ABSTRACT
RESUMEN Introducción: la cirrosis hepática de etiología viral representa un impactante problema de salud a nivel mundial, no solo por su elevada tasa de prevalencia, sino por los costos generados en la atención médica. Objetivos: determinar el comportamiento de los pacientes cirróticos, de etiología viral, en la provincia de Matanzas. Materiales y métodos: se realizó un estudio descriptivo-retrospectivo en 47 pacientes con cirrosis hepática de etiología viral, atendidos en el Servicio de Gastroenterología del Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas, de enero de 2016 a enero de 2018. Los resultados de las variables analizadas se expusieron en tablas de doble entrada. Resultados: el 68,1 % de los pacientes correspondió a cirrosis por virus C. Predominaron los mayores de 50 años, con carga viral entre 4-6,9 log10, y atendidos en régimen ambulatorio. En el 57,4 % se detectaron signos endoscópicos de hipertensión portal, que se corroboraron en el doppler hepático. La ascitis asociada a diferentes sepsis fueron las complicaciones más registradas. El 55,4 % fue clasificado como Child-Pugh A, y el 76,6 % en etapa clínica compensada. Conclusiones: el diagnóstico y seguimiento de la cirrosis hepática viral sigue siendo un verdadero reto para la comunidad médica. De ahí los esfuerzos que han de realizarse para su control desde las fases compensadas, para retardar la aparición de complicaciones (AU).
ABSTRACT Introduction: viral etiology liver cirrhosis is an impacting health problem around the world, not only because of its high prevalence rate but also because of the costs generated by its medical care. Objective: to determine the behavior of the patients with viral etiology liver cirrhosis in the province of Matanzas. Materials and methods: a descriptive-retrospective study was carried out in 47 patients with viral etiology liver cirrhosis treated in the service of Gastroenterology of the Hospital "Comandante Faustino Perez" of Matanzas, from January 2016 to January 2018. The results of the analyzed variables were shown in double-entry tables. Results: 68.1% of the patients presented cirrhosis caused by C virus, Patients elder 50 years old predominated, with 4-6.9 log10, treated in ambulatory regimen. Endoscopic signs of portal hypertension were found in 57.4%. It was corroborated with liver Doppler. Ascites associated to different sepsis were the most frequently registered complications. 55.4% were classified as Child-Pugh A, and 76.6% were in compensated clinical stage. Conclusions: viral liver cirrhosis diagnosis and follow-up is still a true challenge for the medical community, and hence the efforts that should be made to control it from the compensated stages to delay the appearance of complications (AU).
Subject(s)
Humans , Male , Female , Virus Diseases/etiology , Liver Cirrhosis/etiology , Global Health/standards , Chronic Disease/epidemiology , Liver Cirrhosis/diagnosis , Liver Cirrhosis/epidemiology , Liver Diseases/complications , Liver Diseases/diagnosisABSTRACT
Uncontrolled diabetes results in several metabolic alterations including hyperglycemia. Indeed, several preclinical and clinical studies have suggested that this condition may induce susceptibility and the development of more aggressive infectious diseases, especially those caused by some bacteria (including Chlamydophila pneumoniae, Haemophilus influenzae, and Streptococcus pneumoniae, among others) and viruses [such as coronavirus 2 (CoV2), Influenza A virus, Hepatitis B, etc.]. Although the precise mechanisms that link glycemia to the exacerbated infections remain elusive, hyperglycemia is known to induce a wide array of changes in the immune system activity, including alterations in: (i) the microenvironment of immune cells (e.g., pH, blood viscosity and other biochemical parameters); (ii) the supply of energy to infectious bacteria; (iii) the inflammatory response; and (iv) oxidative stress as a result of bacterial proliferative metabolism. Consistent with this evidence, some bacterial infections are typical (and/or have a worse prognosis) in patients with hypercaloric diets and a stressful lifestyle (conditions that promote hyperglycemic episodes). On this basis, the present review is particularly focused on: (i) the role of diabetes in the development of some bacterial and viral infections by analyzing preclinical and clinical findings; (ii) discussing the possible mechanisms by which hyperglycemia may increase the susceptibility for developing infections; and (iii) further understanding the impact of hyperglycemia on the immune system.
