RESUMO
The physical and chemical properties of silver nanoparticles (AgNPs) have led to their increasing use in various fields such as medicine, food, and industry. Evidence has proven that AgNPs cause adverse effects in aquatic ecosystems, especially when the release of Ag is prolonged in time. Several studies have shown short-term adverse effects of AgNPs on freshwater phytoplankton, but few studies have analysed the impact of long-term exposures on these populations. Our studies were carried out to assess the effects of AgNPs on growth rate, photosynthesis activity, and reactive oxygen species (ROS) generation on the freshwater green algae Scenedesmus armatus and the cyanobacteria Microcystis aeruginosa, and additionally on microcystin (MC-LR) generation from these cyanobacteria. The tests were conducted both in single-species cultures and in phytoplanktonic communities exposed to 1 ngL-1 AgNPs for 28 days. The results showed that cell growth rate of both single-species cultures decreased significantly at the beginning and progressively reached control-like values at 28 days post-exposure. This effect was similar for the community-cultured cyanobacteria, but not for the green algae, which maintained a sustained decrease in growth rate. While gross photosynthesis (Pg) increased in both strains exposed in single cultures, dark respiration (R) and net photosynthesis (Pn) decreased in S. armatus and M. aeruginosa, respectively. These effects were mitigated when both strains were exposed under community culture conditions. Similarly, the ROS generation shown by both strains exposed in single-species cultures was mitigated when exposure occurred in community cultures. MC-LR production and release were significantly decreased in both single-species and community exposures. These results can supply helpful information to further investigate the potential risks of AgNPs and ultimately help policymakers make better-informed decisions about their utilization for environmental restoration.
Assuntos
Água Doce , Nanopartículas Metálicas , Microcystis , Fitoplâncton , Scenedesmus , Prata , Poluentes Químicos da Água , Nanopartículas Metálicas/toxicidade , Prata/toxicidade , Fitoplâncton/efeitos dos fármacos , Microcystis/efeitos dos fármacos , Scenedesmus/efeitos dos fármacos , Poluentes Químicos da Água/toxicidade , Microcistinas/toxicidade , Fotossíntese/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismoRESUMO
BACKGROUND: We aimed to identify the association among nutritional status, Oral Health-Related Quality of Life (OHRQoL) and frailty, and to estimate the mediation effect of these conditions between age and frailty in a group of Mexico City nursing home residents. METHODS: We conducted a cross-sectional study. Fried's phenotype criteria, Full Mini Nutritional Assessment, and General Oral Health Assessment Index was applied. RESULTS: The participants (n = 286) mean age was 82.4 (± 9.2) years. The prevalence of frailty was 58%, and the prevalence of malnutrition and the risk of malnutrition were 22.7% and 59.5%, respectively. A higher risk of frailty was associated with older age (p = 0.015), sex (women) (p = 0.041), poor nutritional status (p <0.001) and compromised OHRQoL (p <0.001). Approximately 40% of the effect of age on frailty was mediated by nutritional status and OHRQoL (p <0.05). CONCLUSION: A strong association between nutritional status and frailty was observed. Additionally, OHRQoL was associated with frailty. The effect of age on frailty was mediated by OHRQoL and nutritional status. Interventions targeted to improve nutritional status and oral health may contribute to preventing or delaying the onset of frailty.
Assuntos
Fragilidade , Desnutrição , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Estado Nutricional , Fragilidade/epidemiologia , Fragilidade/complicações , Qualidade de Vida , Estudos Transversais , México/epidemiologia , Avaliação Geriátrica , Desnutrição/epidemiologia , Avaliação Nutricional , Casas de SaúdeRESUMO
The stability of granules, contaminant removal and microbial structure of an aerobic granular sludge (AGS) process were investigated with a focus on ordinary heterotrophic organisms (OHOs). Long-term stable granules and high removals of COD (97 %), NH4+ (98 %), P (85 %) and total N (77 %) were achieved. Sequencing analyses identified 6.6 % of phosphorus-accumulating organisms in the sludge, concordant with the observed bio-P removal capacity. However, OHOs were the most abundant bacteria in the sludge (70-93 %) without resulting in unstable aggregates. Under current dogmas of microbial competition in activated sludge, it seemed contradictory that OHOs could persist in the long term in the AGS where COD was depleted beginning in the anaerobic phase. Microbial analyses showed that OHOs could survive in granules by micropredation, proteolysis, fermentation and EPS consumption. Heterotrophic-nitrification/ aerobic-denitrification was an active pathway in the AGS. These findings contribute to a better understanding of microbial competition in AGS and its stability.
Assuntos
Esgotos , Eliminação de Resíduos Líquidos , Esgotos/microbiologia , Eliminação de Resíduos Líquidos/métodos , Reatores Biológicos/microbiologia , Nitrogênio/metabolismo , Nitrificação , Fósforo/metabolismo , AerobioseRESUMO
Trypanosoma theileri is a cosmopolitan opportunistic haemoparasite described in wild and domestic ruminants, and also in arthropod vectors. The presence of this parasite has been reported in several South American countries, including Amazonian regions. Despite the importance of livestock production, Ecuador possesses scarce studies about trypanosomosis and no T. theileri reports in its territory. Here, we showed molecular evidences of the presence of T. theileri in cattle from a province located in the Ecuadorian Amazon. Bovine blood samples were collected from 2014 to 2019, during campaigns to detect haemoparasites in the Ecuadorian provinces of Orellana and Sucumbíos. DNA was extracted from the buffy coat and used in PCR assays with three different molecular markers, ITS1, 18S and Cathepsin L-like. T. theileri was detected only in the Sucumbíos province, with a specific molecular prevalence of 8.6% (3/35) using the three primers and an additional animal detected as positive (11.4% prevalence) only by the ITS1 marker. DNA sequences derived from the generated amplicons were subjected to phylogenetics maximum parsimony and maximum likelihood analysis, which indicate the presence of TthI and TthII genotypes circulating in the evaluated animals. Molecular surveillance should be continually implemented in Ecuador in order to deepen the epidemiological and evolutionary knowledge about T. theileri as well other haemoparasites in the amazon parts of the country.
