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1.
Can J Vet Res ; 87(2): 97-104, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37020575

RESUMO

Iron is an essential element for all living organisms, including bacteria, as several virulence factors and replication components are influenced by iron concentration. The objective of this study was to determine whether the composition and diversity of the fecal microbiota of adult horses are affected by supplemental dietary iron. Ten clinically healthy horses were randomly divided into a control and an iron-supplemented group (n = 5). The treated group was supplemented with oral ferrous sulphate monohydrate (720 ppm of iron), whereas the control group received 320 ppm of iron daily for 15 d. Fecal samples were collected before and 5, 10, 15, and 30 d after supplementation and frozen at -80°C. DNA was sequenced using an Illumina MiSeq platform and data were analyzed using the software Mothur and linear discriminant analysis (LDA) effect size (LEfSe). Iron supplementation caused no change in the overall composition of the fecal microbiota, but some minor changes were observed in the low-abundant bacteria, as well as an increased alpha diversity after 15 d of supplementation. Significant differences in community composition of the fecal microbiota over time were observed in both groups, highlighting the importance of a control group, as there are variables that cannot be controlled in microbiome studies.


Le fer est un élément essentiel pour tous les organismes vivants, y compris les bactéries, car plusieurs facteurs de virulence et composants de réplication sont influencés par la concentration en fer. L'objectif de cette étude était de déterminer si la composition et la diversité du microbiote fécal des chevaux adultes sont affectées par la supplémentation en fer alimentaire. Dix chevaux cliniquement sains ont été divisés au hasard en un groupe témoin et un groupe supplémenté en fer, n = 5 par groupe. Le groupe traité a reçu un supplément oral de sulfate ferreux monohydraté (720 ppm de fer) et le groupe témoin a reçu 320 ppm de fer par jour pendant 15 jours. Des échantillons fécaux ont été prélevés avant la supplémentation et 5, 10, 15 et 30 jours après la supplémentation puis congelés à −80 °C. L'ADN a été séquencé à l'aide de la plateforme Illumina MiSeq et les données ont été analysées à l'aide des logiciels Mothur et analyse de la fonction discriminante linéaire taille de l'effet LefSe. La supplémentation en fer n'a provoqué aucun changement dans la composition du microbiote fécal, mais certains changements ont été observés chez les bactéries peu abondantes, ainsi qu'une augmentation de la diversité alpha après 15 jours de supplémentation. Au fil du temps, des différences significatives dans la composition de la communauté bactérienne ont été observées dans les deux groupes, soulignant l'importance d'un groupe témoin, car il existe des variables qui ne peuvent être contrôlées dans les études sur le microbiome.(Traduit par les auteurs).


Assuntos
Ferro da Dieta , Microbiota , Animais , Cavalos , Ferro da Dieta/farmacologia , Ferro , Fezes/microbiologia , Bactérias/genética , Suplementos Nutricionais
2.
PLoS One ; 18(3): e0282738, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36920969

RESUMO

Alveolar macrophages (AMs) are the predominant innate immune cell in the distal respiratory tract. During inflammatory responses, AMs may be supplemented by blood monocytes, which differentiate into monocyte-derived macrophages (MDMs). Macrophages play important roles in a variety of common equine lower airway diseases, including severe equine asthma (SEA). In an experimental model, an inhaled mixture of Aspergillus fumigatus spores, lipopolysaccharide, and silica microspheres (FLS), induced SEA exacerbation in susceptible horses. However, whether equine AMs and MDMs have differing immunophenotypes and cytokine responses to FLS stimulation is unknown. To address these questions, alveolar macrophages/monocytes (AMMs) were isolated from bronchoalveolar lavage fluid and MDMs derived from blood of six healthy horses. Separately, AMMs and MDMs were cultured with and without FLS for six hours after which cell surface marker expression and cytokine production were analyzed by flow cytometry and a bead-based multiplex assay, respectively. Results showed that regardless of exposure conditions, AMMs had significantly higher surface expression of CD163 and CD206 than MDMs. Incubation with FLS induced secretion of IL-1ß, IL-8, TNF-α and IFN-γ in AMMs, and IL-8, IL-10 and TNF-α in MDMs. These results suggest that AMMs have a greater proinflammatory response to in vitro FLS stimulation than MDMs, inferring differing roles in equine lung inflammation. Variability in recruitment and function of monocyte-macrophage populations warrant more detailed in vivo investigation in both homeostatic and diseased states.


Assuntos
Macrófagos Alveolares , Fator de Necrose Tumoral alfa , Cavalos , Animais , Macrófagos Alveolares/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Interleucina-8/metabolismo , Macrófagos/metabolismo , Citocinas/metabolismo , Células Cultivadas
3.
Rev. bras. enferm ; 76(4): e20220734, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS, BDENF | ID: biblio-1514999

RESUMO

ABSTRACT Objective: to analyze vaccination coverage spatial distribution in children under one year old and the socioeconomic factors associated with meeting the recommended goals in Minas Gerais. Methods: an ecological study, carried out in 853 municipalities in the state. Pentavalent, poliomyelitis, meningococcal conjugate, yellow fever, rotavirus, and 10-valent pneumococcal conjugate vaccination coverage were analyzed. Scan statistics and multiple logistic regression were performed to identify spatial clusters and factors associated with meeting coverage goals. Results: spatial analysis revealed clusters with risk of low coverage for all vaccines. Number of families with per capita income of up to 1/2 wage, Minas Gerais Social Responsibility Index and percentage of the poor or extremely poor population were associated with meeting the established goals. Conclusions: the results are useful for designing interventions regarding the structuring of vaccination services and the implementation of actions to increase vaccination coverage in clusters with less propensity to vaccinate.


RESUMEN Objetivo: analizar la distribución espacial de las coberturas de vacunación en menores de un año y los factores socioeconómicos asociados al cumplimiento de las metas recomendadas en Minas Gerais. Métodos: estudio ecológico, realizado en 853 municipios del estado. Se analizaron las coberturas vacunales de pentavalente, poliomielitis, meningococo C, fiebre amarilla, rotavirus y neumococo conjugado decavalente. Se realizaron estadísticas de escaneo y regresión logística múltiple para identificar grupos espaciales y factores asociados con el cumplimiento de los objetivos de cobertura. Resultados: el análisis espacial reveló conglomerados con riesgo de baja cobertura para todas las vacunas. Número de familias con renta per cápita de hasta 1/2 salario, Índice de Responsabilidad Social Minas Gerais y porcentaje de población pobre o extremadamente pobre se asociaron al cumplimiento de las metas establecidas. Conclusiones: los resultados son útiles para el diseño de intervenciones en cuanto a la estructuración de los servicios de vacunación y la implementación de acciones para aumentar las coberturas de vacunación en los conglomerados con menor propensión a vacunar.


