Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 76
Filtrar
1.
Eur J Haematol ; 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32236988

RESUMO

OBJECTIVES: During allogeneic hematopoietic stem cell transplantation (allo-SCT), infections significantly contribute to morbidity and mortality. A monocentric prospective analysis was performed to assess epidemiology, risk factors, and outcomes of infections during the peri-transplant period. METHODS: Data were recorded prospectively using a predefined questionnaire. RESULTS: In 2015, 163 consecutive patients, 37.4% female, median age 59 (range 18-79) years received 166 allo-SCT. Median duration of leukopenia <109 /L was 14.5 days (range 4-43 days). Fever of unknown origin (FUO) occurred in 118/166 patients (71.1%). Severe sepsis developed in 95, septic shock in 26 patients. Intensive diagnostic workup helped to identify causative microorganisms only in a small number of infectious courses. All but 13 patients needed antibiotic therapy, each according to the standard operating procedures of the department. Cumulative incidence of death by infection after one year was 16.6% (95%CI 11.3-22.7%). The only risk factor for FUO in neutropenia was duration of neutropenia

2.
Pest Manag Sci ; 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-32061024

RESUMO

BACKGROUND: Soil-dwelling predatory mites of the family Laelapidae are augmentatively released for the biological control of several pests with an edaphic phase in numerous greenhouse crops. Yet, there is no information about the potential of releasing these predators to control pests in open field crops. We tested, during two consecutive years, the potential of augmentative releases of Gaeolaelaps aculeifer, alone or in combination with coco fiber discs as mulch, to reduce the damage caused on citrus fruits by the invasive thrips Pezothrips kellyanus in Mediterranean citrus. In a separate trial, we also compared different mulch types (coco fiber discs, rice husks or a mixture of sawdust and wheat bran) for their potential to support the establishment and population development of the predatory mites after their release. RESULTS: The percentage of unmarketable fruits caused by P. kellyanus was significantly reduced in the plots where G. aculeifer was released. The addition of coco fiber discs did not reduce further the percentage of unmarketable fruits. Sawdust + bran mulch was the most effective in preserving immature and adult predatory mite population after their release. CONCLUSION: Augmentative releases of G. aculeifer have the potential to reduce fruit damage caused by P. kellyanus in citrus. © 2020 Society of Chemical Industry.

3.
Int J Mol Sci ; 21(3)2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32033219

RESUMO

Characteristic or classic phenotype of Cornelia de Lange syndrome (CdLS) is associated with a recognisable facial pattern. However, the heterogeneity in causal genes and the presence of overlapping syndromes have made it increasingly difficult to diagnose only by clinical features. DeepGestalt technology, and its app Face2Gene, is having a growing impact on the diagnosis and management of genetic diseases by analysing the features of affected individuals. Here, we performed a phenotypic study on a cohort of 49 individuals harbouring causative variants in known CdLS genes in order to evaluate Face2Gene utility and sensitivity in the clinical diagnosis of CdLS. Based on the profile images of patients, a diagnosis of CdLS was within the top five predicted syndromes for 97.9% of our cases and even listed as first prediction for 83.7%. The age of patients did not seem to affect the prediction accuracy, whereas our results indicate a correlation between the clinical score and affected genes. Furthermore, each gene presents a different pattern recognition that may be used to develop new neural networks with the goal of separating different genetic subtypes in CdLS. Overall, we conclude that computer-assisted image analysis based on deep learning could support the clinical diagnosis of CdLS.

