Incomplete recovery of the CD4+/CD8+ ratio is associated with the late introduction of antiretroviral therapy among people living with HIV infection

ABSTRACT Despite being subject to lower AIDS-related mortality rates and having a higher life expectancy, patients with HIV are more prone to develop non-AIDS events. A low CD4+/CD8+ ratio during antiretroviral therapy identifies people with heightened immune senescence and increased risk of mortality. In clinical practice, finding determinants of a low CD4+/CD8+ ratio may be useful for identifying patients who require close monitoring due to an increased risk of comorbidities and death. We performed a prospective study on the evolution of the CD4+/CD8+ ratio in 60 patients infected with HIV (80% males), who were subjected to two different antiretroviral regimens: early and deferred therapy. The initial CD4+/CD8+ ratio was ≤1 for 70% of the patients in both groups. Older age, CD4+ cell count at inclusion, Nadir CD8+T-cell count, and Initial CD4+/CD8+ ratio ≤ 1 were risk factors for lack of ratio recovery. In the multivariate analysis, a CD4+/CD8+ ratio > 1 at the start of the treatment was found to be a determinant factor in maintaining a CD4+/CD8+ ratio > 1. The nadir CD4+T-cell count was lower in the deferred therapy group (p=0.004), and the last CD4+/CD8+ ratio ≤1 was not associated with comorbidities. Ratio recovery was not associated with the duration of HIV infection, time without therapy, or absence of AIDS incidence. A greater improvement was observed in patients treated early (p=0.003). In contrast, the slope of increase was slower in patients who deferred treatment. In conclusion, the increase in the CD4+/CD8+ ratio occurred mostly for patients undergoing early strategy treatment and its extension did not seem to be related to previous HIV-related factors.

Advances in Material Modification with Smart Functional Polymers for Combating Biofilms in Biomedical Applications.

Biofilms as living microorganism communities are found anywhere, and for the healthcare sector, these constitute a threat and allied mechanism for health-associated or nosocomial infections. This review states the basis of biofilms and their formation. It focuses on their relevance for the biomedical sector, generalities, and the major advances in modified or new synthesized materials to prevent or control biofilm formation in biomedicine. Biofilm is conceptualized as an aggregate of cells highly communicated in an extracellular matrix, which the formation obeys to molecular and genetic basis. The biofilm offers protection to microorganisms from unfavorable environmental conditions. The most frequent genera of microorganisms forming biofilms and reported in infections are Staphylococcus spp., Escherichia spp., and Candida spp. in implants, heart valves, catheters, medical devices, and prostheses. During the last decade, biofilms have been most commonly related to health-associated infections and deaths in Europe, the United States, and Mexico. Smart, functional polymers are materials capable of responding to diverse stimuli. These represent a strategy to fight against biofilms through the modification or synthesis of new materials. Polypropylene and poly-N-isopropyl acrylamide were used enough in the literature analysis performed. Even smart polymers serve as delivery systems for other substances, such as antibiotics, for biofilm control.

Caracterización clínica y sociodemográfica de Diabetes Mellitus en pacientes pediátricos del Hospital Regional de la Orinoquía, Yopal, Colombia

Introducción: La Diabetes Mellitus (DM) es una alteración metabólica crónica, creciente en la población pediátrica que conduce a múltiples complicaciones micro y macrovasculares. Es un problema de salud pública por los altos costos que conlleva el diagnóstico y tratamiento. Según la Federación Internacional de Diabetes (IFD), la incidencia anual en el mundo está aumentando, debido a que la prevalencia de edad entre 0-14 años es de 98.2% y de 0-19 años es de 128.9% entre el 2019 y 2021 con una incidencia de 108.3% y 149.5%, respectivamente, por 100.000 habitantes en 215 países. Objetivo: Describir las características clínicas de un grupo de niños y adolescentes que ingresaron al servicio de urgencias del Hospital Regional de la Orinoquía (HORO) de Yopal-Casanare, en el período 2019 -2020 con diagnóstico de novo o previo de diabetes mellitus. Metodología: Se realizó un estudio observacional, descriptivo y retrospectivo, tipo serie de casos, donde se incluyeron pacientes menores de 18 años con diagnóstico de novo o previo de diabetes mellitus en el período de 2019 -2020 en el Hospital Regional de la Orinoquía. Se analizaron un total de 15 pacientes. Resultados: Se muestra la clasificación de los pacientes según grupo de edades y sexo, se encuentra predominio del género masculino con un 53,3% de los 15 pacientes que cumplían con los criterios diagnósticos, mientras que la población femenina fue de 46,6%. La edad promedio de los pacientes pediátricos fue de 13 ± 13.2 Conclusiones: En el estudio realizado en el Hospital regional de la Orinoquía, la edad entre 11 - 13 años es la más frecuente para DM, con un predominio significativo del sexo masculino, provenientes de áreas urbanas. Se halló que el bajo peso es un dato alarmante, además de valores de glicemia alterados que se relacionan con las complicaciones presentadas al momento del ingreso del paciente, lo cual representa un problema de salud pública entre niños y adultos jóvenes debido a la heterogeneidad, del factor genético y ambiental.

