RESUMO
Iron is a crucial element for almost all organisms because it plays a vital role in oxygen transport, enzymatic processes, and energy generation due to its electron transfer capabilities. However, its dysregulation can lead to a form of programmed cell death known as ferroptosis, which is characterized by cellular iron accumulation, reactive oxygen species (ROS) production, and unrestricted lipid peroxidation. Both iron and ferroptosis have been identified as key players in the pathogenesis of various neurodegenerative diseases. While in epilepsy this phenomenon remains relatively understudied, seizures can be considered hypoxic-ischemic episodes resulting in increased ROS production, lipid peroxidation, membrane disorganization, and cell death. All of this is accompanied by elevated intracellular free Fe2+ concentration and hemosiderin precipitation, as existing reports suggest a significant accumulation of iron in the brain and heart associated with epilepsy. Generalized tonic-clonic seizures (GTCS), a primary risk factor for Sudden Unexpected Death in Epilepsy (SUDEP), not only have an impact on the brain but also lead to cardiogenic dysfunctions associated with "Iron Overload and Cardiomyopathy" (IOC) and "Epileptic heart" characterized by electrical and mechanical dysfunction and a high risk of malignant bradycardia. In line with this phenomenon, studies conducted by our research group have demonstrated that recurrent seizures induce hypoxia in cardiomyocytes, resulting in P-glycoprotein (P-gp) overexpression, prolonged Q-T interval, severe bradycardia, and hemosiderin precipitation, correlating with an elevated spontaneous death ratio. In this article, we explore the intricate connections among ferroptosis, epilepsy, and SUDEP. By synthesizing current knowledge and drawing insights from recent publications, this study provides a comprehensive understanding of the molecular underpinnings. Furthermore, this review offers insights into potential therapeutic avenues and outlines future research directions.
Assuntos
Epilepsia , Ferroptose , Ferro , Morte Súbita Inesperada na Epilepsia , Humanos , Ferroptose/fisiologia , Epilepsia/metabolismo , Ferro/metabolismo , Animais , Espécies Reativas de Oxigênio/metabolismoRESUMO
Restoration of intestinal continuity at a second stage after emergency total proctocolectomy may be difficult or hazardous due to the pelvic cavity being closed off. We present a way of keeping the pelvic cavity open and accessible following total proctocolectomy by insertion of a breast implant that hinders fibrosis and prevents intestinal loops from occupying the space. A 275 ml silicone breast implant was placed in the pelvic cavity after total proctocolectomy and closure of the rectal stump. Three months after the initial surgery, the breast implant had kept the pelvic cavity open, facilitating identification of the rectal stump and creation of an ileoanal J-pouch at this second stage. The use of a breast implant to fill the pelvic cavity may facilitate restoration of intestinal continuity in second-stage surgery and thereby decrease the number of associated complications.
Assuntos
Implantes de Mama , Colite Ulcerativa/cirurgia , Bolsas Cólicas , Proctocolectomia Restauradora , Anastomose Cirúrgica , Humanos , Ileostomia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-IdadeRESUMO
La fístula biliar es la complicación específica más frecuente de las resecciones hepáticas. Tienen una frecuencia de entre un 4,8 a 7,6 por ciento. Las principales series que analizan esta complicación, se refieren a pacientes con daño hepático crónico, cuya consecuencia final es la insuficiencia hepática y sepsis intrabdominal. Sin embargo en las series en que el daño hepático crónico es la excepción, la consecuencia de esta complicación no está completamente establecida. El objetivo es mostrar nuestra experiencia en el manejo y el prónostico de esta complicación en pacientes sin daño hepático crónico, y realizar una revisión de la literatura con el fin de intentar una sistematización de manejo y pronóstico. Para el presente estudio, consideramos bilirragia o filtraciones biliares al escape de contenido bilioso a través de los drenajes a partir del primer día postoperatorio y con un volumen mayor a 50 milímetros al día, y que se mantenga a lo menos por 72 horas. En cambio, fístula biliar, es aquella bilirragia que se prolongue más allá de 10 días, con un trayecto externo establecido, independiente del volumen de bilis drenado. Entre Junio de 1991 y Junio del 2002, hemos realizado 89 resecciones hepáticas regladas en nuestro servicio. Las indicaciones más frecuentes son el cáncer vesicular y la resecciones de metástasis por cáncer colorectal. Sólo un paciente de la serie era portador de daño hepático crónico. La frecuencia de fístula biliar fue de 10 por ciento (9 pacientes). La evolución en 8 casos consistió en el cierre espontáneo entre el día 6 y 12. En el paciente restante el cierre se produjo en el día 35 del postoperatorio, con estudio de colangio endoscópico negativo para demostrar el sitio de escape biliar. Estos resultados mas los obtenidos al revisar la literatura, nos llevan a proponer una clasificación de fístula biliar posthepatectomia en 4 tipos: Tipo I, autolimitadas, con conexión a la vía biliar principal. Tipo II, sin conexión a la vía biliar principal y cierre tardío, Tipo III, secundarias a lesión de vía biliar periférica, que requiere intervención, y Tipo IV cualquiera de las anteriores complicada con ascitis e insuficiencia hepática, de alta morbimortalidad.