Assuntos
Doenças dos Bovinos , Trypanosoma , Tripanossomíase , Bovinos , Animais , Equador/epidemiologia , Doenças dos Bovinos/parasitologia , Trypanosoma/genética , Tripanossomíase/epidemiologia , Tripanossomíase/veterinária , Tripanossomíase/parasitologia , RuminantesRESUMO
BACKGROUND: Myofibroblasts (MF) are mesenchymal cells with features of both fibroblasts and smooth muscle cells. Although these are usually reactive cells, they can lead to myofibroblastic tumors that may share clinical and histomorphological characteristics but with different prognosis. The aim of this study is to perform a histomorphological evaluation as well as to compare and evaluate two different cell proliferation immunomarkers and two endothelial markers in a group of oral and maxillofacial myofibroblastic lesions (MFL). MATERIAL AND METHODS: Cross-sectional and retrospective study. Demographic, clinical, histomorphological and immunohistochemical characteristics of 39 cases of MFL were analyzed. Immunohistochemical reactions were performed with the Ki67, MCM2, CD34 and CD105 antibodies. Kruskal-Wallis test and Spearman correlation analysis were used. RESULTS: Four cases of nodular fasciitis (NF), 18 myofibromas (My), 6 desmoplastic fibromas (DF), 7 inflammatory myofibroblastic tumors (IMT) and 4 myofibroblastic sarcomas (MFS) were studied. There were twenty women (51.2%); the median age was 13 [Q1-Q3: 8-24] years and most cases occurred in the mandible (48.7%). A statistically significant difference with MCM2 immunostaining (p=0.0221) was observed between the MFL; furthermore, a correlation between CD34 and CD105 immunostaining in NF (p <0.0001) and IMT (p=0.0408), between MCM2 and CD34 in IMT (p=0.0362) and between MCM2 and CD105 in MFS (p <0001) were found. CONCLUSIONS: MCM2 immunostaining could assess more clearly the cell growth fraction in MFL. The correlation between MCM2 and CD34 in IMT and between MCM2 and CD105 in MFS are indicative of the high activity of these lesions. These results emphasize the importance of the studied immunohistochemistry markers as possible tools for a better characterization of some of the MFL.
Assuntos
Granuloma de Células Plasmáticas , Miofibroblastos , Humanos , Feminino , Adolescente , Miofibroblastos/química , Miofibroblastos/patologia , Estudos Retrospectivos , Estudos Transversais , Imuno-Histoquímica , Proliferação de Células , Granuloma de Células Plasmáticas/patologia , Biomarcadores/análise , Biomarcadores Tumorais/análiseRESUMO
Resumen Introducción: La úlcera por presión más frecuente es la sacra. Si compromete el hueso puede provocar osteomielitis por lo que requiere aseo quirúrgico y colgajo miocutáneo de gluteus maximus por deslizamiento en V-Y. Materiales y Método: En el servicio de cirugía plástica del hospital del Salvador entre 2011 y 2020 se han operado 82 pacientes con ulceras sacras grado 4 que requirieron cobertura con colgajo miocutáneo de gluteus maximus en V-Y. De ellas se analizaron los últimos 37 pacientes. Resultados De los 37 pacientes, 12 fueron mujeres, 25 hombres, 17 parapléjicos, 12 tetrapléjicos y 8 deambulaban. 6 pacientes presentaron COVID-19. 24 fueron bilaterales y 13 unilaterales. Los colgajos cicatrizaron bien en 30 pacientes. Las complicaciones fueron de 16% consistente en 2 hematomas, 2 dehiscencias, 2 celulitis y 1 seroma, todas resueltas sin problemas. Seguimiento de entre 3 y 6 meses. Discusión El tratamiento quirúrgico con colgajo miocutáneo de gluteus maximus en V-Y, aparte de aportar volumen para ocluir la úlcera, aporta irrigación excelente con oxígeno, nutrientes y antibióticos que aseguran una óptima cicatrización. Dependiendo del diámetro de la úlcera el colgajo puede ser uni o bilateral. Dado lo complejo del tratamiento, en general, el porcentaje de complicaciones de 16% se considera bajo. Conclusión: El tratamiento quirúrgico de las úlceras por presión sacras con colgajos miocutáneos deslizantes de gluteus maximus ha sido exitoso con buenos resultados quirúrgicos con buen flujo sanguíneo y buena evolución.
