ABSTRACT
Se valoró la situación actual del acceso vascular para hemodiálisis mediante un estudio transversal y longitudinal de pacientes activos actualmente, que comenzaron su tratamiento desde la creación del Departamento de Hemodiálisis en el Hospital General Docente Dr Juan Bruno Zayas de Santiago de Cuba en 1996 hasta septiembre del 2008. Los datos necesarios (causas de la enfermedad renal, sexo, edad, tipo de acceso vascular, tiempo en diálisis, intento anterior para fístula arteriovenosa y otros) se obtuvieron de la historia clínica automatizada, del examen físico y de la evaluación del acceso vascular. Este último se realizó predominantemente a través de una fístula arteriovenosa autógena, situada en la flexura anterior del codo; procedimiento que había sido intentado 2 ó más veces en 21 pacientes del total y fallado por deficiencia del estado de los vasos y trombosis de las mencionadas fístulas. La producción de aneurismas fue la complicación más frecuente, atribuible a la poca rotación en el sitio de punción.
The current situation of the vascular approach for hemodialysis was valued by means of a longitudinal and cross-sectional study of active patients that started their treatment from the creation of the Department of Hemodyalisis in Dr Juan Bruno Zayas General Teaching Hospital of Santiago de Cuba from 1996 to September, 2008. Neccesary data (cause of renal disease, sex, age, type of vascular approach, time in dialysis, previous attempt at arteriovenous fistula and others) were obtained from automated medical records, physical examination and evaluation of the vascular approach. The latter was performed specially through an autogenous arteriovenous fistula located in the elbow anterior flexure; a procedure that had been attempted 2 or more times in 21 patients of the total and it had failed by deficiency of the vessel state and thrombosis of these fistulae. The occurrence of aneurysms was the most frequent complication attributable to the little rotation in the punction site.
Subject(s)
Humans , Male , Female , Cross-Sectional Studies , Catheters, Indwelling/adverse effects , Renal Dialysis/mortality , Longitudinal Studies , Quality of LifeABSTRACT
Background: The genes cagA and vacA encode H pylori virulence factors. Aim: To genotype these genes in H pylori strains isolated from patients with upper gastrointestinal symptoms. Material and methods: We studied 50 patients who underwent an upper gastrointestinal endoscopy, with positive culture for H pylori. Detection of cagA and vacA gerotyping was done using polymerase chain reactions. Results: The gene cagA was detected in 19 samples (38 per cent). Signal sequences s1 and s2 of vacA gene were detected in 16 samples each (32 per cent). There was simultaneous amplification of s1 and s2 in 6 samples and they were not detected in 9 samples. The middle region of vacA was m1 in 9 samples, m2 in 29 samples and there was simultaneous amplification of m1 and m2 in 12 samples. In 16 samples (32 per cent), more than one type of signal sequence or medial region was detected. Of those patients in whom vacA was the only genotype detected, 15 were s2/m2, 7 were s1/m1, 4 were s1/m2 and 1 was s2/m1. Conclusions: In these patients, the infection with cagA- H pylori strains, predominates, the prevalence of infection with s1 or s2 strains is similar and the predominant medial region is m2
Subject(s)
Humans , Helicobacter pylori , Genotype , Biopsy , Duodenoscopy , Gastroscopy , Electrophoresis, Agar Gel , Protein Sorting SignalsABSTRACT
Some properties of the beta-lactamases produced by one strain of Shigella flexneri, one strain of Shigella sonnei, and one strain of Shigella boydii are studied. Susceptibility of these microorganisms to ampicillin and to cephalotin is investigated before and after a curing treatment with acridine oragne. The substrate profiles of these beta-lactamases, as well as their inducibility, their release to the extracellular environment by osmotic shcok,their susceptibility to enzime inhibitors, and their isoelectric points are also investigated. Transference of ampicillin resistance is tried by bacterial conjugation using a recipient strain of Escherichia coli K-12. The extrachromosomal DNA of the strain is also investigated. Through the analysis of the results the classification of these beta of these beta-lactamases is attempted in relation to the main groups of enzymes which are known at the present time. The three strains proved to be resistant to ampicillin and cephalotin but the transference of this resistance by conjugation was positive only for Sh. flexneri. Several bands of extrachromosomal DNA were observed in these microorganisms. It is concluded that, according to the properties of the enzymes, the beta-lactamase produced by Sh. flexneri belong to the TEM group of enzymes (plasmid-coded beta-lactamases). In relation to the beta-lactamase of Sh. sonnei, its general properties agree with those previously described for enzymes of the same bacterial species and allow the classification of this beta-lactamase as a constitutive cephalosporinase. It is also concluded that the bata-lactamase produced by Sh. boydii is plasmic-coded, since a curing effect was obtained with acridine orange and enzyme activity was released by osmotic shock procedure to the extracellualar environment in more than 80%. However, according to other properties (isolectric point and inhibition profile), this enzyme does not seem to belong to any of the know groups of plasmid-coded beta-lactamases...