RESUMO
BACKGROUND: Human Gut Microbiota (HGM) is composed of more than one thousand species, playing an important role in the health status of individuals. Dysbiosis (an HGM imbalance) is augmented as chronic kidney disease (CKD) progresses, as loss of kidney function accelerates. Increased antibiotic use in CKD subjects and consumption of nephrotoxic heavy metals and metalloids such as lead, cadmium, arsenic, and mercury in tap water increases the dysbiosis state. Studies in people with stage 3 CKD are complex to carry out, mainly because patients are self-reliant who rarely consult a specialist. The current work focused on this type of patient. RESULTS: Lead and arsenic-resistant bacteria were obtained from self-reliant (that stands on its own) stage 3 CKD subjects. Pathogen-related Firmicutes and Proteobacteria genus bacteria were observed. Resistance and potentiation of antibiotic effects in the presence of metal(loid)s in vitro were found. Furthermore, the presence of the following genes markers for antibiotic and metal(loid) resistance were identified by qPCR: oxa10, qnrB1, mphB, ermB, mefE1, arr2, sulll, tetA, floR, strB, dhfr1, acrB, cadA2k, cadA3k, arsC, pbrA. We observed a decrease in the number of metal resistance markers. CONCLUSIONS: The presence of cadA and arsC genetic markers of antibiotics and metal(loid)s resistance were detected in samples from stage 3 CKD subjects. Lower gene amplification in advanced stages of CKD were also observed, possibly associated with a decrease in resident HGM during kidney disease progression.
Assuntos
Arsênio , Microbioma Gastrointestinal , Metais Pesados , Insuficiência Renal Crônica , Antibacterianos/farmacologia , Bactérias/genética , Resistência Microbiana a Medicamentos , Disbiose/microbiologia , HumanosRESUMO
BACKGROUND: Human Gut Microbiota (HGM) is composed of more than one thousand species, playing an important role in the health status of individuals. Dysbiosis (an HGM imbalance) is augmented as chronic kidney disease (CKD) progresses, as loss of kidney function accelerates. Increased antibiotic use in CKD subjects and consumption of nephrotoxic heavy metals and metalloids such as lead, cadmium, arsenic, and mercury in tap water increases the dysbiosis state. Studies in people with stage 3 CKD are complex to carry out, mainly because patients are self-reliant who rarely consult a specialist. The current work focused on this type of patient. RESULTS: Lead and arsenic-resistant bacteria were obtained from self-reliant (that stands on its own) stage 3 CKD subjects. Pathogen-related Firmicutes and Proteobacteria genus bacteria were observed. Resistance and potentiation of antibiotic effects in the presence of metal(loid)s in vitro were found. Furthermore, the presence of the following genes markers for antibiotic and metal(loid) resistance were identified by qPCR: oxa10, qnrB1, mphB, ermB, mefE1, arr2, sulll, tetA, floR, strB, dhfr1, acrB, cadA2k, cadA3k, arsC, pbrA. We observed a decrease in the number of metal resistance markers. CONCLUSIONS: The presence of cadA and arsC genetic markers of antibiotics and metal(loid)s resistance were detected in samples from stage 3 CKD subjects. Lower gene amplification in advanced stages of CKD were also observed, possibly associated with a decrease in resident HGM during kidney disease progression.
Assuntos
Humanos , Arsênio , Metais Pesados , Insuficiência Renal Crônica , Microbioma Gastrointestinal , Bactérias/genética , Resistência Microbiana a Medicamentos , Disbiose/microbiologia , Antibacterianos/farmacologiaRESUMO
BACKGROUND: Early diagnosis is fundamental in patients with Parkinson's disease (PD) to improve their quality of life. AIM: To determine the latency in the diagnosis of Parkinson's disease (PD) after the onset of motor symptoms. PATIENTS AND METHODS: Prospective study carried out during 16 months in a public hospital. Two hundred newly diagnosed patients aged 41 to 90 years (50% women), were included and analyzed. RESULTS: The lapse between the first symptom -more commonly tremor- and the diagnosis made by a neurologist ranged from 1 to 84 months (19.1 ± 13.8). In 39% of patients, it was done in the first year, in 26% during the second year and in 35% of patients, it took more than two years. The referral by a general practitioner had a delay ranging from 1 to 36 months. Sixty nine and 95% of patients were evaluated within the first 6 months after referral if they came from primary care or the same hospital, respectively. Twenty six percent of patients were classified in stages III to V of Hoehn & Yahr's staging and the Parkinson's Disease Rating Scale motor examination ranged from 5 to 81 points, mean 24 (± 12.8). CONCLUSIONS: The diagnosis of PD has a delay in a public hospital that could be influenced by the referral system.