Subject(s)
Bacterial Infections/etiology , COVID-19/etiology , Diabetes Complications/immunology , Diabetes Complications/physiopathology , Disease Susceptibility , Hyperglycemia/complications , Virus Diseases/etiology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle AgedABSTRACT
Background: The introduction of any infectious agent into an industrial or subsistence farm worries agribusiness owners in Brazilbecause it reduces product quality and increases treatment costs, although most diseases are untreatable, thus causing economic losseswith morbidity and mortality. Therefore, an epidemiological survey of viral diseases associated with poultry was developed by performing a detailed description of the risk factors that may be related to existing diseases using domestic poultry sample data recordedin the Regional Diagnostic Laboratory (LRD) of College of Veterinary Medicine of the Federal University of Pelotas (UFPel), RioGrande do Sul, Brazil, from 2000 to 2016.Materials, Methods & Results: Epidemiological and clinical-pathological data were collected and then compared with disease databy multivariate analysis using statistical EpiInfo version 6.04 and Microsoft Office Excel 2010 software. The frequencies and 95%confidence intervals (CI), association measures (odds ratio=OR and relative risk=RR), Chi-square test, and the results consideredsignificant with a value of P ≤ 0.05 were described. A total of 410 samples of domestic poultry were tested, and the results showed66 (16.1%) viral diseases. The following conditions were the most commonly found diseases in this study: Mareks disease (42.4%),Infectious bursal disease (31.8%), Avian leukosis (16.6%), Avian pox (7.5%) and Avian infectious bronchitis (1.5%). In this articlewe discuss the most frequent viral diseases: Mareks disease (DM) and Gumboro disease. It was also possible to conclude that birdswith Mareks disease presented higher odds of developing nerve, tegumentary and locomotors signs (P ≤ 0.05). As well as, morelikely to present tumoriform lesions in the liver, spleen, kidneys and heart P ≤ 0.05, as well as lesions in the proventriculus, musclelesions and in the sciatic nerve P ≤ 0.05. Laying poultry...(AU)
Subject(s)
Animals , Poultry/virology , Risk Factors , Virus Diseases/epidemiology , Virus Diseases/etiology , Virus Diseases/veterinary , Marek Disease , Infectious bursal disease virus , Avian Leukosis , Fowlpox , Infectious bronchitis virusABSTRACT
Background: The introduction of any infectious agent into an industrial or subsistence farm worries agribusiness owners in Brazilbecause it reduces product quality and increases treatment costs, although most diseases are untreatable, thus causing economic losseswith morbidity and mortality. Therefore, an epidemiological survey of viral diseases associated with poultry was developed by performing a detailed description of the risk factors that may be related to existing diseases using domestic poultry sample data recordedin the Regional Diagnostic Laboratory (LRD) of College of Veterinary Medicine of the Federal University of Pelotas (UFPel), RioGrande do Sul, Brazil, from 2000 to 2016.Materials, Methods & Results: Epidemiological and clinical-pathological data were collected and then compared with disease databy multivariate analysis using statistical EpiInfo version 6.04 and Microsoft Office Excel 2010 software. The frequencies and 95%confidence intervals (CI), association measures (odds ratio=OR and relative risk=RR), Chi-square test, and the results consideredsignificant with a value of P ≤ 0.05 were described. A total of 410 samples of domestic poultry were tested, and the results showed66 (16.1%) viral diseases. The following conditions were the most commonly found diseases in this study: Mareks disease (42.4%),Infectious bursal disease (31.8%), Avian leukosis (16.6%), Avian pox (7.5%) and Avian infectious bronchitis (1.5%). In this articlewe discuss the most frequent viral diseases: Mareks disease (DM) and Gumboro disease. It was also possible to conclude that birdswith Mareks disease presented higher odds of developing nerve, tegumentary and locomotors signs (P ≤ 0.05). As well as, morelikely to present tumoriform lesions in the liver, spleen, kidneys and heart P ≤ 0.05, as well as lesions in the proventriculus, musclelesions and in the sciatic nerve P ≤ 0.05. Laying poultry...
