ABSTRACT
BACKGROUND: Fluconazole-resistant Candida parapsilosis is a matter of concern. OBJECTIVES: To describe fluconazole-resistant C. parapsilosis genotypes circulating across hospitals in Spain and Rome and to study their azole-resistance profile associated with ERG11p substitutions. PATIENTS/METHODS: We selected fluconazole-resistant C. parapsilosis isolates (n = 528 from 2019 to 2023; MIC ≥8 mg/L according to EUCAST) from patients admitted to 13 hospitals located in five Spanish cities and Rome. Additionally, we tested voriconazole, posaconazole, isavuconazole, amphotericin B, micafungin, anidulafungin and ibrexafungerp susceptibility. RESULTS: Of the 53 genotypes found, 49 harboured the Y132F substitution, five of which were dominating city-specific genotypes involving almost half the isolates. Another genotype involved isolates harbouring the G458S substitution. Finally, we found two genotypes with the wild-type ERG11 gene sequence and one with the R398I substitution. All isolates were fully susceptible/wild-type to amphotericin B, anidulafungin, micafungin and ibrexafungerp. The azole-resistance patterns found were: voriconazole-resistant (74.1%) or voriconazole-intermediate (25.2%), posaconazole-resistant (10%) and isavuconazole non-wild-type (47.5%). Fluconazole-resistant and voriconazole non-wild-type isolates were likely to harbour substitution Y132F if posaconazole was wild type; however, if posaconazole was non-wild type, substitution G458S was indicated if isavuconazole MIC was >0.125 mg/L or substitution Y132F if isavuconazole MIC was ≤0.125 mg/L. CONCLUSIONS: We detected a recent clonal spread of fluconazole-resistant C. parapsilosis across some cities in Spain, mostly driven by dominating city-specific genotypes, which involved a large number of isolates harbouring the Y132F ERG11p substitution. Isolates harbouring substitution Y132F can be suspected because they are non-susceptible to voriconazole and rarely posaconazole-resistant.
Subject(s)
Azoles , Fluconazole , Glycosides , Nitriles , Pyridines , Triazoles , Triterpenes , Humans , Azoles/pharmacology , Fluconazole/pharmacology , Candida parapsilosis/genetics , Cities , Voriconazole/pharmacology , Amphotericin B , Anidulafungin , Micafungin , Italy , Hospitals , GenotypeABSTRACT
BACKGROUND: In May, 2022, several European countries reported autochthonous cases of monkeypox, which rapidly spread globally. Early reports suggest atypical presentations. We aimed to investigate clinical and virological characteristics of cases of human monkeypox in Spain. METHODS: This multicentre, prospective, observational cohort study was done in three sexual health clinics in Madrid and Barcelona, Spain. We enrolled all consecutive patients with laboratory-confirmed monkeypox from May 11 to June 29, 2022. Participants were offered lesion, anal, and oropharynx swabs for PCR testing. Participant data were collected by means of interviews conducted by dermatologists or specialists in sexually transmitted infections and were recorded using a standard case report form. Outcomes assessed in all participants with a confirmed diagnosis were demographics, smallpox vaccination, HIV status, exposure to someone with monkeypox, travel, mass gathering attendance, risk factors for sexually transmitted infections, sexual behaviour, signs and symptoms on first presentation, virological results at multiple body sites, co-infection with other sexually transmitted pathogens, and clinical outcomes 14 days after the initial presentation. Clinical outcomes were followed up until July 13, 2022. FINDINGS: 181 patients had a confirmed monkeypox diagnosis and were enrolled in the study. 166 (92%) identified as gay men, bisexual men, or other men who have sex with men (MSM) and 15 (8%) identified as heterosexual men or heterosexual women. Median age was 37·0 years (IQR 31·0-42·0). 32 (18%) patients reported previous smallpox vaccination, 72 (40%) were HIV-positive, eight (11%) had a CD4 cell count less than 500 cells per µL, and 31 (17%) were diagnosed with a concurrent sexually transmitted infection. Median incubation was 7·0 days (IQR 5·0-10·0). All participants presented with skin lesions; 141 (78%) participants had lesions in the anogenital region, and 78 (43%) in the oral and perioral region. 