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1.
J Nephrol ; 2024 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-38285316

RESUMO

BACKGROUND: Blood transfusion reactions may have a negative impact on organ function. It is unknown whether this association holds true for acute kidney injury (AKI). Therefore, we conducted a cohort study to assess the association between transfusion reactions and the incidence of AKI and major adverse kidney events. METHODS: In this retrospective cohort study, we included patients who received transfusion of blood products during hospitalization at the Hospital Civil of Guadalajara. We analyzed them according to the development of transfusion reactions, and the aim was to assess the association between transfusion reactions and AKI during long-term follow-up. RESULTS: From 2017 to 2021, 81,635 patients received a blood product transfusion, and 516 were included in our study. The most common transfusion was red blood cell packaging (50.4%), fresh frozen plasma (28.7%) and platelets (20.9%); of the 516 patients, 129 (25%) had transfusion reactions. Patients who had transfusion reactions were older and had more comorbidities. The most common type of transfusion reaction was allergic reaction (70.5%), followed by febrile nonhemolytic reaction (11.6%) and anaphylactoid reaction (8.5%). Most cases were considered mild. Acute kidney injury was more prevalent among those who had transfusion reactions (14.7%) than among those who did not (7.8%), p = < 0.01; those with AKI had a higher frequency of diabetes, vasopressors, and insulin use. Transfusion reactions were independently associated with the development of AKI (RR 2.1, p = < 0.02). Major adverse kidney events were more common in those with transfusion reactions. The mortality rate was similar between subgroups. CONCLUSION: In our retrospective cohort of patients who received blood product transfusions, 25% experienced transfusion reactions, and this event was associated with a twofold increase in the probability of developing AKI and some of the major adverse kidney events during long follow-up.

2.
J Clin Microbiol ; 61(8): e0043823, 2023 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-37395662

RESUMO

Bacteria of the genus Brucella are facultative intracellular parasites that cause brucellosis, a severe animal and human disease. Recently, a group of taxonomists merged the brucellae with the primarily free-living, phylogenetically related Ochrobactrum spp. in the genus Brucella. This change, founded only on global genomic analysis and the fortuitous isolation of some opportunistic Ochrobactrum spp. from medically compromised patients, has been automatically included in culture collections and databases. We argue that clinical and environmental microbiologists should not accept this nomenclature, and we advise against its use because (i) it was presented without in-depth phylogenetic analyses and did not consider alternative taxonomic solutions; (ii) it was launched without the input of experts in brucellosis or Ochrobactrum; (iii) it applies a non-consensus genus concept that disregards taxonomically relevant differences in structure, physiology, population structure, core-pangenome assemblies, genome structure, genomic traits, clinical features, treatment, prevention, diagnosis, genus description rules, and, above all, pathogenicity; and (iv) placing these two bacterial groups in the same genus creates risks for veterinarians, medical doctors, clinical laboratories, health authorities, and legislators who deal with brucellosis, a disease that is particularly relevant in low- and middle-income countries. Based on all this information, we urge microbiologists, bacterial collections, genomic databases, journals, and public health boards to keep the Brucella and Ochrobactrum genera separate to avoid further bewilderment and harm.


Assuntos
Brucella , Ochrobactrum , Ochrobactrum/classificação , Ochrobactrum/genética , Ochrobactrum/patogenicidade , Ochrobactrum/fisiologia , Brucella/classificação , Brucella/genética , Brucella/patogenicidade , Brucella/fisiologia , Terminologia como Assunto , Filogenia , Brucelose/tratamento farmacológico , Brucelose/microbiologia , Humanos , Infecções Oportunistas/microbiologia
3.
mSphere ; 8(4): e0006123, 2023 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-37404031

