RESUMO
INTRODUCTION: gonarthrosis is a degenerative disease, whose loss of cartilage causes changes in the adjacent bone and its response produces deformations and attempts at regeneration. In 1934 Meyer and Palmer isolated bovine vitreous humor, a polysaccharide called hyaluronic acid, which has the property of visco-elasticity. Today, multiple procedures performed in orthopedics are known, in order to limit the degenerative process that this entails. OBJECTIVE: to know the use and efficacy of hyaluronic acid in the patient requiring knee arthroscopy, evaluating the evolution of the patient using the WOMAC scale; as well as the ideal time of application of hyaluronic acid in this study group. MATERIAL AND METHODS: clinical, non-randomized, prospective, analytical trial. 48 patients from 45 to 60 years of age, divided into 3 groups with a diagnosis of gonarthrosis grade II-III, who underwent arthroscopy with subsequent hyaluronic acid application, were evaluated; in the postoperative period (group 1), one month after the postoperative period (group 2) and without application (group 3) in a period from September 2015 to June 2016 at the ISSSTE Hospital "Dr. Darío Fernández Fierro". RESULTS: the treatment showed differences in patients regarding reduction of pain and stiffness; and improvement in functional capacity. CONCLUSION: despite, there are no conclusive results if the treatment is better than the other, certain data suggests that using hyaluronic acid in the postoperative improves rigidity and function, however, it was not statistically significant.
INTRODUCCIÓN: la gonartrosis es una enfermedad degenerativa, cuya pérdida de cartílago origina cambios en el hueso adyacente y su respuesta produce deformaciones e intentos de regeneración. En 1934 Meyer y Palmer aislaron el humor vítreo bovino, polisacárido denominado ácido hialurónico, que tiene la propiedad de visco elasticidad. Hoy en día se conocen múltiples procedimientos realizados en ortopedia, con la finalidad de limitar el proceso degenerativo que este conlleva. OBJETIVO: conocer el uso y la eficacia del ácido hialurónico, en el paciente que requiere artroscopía de rodilla, valorando la evolución del paciente mediante escala de WOMAC; así como el tiempo ideal de aplicación del ácido hialurónico en este grupo de estudio. MATERIAL Y MÉTODOS: ensayo clínico, no aleatorizado longitudinal, prospectivo, analítico. Se valoraron 48 pacientes de 45 a 60 años de edad, divididos en tres grupos con diagnóstico de gonartrosis grado II-III, en quienes se realizaron artroscopía con posterior aplicación ácido hialurónico; en el transquirúrgico (grupo 1), al mes del postquirúrgico (grupo 2) y sin aplicación (grupo 3) en un período de Septiembre de 2015 a Junio de 2016 en el Hospital del ISSSTE "Dr. Darío Fernández Fierro". RESULTADOS: el tratamiento mostró diferencias en los pacientes en cuanto a reducción de dolor y rigidez; y mejoría en capacidad funcional. CONCLUSIÓN: a pesar de que no es concluyente si algún tratamiento es mejor que otro, ciertos datos sugieren que el utilizar ácido hialurónico en el transquirúrgico mejora la rigidez y la función, sin embargo, no logró ser estadísticamente significativo.
Assuntos
Ácido Hialurônico , Osteoartrite do Joelho , Animais , Bovinos , Humanos , Artroscopia , Ácido Hialurônico/uso terapêutico , Injeções Intra-Articulares , Osteoartrite do Joelho/tratamento farmacológico , Estudos Prospectivos , Resultado do TratamentoRESUMO
Peppers are fruits that grow on plants of the genus Capsicum and are popular for their use in gastronomy as a condiment and for their anti-inflammatory and anti-cancer properties due to their phytocompounds such as flavonoids, polyphenols, or alkaloids. Semiconductor zinc oxide (ZnO) nanoparticles (NPs) were synthesized using a green approach employing natural aqueous extracts of several varieties of peppers (jalapeño, morita, and ghost). The obtained NPs were characterized by different techniques, and their photocatalytic and antibacterial activity was studied. The signal at 620 cm-1 in the FTIR spectra belonging to the Zn-O bond, the appearance of the main peaks of a hexagonal wurtzite structure in the XRD pattern, and the characteristic signals in the UV-Vis spectra confirm the correct formation of ZnO NPs. The photocatalytic activity was analyzed against Methylene Blue (MB), Rhodamine B (RB), and Methyl Orange (MO) under UV and sunlight. All syntheses were able to degrade more than 93% of the pollutants under UV light. Antibacterial assays were performed against gram-positive and gram-negative bacteria. All syntheses exhibited antibacterial activity against all bacteria and maximum growth inhibition against Bacillus subtilis. The prominent results demonstrate that natural aqueous extracts obtained from peppers can be used to synthesize ZnO NPs with photocatalytic and biomedical applications.
Assuntos
Nanopartículas Metálicas , Nanopartículas , Óxido de Zinco , Óxido de Zinco/farmacologia , Óxido de Zinco/química , Antibacterianos/farmacologia , Antibacterianos/química , Bactérias Gram-Negativas , Bactérias Gram-Positivas , Extratos Vegetais/farmacologia , Extratos Vegetais/química , Nanopartículas/química , Nanopartículas Metálicas/química , Testes de Sensibilidade MicrobianaRESUMO
Large-amplitude internal gravity waves were observed using Rayleigh lidar temperature soundings above Rio Grande, Argentina ([Formula: see text], [Formula: see text]), in the period 16-23 June 2018. Temperature perturbations in the upper stratosphere amounted to 80 K peak-to-peak and potential energy densities exceeded 400 J/kg. The measured amplitudes and phase alignments agree well with operational analyses and short-term forecasts of the Integrated Forecasting System (IFS) of the European Centre for Medium-Range Weather Forecasts (ECMWF), implying that these quasi-steady gravity waves resulted from the airflow across the Andes. We estimate gravity wave momentum fluxes larger than 100 mPa applying independent methods to both lidar data and IFS model data. These mountain waves deposited momentum at the inner edge of the polar night jet and led to a long-lasting deceleration of the stratospheric flow. The accumulated mountain wave drag affected the stratospheric circulation several thousand kilometers downstream. In the 2018 austral winter, mountain wave events of this magnitude contributed more than 30% of the total potential energy density, signifying their importance by perturbing the stratospheric polar vortex.
RESUMO
Zika virus (ZIKV) infection is an emergent worldwide public health problem. Historically, 84 countries have reported vector-borne ZIKV transmission, 61 of which report on-going transmission. It is a Flavivirus transmitted through arthropods belonging to the Aedes genus. Since 2015, ZIKV infections have increased dramatically; with 1.3 million people infected during 2015 in Brazil alone. This paper's objective is to highlight the conjectural epidemiological points of the virus' dissemination. The digital archives Pubmed, MEDLINE, EMBASE and Cochrane were searched for papers that assessed aspects of ZIKV transmission and epidemiology. The first isolation occurred in Uganda in 1947. Since then, important outbreaks were documented globally. Consequently, an emergent public health problem arose from a rapidly increasing incidence and its association with the development of neurological diseases such as microcephaly and Guillain-Barré syndrome. Key factors in the successful containment of outbreaks include surveillance of mosquitos in the neighbourhood, an early mosquito control treatment, an assertive information campaign, and the involvement of the local population and healthcare workers. As such, while ZIKV seems to be spreading globally in a similar manner to other arboviruses, such as Dengue and Chikungunya viruses, it can also be rapidly contained due to the pre-existing availability of necessary resources and regulatory tools as control measures. This review aims to provide a description of those characteristics of ZIKV infection that may be useful in the construction of effective outbreak control strategies.
Assuntos
Surtos de Doenças , Pandemias , Infecção por Zika virus/epidemiologia , Controle de Doenças Transmissíveis/métodos , Transmissão de Doença Infecciosa/prevenção & controle , Saúde Global , Humanos , Incidência , Infecção por Zika virus/prevenção & controle , Infecção por Zika virus/transmissãoRESUMO
Toxoplasmosis is caused by infection with the protozoan parasite Toxoplasma gondii, which has the capacity to infect all warm-blooded animals worldwide. Toxoplasmosis is a major cause of visual defects in the Colombian population; however, the association between genetic polymorphisms in cytokine genes and susceptibility to ocular toxoplasmosis has not been studied in this population. This work evaluates the associations between polymorphisms in genes coding for the cytokines tumor necrosis factor alpha (TNF-α) (rs1799964, rs1800629, rs1799724, rs1800630, and rs361525), interleukin 1ß (IL-1ß) (rs16944, rs1143634, and rs1143627), IL-1α (rs1800587), gamma interferon (IFN-γ) (rs2430561), and IL-10 (rs1800896 and rs1800871) and the presence of ocular toxoplasmosis (OT) in a sample of a Colombian population (61 patients with OT and 116 healthy controls). Genotyping was performed with the "dideoxynucleotide (ddNTP) primer extension" technique. Functional-effect predictions of single nucleotide polymorphisms (SNPs) were done by using FuncPred. A polymorphism in the IL-10 gene promoter (-1082G/A) was significantly more prevalent in OT patients than in controls (P = 1.93e-08; odds ratio [OR] = 5.27e+03; 95% confidence interval [CI] = 3.18 to 8.739; Bonferroni correction [BONF] = 3.48e-07). In contrast, haplotype "AG" of the IL-10 gene promoter polymorphisms (rs1800896 and rs1800871) was present at a lower frequency in OT patients (P = 7e-04; OR = 0.10; 95% CI = 0.03 to 0.35). The +874A/T polymorphism of IFN-γ was associated with OT (P = 3.37e-05; OR = 4.2; 95% CI = 2.478 to 7.12; BONF = 6.07e-04). Haplotype "GAG" of the IL-1ß gene promoter polymorphisms (rs1143634, rs1143627, and rs16944) appeared to be significantly associated with OT (P = 0.0494). The IL-10, IFN-γ, and IL-1ß polymorphisms influence the development of OT in the Colombian population.