Subject(s)
Animals , Poultry/virology , Risk Factors , Virus Diseases/epidemiology , Virus Diseases/etiology , Virus Diseases/veterinary , Marek Disease , Avian Leukosis , Fowlpox , Infectious bronchitis virus , Infectious bursal disease virusABSTRACT
Fundamento: las infecciones respiratorias agudas constituyen la causa principal de morbilidad a nivel mundial, al ser sus principales agentes etiológicos los virus respiratorios. Objetivo: determinar el papel de diferentes virus respiratorios en la causa de la infección respiratoria aguda grave durante el período mayo 2012 - junio 2013, en Cuba. Métodos: se realizó un estudio analítico transversal, el universo fueron las muestras clínicas recibidas en el Laboratorio Nacional de Referencia (LNR) de Virus Respiratorios del Instituto de Medicina Tropical Pedro Kourí (IPK) como parte de la vigilancia de las IRA de posible etiología viral, desde el 1 de mayo de 2012 y el 30 de junio de 2013. . Para el diagnóstico se emplearon tres ensayos de TR-RCP múltiple de tipo anidado y un TR-RCP en tiempo real.Resultados: los rinovirus fueron los agentes más identificados, seguidos de los virus Influenza y del virus sincitial respiratorio. Los de mayor frecuencia en los pacientes con infección respiratoria aguda grave fueron los virus Influenza se demostró asociación significativa (OR 6,437; 95 porciento IC: 3,407-12,159; p=0,000) y en los pacientes <1 año se encontró también asociación con la detección del virus sincitial respiratorio; hubo correlación también en la población de 15-59 años con los virus Influenza (p=0,000). El virus Influenza B circuló entre los meses de mayo y septiembre del año 2012, mientras que el virus Influenza A (H1N1) pdm09 predominó en la circulación durante el 2013. Conclusiones: los resultados de esta investigación permiten esclarecer la contribución específica de los diferentes virus respiratorios en la causa de dicha enfermedad. Al mismo tiempo alertan a los programas nacionales la necesidad de centralizar los esfuerzos de la vigilancia en este tipo de infección para la identificación oportuna de eventos de salud inusitados por los virus Influenza (AU)
Background: acute respiratory infections are the main cause of mortality and morbidity worldwide, with respiratory viruses as main causative agents. Objective:to determine the paper of different respiratory viruses in the etiology of the severe acute respiratory infections during the period May 2012- June 2013, in Cuba. Methods:a transverse analytical study was carried out, the universe there were the clinical samples received in the National Laboratory of Reference (LNR) of Respiratory Viruses of the Institute of Tropical Medicine Pedro Kourí (IPK) as part of the alertness of the IRA of possible viral etiology, from May 1, 2012 and June 30, 2013. There were studied 1 604 samples proceeding from patients of all the ages with clinical declarations. For the diagnosis, there were used three essays of multiple TR-RCP of sheltered type and a TR-RCP in real-time. Results: rhinoviruses were the agents largely identified, followed by the Influenza viruses and the respiratory syncytial virus. The ones of bigger frequency in patients with severe acute respiratory infection were Influenza viruses demonstrating significant association (OR 6,437; 95 percent CI: 3,407-12,159; p= 0,000) and in patients <1 year old it was also found association with the detection of respiratory syncytial virus; correlation was also in the population of 15-59 years with the viruses Influenza (p= 0,000). The Influenza virus B circulated mainly between the months of May and September of the year 2012, while the virus Influenza A (H1N1) pdm09 predominated during 2013. Conclusions:the results of this investigation allow explaining thespecific contribution of the different respiratory viruses in the etiology of said pathology. At the same time, they alert the national programs of the need to centralize the efforts in vigilance of this type of infection to achieve opportune identification of health events unusual for the viruses Influenza (AU)
Subject(s)
Humans , Respiratory Tract Diseases/etiology , Respiratory Tract Infections/etiology , Virus Diseases/etiology , Analytical Epidemiology , Cross-Sectional StudiesABSTRACT
INTRODUCTION: The development of biologic therapies for treating patients with rheumatic, hematologic, or oncological diseases has increased in the last few years, spreading their use in clinical practice. Areas covered: Clinical experience has evidenced substantial risks for some viral infections and/or reactivations such as viral hepatitis, herpetic infections, and other viruses, as a consequence of specific immune pathway blockages. Biological therapies produce a variable risk of reactivation of viral infections, which is particularly uncertain in the case of the most recently introduced agents. Here we make an extensive review of the viral infections associated with the use of biological drugs and provide a series of recommendations for its prevention and management. Expert commentary: To prevent these infections/reactivations, the practitioner must be aware of the infection-risk profile, performing accurate screening during and after the use of any biologic agent. In some instances, expert recommendations are made for some therapies, while in other scenarios recommendations have not yet been defined making experimental and clinical research an essential approach to elucidate multiple issues yet not resolved in this field.
Subject(s)
Biological Products/administration & dosage , Biological Therapy/adverse effects , Virus Diseases/epidemiology , Biological Products/adverse effects , Biological Therapy/methods , Humans , Mass Screening/methods , Virus Activation , Virus Diseases/etiology , Virus Diseases/prevention & controlABSTRACT
Vitamin D (VD) is a fat-soluble steroid essential for life in higher animals. It is technically a pro-hormone present in few food types and produced endogenously in the skin by a photochemical reaction. In recent decades, several studies have suggested that VD contributes to diverse processes extending far beyond mineral homeostasis. The machinery for VD production and its receptor have been reported in multiple tissues, where they have a pivotal role in modulating the immune system. Similarly, vitamin D deficiency (VDD) has been in the spotlight as a major global public healthcare burden. VDD is highly prevalent throughout different regions of the world, including tropical and subtropical countries. Moreover, VDD may affect host immunity leading to an increased incidence and severity of several infectious diseases. In this review, we discuss new insights on VD physiology as well as the relationship between VD status and various infectious diseases such as tuberculosis, respiratory tract infections, human immunodeficiency virus, fungal infections and sepsis. Finally, we critically review the latest evidence on VD monitoring and supplementation in the setting of infectious diseases.