RESUMO

Desmodus rotundus, vampire bats, transmit dangerous infections, and brucellosis is a hazardous zoonotic disease, two adversities that coexist in the subtropical and tropical areas of the American continent. Here, we report a 47.89% Brucella infection prevalence in a colony of vampire bats inhabiting the tropical rainforest of Costa Rica. The bacterium induced placentitis and fetal death in bats. Wide-range phenotypic and genotypic characterization placed the Brucella organisms as a new pathogenic species named Brucella nosferati sp. nov., isolated from bat tissues, including the salivary glands, suggesting feeding behavior might favor transmission to their prey. Overall analyses placed B. nosferati as the etiological agent of a reported canine brucellosis case, demonstrating its potential for infecting other hosts. To assess the putative prey hosts, we analyzed the intestinal contents of 14 infected and 23 non-infected bats by proteomics. A total of 54,508 peptides sorted into 7,203 unique peptides corresponding to 1,521 proteins were identified. Twenty-three wildlife and domestic taxa, including humans, were foraged by B. nosferati-infected D. rotundus, suggesting contact of this bacterium with a broad range of hosts. Our approach is appropriate for detecting, in a single study, the prey preferences of vampire bats in a diverse area, demonstrating its suitability for control strategies where vampire bats thrive. IMPORTANCE The discovery that a high proportion of vampire bats in a tropical area is infected with pathogenic Brucella nosferati and that bats forage on humans and many wild and domestic animals is relevant from the perspective of emerging disease prevention. Indeed, bats harboring B. nosferati in their salivary glands may transmit this pathogenic bacterium to other hosts. This potential is not trivial since, besides the demonstrated pathogenicity, this bacterium possesses all the required virulent arsenal of dangerous Brucella organisms, including those that are zoonotic for humans. Our work has settled the basis for future surveillance actions in brucellosis control programs where these infected bats thrive. Moreover, our strategy to identify the foraging range of bats may be adapted for exploring the feeding habits of diverse animals, including arthropod vectors of infectious diseases, and therefore of interest to a broader audience besides experts on Brucella and bats.


Assuntos
Brucella , Brucelose , Quirópteros , Humanos , Animais , Cães , Estados Unidos , Animais Domésticos , Quirópteros/microbiologia , Animais Selvagens , Brucelose/veterinária
4.
Biomedicines ; 11(7)2023 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-37509537

RESUMO

The vertiginous advance for identifying the genomic sequence of SARS-CoV-2 allowed the development of a vaccine including mRNA-based vaccines, inactivated viruses, protein subunits, and adenoviral vaccines such as Sputnik. This study aims to report on autoimmune disease manifestations that occurred following COVID-19 Sputnik vaccination. Patients and Methods: A retrospective study was conducted on patients with new-onset autoimmune diseases induced by a post-COVID-19 vaccine between March 2021 and December 2022, in two referral hospitals in Mexico City and Argentina. The study evaluated patients who received the Sputnik vaccine and developed recent-onset autoimmune diseases. Results: Twenty-eight patients developed recent-onset autoimmune diseases after Sputnik vaccine. The median age was 56.9 ± 21.7 years, with 14 females and 14 males. The autoimmune diseases observed were neurological in 13 patients (46%), hematological autoimmune manifestations occurred in 12 patients (42%), with thrombotic disease observed in 10 patients (28%), and autoimmune hemolytic anemia in two patients (7.1%). Rheumatological disorders were present in two patients (7.1%), and endocrine disorders in one patient (3.5%). Principio del formulario Conclusion: Although the COVID-19 Sputnik vaccine is generally safe, it can lead to adverse effects. Thrombosis and Guillain-Barre were the most frequent manifestations observed in our group of patients.

5.
Br J Haematol ; 202(4): 776-784, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37386877

RESUMO

The aims of our study were to analyse compliance with the 2014 GELTAMO SMZL Guidelines, in patients with splenic marginal zone lymphoma (SMZL), and to evaluate the outcome according to the HPLLs/ABC-adapted therapeutic strategy. Observational prospective multicenter study of 181 SMZL patients diagnosed between 2014 and 2020. Lymphoma-specific survival (LSS), composite event-free survival (CEFS) and response rates were assessed. 57% of the 168 patients included in the analysis followed the Guidelines. The overall response rate was higher in the rituximab chemotherapy and in the rituximab arms compared with the splenectomy arm (p < 0.001). The 5-year overall survival was 77% and the 5-year LSS of 93%. There were no differences in the 5-year LSS according to the treatment received (p = 0.68). The 5-year CEFS in the overall series was 45%, and there were significant differences between scores A and B (p = 0.036). There were no significant differences when comparing LSS and progression-free survival in patients treated with rituximab or rituximab chemotherapy at diagnosis or after observation. Our data support HPLLs/ABC score as a practical tool for the management of SMZL, observation as the best approach for patients in group A and rituximab as the best treatment for group B.


Assuntos
Leucemia Linfocítica Crônica de Células B , Linfoma de Zona Marginal Tipo Células B , Neoplasias Esplênicas , Humanos , Rituximab/uso terapêutico , Resultado do Tratamento , Estudos Prospectivos , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/tratamento farmacológico , Neoplasias Esplênicas/tratamento farmacológico , Neoplasias Esplênicas/patologia , Esplenectomia/efeitos adversos , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico
7.
Blood Adv ; 7(14): 3695-3709, 2023 07 25.
Artigo em Inglês | MEDLINE | ID: mdl-36995085

