RESUMO
Minimally invasive percutaneous insertion procedures are widely used techniques in medicine. Their success is highly dependent on the skills of the practitioner. This paper presents a haptic simulator for training in these procedures, whose key component is a real percutaneous insertion needle with a sensory system incorporated to track its 3D location at every instant. By means of the proposed embedded vision system, the attitude (spatial orientation) and depth of insertion of a real needle are estimated. The proposal is founded on a novel depth estimation procedure based on optical flow techniques, complemented by sensory fusion techniques with the attitude calculated with data from an Inertial Measurement Unit (IMU) sensor. This procedure allows estimating the needle attitude with an accuracy of tenths of a degree and the displacement with an accuracy of millimeters. The computational algorithm runs on an embedded computer with real-time constraints for tracking the movement of a real needle. This haptic needle location data is used to reproduce the movement of a virtual needle within a simulation app. As a fundamental result, an ergonomic and realistic training simulator has been successfully constructed for healthcare professionals to acquire the mental model and motor skills necessary to practice percutaneous procedures successfully.
Assuntos
Fluxo Óptico , Humanos , Agulhas , Simulação por Computador , Movimento , Algoritmos , Interface Usuário-ComputadorRESUMO
Nowadays, one of the choice techniques for the spasticity treatment is the ultrasound-guided infiltration of Botulinum Toxin, because it is safe and effective. In order to medical professionals can carry out this technique, they need training and education. One of the safest and most time-free ways to facilitate the acquisition of practical medical skills is through simulators. In this paper we present an innovative technological environment, which includes an ultrasound simulator for training in muscle exploration and infiltration. The simulation platform will guide health professionals, with great realism and high degree of interactivity, in the autonomous training of all the tasks involved in the spasticity treatment procedure by infiltration of Botulinum Toxin, without the need for a real patient or costly phantoms.
Assuntos
Toxinas Botulínicas/administração & dosagem , Pessoal de Saúde/educação , Espasticidade Muscular/tratamento farmacológico , Sistema Musculoesquelético , Software , Simulação por Computador , Humanos , Masculino , Pessoa de Meia-Idade , Ultrassonografia/métodosRESUMO
Synovial sarcoma is a malignant spindle cell neoplasm normally arising from tissues around joints, bursa and tendon sheaths. Several reports involving the gastrointestinal tract, mainly the oesophagus and stomach, have been documented; however, the omentum remains an extremely unusual location. Monophasic type is composed exclusively of spindle cells arranged in fascicles. Establishing the correct diagnosis of these tumours could be challenging because of the similarities with gastrointestinal stromal tumours and other mesenchymal tumours with similar histology.
Assuntos
Omento , Neoplasias Peritoneais , Sarcoma Sinovial , Humanos , Imuno-Histoquímica , Omento/diagnóstico por imagem , Omento/patologia , Omento/cirurgia , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/cirurgia , Radiografia Abdominal , Sarcoma Sinovial/diagnóstico por imagem , Sarcoma Sinovial/patologia , Sarcoma Sinovial/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Leishmaniosis caused by Leishmania infantum is present in Mediterranean countries, with high prevalence in areas of the center and south of Spain. However, in some regions such as Extremadura (in southwest of Spain), data has not been updated since 1997. The aim of this work was (i) to provide information about the distribution of phlebotomine sand fly species in western of Spain (Extremadura region), (ii) to determine risk factors for the presence of sand fly vectors and (iii) to detect Leishmania DNA and identify blood meal sources in wild caught females. During 2012-2013, sand flies were surveyed using CDC miniature light-traps in 13 of 20 counties in Extremadura. Specimens were identified morphologically and females were used for molecular detection of Leishmania DNA by kDNA, ITS-1 and cyt-B. In addition, blood meals origins were analyzed by a PCR based in vertebrate cyt b gene. A total of 1083 sand flies of both gender were captured and identified. Five species were collected, Phlebotomus perniciosus (60.76%), Sergentomyia minuta (29.92%), P. ariasi (7.11%), P. papatasi (1.48%) and P. sergenti (0.74%). The last three species constitute the first report in Badajoz, the most southern province of Extremadura region. Leishmania DNA was detected in three out of 435 females (one P. pernicious and two S. minuta). Characterization of obtained DNA sequences by phylogenetic analyses revealed close relatedness with Leishmania tarentolae in S. minuta and L. infantum in P. perniciosus. Haematic preferences showed a wide range of hosts, namely: swine, humans, sheep, rabbits, horses, donkeys and turkeys. The simultaneous presence of P. perniciosus and P. ariasi vectors, the analysis of blood meals, together with the detection of L. infantum and in S. minuta of L. tarentolae, confirms the ideal conditions for the transmission of this parasitosis in the western of Spain. These results improve the epidemiological knowledge of leishmaniosis and its vectors in this part of Spain, highlighting the need for ongoing entomological and parasitological surveillance.
