RESUMEN
The transition to parenthood is a significant period of transformation and adjustment for all members of a new family, reshaping relational dynamics that often endure throughout the initial years of a child's life. This qualitative and longitudinal study aimed to explore coparenting representations held by both partners in a parental couple, along with observations of their family interactions, at three distinct points in time, with the aim to better understand the interaction between these representational and behavioral observations. In-depth interviews were conducted with 17 heterosexual, first-time parents in Santiago de Chile, during pregnancy and at two different times during the first year of their child's life. Family interactions were assessed using the Lausanne Trilogue Play task (LTP) on all occasions. Three main coparenting representation categories emerged: traditional, ambiguous, and co-responsible. On observation, approximately half of the couples showed cooperative coparenting interactions, while the other half had conflictual interactions. Couples generally followed stable trajectories over time. Cooperative couples demonstrated co-responsibility and open dialogue, while conflictual couples tended to follow traditional gender roles with tacit communication styles. This study highlights the importance of promoting co-responsibility and dialogue for fostering cooperative relational dynamics during the critical transition to parenthood.
La transición a la paternidad/maternidad es un período significativo de transformación y ajuste para todos los miembros de una nueva familia, dándole nueva forma a las dinámicas de relación que a menudo se sobrellevan a lo largo de los años iniciales de la vida del niño. Este estudio cualitativo y longitudinal se propuso explorar las representaciones en la crianza compartida que tienen ambos miembros de una pareja de padres, junto con observaciones de sus interacciones familiares, en tres puntos distintivos en el tiempo, con el propósito de comprender mejor la interacción entre estas observaciones representacionales y de comportamiento. Se llevaron a cabo entrevistas profundas con 17 padres primerizos, heterosexuales, en Santiago de Chile, durante el embarazo y en dos momentos diferentes durante el primer año de vida de sus niños. Se evaluaron las interacciones de familia usando la tarea del Juego Tripartito de Lausanne (LTP) en todas las ocasiones. Tres principales categorías representacionales de crianza compartida surgieron: tradicional, ambigua y de responsabilidad compartida. Bajo observación, aproximadamente la mitad de las parejas mostró interacciones cooperadoras de crianza compartida, mientras que la otra mitad tuvo interacciones conflictivas. Las parejas generalmente siguieron trayectorias estables a lo largo del tiempo. Las parejas cooperadoras demostraron responsabilidad compartida y diálogo abierto, mientras que las parejas conflictivas tendieron a seguir papeles tradicionales de género con estilo de comunicación tácitos. Este estudio subraya la importancia de promover la responsabilidad compartida y el diálogo para cultivar relaciones dinámicas de cooperación durante la crucial transición a la paternidad/maternidad.
Asunto(s)
Responsabilidad Parental , Padres , Humanos , Femenino , Masculino , Padres/psicología , Adulto , Responsabilidad Parental/psicología , Estudios Longitudinales , Chile , Investigación Cualitativa , Embarazo , Lactante , Adulto Joven , Relaciones Familiares/psicologíaRESUMEN
BACKGROUND AND AIMS: Postoperative stricture is a serious common adverse event after extensive endoscopic submucosal dissection (ESD) in the esophagus. Self-assembling peptide (SAP) gel has been shown to promote tissue healing and re-epithelialization. The aim of this study was to evaluate the effect of the SAP gel for esophageal stricture prevention after ESD. METHODS: This was a multicenter prospective study of patients who underwent esophageal ESD followed by SAP gel application between March 2022 and December 2023. Patients were included if the ESD mucosal defect involved ≥50% of the circumference of the esophagus. High-risk cases were defined as mucosal defects ≥75% of the circumference. Stricture was defined as the inability to pass an endoscope ≥8.9 mm in diameter or a narrow-caliber lumen in a patient with symptoms. RESULTS: A total of 43 patients (median age, 71 years; 81.4% male) underwent ESD (median resected specimen size, 50 mm) during the study period. SAP gel (median, 3 mL) was successfully applied in all cases (median time, 4 minutes). In aggregate, stricture occurred in 20.9% (9 of 43) of the cases. Stricture developed in 30.8% of the high-risk cases: 80% (4 of 5) after circumferential ESD and 19% (4 of 21) in those with defects ≥75% but <100% of the circumference. All cases of stricture resolved with endoscopic treatment. Three cases (6.9%) of postoperative bleeding occurred and were adequately managed endoscopically. CONCLUSIONS: We show that SAP gel application was easy, quick, and associated with a relatively low stricture rate comparable to other prophylactic methods. Additional comparative studies are needed to corroborate these preliminary findings.