70 (39%) participants had complications requiring treatment: 45 (25%) had a proctitis, 19 (10%) had tonsillitis, 15 (8%) had penile oedema, six (3%) an abscess, and eight (4%) had an exanthem. Three (2%) patients required hospital admission. 178 (99%) of 180 swabs from skin lesions collected tested positive, as did 82 (70%) of 117 throat swabs. Viral load was higher in lesion swabs than in pharyngeal specimens (mean cycle threshold value 23 [SD 4] vs 32 [6], absolute difference 9 [95% CI 8-10]; p<0·0001). 108 (65%) of 166 MSM reported anal-receptive sex. MSM who engaged in anal-receptive sex presented with proctitis (41 [38%] of 108 vs four [7%] of 58, absolute difference 31% [95% CI 19-44]; p<0·0001) and systemic symptoms before the rash (67 [62%] vs 16 [28%], absolute difference 34% [28-62]; p<0·0001) more frequently than MSM who did not engage in anal-receptive sex. 18 (95%) of 19 participants with tonsillitis reported practising oral-receptive sex. The median time from onset of lesions to formation of a dry crust was 10 days (IQR 7-13). INTERPRETATION: In our cohort, monkeypox caused genital, perianal, and oral lesions and complications including proctitis and tonsillitis. Because of the variability of presentations, clinicians should have a low threshold for suspicion of monkeypox. Lesion swabs showed the highest viral loads, which, combined with the history of sexual exposure and the distribution of lesions, suggests close contact is probably the dominant transmission route in the current outbreak. FUNDING: None.
Subject(s)
HIV Infections , Mpox (monkeypox) , Proctitis , Sexual and Gender Minorities , Sexually Transmitted Diseases , Smallpox , Tonsillitis , Adult , Female , Homosexuality, Male , Humans , Male , Monkeypox virus , Prospective Studies , Sexual Behavior , SpainABSTRACT
The phosphorus chemical shift anisotropies, 31 PΔcs, and asymmetry parameters η were measured by the 31 P{1 H} NMR experiments in static and low-frequency spinning samples of the zirconium phosphates and phosphonates and also in the mixed Zr (IV)/Sn (IV) phosphate/phosphonate material. The data obtained have shown a 111 connectivity in the HPO4 and PO3 groups, which does not change at modification and intercalation of the materials. The 31 PΔcs values of the phosphonate groups (43-49 ppm) significantly surpass the values characterizing the HPO4 groups (23-37 ppm). The 31 P Δcs values obtained for the metal (IV) phosphates were discussed in terms of P-O distances. The 31 P chemical shift anisotropy parameters can help at elucidation of local structures in phosphate and phosphonate materials.
ABSTRACT
A layered crystalline phosphate α-Sn(HPO4)2·H2O (1), prepared and characterized in the present study by the multinuclear solid-state nuclear magnetic resonance (NMR), powder X-ray diffraction, and thermogravimetric analysis techniques, was treated with D2O and HOD imitating the reaction conditions in a water medium. The 2H solid-echo magic angle spinning NMR spectra of the products have revealed on their surface low mobile water molecules and hydronium ions, forming a structure close to the Zundel cation, [D2O···D-OD2]+. All the deuterons in the hydronium ions are tangled by hydrogen bonds with the water and the surface phosphate groups and stabilized by ionic interactions.
Subject(s)
Phosphates , Water , Magnetic Resonance Spectroscopy/methods , Hydrogen Bonding , Water/chemistry , CationsABSTRACT
In developing the approach to understanding dynamics of intercalates in layered materials, crystalline-layered zirconium phosphate Zr (HPO4 )2 ·0.35D2 O has been prepared and characterized by the 1 H, 31 P, and 2 H solid-state MAS NMR spectra, including 31 P and 2 H T1 measurements. At temperatures >253 K, the intercalated water shows two spectrally-distinguished deuterons unprecedentedly with different DQCC's and 2 H T1 times, one of which is hydrogen bonded. The collected data allowed to identify an unexpected bonding/dynamic mode of water molecules, which experience fast rotation around the hydrogen bond, formed with a zirconium-coordinated oxygen. The low-temperature 2 H MAS NMR experiments have demonstrated the presence of additional hydrogen bond P(H)OËËË DO, population of which grows on cooling to 195 K corresponding to the doubly hydrogen-bonded immobile water molecule.