Subject(s)
Bacterial Infections/etiology , Virus Diseases/etiology , Vitamin D Deficiency , Vitamin D/biosynthesis , Vitamin D/pharmacology , Dietary Supplements , Humans , Vitamin D/administration & dosage , Vitamin D/chemistryABSTRACT
Nowadays, the metagenomic approach has been a very important tool in the discovery of new viruses in environmental and biological samples. Here we discuss how these discoveries may help to elucidate the etiology of diseases and the criteria necessary to establish a causal association between a virus and a disease.
Subject(s)
Metagenomics , Virus Diseases/etiology , Viruses/genetics , Causality , Humans , Viruses/isolation & purificationABSTRACT
Introdução: Os pacientes com diagnóstico de artrite reumatoide (AR) apresentam risco aumentado de infecções. A vacinação é uma medida preventiva recomendada. Não há estudos avaliando a prática da vacinação nos pacientes com AR inicial. Objetivos: Avaliar a frequência de vacinação e a orientação (feita pelo médico) sobre vacinas entre os pacientes com diagnóstico de AR inicial. Métodos: Estudo transversal incluindo pacientes da coorte Brasília de AR inicial. Foram analisados dados demográficos, índice de atividade da doença (Disease Activity Score 28 - DAS28), incapacidade funcional (Health Assessment Questionnaire - HAQ), dados sobre tratamento e vacinação após o diagnóstico da AR. Resultados: Foram avaliados 68 pacientes, sendo 94,1% mulheres, com idade média de 50,7 ± 13,2 anos. O DAS28 foi de 3,65 ± 1,64, e o HAQ de 0,70. A maioria dos pacientes (63%) possuía cartão vacinal. Apenas cinco pacientes (7,3%) foram orientados pelo médico sobre uso das vacinas. Os pacientes foram vacinados para tríplice viral (8,8%), tétano (44%), febre amarela (44%), hepatite B (22%), gripe (42%), influenza H1N1 (61,76%), pneumonia (1,4%), meningite (1,4%) e varicela (1,4%). Todos os pacientes vacinados com vírus vivo atenuado estavam em uso de imunossupressores e receberam as vacinas de forma inadvertida, sem orientação médica. Não houve associação entre o uso de nenhuma vacina e atividade da doença, incapacidade funcional, anos de escolaridade, hábitos de vida, comorbidades. Conclusão: Os pacientes foram pouco orientados pelo médico com relação ao uso das vacinas, com elevada frequência de vacinação inadvertida com componente vivo atenuado, enquanto a imunização com vírus ...
Introduction: Patients with a diagnosis of rheumatoid arthritis (RA) are at increased risk of infections. Vaccination is a recommended preventive measure. There are no studies evaluating the practice of vaccination in patients with early RA. Objectives: To evaluate the frequency of vaccination and the orientation (by the doctor) about vaccines among patients with early RA diagnosis. Methods: Cross-sectional study including patients from the early RA Brasilia cohort. Demographic data, disease activity index (Disease Activity Score 28 - DAS28), functional disability (Health Assessment Questionnaire - HAQ), and data on treatment and vaccination after diagnosis of RA were analyzed. Results: Sixty-eight patients were evaluated, 94.1% women, mean age 50.7 ± 13.2 years. DAS28 was 3.65 ± 1.64, and HAQ was 0.70. Most patients (63%) had vaccination card. Only five patients (7.3%) were briefed by the doctor about the use of vaccines. Patients were vaccinated for MMR (8.8%), tetanus (44%), yellow fever (44%), hepatitis B (22%), influenza (42%), H1N1 (61.76%), pneumonia (1.4%), meningitis (1.4%), and chickenpox (1.4%). All patients vaccinated with live attenuated virus were undergoing immunosuppressive therapy, and were vaccinated inadvertently, without medical supervision. There was no association between the use of any vaccine and disease activity, functional disability, years of education, lifestyle, and comorbidities. Conclusion: Patients were infrequently briefed by the physician regarding use of vaccines, with high frequency of inadvertent vaccination with live attenuated component, while immunization with killed virus was below the recommended level. .
