RESUMEN
Osteomyelitis often involves Staphylococcus spp. as the isolated genus in domestic animal cases. Implant-related infections, frequently associated with biofilm-forming microorganisms like staphylococci species, necessitate careful material selection. This study assessed biofilm formation by Staphylococcus pseudintermedius on titanium nuts used in veterinary orthopaedic surgery. Biofilm quantification employed safranin staining and spectrophotometric measurement, while bacterial counts were determined in colony-forming units (CFU). Scanning Electron Microscopy (SEM) evaluated the biofilm morphology on the surface of titanium nuts. All samples had CFU counts. Absorbance values that evidence biofilm formation were observed in seven of the eight samples tested. SEM images revealed robust bacterial colonization, and significant extracellular polymeric substance production, and the negative control displayed surface irregularities on the nut. Whole genome sequencing revealed accessory Gene Regulator (agr) type III in six samples, agr IV and agr II in two each. Genes encoding hlb, luk-S, luk-F, siet, se_int, and the icaADCB operon were identified in all sequenced samples. Other exfoliative toxins were absent. Biofilm formation by S. pseudintermedius was detected in all samples, indicating the susceptibility of orthopaedic titanium alloys to adhesion and biofilm formation by veterinary species. The biofilm formation capacity raises concerns about potential post-surgical complications and associated costs.
Asunto(s)
Biopelículas , Infecciones Estafilocócicas , Animales , Titanio , Matriz Extracelular de Sustancias Poliméricas , Staphylococcus/genéticaRESUMEN
This work aimed to understand how lifelong exercise training promotes the remodelling of the immune system and prostate signalome in a rat model of PCa. Fifty-five male Wistar rats were divided into four groups: control sedentary, control exercised, induced PCa sedentary and induced PCa exercised. Exercised animals were trained in a treadmill for 53 weeks. Pca induction consisted on the sequential administration of flutamide, N-methyl-N-nitrosourea and testosterone propionate implants. Serum concentrations of C-reactive protein (CRP) and tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) were not different among groups. Peripheral levels of γδ T cells were higher in Pca exercised group than in the PCa sedentary group (p < 0.05). Exercise training also induced Oestrogen Receptor (ESR1) upregulation and Mitogen-activated Protein Kinase 13 (MAPK13) downregulation, changed the content of the phosphorylated (at Ser-104) form of this receptor (coded by the gene ESR1) and seemed to increase Erα phosphorylation and activity in exercised PCa rats when compared with sedentary PCa rats. Our data highlight the exercise-induced remodelling of peripheral lymphocyte subpopulations and lymphocyte infiltration in prostate tissue. Moreover, exercise training promotes the remodelling prostate signalome in this rat model of prostate carcinogenesis.
Asunto(s)
Condicionamiento Físico Animal , Próstata , Ratas , Masculino , Animales , Ratas Sprague-Dawley , Próstata/metabolismo , Próstata/patología , Ratas Wistar , Sistema Inmunológico , CarcinogénesisRESUMEN
This study aims to evaluate if the relation between love life satisfaction, assessed by the satisfaction with love life scale (SWLLS), and capacity to love, assessed by the capacity to love inventory (CTL-I), is moderated by gender and by being or not in a romantic relationship, in a Portuguese sample. To this end, the adaptation and validation of CTL-I for this population were carried out through an exploratory factorial analysis (EFA) followed by a Robust Maximum Likelihood (MLR) confirmatory factorial analysis (CFA). A multi-group analysis for measurement invariance depending on being in a romantic relationship or not was assessed. The model's reliability was also evaluated. The associations between SWLLS and CTL-I were tested by correlations, regressions and moderations. At last, differences between means and distributions concerning sociodemographic variables were determined. The results showed that a good model fit for the Portuguese version of the CTL-I was found, as well as good psychometric properties. Results also showed that satisfaction with love life contributes to explaining the capacity to love and all its dimensions, and that gender and being in a romantic relationship moderate the association between love life satisfaction and the capacity to love. Being female and being in a romantic relationship make the relationship between love life satisfaction and the capacity to love stronger and more meaningful.
