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1.
Euro Surveill ; 29(6)2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38333937

RESUMO

The monoclonal antibody nirsevimab was at least 70% effective in preventing hospitalisations in infants with lower respiratory tract infections (LRTI) positive for respiratory syncytial virus (RSV) in Spain (Oct 2023-Jan 2024), where a universal immunisation programme began late September (coverage range: 79-99%). High protection was confirmed by two methodological designs (screening and test-negative) in a multicentre active surveillance in nine hospitals in three regions. No protection against RSV-negative LRTI-hospitalisations was shown. These interim results could guide public-health decision-making.


Assuntos
Anticorpos Monoclonais Humanizados , Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Infecções Respiratórias , Lactente , Humanos , Espanha/epidemiologia , Antivirais/uso terapêutico , Infecções por Vírus Respiratório Sincicial/tratamento farmacológico , Infecções por Vírus Respiratório Sincicial/prevenção & controle , Infecções por Vírus Respiratório Sincicial/epidemiologia , Hospitalização , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/epidemiologia , Hospitais
2.
Data Brief ; 50: 109617, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37808543

RESUMO

Glioblastoma, a highly aggressive primary brain tumor, is associated with poor patient outcomes. Although magnetic resonance imaging (MRI) plays a critical role in diagnosing, characterizing, and forecasting glioblastoma progression, public MRI repositories present significant drawbacks, including insufficient postoperative and follow-up studies as well as expert tumor segmentations. To address these issues, we present the "Río Hortega University Hospital Glioblastoma Dataset (RHUH-GBM)," a collection of multiparametric MRI images, volumetric assessments, molecular data, and survival details for glioblastoma patients who underwent total or near-total enhancing tumor resection. The dataset features expert-corrected segmentations of tumor subregions, offering valuable ground truth data for developing algorithms for postoperative and follow-up MRI scans.

3.
Am J Crit Care ; 31(6): 483-493, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36316178

RESUMO

BACKGROUND: Weaning from venoarterial extracorporeal membrane oxygenation (VA-ECMO) support fails in 30% to 70% of patients. OBJECTIVE: To explore the utility of echocardiographic parameters in predicting successful disconnection from VA-ECMO. METHODS: Patients receiving VA-ECMO in a referral hospital were included. The relationships between echocardiographic parameters during the weaning trial and weaning success (survival > 24 hours after VA-ECMO explant and no death from cardiogenic shock, heart failure, or cardiac arrest during the hospital stay) and survival were evaluated. RESULTS: Of 85 patients included, 61% had successful weaning. Parameters significantly related to weaning success were higher left ventricular ejection fraction (LVEF; 40% in patients with weaning success vs 30% in patients with weaning failure, P = .01), left ventricular outflow tract velocity time integral (15 cm vs 11 cm, P = .01), aortic valve opening in every cycle (98% vs 91% of patients, P = .01), and normal qualitative right ventricular function (60% vs 42% of patients, P = .02). The LVEF remained as an independent predictor of weaning success (hazard ratio, 0.938; 95% CI, 0.888-0.991; P = .02). An LVEF >33.4% was the optimal cutoff value to discriminate patients with successful weaning (area under the curve, 0.808; sensitivity, 93%; specificity, 72%) and was related to higher survival at discharge (60% vs 20%, P < .001). CONCLUSION: Among weaning trial echocardiographic parameters, LVEF was the only independent predictor of successful VA-ECMO weaning. An LVEF >33.4% was the optimal cutoff value to discriminate patients with successful weaning and was related to final survival.


