Factors Associated with Neonatal Arterial Hypertension: Case and Control Study.

Background. Neonatal high blood pressure has been diagnosed more frequently in recent years, and its impact extends to adulthood. However, the knowledge gaps on associated factors, diagnosis, and treatment are challenging for medical personnel. The incidence of this condition varies depending on neonatal conditions. Patients in the Newborn Unit are at increased risk of developing high blood pressure. The persistence of this condition beyond the neonatal stage increases the risk of cardiovascular disease and chronic kidney disease in childhood and adulthood. Methodology. A case-control study was carried out. It included hospitalized patients with neonatal hypertension as cases. Three controls were randomly selected for each case and matched by gestational age. The variables were analyzed based on their nature. Multivariate analysis was performed using a multivariate conditional regression model to identify variables associated with the outcome. Finally, the model was adjusted for possible confounders. Results. 37 cases were obtained and matched with 111 controls. In the univariate analysis, heart disease (OR 2.86; 95% CI 1.22-6.71), kidney disease (OR 7.24; 95% CI 1.92-28.28), bronchopulmonary dysplasia (OR 6.62; 95% CI 1.42-50.82) and major surgical procedures (OR 3.71; 95% CI 1.64-8.39) had an association with neonatal arterial hypertension. Only the latter maintained this finding in the multivariate analysis (adjusted OR 2.88; 95% CI 1.14-7.30). A significant association of two or more comorbidities with neonatal arterial hypertension was also found (OR 3.81; 95% CI 1.53-9.49). Conclusions. The study analyzed the factors related to high blood pressure in hospitalized neonates, finding relevant associations in the said population. The importance of meticulous neonatal care and monitoring of risk factors such as birth weight and major surgeries is highlighted.

Identification of Adipose Tissue as a Reservoir of Macrophages after Acute Myocardial Infarction.

Medullary and extra-medullary hematopoiesis has been shown to govern inflammatory cell infiltration and subsequently cardiac remodeling and function after acute myocardial infarction (MI). Emerging evidence positions adipose tissue (AT) as an alternative source of immune cell production. We, therefore, hypothesized that AT could act as a reservoir of inflammatory cells that participate in cardiac homeostasis after MI. To reveal the distinct role of inflammatory cells derived from AT or bone marrow (BM), chimeric mice were generated using standard repopulation assays. We showed that AMI increased the number of AT-derived macrophages in the cardiac tissue. These macrophages exhibit pro-inflammatory characteristics and their specific depletion improved cardiac function as well as decreased infarct size and interstitial fibrosis. We then reasoned that the alteration of AT-immune compartment in type 2 diabetes could, thus, contribute to defects in cardiac remodeling. However, in these conditions, myeloid cells recruited in the infarcted heart mainly originate from the BM, and AT was no longer used as a myeloid cell reservoir. Altogether, we showed here that a subpopulation of cardiac inflammatory macrophages emerges from myeloid cells of AT origin and plays a detrimental role in cardiac remodeling and function after MI. Diabetes abrogates the ability of AT-derived myeloid cells to populate the infarcted heart.

Extracellular vesicles from human cardiovascular progenitors trigger a reparative immune response in infarcted hearts.

AIMS: The cardioprotective effects of human induced pluripotent stem cell-derived cardiovascular progenitor cells (CPC) are largely mediated by the paracrine release of extracellular vesicles (EV). We aimed to assess the immunological behaviour of EV-CPC, which is a prerequisite for their clinical translation. METHODS AND RESULTS: Flow cytometry demonstrated that EV-CPC expressed very low levels of immune relevant molecules including HLA Class I, CD80, CD274 (PD-L1), and CD275 (ICOS-L); and moderate levels of ligands of the natural killer (NK) cell activating receptor, NKG2D. In mixed lymphocyte reactions, EV-CPC neither induced nor modulated adaptive allogeneic T cell immune responses. They also failed to induce NK cell degranulation, even at high concentrations. These in vitro effects were confirmed in vivo as repeated injections of EV-CPC did not stimulate production of immunoglobulins or affect the interferon (IFN)-γ responses from primed splenocytes. In a mouse model of chronic heart failure, intra-myocardial injections of EV-CPC, 3 weeks after myocardial infarction, decreased both the number of cardiac pro-inflammatory Ly6Chigh monocytes and circulating levels of pro-inflammatory cytokines (IL-1α, TNF-α, and IFN-γ). In a model of acute infarction, direct cardiac injection of EV-CPC 2 days after infarction reduced pro-inflammatory macrophages, Ly6Chigh monocytes, and neutrophils in heart tissue as compared to controls. EV-CPC also reduced levels of pro-inflammatory cytokines IL-1α, IL-2, and IL-6, and increased levels of the anti-inflammatory cytokine IL-10. These effects on human macrophages and monocytes were reproduced in vitro; EV-CPC reduced the number of pro-inflammatory monocytes and M1 macrophages, while increasing the number of anti-inflammatory M2 macrophages. CONCLUSIONS: EV-CPC do not trigger an immune response either in in vitro human allogeneic models or in immunocompetent animal models. The capacity for orienting the response of monocyte/macrophages towards resolution of inflammation strengthens the clinical attractiveness of EV-CPC as an acellular therapy for cardiac repair.

