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Resumen: Los anestésicos locales se definen como fármacos que bloquean la generación y propagación de impulsos en tejidos excitables desde médula ósea, raíces nerviosas, nervios periféricos hasta otros tejidos excitables como músculo cardíaco, músculo liso y cerebro. La intoxicación sistémica se produce debido a las concentraciones plasmáticas elevadas después de altas dosis o la administración intravenosa inadvertida. El creciente uso de técnicas de anestesia locorregional obliga a tener presente la intoxicación sistémica por anestésicos locales como una complicación anestésica de baja incidencia, pero alta morbimortalidad, además de constituir una de las causas de paro cardiorrespiratorio de origen anestésico más frecuentes. La presentación clínica de esta complicación es muy variable y abarca un gran espectro de síntomas relacionados principalmente con la toxicidad neurológica y cardiovascular. Aunque infrecuentes, las reacciones pueden ser muy graves, y resultar en daño irreversible o muerte del paciente. La prevención parece haber disminuido la intoxicación de los anestésicos locales y es más efectiva que el tratamiento. El manejo se basa en medidas de reanimación cardiopulmonar avanzada, el tratamiento farmacológico y el empleo precoz de las emulsiones lipídicas. Se presenta un caso de intoxicación sistémica utilizando lidocaína simple como único anestésico local durante la realización de bloqueo de nervio periférico en cirugía electiva.
Abstract: The local anesthesics are defined as medicaments that block the generation and spread of impulses in excitable fabrics, from bony marrow, nervous roots, peripheral nerves or other excitable fabrics as cardiac muscle, smooth muscle and brain. The systemic intoxication takes place due to the plasmatic concentrations raised after high doses or the intravenous inadvertent administration. The increasing use of technologies of anesthesia locorregional forces to bear in mind the systemic intoxication for local anesthesics as an anesthesic complication of low incident, but high morbi-mortality, beside constituting one of the more frequent reasons of cardiorespiratory unemployment of anesthesic origin. The clinical presentation of this complication is very variable and includes a great spectrum of symptoms related principally to the neurological and cardiovascular toxicity. Though infrequent, the reactions can be very serious, and to result in irreversible hurt or death of the patient. The prevention seems to have diminished the poisoning of the local anesthesics and is more effective than the treatment. The managing is based on measures of resuscitation cardiopulmonar advanced, the pharmacological treatment and the precocious employment of the lipid emulsions. I present a case of systemic intoxication using lidocaine simply as anesthesic local only one during the accomplishment of blockade of peripheral nerve in elective surgery.
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RESUMEN Introducción: Ecuador no cubre las recomendaciones de mantener la lactancia materna hasta los seis meses de edad del recién nacido. Objetivo: Analizar los factores relacionados con la duración de la lactancia materna exclusiva en madres trabajadoras de una institución universitaria ecuatoriana. La población de estudio. Métodos: Estudio cuantitativo, descriptivo, transversal, con carácter retrospectivo mediante un cuestionario diseñado ad hoc que se invitó a cumplimentar a todas las madres trabajadoras que lo habían sido en los últimos 10 años de la institución. El período de ejecución del estudio fue de septiembre 2018 a junio de 2019. Resultados: Participaron 316 madres, 62,8 % recibió información sobre lactancia materna y proveniente del médico 55,6 %. La primera hora de vida amamantaron 63,9 %. Más de la mitad de las participantes amamantaron durante un periodo de 6 meses (56,9 %), con lactancia materna exclusiva una media de 4,56 meses. El principal motivo para el abandono fue hipogalactia (26,9 %); incorporación al trabajo (19,2 %); enfermedad materna (5,1 %). La media de lactancia materna exclusiva fue mayor en las madres docentes e investigadoras 4,79 (DE ± 1,8) que en las administrativas y de servicios 4,2 (DE ± 2,05), p= 0,012. Conclusiones: Entre los factores que favorecen la lactancia materna están la información durante el embarazo, así como instaurarla en la primera hora de vida. La situación laboral de la mujer influye en el mantenimiento de dicha lactancia por más tiempo y es una causa de abandono, aunque la más frecuente son los problemas de salud de la madre o del recién nacido.
