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BACKGROUND: Ex vivo lung perfusion (EVLP) constitutes a tool with great research potential due to its advantages over in vivo and in vitro models. Despite its important contribution to lung reconditioning, this technique has the disadvantage of incurring high costs and can induce pulmonary endothelial injury through perfusion and ventilation. The pulmonary endothelium is made up of endothelial glycocalyx (EG), a coating of proteoglycans (PG) on the luminal surface. PGs are glycoproteins linked to terminal sialic acids (Sia) that can affect homeostasis with responses leading to edema formation. This study evaluated the effect of two ex vivo perfusion solutions on lung function and endothelial injury. METHODS: We divided ten landrace swine into two groups and subjected them to EVLP for 120 min: Group I (n = 5) was perfused with Steen® solution, and Group II (n = 5) was perfused with low-potassium dextran-albumin solution. Ventilatory mechanics, histology, gravimetry, and sialic acid concentrations were evaluated. RESULTS: Both groups showed changes in pulmonary vascular resistance and ventilatory mechanics (p < 0.05, Student's t-test). In addition, the lung injury severity score was better in Group I than in Group II (p < 0.05, Mann-Whitney U); and both groups exhibited a significant increase in Sia concentrations in the perfusate (p < 0.05 t-Student) and Sia immunohistochemical expression. CONCLUSIONS: Sia, as a product of EG disruption during EVLP, was found in all samples obtained in the system; however, the changes in its concentration showed no apparent correlation with lung function.
Assuntos
Lesão Pulmonar , Ácido N-Acetilneuramínico , Animais , Suínos , Respiração , Perfusão , Pulmão , Modelos TeóricosRESUMO
Research on host response to infectious disease often involves pharmacological induction of immunosuppression, frequently through administration of dexamethasone. Reports on the effect of dexamethasone in birds are largely restricted to poultry and pigeons. This study describes changes in white blood cell (WBC) differentials, hemoparasite counts, splenic histology, and splenic CD3 immunoreactivity in House Finches (Haemorhous mexicanus). Experimental group birds (n=9) were treated with a daily intramuscular injection of 25 µg of dexamethasone for 8 d; a control group (n=9) received daily saline solution. Smears were made with blood collected immediately before the first dose (day 0) and on d 4, 8, and 9, and stained with modified Wright. The WBC differential counts were performed by three blinded observers, parasite counts by two blinded observers, and histology by one blinded observer. Dexamethasone-treated birds experienced relative heterophilia and lymphopenia on d 4 (P=0.008); heterophilia was also present at d 8 (P=0.018). Hemosporidian counts were significantly increased in dexamethasone-treated birds on d 4 and 8 (P=0.048 and P=0.031, respectively). In contrast with control birds, all dexamethasone-treated birds lacked histologically apparent splenic lymphoid follicles (P<0.001). No significant difference was observed in splenic CD3 immunoreactivity between groups. Our results indicate that dexamethasone has an effect on the hematologic profile of House Finches and suggest that it may be a useful method to induce immunosuppression in this species.
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Doenças das Aves , Tentilhões , Infecções por Mycoplasma , Animais , Doenças das Aves/tratamento farmacológico , Dexametasona/farmacologia , Tentilhões/fisiologia , Infecções por Mycoplasma/veterináriaRESUMO
SARS-CoV-2, the cause of the COVID-19 pandemic, has provoked a global crisis and death of millions of people. Several serological assays to determine the quality of the immune response against SARS-CoV-2 and the efficacy of vaccines have been developed, among them the gold standard conventional virus neutralization assays. However, these tests are time consuming, require biosafety level 3 (BSL3), and are low throughput and expensive. This has motivated the development of alternative methods, including molecular inhibition assays. Herein, we present a safe cell-based ELISA-virus neutralization test (cbE-VNT) as a surrogate for the conventional viral neutralization assays that detects the inhibition of SARS-CoV-2 RBD binding to ACE2-bearing cells independently of species. Our test shows a very good correlation with the conventional and molecular neutralization assays and achieves 100% specificity and 95% sensitivity. cbE-VNT is cost-effective, fast and enables a large-scale serological evaluation that can be performed in a BSL2 laboratory, allowing its use in pre-clinical and clinical investigations.
