RESUMO
Resumen El 11 de marzo de 2020, la Organización Mundial de la Salud, declaró la pandemia a nivel mundial por la COVID-19. Ante este escenario, los centros de información y asesoramiento toxicológico (CIAT) de América Latina comenzaron a recibir consultas por exposición/intoxicación a dióxido de cloro/clorito de sodio y sus compuestos relacionados, por desvío de uso, destinado a la prevención y/o tratamiento de la COVID-19 sin aval científico alguno ni contar con registro sanitario para ese fin. A través de la Red de Toxicología de América Latina y el Caribe (RETOXLAC), se comprobó que no eran hechos aislados, sino que se estaba produ ciendo el mismo fenómeno en toda la región y que existían antecedentes de intoxicaciones con dichos productos y alertas desde hace más de una década, con indicaciones no aprobadas, para el tratamiento de distintas patologías como SIDA, cáncer, esclerosis lateral amiotrófica ELA, malaria, autismo, entre otras, sin evidencia. Ante esta realidad, los CIAT presentan una revisión de los signos y síntomas observados según la vía de ingreso, basados en la comunicación de riesgo en salud; proponiéndose pruebas de apoyo al diagnóstico, algoritmo de tratamiento para las intoxicaciones y modelo de ficha clínica para la vigilancia epidemiológica de los casos atendidos. Recomendamos a las autoridades y organismos responsables, reforzar las acciones tendientes a la vigilancia, control y prevención de este tipo de intoxicaciones, producto del mal uso de un desinfectante no autorizado para fines terapéuticos/médicos.
Abstract On March 11th, 2020, the World Health Organization declared a global pandemic due to COVID-19. Faced with this sce- nario, the Poison Control Centers (CIATs for its initials in spanish) in Latin America began to receive consultations for exposure/poi- soning to chlorine dioxide/sodium chlorite and its related compounds for their use aimed to prevent or treat COVID-19 without any scientific endorsement or having a sanitary registry for that purpose. It was found through the Toxicology Network of Latin America and the Caribbean (RETOXLAC) that they were not isolated events but rather that the same phenomenon was occurring throughout the region and that there has been a history of poisoning and alerts with these products for more than a decade with unapproved indications for the treatment of different pathologies such as AIDS, cancer, amyotrophic lateral sclerosis (ALS), malaria, autism, among others, without evidence. In the light of this situation, the CIATs present a review of the signs and symptoms observed ac- cording to the route of exposure based on health risk communication; proposing tests to support the diagnosis, an algorithm for poisoning treatment, and a model of a clinical record for the epidemiological surveillance of the assisted cases. We recommend to the authorities and responsible organisms reinforce the actions aimed at surveillance, control, and prevention of this type of poisoning due to the misuse of an unauthorized disinfectant for therapeutic or medical purposes.
Assuntos
Humanos , Intoxicação/complicações , Intoxicação/epidemiologia , Dióxido de Cloro , Centros de Controle de Intoxicações/estatística & dados numéricos , Intoxicação/prevenção & controle , América Latina/epidemiologiaRESUMO
Advances in tissue engineering require the development of new biomaterials with adequate properties of cell attachment and growth. The properties of biomaterials can be improved by incorporation of bioactive molecules to enhance in vitro and/or in vivo functions. In this work, we study the role of a wheat germin-like protease inhibitor (GLPI), free or immobilized in biocompatible matrices to improve cell-attachment ability on different mammalian cell lines. The phylogenetic relationships and functional diversity of the GLPI were analyzed among diverse genera to get insights into sequence motif conservations. The cytocompatibility effect of free GLPI on C2C12 premyoblastic cells and B16 cells as tumoral model has been tested. GLPI promoted proliferation and metabolic activity of both cell types on in vitro models, not showing cytotoxic effects. Furthermore, GLPI was immobilized in chitin microparticles and in chitosan films; we demonstrated an accelerated cell adhesion process in both biomaterials.
