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1.
Nature ; 593(7858): 233-237, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33981052

RESUMEN

Atmospheric acidity is increasingly determined by carbon dioxide and organic acids1-3. Among the latter, formic acid facilitates the nucleation of cloud droplets4 and contributes to the acidity of clouds and rainwater1,5. At present, chemistry-climate models greatly underestimate the atmospheric burden of formic acid, because key processes related to its sources and sinks remain poorly understood2,6-9. Here we present atmospheric chamber experiments that show that formaldehyde is efficiently converted to gaseous formic acid via a multiphase pathway that involves its hydrated form, methanediol. In warm cloud droplets, methanediol undergoes fast outgassing but slow dehydration. Using a chemistry-climate model, we estimate that the gas-phase oxidation of methanediol produces up to four times more formic acid than all other known chemical sources combined. Our findings reconcile model predictions and measurements of formic acid abundance. The additional formic acid burden increases atmospheric acidity by reducing the pH of clouds and rainwater by up to 0.3. The diol mechanism presented here probably applies to other aldehydes and may help to explain the high atmospheric levels of other organic acids that affect aerosol growth and cloud evolution.

2.
Psychol Med ; 50(16): 2702-2710, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-31637990

RESUMEN

BACKGROUND: Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years. METHODS: The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis. RESULTS: At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (-10.215 to -0.337) and (-4.731 to -0.605) respectively). CONCLUSIONS: Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.


Asunto(s)
Reserva Cognitiva , Funcionamiento Psicosocial , Trastornos Psicóticos/psicología , Cognición Social , Adolescente , Adulto , Femenino , Humanos , Modelos Lineales , Masculino , Análisis de Mediación , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Trastornos Psicóticos/diagnóstico , Adulto Joven
3.
Ultrasound Obstet Gynecol ; 55(2): 257-263, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31332857

RESUMEN

OBJECTIVE: To determine whether differences exist in the rate of levator ani muscle (LAM) avulsion between women who had undergone either Malmström vacuum delivery (MVD) or Kielland forceps delivery (KFD), allowing for potential confounding factors. METHODS: This was a prospective observational study of nulliparous women undergoing instrumental delivery using Malmström vacuum extractor or Kielland forceps, at two hospital centers in Spain. Fetal head position (anterior, posterior or transverse) and fetal head station (low or mid) were assessed by ultrasound and digital examination, respectively. Avulsion was defined on tomographic ultrasound imaging as an abnormal insertion of the LAM in the three central slices from the plane of minimal hiatal dimensions. RESULTS: In total, 414 patients were included in the study (212 MVD and 202 KFD). We observed a higher rate of LAM avulsion in the KFD group (KFD 49.5% vs MVD 32.5%; P = 0.001). When the results were evaluated according to fetal head position and station, we observed no differences in LAM avulsion. The crude odds ratio (OR) for the difference in avulsion between women in the KFD and MVD groups was 2.03 (95% CI, 1.36-3.03). However, when adjusted for duration of second stage of labor, fetal head circumference and fetal head station, the OR was no longer statistically significant (OR, 2.14 (95% CI, 0.95-4.85); P = 0.068). CONCLUSION: When potential confounding factors are taken into account, the rate of LAM avulsion does not differ between women according to whether they have undergone KFD or MVD. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.


Asunto(s)
Complicaciones del Trabajo de Parto/terapia , Forceps Obstétrico/efectos adversos , Diafragma Pélvico/lesiones , Extracción Obstétrica por Aspiración/efectos adversos , Adulto , Femenino , Feto/diagnóstico por imagen , Humanos , Presentación en Trabajo de Parto , Complicaciones del Trabajo de Parto/diagnóstico por imagen , Oportunidad Relativa , Embarazo , Estudios Prospectivos , España , Ultrasonografía Prenatal
4.
Faraday Discuss ; 218(0): 115-137, 2019 08 15.
Artículo en Inglés | MEDLINE | ID: mdl-31123727