Introduction: Diabetes mellitus (DM) is a chronic metabolic disorder that is increasing in the pediatric population and leads to multiple microvascular and macrovascular complications. It is a public health problem due to the high costs of diagnosis and treatment. According to the International Diabetes Federation (IFD) the annual incidence in the world is increasing, due to an age prevalence between 0-14 years of 98.2% and 0-19 years of 128.9% between 2019 and 2021 with an incidence of 108.3% and 149.5% respectively per 100,000 inhabitants in 215 countries. Objective: To describe the clinical characteristics of a group of children and adolescents admitted to the emergency department of the Hospital Regional de la Orinoquía (HORO) in Yopal-Casanare in the period 2019 to 2020 with de novo or previous diagnosis of diabetes mellitus. Methodology: An observational, descriptive, and retrospective study, case series type, where patients under 18 years of age with de novo or previous diagnosis of diabetes mellitus were included in the period from 2019 to 2020 in the Orinoquía Regional Hospital. Results: The classification of the patients according to age group and sex shows a predominance of the male gender with 53.3% of the 15 patients who met the diagnostic criteria, while the female population was 46.6%. The average age of the pediatric patients was 13 ± 13.2 Conclusions: The study carried out at the Hospital Regional de la Orinoquía showed that the most frequent age group was 11 to 13 years old, with a significant predominance of males, coming from urban areas. It was found that low weight is an alarming fact plus altered glycemia values are related to the complications presented at the time of the patient's admission, which represents a public health problem among children and young adults due to the heterogeneity of the genetic and environmental factors.

In Vivo ETosis of Human Eosinophils: The Ultrastructural Signature Captured by TEM in Eosinophilic Diseases.

Eosinophilic diseases, also termed eosinophil-associated diseases (EADs), are characterized by eosinophil-rich inflammatory infiltrates and extensive eosinophil degranulation with clinically relevant organ pathology. Recent evidence shows that eosinophil cytolytic degranulation, that is, the release of intact, membrane-delimited granules that arises from the eosinophil cytolysis, occurs mainly through ETosis, meaning death with a cytolytic profile and extrusion of nucleus-originated DNA extracellular traps (ETs). The ultrastructural features of eosinophil ETosis (EETosis) have been studied mostly in vitro after stimulation, but are still poorly understood in vivo. Here, we investigated in detail, by transmission electron microscopy (TEM), the ultrastructure of EETosis in selected human EADs affecting several tissues and organ systems. Biopsies of patients diagnosed with eosinophilic chronic rhinosinusitis/ECRS (frontal sinus), ulcerative colitis/UC (intestine), and hypereosinophilic syndrome/HES (skin) were processed for conventional TEM. First, we found that a large proportion of tissue-infiltrated eosinophils in all diseases (~45-65% of all eosinophils) were undergoing cytolysis with release of free extracellular granules (FEGs). Second, we compared the morphology of tissue inflammatory eosinophils with that shown by in vitro ETosis-stimulated eosinophils. By applying single-cell imaging analysis, we sought typical early and late EETosis events: chromatin decondensation; nuclear delobulation and rounding; expanded nuclear area; nuclear envelope alterations and disruption; and extracellular decondensed chromatin spread as ETs. We detected that 53% (ECRS), 37% (UC), and 82% (HES) of all tissue cytolytic eosinophils had ultrastructural features of ETosis in different degrees. Eosinophils in early ETosis significantly increased their nuclear area compared to non-cytolytic eosinophils due to excessive chromatin decondensation and expansion observed before nuclear envelope disruption. ETosis led not only to the deposition of intact granules, but also to the release of eosinophil sombrero vesicles (EoSVs) and Charcot-Leyden crystals (CLCs). Free intact EoSVs and CLCs were associated with FEGs and extracellular DNA nets. Interestingly, not all cytolytic eosinophils in the same microenvironment exhibited ultrastructure of ETosis, thus indicating that different populations of eosinophils might be selectively activated into this pathway. Altogether, our findings captured an ultrastructural signature of EETosis in vivo in prototypic EADs highlighting the importance of this event as a form of eosinophil degranulation and release of inflammatory markers (EoSVs and CLCs).

Complicaciones crónicas y enfermedades asociadas en adultos mayores con diabetes mellitus tipo 2 en Punta Brava, Cuba de enero a junio de 2019 / Chronic complications and associated diseases in older adults with type 2 diabetes mellitus in Punta Brava, Cuba from January to June 2019

