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1.
Medicina (B Aires) ; 81(1): 37-46, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-33611243

RESUMO

Community-acquired pneumonia (CAP) represents a major health issue and ≈20% of the patients require in-hospital attention. The main objective of the study was to determine clinical-imaging features of CAP episodes requiring hospitalization. The secondary objectives were to determine the diagnostic yield of microbiological analyses and the medical complications. A retrospective analytical study was conducted on adults admitted due to CAP in a third-level hospital in the period 2017-2019. Pregnant women were excluded. A total of 340 CAP episodes were identified in 321 patients; the median age was 75 years old (interquartile range 57-85). The most frequent risk factors were immunocompromise 102 (30%), neurological disease 75 (22%), and chronic kidney disease 58 (17%). According to three prognostic scores, CURB65, qSOFA and PSI/PORT, 216 (63.5%), 290 (83.5%) and 130 (38%) patients were identified as low risk, respectively. A total of 49 (14.4%) episodes required admission at the critical care unit and 39 (11.5%) required mechanical ventilation; 30 patients (8.8%) died during hospitalization. The radiologic patterns most frequently found were consolidation in 134 (39.4%), interstitial-alveolar pattern in 98 (28.8%), and the combination of both patterns in 67 (19.7%) episodes. Identification of the causal agent was achieved in 79 (23.2%) episodes. The most frequently isolated microorganisms were influenza virus in 37 (10.9%) episodes and Streptococcus pneumoniae in 11 (3.2%). Most of the hospitalized CAP patients were elderly with consolidative radiological patterns. The causal agent could be identified in less than a quarter of the patients, with the influenza test being the method with the highest diagnostic yield.


Assuntos
Infecções Comunitárias Adquiridas , Pneumonia Pneumocócica , Pneumonia , Adulto , Idoso , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/terapia , Feminino , Hospitalização , Humanos , Pneumonia/diagnóstico por imagem , Pneumonia/epidemiologia , Gravidez , Estudos Retrospectivos , Streptococcus pneumoniae
2.
Rev. habanera cienc. méd ; 19(5): e2880, sept.-oct. 2020. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1144691

RESUMO

RESUMEN Introducción: la hipertensión arterial es un problema de salud pública. Los disturbios del sueño son condiciones que predisponen a la hipertensión y agravan la calidad de vida de los pacientes hipertensos. Objetivo: describir las características de la calidad de sueño y las características de los pacientes con hipertensión arterial en un hospital nacional de Cusco-Perú a 3400 metros sobre el nivel del mar (msnm). Material y Métodos: se realizó un estudio descriptivo transversal con datos de pacientes con hipertensión arterial que acudieron entre los meses de agosto a diciembre de 2017 a consulta ambulatoria del servicio de cardiología de un hospital nacional de Cusco-Perú. Los pacientes fueron mayores de 40 años y sin comorbilidades. Para caracterizar la calidad de sueño se aplicó el cuestionario del índice de Pittsburg, previo consentimiento informado de los pacientes. Resultados: Se estudiaron 272 pacientes, con edad promedio de 65 años y tiempo de enfermedad media de 8 años. El 75 por ciento de los pacientes tenían mala calidad de sueño y la mayoría tenía una duración del sueño entre 6 y 7 horas. Todos los pacientes presentaron disturbios del sueño y el 94,1 por ciento no usaba medicación para dormir. Conclusiones: La calidad de sueño en pacientes de la población estudiada fue mala en la mayoría. Es necesario hacer seguimiento de este parámetro clínico para evaluar las posibles complicaciones que puede ocasionar a largo plazo(AU()


ABSTRACT Introduction: Hypertension is a public health problem; sleep disturbances are conditions that predispose to hypertension and aggravate the quality of life of hypertensive patients. Objectives: To describe the characteristics of sleep quality in patients with hypertension in a national hospital in the city of Cusco-Peru, at 3400 meters above sea level (msnm). Material and Methods: A descriptive cross-sectional study was carried out with data of patients with arterial hypertension who attended an outpatient consultation of the cardiology service of a national hospital in Cusco-Peru between August and December 2017. The patients were older than 40 years without comorbidities. To characterize sleep quality, Pittsburg sleep quality index was used with prior informed consent of the patients. Results: A total of 272 patients were studied. The average age was 65 years and the average time of the disease was 8 years. The results show that 75 percent of the patients had poor sleep quality and most of the patients had a sleep duration between 6 and 7 hours. All the patients presented some sleep disturbance and 94.1 percent did not take any medication to sleep. Conclusions: Sleep quality was poor in most of the patients studied. The follow-up of this clinical condition is necessary to evaluate the possible complications that it can cause in the long term(AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Transtornos do Sono-Vigília/complicações , Hipertensão/complicações , Peru , Epidemiologia Descritiva , Estudos Transversais
3.
Epilepsy Behav ; 112: 107396, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32911299

