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1.
Physiol Res ; 72(1): 111-116, 2023 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-36545875

RESUMO

Asthma poses an increased risk for cardiovascular disorders, suggesting that allergy, which is an underlying process in asthma, causes atypical functioning of organs other than lungs. In a previous study in a guinea pig asthma model, we concluded that allergic sensitization increased aorta contractile responses to 5-HT. To further characterize these responses, here we explored the role of the 5-HT2 receptors family. We found that TCB-2 (5-HT2A agonist) and WAY161503 (5-HT2C agonist) induced aorta contractions resembling those elicited by 5-HT but less intense (~43 % and ~25 %, respectively). In these experiments, aortas from sensitized guinea pigs showed increased contractions to TCB-2, but not to WAY161503. In turn, MDL 100907 (5-HT2A antagonist) and RS-102221 (5-HT2C antagonist) caused a notably and a mild reduction of the 5-HT-induced contractions, respectively, with no differences seen between sensitized and non-sensitized tissues. BW723C86 (5-HT2B agonist) did not induce contractile responses and RS-127445 (5-HT2B antagonist) did not modify the contractile responses to 5-HT. In non-sensitized aortas, the pattern of protein expression of receptors was 5HT2B>5-HT2A=5-HT2C, which did not change in sensitized animals. In conclusion, we found that allergic sensitization increased the aorta contractile responses to 5-HT, partly mediated by enhanced responses of 5-HT2A receptors, which was unrelated to changes in the expression of these receptors.


Assuntos
Asma , Serotonina , Animais , Cobaias , Receptores de Serotonina/metabolismo , Receptores 5-HT2 de Serotonina , Aorta
2.
Physiol Res ; 69(1): 191-197, 2020 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-31852196

RESUMO

Epidemiological and clinical studies suggest that asthma is associated with adverse cardiovascular outcomes, but its mechanism is uncertain. 5-Hydroxytryptamine (5-HT) is a mediator involved in asthma and in cardiovascular functioning. Thus, in the present study, we explored whether allergic sensitization in guinea pigs modifies 5-HT-induced contractile responses and 5-HT2A receptor expression in thoracic aorta rings. We found that sensitization produced a significant increase of 100 microM 5-HT-induced contractions of aorta rings (~27 % greater contraction than in non-sensitized animals, p<0.05). Preincubation with 10 nM ketanserin (a 5-HT2A receptor antagonist) reduced by ~30 % (p=0.003) and ~36 % (p=0.005) the area under the curve of 5-HT-induced contractions in aortas from non-sensitized and sensitized animals, respectively. There were no differences between sensitized and non-sensitized animals with respect to mRNA (qPCR) and protein (Western blot) expression of 5-HT2A receptor in thoracic aortas. We concluded that in this guinea pig model of asthma, allergic sensitization is not confined to airways, but also affects arterial contractile responses to 5-HT; changes in the expression of the 5-HT2A receptor appear not to be involved in this phenomenon.


Assuntos
Aorta/fisiopatologia , Asma/fisiopatologia , Músculo Liso Vascular/fisiopatologia , Receptor 5-HT2A de Serotonina/fisiologia , Serotonina/fisiologia , Animais , Modelos Animais de Doenças , Cobaias , Masculino
3.
Physiol Meas ; 38(6): 992-1005, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28378711

RESUMO

Objective and approach: In this study, we estimated the constant phase model (CPM) parameters from the respiratory impedance of male BALB/c mice by performing the forced oscillation technique (FOT) in a control group (n = 8) and in a murine model of asthma (OVA) (n = 10). Then, we compared the results obtained by two different methods, using a commercial equipment (flexiVent-flexiWare 7.X; SCIREQ, Montreal, Canada) (FXV) and a wavetube method equipment (Sly et al 2003 J. Appl. Physiol. 94 1460-6) (WVT). We believe that the results from different methods may not be comparable. First, we compared the results performing a two-way analysis of variance (ANOVA) for the resistance, elastance and tissue damping. MAIN RESULTS: We found statistically significant differences in all CPM parameters, except for resistance, when comparing Control and OVA groups. When comparing devices, we found statistically significant differences in resistance, while differences in elastance were not observed. For tissue damping, the results from WVT were observed to be higher than those from FXV. Finally, when comparing the relative variation between the CPM parameters of the Control and OVA groups in both devices, no significant differences were observed for all parameters. SIGNIFICANCE: We then conclude that this assessment can compensate the effect of using different cannulas. Furthermore, tissue damping differences between groups can be compensated, since bronchoconstrictors were not used. Therefore, we believe that relative variations in the results between groups can be a comparing parameter when using different equipment without bronchoconstrictor administration.