Assuntos
Comportamento Alimentar/fisiologia , Leishmania infantum/genética , Psychodidae/fisiologia , Animais , DNA de Cinetoplasto , Feminino , Humanos , Masculino , Reação em Cadeia da Polimerase , Psychodidae/classificação , Fatores de Risco , Espanha/epidemiologiaRESUMO
Food safety regulations require the control of the presence of protozoa in meats destined for human consumption. Wild boar (Sus scrofa) meat may constitute a source of zoonoses. A 23.8% (688/2881) seroprevalence of anti-Toxoplasma gondii antibodies and 72.2% (662/910) Sarcocystis sarcocysts prevalence were detected among wild boars hunted in Southwestern areas of Spain. Identity of Sarcocystis spp. was performed by RFLP-PCR and sequencing, detecting S. miescheriana (7/8) and the zoonotic S. suihominis (1/8). Risk assessment studies of these coccidian in meats destined to human consumption are needed.
Assuntos
Sarcocystis/isolamento & purificação , Sarcocistose/veterinária , Sus scrofa , Toxoplasma/isolamento & purificação , Toxoplasmose Animal/parasitologia , Animais , Feminino , Masculino , Sarcocistose/epidemiologia , Sarcocistose/parasitologia , Estudos Soroepidemiológicos , Espanha/epidemiologia , Suínos , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/parasitologia , Toxoplasmose Animal/epidemiologia , ZoonosesRESUMO
OBJECTIVES: Foam sclerotherapy effectiveness mainly depends on the concentration of the sclerosing agent and foam stability. The objective of this study was to determine if the addition of glycerol at different concentrations contributes to the stability of polidocanol foam. CONTROL GROUP: 3% polidocanol. Group 1: polidocanol 3% + glycerin 1.66%. Group 2: polidocanol 3% + glycerin 3.3%. Group 3: polidocanol 3% + Glycerin 5%. Tessari standard method. Five recordings were made for each mixture. Early visual liquefaction time and half liquid time decay were recorded in seconds. Microscopic measurement of the foams. Mixtures surface tension measurement (N/m). RESULTS: Early visual liquefaction: CONTROL GROUP: 27 (±3.11); Group 1: 67.8 (±6.49); Group 2: 48.6 (±8.2); and Group 3: 35.8 (±4.49). Half-liquid time: CONTROL: 129.2 (±11.00); Group 1: 260.4 (±18.99); Group 2: 224.6 (±13.03); and Group 3: 189.2 (±8.52). Bubbles/mm(2)-diameter-wall thickness: CONTROL: 68-98 µm-7 µm; Group 1: 189-60 µm-9 µm; Group 2: 76-92 µm-12 µm; and Group 3: 49-112 µm-20 µm. Surface tension: CONTROL = 5.54 N/m; Group 1 = 5.45 N/m; Group 2 = 5.35 N/m; and Group 3 = 5.21 N/m. CONCLUSIONS: Small amounts of glycerin highly increase the stability and quality of polidocanol foam. This simple chemical method is easily reproducible and applicable.
