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Introducción. Los pacientes octogenarios y nonagenarios conforman un grupo etario en progresivo crecimiento. La hernia inguinal es una patología que aumenta progresivamente con la edad. Este trabajo tuvo como objetivo conocer los resultados quirúrgicos de los pacientes mayores de 80 años a quienes se les realizó herniorrafía inguinal. Métodos. De acuerdo con las guías PRISMA, se realizó una revisión sistemática de PubMed, Embase y Google Scholar. Se incluyeron estudios que reportaron la incidencia de complicaciones y mortalidad después de una herniorrafía inguinal en los pacientes octogenarios y nonagenarios. Se calculó la proporción de pacientes con complicaciones después de una herniorrafía inguinal según los datos presentados, con su respectivo intervalo de confianza del 95 %. Resultados. Catorce estudios reportaron un total de 19.290 pacientes, entre quienes se encontró una incidencia acumulada de infección del sitio operatorio de 0,5 % (IC95% 0,460 - 0,678), seroma de 8,7 % (IC95% 6,212 - 11,842), hematoma de 2,6 % (IC95% 2,397 - 2,893), dolor crónico de 2,1 % (IC95% 0,778 - 4,090) y recidiva de 1,2 % (IC95%0,425 - 2,284), para una morbilidad de 14,7 % (IC95% 9,525 - 20,833). Conclusión. Las complicaciones de la herida quirúrgica, el dolor crónico y la recidiva en los pacientes mayores de 80 años a quienes se les realiza herniorrafia inguinal son comparables con las de la población general.
Introduction. Octogenarian and nonagenarian patients constitute a progressively growing age group. Inguinal hernia is a pathology that increases with age. This study aims to understand the surgical outcomes of inguinal herniorrhaphy in patients over 80 years of age. Methods. A systematic review of PubMed, Embase, and Google Scholar was conducted following PRISMA guidelines. Studies reporting the incidence of complications and mortality after inguinal herniorrhaphy in octogenarian and nonagenarian patients were included. The proportion of patients with complications after inguinal herniorrhaphy was calculated based on the data presented, with its respective 95% confidence interval. Results. Fourteen studies reported a total of 19,290 patients, among whom a cumulative incidence of surgical site infection of 0.5 (95% CI 0.460 0.678), seroma of 8.7% (95% CI 6.212 11.842), hematoma of 2.6% (95% CI 2.397 2.893), chronic pain 2.1% (95% CI 0.778 4.090), recurrence 1.2% (95% CI 0.425 2.284), and morbidity 14.7% (95% CI 9.525 20.833) were found. Conclusion. Surgical wound complications, chronic pain, and recurrence in patients over 80 years of age undergoing inguinal herniorrhaphy are comparable to those in the general population.
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Humanos , Herniorrafia , Hérnia Inguinal , Complicações Pós-Operatórias , Recidiva , Idoso de 80 Anos ou mais , MetanáliseRESUMO
Introduction: Nephroblastoma, or Wilms' tumor, is a malignant renal neoplasm commonly found in children, is extremely rare in adults representing only 0.5% of all renal neoplasms. Adult Wilms tumor is rare, to our knowledge fewer than 300 cases have been reported in the English literature to date. However, in older adults after 60 years of age, only less than 45 cases have been reported. For this reason, treatment guidelines in adults still are lacking. Prognosis in nephroblastoma for adult patients is found to be worse than in children. Case Presentation: We report the case of a 65-year-old female with lumbar fossa mass, flank pain and hematuria, and pathologic diagnosis of Wilms tumor. We performed nephrectomy. No adjuvant treatment was given. Our patient remains asymptomatic and without evidence of recurrence 12 months after the surgery. Conclusion: Nephroblastoma in the elderly presents different clinical behavior and prognosis compared to nephroblastoma in children.
