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The impact of concurrent fatty liver (FL) on response to antiviral therapy in chronic hepatitis B (CHB) patients has not been well characterized. We aimed to systematically review and analyse antiviral treatment response in CHB patients with and without FL. We searched PubMed, Embase, Web of Science and the Cochrane Library databases from inception to 31 May 2023 for relevant studies. Biochemical response (BR), complete viral suppression (CVS) and hepatitis B e antigen (HBeAg) seroconversion in CHB patients with FL (CHB-FL) and without FL (non-FL CHB) were compared. In an initial pool of 2101 citations, a total of 10 studies involving 2108 patients were included. After 12 weeks of treatment, CHB-FL patients as compared with non-FL CHB patients had lower BR rate (48.37% [108/227] vs. 72.98% [126/174], p = .04) but similar trend for CVS (36.86% [80/227] vs. 68.81% [114/174], p = .05) and similar rates of HBeAg seroconversion (6.59% [7/103] vs. 7.40% [7/110], p = .89). However, at week 48, there were no statistically significant differences between CHB-FL and non-FL CHB patients in any of the outcomes, including BR (60.03% [213/471] vs. 69.37% [314/717], p = .67), CVS (65.63% [459/746] vs. 73.81% [743/1132], p = .27) and HBeAg seroconversion (10.01% [30/275] vs. 14.06% [65/453], p = .58) with similar findings for week 96. BR rate was lower in CHB-FL patients after 12 weeks of antiviral treatment. However, after a longer follow-up of either 48 or 96 weeks, no statistically significant differences were observed in BR, CVS or HBeAg seroconversion rates between CHB patients with and without FL.
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Antivirales , Hígado Graso , Antígenos e de la Hepatitis B , Hepatitis B Crónica , Humanos , Hepatitis B Crónica/tratamiento farmacológico , Antivirales/uso terapéutico , Antígenos e de la Hepatitis B/sangre , Resultado del Tratamiento , Seroconversión , Virus de la Hepatitis B/inmunología , Virus de la Hepatitis B/efectos de los fármacos , ADN Viral/sangreRESUMEN
PURPOSE: Guidelines recommend low-molecular-weight heparins (LMWHs) for patients with cancer-associated thrombosis. However, until recently, only dalteparin and tinzaparin were approved in the European Economic Area (EEA) for these patients. This study compares the benefit-risk profile of enoxaparin with dalteparin and tinzaparin for the extended treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrence in adult patients with active cancer. METHODS: A semi-quantitative structured benefit-risk assessment was conducted for the label-extension application of enoxaparin based on the benefit-risk action team descriptive framework: define decision context; determine key benefit and risk outcomes; identify data sources; extract data; interpret results. RESULTS: The key benefits were defined as reduced all-cause mortality and venous thromboembolism (VTE) recurrence (including symptomatic DVT, fatal PE or non-fatal PE); the key risks were major and non-major bleeding of clinical significance, and heparin-induced thrombocytopenia (HIT). Enoxaparin demonstrated comparable effects for the reduction of VTE recurrence and all-cause mortality versus other EEA-approved LMWHs (dalteparin, tinzaparin). There was no evidence of a significant difference between enoxaparin and the comparator groups with regard to incidence of major and non-major bleeding. The data on HIT were too limited to assess the difference between the two groups. CONCLUSIONS: The assessment demonstrated a favourable benefit-risk profile for enoxaparin similar to that of other EEA-approved LMWHs for the treatment of DVT and PE and the prevention of recurrence in patients with active cancer and thus supported the label-extension approval.