Assuntos
Materiais Biocompatíveis/química , Quitina/química , Quitosana/química , Glicoproteínas/química , Proteínas de Plantas/química , Engenharia Tecidual , Animais , Materiais Biocompatíveis/farmacologia , Adesão Celular/efeitos dos fármacos , Linhagem Celular , Humanos , Filogenia , Triticum/efeitos dos fármacosRESUMO
Resumen Los centros de información y asesoramiento toxicológico CIATs de América Latina, en el contexto de la pandemia de COVID-19, recibieron una serie de llamadas para consultas y asesoramientos relacionados con el uso de dióxido de cloro/clorito de sodio, que se estaban empleando en el tratamiento o prevención de dicha enfermedad. Dentro de la legislación vigente en los países de América Latina, no se contemplan productos farmacéuticos registrados para uso en humanos, ni se tiene evidencia de registros sanitarios en Europa, Canadá o Estados Unidos para tal fin, que contengan dióxido de cloro o clorito de sodio. Esta publicación, compila la información registrada como parte de la estadística del trabajo de ocho CIATs correspondientes a igual número de países de América Latina. Se identificó sexo, edad, sintomatología, circunstancia y grado de severidad de los 56 casos de pacientes intoxicados con dióxido de cloro/clorito de sodio registrados en el período del 15 de marzo al 30 de septiembre de 2020 en estos ocho países. Los resultados obtenidos confirman que la causa más común fue por mal uso, y el lugar de ocurrencia fue el hogar o sus alrededores, siendo el mayor porcentaje adultos jóvenes comprendidos entre 30 y 49 años. Los síntomas de intoxicación más frecuentemente encontrados fueron gastrointestinales, seguidos de cardiovasculares y respiratorios. La vía de ingreso al organismo en la mayoría de los casos fue por vía oral, reportándose algunos casos por vía inhalatoria, y en el 50% de los casos se constituyeron casos de severidad moderada, severa o fatal (3 fallecimientos). Este estudio contribuye a generar información relevante para las diferentes autoridades sanitarias, los ministerios de salud, las entidades encargadas de inspección, vigilancia y control de los países en los que se comercializan estos productos de manera ilegal por medio de redes sociales y promoviéndolos para uso en humanos para prevenir o curar COVID-19.
Abstract The Poison Control Centers in Latin America, in the context of COVID-19 pandemic, received a series of calls for consultations and recommendations related to the use of chlorine dioxide/sodium chlorite, in the treatment or prevention of CO-VID-19. Under current legislation in Latin America, no pharmaceutical products are registered for use in humans that contain chlorine dioxide or sodium chlorite, nor is there evidence of sanitary registries in Europe, Canada, or the United States for this purpose. This publication compiles the information registered by eight Poison Control Centers that correspond to the same number of Latin American countries. Sex, age, symptoms, circumstance, and degree of severity of the 56 cases of patients poisoned with chlorine dioxide/ sodium chlorite registered in the period from March 15th to September 30th, 2020 were identified. The results obtained confirm that the most common cause of poisoning was unintentional misuse, all of which occurred at home or its surroundings, with the highest percentage of registered cases being young adults between 30 and 49 years old. The most frequent symptoms of intoxication were gastrointestinal, followed by cardiovascular and respiratory. The route of exposure in most cases was oral, with some cases reported by inhalation; 48.2% of the cases were of moderate, severe, or fatal (3 deaths). This study contributes to the generation of relevant information for different health authorities, ministries of health, entities in charge of inspection, surveillance, and control in countries where these products are illegally marketed through social networks and promoted for use in humans to prevent or cure COVID-19.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Centros de Controle de Intoxicações/estatística & dados numéricos , Intoxicação/epidemiologia , Cloretos/efeitos adversos , Dióxido de Cloro/efeitos adversos , COVID-19/terapia , Intoxicação/complicações , Intoxicação/prevenção & controle , Estudos Retrospectivos , América Latina/epidemiologiaRESUMO