Assuntos
Humanos , Fístula Biliar/etiologia , Hepatectomia/efeitos adversos , Chile , Fístula Biliar/classificação , Fístula Biliar/prevenção & controle , Complicações Pós-Operatórias , Prognóstico , ReoperaçãoRESUMO
Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients. The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes. This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium. The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina. In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes. All the isolates were found to be sensitive to penicillin. A 6% of resistance to erythromycin and a 4.5% to clindamycin were detected. In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected. These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine. The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment.
Assuntos
Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/classificação , Streptococcus agalactiae/efeitos dos fármacos , Argentina , Farmacorresistência Bacteriana , Humanos , Testes de Sensibilidade Microbiana , Sorotipagem , VirulênciaRESUMO
Streptococcus agalactiae es una bacteria colonizante que ha emergido en los últimos años como causante de infecciones neonatales, perinatales y en pacientes con compromiso inmunológico. La caracterización del polisacárido capsular, de las proteínas de superficie (c, X, R), así como el análisis de marcadores moleculares, permiten su clasificación en serotipos y genotipos. Esto resulta de utilidad para fines epidemiológicos y para estudios de virulencia de la bacteria. El objetivo de este trabajo fue conocer los serotipos prevalentes y la sensibilidad antimicrobiana de aislamientos provenientes de procesos infecciosos en pacientes de distintas zonas de Argentina. En la muestra analizada se obtuvo predominio de los serotipos Ia y III, seguido de II y IV. Todas las cepas resultaron sensibles a penicilina. Se observó 6% de resistencia a eritromicina y 4,5% a clindamicina. En 3 de las cepas se detectó fenotipo MLS (resistencia a macrólidos, lincosaminas y estreptograminas) constitutiva y en una cepa, resistencia MLS inducible. Los resultados logrados en este estudio destacan la importancia de efectuar un relevamiento de los serotipos más frecuentes en nuestro país en vistas a la prevención de esta infección con una vacuna que realmente sea eficaz, como así también el conocimiento de la sensibilidad antimicrobiana para lograr éxito terapéutico en los tratamientos.
Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients. The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes. This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium. The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina. In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes. All the isolates were found to be sensitive to penicillin. A 6% of resistance to erythromycin and a 4.5% to clindamycin were detected. In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected. These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine. The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment.
Assuntos
Humanos , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/classificação , Streptococcus agalactiae/efeitos dos fármacos , Argentina , Farmacorresistência Bacteriana , Testes de Sensibilidade Microbiana , Sorotipagem , VirulênciaRESUMO
Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients. The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes. This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium. The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina. In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes. All the isolates were found to be sensitive to penicillin. A 6
of resistance to erythromycin and a 4.5
to clindamycin were detected. In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected. These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine. The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment.
RESUMO
Bacteremia is associated with high morbidity and mortality. Nosocomial bacteremia is associated with an attributable mortality of 35%. In order to characterize the etiological agent of bacteremia cases during two time periods, 6605 patients were studied as follows: 1) from 1980 to 1982 (n = 2401) and 2) from 1988 to 2000 (n = 4204). A total of 596 cases of bacteremia were detected. The most frequent agents were Staphylococcus aureus, negative coagulase (CNS) Staphylococcus, Klebsiella pneumoniae and Escherichia coli. In the second period, an increase in the frequency of bacteremia caused by gram positive bacteria, particularly gram-positive cocci, was noted. Conversely, gram negative bacteria diminished significantly in the second period, specially enterobacterial species. Methicillin-resistant S. aureus and CNS were significantly more frequently isolated in the second period. Infrequent agents of endocarditis, such as Actinobacillus actinomycetemcomitans, Haemophilus aphrophilus, and Corynebacterium urealyticum, were isolated.
