RESUMO
BACKGROUND: Nitric oxide is produced by different nitric oxide synthases isoforms. NO activates two signaling pathways, one dependent on soluble guanylate cyclase and protein kinase G, and other where NO post-translationally modifies proteins through S-nitrosylation, which is the modification induced by NO in free-thiol cysteines in proteins to form S-nitrosothiols. High levels of NO have been detected in blood of breast cancer patients and increased NOS activity has been detected in invasive breast tumors compared to benign or normal breast tissue, suggesting a positive correlation between NO biosynthesis, degree of malignancy and metastasis. During metastasis, the endothelium plays a key role allowing the adhesion of tumor cells, which is the first step in the extravasation process leading to metastasis. This step shares similarities with leukocyte adhesion to the endothelium, and it is plausible that it may also share some regulatory elements. The vascular cell adhesion molecule-1 (VCAM-1) expressed on the endothelial cell surface promotes interactions between the endothelium and tumor cells, as well as leukocytes. Data show that breast tumor cells adhere to areas in the vasculature where NO production is increased, however, the mechanisms involved are unknown. RESULTS: We report that the stimulation of endothelial cells with interleukin-8, and conditioned medium from breast tumor cells activates the S-nitrosylation pathway in the endothelium to induce leukocyte adhesion and tumor cell extravasation by a mechanism that involves an increased VCAM-1 cell surface expression in endothelial cells. We identified VCAM-1 as an S-nitrosylation target during this process. The inhibition of NO signaling and S-nitrosylation blocked the transmigration of tumor cells through endothelial monolayers. Using an in vivo model, the number of lung metastases was inhibited in the presence of the S-nitrosylation inhibitor N-acetylcysteine (NAC), which was correlated with lower levels of S-nitrosylated VCAM-1 in the metastases. CONCLUSIONS: S-Nitrosylation in the endothelium activates pathways that enhance VCAM-1 surface localization to promote binding of leukocytes and extravasation of tumor cells leading to metastasis. NAC is positioned as an important tool that might be tested as a co-therapy against breast cancer metastasis.
Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/patologia , Adesão Celular , Células Endoteliais , Molécula 1 de Adesão de Célula Vascular/metabolismo , Óxido Nítrico/metabolismo , Melanoma Maligno CutâneoRESUMO
BACKGROUND: Guillain-Barré syndrome is the most common cause of flaccid paralysis, with multiple known clinical variants. Autonomic dysfunction, although frequently reported in the clinical course, is often overlooked in the pediatric population and is usually not the initial presenting symptom in this age group CASE PRESENTATION: We present the case of a previously healthy 17-year-old who arrived at the Emergency Department complaining of gastrointestinal symptoms associated with lipothymia. An initial electrocardiogram (ECG) showed sustained sinus bradycardia subsequently associated with arterial hypertension. Structural and inflammatory cardiac pathology were ruled out, as well as auriculoventricular conduction block and posterior reversible encephalopathy syndrome. On the ninth day after initial symptoms, the patient presented sensory and motor nerve disturbances with the cerebrospinal fluid analysis showing a clear albumin-cytologic dissociation, consistent with an atypical presentation of GBS with autonomic dysfunction. Immunoglobulin therapy was administered, developing subsequent aseptic meningitis, that required discontinuation of previous therapy and treatment with plasmapheresis. Clinical improvement was achieved with full motor function recovery. CONCLUSION: This case illustrates a Guillain-Barré syndrome variant in which autonomic dysfunction preceded neurologic deficit, a finding uncommon in children, emphasizing this as an important differential diagnosis for severe bradycardia in pediatric patients.