Endothelial Cell Indoleamine 2, 3-Dioxygenase 1 Alters Cardiac Function After Myocardial Infarction Through Kynurenine.

BACKGROUND: Ischemic cardiovascular diseases, particularly acute myocardial infarction (MI), is one of the leading causes of mortality worldwide. Indoleamine 2, 3-dioxygenase 1 (IDO) catalyzes 1 rate-limiting step of L-tryptophan metabolism, and emerges as an important regulator of many pathological conditions. We hypothesized that IDO could play a key role to locally regulate cardiac homeostasis after MI. METHODS: Cardiac repair was analyzed in mice harboring specific endothelial or smooth muscle cells or cardiomyocyte or myeloid cell deficiency of IDO and challenged with acute myocardial infarction. RESULTS: We show that kynurenine generation through IDO is markedly induced after MI in mice. Total genetic deletion or pharmacological inhibition of IDO limits cardiac injury and cardiac dysfunction after MI. Distinct loss of function of IDO in smooth muscle cells, inflammatory cells, or cardiomyocytes does not affect cardiac function and remodeling in infarcted mice. In sharp contrast, mice harboring endothelial cell-specific deletion of IDO show an improvement of cardiac function as well as cardiomyocyte contractility and reduction in adverse ventricular remodeling. In vivo kynurenine supplementation in IDO-deficient mice abrogates the protective effects of IDO deletion. Kynurenine precipitates cardiomyocyte apoptosis through reactive oxygen species production in an aryl hydrocarbon receptor-dependent mechanism. CONCLUSIONS: These data suggest that IDO could constitute a new therapeutic target during acute MI.

Neutrophil microvesicles drive atherosclerosis by delivering miR-155 to atheroprone endothelium.

Neutrophils are implicated in the pathogenesis of atherosclerosis but are seldom detected in atherosclerotic plaques. We investigated whether neutrophil-derived microvesicles may influence arterial pathophysiology. Here we report that levels of circulating neutrophil microvesicles are enhanced by exposure to a high fat diet, a known risk factor for atherosclerosis. Neutrophil microvesicles accumulate at disease-prone regions of arteries exposed to disturbed flow patterns, and promote vascular inflammation and atherosclerosis in a murine model. Using cultured endothelial cells exposed to disturbed flow, we demonstrate that neutrophil microvesicles promote inflammatory gene expression by delivering miR-155, enhancing NF-κB activation. Similarly, neutrophil microvesicles increase miR-155 and enhance NF-κB at disease-prone sites of disturbed flow in vivo. Enhancement of atherosclerotic plaque formation and increase in macrophage content by neutrophil microvesicles is dependent on miR-155. We conclude that neutrophils contribute to vascular inflammation and atherogenesis through delivery of microvesicles carrying miR-155 to disease-prone regions.

Surveillance of the Antimicrobial Resistance Rates of Helicobacter pylori Ten Years Later in the Western Central Region, Colombia.

BACKGROUND: Helicobacter pylori is a bacterium associated with gastroduodenal disease and gastric cancer. Empirical therapy in the treatment of H. pylori infection increases the risk of apparition of antimicrobial drug resistance. In a previous report, in H. pylori clinical isolates, resistance rates to commonly used antimicrobial drugs were as follows: metronidazole 82%, clarithromycin 3.8%, and amoxicillin 1.9%. The aim was to establish the variation of resistance rates and the detection of H. pylori genetic mutations isolated from dyspeptic patients. METHODS: Antimicrobial susceptibility profiles were performed by the E-test method for metronidazole, clarithromycin, amoxicillin, and tetracycline in 61 clinical isolates. Sequencing was performed to detect mutations associated with resistance to clarithromycin. RESULTS: According to our results, resistance rates found in the 61 isolates were 78.60% for metronidazole and 8.20% for clarithromycin. None of the studied isolates had resistance to tetracycline and amoxicillin. Secondary resistance rates displayed an increase when compared to primary rates for metronidazole (87.50 vs. 77.35%) and for clarithromycin (25.66 vs. 5.66%). Of 5 isolates resistant to clarithromycin, 3 had the A2143G mutation. By comparing the results in this work with previous reports, antimicrobial drug resistance rates did not show major modifications for metronidazole, amoxicillin, and tetracycline during the last 10 years. For clarithromycin, the resistance rate showed a moderate increase; nevertheless, it remains low (<15%) and this change was not statistically significant. CONCLUSION: Together, all findings in this work indicate that these antimicrobial drugs can still be used as first line of defense on infected patients living in this region of the country.

