RESUMO
Acidithiobacillus ferrooxidans is an acidophilic bacterium able to grow in environments with high concentrations of metals. It is a chemolithoautotroph able to form biofilms on the surface of solid minerals to obtain its energy. The response of both planktonic and sessile cells of A. ferrooxidans ATCC 23270 grown in elemental sulfur and adapted to high copper concentration was analyzed by quantitative proteomics. It was found that 137 proteins varied their abundance when comparing both lifestyles. Copper effllux proteins, some subunits of the ATP synthase complex, porins, and proteins involved in cell wall modification increased their abundance in copper-adapted sessile lifestyle cells. On the other hand, planktonic copper-adapted cells showed increased levels of proteins such as: cupreredoxins involved in copper cell sequestration, some proteins related to sulfur metabolism, those involved in biosynthesis and transport of lipopolysaccharides, and in assembly of type IV pili. During copper adaptation a decreased formation of biofilms was measured as determined by epifluorescence microscopy. This was apparently due not only to a diminished number of sessile cells but also to their exopolysaccharides production. This is the first study showing that copper, a prevalent metal in biomining environments causes dispersion of A. ferrooxidans biofilms. SIGNIFICANCE: Copper is a metal frequently found in high concentrations at mining environments inhabitated by acidophilic microorganisms. Copper resistance determinants of A. ferrooxidans have been previously studied in planktonic cells. Although biofilms are recurrent in these types of environments, the effect of copper on their formation has not been studied so far. The results obtained indicate that high concentrations of copper reduce the capacity of A. ferrooxidans ATCC 23270 to form biofilms on sulfur. These findings may be relevant to consider for a bacterium widely used in copper bioleaching processes.
Assuntos
Cobre , Matriz Extracelular de Substâncias Poliméricas , Acidithiobacillus , Proteínas de Bactérias , Biofilmes , EnxofreAssuntos
Parto Obstétrico , Violência de Gênero/legislação & jurisprudência , Parto , Qualidade da Assistência à Saúde/legislação & jurisprudência , Direitos da Mulher/legislação & jurisprudência , Atitude do Pessoal de Saúde , Desumanização , Feminino , Violência de Gênero/prevenção & controle , Humanos , América Latina , Serviços de Saúde Materna/legislação & jurisprudência , GravidezRESUMO
BACKGROUND AND PURPOSE: Recombinant IFN-ß is one of the first-line treatments in multiple sclerosis (MS), despite its lack of efficacy in some patients. In this context, mesenchymal stem cells (MSCs) represent a promising therapeutic alternative due to their immunomodulatory properties and multipotency. Moreover, by taking advantage of their pathotropism, these cells can be genetically modified to be used as carriers for delivering or secreting therapeutic drugs into injured tissues. Here, we report the therapeutic effect of systemic delivery of adipose-derived MSCs (AdMSCs), transduced with the IFN-ß gene, into mice with experimental autoimmune encephalomyelitis (EAE). EXPERIMENTAL APPROACH: Relapsing-remitting and chronic progressive EAE were induced in mice. Cells were injected i.v. Disease severity, inflammation and tissue damage were assessed clinically, by flow cytometry of spleens and histopathological evaluation of the CNS respectively. KEY RESULTS: Genetic engineering did not modify the biological characteristics of these AdMSCs (morphology, growth rate, immunophenotype and multipotency). Furthermore, the transduction of IFN-ß to AdMSCs maintained and, in some cases, enhanced the functional properties of AdMSCs by ameliorating the symptoms of MS in EAE models and by decreasing indications of peripheral and central neuro-inflammation. CONCLUSION AND IMPLICATIONS: Gene therapy was found to be more effective than cell therapy in ameliorating several clinical parameters in both EAE models, presumably due to the continuous expression of IFN-ß. Furthermore, it has significant advantages over AdMSC therapy, and also over systemic IFN-ß treatment, by providing long-term expression of the cytokine at therapeutic concentrations and reducing the frequency of injections, while minimizing dose-limiting side effects.
