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As a consequence of the development of AM, strategies have been developed to optimize the printing process, which focuses on reducing manufacturing time, such as using genetic algorithms (GAs), among others. The effect caused by the modification of path patterns is an effect of interest in two aspects: dimensional assurance focused on the compliance of the dimensions of the components in comparison with the digital design of the components, and the structural composition and resistance that the printing process itself can generate. This paper aims to present the effect of optimizing the path of fused filament fabrication (FFF) equipment on the dimensional finish and structural quality of a multi-geometric component using computed tomography. For this purpose, a template composed of 23 geometric elements, printed using FFF technology and PLA as the base material, is used. The results show an 11% reduction in the total process time required to print the component. The effect on the dimensional precision of different geometric elements was identified. In addition, it was possible to ensure that the structural quality of the multi-geometric component was not affected by the modification of the path required by the printing process.
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PURPOSE: To analyze antibiotic resistance and genetic profile of conjunctival bacteria flora before and after cataract surgery with the focus on coagulase-negative staphylococci (CNS) during cataract surgery and discuss the implications of this colonization as a potential risk of acquiring endophthalmitis. METHODS: After approval of the institutional review board and informed consent from patients had been obtained, conjunctival swabs for culture from 59 patients undergoing cataract surgery were taken of the fellow eye at baseline (C0) and from the eye to be operated before (T0) and after (T1) irrigation with povine-iodine 5%, and at the end of surgery (T2). Genes responsible for virulence (mecA, ica and atlE) and antibiotic profile were determined; strain clonality of persistent colonizing Staphylococcus epidermidis strains was established by the Multi-locus sequence typing (MLST). RESULTS: The frequency of CNS was significantly reduced in T1 (13.6%) from 81.4% in T0 and 86.4% in C0. The frequency of mecA, ica and atlE genes was 34.4%, 37.5% and 61.4%, respectively; and methicillin phenotypic resistance was 35.4%. S. epidermidis was the most frequent species isolated in every time point. MLST revealed in 7 patients 100% coincidence of the seven alleles of the S. epidermidis isolated previous to povine-iodine 5% disinfection and at the end of the surgery. CNS isolates from T1 or T2 corresponded to the same species, antibiotic and virulence profile as those isolates from C0 or T0. CONCLUSION: Povidone-iodine 5% prophylaxis before surgery significantly reduced conjunctival contamination; in those that persisted, the source of contamination was mostly the patient's microbiota confirmed by the MLST system.
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Extracción de Catarata , Catarata , Yodo , Humanos , Tipificación de Secuencias Multilocus , Perfil Genético , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Conjuntiva , Staphylococcus/genética , Bacterias , Farmacorresistencia MicrobianaRESUMEN
A genotoxic study was conducted with 101 elementary school children (56 girls and 45 boys) in the 6-7, 8-9, and 10-12 age ranges from El Fraile rural community, which is located beside the El Fraile mine tailings in Taxco of Alarcon City, in northern Guerrero State, Mexico. For this, we used the alkaline comet assay in exfoliated buccal mucosa cells, scoring three genotoxic parameters: tail intensity, tail moment, and tail length. Additionally, we detected oxidative DNA damage through urinary 8-OHdG levels by enzyme-linked immunosorbent assay. We also evaluated a control group consisting of 101 children in the same age ranges from Chilpancingo City, Guerrero, who had never lived near mining zones. Genotoxic results showed that there was a significant increase in three genotoxic parameters and urinary 8-OHdG levels in the exposed children group compared with the control group. Analysis of MANOVA revealed that boys aged 8 and 9 years had higher DNA damage than girls from the same exposure group, and Spearman's analysis identified a positive correlation between DNA damage and sex and age. This study provides the first valuable genotoxic data in children living in areas with environmental pollution.
