RESUMO
OBJECTIVE: Aminoglycosides were introduced into use over 60 years ago. The University Hospital of the West Indies (UHWI), a tertiary care teaching hospital, in Kingston, Jamaica, introduced the use of gentamicin in 1973 and amikacin in 1980. This report examined the susceptibility patterns to these agents in 1547 consecutive isolates of Gram negative bacilli (GNB) encountered between September 1 and November 30, 2011, at UHWI and compares the data with those observed previously in 1981 at the same institution. METHODS: The Vitek 2 (bioMeriéux, Durham, NC) was used for isolate identification, minimum inhibitory concentration determination and aminoglycoside susceptibility testing. Quality control was done using American Type Culture Collection standard strains of E coli (ATCC 25922) and Pseudomonas aeruginosa (ATCC 27853). RESULTS: Of the 1547 organisms, 267 had resistance to one or both aminoglycosides. Amikacin resistance increased from 0.6% (1981) to 7.2% [2011] (p < 0.05), while gentamicin resistance increased from 6.7% to 14.8% (p < 0.05) for the corresponding period. The majority of samples with aminoglycoside resistant organisms came from the intensive care unit and surgical inpatients. Urine samples persistently produced the largest amount of gentamicin resistant isolates. CONCLUSIONS: Although there has been a statistically significant rise in aminoglycoside resistance, aminoglycosides continue to remain highly effective against approximately 83% of GNB despite continuous usage at this institution for over three decades. Continued national surveillance, implementation of infection control policies and antibiotic stewardship are all essential in retaining low resistance levels.
RESUMO
Freshwater snails of the genus Biomphalaria, Preston 1910, are the most important and widely distributed intermediate hosts of Schistosoma mansoni, the blood fluke responsible for human intestinal schistosomiasis, in Africa and the Neotropics. S. mansoni is thought to have been imported repeatedly into the Americas during the last 500 years with the African slave trade. Surprisingly considering that the New and Old World separated 95-106 million years (Myr) ago, the disease rapidly became established due to the presence of endemic susceptible hosts. Reconstructing the phylogenetic relationships within Biomphalaria may provide insights into the successful intercontinental spread of S. mansoni. Parsimony and distance analyses of mitochondrial and nuclear sequences show African taxa to be monophyletic and Neotropical species paraphyletic, with Biomphalaria glabrata forming a separate clade from other Neotropical Biomphalaria, and ancestral to the African taxa. A west to east trans-Atlantic dispersal of a B. glabrata-like taxon, possibly as recently as the Plio-Pleistocene (1.8-3.6 Myr ago) according to a general mitochondrial clock, would fit these observations. Vicariance or an African origin for B. glabrata followed by multiple introductions to South America over the past 500 years with the African slave trade seem unlikely explanations. Knowledge of the phylogenetic relationships among important intermediate host species may prove useful in furthering control measures which exploit genetic differences in susceptibility to parasites, and in elucidating the evolution of schistosome resistance.
Assuntos
Biomphalaria/genética , Biomphalaria/parasitologia , Vetores de Doenças , Schistosoma mansoni/patogenicidade , África , Animais , DNA Mitocondrial/genética , Evolução Molecular , Genética Populacional , Humanos , Filogenia , Esquistossomose mansoni/transmissão , América do Sul , Especificidade da EspécieRESUMO
Growth hormone (GH) has long been recognized as one of the principal factors that control postnatal growth. Advances made in the last 5 years have increased our understanding of the intracellular signaling mechanisms subsequent to GH binding. The earliest event in GH signaling appears to be the binding of a single GH molecule by a pair of GH receptors (GHRs). The dimerization of GHRs leads to the activation of Janus kinase 2 (JAK2), a nonreceptor tyrosine kinase that associates with the cytoplasmic domain of GHR. It is thought that all signaling downstream from GHR depends on this initial activation of JAK2. Once activated, JAK2 tyrosyl-phosphorylates both itself and the cytoplasmic domain of GHR. These phosphorylated tyrosine residues act as docking sites for various signaling molecules that contain Src homology 2 (SH-2) or other phosphotyrosyl-binding domains. The signaling molecules that are recruited and activated by the GHR-JAK2 complex include signal transducers and activators of transcription (Stat) factors, the adapter protein Shc, and the insulin receptor substrates (IRSs) 1 and 2. The recruitment and activation of these signaling intermediates leads to the activation of enzymes such as MAP kinase, phosphatidylinositol-3'-kinase, protein kinase C, and phospholipase A2 and to the release of various second messengers such as diacylglycerol, calcium, and nitric oxide. Ultimately, these pathways modulate cellular functions such as gene transcription, metabolite transport, and enzymatic activities that affect the GH-dependent control of growth and metabolism.
Assuntos
Hormônio do Crescimento Humano/fisiologia , Proteínas Proto-Oncogênicas , Transdução de Sinais/fisiologia , Cálcio/metabolismo , Criança , Citoplasma/metabolismo , Diglicerídeos/metabolismo , Dimerização , Ativação Enzimática , Crescimento/fisiologia , Humanos , Janus Quinase 2 , Quinases de Proteína Quinase Ativadas por Mitógeno , Óxido Nítrico/metabolismo , Fosfatidilinositol 3-Quinases , Fosfolipases A/metabolismo , Fosfolipases A2 , Fosforilação , Fosfotransferases (Aceptor do Grupo Álcool)/metabolismo , Fosfotirosina/metabolismo , Ligação Proteica , Proteína Quinase C/metabolismo , Proteínas Quinases/metabolismo , Proteínas Tirosina Quinases/fisiologia , Proteínas/fisiologia , Receptor de Insulina/fisiologia , Receptores da Somatotropina/fisiologia , Sistemas do Segundo Mensageiro/fisiologia , Fatores de Transcrição/fisiologia , Transcrição Gênica , Domínios de Homologia de src/fisiologiaRESUMO
We describe here the sequence of the circumsporozoite protein gene of the monkey malaria parasite Plasmodium brasilianum and show that the immunodominant repeat domain is the same as that of the human malaria parasite, Plasmodium malariae. The immunodominant epitope on the surface of sporozoites of a third species of human malaria parasite has, therefore, been identified. This genetic based data and the biological similarities between P. brasilianum and P. malariae support their putative zoonotic/anthroponotic relationship. We also show that an ape malaria parasite, Plasmodium reichenowi, and the human malaria parasite, Plasmodium falciparum, have a similar relationship. The implications of these observations are discussed with respect to vaccine development.
Assuntos
Antígenos de Superfície/genética , Plasmodium/genética , Proteínas de Protozoários , Sequência de Aminoácidos , Animais , Antígenos de Protozoários/genética , Antígenos de Superfície/imunologia , Apicomplexa , Sequência de Bases , DNA Recombinante , Reservatórios de Doenças , Imunofluorescência , Dados de Sequência Molecular , Hibridização de Ácido Nucleico , Plasmodium falciparum/genética , Plasmodium malariae/genética , Plasmodium vivax/genéticaRESUMO
A analise de 2.080 culturas positivas para dermatofitos no periodo de janeiro de 1978 a dezembro de 1982 mostrou que, em Brasilia, sao sete as especies implicadas. A comparacao com levantamento anterior revela que, neste periodo, o T. rubrun mostrou um predominio ainda maior (62%) sobre os demais, e que o T. tonsurans apresentou um significativo aumento de incidencia
Assuntos
Humanos , Arthrodermataceae , BrasilRESUMO
Os autores apresentam um caso tipico de eritrodermia ictiosiforme congenita em adulto e mostram os resultados terapeuticos obtidos com o acido trans-retinoico (RO-109359/31)