RESUMO
The ancestral knowledge of the community of Colón Putumayo unfolds in several dimensions that allow us to recognise the ethnomedicinal properties of plants. The research focused on systematising ethnobotanical and ethnomedicinal knowledge on the use of plants as alternatives for treating illnesses. A cross-sectional study was carried out through semi-structured questionnaires to 100 inhabitants of the community of Colón. We found 38 plant species catalogued in 18 botanical families where 10 species of medicinal plants were prioritised by the community for the treatment of illnesses. The use value (UV) evaluation showed that Chamaemelum nobile equals 0.18 compared to Cymbopogon citratus and Lippia alba with 0.04. The Informant Consensus Factor (ICF) for the cited medicinal use categories equivalent to 1.00 are for the treatment of six types of ailments, however, the plants can treat 16 types of ailments. The Fidelity Level (LF) found identified that four plants are used for the treatment of one type of ailment while three are used to alleviate several ailments. The local knowledge of the community of Colón Putumayo is linked to the ancestry of the territory, culture, and family farming practices.
RESUMO
Resumen El objetivo es conocer acerca del efecto indirecto de la inteligencia emocional en la autoeficacia académica a través del compromiso académico en una muestra de estudiantes universitarios del Ecuador. Para ello se realizó un análisis de tipo descriptivo correlacional, de determinación, de mediación parcial a través de SEM y de corte transversal. El instrumental empleado corresponde a la Brief Emotional Intelligence Inventory for Senior Citizens, la Utrecht Work Engagement Scale y la Escala de Autoeficacia Percibida Específica de Situaciones Académicas. La muestra estuvo conformada por 500 estudiantes (57.5 % mujeres y 42.4 % hombres), entre 18 y 45 años (M = 24.5 años; SD = 6.9), procedentes de dos universidades de Ambato y Quito en Ecuador y de 11 carreras de pregrado. Entre los resultados se encontró que los niveles de las variables en análisis son normales entre los estudiantes, aunque un 30 % se encuentran en zona de riesgo por baja autoeficacia académica. Se confirma la relación entre inteligencia emocional (r = .522; p < .01) y el compromiso académico (r = .326; p < .01) en la autoeficacia académica. Estas variables forman un modelo explicativo del 30.6 % del cambio de la varianza de la autoeficacia académica. Además, la inteligencia emocional ejerce un efecto indirecto sobre la autoeficacia académica por medio del compromiso académico (ab = .031; p < .01). Como conclusión se establece que la inteligencia emocional y el compromiso académico son predictores de la autoeficacia académica. Además, que el compromiso académico es una variable de mediación parcial entre la inteligencia emocional y la autoeficacia académica en universitarios del Ecuador. La inteligencia emocional tiene como propiedad que ejerce un efecto directo en la autoeficacia académica e indirecto-parcial por medio del compromiso.
Abstract The intrapersonal and self-influence elements of individuals are necessary to know the impact they maintain in the educational context, because they are strong internal motivators that direct the behaviour of the individual to carry out various activities, as well as their achievement and success. There is evidence of the capacities that students have to monitor, control and regulate their own behaviours in the learning process. Although historically academic performance has been associated with intelligence in general, elements such as self-monitoring, self-control, self-regulation, self-motivation and others are key pieces to prevent school failure and maintain an adequate school performance. Within educational research, phenomena such as emotional intelligence, engagement and academic self-efficacy stand out due to their impact on academic performance. There are several studies that analyse the existing dynamics of these three variables, although separately, so a multifactorial study could expand the current conception of these internal elements and their effect on education. This investigation's objectives are to identify the current state of emotional intelligence, engagement and academic self-efficacy in a sample of university students from Ecuador, as well as the relationship between these variables and the indirect effect of emotional intelligence on academic self-efficacy through academic engagement. Thus, this study is a descriptive correlational, determination and partial mediation analysis, carried out through SEM using the Brief Emotional Intelligence Inventory for Senior Citizens, the Utrecht Work Engagement Scale and the Scale of Perceived Self-efficacy Specific to Academic Situations. The sample was made up of 500 students (57.5 % women and 42.4 % men), between 18 and 45 years old (M = 24.5 years; SD = 6.9), from two universities in Ambato and Quito in Ecuador and 11 undergraduate majors. The participants were selected through an intentional non-probabilistic sampling with inclusion criteria, which were: (a) be legally enrolled in one of the universities in this study; (b) voluntary participation in the study; (c) signed participation consent; and (c) be of legal age. In general, the levels of emotional intelligence, engagement and self-efficacy are normal among students; however, in academic engagement, 30 % are in a risk zone. The relationship between emotional intelligence (r = 0.522; p < .01) and academic engagement (r = 0.326; p < .01) in academic self-efficacy is confirmed. Together, these variables form an explanatory model that can predict changes in variance by 30.6 %. The theoretical model proposed by means of structural linear regression has an adequate adjustment indicator χ. = 252.9; p < .001; df = 116; χ./df = 2.1; CFI = .96; TLI = .95; RMSEA = .049 [.040 - .057]; SRMR = .042. In addition, emotional intelligence has an indirect effect on academic self-efficacy through academic engagement (ab = .0031; p < .01). Among the conclusions of the study, it is mentioned that emotional intelligence and academic engagement are predictors of academic self-efficacy. Therefore, their interest and management in the educational context is relevant. Moreover, the academic engagement is a partial mediation variable between emotional intelligence and academic self-efficacy in university students in Ecuador. Emotional intelligence has the ability to exert not only direct effects, but also partial indirect effects through a third variable. One of the implications of the study is that the use of more contemporary methods such as SEM allows a broader vision of the modelling of academic behaviour, which is an important contribution because it significantly reduces measurement bias. In addition, these results contribute to the future development of psychoeducational intervention processes that contribute to the improvement of the academic performance of students and to the teaching-learning processes in general. Finally, it is important to replicate similar studies in order to generalize these findings.
