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1.
RECIIS (Online) ; 18(1)jan.-mar. 2024.
Article in English | LILACS, ColecionaSUS | ID: biblio-1553578

ABSTRACT

The aim of this article was to analyze the literature on technological development in telemedicine through bibliometrics, by identifying the state of the art, research gaps, and trends in the literature. The analysis covers a total of 67 articles related to the field of study, published between 2010-2020 in the Springer Link, Science Direct, Wiley Online Library, Web of Science, and Scopus databases. The data was processed using the software StArt, Excel, IBM SPSS Statistics, and Iramuteq. The results presented bibliometric analysis of the articles, classified into the areas of Management (52.2%), IT (25.4%), and Medicine (22.4%), along with a Table of 34 suggestions for future research. Literature trends encompassed six study clusters (health, study, service, technology, patient, and telemedicine), which further subdivided into nine research themes (digital platform, telemedicine service management, telemedicine service operation, end-user perception, business opportunities, healthcare professional perception, covid-19, regulation, and robotics). An observed outcome was a significant increase in the number of publications in the area due to covid-19.


O objetivo deste artigo foi analisar a literatura acerca do desenvolvimento tecnológico na telemedicina, por meio da bibliometria, ao identificar o estado da arte, lacunas de pesquisa e tendências na literatura. Analisou-se 67 artigos relacionados ao campo de estudo, publicados entre 2010-2020 nas bases de dados Springer Link, Science Direct, Wiley Online Library, Web of Science e Scopus. O tratamento dos dados se deu por meio dos softwares StArt, Excel, IBM SPSS Statistics e Iramuteq. Os resultados apresentaram a análise bibliométrica dos artigos, classificados nas áreas de Gestão (52,2%), TI (25,4%) e Medicina (22,4%), e uma tabela com 34 sugestões para pesquisas futuras. As tendências da literatura envolveram seis classes de estudo (saúde, estudo, serviço, tecnologia, paciente e telemedicina), que se subdividiram em nove temas de pesquisa (plataforma digital, gestão do serviço de telemedicina, operação do serviço de telemedicina, percepção do usuário final, oportunidades de negócios, percepção de profissionais de saúde, covid-19, regulamentação e robótica). Observou-se aumento significativo no número de publicações na área devido à covid-19.


El objetivo de este artículo fue analizar la literatura sobre el desarrollo tecnológico en la telemedicina me-diante bibliometría, identificando el estado del arte, las lagunas de investigación y las tendencias en la literatura. Se analizaron un total de 67 artículos relacionados con el campo de estudio, publicados entre 2010-2020 en las bases de datos de Springer Link, Science Direct, Wiley Online Library, Web of Science y Scopus. Los datos fueron procesados utilizando los programas StArt, Excel, IBM SPSS Statistics e Iramuteq. Los resultados presentaron un análisis bibliométrico de los artículos, clasificados en las áreas de Gestión (52,2%), TI (25,4%) y Medicina (22,4%), junto con una tabla de 34 sugerencias para futuras investiga-ciones. Las tendencias en la literatura abarcaron seis clases de estudio (salud, estudio, servicio, tecnología, paciente y telemedicina), que se subdividieron en nueve temas de investigación (plataforma digital, gestión del servicio de telemedicina, operación del servicio de telemedicina, percepción del usuario final, oportuni-dades de negocio, percepción de los profesionales de la salud, covid-19, regulación y robótica). Un resultado observado fue un aumento significativo en el número de publicaciones en el área debido al covid-19.


Subject(s)
Bibliometrics , Databases, Bibliographic , Telemedicine , COVID-19 , Technological Development , Health Personnel
2.
Acta Pharmaceutica Sinica ; (12): 775-783, 2024.
Article in Chinese | WPRIM | ID: wpr-1016625

ABSTRACT

Tropane alkaloids (TAs) are a class of anticholinergic drugs widely used in clinical practice and mainly extracted from plant, among which Atopa belladonna is the main commercial drug source. It is of great industrial value to obtain TAs in large quantities by plant metabolic engineering. In TAs pathway, cytochrome oxidase CYP82M3 catalyze the synthesis of tropinone and then tropinone reductase I (TRI) compete with TRII for tropinone to form tropine leading to the TAs synthesis (drainage). In this study, based on the "increasing flow and drainage" metabolic engineering strategy, two genes, namely HnCYP82M3 and DsTRI from Hyoscyamus niger and Datura stramonium, respectively, were overexpressed in the hair roots of A. belladonna, with a view to promote the TAs accumulation. The HnCYP82M3 gene was cloned from the root of H. niger, and it encoded amino acid with 91.7% sequence identity with AbCYP82M3 from A. belladonna. Overexpression of HnCYP82M3 alone did not affect the content of TAs in hair roots of A. belladonna, indicating that CYP82M3 was not a key enzyme in TAs biosynthesis. Simultaneous overexpression of HnCYP82M3 and DsTRI greatly promoted the accumulation of the three TAs, and the contents of hyoscyamine, anisodamine and scopolamine were 4.97 times, 2.83 times and 2.19 times that of the control, respectively, and the increase amplitude was greater than that of single overexpression of DsTRI. This study showed that the "increasing flow and drainage" strategy of enzyme genes co-expression at branch points was a promising metabolic engineering method to effectively improve the biosynthesis of TAs in A. belladonna, and laid a theoretical and technical foundation for the large-scale industrial acquisition of TAs.

3.
Chinese Pharmacological Bulletin ; (12): 285-291, 2024.
Article in Chinese | WPRIM | ID: wpr-1013632

ABSTRACT

Aim To investigate the role and potential mechanism of methyltransferase-like 5 (METTL5) in triple-negative breast cancer (TNBC) . Methods The expression of METTL5 in TNBC tumor tissues and cell lines was detected by immunohistochemistry and Western blot. After shRNA targeting METTL5 (shRNAMETTL5) was transfected into TNBC cells, cell proliferation, migration and invasion were detected by CCK-8, colony formation, wound healing and Transwell assays, respectively. Western blot was used to detect the expression of Wnt/p-catenin signaling-related key proteins. A xenograft tumor model was constructed to verify the effect of METTL5 knockdown on the growth of TNBC cells and Wnt/p-catenin signaling activity in vivo. Results The expression of METTL5 was up-regulated in TNBC tumor tissues and cell lines (P < 0. 01) . Knockdown of METTL5 significantly inhibited the proliferation, migration and invasion of TNBC cells and reduced the expression of Wnt/p-catenin signaling molecules (3-catenin, cyclin Dl, matrix metalloproteinase (MMP) -2 and MMP-7 (all P < 0. 01) . Knockdown of METTL5 reduced tumor growth and Wnt/pcatenin signaling activity in vivo. Conclusions Knockdown of METTL5 can inhibit the proliferation, migration and invasion of TNBC cells, which may be related to the inhibition of Wnt/p-catenin signaling pathway.