Assuntos
Encefalomielite Autoimune Experimental/terapia , Terapia Genética/métodos , Interferon beta/genética , Transplante de Células-Tronco Mesenquimais/métodos , Esclerose Múltipla Recidivante-Remitente/terapia , Tecido Adiposo/citologia , Animais , Modelos Animais de Doenças , Encefalomielite Autoimune Experimental/genética , Encefalomielite Autoimune Experimental/fisiopatologia , Feminino , Citometria de Fluxo , Células-Tronco Mesenquimais/citologia , Camundongos , Camundongos Endogâmicos C57BL , Esclerose Múltipla Crônica Progressiva/genética , Esclerose Múltipla Crônica Progressiva/fisiopatologia , Esclerose Múltipla Crônica Progressiva/terapia , Esclerose Múltipla Recidivante-Remitente/genética , Esclerose Múltipla Recidivante-Remitente/fisiopatologia , Índice de Gravidade de DoençaRESUMO
Introducción y objetivo. Minimizar el estrés preoperatorio y aumentar la cooperación del niño durante la inducción de la anestesia es uno de los objetivos más importantes de los programas perioperatorios. La escala modified Yale Preoperative Anxiety Scale fue desarrollada para evaluar la ansiedad preoperatoria de los niños. El propósito de este estudio fue traducir al español y validar las propiedades psicométricas de esta versión en español. Material y métodos. La traducción al español de la escala se realizó siguiendo la guía de la Organización Mundial de la Salud. Durante la inducción de la anestesia, se grabaron 81 niños de 2 a 12 años. Dos observadores evaluaron las grabaciones de forma independiente. Se valoró el índice de validez de contenido. Se calculó el índice Kappa ponderado para medir el acuerdo interobservadores y se determinó el coeficiente de correlación de Pearson con la escala de comportamiento Induction Compliance Checklist. Resultados. La versión en español de la escala obtuvo un índice de validez de contenido elevado (0,91-0,98). La fiabilidad se evaluó con el índice Kappa ponderado, revelando un acuerdo interobservadores de 0,54 a 0,75. La validez concurrente fue elevada (r = 0,94; p < 0,001). Conclusiones. Son necesarias herramientas estandarizas y válidas para evaluar las intervenciones que se realizan para reducir la ansiedad del niño que va a ser operado. La versión en español de la modified Yale Preoperative Anxiety Scale evaluada en este estudio ha mostrado buenas propiedades psicométricas de fiabilidad y validez (AU)
Introduction and objective. To minimise preoperative stress and increase child cooperation during induction of anaesthesia is one of the most important perioperative objectives. The modified Yale Preoperative Anxiety Scale was developed to evaluate anxiety. The aim of this study was to translate into Spanish, and validate the psychometric properties of the Spanish version of this scale. Material and methods. The Spanish translation of the scale was performed following the World Health Organisation guidelines. During induction of anaesthesia, 81 children aged 2 to 12 years were recorded. Two observers evaluated the recordings independently. Content validity index of modified Yale Preoperative Anxiety Scale Spanish version was assessed. Weighted Kappa was calculated to measure interobserver agreement, and the Pearson correlation between the Induction Compliance Checklist and the modified Yale Preoperative Anxiety Scale was determined. Results. The Spanish version obtained high content validity (0.91 to 0.98). Reliability analysis using weighted Kappa statistics revealed that interobserver agreement ranged from 0.54 to 0.75. Concurrent validity was high (r = 0.94; P < .001). Conclusions. Validated assessment tools are needed to evaluate interventions to reduce child preoperative anxiety. The Spanish version of the modified Yale Preoperative Anxiety Scale evaluated in this study has shown good psychometric properties of reliability and validity (AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Ansiedade/diagnóstico , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/cirurgia , Escala de Ansiedade Frente a Teste/estatística & dados numéricos , Estresse Psicológico/diagnóstico , Psicometria/métodos , Reprodutibilidade dos Testes , Escala Fujita-Pearson , TraduçãoRESUMO
