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PURPOSE: Gestational diabetes mellitus (GDM) induces cardiovascular and metabolic disturbances in offspring. However, the effects of GDM in pain processing in offspring and whether male and female offspring are equally affected is not well known. Thus, we determined: i) whether GDM in mice affects offspring hindpaw mechanical sensitivity, capsaicin-induced spontaneous pain-like behaviors, and epidermal nerve fiber density (ENFD); and ii) whether there is sexual dimorphism in these parameters in offspring from GDM dams. METHODS: GDM was induced in pregnant ICR mice via i.p. streptozotocin (STZ). Then, glucose levels from dams and offspring were determined. Male and female offspring 2-3 months of age were evaluated for: a) baseline mechanical sensitivity of the hind paw by using von Frey filaments; b) number of flinches and time spent guarding induced by intraplantar capsaicin (0.1%); and c) density of PGP-9.5 and CGRP axons in the epidermis from the hind paw glabrous skin. RESULTS: Prepartum levels of glucose in STZ-treated dams were significantly increased compared to vehicle-treated dams; however, GDM or vehicle offspring displayed normal and similar blood glucose levels. Male and female GDM offspring showed significantly greater mechanical sensitivity and capsaicin-induced pain behaviors compared to vehicle offspring. Male GDM offspring displayed a slightly more intense nociceptive phenotype in the capsaicin test. PGP-9.5 and CGRP ENFD in hind paw glabrous skin were greater in male and female GDM offspring versus their controls. Sexual dimorphism was generally not observed in GDM offspring in most of the studied parameters. CONCLUSION: These results suggest GDM induced greater pain-like behaviors in adult offspring regardless of sex along with an increased ENFD of PGP-9.5 and CGRP in the hind paw glabrous skin. We show that GDM peripheral neuropathy differs from diabetic peripheral neuropathy acquired in adulthood and set the foundation to further study this in human babies exposed to GDM.
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INTRODUCTION: We define a fluid library as a library of samples of different biological fluids (from humans, animals or vectors) collected and properly stored on filter paper, which allows retrospective studies, especially of diagnosis or detection of infectious agents in these samples, using different techniques. The objective of this work was the retrospective diagnosis of American trypanosomiasis by PCR in a Venezuelan endemic area using a fluid library. METHODS: A fluid library with samples that had been collected on filter paper, 5 years ago, was used for the detection of Trypanosoma cruzi DNA. 165 blood samples of humans, 30 samples of 25 animals (Didelphis marsupialis, Canis familiaris, Equus asinus and Felis catus) and 8 samples of vectors from endemic areas of Anzoátegui state, were analysed by PCR. RESULTS: The results revealed that 16.4% of the humans samples were positive, 11.1% of those detected positive were children younger than 10 years old, and 26.72% young people aged 11-20 years, suggesting that T. cruzi infection has been active for the past two decades. 56% of the animal samples showed amplification; Didelphis marsupialis 66%, Canis familiaris 54.5%, Equus asinus 50%, and Felis catus 33.3%. On the other hand, positivity (50%) was detected in the studied vectors, of which the 3 most important species in Venezuela (Rhodnius prolixus, Triatoma maculata and Panstrongylus geniculatus) were involved. CONCLUSIONS: The PCR using a fluid library allowed the detection of T. cruzi DNA in old samples from the three host of the epidemiological chain, suggesting that retrospective diagnosis can be made through this strategy and demonstrate that there has been active transmission, which helps to clarify the epidemiological situation in areas where there are no previous reports.
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Doença de Chagas , Trypanosoma cruzi , Adolescente , Animais , Gatos , Cães , Humanos , Insetos Vetores , Estudos Retrospectivos , Venezuela/epidemiologiaRESUMO
Resumen Este artículo presenta los resultados de una investigación sobre la enseñanza de Alfabetización Informacional (ALFIN) en la educación básica, cuyo objetivo fue determinar las mejores prácticas para su implementación e identificar los temas a incorporar en una iniciativa de esta naturaleza, así como las formas de afrontar la problemática de la saturación de la información, de modo que se pretende que cada estudiante aprenda a buscar, a encontrar, a seleccionar, a evaluar y a comunicar información, para adquirir conocimientos, habilidades y actitudes. La metodología del estudio se basó en el análisis de experiencias usando un enfoque cualitativo, donde se concluye que ALFIN se implementó exitosamente por medio del uso del juego, aplicaciones digitales para su enseñanza, cursos específicos en sobre el tema, juegos de mesa, la técnica booleana de búsqueda de información, la lectoescritura, enseñanza por medio del dibujo e instrumentos para la evaluación y utilización de recursos educativos. El logro principal fue contribuir con el desarrollo de las competencias que necesita el estudiantado para desempeñarse con éxito en la escuela y para lograr la capacidad del aprendizaje permanente.
ABSTRACT This article presents a research on the teaching of Information Literacy (IL) in elementary education, whose objective is to determine the best practices for its implementation and to identify the topics that need to be incorporated into such an initiative, as well as the ways of facing the problem of information saturation; so that students learn to search, retrieve, select, evaluate and communicate information, in order to acquire knowledge, competences and attitudes. The methodology employed was based on the qualitative analysis of experiences, which allowed us to concluded that IL has been successfully implemented through the use of educational games, digital applications for its teaching, specific courses on the subject, board games, Boolean search techniques, teaching through drawing, and instruments for the evaluation and use of educational resources. The main achievement was to contribute to the development of the competences that students need to perform successfully in school and to reach the capacity required for lifelong learning.
