Malestar psicológico en familiares de pacientes con daño neurológico durante la fase subaguda de NeuroRehabilitación / Psychological distress in relatives of patients with neurological damage during the subacute phase of NeuroRehabilitation

Durante la última década la Neurorehabilitación ha comenzado a prestar mayor atención a las familias de personas que adquieren un daño neurológico. Este giro parece responder a un creciente número de estudios describiendo importantes niveles de malestar psicólogico en dichas familias y advirtiendo de su impacto en el proceso de rehabilitación. En Chile, lamentablemente, no contamos con estudios que exploren el estado emocional de familiares en ninguna de las etapas de rehabilitación, esto, a pesar de existir guías clínicas que sugieren el abordaje familiar como meta central. Dicha falta de información limita tanto la capacidad diagnóstica como interventiva de los equipos de rehabilitación. El objetivo de este artículo es describir, y comparar, el perfil de malestar psicológico en familiares de personas con lesión cerebral y medular en etapa subaguda de rehabilitación. Método. 89 familiares de personas con daño neurológico (Lesión Cerebral Adquirida = 50; Trauma Raquimedular = 39) respondieron el General Health Questionnaire-28 como medida de malestar psicológico. Este instrumento que se compone de cuatro subescalas: síntomas somáticos, ansiedad e insomnio, disfunción social y depresión grave. Resultados. En ambas poblaciones el puntaje total del GHQ-28 se observó por encima de los estándares poblacionales, sugiriendo niveles clínicos de malestar psicológico en 90 por ciento de la muestra. No se observaron diferencias entre ambas poblaciones en términos de puntaje total o puntaje de subescalas, sugiriendo similares perfiles de malestar psicólogico. Dicho perfil se caracterizó por altos niveles de ansiedad e insomnio, seguido en menor grado de síntomas somáticos...

During the last decade NeuroRehabilitation has begun to pay more attention to the families of people with neurological damage. This shift seems to respond to a growing number of studies describing significant levels of psychological distress in families, and warning professionals of its potential impact in the process of rehabilitation. In Chile, unfortunately, we have no studies that explore the emotional state of families in any stage of the rehabilitation process, this, despite the existence of clinical guidelines suggesting to address family needs as a central goal. This lack of information limits rehabilitation teams’ ability as well as their capacity to develop interventions. The aim of this article is to describe, and compare, the profile of psychological distress in relatives of people with brain damage and spinal cord injuries, during the sub-acute phase of rehabilitation. Method. 89 relatives of people with neurological damage (Acquired Brain Injury = 50; Spinal Cord Injury = 39) completed the General Health Questionnaire-28, a self-report measure of psychological distress. This instrument has four subscales, each of them screening for different types of symptoms: somatic, anxiety/insomnia, social dysfunction and severe depression. Results. Both neurological groups presented GHQ-28 total scored above population standards, thus suggesting clinical levels of psychological distress in 90 percent of the sample. No differences were observed between the two groups in terms of GHQ-28 total score or subscale score, thus, suggesting similar profiles of psychological distress. High levels of anxiety and insomnia, followed to a lesser degree by somatic symptoms, characterized this profile...

PCR identification of Mycobacterium tuberculosis complex in a clinical sample from a patient with symptoms of tuberculous spondylodiscitis

A 42-year-old male complaining of thoracic spine pain was admitted to the hospital for evaluation. An X-ray and computer tomography of the thoracic spine showed spondylodiscitis of the L3 lumbar and L2-L3 intervertebral disk. The tuberculin skin test (PPD) was strongly positive. A radioscopy-guided fine needle aspirate of the affected area was cultured but did not reveal the cause of the disease. Two biopsy attempts failed to reveal the cause of the disease by culturing or by acid-fast-resistant staining (Ziehl Neelsen) of the specimens. A third biopsy also failed to detect the infectious agent by using microbiological procedures, but revealed the presence of a 245-bp amplicon characteristic of the Mycobacterium tuberculosis complex after PCR of the sample. The result demonstrates the efficacy of PCR for the identification of M. tuberculosis in situations in which conventional diagnosis by culturing techniques or direct microscopy is unable to detect the microorganism. Following this result the patient was treated with the antituberculous cocktail composed by rifampicin, pirazinamide and isoniazid during a six-month period. At the end of the treatment the dorsalgia symptoms had disappeared.