RESUMEN

The intricate chemistry of the carbonaceous particle surface layer (which drives their reactivity, environmental and health impacts) results in complex mass spectra. In this respect, detailed molecular-level analysis of combustion emissions may be challenging even with high-resolution mass spectrometry. Building on a recently proposed comprehensive methodology (encompassing all stages from sampling to data reduction), we propose herein a comparative analysis of soot particles produced by three different sources: a miniCAST standard generator, a laboratory diffusion flame and a single cylinder internal combustion engine. The surface composition is probed by either laser or secondary ion mass spectrometry. Two examples of multivariate analysis, Principal component analysis and hierarchical clustering analysis proved their efficiency in both identifying general trends and evidencing subtle differences that otherwise would remain unnoticed in the plethora of data generated during mass spectrometric analyses. Chemical information extracted from these multivariate statistical procedures contributes to a better understanding of fundamental combustion processes and also opens to practical applications such as the tracing of engine emissions.

6.
J Dairy Sci ; 99(7): 5074-5082, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27085414

RESUMEN

In this study, we analyzed antioxidant capacity of 224 cheese samples prepared using 16 varied mixtures of milk from cows, ewes, and goats, in 2 manufacturing seasons (winter and summer), and over 6mo of ripening. Antioxidant capacity was evaluated using the spectrophotometric 2,2-azinobis(3-ethylenebenzothiazoline-6-sulfonic acid) (ABTS) method. Total antioxidant capacity was significantly correlated with season of manufacturing and time of ripening but not with animal species providing the milk. Moreover, statistically significant correlations between the total antioxidant capacity and retinol (r=0.399), fat percentage (r=0.308), protein percentage (r=0.366), K (r=0.385), Mg (r=0.312), Na (r=0.432), and P (0.272) were observed. We evaluated the use of near infrared spectroscopy technology, together with the use of a remote reflectance fiber-optic probe, to predict the antioxidant capacity of cheese samples. The model generated allowed us to predict antioxidant capacity in unknown cheeses of different compositions and ripening times.


Asunto(s)
Antioxidantes/análisis , Bovinos , Queso/análisis , Cabras , Oveja Doméstica , Animales , Espectroscopía Infrarroja Corta
7.
Transpl Infect Dis ; 17(2): 221-33, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25652036

RESUMEN

BACKGROUND: Umbilical cord blood transplantation (CBT) is an established alternative source of stem cells in the setting of unrelated transplantation. When compared with other sources, single-unit CBT (sCBT) is associated with a delayed hematologic recovery, which may lead to a higher infection-related mortality (IRM). Co-infusion with the sCBT of CD34+ peripheral blood stem cells from a third-party donor (TPD) (sCBT + TPDCD34+) has been shown to markedly accelerate leukocyte recovery, potentially reducing the IRM. However, to our knowledge, no comparative studies have focused on severe infections and IRM with these 2 sCBT strategies. METHODS: A total of 148 consecutive sCBT (2000-2010, median follow-up 4.5 years) were included in a multicenter retrospective study to analyze the incidence and risk factors of IRM and severe viral and invasive fungal infections (IFIs). Neutrophil engraftment occurred in 90% of sCBT (n = 77) and 94% sCBT + TPDCD34+ (n = 71) recipients at a median of 23 and 12 days post transplantation, respectively (P < 0.01). RESULTS: The 4-year IRM was 24% and 20%, respectively (P = 0.7), with no differences at day +30 (5% and 4%, respectively) and day +100 (10% and 8%, respectively). In multivariate analysis early status of the underlying malignancy, cytomegalovirus (CMV)-seronegative recipient and high CD34+ cell content in the cord blood unit before cryostorage (≥1.4 × 10(5) /kg) were protective of IRM. Among the causes of IRM, bacterial infections and IFIs were more common in sCBT (15% vs. 4%), while CMV disease and parasitic infections were more common in the sCBT + TPDCD34+ cohort (5% vs. 16%). CONCLUSION: These data show that sCBT supported with TPDCD34(+) cells results in much shorter periods of post-transplant leukopenia, but the short- and long-term rates of IRM were comparable to those of sCBT, presumably because immune recovery is equally delayed in both graft types.


