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1.
Traffic Inj Prev ; 23(3): 135-139, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35191806

RESUMO

OBJECTIVE: Autonomous driving cars must be developed to ensure that children will have the highest level of protection in case of collision. Changes to the vehicle cabin design (different seat orientations, fully reclining seats, etc.) may significantly impact child occupant safety. Understanding child occupant responses under these new conditions is necessary to decrease risk and enhance child safety. In this study, child occupant response in different seating orientations exposed to frontal impacts with a focus on the head injuries and kinematics was analyzed. METHODS: Finite elements simulations were performed using the PIPER 6-year-old human body model (HBM). All simulations were carried out in a generic full vehicle environment. The child model was positioned in an adequate generic car restraint system (CRS) in the left rear vehicle seat in 4 seating orientations: 0° (forward-facing position), 30°, 60°, and 90° (living room position). Two scenarios were evaluated for all seating orientations according to the left front seat backrest position: reclined position nominal upright and rest position (55°). All seat configurations were subjected to the mobile progressive deformable barrier frontal impact (European New Car Assessment Programme [Euro NCAP] frontal impact testing protocol). A total of 8 scenarios were simulated in LS-DYNA. RESULTS: Based on the Euro NCAP injury risk rate, 90° seating orientation (living room position) was the safest among all selected scenarios independent of the left front seat backrest position. The worst case was found in 60° seat rotation. The highest values for Head Injury Criterion (HIC) and head acceleration (Acc 3 ms) were noted for this case. Higher Brain Injury Criterion (BrIC) values were observed at higher seat rotation angles. Hence, a 90° seating orientation showed the highest BrIC value. Attending to the skull stress, greater head injuries were caused principally by contact with the vehicle interior (seat headrest). Maximum stress values were reached at 30° and 60° seating orientations with the front seat in rest position. In 90° seating orientation, high stress values were also identified. CONCLUSIONS: These results show that attending to these new seating orientations, current child safety standards are not sufficient to ensure children the highest level of protection. Other additional criteria such as BrIC or skull stress that offer a way to capture brain injuries should be used.


Assuntos
Condução de Veículo , Corpo Humano , Acidentes de Trânsito , Automóveis , Fenômenos Biomecânicos , Criança , Humanos
2.
Rev. esp. quimioter ; 32(2): 114-120, abr. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-182812

RESUMO

Introduction: Last guidelines have recommended the introduction of dual antimicrobial therapy in order to avoid treatment failure. In the present report, the susceptibility to some antibiotics was evaluated, and the typing of Neisseria gonorrhoeae strains was performed. Material and methods: Gonococcal isolates were tested for susceptibility according to the recommendations of both CLSI and EUCAST. A total of 134 isolates were typed by the NG-MAST technique. Results: Seventy-two different N. gonorrhoeae types were found, and the most frequent types obtained were ST 1407, ST 14958, ST 7192, ST 13251 and ST 5405. If CLSI/EUCAST criteria were applied, a ST 9807 type was found nonsusceptible to ceftriaxone and cefixime (MIC 0.5 mg/L), and a ST 12800 type was found nonsusceptible only to cefixime (MIC 0.25 mg/L). When only EUCAST breakpoints were taken into account, three strains were also resistant to cefixime (MIC 0.25 mg/L) and three isolates were resistant to ceftriaxone (MIC 0.19, 0.16 and 0.25 mg/L, respectively). The majority of strains were resistant to ciprofloxacin (68.6%), and all N. gonorrhoeae strains were susceptible to spectinomycin; 9.7% of isolates were resistant to azithromycin. Conclusions: Molecular typing may be a useful tool to predict antimicrobial resistance. High rates of resistance to penicillin, tetracycline and ciprofloxacin were found in this area. It is highly recommended to carry out antimicrobial susceptibility in all gonorrhoea cases and to identify treatment failures to verify emerging resistance