RESUMO
Introducción: El clima laboral se relaciona con el acoso psicológico en el trabajo. No obstante, son escasos los estudios encontrados sobre la relación entre clima y violencia laboral en el contexto universitario. Objetivo: Analizar la relación entre el clima y la violencia laboral en funcionarios de una universidad pública. Materiales y métodos: Estudio descriptivo correlacional con diseño transversal, con la participación de 410 funcionarios. Se utilizó el Cuestionario de Clima Laboral del Departamento Administrativo de la Función Pública de Colombia y el Inventario de Violencia y Acoso Psicológico en el Trabajo. Resultados: Se encontró que existe una relación negativa entre el clima y la violencia laboral (r=-0,441, p<0,005), en esta se resaltan estrechas asociaciones entre la dimensión obstáculos al desempeño laboral, y estilo de liderazgo, administración del talento humano y clima general. Conclusiones: La presencia de violencia laboral se relaciona con bajos niveles de favorabilidad de clima laboral y viceversa. Los comportamientos característicos de obstáculos al desempeño laboral y los referentes a "manipulación para inducir al castigo" son los que aportan en mayor medida a esta desfavorabilidad. Este tipo de violencia, sin una debida intervención puede llegar a convertirse en acoso psicológico en el trabajo.
Introduction: Work environment isaffected by psychological harassment in the workplace. However, there are few studies on the relationship between workplace climate and violence in the university context. Objective: To analyze the relationship between workplace climate and violence in public university employees. Materials and Methods: A descriptive correlational study with a cross-sectional design was conducted with 410 workers. The Work Climate Questionnaire of the Administrative Department of Public Service of Colombia and the Inventory of Violence and Psychological Harassment at Work were used. Results: It was found that there is a negative relationship between climate and violence in the workplace (r = -0.441, p <0.005), in which two close associations are highlighted: (i) the dimension of work performance obstacles and the leadership style; and (ii) human talent management and general climate. Conclusions: The presence of workplace violence is related to low levels of a favorable work environment and vice versa. The characteristic behaviors of the dimension world performance obstacles and those related to the variable manipulation to induce punishment are the ones that contribute the most to this unfavorable association. This type of violence, without proper intervention, can become psychological harassment at work.
Assuntos
Relações Trabalhistas , Organizações , Violência no Trabalho , Categorias de TrabalhadoresRESUMO
Hydroxyapatite (HAp) is the most commonly used biomaterial in modern bone regeneration studies because of its chemical similarity to bone, biocompatibility with different polymers, osteoconductivity, low cost, and lack of immune response. However, to overcome the disadvantages of HAp, which include fragility and low mechanical strength, current studies typically focus on property modification through the addition of other materials. Objective. To develop and evaluate the biocompatibility of a HAp material extracted from eggshells and modified with silicon (Si) and poly(lactic-co-glycolic) acid (PLGA). Materials and Methods. An in vitro experimental study in which a HAp material prepared from eggshells was synthesized by wet chemical and conventional chemical precipitation. Subsequently, this material was reinforced with Si/PLGA using the freezing/lyophilization method, and then osteoblast cells were seeded on the experimental material (HAp/Si/PLGA). To analyse the biocompatibility of this composite material, scanning electron microscopy (SEM) and fluorescence confocal microscopy (FCM) techniques were used. PLGA, bovine bone/PLGA (BB/PLGA), and HAp/PLGA were used as controls. Results. A cellular viability of 96% was observed for the experimental HAp/Si/PLGA material as well as for the PLGA. The viability for the BB/PLGA material was 90%, and the viability for the HAp/PLGA was 86%. Cell adhesion was observed on the exterior surface of all materials. However, a continuous monolayer and the presence of filopodia were observed over both external and internal surface of the experimental materials. Conclusions. The HAp/Si/PLGA material is highly biocompatible with osteoblastic cells and can be considered promising for the construction of three-dimensional scaffolds for bone regeneration in dentistry.
RESUMO
Introducción: La miocardiopatía hipertrófica es una enfermedad compleja que se ha asociado durante años con tasas altas de morbimortalidad. Sin embargo, mucha de la información que tenemos en relación con su evolución proviene de centros en los que se incluyeron pacientes seleccionados, principalmente de riesgo alto. Objetivo: Evaluar los eventos en el seguimiento de pacientes con miocardiopatía hipertrófica en nuestro medio. Material y métodos: Se evaluó una cohorte retrospectiva de pacientes con diagnóstico de miocardiopatía hipertrófica. Se analizó la evolución de la clase funcional junto con la ocurrencia de eventos clínicos. Se recabaron datos del ecocardiograma y de la resonancia magnética cardíaca. Resultados: Se incluyeron 259 pacientes, con una mediana de seguimiento de 3,5 años (2-10). La edad promedio fue de 56 ± 16,8 años y el 38,2% de los pacientes tenían formas obstructivas de la enfermedad. Al inicio del seguimiento, el 67% se encontraban en clase funcional I. En la evolución, la mortalidad global fue del 1,6%, con el 1,1% de muerte súbita o choque apropiado de desfibrilador y el 6,6% de los pacientes presentaron fibrilación auricular. La tasa de internación por insuficiencia cardíaca resultó del 5,8% y en el 14,3% de los pacientes empeoró la clase funcional. Se realizaron 22 procedimientos de ablación septal y 15 miectomías, con mejoría significativa de la sintomatología. Conclusiones: El trabajo muestra que en el seguimiento de esta cohorte de pacientes con miocardiopatía hipertrófica la tasa de morbimortalidad fue baja; el principal evento adverso fue el empeoramiento de la clase funcional, seguido por el desarrollo de fibrilación auricular y la insuficiencia cardíaca, con una tasa baja de muerte súbita.