4.
Chinese Journal of Biologicals ; (12): 310-315, 2024.
Article in Chinese | WPRIM | ID: wpr-1013394

ABSTRACT

@#Objective To prepare murine and rabbit polyclonal antibodies against rabies virus(RV) matrix(M) protein and compare their reactivity.Methods The prokaryotic expression vector pET-28a-M was constructed by using the cDNA of cells infected with RV CVS-11 strain as template,then transformed into E.coli BL21(DE3),and the induced by IPTG to express M protein.After nickel column affinity chromatography and dialysis renaturation,female BALB/c mice and New Zealand white rabbits were immunized with the M protein,and the whole blood was taken to separate the serum.The titers of the murine and rabbit polyclonal antibodies were detected by ELISA,and the reactivity was measured by Western blot,indirect immunofluorescence assay(IFA) and immunoprecipitation(IP).Results The plasmid pET-28a-M was constructed correctly as identified by sequencing.The titers of murine and rabbit polyclonal antibodies were 1:100 and 1:256 000respectively,and the polyclonal antibodies had reactivity with different RV strains.Conclusion The murine and rabbit polyclonal antibodies against M protein were successfully prepared,which provides important biological tools for exploring the interaction between M protein and host protein as well as studying the pathogenesis of RV.

5.
International Eye Science ; (12): 589-595, 2024.
Article in Chinese | WPRIM | ID: wpr-1012827

ABSTRACT

N6-methyladenosine(m6A), the most common, abundant, and conserved RNA modification in eukaryotic cells, regulates RNA splicing, stability, output, degradation and translation through m6A methyltransferase, m6A demethylase, and m6A methylated binding proteins. Recent studies have found that abnormal m6A methylation may mediate a variety of pathological processes in eyes and participate in the occurrence and development of metabolic, inflammatory, degenerative ocular diseases and ocular tumors, such as diabetic retinopathy, cataract, age-related macular degeneration and uveal melanoma. This review aims to summarize the roles of m6A methylation modification in ocular cells and ocular diseases, elucidate the potential molecular mechanisms of m6A methylation in ocular diseases, so as to encourage innovative approaches in the treatment of these ocular diseases.

6.
Acta Medica Philippina ; : 1-6, 2024.
Article in English | WPRIM | ID: wpr-1006387

ABSTRACT

Background and Objective@#Leptospirosis is a disease caused by pathogenic Leptospira prevalent in tropical countries like the Philippines. Some studies have shown that the role of currently used antibiotics for leptospirosis is unclear since trials have found no significant benefit to patient outcomes compared to placebo. This signals the need for alternative therapies, such as herbal medicines, which may provide effective therapeutic regimens in treating this infection. In this study, we characterized the antibacterial potential of three Philippine herbal medicines against Leptospira interrogans. @*Methods@#Crude methanolic extracts of Momordica charantia, Cassia alata, and Allium sativum were subjected to an optimized broth microdilution assay against L. interrogans, utilizing the resazurin-resorufin reaction as a cell proliferation and viability indicator. @*Results@#The respective minimum inhibitory concentrations of the plants were found to be as follows: 1.25 mg/mL (M. charantia), 2.5 mg/mL (C. alata), and >5 mg/mL (A. sativum). @*Conclusions@#Among the three herbal medicines, M. charantia and C. alata proved to have antibacterial activity against L. interrogans. Given the promising potential of two of these plant extracts, exploring the use of other solvents to extract natural compounds from these plants, and discovering possible synergistic effects between these plants and conventional antibiotics may be worthwhile.


Subject(s)
Leptospira interrogans , Herbal Medicine
7.
Journal of Prevention and Treatment for Stomatological Diseases ; (12): 143-148, 2024.
Article in Chinese | WPRIM | ID: wpr-1006380

ABSTRACT

@#Epigenetic modification plays an important role in the biological regulatory process of eukaryotic cells. Tumor immunotherapy is an important means and clinical strategy for the treatment of some cancers. 5-Methylcytosine (m5C) is an important component of the epigenetic regulatory network discovered after m6A and has become a new topic for life science research in recent years. The m5C methylation of RNA can affect the fate of the modified RNA molecules and play an important role in various biological processes, including RNA stability, protein synthesis and transcriptional regulation. Recent studies have shown that m5C writers, erasers and readers are related to a variety of cellular biological processes and systemic diseases, including the occurrence, metastasis and tumor immune microenvironment. m5C methylation can widely affect gene expression and the biological process of tumorigenesis and development at multiple levels, but its specific mechanism and potential interaction with other epigenetic modifications in tumor immunotherapy are still unclear, and its regulatory mechanism, risk assessment and role in targeted therapy for malignant tumors need to be further studied. This article will review the dynamic regulatory network of m5C, the biological role of m5C modification in solid tumors and potential targets in tumor immunotherapy.

8.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 80-87, 2024.
Article in Chinese | WPRIM | ID: wpr-1006271

ABSTRACT

ObjectiveThe antitumor activity of sesquiterpenoid M36 isolated from Myrrha against human hepatoma HepG2 cells was investigated in this study. MethodHepG2 cells were treated with M36 at different concentrations (0, 2, 4, 6, 8, 10 μmol·L-1). Firstly, the effects of M36 on the proliferation of human hepatoma HepG2 cells were detected by methyl thiazolyl tetrazolium (MTT), colony formation assay, and EdU proliferation assay. Hoechst staining, flow cytometry analysis, and Western blot were used to explore the effect of M36 on the apoptosis of human hepatoma HepG2 cells. Acridine orange staining and western blotting were used to examine the effect of M36 on autophagy in HepG2 cells. Finally, Western blot was used to detect protein expression of cancer-related signaling pathways. ResultCompared with the blank group, M36 treatment significantly inhibited the proliferation of human hepatoma HepG2 cells (P<0.01), and the half inhibitory concentration (IC50) value of M36 for 48 h was 5.03 μmol·L-1, in a dose- and time-dependent manner. M36 was also able to induce apoptosis and autophagy in human hepatoma HepG2 cells. After treatment with 8 μmol·L-1 M36 for 48 hours, the apoptosis rate of HepG2 cells was (42.03±9.65)% (P<0.01). Compared with the blank group, HepG2 cells treated with 4 and 8 μmol·L-1 M36 for 48 h had a significant increase in cleaved poly ADP-ribose polymerase (cleaved-PARP) protein levels (P<0.01). Acridine orange staining showed that autophagy was significantly activated in HepG2 cells treated with 4 and 8 μmol·L-1 M36 for 48 h compared with the blank group (P<0.01), which was further verified by the up-regulation of microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ). Western blot results showed that compared with the blank group, the levels of phosphorylated extracellular regulated protein kinase (p-ERK), phosphorylated p38 mitogen-activated protein kinase (p-p38 MAPK), phosphorylated c-Jun N-terminal kinase (p-JNK), and its downstream nuclear transcription factors c-Jun and p-c-Jun protein were significantly increased in M36 group (P<0.05, P<0.01). The mechanism may be related to the up-regulation of MAPK signaling pathway. ConclusionThe sesquiterpenoid M36 isolated from Myrrha inhibits the proliferation of human hepatoma HepG2 cells and promotes apoptosis and autophagy, which may be related to the activation of the MAPK signaling pathway.

