RESUMO
OBJECTIVE: Concerns exist about the possible detrimental effects of exercise training on aortic size and valve function in individuals with bicuspid aortic valve (BAV). This multicentre international study aimed to determine the characteristics of aortic size and valve function in athletes versus non-athletes with BAV and athletes with tricuspid aortic valve (TAV). METHODS: We enrolled competitive athletes with BAV and age- and sex-matched athletes with TAV and non-athletes with BAV. We assessed valve function, aortic size and biventricular measures using echocardiography. Individuals with established moderate-severe AV stenosis, regurgitation or significant aortic dilation were excluded from the study. RESULTS: The study population comprised 504 participants: 186 competitive athletes with BAV (84% males; age 30±11 years), 193 competitive athletes with TAV and 125 non-athletes with BAV. The aortic annulus was greater in athletes with BAV than athletes with TAV and non-athletes with BAV (p<0.001). Both athletic and non-athletic individuals with BAV had greater sinuses of Valsalva, sino-tubular junction and ascending aorta diameters than athletes with TAV (p<0.001). However, no significant differences were found between athletes and non-athletes with BAV. Left ventricular index volumes and mass were greater in athletes with BAV than in the other two groups (p<0.001). Individuals with BAV (athletes and non-athletes) had greater mean gradients than TAV athletes. CONCLUSION: This multicentre international study demonstrates no differences between athletes with BAV and non-athletes with BAV regarding aortic valve function or aortic dimensions. However, athletes with BAV have larger aortic diameters and a relatively worse valvular function than athletes with TAV.
RESUMO
BACKGROUND: There is lack of evidence regarding safety, effectiveness and applicability of prehabilitation on cardiac surgery population, particularly in patients candidates to cardiac valve replacement. The aim of the study is to assess and compare the effect of a multimodal prehabilitation program on functional capacity in patients with severe aortic stenosis (AoS) and severe mitral regurgitation (MR) proposed for valve replacement surgery. METHODS: Secondary analysis from a randomised controlled trial whose main objective was to analyze the efficacy of a 4-6 weeks multimodal prehabilitation program in cardiac surgery on reducing postoperative complications. For this secondary analysis, only candidates for valve replacement surgery were selected. The primary outcome was the change in endurance time (ET) from baseline to preoperative assessment measured by a cycling constant work-rate cardiopulmonary exercise test. RESULTS: 68 patients were included in this secondary analysis, 34 (20 AoS and 14 MR) were allocated to the prehabilitation group and 34 (20 AoS and 14 MR) to control group. At baseline, patients with AoS had better left systolic ventricular function and lower prevalence of atrial fibrillation compared to MR (p = 0.022 and p = 0.035 respectively). After prehabilitation program, patients with MR showed greater improvement in ET than AoS patients (101% vs. 66% increase from baseline). No adverse events related to the prehabilitation program were observed. CONCLUSIONS: A 4-6 week exercise training program is safe and overall improves functional capacity in patients with severe AoS and MR. However, exercise response is different according to the cardiac valve type disfunction, and further studies are needed to know the factors that predispose some patients to have better training response. TRIAL REGISTRATION: The study has been registered on the Registry of National Institutes of Health ClinicalTrials.gov (NCT03466606) (05/03/2018).
Assuntos
Estenose da Valva Aórtica , Implante de Prótese de Valva Cardíaca , Insuficiência da Valva Mitral , Exercício Pré-Operatório , Humanos , Masculino , Feminino , Implante de Prótese de Valva Cardíaca/métodos , Insuficiência da Valva Mitral/cirurgia , Estenose da Valva Aórtica/cirurgia , Idoso , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/epidemiologia , Teste de Esforço/métodos , Cuidados Pré-Operatórios/métodosRESUMO
The bicuspid aortic valve (BAV) is the most common congenital heart defect among adults, often leading to severe valve dysfunction and aortic complications. Despite its clinical significance, uncertainties persist regarding the impact of sports participation on the natural course of BAV disease. The SPREAD (Sport PRactice and its Effects on Bicuspid Aortic valve Disease) study is a multicenter and multinational project designed to investigate this relationship. This paper outlines the study's design, and objectives. The study is divided into two phases; phase one involves a cross-sectional analysis comparing aortic dimensions and valve function among competitive athletes with BAV, athletes with tricuspid aortic valves (TAV), and sedentary individuals with BAV. The second phase is a prospective, longitudinal follow-up aiming to evaluate the impact of regular sports training on disease progression. The SPREAD study seeks to provide evidence-based insights into the effects of sports participation on BAV disease progression, guiding clinical decision-making regarding sports eligibility and risk stratification for individuals with BAV.
