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The purpose of this investigation was to determine whether differences in body composition, pharmacological treatment, and physical activity explain the increased resting metabolic rate (RMR) and impaired insulin sensitivity in hypertension. Resting blood pressure, RMR (indirect calorimetry), body composition (dual-energy X-ray absorptiometry), physical activity (accelerometry), maximal oxygen uptake (VO2 max) (ergospirometry), and insulin sensitivity (Matsuda index) were measured in 174 patients (88 men and 86 women; 20-68 years) with overweight or obesity. Hypertension (HTA) was present in 51 men (58%) and 42 women (49%) (p = .29). RMR was 6.9% higher in hypertensives than normotensives (1777 ± 386 and 1663 ± 383 kcal d-1 , p = .044). The double product (systolic blood pressure × heart rate) was 18% higher in hypertensive than normotensive patients (p < .001). The observed differences in absolute RMR were non-significant after adjusting for total lean mass and total fat mass (estimated means: 1702 kcal d-1 , CI: 1656-1750; and 1660 kcal d-1 , CI: 1611-1710 kcal d-1 , for the hypertensive and normotensive groups, respectively, p = .19, HTA × sex interaction p = .37). Lean mass, the double product, and age were the variables with the higher predictive value of RMR in hypertensive patients. Insulin sensitivity was lower in hypertensive than in normotensive patients, but these differences disappeared after accounting for physical activity and VO2max . In summary, hypertension is associated with increased RMR and reduced insulin sensitivity. The increased RMR is explained by an elevated myocardial oxygen consumption due to an increased resting double product, combined with differences in body composition between hypertensive and normotensive subjects.
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Metabolismo Basal/fisiologia , Hipertensão/fisiopatologia , Resistência à Insulina/fisiologia , Sobrepeso/fisiopatologia , Consumo de Oxigênio/fisiologia , Adulto , Idoso , Composição Corporal , Calorimetria , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Adulto JovemRESUMO
Patients with Down syndrome (DS) often have a high occurrence of obstructive sleep apnea-hypopnea (OSA) syndrome. We studied a large cohort of adults with DS attended due to clinical suspicion of OSA. A standardized questionnaire and full medical assessment were conducted, including a sleep study. One hundred and fifty-seven DS individuals were studied, with a mean ± SD age of 36 ± 10 years, 40.7% women, BMI 29.4 ± 5.6 kg/m2 . The main clinical symptom was daytime sleepiness (64.9%). A sleep study was conducted in 114 patients. All 114 DS patients were diagnosed with OSA, with a predominance of obstructive and hypopnea events, (apnea-hypopnoea index, AHI, 35.0 ± 26.6), with an oxygen desaturation index of 32.9, and a Tc90% of 24.7%. Continuous positive airway pressure (CPAP) treatment was implemented in 75 (65.8%) of subjects. Tolerance was considered good in 75% of them, with a high compliance of 79.2% >4 hr/day (mean 7.1 hr/day), resulting in a symptomatic improvement in 58.7% of them. Obstructive sleep apnea is frequently confirmed in patients with DS when it clinically suspected. Treatment with CPAP in DS is feasible, and with higher adherence than in adults with normal cognitive functioning.
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Síndrome de Down/complicações , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/patologia , Adulto , Estudos de Coortes , Pressão Positiva Contínua nas Vias Aéreas , Feminino , Humanos , Masculino , Prognóstico , Apneia Obstrutiva do Sono/etiologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Hamsters are popular companion animals which may present to veterinarians for treatment of skin diseases. Most descriptions of dermatoses in hamsters have primarily been in case reports and in text books. HYPOTHESIS/OBJECTIVES: To document skin diseases and their prevalence in companion hamsters examined in northern California, USA, and Nantes, France, and to investigate predilections for the most common conditions documented in medical records over a 33 year or 15 year period, respectively. ANIMALS: One hundred and one hamsters from two hospital populations. METHODS AND MATERIAL: A computerized search of medical records of all hamsters seen at the School of Veterinary Medicine at UC-Davis in California, USA, from 1 January 1985 to 1 January 2018, was performed using the key search words "skin" and "dermatitis". The medical records of all hamsters presenting to the Ecole Nationale Vétérinaire, Nantes, from 1 September 1998 to 1 December 2013, were reviewed for skin diseases. The presence of lesions noted in key search words for the California records were used as inclusion guidelines for both institutions. Cases of suspected mammary neoplasia were excluded. RESULTS: Of the 65 hamsters seen in California, 34 (54%) had skin disease; of a total of 164 hamsters in Nantes, 67 (41%) had skin disease. Nodules were the most common lesions noted by both institutions. CONCLUSIONS AND CLINICAL IMPORTANCE: Cutaneous conditions in companion hamsters are common. Clinicians should include a dermatological examination when examining these rodents.