RESUMO

BACKGROUND: The aim of this study was to have a better understanding of the influence of the coronavirus disease 2019 (COVID-19) pandemic in people with epilepsy (PWE) and to assess whether there have been changes in seizure control during the current COVID-19 outbreak, exploring the possible causes thereof. METHODS: This is an observational, retrospective study based on prospective data collection of 100 successive patients who attended an epilepsy outpatient clinic either face-to-face or telephonically during the months of the COVID-19 outbreak and national state of emergency. RESULTS: One hundred patients were included, 52% women, mean age 42.4 years. During the COVID-19 period, 27% of the patients presented an increase of >50% of seizure frequency. An increase of stress/anxiety (odds ratios (OR): 5.78; p = 0.008) and a prior higher seizure frequency (OR: 12.4; p = 0.001) were associated with worsening of seizures. Other risk factors were exacerbation of depression, sleep deprivation, less physical activity, and history of epilepsy surgery. Three patients had status epilepticus (SE) and one a cluster of seizures. Likewise, 9% of patients improved their seizure control. Reduction in stress/anxiety (OR: 0.05; p = 0.03) and recent adjustment of antiepileptics (OR: 0.07; p = 0.01) acted as protecting factors. CONCLUSIONS: A high proportion of PWE suffered a significant worsening of their seizure control during the months of the COVID-19 pandemic. Emotional distress due to home confinement was the main factor for the change in seizure control. Promoting physical activity and adequate sleep may minimize the potential impact of the pandemic in PWE. Ensuring correct follow-up can prevent decompensation in those PWE at high risk.


Assuntos
Anticonvulsivantes/uso terapêutico , Ansiedade/fisiopatologia , Infecções por Coronavirus , Epilepsia/fisiopatologia , Pandemias , Pneumonia Viral , Estresse Psicológico/fisiopatologia , Adolescente , Adulto , Ansiedade/psicologia , Betacoronavirus , Depressão/fisiopatologia , Depressão/psicologia , Progressão da Doença , Epilepsia/tratamento farmacológico , Epilepsia/psicologia , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , Convulsões/fisiopatologia , Privação do Sono/fisiopatologia , Espanha , Estado Epiléptico/fisiopatologia , Estresse Psicológico/psicologia
4.
Fish Shellfish Immunol ; 107(Pt A): 95-103, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32966893

RESUMO

Gastropod hematopoiesis occurs at specialized tissues in some species, but the evidence also suggests that hemocyte generation is maybe widespread in the connective tissues or the blood system in others. In Ampullariidae (Caenogastropoda), both the kidney and the lung contain putative hematopoietic cells, which react to immune challenges. In the current study, we wanted to explore if hematopoiesis occurs in the blood of Pomacea canaliculata. Thus, we obtained circulating hemocytes from donor animals and tested their ability to proliferate in the blood of conspecific recipients. We tracked cell proliferation by labeling the donors' hemocytes with the fluorescent cell proliferation marker carboxyfluorescein diacetate succinimidyl ester (CFSE). Transferred CFSE-labeled hemocytes survived and proliferated into the recipients' circulation for at least 17 days. We also determined the cell cycle status of circulating hemocytes by using the propidium iodide (PI) and acridine orange (AO) staining methods. Flow cytometry analyses showed that most PI-stained hemocytes were in the G1 phase (~96%), while a lower proportion of cells were through the G2/S-M transition (~4%). When we instead used AO-staining, we further distinguished a subpopulation of cells (~5%) of low size, complexity-granularity, and RNA content. We regarded this subpopulation as quiescent cells. In separate experimental sets, we complemented these findings by assessing in circulating hemocytes two evolutionary conserved features of quiescent, undifferentiated cells. First, we used JC-1 staining to determine the mitochondrial membrane potential (Ψm) of circulating hemocytes, which is expected to be low in quiescent cells. Most hemocytes (~87%) showed high aggregation of JC-1, which indicates a high Ψm. Besides that, a small hemocyte subpopulation (~11%) showed low aggregation of the dye, thus indicating a low Ψm. It is known that the transition from a quiescent to a proliferating state associates with an increase of the Ψm. The specificity of these changes was here controlled by membrane depolarization with the Ψm disruptor CCCP. Second, we stained hemocytes with Hoechst33342 dye to determine the efflux activity of ABC transporters, which participate in the multixenobiotic resistance system characteristic of undifferentiated cells. Most hemocytes (>99%) showed a low dye-efflux activity, but a small proportion of cells (0.06-0.12%) showed a high dye-efflux activity, which was significantly inhibited by 100 and 500 µM verapamil, and thus is indicative of an undifferentiated subpopulation of circulating hemocytes. Taken together, our results suggest that, among circulating hemocytes, there are cells with the ability to proliferate or to stay in a quiescent state and behave as progenitor cells later, either in the circulation or the hematopoietic tissues/organs.

5.
Brain ; 143(10): 3089-3103, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32645151

RESUMO

Since the appearance of the first case of coronavirus disease 2019 (COVID-19) a pandemic has emerged affecting millions of individuals worldwide. Although the main clinical manifestations are respiratory, an increase in neurological conditions, specifically acute cerebrovascular disease, has been detected. We present cerebrovascular disease case incidence in hospitalized patients with SARS-CoV-2 infection. Patients were confirmed by microbiological/serological testing, or on chest CT semiology. Available data on co-morbidity, laboratory parameters, treatment administered, neuroimaging, neuropathological studies and clinical evolution during hospitalization, measured by the modified Rankin scale, were analysed. A bivariate study was also designed to identify differences between ischaemic and haemorrhagic subtypes. A statistical model of binary logistic regression and sensitivity analysis was designed to study the influence of independent variables over prognosis. In our centre, there were 1683 admissions of patients with COVID-19 over 50 days, of which 23 (1.4%) developed cerebrovascular disease. Within this group of patients, cerebral and chest CT scans were performed in all cases, and MRI in six (26.1%). Histological samples were obtained in 6/23 cases (two brain biopsies, and four arterial thrombi). Seventeen patients were classified as cerebral ischaemia (73.9%, with two arterial dissections), five as intracerebral haemorrhage (21.7%), and one leukoencephalopathy of posterior reversible encephalopathy type. Haemorrhagic patients had higher ferritin levels at the time of stroke (1554.3 versus 519.2, P = 0.004). Ischaemic strokes were unexpectedly frequent in the vertebrobasilar territory (6/17, 35.3%). In the haemorrhagic group, a characteristic radiological pattern was identified showing subarachnoid haemorrhage, parieto-occipital leukoencephalopathy, microbleeds and single or multiple focal haematomas. Brain biopsies performed showed signs of thrombotic microangiopathy and endothelial injury, with no evidence of vasculitis or necrotizing encephalitis. The functional prognosis during the hospital period was unfavourable in 73.9% (17/23 modified Rankin scale 4-6), and age was the main predictive variable (odds ratio = 1.5; 95% confidence interval 1.012-2.225; P = 0.043). Our series shows cerebrovascular disease incidence of 1.4% in patients with COVID-19 with high morbidity and mortality. We describe pathological and radiological data consistent with thrombotic microangiopathy caused by endotheliopathy with a haemorrhagic predisposition.