RESUMO

The genetic mechanisms associated with splenic marginal zone lymphoma (SMZL) transformation are not well defined. We studied 41 patients with SMZL that eventually underwent large B-cell lymphoma transformation. Tumor material was obtained either only at diagnosis (9 patients), at diagnosis and transformation (18 patients), and only at transformation (14 patients). Samples were categorized in 2 groups: (1) at diagnosis (SMZL, n = 27 samples), and (2) at transformation (SMZL-T, n = 32 samples). Using copy number arrays and a next-generation sequencing custom panel, we identified that the main genomic alterations in SMZL-T involved TNFAIP3, KMT2D, TP53, ARID1A, KLF2, 1q gains, and losses of 9p21.3 (CDKN2A/B) and 7q31-q32. Compared with SMZL, SMZL-T had higher genomic complexity, and higher incidence of TNFAIP3 and TP53 alterations, 9p21.3 (CDKN2A/B) losses, and 6p gains. SMZL and SMZL-T clones arose by divergent evolution from a common altered precursor cell that acquired different genetic alterations in virtually all evaluable cases (92%, 12 of 13 cases). Using whole-genome sequencing of diagnostic and transformation samples in 1 patient, we observed that the SMZL-T sample carried more genomic aberrations than the diagnostic sample, identified a translocation t(14;19)(q32;q13) present in both samples, and detected a focal B2M deletion due to chromothripsis acquired at transformation. Survival analysis showed that KLF2 mutations, complex karyotype, and International Prognostic Index score at transformation were predictive of a shorter survival from transformation (P = .001; P = .042; and P = .007; respectively). In summary, SMZL-T are characterized by higher genomic complexity than SMZL, and characteristic genomic alterations that could represent key players in the transformation event.


Assuntos
Leucemia Linfocítica Crônica de Células B , Linfoma Difuso de Grandes Células B , Neoplasias Esplênicas , Humanos , Neoplasias Esplênicas/genética , Neoplasias Esplênicas/diagnóstico , Neoplasias Esplênicas/patologia , Mutação , Translocação Genética , Linfoma Difuso de Grandes Células B/genética , Leucemia Linfocítica Crônica de Células B/genética
8.
Environ Manage ; 71(4): 847-866, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36348074

RESUMO

The analysis of environmental governance and the analytical frameworks used to study this concept in Latin America show that the term is diffuse and polysemic. The term governance refers to democratic societies that theoretically encourage the plural participation of actors in decision making to solve public or collective socioenvironmental problems. However, in Latin America, there is a broad social perception of a democratic deficit that affects the socioenvironmental sphere. The objective of this work is to determine the main trends in studies on environmental governance in Latin America, the most commonly used analytical frameworks and the predominant approaches to characterize the scientific and political uses of the concept. A systematic literature review is carried out on databases in English and Spanish, and 140 articles that consider environmental governance using various analytical frameworks are analyzed. The main finding is the predominance of a critical perspective on the effectiveness of environmental governance, as well as the associated institutional components and social organizations, because the democratic practices that should support it are questionable.


Assuntos
Conservação dos Recursos Naturais , Política Ambiental , América Latina
9.
Br J Haematol ; 196(1): 146-155, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34519021

RESUMO

We describe 36 patients with splenic marginal zone lymphoma (SMZL) with transformation (SMZL-T), including 15 from a series of 84 patients with SMZL diagnosed at the Hospital Clinic of Barcelona (HCB) and 21 diagnosed with SMZL-T in other centres. In the HCB cohort, the cumulative incidence of transformation at 5 years was 15%. Predictors for transformation were cytopenias, hypoalbuminaemia, complex karyotype (CK) and both the Intergruppo Italiano Linfomi (ILL) and simplified Haemoglobin, Platelet count, lactate dehydrogenase (LDH) and extrahilar Lymphadenopathy (HPLL)/ABC scores (P < 0·05). The only independent predictor for transformation in multivariate analysis was CK [hazard ratio (HR) 4·025, P = 0·05]. Patients with SMZL-T had a significantly higher risk of death than the remainder (HR 3·89, P < 0·001). Of the 36 patients with SMZL-T, one developed Hodgkin lymphoma and 35 a diffuse large B-cell lymphoma, 71% with a non-germinal centre phenotype. The main features were B symptoms, lymphadenopathy, and high serum LDH. CK was observed in 12/22 (55%) SMZL-T and fluorescence in situ hybridisation detected abnormalities of MYC proto-oncogene, basic helix-loop-helix transcription factor (MYC), B-cell leukaemia/lymphoma 2 (BCL2) and/or BCL6 in six of 14 (43%). In all, 21 patients received immunochemotherapy, six chemotherapy, one radiotherapy and three splenectomy. The complete response (CR) rate was 61% and the median survival from transformation was 4·92 years. Predictors for a worse survival in multivariate analysis were high-risk International Prognostic Index (HR 5·294, P = 0·016) and lack of CR (HR 2·67, P < 0·001).