Assuntos
Impedância Elétrica , Mecânica Respiratória , Animais , Asma/fisiopatologia , Broncoconstritores/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Modelos Biológicos , Mecânica Respiratória/efeitos dos fármacos , Processamento de Sinais Assistido por Computador
4.
Allergol Immunopathol (Madr) ; 44(6): 504-511, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27707587

RESUMO

BACKGROUND: OM-85 is an immunostimulant bacterial lysate, which has been proven effective in reducing the number of lower airways infections. We investigated the efficacy of the bacterial lysate OM-85 in the primary prevention of a murine model of asthma. METHODS: In the first phase of our study the animals received doses of 0.5µg, 5µg and 50µg of OM-85 through gavage for five days (days -10 to -6 of the protocol), 10 days prior to starting the sensitisation with ovalbumin (OVA), in order to evaluate the results of dose-response protocols. A single dose (5µg) was then chosen in order to verify in detail the effect of OM-85 on the pulmonary allergic response. Total/differential cells count and cytokine levels (IL-4, IL-5, IL-13 and IFN-γ) from bronchoalveolar lavage fluid (BALF), OVA-specific IgE levels from serum, lung function and lung histopathological analysis were evaluated. RESULTS: OM-85 did not reduce pulmonary eosinophilic response, regardless of the dose used. In the phase protocol using 5µg/animal of OM-85, no difference was shown among the groups studied, including total cell and eosinophil counts in BALF, serum OVA-specific IgE, lung histopathologic findings and lung resistance. However, OM-85 decreased IL-5 and IL-13 levels in BALF. CONCLUSIONS: OM-85, administered in early life in mice in human-equivalent doses, does not inhibit the development of allergic pulmonary response in mice.


Assuntos
Asma/prevenção & controle , Extratos Celulares/administração & dosagem , Eosinófilos/efeitos dos fármacos , Animais , Asma/imunologia , Citocinas/metabolismo , Modelos Animais de Doenças , Eosinófilos/imunologia , Feminino , Humanos , Imunização , Imunoglobulina E/sangue , Camundongos , Camundongos Endogâmicos BALB C
5.
Allergy ; 71(1): 124-8, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26405014

RESUMO

Several studies suggest that ATP and related nucleotides play a role in the pathophysiology of asthma. However, the functionality of ectonucleotidases in this disease has been scantly investigated. We studied total ectonucleotidase activity in leukocytes from patients suffering from asthma exacerbation and explored the expression of E-NTPDase 1, 2, 3, and 8, and E-NPP1, 2, and 3, in their polymorphonuclear cells by immunofluorescence and qPCR. Leukocytes from patients with mild or moderate asthma exacerbation had similar ectonucleotidase activity than leukocytes from healthy subjects, while in patients with severe asthma exacerbation, this activity was lower. Of the ectonucleotidases studied, only E-NPP1 displayed diminished immunofluorescence and a significant decrease in its mRNA expression, both in patients with severe asthma exacerbation. This reduced E-NPP1 expression could be responsible for increased amounts of ATP or other nucleotides, capable of worsening asthma exacerbation, and warranting further investigation.


Assuntos
Asma/genética , Regulação da Expressão Gênica , Leucócitos/metabolismo , Diester Fosfórico Hidrolases/genética , Pirofosfatases/genética , Trifosfato de Adenosina/metabolismo , Asma/diagnóstico , Asma/metabolismo , Progressão da Doença , Imunofluorescência , Humanos , Diester Fosfórico Hidrolases/metabolismo , Pirofosfatases/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo
6.
Transplant Proc ; 47(6): 1653-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26293029

RESUMO

The success of lung transplantation is threatened by the appearance of ischemia-reperfusion injury, which is characterized by increased vascular permeability. 5-Hydroxytryptamine (5-HT; serotonin) is known to produce microvascular leakage in the systemic circulation, but its possible role in ischemia-reperfusion injury after lung preservation has not been reported. In this work we measured the release of 5-HT during a 24-hour rabbit lung preservation, and the effect of methiothepin (antagonist of the majority of 5-HT receptors) and SB204741 (antagonist of 5-HT2B/2C receptors) on the modified capillary filtration coefficient (mKf,c) was evaluated at the end of this period. Our results showed that the highest release rate of 5-HT occurred during the first 15 minutes after the lung harvesting and progressively decreased in the following time intervals. The baseline mKf,c greatly increased after 24 hours of lung preservation, and this increment was partially reduced by methiothepin and even more by SB204741. We concluded that 5-HT may play an important role in the ischemia-reperfusion process after lung preservation.