RESUMO Objetivo: analisar a distribuição espacial da cobertura vacinal em menores de um ano e os fatores socioeconômicos associados ao cumprimento das metas preconizadas em Minas Gerais. Métodos: estudo ecológico, realizado nos 853 municípios do estado. Foram analisadas as coberturas vacinais da pentavalente, poliomielite, meningocócica C, febre amarela, rotavírus, e pneumocócica conjugada 10-valente. Realizou-se estatística de varredura e regressão logística múltipla para identificar agrupamentos espaciais e fatores associados ao cumprimento das metas de cobertura. Resultados: a análise espacial revelou aglomerados com risco de baixas coberturas para todas as vacinas. Número de famílias com renda per capita até 1/2 salário, Índice Mineiro de Responsabilidade Social e percentual da população pobre ou extremamente pobre se mostraram associados ao cumprimento das metas preconizadas. Conclusões: os resultados são úteis para projetar intervenções quanto à estruturação dos serviços de vacinação e implementação de ações para aumentar a cobertura vacinal nos aglomerados com menor propensão à vacinação.

4.
Adv Healthc Mater ; 11(8): e2102153, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35007407

RESUMO

Cognitive deficits (chemobrain) and peripheral neuropathy occur in ∼75% of patients treated for cancer with chemotherapy and persist long-term in >30% of survivors. Without preventive or curative interventions and with increasing survivorship rates, the population debilitated by these neurotoxicities is rising. Platinum-based chemotherapeutics, including cisplatin, induce neuronal mitochondrial defects leading to chemobrain and neuropathic pain. This study investigates the capacity of nasally administered mesenchymal stem cell-derived mitochondria coated with dextran-triphenylphosphonium polymer (coated mitochondria) to reverse these neurotoxicities. Nasally administered coated mitochondria are rapidly detectable in macrophages in the brain meninges but do not reach the brain parenchyma. The coated mitochondria change expression of >2400 genes regulating immune, neuronal, endocrine and vascular pathways in the meninges of mice treated with cisplatin. Nasal administration of coated mitochondria reverses cisplatin-induced cognitive deficits and resolves neuropathic pain at a >55-times lower dose compared to uncoated mitochondria. Reversal of these neuropathologies is associated with resolution of cisplatin-induced deficits in myelination, synaptosomal mitochondrial integrity and neurogenesis. These findings demonstrate that nasally administered coated mitochondria promote resolution of chemobrain and peripheral neuropathy, thereby identifying a novel facile strategy for clinical application of mitochondrial donation and treating central and peripheral nervous system pathologies by targeting the brain meninges.


Assuntos
Antineoplásicos , Comprometimento Cognitivo Relacionado à Quimioterapia , Neuralgia , Animais , Antineoplásicos/metabolismo , Cisplatino/farmacologia , Humanos , Meninges/metabolismo , Camundongos , Mitocôndrias
5.
Can Vet J ; 62(7): 743-750, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34219784

RESUMO

The objective of this study was to describe the clinical findings, medical management, and outcomes of horses with sabulous cystitis, and to describe a high flow bladder lavage procedure in horses that are standing or under general anesthesia. The medical records of 13 horses diagnosed with sabulous cystitis via cystoscopy between 2013 and 2020 were reviewed. Geldings (92%) and Warmbloods (46%) were overrepresented. The most common presenting complaint was urinary incontinence (69%). Complete blood cell count, serum biochemistry profile and urine cytology results were non-specific. Six (46%) horses had various degrees of erosion, ulceration, and hemorrhage of the bladder mucosa. All horses were treated with bladder lavage either with standing sedation (n = 12) or general anesthesia (n = 2), as well as antimicrobials (54%), anti-inflammatory drugs (62%), bethanechol (15%), and phenazopyridine (15%). Most horses (85%) were discharged from the hospital, but only a small percentage (23%) was reported as having no urinary abnormalities on follow-up communication. Key clinical message: Copious bladder lavage with a high flow rate system could mitigate the acute clinical signs and improve the quality of life of horses with sabulous cystitis, but the prognosis for return to previous level of athletic performance and long-term survival is guarded.


Cystite sableuse chez le cheval: 13 cas (2013­2020). L'objectif de cette étude était de décrire les résultats cliniques, la prise en charge médicale et les résultats des chevaux atteints de cystite sableuse, et de décrire une procédure de lavage de la vessie à haut débit chez les chevaux debout ou sous anesthésie générale. Les dossiers médicaux de 13 chevaux diagnostiqués avec une cystite sableuse par cystoscopie entre 2013 et 2020 ont été revus. Les hongres (92 %) et les Warmbloods (46 %) étaient surreprésentés. La plainte la plus fréquente était l'incontinence urinaire (69 %). Un hémogramme complet, le profil biochimique sérique et les résultats de cytologie urinaire n'étaient pas spécifiques. Six chevaux (46 %) présentaient divers degrés d'érosion, d'ulcération et d'hémorragie de la muqueuse de la vessie. Tous les chevaux ont été traités par lavage de la vessie soit avec sédation debout (n = 12) ou anesthésie générale (n = 2), ainsi que des antimicrobiens (54 %), des anti-inflammatoires (62 %), du béthanéchol (15 %) et de la phénazopyridine (15 %). La plupart des chevaux (85 %) sont sortis de l'hôpital, mais seul un petit pourcentage (23 %) a été signalé comme n'ayant aucune anomalie urinaire lors de la communication de suivi.Message clinique clé:Un lavage vésical abondant avec un système à débit élevé pourrait atténuer les signes cliniques aigus et améliorer la qualité de vie des chevaux atteints de cystite sableuse, mais le pronostic du retour au niveau antérieur de performance athlétique et de survie à long terme est réservé.(Traduit par Dr Serge Messier).