Assuntos
Linfoma de Zona Marginal Tipo Células B/diagnóstico , Baço/patologia , Neoplasias Esplênicas/diagnóstico , Adulto , Idoso , Biomarcadores Tumorais , Transformação Celular Neoplásica , Análise Citogenética , Gerenciamento Clínico , Suscetibilidade a Doenças , Feminino , Humanos , Imuno-Histoquímica , Imunofenotipagem , Hibridização in Situ Fluorescente , Incidência , Linfoma de Zona Marginal Tipo Células B/epidemiologia , Linfoma de Zona Marginal Tipo Células B/etiologia , Linfoma de Zona Marginal Tipo Células B/metabolismo , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Prognóstico , Neoplasias Esplênicas/epidemiologia , Neoplasias Esplênicas/etiologia , Neoplasias Esplênicas/metabolismo
10.
PLoS One ; 16(11): e0260288, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34807952

RESUMO

Bovine brucellosis induces abortion in cows, produces important economic losses, and causes a widely distributed zoonosis. Its eradication was achieved in several countries after sustained vaccination with the live attenuated Brucella abortus S19 vaccine, in combination with the slaughtering of serologically positive animals. S19 induces antibodies against the smooth lipopolysaccharide (S-LPS), making difficult the differentiation of infected from vaccinated bovines. We developed an S19 strain constitutively expressing the green fluorescent protein (S19-GFP) coded in chromosome II. The S19-GFP displays similar biological characteristics and immunogenic and protective efficacies in mice to the parental S19 strain. S19-GFP can be distinguished from S19 and B. abortus field strains by fluorescence and multiplex PCR. Twenty-five heifers were vaccinated withS19-GFP (5×109 CFU) by the subcutaneous or conjunctival routes and some boosted with GFP seven weeks thereafter. Immunized animals were followed up for over three years and tested for anti-S-LPS antibodies by both the Rose Bengal test and a competitive ELISA. Anti-GFP antibodies were detected by an indirect ELISA and Western blotting. In most cases, anti-S-LPS antibodies preceded for several weeks those against GFP. The anti-GFP antibody response was higher in the GFP boosted than in the non-boosted animals. In all cases, the anti-GFP antibodies persisted longer, or at least as long, as those against S-LPS. The drawbacks and potential advantages of using the S19-GFP vaccine for identifying vaccinated animals in infected environments are discussed.


Assuntos
Vacina contra Brucelose/análise , Brucella abortus/isolamento & purificação , Brucelose Bovina/diagnóstico , Brucelose Bovina/prevenção & controle , Proteínas de Fluorescência Verde/análise , Animais , Vacina contra Brucelose/uso terapêutico , Bovinos/microbiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Fluorescência , Proteínas de Fluorescência Verde/uso terapêutico , Camundongos , Reação em Cadeia da Polimerase Multiplex , Vacinação/veterinária
11.
Environ Manage ; 68(6): 900-913, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34528108

RESUMO

The sustainability of management practices in forest ecosystems should provide ecosystem services and maintain the livelihoods that largely depend on the benefits directly derived from forests; but this goal requires various theoretical and analytical approaches. This research aims to develop a conceptual model for sustainable forest management based on the integration of three conceptual frameworks founded on the society-ecosystem interaction: socio-ecological systems, sustainable forest management, and ecosystem services. The results offer a methodological, analytical, organizational, and operational route to integrate a scientific model at the material, causal, and dynamic levels, considering theoretical and empirical information; it uses grounded theory methodology to select the interactions between variables and socio-ecological dynamics of forest ecosystems under community management. For example, it integrates social components (local knowledge, governance, and social organization) and ecological components (diversity and composition of plant species, carbon pools, and nutrient dynamics) to understand their interactions through management practices and the magnitude of the ecosystem services provided according to the local contexts. We illustrate this process by analyzing the influence of governance, decision-making, resource use, and management practices on forest management and ecosystem services; this exemplifies the factors, interactions, and effects on socio-ecological systems based on experience in forest communities. These integrated frameworks provide steps through which our understanding of specific socio-ecological approaches produces better outcomes for sustainable forest management, preserves ecosystems services and benefits livelihoods in Mexican temperate forests.