INTRODUCTION: Resistance to macrolide antibiotics is increasing in clinical isolates of Streptococcus pneumoniae and is associated with the presence of mobile genetic elements. Objetive: The aim of this study was to determine the distribution of serotypes and transposons among macrolide-resistant invasive isolates of S. pneumoniae in Colombia from 1994 to 2011. MATERIALS AND METHODS: A total of 225 macrolide-resistant S. pneumoniae isolates were analyzed. The isolates had epidemiological data, serotyping and antimicrobial susceptibility patterns. The phenotypes were tested by erythromycin-clindamycin double-disk test. We investigated the presence of transposons by several multiplex PCRs to identify the genes erm (B), mef(A), mef(E), tet M, Cat , Aph3 -III, int -Tn 916 , xis -Tn 916 , TnpA -Tn 917 , TnpR -Tn 917 and int -Tn 5252 . RESULTS: Of all isolates, 62.7%, 2.7% and 34.6% of isolates exhibited cMLS B, iMLS B, and M phenotypes, respectively. Multiresistance was observed in 69.3% of these strains. The most prevalent genetic elements in MLS B were the Tn 5253 (34%), mostly carried in serotype 6B isolates and found to be related to the international clone Spain-ST90; Tn 1545 (18.4%), carried by serotype 19A and related to ST276, and Tn 3872 (14.9%), mainly detected in capsular types 6B and 14. Other seven transposons (32.7%) were associated with different serotypes. The mega element (62.8%) was associated to serotype 6A and ST473 in M phenotype. CONCLUSIONS: The majority of erythromycin-resistance isolates of S. pneumoniae in Colombia had the cMLS B phenotype and was associated with the presence of transposons, which carry multiple resistance determinants for other antibiotics. Moreover, isolates with M phenotype carried the gene mef( E) in the mega element.
Assuntos
Antibacterianos/farmacologia , Elementos de DNA Transponíveis/genética , Farmacorresistência Bacteriana Múltipla/genética , Eritromicina/farmacologia , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae/genética , Proteínas de Bactérias/genética , Clindamicina/farmacologia , Colômbia/epidemiologia , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Genes Bacterianos , Humanos , Proteínas de Membrana/genética , Fenótipo , Infecções Pneumocócicas/epidemiologia , Sorotipagem , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/isolamento & purificaçãoRESUMO
In Colombia, a laboratory-based surveillance of invasive Streptococcus pneumoniae isolates as part of SIREVA II PAHO has been conducted since 1994. This study describes the serotype distribution, antimicrobial resistance, and genetic relationships of pneumococcal isolates recovered in Colombia from 2005 to 2010. In this study, demographic data of invasive S. pneumoniae isolates were analyzed, and antimicrobial susceptibility patterns were determined. Pulse field gel electrophoresis (nâ=â629) and multilocus sequence typing (nâ=â10) were used to determine genetic relationship of isolates with minimal inhibitory concentration to penicillin ≥0.125 µg/mL. A total of 1775 isolates of S. pneumoniae were obtained. Fifteen serotypes accounted for 80.7% of isolates. Serotype 14 (23.1%) was the most frequent in the general population. Penicillin resistance was 30.7% in meningitis and 9.0% in non-meningitis. Clones Spain(6B)ST90, Spain(9V)ST156, Spain(23F)ST81, and Colombia(23F)ST338 were associated to isolates. Additionally, serotype 6A isolates were associated with ST460 and ST473, and 19A isolates with ST276, ST320, and ST1118. In conclusion, the surveillance program provided updated information of trends in serotype distribution, antimicrobial resistance and the circulation of clones in invasive pneumococcal diseases. These results could be helpful to understand the epidemiology of S. pneumoniae in Colombia, and provide a baseline to measure the impact of vaccine introduction.