Avaliação dos conhecimentos para o tratamento não farmacológico da dor / Evaluación de conocimientos para el manejo no farmacológico del dolor / Evaluation of knowledge for the non-pharmacological management of pain

Las intervenciones para el alivio del dolor se clasifican en farmacológicas y no farmacológicas; las primeras incluyen la administración de fármacos analgésicos y las segundas utilizan terapias complementarias. El objetivo de este estudio fue diseñar y validar un instrumento de medición denominado "Conocimiento sobre intervenciones no farmacológicas para el alivio del dolor" para evaluar el nivel de conocimientos sobre intervenciones no farmacológicas para el manejo del dolor en un grupo de enfermeras profesionales y auxiliares de enfermería de una institución de salud de Bucaramanga, Colombia. Métodos: El instrumento se desarrolló en dos fases; la primera fase consistió en la búsqueda bibliográfica para el diseño, la validación facial y de contenido por expertos. En la segunda fase se evalúo la confiabilidad prueba- reprueba de la versión final del cuestionario. Resultados: La versión final del cuestionario contempla seis dimensiones propuestas por el Instituto Nacional de Medicina Alternativa de Estados Unidos con un total de 30 ítems. La confiabilidad de este instrumento fue baja (Índice Kappa-Cohen <0.60) en el 80% de los ítems. Conclusión: Este es el primer instrumento diseñado para medir los conocimientos sobre intervenciones no farmacológicas para el alivio del dolor en enfermeras y auxiliares de enfermería en nuestro país, sin embargo, se requiere continuar con procesos que permitan mejorar su confiabilidad y evaluar su validez.

As intervenções para o alivio da dor classificam-se em farmacológicas e não farmacológicas; as primeiras, consideram a administração de analgésicos, as segundas, empregam-se terapias complementarias. Objetivo: desenvolver e validar um questionário para à avaliação do nível de conhecimentos sob intervenções não farmacológicas para o tratamento da dor num grupo de enfermeiras padrão e auxiliares de enfermagem numa instituição de saúde de Bucaramanga, Colômbia. Materiais e métodos: O instrumento desenvolveu-se em duas fases: a primeira constou da busca de literatura, o desenho, a validação facial e de conteúdo por expertos. Na segunda fase, o questionário aplicou-se duas vezes a 30 enfermeiras e auxiliares de enfermagem com um intervalo de 30 dias para avaliar a confiabilidade. Calculou-se a pontuação total do instrumento e o índice Kappa-Cohen. Resultados: A versão final do questionário tem 30 questões avaliando seis dimensões propostas pelo Instituto Nacional de Medicina Alternativa dos Estados Unidos. Mais do 80% dos participantes teve o 70% das perguntas acertadas, entretanto, a confiabilidade do instrumento foi baixa (Kappa-Cohen <0,60) no 80% dos itens. Conclusão: Este é o primeiro instrumento desenvolvido para aferir conhecimentos sobre terapia não farmacológica para o alivio da dor em enfermeiras e auxiliares de enfermagem na Colômbia, entretanto requer continuar aprimorando a sua confiabilidade e a avaliação da sua validez.

Interventions to alleviate pain are classified in two categories, pharmacological and non/pharmacological; the first ones include the administration of pain relievers and the second ones use complementary therapies. Objective. Design and validate an instrument of measurement to evaluate the level of knowledge about non-pharmacological interventions to manage pain in a group of professional nurses and auxiliary nurses from a health institution in Bucaramanga, Colombia. Materials and Methods: The instrument was developed in two stages: the first stage consisted of the bibliographic research, the design and the facial and content validation by experts. In the second phase, the instrument was applied twice to 30 nurses and auxiliary nurses with an interval of 30 days to evaluate reliability. The total score of the instrument and the Cohen's kappa coefficient were calculated. Results: The final version of the questionnaire contemplates six dimensions proposed by the National Center for Complementary and Integrative Health (NCCIH), with a total of 30 items. More than 80% of the participants had 70% of the answers correct, however, the reliability of this instrument was low (Cohen's kappa < 0.60) in 80% of the items. Conclusion: This is the first instrument designed to measure knowledge about non-pharmacological interventions to alleviate pain for nurses and auxiliary nurses in our country, however, it is required to continue with processes that allow the instrument to improve its reliability and evaluate its validity.