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Estudantes , Bibliotecários , Bibliotecas Digitais , Produtos e Serviços de Informação , Competência em InformaçãoRESUMO
Resumen Antecedentes: el acceso a la universidad supone un cambio importante en el estilo de vida del estudiante, que puede repercutir en su estado nutricional. Objetivo: buscar una asociación entre estilo de vida y cambios antropométricos en estudiantes universitarios de la Escuela Superior Politécnica del Litoral de Guayaquil, Ecuador en un periodo de tres años. Materiales y métodos: estudio descriptivo de cohorte con una muestra de 336 estudiantes de ambos sexos en quienes se evaluó el estado nutricional por antropometría y se indagó sobre su estilo de vida mediante encuesta previamente validada. Resultados: entre 2014 y 2017 incrementó el exceso de peso (sobrepeso + obesidad) de 25,6 % a 31,9 %, IMC, grasa corporal, circunferencia de cintura, circunferencia de cadera, e índice cintura/cadera (p<0,05). Se asoció el consumo de alcohol con mayor peso (+3,7 kg) e índice cintura/cadera; y, mayor frecuencia de consumo de gaseosas con mayor peso (+5 kg). El consumo de comidas rápidas se asoció con el incremento del índice cintura/cadera (p<0,05). No se encontraron diferencias antropométricas según consumo de cigarrillos, actividad física, consumo de frutas y verduras. Conclusión: en la población universitaria estudiada, el exceso de peso y de grasa corporal está aumentando; el consumo de alcohol, de gaseosas y fumar afectan el estado nutricional.
Abstract Background: Attendance to university is a major change in a student's lifestyle, which may be reflected in their nutritional status. Objective: Seek the association between lifestyle and anthropometric changes in university students of the Polytechnic School of the Litoral in Guayaquil-Ecuador over a period of three years. Materials and Methods: Descriptive cohort study with a sample of 336 students of both sexes, in whom nutritional status was evaluated by anthropometry, and lifestyle was investigated through a previously validated survey. Results: Between 2014 and 2017, excess weight (overweight + obesity) increased from 25.6% to 31.9%, BMI, body fat, waist circumference, hip circumference and waist to hip ratio (p <0.05). Alcohol consumption was associated with greater weight (+3.7 Kg) and waist to hip ratio, and higher frequency of consumption of soft drinks with greater weight (+5 kg). The consumption of fast foods was associated with increase in waist to hip ratio (p <0.005). No anthropometric differences were found associated with cigarette use, physical activity, or consumption of fruits and vegetables. Conclusion: In the university population studied, excess weight and body fat is increasing, while alcohol and soda consumption as well as smoking affect nutritional status.
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Inteligência AmbientalRESUMO
La hipertensión pulmonar asociada a la infección por virus de inmunodeficiencia humana es una enfermedad sumamente infrecuente en pediatría, por lo que requiere alta sospecha clínica para llegar a su diagnóstico. Su aparición es de pronóstico desfavorable, pero el diagnóstico precoz y el tratamiento específico pueden mejorar su evolución. Se presenta el caso clínico de un paciente de 15 años con diagnóstico de infección por virus de inmunodeficiencia humana de transmisión vertical, sin tratamiento antirretroviral, con tos y disnea de esfuerzo progresiva asociadas a signos de falla cardíaca derecha en el cual se diagnosticó hipertensión pulmonar grave. Luego de descartarse otras causas, se asumió la hipertensión pulmonar asociada a la infección por virus de inmunodeficiencia humana. Se realizó el tratamiento con sildenafil y presentó buena respuesta.
Pulmonary hypertension associated with human immunodeficiency virus infection is an extremely rare disease in pediatrics; it requires a high clinical suspicion to reach a diagnosis. Its appearance poses an unfavorable prognostic, but early diagnosis and specific treatment can improve outcomes. We report the clinical case of a fifteen-year-old patient diagnosed with human immunodeficiency virus infection of vertical transmission, without antiretroviral treatment, with cough and progressive exertional dyspnea, associated with signs of right heart failure in which severe pulmonary hypertension was diagnosed. After discarding other causes, it was assumed pulmonary hypertension associated with human immunodeficiency virus infection. Treatment was performed with sildenafil with good response.
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Humanos , Adolescente , Vasodilatadores/uso terapêutico , Infecções por HIV/complicações , Citrato de Sildenafila/uso terapêutico , Hipertensão Pulmonar/tratamento farmacológico , Índice de Gravidade de Doença , Infecções por HIV/transmissão , Resultado do Tratamento , Transmissão Vertical de Doenças Infecciosas , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/virologia , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/virologiaRESUMO
Pulmonary hypertension associated with human immunodeficiency virus infection is an extremely rare disease in pediatrics; it requires a high clinical suspicion to reach a diagnosis. Its appearance poses an unfavorable prognostic, but early diagnosis and specific treatment can improve outcomes. We report the clinical case of a fifteen-year-old patient diagnosed with human immunodeficiency virus infection of vertical transmission, without antiretroviral treatment, with cough and progressive exertional dyspnea, associated with signs of right heart failure in which severe pulmonary hypertension was diagnosed. After discarding other causes, it was assumed pulmonary hypertension associated with human immunodeficiency virus infection. Treatment was performed with sildenafil with good response.
