Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 155
Filtrar
Más filtros

Tipo del documento
Intervalo de año de publicación
1.
J Intern Med ; 283(5): 461-475, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29415332

RESUMEN

BACKGROUND: CCL23 role in the inflammatory response after acute brain injuries remains elusive. Here, we evaluated whether CCL23 blood levels associate with acquired cerebral lesions and determined CCL23 predictive capacity for assessing stroke prognosis. We used preclinical models to study the CCL23 homologous chemokines in rodents, CCL9 and CCL6. METHODS: Baseline CCL23 blood levels were determined on 245 individuals, including ischaemic strokes (IS), stroke mimics and controls. Temporal profile of circulating CCL23 was explored from baseline to 24 h in 20 of the IS. In an independent cohort of 120 IS with a 3-month follow-up, CCL23 blood levels were included in logistic regression models to predict IS outcome. CCL9/CCL6 cerebral expression was evaluated in rodent models of brain damage. Both chemokines were also profiled in circulation and histologically located on brain following ischaemia. RESULTS: Baseline CCL23 blood levels did not discriminate IS, but permitted an accurate discrimination of patients presenting acute brain lesions (P = 0.003). IS exhibited a continuous increase from baseline to 24 h in circulating CCL23 (P < 0.001). Baseline CCL23 blood levels resulted an independent predictor of IS outcome at hospital discharge (ORadj : 19.702 [1.815-213.918], P = 0.014) and mortality after 3 months (ORadj : 21.47 [3.434-134.221], P = 0.001). In preclinics, expression of rodent chemokines in neurons following cerebral lesions was elevated. CCL9 circulating levels decreased early after ischaemia (P < 0.001), whereas CCL6 did not alter within the first 24 h after ischaemia. CONCLUSIONS: Although preclinical models do not seem suitable to characterize CCL23, it might be a novel promising biomarker for the early diagnosis of cerebral lesions and might facilitate the prediction of stroke patient outcome.


Asunto(s)
Quimiocinas CC/sangre , Accidente Cerebrovascular/sangre , Accidente Cerebrovascular/mortalidad , Anciano , Anciano de 80 o más Años , Animales , Biomarcadores/sangre , Estudios de Casos y Controles , Quimiocinas/metabolismo , Modelos Animales de Enfermedad , Diagnóstico Precoz , Femenino , Estudios de Seguimiento , Humanos , Proteínas Inflamatorias de Macrófagos/sangre , Masculino , Ratones Endogámicos C57BL , Neuronas/metabolismo , Neutrófilos/metabolismo , Pronóstico , Ratas Wistar , Accidente Cerebrovascular/diagnóstico , Regulación hacia Arriba
2.
Acta Neurol Scand ; 137(1): 67-75, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28832891

RESUMEN

OBJECTIVES: Lacosamide is an antiepileptic drug (AED), which has proven to be effective to control seizures, including acute conditions such as status epilepticus. The aim of this study is to describe the clinical experience with lacosamide in neuro-oncological patients. MATERIALS AND METHODS: Multicenter retrospective study in patients with cancer-related seizures, who received lacosamide as an add-on therapy. RESULTS: Forty-eight patients with benign and malignant tumors, including primary brain tumors, lymphomas, systemic cancer with central nervous system involvement, or paraneoplastic encephalitis, were included. Lacosamide was effective in the control of chronic seizures in patients with either benign or malignant tumors. The success rate was greater in malignant tumors, and drug-resistant epilepsies were more likely associated with benign tumors. Adverse events occurred in nearly 70% of patients, particularly in acute conditions and associated with the concomitant use of radio-/chemotherapy. Lacosamide-related adverse events were more likely somnolence and dizziness, which usually resolved after dose adjustment. After starting lacosamide, nearly half of the patients discontinued one of the baseline AEDs and decreased or discontinued dexamethasone. Fifteen patients with status epilepticus were treated with intravenous lacosamide, and 73% of them had their condition resolved without serious drug-related adverse events. CONCLUSION: Lacosamide is an AED to consider in cases of cancer-related seizures. Lacosamide pharmacodynamics and pharmacokinetics allow the achievement of responder rates over 50% with no serious adverse effects, amelioration of side effects from other AEDs or radio-/chemotherapy, and no significant drug interactions. Furthermore, the intravenous formulation shows clear benefits in acute conditions such as status epilepticus.