RESUMO
BACKGROUND: The aim of the study was to evaluate the value of high-sensitivity cardiac troponin (hs-cTn) for identifying high-risk patients. METHODS AND RESULTS: One hundred and eighty-seven patients admitted with acute heart failure (HF) (without myocardial infarction) were consecutively included; hs-cTn was measured at admission; the relation between elevated hs-cTn and the clinical outcome during hospitalization and at 90 days was analyzed; 93% (n = 174) had hs-cTn above the maximal normal value (14 ng/L); median hs-cTn was 42 ng/L (IQR 24-81). Patients with ejection fraction (EF) ≤ 45% had higher hs-cTn values (p = 0.0004). Patients with low cardiac output syndrome (LCOS) or shock had higher troponin levels compared with those with less severe clinical presentations (p = 0.004). Patients who required inotropic presented higher troponin values (p = 0.002), troponin values were also higher in those requiring complex therapies (intra-aortic balloon pump, mechanical ventilation or hemodialysis, p = 0.002). At 90-day follow-up, 28 (15.5%) patients died and 27 rehospitalizations occurred (55 events). The risk of events was greater in patients with hs-cTn > 42 ng/L (0.021), low blood pressure at admission (p = 0.002), LCOS or shock (p < 0.0001), EF ≤ 45% (p = 0.005) and inotropic use (p < 0.0001). In multivariate analysis, only inotropic agents requirements was associated independently with a high risk of death or rehospitalizations at 90 days (p = 0.007). CONCLUSIONS: Elevation of hs-cTn is a finding almost constant in patients with decompensated HF. In subjects with higher troponin levels ventricular dysfunction is frequent. The use of hs-cTn for risk stratification at admission helps to identify populations with poor outcome during hospitalization and increased risk of death or rehospitalizations during follow-up who will require rapid implementation of aggressive treatment.
Assuntos
Insuficiência Cardíaca/sangue , Troponina/sangue , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Biomarcadores/sangue , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/terapia , Hospitalização , Humanos , Estimativa de Kaplan-Meier , Masculino , Valor Preditivo dos Testes , Prevalência , Prognóstico , Modelos de Riscos Proporcionais , Medição de Risco , Fatores de Risco , Fatores de Tempo , Regulação para CimaRESUMO
No existen modelos animales apropiados para el estudio de la fisiopatología y las manifestaciones clínicas de la enfermedad causada por la infección con virus dengue, por lo que para ello se requiere desarrollar modelos experimentales. El propósito del presente trabajo fue establecer un modelo de infección in vitro con virus dengue serotipo-2 (DENV-2). Para esto se obtuvieron células mononucleares de sangre periférica (CMSP) usando un gradiente de Ficoll, y se las cultivó e infectó con DENV-2 a una baja multiplicidad de infección. La subpoblación celular que se infectó y produjo citocinas se identificó empleando un análisis multiparamétrico por citometría de flujo. Como resultado, las CMSP fueron permisivas a la infección, que se detectó a las 24 horas de inoculado el virus. Además, en este mismo tiempo, los monocitos CD14+, pero no los linfocitos CD3+ o CD19+, fueron la subpoblación celular preferencialmente infectada y responsable de la producción de TNF-α e IL-6. En conclusión, se estableció un modelo de infección in vitro usando CMSP no fraccionadas, en el que se identificó a los monocitos CD14+ como la principal célula blanco de la infección con DENV-2 y productora de citocinas proinflamatorias.
To date, there are no appropriate animal models for the study of the pathophysiology and clinical manifestations of the disease caused by dengue virus infection; therefore, experimental models are required for that purpose. The objective of the present work was to establish a model of in vitro infection with DENV-2. To this end, human peripheral blood mononuclear cells (PBMC) were obtained using a Ficoll gradient, and infected with DENV-2 using a low multiplicity of infection. The cell populations infected and responsible for the production of cytokines were identified using a multiparametric analysis by flow cytometry. As a result, PBMC were permissive to infection that was detected 24 hours after virus inoculation. Additionally, at this same time, CD14+ cells, but not CD3+ or CD19+ cells, were preferentially infected and responsible for the production of TNF-α and IL-6. In conclusion, we established a model of in vitro infection using unfractionated PBMC, in which CD14+ cells were identified as the primary target cells for infection with DENV-2, and the production of proinflammatory cytokines.