Asunto(s)
Infecciones Bacterianas/epidemiología , Trasplante de Células Madre de Sangre del Cordón Umbilical/métodos , Inmunosupresores/uso terapéutico , Leucemia/terapia , Linfoma/terapia , Micosis/epidemiología , Agonistas Mieloablativos/uso terapéutico , Trasplante de Células Madre de Sangre Periférica/métodos , Virosis/epidemiología , Adolescente , Adulto , Antígenos CD34 , Infecciones Bacterianas/mortalidad , Busulfano/uso terapéutico , Estudios de Cohortes , Ciclosporina/uso terapéutico , Femenino , Factor Estimulante de Colonias de Granulocitos/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Micosis/mortalidad , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Tiotepa/uso terapéutico , Acondicionamiento Pretrasplante/métodos , Vidarabina/análogos & derivados , Vidarabina/uso terapéutico , Virosis/mortalidad , Irradiación Corporal Total , Adulto Joven
8.
Chaos ; 24(2): 023133, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24985447

RESUMEN

One-dimensional patterns subjected to counter-propagative flows or speed jumps exhibit a rich and complex spatiotemporal dynamics, which is characterized by the perpetual emergence of spatiotemporal dislocation chains. Using a universal amplitude equation of drifting patterns, we show that this behavior is a result of a combination of a phase instability and an advection process caused by an inhomogeneous drift force. The emergence of spatiotemporal dislocation chains is verified in numerical simulations on an optical feedback system with a non-uniform intensity pump. Experimentally this phenomenon is also observed in a tilted quasi-one-dimensional fluidized shallow granular bed mechanically driven by a harmonic vertical vibration.

9.
Photochem Photobiol ; 2024 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-38958000

RESUMEN

The thermodynamic characteristics, antioxidant potential, and photoprotective benefits of full-spectrum cannabidiol (FS-CBD) against UVB-induced cellular death were examined in this study. In silico analysis of CBD showed antioxidant capacity via proton donation and UV absorption at 209.09, 254.73, and 276.95 nm, according to the HAT and SPLET methodologies. FS-CBD protected against UVB-induced bacterial death for 30 min. FS-CBD protected against UVB-induced cell death by 42% (1.5 µg/mL) and 35% (3.5 µg/mL) in an in vitro keratinocyte cell model. An in vivo acute irradiated CD-1et/et mouse model (UVB-irradiated for 5 min) presented very low photoprotection when FS-CBD was applied cutaneously, as determined by histological analyses. In vivo skin samples showed that FS-CBD regulated inflammatory responses by inhibiting the inflammatory markers TGF-ß1 and NLRP3. The docking analysis showed that the CBD molecule had a high affinity for TGF-ß1 and NLRP3, indicating that protection against inflammation might be mediated by blocking these proinflammatory molecules. This result was corroborated by the docking interactions between CBD and TGF-ß1 and NLRP3, which resulted in a high affinity and inhibition of both proteins The present work suggested a FS-CBD moderate photoprotective agent against UVB light-induced skin damage and that this effect is partially mediated by its anti-inflammatory activity.

10.
J Chem Phys ; 139(8): 084312, 2013 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-24007002

RESUMEN

The first step in atmospheric new particle formation involves the aggregation of gas phase molecules into small molecular clusters that can grow by colliding with gas molecules and each other. In this work we used first principles quantum chemistry combined with a dynamic model to study the steady-state kinetics of sets of small clusters consisting of sulfuric acid and ammonia or sulfuric acid and dimethylamine molecules. Both sets were studied with and without electrically charged clusters. We show the main clustering pathways in the simulated systems together with the quantum chemical Gibbs free energies of formation of the growing clusters. In the sulfuric acid-ammonia system, the major growth pathways exhibit free energy barriers, whereas in the acid-dimethylamine system the growth occurs mainly via barrierless condensation. When ions are present, charged clusters contribute significantly to the growth in the acid-ammonia system. For dimethylamine the role of ions is minor, except at very low acid concentration, and the growing clusters are electrically neutral.

