RESUMO
Acylpeptide hydrolase (APEH) is a serine protease involved in amino acid recycling from acylated peptides (exopeptidase activity) and degradation of oxidized proteins (endoproteinase activity). This enzyme is inhibited by dichlorvos (DDVP), an organophosphate compound used as an insecticide. The role of APEH in spermatogenesis has not been established; therefore, the aim of this study was to characterize the distribution and activity profile of APEH during this process. For this purpose, cryosections of male reproductive tissues (testis and epididymis) and isolated cells (Sertoli cells, germ cells, and spermatozoa) were obtained from adult rats in order to analyze the intracellular localization of APEH by indirect immunofluorescence. In addition, the catalytic activity profiles of APEH in the different male reproductive tissues and isolated cells were quantified. Our results show that APEH is homogeneously distributed in Sertoli cells and early germ cells (spermatocytes and round spermatids), but this pattern changes during spermiogenesis. Specifically, in elongated spermatids and spermatozoa, APEH was localized in the acrosome and the principal piece. The exopeptidase activity was higher in the germ cell pool, compared to sperm and Sertoli cells, while the endoproteinase activity in epididymal homogenates was higher compared to testis homogenates at 24 h of incubation. In isolated cells, this activity was increased in Sertoli and germ cell pools, compared to spermatozoa. Taken together, these results indicate that APEH is differentially distributed in the testicular epithelium and undergoes re-localization during spermiogenesis. A possible role of APEH as a component of a protection system against oxidative stress and during sperm capacitation is discussed.
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BACKGROUND: Little is known about the dermoscopic evaluation of cutaneous adverse drug reactions (CADRs). OBJECTIVES: To evaluate the dermoscopic patterns of CADRs and identify those associated with severe cutaneous adverse reactions to drugs (SCARDs). PATIENTS AND METHODS: Patients included in this study from May 2015 to April 2016 had presented with CADRs. CADR presentation and classification were based on standard criteria. SCARDs included Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), overlap SJS/TEN, drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP). The dermoscopic features of CADRs were described and compared according to the severity of the reactions. RESULTS: Sixty-nine patients were included. Sixteen patients (23.2%) presented SCARDs. The main dermoscopic findings in SJS, overlap SJS/TEN and TEN were black dots or necrotic areas (100%). Erosion [respectively, 4/6 (66.7%), 3/3 (100%) and 1/1 (100%)], necrotic borders [respectively, 4/6 (66.7%), 3/3 (100%) and 1/1, (100%)] and epidermal detachment [respectively, 5/6 (83.3%); 2/3 (66.7%) and 1/1 (100%)] were also common among these reactions. Erythema and purpuric dots were the main dermoscopic findings [respectively, 5/6 (83.3%) and 4/6 (66.7%)] in DRESS. In non-severe reactions, the most prevalent structures were erythema and purpura in exanthema [respectively, 31/33 (93.9%) and 24/33 (72.7%)] and erythema and vascular structures in urticarial reactions [respectively, 6/6 (100%) and 3/6 (50%)]. Black dots or necrotic areas, epidermal detachment, necrotic borders and erosion were highly associated with SCARDs (P < 0.001). CONCLUSIONS: Dermoscopy improves clinical recognition of SCARDs.
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Resumen La portación nasal de Staphylococcus aureus representa un riesgo considerable para infecciones tanto nosocomiales como comunitarias. El objetivo del trabajo fue investigar la prevalencia de portación nasal de S. aureus sensibles (SAMS) y resistentes a meticilina (SAMR) en trabajadores de la salud, determinar su asociación con factores epidemiológicos y sus patrones de resistencia a los antimicrobianos. Se tomaron 152 muestras nasales de personal de dos hospitales de la ciudad de Bahía Blanca (Argentina). Los aislados de S. aureus se identificaron por métodos convencionales y por el sistema automatizado BD PhoenixTM 100. La prevalencia de portación nasal de S. aureus fue de 32,2% y, de SAMR, de 12,2%. La frecuencia de portación en el personal de laboratorio (58,8%) resultó estadísticamente significativa. Los aislados fueron sensibles a trimetoprima-sulfametoxazol, cloranfenicol, rifampicina, fluoroquinolonas y vancomicina. Estos datos alertan sobre la necesidad de identificar portadores de S. aureus e implementar estrategias que controlen una potencial diseminación de estos microorganismos.