Introducción: Las últimas guías recomiendan la introducción de tratamiento antimicrobiano doble para evitar fallos de tratamiento. En esta publicación, se evaluó la sensibilidad a algunos antibióticos, y se realizó el tipado de las cepas de Neisseria gonorrhoeae. Material y métodos: La determinación de sensibilidad fue realizada según las recomendaciones tanto del CLSI como del (EUCAST). Un total de 134 cepas fueron tipadas mediante la técnica de NG-MAST. Resultados: Se encontraron 72 tipos diferentes de N. gonorrhoeae, siendo los más frecuentes el ST 1407, 14958, 7192, 13251 y 5405. Aplicando los criterios del CLSI/EUCAST, un tipo ST 9807 fue no sensible a ceftriaxona y cefixima (CMI 0,5 mg/L), y un tipo ST 12800 fue no sensible solo a cefixima (CMI 0,25 mg/L). Al aplicar solamente los puntos de corte de EUCAST, tres cepas fueron también resistentes a cefixima (CMI 0,25 mg/L) y tres lo fueron también a ceftriaxona (CMI 0,19, 0,16 y 0,25 mg/L, respectivamente). La mayoría de cepas fueron resistentes a ciprofloxacino (68,6%), y todas las cepas de N. gonorrhoeae fueron sensibles a espectinomicina; el 9,7% de aislamientos fueron resistentes a azitromicina. Conclusiones: El tipado molecular puede ser una herramienta útil para predecir resistencia a antimicrobianos. En esta área se encontraron altas tasas de resistencia a penicilina, tetraciclina y ciprofloxacino. Se recomienda encarecidamente realizar estudio de sensibilidad a antibióticos en todos los casos de gonorrea e identificar fallos de tratamiento para verificar la aparición de resistencias


Assuntos
Humanos , Testes de Sensibilidade Microbiana/métodos , Gonorreia/tratamento farmacológico , Neisseria gonorrhoeae/efeitos dos fármacos , Antibacterianos/uso terapêutico , Resistência Microbiana a Medicamentos , Neisseria gonorrhoeae/isolamento & purificação , Espanha/epidemiologia , Tipagem Molecular/métodos
3.
Metas enferm ; 20(2): 25-31, mar. 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-161332

RESUMO

INTRODUCCIÓN: la aparición de úlceras por presión (UPP) es un buen indicador de la calidad asistencial; su control y monitorización es una responsabilidad de los profesionales de Enfermería como actividad básica de seguridad clínica. OBJETIVOS: disminuir las tasas de incidencia de úlceras por presión en la Unidad de Cuidados Intensivos. Determinar la eficacia de los apósitos preventivos de espuma de adhesión atraumática (Mepilex Border Sacrum® y Mepilex Heel®). RESULTADOS: se desarrollaron 11 úlceras por presión, n= 10 en rama de medidas estándar de prevención, y n= 1 en la rama de tratamiento (sacro), 10 UPP en zona sacra y una en talones. La incidencia de úlceras por presión en la muestra fue del 10,47%, 5,07 puntos inferior a la incidencia media en el presente medio, siendo la diferencia estadísticamente significativa. CONCLUSIÓN: parece razonable, a la luz de los resultados, que se establezca un protocolo de apósitos preventivos (Mepilex Border Sacrum® y Mepilex Heel®) en zonas de mayor riesgo de padecer UPP (sacro y talones) en aquellos pacientes con un Braden objetivo de riesgo para padecer dichas UPP igual o inferior a 13-14 y con enfermedades crónicas graves


INTRODUCTION: the presence of pressure ulcers (PUs) is a good indicator of quality of care; nursing professionals are responsible for their control and monitoring as a basic activity within clinical safety. OBJECTIVES: to reduce the incidence rates of pressure ulcers in the Intensive Care Unit. To determine the efficacy of the preventive shaped foam dressings with non-traumatic adhesion (Mepilex Border Sacrum and Mepilex Heel). RESULTS: eleven pressure ulcers were developed, n= 10 in the arm with standard prevention measures, and n= 1 in the treatment arm (sacrum), 10 PUs in the sacral region and one in the heels. There was a 10.47% incidence of pressure ulcers in our sample, 5.07 scores below the mean incidence in the current setting, with a statistically significant difference. CONCLUSION: it seems reasonable, given the results, to establish a protocol for preventive dressings (Mepilex Border Sacrum and Mepilex Heel) in the areas at higher risk of PUs (sacrum and heels), in those patients with a ≤13-14 risk of PUs according to the Braden Scale, and with severe chronic diseases


