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Brucellosis is a worldwide zoonotic disease caused by Brucella spp. and transmitted from domestic and wild animals to humans. Brucellosis causes important economic losses in livestock, has a significant impact on public health, and may affect the health of wildlife. Hunting and consumption of meat from culled wildlife constitute a risk for Brucella spp. infection in humans and hunting dogs. In El Palmar National Park (EPNP), Argentina, the invasive alien mammals wild boar (Sus scrofa) and axis deer (Axis axis) are controlled, slaughtered in situ, and consumed by hunters, with meat trimmings and offal often fed to dogs. In this study, we evaluated but did not detect anti-Brucella antibodies in wild boar (n=95) and axis deer (n=238) from EPNP or in game consumers, dogs (n=39) and humans (n=61). These results suggest a lack of exposure to Brucella spp. at this site during the study period. Despite negative findings in the sampled location, One Health surveillance across multiple species contributes to our understanding of pathogen dynamics and enables targeted interventions to minimize health risks.
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Brucella , Brucelose , Cervos , Sus scrofa , Animais , Argentina/epidemiologia , Cervos/microbiologia , Brucelose/veterinária , Brucelose/epidemiologia , Cães , Humanos , Brucella/imunologia , Estudos Soroepidemiológicos , Espécies Introduzidas , Parques Recreativos , Anticorpos Antibacterianos/sangue , Doenças do Cão/epidemiologia , Doenças do Cão/microbiologia , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/microbiologia , Animais Selvagens , Suínos , FemininoRESUMO
Introducción: La Enfermedad Renal Crónica ha cobrado interés debido a su alta tasa de morbimortalidad. Además de las causas vasculares y de la diabetes mellitus, se ha identificado una causa de Origen Desconocido en jóvenes agricultores. Objetivo: El objetivo del estudio es determinar la prevalencia de la población en hemodiálisis, sospechosa de la Nefritis Intersticial Crónica en Comunidades Agrícolas, para categorizar la verdadera etiología de su patología renal. Metodología: Se aplicó un diseño observacional descriptivo durante los meses de diciembre de 2022, enero y febrero de 2023; y se encuestó a 684 pacientes de ambos sexos en 8 centros de hemodiálisis de la Capital y el Departamento Central del Paraguay. Resultados: La prevalencia de casos sospechosos por la exposición a factores de riesgo resultó ser del 18.1%. Esta cifra podría ser mayor, ya que 22.6% de los pacientes con diabetes mellitus tipo 2, no presentó retinopatía clínica ni otros signos clínicos de la enfermedad al momento del diagnóstico de la falla renal. Este panorama nos advierte de un probable diagnóstico desacertado en una cantidad considerable de pacientes. Conclusión: La importancia de esta investigación se sustenta en generar acciones preventivas en la población agrícola y concientizar a la sociedad médica de la relevancia diagnóstica de esta patología para mejorar la calidad y pronóstico de vida en la población paraguaya.
Introduction: Chronic Kidney Disease has gained interest due to its high morbidity and mortality rate. In addition to vascular causes and diabetes mellitus, an unknown cause has been identified in young farmers. Objective: This study aims to determine the prevalence of the population on hemodialysis, suspected of Chronic Interstitial Nephritis in agricultural communities, to categorize the true etiology of their renal pathology. Methodology: A descriptive observational design was applied during December 2022, January, and February 2023; and 684 patients of both sexes were surveyed in 8 hemodialysis centers in the Capital and the Central Department of Paraguay. Results: The prevalence of suspected cases due to the exposure to risk factors was 18.1%. This figure could be higher since 22.6% of patients with type 2 diabetes mellitus did not present clinical retinopathy or other clinical signs of the disease at the time of the diagnosis of kidney failure. This scenario warns us of a probable misdiagnosis in a considerable number of patients. Conclusion: The importance of this research lies in generating preventive actions in the agricultural population and raising awareness in the medical community about the diagnostic relevance of this pathology to improve the quality and prognosis of life in the Paraguayan population.