Abstract The nasal carriage of Staphylococcus aureus represents a considerable risk for both nosocomial and community infections. The objective of this work was to investigate the prevalence of nasal carriage of both methicilin-susceptible (MSSA) and methicillin-resistant S. aureus (MRSA) in health workers, to determine their association with epidemiological factors and their patterns of antimicrobial resistance. One hundred and fifty-two nasal samples were taken from personnel from two hospitals in the Bahía Blanca city (Argentina). The S. aureus isolates were identified by conventional methods and by the automated BD PhoenixTM 100 system. The prevalence of S. aureus nasal carriage was 32.2% and that of MRSA, 12.2%. The frequency of carrying deterin laboratory personnel was statistically significant (58.8%). The isolates were susceptible to trimethoprim-sulfamethoxazole, chloramphenicol, rifampin, fluoroquinolones and vancomycin. These data warn of the need to identify S. aureus carriers and implement strategies that control the potential spread of these microorganisms.
Resumo O carreamento nasal de Staphylococcus aureus representa um risco considerável para infecções tanto nosocomiais quanto comunitárias. O objetivo do trabalho foi investigar a prevalência de carreamento nasal de S. aureus sensíveis (SAMS) e resistentes à meticilina (SARM) em profissionais da saúde; determinar sua associação com fatores epidemiológicos e seus padrões de resistência aos antimicrobianos. Foram coletadas 152 amostras nasais de funcionários de dois hospitais da cidade de Bahía Blanca (Argentina). Os isolados de S. aureus foram identificados por métodos convencionais e pelo sistema automatizado BD PhoenixTM 100. A prevalência de carreamento nasal de S. aureus foi de 32,2% e a de SARM, de 12,2%. A frequência de carreamento no pessoal do laboratório foi estatisticamente significativa (58,8%). Os isolados foram sensíveis a trimetoprim-sulfametoxazol, cloranfenicol, rifampicina, fluoroquinolonas e vancomicina. Esses dados alertam para a necessidade de identificar portadores de S. aureus e implementar estratégias que controlem a propagação potencial desses microrganismos.
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Common bean (Phaseolus vulgaris L.) is a source of proteins for about one billion people worldwide. In Brazil, 'BRS Sublime', 'BRS Vereda', 'BRS Esteio', and 'BRS Estilo' cultivars were developed by Embrapa to offer high yield to farmers and excellent quality to final consumers. In this work, grain proteomes of these common bean cultivars were compared based on two-dimensional gel electrophoresis (2-DE) and tandem mass spectrometry (MS/MS). Principal component analysis (PCA) was applied to compare 349 matched spots in these cultivars proteomes, and all cultivars were clearly separated in PCA plot. Thirty-two differentially accumulated proteins were identified by MS. Storage proteins such as phaseolins, legumins, and lectins were the most abundant, and novel proteins were also identified. We have built a useful platform that could be used to analyze other Brazilian cultivars and genotypes of common beans.
