RESUMO
OBJECTIVE: In addition to the lungs, the placenta and the endothelium can be affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are markers of endothelial dysfunction and could potentially serve as predictors of severe coronavirus disease 2019 (COVID-19). We aimed to investigate the association of serum concentrations of sFlt-1 and PlGF with the severity of COVID-19 in pregnancy. METHODS: This was a prospective cohort study carried out in a tertiary care hospital in Mexico City, Mexico. Symptomatic pregnant women with a positive reverse-transcription quantitative polymerase chain reaction test for SARS-CoV-2 infection who fulfilled the criteria for hospitalization were included. The primary outcome was severe pneumonia due to COVID-19. Secondary outcomes were intensive care unit (ICU) admission, viral sepsis and maternal death. sFlt-1 levels were expressed as multiples of the median (MoM). The association between sFlt-1 and each adverse outcome was explored by logistic regression analysis, adjusted for gestational age for outcomes occurring in more than five patients, and the predictive performance was assessed by receiver-operating-characteristics-curve analysis. RESULTS: Among 113 pregnant women with COVID-19, higher sFlt-1 MoM was associated with an increased probability of severe pneumonia (adjusted odds ratio (aOR), 1.817 (95% CI, 1.365-2.418)), ICU admission (aOR, 2.195 (95% CI, 1.582-3.047)), viral sepsis (aOR, 2.318 (95% CI, 1.407-3.820)) and maternal death (unadjusted OR, 5.504 (95% CI, 1.079-28.076)). At a 10% false-positive rate, sFlt-1 MoM had detection rates of 45.2%, 66.7%, 83.3% and 100% for severe COVID-19 pneumonia, ICU admission, viral sepsis and maternal death, respectively. PlGF values were similar between women with severe and those with non-severe COVID-19 pneumonia. CONCLUSION: sFlt-1 MoM is higher in pregnant women with severe COVID-19 and has the capability to predict serious adverse pregnancy events, such as severe pneumonia, ICU admission, viral sepsis and maternal death. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
Assuntos
COVID-19 , Unidades de Terapia Intensiva/estatística & dados numéricos , Pneumonia Viral , Complicações Infecciosas na Gravidez , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/sangue , Adulto , COVID-19/sangue , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/terapia , Estudos de Coortes , Endotélio Vascular/metabolismo , Endotélio Vascular/fisiopatologia , Feminino , Idade Gestacional , Humanos , México/epidemiologia , Mortalidade , Placenta/metabolismo , Placenta/fisiopatologia , Fator de Crescimento Placentário/sangue , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Gravidez , Complicações Infecciosas na Gravidez/sangue , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/terapia , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de DoençaRESUMO
Chagas disease is one of the most important vector-borne diseases in Latin America, including Mexico. Meccus phyllosomus pallidipennis (Stål), 1872 (Hemiptera: Reduviidae) is a Mexican triatomine vector that is commonly associated with hens and rabbits. The biological parameters of two cohorts fed on hens (H) and on rabbits (R) were evaluated. The median lifecycles of the two cohorts were 198 days (H) and 180 days (R). Moreover, mortality was around 30% in both cohorts. Time lapse for beginning of feeding was 0.5-1.9 (H) and 1.1-2.4 min (R). Feeding times of each instar in both cohorts were over 10 min. Most specimens fed on hens defecated immediately after feeding, whereas those that fed on rabbits defecated within 1-5 min post-feeding. Similar numbers of males and females (50%) were obtained in both cohorts. An average of 2.1-2.3 eggs per female per day was noted in both cohorts, with eclosion rates of 95.4 (H) and 88.8% (R). Thus, it can be concluded that M. phyllosomus pallidipennis may take advantage of feeding in hens, as in rabbits, which could imply a higher risk of Trypanosoma cruzi transmission to humans and animals in its distribution area.
