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Hard-to-reach communities represent Peru's main challenge for malaria elimination, but information about transmission in these areas is scarce. Here, we assessed Plasmodium vivax (Pv) and P. falciparum (Pf) transmission dynamics, resistance markers, and Pf hrp2/3 deletions in Nueva Jerusalén (NJ), a remote, indigenous community in the Peruvian Amazon with high population mobility. We collected samples from November 2019 to May 2020 by active (ACD) and passive case detection (PCD) in NJ. Parasites were identified with microscopy and PCR. Then, we analyzed a representative set of positive-PCR samples (Pv = 68, Pf = 58) using highly-multiplexed deep sequencing assays (AmpliSeq) and compared NJ parasites with ones from other remote Peruvian areas using population genetics indexes. The ACD intervention did not reduce malaria cases in the short term, and persistent malaria transmission was observed (at least one Pv infection was detected in 96% of the study days). In Nueva Jerusalen, the Pv population had modest genetic diversity (He = 0.27). Pf population had lower diversity (He = 0.08) and presented temporal clustering, one of these clusters linked to an outbreak in February 2020. Moreover, Pv and Pf parasites from NJ exhibited variable levels of differentiation (Pv Fst = 0.07-0.52 and Pf Fst = 0.11-0.58) with parasites from other remote areas. No artemisin resistance mutations but chloroquine (57%) and sulfadoxine-pyrimethamine (35-67%) were detected in NJ's Pf parasites. Moreover, pfhrp2/3 gene deletions were common (32-50% of parasites with one or both genes deleted). The persistent Pv transmission and the detection of a Pf outbreak with parasites genetically distinct from the local ones highlight the need for tailored interventions focusing on mobility patterns and imported infections in remote areas to eliminate malaria in the Peruvian Amazon.
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Malária Falciparum , Malária Vivax , Plasmodium falciparum , Plasmodium vivax , Proteínas de Protozoários , Peru/epidemiologia , Humanos , Plasmodium falciparum/genética , Plasmodium falciparum/isolamento & purificação , Plasmodium vivax/genética , Plasmodium vivax/isolamento & purificação , Malária Falciparum/epidemiologia , Malária Falciparum/parasitologia , Malária Falciparum/transmissão , Malária Vivax/epidemiologia , Malária Vivax/parasitologia , Malária Vivax/transmissão , Proteínas de Protozoários/genética , Feminino , Masculino , Criança , Adulto , Antimaláricos/uso terapêutico , Antimaláricos/farmacologia , Adolescente , Resistência a Medicamentos/genética , Pessoa de Meia-Idade , Povos Indígenas/genética , Adulto Jovem , Pré-Escolar , Genômica/métodos , Variação Genética , Antígenos de Protozoários/genéticaRESUMO
BACKGROUND: Plasmodium vivax is the most predominant malaria species in Latin America, constituting 71.5% of malaria cases in 2021. With several countries aiming for malaria elimination, it is crucial to prioritize effectiveness of national control programs by optimizing the utilization of available resources and strategically implementing necessary changes. To support this, there is a need for innovative approaches such as genomic surveillance tools that can investigate changes in transmission intensity, imported cases and sources of reintroduction, and can detect molecular markers associated with drug resistance. METHODOLOGY/PRINCIPAL FINDINGS: Here, we apply a modified highly-multiplexed deep sequencing assay: Pv AmpliSeq v2 Peru. The tool targets a newly developed 41-SNP Peru barcode for parasite population analysis within Peru, the 33-SNP vivaxGEN-geo panel for country-level classification, and 11 putative drug resistance genes. It was applied to 230 samples from the Peruvian Amazon (2007-2020), generating baseline surveillance data. We observed a heterogenous P. vivax population with high diversity and gene flow in peri-urban areas of Maynas province (Loreto region) with a temporal drift using all SNPs detected by the assay (nSNP = 2909). In comparison, in an indigenous isolated area, the parasite population was genetically differentiated (FST = 0.07-0.09) with moderate diversity and high relatedness between isolates in the community. In a remote border community, a clonal P. vivax cluster was identified, with distinct haplotypes in drug resistant genes and ama1, more similar to Brazilian isolates, likely representing an introduction of P. vivax from Brazil at that time. To test its applicability for Latin America, we evaluated the SNP Peru barcode in P. vivax genomes from the region and demonstrated the capacity to capture local population clustering at within-country level. CONCLUSIONS/SIGNIFICANCE: Together this data shows that P. vivax transmission is heterogeneous in different settings within the Peruvian Amazon. Genetic analysis is a key component for regional malaria control, offering valuable insights that should be incorporated into routine surveillance.