Assuntos
Isquemia/metabolismo , Lesão Pulmonar/metabolismo , Pulmão/metabolismo , Preservação de Órgãos/efeitos adversos , Traumatismo por Reperfusão/metabolismo , Antagonistas da Serotonina/metabolismo , Animais , Capilares , Pulmão/irrigação sanguínea , Transplante de Pulmão , Masculino , Coelhos , Reperfusão
7.
Allergy ; 69(12): 1696-700, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25130372

RESUMO

Asthma is associated with a loss of the structural integrity of airway epithelium and dysfunction of the physical barrier, which protects airways from external harmful factors. Granulocyte activation causes the formation of extracellular traps, releasing web-like structures of DNA and proteins, being important to kill pathogens extracellularly. We investigated whether eosinophils infiltrating airways in an experimental model of asthma would induce eosinophil extracellular traps (EETs) in bronchoalveolar lavage fluid and lung tissue. We showed that an ovalbumin (OVA) asthma protocol presented a significant increase in eosinophil counts with increased extracellular DNA in bronchoalveolar lavage fluid as well as in lung tissue, confirming the presence of DNA traps colocalized with eosinophil peroxidase. EETs formation was reversed by DNase treatment. With these approaches, we demonstrated for the first time that OVA-challenged mice release extracellular DNA traps, which could aggravate pulmonary dysfunction.


Assuntos
Líquido da Lavagem Broncoalveolar/imunologia , DNA/metabolismo , Armadilhas Extracelulares/imunologia , Armadilhas Extracelulares/metabolismo , Eosinofilia Pulmonar/imunologia , Eosinofilia Pulmonar/metabolismo , Animais , Asma/imunologia , Asma/patologia , Modelos Animais de Doenças , Inflamação/imunologia , Inflamação/metabolismo , Inflamação/patologia , Camundongos , Ovalbumina/efeitos adversos , Eosinofilia Pulmonar/patologia
8.
Allergy ; 68(4): 462-71, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23414231

RESUMO

BACKGROUND: Nucleotides released to the extracellular space stimulate purinergic receptors, and their effects are modulated by ectonucleotidases. The role of ATP in the allergic bronchospasm has been scantly studied. METHODS: We used several techniques (plethysmography, organ baths, confocal microscopy, RT-PCR, ATP measurement) to explore the role of nucleotides and ectonucleotidases in the allergic bronchospasm in guinea pigs. RESULTS: While allergenic challenge with a low-dose ovalbumin (OVA) only produced a small bronchospasm (~2-fold the basal lung resistance), previous inhibition of ectonucleotidases by ARL-67156 greatly intensified this response (~11-fold the basal lung resistance, with 44% mortality). Bronchoalveolar lavage fluid obtained during this bronchospasm contained increased ATP concentration. This potentiation was abolished by antagonism of purinergic receptors (suramin+RB2) or TXA2 receptor (SQ29548), or by intratracheal apyrase. In tracheal rings and lung parenchyma strips, OVA caused a concentration-dependent contraction. Suramin+RB2 or levamisole produced a significant rightward displacement of this response, and ARL-67156 did not modify it. Platelets stimulated with OVA released ATP. Confocal images of nonsensitized tracheas showed slight fluorescence for P2Y6 receptors in epithelium and none for P2Y4 . Sensitized animals showed strong fluorescence to both receptors and to alkaline phosphatase in the airway epithelium. This correlated with a large increment in mRNA for P2Y4 and P2Y6 receptors in sensitized animals. CONCLUSIONS: Nucleotides greatly potentiate the allergic bronchospasm when ectonucleotidases activity is diminished, and this effect is probably favored by the upregulation of P2Y4 and P2Y6 receptors in airway epithelium during sensitization. These results prompt for further research on these mechanisms in human asthma.


