IgE-Mediated Sensitization to Blo t 21 and Blo t 5 Is Associated With Asthma in the Tropics: A Case-Control Study.

BACKGROUND AND OBJECTIVE: Sensitization to Blomia tropicalis is associated with asthma in various tropical and subtropical countries; however, information about the specific molecular components associated with this disease is scarce. Using molecular diagnosis, we sought to identify B tropicalis allergens associated with asthma in Colombia. METHODS: Specific IgE (sIgE) to 8 B tropicalis recombinant allergens (Blo t 2, 5, 7, 8, 10, 12, 13, and 21) was determined using an in-house ELISA system in asthma patients (n=272) and controls (n=298) recruited in a national prevalence study performed in several Colombian cities (Barranquilla, Bogotá, Medellín, Cali, and San Andrés). The study sample included children and adults (mean [SD] age, 28 [17] years). Cross-reactivity between Blo t 5 and Blo t 21 was evaluated using ELISA-inhibition. RESULTS: Specific IgE (sIgE) to 8 B tropicalis recombinant allergens (Blo t 2, 5, 7, 8, 10, 12, 13, and 21) was determined using an in-house ELISA system in asthma patients (n=272) and controls (n=298) recruited in a national prevalence study performed in several Colombian cities (Barranquilla, Bogotá, Medellín, Cali, and San Andrés). The study sample included children and adults (mean [SD] age, 28 [17] years). Cross-reactivity between Blo t 5 and Blo t 21 was evaluated using ELISA-inhibition. CONCLUSION: Although Blo t 5 and Blo t 21 are considered common sensitizers, this is the first report of their association with asthma. Both components should be included in molecular panels for diagnosis of allergy in the tropics.

IgE sensitization to Blo t 21 and Blo t 5 is associated with asthma in the tropics: a case-control study.

BACKGROUND AND OBJECTIVES: Blomia tropicalis sensitization is associated with asthma in different tropical and sub-tropical countries; however, information about the specific molecular components associated with this disease is scarce. Using molecular diagnosis, we sought to identify B. tropicalis allergens associated with asthma in Colombia. METHODS: Specific IgE (sIgE) to eight B. tropicalis recombinant allergens (Blo t 2/5/7/8/10/12/13 and 21) was determined using an in-house developed ELISA system in asthmatic patients (n=272) and control subjects (n=298) recruited in a national prevalencestudy performed in Colombian cities (Barranquilla, Bogotá, Medellín, Cali and San Andrés). Sample study included children and adults (mean age: 28±SD 17 years old). Cross-reactivity between Blot 5 and Blo t 21 was evaluated by ELISA-inhibition. RESULTS: Sensitization to Blo t 21 (aOR: 1.9; 95% CI: 1.2 - 2.9) and Blo t 5 (aOR: 1.6; 95%CI: 1.1 - 2.5), but not Blo t 2, was associated with asthma. sIgE levels to Blo t 21 and to Blo t 5 were significantly higher in the disease group. Cross-reactivity between Blo t 21 and Blo t 5 is on average moderate; however, individual analysis indicates that may be high (>50%) in some cases. CONCLUSIONS: Although Blo t 5 and Blo t 21 has been described as common sensitizers, this is the first report of their association with asthma. Both components should be included in molecular panels for allergy diagnosis in the tropics.

Evaluation of myopic cornea lenticules. A histochemical and clinical correlation.

In this work, we have analyzed the main clinical and corneal histological parameters that may be associated to the spherical equivalent (SE), age and gender of individuals with myopic refractive errors. For this purpose, 108 cornea stroma lenticules were obtained from patients subjected to ReLEx-SMILE myopia correction. Histological analyses were carried out and histochemistry and immunohistochemistry were used to quantify key histological components of the cornea stroma, including mature collagen fibers, reticular and elastic fibers, glycoproteins, proteoglycans, type-V collagen and several crystallins. Clinical and histological data were analyzed to determine their association with SE, age and gender. Results showed a significant correlation between the age range of the patients and the expression of crystallins CRY-α-A, CRY-λ1 and type-V collagen and between CRY-λ1 and corneal thickness, spherical diopters (D) and SE, although correlation between CRY-λ1 and SE was non-significant when age was controlled. Comparison of cases with low myopia and high/moderate myopia found statistical differences for D and lenticule thickness and diameter. The binary logistic regression analysis allowed us to construct a model using two clinical parameters (D and lenticule thickness). Parameters showing significant correlation with the age were the corneal radius, keratometry reading (K), OZ, CRY-α-A and type-V collagen, whereas SE, lenticule thickness, OZ, CRY-λ1 and type-V collagen showed statistically significant differences between the youngest and the oldest patients. A binary logistic regression analysis model was generated including 3 variables (D, cornea radius and OZ). No gender differences were found. The specific clinical and histological modifications found to be associated to the SE and age could be useful for a better understanding of the mechanisms involved in the genesis or progression of myopia and could establish the basement for future therapeutic options.