Asunto(s)
Resección Endoscópica de la Mucosa , Neoplasias Esofágicas , Estenosis Esofágica , Geles , Complicaciones Posoperatorias , Humanos , Resección Endoscópica de la Mucosa/efectos adversos , Resección Endoscópica de la Mucosa/métodos , Masculino , Femenino , Estenosis Esofágica/prevención & control , Estenosis Esofágica/etiología , Anciano , Estudios Prospectivos , Persona de Mediana Edad , Neoplasias Esofágicas/cirugía , Complicaciones Posoperatorias/prevención & control , Péptidos/administración & dosificación , Péptidos/uso terapéutico , Anciano de 80 o más Años , Esofagoscopía/métodos , Estados UnidosRESUMEN
Eight colonies of live microbes were isolated from an extensively surface-sterilized halite sample which had been retrieved from a depth of 2000 m from a salt mine in the Qianjiang Depression, Hubei Province, PR China. The eight colonies, obtained after 4 weeks of incubation, were named JI20-1T-JI20-8 and JI20-1T was selected as the type strain. The strains have been previously described, including a genomic analysis based on the complete genome for strain JI20-1T and draft genomes for the other strains. In that study, the name Halobacterium hubeiense was suggested, based on the location of the drilling site. Previous phylogenomic analysis showed that strain JI20-1T is most closely related to the Permian isolate Halobacterium noricense from Alpine rock salt. The orthologous average nucleotide identity (orthoANI) and digital DNA-DNA hybridization (dDDH) percentages between the eight strains are 100-99.6â% and 99.8-96.4â%, respectively. The orthoANI and dDDH values of these strains with respect to the type strains of species of the genus Halobacterium are 89.9-78.2â% and 37.3-21.6â%, respectively, supporting their placement in a novel extremely halophilic archaeal species. The phylogenomic tree based on the comparison of sequences of 632 core-orthologous proteins confirmed the novel species status for these haloarchaea. The polar lipid profile includes phosphatidylglycerol, phosphatidylglycerol phosphate methyl ester, phosphatidylglycerol sulfate, and sulfated galactosyl mannosyl galactosyl glucosyl diether, a profile compatible with that of Halobacterium noricense. Based on genomic, phenotypic, and chemotaxonomic characterization, we propose strain JI20-1T (=DSM 114402T = HAMBI 3616T) as the type strain of a novel species in the genus Halobacterium, with the name Halobacterium hubeiense sp. nov.
Asunto(s)
Halobacteriaceae , Halobacterium , Análisis de Secuencia de ADN , Filogenia , ARN Ribosómico 16S/genética , Composición de Base , Técnicas de Tipificación Bacteriana , ADN Bacteriano/genética , Ácidos Grasos/química , Cloruro de Sodio , China , Fosfatidilgliceroles , ADN de Archaea/genéticaRESUMEN
Thyroid disorders are clinically characterized by alterations of L-3,5,3',5'-tetraiodothyronine (T4), L-3,5,3'-triiodothyronine (T3), and/or thyroid-stimulating hormone (TSH) levels in the blood. The most frequent thyroid disorders are hypothyroidism, hyperthyroidism, and hypothyroxinemia. These conditions affect cell differentiation, function, and metabolism. It has been reported that 40% of the world's population suffers from some type of thyroid disorder and that several factors increase susceptibility to these diseases. Among them are iodine intake, environmental contamination, smoking, certain drugs, and genetic factors. Recently, the intestinal microbiota, composed of more than trillions of microbes, has emerged as a critical player in human health, and dysbiosis has been linked to thyroid diseases. The intestinal microbiota can affect host physiology by producing metabolites derived from dietary fiber, such as short-chain fatty acids (SCFAs). SCFAs have local actions in the intestine and can affect the central nervous system and immune system. Modulation of SCFAs-producing bacteria has also been connected to metabolic diseases, such as obesity and diabetes. In this review, we discuss how alterations in the production of SCFAs due to dysbiosis in patients could be related to thyroid disorders. The studies reviewed here may be of significant interest to endocrinology researchers and medical practitioners.
Asunto(s)
Microbioma Gastrointestinal , Humanos , Microbioma Gastrointestinal/fisiología , Disbiosis , Glándula Tiroides/metabolismo , Ácidos Grasos Volátiles/metabolismo , Intestinos/microbiologíaRESUMEN
Socioemotional development is central throughout life, and it unfolds in an interpersonal context in which each significant caregiver has an impact, particularly during infancy. However, only a relatively small number of studies have investigated associations between mothers and fathers' personality and emotional characteristics with their infant's socioemotional development during the perinatal period. Therefore, the present article examines the relationship between maternal and paternal personality traits and emotion regulation difficulties during the prenatal period with offspring's socioemotional development. This was a non-experimental and longitudinal study that included a community sample of 55 mother-father-baby triads. Parental assessments were carried out between the second and third trimester of pregnancy, and baby's socio-emotional development was assessed during their 2nd month after birth. Results evidenced differences between maternal and paternal personality traits and emotion regulation difficulties during the perinatal period as well as distinct contributions on infant's socioemotional development.
Asunto(s)
Regulación Emocional , Masculino , Femenino , Humanos , Lactante , Estudios Longitudinales , Responsabilidad Parental/psicología , Padres , Padre/psicología , Madres/psicología , PersonalidadRESUMEN
Introduction: Gestational hypothyroxinemia (HTX) is a condition that occurs frequently at the beginning of pregnancy, and it correlates with cognitive impairment, autism, and attentional deficit in the offspring. Evidence in animal models suggests that gestational HTX can increase the susceptibility of the offspring to develop strong inflammation in immune-mediated inflammatory diseases. Ulcerative colitis (UC) is a frequent inflammatory bowel disease with unknown causes. Therefore, the intensity of ulcerative colitis-like disorder (UCLD) and the cellular and molecular factors involved in proinflammatory or anti-inflammatory responses were analyzed in the offspring gestated in HTX (HTX-offspring) and compared with the offspring gestated in euthyroidism (Control-offspring). Methods: Gestational HTX was induced by the administration of 2-mercapto-1-methylimidazole in drinking water to pregnant mice during E10-E14. The HTX-offspring were induced with UCLD by the acute administration of dextran sodium sulfate (DSS). The score of UCLD symptomatology was registered every day, and colon histopathology, immune cells, and molecular factors involved in the inflammatory or anti-inflammatory response were analyzed on day 6 of DSS treatment. Results: The HTX-offspring displayed earlier UCLD pathological symptoms compared with the Control-offspring. After 6 days of DSS treatment, the HTX-offspring almost doubled the score of the Control-offspring. The histopathological analyses of the colon samples showed signs of inflammation at the distal and medial colon for both the HTX-offspring and Control-offspring. However, significantly more inflammatory features were detected in the proximal colon of the HTX-offspring induced with UCLD compared with the Control-offspring induced with UCLD. Significantly reduced mRNA contents encoding for protective molecules like glutamate-cysteine ligase catalytic subunit (GCLC) and mucin-2 (MUC-2) were found in the colon of the HTX-offspring as compared with the Control-offspring. Higher percentages of Th17 lymphocytes were detected in the colon tissues of the HTX-offspring induced or not with UCLD as compared with the Control-offspring. Discussion: Gestational HTX accelerates the onset and increases the intensity of UCLD in the offspring. The low expression of MUC-2 and GCLC together with high levels of Th17 Lymphocytes in the colon tissue suggests that the HTX-offspring has molecular and cellular features that favor inflammation and tissue damage. These results are important evidence to be aware of the impact of gestational HTX as a risk factor for UCLD development in offspring.
