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BACKGROUND: Invasive pneumococcal diseases (IPD) are associated with high morbidity, mortality, and health costs worldwide, particularly in Latin America and the Caribbean (LAC). Surveillance about the distribution of serotypes causing IPD and the impact of pneumococcal vaccination is an important epidemiological tool to monitor disease activity trends, inform public health decision-making, and implement relevant prevention and control measures. OBJECTIVES: To estimate the serotype distribution for IPD and the related disease burden in LAC before, during, and after implementing the pneumococcal vaccine immunization program in LAC. METHODS: Systematic literature review following Cochrane methods of studies from LAC. We evaluated the impact of the pneumococcal vaccine on hospitalization and death during or after hospitalizations due to pneumococcal disease and serotype-specific disease over time. We also analyzed the incidence of serotyped IPD in pneumococcal conjugate vaccine PCV10 and PCV13. The protocol was registered in PROSPERO (ID: CRD42023392097). RESULTS: 155 epidemiological studies were screened and provided epidemiological data on IPD. Meta-analysis of invasive diseases in children <5 years old found that 57%-65% of causative serotypes were included in PCV10 and 66%-84% in PCV13. After PCV introduction, vaccine serotypes declined in IPD, and the emergence of non-vaccine serotypes varied by country. CONCLUSIONS: Pneumococcal conjugate vaccines significantly reduced IPD and shifted serotype distribution in Latin America and the Caribbean. PCV10/PCV13 covered 57-84% of serotypes in children under 5, with marked decline in PCV serotypes post-vaccination. Continuous surveillance remains crucial for monitoring evolving serotypes and informing public health action.
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Infecções Pneumocócicas , Vacinas Pneumocócicas , Sorogrupo , Streptococcus pneumoniae , Humanos , América Latina/epidemiologia , Região do Caribe/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Infecções Pneumocócicas/imunologia , Vacinas Pneumocócicas/imunologia , Vacinas Pneumocócicas/uso terapêutico , Streptococcus pneumoniae/imunologia , Streptococcus pneumoniae/classificação , Vacinação , Efeitos Psicossociais da Doença , IncidênciaRESUMO
Cultural heritage has become a keystone for comprehending our society, as it represents and reflects our origins, passions, beliefs and traditions. Furthermore, it provides fundamental information about specific temporary spaces, materials' availability, technology, artist's intention, and site weather conditions. Our aim was to develop a multidisciplinary approach with a main focus on investigating two Italian large-format paintings located in highly diverse environments such as the National Theater of Costa Rica. We monitored environmental conditions and quantified fungal aerial spores. Then, we determined regions of possible biodeterioration with the software MicroorganismPattern and used the software PigmentArrangement to elucidate the apparent colour of the paintings based on distribution and arrangement of the pigment crystals. Finally, we characterized eight genera of calcareous nannofossils found in the ground layers of the artwork. The former Men's Canteen at the National Theater of Costa Rica presented a mean air temperature of 23.5 [Formula: see text]C, a relative humidity of 72.7% and a concentration of CO[Formula: see text] of 570 ppm. The fungal aerial concentration was 1776 spores/m[Formula: see text]. The software MicroorganismPattern identified 32 sampling regions, out of which 11 were positive for microbial contamination. The software PigmentArrangement determined that the blue crystals (ultramarine pigment) had the shortest distances between themselves (29 [Formula: see text]m). Finally, the nanofossils identified enabled us to restrict the age of the material to a biostratigraphic interval ranging from Coniacian to Maastricthian ages. By using a multidisciplinary approach we were able to explore the diptych, suggest a set of minimally invasive perspectives in tropical environments to be used worldwide and obtain key information about the artist's artistic process, materials used along with better understand its state of conservation.
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Introducción: La hipoxia intermitente consiste en la administración de aire reducido en oxígeno por episodios, para lograr hipoxia en sangre, alternados con intervalos de normoxia. Tiene uso terapéutico en varias patologías médicas, pero sus efectos psiquiátricos no han sido estudiados. Se han descrito efectos neurogénicos y en modelos animales puede ayudar a prevenir depresión y ansiedad en respuesta al estrés. Objetivo: Determinar la existencia de efectos psiquiátricos de la hipoxia normobárica intermitente en seres humanos. Método: Estudio prospectivo descriptivo. Se incluyeron pacientes mayores de 18 años, que tuvieran programado un plan de hipoxia normobárica intermitente en la clínica Hipoxykine. Se utilizó una ficha de registro y la escala breve de síntomas (BSI) que fue realizada al inicio, mitad (segunda semana) y finalizado el tratamiento (cuarta semana). Resultados: Se incluyeron 22 participantes (50% mujeres) con una mediana de edad de 46 años. Hubo una reducción del índice global de gravedad del BSI estadísticamente significativo (p <0.05) al comparar tanto la primera como la segunda medición respecto a la final. Respecto al análisis según género, esta diferencia fue estadísticamente significativa (p <0.05) en hombres. Conclusiones: La hipoxia normobárica intermitente no produce ni empeora síntomas psiquiátricos y podría tener potencial terapéutico. Se requieren nuevos estudios prospectivos.