Assuntos
Genótipo , Meningites Bacterianas/epidemiologia , Infecções Pneumocócicas/epidemiologia , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/patogenicidade , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Colômbia/epidemiologia , Eletroforese em Gel de Campo Pulsado , Monitoramento Epidemiológico , Feminino , Humanos , Lactente , Masculino , Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/microbiologia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Tipagem de Sequências Multilocus , Resistência às Penicilinas/efeitos dos fármacos , Resistência às Penicilinas/genética , Penicilinas/uso terapêutico , Infecções Pneumocócicas/tratamento farmacológico , Infecções Pneumocócicas/microbiologia , Sorotipagem , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/isolamento & purificação , VirulênciaRESUMO
The aim of this study was to determine the molecular characterization of invasive penicillin non-susceptible Streptococcus pneumoniae serotype 19A isolates, collected in Colombia between 1994 and 2012. A total of 115 isolates serotype 19A were analyzed. Genetic relationship of 80 isolates with minimal inhibitory concentration (MIC) to penicillin ≥0.125 µg/was determined by pulsed-field gel electrophoresis (PFGE) and selected strains were studied by multilocus sequence typing (MLST). Among the 115 isolates, resistance to penicillin in meningitis was 64.2%, in non-meningitis 32.2% were intermediate and 1.1% were high resistance. The most frequent sequence types were ST320 (33.7%), ST276 (21.5%), and ST1118 (11.2%). Five isolates were associated with the Spain(9V)-ST156 clone, and two isolates were related to Colombia(23F)-ST338 clone. S. pneumoniae serotype 19A increased in Colombia was associated with the spread of isolates genetically related to ST320 and ST276, and emergence of capsular variants of worldwide-disseminated clones.
Assuntos
Resistência às Penicilinas , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae/classificação , Colômbia , Eletroforese em Gel de Campo Pulsado , Humanos , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Sorotipagem , Streptococcus pneumoniae/isolamento & purificaçãoRESUMO
Introducción: el deterioro cognitivo leve (DCL) se caracteriza por la alteración de uno o varios procesos cognitivos sin afectación significativa en las actividades de la vida diaria del paciente y que puede presentarse acompañado de síntomas neuropsiquiátricos, lo que incrementa el riesgo a evolucionar a demencia. Objetivo: identificar la frecuencia y severidad de las alteraciones comportamentales en una población con deterioro cognitivo leve de tipo amnésico. (DCL-A)Procedimiento: estudio no experimental, transversal de alcance descriptivo, que contó con 70 personas, con diagnostico de DCL-A. Seleccionada la muestra los cuidadores respondieron el inventario neuropsiquiátrico. Resultados: el 65.7 por ciento de los participantes presentaron síntomas comportamentales, donde la irritabilidad fue la mas frecuente (32.9 por ciento), seguido por depresión (30 por ciento) y agitación (25.7 por ciento). La apatía fue el síntoma que se presenta con mayor severidad sin ser el más frecuente. Discusión: dentro del cuadro clínico propio del DCL-A se reportan síntomas neuropsiquiátricos que acompañan el déficit cognitivo. En la población estudiada el 65.7 por ciento presentaba dichos síntomas, dato que se aproxima a lo encontrado en la literatura; sin embargo el síntoma más frecuente fue la irritabilidad, no la depresión como se ha reportado en otros estudios; los síntomas menos frecuentes fueron conductas eufóricas y conductas motoras aberrantes.
Introduction: Mild Cognitive Impairment (MCI) is characterized by the alteration of one or more cognitive processes without significant impairment in the activities of patients daily life and may be accompanied by neuropsychiatric symptoms, which increase the risk to develop dementia. Objective: To identify the frequency and severity of behavioral alterations in a population with mild cognitive impairment amnesiac type (MCI-A) Procedure: non experimental study, with a cross-sectional descriptive scope, attended by 70 people with diagnosis of MCI-A.Selected sample of caregivers responded neuropsychiatric inventory. Results: 65.7 percent of participants had behavioral symptoms, where irritability was the most frequent (32.9 percent), followed by depression (30 percent) and agitation (25.7 percent). Apathy was the symptom presented with most severity but not the most frequent. Discussion: Neuropsychiatric symptoms that accompany cognitive deficits are reported in clinical features of MCI-A. In the population studied, 65.7 percent had such symptoms, data that approximates those found in literature. Nonetheless, the most common symptom was irritability and not depression, as has been reported in other studies; euphoric and aberrant motor behaviors were theless frequent symptoms.