Prognostic factors and predictive model for in-hospital mortality following hip fractures in the elderly.

PURPOSE: The incidence of hip fractures is increasing within the aging population. Our objective was to identify and quantify the risk factors and develop a predictive model for the in-hospital mortality among hip fracture patients older than 65 years. METHODS: This is a prospective study conducted on 331 hip fracture patients older than 65 years admitted to our hospital from 2011 to 2014. Patients' demographics, prehospitalization residential status, prefracture comorbidity data, anti-aggregant and anticoagulant medication, preoperative hemoglobin value, type of fractures, type of treatments, time to surgery, and complications were recorded. RESULTS: The average age was 83 years, 73% female, and 57% of them sustained a femoral neck fracture. In 62.8% of patients, the number of pre-fracture baseline comorbidities was ≥2. The in-hospital mortality rate was 11.4%. In multivariate analysis, age over 90 years, congestive heart failure, asthma, rheumatologic disease, lung cancer, and not taking antiaggregant medication were independently associated with in-hospital mortality. A formula and risk stratification scoring for predicting the risk for in-hospital mortality was developed. Risk-adjustment model based on these variables had acceptable accuracy for predicting in-hospital mortality (c-statistic 0.77). CONCLUSION: Advanced age, and five prefracture comorbidities have a strong association with in-hospital mortality in a hip fracture patient older than 65 years old. Our predictive model was specifically designed for the old hip fracture population. It has an accuracy similar to other risk models. The specificity, positive predictive value, and negative predictive value are high. In addition, it could discriminate a high risk patient from a low risk patient for in-hospital mortality.

Synergism between phorbol-12-myristate-13-acetate and vitamin D3 in the differentiation of U937 cells to monocytes and macrophages.

Phorbol-12-myristate-13-acetate (PMA) and 1,25-dihydroxyvitamin D3 (VD3) are stimuli commonly used to induce macrophage differentiation in monocytic cell lines, but the extent of differentiation in comparison to primary tissue macrophages is unclear. Here, we examine the morphological/phenotypic markers associated with differentiation of U937 cells into monocytes/macrophages, in response to PMA or VD3 treatment. PMA stimulus but not with VD3, induced changes in cell morphology indicative of differentiation, but did not show differentiation comparable to monocyte-derive macrophage (MDM). The cells treated with PMA+VD3 for 2 days (d) acquired morphological/phenotypic features similar to those acquired by monocytes. In contrast, U937 cells treated for 2d with PMA and VD3 followed by 6d of resting in culture without PMA but in the presence of VD3 acquired morphological and phenotypic markers similar to those of MDM; i.e. reduced nucleus/cytoplasmic ratio, high auto-fluorescence and cytoplasmic complexity. Furthermore, low expression of CD14/TLR2 and high expression of CD68/CD86 were observed. In conclusion, our results indicate a synergistic effect between PMA and VD3 in U937 cells differentiation into both monocytes or macrophages and we propose a modified PMA differentiation protocol to enhance monocyte/macrophage differentiation of U937 cells.

Candida tropicalis antifungal cross-resistance is related to different azole target (Erg11p) modifications.

