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1.
J Frailty Aging ; 13(2): 172-178, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38616374

RESUMO

BACKGROUND: Older patients in hemodialysis have high prevalence of malnutrition that is often associated with rapid weight loss till cachexia. OBJECTIVES: We aimed to investigate whether in older patients undergoing hemodialysis the association between poor nutritional status and mortality may be independent of comorbidities and other risk factors. DESIGN: Retrospective longitudinal study. SETTING: Unit of Nephrology, Dialysis and Kidney Transplantation of the Policlinic Hospital of Milan, Milan, Italy. PARTICIPANTS: A total of 107 prevalent patients undergoing hemodialysis for at least three months. MEASUREMENTS: Sociodemographic, clinical, and biological data were recorded. Unintentional weight loss (UWL) was defined as loss of body weight > 5% in 3 months or > 10% in 6 months. We computed a 21-item Frailty Index that included clinical conditions associated with malnutrition and mortality in this population. Unadjusted and adjusted Cox proportional hazard models were performed to test the association of UWL, albumin and transferrin levels with death. Survival analyses based on Kaplan-Meier estimates were performed. RESULTS: Patients' age was 79 (±7.7) years; 38 (35%) were women. Thirty-one patients (29%) died during follow-up. Eighteen (16.8%) patients experienced UWL during the follow-up period. UWL was positively associated with death in the unadjusted model and even after the progressive inclusion of potential confounders. Low albumin levels were positively associated with death only in the unadjusted and partially adjusted models while low transferrin levels were not associated with death in none of the models. Mortality was significantly higher in those patients experiencing both UWL and albumin levels below 3.5 mg/dL. CONCLUSIONS: In older patients undergoing chronic hemodialysis UWL is associated with mortality independently of comorbidities and other risk factors. Patients presenting both UWL and low albumin levels were those experiencing the worst outcomes in terms of mortality.


Assuntos
Desnutrição , Estado Nutricional , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Masculino , Estudos Longitudinais , Estudos Retrospectivos , Desnutrição/epidemiologia , Redução de Peso , Albuminas , Transferrinas
2.
J Frailty Aging ; 12(3): 244-246, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37493386

RESUMO

Older persons with chronic kidney disease (CKD) undergoing hemodialysis represent a growing portion of patients characterized by high vulnerability but still marginally studied. This study aimed at exploring the relationship between the number of prescriptions and fractures in older patients with CKD undergoing hemodialysis. A 24-item Frailty Index (FI) based on sociodemographic, clinical and biological data was computed. Unadjusted and adjusted logistic regression models were performed to test the association of prescribed medications with history of fractures. A total of 107 older patients undergoing hemodialysis (38 [35.5%] women, mean age 79.1 standard deviation, SD=7.7) were included in the study. Mean number of prescribed medications was 9.9 (SD=3.9) and was significantly associated with fractures (OR 1.18, 95% CI 1.06-1.32, p=0.003), even after adjustment for potential confounders (OR 1.16, 95% CI 1.03-1.30, p=0.016). If these results will be confirmed, interventions based on deprescribing will become essential in older persons undergoing hemodialysis.


Assuntos
Fragilidade , Insuficiência Renal Crônica , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Masculino , Fragilidade/epidemiologia , Diálise Renal , Polimedicação
3.
J Vet Cardiol ; 36: 77-88, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34118562