Asunto(s)
Colitis Ulcerosa , Hipotiroidismo , Embarazo , Femenino , Masculino , Animales , Ratones , Colitis Ulcerosa/inducido químicamente , Inflamación/patología , Antiinflamatorios/farmacología , Sulfato de Dextran/efectos adversosRESUMEN
Introduction: Maternal sensitivity and mentalization are fundamental for children's mental health development. These skills have been negatively associated with maternal postpartum depressive symptomatology. Moreover, its prevalence increases in low socioeconomic and psychosocial risk contexts, where the access to treatment is scarce. Even though Attachment Based Interventios, such as Video-Feedback has been internationally recognized as an effective intervention. Its cost, as well as the need for language translation and cultural adaptation makes it difficult to implement in Latinamerican countries. Aim: The present study aims to assess the feasibility and acceptability of an online Video-Feedback intervention informed n mentalization aimed at mother-infant dyads with depressive symptomatology who attend Chilean public health centers. Method: This is a pilot randomized clinical trial with two groups of 60 mother-infant dyads between 4 and 12 months of age. Participants will be randomly assigned to control and experimental groups in a 1:1 ratio. Even though both groups will receive usual treatment, the experimental group will also receive the present video-intervention. At the end of the study, feasibility will be assessed based on focus groups aimed at interveners and quantitative outcomes such as recruitment rate, questionnaire completion rate and intervention completeness. Acceptability will be assessed from in-depth interviews with participants. In addition, effect sizes of primary and secondary outcomes will be calculated. Expected results: Results are expected to generate parameters to design a larger-scale clinical trial and to preliminary assess the effect of the reported mentalization-informed intervention on maternal sensitivity. Additionally, it seeks to contribute with a mental health intervention for low-income mother-infant dyads, which can be implemented remotely, at a low cost, and that would be suitable for implementation at a mental health care system policy. The protocol of this trial's design was registered at Clinical Trials (NCT04748731).
Introducción: La sensibilidad y la mentalización materna constituyen competencias fundamentales para el desarrollo de la salud mental infantil. A su vez, dichas habilidades han sido negativamente asociadas con la presencia de sintomatología depresiva postparto, la cual aumenta su prevalencia en contextos de bajo nivel socioeconómico y riesgo psicosocial, en donde el acceso a tratamiento escasea. Paralelamente, si bien internacionalmente el video-retroalimentación constituye una herramienta efectiva en intervenciones basadas en el apego, el costo, idioma y necesidad de adaptación cultural dificultan su implementación en países latinoamericanos. Objetivo: Evaluar la factibilidad y aceptabilidad de una video-intervención informada por la mentalización, dirigida a díadas madre-bebé con sintomatología depresiva, atendidas en centros públicos de atención en salud mental en Chile. Métodos: Ensayo clínico aleatorio piloto con dos grupos de 60 díadas madre-bebé de entre 4 y 12 meses de edad, quienes serán asignados aleatoriamente a grupos control y experimental en una proporción de 1:1. Si bien ambos grupos recibirán el tratamiento habitual, el grupo experimental recibirá también la video-intervención. Al término del estudio se evaluará la factibilidad a partir de grupos focales dirigidos a interventores e indicadores de resultados cuantitativos tales como tasa de reclutamiento, de completación de cuestionarios y finalización de la intervención. La aceptabilidad se evaluará a partir de entrevistas en profundidad a las participantes. Adicionalmente se calculará tamaño del efecto de indicadores de resultados primarios y secundarios. Resultados esperados: Se espera que los resultados del estudio generen parámetros para diseñar un ensayo clínico de mayor escala y evaluar preliminarmente el efecto de la intervención informada en la mentalización en la sensibilidad materna. Se busca además contribuir con una intervención en salud mental basada en la teoría del apego dirigida a díadas madre-bebé de bajos ingresos, que pueda ser implementada de manera remota, a bajo costo y apta para ser escalada a los sistemas de atención en salud mental.