Assuntos
Oxigenação por Membrana Extracorpórea , Humanos , Volume Sistólico , Função Ventricular Esquerda , Choque Cardiogênico/terapia , Ecocardiografia , Estudos Retrospectivos
4.
Rev. argent. microbiol ; 54(2): 91-100, jun. 2022. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1407184

RESUMO

Resumen Si bien se han realizado múltiples intentos de modelar matemáticamente la pande-mia de la enfermedad por coronavirus 2019 (COVID-19), causada por SARS-CoV-2, pocos modeloshan sido pensados como herramientas interactivas accesibles para usuarios de distintos ámbitos.El objetivo de este trabajo fue desarrollar un modelo que tuviera en cuenta la heterogeneidadde las tasas de contacto de la población e implementarlo en una aplicación accesible, que per-mitiera estimar el impacto de posibles intervenciones a partir de información disponible. Sedesarrolló una versión ampliada del modelo susceptible-expuesto-infectado-resistente (SEIR),denominada SEIR-HL, que asume una población dividida en dos subpoblaciones, con tasas decontacto diferentes. Asimismo, se desarrolló una fórmula para calcular el número básico dereproducción (R0) para una población dividida en n subpoblaciones, discriminando las tasas decontacto de cada subpoblación según el tipo o contexto de contacto. Se compararon las pre-dicciones del SEIR-HL con las del SEIR y se demostró que la heterogeneidad en las tasas decontacto puede afectar drásticamente la dinámica de las simulaciones, aun partiendo de lasmismas condiciones iniciales y los mismos parámetros. Se empleó el SEIR-HL para mostrar elefecto sobre la evolución de la pandemia del desplazamiento de individuos desde posiciones dealto contacto hacia posiciones de bajo contacto. Finalmente, a modo de ejemplo, se aplicó elSEIR-HL al análisis de la pandemia de COVID-19 en Argentina; también se desarrolló un ejemplode uso de la fórmula del R0. Tanto el SEIR-HL como una calculadora del R0fueron implementadosinformáticamente y puestos a disposición de la comunidad.


Abstract Although multiple attempts have been made to mathematically model the currentepidemic of SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19), fewmodels have been conceived as accessible interactive tools for users from various backgrounds.The goal of this study was to develop a model that took into account the heterogeneity incontact rates within the population and to implement it in an accessible application allowingto estimate the impact of possible interventions based on available information. An extendedversion of the Susceptible-Exposed-Infected-Resistant (SEIR) model, named SEIR-HL, was deve-loped, assuming a population divided into two subpopulations, with different contact rates.Additionally, a formula for the calculation of the basic reproduction number (R0) for a popula-tion divided into n subpopulations was proposed, where the contact rates for each subpopulationcan be distinguished according to contact type or context. The predictions made by SEIR-HLwere compared to those of SEIR, showing that the heterogeneity in contact rates can drama-tically affect the dynamics of simulations, even when run from the same initial conditions andwith the same parameters. SEIR-HL was used to predict the effect on the epidemic evolution ofthe displacement of individuals from high-contact positions to low-contact positions. Lastly, byway of example, SEIR-HL was applied to the analysis of the SARS-CoV-2 epidemic in Argentinaand an example of the application of the R0formula was also developed. Both the SEIR-HLmodel and an R0calculator were computerized and made available to the community.

5.
Rev Argent Microbiol ; 54(2): 81-94, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-34509309

RESUMO

Although multiple attempts have been made to mathematically model the current epidemic of SARS-CoV-2, the causative agent of coronavirus disease 2019 (COVID-19), few models have been conceived as accessible interactive tools for users from various backgrounds. The goal of this study was to develop a model that took into account the heterogeneity in contact rates within the population and to implement it in an accessible application allowing to estimate the impact of possible interventions based on available information. An extended version of the Susceptible-Exposed-Infected-Resistant (SEIR) model, named SEIR-HL, was developed, assuming a population divided into two subpopulations, with different contact rates. Additionally, a formula for the calculation of the basic reproduction number (R0) for a population divided into n subpopulations was proposed, where the contact rates for each subpopulation can be distinguished according to contact type or context. The predictions made by SEIR-HL were compared to those of SEIR, showing that the heterogeneity in contact rates can dramatically affect the dynamics of simulations, even when run from the same initial conditions and with the same parameters. SEIR-HL was used to predict the effect on the epidemic evolution of the displacement of individuals from high-contact positions to low-contact positions. Lastly, by way of example, SEIR-HL was applied to the analysis of the SARS-CoV-2 epidemic in Argentina and an example of the application of the R0 formula was also developed. Both the SEIR-HL model and an R0 calculator were computerized and made available to the community.


