RESUMO
BACKGROUND: To analyse specific immune response to the 23-valent pneumococcal polysaccharide vaccine by measuring pneumococcal antibodies in children with asthma and with respiratory recurrent infection (RRI) as compared to healthy children. METHODS: The study included 60 children, divided into three groups: 20 with asthma, 20 with RRI, and 20 healthy controls. Post-vaccination specific IgG antibodies against 10 pneumococcal serotypes (S1, S3, S4, S5, S6B, S9V, S14, S18C, S19F, and S23F) contained in the 23-valent pneumococcal polysaccharide vaccine (PPV) were measured. A specific IgG concentration ≥1.3µg/mL was considered a protective response to the vaccine. For statistical analysis, levels of specific IgG antibodies against each of the 10 pneumococcal serotypes were compared across the three groups of children using the x(2) test. RESULTS: All of the children showed antipneumococcal antibody levels >1.3µg/mL for over 70% of the serotypes, considered within the normal range of response. Average IgG antibody levels and percentages of children protected were statistically comparable among the three groups studied. CONCLUSION: The asthmatic children without RRI had pneumococcal antibody levels and percentages of serotype-specific protection to PPV comparable to those of healthy children. Asthmatic children with recurrent infections should be evaluated for specific antibody deficiency (SAD). Because asthma patients are at high risk for invasive pneumococcal infections, it would be worthwhile to explore systematic administration of PPV in children over the age of two years who have not received a pneumococcal conjugate vaccine, considering the positive response to PPV reported here.
Assuntos
Anticorpos Antibacterianos/sangue , Asma/imunologia , Vacinas Pneumocócicas/imunologia , Infecções Respiratórias/imunologia , Streptococcus pneumoniae/imunologia , Adolescente , Asma/sangue , Criança , Pré-Escolar , Chile , Feminino , Voluntários Saudáveis , Humanos , Imunoglobulina G/sangue , Síndromes de Imunodeficiência/diagnóstico , Masculino , Vacinas Pneumocócicas/administração & dosagem , Estudos Prospectivos , Infecções Respiratórias/sangue , VacinaçãoRESUMO
Introducción: Los pacientes con alteraciones neurológicas severas dependen del cuidado de terceros, muchas veces son las familias quienes asumen este rol, pero se desconoce cuánto logran integrar del manejo postural continuo. Objetivo: Determinar la percepción del nivel cognoscitivo de los cuidadores, en relación al manejo postural continuo, de pacientes en silla de ruedas, que asisten al Instituto Teletón Concepción, durante el año 2011. Pacientes y Métodos: Se realizó un estudio cualitativo fenomenológico con muestra de casos tipos en 8 cuidadores, que permitió profundizar en las experiencias individuales de estos, a través de entrevistas semi-estructuradas. Se realizó análisis semántico estructural sobre el discurso de los cuidadores. Resultados: Se estableció los códigos principales bajo los cuales los cuidadores comprenden el manejo postural continuo, el cual se entendió por el concepto de alineación corporal, la condición muscular del paciente y las expectativas de rehabilitación. Hay un mayor reconocimiento de los padres a la información entregada por sus pares, dándole mayor valor emocional. Las experiencias particulares de cada cuidador pueden ser una fuente positiva de refuerzo del programa de manejo postural continuo. Conclusiones: Los cuidadores refieren poseer amplios conocimientos del manejo postural continuo, pero no son capaces de detallar los aspectos básicos del mismo, evidenciando una falta de integración del conocimiento en esta área.
Introduction: Patients with severe neurological disorders depend on a third party for their care. Usually it is within their own families, that someone takes over that role, however, it is unknown to what extent they are able to integrate continuous postural management. Objective: To determine caregivers cognitive perception level with regards to continuous postural management, of patients who use wheelchairs and who attended Teletón Institute at Concepción, Chile, during the year 2011. Patients and Method: A phenomenological qualitative research using type cases samples in 8 caregivers was carried out. This made possible to go in depth with their individual experiences by conducting semi-structured interviews. A structural semantic analysis about the caregivers speech was done. Outcomes: Main codes under which caregivers understand continuous postural management were established. This was understood as the concept of body or corporal alignment, patients muscular condition and rehabilitation expectancies. There is greater acknowledgment from parents regarding information provided by their peers, which adds greater emotional value. Therefore, each caregivers individual experience may become a constructive strengthening source for the continuous postural management program. Conclusions: Caregivers reported having broad knowledge regarding continuous posture management, however they were unable to provide details about its basic characteristics, thus showing lack of knowledge integration in this area.