5.
Int J Mol Sci ; 20(24)2019 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-31817290

RESUMO

There are three human enzymes with HMG-CoA lyase activity that are able to synthesize ketone bodies in different subcellular compartments. The mitochondrial HMG-CoA lyase was the first to be described, and catalyzes the cleavage of 3-hydroxy-3-methylglutaryl CoA to acetoacetate and acetyl-CoA, the common final step in ketogenesis and leucine catabolism. This protein is mainly expressed in the liver and its function is metabolic, since it produces ketone bodies as energetic fuels when glucose levels are low. Another isoform is encoded by the same gene for the mitochondrial HMG-CoA lyase (HMGCL), but it is located in peroxisomes. The last HMG-CoA lyase to be described is encoded by a different gene, HMGCLL1, and is located in the cytosolic side of the endoplasmic reticulum membrane. Some activity assays and tissue distribution of this enzyme have shown the brain and lung as key tissues for studying its function. Although the roles of the peroxisomal and cytosolic HMG-CoA lyases remain unknown, recent studies highlight the role of ketone bodies in metabolic remodeling, homeostasis, and signaling, providing new insights into the molecular and cellular function of these enzymes.

7.
Reumatol. clín. (Barc.) ; 15(4): 229-236, jul.-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184416

RESUMO

Objetivo: Describir los objetivos, la metodología y los resultados del primer año de la nueva versión del registro español de acontecimientos adversos de terapias biológicas y fármacos sintéticos con diana identificable en enfermedades reumáticas (BIOBADASER III). Metodología: Registro prospectivo multicéntrico de pacientes con enfermedades inflamatorias reumáticas en tratamiento con terapia biológica o fármacos sintéticos con diana identificable y atendidos en servicios de Reumatología en España. El objetivo principal de BIOBADASER Fase III es la recogida y análisis de acontecimientos adversos al que se ha añadido como objetivo secundario la evaluación de la efectividad mediante la recogida de índices de actividad. Los pacientes que entran en el registro son evaluados al menos una vez cada año y cada vez que presenten un acontecimiento adverso o se produzcan modificaciones en el tratamiento. La recogida de datos de la fase iii se inició el 17 de diciembre del 2015. Resultados: Durante el primer año han participado 35 centros. El número de pacientes incluidos en esta nueva fase en diciembre del 2016 era de 2.664. La edad media era de 53,7 años, con una mediana de duración de la enfermedad hasta el inicio de tratamiento de 8,1 años. Un 40,4% de los pacientes estaban diagnosticados de artritis reumatoide. Los acontecimientos adversos más frecuentes eran las infecciones e infestaciones. Conclusiones: La fase iii de BIOBADASER se ha puesto en marcha para responder a un entorno farmacológico cambiante con la aparición de los biosimilares y las pequeñas moléculas en el tratamiento de la patología reumática. Esta nueva etapa se adapta a los cambios normativos en la comunicación de acontecimientos adversos y amplía la información recogida incluyendo los índices de actividad


Objective: Describe the objectives, methods and results of the first year of the new version of the Spanish registry of adverse events involving biological therapies and synthetic drugs with an identifiable target in rheumatic diseases (BIOBADASER III). Methodology: Multicenter prospective registry of patients with rheumatic inflammatory diseases being treated with biological drugs or synthetic drugs with an identifiable target in rheumatology departments in Spain. The main objective of BIOBADASER Phase III is the registry and analysis of adverse events; moreover, a secondary objective was added consisting of assessing the effectiveness by means of the registry of activity indexes. Patients in the registry are evaluated at least once every year and whenever they experience an adverse event or a change in treatment. The collection of data for phase iii began on 17 December 2015. Results: During the first year, 35 centers participated. The number of patients included in this new phase in December 2016 was 2,664. The mean age was 53.7 years and the median duration of treatment was 8.1 years. In all, 40.4% of the patients were diagnosed with rheumatoid arthritis. The most frequent adverse events were infections and infestations. Conclusions: BIOBADASER Phase III has been launched to adapt to a changing pharmacological environment, with the introduction of biosimilars and small molecules in the treatment of rheumatic diseases. This new stage is adapted to the changes in the reporting of adverse events and now includes information related to activity scores


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Sistemas de Notificação de Reações Adversas a Medicamentos/organização & administração , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Terapia Biológica/efeitos adversos , Doenças Reumáticas/tratamento farmacológico , Antirreumáticos/efeitos adversos , Anticorpos Monoclonais Humanizados/efeitos adversos , Medicamentos Sintéticos/efeitos adversos
8.
Nutr Hosp ; 36(1): 233-237, 2019 Mar 07.
Artigo em Espanhol | MEDLINE | ID: mdl-30834770