ABSTRACT Introduction: Ecuador does not cover the recommendations to maintain breastfeeding until six months of age of the newborn. Objective: Analyze the factors related to the duration of exclusive breastfeeding in working mothers of an Ecuadorian university institution. The study population. Methods: Quantitative, descriptive, cross-sectional study, with retrospective character using a questionnaire designed ad hoc; all working mothers who had been in the last 10 years in the institution were invited to fill it. The study was carried out from September 2018 to June 2019. Results: 316 mothers participated, 62.8% received information on breastfeeding and 55.6% from the doctor. The first hour of life, 63.9% mothers breastfed. More than half of the participants breastfed for a period of 6 months (56.9%), and with exclusive breastfeeding during an average of 4.56 months. The main reason for not breastfeeding was hypogalactia (26.9%); work placement (19.2%); maternal disease (5.1%). The mean of exclusive breastfeeding was higher in mother who are teachers and researchers (4.79) (SD ± 1.8) than in mothers with administrative and service positions 4.2 (SD ± 2.05), p = 0.012. Conclusions: Among the factors that favor breastfeeding are information during pregnancy, as well as establishing it in the first hour of life. The employment situation of women influences the maintenance of breastfeeding for longer and is a cause of dropout, although the most frequent are the health problems of the mother or the newborn.
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INTRODUCTION: Intra-arterial chemotherapy (IAC) is useful for eye preservation in advanced retinoblastoma (Rb). Intra-vitreal chemotherapy (IvitC) is the latest treatment for vitreous seeds. METHODS: The present study is a retrospective assessment of 100 eyes, treated with primary or secondary IAC alone or with IvitC. We evaluated demographic and clinical variables, eye salvage, associated adverse events, and patient survival. Data were analyzed using descriptive statistics. Kaplan-Meier survival curves and Cox hazard ratios were utilized to assess the effect of demographic and clinical variables over eye salvage. RESULTS: Bilateral Rb was observed in 61% of patients, and 57% of eyes received secondary treatment. Forty eyes needed intra-arterial plus IvitC and 62 presented advanced disease (group D and E). Three- and 5-year ocular survival probabilities were 75 and 68%. We found a higher risk in group D and E eyes and those requiring 2 or more routes for ophthalmic artery catheterization. Patients coming from other countries also showed increased risk. Using primary or secondary treatment, or IvitC, did not affect this risk. Overall rates of survival and eye salvages were 98.8 and 73%, and we had a 100% catheterization success and none ophthalmic arterial occlusions. CONCLUSIONS: In an upper middle-income country such as Colombia, a specialized institution counting with therapeutic alternatives and a multidisciplinary team can reach rates of patient survival and eye salvage similar to those of high-income countries.
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Background: Mexico declared the first case of novel coronavirus disease (COVID-19) in February 2020. At the time we write this article, our country is facing a community spread phase, expecting a rapid increase in the number of cases and fatalities. The Fray Antonio Alcalde Civil Hospital of Guadalajara has been declared a non-COVID-19 hospital with the mission of providing care to patients already registered and also those transferred from neurosurgical departments of neighboring centers, which have been converted into COVID-19 only hospitals. Methods: An organized response regarding personnel, surgical case selection, operating room behavior, and facility reorganization were designed to prevent an internal coronavirus outbreak in the neurosurgery department at the Fray Antonio Alcalde Civil Hospital of Guadalajara. Results: Distancing actions by the staff and residents, including ward case discussions, neurosurgery rounds, and classes, will be carried out virtually. We classified neurosurgical patients into 4 groups depending on whether their condition demands care in 0-6 hours, 6-48 hours, 48 hours to 14 days, and >14 days. Subsequently, a questionnaire with epidemiologic, radiologic, clinical, and serologic criteria will be applied to determine the risk of COVID-19 infection to define to which area they are going to be transferred according to the different risk zones in our facility. Conclusions: Despite not being a COVID-19 center, we consider all patients at the neurosurgical ward and staff members as asymptomatic carriers or infected in the preclinical period. Specific measures must be taken to ensure the safety and care of neurosurgical patients and medical staff during the community spread phase.