Assuntos
Humanos , Úlcera por Pressão/epidemiologia , Cuidados Críticos/métodos , Cuidados de Enfermagem/métodos , Úlcera por Pressão/enfermagem , Unidades de Terapia Intensiva/estatística & dados numéricos , Prevenção Secundária/métodos , Curativos Oclusivos
5.
Malar J ; 15(1): 339, 2016 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-27368160

RESUMO

BACKGROUND: Artemisinin-based combination therapy (ACT) has been adopted by the World Health Organization as a first-line treatment for uncomplicated Plasmodium falciparum malaria. In endemic regions, it has proven more effective in treating the disease, and even in reducing its transmission. Nonetheless, there is a scarcity of studies carried out in non-endemic areas on imported uncomplicated malaria. METHODS: This is a retrospective, observational study performed on patients diagnosed and admitted with uncomplicated P. falciparum malaria between 2004 and 2015. The objective was to compare the parasite clearance period and the average hospital length of stay for patients treated with ACT vs those receiving other treatment regimens. RESULTS: Eighty-five patients were included in the study. Fifty-one received ACT treatment (dihydroartemisinin-piperaquine) and thirty-four patients were treated with quinine sulfate+doxycycline or atovaquone/proguanil. The parasite clearance period was shorter in the group of patients treated with ACT compared to those receiving other treatment types: 24 h (IQR 24) vs 48 h (IQR 48), p < 0.01. The average hospital stay was also shorter in the ACT group with respect to the second group: 2.67 days (IQR 1.08) vs 3.96 days (IQR 2.87), p < 0.001. A mild case of hepatitis was registered in the group treated with ACT. CONCLUSIONS: ACT treatment of admitted hospital patients with imported uncomplicated malaria from P. falciparum reduced the days spent hospitalized as well as producing a more rapid parasite clearance compared to classic treatment. In spite of being treated with safe medications, one has to be alert to possible adverse effects such as hepatitis and delayed haemolytic anaemia.


Assuntos
Antimaláricos/uso terapêutico , Artemisininas/uso terapêutico , Malária Falciparum/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Combinada , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
6.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 34(4): 261-269, abr. 2016. graf, tab, mapas
Artigo em Espanhol | IBECS | ID: ibc-151993

RESUMO

La incidencia de tuberculosis va descendiendo a nivel mundial. Sin embargo, en los países occidentales este descenso es más lento debido al impacto de la inmigración. La tuberculosis en la población inmigrante se relaciona con el estatus de salud en el país de origen y con las condiciones de hacinamiento y pobreza en el país de acogida. Los inmigrantes con tuberculosis son más jóvenes, tienen mayor prevalencia de formas extrapulmonares, mayor proporción de casos de resistencia y tasas de abandono de tratamiento superiores a los autóctonos. Las nuevas técnicas moleculares, además de reducir el tiempo de demora diagnóstica, permiten la identificación rápida de resistencias y mejoran el conocimiento de los patrones de transmisión. Es necesario implementar medidas que mejoren la cumplimentación del tratamiento de este grupo de población como el uso de pautas fijas de tratamiento, el empleo de mediadores y agentes comunitarios de salud, facilitar el acceso a la tarjeta sanitaria y la gratuidad de los fármacos


The incidence of tuberculosis worldwide is declining. However, in Western countries this decline is slower due to the impact of immigration. Tuberculosis in the immigrant population is related to health status in the country of origin and with overcrowding and poverty conditions in the host country. Immigrants with tuberculosis are younger, have a higher prevalence of extrapulmonary forms, greater proportion of drug resistance and higher treatment default rates than those of natives. New molecular techniques not only reduce diagnostic delay time but also allow the rapid identification of resistances and improve knowledge of transmission patterns. It is necessary to implement measures to improve treatment compliance in this population group like facilitating access to health card, the use of fixed-dose combination drugs, the participation of cultural mediators and community health workers and gratuity of drugs


Assuntos
Humanos , Tuberculose/microbiologia , Mycobacterium tuberculosis/patogenicidade , Tuberculose Latente/microbiologia , Tuberculose/epidemiologia , Teste Tuberculínico/métodos , Emigrantes e Imigrantes/estatística & dados numéricos , Antituberculosos/uso terapêutico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia
7.
Nutr. hosp ; 33(2): 359-367, mar.-abr. 2016. tab
Artigo em Inglês | IBECS | ID: ibc-153314