Assuntos
Diagnóstico Tardio , Doença de Parkinson/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Chile , Estudos Transversais , Feminino , Hospitais Públicos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores SocioeconômicosRESUMO
Background: Early diagnosis is fundamental in patients with Parkinson’s disease (PD) to improve their quality of life. Aim: To determine the latency in the diagnosis of Parkinson’s disease (PD) after the onset of motor symptoms. Patients and Methods: Prospective study carried out during 16 months in a public hospital. Two hundred newly diagnosed patients aged 41 to 90 years (50% women), were included and analyzed. Results: The lapse between the first symptom -more commonly tremor- and the diagnosis made by a neurologist ranged from 1 to 84 months (19.1 ± 13.8). In 39% of patients, it was done in the first year, in 26% during the second year and in 35% of patients, it took more than two years. The referral by a general practitioner had a delay ranging from 1 to 36 months. Sixty nine and 95% of patients were evaluated within the first 6 months after referral if they came from primary care or the same hospital, respectively. Twenty six percent of patients were classified in stages III to V of Hoehn & Yahr’s staging and the Parkinson’s Disease Rating Scale motor examination ranged from 5 to 81 points, mean 24 (± 12.8). Conclusions: The diagnosis of PD has a delay in a public hospital that could be influenced by the referral system.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diagnóstico Tardio , Doença de Parkinson/diagnóstico , Chile , Estudos Transversais , Hospitais Públicos , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores SocioeconômicosRESUMO
Pathogenic substitutions in the leucine-rich repeat kinase 2 protein (Lrrk2), R1441G and G2019S, are a prevalent cause of autosomal dominant and sporadic Parkinson's disease in the Northern Spanish population. In this study we examined the frequency of these two substitutions in 166 Parkinson's disease patients and 153 controls from Chile, a population with Spanish/European-Amerindian admixture. Lrrk2 R1441G was not observed, however Lrrk2 G2019S was detected in one familial and four sporadic Parkinson's disease patients. These findings suggest Lrrk2 G2019S may play an important role in Parkinson's disease on the South American Continent and further studies are now warranted.
Assuntos
Predisposição Genética para Doença , Doença de Parkinson/genética , Proteínas Serina-Treonina Quinases/genética , Idade de Início , Chile/epidemiologia , Análise Mutacional de DNA , Feminino , Frequência do Gene , Haplótipos , Humanos , Serina-Treonina Proteína Quinase-2 com Repetições Ricas em Leucina , Masculino , Pessoa de Meia-Idade , Mutação , Reação em Cadeia da PolimeraseRESUMO
We have studied the association of a null mutation of Glutathione Transferase M1 (GST M1*0/0) with Parkinson's disease (MIM 168600) in a Chilean population with a strong Amerindian genetic component. We determined the genotype in 349 patients with idiopathic Parkinson's disease (174 female and 175 male; 66.84+/-10.7 years of age), and compared that to 611 controls (457 female and 254 male; 62+/-13.4 years of age). A significant association of the null mutation in GST M1 with Parkinson's disease was found (p=0.021), and the association was strongest in the earlier age range. An association of GSTM1*0/0 with Parkinson's disease supports the hypothesis that Glutathione Transferase M1 plays a role in protecting astrocytes against toxic dopamine oxidative metabolism, and most likely by preventing toxic one-electron reduction of aminochrome.
