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1.
Int J Nanomedicine ; 19: 4995-5010, 2024.
Article in English | MEDLINE | ID: mdl-38832336

ABSTRACT

Introduction: Prostate cancer (PC) is the second most common cancer and the fifth most frequent cause of cancer death among men. Prostate-specific membrane antigen (PSMA) expression is associated with aggressive PC, with expression in over 90% of patients with metastatic disease. Those characteristics have led to its use for PC diagnosis and therapies with radiopharmaceuticals, antibody-drug conjugates, and nanoparticles. Despite these advancements, none of the current therapeutics are curative and show some degree of toxicity. Here we present the synthesis and preclinical evaluation of a multimodal, PSMA-targeted dendrimer-drug conjugate (PT-DDC), synthesized using poly(amidoamine) (PAMAM) dendrimers. PT-DDC was designed to enable imaging of drug delivery, providing valuable insights to understand and enhance therapeutic response. Methods: The PT-DDC was synthesized through consecutive conjugation of generation-4 PAMAM dendrimers with maytansinoid-1 (DM1) a highly potent antimitotic agent, Cy5 infrared dye for optical imaging, 2,2',2"-(1,4,7-triazacyclononane-1,4,7-triyl)triacetic acid (NOTA) chelator for radiolabeling with copper-64 and positron emission tomography tomography/computed tomography (PET/CT), lysine-urea-glutamate (KEU) PSMA-targeting moiety and the remaining terminal primary amines were capped with butane-1,2-diol. Non-targeted control dendrimer-drug conjugate (Ctrl-DDC) was formulated without conjugation of KEU. PT-DDC and Ctrl-DDC were characterized using high-performance liquid chromatography, matrix assisted laser desorption ionization mass spectrometry and dynamic light scattering. In vitro and in vivo evaluation of PT-DDC and Ctrl-DDC were carried out in isogenic human prostate cancer PSMA+ PC3 PIP and PSMA- PC3 flu cell lines, and in mice bearing the corresponding xenografts. Results: PT-DDC was stable in 1×PBS and human blood plasma and required glutathione for DM1 release. Optical, PET/CT and biodistribution studies confirmed the in vivo PSMA-specificity of PT-DDC. PT-DDC demonstrated dose-dependent accumulation and cytotoxicity in PSMA+ PC3 PIP cells, and also showed growth inhibition of the corresponding tumors. PT-DDC did not accumulate in PSMA- PC3 flu tumors and did not inhibit their growth. Ctrl-DDC did not show PSMA specificity. Conclusion: In this study, we synthesized a multimodal theranostic agent capable of delivering DM1 and a radionuclide to PSMA+ tumors. This approach holds promise for enhancing image-guided treatment of aggressive, metastatic subtypes of prostate cancer.


Subject(s)
Antigens, Surface , Dendrimers , Glutamate Carboxypeptidase II , Prostatic Neoplasms , Dendrimers/chemistry , Dendrimers/pharmacokinetics , Dendrimers/pharmacology , Male , Humans , Glutamate Carboxypeptidase II/metabolism , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/metabolism , Antigens, Surface/metabolism , Cell Line, Tumor , Animals , Mice , Positron Emission Tomography Computed Tomography/methods , Drug Delivery Systems/methods
2.
J Appl Microbiol ; 134(9)2023 Sep 05.
Article in English | MEDLINE | ID: mdl-37660235

ABSTRACT

AIMS: The aim of the present work was to characterize the Lactiplantibacillus sp. LP5 strain, isolated from pork production, and identify bacteriocin-like inhibitory substances produced by this strain. METHODS AND RESULTS: In this study, LP5 was identified by species-specific PCR and 16S rRNA sequencing. Additionally, bacterial growth kinetics, antimicrobial activity, the detection of genes related to plantaricin production, and the genetic expression of plantaricins were determined. Lactiplantibacillus sp. LP5 was identified as Lactiplantibacillus plantarum. The well-diffusion test using cell-free supernatants (CFS), neutralized CFS, CFS treated with catalase, and CFS treated with proteinase K showed that inhibitory effects on a Shiga toxin-producing Escherichia coli (STEC) strain were produced by bacteriocins. The PCR technique allowed the detection of genes encoding E/F plantaricins, as well as J/K and whole genome sequencing, and bacteriocin mining analysis allowed us to confirm the presence of these plantaricins. CONCLUSIONS: We can conclude that the inhibitory effect of L. plantarum LP5 isolated from pigs against the STEC EDL933 strain could be associated with the bacteriocins production and represents a potential use as a probiotic strain.


Subject(s)
Anti-Infective Agents , Bacteriocins , Animals , Swine , RNA, Ribosomal, 16S/genetics , Bacteriocins/genetics , Bacteriocins/pharmacology , Endopeptidase K , Gene Expression
3.
Foods ; 12(14)2023 Jul 11.
Article in English | MEDLINE | ID: mdl-37509768

ABSTRACT

The objective of this work was to molecularly and genotypically characterize and test the inhibitory activity of six colicinogenic Escherichia coli strains (ColEc) and their partially purified colicins against STEC O157:H7 isolated from clinical human cases. Inhibition tests demonstrated the activity of these strains and their colicins against STEC O157:H7. By PCR it was possible to detect colicins Ia, E7, and B and microcins M, H47, C7, and J25. By genome sequencing of two selected ColEc strains, it was possible to identify additional colicins such as E1 and Ib. No genes coding for stx1 and stx2 were detected after analyzing the genome sequence. The inhibitory activity of ColEc against STEC O157:H7 used as an indicator showed that colicins are potent growth inhibitors of E. coli O157:H7, being a potential alternative to reduce the presence of pathogens of public health relevance.

