RESUMO
Between August and December 2013, the offshore cages of a commercial marine farm culturing red drum Sciaenops ocellatus in Campeche Bay Mexico were affected by an outbreak of an ulcerative granulomatous disease with up to 70% cumulative mortality. Thirty-one adults displaying open ulcers on the skin were submitted for diagnosis. At necropsy, multiple white-yellowish nodules (0.1-0.5 cm in diameter) were present in all internal organs, where the kidney and the spleen were the most severely affected. Histopathology evinced typical systemic granulomatous formations. Gram and Ziehl-Neelsen stains on tissue imprints, bacterial swabs and tissue sections revealed Gram-positive, acid-fast, branching beaded long rod filamentous bacteria. Tissue samples resulted positive for nocardiosis with a Nocardia genus-specific nested PCR. Definite identification at the species level and taxonomic positioning of the fastidious pathogen were achieved through a specific Nocardia seriolae PCR and by sequencing the gyrB gene of pure isolates. After administration of antibiotics during fry production, a posterior follow-up monitoring (from 2014 to 2017) detected mild but recurrent outbreaks of the bacteria with no seasonality pattern. To the extent of our knowledge, this is the first report of piscine nocardiosis in Mexico and the first time this disease is detected in red drum.
Assuntos
Doenças dos Peixes/diagnóstico , Peixes , Nocardiose/veterinária , Nocardia/isolamento & purificação , Animais , Doenças dos Peixes/microbiologia , México , Nocardia/classificação , Nocardia/genética , Nocardiose/diagnóstico , Nocardiose/microbiologiaRESUMO
Background: Chronic kidney disease (CKD) affects 10-13% of the population worldwide. CKD classification stratifies patients in five stages of risk for progressive renal disease based on estimated glomerular filtration rate (eGFR) by formulas and albuminuria. However, the reliability of formulas to reflect real renal function is a matter of debate. The effect of the error of formulas in the CKD classification is unclear, particularly for cystatin C-based equations. Methods: We evaluated the reliability of a large number of cystatin C and/or creatinine-based formulas in the definition of the stages of CKD in 882 subjects with different clinical situations over a wide range of glomerular filtration rates (GFRs) (4.2-173.7 mL/min). Results: Misclassification was a constant for all 61 formulas evaluated and averaged 50% for creatinine-based and 35% for cystatin C-based equations. Most of the cases were misclassified as one stage higher or lower. However, in 10% of the subjects, one stage was skipped and patients were classified two stages above or below their real stage. No clinically relevant improvement was observed with cystatin C-based formulas compared with those based on creatinine. Conclusions: The error in the classification of CKD stages by formulas was extremely common. Our study questions the reliability of both cystatin C and creatinine-based formulas to correctly classify CKD stages. Thus the correct classification of CKD stages based on estimated GFR is a matter of chance. This is a strong limitation in evaluating the severity of renal disease, the risk for progression and the evolution of renal dysfunction over time.