Asunto(s)
Relaciones Interpersonales , Amor , Humanos , Femenino , Masculino , Reproducibilidad de los Resultados , Satisfacción Personal , PsicometríaRESUMEN
AIMS: The purpose of this study was to characterize the capacity for biofilm formation, antimicrobial resistance rates, and search for genetic determinants of resistance and virulence in the species. METHODS AND RESULTS: Strains were collected from asymptomatic and infected dogs. Identification was conducted using matrix-assisted laser desorption ionization-time of flight (MALDI-TOF), antimicrobial susceptibility using disk diffusion and PCR targeting mecA. Biofilm formation was evaluated on a microtiter plate assay. A total of 27 strains were selected for whole-genome sequencing. We identified 111 Staphylococcus coagulans. The highest number was obtained from infected dogs. The highest resistance rates were observed for penicillin, gentamicin, and ciprofloxacin/erythromycin. Twelve strains were characterized as resistant to methicillin. All isolates had the ability to form biofilm and were strong producers. Among Methicillin Resistant Staphylococcus coagulans (MRSC), SCCmec types IIIA, and Vc were identified. Acquired resistance genes, such as aac(6')-aph(2''), tet(K), blaZ, qacG, qacJ, and erm(C) were found. Different virulence genes were identified. Of note, Panton-Valentine Leucocidin was highly prevalent among the isolates. CONCLUSION: Staphylococcus coagulans had a high isolation rate among infected dogs and demonstrated significant resistance to commonly used antibiotics such as penicillin and gentamicin.
Asunto(s)
Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas , Perros , Animales , Staphylococcus aureus Resistente a Meticilina/genética , Leucocidinas/genética , Prevalencia , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/veterinaria , Pruebas de Sensibilidad Microbiana , Brasil/epidemiología , Antibacterianos/farmacología , Staphylococcus/genética , Meticilina , Gentamicinas/farmacologíaRESUMEN
Dogs often carry methicillin-resistant Staphylococci asymptomatically. These bacteria are frequently linked to conditions such as canine pyoderma and otitis. Close interaction between dogs and humans can facilitate the exchange of resistant strains, particularly Methicillin-resistant Staphylococcus pseudintermedius (MRSP). This represents a public health issue, since these strains, in addition to occasionally causing infections in humans, can also serve as a source of resistance and virulence genes for strains of greater importance in human medicine, such as Staphylococcus aureus. Furthermore, MRSP strains are often multidrug resistant, which ends up compromising the treatment of infections. This study aimed to assess the potential transmission of Staphylococcus pseudintermedius among dogs and their owners. We examined a total of one hundred canine samples collected from cases of pyoderma and otitis to detect the presence of staphylococci. Simultaneously, we conducted evaluations on all dog owners. Staphylococci strains were identified using MALDI-TOF MS and PCR targeting the nuc gene. Methicillin resistance screening was also performed by detecting the mecA gene using PCR. Among the sampled dogs, 64 carried S. pseudintermedius. Nine were identified as MRSP. In six instances, dogs and their owners exhibited S. pseudintermedius. These samples underwent genome sequencing and were screened for antimicrobial resistance genes, SCCmec typing, MLST characterization, and Single Nucleotide Polymorphisms (SNP) analyses. The results of the phylogenetic analysis revealed that in three cases, dogs and owners had closely related isolates, suggesting interspecies transmission. Two of these cases involved MRSP and one MSSP. Moreover, in the two MRSP cases, the same SCCmec type (type V) was detected. Additionally, the sequence type was consistent across all three cases involving dogs and owners (MSSP ST2277, MRSP ST2282, and ST2286). These findings strongly indicate a transmission event. Since Staphylococcus pseudintermedius is primarily isolated from canine samples, it is plausible that dogs may have acted as a potential source. In the remaining three cases, despite identifying the same species in both samples, they had notable phylogenetic differences.