9.
China Pharmacy ; (12): 15-20, 2024.
Article in Chinese | WPRIM | ID: wpr-1005207

ABSTRACT

OBJECTIVE To investigate the mechanism of catalpol affecting the differentiation of helper T cell 17 (Th17) by interfering the expressions of pyruvate kinase M2 (PKM2) and lactate dehydrogenase A (LDHA). METHODS The naive CD4+ T cells were selected from the spleen of C57BL/6 mice, and were differentiated into Th17 cells by adding directional differentiation stimulants for 72 hours. At the same time, the cells were treated with 0 (directed control), 20, 40 and 80 μg/mL catalpol. The flow cytometry was used to detect the proportion of Th17 cell differentiation in cells; the colorimetric method was adopted to detect the levels of pyruvate and lactate in cell culture supernatant; mRNA expressions of retinoid-related orphan nuclear receptor gamma t (RORγt), PKM2 and LDHA were detected by qRT-PCR method; Western blot was used to detect the expression levels of PKM2, LDHA, signal transducer and activator of transcription 3 (STAT3), and phosphorylated STAT3 (p-STAT3) proteins in cells. RESULTS Compared with the directed control group, after 72 hours of treatment with 20, 40, 80 μg/mL catalpol, the differentiation ratio of Th17 cells were decreased by 6.74%, 8.41%, 9.24%, and the levels of pyruvate and lactate in the cell culture supernatant, the mRNA expressions of PKM2, LDHA and RORγt as well as the protein expressions of PKM2 and LDHA and the phosphorylation of STAT3 were significantly reduced (P<0.05). CONCLUSIONS Catalpol can reduce the glycolysis level by down-regulating the expressions of PKM2 and LDHA, thereby inhibiting the differentiation of Th17 cells.

10.
Rev. Ocup. Hum. (En línea) ; 24(1): 64-81, 20240000.
Article in Portuguese | LILACS, COLNAL | ID: biblio-1532404

ABSTRACT

Paulo Freire é um importante autor que sustenta a práxis da Terapia Ocupacional Social. O intuito do presente trabalho é ampliar o escopo e adensar o caráter da presença acadêmica deste autor no campo da Terapia Ocupacional Social, tomando como referência produções científicas brasileiras. Como percurso metodológico, foi realizada uma revisão de escopo, com levantamento de estudos publicados em quatro periódicos brasileiros e bases de dados internacionais. As buscas foram realizadas utilizando a língua portuguesa. A revisão não definiu período inicial e considerou os artigos disponíveis online até fevereiro de 2023. Foram incluídos 18 estudos que possuem as obras de Freire em suas referências. Pedagogia do oprimido e Educação como prática de liberdade são as obras que mais aparecem nos artigos encontrados. Foi rea-lizado o refinamento das categorias freireanas, e constatou-se a presença de 42 delas, com destaque para conscientização, com onze ocorrências, transformação/ação transformadora e práxis/ação-reflexão, ambas com dez. Com os dados obtidos pelo estudo foi possível constatar o aumento do número de publicações na área da Terapia Ocupacional Social que utilizam o referencial teórico de Freire. A obra do autor tem colaborado de forma significativa na construção de uma Terapia Ocupacional Social problematizadora e emancipatória


Paulo Freire es un autor importante para apoyar la praxis de la Terapia Ocupacional Social. El propósito de este estudio es ampliar el alcance y profundizar en el carácter de la presencia académica de este autor en el campo de la Terapia Ocupacional Social. Como abordaje metodológico, se realizó una revisión de alcance con relevamiento de estudios publicados en cuatro revistas brasileñas y en bases de datos internacionales. Las búsquedas se realizaron solamente en portugués. No se estableció una fecha de inicio y se consideraron artículos disponibles en línea y publicados hasta febrero de 2023. El corpus estuvo constituido por 18 artículos que incluyen obras de Paulo Freire en sus referencias. Pedagogía del oprimido y Educación como práctica de libertadson las obras que más se referencian. Se depuraron las categorías freireanas y se constató la presencia de 42 de ellas, especialmente: concientización, once veces; transformación / acción transformadora y praxis / acción-reflexión, ambas, diez veces. Los resultados permiten constatar el aumento del número de publicaciones en el área de Terapia Ocupacional Social que utilizan el marco teórico de Freire. La obra del autor ha aportado significativamente a la construcción de una Terapia Ocupacional Social problematizadora y emancipadora.


Paulo Freire's work is important to support the praxis of Social Occupational Therapy. The purpose of this study is to expand the scope and deepen the character of the academic presence of Paulo Freire in Social Occupational Therapy. A scoping review was carried out as a methodological approach, including studies in four Brazilian journals and three international databases. The searches were conducted only in Portuguese; no year parameters were stipulated. The review considered articles published at any time up to February 2023. A total of 18 studies with Freire's works in their references were included; "Pedagogy of the Oppressed" and "Education, the Practice of Freedom" are the works that mostly appeared in the articles included. The refinement of the Freirean categories was carried out, and 42 categories were verified: conscientization, eleven times, transformation/transformative action, and praxis/action-reflection, both ten times. With the data obtained in the study, it was possible to verify the increase in the number of publications in Social Occupational Therapy that use Freire's theoretical framework. The author's work has contributed significantly to the construction of a problematizing and emancipating Social Occupational Therapy.

11.
RECIIS (Online) ; 17(4): 850-866, out.-dez. 2023.
Article in English | LILACS, ColecionaSUS | ID: biblio-1531979

ABSTRACT

Low user engagement in m-Health applications has been driving the use of retention techniques that aim to ensure a satisfactory long-term user experience. The aim was to understand the experience of hypertensive patients interacting with a mobile health application for 12 months. A qualitative/exploratory study was conducted after 12 months, with the same experimental group of participants as the non-randomized con-trolled clinical trial conducted in 2019. The mean age of the 16 participants was 57 years (SD=8), of which11 were female. All had low socioeconomic and educational levels. Content analysis showed no engagement with the m-health app over time. The main factors contributing to the lack of engagement were; inability of the user to use the app, lack of support and technical problems. When designing m-Health interventions, it is important to understand users' behavioral characteristics, motivations for treatment, level of involve-ment in health care, and ability to use technology