Assuntos
Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/epidemiologia , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/epidemiologia , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/epidemiologia , Leucoencefalopatias/epidemiologia , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Fatores Etários , Idoso , Betacoronavirus , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Isquemia Encefálica/patologia , Hemorragia Cerebral/sangue , Hemorragia Cerebral/patologia , Comorbidade , Infecções por Coronavirus/sangue , Infecções por Coronavirus/patologia , Feminino , Ferritinas/sangue , Humanos , Incidência , Leucoencefalopatias/diagnóstico por imagem , Leucoencefalopatias/patologia , Imagem por Ressonância Magnética , Masculino , Neuroimagem , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/patologia , Espanha/epidemiologia , Tomografia Computadorizada por Raios X
6.
Biomedica ; 40(2): 404-411, 2020 06 15.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32673466

RESUMO

Introduction: Rhodnius (Hemiptera: Reduviidae: Triatominae) species are made up of haematophagous insect vectors for Trypanosoma cruzi (Chagas' disease aetiological agent) and T. rangeli, an infective parasite that is not pathogenic for vertebrate hosts. The study of their salivary protein diversity enables the obtention of characteristic one-dimensional electrophoretic profiles of some triatomine species; however, few reports have dealt with Rhodnius species salivary proteins electrophoretic patterns. Objective: To compare R. colombiensis, R. pallescens, R. pictipes, R. prolixus, and R. robustus' salivary proteins one-dimensional electrophoretic profiles. Materials and methods: SDS-PAGE was used for obtaining electrophoretic profiles of saliva from the species under study. The unweighted pair group method with arithmetic mean (UPGMA) was used for constructing a phenogram. Results: Electrophoretic profiles of soluble saliva had protein bands ranging from 15 to 45 kDa, thereby enabling the five species studied to be differentiated. The phenogram revealed two main groups, one formed by the Pictipes and Prolixus cis-Andean groups and another consisting of the Pallescens trans-Andean group. Conclusion: Differences were revealed regarding R. colombiensis, R. pallescens, R. pictipes, R. prolixus, and R. robustus electrophoretic profiles of salivary proteins; their variability facilitated constructing a phenogram which was taxonomically congruent with the groups from the genus Rhodnius.

7.
Neurology ; 95(8): e1060-e1070, 2020 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-32482845

RESUMO

OBJECTIVE: The coronavirus disease 2019 (COVID-19) has spread worldwide since December 2019. Neurologic symptoms have been reported as part of the clinical spectrum of the disease. We aimed to determine whether neurologic manifestations are common in hospitalized patients with COVID-19 and to describe their main characteristics. METHODS: We systematically reviewed all patients diagnosed with COVID-19 admitted to the hospital in a Spanish population during March 2020. Demographic characteristics, systemic and neurologic clinical manifestations, and complementary tests were analyzed. RESULTS: Of 841 patients hospitalized with COVID-19 (mean age 66.4 years, 56.2% men), 57.4% developed some form of neurologic symptom. Nonspecific symptoms such as myalgias (17.2%), headache (14.1%), and dizziness (6.1%) were present mostly in the early stages of infection. Anosmia (4.9%) and dysgeusia (6.2%) tended to occur early (60% as the first clinical manifestation) and were more frequent in less severe cases. Disorders of consciousness occurred commonly (19.6%), mostly in older patients and in severe and advanced COVID-19 stages. Myopathy (3.1%), dysautonomia (2.5%), cerebrovascular diseases (1.7%), seizures (0.7%), movement disorders (0.7%), encephalitis (n = 1), Guillain-Barré syndrome (n = 1), and optic neuritis (n = 1) were also reported, but less frequent. Neurologic complications were the main cause of death in 4.1% of all deceased study participants. CONCLUSIONS: Neurologic manifestations are common in hospitalized patients with COVID-19. In our series, more than half of patients presented some form of neurologic symptom. Clinicians need to maintain close neurologic surveillance for prompt recognition of these complications. The mechanisms and consequences of severe acute respiratory syndrome coronavirus type 2 neurologic involvement require further studies.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Doenças do Sistema Nervoso/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Sistema de Registros , Idoso , Betacoronavirus/patogenicidade , Comorbidade , Feminino , Humanos , Masculino , Pandemias , Espanha/epidemiologia
8.
Rev. argent. coloproctología ; 31(2): 63-69, jun. 2020. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1117012

