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Introducción. Según la Organización Mundial de la Salud, la cuarta parte de la población mundial sufre hipertensión arterial y diabetes mellitus tipo 2. Al padecer estas dos enfermedades, el riesgo de desarrollar enfermedad renal crónica, se multiplica. Objetivo. Analizar los conocimientos, actitudes y prácticas sobre la prevención de enfermedad renal crónica en usuarios con diabetes mellitus tipo 2 e hipertensión arterial, en el municipio de Jocoaitique, departamento de Morazán. Metodología. Estudio transversal descriptivo. Los datos fueron recolectados en visitas domiciliares y en la consulta general, realizando una entrevista a 125 personas, 108 hipertensos y 17 diabéticos. Luego fueron analizados a través del programa Perfect Statistics Professionally Presented versión libre. Resultados. De los participantes, el 96 % tiene un bajo nivel educativo, el 4 % ha realizado bachillerato y estudios superiores; el 83 % pertenece al área rural y la ocupación predominante es ama de casa (58 %); el resto son jornaleros y agricultores (38 %). El 73 % tienen un nivel medio de conocimientos, el 66 % actitudes de indiferencia y el 76 % realizan prácticas inadecuadas de autocuidado en la prevención de la enfermedad renal crónica. Conclusiones. Los conocimientos sobre la prevención de la enfermedad renal crónica, se encuentran en un nivel medio en la mayoría de los encuestados. Más de la mitad de la población expresa actitudes de indiferencia y más de la tercera parte realiza prácticas inadecuadas de prevención sobre la enfermedad renal crónica
Introduction. According to the World Health Organization, a quarter of the world's population suffers from hypertension and type 2 diabetes mellitus. By suffering from these two diseases, the risk of developing chronic kidney disease multiplies. Objective. To analyze the knowledge, attitudes and practices on the prevention of chronic kidney disease in users with type 2 diabetes mellitus and arterial hypertension, in the municipality of Jocoaitique, department of Morazán. Methodology. Descriptive cross-sectional study. The data were collected in home visits and in the general consultation, conducting an interview with 125 people, 108 hypertensive and 17 diabetics. They were then analyzed through the Perfect Statistics Professionally Presented free version program. Results. Of the participants, 96% have a low educational level, 4% have completed high school and higher education; 83% belong to rural areas and the predominant occupation is housewife (58%); the rest are day laborers and farmers (38%). 73% have a medium level of knowledge, 66% attitudes of indifference and 76% carry out inadequate self-care practices in the prevention of chronic kidney disease. Conclusions. Knowledge about the prevention of chronic kidney disease is at an average level in most of the respondents. More than half of the population expresses attitudes of indifference and more than a third carry out inadequate prevention practices regarding chronic kidney disease
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Diabetes Mellitus Tipo 2 , Insuficiência Renal Crônica , HipertensãoRESUMO
RESUMEN Fundamento: el diagnóstico prenatal citogenético forma parte de la atención que se brinda a la embarazada de alto riesgo y es un componente indispensable de los programas preventivos de genética que impulsa la Organización Mundial de la Salud. Objetivo: exponer los resultados del diagnóstico prenatal citogenético en la provincia Cienfuegos entre los años 2007 y 2018. Método: se realizó un estudio descriptivo, retrospectivo, análisis estadístico y de serie cronológica desarrollado en el Centro Provincial de Genética Médica de Cienfuegos acerca de todos los diagnósticos prenatales citogenéticos que se realizaron entre los años 2007 y 2018. Se analizaron: causas de estudio, cantidad de diagnósticos realizados, tipos de anomalías detectadas, relación entre las causas del estudio con los resultados del diagnóstico. Estos diagnósticos se obtuvieron de la base de datos del laboratorio de la Institución y se realizó una valoración cualitativa y cuantitativa de su comportamiento en el periodo analizado. Los resultados se presentan en tablas mediante números absolutos y porcentajes. Resultados: en el período estudiado se determinaron 3260 diagnósticos prenatales citogenéticos, de ellos 83 presentaron alteraciones cromosómicas, para un 2,6 % de positividad. Solo el 33, 7 % de los casos positivos y sanos portadores tienen menos de 37 años. La anomalía cromosómica más frecuente fue la trisomía libre del 21 (45,8 %), las aberraciones estructurales fueron el 21,7 %, los mosaicos el 13,3 %, y el motivo de indicación más frecuente entre los casos positivos fue la edad materna avanzada (45 casos). Conclusiones: los indicadores analizados se comportan de manera similar a los reportados en en el 2012 y en la literatura de Cuba y del mundo.
ABSTRACT Background cytogenetic prenatal diagnosis is part of the care provided to the high-risk pregnant woman and is an indispensable component of preventive genetic programs promoted by the World Health Organization. Objective: to expose the results of the cytogenetic prenatal diagnosis in the Cienfuegos province between 2007 and 2018. Method: a descriptive, retrospective, statistical and chronological series analysis was carried out at the Provincial Center of Medical Genetics of Cienfuegos about all the cytogenetic prenatal diagnoses made between 2007 and 2018. There were analyzed: causes of study, number of diagnoses made, types of anomalies detected, relationship between causes of the study with the results of the diagnosis. Diagnoses were obtained from the database of the Institution's laboratory and a qualitative and quantitative assessment of their behavior was carried out during the period analyzed. The results are presented in tables using absolute numbers and percentages. Results: 3260 cytogenetic prenatal diagnoses were determined during the study period, 83 of them presented chromosomal alterations, for 2,6 % positivity. Only 33,7 % of positive cases and healthy carriers are under 37 years old. The most frequent chromosomal abnormality was the free trisomy of 21 (45,8 %), the structural aberrations were 21,7 %, the mosaics were 13,3 %, and the most frequent reason for indication among the positive cases was age advanced maternal (45 cases). Conclusions: the indicators analyzed behave similarly to those reported in 2012, in the literature of Cuba and the world.
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OBJECTIVE: To evaluate the risk factors associated with pre-neoplastic lesions and gastric cancer in countries with different cancer risk in Latin America. METHODS: 1222 questionnaires of risk factors related to pre-neoplastic lesions and gastric cancer were obtained from patients from Mexico (Nâ¯=â¯559), Colombia (Nâ¯=â¯461) and Paraguay (Nâ¯=â¯202), who were treated at the gastroenterology or oncology service of participant hospitals. In addition, biopsies specimens to establish histological diagnosis and blood to detect IgG antibodies against Helicobacter-pylori (H. pylori) whole-cell antigens and CagA protein using an ELISA were collected. These consisted of 205 gastric cancer, 379 pre-neoplastic (intestinal metaplasia (IM) / atrophic gastritis) and 638 control (normal /non-atrophic gastritis) cases. The odds ratio (OR) and 95% confidence intervals (CI) associated with potential risk factors were estimated by polynomial logistic regression model. RESULTS: Seropositivity to H. pylori was associated with risk of pre-neoplastic lesions, with ORâ¯=â¯1.9 (CI 95% 1.2-2.9; pâ¯=â¯0.006). Grain / cereal intake (ORâ¯=â¯1.6, 95% CI 1.0-2.5 ; pâ¯=â¯0.049) and egg intake (ORâ¯=â¯1.7 95% CI 1.1-2.6 ; pâ¯=â¯0.021) were related to gastric cancer. Among, people who did not developed gastric cancer, smoking more than five cigarette per day had the highest risk of being infected by H. pylori (ORâ¯=â¯1.9; CI 95% 1.1-3.3 ; pâ¯=â¯0.028). CONCLUSION: The present study in Latin American countries confirmed that similar environmental factors such as smoking and grain/cereal consumption were associated with H. pylori infection and its induced gastric lesions as reported in other regions where dominant H. pylori strains differ.
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Lesões Pré-Cancerosas/complicações , Neoplasias Gástricas/diagnóstico , Adulto , Feminino , Humanos , América Latina , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/patologia , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
Certain variants of human papillomavirus (HPV)type 58 are associated with an increased risk of high grade squamous intraepithelial lesions and cervical cancer. However, little is known about the persistence of HPV58 E6/E7 variants in women with incident HPV58 infections. The aim of the present study was to evaluate the presence and persistence of HPV58 E6/E7 variants in 71 women with incident HPV58 infection throughout their follow-up. These women belonged to a cohort examined in a longitudinal study of 1,610 Colombian women, who were HPV-negative and had normal baseline cytology. E6/E7 DNA regions of HPV58-positive samples were amplified and sequenced using automated direct sequencing. A total of 639 samples were analyzed from the 71 women, and 117 samples (18.3%) were HPV58-positive. HPV58 E6/E7 variants were detected in 85.5% of the samples. The T307/A694/G744/A761 variant was identified in 88% of the samples, the T307/G744 variant was identified in 9% of samples and the T187/T307/A367/G744/G793/T798/A801/T840/C852 was identified in 3% of the samples. Overall, 50% of the HPV58 infections were present after 1 year of follow-up and all infections were cleared after 7 years. Women who had first sexual intercourse at >15 years of age had a lower clearance rate than those who had sexual intercourse for the first time at ≤15 years of age [hazard ratio (HR)=0.29; 95% confidence interval (CI)=0.09-0.92]. Likewise, parous women had a higher clearance rate than nulliparous women (HR=3.43, 95% CI=1.23-9.60). There was no difference in clearance rates between HPV58 E6/E7 variants. In conclusion, HPV58 variants were not associated with persistence of the infection in this group of women.
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Fundamento: Las alteraciones cromosómicas causan frecuentemente pérdidas de embarazos e infertilidad, y son una causa importante de retraso mental. El diagnóstico precoz permite la extensión del estudio a las familias de los portadores de estas translocaciones. Objetivo: identificar las translocaciones cromosómicas mediante diagnóstico citogenético. Métodos: se realizó un estudio descriptivo retrospectivo de los casos estudiados entre 2006 y 2016 de fetos diagnosticados con alguna translocación, los cuales se concentraron en 10 familias (25 individuos en total). Los datos fueron tomados de los registros del CPGMC, que contienen los diagnósticos prenatales cromosómicos realizados a la población de riesgo, y los estudios posnatales realizados en sangre periférica a los padres y otros familiares de los fetos. Fueron analizadas las siguientes variables: diagnóstico (enfermo, sano portador), tipo de aberración cromosómica (estructural, numérica), vía de heredabilidad de las aberraciones estructurales (padre o madre), y fórmula cromosómica y tipo de translocación.Resultados: del total de casos positivos y portadores diagnosticados prenatalmente, el 76,71 % fueron aberraciones numéricas. De los 17 casos de aberraciones estructurales, 13 fueron translocaciones cromosómicas, (balanceadas y no balanceadas), todas ellas heredadas de uno de los progenitores. Fueron identificados, mediante diagnóstico prenatal y posnatal, dos individuos enfermos y 23 sanos portadores en las familias estudiadas. Conclusión: existe en la provincia Cienfuegos un conjunto de personas sanas, pero portadoras de translocaciones cromosómicas, las cuales pueden transmitir a sus descendientes, lo que se traduce en la posibilidad de que estos nazcan con malformaciones.
Background: Chromosomal abnormalities frequently cause pregnancy losses and infertility, and they are an important cause of mental retardation. Early diagnosis allows extending the study to the families of these translocations carriers.Objective: to identify chromosomal translocations by cytogenetic diagnosis.Methods: a retrospective description was conducted of the studied cases between 2006 and 2016 of fetuses diagnosed with some translocation, which were grouped in 10 families (25 individuals). Data were taken from the CPGMC records, which contain the prenatal chromosomal diagnoses of population at risk, and postnatal studies in peripheral blood performed to parents and other fetuses relatives. The following variables were analyzed: diagnosis (sick, healthy carrier), type of chromosomal aberration (structural, numerical), heritability pathway of structural anomalies (father or mother), chromosome formula and type of translocation.Results: out of all positive cases and carriers diagnosed prenatally, 76.71% were numerical anomalies. From 17 cases of structural anomalies, 13 were chromosomal translocations, (balanced and unbalanced), all inherited from one of the progenitors. Two sick individuals and 23 healthy carriers in the studied families were identified by prenatal and postnatal diagnosis.Conclusion: in the Cienfuegos province, there is a healthy group of people who carry chromosomal translocations, which can be transmited to their descendants; therefore with the possibility that they are born with malformations.
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In stands with a broad range of diameters, a small number of very large trees can disproportionately influence stand basal area and transpiration (Et). Sap flow-based Et estimates may be particularly sensitive to large trees due to nonlinear relationships between tree-level water use (Q) and tree diameter at breast height (DBH). Because Q is typically predicted on the basis of DBH and sap flow rates measured in a subset of trees and then summed to obtain Et, we assessed the relative importance of DBH and sap flow variables (sap velocity, Vs, and sapwood depth, Rs) in determining the magnitude of Et and its dependence on large trees in a tropical montane forest ecosystem. Specifically, we developed a data-driven simulation framework to vary the relationship between DBH and Vs and stand DBH distribution and then calculate Q, Et and the proportion of Et contributed by the largest tree in each stand. Our results demonstrate that variation in how Rs is determined in the largest trees can alter estimates up to 26% of Et while variation in how Vs is determined can vary results by up to 132%. Taken together, these results highlight a great need to expand our understanding of water transport in large trees as this hinders our ability to predict water fluxes accurately from stand to catchment scales.
