RESUMO
The pathogenesis of diabetic nephropathy (DN) has not been clearly established, making diagnosis and patient management difficult. Recent studies using experimental diabetic models have implicated adenosine signaling with renal cells dysfunction. Therefore, the study of the biochemical mechanisms that regulate extracellular adenosine availability during DN is of emerging interest. Using streptozotocin-induced diabetic rats we demonstrated that urinary levels of adenosine were early increased. Further analyses showed an increased expression of the ecto 5'-nucleotidase (CD73), which hydrolyzes AMP to adenosine, at the renal proximal tubules and a higher enzymatic activity in tubule extracts. These changes precede the signs of diabetic kidney injury recognized by significant proteinuria, morphological alterations and the presence of the renal fibrosis markers alpha smooth muscle actin and fibronectin, collagen deposits and thickening of the glomerular basement membrane. In the proximal tubule cell line HK2 we identified TGF-ß as a key modulator of CD73 activity. Importantly, the increased activity of CD73 could be screened in urinary sediments from diabetic rats. In conclusion, the increase of CD73 activity is a key component in the production of high levels of adenosine and emerges as a new tool for the early diagnosis of tubular injury in diabetic kidney disease.
Assuntos
5'-Nucleotidase/metabolismo , 5'-Nucleotidase/urina , Adenosina/urina , Diabetes Mellitus Experimental/urina , Nefropatias Diabéticas/urina , Rim/patologia , 5'-Nucleotidase/análise , Adenosina/análise , Adenosina/metabolismo , Monofosfato de Adenosina/metabolismo , Animais , Linhagem Celular , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/patologia , Nefropatias Diabéticas/complicações , Nefropatias Diabéticas/metabolismo , Nefropatias Diabéticas/patologia , Humanos , Rim/metabolismo , Túbulos Renais Proximais/metabolismo , Túbulos Renais Proximais/patologia , Masculino , Ratos , Ratos Sprague-DawleyRESUMO
BACKGROUND: Postpartum depression (PPD) has adverse effects on psychomotor development of the offspring. AIM: To evaluate the relationship between PPD and psychomotor development in children aged 18 months, consulting in primary care. MATERIAL AND METHODS: Cross-sectional study with 360 infants and their mothers. Children had their psychomotor evaluation at l8 months and mothers completed the Edinburgh Postnatal Depression Scale at 4 and 12 weeks postpartum. The prevalence of both PPD and psychomotor alteration was estimated. The association between PPD and psychomotor alteration, including confounding variables, was estimated through logistic multiple regression analysis. RESULTS: The prevalence of PPD and psychomotor alteration was 29 and 16%, respectively Mothers with PPD had twice the probability of having an offspring with psychomotor alteration (Odds ratio = 2.0, confidence intervals = 1.07-3.68). This probability was significantly higher among single mothers or those with an unstable partner. CONCLUSIONS: PPD has a detrimental impact on psychomotor development of children.
Assuntos
Depressão Pós-Parto/psicologia , Transtornos Psicomotores/etiologia , Adolescente , Adulto , Peso ao Nascer , Chile/epidemiologia , Estudos Transversais , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Atenção Primária à Saúde , Transtornos Psicomotores/epidemiologia , Fatores de Risco , Adulto JovemRESUMO
Background: Postpartum depression (PPD) has adverse effects on psychomotor development of the offspring. Aim: To evaluate the relationship between PPD and psychomotor development in children aged 18 months, consulting in primary care. Material and Methods: Cross-sectional study with 360 infants and their mothers. Children had their psychomotor evaluation atl8 months and mothers completed the Edinburgh Postnatal Depression Scale at 4 and 12 weeks postpartum. The prevalence of both PPD and psychomotor alteration was estimated. The association between PPD and psychomotor alteration, including confounding variables, was estimated through logistic multiple regression analysis. Results: The prevalence of PPD and psychomotor alteration was 29 and 16%, respectively Mothers with PPD had twice the probability of havingan offspring with psychomotor alteration (Odds ratio = 2.0, confidence intervals = 1.07-3.68). This probability was significantly higher among single mothers or those with an unstable partner. Conclusions: PPD has a detrimental impact on psychomotor development of children.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Depressão Pós-Parto/psicologia , Transtornos Psicomotores/etiologia , Peso ao Nascer , Chile/epidemiologia , Estudos Transversais , Depressão Pós-Parto/epidemiologia , Prevalência , Atenção Primária à Saúde , Transtornos Psicomotores/epidemiologia , Fatores de RiscoRESUMO
Intestinal tract colonization with vancomycin resistant enterococci (VRE) was studied during five months and 25 days. Out of 171 patients hospitalized in the intensive care unit, 124 (73%) were included in this study. Thirty five of them (28%) were recognized as colonized with VRE. VRE isolates (n = 35) were identified as Enterococcus faecium (n = 18), Enterococcus gallinarum (n = 16), and Enterococcus raffinosus (n = 1). All of them were resistant to vancomycin (MIC90 = 512 microg/ml) and to teicoplanin (MIC90 = 32 microg/ml), having the vanA gene. By means of molecular methods a high homology was found among E. faecium and E. gallinarum isolates, respectively, suggesting their spread as a kind of outbreak. No significant differences in age or sex were found among colonized and non-colonized patients (p > 0.05). On the other hand, the hospitalization time and the use of broad-spectrum antibiotics were associated with colonization. From this study we highlight the importance of enhancing all measures of control and prevention of hospital infections, carefully analyzing the empiric antimicrobial schemes, trying to reduce the hospital stage, and following the surveillance to evaluate the efficacy of such procedures.
Assuntos
Enterococcus/isolamento & purificação , Unidades de Terapia Intensiva , Intestinos/microbiologia , Resistência a Vancomicina , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina , Estudos de Coortes , Comorbidade , DNA Bacteriano/genética , Farmacorresistência Bacteriana Múltipla , Enterococcus/efeitos dos fármacos , Enterococcus/genética , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Teicoplanina/farmacologia , Vancomicina/farmacologiaRESUMO
En un período de cinco meses y 25 días se investigó la portación intestinal de enterococos resistentes a vancomicina (EVR). Se estudiaron 124 pacientes (73%) de 171 admitidos en la unidad de terapia intensiva (UTI), 35 de los cuales (28%) resultaron ser portadores. Los aislamientos de EVR (n=35) fueron identificados como Enterococcus faecium (n=18), Enterococcus gallinarum (n=16) y Enterococcus raffinosus (n=1). Todos los aislamientos estudiados fueron resistentes a vancomicina (VAN) (CIM90= 512 µg/ml) y teicoplanina (CIM90= 32 µg/ml) y portaban el gen vanA. Los estudios de tipificación molecular mostraron un alto grado de homología entre los aislamientos de E. faecium (un clon dominante) y E. gallinarum (dos tipos clonales), sugiriendo su diseminación a modo de brote. No se encontraron diferencias significativas con la edad y el sexo de los pacientes no portadores (p>0,05), pero si con el tiempo de hospitalización y el uso de esquemas antibióticos de amplio espectro (p<0,05), estando estos dos factores asociados al estado de portación. Se deduce de este estudio, la importancia de maximizar las medidas de prevención y control de las infecciones nosocomiales, analizar los esquemas empíricos empleados, tratar de disminuir el tiempo de hospitalización y continuar con los estudios de vigilancia para evaluar la eficacia de las acciones implementadas.
Intestinal tract colonization with vancomycin resistant enterococci (VRE) was studied during five months and 25 days. Out of 171 patients hospitalized in the intensive care unit, 124 (73%) were included in this study. Thirty five of them (28%) were recognized as colonized with VRE. VRE isolates (n = 35) were identified as Enterococcus faecium (n=18), Enterococcus gallinarum (n=16), and Enterococcus raffinosus (n=1). All of them were resistant to vancomycin (MIC90= 512 µg/ml) and to teicoplanin (MIC90= 32 µg/ml), having the vanA gene. By means of molecular methods a high homology was found among E. faecium and E. gallinarum isolates, respectively, suggesting their spread as a kind of outbreak. No significant differences in age or sex were found among colonized and non-colonized patients (p>0.05). On the other hand, the hospitalization time and the use of broad-spectrum antibiotics were associated with colonization. From this study we highlight the importance of enhancing all measures of control and prevention of hospital infections, carefully analyzing the empiric antimicrobial schemes, trying to reduce the hospital stage, and following the surveillance to evaluate the efficacy of such procedures.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enterococcus/isolamento & purificação , Unidades de Terapia Intensiva , Intestinos/microbiologia , Resistência a Vancomicina , Argentina , Estudos de Coortes , Comorbidade , DNA Bacteriano/genética , Farmacorresistência Bacteriana Múltipla , Enterococcus/efeitos dos fármacos , Enterococcus/genética , Genótipo , Estudos Prospectivos , Teicoplanina/farmacologia , Vancomicina/farmacologiaRESUMO
Intestinal tract colonization with vancomycin resistant enterococci (VRE) was studied during five months and 25 days. Out of 171 patients hospitalized in the intensive care unit, 124 (73
) were included in this study. Thirty five of them (28
) were recognized as colonized with VRE. VRE isolates (n = 35) were identified as Enterococcus faecium (n = 18), Enterococcus gallinarum (n = 16), and Enterococcus raffinosus (n = 1). All of them were resistant to vancomycin (MIC90 = 512 microg/ml) and to teicoplanin (MIC90 = 32 microg/ml), having the vanA gene. By means of molecular methods a high homology was found among E. faecium and E. gallinarum isolates, respectively, suggesting their spread as a kind of outbreak. No significant differences in age or sex were found among colonized and non-colonized patients (p > 0.05). On the other hand, the hospitalization time and the use of broad-spectrum antibiotics were associated with colonization. From this study we highlight the importance of enhancing all measures of control and prevention of hospital infections, carefully analyzing the empiric antimicrobial schemes, trying to reduce the hospital stage, and following the surveillance to evaluate the efficacy of such procedures.
RESUMO
La enfermedad por arañazo de gato (EAG), es considerada la causa más frecuente de linfoadenopatía benigna crónica en niños y adolescentes. En los casos existe el antecedente de contacto con gatos (90 por ciento) y de rasguño y/o mordedura (60 por ciento). La infección con Bartonella spp se manifiesta como desde una linfoadenopatía (EAG) a una enfermedad sistémica. El 10 po ciento tiene manifestaciones atípicas y 2 por ciento presenta complicaciones graves. Debe sospecharse EAG por exclusión de otras etiologías habituales y por el antecedente epidemiológico de contacto y/o rasguño de gato, con o sin lesión de inoculación primaria. Se presentan 4 casos de EAG atípicas en niños del S.S. Valdivia, donde se confirmó el agente por IFI IgG contra Bartonella henselae, con títulos > 1: 256.
Assuntos
Masculino , Lactente , Pré-Escolar , Criança , Doença da Arranhadura de Gato , Claritromicina/uso terapêutico , Chile , Infecções por Bartonella/diagnósticoAssuntos
Transplante de Fígado , Doadores de Tecidos , Biópsia , Parada Cardíaca , Humanos , Fígado/patologia , Fatores de TempoRESUMO
Xenograft transplantation is perhaps the most immunologically difficult problem in transplantation today. An overwhelming hyperacute rejection reaction (HAR) occurs within minutes of organ implantation. Preformed antibodies are thought to initiate this process. We used a pig-to-dog renal xenograft transplant model and investigated methods of decreasing the severity of hyperacute rejection. Female pigs weighing 15-20 kg were used as donors. Recipients were mongrel dogs weighing 15-25 kg. Experimental dogs were all given a number of treatments of IgG depletion using an antibody removal system (Dupont-Excorim). This machine immunoadsorbs plasma against a column containing immobilized staphylococcal protein A, which is known to bind the IgG Fc receptor. An 84% reduction in the IgG levels and a 71% reduction in IgM levels was achieved. Postoperative assessment was made of urine output, time to onset of HAR, and histopathological examination of the rejected kidneys. Although cross-matches between donor lymphocytes and recipient sera remained strongly positive in the treated dogs, there was a two- to fourfold reduction in the titers. The time to onset of HAR was prolonged in the experimental group, and the urine output was increased slightly. The histopathologic changes in the experimental group generally showed signs of HAR, but of less intensity than in the nonimmunodepleted control group.
Assuntos
Rejeição de Enxerto/imunologia , Transplante Heterólogo/imunologia , Animais , Cães , Feminino , Imunoglobulina G/isolamento & purificação , Imunoglobulina M/isolamento & purificação , Técnicas de Imunoadsorção , Transplante de Rim/imunologia , Masculino , Suínos , Transplante Heterólogo/efeitos adversosRESUMO
A model of hepatic ischemia was developed in dogs using a pump-driven splanchnic-to-jugular vein bypass during crossclamping of the portal triad. An LD50 was established with three hours of ischemia. PGI2 given for one hour before the ischemic insult ameliorated the ischemic injury and increased survival.