RESUMO

OBJECTIVES: To identify the predictive value on time to onset of heart failure (HF) or cardiac death of clinical, radiographic, and echocardiographic variables, as well as cardiac biomarkers N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac troponin I in dogs with preclinical myxomatous mitral valve disease (MMVD). ANIMALS: One hundred sixty-eight dogs with preclinical MMVD and left atrium to aortic root ratio ≥1.6 (LA:Ao) and normalized left ventricular end-diastolic diameter ≥1.7 were included. METHODS: Prospective, randomized, multicenter, single-blinded, placebo-controlled study. Clinical, radiographic, echocardiographic variables and plasma cardiac biomarkers concentrations were compared at different time points. Using receiving operating curves analysis, best cutoff for selected variables was identified and the risk to develop the study endpoint at six-month intervals was calculated. RESULTS: Left atrial to aortic root ratio >2.1 (hazard ratio [HR] 3.2, 95% confidence interval [95% CI] 1.9-5.6), normalized left ventricular end-diastolic diameter > 1.9 (HR: 6.3; 95% CI: 3.3-11.8), early transmitral peak velocity (E peak) > 1 m/sec (HR: 3.9; 95% CI: 2.3-6.7), and NT-proBNP > 1500 ρmol/L (HR: 5.7; 95% CI: 3.3-9.5) were associated with increased risk of HF or cardiac death. The best fit model to predict the risk to reach the endpoint was represented by the plasma NT-proBNP concentrations adjusted for LA:Ao and E peak. CONCLUSIONS: Logistic and survival models including echocardiographic variables and NT-proBNP can be used to identify dogs with preclinical MMVD at higher risk to develop HF or cardiac death.


Assuntos
Doenças do Cão , Insuficiência Cardíaca , Animais , Biomarcadores , Morte , Doenças do Cão/diagnóstico por imagem , Cães , Ecocardiografia/veterinária , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/veterinária , Valva Mitral/diagnóstico por imagem , Peptídeo Natriurético Encefálico , Fragmentos de Peptídeos , Estudos Prospectivos
4.
Rev Sci Instrum ; 91(7): 074712, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32752818

RESUMO

A module of a wireless high voltage generator was tested immersed in both gaseous and liquid environments providing electrical insulation. The overall performance of the module as well as a detailed performance of the key components are reported, and a comparison between the results in gas and liquid is given. The tests performed on the liquid dielectric show that it is a valid alternative to high pressure gas electrical insulation.

5.
J Vet Cardiol ; 27: 34-53, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32032923

RESUMO

INTRODUCTION: Efficacy of renin-angiotensin-aldosterone system (RAAS) blockade using angiotensin-converting enzyme inhibitors (ACEi) in dogs with preclinical myxomatous mitral valve disease (MMVD) is controversial. HYPOTHESIS: Administration of spironolactone (2-4 mg q 24 h) and benazepril (0.25-0.5 mg q 24 h) in dogs with preclinical MMVD, not receiving any other cardiac medications, delays the onset of heart failure (HF) and cardiac-related death. Moreover, it reduces the progression of the disease as indicated by echocardiographic parameters and level of cardiac biomarkers N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI). ANIMALS: 184 dogs with pre-clinical MMVD and left atrium-to-aortic root ratio (LA:Ao) ≥1.6 and normalized left ventricular end-diastolic diameter (LVEDDn) ≥1.7. METHODS: This is a prospective, randomized, multicenter, single-blinded, placebo-controlled study. Primary outcome variable was time-to-onset of first occurrence of HF or cardiac death. Secondary end points included effect of treatment on progression of the disease based on echocardiographic and radiographic parameters, as well as variations of NT-proBNP and cTnI concentrations. RESULTS: The median time to primary end point was 902 days (95% confidence interval (CI) 682-not available) for the treatment group and 1139 days (95% CI 732-NA) for the control group (p = 0.45). Vertebral heart score (p = 0.05), LA:Ao (p < 0.001), LVEDDn (p < 0.001), trans-mitral E peak velocity (p = 0.011), and NT-proBNP (p = 0.037) were lower at the end of study in the treatment group. CONCLUSIONS: This study failed in demonstrating that combined administration of spironolactone and benazepril delays onset of HF in dogs with preclinical MMVD. However, such treatment induces beneficial effects on cardiac remodeling and these results could be of clinical relevance.