Introduction: Intermittent normobaric hypoxia consists of the administration of air reduced in oxygen by episodes, to achieve hypoxia in blood alternated with intervals of normoxia. It has a role in brain development and neuroprotection. However, in the literature there are only studies in animal models. Objective: To determine the existence of psychiatric effects of intermittent normobaric hypoxia in humans. Method: Prospective descriptive study. We included patients over 18 years of age who had an intermittent normobaric hypoxia plan scheduled at the Hipoxykine clinic. A record sheet and the brief symptom inventory (BSI) were carried out at the beginning, middle (second week) and end of treatment (fourth week). Results: We included 22 participants (50% women) with a median age of 46 years. There was a reduction in the overall severity index of the statistically significant (p <0.05) when comparing both the first and second measurements with respect to the final. Regarding the analysis according to gender, this difference was statistically significant (p <0.05) in men. Conclusions: Intermittent normobaric hypoxia does not produce or worsen psychiatric symptoms. It could have therapeutic potential. Further prospective studies are required.
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AIM: The aim of this study was to evaluate the efficacy and safety of tiapride compared to topiramate as a prophylactic in chronic migraine. PATIENTS AND METHODS: The study was conducted under randomised and double blind conditions. A total of 56 patients aged 18-65 years with chronic migraine were assigned to two treatment arms: tiapride, 100 mg twice daily, or topiramate, 25 mg twice daily, for 12 weeks. The primary endpoint was the change in the monthly average number of migraine days. In addition, measurements were performed to determine the change in the monthly number of headache days, the percentage of subjects with >50% and >75% decrease in their monthly migraine days, and the change in headache impact as measured by the Headache Impact Test-6. RESULTS: The intention-to-treat population included 39 subjects (tiapride = 21; topiramate = 18), 35 of whom (tiapride = 18; topiramate = 16) completed the trial. The tiapride group had a mean reduction of 7.2 ± 7.5 migraine days per month compared to 7.6 ± 5.8 for the topiramate group (p = 0.86). As with the other efficacy variables measured, no differences were found between the two groups. Adverse side effects were mild in both groups. CONCLUSION: In patients with chronic migraine, tiapride was found to be an effective, safe and well-tolerated prophylactic treatment when compared to topiramate.
TITLE: Comparación de la tiaprida y el topiramato en el tratamiento profiláctico de la migraña crónica: estudio piloto, aleatorizado y doble ciego.Objetivo. Evaluar la eficacia y la seguridad de la tiaprida en comparación con el topiramato en la profilaxis de la migraña crónica. Pacientes y métodos. Es un estudio aleatorizado y doble ciego. Un total de 56 pacientes de 18 a 65 años con migraña crónica fueron asignados a dos brazos de tratamiento: tiaprida, 100 mg dos veces al día, o topiramato, 25 mg dos veces al día, durante 12 semanas. El criterio de valoración principal fue el cambio en el promedio mensual de días de migraña. Además, se midió el cambio en el número mensual de días de cefalea, el porcentaje de sujetos con disminución > 50% y > 75% de sus días de migraña mensual, y el cambio del impacto de la cefalea medido por el Headache Impact Test-6. Resultados. La población por intención de tratar incluyó a 39 sujetos (tiaprida = 21; topiramato = 18) y completaron el ensayo 35 participantes (tiaprida = 18; topiramato = 16). El grupo con tiaprida tuvo una reducción media de 7,2 ± 7,5 días con migrañas por mes en comparación con 7,6 ± 5,8 para el grupo con topiramato (p = 0,86). Al igual que en las otras variables de eficacia medidas, no hubo diferencias significativas entre ambos grupos. Los efectos adversos fueron leves en ambos grupos. Conclusión. En pacientes con migraña crónica, la tiaprida demostró ser un tratamiento profiláctico eficaz, seguro y bien tolerado, al compararla con el topiramato.
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Transtornos de Enxaqueca , Cloridrato de Tiaprida , Método Duplo-Cego , Frutose/uso terapêutico , Cefaleia , Humanos , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/prevenção & controle , Projetos Piloto , Cloridrato de Tiaprida/uso terapêutico , Topiramato/uso terapêutico , Resultado do TratamentoRESUMO
Plants, as sessile organisms, have adapted a fine sensing system to monitor environmental changes, therefore allowing the regulation of their responses. As the interaction between plants and environmental changes begins at the surface, these changes are detected by components in the plasma membrane, where a molecule receptor generates a lipid signaling cascade via enzymes, such as phospholipases (PLs). Phospholipids are the key structural components of plasma membranes and signaling cascades. They exist in a wide range of species and in different proportions, with conversion processes that involve hydrophilic enzymes, such as phospholipase-C (PLC), phospholipase-D (PLD), and phospholipase-A (PLA). Hence, it is suggested that PLC and PLD are highly conserved, compared to their homologous genes, and have formed clusters during their adaptive history. Additionally, they generate responses to different functions in accordance with their protein structure, which should be reflected in specific signal transduction responses to environmental stress conditions, including innate immune responses. This review summarizes the phospholipid systems associated with signaling pathways and the innate immune response.