Assuntos
Síndrome de Guillain-Barré , Hipertensão , Síndrome da Leucoencefalopatia Posterior , Adolescente , Bradicardia/complicações , Bradicardia/etiologia , Criança , Diagnóstico Diferencial , Síndrome de Guillain-Barré/complicações , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/terapia , Humanos , Hipertensão/diagnóstico , Síndrome da Leucoencefalopatia Posterior/complicações , Síndrome da Leucoencefalopatia Posterior/diagnósticoRESUMO
BACKGROUND: The use of rosuvastatin plus colchicine and emtricitabine/tenofovir in hospitalized patients with SARS-CoV-2 disease (COVID-19) has not been assessed. The objective of this study was to assess the effectiveness and safety of rosuvastatin plus colchicine, emtricitabine/tenofovir, and their combined use in these patients. METHODS: This was a randomized, controlled, open-label, multicentre, parallel, pragmatic study conducted in six referral hospitals in Bogotá, Colombia. The study enrolled hospitalized patients over 18 years of age with a confirmed diagnosis of COVID-19 complicated with pneumonia, not on chronic treatment with the study medications, and with no contraindications for their use. Patients were assigned 1:1:1:1. 1) emtricitabine with tenofovir disoproxil fumarate (FTC/TDF, 200/300 mg given orally for 10 days); 2) colchicine plus rosuvastatin (COLCH+ROSU, 0.5 mg and 40 mg given orally for 14 days); 3) emtricitabine with tenofovir disoproxil plus colchicine and rosuvastatin at the same doses and for the same period of time (FTC/TDF+COLCH+ROSU); or 4) the Colombian consensus standard of care, including a corticosteroid (SOC). The primary endpoint was 28-day all-cause mortality. A modified intention-to-treat analysis was used together with a usefulness analysis to determine which could be the best treatment. The trial was registered at ClinicalTrials.gov: NCT04359095. FINDINGS: Out of 994 candidates considered between August 2020 and March 2021, 649 (65.3%) patients agreed to participate and were enrolled in this study; among them, 633 (97.5%) were included in the analysis. The mean age was 55.4 years (SD ± 12.8 years), and 428 (68%) were men; 28-day mortality was significantly lower in the FTC/TDF+COLCH+ROSUV group than in the SOC group, 10.7% (17/159) vs. 17.4% (28/161) (hazard ratio [HR] 0.53; 95% CI 0.29 to 0.96). Mortality in the FTC/TDF group was 13.8% (22/160, HR 0.68, 95% CI 0.39 to 1.20) and 14.4% in the COLCH+ROSU group (22/153) (HR 0.78, 95% CI 0.44 to 1.36). A lower need for invasive mechanical ventilation was observed in the FTC/TDF+COLCH+ROSUV group than in the SOC group (risk difference [RD] - 0.08, 95% CI 0.11 to 0.04). Three patients presented severe adverse events, one severe diarrhoea in the COLCH+ROSU and one in the FTC/TDF+COLCH+ROSU group and one general exanthema in the FTC/TDF group. INTERPRETATION: The combined use of FTC/TDF+COLCH+ROSU reduces the risk of 28-day mortality and the need for invasive mechanical ventilation in hospitalized patients with pulmonary compromise from COVID-19. More randomized controlled trials are needed to compare the effectiveness and cost of treatment with this combination versus other drugs that have been shown to reduce mortality from SARS-CoV-2 infection and its usefulness in patients with chronic statin use.
RESUMO
Diarrheagenic (DEC) and avian pathogenic Escherichia coli (APEC) are associated with intestinal and extra-intestinal infections (ExPEC), respectively. We aimed to analyze the antimicrobial susceptibility, gene encoding virulence factors associated to DEC and APEC, and phylogenetic classification in E. coli isolated from 320 samples of feed and ingredients. Antimicrobial susceptibility was performed using the disk diffusion method and Multiple Antibiotic Resistance (MAR) Index and Multi-Drug Resistance (MDR) were calculated. Phylogenetic classification was performed on samples harboring DEC and/or APEC virulence-associated genes. A total of 110 E. coli strains were isolated in 15% (49/320) of the evaluated inputs (n=13 vegetable meal; n=33 animal meal, n=3 feed). In general, the isolates showed the highest rates of antimicrobial resistance to sulfonamide and cefazolin and 18% (20/110) were multi-drug resistant. MAR index of feed samples was the highest (0.467). Six and five strains had APEC and DEC virulence-associated genes, respectively, and belonging to phylogenetic groups A and B1. These findings point to the need for strict microbiological control during the production process of these foods.(AU)