RESUMO

Introducción: La introducción del sistema Da Vinci, ha revolucionado el campo de la cirugía mínima invasiva en el cual el cirujano tiene control de la cámara 3D y los instrumentos son de gran destreza y confort ergonómico, acortando la curva de aprendizaje quirúrgica. Objetivo: Describir nuestra experiencia inicial de cirugía robótica colorectal en un hospital de comunidad cerrada de la Ciudad Autónoma de Buenos Aires. Materiales y Método: Estudio retrospectivo descriptivo sobre una base prospectiva de cirugías colorectales robóticas realizadas por el mismo equipo quirúrgico desde mayo de 2016 a abril de 2019. Resultados: Se operaron 41 pacientes. Trece de ellos fueron colectomías derechas, 17 colectomías izquierdas y 11 cirugías de recto. El tiempo quirúrgico promedio fue de 170 minutos (90-330), la estadía hospitalaria de 4 días (3-30), la tasa de conversión de 7,31% (3/41 pacientes) y la tasa de dehiscencia anastomótica del 9,75% (4/41 pacientes). Morbilidad global del 19.5% (8/41 pacientes). Conclusión: Hemos repasado los resultados iniciales de nuestra experiencia en cirugía robótica colorectal en un número reducido de casos, pero suficiente para evaluar la seguridad y reproducibilidad del método al comienzo de una curva de aprendizaje.


Introduction: The introduction of the Da Vinci System, has revolved the field of invasive minimal surgery in which the surgeon has control of the 3d camera and the instruments are of great strength and ergonomic comfort by cutting the surgical learning curve. Objective: Of this preliminary presentation is to describe our initial experience of colorectal robotic surgery in a closed community hospital of the Autonomous City of Buenos Aires. Materials and Method: Retrospective descriptive study on a prospective basis of robotic colorectal surgeries performed by the same surgical team from May 2016 to April 2019.Results: 41 patients were operated. 13 of them were right colectomies, 17 left colectomies and 11 rectum surgeries. The average surgical time was 170 minutes (90-330), the average hospital stay of 4 days (3-30), the conversion rate of 7.31% (3/41 patients) and the anastomotic dehiscence rate of 9 , 75% (4/41 patients). Overall morbidity of 19.5% (8/41 patients).Conclusion: We have reviewed the initial results of our experience in colorectal robotic surgery in a reduced number of cases but sufficient to evaluate the security and reproducibility of the methodic learning of a learning curve.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Neoplasias Colorretais/cirurgia , Cirurgia Colorretal/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Reto/cirurgia , Estudos Retrospectivos , Colectomia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Protectomia/métodos , Hospitais Comunitários
9.
Rev. colomb. nefrol. (En línea) ; 7(1): 143-148, ene.-jun. 2020. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1144382

RESUMO

Resumen La cistitis enfisematosa hace referencia a una entidad infrecuente, generalmente secundaria a infecciones de vías urinarias bajas, que por diferentes mecanismos producen gas alrededor de la vejiga. Esta patología se asocia a gérmenes (E. Coli, Enterobacter Arogenes, y Klebsiella, entre otros), y factores de riesgo como género femenino, edad avanzada y diabetes. Este diagnóstico requiere un manejo oportuno, con antibioticoterapia dirigida y control de comorbilidades asociadas; a continuación, se reporta el caso de un paciente masculino de 81 años, en el hospital de San José de Bogotá, a quien se le diagnostica esta patología, con el respectivo aislamiento microbiológico, factores de riesgo, diagnóstico y manejo instaurado.


Abstract The emphysematous cystitis refers to an uncommon entity generally secondary to low urinary tract infections producing gas around the bladder. It is associated with infections by E. Coli, Enterobacter Arogenes, and Klebsiella as well as patient risk factors such as advanced age, diabetics and female gender. The diagnosis requires a timely management as well as directed antibiotic and associated comorbidities control. In the following case report a male patient is described in the hospital of San José de Bogotá in whom this pathology is diagnosed. In the following case report we going to describe etiologies diagnosis and therapy.

10.
Biomédica (Bogotá) ; 40(2): 404-411, abr.-jun. 2020. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1124234

RESUMO

Resumen Introducción. Las especies Rhodnius (Hemiptera: Reduviidae: Triatominae) están conformadas por insectos hematófagos vectores de Trypanosoma cruzi, agente etiológico de la enfermedad de Chagas, y T. rangeli, parásito infectivo pero no patógeno para el vertebrado. El estudio de la diversidad proteica de la saliva de estos insectos permite la obtención de perfiles electroforéticos unidimensionales característicos de algunas especies de triatominos. Sin embargo, el reporte de los patrones electroforéticos de proteínas salivales de las especies de Rhodnius ha sido escaso. Objetivo. Hacer un análisis comparativo de los perfiles electroforéticos unidimensionales de las proteínas salivales de R. colombiensis, R. pallescens, R. pictipes, R. prolixus y R. robustus. Materiales y métodos. Se obtuvieron los perfiles electroforéticos de la saliva de las especies en estudio mediante electroforesis en gel de poliacrilamida con dodecilsulfato sódico (Sodium Dodecyl Sulfate Polyacrylamide Gel Electrophoresis, SDS-PAGE) y se construyó un fenograma mediante el método UPGMA (Unweighted Pair Group Method Using Arithmetic Averages). Resultados. Los perfiles electroforéticos de las proteínas solubles de saliva presentaron bandas en un rango de masa aproximado de 15 a 45 kDa, los cuales permitieron diferenciar las cinco especies estudiadas. El fenograma reveló la existencia de dos grupos principales: uno conformado por los grupos cisandinos Pictipes y Prolixus y otro constituido por el grupo transandino Pallescens. Conclusiones. Existen diferencias en los perfiles electroforéticos de las proteínas salivales entre R. colombiensis, R. pallescens, R. pictipes, R. prolixus y R. robustus, cuya variabilidad permitió construir un fenograma congruente con los grupos del género Rhodnius.