Assuntos
Creatinina/sangue , Cistatina C/sangue , Nefrologia/normas , Insuficiência Renal Crônica/sangue , Adulto , Idoso , Albuminúria/sangue , Progressão da Doença , Feminino , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Risco , Índice de Gravidade de DoençaRESUMO
El sistema digestivo es de los más afectados por defectos congénitos, los cuales constituyen un problema de salud global por aparecer entre las primeras causas de mortalidad infantil y por lo difícil de su prevención.Objetivo: identificar factores asociados a la aparición de defectos congénitos del sistema digestivo y la magnitud del riesgo que implica su presencia en el municipio Camagüey.Método: estudio de casos y controles con un universo conformado por todas las concepciones del período estudiado. De la población compuesta por 53 defectos congénitos del sistema digestivo, la muestra fue de 30 casos. Los 30 controles fueron niños sanos de la misma área de salud e igual sexo y edad probable para cada caso, en el periodo desde enero de 2006 a enero del 2011.Resultados: los defectos congénitos del sistema digestivo fueron segundos en prevalencia superados por el sistema nervioso y seguidos por las cardiopatías. La gastrosquisis fue la anomalía más frecuente, seguida por las hernias diafragmáticas, el onfalocele y las atresias esofágicas. El consumo de café en la madre (p=0,002;OR:5,53;IC:1,03-1,14), el hábito de fumar en el padre (p=0,009;OR:6,45;IC:1,57-26,36) y los antecedentes familiares de anomalías (p=0,009;OR:6,40;CI:1,60-25,66) fueron los factores que mostraron asociación estadística con la presencia de defectos congénitos del sistema digestivo.Conclusiones: no se constataron frecuencias erráticas que indicaran la acción de teratógenos exógenos; cada factor independiente identificado incrementó en más de cinco veces la probabilidad de presentar defectos congénitos del sistema digestivo y su asociación triplicaría esa cifra. Los resultados sugieren redirigir el proyecto a la exploración exhaustiva de los factores identificados y se recomiendan estudios sucesivos con muestras mayores para llegar a conclusiones clínicas con mejor certidumbre...
Digestive system is one of the most affected by congenital defects which constitute a global health problem; they are among the main causes of infant mortality and also difficult to prevent.Objective: to identify factors associated to congenital defects of the digestive system and the magnitude of the risk that entails its presence in Camagüey municipality.Methods: a case-control study was conducted from January 2006 to January 2011. The universe was composed of all the conceptions of the studied period, of a population composed of 53 congenital defects; the sample was of 30 cases. The 30 control group members were healthy children from the same health area, of the same sex and probable age for each case.Results: congenital defects of the nervous system and cardiopathies predominated over congenital malformations of the digestive system. Gastroschisis was the most frequent anomaly fallowed by diaphragmatic hernias, omphalocele, and esophageal atresia. Coffee consumption in the mother (p=0,002;OR:5,53;IC:1,03-1,14), smoking in the father (p=0,009;OR:6,45;IC:1,57-26,36), and family history of anomalies (p=0,009;OR:6,40;CI:1,60-25,66) were the factors that showed statistical association to the presence of congenital defects of digestive system.Conclusions: erratic frequencies that indicated the action of exogenous teratogens were not established; each identified independent factor increased in more than five times the probability of presenting congenital defects of the digestive system and its action would triple that number. Results suggest redirecting the project to the exhaustive exploration of the identified factors; subsequent studies with greater samples to get to clinical conclusions with more certitude are recommended...
Assuntos
Humanos , Criança , Anormalidades do Sistema Digestório/epidemiologia , Anormalidades do Sistema Digestório/prevenção & controle , Ensaios Clínicos Controlados como Assunto , Mortalidade Infantil , Estudos de Casos e ControlesRESUMO
El diazepam por vía intravenosa o rectal constituye el tratamiento de elección en niños con convulsión febril. Algunos autores consideran que pudiera ser la vía bucal una alternativa más práctica y efectiva. Objetivo: evaluar la eficacia y seguridad del diazepam administrado por vía retrolabial en el tratamiento de niños con convulsión febril en el Hospital Pediátrico de Gambia, desde julio de 2007 hasta julio de 2008. Método: Se realizó un ensayo clínico, aleatorizado, paralelo, unicéntrico, a ciego por tercero, de eficacia del diazepam retrolabial controlado con diazepam intravenoso en el tratamiento de la convulsión febril. Fueron incluidos 66 niños, con convulsión y fiebre, mayores de seis meses y menores de cinco años de edad, de ambos sexos y con consentimiento informado del familiar. Se determinó el tiempo que transcurrió para alcanzar la vía de administración, el tiempo de alivio de la convulsión una vez administrado el medicamento y la aparición de reacciones adversas. Al grupo de tratamiento se le administró diazepam retrolabial 0,50 mg/kg/dosis y al grupo control diazepam intravenoso 0,25 mg/kg/dosis. Resultados: el tiempo necesario para alcanzar la vía de administración fue significativamente menor para el grupo que recibió diazepam retrolabial y más prolongado para la administración intravenosa. El tiempo al que se logró la acción anticonvulsivante una vez administrado el medicamento no varió entre los dos grupos. El diazepam administrado por vía retrolabial fue bien tolerado y presentó menor riesgo de padecer reacciones adversas medicamentosas que el intravenoso. Conclusiones: el diazepam por vía retrolabial es eficaz y seguro para tratar la crisis de convulsión febril en niños.
