobacterium tuberculosis , Tuberculosis , Humanos , Interleucina-10 , Interferón gamma/metabolismo , Inmunoglobulina GRESUMEN
Divergent natural selection should lead to adaptive radiation-that is, the rapid evolution of phenotypic and ecological diversity originating from a single clade. The drivers of adaptive radiation have often been conceptualized through the concept of "adaptive landscapes," yet formal empirical estimates of adaptive landscapes for natural adaptive radiations have proven elusive. Here, we use a 17-year dataset of Darwin's ground finches (Geospiza spp.) at an intensively studied site on Santa Cruz (Galápagos) to estimate individual apparent lifespan in relation to beak traits. We use these estimates to model a multi-species fitness landscape, which we also convert to a formal adaptive landscape. We then assess the correspondence between estimated fitness peaks and observed phenotypes for each of five phenotypic modes (G. fuliginosa, G. fortis [small and large morphotypes], G. magnirostris, and G. scandens). The fitness and adaptive landscapes show 5 and 4 peaks, respectively, and, as expected, the adaptive landscape was smoother than the fitness landscape. Each of the five phenotypic modes appeared reasonably close to the corresponding fitness peak, yet interesting deviations were also documented and examined. By estimating adaptive landscapes in an ongoing adaptive radiation, our study demonstrates their utility as a quantitative tool for exploring and predicting adaptive radiation.
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Pinzones , Passeriformes , Animales , Pinzones/genética , Selección Genética , Fenotipo , Ecuador , PicoRESUMEN
Evidence suggests that Mexican adults living in Mexico have a more favorable cardiovascular risk profile than Mexican adults living in the U.S. However, this relationship has not been evaluated among patients with chronic kidney disease (CKD), which is a question of importance given the high risk for cardiovascular disease among patients with CKD. Using data from two ongoing observational cohort studies, we compared the prevalence of ideal cardiovascular health metrics (assessed by the American Heart Association "Life's Simple 7" criteria) in 309 Mexican adults with CKD living in Mexico City to 343 Mexican adults with CKD living in Chicago. Mexican adults with CKD living in Mexico City had a significantly higher prevalence of ideal body mass index (25 vs. 10%), diet (17 vs. 8%), total cholesterol (80 vs. 63%), blood pressure (43 vs. 25%), and fasting glucose (54 vs. 42%). Mexican adults with CKD living in both Mexico City and Chicago had low levels of cardiovascular health scores. Future work is needed to better understand the lower prevalence of ideal cardiovascular health metrics in Chicago as compared to Mexico City.
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Enfermedades Cardiovasculares , Insuficiencia Renal Crónica , Estados Unidos , Humanos , Adulto , Factores de Riesgo , Chicago/epidemiología , México/epidemiología , Enfermedades Cardiovasculares/epidemiología , Presión Sanguínea , Insuficiencia Renal Crónica/epidemiologíaRESUMEN
Tuberculosis (TB) remains a public health problem worldwide and is one of the deadliest infectious diseases, only after the current COVID-19 pandemic. Despite significant advances in the TB field, there needs to be more immune response comprehension; for instance, the role played by humoral immunity is still controversial. This study aimed to identify the frequency and function of B1 and immature/transitional B cells in patients with active and latent TB (ATB and LTB, respectively). Here we show that LTB patients have an increased frequency of CD5+ B cells and decreased CD10+ B cells. Furthermore, LTB patients stimulated with mycobacteria's antigens increase the frequency of IFN-γ-producing B cells, whereas cells from ATB do not respond. Moreover, under the mycobacterial protein stimulus, LTB promotes a pro-inflammatory environment characterized by a high level of IFN-γ but also can produce IL-10. Regarding the ATB group, they cannot produce IFN-γ, and mycobacterial lipids and proteins stimulate only the IL-10 production. Finally, our data showed that in ATB, but not in LTB, B cell subsets correlate with clinical and laboratory parameters, suggesting that these CD5+ and CD10+ B cell subpopulations have the potential to be biomarkers to differentiate between LTB and ATB. In conclusion, LTB has increased CD5+ B cells, and these cells can maintain a rich microenvironment of IFN-γ, IL-10, and IL-4. In contrast, ATB only maintains an anti-inflammatory environment when stimulated with mycobacterial proteins or lipids.