Assuntos
Benzazepinas/uso terapêutico , Doenças do Cão/tratamento farmacológico , Doenças das Valvas Cardíacas/veterinária , Espironolactona/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina , Animais , Cães , Ecocardiografia/veterinária , Feminino , Doenças das Valvas Cardíacas/tratamento farmacológico , Masculino , Valva Mitral , Peptídeo Natriurético Encefálico , Fragmentos de Peptídeos , Estudos Prospectivos , Troponina I
6.
J Vet Cardiol ; 25: 52-60, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31669853

RESUMO

Aortic dissection (AD) is characterized by bleeding within the aortic wall or a tear in the intimal layer of the aortic wall, resulting in the passage of blood from the aortic lumen into the tunica media. In cases of AD, a floating, intimal flap in the aortic lumen divides the lumen into a true portion, with flow present, and a false portion, with no flow. We describe a series of 4 cats with AD of the ascending aorta and moderate aortic insufficiency. Three cats had an acute onset of clinical signs with pericardial effusion and cardiac tamponade, whereas one cat showed a chronic onset without pericardial effusion. Detailed gross and histopathological characterization is available for two cats, which revealed the typical features of AD. One cat also showed connective tissue abnormalities, microscopically resembling Marfan-like syndrome. Concomitant detection of hypertrophic cardiomyopathy in 2 cats represents a novel finding in the veterinary literature. Feline AD is generally associated with systemic hypertension. In all the cats of this case series, blood pressure was normal at presentation, although systemic hypertension before the acute dissection cannot be ruled out. In humans, hypotension is more common with AD of the ascending aorta, so the anatomical location could also play a role in cats. Hypertrophic cardiomyopathy in cats could have been a potential trigger of AD through shear stress. Transthoracic echocardiography, as herein demonstrated, can be considered as a rapid, non-invasive and useful method for the diagnosis of dissection at the level of the ascending aorta.


Assuntos
Aorta/diagnóstico por imagem , Dissecção Aórtica/veterinária , Doenças do Gato/diagnóstico por imagem , Dissecção Aórtica/diagnóstico por imagem , Animais , Gatos , Ecocardiografia/veterinária , Feminino , Masculino
7.
J Endocrinol Invest ; 41(11): 1259-1266, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29536433

RESUMO

PURPOSE: To examine differences in effects according to growth hormone (GH) treatment duration in adult GH-deficient patients. METHODS: In the Italian cohort of the observational Hypopituitary Control and Complications Study, GH-treated adults with GH deficiency (GHD) were grouped by duration of treatment; ≤ 2 years (n = 451), > 2 to ≤ 6 years (n = 387) and > 6 years (n = 395). Between-group differences in demographics, medical history, physical characteristics, insulin-like growth factor-I standard deviation score (IGF-I SDS) and lipid profile at baseline, last study visit and changes from baseline to last study visit were assessed overall, for adult- and childhood-onset GHD and by gender using ANOVA for continuous variables and Chi-squared test for categorical variables. RESULTS: At baseline, treatment duration groups did not differ significantly for age, gender, body mass index, GHD onset, IGF-I SDS, lipid profile, and quality of life. Mean initial GH dose did not differ significantly according to treatment duration group in any subgroup, except female patients, with highest mean dose seen in the longest duration group. In the longest duration group for patients overall, adult-onset patients and male patients, there were significant decreases in GH dose from baseline to last visit, and in total and low-density lipoprotein (LDL)-cholesterol concentrations. IGF-I SDS increased, to a greater extent, in the longest duration group for patients overall and female patients. CONCLUSIONS: The results show that long-term GH treatment is associated with decreasing GH dose, increased IGF-I, decreased LDL-cholesterol and the presence of surrogate markers that help to give confidence in a diagnosis of GHD.


Assuntos
Terapia de Reposição Hormonal/métodos , Hormônio do Crescimento Humano/uso terapêutico , Hipopituitarismo/tratamento farmacológico , Fator de Crescimento Insulin-Like I/metabolismo , Adulto , Fatores Etários , Índice de Massa Corporal , Estudos de Coortes , Relação Dose-Resposta a Droga , Feminino , Hormônio do Crescimento Humano/sangue , Hormônio do Crescimento Humano/deficiência , Humanos , Hipopituitarismo/sangue , Itália , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Resultado do Tratamento
8.
Rev Sci Instrum ; 88(11): 113303, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29195346