Assuntos
Humanos , Cuidadores , Pessoas com Deficiência , Conhecimentos, Atitudes e Prática em Saúde , Postura , Pesquisa Qualitativa , Cadeiras de RodasRESUMO
The knowledge of the anatomical characteristics of the temporomandibular joint (TMJ) articular surfaces is essentital to enable physicians and dentists to recognize the morphological changes that occur in this articulation in patients with temporomandibular disorders (TMD). Several researchers associate the TMD with changes of TMJ articular surfaces. The careful identification of bone changes related to TMJ is critical, since these abnormalities are associated with signs and symptoms of TMD and the knowledge of TMD signs and symptoms is fundamental for correctly diagnosing and for adequate treatment planning. The aim of this study was to evaluate the morphological characteristics of the TMJ articular surfaces in patients with TMD diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). In addition, therelationship between increasing age-osteoarthrosis was evaluated. For the sample we selected 19 patients, 17 female and 2 male, referred to the "Unidad de Trastornos Cráneo Cérvico Mandibulares (UCRACEM) - Universidad de Talca, Chile". The imaging assessment was carried out by Cone-Beam Computed Tomography (CBCT). In the imaging analysis of the articular surfaces 11 joints (28.94 percent) showed normal morphology. The bone changes found were: sclerosis, flattening, erosion, osteoarthrosis, osteophytes, subcondral cysts. We found statistically significant difference between increasing age-osteoarthrosis (p=0.00). Considering our results we concluded that bone changes of the TMJ articular surfaces in patients with TMD are very common, with sclerosis as the most frequent finding. It was also possible to conclude that there was a significant association between increasing age-osteoarthrosis.
El conocimiento de las características anatómicas de las superficies articulares de la articulación temporomandibular (ATM) es fundamental para que clínicos y odontólogos reconozcan las alteraciones morfológicas que ocurren en la articulación de pacientes con trastornos temporomandibulares (TTM). Diversos investigadores asocian los TTMs con alteraciones en las superficies articulares de la ATM. La identificación de los cambios óseos relacionados con la ATM es crítica, ya que estos se asocian a signos y síntomas de TTM, y el conocimiento de estos es fundamental para el correcto diagnóstico y adecuada planificación de tratamiento. El objetivo fue analizar las características morfológicas de las superficies articulares de la ATM en pacientes con diagnóstico de TTM, diagnosticado de acuerdo a los Criterios Diagnósticos para Investigación de los Trastornos Temporomandibulares (CDI/TTM), junto con analizar la relación existente entre incremento de edad-osteoartrosis. Fueron seleccionados 19 pacientes, 17 mujeres y 2 hombres, de la Unidad de Trastornos Cráneo Cérvico Mandibulares (UCRACEM) - Universidad de Talca, Chile. La evaluación imagenológica se realizó mediante el examen de Tomografía Computarizada Cone-Beam (TCCB). En el análisis de las superficies articulares, 11 (28,94 por ciento) presentaron morfología normal. Los cambios óseos encontrados fueron: esclerosis, aplanamiento de la cabeza de la mandíbula, erosión, osteoartrosis, osteofitos y quiste subcondral. Hubo relación estadística significativa entre incremento de edad-osteoartrosis (p=0,00). Nuestros hallazgos nos permiten concluir que los cambios óseos en las caras articulares de la ATM en pacientes con TTM son frecuentes, y la esclerosis el hallazgo más común. También se encontró asociación entre incremento de edad y osteoartrosis.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Tomografia Computadorizada de Feixe Cônico , Transtornos da Articulação Temporomandibular/patologia , Transtornos da Articulação TemporomandibularRESUMO
El Salvador harbours one of the largest Central American human immunodeficiency virus (HIV) epidemics, but few studies have analysed it in depth. Here, we describe the presence of transmitted drug resistance (TDR) and HIV variants in the HIV-infected adult population in El Salvador. Dried blood spots from 119 HIV-infected antiretroviral-naive adults attended in El Salvador were collected in 2011. The TDR was assessed according to the list recommended by the WHO. HIV-1 variants were described using phylogeny. Pol sequences could be amplified in 88 patients (50.6% men), with a mean age of 35 years. Almost all (96.7%) were infected with HIV through sexual practice and 58.7% were recently diagnosed. The mean CD4(+) count was 474 cells/mm(3) and 43.1% and 15.5% of patients showed moderate (<500 CD4 cells) or severe (<200) immune suppression, respectively. HIV-1 viral load was >100 000 copies/mL in 24.7% of patients and <2000 copies/mL in 9.1%. Five samples (5.7%) harboured any TDR mutation: 2.3% for nucleoside reverse transcriptase inhibitor (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI), and 1.4% for protease inhibitor (PI). All showed only one TDR single-class resistance mutation: M184I (two cases) for NRTI, K101E and K103N for NNRTI and L23I for PI. All viruses excepting one (URF_BG) belonged to subtype B. No phylogenetic TDR networks were found. In conclusion, we report a TDR prevalence of 5.7% in El Salvador, lower than in other Central American studies. Periodical studies are essential to monitor and prevent TDR emergence in low-income and middle-income regions. Also, more efforts are needed to promote early diagnosis and prevention of infection in El Salvador.