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AIMS: Patients with aortic dissection have a high prevalence of left ventricular structural alterations, including left ventricular hypertrophy (LVH), but little is known about the impact of sex on this regard. This study compared clinical, cardiac, and prognostic characteristics between men and women with aortic dissection. METHODS: We retrospectively assessed clinical and echocardiographic characteristics, and 1-year mortality in 367 aortic dissection patients (30% women; 66% with Stanford-A) who underwent echocardiography 60âdays before or after the diagnosis of aortic dissection from three Brazilian centers. RESULTS: Men and women had similar clinical characteristics, except for higher age (59.4â±â13.4 vs. 55.9â±â11.6âyears; P â=â0.013) and use of antihypertensive classes (1.4â±â1.3 vs. 1.1â±â1.2; P â=â0.024) and diuretics (32 vs. 19%; P â=â0.004) in women compared with men. Women had a higher prevalence of LVH (78 vs. 65%; P â=â0.010) and lower prevalence of normal left ventricular geometry (20 vs. 10%; P â=â0.015) than men. Logistic regression analysis adjusted for confounding factors showed that women were less likely to have normal left ventricular geometry (odds ratio, 95% confidence intervalâ=â0.42, 0.20-0.87; P â=â0.019) and were more likely to have LVH (odds ratio, 95% confidence intervalâ=â1.91, 1.11-3.27; P â=â0.019). Conversely, multivariable Cox-regression analysis showed that women had a similar risk of death compared to men 1 year after aortic dissection diagnosis (hazard ratio, 95% confidence intervalâ=â1.16, 0.77-1.75; P â=â0.49). CONCLUSION: In aortic dissection patients, women were typically older, had higher use of antihypertensive medications, and exhibited a greater prevalence of LVH compared with men. However, 1-year mortality after aortic dissection diagnosis did not differ between men and women.
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Dissecção Aórtica , Hipertrofia Ventricular Esquerda , Remodelação Ventricular , Humanos , Masculino , Feminino , Dissecção Aórtica/epidemiologia , Dissecção Aórtica/fisiopatologia , Dissecção Aórtica/mortalidade , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Idoso , Hipertrofia Ventricular Esquerda/fisiopatologia , Hipertrofia Ventricular Esquerda/epidemiologia , Hipertrofia Ventricular Esquerda/diagnóstico por imagem , Brasil/epidemiologia , Prevalência , Adulto , Fatores de Risco , Ecocardiografia , Aneurisma Aórtico/epidemiologia , Aneurisma Aórtico/mortalidade , Aneurisma Aórtico/diagnóstico por imagem , Aneurisma Aórtico/fisiopatologia , Prognóstico , Fatores de TempoRESUMO
El sangrado uterino anormal tiene una etiología variable, que va desde causas estructurales hasta causas funcionales, que se describen clásicamente en el acrónimo PALM-COEIN. No obstante, hay una pobre sensibilización de este síntoma como un marcador de enfermedades graves. En esta revisión se describe la relación de la hemorragia uterina anormal como síntoma clave o de presentación de malignidad hematológica, así como la posible relación con la hemofilia adquirida secundaria a neoplasia hematológica como causal del evento hemostático. Se realizó búsqueda en la literatura, con la mayoría de los artículos obtenidos de Medline, 24 de los cuales cumplieron con los objetivos para resolver la pregunta de investigación. Se encontraron diferentes malignidades hematológicas asociadas a sangrado uterino anormal, de las cuales la hemofilia adquirida y la trombocitopenia como potenciales causales de esta; la mayor correlación fue con leucemia, seguido de linfomas, y en menor cuantía la asociación con mieloma múltiple.
Abnormal uterine bleeding has a variable etiology, ranging from structural to functional causes, classically described by the acronym PALM-COEIN. However, there is poor awareness of this symptom as a marker of serious disease; in this review, we describe the relationship of abnormal uterine bleeding as a key symptom or debut of hematologic malignancy, as well as its possible relationship to acquired hemophilia secondary to hematologic neoplasia as causative of the hemostatic event. A literature search was performed, with most of the articles obtained from Medline, 24 of which met the objectives to solve the research question. Different hematological malignancies associated with abnormal uterine bleeding were found, of which acquired hemophilia and thrombocytopenia were found as potential causes; the highest correlation was with leukemia, followed by lymphomas, and to a lesser extent the association with multiple myeloma.