Introducción: Con el envejecimiento de las poblaciones se produce un aumento de las enfermedades crónicas no trasmisibles, entre ellas la diabetes mellitus tipo 2. Esta constituye un serio problema de salud pública a nivel mundial por su elevada prevalencia, crecimiento constante, complicaciones crónicas y mortalidad. Objetivo: Identificar las complicaciones crónicas de la diabetes mellitus tipo 2 y las enfermedades asociadas en personas de 60 años y más en el poblado de Punta Brava. Métodos: Se realizó un estudio descriptivo y transversal a partir de los gerontes con diabetes que asistieron a la consulta de Medicina Interna en el periodo de enero a junio de 2019. Con la información recopilada de las historias clínicas se creó una base de datos en Visual FoxPro 8.0. Resultados: Predominó el grupo de edad de 60 a 69 años y el sexo femenino. La hipertensión arterial fue la enfermedad asociada más frecuente con 86,0 por ciento, seguida por la cardiopatía isquémica con 70,6 por ciento y la enfermedad cerebrovascular con 67,0 por ciento. La polineuropatía diabética fue la complicación crónica más representativa (79,3 por ciento), seguida de la nefropatía (15,0 por ciento) que aparece a mayor tiempo de evolución de la enfermedad. Conclusiones: Predominó la hipertensión arterial y la enfermedad cerebrovascular como padecimientos asociados en adultos mayores con diabetes tipo 2. La polineuropatía y la nefropatía diabéticas fueron las complicaciones crónicas más frecuentes con diferencias según el sexo y relacionadas con el mayor tiempo de evolución(AU)

Introduction: The aging of populations also brings an increase in chronic non-communicable diseases, including type 2 diabetes mellitus, which constitutes a serious public health problem worldwide due to the high prevalence, constant growth, chronic complications and mortality. Objective: To identify the chronic complications of type 2 diabetes mellitus and associated diseases in people aged 60 years and older in Punta Brava town. Methods: A descriptive and cross-sectional study was carried out from the elderly with diabetes who attended the Internal Medicine consultation from January to June 2019. A database was created in Visual Fox Pro 8.0 with the information collected from the medical records. Results: The age group of 60 to 69 years and the female sex prevailed. Hypertension was the most frequent associated disease (86.0 percent), followed by ischemic heart disease (70.6 percent) and cerebrovascular disease (67.0 percent). Diabetic polyneuropathy was the most representative chronic complication (79.3 percent), followed by nephropathy (15.0 percent), appearing later in the course of the disease. Conclusions: Hypertension and cerebrovascular disease predominated as associated conditions in older adults with type 2 diabetes. Diabetic polyneuropathy and nephropathy were the most frequent chronic complications, with differences according to sex and related to the longest evolution time(AU)

Caracterización clínica y de gravedad de adultos con COVID-19 hospitalizados / Clinical and severity characterization of hospitalized adults with COVID-19

Se realizó una investigación de tipo cuantitativa, observacional, descriptiva y transversal en adultos ingresados en el Hospital General Alfredo Noboa Montenegro, de Guaranda, Ecuador, desde el 1ro. de julio al 30 de septiembre del 2020. Se realizó una caracterización clínica y de gravedad de adultos con COVID-19 hospitalizada. Se encontró que en el caso de presentar enfermedad cardiometabólica se aumenta la probabilidad de presentar los indicadores de gravedad (p<0,05). Presentar otras enfermedades asociadas (no cardiometabólicas) también incrementó la probabilidad de presentar indicadores de gravedad con un nivel de significación del 5%, al igual que padecer de asma bronquial (p<0,05 para ambas características); en el caso del tabaquismo solo fue estadísticamente significativo el aumento de la probabilidad de ingreso en el hospital, de presentar neumonía y de fallecer (p<0,05 para las tres variables). Los resultados de este estudio pueden usarse para identificar los factores de riesgo asociados con un mal pronóstico en pacientes con COVID-19 en Ecuador y ayudar a desarrollar medidas preventivas para disminuir la carga de la enfermedad y trazar estrategias para el manejo de los casos(AU)

A quantitative, observational, descriptive and cross-sectional investigation was carried out in adults admitted to the Alfredo Noboa Montenegro General Hospital, in Guaranda, Ecuador, from the 1st. from July to September 30, 2020. A clinical and severity characterization of hospitalized adults with COVID-19 was carried out. It was found that in the case of presenting cardiometabolic disease, the probability of presenting severity indicators is increased (p<0.05). Presenting other associated diseases (not cardiometabolic) also increased the probability of presenting severity indicators with a significance level of 5%, as well as suffering from bronchial asthma (p<0.05 for both characteristics); In the case of smoking, only the increase in the probability of hospital admission, pneumonia and death was statistically significant (p<0.05 for the three variables). The results of this study can be used to identify risk factors associated with a poor prognosis in patients with COVID-19 in Ecuador and help develop preventive measures to reduce the burden of the disease and devise strategies for case management(AU)

Complicaciones posquirúrgicas en pacientes con aneurisma de la aorta abdominal operados electivamente / Post-surgical complications in patients with electively operated abdominal aortic aneurysm