Cardiomyocytes and Macrophages Discourse on the Method to Govern Cardiac Repair.

In response to pathophysiological stress, the cardiac tissue undergoes profound remodeling process that incorporates the elimination of dying resident cells, compensatory hypertrophy of functional cardiomyocytes, growth and remodeling of the vascular compartment and formation of a fibrotic scar. Accumulating evidences indicate that cardiac remodeling is, at least in part, controlled by a complex crosstalk between cardiomyocytes and macrophages. The strategic location of abundant macrophages to the proximity of cardiomyocytes suggest that they could regulate the fate of cardiomyocytes in the injured heart. As such, macrophages appear as critical support cells for cardiomyocytes and play central roles in cardiac hypertrophy, fibrosis and remodeling. Notably, the cardiac tissue expands heterogeneous population of cardiac macrophages through local proliferation of resident macrophage as well as recruitment and differentiation of blood-derived monocytes. It has also been suggested that cardiac-resident macrophages display distinct functional properties from that of monocyte-derived macrophages in cardiac tissue. Furthermore, macrophages are an overflowing source of biological entities with non-canonical roles on cardiac conduction or cardiomyocyte proliferation by regulating action potential diffusion or cardiac cell cycle reentry. Alternatively, stressed cardiomyocytes can trigger the release of a broad repertoire of instructive signals that can regulate macrophage number, skew their phenotype and therefore direct their beneficial or deleterious actions. In this review, we highlight recent discoveries describing how the intricate dialogue between cardiomyocytes and macrophages can shape the deleterious or healing signaling mechanisms in the injured cardiac tissue.

Inhibition of microsomal PGE synthase-1 reduces human vascular tone by increasing PGI2 : a safer alternative to COX-2 inhibition.

BACKGROUND AND PURPOSE: The side effects of cyclooxygenase-2 (COX-2) inhibitors on the cardiovascular system could be associated with reduced prostaglandin (PG)I2 synthesis. Microsomal PGE synthase-1 (mPGES-1) catalyses the formation of PGE2 from COX-derived PGH2 . This enzyme is induced under inflammatory conditions and constitutes an attractive target for novel anti-inflammatory drugs. However, it is not known whether mPGES-1 inhibitors could be devoid of cardiovascular side effects. The aim of this study was to compare, in vitro, the effects of mPGES-1 and COX-2 inhibitors on vascular tone in human blood vessels. EXPERIMENTAL APPROACH: The vascular tone and prostanoid release from internal mammary artery (IMA) and saphenous vein (SV) incubated for 30 min with inhibitors of mPGES-1 or COX-2 were investigated under normal and inflammatory conditions. KEY RESULTS: In inflammatory conditions, mPGES-1 and COX-2 proteins were more expressed, and increased levels of PGE2 and PGI2 were released. COX-2 and NOS inhibitors increased noradrenaline induced vascular contractions in IMA under inflammatory conditions while no effect was observed in SV. Interestingly, the mPGES-1 inhibitor significantly reduced (30-40%) noradrenaline-induced contractions in both vessels. This effect was reversed by an IP (PGI2 receptor) antagonist but not modified by NOS inhibition. Moreover, PGI2 release was increased with the mPGES-1 inhibitor and decreased with the COX-2 inhibitor, while both inhibitors reduced PGE2 release. CONCLUSIONS AND IMPLICATIONS: In contrast to COX-2 inhibition, inhibition of mPGES-1 reduced vasoconstriction by increasing PGI2 synthesis. Targeting mPGES-1 could provide a lower risk of cardiovascular side effects, compared with those of the COX-2 inhibitors. LINKED ARTICLES: This article is part of a themed section on Targeting Inflammation to Reduce Cardiovascular Disease Risk. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.22/issuetoc and http://onlinelibrary.wiley.com/doi/10.1111/bcp.v82.4/issuetoc.

Angiopoietin-1 enhances neutrophil chemotaxis in vitro and migration in vivo through interaction with CD18 and release of CCL4.

Angiopoietins are a family of growth factors that are ligands for the tyrosine kinase receptor, Tie2. Angiopoietin 1 (Ang-1) is agonistic for Tie2, plays a key role in blood vessel maturation and stability and has been shown to possess anti-inflammatory properties. However, Tie2 expression has been demonstrated on human neutrophils and the observation that neutrophils migrate in response to Ang-1 in vitro has confounded research into its exact role in inflammation as well as its potential use as a therapeutic agent. We used a mouse model of peritoneal neutrophilic inflammation to determine if Ang-1 could stimulate neutrophil migration in vivo. Tie2 expression was demonstrated on mouse neutrophils. In addition, recombinant human Ang-1 induced significant chemotaxis of isolated mouse neutrophils in a Tie2- and CD18-dependent manner. Subsequently, co-immunoprecipitation of Ang-1 and CD18 demonstrated their interaction. Intraperitoneal injection of an engineered angiopoietin-1, MAT.Ang-1, induced significant neutrophil migration into the peritoneum and a significant increase in the levels of CCL4 in peritoneal lavage fluid. Depletion of resident peritoneal macrophages prior to, or concomitant injections of an anti-CCL4 antibody with MAT.Ang-1 resulted in a significant reduction in neutrophil recruitment. These data indicate a pro-inflammatory role for Ang-1 with respect to neutrophil recruitment.