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Humanos , Feminino , Hemorragia Uterina/etiologia , Doenças Hematológicas/complicações , Leucemia/complicações , Hemofilia A/complicaçõesRESUMO
Trichinellosis is a foodborne disease caused by ingestion of raw or undercooked meat containing Trichinella spp. larvae. Consumption of wild boar (Sus scrofa) meat represents an important source of human trichinellosis worldwide. In El Palmar National Park (EPNP), Argentina, invasive alien wild boars are controlled and meat from culled animals is released for public consumption following on-site artificial digestion (AD) testing. Meat trimmings and offal from the control program are often used as food for dogs (Canis familiaris). We evaluated infection and exposure to Trichinella spp. in wild boars from EPNP, as well as exposure to Trichinella spp. and associated risk factors in dogs and human consumers of wild boar meat. Trichinella spp. larvae were detected in muscle samples from 5/49 wild boars by AD (10.2%; 95% confidence interval [CI], 3.8%-23%), with a mean burden of 0.24 larvae per gram (lpg; range, 0.06-0.95 lpg). Anti-Trichinella antibodies were not detected in wild boar serum samples (n=42). In dogs, 12/34 were seropositive to Trichinella spp. (35.29%; 95%, CI, 20.3%-53.5%). Immunoglobulin (Ig) G antibodies were not detected in human serum samples (n=63). Our results reveal the presence, albeit at low prevalence, of Trichinella spp. in wild boars and exposure in dogs fed game offal. These findings suggest that the low prevalence and parasitic load in wild boars, together with the best practices applied by EPNP culling program personnel, contribute to keeping the risk of infection in people low. The dog results highlight that the parasite is circulating in the area, and therefore the risk of infection is not negligible. We recommend the implementation of an animal surveillance strategy in order to monitor the evolution of this zoonosis in the study area.
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Doenças do Cão , Nitrofenóis , Doenças dos Suínos , Trichinella , Triquinelose , Suínos , Humanos , Animais , Cães , Triquinelose/epidemiologia , Triquinelose/veterinária , Triquinelose/parasitologia , Argentina/epidemiologia , Parques Recreativos , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/parasitologia , Carne/parasitologia , Imunoglobulina G , Sus scrofa , Doenças do Cão/epidemiologia , Compostos de EpóxiRESUMO
OBJECTIVE: To test feasibility and safety of administering sildenafil in neonates with neonatal encephalopathy (NE), developing brain injury despite therapeutic hypothermia (TH). STUDY DESIGN: We performed a randomized, double-blind, placebo-controlled phase Ib clinical trial between 2016 and 2019 in neonates with moderate or severe NE, displaying brain injury on day-2 magnetic resonance imaging (MRI) despite TH. Neonates were randomized (2:1) to 7-day sildenafil or placebo (2 mg/kg/dose enterally every 12 hours, 14 doses). Outcomes included feasibility and safety (primary outcomes), pharmacokinetics (secondary), and day-30 neuroimaging and 18-month neurodevelopment assessments (exploratory). RESULTS: Of the 24 enrolled neonates, 8 were randomized to sildenafil and 3 to placebo. A mild decrease in blood pressure was reported in 2 of the 8 neonates after initial dose, but not with subsequent doses. Sildenafil plasma steady-state concentration was rapidly reached, but decreased after TH discontinuation. Twelve percent of neonates (1/8) neonates died in the sildenafil group and 0% (0/3) in the placebo group. Among surviving neonates, partial recovery of injury, fewer cystic lesions, and less brain volume loss on day-30 magnetic resonance imaging were noted in 71% (5/7) of the sildenafil group and in 0% (0/3) of the placebo group. The rate of death or survival to 18 months with severe neurodevelopmental impairment was 57% (4/7) in the sildenafil group and 100% (3/3) in the placebo group. CONCLUSIONS: Sildenafil was safe and well-absorbed in neonates with NE treated with TH. Optimal dosing needs to be established. Evaluation of a larger number of neonates through subsequent phases II and III trials is required to establish efficacy. CLINICAL TRIAL REGISTRATION: ClinicalTrials.govNCT02812433.
