RESUMO
BACKGROUND: There is a lack of uniform criteria for the diagnosis and management of tuberculosis (TB) in children in Cali, Colombia. Addressing TB in children is a challenge in this setting, under both programmatic and research conditions. OBJECTIVES: To facilitate the diagnostic assessment of TB in a paediatric cohort of TB household contacts. METHODS: A diagnostic and management algorithm (DMA) was used to assess children exposed to adult TB cases, according to clinical and epidemiological findings and under programmatic conditions. On the basis of diagnostic tests, cases were classified as TB exposure, TB infection, suspected TB, possible TB or confirmed TB and then submitted to a management plan. This was a prospective pilot study nested within a national cohort study of the transmission dynamics of Mycobacterium tuberculosis, undertaken in Colombia during 2005-2008. RESULTS: During 24 months of follow-up, 54 of 217 children met the criteria for assessment by DMA, 18 of whom (33%) were considered to be TB incident cases (new TB cases among household contacts). The main clinical findings were failure to thrive and cough lasting >21 days. Only one case was smear-positive and culture-confirmed TB. TB treatment was given to 16 children and they demonstrated clinical and radiographic resolution at follow-up. Conducting the study under programmatic conditions demonstrated barriers to accessing competent radiological evaluation, correct interpretation of the tuberculin skin test, and proper specimen collection. CONCLUSION: Structured assessment using DMA facilitated the detection of incident TB cases. The study identified potential barriers to addressing childhood TB in Cali.
Assuntos
Antituberculosos/uso terapêutico , Atenção à Saúde/organização & administração , Saúde da Família , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Adolescente , Adulto , Criança , Pré-Escolar , Estudos de Coortes , Colômbia , Humanos , Recém-Nascido , Estudos Prospectivos , Tuberculose Pulmonar/transmissãoRESUMO
An in vitro presymbiotic system between mesquite [Prosopis laevigata(Willd.) M.C. Johnst], a semi-arid leguminous plant, and pregerminated spores of Gigaspora rosea Nicol. & Schenck was established. After characteristic hyphal branching, high performance liquid chromatographic analyses of methanol extracts from P. laevigata roots revealed a concentration change in one ultraviolet-detectable product. This product was identified by nuclear magnetic resonance and mass spectrometry as trigonelline, a pyridine alkaloid. The concentration of trigonelline was constant in the aerial parts of the plant with or without G. rosea, but its concentration in the roots increased 1.8-fold when G. roseawas present. Trigonelline may be a regulatory factor during early signal events in the establishment of the arbuscular mycorrhizal symbiosis in P. laevigata.
Assuntos
Alcaloides/análise , Micorrizas/fisiologia , Prosopis/química , Fungos/fisiologia , Raízes de Plantas/química , Raízes de Plantas/microbiologia , Prosopis/microbiologia , Prosopis/fisiologia , Simbiose/fisiologiaRESUMO
The aerial parts of Trixis pallida afforded seven known trixanolides (18-24) together with 17 new trixanolides (1-17). Their structures were determined by 1D and 2D NMR techniques, while the absolute configuration of the trixane skeleton was determined using the Mosher method and turned out to be enantiomeric to that reported using the Horeau method. This result is further discussed from the biosynthetic point of view.
Assuntos
Asteraceae/química , Plantas Medicinais/química , Sesquiterpenos/isolamento & purificação , Argentina , Cromatografia Líquida de Alta Pressão , Espectroscopia de Ressonância Magnética , Espectrometria de Massas , Conformação Molecular , Estrutura Molecular , Sesquiterpenos/química , Espectrofotometria Infravermelho , EstereoisomerismoRESUMO
Bioassay-guided fractionation of the antiprotozoal extract of Geranium niveum led to the isolation of two new A-type proanthocyanidins, epi-afzelechin-(4beta-->8, 2beta-->O-->7)-afzelechin (1) and epi-catechin-(4beta-->8, 2beta-->O-->7)-afzelechin (2). Compounds 1 and 2 were given the trivial names of geranins A and B, respectively. In addition, five known compounds, mahuannin B (3), reynoutrin (4), hyperin (5), methyl gallate (6), and 3-beta-caffeoyl-12-oleanen-28-oic acid (7), were obtained. The structures of the new proanthocyanidins were elucidated by spectroscopic and chemical methods as well as CD measurements. Compounds 1, 2, and 4-7 were tested against axenically grown trophozoites of Giardia lamblia and Entamoeba histolytica.