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Introducción: La arteritis de Takayasu (TAK) es una enfermedad idiopática granulomatosa de grandes vasos que afecta predominantemente a la aorta, ramas arteriales principales y pulmonares. La prevalencia es mayor en adultos que en niños, con una incidencia de 1,1 por millón de personas. Su etiología sigue siendo poco conocida. Caso Clínico: Se presenta el caso de un paciente pediátrico con pérdida de la masa renal izquierda por disminución del calibre de arteria renal ipsilateral meses después del debut de la Arteritis de Takayasu como aneurisma de aorta abdominal. El paciente cumple criterios de TAK según clasificación EULAR/PRINTO/PReS basados en anomalía angiográfica, hipertensión arterial y elevación reactantes de fase aguda. La TAK presenta afectación sistémica y alteraciones cardiovasculares (75-85%), hipertensión en más del 80% de los casos, con estenosis de la arteria renal en casi el 50% de los pacientes. Conclusiones: El tratamiento general de la TAK está dirigido a controlar la inflamación vascular y prevenir el daño orgánico irreversible. A pesar de un diagnóstico temprano con tratamiento oportuno y agresivo el seguimiento en la enfermedad de Takayasu es imprescindible dado que la progresión de esta puede seguirse dando. Deben establecerse estrategias para asegurar la adherencia al seguimiento. (provided by Infomedic Intl.)
Introduction: Takayasu's arteritis (TAK) is an idiopathic granulomatous large vessel disease predominantly affecting the aorta, main arterial branches and pulmonary arteries. The prevalence is higher in adults than in children, with an incidence of 1.1 per million people. Its etiology remains poorly understood. Case Report: We present the case of a pediatric patient with loss of left renal mass due to decreased ipsilateral renal artery caliber months after the debut of Takayasu's arteritis as abdominal aortic aneurysm. The patient meets TAK criteria according to EULAR/PRINTO/PReS classification based on angiographic abnormality, arterial hypertension and elevated acute phase reactants. TAK presents systemic involvement and cardiovascular alterations (75-85%), hypertension in more than 80% of cases, with renal artery stenosis in almost 50% of patients. Conclusions: The general treatment of TAK is aimed at controlling vascular inflammation and preventing irreversible organ damage. Despite early diagnosis with timely and aggressive treatment, follow-up in Takayasu's disease is imperative as progression may still occur. Strategies should be established to ensure adherence to follow-up. (provided by Infomedic Intl.)
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Introducción: La acidosis tubular renal (ATR) incluye una clínica diversa que depende del sitio anatómico en el que se encuentre la alteración tubular, diferenciándose cuatro tipos de ATR. La acidosis tubular renal distal (ATRd) o Tipo I es una condición clínica poco frecuente (1:100.000 niños) que es debida a causas primarias o genéticas; en los niños con frecuencia se han encontrado alterados los genes ATP6V0A4 y ATP6V1B1 en forma homocigota, lo que causa una disfunción de la bomba ATPasa de H+ de las membranas apicales en el túbulo distal generando una inadecuada secreción de hidrogeniones traduciéndose en acidosis metabólica hiperclorémica persistente, con trastornos hidroelectrolíticos que pueden generar alteraciones en el metabolismo óseo, alteraciones renales, gastrointestinales y falla para crecer. Conclusión: El diagnóstico oportuno, seguimiento y tratamiento adecuados pueden evitar las complicaciones y permitir un adecuado crecimiento durante la infancia. (provisto por Infomedic International)
Introduction: Renal tubular acidosis (RTA) includes a diverse clinic that depends on the anatomical site where the tubular alteration is located, with four types of RTA being differentiated. Distal renal tubular acidosis (dRTA) or Type I is a rare clinical condition (1:100,000 children) that is due to the presence of a tubular disorder. It is due to primary or genetic causes; In children, the ATP6V0A4 and ATP6V1B1 genes have frequently been found to be homozygously altered, which causes dysfunction of the H+ ATPase pump of the apical membranes in the distal tubule generating an inadequate secretion of hydrogenions resulting in persistent hyperchloremic metabolic acidosis, with hydroelectrolytic disorders that can generate alterations in bone metabolism, renal and gastrointestinal alterations, and failure to grow. Conclusion: Timely diagnosis, adequate follow-up and treatment can avoid complications and allow adequate growth during childhood. (provided by Infomedic International)