Assuntos
Farmacorresistência Viral/genética , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , HIV-1/genética , Produtos do Gene pol do Vírus da Imunodeficiência Humana/genética , Adolescente , Adulto , Idoso , Fármacos Anti-HIV/uso terapêutico , Estudos de Coortes , Teste em Amostras de Sangue Seco , El Salvador/epidemiologia , Feminino , Variação Genética , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , HIV-1/imunologia , Humanos , Lamivudina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Filogenia , Pobreza/prevenção & controle , Adulto JovemRESUMO
El objetivo del presente estudio fue determinar la prevalencia de hallazgos radiográficos en pacientes mayores de 60 años, atendidos en el Servicio de Radiología del Centro de Clínicas Odontológicas de la Universidad de Talca entre los meses de marzo y octubre del año 2010. Se evaluaron 190 radiografías panorámicas digitales de pacientes mayores de 60 años de edad. Se determinó la presencia de lesiones radiolúcidas (RL), lesiones radiopacas (RO), restos radiculares (RR), lesiones apicales (LA), cuerpos extraños (CE), dientes incluidos (DI), calcificaciones en tejidos blandos (CTB) y calcificaciones del complejo estilohioídeo (CCE). El 58,9 % del total de la muestra tuvo hallazgos. En pacientes edéntulos totales, el 51,4% de las radiografías tuvieron algún hallazgo, mientras que en edéntulos parciales, el porcentaje el 60,6% presentaron hallazgos radiográficos. Estos en el total de la muestra se encontraron en orden decreciente fueron CCE 25,26%; CTB 24,21%; LA 19%; RO 11,05%; RR 7,36%; PI 4,21%; RL 3,68%. No se encontró cuerpos extraños. La mayoría de los hallazgos se encontró de manera única (57%). Nuestros resultados sugieren que sería adecuado solicitar una radiografía panorámica antes de iniciar el tratamiento rehabilitador de un paciente adulto mayor, para obtener información que permita la realización de un tratamiento odontológica de forma segura
The aim of this study was to determine prevalence of radiological findings in digital panoramic radiographs of 60-year-old patients and more, treated in Radiological Service of Universidad de Talca`s Dental Clinical Center during the period between March and October of year 2010. 190 digital panoramic radiographs from elderly patients were observed. Radiolucent lesions (RL), radiopaque lesions (RO), periapical radiolucent lesions (LA), root fragments (RF), foreign bodies (FB), unerupted teeth (UT), soft tissue calcifications (STC) and calcified stylohyoid complex (CSC) were assessed. 58,9 % of full sample showed radiological findings. In edentulous mouths, 51,4% of radiographs had findings, whereas in partially edentulous, percentage of Rx with findings was 60,6%. Radiological findings of full sample in decreasing order were as next: CSC 25,26%; STC 24,21%; LA 19%; RO 11,05%; RF 7,36%; UT 4,21%; RL 3,68%. Foreign bodies were not found. Radiological findings were seen multiple in 43%. Our results suggest that prescribe a panoramic radiograph before starting a rehabilitation treatment to an elderly patient, would be beneficial in order to obtain useful information for safer dental treatments
Assuntos
Feminino , Idoso , Radiografia Dentária Digital , Radiografia Dentária , Radiografia Panorâmica , OdontologiaRESUMO
BACKGROUND: Lung involvement in rheumatologic disease in children has been described with low frequency. OBJECTIVE: To describe the lung function test and the radiological findings in a group of paediatric patients with rheumatologic diseases. METHODS: Descriptive study. Pulmonary function was evaluated with spirometry, carbon monoxide diffusing capacity, blood arterial gas at rest and post exercise in addition to chest radiography and high resolution computed tomography were performed in children with rheumatologic disease. RESULTS: Of the fourteen patients studied: 11 were diagnosed with juvenile idiopathic arthritis (JIA), two with systemic lupus erythematosus (SLE), and one with juvenile dermatomyositis (JDM). Mean age: 13 years (range 7-18 years). Nine females, duration of disease 4 ± 2.8 years (range 1-11 years). Four patients had any grade of abnormalities in one or more lung function tests and/or radiological test. CONCLUSION: We recommend routine checks of pulmonary function in all patients with rheumatologic diseases even in the absence of respiratory symptoms.
Assuntos
Artrite Juvenil/diagnóstico , Dermatomiosite/diagnóstico , Pulmão , Lúpus Eritematoso Sistêmico/diagnóstico , Adolescente , Artrite Juvenil/patologia , Artrite Juvenil/fisiopatologia , Criança , Pré-Escolar , Dermatomiosite/patologia , Dermatomiosite/fisiopatologia , Feminino , Humanos , Lactente , Pulmão/diagnóstico por imagem , Pulmão/patologia , Lúpus Eritematoso Sistêmico/patologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Masculino , Testes de Função Respiratória , Reumatologia/métodos , Tomografia Computadorizada por Raios XRESUMO
The effects of olanzapine (OLZ) on the viability and functioning of human polymorphonuclearcells (PMNs) are clearly opposite to those previously reported forclozapine (CLZ). In fact, after 4- or 24-h-treatment with 20-50 μM OLZ, a significant inhibition of the respiratory burst in PMNs activated with opsonized zimosanor phorbol myristate acetate (PMA) was observed, whereas the burst provoked byformyl-methionyl-leucyl-phenylalanine (fMLP) was only inhibited at 50 μM OLZ.Under the same conditions, spontaneous apoptosis was accelerated at 20-50 μMOLZ, while the exogenous addition of H2O2 resulted in the PMN apoptosis beingdose-dependently inhibited by OLZ in the entire range of concentrations. However,when H2O2 was intracellularly generated by treatment with PMA, the induced apoptosis was only decreased at 2 μM OLZ. Absorbance scans revealed that OLZis able to react with equimolar quantities of either H2O2 or HOCl. These results suggest that OLZ inhibits both ROS-induced PMN apoptosis and respiratory burst due to extracellular scavenging of released ROS.
Los efectos de olanzapine (olz) sobre la viabilidad y el funcionamiento de células humanas polimorfonucleares (pmn, por sus siglas en inglés) claramente son opuestosa los señalados para la clozapine (clz). En efecto, después de 4-24 h de tratamiento con 20-50 μM olz, se observó una inhibición significativa del estallido respiratorio en pmn activados con zimosan o con forbol acetato miristato, mientras que la inhibición provocada por el formil-metionil-leucil-fenilalanina fue sólo inhibida a 50μM de olz. En las mismas condiciones, la apoptosis espontánea se aceleró con 20-50μM olz, mientras que la adición exógena de H2O2 dio lugar a la apoptosis de pmn en dosis dependiente inhibida por olz en el rango entero de concentraciones. Sin embargo, cuando se generó H2O2 intracelular por tratamiento con pma, la apoptosis inducida se disminuyó solamente con 2 μM olz. Las exploraciones de los espectros de absorbancia revelaron que olz puede reaccionar con cantidades equimolares de H2O2 o de HOCL. Estos resultados sugieren que olz inhibe ambos tipos de apoptosis de pmn (la inducida por especies reactivas oxigenadas y por estallido respiratorio debido a atrapadores extracelulares de estas especies reactivas oxigenadas).