Assuntos
Galinhas/sangue , Insetos Vetores/fisiologia , Coelhos/sangue , Triatominae/fisiologia , Animais , Doença de Chagas/parasitologia , Doença de Chagas/transmissão , Estudos de Coortes , Defecação/fisiologia , Comportamento Alimentar/fisiologia , Feminino , Masculino , Ninfa/fisiologia , Fatores de TempoRESUMO
The main objective of this work was to evaluate the operational stability of a laboratory-scale aerobic biobarrier designed for the treatment of water contaminated by mixtures of three herbicides frequently found in agricultural runoffs, atrazine, simazine and 2,4-dichlorophenoxyacetic acid (2,4-D). The microbial consortium used to degrade the herbicides was composed by six cultivable bacterial strains, identified as members of the genera Variovorax, Sphingopyxis, Hydrocarboniphaga, Methylobacterium, Pseudomonas and Acinetobacter. The effect caused by a seventh member of the microbial consortium, a ciliated protozoa of the genus Colpoda, on the herbicides biodegradation kinetics, was also evaluated. The biodegradation of five combinations of the herbicides 2,4-D, atrazine and simazine was studied in the biobarrier, operated in steady state continuous culture at different volumetric loading rates. In all cases, removal efficiencies determined by chemical oxygen demand (COD) and HPLC were nearly 100 %. These results, joined to the null accumulation of aromatic byproducts of atrazine and simazine catabolism, show that after 495 days of operation, in the presence of the protozoa, the adaptability of the microbial consortium to changing environmental conditions allowed the complete removal of the mixture of herbicides.
Assuntos
Reatores Biológicos/microbiologia , Herbicidas/metabolismo , Atrazina/metabolismo , Biofilmes/crescimento & desenvolvimento , Análise da Demanda Biológica de Oxigênio , Cromatografia Líquida de Alta Pressão , Simazina/metabolismoRESUMO
Reproductive isolation between Triatoma mexicana (Herrich-Scaeffer) and the six species of the Phyllosoma complex, belonging to the genus Meccus, was examined by analyzing the fertility of experimental hybrids. The percentage of couples with offspring was highest in the set of crosses between Meccus phyllosomus (Burmeister) and T. mexicana, and lowest in those between Meccus pallidipennis (Stål) and Meccus bassolsae (Alejandre-Aguilar, Nogueda-Torres, Cortés-Jiménez, Jurberg, Galvão, and Carcavallo) with respect to T. mexicana. Crosses between Meccus mazzottii (Usinger), Meccus picturatus (Usinger), and Meccus longipennis (Usinger) and T. mexicana had scarce offspring, whereas offspring from crosses between M. phyllosomus and T. mexicana were abundant. However, all F1 nymphs died in different instars before reaching sexual maturity. The biological evidence in this study suggests that different degrees of reproductive isolation exist between T mexicana and the different species of Meccus. Our data also support the current status of T. mexicana as a separate species.
Assuntos
Triatominae/genética , Animais , Fertilidade , Hibridização Genética , México , Filogenia , Reprodução , Triatoma/classificação , Triatoma/genética , Triatoma/fisiologia , Triatominae/classificação , Triatominae/fisiologiaRESUMO
El dengue es una enfermedad aguda grave considerada actualmente como infección reemergente, cuyo vector principal es el Aedes aegypti. En Paraguay en el 2007 fueron reportados 28.181 casos, 55 se clasificaron como fiebre hemorrágica del dengue de los cuales 7 fallecieron. El 90% de los casos fueron de Asunción y del Departamento Central,10% del resto del país. En los últimos años se han desarrollado diferentes sistemas inmunoenzimáticos para el diagnóstico del dengue, entre ellos el ELISA de captura de IgM (MAC ELISA). El objetivo de este estudio observacional analítico de corte transverso fu ecomparar la prueba del MAC ELISA desarrollada en el Instituto de Investigaciones en Ciencias de la Salud (IICS) utilizando antígenos suministrados por el Instituto Pedro Kouri(IPK) de Cuba y el Evandro Chagas de Brasil, con el kit comercial ELISA IgM por capturapara virus del dengue (Focus Diagnostics Inc. Cypress, CA, USA). Fueron seleccionados alazar 92 sueros de pacientes codificados que concurrieron al IICS con sospecha de dengue, respetándose la confidencialidad de los mismos. La concordancia obtenida fue del94.6% (Índice Kappa: 0.891) utilizando el antígeno del IPK y 96.7% (Índice Kappa:0.9350) con el antígeno del Evandro Chagas, mostrándose alta significancia estadística(p<0.00001) en ambos casos. La excelente concordancia obtenida con los dos antígenos indica que los mismos pueden ser utilizados indistintamente en la prueba del MAC ELISA desarrollada en el IICS, a fin de apoyar el diagnóstico del dengue a menor costo y quesería de producción local.