Asunto(s)
Acetamidas/uso terapéutico , Anticonvulsivantes/uso terapéutico , Neoplasias Encefálicas/complicaciones , Convulsiones/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Lacosamida , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Convulsiones/etiología , Resultado del Tratamiento , Adulto Joven
3.
Opt Express ; 25(15): 17167-17173, 2017 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-28789211

RESUMEN

Acousto-optic coupling in polyimide-coated single-mode optical fibers using flexural elastic waves is demonstrated. The effect of the polyimide coating on the acousto-optic interaction process is analyzed in detailed. Theoretical and experimental results are in good agreement. Although the elastic attenuation is significant, we show that acousto-optic coupling can be produced with a reasonably good efficiency. To our knowledge, it is the first experimental demonstration of acousto-optic coupling in optical fibers with robust protective coating.

4.
Opt Express ; 24(5): 4899-4905, 2016 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-29092317

RESUMEN

Acousto-optic interaction in optical fibers is exploited for the accurate and broadband characterization of two-mode optical fibers. Coupling between LP01 and LP1m modes is produced in a broadband wavelength range. Difference in effective indices, group indices, and chromatic dispersions between the guided modes, are obtained from experimental measurements. Additionally, we show that the technique is suitable to investigate the fine modes structure of LP modes, and some other intriguing features related with modes' cut-off.

5.
Actas Dermosifiliogr ; 107(1): e1-5, 2016.
Artículo en Inglés, Español | MEDLINE | ID: mdl-25843790

RESUMEN

Urticaria multiforme is a cutaneous disorder that affects infants and small children. It is characterized by large, annular urticarial plaques with a violaceous center and is frequently accompanied by fever. Urticaria multiforme follows a benign, self-limiting course, but the striking appearance of the lesions can cause alarm and considerable anxiety among parents. We present 5 cases of urticaria multiforme seen in our hospital over a period of 18 months. All the cases were preceded by an infection of the upper airways or otitis, and they were all empirically with amoxicillin. It is important to be familiar with this condition to reassure parents and avoid unnecessary hospital admissions and tests.


Asunto(s)
Eritema Multiforme/diagnóstico , Urticaria/diagnóstico , Eritema Multiforme/tratamiento farmacológico , Femenino , Fiebre , Humanos , Lactante , Masculino , Urticaria/tratamiento farmacológico
6.
Opt Express ; 23(6): 7345-50, 2015 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-25837077

RESUMEN

The time-resolved acousto-optic technique demonstrated recently to be a very useful method for the analysis of fiber axial non-uniformities, able to detect variations of fiber diameter in the nanometric scale with a spatial resolution of few cm. An edge interrogation approach is proposed to improve further the performance of this technique. The detection of subnanometer fiber diameter changes or sub-ppm changes of the core refractive index is demonstrated.

7.
Opt Lett ; 40(5): 689-92, 2015 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-25723408

RESUMEN

In-fiber acousto-optic interaction is used to characterize the refractive index changes at the C band in a single-mode ytterbium-doped optical fiber under 980 nm pumping. The transmission notch created by the acoustic-induced coupling between the core mode and a cladding mode shifts to longer wavelengths when the pump is delivered to the fiber. The electronic contribution to the refractive index change is quantified from the wavelength shift. Using a time-resolved acousto-optic method, we investigate the distribution of pump absorption, and the resulting refractive index change profile, along sections of ytterbium-doped fiber exceeding 1 m long under different pump power levels.