Abstract Introduction: Rhodnius (Hemiptera: Reduviidae: Triatominae) species are made up of haematophagous insect vectors for Trypanosoma cruzi (Chagas' disease aetiological agent) and T. rangeli, an infective parasite that is not pathogenic for vertebrate hosts. The study of their salivary protein diversity enables the obtention of characteristic one-dimensional electrophoretic profiles of some triatomine species; however, few reports have dealt with Rhodnius species salivary proteins electrophoretic patterns. Objective: To compare R. colombiensis, R. pallescens, R. pictipes, R. prolixus, and R. robustus' salivary proteins one-dimensional electrophoretic profiles. Materials and methods: SDS-PAGE was used for obtaining electrophoretic profiles of saliva from the species under study. The unweighted pair group method with arithmetic mean (UPGMA) was used for constructing a phenogram. Results: Electrophoretic profiles of soluble saliva had protein bands ranging from 15 to 45 kDa, thereby enabling the five species studied to be differentiated. The phenogram revealed two main groups, one formed by the Pictipes and Prolixus cis-Andean groups and another consisting of the Pallescens trans-Andean group. Conclusion: Differences were revealed regarding R. colombiensis, R. pallescens, R. pictipes, R. prolixus, and R. robustus electrophoretic profiles of salivary proteins; their variability facilitated constructing a phenogram which was taxonomically congruent with the groups from the genus Rhodnius.

11.
Materials (Basel) ; 13(9)2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32369963

RESUMO

In the present work, the effect of mineral aggregates (pumice stone and expanded clay aggregates) and chemical admixtures (superplasticizers and shrinkage reducing additives) as an alternative internal curing technique was investigated, to improve the properties of high-performance concrete. In the fresh and hardened state, concretes with partial replacements of Portland cement (CPC30R and OPC40C) by pulverized fly ash in combination with the addition of mineral aggregates and chemical admixtures were studied. The physical, mechanical, and durability properties in terms of slump, density, porosity, compressive strength, and permeability to chloride ions were respectively determined. The microstructural analysis was carried out by scanning electronic microscopy. The results highlight the effect of the addition of expanded clay aggregate on the internal curing of the concrete, which allowed developing the maximum compressive strength at 28 days (61 MPa). Meanwhile, the replacement of fine aggregate by 20% of pumice stone allowed developing the maximum compressive strength (52 MPa) in an OPC-based concrete at 180 days. The effectiveness of internal curing to develop higher strength is attributed to control in the porosity and a high water release at a later age. Finally, the lowest permeability value at 90 days (945 C) was found by the substitutions of fine aggregate by 20% of pumice stone saturated with shrinkage reducing admixture into pores and OPC40C by 15% of pulverized fly ash. It might be due to impeded diffusion of chloride ions into cement paste in the vicinity of pulverized fly ash, where the pozzolanic reaction has occurred. The proposed internal curing technology can be considered a real alternative to achieve the expected performance of a high-performance concrete since a concrete with a compressive strength range from 45 to 67 MPa, density range from 2130 to 2310 kg/m3, and exceptional durability (< 2000 C) was effectively developed.

12.
J Allergy Clin Immunol ; 146(2): 367-376.e3, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32407835

RESUMO

BACKGROUND: Fibrostenosis, the most serious eosinophilic esophagitis (EoE) complication, is mediated by epithelial-mesenchymal transition (EMT). Transitioned cells contribute to pathogenesis by overproducing extracellular matrix. OBJECTIVE: Our aim was to determine whether RPC4046 (anti‒IL-13 mAb) modulates EMT biomarkers in biopsy samples from adults with active EoE in a substudy of a double-blind, placebo-controlled phase 2 trial. METHODS: Baseline and week 16 esophageal biopsy samples were taken from 69 patients who were randomized to weekly treatment with subcutaneous RPC4046, 180 mg (n = 19), 360 mg (n = 26), or placebo (n = 24). Duplex immunofluorescence slides stained for E-cadherin and vimentin were digitally analyzed by mapping each epithelial cell and recording fluorescence intensities. End points included change from baseline to week 16 in percentage of vimentin-positive epithelial cells (primary), total E-cadherin expression, and vimentin-to-E-cadherin ratio per cell (an average of 47,000 cells per biopsy sample analyzed). RESULTS: The mean percentage of vimentin-positive cells decreased by 0.94%, 2.75%, and 4.24% in the placebo, low-dose, and high-dose groups, respectively (P =.032 for the high-dose vs placebo group). Mean E-cadherin expression per cell increased 5.6-fold in both dose groups versus in the placebo group (high-dose group P = .047). The increases in E-cadherin expression per cell from baseline to week 16 were correlated with improvements in histology, eosinophil counts, endoscopic findings, and symptoms. CONCLUSION: RPC4046 significantly reduced EMT markers in adults with active EoE, with greater effects at 360 mg. Together with results for eosinophil density and clinical end points from the main trial, these data support the hypothesis that pharmacologic IL-13 inhibition ameliorates both inflammatory and remodeling pathways and could potentially reduce the risk of fibrostenotic complications.