Asunto(s)
Staphylococcus aureus Resistente a Meticilina , Otitis , Piodermia , Infecciones Estafilocócicas , Perros , Animales , Humanos , Resistencia a la Meticilina , Tipificación de Secuencias Multilocus/veterinaria , Filogenia , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/veterinaria , Infecciones Estafilocócicas/microbiología , Antibacterianos/farmacología , Pruebas de Sensibilidad MicrobianaRESUMEN
Choanoflagellates are microeukaryotes that inhabit freshwater and marine environments and have long been regarded as the closest living relatives of Metazoa. Knowledge on the evolution of choanoflagellates is key for the understanding of the ancestry of animals, and although molecular clock evidence suggests the appearance of choanoflagellates by late Neoproterozoic, no specimens of choanoflagellates are known to occur in the fossil record. Here the first putative occurrence of choanoflagellates in sediments from the Cretaceous (Cenomanian-Turonian) is described by means of several cutting-edge petrographic techniques, and a discussion of its paleoenvironmental significance is performed. Furthermore, their placement in the organic matter classification systems is argued, with a placement in the Zoomorph Subgroup (Palynomorph Group) of the dispersed organic matter classification system being proposed. Regarding the ICCP System 1994, incorporation of choanoflagellates is, at a first glance, straightforward within the liptinite group, but the definition of a new maceral may be necessary to accommodate the genetic origin of these organisms. While modern choanoflagellates may bring light to the cellular foundations of animal origins, this discovery may provide an older term of comparison to their extant specimens and provide guidelines for possible identification of these organic components in other locations and ages throughout the geological record.
Asunto(s)
Coanoflagelados , Animales , Filogenia , Coanoflagelados/genética , Fósiles , Agua Dulce , Evolución BiológicaRESUMEN
Staphylococcus pseudintermedius is the primary cause of pyoderma and surgical site infection (SSI) in dogs, and biofilm formation is the main reason for persistent SSI. The presence of biofilm in medical devices can directly impact treatment. Methicillin-resistant S. pseudintermedius (MRSP) emerged rapidly in companion animals, limiting treatment options. MRSP is a public health problem since zoonotic transmission can occur. The study seeks to evaluate biofilm formation capacity via Staphylococcus pseudintermedius collected from dogs affected by topical infections, in suture materials commonly used in companion animal surgery. We tested segments of four types of sutures. Biofilm production was measured by staining with safranin and colorimetric absorbance measurement. We calculated colony-forming units (CFUs) for each type of sutures and visualized biofilm via Scanning Electron Microscopy (SEM) images. The genes associated with biofilm formation (icaA and icaD) were identified using PCR. The colorimetric tests showed that the biofilm is most abundantly formed on the cotton sutures and polyglactin 910. The ability to form biofilm on polypropylene and nylon sutures has also been demonstrated, although at varying intensities. PCR revealed the presence of the two genes (icaA and icaD) in all the isolates. We used a positive control using a reference strain and negative control without bacteria for comparisons. Suture material allowing biofilm formation makes it difficult to prevent and treat surgical site infections. Therefore, it is important to know which suture thread is more susceptible to biofilm formation by bacteria to prevent possible secondary infections at surgical sites.
Asunto(s)
Enfermedades de los Perros , Infecciones Estafilocócicas , Perros , Animales , Nylons , Polipropilenos , Poliglactina 910 , Biopelículas , Suturas , Enfermedades de los Perros/microbiología , Infecciones Estafilocócicas/veterinaria , Infecciones Estafilocócicas/microbiología , AntibacterianosRESUMEN
BACKGROUND: This study aimed to compare factors associated with CRC in patients younger than 50 and in those 50 and older, that required surgical resection due to malignancy or premalignant conditions. METHODS: A retrospective chart review was conducted looking at patients who had bowel resection due to CRC or advanced polyps; individuals found to have hereditary tumors and inflammatory bowel disease were excluded. Data was analyzed with chi square test of association comparing proportions of patients in the two age groups. RESULTS: A significantly higher proportion of the younger population had advanced stages of CRC. Data from this and other studies suggests that the colorectal tumors seen in patients under 50 have a higher virulence, and perhaps this is due to different tumor biology. CONCLUSION: These findings illustrate how changes in screening guidelines reinforced by proper support from insurance providers/payors and a widespread aggressive educational campaign for patients and providers can benefit this increasingly vulnerable population.