8.
Mult Scler ; 21(13): 1632-43, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26432853

RESUMEN

BACKGROUND: Studies in multiple sclerosis (MS) and in experimental models point to a critical role of semaphorin (sema)3A and sema7A in MS pathogenesis. OBJECTIVE: The objective of this paper is to characterise the expression of sema3A, sema7A, and their receptors in MS lesions. METHODS: We included 44 demyelinating lesions from MS patients, 12 lesions with acute cerebral infarct, 11 lesions with progressive multifocal leucoencephalopathy and 10 non-neurological control patients. MS lesions were classified according to inflammatory activity and all samples were immunostained for sema3A, sema7A, neuropilin 1 (Np-1), α1-integrin, and ß1-integrin. RESULTS: In MS-damaged white matter sema3A and Np-1 were both detected in microglia/macrophages, whereas reactive astrocytes expressed only sema3A. Otherwise, sema7A, α1-integrin and ß1-integrin were observed in reactive astrocytes, and microglia/macrophages only expressed ß1-integrin. The expression of sema3A, sema7A and their receptors is more relevant in MS than in other demyelinating diseases. Sema3A and sema7A expression correlated with the inflammatory activity of the MS lesions, suggesting their involvement in the immunological process that takes place in MS. CONCLUSIONS: The expression pattern of sema3A, sema7A and their receptors in MS lesions suggests that both molecules contribute to create a negative environment for tissue regeneration, influencing the ability to regenerate the damaged tissue.


Asunto(s)
Antígenos CD/metabolismo , Astrocitos/metabolismo , Esclerosis Múltiple/metabolismo , Semaforina-3A/metabolismo , Semaforinas/metabolismo , Sustancia Blanca/patología , Infarto Encefálico/etiología , Infarto Encefálico/metabolismo , Infarto Encefálico/patología , Femenino , Proteínas Ligadas a GPI/metabolismo , Humanos , Inflamación/metabolismo , Inflamación/patología , Integrina alfa1/metabolismo , Integrina beta1/metabolismo , Leucoencefalopatía Multifocal Progresiva/etiología , Leucoencefalopatía Multifocal Progresiva/metabolismo , Leucoencefalopatía Multifocal Progresiva/patología , Macrófagos/metabolismo , Masculino , Microglía/metabolismo , Persona de Mediana Edad , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/patología , Neuropilina-1/metabolismo
9.
Antimicrob Agents Chemother ; 58(7): 4227-9, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24798272

RESUMEN

Mitochondrial toxicity has been recently suggested to be the underlying mechanism of long-term linezolid-associated toxicity in patients with 16S rRNA genetic polymorphisms. Here, we report for the first time two cases of lactic acidosis due to long-term linezolid exposure in liver transplant recipients who presented an A2706G mitochondrial DNA polymorphism.


Asunto(s)
Acetamidas/efectos adversos , Acidosis Láctica/inducido químicamente , ADN Mitocondrial/genética , Mitocondrias/genética , Oxazolidinonas/efectos adversos , Acetamidas/uso terapéutico , Acidosis Láctica/terapia , Adulto , Anciano , Femenino , Predisposición Genética a la Enfermedad , Humanos , Linezolid , Trasplante de Hígado , Masculino , Nocardiosis/tratamiento farmacológico , Nocardia asteroides/efectos de los fármacos , Oxazolidinonas/uso terapéutico , Polimorfismo de Nucleótido Simple , ARN Ribosómico 16S/genética , Tuberculosis Pulmonar/tratamiento farmacológico
10.
Opt Lett ; 39(6): 1437-40, 2014 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-24690807

RESUMEN

We report on a time-resolved acousto-optic interaction technique for the detection of axial nonuniformities in single-mode fibers. It is based on the propagation of short packets of flexural acoustic waves. Small axial nonuniformities (of the order of nanometers) are detected by measuring the transmittance of the fundamental mode as a function of time. It is shown that the technique allows the detection of axial nonuniformities along sections of single-mode fiber exceeding 1 m long with spatial resolution of the order of a few centimeters.

12.
Rev Neurol ; 76(8): 273-275, 2023 04 16.
Artículo en Español | MEDLINE | ID: mdl-37046396

RESUMEN

INTRODUCTION: Intracranial atheromatosis is one of the most frequent causes of stroke. It is usually a slowly progressive process and normally associated with the sum of vascular risk factors. CASE REPORT: In this case we present a rapidly progressive development of intracranial atheromatosis demonstrated by serial neuroimaging techniques and sample analysis in a 72-year-old female patient with high levels of interleukin-6 and C-reactive protein, with no signs of vasculitis. CONCLUSION: Rapidly progressive intracranial atheromatosis should be considered in adult patients over 50 years of age with recurrent stroke.