RESUMO

Low energy threshold detectors are necessary in many frontier fields of the experimental physics. In this work, we present a novel detection approach based on pure or doped matrices of inert gases solidified at cryogenic temperatures. The small energy release of the incident particle can be transferred directly (in pure crystals) or through a laser-driven ionization (in doped materials) to the electrons of the medium that are then converted into free electrons. The charge collection process of the electrons that consists in their drift within the crystal and their extraction through the solid-vacuum interface gives rise to an electric signal that we exploit for preliminary tests of charge collection and crystal quality. Such tests are carried out in different matrices of neon and methane using an UV-assisted apparatus for electron injection in crystals.

10.
Rev Sci Instrum ; 87(2): 02B320, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26932048

RESUMO

Neutral Beam Injectors (NBIs), which need to be strongly optimized in the perspective of DEMO reactor, request a thorough understanding of the negative ion source used and of the multi-beamlet optics. A relatively compact radio frequency (rf) ion source, named NIO1 (Negative Ion Optimization 1), with 9 beam apertures for a total H(-) current of 130 mA, 60 kV acceleration voltage, was installed at Consorzio RFX, including a high voltage deck and an X-ray shield, to provide a test bench for source optimizations for activities in support to the ITER NBI test facility. NIO1 status and plasma experiments both with air and with hydrogen as filling gas are described. Transition from a weak plasma to an inductively coupled plasma is clearly evident for the former gas and may be triggered by rising the rf power (over 0.5 kW) at low pressure (equal or below 2 Pa). Transition in hydrogen plasma requires more rf power (over 1.5 kW).

11.
J Vet Intern Med ; 29(2): 569-74, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25818210

RESUMO

BACKGROUND: Pulmonary hypertension (PH) is common in dogs with myxomatous mitral valve disease (MMVD) but its effect on clinical outcome has not been investigated. HYPOTHESIS/OBJECTIVES: The presence of PH worsens the outcome in dogs with MMVD. To compare survival times of dogs with MMVD and PH to those without PH. ANIMALS: Two hundred and twelve client-owned dogs. METHODS: Case review study. Medical records of dogs diagnosed with ACVIM stage B2 and C MMVD between January 2010 and December 2011 were retrospectively reviewed. Long-term outcome was determined by telephone interview or from the medical record. End of the observation period was March 2013. PH was identified if tricuspid regurgitation peak velocity was >3 m/s. RESULTS: Two hundred and twelve were identified. Eighty-three dogs (39%) had PH. PH was more commonly identified in stage C compared to B2 (P < .0001). One hundred and five (49.5%) dogs died during the observation period. Median survival time for the entire study population was 567 days (95% CI 512-743). Stage C (P = .003), the presence of PH (P = .009), left atrial to aortic root ratio (LA/Ao) >1.7 (P = .0002), normalized left-ventricular end-diastolic diameter (LVEDn) >1.73 (P = .048), and tricuspid regurgitation pressure gradient (TRPG) >55 mmHg (P = .009) were associated with worse outcomes in the univariate analyses. The presence of TRPG >55 mmHg (HR 1.8 95% CI 1-2.9; P = .05) and LA/Ao > 1.7 (HR 2 95% CI 1.2-3.4; P = .01) remained significant predictors of worse outcome in the multivariate analysis. CONCLUSIONS AND CLINICAL IMPORTANCE: In dogs with MMVD, moderate to severe PH worsens outcome.


Assuntos
Doenças do Cão/patologia , Hipertensão Pulmonar/veterinária , Prolapso da Valva Mitral/veterinária , Animais , Doenças do Cão/epidemiologia , Doenças do Cão/etiologia , Cães , Feminino , Hipertensão Pulmonar/complicações , Hipertensão Pulmonar/epidemiologia , Masculino , Prolapso da Valva Mitral/complicações , Prevalência , Prognóstico , Estudos Retrospectivos
12.
Int J Obes (Lond) ; 39(6): 977-85, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25771927

