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The aim of this study was to assess the shear wave velocity by LUS elastography (SWE2D) for the evaluation of superficial lung stiffness after COVID-19 pneumonia, according to "fibrosis-like" signs found by Computed Tomography (CT), considering the respiratory function. Seventy-nine adults participated in the study 42 to 353 days from symptom onset. Paired evaluations (SWE2D and CT) were performed along with the assessment of arterial blood gases and spirometry, three times with 100 days in between. During the follow-up and within each evaluation, the SWE2D velocity changed over time (MANOVA, p < 0.05) according to the extent of "fibrosis-like" CT signs by lung lobe (ANOVA, p < 0.05). The variability of the SWE2D velocity was consistently related to the first-second forced expiratory volume and the forced vital capacity (MANCOVA, p < 0.05), which changed over time with no change in blood gases. Covariance was also observed with age and patients' body mass index, the time from symptom onset until hospital admission, and the history of diabetes in those who required intensive care during the acute phase (MANCOVA, p < 0.05). After COVID-19 pneumonia, SWE2D velocity can be related to the extent and regression of "fibrotic-like" involvement of the lung lobes, and it could be a complementary tool in the follow-up after COVID-19 pneumonia.
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Balamuthia mandrillaris is a pathogenic protozoan that causes a rare but almost always fatal infection of the central nervous system and, in some cases, cutaneous lesions. Currently, the genomic data for this free-living amoeba include the description of several complete mitochondrial genomes. In contrast, two complete genomes with draft quality are available in GenBank, but none of these have a functional annotation. In the present study, the complete genome of B. mandrillaris isolated from a freshwater artificial lagoon was sequenced and assembled, obtaining an assembled genome with better assembly quality parameter values than the currently available genomes. Afterward, the genome mentioned earlier, along with strains V039 and 2046, were subjected to functional annotation. Finally, comparative genomics analysis was performed, and it was found that homologous genes in the core genome potentially involved in the virulence of Acanthamoeba spp. and Trypanosoma cruzi. Moreover, eleven of fifteen genes were identified in the three strains described as potential target genes to develop new treatment approaches for B. mandrillaris infections. These results describe proteins in this protozoan's complete genome and help prioritize which target genes could be used to develop new treatments.
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Acanthamoeba , Balamuthia mandrillaris , Balamuthia mandrillaris/genética , Virulência/genética , Hibridização Genômica Comparativa , Acanthamoeba/genética , GenômicaRESUMO
The gut microbiota is involved in the productivity of beef cattle, but the impact of different analysis strategies on microbial composition is unclear. Ruminal samples were obtained from Beefmaster calves (n = 10) at both extremes of residual feed intake (RFI) values (5 with the lowest and 5 with the highest RFI) from two consecutive days. Samples were processed using two different DNA extraction methods. The V3 and V4 regions of the 16S rRNA gene were amplified using PCR and sequenced with a MiSeq instrument (Illumina). We analyzed 1.6 million 16S sequences from all 40 samples (10 calves, 2 time points, and 2 extraction methods). The abundance of most microbes was significantly different between DNA extraction methods but not between high-efficiency (LRFI) and low-efficiency (HRFI) animals. Exceptions include the genus Succiniclasticum (lower in LRFI, p = 0.0011), and others. Diversity measures and functional predictions were also mostly affected by DNA extraction methods, but some pathways showed significant differences between RFI levels (e.g., methylglyoxal degradation, higher in LRFI, p = 0.006). The results suggest that the abundance of some ruminal microbes is associated with feed efficiency and serves as a cautionary tale for the interpretation of results obtained with a single DNA extraction method.
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Free-living amoebae (FLA) are protozoa widely distributed in the environment, found in a great diversity of terrestrial biomes. Some genera of FLA are linked to human infections. The genus Acanthamoeba is currently classified into 23 genotypes (T1-T23), and of these some (T1, T2, T4, T5, T10, T12, and T18) are known to be capable of causing granulomatous amoebic encephalitis (GAE) mainly in immunocompromised patients while other genotypes (T2, T3, T4, T5, T6, T10, T11, T12, and T15) cause Acanthamoeba keratitis mainly in otherwise healthy patients. Meanwhile, Naegleria fowleri is the causative agent of an acute infection called primary amoebic meningoencephalitis (PAM), while Balamuthia mandrillaris, like some Acanthamoeba genotypes, causes GAE, differing from the latter in the description of numerous cases in patients immunocompetent. Finally, other FLA related to the pathologies mentioned above have been reported; Sappinia sp. is responsible for one case of amoebic encephalitis; Vermamoeba vermiformis has been found in cases of ocular damage, and its extraordinary capacity as endocytobiont for microorganisms of public health importance such as Legionella pneumophila, Bacillus anthracis, and Pseudomonas aeruginosa, among others. This review addressed issues related to epidemiology, updating their geographic distribution and cases reported in recent years for pathogenic FLA.
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Bovine leukemia virus (BLV) subclinical infection promotes persistent lymphocytosis (PL), which is related to susceptibility and progression to lymphoma. Moreover, lymphocyte counts directly correlate with BLV antibody titers and proviral load, and cell immune responses are considered atypical due to immune suppression. In order to determine the relationship of PL, antibody titers, and proviral load with interleukin (IL)-12, interferon (IFN)-γ, IL-2, IL-4, IL-10, and transforming growth factor (TGF)-ß expression in a 3-month interval, 58 cows were selected (30 BLV+ and 28 BLV-) from a high-prevalence dairy herd to complete 3 monthly blood samplings for the assessment of PL, BLV antibody titers, BLV proviral load, and IL-12, IFN-γ, IL-2, IL-4, IL-10, and TGF-ß expression. At sampling conclusion, the BLV-infected cows were grouped according to PL, BLV proviral load, and BLV antibody titers as follows: BLV+PL+ (n = 16) and BLV+PL- (n = 14); high proviral load (HPL) (n = 18) and low proviral load (LPL) (n = 13); high antibody titers (HAT) (n = 17) and low antibody titers (LAT) (n = 14). The BLV+PL+ cows showed significantly higher proviral load and antibody titers than the BLV+PL- group; however, the former suggested spread presumably unrelated to lymphoma outcome, because HPL was observed in PL- cows in the last sampling. Consistent with the data, a higher antibody response strongly indicated BLV susceptibility since it was linked to PL+ occurrence and a cytokine profile compatible with immune suppression. Furthermore, a reversion to lower antibody titers was observed in cows with HPL far ahead of time, most likely due to long-term immune suppression. In addition, high expression of IL-10 and TGF-ß was associated with reduced IL-12, IFN-γ, IL-2, and IL-4 expression alongside PL, HAT, and HPL in BLV-infected cows, suggesting an IL-10- and TGF-ß-induced immune suppression. The IL-10 expression was increasing throughout, implying disease progression, as described. In conclusion, the proliferative expansion of lymphocytes known as PL might enhance a regulatory-rich cell population (Bregs and/or Tregs) that secretes IL-10 and TGF-ß, leading to immune suppression. Further studies must be conducted regarding the types of regulatory cells involved in BLV-induced immune suppression.
L'infection subclinique par le virus de la leucémie bovine (BLV) favorise une lymphocytose persistante (PL), qui est liée à la susceptibilité et à la progression vers le lymphome. De plus, le nombre de lymphocytes est directement corrélé aux titres d'anticorps BLV et à la charge provirale, et les réponses immunitaires cellulaires sont considérées comme atypiques en raison de la suppression immunitaire. Afin de déterminer la relation entre PL, les titres d'anticorps et la charge provirale avec l'interleukine (IL)-12, l'interféron (IFN)-γ, l'IL-2, l'IL-4, l'IL-10 et l'expression du facteur de croissance transformant (TGF)-ß dans un intervalle de 3 mois, 58 vaches ont été sélectionnées (30 BLV+ et 28 BLV−) à partir d'un troupeau laitier à forte prévalence pour compléter trois prélèvements sanguins mensuels pour l'évaluation de PL, des titres d'anticorps BLV, de la charge provirale BLV et l'expression d'IL-12, IFN-γ, d'IL-2, d'IL-4, d'IL-10 et TGF-ß. À la fin de l'échantillonnage, les vaches infectées par le BLV ont été regroupées en fonction du PL, de la charge provirale du BLV et des titres d'anticorps du BLV comme suit : BLV+PL+ (n = 16) et BLV+PL− (n = 14); charge provirale élevée (HPL) (n = 18) et charge provirale faible (LPL) (n = 13); titres d'anticorps élevés (HAT) (n = 17) et titres d'anticorps faibles (LAT) (n = 14). Les vaches BLV+PL+ ont montré une charge provirale et des titres d'anticorps significativement plus élevés que le groupe BLV+PL−; cependant, le premier suggère une propagation vraisemblablement sans rapport avec l'issue du lymphome, car HPL a été observé chez les vaches PL− lors du dernier échantillonnage. Conformément aux données, une réponse anticorps plus élevée indiquait fortement une sensibilité au BLV puisqu'elle était liée à l'apparition de PL+ et à un profil de cytokines compatible avec la suppression immunitaire. De plus, un retour à des titres d'anticorps plus faibles a été observé chez les vaches atteintes de HPL bien avant le temps, probablement en raison d'une immunosuppression à long terme. De plus, une expression élevée d'IL-10 et de TGF-ß était associée à une expression réduite d'IL-12, d'IFN-γ, d'IL-2 et d'IL-4 aux côtés de PL, HAT et HPL chez les vaches infectées par le BLV, suggérant une immunosuppression induite par IL-10 et le TGF-ß. L'expression d'IL-10 augmentait tout au long, impliquant une progression de la maladie, comme décrit. En conclusion, l'expansion proliférative des lymphocytes connus sous le nom de PL pourrait renforcer une population de cellules riches en régulation (Bregs et/ou Tregs) qui sécrète d'IL-10 et du TGF-ß, conduisant à une suppression immunitaire. D'autres études doivent être menées sur les types de cellules régulatrices impliquées dans la suppression immunitaire induite par le BLV.(Traduit par Docteur Serge Messier).