BCG lymphadenopathy detected in a BCG-vaccinated infant

Large-scale vaccination with BCG, the live attenuated strain of Mycobacterium bovis, is being adopted around the world, although sporadic complications have occurred after the procedure. Lymphadenopathy is not uncommon especially in babies under one year (0.73 percent of vaccinated infants), but the swelling subsides within 2 months in most cases, with no medical or surgical treatment. Brazil adopted BCG vaccination program earlier in the seventies and by 1995 more than 96 percent of the infant population received this immunization. We report here the occurrence of lymphadenopathy in a two-year-old child vaccinated with the Brazilian BCG strain. The diagnosis was made using a lymph node biopsy and intestinal aspirates that yielded a positive mycobacterial culture. The isolate was resistant to isoniazid, rifampicin, pyrazinamide and thiophen-2-carbonic acid hydrazide, sensitive to streptomycin, ethambutol, and p-nitrobenzoic acid, and reacted positively to cyclo-serine and negatively to niacin. The pncA gene involved in bacterial activation of pyrazinamide contains in M. bovis a point mutation that renders pyrazinamidase unable to catalyze drug activation. Therefore, this polymorphism is a good option for developing methods to differentiate M. bovis and M. tuberculosis. Taking advantage of this difference we further analyzed the isolates by single-stranded conformation polymorphism electrophoresis of DNA following PCR of the pncA gene. The isolate identity was confirmed by RFLP electrophoretic analysis of the amplified fragment following Eco065I digestion, which selectively cleaves M. tuberculosis DNA. From this result it is proposed that RFLP of pncA gene represents an alternative for differential diagnosis of M. bovis.

Mycobacterium bovis: polymerase chain reaction identification in bovine Lymphonode biopsies and genotyping in isolates from Southeast Brazil by spolygotyping and restriction fragment length polymorphism

Diagnosis of the Mycobacterium tuberculosis complex by direct PCR of mediastinal lymphnode DNA and microbiological tests were compared in cattle suspicious of bearing tuberculous-like lesions detected during slaughter. The PCR procedure applied on DNA samples (n=54) obtained by adding alpha -casein into the thiocyanate extraction mix was positive in 70 percent of the samples. PCR confirmed the identification of 23 samples (100 percent) that grew in culture, 9 samples (60 percent) that failed to grow in culture, plus 6 (37.5 percent) samples that resulted in growth of bacterial contaminants. Genotyping by IS6110-RFLP and DR-spoligotyping analysis of seven samples revealed the presence of several polimorphisms. Seven of the isolates contained multiple copies of IS6110, thus defining the existence of five singular genotypes

A comparison of three DNA extractive procedures with Leptospira for polymerase chain reaction analysis

Three DNA extraction methods were evaluated in this study: proteinase K followed by phenol-chloroform; a plant proteinase (E6870) followed by phenol-chloroform; and boiling of leptospires in 0.1 mM Tris, pH 7.0 for 10 min at 100°C, with no phenol treatment. Every strain treated with proteinase K or E6870 afforded positive polymerase chain reaction (PCR) reaction. On the other hand, from five strains extracted by the boiling method, three did not feature the 849 bp band characteristic in Leptospira. We also evaluated by RAPD-PCR, DNAs from serovars isolated with proteinase K and proteinase 6870 with primers B11/B12. Each of the DNA samples provided PCR profiles in agreement with previous data. Moreover, the results with E6870 showed less background non-specific amplification, suggesting that removal of nucleases was more efficient with E6870. The limit for detection by PCR using Lep13/Lep14 was determined to be 10(2) leptospira, using the silver stain procedure.