O baixo envolvimento dos usuários em aplicativos m-Health vem impulsionando o uso de técnicas de retenção que visam garantir uma experiência do usuário (UX) satisfatória a longo prazo. Objetivou-se compreender a experiência de pacientes hipertensos interagindo com um aplicativo de saúde móvel (m-Health) durante 12 meses. Realizou-se estudo qualitativo/exploratório após 12 meses, com o mesmo grupo experimental de participantes do ensaio-clínico controlado e não-randomizado realizado em 2019. A idade média dos 16 participantes foi de 57 anos (DP=8); 11 eram do sexo feminino, com baixos níveis socioeconômicos e educacionais. A análise de conteúdo não mostrou nenhum envolvimento ao longo do tempo usando o aplicativo m-Health. Os principais fatores que contribuíram para a falta de envolvimento foram: incapacidade do usuário de usar o aplicativo, falta de suporte e problemas técnicos. Ao propor intervenções que utilizem m-Health, é essencial conhecer características comportamentais dos usuários, motivações para o tratamento, nível de envolvimento nos cuidados com a saúde e sua capacidade de usar tecnologias


La baja participación de los usuarios en las aplicaciones de m-Health ha impulsado el uso de técnicas de retención que tienen como objetivo garantizar una experiencia de usuario satisfactoria a largo plazo. Se pretendió comprender la experiencia de pacientes hipertensos interactuando con una aplicación de salud móvil durante 12 meses. Se realizó un estudio cualitativo/exploratorio después de 12 meses, utilizando los participantes del ensayo clínico controlado no aleatorizado que se llevó a cabo en 2019. La edad media de los 16 participantes fue 57 años (SD=8); 11 mujeres, con niveles socioeconómicos y educativos bajos. El análisis de contenido no mostró compromiso a lo largo del tiempo utilizando la aplicación m-Health. Los principales factores contribuyentes fueron: incapacidad del usuario para utilizar la aplicación, falta de apoyo y problemas técnicos. Cuando se proponen intervenciones con m-Health, es esencial conocer las características de comportamiento de los usuarios, sus motivaciones para el tratamiento, nivel de implicación en el cuidado de la salud y capacidad para utilizar tecnologías


Subject(s)
Humans , Telemedicine , Mobile Applications , Health Services Accessibility , Patients , Diversity, Equity, Inclusion , Hypertension
12.
Rev. chil. infectol ; 40(6)dic. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1529994

ABSTRACT

Introducción: La detección de patrones de resistencia de Mycobacterium tuberculosis se basa en pruebas de susceptibilidad fenotípicas y genotípicas. Los resultados discordantes entre ellas son un desafío clínico para el manejo de pacientes con tuberculosis resistente a fármacos. Objetivo: Evaluar la concordancia entre pruebas fenotípicas y moleculares en pacientes con tuberculosis resistente a fármacos atendidos en una institución de Cali, Colombia. Materiales y Métodos: Se realizó un estudio transversal en el que se obtuvo el perfil de sensibilidad fenotípico de cultivos de micobacterias y la susceptibilidad genotípica con las pruebas moleculares Xpert-MTB/ RIF® o Genotype-MDRTBplus ®. Se evaluó el porcentaje de resistencia y porcentaje de acuerdo entre los resultados de las pruebas fenotípicas y genotípicas. Se estimó un coeficiente de kappa de Cohen (κ) para cada tipo de resistencia según la prueba utilizada. Resultados: Se incluyeron 30 casos con resultados de pruebas genotípicas y fenotípicas. Las pruebas fenotípicas detectaron resistencia a fármacos de primera línea en 29/30 casos, mientras que las moleculares detectaron la resistencia en todos los casos evaluados. El porcentaje de resistencia a rifampicina detectado entre la prueba fenotípica y Genotype-MDRTBplus ® &e 61,5% (acuerdo global 41,1%, κ = 0,40, p = 0,96), mientras que el porcentaje de resistencia detectado con Xpert-MTB/RIF® fue 100% (acuerdo global 81,82%, κ: 0,00, p < 0,001) para este mismo medicamento. El porcentaje de resistencia a isoniacida detectado entre la prueba fenotípica y Genotype-MDRTBplus ® fue 94,4% (acuerdo global 89,47%, κ: -0,055 p = 0,59). Conclusiones: La discordancia entre los resultados de las pruebas genotípicas y fenotípicas es posible, por lo que es importante usar e interpretar ambos tipos de pruebas de manera complementaria en el diagnóstico de la resistencia a fármacos de primera línea en la infección por M. tuberculosis.


Background: The detection of Mycobacterium tuberculosis resistance patterns is based on phenotypic and genotypic susceptibility tests. The discordant results between them are a clinical challenge for the management of patients with drug-resistant tuberculosis. Aim: To evaluate the concordance between phenotypic and molecular tests in patients with drug-resistant tuberculosis treated in an institution in Cali, Colombia. Methods: A cross-sectional study was conducted. A phenotypic sensitivity profile was obtained from mycobacterial cultures. The genotypic susceptibility was obtained with Xpert-MTB/ RIF® or Genotype-MDRTBplus ®. The percentage of resistance and percentage of agreement between the results of the phenotypic and genotypic tests were evaluated. A Cohen's kappa coefficient (κ) was estimated for each type of resistance according to the test used. Results: A total of 30 cases with both genotypic and phenotypic testing were included. The phenotypic tests detected resistance to first-line drugs in 29/30 cases, while the molecular tests detected resistance in all the cases evaluated. The percentage of resistance detected between Genotype-MDRTBplus® and the phenotypic test for rifampicin was 61.5% (overall agreement 41.1%, κ = 0.40, p = 0.96), while the percentage of resistance detected with XpertMTB/RIF® was 100% (overall agreement 81.82%, κ: 0.00, p < 0.001) for this same drug. Resistance to isoniazid detected by both types of tests was 94.4% (overall agreement 89.47%, κ: -0.055 p = 0.59). Conclusions: Discordance between the results of genotypic and phenotypic tests is possible, so it is important to use and interpret both types of tests in a complementary way in the diagnosis of resistance to first-line drugs in M. tuberculosis infection.