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Malária Vivax , Plasmodium vivax , Polimorfismo de Nucleotídeo Único , Plasmodium vivax/genética , Plasmodium vivax/isolamento & purificação , Plasmodium vivax/classificação , Peru/epidemiologia , Malária Vivax/epidemiologia , Malária Vivax/parasitologia , Humanos , Resistência a Medicamentos/genética , Genoma de Protozoário , Sequenciamento de Nucleotídeos em Larga Escala , Monitoramento Epidemiológico , GenômicaRESUMO
Plasmacytoid dendritic cells (pDCs) are vital players in antiviral immune responses because of their high levels of IFN-α secretion. However, this attribute has also implicated them as critical factors behind the immunopathogenesis of inflammatory diseases, and no currently available therapy can efficiently inhibit pDCs' aberrant activation. Mesenchymal stromal cells (MSCs) possess stromal immunomodulatory functionality, regulating immune cell activation through several mechanisms, including the adenosinergic (CD39/CD73/adenosine) pathway. The IFN-γ preconditioning of bone marrow MSCs improves their inhibitory properties for therapy applications; however, isolating human gingival tissue-derived MSCs (hGMSCs) is more accessible. These cells have shown better immunomodulatory effects, yet the outcome of IFN-γ preconditioning and its impact on the adenosinergic pathway has not been evaluated. This study first validated the immunoregulatory properties of primary-cultured hGMSCs, and the results showed that IFN-γ preconditioning strengthens CD39/CD73 coexpression, adenosine production, and the regulatory properties of hGMSC, which were confirmed by describing for the first time their ability to reduce pDC activation and their IFN-α secretion and to increase the frequency of CD73+ pDC. In addition, when CD73's enzymatic activity was neutralized in hGMSCs, adenosine production and the IFN-γ preconditioning effect were restrained. This evidence might be applied to design hGMSCs- and adenosine-based immunotherapeutic strategies for treating inflammatory disorders that are associated with pDC overactivation.
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5'-Nucleotidase , Adenosina , Células Dendríticas , Gengiva , Interferon gama , Células-Tronco Mesenquimais , Humanos , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/imunologia , Células-Tronco Mesenquimais/citologia , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Adenosina/metabolismo , Interferon gama/metabolismo , Gengiva/citologia , 5'-Nucleotidase/metabolismo , Células Cultivadas , Apirase/metabolismo , Proteínas Ligadas por GPIRESUMO
Background: Anti-LGI1 encephalitis is characterized by a pattern of inflammation that predominantly affects the limbic system It is part of the autoimmune encephalitis that attack neuronal surface antigens. It is characterized by the triad of subacute dementia, faciobrachial dystonic crises, and hyponatremia, presenting an excellent response to immunotherapy. The aim of this article is to describe the clinical evolution and functional outcome at 6 months of two patients with anti-LGI1 encephalitis using clinical cases. Clinical cases: Case 1: 62-year-old man with 8-week symptoms manifested by changes in mood, disorientation, and focal motor seizures. Case 2 A 72-year-old woman with a 5-month evolution of rapidly progressive dementia, hyponatremia and bitemporal hyperintensities on MRI. In both, due to clinical suspicion, acute dual immunotherapy with steroid and immunoglobulin was given with substantial improvement. Subsequently, the existence of anti-LGI1 antibodies in cerebrospinal fluid was confirmed. Although both patients received a dose of rituximab during their hospitalization, only the patient in the first case continued biannual doses of rituximab. The second patient was not initially considered to continue long-term immunomodulatory treatment and experienced a relapse. Conclusions: These clinical vignettes present the reader with the classic characteristics of this disease. This can facilitate its recognition and timely initiation of treatment, improving the functional prognosis of patients.
Introducción: la encefalitis anti-LGI1 se caracteriza por un patrón de inflamación que afecta de forma predominante al sistema límbico. Forma parte de las encefalitis autoinmunes que atacan a antígenos de superficie neuronal. Se caracteriza por la tríada de demencia subaguda, crisis distónicas faciobraquiales e hiponatremia, presentando una respuesta excelente a la inmunoterapia. El objetivo de este trabajo es describir por casos clínicos la evolución clínica y resultado funcional a 6 meses de dos pacientes con encefalitis anti-LGI1. Casos clínicos: caso 1: hombre de 62 años con cuadro de 8 semanas, manifestado por cambios en el estado de ánimo, desorientación y crisis focales motoras. Caso 2: mujer de 72 años con una evolución de 5 meses de demencia rápidamente progresiva, hiponatremia e hiperintensidades bitemporales en RMN. En ambos, ante la sospecha clínica, se otorgó inmunoterapia dual aguda con esteroide e inmunoglobulina con mejoría sustancial, posteriormente se corroboró la existencia de anticuerpos anti-LGI1 en líquido cefalorraquídeo. Pese a que ambos pacientes recibieron una dosis de rituximab durante su hospitalización, solo el primer caso continuó dosis semestrales de rituximab. El segundo no fue considerado inicialmente para continuar con tratamiento inmunomodulador a largo plazo y presentó una recaída. Conclusiones: estos casos, presentan al lector las características clásicas de esta enfermedad. Esto puede facilitar su reconocimiento y la instauración oportuna del tratamiento, mejorando el pronóstico funcional de los pacientes.