La hipertensión pulmonar asociada a la infección por virus de inmunodeficiencia humana es una enfermedad sumamente infrecuente en pediatría, por lo que requiere alta sospecha clínica para llegar a su diagnóstico. Su aparición es de pronóstico desfavorable, pero el diagnóstico precoz y el tratamiento específico pueden mejorar su evolución. Se presenta el caso clínico de un paciente de 15 años con diagnóstico de infección por virus de inmunodeficiencia humana de transmisión vertical, sin tratamiento antirretroviral, con tos y disnea de esfuerzo progresiva asociadas a signos de falla cardíaca derecha en el cual se diagnosticó hipertensión pulmonar grave. Luego de descartarse otras causas, se asumió la hipertensión pulmonar asociada a la infección por virus de inmunodeficiencia humana. Se realizó el tratamiento con sildenafil y presentó buena respuesta.
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Infecções por HIV/complicações , Hipertensão Pulmonar/tratamento farmacológico , Citrato de Sildenafila/uso terapêutico , Vasodilatadores/uso terapêutico , Adolescente , Infecções por HIV/transmissão , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/virologia , Humanos , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/virologia , Transmissão Vertical de Doenças Infecciosas , Masculino , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
El síndrome hemofagocítico secundario es infrecuente en pediatría y, más aun, asociado a tuberculosis. Presentamos el caso de una paciente con síndrome de inmunodeficiencia adquirida, tuberculosis diseminada y síndrome hemofagocítico. Niña de 8 años, condiagnóstico de síndrome deinmunodeficiencia adquirida, que se internó por fiebre, vómitos y dolor abdominal. Presentaba distensión abdominal, deshidratación, taquipnea, rales subcrepitantes y sibilancias en ambos pulmones, anemia, plaquetopenia y alteración de la coagulación. Recibió antibióticos de amplio espectro y se realizó una laparotomía exploradora con apendicectomia y biopsia ganglionar. A las 72 horas, presentó convulsión tónico clónica, deterioro del sensorio, fiebre, hipoxemia, hepatoesplenomegalia, ascitis y edema periférico. Presentaba bicitopenia, hiperferritinemia y examen microscópico de médula ósea con hemofagocitosis. Recibió gammaglobulina intravenosa, corticoides y transfusiones sanguíneas. Se aisló Mycobacterium tuberculosis del aspirado gástrico, médula ósea y biopsia ganglionar abdominal. Se trató con isoniacida, rifampicina, estreptomicina y etambutol, y presentó franca mejoría.
The secondary hemophagocytic syndrome is rare in children and even rarer associated with tuberculosis. e report the case of a patient with acquired immunodeficiency syndrome, disseminated tuberculosis and hemophagocytic syndrome. An 8-year-old girl, diagnosed with acquired immunodeficiency syndrome, was admitted due to fever, vomiting and abdominal pain. She presented abdominal distension, dehydration, tachypnea, crackles and wheezing in both lungs, anemia, thrombocytopenia and coagulopathy. She received broad-spectrum antibiotics and exploratory laparotomy was performed with appendectomy and lymph node biopsy. After 72 hours the patient presented tonic clonic seizure, impaired sensory, fever, hypoxemia, hepatosplenomegaly, ascites and peripheral edema. She developed bicytopenia, hyperferritinemia and bone marrow microscopic examination with hemophagocytosis. She received intravenous gammaglobulin, steroids and blood transfusions. Mycobacterium tuberculosis was cultured in gastric aspirate, bone marrow and abdominal lymph node biopsy. She was treated with isoniazid, rifampicin, streptomycin and ethambutol, showing marked improvement.
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Humanos , Feminino , Criança , Tuberculose/complicações , Síndrome da Imunodeficiência Adquirida/complicações , Linfo-Histiocitose Hemofagocítica/etiologiaRESUMO
The secondary hemophagocytic syndrome is rare in children and even rarer associated with tuberculosis. e report the case of a patient with acquired immunodeficiency syndrome, disseminated tuberculosis and hemophagocytic syndrome. An 8-year-old girl, diagnosed with acquired immunodeficiency syndrome, was admitted due to fever, vomiting and abdominal pain. She presented abdominal distension, dehydration, tachypnea, crackles and wheezing in both lungs, anemia, thrombocytopenia and coagulopathy. She received broad-spectrum antibiotics and exploratory laparotomy was performed with appendectomy and lymph node biopsy. After 72 hours the patient presented tonic clonic seizure, impaired sensory, fever, hypoxemia, hepatosplenomegaly, ascites and peripheral edema. She developed bicytopenia, hyperferritinemia and bone marrow microscopic examination with hemophagocytosis. She received intravenous gammaglobulin, steroids and blood transfusions. Mycobacterium tuberculosis was cultured in gastric aspirate, bone marrow and abdominal lymph node biopsy. She was treated with isoniazid, rifampicin, streptomycin and ethambutol, showing marked improvement.