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INTRODUCTION: Heart failure and type 2 diabetes mellitus are critical public health issues. OBJECTIVE: To characterize the risk factors for mortality in patients with heart failure and type 2 diabetes mellitus from a large registry in Colombia and to evaluate the potential effect modifications by type 2 diabetes mellitus over other risk factors. MATERIALS AND METHODS: Heart failure patients with and without type 2 diabetes mellitus enrolled in the Registro Colombiano de Falla Cardíaca (RECOLFACA) were included. RECOLFACA enrolled adult patients with heart failure diagnosis from 60 medical centers in Colombia during 2017-2019. The primary outcome was all-cause mortality. Survival analysis was performed using adjusted Cox proportional hazard models. RESULTS: A total of 2514 patients were included, and the prevalence of type 2 diabetes mellitus was 24.7% (n = 620). We found seven independent predictors of short-term mortality for the general cohort, chronic obstructive pulmonary disease, sinus rhythm, triple therapy, nitrates use, statins use, anemia, and hyperkalemia. In the type 2 diabetes mellitus group, only the left ventricle diastolic diameter was an independent mortality predictor (HR = 0.96; 95% CI: 0.93-0.98). There was no evidence of effect modification by type 2 diabetes mellitus on the relationship between any independent predictors and all-cause mortality. However, a significant effect modification by type 2 diabetes mellitus between smoking and mortality was observed. CONCLUSIONS: Patients with type 2 diabetes mellitus had higher mortality risk. Our results also suggest that type 2 diabetes mellitus diagnosis does not modify the effect of the independent risk factors for mortality in heart failure evaluated. However, type 2 diabetes mellitus significantly modify the risk relation between mortality and smoking in patients with heart failure.
Introducción. La insuficiencia cardíaca y la diabetes mellitus de tipo 2 son problemas críticos de salud pública. Objetivo. Caracterizar los factores de riesgo de mortalidad en pacientes con insuficiencia cardíaca y la diabetes mellitus de tipo 2 de un registro grande en Colombia y evaluar las posibles modificaciones del efecto de la diabetes mellitus de tipo 2 sobre otros factores de riesgo. Materiales y métodos. Se incluyeron pacientes con insuficiencia cardíaca con y sin diabetes mellitus de tipo 2, inscritos en el Registro Colombiano de Insuficiencia Cardíaca (RECOLFACA). RECOLFACA incorporó pacientes adultos con diagnóstico de insuficiencia cardíaca de 60 centros médicos de Colombia durante 2017-2019. El resultado primario fue la mortalidad por todas las causas. El análisis de supervivencia se realizó utilizando modelos ajustados de riesgos proporcionales de Cox. Resultados. Se incluyeron 2.514 pacientes, la prevalencia de diabetes mellitus de tipo 2 fue del 24,7 % (n = 620). Encontramos siete predictores independientes de mortalidad a corto plazo para la enfermedad pulmonar obstructiva crónica del grupo sin diabetes mellitus de tipo 2, el ritmo sinusal, la terapia triple, el uso de nitratos, el uso de estatinas, la anemia y la hiperpotasemia. En el grupo de diabetes mellitus de tipo 2, solo el diámetro diastólico del ventrículo izquierdo fue un predictor de mortalidad independiente (HR = 0,96; IC95 %: 0,93 - 0,98). No hubo evidencia de modificación del efecto de la diabetes mellitus de tipo 2 sobre la relación entre ningún predictor independiente y la mortalidad por todas las causas. Sin embargo, se observó una modificación significativa del efecto de la diabetes mellitus de tipo 2 entre el tabaquismo y la mortalidad. Conclusiones. Los pacientes con diabetes mellitus de tipo 2 tuvieron mayor riesgo de mortalidad. Los resultados también sugieren que el diagnóstico de diabetes mellitus de tipo 2 no modifica el efecto de los factores de riesgo independientes de mortalidad en IC evaluados. Sin embargo, la diabetes mellitus de tipo 2 modifica significativamente la relación de riesgo entre mortalidad y tabaquismo en pacientes con insuficiencia cardíaca, posiblemente debido a un efecto sinérgico negativo que resulta en lesión vascular.