Assuntos
Glicerol/química , Polietilenoglicóis/química , Soluções Esclerosantes/química , Estabilidade de Medicamentos , Polidocanol , Tensão Superficial , Fatores de TempoRESUMO
Introducción. Existe insuficiente conocimiento sobre qué confianza tienen los pacientes en quienes prestan cuidados de rehabilitación, sus determinantes y la asociación con la evaluación del servicio. Objetivos. Examinar la confianza en la profesionalidad del fisioterapeuta por parte de pacientes en fases post-agudas en Unidades externas de Rehabilitación; determinar los aspectos asistenciales de los pacientes que la condicionan y su relación con la satisfacción del paciente. Material y métodos. Estudio transversal mediante cuestionario autocumplimentado, realizado en Unidades de Rehabilitación de 3 hospitales de la red MAPFRE. Las medidas de resultado fueron: puntuación de problemas (de 0 a 100%) de las experiencias autoinformadas en 7 aspectos de los cuidados (pertenecientes al ambiente organizacional y las actitudes del profesional), satisfacción, confianza en la profesionalidad y, características sociodemográficas y de salud de los participantes. Resultados. Participaron 465 pacientes (respuesta: 90%) con una media de 39,4 (DE=11,9) años. La confianza fue completa en el 61,1% de los participantes. Mientras que la odds ratio (OR)de completa confianza se incrementa con la percepción de cambio funcional (OR=3,77), de crece con tener experiencias problemáticas en algunos aspectos asistenciales: «educación e información» (OR=0,99), «apoyo emocional» (OR=0,97) e «interrupciones durante las sesiones» (OR=0,99). La confianza presenta una correlación positiva con los niveles de satisfacción (p<0,01). Conclusiones. Son muchos los pacientes que desarrollan una completa confianza en los fisioterapeutas, especialmente los que presentan notable mejora funcional y pocas situaciones problemáticas en determinados aspectos asistenciales. Aunque no todos los aspectos asistenciales son igualmente determinantes de la confianza, esta siempre se relaciona con la satisfacción (AU)
Introduction. There is still insufficient knowledge about levels of trust in those who provide rehabilitation care, its determinants and association with service evaluation. Objectives. To examine trust in the professionalism of the physiotherapist who treats patients in post-acute phases in external rehabilitation units. To determine the care aspects of the patients that condition it and its relation with the patients' satisfaction. Materials and methods. A cross-sectional study using a self-administered questionnaire was carried out in the rehabilitation units of 3 private hospitals, belonging to the private network of MAPFRE. Outcome measurements were: scoring problems (from 0 to 100%) of the self-reported experiences in 7 care aspects (belonging to organizational setting and professionals' attitudes), satisfaction, trust in professionalism, and the patients' socio-demographic and health characteristics. Results. A total of 465 patients (response 90%) took part. Mean age was 39.4 years (SD=11.9) and 61.1% of participants had full trust in their physiotherapists. While the odds ratio of full trust increases with perception of functional change (OR=3.77), it decreases with having problematic experiences in certain care aspects: "education and information" (OR=.99), "emotional support" (OR=.97) and "interruptions during the sessions" (OR=.99). Trust has a positive correlation with satisfaction (P<.01). Conclusions. Many patients develop full trust in their physiotherapists, particularly those who experience functional improvement and have few problematic situations in certain care aspects. Although not all care aspects are equally decisive for trust, the latter is always associated with satisfaction (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Serviço Hospitalar de Fisioterapia , Serviço Hospitalar de Fisioterapia , Especialidade de Fisioterapia , Técnicas de Exercício e de Movimento , Satisfação do Paciente/estatística & dados numéricos , Confiança , Conhecimentos, Atitudes e Prática em Saúde , /ética , Especialidade de Fisioterapia/ética , Satisfação do Paciente/economia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Avaliação de Processos e Resultados em Cuidados de Saúde/tendências , Estudos Transversais/métodos , Inquéritos e Questionários , Coleta de Dados/métodos , Coleta de Dados , Modelos LogísticosRESUMO
BACKGROUND: While patients' satisfaction with rehabilitation care is often measured, the knowledge of their experiences during delivery of care and of which characteristics may lead them to experience problems remains largely undocumented. AIM: To assess the quality of patients' experiences receiving post-acute care for musculoskeletal disorders in outpatient rehabilitation settings. To describe the extent to which variations in reported quality of patients' experiences were related to their characteristics. DESIGN: A cross sectional, self-reported survey. SETTING: 3 outpatient rehabilitation units. POPULATION: Four hundred sixty-five outpatients. Mean age 39.4 (SD=11.9). METHODS: A problem score (from 0 to 100%) of self-reported experiences was calculated on 7 specific aspects of care (belonging to organizational environment and professionals' attitudes and behaviors) and compared among participants' subgroups. RESULTS: Mean scores of the organizational environment area showed higher amount of problems (43.3%) than the professionals' attitudes and behaviours area (34.7%). Two multivariate linear regression models (with adjusted R(2) 9.3% and 4.9%) indicated that older patients and those with high global rating change were less likely to experience problems in the two areas. CONCLUSION: Problems on aspects of care were commonly experienced by patients with musculoskeletal disorders in outpatient rehabilitation settings. The age and health of patients were associated to these problems, but explained only a small variation in them. CLINICAL REHABILITATION IMPACT: Surveys measuring patients' experiences can be used to monitor the actual performance of rehabilitation settings and to pinpoint the exact issues needing to be addressed to improve quality as well as to make comparison among centres.