Introduction: Pressure sores are the result of the compression of soft tissues in the prominent bones areas, mainly in patients without movement. If the depth of the ulcer compromises the sacral bone, the treatment will be the gluteus maximus myocutaneous flap in V-Y. Materials and Method: In the plastic surgery service of the hospital del Salvador 82 patients with sacral pressure sores grade 4 were operated on between 2011 and 2020 with gluteus maximus myocutaneous V-Y flap. The last 37 patients were analyzed. Results: With this treatment the flaps were doing well in all cases with good blood supply. Complications: dehiscence: 2 patients, cellulitis: 2 patients, hematoma: 2 patients and seroma: 1 patient. The overall complication was 16%. Follow up between three and six months. Discussion: The most important part in pressure sores is their prevention. When the ulcer is in prominent parts of the body, the sore, could be in different grades of depth. The classification of them is in grades 1: erythema, 2: subcutaneous tissue. These two grades are solved with conservative treatment. When the ulcers are in grade 3 or 4, and with little ulcer in the skin but with damage of the deep plane, the treatment will be with surgery. In our casuistic the most frequent pressure sore is in the sacrum treated with gluteus maximus sliding myocutaneous flap in V-Y. With this treatment the flaps were doing well in all cases with good blood supply. The complications of 16% were considered low. Conclusion: The sliding gluteus Maximus myocutaneous flap in V-Y for treatment for sacral pressures sores have been successful for our patients.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Retalhos Cirúrgicos , Úlcera por Pressão/cirurgia , Complicações Pós-Operatórias , Sacro , Fatores Socioeconômicos , Causalidade , Procedimentos de Cirurgia Plástica , Retalho Miocutâneo/cirurgiaRESUMO
Resumen Introducción: La Ulcera con radionecrosis debe ser resecada ampliamente y reparada con colgajos miocutáneos y fasciocutáneos. Objetivo: Presentar el tratamiento quirúrgico de las úlceras por radionecrosis mediante colgajos Miocutáneos y Fasciocutáneos pediculados y microquirúrgicos. Materiales y Método: La casuística es de 31 pacientes portadores de úlceras por radionecrosis resueltas con colgajos miocutáneos y fasciocutáneos. Ellos han sido pediculados y microquirúrgicos. Las edades fluctuaron entre 30 y 75 años operados entre el 2000 y el 2019. Resultados: Se realizaron 19 colgajos musculares o miocutáneos y 12 fasciocutáneos en diferentes zonas del organismo. Los colgajos correspondieron a: temporal, latissimus dorsi de pedículo central y en reversa, latissimus dorsi microquirúrgicos, recto abdominal, escapular microquirúrgico, para escapular, gracilis, gastrocnemius, rectus femoris, cubital microquirúrgico, fasciocutaneos: cone flap y de rotación local. Las complicaciones fueron dehiscencia de herida operatoria suturada y celulitis tratada con antibióticos. No hubo necrosis completa de los colgajos. El seguimiento fue de 3 a 6 meses. Discusión: En esta serie hemos utilizados los colgajos músculo cutáneos de preferencia, los fasciocutáneos los hemos reservados para aquellos casos en los que por razones anatómicas, de localización de las úlceras, era más adecuado usar estos últimos, como en las lesiones planas o poco profundas. Generalmente los colgajos fueron pediculados y en determinados casos, cuando el tejido vecino de reparación no estaba disponible, realizamos colgajos con microcirugía. Conclusión: El tratamiento de las úlceras por radionecrosis es efectivo cuando se realiza desbridamiento exhaustivo con cobertura inmediata con colgajos musculares o músculocutáneos y fasciocutáneos. Fueron colgajos pediculados y microquirúrgicos.
Introduction: The radionecrosis ulcer have to be widely resected and repaired trough flaps with good blood supply who contibute with oxigen, nutrients and antibiotics. Thinking on this the more suitable flaps are the myocutaneous ones and in special conditions the fasciocutaneous. Aim: The objetive of this paper is to show the surgical treatment of radionecrosis ulcers with myocutaneous and fasciocutaneous flaps. Materials and Method: Casuistic is 31 patients with radionecrosis ulcers treated with, mainly, myocutaneous flaps and in special areas with fasciocutaneous ones. The majority were pedicle flaps and in less number microsurgical flaps. The age of patients were betwee30 and 75 years old. Results: 19 muscle or myocutaneous flaps and 12 fasciocutaneous flaps were made. Flaps were latissimus dorsi, temporal, escapular, para escapular, rectus abdominis, rectus femoris, gracilis, gatrocnemius, cone flap and local fasciocutaneous flaps. Complications were sutured operative wound dehiscence and cellulitis treated with antibiotics. There were no complete necrosis of any flap. Discusion: In this serie we used muscle or myocutaneous flaps because they give good blood supply, oxigen, nutrients and arrival of antibiotic with filling of the deep ulcers. When the ulcers were shallow we use fasciocutaneous flaps. The majority of our flaps were pedicles and microsurgical flaps were used when there was no near avialable tissue. Conclusion: The treatment have to be wide debridement of the ulcer. The surgical treatment is with myocutaneous and fasciocutaneous flaps sometimes pediculates and in others conditions microsurgicals.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Radioterapia/efeitos adversos , Úlcera Cutânea , Retalhos Cirúrgicos/cirurgia , Estudos Retrospectivos , Transplante de Pele/métodos , Procedimentos de Cirurgia Plástica/métodos , Retalho MiocutâneoRESUMO
PURPOSE: To analyse the relationship between the transcriptional expression of Krüppel-like factor-6 (KLF6) and local response to treatment with radiotherapy in patients with head and neck squamous cell carcinoma (HNSCC). METHODS: We determined the transcriptional expression of KLF6 in tumour biopsies obtained before treatment with radiotherapy in 83 HNSCC patients. The KLF6 expression was categorized according to the local control of the disease with a recursive partitioning analysis. RESULTS: During the follow-up period, 27 patients (32.5%) had a local recurrence of the tumour. Patients with local recurrence had significantly higher levels of KLF6 expression than patients in which radiotherapy achieved local control of the disease (P = 0.029). Five-year local recurrence-free survival for patients with a high transcriptional expression of KLF6 (n = 46) was 51.1% (95% CI 36.4-66.2%), and for patients with low expression it was 85.6% (95% CI 73.9-97.3%) (P = 0.0001). The results of a multivariate analysis showed that patients with a high KLF6 expression had a 3.8 times higher risk of local recurrence after treatment with radiotherapy (95% CI 1.4-10.5, P = 0.008). CONCLUSION: Transcriptional expression of KLF6 was significantly related to local control in HNSCC patients treated with radiotherapy. Patients with high levels of KLF6 expression had a significantly higher risk of local recurrence after treatment.