13.
Polymers (Basel) ; 12(4)2020 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-32316512

RESUMO

Researches on thermoplastic composites using natural fiber as reinforcement are increasing, but studies of durability over time are scarce. In this sense the objective of this study is to evaluate changes in the properties of polypropylene/bamboo fiber (PP/BF) composite and the influence of the use of coupling agent (CA) in these composites after natural ageing. The PP/BF (70/30 wt) composites and 3% wt CA (citric acid from natural origin and maleic anhydride grafted polypropylene from petrochemical origin) were prepared by using an internal mixer chamber and then injection-molded. The samples were exposed to natural weathering for a total period of 12 months and characterized before and after exposure. All exposed composites experienced a decrease in their properties, however, the use of CA promoted more stability; in mechanical properties, the composites with CA showed lower loss about 23% in Young's modulus, 18% in tensile stress at break, and 6% in impact strength. This behavior was similar in thermal and physical properties, the result for the CA of natural origin being similar to that of synthetic origin. These results indicate that the use of a CA may promote higher interaction between the fiber and the polymer. In addition, the CAs of organic origin and synthetic origin exhibited similar responses to natural ageing.

14.
Artigo em Inglês | MEDLINE | ID: mdl-32205221

RESUMO

BACKGROUND & AIMS: The short-term efficacy of PC4046, a monoclonal antibody against interleukin-13, has been shown in patients with eosinophilic esophagitis (EoE). We investigated the long-term efficacy and safety of RPC4046 in an open-label, long-term extension (LTE) study in adults with EoE. METHODS: We analyzed data from 66 patients who coRmpleted the 16-week, double-blind, induction portion of a phase 2 study of RPC4046 (180 mg or 360 mg/wk) vs placebo and then completed a 52-week LTE, receiving open-label RPC4046 360 mg/wk. The study was conducted at 28 centers in 3 countries; patients were enrolled between September 2014 and January 2017. Outcomes were stratified by double-blind dose group and included esophageal eosinophil counts, EoE endoscopic reference score, EoE histologic scoring system score, symptom-based EoE activity index score, and safety. RESULTS: By week 12 of the LTE, esophageal eosinophil mean and peak counts, total EoE endoscopic reference scores, and EoE histologic scoring system grade and stage scores did not differ considerably between patients who originally received placebo vs RPC4046. Most patients maintained responses through week 52. Symptom remission (symptom-based EoE activity index score, ≤20) increased from 14% at LTE entry to 67% at LTE week 52 in placebo‒RPC4046 patients and from 30% to 54% in RPC4046‒RPC4046 (either dose) patients. Of the 28 patients who did not have a histologic response to RPC4046 during the double-blind induction phase, 10 patients (36%) achieved response during the LTE. The most common adverse events were upper respiratory tract infection (21%) and nasopharyngitis (14%). CONCLUSIONS: One year of treatment with RPC4046 is generally well tolerated and results in continued improvement and/or maintenance of endoscopic, histologic, and clinical measures of EoE disease activity relative to baseline. TRIAL REGISTRATION: NCT02098473.

15.
Materials (Basel) ; 13(3)2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31991703

RESUMO

Today, dendrimers are the main nanoparticle applied to drug delivery systems. The physicochemical characteristics of dendrimers and their versatility structural modification make them attractive to applied as a platform to bioactive molecules transport. Nanoformulations based on dendrimers enhance low solubility drugs, arrival to the target tissue, drugs bioavailability, and controlled release. This review describes the latter approaches on the transport of bioactive molecules based on dendrimers. The review focus is on the last therapeutic strategies addressed by dendrimers conjugated with bioactive molecules. A brief review of the latest studies in therapies against cancer and cardiovascular diseases, as well as future projections in the area, are addressed.

16.
J Asthma ; 57(2): 113-122, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30915868

RESUMO

Objective: This study aimed to estimate asthma control at specialist treatment centers in four Latin American countries and assess factors influencing poor asthma control.Methods: Patients aged ≥12 years with an asthma diagnosis and asthma medication prescription, followed at outpatient specialist centers in Argentina, Chile, Colombia, and Mexico, were included. The study received all applicable ethical approvals. The Asthma Control Test (ACT) was used to classify patients as having controlled (ACT 20-25) or uncontrolled (ACT ≤19) asthma. Frequency and statistical tests were used to assess the association between hospital admissions/exacerbations/emergency department (ED) visits and uncontrolled asthma; multivariate logistic regression was used to assess the association of uncontrolled asthma with clinical/demographic variables.Results: A total of 594 patients were included. Overall controlled-asthma prevalence was 43.4% (95% confidence interval [CI]: 39.0, 47.4). Patients with uncontrolled asthma were more likely to be women (adjusted odds ratio [aOR]: 1.85; p = 0.003), non-white (aOR: 2.14; p < 0.001), obese (aOR: 1.71; p = 0.036), to have a low monthly family income (aOR: 1.75; p = 0.004), to have severe asthma (aOR:1.59; p = 0.26), and, compared with patients with controlled asthma, to have a higher likelihood of asthma exacerbations (34.5% vs. 15.9%; p < 0.001), hospital admissions (6.9% vs. 3.1%; p = 0.042), and ED visits (34.5% vs. 15.9%; p < 0.001) due to asthma.Conclusions: Even in specialist ambulatory services, fewer than half of patients were classified as having controlled asthma. The proportion of uncontrolled patients varied according to clinical and demographic variables.