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Dalteparina , Enoxaparina , Heparina de Bajo-Peso-Molecular , Neoplasias , Embolia Pulmonar , Tinzaparina , Trombosis de la Vena , Humanos , Enoxaparina/administración & dosificación , Enoxaparina/efectos adversos , Enoxaparina/uso terapéutico , Embolia Pulmonar/prevención & control , Embolia Pulmonar/tratamiento farmacológico , Trombosis de la Vena/prevención & control , Trombosis de la Vena/tratamiento farmacológico , Medición de Riesgo , Neoplasias/tratamiento farmacológico , Neoplasias/complicaciones , Dalteparina/administración & dosificación , Dalteparina/efectos adversos , Dalteparina/uso terapéutico , Tinzaparina/administración & dosificación , Tinzaparina/uso terapéutico , Heparina de Bajo-Peso-Molecular/administración & dosificación , Heparina de Bajo-Peso-Molecular/efectos adversos , Heparina de Bajo-Peso-Molecular/uso terapéutico , Anticoagulantes/administración & dosificación , Anticoagulantes/efectos adversos , Anticoagulantes/uso terapéutico , Prevención Secundaria/métodos , Hemorragia/inducido químicamente , AdultoRESUMEN
BACKGROUND: Atopic dermatitis (AD, eczema) is driven by a combination of skin barrier defects, immune dysregulation, and extrinsic stimuli such as allergens, irritants, and microbes. The role of environmental allergens (aeroallergens) in triggering AD remains unclear. OBJECTIVE: We systematically synthesized evidence regarding the benefits and harms of allergen immunotherapy (AIT) for AD. METHODS: As part of the 2022 American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology Joint Task Force on Practice Parameters AD Guideline update, we searched the MEDLINE, EMBASE, CENTRAL, CINAHL, LILACS, Global Resource for Eczema Trials, and Web of Science databases from inception to December 2021 for randomized controlled trials comparing subcutaneous immunotherapy (SCIT), sublingual immunotherapy (SLIT), and/or no AIT (placebo or standard care) for guideline panel-defined patient-important outcomes: AD severity, itch, AD-related quality of life (QoL), flares, and adverse events. Raters independently screened, extracted data, and assessed risk of bias in duplicate. We synthesized intervention effects using frequentist and Bayesian random-effects models. The GRADE approach determined the quality of evidence. RESULTS: Twenty-three randomized controlled trials including 1957 adult and pediatric patients sensitized primarily to house dust mite showed that add-on SCIT and SLIT have similar relative and absolute effects and likely result in important improvements in AD severity, defined as a 50% reduction in SCORing Atopic Dermatitis (risk ratio [95% confidence interval] 1.53 [1.31-1.78]; 26% vs 40%, absolute difference 14%) and QoL, defined as an improvement in Dermatology Life Quality Index by 4 points or more (risk ratio [95% confidence interval] 1.44 [1.03-2.01]; 39% vs 56%, absolute difference 17%; both outcomes moderate certainty). Both routes of AIT increased adverse events (risk ratio [95% confidence interval] 1.61 [1.44-1.79]; 66% with SCIT vs 41% with placebo; 13% with SLIT vs 8% with placebo; high certainty). AIT's effect on sleep disturbance and eczema flares was very uncertain. Subgroup and sensitivity analyses were consistent with the main findings. CONCLUSIONS: SCIT and SLIT to aeroallergens, particularly house dust mite, can similarly and importantly improve AD severity and QoL. SCIT increases adverse effects more than SLIT. These findings support a multidisciplinary and shared decision-making approach to optimally managing AD.
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Asma , Dermatitis Atópica , Eccema , Hipersensibilidad , Inmunoterapia Sublingual , Adulto , Animales , Humanos , Niño , Dermatitis Atópica/tratamiento farmacológico , Calidad de Vida , Teorema de Bayes , Desensibilización Inmunológica/efectos adversos , Pyroglyphidae , Hipersensibilidad/etiología , Asma/tratamiento farmacológico , Alérgenos/uso terapéutico , Inmunoterapia Sublingual/efectos adversos , Dermatophagoides pteronyssinusRESUMEN
BACKGROUND: Concern about disease exacerbations and fear of reactions after coronavirus disease 2019 (COVID-19) vaccinations are common in chronic urticaria (CU) patients and may lead to vaccine hesitancy. OBJECTIVE: We assessed the frequency and risk factors of CU exacerbation and adverse reactions in CU patients after COVID-19 vaccination. METHODS: COVAC-CU is an international multicenter study of Urticaria Centers of Reference and Excellence (UCAREs) that retrospectively evaluated the effects of COVID-19 vaccination in CU patients aged ≥18 years and vaccinated with ≥1 dose of any COVID-19 vaccine. We evaluated CU exacerbations and severe allergic reactions as well as other adverse events associated with COVID-19 vaccinations and their association with various CU parameters. RESULTS: Across 2769 COVID-19-vaccinated CU patients, most (90%) received at least 2 COVID-19 vaccine doses, and most patients received CU treatment and had well-controlled disease. The rate of COVID-19 vaccination-induced CU exacerbation was 9%. Of 223 patients with CU exacerbation after the first dose, 53.4% experienced recurrence of CU exacerbation after the second dose. CU exacerbation most often started <48 hours after vaccination (59.2%), lasted for a few weeks or less (70%), and was treated mainly with antihistamines (70.3%). Factors that increased the risk for COVID-19 vaccination-induced CU exacerbation included female sex, disease duration shorter than 24 months, having chronic spontaneous versus inducible urticaria, receipt of adenovirus viral vector vaccine, having nonsteroidal anti-inflammatory drug/aspirin intolerance, and having concerns about getting vaccinated; receiving omalizumab treatment and Latino/Hispanic ethnicity lowered the risk. First-dose vaccine-related adverse effects, most commonly local reactions, fever, fatigue, and muscle pain, were reported by 43.5% of CU patients. Seven patients reported severe allergic reactions. CONCLUSIONS: COVID-19 vaccination leads to disease exacerbation in only a small number of CU patients and is generally well tolerated.
