RESUMO
OBJECTIVE: Firearm violence has a high economic impact, representing the third most expensive injury and associated with the fourth highest hospitalisation cost. This study was performed to determine the clinical and epidemiological characteristics of patients with injuries due to firearm projectile during a period of increased violence related to organised crime in our country. METHODS: A retrospective study (2010-2017) was conducted to analyse the clinical data of patients admitted due to firearm projectile injury. Clinical and epidemiological characteristics of each patient were recorded, and patients were stratified by sex and age. Compared low-energy versus high-energy gunshot injuries, complications and treatment. RESULTS: A total of 1309 gunshot wounds in appendicular skeleton and spine fractures. The mean age of the patients was 29±11.5 years. Upper extremities wounds in 358 cases, lower extremities wounds in 727 cases and 224 fractures in spine region. There were no significant differences between low-velocity and high-velocity projectiles in anatomic affected region, complications and treatment. CONCLUSIONS: We concluded that firearm projectiles cause a variety of injuries both in soft and bone tissues and caused a major rate of complications in our patients even with low- or high-energy weapons. The majority of patients affected were the civilian population. Most patients with gunshot wounds were young males. We observed a low mortality rate in our patients. LEVEL OF EVIDENCE: III; retrospective cohort study.
Assuntos
Fraturas Ósseas , Ferimentos por Arma de Fogo , Adolescente , Adulto , Fraturas Ósseas/complicações , Hospitalização , Humanos , Masculino , Estudos Retrospectivos , Violência , Ferimentos por Arma de Fogo/complicações , Ferimentos por Arma de Fogo/epidemiologia , Adulto JovemRESUMO
Introducción: La hipoglucemia inadvertida incrementa el riesgo de la hipoglucemia severa en pacientes con diabetes. Una medición objetiva de la misma requiere instrumentos como el HypoA-Q, que, a diferencia de otros, mide conciencia de episodios nocturnos; sin embargo, no se dispone de una versión en español. Objetivo: Traducir y adaptar culturalmente la escala HypoA-Q para la medición de conciencia de la hipoglucemia en pacientes colombianos con Diabetes Mellitus. Metodología: Estudio de Adaptación transcultural del instrumento Hy-poA-Q. Se obtuvo la autorización de la autora para su traducción y adaptación a la población colombiana. Se siguió la metodología de la European Organisation for Research and Treat-ment for Cancer (EORTC). Al respecto, se realizaron dos traducciones directas por hablantes nativos del español, una versión reconciliada, dos traducciones inversas por dos hablantes nativos del inglés y una prueba piloto en 15 pacientes con diagnóstico de diabetes. Resulta-dos: Aunque las traducciones directas al español fueron similares, se hicieron ajustes para obtener una versión reconciliada con palabras más fáciles de comprender cambiando las uni-dades de mmol/L a mg/dl. Las traducciones inversas fueron similares al original en inglés. La prueba piloto, realizada en 15 pacientes, no requirió ajustar ningún ítem, pues la frecuencia de ítems con dificultades de comprensión, confusión o palabras ofensivas fue menor al 15%. Conclusiones: Se dispone de la versión en español para Colombia de la escala HypoA-Q. Se aconseja realizar un estudio de evaluación de sus propiedades psicométricas antes de ser usada en investigaciones o en la práctica clínica
Introdução: a hipoglicemia inadvertida incrementa o risco de hipoglicemia severa em pacientes com diabetes. Uma medição da mesma requer instrumentos como o HypoA-Q, que a diferença de outros, mede consciência de episódios noturnos; entretanto, não se dispõe de uma versão em espanhol. Objetivo: traduzir e adaptar culturalmente a escala HypoA-Q para mensurar a consciência de hipoglicemia em pacientes colombianos com Diabetes Mellitus. Materiais e métodos: estudo de adaptação transcultural do instrumento HypoA-Q. Obteve-se a autorização da autora para a sua tradução e adaptação à população colombiana. Seguiu-se a metodologia da European Organization for Research Treatment for Cancer (EORTC). Realizaram-se duas traduções diretas por falantes nativos de língua espanhola e uma versão conciliada, duas traduções inversas por falantes nativos da língua inglesa e uma prova piloto em 15 pacientes com diagnostico de diabetes. Resultados: Embora as traduções diretas ao espanhol foram semelhantes, foram feitos ajustes para obter uma versão conciliada com palavras mais simples de compreender substituindo as unidades de mmol/L para mg/dl. As traduções inversas foram semelhantes ao instrumento original em inglês. A prova piloto realizada não precisou ajustar nenhum item, devido a que os itens com dificuldade de compreensão, confusão ou palavras ofensivas foi inferior ao 15%. Conclusão: Dispõe-se da versão em espanhol para Colômbia da escala HypoA-Q. Aconselha-se realizar um estudo de avaliação das propriedades psicométricas antes de ser usada em pesquisa ou na prática clinica
