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1.
Artículo en Inglés | MEDLINE | ID: mdl-38822829

RESUMEN

Whilst the contribution of peripheral and central inflammation to neurodegeneration in Parkinson's disease and the role of the immune response in this disorder are well known, the effects of the anti-inflammatory response on the disease have not been described in depth. This study is aimed to assess the changes in the regulatory/inflammatory immune response in recently diagnosed, untreated PD patients and a year after. Twenty-one PD patients and 19 healthy controls were included and followed-up for 1 year. The levels of immunoregulatory cells (CD4+ Tregs, Bregs, and CD8+ Tregs); classical, nonclassical, and intermediate monocytes, and proinflammatory cells (Th1, Th2, and Th17) were measured by flow cytometry. Cytokine levels were determined by ELISA. Clinical follow-up was based on the Hoehn & Yahr and UDPRS scales. Our results indicate that the regulatory response in PD patients on follow-up was characterized by increased levels of active Tregs, functional Tregs, TR1, IL-10-producing functional Bregs, and IL-10-producing classical monocytes, along with decreased counts of Bregs and plasma cells. With respect to the proinflammatory immune response, peripheral levels of Th1 IFN-γ+ cells were decreased in treated PD patients, whilst the levels of CD4+ TBET+ cells, HLA-DR+ intermediate monocytes, IL-6, and IL-4 were increased after a 1-year follow-up. Our main finding was an increased regulatory T cell response after a 1-year follow-up and its link with clinical improvement in PD patients. In conclusion, after a 1-year follow-up, PD patients exhibited increased levels of regulatory populations, which correlated with clinical improvement. However, a persistent inflammatory environment and active immune response were observed.

2.
Eur Urol ; 2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38782695

RESUMEN

Treatment options are limited for patients with non-clear cell renal cell carcinoma (nccRCC). Patients with nccRCC experienced a favorable objective response rate (ORR) in a phase 2 trial of cabozantinib plus nivolumab. We now report updated efficacy and safety results at median follow-up of 34 mo for patients with papillary, unclassified, or translocation-associated RCC. Cabozantinib and nivolumab were administered at standard doses to patients with metastatic nccRCC that had progressed on zero or one line of systemic therapy. The primary endpoint was the ORR according to Response Evaluation Criteria in Solid Tumors v1.1. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and adverse events. Forty patients were treated. At median follow-up of 34 mo for survivors, the ORR was 48% (95% confidence interval [CI] 31.5-63.9%). Median PFS was 13 mo (95% CI 7-16); the 12-mo and 24-mo PFS rates were 51% (95% CI 34-65%) and 23% (95% CI 11-37%), respectively. Median OS was 28 mo (95% CI 23-43); the 18-mo and 36-mo OS rates were 70% (95% CI 53-82%) and 44% (95% CI 28-60%), respectively. No new safety signals were seen with cabozantinib and nivolumab. This extended follow-up analysis demonstrates promising efficacy, and highlights the potential for sustained responses with cabozantinib plus nivolumab in patients with metastatic nccRCC. PATIENT SUMMARY: We evaluated outcomes for patients with metastatic kidney cancer of the non-clear cell (NCC) type who were treated with cabozantinib + nivolumab. We found that 48% of the patients responded to the treatment, and there were no unexpected side effects. Among patients who responded to the treatment, the response lasted for a median of 17 months. We conclude that cabozantinib + nivolumab is a safe and effective treatment for NCC kidney cancer.

3.
IBRO Neurosci Rep ; 16: 598-608, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38800085

RESUMEN

Progressive supranuclear palsy (PSP) is a neurodegenerative disease, commonly observed as a movement disorder in the group of parkinsonian diseases. The term PSP usually refers to PSP-Richardson's syndrome (PSP-RS), the most typical clinical presentation. However, the broad concept of progressive supranuclear palsy syndrome (PSP-S) applies to a set of clinical entities that share a pathophysiological origin and some symptoms. According to its clinical predominance, PSP-S is divided into subtypes. PSP-S has clinical similarities with Parkinson's disease, and both pathologies are classified in the group of parkinsonisms, but they do not share pathophysiological traits. By contrast, the pathophysiology of corticobasal syndrome (CBS) depends on tau expression and shares similarities with PSP-S in both pathophysiology and clinical picture. An involvement of the immune system has been proposed as a cause of neurodegeneration. The role of neuroinflammation in PSP-S has been studied by neuroimaging, among other methods. As it is the case in other neurodegenerative pathologies, microglial cells have been attributed a major role in PSP-S. While various studies have explored the detection and use of possible inflammatory biomarkers in PSP-S, no significant advances have been made in this regard. This review is aimed at highlighting the most relevant information on neuroinflammation and peripheral inflammation in the development and progression of PSP-S, to lay the groundwork for further research on the pathophysiology, potential biomarkers, and therapeutic strategies for PSP-S.