Assuntos
Humanos , Vírus da Dengue , Técnicas In Vitro , Leucócitos MononuclearesAssuntos
Insuficiência Cardíaca/etiologia , Doença de Still de Início Tardio/complicações , Doença Aguda , Eletrocardiografia , Fibrose Endomiocárdica/etiologia , Fibrose Endomiocárdica/patologia , Feminino , Insuficiência Cardíaca/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Miocárdio/patologia , Recidiva , Doença de Still de Início Tardio/patologia , Ultrassonografia Doppler em Cores , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/etiologiaRESUMO
Chronic periodontitis is a multifactorial infectious disease associated with Gram-negative strict anaerobes which are immersed in the subgingival biofilm. Porphyromonas gingivalis, an important periodontal pathogen, is frequently detected in patients with chronic periodontitis. Although isolates of P. gingivalis tend to be susceptible to most antimicrobial agents, relatively little information is available on its in vitro antimicrobial susceptibility. The aim of this study was to determine the frequency of P. gingivalis in patients with chronic periodontitis and to assess antimicrobial susceptibility in terms of minimum inhibitory concentration (MIC) of clinical isolates to metronidazole and tetracycline. A descriptive, observational study was performed including 87 patients with chronic periodontitis. Samples were taken from the periodontal pocket using paper points, which were placed in thioglycollate broth. Samples were incubated for 4 hours at 37°C in anaerobic conditions and finally replated on Wilkins-Chalgren anaerobic agar (Oxoid). Bacteria were identified using the RapIDTMANAII system (Remel) and antimicrobial susceptibility was determined with the M.I.C. Evaluator test (MICE, Oxoid). P. gingivalis was identified in 30 of the 87 patients with chronic periodontitis, which represents a frequency of 34.5%. All 30 isolates (100%) were sensitive to metronidazole, with MIC values ranging from 0015-4ug/ml. Regarding tetracycline, 27 isolates (90%) were sensitive, with MIC values ranging from <0.015 to 4 ug /ml, the remaining three isolates (10%) were resistant to tetracycline with MIC values of 8ug/ ml. There was no statistically significant difference in age, gender, pocket depth, clinical attachment level and severity of periodontitis between the group of patients with chronic periodontitis and P. gingivalis and the group of patients with chronic periodontitis without P. gingivalis. In conclusion, P. gingivalis was found at a frequency of 34.5% in patients with chronic periodontitis and clinical isolates were highly sensitive to metronidazole and tetracycline.
Assuntos
Antibacterianos/farmacologia , Periodontite Crônica/microbiologia , Metronidazol/farmacologia , Porphyromonas gingivalis/isolamento & purificação , Tetraciclina/farmacologia , Adolescente , Adulto , Idoso , Carga Bacteriana , Técnicas Bacteriológicas , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Perda da Inserção Periodontal/microbiologia , Índice Periodontal , Bolsa Periodontal/microbiologia , Porphyromonas gingivalis/efeitos dos fármacos , Adulto JovemRESUMO
La periodontitis crónica es una enfermedad infecciosa multifactorialasociada a bacilos Gram-negativos anaeróbicos estrictos que se encuentran inmersos en la biopelícula subgingival. Porphyromonas gingivalis, importante patógeno periodontal, es frecuentemente detectado en pacientes con periodontitis crónica. Los aislamientos clínicos de P. gingivalis tienden a ser susceptibles a la mayoría de agentes antimicrobianos; sin embargo, se tiene poca información sobre la susceptibilidad antimicrobiana invitro. El objetivo de este estudio fue determinar la frecuencia de P. gingivalis en pacientes con periodontitis crónica y determinar la susceptibilidad antimicrobiana en términos de concentración inhibitoria mínima (CIM) de los aislamientos clínicos a metronidazol y tetraciclina. Se realizó un estudio observacional descriptivo enel que se incluyeron 87 pacientes con periodontitis crónica. Las muestras tomadas con conos de papel de la bolsa periodontal se depositaron en caldo tioglicolato, se incubaron durante 4 horas a 37 oC en anaerobiosis y se resembraron en agar anaeróbico Wilkins-Chalgren (Oxoid). La identitficación de los aislamientos serealizó con el sistema RapIDTM ANA II (Remel) y la susceptibilidadantibiótica para metronidazol y tetraciclina se evaluó mediante la técnica M.I.C.Evaluator (M.I.C.E., Oxoid). En 30 de los 87 pacientes con periodontitis crónica se identificó P. gingivalis, lo que representa una frecuencia de 34.5 por ciento. Todos los 30 aislamientos (100 por ciento) fueron sensibles al metronidazol con valores de CIM desde 0.015 hasta 4 ug/ml. En cuanto a tetraciclina, 27 aislamientos(90 por ciento) fueron sensibles con valores de CIM desde <0.015 hasta4 ug/ml; los restantes 3 aislamientos (10%) fueron resistentes a tetraciclina con valores de CIM de 8 ug/ml. En cuanto a edad, género, profundidad de bolsa, nivel de inserción clínico y severidad de la periodontitis no se presentaron diferencias estadísticamentesignificativas
Assuntos
Adolescente , Adulto Jovem , Metronidazol/uso terapêutico , Periodontite Crônica/microbiologia , Porphyromonas gingivalis/isolamento & purificação , Tetraciclina/uso terapêutico , Bolsa Periodontal/microbiologia , Colômbia , Meios de Cultura , Epidemiologia Descritiva , Testes de Sensibilidade Microbiana , Índice Periodontal , Contagem de Colônia Microbiana/métodos , Interpretação Estatística de DadosRESUMO
Chronic periodontitis is a multifactorial infectious disease associated with Gram-negative strict anaerobes which are immersed in the subgingival biofilm. Porphyromonas gingivalis, an important periodontal pathogen, is frequently detected in patients with chronic periodontitis. Although isolates of P. gingivalis tend to be susceptible to most antimicrobial agents, relatively little information is available on its in vitro antimicrobial susceptibility. The aim of this study was to determine the frequency of P. gingivalis in patients with chronic periodontitis and to assess antimicrobial susceptibility in terms of minimum inhibitory concentration (MIC) of clinical isolates to metronidazole and tetracycline. A descriptive, observational study was performed including 87 patients with chronic periodontitis. Samples were taken from the periodontal pocket using paper points, which were placed in thioglycollate broth. Samples were incubated for 4 hours at 37°C in anaerobic conditions and finally replated on Wilkins-Chalgren anaerobic agar (Oxoid). Bacteria were identified using the RapIDTMANAII system (Remel) and antimicrobial susceptibility was determined with the M.I.C. Evaluator test (MICE, Oxoid). P. gingivalis was identified in 30 of the 87 patients with chronic periodontitis, which represents a frequency of 34.5