Assuntos
COVID-19 , Pandemias , Número Básico de Reprodução , COVID-19/epidemiologia , Suscetibilidade a Doenças/epidemiologia , Humanos , Pandemias/prevenção & controle , SARS-CoV-2
6.
Artif Organs ; 46(5): 867-877, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34780090

RESUMO

BACKGROUND: Age over 70 years seems to confer poor prognosis for patients under mechanical circulatory support (MCS). Advanced age is usually a relative contraindication. Our objective was to assess the impact of age on survival of patients with short-term MCS. METHODS: Retrospective analysis of ≥70-year-old patients supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or Impella CP® due to cardiogenic shock and other situations of hemodynamic instability in a referral hospital (elderly group), compared with younger patients (<70 years). We analyze factors associated with survival in elderly group. RESULTS: Out of 164 short-term MCS implants from 2013 to October 2020, 45 (27.4%) correspond to ≥70-year-old patients (73.3% VA-ECMO; 26.7% Impella CP®), 80% as bridge to recovery and 15.6% for high-risk percutaneous coronary intervention (PCI). We found no significant differences in complications developed between both groups. Survivals at discharge (40% vs. 43.7%, p = 0.403) and at follow-up (median 13.6 [30] months) were similar in elderly and young patients (35.6% vs. 37.8%, log-rank p = 0.061). Predictive factors of mortality in elderly patients were peripheral artery disease (p = 0.037), higher lactate (p = 0.003) and creatinine (p = 0.035) at implant, longer cardiac arrest (p = 0.003), and worse post-implantation left ventricular ejection fraction (p = 0.003). Patients with indication of MCS for high-risk PCI had higher survival compared to other indications (p = 0.013). CONCLUSION: Short-term MCS with VA-ECMO or Impella CP® in elderly patients may be a reasonable option in hemodynamic compromise situations as bridge to recovery or elective high-risk PCI, without a significant increase in complications or mortality. Age should not be an absolute contraindication, but careful selection of candidate patients is necessary.


Assuntos
Coração Auxiliar , Intervenção Coronária Percutânea , Idoso , Coração Auxiliar/efeitos adversos , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Estudos Retrospectivos , Choque Cardiogênico/etiologia , Choque Cardiogênico/cirurgia , Volume Sistólico , Resultado do Tratamento , Função Ventricular Esquerda
7.
Nutrients ; 13(5)2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-34068354

RESUMO

Lockdown during the COVID-19 pandemic imposed changes in children's daily routine that could lead to changes in behavior patterns. Using a survey targeted at children under 17 years of age, we described dietary (adherence to Mediterranean diet, AMD) and sleeping habits (disorders of initiating and maintaining sleep) after the implementation of lockdown, and examined the probability of the inadequate frequency of physical activity (PA) and use of TV and electronic devices (TV-ED) before and after lockdown through generalized estimating equation models, accounting for age and gender differences. From 3464 children included, 53.2% showed optimal AMD; 79.2% referred to delayed bedtime; and 16.3% were suspected of sleeping disorders after the implementation of lockdown. Delay in bedtime was more frequent among children older than 6 years, and inadequate sleeping hours among those younger than 11 years. There were no gender differences in AMD or sleeping habits. The odds of inadequate frequency of PA and TV-ED use were greater after lockdown, with a greater risk for TV-ED use. Boys were at greater risk of inadequate PA frequency and TV-ED use. Odds ratio of inadequate PA was greater at older ages. Lockdown could influence changes in children's habits that could lead to risk factors for non-communicable diseases during adulthood if such behaviors are sustained over time.