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Asfixia Neonatal , Lesões Encefálicas , Hipotermia Induzida , Hipóxia-Isquemia Encefálica , Doenças do Recém-Nascido , Recém-Nascido , Humanos , Citrato de Sildenafila/efeitos adversos , Asfixia/complicações , Estudos de Viabilidade , Asfixia Neonatal/terapia , Lesões Encefálicas/complicações , Lesões Encefálicas/tratamento farmacológico , Doenças do Recém-Nascido/terapia , Hipóxia-Isquemia Encefálica/terapia , Hipotermia Induzida/métodos , Método Duplo-CegoRESUMO
OBJECTIVE: To understand better those factors relevant to the increment of rise in platelet count following a platelet transfusion among thrombocytopenic neonates. STUDY DESIGN: We reviewed all platelet transfusions over 6 years in our multi-neonatal intensive care unit system. For every platelet transfusion in 8 neonatal centers we recorded: (1) platelet count before and after transfusion; (2) time between completing the transfusion and follow-up count; (3) transfusion volume (mL/kg); (4) platelet storage time; (5) sex and age of platelet donor; (6) gestational age at birth and postnatal age at transfusion; and magnitude of rise as related to (7) pre-transfusion platelet count, (8) method of enhancing transfusion safety (irradiation vs pathogen reduction), (9) cause of thrombocytopenia, and (10) donor/recipient ABO group. RESULTS: We evaluated 1797 platelet transfusions administered to 605 neonates (median one/recipient, mean 3, and range 1-52). The increment was not associated with gestational age at birth, postnatal age at transfusion, or donor sex or age. The rise was marginally lower: (1) with consumptive vs hypoproductive thrombocytopenia (P < .001); (2) after pathogen reduction (P < .01); (3) after transfusing platelets with a longer storage time (P < .001); and (4) among group O neonates receiving platelets from non-group O donors (P < .001). Eighty-seven neonates had severe thrombocytopenia (<20 000/µL). Among these infants, poor increments and death were associated with the cause of the thrombocytopenia. CONCLUSION: The magnitude of post-transfusion rise was unaffected by most variables we studied. However, the increment was lower in neonates with consumptive thrombocytopenia, after pathogen reduction, with longer platelet storage times, and when not ABO matched.
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Transfusão de Plaquetas , Trombocitopenia Neonatal Aloimune , Humanos , Recém-Nascido , Plaquetas , Transfusão de Sangue , Contagem de Plaquetas , Transfusão de Plaquetas/efeitos adversos , Trombocitopenia Neonatal Aloimune/etiologia , Trombocitopenia Neonatal Aloimune/terapia , Masculino , FemininoRESUMO
We describe a new species of gymnophthalmid lizard, Oreosaurus bisbali sp. nov., from the Turimiquire Massif in northeastern Venezuela. It is one of three reptile species known to be endemic to the region and the fifth species of Oreosaurus from Venezuela. It can be distinguished from all congeners by a combination of rectangular dorsal scales at midbody, having two scales separating femoral pores medially, and lacking a nasoloreal suture. The new species is likely to be restricted in distribution to the highlands of the Turimiquire Massif, which have been significantly degraded by agriculture.
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Lagartos , Distribuição Animal , Animais , VenezuelaRESUMO
The relationships of the hyline tribe Dendropsophini remain poorly studied, with most published analyses dealing with few of the species groups of Dendropsophus. In order to test the monophyly of Dendropsophini, its genera, and the species groups currently recognized in Dendropsophus, we performed a total evidence phylogenetic analysis. The molecular dataset included sequences of three mitochondrial and five nuclear genes from 210 terminals, including 12 outgroup species, the two species of Xenohyla, and 93 of the 108 recognized species of Dendropsophus. The phenomic dataset includes 46 terminals, one per species (34 Dendropsophus, one Xenohyla, and 11 outgroup species). Our results corroborate the monophyly of Dendropsophini and the reciprocal monophyly of Dendropsophus and Xenohyla. Some species groups of Dendropsophus are paraphyletic (the D. microcephalus, D. minimus, and D. parviceps groups, and the D. rubicundulus clade). On the basis of our results, we recognize nine species groups; for three of them (D. leucophyllatus, D. microcephalus, and D. parviceps groups) we recognize some nominal clades to highlight specific morphology or relationships and facilitate species taxonomy. We further discuss the evolution of oviposition site selection, where our results show multiple instances of independent evolution of terrestrial egg clutches during the evolutionary history of Dendropsophus.