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Doenças Autoimunes do Sistema Nervoso , Demência , Encefalite , Hiponatremia , Encefalite Límbica , Masculino , Feminino , Humanos , Idoso , Pessoa de Meia-Idade , Peptídeos e Proteínas de Sinalização Intracelular/uso terapêutico , Autoanticorpos/líquido cefalorraquidiano , Autoanticorpos/uso terapêutico , Encefalite Límbica/tratamento farmacológico , México , Rituximab/uso terapêutico , Recidiva Local de Neoplasia , Encefalite/diagnósticoRESUMO
El acoso escolar o ¨bullying¨ es un problema social que se ha incrementado de tal manera que representa una preocupación a nivel mundial, de lo cual Cuba no está exenta. En este trabajo se reflexiona acerca de las condiciones y riesgos que pueden generar consecuencias negativas en personas vulnerables a sufrir este tipo de agresión. Se precisa que la depresión, la ansiedad y determinadas condiciones físicas y sociales, destacan en los afectados y, entre estas, el padecimiento de obesidad que pudiera incrementar, como riesgo acumulativo, trastornos del sueño en niños y adolescentes. Se realizó una revisión acerca de los posibles impactos de la vinculación de la obesidad y el acoso escolar en cuanto a los trastornos del sueño en niños y adolescentes. Se concluye que existe una asociación entre la obesidad, el acoso escolar y el riesgo de padecer trastornos del sueño, lo que, fundamentalmente desde la Atención Primaria de Salud, debe considerarse de manera que se puedan detectar y aplicar los protocolos correspondientes sobre esta población de riesgo y de su entorno por lo que se recomiendan acciones psicopedagógicas y de coordinación intersectorial.
School bullying or bullying is a social problem that has increased in such a way that it represents a worldwide concern, from which Cuba is not exempt. This paper reflects on the conditions and risks that can generate negative consequences in vulnerable people to suffer this type of aggression. Depression, anxiety and certain physical and social conditions stand out in those affected and, among these, the suffering from obesity that could increase, as a cumulative risk, sleep disorders in children and adolescents. A review was carried out about the possible impacts of linking obesity and bullying in terms of sleep disorders in children and adolescents. It is concluded that there is an association between obesity, bullying and the risk of suffering from sleep disorders, which, fundamentally from Primary Health Care, should be considered so that the corresponding protocols can be detected and applied to this population at risk and its environment, for which psycho-pedagogical actions and intersectoral coordination are recommended.
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Background: The Amyotrophic Lateral Sclerosis-Parkinsonism-Dementia Complex (ALS-PDC) was first described in the islands of Guam. This pathology presented its peak incidence in the 1950s. Due to the rarity of the association, we report a clinical case with this complex. The objective was to describe the nosological and pathogenic implications of these neurodegenerative disorder, since they are not frequent to find in our population. Clinical case: We present a case of Latinoamerican origin who initially manifested systemic symptoms of more than 6 years of evolution, with subsequent cognitive alterations. Later, patient began with gait disturbances and motor symptoms suggestive of parkinsonism with atypical data and data of motor neurone disease (MND). More studies were carried out and confirmed findings compatible with upper and lower motor neuron involvement. A mutation in the POLG gene was observed, related to mitochondrial depletion syndrome. Conclusion: Despite the knowledge of this association, it is an entity whose clinical diagnosis could be very difficult to achieve. In addition, molecular mechanisms have not been fully identified, the most common genes related to Parkinsonism and ALS have been excluded, and even attempts to locate the locus were made, without achieving accurate results. Unfortunately, being a neurodegenerative disease, the prognosis is fatal, with no disease-modifying treatment.
Introducción: el complejo parkinsonismo-demencia-esclerosis lateral amiotrófica fue descrito por primera vez en las islas de Guam. Esta patología presentó su pico de incidencia en los años 50. Debido a la rareza de la asociación, informamos sobre un caso clínico que la presenta. El objetivo fue describir las implicaciones nosológicas y patogénicas de este trastorno neurodegenerativo, ya que no es frecuente encontrar esta asociación en nuestra población. Caso clínico: presentamos un caso de origen latinoamericano que inicialmente se manifestó con síntomas sistémicos de más de 6 años de evolución, con posteriores alteraciones cognitivas. Después presentó alteraciones de la marcha y síntomas motores sugestivos de parkinsonismo con datos atípicos y datos de enfermedad de motoneurona. Se hicieron estudios de extensión que confirmaron hallazgos compatibles con afectación en motoneurona superior e inferior. Observamos mutación en gen POLG, relacionada con síndrome de depleción mitocondrial. Conclusión: a pesar del conocimiento de esta asociación, es una entidad cuyo diagnóstico clínico puede ser muy difícil de obtener. Además, no se han identificado del todo los mecanismos moleculares, se han excluido los genes más comunes relacionados con parkinsonismos y esclerosis lateral amiotrófica e incluso se intentó localizar el locus, sin lograr resultados certeros. Desafortunadamente al ser una enfermedad neurodegenerativa el pronóstico es fatal, sin que haya tratamiento modificador de la enfermedad.