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COVID-19 , Urticaria Crónica , Urticaria , Humanos , Femenino , Adolescente , Adulto , Vacunas contra la COVID-19/efectos adversos , COVID-19/prevención & control , Estudios Retrospectivos , Urticaria/tratamiento farmacológico , Vacunación/efectos adversosRESUMEN
We assessed tecovirimat treatment equity for 3,740 mpox patients in New York, New York, USA, during the 2022 mpox emergency; 32.4% received tecovirimat. Treatment rates by race/ethnicity were 38.8% (White), 31.3% (Black/African American), 31.0% (Hispanic/Latino), and 30.1% (Asian/Pacific Islander/other). Future public health emergency responses must prioritize institutional and structural racism mitigation.
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Antivirales , Mpox , Humanos , Hispánicos o Latinos/estadística & datos numéricos , Mpox/epidemiología , Mpox/etnología , Mpox/terapia , New York/epidemiología , Factores Socioeconómicos , Factores Raciales/estadística & datos numéricos , Blanco/estadística & datos numéricos , Negro o Afroamericano/estadística & datos numéricos , Asiático Americano Nativo Hawáiano y de las Islas del Pacífico/estadística & datos numéricos , Antivirales/uso terapéuticoRESUMEN
BACKGROUND & AIMS: Due to ageing of the global population, hepatocellular carcinoma (HCC) is increasingly common among elderly patients, but outcomes after curative hepatic resection are unclear. Using a metanalytic approach, we aimed to estimate overall survival (OS), recurrence free survival (RFS) and complication rates in elderly HCC patients undergoing resection. METHODS: We searched PubMed, Embase, and Cochrane databases from inception to Nov 10, 2020 for studies reporting outcomes in elderly (age ≥ 65 years) patients with HCC undergoing curative surgical resection. Pooled estimates were generated using a random-effects model. RESULTS: We screened 8,598 articles and included 42 studies (7,778 elderly patients). The mean age was 74.45 years (95% CI 72.89-76.02), 75.54% were male (95% CI 72.53-78.32) and 66.73% had cirrhosis (95% CI 43.93-83.96). The mean tumor size was 5.50 cm (95% CI 4.71-6.29) and 16.01% had multiple tumors (95% CI 10.74-23.19). The 1-year (86.02% versus 86.66%, p=0.84) and 5-year OS (51.60% versus 53.78%) between non-elderly versus elderly patients were similar. Likewise, there were no differences in the 1-year (67.32% versus 73.26%, p=0.11) and 5-year RFS (31.57% versus 30.25%, p=0.67) in non-elderly versus elderly patients. There was a higher rate of minor complications (21.95% versus 13.71%, p=0.03) among elderly patients compared with non-elderly patients, but no difference in major complications (p=0.43) Conclusion: This data shows that overall survival, recurrence and major complications after liver resection for HCC are comparable between elderly and non-elderly patients, and may inform clinical management of HCC in this population.
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Hydrogen peroxide (H2O2) plays a role in many facets - a household item, an important industrial chemical, a biomarker in vivo, and several others. For this reason, its measurement and quantification in a variety of media are important. While spectroscopic detection is primarily used for H2O2, electrochemical methods offer advantages in versatility, cost, and sensitivity. In this work, we investigate a 2-step surface metal nanoparticle (NP) modification for platinum (Pt) and palladium (Pd) on boron-doped diamond (BDD) electrodes for the detection of H2O2. Several parameters such as the metal salt concentration and electrodeposition charge in the 2-step modification were varied to find an optimum. Using cyclic voltammetry (CV), the BDD-PdNP electrode types were found to yield a sharper, more well-resolved H2O2 oxidation peak compared to the BDD-PtNP electrodes. Both metal NP electrode types significantly improved the response compared to the bare BDD electrode; a 150-200× improvement in sensitivity was observed across all modified electrode types. Calibration experiments were completed at both low and high concentration ranges in stagnant and flow-based solutions. The lowest limit of detection (LOD) obtained was 50 nM (5E-08 M) on a BDD-PdNP electrode modified with 1.0 mM PdCl2 to 5.0 mC in the wet chemical seeding and electrodeposition steps. 0.25 mM PdCl2 to 3.23 mC and 0.25 mM HPtCl6- to 3.23 mC also yielded a sufficient response for low-level H2O2, with LODs around 100 nM (1E-07 M). Overall, this work exemplifies the wide applicability of BDD and achieves sub-µM H2O2 LODs with a non-enzymatic electrode material.