Assuntos
Cistite , Doenças dos Cavalos , Incontinência Urinária , Animais , Cistite/veterinária , Doenças dos Cavalos/terapia , Cavalos , Masculino , Qualidade de Vida , Incontinência Urinária/veterinária
6.
Can Vet J ; 62(4): 397-402, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33867554

RESUMO

The use of a laparoscopic suction-irrigation device in 2 standing horses for lavage of the abdomen for the treatment of primary suppurative peritonitis is reported. Two horses were presented with a 1- to 2-week history of weight loss. Abdominocentesis revealed highly elevated total nucleated cell count. Peritoneal lavage systems were placed in both horses, but complications prevented adequate lavage. Both horses underwent standing laparoscopy; the dorsal abdomen was explored and the abdomen was profusely lavaged, using a suction-irrigation device. The procedure was efficient and allowed adequate visualization of the dorsal abdomen and lavage. A successful outcome was achieved in both cases. Key clinical message: Lavage of the abdomen of horses with peritonitis can be achieved under standing sedation, using a laparoscopic technique. In appropriately selected cases, this allows for adequate visualization of the dorsal abdomen and efficacious abdominal lavage.


Lavage abdominal laparoscopique debout à l'aide d'un dispositif d'irrigation par aspiration chez deux chevaux atteints de péritonite suppurée primaire. L'utilisation d'un dispositif laparoscopique d'irrigation par aspiration pour le lavage de l'abdomen pour le traitement d'une péritonite suppurée primaire chez deux chevaux debout est rapportée. Deux chevaux ont été présentés avec une histoire de 1 à 2 semaines de perte de poids. L'abdominocentèse a révélé un nombre total de cellules nucléées très élevé. Des systèmes de lavage péritonéal ont été placés chez les deux chevaux, mais des complications ont empêché un lavage adéquat. Les deux chevaux ont subi une laparoscopie debout; l'abdomen dorsal a été exploré, et l'abdomen a été abondamment lavé à l'aide d'un dispositif d'irrigation par aspiration. La procédure était efficace et permettait une visualisation adéquate de l'abdomen dorsal et un lavage. Une résolution positive a été obtenue dans les deux cas.Message clinique clé:Le lavage de l'abdomen de chevaux atteints de péritonite peut être réalisé sous sédation debout, en utilisant une technique laparoscopique. Dans des cas bien choisis, cela permet une visualisation adéquate de l'abdomen dorsal et un lavage abdominal efficace.(Traduit par Dr Serge Messier).


Assuntos
Doenças dos Cavalos , Laparoscopia , Peritonite , Abdome , Animais , Doenças dos Cavalos/cirurgia , Cavalos , Laparoscopia/veterinária , Lavagem Peritoneal/veterinária , Peritonite/cirurgia , Peritonite/veterinária , Sucção/veterinária
7.
Theranostics ; 11(7): 3109-3130, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33537077

RESUMO

Up to seventy-five percent of patients treated for cancer suffer from cognitive deficits which can persist for months to decades, severely impairing quality of life. Although the number of cancer survivors is increasing tremendously, no efficacious interventions exist. Cisplatin, most commonly employed for solid tumors, leads to cognitive impairment including deficits in memory and executive functioning. We recently proposed deficient neuronal mitochondrial function as its underlying mechanism. We hypothesized nasal administration of mitochondria isolated from human mesenchymal stem cells to mice, can reverse cisplatin-induced cognitive deficits. Methods: Puzzle box, novel object place recognition and Y-maze tests were used to assess the cognitive function of mice. Immunofluorescence and high-resolution confocal microscopy were employed to trace the nasally delivered mitochondria and evaluate their effect on synaptic loss. Black Gold II immunostaining was used to determine myelin integrity. Transmission electron microscopy helped determine mitochondrial and membrane integrity of brain synaptosomes. RNA-sequencing was performed to analyse the hippocampal transcriptome. Results: Two nasal administrations of mitochondria isolated from human mesenchymal stem cells to mice, restored executive functioning, working and spatial memory. Confocal imaging revealed nasally delivered mitochondria rapidly arrived in the meninges where they were readily internalized by macrophages. The administered mitochondria also accessed the rostral migratory stream and various other brain regions including the hippocampus where they colocalized with GFAP+ cells. The restoration of cognitive function was associated with structural repair of myelin in the cingulate cortex and synaptic loss in the hippocampus. Nasal mitochondrial donation also reversed the underlying synaptosomal mitochondrial defects. Moreover, transcriptome analysis by RNA-sequencing showed reversal of cisplatin-induced changes in the expression of about seven hundred genes in the hippocampus. Pathway analysis identified Nrf2-mediated response as the top canonical pathway. Conclusion: Our results provide key evidence on the therapeutic potential of isolated mitochondria - restoring both brain structure and function, their capability to enter brain meninges and parenchyma upon nasal delivery and undergo rapid cellular internalization and alter the hippocampal transcriptome. Our data identify nasal administration of mitochondria as an effective strategy for reversing chemotherapy-induced cognitive deficits and restoring brain health, providing promise for the growing population of both adult and pediatric cancer survivors.


Assuntos
Comprometimento Cognitivo Relacionado à Quimioterapia/terapia , Mitocôndrias/metabolismo , Mitocôndrias/transplante , Administração Intranasal/métodos , Animais , Encéfalo/patologia , Comprometimento Cognitivo Relacionado à Quimioterapia/patologia , Cisplatino/efeitos adversos , Cisplatino/farmacologia , Cognição , Disfunção Cognitiva/patologia , Disfunção Cognitiva/terapia , Modelos Animais de Doenças , Hipocampo/patologia , Humanos , Memória , Transplante de Células-Tronco Mesenquimais/métodos , Células-Tronco Mesenquimais/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Neurônios/patologia
8.
Rev. méd. Urug ; 37(2): e206, 2021. tab
Artigo em Espanhol | LILACS, BNUY | ID: biblio-1280506