Assuntos
Atitude Frente a Saúde , Pessoas com Deficiência/reabilitação , Doenças Musculoesqueléticas/reabilitação , Pacientes Ambulatoriais/psicologia , Satisfação do Paciente , Qualidade da Assistência à Saúde , Adolescente , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Pessoas com Deficiência/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/psicologia , Psicometria , Inquéritos e Questionários , Adulto JovemAssuntos
Hepacivirus/genética , Hepatite C/virologia , Adulto , Genótipo , Humanos , Masculino , EspanhaRESUMO
The aim of this study was to describe the surgical technique employed and our results in the treatment of saccular aneurysms of the internal carotid artery at the extracranial level. We describe 3 cases of patients with saccular aneurysms of the extracranial internal carotid who underwent surgery at our unit within the last 3 years. We report on indications for treatment, surgical technique and results in terms of morbidity-mortality and also review the pertinent literature. Surgical treatment was indicated on the grounds of the patients being symptomatic: 2 had a history of cerebral ischemia, and 1 showed local compression symptoms. The surgical approach was presternocleidomastoid cervicotomy extended distally, and in 2 patients was accompanied by nasotracheal intubation to achieve adequate exposure. In 2 cases, we performed an aneurysmectomy with end-to-end anastomosis. In the third patient, the aneurysm neck was ligated from within the sac followed by aneurysmectomy. There was no mortality or neurological morbidity (local or general). The patients remain free from neurological symptoms with a patent carotid axis. Our clinical experience suggests that, despite the anatomically unfavorable location of this type of aneurysm and the greater complexity of the surgical technique, this patient group can be effectively treated. The frequent presence of an elongated carotid axis and an aneurysmal neck means the surgeon can easily restore arterial continuity by direct procedures.
Assuntos
Aneurisma/cirurgia , Artéria Carótida Interna/cirurgia , Procedimentos Cirúrgicos Vasculares , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica , Aneurisma/diagnóstico por imagem , Aneurisma/fisiopatologia , Angiografia Digital , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/fisiopatologia , Feminino , Humanos , Ligadura , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Grau de Desobstrução Vascular , Procedimentos Cirúrgicos Vasculares/efeitos adversosRESUMO
BACKGROUND: According to the World Health Organization (WHO), goiter is endemic in Spain. The main cause of endemic goiter is iodine deficiency, which is also the principal cause of mental retardation and avoidable cerebral palsy throughout the world. MATERIAL AND METHODS: We conducted an observational study to determine the prevalence of endemic goiter and nutritional iodine status in the province of Alicante. Urinary iodine excretion was measured in a morning urine sample, and thyroid volume was measured by means of a thyroid ultrasound scan. A case of goiter was diagnosed if thyroid volume was above the 97th percentile adjusted by age, as published by the WHO. RESULTS: No cases of goiter were found. In addition, the median urinary iodine excretion levels adjusted by age were within the normal range, as defined by the WHO's criteria. CONCLUSIONS: Endemic goiter was not found in the province of Alicante and urinary iodine excretion values demonstrated adequate iodine intake. Further ultrasound studies are needed to establish reference thyroid volumes for our population.