Introducción y objetivo: La evidencia científica muestra la necesidad de tratar la ansiedad del niño antes de iniciar una anestesia para conseguir una mayor colaboración y una inducción menos traumática. La evaluación de la ansiedad se basa por lo general en el juicio, habilidad o experiencia del personal asistencial para determinar la necesidad de medicación sedativa. El objetivo de este estudio es evaluar la habilidad de la enfermera en valorar la ansiedad del niño antes de la inducción de la anestesia. Materiales y métodos: Se seleccionaron 8 pacientes de 2 a 12 años de edad que debían ser operado en una Unidad de Cirugía Ambulatoria. Las enfermeras evaluaron la ansiedad del niño utilizando una escala de dos valores y la escala `modified Yale Preoperative Anxiety Scale`(mYPAS), que había sido previamente validada al español por nuestro grupo. Esta herramienta se usó como gold standard para calcular los índices de sensibilidad y especificidad de la evaluación de la enfermera. Resultados: La habilidad de la enfermera para detectar al niño ansioso obtuvo una especificidad muy elevada pero una sensibilidad baja. Conclusiones: La habilidad de la enfermera para detectar la detección del niño con alto grado de ansiedad se muestra muy eficiente, pero en niños con ansiedad enmascarada por diversas actitudes o falta de verbalización se muestra insuficiente, por lo que se precisa de herramientas de diagnóstico más precisas. Son muchos los factores involucrados en el diagnóstico de la ansiedad, lo que obliga a más estudios para poder realizar una correcta detección (AU)
Introduction and objective: Scientific evidence shows the need to treat the childs anxiety before starting anesthesia to have a child more partner and less traumatic induction. To determine the need for sedative medication the assessment of anxiety is usually based on the judgment, skill or experience of the caregivers. The aim of this study is to evaluate the ability of the nurse in assessing the childs anxiety before induction of anesthesia. Material and methods: 81 patients aged 2 to 12 years old were selected; they should be operated in an ambulatory surgery unit. The nurses evaluated the childs anxiety on a scale of two items and scale `modified Yale Preoperative Anxiety Scale`(mYPAS), which had been previously validated by our group to Spanish. This tool was used as the gold standard for calculating the indices of sensitivity of the evaluation of the nurse. Results: the ability of the nurse to classify the anxious child got a very specificity and low sensitivity. Conclusions: The ability of the nurse for detection the child with a high degree of anxiety is very efficient, but in children with anxiety masked by various attitudes or lack of verbalization is shown insufficient, so it requires more accurate diagnostic tools. There are many factors involved in the diagnosis of anxiety, which require more study to make a correct detection (AU)
Assuntos
Humanos , Criança , Avaliação em Enfermagem/métodos , Ansiedade/enfermagem , Procedimentos Cirúrgicos Ambulatórios/estatística & dados numéricos , Liberação de Cirurgia/enfermagem , Hospitais Pediátricos/estatística & dados numéricos , Qualidade da Assistência à SaúdeRESUMO
Evaluar la ansiedad del niño durante la inducción anestésica es de gran utilidad para determinar si las estrategias utilizadas en el preoperatorio han sido eficaces en la disminución de la ansiedad. El objetivo de este trabajo ha sido la revisión de la literatura de las escalas empleadas para medir el comportamiento, conducta o ansiedad del niño durante la inducción de la anestesia. Se revisaron sin límite de fecha las bases de datos electrónicas en diciembre de 2013 repitiéndose la búsqueda en septiembre de 2014. Se aplicó una plantilla de extracción de datos para hallar en los artículos las escalas utilizadas. Se encontraron un total de 8 escalas observacionales. Seis de ellas únicamente pueden utilizarse durante la inducción de la anestesia y 2 en varios momentos del perioperatorio, en el preoperatorio y durante la inducción de la anestesia (AU)
The assessment of children's anxiety during anaesthetic induction is useful to determine if pre-operative strategies have been effective in reducing anxiety. The aim of this study is to review the different tools used to evaluate child anxiety or behaviour during the induction of anaesthesia. The electronic databases with no date limits were reviewed in December 2013, with a second review repeated in September 2014. A data extraction template was applied to find the scales used in the articles. Eight observational scales were found. Six of them can only be used during induction of anaesthesia, and two of those could be applied at various perioperative times, before surgery and during induction of anaesthesia (AU)
Assuntos
Humanos , Masculino , Feminino , Pediatria/educação , Anestesia/métodos , Ansiedade/metabolismo , Ansiedade/psicologia , Pesos e Medidas , Comportamento Infantil/psicologia , Terapêutica/métodos , Terapêutica/psicologia , Pediatria/métodos , Anestesia/normas , Ansiedade/complicações , Ansiedade/genética , Assistência Hospitalar , Comportamento Infantil/fisiologia , Terapêutica/normas , TerapêuticaRESUMO