Assuntos
Conservação dos Recursos Naturais , Ecossistema , Florestas , México , Plantas
12.
Vet Microbiol ; 257: 109072, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33965789

RESUMO

Brucellosis is a prevalent disease in Costa Rica (CR), with an increasing number of human infections. Close to half of homes in CR have one or more dogs, corresponding to ∼1.4 million canines, most of them in the Central Valley within or near the cities of San José, Heredia, and Alajuela. From 302 dog sera collected from this region, 19 were positive for Brucella canis antigens, and five had antibodies against smooth lipopolysaccharide, suggesting infections by both B. canis and other Brucella species. B. canis strains were isolated in the Central Valley from 26 kennel dogs and three pet dogs, all displaying clinical signs of canine brucellosis. We detected three recent introductions of different B. canis strains in kennels: two traced from Mexico and one from Panama. Multiple locus-variable number tandem repeats (MLVA-16) and whole-genome sequencing (WGSA) analyses showed that B. canis CR strains comprise three main lineages. The tree topologies obtained by WGSA and MLVA-16 just partially agreed, indicating that the latter analysis is not suitable for phylogenetic studies. The fatty acid methyl ester analysis resolved five different B. canis groups, showing less resolution power than the MLVA-16 and WGSA. Lactobacillic acid was absent in linages I and II but present in linage III, supporting the recent introductions of B. canis strains from Mexico. B. canis displaying putative functional cyclopropane synthase for the synthesis of lactobacillic acid are phylogenetically intertwined with B. canis with non-functional protein, indicating that mutations have occurred independently in the various lineages.


Assuntos
Brucella canis/genética , Brucelose/epidemiologia , Brucelose/veterinária , Surtos de Doenças/veterinária , Doenças do Cão/microbiologia , Filogenia , Animais , Brucella canis/classificação , Brucella canis/patogenicidade , Costa Rica/epidemiologia , Doenças do Cão/epidemiologia , Cães , Evolução Molecular , Feminino , Variação Genética , Genoma Bacteriano , Genótipo , Espécies Introduzidas , Masculino , México , Panamá , Animais de Estimação/microbiologia , Sequenciamento Completo do Genoma
13.
J Clin Rheumatol ; 27(8): 317-323, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32501939

RESUMO

Galectin-1 (Gal-1) and galectin-3 (Gal-3) are carbohydrate-binding proteins involved in normal processes, autoimmunity, and cancer. Increased serum Gal-3 levels in scleroderma were associated with active disease, vasculopathy, and mortality. OBJECTIVES: The aim of this study was to evaluate Gal-1 and Gal-3 expression in the lesional skin of patients with scleroderma regarding disease severity and organ involvement. METHODS: A cross-sectional study was conducted on patients diagnosed as systemic sclerosis (SSc), after informed consent. Clinical and serological profiles were reviewed from medical records. Lesional skin biopsies were taken by losange incision from patients. Samples were analyzed by immunohistochemistry and compared with normal skin of a healthy patient. Parametric statistical analysis was done with Student t test and Pearson coefficient. Significance was established as p ≤ 0.05 with a 95% confidence interval. RESULTS: Biopsies of 10 patients and a healthy control (9 female, 1 male) were analyzed. The mean age was 54.5 years (18-74 years). Four of 10 patients had diffuse, 4 had limited scleroderma, 1 had overlap syndrome, and 1 had sclerodermiform graft-versus-host disease. The mean fibroblasts count per field was 13.2 in scleroderma versus 7.2 in normal skin. The mean expression of Gal-1 in scleroderma fibroblasts was 13% (0%-56%) and 47.5% for Gal-3 (6.5%-95.5%); in normal skin, the mean expression was 91% (90%-95%) for Gal-1 and 97% (89%-100%) for Gal-3. A higher Gal-3 expression in scleroderma (within its lower expression compared with normal skin) was associated with pulmonary artery hypertension (p = 0.004) and to a higher modified Rodnan's skin score (p = 0.0003). In a similar manner, anti-centromere antibodies were associated with a higher Gal-1 expression in SSc skin fibroblasts (p = 0.04). CONCLUSIONS: Gal-1 and Gal-3 had a lower expression in scleroderma lesional skin compared with a normal control. We found a significant correlation between a higher Gal-3 expression (within the lower ones compared with normal skin) in fibroblasts from SSc patients and severe disease (pulmonary hypertension and a higher modified Rodnan's skin score) compared with patients with lower expression of this protein. Similarly, the presence of anti-centromere antibodies was associated with a higher expression of Gal-1 within this group of patients.


Assuntos
Proteínas Sanguíneas/genética , Galectina 1/genética , Galectinas/genética , Escleroderma Sistêmico , Estudos Transversais , Feminino , Galectina 3 , Humanos , Masculino , Pessoa de Meia-Idade , Escleroderma Sistêmico/diagnóstico , Índice de Gravidade de Doença , Pele
14.
Rev. odontopediatr. latinoam ; 11(1): e-220163, 2021. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1379319