El síndrome hemofagocítico secundario es infrecuente en pediatría y, más aun, asociado a tuberculosis. Presentamos el caso de una paciente con síndrome de inmunodeficiencia adquirida, tuberculosis diseminada y síndrome hemofagocítico. Niña de 8 años, condiagnóstico de síndrome deinmunodeficiencia adquirida, que se internó por fiebre, vómitos y dolor abdominal. Presentaba distensión abdominal, deshidratación, taquipnea, rales subcrepitantes y sibilancias en ambos pulmones, anemia, plaquetopenia y alteración de la coagulación. Recibió antibióticos de amplio espectro y se realizó una laparotomía exploradora con apendicectomia y biopsia ganglionar. A las 72 horas, presentó convulsión tónico clónica, deterioro del sensorio, fiebre, hipoxemia, hepatoesplenomegalia, ascitis y edema periférico. Presentaba bicitopenia, hiperferritinemia y examen microscópico de médula ósea con hemofagocitosis. Recibió gammaglobulina intravenosa, corticoides y transfusiones sanguíneas. Se aisló Mycobacterium tuberculosis del aspirado gástrico, médula ósea y biopsia ganglionar abdominal. Se trató con isoniacida, rifampicina, estreptomicina y etambutol, y presentó franca mejoría.
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Síndrome da Imunodeficiência Adquirida/complicações , Linfo-Histiocitose Hemofagocítica/etiologia , Tuberculose/complicações , Criança , Feminino , HumanosRESUMO
OBJECTIVES: To assess and compare the prevalence of prescribing of potentially inappropriate medications (PIMs) identified using the Beers and STOPP criteria; and to determine the clinical variables related with the prescription of PIMs in older adults. METHODS: An observational study of 250 patients aged 65 years or older was conducted in a large teaching hospital. Beers (2012) and STOPP (2008) criteria were utilized to identify PIMs. Data on age, sex, admission and discharge dates, diagnoses, and medications prescribed were obtained from medical records. Multivariate logistic regression was used to determine patient variables related with the prescription of PIMs. KEY FINDINGS: Using Beers criteria, 375 PIMs were identified in 198 patients. 32% of these patients were prescribed one PIM, 20% were prescribed two PIMs, and 48% were prescribed more than two PIMs. Using STOPP criteria, 148 PIMs were identified in 120 patients. 41% of these patients were prescribed one PIM, 51% were prescribed two PIMs, and 8% were prescribed more than two PIMs. An association between PIM prescribing and polypharmacy was detected with both criteria. After adjusting for confounding variables, the prescription of Beers-identified PIMs was significantly associated with patients older than 80 (OR: 2.99; 95% CI: 1.13-7.89) and with length of hospital stay of more than 15days (OR: 2.78; 95% CI: 1.20-6.44). CONCLUSION: These two criteria showed that the prescription of PIMs is prevalent in hospitalized elderly patients. It may be beneficial to educate healthcare teams about these criteria to reduce the prescription of PIMs.
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Doença Crônica/tratamento farmacológico , Prescrição Inadequada/prevenção & controle , Polimedicação , Lista de Medicamentos Potencialmente Inapropriados/organização & administração , Idoso , Idoso de 80 Anos ou mais , Chile , Feminino , Humanos , Masculino , Fatores de RiscoRESUMO
EL síndrome metabólico es un conjunto de factores de riesgo de origen metabólico que pueden aparecer de manera simultánea o secuencial en un mismo individuo, el SM es causado por la combinación de factores genéticos y factores asociados al estilo de vida, especialmente la sobrealimentación y la ausencia de actividad física, que promueven a su vez el desarrollo de enfermedades cardiovasculares (ECV) y otras patologías como la diabetes, enfermedad coronaria y cerebro vascular.. Entre los factores indirectos del síndrome metabólico, se ha establecido recientemente los niveles bajos de te stosterona como factor desencadenante en hombres. De allí que se desarrolló la presente investigación con el objeto de relacionar los niveles séricos de testosterona total y libre con el síndrome metabólico y sus criterios, en la población masculina. Para ello se determinaron los parámetros clínicos (presión arterial, circunferencia abdominal) y bioquímicos (glucemia basal, HDL-Colesterol, Triglicéridos ) que evalúan el síndrome metabólico asi como los niveles de Testosterona Total y Ligada . Resultados: los niveles de testosterona total y libre, son inferiores en el grupo de pacientes con síndrome metabólico, sin embargo al determinar la significancia estadística mediante la t de Student, no se aprecia diferencia en los valores promedio de testosterona total (sig 0,08) más si en los valores promedio de testosterona libre (sig 0,000). Ambas (testosterona total y libre) se correlacionan significativamente de manera inversa con la obesidad abdominal. Los niveles de testosterona libre se relacionan inversa y significativamente con la edad.
The Metabolic syndrome is a cluster of risk factors of metabolic origin that may occur simultaneously or sequentially in the same individual, the SM is caused by a combination of genetic factors and factors related to lifestyle, especially overeating and lack physical activity, which in turn promote the development of cardiovascular disease (CVD) and other diseases such as diabetes, heart disease and cerebrovascular .. Indirect factors of metabolic syndrome, was recently established low levels of testosterone as a factor trigger in men. Hence, this research was conducted in order to relate the serum total and free testosterone with metabolic syndrome and its criteria in the male population. For this clinical parameters (blood pressure, abdominal circumference) and biochemical (fasting glucose, HDL-cholesterol, triglycerides) evaluating the metabolic syndrome as well as Total Testosterone levels were determined and Bound. Results: The levels of total and free testosterone are lower in the group of patients with metabolic syndrome, however to determine statistical significance using Student's t, no difference was seen in the average values of total testosterone (sig 0.08 ) more if in the mean values of free testosterone (sig 0.000). Both (total and free testosterone) was significantly inversely correlated with abdominal obesity. Free testosterone levels are associated inversely and significantly with age.