. All 30 isolates (100
) were sensitive to metronidazole, with MIC values ranging from 0015-4ug/ml. Regarding tetracycline, 27 isolates (90
) were sensitive, with MIC values ranging from <0.015 to 4 ug /ml, the remaining three isolates (10
) were resistant to tetracycline with MIC values of 8ug/ ml. There was no statistically significant difference in age, gender, pocket depth, clinical attachment level and severity of periodontitis between the group of patients with chronic periodontitis and P. gingivalis and the group of patients with chronic periodontitis without P. gingivalis. In conclusion, P. gingivalis was found at a frequency of 34.5
in patients with chronic periodontitis and clinical isolates were highly sensitive to metronidazole and tetracycline.
RESUMO
Chronic periodontitis is a multifactorial infectious disease associated with Gram-negative anaerobes which are part of the subgingival microflora. In recent years, studies have been conducted to assess the presence of Gram-negative facultative anaerobes (Enterobacteriaceae) and their participation in the development and progression of chronic periodontitis. The aim of this study was to determine the presence of Enterobacteriaceae in patients with chronic periodontitis and gingivitis and to assess antimicrobial susceptibility of clinical isolates. A descriptive, observational study was performed including 64 patients with chronic periodontitis and 22 patients with gingivitis. Microbiological samples were taken from the gingival sulcus using paper points, which then were placed in thioglycollate broth. Samples were incubated for 4 hours at 37 degrees C and finally replated on MacConkey agar Bacteria were identified using the API-20E system (Biomerieux, France) and antimicrobial susceptibility was determined using the disk diffusion method. The evaluation of samples showed presence of 29 enterobacterial species distributed as follows: 7 in the group with gingivitis and 22 in the group with chronic periodontitis. In the chronic periodontitis group the most common species were: K. oxytoca n = 5, S. liquefaciens n = 4 and K. pneumoniae and E. coli with n = 3. The gingivitis group had the highest frequency of Erwinia sp. (n = 2). Clinical isolates showed very low sensitivity levels to beta-lactam ampicillin and amoxicillin/ clavulanic acid, 17.2% and 27.6% respectively, and higher sensitivity levels to ciprofloxacin (96.6%), amikacin (79.3%), gentamicin (68.9%) and ceftazidime, ceftriaxone, kanamycin and trimethoprimsulfa (65.5%). In conclusion, the existence of a high frequency of enterobacteria in patients with chronic periodontitis and gingivitis shows that periodontologists should pay greater attention to prevention protocols, and develop mechanical and antimicrobial therapies in which antimicrobial susceptibility profile reports should be considered as part of periodontal treatment.
Assuntos
Antibacterianos/farmacologia , Periodontite Crônica/microbiologia , Infecções por Enterobacteriaceae/microbiologia , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/isolamento & purificação , Gengivite/microbiologia , Feminino , Bacilos Gram-Negativos Anaeróbios Facultativos/efeitos dos fármacos , Bacilos Gram-Negativos Anaeróbios Facultativos/isolamento & purificação , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-IdadeRESUMO
La periodontitis crónica es una enfermedad infecciosa multifactorial hacen parte de la microflora subgingival. En los últimos años se han realizado estudios para valorar la presencia de bacilos Gramnegativos anaerobios facultativos (enterobacterias) y suimportancia en el desarrollo y rogresión de la periodontitis crónica. El objetivo de este estudio fue determinar la presencia de enterobacterias en pacientes con periodontitis crónica y gingivitis y conocer la susceptibilidad antimicrobiana de los aislamientosclínicos. Se realizó un estudio observacional y descriptivo en elque se incluyeron 64 pacientes con periodontitis crónica y 22 pacientes con gingivitis. Las muestras tomadas en el surco gingival con conos de papel se depositaron en caldo tioglicolato, seincubaron durante 4 horas a 37 oC y se resembraron finalmente en Agar MacConkey. En la identificación de las bacterias se utilizó el sistema API-20E (Biomerieux, France) y la susceptibilidadantimicrobiana se realizó por el método de difusión en disco. En los dos grupos se identificaron 29 especies enterobacterianas, 7 en el grupo con gingivitis y 22 en el grupo con periodontitis crónica. En el grupo de periodontitis crónica las especies masfrecuentes fueron: K. oxytoca n=5, S. liquefaciens n=4 y K.pneumoniaey E. coli con n=3. En el grupo con gingivitis, Erwiniasp tuvo la mayor frecuencia (n=2). Los aislamientos clínicos presentaron níveles muy bajos de sensibilidad a los B-lactamicosampicilina y amoxicilina/ ac.clavulanico, 17.2 y 27.6 por ciento, y la mayor sensibilidad a ciprofloxacina. En conclusión, la alta frecuencia de enterobacterias en pacientes con periodontitis debe conducir a la prevención y a desarrollar terapias mecánicas y antimicrobianas en las cuales se tengan en cuenta, como parte del tratamiento periodontal, los perfiles antimicrobianos reportados.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Antibacterianos/farmacologia , Enterobacteriaceae/isolamento & purificação , Enterobacteriaceae , Gengivite/microbiologia , Infecções por Enterobacteriaceae/microbiologia , Periodontite/microbiologia , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Negativas , Testes de Sensibilidade MicrobianaRESUMO