Diazepam administered rectal or intravenously constitutes the election treatment in children with febrile convulsion. Some authors consider that buccal route could be more practice and effective alternative. Objective: to evaluate the effectiveness of diazepam administered by buccal route in the treatment of children with febrile convulsion at the Pediatric Hospital of Gambia, from July 2007 to July 2008. Method: a randomized, parallel, unicentric, third blind clinical trial was conducted on the effectiveness of the controlled buccal diazepam with intravenous diazepam in the treatment of febrile convulsion. Sixty-six children were included with convulsion and fever, older than six months and under five years old, from both sexes and with their relative informed consent. The time to reach the administration route; the relief time of convulsion once the drug was administered and the appearance of adverse reactions were determined. To the treatment group was administered buccal diazepam 0,50 mg/kg/dose and to the control group intravenous diazepam 0,25 mg/kg/dose. Results: the necessary time to reach the administration route was significantly smaller for the group that received buccal diazepam and more prolonged than the one of intravenous administration. The time to which the anticonvulsant action was achieved once the drug was administered didn't vary among the two groups. Diazepam administered by buccal route was well tolerated and it presented lower risk of suffering adverse reactions than intravenous one. Conclusions: diazepam administered by buccal route is effective and safe to treat febrile seizures in children.
Assuntos
Humanos , Criança , Ensaios Clínicos Fase I como Assunto , Diazepam , Convulsões FebrisRESUMO
El Síndrome de Stevens-Johnson es una enfermedad inflamatoria aguda, caracterizada por un eritema multiforme vesiculobuloso de la piel y otros órganos, se califica como la etapa inicial de una reacción dérmica cuya presentación más severa es la necrólisis epidérmica tóxica. La causa de esta enfermedad está ligada al uso de algunos fármacos en un 60 %, además de causas infecciosas y algunos factores genéticos predisponentes. La ciprofloxacino produce el síndrome en una frecuencia menor de uno en diez mil. Caso Clínico: se presenta el caso de una paciente de 69 años de edad con diagnóstico de Amigdalitis, recibió tratamiento con ciprofloxacina tabletas, a las veinticuatro horas de evolución, desarrolló un síndrome de Stevens-Johnson en forma muy severa con manifestaciones cutáneas, oculares y de la mucosa oral, que evolucionó a una necrólisis epidérmica tóxica, se acompañó de otras complicaciones y tuvo un desenlace fatal. Discusión: el Síndrome de Stevens-Johnson y la necrólisis epidérmica tóxica pueden presentarse con una erupción morbiliforme que puede evolucionar a necrosis de piel, comprometer el tubo digestivo, la tráquea, los bronquios, el tracto urinario, la vagina y las conjuntivas. En los casos graves pueden aparecer complicaciones como lesiones oculares persistentes, neumonía, estenosis esofágica, insuficiencia renal aguda, insuficiencia hepática, trastornos hematológicos, pérdidas masivas de fluidos por vía transepidérmica y sepsis, esta última constituye la causa principal de muerte.