Assuntos
Citocinas/genética , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único , Toxoplasmose Ocular/genética , Alelos , Estudos de Casos e Controles , Colômbia , Suscetibilidade a Doenças , Feminino , Frequência do Gene , Redes Reguladoras de Genes , Genótipo , Haplótipos , Humanos , Masculino , Regiões Promotoras GenéticasRESUMO
INTRODUCCIÓN La depresión es frecuente en pacientes internados por enfermedades clínicas. Sin embargo, la prevalencia reportada en la literatura es altamente variable. OBJETIVOS Determinar la prevalencia de depresión en tres hospitales del área metropolitana de la provincia de Buenos Aires; evaluar los factores asociados (clínico-epidemiológicos) y tres de las escalas más usadas para su diagnóstico. MÉTODOS Los pacientes fueron evaluados dentro de un estudio de corte transversal para medir depresión (según criterios del DSM-IV) por psiquiatras guiados por el examen MINI, comparando luego este valor con el arrojado por otros métodos de diagnóstico. Los factores de riesgo fueron analizados en análisis bivariado seguidos de un modelo de regresión logística multivariad. RESULTADOS La prevalencia de depresión por examen psiquiátrico en 257 sujetos fue del 27%, encontrando un resultado similar con la Escala de Ansiedad y Depresión Hospitalaria (HADS) (25%) y bastante mayor con el Inventario de Depresión de Beck (BDI) (44%) y con el Cuestionario de Salud del Paciente (PHQ-9) (56%). Entre los factores asociados a depresión, el tratamiento previo con psicofármacos, el sexo femenino, el número de hijos, así como el consumo de tabaco se asociaron significativamente y de forma independiente luego del análisis multivariado. Entre los trastornos médicos, el riesgo de depresión fue más alto en las enfermedades neoplásicas, urológicas e infecciosas, y más bajo en las pulmonares, neurológicas y hematológicas. Discusión Este estudio encontró alta prevalencia de depresión en los hospitales generales, la cual se asocia a varios factores; así como también, la existencia de gran variación en la estimación de la depresión entre los métodos de diagnóstico. Los resultados ratifican la necesidad de identificar depresión en los pacientes hospitalizados por enfermedades médicas utilizando métodos validados, fiables y rentables que contribuyan a la planificación racional para la utilización de recursos.
Assuntos
Fatores de Risco , Depressão , Hospitais GeraisRESUMO
Resumen Objetivos: Describir los principales signos y síntomas, así como el tratamiento inicial de un paciente con diagnóstico de uveítis con el propósito de evitar retardo en la remisión y el inicio del manejo oportuno de esta patología. Métodos: Se realizó una revisión sistemática de la literatura en la cual se identificaron los principales signos y síntomas que deben ser tenidos en cuenta para sospechar el diagnóstico de uveítis y su tratamiento indicado. Se llevó a cabo una búsqueda en PubMed durante el periodo del 2010-2015, se eligieron 439 artículos, los cuales fueron sometidos a dos procesos de filtrado manual, eligiendo por un grupo de investigadores los resúmenes que respondieran nuestra pregunta de investigación. Posteriormente un grupo de oftalmólogos expertos y médicos con experiencia en oftalmología realizaron una segunda revisión. Resultados: Posterior al primer proceso de filtrado se obtuvieron 73 artículos que se sometieron a un segundo proceso de selección donde se obtuvieron 30 artículos. De la selección final de artículos: seis fueron estudios observacionales o ensayos clínicos; los artículos restantes fueron revisiones de la literatura. Los estudios observacionales y ensayos clínicos aleatorizados se evaluaron con la herramienta GRADE siendo la mayoría de evidencia alta. Se hizo una revisión de los treinta artículos seleccionados, por parte de nuestros investigadores, dando como resultado recomendaciones para el diagnóstico y tratamiento de la uveítis para el personal médico no oftalmólogo. Conclusiones: Existen un conjunto de signos y síntomas que pueden hacer sospechar al médico no oftalmólogo el diagnóstico de uveítis. Ante un paciente que presenta dolor ocular asociado a disminución de la agudeza visual, fotofobia, ojo rojo sin secreción conjuntival, miosis pupilar, depósitos retroquératicos y hallazgos al fondo de ojo como vitreitis o coriorretinitis se debe sospechar una uveítis. El manejo precoz de la uveítis anterior no infecciosa puede ser instaurado por el médico no oftalmólogo con corticoides tópicos, sin embargo, en caso de uveítis intermedia y posterior es importante remitir al oftalmólogo cuanto antes. Proponemos un algoritmo para ayudar al diagnóstico de la uveítis y recomendaciones para su manejo inicial.
Abstract Objective: The purpose of this study was to describe the main diagnostic features and the initial management of uveitis, in order to avoid delays in the treatment and the remission to the ophthalmologist. Methods: A systematic review of the literature, which identified the main signs and symptoms and initial treatment for patients with uveitis, was done. A search of the literature published through 2010-2015 was performed using PubMed database. Four hundred and thirty nine eligible articles underwent a selection process in which titles, abstracts and full texts were reviewed, obtaining thirty final articles. Results: Thirty articles were reviewed, six were observational studies and clinical trials; 24 articles were reviews or case reports. The observational studies and clinical trials were rated with the Grading of Recommendations Assessment (GRADE) tool. After the grading tree of the articles were of high level of evidence. Conclusions: In a patient with ocular pain related to decreased visual acuity, photophobia, red eye without secretion, miosis, keratic precipitates, and vitritis or chorioretinitis the healthcare provider should rule out the diagnosis of uveitis. A non-ophthalmologist physician can start the initial management of an anterior uveitis and then refer the patient to the ophthalmologist as soon as possible. If the diagnosis is an infectious anterior uveitis, intermediate uveitis or posterior uveitis the patient should be derived to the ophthalmologist immediately.
Assuntos
Humanos , Uveíte , Oftalmologia , Patologia , CorticosteroidesRESUMO
Antimicrobial resistance is known to be an emerging problem, but the extent of the issue remains incomplete. The aim of this study was to determine the presence or absence of nine resistance genes (blaTEM , catI, mecA, qnrS, sulI, sulII, tet(A), tet(Q), vanA) in the faeces of 141 pigeons from four urban parks in Alajuela, Guadalupe, Tres Ríos and San José in Costa Rica. The genes were identified by real-time PCR directly from enema samples. About 30% of the samples were positive for genes catI and sulI; between 13% and 17% were positive for qnrS, sulII, tet(A) and tet(Q); and 4% were positive for blaTEM . The mecA and vanA genes were not detected. The average of antimicrobial resistance genes detected per pigeon was 2. Eight different patterns of resistance were identified, without differences in the sampling areas, being the most common pattern 2 (sulII positive samples). During rainy season, the genes more frequently found were sulI and tet(A). In conclusion, the urban inhabiting pigeons tested are currently carrying antimicrobial resistance genes, potentially acting as reservoirs of resistant bacteria and vectors to humans. To the authors' knowledge, this is the first study carried out on direct detection of resistance genes in the digestive metagenomes of pigeons.
Assuntos
Bactérias/genética , Columbidae/microbiologia , DNA Bacteriano/genética , Farmacorresistência Bacteriana/genética , Animais , Bactérias/efeitos dos fármacos , Costa Rica , DNA Bacteriano/química , Fezes/químicaRESUMO
BACKGROUND: Latino children and youth have some of the highest rates of overweight and obesity. Early intervention is important to prevent future obesity and illness in this population. METHODS: A 3-year, multifaceted intervention was designed to reduce the rate of growth of body mass index (BMI) among Mexican-origin children. Two communities in California's agricultural Central Valley were targeted for intervention and comparison. To assess impact, anthropometric measures of participating children (N = 422) were collected and analysed at baseline and after 1 year of intervention. RESULTS: After 1 year of intervention, triceps skin-fold thickness in girls showed a significant decrease in unadjusted analysis between children in the two communities. In multivariate analysis, a reduction in BMI growth was seen among obese boys in the intervention community (ß-coefficient = -1.94, P = 0.05). Obese boys in the intervention community also had a smaller increase in waist circumference (ß-coefficient = -5.2, P = 0.04) than the comparison community. CONCLUSIONS: These early findings indicate the intervention's effectiveness for preventing BMI growth among obese boys. Longitudinal follow-up is needed to determine the sustainability of results and whether similar results extend to obese girls and overweight boys or girls.