Subject(s)
Water , Zirconium , Magnetic Resonance Spectroscopy , Phase Transition , Zirconium/chemistryABSTRACT
Solid-state NMR experiments on 2 H, 31 P, 13 C, and 1 H nuclei, including 31 P T1 , 1 H T1 , and 1 H T1ρ measurements, as well as on the kinetics of proton-phosphorus cross-polarization have been performed to characterize the crystalline and amorphous α-zirconium phosphates, which were intercalated with D2 O and/or CD3 OD. The 13 C{1 H} CP MAS NMR experiment performed for compound 1-CD3 OD (Zr (HPO4 )2. 0.2CD3 OD) with carbon cross-polarization via protons of phosphate groups has provided a prove that the methanol was intercalated into the interlayer spaces of this compound. The variable-temperature 2 H solid-echo MAS NMR spectra of intercalated compounds demonstrated that the methanol molecules, in contrast to the mobile water, were immobile, keeping, however, free CD3 rotations around the C3 -axis. It has been demonstrated that the intercalated species, D2 O and CD3 OD, do not affect the high-frequency motions of the phosphate groups. By utilizing local structural models that satisfy the constraints of the experimental data, it has been suggested that the immobile methanol molecules are located in the cavity between two neighboring layers of the zirconium phosphates. Thus, the present work illustrates the reliable criteria in a comprehensive NMR approach to structural and dynamic studies of such systems.
Subject(s)
Methanol , Zirconium , Magnetic Resonance Spectroscopy , Phosphates , Protons , Water , Zirconium/chemistryABSTRACT
Nanosized α-zirconium phenylphosphonate particles were successfully prepared by the reaction between different zirconium sources and molten phenylphosphonic acid in the absence of solvent. The resultant nanoplates exhibit particle sizes in the range of 15 to 30â nm. The use of a topotactic anion exchange method starting from α-zirconium phosphate instead resulted in the generation of 15 to 180â nm plates, while also resulting in nanoparticles with a higher degree of crystallinity. The topotactic anion exchange of the phosphate groups by phenylphosphonate groups could be performed to completion when performed in molten phenylphosphonic acid. Characterization of both the final products as well as the individual steps in the anion exchange were performed by powder XRD, fast neutron activation analysis, TGA, FTIR spectroscopy, TEM, solid-state NMR and XPS.
ABSTRACT
We show how the structural order of nanocrystalline zirconium phosphates (ZrP) is tuned by the synthetic methods and conditions through the use of synchrotron X-ray atomic pair distribution function analysis. With different synthetic route and different phosphoric acid concentrations in the synthesis, the product zirconium phosphates vary from turbostratically disordered nanoscale structures to fully ordered ones. We show that a change in the structural order leads to different ion-exchange properties. The samples are characterized using multiple techniques, including powder X-ray diffraction, ion exchange, thermogravimetric analysis, transmission electron microscopy, fast neutron activation analysis, solid-state NMR spectroscopy, IR spectroscopy, and X-ray photoelectron spectroscopy.