RESUMO

BACKGROUND/OBJECTIVES: Lymphocytes have a critical role in visceral adipose tissue (AT) inflammation. The CD28 costimulatory molecule is required for lymphocyte activation and for the development of a functional regulatory T cells (Tregs) compartment; however, its role during obesity is unknown. METHODS: During diet-induced obesity, we investigated the effects of selective interference with CD28 signaling using knockout mice (Cd28KO) and a CTLA4-Ig fusion protein inhibiting CD28-B7 interactions. RESULTS: Cd28 deficiency decreased pathogenic T cells and Treg content within AT without changing the macrophages number. Cd28KO epididymal but not subcutaneous fat was characterized by enlarged adipocytes, reduced levels of inflammatory cytokines and increased Glut4, adiponectin and lipogenic enzyme mRNA levels. This was associated with reduced inflammation, fat accumulation and enhanced glucose metabolism in liver. Weight gain and fasting glucose tolerance were not affected. CTLA4-Ig injections reduced the number of T cells in epididymal AT (epiAT) but not the inflammatory cytokines levels and failed to improve liver fat accumulation. CONCLUSIONS: Deletion of CD28 creates a new pro/anti-inflammatory balance in epiAT and liver and exerts a protective effect against hepatic steatosis.


Assuntos
Tecido Adiposo/patologia , Antígenos CD28/genética , Fígado Gorduroso/patologia , Deleção de Genes , Inflamação/patologia , Fígado/patologia , Obesidade/patologia , Animais , Modelos Animais de Doenças , Inflamação/metabolismo , Resistência à Insulina , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Metabolismo dos Lipídeos , Fígado/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Membro 7 da Superfamília de Receptores de Fatores de Necrose Tumoral
13.
Rev Sci Instrum ; 85(2): 02A704, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24593438

RESUMO

Neutral Beam Injectors (NBI), which need to be strongly optimized in the perspective of DEMO reactor, request a thorough understanding of the negative ion source used and of the multi-beamlet optics. A relatively compact RF ion source, named NIO1 (Negative Ion Optimization 1), with 9 beam apertures for a total H(-) current of 130 mA, 60 kV acceleration voltage, is being installed at Padua, in Consorzio RFX, to provide a test bench for source optimizations in the framework of the accompanying activities in support to the ITER NBI test facility. NIO1 construction and status of the overall installation, including a high voltage deck and an optical cavity ring down spectrometer are here summarized and reported. Plasma and low voltage beam operations are discussed. Development of a sampling beam calorimeter (with small sampling holes, and a segmented cooling circuit) is also discussed.

14.
Res Vet Sci ; 95(2): 569-71, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23623757

RESUMO

A wild Beech Marten (Martes foina), was referred for necropsy to the Department of Animal Pathology of the University of Turin (Italy). At gross examination, whitish and firm masses, 10-mm in diameter, were found on the heart and in the kidney. Spleen showed lighter color and greater consistency, and the cut surface of the liver appeared scattered with whitish-yellow coalescing foci homogeneously distributed. Amyloid deposits were present in the perivascular and intercellular spaces of the visceral organs, such as the heart, liver, and kidneys. Amyloid stained positively with Congo red with and without 5% potassium permanganate pretreatment and showed green birefringence observable under polarized light. A diagnosis of systemic AL amyloidosis was made. This is the first description of systemic AL amyloidosis in a wild Stone Marten.


Assuntos
Amiloidose/veterinária , Mustelidae , Amiloidose/classificação , Amiloidose/patologia , Animais , Feminino
15.
Clin Vaccine Immunol ; 20(5): 657-9, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23446218

RESUMO

In this study, we compared a rapid immunochromatographic test (Speed Leish K; BVT Groupe Virbac, La Seyne sur Mer, France) with an indirect immunofluorescence assay (IFAT) and Western blotting (WB) for the detection of Leishmania infantum antibodies in dogs. A total of 250 serum samples were collected from 125 L. infantum-positive and 125 L. infantum-negative dogs. Among the positive samples, 81 were strongly positive at low IFAT dilutions, while 44 were low-reactivity sera (IFAT titers, 1:40 to 1:80). The sensitivity and specificity of the Speed Leish K were 96.3% and 100%, respectively, compared with those of the IFAT. When IFAT low-reactivity sera (titers, 1:40 or 1:80) were tested with the Speed Leish K, using WB results as a reference, the sensitivities were 93.75% for sera with a 1:80 titer and 73.33% for sera with a 1:40 titer, and the specificity was 100%. The Speed Leish K is easy to use and performs well, so it can be considered a quick and reliable tool for the diagnosis of L. infantum infection in dogs.