Asunto(s)
Depresión , Madres , Femenino , Humanos , Lactante , Depresión/terapia , Estudios de Factibilidad , Retroalimentación , Salud Mental , Madres/psicología , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
INTRODUCTION: Maternal sensitivity and mentalization are fundamental for children's mental health development. These skills have been negatively associated with maternal postpartum depressive symptomatology. Moreover, its prevalence increases in low socioeconomic and psychosocial risk contexts, where the access to treatment is scarce. Even though Attachment Based Interventios, such as Video-Feedback has been internationally recognized as an effective intervention. Its cost, as well as the need for language translation and cultural adaptation makes it difficult to implement in Latinamerican countries. AIM: The present study aims to assess the feasibility and acceptability of an online Video-Feedback intervention informed n mentalization aimed at mother-infant dyads with depressive symptomatology who attend Chilean public health centers. METHOD: This is a pilot randomized clinical trial with two groups of 60 mother-infant dyads between 4 and 12 months of age. Participants will be randomly assigned to control and experimental groups in a 1:1 ratio. Even though both groups will receive usual treatment, the experimental group will also receive the present video-intervention. At the end of the study, feasibility will be assessed based on focus groups aimed at interveners and quantitative outcomes such as recruitment rate, questionnaire completion rate and intervention completeness. Acceptability will be assessed from in-depth interviews with participants. In addition, effect sizes of primary and secondary outcomes will be calculated. EXPECTED RESULTS: Results are expected to generate parameters to design a larger-scale clinical trial and to preliminary assess the effect of the reported mentalization-informed intervention on maternal sensitivity. Additionally, it seeks to contribute with a mental health intervention for low-income mother-infant dyads, which can be implemented remotely, at a low cost, and that would be suitable for implementation at a mental health care system policy. The protocol of this trial's design was registered at Clinical Trials (NCT04748731).
INTRODUCCIÓN: La sensibilidad y la mentalización materna constituyen competencias fundamentales para el desarrollo de la salud mental infantil. A su vez, dichas habilidades han sido negativamente asociadas con la presencia de sintomatología depresiva postparto, la cual aumenta su prevalencia en contextos de bajo nivel socioeconómico y riesgo psicosocial, en donde el acceso a tratamiento escasea. Paralelamente, si bien internacionalmente el video-retroalimentación constituye una herramienta efectiva en intervenciones basadas en el apego, el costo, idioma y necesidad de adaptación cultural dificultan su implementación en países latinoamericanos. OBJETIVO: Evaluar la factibilidad y aceptabilidad de una video-intervención informada por la mentalización, dirigida a díadas madre-bebé con sintomatología depresiva, atendidas en centros públicos de atención en salud mental en Chile. MÉTODOS: Ensayo clínico aleatorio piloto con dos grupos de 60 díadas madre-bebé de entre 4 y 12 meses de edad, quienes serán asignados aleatoriamente a grupos control y experimental en una proporción de 1:1. Si bien ambos grupos recibirán el tratamiento habitual, el grupo experimental recibirá también la video-intervención. Al término del estudio se evaluará la factibilidad a partir de grupos focales dirigidos a interventores e indicadores de resultados cuantitativos tales como tasa de reclutamiento, de completación de cuestionarios y finalización de la intervención. La aceptabilidad se evaluará a partir de entrevistas en profundidad a las participantes. Adicionalmente se calculará tamaño del efecto de indicadores de resultados primarios y secundarios. RESULTADOS ESPERADOS: Se espera que los resultados del estudio generen parámetros para diseñar un ensayo clínico de mayor escala y evaluar preliminarmente el efecto de la intervención informada en la mentalización en la sensibilidad materna. Se busca además contribuir con una intervención en salud mental basada en la teoría del apego dirigida a díadas madre-bebé de bajos ingresos, que pueda ser implementada de manera remota, a bajo costo y apta para ser escalada a los sistemas de atención en salud mental.
Asunto(s)
Humanos , Femenino , Lactante , Depresión/terapia , Madres/psicología , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios de Factibilidad , Salud Mental , RetroalimentaciónRESUMEN
Quality of early family interactions has been associated with child development, bonding, and mental health. Childhood adversity, stress, and depression impact parenting, affecting the quality of the interaction within the mother-father-child triad. The aim of the present study was to analyze the influence of parents' adverse childhood experiences, depressive symptoms, and parental stress, on their sensitive response toward their tooddler and quality of traidic interactions. A correlational cross-sectional method was used. The sample included 80 mother-father-child triads, of toddlers with social-emotional difficulties. Parents early adverse experiences, parental stress, and depressive symptoms were assessed through self-report measures. Observational measures on parental sensitivity and triadic interaction were used. For mothers and fathers, adverse childhood experiences were associated with depressive symptoms in adulthood. Sensitivity toward their child and stress were positively associated among both parents. Symptoms of depression in mothers were associated with lower sensitivity toward their child, but in fathers, their sensitive response was influenced by the level of parental stress in the mother. In both parents, greater sensitivity in the dyadic interaction with the child was associated with a higher quality of the triadic interactions, in the triad as a whole, and in the regulation and involvement of the child.
Se ha asociado la calidad de las tempranas interacciones de familia con el desarrollo, la unión afectiva y la salud mental del niño. La adversidad en la niñez, el estrés y la depresión tienen un impacto en la crianza, lo cual afecta la calidad de la interacción dentro de la tríada madre-padre-niño. El propósito del presente estudio fue analizar la influencia que las adversas experiencias de niñez de los padres, los síntomas depresivos y el estrés de crianza ejercen sobre sus sensibles respuestas hacia su niño pequeñito y la calidad de las interacciones tríadicas. Se utilizó un método correlacional entre las secciones. El grupo muestra estuvo compuesto de 80 tríadas madre-padre-niño, de niños pequeñitos con dificultades socio-emocionales. A través de medidas de auto-reportes, se evaluaron las tempranas experiencias adversas de los padres, el estrés de crianza, así como los síntomas depresivos. Se usaron medidas de observación de la sensibilidad de los padres y la interacción tríadica. Para mamás y papás, las adversas experiencias de niñez estuvieron asociadas con síntomas depresivos en la edad adulta. La sensibilidad hacia su niño y el estrés se asociaron positivamente entre ambos padres. Se asociaron los síntomas de depresión en las madres con una más baja sensibilidad hacia su niño, pero en los papás la respuesta sensible estuvo influida por el nivel de estrés de crianza de la madre. En ambos padres, una mayor sensibilidad en la interacción diádica con el niño se asoció con una más alta calidad de las interacciones tríadicas, en la tríada en general, así como en la regulación y participación del niño.