ABSTRACT
OBJECTIVES: We propose fast and accurate molecular detection of the Y132F ERG11p substitution directly on pure-cultured Candida parapsilosis isolates. We also assessed a discriminative genotyping scheme to track circulating genotypes. METHODS: A total of 223 C. parapsilosis isolates (one patient each) from 20 hospitals, located in Spain and Italy were selected. Isolates were fluconazole-resistant (n = 94; harbouring the Y132F ERG11p substitution [n = 85], the G458S substitution [n = 6], the R398I substitution [n = 2], or the wild-type ERG11 gene sequence) or fluconazole-susceptible (n = 129). Two targeted-A395T-mutation PCR formats (conventional and real-time) were engineered and optimized on fluconazole-susceptible and fluconazole-resistant pure-cultured isolates, thus skipping DNA extraction. Two genotyping schemes were compared: Scheme 1 (CP1, CP4a, CP6, and B markers), and Scheme 2 (6A, 6B, 6C, CP1, CP4a, and CP6 markers). RESULTS: The screening performed using both PCR formats showed 100% specificity (fluconazole-susceptible isolates; n = 129/129) and sensitivity (Y132F isolates; n = 85/85) values; however, results were available in 3 and 1.5 hours with the conventional and real-time PCR formats, respectively. Overall, Scheme 1 showed higher genetic diversity than Scheme 2, as shown by the number of alleles detected (n = 98; mean 23, range 13-38), the significantly higher observed and expected heterozygosity, and the probability of identity index (2.5 × 10-6). Scheme 2 markers did not provide further genotypic discrimination of Y132F fluconazole-resistant genotypes. CONCLUSION: Both proposed PCR formats allow us to speed up the accurate detection of substitution Y132F ERG11p in C. parapsilosis isolates with 100% specificity and sensitivity. In addition, we recommend CP1, CP4a, CP6, and B microsatellite markers for genotyping fluconazole-resistant isolates.
ABSTRACT
ABSTRACT: Our objective was to analyze in vitro the persistence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in the packaging material of the drugs dispensed to hospital wards. Additionally, to evaluate if the protection with a double plastic bag prevents the contamination of the medication dispensed to an intensive care unit (ICU).On the first part, different materials containing different drugs within an ICU were sampled to confirm the lack of contamination by SARS-CoV-2. The confirmation of the virus was performed using real time reverse transcription polymerase chain reaction. As a control group, in the microbiology laboratory we inoculated the virus into the different surfaces containing the same drugs included in the first part. Samples were obtained with a sterile swab at 3, 6, 8, 10, 14, 21, and 30âdays after inoculation and analyzed through real time reverse transcription polymerase chain reaction.None of the studied materials containing the drugs within an ICU was contaminated by SARS-CoV-2. In the second part, SARS-CoV-2 was found in all surfaces for up to 30âdays.The use of double-bag unit-dose system to deliver medication in a pandemic seems effective to prevent the potential transmission of SARS-CoV-2. A striking SARS-CoV-2 RNA stability of up to 30âdays was found in the surfaces containing the drugs.
Subject(s)
COVID-19/prevention & control , Disease Outbreaks/prevention & control , Drug Contamination/prevention & control , Intensive Care Units/standards , Pharmaceutical Preparations , COVID-19/epidemiology , Hospitals , Humans , RNA, Viral/genetics , RNA, Viral/isolation & purification , Real-Time Polymerase Chain Reaction , SARS-CoV-2ABSTRACT
According to the solid-state 13C, 31P NMR study and 13C chemical shift anisotropy (CSA) measurements, aromatic rings in the layered metal(IV) phosphonate materials behave as low-energy rotors at rotation activation energy, Eact, of 1.4-3.0 kcal/mol. The rotational mechanism consists of 180° flips and librations around C(1)-C(4) axis. The amplitude of the librations, added to the flips, grows with temperature, shifting the reorientations toward rotational diffusion at high temperatures.
ABSTRACT
Isotropic and anisotropic motions and molecular states of pyridine-d5, adsorbed on the surface within the pores of a layered Sn(iv) phosphonate-phosphate material (1) have been characterized thermodynamically and kinetically by solid-state NMR. The data obtained provide formulation of macrostructure and shapes of pores in 1.