Assuntos
Esclerose Lateral Amiotrófica , Demência , Doenças Neurodegenerativas , Doença de Parkinson , Transtornos Parkinsonianos , Humanos , Esclerose Lateral Amiotrófica/complicações , Esclerose Lateral Amiotrófica/diagnóstico , Esclerose Lateral Amiotrófica/epidemiologia , Doença de Parkinson/complicações , Doença de Parkinson/patologia , Demência/complicações , Demência/epidemiologia , Demência/patologia , Guam/epidemiologia , Transtornos Parkinsonianos/etiologia , Transtornos Parkinsonianos/complicaçõesRESUMO
Se muestra caso de rubor hemifacial que se desarrolló en una mujer de 86 años de edad Palabras claves: rubor, sepsis, venas yugulares.
We show a case of hemifacial flushing that developed in an 86-year-old woman. Key words: flushing, sepsis, jugular veins
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Fundamento: a pesar de la importancia del cálculo del riesgo cardiovascular global en hipertensos y los beneficios de su implementación en la Atención Primaria de Salud, en la Universidad de Ciencias Médicas de Cienfuegos son insuficientes los estudios sobre su estimación. Objetivo: determinar el riesgo cardiovascular global en hipertensos de la Universidad de Ciencias Médicas de Cienfuegos en el año 2021. Métodos: se realizó un estudio descriptivo, transversal y correlacional. La muestra estuvo conformada por 105 hipertensos entre 40-80 años de la Universidad de Ciencias Médicas de Cienfuegos en el 2021. Las variables estudiadas fueron: edad, género, colesterol total, tabaquismo, presión arterial sistólica, diabetes mellitus diagnosticada y el riesgo cardiovascular global. Se calcularon la frecuencia absoluta y relativa de las variables y se aplicó la Chi cuadrado de Pearson en la asociación de las variables y el riesgo cardiovascular bajo con un nivel de significación p=0,05. Los resultados se presentaron en tablas. Resultados: predominó el género femenino, el grupo etáreo de 50-69 años, los no diabéticos y los no fumadores, con colesterol normal y prehipertensos. El 93,3 % presentó riesgo cardiovascular global bajo y el 6,7 % de moderado a crítico. Los pacientes no diabéticos y con presión arterial sistólica normal presentaron asociación significativa con el riesgo cardiovascular bajo. Conclusiones: los hipertensos de la Universidad de Ciencias Médicas de Cienfuegos presentan un riesgo cardiovascular global bajo, se mostró una correlación entre el riesgo cardiovascular bajo y la presión arterial sistólica normal y los antecedentes de no diabetes, lo que condicionaría protección a eventos cardiovasculares y cerebrovasculares en el futuro.
Background: despite the importance of calculating global cardiovascular risk in hypertensive patients and the benefits of its implementation in Primary Health Care, studies on its estimation are insufficient at the University of Medical Sciences of Cienfuegos. Objective: to determine the global cardiovascular risk in hypertensive patients at the University of Medical Sciences of Cienfuegos in the year 2021. Methods: a descriptive, cross-sectional and correlational study was carried out. The sample consisted of 105 hypertensive patients between 40-80 years of age from the University of Medical Sciences of Cienfuegos in 2021. The variables studied were: age, gender, total cholesterol, smoking, systolic blood pressure, diagnosed diabetes mellitus, and global cardiovascular risk. The absolute and relative frequency of the variables were calculated and Pearson's Chi square was applied in the association of the variables and low cardiovascular risk with a significance level of p=0.05. The results were presented in tables. Results: the female gender, the age group of 50-69 years, non-diabetics and non-smokers, with normal cholesterol and prehypertensive predominated. 93.3 % presented low overall cardiovascular risk and 6.7 % moderate to critical. Non-diabetic patients with normal systolic blood pressure presented a significant association with low cardiovascular risk. Conclusions: hypertensive patients at the University of Medical Sciences of Cienfuegos have a low overall cardiovascular risk, a correlation was shown between low cardiovascular risk and normal systolic blood pressure and a history of non-diabetes, which would determine protection against cardiovascular and cerebrovascular events in the future
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Tegumentary leishmaniasis, a disease caused by protozoan parasites of the genus Leishmania, is a major public health problem in many regions of Latin America. Its diagnosis is difficult given other conditions resembling leishmaniasis lesions and co-occurring in the same endemic areas. A combination of parasitological and molecular methods leads to accurate diagnosis, with the latter being traditionally performed in centralized reference and research laboratories as they require specialized infrastructure and operators. Clustered regularly interspaced short palindromic repeats/CRISPR-associated protein (CRISPR/Cas) systems have recently driven innovative tools for nucleic acid detection that combine high specificity, sensitivity and speed and are readily adaptable for point-of-care testing. Here, we harnessed the CRISPR-Cas12a system for molecular detection of Leishmania spp., emphasizing medically relevant parasite species circulating in Peru and other endemic areas in Latin America, with Leishmania (Viannia) braziliensis being the main etiologic agent of cutaneous and mucosal leishmaniasis. We developed two assays targeting multi-copy targets commonly used in the molecular diagnosis of leishmaniasis: the 18S ribosomal RNA gene (18S rDNA), highly conserved across Leishmania species, and a region of kinetoplast DNA (kDNA) minicircles conserved in the L. (Viannia) subgenus. Our CRISPR-based assays were capable of detecting down to 5 × 10-2 (kDNA) or 5 × 100 (18S rDNA) parasite genome equivalents/reaction with PCR preamplification. The 18S PCR/CRISPR assay achieved pan-Leishmania detection, whereas the kDNA PCR/CRISPR assay was specific for L. (Viannia) detection. No cross-reaction was observed with Trypanosoma cruzi strain Y or human DNA. We evaluated the performance of the assays using 49 clinical samples compared to a kDNA real-time PCR assay as the reference test. The kDNA PCR/CRISPR assay performed equally well as the reference test, with positive and negative percent agreement of 100%. The 18S PCR/CRISPR assay had high positive and negative percent agreement of 82.1% and 100%, respectively. The findings support the potential applicability of the newly developed CRISPR-based molecular tools for first-line diagnosis of Leishmania infections at the genus and L. (Viannia) subgenus levels.