13.
Rev. Urug. med. Interna ; 8(3)dic. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1521625

ABSTRACT

está disponible en el texto completo


Introduction: Sleep-disordered breathing (SDB) are highly prevalent in patients with heart failure (HF). The presence of obstructive sleep apnea syndrome (OSA) determines a worse prognosis in these patients. There are questionnaires aimed at evaluating the probability of OSA, although none have been validated in patients with HF. The primary objective of this study was to establish the prevalence of SDB in a cohort of patients with HF and reduced ejection fraction (HFrEF) from the Multidisciplinary HF Unit (UMIC). As a secondary objective, to evaluate the usefulness of the Stop-Bang, Berlin, and 2ABN3M questionnaires for TRS screening in these patients. Methodology: Cross-sectional, observational study, including the active cohort of the UMIC, over 18 years with HFrEF, clinically stable and informed consent. Patients with cognitive, neurological or hearing impairment with limitations when conducting the interview were excluded. Patients with other limiting or uncontrolled sleep disorders, continuous home oxygen therapy requirements, did not enter the study. Berlin, Stop-Bang, and 2ABN3M questionnaires were administered, classifying the population into high-risk, intermediate-risk, and low-risk groups of presenting SDB. All patients underwent outpatient respiratory polygraphy (RP). Descriptive statistics were used to characterize demographic variables, measures of central tendency and dispersion. SPSS statistical software was used. Results: 387 patients were included, 248 men (64.1%), mean age was 63.5 ± 0.6 years. The etiology of HF was ischemic in 41.6% of patients. The body mass index was 29.3 ± 0.3 kg/m2. LVEF was 34.2 ± 0.5, pro-BNP 1233.8 ± 137.6 pg/ml. The results of the questionnaires showed that 52.1% (198) presented a high risk of SDB according to the Berlin questionnaire. With Stop-Bang, 35.9% (139) were high risk, 42.1% (163) intermediate risk, and the remaining 22% (85) low risk. With the 2ABN3M score, 62% (240) were high risk. A total of 156 respiratory polygraphs (40.3% of the population) were performed. The cut-off point to define the presence of sleep apnea was considered to be an AHI >15. 58.3% (91) of the patients presented TRS. Of these, 95% presented obstructive apnea and 5% central apnea with periodic Cheyne-Stokes breathing. A high percentage (26%) presented AHI greater than 30. The sensitivity of the Berlin and Stop-Bang questionnaires was 75.8% and 91.2%, respectively, with a specificity of 53.8% and 24.6%. Regarding the 2ABN3M score, a sensitivity of 71.4% and a specificity of 44.6% were observed. Conclusions: The prevalence of sleep-disordered breathing in patients with HFrEF was high in our cohort and obstructive apnea predominated. Given the high sensitivity (91.2%) of the Stop-Bang questionnaire found in our study, it could be useful as a screening tool for TRS in this type of patient. The importance of investigating this pathology whose clinical presentation can be non-specific and remain underdiagnosed is highlighted.


Introdução: Os distúrbios respiratórios do sono (DRS) são altamente prevalentes em pacientes com insuficiência cardíaca (IC). A presença da síndrome da apneia obstrutiva do sono (SAOS) determina pior prognóstico nesses pacientes. Existem questionários destinados a avaliar a probabilidade de AOS, porém nenhum foi validado em pacientes com IC. O objetivo primário deste estudo foi estabelecer a prevalência de DRS em uma coorte de pacientes com IC e fração de ejeção reduzida (ICFEr) da Unidade Multidisciplinar de IC (UMIC). Como objetivo secundário, avaliar a utilidade dos questionários Stop-Bang, Berlin e 2ABN3M para triagem de SRT nesses pacientes. Metodologia: Estudo transversal, observacional, inclui a coorte ativa da UMIC, maiores de 18 anos com ICFEr, clinicamente estável e consentimento informado. Foram excluídos pacientes com deficiência cognitiva, neurológica ou auditiva com limitações na realização da entrevista. Pacientes com outros distúrbios do sono limitantes ou descontrolados, requisitos de oxigenoterapia domiciliar contínua, não entraram no estudo. Os questionários Berlin, Stop-Bang e 2ABN3M foram aplicados, classificando a população em grupos de alto risco, risco intermediário e baixo risco de apresentar DRS. Todos os pacientes foram submetidos à poligrafia respiratória (PR) ambulatorial. A estatística descritiva foi utilizada para caracterizar as variáveis ​​demográficas, medidas de tendência central e dispersão. Foi utilizado o software estatístico SPSS. Resultados: foram incluídos 387 pacientes, 248 homens (64,1%), com idade média de 63,5 ± 0,6 anos. A etiologia da IC foi isquêmica em 41,6% dos pacientes. O índice de massa corporal foi de 29,3 ± 0,3 kg/m2. FEVE foi de 34,2 ± 0,5, pro-BNP 1233,8 ± 137,6 pg/ml. Os resultados dos questionários mostraram que 52,1% (198) apresentaram alto risco de DRS de acordo com o questionário de Berlim. Com Stop-Bang, 35,9% (139) eram de alto risco, 42,1% (163) de risco intermediário e os restantes 22% (85) de baixo risco. Com a pontuação 2ABN3M, 62% (240) eram de alto risco. Foram realizados 156 polígrafos respiratórios (40,3% da população). O ponto de corte para definir a presença de apneia do sono foi considerado um IAH >15. 58,3% (91) dos pacientes apresentaram SRT. Destes, 95% apresentavam apnéia obstrutiva e 5% apnéia central com respiração Cheyne-Stokes periódica. Uma alta porcentagem (26%) apresentou IAH maior que 30. A sensibilidade dos questionários Berlin e Stop-Bang foi de 75,8% e 91,2%, respectivamente, com especificidade de 53,8% e 24,6%. Em relação ao escore 2ABN3M, observou-se sensibilidade de 71,4% e especificidade de 44,6%. Conclusões: A prevalência de distúrbios respiratórios do sono em pacientes com ICFEr foi alta em nossa coorte, com predominância de apneias obstrutivas. Dada a alta sensibilidade (91,2%) do questionário Stop-Bang encontrado em nosso estudo, ele pode ser útil como uma ferramenta de triagem para ERT nesse tipo de paciente. Ressalta-se a importância da investigação dessa patologia cuja apresentação clínica pode ser inespecífica e permanecer subdiagnosticada.

14.
Int. j. morphol ; 41(6): 1775-1780, dic. 2023. ilus, tab
Article in English | LILACS | ID: biblio-1528801

ABSTRACT

SUMMARY: The Innervation Zones (IZ) correspond to clusters of neuromuscular junctions. The traditional method of locating IZs through voluntary muscle contractions may not be feasible in individuals with motor disorders. Imposed contractions by electrostimulation are an alternative. However, there is limited evidence regarding the factors that affect inter-evaluator concordance and the number of localized IZs when using imposed contraction. The main objective of this research was to determine the effect of the amplitude of compound motor action potentials (CMAPs) containing the M-wave on inter-evaluator agreement. As a secondary objective, was investigate the effect on the number of detected IZs. Twenty-four healthy volunteers (age: 21.2 ± 1.5years, weight: 67.4 ± 13.2kg, height: 1.68 ± 0.80m) participated in the study. Electrostimulation was applied to the tibial nerve to induce contraction of the medial gastrocnemius. The IZ were identified based on the M-wave recorded through multichannel electromyography. A receiver operating characteristic (ROC) analysis was conducted to assess sensitivity and specificity in detecting the IZs. Inter-rater agreement was evaluated using a two-way mixed effects test to determine the intraclass correlation coefficients (ICC). A p-value less than 0.05 was considered statistically significant. The ROC analysis revealed that for both evaluators, a specificity of 95% was achieved with an amplitude ≥30 %. The area under the ROC curve was 0.980 [0.964, 0.996], indicating a strong influence of CMAP amplitude on detection of IZs. The highest level of agreement (ICC = 0.788 [0.713, 0.844]) among the evaluators was observed with CMAP amplitudes equal to or greater than 80 % of the maximum M-wave. The findings of this study demonstrate that both the number and the inter-evaluator concordance for detecting IZs using imposed contractions are strongly influenced by the amplitude of the M-wave. Higher M-wave amplitudes were associated with improved concordance and increased IZ detection, making it crucial to standardize amplitude settings for reliable outcomes.