La qualité des interactions précoces de la famille a été liée au développement de l'enfant, à la connexion et à la santé mentale. L'adversité durant l'enfant, le stress et la dépression impactent le parentage, affectant la qualité de l'interaction au sein de la triade mère-père-enfant. Le but de cette étude était d'analyser l'influence d'expériences négatives de l'enfance, de symptômes dépressifs et de stress parental sur leur réaction sensible envers leur petit enfant et la qualité des interactions triadiques. Une méthode transversale corrélative a été utilisée. L'échantillon a inclus 80 triades mère-père-enfant, de jeunes enfants avec des difficultés socio-émotionnelles. Les expériences négatives précoces des parents, le stress parental, et les symptômes dépressifs ont été évalués au travers de mesures d'auto-évaluation. Des mesures d'observation de la sensibilité parentale et de l'interaction triadique ont été utilisées. Pour les mères et les pères les expériences négatives de l'enfance étaient liées à des symptômes dépressifs à l'âge adulte. La sensibilité envers leur enfant et le stress étaient liés de manière positive chez les deux parents. Les symptômes de dépression chez les mères étaient liés à une sensibilité moindre envers leur enfant mais chez les pères leur réaction sensible était influencée par le niveau de stress parental chez la mère. Chez les deux parents une plus grande sensibilité dans l'interaction dyadique avec l'enfant était liée à une qualité plus élevée des interactions triadiques, dans la triade dans son ensemble, et dans la régulation et l'engagement de l'enfant.
Asunto(s)
Padre , Madres , Adulto , Estudios Transversales , Depresión/psicología , Padre/psicología , Femenino , Humanos , Lactante , Masculino , Madres/psicología , Responsabilidad Parental/psicología , PadresRESUMEN
Multiple sclerosis (MS) is an autoimmune disease characterized by a robust inflammatory response against myelin sheath antigens, which causes astrocyte and microglial activation and demyelination of the central nervous system (CNS). Multiple genetic predispositions and environmental factors are known to influence the immune response in autoimmune diseases, such as MS, and in the experimental autoimmune encephalomyelitis (EAE) model. Although the predisposition to suffer from MS seems to be a multifactorial process, a highly sensitive period is pregnancy due to factors that alter the development and differentiation of the CNS and the immune system, which increases the offspring's susceptibility to develop MS. In this regard, there is evidence that thyroid hormone deficiency during gestation, such as hypothyroidism or hypothyroxinemia, may increase susceptibility to autoimmune diseases such as MS. In this review, we discuss the relevance of the gestational period for the development of MS in adulthood.
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Encefalomielitis Autoinmune Experimental , Esclerosis Múltiple , Animales , Sistema Nervioso Central , Femenino , Esclerosis Múltiple/etiología , Vaina de Mielina , Embarazo , Factores de RiesgoRESUMEN
Interaction of Clostridioides difficile spores with the intestinal mucosa contributes to the persistence and recurrence of the infection. Advanced age is one of the main risk factors for C. difficile infection and recurrence of the disease. However, interaction of C. difficile spores with the intestinal mucosa during aging has not been evaluated. In the present work, using intestinal ligated loop technique in a mouse model, we analyzed C. difficile spore adherence and internalization to the ileum and colonic mucosa during aging. Additionally, we provide visual documentation of the critical steps of the procedure. Consequently, our data suggest that spore internalization in the ileum and colonic mucosa is higher in elderly mice rather than adults or young mice. Also, our data suggest that spore adherence to the ileum and colonic mucosa decreases with aging.
Asunto(s)
Envejecimiento , Adhesión Bacteriana , Clostridioides difficile/fisiología , Infecciones por Clostridium/microbiología , Mucosa Intestinal/microbiología , Animales , Sitios de Ligazón Microbiológica , Modelos Animales de Enfermedad , Femenino , Masculino , Ratones , Ratones Endogámicos C57BL , Microscopía Confocal , Esporas Bacterianas/fisiologíaRESUMEN
BACKGROUND: During child psychiatry hospitalization, working with the families or attachment figures is a challenge, most of the children who are admitted to these units come from multi-problem families, with limited research in this area. Video feedback (VF) interventions have proved to be a powerful resource to promote parental and child well-being in small children and has been used with parents with a psychiatric condition. Parental Reflective Functioning (PRF) is one of the parental abilities that can be improved with VF and could be especially important in coping with conflict and negative emotions in older children. The aim of this study is to implement Video Intervention Therapy (VIT) to enhance PRF in primary caregivers of inpatient psychiatric children. As there is no published research using VF with parents of children with severe psychopathology in a hospitalized context. This report, then, becomes a much needed pilot study providing evidence for a larger randomized control trial (RCT). METHODS: The study is a single-center, two-arm feasibility randomized control trial with a qualitative component. Block randomization was done to generate a 2:1 allocation, leaving more participants in the intervention group. The intervention comprises four modules; every module has both one video-recorded play session and one VIT session (in a group setting) per week. Evaluation of the caregivers included assessments of PRF and well-being, and child assessment included parent-ratings and clinician-ratings of symptomatology and general functioning. RESULTS: Thirty participants were randomized; eligibility and recruitment rate were 70.6% and 83.3%, respectively. The compliance-to-intervention rate was 85% in the VIT group and 90% in the control group. All participants completed entry evaluation and 90% at the 3-month follow-up. The intervention was acceptable to participants and feasible for therapists to deliver. Outcome data must be treated with caution due to the small numbers involved, yet indicate that the VIT may have a positive effect in improving parental and child mental health outcomes. CONCLUSIONS: VIT for primary caregivers of child inpatient children was feasible to deliver and acceptable for participants, therapist, and the staff unit involved; there is sufficient evidence to undertake a full-scale effectiveness RCT. TRIAL REGISTRATION: ClinicalTrials.gov NCT03374904 . Registered on 14 December 2017.