ABSTRACT
Introducción: La siguiente revisión bibliográfica se realiza con el propósito de recopilar las causas de fracaso de la fístula arteriovenosa interna, haciendo especial hincapié en la relación entre la técnica de punción y fracaso de la misma, dada la importancia que el manejo y cuidados de enfermería tienen en el acceso vascular del paciente en hemodiálisis. Objetivo: Revisar la producción científica disponible sobre fallo primario o secundario de la fístula arteriovenosa interna. Metodología: Se realizó una revisión sistemática no metaanalítica, con búsqueda de información en las bases de datos Medline, Proquest, Scopus y Google Scholar. Se incluyeron artículos en español, inglés y francés. Resultados: Se revisaron 38 artículos publicados entre el año 2001 y 2016. La mayoría de ellos estudios observacionales. Tras el análisis de todas las variables se encontró que la edad avanzada, el género femenino, estado inflamatorio y de coagulación, la diabetes, episodios de hipotensión, localización y uso de catéter venoso central influyen negativamente en la supervivencia de la fístula arteriovenosa interna. En cuanto a la influencia de las diferentes técnicas de punción de la fístula, en la supervivencia de la misma, no hay datos concluyentes a favor de la ninguna técnica. Conclusiones: Podemos concluir que los factores que influyen negativamente en la supervivencia de la fístula arteriovenosa interna son: edad avanzada, género femenino, diabetes, estado inflamatorio, episodios de hipotensión, localización distal y uso previo de catéter venoso central (AU)
Introduction: The following literature review aims to collect the causes of failure of arteriovenous fistula, with particular emphasis on the relationship between puncture technique and the failure of it, given the importance of management and nursing care in the vascular access of hemodialysis patients. Objective: To review the available scientific literature about the primary or secondary failure of arteriovenous fistula. Methods: A, non-meta-analytic, systematic review was carried out with information search in the following databases: Medline, ProQuest, Scopus and Google Scholar. Articles in Spanish, English and French are included. Results: The review includes 38 articles published between 2001 and 2016. Most of them are observational studies. After analyzing all the variables, we found that older age, female gender, inflammatory and coagulation status, diabetes, episodes of hypotension, location and use of central venous catheter adversely affect the survival of arteriovenous fistula. Regarding the influence of different needling techniques in the survival of the fistula, there is no conclusive evidence in favor of any technique. Conclusions: We can conclude that factors which adversely affect the survival of arteriovenous fistula are: advanced age, female gender, diabetes, inflammatory state, episodes of hypotension, distal location and previous use of central venous catheter (AU)
Subject(s)
Humans , Male , Female , Survival Analysis , Arteriovenous Fistula/epidemiology , Arteriovenous Fistula/nursing , Thrombosis/nursing , Nephrology Nursing/methods , Arteriovenous Fistula/surgery , Biopsy, Needle/methods , Biopsy, Needle , Bibliometrics , Hypotension/complicationsABSTRACT
Introducción: Los enfermos con enfermedad renal crónica avanzada en hemodiálisis son cada vez mayores. Además de la edad, presentan una alta comorbilidad asociada que, unido a una serie de alteraciones en el metabolismo óseo-mineral propios de la enfermedad, condiciona que sean una población especialmente frágil ante las caídas. Objetivos: Analizar la incidencia y características de las caídas de los pacientes con enfermedad renal crónica avanzada en hemodiálisis fuera de la unidad de diálisis. Pacientes y Métodos: Se estudiaron 60 pacientes con una edad media de 66.6±14.2 años (70% hombres, 30% mujeres).Del total de la muestra, 27 pacientes (45%) tuvieron alguna caída en el último año. Se encontraron diferencias significativas entre los pacientes que tuvieron caídas frente a los que no (p=0.017) en el tiempo en diálisis. Un 37% de los hombres habían sufrido caídas mientras que las mujeres que se habían caído fueron el 61%. Un 59% de las caídas tuvieron lugar en el propio domicilio, el 22% en la calle, el 8% en el hospital. Respecto al día de la caída el 41% de las caídas se produjeron el día de descanso, el 22% antes o después de la sesión y el 15% no lo recuerdan. Conclusiones: Nuestros resultados indican que las caídas de los pacientes en hemodiálisis tienen una incidencia alta. Estas caídas están relacionadas con ser mujer, llevar más tiempo en diálisis, tener mayor grado de dependencia o realizar menor actividad física; y se producen mayoritariamente en el domicilio del paciente el día de descanso de diálisis (AU)