RESUMO
BACKGROUND: Sports medical examinations are a tool to detect potentially life-threatening situations during physical activity, but their usefulness and protocols in young athletes remain controversial. The aim was to describe the diagnostic performance of a 2-step ECG and echocardiogram screening model in a large sample of healthy young-adolescent athletes (aged 11-16 years), evaluating its cost-effectiveness for cardiovascular disease (CVD) detection. METHODS: Cross-sectional study of 2617 individuals (81 % male, mean age 15 years), over 20 federated sports (La Rioja-Spain). A cardiological examination included family and personal history, physical examination, ECG, and transthoracic echocardiogram. The previous ECG, conducted at 11-13 years old, was reviewed in 1589 individuals (60 %). ECGs were interpreted according to 2017 international criteria. The prevalence of structural cardiac disease (CD) was investigated, and the diagnostic performance of both tests and the cost of screening was evaluated. RESULTS: CVD was diagnosed in 63 athletes (2.4 %) and 16 (0.6 %) with pathology related to sudden cardiac death (SCD). In 3 cases (0.11 %), cessation of sporting activity was indicated, and in 2 cases (0.07 %) treatment for congenital CD was indicated. ECG alterations were infrequent (2.5 %). Eighty percent of the structural CD diagnosed by echocardiogram had a normal ECG. The cost per CVD detected was 3,080, and for CVD associated with SCD, it was 12,323. CONCLUSIONS: Our study shows the diagnostic cost-effectiveness of a two-step cardiac screening protocol, including ECG, and highlights the role of echocardiography in young adolescent athletes, which could be implemented at a low and reasonable cost.
Assuntos
Atletas , Doenças Cardiovasculares , Análise Custo-Benefício , Ecocardiografia , Eletrocardiografia , Humanos , Adolescente , Masculino , Feminino , Estudos Transversais , Ecocardiografia/métodos , Ecocardiografia/economia , Criança , Atletas/estatística & dados numéricos , Eletrocardiografia/economia , Eletrocardiografia/métodos , Doenças Cardiovasculares/economia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/diagnóstico , Espanha/epidemiologia , Morte Súbita Cardíaca/prevenção & controle , Morte Súbita Cardíaca/epidemiologia , Programas de Rastreamento/métodos , Programas de Rastreamento/economia , PrevalênciaRESUMO
Background: Moyamoya disease (MMD) is a non-atherosclerotic intracranial steno-occlusive condition placing patients at high risk for ischemic stroke. Direct and indirect surgical revascularization can improve blood flow in MMD; however, randomized trials demonstrating efficacy have not been performed and biomarkers of parenchymal hemodynamic impairment are needed to triage patients for interventions and evaluate post-surgical efficacy. We test the hypothesis that hypercapnia-induced maximum cerebrovascular reactivity (CVR MAX ) and the more novel indicator cerebrovascular reactivity (CVR) response time (CVR DELAY ), both assessed from time-regression analyses of non-invasive hypercapnic imaging, correlate with recent focal ischemic symptoms. Methods: Hypercapnic reactivity medical resonance imaging (blood oxygenation level-dependent; echo time=35ms; spatial resolution=3.5×3.5×3.5mm) and catheter angiography assessments of cortical reserve capacity and vascular patency, respectively, in MMD participants (n=73) were performed in sequence. Time regression analyses were applied to quantify CVR MAX and CVR DELAY . Symptomatology information for each hemisphere (n=109) was categorized into symptomatic (ischemic symptoms within six months) or asymptomatic (no history of ischemic symptoms) and logistic regression analysis assessed the association of CVR metrics with ischemic symptoms after controlling for age and sex. Results: Symptomatic hemispheres displayed lengthened CVR DELAY (p<0.001), which was more discriminatory between hemispheres than CVR MAX (p=0.037). CVR DELAY (p<0.001), but not CVR MAX (p=0.127), was found to be sensitively related to age in asymptomatic tissue (0.33-unit increase/year); age-dependent normative ranges are presented to enable quantitative assessment of patient-specific impairment. Furthermore, the area under the receiver operating characteristic curves shows that CVR DELAY predicts ischemic symptoms (p<0.001), whereas CVR MAX does not (p=0.056). Conclusion: Findings support that CVR metrics are uniquely altered in hemispheres with recent ischemic symptoms, motivating the investigation of CVR as a surrogate of ischemic symptomatology and treatment efficacy.