4.
J Clin Invest ; 133(17)2023 09 01.
Article in English | MEDLINE | ID: mdl-37463049

ABSTRACT

HIV-1 persists in a latent reservoir in resting CD4+ T cells despite antiretroviral therapy (ART). The reservoir decays slowly over the first 7 years of ART (t1/2 = 44 months). However, whether decay continues with long-term ART is unclear. Recent integration site studies indicate gradual selection against inducible, intact proviruses, raising speculation that decades of ART might allow treatment interruption without viral rebound. Therefore, we measured the reservoir in 42 people on long-term ART (mean 22 years) using a quantitative viral outgrowth assay. After 7 years of ART, there was no long-term decrease in the frequency of inducible, replication-competent proviruses but rather an increase with an estimated doubling time of 23 years. Another reservoir assay, the intact proviral DNA assay, confirmed that reservoir decay with t1/2 of 44 months did not continue with long-term ART. The lack of decay reflected proliferation of infected cells. Most inducible, replication-competent viruses (79.8%) had env sequences identical to those of other isolates from the same sample. Thus, although integration site analysis indicates changes in reservoir composition, the proliferation of CD4+ T cells counteracts decay, maintaining the frequency of inducible, replication-competent proviruses at roughly constant levels over the long term. These results reinforce the need for lifelong ART.


Subject(s)
HIV Infections , HIV-1 , Humans , Anti-Retroviral Agents/pharmacology , Anti-Retroviral Agents/therapeutic use , HIV Infections/drug therapy , Virus Replication , Proviruses/genetics , CD4-Positive T-Lymphocytes , Viral Load , Virus Latency
5.
Int J Mol Sci ; 24(3)2023 Feb 01.
Article in English | MEDLINE | ID: mdl-36769094

ABSTRACT

Shiga toxin-producing Escherichia coli (STEC) is a zoonotic pathogen that causes gastroenteritis and Hemolytic Uremic Syndrome. Cattle are the main animal reservoir, excreting the bacteria in their feces and contaminating the environment. In addition, meat can be contaminated by releasing the intestinal content during slaughtering. Here, we evaluated the safety and immunogenicity of a vaccine candidate against STEC that was formulated with two chimeric proteins (Chi1 and Chi2), which contain epitopes of the OmpT, Cah and Hes proteins. Thirty pregnant cows in their third trimester of gestation were included and distributed into six groups (n = 5 per group): four groups were administered intramuscularly with three doses of the formulation containing 40 µg or 100 µg of each protein plus the Quil-A or Montanide™ Gel adjuvants, while two control groups were administered with placebos. No local or systemic adverse effects were observed during the study, and hematological parameters and values of blood biochemical indicators were similar among all groups. Furthermore, all vaccine formulations triggered systemic anti-Chi1/Chi2 IgG antibody levels that were significantly higher than the control groups. However, specific IgA levels were generally low and without significant differences among groups. Notably, anti-Chi1/Chi2 IgG antibody levels in the serum of newborn calves fed with colostrum from their immunized dams were significantly higher compared to newborn calves fed with colostrum from control cows, suggesting a passive immunization through colostrum. These results demonstrate that this vaccine is safe and immunogenic when applied to pregnant cows during the third trimester of gestation.


Subject(s)
Escherichia coli Infections , Hemolytic-Uremic Syndrome , Shiga-Toxigenic Escherichia coli , Vaccines, Subunit , Animals , Cattle , Female , Pregnancy , Escherichia coli Infections/prevention & control , Escherichia coli Infections/veterinary , Immunization, Passive , Immunoglobulin G , Vaccines, Subunit/adverse effects
7.
Front Public Health ; 10: 983174, 2022.
Article in English | MEDLINE | ID: mdl-36091556