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BACKGROUND: Non-adherence to prescribed treatment is a principle cause of treatment failure in patients with chronic diseases, such as type 2 diabetes mellitus (T2DM) and hypertension. Improved patient monitoring and education have been shown to improve adherence and clinical outcomes. OBJECTIVE: This study evaluates the impact of a pharmacotherapy optimization plan centered on patient education that was implemented at a hospital in Arauco, Chile. METHODS: A prospective study was conducted using 50 randomly selected patients diagnosed with both T2DM and hypertension. Each patient participated in three successive interview sessions over 6 months. At each session, the following variables were evaluated by a pharmacist: blood pressure, HbA1c, adherence to prescribed medication, and patient knowledge of disease. RESULTS: Significant decreases were observed for HbA1c (<0.001), and SBP (<0.001), with stronger and more significant decreases observed for females. Patient adherence to prescribed medication also improved, but not significantly. The number of patients with full knowledge of their diseases increased significantly (p < 0.001) from 10 to 66%. CONCLUSION: This study suggests that the incorporation of a pharmacotherapeutic optimization plan for patients with chronic diseases can have a positive impact on the control of chronic diseases, such as T2DM and hypertension.
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Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Adesão à Medicação , Educação de Pacientes como Assunto/métodos , Farmacêuticos , Papel Profissional , Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Chile , Doença Crônica , Diabetes Mellitus Tipo 2/psicologia , Feminino , Hemoglobinas Glicadas/efeitos dos fármacos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hipertensão/psicologia , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
BACKGROUND & OBJECTIVES: Several studies have demonstrated genetic heterogeneity in populations of Trypanosoma cruzi that allowed the identification of six different discrete typing units (DTU) classified as TcI, TcII, TcIII, TcIV, TcV and TcVI. Furthermore, some characterization studies have described genetic variability within TcI isolates from endemic regions. The objective of the present study was to analyze Venezuelan T. cruzi isolates, obtained from triatomine-vectors, mammal-hosts including infected humans, detected in both rural and urban areas from diverse geographic origins. METHODS: Molecular characterization of 44 Venezuelan T. cruzi isolates, obtained from triatomine-vectors, mammalian hosts and human patients from both rural and urban areas of different geographic origins, were carried out. Samples were analyzed by PCR amplification of the intergenic region of the mini-exon gene, 24Sα rDNA and 18S rDNA, followed by sequencing of the amplification products. RESULTS: The TcI amplification pattern was found in 42 out of 44 (95.5%) isolates; a TcIII strain and one possible TcIV were also found. The sequence analysis of the TcI Venezuelan isolates showed genetic variability among them. Urban isolates formed a homogeneous group, with differences in their sequences, when compared to rural isolates. INTERPRETATION & CONCLUSION: The results showed genetic heterogeneity in Venezuelan TcI strains, probably in response to different environmental conditions.
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Doença de Chagas/parasitologia , Variação Genética , Trypanosoma cruzi/genética , Animais , Sequência de Bases , DNA Intergênico/genética , DNA de Protozoário/química , DNA de Protozoário/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Éxons/genética , Genótipo , Humanos , Análise de Sequência de DNA , Trypanosoma cruzi/isolamento & purificação , VenezuelaRESUMO
CD56+ cells have been recognized as being involved in bridging the innate and acquired immune systems. Herein, we assessed the effect of two major classes of immunostimulatory oligonucleotides (ODNs), PyNTTTTGT and CpG, on CD56+ cells. Incubation of human peripheral blood mononuclear cells (hPBMC) with some of these ODNs led to secretion of significant amounts of interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α) and granulocyte/monocyte colony-stimulating factor (GM-CSF), but only if interleukin 2 (IL2) was present. IMT504, the prototype of the PyNTTTTGT ODN class, was the most active. GM-CSF secretion was very efficient when non-CpG ODNs with high T content and PyNTTTTGT motifs lacking CpGs were used. On the other hand, CpG ODNs and IFNα inhibited this GM-CSF secretion. Selective cell type removal from hPBMC indicated that CD56+ cells were responsible for GM-CSF secretion and that plasmacytoid dendritic cells (PDCs) regulate this process. In addition, PyNTTTTGT ODNs inhibited the IFNα secretion induced by CpG ODNs in PDCs by interference with the TLR9 signaling pathway. Since IFNα is essential for CD56+ stimulation by CpG ODNs, there is a reciprocal interference of CpG and PyNTTTTGT ODNs when acting on this cell population. This suggests that these synthetic ODNs mimic different natural alarm signals for activation of the immune system.
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Fator Estimulador de Colônias de Granulócitos e Macrófagos/metabolismo , Células Matadoras Naturais/efeitos dos fármacos , Células T Matadoras Naturais/efeitos dos fármacos , Oligodesoxirribonucleotídeos/farmacologia , Humanos , Interferon-alfa/metabolismo , Interferon gama/metabolismo , Interleucina-2/farmacologia , Interleucina-8/metabolismo , Células Matadoras Naturais/metabolismo , Células T Matadoras Naturais/metabolismo , Fator de Necrose Tumoral alfa/metabolismoRESUMO
OBJECTIVES: To compare two extraction protocols of Trypanosoma cruzi DNA for use in DNA amplification of kinetoplast minicircles (kDNA) through the technique of Polymerase Chain Reaction (PCR). MATERIALS AND METHODS: Epimastigotes of T. cruzi were cultured in axenic conditions and masses from 1.5 to 100 x 106 parasites were obtained. DNA extraction was performed using two protocols: extraction with organic solvents (phenol/chloroform), and with resin (Chelex100), from different parasitic sediments. Concentration and purity of DNA was determined by spectrophotometry, and integrity was assessed by agarose gel electrophoresis. Analysis of variance and comparisons of means were performed through Tukey's test, using the Statistix 8.0 software. RESULTS: Ten DNA extractions were done of each one of the different amounts of parasitic sediments. In the DNA extraction with Chelex100 resin, a higher performance was obtained but a lower purity and integrity compared to the extraction with organic solvents. However, it allowed a product amplification of 330 bp of T. cruzi kDNA. CONCLUSIONS: Although the technique of Chelex100 provided less purity and integrity of DNA, it allowed a successful amplification of kDNA by PCR, avoiding the use of laborious techniques and toxic organic solvents.