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Diabetes Mellitus Tipo 2 , Insuficiência Cardíaca , Humanos , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Colômbia/epidemiologia , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Fatores de Risco , Sistema de Registros , Modelos de Riscos ProporcionaisRESUMO
Introduction: Sick building syndrome (SBS) refers to non-specific complaints, including upper-respiratory irritative symptoms, headaches, fatigue, and rash, which are usually associated with a particular building by their temporal pattern of occurrence and clustering among inhabitants or colleagues. The aim of the study was to determine the association between the clinical manifestations of sick building syndrome with outdoor pollutants and airborne pollen. Methods: It was a descriptive and prospective observational study conducted from November 2021 to April 2022. It included subjects over 18 years old who completed an online survey on sick building syndrome (general symptoms, nasal, ocular, oropharyngeal, and skin symptoms) presented at home, housing information and personal history. The APS-330 from Pollen Sense ® was used to obtain data on pollen in the air and the local pollution monitoring system (SIMA) to obtain information regarding pollutants. For statistical analysis, SPSS version 16 was used. Results: A total of 402 surveys were included; 91% of the subjects reported having at least 1 symptom. Females presented more general symptoms (fatigue and headache) than males. Subjects with a personal history of atopy showed a higher prevalence of practically all symptoms. Airborne pollen exposure was positively associated with mucosal symptoms in eyes and nose. Outdoor fungi spore exposure was positively associated with oculo-nasal and cutaneous symptoms in the scalp. Conclusion: This study found significant associations with female gender and a history of atopy, which suggests a higher risk for these subjects. Despite the limitations of the study, we can conclude that there is an association between the clinical manifestations of sick building syndrome with indoor and outdoor pollution.
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CONTEXT: The Global Atlas of Palliative Care (GAPC) ranked Mexico's palliative care services at a preliminary integration stage into mainstream healthcare services. However, this data does not reflect pediatric palliative care (PPC) development. OBJECTIVES: To analyze the current need and level of development of PPC within Mexico. METHODS: PPC need was estimated using causes of death associated with serious health-related suffering from national mortality data from the General Directorate of Health Information. The level of development was measured through six indicators involving access to PPC services and opioids, then classified using the GAPC development categories adapted to regional territories based on available data. RESULTS: In 2021, 37,444 children died in Mexico. Of those, 10,677 (28.29%) died from conditions with serious health-related suffering, averaging a need for PPC of 25/100,000 children. Out of Mexico's 32 states, two (6.2%) had no PPC activity (category 1), twenty (62.6%) were in a capacity-building phase (category 2), eight (25%) had isolated PPC provision (category 3a), while two (6.2%) had generalized PPC provision (category 3b). No state had early (category 4a) or advanced PPC integration (category 4b). Overall, Mexico was classified as category 2. CONCLUSIONS: PPC services are distributed unevenly across the country, leading to inequitable access to care and an inability to meet the needs of patients and families. There is a disparity between the level of development of adult palliative care services and the underdevelopment of PPC in Mexico. This information can help stakeholders guide the development of PPC where it is needed most.
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Acessibilidade aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Cuidados Paliativos , Humanos , México , Criança , Lactente , Pré-Escolar , Adolescente , Pediatria , Recém-Nascido , MasculinoRESUMO
There is a growing market for craft beverages with unique flavors. This study aimed to obtain a palate-pleasing mead derived from Pichia kudriavzevii 4A as a monoculture. Different culture media were evaluated to compare the fermentation kinetics and final products. The crucial factors in the medium were ~200 mg L-1 of yeast assimilable nitrogen and a pH of 3.5-5.0. A panel of judges favored the mead derived from Pichia kudriavzevii 4A (fermented in a medium with honey initially at 23 °Bx) over a commercial sample produced from Saccharomyces cerevisiae, considering its appearance, fruity and floral flavors (provided by esters, aldehydes, and higher alcohols), and balance between sweetness (given by the 82.91 g L-1 of residual sugars) and alcohol. The present mead had an 8.57% v/v ethanol concentration, was elaborated in 28 days, and reached a maximum biomass growth (2.40 g L-1) on the same fermentation day (6) that the minimum level of pH was reached. The biomass growth yield peaked at 24 and 48 h (~0.049 g g-1), while the ethanol yield peaked at 24 h (1.525 ± 0.332 g g-1), in both cases declining thereafter. The Gompertz model adequately describes the kinetics of sugar consumption and the generation of yeast biomass and ethanol. Pathogenic microorganisms, methanol, lead, and arsenic were absent in the mead. Thus, Pichia kudriavzevii 4A produced a safe and quality mead with probable consumer acceptance.