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Infecções por Coronavirus/epidemiologia , Neurocirurgia , Salas Cirúrgicas , Equipamento de Proteção Individual , Admissão e Escalonamento de Pessoal , Pneumonia Viral/epidemiologia , Triagem , Betacoronavirus , COVID-19 , Planejamento Ambiental , Departamentos Hospitalares , Unidades Hospitalares , Humanos , México/epidemiologia , Procedimentos Neurocirúrgicos , Pandemias , Medição de Risco , SARS-CoV-2RESUMO
The aim of the present study was to analyze the relationship between family communication problems and cyberbullying, through psychosocial adjustment-psychological distress, attitude towards institutional authority, and problematic use of social networking sites-in adolescents. Random sampling by conglomerates was performed. A total of 8115 adolescents participated in the study (51.5% boys, 49.5% girls), and were aged between 11 and 16 years old (M = 13.34, SD = 1.04) and enrolled in the State of Nuevo León (Mexico). A structural equations model was developed using the Structural Equation Modeling Software (EQS). The results showed that problematic family communication is directly associated with cyberbullying, and also indirectly through the relationships of psychological distress and attitude towards transgression of social norms with the problematic use of social networking sites. The multi-group analyses also revealed gender differences in these relationships. Finally, the obtained results were discussed and their practical implications were shown.
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Adaptação Psicológica , Comportamento do Adolescente/psicologia , Cyberbullying , Família/psicologia , Adolescente , Atitude , Criança , Comunicação , Feminino , Humanos , Masculino , México , Fatores Sexuais , Rede SocialRESUMO
Nowadays the development of sustainable technologies for the effective production of polymeric materials that can be used as biomaterials will be of importance. In this work, cellulose (CEL) was purified from potato peel waste (PPW) and used to produce electrospun nanofibers for tissue engineering applications. The purified CEL was solubilized in copper ethylenediamine (Cuen) and the electrospun nanofibers was produced through electrospinning technique in diameter range of 250-500 nm at electrical field strength of 20 kV. To confirm the applicability of the electrospun CEL scaffolds in tissue engineering, in vitro BALB-3T3 fibroblastic cell adhesion and cell proliferation tests were employed in this study. Cell viability was evaluated by staining with ethidium bromide (EtBr) and acridine orange (AO) to evaluate the possible effects of cytotoxicity of the CNF scaffolds. Fluorescence studies confirmed that BALB-3T3 viable cells attached and spread throughout the CEL scaffold. The attachment and spreading of viable cells suggests that electrospun CEL scaffolds support growth of BALB-3T3 fibroblasts cells and suggests that PPW can be a useful source of raw material for the production of scaffolds for tissue engineering.
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Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Biomassa , Celulose/química , Celulose/farmacologia , Eletricidade , Alicerces Teciduais/química , Células 3T3 , Animais , Proliferação de Células/efeitos dos fármacos , Teste de Materiais , Camundongos , Propriedades de SuperfícieRESUMO
El objetivo del presente trabajo fue examinar la violencia relacional entre iguales desde una perspectiva psicosocial, analizando variables familiares (funcionamiento y comunicación familiar), sociales (reputación social - percibida e ideal - y actitud hacia la autoridad institucional) e individuales (malestar psicológico e ideación suicida) en adolescentes escolarizados. La muestra fue de 8115 adolescentes, con edades comprendidas entre los 11 y los 16 años, del estado de Nuevo León, México. Se realizó un análisis de regresión lineal múltiple, paso a paso, cuyos resultados mostraron que la dimensión más importante en la predicción de la conducta violenta relacional es la autopercepción no conformista, seguido del malestar psicológico. Finalmente, se discuten estos resultados y sus implicaciones.
The aim of this research was to study relational violence between peers from a psychosocial perspective, by analyzing family variables (family functioning and communication), social variables (social reputation both perceived and ideal and attitude towards institutional authority), and individual variables (psychological distress and suicide ideation) in adolescent students. The sample consisted of 8,115 adolescents aged 11 to 16 years from the State of Nuevo León, Mexico. We performed a forward stepwise multiple regression analysis, the results of which showed that the most important factor in the prediction of violent relational behavior at school is the nonconformist self-perception, followed by psychological distress. Finally, these results and their implications are discussed.