Assuntos
COVID-19/epidemiologia , Saúde da Criança , Hábitos , Doenças não Transmissíveis/epidemiologia , Pandemias , Obesidade Infantil/epidemiologia , SARS-CoV-2 , Adolescente , Criança , Pré-Escolar , Exercício Físico , Feminino , Humanos , Masculino , Espanha/epidemiologia
8.
Rev Esp Enferm Dig ; 113(12): 825-832, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34157846

RESUMO

INTRODUCTION: abnormal liver biochemistry (ALB) is correlated with increased clinical involvement or severity in COVID-19, but its prognostic implications have not been studied extensively. The aim of this study was to determine whether ALB is a risk factor for unfavorable clinical outcome and involvement. MATERIALS AND METHODS: a retrospective, single-center study in confirmed COVID-19 cases. Patients with pharmacological hepatotoxicity or liver diseases were excluded. ALB was defined as any elevation of total bilirubin, AST, ALT, alkaline phosphatase, and/or GGT above the upper limit of normal. First, an assessment was made of the correlation between ALB and need for hospitalization. This was followed by an assessment of the correlation of ALB in hospitalized patients with demographic variables, comorbidities, and treatment for COVID-19, and with clinical involvement and outcome. The statistical analysis was performed using an age-adjusted multiple logistic regression with a p-value < 0.05. RESULTS: of 1,277 confirmed cases, 346 required hospitalization and 302 were included. The prevalence of ALB was higher in hospitalized patients compared to non-hospitalized patients (60.9 % vs. 10.3 %, p ˂ 0.001). Among hospitalized patients, there was no correlation between ALB and demographic variables, comorbidities, or treatment for COVID-19, except for low molecular weight heparin. There was a significant correlation between ALB and moderate/severe COVID-19 involvement and between unfavorable clinical outcomes and elevated total bilirubin. The period of greatest clinical worsening and deterioration of liver biochemistry parameters occurred during the first seven days. There was a significant correlation of ALB with longer hospital stay and admission to the intensive care unit, but this did not imply increased mortality. CONCLUSIONS: ALB correlates with greater clinical involvement and worse clinical outcomes in hospitalized patients with COVID-19.


Assuntos
COVID-19 , Hospitalização , Humanos , Fígado , Prognóstico , Estudos Retrospectivos , SARS-CoV-2
9.
Eur J Clin Invest ; 51(11): e13591, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34002363

RESUMO

BACKGROUND AND OBJECTIVES: Elevated troponin T (cTnT) values are associated with comorbidities and early mortality, in both cardiovascular and noncardiovascular diseases. The objective of this study is to evaluate the prognostic accuracy of the sole utilization of prehospital point-of-care cardiac troponin T to identify the risk of early in-hospital deterioration, including mortality within 28 days. METHODS: We conducted a prospective, multicentric, controlled, ambulance-based, observational study in adults with acute diseases transferred with high priority by ambulance to emergency departments, between 1 January and 30 September 2020. Patients with hospital diagnosis of acute coronary syndrome were excluded. The discriminative power of the predictive cTnT was assessed through a discrimination model trained using a derivation cohort and evaluated by the area under the curve of the receiver operating characteristic on a validation cohort. RESULTS: A total of 848 patients were included in our study. The median age was 68 years (25th-75th percentiles: 50-81 years), and 385 (45.4%) were women. The mortality rate within 28 days was 12.4% (156 cases). The predictive ability of cTnT to predict mortality presented an area under the curve of 0.903 (95% CI: 0.85-0.954; P < .001). Risk stratification was performed, resulting in three categories with the following optimal cTnT cut-off points: high risk greater than or equal to 100, intermediate risk 40-100 and low risk less than 40 ng/L. In the high-risk group, the mortality rate was 61.7%, and on the contrary, the low-risk group presented a mortality of 2.3%. CONCLUSIONS: The implementation of a routine determination of cTnT on the ambulance in patients transferred with high priority to the emergency department can help to stratify the risk of these patients and to detect unknown early clinical deterioration.