Reverse Regulatory Pathway (H2S / PGE2 / MMP) in Human Aortic Aneurysm and Saphenous Vein Varicosity.

Hydrogen sulfide (H2S) is a mediator with demonstrated protective effects for the cardiovascular system. On the other hand, prostaglandin (PG)E2 is involved in vascular wall remodeling by regulating matrix metalloproteinase (MMP) activities. We tested the hypothesis that endogenous H2S may modulate PGE2, MMP-1 activity and endogenous tissue inhibitors of MMPs (TIMP-1/-2). This regulatory pathway could be involved in thinning of abdominal aortic aneurysm (AAA) and thickening of saphenous vein (SV) varicosities. The expression of the enzyme responsible for H2S synthesis, cystathionine-γ-lyase (CSE) and its activity, were significantly higher in varicose vein as compared to SV. On the contrary, the endogenous H2S level and CSE expression were lower in AAA as compared to healthy aorta (HA). Endogenous H2S was responsible for inhibition of PGE2 synthesis mostly in varicose veins and HA. A similar effect was observed with exogenous H2S and consequently decreasing active MMP-1/TIMP ratios in SV and varicose veins. In contrast, in AAA, higher levels of PGE2 and active MMP-1/TIMP ratios were found versus HA. These findings suggest that differences in H2S content in AAA and varicose veins modulate endogenous PGE2 production and consequently the MMP/TIMP ratio. This mechanism may be crucial in vascular wall remodeling observed in different vascular pathologies (aneurysm, varicosities, atherosclerosis and pulmonary hypertension).

LA INVESTIGACIÓN SOBRE EL SÍNDROME DE BURNOUT EN LATINOAMERICA ENTRE 2000 Y EL 2010 / Research on burnout from 2000 to 2010 in Latin America

Con el objetivo de crear un panorama sobre las investigaciones en burnout en América Latina se llevó a cabo una revisión sistemática de 89 estudios, realizados y publicados en revistas científicas, libros y en memorias de eventos científicos en 12 países latinoamericanos entre el 2000 y el 2010. Las bases de datos y buscadores utilizados fueron Science Direct, Scopus, Ebsco, Redalyc, Scielo y Google Académico. En cuanto a los resultados, se evidencia la tendencia al uso de los planteamientos conceptuales y los instrumentos elaborados por Maslach y Jackson, seguidos por los del investigador español Pedro Gil-Monte. Los diseños de las investigaciones son descriptivos-correlaciones. Se presentan validaciones de instrumentos, en su mayoría en profesiones asistenciales. Se concluye que, en la mayoría de estudios, se hizo uso de teorías y métodos de evaluación creados en países "desarrollados", industrializados, sin la reflexión acerca de la especificidad de los procesos de trabajo propios del contexto latinoamericano.

In order to create an overview of research in Latin America burnout, we make a systematic review of 89 studies, that have been published in scientific journals, books and reports of scientific events in Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Mexico, Peru, Uruguay, Dominican Republic and Venezuela, from 2000 year to 2010; a high percentage of research methodological approaches used in the conceptual approaches and the instrument developed by Maslach and Jackson, followed by Pedro Gil -Monte. The designs of the research are descriptive - correlations. Some research conducted validation of instruments, mostly in caring professions. It is concluded that, in most of the research was done using theories and testing methods created in "developed", industrialized countries without reflection on the specificity of their own work processes in the Latin American context.

[Tuberculosis and drug-resistance tuberculosis in prisoners. Colombia, 2010-2012]. / Tuberculosis y tuberculosis farmacorresistente en personas privadas de la libertad. Colombia, 2010-2012.