4.
Artículo en Inglés | MEDLINE | ID: mdl-38652435

RESUMEN

The association of silver nanoparticles (AgNps) to sealant agent Palaseal® can be a promising alternative for complete denture wearers who may develop denture stomatitis (DS). The study aimed to evaluate the anti-Candida and biocompatible potential of silver nanoparticles synthesized by three routes associated with denture glaze to prevent and/or treat oral candidiasis. Surface acrylic resin specimens were treated with different associations of glaze with AgNps (VER+AgUV, VER+AgTurk and VER+AgGm). As controls, specimens were treated with glaze+nystatin (VER+Nyst), glaze only (VER) or submerged in PBS (PBS). Afterwards, Candida albicans biofilm was developed for 24 h, 15 d and 30 d. Subsequently, the biofilm was quantified by CFU/mL, XTT assay and confocal laser scanning microscopy. Fibroblasts were submitted to conditioned medium with the same associations for 24, 48 and 72 h and LIVE/DEAD® viability test was carried out. Regardless of the period, there was a significant reduction (p < 0.01) of viable fungal cells load, as well as inhibition of fungal metabolic activity, in specimens treated with glaze+AgNps associations, compared to VER and PBS. The anti-Candida effects of the associations were similar to the VER+Nyst group, with emphasis on VER+AgGm, which showed the highest percentage values of non-viable fungal cells maintained over time. The associations did not prove toxicity to fibroblasts. The AgNps exerted antimicrobial activity against C. albicans biofilms and are biocompatible. The most effective results were achieved with the association of glaze+silver nanoparticles synthesized by the green chemistry method (AgGm), proving to be an innovative alternative in the management of DS.

5.
J Neurochem ; 2024 Mar 29.
Artículo en Inglés | MEDLINE | ID: mdl-38549444

RESUMEN

The neurovascular unit, composed of vascular endothelium, vascular smooth muscle, extracellular matrix components, pericytes, astrocytes, microglia, and neurons, allows the highly regulated exchange of molecules and the limited trafficking of cells to the brain through coordinated signaling activity. The passage of peripheral immune cells to the brain parenchyma is observed when there is clear damage to the barriers of this neurovascular unit, as occurs in traumatic brain injury. The possibility of leukocyte infiltration to the brain in neurodegenerative conditions has been proposed. In this review, we focus on describing the evidence for peripheral immune cell infiltration to the brain in the two most frequent neurodegenerative diseases: Alzheimer's and Parkinson's diseases. In particular, we address the mechanisms that promote the passage of these cells into the brain under such pathological conditions. We also discuss the relevance of the resulting cellular interactions, which provide evidence that the presence of peripheral immune cells in the brain is a key point in these neurodegenerative diseases.

6.
Genes (Basel) ; 14(10)2023 10 07.
Artículo en Inglés | MEDLINE | ID: mdl-37895262

RESUMEN

Parkinson's disease (PD) pathophysiology includes mitochondrial dysfunction, neuroinflammation, and aging as its biggest risk factors. Mitochondrial DNA copy number (mtDNA-CN) and telomere length (TL) are biological aging markers with inconclusive results regarding their association with PD. A case-control study was used to measure TL and mtDNA-CN using qPCR in PBMCs. PD patients were naive at baseline (T0) and followed-up at one (T1) and two (T2) years after the dopaminergic treatment (DRT). Plasmatic cytokines were determined by ELISA in all participants, along with clinical parameters of patients at T0. While TL was shorter in patients vs. controls at all time points evaluated (p < 0.01), mtDNA-CN showed no differences. An increase in mtDNA-CN and TL was observed in treated patients vs. naive ones (p < 0.001). Our statistical model analyzed both aging markers with covariates, showing a strong correlation between them (r = 0.57, p < 0.01), and IL-17A levels positively correlating with mtDNA-CN only in untreated patients (r = 0.45, p < 0.05). TL and mtDNA-CN could be useful markers for monitoring inflammation progression or treatment response in PD. DRT might modulate TL and mtDNA-CN, reflecting a compensatory mechanism to counteract mitochondrial dysfunction in PD, but this needs further investigation.