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Despite the increasing utilization of lean practices and digital technologies (DTs) related to Industry 4.0, the impact of such dual interventions on healthcare services remains unclear. This study aims to assess the effects of those interventions and provide a comprehensive understanding of their dynamics in healthcare settings. The methodology comprised a systematic review following the PRISMA guidelines, searching for lean interventions supported by DTs. Previous studies reporting outcomes related to patient health, patient flow, quality of care, and efficiency were included. Results show that most of the improvement interventions relied on lean methodology followed by lean combined with Six Sigma. The main supporting technologies were simulation and automation, while emergency departments and laboratories were the main settings. Most interventions focus on patient flow outcomes, reporting positive effects on outcomes related to access to service and utilization of services, including reductions in turnaround time, length of stay, waiting time, and turnover time. Notably, we found scarce outcomes regarding patient health, staff wellbeing, resource use, and savings. This paper, the first to investigate the dual intervention of DTs with lean or lean-Six Sigma in healthcare, summarizes the technical and organizational challenges associated with similar interventions, encourages further research, and promotes practical applications.
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Tecnología Digital , Eficiencia Organizacional , Atención a la Salud , Servicio de Urgencia en Hospital , Humanos , Mejoramiento de la Calidad , Gestión de la Calidad TotalRESUMEN
The biosynthesis of oxide semiconductor nanoparticles (NPs) using materials found in nature opens a wide field of study focused on sustainability and environmental protection. Biosynthesized NPs have the capacity to eliminate organic dyes, which pollute water and cause severe damage to the environment. In the present work, the green synthesis of zinc oxide (ZnO) NPs was carried out using Capsicum annuum var. Anaheim extract. The photocatalytic elimination of methylene blue (MB), methyl orange (MO), and Rhodamine B (RhB) in UV radiation was evaluated. The materials were characterized by scanning and transmission electron microscopy (SEM and TEM) and SEM-coupled energy dispersive spectroscopy (EDS), attenuated total reflectance-infrared (ATR-IR), X-ray photoelectron spectroscopy (XPS), X-ray diffraction (XRD), Photoluminescence (PL), and ultraviolet-visible spectroscopy (UV-Vis). The TEM analysis showed the NPs have an average size of 40 nm and quasi-spherical shape. ATR-IR showed the ZnO NPs contained functional groups from the extract. The analysis through XRD indicated that the NPs have a hexagonal zincite crystal structure with an average crystallite size of approximately 17 nm. The photoluminescence spectrum (PL) presented an emission band at 402 nm. From the UV-Vis spectra and TAUC model, the band-gap value was found to be 2.93 eV. Finally, the photocatalytic assessment proved the ZnO NPs achieved 100% elimination of MB at 60 min exposure, and 85 and 92% degradation of MO and RhB, respectively, at 180 min. This indicates that ZnO NPs, in addition to using a friendly method for their synthesis, manage to have excellent photocatalytic activity in the degradation of various organic pollutants.
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BACKGROUND: This research work establishes the relationship between job strain and being overweight among Mexican managers. Recently in Mexico, there has been a sharp increase in work-related diseases and mental health disorders. Furthermore, evidence shows that Mexicans rank top among employees who suffer from stress, yet research on the impact of job strain on the phenomena of obesity and being overweight among such vulnerable job positions in the industrial field is scarce. METHODS: The sample included 170 overweight middle and senior managers from six companies in the Mexican Manufacturing Industry. Cedillo's Spanish version of the Job Content Questionnaire by Karasek was used, and the Body Mass Index (BMI) was used to characterize an overweight condition. Structural Equations Modelling studied the relationships among variables. RESULTS: Even though, the model shows a power of explanation of 6%(R2â=â0.06), the variable showing the greatest direct effect on the overweight variable is social support, with 21%(pâ<â0.01, ß=â-0.21). Regarding the total effects, only two of the four variables studied contributed directly to the overweight variation: the social support variable and the job demand variable. CONCLUSIONS: The results of the model hold a relatively low explanatory power; however, they do show a relationship between the studied variables. Also, the importance of the supervisor and co-workers' support should be considered when developing organizational strategies for the prevention of work stress and an overweight condition.