Candida tropicalis ranks between third and fourth among Candida species most commonly isolated from clinical specimens. Invasive candidiasis and candidemia are treated with amphotericin B or echinocandins as first-line therapy, with extended-spectrum triazoles as acceptable alternatives. Candida tropicalis is usually susceptible to all antifungal agents, although several azole drug-resistant clinical isolates are being reported. However, C. tropicalis resistant to amphotericin B is uncommon, and only a few strains have reliably demonstrated a high level of resistance to this agent. The resistance mechanisms operating in C. tropicalis strains isolated from clinical samples showing resistance to azole drugs alone or with amphotericin B cross-resistance were elucidated. Antifungal drug resistance was related to mutations of the azole target (Erg11p) with or without alterations of the ergosterol biosynthesis pathway. The antifungal drug resistance shown in vitro correlated very well with the results obtained in vivo using the model host Galleria mellonella. Using this panel of strains, the G. mellonella model system was validated as a simple, nonmammalian minihost model that can be used to study in vitro-in vivo correlation of antifungals in C. tropicalis. The development in C. tropicalis of antifungal drug resistance with different mechanisms during antifungal treatment has potential clinical impact and deserves specific prospective studies.

Studying light propagation in self-assembled hybrid photonic-plasmonic crystals by fourier microscopy.

Hybrid metallodielectric systems where dielectric components are combined with metals supporting surface plasmons are able to spatially redistribute the electromagnetic field intensity within its volume through hybrid photonic-plasmonic modes. While most of the work done recently in this kind of systems has been focused on the way such redistribution takes place and how light couples to or is emitted from such samples, the way light propagation takes place has not been studied in depth. Here we consider light propagation in hybrid systems fabricated by self-assembly methods measuring their equifrequency surfaces both in reflection and emission configurations. Comparing spectroscopic measurements with equifrequency surfaces provides a deeper insight into the way light propagates in these structures, showing the possibilities they may present for several applications.

Developing a disease prevention strategy in the Caribbean: the importance of assessing animal health-related risks at regional level.

In 2009 CaribVET conducted a survey among Caribbean national Veterinary Services to assess perceptions of risk assessment and to identify the principal exotic diseases of concern in the region and their means of introduction. The results showed that the introduction of live animals was considered the most likely route of introduction of exotic animal pathogens, followed by the uncontrolled introduction of animal products by boat passengers. The results were used to define a regional strategy for assessing animal health risks that highlights the importance of within-region exchanges.

Comparative validity of the OIDP and OHIP-14 in describing the impact of oral health on quality of life in a cross-sectional study performed in Spanish adults.

OBJECTIVES: We aimed to compare the utility and validity of two popular socio-dental indicators (OIDP and OHIP-14) for describing the impact of oral conditions on quality of life applied simultaneously. STUDY DESIGN: We recruited a consecutive sample of 270 healthy Spanish workers visiting the Employment Risk Prevention Centre for a routine medical check-up. OHIP-14 was self-completed before the oral examination and the face to face interview of the OIDP was performed. Both instruments were compared by evaluating its reliability and its validity. RESULTS AND CONCLUSIONS: The standardised Cronbach alphas for OHIP-14 and OIDP were 0.89 and 0.74 respectively. OIDP showed lower face validity but higher content validity than OHIP-14. Both indicators showed high construct and criterion validity, since individuals perceiving need for dental treatment or having any complaint about their mouth obtained significantly higher total OIDP and OHIP scores than their counterparts. The prevalence of impacts was much higher using the OHIP (80.7%) than the OIDP (27.8%).

Two-dimensional surface emitting photonic crystal laser with hybrid triangular-graphite structure.

We present laser emission of a compact surface-emitting micro laser, optical pumped and operating at 1.5 microm at room temperature. A two-dimensional photonic crystal lattice conformed in a hybrid triangular-graphite configuration is designed for vertical emission. The structures have been fabricated in an InP slab, including four InAsP quantum wells as active layer, on the top of a Si substrate SiO(2) wafer bonded. Laser emission with thresholds around 70 microW and quality factors (Qs) up to 12000 have been measured. The Bloch mode selected for the emission keeps a high Q (>or= 2 x 10(5)) around the Gamma point for a wide range of in-plane values k(||)

Impact of prosthodontic status on oral wellbeing: a cross-sectional cohort study.

To assess the impact of the prosthodontic status on oral health-related quality of life and satisfaction. We performed a cohort study at the University Clinic in Salamanca in which a group requesting prosthetic treatment (P0; n = 31) was compared with a group treated with conventional prostheses (P1; n = 29) and a control group (C; n = 18) not requesting or treated with prostheses. A clinical examination for the presence of caries, periodontal disease and edentulism was carried out. An assessment was made on the impact on the quality of life employing the oral impacts on daily performance-Spanish version and the oral health impact profile 14-Spanish version, and wellbeing was assessed by the self-rated satisfaction on a 0-10 scale. The P0 cohort was significantly less satisfied and suffered a greater level of impact as regard their quality of life than the other cohorts. The main benefit of conventional prosthetic treatment was perceived by most of the treated patients (P1) in dimensions related to chewing, the aesthetic function and the assessment of the general state of the mouth. However, an unexpected proportion of patients underwent a worsening of their oral wellbeing after prosthetic treatment, mainly in the chewing ability (23%) and pain discomfort (19%) dimensions. Satisfaction and quality of life were higher in the treated group (P1) and controls (C) than in those requesting prosthetic treatment (P0).

Multi-environment evaluation of oil accumulation pattern parameters in olive.

The pattern of olive oil accumulation is of paramount importance in olive because its influence in determining final oil yield and optimal harvesting date. In this work, we have evaluated the genetic and environment influence on the olive oil accumulation pattern. For that purpose, a set of cultivars and breeding selections planted in a multi-environment trial was evaluated in two consecutive harvest seasons. Significant effect of the environment, genotype and their interaction were observed for the maximum oil content reached and the rate of oil accumulation. On the contrary, the date of maximum oil content seems to depend only on the environment. The two breeding selections evaluated showed, in general, high stability and adaptability in oil accumulation parameters. Among the potential environmental factors that could affect oil accumulation, PLS analysis suggests that temperature could play a determinant environmental effect in the oil accumulation parameters tested in this study. These results underline the relevance of using multi-environment trials for adequate characterization of genotypes showing either good behaviour in variable environments or only under specific environmental conditions.

Effect of implementation of a Bragg reflector in the photonic band structure of the Suzuki-phase photonic crystal lattice.

We investigate the change of the photonic band structure of the Suzuki-phase photonic crystal lattice when the horizontal mirror symmetry is broken by an underlying Bragg reflector. The structure consists of an InP photonic crystal slab including four InAsP quantum wells, a SiO(2) bonding layer, and a bottom high index contrast Si/SiO(2) Bragg mirror deposited on a Si wafer. Angle- and polarization-resolved photoluminescence spectroscopy has been used for measuring the photonic band structure and for investigating the coupling to a polarized plane wave in the far field. A drastic change in the k-space photonic dispersion between the structure with and without Bragg reflector is measured. An important enhancement on the photoluminescence emission up to seven times has been obtained for a nearly flat photonic band, which is characteristic of the Suzuki-phase lattice.

[Primary hepatic lymphoma - favorable outcome with chemotherapy plus rituximab]. / Linfoma hepático primario. Evolución favorable con quimioterapia combinada con rituximab.

This article describes the case of a patient with a non-Hodgkin primary hepatic lymphoma who was successfully treated with chemotherapy combined with rituximab. Using the Medical Subject Headings the published reports of this rare entity were reviewed.

[Technical aspects of isolated organ perfusion devices]. / Aspectos técnicos de los dispositivos de perfusión de órgano aislado.

An aspect of capital importance in the transplant field is the maintainance and preservation of organs during the ischemic phase. Organ susceptibility and injuries secondary to ischemia, organ procurement and transportation are still nowadays one of the main causes for organ failure. Effective artificial organ perfusion has remained a main goal for researchers in this field for more than 100 years. In the second half of the XXth century these techniques have been applied to experimental and clinical organ preservation, with the aim of extending the period of an effective storage (which guarantees an early and good function after the transplant). Primary goal of any organ preservation is to maintain integrity in every cell system in order to minimize those injuries which produces graft dysfunction.

[Hystologic and hemodynamic aspects of warm ischemic graft in relation to the preservation method]. / Caracterización histoló6gica y hemodinámica del injerto con isquemia caliente según el método de preservación.