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Polycyclic aromatic hydrocarbons (PAHs) are organic compounds generated mainly by anthropogenic sources. They are considered toxic to mammals, since they have carcinogenic, mutagenic and genotoxic properties, among others. Although mycoremediation is an efficient, economical and eco-friendly technique for degrading PAHs, the fungal degradation potential of the phylum Ascomycota has not been widely studied. In this work, we evaluated different fungal strains from the polluted soil of 'La Escondida' lagoon in Reynosa, Mexico to know their potential to degrade phenanthrene (PHE). Forty-three soil isolates with the capacity to grow in the presence of PHE (0·1% w/v) were obtained. The fungi Aspergillus oryzae MF13 and Aspergillus flavipes QCS12 had the best potential to degrade PHE. Both fungi germinated and grew at PHE concentrations of up to 5000 mg l-1 and degraded 235 mg l-1 of PHE in 28 days, with and without an additional carbon source. These characteristics indicate that A. oryzae MF13 and A. flavipes QCS12 could be promising organisms for the remediation of sites contaminated with PAHs and detoxification of recalcitrant xenobiotics.
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Ascomicetos/metabolismo , Aspergillus oryzae/metabolismo , Aspergillus/metabolismo , Biodegradação Ambiental , Fenantrenos/metabolismo , Poluentes do Solo/metabolismo , Aspergillus/isolamento & purificação , Aspergillus oryzae/isolamento & purificação , México , Hidrocarbonetos Policíclicos Aromáticos/metabolismo , Solo/química , Microbiologia do Solo , Xenobióticos/metabolismoRESUMO
Signal transduction in plants determines their successful adaptation to diverse stress factors. Our group employed suspension cells to study the phosphoinositide pathway, which is triggered by aluminium stress. We investigated about members of the PI-specific phospholipase C (PLC) family and evaluated their transcription profiles in Coffea arabica (Ca) suspension cells after 14days of culture when treated or not with 100µM AlCl3. The four CaPLC1-4 members showed changes in their transcript abundance upon AlCl3 treatment. The expression profiles of CaPLC1/2 exhibited a rapid and transitory increase in abundance. In contrast, CaPLC3 and CaPLC4 showed that transcript levels were up-regulated in short times (at 30s), while only CaPLC4 kept high levels and CaPLC3 was reduced to basal after 3h of treatment. CaPLC proteins were heterologously expressed, and CaPLC2 and CaPLC4 were tested for in vitro activity in the presence or absence of AlCl3 and compared to Arabidopsis PLC2 (AtPLC2). A crude extract was isolated from coffee cells. CaPLC2 showed a similar inhibition (30%) as in AtPLC2 and in the crude extract, while in CaPLC4, the activity was enhanced by AlCl3. Additionally, we visualized the yellow fluorescent protein PH domain of human PLCδ1 (YFP-PHPLCδ1) subcellular localization in cells that were treated or not with AlCl3. In non-treated cells, we observed a polar fluorescence signal towards the fused membrane. However, when cells were treated with AlCl3, these signals were disrupted. Finally, this is the first time that PLC activity has been shown to be stimulated in vitro by AlCl3.
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Alumínio/toxicidade , Coffea/efeitos dos fármacos , Coffea/enzimologia , Proteínas de Plantas/metabolismo , Fosfolipases Tipo C/metabolismo , Arabidopsis , Coffea/genética , Perfilação da Expressão Gênica , Humanos , Proteínas de Plantas/genética , Transdução de Sinais , Estresse Fisiológico , Fosfolipases Tipo C/genéticaRESUMO
Helicobacter pylori (H. pylori) eradication using standard triple therapy (STT) with proton pump inhibitors (PPI), amoxicillin and clarithromycin (CLA) has been the standard in Latin America. However, CLA resistance is a rising problem affecting eradication rates. Genetic polymorphisms of CYP2C19, a PPI metabolizer may also affect eradication. The primary aims of this study were to evaluate the effect of clarithromycin resistance on H. pylori eradication in a population from Santiago, and to establish the pooled clarithromycin resistance in Santiago, Chile. Symptomatic adult patients attending a tertiary hospital in Santiago were recruited for this study. CLA resistance and the polymorphisms of CYP2C19 were determined on DNA extracted from gastric biopsies, using PCR. The STT was indicated for 14 days and eradication was determined by a urea breath test 4-6 weeks after therapy. A meta-analysis of CLA resistance studies among adult residents in Santiago was performed. Seventy-three out of 121 consecutive patients had positive rapid urease test (RUT) and received STT. Sixty-nine patients (95%) completed the study. The H. pylori eradication rate was 63% and the prevalence of CLA resistance was 26%. According to the CYP2C19 polymorphisms, 79.5% of the RUT-positive patients were extensive metabolizers. Multivariable analyses showed that only CLA resistance was significantly and inversely associated with failure of eradication (OR: 0.13; 95% confidence interval [95% CI], 0.04-0.49). A meta-analysis of two previous studies and our sample set (combined n = 194) yielded to a pooled prevalence of CLA resistance of 31.3% (95% CI 23.9-38.7). Our study shows that CLA resistance is associated with failure of H. pylori eradication. Given the high pooled prevalence of CLA resistance, consideration of CLA free therapies in Santiago is warranted. We could recommend bismuth quadruple therapy or high-dose dual therapy, according to bismuth availability. Further studies need to evaluate the best therapy.