Asunto(s)
Psiquiatría Infantil , Trastornos Mentales , Cuidadores , Niño , Estudios de Factibilidad , Humanos , PadresRESUMEN
INTRODUCTION: Alternatives to carbapenems are needed in the treatment of third-generation cephalosporin-resistant Enterobacterales (3GCR-E). Temocillin is a suitable candidate, but comparative randomised studies are lacking. The objective is to investigate if temocillin is non-inferior to carbapenems in the targeted treatment of bacteraemia due to 3GCR-E. METHODS AND ANALYSIS: Multicentre, open-label, randomised, controlled, pragmatic phase 3 trial. Patients with bacteraemia due to 3GCR-E will be randomised to receive intravenously temocillin (2 g three times a day) or carbapenem (meropenem 1 g three times a day or ertapenem 1 g once daily). The primary endpoint will be clinical success 7-10 days after end of treatment with no recurrence or death at day 28. Adverse events will be collected; serum levels of temocillin will be investigated in a subset of patients. For a 10% non-inferiority margin, 334 patients will be included (167 in each study arm). For the primary analysis, the absolute difference with one-sided 95% CI in the proportion of patients reaching the primary endpoint will be compared in the modified intention-to-treat population. ETHICS AND DISSEMINATION: The study started after approval of the Spanish Regulatory Agency and the reference institutional review board. Data will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT04478721.
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Bacteriemia , Meropenem , Penicilinas , Bacteriemia/tratamiento farmacológico , Cefalosporinas/farmacología , Ensayos Clínicos Fase III como Asunto , Enterobacteriaceae/efectos de los fármacos , Humanos , Meropenem/uso terapéutico , Estudios Multicéntricos como Asunto , Penicilinas/uso terapéutico , Ensayos Clínicos Pragmáticos como Asunto , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Clostridioides difficile spores produced during infection are important for the recurrence of the disease. Here, we show that C. difficile spores gain entry into the intestinal mucosa via pathways dependent on host fibronectin-α5ß1 and vitronectin-αvß1. The exosporium protein BclA3, on the spore surface, is required for both entry pathways. Deletion of the bclA3 gene in C. difficile, or pharmacological inhibition of endocytosis using nystatin, leads to reduced entry into the intestinal mucosa and reduced recurrence of the disease in a mouse model. Our findings indicate that C. difficile spore entry into the intestinal barrier can contribute to spore persistence and infection recurrence, and suggest potential avenues for new therapies.
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Clostridioides difficile/fisiología , Infecciones por Clostridium/microbiología , Células Epiteliales/microbiología , Células Epiteliales/patología , Intestinos/microbiología , Intestinos/patología , Esporas Bacterianas/fisiología , Animales , Adhesión Bacteriana/efectos de los fármacos , Proteínas Bacterianas/metabolismo , Línea Celular , Clostridioides difficile/efectos de los fármacos , Clostridioides difficile/ultraestructura , Colágeno/metabolismo , Endocitosis , Células Epiteliales/ultraestructura , Femenino , Fibronectinas/metabolismo , Humanos , Integrinas/metabolismo , Mucosa Intestinal/efectos de los fármacos , Mucosa Intestinal/microbiología , Mucosa Intestinal/patología , Masculino , Ratones Endogámicos C57BL , Nistatina/farmacología , Unión Proteica/efectos de los fármacos , Recurrencia , Esporas Bacterianas/efectos de los fármacos , Esporas Bacterianas/ultraestructura , Ácido Taurocólico/farmacología , Vitronectina/metabolismoRESUMEN
Resumen Introducción: La infección genital por el Virus de Papiloma Humano (VPH) se ha asociado con el cáncer cérvicouterino (CCE) al provocar la aparición de lesiones precursoras de cáncer en la zona de transformación de la unión escamo-columnar del cuello uterino. Existen más de 100 tipos de VPH, clasificados en bajo riesgo oncogénico (VPH-BR) y alto riesgo oncogénico (VPH-AR). Estudios reportan la infección por genotipos de alto riesgo en el 100% de los CCE. En Venezuela, el 67,7% de los CCE, se relacionan con el genotipo de VPH-AR 16. Objetivo: Detectar la presencia de VPH en pacientes con cambios citológicos cervicouterino. Metodología: Se incluyeron 49 pacientes que presentaban cambios citológicos, se tomaron las muestras de la región endocervical y exocervical para la detección y genotipificación del virus mediante la técnica de Multiple PCR. Resultados: Las alteraciones citológicas presentes fueron Células Escamosas Atípicas (69,4%), Células Glandulares Atípicas (4,1%), Lesión Escamosa Intraepitelial de Bajo Grado (16,3%), y Lesión Escamosa Intraepitelial de Alto Grado (10,2%). La detección molecular demostró que 16,3% presentaba VPH, 62,5% correspondían a VPH-AR, 25% a VPH-BR, 12,5% al genotipo 16 y no se detectó el genotipo 18. Se reportó un solo caso de coinfección. Conclusiones: A diferencia de otros estudios, no se encontró una relación estadísticamente significativa entre la presencia del virus y la aparición de cambios citológicos cervicouterino en esta población. No obstante, se detectaron genotipos de alto riesgo oncogénico, lo que puede traducirse en una mayor incidencia de cáncer cervicouterino a futuro.