RESUMO
BACKGROUND: The Mediterranean Diet (MedDiet) is the dietary pattern par excellence for managing and preventing metabolic diseases, such as Type 2 Diabetes (T2DM). The MedDiet incorporates spices and aromatic herbs, which are abundant sources of bioactive compounds. The aim of this study was to analyze the effect of all aromatic herbs and spices included in the MedDiet, such as black cumin, clove, parsley, saffron, thyme, ginger, black pepper, rosemary, turmeric, basil, oregano, and cinnamon, on the glycemic profile in T2DM subjects. METHODS: PubMed, Web of Science, and Scopus databases were searched for interventional studies investigating the effect of these aromatic herbs and spices on the glycemic profile in T2DM subjects. RESULTS: This systematic review retrieved 6958 studies, of which 77 were included in the qualitative synthesis and 45 were included in the meta-analysis. Our results showed that cinnamon, turmeric, ginger, black cumin, and saffron significantly improved the fasting glucose levels in T2DM subjects. The most significant decreases in fasting glucose were achieved after supplementation with black cumin, followed by cinnamon and ginger, which achieved a decrease of between 27 and 17 mg/dL. CONCLUSIONS: Only ginger and black cumin reported a significant improvement in glycated hemoglobin, and only cinnamon and ginger showed a significant decrease in insulin.
Assuntos
Crocus , Diabetes Mellitus Tipo 2 , Dieta Mediterrânea , Zingiber officinale , Humanos , Especiarias/análise , GlucoseRESUMO
Background: In Mexico, there are six scientific collections of polychaetous annelids. The "Colección Poliquetológica" from the Universidad Autónoma de Nuevo León houses one of the three most important collections of annelids in the country, based on a number of lots and number of type materials deposited, as well as geographical coverage. New information: A catalogue of type materials of polychaete annelids housed at the "Colección Poliquetológica" from the Universidad Autónoma de Nuevo León (México) is presented for the first time. The Collection contains 37 holotypes, 174 paratypes and one syntype. These type materials are grouped in 15 families, 35 genera and 54 species of marine worms. Types were described mostly from the Mexican waters, with a low number of types from Ecuador, El Salvador, Argentina, USA, Philippines, New Caledonia and Japan.
RESUMO
PURPOSE: We designed a nurse-led algorithm to standardize urinary tract infection (UTI) diagnosis for older adults receiving home-based medical care. Aims of this pilot quality improvement study were to reduce the frequency of empiric antibiotic therapy initiated without a urinalysis and urine culture (UA/UC) first being obtained, reduce antibiotic use without a concomitant increase in emergency department (ED) visits or hospital admissions, and ensure stakeholders' satisfaction with algorithm use. METHOD: A nurse-led diagnostic algorithm was designed and pilot-tested to address challenges and standardize diagnosis of UTI in a population of homebound older adults. RESULTS: In pre/post data analysis, algorithm implementation was associated with improved frequency of obtaining UA/UC before empiric antibiotic therapy was initiated, but the overall rate of antibiotic use for UTI did not decrease. No increase in ED or hospital admissions was identified. CONCLUSION: Use of a diagnostic algorithm for UTI among homebound older adults was associated with reduced frequency of empiric antibiotic initiation for suspected UTI without a UA/UC first being obtained. More rigorous study is needed to confirm and expand on these findings. [Research in Gerontological Nursing, 17(2), 92-97.].