Assuntos
Espasmo Brônquico/enzimologia , Espasmo Brônquico/imunologia , Hipersensibilidade/enzimologia , Hipersensibilidade/imunologia , Nucleotidases/metabolismo , Nucleotídeos/metabolismo , Trifosfato de Adenosina/análogos & derivados , Trifosfato de Adenosina/metabolismo , Trifosfato de Adenosina/farmacologia , Fosfatase Alcalina/metabolismo , Animais , Plaquetas/efeitos dos fármacos , Plaquetas/metabolismo , Espasmo Brônquico/induzido quimicamente , Espasmo Brônquico/genética , Líquido da Lavagem Broncoalveolar/imunologia , Relação Dose-Resposta a Droga , Espaço Extracelular/metabolismo , Cobaias , Hidrólise/efeitos dos fármacos , Hipersensibilidade/genética , Nucleotidases/antagonistas & inibidores , Ovalbumina/efeitos adversos , Ovalbumina/imunologia , Receptores Purinérgicos P2/genética , Receptores Purinérgicos P2/metabolismo
9.
Eur Respir J ; 42(1): 169-179, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23060633

RESUMO

The broadest pattern of tuberculosis (TB) drug resistance for which a consensus definition exists is extensively drug-resistant (XDR)-TB. It is not known if additional drug resistance portends worsened patient outcomes. This study compares treatment outcomes of XDR-TB patients with and without additional resistance in order to explore the need for a new definition. Individual patient data on XDR-TB outcomes were included in a meta-analysis comparing outcomes between XDR alone and three nonmutually exclusive XDR-TB patient groups: XDR plus resistance to all the second-line injectables (sli) and capreomycin and kanamycin/amikacin (XDR+2sli) XDR plus resistance to second-line injectables and to more than one group 4 drug, i.e. ethionamide/protionamide, cycloserine/terizidone or para-aminosalicylic acid (XDR+sliG4) and XDR+sliG4 plus resistance to ethambutol and/or pyrazinamide (XDR+sliG4EZ). Of 405 XDR-TB cases, 301 were XDR alone, 68 XDR+2sli, 48 XDR+sliG4 and 42 XDR+sliG4EZ. In multivariate analysis, the odds of cure were significantly lower in XDR+2sli (adjusted OR 0.4, 95% CI 0.2-0.8) compared to XDR alone, while odds of failure and death were higher in all XDR patients with additional resistance (adjusted OR 2.6-2.8). Patients with additional resistance beyond XDR-TB showed poorer outcomes. Limitations in availability, accuracy and reproducibility of current drug susceptibility testing methods preclude the adoption of a useful definition beyond the one currently used for XDR-TB.


Assuntos
Farmacorresistência Bacteriana , Tuberculose Extensivamente Resistente a Medicamentos/tratamento farmacológico , Adulto , Antituberculosos/farmacologia , Estudos de Coortes , Quimioterapia Combinada/métodos , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Análise Multivariada , Mycobacterium tuberculosis/efeitos dos fármacos , Reprodutibilidade dos Testes , Resultado do Tratamento
10.
Clin Exp Allergy ; 40(2): 327-38, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19995401