Asunto(s)
ADN Mitocondrial , Enfermedad de Parkinson , Humanos , ADN Mitocondrial/genética , Estudios de Casos y Controles , Variaciones en el Número de Copia de ADN/genética , Enfermedad de Parkinson/genética , Telómero/genética , Mitocondrias/genética , Biomarcadores
7.
Int J Prosthodont ; 0(0): 0, 2023 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-37729481

RESUMEN

PURPOSE: To evaluate the published literature on tooth-tissue supported removable partial dentures (RPDs) and determine the attachment system that provides the best clinical outcome. MATERIALS AND METHODS: A comprehensive search of studies published up to November 2021 was performed in the PubMed/MEDLINE, Web of Science, and Cochrane Library databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The study protocol was approved and was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42021268449). The PICO question was, "What is the best attachment system used in Kennedy class I and II removable partial dentures?" RESULTS: The search identified 871 articles, of which 21 met the inclusion criteria. The evaluation period in the studies ranged from 3 to 282 months. A total of 1,357 patients were included, of which 526 used prostheses with attachments. The mini SG attachment (extracoronal) was the most commonly used attachment, and the survival rate ranged from 37% to 98.1% in 10 studies, with no significant differences between the systems. Among the 10 studies selected for quantitative analysis, the meta-analysis revealed an overall failure rate of 16.6% (95% confidence interval: 10.4-25.4%), and heterogeneity of I²=65.725 (Q-value: 26.258, P=.002). CONCLUSION: Clinical studies comparing different attachment systems for rehabilitation are lacking. Our findings suggest that attachment-retained RPDs have good retention and better esthetics than conventional RPDs and that the extracoronal attachment system is the most viable choice for treatment at the free end.

8.
Rev Invest Clin ; 75(4): 193-202, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37607031

RESUMEN

Background: In Parkinson's disease (PD), exosomes carry α-synuclein (α-syn), a fibrillar protein aggregates with potential value as a biomarker. Objective: Evidence on blood levels of exosomal α-syn in PD patients and controls was reviewed for their consistency. Methods: Thirty-six studies on exosomal α-syn concentrations in PD were identified in a systematic literature search and meta-analysis. Results: Both raw and ratio-adjusted blood exosomal α-syn levels were consistently higher in PD patients than in controls. The standardized mean difference (SMD) was 1.54 (0.18-2.90, CI95%, p < 0.01) and 1.53 (0.23-2.83, CI95%, p < 0.01), respectively. Conclusion: Our results suggest that exosomal α-syn concentrations could be a useful biomarker for PD.


Asunto(s)
Vesículas Extracelulares , Enfermedad de Parkinson , Humanos , alfa-Sinucleína , Biomarcadores , Enfermedad de Parkinson/diagnóstico
9.
Rev. invest. clín ; 75(4): 193-202, Jul.-Aug. 2023. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1515323

RESUMEN

ABSTRACT Background: In Parkinson's disease (PD), exosomes carry α-synuclein (α-syn), a fibrillar protein aggregates with potential value as a biomarker. Objective: Evidence on blood levels of exosomal α-syn in PD patients and controls was reviewed for their consistency. Methods: Thirty-six studies on exosomal α-syn concentrations in PD were identified in a systematic literature search and meta-analysis. Results: Both raw and ratio-adjusted blood exosomal α-syn levels were consistently higher in PD patients than in controls. The standardized mean difference (SMD) was 1.54 (0.18-2.90, CI95%, p < 0.01) and 1.53 (0.23-2.83, CI95%, p < 0.01), respectively. Conclusion: Our results suggest that exosomal α-syn concentrations could be a useful biomarker for PD.