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RESUMEN La manera en que se concibe, ejecuta y controla la actividad de estudio resulta determinante en el alcance de los objetivos educacionales, especialmente en disciplinas integradas. En este artículo, sus autores reflexionan acerca de los vacíos que obstaculizanla estructuración del trabajo independiente, en las asignaturas de la disciplina Bases Biológicas de la Medicina que más posibilitan la integración y sugieren un grupo de acciones a teneren cuenta para su mejora. Existen ¨vacíos de comprensión¨, que afectan la perspectiva de conjunto yla lógica común integradora necesaria para el establecimiento de los nexos internos entre los contenidos y conseguir una adecuada estructuraciónde ese trabajo independiente, que puede mejorarse si se tienen en cuenta el enfoque sistémico del sistema de habilidades y la delimitación de los conocimientos que permiten el establecimiento de los nexos internos en cada tema, entre otras acciones.
ABSTRACT The way in which the study activity is conceived, executed and controlled is decisive in the achievement of educational objectives, especially in integrated disciplines. In this article, its authors reflect on the gaps that hinder the structuring of independent work, in the subjects of the Biological Bases of Medicine discipline that most enable integration, and suggest a group of actions to take into account for its improvement. There are "understanding gaps" that affect the overall perspective and the common integrating logic necessary to establish the internal links between the contents and achieve an adequate structuring of this independent work, which can be improved if the systemic approach is taken into account. of the skills system and the delimitation of knowledge that allow the establishment of internal links in each subject, among other actions.
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RESUMEN El actual desarrollo de la ciencia y la técnica constituye un reto para las universidades médicas, como centros de formación en pos de garantizar un egresado capaz de gestionar el conocimiento necesario para cumplimentar su encargo social. Se precisa de una adecuada habilidad para la búsqueda de la información, la cual permita una apropiada gestión del conocimiento y mejores resultados docentes; pero el claustro profesoral debe planificar acciones estratégicas con vistas a alcanzar la formación de esta habilidad de investigación. Se sugieren acciones para trabajar en la formación de la habilidad antes mencionada, sobre la base de talleres que aborden las esencialidades para su operacionalización a través de contenidos que se imparten; y tributen a la ejecución de investigaciones estudiantiles. La búsqueda de información no solo brinda herramientas para el desarrollo de las investigaciones, sino también constituye un instrumento para fomentar las habilidades lógicas del pensamiento, con elevado impacto cuando el estudiante, de forma independiente, enfrenta tareas de mayor envergadura, por lo que se sugiere desarrollar un sistema de talleres para la preparación profesoral.
ABSTARCT The current development of science and technology constitutes a challenge for medical universities, as training centers in order to guarantee a graduate capable of managing the necessary knowledge to fulfill their social mission. An adequate ability to search for information is required, which allows for proper knowledge management and better teaching results; but the teaching staff must plan strategic actions with a view to achieving the formation of this research skill. Actions are suggested to work on the formation of the aforementioned skill, based on workshops that address the essentials for its operationalization through the contents that are taught; and tax the execution of student research. The search for information not only provides tools for the development of research, but also constitutes an instrument to promote logical thinking skills, with a high impact when the student, independently, faces larger tasks, for which it is suggested develop a system of workshops for teacher preparation.