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Dermatite/veterinária , Dermatopatias/veterinária , Pele/patologia , Animais , California/epidemiologia , Cricetinae , Dermatite/epidemiologia , França/epidemiologia , Hospitais Veterinários , Hospitais de Ensino , Animais de Estimação , Prevalência , Estudos Retrospectivos , Dermatopatias/epidemiologia , UniversidadesRESUMO
BACKGROUND: Rats are popular companion animals that are often presented to veterinarians for treatment of skin diseases. However, descriptions of dermatoses in rats have primarily been limited to case reports and text books. HYPOTHESIS/OBJECTIVES: To document skin diseases and their prevalence in companion rats examined in northern California, USA and Nantes, France and to investigate predilections for the most common conditions over a 33 year or 15 year period, respectively. ANIMALS: Four hundred and seventy rats from two hospital populations met the inclusion criteria. METHODS AND MATERIALS: A retrospective study was performed by searching computerized medical records of rats seen at the School of Veterinary Medicine at University of California, Davis (UCD), USA from 1 January 1985 to 1 January 2018 using the key words "skin" and "dermatitis". The medical records of rats presenting to Ecole Nationale Vétérinaire, Agroalimentaire et de l'Alimentation Nantes-Atlantique (ONIRIS), France from 1995 to 2016 were reviewed for evidence of skin disease. The presence of lesions as noted in the key search words for the UCD records were used as the inclusion criteria for both institutions. RESULTS: Of 494 rats examined at UCD, 231 (47%) had skin disease, with neoplasia the most common diagnosis. Of the 619 rats examined at ONIRIS, 239 (39%) had skin disease, with ectoparasitism being the most common diagnosis. CONCLUSIONS AND CLINICAL IMPORTANCE: Cutaneous conditions in companion rats are common. Clinicians should include a dermatological examination when examining these rodents, especially in regard to neoplasia, ectoparasites and pyoderma.
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Neoplasias/veterinária , Dermatopatias/veterinária , Animais , California/epidemiologia , França/epidemiologia , Hospitais Veterinários , Hospitais de Ensino , Neoplasias/diagnóstico , Animais de Estimação , Ratos , Estudos Retrospectivos , Dermatopatias/epidemiologia , UniversidadesRESUMO
BACKGROUND/AIMS: It is estimated that up to 30% of CD patients develop abdominal abscesses; the management of active luminal CD in such patients represents a clinical challenge. The aim of this study is to assess the safety of biologics in patients with Crohn's disease and abdominal abscesses treated with percutaneous drainage and/or broad-spectrum antibiotics. METHODOLOGY: We performed a retrospective review of the clinical charts of consecutive Crohn's disease patients with abdominal abscesses treated with anti-TNFα therapy attended in our institution. RESULTS: 12 patients were finally included in the study. All were treated with broad-spectrum antibiotic and biological therapy (anti-TNF); indication of anti-TNFα therapy was moderate to severe activity of CD in all of them. Percutaneous drainage of the abscess was performed in 7 of the 12 patients. No complications were observed during a mean follow-up of 37,8 (16-71) months, including abscess volume increase, enterocutaneous fistula, soft tissue infections, bacteraemia, or need for emergency surgery. CONCLUSIONS: In addition to conventional treatment, the use of anti-TNFα therapy in Crohn's disease patients with abdominal abscesses seems to be safe. Usefulness of this approach has to be validated in larger cohorts.