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Gene regulatory networks are graph models representing cellular transcription events. Networks are far from complete due to time and resource consumption for experimental validation and curation of the interactions. Previous assessments have shown the modest performance of the available network inference methods based on gene expression data. Here, we study several caveats on the inference of regulatory networks and methods assessment through the quality of the input data and gold standard, and the assessment approach with a focus on the global structure of the network. We used synthetic and biological data for the predictions and experimentally-validated biological networks as the gold standard (ground truth). Standard performance metrics and graph structural properties suggest that methods inferring co-expression networks should no longer be assessed equally with those inferring regulatory interactions. While methods inferring regulatory interactions perform better in global regulatory network inference than co-expression-based methods, the latter is better suited to infer function-specific regulons and co-regulation networks. When merging expression data, the size increase should outweigh the noise inclusion and graph structure should be considered when integrating the inferences. We conclude with guidelines to take advantage of inference methods and their assessment based on the applications and available expression datasets.
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BACKGROUND: It is recommended that continued education in pain should be supported using information and communication technologies (ICTs), but there are gaps about the previous competencies of health professionals, especially in low- and middle-income countries. This study characterized the competencies of professionals in the Colombian Caribbean, the circumstances that favor and hinder the development of appropriate care, as well as the preferences, expectations and attitudes toward an educational intervention supported by ICTs. METHODS: We used a qualitative, phenomenological approach, combining documentary review and data obtained through observation, an online survey and two focus groups involving 55 healthcare professionals (physicians, nurses and psychologists) of varying experience. For the analysis and integration of results, the Capacity, Opportunity, Motivation and Behavior model and the Theoretical Domains Framework were used as references. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist guided the reporting of this study. RESULTS: Competency deficits were found regardless of the profession and experience, which are related to inadequacies in undergraduate and post-graduate training. Structural problems in Colombian society and healthcare service organization were also discovered, which were considered unmodifiable barriers and have been aggravated by the social, economic and health effects of the pandemic. The main modifiable barriers found were as follows: pain underestimation and under-treatment of older adults, as well as stereotypes regarding old age and pain, lack of knowledge of the psychosocial determinants of pain and of techniques for its assessment and treatment, overestimation of pharmacological treatment and failure to update pharmacological and non-pharmacological techniques. CONCLUSIONS: Recommendations for the design of the educational intervention were established as follows: favoring non-synchronous resources, facilitating synchronous activities of short duration, facilitating permanent access to information and resources and generating incentives for continuing education, such as certification, institutional recognition and encouraging popular recognition.
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Dolor Musculoesquelético , Anciano , Humanos , Colombia , Personal de Salud , Dolor Musculoesquelético/terapia , Pandemias , Estudiantes , Investigación Cualitativa , Educación Basada en CompetenciasRESUMEN
The pepper weevil Anthonomus eugenii is one of the most damaging pests to the pepper crop. To offer alternative management strategies to insecticides, several studies have identified the semiochemicals that are involved in the pepper weevil's aggregation and mating behavior; however, there is no information on its perireceptor molecular mechanism, to date. In this study, bioinformatics tools were used to functionally annotate and characterize the A. eugenii head transcriptome and their probable coding proteins. We identified twenty-two transcripts belonging to families related to chemosensory processes, seventeen corresponding to odorant-binding proteins (OBP), and six to chemosensory proteins (CSP). All results matched with closely related Coleoptera: Curculionidae homologous proteins. Likewise, twelve OBP and three CSP transcripts were experimentally characterized by RT-PCR in different female and male tissues. The results by sex and tissue display the different expression patterns of the AeugOBPs and AeugCSPs; some are present in both sexes and all tissues, while others show expressions with higher specificity, which suggests diverse physiological functions in addition to chemo-detection. This study provides information to support the understanding of odor perception in the pepper weevil.
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Escarabajos , Insecticidas , Receptores Odorantes , Gorgojos , Humanos , Animales , Masculino , Femenino , Gorgojos/genética , Escarabajos/genética , Odorantes , Transcriptoma , Proteínas de Insectos/genética , Receptores Odorantes/metabolismo , Filogenia , Perfilación de la Expresión GénicaRESUMEN
Potential pollution of mining environmental liabilities' locations can be preliminarily and efficiently assessed by the potential generation of acid mine drainage and indices of contamination. This research evaluates the potential pollution by potentially toxic elements at locations with uranium mining liability evidence, using the net acid generation test and determining the background values to estimate acid mine drainage and indices of contamination. Sixty soil samples were collected, and the mineralogy and potentially toxic elements' total contents were determined by x-ray diffraction and optical spectrometry. The findings suggest that the soils related to a specific lithology might not present potential acid mine drainage generation but potential soil and sediment contamination. Future research is recommended on applying leaching tests to identify which potentially toxic elements are effectively being solubilized. Finally, it can be concluded that the study area's potential contamination is relatively low overall.