RESUMO

Objetivo: efectuar una revisión sistemática sobre la efectividad de las técnicas de manejo de la conducta en niños sistémicamente sanos, en la consulta de Odontopediatría. Métodos: Investigación descriptiva, retrospectiva, de estudios observacionales y ensayos clínicos aleatorios controlados que evaluaron la efectividad de las técnicas en niños y adolescentes de 03 a 18 años de edad. Resultados: criterios de inclusión artículos en inglés y español, publicados desde 2014 al 2019. El análisis de la calidad metodológica de los estudios se realizó mediante la guía Strobe y CASPe. Se identificaron términos de búsqueda en inglés en el tesauro MeSH en la base de datos Pub­M/Medline, Scopus /Elsevier, español, se utilizaron descriptores de las Ciencias de la Salud (DeCS/BIREME) en la base de datos SciELO.org Redalyc.org, Latindex, Dialnet y google académico. Hubo homogeneidad en los estudios respecto a la selección de escalas para medir ansiedad y miedo en los niños al recibir tratamiento preventivo, curativo o restaurador. Los estudios evaluaron mayoritariamente técnicas de distracción aplicadas con recursos audiovisuales para determinar efectividad sobre el comportamiento de los niños en el consultorio odontológico. También reportaron disminución de la ansiedad y miedo, después de la aplicación de técnicas de distracción, e informaron que hubo cambios de conducta de pacientes ansiosos y negativos a pacientes positivos y colaboradores. Conclusiones: estudios mostraron una insuficiente calidad en sus diseños, lo que no permitió emitir juicios respecto a la contundencia y solidez de la evidencia sobre la efectividad de las técnicas aplicadas.


Objetivo: Realizar uma revisão sistemática da eficácia das técnicas de gerenciamento de comportamento em crianças sistemicamente saudáveis, na consultório de Odontopediatria. Métodos: Estudos descritivos, retrospectivos, observacionais e ensaios clínicos controlados e randomizados que avaliaram a eficácia das técnicas em crianças e adolescentes de 03 a 18 anos. Resultados: Os critérios de inclusão foram artigos em inglês e espanhol, publicados de 2014 a 2019. A análise da qualidade metodológica dos estudos foi realizada na guia Strobe and Consort. Os termos de pesquisa em inglês foram identificados na tesauro MeSH na base de dados PubMed / Medline, Scopus / Elsevier e, em espanhol, os descritores de Ciências da Saúde (DeCS / BIREME) foram utilizados na base de dados SciELO.org Redalyc.org, Latindex, Dialnet e Google Scholar. Houve homogeneidade nos estudos em relação à seleção de escalas para medir ansiedade e medo em crianças ao receber tratamento preventivo, curativo ou restaurador. Os estudos avaliaram principalmente técnicas de distração aplicadas com recursos audiovisuais para determinar sua eficácia na comportamento de crianças na consultório odontológico. Eles também relataram diminuição da ansiedade e medo, após a aplicação de técnicas de distração, e relataram que houve mudanças comportamentais de pacientes ansiosos e negativos para pacientes positivos e colaborativos. Conclusões: Os estudos mostraram qualidade insuficiente em seus desenhos, o que não permitiu julgamentos sobre a força e a força das evidências sobre a eficácia das técnicas aplicadas.


Aim: to conduct a systematic review of the effectiveness of behavior management techniques in systemically healthy children, in the Pediatric Dentistry office. Methods: Descriptive, retrospective, observational studies and randomized controlled clinical trials that evaluated the effectiveness of the techniques in children and teenangers aged 03 to 18 years. Results: The inclusion criteria were articles in English and Spanish, published from 2014 to 2019. The analysis of the methodological quality of the studies was carried out using the Strobe and Consort guide. English search terms were identified in the MeSH thesaurus in the Pub¬M / Medline, Scopus / Elsevier database, and in Spanish, descriptors of Health Sciences (DeCS / BIREME) were used in the SciELO.org database, Redalyc.org, Latindex, Dialnet and Google Scholar. There was homogeneity in the studies regarding the selection of scales to measure anxiety and fear in children when receiving preventive, curative or restorative treatment. The studies mostly evaluated distraction techniques applied with audiovisual resources to determine their effectiveness on the behavior of children in the dentistry office. They also reported decreased anxiety and fear, after the application of distraction techniques, and reported that there were behavioral changes from anxious and negative patients to positive and collaborative patients. Conclusions: The studies showed insufficient quality in their designs, which did not allow judgments regarding the strength and strength of the evidence on the effectiveness of the techniques applied.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Doenças Dentárias/terapia , Efetividade , Comportamento Infantil/psicologia , Assistência Odontológica para Crianças/métodos , Recursos Audiovisuais , Epidemiologia Descritiva , Estudos Retrospectivos , Ansiedade ao Tratamento Odontológico/psicologia , Medo/psicologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-32583689