Las Zonas de Inervación (IZ) corresponden a grupos de uniones neuromusculares. El método tradicional para localizar IZs mediante contracciones musculares voluntarias puede no ser factible en personas con trastornos motores. Las contracciones impuestas mediante electro estimulación son una alternativa. Sin embargo, existe poca evidencia sobre los factores que afectan la concordancia entre evaluadores y el número de IZs localizadas al usar este tipo de contracciones. El objetivo de esta investigación fue determinar el efecto de la amplitud de los potenciales de acción motores compuestos (PAMCs) que contienen la onda M sobre la concordancia entre evaluadores. Como objetivo secundario, se investigó el efecto sobre el número de IZs detectadas. Veinticuatro voluntarios sanos (edad: 21.2 ± 1.5 años, peso: 67.4 ± 13.2 kg, altura: 1.68 ± 0.80 m) participaron en el estudio. Se aplicó electroestimulación al nervio tibial para inducir la contracción del gastrocnemio medial. Las IZs se identificaron según la onda M registrada mediante electromiografía multicanal. Se realizó un análisis de curva de las característica del receptor (ROC) para evaluar la sensibilidad y especificidad en la detección de las IZs. La concordancia entre evaluadores se evaluó utilizando una prueba de efectos mixtos de dos vías para determinar los coeficientes de correlación intraclase (ICC). Se consideró un valor de p menor que 0.05 como estadísticamente significativo. El análisis ROC reveló que para ambos evaluadores se logró una especificidad del 95% con una amplitud ≥30 %. El área bajo la curva ROC fue de 0.980 [0.964, 0.996], lo que indica una fuerte influencia de la amplitud del CMAP en la detección de las IZs. El nivel más alto de concordancia (ICC = 0.788 [0.713, 0.844]) entre los evaluadores se observó con amplitudes de CMAP iguales o mayores al 80 % de la onda M máxima. Los hallazgos de este estudio demuestran que tanto el número como la concordancia entre evaluadores para detectar IZs mediante contracciones impuestas están fuertemente influenciados por la amplitud de la onda M. Las amplitudes más altas de la onda M se asociaron con una concordancia mejorada y un aumento en la detección de IZs, lo que hace crucial estandarizar los ajustes de amplitud para obtener resultados confiables.


Subject(s)
Humans , Male , Female , Young Adult , Muscle, Skeletal/innervation , Observer Variation , ROC Curve , Sensitivity and Specificity , Electromyography/methods , Muscle Contraction
15.
Vive (El Alto) ; 6(18): 948-960, dic. 2023.
Article in Spanish | LILACS | ID: biblio-1530585

ABSTRACT

La medicina nuclear utiliza radiofármacos, conocidos como radiotrazadores, para evaluar la función y el metabolismo de órganos y sistemas del cuerpo. Objetivo. Examinar la relevancia de los radiotrazadores MDP, DTPA y MIBI, marcados con tecnecio-99m (Tc99m), en el diagnóstico en medicina nuclear. Metodología. Se siguió el método PRISMA para identificar estudios publicados entre 2010 y 2022. Las bases de datos consultadas incluyeron Dialnet, Elsevier, Research, Redalyc, PubMed, Google Académico y Scielo. Se utilizaron descriptores específicos como "radiotrazadores Tc99m", "MDP", "DTPA", "MIBI", y "medicina nuclear", centrando la búsqueda en diagnóstico y excluyendo propósitos terapéuticos. Resultados. De 14 estudios analizados, se observó una predominancia en investigaciones sobre radiotrazadores MDP y MIBI marcados con Tc99m, enfocándose en diagnósticos relacionados con lesiones paratiroideas, hiperparatiroidismo, enfermedades esqueléticas, enfermedad arterial coronaria y perfusión miocárdica. Conclusiones. Los radiotrazadores MDP, DTPA y MIBI marcados con Tc99m demuestran eficacia en diversas aplicaciones diagnósticas, incluyendo la localización de adenomas paratiroideos y la detección de condiciones como el mieloma múltiple. A pesar de sus beneficios, es crucial continuar investigando y desarrollando nuevos radiofármacos para expandir su utilidad clínica y mejorar aún más la atención médica en el campo de la medicina nuclear.


Nuclear medicine uses radiopharmaceuticals, known as radiotracers, to assess the function and metabolism of organs and body systems. Objective. To examine the relevance of technetium-99m (Tc99m)-labeled MDP, DTPA, and MIBI radiotracers in nuclear medicine diagnostics. Methodology. The PRISMA method was followed to identify studies published between 2010 and 2022. The databases consulted included Dialnet, Elsevier, Research, Redalyc, PubMed, Google Scholar and Scielo. Specific descriptors such as "Tc99m radiotracers", "MDP", "DTPA", "MIBI", and "nuclear medicine" were used, focusing the search on diagnosis and excluding therapeutic purposes. Results. Of 14 studies analyzed, there was a predominance of research on Tc99m-labeled MDP and MIBI radiotracers, focusing on diagnoses related to parathyroid lesions, hyperparathyroidism, skeletal diseases, coronary artery disease, and myocardial perfusion. Conclusions. Tc99m-labeled MDP, DTPA, and MIBI radiotracers demonstrate efficacy in a variety of diagnostic applications, including localization of parathyroid adenomas and detection of conditions such as multiple myeloma. Despite their benefits, it is crucial to continue researching and developing new radiopharmaceuticals to expand their clinical utility and further improve medical care in the field of nuclear medicine.


A medicina nuclear utiliza radiofármacos, conhecidos como radiotraçadores, para avaliar a função e o metabolismo de órgãos e sistemas corporais. Objetivo. Examinar a importância dos radiotraçadores MDP, DTPA e MIBI, marcados com tecnécio-99m (Tc99m), em diagnósticos de medicina nuclear. Metodologia. O método PRISMA foi usado para identificar estudos publicados entre 2010 e 2022. Os bancos de dados consultados incluíram Dialnet, Elsevier, Research, Redalyc, PubMed, Google Scholar e Scielo. Foram utilizados descritores específicos como "radiotraçadores Tc99m", "MDP", "DTPA", "MIBI" e "medicina nuclear", concentrando a busca em fins diagnósticos e excluindo fins terapêuticos. Resultados. Dos 14 estudos analisados, houve predomínio de pesquisas com os radiotraçadores MDP e MIBI marcados com Tc99m, com foco em diagnósticos relacionados a lesões da paratireoide, hiperparatireoidismo, doenças esqueléticas, doença arterial coronariana e perfusão miocárdica. Conclusões. Os radiotraçadores MDP, DTPA e MIBI marcados com Tc99m demonstram eficácia em uma variedade de aplicações diagnósticas, incluindo a localização de adenomas de paratireoide e a detecção de doenças como o mieloma múltiplo. Apesar de seus benefícios, é fundamental continuar a pesquisa e o desenvolvimento de novos radiofármacos para expandir sua utilidade clínica e melhorar ainda mais o atendimento médico no campo da medicina nuclear.