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Abscesso Abdominal/terapia , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Produtos Biológicos/uso terapêutico , Doença de Crohn/tratamento farmacológico , Drenagem , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Abscesso Abdominal/diagnóstico , Abscesso Abdominal/imunologia , Adulto , Antibacterianos/efeitos adversos , Anti-Inflamatórios/efeitos adversos , Produtos Biológicos/efeitos adversos , Doença de Crohn/complicações , Doença de Crohn/diagnóstico , Doença de Crohn/imunologia , Drenagem/efeitos adversos , Registros Eletrônicos de Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Fator de Necrose Tumoral alfa/imunologia , Adulto JovemRESUMO
We sought to characterize the ocular pharmacology, tolerability and intraocular pressure (IOP)-lowering efficacy of FR-190997, a non-peptidic bradykinin (BK) B2-receptor agonist. FR-190997 possessed a relatively high receptor binding affinity (Ki = 27 nM) and a high in vitro potency (EC50 = 18.3 ± 4.4 nM) for inositol-1-phosphate generation via human cloned B2-receptors expressed in host cells with mimimal activity at B1-receptors. It also mobilized intracellular Ca2+ in isolated human trabecular meshwork (h-TM), ciliary muscle (h-CM), and in immortalized non-pigmented ciliary epithelial (h-iNPE) cells (EC50s = 167-384 nM; Emax = 32-86% of BK-induced response). HOE-140, a selective B2-receptor antagonist, potently blocked the latter effects of FR-190997 (e.g., IC50 = 7.3 ± 0.6 nM in h-CM cells). FR-190997 also stimulated the release of prostaglandins (PGs) from h-TM and h-CM cells (EC50s = 60-84 nM; Emax = 29-44% relative to max. BK-induced effects). FR-190997 (0.3-300 µg t.o.) did not activate cat corneal polymodal nociceptors and did not cause ocular discomfort in Dutch-Belted rabbits, but it was not well tolerated in New Zealand albino rabbits and Hartley guinea pigs. A single topical ocular (t.o.) dose of 1% FR-190997 in Dutch-Belted rabbits and mixed breed cats did not lower IOP. However, FR-190997 efficaciously lowered IOP of conscious ocular hypertensive cynomolgus monkey eyes (e.g., 34.5 ± 7.5% decrease; 6 h post-dose of 30 µg t.o.; n = 8). Thus, FR-190997 is an unexampled efficacious ocular hypotensive B2-receptor non-peptide BK agonist that activates multiple signaling pathways to cause IOP reduction.
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Pressão Intraocular/efeitos dos fármacos , Quinolinas/farmacologia , Receptor B2 da Bradicinina/agonistas , Malha Trabecular/efeitos dos fármacos , Animais , Células CHO , Cálcio/metabolismo , Gatos , Cricetulus , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Cobaias , Humanos , Fosfatos de Inositol/metabolismo , Macaca fascicularis , Prostaglandinas/metabolismo , Coelhos , Transdução de Sinais , Malha Trabecular/metabolismoRESUMO
Sexual violence is prevalent on university campuses globally. In this article, we report a qualitative insider research study examining practices for addressing sexual violence at four universities across Australia and Aotearoa New Zealand. We collected, analysed, and synthesised descriptive information about the practices at each institution. We found unique institutional approaches that nonetheless share some commonalities, yieldingseveral themes that are central to practice. In reflecting on our findings, we conclude with an outline of critical considerations and a call to action for future efforts to address campus-based sexual violence, particularly as this field remains underdeveloped across Australia and Aotearoa New Zealand.
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Delitos Sexuais , Humanos , Nova Zelândia , Pesquisa Qualitativa , Universidades , AustráliaRESUMO
BACKGROUND: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. The development of leprosy involves several factors, including the causative agent, the individual host's immune response, environmental factors, and the genetic background of the host. Specifically, the host's innate immune response, encoded by genes, determines their susceptibility to developing leprosy post-infection. Polymorphic variants in the nucleotide-binding oligomerization domain 2 (NOD2) gene are associated with leprosy among populations in a variety of endemic areas around the world. Colombia, a country located in the tropical zone, has several leprosy-endemic regions, including Norte de Santander. The aim of this study was to analyze the rs7194886, rs2111234, rs3135499, and rs8057341 single nucleotide polymorphisms (SNPs) in the NOD2 gene using a case-control study to determine whether they confer greater or lesser susceptibility to the development of leprosy. METHODOLOGY: The TaqMan qPCR amplification system was used for SNPs detection. FINDINGS: An association between the A-rs8057341 SNP (p = 0,006286) and resistance to leprosy was found. However, the rs3135499 (p = 0,9063) and rs2111234 (p = 0.1492) were not found to be associated with leprosy susceptibility. In addition, the rs7194886 SNP was not found to be in Hardy-Weinberg equilibrium (HWE) in the study population. The GAG haplotype, consisting of SNPs rs2111234-G, rs3135499-A, and rs8057341G, acts as a susceptibility factor for the development of leprosy in women. SNPs rs3135499 and rs8057341 are functionally related to decreased NOD2 expression according to an in-silico analysis. CONCLUSIONS: The SNPs rs8057341-A was related with resistance to leprosy and the haplotype rs2111234-G, rs3135499-A and rs8057341-G SNPs was related with susceptibility in the Norte de Santander Colombia, studied population.
