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OBJECTIVES: Ceftazidime-avibactam (CAZ-AVI) is an option for infections caused by MDR gram-negative bacilli. In this study, we aimed to analyze the in vitro antimicrobial activity of CAZ-AVI and other antimicrobial agents against gram-negative bacilli that were collected in Colombia between 2019 and 2021 from patients with bacteremia and skin and soft-tissue infections (SSTIs). METHODS: A total of 600 Enterobacterales and 259 P. aeruginosa strains were analyzed. The phenotypic resistance of isolates, particularly non-susceptibility to meropenem, multidrug-resistant (MDR) isolates, and difficult-to-treat (DTR) P. aeruginosa, was evaluated according to CLSI breakpoints. RESULTS: Enterobacterales had the most susceptibility to CAZ-AVI (96.5 %) and tigecycline (95 %). Tigecycline and CAZ-AVI were the antimicrobial agents with the most in vitro activity against carbapenem-resistant Enterobacterales (CRE). CAZ-AVI was the antimicrobial treatment with the most activity against P. aeruginosa. CONCLUSIONS: Tigecycline and CAZ-AVI were the antimicrobial agents with the most activity against CRE and MDR Enterobacterales. For P. aeruginosa, CAZ-AVI was the antimicrobial treatment with the most in vitro activity.
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Antibacterianos , Compostos Azabicíclicos , Bacteriemia , Ceftazidima , Combinação de Medicamentos , Bactérias Gram-Negativas , Testes de Sensibilidade Microbiana , Infecções dos Tecidos Moles , Tigeciclina , Humanos , Ceftazidima/farmacologia , Infecções dos Tecidos Moles/microbiologia , Infecções dos Tecidos Moles/tratamento farmacológico , Colômbia , Compostos Azabicíclicos/farmacologia , Antibacterianos/farmacologia , Bacteriemia/microbiologia , Bacteriemia/tratamento farmacológico , Bactérias Gram-Negativas/efeitos dos fármacos , Tigeciclina/farmacologia , Pseudomonas aeruginosa/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Enterobacteriaceae/efeitos dos fármacos , Dermatopatias Bacterianas/microbiologia , Dermatopatias Bacterianas/tratamento farmacológicoRESUMO
Petroleum-based plastics dominate everyday life, necessitating the exploration of natural polymers as alternatives. Starch, abundant and biodegradable, is a promising raw material. However, understanding the molecular mechanisms underlying starch plasticization has proven challenging. To address this, we employ molecular dynamics simulations, focusing on amylose as a model. Our comprehensive evaluation revealed that chain size affects solubility, temperature influenced diffusivity and elastic properties, and oleic acid expressed potential as an alternative plasticizer. Furthermore, blending glycerol or oleic acid with water suggested the enhancement amylose's elasticity. These findings contribute to the design of sustainable and improved biodegradable plastics.
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Plásticos Biodegradáveis , Amido , Amilose , Ácido Oleico , Glicerol , Simulação de Dinâmica Molecular , PlásticosRESUMO
This topic review aims to present a global vision of multilevel analysis models' applicability to health research, explaining its theoretical, methodological, and statistical foundations. We describe the basic steps to build these models and examples of their application according to the data hierarchical structure. It ir worth noticing that before using these models, researchers must have a rationale for needing them, and a statistical evaluation accounting for the variance percentage explained by the observations grouping effect. The requirements to conduct this type of analysis depends on special conditions such as the type of variables, the number of units per level, or the type of hierarchical structure. We conclude that multilevel analysis models are a useful tool to integrate information, considering the complexity of the relationships and interactions involved in most health conditions, including the loss of independence between observation units.
Este trabajo tiene como objetivo presentar una mirada global de la aplicabilidad de los modelos de análisis multinivel en el ámbito de la investigación sanitaria. Ofrece información sobre los fundamentos teóricos, metodológicos y estadísticos y, además, menciona los pasos básicos para la construcción de estos modelos, y da ejemplos de su uso, según la estructura jerárquica de los datos. Cabe resaltar que, antes de utilizar estos modelos, se requiere contar con un soporte teórico sobre la necesidad de uso y una valoración estadística que dé cuenta del porcentaje de varianza explicada por el efecto de agrupación de las observaciones. Los requisitos para llevar a cabo este tipo de análisis dependen de condiciones especiales como el tipo de variables, la cantidad de unidades por nivel o el tipo de estructura jerárquica. Se concluye que los modelos de análisis multinivel son una herramienta útil para lograr la integración de información, dadas la complejidad de las relaciones y las interacciones que determinan la mayoría de las condiciones de salud, incluida la pérdida de independencia entre las unidades de observación.