TITLE: Arterioesclerosis intracraneal rápidamente progresiva, una rara etiología de ictus.Introducción. La ateromatosis intracraneal es una de las causas más frecuentes de ictus. Suele ser un proceso lentamente progresivo y normalmente asociado a la suma de factores de riesgo vascular. Caso clínico. En este caso presentamos una evolución rápidamente progresiva de la ateromatosis intracraneal demostrada por técnicas de neuroimagen seriadas y análisis de la muestra en una paciente de 72 años con niveles altos de interleucina-6 y proteína C reactiva, sin signos de vasculitis. Conclusión. La ateromatosis intracraneal rápidamente progresiva se debe tener en cuenta en pacientes adultos mayores de 50 años con ictus de repetición.


Asunto(s)
Arteriosclerosis Intracraneal , Accidente Cerebrovascular , Vasculitis , Adulto , Femenino , Humanos , Persona de Mediana Edad , Anciano , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/etiología , Arterias , Factores de Riesgo , Neuroimagen , Vasculitis/complicaciones , Arteriosclerosis Intracraneal/complicaciones
13.
Neuropathol Appl Neurobiol ; 38(2): 153-61, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21726270

RESUMEN

BACKGROUND: In definite Creutzfeldt-Jakob disease (CJD), morphological and immunohistochemical patterns are useful to identify molecular subtypes. Severe cerebellar pathology and hippocampal involvement helps to identify VV subtypes. The rare VV1 variant (<1%), more frequent in young individuals, is additionally characterized by the presence of ballooned neurones in affected areas. In 1985, Cartier et al. described a family cluster of three individuals with an ataxic CJD form, showing, in addition to severe cerebellar and hippocampal involvement, the presence of frequent Hirano bodies (HB) in CA1 pyramidal neurones. HB are frequently found in aged individuals with Alzheimer pathology although they are not a specific finding. AIMS AND METHODS: In this study, we evaluated the presence of HB in hippocampi of 54 genetically and molecularly characterized CJD cases, aiming to elucidate whether additional morphological features could be helpful to point to molecular subtypes. RESULTS: We identified nine cases (four VV1, one out of three MV2K, three out of six MV2K+2C and one MV carrying a 96-base pair insertion) with abundant, partly bizarre and clustered HB in CA1 sector, not observed in other subtypes. The presence of HB was independent of hippocampal involvement by the disease itself. CONCLUSIONS: Clusters of abundant HB might be found in rare CJD subtypes such as VV1, MV2K/MV2K+2C and some genetic cases. In addition to histopathological and PrP immunohistochemical deposition patterns, their presence might be a useful additional morphologic feature that could point to the molecular subtype, especially when genetic and/or Western blot analyses are not available.


Asunto(s)
Encéfalo/patología , Síndrome de Creutzfeldt-Jakob/clasificación , Síndrome de Creutzfeldt-Jakob/patología , Hipocampo/patología , Proteínas 14-3-3/líquido cefalorraquídeo , Adulto , Factores de Edad , Anciano , Western Blotting , Encéfalo/metabolismo , Síndrome de Creutzfeldt-Jakob/diagnóstico , Síndrome de Creutzfeldt-Jakob/metabolismo , Femenino , Hipocampo/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Proteínas PrPSc/metabolismo
14.
Rev Neurol ; 74(3): 83-92, 2022 02 01.
Artículo en Español | MEDLINE | ID: mdl-35084733