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Hanseníase , Polimorfismo de Nucleotídeo Único , Humanos , Feminino , Estudos de Casos e Controles , Colômbia/epidemiologia , Hanseníase/genética , Mycobacterium leprae , Proteína Adaptadora de Sinalização NOD2/genéticaRESUMO
BACKGROUND: Single nucleotide variants in toll-like receptor genes play a crucial role in leprosy susceptibility or resistance. METHODS: With an epidemiology case-control study, associations between SNVs rs5743618 in TLR1, rs5743708 in TLR2, and rs5743810 in TLR6 and overall susceptibility for leprosy were estimated in 114 cases and 456 controls. Following that, stratified analysis was performed. DNA was extracted from peripheral blood. Genotyping was performed using predesigned TaqMan probes. RESULTS: The A/G genotype of rs5743810 behaved as a protective factor for the development of leprosy in the codominant (OR= 0.37; 95% CI = 016-0.86, p = 0.049) and over-dominant (OR = 0.38; 95% CI = 0.16-0.88, p = 0.019) inheritance models. The A/G and A/A genotypes behaved as a protective factor (OR = 0.39; 95% CI = 0.17-0.87, p = 0.016) in the dominant model. The SNVs rs5743618 and rs5743708 showed no association with any of the models. The CGG haplotype (rs5743618-rs5743708-rs5743810) behaved as a susceptibility factor for developing leprosy (OR = 1.86; 95% CI = 1.11-3.10, p = 0.019). The latter haplotype behaved as a susceptibility factor for leprosy development in women (OR = 2.39; 95% CI = 1.21-4.82, p = 0.013). CONCLUSIONS: The identified variants in the genes encoding TLRs, specifically rs5743810 in TLR6 and CGG (rs5743618-rs5743708-rs5743810) haplotypes, may somehow explain leprosy susceptibility in the studied population in a leprosy endemic region in Colombia.
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Breast cancer is currently the most commonly diagnosed cancer, with 287,850 new cases estimated for 2022 as reported by the American Cancer Society. Therefore, finding an effective treatment for this disease is imperative. Chalcones are α,ß-unsaturated systems found in nature. These compounds have shown a wide array of biological activities, making them popular synthetic targets. Chalcones consist of two aromatic substituents connected by an enone bridge; this arrangement allows for a large number of derivatives. Given the biological relevance of these compounds, novel ferrocene-heterocycle-containing chalcones were synthesized and characterized based on a hybrid drug design approach. These heterocycles included thiophene, pyrimidine, thiazolyl, and indole groups. Fourteen novel heterocyclic ferrocenyl chalcones were synthesized and characterized. Herein, we also report their cytotoxicity against triple-negative breast cancer cell lines MDA-MB-231 and 4T1 and the noncancer lung cell line MRC-5. System 3 ferrocenyl chalcones displayed superior anticancer properties compared to their system 1 analogues. System 3 chalcones bearing five-membered heterocyclic substituents (thiophene, pyrazole, pyrrole, and pyrimidine) were the most active toward the MDA-MB-231 cancer cell line with IC50 values from 6.59 to 12.51 µM. Cytotoxicity of the evaluated compounds in the 4T1 cell line exhibited IC50 values from 13.23 to 213.7 µM. System 3 pyrazole chalcone had consistent toxicity toward both cell lines (IC50 â¼ 13 µM) as well as promising selectivity relative to the noncancer MRC-5 control. Antioxidant activity was also evaluated, where, contrary to anticancer capabilities, system 1 ferrocenyl chalcones were superior to their system 3 analogues. Antioxidant activity comparable to that of ascorbic acid was observed for thiophene-bearing ferrocenyl chalcone with EC50 = 31 µM.
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Here, we present the draft genome sequences of 29 Colombian Helicobacter pylori strains. These strains were isolated in Bogotá, Colombia, from patients diagnosed with chronic gastritis. The genomic characterization of these strains will provide more information on the genetic composition of H. pylori strains from Colombia.
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This study aimed to determine whether the measured resting energy expenditure (REE) in overweight and obese patients living in a temperate climate is lower than the predicted REE; and to ascertain which equation should be used in patients living in a temperate climate. REE (indirect calorimetry) and body composition (DXA) were measured in 174 patients (88 men and 86 women; 20-68 years old) with overweight or obesity (BMI 27-45 kg m-2). All volunteers were residents in Gran Canaria (monthly temperatures: 18-24 °C). REE was lower than predicted by most equations in our population. Age and BMI were similar in both sexes. In the whole population, the equations of Mifflin, Henry and Rees, Livingston and Owen, had similar levels of accuracy (non-significant bias of 0.7%, 1.1%, 0.6%, and -2.2%, respectively). The best equation to predict resting energy expenditure in overweight and moderately obese men and women living in a temperate climate all year round is the Mifflin equation. In men, the equations by Henry and Rees, Livingston, and by Owen had predictive accuracies comparable to that of Mifflin. The body composition-based equation of Johnston was slightly more accurate than Mifflin's in men. In women, none of the body composition-based equations outperformed Mifflin's.