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BACKGROUND: Giardia duodenalis is the most common intestinal pathogenic protozoan infection reported in humans. Both in vitro studies and 4 separate, sequential, comparative clinical trials conducted by our group in Cuba demonstrated mebendazole activity against G. duodenalis infection in both children and adults. OBJECTIVE: The 2 additional, prospective, open-label, Phase IV follow-up studies reported here were performed to further assess the effectiveness and safety profile of mebendazole in the outpatient treatment of G. duodenalis infection. METHODS: Assenting children (nâ¯=â¯522) whose guardians gave permission and consenting adults (nâ¯=â¯423) diagnosed with G. duodenalis infection were given mebendazole (200 mg 3 times daily for 3 days). Medical histories and stool samples were obtained and physical/laboratory examinations were performed pretreatment then repeated on days 3, 5, and 7 after treatment completion. The evaluation of efficacy (ie, cure) was based on parasitologic response to therapy. Participants were considered cured, if no Giardia trophozoites or cysts were found in any of the 3 posttreatment fecal specimens evaluated by direct wet mounts and/or after Ritchie concentration techniques. RESULTS: No participant refused to be enrolled and all returned for follow-up examinations. At the end of the treatment, stool samples were negative in 450 out of 522 children (86.2%) and 392 of 423 adults (92.7%). Treatment was well tolerated. In adults, the only adverse effect reported was abdominal pain (6.2%). Side effects reported in children included abdominal pain (5.6%), nausea (2.9%), and vomiting (2.3%). Reported side effects were all mild, transient, and self-limited and did not require discontinuation of treatment or additional medication. CONCLUSIONS: Mebendazole may be an effective alternative treatment of G. duodenalis infections in both children and adults.
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Levonorgestrel (LNG), a synthetic 19 nor-testosterone derivative, is widely used for emergency contraception. It is well known that LNG prevents ovulation only when given prior to the surge of serum luteinizing hormone (LH) during the periovulatory phase of the menstrual cycle. This observation suggests that LNG, given its contraceptive efficacy, has additional effects other than those affecting ovulation. In this study, we have evaluated the effects on human sperm functionality of uterine flushings (UF) obtained from women at day LH + 1 of a control cycle (CTR-LH + 1) and after receiving LNG (LNG-LH + 1) two days before the surge of LH. Human sperm from normozoospermic donors were incubated with UF and protein tyrosine phosphorylation, sperm motility, acrosome reaction as well as zona pellucida (ZP) binding capacity were assessed. A significant decrease in total motility and tyrosine phosphorylation accompanied by an increase on spontaneous acrosome reaction was observed when sperm were incubated in the presence of LNG-LH + 1. None of these effects were mimicked by purified glycodelin A (GdA). Moreover, the addition of UF obtained during the periovulatory phase from LNG-treated women or the presence of purified GdA significantly decreased sperm-ZP binding. The data were compatible with changes affecting sperm capacitation, motility and interaction with the ZP. These results may offer evidence on additional mechanisms of action of LNG as an emergency contraceptive.
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Líquidos Corporais , Anticoncepcionais Femininos/uso terapêutico , Levanogestrel/uso terapêutico , Espermatozoides/efeitos dos fármacos , Irrigação Terapêutica , Útero/patologia , Reação Acrossômica/efeitos dos fármacos , Adulto , Líquidos Corporais/efeitos dos fármacos , Líquidos Corporais/fisiologia , Anticoncepcionais Femininos/farmacologia , Feminino , Humanos , Técnicas In Vitro , Levanogestrel/farmacologia , Masculino , Capacitação Espermática/efeitos dos fármacos , Espermatozoides/fisiologiaRESUMO
Free-living amoebae have been found in soil, air and a variety of aquatic environments, but few studies have been conducted on industrial wastewater and none on wastewater from the textile industry. The aim of this study was to determine the presence and distribution of free-living amoebae in a biological treatment system that treats textile industrial wastewater. Samples were taken from input, aeration tank, sedimentation tank and output. Samples were centrifuged at 1200g for 15min, the sediment was seeded on non-nutritive agar with Enterobacter aerogenes (NNE) and the plates were incubated at 30 and 37°C. Free-living amoebae were present in all stages of the treatment system. The highest number of amoebic isolates was found in the aeration tank and no seasonal distribution was observed during the year. A total of 14 amoeba genera were isolated: Acanthamoeba, Echinamoeba, Korotnevella, Mayorella, Naegleria, Platyamoeba, Saccamoeba, Stachyamoeba, Thecamoeba, Vahlkampfia, Vannella, Vermamoeba, Vexillifera and Willaertia. The most frequently found amoebae were Acanthamoeba and Vermamoeba which were found in all treatment system stages. The constant presence and diversity of free-living amoebae in the treatment system were important findings due to the characteristics of the wastewater from the textile plant in terms of the residue content from colorants, fixers, carriers, surfactants, etc., used in fabric dyeing and finishing processes. The factors that determined the presence and distribution of amoebae in the activated sludge system were their capacity to form cysts, which allowed them to resist adverse conditions; food availability; an average temperature of 27-33°C; dissolved oxygen in average concentrations above 2mg/L, and pH in a range of 5.9-7.1.