OBJECTIVE: The non-heart-beating donor has been proposed as a solution to donor shortage for renal transplantation. Because the nature of such donors, the kidneys so derived have been damaged by primary warm ischemia (WI), and so potentially they may never function. Minimizing graft injury is especially important in case of transplantation form marginal donors because of a high rate of delayed graft function or primary nonfunction. The aim of this experimental study is to assess the structural and hemodynamic consequences of hypothermic perfusion (HP) versus cold storage (CS), in renal allograft after a period of WI. MATERIAL AND METHODS: We used 20 mini-pigs. WI was achieved by vascular pedicle occlusion during 45 min. We divided organs in 4 groups: A (n=5), kidneys with WI and then transplanted; group B (n=5), grafts with WI and implanted after HP with Belzer solution in our computerized perfusion system. Group C-control, (n=5) transplanted without WI and D (n=5) with WI and 60 min of CS in UW-Viaspan solution. All the procedure was recorded by a computerized data system. Renal vascular resistance (RVR) and renal vascular flow (RVF) were automatically calculated by means of mathematical formulas after renal transplantation. Subsequently histological study was completed in all cases. RESULTS: We observed two patterns after transplantation: (1). Initial increase of RVR with posterior decrease and increase of vascular flow: in organs with WI and HP prior to transplantation (group B) // organs transplanted without WI (group C-control). Electronic and conventional microscopy showed integrity of endothelial and tubule structure. (2). Initial decrease with posterior increase of RVR. Organs with WI (group A) // organs with WI and CS (group D). Structural study showed endothelial and tubule disruption. CONCLUSION: In our experimental model machine perfusion preserves endothelial and tubule structure of kidneys with WI. After transplantation the hemodynamic pattern of grafts with WI and HP is similar to the control group (without WI and direct transplantation).

[Design of experimental models in surgical investigation]. / Diseño de modelos experimentales en investigación quirúrgica.

INTRODUCTION: Research in Medicine is essentially based on three knowledge resources: diseased people (natural and primary), cadaveric bodies (Pathology primary resource) and experimental animals, whom constitutes physiopathologic knowledge resource. Experimental advances reached in the last century have determined the change of the concept "experimental animal" to a wider term: "experimental model". OBJECTIVES: This paper tryes to clarify this concept. To attain this goal, we must define previous considerations in the meaning of the concept "experimental models" and its two key-elements: statistics and design of experiments.

[Pharmacological preconditioning with sildenafil of warm ischemic kidneys]. / Precondicionamiento farmacológico con sildenafilo del riñón con isquemia normotérmica.

OBJECTIVES: To evaluate the preconditioning effect of sildenafil administered preoperatively in kidneys subjected to a period of warm ischemia (WI), hypothermic perfusion (HP) or cold storage (CS) and finally, autotransplant (AT). MATERIAL AND METHOD: We studied 6 groups of autotransplanted kidneys: no-WI-inmediate AT (Group A); 45 min of WI + immediate AT (Group B); 45 min of WI + 60 min of HP + autotransplant (Group C); 45 min of WI + 60 min of CS + autotransplant (Group D); 100 mg of oral sildenafil preoperatively + 45 min of WI + autotransplant (Group E); 100 mg of oral sildenafil preoperatively + 45 min of WI+60 min of HP + autotransplant (Group F). Belzer solution was used for HP; UW-Viaspan for CS. Inmediately after the autotransplant (reperfusion period), we recorded in real time for 60 min the values of Renal vascular Flow (RVF) and Renal Vascular Resistance (RVR). Nitric Oxide levels in the cava and renal graft vein were recorded every 15 min during the 60 min of the reperfusion-study period. Conventional & Electronic microscopy were completed after the process. RESULTS: We obtained significant higher values of RVF and lower values of RVR in sildenafil groups (E and F) in comparison to the other groups (A-D) (Table 1). NO levels were also significantly higher in groups E and F (Fig. 1). Groups A, B, E and F showed integrity of tubule and endothelium in comparison to groups C and D in the microscopic study. CONCLUSIONS: We showed a beneficious effect of sildenafil in inmediate post-transplant reperfusion hemodynamic and biochemical parameters of kidneys subjected to a critical period of warm-ischemia.