RESUMO

Objectives: The aim of this study was to test the effectiveness of a nutritional education and intervention programme, promoting holistic health and physical exercise in postmenopausal women, with special emphasis on women who smoke, in order to test whether greater adherence to the diet and increased physical activity and healthy lifestyles reduce cardiovascular risk in this population group. Material and methods: The study population consisted of 96 women (aged 46-79) living in Granada (southern Spain). At baseline, the sociodemographic characteristics were compiled and a nutritional assessment conducted, in which food consumption was assessed by 48h recall and the Mediterranean diet score (MDS) was calculated. Anthropometric data were also measured. Other data compiled included serum lipid parameters. When the initial results were obtained, a tailored intervention programme concerning nutrition and healthy lifestyle was provided to each participant. After three months, all the above parameters were re-assessed. Results: At the beginning of the study, it was observed that the diet of the study population complied with recommended patterns. However, the nutritional intervention resulted in an improved caloric and lipid profile and decreased obesity. Among the group of smokers, serum lipid parameters also improved, reaching values similar to those of the non-smokers. Conclusions: An appropriate adhesion to the Mediterranean diet score (MDS) was observed in the Andalusian postmenopausal women assessed in this study. For the whole study population, the nutritional intervention improved the quality of diet and reduced the percentage of obesity, while smokers also improved their lipid profile (AU)


Objetivos: el objetivo de este estudio fue comprobar la eficacia de un programa de educación e intervención nutricional, de salud integral y ejercicio físico en mujeres posmenopáusicas, incidiendo especialmente en el sector de mujeres fumadoras con el fin de reducir el riesgo cardiovascular de este sector de población. Materiales y métodos: la población objeto de estudio estuvo constituida por 96 mujeres (46-79 años) residentes en Granada (sur de España). Al comienzo del estudio se recogieron las características sociodemográficas y se realizó una valoración nutricional; el consumo de alimentos se evaluó mediante una encuesta de 48 preguntas y un estudio de adhesión a la dieta mediterránea. Se determinaron datos antropométricos: índice de masa corporal, porcentaje de masa grasa y magra. Determinamos también el colesterol total, el colesterol LDL, HDL y los triglicéridos. Una vez obtenidos los primeros resultados, se realizó una intervención personalizada, para cada mujer participante en el estudio, de educación nutricional y de hábitos saludables. Transcurridos tres meses, se volvieron a determinar todos los parámetros anteriormente estudiados. Resultados: al comienzo del estudio se observó que la dieta de la población se adecuaba a los patrones de dieta saludable y tras la intervención nutricional se produjo una mejora del perfil calórico y lipídico y un descenso de la obesidad. En el grupo de las mujeres fumadoras además se encontró una mejora de los parámetros lipídicos séricos, alcanzando valores semejantes a los de las no fumadoras. Conclusiones: se observó que las mujeres posmenopáusicas andaluzas participantes en este estudio tenían una adecuada adhesión a la dieta mediterránea. La intervención nutricional mejoró en todo el grupo la calidad de la dieta y el porcentaje de obesidad y, además en las mujeres fumadoras mejoró el perfil lipídico (AU)


Assuntos
Humanos , Masculino , Feminino , Obesidade/terapia , Terapia por Exercício/métodos , Dieta Redutora , Pós-Menopausa/fisiologia , Programas de Redução de Peso/organização & administração , Resultado do Tratamento , Fumar/epidemiologia , Nutrientes/análise , Dieta Mediterrânea/estatística & dados numéricos , Biomarcadores/análise
8.
Enferm Infecc Microbiol Clin ; 34(4): 261-9, 2016 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-26851978

RESUMO

The incidence of tuberculosis worldwide is declining. However, in Western countries this decline is slower due to the impact of immigration. Tuberculosis in the immigrant population is related to health status in the country of origin and with overcrowding and poverty conditions in the host country. Immigrants with tuberculosis are younger, have a higher prevalence of extrapulmonary forms, greater proportion of drug resistance and higher treatment default rates than those of natives. New molecular techniques not only reduce diagnostic delay time but also allow the rapid identification of resistances and improve knowledge of transmission patterns. It is necessary to implement measures to improve treatment compliance in this population group like facilitating access to health card, the use of fixed-dose combination drugs, the participation of cultural mediators and community health workers and gratuity of drugs.