Assuntos
COVID-19 , SARS-CoV-2 , Anticorpos Neutralizantes , Anticorpos Antivirais , COVID-19/diagnóstico , Ensaio de Imunoadsorção Enzimática/métodos , Humanos , Testes de Neutralização/métodos , Pandemias/prevenção & controle , Glicoproteína da Espícula de CoronavírusRESUMO
BACKGROUND: Evolutionary changes in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) include indels in non-structural, structural, and accessory open reading frames (ORFs) or genes. OBJECTIVES: We track indels in accessory ORFs to infer evolutionary gene patterns and epidemiological links between outbreaks. METHODS: Genomes from Coronavirus disease 2019 (COVID-19) case-patients were Illumina sequenced using ARTIC_V3. The assembled genomes were analysed to detect substitutions and indels. FINDINGS: We reported the emergence and spread of a unique 4-nucleotide deletion in the accessory ORF6, an interesting gene with immune modulation activity. The deletion in ORF6 removes one repeat unit of a two 4-nucleotide repeat, which shows that directly repeated sequences in the SARS-CoV-2 genome are associated with indels, even outside the context of extended repeat regions. The 4-nucleotide deletion produces a frameshifting change that results in a protein with two inserted amino acids, increasing the coding information of this accessory ORF. Epidemiological and genomic data indicate that the deletion variant has a single common ancestor and was initially detected in a health care outbreak and later in other COVID-19 cases, establishing a transmission cluster in the Uruguayan population. MAIN CONCLUSIONS: Our findings provide evidence for the origin and spread of deletion variants and emphasise indels' importance in epidemiological studies, including differentiating consecutive outbreaks occurring in the same health facility.
Assuntos
COVID-19 , Fases de Leitura Aberta , SARS-CoV-2 , COVID-19/epidemiologia , COVID-19/virologia , Genoma Viral , Humanos , SARS-CoV-2/genética , Deleção de Sequência , Uruguai/epidemiologiaRESUMO
BACKGROUND Evolutionary changes in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) include indels in non-structural, structural, and accessory open reading frames (ORFs) or genes. OBJECTIVES We track indels in accessory ORFs to infer evolutionary gene patterns and epidemiological links between outbreaks. METHODS Genomes from Coronavirus disease 2019 (COVID-19) case-patients were Illumina sequenced using ARTIC_V3. The assembled genomes were analysed to detect substitutions and indels. FINDINGS We reported the emergence and spread of a unique 4-nucleotide deletion in the accessory ORF6, an interesting gene with immune modulation activity. The deletion in ORF6 removes one repeat unit of a two 4-nucleotide repeat, which shows that directly repeated sequences in the SARS-CoV-2 genome are associated with indels, even outside the context of extended repeat regions. The 4-nucleotide deletion produces a frameshifting change that results in a protein with two inserted amino acids, increasing the coding information of this accessory ORF. Epidemiological and genomic data indicate that the deletion variant has a single common ancestor and was initially detected in a health care outbreak and later in other COVID-19 cases, establishing a transmission cluster in the Uruguayan population. MAIN CONCLUSIONS Our findings provide evidence for the origin and spread of deletion variants and emphasise indels' importance in epidemiological studies, including differentiating consecutive outbreaks occurring in the same health facility.
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Resumen OBJETIVO: Describir los desenlaces maternos y perinatales en embarazadas de edad avanzada. MATERIALES Y MÉTODOS: Estudio de dos cohortes, prospectivo y retrospectivo efectuado con base en la información de expedientes clínicos de pacientes atendidas en el Complexo Hospitalario Universitario de Ourense entre 2017 y 2018. Se establecieron dos cohortes: la cohorte A con edad mayor o igual a 40 años y la cohorte B con edad menor de 40 años. Se realizaron pruebas paramétricas y no paramétricas para determinar la asociación potencial entre las variables de estudio (χ2, t de Student, U de Mann-Whitney). RESULTADOS: Las pacientes de la cohorte A (n = 207) tuvieron significación estadística: índice de masa corporal mayor al inicio del embarazo (p = 0.028), mayor cantidad de embarazos previos (p = 0.001), a expensas de mayor cantidad de abortos (p < 0.001), estados hipertensivos del embarazo (p = 0.03), prematurez (p = 0.009), retraso en el crecimiento intrauterino (p = 0.006), macrosomía fetal (p = 0.04), inducciones (p < 0.001), cesáreas programadas o intraparto y hemorragia posparto (p = 0.001). No se encontraron diferencias en la paridad, amenorrea al parto, diabetes pregestacional-gestacional, peso fetal medio, Apgar, pH de la arteria umbilical y cantidad de recién nacidos con requerimiento de ingreso a la unidad de Neonatología. CONCLUSIONES: La edad materna avanzada es un factor de riesgo importante de morbilidad materna y perinatal. La mayor tasa de complicaciones descritas refleja la importancia del control exhaustivo del embarazo y vigilancia periparto minuciosa.