Escherichia coli diarreiogênicas (DEC) e patogênicas para aves (APEC) são associadas a infecções intestinais e extraintestinais (ExPEC), respectivamente. O objetivo do presente trabalho foi avaliar a sensibilidade antimicrobiana, a presença de genes que codificam os fatores de virulência relacionados à DEC e APEC, e a classificação filogenética em E. coli isoladas de 320 amostras de ração para frangos e ingredientes. A sensibilidade antimicrobiana foi determinada pelo método disco-difusão e calculou-se o índice de resistência múltipla aos antimicrobianos (IRMA) e a resistência a múltiplas drogas (MDR). Nas amostras que possuíam genes de virulência relacionados à DEC e/ou APEC, foi realizada a classificação filogenética. Foram isoladas 110 amostras de E. coli em 15% (49/320) dos insumos avaliados (n=13 farelos vegetais; n=33 farinhas de origem animal; n=3 rações). De forma geral, os isolados apresentaram as maiores frequências de resistência antimicrobiana à sulfonamida e à cefazolina e 18% (20/110) foram resistentes a múltiplas drogas. O IRMA das rações foi o mais alto (0,467). Os genes que codificam fatores de virulência associados à APEC e DEC foram detectados em seis e cinco isolados, respectivamente, pertencentes aos grupos filogenéticos A e B1. Os resultados demonstram a necessidade de rigoroso controle microbiológico durante o processo de produção desses alimentos.(AU)
Assuntos
Animais , Galinhas/virologia , Fatores de Virulência , Diarreia/veterinária , Escherichia coli/isolamento & purificação , Ração Animal/microbiologia , Resistência Microbiana a MedicamentosRESUMO
Diarrheagenic (DEC) and avian pathogenic Escherichia coli (APEC) are associated with intestinal and extra-intestinal infections (ExPEC), respectively. We aimed to analyze the antimicrobial susceptibility, gene encoding virulence factors associated to DEC and APEC, and phylogenetic classification in E. coli isolated from 320 samples of feed and ingredients. Antimicrobial susceptibility was performed using the disk diffusion method and Multiple Antibiotic Resistance (MAR) Index and Multi-Drug Resistance (MDR) were calculated. Phylogenetic classification was performed on samples harboring DEC and/or APEC virulence-associated genes. A total of 110 E. coli strains were isolated in 15% (49/320) of the evaluated inputs (n=13 vegetable meal; n=33 animal meal, n=3 feed). In general, the isolates showed the highest rates of antimicrobial resistance to sulfonamide and cefazolin and 18% (20/110) were multi-drug resistant. MAR index of feed samples was the highest (0.467). Six and five strains had APEC and DEC virulence-associated genes, respectively, and belonging to phylogenetic groups A and B1. These findings point to the need for strict microbiological control during the production process of these foods.(AU)
Escherichia coli diarreiogênicas (DEC) e patogênicas para aves (APEC) são associadas a infecções intestinais e extraintestinais (ExPEC), respectivamente. O objetivo do presente trabalho foi avaliar a sensibilidade antimicrobiana, a presença de genes que codificam os fatores de virulência relacionados à DEC e APEC, e a classificação filogenética em E. coli isoladas de 320 amostras de ração para frangos e ingredientes. A sensibilidade antimicrobiana foi determinada pelo método disco-difusão e calculou-se o índice de resistência múltipla aos antimicrobianos (IRMA) e a resistência a múltiplas drogas (MDR). Nas amostras que possuíam genes de virulência relacionados à DEC e/ou APEC, foi realizada a classificação filogenética. Foram isoladas 110 amostras de E. coli em 15% (49/320) dos insumos avaliados (n=13 farelos vegetais; n=33 farinhas de origem animal; n=3 rações). De forma geral, os isolados apresentaram as maiores frequências de resistência antimicrobiana à sulfonamida e à cefazolina e 18% (20/110) foram resistentes a múltiplas drogas. O IRMA das rações foi o mais alto (0,467). Os genes que codificam fatores de virulência associados à APEC e DEC foram detectados em seis e cinco isolados, respectivamente, pertencentes aos grupos filogenéticos A e B1. Os resultados demonstram a necessidade de rigoroso controle microbiológico durante o processo de produção desses alimentos.(AU)
Assuntos
Animais , Galinhas/virologia , Fatores de Virulência , Diarreia/veterinária , Escherichia coli/isolamento & purificação , Ração Animal/microbiologia , Resistência Microbiana a MedicamentosRESUMO