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Introduction: Gastric outlet obstruction or pyloric syndrome can occur secondary to neoplastic involvement, and metastasis as an etiology is unusual. Breast neoplasms generally cause bone, liver, and lung metastases, rarely involving the gastrointestinal tract. Case presentation: A 69-year-old female patient with infiltrating lobular carcinoma of the right breast consulted for abdominal pain and postprandial emetic episodes with oral intolerance and dyspnea. Bilateral neoplastic breast involvement and dilation of the gastric chamber with thickening of the pylorus were recorded. She required antiemetic management and placement of a nasogastric tube. She was taken to an upper digestive tract endoscopy, which found an ulcerated lesion with an infiltrative appearance at the postpyloric level that circumferentially compromised the duodenal lumen. Then, a biopsy was taken, which was compatible with a breast carcinoma of a lobular type. This entity, called pyloric syndrome due to neoplasia, can be managed with gastrojejunostomy or an enteral prosthesis that improves the quality of life of patients with an ominous short-term prognosis. The patient in our case expressed advance directives not to receive invasive procedures, for which an uncovered metal prosthesis was placed for palliative purposes, achieving the re-establishment of the feeding route and resolution of dyspnea due to restriction. Conclusions: The metastatic involvement of neoplasms of the breast to the gastrointestinal tract is rare; however, it should be suspected in elderly patients with previously documented neoplasms.
Introducción: La obstrucción al tracto de salida gástrico o síndrome pilórico puede presentarse de manera secundaria a compromiso neoplásico, y es inusual el compromiso metastásico como etiología. Las neoplasias de la mama generalmente originan metástasis óseas, hepáticas y pulmonares, y es infrecuente el compromiso del tracto digestivo. Presentación del caso: Se trata de una paciente de 69 años con carcinoma lobulillar infiltrante de mama derecha que consultó por dolor abdominal y episodios eméticos posprandiales con intolerancia a la vía oral y disnea. Se registró un compromiso neoplásico mamario bilateral y dilatación de la cámara gástrica con engrosamiento del píloro. Se dio manejo antiemético y colocación de sonda nasogástrica. Fue llevada a una endoscopia de vías digestivas altas en la que se encontró una lesión ulcerada de aspecto infiltrativo a nivel pospilórico que comprometía de forma circunferencial la luz duodenal, y luego se tomó una biopsia a este nivel, que fue compatible con un carcinoma mamario de tipo lobulillar. Esta entidad, denominada síndrome pilórico por neoplasias, puede manejarse con gastroyeyunostomía o con prótesis enteral que mejore la calidad de vida en pacientes con pronóstico ominoso a corto plazo. La paciente de nuestro caso manifestó voluntades anticipadas para no recibir procedimientos invasivos, por lo cual se ofreció la colocación de una prótesis metálica descubierta con fines paliativos y se logró el restablecimiento de la vía de alimentación y resolución de la disnea por restricción. Conclusiones: El compromiso metastásico de neoplasias de la mama al tracto digestivo es poco frecuente; sin embargo, debe sospecharse en pacientes de edad avanzada y con neoplasias previamente documentadas.
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Perchlorate has been described as an emerging pollutant that compromises water sources and human health. In this study, a new electrotrophic perchlorate reducing microorganism (EPRM) isolated from the Atacama Desert, Dechloromonas sp. CS-1, was evaluated for perchlorate removal in water in a bioelectrochemical reactor (BER) with a chemically modified electrode. BERs were operated for 17 days under batch mode conditions with an applied potential of -500 mV vs. Ag/AgCl. Surface analysis (i.e., SEM, XPS, FT-IR, RAMAN spectroscopy) on the modified electrode demonstrated heterogeneous transformation of the carbon fibers with the incorporation of nitrogen functional groups and the oxidation of the carbonaceous material. The BERs with the modified electrode and the presence of the EAM reached high cathodic efficiency (90.79 ± 9.157%) and removal rate (0.34 ± 0.007 mol m-3-day) compared with both control conditions. The observed catalytic enhancement of CS-1 was confirmed by a reduction in the charge transfer resistance obtained by electrochemical impedance spectroscopy (EIS). Finally, an electrochemical kinetic study revealed an eight-electron perchlorate bioreduction reaction at -638.33 ± 24.132 mV vs. Ag/AgCl. Therefore, our results show the synergistic effect of EPRM and chemically modified electrodes on perchlorate removal in a BER.