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RESUMEN Fundamento existen diversos estudios que muestran una relación de la hiperreactividad cardiovascular con algunos factores de riesgo cardiovascular, pero se hace necesario continuar evidenciando dicha relación. Objetivo: determinar la asociación de la hiperreactividad cardiovascular y la obesidad entre individuos sedentarios y activos en Cienfuegos. Métodos: se realizó un estudio descriptivo, transversal y correlacional en un universo de 80 individuos entre 18 y 30 años del municipio Cienfuegos, durante el año 2020. Las variables analizadas fueron: edad, sexo, color de la piel, nivel de sedentarismo, presión arterial basal con la prueba del peso sostenido, índice de masa corporal y cintura abdominal. Se utilizó Chi Cuadrado de Pearson para describir la asociación de las variables de estudio entre sujetos sedentarios y activos, así como la prueba T para la comparación de las medias. Nivel de significación p˂0,05. Los resultados se expresaron en tablas. Resultados: predominaron las edades de 18-24 años y el color de la piel blanca. El 76,3 % posee la condición de sedentarismo sobre los activos. El 65,6 % de los sedentarios correspondieron al sexo femenino. En las pruebas antropométricas más del 30 % eran sobrepeso-obeso y el 20 % presentaba cintura abdominal alterada, para ambas coexistió la condición de ser sedentarios. Los sedentarios presentaron valores de la media de las variables hemodinámicas superiores a los activos. El 73,8 % de los sedentarios fueron hiperreactivos cardiovasculares al contrario del estado de normorreactivo cardiovascular que estuvo presente en el 94,7 % de los activos. Conclusiones la condición de sedentarismo incrementa los valores de las variables hemodinámicas y antropométricas estudiadas.
ABSTRACT Background: there are several studies that show a relationship between cardiovascular hyperreactivity and some cardiovascular risk factors, but it is necessary to continue showing this relationship. Objective: to determine the association of cardiovascular hyperreactivity and obesity between sedentary and active individuals in Cienfuegos. Methods: a descriptive, cross-sectional and correlational study was carried out in a universe of 80 individuals between 18 and 30 years of age in the Cienfuegos municipality, during 2020. The variables analyzed were: age, sex, skin color, level of sedentary lifestyle, pressure baseline blood pressure with the sustained weight test, body mass index and abdominal waist. Pearson's Chi Square was used to describe the association of the study variables between sedentary and active individuals, as well as the T test for the comparison of means. Significance level p˂0.05. The results were expressed in charts. Results: ages 18-24 years old and white skin color predominated. 76.3 % have a sedentary lifestyle over assets. 65.6 % of the sedentary were female. In the anthropometric tests, more than 30 % were overweight-obese and 20 % had altered abdominal waist, for both the condition of being sedentary coexisted. The sedentary subjects presented mean values of the hemodynamic variables higher than the active subjects. 73.8 % of the sedentary subjects were cardiovascular hyperreactive, as opposed to the normoreactive cardiovascular state that was present in 94.7 % of the active subjects. Conclusions: the condition of sedentary lifestyle increases the values of the hemodynamic and anthropometric variables studied.
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The gastrinomas are rare functional neuroendocrine neoplasms, most are localized to the duodenum (70-90%) or the pancreas (2-30%), but less common ectopic sites have been reported. The primary hepatic gastrinoma is extremely rare, with less tan 40 cases reported in the medical literature. Its low incidence and its non specific clinical presentation make it a difficult disease to diagnose. Providing a timely diagnosis the patient can be treated by surgical resection with high chances of success. The objective of this paper is to describe a case of primary hepatic gastrinoma in Mexico, successfully treated by right liver segmentectomy.
Los gastrinomas son neoplasias neuroendocrinas funcionales raras, y la mayoría se localizan en el duodeno (70-90%) o en el páncreas (2-30%), pero también existen otras localizaciones ectópicas poco comunes. El gastrinoma hepático primario es extremadamente raro, con menos de 40 casos reportados en la literatura médica. Su baja incidencia y su presentación clínica inespecífica lo convierten en una enfermedad difícil de diagnosticar. Al realizar un diagnóstico oportuno puede ser tratado mediante resección quirúrgica con altas posibilidades de éxito. El objetivo de este trabajo es presentar un caso clínico de gastrinoma hepático primario en México, tratado de manera exitosa mediante segmentectomía hepática derecha.
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Gastrinoma , Neoplasias Pancreáticas , Gastrinoma/diagnóstico por imagem , Gastrinoma/cirurgia , Hospitais , Humanos , Fígado , México , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/cirurgiaRESUMO
Here, we describe a detailed step-by-step protocol for the expression, purification, quantification, and activity determination of key enzymes for molecular detection of pathogens. Based on previous reports, we optimized the protocol for LbCas12a, Taq DNA polymerase, M-MLV reverse transcriptase, and TEV protease to make it compatible with minimal laboratory equipment, broadly available in low- and middle-income countries. The enzymes produced with this protocol have been successfully used for molecular detection applications. For complete details on the use and execution of this protocol, please refer to Alcántara et al. (2021a, 2021b).