RESUMO

Introduction: Objective: to present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the year 2016 and 2017. Material and methods: from January 1st 2016 to December 31st 2017, the HEN registry was recorded and afterwards a further descriptive and analytical analysis was done. Results: in 2016, 4,578 active patients were recorded and prevalence was 98.33 patients per one million inhabitants; in 2017, 4,777 patients were recorded, with a prevalence of 102.57 per one million inhabitants; 50.8% were males in 2016 and 50.5% in 2017. During the period 2016-17, median age was 71.5 years (IIQ 57-83), 1,558 HEN episodes were finished and the main cause was death (793 patients, 50.89%). Adult males were younger than females (65.3 vs. 73.3 years, p-value < 0.001). The most frequent diagnosis was the neurological disorder that presents with aphagia or severe dysphagia (59%). Nasogastric tube was the most frequent administration route (48.3%) and it is the most widely used in elderly patients (p < 0.001). One hundred and twenty-six pediatric patients were registered (57.1% females). Median age at the beginning of HEN in children was four months. "Other disorders" was the most recorded diagnostic group (41.3%), followed by the group of neurological disorder that presents with aphagia or severe dysphagia. Regarding children, 57.6% were fed through gastrostomy and the younger ones were fed through nasogastric tube (p-value 0.001). Conclusions: the number of patients in the registry, as well as the number of participating centers, is progressively increasing. The main characteristics of the patients have not changed. Despite the increase in diagnostic possibilities in the pediatric population, the classification within the group of "Other pathologies" is quite significant.


Assuntos
Nutrição Enteral/estatística & dados numéricos , Nutrição Parenteral no Domicílio/estatística & dados numéricos , Sistema de Registros , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Nutrição Enteral/tendências , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Nutrição Parenteral no Domicílio/tendências , Fatores Sexuais , Espanha/epidemiologia , Adulto Jovem
9.
Nutr. hosp ; 36(1): 233-237, ene.-feb. 2019. graf
Artigo em Espanhol | IBECS | ID: ibc-183207

RESUMO

Objetivo: exponer los resultados del registro de nutrición enteral domiciliaria (NED) de los años 2016 y 2017 del Grupo NADYA-SENPE. Material y métodos: se recopilaron los pacientes introducidos en el registro del 1 de enero al 31 de diciembre de 2016 y la mismas fechas de 2017 para proceder al análisis descriptivo y analítico de los datos. Resultados: en el año 2016 se obtuvieron 4.578 pacientes activos (prevalencia = 98,33 pacientes/millón de habitantes) y en 2017 fueron 4.777 (prevalencia = 102,57). Por sexos, hubo un 50,8% de varones en 2016 y un 50,5% en 2017. En el periodo 2016-17, la edad mediana fue de 71,5 años (IIQ 57-83); asimismo, finalizaron 1.558 episodios de NED y la causa principal fue el fallecimiento (793 pacientes, 50,89%). Los varones adultos fueron más jóvenes que las mujeres (65,3 vs. 73,3 años, p-valor < 0,001) y el diagnóstico más frecuente fue la enfermedad neurológica que cursa con afagia o disfagia severa (59%). La sonda nasogástrica (SNG) fue la vía de acceso más utilizada (48,3%) y se observa, además, que esta es la vía que se utiliza en los pacientes más ancianos (p < 0,001). Se registraron 126 pacientes pediátricos (57,1% niñas). La edad mediana de inicio de la NED fue de cuatro meses. Otras patologías fue el grupo diagnóstico más registrado (41,3%), seguido por la enfermedad neurológica que cursa con afagia o disfagia severa. Se alimentaban a través de gastrostomía en el 57,6% de los casos. Se observó que los niños más pequeños eran los que se alimentaban preferentemente por SNG (p-valor 0,001). Conclusiones: el número de pacientes del registro, así como el número de centros participantes, se va incrementando progresivamente. Las principales características de los pacientes no han variado. A pesar del aumento de posibilidades diagnósticas en la población pediátrica, llama la atención la clasificación dentro del grupo de Otras patologías