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Antibacterianos/farmacologia , Claritromicina/farmacologia , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori/efeitos dos fármacos , Adulto , Bismuto/uso terapêutico , Chile/epidemiologia , Estudos de Coortes , Farmacorresistência Bacteriana/efeitos dos fármacos , Feminino , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos ProspectivosRESUMO
Mainstream among topological insulators, GaSb/InAs quantum wells present a broken gap alignment for the energy bands which supports the quantum spin Hall insulator phase and forms an important building block in the search of exotic states of matter. Such structures allow the band-gap inversion with electrons and holes confined in adjacent layers, providing a fertile ground to tune the corresponding topological properties. Using a full 3D eight-band [Formula: see text] method we investigate the inverted band structure of GaSb/InAs/GaSb and InAs/GaSb/InAs multilayers and the behavior of the helical edge states, under the influence of an electric field applied along the growth direction. By tuning the electric field modulus, we induce the change of the energy levels of both conduction and valence bands, resulting in a quantum spin Hall insulator phase where the helical edge states are predominantly confined in the GaSb layer. In particular, we found that InAs/GaSb/InAs has a large hybridization gap of about [Formula: see text] and, therefore, are promising to observe massless Dirac fermions with a large Fermi velocity. Our comprehensive characterization of GaSb/InAs multilayers creates a basis platform upon which further optimization of III-V heterostructures can be contrasted.
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Resumen Los estudios a nivel regional que evalúan las dinámicas espacio-temporales de la vegetación en Costa Rica, especialmente, dentro de los Parques Nacionales son escasos. Así, considerando aportar en este vacío de conocimiento, este artículo analiza la distribución espacio-temporal de la vegetación dentro del periodo 1960-1976, 1992, 1997 y 2012 en Parque Nacional Corcovado, localizado en la Península de Osa y catalogado como el bosque tropical lluvioso más septentrional en la costa pacífica de América. Además, esta área contiene una riqueza de biodiversidad, fundamentada en su antigüedad geológica, el aislamiento que presentó durante largos periodos; así como las condiciones climáticas particulares que generan ecosistemas únicos como bosques nubosos relacionados con brisa marina a alturas de más de 500 msnm. Este estudio evalúa la distribución espacial de la vegetación a partir de mapas resultantes del proceso de fotointerpretación de imágenes del 1960, 1976, 1997 y 2012, así como del análisis del índice de paisaje. Se concluye que las transformaciones espacio-temporales de la vegetación durante el periodo de estudio han sido mínimas, y el hecho de que hayan sido escasas las áreas impactadas por la actividad antrópica, generó una restauración ecológica importante durante las últimas décadas. Se encontró una relación de expansión y contracción entre el bosque nuboso y bosque, así como este último y el bosque inundado, en función de la recuperación de la cobertura boscosa dentro del Parque Nacional y de la Península de Osa, y el volumen y distribución de la precipitación. Asimismo, este estudio propone la necesidad de establecer el monitoreo permanente de la vegetación para esclarecer las relaciones que se establecen entre estos tipos de vegetación.
Abstract Regional studies evaluating spatial-temporal transformations of vegetation in Costa Rica, especially within National Parks, are scarce. Therefore, this paper analyses the vegetation distribution during 1960, 1976, 1997 and 2014 in Corcovado National Park. This protected area is located in the Osa Peninsula, Costa Rica, and represents the Northern most tropical rain forest on the Pacific coast of America. This area offers a great wealth of biodiversity due to its geological formation, isolation for long time periods, and its particular climatic conditions that generate unique ecosystems such as cloud forests associated with ocean situated close to hill breezes located over 500 masl, as well as dense tropical forest. This study evaluates the spatial distribution of vegetation based on maps that resulted from the process of photo-interpretation of 1960, 1976, 1997 and 2012, as well as from the landscape index analysis. It concludes that during the study period, the vegetation changes have been minimal. Instead, in the few areas impacted by human activity (small-scale agriculture and pasture lands) an ecological restoration has occurred during recent decades. In addition, this research suggests that the recovering forest cover within the park and even within the Osa Peninsula has been expanding the cloud forest. An increase and contraction relationship between the different categories (Cloud forest and forests as well of flooded forest and forest in flat zones) was found. Furthermore, this study suggests the need of permanent plots in order to monitor vegetation and identify the factors that explain this previous process. Rev. Biol. Trop. 66(1): 352-367. Epub 2018 March 01.