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Pragmatic trials aim to assess intervention efficacy in usual patient care settings, contrasting with explanatory trials conducted under controlled conditions. In aging research, pragmatic trials are important designs for obtaining real-world evidence in elderly populations, which are often underrepresented in trials. In this review, we discuss statistical considerations from a frequentist approach for the design and analysis of pragmatic trials. When choosing the dependent variable, it is essential to use an outcome that is highly relevant to usual medical care while also providing sufficient statistical power. Besides traditionally used binary outcomes, ordinal outcomes can provide pragmatic answers with gains in statistical power. Cluster randomization requires careful consideration of sample size calculation and analysis methods, especially regarding missing data and outcome variables. Mixed effects models and generalized estimating equations (GEEs) are recommended for analysis to account for center effects, with tools available for sample size estimation. Multi-arm studies pose challenges in sample size calculation, requiring adjustment for design effects and consideration of multiple comparison correction methods. Secondary analyses are common but require caution due to the risk of reduced statistical power and false-discovery rates. Safety data collection methods should balance pragmatism and data quality. Overall, understanding statistical considerations is crucial for designing rigorous pragmatic trials that evaluate interventions in elderly populations under real-world conditions. In conclusion, this review focuses on various statistical topics of interest to those designing a pragmatic clinical trial, with consideration of aspects of relevance in the aging research field.
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This paper presents a novel approach for analyzing bivariate positive data, taking into account a covariate vector and left-censored observations, by introducing a hierarchical Bayesian analysis. The proposed method assumes marginal Weibull distributions and employs either a usual Weibull likelihood or Weibull-Tobit likelihood approaches. A latent variable or frailty is included in the model to capture the possible correlation between the bivariate responses for the same sampling unit. The posterior summaries of interest are obtained through Markov Chain Monte Carlo methods. To demonstrate the effectiveness of the proposed methodology, we apply it to a bivariate data set from stellar astronomy that includes left-censored observations and covariates. Our results indicate that the new bivariate model approach, which incorporates the latent factor to capture the potential dependence between the two responses of interest, produces accurate inference results. We also compare the two models using the different likelihood approaches (Weibull or Weibull-Tobit likelihoods) in the application. Overall, our findings suggest that the proposed hierarchical Bayesian analysis is a promising approach for analyzing bivariate positive data with left-censored observations and covariate information.
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Exome and genome sequencing (ES/GS) are routinely used for the diagnosis of genetic diseases in developed countries. However, their implementation is limited in countries from Latin America. We aimed to describe the results of GS in patients with suspected rare genetic diseases in Colombia. We studied 501 patients from 22 healthcare sites from January to December 2022. GS was performed in the index cases using dried blood spots on filtercards. Ancestry analysis was performed under iAdmix. Multiomic testing was performed when needed (biomarker, enzymatic activity, RNA-seq). All tests were performed at an accredited genetic laboratory. Ethnicity prediction data confirmed that 401 patients (80%) were mainly of Amerindian origin. A genetic diagnosis was established for 142 patients with a 28.3% diagnostic yield. The highest diagnostic yield was achieved for pathologies with a metabolic component and syndromic disorders (p < 0.001). Young children had a median of 1 year of diagnostic odyssey, while the median time for adults was significantly longer (15 years). Patients with genetic syndromes have spent more than 75% of their life without a diagnosis, while for patients with neurologic and neuromuscular diseases, the time of the diagnostic odyssey tended to decrease with age. Previous testing, specifically karyotyping or chromosomal microarray were significantly associated with a longer time to reach a definitive diagnosis (p < 0.01). Furthermore, one out of five patients that had an ES before could be diagnosed by GS. The Colombian genome project is the first Latin American study reporting the experience of systematic use of diagnostic GS in rare diseases.