Asunto(s)
Neoplasias Colorrectales , Lesiones Precancerosas , Colonoscopía , Neoplasias Colorrectales/patología , Humanos , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Juvenile hemochromatosis is a rare inherited disorder of iron regulation leading to iron overload, which usually presents before the age of 30. One of the most serious clinical characteristics associated with early-onset iron overload is liver disease with eventual cirrhosis, often associated with a reduced life expectancy even after treatment. This case report summarizes an asymptomatic pediatric patient with persistently elevated transaminase levels, which led to a diagnosis of juvenile hemochromatosis relatively early in the course of his disease. The aim of this case report is to increase awareness and stress the importance of early diagnosis and treatment, as it is vital to prevent life-threatening complications and optimize patient outcomes. Consideration should be taken to recognize potential manifestations despite the rarity of the condition. Patients with signs of hepatocellular injury without explanation should prompt evaluation including consideration for iron overload after other common causes are ruled out.
RESUMEN
BACKGROUND: Antenatal hydronephrosis (ANH) affects â¼1-5% of pregnancies. The aim of this study was to develop a clinical prediction model of renal injury in a large cohort of infants with isolated ANH. METHODS: This is a longitudinal cohort study of 447 infants with ANH admitted since birth between 1989 and 2015 at a tertiary care center. The primary endpoint was time until the occurrence of a composite event of renal injury, which includes proteinuria, hypertension and chronic kidney disease (CKD). A predictive model was developed using a Cox proportional hazards model and evaluated by C-statistics. RESULTS: Renal pelvic dilatation (RPD) was classified into two groups [Grades 1-2 (n = 255) versus Grades 3-4 (n = 192)]. The median follow-up time was 6.4 years (interquartile range 2.8-12.5). Thirteen patients (2.9%) developed proteinuria, 6 (1.3%) hypertension and 14 (3.1%) CKD Stage 2. All events occurred in patients with RPD Grades 3-4. After adjustment, three covariables remained as predictors of the composite event: creatinine {hazard ratio [HR] 1.27, [95% confidence interval (CI) 1.05-1.56]}, renal parenchyma thickness at birth [HR 0.78(95% CI 0.625-0.991)] and recurrent urinary tract infections [HR 4.52 (95% CI 1.49-13.6)]. The probability of renal injury at 15 years of age was estimated as 0, 15 and 24% for patients assigned to the low-risk, medium-risk and high-risk groups, respectively (P < 0.001). CONCLUSION: Our findings indicate an uneventful clinical course for patients with Society for Fetal Urology (SFU) Grades 1-2 ANH. Conversely, for infants with SFU Grades 3-4 ANH, our prediction model enabled the identification of a subgroup of patients with increased risk of renal injury over time.
RESUMEN
Primary cilia are sensory organelles crucial for cell signaling during development and organ homeostasis. Cilia arise from centrosomes and their formation and function is governed by numerous factors. Through our studies on Townes-Brocks Syndrome (TBS), a rare disease linked to abnormal cilia formation in human fibroblasts, we uncovered the leucine-zipper protein LUZP1 as an interactor of truncated SALL1, a dominantly-acting protein causing the disease. Using TurboID proximity labeling and pulldowns, we show that LUZP1 associates with factors linked to centrosome and actin filaments. Here, we show that LUZP1 is a cilia regulator. It localizes around the centrioles and to actin cytoskeleton. Loss of LUZP1 reduces F-actin levels, facilitates ciliogenesis and alters Sonic Hedgehog signaling, pointing to a key role in cytoskeleton-cilia interdependency. Truncated SALL1 increases the ubiquitin proteasome-mediated degradation of LUZP1. Together with other factors, alterations in LUZP1 may be contributing to TBS etiology.
Primary cilia are the 'antennae' of animal cells: these small, flexible protrusions emerge from the surface of cells, where they help to sense and relay external signals. Cilia are assembled with the help of the cytoskeleton, a dynamic network of mesh-like filaments that spans the interior of the cell and controls many different biological processes. If cilia do not work properly, human diseases called ciliopathies can emerge. Townes-Brocks Syndrome (TBS) is an incurable disease that presents a range of symptoms such as malformations of the toes or fingers, hearing impairment, and kidney or heart problems. It is caused by a change in the gene that codes for a protein called SALL1, and recent work has also showed that the cells of TBS patients have defective cilia. In addition, this prior research identified a second protein that interacted with the mutant version of SALL1; called LUZP1, this protein is already known to help maintain the cytoskeleton. In this study, Bozal-Basterra et al. wanted to find out if LUZP1 caused the cilia defects in TBS. First, the protein was removed from mouse cells grown in the laboratory, which dramatically weakened the cytoskeleton. In keeping with this observation, both the number of cilia per cell and the length of the cilia were abnormal. Cells lacking LUZP1 also had defects in a signalling process that transmits signals received by cilia to different parts of the cell. All these defects were previously observed in cells isolated from TBS patients. In addition, LUZP1-deficient mouse cells showed the same problems with their cilia and cytoskeleton as the cells from individuals with TBS. Crucially, the cells from human TBS patients also had much lower levels of LUZP1 than normal, suggesting that the protein may contribute to the cilia defects present in this disease. The work by Bozal-Basterra et al. sheds light on how primary cilia depend on the cytoskeleton, while also providing new insight into TBS. In the future, this knowledge could help researchers to develop therapies for this rare and currently untreatable disease.