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BACKGROUND: Early steroid withdrawal (ESW) can improve lipid and hemodynamic profiles without severe acute rejection (AR) events in renal transplant patients. Our objective was to evaluate the effects of ESW on the frequency and severity of AR. METHODS: A randomized, open-label, controlled clinical trial was performed on renal transplant recipients with a follow-up of 12 months. In the ESW group, patients were selected for corticosteroid treatment withdrawal on the fifth day post transplantation. In the Control group, patients continued with steroid treatment. All patients were over 18 years of age with panel reactive antibody (PRA) class I and II HLA <20%. RESULTS: In total, 71 patients, 37 in the ESW group (52.1%) and 34 in the Control group (47.9%), had comparable AR incidences at the end of the follow-up (16% vs 15%) (NS) (RR = 1.20, 95% CI = 0.32-3.33). Although renal graft survival was similar between the ESW and Control groups (87% vs 94%), renal function was superior in the ESW group (85 vs 75 mL/min). Additionally, hypertension was less frequent in the ESW group (3% vs 35%), requiring the use of fewer antihypertensives (8% vs 50%). CONCLUSIONS: ESW was also associated with better blood pressure control and similar AR risk. The ESW group exhibited stable renal function.
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Rejeição de Enxerto/prevenção & controle , Sobrevivência de Enxerto/efeitos dos fármacos , Transplante de Rim/efeitos adversos , Esteroides/administração & dosagem , Suspensão de Tratamento , Adulto , Feminino , Rejeição de Enxerto/imunologia , Humanos , Transplante de Rim/métodos , Doadores Vivos , Masculino , México , Pessoa de Meia-Idade , Esteroides/efeitos adversos , Resultado do TratamentoRESUMO
Latex or natural rubber latex is a processed plant-based product, extracted from the tropical tree Hevea Brasiliensis. This raw material is widely used in about 40.000 medical and daily-used products. Latex allergy is a relevant pathology in surgical environments that arose after the establishment of universal precautions during the nineties. Risk groups include health-care workers and children with spine bifida who have a prevalence ranging between 2.9-17 percent and 30-70 percent, respectively. Latex allergy occurs in a variety of ways in health facilities including hypersensitivity reaction type IV or type I. In the former, chemical substances added to latex trigger the allergic reactions; where allergic dermatitis is the most-frequently found case. In the latter, the reactions are triggered by the contact with latex proteins causing from urticarial to anaphylactic shock and death. Diagnosis of latex allergy is based on a clinical history and/or physical examination associated with a confirmatory test as prick test (latex allergy type I) or cutaneous patches (latex allergy type IV). Nowadays, there is no definitive cure for the latex allergy and its treatment is based on allergen avoidance.
El látex o caucho natural es un producto vegetal procesado que se obtiene a partir del árbol tropical Hevea Brasiliensis. Esta materia prima es ampliamente usada, estando presente en hasta 40.000 productos médicos y de uso diario. La alergia al látex es una patología relevante en el ámbito quirúrgico, que surgió posterior a la instauración de las precauciones universales en la década del 90. Dentro de los grupos de riesgo se encuentran trabajadores de la salud y pacientes con espina bífida con una prevalencia que oscila entre 2,9 a 17 por ciento y 30 a 70 por ciento, respectivamente. La presentación clínica de alergia al látex tiene un espectro amplio, pudiendo presentarse como reacciones por hipersensibilidad tipo IV o tipo I. En el primer grupo, las reacciones son gatilladas por los químicos adicionados al látex, siendo la dermatitis alérgica de contacto su presentación más frecuente. En el segundo grupo, las reacciones son secundarias al contacto con proteínas del látex, pudiéndose manifestar desde urticaria hasta shock anafiláctico y muerte. El diagnóstico de alergia al látex se basa en una historia clínica y/o examen físico compatible asociado a un examen confirmatorio, como el prick test (alergia al látex tipo I) y el parche cutáneo (alergia al látex tipo IV). Actualmente no existe una cura definitiva para la alergia al látex y su tratamiento se basa en evitar la exposición al alérgeno.
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Humanos , Hipersensibilidade ao Látex/diagnóstico , Hipersensibilidade ao Látex/epidemiologia , Hipersensibilidade ao Látex/terapia , Período Perioperatório , Fatores de RiscoRESUMO
Se da a conocer el "Premio Espíritu de la Escuela de Enfermería", transcurrido 25 años de su creación, y el significado que ha tenido en quienes lo han recibido. Para ello se realizó un estudio exploratorio a través de una encuesta que se envió vía online a los 25 egresados premiados, invitándolos a responderla en forma voluntaria. Los resultados muestran que se sintieron honrados y orgullosos con el premio y, a la vez, con la responsabilidad y compromiso de representar los valores que destaca este reconocimiento. Relacionan el significado del premio con su ser como persona, con la vocación de servicio, el liderazgo y trabajo en equipo, con la responsabilidad de perfeccionarse en forma continua para otorgar cuidados de excelencia, y el compromiso con la formación de alumnos y pares. Respecto a las acciones que habitualmente realizan, y que dan cuenta de los valores que destaca el premio, mencionan en forma prioritaria el cuidado de enfermería integral, respetuoso, empático, amoroso y esperanzador hacia los pacientes y sus familiares. Entre las acciones que reflejan su compromiso social nombran las actividades de voluntariado, el trabajo en el sector público, la participación en programas de salud innovadores, y el apoyo a la formación de alumnos y pares. Asimismo, incluyen la investigación en áreas que promueven el mejoramiento de la salud y las políticas públicas dirigidas a poblaciones vulnerables, la apertura de nuevos escenarios para enfermería, los aportes a la equidad y las iniciativas para mejorar los cuidados y el sistema de salud, en general. Finalmente, expresan su interés en mantener los vínculos con la escuela y sugieren una variedad de estrategias para reforzar la formación en valores de los estudiantes de enfermería.