Assuntos
Deterioração Clínica , Serviços Médicos de Emergência , Mortalidade Hospitalar , Troponina T/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ambulâncias , Área Sob a Curva , Doenças Cardiovasculares/sangue , Doenças do Sistema Digestório/sangue , Feminino , Humanos , Infecções/sangue , Masculino , Pessoa de Meia-Idade , Mortalidade , Doenças do Sistema Nervoso/sangue , Testes Imediatos , Intoxicação/sangue , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Curva ROC , Doenças Respiratórias/sangue , Ferimentos e Lesões/sangue , Adulto Jovem
10.
Sensors (Basel) ; 21(4)2021 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-33671174

RESUMO

Communication systems that work in jeopardized environments such as space are affected by soft errors that can cause malfunctions in the behavior of the circuits such as, for example, single event upsets (SEUs) or multiple bit upsets (MBUs). In order to avoid this erroneous functioning, this kind of systems are usually protected using redundant logic such as triple modular redundancy (TMR) or error correction codes (ECCs). After the implementation of the protected modules, the communication modules must be tested to assess the achieved reliability. These tests could be driven into accelerator facilities through ionization processes or they can be performed using fault injection tools based on software simulation such as the SEUs simulation tool (SST), or based on field-programmable gate array (FPGA) emulation like the one described in this work. In this paper, a tutorial for the setup of a fault injection emulation platform based on the Xilinx soft error mitigation (SEM) intellectual property (IP) controller is depicted step by step, showing a complete cycle. To illustrate this procedure, an online repository with a complete project and a step-by-step guide is provided, using as device under test a classical communication component such as a finite impulse response (FIR) filter. Finally, the integration of the automatic configuration memory error-injection (ACME) tool to speed up the fault injection process is explained in detail at the end of the paper.

11.
Artif Organs ; 45(7): 717-725, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33377185

RESUMO

Weaning failure and mortality rates in veno-arterial extracorporeal membrane oxygenation (VA-ECMO) supported patients are significant. Small studies suggest the possible usefulness of levosimendan in this environment, especially in postcardiotomy shock. We performed a retrospective analysis of VA-ECMO implants in a referral hospital comparing weaning failure and survival of patients treated with levosimendan with a control group. From 2013 to May 2020, 123 VA-ECMO for several indications were implanted. Levosimendan was administered in 23 patients (18.7%) with good tolerance. Levosimendan was used more frequently in cardiogenic shock due to acute coronary syndrome indication, and in patients with lower left ventricular ejection fraction (LVEF) at the implant. No significant differences were found in success of ECMO weaning (60.9% levosimendan group vs. 44% non-levosimendan group, P = .169) despite worse LVEF in levosimendan group. Survival at follow-up (20.6 [58] months) was higher in the group that received levosimendan, although without finding statistically significant differences (47.8% vs. 32.0%, log rank P = .124). Levosimendan can be safely administered during VA-ECMO support. Patients receiving levosimendan were weaned similarly from circulatory support despite worse LVEF. Its use did not influence in short- and medium-term survival. Randomized studies are needed to evaluate the levosimendan impact in this indication.


Assuntos
Cardiotônicos/uso terapêutico , Oxigenação por Membrana Extracorpórea , Simendana/uso terapêutico , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Choque Cardiogênico/mortalidade , Choque Cardiogênico/terapia
13.
Front Psychol ; 10: 2284, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31649596

RESUMO

The implementation of the European higher education area (EHEA) is a true paradigm change in university education in which the student, with particular consideration given to autonomous work, takes the place of the teacher as the central element of the teaching-learning process. In this autonomous work, the strategies the students regularly use become particularly important, given the supposition that doing that work will lead to academic success. The objective of this study is to analyze the variables that influence students' expectations of success, measured through their intention to persist on the course they are doing. A questionnaire designed ad hoc was given to a sample of 1037 university students. It included aspects related to reasons for choosing the course, institutional integration, use of self-regulation strategies, and intention to drop out. Data analysis allowed the identification of satisfaction with the course chosen and appropriate study skills acquired in secondary education as predictors of expectations of academic persistance, with some differences in terms of gender. Other strategies such as class attendance or going deeply into course content did not figure. These results are at odds with the principles underlying the EHEA and show that they have not yet been interiorized by the students, who continue to perceive their studies more traditionally.