10.
Artículo en Inglés | MEDLINE | ID: mdl-37022372

RESUMEN

Coherent multi-transducer ultrasound (CoMTUS) creates an extended effective aperture through the coherent combination of multiple arrays, which results in images with enhanced resolution, extended field-of-view, and higher sensitivity. The subwavelength localization accuracy of the multiple transducers required to coherently beamform the data is achieved by using the echoes backscattered from targeted points. In this study, CoMTUS is implemented and demonstrated for the first time in 3-D imaging using a pair of 256-element 2-D sparse spiral arrays, which keep the channel count low and limit the amount of data to be processed. The imaging performance of the method was investigated using both simulations and phantom tests. The feasibility of free-hand operation is also experimentally demonstrated. Results show that, in comparison to a single dense array system using the same total number of active elements, the proposed CoMTUS system improves spatial resolution (up to 10 times) in the direction where both arrays are aligned, contrast-to-noise-ratio (CNR, up to 46%), and generalized CNR (up to 15%). Overall, CoMTUS shows a narrower main lobe and higher contrast-to-noise ratio, which results in an increased dynamic range and better target detectability.

11.
Parasitol Res ; 122(7): 1489-1497, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37115316

RESUMEN

The ability to modulate the host immune response has allowed some parasites to establish themselves in the tissues of an immunocompetent organism. While some parasite excretion/secretion products (ESPs) were recently reported to induce differentiation of regulatory T cells (Tregs), their identity is not known. This work is aimed to identify and characterize ESPs of Taenia crassiceps cysticerci linked with Treg induction in vivo. ESPs were obtained from cultures of T. crassiceps cysticerci and inoculated in mice, measuring Treg levels by flow cytometry. Proteins in ESPs were analyzed by electrophoresis; then, ESPs were classified as either differential or conserved. Differentially included proteins were MS-sequenced and functionally characterized. Only 4 of 10 ESPs induced Tregs. Proteins with catalytic activity and those involved in immunological processes predominated, supporting the idea that these molecules could play an important role in the induction of Tregs.


Asunto(s)
Parásitos , Taenia , Animales , Ratones , Cysticercus , Linfocitos T Reguladores , Citometría de Flujo , Ratones Endogámicos BALB C
12.
J Dent ; 131: 104445, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36773742

RESUMEN

OBJECTIVE: To evaluate the antimicrobial potential of silver nanoparticles (Ag NPs) synthesized using three different routes (ultraviolet light, Turkevich, and green chemistry method using Glycine max extract) associated with COREGA® denture powder adhesive. METHODS: Heat-cured acrylic resin specimens were treated with different Ag NPs associated with the adhesive (AD + Ag UV, AD + Ag Turk, and AD + Ag Gm groups). As controls, the specimens were treated with a combination of adhesive and nystatin (AD + Nyst group), only adhesive (AD group), or submerged on the surface of the specimens (PBS group). After the treatments, biofilms of C. albicans developed for 3, 6, and 12 h on the specimen surfaces. The biofilm was quantified using colony-forming units per milliliter, colorimetric assay, and confocal laser scanning microscopy. RESULTS: Regardless of the period, we observed an inhibition of fungal load and a reduction in metabolic activity and biofilm mass in the resin specimens treated with the combinations AD/Ag NPs, compared to AD and PBS. The antimicrobial action of the AD + Turk and AD + Ag Gm groups was similar than that for the AD + Nyst group in all periods and viability tests, except for the biofilm mass (12 h). CONCLUSIONS: The COREGA® adhesive with Ag NPs, mainly those synthesized using the Turkevich and Glycine max methods, showed excellent antimicrobial activity against C. albicans biofilms, maintained for up to 12 h. CLINICAL SIGNIFICANCE: The association of Ag NPs to the adhesive can add preventive or therapeutic effects against denture stomatitis, to this prosthetic material.


Asunto(s)
Antiinfecciosos , Nanopartículas del Metal , Candida albicans/fisiología , Plata/farmacología , Cementos Dentales/farmacología , Antiinfecciosos/farmacología , Biopelículas , Dentaduras , Bases para Dentadura/microbiología
13.
Open Access Rheumatol ; 14: 269-280, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36426199