Macrophages and neutrophils are important cellular components in the process of acute inflammation and its subsequent resolution, and evidence increasingly suggests that they play important functions during the resolution of chronic, adaptive inflammatory processes. Exacerbated neutrophil activity can be harmful to surrounding tissues; this is important in a range of diseases, including allergic asthma and chronic obstructive pulmonary disease in humans, and equine asthma (also known as recurrent airway obstruction (RAO). Tamoxifen (TX) is a non-steroidal estrogen receptor modulator with effects on cell growth and survival. Previous studies showed that TX treatment in horses with induced acute pulmonary inflammation promoted early apoptosis of blood and BALF neutrophils, reduction of BALF neutrophils, and improvement in animals' clinical status. The aim of this study was to describe if TX induces in vitro efferocytosis of neutrophils by alveolar macrophages. Efferocytosis assay, myeloperoxidase (MPO) detection and translocation phosphatidylserine (PS) were performed on neutrophils isolated from peripheral blood samples from five healthy horses. In in vitro samples from heathy horses, TX treatment increases the phenomenon of efferocytosis of peripheral neutrophils by alveolar macrophages. Similar increases in supernatant MPO concentration and PS translocation were observed in TX-treated neutrophils, compared to control cells. In conclusion, these results confirm that tamoxifen has a direct effect on equine peripheral blood neutrophils, through stimulation of the engulfment of apoptotic neutrophils by alveolar macrophages.
Assuntos
Apoptose/efeitos dos fármacos , Neutrófilos/efeitos dos fármacos , Animais , Antagonistas de Estrogênios/farmacologia , Cavalos , Macrófagos/efeitos dos fármacos , Fagocitose/efeitos dos fármacos , Tamoxifeno/farmacologiaRESUMO
The aim of this study was to detect 2 important toxin genes from diarrheagenic Escherichia coli (DEC) in bovine milk using a new multiplex PCR. To standardize the multiplex PCR, the stx2 and elt genes were investigated for the detection of Shiga toxin-producing Escherichia coli (STEC) and enterotoxigenic E. coli (ETEC), respectively. The DNA template was prepared with a thermal procedure (boiling) and a commercial kit. Samples consisted of UHT and pasteurized milk, both skimmed, and STEC and ETEC were tested in concentrations between 101 and 109 cfu/mL. With the thermal procedure, the multiplex PCR system detected both pathotypes of E. coli at 109 cfu/mL in UHT and pasteurized milk. When the commercial kit was used for template preparation, STEC and ETEC could be detected at concentrations as low as 104 cfu/mL in UHT and pasteurized milk. Negative controls (Listeria monocytogenes, Salmonella Typhimurium, Salmonella Enteritidis, and Escherichia coli strain APEC 13) were not amplified with the multiplex PCR. These results indicate that the multiplex PCR was a rapid (less than 6 h) and efficient method to detect STEC and ETEC in milk using different methods for DNA preparation; however, the commercial kit was more sensitive than the thermal procedure.
Assuntos
Escherichia coli Enterotoxigênica/genética , Proteínas de Escherichia coli/genética , Leite/microbiologia , Reação em Cadeia da Polimerase Multiplex/veterinária , Toxina Shiga II/genética , Escherichia coli Shiga Toxigênica/genética , Animais , Bovinos , Escherichia coli Enterotoxigênica/isolamento & purificação , Proteínas de Escherichia coli/isolamento & purificação , Reação em Cadeia da Polimerase Multiplex/métodos , Toxina Shiga II/isolamento & purificação , Escherichia coli Shiga Toxigênica/isolamento & purificaçãoRESUMO
Neutrophils participate in innate immunity as the first line of host defense against microorganisms. However, exacerbated neutrophil activity can be harmful to surrounding tissues; this is important in a range of diseases, including allergic asthma and chronic obstructive pulmonary disease in humans, and equine asthma (also known as recurrent airway obstruction (RAO). Tamoxifen (TX) is a non-steroidal estrogen receptor modulator with effects on cell growth and survival. Previous preliminary studies showed that TX treatment in horses with induced acute pulmonary inflammation promoted early apoptosis of blood and BALF neutrophils, reduction of BALF neutrophils, and improvement in animals' clinical status. The aim of this study was to evaluate the in vitro effect of TX on functional tests in equine peripheral blood neutrophils. Chemotaxis, respiratory burst production and phagocytosis assays were performed on neutrophils isolated from peripheral blood samples from 10 healthy horses. Results showed that IL-8 stimulated cells decrease their chemotactic index when treated with TX (1 and 10µM). Respiratory burst production was also dampened after treatment with TX. In conclusion, these results confirm that tamoxifen has a direct action on equine peripheral blood neutrophils. However, more in vivo and in vitro studies are required to fully understand the mechanisms of action of TX on neutrophils, in order to elucidate if it can be used as treatment in disorders such as allergic asthma in humans and horses.