Assuntos
Papel do Profissional de Enfermagem , Infecções Urinárias , Humanos , Idoso , Infecções Urinárias/diagnóstico , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Hospitalização , Algoritmos , Antibacterianos/uso terapêutico , Estudos RetrospectivosRESUMO
PURPOSE: Axillary lymph nodes (LNs) often present a reservoir for metastatic breast cancer, yet metastatic LN involvement cannot be discerned definitively using diagnostic imaging. This study investigated whether in vivo CEST may discriminate LNs with versus without metastatic involvement. METHODS: 3T MRI was performed in patients with breast cancer before clinically-indicated mastectomy or lumpectomy with LN removal, after which LN metastasic involvement was determined using histological evaluation. Non-contrast anatomical imaging, as well as B0 and B1 field maps, were acquired in sequence with three-point CEST-Dixon (3D turbo-gradient-echo; factor = 25; TR/TE1/ΔTE = 851/1.35/1.1 ms; spatial-resolution = 2.5 × 2.5 × 6 mm; slices = 10; four sinc-gauss pulses with duty-cycle = 0.5, total saturation duration = 701.7 ms; B1 = 1.5 µT; saturation offsets = -5.5 to +5.5 ppm; stepsize = 0.2 ppm; scan duration = 6 min 30 s). The mean z-spectrum from LNs with (n = 20) versus without (n = 22) metastatic involvement were analyzed and a Wilcoxon rank-sum test (significance: p < 0.05) was applied to evaluate differences in B0, B1 , and magnetization transfer ratio (MTR) in differing spectral regions of known proton exchange (nuclear Overhauser effect [NOE], amide, amine, and hydroxyl) between cohorts. RESULTS: No difference in axillary B1 (p = 0.634) or B0 (p = 0.689) was observed between cohorts. Elevated MTR was observed for the NOE (-1.7 ppm; MTR = 0.285 ± 0.075 vs. 0.248 ± 0.039; p = 0.048), amine (+2.5 ppm; MTR = 0.284 ± 0.067 vs. 0.234 ± 0.31; p = 0.005), and hydroxyl (+1 ppm; MTR = 0.394 ± 0.075 vs. 0.329 ± 0.055; p = 0.002) protons in LNs from participants with versus without metastatic involvement. CONCLUSIONS: Findings are consistent with a unique metastatic LN microenvironment detectable by CEST-Dixon and suggest that CEST MRI may have potential for mapping LN metastasis non-invasively in vivo.
Assuntos
Neoplasias da Mama , Linfoma , Humanos , Feminino , Neoplasias da Mama/diagnóstico por imagem , Mastectomia , Imageamento por Ressonância Magnética/métodos , Mama/diagnóstico por imagem , Prótons , Aminas , Microambiente TumoralRESUMO
Promastobranchus Gallardo, 1968 is a small genus in the polychaete family Capitellidae, and the available records are largely reported from the Indo-West Pacific region. Although Gallardo (1968) and Green (2002) noted that Promastobranchus species had intraspecific variation in the number of thoracic chaetigers when they described the two previously known species, this variation has not been corroborated using molecular evidence. In this study, a new Promastobranchus species, Promastobranchusvariabilissp. nov., is described based on 29 specimens collected from the Beibu Gulf, South China Sea. The new species is mainly characterized by having a tessellated epithelium in the anterior thorax, nine teeth in three rows above the main fang in the abdominal hooks, four pairs of genital pores located on the intersegmental grooves between chaetigers 9 and 13, and its unique methyl green staining pattern. Comparisons of multiple gene markers (16S, 18S, 28S, and H3) revealed no genetic divergence (K2P < 0.003) among these type specimens with 9-13 thoracic chaetigers. In other words, the new species exhibited morphological variability in the number of thoracic chaetigers during ontogeny, and this character was unsuitable to differentiate Promastobranchus species as the ranges overlap among Promastobranchus species. This is the third Promastobranchus species known in the world, and it is now recorded along the Fujian coast.