RESUMEN

Purpose: To describe clinical characteristics and effectiveness of health care in patients with rheumatoid arthritis (RA) as part of a multidisciplinary care model (MCM) in a specialized rheumatology center, compared with the results of a national registry of RA (NARRA) as evidence of real-world management. Patients and Methods: We conducted a real-world study (July 1, 2018 to June 30, 2019) based on an analysis of electronic health records of a cohort of RA patients managed with the "Treat-to-Target" strategy in a specialized rheumatology center in Colombia with an MCM, compared with the NARRA that includes different models of usual care. Results: We have analyzed 7053 subjects with RA treated at a specialized rheumatology center and 81,492 patients from the NARRA. Cohorts were similar in their baseline characteristics, with women in predominance and diagnosis age close to 50 years. At the time of diagnosis, a higher proportion of clinical diagnostic test use and rheumatology consultation access was observed in the specialized rheumatology center than in the national registry (4-6 per year versus three or less). In addition, higher proportions of patients in remission and low disease activity were reported for the specialized rheumatology center, with a >40% amount of data lost in the national registry. Pharmacological management was similar regarding the analgesic use. In the specialized center, Certolizumab was more frequently used than in the NARRA registry; also, there were significant differences in methotrexate, leflunomide, and sulfasalazine use, being higher in the specialized rheumatology center. Conclusion: The MCM of a specialized center in RA can guarantee comprehensive care, with better access to all the services required to manage the disease. It ensures specialist management and evidence-based care that facilitates the achievement of therapeutic objectives. In addition, better patient records and follow-ups are available to evaluate health outcomes.

14.
Autoimmun Rev ; 21(3): 103019, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34920107

RESUMEN

BACKGROUND: Corticosteroids are the first-line treatment for several common autoimmune neurological diseases. Other therapeutic approaches, including intravenous immunoglobulin (IVIg) and plasmapheresis, have shown mixed results in patient improvement. OBJECTIVE: To compare the efficacy of IVIg administration with that of corticosteroids, plasmapheresis, and placebo in autoimmune neurological diseases like Guillain-Barré syndrome, myasthenia gravis, chronic inflammatory demyelinating polyneuropathy, optic neuritis, and multiple sclerosis. METHODS: A systematic review was performed on the databases PubMed, MEDLINE, Embase, and Cochrane. Controlled, randomized studies comparing the efficacy of IVIg with placebo, plasmapheresis, and/or glucocorticoid administration were selected. Only studies reporting the number of patients who improved after treatment were included, irrespective of language or publication year. In total, 23 reports were included in the meta-analysis study. RESULTS: Our meta-analysis showed a beneficial effect of IVIg administration on patient improvement over placebo (OR = 2.79, CI [95%] = 1.40-5.55, P = 0.01). Meanwhile, IVIg administration showed virtually identical effects to plasmapheresis (OR = 0.83, CI [95%] = 0.45-1.55, P < 0.01). Finally, no significant differences were found in the efficacy of IVIg and glucocorticoid administration (OR = 0.98, Cl [95%] = 0.58-1.68, P = 0.13). CONCLUSION: IVIg can be regarded as a viable therapeutic approach, either as a first- or second-line therapy, and as an adjuvant therapy for autoimmune neurological diseases.


Asunto(s)
Síndrome de Guillain-Barré , Miastenia Gravis , Polirradiculoneuropatía Crónica Inflamatoria Desmielinizante , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Miastenia Gravis/tratamiento farmacológico , Intercambio Plasmático , Polirradiculoneuropatía Crónica Inflamatoria Desmielinizante/tratamiento farmacológico
15.
Foods ; 10(10)2021 Oct 03.
Artículo en Inglés | MEDLINE | ID: mdl-34681407

RESUMEN

Food Loss and Waste (FLW) reduction and prevention can be crucial entry points to achieve sustainable food systems. However, the complexity of this problem poses the need for multistakeholder and multidimensional approaches. The Costa Rican FLW Reduction Network has been working since 2014 as a collaborative platform that brings together different sectors and disciplines to promote a change through communication and awareness, alliances, and research and innovation. The purpose of our study was to share the experience of Costa Rica in regards to the applied FLW actions and its catalytic effect on FLW innovation. The study was developed through a multimethod approach that included case studies, stakeholder analysis and literacy analysis to provide an overall assessment of the strategy as input for further efforts in this matter. The main findings indicate that collaborative actions among institutions and sectors are vital in promoting FLW reduction; however, FLW innovation is still at an inception phase where financial resources and policy barriers remain as aspects to address. In conclusion, the Costa Rica FLW Network represents an asset to trigger ongoing and future actions, and approaches like an integrated innovation ecosystem must be promoted.

16.
J Transl Med ; 19(1): 378, 2021 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-34488776

RESUMEN

BACKGROUND: Neuroinflammation has been proved to play a role in dopaminergic neuronal death in Parkinson's disease (PD). This link highlights the relevance of the immune response in the progression of the disease. However, little is known about the impact of peripheral immune response on the disease. This study is aimed to evaluate how immune cell populations change in untreated PD patients followed-up for 2 years. METHODS: Thirty-two patients with no previous treatment (PD-0 yr) and twenty-two healthy subjects (controls) were included in the study. PD patients were sampled 1 and 2 years after the start of the treatment. CD4 T cells (naïve/central memory, effector, and activated), CD8 T cells (activated, central memory, effector memory, NKT, Tc1, Tc2, and Tc17), and B cells (activated, plasma, and Lip-AP) were characterized by flow cytometry. RESULTS: We observed decreased levels of naïve/central memory CD4 and CD8 T cells, Tc1, Tc2, NKT, and plasma cells, and increased levels of effector T cells, activated T cells, and Tc17. CONCLUSIONS: PD patients treated for 2 years showed an imbalance in the naive/effector immune response. Naïve and effector cell levels were associated with clinical deterioration. These populations are also correlated to aging. On the other hand, higher Tc17 levels suggest an increased inflammatory response, which may impact the progression of the disease. Our results highlight the relevant effect of treatment on the immune response, which could improve our management of the disease.


Asunto(s)
Enfermedad de Parkinson , Linfocitos T CD4-Positivos , Linfocitos T CD8-positivos , Estudios de Casos y Controles , Humanos , Inmunidad
17.
Int J Life Cycle Assess ; 26(10): 2056-2071, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34522069

RESUMEN

PURPOSE: Several frameworks coincide in the importance of addressing social impacts to ensure sustainability. However, the agri-food sector, regarded as key in sustainable production, still neglects to identify potential social impacts when applying life cycle approaches. This work contributes to understanding the social performance of three agricultural products from a Latin American and Caribbean developing country as Costa Rica while recognising the challenges of Social-Life Cycle Assessment (S-LCA) application in this context. METHODS: S-LCA represents a powerful technique to evaluate the potential social impacts of a product. Three case studies were analysed through S-LCA, using the subcategory assessment method (SAM) to characterise the social impacts and detect hotspots in the production of green coffee, raw milk and leafy vegetables. Primary data was collected through questionnaires to relevant informants and observations. In addition to secondary information, these data and information were used to assess eight impact subcategories for the farmer and worker stakeholder groups and nine subcategories for the local community. RESULTS AND DISCUSSION: The main results suggest that the Costa Rican institutional and market frameworks provide an enabling environment for a generally positive social performance in the studied cases. The assessed stakeholders can fulfil basic needs through access to inputs and services and achieve fair-trading conditions. Child labour, forced labour and evidence of environmental or health risks for the surrounding communities were absent. Important efforts to address the delocalisation, migration and child labour were observed, suggesting the potential development of social handprints in further studies. However, the farm production phase, related to farmers and workers, entails hotspots regarding social security and women's empowerment. Moreover, farmers appear as the most vulnerable group because of their overall social performance. CONCLUSIONS: S-LCA helped identify relevant areas of intervention in the context of these particular case studies; however, further research and capacity building are recommended to tackle the detected challenges, both in the agri-food chains and in the use of S-LCA. Furthermore, these findings can aid in future decision and policy-making to improve and safeguard the positive social performance observed in the studied products. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11367-021-01964-4.

18.
Clinicoecon Outcomes Res ; 13: 583-591, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34188503

RESUMEN

BACKGROUND: Health systems need to optimize the use of resources, especially in high-cost diseases as rheumatoid arthritis (RA). We aimed to evaluate the efficiency of using centers of excellence (CoE) as a strategy for improving RA treatment in Colombia. METHODS: A cost description analysis was carried out using the standard costing technique. We estimated the costs of medical consultations, laboratories, images, and medications for RA. Categories of care standards stratified by severity were defined using the disease activity score in 28 joints (DAS28). We evaluated the impact, in terms of costs (US dollars), for providing RA clinical care for a previously described cohort using the CoE approach. Statistical analyses were performed in Microsoft Excel®, and R. RESULTS: Expenditure on therapeutic drugs increases as the severity of RA increases. Drugs represent 53.6% of the total cost for the low disease activity (LDA) stage, 75.2% for moderate disease activity (MDA), 88.5% for severe disease activity (SDA) and 97% for SDA with biologic treatment (SDA+Biologic). Treating 968 patients would cost US$612,639 (US$487,978-1,220,160) at baseline, per year. After a year of follow-up at the CoE, treating the same patients would cost US$388,765 (US$321,710-708,476), which implies potential cost-savings of up to US$223,874 per year. CONCLUSION: The strategy of providing clinical care for RA through CoE can save US$231.3 per patient-per year. The results of our study show that CoE could greatly impact the public policies dealing with treatment of RA in Colombia. Applying the CoE model in our country would both improve health outcomes, as well as being more efficient in terms of costs.

