RESUMO
Purpose: Outer blood retinal barrier breakdown is a neglected feature of diabetic retinopathy (DR). We demonstrated that the agonism of the δ opioid receptor (DOR) by epicatechin preserves the tight junction proteins in ARPE-19 cells under diabetic conditions. Presently, we aimed to evaluate the possible role of the DOR on the maintenance of tight junction of RPE layer and on the early markers of experimental DR. Methods: DR markers and external retinal tight junction proteins were evaluated in CL57B diabetic mice submitted to intravitreous injection of short hairpin RNA (shRNA)-DOR (108 transducing units [TU]/mL) treated or not with DOR agonist (0.05 g/animal/d of epicatechin in drinking water) for 16 weeks. The presence of DOR in human retina from postmortem eyes from diabetic and nondiabetic donors were also performed. Results: DOR is present in RPE layer and in neuro retina. The treatment with DOR agonist prevented the upregulation of the early markers of retinopathy (glial fibrillary acidic protein, VEGF) and the downregulation of pigment epithelium-derived factor, occludin, claudin-1, and zonula occludens-1 tight junction expressions. The silencing of DOR in retina of diabetic mice partially abolished the protective effects of epicatechin. In human retina specimens, DOR is present throughout the retina, similarly in nondiabetic and diabetic donors. Conclusions: This set of experiments strongly indicates that the DOR agonism preserves RPE tight junctions and reduces the early markers of retinopathy in model of diabetes. These novel findings designate DOR as a potential therapeutic tool to treat DR with preservation of the RPE tight junction proteins.
Assuntos
Catequina/farmacologia , Diabetes Mellitus Experimental/prevenção & controle , Retinopatia Diabética/prevenção & controle , Receptores Opioides delta/agonistas , Epitélio Pigmentado da Retina/metabolismo , Junções Íntimas/metabolismo , Idoso , Animais , Glicemia/metabolismo , Western Blotting , Claudina-1/metabolismo , Diabetes Mellitus Experimental/metabolismo , Retinopatia Diabética/metabolismo , Retinopatia Diabética/patologia , Impedância Elétrica , Proteínas do Olho/metabolismo , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Proteína Glial Fibrilar Ácida/metabolismo , Humanos , Imuno-Histoquímica , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Fatores de Crescimento Neural/metabolismo , Ocludina/metabolismo , RNA Interferente Pequeno , Reação em Cadeia da Polimerase em Tempo Real , Receptores Opioides delta/metabolismo , Serpinas/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Proteína da Zônula de Oclusão-1/metabolismoRESUMO
Three new compounds, a bicyclogermacrene (1) and two 2,3-secoaromadendrane esters (2 and 3), together with (13S)-13-hydroxylabda-8,14-diene (4), fusicogigantone B (5), 3α,14-diacetoxy-2-hydoxybicyclogermacrene (6), fusicogigantone A (7), neofuranoplagiochilal (8), plagiochiline B (9), furanoplagiochilal (10), trans-nerolidol, spathulenol, α-tocopherol, and (+)-globulol were isolated from an Argentine collection of Plagiochila diversifolia. Their structures were elucidated by extensive mono and bidimensional NMR studies. Compounds 4, 5, and 6, incorporated to the larval diet at 100 µg per g of diet, reduced the larval growth of Spodoptera frugiperda (Lepidoptera: Noctuidae) by 70 ± 25, 57 ± 23, and 33 ± 16%, respectively. Compounds 4 and 5 produced 70% and 60% larval mortality at early instars. The latter also showed antifeedant properties in the Choice Test, with a feeding ratio of 0.54 ± 0.16.
Assuntos
Hepatófitas/química , Inseticidas/química , Animais , Argentina , Hepatófitas/metabolismo , Inseticidas/toxicidade , Larva/efeitos dos fármacos , Larva/crescimento & desenvolvimento , Espectroscopia de Ressonância Magnética , Conformação Molecular , Spodoptera/efeitos dos fármacos , Spodoptera/crescimento & desenvolvimentoRESUMO
The study aimed to identify whether payment forms and insurance schemes are associated with severe obstetric complications and maternal mortality. A hospital-based case-control study was conducted in two regions of Colombia, 2009-2011. Data were obtained from each woman's clinical history. Unconditional logistic regression was used. The sample included 1,011 patients: 337 cases and 674 controls. No quality component was statistically significant in either region. In Bogotá, the risk of obstetric complications was significantly higher in the contributive insurance scheme than in subsidized coverage or uninsured; Antioquia showed similar associations, but not statistically significant. Differences in maternal morbidity according to payment scheme were not statistically significant in either Antioquia or Bogotá. Factors associated with maternal morbidity and mortality differed according to the study population, suggesting the need for local studies to identify determinants and make appropriate decisions.