Chronic periodontitis is a multifactorial infectious disease associated with Gram-negative anaerobes which are part of the subgingival microflora. In recent years, studies have been conducted to assess the presence of Gram-negative facultative anaerobes (Enterobacteriaceae) and their participation in the development and progression of chronic periodontitis. The aim of this study was to determine the presence of Enterobacteriaceae in patients with chronic periodontitis and gingivitis and to assess antimicrobial susceptibility of clinical isolates. A descriptive, observational study was performed including 64 patients with chronic periodontitis and 22 patients with gingivitis. Microbiological samples were taken from the gingival sulcus using paper points, which then were placed in thioglycollate broth. Samples were incubated for 4 hours at 37 degrees C and finally replated on MacConkey agar Bacteria were identified using the API-20E system (Biomerieux, France) and antimicrobial susceptibility was determined using the disk diffusion method. The evaluation of samples showed presence of 29 enterobacterial species distributed as follows: 7 in the group with gingivitis and 22 in the group with chronic periodontitis. In the chronic periodontitis group the most common species were: K. oxytoca n = 5, S. liquefaciens n = 4 and K. pneumoniae and E. coli with n = 3. The gingivitis group had the highest frequency of Erwinia sp. (n = 2). Clinical isolates showed very low sensitivity levels to beta-lactam ampicillin and amoxicillin/ clavulanic acid, 17.2
and 27.6
respectively, and higher sensitivity levels to ciprofloxacin (96.6
), amikacin (79.3
), gentamicin (68.9
) and ceftazidime, ceftriaxone, kanamycin and trimethoprimsulfa (65.5
). In conclusion, the existence of a high frequency of enterobacteria in patients with chronic periodontitis and gingivitis shows that periodontologists should pay greater attention to prevention protocols, and develop mechanical and antimicrobial therapies in which antimicrobial susceptibility profile reports should be considered as part of periodontal treatment.
Assuntos
Antibacterianos/farmacologia , Periodontite Crônica/microbiologia , Infecções por Enterobacteriaceae/microbiologia , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/isolamento & purificação , Gengivite/microbiologia , Feminino , Bacilos Gram-Negativos Anaeróbios Facultativos/efeitos dos fármacos , Bacilos Gram-Negativos Anaeróbios Facultativos/isolamento & purificação , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-IdadeRESUMO
La periodontitis crónica es una enfermedad infecciosa multifactorial hacen parte de la microflora subgingival. En los últimos años se han realizado estudios para valorar la presencia de bacilos Gramnegativos anaerobios facultativos (enterobacterias) y suimportancia en el desarrollo y rogresión de la periodontitis crónica. El objetivo de este estudio fue determinar la presencia de enterobacterias en pacientes con periodontitis crónica y gingivitis y conocer la susceptibilidad antimicrobiana de los aislamientosclínicos. Se realizó un estudio observacional y descriptivo en elque se incluyeron 64 pacientes con periodontitis crónica y 22 pacientes con gingivitis. Las muestras tomadas en el surco gingival con conos de papel se depositaron en caldo tioglicolato, seincubaron durante 4 horas a 37 oC y se resembraron finalmente en Agar MacConkey. En la identificación de las bacterias se utilizó el sistema API-20E (Biomerieux, France) y la susceptibilidadantimicrobiana se realizó por el método de difusión en disco. En los dos grupos se identificaron 29 especies enterobacterianas, 7 en el grupo con gingivitis y 22 en el grupo con periodontitis crónica. En el grupo de periodontitis crónica las especies masfrecuentes fueron: K. oxytoca n=5, S. liquefaciens n=4 y K.pneumoniaey E. coli con n=3. En el grupo con gingivitis, Erwiniasp tuvo la mayor frecuencia (n=2). Los aislamientos clínicos presentaron níveles muy bajos de sensibilidad a los B-lactamicosampicilina y amoxicilina/ ac.clavulanico, 17.2 y 27.6 por ciento, y la mayor sensibilidad a ciprofloxacina. En conclusión, la alta frecuencia de enterobacterias en pacientes con periodontitis debe conducir a la prevención y a desarrollar terapias mecánicas y antimicrobianas en las cuales se tengan en cuenta, como parte del tratamiento periodontal, los perfiles antimicrobianos reportados.(AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Antibacterianos/farmacologia , Periodontite/microbiologia , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/isolamento & purificação , Infecções por Enterobacteriaceae/microbiologia , Gengivite/microbiologia , Testes de Sensibilidade Microbiana , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Negativas/efeitos dos fármacosRESUMO
INTRODUCTION AND OBJECTIVES: Patients with heart failure and similar left ventricular systolic dysfunction have differing exercise capacity. The aim of this study was to identify echocardiographic predictors of exercise capacity in patients with heart failure and systolic dysfunction. METHODS: We included 150 patients with class II (70%) or III (30%) heart failure with left ventricular ejection fraction below 40%. Six-minute walking test and cardiac color Doppler-echo, including tissue Doppler of mitral and tricuspid rings, were performed. Moderate and severe mitral regurgitation were considered as significant. Two groups were divided according to the median walking distance (290 m): Group 1, <290 m and Group 2, ≥290 m. RESULTS: Mitral regurgitation was detected in 112 patients (75%), which was significant in 40 (27%). Group 1 showed more significant mitral regurgitation (35 vs 18%), increased left atrium area (27±1 vs 24±1cm(2)), mitral E amplitude (88±5 vs 72±3cm/s) and systolic pulmonary pressure (37±1 vs 32±1mmHg, all P<.05). By logistic regression analysis, only the presence of significant mitral regurgitation was independently associated with less walked distance (odds ratio: 3.44 95% confidence interval 1.02-11.66, P<.05). By multiple linear regression, the only independent predictor of walked distance was left atrium area (r=0.25, beta coefficient: -6.52±2, P<.01). CONCLUSIONS: In patients with class II-III heart failure and left ventricular systolic dysfunction, the main echocardiographic predictors of exercise capacity are related to the presence of significant mitral regurgitation.