Use of a cysteine proteinase from Carica candamarcensis as a protective agent during DNA extraction

We describe the use of a plant cysteine proteinase isolated from latex of Carica candamarcensis as a protective agent during isolation of bacterial DNA following growth in culture of these cells. Between 100 to 720 units of proteinase (1 µg = 6 units) afforded good DNA protection when incubated with various kinds of microorganisms. Agarose gel electrophoresis showed that the resulting DNA was similar in size to DNA preparations obtained by treatment with proteinase K. The viability of the resulting material was checked by PCR amplification using species-specific primers. After standing at room temperature (25oC) for 35 days, the enzyme lost 10 percent of its initial activity. The enzyme stability and good yield of DNA suggest the use of this proteinase as an alternative to proteinase K

Changes in protein profile during coagulation of latex from Carica papaya

We describe the changes in peptide composition by SDS-PAGE analysis of latex from Carioca papaya collected at various times after incision of the unripe fruit. The data show that during latex coagulation several peptides are processed in an orderly fashion.

A biochemical comparison between latex from Carica Candamarcensis and C. papaya

1. A group of plant proteinases is present mainly in the unripe fruit of the papaya tree (Carica papaya), which is a member of the genus Carica. C. candamarcensis is another species that belongs to this group. Its latex contains several proteinases displaying high proteolytic activity. 2. We used several electrophoretic techniques to compare the protein composition of the latex from the two species. Acid electrophoresis followed by staining or Western blot revelated a total of 17 proteins in C. candamarcensis and 7 proteins in C. papaya. Some of the proteins observed in C. papaya have been previously reported in the literature. 3. Electrophoresis on denaturing gels, followed by staining or Western blot revealed the presence of 14 proteins in C. candamarcensis and 6 proteins in C. papaya. Non-equilibrium isoelectrofocusing of the latex from both species showed a larger array of proteins in C. candamarcensis. The analysis of esterase and proteolytic activities on gel fractions after electrophoresis revealed the presence of distinct areas presenting enzyme activity. Some proteins detected in C. candamarcensis have different mobilities when compared with from C. papaya. 4. These results support the view that latex from C. candamarcensis contains a wider diversity of proteins compared to C. papaya, and that some of the proteins not in C. papaya present esterase and proteolytic activity

Transfer RNA nucleoside composition in 13762 rat adenocarcinoma

Abnormalities in patterns of RNA methylation and in the activities of tRNA methyltransferases are well-documented phenomena. In this study, we focused our attention on tRNA from adenocarcinoma, a 9,10-dimethyl-1,2-benznthracene-induced mammary tumor, because prior evidence has suggested the occurence of an abnormal pattern of tRNA methylation. Chemical postlabeling of tumor vs normal rat liver and mammary gland tRNAs revealed tumor specific differences in the modified nucleoside distribution, i.e., a 5.8-fold increase in tumor n-2-methylguanosine together with a 2.7-,2.8-,2.6-, and 2.8-fold decrease in tumor 1-methyladenosine, dihydrouridine, pseudoridine and 5-methylcytidyne, respectively. Class A tRNAs, a slower gel migrating group of tumor tRNAs, exhibited even lower 1-methyladenosine levels. Most of the remaining nucleosides in class A tRNAs showed molar ratios similar to those found in bulk tumor tRNA. However, N-2-methylguanosine levels class A tRNA are intermediate between bulk tumor tRNA (2.8%) and mammary gland tRNA (0.49%). The only qualitative difference found in tumor tRNA seems to be the absence of inosine usually present in tRNAs from liver and mammary tissues. In spite of its abnormal methylation pattern adenocarcinoma tRNA binds to glucocorticoid receptor protein from mouse AtT-20 cells, generating a 65 tRNA-protein complex, in a fashion similar to that previously described for the endogenous tRNA isolated from the same cells