Assuntos
Antineoplásicos Hormonais/efeitos adversos , Cavalos/fisiologia , Neutrófilos/efeitos dos fármacos , Tamoxifeno/efeitos adversos , Animais , Quimiotaxia/efeitos dos fármacos , Feminino , Masculino , Neutrófilos/fisiologia , Fagocitose/efeitos dos fármacos , Explosão Respiratória/efeitos dos fármacosRESUMO
AIM: Neutrophils are the first cells to arrive at sites of injury. Nevertheless, many inflammatory diseases are characterized by an uncontrolled infiltration and action of these cells. Cell migration depends on volume changes that are governed by ion channel activity, but potassium channels in neutrophil have not been clearly identified. We aim to test whether KCa3.1 participates in neutrophil migration and other relevant functions of the cell. METHODS: Cytometer and confocal measurements to determine changes in cell volume were used. Cells isolated from human, mouse and horse were tested for KCa3.1-dependent chemotaxis. Chemokinetics, calcium handling and release of reactive oxygen species were measured to determine the role of KCa3.1 in those processes. A mouse model was used to test for neutrophil recruitment after acute lung injury in vivo. RESULTS: We show for the first time that KCa3.1 is expressed in mammalian neutrophils. When the channel is inhibited by a pharmacological blocker or by genetic silencing, it profoundly affects cell volume regulation, and chemotactic and chemokinetic properties of the cells. We also demonstrated that pharmacological inhibition of KCa3.1 did not affect calcium entry or reactive oxygen species production in neutrophils. Using a mouse model of acute lung injury, we observed that Kca3.1(-/-) mice are significantly less effective at recruiting neutrophils into the site of inflammation. CONCLUSIONS: These results demonstrate that KCa3.1 channels are key actors in the migration capacity of neutrophils, and its inhibition did not affect other relevant cellular functions.
Assuntos
Cálcio/metabolismo , Quimiotaxia , Canais de Potássio Ativados por Cálcio de Condutância Intermediária/metabolismo , Neutrófilos/metabolismo , Animais , Humanos , Inflamação , Potenciais da Membrana/fisiologia , Neutrófilos/citologiaRESUMO
A reduction in inflammatory cell apoptosis is an important concept in the maintenance of inflammation and a potential target for the resolution of inflammation in many inflammatory diseases. Dysregulation of apoptosis has been implicated in a range of diseases, including tumors, neurodegenerative disorders and autoimmunity, and may also be implicated in allergic asthma. In horses, recurrent airway obstruction (RAO) is an asthma-like condition that is characterized increased survival neutrophil bronchial. Tamoxifen is a synthetic, non-steroidal, anti-estrogen agent that is widely used for treating all stages of breast cancer and has been approved for the prevention of breast cancer in high-risk women. The observed efficacy of tamoxifen has been attributed to both growth arrest and the induction of apoptosis. Therefore, the aim of our study was to evaluate the ability of tamoxifen to induce apoptosis in vitro in granulocytic cells from peripheral blood and in mononuclear cells from bronchoalveolar lavage fluid (BALF) in horses. Flow cytometry using commercial AnnexinV-FITC and propidium iodide was used to quantify early and late apoptotic leukocytes, respectively. The results showed a significant increase in early apoptosis in peripheral blood and bronchial granulocytic cells treated with tamoxifen. The rate of early apoptosis of mononuclear cells from blood and BALF when incubated with tamoxifen was significantly lower compared with granulocytic cells. We did not observe a direct effect of tamoxifen on late apoptosis in any of the in vitro assays in the cell types used here. These results indicate that the apoptotic mechanisms under these experimental conditions would affect only blood and BALF granulocytic cells, particularly in early apoptosis. Finally, further in vitro and in vivo studies are needed to better understand apoptotic mechanisms because tamoxifen could be used to treat chronic, inflammatory pathologies associated with granulocytes and allergic diseases, such as asthma or equine RAO.