It discloses the "Spirit Award from the School of Nursing," after 25 years of its creation, and the meaning it has had on those who have received it. A survey was sent online via to the 25 graduates that won it, inviting them to voluntarily answer. The results show that felt honored with the prize and received it with great pride and, at the same time, with the responsibility and commitment to represent the values that enhance this recognition. They relate the significance of the award with their being as a person and with the vocation of service, leadership and teamwork, continuous improvement for responsibility of providing care of excellence and commitment to the training of students and peers. Regarding the actions they usually perform, and which account for the values that emphasizes the award, mentioned as a priority comprehensive, respectful, empathetic, loving and hopeful nursing care towards patients and family. Among the actions that reflect their social commitment named volunteer activities, working in the public sector, participation in innovative health programs, and support for the training of students and peers. They also include research in areas that promote improvement in health and public policies aimed at vulnerable populations, opening new scenarios for nursing, equity contributions and efforts to improve care and the health system in general. Finally, they express an interest in maintaining links with the school and suggest a variety of strategies to strengthen the teaching of values to nursing students.
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Humanos , Distinções e Prêmios , Educação em Enfermagem/história , Enfermagem , Enfermeiras e EnfermeirosRESUMO
OBJETIVOS: describir el comportamiento epidemiológico de pacientes con diagnóstico presuntivo de leptospirosis en el departamento del Tolima (Colombia), entre 2009 y 2011. METODOLOGIA: estudio descriptivo transversal. Se analizaron variables epidemiológicas, clínicas y de laboratorio de 243 pacientes con diagnóstico presuntivo de leptospiroris, utilizando los criterios de FAINE modificado. RESULTADOS : se encontraron 48 casos con diagnóstico presuntivo positivo (19,8%), 87 casos negativos (35,8%) y 108 casos no concluyentes (44%). El icterohemorrágico fue el serovar más frecuente entre los presuntamente positivos, con una edad promedio de aparición de la enfermedad de 37 años, se presentó principalmente en hombres (87%), residentes de zona urbana, con deficiencia de servicios públicos (80,9%). El tratamiento hospitalario fue necesario para el 87,6% de los pacientes, se encontraron casos en forma aguda (91%),conalteración hepática (65,9%); la mortalidad fue del 19%. CONCLUSIONES la leptospirosis es una patología con diferentes características demográficas y clínicas, con un diagnóstico difícil y en ocasiones tardío; si se tuviera un registro adecuado de algunas características en las fichas podría hacerse un diagnóstico presuntivo a priori.Se presentó asociación entre el diagnóstico presuntivo de leptospiroris y laborar en ambiente abierto, residir en condiciones sanitarias deficientes, presentar dolor en las pantorrillas y presentar fiebre.
OBJECTIVE:: To describe the epidemiological behavior of patients with presumptive diagnosis of leptospirosis in department of Tolima (Colombia), between 2009 and 2011. METHODOLOGY A cross sectional study was carried out. Epidemiological, clinical and laboratory findings of 243 patients with presumptive leptospiroris, utilizing modified FAINE criteria were analyzed. RESULTS : There were 48 cases with presumptive diagnosisof leptospirosis (19.8%), 87 negative cases (35.8%) and 108 inconclusive cases (44%). The icterohaemorrhagiaewas the serovarmost common among presumptive positive, most patients were male (87%), with the mean age of 37years, residents of urban areas, with deficient public services (80.9%). Hospital treatment was required in 87.6% of patients;there were acute cases of the disease (91%), hepatic impairment (65.9%), 19% of the patients died. CONCLUSIONS : Leptospirosis is a disease with different demographic and clinical characteristics, with difficult and sometimes late diagnosis. Presumptive diagnosis of leptospiroris was associated with working in open environment, living in unsanitary conditions, having calf pain and fever.