Assuntos
Bócio Endêmico/epidemiologia , Iodo/deficiência , Estado Nutricional , Área Programática de Saúde , Criança , Estudos Transversais , Feminino , Bócio Endêmico/diagnóstico , Bócio Endêmico/metabolismo , Humanos , Masculino , Prevalência , Espanha/epidemiologiaRESUMO
A retrospective study of the susceptibility to antimicrobials (amikacin, tobramycin, gentamicin, ceftazidime, cefepime, piperacillin, piperacil-lin-tazobactam, imipenem, meropenem and ciprofloxacin) of 5,811 Pseudomonas aeruginosa isolates was performed in a general hospital over a period of 12 years. The majority of isolates was from respiratory samples (31.99%), followed by urine samples (26.36%) and ear samples (10.51%). There was a predominance of hospital strains (69.66%); 50.30% of those from medical services, 31.74% from critical care services (mainly ICU) and the remaining from surgical services. No antimicrobial included in our study showed an activity over all isolated strains. In health centers the majority of antimicrobials showed good activity, with a percentage of resistance less than 10%. However, hospital strains showed that only amikacin, piperacillin-tazobactam and meropenem had a percentage of resistance near or lower than 10%. In both environments, gentamicin presented with the highest percentage of resistance. Strains from patients hospitalized in critical care services showed an elevated resistance to tobramycin, imipenem and ceftazidime, while strains from patients in medical services showed resistance to ciprofloxacin. Similar studies published in Spain confirm the importance of conducting local studies in order to understand the antimicrobial susceptibility of P. aeruginosa in each region, and especially to carry out empirically based treatments.
Assuntos
Resistência a Medicamentos , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/efeitos dos fármacos , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Farmacorresistência Bacteriana Múltipla , Departamentos Hospitalares , Hospitais Gerais/estatística & dados numéricos , Humanos , Otite Média/epidemiologia , Otite Média/microbiologia , Infecções por Pseudomonas/epidemiologia , Pseudomonas aeruginosa/isolamento & purificação , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Estudos Retrospectivos , Espanha/epidemiologia , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologiaRESUMO
PURPOSE: To compare efficacy in terms of pathologic response in LARC patients treated with preoperative chemoradiation, with or without a short-intense course of induction oxaliplatin. PATIENTS AND METHODS: From 05/98 to 10/02, 114 patients were treated with preoperative chemoradiation (4500-5040 cGy + oral Tegafur 1200 mg/day) for cT(3)-(4)N(+/x)M(0) rectal cancer. Starting 05/01, 52 consecutive patients additionally received induction FOLFOX-4, oxaliplatin (85 mg/m(2) iv d1), 5-FU (400 mg/m(2) iv bolus d1) and 600 mg/m(2) iv continuous infusion in 22 h with leucovorin (200 mg iv) d1 and d2, every 15 days (2 cycles), followed by the previously described Tegafur chemoradiation regime. Surgery was performed in 5-6 weeks. Pathological assessment investigated post-treatment T and N status in the rectal wall and peri-rectal tissues. RESULTS: Patients, tumor and treatment characteristics were comparable between groups. Incidence of pT(0) specimens was significantly increased by induction FOLFOX-4 (P = 0.006). Total T and N downstaging were 58% versus 75% and 42% versus 40%, respectively (P = ns). T downstaging of > or =2 categories was significantly superior in FOLFOX-4 group (P = 0.029). CONCLUSIONS: Short-intense induction FOLFOX-4 significantly improves pathologic complete response in LARC patients treated with tegafur-sensitized preoperative chemoradiation. The 44% rate of pT(0)-(1) specimens observed in the oxaliplatin group should impulse innovative surgical approaches to promote ano-rectal sphincter conserving protocols.