Dengue is an acute disease currently considered a re-emerging infection, whose main vector is Aedes aegypti. In 2007, 28,181 cases were reported in Paraguay, 55 were classified as dengue hemorrhagic fever and seven of them died. Ninety percent of the cases were from Asunción and the Central Department and the remaining 10% from the rest of the country. In recent years various immunoenzymatic systems have been developed immunoassay for the diagnosis of dengue, including the M antibody captureELISA (MAC ELISA). The aim of this cross-sectional observational study was to compare the MAC ELISA test developed at the Instituto de Investigaciones en Cienciad de la Salud(IICS) using antigens supplied by the Instituto Pedro Kouri (IPK) of Cuba and Evandro Chagas of Brazil with a commercial kit of M antibody capture ELISA for dengue virus (Focus Diagnostics Inc. Cypress, CA, USA). Ninety two coded serum samples wererandomly selected from patients who attended the IICS with suspected dengue, respecting their confidentiality. The concordance obtained was 94.6% (Kappa Index: 0.891) using the IPK antigen and 96.7% (Kappa index: 0.9350) with the antigen from Evandro Chagas showing high statistical significance (p<0.00001) in both cases. The excellent concordance obtained with the two antigens indicates that they can be used indistinctly in the MAC ELISA test developed in the IICS to support the diagnosis of dengue at a lower cost and would be locally produced.
Assuntos
Antígenos , DengueRESUMO
La infección aguda de toxoplasmosis en la mujer durante el embarazo en su mayor parte es asintomática y detectable solo por anticuerpos lo que podría afectar severamenteal feto si no es diagnosticada y tratada precozmente. En este estudio observacionalanalítico de corte transverso se comparó la prueba de ELISA Avidez IgG paratoxoplasmosis desarrollado en el Instituto de Investigaciones en Ciencias de la Salud(IICS) con un test comercial de avidez InmunoLISA Organics USA. Para la concordanciase utilizó 41 sueros mantenidos a -20 ºC procedentes de la seroteca del Departamento de Producción-Bioquímica seleccionados al azar. La concordancia obtenida fue de 92.7% y un índice de Kappa de 0.820 con IC95% (0.6-1) y p<0.0001. El índice bajo de avidez sugiere una infección aguda pero para el diagnóstico debería estar acompañado de otras pruebas serológicas y la clínica del paciente. En cambio un índice alto es diagnóstico de una infección crónica.
The acute infection caused by Toxoplasma gondii in pregnant women is mostly asymptomatic and detectable only by antibodies that could severely affect the fetus if the infection is not diagnosed and treated precociously. In this cross-sectional observational,the analytical the IgG avidity ELISA test for toxoplasmosis, developed at the Instituto de Investigaciones en Ciencias de la Salud (IICS), was compared to a commercial avidity kit InmunoLISA (Organics, USA). For the concordance, 41 serum samples kept at -20ºC atthe Department of Production-Biochemistry of IICS were tested. The concordance obtained was 92.7% and a Kappa index of 0.820 with IC95% (0.6-1) and p <0.0001. The low avidity index suggests an acute infection but for diagnosis this result should beaccompanied by other serologic tests and clinical symptoms. Instead, a high avidity index suggests a chronic infection.
Assuntos
Infecções , Toxoplasma , DiagnósticoRESUMO
La Fiebre Amarilla (FA) es una de las más importantes zoonosis que afecta a poblaciones humanas. La FA silvestre es imposible de ser erradicada, manteniéndose activa en zonas tropicales en África y Sudamérica. Todas las especies de primates son susceptibles y se consideran reservorios en el medio silvestre. La mortalidad es baja, se desconoce su valor con precisión, sin embargo existen epizootias con alta mortalidad, en humanos varía entre 20-50%. El objetivo de este trabajo fue buscar evidencias de FA en primates capturados en áreas de brote de FA de los departamentos de San Pedro y Central del Paraguay mediante la técnica de Neutralización por reducción de placas para FA cepa vacunal 17 D. Los resultados en los 35 primates estudiados fueron negativos, quizás por lo tardío del momento en la toma de muestras y bajo número de primates capturados.