Stevens-Johnson syndrome is an acute inflammatory disease, characterized by an erythema multiforme bullosum of the skin and other organs; it is considered the initial stage of a dermic reaction whose severest presentation is toxic epidermal necrolysis. Its cause is linked to the use of some drugs in a 60 %, as well as infectious causes and some genetic predisposing factors. Clinical case: a 69 years old woman with diagnosis of tonsillitis who received treatment with ciprofloxacin, to the twenty four hours of evolution the patient evolved a severe Stevens-Johnson syndrome with skin, ocular and oral mucosa manifestations that evolved to a toxic epidermal necrolysis, accompanied by other complications and had a fatal outcome. Discussion: Stevens-Johnson syndrome and toxic epidermal necrolysis may appeared with a morbilliform eruption that may develop to a necrosis of the skin, affecting digestive tube, trachea, the bronchi, urinary tract, vagina and conjunctivas. In the critical cases may appear complications like persistent ocular injuries, pneumonia, esophageal stenosis, chronic renal insufficiency, hepatic insufficiency, hematological disorders, massive losses of fluids by trans-epidermal via and sepsis, the last one constitute the main cause of death.
Assuntos
Humanos , Ciprofloxacina , Síndrome de Stevens-Johnson , Síndrome de Stevens-Johnson/diagnósticoRESUMO
La ausencia de datos epidemiológicos sobre los defectos congénitos en Gambia motivó a estudiar los rasgos clínicos de los defectos congénitos y factores asociados. Objetivo: identificar rasgos epidemiológicos y factores asociados a defectos congénitos mayores, en el Hospital Docente Royal Victoria de Banjul, de enero a junio de 2008. Método: se realizó un estudio analítico retrospectivo de casos y controles. Constituyeron el universo mil sesenta y siete menores de un año. La muestra fue de sesenta y dos pacientes, infantes con defectos congénitos mayores y sesenta y dos controles, infantes sanos, del mismo sexo y nacidos el mismo mes que los casos. Los coeficientes de regresión de las variables independientes se tuvieron en cuenta como la influencia de éstas en la presencia de anomalías congénitas, se consideraron significativos los de probabilidad menor que 0,05. Resultados: la incidencia estimada de defectos congénitos fue de 1:17, con proporción de 1,06 masculino por uno femenino. La etnia Wolof representó el 38,71 por ciento de los malformados. El aparato cardiovascular y el sistema nervioso central fueron los más afectados constituyendo el 25 porcienro y el 16,6 porciento respectivamente. La hipertermia y anemia en el embarazo presentaron significación estadística como factores asociados a la aparición de defectos congénitos mayores. Conclusiones: aunque se halló una elevada incidencia de defectos congénitos, su ocurrencia no fue aberrante o inesperada. La anemia y la hipertermia en las madres se asociaron estadísticamente con la presencia de defectos congénitos, pero se necesita de estudios más abarcadores para un adecuado enfoque de riesgo y establecer relaciones de causalidad.
The absence of epidemic data about the congenital defects in Gambia motivated to study the clinical features of the congenital defects and associated factors. Objective: to identify epidemic features and associated factors to greater congenital defects, in the Educational Hospital Royal Victoria of Banjul, from January to June 2008. Method: an analytic retrospective study of cases and controls was performed. The universe was constituted by one-thousand sixty seven minors of one year of life. The sample remain conformed by sixty-two patients, infants with greater congenital defects and sixty two controls, healthy infants, of the same sex and born the same month that the cases. The regression coefficients of the independent variables were taken into account as the influence of these in the presence of congenital anomalies, it were considered significant those of smaller probability than 0.05. Results: the estimate incidence of congenital defects was of 1:17, with masculine proportion of 1, 06 for one feminine. The Wolof ethnic group represented 38,71 percent of the malformed patients. The cardiovascular apparatus and the central nervous system were the most affected ones constituting 25 percent and 16,6 percent respectively. The hyperthermia and anemia in pregnancy presented statistical significance as associated factors to the appearance of greater congenital defects. Conclusions: although a high incidence of congenital defects was found, its occurrence was not aberrant or unexpected. The anemia and the hyperthermia in mothers were statistically associated with the presence of congenital defects, but it is needed of most covered studies for an appropriate focus of risk and to establish relationships of causation.