Assuntos
Asma/epidemiologia , Asma/fisiopatologia , Adolescente , Adulto , Fatores Etários , Idade de Início , Índice de Massa Corporal , Criança , Comorbidade , Estudos Transversais , Feminino , Recursos em Saúde/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Humanos , América Latina/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Razão de Chances , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Índice de Gravidade de Doença , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
17.
PeerJ ; 7: e8125, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31824764

RESUMO

We here compare morphological and molecular characters of some putative endosymbiotic elements of the digestive gland of three ampullariid species (Pomacea canaliculata, Pomacea scalaris and Asolene platae) which coexist in Lake Regatas (Palermo, Buenos Aires). The putative endosymbionts were reported in these species and were identified as C and K corpuscles. The three species show tubuloacinar glands, each adenomere was constituted mainly by two distinct cell types (columnar and pyramidal). C and K corpuscles together occupied from one-fourth to one-fifth of the tissue area in the three host species, where C corpuscles were round and greenish-brown, were delimited by a distinct wall, stained positively with Alcian Blue and were associated with columnar cells. K corpuscles were oval, dark-brown multilamellar bodies and were associated with pyramidal cells. Under TEM, C corpuscles occurred within vacuoles of columnar cells and contained many electron-dense clumps and irregular membrane stacks and vesicles spread in an electron-lucent matrix. Sometimes a membrane appeared detached from the inner surface of the wall, suggesting the existence of a plasma membrane. In turn, K corpuscles were contained within vacuoles of pyramidal cells and were made of concentric lamellae, which were in turn made of an electron-dense fibrogranular material. No membranes were seen in them. Interspecifically, C corpuscles vary significantly in width and inner contents. K corpuscles were also variable in length and width. However, both C and K corpuscles in the three studied species hybridised with generalised cyanobacterial/chloroplast probes for 16S rRNA. Also, both corpuscle types (isolated from gland homogenates) were sensitive to lysozyme digestion, which indicates that bacterial peptidoglycans are an integral part of their covers. The reported data confirm and extend previous studies on P. canaliculata in which the endosymbiotic nature of C and K corpuscles were first proposed. We further propose that the endosymbiotic corpuscles are related to the Cyanobacteria/chloroplasts clade. Based on the known distribution of these corpuscles in the major clades of Ampullariidae, we hypothesise they may be universally distributed in this family, and that may constitute an interesting model for studying the co-evolution of endosymbionts and their gastropod hosts.

18.
Rev. argent. coloproctología ; 30(4): 104-113, dic. 2019. ilus, tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1096799

RESUMO

Introducción: Los pacientes que se presentan con cuadros de peritonitis de origen diverticular (estadios Hinchey III o IV) en un contexto de sepsis severa con inestabilidad hemodinámica (shock séptico) la realización de anastomosis primaria presenta una alta tasa de dehiscencia anastomótica y mortalidad operatoria, aconsejándose la realización de una resección y abocamiento a la manera de Hartmann. Sin embargo, la alta tasa de complicaciones relacionadas a la confección del ostoma, la complejidad de la cirugía de restauración del tránsito intestinal, asociado a que entre el 40 % y el 60 % de los Hartmann no se reconstruyen, ha estimulado a que se intenten otras variables de resolución para esta compleja y grave patología. Diversas publicaciones en los últimos años han propuesto la táctica de "cirugía del control del daño" con el objeto de disminuir la morbimortalidad de estos gravísimos cuadros sépticos y a su vez reducir la tasa de ostomías. El objetivo de este trabajo es presentar nuestra experiencia inicial con esta modalidad de manejo de la peritonitis diverticular Hinchey III/IV sepsis severa e inestabilidad hemodinámica (shock séptico) y realizar una revisión bibliográfica del tema. Material y método: Estudio observacional, descriptivo, de series de casos. Entre noviembre de 2015 y diciembre de 2016. Servicio de coloproctología del complejo médico hospitalario Churruca-Visca de la ciudad de Buenos Aires y práctica privada de los autores. Se utilizó la técnica de laparotomía abreviada y cierre temporal del abdomen mediante un sistema de presión negativa. Resultados: En el periodo descripto se operaron 17 pacientes con peritonitis generalizada purulenta o fecal de origen diverticular. Catorce casos fueron Hinchey III (82,36%) y 3 casos Hinchey IV (17,64%). En 3 casos se observó inestabilidad hemodinámica en el preoperatorio o intraoperatorio. Todos ellos correspondientes al estadio IV de Hinchey. Se describen los 3 casos tratados mediante esta táctica quirúrgica. Discusión: La alta tasa de morbimortalidad de este subgrupo de pacientes incentivó a diversos grupos quirúrgicos a implementar la técnica de control del daño, permitiendo de esta manera estabilizar a los pacientes hemodinámicamente y en un segundo tiempo evaluar la reconstrucción del tránsito intestinal. En concordancia con estas publicaciones, dos de nuestros pacientes operados con esta estrategia, pudieron ser anastomosados luego del segundo lavado abdominal. Conclusión: En pacientes con peritonitis diverticular severa asociado a shock séptico el concepto de laparotomía abreviada con control inicial del foco séptico, cierre temporal del abdomen con sistema de presión negativa y posterior evaluación de la reconstrucción del tránsito intestinal, es muy alentador. Permitiendo una disminución de la morbimortalidad como así también del número de ostomías. (AU)