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Doenças dos Bovinos , Leucose Enzoótica Bovina , Vírus da Leucemia Bovina , Linfocitose , Animais , Bovinos , Citocinas , Leucose Enzoótica Bovina/epidemiologia , Feminino , Interferon gama/genética , Interleucina-10 , Interleucina-12 , Interleucina-2 , Interleucina-4/genética , Vírus da Leucemia Bovina/fisiologia , Linfocitose/veterinária , Prevalência , Provírus/genética , Fator de Crescimento Transformador beta , Fatores de Crescimento TransformadoresRESUMO
Although bariatric surgery (BS) is recognized as an effective strategy for body weight loss, its impact on cardiorespiratory fitness (CRF) is still unclear. We aimed to examine postoperative changes in CRF (VO2max/peak ) and its relationship with weight loss among adults undergoing BS. We systematically searched the WoS, PubMed, MEDLINE, and Scopus databases. Observational and intervention studies were selected reporting the presurgery and postsurgery CRF, measured by breath-by-breath VO2 or its estimation. Eleven articles (312 patients) revealed that BS leads to a reduction in absolute VO2max/peak in the short term (effect size, ES = -0.539; 95%CI = -0.708, -0.369; p < 0.001), and those patients who suffered a more significant decrease in BMI after BS also had a greater loss of absolute VO2max/peak . However, VO2max/peak relative to body weight increased after surgery (ES = 0.658; 95%CI = 0.473, 0.842; p < 0.001). An insufficient number of studies were found investigating medium and long-term changes in CRF after BS. This study provides moderate-quality evidence that the weight loss induced by BS can reduce CRF in the short term, which represents a therapeutic target to optimize BS outcomes. More high-quality studies are needed to evaluate the impact of BS on VO2max/peak in the short, medium, and long term including normalized values for fat-free mass.
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Cirurgia Bariátrica , Aptidão Cardiorrespiratória , Adulto , Humanos , Período Pós-Operatório , Redução de PesoRESUMO
The rate of suicide attempts among people with substance abuse disorders in the U.S. is six times higher than in the general population. The prevalence of suicidal ideations and attempts continues to increase in Puerto Rico, with a significant incidence in substance-abusing populations. This retrospective cohort study evaluate the suicide profile of 4,347 opioid dependent participants in ASSMCA's methadone center in San Juan, PR, from 2015 to 2018 using questions related to suicidal ideation and attempts included in the admission questionnaire. Participants reporting suicide ideation increase from 8.5% in 2015 to 17.0% in 2018. In 2015 only 7.0% claimed to have had a history of a suicide attempt, increasing to 12.4% in 2018. Our data support the need for screening for suicide risk among substance abusing populations to identify targeted interventions. The identification of high-risk populations for suicide can help during rehabilitation and finding the adequate resources needed.
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Transtornos Relacionados ao Uso de Substâncias , Ideação Suicida , Analgésicos Opioides , Humanos , Porto Rico/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tentativa de SuicídioRESUMO
INTRODUCCIÓN El estudio, que se ubica en la interfaz de los campos del arte, la salud y la cultura, aborda los procesos creadores y las experiencias culturales de personas con padecimientos subjetivos que han recibido diagnósticos en salud mental e integran grupalidades en contextos institucionales. OBJETIVOS Se buscó conocer cómo se expresan y qué continuidades establecen dichos procesos y experiencias estéticas en la vida cotidiana. MÉTODOS Desde una perspectiva socio-crítica, este estudio cualitativo tuvo un diseño exploratorio descriptivo. Se realizaron observaciones y entrevistas en cuatro espacios grupales (música, teatro, radio y experimentación plástica) ofrecidos en un hospital monovalente de la región Centro-Este del país durante el periodo 2022-2023. RESULTADOS Los resultados permitieron reconstruir la diversidad de propuestas grupales promovidas en la institución desde una perspectiva histórica, describir las etapas implicadas en los procesos creadores y, finalmente, ubicar tres dimensiones de transformación de la vida cotidiana en la que esos procesos son apropiados. Una dimensión estética, que se refiere a los sentidos respecto de cómo son vivenciadas estas experiencias y el lugar que ocupa el hacer creador en la vida cotidiana; una dimensión socializante, que ubica sentidos relacionados con la posibilidad de construir vínculos soportes de lo cotidiano; y una dimensión proyectiva, que refleja sentidos vinculados a la ampliación de territorios de participación social y la emergencia de narrativas que permiten localizar perspectivas de futuro en los proyectos de vida. DISCUSIÓN Estos espacios cuentan con una larga trayectoria en la institución. Pueden ubicarse continuidades entre los procesos creadores y la vida cotidiana con potencial de transformación singular, grupal, comunitaria, social y cultural.
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Saúde Mental , CulturaRESUMO
Joint cartilage damage affects 10-12% of the world's population. Medical treatments improve the short-term quality of life of affected individuals but lack a long-term effect due to injury progression into fibrocartilage. The use of mesenchymal stem cells (MSCs) is one of the most promising strategies for tissue regeneration due to their ability to be isolated, expanded and differentiated into metabolically active chondrocytes to achieve long-term restoration. For this purpose, human adipose-derived MSCs (Ad-MSCs) were isolated from lipectomy and grown in xeno-free conditions. To establish the best differentiation potential towards a stable chondrocyte phenotype, isolated Ad-MSCs were sequentially exposed to five differentiation schemes of growth factors in previously designed three-dimensional biphasic scaffolds with incorporation of a decellularized cartilage matrix as a bioactive ingredient, silk fibroin and bone matrix, to generate a system capable of being loaded with pre-differentiated Ad-MSCs, to be used as a clinical implant in cartilage lesions for tissue regeneration. Chondrogenic and osteogenic markers were analyzed by reverse transcription-quantitative PCR and cartilage matrix generation by histology techniques at different time points over 40 days. All groups had an increased expression of chondrogenic markers; however, the use of fibroblast growth factor 2 (10 ng/ml) followed by a combination of insulin-like growth factor 1 (100 ng/ml)/TGFß1 (10 ng/ml) and a final step of exposure to TGFß1 alone (10 ng/ml) resulted in the most optimal chondrogenic signature towards chondrocyte differentiation and the lowest levels of osteogenic expression, while maintaining stable collagen matrix deposition until day 33. This encourages their possible use in osteochondral lesions, with appropriate properties for use in clinical patients.
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Resumen En la literatura académica son muy escasos los esfuerzos en los que se analiza, desde la disciplina de la política pública, a un derecho humano específico. Para este trabajo se analizará el caso de la salud mental como derecho humano en Quintana Roo, México. Para dar cumplimiento a lo anterior, se planteó una metodología de revisión histórico-documental que permitió analizar si existen elementos básicos de política pública en materia de salud mental en Quintana Roo. Entre los resultados se encontró que, si bien ya existe un piso mínimo de política pública, no hay condiciones de infraestructura suficientes para poder considerar a la salud mental como derecho humano. Esto deja abierta la puerta a que este trabajo sea el ápice de la discusión sobre la necesidad de generar políticas públicas enfocadas a generar infraestructura física que permitan, en el mediano y largo plazo, considerar la idea de que la salud mental sea derecho humano.
Abstract An elementary condition of any human right is that once it appears in legislation, the government, be it federal, regional or local, is obliged to provide both legal and political conditions as well as physical infrastructure to guarantee full access and enjoyment of the human right in question. Thus, in the academic literature, the analysis of human rights focuses mainly on those which already have that status (access to education, non-discrimination, political rights, children's rights, indigenous rights, women's rights, political rights, property rights, human rights for older adults), leaving aside those which do not yet have a status as human right, but which it should be, such as mental health, for example. And it is precisely on this topic that this document focuses. From the foregoing, it follows the observation that it is very evident that academic discussions on human rights focus on jurisprudential and jurisdiction issues, however, there are very few articles where these are analyzed from the discipline of public policy, and are stillness where the viability of a right to become a human right is analyzed from a perspective where psychology and public policy are involved. Even though health in its broadest definition considers mental health as one of its components, the reality is that public health policy has prioritized physical health over mental health, which is undoubtedly an operationalization bias. This forces a review of the conditions that exist to elevate mental health as a human right in the state of Quintana Roo in Mexico. In order to comply with the above sentence, a vast documentary review as first carried out, mainly of the World Health Organization (WHO) and its guidelines on the design and implementation of health policy, as well as statistics on the situation of mental health and some mental disorders both in the world and in Mexico. The conceptual part is supported in the discussion of basic concepts of public policy, for example o, transversality. The selection of this concept is due to the fact that theoretically public policies, from their conception as a public problem, through their design and management, to their evaluation, must be aligned both horizontally and vertically, that is, they must be coherent between what is mandated and legislates in the federal, state and municipal order and must be appropriate with other policies of the government order in question. Another important part of the conceptual discussion centers on the definition of the human rights. The proposed methodology involved cabinet and documentary work, both legal and newspaper, and official documents by the Mexican and Quintana Roo government to analyze the legal and policy conditions, mainly the basic elements of transversality, governance and public policies design about mental health in the state of Quintana Roo, Mexico. Among the results, it can be found that although there is already a minimum floor in legal matters at the federal level, even at the state level, even though initiatives have been presented from the government itself and from non-governmental entities, it is difficult to think that in In the short term, there are sufficient political, public policy and infrastructure conditions to position mental health as a human right in Quintana Roo. This leaves the door open for this work to be the apex of the discussion on the need and urgency to generate public policies, both in legal terms, as well as budgetary, administrative, operational, and physical infrastructure that allows for the short, medium, and long term. Consider the idea that mental health is a human right in both Quintana Roo and Mexico.
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OBJECTIVES: To explore a method to create affordable anatomical models of the biliary tree that are adequate for training laparoscopic cholecystectomy with an in-house built simulator. METHODS: We used a fused deposition modeling 3D printer to create molds of Acrylonitrile Butadiene Styrene (ABS) from Digital Imaging and Communication on Medicine (DICOM) images, and the molds were filled with silicone rubber. Thirteen surgeons with 4-5-year experience in the procedure evaluated the molds using a low-cost in-house built simulator utilizing a 5-point Likert-type scale. RESULTS: Molds produced through this method had a consistent anatomical appearance and overall realism that evaluators agreed or definitely agreed (4.5/5). Evaluators agreed on recommending the mold for resident surgical training. CONCLUSIONS: 3D-printed molds created through this method can be applied to create affordable high-quality educational anatomical models of the biliary tree for training laparoscopic cholecystectomy.
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Colecistectomia Laparoscópica/educação , Ducto Cístico/anatomia & histologia , Internato e Residência/métodos , Modelos Anatômicos , Treinamento por Simulação/métodos , Colangiopancreatografia por Ressonância Magnética , Ducto Cístico/diagnóstico por imagem , Ducto Cístico/cirurgia , Humanos , Internato e Residência/economia , Impressão Tridimensional , Treinamento por Simulação/economia , Cirurgiões/educaçãoRESUMO
RESUMEN Introducción: la seguridad de la colonoscopia realizada por cirujanos y el tratamiento de sus complica ciones han sido analizados aisladamente y en escasas publicaciones nacionales. Objetivos: el objetivo principal del estudio fue analizar las colonoscopias realizadas por cirujanos co lorrectales, sus complicaciones y resolución. El objetivo secundario fue comparar los resultados entre un hospital universitario y distintos centros del país dotados de cirujanos colorrectales que habían recibido entrenamiento en una residencia posbásica. Material y métodos: estudio multicéntrico, prospectivo a nivel nacional. Se incluyeron las colonosco pias realizadas entre 2011 y 2016 . Se analizaron como variables las complicaciones, edad, sexo, tipo de endoscopia, diagnóstico, tratamiento, sitio de realización y de entrenamiento del cirujano. Se ex presaron en promedios, porcentajes y rangos. El análisis estadístico consistió en el test exacto ordinal, relaciones y proporciones y exacto de Fisher. Se consideró significancia a p < 0,05. Resultados: de 24 907 procedimientos, 17 283 fueron diagnósticos y 17 202 provenían de centros del interior. Hubo 43 complicaciones (0,17%); 35 específicas: perforaciones (19), hemorragias (8), sín drome pospolipectomía (5) y técnicas (3), diagnosticadas y resueltas por el mismo equipo sin mor bimortalidad. No hubo diferencias en las complicaciones según el centro ni tipo de colonoscopia en incidencia o tratamiento. Todos los cirujanos se entrenaron en residencias de posgrado con programas de entrenamiento en colonoscopia. Conclusiones: existen similares resultados entre cirujanos provenientes de instituciones con residen cia posbásica y centros del interior al realizar colonoscopias. La colonoscopia realizada por cirujanos es un procedimiento seguro y posible de ser adquirido como competencia luego de un entrenamiento formal realizado en una residencia posbásica.
ABSTRACT Introduction: The safety of colonoscopies performed by surgeons and the management of their com plications has not been analyzed in depth in the low number of national publications. Objective: The primary endpoint of this study was to analyze the outcomes of colonoscopies perfor med by colorectal surgeons, in terms of complications. and their resolution. The secondary endpoint was to compare the results between a university hospital and different centers nationwide staffed with colorectal surgeons who had received formal training during a residency program in the surgical subspecialty. Material and methods: We conducted a multicenter, prospective and consecutive national study. The colonscopies performed between 2011 and 2016 were included. The variables analyzed included complications, age, sex, type of endoscopy, diagnosis, treatment, location were the procedure was performed and surgeon's training. The results were expressed as mean, percentage and range. The statistical analysis was performed using Fisher's exact test. A p value < 0.05 was considered statistically significant. Results: A total of 24,907 procedures were performed, 17,283 corresponded to diagnostic colonosco pies and 17,202 were made in provincial centers. Forty-four complications were recorded (0.17%), of which 35 were procedure-related complications: 19 perforations, 8 bleeding events, 5 post-polypec tomy syndromes and three related with the technique; all were diagnosed and solved by the same team without morbidity and mortality. There were no differences in the incidence of complications and how they were treated according to the center or type of colonoscopy. All the surgeons received colonoscopy training during a residency program in the surgical subspecialty. Conclusions: The results obtained in colonoscopies performed by surgeons trained in institutions with residency programs in surgical subspecialties are similar t Safe colonoscopies can be performed by surgeons who have been trained in institutions with a residency program in a surgical subspecialty and with a formal training program in colonoscopy.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Colonoscopia/efeitos adversos , Cirurgia Colorretal/efeitos adversos , Estudos Prospectivos , Cirurgiões/educação , Hemorragia , Hospitais Universitários , Internato e ResidênciaRESUMO
Worldwide, many emerging porcine parvoviruses (PPVs) have been linked to porcine circovirus-2 (PCV2) associated disease (PCVAD), which includes post-weaning multi-systemic wasting syndrome (PMWS), PCV2-related reproductive failure (PCV2-RF), as well as other syndromes. To determine the DNA prevalence of PPVs and their relationship with PMWS and PCV2-RF in Mexico, 170 formalin-fixed paraffin-embedded tissues were selected from archival collections to detect PPVs using a nested polymerase chain reaction. The tissues were composed of 50 PMWS cases, 20 age-matched tissues from healthy pigs, 56 PCV2-related reproductive failure (PCV2+ -RF) cases, and 44 PCV2- -RF cases. Overall, PPV2 and PPV6 were the most prevalent species (90.0% and 74.7%, respectively). In 8-11 week old pigs, the highest prevalence was for PPV6 and PPV3. Concerning reproductive failure, the PCV2-affected farms had a significantly higher prevalence for PPV6 (61.6%) and PPV5 (36.4%) than the PCV2-unaffected farms (35.0% and 5.0%, respectively). The concurrent infection rate was high, being significant for PPV2/PPV4 and PPV1/PPV5 within the PMWS cases and for PPV6/PPV5 among the PCV2+ -RF tissues. PPV5 showed a significant relationship with PMWS, whereas PPV5 and PPV6 were significant for PCVAD. The prevalence and coinfection rate of PPVs in Mexico were markedly higher than that described in other countries, denoting that PPV5 and PPV6 might have a potential role in PCVAD in Mexico. It is concluded that it is likely that the density population of pigs in Mexico is contributing to high PPV inter-species and PCV2 coinfections which might lead to a different pathogenic outcome.
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Infecções por Circoviridae/veterinária , Circovirus/isolamento & purificação , Coinfecção , Infecções por Parvoviridae/veterinária , Parvovirus Suíno/isolamento & purificação , Doenças dos Suínos/virologia , Animais , Infecções por Circoviridae/epidemiologia , Infecções por Circoviridae/virologia , Circovirus/genética , Coinfecção/veterinária , Coinfecção/virologia , DNA Viral/isolamento & purificação , México , Infecções por Parvoviridae/epidemiologia , Infecções por Parvoviridae/virologia , Parvovirus Suíno/genética , Prevalência , Estudos Retrospectivos , Suínos/virologia , Doenças dos Suínos/epidemiologiaRESUMO
In cartilage tissue engineering, biphasic scaffolds (BSs) have been designed not only to influence the recapitulation of the osteochondral architecture but also to take advantage of the healing ability of bone, promoting the implant's integration with the surrounding tissue and then bone restoration and cartilage regeneration. This study reports the development and characterization of a BS based on the assembly of a cartilage phase constituted by fibroin biofunctionalyzed with a bovine cartilage matrix, cellularized with differentiated autologous pre-chondrocytes and well attached to a bone phase (decellularized bovine bone) to promote cartilage regeneration in a model of joint damage in pigs. BSs were assembled by fibroin crystallization with methanol, and the mechanical features and histological architectures were evaluated. The scaffolds were cellularized and matured for 12 days, then implanted into an osteochondral defect in a porcine model (n = 4). Three treatments were applied per knee: Group I, monophasic cellular scaffold (single chondral phase); group II (BS), cellularized only in the chondral phase; and in order to study the influence of the cellularization of the bone phase, Group III was cellularized in chondral phases and a bone phase, with autologous osteoblasts being included. After 8 weeks of surgery, the integration and regeneration tissues were analyzed via a histology and immunohistochemistry evaluation. The mechanical assessment showed that the acellular BSs reached a Young's modulus of 805.01 kPa, similar to native cartilage. In vitro biological studies revealed the chondroinductive ability of the BSs, evidenced by an increase in sulfated glycosaminoglycans and type II collagen, both secreted by the chondrocytes cultured on the scaffold during 28 days. No evidence of adverse or inflammatory reactions was observed in the in vivo trial; however, in Group I, the defects were not reconstructed. In Groups II and III, a good integration of the implant with the surrounding tissue was observed. Defects in group II were fulfilled via hyaline cartilage and normal bone. Group III defects showed fibrous repair tissue. In conclusion, our findings demonstrated the efficacy of a biphasic and bioactive scaffold based on silk fibroin and cellularized only in the chondral phase, which entwined chondroinductive features and a biomechanical capability with an appropriate integration with the surrounding tissue, representing a promising alternative for osteochondral tissue-engineering applications.
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Regeneração Óssea , Engenharia Tecidual/métodos , Animais , Cartilagem , Diferenciação Celular , Condrócitos , Fibroínas , Suínos , Alicerces TeciduaisRESUMO
Articular cartilage injuries remain as a therapeutic challenge due to the limited regeneration potential of this tissue. Cartilage engineering grafts combining chondrogenic cells, scaffold materials, and microenvironmental factors are emerging as promissory alternatives. The design of an adequate scaffold resembling the physicochemical features of natural cartilage and able to support chondrogenesis in the implants is a crucial topic to solve. This study reports the development of an implant constructed with IGF1-transduced adipose-derived mesenchymal stem cells (immunophenotypes: CD105+, CD90+, CD73+, CD14-, and CD34-) embedded in a scaffold composed of a mix of alginate/milled bovine decellularized knee material which was cultivated in vitro for 28 days (3CI). Histological analyses demonstrated the distribution into isogenous groups of chondrocytes surrounded by a de novo dense extracellular matrix with balanced proportions of collagens II and I and high amounts of sulfated proteoglycans which also evidenced adequate cell proliferation and differentiation. This graft also shoved mechanical properties resembling the natural knee cartilage. A modified Bern/O'Driscoll scale showed that the 3CI implants had a significantly higher score than the 2CI implants lacking cells transduced with IGF1 (16/18 vs. 14/18), representing high-quality engineering cartilage suitable for in vivo tests. This study suggests that this graft resembles several features of typical hyaline cartilage and will be promissory for preclinical studies for cartilage regeneration.
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Resumen ANTECEDENTES: La edad es un factor pronóstico en los pacientes con infarto agudo de miocardio. OBJETIVO: Establecer las características y pronóstico de los adultos mayores con tratamiento de reperfusión mecánica. MATERIAL Y MÉTODO: Análisis retrospectivo en que se incluyeron pacientes en el programa Código infarto en los que se instauró tratamiento de reperfusión de enero de 2016 a diciembre de 2017. RESULTADOS: Se incluyeron 1025 pacientes; 15.3% eran mayores de 75 años. El intervalo de edad fue de 33 a 92 años. La mortalidad aumentó de forma exponencial a mayor edad (3.4% de los pacientes ≤ 54 años, 6.1% en los de 55 a 64 años, 9.2% en los de 65 a 75 años y 15.9% en los ≥ 75 años, p < 0.001). En los pacientes mayores de 75 años, la angioplastia primaria fue el método de reperfusión preferido (77.7%), sin encontrar en este grupo de pacientes aumento en el evento vascular cerebral de origen isquémico o hemorrágico. Los mayores de 75 años que padecieron choque cardiogénico tuvieron mortalidad mucho mayor comparada con los más jóvenes (17.6, 28, 33 vs 56%, respectivamente; p < 0.001). CONCLUSIONES: A pesar de los diferentes tratamientos de reperfusión, la mortalidad sigue siendo más elevada en los adultos de edad avanzada, principalmente por múltiples comorbilidades y tasa más alta de disfunción ventricular.
Abstract BACKGROUND: Age is an important prognostic factor in patients with acute myocardial infarction. OBJECTIVE: To establish the characteristics and prognosis of older adults treated with mechanical reperfusion treatment. MATERIAL AND METHOD: A retrospective analysis including patients in the program code myocardial reperfusion treatment was carried out from January 2016 to December 2017. RESULTS: There were included 1025 patients; 15.3% older than 75 years. The age range was of 33 to 92 years. The mortality rate was increasing exponentially with higher age (3.4% in patients ≤ 54 years, 6.1% in the group of 55 to 64 years, 9.2% in the group of 65 to 75 years and 15.9% in ≥ 75 years, p < 0.001). In patients older than 75 years, primary angioplasty was the preferred method of reperfusion (77.7%), without finding in this group of patients an increase in the ischemic or hemorrhagic cerebral vascular event. Patients older than 75 years who develop cardiogenic shock had a much higher mortality compared with the younger (17.6%, 28%, 33% vs 56%, respectively; p < 0.001). CONCLUSIONS: Despite the different treatments of reperfusion, mortality remains higher in older adults, mainly by multiple comorbidities and a higher rate of ventricular dysfunction.
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Little is known about the prevalence of Balamuthia mandrillaris within the environment due to its difficult isolation, but once an axenic culture is established, it is relatively easy to maintain. As most of the time researchers are interested mainly in isolating B. mandrillaris from environmental samples, the flora that accompanies it becomes second in importance. Therefore, this study aimed to determine which potentially pathogenic free-living amoebae, in addition to B. mandrillaris, could be found co-inhabiting a source of natural thermal water called "Agua Caliente" (Mexico), where this amoeba has previously been detected twice by molecular methods. A third sampling from this same source was carried out to try to isolate B. mandrillaris and other free-living amoebae using 37 and 45⯰C as isolation temperatures. For PCR techniques, specific primers were used for B. mandrillaris, Naegleria fowleri, and Acanthamoeba species, plus a universal primer set for the eukaryotic 18S SSU rRNA gene for other isolated amoebae. PCR products were sequenced for final identification. 42 strains of the primary isolate were obtained, but only 34 could be kept in culture. Of them, 23 strains were identified as Naegleria lovaniensis, eight strains as Acanthamoeba jacobsi, two strains as Stenamoeba sp. and only one was identified as Vermamoeba vermiformis. The isolation of B. mandrillaris was once again not successful, but the presence of potentially pathogenic and nonpathogenic free-living amoebae is reported for the first time in this type of water in Mexico thanks to molecular methodology.
Assuntos
Amoeba/patogenicidade , Fontes Termais/parasitologia , Acanthamoeba/classificação , Acanthamoeba/genética , Acanthamoeba/isolamento & purificação , Acanthamoeba/patogenicidade , Amoeba/classificação , Amoeba/genética , Amoeba/isolamento & purificação , Balamuthia mandrillaris/classificação , Balamuthia mandrillaris/genética , Balamuthia mandrillaris/isolamento & purificação , Balamuthia mandrillaris/patogenicidade , DNA de Protozoário/química , DNA de Protozoário/isolamento & purificação , Genótipo , Fontes Termais/química , Concentração de Íons de Hidrogênio , México , Naegleria fowleri/classificação , Naegleria fowleri/genética , Naegleria fowleri/isolamento & purificação , Naegleria fowleri/patogenicidade , Filogenia , Reação em Cadeia da Polimerase , Espectrofotometria , TemperaturaRESUMO
Abstract: Background: Primary percutaneous coronary intervention (PPCI) is the treatment of choice for acute ST-elevation myocardial infarction (STEMI). The delays associated with PPCI reduce the benefits of this therapy. To minimize these delays, the pharmacoinvasive strategy (PS) was developed, consisting of applying thrombolytic therapy followed by coronary angioplasty 2 to 24 hours after. Objective: To compare the safety and efficiency of PPCI vs PS in STEMI. Methods: We included patients with STEMI who had emergency PCI. The primary endpoint was combined major adverse cardiac events (MACE), death, reinfarction, stroke, target vessel revascularization (TVR) during hospitalization. The secondary endpoints were the individual components of MACE, and major bleeding (Bleeding Academic Research Consortium: BARC ≥ 3). Results: A total of 400 patients, 263 (65.8%) for PPCI group, 114 (28.5%) for PS group and 23 (5.75%) for diagnostic group. The PS group, 79 (69.3%) were then categorized as systematic angioplasty having had a successful thrombolysis, and 35 (30.7%) were rescue angioplasty because they had a failed thrombolysis. There were no differences in MACE: 13 (9.5%) patients in PS and 27 (10.3%) patients in the PPCI (p = 0.806), there were no differences in the individual components of MACE. The rate of major bleeding was the same, 5 (3.6%) and 4 (1.5%) respectively (p = 0.173). The multivariate analysis did not show a relationship between MACE and the reperfusion strategy. Conclusions: The pharmacoinvasive strategy when compared to PPCI has a similar rate of primary and secondary endpoints. There is no increase in major bleeding therefore, it is an important strategy that offers a reperfusion therapy for patients with STEMI in a non-PCI capable hospital.(AU)
Resumen: Antecedentes: La intervención coronaria percutánea primaria (ICPP) es el tratamiento de elección en infarto agudo al miocardio con elevación del ST (IAMCEST). El retraso relacionado con ICPP disminuye el beneficio. Buscando una reperfusión oportuna se implementa la estrategia farmacoinvasiva (EFI), que consiste en realizar trombólisis seguido de ICP entre 2 a 24 horas después. Objetivo: Comparar la seguridad y eficacia en pacientes sometidos a ICPP contra EFI en IAMCEST. Métodos: Se incluyeron pacientes con IAMCEST sometidos a ICP emergente. El punto final primario son eventos cardiacos adversos mayores (ECAM), muerte, reinfarto, evento vascular cerebral y revascularización del vaso tratado, durante la hospitalización. Los puntos finales secundarios son la presencia de los componentes individuales del ECAM, y el sangrado mayor (BARC ≥ 3). Resultados: Se estudiaron 400 pacientes, 263 (65.8%) de ICPP, 114 (28.5%) a EFI y 23 (5.75%) angiografía diagnóstica. Del grupo EFI, 79 (69.3%) fueron angioplastia sistemática por trombólisis exitosa y 35 (30.7%) por angioplastia de rescate por trombólisis fallida. No se observó diferencia en la frecuencia de ECAM: EFI 13 (9.5%) contra ICPP 27 (10.3%) respectivamente (p = 0.806), tampoco hubo diferencia en los componentes individuales. No se observó diferencia en sangrado mayor, 5 (3.6%) vs 4 (1.5%), (p = 0.173). El análisis multivariado no relacionó la estrategia de reperfusión con los ECAM. Conclusiones: La EFI comparada con ICPP demuestra una tasa similar de ECAM, así como de sus componentes individuales. No se asocia con aumento de hemorragia mayor, concluyendo que ofrece el beneficio de una reperfusión oportuna sin aumento del riesgo en los hospitales que no tienen la capacidad para realizar ICPP.(AU)