Assuntos
Cultura Axênica , DNA de Cinetoplasto/isolamento & purificação , Reação em Cadeia da Polimerase/métodos , Trypanosoma cruzi/genética , Parasitologia/métodosRESUMO
El lupus eritematoso es un desorden inmune multisistémico e inflamatorio crónico que esta asociado con el desarrollo prematuro y severo de ateroesclerosis permitiendo de este modo colocar a las enfermedades cardiovasculares como la principal causa de morbi-morbilidad en pacientes con dicha enfermedad. La presente investigación se propuso, evaluar los factores de riesgo convencionales, no convencionales y lúpicos en pacientes con lupus eritematoso sistematico que contribuyen al desarrollo de ateroesclerosis. Para ello, a los pacientes (femenino n=14 y masculino n=1) se le realizaron las siguientes determinaciones: índice de masa corporal (IMC), circunferencia abdominal (CA), perfil lipídico (colesterol, HDL-c, LDL-c, VLDLc y triglicéridos), ácido úrico, velocidad sedimentación globular (VSG) y fibrinógeno. Donde se encontró, 85,71% (12/15) y 100% (14/15) de las pacientes padecían obesidad, ya que presentaron valores elevados del IMC (38,20±5,30 kg/mm2) y de CA(92,32±7,25 cm), respectivamente; 100% (15/15) baja concentraciones sérica de HDL-c (26,00±13,03 mg/dL); 93,33% (14/15) mostraron un estilo de vida sedentario; 33,33% (5/15) eran hipertensos diagnosticados y con tratamiento hipotensor, 33,33% (5/15) presentaban antecedentes familiares de enfermedad cardiovascular 6,66% (1/ 15) niveles elevados de VLDL-c; 6,66% (1/15) hipertrigliceridemia. También se encontró que 20% (3/15) presentaron hiperfibrinogenemia (434,50±38,90 mg/dL), 26,66% (4/15) hiperuricemia (10,46±2,45 mg/dL) y 100% presentó valores por encima del rango de referencia para la VSG. Estos resultados sugieren que los factores de riesgo cardiovascular evaluados en conjunto favorecen el alto riesgo de desarrollar ateroesclerosis en pacientes co lupus eritematosos sistémico.
Systemic lupus erythematosus is a chronic and multisystemic autoimmune disorder that is associated with early and severe development of atherosclerosis, thus permitting place cardiovascular diseases as the leading cause of morbidity and mortality in patients with this pathology. The present research aimed to evaluate conventional risk factors, unconventional and lupus that contribute to cardiovascular disease development in these individuals. To do this, patients with SLE (n=14 female and male n=1) were performed the following measurements: body mass index (BMI), waist circumference (WC), lipid profile (cholesterol, HDL-c, LDL -C, VLDL-C and triglycerides), uric acid, erythrocyte sedimentation rate (ESR) and fibrinogen. Where found, 85.71% (12/15) and 100% (14/15) of patients were obese, as they showed high values of BMI (38.20±5.30 kg/mm2) and the CA (92.32±7.25 cm), respectively; 100% (15/15) low serum concentrations of HDL-c (26.00±13.03 mg/dL), 93.33% (14/15) exhibited a sedentary lifestyle, 33.33% (5/15) were hypertension patients with hypotensive treatment, 33.33% (5/15) had a family history of cardiovascular disease 6.66% (1/15) elevated VLDL-C, 6.66% (1/15) hypertriglyceridemia. Also found that 20% (3/15) presented hyperfibrinogenemia (434.50±38.90 mg/dL), 26.66% (4/15) hyperuricemia (10.46±2.45 mg/dL) and 100% had values above the reference range for ESR. These results suggest that cardiovascular risk factors evaluated together favor a high risk of developing atherosclerosis with these patients.
RESUMO
Objetivos. Comparar dos protocolos de extracción de ADN de Trypanosoma cruzi para su uso en la amplificación de ADN de minicírculos de kinetoplasto (ADNk) mediante la técnica de Reacción en Cadena de Polimerasa (PCR). Materiales y métodos. Se cultivaron epimastigotas de T. cruzi en condiciones exénicas obteniéndose masas entre 1,5 hasta 100 x 10(6) parásitos. A partir de estas se procedió a la extracción de ADN mediante dos protocolos: extracción con solventes orgánicos (fenol/cloroformo), y empleo de resina (Chelex®100), a partir de los diferentes sedimentos parasitarios. La concentración y pureza del ADN se determinó por espectrofotometría y la integridad se evaluó mediante electroforesis en geles de agarosa. Se realizó el análisis de varianza y comparaciones de medias mediante la prueba de Tukey, utilizando el software Statistix 8.0. Resultados. Se realizaron diez extracciones de ADN de cada una de las diferentes cantidades de parásitos sedimentados. En la extracción de ADN con la resina Chelex®100 se obtuvo mayor rendimiento, pero menor pureza e integridad respecto a la extracción con solventes orgánicos. Sin embargo, permitió la amplificación del producto de 330 pb de ADNk de T. cruzi. Conclusiones. Aun cuando la técnica de Chelex®100 proporcionó menor pureza e integridad del ADN, permitió la amplificación con éxito de ADNk por PCR, evitando el uso de técnicas laboriosas y solventes orgánicos tóxicos.