OBJECTIVE: To characterize tuberculosis drug-resistance using anti-tuberculosis drug-sensitivity tests in Colombian prisoners. METHODS: Descriptive-retrospective analyses were performed on cases of tuberculosis in prisoners. Samples were evaluated by the National Reference Laboratory. Conditions like gender, TB/VIH co-infection and drug-resistance were evaluated. RESULTS: Anti-tuberculosis drug-sensitivity tests were carried out on 72 prisoners. Results showed a distribution of 90.7 % of cases in males and 9.3 % of cases in females. 12 % of cases were TB/VIH co-infections, 94 % of the cases had not received any anti-tuberculosis treatment before, six isolates were drug-resistant corresponding to 8.8 % of total cases, and two cases were multi drug-resistant representing 1.3 % of the cases. Of the drug-resistant cases, 83.3 % were TB/VIH co-infected. Previously treated cases corresponded to 5.6 % of the total cases analyzed. One case with TB/VIH co-infection and rifampicin resistance was observed, representing 1.3 % of the total cases. CONCLUSION: The government must create a clear policy for prisoners in Colombia, because a high rate of disease in prisoners was observed. In addition, the results showed an association between drug-resistance and TB/VIH co-infection. Overcrowding and low quality of life in penitentiaries could become an important public health problem.

Tuberculosis y tuberculosis farmacorresistente en personas privadas de la libertad. Colombia, 2010-2012 / Tuberculosis and drug-resistance tuberculosis in prisoners. Colombia, 2010-2012

Objetivo Caracterizar los casos de tuberculosis farmacorresistente mediante pruebas de susceptibilidad a los fármacos antituberculosos en personas privadas de la libertad en Colombia. Materiales y Métodos Se realizó un análisis descriptivo retrospectivo de los casos de tuberculosis en personas privadas de la libertad procesados por el Laboratorio Nacional de Referencia, evaluando las variables de; sexo, edad, procedencia, coinfección TB/VIH y presencia de farmacorresistencia. Resultados Se realizaron pruebas de susceptibilidad a fármacos antituberculosos a un total de 72 pacientes privados de la libertad. El estudio mostro una distribución de 90,7 % en población masculina y 9,3 % femenina, el 12 % del total de casos presento infección concomitante TB/VIH, el 94 % de los pacientes evaluados no habían tomado tratamiento antituberculoso previo, seis casos presentaron farmacorresistencia que corresponde al 8,8 % y dos casos presentaron tuberculosis multirresistente con un 1,3 %. De los casos farmacorresistentes el 83,3 % presento coinfección con VIH. Los casos antes tratados comprenden el 5,6 % del total evaluado, y se observó el caso con coinfeccion TB/VIH con resistencia a rifampicina correspondiente al 1,3 %. Conclusión El país debe definir una política clara en el tema de tuberculosis en personas privadas de la libertad debido a que se presenta una alta tasa de la enfermedad y se evidencia que la resistencia a los fármacos antituberculosos se asocia a coinfección TB/VIH, que en las condiciones de hacinamiento y poca calidad de vida de estos lugares se pueden convertir en un grave problema de salud pública.

Objective To characterize tuberculosis drug-resistance using anti-tuberculosis drug-sensitivity tests in Colombian prisoners. Methods Descriptive-retrospective analyses were performed on cases of tuberculosis in prisoners. Samples were evaluated by the National Reference Laboratory. Conditions like gender, TB/VIH co-infection and drug-resistance were evaluated. Results Anti-tuberculosis drug-sensitivity tests were carried out on 72 prisoners. Results showed a distribution of 90.7 % of cases in males and 9.3 % of cases in females. 12 % of cases were TB/VIH co-infections, 94 % of the cases had not received any anti-tuberculosis treatment before, six isolates were drug-resistant corresponding to 8.8 % of total cases, and two cases were multi drug-resistant representing 1.3 % of the cases. Of the drug-resistant cases, 83.3 % were TB/VIH co-infected. Previously treated cases corresponded to 5.6 % of the total cases analyzed. One case with TB/VIH co-infection and rifampicin resistance was observed, representing 1.3 % of the total cases. Conclusion The government must create a clear policy for prisoners in Colombia, because a high rate of disease in prisoners was observed. In addition, the results showed an association between drug-resistance and TB/VIH co-infection. Overcrowding and low quality of life in penitentiaries could become an important public health problem.

Evaluación de la técnica BD MGITTM TBc® para identificación del complejo Mycobacterium tuberculosis / Evaluation of the BD MGITTM technique for identifying the Mycobacterium tuberculosis complex