Assuntos
Phaseolus/metabolismo , Proteínas de Plantas/química , Proteoma/química , Brasil , Eletroforese em Gel Bidimensional , Phaseolus/química , Phaseolus/genética , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Proteoma/genética , Proteoma/metabolismo , Sementes/química , Sementes/genética , Sementes/metabolismo , Espectrometria de Massas em TandemRESUMO
BACKGROUND: A genetically modified (GM) common bean event, namely Embrapa 5.1, was approved for commercialization in Brazil. The present work aimed to use principal component analysis (PCA) to compare the proteomic profile of this GM common bean and its non-GM counterpart. RESULTS: Seedlings from four Brazilian common bean varieties were grown under controlled environmental conditions. Leaf proteomic profiles were analyzed by two-dimensional gel electrophoresis (2DE). First, a comparison among 12 gels from four common bean varieties was performed by PCA using volume percentage of 198 matched spots, presented in all gels. The first two principal components (PC) accounted for 46.8% of total variation. Two groups were clearly separated by the first component: Pérola and GM Pérola from Pontal and GM Pontal. Secondly, another comparison among six gels from the same variety GM and its non-GM counterpart was performed by PCA; in this case it was possible to distinguish GM and non-GM. CONCLUSION: Separation between leaf proteomic profile of GM common bean variety and its counterpart was observed only when they were compared in pairs. These results showed higher similarity between GM variety and its counterpart than between two common bean varieties. PCA is a useful tool to compare proteomes of GM and non-GM plant varieties.
Assuntos
Phaseolus/química , Folhas de Planta/química , Plantas Geneticamente Modificadas/química , Brasil , Humanos , Phaseolus/genética , Folhas de Planta/genética , Proteínas de Plantas/química , Proteínas de Plantas/genética , Plantas Geneticamente Modificadas/genética , Análise de Componente PrincipalRESUMO
La infección genital por Chlamydia trachomatis es considerada en la actualidad una de las causas más frecuentes de infecciones transmisibles sexualmente (ITS) a nivel mundial y afecta principalmente al grupo de jóvenes menores de 25 años. El objetivo de este estudio fue determinar la prevalencia de la infección por C. trachomatis en alumnos ingresantes a la Universidad Nacional del Sur (Bahía Blanca, Argentina) y evaluar los factores de riesgo para la adquisición de ITS. Participaron en el estudio 204 jóvenes de edad media de 19 años, que remitieron una muestra de orina de primera micción y respondieron a una encuesta anónima. La investigación de C. trachomatis se realizó sobre 114 muestras válidas mediante una técnica de amplificación génica, cuyo blanco molecular es el gen ompA. Se detectaron 4 casos de infección por C. trachomatis, lo que implicó una prevalencia del 3,5 %. Los factores de riesgo que demostraron estar asociados con la adquisición de esta ITS fueron un historial de 7 o más parejas desde el comienzo de las relaciones sexuales y el contacto con una nueva pareja sexual en los últimos 4 meses. La prevalencia de infección por C. trachomatis reflejó una moderada circulación de este microorganismo en la población estudiada. Si bien algunos aspectos revelados en las encuestas sugieren una población de bajo riesgo para la adquisición de ITS en general, otros datos evidencian lo contrario y alertan sobre la necesidad de incrementar la vigilancia y desarrollar acciones de concienciación y prevención en esta población.
Chlamydia trachomatis genital infection is nowadays considered one of the most frequent causes of sexually transmitted infections (STI) in the world, mainly affecting the group of young people under 25 years old. The aim of this study was to determine the prevalence of C. trachomatis infection in newly admitted students to Universidad Nacional del Sur, Bahía Blanca, Argentina, and to evaluate the risk factors to acquire STI. For that purpose, 204 young college students with a mean age of 19 were involved in this study. Each participant delivered a sample of first-void urine and completed a questionnaire which was then submitted anonymously. The research for C. trachomatis was done on 114 valid samples through a technique of DNA amplification, whose molecular target was the gene ompA. Four cases of infection by C. trachomatis were detected with a prevalence of 3.5 %. The risks factors associated to the infection were a history of 7 or more partners since the start of sexual activity and contact with a new sexual partner in the last 4 months. The prevalence of such infection reflects a moderate circulation of this microorganism in the studied population. This fact, along with some aspects shown by the questionnaire results, would characterize a population having a low risk profile for acquiring STIs. However, some other information obtained from the questionnaires gave some opposite evidence, which would alert us on the need of keeping watch, raising awareness and implementing preventive actions in this population.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Chlamydia trachomatis , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/transmissão , Estudos Transversais , Prevalência , Fatores de Risco , Estudantes , Inquéritos e Questionários , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , UniversidadesRESUMO
La infección genital por Chlamydia trachomatis es considerada en la actualidad una de las causas más frecuentes de infecciones transmisibles sexualmente (ITS) a nivel mundial y afecta principalmente al grupo de jóvenes menores de 25 años. El objetivo de este estudio fue determinar la prevalencia de la infección por C. trachomatis en alumnos ingresantes a la Universidad Nacional del Sur (Bahía Blanca, Argentina) y evaluar los factores de riesgo para la adquisición de ITS. Participaron en el estudio 204 jóvenes de edad media de 19 años, que remitieron una muestra de orina de primera micción y respondieron a una encuesta anónima. La investigación de C. trachomatis se realizó sobre 114 muestras válidas mediante una técnica de amplificación génica, cuyo blanco molecular es el gen ompA. Se detectaron 4 casos de infección por C. trachomatis, lo que implicó una prevalencia del 3,5 %. Los factores de riesgo que demostraron estar asociados con la adquisición de esta ITS fueron un historial de 7 o más parejas desde el comienzo de las relaciones sexuales y el contacto con una nueva pareja sexual en los últimos 4 meses. La prevalencia de infección por C. trachomatis reflejó una moderada circulación de este microorganismo en la población estudiada. Si bien algunos aspectos revelados en las encuestas sugieren una población de bajo riesgo para la adquisición de ITS en general, otros datos evidencian lo contrario y alertan sobre la necesidad de incrementar la vigilancia y desarrollar acciones de concienciación y prevención en esta población.(AU)
Chlamydia trachomatis genital infection is nowadays considered one of the most frequent causes of sexually transmitted infections (STI) in the world, mainly affecting the group of young people under 25 years old. The aim of this study was to determine the prevalence of C. trachomatis infection in newly admitted students to Universidad Nacional del Sur, Bahía Blanca, Argentina, and to evaluate the risk factors to acquire STI. For that purpose, 204 young college students with a mean age of 19 were involved in this study. Each participant delivered a sample of first-void urine and completed a questionnaire which was then submitted anonymously. The research for C. trachomatis was done on 114 valid samples through a technique of DNA amplification, whose molecular target was the gene ompA. Four cases of infection by C. trachomatis were detected with a prevalence of 3.5 %. The risks factors associated to the infection were a history of 7 or more partners since the start of sexual activity and contact with a new sexual partner in the last 4 months. The prevalence of such infection reflects a moderate circulation of this microorganism in the studied population. This fact, along with some aspects shown by the questionnaire results, would characterize a population having a low risk profile for acquiring STIs. However, some other information obtained from the questionnaires gave some opposite evidence, which would alert us on the need of keeping watch, raising awareness and implementing preventive actions in this population.(AU)
RESUMO
Chlamydia trachomatis genital infection is nowadays considered one of the most frequent causes of sexually transmitted infections (STI) in the world, mainly affecting the group of young people under 25 years old. The aim of this study was to determine the prevalence of C. trachomatis infection in newly admitted students to Universidad Nacional del Sur, Bahía Blanca, Argentina, and to evaluate the risk factors to acquire STI. For that purpose, 204 young college students with a mean age of 19 were involved in this study. Each participant delivered a sample of first-void urine and completed a questionnaire which was then submitted anonymously. The research for C. trachomatis was done on 114 valid samples through a technique of DNA amplification, whose molecular target was the gene ompA. Four cases of infection by C. trachomatis were detected with a prevalence of 3.5%. The risks factors associated to the infection were a history of 7 or more partners since the start of sexual activity and contact with a new sexual partner in the last 4 months. The prevalence of such infection reflects a moderate circulation of this microorganism in the studied population. This fact, along with some aspects shown by the questionnaire results, would characterize a population having a low risk profile for acquiring STIs. However, some other information obtained from the questionnaires gave some opposite evidence, which would alert us on the need of keeping watch, raising awareness and implementing preventive actions in this population.