14.
Int J Mol Sci ; 20(19)2019 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-31597315

RESUMO

Iodinated contrast media (CM) are the leading cause of acute renal failure of toxic origin. Between 21% and 50% of patients that receive them develop contrast-induced nephropathy (CIN). All prophylactic measures used so far have failed to provide effective prevention. Since oxidative stress is involved in the damage, a possible preventive strategy could be the administration of antioxidant substances, such as quercetin. This compound has shown renoprotective effects in experimental studies. The aim of this study was to evaluate whether quercetin may be helpful in preventing CIN in patients undergoing coronary catheterization. A clinical phase II study was conducted. Patients were distributed in two groups, namely, CM (patients who only received contrast media) and CM+Q (patients who were pretreated with quercetin orally for 3-5 days). Results showed less incidence of CIN in the CM+Q group, possibly due to glomerular protection, evidenced by a lower increase in serum creatinine and albuminuria; and a lower decrease in the glomerular filtration rate (GFR). Furthermore, in this group, the relative risk of developing CIN observed in patients that received a high dose of contrast media was inferior. In conclusion, this is the first study that demonstrates that quercetin is a promising safe candidate in preventing CIN.


Assuntos
Meios de Contraste/efeitos adversos , Nefropatias/etiologia , Nefropatias/prevenção & controle , Substâncias Protetoras/farmacologia , Quercetina/farmacologia , Idoso , Biomarcadores , Meios de Contraste/administração & dosagem , Meios de Contraste/classificação , Creatinina/metabolismo , Feminino , Taxa de Filtração Glomerular/efeitos dos fármacos , Humanos , Nefropatias/diagnóstico , Nefropatias/metabolismo , Masculino , Substâncias Protetoras/uso terapêutico , Quercetina/uso terapêutico
16.
J Am Heart Assoc ; 7(19): e009444, 2018 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-30371302

RESUMO

Background Ticagrelor use during acute coronary syndromes demonstrated a decrease in all-cause mortality in the PLATO (Platelet Inhibition and Patient Outcomes) trial. This effect has been attributed to a non-platelet-derived improvement in endothelial function. The aim of this study was to determine differences in the number of endothelial progenitor cells and/or circulating endothelial cells found in peripheral blood in patients treated with either ticagrelor or clopidogrel during non-ST-segment-elevation myocardial infarction. Methods and Results In this multicenter, randomized study ( NCT 02244710), patients were considered for inclusion after non-ST-segment-elevation myocardial infarction whenever they were P2Y12-inhibitor naïve. Ticagrelor and clopidogrel were allocated at a 1:1 ratio. Blood samples for determining endothelial progenitor cells and circulating endothelial cells were extracted before the antiplatelet loading dose, 48 hours after presentation of index symptoms, and 1 month after the event. A multichannel cytometer was used for optimal cell characterization. A total of 96 patients fulfilled the inclusion criteria. Circulating endothelial cell levels corrected by white blood cells were as follows at baseline, 48 hours, and 1 month: 44 (28-64), 50 (33-63), and 38 (23-62) cells/mL, respectively, for clopidogrel and 38 (29-60), 45 (32-85), and 35 (24-71) cells/mL, respectively, for ticagrelor ( P=0.6). Endothelial progenitor cell levels were 29 (15-47), 27 (15-33), and 18 (10-25) cells/mL, respectively, for clopidogrel and 20 (11-33), 22 (12-32), and 18 (11-29) cells/mL, respectively, for ticagrelor ( P=0.9). No differences in intraindividual changes were found. Conclusions Patients treated with ticagrelor during non-ST-segment-elevation myocardial infarction, in comparison to clopidogrel, showed similar levels of endothelial progenitor cells and circulating endothelial cells. These data suggest that the endothelial protective effect mediated by ticagrelor is not related to bone marrow physiology modulation. Clinical Trial Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT 02244710.