Subject(s)
Humans , Male , Female , Arthritis, Rheumatoid/complications , Bacterial Infections/prevention & control , Virus Diseases/prevention & control , Vaccination/statistics & numerical data , Bacterial Infections/etiology , Brazil , Virus Diseases/etiology , Cross-Sectional Studies , Cohort Studies , Middle AgedABSTRACT
Introducción: La neumonía adquirida en la comunidad (NAC) representa una de las principales causas de morbi-mortalidad en Pediatría. Su etiología es variable. Material y métodos: Cohorte prospectiva.1/04/2012 al 31/03/2013. Criterios de inclusión: edad entre 1 mes y 15 años, internados en el Hospital de Pediatría Juan P. Garrahan, Rx de tórax y clínica compatible con NAC. Análisis estadístico: Epi info 3.2.2. Resultados: n: 305, 55,4% (n: 169) varones. Edad (mediana) 13,3 meses (rango: 1-180). Enfermedad de base 47,9% (n: 146). Se identificó agente etiológico de NAC en 50,8% (n: 155); de ellos 79,3% (n: 119) fueron virus y 31,3% (n: 47) bacterias. En 11 pacientes (7,1%), ya incluidos en las cifras anteriores, se detectó una coinfección bacteria-virus. Tuvieron bacteriemia 7,9% (n: 24). Los virus identificados más frecuentemente fueron VSR (60,5%; n: 72), ADV (18,5%; n: 22) y Parainfluenza (8,4%; n: 10). Streptococcus pneumoniae representó el 38,2% (n: 18) y Staphylococcus aureus 36.2% (n: 17) de los aislamientos bacterianos (n: 47). Requirieron UCI el 17% (n: 52) de los niños y 1,6% (n: 5) fallecieron por una causa relacionada con la infección. La duración de la internación fue 11,02 días (r: 2-104). Predominaron los menores de 2 años (68,5%; n: 209). Los mayores de 2 años tuvieron más derrame pleural (13,4% vs 39,6%; OR 0,3; IC 95% 0,2 a 0,5; p 0,001), condensación lobar (37,3% vs 49%; OR 0,76; IC 95% 0,58 a 0,99) y pulmonar (5,3% vs 12,5%; OR 0,42; IC 95% 0,14 a 0,92) que los menores. Los virus fueron más frecuentes en los menores de 2 años que en los mayores. (51,1% vs 13,5%; OR 6,5; IC 95% 3,43 a 12,48). Conclusiones: La identificación del agente etiológico es alta si se emplean métodos convencionales (cultivos) y de biología molecular. Las infecciones virales predominaron en los menores de 2 años (AU)
Introduction: Community-acquired pneumonia (CAP) is one of the main causes of morbidity and mortality in pediatrics. Its etiology is variable. Material and methods: Prospective cohort study.1/04/2012 to 31/03/2013. Inclusion criteria: Age between 1 month and 15 years, admission to the Pediatric Hospital Juan P. Garrahan, chest x-rays and clinical features compatible with CAP. Statistical analysis: Epi info 3.2.2. Results: n: 305, 55.4% (n: 169) boys. Age (median) 13.3 months (range: 1-180). Underlying disease 47.9% (n: 146). The etiological agent of CAP was identified in 50.8% (n: 155); of which 79.3% (n: 119) were viruses and 31.3% (n: 47) bacteria. In 11 patients (7.1%), included in the previous numbers, a bacteria-virus coinfection was found. Bacteremia was observed in 7.9% (n: 24). The most frequently identified viruses were SRV (60.5%; n: 72), ADV (18.5%; n: 22), and parainfluenza (8,4%; n: 10). Streptococcus pneumoniae accounted for 38.2% (n: 18) and Staphylococcus aureus for 36.2% (n: 17) of the bacterial isolates (n: 47). Of all children, 17% (n: 52) required ICU admission and 1.6% (n: 5) died because of infection-related causes. Median hospital stay was 11,02 days (r: 2-104). There was a predominance of children under 2 years of age (68.5%; n: 209). Children older than 2 years more frequently had pleural effusion (13.4% vs 39.6%; OR 0.3; 95% CI 0.2 to 0.5; p 0001), and lobular (37.3% vs 49%; OR 0.76; 95% CI 0.58 to 0.99) and pulmonary condensation (5.3% vs 12.5%; OR 0.42; 95% CI 0.14 to 0.92) than younger patients. Viruses were more frequently found in children under 2 years of age than in the older patients (51.1% vs 13.5%; OR 6.5; 95% CI 3.43 to 12.48). Conclusions: The possibility to identify the etiological agent is high when using conventional methods (cultures) and molecular biology. Viral infections predominated in children younger than 2 years of age (AU)
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Pneumonia/diagnosis , Pneumonia/etiology , Pneumonia/mortality , Pneumonia/epidemiology , Community-Acquired Infections/etiology , Bacterial Infections/etiology , Virus Diseases/etiology , Prospective Studies , Cohort StudiesABSTRACT