RESUMO

BACKGROUND: A possible role of 5-hydroxytryptamine (5-HT) in the origin of antigen-induced airway hyperresponsiveness (AI-AHR) has been scarcely investigated. OBJECTIVE: To explore the participation of different 5-HT receptors in the development of AI-AHR in guinea-pigs. METHODS: Lung resistance was measured in anaesthetized guinea-pigs sensitized to ovalbumin (OVA). Dose-response curves to intravenous (i.v.) acetylcholine (ACh) were performed before and 1 h after antigenic challenge and expressed as the 200% provocative dose (PD(200)). Organ bath experiments, confocal microscopy and RT-PCR were additionally used. The 5-HT content in lung homogenates was measured by HPLC. RESULTS: Antigenic challenge significantly decreased PD(200), indicating the development of AI-AHR. This hyperresponsiveness was abolished by a combination of methiothepin (5-HT(1)/5-HT(2)/5-HT(5)/5-HT(6)/5-HT(7) receptors antagonist) and tropisetron (5-HT(3)/5-HT(4) antagonist). Other 5-HT receptor antagonists showed three different patterns of response. Firstly, WAY100135 (5-HT(1A) antagonist) and ondansetron (5-HT(3) antagonist) did not modify the AI-AHR. Secondly, SB269970 (5-HT(7) antagonist), GR113808 (5-HT(4) antagonist), tropisetron or methiothepin abolished the AI-AHR. Thirdly, ketanserin (5-HT(2A) antagonist) produced airway hyporresponsiveness. Animals with bilateral vagotomy did not develop AI-AHR. Experiments in tracheal rings showed that pre-incubation with LP44 or cisapride (agonists of 5-HT(7) and 5-HT(4) receptors, respectively) induced a significant increase of the cholinergic contractile response to the electrical field stimulation. In sensitized lung parenchyma strips, ketanserin diminished the contractile responses to ACh. Sensitization was associated with a ninefold increase in the 5-HT content of lung homogenates. Confocal microscopy showed that sensitization enhanced the immunolabelling and co-localization of nicotinic receptor and 5-HT in airway epithelium, probably located in pulmonary neuroendocrine cells (PNECs). RT-PCR demonstrated that neither sensitization nor antigen challenge modified the 5-HT(2A) receptor mRNA levels. CONCLUSIONS: Our results suggested that 5-HT was involved in the development of AI-AHR to ACh in guinea-pigs. Specifically, 5-HT(2A), 5-HT(4) and 5-HT(7) receptors seem to be particularly involved in this phenomenon. Participation of 5-HT might probably be favoured by the enhancement of the PNECs 5-HT content observed after sensitization.


Assuntos
Hiper-Reatividade Brônquica/fisiopatologia , Receptor 5-HT2A de Serotonina/metabolismo , Receptores 5-HT4 de Serotonina/metabolismo , Receptores de Serotonina/metabolismo , Animais , Hiper-Reatividade Brônquica/induzido quimicamente , Hiper-Reatividade Brônquica/metabolismo , Cromatografia Líquida de Alta Pressão , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Cobaias , Masculino , Ovalbumina/imunologia , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Receptor 5-HT2A de Serotonina/genética , Receptores de Serotonina/genética , Receptores 5-HT4 de Serotonina/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sensibilidade e Especificidade , Serotonina/análise , Serotonina/metabolismo , Antagonistas do Receptor 5-HT2 de Serotonina , Antagonistas do Receptor 5-HT4 de Serotonina
11.
Clin Exp Allergy ; 39(5): 740-51, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19302253

RESUMO

BACKGROUND: A hallmark of airway remodelling in asthma is subepithelial fibrosis, but its relation with airway dysfunction is still controversial. OBJECTIVE: To describe airway functional abnormalities and subepithelial remodelling induced by repetitive antigenic challenges. METHODS: Nine inhaled antigenic challenges were applied every 10 days to guinea-pigs sensitized to ovalbumin (OVA). Antigen-induced airway hyperresponsiveness (AI-AHR) to histamine and its immunohistopathological relationship was evaluated at the first, third and ninth OVA challenges. RESULTS: From the first challenge on, OVA induced acute transient bronchoobstruction followed by development of AI-AHR. A progressive rise in baseline Penh (a bronchoobstruction index) and granulocyte airway infiltration was also observed. After the ninth OVA challenge, the amount of extracellular matrix in the subepithelial region (SER) of bronchi and bronchioles was increased. Immunohistochemistry analysis showed that this SER fibrosis was associated to beta1-integrin subunit overexpression, even in acellular areas. Immunoelectronmicroscopy corroborated the location of beta1-integrin in extracellular matrix, essentially in types l and II collagen fibres. Presence of alpha1- and alpha2-integrin subunits in these areas was also corroborated. AI-AHR was correlated with degree of SER increment, cell infiltration, and beta1-integrin expression. CONCLUSION: Our data suggested that beta1-integrin shedding produced by repetitive allergen challenges in guinea-pigs was associated with collagen deposition in SER of bronchi and bronchioles, along with inflammatory cells infiltration and AI-AHR development.