Assuntos
Biomarcadores Tumorais/metabolismo , Regulação Neoplásica da Expressão Gênica/efeitos da radiação , Neoplasias de Cabeça e Pescoço/patologia , Fator 6 Semelhante a Kruppel/metabolismo , Radioterapia/mortalidade , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Idoso , Biomarcadores Tumorais/genética , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/genética , Neoplasias de Cabeça e Pescoço/metabolismo , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Fator 6 Semelhante a Kruppel/genética , Masculino , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/patologia , Prognóstico , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço/radioterapia , Taxa de SobrevidaRESUMO
Resumen Objetivo: Describir el manejo quirúrgico realizado para la reconstrucción genitoperineal (RGP) en pacientes con secuelas de Gangrena de Fournier (GF). Materiales y Método: Corresponde a una serie de casos retrospectiva de pacientes con secuelas de GF a los que se les realizó RGP entre los años 2011 y 2019. Se realizó un análisis descriptivo con las variables de técnica quirúrgica, edad, sexo, comorbilidades, subunidades anatómicas afectadas, origen anatómico de la gangrena de Fournier, número de procedimientos quirúrgicos, procedimiento de colostomía, terapia de presión negativa, Flexi-Seal®, bacterias aisladas, duración de estancia hospitalaria, tipo de procedimientos reconstructivos y complicaciones. Resultados: Se realizó RGP a 43 pacientes (81,1% hombres), con un promedio de edad de 59,1 (17-86 años), 72,7% eran diabéticos. El número de subunidades involucradas se asocia directamente y significativamente en relación al número de intervenciones quirúrgicas. Las técnicas utilizadas para la reconstrucción en orden de frecuencia fueron: colgajos (23%), cierre parcial más injerto dermoepidérmico de grosor parcial (IPP) (20%), cierre parcial (16%) e IPP (16%), cierre por segunda intención (10%), colgajo más IPP (7%) y cierre parcial para cierre por segunda intención de zona restante (5%). Discusión: La elección de reconstrucción se basa en las características del defecto, es decir, el tamaño, la ubicación y profundidad, así como la disponibilidad de tejido local. De preferencia optar por cierres primarios sin tensión, seguido de colgajos y de IPP. Conclusión: La RGP es un desafío para el cirujano plástico. Las técnicas descritas han demostrado ser seguras y reproducibles para el tratamiento quirúrgico de la gangrena de Fournier.
Aim: To describe the surgical management performed for genital-perineal reconstruction (GPR) in patients with sequelae of Fournier gangrene (FG). Materials and Method: It is based on a retroactive series of cases of patients with effects of FG who were given GPR between 2011 and 2019. We performed a descriptive analysis using the variables surgical technique, age, sex, comorbidities, anatomical subunits affected, anatomic origin of the Fournier's gangrene, number of surgical procedures, colostomy procedure, negative pressure therapy, Flexi-Seal®, bacteria isolated, hospital stay, type of reconstructive procedures and complications. We performed GPR on 43 patients (81.1% male), with a mean age of 59.1 (17-86 years); 72% were diabetic. The number of subunits involved was directly and significantly associated with the number of surgical interventions. Results: The reconstruction techniques most used were, in descending order: flaps (23.2%), wound closure and split-thickness skin graft (STSG) (23.2%), primary closure (16.2%), STSG (16.2%), secondary closure (9.3%), flap and STSG (6.9%) and partial wound closure for healing of the remaining area for a second intention (4.6%). Discussion: The reconstruction choice is based on the characteristics of the defect, that is, the size, location and depth, as well as the availability of local tissue. Preferably opt for primary closures without tension, followed by flaps and IPP. Conclusion: The RGP is a challenge for the plastic surgeon. The techniques described have proven safe and reproducible for the surgical treatment of Fournier Gangrene.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Retalhos Cirúrgicos/transplante , Gangrena de Fournier/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Terapia Combinada , Gangrena de Fournier/epidemiologiaRESUMO
Resumen Objetivo: Demostrar la anatomía y aplicación de la vaina anterior de los rectos para la reparación de defectos herniarios gigantes de la línea media abdominal mediante la cirugía de separación de componentes más la aplicación de un colgajo aponeurótico tipo turn over. Materiales y Método: Disección anatómica con descripción vascular y dinámica de la vaina anterior de los rectos. Posterior aplicación de la técnica en pacientes con hernias gigantes de la línea media. Seguimiento clínico de recidiva y complicaciones locales como sistémicas. Resultados: 8 pacientes fueron seleccionados. La edad promedio fue de 58,6 años y el tamaño del defecto hemiario 19,6 cm. En todos los pacientes se pudo aplicar la técnica sin inconvenientes. Sólo 1 paciente presentó una complicación local (dehiscencia y necrosis parcial del colgajo cutáneo) que se manejó con resección y reavance sin incidentes. No se describen complicaciones sistémicas ni mortalidad. Discusión: Las hernias abdominales gigantes y con pérdida a derecho de domicilio son un desafío quirúrgico. Se han desarrollado importantes avances con abordajes quirúrgicos innovadores. Nuevos materiales biológicos y sintéticos se han convertido en una parte integral del arsenal quirúrgico, sin embargo, involucran muchas veces asumir grandes costos y complicaciones propias a los materiales utilizados, además, de no cumplir con la adaptación dinámica adecuada de la pared requerida. Conclusión: Esta modificación técnica es segura, útil y accesible para los pacientes con eventraciones gigantes. La tasa de complicaciones es baja y está dada principalmente por problemas relacionados al sufrimiento de los colgajos cutáneos.