Objective: to present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the year 2016 and 2017. Material and methods: from January 1st 2016 to December 31st 2017, the HEN registry was recorded and afterwards a further descriptive and analytical analysis was done. Results: in 2016, 4,578 active patients were recorded and prevalence was 98.33 patients per one million inhabitants; in 2017, 4,777 patients were recorded, with a prevalence of 102.57 per one million inhabitants; 50.8% were males in 2016 and 50.5% in 2017. During the period 2016-17, median age was 71.5 years (IIQ 57-83), 1,558 HEN episodes were finished and the main cause was death (793 patients, 50.89%). Adult males were younger than females (65.3 vs. 73.3 years, p-value < 0.001). The most frequent diagnosis was the neurological disorder that presents with aphagia or severe dysphagia (59%). Nasogastric tube was the most frequent administration route (48.3%) and it is the most widely used in elderly patients (p < 0.001). One hundred and twenty-six pediatric patients were registered (57.1% females). Median age at the beginning of HEN in children was four months. "Other disorders" was the most recorded diagnostic group (41.3%), followed by the group of neurological disorder that presents with aphagia or severe dysphagia. Regarding children, 57.6% were fed through gastrostomy and the younger ones were fed through nasogastric tube (p-value 0.001). Conclusions: the number of patients in the registry, as well as the number of participating centers, is progressively increasing. The main characteristics of the patients have not changed. Despite the increase in diagnostic possibilities in the pediatric population, the classification within the group of "Other pathologies" is quite significant


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Nutrição Enteral/estatística & dados numéricos , Nutrição Parenteral no Domicílio/estatística & dados numéricos , Registros , Nutrição Enteral/tendências , Nutrição Parenteral/tendências , Nutrição Parenteral no Domicílio/tendências , Fatores Sexuais , Espanha/epidemiologia
11.
Hum Immunol ; 80(2): 91-92, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30445098

RESUMO

Uros people live in floating reed islands in Titikaka Lake in front of Puno town (Peru). They could have started Tiwanaku culture and shared genes and culture with Pacific Islanders; it is particularly relevant the giant hat covered men statues found in both Tiwanaku at Titikaka Lake shore and Easter Island (3700 km far from Chile in Pacific Ocean). These giants monoliths are very similar one another and unique in America and Pacific Islands. The following HLA alleles are shared in a specifically high frequency between Uros and Pacific Islanders : HLA-A*24:02, HLA-B*35:05, HLA-B*48:01, HLA-DRB1*04:03, HLA-DRB1*08:02 and HLA-DRB1*09:01. Uros also have 3 unique HLA haplotypes: A*24:02-B*15:04 - DRB1*14:02-DQB1*03:01, A*68:01:02-B*35:05-DRB1*04:03-DQB1*03:02, A*24:02-B*48:01-DRB1*04:03-DQB1*03:02. Also Uros seem to be one of the most ancient population in Titikaka Lake that could have started Tiwanaku culture. Prehistoric contacts between Amerindians and Pacific Islanders are strongly suggested by genetic and cultural traits. It is not discarded that Uros could have come from Pacific Islands: Uros show melanic skin and are dolichocephalic; in contrast, surrounding Aymara people have a clear skin and are brachicephalic. The Kon-Tiki project led by Thor Heyerdahl showed that a simple sailing is possible between Peru and Polynesia Islands; also, the most ancient skull found in America is of black origin: Luzia, suggesting that first America peopling was also carried out by Black/coloured people.


