Characterization of metal(loid)s and antibiotic resistance in bacteria of human gut microbiota from chronic kidney disease subjects

BACKGROUND: Human Gut Microbiota (HGM) is composed of more than one thousand species, playing an important role in the health status of individuals. Dysbiosis (an HGM imbalance) is augmented as chronic kidney disease (CKD) progresses, as loss of kidney function accelerates. Increased antibiotic use in CKD subjects and consumption of nephrotoxic heavy metals and metalloids such as lead, cadmium, arsenic, and mercury in tap water increases the dysbiosis state. Studies in people with stage 3 CKD are complex to carry out, mainly because patients are self-reliant who rarely consult a specialist. The current work focused on this type of patient. RESULTS: Lead and arsenic-resistant bacteria were obtained from self-reliant (that stands on its own) stage 3 CKD subjects. Pathogen-related Firmicutes and Proteobacteria genus bacteria were observed. Resistance and potentiation of antibiotic effects in the presence of metal(loid)s in vitro were found. Furthermore, the presence of the following genes markers for antibiotic and metal(loid) resistance were identified by qPCR: oxa10, qnrB1, mphB, ermB, mefE1, arr2, sulll, tetA, floR, strB, dhfr1, acrB, cadA2k, cadA3k, arsC, pbrA. We observed a decrease in the number of metal resistance markers. CONCLUSIONS: The presence of cadA and arsC genetic markers of antibiotics and metal(loid)s resistance were detected in samples from stage 3 CKD subjects. Lower gene amplification in advanced stages of CKD were also observed, possibly associated with a decrease in resident HGM during kidney disease progression.

Latencia diagnóstica en la enfermedad de Parkinson: Estudio en 200 pacientes de novo en un hospital público de Chile / Delay in the diagnosis of Parkinson’s disease in a Chilean public hospital

Background: Early diagnosis is fundamental in patients with Parkinson’s disease (PD) to improve their quality of life. Aim: To determine the latency in the diagnosis of Parkinson’s disease (PD) after the onset of motor symptoms. Patients and Methods: Prospective study carried out during 16 months in a public hospital. Two hundred newly diagnosed patients aged 41 to 90 years (50% women), were included and analyzed. Results: The lapse between the first symptom -more commonly tremor- and the diagnosis made by a neurologist ranged from 1 to 84 months (19.1 ± 13.8). In 39% of patients, it was done in the first year, in 26% during the second year and in 35% of patients, it took more than two years. The referral by a general practitioner had a delay ranging from 1 to 36 months. Sixty nine and 95% of patients were evaluated within the first 6 months after referral if they came from primary care or the same hospital, respectively. Twenty six percent of patients were classified in stages III to V of Hoehn & Yahr’s staging and the Parkinson’s Disease Rating Scale motor examination ranged from 5 to 81 points, mean 24 (± 12.8). Conclusions: The diagnosis of PD has a delay in a public hospital that could be influenced by the referral system.

Realidad del pie diabético del programa de diabetes mellitus del Hospital de Molina año 1999 / Reality of diabetic foot of the diabetes mellitus programme at Hospital de Molina, 1999

Se evaluó mediante cartilla de evaluación del pie diabético al 73 por ciento de la población en control de los pacientes diabéticos del Hospital de Molina, y así poder prevenir las invalidantes consecuencias de esta enfermedad. Los resultados muestran que el daño o alteración del pie es mayor a mayor edad y tiempo de evolución, más aún en varones, con mayor prevalencia en deformidad ósea, y a mayor tiempo de evolución de la enfermedad hay un notable aumento de la neuropatía diabética. El presente trabajo nos orienta para que el equipo de salud dirija los esfuerzos en mejor forma, destinados a la prevención del daño irreversible del pie diabético

Estudio descriptivo del programa de diabetes mellitus del hospital de Molina: año 1997-1998 / Descriptive study of diabetes mellitus programme at Molina hospital: 1997-1998

Con el fin de realizar un diagnóstico de situación del programa Diabetes Mellitus del Hospital de Molina, se efectuó un estudio descriptivo del programa, el cual consideró el total de pacientes en control regular (asistentes) 202 pacientes, que equivale al 82 por ciento del total en control. Se analizaron múltiples variables, obteniendo como resultado una predominancia de sexo femenino, con una distribución por edad en general sobre los 40 años, con grados aceptables de control glicémico (en relación a otras comunidades estudiadas);con una alta incidencia de pacientes obesos o sobrepeso y unn manejo terapéutico de predominio mixto (Dietoterapia más hipoglicemiantes orales). Además, se observó mayor prevalencia de hipertensión en relación a la población general y un grado de pesquisa variable (en general deficiente) de complicaciones secundarias de la enfermedad

Estudio y seguimiento de 22 timomas linfoepiteliales del adulto / Study and follow-up of 22 lymphoepithelial thymonas in adults

Se presentan 22 casos de timonas linfoepiteliales del adulto, agrupados por estadios clínicos. Los 2 factores que determinaron la supervivencia fueron el carácter invasor y la miastemia gravis. Hubo 3 muertes postoperatorias en pacientes con miastenia gravis generalizada y timona maligno. Se hace hincapié en la importancia de la flebografía tímica y semiología angiológica del mediastino para el correcto tratamiento. La cirugía resectiva radical es el tratamiento de elección. La asociación de cobalto y quimioterapia es efectiva en estadios III y IV