Abstract OBJECTIVE: To describe the maternal and perinatal results in pregnant women with advanced age. MATERIALS AND METHODS: A cohort study was conducted with prospective follow-up and retrospective data collection of the Clinical History of the University Hospital Complex of Ourense between 2017 and 2018. Two cohorts were established, cohort A with age greater than and equal to 40 years and the cohort B with age under 40 years. Parametric and non-parametric tests were performed to determine the potential association between the study variables (Chi-Square, Student's T, Mann-Whitney U). RESULTS: The cohort A patients (n = 207) presented with statistical significance: body mass index higher at the beginning of pregnancy (p = 0.028), higher number of previous pregnancies (p = 0.001), but at the expense of a higher number of abortions (p <0.001), hypertensive states of pregnancy (p = 0.03), prematurity (p = 0.009), intrauterine growth retardation (p = 0.006), fetal macrosomia (p = 0.04), inductions (p < 0.001), of both scheduled and intrapartum caesarean sections and postpartum hemorrhage (p = 0.001). No differences were found in parity, amenorrhea at delivery, pregestational / gestational diabetes, mean fetal weight, Apgar score, umbilical artery pH and number of newborns who required admission to the Neonatal Unit. CONCLUSIONS: Advanced maternal age is an important risk factor for maternal and perinatal morbidity. The higher rate of complications described reflects the importance of thorough pregnancy control and careful peripartum surveillance.
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Resumen OBJETIVOS: Analizar las consecuencias a largo plazo del desprendimiento prematuro de placenta normoinserta, principalmente la incidencia de enfermedad cardiovascular y secundariamente otras causas de morbilidad y mortalidad (diabetes, neoplasias o trastornos psiquiátricos). MATERIALES Y MÉTODOS: Estudio de casos y controles, con recolección retrospectiva de datos de pacientes embarazadas que acudieron al Complexo Hospitalario Universitario de Ourense entre 1996 y 2008. El criterio de inclusión en el grupo casos fue el antecedente de desprendimiento prematuro de placenta normoinserta. El grupo control lo integraron pacientes con parto anterior y posterior al grupo de casos y que no habían sufrido desprendimiento de placenta. Las historias clínicas se analizaron mediante la recolección de datos de la "gestación índice" y se realizó el seguimiento a largo plazo para establecer el diagnóstico de hipertensión arterial, diabetes mellitus, enfermedad cardiovascular, neoplasias o alteraciones psiquiátricas. Para el análisis estadístico se requirió el programa SPSS15.0. Se consideró estadísticamente significativo el valor de p < 0.05. RESULTADOS: Se estudiaron 198 mujeres: 66 en el grupo de casos y 132 en el grupo control. Durante el seguimiento (15.8 ± 3.58 años), la incidencia de diabetes mellitus y dislipidemia fue mayor en el grupo de casos, pero sin significación estadística. No se encontraron diferencias en la incidencia de hipertensión arterial, síndrome metabólico, enfermedad cardiovascular ni trastorno ansioso-depresivo. En el grupo de casos se encontró una alta tasa de enfermedad neoplásica. CONCLUSIONES: No existe relación entre desprendimiento prematuro de placenta y enfermedad cardiovascular. Se carece de una explicación que justifique la alta tasa de patología tumoral en este grupo de pacientes.