Assuntos
Predisposição Genética para Doença/genética , Glutationa Transferase/genética , Estresse Oxidativo/genética , Doença de Parkinson/enzimologia , Doença de Parkinson/genética , Polimorfismo Genético/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/genética , Envelhecimento/metabolismo , Astrócitos/enzimologia , Encéfalo/enzimologia , Encéfalo/fisiopatologia , Chile/etnologia , Citoproteção/genética , Análise Mutacional de DNA , Dopamina/metabolismo , Feminino , Testes Genéticos , Genótipo , Humanos , Indígenas Sul-Americanos/etnologia , Indígenas Sul-Americanos/genética , Masculino , Pessoa de Meia-Idade , Mutação , Doença de Parkinson/etnologiaRESUMO
Se evaluó mediante cartilla de evaluación del pie diabético al 73 por ciento de la población en control de los pacientes diabéticos del Hospital de Molina, y así poder prevenir las invalidantes consecuencias de esta enfermedad. Los resultados muestran que el daño o alteración del pie es mayor a mayor edad y tiempo de evolución, más aún en varones, con mayor prevalencia en deformidad ósea, y a mayor tiempo de evolución de la enfermedad hay un notable aumento de la neuropatía diabética. El presente trabajo nos orienta para que el equipo de salud dirija los esfuerzos en mejor forma, destinados a la prevención del daño irreversible del pie diabético
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Diabetes Mellitus/complicações , Pé Diabético/diagnóstico , Deformidades do Pé/etiologia , Hospitais Estaduais/estatística & dados numéricos , Distribuição por Idade , Distribuição por Sexo , Evolução Clínica , Neuropatias Diabéticas/etiologia , Pé Diabético/prevenção & controleAssuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Adolescente , Adulto , Pessoa de Meia-Idade , Ferimentos e Lesões/epidemiologia , Diagnóstico da Situação de Saúde , Braço , Traumatismos do Braço/epidemiologia , Ferimentos e Lesões/classificação , Ferimentos e Lesões/etiologia , Causalidade , Traumatismos Craniocerebrais/epidemiologia , Hospitais Estaduais/estatística & dados numéricos , Traumatismos da Perna/epidemiologia , Acidentes de Trânsito/estatística & dados numéricos , Distribuição por Idade , Fraturas Ósseas/epidemiologia , Hospitalização/estatística & dados numéricosRESUMO
Con el fin de realizar un diagnóstico de situación del programa Diabetes Mellitus del Hospital de Molina, se efectuó un estudio descriptivo del programa, el cual consideró el total de pacientes en control regular (asistentes) 202 pacientes, que equivale al 82 por ciento del total en control. Se analizaron múltiples variables, obteniendo como resultado una predominancia de sexo femenino, con una distribución por edad en general sobre los 40 años, con grados aceptables de control glicémico (en relación a otras comunidades estudiadas);con una alta incidencia de pacientes obesos o sobrepeso y unn manejo terapéutico de predominio mixto (Dietoterapia más hipoglicemiantes orales). Además, se observó mayor prevalencia de hipertensión en relación a la población general y un grado de pesquisa variable (en general deficiente) de complicaciones secundarias de la enfermedad
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Diabetes Mellitus/epidemiologia , Colesterol/sangue , Estado Nutricional , Creatinina/sangue , Triglicerídeos/sangueRESUMO
Se presentan 22 casos de timonas linfoepiteliales del adulto, agrupados por estadios clínicos. Los 2 factores que determinaron la supervivencia fueron el carácter invasor y la miastemia gravis. Hubo 3 muertes postoperatorias en pacientes con miastenia gravis generalizada y timona maligno. Se hace hincapié en la importancia de la flebografía tímica y semiología angiológica del mediastino para el correcto tratamiento. La cirugía resectiva radical es el tratamiento de elección. La asociación de cobalto y quimioterapia es efectiva en estadios III y IV (AU)
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Masculino , Feminino , Miastenia Gravis , Neoplasias do Timo/cirurgia , Timoma/classificaçãoRESUMO
Se presentan 22 casos de timonas linfoepiteliales del adulto, agrupados por estadios clínicos. Los 2 factores que determinaron la supervivencia fueron el carácter invasor y la miastemia gravis. Hubo 3 muertes postoperatorias en pacientes con miastenia gravis generalizada y timona maligno. Se hace hincapié en la importancia de la flebografía tímica y semiología angiológica del mediastino para el correcto tratamiento. La cirugía resectiva radical es el tratamiento de elección. La asociación de cobalto y quimioterapia es efectiva en estadios III y IV