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BACKGROUND: High antibiotic resistance is described in atypical Mycobacteriosis, mainly by Mycobacterium avium complex (MAC). METHODS: A randomized, double-blind, placebo-controlled clinical trial was carried out in two hospitals to evaluate the effect of interferon (IFN) gamma as immunoadjuvant to chemotherapy on patients with atypical mycobacteria lung disease. Patients received placebo or 1 x 106 IU recombinant human IFN gamma intramuscularly, daily for one month and then three times per week up to 6 months as adjuvant to daily oral azithromycin, ciprofloxacin, ethambutol and rifampin. Sputum samples collection for direct smear observation and culture as well as clinical and thorax radiography assessments were done during treatment and one year after. Cytokines and oxidative stress determinations were carried out in peripheral blood before and after treatment. RESULTS: Eighteen patients were included in the IFN group and 14 received placebo. Groups were homogeneous at entry; average age was 60 years, 75% men, 84% white; MAC infection prevailed (94%). At the end of treatment, 72% of patients treated with IFN gamma were evaluated as complete responders, but only 36% in the placebo group. The difference was maintained during follow-up. A more rapid complete response was obtained in the IFN group (5 months before), with a significantly earlier improvement in respiratory symptoms and pulmonary lesions reduction. Disease-related deaths were 35.7% of the patients in the placebo group and only 11.1% in the IFN group. Three patients in the IFN group normalized their globular sedimentation rate values. Although differences in bacteriology were not significant during the treatment period, some patients in the placebo group converted again to positive during follow-up. Significant increments in serum TGF-beta and advanced oxidation protein products were observed in the placebo group but not among IFN receiving patients. Treatments were well tolerated. Flu-like symptoms predominated in the IFN gamma group. No severe events were recorded. CONCLUSION: These data suggest that IFN gamma is useful and well tolerated as adjuvant therapy in patients with pulmonary atypical Mycobacteriosis, predominantly MAC. Further wider clinical trials are encouraged. TRIAL REGISTRATION: Current Controlled Trials ISRCTN70900209.
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Adjuvantes Imunológicos , Interferon gama/imunologia , Infecções por Mycobacterium não Tuberculosas/imunologia , Adjuvantes Imunológicos/administração & dosagem , Adjuvantes Imunológicos/efeitos adversos , Idoso , Cuba , Citocinas/sangue , Método Duplo-Cego , Tratamento Farmacológico , Feminino , Humanos , Interferon gama/administração & dosagem , Interferon gama/efeitos adversos , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Complexo Mycobacterium avium/imunologia , Estresse Oxidativo , Proteínas Recombinantes , Escarro/microbiologiaRESUMO
The aim of this work was to shed light on the anatomical distribution of diarrhetic shellfish poisoning (DSP) toxins in the mussel Mytilus galloprovincialis and to determine any possible changes undergone during the depuration process. To this end, the distribution of two DSP toxins--okadaic acid and DTX2--and some of their derivatives were studied by means of HPLC/MS at different stages of the depuration process. Mussels were collected from mussel farms located in the Galician Rías and they were collected under three types of circumstances: (a) while ingesting toxic phytoplankton cells; (b) 1 week after the toxic cells had disappeared from the water; and (c) after ca. 2 months of depuration. Additionally, in case (b), the distribution among tissues was checked every week over a depuration period of 35 days in the laboratory. DSP toxins were only detected in non-visceral tissues when the extracts were concentrated 20-fold and, even in these cases, the concentrations found were very low. When the maximum possible contribution of non-visceral tissues was computed, taking into account the technique's detection limits and tissue weight, no relevant contribution to the toxin burden of non-visceral tissues was found at any stage of depuration, with the maximum possible contributions usually below 7%. The concentrated samples analysed showed that the actual contribution in all the cases studied was, in fact, less than 1% of the total toxin burden. These findings suggest that (1) when analytical methods are used to monitor DSP toxic mussels, non-visceral tissues should be assumed to be free of toxins in order to precisely compute the toxin concentration of the whole mass of edible tissues and (2) when studying the accumulation kinetics of DSP toxins, transference from the digestive gland to other tissues should not be taken into account, as the other tissues do not contain relevant amounts of DSP toxins.