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Anuros/classificação , Anuros/genética , Filogenia , Animais , Núcleo Celular/genética , Genes Mitocondriais , RNA Ribossômico 16S , Análise de Sequência de DNARESUMO
Pseudogonatodes furvus is an endemic gecko from the region of the Sierra Nevada de Santa Marta, an isolated massif located in the continental Caribbean region of Colombia. Pseudogonatodes furvus is the type species of the genus, and its morphology and natural history remain poorly known. This lizard was described based on two specimens. After its description, the species has only been mentioned in a handful of taxonomic studies of Pseudogonatodes, in which a few morphological characters of P. furvus have been mentioned. One other paper reported two new localities, without providing new information on the external morphology, especially the lepidosis of the newly obtained specimens. Here we review the external morphology of P. furvus, based on examination of the holotype and six additional specimens. We provide an extended diagnosis and definition, description of holotype, variation, comparisons with other Pseudogonatodes, geographic distribution (adding a fourth locality to the known distribution for the species), and conservation status. Additionally, we describe osteological features for the diagnosis of the genus.
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Lagartos , Animais , Tamanho Corporal , OsteologiaRESUMO
Background This study compared left ventricular (LV) characteristics between patients with type-A and type-B aortic dissection (AD) and evaluated the ability of LV remodeling phenotypes (hypertrophy, concentricity, or geometric patterns) to predict mortality in both AD types. Methods and Results We evaluated 236 patients with type A and 120 patients with type B who had echocardiograms within 60 days before or after AD diagnosis (median [25th, 75th percentiles] time difference between echocardiogram and AD diagnosis=1 [0, 6] days) from 3 centers. Patients were stratified according to LV phenotypes, and early (90-day) and late (1-year) mortality after AD diagnosis were assessed. In adjusted logistic regression analysis, patients with type A had higher and lower odds of concentric and eccentric hypertrophy (odds ratio [OR], 2.56; 95% CI, 1.50-4.36; P<0.001; and OR, 0.55; 95% CI, 0.31-0.97; P=0.039, respectively) than those with type B. Results of multivariable Cox-regression analysis showed that LV remodeling phenotypes were not related to mortality in patients with type B. By contrast, LV concentricity was associated with greater early and late mortality (hazard ratio [HR], 2.22; 95% CI, 1.24-3.96; P=0.007 and HR, 2.06; 95% CI, 1.20-3.54; P=0.009, respectively) in type A. In further analysis considering normal LV geometry as reference, LV concentric remodeling and concentric hypertrophy were associated with early mortality (HR, 7.78; 95% CI, 2.35-25.78; P<0.001 and HR, 4.38; 95% CI, 1.47-13.11; P=0.008, respectively), whereas concentric remodeling was associated with late mortality (HR, 5.40; 95% CI, 1.91-15.26; P<0.001) among patients with type A. Assessment of LV geometric patterns and concentricity provided incremental prognostic value in predicting early and late mortality beyond clinical variables in patients with type A based on net reclassification improvement and integrated discrimination improvement. Conclusions LV geometric patterns derived from LV concentricity were associated with greater mortality among patients with type A and may be markers of adverse prognosis in this population.
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Aneurisma da Aorta Torácica/diagnóstico , Dissecção Aórtica/diagnóstico , Ventrículos do Coração/diagnóstico por imagem , Função Ventricular Esquerda/fisiologia , Remodelação Ventricular/fisiologia , Dissecção Aórtica/mortalidade , Dissecção Aórtica/fisiopatologia , Aneurisma da Aorta Torácica/mortalidade , Aneurisma da Aorta Torácica/fisiopatologia , Brasil/epidemiologia , Progressão da Doença , Ecocardiografia , Feminino , Seguimentos , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida/tendênciasRESUMO
The present study reports the first structural characterization of protonated cyameluric acid ([CA + H]+) in the gas phase, which paves the way for prospective bottom-up research on the condensed-phase chemistry of CA in the protonated form. A number of [CA + H]+ keto-enol isomers can a priori be produced as a result of protonation at available N and O positions of precursor neutral CA tautomers, yet ab initio computations predict different reduced [CA + H]+ isomer populations dominating the solution and gas phases that are involved in the ion generation process (i.e., electrospray ionization). Infrared multiple photon dissociation spectra were recorded in the 990-1900 and 3300-3650 cm-1 regions and compared with theoretical [B3LYP/6-311++G(d,p)] IR absorption spectra of several [CA + H]+ isomers, providing a satisfactory agreement for the most stable monohydroxy form in the gas phase, [1358a]+, yet the contribution of its nearly isoenergetic OH rotamer, [1358b]+, cannot be neglected. This is indicative of the occurrence of [CA + H]+ isomer interconversion reactions, assisted by protic solvent molecules, during their transfer into the gas phase. The results suggest that available O positions on neutral CA are energetically favored protonation sites in the gas phase.