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cuidados Pré-Operatórios/métodos , Neoplasias Retais/tratamento farmacológico , Tegafur/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Terapia Combinada , Feminino , Fluoruracila/efeitos adversos , Fluoruracila/uso terapêutico , Humanos , Leucovorina/efeitos adversos , Leucovorina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Compostos Organoplatínicos/administração & dosagem , Compostos Organoplatínicos/efeitos adversos , Compostos Organoplatínicos/uso terapêutico , Oxaliplatina , Dosagem Radioterapêutica , Neoplasias Retais/patologia , Neoplasias Retais/radioterapia , Neoplasias Retais/cirurgia , Tegafur/efeitos adversosRESUMO
Todos los pacientes a los que se les ha realizado una amputación de miembro inferior (AMI) entre enero de 1989 y diciembre de 2003 en el Área 7 de Madrid se identificaron a través de los partes de quirófano. Los informes de alta del servicio de cirugía vascular y del servicio de endocrinología, así como los médicos de familia (prescriptores), se utilizaron como fuente secundaria. De acuerdo con la Declaración de San Vincent, se observó una reducción en las AMI y un retraso en la edad de presentación, y se relacionó con una mejoría en la asistencia dispensada a las personas con diabetes. A pesar de esta mejoría, se podría alcanzar una reducción más importante en las AMI con un cribado de neuropatía más temprano, con programas de intervención basados en una educación bien estructurada de forma continuada, y facilitando el acceso al podólogo cubierto por la Seguridad Social en pacientes con pie en riesgo. El coste económico ahorrable se ha estimado en más de 100.000 A anuales por cada 100.000 habitantes
All patients who underwent a lower extremity amputation (LEAs) between January 1989 and December 2003 in Area 7, Madrid, were identified through operating theatre records. Vascular surgery department and Endocrinology service discharge records, and prescribing family doctors were used as secondary sources. According to Saint Vincent Declaration, a substantial decrease in LEAs and a later presentation were observed and related to a series of improvements in diabetic treatment. Despite these figures, a more substantial reduction in LEAs in diabetic people could be achieved with an earlier neuropathy screening, and intervention programes based on a continuing and well-structured education. The potential cost saving per 100.000 inhabitants and per year was estimated to be about 100.000 A
Assuntos
Humanos , Pé Diabético/cirurgia , Pé Diabético/economia , Pé Diabético/prevenção & controle , Amputação Cirúrgica/estatística & dados numéricos , Amputação Cirúrgica/economia , Amputação Cirúrgica/tendênciasRESUMO
A total of 72 specific pathogen-free (SPF) and Iberian pigs (three animals per group) were inoculated with 200, 1000 or 20,000 muscle larvae of T. spiralis, T. nativa, T. britovi and T. pseudospiralis. For each animal, the muscle larva burden was evaluated in nine muscle samples by digestion. The anti-Trichinella IgG kinetics in blood samples, taken twice prior and at days 5, 10, 15, 20, 25, 30, 40, 50 and 60 post-inoculation, and in muscle juice, obtained at necropsy, was evaluated by an ELISA using an excretory/secretory antigen. The mean larval recovery rate in SPF/Iberian pigs corresponded with the level of inoculum dose, and tongue, diaphragm and masseter were identified as predilection muscles. In SPF and Iberian pigs receiving 20,000 larvae of T. spiralis, an earlier seroconversion was detected from day 25 post-inoculation. At a 10-fold dilution, the muscle juice showed a good test agreement with blood serum.