INTRODUCCIÓN: La evaluación del dolor postoperatorio es un aspecto fundamental de los cuidados posquirúrgicos. Cuando la cirugía es ambulatoria, los principales responsables de la evaluación del dolor son los padres, pero los padres no siempre pueden evaluar correctamente el dolor de los niños. Esto hace necesario disponer de instrumentos que les ayuden a valorar el dolor postoperatorio de manera fiable. La Parent's Postoperative Pain Measurement (PPPM) es una medida conductual de dolor postoperatorio desarrollada para ayudar a los padres a evaluar el dolor postoperatorio de los niños. El propósito de este trabajo fue traducir al español esta escala y validar las propiedades psicométricas de esta versión en español. MÉTODO: Participaron 111 niños de entre 2 y 12 años sometidos a cirugía y uno de sus padres. Tras la operación, se valoró el nivel de dolor de los niños y los padres completaron la escala PPPM en español. RESULTADOS: Los ítems de la escala PPPM en español mostraron buena consistencia interna (alfa de Cronbach entre 0,784 y 0,900) y las puntuaciones en la escala estuvieron fuertemente relacionadas con la evaluación global del dolor (correlación Rho de Spearman entre 0,626 y 0,431). La puntuación en la escala disminuyó entre el día de la operación y el día siguiente, y discriminó bien entre los niños sometidos a cirugías calificadas como de dolor bajo/moderado y de alto dolor. CONCLUSIONES: Concluimos que la versión española de la escala PPPM que se incluye en este trabajo tiene buenas propiedades psicométricas para evaluar el dolor postoperatorio en el domicilio por parte de los padres
INTRODUCTION: Assessment of postoperative pain is a fundamental aspect of post-surgical care. When surgery is performed as an outpatient, the parents are mainly responsible for the assessment of pain, but they may not always correctly evaluate their children's pain. This makes it necessary to have tools that help them to assess postoperative pain reliably. The Parent's Postoperative Pain Measurement (PPPM) is a behavioral measurement tool of post-operative pain developed to help parents to assess their children's post-operative pain. The purpose of this work was to translate this scale into Spanish, and validate the psychometric properties of the Spanish version of the scale. METHOD: Participants were 111 children aged 2 to 12 years, who had undergone surgery, and one of their parents. After the operation, the children's level of pain was assessed, and the parents completed the PPPM scale in Spanish. RESULTS: The PPPM items in Spanish showed good internal consistency (Cronbach alpha between 0.784 and 0.900) and the scale scores were closely related to the global pain assessment (Spearman's rho correlation between 0.626 and 0.431). The score on the scale decreased between the day of the operation and the next day, and discriminated well between children undergoing surgery qualified as low/moderate pain and high pain. CONCLUSIONS: We conclude that the Spanish version of the PPPM scale evaluated in this study, has good psychometric properties to assess postoperative pain by parents at home
Assuntos
Humanos , Masculino , Feminino , Criança , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/psicologia , Dor Pós-Operatória/terapia , Medição da Dor/métodos , Manejo da Dor/métodos , Manejo da Dor/psicologia , Psicometria/métodos , Psicometria/tendências , Pais/psicologia , Notificação aos Pais , Reprodutibilidade dos Testes , Análise FatorialRESUMO
INTRODUCTION: Assessment of postoperative pain is a fundamental aspect of post-surgical care. When surgery is performed as an outpatient, the parents are mainly responsible for the assessment of pain, but they may not always correctly evaluate their children's pain. This makes it necessary to have tools that help them to assess postoperative pain reliably. The Parent's Postoperative Pain Measurement (PPPM) is a behavioral measurement tool of post-operative pain developed to help parents to assess their children's post-operative pain. The purpose of this work was to translate this scale into Spanish, and validate the psychometric properties of the Spanish version of the scale. METHOD: Participants were 111 children aged 2 to 12 years, who had undergone surgery, and one of their parents. After the operation, the children's level of pain was assessed, and the parents completed the PPPM scale in Spanish. RESULTS: The PPPM items in Spanish showed good internal consistency (Cronbach alpha between 0.784 and 0.900) and the scale scores were closely related to the global pain assessment (Spearman's rho correlation between 0.626 and 0.431). The score on the scale decreased between the day of the operation and the next day, and discriminated well between children undergoing surgery qualified as low/moderate pain and high pain. CONCLUSIONS: We conclude that the Spanish version of the PPPM scale evaluated in this study, has good psychometric properties to assess postoperative pain by parents at home.