Assuntos
Asma/imunologia , Brônquios/imunologia , Integrina beta1/metabolismo , Administração por Inalação , Animais , Asma/patologia , Brônquios/ultraestrutura , Líquido da Lavagem Broncoalveolar/imunologia , Doença Crônica , Colágeno/imunologia , Colágeno/metabolismo , Modelos Animais de Doenças , Matriz Extracelular/imunologia , Matriz Extracelular/metabolismo , Cobaias , Integrina beta1/imunologia , Masculino , Microscopia Imunoeletrônica , Ovalbumina/imunologia
12.
Acta Paediatr ; 97(7): 928-34, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18430068

RESUMO

AIM: Children with leukaemia are at increased risk of pulmonary complications, often with unspecific clinical data, delayed diagnosis and a high mortality rate. We evaluated the usefulness of diagnostic-therapeutic guidelines (DTG) in which specific times for decision making were incorporated. METHODS: Clinical charts of children with acute leukaemia and suspicion of pulmonary involvement were reviewed. Patients were allocated to group I if their diagnostic and therapeutic decisions were in accordance with the DTG, and to group II if not. RESULTS: Children from group I (n=32) and group II (n=28) did not differ with respect to age (9.3+/-0.5 years old, mean+/-SEM), gender, type, risk and stage of leukaemia, anaemia and neutropenia. Total length of hospital stay and hospitalization due to the pulmonary disease were shorter in group I than in group II (14.8+/-2.1 vs. 28.5+/-3.7 days, p=0.0016; and 10.8+/-1.0 vs. 18.4+/-1.8 days, p=0.0003, respectively). Two patients (6.3%) died due to the pulmonary pathology in group I, and nine (32.1%, p=0.016) in group II. CONCLUSIONS: Diagnostic-therapeutic guidelines that incorporate timely decisions constitute a useful algorithm to reduce the length of hospital stay and mortality in children with acute leukaemia and pulmonary infiltrates. A prospective study is needed to validate these results.


Assuntos
Leucemia Mieloide Aguda/complicações , Pneumopatias/diagnóstico , Pneumopatias/terapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Adolescente , Algoritmos , Criança , Feminino , Humanos , Pneumopatias/complicações , Masculino
13.
Int J Tuberc Lung Dis ; 8(11): 1321-4, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15581199

RESUMO

SETTING: Pulmonary tuberculosis (PTB) incidence greatly varies around the world, a phenomenon usually attributed to socio-economic factors or health service availability. A recent study, however, indicated that PTB was inversely related to altitude. OBJECTIVE: To evaluate factors associated with PTB notification rates in Mexico. METHODS: Annual notification rates (1998-2002) of PTB in each of the 32 Mexican states were analysed, and likely factors were assessed through correlation and multiple regression analyses. RESULTS: Most variables lacked association with PTB rates, including percentage of population aged > or = 65 years, population density, percentage of population with < or = 2 minimum salaries, percentage of population with social security, level of education, diabetes incidence, percentage of immigration, percentage of rural population and a global marginalisation index. Only altitude above sea level correlated with tuberculosis incidence (r = -0.74, P < 0.0001). Likewise, in the multiple regression analysis only altitude reached a statistically significant association. CONCLUSION: Our results showed that altitude had a strong inverse relationship to PTB notification rates in Mexico, which might be related to the well known changes in alveolar oxygen pressure at different altitudes. Interestingly, several factors traditionally considered as predisposing conditions for the development of PTB did not correlate with the disease.


Assuntos
Altitude , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Incidência , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Análise de Regressão , Fatores de Risco , Fatores Socioeconômicos , Topografia Médica
14.
Arch Bronconeumol ; 39(11): 524-6, 2003 Nov.
Artigo em Espanhol | MEDLINE | ID: mdl-14588206

RESUMO

Infection by Strongyloides stercoralis can cause asthma-like symptoms through mechanisms that have not yet been clarified. A 55-year-old male farm worker with a 2-year history of illness diagnosed as asthma and treated unsuccessfully with bronchodilators and corticosteroids was referred to our hospital with severe dyspnea. The initial chest radiograph showed mild air trapping, and pulmonary function tests detected airway obstruction that did not respond to salbutamol. Bronchoscopy revealed multiple nodules protruding into the airway lumen. S. stercoralis larvae were detected in bronchoalveolar lavage fluid and stool samples. Although treatment with albendazole was initiated, the patient's condition worsened over the next 3 days, hemoptysis presented, and the process ended in death. Autopsy demonstrated Strongyloides larvae in the bronchial nodules. Infection by S. stercoralis should be considered in the differential diagnosis of asthmatic-like symptoms refractory to treatment. In such cases nodules may be responsible for obstruction.