Assuntos
Bacteriemia/epidemiologia , Infecção Hospitalar/epidemiologia , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Bactérias Gram-Positivas/epidemiologia , Argentina/epidemiologia , Bacteriemia/microbiologia , Infecção Hospitalar/microbiologia , Endocardite Bacteriana/epidemiologia , Endocardite Bacteriana/microbiologia , Infecções por Enterobacteriaceae/epidemiologia , Infecções por Enterobacteriaceae/microbiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Estudos Retrospectivos , Infecções Estafilocócicas/epidemiologiaRESUMO
The incidence of severe infections caused by Lactobacillus spp. is very low. This paper reports a case of a liver abscess and bacteremia due to Lactobacillus rhamnosus. The patient is a 73 year-old woman with antecedent of diabetes mellitus. She has undergone surgery and received antimicrobial therapy (ampicillin plus gentamicin). The clinical outcome was favorable.
Assuntos
Bacteriemia/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Lactobacillus/isolamento & purificação , Abscesso Hepático/microbiologia , Idoso , Diabetes Mellitus Tipo 2/complicações , Suscetibilidade a Doenças , Feminino , Humanos , Lactobacillus/patogenicidadeRESUMO
Las infecciones severas por Lactobacillus spp. son infrecuentes. En una paciente de 73 años, de sexo femenino, diabética descompensada, se presenta un caso de absceso hepático y bacteriemia causado por Lactobacillus rhamnosus. La misma fue sometida a laparotomía con drenaje de absceso del lóbulo derecho y tratada con ampicilina y gentamicina con una evolución favorable. (AU)
Assuntos
Feminino , Idoso , Abscesso Hepático/microbiologia , Bacteriemia/microbiologia , Lactobacillus/patogenicidade , ArgentinaRESUMO
Las infecciones severas por Lactobacillus spp. son infrecuentes. En una paciente de 73 años, de sexo femenino, diabética descompensada, se presenta un caso de absceso hepático y bacteriemia causado por Lactobacillus rhamnosus. La misma fue sometida a laparotomía con drenaje de absceso del lóbulo derecho y tratada con ampicilina y gentamicina con una evolución favorable.
Assuntos
Feminino , Idoso , Abscesso Hepático/microbiologia , Argentina , Bacteriemia , LactobacillusRESUMO
The incidence of severe infections caused by Lactobacillus spp. is very low. This paper reports a case of a liver abscess and bacteremia due to Lactobacillus rhamnosus. The patient is a 73 year-old woman with antecedent of diabetes mellitus. She has undergone surgery and received antimicrobial therapy (ampicillin plus gentamicin). The clinical outcome was favorable.
RESUMO
Bacteremia is associated with high morbidity and mortality. Nosocomial bacteremia is associated with an attributable mortality of 35
. In order to characterize the etiological agent of bacteremia cases during two time periods, 6605 patients were studied as follows: 1) from 1980 to 1982 (n = 2401) and 2) from 1988 to 2000 (n = 4204). A total of 596 cases of bacteremia were detected. The most frequent agents were Staphylococcus aureus, negative coagulase (CNS) Staphylococcus, Klebsiella pneumoniae and Escherichia coli. In the second period, an increase in the frequency of bacteremia caused by gram positive bacteria, particularly gram-positive cocci, was noted. Conversely, gram negative bacteria diminished significantly in the second period, specially enterobacterial species. Methicillin-resistant S. aureus and CNS were significantly more frequently isolated in the second period. Infrequent agents of endocarditis, such as Actinobacillus actinomycetemcomitans, Haemophilus aphrophilus, and Corynebacterium urealyticum, were isolated.
RESUMO
Bacteremia is associated with high morbidity and mortality. Nosocomial bacteremia is associated with an attributable mortality of 35
. In order to characterize the etiological agent of bacteremia cases during two time periods, 6605 patients were studied as follows: 1) from 1980 to 1982 (n = 2401) and 2) from 1988 to 2000 (n = 4204). A total of 596 cases of bacteremia were detected. The most frequent agents were Staphylococcus aureus, negative coagulase (CNS) Staphylococcus, Klebsiella pneumoniae and Escherichia coli. In the second period, an increase in the frequency of bacteremia caused by gram positive bacteria, particularly gram-positive cocci, was noted. Conversely, gram negative bacteria diminished significantly in the second period, specially enterobacterial species. Methicillin-resistant S. aureus and CNS were significantly more frequently isolated in the second period. Infrequent agents of endocarditis, such as Actinobacillus actinomycetemcomitans, Haemophilus aphrophilus, and Corynebacterium urealyticum, were isolated.