Assuntos
Ensaio de Imunoadsorção Enzimática/veterinária , Doenças dos Suínos/parasitologia , Trichinella/crescimento & desenvolvimento , Triquinelose/veterinária , Animais , Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos/química , Ensaio de Imunoadsorção Enzimática/métodos , Proteínas de Helminto/química , Músculo Esquelético/parasitologia , Organismos Livres de Patógenos Específicos , Suínos , Doenças dos Suínos/diagnóstico , Triquinelose/sangue , Triquinelose/parasitologiaRESUMO
Severe aortoiliac occlusive disease (AOD) is a clinical manifestation of peripheral arteriosclerosis. Atherosclerosis has been associated with some human leukocyte antigen (HLA)-DRB1 alleles, stressing its relationship with autoimmune or inflammatory disorders. Additionally, in rheumatoid arthritis patients, the DRB1*0404 allele is specifically associated with endothelial dysfunction. Our objective was to assess the role of class II HLA alleles in the susceptibility to AOD; a combined study of the nearby tumor necrosis factor (TNF) locus was also performed. We included 104 AOD patients and 504 healthy controls from Madrid. DRB1 typing and DRB1*04 subtyping was done by polymerase chain reaction amplification followed by hybridization with specific oligonucleotides. TNF-alpha and TNF-beta microsatellites were studied by polymerase chain reaction and capillary electrophoresis. None of the markers was associated with AOD, although a trend was observed for DRB1*0404 (OR = 2.18; p = 0.05). However, among DRB1*0404 individuals, the TNFa11-b4 pair was present more frequently in patients than in controls (OR = 16.0; p = 0.007). The combined appearance of TNFa11-b4 and DRB1*0404 was much more frequent in patients than in controls (OR = 5.92; p = 0.0013), a result enhanced by haplotypic estimates (OR = 10.0; p = 0.00017). Our results show that the HLA region modulates the predisposition to AOD. More specifically, they suggest that an extended haplotype encompassing DRB1*0404 and TNFa11-b4 carries a genetic factor conferring susceptibility to AOD.
Assuntos
Arteriopatias Oclusivas/genética , Aterosclerose/genética , Antígenos HLA-DR/genética , Linfotoxina-alfa/genética , Fator de Necrose Tumoral alfa/genética , Alelos , Intervalos de Confiança , Feminino , Frequência do Gene , Predisposição Genética para Doença , Cadeias HLA-DRB1 , Haplótipos , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Polimorfismo GenéticoRESUMO
This research consists of an evaluation of the effectiveness of different substances administered as adjuvants in the stimulation of humoral immune response induced by the vaccine composed of strains A1, A2 and C of Dichelobacter nodosus. To do this, a total of 120 Merino sheep were vaccinated and revaccinated. These sheep were selected from a farm located in the region of Extremadura (Spain), and they were divided into 12 groups of 10 animals each. An additional group with 10 sheep was used as control. The immune response (titre of antibodies) was determined by agglutination tests and ELISA. The most pronounced immune response was obtained by the use of Freund's incomplete adjuvant and aluminium hydroxide as adjuvants.
Assuntos
Adjuvantes Imunológicos/normas , Anticorpos Antibacterianos/biossíntese , Dichelobacter nodosus/imunologia , Infecções por Bactérias Gram-Negativas/veterinária , Doenças dos Ovinos/prevenção & controle , Vacinação/veterinária , Testes de Aglutinação/veterinária , Animais , Anticorpos Antibacterianos/sangue , Temperatura Corporal , Estudos de Casos e Controles , Dichelobacter nodosus/patogenicidade , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Infecções por Bactérias Gram-Negativas/imunologia , Infecções por Bactérias Gram-Negativas/prevenção & controle , Masculino , Ovinos , Doenças dos Ovinos/imunologiaRESUMO
The immunodetection of local Ascaris suum antigens and local and systemic antibodies were analysed in pigs reinfected with eggs or immunized with the 14, 42 and 97 kilodalton (kDa) fractions from A. suum. Twenty-one Iberian pigs were divided in 7 groups of 3 pigs. Groups 1 and 2 were uninfected and challenge control groups, respectively. Groups 3 and 4 were infected weekly with increasing doses of A. suum eggs and Group 4 was additionally treated with pyrantel pamoate. Groups 5, 6 and 7 were immunised with the 14, 42 or 97 kDa fractions from adult worms, respectively. Groups 2-7 were challenged with 10,000 infective eggs. Animals of Groups 3 and 4 showed a pulmonary granulomatous reaction with moderate number of eosinophils and leukocytes, while Groups 5-7 presented higher number of cells, especially in animals immunized with the 42 kDa fraction. These immunized groups presented abundant deposition of Ascaris body fluid (BF) and body wall (BW) antigens as well as the 14 and 42 kDa fractions in the pulmonary and intestinal tissues, while lower deposition of antigens was observed in animals of Groups 3 and 4. The immunized pigs of Groups 5 and 6 showed the highest systemic IgG titres in serum and these antibodies were negatively correlated with the number of larvae recovered in the lungs, suggesting that the IgG response may have a protective function against the ascariosis. The highest concentrations of IgA-bearing cells were observed in animals of Groups 3 and 4 compared to the immunised pigs (Groups 5-7), suggesting that local IgA production may be involved in the protection against migrating larvae. The main localisations of IgA-bearing cells were the bronchial and peribronchial areas of lungs and the lamina propia of duodenum. Low numbers of local IgG-bearing cells were observed in all animals and no IgM-bearing cells were detected in the local tissues.