Assuntos
Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/transmissão , Chlamydia trachomatis , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/transmissão , Estudantes , Inquéritos e Questionários , Universidades , Adulto JovemRESUMO
Chlamydia trachomatis genital infection is nowadays considered one of the most frequent causes of sexually transmitted infections (STI) in the world, mainly affecting the group of young people under 25 years old. The aim of this study was to determine the prevalence of C. trachomatis infection in newly admitted students to Universidad Nacional del Sur, Bahía Blanca, Argentina, and to evaluate the risk factors to acquire STI. For that purpose, 204 young college students with a mean age of 19 were involved in this study. Each participant delivered a sample of first-void urine and completed a questionnaire which was then submitted anonymously. The research for C. trachomatis was done on 114 valid samples through a technique of DNA amplification, whose molecular target was the gene ompA. Four cases of infection by C. trachomatis were detected with a prevalence of 3.5
. The risks factors associated to the infection were a history of 7 or more partners since the start of sexual activity and contact with a new sexual partner in the last 4 months. The prevalence of such infection reflects a moderate circulation of this microorganism in the studied population. This fact, along with some aspects shown by the questionnaire results, would characterize a population having a low risk profile for acquiring STIs. However, some other information obtained from the questionnaires gave some opposite evidence, which would alert us on the need of keeping watch, raising awareness and implementing preventive actions in this population.
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The Embrapa 5.1 genetically modified (GM) common bean was approved for commercialization in Brazil. Methods for the quantification of this new genetically modified organism (GMO) are necessary. The development of a suitable endogenous reference is essential for GMO quantification by real-time PCR. Based on this, a new taxon-specific endogenous reference quantification assay was developed for Phaseolus vulgaris L. Three genes encoding common bean proteins (phaseolin, arcelin, and lectin) were selected as candidates for endogenous reference. Primers targeting these candidate genes were designed and the detection was evaluated using the SYBR Green chemistry. The assay targeting lectin gene showed higher specificity than the remaining assays, and a hydrolysis probe was then designed. This assay showed high specificity for 50 common bean samples from two gene pools, Andean and Mesoamerican. For GM common bean varieties, the results were similar to those obtained for non-GM isogenic varieties with PCR efficiency values ranging from 92 to 101 %. Moreover, this assay presented a limit of detection of ten haploid genome copies. The primers and probe developed in this work are suitable to detect and quantify either GM or non-GM common bean.
Assuntos
Phaseolus/genética , Lectinas de Plantas/genética , Reação em Cadeia da Polimerase em Tempo Real/normas , DNA de Plantas/análise , Phaseolus/classificação , Plantas Geneticamente Modificadas/genética , Reação em Cadeia da Polimerase em Tempo Real/métodos , Padrões de ReferênciaRESUMO
The purpose of this study is to compare scanning electron microscopy findings of the blister roof in three distinct bullous diseases: one intraepidermal acantholytic (pemphigus foliaceus); one due to hemidesmosomal dysfunction (bullous pemphigoid); and one secondary to anchoring fibril dysfunction - type VII collagen (dystrophic epidermolysis bullosa). In pemphigus foliaceus, acantholytic phenomena were readily demonstrated. In bullous pemphigoid, the epidermis had a solid aspect. In dystrophic epidermolysis bullosa a net was seen in the blister roof.
Assuntos
Epidermólise Bolhosa Distrófica/patologia , Microscopia Eletrônica de Varredura/métodos , Dermatopatias Vesiculobolhosas/patologia , HumanosRESUMO
The purpose of this study is to compare scanning electron microscopy findings of the blister roof in three distinct bullous diseases: one intraepidermal acantholytic (pemphigus foliaceus); one due to hemidesmosomal dysfunction (bullous pemphigoid); and one secondary to anchoring fibril dysfunction - type VII collagen (dystrophic epidermolysis bullosa). In pemphigus foliaceus, acantholytic phenomena were readily demonstrated. In bullous pemphigoid, the epidermis had a solid aspect. In dystrophic epidermolysis bullosa a net was seen in the blister roof.