Introducción: Los aneurismas aórticos abdominales constituyen un problema de salud por la alta mortalidad que provocan. Su seguimiento y tratamiento son fundamentales para evitar las complicaciones posquirúrgicas. Objetivo: Caracterizar las principales complicaciones posquirúrgicas de los pacientes con aneurisma de la aorta abdominal operados electivamente. Métodos: Se realizó un estudio observacional y descriptivo en 94 pacientes operados de forma electiva en el Instituto Nacional de Angiología y Cirugía Vascular por presentar un diagnóstico de aneurisma de la aorta abdominal. Las variables de estudio fueron: edad, sexo, color de la piel, enfermedades asociadas, diámetro del aneurisma, profilaxis antibiótica, tiempo quirúrgico, tipo de prótesis vascular, tipo de complicación posoperatoria, tiempo de aparición de las complicaciones, estadía hospitalaria posoperatoria y estado al egreso. Se determinaron las frecuencias absolutas y relativas. Resultados: El 56,4 por ciento de los pacientes operados presentó algún tipo de complicación, las cuales fueron más frecuentes en el sexo masculino por encima de los 60 años. Las más predominantes resultaron la bronconeumonía (24,5 por ciento) y las arritmias cardíacas (20,8 por ciento). La proporción de complicaciones se mostró mayor en los pacientes con injertos bifurcados, así como en aquellos sin profilaxis y con un tiempo quirúrgico prolongado. Hubo mayor frecuencia de enfermedades cardiovasculares entre los fallecidos. Conclusiones: En los pacientes operados de forma electiva de aneurisma de la aorta abdominal predominaron las complicaciones respiratorias y cardiovasculares, estas últimas provocaron un aumento en la mortalidad(AU)

Introduction: Abdominal aortic aneurysms are a health problem because of the high mortality they cause. Their follow-up and treatment are essential to avoid post-surgical complications. Objective: Characterize the main post-surgical complications of patients with electively operated abdominal aortic aneurysm. Methods: An observational and descriptive study was conducted in 94 electively operated patients at the National Institute of Angiology and Vascular Surgery after having a diagnosis of abdominal aortic aneurysm. The study variables were: age, sex, skin color, associated diseases, aneurysm diameter, antibiotic prophylaxis, surgical time, type of vascular prosthesis, type of postoperative complication, time of onset of complications, postoperative hospital stay, and state at discharge moment. Absolute and relative frequencies were determined. Results: 56.4 percent of operated patients had some form of complication, which were more common in the males over 60 years. The most predominant complications were bronchopneumonie (24.5 percent) and cardiac arrhythmias (20.8 percent). The proportion of complications was shown to be higher in patients with forked grafts, as well as in those without prophylaxis and with prolonged surgical time. There was a higher frequency of cardiovascular diseases among the deceased patients. Conclusions: In patients electively operated of abdominal aortic aneurysm, there was a predominance of respiratory and cardiovascular complications, and the latter caused an increase in mortality(AU)

Hallmarks of Aging in Macrophages: Consequences to Skin Inflammaging.

The skin is our largest organ and the outermost protective barrier. Its aging reflects both intrinsic and extrinsic processes resulting from the constant insults it is exposed to. Aging in the skin is accompanied by specific epigenetic modifications, accumulation of senescent cells, reduced cellular proliferation/tissue renewal, altered extracellular matrix, and a proinflammatory environment favoring undesirable conditions, including disease onset. Macrophages (Mφ) are the most abundant immune cell type in the skin and comprise a group of heterogeneous and plastic cells that are key for skin homeostasis and host defense. However, they have also been implicated in orchestrating chronic inflammation during aging. Since Mφ are related to innate and adaptive immunity, it is possible that age-modified skin Mφ promote adaptive immunity exacerbation and exhaustion, favoring the emergence of proinflammatory pathologies, such as skin cancer. In this review, we will highlight recent findings pertaining to the effects of aging hallmarks over Mφ, supporting the recognition of such cell types as a driving force in skin inflammaging and age-related diseases. We will also present recent research targeting Mφ as potential therapeutic interventions in inflammatory skin disorders and cancer.

Detection of polyomavirus microRNA-5p expression in saliva shortly after kidney transplantation.

Background: MicroRNAs (miRNAs) of polyomavirus (PyV) are present in several biological fluids and are suggested to be relevant viral factors for monitoring its persistence. Aim: To evaluate the effect of an immunosuppressive regimen on the status of PyV-miRNA-5p in the oral cavity. Materials and Methods: The JCPyV, BKPyV, MCPyV miRNA-5p were investigated in paired saliva and plasma samples obtained from 23 patients before and shortly after renal-transplantation by using real-time RT-PCR. Results: Overall, within a short-time after transplantation, patients exhibited decreased numbers of leukocyte and lymphocyte as well as low levels of creatinine. During the clinical management of the patients, a significant amount of saliva samples were positive for JCPyV and BKPyV miRNA-5p (range: 26%-91%) compared to paired plasma samples (range: 9%-35%). Among the two polyomaviruses showing positive expression of miRNA-5p, BKPyV presented the highest positivity in saliva (91%) and MCPyV-miRNA-5p was constantly negative in both saliva and plasma samples. Compared to the time before transplantation, a significant reduction in the expression of JCPyV-miRNA-5p was observed in saliva samples obtained after transplantation. Conclusions: Altogether, these data suggest that additional investigations of polyomavirus miRNA-5p in saliva should be performed shortly after renal-transplantation to evaluate the potential role in early viral reactivation.