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Diarreia/etiologia , Toxinas Marinhas/metabolismo , Mytilus/patogenicidade , Ácido Okadáico/metabolismo , Piranos/metabolismo , Intoxicação por Frutos do Mar , Animais , Distribuição TecidualRESUMO
Pheochromocytomas are rare neuroendocrine tumors that arise from chromaffin cells of the adrenal medulla. Malignant pheochromocytoma is defined as the presence of metastatic spread in tissues where chromaffin cells are not usually present. This case report describes the case of a relapsed malignant pheochromocytoma, spread to the right liver lobe, superior pole of the right kidney, posterior right hemidiaphragm, right hemidiaphragmatic pillar, inferior vena cava, and regional lymph nodes. After evaluation, an extensive surgery was performed, with resection of all the affected tissues and regional lymphadenectomy. No adjuvant treatment (radiotherapy or chemotherapy) was given. Complete clinical, biochemical, and radiological remission was achieved, with normalisation of metanephrine and normetanephrine. To date, six years after surgery, the patient remains asymptomatic and normotensive without taking any antihypertensive medication. We conclude that the therapeutic approach should be individualized in the case of metastatic pheochromocytoma. Extensive surgery can be considered as a treatment option, even in the case of multiple metastases, as it may be able to achieve complete remission of the disease, avoiding costly and potentially dangerous adjuvant therapies.
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BACKGROUND: Alcohol-based hand rubs play a key role in reducing the transmission of pathogens in acute care settings, especially as part of a comprehensive hand hygiene program. However, their use in long-term care facilities (LTCFs) has been virtually unstudied. METHODS: Infection data, including those meeting McGeer et al and the Pennsylvania Patient Safety Authority's surveillance definitions, for lower respiratory tract infections (LRTIs) and skin and soft-tissue infections (SSTIs), as well as hospitalization data were collected in a 174-bed LTCF for 22 months (May 2009 to February 2011). In March 2010, a comprehensive hand hygiene program including increased product availability, education for health care personnel (HCP) and residents, and an observation tool to monitor compliance, was implemented. RESULTS: Infection rates for LRTIs were reduced from 0.97 to 0.53 infections per 1,000 resident-days (P = .01) following the intervention, a statistically significant decline. Infection rates for SSTIs were reduced from 0.30 to 0.25 infections per 1,000 resident-days (P = .65). A 54% compliance rate was observed among HCP. CONCLUSION: This study demonstrates that the use of alcohol-based hand rubs, as part of a comprehensive hand hygiene program for HCP and residents, can decrease infection rates in LTCFs.
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Infecção Hospitalar/prevenção & controle , Higiene das Mãos/métodos , Higiene das Mãos/organização & administração , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Assistência de Longa Duração/métodos , Infecção Hospitalar/epidemiologia , Instalações de Saúde , Hospitalização/estatística & dados numéricos , Humanos , Prevalência , Infecções Respiratórias/epidemiologia , Infecções dos Tecidos Moles/epidemiologia , Estados Unidos/epidemiologiaRESUMO
Peripheral neural mechanisms underlying the sensations of irritation, discomfort, and itch accompanying the eye allergic response have not been hitherto analyzed. We explored this question recording the changes in the electrical activity of corneoconjunctival sensory nerve fibers of the guinea pig after an ocular allergic challenge. Sensitization was produced by i.p. ovalbumin followed by repeated application in the eye of 10% ovalbumin on days 14 to 18. Blinking and tearing rate were measured. Spontaneous and stimulus-evoked (mechanical, thermal, chemical) impulse activity was recorded from mechanonociceptor, polymodal nociceptor and cold corneoscleral sensory afferent fibers. After a single (day 14) or repeated daily exposures to the allergen during the following 3 to 4days, tearing and blinking rate increased significantly. Also, sensitization was observed in mechanonociceptors (transient reduction of mechanical threshold only on day 14) and in polymodal nociceptors (sustained enhancement of the impulse response to acidic stimulation). In contrast, cold thermoreceptors showed a significant decrease in basal ongoing activity and in the response to cooling. Treatment with the TRPV1 and TRPA1 blockers capsazepine and HC-030031 reversed the augmented blinking. Only capsazepine attenuated tearing rate increase and sensitization of the polymodal nociceptors response to CO2. Capsazepine also prevented the decrease in cold thermoreceptor activity caused by the allergic challenge. We conclude that changes in nerve impulse activity accompanying the ocular allergic response, primarily mediated by activation of nociceptor's TRPV1 and to a lesser degree by activation of TRPA1 channels, explain the eye discomfort sensations accompanying allergic episodes.