Introduction: Patients with advanced chronic kidney disease on hemodialysis are increasing. Apart from age, they have a high comorbidity that together with a series of alterations in bone-mineral metabolism associated with the disease cause a greater propensity to fall. Objectives: To analyze the incidence and characteristics of falls in patients with advanced chronic kidney disease on hemodialysis outside the dialysis unit. Patients and Methods: We studied 60 patients with a mean age of 66.6 ± 14.2 years (70% men, 30% women). From the total sample, 27 patients (45%) had a fall in the last year. Significant differences between patients who had fallen versus those who had not fallen (p = 0.017) on the dialysis time were found. 37% of men had suffered falls while women who had fallen were 61%. 59% of falls occurred in the home, 22% in the street and 8% in the hospital. Regarding the day of the fall, 41% of falls occurred the day of rest, 22% before or after the session and 15% did not remember. Conclusions: Our results indicate that falls in hemodialysis patients have a high incidence. These falls are related to being a woman, staying longer on dialysis, have a greater degree of dependence or perform less physical activity. Falls occur mainly in the patients home and the rest day (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Accidents/trends , Accidents, Home/prevention & control , Accidents, Home/trends , Renal Dialysis/methods , Renal Dialysis/nursing , Accident Prevention/standards , Frail Elderly/statistics & numerical data , Cross-Sectional Studies/instrumentation , Cross-Sectional Studies/methods , Cross-Sectional Studies , 28599ABSTRACT
Two commercial polymerase chain reaction (PCR) assays (a real-time PCR [Cepheid] and an oligochromatographic test [Speed-oligo]) and 1 serology test (Serodia-Myco II) for detecting Mycoplasma pneumoniae in nasopharyngeal aspirates and serum samples were studied. Among the 145 samples, 32 serum pairs were serologically positive for M. pneumoniae. Of these, in 30 nasopharyngeal aspirates, M. pneumoniae was detected using the real-time PCR assay and 25 using Speed-oligo, corresponding to a sensitivity of 93.7% and 78.1%, respectively. Among the 94 samples with negative serology, we only obtained 1 positive result by real-time PCR assay. In the group of samples from healthy children, no positive results were obtained.
Subject(s)
Molecular Diagnostic Techniques/methods , Mycoplasma Infections/diagnosis , Mycoplasma pneumoniae/isolation & purification , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Mycoplasma pneumoniae/genetics , Mycoplasma pneumoniae/immunology , Nasopharynx/microbiology , Sensitivity and Specificity , Serologic Tests/methods , Serum/microbiologyABSTRACT
Introducción: La mala adherencia a largo plazo es reconocida como uno de los principales problemas clínicos en la gestión de las enfermedades crónicas, y en concreto de la enfermedad renal crónica avanzada. Objetivo: Conocer la producción científica sobre el grado de adherencia al tratamiento farmacológico en pacientes en hemodiálisis. Metodología: Se ha realizado una revisión sistemática no metaanalítica mediante una búsqueda en las bases de datos de Scielo, PubMed y Google Académico. Se incluyeron artículos escritos en inglés y español. Se analizaron los artículos que trataban la adherencia al tratamiento en pacientes en hemodiálisis. Resultados: Se han revisado 19 artículos, 6 revisiones y 13 estudios observacionales, publicados entre el 2007 y 2015. Se estudiaron variables sociodemográficas: edad, género, nivel socioeconómico y estudios, estado civil, raza y situación laboral; variables clínicas y psicosociales y, factores relacionados con la medicación. Se encontró que entre 15-72% de los pacientes en hemodiálisis presentan falta de adherencia al tratamiento farmacológico. La depresión se encuentra asociada a la falta de adherencia. La edad se asocia a mayor adherencia. Conclusiones: Los pacientes en hemodiálisis presentan con frecuencia falta de adherencia al tratamiento farmacológico, aunque con una gran variabilidad, debido a las diferencias en la definición y medición de la falta de adherencia. La depresión parece ser el predictor más influyente en la falta de adhesión. Los factores demográficos y clínicos no están consistentemente asociados con la falta de adherencia, a excepción de la edad, siendo los pacientes de mayor edad los que presentan mayor adherencia (AU)