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Industria Manufacturera , Sobrepeso , Humanos , Industrias , México/epidemiología , Sobrepeso/epidemiología , Apoyo Social , Estrés Psicológico , Encuestas y CuestionariosRESUMEN
Introduction: Family eating behavior is determined by the meaning that the caretaker gives to food and the act of eating in the domestic environment, as well as the beliefs and perceptions around those concepts. Objective: Identify the place that nutrition has within the dimensions of child care, the specific weight that the caregiver gives to it within the range of actions deployed and if there are differences when the child exhibits neurodevelopmental disorders, as a contribution to the design of interventions in health promotion. Methodology: Qualitative, exploratory, two-stage study, with the approach of cognitive anthropology; proposal sampling of maximum differences, 121 informants participated in three groups, caregivers of: (1) healthy children, (2) children who had been hospitalized between 3 and 6 months prior to the time of the interview, and (3) children with a diagnosis of permanent neurological injury and that express some type of neurodevelopmental disorder. Results: Nourishment is the element that reaches the highest values of cultural relevance in the three groups, is located in different domains according to the condition of the care receiver. Conclusion: The common domains are Well-being, Health Maintenance, Coexistence, and Security, in the 3rd group the domain of Socialization emerges, the elements that make up the conceptual dimensions were identified, the comparative design allowed to identify differences. The description of the domains can represent the cognitive spaces of educational intervention and the elements that configure them are the triggers of the interaction, due to the importance they are given in everyday life.
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Cuidado del Niño , Promoción de la Salud , Cuidadores , Niño , Conducta Alimentaria , Hábitos , HumanosRESUMEN
Burnout syndrome (BS) and obesity are two growing conditions that affect employees' health and company productivity. Recently, several studies have pointed to a possible relationship between both phenomena. However, such a relationship has not been clearly defined. This research analyzes the relationship between BS dimensions and body mass index (BMI), the latter being treated as a moderator variable among obese senior and middle managers in the Mexican maquiladora industry through a structural equation model. A total of 361 senior and middle managers (124 of them classified as obese under the World Health Organization's criteria) completed both the Maslach Burnout Inventory-General Survey [with emotional exhaustion (EE), cynicism, and professional efficacy (PE) as subscale dimensions] and a sociodemographic questionnaire (which included BMI). The results showed a statistically significant relationship between EE and PE (P < 0.001; ß = -0.320), with BMI acting as a moderator variable. The results showed that when BMI increases as a moderator variable, the strength of the relationship between EE and PE also changes. For example, although PE had a negative value of 0.14 before the moderator effect, the value increased up to 0.32 when the BMI was factored into the relationship. Therefore, maquiladora industries are being advised to increase their investments on the identification and prevention of employees' EE and obesity. Such interventions would promote a better quality of life and could prevent economic losses resulting from poor employee performance.
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Healthcare services are facing challenges in increasing their efficiency, quality of care, and coping with surges in demand. To this end, some hospitals have implemented lean healthcare. The aim of this systematic review is to evaluate the effects of lean healthcare (LH) interventions on inpatient care and determine whether patient flow and efficiency outcomes improve. The review was performed according to PRISMA. We used six databases to search for studies published from 2002 to 2019. Out of 5732 studies, 39 measuring one or more defined outcomes were included. Hospital length of stay (LOS) was measured in 23 studies, 16 of which reported a reduction, turnover time (TOT) decreased in six out of eight studies, while the turnaround time (TAT) and on-time starts (OTS) improved in all five and seven studies, respectively. Moreover, eight out of nine studies reported an earlier discharge time, and the boarding time decreased in all four cases. Meanwhile, the readmission rate did not increase in all nine studies. Lastly, staff and patient satisfaction improved in all eight studies. Our findings show that by focusing on reducing non-value-added activities, LH contributed to improving patient flow and efficiency within inpatient care.
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Hospitalización , Calidad de la Atención de Salud , Gestión de la Calidad Total , Estudios de Cohortes , Hospitales , Humanos , Pacientes Internos , Tiempo de InternaciónRESUMEN
Foodborne diseases are a significant cause of morbidity and mortality worldwide. Studies have shown that the knowledge, attitude, and practices of food handlers are important factors in preventing foodborne illness. The purpose of this research is to assess the effects of training interventions on knowledge, attitude, and practice on food safety and hygiene among food handlers at different stages of the food supply chain. To this end, we conducted a systematic review and meta-analysis with close adherence to the PRISMA guidelines. We searched for training interventions among food handlers in five databases. Randomized control trials (RCT), quasi-RCTs, controlled before-after, and nonrandomized designs, including pre-post studies, were analyzed to allow a more comprehensive assessment. The meta-analysis was conducted using the random-effects model to calculate the effect sizes (Hedges's g) and 95% confidence interval (CI). Out of 1094 studies, 31 were included. Results showed an effect size of 1.24 (CI = 0.89-1.58) for knowledge, an attitude effect size of 0.28 (CI = 0.07-0.48), and an overall practice effect size of 0.65 (CI = 0.24-1.06). In addition, subgroups of self-reported practices and observed practices presented effect sizes of 0.80 (CI = 0.13-1.48) and 0.45 (CI = 0.15-0.76) respectively.