Assuntos
Humanos , Epidermólise Bolhosa Distrófica/patologia , Microscopia Eletrônica de Varredura/métodos , Dermatopatias Vesiculobolhosas/patologiaRESUMO
The association of microphthalmia and linear skin defects was named microphthalmia with linear skin defects syndrome (MLS) or MIDAS syndrome (microphthalmia, dermal aplasia, and sclerocornea), an X-chromosomal disorder manifesting mainly in females. We examined a female newborn with facial linear skin defects following the Blaschko lines. Computer tomography and ophthalmological examination confirmed bilateral microphthalmia. An interstitial microdeletion at Xp22.2, encompassing the entire HCCS gene, was identified. Dermatoscopic examination showed erythematous linear areas with telangectasias and absence of sebaceous glands, which appear as brilliant white dots. Vellus hairs were also absent in the red areas. Dermatoscopy could help to establish the diagnosis of MLS/MIDAS syndrome by confirming the aplastic nature of the lesions.
Assuntos
Dermoscopia/métodos , Doenças Genéticas Ligadas ao Cromossomo X/patologia , Microftalmia/patologia , Anormalidades da Pele/patologia , Deleção Cromossômica , Feminino , Doenças Genéticas Ligadas ao Cromossomo X/genética , Humanos , Recém-Nascido , Microftalmia/genética , Pele/patologia , Anormalidades da Pele/genética , SíndromeRESUMO
We performed scanning electron microscopy of an inverted blister roof in a case of pemphigus foliaceus. The loss of intercellular adherence could be easily seen with low magnification. The acantholytic keratinocytes displayed an irregular and sometimes polygonal contour. Round cells, typically seen in light microscopy, were also observed. The examination of a blister roof allows ultrastructural documentation of the acantholytic changes.
Assuntos
Acantólise/patologia , Pênfigo/patologia , Queratinócitos/ultraestrutura , Microscopia Eletrônica de VarreduraRESUMO
We performed scanning electron microscopy of an inverted blister roof in a case of pemphigus foliaceus. The loss of intercellular adherence could be easily seen with low magnification. The acantholytic keratinocytes displayed an irregular and sometimes polygonal contour. Round cells, typically seen in light microscopy, were also observed. The examination of a blister roof allows ultrastructural documentation of the acantholytic changes.
Realizamos microscopia eletrônica de varredura do teto invertido de uma bolha de um caso de pênfigo foliáceo. Com pequeno aumento, a perda da adesão intercelular pôde ser vista claramente. Os queratinócitos acantolíticos demostraram um contorno irregular, algumas vezes poligonal. Células arredondadas, como vistas tipicamente na microscopia óptica, também foram observadas. O exame de um teto de bolha permite uma documentação ultraestrutural das alterações acantolíticas.
Assuntos
Acantólise/patologia , Pênfigo/patologia , Queratinócitos/ultraestrutura , Microscopia Eletrônica de VarreduraRESUMO
OBJECTIVE: The aim of this study was to evaluate the association of serum magnesium levels with proton pump inhibitors (PPIs) use and other factors. METHODS: This was a cross-sectional study of 151 patients admitted with acute diseases in the Internal Medicine Division of the Hospital de Clinicas de Porto Alegre, after the exclusion of conditions that are commonly associated with hypomagnesemia: diarrhea; vomiting; chronic alcohol use; severely uncompensated diabetes mellitus; and chronic use of laxatives, diuretics or other drugs causing magnesium deficiency. RESULTS: All patients had normal serum magnesium levels. Serum albumin and creatinine levels were positively associated with serum magnesium levels, after adjusting for confounders. There was no difference between mean serum magnesium levels of PPI users and non-users, nor between men and women; there was also no correlation among age, serum phosphorus, and potassium levels with serum magnesium levels. Limitations of this study include the absence of an instrument for measuring adherence to PPI use and the sample size. CONCLUSION: The association of PPI use and hypomagnesemia is uncommon. Congenital defects in the metabolism of magnesium may be responsible for hypomagnesemia in some patients using this drug class.