Introduction: Poor long-term adherence to the treatment is recognized as one of the major clinical problems in the management of chronic diseases, in particular of advanced chronic kidney disease. Objective: To study the scientific production on the degree of adherence to the pharmacologic therapy in hemodialysis patients. Methods: A, no meta-analytic, systematic review was conducted through a search of the following databases: Scielo, PubMed and Google Scholar. Manuscripts in English and Spanish were included. Manuscripts dealing with treatment adherence in hemodialysis patients were analyzed. Results: We reviewed 19 articles, 6 reviews and 13 observational studies published between 2007 and 2015. Sociodemographic variables were studied: age, gender, socioeconomic status, marital status, race and employment status; clinical and psychosocial variables and factors related to medication. It was found that between 15-72% of patients on hemodialysis, have poor adherence to the pharmacologic treatment. Depression is associated with non-adherence. Age is associated with increased adherence. Conclusions: Patients on hemodialysis have often nonadherence to drug therapy, although with great variability due to differences in the definition and measurement of nonadherence. Depression seems to be the most influential predictor of non-adherence. Demographic and clinical factors are not consistently associated with non-adherence, except age, being older patients who have greater adherence (AU)
Subject(s)
Humans , Male , Female , Renal Dialysis/methods , Medication Adherence/statistics & numerical data , Nephrology Nursing/methods , Nephrology Nursing/organization & administration , Nephrology Nursing/standards , Chronic Disease/nursing , Chronic Disease/prevention & control , Chronic Disease/rehabilitation , Risk Factors , BibliometricsABSTRACT
El presente trabajo se realizó con el propósito de evaluar el efecto de la transferencia embrionaria ipsilateral y contralateral a la posición del cuerpo lúteo (CL), así como el tamaño del CL sobre la tasa de supervivencia embrionaria en llamas. Se utilizaron 43 llamas receptoras, adultas, distribuidas aleatoriamente en 4 grupos: G1 (n=10): CL en ovario derecho y transferencia ipsilateral, G2 (n=10): CL en ovario derecho y transferencia contralateral, G3 (n=15): CL en ovario izquierdo y transferencia ipsilateral y G4 (n=8): CL en ovario izquierdo y transferencia contralateral. Se usaron 10 llamas como donadoras de embriones, que fueron sincronizadas con LH (1 ml) (Día 0=D0), superovuladas con1000 UI de eCG en el D3, a las que se les provocó luteólisis con PGF 2 en el D7 y se les empadró en el D8. Ese día, las receptoras se trataron con LH para sincronizarlas con las donadoras. En el D14 se colectó, evaluó y transfirió los embriones. El 60 (G1) y 75% (G3) de las hembras preñaron con transferencia ipsilateral derecha e izquierda, respectivamente, mientras solo el 30 (G2) y 25% (G4) preñaron con transferencia contralateral derecha e izquierda, respectivamente. Sin embargo, solo se encontró diferencia significativa entre el grupo G3 con los grupos G2 y G4 (p<0.05). Los resultados indican una mayor tasa de supervivencia embrionaria en llamas al realizar la transferencia en el cuerno ipsilateral a la posición del CL ubicado en el ovario izquierdo.
The study was carried out to evaluate the effect the embryo transfer to the uterine horn ipsilateral and contralateral to the side of the corpus luteum (CL) and the size of CL on the embryo survival in llamas. It was used 43 recipient adult females randomly assigned to 4 groups: G1 (n=10): CL in right ovary and ipsilateral embryo transfer, G2 (n=10): CL in right ovary and contralateral transfer, G3 (n=15): CL in left ovary and ipsilateral transfer, and G4 (n=8): CL in left ovary and contralateral transfer. Ten llamas were used as embryo donors. They were synchronized with LH (1 ml) on Day 0 (D0), superovulated with 1000 UI eCG on D3, luteolysis was induced with PGF 2 on D7, and mated on D8. Recipients were treated on D7 with LH to get synchrony with the donors. On D14 embryos were collected, evaluated and transferred. The results showed that 60 (G1) and 75% (G3) recipients conceived when embryo transfer was right and left ipsilateral respectively, while only 30 (G2) and 25% (G4) conceived when embryo transfer was right and left contralateral respectively. However, statistical difference was only observed between G3 with G2 and G4 (p<0.05). These results indicate that pregnancy rate is higher in llamas when the embryo transfer was done in to the uterine horn ipsilateral to the CL in the left ovary.