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Introduction: Hypertensive disorders are of interest in obstetrics and gynecology because they are the second place among causes of maternal mortality and a source of complications in the short, mid, and long term. Even if the pathophysiological process behind preeclampsia (PE) is still unknown, stress factors have been revealed to play an important role in the genesis of this pathologic process. Methods: A case-control study was designed with the purpose of determining if there is a differential methylation in NR3C1, HSD11B2, CYP11A1, CRHBP, TEAD3, and HSP90AA1 genes, related to signaling of the hypothalamic-pituitary-adrenal axis, and its regulation on early-onset PE (EOPE). Results: A total of 20 cases and 20 controls were studied by DNA methylation analysis, demonstrating differences among groups in the percentage of methylation of the NR3C1 gene. After a contingency analysis, an odds ratio (OR) for PE of 12.25 was identified for NR3C1 and 9.9 for HSP90AA1 genes. NR3C1, TEAD3, and HSP90AA1 genes showed a positive correlation with the systolic and diastolic blood pressure levels with a p ≤ 0.05. Conclusion: This study found a differential methylation in the glucocorticoid receptor (GR) NR3C1 and its co-chaperone HSP90AA1 in women with PE, with a possible regulatory role in the response to stress in pregnancy and is a likely physiopathological mechanism in PE.
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Mental health disorders resulting from work stressors are increasing in the Mexican manufacturing industry and worldwide. Managerial positions in these contexts are highly stressful, and although physical activity may reduce the negative effects of work stress, the relationships between these two aspects regarding their effects on the body mass index (BMI) of obese managers are scarcely studied. This article aims to study such relationships by using the Job Content Questionnaire (JCQ) dimensions with the Baecke's physical activity questionnaire dimensions and analyzing their effects on the BMI. A sample of 255 managers from the Mexican industry, with a (BMI > 30) participated by answering the surveys and providing their weight, their height, and certain sociodemographic information. The research hypotheses were tested using WarpPLS® 6.0 for structural equation modeling. The results for three models featuring acceptable reliability to estimate the direct, indirect, and total effects are presented. The first model showed a medium explanatory power, the variable of job decision-making authority having the greatest direct effect on BMI. The second model showed a medium explanatory power, and the variable of physical activity during leisure-time observed the unique direct effect on BMI. Finally, although the integrating model showed a small explanatory power, both work stress and the physical activity exerted observed direct effects on BMI reduction.
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Ejercicio Físico , Obesidad , Índice de Masa Corporal , Humanos , Industria Manufacturera , México , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
Improvement projects (IPs) are a fundamental element in any quality management system from any organization. In Higher Education Institutions (HEIs), IPs are constantly implemented to maintain excellence in academic and administrative processes. In this study, we propose a model for IP implementation that is based on the Baldrige Performance Excellence Program (BPEP). As a part of the model, we propose a series of research hypotheses to be tested. The data used to test the hypotheses were gathered from a questionnaire that was developed after an extensive literature review. The survey was administered to Mexican public HEIs, and more than 700 responses were collected. The data were assessed in terms of convergent and discriminant validity, obtaining satisfactory results. To test the proposed relationships between the model constructs, we utilized Structural Equation Modeling (SEM) using the software IBM SPSS Amos. The analysis confirmed the statistical validity of both the model and the hypotheses. In conclusion, our model for IP implementation is a useful tool for HEIs that seek to attain excellence in their processes through IPs.