RESUMO
Arcanobacterium haemolyticum is a bacterial pharyngeal pathogen that predominantly infects adolescents and young adults. It rarely causes severe infection. A case of sinusitis in an 18-year-old female patient with a skin rash is presented. The strain was susceptible to erythromicin, ampicilin, vancomicin, cephalotin, clindamicin, rifampicin and penicillin. Erythromicin has been proposed as first-line therapy.
Assuntos
Actinomycetaceae/isolamento & purificação , Infecções por Actinomycetales/microbiologia , Rinite/microbiologia , Sinusite/microbiologia , Infecções por Actinomycetales/tratamento farmacológico , Adolescente , Feminino , Humanos , Rinite/tratamento farmacológico , Sinusite/tratamento farmacológicoRESUMO
Arcanobacterium haemolyticum is a bacterial pharyngeal pathogen that predominantly infects adolescents and young adults. It rarely causes severe infection. A case of sinusitis in an 18-year-old female patient with a skin rash is presented. The strain was susceptible to erythromicin, ampicilin, vancomicin, cephalotin, clindamicin, rifampicin and penicillin. Erythromicin has been proposed as first-line therapy.
RESUMO
BACKGROUND: There is a high prevalence of infection by Enterohemorrhagic Escherichia coli (EHEC) and patients with hemolytic uremic syndrome (HUS) in Argentina. AIM: To study cattle and pigs as a possible reservoir of EHEC in Argentina. MATERIAL AND METHODS: One hundred two healthy animals (68 cattles and 31 pigs) from a livestock in Argentina, were studied. Stool samples were obtained with a rectal swab. The strains were identified by DNA hybridization with specific gene probes detecting Shiga-like toxin 1 and 2 (Stx1, Stx2), and hly gen related to fimbrial adhesin-associated plasmid. EHEC strains were serogrouped using commercial antisera. RESULTS: EHEC was isolated from 30 out of 68 bovines cultures (44.1%) and from 25 out of 31 pigs (58.1%). Isolates carrying genes codifying both Stx1 and Sxt2, were observed in 50% of cattle and 63.9% of pigs. The gene which codifies for hemolysin (associated to fimbrial adhesin) was observed in about 41% of EHEC isolates. Strains belonging to serogroups O26, O111, and O157 were isolated from cattle, and O111, and O157 from pigs. CONCLUSIONS: The high percentage of EHEC in both cattle and pigs and the presence of human infection-associated serogroups, suggests that these animals are a reservoir of EHEC associated with disease in humans.
Assuntos
Portador Sadio/veterinária , Vetores de Doenças , Escherichia coli O157/genética , Animais , Argentina/epidemiologia , Portador Sadio/microbiologia , Bovinos , Infecções por Escherichia coli/epidemiologia , Escherichia coli O157/isolamento & purificação , Feminino , Genótipo , Humanos , Masculino , Gravidez , Prevalência , SuínosRESUMO
We report a case of spinal epidural abscess. In our knowledge this is the first ever reported case due to Fusobacterium nucleatum. An 83 year old female patient with a history of lumbar trauma presented severe lumbalgia. Magnetic resonance showed the unusual anterior location, complicated by psoas abscess. Laminectomy and lumbar drainage were performed. She was treated with ceftriaxone plus metronidazole during 10 days. The evolution was favourable without any residual neurological morbidity.
Assuntos
Abscesso/microbiologia , Espaço Epidural/microbiologia , Infecções por Fusobacterium/complicações , Fusobacterium nucleatum , Abscesso/diagnóstico , Abscesso/cirurgia , Idoso , Idoso de 80 Anos ou mais , Espaço Epidural/cirurgia , Feminino , HumanosRESUMO
Corynebacterium urealyticum has been recognised as causing inflammatory cystitis and other human infections. In our knowledge this is the first case of a prosthetic valve endocarditis due to C. urealyticum. It was diagnosed in a 61 year old male patient with a history of rheumatic fever, hypertension and aortic stenosis. He had undergone surgery to replace the aortic valve and to perform triple aortocoronary bypass. The isolate was not multiresistant. Endocarditis due to C. urealyticum is very rare. Corynebacterium species, usually considered as contaminants, frequently colonize surgical cardiovascular areas and must be taken into account as causative agents of severe endocarditis.