Assuntos
Emigração e Imigração , Tuberculose/epidemiologia , Diagnóstico Tardio , Emigrantes e Imigrantes , Humanos , Incidência
9.
Artigo em Inglês | IBECS | ID: ibc-148498

RESUMO

BACKGROUND: Gonorrhoea remains an important health problem worldwide. The latest European guidelines have recommended the introduction of dual antimicrobial therapy due to the increase in its resistance to antimicrobial agents. METHODS: In the present study, the susceptibility to some antibiotics was evaluated, and the typing of Neisseria gonorrhoeae strains was also performed. All Neisseria gonorrhoeae (NG) strains isolated from January 2012 to October 2014 were included in this work. Gonococcal isolates were tested for susceptibility according to the recommendations of both the Clinical and Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST). A total of 65 isolates were typed by the NG multi-antigen sequence types (NG-MAST) technique. RESULTS: The most frequent types found were ST 1407, ST 5405, ST 2992, and ST 5120. If CLSI and EUCAST criteria were applied, an ST 9807 type was found non-susceptible to ceftriaxone and cefixime (MIC 0.5 mig/mL). When only EUCAST breakpoints were taken into account, three strains were also resistant to cefixime (MIC 0.25 mig/mL) and two isolates were resistant to ceftriaxone (MIC 0.19 and 0.25 mig/mL, respectively). The majority of strains were resistant to ciprofloxacin, and all Neisseria gonorrhoeaestrains were susceptible to spectinomycin; twenty-five percent of isolates were resistant to azithromycin. CONCLUSIONS: The implementation of antimicrobial surveillance programs at regional level should be part of an overall gonococcal infection control strategy. Efforts should be made to perform antimicrobial susceptibility, a "cured test" in all gonorrhoea cases, and identify treatment failures to verify emerging resistance. Some types have been associated with decreased susceptibility to cephalosporins, making molecular typing a useful tool to predict antimicrobial resistance


ANTECEDENTES: La gonorrea sigue siendo un importante problema de salud pública a nivel mundial. Las últimas guías en Europa han recomendado la introducción de tratamiento antimicrobiano dual debido al incremento de las resistencias a los antimicrobianos. MÉTODOS: En este estudio fue evaluada la sensibilidad a algunos antibióticos y se realizó el tipado de cepas deNeisseria gonorrhoeae. Todas las cepas aisladas desde enero de 2012 hasta octubre de 2014 fueron incluidas en este trabajo. El estudio de la sensibilidad de las cepas de gonococo fue realizado según las recomendaciones del Clinical and Laboratory Standards Institute (CLSI) y del European Committee on Antimicrobial Susceptibility Testing (EUCAST). Un total de 65 cepas fueron tipadas mediante la técnica NG-multiantigen sequence types (NG-MAST). RESULTADOS: Los tipos encontrados más frecuentemente fueron el ST 1407, ST 5405, ST 2992 y el ST 5120. Al aplicar los criterios del CLSI y del EUCAST, un tipo ST 9807 resultó no sensible a ceftriaxona y cefixime (CMI 0,5 mig/mL). Al tener solo en cuenta los puntos de corte del EUCAST, 3 cepas más fueron también resistentes a cefixime (CMI 0,25 migr/mL) y 2 más fueron resistentes a ceftriaxona (CMI 0,19 y 0,25 mig/mL, respectivamente). La mayoría de las cepas fueron resistentes a ciprofloxacino, y todas las cepas testadas fueron sensibles a espectinomicina; el 25% de los aislamientos fueron resistentes a azitromicina. CONCLUSIONES: La implementación de programas de vigilancia antimicrobiana a nivel regional debe ser parte de la estrategia de control para la infección gonocócica. Deben ser realizados esfuerzos para el estudio de la sensibilidad antimicrobiana, test de cura en todos los casos de gonorrea y la identificación de los fallos de tratamiento para verificar el aumento de resistencias. Algunos tipos han sido asociados con disminución de la sensibilidad a cefalosporinas, por lo que el tipado molecular puede ser una herramienta diagnóstica útil para predecir la resistencia a antibióticos