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Rendimiento Académico/normas , Eficiencia Organizacional/normas , Universidades/normas , Humanos , MéxicoRESUMEN
La endoftalmitis infecciosa es una condición intraocular grave, aunque poco frecuente, que puede llevar a la pérdida de la visión. El diagnóstico etiológico precoz y el tratamiento adecuado llevan a una mejor evolución. Las técnicas microbiológicas convencionales tienen baja sensibilidad en el diagnóstico de la endoftalmitis infecciosa, en cambio la reacción en cadena de la polimerasa (PCR) es un método de mayor sensibilidad que está siendo utilizado ampliamente. El objetivo fue determinar por cultivo y PCR la etiología de la endoftalmitis infecciosa en pacientes que consultaron en centros oftalmológicos de Paraguay. Se estudiaron muestras de humor vítreo obtenidas por punción de 51 pacientes con endoftalmitis. La muestra se dividió en dos alícuotas; una para el estudio microbiológico convencional y la otra para la PCR anidada. Esta última utiliza un par de cebadores basado en secuencias conservadas del gen 16S ribosomal y cebadores específicos para bacterias gram positivas. Se estandarizó la PCR logrando una sensibilidad de detección de 3.10-5 ng/µl para S. aureus, 2,5.10-3 ng/µl para S. pneumoniae y 6.10-7 ng/µl para E. coli. De las 51 muestras, 12 (23,5%) fueron positivas por métodos microbiológicos convencionales y 26 (51,0%) por la PCR anidada. Por cultivo se identificaron predominantemente bacterias grampositivas 8/11 (73%) y un aislado de hongo filamentoso. La PCR anidada presentó muy buena sensibilidad y de gran utilidad en la identificación del origen bacteriano de la endoftalmitis, mejorando la sensibilidad del cultivo en 27,5%. La discriminación bacteriana en grampositivos y gramnegativos por la PCR se correlacionó con el cultivo en el 100% de los casos(AU)
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Endoftalmitis/microbiología , Reacción en Cadena de la Polimerasa , Endoftalmitis/diagnóstico , Estudios Transversales , Sensibilidad y Especificidad , Bacterias Grampositivas/genéticaRESUMEN
Due to globalization and the accelerated growth of technology, ever more employees of companies are affected by burnout syndrome, the psychological nature of which requires a prolonged response to chronic interpersonal stressors in work environments. The present research aims to validate the operability of the Maslach Burnout Inventory-General Survey (MBI-GS) using a sample of 378 professionals belonging to middle and senior management working in companies within the IMMEX sector (comprising the industrial-manufacturing, maquiladora and export services) located in the state of Baja California, Mexico. Firstly, an exploratory factor analysis using the principal components method and Varimax rotation was performed and the results revealed the existence of three factors representing more than 67 percent of the total variance. Secondly, a confirmatory factorial analysis was carried out performing appropriate results for the indices Chi-square goodness-of-fit model, Root Mean Square Error of Approximation (RMSEA), Normed Fit Index (NFI), Comparative Fit Index (CFI), Relative Fit Index (RFI), Parsimony Ratio (PRATIO) and Parsimony Normed Fit Index (PNFI), which are highly recommended by literature in these types of studies. Additionally, construct validity was satisfactorily verified. The factorial solution coincided with the Maslach Burnout Inventory original proposal so that this instrument can be considered a valid and reliable option to analyze the burnout levels in people pertaining to middle and senior management in these types of industries.
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Personal Administrativo/psicología , Agotamiento Profesional/diagnóstico , Agotamiento Profesional/psicología , Industrias/estadística & datos numéricos , Estrés Psicológico/diagnóstico , Encuestas y Cuestionarios/normas , Lugar de Trabajo/psicología , Personal Administrativo/estadística & datos numéricos , Adulto , Análisis Factorial , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Reproducibilidad de los Resultados , Lugar de Trabajo/estadística & datos numéricosRESUMEN
OBJECTIVES: It is currently recommended that after return of spontaneous circulation following cardiac arrest, fever should be prevented using TTM through a servo-controlled system. This technology is not yet available in many global settings, where manual physical measures without servo-control is the only option. Our aim was to compare feasibility, safety and quality assurance of servo-controlled system versus no servo-controlled system cooling, TTM protocols for cooling, maintenance and rewarming following return of spontaneous circulation after cardiac arrest in children. DESIGN: Prospective, multicenter, nonrandomized, study. SETTING: PICUs of 20 hospitals in South America, Spain, and Italy, 2012-2014. PATIENTS: Under 18 years old with a cardiac arrest longer than 2 