RESUMO
Introduction: Glycerides, commonly called "blood worms", are relatively thin polychaetes that reach considerable sizes. They have been reported for all the seas of the world from the intertidal zone to abyssal depths. Objective: Evidence the presence of two species of Glycera for the littorals of the Mexican Pacific. Methods: An analysis of the glycerides of the Pacific coast of Mexico was carried out, finding two species that were collected, one of shrimp trawl at a depth of 18 meters off Puertecitos, Baja California, as well as by manual sampling in the intertidal zone of Concepción Bay, Baja California Sur in the Gulf of California. For their taxonomic determination, morphological characters of greater relevance for their identification were examined, such as jaws, aileron shape, parapodia, chaetae, and the type of pharyngeal papillae. Results: We diagnosed and schematized Glycera guatemalensis Böggemann & Fiege, 2001 and Glycera sphyrabrancha Schmarda, 1861. Conclusions: Glycera guatemalensis described for Guatemala and Glycera sphyrabrancha described for Jamaica, are recorded for the first time for the Gulf of California.
Introducción: Los Glicéridos son llamados comúnmente "gusanos de sangre", son poliquetos relativamente delgados que alcanzan tallas considerables. Han sido reportados para todos los mares del mundo desde la zona de entremareas hasta profundidades abisales. Objetivo: Evidenciar la presencia de dos especies de Glycera para los litorales del Pacífico mexicano. Métodos: Se realizó un análisis de los glicéridos de la costa del pacífico de México, encontrando dos especies que fueron recolectadas, una de arrastre camaronero a una profundidad de 18 metros frente a Puertecitos, Baja California, así como mediante muestreo manual en la zona de entremareas de bahía Concepción, Baja California Sur en el golfo de California. Para su determinación taxonómica se examinaron los caracteres morfológicos de mayor relevancia para su determinación, como mandíbulas, forma del aileron, parapodios, setas, branquia, y tipo de papilas faríngeas. Resultados: En este trabajo se diagnostican y esquematizan Glycera guatemalensis Böggemann & Fiege, 2001 y Glycera sphyrabrancha Schmarda, 1861. Conclusión: Glycera guatemalensis descrita para Guatemala y Glycera sphyrabrancha descrita para Jamaica, se registran por primera vez para el golfo de California.
RESUMO
Abstract Introduction: There is a high rate of deliveries in adolescents in Mexico. This age group is vulnerable to obstetric complications, including lacerations of the anal sphincter. Objective: To determine the prevalence of third and fourth degree perineal tears in adolescents during childbirth, and to evaluate risk factors in comparison with deliveries with lacerations of adult women. Methods: All obstetric care episodes were reviewed from a public tertiary hospital data in Monterrey, Mexico in 2014. Age, primiparity, delivery instrumentation, episiotomy, body mass index, product weight and tear´s degree were documented at the deliveries with tears of third and fourth degree. Results: The prevalence of third and fourth degree tears of 2.0% was found in the general population, being adolescents the most affected with 2.5%. The unadjusted odds ratio of high-grade tears in adolescent females at delivery, compared to adult females, was 1.36 (95% CI = 0.99-1.86, p= 0.05). No difference was found when comparing risk factors among high-grade tear deliveries in adolescents versus adults. Conclusions: A higher prevalence than previous reported for high grade tears during delivery was found. The data suggest adolescence as a risk factor for high-grade tears during delivery.