Assuntos
Genótipo , Antígenos HLA/genética , Grupos Populacionais , Alelos , Antropometria , Evolução Biológica , Bolívia , Genética Populacional , Haplótipos , Humanos , Imunogenética , Ilhas do Pacífico , Peru , Pigmentação , Polinésia
12.
Reumatol Clin ; 15(4): 229-236, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28935290

RESUMO

OBJECTIVE: Describe the objectives, methods and results of the first year of the new version of the Spanish registry of adverse events involving biological therapies and synthetic drugs with an identifiable target in rheumatic diseases (BIOBADASER III). METHODOLOGY: Multicenter prospective registry of patients with rheumatic inflammatory diseases being treated with biological drugs or synthetic drugs with an identifiable target in rheumatology departments in Spain. The main objective of BIOBADASER Phase III is the registry and analysis of adverse events; moreover, a secondary objective was added consisting of assessing the effectiveness by means of the registry of activity indexes. Patients in the registry are evaluated at least once every year and whenever they experience an adverse event or a change in treatment. The collection of data for phase iii began on 17 December 2015. RESULTS: During the first year, 35 centers participated. The number of patients included in this new phase in December 2016 was 2,664. The mean age was 53.7 years and the median duration of treatment was 8.1 years. In all, 40.4% of the patients were diagnosed with rheumatoid arthritis. The most frequent adverse events were infections and infestations. CONCLUSIONS: BIOBADASER Phase III has been launched to adapt to a changing pharmacological environment, with the introduction of biosimilars and small molecules in the treatment of rheumatic diseases. This new stage is adapted to the changes in the reporting of adverse events and now includes information related to activity scores.

13.
Rev. senol. patol. mamar. (Ed. impr.) ; 31(4): 155-156, oct.-dic. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-176857

RESUMO

Presentamos el caso de una paciente intervenida de mastectomía radical modificada por carcinoma ductal infiltrante de tipo inflamatorio, que durante el postoperatorio inmediato presenta un empeoramiento clínico generalizado secundario a un fallo hepático fulminante desencadenado por la aparición de múltiples metástasis. La paciente fallece a las horas del comienzo del cuadro por fallo multiorgánico


We present the case of a woman who underwent a modified radical mastectomy due to an infiltrating inflammatory ductal carcinoma and who, during the immediate postoperative period showed clinical deterioration due to acute liver failure caused by the presence of multiple metastases. The patient died a few hours after the onset of multiorgan failure


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Neoplasias da Mama/complicações , Carcinoma Ductal de Mama/complicações , Metástase Neoplásica/patologia , Falência Hepática Aguda/patologia , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Insuficiência de Múltiplos Órgãos/complicações
14.
Arthritis Res Ther ; 20(1): 227, 2018 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-30305158

RESUMO

BACKGROUND: Biologic therapy has changed the prognosis of patients with juvenile idiopathic arthritis (JIA). The aim of this study was to examine the pattern of use, drug survival, and adverse events of biologics in patients with JIA during the period from diagnosis to adulthood. METHODS: All patients included in BIOBADASER (Spanish Registry for Adverse Events of Biological Therapy in Rheumatic Diseases), a multicenter prospective registry, diagnosed with JIA between 2000 and 2015 were analyzed. Proportions, means, and SDs were used to describe the population. Incidence rates and 95% CIs were calculated to assess adverse events. Kaplan-Meier analysis was used to compare the drug survival rates. RESULTS: A total of 469 patients (46.1% women) were included. Their mean age at diagnosis was 9.4 ± 5.3 years. Their mean age at biologic treatment initiation was 23.9 ± 13.9 years. The pattern of use of biologics during their pediatric years showed a linear increase from 24% in 2000 to 65% in 2014. Biologic withdrawal for disease remission was higher in patients who initiated use biologics prior to 16 years of age than in those who were older (25.7% vs 7.9%, p < 0.0001). Serious adverse events had a total incidence rate of 41.4 (35.2-48.7) of 1000 patient-years. Patients younger than 16 years old showed significantly increased infections (p < 0.001). CONCLUSIONS: Survival and suspension by remission of biologics were higher when these compounds were initiated in patients with JIA who had not yet reached 16 years of age. The incidence rate of serious adverse events in pediatric vs adult patients with JIA treated with biologics was similar; however, a significant increase of infection was observed in patients under 16 years old.