Asunto(s)
Anomalías Múltiples/etiología , Citoesqueleto de Actina/metabolismo , Ano Imperforado/etiología , Cilios/metabolismo , Proteínas del Citoesqueleto/fisiología , Pérdida Auditiva Sensorineural/etiología , Pulgar/anomalías , Anomalías Múltiples/metabolismo , Adulto , Animales , Ano Imperforado/metabolismo , Centrosoma/metabolismo , Proteínas del Citoesqueleto/metabolismo , Fibroblastos/metabolismo , Pérdida Auditiva Sensorineural/metabolismo , Humanos , Masculino , Ratones , Factores de Transcripción/metabolismoRESUMEN
ABSTRACT: The objective of this study was to analyze the potential of the jabuticaba peel flour (JPF) as an ingredient in whole-grain bread. Pan bread formulations with different concentrations of jabuticaba peel flour were made: 0% (T0), 5% (T1), 10% (T2), and 15% (T3). Proximate composition, pH, water activity, color, phenolic compounds and antioxidant activity of bread were determined. The addition of JPF to the bread formulations led to a reduction of carbohydrate levels (51.14 to 46.55 g 100 g-1), lipids (4.79 to 3.35 g 100 g-1) and an increase in moisture (31.06 to 37.31 g 100 g-1) and ash (0.22 to 0.35 g 100 g-1). The fiber content increased up to three times, and the phenolic compounds up to seven times, thus increasing the antioxidant activity of the JPF-based bread when compared to the control. Bread made with the addition of JPF presented lower L* values (46.72 to 36.07) and higher a* values (3.10 to 9.07) compared to the control. Therefore, jabuticaba peel flour can be considered a potential ingredient for addition to whole-grain pan bread with desirable nutritional and functional characteristics.
RESUMO: Este trabalho teve como objetivo analisar o potencial da farinha de casca de jabuticaba (FCJ) como ingrediente em pães de forma integrais. Foram elaboradas formulações de pães com diferentes concentrações de farinha de casca de jabuticaba: 0% (T0), 5% (T1), 10% (T2) e 15% (T3). Foram realizadas análises de composição centesimal, pH, atividade de água, cor, compostos fenólicos e atividade antioxidante dos pães. A adição de FCJ às formulações de pão levou a uma redução dos níveis de carboidratos (51,14 a 46,55 g 100 g-1), lipídios (4,79 a 3,35 g 100 g-1) e aumento da umidade (31,06 a 37,31 g 100 g-1) e minerais (0.22 a 0.35 g 100 g-1). O teor de fibras aumentou até três vezes e os compostos fenólicos até sete vezes, aumentando a atividade antioxidante do pão à base de FCJ quando comparado ao controle. O pão elaborado com a adição de FCJ apresentou menores valores de L* (46,72 a 36,07) e maiores valores de a* (3,10 a 9,07) em relação ao controle. Portanto, a farinha de casca de jabuticaba pode ser considerada um ingrediente potencial para a adição ao pão de forma integral com características nutricionais e funcionais desejáveis.
RESUMEN
The aim of this study was to identify predictive factors and develop a model to assess individualized risk of postnatal surgical intervention in patients with antenatal hydronephrosis. This is a retrospective cohort study of 694 infants with prenatally detected congenital anomalies of kidney and urinary tract with a median follow-up time of 37 months. The main event of interest was postnatal surgical intervention. A predictive model was developed using Cox model with internal validation by bootstrap technique. Of 694 patients, 164 (24%) infants underwent surgical intervention in a median age of 7.8 months. Predictors of the surgical intervention in the model were: baseline glomerular filtration rate, associated hydronephrosis, presence of renal damage and the severity of renal pelvic dilatation. The optimism corrected c statistic for the model was 0.84 (95%CI, 0.82-0.87). The predictive model may contribute to identify infants at high risk for surgical intervention. Further studies are necessary to validate the model in patients from other settings.