Assuntos
Ecocardiografia , Tolerância ao Exercício/fisiologia , Insuficiência Cardíaca Sistólica/diagnóstico por imagem , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência da Valva Mitral/diagnóstico por imagem , Idoso , Ecocardiografia Doppler em Cores , Ecocardiografia Transesofagiana , Feminino , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca Sistólica/fisiopatologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/fisiopatologia , Valor Preditivo dos Testes , CaminhadaRESUMO
BACKGROUND: Low plasma triiodothyronine (T(3)) levels are considered a prognostic predictor of death in heart failure (HF) patients. AIM: To study an association between plasma T(3) levels and several cardiac, neurohormonal, and metabolic markers of HF. METHODS: A total of 133 ambulatory HF patients (114 males; mean age 63.2 years) with left ventricular ejection fraction <40% were enrolled. TSH, total tetraiodothyronine (T(4)) and T(3), N-terminal pro-brain natriuretic peptide (NT-proBNP), and other cardiac and metabolic parameters were measured. The lowest tertile of T(3) (group 1) was compared against the two upper ones (group 2). RESULTS: In simple logistic regression, the lowest T(3) tertile was associated with more advanced HF disease status: older (age: odds ratio (OR)=1.05; confidence interval (CI) 95% 1.01-1.09, P=0.004), lower functional capacity (walking test: OR=0.996; CI 95% 0.993-0.999, P=0.008), higher NT-proBNP (OR=1.64; CI 95% 1.19-2.27, P=0.003) and adiponectin levels (OR=1.07; CI 95% 1.02-1.11, P=0.004), lower DHEAS log-transformed (OR=0.50; CI 95% 0.31-0.80, P=0.004), and the presence of lower phase angle values as measured by body bioelectrical impedance analysis (OR=3.18; CI 95% 1.50-6.71, P=0.04) and worse renal function (OR=0.96; CI 95% 0.94-0.98, P=0.003). T(3) levels in the lowest tertile were independently associated with low phase angle values (OR=2.95, CI 95% 1.16-7.50, P=0.02) and the log transformation of DHEAS (OR=0.56; CI 95% 0.32-0.97, P=0.04). CONCLUSION: We have demonstrated an association between plasma T(3) levels in the lower range and other deranged hormonal and metabolic parameters in HF patients.
Assuntos
Insuficiência Cardíaca/metabolismo , Insuficiência Cardíaca/patologia , Tri-Iodotironina/deficiência , Idoso , Biomarcadores , Cardiomiopatia Dilatada/diagnóstico por imagem , Cardiomiopatia Dilatada/patologia , Ecocardiografia , Impedância Elétrica , Teste de Esforço , Feminino , Insuficiência Cardíaca/diagnóstico por imagem , Hemodinâmica/fisiologia , Hormônios/sangue , Humanos , Inflamação/sangue , Modelos Logísticos , Masculino , Membranas/patologia , Pessoa de Meia-Idade , Neurotransmissores/sangue , Prognóstico , Estudos Prospectivos , Volume Sistólico/fisiologia , Tri-Iodotironina/sangue , Função Ventricular Esquerda/fisiologia , Caminhada/fisiologiaRESUMO
Catabolism and inflammation play a role in the physiopathology of heart failure with reduced ejection fraction and are more pronounced in the advanced stages of the disease. Our aim was to demonstrate that in patients with stable heart failure with reduced ejection fraction adequately treated, a direct relation exists between functional impairment, as evaluated by left ventricular ejection fraction (LVEF) and the 6-minute walking distance (6MWD), and catabolic and inflammatory markers. In 151 outpatients with heart failure and a LVEF of < or =40% (median age 64 years, LVEF 29%, and 6MWD 290 m) we measured the laboratory and body composition parameters that indicate directly or indirectly inflammatory activation, anabolic-catabolic balance, and nutritional status. We performed an analysis stratified by quartiles of LVEF and 6MWD and linear regression analysis to explore our hypothesis. In the linear regression analysis, after adjusting for age, gender, and etiology, LVEF was not related to the metabolic, inflammatory, or nutritional parameters. The 6MWD was directly related to albumin (p = 0.002) and log transformation of dehydroepiandrosterone (p = 0.013) and inversely to adiponectin (p = 0.001) and the log-transformation of high-sensitivity C-reactive protein (p = 0.037). In conclusion, in a population with stable heart failure with reduced ejection fraction, the 6MWD was related to the degree of inflammatory activity and catabolism, but LVEF was not. Even a slightly diminished functional capacity implies underlying inflammation and catabolic activation.