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Conjuntivite Alérgica/fisiopatologia , Olho/inervação , Ceratoconjuntivite/fisiopatologia , Células Receptoras Sensoriais/fisiologia , Animais , Piscadela , Dióxido de Carbono/metabolismo , Corpo Ciliar/fisiopatologia , Córnea/inervação , Córnea/fisiopatologia , Potenciais Evocados/fisiologia , Feminino , Cobaias , Masculino , Terminações Nervosas/fisiologia , Nociceptores/fisiologia , Prurido/fisiopatologia , Canais de Cátion TRPM/antagonistas & inibidores , Canais de Cátion TRPM/metabolismo , Canais de Cátion TRPV/antagonistas & inibidores , Canais de Cátion TRPV/metabolismo , Lágrimas/metabolismo , Termorreceptores/fisiologiaRESUMO
The possibility and effectiveness of microencapsulation of okadaic acid (OA) in gelatin-acacia microcapsules has been studied. The encapsulation efficiency was higher than 33%. The microcapsules were shown to be very stable, not leaching more than 9% of the encapsulated OA in a 20-h period. OA from the microcapsules was absorbed by the mussels very efficiently, accumulating--after 3 days of feeding and one of depuration--65% of the OA in microcapsules and 22% of the total OA used at the beginning of the microencapsulation process. These efficiencies and the possibility of encapsulating single DSP toxins and derivatives constitute a valuable tool for the study of the accumulation and biotransformation of DSP toxins in bivalves.
Assuntos
Bivalves/metabolismo , Composição de Medicamentos , Toxinas Marinhas/metabolismo , Ácido Okadáico/metabolismo , Intoxicação por Frutos do Mar , Testes de Toxicidade/métodos , Animais , Dinoflagellida/patogenicidade , Ácido Okadáico/químicaRESUMO
Introducción: la preocupación mundial ante las enfermedades causadas por micobacterias ambientales es creciente, debido a las dificultades diagnósticas y de tratamiento. Objetivos: determinar el comportamiento de la enfermedad pulmonar por especies del complejo Mycobacterium avium intracellulare y la correspondencia con la terapéutica recibida en el Hospital Neumológico Benéfico Jurídico de La Habana, durante el período 2000-2010. Métodos: se realizó un estudio descriptivo retrospectivo, que abarcó 55 pacientes con el diagnóstico de la enfermedad, los cuales cumplieron con los criterios de inclusión-exclusión predefinidos; la tendencia en el registro de diagnósticos se basó en el coeficiente de correlación lineal; en las variables cualitativas y cuantitativas discretas se usaron distribuciones de frecuencia con el cálculo del porcentaje y su respectivo intervalo de confianza de 95 porciento. Resultados: se obtuvo una tendencia decreciente en el diagnóstico de enfermedad pulmonar por especies del complejo Mycobacterium avium intracellulare, el 47,3 porciento de los pacientes estudiados se encontraba entre los 50 y 69 años de edad. La mayor parte del grupo no tenía ocupación de riesgo epidemiológico y la comorbilidad pulmonar se detectó en 97,9 porciento, sobresaliendo la tuberculosis pulmonar. Se comprobó la no correspondencia entre la terapéutica recibida y el régimen recomendado por la American Thoracic Society, en 100 porciento de los pacientes. Conclusión: la instauración de un programa ajustado a las normativas de tratamiento internacionalmente aceptadas, constituye en el Hospital Benéfico Jurídico, una necesidad para la atención a este grupo de enfermos
Introduction: the global concern about diseases caused by environmental mycobacteria is growing since their diagnosis and treatment are difficult. Objectives: to determine the behavior of Mycobacterium avium intracellulare complex pulmonary disease, and the therapeutic match with the treatment given at Benéfico Jurídico Pneumological Hospital, during the 2000-2010 period. Methods: a retrospective descriptive study of 55 patients diagnosed with the disease, who met the previously defined inclusion/exclusion criteria. The diagnostic registration trend was based on the linear correlation coefficient; the qualitative quantitative discrete variables used frequency distributions with percentage calculations and their respective 95 percent confidence intervals (CI). Results: a decreasing trend in the diagnosis of pulmonary disease from Mycobacterium avium-intracellular complex species; 47.3 percent of the studied patients aged 50 to 69 years. Most of the group had no occupation with epidemiological risk, and the pulmonary comorbidity was detected in 97.9 percent of patients, mainly pulmonary tuberculosis. A mismatch between the received therapy and the recommended treatment by the American Thoracic Society (ATS) was proved in 100 percent of patients. Conclusion: the introduction of a therapeutic program adapted to the internationally accepted standards of treatment is a must for the care of this group of patients in Benefico Juridico Hospital
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Pneumopatias/diagnóstico , Pneumopatias/tratamento farmacológico , Infecção por Mycobacterium avium-intracellulare/epidemiologia , Infecção por Mycobacterium avium-intracellulare/microbiologia , Cuba/epidemiologia , Epidemiologia Descritiva , Programas Nacionais de Saúde/ética , Estudos RetrospectivosRESUMO