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Enzimas , Escherichia coli , Proteínas Recombinantes , Cromatografia de Afinidade , Ensaios Enzimáticos , Enzimas/genética , Enzimas/isolamento & purificação , Enzimas/metabolismo , Escherichia coli/genética , Escherichia coli/metabolismo , Tipagem Molecular , Proteínas Recombinantes/genética , Proteínas Recombinantes/isolamento & purificação , Proteínas Recombinantes/metabolismo , Transformação BacterianaRESUMO
Proper health management is essential for productivity in duck farming. However, there is limited information on the effect of management conditions on rates of metabolic problems and parasitic infections in anatids. We evaluated the rates of metabolic syndromes and gastrointestinal parasite involvement in Muscovy ducks up to 12 weeks of age, under 3 management conditions: backyard, organized, and organized with probiotics. Individuals under organized management developed 2 metabolic problems: ascites, which was rare (3.5%), fatal, and affected both males and females, and angel wing syndrome, which was more frequent (10.6%), has low impact on general health, and only affected males. The treatments do not have a significant effect on the development of ascites, but only individuals in controlled conditions presented this syndrome, and due to its low prevalence, further studies with a larger sample size are required. The risk of angel wing syndrome increased significantly with probiotic supplementation. Regarding to parasitic infection, the improvement of sanitary management and the use of probiotics supplementation reduced the occurrence of coccidiosis. Similarly organized management with probiotic supplementation showed a protective effect on helminthiasis by reducing the frequency of Heterakis gallinarum and greatly reducing the helminth egg load. Coccidiosis and helminthiasis infections were not significantly correlated with the final weight of the ducks. Therefore, organized management and the use of probiotics seems to reduce the impact of parasitic infection, although it increases the risk of developing metabolic syndrome.
Assuntos
Coccidiose , Doenças Transmissíveis , Síndrome Metabólica , Doenças Parasitárias , Animais , Coccidiose/veterinária , Doenças Transmissíveis/veterinária , Patos , Feminino , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/veterináriaRESUMO
RESUMEN La enfermedad provocada por el coronavirus (SARS-CoV-2), causante de la COVID-19, ha generado un movimiento hacia una revisión de todo el enfoque de las ciencias médicas y a profundizar en todos los mecanismos inherentes a la respuesta inmune asociados a esta enfermedad. Se pone en evidencia el necesario pensamiento clínico epidemiológico declarado en el plan de estudio de la carrera de Medicina; la formación investigativa desde los primeros años. La asignatura Sangre-Sistema Inmune incluye en su contenido un gran número de problemas de salud por desequilibrio en la respuesta inmune, lo que constituye una clara justificación para redimensionar el proceso de formación científica. El objetivo de este trabajo es valorar la significación de la asignatura para la interpretación de las desviaciones de la respuesta inmune y emitir sugerencias para potenciar el trabajo investigativo en ella.
ABSTRACT The disease caused by the coronavirus (SARS-CoV-2), which causes COVID-19, has generated a movement towards a review of the entire approach of medical sciences and to delve into all the mechanisms inherent to the immune response associated with this disease. The necessary clinical epidemiological thinking declared in the study plan of the Medicine career is evidenced; research training from the early years. The subject Blood-Immune System includes in its content a large number of health problems due to imbalance in the immune response, which constitutes a clear justification for resizing the scientific training process. The objective of this work is to assess the significance of the subject for the interpretation of the deviations of the immune response and to make suggestions to enhance the research work in it.
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RESUMEN En tiempos de COVID-19, la evaluación de las actividades docentes ha sido una de las prácticas pedagógicas que mayor reto ha representado para todos los involucrados en la realización de acciones académicas. En este artículo se reflexiona acerca de cómo pudiera influir sobre la calidad de la pesquisa, la implementación de una retroalimentación efectiva durante el proceso de evaluación de las actividades docentes. Se concluye que la retroalimentación es esencial en este proceso, porque permite que los estudiantes comprendan e integren a su comportamiento criterios de calidad, los cuales pueden ser transferidos al contexto de otras actividades, como las de pesquisa, con influencias muy positivas en los resultados de esta.
ABSTRACT In times of COVID-19, the evaluation of teaching activities has been one of the pedagogical practices that have represented the greatest challenge for all those involved in carrying out academic actions. This article reflects on how the implementation of effective feedback during the evaluation process of teaching activities could influence the quality of the research. It is concluded that feedback is essential in this process, because it allows students to understand and integrate quality criteria into their behavior, which can be transferred to the context of other activities, such as research, with very positive influences on the results of the research.