ABSTRACT

Background: Antibiotic-resistant gram-negative bloodstream infections (BSI) remain a leading cause morbidity and mortality in pediatric patients with a high impact on the public health system. Data in resource-limited countries, including those in Latin America and the Caribbean region, are scarce. The aim of the study was to identify risk factors for acquiring carbapenem-resistant Enterobacteriaceae (CRE) bacteremia in children and to assess the use of resources. Methods: A retrospective case-control study was conducted to analyze demographic, epidemiological, clinical, microbiological, and outcome data as well as the use of resources between 2014 and 2019. Univariate and logistic regression analysis was performed in order to identify risk factors associated with CRE-BSI. The R software version 4.1.2 was used. Results: A total of 46 cases with CRE-BSI and 92 controls with gram-negative non-CRE-BSI were included. No statistical difference was observed regarding: median age (36 months; IQR, 11.2-117 vs. 48 months, IQR 13-119), male sex (50 vs. 60%), and underlying disease (98 vs. 91%) in cases vs. controls, respectively. The most frequent mechanism of CRE bacteremia were: KPC in 74%, OXA in 15%, and NDM in 6.5%. A total of 54.3% of cases vs. 32.6 % (p = 0.016) of controls were admitted to the pediatric intensive care unit (PICU), and 48 vs. 21% (p = 0.001) required mechanical ventilation. Bacteremia secondary to intra-abdominal infection was observed in 56.5% of cases vs. 35% of controls (p = 0.032). Previous colonization with CRE was detected in 76% of cases vs. 8% of controls. Combination antimicrobial treatment was most frequent in cases vs. control (100 vs. 56.5%). No difference was observed in median length of hospital stay (22 days; IQR, 19-31 in cases vs. 17.5 days; IQR, 10-31 in controls; p = 0.8). Overall case fatality ratio was 13 vs. 5.5%, respectively. The most statistically significant risk factors included previous PICU stay (OR, 4; 95%CI, 2-8), invasive procedures/surgery (OR, 3; 95%CI, 1-7), central venous catheter placement (OR, 6.5; 95%CI, 2-19), urinary catheter placement (OR, 9; 95%CI 4-20), mechanical ventilation (OR, 4; 95%CI, 2-10), liver transplantation (OR, 8; 95%CI, 2-26), meropenem treatment (OR, 8.4; 3.5-22.6) in univariate analysis. The logistic regression model used for multivariate analysis yielded significant differences for previous meropenem treatment (OR, 13; 95%CI, 3-77; p = 0.001), liver transplantation (OR, 13; 95%CI, 2.5-100; p = 0.006), and urinary catheter placement (OR, 9; 95%CI, 1.4-94; p = 0.03). Conclusion: CRE-BSI affects hospitalized children with underlying disease, mainly after liver transplantation, with previous urinary catheter use and receiving broad-spectrum antibiotics, leading to high PICU requirement and mortality. These risk factors will have to be taken into account in our region in order to establish adequate health policies and programs to improve antimicrobial stewardship.


Subject(s)
Bacteremia , Carbapenem-Resistant Enterobacteriaceae , Enterobacteriaceae Infections , Sepsis , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Argentina/epidemiology , Bacteremia/drug therapy , Bacteremia/epidemiology , Bacteremia/microbiology , Carbapenems/pharmacology , Carbapenems/therapeutic use , Case-Control Studies , Child , Child, Preschool , Enterobacteriaceae Infections/drug therapy , Enterobacteriaceae Infections/epidemiology , Enterobacteriaceae Infections/microbiology , Hospitals, Pediatric , Humans , Infant , Male , Meropenem/therapeutic use , Referral and Consultation , Retrospective Studies , Sepsis/drug therapy
8.
Arch. argent. pediatr ; 120(3): 167-173, junio 2022. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1368141

ABSTRACT

Objetivos. Describir el uso de la guía ecográfica en el cateterismo venoso central, comparando el número de intentos (1 versus 2 o más intentos), en relación con los catéteres insertados en vena yugular interna (VYI) versus vena femoral (VF). Material y métodos. Estudio descriptivo, prospectivo de catéteres venosos centrales (CVC) colocados mediante punción ecoguiada en pacientes de 1 mes a 18 años. Se realizó un modelo de regresión multivariado considerando el punto final primario, éxito a la primera punción en relación con el sitio de inserción (VYI versus VF) y variables predictoras de éxito. Resultados. Se colocaron 257 CVC, VYI 118 (45,9 %), VF 139 (54,1 %); 161 (62,7 %) insertados en la primera punción y 96 (37,3 %) requirieron más de una punción. Las inserciones en VYI fueron exitosas en la primera punción en 86 pacientes (53,5 %) y en VF fueron 75 (46,5 %) (p 0,0018; OR: 0,43 [IC95%: 0,24-0,76]). Hubo 21 (8,1 %) complicaciones inmediatas, 3 (1,86 %) se relacionaron con la primera punción, 18 (18,75 %) lo hicieron con más de una punción (p 0,0001 [IC95%: 3,36-45,68]). Las complicaciones graves, como neumotórax, fueron 4. Conclusiones. El cateterismo venoso guiado por ultrasonido demostró ser significativamente exitoso en el primer intento cuando el vaso de elección fue la VYI comparado con VF, especialmente en menores de 6 meses. Las complicaciones inmediatas fueron más frecuentes en los pacientes que requirieron más de una punción