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Amoeba/isolamento & purificação , Resíduos Industriais , Indústria Têxtil , Águas Residuárias/parasitologia , Amoeba/classificação , Concentração de Íons de Hidrogênio , México , TemperaturaRESUMO
Objetivo: describir la supervivencia libre de enucleación, respuesta al tratamiento y complicaciones de los pacientes sometidos a tratamiento con quimioterapia intraarterial (QIA) para el control del retinoblastoma en el Hospital Universitario de San Vicente Fundación (HUSVF). Tipo de estudio: estudio de cohortes. Materiales y Métodos: se incluyeron todos los pacientes con diagnóstico de retinoblastoma tratados en el husvf con qia supraselectiva de la arteria oftálmica entre agosto del 2011 y agosto de 2013. Resultados: se realizó tratamiento a 21 pacientes, 24 ojos, en un periodo de 23.5 meses. La edad media al momento de inicio de la QIA fué 19 meses (rango 5-60 meses) con un seguimiento promedio de 9.3 meses (rango 3 semanas a 23.5 meses). Se realizaron 78 cateterizaciones, siendo 9 de ellas bilaterales. El salvamento ocular se alcanzó en el 100% de los Grupo A (n1), 100% B (n=2), 100% C (n=5) y 87.5% D (n=16), según la Clasificación Internacional para Retinoblastoma (CIRB). Sólo se reportaron dos eventos adversos importantes, una hemiparesia transitoria y una reacción alérgica severa. Ninguno de los pacientes ha fallecido, ha tenido compromiso metastásico o necesidad de radioterapia externa. Sólo se realizaron dos enucleaciones. La media de supervivencia de los 24 globos oculares tratados es de 10.4 meses ± 1.6. La media de supervivencia de los 21 pacientes tratados es de 10.4 meses ±1.7. Conclusiones: los resultados muestran una respuesta satisfactoria, constituyéndose la QIA como procedimiento seguro y con baja tasa de complicaciones en el tratamiento del retinoblastoma.
Purpose: to describe globe salvage, treatment response and complications of patients following intra-arterial chemotherapy (IAC) for retinoblastoma at Hospital Universitario de San Vicente Fundacion (HUSVF). Type of study: Cohort Study. Materials and methods: We included all patients diagnosed with retinoblastoma and treated with IAC between from August 2011 to August 2013. Results: A total of 21 patients, with a total of 24 eyes, were treated with IAC over a period of 23.5 months. The mean age of patients at time of treatment was 19 months (range 5-60 months) with a mean follow-up time of 9.3 months (range 3 weeks to 23.5 months). 78 catheterizations were performed, nine of them being bilateral. Ocular salvage rate was achieved in 100% of the Group A (n1), 100% in group B (n = 2), 100% in group C (n = 5) and 87.5% in group D (n = 16), according to the International Classification for Retinoblastoma. Only two major adverse events were reported, a transient hemiparesis and a severe allergic reaction. No deaths, metastatic involvement or need for external beam radiotherapy were reported. Two eyes, from group D, required enucleation. The mean survival rate of 24 eyes treated was 10.4 months ± 1.6. The mean survival rate of the 21 patients treated was 10.4 ± 1.7 months. Conclusions: The results show a satisfactory response, becoming the IAC a safe procedure with a low complication rate in retinoblastoma treatment.
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Retinoblastoma/tratamento farmacológico , Retinoblastoma/terapia , Tratamento Farmacológico/tendências , Oftalmopatias/tratamento farmacológicoRESUMO
El objetivo del presente estudio fue realizar un análisis psicosocial del consumo de alcohol en adolescentes mexicanos, considerando de forma simultánea las variables personales, familiares, escolares y sociales. Se realizó un estudio de tipo explicativo. La muestra estuvo conformada por 1.245 adolescentes de ambos sexos, procedentes de dos centros educativos de secundaria y dos de preparatoria, con edades comprendidas entre los 12 y los 17 años. Se realizó un modelo de ecuaciones estructurales que explicó el 66 % de la varianza y se exploró el efecto moderador del género. Los resultados se discuten en función de los estudios más relevantes en la temática de esta investigación.