11.
Eur Addict Res ; 19(3): 146-54, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23183847

RESUMEN

BACKGROUND: The current study aims to identify predictors of pathological gambling (PG) severity, taking gender differences into account, in an outpatient sample of pathological gamblers seeking treatment. METHODS: The sample for this study consisted of 103 subjects (51 women and 52 men) meeting current DSM-IV-TR criteria for PG. Linear and logistic regression analyses were used to examine different risk factors (gender, age, impulsivity, sensation seeking, self-esteem) and risk markers (depression, anxiety, gambling-related thoughts, substance abuse) as predictors of PG severity. RESULTS: Impulsivity, maladjustment in everyday life and age at gambling onset were the best predictors in the overall sample. When gender differences were taken into account, duration of gambling disorder in women and depression and impulsivity in men predicted PG severity. In turn, a high degree of severity in the South Oaks Gambling Screen score was related to older age and more familiy support in women and to low self-esteem and alcohol abuse in men. Female gamblers were older than male gamblers and started gambling later in life, but became dependent on gambling more quickly than men. CONCLUSIONS: Further research should examine these data to tailor treatment to specific patients' needs according to sex and individual characteristics.


Asunto(s)
Juego de Azar/diagnóstico , Juego de Azar/psicología , Caracteres Sexuales , Adaptación Psicológica , Adolescente , Adulto , Factores de Edad , Edad de Inicio , Ansiedad/complicaciones , Ansiedad/psicología , Depresión/complicaciones , Depresión/psicología , Femenino , Juego de Azar/complicaciones , Juego de Azar/terapia , Humanos , Conducta Impulsiva/complicaciones , Conducta Impulsiva/psicología , Masculino , Personalidad , Factores de Riesgo , Asunción de Riesgos , Autoimagen , Índice de Severidad de la Enfermedad , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/psicología
12.
Bone Marrow Transplant ; 58(12): 1348-1356, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37673982

RESUMEN

The COVID-19 pandemic has had a significant impact on medical practices, including the delivery of allogeneic hematopoietic cell transplantation (HCT). In response, transplant centers have made changes to their procedures, including an increased use of cryopreservation for allogeneic haematopoietic progenitor cell (HPC) grafts. The use of cryopreserved grafts for allogeneic HCT has been reviewed and analysed in terms of potential benefits and drawbacks based on existing data on impact on cell subsets, hematological recovery, and clinical outcomes of approximately 2000 patients from different studies. A survey of European Society for Blood and Marrow Transplantation centers was also conducted to assess changes in practice during the pandemic and any unnecessary burdens on HPC donors. Before the pandemic, only 7.4% of transplant centers were routinely cryopreserving HPC products, but this percentage increased to 90% during the pandemic. The results of this review and survey suggest that cryopreservation of HPC grafts is a viable option for allogeneic HCT in certain situations, but further research is needed to determine long-term effects and ethical discussions are required to balance the needs of donors and patients when using frozen allografts.


Asunto(s)
COVID-19 , Enfermedades Transmisibles , Trasplante de Células Madre Hematopoyéticas , Humanos , Pandemias , Trasplante de Células Madre Hematopoyéticas/métodos , Trasplante de Médula Ósea/métodos
13.
Transplant Cell Ther ; 29(3): 151-163, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36442770