Objectives. Describe ultrasound-guided central venous catheterization use comparing the number of attempts (1 versus 2 or more attempts) in relation to catheters placed in the internal jugular vein (IJV) versus the femoral vein (FV). Material and methods. Descriptive, prospective study of central venous catheters (CVCs) inserted via ultrasound-guided puncture in patients aged 1 month to 18 years. A multivariate regression model was done considering the primary endpoint, first puncture success in relation to the insertion site (IJV versus FV), and predictors of success. Results. A total of 257 CVCs were inserted: IJV 118 (45.9%), FV 139 (54.1%); 161 (62.7%) were inserted in the first attempt and 96 (37.3%) required more than 1 attempt. IJV insertions were successful with the first puncture in 86 patients (53.5%) and FV insertions, in 75 (46.5%) (p 0.0018; OR: 0.43 [95% CI: 0.24-0.76]). There were 21 (8.1%) immediate complications: 3 (1.86%) were related to the first puncture, 18 (18.75%), to more than 1 puncture (p 0.0001 [95% CI: 3.36-45.68]). There were 4 cases of severe complications, including pneumothorax. Conclusions. Ultrasound-guided venous catheterization demonstrated to be significantly successful in the first attempt when using the IJV versus FV, especially in infants younger than 6 months. Immediate complications occurred more frequently in patients requiring more than 1 puncture.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Catheterization, Central Venous/adverse effects , Epidemiology, Descriptive , Prospective Studies , Ultrasonography, Interventional , Intensive Care Units , Jugular Veins/diagnostic imaging
9.
Arch Argent Pediatr ; 120(3): 167-173, 2022 06.
Article in English, Spanish | MEDLINE | ID: mdl-35533118

ABSTRACT

OBJECTIVE: Describe ultrasound-guided central venous catheterization use comparing the number of attempts (1 versus 2 or more attempts) in relation to catheters placed in the internal jugular vein (IJV) versus the femoral vein (FV). MATERIAL AND METHODS: Descriptive, prospective study of central venous catheters (CVCs) inserted via ultrasound-guided puncture in patients aged 1 month to 18 years. A multivariate regression model was done considering the primary endpoint, first puncture success in relation to the insertion site (IJV versus FV), and predictors of success. RESULTS: A total of 257 CVCs were inserted: IJV 118 (45.9%), FV 139 (54.1%); 161 (62.7%) were inserted in the first attempt and 96 (37.3%) required more than 1 attempt. IJV insertions were successful with the first puncture in 86 patients (53.5%) and FV insertions, in 75 (46.5%) (p 0.0018; OR: 0.43 [95% CI: 0.24-0.76]). There were 21 (8.1%) immediate complications: 3 (1.86%) were related to the first puncture, 18 (18.75%), to more than 1 puncture (p 0.0001 [95% CI: 3.36-45.68]). There were 4 cases of severe complications, including pneumothorax. CONCLUSIONS: Ultrasound-guided venous catheterization demonstrated to be significantly successful in the first attempt when using the IJV versus FV, especially in infants younger than 6 months. Immediate complications occurred more frequently in patients requiring more than 1 puncture.


OBJETIVOS: Describir el uso de la guía ecográfica en el cateterismo venoso central, comparando el número de intentos (1 versus 2 o más intentos), en relación con los catéteres insertados en vena yugular interna (VYI) versus vena femoral (VF). Material y métodos. Estudio descriptivo, prospectivo de catéteres venosos centrales (CVC) colocados mediante punción ecoguiada en pacientes de 1 mes a 18 años. Se realizó un modelo de regresión multivariado considerando el punto final primario, éxito a la primera punción en relación con el sitio de inserción (VYI versus VF) y variables predictoras de éxito. RESULTADOS: Se colocaron 257 CVC, VYI 118 (45,9 %), VF 139 (54,1 %); 161 (62,7 %) insertados en la primera punción y 96 (37,3 %) requirieron más de una punción. Las inserciones en VYI fueron exitosas en la primera punción en 86 pacientes (53,5 %) y en VF fueron 75 (46,5 %) (p 0,0018; OR: 0,43 [IC95%: 0,24-0,76]). Hubo 21 (8,1 %) complicaciones inmediatas, 3 (1,86 %) se relacionaron con la primera punción, 18 (18,75 %) lo hicieron con más de una punción (p 0,0001 [IC95%: 3,36-45,68]). Las complicaciones graves, como neumotórax, fueron 4. CONCLUSIONES: El cateterismo venoso guiado por ultrasonido demostró ser significativamente exitoso en el primer intento cuando el vaso de elección fue la VYI comparado con VF, especialmente en menores de 6 meses. Las complicaciones inmediatas fueron más frecuentes en los pacientes que requirieron más de una punción.


Subject(s)
Catheterization, Central Venous , Catheterization, Central Venous/adverse effects , Child , Humans , Infant , Intensive Care Units , Jugular Veins/diagnostic imaging , Prospective Studies , Ultrasonography, Interventional
10.
Rev. cient. (Guatem.) ; 30(2)20220211.
Article in Spanish, English | LILACS-Express | LILACS | ID: biblio-1391426

ABSTRACT

The respiratory disease caused by SARS-CoV2 is an infectious-contagious viral disease that affects our population, especially older adults and young adults throughout the world. One of the main causes of this pathology is the limited immunization capacity at a global level, especially in developing countries, to combat outbreaks of this disease. It develops in phases of very characteristic respiratory symptoms which can guide an early diagnosis, otherwise it may require hospitalization for treatment; At a global and local level, different therapies have been tried without complete success. Presumptive diagnosis is clinical and confirmatory through nasopharyngeal swabs, which isolate beta virus, SARS-CoV-2 coronavirus, a name issued by the World Health Organization, who declared the pandemic for this disease in particular. A case of a patient with the disease caused by the virus in question is presented who comes to our health home, for not accessing a more complex hospital unit, due to hospital saturation, with a mild to moderate respiratory syndrome, in view of the impossibility of accessing other treatments, we started the administration of silymarin/silibinin in daily doses twice a day. In order for the treatment tested with different molecules to have a common denominator, which is based on attacking the cascade of inflammatory cytokines derived from the activation of the STAT3 receptor and the modulation of type 1 IFG; with corticotherapy mainly dexamethasone, or methylprednisolone, and molecules such as Remdesivir, Sofosbuvir and Ribavirin, which continue to be the focus of discussion, so optional treatments are being evaluated to combat the effects of this disease. The incidence of this disease is global, being higher in underdeveloped countries which do not have an appropriate immunization program.

11.
Arch. argent. pediatr ; 119(4): 259-265, agosto 2021. tab
Article in English, Spanish | BINACIS, LILACS | ID: biblio-1280911

ABSTRACT

Introducción. La transferencia de pacientes es un proceso interactivo de comunicación de datos y traspaso de responsabilidades para mantener la continuidad de la atención en forma segura. Las fallas en este proceso pueden derivar en cuidados inadecuados y favorecer la comisión de errores. Objetivo. Implementar una herramienta estandarizada para la transferencia de pacientes desde la unidad de cuidados intensivos (UCI) hacia la de cuidados intermedios y moderados (CIM) y comparar la comunicación entre los profesionales antes y después de la intervención. Población y métodos. Estudio del tipo antes y después, realizado en el Hospital de Pediatría "Prof. Dr. Juan P. Garrahan". Como intervención, se utilizó un formulario de transferencia escrito. La muestra estudiada antes de la intervención estaba formada por los pacientes transferidos de las UCI a las CIM entre el 1 y el 31-10-2015. La muestra estudiada luego de la intervención fueron los pacientes transferidos entre el 1 y el 31-3-2016. Participaron cuatro CIM y tres UCI. La variable principal de estudio fue la parte escrita de la transferencia; en particular, si fue oportuna y completa. Resultados. Se analizaron 50 traspasos en cada etapa. En la transferencia escrita hubo un aumento en la comunicación de datos clínicos en el 88 % de las variables (comunicación oral médico a médico, médico responsable, adecuación terapéutica, diagnóstico, evolución, entre otras); la diferencia fue estadísticamente significativa. Conclusión. Con la implementación de la herramienta mejoró la transferencia de datos clínicos del paciente relevantes para la continuidad de la atención en forma segura


Introduction. Patient handoff is an interactive process including data communication and responsible transfer in order to safely maintain the continuity of care. Failure in this process may result in inadequate care and favor the occurrence of errors. Objective. To implement a standardized instrument for patient handoff from the intensive care unit (ICU) to the intermediate-medium care unit (IMCU), and compare communication between health care providers before and after the intervention. Population and methods. Before-and-after study conducted at Hospital de Pediatría "Prof. Dr. Juan P. Garrahan." The intervention consisted in a written handoff form. The pre-intervention sample included patients transferred from ICUs to IMCUs between October 1st and October 31st, 2015. The post-intervention sample included patients transferred between March 1st and March 31st, 2016. A total of 4 IMCUs and 3 ICUs participated in the study. The main study variable was the written part of the handoff; in particular, whether it was timely and complete. Results. A total of 50 handoffs were analyzed for each stage. With the written handoff, there was an increase in the communication of clinical data in 88 % of variables (oral communication between physicians, treating physician, therapeutic adequacy, diagnosis, course, etc.); the difference was statistically significant. Conclusion. After implementing the tool, there was an improvement in the transfer of patient clinical data relevant to the safe continuity of care


Subject(s)
Humans , Patient Transfer , Communication , Continuity of Patient Care , Controlled Before-After Studies
12.
Arch Argent Pediatr ; 119(4): 259-265, 2021 08.
Article in English, Spanish | MEDLINE | ID: mdl-34309302

ABSTRACT

INTRODUCTION: Patient handoff is an interactive process including data communication and responsible transfer in order to safely maintain the continuity of care. Failure in this process may result in inadequate care and favor the occurrence of errors. OBJECTIVE: To implement a standardized instrument for patient handoff from the intensive care unit (ICU) to the intermediate-medium care unit (IMCU), and compare communication between health care providers before and after the intervention. POPULATION AND METHODS: Before-and-after study conducted at Hospital de Pediatría "Prof. Dr. Juan P. Garrahan." The intervention consisted in a written handoff form. The pre-intervention sample included patients transferred from ICUs to IMCUs between October 1st and October 31st, 2015. The post-intervention sample included patients transferred between March 1st and March 31st, 2016. A total of 4 IMCUs and 3 ICUs participated in the study. The main study variable was the written part of the handoff; in particular, whether it was timely and complete. RESULTS: A total of 50 handoffs were analyzed for each stage. With the written handoff, there was an increase in the communication of clinical data in 88 % of variables (oral communication between physicians, treating physician, therapeutic adequacy, diagnosis, course, etc.); the difference was statistically significant. CONCLUSION: After implementing the tool, there was an improvement in the transfer of patient clinical data relevant to the safe continuity of care.


Introducción. La transferencia de pacientes es un proceso interactivo de comunicación de datos y traspaso de responsabilidades para mantener la continuidad de la atención en forma segura. Las fallas en este proceso pueden derivar en cuidados inadecuados y favorecer la comisión de errores. Objetivo. Implementar una herramienta estandarizada para la transferencia de pacientes desde la unidad de cuidados intensivos (UCI) hacia la de cuidados intermedios y moderados (CIM) y comparar la comunicación entre los profesionales antes y después de la intervención. Población y métodos. Estudio del tipo antes y después, realizado en el Hospital de Pediatría "Prof. Dr. Juan P. Garrahan". Como intervención, se utilizó un formulario de transferencia escrito. La muestra estudiada antes de la intervención estaba formada por los pacientes transferidos de las UCI a las CIM entre el 1 y el 31-10-2015. La muestra estudiada luego de la intervención fueron los pacientes transferidos entre el 1 y el 31-3-2016. Participaron cuatro CIM y tres UCI. La variable principal de estudio fue la parte escrita de la transferencia; en particular, si fue oportuna y completa. Resultados. Se analizaron 50 traspasos en cada etapa. En la transferencia escrita hubo un aumento en la comunicación de datos clínicos en el 88 % de las variables (comunicación oral médico a médico, médico responsable, adecuación terapéutica, diagnóstico, evolución, entre otras); la diferencia fue estadísticamente significativa. Conclusión. Con la implementación de la herramienta mejoró la transferencia de datos clínicos del paciente relevantes para la continuidad de la atención en forma segura.


Subject(s)
Patient Handoff , Physicians , Child , Communication , Hospitals, Pediatric , Humans , Intensive Care Units
13.
Arq. Inst. Biol ; 87: e0432018, 2020. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1118052

ABSTRACT

The spotted-wing drosophila, Drosophila suzukii Matsumura, is considered the main insect pest of small fruit in the world. Identifying susceptible hosts is essential to develop management strategies. The aim of this study was to verify the level of D. suzukii infestation in blackberry, blueberry, strawberry, cattley guava and Surinam cherry fruits cultivated in the southern region in Brazil, and to determine the infestation index (II) per fruit. The studies were carried out during two harvests (2015/16 and 2016/17) in three areas with organic cultivation of small fruit. The highest level of D. suzukii natural infestation was observed in blackberry (40 to 65% infestation), and strawberry (approximately 30% infestation) fruits. In contrast, blueberries were less preferred (< 7% infestation). For native fruit of the region (cattley guava and Surinam cherry), it was also verified infestation of the fly, demonstrating they are hosts for multiplication in the off-season periods of the other crops. In relation to II, blackberry and Surinam cherry provided a higher average number of insects per gram of fruit (≈ 1.6 adults of D. suzukii). In contrast, blueberries and cattley guava had the lowest insect ratio per gram of fruit (≈ 0.7 adults per gram). The period between late spring to mid-autumn was considered ideal for the pest occurrence in the field. The knowledge of natural infestation levels is essential for understanding the behavior of the pest in the field, which will assist in the design of management strategies.(AU)


A drosófila-da-asa-manchada, Drosophila suzukii Matsumura, é considerada o principal inseto-praga de pequenos frutos no mundo. A identificação de hospedeiros suscetíveis é essencial para o desenvolvimento de estratégias de manejo. O objetivo deste estudo foi verificar o nível de infestação de D. suzukii em frutos de amoreira-preta, mirtileiro, morangueiro, araçazeiro e pitangueira cultivados na região no sul do Brasil e determinar os índices de infestação (II) por fruto. Os estudos foram realizados durante duas safras (2015/16 e 2016/17) em três áreas com cultivo orgânico de pequenas frutas. O maior nível de infestação natural de D. suzukii foi observado em amora-preta (40 a 65% de infestação) e morango (aproximadamente 30% de infestação). Em contraste, o mirtilo foi menos preferido (< 7% de infestação). Para as frutas nativas da região (araçá e pitanga), também ocorreu infestação da mosca, demonstrando serem hospedeiros potenciais para a multiplicação da praga nos períodos de entressafras. Em relação ao II, amoras e pitangas proporcionaram um maior número médio de insetos por grama de fruto (≈ 1,6 adultos de D. suzukii). Por outro lado, mirtilos e araçás apresentaram a menor relação de insetos emergidos por gramas de frutos (≈ 0,7 adultos por grama). O período entre final da primavera até meados do outono foi considerado ideal para a ocorrência da praga no campo. O conhecimento dos níveis de infestação natural é fundamental para o entendimento do comportamento da praga no campo, o que auxiliará no delineamento de estratégias de manejo.(AU)


Subject(s)
Drosophila , Fruit/parasitology , Seasons , Brazil , Agricultural Pests , Vaccinium myrtillus , Morus , Fragaria , Introduced Species , Eugenia
14.
PLoS One ; 14(12): e0226366, 2019.
Article in English | MEDLINE | ID: mdl-31869829