Assuntos
Ascaríase/imunologia , Ascaríase/veterinária , Ascaris suum/crescimento & desenvolvimento , Intestino Delgado/imunologia , Pulmão/imunologia , Doenças dos Suínos/imunologia , Doenças dos Suínos/parasitologia , Animais , Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos/imunologia , Ascaríase/sangue , Ascaríase/parasitologia , Ascaris suum/imunologia , Contagem de Células/veterinária , Ensaio de Imunoadsorção Enzimática/veterinária , Imunização/veterinária , Imuno-Histoquímica/veterinária , Intestino Delgado/parasitologia , Intestino Delgado/patologia , Pulmão/parasitologia , Pulmão/patologia , Distribuição Aleatória , Suínos , Doenças dos Suínos/sangueRESUMO
A total of 35 pigs aged 15 weeks old, and 21 pigs aged 8 weeks old were divided into 7 groups. Groups 1 and 2 were uninfected and challenge control groups, respectively. Groups 3 and 4 were infected weekly with 6 increasing doses of Ascaris suum eggs, and group 4 was additionally treated with pyrantel. Groups 5, 6, and 7 were immunized weekly with the 14, 42, or 97 kDa fractions from adult worms, respectively. Animals of groups 2-7 were challenged with 10000 A. suum eggs 7 days after the last infection/immunization. Serum was sampled weekly and specific IgG1, IgG2, and IgM responses were measured. Pigs of groups 5, 6, and 7 showed high IgG1 and IgG2 responses especially against adult worms antigens, while infected groups had high IgG1 and IgM responses, especially against larva. The IgG1 responses were negatively correlated to the numbers of larvae in the lungs, and positively associated with the liver white spot numbers. There was a positive correlation between IgG2 and the numbers of white spots and lung larvae, while IgM was negatively correlated with these parasitological measures. These findings are discussed and it is suggested that acquired resistance against A. suum larvae is correlated with the induction of IgG1 and IgM, and not with IgG2, and that future vaccination protocols may focus on inducing the Th2 activity.
Assuntos
Anticorpos Anti-Helmínticos/biossíntese , Ascaríase/veterinária , Ascaris suum/imunologia , Imunização/veterinária , Imunoglobulina G/biossíntese , Imunoglobulina M/biossíntese , Doenças dos Suínos/parasitologia , Animais , Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos/imunologia , Ascaríase/imunologia , Ascaríase/parasitologia , Ensaio de Imunoadsorção Enzimática , Imunoglobulina G/sangue , Isotipos de Imunoglobulinas/biossíntese , Isotipos de Imunoglobulinas/sangue , Imunoglobulina M/sangue , Fígado/parasitologia , Fígado/patologia , Pulmão/parasitologia , Pulmão/patologia , Suínos , Doenças dos Suínos/imunologiaRESUMO
OBJECTIVE: to establish a possible role for autoimmunity in the aetiology of abdominal aortic aneurysm (AAA) by examining human leukocyte antigen class II (HLA-II) immune response genes. MATERIALS AND METHODS: HLA-II typing was performed in a series of 72 AAA patients and a control group of 380 healthy subjects. RESULTS: a higher incidence of the allele subtype HLA-DR B1*0401 was detected in the AAA group with respect to the control group (12.5 vs 5.2%; p = 0.02, OR 2.59). In contrast, the HLA-DR B1*01 allele tended to behave as a protective factor for AAA (12.5% AAA vs 21.3% controls; p = 0.09, OR 0.5). CONCLUSIONS: the association observed here between HLA-DR B1*0401 and HLA-DR B1*01 and unspecific AAA is similar to that reported in several autoimmune diseases. This similarity suggests an essential role for autoimmune factors in the formation of the AAA.