RESUMEN

Transplantation-associated thrombotic microangiopathy (TA-TMA) is an increasingly recognized complication of hematopoietic cell transplantation (HCT) associated with significant morbidity and mortality. However, TA-TMA is a clinical diagnosis, and multiple criteria have been proposed without universal application. Although some patients have a self-resolving disease, others progress to multiorgan failure and/or death. Poor prognostic features also are not uniformly accepted. The lack of harmonization of diagnostic and prognostic markers has precluded multi-institutional studies to better understand incidence and outcomes. Even current interventional trials use different criteria, making it challenging to interpret the data. To address this urgent need, the American Society for Transplantation and Cellular Therapy, Center for International Bone Marrow Transplant Research, Asia-Pacific Blood and Marrow Transplantation, and European Society for Blood and Marrow Transplantation nominated representatives for an expert panel tasked with reaching consensus on diagnostic and prognostic criteria. The panel reviewed literature, generated consensus statements regarding diagnostic and prognostic features of TA-TMA using the Delphi method, and identified future directions of investigation. Consensus was reached on 4 key concepts: (1) TA-TMA can be diagnosed using clinical and laboratory criteria or tissue biopsy of kidney or gastrointestinal tissue; however, biopsy is not required; (2) consensus diagnostic criteria are proposed using the modified Jodele criteria with additional definitions of anemia and thrombocytopenia. TA-TMA is diagnosed when ≥4 of the following 7 features occur twice within 14 days: anemia, defined as failure to achieve transfusion independence despite neutrophil engraftment; hemoglobin decline by ≥1 g/dL or new-onset transfusion dependence; thrombocytopenia, defined as failure to achieve platelet engraftment, higher-than-expected transfusion needs, refractory to platelet transfusions, or ≥50% reduction in baseline platelet count after full platelet engraftment; lactate dehydrogenase (LDH) exceeding the upper limit of normal (ULN); schistocytes; hypertension; soluble C5b-9 (sC5b-9) exceeding the ULN; and proteinuria (≥1 mg/mg random urine protein-to-creatinine ratio [rUPCR]); (3) patients with any of the following features are at increased risk of nonrelapse mortality and should be stratified as high-risk TA-TMA: elevated sC5b-9, LDH ≥2 times the ULN, rUPCR ≥1 mg/mg, multiorgan dysfunction, concurrent grade II-IV acute graft-versus-host disease (GVHD), or infection (bacterial or viral); and (4) all allogeneic and pediatric autologous HCT recipients with neuroblastoma should be screened weekly for TA-TMA during the first 100 days post-HCT. Patients diagnosed with TA-TMA should be risk-stratified, and those with high-risk disease should be offered participation in a clinical trial for TA-TMA-directed therapy if available. We propose that these criteria and risk stratification features be used in data registries, prospective studies, and clinical practice across international settings. This harmonization will facilitate the investigation of TA-TMA across populations diverse in race, ethnicity, age, disease indications, and transplantation characteristics. As these criteria are widely used, we expect continued refinement as necessary. Efforts to identify more specific diagnostic and prognostic biomarkers are a top priority of the field. Finally, an investigation of the impact of TA-TMA-directed treatment, particularly in the setting of concurrent highly morbid complications, such as steroid-refractory GVHD and infection, is critically needed.


Asunto(s)
Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas , Microangiopatías Trombóticas , Humanos , Niño , Pronóstico , Médula Ósea , Estudios Prospectivos , Microangiopatías Trombóticas/diagnóstico , Microangiopatías Trombóticas/etiología , Microangiopatías Trombóticas/patología , Trasplante de Células Madre Hematopoyéticas/efectos adversos
14.
Acta Psychiatr Scand ; 125(4): 335-41, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22283440

RESUMEN

OBJECTIVE: The aim of this 1-year follow-up study was to compare functional outcome as well as clinical differences between patients with first- and multiple-episode bipolar disorder. METHOD: Bipolar disorder patients with first (n = 60) and multiple episodes (n = 59) were recruited from two hospitals in Spain. The Functioning Assessment Short Test (FAST) was used to assess functioning. The Hamilton Depression Rating Scale (HAMD) and the Young Mania Rating Scale (YMRS) were administered to assess mood symptoms. RESULTS: As expected, patients with first episode experienced a greater functioning compared to patients with multiple episodes (11.26 ± 10.94 vs. 26.91 ± 13.96; t = 6.436, P < 0.001). There were significant demographic and clinical differences between both groups. Baseline depressive symptoms (F = 9.553, df = 4, 102; P < 0.001) and age (F = 14.145, df = 4, 103; P < 0.001) were significantly associated with poor functional recovery at 6-month and 12-month assessment, respectively, in a group of patients with multiple episodes. CONCLUSION: Our data give support to the model of staging in bipolar disorder, showing that the enduring neurotoxicity of repeated episodes may contribute to sustained impairment in multiple areas of psychosocial functioning.