RESUMO

The clinical manifestations of amyotrophic lateral sclerosis (ALS) are variable in terms of age at disease onset, site of onset, progression of symptoms, motor neuron involvement, and the occurrence of cognitive and behavioral changes. Genetic background is a key determinant of the ALS phenotype. The mortality of the disease also varies with the ancestral origin of the affected population and environmental factors are likely to be associated with ALS at least within some cohorts. Disease heterogeneity is likely underpinned by the presence of different pathogenic mechanisms. A variety of ALS animal models can be informative about the heterogeneity of the neuropathological or genetic aspects of the disease and can support the development of new therapeutic intervention. Evolving biomarkers can contribute to the identification of differing genotypes and phenotypes, and can be used to explore whether genotypic and phenotypic differences in animal models might help to provide a better definition of the heterogeneity of ALS in humans. These include neurofilaments, peripheral blood mononuclear cells, extracellular vesicles, microRNA and imaging findings. These biomarkers might predict not only the development of the disease, but also the variability in progression, although robust validation is required. A promising area of progress in modeling the heterogeneity of human ALS is represented by the use of human induced pluripotent stem cell (iPSCs)-derived motor neurons. Although the translational value of iPSCs remains unclear, this model is attractive in the perspective of replicating the heterogeneity of sporadic ALS as a first step toward a personalized medicine strategy.


Assuntos
Esclerose Lateral Amiotrófica , Células-Tronco Pluripotentes Induzidas , Esclerose Lateral Amiotrófica/epidemiologia , Esclerose Lateral Amiotrófica/genética , Animais , Humanos , Leucócitos Mononucleares , Neurônios Motores , Fenótipo
16.
PLoS Negl Trop Dis ; 14(4): e0008235, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32287327

RESUMO

Brucellosis, caused by Brucella abortus, is a major disease of cattle and humans worldwide distributed. Eradication and control of the disease has been difficult in Central and South America, Central Asia, the Mediterranean and the Middle East. Epidemiological strategies combined with phylogenetic methods provide the high-resolution power needed to study relationships between surveillance data and pathogen population dynamics, using genetic diversity and spatiotemporal distributions. This information is crucial for prevention and control of disease spreading at a local and worldwide level. In Costa Rica (CR), the disease was first reported at the beginning of the 20th century and has not been controlled despite many efforts. We characterized 188 B. abortus isolates from CR recovered from cattle, humans and water buffalo, from 2003 to 2018, and whole genome sequencing (WGS) was performed in 95 of them. They were also assessed based on geographic origin, date of introduction, and phylogenetic associations in a worldwide and national context. Our results show circulation of five B. abortus lineages (I to V) in CR, phylogenetically related to isolates from the United States, United Kingdom, and South America. Lineage I was dominant and probably introduced at the end of the 19th century. Lineage II, represented by a single isolate from a water buffalo, clustered with a Colombian sample, and was likely introduced after 1845. Lineages III and IV were likely introduced during the early 2000s. Fourteen isolates from humans were found within the same lineage (lineage I) regardless of their geographic origin within the country. The main CR lineages, introduced more than 100 years ago, are widely spread throughout the country, in contrast to new introductions that seemed to be more geographically restricted. Following the brucellosis prevalence and the farming practices of several middle- and low-income countries, similar scenarios could be found in other regions worldwide.


Assuntos
Brucella abortus/classificação , Brucella abortus/isolamento & purificação , Brucelose Bovina/epidemiologia , Brucelose Bovina/microbiologia , Brucelose/epidemiologia , Brucelose/microbiologia , Genótipo , Animais , Brucella abortus/genética , Búfalos , Bovinos , Costa Rica/epidemiologia , Humanos , Epidemiologia Molecular , Filogenia , Dinâmica Populacional , Prevalência , Sequenciamento Completo do Genoma
17.
Vector Borne Zoonotic Dis ; 19(12): 889-895, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31407956

RESUMO

Leptospirosis and rabies are zoonotic diseases of public health importance and endemic diseases in tropical countries such as Costa Rica. Peridomestic wild animals such as raccoons (Procyon lotor) have been implicated as competent hosts of Leptospira spirochetes and rabies virus. This study focused on understanding the role of urban raccoons in the dynamics of leptospirosis and rabies in a tropical environment. A total of 97 specimens of the common raccoon were captured within the Greater Metropolitan Area of Costa Rica; 32.6% (31/95) of raccoons presented evidence of antibodies (> 1: 100) against Leptospira sp. Attempts to cultivate Leptospira failed, but 19 serovars were identified, which are also responsible for causing disease in humans in Costa Rica. Detected titers ranged from 1: 100 to 1: 6400. Lymphoid hyperplasia in kidneys and spirochetes were demonstrated in 3 of 20 necropsied cases (15%). Twenty brain samples were analyzed by hematoxylin and eosin stain for evidence of encephalitis and Negri body detection and simultaneously frozen brain material was employed to perform a rapid immunoassay test for rabies antigen. All tested samples were negative. This study is the first report of Leptospira seroprevalence in raccoons that cohabit urban areas in Costa Rica. We also highlight the importance of the raccoon as one of their natural competent host and sentinel animals within highly populated urban environments in tropical cities.