RESUMO

Resumen: Objetivos: describir las características clínicas y epidemiológicas de niños admitidos por bronquiolitis en 13 unidades de cuidados intensivos pediátricos (UCIP) del Uruguay y comparar los resultados asistenciales finales entre UCIP de Montevideo (UM) y del interior del país (UI). Material y método: estudio observacional retrospectivo multicéntrico de los registros ingresados a base de datos prospectiva de LARed Network. Se incluyeron niños mayores de 1 mes y menores de 2 años admitidos en el período 1 de mayo de 2017 y 30 de abril de 2019 con diagnóstico de bronquiolitis comunitaria. Se analizaron datos demográficos, clínicos, así como intervenciones y desenlaces al alta. Resultados: se analizaron 666 casos. No se detectaron diferencias significativas de comorbilidades ni en el soporte respiratorio al ingreso. En UI los pacientes fueron derivados con más frecuencia desde otro hospital. La distancia y tiempo medio, así como el porcentaje de traslados mayor de 50 km, fue también mayor. En UI los pacientes tuvieron mayor gravedad clínica y gasométrica al ingreso. El perfil radiológico y etiológico fue similar. Virus respiratorio sincicial (VRS) aislado > 50%. La indicación global de corticoides superó el 25% y el de broncodilatadores el 85%. La prescripción de antibióticos y adrenalina nebulizada fue mayor en UI. La cánula nasal de alto flujo (CNAF) fue globalmente el método de soporte respiratorio más utilizado, aunque se observó un mayor uso de ventilación mecánica invasiva (VMI) y CPAP en UI (47% vs 28% en UM). No hubo diferencias en el número de complicaciones por VMI o ventilación no invasiva, ni en el uso de terapias de rescate. Tampoco se notaron diferencias significativas en la duración de la estadía en UCIP, ni en la mortalidad absoluta y ajustada, y hubo un solo caso de nueva morbilidad. Conclusiones: los niños admitidos en UI tuvieron mayor gravedad al ingreso y más factores de riesgo relacionados con mal pronóstico en el traslado, recibiendo más antibióticos y soporte invasivo que aquellos ingresados en UM. El CNAF fue el tipo de soporte respiratorio más utilizado en el país. Se detectó alto porcentaje de prescripción de terapias no recomendadas, como broncodilatadores y corticoides. La mortalidad y complicaciones fueron bajas, así como la generación de morbilidad residual.


Summary: Objectives: to describe the clinical and epidemiological characteristics of children admitted for bronchiolitis in 13 Pediatric Intensive Care Units (UCIP) in Uruguay and compare the final care outcomes between Montevideo (UM) and Interior of the country (IU). Method: multicenter, retrospective, observational study of data entered in the LARed Network prospective database. Children over 1 month and younger than 2 years admitted between May 1, 2017 and April 30, 2019 with a diagnosis of Community Bronchiolitis were included in the study. Demographic and clinical data were analyzed, as well as interventions and discharge outcomes. Results: 666 cases were analyzed. No significant differences in comorbidity and respiratory support were detected at admission. In IU patients were referred more frequently from another hospital. The distance and average time, as well as the percentage of transfers greater than 50 km, was also higher. In IU, patients had greater clinical and gasometrical severity at admission. The radiological and etiological profile was similar (VRS at > 50%). The overall indication of corticosteroids exceeded 25% and that of bronchodilators exceeded 85%. The prescription for antibiotics and nebulized adrenaline was higher in IU. The high flow nasal cannula (HFNC) was globally the most widely used respiratory support method, although increased use of invasive mechanical ventilation (IMV) and CPAP in IU (43% vs 28% in UM) was observed. There were no differences in the number of complications from IVF or non-invasive ventilation, nor in the use of rescue therapies. There were also no significant differences in the length of stay at UCIP or in absolute and adjusted mortality and there was only one case of new morbidity. Conclusions: children admitted to IU had higher severity scores and more transfer-related risk factors, received more antibiotics and invasive support. HFNC was the most widely used type of respiratory support in the country. A high prescription of non-recommended therapies such as bronchodilators and corticosteroids was detected. Mortality and complications were low, as were the generation of new morbidity.


Resumo: Objetivos: descrever as características clínicas e epidemiológicas de crianças internadas por bronquiolite em 13 Unidades de Terapia Intensiva Pediátrica (UTIP) do Uruguai e comparar os resultados finais do atendimento entre UTIP de Montevidéu (UM) e do Interior do país (IU). Material e métodos: estudo observacional retrospectivo multicêntrico dos dados inseridos no banco de dados prospectivo da Rede LARed. Foram incluídas crianças maiores de 1 mês e menores de 2 anos internadas no período de 1º de maio de 2017 a 30 de abril de 2019 com diagnóstico de bronquiolite comunitária. Dados demográficos e clínicos, bem como intervenções e desfechos na alta, foram analisados. Resultados: foram analisados 666 casos. Não foram detectadas diferenças significativas nas comorbidades ou no suporte respiratório na admissão. No IU, os pacientes foram encaminhados com maior frequência a outro hospital. A distância e o tempo médios, assim como o percentual de transferências superiores a 50 km, também foram maiores. No IU, os pacientes apresentaram maior gravidade clínica e gasométrica na admissão. O perfil radiológico e etiológico foi semelhante. O vírus sincicial respiratório (RSV) foi isolado em > 50%. A indicação global de corticosteroides ultrapassou 25% e a de broncodilatadores 85%. A prescrição de antibióticos e adrenalina nebulizada foi maior no IU. A cânula nasal de alto fluxo (CNAF) foi o método de suporte respiratório mais utilizado, embora tenha sido observado um maior uso de ventilação mecânica invasiva (VMI) e CPAP no IU (47% vs 28% em UM). Não houve diferenças no número de complicações devido à VMI ou Ventilação Não Invasiva, ou no uso de terapias de resgate. Também não foram observadas diferenças significativas no tempo de internação na UTIP ou na mortalidade absoluta e ajustada, havendo apenas um caso de nova morbidade. Conclusões: as crianças admitidas no IU apresentaram maior gravidade na admissão e mais fatores de risco relacionados ao mau prognóstico na transferência, recebendo mais antibióticos e suporte invasivo do que as internadas em UM. O CNAF foi o tipo de suporte respiratório mais utilizado no país. Detectou-se alto percentual de prescrição de terapias não recomendadas, como broncodilatadores e corticosteroides. A mortalidade e as complicações foram baixas, assim como a geração de morbidade residual.


Assuntos
Humanos , Pré-Escolar , Criança , Bronquiolite , Morbidade , Ventilação não Invasiva , Cânula , Unidades de Terapia Intensiva Pediátrica
9.
Rev. MVZ Córdoba ; 25(3): 126-143, sep.-dic. 2020. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1394669

RESUMO

RESUMEN Objetivo. Analizar la producción científica en Medicina Veterinaria y Zootecnia en Colombia en el período 2010-2019. Materiales y métodos. Se realizó un estudio descriptivo transversal retrospectivo, mediante el análisis bibliométrico de los artículos publicados en nueve revistas del área de la Medicina Veterinaria y Zootecnia en Colombia. La información se obtuvo mediante la búsqueda en internet de la página web de cada revista. Los artículos incluidos fueron artículos originales, revisiones de literatura, comunicaciones breves, casos clínicos y editoriales. Resultados. El total de artículos fue 3.000; 2.250 (75%) publicados en español, 673 (22.4%) en inglés y 77 (2.6%) en portugués. 2.282 (76.1%) fueron originales, 224 (7.5%) revisiones de literatura, 165 (5.5%) casos clínicos, 105 (3.5%) comunicaciones breves, 204 (6.8%) editoriales y 21 (0.6%) otros. Hubo 10.296 autores; 7.109 (69%), nacionales y 3.187 (31%) extranjeros. Del total de autores, 6.659 (64.7%) fueron hombres; 3.199 (31%) mujeres y 438 (4.3%) sin identificación; con un promedio de 3.38 autores/artículo. Las entidades públicas aportaron el 77.9% de la producción científica y las privadas el 22.1%. Las áreas con mayor número de publicaciones fueron zootecnia, salud animal, agricultura y fauna silvestre. El top 5 de las filiaciones de los autores correspondió a universidades públicas. Conclusiones. Las revistas que publican en inglés consiguen un mejor posicionamiento internacional y en ellas publican el mayor número de autores extranjeros. Los artículos más publicados fueron los originales. El top 10 de los artículos más citados arrojó un total de 810 citas que contribuyen con la internacionalización de las revistas colombianas y de Colombia.