OBJETIVO: O objetivo desse estudo foi verificar a associação do nível sérico do magnésio com o uso de inibidores de bomba de prótons (IBP) e outros fatores. MÉTODOS: Realizou-se estudo transversal com 151 pacientes admitidos com doenças agudas no serviço de medicina interna do Hospital de Clínicas de Porto Alegre. Foram excluídos aqueles pacientes com condições usualmente relacionadas à hipomagnesemia: diarréia; vômitos; diabéticos agudamente descompensados; uso crônico de laxantes, álcool, diuréticos ou outros fármacos relacionados. RESULTADOS: Todos os pacientes apresentaram níveis normais de magnésio. Albumina e creatinina sérica se associaram positivamente com os níveis de magnésio sérico, após ajuste para fatores confundidores. Não houve diferença no nível sérico de magnésio em usuários ou não-usuários de IBP ou entre homens e mulheres. Não houve correlação com idade, nível sérico de fósforo e potássio. As principais limitações desse estudo foram a ausência de instrumento para medir a adesão aos IBPs e o tamanho da amostra. CONCLUSÃO: A associação do uso de IBP e hipomagnesemia é rara. Defeitos congênitos no metabolismo do magnésio devem ser responsáveis pelo surgimento de hipomagnesemia em usuários de dessa classe de fármacos.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Deficiência de Magnésio/induzido quimicamente , Deficiência de Magnésio/epidemiologia , Magnésio/sangue , Inibidores da Bomba de Prótons/efeitos adversos , Creatinina/sangue , Métodos Epidemiológicos , Deficiência de Magnésio/sangue , Deficiência de Magnésio/diagnóstico , Albumina Sérica/análiseRESUMO
OBJECTIVE: The aim of this study was to evaluate the association of serum magnesium levels with proton pump inhibitors (PPIs) use and other factors. METHODS: This was a cross-sectional study of 151 patients admitted with acute diseases in the Internal Medicine Division of the Hospital de Clinicas de Porto Alegre, after the exclusion of conditions that are commonly associated with hypomagnesemia: diarrhea; vomiting; chronic alcohol use; severely uncompensated diabetes mellitus; and chronic use of laxatives, diuretics or other drugs causing magnesium deficiency. RESULTS: All patients had normal serum magnesium levels. Serum albumin and creatinine levels were positively associated with serum magnesium levels, after adjusting for confounders. There was no difference between mean serum magnesium levels of PPI users and non-users, nor between men and women; there was also no correlation among age, serum phosphorus, and potassium levels with serum magnesium levels. Limitations of this study include the absence of an instrument for measuring adherence to PPI use and the sample size. CONCLUSION: The association of PPI use and hypomagnesemia is uncommon. Congenital defects in the metabolism of magnesium may be responsible for hypomagnesemia in some patients using this drug class.
Assuntos
Deficiência de Magnésio/induzido quimicamente , Deficiência de Magnésio/epidemiologia , Magnésio/sangue , Inibidores da Bomba de Prótons/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Creatinina/sangue , Métodos Epidemiológicos , Feminino , Humanos , Deficiência de Magnésio/sangue , Deficiência de Magnésio/diagnóstico , Masculino , Pessoa de Meia-Idade , Albumina Sérica/análise , Adulto JovemRESUMO
O uso de sacarose na terapêutica de feridas é uma prática comum que parece favorecer a cicatrização tissular e reduzir a carga microbiana. Objetivou-se, desta forma analisar as evidências científicas por meio da revisão integrativa a fim de determinar a indicação e contraindicação do uso da sacarose (nas apresentações de açúcar cristal, mascavo e/ou refinado) em feridas infectadas e assim auxiliar o profissional na tomada de decisão clínica. Selecionaram-se 10 estudos publicados na íntegra, no período de 2002 a 2012 e indexados no PubMed, Cinahl, Lilacs e Cochrane. Considerando a análise dos estudos, em sua maioria experimentais no modelo animal, verificou-se a efetividade do açúcar na reparação tecidual e modulagem positiva na resposta inflamatória. Com vistas a elucidar os mecanismos ou ação da sacarose na ferida, recomendam-se ensaios clínicos adicionais para padronizar a concentração, volume e periodicidade da sacarose nas trocas de coberturas.