Assuntos
Clopidogrel/administração & dosagem , Células Progenitoras Endoteliais/metabolismo , Endotélio Vascular/fisiopatologia , Infarto do Miocárdio sem Supradesnível do Segmento ST/tratamento farmacológico , Ticagrelor/administração & dosagem , Vasodilatação/fisiologia , Idoso , Eletrocardiografia , Células Progenitoras Endoteliais/citologia , Feminino , Seguimentos , Humanos , Masculino , Infarto do Miocárdio sem Supradesnível do Segmento ST/metabolismo , Infarto do Miocárdio sem Supradesnível do Segmento ST/fisiopatologia , Inibidores da Agregação Plaquetária/administração & dosagem , Prognóstico , Método Simples-Cego
17.
Oncotarget ; 8(67): 110994-111011, 2017 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-29340032

RESUMO

Previous observations indicated that C3G (RAPGEF1) promotes α-granule release, evidenced by the increase in P-selectin exposure on the platelet surface following its activation. The goal of the present study is to further characterize the potential function of C3G as a modulator of the platelet releasate and its implication in the regulation of angiogenesis. Proteomic analysis revealed a decreased secretion of anti-angiogenic factors from activated transgenic C3G and C3G∆Cat platelets. Accordingly, the secretome from both transgenic platelets had an overall pro-angiogenic effect as evidenced by an in vitro capillary-tube formation assay with HUVECs (human umbilical vein endothelial cells) and by two in vivo models of heterotopic tumor growth. In addition, transgenic C3G expression in platelets greatly increased mouse melanoma cells metastasis. Moreover, immunofluorescence microscopy showed that the pro-angiogenic factors VEGF and bFGF were partially retained into α-granules in thrombin- and ADP-activated mouse platelets from both, C3G and C3GΔCat transgenic mice. The observed interaction between C3G and Vesicle-associated membrane protein (Vamp)-7 could explain these results. Concomitantly, increased platelet spreading in both transgenic platelets upon thrombin activation supports this novel function of C3G in α-granule exocytosis. Collectively, our data point out to the co-existence of Rap1GEF-dependent and independent mechanisms mediating C3G effects on platelet secretion, which regulates pathological angiogenesis in tumors and other contexts. The results herein support an important role for platelet C3G in angiogenesis and metastasis.

18.
Medicine (Baltimore) ; 96(47): e8669, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29381944

RESUMO

BACKGROUND: Acquired hemophilia A (AHA) is a rare bleeding disease caused by autoantibodies against factor VIII. Spontaneous bleeding symptoms usually affect the skin and muscle, while pericardial effusion is an extremely rare manifestation. In the elderly, anticoagulant treatment is frequent and bleeding symptoms are usually associated with this. CLINICAL FINDINGS: We report a hemorrhagic pericardial effusion as the AHA debut in a patient with untreated chronic lymphocytic leukemia and anticoagulated with apixaban for atrial fibrillation and chronic arterial ischemia. The patient was treated with recombinant activated factor VII to control the active bleeding and corticosteroids and cyclophosphamide to eradicate the inhibitor. In addition, a briefly review of hematological malignancies associated to acquired hemophilia was performed. PARTICULARITIES:: a) anticoagulant treatment may confuse the suspicion of AHA and its diagnosis; b) hemorrhagic pericardial effusion is an extremely rare presentation; c) bypassing agents raise the risk of thromboembolism; d) hematological malignancies rarely cause AHA (<20% of cases). CONCLUSION: A multidisciplinary team is needed to diagnose and manage AHA effectively. The use of anticoagulants may lead to the misdiagnosis of clinical symptoms. Chronic lymphocytic leukemia is one of the main causes of hematological malignancies associated. The specific treatment of CLL is still recommended in the event of active disease.