Aim: To demonstrate the anatomy and application of the anterior rectus sheet in the repair of giant abdominal wall hernias through a classic component surgery plus a turn over flap. Materials and Method: Anatomic dissection with vascular and dynamic description of the anterior rectus sheet. Posterior application of the technique in patients with giant abdominal wall hernias. Clinical follow up of recurrence, local and systemic complications. Results: 8 patients were selected. The average age was 58.6 years old and the abdominal wall defect 19.6 cm wide. The technique could be applied in every patient without inconveniences. Only 1 patient had a complication (dehiscence and partial skin flap necrosis) that was successfully treated with resection and readvancement. No systemic complications nor mortality was described. Discussion: Giant abdominal wall hernias are a surgical challenge. Great and innovative advances have been made. New biological and synthetic materials have been developed, nevertheless they frequently involve great costs and complications related to them. Also, they do not adapt adequately to the dynamic required for the abdominal wall. Conclusion: This technical modification is useful, safe and accessible for the patients who present giant wall hernias. The complication rate is low and it's principally given from problems related to skin flap blood flow.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Hérnia Abdominal/cirurgia , Herniorrafia/métodos , Retalho Perfurante/transplante , Resultado do Tratamento , Procedimentos de Cirurgia Plástica/métodos , Hérnia Abdominal/patologia , Retalho Perfurante/cirurgiaRESUMO
Chronic renal disease patients under chronic dialysis (CRDD) have a multifactorial immunological deterioration with an increased risk of Candida infections. Incidence of Candida infections is increasing. Choice of suitable antifungal agents is limited due to the resistance of some species to several antifungals. Aim of the present study was to identify the distribution and antifungal susceptibility patterns of oral isolated Candida species from infected and colonized patients, as well as to investigate the risk factors for oral infection in patients on dialysis. Cross-sectional study, approved by the institutional bioethics committees was performed in CRDD patients. Demographic, clinic data, and oral mucosa samples were obtained. Infection diagnosis was established clinically and confirmed with exfoliative cytology, each sample was plated on CHROMagar Candida and incubated at 36°C for 2 days. Yeast species were identified by carbohydrate assimilation ID 32C AUX system and the apiweb database. For the antifungal susceptibility test, the M44 A-3 method (CLSI) using fluconazole (FCZ), miconazole (MCZ), nystatin (NYS), and voriconazole (VCZ). Study included 119 participants, the main cause of CRD was nephropathy due to DM2 (58%), and three-fourths of the patients were under hemodialysis. Candida prevalence was 56.3% of 67 colonized or infected patients, 88 isolates were obtained. Principal identified species were C. albicans (51.1%), C. glabrata (25%), and C. tropicalis (14.8%). C. glabrata showed a reduced response to FCZ in 50% of isolates and C. albicans had a reduced response in 16% of the isolates. Antifungal agent with the least efficacious response or with the lowest susceptibility in the isolates of these patients was MCZ, followed by VCZ and FCZ, whereas NYS induced the best antifungal response.
Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candidíase Bucal/microbiologia , Boca/microbiologia , Insuficiência Renal Crônica/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Candida/classificação , Candidíase Bucal/complicações , Candidíase Bucal/diagnóstico , Candidíase Bucal/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/microbiologia , Diabetes Mellitus Tipo 2/terapia , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/microbiologia , Nefropatias Diabéticas/terapia , Farmacorresistência Fúngica/efeitos dos fármacos , Feminino , Humanos , Masculino , México/epidemiologia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Diálise Renal/efeitos adversos , Diálise Renal/estatística & dados numéricos , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/terapia , Adulto JovemRESUMO
BACKGROUND: Cryopreservation of embryos is of considerable relevance for the implementation of embryo transfer programs and the establishment of embryo banks in several mammalian species. OBJECTIVE: The present investigation compares two different vitrification systems and two different warming solutions. MATERIALS AND METHODS: Vitrification was performed using Open Pulled Straw (OPS) or CVM RingFibre plug (CVM) devices. Warming was carried out either in a warming solution containing 0.33 M sucrose or in a solution devoid of sucrose. RESULTS: Differences between vitrification systems were not significant. Warming in sucrose-containing diluent resulted in an expansion rate of 64%, as compared to 86% in a solution devoid of sucrose; reported hatching rates were 45% vs. 9%, respectively (p<0.05). Upon transfer, implantation rates for OPS- and CVM were 50% and 27%, respectively, compared with 55% for freshly collected embryos. The implantation rate after warming was 43% for sucrose-containing and 33% for sucrose-free medium. CONCLUSION: a) both vitrification systems are suitable for vitrifying mouse blastocysts; b) warming in sucrose-free diluent yields better embryo survival rates than in diluent containing 0.33 M sucrose.