RESUMEN
Staphylococci are considered a major concern in dairy plants mainly due to the intensive production flow, automation of processing plants and increased demand in the microbiological quality of dairy products. This study aimed to identify S. aureus strains isolated from three Brazilian dairy plants, evaluate the influence of time, temperature and contact surface on the bacterial adhesion process, as well as the efficiency of simulated hygiene and sanitation protocol in removing adhered cells. For genotypic analyses, the presence of icaA and icaD in strains was evaluated. Adherence assays were performed in biofilm reactor, comparing the influence of 2 temperatures (5°C and 35°C), 2 surfaces (stainless steel and polypropylene) and 4 contact times (3, 6, 12h and post-sanitization). To evaluate the process effectiveness in removing adhered cells, neutral detergent and sanitizing agent based on sodium hypochlorite were used in order to simulate the situation observed in one of the dairy plants analyzed. The presence of icaA and icaD genes was determined in 75.3% and 77.6% of strains, respectively; 70.6% of isolates showed both genes, whereas 17.6% showed no genes. Genes for enterotoxin production were found in all samples, relating to SEG and SEH toxins. The number of cells adhered on both surfaces was about 3 and 6 log10 CFU/cm2 at temperatures of 5°C and 35°C, respectively, for most situations evaluated, with significant increase over the evaluation period. In general, the temperature of 35°C favored greater adherence of S. aureus. At 5°C, there was a considerable number of adhered cells, but in populations significantly lower than those observed at 35°C. The cleaning and sanitizing protocol was ineffective in removing adhered cells; better performance of sodium hypochlorite was observed at 5°C, which should be related to lower adherence observed at this temperature. Thus, the process was not able to reduce the number of S. aureus bacteria adhered on both surfaces to safe levels under the conditions evaluated.
Asunto(s)
Adhesión Bacteriana/efectos de los fármacos , Biopelículas/efectos de los fármacos , Detergentes/farmacología , Desinfectantes/farmacología , Enterotoxinas/genética , Hipoclorito de Sodio/farmacología , Staphylococcus aureus/efectos de los fármacos , Adhesión Bacteriana/fisiología , Brasil , Industria Lechera , Infecciones Estafilocócicas/prevención & control , Staphylococcus aureus/genética , Staphylococcus aureus/aislamiento & purificaciónRESUMEN
Introdução: a insuficiência cardíaca (IC) é uma condição que determina grande sofrimento aos pacientes. Entretanto, a prática de cuidados paliativos (CP) no seu manejo ainda é bastante incipiente. Objetivos: analisar a distribuição territorial dos serviços de CP no Brasil e discutir o papel destes no manejo de pacientes com IC. Metodologia: estudo exploratório documental, com informações demográficas e epidemiológicasobtidas do DATASUS e do IBGE. A relação dos serviços de CP foi obtida da Associação Brasileira de Cuidados Paliativos (ABCP), da Academia Nacional de Cuidados Paliativos (ANCP) e do Ministério da Saúde (MS). A revisão bibliográfica foi realizada nas bases PubMed, LILACS e Scielo, usando os descritores insuficiência cardíaca, cuidados paliativos,qualidade de vida e assistência terminal. Resultados: entre 1996 e 2013 houve mais de 500 mil óbitos por IC no país. Em 2014, os custos hospitalares para tratamento de IC foram superiores a R$ 315 milhões. Embora os CP sejam eficazes no manejo da IC, há baixa disponibilidade desses serviços, que se concentram principalmente no Sudeste, vinculados a instituições oncológicas. Conclusão: a IC é uma síndrome clínica complexa que exige abordagem interdisciplinar. A atenção holística provida pelos CPs mostra-se eficaz na redução de internações por doença descompensada, na incidência de depressão e na melhoria da qualidade de vida do paciente.