Assuntos
Humanos , Neisseria gonorrhoeae/isolamento & purificação , Técnicas de Tipagem Bacteriana/métodos , Gonorreia/tratamento farmacológico , Testes de Sensibilidade Microbiana/métodos , Resistência Microbiana a Medicamentos , Neisseria gonorrhoeae/patogenicidade , Gonorreia/epidemiologia , Estudos Retrospectivos
10.
Enferm Infecc Microbiol Clin ; 34(1): 3-7, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25735717

RESUMO

BACKGROUND: Gonorrhoea remains an important health problem worldwide. The latest European guidelines have recommended the introduction of dual antimicrobial therapy due to the increase in its resistance to antimicrobial agents. METHODS: In the present study, the susceptibility to some antibiotics was evaluated, and the typing of Neisseria gonorrhoeae strains was also performed. All Neisseria gonorrhoeae (NG) strains isolated from January 2012 to October 2014 were included in this work. Gonococcal isolates were tested for susceptibility according to the recommendations of both the Clinical and Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST). A total of 65 isolates were typed by the NG multi-antigen sequence types (NG-MAST) technique. RESULTS: The most frequent types found were ST 1407, ST 5405, ST 2992, and ST 5120. If CLSI and EUCAST criteria were applied, an ST 9807 type was found non-susceptible to ceftriaxone and cefixime (MIC 0.5µg/mL). When only EUCAST breakpoints were taken into account, three strains were also resistant to cefixime (MIC 0.25µg/mL) and two isolates were resistant to ceftriaxone (MIC 0.19 and 0.25µg/mL, respectively). The majority of strains were resistant to ciprofloxacin, and all Neisseria gonorrhoeae strains were susceptible to spectinomycin; twenty-five percent of isolates were resistant to azithromycin. CONCLUSIONS: The implementation of antimicrobial surveillance programs at regional level should be part of an overall gonococcal infection control strategy. Efforts should be made to perform antimicrobial susceptibility, a "cured test" in all gonorrhoea cases, and identify treatment failures to verify emerging resistance. Some types have been associated with decreased susceptibility to cephalosporins, making molecular typing a useful tool to predict antimicrobial resistance.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Neisseria gonorrhoeae/efeitos dos fármacos , Técnicas de Tipagem Bacteriana , Gonorreia/tratamento farmacológico , Humanos , Testes de Sensibilidade Microbiana , Neisseria gonorrhoeae/classificação , Espanha
11.
Fetal Diagn Ther ; 39(2): 147-51, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26278975

RESUMO

INTRODUCTION: The objective of this study was to evaluate placental 11B-hydroxysteroid dehydrogenase type 2 (11B-HSD-2) mRNA levels in intrauterine growth-restricted fetuses (IUGR) as compared with small-for-gestational-age (SGA) fetuses according to clinical criteria. MATERIAL AND METHODS: Placental levels of 11B-HSD-2 mRNA levels were measured in SGA (birth weight <10th centile) and gestational-age-matched, appropriate-for-gestational-age (AGA) births. SGA was classified as IUGR (birth weight <3rd centile or <10th percentile with abnormal uterine artery Doppler or cerebroplacental ratio) or non-IUGR SGA. After RNA extraction, mRNA levels were determined by reverse transcription and quantitative PCR. RESULTS: A total of 38 placentas were analyzed (20 AGA and 18 SGA). Among the SGA pregnancies, 13 qualified as IUGR. The activity of 11B-HSD-2 in IUGR pregnancies [0.105 (SD 0.328)] was significantly reduced compared to non-IUGR SGA [0.304 (SD 0.261); p = 0.018] and AGA [0.294 (SD 0.328); p = 0.001]. These differences remained significant after adjusting for potential confounders (such as smoking or maternal cortisol levels). Activity levels did not significantly differ between non-IUGR SGA and AGA. DISCUSSION: IUGR fetuses had reduced 11B-HSD-2 activity in comparison with SGA and normally grown fetuses. This finding provides opportunities to develop new placental biomarkers for the phenotypic characterization of fetal smallness.