Abstract Introduction: Genital infection by the Human Papilloma Virus (HPV) has been associated with cervical cancer (CC) since it causes the appearance of precursor cancer lesions in the transformation area of the squamous-columnar junction of the cervix. There are more than 100 types of HPV that are classified as low oncogenic risk (LR-HPV) and high oncogenic risk (HR-HPV). Studies report that the infection by high-risk genotypes is present in 100% of CC. In Venezuela, 67.7% of CC is related to the HPV-16 genotype. Objective: This study seeks to detect the presence of HPV in patients with cervical cytological cell changes. Methodology : Forty-nine patients with cytological changes were studied. The endocervical and ectocervical areas were sampled to detect and genotype the virus by using the Multiplex PCR technique. Results: The cytological alterations presented were: Atypical Squamous Cells (69.4%), Atypical Glandular Cells (4.1%), Low-grade Squamous Intraepithelial Lesion (16.3%) and High-grade Squamous Intraepithelial Lesion (10.2%). Besides, the general molecular detection showed that 16.3% had HPV, 62.5% of it corresponded to HR-HPV, 25% to LR-HPV, and 12.5% to genotype 16. The genotype 18 was not detected, and only one co-infection case was reported. Conclusions: Unlike other studies, a statistically significant relationship was not found between the virus presence and the appearance of cervical cytological cell changes in this population. However, genotypes with high oncogenic risk were detected, which may lead to a higher incidence of cervical cancer in the future.
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Humanos , Femenino , Papillomaviridae , Neoplasias del Cuello Uterino , Cuello del Útero , Reacción en Cadena de la Polimerasa , Biología Celular , Infecciones del Sistema Genital , Células Escamosas Atípicas del Cuello del Útero , Ginecología , Venezuela , Papillomavirus Humano 16 , Coinfección , Reacción en Cadena de la Polimerasa Multiplex , Lesiones Intraepiteliales Escamosas , Genitales , Herpes ZósterRESUMEN
A comparative taxonomic study of Spiribacter and Halopeptonella species was carried out using a phylogenomic approach based on comparison of the core genome, orthologous average nucleotide identity (OrthoANIu), Genome-to-Genome Distance Calculator (GGDC) and average amino acid identity (AAI). Phylogenomic analysis based on 976 core translated gene sequences obtained from their genomes showed that Spiribacter aquaticus SP30T, S. curvatus UAH-SP71T, S. roseus SSL50T, S. salinus M19-40T and Halopeptonella vilamensis DSM 21056T formed a robust cluster, clearly separated from the remaining species of closely related taxa. AAI between H. vilamensis DSM 21056T and the species of the genus Spiribacter was ≥73.1â%, confirming that all these species belong to the same single genus. On the other hand, S. roseus SSL50T and S. aquaticus SP30T showed percentages of OrthoANIu and digital DNA-DNA hybridization of 98.4â% and 85.3 %, respectively, while these values among those strains and the type strains of the other species of Spiribacter and H. vilamensis DSM 21056T were ≤80.8 and 67.8â%, respectively. Overall, these data show that S. roseus SSL50T and S. aquaticus SP30T constitute a single species and thus that S. aquaticus SP30T should be considered as a later, heterotypic synonym of S. roseus SSL50T based on the rules for priority of names. We propose an emended description of S. roseus, including the features of S. aquaticus. We also propose the reclassification of H. vilamensis as Spiribacter vilamensis comb. nov.
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Ectothiorhodospiraceae/clasificación , Filogenia , Técnicas de Tipificación Bacteriana , Composición de Base , ADN Bacteriano/genética , Hibridación de Ácido Nucleico , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADNRESUMEN
Early childhood is a critical period for social-emotional development; during this period, the child's immediate family is the system with the greatest influence on his or her development. The parents' capacity to reflect on the children's ability to process and interact within a social environment, called parental reflective functioning (RF), is considered an important factor in protecting children from highly prevalent social-emotional difficulties and may have a strong influence on children's long-term development. OBJECTIVE: To describe and analyze the relationships among parents' RF, the quality of the mother-father-child triadic interaction, and children's social-emotional difficulties. METHOD: A nonexperimental, cross-sectional, correlational study was conducted. Fifty mother-father-child triads, each in a current relationship that included at least one child aged 12-36 months, were evaluated. Sociodemographic background, triadic interaction, parental RF, and social-emotional difficulties were assessed. RESULTS: Triadic interaction was found to have a significant effect on the child's social-emotional difficulties, explaining 9% of the variance. In addition, the mothers' RF had a significant influence on triadic interaction, explaining 19% of the variance. An exploratory finding showed that triadic interaction mediates the relationship between mothers' RF and children's social-emotional difficulties.