Assuntos
Humanos , Lactente , Anormalidades Congênitas , LactenteRESUMO
A finales de la década del 50, en Europa, Australia, Japón y varios países africanos, la talidomida provocó más de 10 000 casos de defectos congénitos en hijos de madres que la consumieron durante el embarazo. En 1962, es retirada del mercado. Tres décadas después, se reivindica su prescripción en el manejo de enfermedades de pronóstico desfavorable. Sus propiedades antiangiogénicas e inmunorreguladoras la hacen diferente al fármaco de los años 50 en gran medida. A pesar de poseer las mismas propiedades farmacológicas y riesgos teratogénicos, la molécula talidomida tiene otras las indicaciones, dosis, campos de aplicación y condiciones legales de uso. Esta revisión tiene como objetivo reseñar los contextos históricos y éticos que condicionaron la proscripción de la talidomida a principios de los años 60, así como las actuales condiciones clínicas en que se usan o ensayan actualmente sus efectos terapéuticos.
In Europe, Australia, Japan, and some African countries in the late 50's, Thalidomide caused more than 10 000 cases of congenital defects in children whose mothers consumed it during pregnancy. In 1962, it was withdrawn from market. Thirty years later, it is used for the management diseases with unfavorable prognosis. Its antiangiogenic and immunoregulatory characteristics distinguish it from the drug of 1950. Although containing the same pharmacological features and teratogenic risks, the molecule thalidomide does have other prescriptions, doses, application fields, and lawful conditions of use. This revision points out both the historical and ethical contexts, which conditioned the banning of Thalidomide in the early 60's, and the clinical conditions in which its therapeutic effects are used and studied today.
RESUMO
Tribolium castaneum is a member of the most species-rich eukaryotic order, a powerful model organism for the study of generalized insect development, and an important pest of stored agricultural products. We describe its genome sequence here. This omnivorous beetle has evolved the ability to interact with a diverse chemical environment, as shown by large expansions in odorant and gustatory receptors, as well as P450 and other detoxification enzymes. Development in Tribolium is more representative of other insects than is Drosophila, a fact reflected in gene content and function. For example, Tribolium has retained more ancestral genes involved in cell-cell communication than Drosophila, some being expressed in the growth zone crucial for axial elongation in short-germ development. Systemic RNA interference in T. castaneum functions differently from that in Caenorhabditis elegans, but nevertheless offers similar power for the elucidation of gene function and identification of targets for selective insect control.
Assuntos
Genes de Insetos/genética , Genoma de Inseto/genética , Tribolium/genética , Animais , Composição de Bases , Padronização Corporal/genética , Sistema Enzimático do Citocromo P-450/genética , Elementos de DNA Transponíveis/genética , Crescimento e Desenvolvimento/genética , Humanos , Inseticidas/farmacologia , Neurotransmissores/genética , Oogênese/genética , Filogenia , Proteoma/genética , Interferência de RNA , Receptores Acoplados a Proteínas G/genética , Receptores Odorantes/genética , Sequências Repetitivas de Ácido Nucleico/genética , Paladar/genética , Telômero/genética , Tribolium/classificação , Tribolium/embriologia , Tribolium/fisiologia , Visão Ocular/genéticaRESUMO
The rhesus macaque (Macaca mulatta) is an abundant primate species that diverged from the ancestors of Homo sapiens about 25 million years ago. Because they are genetically and physiologically similar to humans, rhesus monkeys are the most widely used nonhuman primate in basic and applied biomedical research. We determined the genome sequence of an Indian-origin Macaca mulatta female and compared the data with chimpanzees and humans to reveal the structure of ancestral primate genomes and to identify evidence for positive selection and lineage-specific expansions and contractions of gene families. A comparison of sequences from individual animals was used to investigate their underlying genetic diversity. The complete description of the macaque genome blueprint enhances the utility of this animal model for biomedical research and improves our understanding of the basic biology of the species.