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Metales Pesados , Contaminantes del Suelo , Uranio , Uranio/análisis , México , Monitoreo del Ambiente/métodos , Contaminantes del Suelo/análisis , Suelo/química , Minería , Ácidos/análisis , Metales Pesados/análisisRESUMEN
Platelets play a major role in coagulation and hemostasis; evidence supports the hypothesis that they also contribute to immunological processes. Increased platelet counts have been associated with poor prognosis in tuberculosis (TB). Platelet-monocyte aggregates have been reported in patients with TB, but it is still unclear if only one monocyte subpopulation is correlated to the platelet count; moreover, the platelet-monocyte axis has not been studied during latent tuberculosis (LTB). In this study, mononuclear cells and plasma were obtained from patients diagnosed with active drug-sensitive TB (DS-TB, n = 10) and LTB (n = 10); cytokines and growth factors levels associated to platelets were evaluated, and correlations with monocyte subpopulations were performed to identify a relationship between them, as well as an association with the degree of lung damage. Our data showed that, compared to LTB, DS-TB patients had an increased frequency of platelets, monocytes, and neutrophils. Although DS-TB patients showed no significant difference in the frequency of classical and non-classical monocytes, the classical monocytes had increased CD14 intensity of expression and frequency of TLR-2+. Furthermore, the plasma levels of angiogenic factors such as vascular endothelial growth factor (VEGF-A), platelet-derived growth factor (PDGF-BB), and platelet factor-4 (PF4), and pro-inflammatory cytokines like interleukin 6 (IL-6), interleukin 1 beta (IL-1ß), and interferon-γ-inducible protein 10 (IP-10) were increased in DS-TB patients. In addition, PF-4 and VEGF-A correlated positively with the frequency of classical monocytes and the platelet count. Using a principal component analysis, we identified four groups of DS-TB patients according to their levels of pro-inflammatory cytokines, angiogenic factors, and degree of lung damage. This study establishes that there is a correlation between VEGF-A and PF4 with platelets and classical monocytes during active TB, suggesting that those cell subpopulations are the major contributors of these molecules, and together, they control the severity of lung damage by amplification of the inflammatory environment.
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Monocitos , Tuberculosis , Humanos , Factor Plaquetario 4/metabolismo , Factor A de Crecimiento Endotelial Vascular/metabolismo , Tuberculosis/metabolismo , Citocinas/metabolismo , Inflamación/metabolismo , Factores Inmunológicos/metabolismoRESUMEN
A comparative proteomic study at 6 h of growth in minimal medium (MM) and bacteroids at 18 days of symbiosis of Rhizobium etli CFN42 with the Phaseolus vulgaris leguminous plant was performed. A gene ontology classification of proteins in MM and bacteroid, showed 31 and 10 pathways with higher or equal than 30 and 20% of proteins with respect to genome content per pathway, respectively. These pathways were for energy and environmental compound metabolism, contributing to understand how Rhizobium is adapted to the different conditions. Metabolic maps based on orthology of the protein profiles, showed 101 and 74 functional homologous proteins in the MM and bacteroid profiles, respectively, which were grouped in 34 different isoenzymes showing a great impact in metabolism by covering 60 metabolic pathways in MM and symbiosis. Taking advantage of co-expression of transcriptional regulators (TF's) in the profiles, by selection of genes whose matrices were clustered with matrices of TF's, Transcriptional Regulatory networks (TRN´s) were deduced by the first time for these metabolic stages. In these clustered TF-MM and clustered TF-bacteroid networks, containing 654 and 246 proteins, including 93 and 46 TFs, respectively, showing valuable information of the TF's and their regulated genes with high stringency. Isoenzymes were specific for adaptation to the different conditions and a different transcriptional regulation for MM and bacteroid was deduced. The parameters of the TRNs of these expected biological networks and biological networks of E. coli and B. subtilis segregate from the random theoretical networks. These are useful data to design experiments on TF gene-target relationships for bases to construct a TRN.