ABSTRACT Objective. Analyze the scientific production in Veterinary Medicine and Animal Husbandry in Colombia in the period 2010-2019. Materials and methods. A retrospective cross-sectional descriptive study was carried out, through the bibliometric analysis of articles published in nine journals in the area of Veterinary Medicine and Animal Husbandry in Colombia. The information was obtained by searching theinternet for each journal's website. The articles included were original articles, literature reviews, brief communications, clinical cases and editorials. Results. The total number of articles was 3.000; 2.250 (75%) published in Spanish, 673 (22.4%) in English and 77 (2.6%) in Portuguese. 2.282 (76.1%) were original, 224 (7.5%) literature reviews, 165 (5.5%) clinical cases, 105 (3.5%) brief communications, 204 (6.8%) editorials and 21 (0.6%) others. There were 10,296 authors; 7.109 (69%), nationals and 3.187 (31%) foreigners. Of the total Authors, 6.659 (64.7%) were men; 3.199 (31%) women and 438 (4.3%) without identification, with an average of 3.38 authors/article. Public entities contributed 77.9% of scientific production and private entities 22.1%. The areas with the highest number of publications were zootechnics, animal health, agriculture and wildlife. The top 5 of affiliations of the authors corresponded to public universities. Conclusions. The journal that publish in English achieve a better international positioning and in them the largest number of foreign authors publishes. The most published articles were the original ones. The top 10 of the most cited articles yielded a total of 810 citations that contribute to the internationalization of Colombia and Colombian journals.

10.
Acta Neuropathol Commun ; 8(1): 193, 2020 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-33183353

RESUMO

Frequently reported neurotoxic sequelae of cancer treatment include cognitive deficits and sensorimotor abnormalities that have long-lasting negative effects on the quality of life of an increasing number of cancer survivors. The underlying mechanisms are not fully understood and there is no effective treatment. We show here that cisplatin treatment of mice not only caused cognitive dysfunction but also impaired sensorimotor function. These functional deficits are associated with reduced myelin density and complexity in the cingulate and sensorimotor cortex. At the ultrastructural level, myelin abnormalities were characterized by decompaction. We used this model to examine the effect of bexarotene, an agonist of the RXR-family of nuclear receptors. Administration of only five daily doses of bexarotene after completion of cisplatin treatment was sufficient to normalize myelin density and fiber coherency and to restore myelin compaction in cingulate and sensorimotor cortex. Functionally, bexarotene normalized performance of cisplatin-treated mice in tests for cognitive and sensorimotor function. RNAseq analysis identified the TR/RXR pathway as one of the top canonical pathways activated by administration of bexarotene to cisplatin-treated mice. Bexarotene also activated neuregulin and netrin pathways that are implicated in myelin formation/maintenance, synaptic function and axonal guidance. In conclusion, short term treatment with bexarotene is sufficient to reverse the adverse effects of cisplatin on white matter structure, cognitive function, and sensorimotor performance. These encouraging findings warrant further studies into potential clinical translation and the underlying mechanisms of bexarotene for chemobrain.


Assuntos
Antineoplásicos/farmacologia , Bexaroteno/farmacologia , Cisplatino/toxicidade , Cognição/efeitos dos fármacos , Giro do Cíngulo/efeitos dos fármacos , Bainha de Mielina/efeitos dos fármacos , Desempenho Psicomotor/efeitos dos fármacos , Córtex Sensório-Motor/efeitos dos fármacos , Animais , Antineoplásicos/toxicidade , Comprometimento Cognitivo Relacionado à Quimioterapia/metabolismo , Comprometimento Cognitivo Relacionado à Quimioterapia/patologia , Comprometimento Cognitivo Relacionado à Quimioterapia/fisiopatologia , Marcha/efeitos dos fármacos , Perfilação da Expressão Gênica , Giro do Cíngulo/metabolismo , Giro do Cíngulo/patologia , Giro do Cíngulo/fisiopatologia , Camundongos , Bainha de Mielina/metabolismo , Bainha de Mielina/patologia , Bainha de Mielina/ultraestrutura , Netrinas/efeitos dos fármacos , Netrinas/genética , Netrinas/metabolismo , Neurregulinas/efeitos dos fármacos , Neurregulinas/genética , Neurregulinas/metabolismo , Teste de Campo Aberto , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Pré-Frontal/metabolismo , Córtex Pré-Frontal/patologia , Córtex Pré-Frontal/fisiopatologia , RNA-Seq , Receptores X de Retinoides/efeitos dos fármacos , Receptores X de Retinoides/genética , Receptores X de Retinoides/metabolismo , Córtex Sensório-Motor/metabolismo , Córtex Sensório-Motor/patologia , Córtex Sensório-Motor/fisiopatologia , Substância Branca/efeitos dos fármacos , Substância Branca/metabolismo , Substância Branca/patologia
11.
Rev. chil. pediatr ; 91(2): 216-225, abr. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1098894