Assuntos
Estudo de Validação , Inquéritos e Questionários , Consciência , HipoglicemiaRESUMO
BACKGROUND AND OBJECTIVE: Clostridium difficile NAP1/ribotype 027 is associated with severe disease and high mortality rates. Our aim was to determine the prevalence of NAP1/ribotype 027 among C. difficile isolates in a tertiary care hospital, and review the main clinical data. METHODS: We included 106 stool samples from 106 patients. Samples were tested for A&B toxins and were cultured on CCFA agar. The genes tcdA, tcdB, tcdC, cdtA, and cdtB were amplified using PCR in clinical isolates. The tcdA 3'-end deletion analysis, PCR-ribotyping, and pulsed-field gel electrophoresis (PFGE) were also performed. Stool samples that were positive for culture were tested by the GeneXpert C. difficile assay. Clinical data were collected. RESULTS: Thirty-six patients tested positive for A&B toxins; and 22 patients had positive culture for C. difficile, 14 of which tested positive for the A&B toxins and all 22 patients tested positive by the GeneXpert C. difficile assay. Risk factors included an average hospital stay of 16.1 days prior to toxin detection, average antibiotic use for 16.2 days, and a median of 3 antibiotics used. The 30-day crude mortality rate was 8.4%. Six of the 22 patients died, and 3 of those deaths were directly attributed to C. difficile infection. The majority of isolates, 90.9% (20/22), carried genes tcdB, tcdA, cdtA, and cdtB; and these strains carried the corresponding downregulator gene tcdC, with an 18-bp deletion. PFGE was performed on 17 isolates, and one main pattern was observed. Analysis of the ribotyping data showed similar results. CONCLUSION: The above findings represent the clonal spread of C. difficile in our institution, which mainly includes the NAP1/027 strain. This is the first report of C. difficile ribotype NAP1/027 in Mexico.
Assuntos
Proteínas de Bactérias/isolamento & purificação , Toxinas Bacterianas/isolamento & purificação , Clostridioides difficile/genética , Enterocolite Pseudomembranosa/epidemiologia , Enterotoxinas/isolamento & purificação , Genes Bacterianos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Clostridioides difficile/classificação , Clostridioides difficile/isolamento & purificação , Clostridioides difficile/patogenicidade , Eletroforese em Gel de Campo Pulsado , Enterocolite Pseudomembranosa/tratamento farmacológico , Enterocolite Pseudomembranosa/microbiologia , Enterocolite Pseudomembranosa/mortalidade , Fezes/química , Fezes/microbiologia , Feminino , Humanos , Tempo de Internação , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Ribotipagem , Fatores de Risco , Análise de Sobrevida , Centros de Atenção TerciáriaRESUMO
C-type lectins are multifunctional sugar-binding molecules expressed on dendritic cells (DCs) and macrophages that internalize antigens for processing and presentation. Macrophage galactose-type lectin 1 (MGL1) recognizes glycoconjugates expressing Lewis X structures which contain galactose residues, and it is selectively expressed on immature DCs and macrophages. Helminth parasites contain large amounts of glycosylated components, which play a role in the immune regulation induced by such infections. Macrophages from MGL1(-/-) mice showed less binding ability toward parasite antigens than their wild-type (WT) counterparts. Exposure of WT macrophages to T. crassiceps antigens triggered tyrosine phosphorylation signaling activity, which was diminished in MGL1(-/-) macrophages. Following T. crassiceps infection, MGL1(-/-) mice failed to produce significant levels of inflammatory cytokines early in the infection compared to WT mice. In contrast, MGL1(-/-) mice developed a Th2-dominant immune response that was associated with significantly higher parasite loads, whereas WT mice were resistant. Flow cytometry and RT-PCR analyses showed overexpression of the mannose receptors, IL-4Rα, PDL2, arginase-1, Ym1, and RELM-α on MGL1(-/-) macrophages. These studies indicate that MGL1 is involved in T. crassiceps recognition and subsequent innate immune activation and resistance.
Assuntos
Antígenos de Helmintos/imunologia , Assialoglicoproteínas/metabolismo , Resistência à Doença/imunologia , Lectinas Tipo C/metabolismo , Macrófagos Peritoneais/metabolismo , Proteínas de Membrana/metabolismo , Transdução de Sinais , Taenia/imunologia , Teníase/imunologia , Acetilgalactosamina/metabolismo , Animais , Assialoglicoproteínas/deficiência , Citocinas/biossíntese , Feminino , Galactose/metabolismo , Glicoconjugados/metabolismo , Imunidade , Espaço Intracelular/metabolismo , Cinética , Lectinas Tipo C/deficiência , Ativação de Macrófagos/imunologia , Proteínas de Membrana/deficiência , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Fosforilação , Fosfotirosina/metabolismo , Ligação Proteica , Solubilidade , Teníase/parasitologiaRESUMO
The glycoprotein envelope surrounding the Bufo arenarum egg exists in different functional forms. Conversion between types involves proteolysis of specific envelope glycoproteins. When the egg is released from the ovary, the envelope cannot be penetrated by sperm. Conversion to a penetrable state occurs during passage through the pars recta portion of the oviduct, where oviductin, a serine protease with trypsin-like substrate specificity, hydrolyzes two kinds of envelope glycoproteins: gp84 and gp55. The nucleotide sequence of a 3203 bp B. arenarum oviductin cDNA was obtained. Deduced amino acid sequence showed a complete open reading frame encoding 980 amino acids. B. arenarum oviductin is a multi-domain protein with a protease domain at the N-terminal region followed by two CUB domains and toward the C-terminal region another protease domain, which lacked an active histidine site, and one CUB domain. Expression of ovochymase 2, the mammalian orthologous of amphibian oviductin, was assayed in mouse female reproductive tract. Ovochymase 2 mRNA was unnoticeable in the mouse oviduct but expression was remarkable in the uterus. Phylogenetic relationship between oviductin and ovochymase 2 opens the possibility to understand the role of this enzyme in mammalian reproduction.
Assuntos
Proteínas de Anfíbios/genética , Bufo arenarum/genética , Regulação Enzimológica da Expressão Gênica , Serina Endopeptidases/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Bufo arenarum/metabolismo , Clonagem Molecular , DNA Complementar/genética , Endopeptidases/genética , Endopeptidases/metabolismo , Tubas Uterinas/citologia , Tubas Uterinas/metabolismo , Feminino , Camundongos , Camundongos Endogâmicos BALB C , Dados de Sequência Molecular , Fases de Leitura Aberta , Filogenia , Sinais Direcionadores de Proteínas , Estrutura Terciária de Proteína , Alinhamento de Sequência , Análise de Sequência de DNA , Especificidade por Substrato , Útero/citologia , Útero/metabolismo , Xenopus laevis/genética , Xenopus laevis/metabolismoRESUMO
Living organisms are subject to stress, and among these stressors, heavy metals exposure triggers accumulation of sulfur metabolites. Among these metabolites, glutathione and phytochelatins are found in several organisms, such as Euglena gracilis. Pre-exposing E. gracilis to low concentrations of Hg2+ generates a population with resistance to even 0.2 mM Cd2+, and this resistance relies partly on phytochelatins. p38 MAPK is stimulated by stress and is involved in apoptotic as well as survival mechanisms. In this study, we explored its participation in heavy metal-induced stress and its possible role in sulfur metabolite accumulation. We found that about 51% of the E. gracilis pretreated with Hg2+ becomes resistant to Cd2+ and proliferates despite the presence of this metal. The accumulation of the sulfur metabolites gamma-glu-cys, glutathione and phytochelatin 2 displayed cyclic patterns that were disturbed by a challenge with Cd2+. We observed a p38 MAPK-like activity that was stimulated by acute or chronic heavy metal exposure, and its inhibition by SB203580 slightly diminished the accumulation of sulfur compounds. p38 MAPK inhibition also affected basal levels of glutathione in either pretreated or control cells. Thus, it appears that p38 MAPK mediates redox stress component of the signal pathway induced by heavy metals.
Assuntos
Euglena gracilis/metabolismo , Metais Pesados/metabolismo , Proteínas de Protozoários/metabolismo , Transdução de Sinais , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , AnimaisRESUMO
A través del presente estudio se analizaron plasmas sanguíneos de seis especies, incluyendo el humano tanto en estado gestante como no gestante, identificándose por primera vez en plasma, la glicoproteína α2-Macroglobulina (α2-M) de ovino de pelo (Ovis aries) y de búfalo (Bubalus bubalis). La presencia de esta proteína en el plasma sanguíneo de todas las especies en estudio se demostró mediante electroforesis en gel de poliacrilamida usando sodio dodecilsulfato como agente denaturante (SDS PAGE) al 7.5% identificándose como bandas de 180 kDa y en forma no denaturante PAGE 5% como bandas de 720 kDa. Estas últimas bandas fueron claramente intercambiables de la forma tetramérica a la forma monomérica en los ensayos electroforéticos. Como controles se usaron la α2-M (tetramérica) y la proteína de la zona de gestación (PZP) (dimérica) purificadas a un 98%; así como, las bandas de estas dos proteínas en el plasma humano. El análisis de la secuencia del dominio N-terminal de la (α2-M) de ovino de pelo, fue muy similar al de la proteína humana purificada. Tanto la α2-M humana como la bovina llegaron a ser activadas a la forma rápida por medio de la reacción con metilamina. Lo anterior demuestra diferencias en la reactividad de las α2-M animales con la amina primaria cuando se comparan los resultados con la forma rápida de la α2-M humana. Será necesario unificar los métodos de purificación de esta proteína en todas las especies, de tal manera que los dominios sensibles de las α-macroglobulinas (tioιster y región señuelo) tengan el mismo tratamiento y el mismo grado de desnaturalización para todas las preparaciones de α2-M.
Blood plasma from six different non pregnant and pregnant species, including human blood plasma, was analyzed for detection of α2-Macroglobulin (α2-M). The tropical hair sheep (Ovis aries) and the buffalo (Bubalus bubalis) were studied for the first time in Colombia. The presence of the α2-M in plasma of all the species was demonstrated by SDS 7.5% PAGE as bands of 180 kDa as well as by non-denaturing 5% PAGE with bands of 720 kDa. The tetrameric form α2-M (tetramérica) and the pregnancy zone protein (PZP) (dimeric) purified at 98%, as well as its corresponding bans from human plasma were used as control. The N-terminal sequence of the band of 180 kDa in Tropical hair sheep plasma was very similar to the purified human α2-M. The results indicated the presence of α2-M in blood plasma of all the species tested, while the PZP was present only in the pregnant human plasma. Both human and bovine α2-M became activated with the fast form by reacting with Methylamine. This Fac. demonstrates the differences in the reactivity of the animal’s α2-M with primary amine as compared with the human α2-M. It could be necessary to unify purification methods into one method for all species, so that the sensitive domain of the α-macroglobulins (thiolester and bait region) receives the same treatment and grade of denaturation for all α2-M preparation.
RESUMO
A new, easier and efficient purification method, using Sephacryl and DEAE-Sephacel, of the C-terminal fragment of two alpha-macroglobulins, alpha(2)-M and PZP, is presented. Two larger peptides were identified for each protein as the C-terminal fragment, with molecular weights of approximately 30 kDa and the N-terminal sequences were determined to be SSTQDTV for alpha(2)-M and VALHLS for PZP. The smaller peptides with molecular weights of 18 kDa correspond to a shorter C-terminal sequence of these proteins, and they were determined to be EEFPFA for alpha(2)-M and ALKVQTV for PZP, with no interfering sequences detected. The results confirmed the discriminatory capacity of the purification procedure and the purity of the fragments. This new methodology facilitates biological studies of alpha-macroglobulins, and will enable elucidation of the role the C-terminal region may exert to eliminate alpha-macroglobulin-proteinases complexes from the circulation by the LRP/receptor.
Assuntos
Endopeptidases/metabolismo , Proteína-1 Relacionada a Receptor de Lipoproteína de Baixa Densidade/química , Fragmentos de Peptídeos/isolamento & purificação , Proteínas da Gravidez/química , alfa-Macroglobulinas/química , Sequência de Aminoácidos , Anticorpos Monoclonais/metabolismo , Western Blotting , Quimotripsina/farmacologia , Eletroforese em Gel de Poliacrilamida , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Hidrólise , Proteína-1 Relacionada a Receptor de Lipoproteína de Baixa Densidade/metabolismo , Dados de Sequência Molecular , Peso Molecular , Fragmentos de Peptídeos/química , Gravidez , Proteínas da Gravidez/metabolismo , Estrutura Terciária de Proteína , Análise de Sequência de Proteína , Fatores de Tempo , alfa-Macroglobulinas/metabolismoRESUMO
El propósito de este trabajo es estudiar la aptitud de un modelo de precipitación orográfica (P.O.) para estimar el campo de nieve acumulada invernal en una cuenca lacustre, con su distribución espacial, sus variaciones en la vertical y sus peculiaridades debidas a la orografía y a los sistemas de tiempo atmosférico imperantes