Abstract OBJECTIVE: To analyze if women with a history of premature placental abruption have a long-term increase in morbidity and mortality. MATERIALS AND METHODS: Case-control study with retrospective data collection of pregnant women from the Hospital University Complex of Ourense between 1996 and 2008. The criteria for inclusion in the case group were the history of placental abruption. The control group was constituted by the women with previous and subsequent delivery to the case group and who had not presented placental abruption. The clinical histories were analyzed with data collection of the index pregnancy and a long-term follow-up was carried out to detect the subsequent diagnosis of arterial hypertension, diabetes mellitus, cardiovascular disease, as well as neoplastic and psychiatric pathology. The statistical study was carried out using the SPSS15.0 computer program. Values of p < 0,05 were considered significant results. RESULTS: A total of 198 women were studied, of which 66 belong to the case group and 132 to the control group. In the follow-up period (15,8±3,58 years) the incidence of diabetes mellitus and dyslipidemia was higher in the case group, but without statistical significance. No differences were found in the incidence of hypertension, metabolic syndrome, cardiovascular disease or anxiety-depressive illness. In the case group, a high rate of oncological pathology was found. CONCLUSIONS: We found no relationship between the history of placental abruption and cardiovascular disease. We lack an explanation that justifies the high rate of tumor pathology in this group of women.
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Abstract Background and objectives: Propofol is commonly employed as a hypnotic agent to perform electroconvulsive therapy, but it exhibits also anticonvulsant properties. The main objective was to study the effect of the weight-adjusted dose of propofol on duration of the electrical seizure. Secondary objectives were to study the effect of absolute dose of propofol on duration of electrical seizure, the effect of both absolute and weight-adjusted doses on values of bispectral index, and the influence of blood chemistry on anticonvulsant effect. Methods: After approval of the Institutional Review Board, a retrospective chart review was performed of all patients who underwent at least one electroconvulsive therapy session. Multiple lineal regression analysis adjusted for potential confounders was employed to explore the effect of propofol dosage on values of bispectral index and on duration of seizure; bivariate correlation analyses were previously performed to identify variables fulfilling confounding criteria, specifically values of Spearman's rho >0.10. Results of regression analysis were expressed as B coefficient with its 95% confident interval. Results: 76 patients received 631 acute phase sessions. Propofol showed a statistically significant negative effect on duration of seizure (specifically a reduction of 4.081 s for every mg.kg−1 of propofol; CI95%: −7906 to −0.255, p = 0.037) but not on bispectral index values. Slight anemia and hypoalbuminemia were very infrequent conditions, and the anticonvulsant effect was not influenced by these parameters. Conclusions: Propofol weight-adjusted dose is negatively related to duration of seizures. It should be carefully titrated when employed to perform electroconvulsive therapy.
Resumo Justificativa e objetivos: O propofol é comumente usado como agente hipnótico na terapia eletroconvulsiva, mas apresenta também propriedades anticonvulsivantes. O objetivo principal foi avaliar o efeito da dose de propofol ajustada ao peso na duração da convulsão elétrica. Os objetivos secundários foram avaliar o efeito da dose total de propofol na duração da convulsão elétrica, o efeito da dose tanto total quanto ajustada ao peso nos valores do índice bispectral e a influência da bioquímica do sangue no efeito anticonvulsivante. Métodos: Após aprovação do Comitê de Ética em Pesquisa, foi feita uma revisão retrospectiva dos prontuários de todos os pacientes que fizeram pelo menos uma sessão de eletroconvulsoterapia. Análise de regressão linear múltipla ajustada para potenciais confundidores foi feita para explorar o efeito da dosagem de propofol sobre os valores do índice bispectral e a duração da convulsão; análises de correlação bivariada foram previamente feitas para identificar as variáveis que atendem aos critérios de confusão, especificamente valores de r de Spearman > 0,10. Os resultados da análise de regressão foram expressos como coeficiente B com intervalo de confiança de 95%. Resultados: Setenta e seis pacientes receberam 631 sessões de fase aguda. Propofol mostrou um efeito negativo estatisticamente significativo sobre a duração da convulsão (especificamente uma redução de 4,081 segundos para cada mg.kg−1 de propofol; IC de 95%: -7906 para -0,255, p = 0,037), mas não para os valores do índice bispectral. Anemia leve e hipoalbuminemia foram condições muito raras e o efeito anticonvulsivante não foi influenciado por esses parâmetros. Conclusões: A dose de propofol ajustada ao peso está negativamente relacionada com a duração das crises convulsivas, deve ser cuidadosamente titulada quando usada na terapia eletroconvulsiva.