Assuntos
Anticorpos Antiprotozoários/sangue , Cromatografia de Afinidade/veterinária , Doenças do Cão/diagnóstico , Leishmania infantum/imunologia , Leishmaniose Visceral/diagnóstico , Animais , Western Blotting/veterinária , Doenças do Cão/imunologia , Cães , Técnica Indireta de Fluorescência para Anticorpo/veterinária , Leishmaniose Visceral/imunologia , Sensibilidade e Especificidade
16.
Rev. chil. infectol ; 28(4): 310-315, ago. 2011. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-603059

RESUMO

Syphilis is a sexually transmitted disease caused by Treponema pallidum. The diagnosis is based mainly in clinical presentation and non-specific assays. PCR-based diagnosis has been suggested as an attractive alternative method. The aim of this study was the validation of a PCR-based test for the diagnosis of early syphilis (ES) and neurosyphilis (NS). Clinical samples of mucocutaneous lesions and cerebrospinal fluid (CSF) specimens from patients previously diagnosed for ES and NS respectively using an enlarged gold standard, were tested by PCR. The reaction was done using primers targeting the tpN47gene. Twenty out of 21 mucocutaneous samples from patients diagnosed with ES were positive by PCR, with a clinical sensitivity of 95 percent. Four out of 8 CSF samples from patients previously diagnosed with NS were positive by PCR, with a clinical sensitivity of 50 percent. The clinical specificity for both ES and NS was 100 percent. The PCR sensitivity and specificity for mucocutaneous samples allowed us to implement this assay in our laboratory for routine diagnosis. Although the sensitivity of the PCR in CSF was low, it may be useful to support clinical diagnosis.


La sífilis es una enfermedad de transmisión sexual producida por Treponema pallidum, cuyo diagnóstico se realiza presuntivamente basándose en aspectos clínicos y análisis de especificidad limitada. La reacción de la polimerasa en cadena (RPC) ha sido planteada como una alternativa diagnóstica de mayor sensibilidad y especificidad. El objetivo de este trabajo fue validar una RPC para el diagnóstico de sífilis temprana (ST) y neurosífilis (NS). Se utilizaron muestras de lesiones muco-cutáneas y de LCR de pacientes con sospecha de cursar ST y NS respectivamente, previamente diagnosticados, utilizando un estándar de oro ampliado. La RPC fue realizada con partidores dirigidos al gen tpN47. De las 21 muestras de pacientes con ST, la RPC resultó positiva en 20, lo que resulta en una sensibilidad clínica de 95 por ciento. De las 8 muestras de pacientes con NS, la RPC resultó positiva en 4, obteniéndose una sensibilidad clínica de 50 por ciento. La especificidad clínica para ST y NS fue de 100 por ciento. La excelente sensibilidad y especificidad de la RPC para muestras muco-cutáneas permitió la exitosa implementación de este análisis en nuestro laboratorio para el diagnóstico de rutina. Si bien la sensibilidad de la RPC en LCR es baja, es muy útil para apoyar el diagnóstico clínico.