16.
Actual. osteol ; 19(2): 160-166, sept. 2023. ilus, tab
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1525671

ABSTRACT

Introducción: describir el caso de un paciente con pancreatitis aguda secundaria a hipercalcemia por hiperparatiroidismo prImario. Esta es una causa poco frecuente de pancreatitis, asociada a morbimortalidad significativa en caso de no ser diagnosticada oportunamente Caso clínico: un hombre de 44 años, con antecedente de pancreatitis de presunto origen biliar que había requerido previamente colecistectomía, consultó por dolor abdominal y náuseas. Los estudios complementarios fueron compatibles con un nuevo episodio de pancreatitis aguda. Presentaba hipercalcemia y hormona paratiroidea (PTH) elevada, configurando hiperparatiroidismo primario. La gammagrafía informó hallazgos compatibles con adenoma paratiroideo. Se inició tratamiento con reanimación hídrica y analgesia con adecuada disminución de calcio sérico y resolución de dolor abdominal. Después de la paratiroidectomía se logró normalizar los niveles de calcio y PTH. Discusión: la pancreatitis aguda es una condición potencialmente fatal, por lo que la sospecha de causas poco frecuentes como la hipercalcemia debe tenerse en cuenta. El tratamiento de la hipercalcemia por adenoma paratiroideo se basa en reanimación hídrica adecuada y manejo quirúrgico del adenoma, con el fin de evitar recurrencia de pancreatitis y mortalidad. (AU)


Introduction: we describe the case of a patient with acute pancreatitis secondary to hypercalcemia due to primary hyperparathyroidism. This is a rare cause of pancreatitis associated with significant morbidity and mortality if not diagnosed in time. Clinical case: a 44-year-old man with a history of pancreatitis of presumed biliary origin, which had previously required cholecystectomy, consulted for abdominal pain and nausea. The laboratory findings were compatible with a new episode of acute pancreatitis. He presented hypercalcemia and an elevated parathyroid hormone (PTH), configuring primary hyperparathyroidism. Scintigraphy was performed, yielding findings compatible with parathyroid adenoma. Treatment with fluid resuscitation and analgesia was started, resulting in an adequate decrease in serum calcium and resolution of abdominal pain. After parathyroidectomy, calcium and PTH levels were normalized. Discussion: acute pancreatitis is a potentially fatal condition; therefore the suspicion of rare causes, such as hypercalcemia, should be considered. The treatment of hypercalcemia due to parathyroid adenoma is based on adequate fluid resuscitation and surgical management of the adenoma, to avoid recurrence of pancreatitis and death. (AU)


Subject(s)
Humans , Male , Adult , Pancreatitis/etiology , Parathyroid Neoplasms/diagnostic imaging , Hyperparathyroidism, Primary/diagnostic imaging , Hypercalcemia/etiology , Pancreatitis/prevention & control , Parathyroid Neoplasms/surgery , Parathyroid Neoplasms/complications , Radionuclide Imaging , Technetium Tc 99m Sestamibi , Hyperparathyroidism, Primary/complications , Hypercalcemia/blood , Hypercalcemia/therapy
17.
Indian J Ophthalmol ; 2023 Sep; 71(9): 3160-3165
Article | IMSEAR | ID: sea-225244

ABSTRACT

Purpose: To curtail the potential of donor corneal tissue disseminating fungi to the recipient抯 eye, we evaluated the addition of amphotericin B to McCarey?Kaufman (M?K)梒orneal storage medium supplemented with colistin. Methods: Amphotericin B was examined for its ability to inhibit the growth of Candida albicans and Aspergillus flavus using a microbroth dilution test and checkerboard assay in combination with only gentamicin and a combination of colistin, gentamicin, and amphotericin B. The safety on epithelium and endothelium was evaluated by 3?(4,5?dimethylthiazol?2?yl)?2, 5?diphenyltetrazolium bromide (MTT) assay. Results: The minimal inhibitory concentration of gentamicin was found to be >256 ?g/ml against both C. albicans and A. flavus, whereas that of amphotericin B was found to be in a range of 0.25�5 and 1�?g/ml for C. albicans and A. flavus, respectively. According to the checkerboard assay, 80% (4/5) of C. albicans isolates and 100% (5/5) of A. flavus isolates responded synergistically to the combination of amphotericin B and gentamicin, but only 20% (1/5) of C. albicans isolates showed an additive effect. None of the tested isolates displayed antagonism. The combined effect of the three drugs also did not display any antagonistic effect. Additionally, the MTT assay reveals no toxic effect of the antimicrobials used on corneal epithelial and endothelial cells. Conclusion: In vitro experiments demonstrate that amphotericin B is not toxic to either epithelium or endothelium and is a promising additive to the M?K medium supplemented with colistin.

18.
Indian J Pathol Microbiol ; 2023 Sept; 66(3): 478-487
Article | IMSEAR | ID: sea-223511

ABSTRACT

Objective: This article aims to study the effect of phosphate and tension homolog deleted on chromosome ten (PTEN) knockdown on colon cancer progression and macrophage polarization in the cancer environment. Materials and Methods and Results: The expression of PTEN in colon cancer tissues and colon cancer cells was significantly lower than in precancerous tissues or CCD-18Co cells, and the decrease was most evident in SW620 cells. The expressions of phosphate (p)-p38, c-Jun N-terminal kinase (JNK), activator protein 1 (AP-1), B-cell lymphoma-2 (Bcl-2) protein in colon cancer tissues and cells were significantly higher than in precancerous tissues or CCD-18Co cells (P-values < 0.05). Bcl-2-associated X (Bax) and Caspase-3 expressions in colon cancer tissues and cells were significantly lower than in precancerous tissues or CCD-18Co cells (P-values < 0.05). 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) was applied to measure cell viability. Transwell evaluated the cell migration and invasion ability. Si-PTEN improved the proliferation, migration, and invasion of SW620 cells (P-values < 0.05). The expression levels of arginase-1 (Arg-1), CD163, CD206 in colon cancer tissues were significantly higher than in precancerous tissues (P-values < 0.05). The cell cycle, the number of M1 and M2 double-positive cells were assessed by flow cytometry. Si-PTEN reduced the expression of tumor necrosis factor-alpha (TNF-?), interleukin-1beta (IL-1?), and inducible nitric oxide synthase (iNOS), which upregulated the expression of Arg-1, CD206, CD163, p-p38, JNK, and AP-1 (P-values < 0.05). Conclusion: Si-PTEN promoted colon cancer progression and induced the polarization of M2 tumor-associated macrophages in the colon cancer cell environment.