minutes, in coma and surviving to PICU admission requiring mechanical ventilation were included. METHODS: TTM to 32-34°C was performed by prospectively designed protocol across 20 centers, with either servo-controlled system or no servo-controlled system methods, depending on servo-controlled system availability. We analyzed clinical data, cardiac arrest, temperature, mechanical ventilation duration, length of hospitalization, complications, survival, and neurologic outcomes at 6 months. PRIMARY OUTCOME: feasibility, safety and quality assurance of the cooling technique and secondary outcome: survival and Pediatric Cerebral Performance Category at 6 months. MEASUREMENTS AND MAIN RESULTS: Seventy patients were recruited, 51 of 70 TTM (72.8%) with servo-controlled system. TTM induction, maintenance, and rewarming were feasible in both groups. Servo-controlled system was more effective than no servo-controlled system in maintaining TTM (69 vs 60%; p = 0.004). Servo-controlled system had fewer temperatures above 38.1°C during the 5 days of TTM (0.1% vs 2.9%; p < 0.001). No differences in mortality, complications, length of mechanical ventilation and of stay, or neurologic sequelae were found between the two groups. CONCLUSIONS: TTM protocol (for cooling, maintenance and rewarming) following return of spontaneous circulation after cardiac arrest in children was feasible and safe with both servo-controlled system and no servo-controlled system techniques. Achieving, maintaining, and rewarming within protocol targets were more effective with servo-controlled system versus no servo-controlled system techniques.
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Reanimación Cardiopulmonar/métodos , Protocolos Clínicos/normas , Paro Cardíaco/terapia , Hipotermia Inducida/métodos , Hipotermia Inducida/normas , Adolescente , Temperatura Corporal , Niño , Preescolar , Europa (Continente) , Femenino , Humanos , Lactante , Unidades de Cuidado Intensivo Pediátrico , Masculino , Estudios Prospectivos , Recalentamiento/métodos , América del SurRESUMEN
BACKGROUND: The anti-neutrophil cytoplasmic antibody-associated (ANCA) vasculitides includes granulomatosis with polyangiitis (Wegener's) (GPW), Chrug-Strauss syndrome (CSS) and microscopic polyangiitis (MPA). Since it has low incidence in our field, there are a few published papers. The aim of this study was to report the clinical characteristics, activity and damage of these vasculitides in Mexico City's metropolitan eastern area. METHODS: We studied 28 cases with ANCA-associated vasculitis in the aforementioned area. The classification was made according to the ACR 1990 criteria, the Chapel Hill 2012 consensus, and the EULAR 2007 recommendations. We collected demographic data, as well as data of clinical manifestations, laboratory, management and outcomes. The activity was established using the Birmingham Vasculitis Activity Score (BVAS) and the damage using the Vasculitis Damage Index (VDI). We used paired t test and 95% confidence intervals (95% CI). RESULTS: 15 females and 13 males were included, 20 with GPW and 8 with CCS. The mean age was 50.1 ± 12.7 years, and the evolution time was 69 ± 49.6 months. We didn't find cases of MAP. 23 patients (82.1%) had general symptoms. The initial and final BVAS means were 10.5 and 1.5 (p < 0.001) and the global VDI was 2.4. CONCLUSIONS: The presence of ANCA-associated vasculitides is rare in the eastern Metropolitan area of Mexico City. GPW was predominant over CCS, and MPA was absent. They are multi-system vasculitides with high scores of initial activity and moderate damage.
Introducción: las vasculitis asociadas a anticuerpos anticitoplasma de neutrófilo (ANCA) incluyen la granulomatosis con poliangeítis (GPW), el síndrome de Churg-Strauss (SChS) y la poliangeítis microscópica (PAM). Como son de baja incidencia, los informes son escasos. El objetivo fue reportar las características clínicas, la actividad y el daño de casos con estas vasculitis en la zona oriente de la Ciudad de México. Métodos: Se incluyeron 28 casos. La clasificación de las vasculitis se hizo según los criterios ACR 1990, Chapel Hill 2012 y EULAR 2007. Se recabaron datos demográficos, manifestaciones clínicas, de laboratorio, tratamientos y evolución clínica. Se determinó el puntaje de actividad de Birmingham (BVAS) y el daño de la vasculitis (VDI). Se utilizó la prueba t pareada e intervalos de confianza al 95% (IC 95%). Resultados: 15 mujeres y 13 hombres fueron incluidos, 20 con GPW y 8 con SChS, con edad de 50.1 ± 12.7 años y evolución de 69 ± 49.6 meses. No hubo casos con PAM. Presentaron ataque al estado general 23 (82.1%). Los promedios BVAS inicial y final fueron: 10.5 y 1.5 (p < 0.001) y el VDI global fue de 2.4. Conclusiones: las vasculitis asociadas a ANCA son raras en esta zona de la Ciudad de México. Predominaron los casos de GPW sobre SChS y fueron nulos para PAM. Tienen presentación multisistémica, altos puntajes de actividad inicial y daño moderado.
