ABSTRACT
BACKGROUND: Convenience stores in Guatemala provide essential consumer goods in communities, but many dispense antibiotics illegally. Federal legislation, passed in August of 2019, requires prescriptions for antibiotic purchase at pharmacies but it is unclear if this legislation is enforced or if it has any impact on unlawful sales of antibiotics. METHODS: To determine if antibiotic availability changed in convenience stores, we carried out a repeated measures study collecting antibiotic availability data before and after implementation of the dispensing regulation. RESULTS: There was no statistical difference in the proportion of convenience stores that sold antibiotics before and after antibiotic regulations [66.6% (295/443) and 66.7% (323/484), respectively, P>0.96], nor in the number of stores selling amoxicillin [55.5% (246/443) and 52.3% (253/484), respectively, P>0.96], but fewer stores (20%) sold tetracycline capsules after regulation was passed (P<0.05). For stores visited both before and after passage of legislation (n=157), 15% stopped selling antibiotics while 25% started selling antibiotics. Antibiotics from convenience stores were reportedly sold for use in people and animals. CONCLUSIONS: Antibiotics remain widely available in convenience stores consistent with no significant change in the informal sector after implementation of prescription requirements for pharmacies. Importantly, effects from regulatory change could have been masked by potential changes in antibiotic use during the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic.
Subject(s)
Anti-Bacterial Agents , Pharmacies , Humans , Anti-Bacterial Agents/therapeutic use , Commerce , Drug Prescriptions , Amoxicillin , TetracyclineABSTRACT
BACKGROUND: The objective of this study was to describe the bacterial communities associated with pediatric patients with endodontic infections of temporal teeth by targeting the 16S rRNA gene using pyrosequencing. MATERIAL AND METHODS: Microbiological samples were obtained from the lower primary molars of thirteen 13 pediatric patients with dental infections. An aspiration method for microbiological sampling was used. The identification of microbiota employing the pyrosequencing method by targeting the 16S gene was performed. RESULTS: Ribosomal 16S RNA gene sequences were amplified, obtaining a total of 16,182 sequences from 13 primary infected molars (13 different individuals) by pyrosequencing. Bacteroidetes phyla (35.15%) were the most abundant followed by Firmicutes (33.3%) and Fusobacteria (10.05%); the presence of specific pathogenic bacteria was determined as well. CONCLUSIONS: The infected root canal of primary teeth contains a high diversity of anaerobic bacteria, and Bacteroidetes, Firmicutes, and Fusobacteria phyla were the most abundant; Prevotella and Streptococcus genera were the most prevalent.
Subject(s)
Bacteria , Bacteroidetes/genetics , Child , Humans , RNA, Ribosomal, 16S , Sequence Analysis, DNA , Tooth, DeciduousABSTRACT
BACKGROUND: Staphylococcus aureus is a leading cause of broad-spectrum infections both in the community and within healthcare settings. Methicillin-resistant Staphylococcus aureus (MRSA) has become a global public health issue. The aim of this study was to examine the clinical and molecular characteristics of Staphylococcus aureus isolates and to define the population structure and distribution of major MRSA clones isolated in a tertiary-care hospital in Mexico. RESULTS: From April 2017 to April 2018, 191 Staphylococcus aureus isolates were collected. The frequency of MRSA was 26.7%; these strains exhibited resistance to clindamycin (84.3%), erythromycin (86.2%), levofloxacin (80.3%), and ciprofloxacin (86.3%). The majority of MRSA strains harbored the SCCmec type II (76.4%) and t895 (56.8%) and t9364 (11.7%) were the most common spa types in both hospital-associated MRSA and community-associated MRSA isolates. ST5-MRSA-II-t895 (New York /Japan clone) and ST1011-MRSA-II-t9364 (New York /Japan-Mexican Variant clone) were the most frequently identified clones. Furthermore, different lineages of Clonal Complexes 5 (85.4%) and 8 (8.3%) were predominantly identified in this study. CONCLUSION: Our study provides valuable information about the epidemiology of MRSA in a city of the central region of Mexico, and this is the first report on the association between t895 and t9364 spa types and ST5 and ST1011 lineages, respectively. These findings support the importance of permanent surveillance of MRSA aimed to detect the evolutionary changes of the endemic clones and the emergence of new strains.
Subject(s)
Anti-Bacterial Agents/pharmacology , Community-Acquired Infections/microbiology , Cross Infection/microbiology , Methicillin-Resistant Staphylococcus aureus/classification , Molecular Typing/methods , Staphylococcal Infections/epidemiology , Adolescent , Adult , Child , Child, Preschool , Community-Acquired Infections/epidemiology , Cross Infection/epidemiology , Drug Resistance, Multiple, Bacterial , Female , Humans , Infant , Infant, Newborn , Male , Methicillin-Resistant Staphylococcus aureus/genetics , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Mexico/epidemiology , Microbial Sensitivity Tests , Middle Aged , Phylogeny , Prevalence , Tertiary Care Centers , Young AdultABSTRACT
The two co-authors of the mentioned above article were incorrect. The correct are authors should have been "P. A. Beltrán" instead of "P. A. B. Roa" and "J. F. Diaz-Coto" instead of "L. Diaz Soto".
ABSTRACT
INTRODUCTION: Biologics have improved the treatment of rheumatic diseases, resulting in better outcomes. However, their high cost limits access for many patients in both North America and Latin America. Following patent expiration for biologicals, the availability of biosimilars, which typically are less expensive due to lower development costs, provides additional treatment options for patients with rheumatic diseases. The availability of biosimilars in North American and Latin American countries is evolving, with differing regulations and clinical indications. OBJECTIVE: The objective of the study was to present the consensus statement on biosimilars in rheumatology developed by Pan American League of Associations for Rheumatology (PANLAR). METHODS: Using a modified Delphi process approach, the following topics were addressed: regulation, efficacy and safety, extrapolation of indications, interchangeability, automatic substitution, pharmacovigilance, risk management, naming, traceability, registries, economic aspects, and biomimics. Consensus was achieved when there was agreement among 80% or more of the panel members. Three Delphi rounds were conducted to reach consensus. Questionnaires were sent electronically to panel members and comments about each question were solicited. RESULTS: Eight recommendations were formulated regarding regulation, pharmacovigilance, risk management, naming, traceability, registries, economic aspects, and biomimics. CONCLUSION: The recommendations highlighted that, after receiving regulatory approval, pharmacovigilance is a fundamental strategy to ensure safety of all medications. Registries should be employed to monitor use of biosimilars and to identify potential adverse effects. The price of biosimilars should be significantly lower than that of reference products to enhance patient access. Biomimics are not biosimilars and, if they are to be marketed, they must first be evaluated and approved according to established regulatory pathways for novel biopharmaceuticals. KEY POINTS: ⢠Biologics have improved the treatment of rheumatic diseases. ⢠Their high cost limits access for many patients in both North America and Latin America. ⢠Biosimilars typically are less expensive, providing additional treatment options for patients with rheumatic diseases. ⢠PANLAR presents its consensus on biosimilars in rheumatology.
Subject(s)
Biosimilar Pharmaceuticals/therapeutic use , Rheumatic Diseases/drug therapy , Biosimilar Pharmaceuticals/adverse effects , Consensus , Evidence-Based Medicine , Humans , Latin America/epidemiology , North America , Practice Guidelines as Topic , Rheumatology , Societies, MedicalABSTRACT
AIM: There is an important lack of knowledge as to the functioning of multidisciplinary teams on thyroid cancer in current clinical practice. We aimed to retrieve data on the composition, structure, and procedures developed by the multidisciplinary units of thyroid cancer in Spain. METHODS: A nationwide survey consisting of questions about composition, structure, and functioning of multidisciplinary teams was designed. It was available online from November 15, 2017 to February 15, 2018. RESULTS: Seventy-two multidisciplinary units responded to our survey. Of these, 15 (20.8%) focused only in thyroid cancer, while 57 (79.2%) included other endocrine disorders or non-endocrine tumors. The median (interquartile range) of members of the teams was 11 (9-14). The most frequent medical specialties in the units were endocrinology (100%), surgery (94.4%), pathology (80.6%), radiology (75.0%), nuclear medicine (73.6%), and medical oncology (55.6%). The annual number of patients reviewed by the teams was 40 (20-74). 56.9% of the multidisciplinary teams have elaborated clinical protocols for local use. Apart from clinical case discussions in the meetings, 45.8% of the units included educational activities and 36.1% research subjects. Quality indicators were developed by 22% of the teams. CONCLUSIONS: These results suggest that there are some hopeful signs that international recommendations of having multidisciplinary approach to patients with thyroid cancer are being followed in Spain. This gives us the opportunity to proceed with further studies to analyze the real impact of this high standard of care on patient outcomes.
Subject(s)
Patient Care Team/organization & administration , Thyroid Neoplasms/therapy , Chi-Square Distribution , Guideline Adherence/statistics & numerical data , Health Care Surveys/statistics & numerical data , Humans , Patient Care Team/statistics & numerical data , Quality Indicators, Health Care , Spain , Statistics, NonparametricABSTRACT
Las anomalías dentoesqueletales se presentan en el 2-3% de la población. Las mismas afectan el complejo maxilomandibular como también la relación entre las arcadas dentarias. Estas alteraciones producen problemas fonéticos, deglutorios, respiratorios y estéticos. Existe una tendencia en corregir las alteraciones dentarias sin tratar las discrepancias esqueletales, dificultando la corrección quirúrgica, si esta fuera necesaria. Actualmente, la cirugía ortognática ha tenido mayor aceptación como el tratamiento ideal para pacientes con estas anomalías. Se presentará una revisión de la literatura sobre las características que esta alteración presenta, junto a la resolución de casos clínicos (AU)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Osteotomy, Le Fort , Maxillofacial Abnormalities/surgery , Orthognathic Surgery , Malocclusion, Angle Class II/surgery , Malocclusion, Angle Class III/surgery , Argentina , Schools, Dental , Mandibular Advancement , Open Bite/surgeryABSTRACT
The Southern Westerly Winds (SWW) are the surface expression of geostrophic winds that encircle the southern mid-latitudes. In conjunction with the Southern Ocean, they establish a coupled system that not only controls climate in the southern third of the world, but is also closely connected to the position of the Intertropical Convergence Zone and CO2 degassing from the deep ocean. Paradoxically, little is known about their behavior since the last ice age and relationships with mid-latitude glacier history and tropical climate variability. Here we present a lake sediment record from Chilean Patagonia (51°S) that reveals fluctuations of the low-level SWW at mid-latitudes, including strong westerlies during the Antarctic Cold Reversal, anomalously low intensity during the early Holocene, which was unfavorable for glacier growth, and strong SWW since ~7.5 ka. We detect nine positive Southern Annular Mode-like events at centennial timescale since ~5.8 ka that alternate with cold/wet intervals favorable for glacier expansions (Neoglaciations) in southern Patagonia. The correspondence of key features of mid-latitude atmospheric circulation with shifts in tropical climate since ~10 ka suggests that coherent climatic shifts in these regions have driven climate change in vast sectors of the Southern Hemisphere at centennial and millennial timescales.
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BACKGROUND AND OBJECTIVE: Experimental models suggest the use of different therapy protocols in rheumatoid arthritis (RA) as modulators on periodontal condition. This study evaluated the effects of conventional drug treatment and anti-TNF therapy in patients with RA on microbiological and periodontal condition, establishing the association of markers of periodontal infection with indexes of rheumatic activity. MATERIALS AND METHODS: One hundred seventy nine individuals with RA were evaluated (62 with anti-TNF-. and 115 with only DMARDs). The periodontal evaluation included plaque and gingival indexes, bleeding on probing (BOP), clinical attachment loss (CAL), pocket depth (PD) and subgingival plaque samples for microbiological analysis. Rheumatologic evaluations included a clinical examination, rheumatoid factor (RF), antibodies against cyclic-citrullinated peptides (ACPAs), and activity markers (DAS28-ERS), high sensitive C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR). RESULTS: Anti-TNF-alpha therapy influenced periodontal microbiota with a higher frequency of T. denticola (p=0.01). Methotrexate combined with leflunomide exhibited a higher extension of CAL (p=0.005), and anti-TNF-alpha therapy with methotrexate was associated with a lower extension of CAL (p=0.05). The use of corticosteroids exerted a protective effect on the number of teeth (p=0.027). The type of DMARD affected P. gingivalis, T. forsythia and E. nodatum presence. Elevated ACPAs titers were associated with the presence of red complex periodontal pathogens (p=0.025). Bleeding on probing was associated with elevated CPR levels (p=0.05), and ESR was associated with a greater PD (p=0.044) and presence of red complex (p=0.030). CONCLUSION: Different pharmacological treatments for RA affect the clinical condition and subgingival microbiota.
Subject(s)
Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/drug therapy , Periodontium/drug effects , Periodontium/microbiology , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Periodontal Diseases/complications , Periodontal Diseases/microbiology , Young AdultABSTRACT
El ameloblastoma es una entidad patológica benigna de origen odontogénico, de alta agresividad local, lo que ha sido un punto de controversia en la literatura científica. Se presenta un caso clínico, con ubicación en maxilar superior con diagnóstico de ameloblastoma sólido multiquístico. Se evalúa el caso, su posibilidad de tratamiento, revisando las características clínicas y anatomopatológicas de laentidad, basándose en una búsqueda bibliográfica.
Ameloblastoma is a benign pathological entity of odontogenic origin, very aggressive at a local level, which has become a controversial issuein cientific literature. A clinic case is presented, located in the superior maxilla diagnosed as a solid multicystic ameloblastoma. The case isevaluated, its ways of treatment, the clinical and anatomopathological characteristics of the entity with an intensive bibliographical researc.
Subject(s)
Humans , Male , Middle Aged , Ameloblastoma/surgery , Ameloblastoma/diagnosis , Ameloblastoma/pathology , Maxillary Neoplasms/classification , Oral Surgical Procedures/methods , Argentina , Dental Service, Hospital , Maxillofacial Prosthesis , Patient Care PlanningABSTRACT
Within the volcanological community there is a growing awareness that many large- to small-scale, point-source eruptive events can be fed by multiple melt bodies rather than from a single magma reservoir. In this study, glass shard major- and trace-element compositions were determined from tephra systematically sampled from the outset of the Puyehue-Cordón Caulle (PCC) eruption (~1 km(3)) in southern Chile which commenced on June 4(th), 2011. Three distinct but cogenetic magma bodies were simultaneously tapped during the paroxysmal phase of this eruption. These are readily identified by clear compositional gaps in CaO, and by Sr/Zr and Sr/Y ratios, resulting from dominantly plagioclase extraction at slightly different pressures, with incompatible elements controlled by zircon crystallisation. Our results clearly demonstrate the utility of glass shard major- and trace-element data in defining the contribution of multiple magma bodies to an explosive eruption. The complex spatial association of the PCC fissure zone with the Liquiñe-Ofqui Fault zone was likely an influential factor that impeded the ascent of the parent magma and allowed the formation of discrete melt bodies within the sub-volcanic system that continued to independently fractionate.
ABSTRACT
OBJECTIVES: To evaluate the clinical response at 12 month in a cohort of patients with rheumatoid arthritis treated with Etanar (rhTNFR:Fc), and to register the occurrence of adverse effects. METHODS: This is a multicentre observational cohort study. It included patients over 18 years of age with an active rheumatoid arthritis diagnosis for which the treating physician had begun a treatment scheme of 25 mg of subcutaneous etanercept (Etanar ® 25 mg: biologic type rhTNFR:Fc), twice per week. Follow-up was done during 12 months, with assessments at weeks 12, 24, 36 and 48. Evaluated outcomes included tender joint count, swollen joint count, ACR20, ACR50, ACR70, HAQ and DAS28. RESULTS: One-hundred and five (105) subjects were entered into the cohort. The median of tender and swollen joint count, ranged from 19 and 14, respectively at onset to 1 at the 12th month. By month 12, 90.5% of the subjects reached ACR20, 86% ACR50, and 65% ACR70. The median of DAS28 went from 4.7 to 2, and the median HAQ went from 1.3 to 0.2. The rate of adverse effects was 14 for every 100 persons per year. No serious adverse effects were reported. The most frequent were pruritus (5 cases), and rhinitis (3 cases). CONCLUSIONS: After a year of following up a patient cohort treated with etanercept 25 mg twice per week, significant clinical results were observed, resulting in adequate disease control in a high percentage of patients with an adequate level of safety.
Subject(s)
Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/drug therapy , Etanercept , Adult , Aged , Antirheumatic Agents/administration & dosage , Antirheumatic Agents/adverse effects , Arthritis, Rheumatoid/epidemiology , Arthritis, Rheumatoid/metabolism , Colombia/epidemiology , Drug Monitoring/methods , Etanercept/administration & dosage , Etanercept/adverse effects , Female , Humans , Male , Middle Aged , Receptors, Tumor Necrosis Factor/metabolism , Treatment Outcome , Tumor Necrosis Factor-alpha/antagonists & inhibitorsABSTRACT
Background: Median arcuate ligament syndrome (SLAM) is caused by extrinsic compression of the celiac artery by fibrous bands of this ligament and periaortic lymph node tissue. Case report: We report a 59 years old man with a history of weight loss, epigastric pain and a postprandial murmur. The syndrome was diagnosed by CT angiography. The patient was operated, performing a midline laparotomy and releasing the extrinsic compression. An early and sustained remission of symptoms was achieved.
Introducción: El síndrome del ligamento arcuato medio (SLAM), es causado por la compresión extrínseca del tronco celíaco por bandas fibrosas de este ligamento y tejido ganglionar periaórtico. Caso clínico: Reportamos el caso de un hombre de 59 años con historia de baja de peso, dolor postprandial y soplo epigástrico, al cual se le diagnostica SLAM por medio de angioTC. Se realiza abordaje quirúrgico, con laparotomía media y liberación de la compresión extrínseca, logrando remisión de los síntomas de forma inmediata y sostenida. El SLAM es una causa infrecuente de dolor abdominal, requiere estudio por imágenes para su diagnóstico, la resolución quirúrgica constituye su tratamiento.
Subject(s)
Humans , Male , Middle Aged , Celiac Artery/surgery , Celiac Artery/pathology , Constriction, Pathologic/surgery , Constriction, Pathologic/etiology , Ligaments/surgery , Ligaments/pathology , Angiography , Tomography, X-Ray ComputedABSTRACT
A specific, fast and sensitive LC-MS/MS assay was developed for the determination of finasteride in human plasma using betamethsone dipropionate as the internal standard (IS). The limit of quantification was 1.0 ng/ml and the method was linear in the range of 1.0-25.0 ng/ml. The retention times were 0.75 min for finasteride and 0.85 min for IS. Method intra-batch precision and accuracy ranged from 3.6 to 7.1%, and 96.6 to 103.9%, respectively. Inter-batch precision ranged from 2.5 to 3.4%, while Inter-batch accuracy ranged from 100.3 to 103.5%. The analytical method was applied to evaluate the pharmacokinetic and relative bioavailability of 2 different pharmaceutical formulations containing 1.0 mg of finasteride. This study evaluated 38 volunteers in a randomized, 2-period crossover study with 7 days washout period between doses. The geometric mean and respective 90% CI of finasteride test/reference percent ratios were 95.68% (91.2 - 104.6%) for Cmax, 97.5% (92.1-103.3%) for AUC0-t and 98.1 (92.67-103.8) for AUC0-inf. Based on the 90% confidence interval of the individual ratios (test formulation/reference formulation) for Cmax and AUC0-inf, it was concluded that the test formulation is bioequivalent to the reference one with respect to the rate and extent of absorption of finasteride.
Subject(s)
Finasteride/blood , Finasteride/pharmacokinetics , 5-alpha Reductase Inhibitors/blood , 5-alpha Reductase Inhibitors/pharmacokinetics , Adolescent , Adult , Betamethasone/analogs & derivatives , Betamethasone/blood , Betamethasone/pharmacokinetics , Biological Availability , Chromatography, High Pressure Liquid , Cross-Over Studies , Humans , Limit of Detection , Male , Middle Aged , Spectrometry, Mass, Electrospray Ionization , Tandem Mass Spectrometry , Therapeutic Equivalency , Young AdultABSTRACT
Introduction: Spontaneous dissection of the superior mesenteric artery (AMS) is a infrecuent pathology, representing the main frequency of isolated peripheral artery dissection, it is more common in males and occurs in the fifth decade of life. Materials and Methods: Retrospective cases analysis of patients with spontaneous dissection of AMS that were handled in our hospital, in last two years. Results: Two patients were diagnosed in this period, both active smoking and hypertensive pathology, appearing with severe abdominal and back pain. The diagnosis was made by CT angiogram of the abdomen and pelvis; establishing medical management of hypertension and standard heparin anticoagulation. Both patients had dissections at new imaging controls and one patient required exploratory laparotomy with bowel resection and intestinal anastomosis. Patients recovered satisfactorily and are in control. Conclusions: Spontaneous dissection of the SMA is a rare disease with uncertain evolution, it may occur in middle age of life, associated with smoking and hypertension. The suspected diagnosis is clinical and can be confirmed by CT angiography. Initial management remains conservative and occasionally is surgical.
Introducción: La Disección espontánea de la arteria mesentérica superior (AMS) es una patología infrecuente, representando la primera frecuencia de disección de arteria periférica aislada, ocurre más en varones en la quinta década de la vida. Material y Método: Casos en los últimos 2 años revisados en forma retrospectiva. Resultados: Dos pacientes fueron diagnosticados en este período, presentándose ambos por dolor abdominal y lumbar de gran intensidad al Servicio de Urgencia del hospital; ambos tabáquicos activos y con hipertensión arterial (HTA). El diagnóstico fue realizado por angioTC de abdomen y pelvis, instaurándose manejo médico de HTA y anticoagulación con heparina estándar. Los 2 pacientes presentaron nuevas disecciones en los controles imagenológicos y un paciente requirió laparotomía exploradora con resección intestinal y anastomosis por isquemia intestinal. Los pacientes evolucionaron satisfactoriamente y se encuentran en control. Conclusiones: La disección espontánea de la AMS es una enfermedad poco frecuente de evolución incierta, que ocurre en la edad media de la vida, asociada a tabaquismo e HTA, la sospecha es clínica y el diagnóstico por imágenes. El manejo inicial sigue siendo médico y ocasionalmente es quirúrgico.
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Aortic Dissection , Aortic Dissection/therapy , Mesenteric Artery, Superior , Angiography , Rupture, Spontaneous , Tomography, X-Ray ComputedABSTRACT
Aberrant mucin O-glycosylation often occurs in different cancers and is characterized by immature expression of simple mucin-type carbohydrates. At present, there are some controversial reports about the Tn antigen (GalNAcα-O-Ser/Thr) expression and there is a great lack of information about the [UDP-N-acetyl-α-d-galactosamine:polypeptide N-acetylgalactosaminyltransferase (GalNAc-Ts)] expression in chronic lymphocytic leukemia (CLL). To gain insight in these issues we evaluated the Tn antigen expression in CLL patient samples using two Tn binding proteins with different fine specificity. We also studied the expression from 14 GalNAc-Ts genes in CLL patients by RT-PCR. Our results have provided additional information about the expression level of the Tn antigen, suggesting that a low density of Tn residues is expressed in CLL cells. We also found that GALNT11 was expressed in CLL cells and normal T cell whereas little or no expression was found in normal B cells. Based on these results, GALNT11 expression was assessed by qPCR in a cohort of 50 CLL patients. We found significant over-expression of GALNT11 in 96% of B-CLL cells when compared to normal B cells. Moreover, we confirmed the expression of this enzyme at the protein level. Finally we found that GALNT11 expression was significantly associated with the mutational status of the immunoglobulin heavy chain variable region (IGHV), [×(2)(1)=18.26; P<0.0001], lipoprotein lipase expression [×(2)(1)=13.72; P=0.0002] and disease prognosis [×(2)(1)=15.49; P<0.0001]. Our evidence suggests that CLL patient samples harbor aberrant O-glycosylation highlighted by Tn antigen expression and that the over-expression of GALNT11 constitutes a new molecular marker for CLL.
Subject(s)
Biomarkers, Tumor/blood , Leukemia, Lymphocytic, Chronic, B-Cell/blood , N-Acetylgalactosaminyltransferases/genetics , Base Sequence , DNA Primers , Humans , Jurkat Cells , Leukemia, Lymphocytic, Chronic, B-Cell/immunology , Real-Time Polymerase Chain Reaction , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
SETTING: Tijuana, Mexico. OBJECTIVE: To describe the association between salivary cotinine levels and interferon-gamma (IFN-γ) release assay results. DESIGN: We conducted a cross-sectional study among injection drug users. Salivary cotinine levels were measured using NicAlert, a semi-quantitative dipstick assay. QuantiFERON©-TB Gold In-Tube (QFT-GIT) was used to determine Mycobacterium tuberculosis infection. RESULTS: Among 234 participants, the prevalence of QFT-GIT positivity for NicAlert cotinine categories 0 (non-smoking), 1 (second-hand smoke exposure or low-level smoking) and 26 (regular smoking) were respectively 42.1%, 46.4% and 65.2% (Ptrend 0.012). We found increasing trends in QFT-GIT positivity (Ptrend 0.003) and IFN-γ concentrations (Spearman's r 0.200, P 0.002) across cotinine levels 0 to 6. In multivariable log-binomial regression models adjusted for education, cotinine levels were not associated with QFT-GIT positivity when included as smoking categories (1 and 26 vs. 0), but were independently associated with QFT-GIT positivity when included as an ordinal variable (prevalence ratio 1.09 per 1 cotinine level, 95%CI 1.021.16). CONCLUSION: Our findings suggest that a dose-response relationship exists between tobacco smoke exposure and M. tuberculosis infection. Longitudinal studies that use biochemical measures for smoking status are needed to confirm our findings.