RESUMEN

INTRODUCTION: Neuropsychiatric symptoms are common in patients with mild cognitive impairment and dementia. This symptomatology can appear or be exacerbated with changes in routine and in the patient's usual environment. The lockdown situation during the COVID-19 pandemic has meant a drastic and unexpected change in the daily life of the general population, with a particular impact on the most physically and mentally vulnerable groups, including patients with cognitive impairment. AIM: To know the impact of lockdown measures imposed due to the COVID-19 pandemic on neuropsychiatric symptomatology in people with mild cognitive impairment and dementia. MATERIALS AND METHODS: Exploratory systematic review, in accordance with the PRISMA guidelines, of Pubmed and Psycinfo databases papers published from January 2020 to April 2021 which related confinement due to COVID-19 with the presentation or worsening of neuropsychiatric symptoms in patients with mild cognitive impairment mild or dementia. RESULTS: Worsening of neuropsychiatric symptoms was observed in patients with dementia and mild cognitive impairment, especially agitation/aggression, anxiety, depression and apathy. Neuropsychiatric symptoms were more common in patients with dementia than in those with mild cognitive impairment, although their typology varied depending on the severity of dementia. CONCLUSIONS: During lockdown a worsening in the psychobehavioral area has been observed in people with mild cognitive impairment or dementia. Therefore, considerations arise on the need of promoting social contact in people with mild cognitive impairment and dementia, avoiding situations of isolation and low stimulation.


TITLE: Síntomas neuropsiquiátricos en personas con demencia relacionados con el confinamiento por la pandemia de la COVID-19. Revisión sistemática exploratoria.Introducción. En pacientes con deterioro cognitivo leve y demencia, son frecuentes los síntomas neuropsiquiátricos, que pueden aparecer o exacerbarse ante los cambios en la rutina y el entorno habitual del paciente. La situación de confinamiento durante la pandemia de la COVID-19 ha supuesto un cambio en la vida cotidiana de la población general, con especial impacto en los grupos más vulnerables, como los pacientes con afectación cognitiva. Objetivo. Conocer la repercusión de las medidas de confinamiento y cuarentena impuestas por la pandemia de la COVID-19 en la sintomatología neuropsiquiátrica en personas con deterioro cognitivo leve (DCL) y demencia. Materiales y métodos. Revisión sistemática exploratoria, siguiendo las directrices PRISMA, de artículos en las bases datos PubMed y PsycINFO publicados entre enero de 2020 y abril de 2021, que relacionaron el confinamiento por la COVID-19 con la presentación o el empeoramiento de síntomas neuropsiquiátricos en pacientes con DCL o con demencia. Resultados. Se observó un empeoramiento de los síntomas neuropsiquiátricos en los pacientes con demencia y DCL, especialmente agitación/agresión, ansiedad, depresión y apatía. Los síntomas neuropsiquiátricos fueron más comunes en los pacientes con demencia que en los que presentaban DCL, aunque su tipología varió en función de la gravedad de la demencia. Conclusiones. Durante el confinamiento se ha objetivado un detrimento en la esfera psicoconductual en personas con DCL o demencia. Consecuentemente, surge la reflexión sobre la necesidad de fomentar el contacto social en las personas con DCL y demencia, evitando las situaciones de aislamiento y baja estimulación.


Asunto(s)
COVID-19/psicología , Disfunción Cognitiva/psicología , Demencia/psicología , Pandemias , Cuarentena/psicología , SARS-CoV-2 , Actividades Cotidianas , Agresión , Ansiedad/etiología , Apatía , Argentina , COVID-19/prevención & control , Depresión/etiología , Europa (Continente) , Humanos , Trastornos Mentales/etiología , Trastornos del Humor/etiología , Pruebas Neuropsicológicas , Agitación Psicomotora/etiología , Estudios Retrospectivos , Trastornos del Inicio y del Mantenimiento del Sueño/etiología , Aislamiento Social/psicología , Estados Unidos
15.
Rev Neurol ; 74(4): 107-116, 2022 02 16.
Artículo en Inglés, Español | MEDLINE | ID: mdl-35148419