Assuntos
Açúcares , Sacarose , Sacarose/uso terapêutico , CicatrizRESUMO
Decreased pulse pressure (PP) is associated with low cardiac output and increased mortality in heart failure (HF) inpatients. QRS width is a well-known prognostic factor in HF. The study purpose was to explore the mortality effect of combining PP and QRS width in HF outpatients. Initial sphygmomanometrically determined PP and QRS width on the first electrocardiograph in 327 consecutive patients at an HF clinic were recorded. According to PP > or = or <40 mm Hg and QRS width > or = or <120 ms, patients were classified into 4 groups. Study groups were analyzed for their effect on mortality using Cox proportional hazards regression analysis. Patients with PP <40 mm Hg had higher mortality (59% vs 45%; P=.015). QRS width > or =120 ms indicated a trend toward higher mortality (57% vs 48%; P=.067). Actuarial survival curves showed that group 4 (QRS width > or =120 ms and PP <40 mm Hg) had significant increased mortality risk in 3.5 years' mean follow-up. Group 4 had a mean survival time of 1124 days (SD=124) vs 2233 days (SD=285) in group 1 (QRS width <120 ms and PP > or =40 mm Hg) (P=.022). There was a linear association between left ventricular ejection fraction (LVEF) and study groups. PP and QRS width are readily available, inexpensive, and relevant clinical measures to help identify HF outpatients with significantly worse prognosis and decreased LVEF.
Assuntos
Pressão Sanguínea , Insuficiência Cardíaca/diagnóstico , Análise de Variância , Brasil , Débito Cardíaco , Cardiotônicos/uso terapêutico , Eletrocardiografia , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/fisiopatologia , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Análise de Regressão , Medição de Risco , Esfigmomanômetros , Volume Sistólico , Função Ventricular EsquerdaRESUMO
BACKGROUND: Diagnosis of spontaneous bacterial peritonitis (SBP) is currently based on ascitic cell counting, but there is a need for a more simple and rapid diagnostic tool. The objectives of this study are to evaluate the accuracy of reagent strips in diagnosing SBP and compare their costs with total and differential cell counts. PATIENTS AND METHODS: 71 cirrhotic in- and outpatients were consecutively included (159 samples). Spontaneous bacterial peritonitis was defined as neutrophil cells >or= 250/microL. The cutoff values for each reagent strip were defined by a receiver operating characteristic (ROC) curve. Sensitivity (S), Specificity (Sp), Positive and Negative Predictive Values (PPV and NPV), Accuracy (Ac) and cost-effectiveness (US$) in comparison to cell count exam were calculated. RESULTS: Spontaneous bacterial peritonitis was diagnosed in 17 patients (23.9%), 11 of them with positive culture (64.7%). The best cutoff points found in ROC curves were 1+ for Multistix 10 SG and ca. 75 for Choiceline 10 (Multistix 10 SG S = 80%, Sp = 98.5%, PPV = 90.9%, NPV = 96.2%, Ac = 95%; Choiceline 10 S = 76.9%, Sp = 97.7%, PPV = 87%, NPV = 95.6%, Ac = 94%). In terms of cost-effectiveness by cost/accuracy, cell count was 41.5, Multistix 10 SG 0.57, and Choiceline 10, 0.19 (P < 0.001). CONCLUSION: Reagent strips are a useful tool for diagnosing SBP in cirrhotic patients, but they have some limitations. Strips are especially indicated when total and differential cell counts are not quickly available or sometimes unavailable. They are also indicated as screening test in emergency rooms to anticipate the diagnosis of SBP and allow its early treatment. It's an interesting option in developing countries.