Objetivo Evaluar la técnica BD MGITTM TBc® para identificación del complejo Mycobacterium tuberculosis a partir de aislamientos en medio de cultivo sólido y líquido. Materiales y Métodos Se desarrolló un estudio descriptivo, donde se analizaron 117 aislamientos por la técnica de inmucromatografía a partir de cultivos en medio sólido y líquido para identificación del complejo Mycobacterium tuberculosis. Se calculó coeficiente kappa para determinar el grado de acuerdo entre los dos métodos. Cuando hubo diferencia de resultados estos se confirmaron mediante pruebas convencionales. La herramienta empleada para el análisis de datos fue Epidat 3.1. Resultados La metodología BD MGITTM TBc® realizada a partir de cultivos en medio sólido y líquido, presentó un grado de acuerdo excelente con un coeficiente kappa de 0,84. Conclusión La técnica BD MGITTM TBc® realizada a partir de cultivos en medio sólido, para la identificación del complejo Mycobacterium tuberculosis, presenta excelente concordancia, comparada con los resultados obtenidos en medio de cultivo líquido. El Laboratorio Nacional de Referencia recomienda el uso de esta técnica para la identificación de especie en medio de cultivos sólidos.(AU)

Objetive To evaluate BD MGITTM TBc® technique for identifying the Mycobacterium tuberculosis complex using isolates obtained in liquid and solid media. Methods A descriptive study was conducted in which 117 isolates were analyzed by the immune-chromatography technique obtained from solid and liquid cultures to identify the Mycobacterium tuberculosis complex. The kappa coefficient was calculated to determine the degree of agreement between the two methods .When there were different results, they were confirmed with a conventional test. The tool used to analyze the data was Epidat 3.1 Results The BD MGITTM TBc® methodology performed in solid and liquid culture isolates, showed an excellent degree of agreement with a kappa coefficient 0.84. Conclusion The BD MGITTM TBc® technique using solid media culture isolates for the identification of the Mycobacterium tuberculosis complex has a good correlation compared to results obtained from liquid media culture isolates. The Reference National Laboratory recommends the use of this technique for the identification of species in solid media culture isolates.(AU)

La comunicación en tres casos de acoso laboral / Comunication in three cases of mobbing

La investigación tuvo como objetivo identificar elementos y dinámicas de la comunicación, relacionados con la interrupción, distorsión o ruptura de esta, también la descalificación y desacreditación, la denigración e insinuaciones hostiles y la ruptura de los contactos sociales en tres casos de acoso laboral; se partió de un abordaje cualitativo de tipo exploratorio descriptivo. Se aplicó una entrevista semiestructurada construida a partir de categorías de análisis previamente establecidas a los tres participantes quienes habían cumplido con los criterios para acoso laboral, de acuerdo al Cuestionario Leymann (LIPT: Leymann Inventory of Psychological Terror). Durante las entrevistas emergió la categoría estrategias de afrontamiento como elemento relevante para el manejo de la problemática. Se encontró que la comunicación se caracteriza por ser una comunicación verbal abusiva que no queda registrada en ningún soporte físico, salvo en los registros internos y emocionales de las personas que los experimentan y que en las organizaciones las comunicaciones interpersonales y grupales han llegado a niveles precarios en los que predomina la agresividad verbal y no verbal, el aislamiento y la falta de intervención efectiva por parte de instancias de dirección.

The research aimed to identify elements and dynamics of communication related to the interruption, distortion or breakdown of communication, disqualification and decertification, vilification and hostile overtones and rupture of the social in three cases of workplace harassment contacts; the design was a descriptive exploratory qualitative approach. A semi-structured interview was applied, built from previously established categories of analysis, to three participants meeting the criteria for workplace harassment on the LIPT (Leymann Inventory of Psychological Terror). During interviews, the coping strategies category emerged as a relevant element for the management of the problem. Communication was found to be abusive verbal communication that is not recorded in any medium, except in emotional and internal records of people who experience it. Interpersonal and group communications have become precarious, with dominant verbal and non-verbal aggressiveness, isolation and lack of effective intervention by management.

Decreased PGE2 content reduces MMP-1 activity and consequently increases collagen density in human varicose vein.

UNLABELLED: Varicose veins are elongated and dilated saphenous veins. Despite the high prevalence of this disease, its pathogenesis remains unclear. AIMS: In this study, we investigated the control of matrix metalloproteinases (MMPs) expression by prostaglandin (PG)E2 during the vascular wall remodeling of human varicose veins. METHODS AND RESULTS: Varicose (small (SDv) and large diameter (LDv)) and healthy saphenous veins (SV) were obtained after surgery. Microsomal and cytosolic PGE-synthases (mPGES and cPGES) protein and mRNA responsible for PGE2 metabolism were analyzed in all veins. cPGES protein was absent while its mRNA was weakly expressed. mPGES-2 expression was similar in the different saphenous veins. mPGES-1 mRNA and protein were detected in healthy veins and a significant decrease was found in LDv. Additionally, 15-hydroxyprostaglandin dehydrogenase (15-PGDH), responsible for PGE2 degradation, was over-expressed in varicose veins. These variations in mPGES-1 and 15-PGDH density account for the decreased PGE2 level observed in varicose veins. Furthermore, a significant decrease in PGE2 receptor (EP4) levels was also found in SDv and LDv. Active MMP-1 and total MMP-2 concentrations were significantly decreased in varicose veins while the tissue inhibitors of metalloproteinases (TIMP -1 and -2), were significantly increased, probably explaining the increased collagen content found in LDv. Finally, the MMP/TIMP ratio is restored by exogenous PGE2 in varicose veins and reduced in presence of an EP4 receptor antagonist in healthy veins. CONCLUSIONS: In conclusion, PGE2 could be responsible for the vascular wall thickening in human varicose veins. This mechanism could be protective, strengthening the vascular wall in order to counteract venous stasis.