The objective of the present study was to analyze the psychosocial alcohol consumption in Mexican adolescents, taking into account simultaneously personal, family, school and social variables. The type of study is explanatory. The sample consisted of 1245 adolescents girls and boys form two secondary and preparatory schools, with ages between 12 and 17 years old. A structural equations model explained 66% of the variance and also it was explored the moderating effect of gender. The results are discussed in terms of the relevant studies on the subject of this investigation.
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Alcoolismo , Consumo de Álcool por Menores , MéxicoRESUMO
Los tumores de glándulas salivales son relativamente infrecuentes, constituyendo el 1% de los tumores de cabeza y cuello, siendo aún más raros los tumores de glándulas sublinguales, aunque frecuentemente su diagnóstico es maligno. El propósito de este trabajo es la presentación de un caso clínico que presentó un carcinoma adenoquístico de glándula sublingual en suelo de boca lado izquierdo. Clínicamente apareció una lesión alargada, sobre el trayecto del conducto de Wharton, con una coloración normal, lisa, brillante y asintomática. Se le realizó exéresis simple de la lesión y el Departamento de Anatomía Patológica confirmó el diagnóstico. Se procedió a revisar la bibliografía nacional e internacional sobre estas lesiones encontrándose escasas referencias debido a su rareza. La evolución de la paciente después de 16 meses ha sido satisfactoria.
The salivary gland tumors are relatively infrequent, being only 1 % of the head and neck tumors; the sublingual gland tumors are even more unusual, although their diagnosis is frequently malignant. The purpose of the current work is presenting a clinical case carrying a sublingual gland adenocystic carcinoma on the left side of the mouth bottom. Clinically, there it was a long lesion, over the course of the Wharton’s duct, with an asymptomatic, normal, brilliant and smooth color. The lesion was simply removed and the Department of Pathologic Anatomy confirmed the diagnosis. We reviewed the national and international literature on these lesions, finding scarce references because of its unusualness. The patient’s evolution is satisfactory when 16 months have passed from the surgery.
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PURPOSE: To examine the mortality risk associated with diabetes in the Mexico City Diabetes Study (MCDS) and the San Antonio Heart Study (SAHS). METHODS: Prospective cohorts conducted 1990-2007 in MCDS and 1979-2000 in SAHS. Mortality risk was examined using Cox proportional hazard models in 1402 non-Hispanic whites (NHW), 1907 U.S.-born Mexican-Americans (MA), 444 Mexican-born MA, and 2281 Mexico City residents (MCR) between the ages of 35-64. RESULTS: Age- and sex-adjusted mortality hazard ratios (HR) comparing U.S.-born MA, Mexican-born MA, and MCR to NHW were 1.09 (95% confidence interval [CI]: 0.86, 1.37), 1.23 (95% CI: 0.86, 1.76), and 0.97 (95% CI: 0.77, 1.23), respectively, in nondiabetic individuals; in contrast, mortality risk varied in diabetic individuals with respective HRs of 1.77 (95% CI: 1.20, 2.61), 1.08 (95% CI: 0.59, 1.97), and 2.27 (95% CI: 1.53, 3.35) (interaction p = .0003). Excluding Mexican-born MA and nondiabetic individuals, controlling for medication use, insulin use, fasting glucose levels, and duration of diabetes explained a significant proportion of the mortality differential (HRs relative to NHW were 1.31 [95% CI: 0.87, 1.98] in U.S.-born MA and 1.38 [95% CI: 0.89, 2.12] in MCR). CONCLUSIONS: This study provides evidence that diabetes is more lethal in U.S.-born MA and MCR than in NHW.