Assuntos
Manejo da Dor , Medição da Dor/métodos , Dor Pós-Operatória/terapia , Criança , Humanos , Pais , PsicometriaRESUMO
The assessment of children's anxiety during anaesthetic induction is useful to determine if pre-operative strategies have been effective in reducing anxiety. The aim of this study is to review the different tools used to evaluate child anxiety or behaviour during the induction of anaesthesia. The electronic databases with no date limits were reviewed in December 2013, with a second review repeated in September 2014. A data extraction template was applied to find the scales used in the articles. Eight observational scales were found. Six of them can only be used during induction of anaesthesia, and two of those could be applied at various perioperative times, before surgery and during induction of anaesthesia.
Assuntos
Ansiedade , Comportamento Infantil , Anestesia , Transtornos de Ansiedade , Criança , HumanosRESUMO
INTRODUCTION AND OBJECTIVE: To minimise preoperative stress and increase child cooperation during induction of anaesthesia is one of the most important perioperative objectives. The modified Yale Preoperative Anxiety Scale was developed to evaluate anxiety. The aim of this study was to translate into Spanish, and validate the psychometric properties of the Spanish version of this scale. MATERIAL AND METHODS: The Spanish translation of the scale was performed following the World Health Organisation guidelines. During induction of anaesthesia, 81 children aged 2 to 12 years were recorded. Two observers evaluated the recordings independently. Content validity index of modified Yale Preoperative Anxiety Scale Spanish version was assessed. Weighted Kappa was calculated to measure interobserver agreement, and the Pearson correlation between the Induction Compliance Checklist and the modified Yale Preoperative Anxiety Scale was determined. RESULTS: The Spanish version obtained high content validity (0.91 to 0.98). Reliability analysis using weighted Kappa statistics revealed that interobserver agreement ranged from 0.54 to 0.75. Concurrent validity was high (r=0.94; P<.001). CONCLUSIONS: Validated assessment tools are needed to evaluate interventions to reduce child preoperative anxiety. The Spanish version of the modified Yale Preoperative Anxiety Scale evaluated in this study has shown good psychometric properties of reliability and validity.
Assuntos
Ansiedade , Anestesia , Transtornos de Ansiedade , Criança , Pré-Escolar , Humanos , Psicometria , Reprodutibilidade dos TestesRESUMO
Self-injurious acts are understood as transnosologic behaviors, which by their vital risk and psychopathological complexity require a specific medical diagnosis and treatment. Their management should be known by psychiatrists and other medical specialties. There are varied reasons that can trigger these maladaptive behaviors which are coming from the specific difficulties arising from the patient's mental state. It is essential to identify the presence of triggering or concomitant psychiatric disorders for the appropriate guiding of clinical management...
Las conductas autoagresivas pueden comprenderse como comportamientos transnosológicos que, por su riesgo vital y complejidad psicopatológica, requieren de un diagnóstico y manejo médico específicos. Este manejo debe ser conocido tanto por el médico psiquiatra como por facultativos de otras especialidades. Existen variadas motivaciones que pueden desencadenar conductas autolesivas, las que tienen su origen en dificultades específicas relacionadas con el estado mental del paciente. Resulta imperativo identificar la presencia de patologías psiquiátricas desencadenantes, o concomitantes, para orientar el apropiado manejo clínico...
Assuntos
Humanos , Comportamento Autodestrutivo/diagnóstico , Transtornos da Personalidade , Comportamento Autodestrutivo/classificação , Comportamento Autodestrutivo/epidemiologia , Tentativa de SuicídioRESUMO
AIMS: The primary goal of this study was to characterize the existence of a functional c-di-GMP pathway in the bioleaching bacterium Acidithiobacillus ferrooxidans. METHODS AND RESULTS: A bioinformatic search revealed that the genome sequence of At. ferrooxidans ATCC 23270 codes for several proteins involved in the c-di-GMP pathway, including diguanylate cyclases (DGC), phosphodiesterases and PilZ effector proteins. Overexpression in Escherichia coli demonstrated that four At. ferrooxidans genes code for proteins containing GGDEF/EAL domains with functional DGC activity. MS/MS analysis allowed the identification of c-di-GMP in nucleotide preparations obtained from At. ferrooxidans cells. In addition, c-di-GMP levels in cells grown on the surface of solid energetic substrates such as sulfur prills or pyrite were higher than those measured in ferrous iron planktonic cells. CONCLUSIONS: At. ferrooxidans possesses a functional c-di-GMP pathway that could play a key role in At. ferrooxidans biofilm formation during bioleaching processes. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first global study about the c-di-GMP pathway in an acidophilic bacterium of great interest for the biomining industry. It opens a new way to explore the regulation of biofilm formation by biomining micro-organisms during the bioleaching process.