Estado nutricional en adultos de población rural en un cantón de la sierra ecuatoriana / Nutritional Status in Adults of Rural Population in a Canton of the Ecuadorian Highlands / Estado nutricional en adultos de população rural em um cantão da serra equatoriana

Resumen Introduction: La desnutrición es un problema de salud en el mundo, y la Sierra ecuatoriana es una región bastante afectada por dicha situación. En esta investigación, se evaluó el estado nutricional de la población adulta no hospitalizada de un cantón de dicha zona. Materiales y métodos: se realizó un estudio observational, descriptivo, de corte transversal en una muestra de 115 pacientes adultos del cantón Cevallos, en la región Sierra del Ecuador durante el periodo de abril a septiembre del 2016. Para determinar el estado nutricional, se utilizó el cálculo del índice de masa corporal. Las enfermedades asociadas se determinaron a partir de la anamnesis de cada uno de los pacientes. Todos los resultados fueron evaluados mediante la determinación de valores porcentuales y se utilizó el coeficiente de correlación de Pearson para determinar la relación entre estado nutricional y enfermedades asociadas. Resultados: el 82.61% de los pacientes estaban desnutridos. El 69.56% presentaba enfermedades asociadas a un predominio de hipertensión arterial (41.84%), diabetes mellitus (21.44%) y cardiopatía isquémica (18.37%). La correlación desnutrición-enfermedades asociadas fue prácticamente nula. Conclusiones: conocer el estado de salud de la población de los adultos pertenecientes al cantón Cevallos, permitió crear los espacios necesarios para garantizar atención médica en el desarrollo de las actividades de la población, así como diseñar un programa de charlas educativas para los beneficiarios.

Abstract Introduction: Malnutrition is a global health problem, which includes, in Ecuador, the rural population of the Sierra. This is why it was decided to evaluate the nutritional status of the non-hospitalized adults of an Ecuadorian mountains canton. Materials and methods: The study carried out was an observational, descriptive, cross-sectional study with a sample of 115 mature patients of the canton Cevallos in Ecuador's Sierra region during the period April-September 2016. To determine the nutritional state, the calculation of the Body Mass Index (BMI) was used. The associate illnesses were determined, starting from the anamnesis to each one of the patients. All the results were evaluated by means of the determination of percentage values; the Pearson correlation coefficient was used to determine the relationship between BMI and associated diseases. Results: The patients' 82.6% was undernourished; 69.57% presented illnesses associated with the prevalence of arterial hypertension (41.84 °%), diabetes Mellitus (21.43 °%), and ischemic cardiopathy (18.37 °/o). All the patients considered as very satisfactory the intervention strategy. The correlation between malnutrition and associated diseases was practically nil. Conclusions: Knowing the state of the populations of the adults belonging to the canton health, Cevallos propitiated the creation of the necessary spaces to guarantee the medical care in the development of the population's activities, as well as to design a program of educational chats to the patient beneficiaries.

Resumo Introdução: a desnutrição constitui um problema de saúde mundial, onde se inclui, no Equador, à população rural da região serra do país, motivo pelo que se decidiu avaliar o estado nutricional da população adulta não hospitalizada de um cantão a região Serra do Equador. Materiais e métodos: se realizou um estudo observacional, descritivo, de corte transversal em uma amostra de 115 participantes adultos do cantão Cevallos na região Serra do Equador durante o período abril-setembro 2016. Para determinar o estado nutricional se utilizou o cálculo do Índice de Massa Corporal. As doenças associadas determinaramse a partir da anamnese a cada um dos pacientes. Todos os resultados foram avaliados mediante a determinação de valores percentuais e se utilizou o coeficiente de correlação de Pearson para determinar a relação entre estado nutricional e doenças associadas. Resultados: o 82.61%> dos pacientes estavam desnutridos. O 69.56%> apresentava doenças associadas a predomínio de hipertensão arterial (41.84%>), diabetes mellitus (21.44%>) e cardiopatia isquêmica (18.37%>). A correlação desnutrição-doença associada foi praticamente nula. Conclusões: Conhecer o estado de saúde da população dos adultos pertencentes ao cantão Cevallos propiciou criar os espaços necessários para garantir a atenção médica no desenvolvimento das atividades da população, assim como desenhar um Programa de Palestras Educativas aos beneficiários.

The emerging role of Wnt signaling dysregulation in the understanding and modification of age-associated diseases.

Wnt signaling is a highly conserved pathway that participates in multiple aspects of cellular function during development and in adults. In particular, this pathway has been implicated in cell fate determination, proliferation and cell polarity establishment. In the brain, it contributes to synapse formation, axonal remodeling, dendrite outgrowth, synaptic activity, neurogenesis and behavioral plasticity. The expression and distribution of Wnt components in different organs vary with age, which may have important implications for preserving tissue homeostasis. The dysregulation of Wnt signaling has been implicated in age-associated diseases, such as cancer and some neurodegenerative conditions. This is a relevant research topic, as an important research avenue for therapeutic targeting of the Wnt pathway in regenerative medicine has recently been opened. In this review, we discuss the recent findings on the regulation of Wnt components during aging, particularly in brain functioning, and the implications of Wnt signaling in age-related diseases.