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Diabetes Mellitus/mortalidade , Hispânico ou Latino/estatística & dados numéricos , Adulto , Fatores Etários , Intervalos de Confiança , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etnologia , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , México/epidemiologia , México/etnologia , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Estados Unidos/epidemiologia , População Branca/psicologia , População Branca/estatística & dados numéricosRESUMO
The union between mammalian gametes begins with the sperm binding to the zona pellucida (ZP). We studied the interaction between human sperm and ZP by using recombinant human ZP proteins (rhZP). The cDNAs coding for human ZP2, ZP3, and ZP4 were expressed in Sf9 cells and proteins were characterized to determine their competence for sperm binding. Capacitated human sperm binding abilities were analyzed using immobilized rhZP and a well-characterized antihuman sperm antiserum. The results demonstrated that all rhZP proteins were structurally similar to their native counterparts and were specifically recognized, in a dose and time dependent manner, by human sperm. The rhZP4 was the main sperm binder followed by rhZP3 and rhZP2, although combinations of rhZP proteins enhanced sperm adhesion. Moreover, this experimental approach may represent a useful model to study sperm-ZP interactions for research and clinical purposes.
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Proteínas do Ovo/metabolismo , Glicoproteínas de Membrana/metabolismo , Receptores de Superfície Celular/metabolismo , Interações Espermatozoide-Óvulo/fisiologia , Espermatozoides/metabolismo , Zona Pelúcida/metabolismo , Feminino , Humanos , Masculino , Ligação Proteica , Proteínas Recombinantes/metabolismo , Glicoproteínas da Zona PelúcidaRESUMO
The acrosome reaction (AR), an absolute requirement for spermatozoa and egg fusion, requires the influx of Ca²(+) into the spermatozoa through voltage-dependent Ca²(+) channels and store-operated channels. Maitotoxin (MTx), a Ca²(+)-mobilizing agent, has been shown to be a potent inducer of the mouse sperm AR, with a pharmacology similar to that of the zona pellucida (ZP), possibly suggesting a common pathway for both inducers. Using recombinant human ZP3 (rhZP3), mouse ZP and two MTx channel blockers (U73122 and U73343), we investigated and compared the MTx- and ZP-induced ARs in human and mouse spermatozoa. Herein, we report that MTx induced AR and elevated intracellular Ca²(+) ([Ca²(+)](i)) in human spermatozoa, both of which were blocked by U73122 and U73343. These two compounds also inhibited the MTx-induced AR in mouse spermatozoa. In disagreement with our previous proposal, the AR triggered by rhZP3 or mouse ZP was not blocked by U73343, indicating that in human and mouse spermatozoa, the AR induction by the physiological ligands or by MTx occurred through distinct pathways. U73122, but not U73343 (inactive analogue), can block phospholipase C (PLC). Another PLC inhibitor, edelfosine, also blocked the rhZP3- and ZP-induced ARs. These findings confirmed the participation of a PLC-dependent signalling pathway in human and mouse zona protein-induced AR. Notably, edelfosine also inhibited the MTx-induced mouse sperm AR but not that of the human, suggesting that toxin-induced AR is PLC-dependent in mice and PLC-independent in humans.
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Reação Acrossômica/fisiologia , Canais de Cálcio/metabolismo , Toxinas Marinhas/farmacologia , Oxocinas/farmacologia , Espermatozoides/metabolismo , Zona Pelúcida/metabolismo , Reação Acrossômica/efeitos dos fármacos , Animais , Cálcio/metabolismo , Bloqueadores dos Canais de Cálcio/farmacologia , Estrenos/farmacologia , Humanos , Masculino , Camundongos , Pirrolidinonas/farmacologia , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/fisiologia , Capacitação Espermática/fisiologia , Espermatozoides/efeitos dos fármacos , Fosfolipases Tipo C/antagonistas & inibidores , Zona Pelúcida/efeitos dos fármacosRESUMO
The first report to our knowledge, of hyperinfection by Strongyloides stercoralis (HS) and hypereosinophilia, associated to immune suppression by Rituximab (the only drug received for the last one year and 10 months), in a patient with mantle-cell lymphoma (MCL), is presented. The patient has a 3-year history of MCL, and developed two accesses of HS during 2008, including meningitis, pneumonia and presence of larvae of S. stercoralis in the lungs. We had a unique chance to look at cytotoxicity of filariform larvae in the expectoration after Ivermectin treatment, showing immobilization and death of larvae, associated with eosinophils attached to the cuticle of the parasite.
