RESUMO
OBJECTIVE: Our objective was to describe the risk of hospital admission for virologically confirmed dengue (VCD) and the risk of clinically severe hospitalized VCD occurring up to 4 years after the first dose (years 1 to 4) in three randomized clinical trials comparing tetravalent dengue vaccine with placebo. METHODS: The relative risks (RR) for hospitalized VCD from first dose to year 4 were estimated by year and age-group in individual and combined studies. RESULTS: Overall, from Year 1 to Year 4, 233 and 228 participants had at least one episode of hospitalized VCD in the vaccinated (n = 22 603) and placebo (n = 11 301) groups, respectively (RR = 0.511, 95% CI 0.42-0.62). Among these, 48 and 47 cases, respectively, were classified as clinically severe. In children aged ≥9 years, 88 and 136 participants had at least one episode of hospitalized VCD in the vaccinated (n = 17 629) and placebo (n = 8821) groups, respectively (RR = 0.324; 95% CI 0.24-0.43). In vaccinated participants aged <9 years, particularly in those aged 2-5 years, there were more hospitalized VCD cases compared with the control participants in Year 3 but not in Year 4. The overall RR in those aged <9 years for Year 1 to Year 4 was 0.786 (95% CI 0.60-1.03), with a higher protective effect in the 6-8 year olds than in the 2-5 year olds. CONCLUSIONS: The overall benefit-risk remained positive in those aged ≥9 years up to year 4, although the protective effect was lower in years 3 and 4 than in years 1 and 2.
Assuntos
Vacinas contra Dengue/imunologia , Vírus da Dengue/imunologia , Dengue/prevenção & controle , Vacinas Atenuadas/imunologia , Adolescente , Anticorpos Antivirais/sangue , Ásia/epidemiologia , Criança , Pré-Escolar , Dengue/epidemiologia , Feminino , Seguimentos , Hospitalização/estatística & dados numéricos , Humanos , América Latina/epidemiologia , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Risco , Sorogrupo , ViremiaRESUMO
Anterior cruciate ligament reconstruction is a very frequent procedure. Postoperative infection after this procedure is a catastrophic, although infrequent, complication. According to the literature, it occurs in less than 1% of all reconstructions done in the United States. We present herein a case report of septic arthritis of the posterior knee associated with anterior cruciate ligament reconstruction.
Assuntos
Reconstrução do Ligamento Cruzado Anterior/efeitos adversos , Artrite Infecciosa/microbiologia , Articulação do Joelho , Infecções por Pseudomonas/etiologia , Pseudomonas aeruginosa , Adolescente , Atletas , Humanos , MasculinoRESUMO
Juvenile hormones (JHs) play key roles in regulating metamorphosis and reproduction in insects. The last two steps of JH synthesis diverge depending on the insect order. In Lepidoptera, epoxidation by a P450 monooxygenase precedes esterification by a juvenile hormone acid methyltransferase (JHAMT). In Orthoptera, Dictyoptera, Coleoptera and Diptera epoxidation follows methylation. The aim of our study was to gain insight into the structural basis of JHAMT's substrate recognition as a means to understand the divergence of these pathways. Homology modeling was used to build the structure of Aedes aegypti JHAMT. The substrate binding site was identified, as well as the residues that interact with the methyl donor (S-adenosylmethionine) and the carboxylic acid of the substrate methyl acceptors, farnesoic acid (FA) and juvenile hormone acid (JHA). To gain further insight we generated the structures of Anopheles gambiae, Bombyx mori, Drosophila melanogaster and Tribolium castaneum JHAMTs. The modeling results were compared with previous experimental studies using recombinant proteins, whole insects, corpora allata or tissue extracts. The computational study helps explain the selectivity toward the (10R)-JHA isomer and the reduced activity for palmitic and lauric acids. The analysis of our results supports the hypothesis that all insect JHAMTs are able to recognize both FA and JHA as substrates. Therefore, the order of the methylation/epoxidation reactions may be primarily imposed by the epoxidase's substrate specificity. In Lepidoptera, epoxidase might have higher affinity than JHAMT for FA, so epoxidation precedes methylation, while in most other insects there is no epoxidation of FA, but esterification of FA to form MF, followed by epoxidation to JH III.