Micoplasma hyopneumoniae associado ao circovírus suíno tipo 2 em plantéis não vacinados para micoplasmose / Mycoplasma hyopneumoniae associated with porcine circovirus type 2 in non-vaccinated herds for mycoplasmosis

A síndrome circovirose suína e doenças associadas (PCVAD) tem sido descrita em diversas regiões do mundo. Seu agente primário, o circovírus suíno tipo 2 (PCV2), está associado a elevados índices de refugagem nas granjas e a vultuosos prejuízos econômicos. Diversos fatores de risco estão relacionados à manifestação dos quadros clínicos da síndrome, nomeadamente deficiências de manejo, presença de coinfecções e imunização diante do agente. Entre os agentes frequentemente relatados associados ao PCV2 está o Mycoplasma hyopneumoniae. Este estudo objetivou verificar a ocorrência de M. hyopneumoniae em animais diagnosticados estarem acometidos pela PCVAD, em sistemas intensivos de produção de suínos do estado de Goiás. Amostras de secreção nasal de 40 animais foram analisadas para a pesquisa do DNA de M. hyopneumoniae. Do total das amostras de secreção nasal, 6 (15%) foram positivas na reação em cadeia da polimerase (PCR) para o M. hyopneumoniae, apenas em granjas que não praticavam a vacinação contra esse agente. Os resultados relacionados à presença de micoplasma estão de acordo com os achados clínicos dos animais analisados que apresentavam sintomatologia de doenças respiratórias e lesões relacionadas ao trato respiratório. Este é o primeiro relato da associação de PCV2 com M. hyopneumoniae em suínos identificados com PCVAD no estado de Goiás.(AU)

Porcine circovirus associated diseases (PCVAD) have been reported around the world. They are associated with high culling rates and large economic losses. Porcine circovirus type 2 (PCV2) is the primary causative agent. Several risk factors are related to the manifestation of clinical syndrome, including deficiencies of management, presence of co-infections and immunization against involved agents. Mycoplasma hyopneumoniae is often reported as an agent associated to PCV2 infections. The aim of this study was to verify the occurrence of M. hyopneumoniae in animals diagnosed with PCVAD in intensive pig farming systems in Goiás, Brazil. Forty nasal secretion samples were collected for M. hyopneumoniae DNA detection by polymerase chain reaction (PCR). Out of this, 6 (15%) were positive for M. hyopneumoniae DNA. All positive samples were collected from animals in non-vaccinated herds. Mycoplasma has been detected in animals showing clinical signs and lesions of respiratory diseases. To our knowledge, this is the first report of PCV2 association with M. hyopneumoniae in pigs with PCVAD identified in the state of Goiás, Brazil.(AU)

Micoplasma hyopneumoniae associado ao circovírus suíno tipo 2 em plantéis não vacinados para micoplasmose / Mycoplasma hyopneumoniae associated with porcine circovirus type 2 in non-vaccinated herds for mycoplasmosis

A síndrome circovirose suína e doenças associadas (PCVAD) tem sido descrita em diversas regiões do mundo. Seu agente primário, o circovírus suíno tipo 2 (PCV2), está associado a elevados índices de refugagem nas granjas e a vultuosos prejuízos econômicos. Diversos fatores de risco estão relacionados à manifestação dos quadros clínicos da síndrome, nomeadamente deficiências de manejo, presença de coinfecções e imunização diante do agente. Entre os agentes frequentemente relatados associados ao PCV2 está o Mycoplasma hyopneumoniae. Este estudo objetivou verificar a ocorrência de M. hyopneumoniae em animais diagnosticados estarem acometidos pela PCVAD, em sistemas intensivos de produção de suínos do estado de Goiás. Amostras de secreção nasal de 40 animais foram analisadas para a pesquisa do DNA de M. hyopneumoniae. Do total das amostras de secreção nasal, 6 (15%) foram positivas na reação em cadeia da polimerase (PCR) para o M. hyopneumoniae, apenas em granjas que não praticavam a vacinação contra esse agente. Os resultados relacionados à presença de micoplasma estão de acordo com os achados clínicos dos animais analisados que apresentavam sintomatologia de doenças respiratórias e lesões relacionadas ao trato respiratório. Este é o primeiro relato da associação de PCV2 com M. hyopneumoniae em suínos identificados com PCVAD no estado de Goiás.(AU)

Porcine circovirus associated diseases (PCVAD) have been reported around the world. They are associated with high culling rates and large economic losses. Porcine circovirus type 2 (PCV2) is the primary causative agent. Several risk factors are related to the manifestation of clinical syndrome, including deficiencies of management, presence of co-infections and immunization against involved agents. Mycoplasma hyopneumoniae is often reported as an agent associated to PCV2 infections. The aim of this study was to verify the occurrence of M. hyopneumoniae in animals diagnosed with PCVAD in intensive pig farming systems in Goiás, Brazil. Forty nasal secretion samples were collected for M. hyopneumoniae DNA detection by polymerase chain reaction (PCR). Out of this, 6 (15%) were positive for M. hyopneumoniae DNA. All positive samples were collected from animals in non-vaccinated herds. Mycoplasma has been detected in animals showing clinical signs and lesions of respiratory diseases. To our knowledge, this is the first report of PCV2 association with M. hyopneumoniae in pigs with PCVAD identified in the state of Goiás, Brazil.(AU)