Assuntos
Insuficiência Cardíaca/metabolismo , Insuficiência Cardíaca/fisiopatologia , Inflamação/complicações , Volume Sistólico/fisiologia , Adiponectina/biossíntese , Idoso , Proteína C-Reativa/metabolismo , Doença Crônica , Desidroepiandrosterona/metabolismo , Feminino , Insuficiência Cardíaca/patologia , Humanos , Masculino , Metabolismo , Pessoa de Meia-Idade , CaminhadaRESUMO
Introducción La disfunción renal está fuertemente asociada con la insuficiencia cardíaca crónica. Es una complicación habitual y progresiva de esta condición, con una evolución clínica que fluctúa con la clase funcional y el tratamiento farmacológico. Objetivos Definir la prevalencia y el perfil clínico y funcional de pacientes con disfunción renal en el contexto de insuficiencia cardíaca con baja fracción de eyección. Material y métodos En 132 pacientes con insuficiencia cardíaca y fracción de eyección < 40% se midió la depuración de creatinina. Se definió disfunción renal a una depuración de creatinina < 60 ml/ min. Se realizaron analítica sanguínea, ecocardiograma, bioimpedanciometría y caminata de 6 minutos. Resultados La prevalencia de disfunción renal fue del 43,2% (57 pacientes). Comparados con el resto, en estos pacientes hubo mayor prevalencia de sexo femenino, mayor edad y menos frecuentemente etiología coronaria. En el laboratorio tuvieron valores menores de hemoglobina, albúmina, ferritina y triyodotironina y mayor prevalencia de troponina T dosable. Fueron menores el índice de masa corporal (IMC), la tasa metabólica basal, la masa muscular y el ángulo de fase, mientras que la relación agua extracelular/agua corporal total fue mayor. La distancia recorrida en la prueba de 6 minutos fue menor. Respecto del tratamiento, sólo difirió el uso de betabloqueantes y amiodarona. En el análisis multivariado, la edad, el nivel de NT-proBNP, la presencia de troponina T positiva y la masa muscular como variable continua fueron predictores independientes de disfunción renal en pacientes con insuficiencia cardíaca sistólica. Conclusiones La disfunción renal es frecuente en pacientes con insuficiencia cardíaca con baja fracción de eyección y se vincula con características distintivas que pueden contribuir a explicar el cuadro clínico.
Background Renal dysfunction is strongly associated with chronic heart failure, and is a frequent and progressive complication of this condition, with clinical outcomes which depend on the functional class and pharmacological treatment. Objectives To define the prevalence and the clinical and functional profile of patients with renal dysfunction in the setting of heart failure with depressed ejection fraction. Material and Methods Creatinine clearance was measured in 132 patients with heart failure and an ejection fraction <40%. Renal dysfunction was defined as a creatinine clearance <60 ml/min. Patients underwent routine lab tests, echocardiogram, bioelectrical impedance analysis and 6-minute walk test. Results The prevalence of renal dysfunction was 43.2% (57 patients). Among these patients, there was a greater prevalence of women and elder subjects, yet the prevalence of coronary artery disease was low. Lab tests showed lower levels of hemoglobin, albumin, ferritin and triiodothyronine, and greater prevalence of measurable levels of troponin T. Body mass index (BMI), basal metabolic rate, muscle mass and phase angle were lower, while the ratio of extracellular water to total body water was greater in patients with renal dysfunction. The distance walked in the 6-minute test was lower. The use of beta blockers and amiodarone was the only difference in therapy. At multivariate analysis, age, NTproBNP level, the presence of positive troponin T and muscle mass as a continuous variable were independent predictors of renal dysfunction in patients with systolic heart failure. Conclusions Renal dysfunction is frequent in patients with heart failure with depressed ejection fraction and is associated with distinctive features that may contribute to explain the clinical picture.
RESUMO
Analysis of the transcriptional regulation of the Clara cell secretory protein (CCSP) gene has resulted in the characterization of several trans-acting factors that regulate the activity of this gene. However, little is known about negative regulatory elements involved in CCSP gene transcription. Using transient transfections of luciferase reporter constructs driven by various fragments of the Neotomodon CCSP (nCCSP) promoter, we identified an inhibitory region that contains an inverted CCAAT box located -225 to -221 bp upstream of the transcriptional start site. Sequence analysis in a broad region of the nCCSP promoter (-744/+33) identified another potentially important CCAAT motif (-459/-455). Gel shift and supershift assays indicated that the transcription factor NF-Y binds to both CCAAT boxes. Mutation of the CCAAT motif prevented the in vitro binding of NF-Y and led to a significant increase of CCSP promoter activity in both pulmonary (H441) and non-pulmonary (HeLa and MCF-7) cells, suggesting that NF-Y is involved in a negative transcriptional regulation that may potentially contribute to the highly cell-specific expression of the anti-inflammatory CCSP gene.