Assuntos
Acidithiobacillus/fisiologia , GMP Cíclico/análogos & derivados , Minerais/metabolismo , Transdução de Sinais , Acidithiobacillus/genética , Acidithiobacillus/metabolismo , Proteínas de Bactérias/química , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Biofilmes , GMP Cíclico/química , GMP Cíclico/genética , GMP Cíclico/metabolismo , Escherichia coli/genética , Espaço Intracelular/metabolismo , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Espectrometria de Massas em TandemRESUMO
Introducción: Los Trastornos de Personalidad (TP) tienen una alta complejidad, impacto existencial, difícil vínculo terapéutico y cifras de prevalencia muy variables. La Clínica Psiquiátrica Universitaria de la Universidad de Chile (CPU) tiene desde 1997 la unidad multidisciplinaria para pacientes con TP Unidad de Trastornos de Personalidad (UTP). El objetivo de este trabajo es describir demográfica y psicopatológicamente a los pacientes con TP atendidos en la UTP. Método: Revisión de 174 fichas de pacientes atendidos en la UTP entre los años 2006 y 2008, con base de datos prediseñada y análisis estadístico de ella. Resultados: Existió una mayor proporción de pacientes de sexo femenino (3:1), solteros (48 por ciento), con hijos (56 por ciento), con estudios superiores (56 por ciento), trabajo estable (32 por ciento), con múltiples episodios previos (35 por ciento) y para la mayoría fue su primera hospitalización psiquiátrica (51,7 por ciento). El 71 por ciento de los pacientes tiene algún nivel de riesgo suicida. El diagnóstico de TP más frecuente fue el de Trastorno Límite de la Personalidad (48 por ciento). En Trastornos del Eje I un 30 por ciento presentó depresión, pero un 44 por ciento tenía varios trastornos. Conclusión: Los datos analizados son necesarios para la futura implementación y evaluación de intervenciones orientadas al mejor cuidado de los pacientes con TP de ésta y otras unidades especializadas en el tratamiento de este tipo de pacientes.
Introduction: Personality Disorders (PD) have a high complexity, existential impact, difficult therapeutic bond and prevalence values vary widely. University Psychiatric Clinic of the University of Chile (UPC) has since 1997 a multidisciplinary unit for patients with DP Personality Disorders Unit (PDU). The objective of this paper is to describe demographic and psychopathological patients treated with DP in the PDU. Methods: Review of 174 records of patients treated in the PDU between years 2006 and 2008, with predesigned database and statistical analysis of it. Results: There was a higher proportion of female patients (3:1), single (48 percent) with children (56 percent), highly educated (56 percent), stable job (32 percent) with multiple prior episodes (35 percent) and for most it was their first psychiatric hospitalization (51.7 percent). 71 percent of patients have any level of suicidal risk. The most frequent of PD diagnosis was Borderline Personality Disorder (48 percent). In Axis I disorders 30 percent had depression, but 44 percent had multiple disorders. Conclusion: The analyzed data are needed for future implementation and evaluation of interventions to better care for patients with PD from this and other specialized units created to treat such patients.
Assuntos
Humanos , Masculino , Feminino , Hospitais Psiquiátricos/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Transtornos da Personalidade/epidemiologia , Admissão do Paciente/estatística & dados numéricos , Comorbidade , Estudos Transversais , Chile/epidemiologia , Demografia , Violência Doméstica , Tentativa de Suicídio/estatística & dados numéricos , Psicopatologia , Fatores SocioeconômicosRESUMO
Introduction: Impulsiveness and aggressiveness are characteristics of borderline personality disorders. Aggressive and impulsive behaviors are associated to a serotoninergic system dysfunction and are treated with selective serotonin reuptake inhibitors (SSRJs). The short (S) allele of the serotonin transporter promoter (5-HTTPR) gene is associated to a worse response to SSRI in major depression. The objective of this work is to study the anti-impulsive effect of fluoxetine and his relation with short and long alleles of 5-HTTPR gene in borderline personality disordered patients. Method: 59 patients with DSM-IV borderline personality disorder were treated with fluoxetine for 12 weeks. Impulsivity was evaluated with the Overt Aggression Scale Modified (OAS-M). Polymorphisms L and S of the 5-HTTPR gene were determined. Results: S carriers (LS and SS) had a significantly minor response on OAS-M and Aggression subscale than LL carriers. Conclusions: S allele of the 5-HTTPR gene predicts poor response to anti-impulsive effect of fluoxetine in borderline personality disorder. It is likely that multiple genes contribute to a SSRI response.