Assuntos
Antirreumáticos/efeitos adversos , Artrite Juvenil/tratamento farmacológico , Artrite Juvenil/epidemiologia , Terapia Biológica/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Sistema de Registros , Adolescente , Adulto , Antirreumáticos/uso terapêutico , Artrite Juvenil/diagnóstico , Terapia Biológica/métodos , Criança , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Espanha/epidemiologia , Resultado do Tratamento
15.
Cir. Esp. (Ed. impr.) ; 96(6): 363-368, jun.-jul. 2018. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-176354

RESUMO

Introducción: La punción-aspiración con aguja fina es una pieza clave en la evaluación preoperatoria del nódulo tiroideo y el sistema Bethesda es el más aceptado para categorizar el análisis citológico. El objetivo del estudio es evaluar la validez del sistema Bethesda en la enfermedad nodular tiroidea para diagnosticar malignidad. Métodos: Se incluye a los pacientes intervenidos de tiroides consecutivamente entre junio de 2010 y junio de 2017. Se realizó el análisis de la punción preoperatoria según el sistema Bethesda, correlacionando este dato con la histología definitiva para cada nódulo biopsiado. Los parámetros de prueba diagnóstica se calcularon como prueba de screening (verdadero positivo: categorías IV, V, VI) y como método para identificar malignidad (verdadero positivo: categorías V, VI). Resultados: Se incluyó a 522 pacientes, de los que 184 (35,2%) presentaron un carcinoma en la histología definitiva; siendo el carcinoma papilar el más frecuente (84,2%). Los porcentajes de malignidad en el nódulo biopsiado para cada categoría Bethesda fueron: I, 0%; II, 1,5%; III, 6,4%; IV, 31%; V, 86,5% y VI, 100%. En el análisis como prueba de screening, se identificó una sensibilidad del 98,9%, especificidad del 84,4%, valor predictivo positivo del 69,6%, valor predictivo negativo del 99,5% y precisión diagnóstica global del 88,2%. En el análisis para detectar malignidad, los parámetros fueron: sensibilidad 98,6%, especificidad 97,6%, valor predictivo positivo 93,5%, valor predictivo negativo 99,5% y precisión diagnóstica global 97,9%. Conclusiones: El sistema Bethesda es un método sencillo y reproducible en la categorización citológica del nódulo tiroideo, una herramienta útil en el manejo y eficaz para identificar el riesgo de malignidad


Introduction: Fine-needle aspiration biopsies are a key tool for preoperative assessment of thyroid nodules, and the Bethesda system is the preferred method to report cytological analysis. The purpose of this study is to assess the efficiency of the Bethesda system to identify the malignancy risk of thyroid nodules. Methods: Patients who underwent thyroid surgery between June 2010 and June 2017 were included. Samples were classified into 6 categories according to rates of malignancy associated with each diagnostic category. In order to investigate the correlation between categories, a statistical analysis compared the categories with pathology reports. Diagnostic indicators were calculated as a screening test (categories IV, V, VI as true-positive) and as a method to identify malignancy (V, VI as true-positive). Results: In a series of 522 patients, we found 184 (35.2%) malignant tumours, papillary carcinoma being the most prevalent with 155 cases (84.2%). Malignant rates for diagnostic categories were: I, 0%; II, 1.5%; III, 6.4%; IV, 31%; V, 86.5%; VI, 100%. A robust correlation was identified between categories on statistical analysis. For the «screening test» analysis, sensitivity was 98.9%, specificity 84.4%, positive predictive value 69.6%, negative predictive value 99.5%, and diagnostic accuracy 88.2%. Analysing the accuracy to detect malignancy, values were: sensitivity 98.6%, specificity 97.6%, positive predictive value 93.5%, negative predictive value 99.5%, diagnostic accuracy 97.9%. Conclusion: The Bethesda system is a clear and reliable approach to report thyroid cytology and therefore is an effective tool to identify malignancy risk and guide clinical management


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Nódulo da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Biópsia por Agulha Fina , Reprodutibilidade dos Testes , Nódulo da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia
16.
BMC Infect Dis ; 18(1): 267, 2018 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-29884118