La temprana niñez es un período crítico para el desarrollo socio-emocional; durante este período, el núcleo familiar del niño es el sistema con la mayor influencia en su desarrollo. La capacidad de los padres de reflexionar sobre la habilidad del niño de procesar e interactuar dentro del ambiente social, llamada la función reflexiva de los padres (RF), es considerada un factor importante en la protección del niño en cuanto a dificultades socio-emocionales altamente prevalentes y pudiera tener una fuerte influencia en el desarrollo del niño a largo plazo. OBJETIVO: Describir y analizar la relación entre la función reflexiva de los padres (RF), la calidad de la interacción tríadica entre mamá, papá y niño, y las dificultades socio-emocionales de los niños. MÉTODO: Se llevó a cabo un estudio no experimental, transversal y correlacional. Se evaluaron cincuenta tríadas de mamá, papá y niño, cada una de ellas en una relación presente que incluía por lo menos un niño de edad entre 12 y 36 meses. Se evaluaron el trasfondo demográfico, la interacción tríadica, la RF de los padres, así como las dificultades socio-emocionales. RESULTADOS: Se encontró que las interacciones tríadicas tenían un efecto significativo en las dificultades socio-emocionales del niño, lo cual explica el 9% de la variación. Adicionalmente, la RF de las mamás tuvo una influencia significativa en la interacción tríadica, lo cual explica el 19% de la variación. Un resultado exploratorio mostró que la interacción tríadica sirve de mediadora en la relación entre la RF de la mamá y las dificultades socio-emocionales de los niños.
La petite enfance est une période critique pour le développement socio-émotionnel. Durant cette période la famille proche de l'enfant est le système ayant la plus grande influence sur son développement. La capacité des parents à réfléchir à la capacité des enfants à traiter et à interagir avec l'environnement social, appelée le fonctionnement de réflexion parentale (abrégé en anglais RF), est considérée comme étant un facteur important qui protège les enfants de difficultés socio-émotionnelles extrêmement prévalente et qui peut avoir une forte influence sur le développement long-terme des enfants. OBJECTIF: Décrire et analyser les relations entre le RF des parents, la qualité de l'interaction triadique mère-père-enfant, et les difficultés socio-émotionnelles des enfants. MÉTHODE: Une étude non-expérimentale, corrélationnelle, avec une coupe transversale a été effectuée. Cinquante triades mère-père-enfant, chacune dans la relation actuelle qui incluait au moins un enfant âgé de 12 à 36 mois, ont été évaluées. Le contexte sociodémographique, l'interaction triadique, le RF parents, et les difficultés socio-émotionnelles ont été évalués. RÉSULTATS: On a trouvé que l'interaction triadique avait un effet important sur les difficultés socio-émotionnelles de l'enfant, expliquant 9% de l'écart. De plus, le RF des mères s'est avéré avoir une influence importante sur l'interaction triadique, expliquant 19% de l'écart. Un résultat exploratoire a montré que l'interaction triadique affecte la relation entre es le RF des mères et les difficultés socio-émotionnelles des enfants.
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Emociones/fisiología , Relaciones Padres-Hijo , Responsabilidad Parental/psicología , Padres/psicología , Medio Social , Adulto , Preescolar , Estudios Transversales , Relaciones Familiares , Femenino , Humanos , Lactante , Masculino , Adulto JovenRESUMEN
Relationships with primary caregivers provide the context for early childhood development, and evaluating those relationships during the early years can detect difficulties that may influence future mental health. Video feedback is a valuable intervention tool in early childhood, both for family relationships and child development. An intervention was implemented using this technique, focused on mother-father-child triads that were experiencing difficulties in social-emotional development. Participants were 80 mother-fatherinfant triads (experimental group, EG=40, control group, CG=40), with children between 1 and 3 years old. Socio-emotional difficulties decreased significantly in the children who received the intervention (Wilks λ=0.930, F (1, 78)=5.907; P=.017). There was also an increase in psychomotor development in communication (Wilks λ=0.948, F (1, 78) =4.284; P=.042) and fine motor skills (Wilks λ=0.875, F (1, 78)=11.185; P=.001) in children in the EG compared with children in the CG.
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A moderately halophilic bacterium designated strain M6-53T was isolated from water of a pond from a marine saltern located in Huelva, south-west Spain. Cells of the strain were Gram-stain-negative, strictly aerobic, motile, slightly curved rods, able to grow in media containing 5-25â% (w/v) NaCl (optimal growth at 10â%, w/v), at temperatures from 20 to 40 °C (optimally at 37 °C) and at pH 6.5-9 (optimally at pH 7.0). Phylogenetic analysis based on 16S rRNA gene sequences placed the new isolate within the genus Marinobacter, with the type strains of the most closely related species being Marinobacter persicus IBRC-M 10445T (98.5â% similarity), Marinobacter oulmenensis Set74T (97.2â%) and Marinobacter hydrocarbonoclasticus ATCC 49840T (97.1â%). The major fatty acids present in strain M6-53T were C18â:â1ω9c (29.5â%), C16â:â0 (26.7â%), C12â:â0 3-OH (15.1â%), C18â:â0 (10.2â%) and C16â:âω9c (9.6â%). The G+C content of the genomic DNA for this strain was determined to be 56.4 mol%. The DNA-DNA hybridization values between strain M6-53T and M. persicus CECT 7991T, M. oulmenensis CECT 7499T and M. hydrocarbonoclasticus DSM 50418 were 8, 41 and 38â%, respectively. These values are lower than the accepted 70â% threshold and showed that the new isolate represented a different species within the genus Marinobacter. Phylogenetic analysis based on the 16S rRNA gene sequence and the phenotypic, genotypic and chemotaxonomic features of this new isolate support the placement of strain M6-53T as a representative of a novel species of the genus Marinobacter, for which we propose the name Marinobacter aquaticus sp. nov., with strain M6-53T (=CECT 9228T=LMG 30006T) as the type strain.