ABSTRACT

Gap wind jets (Tehuano winds) trigger supersquirts of colder water and mesoscale asymmetric dipoles in the Gulf of Tehuantepec (GT). However, the effects of successive gap wind jets on dipoles and their effects inside eddies have not yet been studied. Based on the wind fields, geostrophic currents, and surface drifter dispersion, this research documented three dipoles triggered and modified by Tehuano winds. Once a dipole develops, successive gap wind jets strengthen the vortices, and the anticyclonic eddy migrates southwestward while the cyclonic eddy is maintained on the east side of the GT. During the wind relaxation stage, the cyclonic eddy may propagate westward, but due to the subsequent re-intensification of the Tehuano winds, the vortex could break down, as was suggested by surface drifter dispersion pattern and geostrophic field data. The effect of the Tehuano winds was evaluating via eddy-Ekman pumping. Under Tehuano wind conditions, Ekman downwelling (upwelling) inside the anticyclonic (cyclonic) eddies may reach ~ -2.0 (0.5) m d-1 and decrease as the wind weakens. In the absence of Tehuano winds, Ekman downwelling inside the anticyclonic eddy was ~ 0.1 (-0.1) m d-1. The asymmetry of downwelling and upwelling inside eddies during Tehuano wind events may be associated with Tehuano wind forcing.


Subject(s)
Cyclonic Storms , Satellite Imagery , Seawater , Water Movements , Wind , Cold Temperature , Databases, Factual , Ecosystem , Geographic Mapping , Mexico , Seasons , Seawater/analysis
15.
An Acad Bras Cienc ; 91(2): e20180375, 2019 May 23.
Article in English | MEDLINE | ID: mdl-31141011

ABSTRACT

Drosophila suzukii is one of the main pests of small fruits in the world. An effective monitoring is fundamental to detect the presence of the fly and to predict the infestation of fruits in new areas. We evaluated the food baits Ceratrap®, Torula®, Biofruit®, Suzukii Trap®, apple cider vinegar, and a homemade mixture comprising wine, vinegar and molasses (WVM) for D. suzukii attractiveness, and if reproductive stage affects females attraction and capture in the different baits. Bait selectivity of non-target insects was assessed. The preference of adults between ripe blackberry fruit and the food baits was also evaluated. Adults showed a higher attraction (61.97% of the captured insects) to the WVM mixture than to Ceratrap® (1.32%), Torula® (0.52%), Biofruit® (13.15%), Suzukii Trap® (17.6%), and apple vinegar (5.4%). Considering the attractiveness to D. suzukii, Suzukii Trap® and apple vinegar were the most selective to non-target insects. In general, reproductively immature females showed a preference for Biofruit®, apple vinegar, and WVM, whereas mature females did not show bait preferences. Adults preferred ripe blackberry fruit over the WVM mixture. Understanding the field behavior of D. suzukii is of foremost importance to estimate insect population density and outline pest management strategies.


Subject(s)
Drosophila/physiology , Insect Control/methods , Pheromones , Animals , Brazil , Drosophila/classification , Female , Insect Control/instrumentation , Male
17.
Arch Esp Urol ; 70(9): 759-765, 2017 Nov.
Article in Spanish | MEDLINE | ID: mdl-29099378

ABSTRACT

OBJECTIVE: To analyze prognostic variables that impact on the trial without catheter after tamsulosin in patients with acute urine retention. METHODS: Retrospective analysis of a prospective database of a cohort of successive patients with acute urinary retention due to benign prostatic hyperplasia attended at the urology emergency room during one year time period. We analyzed the clinical and radiological characteristics and the international prostatic symptom score questionnaire of a total 65 male patients. RESULTS: The trial without catheter after tamsulosin showed positive results in 25 patients (38%) and failed in the remaining 40 (62%). In multivariate analysis, none of the analyzed variables resulted in an independent predictive factor for spontaneous micturition after the trial without catheter. However, the severe IPSS (p=0.085) presented an important statistical tendency for predicting failure of spontaneous micturition, as well as we found that the 84% of diabetic patients presented failure to the trial with catheter. CONCLUSIONS: The only variable that impact negatively on the trial without catheter was the severe IPSS with an approximation to statistical significance. The presence of diabetes as a related factor is a hypothesis that should be investigated with a higher number of cases.


Subject(s)
Adrenergic alpha-1 Receptor Antagonists/therapeutic use , Sulfonamides/therapeutic use , Urinary Catheterization , Urinary Retention/drug therapy , Acute Disease , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Prognosis , Prostatic Hyperplasia/complications , Retrospective Studies , Tamsulosin , Urinary Retention/etiology
18.
Arch. esp. urol. (Ed. impr.) ; 70(9): 759-765, nov. 2017. ilus, tab
Article in Spanish | IBECS | ID: ibc-168573

ABSTRACT

OBJETIVO: Analizar las variables relacionadas con el fracaso en la prueba miccional con Tamsulosina en pacientes con retención aguda de orina. MÉTODOS: Análisis retrospectivo de una base de datos de cumplimentación prospectiva de pacientes consecutivos durante un año que acudieron al servicio de urgencias de urología por retención aguda de orina secundaria a hiperplasia prostática benigna. Se analizaron las características clínicas, radiológicas y cuestionario international prostatic symptom score (IPSS) antes de la retención aguda de orina (RAO) de un total de 65 pacientes. RESULTADOS: La prueba miccional con Tamsulosina fue positiva en 25 pacientes (38%) y fallida en 40 (62%). Se realizó análisis multivariante en el cual ninguna de las variables analizadas se comportó como un factor pronóstico independiente para predecir la micción espontánea tras la prueba miccional. Sin embargo, el IPSS severo (p = 0,085) presentó una tendencia estadística importante a la significación para predecir negativamente la micción espontánea, también encontrando que el 84% de los pacientes diabéticos presentaron fracaso en la prueba miccional. CONCLUSIÓN: La única variable que impacta negativamente en la prueba miccional con aproximación a la significancia estadística fue el IPSS. La presencia de diabetes como factor relacionado con el desenlace en la prueba miccional es una hipótesis que requiere una investigación con un mayor número de casos