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Pediococcus pentosaceus strain PP16CC comes from the intestine of Crassostrea corteziensis. A 1.82-Mbp draft genome of this strain was assembled using A5-miseq from illumina reads, resulting in 4 contigs and 1,856 predicted protein coding genes. Additionally, 23 proteins belonging to various glycosyl hydrolase families and 6 prophage regions were identified.
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Ecuador is the third largest cacao exporter in the world. Up to 10 % of Ecuador's cacao production is grown in the Amazon region, mostly under conventional (CA) and organic (OA) agroforestry systems. Despite the importance of cacao in this area, no previous studies on its environmental impact and economic viability have yet been carried out. The main objective of this research is to fill this gap and, more specifically, perform a comparative analysis between CA and OA systems. For this purpose, primary information was gathered from 90 farms (44 conventional and 46 organic ones) that implement land management practices. The environmental performance of cacao production was assessed using a life cycle analysis methodology, with a cradle-to-farm gate approach. Up to twelve impact categories and five environmental and monetary efficiency indicators were estimated based on three functional units (1 kg of cacao, 1 kg of output sold, and 1 ha). Additionally, an economic viability analysis was performed, focused on profitability. The results show that organic management allows to reduce the environmental impact in all the analyzed categories, except for the land footprint, and improved the environmental and economic efficiency of agroforestry systems. The economic analysis shows no statistically significant differences between CA and OA profitability (net margin), which can be improved by selling co-products. Despite the low environmental impact of both types of system, economic profitability is certainly one of the weaknesses of cacao production in the Ecuadorian Amazon region. This study contributes to develop technical, production-related and political actions that could improve the economic cacao production situation without jeopardizing the environmental benefit obtained by these systems.
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Cacao , Ecuador , AmbienteRESUMEN
Macrophages are necessary to eliminate pathogens. However, some pathogens have developed mechanisms to avoid the immune response. One of them is modulating the cell death mechanism to favor pathogen survival. In this study, we evaluated if virulent Mycobacterium tuberculosis (M. tb) can simultaneously activate more than one cell death mechanism. We infected human monocyte-derived macrophages (MDM) in vitro with avirulent (H37Ra) and virulent (H37Rv) strains, and then we measured molecules involved in apoptosis, necroptosis, and pyroptosis. Our data showed that H37Rv infection increased the BCL-2 transcript and protein, decreased the BAX transcript, and increased phosphorylated BCL-2 at the protein level. Moreover, H37Rv infection increased the expression of the molecules involved in the necroptotic pathway, such as ASK1, p-38, RIPK1, RIPK3, and caspase-8, while H37Ra increased caspase-8 and decreased RIPK3 at the transcriptional level. In addition, NLRP3 and CASP1 expression was increased at low MOI in both strains, while IL-1ß was independent of virulence but dependent on infection MOI, suggesting the activation of pyroptosis. These findings suggest that virulent M. tb inhibits the apoptosis mediated by BCL-2 family molecules but, at the same time, increases the expression of molecules involved in apoptosis, necroptosis, and pyroptosis at the transcriptional and protein levels, probably as a mechanism to avoid the immune response and guarantee its survival.
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Globally, nutrient river discharges drive water quality of coastal ecosystems, and excess nutrients can cause eutrophication impacts. The Grijalva-Usumacinta River System (GURS) discharges in the southern Gulf of Mexico (SGoM) and it is the second largest riverine input to the Gulf. To study how contrasting GURS freshwater flow between rainy and dry seasons affects nutrients concentrations in the receiving coastal ecosystem, we evaluated nutrient variability in the water column during both seasons. High inorganic nutrients and total phosphate outline the rivers discharge plumes during rainy season, and were significantly higher than during the dry season throughout the study area, suggesting contrasting seasonal nutrient discharge of the GURS to coastal waters. On average the GURS discharged 141,123 t N yr-1 6893 t P yr-1 and 928,904 t Si yr-1 to SGoM. These results contribute with a nutrient baseline in the SGoM that could be useful for GURS decision-makers.