Introduction: Heart failure (HF) is a condition that results in great suffering to patients. However, the practice of palliative care in their management is still incipient. Objective: The aim of this study was to analyze the territorial distribution of palliative care services in Brazil and discuss their role in the treatment of patients with HF. Methods: This is a documental exploratory study, with information obtained from DATASUS, IBGE, the Brazilian Association of Palliative Care (ABCP) and the National Palliative Care Academy (ANCP). A literature review was conducted on PubMed, LILACS and Scielo, using the descriptors Heart Failure, Palliative Care, Quality of Life and Terminal Care. Results: Between 1996 and 2013 there were over than 500.000 deaths due to HF in Brazil. In 2014, hospital costs for treating HF were higher than R$ 315 million. Despite the evidence of the effectiveness of palliative care in heart failure?s management, there is low availability of these services, which is mainly concentrated in the southeast of the country, linked to oncological institutions. Conclusion: The HF is a clinical syndrome that requires an interdisciplinary approach. The holistic care provided by palliative care is effective in reducinghospitalizations for complications of the HF, the incidence of depression and in improving the patient?s quality of life.
Asunto(s)
Humanos , Masculino , Femenino , Cuidados Paliativos , Enfermedad Crítica/terapia , Insuficiencia Cardíaca , Salud Holística , Enfermedades Cardiovasculares/epidemiología , Indicadores de Morbimortalidad , Cardiopatías/diagnósticoRESUMEN
BACKGROUND: The ability to determine the direction of a sound source is based on the fact that sounds reach both cars at different times, phase, intensity and/or frequency. The perception of a sound source favors speech intelligibility in noisy environments. AIM: To identify the minimum time of interaural delay--produces lateralization to the car which the stimulus reached first--through ascendant and descendent techniques, using the Sound Lateralization Test in elderly individuals with normal hearing thresholds in the frequencies which are most important for speech comprehension. METHOD: The Lateralization Test was used in 30 individuals with ages above 60 years, who presented hearing thresholds up to 25 dBHL in 500, 1000 and 2000 Hz and with no air-bone gap. RESULTS: Mean times of interaural delay in sound lateralization were: a) ascending technique: 125.56 sec. (female) and 83.61 sec. (male); b) descending technique: 95.06 sec. (female) and 61.68 sec (male). CONCLUSION: There is no difference between the mean time of interaural delay in sound lateralization obtained with the ascending or descending technique regarding the variable initial tested ear (right or left ear); the mean time of interaural delay in sound lateralization is smaller in males, when considering both ascendant and descendent techniques; the mean time of interaural delay in sound lateralization obtained with the descendent technique is smaller than that obtained with the ascendant technique; individuals who present hearing losses beginning at 3000 Hz have smaller mean times of interaural delay in sound lateralization than normal hearing individuals in both techniques.
Asunto(s)
Lateralidad Funcional , Pérdida Auditiva/complicaciones , Audición/fisiología , Localización de Sonidos/fisiología , Anciano , Análisis de Varianza , Intervalos de Confianza , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
TEMA: a habilidade de determinar a direção da fonte sonora está baseada no fato de que os sons chegam às duas orelhas em tempo, fase, intensidade e/ ou freqüência diferentes. A percepção da direção da fonte sonora favorece a inteligibilidade de fala em ambientes ruidosos. OBJETIVO: identificar o menor tempo de atraso interaural, que é capaz de produzir lateralização para a orelha em que o estímulo chegou primeiro, por meio das técnicas ascendente e descendente, utilizando-se o Teste de Lateralização Sonora, em indivíduos idosos, com audição normal nas freqüências mais importantes para a compreensão da fala. MÉTODO: foi aplicado o Teste de Lateralização Sonora em 30 indivíduos acima de 60 anos de idade, que possuíam limiares de audibilidade até 25dBNA nas freqüências de 500, 1000 e 2000Hz, sem gap aéreo-ósseo. RESULTADOS: os tempos médios de atraso interaural de lateralização sonora foram: a) técnica ascendente: 125,56s (sexo feminino) e 83,61 s (sexo masculino); b) técnica descendente: 95,06 s (sexo feminino) e 61,68s (sexo masculino). CONCLUSÃO: não há diferença entre o tempo médio de atraso interaural de lateralização sonora, obtido com a técnica ascendente e descendente segundo a variável lado de início do teste (orelha direita ou orelha esquerda); o tempo médio de atraso interaural de lateralização sonora é menor nos indivíduos do sexo masculino, em ambas as técnicas, descendente e ascendente; o tempo de atraso interaural médio obtido por meio da técnica descendente é menor que o obtido na técnica ascendente; os indivíduos que apresentam perda de audição à partir da freqüência de 3000Hz têm tempo médio de atraso interaural de lateralização sonora menor que os indivíduos com audição normal, tanto na técnica ascendente quanto na técnica descendente.