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Humanos , Masculino , Feminino , Adulto , Idoso , Propofol/administração & dosagem , Eletroconvulsoterapia , Hipnóticos e Sedativos/administração & dosagem , Convulsões , Fatores de Tempo , Análise Química do Sangue , Peso Corporal , Estudos Retrospectivos , Monitores de Consciência , Pessoa de Meia-IdadeRESUMO
BACKGROUND AND OBJECTIVES: Propofol is commonly employed as a hypnotic agent to perform electroconvulsive therapy, but it exhibits also anticonvulsant properties. The main objective was to study the effect of the weight-adjusted dose of propofol on duration of the electrical seizure. Secondary objectives were to study the effect of absolute dose of propofol on duration of electrical seizure, the effect of both absolute and weight-adjusted doses on values of bispectral index, and the influence of blood chemistry on anticonvulsant effect. METHODS: After approval of the Institutional Review Board, a retrospective chart review was performed of all patients who underwent at least one electroconvulsive therapy session. Multiple lineal regression analysis adjusted for potential confounders was employed to explore the effect of propofol dosage on values of bispectral index and on duration of seizure; bivariate correlation analyses were previously performed to identify variables fulfilling confounding criteria, specifically values of Spearman's rho >0.10. Results of regression analysis were expressed as B coefficient with its 95% confident interval. RESULTS: 76 patients received 631 acute phase sessions. Propofol showed a statistically significant negative effect on duration of seizure (specifically a reduction of 4.081s for every mg.kg-1 of propofol; CI95%: -7906 to -0.255, p=0.037) but not on bispectral index values. Slight anemia and hypoalbuminemia were very infrequent conditions, and the anticonvulsant effect was not influenced by these parameters. CONCLUSIONS: Propofol weight-adjusted dose is negatively related to duration of seizures. It should be carefully titrated when employed to perform electroconvulsive therapy.
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Eletroconvulsoterapia , Hipnóticos e Sedativos/administração & dosagem , Propofol/administração & dosagem , Adulto , Idoso , Análise Química do Sangue , Peso Corporal , Monitores de Consciência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Convulsões , Fatores de TempoRESUMO
BACKGROUND: Studies of avian haemosporidians allow understanding how these parasites affect wild bird populations, and if their presence is related to factors such as habitat loss, degradation and fragmentation, and climate change. Considering the importance of the highland Plateau of Mexico as part of the North American bird migratory route and as a region containing important habitat for numerous bird species, the purpose of this study was to document haemosporidian species richness and how habitat degradation, bird body condition, and distance from water sources correlate with bird parasitemia. METHODS: We assessed the presence of avian haemosporidians in three resident bird species through microscopy and PCR amplification of a fragment of the haemosporidian cytochrome b gene. Average parasitemia was estimated in each species, and its relationship with habitat degradation through grazing, bird body condition and distance from water bodies was assessed. RESULTS: High levels of parasitemia were recorded in two of the three bird species included in this study. Four lineages of haemosporidians were identified in the study area with nearly 50 % prevalence. Areas with highly degraded shrublands and villages showed higher parasitemia relative to areas with moderately degraded shrublands. No strong relationship between parasitemia and distance from water bodies was observed. There were no significant differences in prevalence and parasitemia between the two bird species infected with the parasites. Two of the sequences obtained from the fragments of the parasite's cytochrome b gene represent a lineage that had not been previously reported. CONCLUSIONS: Haemosporidian diversity in arid zones of the Mexican highland plateau is high. Shrubland habitat degradation associated to the establishment of small villages, as well as tree extraction and overgrazing in the surroundings of these villages, significantly enhances parasitemia of birds by haemosporidians.
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Doenças das Aves/epidemiologia , Doenças das Aves/parasitologia , Variação Genética , Haemosporida/isolamento & purificação , Infecções Protozoárias em Animais/epidemiologia , Animais , Aves , Citocromos b/genética , DNA de Protozoário/química , DNA de Protozoário/genética , Ecossistema , Eritrócitos/parasitologia , Geografia , Haemosporida/genética , México/epidemiologia , Parasitemia/epidemiologia , Parasitemia/veterinária , Filogenia , Prevalência , Infecções Protozoárias em Animais/parasitologia , Proteínas de Protozoários/genética , Análise de Sequência de DNA/veterinária , Especificidade da EspécieRESUMO
OBJECTIVE: Determine maternal and fetal characteristics of in vitro fertilization twin pregnancies in comparison with spontaneous twin pregnancies. MATERIAL AND METHODS: Retrospective historical cohort study between 2011 and 2013. Statistical analysis was performed with SPSS 15.0 program and Epidat 3.0. A value of p<0.05 was considered statistically significant. RESULTS: 96 twin pregnancies met inclusive criteria with an incidence of 2.01%, of which 54.16% were spontaneous twin pregnancies and 45.83% in vitro fertilization twin pregnancies. Mean maternal age at delivery was higher in vitro fertilization twin pregnancies (p=0.004). The primigravidae were more frequent in vitro fertilization twin pregnancies group (p<0.001). Monochorionic pregnancies percentage was superior in spontaneous pregnancies (p=0.009). Amenorrhea at delivery was not a significant difference between cohorts (p=.9). Preterm rate was superior in spontaneous twin pregnancies group (p=0.003). However, "great preterm deliveries" were higher in in vitro fertilization twin pregnancies (p<0.001). Significant differences were not observed in fetal presentation at delivery, first-born child birth-weight or intrauterine growth retardation between the two groups. Nevertheless, the mean birth-weight of second-born spontaneously conceived twins was higher than second-born twins of the in vitro fertilization conceived group (p=0.027). Gestational pathology presented the same distribution in both cohorts. There was no significant difference in the mode of delivery between the two groups. Total perinatal mortality rate was 20,83%o and comprised 2 first born twins and 2 second born twins. Three of the stillbirths came from the spontaneous pregnancies group and one from the in vitro fertilization group. CONCLUSIONS: Perinatal death was secondary to stillbirths, which we found higher in spontaneously conceived twin pregnancies due to higher number of monochorionic pregnancies.
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Fertilização in vitro , Complicações na Gravidez/epidemiologia , Resultado da Gravidez , Gravidez de Gêmeos , Adulto , Peso ao Nascer , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Idade Materna , Pessoa de Meia-Idade , Mortalidade Perinatal , Gravidez , Estudos Retrospectivos , Natimorto/epidemiologia , Gêmeos , Adulto JovemRESUMO
INTRODUCTION: Severe sepsis and septic shock are common and often fatal medical problems. The Prehospital Sepsis Project is a multifaceted study that aims to improve the out-of-hospital care of patients with sepsis by means of education and enhancement of skills. The objective of this Project was to assess the knowledge and attitudes in the principles of diagnosis and management of sepsis in a cohort of United States out-of-hospital care providers. METHODS: This was cross-sectional study. A 15-item survey was administered via the Web and e-mailed to multiple emergency medical services list-servers. The evaluation consisted of four clinical scenarios as well as questions on the basics of sepsis. For intra-rater reliability, the first and the fourth scenarios were identical. Chi-square and Fisher's Exact testing were used to assess associations. Relative risk (RR) was used for strength of association. Statistical significance was set at .05. RESULTS: A total of 226 advanced EMS providers participated with a 85.4% (n = 193) completion rate, consisting of a 30.7% rural, 32.3% urban, and 37.0% suburban mix; 82.4% were paramedics and 72.5% had worked in EMS >10 years. Only 57 (29.5%) participants scored both of the duplicate scenarios correctly, and only 19 of the 193 (9.8%) responded to all scenarios correctly. Level of training was not a predictor of correctly scoring scenarios (P = .71, RR = 1.25, 95% CI = 0.39-4.01), nor was years of service (P = .11, RR = 1.64, 95% CI = 0.16-1.21). CONCLUSIONS: Poor understanding of the principles of diagnosis and management of sepsis was observed in this cohort, suggesting the need for enhancement of education. Survey items will be used to develop a focused, interactive Web-based learning program. Limitations include potential for self-selection and data accuracy.
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Serviços Médicos de Emergência , Auxiliares de Emergência , Enfermagem em Emergência , Conhecimentos, Atitudes e Prática em Saúde , Avaliação das Necessidades , Sepse/terapia , Estudos Transversais , Educação a Distância , Auxiliares de Emergência/educação , Enfermagem em Emergência/educação , Humanos , Capacitação em Serviço , Estados UnidosAssuntos
Algoritmos , Infecções por HIV/diagnóstico , Laboratórios/normas , Programas de Rastreamento/métodos , Western Blotting/métodos , Cuba/epidemiologia , Diagnóstico Precoce , Ensaio de Imunoadsorção Enzimática , Infecções por HIV/epidemiologia , Humanos , Reação em Cadeia da Polimerase , Controle de QualidadeRESUMO
Persistent Organic Pollutants (POPs) are still used for agricultural and disease vector control, as well as for industrial purposes. In the last decades, various studies have shown that fish are sensitive to the toxicological effects of certain POPs, including a large class of endocrine- disrupting chemicals (EDCs). In the present study, the relationship between of POPs and their effects using vitellogenin gene expression as biomarker of effect in hardhead catfish Ariopsis felis (Linnaeus, 1766) from three ecosystems in the Southern Gulf of Mexico and Yucatan Peninsula are discussed. Contaminant results showed that median concentrations of PCBs, HCHs, DDTs and Chlordanes were higher in Laguna de Terminos with respect to Celestun and Dzilam. In the same way, the vitellogenin gene expression was clearly over-expressed in fish collected from Terminos Lagoon. Principal Component Analysis showed that vitellogenin gene expression is related to the concentrations of total DDTs and PCBs, and negatively related to total Drins. Overall, this study represents the first tests exploring changes in molecular diagnostic indicators following exposure of several organic compounds in our country. Vitellogenin gene expressions associated with some endocrine disruptors detected in Terminos Lagoon were measured and we can now report clear changes in fish exposed.
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Peixes-Gato/genética , Hidrocarbonetos Clorados/toxicidade , Praguicidas/toxicidade , Vitelogeninas/genética , Poluentes Químicos da Água/toxicidade , Animais , Biomarcadores/metabolismo , Peixes-Gato/metabolismo , Ecossistema , Monitoramento Ambiental , Expressão Gênica/efeitos dos fármacos , Hidrocarbonetos Clorados/metabolismo , Fígado/metabolismo , Masculino , México , Praguicidas/metabolismo , RNA Mensageiro/metabolismo , Água do Mar , Poluentes Químicos da Água/metabolismoRESUMO
Objetivos: Determinar los síntomas presentes al ingreso que predicen evolución a dengue hemorrágico. Material y métodos: Se realizó un estudio de casos y controles de 88 pacientes ingresados en el servicio de pediatría del Hospital "Dr. Enrique Baltodano" de Liberia en el año 2003. Los pacientes incluidos en el estudio tuvieron serología positiva IgM al egreso. Se realizó la fase descriptiva sexo, edad y posteriormente un análisis multivariado de las variables clínicas asociadas con evolución a dengue hemorrágico. Resultados: De los 88 pacientes, 22 evolucionaron a dengue hemorrágico y 66 a dengue clásico. 39.8 por ciento (n igual 35) masculinos, 60.2 por ciento (n igual 53) femeninos. La edad promedio en años 5.2 años los dengues hemorrágicos y 7.7 años los dengues clásicos. La estancia promedio en días: 4 para los diagnosticados por dengue hemorrágico y 2.7 los diagnosticados con dengue clásicos. Dolor abdominal y dolor retroocular son los predictores independientes de dengue hemorrágico en niños. Los hallazgos de ultrasonido fueron ascitis en 45 por ciento (n igual 10) y 55 por ciento (n igual 12) además de ascitis, derrame pleural y edema de vesícula. Conclusiones: Dolor abdominal y retroocular detectados al ingreso son los predictores independientes de dengue hemorrágico.
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Humanos , Masculino , Feminino , Criança , Dengue , Dengue Grave/diagnóstico , Dengue Grave/etiologia , Dengue Grave/fisiopatologia , Ultrassonografia , Costa RicaRESUMO
The analysis shown below was made in order to bring out the importance of the nursery professional behavior on its three levels related to the Systemic Arterial Hypertension, which is considered as the main factor for cardiovascular, brain vascular and renal sufferings because it's an unknown affectation for most of the people who suffers from, it. This is why is for the professional nurse to have all the knowledge that would let him develop correctly a diagnostic which may help to improve the service they provide, in order to promote the public weal, the timely disease detection, the cares needed and the supervision of treatments. The professional nurse will have to be able to create specific conditions in every patient, so they can change their life styles habits appropriately. This is how society will be involved on issues just as prevention, control and eradication of this particular disease and also these actions will help to minimize the mortality index, the families welfare and particularly the people's quality life styles.
Assuntos
Hipertensão/enfermagem , Humanos , Hipertensão/diagnóstico , Hipertensão/reabilitaçãoRESUMO
Una de las formas de valorar el uso adecuado de la anticoncepción y la eficacia de la planificación familiar es conociendo la efectividad y continuidad de los métodos anticonceptivos. El objetivos de este trabajo es mostrar las tasas de efectividad, abandono y fallo de la anticoncepción en mujeres del municipio Diez de Octubre. La información proviene de un proyecto financiado por el Programa de Reproducción Humana de la Organización Mundial de la Salud 'Contracepción y Factores Asociados'. Se utilizó la historia de uso de anticonceptivos de 876 mujeres. Mediante la tabla de vida se obtuvieron todos los indicadores. Las tasas de fallo encontradas van desde 12,67 por cien episodios para los métodos tradicionales, a 5,26 para los DIU tuvo una tasa de fallo de 18,01 por cien episodios. Se encontró diferencia significativa al 0,0001 (con la prueba de Lee-Disu) para el comportamiento del fallo y del abandono en relación con los antecedentes de hijos y abortos previos al inicio del uso. Se concluye que las tasas de fallo del DIU es una de las más altas en comparación con países con información y que tanto el fallo como el abandono de los DIU es elevado. Se recomienda que en el municipio se revisen las orientaciones del uso del DIU para beneficio de la salud reproductiva de las mujeres y aumento de la efectividad de los métodos
Assuntos
Humanos , Feminino , Adolescente , Adulto , Anticoncepcionais Orais , Efetividade , Falha de Equipamento , Dispositivos Intrauterinos , Tábuas de Vida , Planejamento Familiar/métodos , Anticoncepção/métodosRESUMO
En el seguimiento de las personas afectadas con el VIH-1 resulta de gran utilidad el empleo de sistemas para detectar la presencia de proteina de 24 KD y los niveles de anticuerpos a esta; para el desarrollo de estos sistemas es necesario contar con esta proteina purificada. El presente trabajo describe la purificacion de p24 a partir de lisado rival semipurificado sobre gradiente de sacarosa, empleando cromatografia de inmunoafinidad con anticuerpos monoclonales acoplados a Sefarosa 4B activada con bromuro de cianogeno. Para la caracterizacion del producto purificado se utilizo electroforesis en gel de poliacrilamida con tincion de plata e inmunoelectrotransferencia. Como resultado de este trabajo se obtuvo p24 util para ser empleada en el desarrollo de medios diagnosticos y anticuerpos monoclonales
Assuntos
Cromatografia de Afinidade , Eletroforese em Gel de Poliacrilamida , Seguimentos , HIV-1/isolamento & purificação , /isolamento & purificaçãoRESUMO
El Síndrome de Goldenhar o displasia oculoauriculovertebral, pertenece al grupo de los síndromes otocraneofaciales con afectación asimétrica de las estructuras del cráneo y de la cara. Se caracteriza por dermoides preauriculares, malformación de los pabellones auriculares y anomalías vertebrales y pueden asociarse a otras anomalías viscerales toracoabdominales y de extremidades. Estudiamos 5 pacientes oftalmológica, genética y clínicamente y destacamos las malformaciones oculares que caracterizan esta enfermedad