RESUMO

Resumen: Objetivo: describir las terapias utilizadas en lactantes con bronquiolitis aguda admitidos en 20 Uni dades de Cuidados Intensivos (UCI) pediátricos miembros de LARed en 5 países latinoamerica nos. Pacientes y Método: Estudio observacional retrospectivo, multicéntrico, de datos del Registro Latinoamericano de Falla Respiratoria Aguda Pediátrica. Se incluyeron niños menores de 2 años ingresados a UCI pediátrica por bronquiolitis aguda comunitaria entre mayo-septiembre 2017. Se recolectaron datos demográficos, clínicos, soporte respiratorio, terapias utilizadas y resultados clí nicos. Se realizó análisis de subgrupos según ubicación geográfica, tipo financiación y presencia de academia. Resultados: Ingresaron al registro 1155 pacientes con falla respiratoria aguda. Seis casos fueron excluidos por no tener formulario completo. De los 1147 pacientes, 908 eran menores de 2 años. De ellos, 467 tuvieron diagnóstico de bronquiolitis aguda, correspondiendo a la principal causa de ingreso a UCI pediátrica por falla respiratoria aguda (51,4%). Las características demográficas y de gravedad entre los centros fueron similares. El soporte máximo respiratorio más frecuente fue cánula nasal de alto flujo (47%), seguido por ventilación mecánica no invasiva (26%) y ventilación mecánica invasiva (17%), con un coeficiente de variación (CV) amplio entre los centros. Hubo una gran dispersión en uso de terapias, siendo frecuente el uso de broncodilatadores, antibióticos y corticoides, con CV hasta 400%. El análisis de subgrupos mostró diferencias significativas en soporte respiratorio y tratamientos utilizados. Un paciente falleció en esta cohorte. Conclusión: Detectamos gran variabilidad en el soporte respiratorio y tratamientos entre UCI pediátricas latinoamericanas. Esta variabilidad no es explicada por disparidades demográficas ni clínicas. Esta heterogeneidad de tratamientos debería promover iniciativas colaborativas para disminuir la brecha entre la evidencia científica y la práctica asistencial.


Abstract: The objective of this study was to describe the management of infants with acute bronchiolitis admit ted to 20 pediatric intensive care units (PICU) members of LARed in 5 Latin American countries. Pa tients and Method: Retrospective, multicenter, observational study of data from the Latin American Registry of Acute Pediatric Respiratory Failure. We included children under 2 years of age admitted to the PICU due to community-based acute bronchiolitis between May and September 2017. Demo graphic and clinical data, respiratory support, therapies used, and clinical results were collected. A subgroup analysis was carried out according to geographical location (Atlantic v/s Pacific), type of insurance (Public v/s Private), and Academic v/s non-Academic centers. Results: 1,155 patients were included in the registry which present acute respiratory failure and 6 were excluded due to the lack of information in their record form. Out of the 1,147 patients, 908 were under 2 years of age, and out of those, 467 (51.4%) were diagnosed with acute bronchiolitis, which was the main cause of admission to the PICU due to acute respiratory failure. The demographic and severity characteristics among the centers were similar. The most frequent maximum ventilatory support was the high-flow nasal can nula (47%), followed by non-invasive ventilation (26%) and invasive mechanical ventilation (17%), with a wide coefficient of variation (CV) between centers. There was a great dispersion in the use of treatments, where the use of bronchodilators, antibiotics, and corticosteroids, representing a CV up to 400%. There were significant differences in subgroup analysis regarding respiratory support and treatments used. One patient of this cohort passed away. Conclusion: we detected wide variability in respiratory support and treatments among Latin American PICUs. This variability was not explained by demographic or clinical differences. The heterogeneity of treatments should encourage collabora tive initiatives to reduce the gap between scientific evidence and practice.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Padrões de Prática Médica/estatística & dados numéricos , Bronquiolite/terapia , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Fidelidade a Diretrizes/estatística & dados numéricos , Cuidados Críticos/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Bronquiolite/diagnóstico , Sistema de Registros , Doença Aguda , Estudos Retrospectivos , Guias de Prática Clínica como Assunto , Cuidados Críticos/métodos , América Latina
12.
Am J Ophthalmol Case Rep ; 15: 100460, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31193243

RESUMO

PURPOSE: To describe the long-term outcome of a patient with multifocal choroiditis, who underwent surgical removal of a type 2 choroidal neovascular membrane employing 23 G pars plana vitrectomy. OBSERVATIONS: A 50-year-old man was treated with 3 monthly intravitreal bevacizumab injections, but despite treatment, visual acuity continued to worsen from 20/40 to 20/100, and bleeding was not receding. A minimal invasive pars plana vitrectomy was performed for surgical removal of the neovascular complex without any complicating incident. Subsequent visual acuity was 20/25 for more than eleven years. CONCLUSIONS AND IMPORTANCE: Surgical removal of choroidal neovascular membranes employing minimal invasive surgery in addition to anti-VEGF therapy, and OCT evaluation can be a viable approach for selected cases of juxtafoveal type 2 CNV.

13.
Vet Pathol ; 55(1): 159-172, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28812528

RESUMO

Leukemia is broadly divided into acute and chronic lymphocytic and myeloid types based on the proportion of blasts, morphology of cells, and expression of specific antigens on neoplastic cells. Classifying leukemia in horses can be challenging if blasts predominate and since few antibodies to identify cell types are available. The objective of this study was to describe in detail the clinical and pathologic features of acute leukemia in horses. Twelve horses ranging from 0.2 to 25.9 years of age were diagnosed with acute leukemia. Six cases were classified as acute lymphocytic leukemia (ALL) based on predominance of blasts, lack of granulocytic or monocytic differentiation, and detection of CD3, CD20, and/or CD79a antigens by immunohistochemistry. Six other cases were classified as acute myeloid leukemia (AML) with myelomonocytic ( n = 4), basophilic ( n = 1), and eosinophilic ( n = 1) differentiation based on > 20% bone marrow blasts and partial leukocytic differentiation. Reactivity with antibodies to Iba-1/AIF-1, CD172a, and CD163 was determined for all cases of AML. Eleven horses had thrombocytopenia, 10 had neutropenia, 8 had anemia, all had blasts on blood films, and none had leukocytosis. Ten horses had increased serum acute phase proteins. Bone marrow cellularity ranged from 30% to 100%, and the proportion of blasts ranged from 80% to 100% and 30% to 60% in ALL and AML, respectively. Horses were severely ill at diagnosis and euthanized within days or weeks. Unique features of acute leukemia in horses compared to other species were variable lymphocyte antigen expression (ALL) and frequent inflammation (ALL and AML).