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Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/diagnóstico , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/epidemiología , Salud Urbana/estadística & datos numéricos , Adulto , Anciano , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/terapia , Femenino , Estudios de Seguimiento , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
PURPOSE: In this prospective study, multiplex polymerase chain reaction (PCR) was used to identify genes encoding virulence factors (ica, atlE and mecA) in Coagulase-negative Staphylococcus (CNS) isolates from the ocular microbiota of patients undergoing cataract surgery and to investigate possible changes in the CNS profile due to antibiotic prophylaxis. METHODS: Between 09/2011 and 08/2013, patients undergoing cataract surgery were recruited at the Department of Ophthalmology, National University of Asuncion, Paraguay. In the eye to be operated on, patients received moxifloxacin 0.5 % eye drops four times at the day before surgery and a last drop 1 hour before surgery (T1). The other eye remained as control (T0). Conjunctival swabs were taken from both eyes 1 hour after the last drop. The presence of genes encoding biofilm formation (ica and atlE) and methicillin resistance (mecA) was detected by a multiplex PCR. RESULTS: Of the 162 patients (162 study eyes, 162 fellow eye as control group), 87 (53.7 %) eyes were positive for CNS at T0 yielding 96 CNS isolates; 70 eyes (43.2 %) were positive at T1 yielding 77 CNS isolates. For this study, 43 CNS isolates (44.8 %) from T0 and 45 (64.3 %) from T1 were used. Of the total isolates, 81.8 % (72/88) had at least one virulence factor gene (37/43 from T0 and 35/45 from T1) (p = 0.314). Simultaneous detection of ica and atlE genes was higher in T0 (58.0 %) than T1 (46.7 %), but the difference was not significant (p = 0.28). CONCLUSION: A high frequency of genes encoding virulence factors was observed in the coagulase-negative Staphylococcus isolates. The use of moxifloxacin did not significantly modify the CNS virulence factor profiles.
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Antibacterianos/uso terapéutico , Profilaxis Antibiótica/métodos , Extracción de Catarata/efectos adversos , Infecciones Bacterianas del Ojo/prevención & control , Infecciones Estafilocócicas/prevención & control , Staphylococcus/patogenicidad , Infección de la Herida Quirúrgica/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Coagulasa/metabolismo , ADN Bacteriano/análisis , Infecciones Bacterianas del Ojo/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Estudios Prospectivos , Infecciones Estafilocócicas/microbiología , Staphylococcus/enzimología , Staphylococcus/genética , Infección de la Herida Quirúrgica/microbiología , Factores de VirulenciaRESUMEN
The associations among respiratory complexes in energy-transducing membranes have been established. In fact, it is known that the Gram-negative bacteria Paracoccus denitrificans and Escherichia coli have respiratory supercomplexes in their membranes. These supercomplexes are important for channeling substrates between enzymes in a metabolic pathway, and the assembly of these supercomplexes depends on the protein subunits and membrane lipids, mainly cardiolipin, which is present in both the mitochondrial inner membrane and bacterial membranes. The Gram-positive bacterium Bacillus subtilis has a branched respiratory chain, in which some complexes generate proton motive force whereas others constitute an escape valve of excess reducing power. Some peculiarities of this respiratory chain are the following: a type II NADH dehydrogenase, a unique b 6 c complex that has a b 6 type cytochrome with a covalently bound heme, and a c-type heme attached to the third subunit, which is similar to subunit IV of the photosynthetic b 6 f complex. Cytochrome c oxygen reductase (caa 3 ) contains a c-type cytochrome on subunit I. We previously showed that the b 6 c and the caa 3 complexes form a supercomplex. Both the b 6 c and the caa 3 together with the quinol oxygen reductase aa 3 generate the proton motive force in B. subtilis. In order to seek proof that this supercomplex is important for bacterial growth in aerobic conditions we compared the b 6 c: caa 3 supercomplex from wild type membranes with membranes from two mutants lacking cardiolipin. Both mutant complexes were found to have similar activity and heme content as the wild type. Clear native electrophoresis showed that mutants lacking cardiolipin had b 6 c:caa 3 supercomplexes of lower mass or even individual complexes after membrane solubilization with digitonin. The use of dodecyl maltoside revealed a more evident difference between wild-type and mutant supercomplexes. Here we provide evidence showing that cardiolipin plays a role in the stability of the b 6 c:caa 3 supercomplex in B. subtilis.