Assuntos
Aedes/enzimologia , Proteínas de Insetos/química , Proteínas de Insetos/metabolismo , Hormônios Juvenis/biossíntese , Metiltransferases/química , Metiltransferases/metabolismo , Aedes/química , Aedes/genética , Aedes/metabolismo , Sequência de Aminoácidos , Animais , Sítios de Ligação , Ácidos Graxos Insaturados/metabolismo , Proteínas de Insetos/genética , Insetos/química , Insetos/enzimologia , Insetos/genética , Isomerismo , Hormônios Juvenis/química , Metiltransferases/genética , Modelos Moleculares , Dados de Sequência Molecular , Processamento de Proteína Pós-Traducional , Alinhamento de Sequência , Especificidade por SubstratoRESUMO
INTRODUCTION: Several programs of organ and tissues transplantation have been developed for over a decade at the University Hospital. OBJECTIVE: To describe long term complications and survival in the liver transplant program at the University Hospital, UANL. MATERIAL AND METHODS: The long term complications and survival were analyzed in the liver transplant program at the University Hospital Dr. José Eleuterio González in the period between 1991 and 2011. RESULTS: Ninety six liver transplants were performed during this period, four of them received one re-transplant and one patient received 2 retransplants. Most common long term complications were metabolic 62%, bony 31% and infectious 28%. Median survival was 78 months. CONCLUSIONS: Liver transplant program at the University Hospital UANL has grown, being the most active in the state of Nuevo Leon, with 1-, 5- and 10-years survival of 66.1, 53.3 and 46.2%, respectively.
Assuntos
Transplante de Fígado/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Hospitais Universitários , Humanos , Lactente , Transplante de Fígado/efeitos adversos , Masculino , México , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Adulto JovemRESUMO
Attenuated Salmonella typhi are attractive for use as live vector vaccines to express protozoal antigens and deliver them to the human immune system. The gene encoding the mature form of Leishmania mexicana mexicana gp63 under control of tac promoter was integrated into the delta aroC locus of the chromosome of attenuated delta aroC, delta aroD S. typhi strain CVD 908. After oral immunization of BALB/c mice with two 1 x 10(9) colony forming unit doses given 21 days apart, CVD 908 omega (delta aroC::Ptac-gp63) elicited a broad T cell-mediated immune response against L. m. mexicana gp63 as demonstrated by: (1) lymphoproliferative response to fixed whole L. m. mexicana promastigotes; (2) activation of IL-2 (but not IL-4)-producing lymphocytes; (3) appearance of cytotoxic T cells against mouse mastocytoma cells expressing gp63. This T-cell mediated immune response was associated with significant protection in F1 (BALB/cXC57Bl/6) mice challenged in their footpads with a wild type strain of L. m. mexicana.
Assuntos
Antígenos de Protozoários/genética , Leishmania mexicana/genética , Leishmania mexicana/imunologia , Metaloendopeptidases/genética , Metaloendopeptidases/imunologia , Proteínas de Protozoários/genética , Proteínas de Protozoários/imunologia , Vacinas Protozoárias/genética , Vacinas Protozoárias/imunologia , Salmonella typhi/genética , Salmonella typhi/imunologia , Vacinas Sintéticas/genética , Vacinas Sintéticas/imunologia , Administração Oral , Animais , Sequência de Bases , Citotoxicidade Imunológica , Primers do DNA/genética , Genes de Protozoários , Vetores Genéticos , Humanos , Técnicas In Vitro , Interleucina-2/biossíntese , Leishmaniose Cutânea/imunologia , Leishmaniose Cutânea/prevenção & controle , Ativação Linfocitária , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Vacinas Protozoárias/administração & dosagem , Proteínas Recombinantes/genética , Proteínas Recombinantes/imunologia , Linfócitos T/imunologia , Vacinas Sintéticas/administração & dosagemRESUMO
Autogeny, the capacity of a female to lay eggs without having ingested any blood meal in the adult stage, was studied in three species of Triatominae: Triatoma infestans, Triatoma rubrovaria, and Rhodnius prolixus. When nymphs of T. rubrovaria and R. prolixus were fed chicken blood, autogeny occurred frequently, even with only one meal. In T. infestans autogeny was frequent as well, but demanded at least two nymphal blood meals. Total number of autogenic eggs was positively correlated with the body weight of the adult female. We conclude, therefore, that autogeny is common in Triatominae.