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Ecosistema , Ríos , Golfo de México , Nutrientes , Estaciones del AñoRESUMEN
Introducción: En los últimos años la anestesia local sin torniquete y con el paciente despierto, técnica conocida por WALANT (por sus siglas en inglés), ha ganado mucha popularidad en las cirugías de la mano y la muñeca. Objetivo: Reportar nuestra experiencia con el uso de la técnica WALANT, a fin de prescindir del uso del torniquete en las cirugías de la mano. Métodos: En noviembre del 2020 fueron intervenidos 30 pacientes por diversas enfermedades ortopédicas, entre las que figuraron: dedos en resorte, síndrome del túnel carpiano, tenovaginitis estenosante del pulgar, gangliones del carpo y amputación del tercer radio por rigidez en extensión postraumática, entre otras. Para la evaluación de la técnica tuvimos en cuenta: tiempo quirúrgico, magnitud del sangrado, dolor durante la infiltración anestésica, la intervención, y en las primeras 24 horas del postoperatorio, la necesidad de refuerzo anestésico, uso de isquemia, complicaciones y nivel de satisfacción del paciente. Resultados: Los resultados obtenidos con esta técnica anestésica son semejantes a otras, con las ventajas que el sangrado es leve, no hay que utilizar isquemia, el tiempo quirúrgico es menor y el efecto anestésico duró entre 10 y 12 horas en todos los pacientes. En ninguno de los pacientes hubo necesidad de refuerzo anestésico. Conclusiones: Se demuestra la efectividad de la técnica WALANT en las cirugías de mano. Con ella se disminuye el gasto de materiales para el acto quirúrgico, así como de personal, es de fácil aplicación y disminuyen las sensaciones desagradables y los peligros del uso de isquemia en los pacientes(AU)
Introduction: Currently, the use of local anaesthetic with no tourniquet and wide awake patient (Wide Awake Local Anaesthetic No Tourniquet - WALANT) has gained popularity in surgeries of the hand and wrist. Objective: To report our experience in the use of WALANT technique in order to discard the use of tourniquet in hand surgeries. Method: In November 2020, thirty patients underwent surgery due to different orthopaedic conditions, among them trigger fingers, carpal tunnel syndrome, stenosing tenovaginitis of the thumb, carpal ganglion and amputation of the third radius due to post trauma stiffness, among others. In order to assess this technique, we considered surgical time, volume of bleeding, pain during anesthetic infiltration, intervention and the need for additional anesthetic during the first 24 hours after surgery; we considered also ischemia, complications and level patient´s satisfaction. Results: This technique had similar results to others; however, the bleeding is mild, there is no need for ischemia, the surgical time is lesser and the anesthetic effect lasted 10 to 12 hours in all patients. None of them required additional anesthetic. All subjects felt the initial infiltration but none complained of pain during the rest of the anesthetic injection or during the surgical act. There were no complications. Conclusions: The effectiveness of WALANT technique in hand surgeries is shown. The cost of materials for the surgical act is reduced with it, as well as the surgical staff, it is easy to use and unpleasant sensations and dangers of the use of ischemia in patients are reduced(AU)
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Humanos , Neoplasias Óseas/cirugía , Epinefrina/administración & dosificación , Bicarbonato de Sodio/administración & dosificación , Mano/cirugía , Lidocaína/administración & dosificación , Muñeca/cirugía , EfectividadRESUMEN
Introducción: Actualmente la relación hombre-trabajo se encuentra limitada por condiciones de salud, que pueden agravarse frente a la exposición a factores de riesgo. Materiales y métodos: Estudio descriptivo, transversal, diseño no experimental, enfoque cuantitativo, realizado en 1570 consultantes a ingreso laboral, durante el período de octubre de 2019 a marzo de 2020 a nivel local; con una muestra probabilística de 1073, nivel de confianza de 98,00 % y margen de error del 2,00 %. Criterios de inclusión: solicitantes de consulta pre-empleo, mayores de edad, de ambos sexos que aceptaron participar en el estudio; excluidos menores de edad, autorizados por el Ministerio de Trabajo. La recolección de la información se realizó mediante evaluación médico-ocupacional y exámenes complementarios, utilizando equipos biomédicos calibrados y formatos validados por la Institución. El análisis de la información se realizó mediante estadística descriptiva, aplicando media, moda, desviación estándar, tablas y figuras. Se respetaron los principios éticos para la investigación en humanos. Resultados: Edad promedio 32 años, edad mínima de 18 y máxima de 66 años, desviación estándar de 9,2. De los participantes, 51,57 % presentó antecedentes personales patológicos; 47,15 % índice de masa corporal normal, seguido de sobrepeso 11.00 % e hipertensión arterial 1,95 %. La prevalencia de restricciones y aplazamientos laborales fue de 12,86 %, generadas principalmente por enfermedades cardiovasculares, visuales, osteomusculares y digestivas. Conclusiones: Las restricciones y aplazamientos para el ingreso al trabajo guardan correspondencia con las enfermedades que se describen en las estadísticas vitales presentadas en el país y en el departamento de Sucre.