Asunto(s)
Bacillus subtilis/metabolismo , Cardiolipinas/fisiología , Transporte de Electrón/fisiología , Bacillus subtilis/enzimología , Bacillus subtilis/ultraestructura , Proteínas Bacterianas/metabolismo , Biomasa , Membrana Celular , Complejos Multienzimáticos/metabolismo , Proteínas Mutantes , Subunidades de Proteína , Fuerza Protón-MotrizRESUMEN
Staphylococcus aureus (S. aureus) es actualmente el agente etiológico más frecuente en infecciones de piel y tejidos blandos. El S. aureus meticilino resistente (SAMR) aislado en infecciones de pacientes de la comunidad ha ido aumentando, constituyéndose en un problema de salud pública a nivel mundial. En Paraguay existen pocos registros sobre la meticilino resistencia y factores de virulencia a nivel comunitario, por lo que se realizó este estudio observacional descriptivo para determinar la frecuencia de SAMR y del factor de virulencia leucocidina de Panton Valentine (PVL-Panton Valentine leukocidin), así como el perfil de resistencia antimicrobiana acompañante a la meticilino resistencia en S. aureus aisladosde infecciones de piel y partes blandas de pacientes ambulatorios de dos laboratorios de Asunción, Paraguay, entre octubre de 2012 a febrero de 2014. La identificación bacteriana se realizó mediante técnicas microbiológicas convencionales y la susceptibilidad antimicrobiana por la prueba de difusión en disco. Elgen mecA y luk-PV fueron detectados por la técnica de PCR. De los 70 aislados de S. aureus estudiados, el 54,3% (38/70) fue SAMR tanto por método fenotípico como molecular. La frecuenciade PVL fue de 15,7% (11/70), siendo mayor en los SAMR (21%; 8/38) que en los SAMS (9,4%; 3/32). El 2,6% de los SAMR presentó resistencia a ciprofloxacina, no se observó multiresistencia en ningún aislado. Se encontró alta frecuencia de SAMR comparado con reportes previos en Paraguay. Se requiere fortalecer estrategias de vigilancia, prevención y control de la resistencia bacteriana en ambientes hospitalarios y de la comunidad.
Staphylococcus aureus (S. aureus) is currently the most common etiologic agentof skin and soft tissue infections. The isolation of methicillin-resistant S. aureus(MRSA) from infections of patients in the community has increased, becoming a public health problem worldwide. In Paraguay, there are few records aboutmethicillin resistance and virulence factors at community level. Therefore, this descriptive observational study was performed to determine the frequency of MRSA and factor virulence of Panton-Valentine leukocidin (PVL) as well as the antimicrobial resistance profile accompanying methicillin resistance in S. aureusisolated from skin and soft tissue infections in ambulatory patients from two laboratories of Asuncion, Paraguay from October, 2012 to February, 2014. The bacterial identification was performed using conventional microbiological techniques and the antimicrobial susceptibility was determined by disk diffusion. The mecA andluk-PV genes were detected by PCR technique. Out of the 70 S. aureus isolates studied, 54.3% (38/70) was SAMR by phenotypic and molecular methods. PVL frequency was 15.7% (11/70) being higher in MRSA (21%; 8/38) than in the SAMS (9.4%; 3/32), 2.6% of the MRSA was resistant to ciprofloxacin and multidrug resistance was not observed in any isolates. A high frequency of MRSA was found compared with previous reports in Paraguay. It is required to strengthen surveillance, prevention and control of bacterial resistance strategies in hospital and community environments.