RESUMO

BACKGROUND: Central line-associated bloodstream infections (CLABSI) are a major source of sepsis in modern intensive care medicine. Some years ago bundle interventions have been introduced to reduce CLABSI. The use of checklists may be an additional tool to improve the effect of these bundles even in highly specialized institutions. In this study we investigate if the introduction of a checklist reduces the frequency of CLABSI. METHODS: During the study period from October 2011 to September 2012, we investigated the effect of implementing a checklist for the placement of central venous lines (CVL). Patients were allocated either to the checklist group or to the control group, roughly in a 1:2 ratio. The frequency of CLABSI was compared between the two groups. RESULTS: During the study period 4416 CVL were inserted; 1518 in the checklist group and 2898 in the control group. The use of the checklist during CVL placement resulted in a lower CLABSI frequency. The incidence in the checklist group was 3.8 per 1000 catheter days as compared to 5.9 per 1000 catheter days in the control group (IRR = 0.57; p = 0.001). The use of the checklist also reduced the frequency of catheter colonisation significantly, 36.3 per 1000 catheter days in the checklist group vs 21.2 per 1000 catheter days in the control group, respectively (IRR = 0.58; p < 0.001). CONCLUSION: The introduction of a checklist to improve the adherence to hygiene standards while placement of central venous lines reduced the frequency of infections significantly.


Assuntos
Infecções Relacionadas a Cateter/prevenção & controle , Lista de Checagem , Adulto , Bactérias/química , Bactérias/isolamento & purificação , Bactérias/metabolismo , Estudos de Casos e Controles , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/microbiologia , Cateterismo Venoso Central , Feminino , Humanos , Incidência , Unidades de Terapia Intensiva , Masculino , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz
17.
Hum Immunol ; 79(8): 585-586, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29864459

RESUMO

Original San Basilio de Palenque population (North Colombia) fled from Spanish traders that carried them as slaves and they funded in nearby Maria Mountains a fortified town (Palenque). They started helping new Africans brought as slaves to flee and join them. Most of them spoke a Bantu-Congo language and nowadays they speak the only one extant Bantu-Spanish Creole language. Spanish Crown was forced to issue a decree declaring them free (1691 CE), more than 100 years before than Haiti Republic existed. HLA-A, -B, -DRB1 and -DQB1 alleles were studied and further computer procedures were performed with Arlequin 3.5 software. No Amerindian or Europeans gene flow to this population was found. However, three specific HLA extended haplotypes are found in this population, which may reflect an isolation from other Africans or Afro-Americans also. This may be due to the maintenance of their own African culture, and even their unique Creole language.


Assuntos
Grupo com Ancestrais do Continente Africano , Genótipo , Antígenos HLA/genética , Alelos , Colômbia , Grupo com Ancestrais do Continente Europeu , Fluxo Gênico , Frequência do Gene , Genética Populacional , Haplótipos , Teste de Histocompatibilidade , Humanos , Índios Sul-Americanos , Idioma , Espanha
18.
Hum Immunol ; 79(7): 530-531, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29729321

RESUMO

We have studied Wiwa/Sanja Amerindians HLA-A, -B, -C, -DRB1 and DQB1 allele frequencies and extended haplotypes in 52 unrelated individuals from "El Encanto" town at Guanachaca riverside. High frequency alleles were in general present in other Amerindian populations. Also, three extended haplotypes and eight ones were respectively both "new found" and already described in Amerindians from North, Central and South America, including Lakota-Sioux, Mayas, Teeneks, Quechua and Aymaras. Analyses of HLA-A*24:02 and -C*01:02 Wiwa high frequency alleles suggested a specific relatedness with another Amerindian and Pacific Islander ethnic groups (these two particular alleles bearing in high frequencies); they include New Zealand Maoris, Taiwanese, Japanese, Papua New Guinea, and Samoans among others. This may indicate that selective forces are maintaining these two alleles high frequency within this wide American/Pacific area.