Assuntos
Fator VIII , Fator VIIa/administração & dosagem , Hemofilia A , Leucemia Linfocítica Crônica de Células B , Derrame Pericárdico , Pericardiectomia/métodos , Idoso , Anticorpos/sangue , Testes de Coagulação Sanguínea/métodos , Coagulantes/administração & dosagem , Ciclofosfamida/administração & dosagem , Ecocardiografia/métodos , Fator VIII/análise , Fator VIII/imunologia , Hemofilia A/sangue , Hemofilia A/complicações , Hemofilia A/etiologia , Humanos , Imunossupressores/administração & dosagem , Leucemia Linfocítica Crônica de Células B/complicações , Leucemia Linfocítica Crônica de Células B/diagnóstico , Masculino , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/etiologia , Derrame Pericárdico/fisiopatologia , Prednisona/administração & dosagem , Radiografia Torácica/métodos , Proteínas Recombinantes/administração & dosagem , Resultado do Tratamento
19.
Horm Res Paediatr ; 86(3): 154-160, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27529349

RESUMO

BACKGROUND: The influence of gonadotropin-releasing hormone analogue (GnRHa) treatment on body mass index (BMI) evolution in girls with idiopathic central precocious puberty (CPP) is unclear. Hence, we aimed to evaluate the effect of GnRHa treatment on BMI-standard deviation score (SDS) from diagnosis of idiopathic CPP until adult height. METHODS: An observational study of girls diagnosed with CPP in Spain was carried out between January 2008 and December 2014. A computer program was designed to process clinical and biological data from patients treated in 55 departments of pediatric endocrinology throughout the country. The inclusion criteria were (1) girls diagnosed with CPP before 8 years of age; (2) born after 1992; (3) with a difference between bone and chronological age of at least 1 year, and (4) with a luteinizing hormone peak >7 U/l during luteinizing hormone-releasing hormone testing. The influence of GnRHa treatment on BMI-SDS evolution was analyzed. RESULTS: Data from 333 girls (22.2% adopted) were evaluated. We report follow-up data at 6, 12, 24, 36, 48 and 60 months and adult height from 269, 232, 198, 153, 105, 56 and 49 girls, respectively. During treatment, there was an increase in BMI-SDS of 0.43 ± 1.17 (95% CI: 0.20-0.64). At adult height (n = 49), BMI-SDS was 1.51 ± 1.38, which was 0.60 ± 1.09 higher than at diagnosis (95% CI: 0.43-0.75). CONCLUSIONS: During treatment with GnRHa, girls experience a significant increase in BMI-SDS that persists after therapy is stopped and adult height has been reached. © 2016 S. Karger AG, Basel.


Assuntos
Índice de Massa Corporal , Hormônio Liberador de Gonadotropina/análogos & derivados , Hormônio Liberador de Gonadotropina/uso terapêutico , Terapia de Reposição Hormonal , Puberdade Precoce , Sistema de Registros , Adolescente , Adulto , Criança , Feminino , Humanos , Puberdade Precoce/tratamento farmacológico , Puberdade Precoce/patologia , Puberdade Precoce/fisiopatologia , Espanha
20.
Org Biomol Chem ; 14(16): 3906-12, 2016 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-27035271

RESUMO

The combination of a 1,3-ketoenol system and two pyridine molecules attached as sulfonamide and carboxamide to a benzofuran skeleton allows the preparation of a novel chiral receptor for zwitterionic phenylalanine association. Interestingly, no crown-ether, urea or guanidinium are necessary to carry out the extraction of amino acids from the aqueous solution, which constitutes a breakthrough in comparison with other receptors for zwitterionic amino acid extraction.


Assuntos
Fenilalanina/química , Espectroscopia de Ressonância Magnética , Modelos Moleculares
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