RESUMO
Objetivo: Determinar los factores de riesgo asociados a preeclampsia en las pacientes del área de GinecoObstetricia, en el Hospital Nacional Nuestra Señora de Fátima Cojutepeque, El Salvador, de enero a junio del año 2018 Diseño: Analítico, de casos y controles. Tomando a 50 expedientes de pacientes que presentaron preeclampsia y 150 expedientes al azar que no la presentaron, usando como base el sistema perinatal y el sistema de morbimortalidad. Resultado: La edad más frecuente fue de 18 años (27.5%). El área geográfica no tuvo relación con la preeclamsia (OR=0.85; p=0.685). Las primigestas tuvieron más riesgo de padecer preeclamsia (OR=2.4; p=0.009); las pacientes acompañadas un 33.3% presentaron preeclampsia. las que llevo más de un control 49(25.9%.) presentaron preeclampsia, 1(0.5%) cual presento hemorragia y preeclampsia (p 0.082.) no hubo óbitos, embarazos molares ni bajo peso. solo 1(1%) fue catalogada como obesas (P 0.41 y un OR de 1.34). Solo una paciente padeció Diabetes mellitus y preeclampsia. 192(92%), 7 (87.5%) presentaron preeclampsia e hipertensión (p 0.000 y un OR de 0.73), solo un caso reportado que no recibió nutrientes (p 0.56: OR de 0.57). Conclusiones: Los principales factores presentes fueron la edad, área rural, primigestas que no tienen apoyo de la pareja y que padecen diabetes mellitus. Los controles prenatales y micro nutrientes sugieren ser un factor protector para la preclamsia, El nivel de estudio de las mujeres así como las hemorragias óbitos y embarazos molares obesidad o desnutrición no tuvieron una significancia estadística
Assuntos
Humanos , Gravidez , Pré-Eclâmpsia , Complicações na Gravidez , Pressão Sanguínea , Fatores de Risco , Gravidez de Alto Risco , Estudos de Casos e Controles , EpidemiologiaRESUMO
The aim of this study was to increase the antibacterial spectrum of modified hen egg white lysozyme (HEWL) with thermal and chemical treatments against Gram-negative bacteria. The antibacterial activity of heat-denatured HEWL and chemical denatured HEWL against Gram-negative and Gram-positive bacteria was evaluated in 15 h of incubation tests. HEWL was denatured by heating at pH 6.0 and pH 7.0 and chemical denaturing was carried out for 1.0, 1.5, 2.0, and 4.0 h with DL-Dithiothreitol (DTT). HEWL modified by thermal and chemical treatments was characterized using the sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) electrophoresis method. Heat-denatured HEWL lytic activity against Micrococcus lysodeikticus lessened with increasing temperature and time of incubation with the chemical agent (DTT). The loss of lytic activity in modified HEWL suggests that the mechanism of action of the antibacterial activity is not dependent on the lytic activity. Thermal and chemical treatments of HEWL enabled the production of oligoforms and increased antibacterial activity over a wider spectrum. Heat-denatured HEWL at pH 6.0 and chemically-denatured HEWL increased the HEWL antibacterial spectrum against Gram-negative bacteria (Escherichia coli ATCC 25922). HEWL at 120 °C and pH 6.0 (1.0 mg/mL) inhibited 78.20% of the growth of E. coli. HEWL/DTT treatment for 4.0 h (1.0 mg/mL) inhibited 68.75% of the growth E. coli. Heat-denatured HEWL at pH 6.0 and pH 7.0 and chemically-denatured HEWL (1.0, 1.5, 2.0, and 4.0 h with DTT) were active against Gram-positive bacteria (Staphylococcus carnosus CECT 4491T). Heat-denatured and chemical-denatured HEWL caused the death of the bacteria with the destruction of the cell wall. LIVE/DEAD assays of fluorescent dye stain of the membrane cell showed membrane perturbation of bacteria after incubation with modified HEWL. The cell wall destruction was viewed using electron microscopy. The results obtained in this study suggest that heat-denatured HEWL at pH 6.0 and chemical-denatured HEWL treatments increase the HEWL antibacterial activity against Gram-negative bacteria.
RESUMO
OBJECTIVE: Despite the progress that has been reached in emergency medical systems and resuscitation, sudden cardiac death (SCD) continues to be the major cause of the death, and remains a significant public health problem. In this publication we are reporting our Latin American experience in the secondary prevention of SCD, by means of an ongoing registry involving seven Latin American countries and 770 patients. METHODS: Every individual within the present registry to date has presented with antecedents of aborted sudden death or cardiac arrest due to ventricular tachycardia or ventricular fibrillation. Patients included have fulfilled the Class I indication for implantable cardioverter defibrillator (ICD) and they were implanted with a Biotronik ICD (all models). The study was not sponsored by Biotronik, nor did they have access to the data. A specific protocol was designed for implantation and follow-up of patients. The database was completely registered through the Internet and a personal password was assigned to each group of investigators. The primary end point was death from all causes. Secondary end points were SCD and death due to congestive heart failure (CHF). RESULTS: The etiology of cardiac disease was found to be predominantly coronary artery disease (CAD) 39.7% (306 patients), followed by Chagas disease (ChD), 26.1% (201 patients), and idiopathic dilated cardiomyopathy (DCM), 17% (131 patients). Any remaining pathologies were included as miscellaneous 13.2% (101 patients). In 31 patients (4%) the etiology was unknown. The age did not differ within the principal pathologies, but was significantly older than the miscellaneous group (62.0 +/- 11.3 years vs 48.2 +/- 18.9 years, P < 0.0001). The follow-up period was 27 +/- 25 months (1-113 months) for the whole group. The mortality in functional classes I-II was significantly lower than mortality for functional classes III-IV (relative risk 1.46, CI 95%, P < 0.0001). Mean left ventricular ejection fraction (LVEF) for the whole group was 37.7 +/- 14.3%. Male LVEF was 36.1 +/- 14.1% and female LVEF was 42.2 +/- 13.8% P < 0.0001. During the follow-up period, 130 deaths were reported (global mortality 16.9 +/- 9.7%), out of which 84 (64.6%) were attributed to cardiac causes (10.9 +/- 5.1% of the total population). The annual adjusted cardiac mortality was 5.2 +/- 1.72% (range 3.5-7.0%). Among cardiac deaths the most common cause was progressive heart failure, 48 patients (57%) including 3 patients with pulmonary embolism. The second main cause of cardiac death was SCD, 36 patients (43%), including 4 patients with electrical storm and 3 patients with electromechanical dissociation after multiple shock therapy treatments. CONCLUSIONS: Despite the differences in terms of pathologies between the ICD-LABOR (Latin American bioelectronic ongoing registry) and randomized ICD trials, a parallel evolution in all cause mortality and cardiac mortality was observed. Independent risk factors for mortality included age >70 years, male gender, NYHA III/IV, and ejection fraction <0.30. The etiology of heart disease (Chagas vs Coronary Disease) was not found to be a risk factor.