RESUMEN

INTRODUCTION: Non-pharmacological intervention options, including individual reminiscence therapy (iRT), have been effective in improving cognitive functioning, mood, and quality of life (QoL) in persons with neurocognitive disorders (NCD). OBJECTIVES: A 13-week randomized trial intervention utilizing iRT was conducted on older adults with NCD. We explored predictors of participants with positive and non-positive intervention responses using responder analysis, an analytic strategy that focuses on contributors to intervention response. PATIENTS AND METHODS: Re-analysis of a published single-blind, multicentre, randomised controlled trial on 251 older adult residents with NCD from residential facilities across Portugal. Participants received 13 weeks of biweekly iRT (26 sessions) or treatment/programming as usual. Outcomes included global cognition (Minimental State Examination), memory (MAT), executive functioning (FAB), depressive symptoms (GDS-15), and QoL (QoL-AD). RESULTS: There were more responders in the intervention than the control group on all five criteria, with significant differences for cognition (p = 0.001; f = 0.202; NNT = 5) and memory (p = 0.004; f = 0.184; NNT = 6). At baseline, intervention responders vs non-responders had: higher QoL-AD scores (30.23 vs 25.57; p < 0.001; d = -0.774) for cognition; lower FAB scores (1.41 vs -2.12; p < 0.001; d = 0.928) for executive functioning; higher GDS-15 scores for the depressive symptoms (7.57 vs 4.91; p < 0.001; d = -0.845), and for QoL (6.81 vs 5.33; p = 0.013; d = -0.443). CONCLUSIONS: The iRT intervention showed high response rates for cognition and memory. Those with worse executive dysfunction, mood, and QoL, benefitted most from the intervention for those respective outcomes. Therefore, the presented iRT has beneficial effects for people with NCD, with mood and QoL as important influential factors.


TITLE: Ensayo aleatorio de terapia de reminiscencia individual para adultos mayores con deterioro cognitivo: un análisis de respuesta de tres meses.Introducción. La terapia de reminiscencia individual (iTR) ha demostrado mejorar la cognición, el estado de ánimo y la calidad de vida (CdV) de personas con trastornos neurocognitivos (TNC). Objetivo. Se exploraron los predictores de la respuesta positiva a la iTR utilizando el análisis de respuesta, una estrategia analítica de los factores que contribuyen a una respuesta a la intervención. Pacientes y métodos. Reanálisis de un ensayo controlado aleatorizado de 251 adultos mayores portugueses con TNC. Los participantes recibieron dos sesiones de iTR durante 13 semanas (26 sesiones) o el tratamiento habitual. Las variables analizadas fueron la cognición global (Minimental State Examination), la memoria (test de alteración de la memoria), el funcionamiento ejecutivo ­batería de evaluación frontal (FAB)­, los síntomas depresivos ­escala de depresión geriátrica-15 (GDS-15)­ y la CdV ­escala de calidad de vida en la enfermedad de Alzheimer (QOL-AD)­. Resultados. Hubo más respondedores en el grupo de intervención que en el de control en los cinco criterios, con diferencias significativas para cognición (p = 0,001; f = 0,202; número necesario para tratar = 5) y memoria (p = 0,004; f = 0,184; número necesario para tratar = 6). En la línea de base, los respondedores tenían: puntuaciones más altas de QOL-AD (30,23 frente a 25,57; p menor de 0,001; d = ­0,774) para la cognición; puntuaciones FAB más bajas (1,41 frente a ­2,12; p menor de 0,001; d = 0,928) para el funcionamiento ejecutivo; y mayores puntuaciones en la GDS-15 para los síntomas depresivos (7,57 frente a 4,91; p menor de 0,001; d = ­0,845) y para la CdV (6,81 frente a 5,33; p = 0,013; d = ­0,443). Conclusiones. La iTR mostró altas tasas de respuesta para la cognición y la memoria. Los que tienen peor función ejecutiva, estado de ánimo y CdV se beneficiaron más de la intervención para esas respectivas variables. La iTR tiene efectos beneficiosos en los TNC, con el estado de ánimo y la CdV como factores influyentes.


Asunto(s)
Disfunción Cognitiva/terapia , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Memoria , Psicoterapia , Método Simple Ciego , Factores de Tiempo , Resultado del Tratamiento
17.
Nat Med ; 4(9): 1058-61, 1998 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-9734400

RESUMEN

A high-fat diet increases the risk of colon, breast and prostate cancer. The molecular mechanism by which dietary lipids promote tumorigenesis is unknown. Their effects may be mediated at least in part by the peroxisome proliferator-activated receptors (PPARs). These ligand-activated nuclear receptors modulate gene expression in response to fatty acids, lipid-derived metabolites and antidiabetic drugs. To explore the role of the PPARs in diet-induced carcinogenesis, we treated mice predisposed to intestinal neoplasia with a synthetic PPARgamma ligand. Reflecting the pattern of expression of PPARgamma in the gastrointestinal tract, treated mice developed a considerably greater number of polyps in the colon but not in the small intestine, indicating that PPARgamma activation may provide a molecular link between a high-fat diet and increased risk of colorectal cancer.