Resumen Introducción: En México hay una elevada tasa de partos en adolescentes. Este grupo es vulnerable para complicaciones obstétricas, entre ellas laceración del esfínter anal. Objetivo: Conocer la prevalencia de desgarros perineales de tercer y cuarto grado en adolescentes durante el parto y evaluar factores de riesgo en comparación con partos con laceración de mujeres adultas. Métodos: Se revisaron todas las atenciones obstétricas en un hospital publico de tercer nivel en Monterrey, Nuevo León, México en el año 2014. Se documentó edad, primiparidad, instrumentación del parto, realización de episiotomía, índice de masa corporal, peso del producto y grado del desgarro en los partos que presentaron desgarros de tercer y cuarto grado Resultados: Se encontró una prevalencia general de 2.0% de desgarros de tercer y cuarto grado y en adolescentes de 2.5%. La razón de momios sin ajustar de desgarros de alto grado en mujeres adolescentes en comparación con mujeres adultas fue de 1.36 (IC 95%= 0.99-1.86, p= 0.05). No se encontró diferencia al comparar factores de riesgo entre los partos con desgarro de alto grado en adolescentes contra adultas. Conclusiones: Se encontró una prevalencia mayor a lo reportado de desgarros de alto grado durante el parto. Los datos sugieren a la adolescencia como factor de riesgo para desgarros de alto grado.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Gravidez , Adulto Jovem , Canal Anal/lesões , Períneo/lesões , Lacerações/epidemiologia , Complicações do Trabalho de Parto/epidemiologia , Gravidez na Adolescência , Trabalho de Parto , Prevalência , Fatores de Risco , Lacerações/etiologia , Episiotomia/estatística & dados numéricos , México/epidemiologiaRESUMO
Objetivo: Determinar la frecuencia de incontinencia fecal y el impacto en la calidad de vida de los pacientes geriátricos hospitalizados en una muestra de un hospital de segundo nivel de Monterrey, Nuevo León, México. Material y métodos: Se interrogó a los pacientes mayores de 60 años hospitalizados o sus cuidadores acerca de incontinencia fecal. A los que respondieran afirmativamente y pudieran responder se les realizaron los siguientes cuestionarios y escalas: Minimental, calidad de vida de Rockwood para incontinencia fecal y escala de Wexner modificada para severidad de incontinencia; además de datos clínicos. Se calculó la frecuencia en base a una muestra y se determinaron asociaciones entre grado de incontinencia y calidad de vida. Resultados: Se interrogaron un total de 234 pacientes, de los cuales 135 (57,69%) eran mujeres y 99 (42,31%) hombres. Se documentó un total de 34 pacientes con incontinencia fecal, esto representa una frecuencia de 14,53% (IC95%, 10,2819,71%) en esta población. Se encontró una correlación positiva de la severidad de la incontinencia con la dimensión de estilo de vida (relación (r) = -0,61, p=0,04), vergüenza (r=-0,70, p=0,01), conducta (r=-0,73, p=0,001) y el promedio de las cuatro dimensiones (r=-0,67, p=0,02) pero no con la dimensión de depresión del cuestionario de calidad de vida en incontinencia fecal. Conclusión: Al comparar con otros estudios nacionales e internacionales, la frecuencia de incontinencia fecal encontrada es menor a lo documentado en otras series. La calidad de vida de los pacientes ancianos hospitalizados con incontinencia fecal en esta muestra se encuentra disminuida y su impacto en la calidad de vida se correlaciona con la severidad de la incontinencia fecal.
Objective: To determine the frequency of fecal incontinence and the impact on the quality of life of hospitalized geriatric patients in a sample from a level two hospital in Monterrey, Nuevo Leon, Mexico. Materials and methods: Hospitalized patients over 60 years of age or their caregivers were questioned about the presence of fecal incontinence. Those who responded affirmatively and could respond were given the following questionnaires and scales: Mini-Mental, Rockwood quality of life for fecal incontinence and Wexner scale modified for severity of incontinence; in addition to clinical data. The frequency was calculated based on a sample and associations were determined between degree of incontinence and quality of life. Results: A total of 234 patients were questioned, of whom 135 (57.69%) were women and 99 (42.31%) men. A total of 34 patients with fecal incontinence were documented, this represents a frequency of 14.53% (95% CI, 10.28-19.71%) in this population. A positive correlation of the severity of incontinence was found with the lifestyle dimension (relation (r) = -0.61, p = 0.04), shame (r = -0.70, p = 0.01), behavior (r = -0.73, p = 0.001) and the average of the four dimensions (r = -0.67, p = 0.02) but not with the depression dimension of the quality of life questionnaire in fecal incontinence. Conclusion: When compared with other national and international studies, the frequency of fecal incontinence found was lower than that documented in other series. The quality of life of hospitalized elderly patients with fecal incontinence in this sample was diminished and its impact on quality of life correlated with the severity of fecal incontinence.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Incontinência Fecal/epidemiologia , Hospitalização , Índice de Gravidade de Doença , Incontinência Fecal/diagnóstico , México/epidemiologiaRESUMO
OBJETIVO: Determinar la prevalencia de hipertensión arterial (HTA) y los factores de riesgo asociados en escolares de 6 a 12 años, con la metodología aceptada. MATERIAL Y MÉTODOS: Se examinaron 329 alumnos de educación primaria para investigar asociaciones entre HTA, índice de masa corporal (IMC), edad y género, usando un estudio transversal. Se midió la presión arterial y se utilizó el percentil 95 para diagnosticar HTA. Se compararon niños con y sin HTA. Se utilizaron las razones de momios simple y ajustada con la X² de Mantel-Haenszel como medidas de asociación. RESULTADOS: Los niños con sobrepeso (IMC > 85 percentil) y del grupo de 11-12 años tuvieron al menos cuatro veces más posibilidades de HTA después de controlar variables confusoras. CONCLUSIONES: Los niños que presentaron HTA ascendieron a 4.9 por ciento, con mayor prevalencia entre aquellos con sobrepeso y pertenecientes a un grupo etario mayor. Las asociaciones encontradas pueden ser marcadores de HTA en niños mexicanos.