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Blastocisto , Criopreservação , Sacarose , Vitrificação , Animais , Camundongos , Sacarose/farmacologiaRESUMO
INTRODUCTION: Patients with temporal lobe epilepsy (TLE) perform poorly on semantic verbal fluency (SVF) tasks. Completing these tasks successfully involves multiple cognitive processes simultaneously. Therefore, quantitative analysis of SVF (number of correct words in one minute), conducted in most studies, has been found to be insufficient to identify cognitive dysfunction underlying SVF difficulties in TLE. OBJECTIVES: To determine whether a sample of patients with TLE had SVF difficulties compared with a control group (CG), and to identify the cognitive components associated with SVF difficulties using quantitative and qualitative analysis. METHODS: SVF was evaluated in 25 patients with TLE and 24 healthy controls; the semantic verbal fluency test included 5 semantic categories: animals, fruits, occupations, countries, and verbs. All 5 categories were analysed quantitatively (number of correct words per minute and interval of execution: 0-15, 16-30, 31-45, and 46-60seconds); the categories animals and fruits were also analysed qualitatively (clusters, cluster size, switches, perseverations, and intrusions). RESULTS: Patients generated fewer words for all categories and intervals and fewer clusters and switches for animals and fruits than the CG (P<.01). Differences between groups were not significant in terms of cluster size and number of intrusions and perseverations (P>.05). CONCLUSIONS: Our results suggest an association between SVF difficulties in TLE and difficulty activating semantic networks, impaired strategic search, and poor cognitive flexibility. Attention, inhibition, and working memory are preserved in these patients.
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Epilepsia do Lobo Temporal/fisiopatologia , Semântica , Comportamento Verbal/fisiologia , Adulto , Feminino , Humanos , Masculino , México , Análise e Desempenho de TarefasRESUMO
RESUMEN La Tomografía de Coherencia Óptica (OCT) ha sido recientemente muy usada en diversas patologías de piel. Es una técnica no invasiva para la investigación morfológica de los tejidos, comparable con una biopsia virtual, capaz de generar imágenes en sección transversal de la microestructura del tejido; esta técnica se basa principalmente en el esparcimiento de la luz en los medios a estudiar y gracias a las fibras de colágeno hace que pueda utilizarse en la piel. Con el uso de OCT, es posible caracterizar la morfología normal y patológica de la piel, similar a la arquitectura del tejido que se observa en la histología de rutina, así como la progresión de la enfermedad, la cual se puede investigar in situ. Representa un enfoque no traumático y eficiente en el tiempo para el diagnóstico y seguimiento de un amplio número de enfermedades dermatológicas.
SUMMARY The Optical Coherence Tomography (OCT) has recently been widely used in various skin pathologies. It is a non-invasive technique for the morphological research of tissues, comparable with a virtual biopsy, capable of generating cross-sectional images of the tissue microstructure; this technique is based mainly on the scattering of light in the media to be studied and thanks to the collagen fibers it can be used on the skin. With the use of OTC, it is possible to characterize the normal and pathological morphology of the skin, similar to the tissue architecture observed in routine histology, as well as the progression of the disease which can be investigated in situ. Representing a non-traumatic and time-efficient approach for the diagnosis and monitoring of a large number of dermatological diseases.
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Resumen Introducción: El manejo endovascular para patologías de la aorta ha aumentado como opción para pacientes de alto riesgo quirúrgico de cirugía convencional abierta. Los resultados a corto plazo para mortalidad, libertad de enfermedad y reintervención, evidencian resultados favorables respecto a la cirugía abierta, pero a mediano (1-12 meses) y largo plazo (>1 año) no existen resultados en nuestro medio. Métodos: Estudio de cohorte bidireccional, en el cual se realizó el segmento retrospectivo en pacientes sometidos a manejo endovascular con prótesis aórtica y el segmento prospectivo en el seguimiento de los pacientes. Resultados: Se identificaron 194 pacientes entre abril de 2002 y diciembre de 2015 sometidos a tratamiento endovascular, que cumplían con los criterios de inclusión. El seguimiento se completó en el 82,2%. 92 casos (56.8%) de aorta abdominal con un seguimiento de 4,9 años (RIC 2,5-8,9. La sobrevida calculada fue 92% al año, 86% 2 años y 66.4% a los 5 años. El periodo libre de enfermedad fue 88.7% al año, 86.4% 2 años y 78.5% a los 10 años y 13 pacientes requirieron reintervención. 67 casos de aorta torácica con un seguimiento de 5,3 años (RIC 2,9-10.2), la sobrevida calculada 94% al año, 90.7% 2 años y 75.2% a los 5 años. El periodo libre de enfermedad fue 88.7% al año, 86.4% 2 años y 78.5% a los 10 años y 9 pacientes requirieron reintervención. Conclusiones: Los resultados obtenidos son favorables e incentivan para continuar ofreciendo el abordaje endovascular ya que la supervivencia y la libertad de reoperación se encuentran de acuerdo con lo reportado en la literatura.