Esta investigación tiene como objetivo comparar la evaluación de la efectividad de la funcionalidad familiar de familias con adolescentes gestantes, y no gestantes, atendidas en la Empresa Social del Estado, Instituto de Salud de Bucaramanga (ESE Isabu), durante el primer semestre de 2009. Es un estudio comparativo, transversal, cuantitativo, realizado con la participación de 77 familias con adolescentes gestantes y 104 familias con adolescentes no gestantes, en las cuales los informantes fueron de cada familia: la adolescente gestante o no gestante, y un familiar que viviera en el mismo hogar de la adolescente participante en el estudio. Para la recolección de la información se utilizó el instrumento ASF-E, de María Luisa Friedemann (1), que mide el nivel de efectividad de la funcionalidad familiar por medio de las dimensiones: cambio, mantenimiento, individuación, coherencia, y las metas: espiritualidad, crecimiento, control, estabilidad del sistema familiar. En los resultados se encontró que las familias con adolescentes gestantes presentan un nivel alto de efectividad de la funcionalidad familiar, referido por las adolescentes gestantes (49,4%) y sus familiares (54,5%); mientras que las familias con adolescentes no gestantes presentan un nivel intermedio de efectividad, referido tanto por adolescentes no gestantes como por sus familiares, con igual porcentaje: 57,7%.En conclusión, existen diferencias estadísticamente significativas entre los dos grupos de familias, sobre la efectividad de la funcionalidad familiar, identificada en la prueba T con p: 0,012. Igualmente hay diferencias en las metas de estabilidad (p 0,009) y control (p 0,007) y en las dimensiones de coherencia (p 0,013) y mantenimiento del sistema familiar (p 0,033).
The purpose of the research is to compare the evaluation of the effectiveness of family functionality of families with pregnant and non pregnant adolescents attended in the Social State Company (Instituto de Salud) in Bucaramanga (ESE Isabu), during the first semester of 2009. It is a comparative, cross-cutting, quantitative study carried out with the participation of 77 families with pregnant adolescents and 104 families with non pregnant adolescents; being the informant in each family, either: the pregnant or non pregnant adolescent or a relative living in the same home as the adolescent participating in the study. To collect the information, the ASF-E tool by María Luisa Friedemann (1) was used, which measures the effectiveness of family effectiveness through the following dimensions: change, maintenance, individualization, coherence and with the following goals: family systems spirituality, growth, control and stability. Results showed that families with pregnant adolescents have a high level of family functionality effectiveness, reported by pregnant adolescents (49,4%) and their relatives (54,5%); while families with non pregnant adolescents show an intermediate level of effectiveness reported by non pregnant adolescents as well as by their relatives, with the same percentage: 57,7%In conclusion, there are statistically significant differences between the two groups of families, regarding the effectiveness of family functionality, identified in the T test with p: 0,012. Likewise, there are differences in the stability goals (p 0,009), control (p 0,007), coherence (p 0,013) and family system maintenance (p 0,033) dimensions.
Esta pesquisa visa comparar a avaliação da efetividade da funcionalidade familiar das famílias de adolescentes grávidas e não grávidas; atendidas na Empresa Social do Estado Instituto de Saúde de Bucaramanga (ESSE Isabu), durante o primeiro semestre de 2009. Através de um levantamento comparativo, transversal, quantitativo, no qual participaram 77 famílias de adolescentes grávidas, e 104 famílias de adolescentes não grávidas. Os participantes que forneceram os dados do estudo foram: a adolescente grávida ou a não grávida, e um familiar que viesse do mesmo lar que a adolescente que participa do estudo.Para reunir os dados, foi utilizado o instrumento ASF-E de María Friedemann (1), que mede o nível de funcionalidade familiar através das dimensões: mudança, manutenção, individuação, coerência; e as metas: espiritualidade, crescimento, controle, estabilidade do sistema familiar.O resultado obtido foi que as famílias de adolescentes grávidas apresentam um alto nível de efetividade de funcionalidade familiar, segundo as próprias adolescentes (49,4%) e familiares dela (54,5%); por outro lado as famílias de adolescentes não grávidas apresentam um nível intermédio de efetividade, segundo as próprias adolescentes não grávidas e os familiares dela, que obtiveram a mesma percentagem: 57,7%.Em conclusão, existem significativas diferenças estadísticas entre ambos os grupos de famílias no referente à efetividade da funcionalidade familiar, identificada na prova T com p: 0,012. Igualmente, existem diferenças nas metas de estabilidade (p 0,009) e de controle (p 0,007); e nas dimensões de coerência (p 0,013) e manutenção do sistema familiar (p 0,033).