Asunto(s)
Adenocarcinoma/fisiopatología , Poliposis Adenomatosa del Colon/fisiopatología , Receptores Citoplasmáticos y Nucleares/fisiología , Tiazolidinedionas , Factores de Transcripción/fisiología , Adenocarcinoma/patología , Poliposis Adenomatosa del Colon/patología , Animales , Cromanos/farmacología , Dieta , Humanos , Ligandos , Ratones , Ratones Endogámicos C57BL , Receptores Citoplasmáticos y Nucleares/metabolismo , Tiazoles/farmacología , Factores de Transcripción/metabolismo , Troglitazona
18.
Rev Neurol ; 73(1): 10-16, 2021 07 01.
Artículo en Español | MEDLINE | ID: mdl-34170003

RESUMEN

INTRODUCTION: Weakness is a frequent complication in those critically ill due to COVID-19. This study describes its characteristics and the factors that can condition and predict it. PATIENTS AND METHODS: We conducted a prospective, descriptive, observational study of patients admitted to the intensive care unit (ICU) due to COVID-19 between April and May 2020 with muscle weakness. A motor balance equal to or lower than 3/5 according to the modified Medical Research Council muscle strength scale was considered to be severe clinical impairment. Altogether 25 analytical studies, 16 neurophysiological studies and one muscle biopsy were performed, with a telephone follow-up at one month, a comparative analysis between the groups with and without severe compromise, and determination of cut-off points for analytical parameters to predict severe involvement using ROC curves. RESULTS: The sample consisted of 25 patients with a mean age of 58 years (standard deviation ± 9). The median length of stay in the ICU was 27.5 days. All the electromyograms exhibited a myogenic pattern and 75% also showed neuropathy. The group with severe clinical involvement had higher levels of D-dimer (p = 0.08), lactate dehydrogenase (p = 0.03) and interleukin-6 (p = 0.10), and the combination of the alteration of any two of these three parameters predicted severe involvement with a sensitivity of 100% and a specificity of 76.9%. At one month of follow-up, 36% were unable to walk autonomously and 92% continued with muscle weakness. CONCLUSIONS: Weakness in severe COVID-19 patients has a major clinical impact. Its early detection and study by means of predictors of its development may allow for better management. The absence in some cases of classical risk factors for ICU-acquired weakness suggests a different pathophysiology.


TITLE: Debilidad como complicación del paciente crítico por COVID-19: características clínicas y factores pronósticos en una serie de casos.Introducción. La debilidad es una complicación frecuente en el enfermo crítico por COVID-19. Se describen sus características, y los factores que pueden condicionarla y predecirla. Pacientes y métodos. Estudio observacional descriptivo prospectivo con pacientes ingresados en la unidad de cuidados intensivos (UCI) por COVID-19 entre abril y mayo de 2020 con debilidad muscular. Se consideró una afectación clínica grave un equilibrio motor igual o inferior a 3/5 según la escala de fuerza muscular modificada del Medical Research Council. Se han realizado 25 estudios analíticos, 16 estudios neurofisiológicos y una biopsia muscular; seguimiento telefónico al mes; análisis comparativo entre los grupos con y sin afectación grave, y determinación de puntos de corte de parámetros analíticos para predecir afectación grave mediante curvas ROC. Resultados. Se incluyó a 25 pacientes con 58 años (desviación estándar ± 9) de edad media. La mediana de estancia en la UCI fue de 27,5 días. Todos los electromiogramas mostraban un patrón miógeno y el 75%, también una neuropatía. El grupo con afectación clínica grave tenía mayores niveles de dímero-D (p = 0,08), lactato deshidrogenasa (p = 0,03) e interleucina 6 (p = 0,10), y la combinación de la alteración de dos cualquiera de estos tres parámetros pronosticaba la afectación grave con una sensibilidad del 100% y una especificidad del 76,9%. Al mes de seguimiento, el 36% no podía deambular autónomamente y el 92% seguía con debilidad muscular. Conclusiones. La debilidad en el enfermo por COVID-19 grave tiene una repercusión clínica importante. Su detección y estudio precoces mediante predictores de su desarrollo pueden permitir un mejor manejo. La ausencia en algunos casos de los factores de riesgo clásicos para la debilidad adquirida en la UCI sugiere una fisiopatología diferente.


Asunto(s)
COVID-19/complicaciones , Debilidad Muscular/diagnóstico , Debilidad Muscular/etiología , Adulto , Anciano , Enfermedad Crítica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos
19.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33636161

RESUMEN

The development of perianal ulcers related to the use of a hemorrhoidal ointment has not been reported in the literature. We describe a series of 11 patients who were treated for perianal ulcers in 10 Spanish hospitals after they used the same ointment containing the active ingredients triamcinolone acetonide, lidocaine, and pentosan polysulfate sodium. No prior or concomitant conditions suggesting an alternative cause for the condition could be identified, and after the patients stopped using the ointment, their ulcers cleared completely in 8 weeks on average. This case series shows the damage that can be caused by an over-the-counter pharmaceutical product used without medical follow-up. It also illustrates the need to ask patients with perianal ulcers about any topical agents used before the lesions appeared.

20.
Rev Neurol ; 68(5): 190-198, 2019 Mar 01.
Artículo en Español | MEDLINE | ID: mdl-30805917

RESUMEN

INTRODUCTION: There is a growing need for scientific studies and tools that allow the evaluation of the effects at an affective level of some non-pharmacological therapies for people with dementia such as the creative therapeutic dance. AIMS: To explore the validity and reliability of the Profile of Mood States (POMS) in people with dementia and to analyse the possible differences in the scores of the participants before and after sessions of creative therapeutic dance. PATIENTS AND METHODS: POMS was administered to 36 people with dementia before and after four group sessions of creative therapeutic dance. To verify the construct validity, PANAS and STAXI-2 were also administered. RESULTS: The POMS presented a good internal consistency for each factor and an excellent one for the total scale. The temporal stability was medium-high. Convergent validity results support construct validity. After the creative therapeutic dance sessions, POMS factors tension, depression and confusion were reduced, while vigour increased significantly. There was no effect on fatigue and anger. CONCLUSIONS: The validity and reliability of POMS have been demonstrated in a population with dementia. Creative therapeutic dance can offer emotional benefits for people with dementia.


TITLE: Propiedades psicometricas del Profile of Mood States (POMS) en personas con demencia y su aplicacion en la evaluacion de los efectos de la danza creativa terapeutica.Introduccion. Existe una creciente necesidad de estudios cientificos e instrumentos que permitan evaluar los efectos en el plano afectivo de algunas terapias no farmacologicas para personas con demencia, como la danza creativa terapeutica. Objetivos. Determinar la validez y fiabilidad del Profile of Mood States (POMS) en personas con demencia y analizar las posibles diferencias en las puntuaciones de los participantes antes y despues de sesiones de danza creativa terapeutica. Pacientes y metodos. El POMS se administro a 36 personas con demencia antes y despues de cuatro sesiones grupales de danza creativa terapeutica. Para comprobar la validez de constructo se administraron dos cuestionarios autoinformados (PANAS y STAXI-2). Resultados. El POMS presento una buena consistencia interna para cada factor y excelente para la escala total. La estabilidad temporal fue media-alta. Los resultados de validez convergente apoyan la validez de constructo. Despues de las sesiones de danza creativa terapeutica, los factores tension, depresion y confusion del POMS se redujeron, mientras que el factor vigor aumento significativamente. No hubo ningun efecto sobre la fatiga y la colera. Conclusiones. Se ha demostrado la validez y fiabilidad del POMS en una poblacion con demencia. La danza creativa terapeutica puede ofrecer beneficios emocionales para personas con demencia.


Asunto(s)
Afecto , Danzaterapia , Demencia/psicología , Adulto , Anciano , Anciano de 80 o más Años , Demencia/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Autoinforme , Resultado del Tratamiento
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA