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1.
Front Microbiol ; 15: 1395568, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38846576

RESUMO

The wood-feeding termite, Coptotermes formosanus, presents an efficient lignocellulolytic system, offering a distinctive model for the exploration of host-microbial symbiosis towards lignocellulose degradation. Despite decades of investigation, understanding the diversity, community structure, and functional profiles of bacterial symbionts within specific gut regions, particularly the foregut and midgut of C. formosanus, remains largely elusive. In light of this knowledge gap, our efforts focused on elucidating the diversity, community composition and functions of symbiotic bacteria inhabiting the foregut, midgut, and hindgut of C. formosanus via metagenomics. The termite harbored a diverse community of bacterial symbionts encompassing 352 genera and 26 known phyla, exhibiting an uneven distribution across gut regions. Notably, the hindgut displayed a higher relative abundance of phyla such as Bacteroidetes (56.9%) and Spirochetes (23.3%). In contrast, the foregut and midgut were predominantly occupied by Proteobacteria (28.9%) and Firmicutes (21.2%) after Bacteroidetes. The foregut harbored unique phyla like Candidate phylum_TM6 and Armatimonadetes. At the family level, Porphyromonadaceae (28.1, 40.6, and 53.5% abundance in foregut, midgut, and hindgut, respectively) and Spirochaetaceae (foregut = 9%, midgut = 16%, hindgut = 21.6%) emerged as dominant families in the termite's gut regions. Enriched operational taxonomic units (OTUs) were most abundant in the foregut (28), followed by the hindgut (14), while the midgut exhibited enrichment of only two OTUs. Furthermore, the functional analyses revealed distinct influences of bacterial symbionts on various metabolic pathways, particularly carbohydrate and energy metabolisms of the host. Overall, these results underscore significant variations in the structure of the bacterial community among different gut regions of C. formosanus, suggesting unique functional roles of specific bacteria, thereby inspiring further investigations to resolve the crosstalk between host and microbiomes in individual gut-regions of the termite.

2.
PDA J Pharm Sci Technol ; 78(3): 348-357, 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38942475

RESUMO

In the execution of its legislated responsibilities, the United States Food and Drug Administration commonly refers to standard test methods detailed in the United States Pharmacopeia (USP). Microbiological test methods (contained in general chapters) are listed in chapters <51> to <80> with details regarded as enforceable where referenced as a test method. USP <61> "Microbiological Examination of Nonsterile Products: Microbial Enumeration Tests" is a globally harmonized chapter that has been successfully employed for the enumeration of microorganisms recoverable from nonsterile finished drug products. The content of USP <61> is not always scientifically principled nor emphatically understood by all pharmaceutical microbiologists. Consequently, misunderstanding and misapplication of USP <61> may result in analyses and assessments of microbiological quality that are flawed or erroneous. In this article, clarification is provided to assist the pharmaceutical microbiologist in the appropriate and intended use of USP <61>, including provision of details not always commonly known or understood.


Assuntos
Contaminação de Medicamentos , Farmacopeias como Assunto , Farmacopeias como Assunto/normas , Contaminação de Medicamentos/prevenção & controle , Estados Unidos , United States Food and Drug Administration/normas , Técnicas Microbiológicas/normas , Técnicas Microbiológicas/métodos , Contagem de Colônia Microbiana/normas , Preparações Farmacêuticas/normas , Preparações Farmacêuticas/análise
3.
Insects ; 14(4)2023 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-37103218

RESUMO

Fungus-growing termites are eusocial insects that represent one of the most efficient and unique systems for lignocellulose bioconversion, evolved from a sophisticated symbiosis with lignocellulolytic fungi and gut bacterial communities. Despite a plethora of information generated during the last century, some essential information on gut bacterial profiles and their unique contributions to wood digestion in some fungus-growing termites is still inadequate. Hence, using the culture-dependent approach, the present study aims to assess and compare the diversity of lignocellulose-degrading bacterial symbionts within the gut systems of three fungus-growing termites: Ancistrotermes pakistanicus, Odontotermes longignathus, and Macrotermes sp. A total of 32 bacterial species, belonging to 18 genera and 10 different families, were successfully isolated and identified from three fungus-growing termites using Avicel or xylan as the sole source of carbon. Enterobacteriaceae was the most dominant family represented by 68.1% of the total bacteria, followed by Yersiniaceae (10.6%) and Moraxellaceae (9%). Interestingly, five bacterial genera such as Enterobacter, Citrobacter, Acinetobacter, Trabulsiella, and Kluyvera were common among the tested termites, while the other bacteria demonstrated a termite-specific distribution. Further, the lignocellulolytic potential of selected bacterial strains was tested on agricultural waste to evaluate their capability for lignocellulose bioconversion. The highest substrate degradation was achieved with E. chengduensis MA11 which degraded 45.52% of rice straw. All of the potential strains showed endoglucanase, exoglucanase, and xylanase activities depicting a symbiotic role towards the lignocellulose digestion within the termite gut. The above results indicated that fungus-growing termites harbor a diverse array of bacterial symbionts that differ from species to species, which may play an inevitable role to enhance the degradation efficacy in lignocellulose decomposition. The present study further elaborates our knowledge about the termite-bacteria symbiosis for lignocellulose bioconversion which could be helpful to design a future biorefinery.

4.
Folia Microbiol (Praha) ; 67(6): 861-872, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35729301

RESUMO

Chironomids are the most abundant aquatic insects in freshwater habitats that can survive in extreme conditions. In this study, as the microbiome provides extended genotype to the host to perform various functions, we explored the microbiota of the Chironomus circumdatus larvae to find out the putative role played by the symbiotic bacteria for the host. The metabarcoding analyses of the larvae revealed that the insect harbors 1771 phylotypes. Out of the various microbial communities found, the majority corresponded to the phyla Proteobacteria (52.59%) and Actinobacteria (20.56%), respectively. The midges also harbored Klebsiella (2.57%), Enterobacter (1.32%), Bacillus (2.29%), and Acinetobacter (2.13%) genera that are involved in detoxification of xenobiotics present in the water. The presence of radiation-resistant genera like Deinococcus, including bacterial species like radiodurans, a highly radiation-resistant bacterium, indicates its potential to support the host's ability to sustain in adverse environments. The functional profiling of the bacteria showed the relative abundance of many enzyme groups, such as transferases (40.62%), oxidoreductases (23.49%), and hydrolases (3.77%). The results indicate that the larvae harbor a considerable variety of bacteria that help the host adapt and survive in the polluted waters. The present study provides thorough insights into the microbiome of the C. circumdatus larvae that can be exploited for the bioremediation of certain pollutants through biomimetic strategies. It also gives us a wake-up call to take a good look at the guts of these disease-carrying insects' inabilities to spread deadly human diseases.


Assuntos
Chironomidae , Microbioma Gastrointestinal , Microbiota , Animais , Humanos , Chironomidae/microbiologia , Larva/microbiologia , Bactérias/genética
5.
Insect Sci ; 29(5): 1414-1432, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35134272

RESUMO

The wood-feeding termite Coptotermes formosanus represents a unique and impressive system for lignocellulose degradation. The highly efficient digestion of lignocellulose is achieved through symbiosis with gut symbionts like bacteria. Despite extensive research during the last three decades, diversity of bacterial symbionts residing in individual gut regions of the termite and their associated functions is still lacking. To this end, cellulose, xylan, and dye-decolorization bacteria residing in foregut, midgut, and hindgut regions of C. formosanus were enlisted by using enrichment and culture-dependent molecular methods. A total of 87 bacterial strains were successfully isolated from different gut regions of C. formosanus which belonged to 27 different species of 10 genera, majorly affiliated with Proteobacteria (80%) and Firmicutes (18.3%). Among the gut regions, 37.9% of the total bacterial isolates were observed in the hindgut that demonstrated predominance of cellulolytic bacteria (47.6%). The majority of the xylanolytic and dye-decolorization bacteria (50%) were obtained from the foregut and midgut, respectively. Actinobacteria represented by Dietza sp. was observed in the hindgut only. Based on species richness, the highest diversity was observed in midgut and hindgut regions each of which harbored seven unique bacterial species. The members of Enterobacter, Klebsiella, and Pseudomonas were common among the gut regions. The lignocellulolytic activities of the selected potential bacteria signpost their assistance to the host for lignocellulose digestion. The overall results indicate that C. formosanus harbors diverse communities of lignocellulolytic bacteria in different regions of the gut system. These observations will significantly advance our understanding of the termite-bacteria symbiosis and their microbial ecology uniquely existed in different gut regions of C. formosanus, which may further shed a light on its potential values at termite-modeled biotechnology.


Assuntos
Isópteros , Animais , Bactérias , Celulose/metabolismo , Corantes/metabolismo , Isópteros/microbiologia , Polissacarídeos , Simbiose , Madeira/metabolismo , Xilanos/metabolismo
6.
Ecotoxicology ; 31(3): 385-395, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35083604

RESUMO

Phthalates are used as plasticizers in products made of polyvinyl chloride to increase the flexibility of polymers. Unfortunately, these are known to cause adverse effects on living organisms, and also, fast depletion of petroleum resources calls for the exploration of alternatives as replacements. Recent developments in bio-based plasticizers have led to their use as additives for various applications. As they have received much attention in the past decade, it is crucial to study the effects of these plasticizers on living organisms. Hence, we tried to compare the effects of synthetic plasticizer dioctyl phthalate and bio-based plasticizer ethanolamine on Chironomus circumdatus larvae. Mortality was achieved at a lethal concentration (LC50) value of 0.385 mg/L for ethanolamine and dioctyl phthalate at 0.125 mg/L. Disruption in the level of metabolites along with lipid peroxidation was observed in the larvae exposed to plasticizer mediated stress. To overcome these changes, an increase in the levels of antioxidant enzymes such as Superoxide Dismutase, Catalase, Glutathione Peroxidase and Glutathione Reductase, as well as in the levels of detoxifying enzymes like Glutathione-S-Transferase, Esterases and Mixed Function Oxidase during post-exposure recovery conditions was seen. Alterations in the expression levels of heat shock protein 70 and ecdysone receptor genes were also observed. From the comparative study, it could be concluded that Chironomus circumdatus larvae, to a certain extent, have developed tolerance to both ethanolamine and dioctyl phthalate mediated stress. However, dioctyl phthalate has led to more stress as compared to ethanolamine in these larvae.


Assuntos
Chironomidae , Poluentes Químicos da Água , Animais , Larva , Peroxidação de Lipídeos , Estresse Oxidativo , Plastificantes/toxicidade , Poluentes Químicos da Água/metabolismo , Poluentes Químicos da Água/toxicidade
7.
Microorganisms ; 9(9)2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34576846

RESUMO

Bioconversion of lignocellulose into renewable energy and commodity products faces a major obstacle of inefficient saccharification due to its recalcitrant structure. In nature, lignocellulose is efficiently degraded by some insects, including termites and beetles, potentially due to the contribution from symbiotic gut bacteria. To this end, the presented investigation reports the isolation and characterization of cellulolytic bacteria from the gut system of red flour beetle, Tribolium castaneum. Out of the 15 isolated bacteria, strain RSP75 showed the highest cellulolytic activities by forming a clearance zone of 28 mm in diameter with a hydrolytic capacity of ~4.7. The MALDI-TOF biotyping and 16S rRNA gene sequencing revealed that the strain RSP75 belongs to Bacillus altitudinis. Among the tested enzymes, B. altitudinis RSP75 showed maximum activity of 63.2 IU/mL extract for xylanase followed by ß-glucosidase (47.1 ± 3 IU/mL extract) which were manifold higher than previously reported activities. The highest substrate degradation was achieved with wheat husk and corn cob powder which accounted for 69.2% and 54.5%, respectively. The scanning electron microscopy showed adhesion of the bacterial cells with the substrate which was further substantiated by FTIR analysis that depicted the absence of the characteristic cellulose bands at wave numbers 1247, 1375, and 1735 cm-1 due to hydrolysis by the bacterium. Furthermore, B. altitudinis RSP75 showed co-culturing competence with Saccharomyces cerevisiae for bioethanol production from lignocellulose as revealed by GC-MS analysis. The overall observations signify the gut of T. castaneum as a unique and impressive reservoir to prospect for lignocellulose-degrading bacteria that can have many biotechnological applications, including biofuels and biorefinery.