Introducción: Los trastornos límite de personalidad se caracterizan por una elevada impulsividad y agresividad. Las conductas agresivas e impulsivas se han asociado a disfunciones del sistema serotoninérgico y responden a los inhibidores de la recaptura de serotonina (ISRS). En depresión mayor el alelo corto (S) del promotor del gene del transportador de serotonina se asocia a pobre respuesta a los ISRS. El objetivo de este trabajo es estudiar el efecto anti-impulsivo de serotonina y su relación con los alelos LyS en pacientes con trastorno límite de personalidad. Método: 59 pacientes con trastorno límite de personalidad fueron tratados por 12 semanas confluoxetina. Se evaluó la impulsividad mediante la Overt Aggression Scale Modified (OAS-M)y se determinó los polimorfismos LyS. Resultados: Los portadores de S (LS y SS) presentaron una menor reducción en la OAS-M total y en la subescala de agresividad que los homocigotos LL. Conclusiones: En trastorno límite de personalidad el alelo S del promotor del gene del transportador de serotonina predice pobre respuesta anti-impulsiva de la fluoxetina. Probablemente múltiples genes participen en la respuesta a los ISRS.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Antidepressivos de Segunda Geração/uso terapêutico , Fluoxetina/uso terapêutico , Polimorfismo Genético , Transtorno da Personalidade Borderline/genética , Transtorno da Personalidade Borderline/tratamento farmacológico , Agressão , Comportamento Impulsivo/psicologia , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Farmacogenética , Regiões Promotoras Genéticas , Escalas de Graduação Psiquiátrica , Proteínas da Membrana Plasmática de Transporte de Serotonina , Transtorno da Personalidade Borderline/psicologiaRESUMO
Existe una controversia respecto a la independencia nosológica del trastorno límite de personalidad. Algunos autores sostienen que es parte del trastorno bipolar, mientras otros afirman que es una entidad independiente. En este trabajo se analiza la evolución histórica de los conceptos de trastorno límite y trastorno bipolar. Se discuten los argumentos a favor y en contra de incluir el trastorno límite dentro del trastorno bipolar. Por último se proponen nuevas estrategias para abordar este problema.
The independent nosological status of borderline personality disorder is a controversial issue. Some authors consider borderline as part of bipolar spectrum, but other sustain that is a independent entity. The historical evolution of borderline personality disorder and bipolar disorder is analyzed in this work. The arguments for include, or not include, borderline personality disorder in bipolar disorder is discussed. Finally, new strategies for study this problem are proposed.
Assuntos
Transtorno Bipolar/história , Transtorno da Personalidade Borderline/história , PsiquiatriaRESUMO
Genetic studies on depression have focused on the polimorphisms of the serotonin system genes. It has been investigated the tryptophan hydroxylase and the serotonin receptor genes, specifically the serotonin transporter. Two alleles of the promoter for the serotonin transporter gene have been described: a long allele (L) and a short allele (S). Studies suggest that the presence of the short allele (S) is associated to a higher vulnerability for depression in the presence of adverse environmental factors. By the other hand, the presence of the long allele (L) gives resilience for stressful situations. It is believed that the acquisition of higher vulnerability for stress must occur during early stages of neurodevelopment.
Los estudios genéticos en depresión se han enfocado especialmente en los polimorfismos de los genes asociados al sistema serotoninérgico. Se han investigado los genes de la triptofano hidroxilasa, de algunos receptores de serotonina y particularmente del transportador de serotonina. Se han descrito dos alelos en la región promotora del transportador de serotonina: uno largo (L) y otro corto (S). Los estudios sugieren que la presencia del alelo corto (S) se asocia a una mayor vulnerabilidad a la depresión en presencia de factores ambientales adversos. A la inversa, la presencia del alelo largo (L) parece conferir resiliencia frente a las situaciones de estrés. Se cree que la adquisición de la mayor vulnerabilidad al estrés debe ocurrir en etapas tempranas del neurodesarrollo.