Assuntos
Grupos Étnicos , Antígenos HLA/genética , Índios Sul-Americanos , Grupo com Ancestrais Oceânicos , Colômbia , Frequência do Gene , Genótipo , Haplótipos , Teste de Histocompatibilidade , Humanos , Linguística , Ilhas do Pacífico , Filogenia
19.
Vet Microbiol ; 217: 7-12, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29615260

RESUMO

Antibiotic use in animal husbandry has raised concerns on the spread of resistant bacteria. Currently animal products are traded globally with unprecedented ease, which has been challenging the control of antimicrobial resistance. This study aims to detect and characterize extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae from imported and locally produced poultry products sold in Ghana. Local and imported chicken meat was collected from 94 stores and markets throughout Kumasi (Ghana) and cultured on selective ESBL screening agar. Phenotypic ESBL-producing E. coli and K. pneumoniae isolates were confirmed by combined disc test and further characterized by antibiotic susceptibility testing, amplification of the blaCTX-M, blaTEM and blaSHV genes as well as multilocus sequence typing (MLST) and linked to the country of origin. Out of 200 meat samples, 71 (36%) samples revealed 81 ESBL-producing isolates (46 E. coli and 35 K. pneumoniae), with 44% (30/68) of local poultry and 31% (41/132) of imported products being contaminated. Most ESBL-producing isolates harboured the blaCTX-M-15 gene (61/81, 75%) and the dominant Sequence Types (ST) were ST2570 (7/35, 20%) among K. pneumoniae and ST10 (5/46, 11%) among E. coli. High numbers of ESBL-producing bacteria, particularly on local but also imported poultry meat, represent a potential source for human colonization and infection as well as spread within the community. Surveillance along the poultry production-food-consumer chain would be a valuable tool to identify sources of emerging multidrug resistant pathogens in Ghana.


Assuntos
Infecções por Escherichia coli/veterinária , Escherichia coli/enzimologia , Infecções por Klebsiella/veterinária , Klebsiella pneumoniae/enzimologia , beta-Lactamases/biossíntese , Animais , Antibacterianos/farmacologia , Galinhas/microbiologia , Ciprofloxacino/farmacologia , Farmacorresistência Bacteriana , Escherichia coli/efeitos dos fármacos , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/epidemiologia , Microbiologia de Alimentos/estatística & dados numéricos , Gana/epidemiologia , Humanos , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , Tipagem de Sequências Multilocus , Aves Domésticas/microbiologia
20.
Cir Esp ; 96(6): 363-368, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29605452

RESUMO

INTRODUCTION: Fine-needle aspiration biopsies are a key tool for preoperative assessment of thyroid nodules, and the Bethesda system is the preferred method to report cytological analysis. The purpose of this study is to assess the efficiency of the Bethesda system to identify the malignancy risk of thyroid nodules. METHODS: Patients who underwent thyroid surgery between June 2010 and June 2017 were included. Samples were classified into 6categories according to rates of malignancy associated with each diagnostic category. In order to investigate the correlation between categories, a statistical analysis compared the categories with pathology reports. Diagnostic indicators were calculated as a screening test (categories IV, V, VI as true-positive) and as a method to identify malignancy (V, VI as true-positive). RESULTS: In a series of 522 patients, we found 184 (35.2%) malignant tumours, papillary carcinoma being the most prevalent with 155 cases (84.2%). Malignant rates for diagnostic categories were: I, 0%; II, 1.5%; III, 6.4%; IV, 31%; V, 86.5%; VI, 100%. A robust correlation was identified between categories on statistical analysis. For the «screening test¼ analysis, sensitivity was 98.9%, specificity 84.4%, positive predictive value 69.6%, negative predictive value 99.5%, and diagnostic accuracy 88.2%. Analysing the accuracy to detect malignancy, values were: sensitivity 98.6%, specificity 97.6%, positive predictive value 93.5%, negative predictive value 99.5%, diagnostic accuracy 97.9%. CONCLUSION: The Bethesda system is a clear and reliable approach to report thyroid cytology and therefore is an effective tool to identify malignancy risk and guide clinical management.


Assuntos
Nódulo da Glândula Tireoide/patologia , Biópsia por Agulha Fina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Nódulo da Glândula Tireoide/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA