ABSTRACT
BACKGROUND: Most preventing measures for reducing ventilator-associated pneumonia (VAP) are based mainly on the decolonization of the internal surface of the endotracheal tubes (ETTs). However, it has been demonstrated that bacterial biofilm can also be formed on the external surface of ETTs. Our objective was to test in vitro the efficacy of selective digestive decontamination solution (SDDs) onto ETT to prevent biofilm formation and eradicate preformed biofilms of three different microorganisms of VAP. METHODS: We used an in vitro model in which we applied, at the subglottic space of ETT, biofilms of either P. aeruginosa ATCC 15442, or E. coli ATCC 25922, or S. aureus ATCC 29213, and the SDDs at the same time (prophylaxis) or after 72 h of biofilm forming (treatment). ETT were incubated during 5 days with a regimen of 2 h-locks. ETT fragments were analyzed by sonication and confocal laser scanning microscopy to calculate the percentage reduction of cfu and viable cells, respectively. RESULTS: Median (IQR) percentage reduction of live cells and cfu/ml counts after treatment were, respectively, 53.2% (39.4%-64.1%) and 100% (100%-100.0%) for P. aeruginosa, and 67.9% (46.7%-78.7%) and 100% (100%-100.0%) for E. coli. S. aureus presented a complete eradication by both methods. After prophylaxis, there were absence of live cells and cfu/ml counts for all microorganisms. CONCLUSIONS: SDDs used as "lock therapy" in the subglottic space is a promising prophylactic approach that could be used in combination with the oro-digestive decontamination procedure in the prevention of VAP.
Subject(s)
Anti-Bacterial Agents/pharmacology , Biofilms/drug effects , Decontamination/methods , Escherichia coli/drug effects , Pseudomonas aeruginosa/drug effects , Colony Count, Microbial , Equipment Contamination/prevention & control , Escherichia coli/physiology , Humans , Intubation, Intratracheal/instrumentation , Microscopy, Confocal , Microscopy, Electron, Scanning , Pneumonia, Ventilator-Associated/prevention & control , Pseudomonas aeruginosa/physiologyABSTRACT
Resumen: Objetivo: Describir la ocurrencia de eventos potencialmente traumáticos (EPT) en estudiantes de preparatoria, medir la sintomatología postraumática subumbral en quienes aún sufren repercusiones de un EPT y asociar la sintomatología con variables sociodemográficas y características del EPT. Material y métodos: Estudio transversal analítico realizado en un muestra por conveniencia de 1000 estudiantes de tres preparatorias del Estado de México. Se aplicó la Escala para Estrés Postraumático en Universitarios Mexicanos. Se evaluó la presencia de síntomas y su frecuencia; la asociación con variables explicativas se realizó con modelos de regresión logística y cuantílica, respectivamente. Resultados: 80% reportó un EPT. De éstos, 79% aún sufría repercusiones actuales y casi la mitad de ellos presentó sintomatología. El sexo, número de eventos y características del EPT (cambios percibidos y gravedad) se encontraron asociados. Conclusiones: Los resultados sugieren intervenir tempranamente para disminuir el riesgo de desarrollar un trastorno.
Abstract: Objective: Describe the occurrence of potentially traumatic events (PTE) in high-school students, measure subthreshold post-traumatic symptomatology in those who still experience PTE repercussions and associate the symptomatology with sociodemographic and PTE characteristics. Materials and methods: Analytic transversal study carried out in a convenience sample of one thousand students from three high schools in the State of Mexico. The Scale for Post Traumatic Stress in University Students was applied. The presence of symptoms, their frequency and their association with explanatory variables was assessed by means of logistic and quantile logistic regression models, respectively. Results: 80% reported PTE. Of this, 79% still experienced current repercussions and almost a half presented symptomatology. Gender, number of events, and PTE characteristics (perceived and grave symptoms) were associated. Conclusions: Results suggest to intervene early to reduce the risk of developing a disorder.
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Stress Disorders, Post-Traumatic/epidemiology , Life Change Events , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Logistic Models , Prevalence , Cross-Sectional Studies , Symptom AssessmentABSTRACT
OBJECTIVE: Describe the occurrence of potentially traumatic events (PTE) in high-school students, measure subthreshold post-traumatic symptomatology in those who still experience PTE repercussions and associate the symptomatology with sociodemographic and PTE characteristics. MATERIALS AND METHODS: Analytic transversal study carried out in a convenience sample of one thousand students from three high schools in the State of Mexico. The Scale for Post Traumatic Stress in University Students was applied. The presence of symptoms, their frequency and their association with explanatory variables was assessed by means of logistic and quantile logistic regression models, respectively. RESULTS: 80% reported PTE. Of this, 79% still experienced current repercussions and almost a half presented symptomatology. Gender, number of events, and PTE characteristics (perceived and grave symptoms) were associated. CONCLUSIONS: Results suggest to intervene early to reduce the risk of developing a disorder.
OBJETIVO: Describir la ocurrencia de eventos potencialmente traumáticos (EPT) en estudiantes de preparatoria, medir la sintomatología postraumática subumbral en quienes aún sufren repercusiones de un EPT y asociar la sintomatología con variables sociodemográficas y características del EPT. MATERIAL Y MÉTODOS: Estudio transversal analítico realizado en un muestra por conveniencia de 1000 estudiantes de tres preparatorias del Estado de México. Se aplicó la Escala para Estrés Postraumático en Universitarios Mexicanos. Se evaluó la presencia de síntomas y su frecuencia; la asociación con variables explicativas se realizó con modelos de regresión logística y cuantílica, respectivamente. RESULTADOS: 80% reportó un EPT. De éstos, 79% aún sufría repercusiones actuales y casi la mitad de ellos presentó sintomatología. El sexo, número de eventos y características del EPT (cambios percibidos y gravedad) se encontraron asociados. CONCLUSIONES: Los resultados sugieren intervenir tempranamente para disminuir el riesgo de desarrollar un trastorno.
Subject(s)
Life Change Events , Stress Disorders, Post-Traumatic/epidemiology , Adolescent , Cross-Sectional Studies , Female , Humans , Logistic Models , Male , Prevalence , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Symptom Assessment , Young AdultABSTRACT
BACKGROUND: : Renal biopsy is an important tool in devising an adequate treatment plan for lupus nephritis. However, it is not always possible to perform a biopsy, and in many cases, treatment must rely exclusively on clinical data. OBJECTIVE: : The aim of this study was to compare the 5-year course of patients treated without a biopsy with another group with histologic evidence of diffuse proliferative glomerulonephritis (DPGN). METHODS: : The no-biopsy group consisted of 30 patients with lupus with strong clinical and laboratory suspicion of proliferative glomerulonephritis in whom a renal biopsy was unavailable either because of medical contraindication or the patient's refusal. The biopsy group included 30 patients undergoing biopsy and a histologic diagnosis of DPGN. Patients were followed from the onset of nephritis and at 18, 36, and 60 months. RESULTS: : At onset, the no-biopsy group showed lower C3 levels and higher proteinuria, although both groups showed evident deterioration of the renal function. No significant differences were found in treatment, outcome, survival, renal function tests, or in the development of kidney failure. CONCLUSIONS: : Proliferative glomerulonephritis deserves prompt diagnosis and treatment. This study demonstrates that experience in the management of lupus nephropathy, together with clinical and laboratory data, are often enough information to adequately treat proliferative glomerulonephritis even in the absence of a renal biopsy.