Assuntos
Feminino , Humanos , Masculino , DNA Bacteriano/análise , Neurossífilis/diagnóstico , Reação em Cadeia da Polimerase , Sífilis Cutânea/diagnóstico , Treponema pallidum/genética , Neurossífilis/líquido cefalorraquidiano , Neurossífilis/patologia , Estudos Prospectivos , Sensibilidade e Especificidade , Sífilis Cutânea/líquido cefalorraquidiano , Sífilis Cutânea/patologia
17.
Rev Chilena Infectol ; 28(2): 118-22, 2011 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-21720690

RESUMO

UNLABELLED: Invasive candidiasis (IC) epidemiology has changed in critically ill patients and limited data are available in Chile. OBJECTIVE: To describe the epidemiological and microbiological profile of IC in critically ill patients. METHODS: Observational prospective study conducted from October 2001 to August 2003 in critically ill adults with suspected or confirmed IC. RESULTS: 53 patients met criteria for IC, finding 18 (33.9%) candidemias, 22 (41.5%) disseminated IC, and 13 (24.5%) local IC. We identified 8 (44.4%) C. albicans and 10 (55.6%) non-albicans Candida in candidemias. C. tropicalis was the predominant non-albicans species (27.7%). An 88.8 % of Candidas sp recovered in candidemias were fluconazole susceptible. Overall hospital mortality was 24.5%. Mortality in candidemia was significantly lower than in disseminated IC (16.6 vs 31.8%, p = 0.02). CONCLUSIONS: A higher proportion of non-albicans Candida was observed in candidemias from critically ill patients. However, most of these strains were fluconazole susceptible. A lower overall mortality was observed in candidemias.


Assuntos
Candidíase Invasiva/mortalidade , Unidades de Terapia Intensiva/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antifúngicos/uso terapêutico , Candidíase Invasiva/tratamento farmacológico , Candidíase Invasiva/microbiologia , Feminino , Mortalidade Hospitalar , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
18.
Rev. chil. infectol ; 28(2): 118-122, abr. 2011. tab
Artigo em Espanhol | LILACS | ID: lil-592093

RESUMO

Invasive candidiasis (IC) epidemiology has changed in critically ill patients and limited data are available in Chile. Objective: To describe the epidemiological and microbiological profile of IC in critically ill patients. Methods: Observational prospective study conducted from October 2001 to August 2003 in critically ill adults with suspected or confirmed IC. Results: 53 patients met criteria for IC, finding 18 (33.9 percent) candidemias, 22 (41.5 percent) disseminated IC, and 13 (24.5 percent) local IC. We identified 8 (44.4 percent) C. albicans and 10 (55.6 percent) non-albicans Candida in candidemias. C. tropicalis was the predominant non-albicans species (27.7 percent). An 88.8 percent of Candidas sp recovered in candidemias were fluconazole susceptible. Overall hospital mortality was 24.5 percent. Mortality in candidemia was significantly lower than in disseminated IC (16.6 vs 31.8 percent, p = 0.02). Conclusions: A higher proportion of non-albicans Candida was observed in candidemias from critically ill patients. However, most of these strains were fluconazole susceptible. A lower overall mortality was observed in candidemias.


La epidemiología de candidiasis invasora (CI) ha cambiado, lo cual no ha sido suficientemente estudiado en Chile. Objetivo: Describir el perfil epidemiológico y microbiológico de CI en pacientes críticos. Métodos: Estudio observacional prospectivo entre octubre 2001 y agosto 2003, en pacientes críticos adultos con sospecha o confimnación de CI. Resultados: 53 pacientes cumplieron criterios de CI. De ellos, 18 (33,9 por ciento) tuvieron candidemia, 22(41,5 por ciento) CI diseminada y 13(24,5 por ciento) CI local. Entre las candidemias, hubo 8 C. albicans (44,4 por ciento) y 10 Candida no albicans (55,6 por ciento), predominando C. tropicalis (27,7 por ciento). Un 88,8 por ciento de las candidemias fueron susceptibles a fluconazol. La mortalidad hospitalaria global fue 24,5 por ciento, significativamente menor en pacientes con candidemias vs CI diseminada (16,6 vs 31,8 por ciento, p = 0,02). Conclusiones: Se observó una mayor proporción de Candida no albicans en candidemias de pacientes críticos. Sin embargo, la mayoría de estas cepas fue susceptible a fluconazol. La mortalidad global fue menor en candidemias.