[Evaluation of the BD MGITTM technique for identifying the Mycobacterium tuberculosis complex]. / Evaluación de la técnica BD MGITTM TBc® para identificación del complejo Mycobacterium tuberculosis.

OBJECTIVES: To evaluate BD MGITTM TBc® technique for identifying the Mycobacterium tuberculosis complex using isolates obtained in liquid and solid media. METHODS: A descriptive study was conducted in which 117 isolates were analyzed by the immune-chromatography technique obtained from solid and liquid cultures to identify the Mycobacterium tuberculosis complex. The kappa coefficient was calculated to determine the degree of agreement between the two methods .When there were different results, they were confirmed with a conventional test. The tool used to analyze the data was Epidat 3.1 RESULTS: The BD MGITTM TBc® methodology performed in solid and liquid culture isolates, showed an excellent degree of agreement with a kappa coefficient 0.84. CONCLUSION: The BD MGITTM TBc® technique using solid media culture isolates for the identification of the Mycobacterium tuberculosis complex has a good correlation compared to results obtained from liquid media culture isolates. The Reference National Laboratory recommends the use of this technique for the identification of species in solid media culture isolates.

A comparative study of PGI2 mimetics used clinically on the vasorelaxation of human pulmonary arteries and veins, role of the DP-receptor.

Prostacyclin (PGI2) and its mimetics (iloprost, treprostinil, beraprost and MRE-269) are potent vasodilators (via IP-receptor activation) and a major therapeutic intervention for pulmonary hypertension (PH). These PGI2 mimetics have anti-proliferative and potent vasodilator effects on pulmonary vessels. We compared the relaxant effects induced by these recognized IP-agonists in isolated human pulmonary arteries (HPA) and veins (HPV). In addition, using selective antagonists, the possible activation of other prostanoid relaxant receptors (DP, EP4) was investigated. Iloprost and treprostinil were the more potent relaxant agonists when both vessels were analyzed. HPA were significantly more sensitive to iloprost than to treprostinil, pEC50 values: 7.94±0.06 (n=23) and 6.73±0.08 (n=33), respectively. In contrast, in HPV these agonists were equipotent. The relaxations induced by treprostinil were completely or partially inhibited by IP-antagonists in HPA or HPV, respectively. The effects of the IP-agonists were not significantly modified by the EP4 antagonist. Finally, DP-antagonists inhibited the relaxations induced by treprostinil in HPV, suggesting that the DP-receptor plays a role in treprostinil-induced relaxation in the HPV. These data suggest that iloprost and treprostinil should be the most effective clinically available agonists to decrease pulmonary vascular resistance and to prevent oedema formation (by similar decrease in HPA and HPV resistance) in PH patients.

Control of human vascular tone by prostanoids derived from perivascular adipose tissue.

Perivascular adipose tissue (PVAT) surrounds most vessels and has now been recognized as a regulator of vascular functions. This effect of PVAT has been mostly demonstrated in vessels obtained from rats and mice. Thus, the aim of this study was to investigate anti-contractile effect of PVAT surrounding human coronary bypass grafts such as saphenous vein (SV) and internal mammary artery (IMA). Moreover, we aimed to determine the involvement of prostanoids in the anticontractile effect of PVAT. Human SV and IMA preparations were set up in an organ bath. The presence of PVAT in SV and IMA preparations significantly attenuated the contractile response to noradrenaline (NA). Preincubation with indomethacin, a cyclooxygenase inhibitor, increased NA contraction in SV preparations with PVAT. This effect was not observed in IMA preparation with PVAT incubated with indomethacin. The lower measurements of prostaglandin E2 (PGE2) released from PVAT surrounding IMA versus SV supported these effects. In conclusion, our results show that PVAT of SV could attenuate NA-induced contraction by releasing both PGE2 and prostacyclin (PGI2). In contrast to SV, PVAT of IMA exerts its anti-contractile effect independently from prostanoids. These observations suggest that retaining PVAT in human SV and IMA preparations may have potential clinical implications to improve coronary bypass graft patency.