Assuntos
Apoptose/efeitos dos fármacos , Líquido da Lavagem Broncoalveolar/citologia , Leucócitos/efeitos dos fármacos , Tamoxifeno/farmacologia , Animais , Antineoplásicos/farmacologia , Granulócitos/efeitos dos fármacos , CavalosRESUMO
BACKGROUND: Keratinocyte life span is modulated by receptors that control proliferation and differentiation, key processes during cutaneous tissue repair. The kinin B(1) receptor (B(1)R) has been reported in normal and pathological human skin, but so far there is no information about its role in keratinocyte biology. OBJECTIVES: To determine the consequence of kinin B(1)R stimulation on tyrosine phosphorylation, a key signalling mechanism involved in keratinocyte proliferation and differentiation. METHODS: Subconfluent primary cultures of human keratinocytes were used to investigate tyrosine phosphorylation, epidermal growth factor receptor (EGFR) transactivation, cell proliferation and keratinocyte differentiation. Cell proliferation was assessed by measuring bromodeoxyuridine incorporation whereas assessment of cell differentiation was based on the expression of filaggrin, cytokeratin 10 (CK10) and involucrin. RESULTS: The major proteins phosphorylated, after B(1)R stimulation, were of molecular mass 170, 125, 89 and 70 kDa. The 170- and 125-kDa proteins were identified as EGFR and p125(FAK), respectively. Phosphorylation was greatly reduced by GF109203X and by overexposure of keratinocytes to phorbol 12-myristate 13-acetate, indicating the participation of protein kinase C. B(1)R stimulation did not increase [Ca(2+)]i, but triggered EGFR transactivation, an event that involved phosphorylation of Tyr(845), Tyr(992) and Tyr(1068) of EGFR. B(1)R stimulation did not elicit keratinocyte proliferation, but triggered cell differentiation, visualized as an increase of filaggrin, CK10 and involucrin. Blockade of EGFR tyrosine kinase by AG1478, before B(1)R stimulation, produced an additional increase in filaggrin expression. CONCLUSIONS: The kinin B(1)R may contribute to keratinocyte differentiation and migration by triggering specific tyrosine signalling pathways or by interacting with the ErbB receptor family.
Assuntos
Diferenciação Celular , Receptores ErbB/metabolismo , Queratinócitos/citologia , Cininas/metabolismo , Receptor B1 da Bradicinina/metabolismo , Receptor B2 da Bradicinina/metabolismo , Células Cultivadas/metabolismo , Proteínas Filagrinas , Humanos , Queratinócitos/metabolismo , Sistema de Sinalização das MAP Quinases/fisiologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Pele/metabolismoRESUMO
We investigated the targeting of the V(1a) receptor fused with the green fluorescence protein (V(1a)R-GFP) in polarized MDCK cells. Cells expressing V(1a)R-GFP displayed binding to vasopressin (AVP) and AVP-induced calcium responses, similar to cells expressing the wild-type V1a receptor. Interestingly, as with the wild-type V(1a)R, V(1a)R-GFP is preferentially distributed in the basolateral side of MDCK cells as monitored by confocal microscopy. Furthermore, AVP induced internalization of GFP-tagged receptors. Therefore, the GFP-tagged V(1a) receptor retains all the sorting signals of the wild-type receptor and offers an excellent system to elucidate the mechanisms of cell trafficking of V(1a) receptors.