Assuntos
Doenças dos Cavalos/patologia , Leucemia/patologia , Animais , Progressão da Doença , Doenças dos Cavalos/classificação , Cavalos , Leucemia/classificação , Leucemia-Linfoma Linfoblástico de Células Precursoras , Trombocitopenia/patologia
14.
J Appl Physiol (1985) ; 122(5): 1088-1094, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-28183822

RESUMO

Calcification of the tunica media of the axial pulmonary arteries (PA) has been reported in a large proportion of racehorses. In humans, medial calcification is a significant cause of arterial stiffening and is implicated in the pathogenesis of cardiac, cerebral, and renal microvascular diseases. Pulse wave velocity (PWV) provides a measure of arterial stiffness. This study aimed to develop a technique to determine PA-PWV in horses and, secondarily, to investigate a potential association between PA-PWV and arterial fibro-calcification. A dual-pressure sensor catheter (PSC) was placed in the main PA of 10 sedated horses. The pressure waves were used to determine PWV along the PA, using the statistical phase offset method. Histological analysis of the PA was performed to investigate the presence of fibro-calcified lesions. The mean (±SD) PWV was 2.3 ± 0.7 m/s in the proximal PA trunk and 1.1 ± 0.1 m/s further distal (15 cm) in a main PA branch. The mean (±SD) of mean arterial pressures in the proximal PA trunk was 30.1 ± 5.2 mmHg, and 22.0 ± 6.0 mmHg further distal (15 cm) within the main PA branch. The mean (±SD) pulse pressure in the proximal PA trunk was 15.0 ± 4.7 mmHg, and 13.5 ± 3.3 mmHg further distal (15 cm) within the main PA branch. Moderate to severe lesions of the tunica media of the PAs were observed in seven horses, but a correlation with PWV could not be established yet. Pulmonary artery PWV may be determined in standing horses. The technique described may allow further investigation of the effect of calcification of large PAs in the pathogenesis of equine pulmonary circulatory disorders.NEW & NOTEWORTHY Pulmonary artery pulse wave velocity was determined safely in standing sedated horses. The technique described may allow further investigation of the effect of calcification of large pulmonary arteries in the pathogenesis of pulmonary circulatory disorders in horses.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Pressão Sanguínea/fisiologia , Cavalos/fisiologia , Artéria Pulmonar/fisiopatologia , Animais , Calcinose/fisiopatologia , Doenças Cardiovasculares/fisiopatologia , Análise de Onda de Pulso/métodos , Rigidez Vascular/fisiologia
15.
Can Vet J ; 57(10): 1067-1071, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27708445

RESUMO

A 3-year-old Standardbred gelding with a history of pyrexia, persistent hemorrhage from the oral cavity, and a large, soft swelling at the junction of the caudal aspect of the mandibular rami and proximal neck was evaluated. The horse had neutropenia and anemia, with atypical granulated cells in a blood smear. Additional tests confirmed acute myeloid leukemia with basophilic differentiation, which has been reported in humans, cats, dogs, and cattle but not horses.


Leucémie myéloïde aiguë avec différenciation basophile chez un hongre Standardbred âgé de 3 ans. Nous avons évalué un hongre Standardbred âgé de 3 ans avec une anamnèse de pyrexie, d'hémorragie persistante de la cavité orale et d'une grosse enflure molle à la jonction de l'aspect caudal des rameaux mandibulaires et du cou proximal. Le cheval souffrait de neutropénie et d'anémie avec des cellules granulées au frottis sanguin. Des tests additionnels ont confirmé une leucémie myéloïde avec différenciation basophile, qui avait déjà été signalée chez les humains, les chats, les chiens et le bétail, mais pas chez les chevaux.(Traduit par Isabelle Vallières).


Assuntos
Coagulação Intravascular Disseminada/veterinária , Doenças dos Cavalos/diagnóstico , Leucemia Mieloide Aguda/veterinária , Animais , Coagulação Intravascular Disseminada/diagnóstico , Coagulação Intravascular Disseminada/etiologia , Coagulação Intravascular Disseminada/patologia , Hemorragia/veterinária , Doenças dos Cavalos/etiologia , Doenças dos Cavalos/patologia , Cavalos , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/patologia , Masculino
16.
Can Vet J ; 55(10): 965-9, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25320385

RESUMO

Endoscopic removal of esophageal and ruminal foreign bodies was successfully performed in 5 Holstein-Friesian calves under sedation or general anesthesia by using an electrocautery snare or a wire-guided Dormi basket. This report describes the endoscopic manipulations, treatment, and outcomes of esophageal foreign body removal in these calves.


Trans-oral endoscopie pour retirer un corps étranger oesophagien ou ruminal chez 5 veaux Holstein. L'extraction d'un corps étranger oesophagien ou ruminale a été effectuée par endoscopie à l'aide d'un lassot ou d'un panier endoscopique (Dormi) avec succès chez cinq veaux de race Holstein, sous sédation ou anesthésie générale. Ce rapport de cas décrit les manipulations endoscopiques, les traitements et le pronostic suite à l'extraction endoscopique du corps étranger chez ces veaux.(Traduit par les auteurs).


Assuntos
Doenças dos Bovinos/cirurgia , Endoscopia Gastrointestinal/veterinária , Esofagoscopia/veterinária , Esôfago , Corpos Estranhos/veterinária , Rúmen , Animais , Bovinos , Endoscopia Gastrointestinal/métodos , Esofagoscopia/métodos , Esôfago/cirurgia , Feminino , Corpos Estranhos/cirurgia , Rúmen/cirurgia
17.
Can Vet J ; 54(10): 965-8, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24155417

RESUMO

A 2-week-old Holstein Friesian female calf was presented with profuse diarrhea and abdominal distension. Clinicopathological findings included marked hypoproteinemia, hypoglycemia and leucopenia, mild hyperlactatemia, and hyperfibrinogenemia. On abdominal ultrasonography, features were consistent with portomesenteric venous gas (PVG), a rare condition reported in the medical literature. The PVG in this calf was associated with severe gastrointestinal illness and sepsis.


Gaz veineux porto-mésentérique chez un veau Holstein âgé de 2 semaines. Une génisse Holstein-Friesian âgée de 2 semaines a été présentée avec une diarrhée abondante et une distension abdominale. Les résultats clinicopathologiques ont inclus de l'hypoprotéinémie, de l'hypoglycémie et de la leucopénie marquées ainsi qu'une hyperlactatémie et une hyperfibrinogénémie légères. À l'échographie abdominale, les caractéristiques étaient conformes à du gaz veineux portomésentérique (GVP), une affection rare signalée dans la littérature médicale. Le GVP de ce veau était associé à une maladie gastrointestinale et à une septicémie graves.(Traduit par Isabelle Vallières).