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(1) Background: The human microbiota is essential for maintaining a healthy body. The gut microbiota plays a protective role against pathogenic bacteria. Probiotics are live microorganisms capable of preventing and controlling gastrointestinal and balancing the immune system. They also aid in better nutrients and vitamins absorption. Examples of natural probiotic cultures are kefir and kombucha. (2) Methods: Therefore, the aim of this review was to address the beneficial properties of probiotic kefir and kombucha using a Boxplot analysis to search for scientific data in the online literature up to January 2024: (Latin American and Caribbean Health Sciences (LILACS), PubMed, Medical Literature Analysis (MED-LINE), Science Direct, Google Scholar/Google Academic, Bioline Inter-national and Springer Link). Boxplots showed the summary of a set of data "Index Terms-Keywords" on kefir and kombucha in three languages (English, Portuguese and Spanish). (3) Results: Google Scholar was the database with the highest number of articles found, when the search for the keywords used in the study (containing ~4 × 106-~4 million articles available). This was Followed by the Science Direct database, containing ~3 × 106-~3 million articles available, and the BVS databases-Biblioteca Virtual de Saúde (Virtual Health Library) e Lilacs, both containing a value of ~2 × 106-~2 million articles available. The databases containing the smallest number of articles found were Nutrients and Medline, both containing a value of ≤0.1 × 106-≤100 thousand articles. (4) Conclusions: Scientific studies indicate that kefir and kombucha certainly contain various functional properties, such as antimicrobial, antitumor, anticarcinogenic and immunomodulatory activity, in addition to having a microbiological composition of probiotic bacteria and yeasts. Kefir and kombucha represent key opportunities in the food and clinic/medical fields.
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p-type Ag-N dual acceptor doped ZnO thin films with long electrical stability were deposited by DC magnetron reactive co-sputtering technique. After deposition, the films were annealed at 400 °C for one hour in a nitrogen-controlled atmosphere. The deposited films were amorphous. However, after annealing, they crystallize in the typical hexagonal wurtzite structure of ZnO. The Ag-N dual acceptors were incorporated substitutionally in the structure of zinc oxide, and achieving that; the three samples presented the p-type conductivity in the ZnO. Initial electrical properties showed a low resistivity of from 1 to 10-3 Ω·cm, Hall mobility of tens cm2/V·s, and a hole concentration from 1017 to 1019 cm-3. The electrical stability analysis reveals that the p-type conductivity of the ZnO:Ag,N films is very stable and does not revert to n-type, even after 36 months of aging. These results reveal the feasibility of using these films for applications in short-wavelength or transparent optoelectronic devices.
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Spontaneous intracerebral hemorrhage carries high mortality and disability rates and usually affects deep brain structures. We have implemented a self-designed low-cost 3D-printed illuminated endoport for the surgical drainage of a deep spontaneous intracerebral hemorrhage in a patient who arrived with right hemiparesis and a GCS score of 10. A minimally invasive approach was made and our patient had a favorable functional outcome after surgery. Carrying out this approach with a low-cost 3D-printed endoport makes it possible to offer a safe and efficient treatment option to a low-income country population.
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Attention Deficit Hyperactivity Disorder (ADHD) is characterized by inappropriate levels of activity, impulsivity, and inattention. Developmental Coordination Disorder (DCD) is a condition involving challenges in acquiring and executing motor skills. This cross-sectional study aimed to distinguish motor symptoms between ADHD and ADHD/DCD. A total of 283 children from two elementary schools underwent screening, leading to the identification of 27 children with ADHD. The assessment encompassed the Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV), the Movement Assessment Battery for Children (MABC-2), and the Motor Development Scale (MDS). The groups consisted of ADHD (14) and ADHD/DCD (13). Statistical analysis revealed significant differences in general motor age means between groups (p = 0.016), indicating inferior performance in the ADHD/DCD group. The coexistence of DCD significantly influenced the motor performance of children with ADHD, particularly in fine motor skills (p = 0.018) and balance (p = 0.033). Both groups exhibited mild to moderate risk of motor development delay. It is suggested that ADHD is associated with motor problems, even when DCD is not co-occurring. Specific domain-based analysis could demonstrate how the co-occurrence with DCD affects the motor performance of children with ADHD, with statistically significant differences observed in fine motor skills and balance.