19.
Front Genet ; 12: 647487, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34149799

RESUMEN

Systemic lupus erythematosus (SLE) is an autoimmune disease with a complex etiology. Various genetic factors are associated with susceptibility to developing SLE and contribute to its onset and progression. Different single-nucleotide polymorphisms (SNPs) have been associated with SLE in several populations. The rs12979860 SNP in interferon lambda 3/4 (IFNλ3/4) is significantly associated with SLE susceptibility in patients negative for nephritis in Taiwanese people, and interferon-stimulated genes (ISGs) are differentially expressed in normal liver by the rs12979860 genotype. This study aimed to investigate whether rs12979860 is associated with the presence of SLE and lupus nephritis in Mexican individuals as well as with the expression of several ISGs in SLE patients. In total, 439 SLE patients and 358 healthy donors were genotyped for rs12979860 using real-time PCR, and allelic discrimination plots were constructed. Additionally, peripheral blood mononuclear cells (PBMCs) were isolated from the venous blood of SLE patients by centrifugation (n = 78). The mRNA levels of 2'-5'-oligoadenylate synthetase like (OASL), myxovirus resistance 1 (MX1), 2'5'-oligoadenylate synthetase 1 (OAS1), interferon-stimulated gene 15 (ISG15) and lymphocyte antigen 6 complex, locus E (LY6E) were determined using real-time PCR. The distributions of rs12979860 genotypes and allele frequencies were compared between SLE patients and healthy donors; case-control analysis revealed that rs12979860 was not associated with SLE susceptibility (OR 1.18, 95% CI 0.97-1.45, p = 0.08) or with the risk for lupus nephritis (OR 0.913, 95% CI 0.590-1.411, p = 0.682). However, OASL expression levels in PBMCs were significantly different between rs12979860 genotypes in SLE patients: median OASL mRNA levels were significantly higher in patients carrying the CC genotype (197.10, IQR 71.10-411.17) than in those with CT/TT genotypes (173.75, IQR 58.80-278.75, p = 0.016). Our results suggest that the SNP rs12979860 does not play a relevant role in susceptibility to SLE in Mexican individuals. However, IFNλ3/4 genotypes appear to be associated with OASL expression in PBMCs from patients with SLE.

20.
J Neuroimmunol ; 355: 577550, 2021 06 15.
Artículo en Inglés | MEDLINE | ID: mdl-33799062

RESUMEN

Rare conditions showing psychiatric symptoms and movement disorders have been linked with the presence of anti-glutamate decarboxylase antibodies. Proinflammatory and antiinflammatory immune responses were assessed in patients with neurological disorders associated to anti-glutamic acid decarboxylase antibodies (NDGAD). Immunoregulatory and proinflammatory cell populations were quantified by flow cytometry. No polarization toward Th1, Th2, or Th17 phenotypes was observed in NDGAD patients. Immunoregulatory responses were significantly reduced for Breg, activated Treg, Tr1, and Th3 cells, suggesting a deficient regulatory response, while intermediate monocyte levels were increased. The reduced levels of regulatory T and B cells suggest an impairment in regulatory immune response, while intermediate monocytes could be playing a role in the increased proinflammatory response.


Asunto(s)
Antiinflamatorios/inmunología , Autoanticuerpos/inmunología , Linfocitos B/inmunología , Glutamato Descarboxilasa/inmunología , Enfermedades del Sistema Nervioso/inmunología , Linfocitos T Colaboradores-Inductores/inmunología , Adulto , Anciano , Antiinflamatorios/sangre , Autoanticuerpos/sangre , Linfocitos B/metabolismo , Femenino , Glutamato Descarboxilasa/sangre , Humanos , Inmunidad Celular/inmunología , Leucocitos Mononucleares/inmunología , Leucocitos Mononucleares/metabolismo , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/sangre , Linfocitos T Colaboradores-Inductores/metabolismo , Adulto Joven
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