INTRODUCTION: Patients with a diagnosis of rheumatoid arthritis (RA) are at increased risk of infections. Vaccination is a recommended preventive measure. There are no studies evaluating the practice of vaccination in patients with early RA. OBJECTIVES: To evaluate the frequency of vaccination and the orientation (by the doctor) about vaccines among patients with early RA diagnosis. METHODS: Cross-sectional study including patients from the early RA Brasilia cohort. Demographic data, disease activity index (Disease Activity Score 28 - DAS28), functional disability (Health Assessment Questionnaire - HAQ), and data on treatment and vaccination after diagnosis of RA were analyzed. RESULTS: 68 patients were evaluated, 94.1% women, mean age 50.7±13.2 years. DAS28 was 3.65±1.64, and HAQ was 0.70. Most patients (63%) had vaccination card. Only five patients (7.3%) were briefed by the doctor about the use of vaccines. Patients were vaccinated for MMR (8.8%), tetanus (44%), yellow fever (44%), hepatitis B (22%), influenza (42%), H1N1 (61.76%), pneumonia (1.4%), meningitis (1.4%), and chickenpox (1.4%). All patients vaccinated with live attenuated virus were undergoing immunosuppressive therapy, and were vaccinated inadvertently, without medical supervision. There was no association between the use of any vaccine and disease activity, functional disability, years of education, lifestyle, and comorbidities. CONCLUSION: Patients were infrequently briefed by the physician regarding use of vaccines, with high frequency of inadvertent vaccination with live attenuated component, while immunization with killed virus was below the recommended level.
Subject(s)
Arthritis, Rheumatoid , Bacterial Infections/prevention & control , Vaccination/statistics & numerical data , Virus Diseases/prevention & control , Arthritis, Rheumatoid/complications , Bacterial Infections/etiology , Brazil , Cohort Studies , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Virus Diseases/etiologyABSTRACT
The HLA-G gene displays several peculiarities that are distinct from those of classical HLA class I genes. The unique structure of the HLA-G molecule permits a restricted peptide presentation and allows the modulation of the cells of the immune system. Although polymorphic sites may potentially influence all biological functions of HLA-G, those present at the promoter and 3' untranslated regions have been particularly studied in experimental and pathological conditions. The relatively low polymorphism observed in the MHC-G coding region both in humans and apes may represent a strong selective pressure for invariance, whereas, in regulatory regions several lines of evidence support the role of balancing selection. Since HLA-G has immunomodulatory properties, the understanding of gene regulation and the role of polymorphic sites on gene function may permit an individualized approach for the future use of HLA-G for therapeutic purposes.
Subject(s)
HLA Antigens/genetics , Histocompatibility Antigens Class I/genetics , Polymorphism, Genetic , Animals , Autoimmune Diseases/genetics , Autoimmune Diseases/immunology , Base Sequence , Evolution, Molecular , HLA Antigens/chemistry , HLA Antigens/immunology , HLA Antigens/metabolism , HLA-G Antigens , Histocompatibility Antigens Class I/chemistry , Histocompatibility Antigens Class I/immunology , Histocompatibility Antigens Class I/metabolism , Humans , Models, Molecular , Molecular Sequence Data , Neoplasms/genetics , Neoplasms/immunology , Transplantation Immunology , Virus Diseases/etiology , Virus Diseases/genetics , Virus Diseases/immunologyABSTRACT
Tracheostomy is the communication between the trachea and the exterior. This procedure is indicated in situations of critical upper airway obstruction or need of long term mechanical ventilation. This condition of airway exposed directly to the environment, without the natural mechanisms of defence, determines a higher risk for infections. This paper seeks defining microbiological situations in patients with tracheostomy and suggests treatment guidelines.
La traqueostomía es un procedimiento que comunica la tráquea con el exterior, indicada en situaciones de obstrucción crítica de la vía aérea alta o necesidad de ventilación mecánica prolongada. Esta situación de comunicación de la vía aérea con el medio, sin los mecanismos de protección naturales, determina un mayor riesgo de infecciones respiratorias. Este artículo busca definir situaciones microbiológicas frecuentes en pacientes con traqueostomía y sugerir líneas de manejo.