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Candidíase Invasiva/mortalidade , Unidades de Terapia Intensiva/estatística & dados numéricos , Antifúngicos/uso terapêutico , Candidíase Invasiva/tratamento farmacológico , Candidíase Invasiva/microbiologia , Mortalidade Hospitalar , Hospitais Universitários , Estudos Prospectivos , Fatores de Risco
19.
Rev. méd. Chile ; 139(4): 542-547, abr. 2011. ilus
Artigo em Espanhol | LILACS | ID: lil-597653

RESUMO

Nowadays, the analysis of genetic markers is a very important and validated tool for the identification of individuals, and for paternity testing. To do so, highly variable regions of the human genome are analyzed, making it possible to obtain the genetic profle of an individual, and to distinguish between different individuals. The methodology used is basically the same all over the world, consisting in the analysis of 13 to 15 markers. To assign biological paternity the child must have inherited the characteristics from the alleged father in each of the genetic markers analyzed. This analysis achieves a certainty higher than with any other test, which is expressed as the probability of paternity. This probability has to be at least 99.9 percent, but greater probabilities are usually obtained, especially if the mother is included in the analysis. If the characteristics of two or more genetic markers from the alleged father are absent in the child, biological paternity is excluded.


El análisis de marcadores genéticos se ha convertido en una herramienta muy importante y ampliamente reconocida para la identificación de individuos y para el estudio de paternidad. Para esto se estudian distintas regiones del genoma humano que son altamente variables en la población y que permiten obtener el perfil genético y distinguir entre distintos individuos. La metodología que se utiliza es básicamente la misma en todo el mundo y consiste en el análisis de entre 13 a 15 marcadores. La paternidad biológica se asigna cuando el hijo/a presenta las características que debe heredar del presunto padre en cada uno de los marcadores genéticos estudiados. A través de este análisis es posible asignar paternidad con un grado de certeza más alto que con cualquier otro sistema, el que se expresa como probabilidad de paternidad. Esta probabilidad debe alcanzar al menos 99,9 por ciento. Sin embargo, es posible obtener probabilidades mucho más altas, sobre todo si se incluye a la madre en el estudio. Si las características genéticas del supuesto padre están ausentes en el hijo/a en al menos dos marcadores, se excluye la paternidad biológica.


Assuntos
Adulto , Pré-Escolar , Feminino , Humanos , Masculino , Marcadores Genéticos/genética , Paternidade , Repetições de Microssatélites/genética , Probabilidade
20.
Radiat Prot Dosimetry ; 143(2-4): 471-6, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21112884

RESUMO

Polysiloxane-based scintillators are promising for employment in harsh environments, owing to their outstanding radiation resistance and thermal properties over the traditional plastics (polyvinyltoluene and polystyrene). In this work, cross-linked polydimethyl-co-diphenylsiloxane (PMPS) scintillators with 22% molar percentage of diphenylsiloxane units have been synthesised. 2,5-Diphenyloxazole and Lumogen Violet (BASF) were employed as primary and secondary fluor, respectively. Thermal neutrons sensitivity was achieved through the addition of 3% wt of ortho-carborane. Scintillation yield measurements were made by exciting with (241)Am alpha source samples with different concentrations of dye molecules. PMPS-based scintillators with ∼50% light yield as compared with the commercial plastic scintillator EJ212 were produced. The scintillation yield of the B-loaded samples under thermal neutrons was tested with a moderated Am-Be source and compared with the commercially available EJ254 (5% wt B). 2.2 MeV neutrons were produced by irradiating with a 4.0 MeV proton beam an LiF target, thus exploiting the reaction (7)Li(p,n)(7)Be. Time-of-flight measurements were performed to distinguish pulses due to neutrons or gamma. A similar test was performed with an EJ254 commercial scintillator for comparison. Using the same set-up, polyethylene bricks were used as a moderator to produce low-energy neutrons for testing B-loaded samples.


Assuntos
Desenho Assistido por Computador , Nêutrons , Monitoramento de Radiação/instrumentação , Contagem de Cintilação/instrumentação , Siloxanas/efeitos da radiação , Desenho de Equipamento , Análise de Falha de Equipamento , Doses de Radiação
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