OBJECTIVE: To analyze prognostic variables that impact on the trial without catheter after tamsulosin in patients with acute urine retention. METHODS: Retrospective analysis of a prospective database of a cohort of successive patients with acute urinary retention due to benign prostatic hyperplasia attended at the urology emergency room during one year time period. We analyzed the clinical and radiological characteristics and the international prostatic symptom score questionnaire of a total 65 male patients. RESULTS: The trial without catheter after tamsulosin showed positive results in 25 patients (38%) and failed in the remaining 40 (62%). In multivariate analysis, none of the analyzed variables resulted in an independent predictive factor for spontaneous micturition after the trial without catheter. However, the severe IPSS (p = 0.085) presented an important statistical tendency for predicting failure of spontaneous micturition, as well as we found that the 84% of diabetic patients presented failure to the trial with catheter.Coclusions: The only variable that impact negatively on the trial without catheter was the severe IPSS with an approximation to statistical significance. The presence of diabetes as a related factor is a hypothesis that should be investigated with a higher number of cases


Subject(s)
Humans , Male , Middle Aged , Aged , Aged, 80 and over , Urinary Retention/physiopathology , Urination , Prostatic Hyperplasia/physiopathology , Adrenergic alpha-Antagonists/pharmacokinetics , Acute Disease , Retrospective Studies , Urinary Catheterization
19.
Rev. bras. entomol ; 61(3): 257-261, July-Sept. 2017. tab, graf
Article in English | LILACS | ID: biblio-1045455

ABSTRACT

Abstract Encyrtids (Hymenoptera: Encyrtidae) are the most important and diverse group of natural enemies of mealybugs (Hemiptera: Pseudococcidae). Blepyrus clavicornis (Compere) is the most common parasitoid associated with Pseudococcus viburni (Signoret) in the Serra Gaúcha region, Brazil. We conducted laboratory studies to assess the development time, sex ratio, adult longevity, host stage selection for parasitism, and effect of food on the longevity of adult females of B. clavicornis. The experiments were conducted in a climate chamber at 25 ± 1 °C, 70 ± 10% RH and 12:12 L:D photoperiod. The solitary parasitoid B. clavicornis parasitized third-instar and adult female stages of P. viburni. The development time was more than 30 days (31.75 ± 0.38 for females and 30.02 ± 0.34 for males) when B. clavicornis laid eggs in adult mealybug females, and 35 days (36.50 ± 0.50 for females and 34.24 ± 0.43 for males) on third-instar mealybug nymphs. The wasps did not survive longer than four days when they were fed only water, while females survived for about 30 days when fed with honey. The lifespan of females is about 20 days longer than the lifespan of males. Although B. clavicornis can provide significant natural control, reducing the number of individuals in the next generation by parasitizing advanced mealybug instars, we consider it unpromising for use in applied biological-control programs. Furthermore, the predominance of males in the progeny observed here suggests that P. viburni may not be the most suitable or preferred host for B. clavicornis.

20.
J Insect Sci ; 142014.
Article in English | MEDLINE | ID: mdl-25527572

ABSTRACT

In southern Brazil, Grapholita molesta (Busck) (Lepidoptera: Tortricidae) uses diapause as survival strategy during the winter (May-August). In our study, we evaluated the effect of diapause on biological characteristics of the species for 4 months in laboratory. Newly hatched larvae of G. molesta were induced to diapause changing the photoperiod and temperature (T) (12 ± 1°C), relative humidity (RH) (70 ± 10%), and a photophase of 12 h and, when they started diapause in the prepupal stage, the conditions were kept for 4 months. Afterwards, the insects were induced to finalize the diapause process at T 25 ± 1°C, RH 70 ± 10%, and a photophase of 16 h. We evaluated the duration and viability of the larval stages and pupae, pupae weight at 24 h and sex ratio (sr), periods of preoviposition, oviposition, and postoviposition; adult life span (males and females); fecundity (daily and total); embryonic period duration and eggs viability, comparing the data with insects nondiapause. The results show that diapause greatly affected the viability of pupal-adult stages of the population (21.8%) when compared with insects' nondiapause (80.0%). Total fecundity (83.0 eggs) and mean life span (12.0 d) of insects diapause was significantly lower compared with insects nondiapause (173.0 and 17.0), respectively. However, these differences were not observed in the sr, which was similar to insects diapause (sr = 0.41) and insects nondiapause (sr = 0.49). The diapause induced for 4 months negatively affects reproduction and life span of adults of G. molesta.


Subject(s)
Diapause, Insect , Moths/physiology , Animals , Brazil , Female , Larva/growth & development , Longevity , Male , Moths/growth & development , Pupa/growth & development , Reproduction
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