Assuntos
Humanos , Epidemiologia , Leptospirose , ColômbiaRESUMO
Los dientes se desarrollan a partir de múltiples interacciones recíprocas entre células del epitelio oral y el ectomesénquima. Una serie de genes participan en el desarrollo del diente, así como de otros órganos y miembros superiores e inferiores. PAX9, miembro de la familia de factores de transcripción, es uno de los principales responsables de este desarrollo, y juega un rol fundamental en la hipodoncia dental y malformaciones en los huesos del miembro inferior. El objetivo de este reporte es presentar un caso de asociación entre hipodoncia y el hueso navicular accesorio. Se trata de una paciente de 18 años de edad, que acude a la consulta dental por dolor agudo en la pieza dentaria 3.6 y dolor de 9 meses de evolución en la cara interna del pie izquierdo. Al examen radiográfico, se observó ausencia de las piezas dentarias 1.7, 2.7, 2.8, 3.8 y 4.8, además en el pie izquierdo se vio la presencia de un hueso navicular accesorio. Es interesante proponer esta rara asociación, de clara herencia autosómica dominante, dado que la agenesia dental y la presencia del hueso navicular accesorio, poseen una prevalencia semejante, lo que hace que pueda existir una nueva asociación sindrómica probablemente relacionada con la ausencia de PAX9(AU)
Teeth are developed from many interactions between oral epithelium and mesenchymal cells. A number of genes are involved in tooth development, as well as in other organs, and upper and lower limbs. PAX9, a member of the transcriptional factor family, is one of the main drivers of this development, playing a key role in dental hypodontia and malformations in the lower limb bones. The aim of this report was to present the association between hypodontia and the accessory navicular bone based on a case report. This is a 18 years old female patient, who attended a dental clinic because she had acute pain in the 3.6 tooth and also pain on the left foot's inner area. The radiographic examination showed loss of the teeth 1.7, 2.7, 2.8, 3.8 and 4.8; and the presence of an accessory navicular bone in the left foot. It is interesting to suggest that this rare association, with clear dominant autosomal inheritance, might exist; since the dental agenesis and the presence of accessory navicular bone have similar prevalence, which could point to a new syndromic association probably related to the lack of PAX9(AU)
Assuntos
Humanos , Feminino , Adolescente , Fator de Transcrição PAX9/efeitos adversos , Anodontia/epidemiologia , Ossos do Tarso/anormalidades , Anodontia/diagnóstico por imagemRESUMO
In this work we checked the hypothesis whether estrone, progesterone, and testosterone are able to modulate the interactions between platelets, monocytes, and endothelial cells either under basal or inflammatory conditions. Using adhesion assays we demonstrated that pretreatment of endothelial cells with estrone, progesterone, or testosterone prevented monocytes and platelets adhesion induced by the proinflammatory agent bacterial lipopolysaccharide. The hormones reduced the expression of mRNA of ICAM-1, VCAM-1, and P-selectin, endothelial surface proteins that mediate monocytes and platelets adhesion respectively. Integrins are the main leukocyte proteins that allow firm adhesion. Using flow cytometry we showed that estrone treatment of monocytes reduced CD11b and CD11c expression, either under basal or injury (lipopolysaccharide) conditions. The three steroids inhibited platelet aggregation in a nitric oxide dependent manner. Platelet function was not affected by the steroid treatment. The molecular mechanisms of action exerted by the steroids included the participation of the intracellular signaling pathways PKC, MAPK, and PI3K, which selectively and differentially mediate the stimulation of nitric oxide release. We evidence that estrone, progesterone, and testosterone modulate monocyte and platelet adhesion to endothelial cells, events that play a major role in the initiation and progression of vascular lesions. The steroid action was evidenced under basal or inflammatory conditions. The mechanisms of action exerted by the steroids included stimulation of nitric oxide production and the participation of PKC, MAPK, and PI3K systems.
Assuntos
Células Endoteliais/fisiologia , Esteroides/fisiologia , Doenças Vasculares/metabolismo , Animais , Adesão Celular/efeitos dos fármacos , Células Cultivadas , Células Endoteliais/efeitos dos fármacos , Endotélio Vascular/citologia , Endotélio Vascular/metabolismo , Estrona/farmacologia , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Molécula 1 de Adesão Intercelular/genética , Leucócitos/efeitos dos fármacos , Monócitos/efeitos dos fármacos , Monócitos/metabolismo , Óxido Nítrico/metabolismo , Selectina-P/genética , Progesterona/farmacologia , Ratos , Ratos Wistar , Transdução de Sinais , Esteroides/farmacologia , Testosterona/farmacologia , Molécula 1 de Adesão de Célula Vascular/genética , Doenças Vasculares/patologiaRESUMO
Antecedentes: Los angiosarcomas son infrecuentes y corresponden a menos del 1 por ciento de tumores de tejidos blandos, pueden presentarse en cualquier localización fundamentalmente en la piel. El angiosarcoma primario uterino fue por primera vez reportado en 1902 por Silberberg con informes ulteriores esporádicos que suman un total de 33 casos incluyendo el presente. Objetivo: Exponer un caso diagnosticado en el Departamento de Patología de la Universidad Industrial de Santander (Bucaramanga-Colombia), y revisar la literatura de los casos previamente descritos. Caso clínico: Paciente de 25 años, con 2 años de evolución de menometrorragias y dolor pélvico crónico. Se realiza ablación endometrial encontrándose tumor maligno de endometrio pobremente diferenciado, infiltrante, el cual no es posible categorizar. Se efectúa una histerectomía ampliada, salpingooforectomía bilateral, linfadenectomía pélvica y omentectomía. El examen microscópico reveló lesión tumoral pobremente diferenciada compatible con un angiosarcoma uterino de alto grado.