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OBJECTIVE: This study compared clinical, echocardiographic, and prognostic characteristics among patients with aortic dissection (AD) with (HypHist) and without (No-HypHist) hypertension history and evaluated the association of blood pressure (BP) at presentation with 1-year mortality, left ventricular (LV) remodeling and renal dysfunction. METHODS: We investigated clinical and echocardiographic characteristics and 1-year mortality among 367 patients with AD (81% HypHist, 66% Type-A) from three Brazilian centers. RESULTS: Patients with No-HypHist were more likely to have Marfan syndrome, bicuspid aortic valve, to undergo surgical therapy, were less likely to have LV hypertrophy and concentricity, and had similar mortality compared with HypHist patients. Adjusted restricted cubic spline analysis showed that systolic BP (SBP) and diastolic BP (DBP) at presentation had a J-curve association with mortality among patients with No-HypHist, but did not associate with death among patients with HypHist (p for interaction = 0.001 for SBP and = 0.022 for DBP). Conversely, the association between SBP at presentation and mortality was influenced by previous use of antihypertensive medications in the HypHist group (p for interaction = 0.002). Results of multivariable logistic regression analysis comprising the whole sample showed direct associations of SBP and DBP at presentation with LV hypertrophy (p = 0.009) and LV concentricity (p = 0.015), respectively, and an inverse association between pulse pressure at presentation and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 (p = 0.008). CONCLUSION: Combined information on BP at presentation, previous diagnosis of hypertension, and use of antihypertensive medications might be useful to predict mortality risk and to estimate extra-aortic end-organ damage among patients with AD.
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We describe a new species of diurnal gecko, Gonatodes machelae sp. nov., from Cerro El Copey, Margarita Island, Venezuela. The new species is distinguished from all congeners by a combination of the following characters: small size, subcaudal pattern C (1'1''), typically three lateral scale rows on the digits, and aspects of coloration. The new species exhibits polychromatism similar to what has been described in some other species of Gonatodes. It is found in humid forests and shrublands from about 450 m to 900 m above sea level.
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Lagartos , Distribuição Animal , Estruturas Animais , Animais , Ilhas , VenezuelaRESUMO
Arterial pressure waves have been described in one dimension using several approaches, such as lumped (Windkessel) or distributed (using Navier-Stokes equations) models. An alternative approach consists of modeling blood pressure waves using a Korteweg-de Vries (KdV) equation and representing pressure waves as combinations of solitons. This model captures many key features of wave propagation in the systemic network and, in particular, pulse pressure amplification (PPA), which is a mechanical biomarker of cardiovascular risk. The main objective of this work is to compare the propagation dynamics described by a KdV equation in a human-like arterial tree using acquired pressure waves. Furthermore, we analyzed the ability of our model to reproduce induced elastic changes in PPA due to different pathological conditions. To this end, numerical simulations were performed using acquired central pressure signals from different subject groups (young, adults, and hypertensive) as input and then comparing the output of the model with measured radial artery pressure waveforms. Pathological conditions were modeled as changes in arterial elasticity (E). Numerical results showed that the model was able to propagate acquired pressure waveforms and to reproduce PPA variations as a consequence of elastic changes. Calculated elasticity for each group was in accordance with the existing literature.
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Determinação da Pressão Arterial/métodos , Modelos Cardiovasculares , Processamento de Sinais Assistido por Computador , Adulto , Idoso , Pressão Sanguínea/fisiologia , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
SETTING AND OBJECTIVE: The International Study of Asthma and Allergies in Childhood (ISAAC) reported asthma prevalence in Peru to be among the highest in the world. We assessed the prevalence and morbidity of self-reported asthma in an underserved, peri-urban area of Lima, Peru, with limited medical access. DESIGN: The study was conducted in the outskirts of Lima from March to May 2011. Five hundred children aged 6-18 years were selected through cluster sampling. Parents completed a modified version of the ISAAC questionnaire. Children underwent spirometry testing. Those with a forced expiratory volume in one second (FEV1% predicted) îº80% were tested for reversibility using salbutamol. RESULTS: Of the 500 children selected, 71% participated. The prevalence of asthma was 16.7%. Asthma symptoms were associated with self-reported asthma (P < 0.001); 52.5% of children with asthma had ever used an inhaler (P < 0.001), and 27.1% had never been to the doctor for respiratory problems (P < 0.001). CONCLUSION: We found a high prevalence of self-reported asthma and high morbidity related to asthma symptoms in the previous 12 months among the study cohort. Symptoms were poorly controlled due to limited availability of medication and access to medical services.