Asunto(s)
Actividades Cotidianas/psicología , Trastorno Bipolar/fisiopatología , Trastorno Bipolar/psicología , Cognición , Empleo/psicología , Relaciones Interpersonales , Adulto , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Actividades Recreativas/psicología , Masculino , Persona de Mediana Edad , Recuperación de la Función
15.
Eur Arch Otorhinolaryngol ; 269(4): 1183-8, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22197995

RESUMEN

Abnormal Wnt signaling and impaired cell-cell adhesion due to abnormal E-cadherin and ß-catenin function have been implicated in many cancers, but have not been fully explored in laryngeal squamous cell carcinoma. In this study, ß-catenin cellular location and E-cadherin expression levels were analyzed in 16 laryngeal squamous cell carcinomas (LSCCs) (9 glottic and 7 supraglottic) and 11 samples of non-tumoral inflammatory larynx tissue, using immunohistochemical methods. All non-tumoral tissues showed equally strong membranous expression of ß-catenin, while cytoplasmic expression was found in only 3 of the 11 samples. By contrast, whereas 8/9 glottic LSCCs exhibited only membranous expression of ß-catenin, 6/7 supraglottic LSCCs displayed both membranous and cytoplasmic expression (p = 0.003). Strong E-cadherin staining was observed in 9/11 non-tumoral tissues and 7/9 glottic LSCCs, whereas 4/7 supraglottic LSCCs exhibited weak expression. Reduced membrane expression of E-cadherin and cytoplasmic retention of ß-catenin in supraglottic LSCC seems to be related with more aggressive biological behavior which has been described in clinical studies. Further research is required to clarify the involvement of ß-catenin in the mechanism associated with malignant transformation in laryngeal tissues.


Asunto(s)
Cadherinas/biosíntesis , Carcinoma de Células Escamosas/metabolismo , Neoplasias Laríngeas/metabolismo , beta Catenina/biosíntesis , Adulto , Anciano , Biomarcadores de Tumor/metabolismo , Carcinoma de Células Escamosas/patología , Progresión de la Enfermedad , Femenino , Humanos , Inmunohistoquímica , Neoplasias Laríngeas/patología , Masculino , Persona de Mediana Edad , Pronóstico , Adulto Joven
16.
Bone Marrow Transplant ; 57(2): 176-182, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34711917

RESUMEN

Traceability of patients who are candidates for Hematopoietic cell transplant (HCT) is crucial to ensure HCT program quality. Continuous knowledge of both a detailed registry from a HCT program and final exclusion causes can contribute to promoting a real-life vision and optimizing patient and donor selection. We analyzed epidemiological data reported in a 4 year-monocentric prospective registry, which included all patients presented as candidates for autologous (Auto) and/or allogeneic (Allo) HCT. A total of 543 patients were considered for HCT: 252 (42.4%) for Allo and 291 (57.6%) for Auto. A total of 98 (38.9%) patients were excluded from AlloHCT due to basal disease progression more commonly (18.2%). Seventy-six (30.2%) patients had an HLA identical sibling, whereas 147 (58.3%) patients had only Haplo. UD research was performed in 106 (42%) cases, significantly more often in myeloid than lymphoid malignancies (57% vs 28.7%, p < 0.001) but 61.3% were finally canceled, due to donor or disease causes in 72.4%. With respect to Auto candidates, a total of 60 (20.6%) patients were finally excluded; progression was the most common cause (12%). Currently, Haplo is the most frequent donor type. The high cancellation rate of UD research should be revised to optimize further donor algorithms.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Selección de Donante , Trasplante de Células Madre Hematopoyéticas/métodos , Humanos , Sistema de Registros , Acondicionamiento Pretrasplante , Trasplante Autólogo
17.
J Antimicrob Chemother ; 66(3): 657-63, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21193475