Assuntos
Doenças dos Bovinos/patologia , Embolia Aérea/veterinária , Veias Mesentéricas/patologia , Veia Porta/patologia , Animais , Bovinos , Doenças dos Bovinos/diagnóstico por imagem , Embolia Aérea/complicações , Embolia Aérea/diagnóstico por imagem , Evolução Fatal , Feminino , Intestinos/irrigação sanguínea , Intestinos/diagnóstico por imagem , Veias Mesentéricas/diagnóstico por imagem , Veia Porta/diagnóstico por imagem , Radiografia
18.
Carbohydr Res ; 378: 15-25, 2013 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-23597587

RESUMO

Clostridium difficile is the most common cause of antimicrobial-associated diarrhea in humans and may cause death. Previously, we discovered that C. difficile expresses three polysaccharides, named PSI, PSII, and PSIII. It has now been established that PSII is a conserved antigen abundantly present on the cell-surface and biofilm of C. difficile. In contrast, the expression of PSI and PSIII appears to be stochastic processes. In this work, the total chemical synthesis of the PSI pentasaccharide repeating unit carrying a linker at the reducing end, α-l-Rhap-(1→3)-ß-d-Glcp-(1→4)-[α-l-Rhap-(1→3)]-α-d-Glcp-(1→2)-α-d-Glcp-(1→O(CH2)5NH2, was achieved by a linear synthesis strategy from four monosaccharide building blocks. The synthesized PSI pentasaccharide was conjugated to a subunit of C. difficile exotoxin B yielding a potential dual C. difficile vaccine. More significantly, sera from healthy horses were shown to contain natural anti-PSI IgG antibodies that detected both the synthetic non-phosphorylated PSI repeat and the native PSI polysaccharide, with a slightly higher recognition of the native PSI polysaccharide.


Assuntos
Clostridioides difficile/química , Cisteína Endopeptidases/metabolismo , Cavalos/sangue , Imunoglobulina G/sangue , Oligossacarídeos/síntese química , Polissacarídeos Bacterianos/síntese química , Polissacarídeos Bacterianos/metabolismo , Animais , Sequência de Carboidratos , Técnicas de Química Sintética , Glicosilação , Imunoglobulina G/imunologia , Dados de Sequência Molecular , Oligossacarídeos/química , Polissacarídeos Bacterianos/química , Polissacarídeos Bacterianos/imunologia
19.
J Clin Virol ; 52(2): 119-22, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21782504

RESUMO

BACKGROUND: The overall seroprevalence of HTLV infection among pregnant women in Spain is below 0.02% and accordingly universal antenatal screening is not recommended. However, as the number of immigrants has significantly increased during the last decade, this population might warrant specific considerations. OBJECTIVE: To evaluate the seroprevalence of HTLV infection among immigrant pregnant women living in Spain. METHODS: From January 2009 to December 2010 a cross-sectional study was carried out in all foreign pregnant women attended at 14 Spanish clinics. All were tested for HTLV antibodies using a commercial enzyme-immunoassay, being reactive samples confirmed by Western blot or PCR. RESULTS: A total of 3337 foreign pregnant women were examined. Their origin was as follows: Latin America 1579 (47%), North Africa 507 (16%), East Europe 606 (18%), Sub-Saharan Africa 316 (9%), North America and West Europe 116 (3.5%) and Asia and Australia 163 (5%). A total of 7 samples were confirmed as HTLV positive, of which 6 were HTLV-1 and 1 HTLV-2. HTLV-1 infection was found in 5 women coming from Latin America and 1 from Morocco. The only woman with HTLV-2 came from Ghana. The overall HTLV seroprevalence was 0.2%, being 0.3% among Latin Americans and 0.2% among Africans. It was absent among women coming from other regions. CONCLUSIONS: The seroprevalence of HTLV infection among foreign pregnant women in Spain is 0.2%, being all cases found in immigrants from Latin America and Africa. Given the benefit of preventing vertical transmission, antenatal screening should be recommended in pregnant women coming from these regions.


Assuntos
Infecções por Deltaretrovirus/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Deltaretrovirus/genética , Infecções por Deltaretrovirus/virologia , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Humanos , Gravidez , Complicações Infecciosas na Gravidez/virologia , Estudos Soroepidemiológicos , Espanha/epidemiologia , Espanha/etnologia , Adulto Jovem
20.
Circ Heart Fail ; 4(2): 129-37, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21216835

RESUMO

BACKGROUND: Cardiac transplantation, a procedure nearly abandoned in the 1970s, has evolved into the standard of care for appropriate patients with end-stage heart failure. Much of this success has been due to improvements in immunosuppression, including the introduction of a triple-drug regimen. Retrospective reports suggested that single-drug immunosuppression with tacrolimus was feasible. As such, a prospective, randomized trial was conducted to test this approach. METHODS AND RESULTS: One hundred fifty adult de novo heart transplant recipients were enrolled in a prospective, randomized, controlled, open-label trial comparing tacrolimus monotherapy (MONO) with tacrolimus and mycophenolate mofetil therapy (COMBO). Corticosteroids were used in the early postoperative period but discontinued in all patients over 8 to 9 weeks. The primary end point was the composite biopsy score at 6 months after transplant. Patients were followed for 1 to 5 years. The composite biopsy score was similar between groups at 6 and 12 months: 6-month MONO, 0.70 ± 0.44 (95% confidence interval, 0.60 to 0.80) versus COMBO, 0.65 ± 0.40 (95% confidence interval, 0.55 to 0.74; P=0.44). Allograft vasculopathy was assessed by angiography and intravascular ultrasound, with no significant differences noted. Three-year survival was also similar (92.4% MONO versus 97% COMBO; P=0.58, log-rank). CONCLUSIONS: Addition of mycophenolate to single-agent immunosuppression did not provide an advantage over single-agent immunosuppression in terms of rejection, allograft vasculopathy, or 3-year survival. Corticosteroids, which have traditionally been a mainstay of therapy, were successfully discontinued in all patients. These conclusions are tempered by the limited statistical power associated with a sample size of only 150 patients. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT00299221.


Assuntos
Doença da Artéria Coronariana/prevenção & controle , Rejeição de Enxerto/prevenção & controle , Sobrevivência de Enxerto/efeitos dos fármacos , Transplante de Coração , Imunossupressores/uso terapêutico , Ácido Micofenólico/análogos & derivados , Tacrolimo/uso terapêutico , Corticosteroides/uso terapêutico , Adulto , Idoso , Biópsia , Angiografia Coronária , Doença da Artéria Coronariana/imunologia , Doença da Artéria Coronariana/patologia , Quimioterapia Combinada , Feminino , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/patologia , Transplante de Coração/efeitos adversos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Ácido Micofenólico/uso terapêutico , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia de Intervenção , Estados Unidos
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