8.
Anaesthesia ; 76(12): 1635-1647, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34251028

RESUMO

Ergonomics in relation to anaesthesia is the scientific study of the interaction between anaesthetists and their workspace environment in order to promote safety, performance and well-being. The foundation for avoiding pain or discomfort at work is to adopt and maintain a good posture, whether sitting or standing. Anaesthetists should aim to keep their posture as natural and neutral as possible. The successful practice of anaesthesia relies on optimisation of ergonomics and lack of attention to detail in this area is associated with impaired performance. The anaesthetic team should wear comfortable clothing, including appropriately-sized personal protective equipment where necessary. Temperature, humidity and light should be adequate at all times. The team should comply with infection prevention and control guidelines and monitoring as recommended by the Association of Anaesthetists. Any equipment or machinery that is mobile should be positioned where it is easy to view or reach without having to change the body or head position significantly when interacting with it. Patients who are supine should, whenever possible, be raised upwards to limit the need to lean towards them. Any item required during a procedure should be positioned on trays or trolleys that are close to the dominant hand. Pregnancy affects the requirements for standing, manually handling, applying force when operating equipment or moving machines and the period over which the individual might have to work without a break. Employers have a duty to make reasonable adjustments to accommodate disability in the workplace. Any member of staff with a physical impairment needs to be accommodated and this includes making provision for a wheelchair user who needs to enter the operating theatre and perform their work.


Assuntos
Ergonomia/métodos , Local de Trabalho , Extubação , Anestesia Geral , Ergonomia/instrumentação , Humanos , Umidade , Unidades de Terapia Intensiva , Intubação Intratraqueal , Iluminação , Segurança do Paciente , Equipamento de Proteção Individual , Temperatura
9.
Curr Microbiol ; 78(8): 3165-3172, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34191052

RESUMO

Insects harbor bacteria that are a rich source of enzymes that can be utilized for various industrial and biotechnological applications. It is predicted that during evolution these detoxifying enzymes have been acquired by insects through bacteria. However, the role of host insect detoxification enzymes has already been extensively studied but only a few resistance development studies have been focused on the enzymes derived from gut bacteria. Thus in this study, two bacterial isolates were found in the gut of Chironomous circumdatus larvae having esterase activity, out of which one bacterium was molecular characterized and it was found to be Enterobacter mori designated as strain BI1245. Further, crude extract from the bacterium was characterized and it was observed that it showed maximum activity at pH 8 and temperature 60 °C. Moreover, the crude extract showed 0.26 mM and 290 U/mg of protein as Km and Vmax value when p-nitrophenyl acetate was used as a substrate. Thereafter, the bacterial isolate was incubated in minimal salts medium containing modified phthalates and it was found that bacterium could utilize shorter alkyl-chain phthalic acid esters faster as compared to long alkyl chains thereby indicating that side chain of the substrates has a significant effect on the utilization of phthalic acid esters. Thus the gut flora present in insects may play an important role in providing resistance to the host to live in phthalate polluted water.