Assuntos
Broncopatias/parasitologia , Strongyloides stercoralis , Estrongiloidíase/complicações , Animais , Asma/parasitologia , Humanos , Masculino , Pessoa de Meia-Idade
15.
Int J Tuberc Lung Dis ; 7(4): 354-8, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12729341

RESUMO

SETTING: Socio-cultural factors have been invoked to explain the male predominance among patients with pulmonary tuberculosis, but there is no conclusive evidence of their role. OBJECTIVE: To assess male predominance in a group of diabetics with pulmonary tuberculosis compared with patients with pulmonary tuberculosis alone. DESIGN: Clinical records of in-patients with pulmonary tuberculosis and with (TBDM group, n = 202) or without (TB group, n = 226) diabetes mellitus were reviewed, and the male percentages in each of six age groups (15-29, 30-39, 40-49, 50-59, 60-69, > or = 70 years) calculated. RESULTS: In the TB group, no gender difference (51% males) was found in the first age period, followed by a male predominance thereafter (71%, 68%, 75%, 63% and 58%). The TBDM group showed a similar pattern in the first two age groups (56% and 74%), followed by a steadily decline (r(S) = -0.90, P = 0.04) in male percentage (60%, 44%, 45%, 27%), leading to a female predominance after age 50. The association of age and gender was also corroborated by logistic regression in TBDM (P = 0.02), but not in TB (P = 0.19) patients. CONCLUSIONS: Diabetes was associated with a progressive shift of male predominance in pulmonary tuberculosis. Because diabetes is a disease that affects social activities similarly in men and women, our results suggest that factors other than socio-cultural ones are also important for determining the male predominance in pulmonary tuberculosis.


Assuntos
Diabetes Mellitus/epidemiologia , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Comorbidade , Diabetes Mellitus/diagnóstico , Feminino , Humanos , Modelos Logísticos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Probabilidade , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Tuberculose Pulmonar/diagnóstico
16.
Acta Paediatr ; 91(4): 453-8, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12061363

RESUMO

AIM: To determine the agreement rates between clinical and autopsy diagnoses in a neonatal intensive care unit (NICU), distinguishing between the main diagnosis and cause of death. METHODS: Clinical and autopsy records of 75 infants who died in two consecutive years in the NICU (autopsy rate 42.6%) of a pediatric hospital in Mexico City were reviewed. RESULTS: Ninety-two percent of main clinical diagnoses were confirmed by autopsy. Four conditions (congenital cardiopathy, prematurity, specific congenital syndromes and hyaline membrane disease) accounted for more than two-thirds of diagnoses. However, for cause of death, the global agreement was only 50%. The most common conditions considered by clinicians (77%) and pathologists (56%) to be the causes of death were cardiogenic, septic or mixed shocks. Additionally, clinicians omitted 34 relevant conditions in 30 (40.0%) patients, and 21 of these conditions possibly played a role in the deaths of 17 (22.7%) patients. The most frequently omitted diagnosis was pneumonia, in 9 (26.5%) patients. Omissions were not related to gestational age, age at death, days as an inpatient, or gender. CONCLUSION: Despite a high agreement rate in the main diagnoses, notable imprecisions were present regarding cause of death and antemortem overlooking of potentially fatal conditions, confirming the useful role of autopsy to verify clinical diagnoses and suggesting that differentiation between the main diagnosis and cause of death should be carried out in future studies.


Assuntos
Autopsia/normas , Causas de Morte , Mortalidade Hospitalar , Mortalidade Infantil , Patologia/normas , Diagnóstico Diferencial , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , México/epidemiologia , Estudos Retrospectivos
18.
Int J Tuberc Lung Dis ; 6(12): 1102-9, 2002 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12546119