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ANTECEDENTES: El sarcoma de células dendríticas foliculares es una enfermedad rara, caracterizada principalmente en sitios nodales como la cabeza, el cuello y la orofaringe, aunque puede ser extranodal, como en el bazo y el hígado. En la mayoría de los casos cursa asintomática, pero puede presentar síntomas generales, dolor abdominal o fiebre. La inmunohistoquímica es indispensable para llegar a un diagnóstico definitivo. PRESENTACIÓN DEL CASO: Mujer de 40 años, con abultamiento submaxilar en el cuello, región frontoparietooccipital derecha, y sequedad de mucosa oral. Se manejó inicialmente como un síndrome de Sjögren, que fue descartado por el resultado histopatológico de la biopsia de glándula salival. Posteriormente se realizó biopsia de ganglio del cuello, que reportó sarcoma de células dendríticas foliculares con expresión inmunohistoquímica positiva para CD23 y negativa para CD21 y ACL. Se manejó con samario y tuvo una sobrevida de 3 meses desde el diagnóstico. CONCLUSIONES: el sarcoma de células dendríticas foliculares es raro y la sobrevida es corta. BACKGROUND: Follicular dendritic cell sarcoma is a rare pathology, it occurs mainly in nodal sites such as head, neck, oropharynx, although extranodal presentation such as spleen and liver may occur. In most cases it is asymptomatic but may present general symptoms, abdominal pain or fever. Immunohistochemistry is essential to make a definitive diagnosis. CASE PRESENTATION: Forty year-old woman, with submaxillary lesion, in the neck, right fronto-parieto-occipital region with dry oral mucosa. It was initially managed as a Sjögren's syndrome ruled out by the histopathological result of salivary gland biopsy. Subsequently, a neck ganglion biopsy was performed that reported follicular dendritic cell sarcoma, with positive immunohistochemical expression for CD23 and negative for CD21 and LCA. It was managed with samarium with a survival of 3 months from the time of its diagnosis. CONCLUSIONS: Follicular dendritic cell sarcoma is rare and its global survival is short.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Sarcoma , Neoplasias de Tecidos Moles , Adulto , Biópsia , Feminino , HumanosRESUMO
RESUMEN El Hospital General de Barrio Obrero no es ajeno a la pandemia, teniendo pacientes hospitalizados con COVID-19 desde inicios de junio de 2020 con un impacto alto en los servicios. Se analizaron 190 pacientes internados en los distintos servicios. Se encontró predominio del sexo masculino 52%. En cuanto a la edad, se observó un claro predominio de gerontes con el 51% del total de pacientes170 (89%) fueron internados en el servicio de clínica médica, a pesar de eso, aún un bajo porcentaje se detectó en servicios como gineco-obstetricia y cirugía general. Según la evolución clínica de los pacientes, 138 (73%) fueron dados de alta, 29 (15%) fueron trasladados a un centro de mayor complejidad por complicación de la enfermedad y 23 (12%) fallecieron, 16 (70%) eran de sexo masculino, según el rango etario, los pacientes que obitaron eran gerontes 17 (74%), adultos mayores 4 (17%) y adultos jóvenes 2 (9%). Octubre fue el mes con más muertes en pacientes internados con SARS-CoV-2. .En cuanto a la comorbilidad, 91% presentaba al menos una comorbilidad, entre las que predominó la hipertensión arterial (25%)
ABSTRACT The Barrio Obrero General Hospital is no stranger to the pandemic, having hospitalized patients with COVID-19 since the beginning of June 2020 with a high impact on services. 190 patients admitted to the different services were analyzed. 52% male predominance was found. Regarding age, a clear predominance of elderly was observed with 51% of all patients170 (89%) were admitted to the medical clinic service, despite this, a low percentage was still detected in services such as gynecology. obstetrics and general surgery. According to the clinical evolution of the patients, 138 (73%) were discharged, 29 (15%) were transferred to a more complex center due to complications of the disease and 23 (12%) died, 16 (70%) were of male sex, according to age range, the patients who obtained were elderly 17 (74%), older adults 4 (17%) and young adults 2 (9%). October was the month with the most deaths in patients hospitalized with SARS-CoV-2. Regarding comorbidity, 91% had at least one comorbidity, among which arterial hypertension predominated (25%).
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Type 1 diabetes (T1D) is an autoimmune disease characterized by the destruction of insulin-producing ß-cells of the pancreatic islets by autoreactive T cells, leading to high blood glucose levels and severe long-term complications. The typical treatment indicated in T1D is exogenous insulin administration, which controls glucose levels; however, it does not stop the autoimmune process. Various strategies have been implemented aimed at stopping ß-cell destruction, such as cellular therapy. Dendritic cells (DCs) as an alternative in cellular therapy have gained great interest for autoimmune disease therapy due to their plasticity to acquire immunoregulatory properties both in vivo and in vitro, performing functions such as anti-inflammatory cytokine secretion and suppression of autoreactive lymphocytes, which are dependent of their tolerogenic phenotype, displayed by features such as semimature phenotype, low surface expression of stimulatory molecules to prime T cells, as well as the elevated expression of inhibitory markers. DCs may be obtained and propagated easily in optimal amounts from peripheral blood or bone marrow precursors, such as monocytes or hematopoietic stem cells, respectively; therefore, various protocols have been established for tolerogenic (tol)DCs manufacturing for therapeutic research in the treatment of T1D. In this review, we address the current advances in the use of tolDCs for T1D therapy, encompassing protocols for their manufacturing, the data obtained from preclinical studies carried out, and the status of clinical research evaluating the safety, feasibility, and effectiveness of tolDCs.