OBJECTIVE: To determine the prevalence and associated risk factors of high blood pressure (HBP) in school children 6 to 12 years of age with the accepted methodology. MATERIAL AND METHODS: Elementary school children were examined (n=329). Associations between HBP, body mass index (BMI), age and gender were investigated using a cross-sectional study. Blood pressure was measured and the 95th percentile was used to determine HBP. Comparisons between children with and without HBP were made. The crude and X² Mantel-Haenszel adjusted odds ratios were used as measures of association. RESULTS: Overweight children (BMI >85th percentile) and those in the age group 11-12 years were at least four times as likely to present with HBP after controlling for confounding factors. CONCLUSION: A total of 4.9 percent of school children had HBP, with a higher prevalence occurring among overweight and the older group. The associations found here can be used as markers for an increased likelihood of HBP in Mexican children.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Hipertensão/epidemiologia , Índice de Massa Corporal , México/epidemiologia , Sobrepeso/epidemiologia , Prevalência , Fatores de RiscoRESUMO
Background. Several factors inhibit cellular immune response by deactivating macrophages, but very few, such as those described here, prevent macrophage activation. Methods. Ascites liquid from 12-day-old BALB/c mice bearing 5178Y lymphoma tumors was collected, and cell-free ascites liquid (CFAL) was separated from lymphoblasts. The supernatant (SI) was obtained from the homogenized and centrifuged lymphoblasts Then, macrophage cultures contaning 0.2 X 10 a the sixth cells from lymphoma-bearing or hearthly mice were added to 10 µL of CFAL or S1, plus 5 µg of lipopolysaccharides (LPS)/mL, 40 U interferon-ç or a blend of both. Macrophages were incubated with CFAL or S1 prior to or after adding the activators to investigate whether any of the previously mentioned lymphoma fraction inhibited macrophage activation or whether they deactivated them. The effect of CFAL or S1 was estimated as the diminution of the amount of nitric ixide released by the experimental macrophage cultures with respect to controls (activated macrophages treated with none of the lymphoma fractions). Results. LPS, IFN-ç, and the LPS/ç blend activated macrophages from both lymphomabearing and healthy mice. None of the lymphoma fractions deactivated macrophages. CFAL, but not S1, inhibited the macrophage activation, i.e., the percentage of inhibition of nitric oxide releasing 76.7 percent in macrophages from healthy and lymphomabearing mice, respectively. In addition, CFAL was unable to inhibit macrophage-activation effect of IFN-ç or the LPS/IFN-ç blend. Conclusions. Mouse L5178Y Lymphoma releases a factor that in vitro inhibits the macrophage activation induced by LPS, but not by IFN-ç controls
Assuntos
Animais , Masculino , Camundongos , Ativação de Macrófagos/imunologia , Linfoma/imunologia , Macrófagos/imunologia , Interferon-alfa/farmacologia , Lipopolissacarídeos/farmacologia , Macrófagos/citologia , Macrófagos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos DBA , Mitógenos/farmacologiaRESUMO
PEHPS medium, developed for zxenic cultivation of Entamoeba histolytica and E. invadens, was also capable of supporting the growth of a Trichomonas vaginalis strain, with an inoculum of 1 to 100 trichomonads/ml. The lorithmic growth phase in PEHPS or in TYI-S-33 medium lasted 72 h; yield (3.33 ñ 0.56 x 10 a the 6 trichomonads/ml), duplication time (4.27 h), number of duplications (16.85), or increase ratio (33,328) in PEHPS medium showed no significant differences with those obtained in TYI-S33 under similar culture conditions. Accordingly, PEHPS medium might be used for the axenic cultivation of T. vaginalis