Assuntos
Vírus da Raiva/isolamento & purificação , Raiva/veterinária , Guaxinins/virologia , Animais , Costa Rica/epidemiologia , Reservatórios de Doenças/veterinária , Feminino , Masculino , Raiva/epidemiologia , Raiva/virologia , Estudos Soroepidemiológicos , População Urbana
18.
Sci Rep ; 9(1): 9313, 2019 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-31249336

RESUMO

Salmonella spp. are frequently shed by wildlife including turtles, but S. enterica subsp. enterica serovar Typhimurium or lesions associated with Salmonella are rare in turtles. Between 1996 and 2016, we necropsied 127 apparently healthy pelagic olive ridley turtles (Lepidochelys olivacea) that died from drowning bycatch in fisheries and 44 live or freshly dead stranded turtles from the west coast of North and Central America and Hawaii. Seven percent (9/127) of pelagic and 47% (21/44) of stranded turtles had renal granulomas associated with S. Typhimurium. Stranded animals were 12 times more likely than pelagic animals to have Salmonella-induced nephritis suggesting that Salmonella may have been a contributing cause of stranding. S. Typhimurium was the only Salmonella serovar detected in L. olivacea, and phylogenetic analysis from whole genome sequencing showed that the isolates from L. olivacea formed a single clade distinct from other S. Typhimurium. Molecular clock analysis revealed that this novel clade may have originated as recently as a few decades ago. The phylogenetic lineage leading to this group is enriched for non-synonymous changes within the genomic area of Salmonella pathogenicity island 1 suggesting that these genes are important for host adaptation.


Assuntos
Adaptação Fisiológica , Interações Hospedeiro-Patógeno , Nefropatias/veterinária , Salmonella typhimurium/fisiologia , Tartarugas/microbiologia , Animais , Nefropatias/microbiologia , Oceano Pacífico , Salmonella typhimurium/genética
19.
Front Vet Sci ; 6: 466, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31921922

RESUMO

Fish within the family Tetraodontidae are potential sources of both endogenous tetrodotoxins (TTXs) and dietary derived saxitoxins (STXs). Ingestion of fish tissues containing these toxins by other vertebrates can lead to severe illness and death. The Caribbean sharpnose puffer (Canthigaster rostrata) is a widespread tetraodontid species within the western Atlantic. Mass settlement of juveniles into foraging habitats have been associated with large-scale puffer fish mortality events. In 2013, 2014, and 2017, puffer mortality events on the southern Caribbean coast of Costa Rica were also associated with strandings of green turtles (Chelonia mydas) found to have fed on C. rostrata. Stranded sea turtles were found dead without apparent cause or alive with severe neurological signs that resolved during short periods of captivity. Puffer fish and turtle organ samples were analyzed for both TTXs and STXs. Concentrations of TTXs were extremely low in the fish (0.5-0.7 µg/g) and undetectable in turtle stomach contents. However, concentrations of STXs in whole fish (16.6-47.5 µg STX-eq/g) exceeded the 0.8 µg STX-eq/g human seafood safety threshold for STXs by orders of magnitude. Saxitoxins were also detected in samples of stomach contents (ingested fish), brain, lung, kidney, and serum from three affected turtles. Study results indicate that saxitoxicosis resulting from opportunistic foraging on C. rostrata during fish mortality events may be a significant factor in episodic stranding of green sea turtles in this region.

20.
J Food Sci Technol ; 55(12): 4964-4972, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30482992

RESUMO

Dry soybean (Glycine max) residue (SBR) is a byproduct rich in dietary fibre and protein with high levels of essential amino acids. The effects due to the substitution of refined wheat flour with 5% or 10% SBR in dough rheology and hot-press tortilla texture, dimensions, colour, protein and dietary fibre contents were studied. Substitution of 10% SBR improved flour in terms of gluten strength and sedimentation without significantly affecting dough hardness, cohesiveness, adhesiveness, and extensibility. The dimensions, colour and sensory acceptance of the supplemented tortillas were not affected by the addition of the SBR. The 10% SBR tortillas contained 1.77 times more insoluble dietary fibre, protein content of 9.3%, in vitro protein digestibility of 84% and protein digestibility corrected amino acid score (PDCAAS) of 52.63%. Results indicated that wheat flour tortillas with 10% SBR an excellent alternative to regular counterparts owing to their higher dietary fibre and protein quantity and quality.

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