Se presenta el primer reporte, hasta donde tengamos información, de hiperinfección por Strongyloides stercoralis (HS) e hipereosinofilia asociados a inmunosupresión por Rituximab (el único medicamento recibido durante 1 año y 10 meses), en un paciente con linfoma de células del manto (LCM). La paciente tuvo una historia de 3 años con LCM, y desarrolló 2 accesos de HS durante el 2008, incluyendo meningitis, neumonía y presencia de larvas de S. stercoralis en los pulmones. Se tuvo la oportunidad única de observar la citotoxicidad contra las larvas filariformes en la expectoración, luego del tratamiento con Ivermectina, mostrando la inmovilización y muerte de las larvas, asociada a la presencia de eosinófilos adheridos a la cutícula del parásito.
Assuntos
Animais , Feminino , Humanos , Pessoa de Meia-Idade , Anticorpos Monoclonais Murinos/efeitos adversos , Antineoplásicos/efeitos adversos , Hospedeiro Imunocomprometido , Estrongiloidíase/imunologia , Superinfecção/imunologia , Antiparasitários/uso terapêutico , Síndrome Hipereosinofílica/imunologia , Ivermectina/uso terapêutico , Linfoma de Célula do Manto/tratamento farmacológico , Linfoma de Célula do Manto/imunologia , Estrongiloidíase/tratamento farmacológico , Superinfecção/parasitologiaRESUMO
A case of meningitis due to Staphylococcus warneri in a patient with a hyperinfection with Strongyloides stercoralis possibly associated with rituximab treatment for mantel cell lymphoma is reported for the first time in the literature. The patient was a 59-year-old woman, with a 3-year history of an apparently well controlled lymphoma after treatment with chemotherapy-immunotherapy and then immunotherapy alone, and diagnosis of strongyloidiasis. Meningitis was diagnosed by cerebrospinal fluid culture and tested with an automated plate system. The patient was successfully treated with vancomycin; although fever and productive cough persisted. Severe gastrointestinal symptoms and pneumonia developed three weeks later. Hyperinfection syndrome by S. stercoralis was diagnosed, with abundant larvae in feces and expectoration.
Assuntos
Linfoma de Célula do Manto/complicações , Meningites Bacterianas/complicações , Infecções Estafilocócicas/complicações , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/complicações , Superinfecção/complicações , Animais , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Murinos , Antineoplásicos/uso terapêutico , Feminino , Humanos , Linfoma de Célula do Manto/tratamento farmacológico , Meningites Bacterianas/diagnóstico , Meningites Bacterianas/microbiologia , Pessoa de Meia-Idade , Rituximab , Índice de Gravidade de Doença , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/microbiologia , Estrongiloidíase/diagnóstico , Superinfecção/diagnóstico , Superinfecção/tratamento farmacológicoRESUMO
A case of meningitis due to Staphylococcus warneri in a patient with a hyperinfection with Strongyloides stercoralis possibly associated with rituximab treatment for mantel cell lymphoma is reported for the first time in the literature. The patient was a 59-year-old woman, with a 3-year history of an apparently well controlled lymphoma after treatment with chemotherapy-immunotherapy and then immunotherapy alone, and diagnosis of strongyloidiasis. Meningitis was diagnosed by cerebrospinal fluid culture and tested with an automated plate system. The patient was successfully treated with vancomycin; although fever and productive cough persisted. Severe gastrointestinal symptoms and pneumonia developed three weeks later. Hyperinfection syndrome by S. stercoralis was diagnosed, with abundant larvae in feces and expectoration.
Caso de meningite por Staphylococcus warneri em paciente com hiperinfecção com Strongyloides stercoralis, possivelmente associada com tratamento de rituximab para linfoma de células do manto é relatada pela primeira vez na literatura. A paciente, mulher de 59 anos com história de três anos de linfoma aparentemente bem controlado com tratamento com quimioterapia-imunoterapia e, em seguida, somente imunoterapia e diagnóstico de estrongiloidíase. Meningite foi diagnosticada por cultura do líquido cefalorraquidiano e testada com sistema automatizado de placa. A paciente foi tratada com sucesso com vancomicina, embora a febre e a tosse produtiva não tenham desaparecido. Após graves sintomas gastrointestinais a paciente desenvolveu pneumonia três semanas mais tarde. Síndrome de hiperinfecção por S. stercoralis foi diagnosticada, com larvas abundantes nas fezes e expectoração.