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Nitrogênio , Percloratos , Humanos , Espectroscopia de Infravermelho com Transformada de Fourier , Nitrogênio/metabolismo , Eletrodos , OxirreduçãoRESUMO
Introduction: Happiness is understood as the perception of subjective well-being, it can be a quality, a result, or a state characterized by well-being or satisfaction that every person wants to achieve. In older adults, this satisfaction is a sum of lifelong achievements and triumphs; However, some factors influence this ideal. Objective: Analyze demographic, family, social, personal, and health factors associated with the subjective perception of happiness in older adults, using data from a study conducted in five cities in Colombia, in order to make a theoretical contribution in the search for improvement of their physical, mental and social health. Materials and methods: A quantitative, cross-sectional, analytical study was carried out, using primary source information, obtained with 2,506 surveys from voluntary participants aged 60 and over, who had no cognitive impairment, and who reside in urban areas but not in long-term centers. The variable happiness (classified as high or moderate/low) was used for: (1) A univariate explorative characterization of older adult, (2) a bivariate estimation of the relationships with the factors studied, and (3) a multivariate construction of profiles through multiple correspondences. Results: 67.2% reported high happiness levels, with differences by city: Bucaramanga (81.6%), Pereira (74.7%), Santa Marta (67.4), Medellín (64%), and Pereira (48.7%). Happiness was explained by the absence of risk of depression and little hopelessness, strengthened psychological well-being, a perception of high quality of life, and living in a functional family. Conclusion: This study provided an overview of possible factors that can be enhanced and strengthened with public policies (structural determinant), community empowerment, family strengthening (intermediate determinant), and educational programs (proximal determinant). These aspects are included in the essential functions of public health, in favor of mental and social health in older adults.
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Municipal and industrial wastewater discharges in coastal and marine environments are of major concern due to their high carbon and nitrogen loads and the resulted phenomenon of eutrophication. Bioelectrochemical reactors (BERs) for simultaneous nitrogen and carbon removal have gained attention owing to their cost efficiency and versatility, as well as the possibility of electrochemical enrich specific groups. This study presented a scalable two-chamber BERs using graphite granules as electrode material. BERs were inoculated and operated for 37 days using natural seawater with high concentrations of ammonium and acetate. The BERs demonstrated a maximum current density of 0.9 A m-3 and removal rates of 7.5 mg NH4+-N L-1 d-1 and 99.5 mg L-1 d-1 for total organic carbon (TOC). Removals observed for NH4+-N and TOC were 96.2% and 68.7%, respectively. The results of nutrient removal (i.e., ammonium, nitrate, nitrite and TOC) and microbial characterization (i.e., next-generation sequencing of the 16S rRNA gene and fluorescence in situ hybridization) showed that BERs operated with a poised cathode at -260 mV (vs. Ag/AgCl) significantly enriched nitrifying microorganisms in the anode and denitrifying microorganisms and planctomycetes in the cathode. Interestingly, the electrochemical enrichment did not increase the total number of microorganisms in the formed biofilms but controlled their composition. Thus, this work shows the first successful attempt to electrochemically enrich marine nitrifying and denitrifying microorganisms and presents a technique to accelerate the start-up process of BERs to remove dissolved inorganic nitrogen and total organic carbon from seawater.
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Compostos de Amônio , Grafite , Nitrogênio/química , Desnitrificação , Nitrificação , Águas Residuárias , Carbono , Nitratos , Reatores Biológicos , RNA Ribossômico 16S , Nitritos , Hibridização in Situ Fluorescente , Água do MarRESUMO
This study evaluated the electrochemical capacity of four perchlorate-reducing microorganisms (PRMs) isolated from an Altiplanic Andean watershed naturally pressured with perchlorate. Three-electrode electrochemical cells were used to test the electrochemical activity of the obtained isolates. Electrochemical evaluation (i.e., cyclic voltammetry, electrochemical impedance spectroscopy, chronoamperometry) revealed that two isolates identified as Dechloromonas sp. CS-1 and Clostridioides sp. CS-2 are electrochemically active PRMs. Bacterial isolates exhibiting cathodic peaks at -651 mV and -303 mV (vs. Ag/AgCl) for CS-1 and CS-2, respectively. Electrotrophic perchlorate removal was demonstrated by a 6-days chronoamperometry with removal rates of 27 and 17 mg L-1 day-1 and cathodic efficiencies of 93% and 45%, for CS-1 and CS-2, respectively. Chemical and electrochemical results suggest two different mechanisms of electrotrophic perchlorate removal, a complete eight-electron bio-reduction (i.e., perchlorate to chloride) for CS-1 and a partial two-electron bio-reduction (i.e., perchlorate to chlorate) for CS-2. The observed differences could be linked to their enzymatic differences, as in their membrane compositions. Thus, the results of this work increase the limited number of known electrotrophic microorganisms and expand the application of bioelectrochemical systems to develop new perchlorate treatment and remediation technologies.