Subject(s)
Humans , Child , Respiratory Tract Infections/etiology , Tracheostomy/adverse effects , Antibiotic Prophylaxis , Anti-Bacterial Agents/therapeutic use , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/drug therapy , Pneumonia, Bacterial/etiology , Tracheitis/etiology , Virus Diseases/etiologyABSTRACT
It has been described some causes that promote the emergency or re-emergency of viral infections. A fundamental factor is the property of viruses to accumulate mutations which may help them to escape from the host immunological system, increasing their virulence or inducing resistance to antivirals. Nevertheless, there exist factors inherent to the human activity that play important roles in the emergency or re-emergency of viruses. These activities are related with traffic of exotic animals, deforestation, migration, introduction or development of human communities in unexplored areas and the climatic changes. Due to the great significance of emerging viruses as a public health concern, it is necessary to know different aspects of these phenomena, to take the necessary steps to prevent or control epidemics or pandemics.
Subject(s)
Communicable Diseases, Emerging , Virus Diseases , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/etiology , Humans , Virus Diseases/epidemiology , Virus Diseases/etiologyABSTRACT
The transcription nuclear factor kappa B (NF-kappaB) was first described in 1986. Currently, the NF-kappaB has been linked to several metabolic and inflammatory diseases as well as to several types of cancer. NF-kappaB will continue to be of interest in many disease processes such as inflammatory, infectious and neoplastic. The discovery of this factor has increased our knowledge about the regulation of inflammation and chronic diseases, as well as the medications used to treat those diseases.
Subject(s)
NF-kappa B/physiology , Atherosclerosis/etiology , Humans , Inflammation/etiology , Virus Diseases/etiologyABSTRACT
El riesgo de transmisión de infección en procedimientos endoscópicos es muy bajo y la mayoría han sido reportados durante los años 80. Se han descrito transmisión principalmente bacteriana, aunque también algunos casos, infección por virus hepatitis B y C. La mayoría de los casos son asociados a prácticas inadecuadas de reprocesamiento por lo que actualmente existen guías internacionales de limpieza y desinfección de endoscopios, los cuales incluyen técnicas de limpieza, enjuague, desinfección, secado y almacenamiento. La limpieza es el paso crítico en el reprocesamiento de los endoscopios y debe realizarse siempre antes de la desinfección. Todos los procesos de desinfección pueden fracasar si la limpieza ha sido inadecuada. La adherencia a las directrices de desinfección es un factor clave que determina la seguridad del endoscopio. Si bien pueden variar las circunstancias, el entrenamiento y los recursos locales, siempre deben mantenerse altos estándares de desinfección. En general, se pueden remover todos los microorganismos, salvo excepciones como los priones en la variante de enfermedad de Creutzfeldt-Jacob. Aunque no hay casos reportados de transmisión, en estos casos es necesario tomar conductas especiales en cuanto al uso de los endoscopios. Es importante monitorear la eficacia del procedimiento de desinfección a intervalos regulares. Además, todo el personal de la salud en una unidad de endoscopía debe recibir entrenamiento en las medidas de control estándar incluyendo aquellas diseñadas para proteger tanto a los pacientes como a los trabajadores de la salud.
The risk of endoscopy-related transmission of a disease is very low and the majority has been reported during the 80´s. Bacterial transmission has been described mostly; also some cases of infection from hepatitis B and C. The majority of outbreaks was related to inadequate reprocessing practices, so international guidelines of cleaning and disinfection have been developed, including cleaning, rinsing, disinfection and drying techniques; as well as endoscope storage. Cleaning is the critical step in endoscope reprocessing and should be done always before the disinfection step. All disinfection processes could fail if cleaning is inadequate. Compliance with endoscope disinfection guidelines is the key factor that determines endoscopy safety. While local circumstances, training and resources may vary, high standards of disinfection must always be observed. In general, all kinds of microorganisms can be removed, but there are exceptions, like prions in the variant of Creutzfeldt-Jakob disease. Although there have not been reported cases of transmission, it is necessary to take some precautions of the use of the endoscopes. It is important to monitor the efficacy of the disinfection procedure at regular intervals. Also, all healthcare personnel in an endoscopy unit should receive training in standard infection control measures, including those designed to protect both patients and healthcare workers.