Assuntos
Humanos , Depressão/genética , Polimorfismo Genético , Proteínas da Membrana Plasmática de Transporte de DopaminaRESUMO
IL-15 is a proinflammatory cytokine which has recently been implicated in multiple sclerosis (MS) pathogenesis, where it may play a role in the initiation and/or progression of the disease. We have used reverse transcriptase-polymerase chain reaction (RT-PCR) to study IL-15 mRNA levels in peripheral blood mononuclear cells (PBMC) from healthy controls and relapsing-remitting MS (RRMS) patients in a stable phase of the disease and during a bout, both before and after corticosteroid treatment (CST). IL-15 mRNA expression was found to be similar in controls and stable patients. We have detected an increased level of IL-15 mRNA in PBMC of patients with a relapse, which was maintained after CST. We have also found an inverse correlation between PBMC IL-15 mRNA levels at the onset of the relapse and the time elapsed since the previous attack, as well as an absence of correlation between IL-15 mRNA levels and the patient demographic and clinical characteristics. Results in the present work further suggest a role for IL-15 in MS pathophysiology.
Assuntos
Interleucina-15/genética , Interleucina-15/imunologia , Esclerose Múltipla Recidivante-Remitente/sangue , Esclerose Múltipla Recidivante-Remitente/imunologia , RNA Mensageiro/sangue , Regulação para Cima/imunologia , Corticosteroides/uso terapêutico , Adulto , Sistema Nervoso Central/imunologia , Sistema Nervoso Central/metabolismo , Sistema Nervoso Central/fisiopatologia , Feminino , Humanos , Leucócitos Mononucleares/imunologia , Leucócitos Mononucleares/metabolismo , Masculino , Esclerose Múltipla Recidivante-Remitente/genética , RecidivaRESUMO
The authors studied plasma testosterone levels and psychological characteristics of male pathological gamblers. Twenty-nine male pathological gamblers and a group of healthy volunteers matched for age and gender were compared on levels of plasma testosterone and scores on the Eysenck Personality Questionnaire (EPQ) and the Psychopathic Deviance scale of the Minnesota Multiphasic Personality Inventory (MMPI). Plasma testosterone levels were similar in the pathological gambling and comparison group (476.06 ng/100 ml vs. 560.71 ng/100 ml). Patients had higher scores on the Neuroticism subscales of the EPQ (13.83 vs. 10.83) and the Psychopathic Deviance scale of the MMPI (27.03 vs. 21.03), but not on any of the other subscales of the EPQ. Testosterone levels did not correlate with the psychological ratings. Testosterone levels are probably not related to impulsivity in pathological gambling.
Assuntos
Jogo de Azar/psicologia , Testosterona/sangue , Adulto , Agressão/fisiologia , Agressão/psicologia , Transtorno da Personalidade Antissocial/sangue , Transtorno da Personalidade Antissocial/diagnóstico , Transtorno da Personalidade Antissocial/psicologia , Humanos , Comportamento Impulsivo/sangue , Comportamento Impulsivo/diagnóstico , Comportamento Impulsivo/psicologia , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade , Fatores de RiscoRESUMO
Inorganic polyphosphate (polyP) is obtained by the polymerization of the terminal phosphate of ATP through the action of the enzyme polyphosphate kinase (PPK). Despite the presence of polyP in every living cell, a gene homologous to that of known PPKs is missing from the currently sequenced genomes of Eukarya, Archaea, and several bacteria. To further study the metabolism of polyP in Archaea, we followed the previously published purification procedure for a glycogen-bound protein of 57 kDa with PPK as well as glycosyl transferase (GT) activities from Sulfolobus acidocaldarius (R. Skórko, J. Osipiuk, and K. O. Stetter, J. Bacteriol. 171:5162-5164, 1989). In spite of using recently developed specific enzymatic methods to analyze polyP, we could not reproduce the reported PPK activity for the 57-kDa protein and the polyP presumed to be the product of the reaction most likely corresponded to glycogen-bound ATP under our experimental conditions. Furthermore, no PPK activity was found associated to any of the proteins bound to the glycogen-protein complex. We cloned the gene corresponding to the 57-kDa protein by using reverse genetics and functionally characterized it. The predicted product of the gene did not show similarity to any described PPK but to archaeal and bacterial glycogen synthases instead. In agreement with these results, the recombinant protein showed only GT activity. Interestingly, the GT from S. acidocaldarius was phosphorylated in vivo. In conclusion, our results convincingly demonstrate that the glycogen-protein complex of S. acidocaldarius does not contain a PPK activity and that what was previously reported as being glycogen-bound PPK is a bacterial enzyme-like thermostable glycogen synthase.