Assuntos
Chironomidae , Ácidos Ftálicos , Animais , Enterobacter , Esterases , Concentração de Íons de Hidrogênio
10.
Arch Microbiol ; 203(5): 1953-1969, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33710379

RESUMO

One of the most abundant natural polymers on earth, chitin is a fibrous and structural polysaccharide, composed of N-acetyl-D-glucosamine. The biopolymer is the major structural constituent of fungi, arthropods, mollusks, nematodes, and some algae. The biodegradation of chitin is largely manifested by chitinolytic enzyme secreting organisms including bacteria, insects, and plants. Among them, bacterial chitinases represent the most promising, inexpensive, and sustainable source of proteins that can be employed for industrial-scale applications. To this end, the presented review comes at a timely moment to highlight the major sources of chitinolytic bacteria. It also discusses the potential pros and cons of prospecting bacterial chitinases that can be easily manipulated through genetic engineering. Additionally, we have elaborated the recent applications of the chitin thereby branding chitinases as potential candidates for biorefinery and biomedical research for eco-friendly and sustainable management of chitin waste in the environment.


Assuntos
Bactérias/metabolismo , Bioprospecção , Quitina/metabolismo , Quitinases/metabolismo , Acetilglucosamina/metabolismo , Bactérias/enzimologia , Bactérias/genética , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Biodegradação Ambiental , Quitina/química , Quitinases/genética , Engenharia Genética
11.
Artigo em Inglês | MEDLINE | ID: mdl-33619421

RESUMO

ABSTRACT: The management of house fly, Musca domestica has become immensely important to prevent epidemics of many detrimental diseases. In view of this objective, the present study demonstrates the efficacy of lemongrass (LG) and tea tree essential oils (TTEOs) against M. domestica. The TTEO proved to be more lethal against larvae and adults of M. domestica depicting an LC50 at 14.88 mg/ dm3 which was 17.19 mg/ dm3 for LGEO. In contrast, pupicidal effect of LGEO was much higher (LD50, 14.49 µl/0.25L) as compared to TTEO. The LGEO drastically reduced the total body sugar, glycogen and protein contents by 3.29, 2.95 and 7.56 fold, respectively, contrasting with high influence of TTEO on lipid content of the late 3rd instar larvae. A considerable reduction in gut enzymes secretion was observed due to treatment of EOs thereby altering gut physiology of the insect. Moreover, significant inhibition of acetylcholine esterase (AchE) was also observed with LGEO at LC50 concentration (5.33 mg/ml) inhibiting insect neurotransmission. The gas chromatography-mass spectrometric (GC-MS) analysis of the LGEO showed 12 major compounds dominated by Citral whereas TTEO contained only 5 major compounds. Further analysis by field emission scanning electron microscopy (FESEM) revealed distortion and shrinkage of larval bodies caused by the treatment of EOs. These overall observations brand LG and TT-EOs as potential organic-insecticides against M. domestica. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s40011-020-01220-z) contains supplementary material, which is available to authorized users.

12.
Indian J Tuberc ; 67(4S): S3-S6, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33308669

RESUMO

OBJECTIVE: Establishment of a TB research centre with the aim of studying the feasibility of domiciliary treatment for the masses. METHODS: In-depth case study of the TB chemotherapy Centres's initial activities and development. RESULTS: Successful setting up of a research centre in 1956 at Madras. CONCLUSION: Four agencies collaborated successfully to demonstrate that domiciliary treatment for the masses is feasible.


Assuntos
Instalações de Saúde/história , Tuberculose Pulmonar/história , História do Século XX , Humanos , Índia , Tuberculose Pulmonar/prevenção & controle
13.
Artigo em Inglês | MEDLINE | ID: mdl-31669664

RESUMO

Plasticizers are used as additives in making plastics. Diethyl phthalate (DEP) is one of the majorly used plasticizers in various products. When plastic materials are dumped in an aquatic system, there is an increase in chances of DEP leaching out and getting deposited in water. Thus the current work focuses on studying the effect of DEP on the larval stages of Chironomus circumdatus. In this study it was found that there was an increase in lipid peroxidation levels indicating imposition of oxidative stress on these larvae due to the exposure of DEP. Changes in the levels of carbohydrates and lipids were also seen. To reduce these effects antioxidant defense system may get activated. Thus investigations showed an increase in enzymatic activity of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and acetylcholinesterases (AchE) and decrease in the activity of glutathione reductase (GR). Nonenzymatic antioxidant glutathione levels were also increased during the post-recovery exposure period. Thus this indicates that both enzymatic, as well as non-enzymatic antioxidants, play a certain role in reducing the stress mediated by DEP. Up-regulation of gene expression of heat shock protein70 (hsp70) was observed, which is one of the conserved protein produced during stress response in many dipterans. Changes in the level of expression of the ecdysone receptor (EcR) gene were also seen in DEP exposed larvae. Thus the insights give us a preliminary indication that physiological and developmental adaptations may take place in these organisms to persist in the DEP contaminated environment. CAPSULE: DEP mediated stress imposes changes in the metabolites and thus activation of antioxidant defense system in aquatic midges of Chironomus circumdatus. Changes in the expression of heat shock protein70 and ecdysone receptor was also seen indicating that DEP mediated stress affects at the molecular level also of the organism. These changes may help them to tolerate and live in DEP polluted water.


Assuntos
Chironomidae/efeitos dos fármacos , Estresse Oxidativo , Ácidos Ftálicos/toxicidade , Plastificantes/toxicidade , Poluentes Químicos da Água/toxicidade , Animais , Metabolismo dos Carboidratos , Catalase/metabolismo , Chironomidae/metabolismo , Glutationa Peroxidase/metabolismo , Glutationa Redutase/metabolismo , Peroxidação de Lipídeos , Espécies Reativas de Oxigênio/metabolismo , Superóxido Dismutase/metabolismo
14.
J Postgrad Med ; 65(4): 227-232, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31571620

RESUMO

Biosimilars are being marketed in India since 2000. Like biologics, biosimilars have a large size, complex structure, and complicated manufacturing process, and they are produced in a living organism. It requires specialized delivery devices for administration and needs tighter temperature control to prevent degradation. As biosimilar development follows abbreviated pathway, adverse events (AEs) previously unknown during a clinical trial may be detected postmarketing. In India, the awareness on pharmacovigilance has increased significantly after implementation of the pharmacovigilance guidance in January 2018. However, biologics require tighter monitoring to ensure their safety and efficacy. This review article discusses the importance of pharmacovigilance for biosimilars, how it is different from generics, and provides recommendations to sensitize clinicians and researchers about the requirement of a different approach to improve pharmacovigilance for biosimilars. Pharmacovigilance for biosimilars is as important as it is for innovator biologics and more important than that for generics.


Assuntos
Produtos Biológicos/normas , Medicamentos Biossimilares/normas , Aprovação de Drogas , Medicamentos Genéricos/normas , Farmacovigilância , Humanos , Índia
15.
Anaesthesia ; 73(5): 579-586, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29349776

RESUMO

The Difficult Airway Society 2015 guidelines recommend and describe in detail a surgical cricothyroidotomy technique for the can't intubate, can't oxygenate (CICO) scenario, but this can be technically challenging for anaesthetists with no surgical training. Following a structured training session, 104 anaesthetists took part individually in a simulated can't intubate, can't oxygenate event using simulation and airway models to evaluate how well they could perform these front-of-neck access techniques. Main outcomes measures were: ability to correctly perform the technical steps; procedural time; and success rate. Outcomes were compared between palpable and impalpable cricothyroid membrane scenarios. Anaesthetists' technical abilities were good, as assessed by a video analysis checklist score. Mean (SD) procedural time was 44 (16) s and 65 (17) s for the palpable and impalpable cricothyroid membrane models, respectively (p ≤ 0.001). First-pass tracheal tube placement was obtained in 103 out of the 104 palpable cricothyroidotomies and in 101 out of the 104 impalpable cricothyroidotomies (p = 0.31). We conclude that anaesthetists can be trained to perform surgical front-of-neck access to an acceptable level of competence and speed when assessed using a simulator.


Assuntos
Serviços Médicos de Emergência , Músculos Laríngeos/cirurgia , Pescoço/cirurgia , Palpação , Adulto , Manuseio das Vias Aéreas , Anestesiologia/educação , Competência Clínica , Feminino , Humanos , Internato e Residência , Intubação Intratraqueal , Músculos Laríngeos/anatomia & histologia , Masculino , Manequins , Pescoço/anatomia & histologia , Obesidade/complicações , Tireoidectomia
17.
Int J Tuberc Lung Dis ; 21(4): 420-424, 2017 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-28284257

RESUMO

SETTING: Rural community in South India. OBJECTIVE: To determine the role of bacille Calmette-Guérin (BCG) in preventing tuberculous infection in children. DESIGN: A prevalence survey was undertaken in 1999-2001 in a representative rural population in Tiruvallur District in South India using cluster sampling. Tuberculin testing was performed among all children aged <15 years, and all adults aged 15 years were questioned about chest symptoms and underwent radiography, followed by sputum examinations, if indicated. RESULTS: In children living in households with a tuberculosis case, the proportion with evidence of tuberculous infection was 35.5% of 200 in the absence of a BCG scar and 27.0% of 100 in its presence, a reduction of 24% (P = 0.14). In very young children (age <5 years), the corresponding proportions were 29.1% of 55 and 11.9% of 42, a reduction of 59%; the difference was statistically significant (P = 0.048). CONCLUSION: There is a possible role for BCG in preventing tuberculous infection in very young children.


Assuntos
Vacina BCG/administração & dosagem , População Rural , Escarro/microbiologia , Tuberculose/prevenção & controle , Adolescente , Fatores Etários , Criança , Pré-Escolar , Características da Família , Feminino , Humanos , Índia , Lactente , Recém-Nascido , Masculino , Prevalência , Estudos Retrospectivos , Teste Tuberculínico , Tuberculose/diagnóstico , Tuberculose/epidemiologia
19.
Lupus ; 26(3): 299-306, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27510603

RESUMO

Objective The objective of this article is to describe and compare clinical features, treatment, and renal outcomes of children with membranous lupus nephritis (MLN), through analysis of a national multicenter registry. Methods Patients with pediatric systemic lupus erythematosus (SLE) and MLN from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry were included. Demographic, disease and medication-related data were collected between 2010 and 2014 from 59 CARRA Legacy Registry sites. Results A total of 132 individuals had MLN, either in isolation or in combination with proliferative LN. Seventy-four patients had pure MLN. The proportion of patients with daily corticosteroid treatment was similar among groups (96%, 91%, and 96%, for class III+V, IV+V, and V, respectively, p = 0.67). Proportion of individuals exposed to any disease-modifying antirheumatic drug (DMARD) or biologic was similar among the three groups (83%, 91%, 95% for class III+V, IV+V, and V, respectively, p = 0.189). Proportion of patients with decreased glomerular filtration rate (less than 90 ml/min/1.73 m2) was significantly different among groups (4%, 38%, and 4%, for class III+V, IV+V, and V, respectively, p < 0.0001). Conclusion This is the largest reported cohort of children with MLN. More research is needed to understand treatment practices for pediatric MLN, particularly decisions related to pharmacologic treatment of pure MLN. More work is also needed to identify prognostic factors and predictors of outcome for pediatric MLN. Future observational studies will be a first step toward understanding and formulating a standardized approach to treatment of pediatric membranous LN and allowing for the initiation of prospective comparative effectiveness studies and interventional trials.


Assuntos
Antirreumáticos/uso terapêutico , Glomerulonefrite Membranosa/tratamento farmacológico , Glomerulonefrite Membranosa/epidemiologia , Nefrite Lúpica/tratamento farmacológico , Nefrite Lúpica/epidemiologia , Adolescente , Criança , Comportamento Cooperativo , Feminino , Taxa de Filtração Glomerular , Glomerulonefrite Membranosa/complicações , Humanos , Rim/patologia , Estudos Longitudinais , Nefrite Lúpica/patologia , Masculino , Pediatria , Sistema de Registros , Sociedades Médicas , Estados Unidos
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