Assuntos
Entamoeba histolytica/crescimento & desenvolvimento , Entamoeba/crescimento & desenvolvimento , Técnicas In Vitro , Trichomonas vaginalis/crescimento & desenvolvimento , Vida Livre de Germes/imunologiaRESUMO
Gossypol, a natural racemic mixture with action on NADP- and NAD-oxidoreductases from diverse species, has been proposed as a possible antiamebic medication considering several of its pharmacological properties. In this study it was found that malic enzyme and alcohol dehydrogenase from Entamoeba histolytica are strongly inhibited by (ñ)-gossypol, and both (+)- and (-)- enantiomers. The inhibition was of the noncompetitive type among their respective substrates in all cases. The (ñ)-, (+)-, (-)-gossypol half-maximal inhibitory concentrations (IC 50) for the malic enzyme were 3.71, 13.37 and 1.03 µM, and againts the alcohol dehydrogenase 79.64, 124.43 and 42.56 µM, respectively. Therefore, the (-) enantiomer resulted 3.6 and 13.0 times more potent than the racemic mixture and (+)- gossypol, respectively, to inhibit the malic enzyme, and 1.9 times and 2.9 times more potent than the racemic mixture and (+)-gossypol, respectively, against the alcohol dehydrogenase. Accordingly, one possible mechanism of the antiamebic affect of gossypol could be the inhibition of vital NADP-dependent enzymes as those analyzed in this study
Assuntos
Oxirredutases do Álcool/uso terapêutico , Entamoeba histolytica/patogenicidade , Gossipol/farmacologia , Malato Desidrogenase/biossínteseRESUMO
Después de la fase exponencial de crecimiento, las amibas de la cepa HK9, mantenidas axénicamente en el medio PEHPS, adquieren en forma espontánea varias semejanzas morfológicas con los quistes naturales y resistencia a choques hipotónicos por ele efecto de una pared, la cual está compuesta parcialmente por polisacáridos. El número de amibas diferenciadas aumenta paulatinamente, pero su viabilidad disminuye, en función del tiempo de incubación, hasta que al noveno día 96 por ciento de la población está constituido por este tipo de células, si bien sólo 6 por ciento de ellas es viable. La estructura ultramicroscópica de la gran mayoría de amibas diferenciadas corresponde a la de quistes inmaduros. Estos y el medio PEHPS constituyen un buen modelo para la caracterización de la iniciación de la diferenciación de E.histolytica y abren la posibilidad de obtener, en condiciones axénicas, cultivos masivos de quistes maduros del agente causal de la amibiasis
Assuntos
Entamoeba histolyticaRESUMO
Para determinar la prevalencia de anticuerpos contra el virus de la inmunodeficiencia humana (V.I.H.) en nuestros pacientes hemofílicos, se estudiaron mediante el método inmunoenzimático aquéllos cuya hemofília se considera de grado moderado o grave. De los 84 pacientes estudiados, 24 se encontraron positivos en dos determinaciones séricas, efectuándose además el examen ENVACORE resultando en todos ellos de nuevo positivo, para una prevalencia de 28.5%. Veinte de ellos se encuentran asintomáticos, tres presentan linfadenopatía crónica y uno síndrome febril, hepato-esplenomegalia y linfadenopatía. Consideramos que nuestra prevalencia es mucho menor que las informadas por otros autores. Ninguno de nuestros pacientes ha desarrollado el síndrome completo, lo que quizá dependa de exposiciones múltiples al V.I.H., intensidad y naturaleza de la respuesta de anticuerpos y de muchos otros factores aún no conocidos