BACKGROUND: the ability to determine the direction of a sound source is based on the fact that sounds reach both ears at different times, phase, intensity and/or frequency. The perception of a sound source favors speech intelligibility in noisy environments. AIM: to identify the minimum time of interaural delay - produces lateralization to the ear which the stimulus reached first - through ascendant and descendent techniques, using the Sound Lateralization Test in elderly individuals with normal hearing thresholds in the frequencies which are most important for speech comprehension. METHOD: the Lateralization Test was used in 30 individuals with ages above 60 years, who presented hearing thresholds up to 25 dBHL in 500, 1000 e 2000Hz and with no air-bone gap. RESULTS: mean times of interaural delay in sound lateralization were: a) ascending technique: 125.56sec. (female) and 83.61sec. (male); b) descending technique: 95.06sec. (female) and 61.68sec (male). CONCLUSION: there is no difference between the mean time of interaural delay in sound lateralization obtained with the ascending or descending technique regarding the variable initial tested ear (right or left ear); the mean time of interaural delay in sound lateralization is smaller in males, when considering both ascendant and descendent techniques; the mean time of interaural delay in sound lateralization obtained with the descendent technique is smaller than that obtained with the ascendant technique; individuals who present hearing losses beginning at 3000Hz have smaller mean times of interaural delay in sound lateralization than normal hearing individuals in both techniques.
Asunto(s)
Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Lateralidad Funcional , Pérdida Auditiva/complicaciones , Audición/fisiología , Localización de Sonidos/fisiología , Análisis de Varianza , Intervalos de Confianza , Factores de TiempoRESUMEN
Mycobacterium tuberculosis interacts with monocyte-macrophages through cell surface molecules including CD14. A soluble form of CD14 (sCD14) exists in human serum, and higher amounts of it are found in tuberculosis. A polymorphism on CD14 gene promoter was associated with increased sCD14 levels in some diseases. To evaluate whether this polymorphism associates with tuberculosis, its clinical forms, and increased sCD14, genotype/allele frequencies in tuberculosis patients were compared with the controls. Results confirmed increased levels of sCD14 in patients with tuberculosis, and those with miliary tuberculosis had the highest levels. sCD14 decreased to normal levels after anti-tuberculosis treatment. No association was found between the CD14 polymorphism and tuberculosis or sCD14 levels. Results suggest that sCD14 may be involved in anti-tuberculosis immune response, but its increase is a consequence of infection rather than a predisposed genetic trait. Measuring sCD14 in tuberculosis may help monitor anti-tuberculosis treatment.
Asunto(s)
Receptores de Lipopolisacáridos/sangre , Receptores de Lipopolisacáridos/genética , Polimorfismo de Longitud del Fragmento de Restricción , Regiones Promotoras Genéticas , Tuberculosis/genética , Adolescente , Adulto , Anciano , Femenino , Frecuencia de los Genes , Humanos , Masculino , Persona de Mediana Edad , Tuberculosis/tratamiento farmacológico , Tuberculosis Miliar/genética , Tuberculosis Pleural/genética , Tuberculosis Pulmonar/genéticaRESUMEN
Tema: a prótese de palato elevadora é indicada para a incompetência velofaríngea, de origem neurológica. Objetivo: investigar o efeito da mesma na análise acústica vocal. Método: a voz de um grupo de 7 adultos disártricos foi avaliada instrumental e perceptivamente. Resultados: a análise acústica näo demonstrou diferença significante entre os indivíduos, nas condiçöes com e sem prótese, enquanto a análise perceptivo-auditiva demonstrou melhora significante apenas na inteligibilidadfe e ressonância de fala. Conclusä: a prótese de palato produziu efeito na fala, mas näo na voz dos indivíduos disártricos.