Subject(s)
Humans , Disinfection , Endoscopes, Gastrointestinal/adverse effects , Endoscopes, Gastrointestinal/microbiology , Bacterial Infections/prevention & control , Virus Diseases/prevention & control , Equipment Contamination/prevention & control , Infection Control , Detergents , Endoscopy, Gastrointestinal/adverse effects , Bacterial Infections/etiology , Cross Infection/prevention & control , Infections/transmission , Virus Diseases/etiologyABSTRACT
Las infecciones respiratorias agudas (IRA) son patologías que afectan el tracto respiratorio desde la faringe proximal hasta los pulmones, con una evolución de menos de 15 días y constituyen la causa más frecuente de morbimortalidad en el mundo. Con la finalidad de identificar los agentes virales asociados a este tipo de infecciones en pacientes del estado Zulia, Venezuela, entre febrero 2005 y julio de 2006, se estudiaron un total de 102 muestras provenientes del tracto respiratorio (hisopado nasal, faríngeo y/o nasofaríngeo, esputo y lavado broncoalveolar) de pacientes con clínica de IRA. El aislamiento viral se realizó a través del cultivo celular y la identificación del agente patógeno por la técnica de inmunofluorescencia directa. Se obtuvieron 46 muestras positivas (45%), la incidencia estuvo homogéneamente distribuida en todos los grupos de estudio aun cuando se observó predominio en el grupo de 41 a 64 años, seguido de los lactantes. No hubo diferencias significativas en cuanto al sexo. Dentro de los patógenos virales aislados el Virus Sincicial Respiratorio (VSR) fue el agente con mayor frecuencia (32,6%) (p<0,05), seguido de Adenovirus (28,2%), Parainfluenza (23,9%) e Influenza (15,2%). Las infecciones respiratorias del tracto inferior fueron las más frecuentes (67,4%). Se demuestra una alta incidencia de agentes virales asociados a IRA en el estado Zulia. Se destaca la alta frecuencia en pacientes adultos y la mayor positividad para VSR.
Acute respiratory infections (ARI) are pathologies that affect the respiratory tract from the proximal pharynx to the lungs, with an evolution of less than 15 days. They constitute the most frequent cause of morbimortality in the world. With the purpose of identifying the viral agents associated to this type of infections in patients of Zulia State, Venezuela, between February 2005 and July 2006, a total of 102 samples of the respiratory tract (oropharyngeal swab, nasopharyngeal swab, nasopharyngeal washing, spit and bronchoalveolar lavage) were studied. Viral isolation was made through a cellular culture and the identification of the pathogenic agents by the technique of direct immunofluorescence. Forty six positive samples were obtained (45%). The greater incidence was found in the groups of 41 to 64 years old patients, followed by lactanting babies (1 to 23 months). There were no significant differences between sexes. Within the isolated viral pathogens, Respiratory Syncytial Virus (RSV) was the agent most frequently found (32.6% p<0.05), followed by Adenovirus (28.2%), Parainfluenza (23.9%) and Influenza (15.2%). The respiratory infections of the low respiratory tract were the most frequent (67.4%). A high incidence of associated viral agents to ARI in Zulia State is demonstrated. A high incidence in adult patients and the greatest positivity was found for RSV.
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Respiratory Tract Diseases/pathology , Fluorescent Antibody Technique, Direct/methods , Cell Culture Techniques/methods , Virus Diseases/etiologyABSTRACT
Infectious diseases are the leading causes of death in patients with multiple myeloma (MM). Major changes have occurred in the spectrum of infections paralleling the changes in the treatment of MM. Bacteria (particularly gram-negative organisms) are the most frequent etiologic agents, and invasive fungal infections caused by molds (Aspergillus sp. and Fusarium sp.) have been increasingly reported. New infections have emerged with an increase in the intensity of the treatment of MM. Management of infections in MM patients must include recognition of the likely pathogens. Specific strategies of diagnosis, prophylaxis, and empirical and specific therapy are based on host factors and probable pathogens.
Subject(s)
Bacterial Infections/etiology , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Multiple Myeloma/immunology , Multiple Myeloma/microbiology , Mycoses/etiology , Virus Diseases/etiology , Antineoplastic Agents/adverse effects , Bacterial Infections/diagnosis , Bacterial Infections/drug therapy , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Multiple Myeloma/drug therapy , Mycoses/diagnosis , Mycoses/drug therapy , Risk Factors , Transplantation Conditioning/adverse effects , Virus Diseases/diagnosis , Virus Diseases/drug therapyABSTRACT
A new and devastating physiological disorder of Vitis vinifera cv. Merlot was recently reported, known as premature berry dehydration (PBD), which is characterized by plant growth reduction, induction of general senescence and pedicel necrosis in the fruit, causing significant reductions in vineyard production. The causes of this disease remain unclear and previous reports suggest that it may be associated with phloem disruption and water provision. For this reason, any factor causing phloem disturbances could cause an important change in the berry water status. As some micro-organisms have been reported to disrupt phloem flow, we analyzed the occurrence of phytoplasma and viruses in commercial vineyards presenting PBD. In this study, a phytoplasma was detected by electron microscopy and nested PCR while virus infections were diagnosed by RT-PCR in samples collected during two growing seasons. The presence of phytoplasma only in samples from grape plants with PBD suggests that this pathogen may be one of the causal agents of this disorder. We suggest that the influence of other factors, such as virus infections, agronomic handling and environmental conditions also modulate berry dehydration. This is the first study at the microscopic and molecular levels that correlates phytoplasma presence with PBD.