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Transpiração Vegetal , Árvores/fisiologia , Água/metabolismo , México , Árvores/crescimento & desenvolvimentoRESUMO
ABSTRACT Objective. Phylogenetic characterization of Ehrlichia canis in dogs naturally infected and ticks, diagnosed by PCR and sequencing of 16SrRNA gene; compare different isolates found in American countries. Materials and methods. Were collected Blood samples from 139 dogs with suggestive clinical manifestations of this disease and they were infested with ticks; part of 16SrRNA gene was sequenced and aligned, with 17 sequences reported in American countries. Two phylogenetic trees were constructed using the Maximum likelihood method, and Maximum parsimony. Results. They were positive to E. canis 25/139 (18.0%) dogs and 29/139 (20.9%) ticks. The clinical manifestations presented were fever, fatigue, depression and vomiting. Rhipicephalus sanguineus Dermacentor variabilis and Haemaphysalis leporis-palustris ticks were positive for E. canis. Phylogenetic analysis showed that the sequences of dogs and ticks in Mexico form a third group diverging of sequences from South America and USA. Conclusions. This is the first phylogenetic analysis of E. canis in Mexico. There are differences in the sequences of Mexico with those reported in South America and USA. This research lays the foundation for further study of genetic variability.
RESUMEN Objetivos. Caracterizar filogenéticamente Ehrlichia canis a partir de perros naturalmente infectados y sus garrapatas, mediante PCR y secuenciación del gene 16SrRNA para compararlos con diferentes aislados encontrados en el continente Americano. Material y métodos. Se colectaron muestras sanguíneas de 139 perros con manifestaciones clínicas sugestivas a Ehrlichiosis, y que estuvieran infestados con garrapatas; una parte del gene 16SrRNA, fue secuenciada y alineada junto con las 17 secuencias reportadas en los países de América. Se construyeron dos árboles filogenéticos utilizando el método de Máxima verosimilitud compuesta, y Máxima parsimonia. Resultados. Fueron positivos a E. canis 25/139 (18.0%) perros y 29/139 (20.9%) garrapatas colectadas sobre los perros. Las manifestaciones clínicas presentadas fueron fiebre, astenia, depresión y vómito. Las garrapatas Rhipicephalus sanguineus, Dermacentor variabilis y Haemaphysalis leporis-palustris fueron positivas para E. canis. El análisis filogenético mostró que las secuencias 16SrRNA de Ehrlichia canis aisladas de perros y garrapatas en este estudio forman un tercer grupo que diverge de las secuencias de Sudamérica y EUA. Conclusiones. Es el primer análisis filogenético de E. canis en México. Hay diferencias entre las secuencias de este estudio, con las reportadas en otros países de Sudamérica y en EUA. Esta investigación sienta las bases para profundizar en el estudio de la variabilidad genética.
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Filogenia , Carrapatos , Ehrlichiose , Ehrlichia canis , CãesRESUMO
We report here the draft genome sequence of Acinetobacter baumannii strain M3AC14-8, sequence type 2 (ST2), carrying a chromosomally carried blaKPC-2 gene. The draft genome consists of a total length of 4.11 Mbp and a G+C content of 39.25%.
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Carbapenems are considered the last-resort antibiotics to treat infections caused by multidrug-resistant Gram-negative bacilli. The Klebsiella pneumoniae carbapenemase (KPC) enzyme hydrolyses ß-lactam antibiotics including the carbapenems. KPC has been detected worldwide in Enterobacteriaceae and Pseudomonas aeruginosa isolates associated with transposon Tn4401 commonly located in plasmids. Acinetobacter baumannii has become an important multidrug-resistant nosocomial pathogen. KPC-producing A. baumannii has been reported to date only in Puerto Rico. The objective of this study was to determine the whole genomic sequence of a KPC-producing A. baumannii in order to (i) define its allelic diversity, (ii) identify the location and genetic environment of the blaKPC and (iii) detect additional mechanisms of antimicrobial resistance. Next-generation sequencing, Southern blot, PFGE, multilocus sequence typing and bioinformatics analysis were performed. The organism was assigned to the international ST2 clone. The blaKPC-2 was identified on a novel truncated version of Tn4401e (tentatively named Tn4401h), located in the chromosome within an IncA/C plasmid fragment derived from an Enterobacteriaceae, probably owing to insertion sequence IS26. A chromosomally located truncated Tn1 transposon harbouring a blaTEM-1 was found in a novel genetic environment within an antimicrobial resistance cluster. Additional resistance mechanisms included efflux pumps, non-ß-lactam antibiotic inactivating enzymes within and outside a resistance island, two class 1 integrons, In439 and the novel In1252, as well as mutations in the topoisomerase and DNA gyrase genes which confer resistance to quinolones. The presence of the blaKPC in an already globally disseminated A. baumannii ST2 presents a serious threat of further dissemination.