RESUMO

SETTING: Several therapeutic regimens for drug-resistant tuberculosis have been suggested, most of them with a total duration of 18-24 months. OBJECTIVE: To report our experience using a shorter regimen. DESIGN: Fifty patients with drug-resistant pulmonary tuberculosis were managed by withdrawing all anti-tuberculosis drugs until the results of a drug sensitivity test were obtained (approximately 3 months), and then a 12-month self-administered regimen with four to six anti-tuberculosis drugs at full daily doses was initiated, based primarily on the sensitivity test and secondarily on the history of previous treatment. RESULTS: In 31 patients treatment was completed as planned, in six it was irregular and 13 definitively abandoned it. In the best scenario, 90.3% (28/31) of patients with full treatment were cured; this outcome was similar for both multidrug-resistant (MDR, n = 18, 88.9%) and non-MDR (n = 13, 92.3%) patients. Six months later, the relapse rate was 4.8%, and after a 5-year follow-up 14 out of 18 cured patients who were located remained asymptomatic (77.8%). If the worst scenario was applied, a 62.0% cure rate (31/50) was obtained. CONCLUSIONS: A 12-month regimen with a minimum of four anti-tuberculosis agents at full dose, essentially selected on drug sensitivity testing, could be an alternative option for the treatment of drug-resistant pulmonary tuberculosis.


Assuntos
Antibióticos Antituberculose/administração & dosagem , Antibióticos Antituberculose/uso terapêutico , Antituberculosos/administração & dosagem , Antituberculosos/uso terapêutico , Etambutol/administração & dosagem , Etambutol/uso terapêutico , Isoniazida/administração & dosagem , Isoniazida/uso terapêutico , Pirazinamida/administração & dosagem , Pirazinamida/uso terapêutico , Rifampina/administração & dosagem , Rifampina/uso terapêutico , Estreptomicina/administração & dosagem , Estreptomicina/uso terapêutico , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Pulmonar/tratamento farmacológico , Adolescente , Adulto , Esquema de Medicação , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos , Fatores de Tempo
19.
Gac Med Mex ; 137(5): 397-401, 2001.
Artigo em Espanhol | MEDLINE | ID: mdl-11692808

RESUMO

Asthma is a very common disease, but its prevalence greatly varies from region to region, even in the same country. In the northwest of Mexico there is a lack of epidemiological studies on this disease. In this work a standardized questionnaire (ISAAC) was applied to parents of children attending 8 primary schools in the Mexican city of Hermosillo, Sonora. Of 3000 questionnaires sent, 1489 (49%) were acceptably answered. Children were of either sex and 9.1 +/- 1.8 years old (mean +/- SD). From this population, 74 (10.4%) out of 713 male and 67 (8.6%) out of 776 female children had an affirmative response to que question "Have you ever had asthma?", from which we conclude that global prevalence of asthma in the studied sample was 9.5%, an intermediate figure among those reported from other studies performed in Mexico.


Assuntos
Asma/epidemiologia , Inquéritos e Questionários , Criança , Estudos Transversais , Feminino , Humanos , Masculino , México , Prevalência , Saúde da População Urbana
20.
J Appl Physiol (1985) ; 91(6): 2595-601, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11717224

RESUMO

Ozone (O(3))-induced airway hyperresponsiveness in laboratory animals is usually demonstrated through dose-response curves with inhaled or intravenous bronchoconstrictor agonists. However, comparability of these two routes has not been well documented. Thus guinea pig airway responsiveness to ACh and histamine was evaluated 16-18 h after O(3) (3 parts/million, 1 h) or air exposure by two plethysmographic methods (spontaneously breathing and mechanically ventilated) and by two administration routes (inhalatory or intravenous). We found that O(3) caused airway hyperresponsiveness to intravenous, but not to inhaled, agonists, independent of the plethysmographic method used. Suitability of the inhalatory route to detect airway hyperresponsiveness was corroborated with inhaled ACh after an antigen challenge or extending O(3) exposure to 3 h. Acetylcholinesterase activity was not modified after O(3) exposure in lung homogenates and blood samples. Thus inhaled agonists were less effective to reveal the airway hyperresponsiveness after an acute O(3) exposure than intravenous ones, at least for the 1-h exposure to 3 parts/million, and this difference seems not to be related to an O(3)-induced inhibition of the acetylcholinesterase activity.


Assuntos
Brônquios/efeitos dos fármacos , Hiper-Reatividade Brônquica/induzido quimicamente , Hiper-Reatividade Brônquica/diagnóstico , Broncoconstritores/administração & dosagem , Ozônio , Acetilcolinesterase/sangue , Acetilcolinesterase/metabolismo , Administração por Inalação , Animais , Relação Dose-Resposta a Droga , Cobaias , Injeções Intravenosas , Pulmão/metabolismo , Masculino , Atividade Motora/fisiologia , Respiração Artificial , Testes de Função Respiratória
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