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Asma/epidemiologia , Acessibilidade aos Serviços de Saúde , Estudantes/estatística & dados numéricos , Adolescente , Asma/diagnóstico , Criança , Estudos de Coortes , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Pais , Peru/epidemiologia , Prevalência , Autorrelato , Espirometria , Inquéritos e Questionários , População UrbanaRESUMO
Estradiol triggers key biological responses in the endometrium, which rely on the presence and levels of its cognate receptors on target cells. Employing the receptor micro-autoradiography (RMAR) technique, we aimed to provide a temporal and spatial map of the functional binding sites for estradiol in the mouse endometrial stroma during early pregnancy. Uterine samples from days 1.5 to 7.5 of pregnancy were collected 1 h after tritiated- (3H-) estradiol administration and prepared for RMAR analysis. Autoradiographic incorporation of 3H-thymidine (after 1-h pulse) was evaluated over the same gestational interval. Combined RMAR with either histochemistry with Dolichus biflorus (DBA) lectin or immunohistochemistry for detection of the desmin further characterized 3H-estradiol binding pattern in uterine Natural Killer (uNK) and decidual cells, respectively. 3H-estradiol binding levels oscillated in the pregnant endometrial stroma between the mesometrial and antimesometrial regions as well as the superficial and deep domains. Although most of the endometrial stromal cells retained the hormone, a sub-population of them, as well as endothelial and uNK cells, were unable to do so. Rises in the levels of 3H-estradiol binding preceded endometrial stromal cell proliferation. 3H-estradiol binding and 3H-thymidine incorporation progressively decreased along the development of the antimesometrial decidua. Endothelial proliferation occurred regardless of 3H-estradiol binding, whereas pericytes proliferation was associated with high levels of hormone binding. Endometrial cell populations autonomously control their levels of 3H-estradiol binding and retention, a process associated with their proliferative competence. Collectively, our results illustrate the intricate regulatory dynamic of nuclear estrogen receptors in the pregnant mouse endometrium.
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Autorradiografia , Endométrio/citologia , Estradiol/análise , Estradiol/metabolismo , Receptores de Estrogênio/análise , Receptores de Estrogênio/metabolismo , Células Estromais/metabolismo , Animais , Sítios de Ligação , Endométrio/metabolismo , Estradiol/administração & dosagem , Feminino , Imuno-Histoquímica , Camundongos , Gravidez , Receptores de Estrogênio/química , Células Estromais/citologiaRESUMO
UNLABELLED: The role of lead (Pb) as an environmental cause of nephropathy is difficult to ascertain due to the difficulty to determine clinically its exposure. AIM: To assess lead levels and renal function in a group of males working in mechanical workshops. MATERIAL AND METHODS: Blood and urine samples were obtained from 100 mechanical workshop workers aged 38 ± 16 years and 95 non-exposed office clerks aged 37 ± 17 years. Blood lead and creatinine levels were determined. In exposed workers, urinary excretion of intestinal alkaline phosphatases (IAP) and N-acetyl-glucosaminidase (NAG) were measured as early markers of renal failure. RESULTS: Blood lead levels were 66.4 ± 43 and 33.6 ± 18 µg/L among mechanical workshop workers and non-exposed controls, respectively, p < 0.01. The figures for serum creatinine were 0.9 ± 0.1 and 0.9 ± 0.1 respectively, p = NS. Among exposed workers urinary excretion of IAP was 0.47 ± 0.6 U/L and of NAG, 0.92 ± 1.1 U/L. There was a positive correlation between blood lead levels and NAG excretion (r = 0.284) and IAP excretion (r = 0.346). CONCLUSIONS: Exposed workers had higher blood lead levels and there was a weak positive association between these levels and the urinary excretion of NAG and IAP.