Abstract Introduction: The endovascular management for diseases of the aorta has increased as an option for patients of high risk for conventional open surgery. The short-term mortality, disease-free and reoperation results, show favourable outcomes compared to open surgery, but there are no results available in this country for the medium (1-12 months) and long-term (>1 year). Methods: A bi-directional cohort study, in which the retrospective segment was conducted on patients subjected to endovascular management with an aortic replacement, and the prospective segment on the follow-up of the patients. Results: A total of 194 patients, subjected to endovascular treatment and met the inclusion criteria, were identified between April 2002 and December 2015. The follow-up was completed in 82.2% of cases. There were 92 (56.8%) cases of abdominal aorta with a mean follow-up of 4.9 years (95% range; 2.5-8.9). The calculated survival was 92% at one year, 86% at 2 years, and 66.4% at 5 years. The period free of disease was 88.7% at one year, 86.4% at 2 years, and 78.5% at 10 years, with 13 patients requiring re-operation. There were 67 cases of thoracic aorta, with a mean follow-up of 5.3 years (95% range; 2.9-10.2). The calculated survival was 94% at one year, 90.7% at 2 years, and 75.2% at 5 years. The period free of disease was 88.7% at one year, 86.4% at 2 years, and 78.5% at 10 years, and 9 patients required re-operation. Conclusions: The results obtained are favourable and are encouraging to continue offering the endovascular approach since the re-operation survival is similar to that reported in the literature.
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Humanos , Masculino , Pessoa de Meia-Idade , Aorta Abdominal , Aorta Torácica , Doenças da Aorta , Aneurisma Aórtico , Sobrevida , Procedimentos EndovascularesRESUMO
RESUMEN En la investigación de la percepción visual comúnmente se usan programas computarizados comerciales para la presentación de los estímulos, configurados por lo general para admitir una respuesta por cada estímulo presentado. Sin embargo, el estudio de la percepción multiestable, requiere la presentación de un estímulo que permanece invariable aunque la percepción de éste puede variar en dos o más configuraciones, lo que demanda que el programa admita respuestas para cada cambio en la percepción de un mismo estímulo. Se presenta PercepFiguras desarrollado con lenguaje de programación C++ que es un sistema de estimulación visual que permite al usuario: a) presentar imágenes y recibir una o varias respuestas a cada una, b) sincronizar las respuestas con un sistema de registro electroencefalográfico mediante el envío de pulsos TTL, c) generar un archivo conductual y d) generar un archivo con el total de respuestas y promedios de las latencias a cada tipo de figura. Se realizó un estudio piloto con una tarea de presentación continua de una figura ambigua alternando con dos variantes de menor ambigüedad, se obtuvo mayor frecuencia de cambios perceptuales y menor estabilidad perceptual para la figura ambigua respecto a las de menor ambigüedad, comprobándose la utilidad del programa.
ABSTRACT In the study of visual perception, the use of computerized commercial programs for the presentation of stimuli, usually configured to admit a response for each stimulus presented, is common. However, the study of multistable perception requires the presentation of a stimulus that remains unchanged, although the perception of it can vary in two or more configurations during its observation, which demands that the program admit responses for each change in perception of the same stimulus. PercepFiguras is a system developed with C++ programming language that allows: a) present images and receive multiple responses to the same stimulus, b) synchronize the responses with an electroencephalographic recording system by sending TTL pulses, c) generate a behavioral file, d) generate a file with the total responses and averages of the latencies for each type of figure. In the pilot study with a task of continuous presentation of an ambiguous figure to alternating with two variants of less ambiguity, we observe greater frequency of perceptual and less perceptual stability to the ambiguous figure with respect to the less ambiguous figures, which proves the usefulness of the program.
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Resumen La enfermedad de Alzheimer/AD es un trastorno neurodegenerativo progresivo que afecta la memoria y todas las funciones cognitivas con una edad de inicio tardío o precoz, y se presenta con una muy baja frecuencia por causa genética por alteración en el gen de la PPA, PS1 O PS2. El elemento etiológico mayor conocido es genético, con múltiples factores de susceptibilidad en interacción con factores medioambientales. Las guías de diagnóstico para la AD incluyen evaluaciones psicológicas, psiquiátricas y neurológicas con función cerebral, y no incluyen estudios de la función visual como parte del protocolo diagnóstico, siendo fuerte la evidencia de cambios oculares en retina y en algunas funciones visuales que aparecen aun sin el deterioro cognitivo característico de esta enfermedad. Objetivo: Describir las características cognitivas y oculares en la enfermedad de Alzheimer. Metodología: Se realizó una revisión documental de literatura científica en las bases de datos PubMed, Science Direct, Hinari y Ebsco Ebsco, Proquest, entre otras, con un periodo de búsqueda de los últimos 10 años, mediante los términos mesh "Alzheimer Disease and ocular changes", "visual cognitive alteration in Alzheimer" "retina and alzheimer disease". Resultados: La AD presenta un proceso neurodegenerativo con deterioro cognitivo, que se presenta en todas las regiones de la corteza cerebral, iniciándose en corteza del hipocampo y amígdala cerebral desde donde progresa a la circunvolución para-hipocampal, lóbulos temporales y frontales. Conclusiones: Varios estudios han demostrado que la AD presenta alteraciones en memoria, lenguaje, orientación visoespacial, acompañada por cambios estructurales en cerebro y en la retina al reducir el espesor de las células ganglionares, de las capas de fibras nerviosas y al contener cuerpos de inclusión con proteína beta amiloide (Aβ) y demuestran además que el diagnóstico de alteraciones funcionales por la acumulación de Aβ es un marcador precoz de la AD.