Assuntos
Seguro Saúde/estatística & dados numéricos , Mortalidade Materna , Assistência Médica/estatística & dados numéricos , Pré-Eclâmpsia/mortalidade , Complicações na Gravidez/mortalidade , Sepse/mortalidade , Hemorragia Uterina/mortalidade , Adulto , Estudos de Casos e Controles , Colômbia/epidemiologia , Feminino , Humanos , Serviços de Saúde Materna/economia , Gravidez , Fatores de Risco , Fatores SocioeconômicosRESUMO
Resumen: El objetivo fue identificar si formas de pago y regímenes de aseguramiento están asociados con la mortalidad materna y morbilidad obstétrica extrema. Estudio de casos y controles de base hospitalaria en dos regiones de Colombia, 2009-2011. Los datos se obtuvieron de la historia clínica de cada gestante. Se utilizó regresión logística no condicional. El resultado fue: 1.011 pacientes, 337 casos y 674 controles. Ningún componente de calidad fue estadísticamente significativo en ambas regiones. En Bogotá, el riesgo de complicación obstétrica, significativamente mayor en Régimen Contributivo que en Subsidiado y no aseguradas; Antioquia, aunque hubo asociaciones similares, no estadísticamente significativas. Diferencias en morbilidad por régimen de pago no estadísticamente significativas en Antioquia ni Bogotá. Factores asociados a la morbimortalidad materna diferentes, según la población estudiada, lo que sugiere la necesidad de estudios locales para identificar factores determinantes propios y tomar decisiones pertinentes.
Abstract: The study aimed to identify whether payment forms and insurance schemes are associated with severe obstetric complications and maternal mortality. A hospital-based case-control study was conducted in two regions of Colombia, 2009-2011. Data were obtained from each woman's clinical history. Unconditional logistic regression was used. The sample included 1,011 patients: 337 cases and 674 controls. No quality component was statistically significant in either region. In Bogotá, the risk of obstetric complications was significantly higher in the contributive insurance scheme than in subsidized coverage or uninsured; Antioquia showed similar associations, but not statistically significant. Differences in maternal morbidity according to payment scheme were not statistically significant in either Antioquia or Bogotá. Factors associated with maternal morbidity and mortality differed according to the study population, suggesting the need for local studies to identify determinants and make appropriate decisions.
Resumo: O presente estudo objetiva identificar se as formas de pagamento e regimes de seguros de saúde estão associados com a mortalidade materna e morbidade materna grave. Trata-se de um estudo caso-controle de base hospitalar em duas regiões da Colômbia entre 2009-2011. Os dados foram obtidos através da história clínica de cada gestante. Foi utilizada a regressão logística não condicionada. A mostra incluiu 1.011 pacientes: 337 casos e 674 controles. Nenhum componente de qualidade foi estatisticamente significativo em ambas as regiões. Em Bogotá, o risco de complicações obstétricas foi significativamente maior no Regime Contributivo do que no Subsidiado e em mulheres sem seguro de saúde. Em Antioquia, embora existam associações similares, não foram estatisticamente significativas. Tanto em Antioquia quanto em Bogotá não se encontraram diferenças significativas de morbilidade por regime de pagamento. Foram encontrados diferentes fatores associados à morbimortalidade materna, segundo a população estudada, o que sugere a necessidade de estudos locais para identificar fatores determinantes próprios e tomar decisões adequadas neste contexto.