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Transtorno do Deficit de Atenção com Hiperatividade , Transtornos das Habilidades Motoras , Destreza Motora , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos das Habilidades Motoras/fisiopatologia , Transtornos das Habilidades Motoras/diagnóstico , Criança , Masculino , Feminino , Estudos Transversais , Destreza Motora/fisiologia , Desempenho Psicomotor/fisiologiaRESUMO
Only a few halophilic archaea producing carboxylesterases have been reported. The limited research on biocatalytic characteristics of archaeal esterases is primarily due to their very low production in native organisms. A gene encoding carboxylesterase from Halobacterium salinarum NRC-1 was cloned and successfully expressed in Haloferax volcanii. The recombinant carboxylesterase (rHsEst) was purified by affinity chromatography with a yield of 81%, and its molecular weight was estimated by SDS-PAGE (33 kDa). The best kinetic parameters of rHsEst were achieved using p-nitrophenyl valerate as substrate (KM = 78 µM, kcat = 0.67 s-1). rHsEst exhibited great stability to most metal ions tested and some solvents (diethyl ether, n-hexane, n-heptane). Purified rHsEst was effectively immobilized using Celite 545. Esterase activities of rHsEst were confirmed by substrate specificity studies. The presence of a serine residue in rHsEst active site was revealed through inhibition with PMSF. The pH for optimal activity of free rHsEst was 8, while for immobilized rHsEst, maximal activity was at a pH range between 8 to 10. Immobilization of rHsEst increased its thermostability, halophilicity and protection against inhibitors such as EDTA, BME and PMSF. Remarkably, immobilized rHsEst was stable and active in NaCl concentrations as high as 5M. These biochemical characteristics of immobilized rHsEst reveal its potential as a biocatalyst for industrial applications.
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Carboxilesterase , Clonagem Molecular , Halobacterium salinarum , Proteínas Recombinantes , Carboxilesterase/genética , Carboxilesterase/metabolismo , Carboxilesterase/química , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Especificidade por Substrato , Halobacterium salinarum/enzimologia , Halobacterium salinarum/genética , Enzimas Imobilizadas/metabolismo , Enzimas Imobilizadas/química , Enzimas Imobilizadas/genética , Concentração de Íons de Hidrogênio , Cinética , Estabilidade Enzimática , Proteínas Arqueais/genética , Proteínas Arqueais/química , Proteínas Arqueais/metabolismo , TemperaturaRESUMO
El síndrome nefrótico se caracteriza por proteinuria importante, hipoalbuminemia, edema generalizado e hiperlipidemia. Según su etiología se clasifica en primario y secundario, siendo este último raramente encontrado en pediatría, cuyas causas pueden ser múltiples como enfermedades sistémicas, fármacos, neoplasias o enfermedades infecciosas. Se presenta el caso clínico de una adolescente femenina con síndrome nefrótico secundario a sífilis, quien recibió manejo antibiótico apropiado con resolución del cuadro clínico. (provisto por Infomedic International)
Nephrotic syndrome is characterized by significant proteinuria, hypoalbuminemia, generalized edema, and hyperlipidemia. According to its etiology, it is classified as primary and secondary, the latter being rarely found in pediatrics, whose causes can be multiple such as systemic diseases, drugs, neoplasms, or infectious diseases. A clinical case is presented of a female adolescent with nephrotic syndrome secondary to syphilis, who received appropriate antibiotic management with resolution of the clinical condition. (provided by Infomedic International)
