ABSTRACT
RESUMEN Introducción: el portador de insuficiencia renal crónica puede presentar diversas alteraciones del estado ácido básico, siendo la acidosis metabólica la más frecuente. Objetivos: describir las características demográficas y clínicas y las alteraciones del estado ácido básico de pacientes adultos que ingresan con insuficiencia renal crónica en dos centros hospitalarios del Paraguay. Metodología: se aplicó un diseño observacional, descriptivo, transversal. Se incluyó a sujetos adultos de ambos sexos, portadores de insuficiencia renal crónica, que acudieron al Hospital Nacional (Itauguá) y Hospital Militar (Asunción) entre abril y noviembre del 2021. Se midieron variables antropométricas, clínicas y laboratoriales al ingreso. Los datos se sometieron a estadística descriptiva con el programa Epi Info 7™. El estudio contó con la aprobación del Comité de Ética de la Universidad Privada del Este, Paraguay. Resultados: se incluyó a 148 sujetos, siendo 78 (52,7 %) varones con edad media 58 ± 16 años y 70 (47,3 %) mujeres con edad media 54 ± 17 años. Las etiologías más frecuentes de la insuficiencia renal crónica fueron la diabetes mellitus e hipertensión arterial (44,5 %). Se detectó 12 sujetos (8,1 %) con gasometría normal. La alteración del estado ácido básico más frecuente fue la acidosis metabólica (87,2 %), predominando en este grupo los casos con brecha aniónica normal. Conclusiones: las alteraciones del estado ácido básico predominantes en pacientes con insuficiencia renal crónica fue la acidosis metabólica con brecha aniónica normal. Se sugiere aplicar los cálculos de los mecanismos compensadores para llegar al diagnóstico certero de estas alteraciones metabólicas.
ABSTRACT Introduction: the carrier of chronic renal failure can present various alterations of the basic acid state, being the metabolic acidosis the most frequent. Objectives: to describe the demographic and clinical characteristics and alterations in the acid-base status of adult patients admitted with chronic renal failure in two hospitals in Paraguay. Methodology: an observational, descriptive, cross-sectional design was applied. Adult subjects of both sexes, carriers of chronic renal failure, who attended the National Hospital (Itauguá) and the Military Hospital (Asunción) between April and November 2021 were included. Anthropometric, clinical and laboratory variables were measured at admission. The data was submitted to descriptive statistics with the Epi Info 7™ program. The study was approved by the Ethics Committee of the Universidad Privada del Este, Paraguay. Results: 148 subjects were included, being 78 (52.7 %) men with a mean age of 58 ± 16 years and 70 (47.3 %) women with a mean age of 54 ± 17 years. The most frequent etiologies of chronic renal failure were diabetes mellitus and arterial hypertension (44.5 %). 12 subjects (8.1 %) with normal blood gases were detected. The most frequent alteration of the acid-base status was metabolic acidosis (87.2 %), with cases with normal anion gap predominating in this group. Conclusions: the predominant acid-base status alterations in patients with chronic renal failure was metabolic acidosis with normal anion gap. It is suggested to apply the calculations of the compensatory mechanisms to arrive at the accurate diagnosis of these metabolic alterations.
ABSTRACT
RESUMO O presente artigo analisou possíveis contribuições da Teoria Ator-Rede (TAR) e da obra de Bruno Latour para se pensar o social na Educação Física. Como metodologia, foi feito um estudo teórico, de característica exploratória, de parte da obra latouriana e da TAR, bem como de textos que tratam do social na Educação Física, para uma reflexão sobre possíveis contribuições da TAR em direção a uma guinada do olhar analítico sobre o social na Educação Física. A partir de nossa análise, constatamos que a TAR e a obra latouriana podem trazer uma análise dinâmica e menos determinista sobre as associações que compõe a Educação Física, reconhecendo os diversos participantes heterogêneos (humanos e não-humanos) que compõe as redes de associações constituintes desta área.
ABSTRACT This article analyzed possible contributions of the Actor-Network theory (ANT) and the work of Bruno Latour to think about the social in Physical Education. As a methodology, a theoretical study was made, of exploratory characteristic, of part of the Latour's work and ANT, as well as texts dealing with the social in Physical Education, for a reflection on possible contributions of ANT towards a turn of the analytical view on the social in Physical Education. From our analysis, we found that ANT and Latour's work can bring a dynamic and less deterministic look at the associations that compose Physical Education, recognizing the various heterogeneous participants (human and non-human) who compose the networks of associations that are constituent of this area.
RESUMEN Este artículo analizó las posibles contribuciones de la teoría Actor-Red (TAR) y el trabajo de Bruno Latour para pensar sobre lo social en Educación Física. Como metodología, se realizó un estudio teórico, de carácter exploratorio, de parte del trabajo Latouriana y TAR, así como textos que tratan de lo social en Educación Física, para una reflexión sobre posibles aportes de TAR hacia un giro de la visión analítica sobre lo social en Educación Física. A partir de nuestro análisis, encontramos que la TAR y el trabajo de Bruno Latour puede aportar una mirada dinámica y menos determinista a las asociaciones que componen la Educación Física, reconociendo los diversos participantes heterogéneos (humanos y no humanos) que componen las redes de asociaciones que son constitutivas de esta área.
ABSTRACT
The development of carbapenem resistance in extraintestinal pathogenic Escherichia coli (ExPEC) has significant clinical implications, particularly in countries where second-line antimicrobials are not readily available, rendering treatments ineffective, and ExPEC infections untreatable. Thus, early detection of high-risk ExPEC lineages and raising awareness of the specific mechanisms underlying carbapenem resistance are mandatory for the selection of appropriate treatment options and the prevention of E. coli spread. This study aims to investigate the phenotypic and genotypic features of the first NDM-5 carbapenemase-producing ExPEC strain isolated from the blood of a patient admitted to the Maputo Central Hospital (MCH), in Mozambique. E. coli SSM100 isolate was identified by MALDI-TOF, it displayed high-level resistance to third generation cephalosporins, carbapenems, fluoroquinolones, and aminoglycosides, performing antimicrobial susceptibilities testing by VITEK 2 system. E. coli SSM100 isolate was classified through whole-genome sequencing as ST405-D-O102: H6, a globally distributed lineage associated with antimicrobial resistance, carrying the blaNDM-5 gene located on an F1:A1:B49 plasmid, coharboring blaCTX-M-15, blaTEM-1, aadA2, sul1, and dfrA12 genes. In addition, mutations in gyrA (S83L and D87N), parC (S80I and E84V), and parE (I529L) conferring fluoroquinolone resistance were also found. Moreover, SSM100 isolate carried 88 virulence genes, of which 28 are reported to be associated with UPEC. The emergence of NDM-5 carbapenemase in a pandemic ST405-D-O102:H6 clone in Mozambique is of great concern. Locations of extended-spectrum ß-lactamase determinants and NDM-5 carbapenemase gene on IncF-plasmid can increase their spread reinforcing the need for antimicrobial surveillance and the urgent introduction of carbapenemase detection tests in diagnostic laboratories of the country.