Introduction: Currently the man-work relationship is limited by health conditions, which can be aggravated by exposure to risk factors. Materials and methods: Descriptive, cross-sectional study, non-experimental design with a quantitative approach, carried out in 1570 consultants at work admission, carried out between October 2019 to March 2020; Probabilistic sample of 1073 people, confidence level of 98.00% and margin of error of 2.00 %. Inclusion criteria: applicants for pre-employment consultation, of legal age, both sexes and who consented to participate in the research; minors are excluded, authorized by the Ministry of Labor. The information was collected through occupational medical evaluations and complementary examinations with formats validated by the Institution and calibrated biomedical equipment. The information analysis was carried out with descriptive statistics, using mean, mode, standard deviation, tables, and figures. The ethical principles for research in humans were respected. Results: Average age 32 years, minimum age of 18 and maximum of 66 years, standard deviation of 9.2. 51.57 % of the participants had a personal pathological history, 47.15 % had a normal body mass index, followed by overweight; 11.00% presented arterial hypertension. The prevalence of work restrictions and postponements was 12.86 %, mainly caused by cardiovascular, visual, musculoskeletal, and digestive diseases. Conclusions: The restrictions and postponements for entering work correspond to the diseases described in the vital statistics presented in the country and in the Department of Sucre.
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INTRODUCTION: Group B Streptococcus (GBS) causes infections in women during pregnancy and puerperium and invasive infections in newborns. The genes lmb, cylE, scpB, and hvgA are involved with increased virulence of GBS, and hypervirulent clones have been identified in different regions. In addition, increasing resistance of GBS to macrolides and lincosamides has been reported, so knowing the patterns of antibiotic resistance may be necessary to prevent and treat GBS infections. This study aimed to identify virulence genes and antibiotic resistance associated with GBS colonization in pregnant women from northeastern Mexico. METHODS: Pregnant women with 35-37 weeks of gestation underwent recto-vaginal swabbing. One swab was inoculated into Todd-Hewitt broth supplemented with gentamicin and nalidixic acid, a second swab was inoculated into LIM enrichment broth, and a third swab was submerged into a transport medium. All samples were subcultured onto blood agar. After overnight incubation, suggestive colonies with or without hemolysis were analyzed to confirm GBS identification by Gram staining, catalase test, hippurate hydrolysis, CAMP test, and incubation in a chromogenic medium. We used latex agglutination to confirm and serotype GBS isolates. Antibiotic resistance patterns were assessed by Vitek 2 and disk diffusion. Periumbilical, rectal and nasopharyngeal swabs were collected from some newborns of colonized mothers. All colonized women and their newborns were followed up for three months to assess the development of disease attributable to GBS. Draft genomes of all GBS isolates were obtained by whole-genome sequencing. In addition, bioinformatic analysis to identify genes encoding capsular polysaccharides and virulence factors was performed using BRIG, while antibiotic resistance genes were identified using the CARD database. RESULTS: We found 17 GBS colonized women out of 1154 pregnant women (1.47%). None of the six newborns sampled were colonized, and no complications due to GBS were detected in pregnant women or newborns. Three isolates were serotype I, 5 serotype II, 3 serotype III, 4 serotype IV, and 2 serotype V. Ten distinct virulence gene profiles were identified, being scpB, lmb, fbsA, acp, PI-1, PI-2a, cylE the most common (3/14, 21%). The virulence genes identified were scpB, lmb, cylE, PI-1, fbsA, PI-2a, acp, fbsB, PI-2b, and hvgA. We identified resistance to tetracycline in 65% (11/17) of the isolates, intermediate susceptibility to clindamycin in 41% (7/17), and reduced susceptibility to ampicillin in 23.5% (4/17). The tetM gene associated to tetracyclines resistance was found in 79% (11/14) and the mel and mefA genes associated to macrolides resistance in 7% (1/14). CONCLUSIONS: The low prevalence of colonization and the non-occurrence of mother-to-child transmission suggest that the intentional search for GBS colonization in this population is not justified. Our results also suggest that risk factors should guide the use of intrapartum antibiotic prophylaxis. The detection of strains with genes coding virulence factors means that clones with pathogenic potential circulates in this region. On the other hand, the identification of decreased susceptibility to antibiotics from different antimicrobial categories shows the importance of adequately knowing the resistance patterns to prevent and to treat GBS perinatal infection.