Yellow Fever (YF) is one of the most important zoonotic diseases affecting human population. It is impossible to eradicate wild YF remaining active in tropical zones of Africa and South America. All species of primates are susceptible and are considered reservoirs in wild regions. Mortality is low and its precise value is unknown though there are epizootics with high mortality rates and in humans varies between 20-50%. The objective of this study was to search for evidence of YF in primates caught in YF outbreaks areas of the departments of San Pedro and Central in Paraguay through the neutralization technique by plates reduction for YF vaccine strain 17 D. The results in the 35 primates studied were negative, perhaps because of the lateness of the time sampling and the low number of captured primates.
Assuntos
Doenças dos Primatas , Saúde Pública Veterinária , Febre AmarelaRESUMO
The epidemiological risk of infection by Trypanosoma cruzi Chagas in human populations of western Mexico is still under study. Although most vectors in this region and their vector capability are already known, new studies estimating the risk and the importance of individual Triatominae species (Hemiptera: Reduviidae) for T. cruzi transmission are necessary. For 1 yr, every month, > 400 human dwellings and their surroundings in eight communities of two western Mexico states were searched for triatomines. More than 1,000 specimens representing four species were collected and checked for T. cruzi infection. Based on the usual entomological indices, only the inhabitants of Gavilán El Progreso-La Villita are at serious risk of vectorial infection by T. cruzi. A population of Meccus longipennis (Usinger) was found living in peridomestic rock pile boundary walls after an insecticide spraying. It was confirmed the major role of peridomestic habitats as shelter areas for triatomines, particularly in rock pile boundary walls and chicken roosts. Triatominae presence also was verified in certain sylvatic habitats, including primarily heaps of stones. The important role of M. longipennis in the potential transmission of T. cruzi in the region and the secondary role of M. picturatus (Usinger) and Triatoma barberi Usinger also were confirmed. Null colonization of houses by T. barberi, which was collected primarily in peridomestic habitats, differs from its common intradomiciliary collection in other studies. Meccus pallidipennis (Stål) most probably does not exist in Nayarit. Meccus mazzottii (Usinger) and Meccus phyllosomus (Burmeister) are no longer found in Nayarit and Jalisco. Additional studies are necessary to determine the current epidemiological situation in other areas of western Mexico.
Assuntos
Doença de Chagas/transmissão , Insetos Vetores , Triatominae/parasitologia , Trypanosoma cruzi/fisiologia , Animais , Doença de Chagas/parasitologia , México/epidemiologia , Triatominae/classificação , Triatominae/fisiologiaRESUMO
Lesiones por shock eléctrico son descritas en la literatura determinando lesiones locales y sistémicas. Lesiones esqueléticas como luxaciones y fracturas son infrecuentes en nuestras emergencias; aparentemente asociadas a contracciones tetánicas de la musculatura circundante. Describimos un paciente femenino, 43 años, ingresado a la emergencia posterior a sufrir choque eléctrico con electrodoméstico (nevera), refiere sitio de entrada en cara volar de los últimos cuatro dedos de mano izquierda, con exposición aproximada de 30 segundos, se interrumpe desconectando electrodoméstico, niega perdida de conciencia y traumatismo directo e indirecto en miembros. Niega antecedentes importantes. Signos vitales normales, sin signos de traumatismo corporal, posterior al ingreso refiere molestia para la flexo-extensión de mano izquierda, presentando dolor a la palpación profunda sobre la Falange Media del dedo medio. La Radiografía Postero-Anterior evidencia fractura espiroidea no desplazado desde apífisis distal hasta diáfisis de Falange medial del dedo medio de la mano izquierda. Es inmovilizada con férula digital, observada durante 24 horas y egresada previo descarte de lesiones sistémicas importantes. Estas fracturas son de fácil diagnóstico cuando comprometen articulaciones y huesos grandes pero nunca olvidar las fracturas de huesos y articulaciones pequeñas ante una clínica leve.