Objectives. To compare two extraction protocols of Trypanosoma cruzi DNA for use in DNA amplification of kinetoplast minicircles (kDNA) through the technique of Polymerase Chain Reaction (PCR). Materials and methods. Epimastigotes of T. cruzi were cultured in axenic conditions and masses from 1.5 to 100 x 106 parasites were obtained. DNA extraction was performed using two protocols: extraction with organic solvents (phenol/chloroform), and with resin (Chelex®100), from different parasitic sediments. Concentration and purity of DNA was determined by spectrophotometry, and integrity was assessed by agarose gel electrophoresis. Analysis of variance and comparisons of means were performed through Tukeys test, using the Statistix 8.0 software. Results. Ten DNA extractions were done of each one of the different amounts of parasitic sediments. In the DNA extraction with Chelex®100 resin, a higher performance was obtained but a lower purity and integrity compared to the extraction with organic solvents. However, it allowed a product amplification of 330 bp of T. cruzi kDNA. Conclusions. Although the technique of Chelex®100 provided less purity and integrity of DNA, it allowed a successful amplification of kDNA by PCR, avoiding the use of laborious techniques and toxic organic solvents.
Assuntos
Cultura Axênica , DNA de Cinetoplasto/isolamento & purificação , Reação em Cadeia da Polimerase/métodos , Trypanosoma cruzi/genética , Parasitologia/métodosRESUMO
The aim of this study was analyze the use of restricted antibiotics by patients hospitalized between 2004 and 2008 in Guillermo Grant Benavente Hospital in Concepcion. Also we attempted to identify possible correlations between antibiotic consumption and patterns of bacterial susceptibility. We performed a retrospective observational study that quantified the use of restricted antibiotics using DDD/100-bed-days, and cumulative susceptibility reports informed by the hospital's microbiology laboratory for bacterial susceptibility. The consumption of restricted antibiotics significantly increased between 2004 and 2008 (35%, p = 0.005). The groups with largest use were glycopeptides (37%) and carbapenems (30 %). These results can be explained by the emergence of endemic Methicillin-resistant Staphylococcus aureus (MRSA) and of Extended-spectrum beta-lactamase (ESBL) Gram negative bacilli. Results showed a decrease in susceptibility of P. aeruginosa to imipenem (p = 0.038) and K. pneumoniae to ciprofloxacin (p = 0.021). The total consumption of restricted antibiotic has significantly increased, especially among complex medical services. A significant decrease in bacterial susceptibility has been observed mainly in gram-negative bacilli. The monitoring of antimicrobial prescribing practices and local susceptibility patterns are essential to promote the rational use of antibiotics.
En Chile no existen estudios para cuantificar el consumo de antimicrobianos de uso restringido al interior de los hospitales. Objetivo: Analizar el consumo de antimicrobianos de uso restringido en pacientes hospitalizados durante los años 2004-2008 en el Hospital Guillermo Grant Benavente de Concepción. Además, se analizaron las correlaciones entre este consumo y el patrón de susceptibilidad in vitro. Material y Método: Se diseñó un estudio observacional retrospectivo empleando las DDD/100-días-cama para evaluar el consumo de antimicrobianos, y el informe acumulado de susceptibilidad in vitro entregado por el laboratorio local, para analizar la evolución de la susceptibilidad. Resultados: El consumo de antimicrobianos se incrementó en 35% (p = 0,005) durante los años 2004-2008, donde los más consumidos fueron glicopéptidos (37%) y carbapenémicos (30%). Estos resultados se pueden explicar por la aparición de cepas de Staphylococcus aureus resistente a meticilina y bacilos gramnegativos productores de Q-lactamasas de espectro extendido. Además, se observó una disminución de la susceptibilidad de Pseudomonas aeruginosa a imipenem (p = 0,038) y de Klebsiella pneumoniae a ciprofloxacina (p = 0,021). Conclusiones: El consumo total de antimicrobianos de uso restringido se incrementó significativamente en los servicios clínicos más complejos, observándose una disminución de la susceptibilidad de algunos bacilos gramnegativos. El monitoreo de la prescripción de antimicrobianos así como de la susceptibilidad in vitro local constituyen medidas esenciales para promover el uso racional de antimicrobianos.