19.
J. bras. nefrol ; 45(3): 344-349, Sept. 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1521102

ABSTRACT

ABSTRACT Introduction: Accurate determination of glomerular filtration rate (GFR) is crucial for selection of kidney donors. Nuclear medicine methods are considered accurate in measuring GFR but are not always easily available. The four-variable Modification of Diet in Renal Disease (MDRD4), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Full Age Spectrum (FAS) formulas are common equations for estimating GFR and are recommended for initial assessment of kidney donors. The aim of this study was to evaluate the performance of these GFR estimation equations compared with technetium-99m diethylenetriaminepentaacetic acid ([99mTc]Tc-DTPA) clearance. Methods: We compared GFR estimation by [99mTc]Tc-DTPA clearance using a two-blood sample method with estimation by MDRD4, CKD-EPI, and FAS creatinine-based equations in a population of healthy potential kidney donors. Results: A total of 195 potential kidney donors (68.2% female; mean age 49 years, range 21-75 years) were included in this study. Mean [99mTc]Tc-DTPA measured GFR (mGFR) was 101.5 ± 19.1 mL/min/1.73 m2. All three equations underestimated the GFR value measured by [99mTc]Tc-DTPA (MDRD4: -11.5 ± 18.8 mL/min/1.73 m2; CKD-EPI: -5.0 ± 17.4 mL/min/1.73 m2; FAS: -8.3 ± 17.4 mL/min/1.73 m2). Accuracy within 30% and 10% of the measured GFR value was highest for CKD-EPI. Conclusion: The CKD-EPI equation showed better performance in estimating GFR in healthy potential kidney donors, proving to be a more accurate tool in the initial assessment of kidney donors. However, creatinine-based equations tended to underestimate kidney function. Therefore, GFR should be confirmed by another method in potential kidney donors.


RESUMO Introdução: Determinar precisamente a taxa de filtração glomerular (TFG) é crucial para seleção de doadores de rim. Métodos de medicina nuclear são considerados precisos na medição da TFG, mas nem sempre estão facilmente disponíveis. As fórmulas Modification of Diet in Renal Disease de 4 variáveis (MDRD4), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), e Full Age Spectrum (FAS) são equações comuns para estimar a TFG, sendo recomendadas para avaliação inicial dos doadores. Este estudo visou avaliar o desempenho destas equações de estimativa da TFG em comparação com o clearance do tecnécio-99m-ácido dietilenotriaminopentacético ([99mTc]Tc-DTPA). Métodos: Comparamos a TFG por clearance de [99mTc]Tc-DTPA usando um método com duas amostras de sangue com estimativa da TFG pelas equações MDRD4, CKD-EPI e FAS baseadas em creatinina em uma população de potenciais doadores saudáveis. Resultados: Incluiu-se 195 potenciais doadores de rim (68,2% mulheres; idade média de 49 anos, intervalo 21-75 anos). A TFG média medida por [99mTc]Tc-DTPA foi 101,5 ± 19,1 mL/min/1,73m2. As três equações subestimaram o valor da TFG medida por [99mTc]Tc-DTPA (MDRD4: -11,5 ± 18,8 mL/min/1,73 m2; CKD-EPI: -5,0 ± 17,4 mL/min/1,73 m2; FAS: -8,3 ± 17,4 mL/min/1,73 m2). A precisão dentro de 30% e 10% do valor da TFG medida foi maior para CKD-EPI. Conclusão: A equação CKD-EPI mostrou melhor desempenho na estimativa da TFG em potenciais doadores de rim saudáveis, revelando-se uma ferramenta mais precisa na avaliação inicial dos doadores. Entretanto, equações baseadas em creatinina tendem a subestimar a função renal. Portanto, a TFG deve ser confirmada por outro método em potenciais doadores.

20.
Biomédica (Bogotá) ; 43(3): 330-343, sept. 2023. tab, graf
Article in Spanish | LILACS | ID: biblio-1533944

ABSTRACT

Introducción. La psitacosis es una enfermedad zoonótica causada por Chlamydia psittaci. Esta bacteria es catalogada como un agente con potencial bioterrorista y ha causado múltiples brotes en trabajadores con exposición laboral a aves en diferentes lugares del mundo. En Colombia, no se hace seguimiento epidemiológico de la infección y existe una gran brecha en el conocimiento. Objetivos. Determinar la frecuencia de anticuerpos contra C. psittaci en trabajadores con exposición laboral a aves y sus factores asociados. Además, revisar la literatura en relación con los estudios sobre el tema realizados en Colombia. Materiales y métodos. Se llevó a cabo un estudio descriptivo, transversal, con intención analítica, en trabajadores en contacto con aves y se revisó la literatura científica relacionada en Colombia. Se detectaron anticuerpos IgM e IgG contra C. psittaci en suero por microinmunofluorescencia. La descripción de las características sociodemográficas y de exposición se hizo con frecuencias y medidas de resumen. Se exploraron factores asociados por análisis bivariados y multivariados. La revisión de la literatura científica y gris se hizo con búsqueda estructurada. Resultados. Se analizaron 54 trabajadores en contacto con aves y se encontró una prevalencia de anticuerpos del 31,5 %. El ejercer funciones de sacrificio y faenado de las aves sin ser médico veterinario fue un factor de riesgo para la presencia de anticuerpos. Solo se encontraron cuatro estudios previos sobre C. psittaci hechos en Colombia. Conclusiones. Este estudio constituye la primera evidencia de la circulación de C. psittaci en trabajadores en contacto con aves en Antioquia y el segundo reporte en el país. Estos hallazgos aportan desde la salud pública a la estrategia One Health.


Introduction. Psittacosis is a zoonotic disease caused by Chlamydia psittaci, a bacterium classified as an agent with bioterrorist potential. It has caused multiple outbreaks in exposed poultry workers around the world. Colombia has no epidemiological follow-up of the infection and a big knowledge gap. Objectives. To determine the antibodies' frequency against C. psittaci in workers with occupational exposure to birds and to review the literature on studies conducted in Colombia. Materials and methods. We conducted a cross-sectional descriptive study with analytical intent on workers in contact with birds and reviewed the related literature in Colombia. IgM and IgG serum antibodies against C. psittaci were detected by microimmunofluorescence. The sociodemographic and exposure characteristics were expressed as frequencies and summary measures. Associated factors were explored by bivariate and multivariate analysis. The scientific and gray literature review was done with a structured search. Results. We analyzed 54 workers in contact with birds. Antibody prevalence was 31.5%. Slaughtering and evisceration by non-veterinarians was a risk factor for antibody presence. There are only four previous studies on C. psittaci in Colombia. Conclusions. Here, we present the first evidence of C. psittaci circulation among workers exposed to birds in Antioquia and the second report in the country. These findings contribute to the "One Health" public health strategy.


Subject(s)
Psittacosis , Birds , Occupational Exposure , Immunoglobulin G , Immunoglobulin M , Seroepidemiologic Studies , Chlamydophila psittaci , One Health
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