RESUMEN

OBJECTIVES: To assess the risk factors, antibiotic therapy and outcomes of multidrug-resistant Gram-negative bacilli (MDRGNB) bacteraemia in hospitalized patients with cancer. METHODS: Episodes of MDRGNB bacteraemia were compared with a susceptible control group in a 4 year prospective study. RESULTS: Of 747 bacteraemias, 372 (49.7%) were caused by a Gram-negative bacilli (GNB). Fifty-one of these (13.7%) were caused by a multidrug-resistant (MDR) strain. Previous antibiotics [odds ratio (OR) 3.57; 95% confidence interval (CI) 1.63-7.80] and urinary catheter (OR 2.41; 95% CI 1.01-5.74) were identified as independent risk factors for MDRGNB acquisition. The most frequent mechanism of resistance was extended-spectrum ß-lactamase (ESBL) production (45%), mainly by Escherichia coli, followed by Amp-C cephalosporinase hyperproduction (24%). Patients with MDRGNB bacteraemia more frequently received inadequate initial antibiotic therapy (69% versus 9%; P < 0.001) and time to adequate therapy was longer in this group (41% versus 4%; P < 0.001). Patients in the resistant group more frequently required intensive care unit (ICU) admission (14% versus 5%; P = 0.023), had greater need for mechanical ventilation (14% versus 3%; P = 0.005) and had a higher overall case-fatality rate (41% versus 21%; P = 0.003). Risk factors for mortality were solid tumour (OR 5.04; 95% CI 2.49-10.19), current corticosteroid use (OR 4.38; 95% CI 2.39-8.05), ICU admission (OR 11.40; 95% CI 3.19-40.74) and MDRGNB bacteraemia (OR 3.52; 95% CI 1.36-9.09). CONCLUSIONS: MDRGNB bacteraemia was common among cancer patients, especially in those exposed to antibiotics and urinary catheter. The most frequent mechanism of resistance was ESBL production. Patients with MDRGNB more frequently received inadequate empirical antibiotic therapy and presented poorer outcomes with a higher overall case-fatality rate (within 30 days).


Asunto(s)
Antibacterianos/uso terapéutico , Bacteriemia/tratamiento farmacológico , Farmacorresistencia Bacteriana Múltiple , Bacterias Gramnegativas/efectos de los fármacos , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Neoplasias/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bacteriemia/epidemiología , Bacteriemia/microbiología , Bacteriemia/mortalidad , Femenino , Infecciones por Bacterias Gramnegativas/epidemiología , Infecciones por Bacterias Gramnegativas/microbiología , Infecciones por Bacterias Gramnegativas/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Resultado del Tratamiento , Adulto Joven
18.
Radiologia ; 53(5): 434-48, 2011.
Artículo en Español | MEDLINE | ID: mdl-21937066

RESUMEN

Sarcoidosis is a multisystemic granulomatous disease of unknown etiology. It mainly affects the thoracic lymph nodes and the lungs. The staging of sarcoidosis, which classifies patients according to their probability of spontaneous remission, is based on the plain chest film findings. Plain chest films are not as sensitive as high resolution computed tomography (HRCT) at detecting involvement of the lymph nodes, lungs, or bronchi. The high resolution CT findings can be typical, practically pathognomic, or atypical. High resolution CT provides information about the activity of the disease and detects incipient signs of fibrosis and other complications. To reach the diagnosis, it is necessary to correlate the clinical and radiological findings (and often the histological findings). Cardiac involvement can cause sudden death. The diagnosis of cardiac involvement is difficult; it is based on various imaging tests, like magnetic resonance imaging, which is more specific, and positron emission tomography. Diagnostic confirmation by endomyocardial biopsy is obtained in few patients.