Assuntos
Proteínas Luminescentes/metabolismo , Receptores de Vasopressinas/biossíntese , Receptores de Vasopressinas/química , Proteínas Recombinantes de Fusão/metabolismo , Animais , Cálcio/metabolismo , Linhagem Celular , DNA Complementar/metabolismo , Cães , Relação Dose-Resposta a Droga , Vetores Genéticos , Proteínas de Fluorescência Verde , Cinética , Fígado/metabolismo , Microscopia Confocal , Ligação Proteica , Ratos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Tempo , TransfecçãoRESUMO
A cascade of mechanisms involving changes in gene expression are substantial to shape the adaptive responses that a eurythermal fish requires upon environmental changes in its habitat. We have previously shown that the cyclical reprogramming of rRNA transcription is a remarkable feature in carp under seasonal acclimatization. Using in situ hybridization and competitive RT-PCR we found significant differences in beta-actin transcripts, generally accepted to be coded by a typical housekeeping gene, in tissues from summer- and winter-acclimatized carp. The physiological differential beta-actin transcription herein reported places us on the alert for the reference genes estimated to be constitutive to quantitatively assess gene transcripts.
Assuntos
Actinas/genética , Adaptação Fisiológica , Carpas/fisiologia , Transcrição Gênica/fisiologia , Animais , Sequência de Bases , Primers do DNA , Hibridização In Situ , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , RNA Ribossômico/genética , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
The objective of this study was to determine the relation between the presence of a bullet (gunshot) after injury to the colon and the incidence of sepsis in its track and the soft tissue where it is retained. A retrospective review was carried out of the charts of consecutive patients admitted for abdominal gunshot wounds with proved colon injury during laparotomy where the bullet was either retained in the soft tissue or exited the body. The review covered a period of 4 years beginning January 1, 1990. Three groups were identified for analysis: (1) patients from whom the bullet was surgically removed, with additional cleansing and debridement of the area (n = 21); (2) patients who did not undergo surgical removal of the bullet (n = 81); and (3) patients in whom the bullet exited spontaneously and in whom only débridement of the skin was carried out (n = 83). Similar risk factors were noted among the groups (age, ATI score, colostomy rate), except for a higher incidence of shock in group 3 (p = 0.003). The incidence of sepsis in soft tissue was least in group 1. It was five and seven times greater in groups 2 and 3, respectively. After an abdominal gunshot with colon injury, the missile should be removed if feasible and the local tissue débrided. If the bullet has exited spontaneously, its internal track must be débrided and lavaged extensively.
Assuntos
Colo/lesões , Infecção dos Ferimentos , Ferimentos por Arma de Fogo/complicações , Adolescente , Adulto , Idoso , Colo/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Ferimentos por Arma de Fogo/cirurgiaRESUMO
During a partial splenectomy, the resultant bleeding of the remaining spleen is difficult to control; some techniques have been described to achieve complete hemostasis. The omentum has been traditionally used to promote hemostasis on raw surfaces of solid viscus, particularly during the repair of liver injuries. We present here a technique to fix the omentum to the spleen after partial resections; emphasis is made to perform it in an atraumatic way to avoid additional damage to the splenic capsule.
Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Hemostasia Cirúrgica/métodos , Omento/cirurgia , Esplenectomia/métodos , HumanosRESUMO
OBJECTIVE: To demonstrate the applicability of nonoperative treatment to penetrating hypopharyngeal wounds. DESIGN: A prospective study. MATERIALS AND METHODS: An analysis of patients with penetrating hypopharyngeal wounds who were treated nonoperatively at the Hospital Universitario del Valle (Cali, Colombia) during 4 years (beginning January 1990) was performed. Patients older than 13 years with proven lesions produced by penetrating trauma were included. Patients with foreign-body-induced or iatrogenic lesions (orotracheal intubation, endoscopy) or immediate need for surgery (for associated lesions) were excluded. Nonoperative management consisted of nasogastric tube for feeding, suspension of oral intake, and parenteral antibiotics for 7 days. MEASUREMENTS AND MAIN RESULTS: Fourteen patients met the above criteria. Gunshot wounds (n = 11) were the most common trauma. An esophagogram/endoscopy demonstrated the lesions. The only complication in the group consisted of a cervical abscess, which presented in a patient during the first week of treatment. There were no complications such as fistula, leakage, and Horner's syndrome. CONCLUSIONS: Conservative management is a good and safe alternative when indicated in penetrating hypopharyngeal wounds.