Assuntos
Oviposição , Rhodnius/fisiologia , Triatoma/fisiologia , Animais , Feminino , Masculino , Comportamento Sexual AnimalRESUMO
When 3H-20-hydroxyecdysone was injected into Triatoma infestans during the fifth nymphal instar, it was converted to very polar metabolites (peak 1). The polar metabolites were glucuronoconjugates of 20-hydroxyecdysone. Acetylation of the conjugates followed by hydrolysis with glucuronidase gave a major labelled product: 20-hydroxyecdysone and minor peaks corresponding to a mixture of 20-hydroxyecdysone acetates. These results indicated that the 2,3,22,25-glucuronoconjugates of 20-hydroxyecdysone were the principal products in the inactivation process.
Assuntos
Ecdisterona/metabolismo , Glucuronidase/metabolismo , Triatoma/metabolismo , Triatominae/metabolismo , Acetilação , Animais , Cromatografia em Camada Fina , Ecdisterona/biossíntese , TrítioRESUMO
When 3H-20-hydroxyecdysone was injected into Triatoma infestans during the fifth nymphal instar, it was converted to very polar metabolites (peak 1). The polar metabolites were glucuronoconjugates of 20-hydroxyecdysone. Acetylation of the conjugates followed by hydrolysis with glucuronidase gave a major labelled product: 20-hydroxyecdysone and minor peaks corresponding to a mixture of 20-hydroxyecdysone acetates. These results indicated that the 2,3,22,25-glucuronoconjugates of 20-hydroxyecdysone were the principal products in the inactivation process.
RESUMO
Al inyectar 20-OH-ecdisona-3H en el 5o.estadio ninfal de T. infestans, se observo la transformacion de la misma a metabolitos muy polares (pico I). La mayor parte de los constituyentes del pico I evidenciaron ser glucurono-conjugados al ser analizados por hidrolisis enzimaticas. La acetilacion de los conjugados seguida por hidrolisis enzimatica permitio identificar las posiciones ocupadas por el acido glucuronico al inactivar la 20-OH-ecdisona.Al inyectar los conjutados radiactivos aislados (pico I) en ninfas del 5o. estadio, se observo que no se revierte el proceso de inactivacion
Assuntos
Animais , Cromatografia em Gel , Ecdisona , TriatomaRESUMO
Al inyectar 20-OH-ecdisona-3H en el 5o.estadio ninfal de T. infestans, se observo la transformacion de la misma a metabolitos muy polares (pico I). La mayor parte de los constituyentes del pico I evidenciaron ser glucurono-conjugados al ser analizados por hidrolisis enzimaticas. La acetilacion de los conjugados seguida por hidrolisis enzimatica permitio identificar las posiciones ocupadas por el acido glucuronico al inactivar la 20-OH-ecdisona.Al inyectar los conjutados radiactivos aislados (pico I) en ninfas del 5o. estadio, se observo que no se revierte el proceso de inactivacion
Assuntos
Animais , Cromatografia em Gel , Ecdisona , TriatomaRESUMO
The case of a 24-year old patient who, in July 1976, submerged into a canal of Guanimar river and, five days later, had a febrile meningoencephalitic clinical picture, is presented; he was in a very severe condition and recovered without sequelae with a treatment based on amphotericin B. The negative cultures for bacteria, fungi and viruses, the characteristics of cerebrospinal fluid and the observation of free-life amebae in the water of the wash of rhinopharynx and pharingeal cavity allowed to establish, with great accuracy, the presuntive diagnosis of primary amebic meningoencephalitis.