Asunto(s)
Cardiomiopatías/diagnóstico por imagen , Sarcoidosis Pulmonar/diagnóstico por imagen , Sarcoidosis/diagnóstico por imagen , Humanos , Sarcoidosis Pulmonar/patología , Tomografía Computarizada por Rayos X/métodos
19.
Sci Rep ; 11(1): 18779, 2021 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-34548549

RESUMEN

The use of lysed microalgae in the diet of carnivorous fish can increase the bioavailability of proteins and bioactive compounds, such as unsaturated fatty acids or vitamins in the digestive tract. These are essential molecules for the proper physiological development of fish in aquaculture. However, some antinutritional components and other undesirable molecules can be released from an excess of microalgae supplied, compromising the integrity of the intestine. The inclusion of small amounts of hydrolized microalgae in the fish diet can be a good strategy to avoid negative effects, improving the availability of beneficial compounds. Nannochloropsis gaditana is an interesting microalgae as it contains nutraceuticals. Previous studies reported beneficial effects after its inclusion in the diet of Sparus aurata, a widely cultured species in Europe and in all Mediterranean countries. However, administration of raw microalgae can produce intestinal inflammation, increased intestinal permeability, bacterial translocation and disturbance of digestion and absorption processes. The aim of this study was to evaluate changes in the intestinal microbiota and barrier stability of S. aurata fed with low inclusion (5%) hydrolysed N. gaditana. Intestinal microbiota was analyzed using Illumina MiSeq technology and libraries were constructed using variable regions V3-V4 of 16S rDNA molecules. Analysis were based in the identification, quantification and comparison of sequences. The predictive intestinal microbial functionality was analyzed with PICRUSt software. The results determined that the intestinal microbiota bacterial composition and the predictive intestinal microbiota functionality did not change statistically after the inclusion of N. gaditana on the diet. The study of gene expression showed that genes involved in intestinal permeability and integrity were not altered in fish treated with the experimental diet. The potential functionality and bacterial taxonomic composition of the intestinal microbiota, and the expression of integrity and permeability genes in the intestine of the carnivorous fish S. aurata were not affected by the inclusion of hydrolysed 5% N. gaditana microalgae.


Asunto(s)
Alimentación Animal , Microbioma Gastrointestinal , Dorada/metabolismo , Estramenopilos , Animales , Acuicultura , Hidrólisis , ARN Ribosómico 16S/genética
20.
Methods Find Exp Clin Pharmacol ; 32 Suppl A: 15-7, 2010 Dec.
Artículo en Español | MEDLINE | ID: mdl-21381283

RESUMEN

In the last decade there has been increasing awareness of the importance of thymus gland function in the reconstitution of host immunity following hematopoietic transplantation. A functional thymus contributes to foster T compartment reconstitution, with an increased diversity of T receptor rearrangement, and a more physiological distribution of the functional subpopulations. Palifermin, a keratinocyte growth factor (KGF) approved for reducing the incidence and severity of oral mucositis, has been proposed as a possible strategy for improving thymus function and immune reconstitution after hematopoietic transplantation. In vitro and animal models show palifermin to protect the thymus from chemo-/radiotherapy induced damage, increasing thymic production, accelerating immune reconstitution, improving response to vaccines, and reducing the incidence of graft-versus-host disease in animal models. To date, no studies have analyzed this possible application in humans. This study reports preliminary data on immune reconstitution in 50 autologous transplant recipients (30 treated with palifermin and 20 controls). The results suggest that palifermin at the doses and involving the regimens indicated for the prevention of oral mucositis has no effect upon thymus gland function in adult patients, and induces no changes in T immune recovery (either CD4 or CD8) or in the percentage of functional T subpopulations or T helper lymphocytes.


Asunto(s)
Factor 7 de Crecimiento de Fibroblastos/uso terapéutico , Trasplante de Células Madre Hematopoyéticas , Factores Inmunológicos/uso terapéutico , Estomatitis/prevención & control , Subgrupos de Linfocitos T/efectos de los fármacos , Timo/efectos de los fármacos , Animales , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , Estomatitis/etiología , Subgrupos de Linfocitos T/inmunología , Timo/inmunología , Trasplante Autólogo , Resultado del Tratamiento
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