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This study describes the anthelmintic efficacy of an organic fraction (EtOAc-F) from Guazuma ulmifolia leaves and the evaluation of its reactive oxidative stress on Haemonchus contortus. The first step was to assess the anthelmintic effect of EtOAc-F at 0.0, 3.5, 7.0 and 14 mg kg of body weight (BW) in gerbil's (Meriones unguiculatus) artificially infected with H. contortus infective larvae (L3). The second step was to evaluate the preliminary toxicity after oral administration of the EtOAc-F in gerbils. Finally, the third step was to determine the relative expression of biomarkers such as glutathione (GPx), catalase (CAT), and superoxide dismutase (SOD) against H. contortus L3 post-exposition to EtOAc-F. Additionally, the less-polar compounds of EtOAc-F were identified by gas mass spectrophotometry (GC-MS). The highest anthelmintic efficacy (97.34%) of the organic fraction was found in the gerbils treated with the 14 mg/kg of BW. Histopathological analysis did not reveal changes in tissues. The relative expression reflects overexpression of GPx (p<0.05, fold change: 14.35) and over expression of SOD (p≤0.05, fold change: 0.18) in H. contortus L3 exposed to 97.44 mg/mL of EtOAc-F compared with negative control. The GC-MS analysis revealed the presence of 4-hydroxybenzaldehyde (1), leucoanthocyanidin derivative (2), coniferyl alcohol (3), ferulic acid methyl ester acetate (4), 2,3,4-trimethoxycinnamic acid (5) and epiyangambin (6) as major compounds. According to these results, the EtOAc-F from G. ulmifolia leaves exhibit anthelmintic effect and increased the stress biomarkers on H. contortus.
Assuntos
Anti-Helmínticos , Catalase , Gerbillinae , Glutationa , Hemoncose , Haemonchus , Estresse Oxidativo , Extratos Vegetais , Folhas de Planta , Superóxido Dismutase , Animais , Haemonchus/efeitos dos fármacos , Folhas de Planta/química , Estresse Oxidativo/efeitos dos fármacos , Hemoncose/veterinária , Hemoncose/tratamento farmacológico , Hemoncose/parasitologia , Anti-Helmínticos/farmacologia , Anti-Helmínticos/uso terapêutico , Anti-Helmínticos/química , Extratos Vegetais/farmacologia , Extratos Vegetais/química , Extratos Vegetais/uso terapêutico , Superóxido Dismutase/metabolismo , Catalase/metabolismo , Catalase/análise , Glutationa/metabolismo , Glutationa/análise , Cromatografia Gasosa-Espectrometria de Massas , Masculino , Contagem de Ovos de Parasitas/veterinária , Biomarcadores , Glutationa Peroxidase/metabolismo , FemininoRESUMO
BACKGROUND: Some maternal characteristics are related to alcohol intake during pregnancy, which irreversibly compromises the maternal-fetal binomial integrity. OBJECTIVES: To identify the frequency, impact, and factors associated with alcohol consumption during pregnancy. DESIGN AND SETTING: A cross-sectional study was performed at the Hospital Materno Infantil Presidente Vargas (HMIPV) in Porto Alegre/RS between March and December 2016. METHODS: A structured questionnaire was administered along with a medical records review. They refer to the maternal sociodemographic and gestational status, alcohol consumption patterns, and characteristics of the fetus/newborn. In the statistical analysis, P values < 0.05 were considered significant. RESULTS: The frequency of alcohol intake was 37.3%; this was characterized by the consumption of fermented beverages (89.3%), especially during the first trimester (79.6%). Risky consumption (high and/or early) occurred for 30.2% of participants. Risk factors associated with maternal alcohol consumption during pregnancy were tobacco use (P < 0.001) and abortion attempt (P = 0.023). Living with a partner (P = 0.002) and planning pregnancy (P = 0.009) were protective factors. Risky consumption was related to all of the aforementioned variables as well as threatened abortion (P = 0.023). CONCLUSIONS: Alcohol intake during pregnancy is common and affects nearly one-third of pregnant women. Knowledge of the population at risk and protective factors is essential for the development of campaigns that seek to reduce consumption and, therefore, its consequences for the mother and fetus.