Assuntos
Evolução Molecular , Genoma , Macaca mulatta/genética , Animais , Pesquisa Biomédica , Feminino , Duplicação Gênica , Rearranjo Gênico , Doenças Genéticas Inatas , Variação Genética , Humanos , Masculino , Família Multigênica , Mutação , Pan troglodytes/genética , Análise de Sequência de DNA , Especificidade da EspécieRESUMO
After the completion of a draft human genome sequence, the International Human Genome Sequencing Consortium has proceeded to finish and annotate each of the 24 chromosomes comprising the human genome. Here we describe the sequencing and analysis of human chromosome 3, one of the largest human chromosomes. Chromosome 3 comprises just four contigs, one of which currently represents the longest unbroken stretch of finished DNA sequence known so far. The chromosome is remarkable in having the lowest rate of segmental duplication in the genome. It also includes a chemokine receptor gene cluster as well as numerous loci involved in multiple human cancers such as the gene encoding FHIT, which contains the most common constitutive fragile site in the genome, FRA3B. Using genomic sequence from chimpanzee and rhesus macaque, we were able to characterize the breakpoints defining a large pericentric inversion that occurred some time after the split of Homininae from Ponginae, and propose an evolutionary history of the inversion.
Assuntos
Cromossomos Humanos Par 3/genética , Animais , Sequência de Bases , Quebra Cromossômica/genética , Inversão Cromossômica/genética , Mapeamento de Sequências Contíguas , Ilhas de CpG/genética , DNA Complementar/genética , Evolução Molecular , Etiquetas de Sequências Expressas , Projeto Genoma Humano , Humanos , Macaca mulatta/genética , Dados de Sequência Molecular , Pan troglodytes/genética , Análise de Sequência de DNA , Sintenia/genéticaRESUMO
Human chromosome 12 contains more than 1,400 coding genes and 487 loci that have been directly implicated in human disease. The q arm of chromosome 12 contains one of the largest blocks of linkage disequilibrium found in the human genome. Here we present the finished sequence of human chromosome 12, which has been finished to high quality and spans approximately 132 megabases, representing approximately 4.5% of the human genome. Alignment of the human chromosome 12 sequence across vertebrates reveals the origin of individual segments in chicken, and a unique history of rearrangement through rodent and primate lineages. The rate of base substitutions in recent evolutionary history shows an overall slowing in hominids compared with primates and rodents.
Assuntos
Cromossomos Humanos Par 12/genética , Animais , Composição de Bases , Ilhas de CpG/genética , Evolução Molecular , Etiquetas de Sequências Expressas , Genes/genética , Humanos , Desequilíbrio de Ligação/genética , Repetições de Microssatélites/genética , Dados de Sequência Molecular , Mutagênese Insercional/genética , Pan troglodytes/genética , Análise de Sequência de DNA , Deleção de Sequência/genética , Elementos Nucleotídeos Curtos e Dispersos/genética , Sintenia/genéticaRESUMO
Objetivo. Valorar el grado de desarrollo de la aptitud para la lectura crítica de artículos de investigación clínica de los residentes de psiquiatría del Instituto Mexicano del Seguro Social en el Distrito Federal. Métodos. Participaron 34 residentes de dos sedes hospitalarias (Ay B) y de los tres años de residencia. Se construyó y validó un instrumento con resúmenes de artículos de investigación publicados y 96 ítemes que exploran los indicadores de interpretación, juicio y propuesta. Su índice de confiabilidad fue de 0.88. Resultados. La mediana de la sede A fue de 11, la de la sede B de 9 y la global de 9.5 (p NS). No hubo diferencias significativas al comparar los resultados de los tres años de residencia. El 76 por ciento de los participantes (n=26) obtuvo una calificación explicable por azar (<18). Conclusiones. El grado de desarrollo de la aptitud para la lectura crítica de los alumnos fue muy bajo. Los resultados sugieren que las sesiones bibliográficas en las cuales intervinieron los residentes de psiquiatría estuvieron orientadas al consumo de información, y el ejercicio de la crítica a la literatura médica fue exiguo.