Micoplasma hyopneumoniae associado ao circovírus suíno tipo 2 em plantéis não vacinados para micoplasmose / Mycoplasma hyopneumoniae associated with porcine circovirus type 2 in non-vaccinated herds for mycoplasmosis

A síndrome circovirose suína e doenças associadas (PCVAD) tem sido descrita em diversas regiões do mundo. Seu agente primário, o circovírus suíno tipo 2 (PCV2), está associado a elevados índices de refugagem nas granjas e a vultuosos prejuízos econômicos. Diversos fatores de risco estão relacionados à manifestação dos quadros clínicos da síndrome, nomeadamente deficiências de manejo, presença de coinfecções e imunização diante do agente. Entre os agentes frequentemente relatados associados ao PCV2 está o Mycoplasma hyopneumoniae. Este estudo objetivou verificar a ocorrência de M. hyopneumoniae em animais diagnosticados estarem acometidos pela PCVAD, em sistemas intensivos de produção de suínos do estado de Goiás. Amostras de secreção nasal de 40 animais foram analisadas para a pesquisa do DNA de M. hyopneumoniae. Do total das amostras de secreção nasal, 6 (15%) foram positivas na reação em cadeia da polimerase (PCR) para o M. hyopneumoniae, apenas em granjas que não praticavam a vacinação contra esse agente. Os resultados relacionados à presença de micoplasma estão de acordo com os achados clínicos dos animais analisados que apresentavam sintomatologia de doenças respiratórias e lesões relacionadas ao trato respiratório. Este é o primeiro relato da associação de PCV2 com M. hyopneumoniae em suínos identificados com PCVAD no estado de Goiás.

Porcine circovirus associated diseases (PCVAD) have been reported around the world. They are associated with high culling rates and large economic losses. Porcine circovirus type 2 (PCV2) is the primary causative agent. Several risk factors are related to the manifestation of clinical syndrome, including deficiencies of management, presence of co-infections and immunization against involved agents. Mycoplasma hyopneumoniae is often reported as an agent associated to PCV2 infections. The aim of this study was to verify the occurrence of M. hyopneumoniae in animals diagnosed with PCVAD in intensive pig farming systems in Goiás, Brazil. Forty nasal secretion samples were collected for M. hyopneumoniae DNA detection by polymerase chain reaction (PCR). Out of this, 6 (15%) were positive for M. hyopneumoniae DNA. All positive samples were collected from animals in non-vaccinated herds. Mycoplasma has been detected in animals showing clinical signs and lesions of respiratory diseases. To our knowledge, this is the first report of PCV2 association with M. hyopneumoniae in pigs with PCVAD identified in the state of Goiás, Brazil.

Prevention of Clostridium difficile infection in hamsters using a non-toxigenic strain / Prevenção da infecção por Clostridium difficile em hamsters usando uma estirpe não toxigênica

ABSTRACT: The present study aimed to evaluate five non-toxigenic strains of Clostridium difficile (NTCD) in vitro and to select one strain to prevent C. difficile (CDI) infection in hamsters (Mesocricetus auratus). The NTCD strains were evaluated for spore production in vitro, antimicrobial susceptibility and presence of antimicrobial resistance genes. Approximately 107 spores of the selected strain (Z31) were administered by esophageal gavage in hamsters pretreated with 30mg kg-1 of clindamycin. The challenge with a toxigenic strain of C. difficile was conducted at 36 and 72h, and the animals were observed for 28 days. The NTCD strain of C. difficile (Z31) was able to prevent CDI in all animals that received it.

RESUMO: O presente trabalho objetivou a avaliação in vitro de cinco estirpes não toxigênicas de Clostridium difficile (NTCD) e seleção de uma delas para prevenção de infecção por C. difficile (CDI) em hamsters (Mesocricetus auratus). As estirpes NTCD foram avaliadas quanto à produção de esporos in vitro, sensibilidade antimicrobiana e presença de genes de resistência a antimicrobianos. Aproximadamente 107 esporos da estirpe selecionada (Z31) foram administrados por gavagem esofágica em hamsters previamente tratados com 30mg kg-1 de clindamicina. O desafio com uma estirpe toxigênica de C. difficile ocorreu nos tempos experimentais 36 e 72h, e os animais foram observados por 28 dias. A estirpe NTCD de C. difficile (Z31) foi capaz de prevenir a CDI em todos os animais que a receberam.

Prevention of Clostridium difficile infection in hamsters using a non-toxigenic strain / Prevenção da infecção por Clostridium difficile em hamsters usando uma estirpe não toxigênica

The present study aimed to evaluate five non-toxigenic strains of Clostridium difficile (NTCD) in vitro and to select one strain to prevent C. difficile (CDI) infection in hamsters ( Mesocricetus auratus ). The NTCD strains were evaluated for spore production in vitro, antimicrobial susceptibility and presence of antimicrobial resistance genes. Approximately 107 spores of the selected strain (Z31) were administered by esophageal gavage in hamsters pretreated with 30mg kg-1 of clindamycin. The challenge with a toxigenic strain of C. difficile was conducted at 36 and 72h, and the animals were observed for 28 days. The NTCD strain of C. difficile (Z31) was able to prevent CDI in all animals that received it.(AU)