Subject(s)
Cotinine/metabolism , Mycobacterium tuberculosis/isolation & purification , Saliva/metabolism , Smoking/metabolism , Tuberculosis/microbiology , Adult , Chi-Square Distribution , Cross-Sectional Studies , Dose-Response Relationship, Drug , Drug Users , Female , Humans , Interferon-gamma Release Tests , Male , Mexico/epidemiology , Middle Aged , Multivariate Analysis , Predictive Value of Tests , Prevalence , Reagent Strips , Risk Factors , Smoking/adverse effects , Smoking/epidemiology , Substance Abuse, Intravenous/epidemiology , Tuberculosis/diagnosis , Tuberculosis/epidemiologyABSTRACT
A growing body of literature reveals that the interactions among the parasite community may be strong and significant for parasite dynamics. There may be inter-specific antagonistic interactions as a result of competition and cross-effective immune response, or synergistic interactions where infection by one parasite is facilitated by another one, either by an impoverishment of the host's defenses, parasite-induced selective immunosuppression, or trade-offs within the immune system. The nature of these interactions may depend on how related are the parasite species involved. Here we explored the presence of associations among gastrointestinal parasites (coccidia and helminths) in natural populations of two wild mammal species, the capybara (Hydrochoerus hydrochaeris) and the guanaco (Lama guanicoe). The associations explored were between the oocyst outputs of a selected Eimeria species and the other coccidia of that parasite community, and between Eimeria spp. and the predominant nematodes. The statistical analysis included adjustment for potential confounders or effect modifiers. In guanacos, the prevailing interactions were synergistic among the coccidia and between coccidia and nematodes (Nematodirus spp.). However, in capybaras, the interaction between nematodes (Viannaiidae) and Eimeria spp. depended on environmental and host factors. The relationship was positive in some circumstances (depending on season, year, sex, or animal size), but it appeared to become antagonistic under different scenarios. These antagonist interactions did not follow a particular seasonal pattern (they occurred in autumn, spring, and summer), but they were predominantly found in females (when they depended on sex) or in 2010 and 2011 (when they depended on the sampling year). These results suggest that the relationship between coccidia and nematodes in capybaras may be context dependent. We propose that the context-dependent immune investment documented in capybaras may be the cause of these varying interactions.
Subject(s)
Camelids, New World/parasitology , Coccidiosis/veterinary , Intestinal Diseases, Parasitic/veterinary , Nematode Infections/veterinary , Rodent Diseases/parasitology , Rodentia/parasitology , Animals , Coccidia/physiology , Coccidiosis/parasitology , Coinfection , Eimeria/physiology , Environment , Feces/parasitology , Female , Host-Parasite Interactions , Intestinal Diseases, Parasitic/parasitology , Male , Nematoda/physiology , Nematode Infections/parasitology , Oocysts , Sex FactorsABSTRACT
Antecedentes: los quistes ováricos fetales son la primera causa de quiste intraabdominal en fetos femeninos. Método: se recogieron datos maternos, del parto, características del quiste y el manejo. Período de estudio: año 2006 y primer trimestre de 2012. Resultados: se diagnosticaron 10 casos, todos ellos durante el tercer trimestre. Más frecuentemente unilaterales y de localización izquierda. En 9 de los casos el parto fue eutócico y a término. Uno concluyó en cesárea por fallo de inducción, con pesos fetales y Apgar normales. Sólo uno requirió cirugía posparto, el resto desapareció o redujeron su tamaño posteriormente. Conclusiones: la ecografía del tercer trimestre es fundamental en el diagnóstico y seguimiento de los quistes ováricos fetales, los que suelen tener localización unilateral izquierda. Los quistes ováricos de menor tamaño (<5 cm), tienen un mejor pronóstico y la mayoría se resuelven espontáneamente o no aumentan su tamaño. Se recomienda una actitud conservadora y seguimiento posnatal de los fetos. Aquellos quistes que superan los 5 cm y no disminuyen de tamaño pueden precisar tratamiento quirúrgico posparto.
Background: fetal ovarian cysts are the main cause of abdominal cysts in female fetuses. Methods: were collected maternal data, delivery, cyst characteristics and management. Study period: 2006 and first quarter of 2012. Results: 10 cases were diagnosed, all of them in the third trimester. The majority had unilateral left location. In 9 cases the birth was euthocic and one case of cesarean because of failure of induction. All of them with normal Apgar test and weights. One case needed postnatal surgery. The rest of the ovarian cyst solved spontaneously or reduced their sizes later. Conclusions: ultrasound of the third trimester is critical in the diagnosis and management of fetal ovarian cysts, which are usually left unilateral location. Ovarian cysts <5 cm, have a better prognosis and most resolve spontaneously or not increase in size. We recommend a conservative approach and postnatal ultrasound monitoring. Those cysts which exceed 5 cm and not shrink postpartum may require surgical treatment.