Assuntos
Hipofaringe/lesões , Ferimentos Penetrantes/terapia , Adolescente , Adulto , Esofagoscopia , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Ferimentos Penetrantes/diagnósticoRESUMO
Pelvic radiography in blunt trauma patients is routinely used in most trauma centers. The purpose of this review was to evaluate the ability of physical examination alone to detect pelvic fractures. Among patients with blunt trauma admitted to the University Hospital del Valle in Cali, Colombia, over a 3-month period, 608 adult patients, with hemodynamic stability, without spinal involvement, and with a Glasgow Coma Scale score greater than 10 were evaluated. All patients had physical examination, pelvic x-ray and adequate follow-up. Fifty-nine (9.7%) patients had pelvic fractures, with 57 of these fractures detected by physical findings. The remaining two patients had stable fractures that required no treatment. After careful analysis, we conclude that a negative physical examination following blunt trauma has a negative predictive value of 99% probability in excluding pelvic fracture, provided that the patient is not a child, is not in coma, is hemodynamically stable without evidence of blood loss, and has no spinal cord injury. A selective use of pelvic x-ray in patients with blunt trauma is a cost-effective policy.
Assuntos
Fraturas Ósseas/diagnóstico por imagem , Ossos Pélvicos/lesões , Ferimentos não Penetrantes/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Custo-Benefício , Feminino , Fraturas Ósseas/classificação , Escala de Coma de Glasgow , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Exame Físico/economia , Exame Físico/métodos , Estudos Prospectivos , Radiografia , Sensibilidade e EspecificidadeRESUMO
The study reported here evaluated the efficacy of antibiotics administered in two periods: preoperative only and additional doses postoperatively. There was no difference in developing surgical sepsis between the groups when they included antibiotics preoperatively and the severity of the trauma was minor (Abdominal Trauma Index [ATI] value < 25). Additionally, the result was the same when one of the injured organs was the colon, in contrast with past studies. One interesting point is related to the association of a Revised Trauma Index value > 20 with a colon wound: in the present study, this combination had a deleterious effect on the patients, always resulting in abdominal sepsis. Emphasis is placed on the economic benefits of the abolition of postoperative antibiotic use in patients with ATI score less than 25.
Assuntos
Traumatismos Abdominais/cirurgia , Antibacterianos/uso terapêutico , Pré-Medicação , Traumatismos Abdominais/complicações , Adulto , Feminino , Humanos , Infecções/etiologia , Masculino , Cuidados Pós-Operatórios , Complicações Pós-Operatórias , Índices de Gravidade do TraumaRESUMO
Se adelanto un trabajo de observacion clinica iniciado en 1990 en el Hospital Universitario del Valle, sobre el comportamiento y el subsiguiente tratamiento de las heridas de la hipofaringe, ocasionadas con arma de fuego y arma blanca. El proposito del estudio fue el de demostrar la conveniencia de no operar e instaurar un tratamiento conservador de tales heridas traumáticas de la hipofaringe. La investigacion incluyo 68 pacientes con lesiones traumáticas comprobadas de la orohipofaringe y el esofago cervical, de los cuales 49 (72 por ciento) fueron tratados quirurgicamente en forma obligatoria, y 19 (28 por ciento) recibieron tratamiento conservador, no quirurgico, en cuya evolucion clinica, como era obvio, hubo mucho menos morbilidad que la observada en el grupo sometido a cirugia. Mediante un completo examen clinico y paraclinico asociado a un juicioso criterio, el cirujano debe ser capaz de discemir sobre cuando no se debe operar un paciente con este tipo de lesiones cervicales.
Assuntos
Hipofaringe , Ferimentos e LesõesRESUMO
Se define el sindrome pospericardiotomia y se califica una entidad infrecuente. Se presenta 1 caso documentado de este estado patologico, diagnosticado en un hombre de 25 años de edad quien habia sufrido una herida con arma cortopunzante en el area precordial. Se discuten aspectos historicos, etiologicos, fisiopatologicos, clinicos, paraclinicos, diagnosticos, terapeuticos y anatomopatologicos del sindrome pospericardiotomia. Por ultimo, se transcriben 21 referencias bibliográficas nacionales e internacionales sobre el tema.