O presente trabalho objetivou a avaliação in vitro de cinco estirpes não toxigênicas de Clostridium difficile (NTCD) e seleção de uma delas para prevenção de infecção por C. difficile (CDI) em hamsters (Mesocricetus auratus ). As estirpes NTCD foram avaliadas quanto à produção de esporos in vitro, sensibilidade antimicrobiana e presença de genes de resistência a antimicrobianos. Aproximadamente 107 esporos da estirpe selecionada (Z31) foram administrados por gavagem esofágica em hamsters previamente tratados com 30mg kg-1 de clindamicina. O desafio com uma estirpe toxigênica de C. difficile ocorreu nos tempos experimentais 36 e 72h, e os animais foram observados por 28 dias. A estirpe NTCD de C. difficile (Z31) foi capaz de prevenir a CDI em todos os animais que a receberam.(AU)

Ansiedade e coração / Anxiety and heart

A ansiedade patológica e suas repercussões fisiológicas não afligem apenas o bem-estar psíquico e a funcionalidade. A saúde geral também fica comprometida, com aumento da incidência de comorbidades clínicas. Entre estas, as mais significativamente associadas com ansiedade são as doenças da tireoide, doença do refluxo gastroesofágico, psoríase e, sobretudo, as doenças cardíacas. Estas são as mais importantes do ponto de vista de morbidade e mortalidade. Ansiedade e doença cardíaca não são meras comorbidades, mas exercem uma complexa interação, que discutiremos neste texto...

The pathological anxiety and the physiological rebounds don't attack well-being and the functionality only. General health is committed as well, whith medical comorbidity increase. Among these, the more associated significantly with anxiety are thyroid disease, gastroesophageal reflux disease, psoriasis, and mainly heart diseases. These are the mostly important point of view about morbidity and mortality. Anxiety and heart disease are not just comorbidity, but they act with a complex interaction which will be discussing in this paper...

Clustering of HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) and infective dermatitis associated with HTLV-1 (IDH) in Salvador, Bahia, Brazil.

Fifteen families with clustering of infective dermatitis associated with HTLV-1 (IDH) and/or HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) were observed among 28 families of IDH index cases, 93% of them occurring in two generations. With the exception of two mothers of children with IDH, all the mothers with HAM/TSP had at least one child with HAM/TSP. This is the first report of such clustering involving many families.

Actualización odontológica en la atención del niño con síndrome de down / Update dental care for the patient with down syndrome

El síndrome de Down (SD) es la mayor condición genética que se asocia con retardo mental y con características físicas específicas. Además de las mismas, se manifiestan condiciones sistémicas e intelectuales que pueden comprometer la salud bucal y el manejo de la situación odontológica. El conocimiento de estos aspectos, al igual que de las alteraciones orofaciales y el desarrollo de las estructuras del sistema estomatognótico, son necesarios para la planificación de un programa efectivo de salud bucal.

Down syndrome (DS) is the most commonly identified genetic from of mental retardation and the leading cause of specific birth defects. Besides physical characteristic features, there are also systemic and cognitive conditions that may affect oral health and dental management is DS. Knowledge of these aspects, as well as of the orofacial manifestations and the development of the oral structures in the syndrome is necessary to plan an effective oral health programme.

Factores asociados a la hipertensión arterial en ancianos del Policlínico Milanés. 2003- 2006 / Factors associated to the arterial hypertension in elder people from the Milanés Policlinic. Years 2003-2006

Se realizó un estudio observacional, prospectivo y descriptivo, con el objetivo de caracterizar el comportamiento de la hipertensión arterial de la población anciana, conviviente en un área de 500 metros en la periferia del Policlínico Universitario Milanés, empleándose la encuesta del grupo de investigación 10/66, avalada internacionalmente, a 901 ancianos. Los datos fueron procesados y se expresaron los resultados en tablas y gráficos. Resultó significativo que la enfermedad afectó predominantemente al sexo femenino, en las edades entre 70 y 74 años, y entre las enfermedades asociadas a la hipertensión se destacaron las enfermedades cardíacas, entre las más frecuentes se presentaron las arritmias, la angina y el infarto agudo de miocardio, así como las enfermedades cerebrales, existiendo un predominio de la demencia, seguido del ictus. Se arribó a la conclusión de que la hipertensión arterial presenta una alta prevalencia en la población estudiada y predispone todas las variantes de enfermedad vascular con mayor frecuencia en los ancianos.

We made a prospective, descriptive, observational study, with the objective of identifying the factors associated to the arterial hypertension in the elder people population living in an area of 500 m in the periphery of the Milanés Teaching Hospital, using the survey of the investigation group 10/66, internationally validated, applied to 901 elder people. Data were processed and the results were shown in tables and graphics. It was significant that the disease affected predominantly the female genre, in ages between 70 and 74 years-old and more than 80 years-old. Among the diseases associated to the hypertension stood out the heart diseases, and the most frequent of theme were: the arrhythmias, the angina and the myocardial infarct, and also the cerebral diseases, with a predominance of the dementia followed by the ictus. We arrived to the conclusion that the arterial hypertension has a high prevalence in the studied elder population.