RESUMO
Two alkalinizing mechanisms coexist in cardiac myocytes to maintain intracellular pH: sodium/bicarbonate cotransporter (electroneutral isoform NBCn1 and electrogenic isoform NBCe1) and sodium/proton exchanger (NHE1). Dysfunction of these transporters has previously been reported to be responsible for the development of cardiovascular diseases. The aim of this study was to evaluate the contribution of the downregulation of the NBCe1 to the development of cardiac hypertrophy. To specifically reduce NBCe1 expression, we cloned shRNA into a cardiotropic adeno-associated vector (AAV9-shNBCe1). After 28 days of being injected with AAV9-shNBCe1, the expression and the activity of NBCe1 in the rat heart were reduced. Strikingly, downregulation of NBCe1 causes significant hypertrophic heart growth, lengthening of the action potential in isolated myocytes, an increase in the duration of the QT interval and an increase in the frequency of Ca2+ waves without any significant changes in Ca2+ transients. An increased compensatory expression of NBCn1 and NHE1 was also observed. We conclude that reduction of NBCe1 is sufficient to induce cardiac hypertrophy and modify the electrical features of the rat heart.
Assuntos
Bicarbonatos , Simportadores de Sódio-Bicarbonato , Ratos , Animais , Simportadores de Sódio-Bicarbonato/genética , Simportadores de Sódio-Bicarbonato/metabolismo , Bicarbonatos/metabolismo , Cardiomegalia/genética , Cardiomegalia/metabolismo , Sódio/metabolismo , Isoformas de Proteínas/metabolismo , Concentração de Íons de HidrogênioRESUMO
OBJECTIVE: To evaluate the performance of a point-of-care (POC) syphilis test when used in urban Bolivian maternity hospitals. METHODS: We tested 8892 pregnant women for syphilis using the Abbott Determine Syphilis TP rapid POC test and rapid plasma reagin (RPR) in the laboratory of four large urban maternity hospitals where national statistics reported a syphilis prevalence of at least 3%. Sera were stored and transferred to the national reference laboratory (INLASA) where RPR testing was repeated. When the reference laboratory staff observed a positive RPR result, a Treponema pallidum particle agglutination assay (TPPA) was performed to confirm these findings. We calculated test performance characteristics for the POC test and hospital RPR using RPR performed at the reference laboratory confirmed by TPPA as the reference standard. Participants received treatment during their initial visit based on the POC test results. RESULTS: The sensitivity, specificity, negative predictive value and positive predictive values of the POC syphilis test were: 91.8% (95% confidence intervals 88.4% to 94.5%), 98.5% (98.2% to 98.8%), 71.0% (66.6% to 75.2%), and 99.7% (99.5% to 99.8%), respectively. The RPR values were 75.7% (70.8% to 80.2%), 99.0% (98.9% to 99.3%), 76.9% (72.0% to 81.3%), and 99.0% (98.8% to 99.2%), respectively. CONCLUSION: The Abbott Determine Syphilis TP test proved to be more sensitive than routine RPR and had comparable specificity. POC testing may be a simple way to expand syphilis screening to clinics with no laboratory facilities, improve case detection, and facilitate treatment delivery.
Assuntos
Sistemas Automatizados de Assistência Junto ao Leito/normas , Complicações Infecciosas na Gravidez/diagnóstico , Diagnóstico Pré-Natal/normas , Sorodiagnóstico da Sífilis/normas , Sífilis/diagnóstico , Adolescente , Adulto , Bolívia , Feminino , Humanos , GravidezRESUMO
This study aims to identify factors contributing to the development of community-acquired infections in hospitalized type-2 diabetics, using an unmatched case-control design. A total of 105 pairs of diabetic patients with community-acquired infections as compared to non-infectious diseases, respectively, were chosen randomly from the discharge registry of the clinical wards of a teaching hospital from 1991 to 1998. Bivariate and multivariate analysis was conducted with estimation of the adjusted odds ratio. According to stratified analysis controlling for age and sex, autonomic neuropathy proved to be a contributing factor to development of urinary tract infections (OR = 4.07). In the multivariate model, peripheral vasculopathy was isolated (R2: 0.24) as a contributing factor in the development of soft-tissue infections (OR = 6.79). Confidence intervals were significant at 0.05. In conclusion, peripheral vasculopathy and neurogenic bladder contribute to the development of community-acquired infections in hospitalized type-2 diabetics.
Assuntos
Infecções Comunitárias Adquiridas/etiologia , Diabetes Mellitus Tipo 2/complicações , Adulto , Análise de Variância , Estudos de Casos e Controles , Infecções Comunitárias Adquiridas/diagnóstico , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Doenças Vasculares Periféricas/complicações , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos , Bexiga Urinaria Neurogênica/complicaçõesRESUMO
Tomando en cuenta que las técnicas de detección de anticuerpo para VIH en general requieren manipulación de sangre por tanto generación de material de desecho potencialmente infectante, se realizó un estudio buscando anticuerpos anti VIH empleando como muestra saliva, los resultados obtenidos muestran que podría ser un método alternativo y seguro para el diagnóstico de infección por VIH
Assuntos
Humanos , HIV , Saliva , Manejo de Espécimes , Síndrome da Imunodeficiência Adquirida , Bolívia , Anticorpos Anti-HIVRESUMO
Non-specific ileojejunitis, characterised by mild to moderate structural changes in the intestinal mucosa and often associated with asymptomatic malabsorption, is known to occur in the tropics and in countries with hot climates. This acquired condition is probably related to environmental factors, and some consider it to be a subclinical form of tropical sprue. Changes in the intestinal mucosa typical of non-specific ileojejunitis were found in 10 indigenous Indians as well as 5 people of Latin stock living in the Southern Peruvian sierra, where tropical sprue has not as yet been demonstrated and which has a temperate climate.