Assuntos
11-beta-Hidroxiesteroide Desidrogenases/metabolismo , Retardo do Crescimento Fetal/genética , Placenta/metabolismo , Peso ao Nascer , Feminino , Retardo do Crescimento Fetal/diagnóstico por imagem , Retardo do Crescimento Fetal/metabolismo , Humanos , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional/metabolismo , Gravidez , RNA Mensageiro , Ultrassonografia Pré-Natal , Artéria Uterina/diagnóstico por imagem
12.
J Immigr Minor Health ; 18(1): 8-15, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25466580

RESUMO

The aim of this study was to evaluate the data on the main imported infectious diseases and public health issues arising from the risk of transmission of tropical and common diseases in the immigrant population. During the period of study, 2,426 immigrants were attended in the Tropical Medicine Unit of the Hospital of Poniente. For each patient, a complete screening for common and tropical diseases was performed. The prevalence and main features of intestinal and urinary parasites, microfilarias, Chagas disease, malaria, hepatitis B (HBV) and C (HCV) viruses, extrapulmonary tuberculosis and syphilis was investigated taking into account the length of stay in Spain. Sub-Saharan Africa patients who had lived for <3 years in Spain had a high significantly number of infections produced by hookworms, Ascaris lumbricoides, Trichuris trichiura, Schistosoma mansoni, Giardia lamblia, Entamoeba histolytica/dispar and Plasmodium spp. In patients who had lived for more than 3 years, there were significantly high rates of HBV infections, although HBV rates in sub-Saharan African patients are high even if the patients have been in Spain for <3 years. However, patients with large stays in Spain had also an important number of parasitological diseases. The main objective of the diagnosis is to avoid important public health problems and further complications in patients. It is advisable to carry out a screening of the main transmissible infections in all immigrant population regardless of the time outside their country. This screening should be individualized according to the geographical area of origin.


Assuntos
Doenças Transmissíveis/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Hepatite/etnologia , Humanos , Doenças Parasitárias/etnologia , Grupos Raciais , Espanha/epidemiologia , Sífilis/etnologia , Fatores de Tempo , Tuberculose/etnologia , Imigrantes Indocumentados
14.
Artigo em Inglês | IBECS | ID: ibc-132723

RESUMO

OBJECTIVE: To analyse clinical and epidemiological characteristics of immigrant patients diagnosed with strongyloidiasis in our area. METHODS: An analyse was performed on patients with strongyloidiasis seen in the Tropical Medicine Unit of the "Hospital de Poniente" in Almeria (Spain), from April 2004 to May 2012. RESULTS: A total of 320 patients were diagnosed with Strongyloides stercoralis infection, and 284 out of 314 patients (90.4%) had a positive specific serology. Forty-two percent of the patients reported symptoms and 45% had eosinophilia. The serological results were monitored in some of the patients, confirming a loss of antibodies in all 20 patients studied. CONCLUSIONS: Strongyloidiasis is a parasitic disease increasingly diagnosed in developed countries due to increased migratory flows from endemic areas. Often being asymptomatic, its diagnosis and treatment may prevent fatal outcomes, especially in immunocompromised patients


OBJETIVO: Analizar las características clínicas y epidemiológicas de los pacientes inmigrantes diagnosticados de strongyloidiasis en nuestra área. MÉTODOS: Se analizaron retrospectivamente los pacientes con strongyloidiasis que acudieron a la Unidad de Medicina Tropical del Hospital de Poniente de Almería (España), entre abril de 2004 mayo de 2012. RESULTADOS: 320 pacientes han sido diagnosticados con infección por S. stercoralis, 284/314 pacientes (90,4%) tenían una serología específica positiva. 42,3% de los pacientes presentaron síntomas y el 45% de los pacientes tenían eosinofilia. La monitorización del tratamiento confirmó la pérdida de anticuerpos en los 20 pacientes estudiados. CONCLUSIONES: La estrongiloidiasis es una parasitosis diagnosticada cada vez con más frecuencia en países desarrollados debido al aumento de los movimientos migratorios procedentes de zonas endémicas. Siendo a menudo asintomática, su diagnóstico y tratamiento pueden prevenir resultados fatales