Introduction: Patients presenting with diverticular peritonitis (Hinchey III or IV stages) in a context of severe sepsis with hemodynamic instability (septic shock), performing primary anastomosis has a high rate of dehiscence anastomotic and operative mortality, advising the realization of a resection and ostoma in the manner of Hartmann. However, the high rate of complications related to performing of ostoma, the complexity of intestinal transit restoration surgery, associated with the 40% to 60% of Hartmann reversal not performed, has encouraged other variables to be attempted resolution for this complex and serious pathology. Several publications in recent years have proposed the tactic of "damage control surgery" in order to reduce the morbidity of these serious septic charts while reducing the rate of ostomies. The objective of this study is to present our initial experience with this modality of management of the diverticular peritonitis Hinchey III/IV severe sepsis and hemodynamic instability (septic shock) and to carry out a bibliographic review of the subject. Material and method: Observational, descriptive study of case series. Between November 2015 and December 2016. Coloproctology service of the Churruca-Visca hospital medical complex in the city of Buenos Aires and private practice of the authors. The technique of abbreviated laparotomy and temporary closure of the abdomen was used by a negative pressure system. Results: In the period described, 17 patients with generalized purulent or fecal peritonitis of diverticular origin were operated. Fourteen cases were Hinchey III (82.36%) and 3 cases Hinchey IV (17.64%).In 3 cases, hemodynamic instability was observed in the preoperative or intraoperative period. all of them corresponding to Hinchey's Stage IV. The 3 cases treated using this surgical tactic are described. Discussion: The high morbidity rate of this subgroup of patients encouraged various surgical groups to implement the damage control technique, thus allowing patients to stabilize hemodynamically and in a second time evaluate reconstruction intestinal transit. In line with these publications, two of our patients operated on with this strategy could be anastomosated after the second abdominal wash. Conclusion: In patients with severe diverticular peritonitis associated with septic shock, the concept of abbreviated laparotomy with initial control of the septic focus, temporary closure of the abdomen with negative pressure system and subsequent evaluation of transit reconstruction intestinal, it's encouraging. Allowing a decrease in morbidity as well as the number of ostomies. (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Peritonite/cirurgia , Choque Séptico , Doença Diverticular do Colo/cirurgia , Tratamento de Ferimentos com Pressão Negativa , Laparotomia/métodos , Peritonite/etiologia , Reoperação , Lavagem Peritoneal , Colostomia/métodos , Colostomia/mortalidade , Doença Aguda , Epidemiologia Descritiva , Sepse , Doença Diverticular do Colo/complicações , Técnicas de Fechamento de Ferimentos Abdominais , Laparotomia/mortalidade
19.
Steroids ; 151: 108469, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31400393

RESUMO

The DAF-12 receptor is a ligand-activated transcription factor that in its ligand-bound form allows the expression of target genes needed to support the reproductive life cycle of the free-living nematode Caenorhabditis elegans, whereas unbound DAF-12 receptor leads to the developmentally arrested "dauer larvae", specialized for survival and dispersal. The endogenous ligands of the DAF-12 receptor are 3-keto-cholestenoic acids dubbed dafachronic acids. In a previous publication we reported that oxysterols with a shorter side chain (C24) modulate the DAF-12 receptor activity either as partial agonists or, in the case of the C24 alcohol 24-hydroxy-4-cholen-3-one, as an antagonist both in vitro and in vivo. Preliminary structure-activity relationships suggested that this activity profile could be improved with more lipophilic and less acidic functional groups at the end of the side chain. Thus, we have now synthesized two fluorine containing analogues in which the C-24 hydroxyl was replaced by a difluoromethyl group (regarded as a "lipophilic hydroxyl") or a difluoromethylidene group with similar lipophilicity but lacking the hydrogen bond donor capacity. Activity was evaluated in vitro using transactivation cell-based assays and in vivo by the effect on the development of wild-type C. elegans. The 24-difluoromethyl analogue retained the antagonist activity in vitro, being completely devoid of agonist activity and exhibited improved activity in vivo. The difluoromethylidene showed a slight antagonist tendency in vitro (statistically not significant), in the concentration range tested and was weakly active in vivo. None of the compounds were toxic, as treated worms recovered to normal development, when transferred to fresh media without added steroids.


Assuntos
Proteínas de Caenorhabditis elegans/antagonistas & inibidores , Colenos/síntese química , Colenos/farmacologia , Halogenação , Receptores Citoplasmáticos e Nucleares/antagonistas & inibidores , Técnicas de Química Sintética , Colenos/química , Células HEK293 , Humanos , Ligação de Hidrogênio
20.
PeerJ ; 7: e7342, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31396441

RESUMO

Ampullariids are freshwater gastropods bearing a gill and a lung, thus showing different degrees of amphibiousness. In particular, Pomacea canaliculata (Caenogastropoda, Ampullariidae) is an obligate air-breather that relies mainly or solely on the lung for dwelling in poorly oxygenated water, for avoiding predators, while burying in the mud during aestivation, and for oviposition above water level. In this paper, we studied the morphological peculiarities of the gill in this species. We found (1) the gill and lung vasculature and innervation are intimately related, allowing alternation between water and air respiration; (2) the gill epithelium has features typical of a transporting rather than a respiratory epithelium; and (3) the gill has resident granulocytes within intraepithelial spaces that may serve a role for immune defence. Thus, the role in oxygen uptake may be less significant than the roles in ionic/osmotic regulation and immunity. Also, our results provide a morphological background to understand the dependence on aerial respiration of Pomacea canaliculata. Finally, we consider these findings from a functional perspective in the light of the evolution of amphibiousness in the Ampullariidae, and discuss that master regulators may explain the phenotypic convergence of gill structures amongst this molluscan species and those in other phyla.

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