Assuntos
Humanos , Feminino , Gravidez , Adulto , Pré-Eclâmpsia/mortalidade , Complicações na Gravidez/mortalidade , Hemorragia Uterina/mortalidade , Mortalidade Materna , Sepse/mortalidade , Seguro Saúde/estatística & dados numéricos , Assistência Médica/estatística & dados numéricos , Fatores Socioeconômicos , Estudos de Casos e Controles , Fatores de Risco , Colômbia/epidemiologia , Serviços de Saúde Materna/economiaRESUMO
To estimate the incidence (any mother to child) and rate (from seropositive mother to child) of mother-to-child transmission of Trypanosoma cruzi, a serological census was conducted, targeting pregnant women and infants born to seropositive mothers, in four municipalities of El Salvador. Of 943 pregnant women, 36 (3.8%) were seropositive for T. cruzi. Of 36, 32 proceeded to serological tests of their infants when they became 6-8 months of age. Six infants seropositive at the age of 6-8 months further proceeded to second-stage serological test at the age of 9-16 months. As the result, one infant was congenitally infected. Thus, serological tests at the age of 6-8 months produced five false positives. To ensure earlier effective medication only for true positives, identification of seropositive infants at the age of 9-16 months is crucial. Incidence and rate of mother-to-child transmission were 0.14 (per 100 person-years) and 4.0%, respectively. Estimated number of children infected through mother-to-child transmission in El Salvador (170 per year) was much higher than that of human immunodeficiency virus (HIV; seven per year). It is recommended that serological testing for T. cruzi be integrated into those for HIV and syphilis as part of antenatal care package.
Assuntos
Doença de Chagas/epidemiologia , Doença de Chagas/transmissão , Transmissão Vertical de Doenças Infecciosas , Complicações Infecciosas na Gravidez/epidemiologia , El Salvador/epidemiologia , Feminino , Humanos , Incidência , Lactente , Masculino , Gravidez , Complicações Infecciosas na Gravidez/parasitologia , Trypanosoma cruzi/isolamento & purificaçãoRESUMO
INTRODUCTION: El Salvador is regarded as a highly endemic country for Chagas disease, as evidenced by the relatively high estimated positive serology rate for Trypanosoma cruzi among blood donors. This study aimed to identify the factors contributing to this high rate by analyzing changes in T. cruzi seroprevalence. METHODOLOGY: Secondary data were collected from 31 blood banks operated by the Ministry of Health, the Red Cross, the Institute of Salvadoran Social Security, and the Military Hospital. The data were analyzed to determine the number of cases of T. cruzi seropositivity, and the average prevalence of seropositivity by province. Simple linear regression was performed to identify trends in T. cruzi seropositivity. RESULTS: Analysis of the 885,187 blood samples collected between 2001 and 2011 revealed 21,693 cases of transfusion-related infections, with a significant reduction of T. cruzi seropositivity from 3.7% in 2001 to 1.7% in 2011, reflecting a 54% decrease over the course of a decade (R(2) = 89.6%, p > 0.001). T. cruzi seroprevalence decreased in San Salvador, Santa Ana, Sonsonate, and Cuscatlán. In contrast, seroprevalence remained high with no decrease in Ahuachapán and San Vicente, and consistently low in the remainder of the country. CONCLUSIONS: Although the national prevalence of T. cruzi among blood donors has decreased, it remains high in the provinces of Ahuachapán and San Vicente. Strengthening vector control activities and developing an approach for the systematic follow-up of prospective blood donors with positive serology for T. cruzi are required, especially in areas with high seropositivity.
Assuntos
Doadores de Sangue , Doença de Chagas/epidemiologia , Trypanosoma cruzi/isolamento & purificação , Adolescente , Adulto , Idoso , Doença de Chagas/parasitologia , El Salvador/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Soroepidemiológicos , Adulto JovemRESUMO
Several parasitological studies carried out in El Salvador between 2000-2012 showed a higher frequency of acute cases of Chagas disease than that in other Central American countries. There is an urgent need for improved Chagas disease surveillance and vector control programs in the provinces where acute Chagas disease occurs and throughout El Salvador as a whole.
Assuntos
Doença de Chagas/epidemiologia , Doenças Negligenciadas/epidemiologia , Adolescente , Adulto , Animais , Doença de Chagas/prevenção & controle , Criança , Pré-Escolar , El Salvador/epidemiologia , Humanos , Lactente , Controle de Insetos , Trypanosoma cruzi/isolamento & purificação , Adulto JovemRESUMO
The new 2,3-secoaromadendrane 1, together with the known compounds plagiochilines A and M (2 and 3, resp.), fusicogigantone A (4), and 1,4-dimethylazulene (5) were isolated from an Argentine collection of the liverwort Plagiochila bursata. Structures were elucidated by extensive 1D- and 2D-NMR studies. Compounds 2 and 4, incorporated to the larval diet at 100 microg per g of diet, reduced the larval growth of Spodoptera frugiperda (Lepidoptera: Noctuidae) by 66+/-29% and 25+/-8% and produced 55 and 75% larval mortality at early instars and 20 and 25% pupal mortality, respectively. Treatment with compound 2 also produced abdomen and wing malformation in adults leading to impossibility to mate.
Assuntos
Hepatófitas/química , Inseticidas/química , Inseticidas/farmacologia , Sesquiterpenos/química , Sesquiterpenos/farmacologia , Spodoptera/crescimento & desenvolvimento , Animais , Inseticidas/isolamento & purificação , Larva/crescimento & desenvolvimento , Pupa/crescimento & desenvolvimento , Sesquiterpenos/isolamento & purificaçãoRESUMO
Se evaluó la posibilidad del cierre no quirúrgico de seudoaneurismas de la arteria femoral común los cuales se presentan posteriores a procedimientos de cateterismos percutáneos trasfemorales. Sediagnosticaron 12 pacientes con hematoma y/o soplo inguinal por medio de ultrasonografía triplex (duplex scan color). Se utilizó para intentar el cierre del seudoaneurisma la técnica de compresión dirigida bajo visión ultrasónica. En 3 pacientes no se practicó la compresión dirigida bajo visión ultrasónica debido a: tromsosis espontánea (N=1), y dolor excesivo (N=2). Los 9 pacientes restantes fueron sometidos a la compresión dirigida bajo visión ultrasónica y se obtuvo cierre de la lesión en todos ellos. No hubo recurrencias o complicaciones detectadas en los controles posteriores a la compresión. Los resultados iniciales muestran la compresión dirigida bajo visión ultrasónica como una técnica simple, de bajo costo y reproducible la cual es elección de primera línea en el tratamiento de las lesiones de la arteria femoral, posteriores a procedimientos intervencionistas que se practican para el diagnóstico y tratamiento de enfermedades vasculares
Assuntos
Humanos , Aneurisma , Artéria Femoral/patologia , Aneurisma/terapia , Artéria FemoralRESUMO
Objetivo: Detreminar la incidencia y las características de las complicaciones cardíacas en un grupo de pacientes colombianos con SIDA. Diseño: Estudio prospectivo, descriptivo realizado entre dos instituciones de tercer nivel, universitarias: la Fundación Santa Fe y la Clínica León XIII. Población: Se estudiaron 108 pacientes de los cuales sólo 29 acudieron a la cita de control (26.8 por ciento). El promedio de seguimiento fue de 8 meses (Rango entre 6-12). Sólo una mujer fue incluida en el estudio pero no evidenció compromiso cardíaco. Todos los pacientes cumplíanlos criterios del SIDA. Resultados: Presentaron anormalidades cardíacas 56 pacientes detectadas por ecocardiograma, ninguno presentaba sintomatología. 24 pacientes tenían prolapso de válvula mitral, 1 paciente ductus y otro aorta bivalva, estas 26 alteraciones no se consideraron relacionadas con la enfermedad. De los 30 pacientes restantes (27.7 por ciento) 12 pacientes tenían disfunción sistólica, 11 derrame pericárdico, 7 disfunción diastólica, 6 pacientes tenían disfunción valvular y 2 hipertensión pulmonar. Durante el seguimineto se confirmó la mejoría de la hipertensión pulmonar en un paciente, de la disfunción sistólica en otro igual que el derrame pleural en dos. Conclusiones: La complicación cardíaca en el paciente con SIDA no resulta ser infrecuente y debe sospecharse siempre ya que se tratan de patologías asintomáticas y que responden fácilmente a tratamiento instaurado. No se logró establecer una lesión caracaterística de la enfermedad
Assuntos
Humanos , Síndrome da Imunodeficiência Adquirida , Doenças Cardiovasculares , Sistema Cardiovascular/fisiopatologia , Cardiopatias Congênitas , Síndrome da Imunodeficiência Adquirida/complicaçõesRESUMO
El granuloma anular profundo de la piel cabelluda carece de las características del granuloma anular clásico, por lo que representa un problema diagnóstico. Se comunican cinco casos de esta entidad en pacientes pediátricos y se discute el diagnóstico diferencial y la terapéutica.