Abstract Alzheimer's disease / AD is a progressive neurodegenerative disorder that affects memory and all cognitive functions with a late or early onset age, and occurs with a very low frequency due to genetic causes due to alteration in the PPA gene.,PS1 or PS2. The largest known etiological element is genetic, with multiple susceptibility factors in interaction with environmental factors. Diagnostic guidelines for AD include psychological, psychiatric and neurological evaluations with brain function, and do not include studies of visual function as part of the diagnostic protocol, with strong evidence of ocular changes in the retina and in some visual functions that appear even without the cognitive deterioration characteristic of this disease. Objective: To describe the cognitive and ocular characteristics in Alzheimer's disease. Methodology: A documentary review of scientific literature was made in the databases PubMed, Science Direct, Hinari and Ebsco Ebsco, Proquest, among others, with a search period of the last 10 years, through the terms mesh "Alzheimer Disease and ocular changes "," visual cognitive alteration in Alzheimer "" retina and alzheimer disease". Results: AD presents a neurodegenerative process with cognitive deterioration, which occurs in all regions of the cerebral cortex, beginning in the cortex of the hippocampus and cerebral tonsil where it progresses to the para-hippocampal gyrus, temporal and frontal lobes. Conclusions: Several studies have shown that AD presents alterations in memory, language, visuospatial orientation, accompanied by structural changes in brain and retina by reducing the thickness of ganglion cells, the layers of nerve fibers and containing inclusion bodies with protein beta amyloid (Aβ) and further demonstrate that the diagnosis of functional alterations due to the accumulation of Aβ is an early marker of AD.
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Humanos , Doença de Alzheimer , Disfunção Cognitiva , Enfermagem em Neurociência , Doenças do Sistema NervosoRESUMO
The aim of the present study was to evaluate associations between intestinal parasitic infection with intestinal and systemic inflammatory markers in school-aged children with high rates of obesity. Plasma concentrations of C-Reactive Protein (CRP), leptin, TNF-α, IL-6 and IL-10 were measured as systemic inflammation markers and count of stool leukocytes as marker of intestinal inflammation in 291 children (6-10 years). Intestinal parasitic infection was measured by stool examination. Logistic regression analyses were performed to determine the odds of having high inflammatory markers for each parasite or group of parasites as compared to parasite-free children while adjusting for sex, age, mother's educational level and percentage of body fat. The prevalence of soil-transmitted helminths and intestinal protozoa infections was 12% and 36%, respectively. Parasitic infection was not associated with CRP, IL-6, IL-10 or TNF-α. Children infected with Ascaris lumbricoides (aOR: 5.91, 95% CI: 1.97-17.70) and Entamoeba coli (aOR: 8.46, 95% CI: 2.85-25.14) were more likely to have higher stool leucocytes than parasite-free children. Children with multiple infections (aOR: 10.60, 95% CI: 2.85-25.14) were more likely to have higher leptin concentrations than parasite-free children. Intestinal parasitic infection was not associated with systemic inflammation, but was associated with intestinal inflammation. Having multiple infections were associated with higher leptin concentrations.
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Helmintíase/sangue , Helmintíase/imunologia , Enteropatias Parasitárias/sangue , Enteropatias Parasitárias/imunologia , Intestinos/parasitologia , Leptina/sangue , Animais , Ascaris lumbricoides/imunologia , Proteína C-Reativa/metabolismo , Criança , Estudos Transversais , Entamoeba histolytica/imunologia , Fezes/parasitologia , Feminino , Helmintíase/parasitologia , Humanos , Inflamação , Interleucina-10/sangue , Interleucina-6/sangue , Enteropatias Parasitárias/parasitologia , Masculino , Obesidade/complicações , Prevalência , Inquéritos e Questionários , Fator de Necrose Tumoral alfa/sangueRESUMO
Patterns formed by the evaporation of a drop containing biological molecules have provided meaningful information about certain pathologies. In this context, several works propose the study of protein solutions as a model to understand the formation of deposits of biological fluids. Generally, dry droplets of proteins in a saline solution create complex aggregates. Here, we present an experimental study on the formation of patterns produced by the evaporation of droplet suspensions containing a protein binary mixture. We explore the structural aspect of such deposits by using optical and atomic force microscopy. We found that salt is unnecessary for the formation of complex structures such as crystal clusters, dendritic and undulated branches, and interlocked chains. Such structural features allow us to differentiate among protein binary mixtures. Finally, we discuss the potential use of this finding to reveal the presence of a protein suspensions, the folded and unfolded state of a protein, as well as their structural changes.
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Muramidase/química , Soroalbumina Bovina/química , Soluções/química , Água/química , Algoritmos , Animais , Bovinos , Microscopia de Força Atômica , Muramidase/metabolismo , Ligação Proteica , Dobramento de Proteína , Desdobramento de Proteína , Soroalbumina Bovina/metabolismo , Cloreto de Sódio/química , Suspensões/química , VolatilizaçãoRESUMO
The propagation of sound waves on lipid monolayers supported on water has been previously studied during the melting transition. Since changes in volume, area, and compressibility in lipid membranes have biological relevance, the observed sound propagation is of paramount importance. However, it is unknown what would occur on a lipid bilayer, which is a more approximate model of a cell membrane. With the aim to answer this relevant question, we built an experimental setup to assemble long artificial lipid membranes. We found that if these membranes are heated in order to force local melting, a thermo-mechanical perturbation propagates a long distance. Our findings may support the existence of solitary waves, postulated to explain the propagation of isentropic signals together with the action potential in neurons.