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Bioprospecção , Percloratos , Eletrodos , Elétrons , OxirreduçãoRESUMO
PURPOSE: Patients with diabetes mellitus (DM) often have keratopathy. However, the compromise of the corneal endothelium in type 1 DM (T1DM) and type 2 DM (T2DM) has so far not been well characterized. METHODS: We performed a systematic literature search to find articles on humans combining T1DM and/or T2DM and the corneal endothelium. The period was from inception to June 2020. The meta-regression evaluated the role of each type of DM on corneal endothelial cell density (CED) and pachymetry. The statistical models included age as a modulator to discriminate between the normal changes due to age and the effect of the disease and to determine the impact of the disease duration. RESULTS: The initial search identified 752 records, of which 17 were included in the meta-regression. Patients with T1DM had, on average, 193 cells/mm 2 lesser than control patients ( P < 0.00001). Patients with T2DM had 151 cells/mm 2 less compared with control patients ( P < 0.00001). The loss of corneal endothelial cells was expected because the aging was similar in patients with T1DM and T2DM and their control groups. Patients with T1DM and T2DM showed an increase in pachymetry versus control patients, and in both groups, it was associated with the duration of the disease. CONCLUSIONS: Both types of DM reduced CED and increased pachymetry. These differences were higher in patients with T1DM versus control patients than patients with T2DM versus control patients. In T1DM, CED reduction was not correlated with the time from diagnosis. In both groups, patients had CED reduction due to aging similar to that of their matched control patients.
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Doenças da Córnea , Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Doenças da Córnea/complicações , Doenças da Córnea/diagnóstico , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Células Endoteliais , Endotélio Corneano , HumanosRESUMO
Resumen Introducción. La Brucelosis bovina, es una enfermedad bacteriana e infecto contagiosa, causada por Brucella abortus. Se transmite a través de la ingestión de forrajes y aguas contaminadas con descargas vaginales infectadas, que conlleva a una patología del sistema reproductor en bovinos, que impactan la sanidad pecuaria y la economía de la agroindustria. Objetivo. Evaluar el comportamiento de la brucelosis bovina en el municipio de Aguazul, Casanare (Colombia) y los factores asociados al desarrollo de esta enfermedad. Metodología. Estudio descritptivo de 26.187 muestras de suero sanguíneo de ganado bovino evaluadas, que corresponden a 260 predios del municipio de Aguazul. Se empleó técnicas serológicascomo rosa de bengala, fluorescencia polarizada y ELISA competitiva para la evaluación de positividad a Brucella abortus y se evaluaron las pérdidas económicas asociadas a positividad en los ensayos de laboratorio. Resultados y conclusiones. La positividad a brucelosis bovina correspondió al 1%, que corresponde a hembras menores de 24 meses de edad y entre 37 a 48 meses y, machos entre los 57 a 68 meses de edad. Se sugiere consolidar esfuerzos en investigación para evaluar los factores que contribuyen a la seropositividad en el ganado y el riesgo para la propagación y mantenimiento de la enfermedad.
Abstract Introduction. Bovine brucellosis is a contagious bacterial and infectious disease caused by Brucella abortus. It is transmitted through the ingestion of forage and water contaminatedwith infected vaginal discharges, which leads to a pathology of the reproductive system inbovines, which impacts livestock health and the economy of agribusiness. Aim. To evaluatethe behavior of bovine brucellosis in the municipality of Aguazul, Casanare (Colombia) and the factors associated with the development of this disease. Methodology. Descriptive study of 26,187 bovine blood serum samples evaluated, corresponding to 260 farms in the municipality of Aguazul. Serological techniques such as rose bengal, polarized fluorescence, and competitive ELISA were used to evaluate positivity to Brucella abortus and the economic losses associated with positivity in laboratory tests were evaluated. Results and conclusions. The positivity to bovine brucellosis corresponded to 1%, which corresponds to females under 24 months of age and between 37 to 48 months and males between 57 to 68 months of age. It is suggested to consolidate research efforts to evaluate the factors that contribute to seropositivity in cattle and the risk for the spread and maintenance of the disease