Assuntos
Humanos , Antibacterianos/farmacologia , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Antibacterianos/administração & dosagem , Antibacterianos/economia , Chile , Farmacorresistência Bacteriana , Testes de Sensibilidade Microbiana , Estudos RetrospectivosRESUMO
The aim of this study was analyze the use of restricted antibiotics by patients hospitalized between 2004 and 2008 in Guillermo Grant Benavente Hospital in Concepcion. Also we attempted to identify possible correlations between antibiotic consumption and patterns of bacterial susceptibility. We performed a retrospective observational study that quantified the use of restricted antibiotics using DDD/100-bed-days, and cumulative susceptibility reports informed by the hospital's microbiology laboratory for bacterial susceptibility. The consumption of restricted antibiotics significantly increased between 2004 and 2008 (35%, p = 0.005). The groups with largest use were glycopeptides (37%) and carbapenems (30 %). These results can be explained by the emergence of endemic Methicillin-resistant Staphylococcus aureus (MRSA) and of Extended-spectrum beta-lactamase (ESBL) Gram negative bacilli. Results showed a decrease in susceptibility of P. aeruginosa to imipenem (p = 0.038) and K. pneumoniae to ciprofloxacin (p = 0.021). The total consumption of restricted antibiotic has significantly increased, especially among complex medical services. A significant decrease in bacterial susceptibility has been observed mainly in gram-negative bacilli. The monitoring of antimicrobial prescribing practices and local susceptibility patterns are essential to promote the rational use of antibiotics.
Assuntos
Antibacterianos/farmacologia , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Antibacterianos/administração & dosagem , Antibacterianos/economia , Chile , Farmacorresistência Bacteriana , Humanos , Testes de Sensibilidade Microbiana , Estudos RetrospectivosRESUMO
Introducción. Identifcar inicialmente los niños con neumonía bacteriana puede reducir el uso inadecuado de antibióticos. El puntaje BPS (Bacterial Pneumonia Score) es un modelo de predicción clínica que alcanzó adecuada precisión diagnóstica en la predicción de niños con neumonía bacteriana. Sin embargo, como la interpretación de la radiografía de tórax que incluye este modelo es algo compleja, se desarrolló una versión simplifcada, cuya validación en otra población aún no se ha realizado. Objetivo. Validar una regla de predicción clínica simplifcada para identifcar niños con riesgo de presentar neumonía bacteriana. Métodos. Se estudiaron niños <5 años internados por neumonía con etiología confirmada (viral o bacteriana), y se registraron componentes de la regla de predicción clínica simplifcada (temperatura axilar, edad, neutróflos totales, neutróflos inmaduros y radiografía de tórax). Resultados. Se incorporaron 168 pacientes (23 presentaron neumonía bacteriana y 145 viral). Aquellos con neumonía bacteriana presentaron un valor de la escala mayor que los de etiología viral (5,3 ± 2,5 contra 2,6 ± 2,02; p <0,001). Un puntaje =3 fue identifcado como el mejor punto de corte para predecir neumonía bacteriana (área bajo la curva de predicción relativa [aucROC]= 0,79; IC95%: 0,68-0,90), y fue signifcativamente más frecuente en pacientes con neumonía bacteriana que viral (19/23 contra 72/145, p= 0,003; OR= 4,8; IC95%: 1,4-17,6). La predicción de neumonía bacteriana mostró una sensibilidad de 82,6%, especifcidad 50,3%, valor predictivo positivo 20,9%, valor predictivo negativo 94,8%, razón de verosimilitud positiva 1,66 y razón de verosimilitud negativa 0,35. Conclusiones. La regla de predicción clínica simplifcada evaluada mostró una limitada capacidad diagnóstica para identifcar a niños con neumonía bacteriana y resultó inferior al BPS.
Introduction. Identifying on admission those children with bacterial pneumonia could reduce inappropriate antibiotic use. The BPS (Bacterial Pneumonia Score) is a clinical prediction rule that accurately identifes children with bacterial pneumonia. Because the interpretation of chest X-ray included in this model could be considered diffcult, a simplifed version was developed, but this version has not yet been validated in a different population. Objective. To validate a simplifed clinical prediction rule to identify children with an increased risk of having bacterial pneumonia. Methods. Children aged under 5 years, hospitalized for pneumonia (viral or bacterial) were included. On admission, axillary temperature, age, absolute neutrophil count, bands, and chest radiograph were evaluated. Results. We included 168 patients (23 with bacterial pneumonia and 145 with viral pneumonia). Those with bacterial pneumonia showed a score higher than those with viral pneumonia (5.3 ± 2.5 vs. 2.6 ± 2.02; p <0.001). A score =3 points was identifed as the optimum cutoff value to predict bacterial pneumonia (aucROC= 0.79; 95% IC: 0.68-0.90), and was more frequent among patients with bacterial than viral pneumonia (19/23 vs. 42/145, p= 0.003; OR: 4.8; CI95%: 1.4-17.6), achieving 82.6% sensitivity, 50.3% specifcity, 20.9% positive predictive value, 94.8% negative predictive value, 1.66 positive likelihood ratio and 0.35 negative likelihood ratio. Conclusions. The evaluated simplifed prediction rule showed a limited diagnostic accuracy on identifying children with bacterial pneumonia, being less accurate than the BPS.
Assuntos
Pré-Escolar , Humanos , Lactente , Pneumonia Bacteriana/diagnóstico , Pneumonia Viral/diagnóstico , Estudos Transversais , Diagnóstico Diferencial , Valor Preditivo dos Testes , Fatores de RiscoRESUMO
Familial hypomagnesemia and hypercalciuria with nephrocalcinosis is a rare autosomal recessive disease characterized by renal calcium and magnesium wasting, evolving in the progressive decrease of renal function, eventually requiring kidney transplant. Clinical findings include urinary infection, polyuria, polydipsia, cramps, tremors, convulsions, among others; these, associated to ocular and/or auditive abnormalities. We present a 4 year-old female with the syndrome, which was manifested by typical signs and symptoms in daily practice: fever, abdominal pain, polyuria and polydipsia. These symptoms may defer the diagnosis of the syndrome.