Assuntos
Humanos , Strongyloides stercoralis/patogenicidade , Estrongiloidíase/epidemiologia , Anticorpos Antideltaretrovirus/isolamento & purificação , Emigrantes e Imigrantes/estatística & dados numéricos , Hospedeiro Imunocomprometido , Fatores de Risco
16.
Enferm Infecc Microbiol Clin ; 33(1): 37-9, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25205127

RESUMO

OBJECTIVE: To analyse clinical and epidemiological characteristics of immigrant patients diagnosed with strongyloidiasis in our area. METHODS: An analyse was performed on patients with strongyloidiasis seen in the Tropical Medicine Unit of the "Hospital de Poniente" in Almeria (Spain), from April 2004 to May 2012. RESULTS: A total of 320 patients were diagnosed with Strongyloides stercoralis infection, and 284 out of 314 patients (90.4%) had a positive specific serology. Forty-two percent of the patients reported symptoms and 45% had eosinophilia. The serological results were monitored in some of the patients, confirming a loss of antibodies in all 20 patients studied. CONCLUSIONS: Strongyloidiasis is a parasitic disease increasingly diagnosed in developed countries due to increased migratory flows from endemic areas. Often being asymptomatic, its diagnosis and treatment may prevent fatal outcomes, especially in immunocompromised patients.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/epidemiologia , Adolescente , Adulto , África Subsaariana/etnologia , África do Norte/etnologia , Idoso , Animais , Anticorpos Anti-Helmínticos/sangue , Fezes/parasitologia , Feminino , Humanos , Hospedeiro Imunocomprometido , América Latina/etnologia , Masculino , Pessoa de Meia-Idade , Doenças Parasitárias/epidemiologia , Estudos Retrospectivos , Espanha/epidemiologia , Strongyloides stercoralis/imunologia , Adulto Jovem
20.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 31(9): 599-601, nov. 2013. tab
Artigo em Espanhol | IBECS | ID: ibc-117775

RESUMO

Objetivos: Estudio de las características clínicas y epidemiológicas de los pacientes inmigrantes diagnosticados de uncinariasis en la Unidad de Medicina Tropical del Hospital de Poniente (El Ejido, Almería).Material y métodos Estudio observacional retrospectivo de todos los pacientes inmigrantes diagnosticados de uncinariasis mediante visualización directa de los huevos en heces desde octubre de 2004 hasta diciembre de 2012.ResultadosDe 1.872 pacientes estudiados, 253 (13,5%) fueron diagnosticados de uncinariasis. En los pacientes con uncinariasis como única helmintiasis, el 8,3% presentó anemia ferropénica, el 65,7% no presentaba eosinofilia, y de estos, el 25,9% tampoco presentaba dolor abdominal. Conclusiones La uncinariasis es una parasitación frecuente en población inmigrante subsahariana. Muchos pacientes se encuentran asintomáticos, por lo que la aplicación del estudio protocolizado en población procedente de zonas endémicas permitiría diagnosticar y tratar un mayor número de pacientes con esta enfermedad (AU)


Objectives: To study the clinical and epidemiological characteristics of immigrant patients diagnosed with a hookworm infection in the Tropical Medicine Unit of the Hospital de Poniente in El Ejido (Almería, Spain).Material and methods: A retrospective observational study of all immigrant patients diagnosed with hookworm, by direct visualization of eggs in stool samples, from October 2004 until December 2012.Results: Of the 1872 patients studied, 253 (13.5%) were diagnosed with a hookworm infection. In patients where hookworm was the only helminthiasis diagnosed, 8.3% had iron deficiency anaemia, 65.7% did not have eosinophilia, and of these, 25.9% had no abdominal pain. Conclusions: Hookworm is a frequent parasite infestation in the Sub-Saharan immigrant population. Many patients are asymptomatic; thus the implementation of a study protocol for immigrants from endemic areas could diagnose and treat more patients with this disease (AU)


Assuntos
Humanos , Ancylostomatoidea/patogenicidade , Infecções por Uncinaria/epidemiologia , Emigrantes e Imigrantes , Estudos Retrospectivos
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