Background: Angiosarcomas are rare and account for less than 1 percent of soft tissue tumors can occur at any location primarily in the skin. The primary uterine angiosarcoma was first reported in 1902 by Silberberg with sporadic subsequent reports, with a total of 33 cases including the present. Objective: To present a case diagnosed in the Department of Pathology, Universidad Industrial de Santander (Bucaramanga, Colombia) and review the literature of the cases previously described. Case report: A 25 years old woman, with 2 years of chronic pelvic pain and menometrorrhagia. Endometrial ablation is performed and an endometrial malignancy was found, poorly differentiated and infiltrating, which is not possible to categorize. It makes an extended hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and omentectomy. Microscopic examination revealed poorly differentiated tumor, compatible with a high-grade uterine angiosarcoma.
Assuntos
Humanos , Feminino , Adulto , Hemangiossarcoma/diagnóstico , Hemangiossarcoma/patologia , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/patologia , Hemangiossarcoma/cirurgia , Imuno-Histoquímica , Neoplasias Uterinas/cirurgiaRESUMO
Poultry is a main reservoir and source of human infection in campylobacteriosis. Three hundred and forty one stool samples (291 human, 50 avian) were analyzed. In the human group, 220 samples were collected from children with acute diarrheal disease (183 inpatients, 37 outpatients) and 71 from healthy children. Erythromycin and ciprofloxacin agar dilution MIC tests, Penner serotyping and RAPD-PCR genotyping were performed on 23 strains isolated. C. jejuni was reported only in patients with acute diarrhea (5.4 percent inpatients, 2.2 percent outpatients). Campylobacter prevalence in poultry was 34 percent. Cross-resistance to nalidixic acid and ciprofloxacin was found in 33.3 percent of human samples and 11.8 percent of animal samples. Human samples could not be typed using the Penner method. F serotype was the most expressed in poultry. We obtained a total of 14 genotypes (4 / 5 human and 10/15 avian). In conclusion, the predominant species in poultry and humans was C. jejuni, a significant amount of quinolone-resistant human and avian samples were obtained, and avian genotypes and serotypes were not found in human samples. The latter would mean that another source of infection could exist; therefore other reservoirs must be studied.
Las aves de consumo constituyen uno de los principales reservorios y fuente de infección humana de la campilo-bacteriosis. Se analizaron 341 muestras de deposiciones, 291 humanas y 50 aviares. De las muestras, 220 de niños con síndrome diarreico agudo-SDA (183 hospitalizados y 37 consultantes ambulatorios) y 71 niños sanos. A las 23 cepas obtenidas se les realizó CIM por dilución en agar a eritromicina y ciprofloxacina, serotipificación de Penner y genotipiicación por RAPD-PCR. Se encontró Campylobacterjejuni sólo en pacientes con SDA, de ellos 5,4 por ciento ambulatorios y 2,2 por ciento hospitalizados. En aves, la prevalencia de Campylobacter spp., fue de 34 por ciento. Hubo resistencia cruzada a ácido nalidixico y ciprofloxacina en 33,3 por ciento cepas de origen humano y 11,8 por ciento animal. Las cepas humanas fueron no tipiicables por el método de Penner. Predominó entre las aves el serotipo F. Se obtuvo un total de 14 genotipos (4/5 humanos y 10/15 aviares). En conclusión, la especie predominante en aves de corral y en humanos fue C. jejuni, existiendo una alta prevalencia de cepas de origen humano y aviar resistentes a quinolonas. Los genotipos y serotipos aviares no fueron encontrados en cepas de origen humano, lo que indica que podría existir otra fuente de infección, por lo que se requiere estudiar otros reservorios.
Assuntos
Adolescente , Animais , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Antibacterianos/farmacologia , Campylobacter coli/efeitos dos fármacos , Campylobacter jejuni/efeitos dos fármacos , Fezes/microbiologia , Aves Domésticas/microbiologia , Doença Aguda , Campylobacter coli/genética , Campylobacter coli/isolamento & purificação , Campylobacter jejuni/genética , Campylobacter jejuni/isolamento & purificação , Diarreia/microbiologia , Genótipo , Técnica de Amplificação ao Acaso de DNA PolimórficoRESUMO
Endosulfan is a hazardous organochlorine pesticide banned or restricted in several countries. However, it has been found in the environment and in animal samples. To study a potential way to bioremediate soils contaminated with this pesticide, two plant species of the genus Ocimum were studied: Ocimum basilicum L. and Ocimum minimum L., since they are economically feasible and well adapted to the climatic conditions of the Nayarit zone (Mexican pacific coast). Young plants were transplanted into soil experimentally polluted with endosulfan. Growth of both species was not affected by endosulfan, the plants grew, flourished, and produced seeds; 30 days later, endosulfan concentration was lower in the soil with O. basilicum than in the soil without plants. On day 90, no differences in endosulfan concentrations were found between soil with or without O. minimum. At day 1, plants in the polluted soil showed lipoperoxidation, as measured by thiobarbituric acid-reactive species (TBARS). Interestingly, a higher TBARS value was observed at day 3 in transplanted plants as compared to non-transplanted plants. In conclusion, both species can endure endosulfan pollution (as high as 1 g kg(-1)) in soils. O. basilicum seems to be an adequate candidate for bioremediation of soils polluted with endosulfan.