Subject(s)
Animals , Camelids, New World , Corpus Luteum , Pregnancy, Animal , Embryo TransferABSTRACT
El objetivo del estudio fue evaluar el efecto de dos métodos de criopreservación sobre la supervivencia in vivo e in vitro de embriones de llama. Se recuperaron 73 embriones en estadio de blastocisto eclosionado mediante una técnica no quirúrgica a los 6.5 días post servicio en llamas superestimuladas. Las llamas receptoras se distribuyeron aleatoriamente en grupo Control (n = 14), de vitrificación (n=30) y de congelación lenta (n=29). Para la vitrificación, los embriones fueron expuestos a la solución de vitrificación (SV) conteniendo 20% Glicerol + 20% Etilenglicol + 0.5M Sucrosa + 10% suero fetal bovino (SFB) + 50 µg/ml sulfato de gentamicina, y sumergidos en nitrógeno líquido dentro de pajillas de 0.25 ml. Para la congelación lenta, los embriones fueron expuestos a fosfato buffer salino (PBS) con 1.5 M de Etilenglicol + 10% de SFB + 50 µg/ml de sulfato de gentamicina, aspirados en pajillas de 0.25 ml, y enfriados a una tasa de descenso de 0.12 °C/min hasta 5 °C y, luego, en la boca del tanque de nitrógeno, se continuó el descenso a una tasa de 5 °C /min hasta -20 °C por 5 min, y luego se sumergieron en el nitrógeno líquido. En la descongelación se utilizaron soluciones de dilución conteniendo dos concentraciones de sucrosa: 0.5 M y 0.2 M para congelación lenta y 0.25 M y 0.12 M para vitrificación. Se realizó una evaluación in vivo a todos los embriones del grupo control y al 50% de los embriones de los dos grupos experimentales, mediante transferencia directa a hembras receptoras previamente sincronizadas. El diagnóstico de preñez se llevó a cabo por ecografía transrectal a los 20 y 30 días. La preñez fue de 4/13, 2/12 y 0/11 para las receptoras de los grupos Control, Vitrificados y Congelación lenta, respectivamente, sin diferencia estadística. Para la evaluación in vitro, los embriones criopreservados fueron cultivados en PBS + 20% SFB, en una atmósfera compuesta por 5% de CO2, 20% de O2 y 75% de N2, durante 1 h a 39 °C, y se observó ...
The aim of the study was to evaluate in llama embryos the effect of two cryopreservation methods on the in vivo and in vitro survival rate. Seventy three hatched blastocysts were recovered by a non-surgical technique at day 6.5 after mating from superstimulated llamas. Receptors were randomly allocated to a control group (n=14), vitrification (n=30) and slow freezing (n=29). On vitrification, embryos were exposed to a vitrification solution (VS) containing 20% Glycerol + 20% Ethylene glycol + 0.5 M Sucrose + 10% fetal calf serum (FCS) + 50 µg/ml gentamicin sulfate, and then plunged into liquid nitrogen in 0.25 ml straws. On the slow freezing, embryos were exposed to phosphate buffer saline (PBS) with 1.5 M Ethylene glycol + 10% FCS + 50 µg/ml gentamicin sulfate, loaded in 0.25 ml straws, and cooled at a rate of 0.12 °C/min to 5 °C. Then, further temperature decrease at 5 °C /min rate, to -20 °C, for 5 min at the mouth of the nitrogen tank; finally straws were plunged into liquid nitrogen. For thawing, two dilution solutions were used composed of two sucrose concentrations: 0.5 M and 0.2 M for slow freezing, and 0.25 M and 0.12 M for vitrification. An in vivo evaluation was performed in all embryos of the control group and in 50% of the experimental groups by direct transfer into previously synchronized female recipients. Pregnancy diagnosis was carried out by transrectal ultrasound evaluation at 20 and 30 days. Pregnancy was in 4/13, 2/12, and 0/11 in recipients from control, vitrification and slow freezing groups respectively, without significant difference. For the in vitro evaluation cryopreservated embryos were cultured in PBS + 20% FCS under atmosphere compose of 5% CO2, 20% O2, and 75% N2 at 39 °C for 1 h, then reexpansion ...