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Humanos , Apoptose , Neutrófilos , Estresse Oxidativo , Explosão RespiratóriaRESUMO
El Instituto Nacional del Tórax fue creado oficialmente el 23 de Agosto de 1954, bajo el impulso y talento del Profesor Héctor Orrego Puelma, quien fuera nombrado posteriormente Maestro de la Especialidad por nuestra Sociedad.El Instituto nació en 1954, a partir del Servicio de Broncopulmonar del Hospital del Salvador, en un principio, sus principales funciones estaban centradas en brindar atención a algunas patologías respiratorias, como la tuberculosis, y capacitar médicos en esta área.Su organización era muy sencilla, pues existían dos grandes servicios clínicos: el de Medicina, a cargo del Profesor Dr. Héctor Orrego Puelma, y el de Cirugía, a cargo del Profesor Dr. Armando Alonso Vial. La dotación de camas daba cuenta del perfil epidemiológico del país de entonces: 102 camas se destinaban a enfermos de tuberculosis, 90 camas para patologías respiratorias no TBC y 100 camas para cirugía de pulmón, en total 292 camas. En sus dos primeros años de funcionamiento, el Instituto recibió 6.068 nuevos pacientes, de los cuales el 25% presentaba una TBC activa
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Hospitais Públicos/história , Saúde Pública/história , ChileRESUMO
El presente estudio se llevó a cabo en tres granjas de reproductoras de carne de la línea Cobb para determinar el nivel y persistencia de anticuerpos al virus de la Anemia Infecciosa Aviar (CIAV) en aves que fueron fueron vacunadas en la etapa de levante. Las aves de una granja (G1) se vacunaron vía oral y las aves de otra granja (G2), por vía intramuscular. Las aves de la tercera granja (G3) no fueron vacunadas pero estuvieron expuestas al virus de campo como todas. Las aves se muestrearon a los 30, 45 y 60 semanas de edad. Además, se evaluó el nivel y porcentaje de transferencia de anticuerpos a la progenie de estos lotes de reproductoras al día de edad. Las muestras fueron procesadas en forma conjunta con la prueba de ELISA para CIAV de los Laboratorios IDEXX. Se detectó una seroconversión total en las granjas vacunadas A y B a las 30 semanas, mientras la granja no vacunada tuvo el 10.5 por ciento de aves negativas, en tanto que todas las aves seroconvirtieron a las 45 y 60 semanas de edad; sin embargo, se observó que los títulos de anticuerpos en las reproductoras descendieron a las 60 semanas en las tres granjas. La transferencia pasiva de anticuerpos a la progenie fue inferior en la granja G1 que en las otras dos granjas.
Three poultry farms (A, B and C) of Cobb breeder broilers were blood monitored at 30, 45, and 60 weeks of age to assess the level and persistence of sera antibodies against chicken infectious anemia virus (CIAV) under two vaccination strategies. Hens in farm A were vaccinated via drinking water and hens in farm B via intramuscular (IM) during the rearing period, whereas farm C was only exposed to a field virus. Progeny´s sera was evaluated at one day old to determine antibodies level and percent of transference. Serum samples were analyzed by a commercial ELISA test. A total seroconversion was detected in farms A and B at the age of 30 weeks while 10.5 por ciento of layers in farm C were negative. All hens in the three farms seroconverterd at 45 and 60 weeks old, but antibody titers decreased at the age of 60 weeks. The passive transference of antibodies to the progeny was much lower in farm A as compared to the other two farms.
Assuntos
Animais , Anticorpos Antivirais , Aves Domésticas , Ensaio de Imunoadsorção Enzimática , Viroses/veterinária , Vírus da Anemia da GalinhaRESUMO
The objective of this study was to analyse the survival rate and cause of death in children with systemic lupus erythematosus (SLE) during the past 30 years in Chile. A retrospective analysis was performed between 1969 and 2000 on patients attending pediatric rheumatology centres in Santiago, Chile. Survival and causes of death in 31 children followed from 1969 to 1980 fulfilling the 1982 American College of Rheumatology criteria for SLE and treated with oral steroids were compared with 50 other patients who were treated with oral steroids and an aggressive treatment of IV bolus of cyclophosphamide (38 patients) and azathioprine (12 patients). Global survival at five and 10 years follow-up for the patients studied from 1969 to 1980 was 68 and 40%, respectively. During the second study period these values were significantly improved and global survival reached 95% at five years and 90% at 10 years follow-up (P < 0.05). Survival at 10 years follow-up for patients with lupus nephropathy increased from 28% (study period 1964-1980) to 86% (study period 1984-2000). Twelve children died (38%) during the 1964-1980 study period. The causes of death were six due to kidney failure, three due to infectious conditions and another three of unknown causes. During the 1980-2000 study period mortality reached 6% (three cases), two cases died of a lupus flare-up and one case due to infection. In the last three decades, we have seen an important increase in the survival of children with SLE, especially in those patients with renal involvement. Management with immunosuppressive drugs, such as IV cyclophosphamide or azathioprine has changed the prognosis in these children. These results demonstrate that our children with SLE increased their life expectancy but are now faced with new types of morbidity because of the sequelae related to the disease itself.