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BACKGROUND: Immunization with live attenuated viral yellow fever vaccine (YFV) grants effective immunity in most cases, and is recommended and prioritized for residents and travelers of endemic countries. YFV is seldom administered to egg-allergic patients (EAP) since it is cultivated in embryonated chicken eggs and may contain residual egg proteins, being a problem for egg-allergic residents and travelers of endemic countries. OBJECTIVE: Describe the frequency of allergic reactions after YFV administration in confirmed EAP from an allergy outpatient center in Bogotá, Colombia. METHODS: An observational, retrospective, cross-sectional, and descriptive study was conducted from January 2017 to December 2019. EAP whose allergy was confirmed with a positive Skin Prick Test (SPT) and/or egg protein-specific IgE levels who hadn't received the YFV were included. Every patient had an SPT, severe EAP, and an additional Intradermal Test (IDT) done with the vaccine. If the vaccine SPT and IDT were negative, the YFV was administered as a single dose; if either were positive, the YFV was administered in graded doses. Statistical analysis was done in Stata16MP. RESULTS: Seventy one patients were included, 24 (33.8%) of those had a history of egg anaphylaxis. All patients had negative YFV SPTs, and two of the five YVF IDTs were positive. Two patients, with previous egg-anaphylaxis, presented allergic reactions to the vaccine. CONCLUSIONS: YFV did not trigger allergic reactions in EAP without history of egg-anaphylaxis. With further research, safe single-dose vaccination to this population could be considered; however, patients with previous egg-anaphylaxis should be evaluated by an allergist before vaccination.
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Anafilaxia , Hipersensibilidad al Huevo , Proteínas del Huevo , Vacuna contra la Fiebre Amarilla , Humanos , Estudios Transversales , Hipersensibilidad al Huevo/epidemiología , Proteínas del Huevo/efectos adversos , Estudios Retrospectivos , Vacunas , Vacuna contra la Fiebre Amarilla/efectos adversosRESUMEN
BACKGROUND: Tropics have some particularities that can impact the natural history and factors associated with allergic diseases. However, few studies described the characteristics of patients with allergic rhinitis (AR) and combined AR and asthma syndrome (CARAS) in Latin American tropical countries. OBJECTIVE: This study aimed to determine the medical, social, and environmental factors associated with AR and CARAS in children aged 5-18 years treated with immunotherapy in two allergy referral centers in Bogotá (Colombia). MATERIAL: and methods: An observational, cross-sectional study was conducted between January 2018 and January 2019. International Study Asthma Allergies Childhood-III and sociodemographic questionnaires were applied to adolescents and parents of children undergoing immunotherapy at the allergy consult in the Hospital Universitario Fundación Santa Fe de Bogotá and UNIMEQ-ORL. RESULTS: Among 830 children aged 5-18 years, 38.1% (n = 316) were women. Up to 63.25% of the population had a positive skin prick test for house dust mites: 63.25% for Dermatophagoides pteronyssinus, 61.81% for Dermatophagoides farinae, and 31.57% for Blomia tropicalis. The factors associated with AR were male sex (PR: 1.31, 95% CI: 1.08-1.57), antibiotic consumption during the first year of life (PR: 0.80; 95% CI: 0.63-0.99), and exposure to dogs (PR: 1.32; 95% CI: 1.06-2.66). The factors associated with CARAS were older age (PR=0.95; 95% CI: 0.95-0.99), acetaminophen consumption over four times a year (PR: 1.31; 95% CI: 1.03-1.55), and antibiotic consumption during the first year of life (PR: 1.21; 95% CI: 1.06-1.34). CONCLUSION: A high prevalence of B. tropicalis was found in this study. The factors associated with AR and CARAS are like those described in high-income tropical countries. Further studies are needed in low- or middle-income tropical countries to identify modifiable factors associated with allergic diseases.
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Asma , Rinitis Alérgica , Rinitis , Animales , Perros , Femenino , Masculino , Antígenos Dermatofagoides , Asma/epidemiología , Asma/terapia , Estudios Transversales , Inmunoterapia , Pyroglyphidae , Rinitis/epidemiología , Rinitis Alérgica/epidemiología , Rinitis Alérgica/terapia , Pruebas Cutáneas , Humanos , Preescolar , Niño , AdolescenteRESUMEN
BACKGROUND: Allergic diseases affect about 10-30% of the population in low- or middle-income tropical countries. Few studies describe the factors associated with allergic diseases in adult patients undergoing immunotherapy in Latin American countries. OBJECTIVE: This study aimed to determine the factors associated with allergic rhinitis (AR) and AR in comorbidity with asthma (CARAS) in adults treated with immunotherapy in two allergy referral centers in Bogotá (Colombia). MATERIAL AND METHODS: Observational, cross-sectional study conducted between January 2018 and January 2019. ISAAC-III and sociodemographic questionnaires were applied to determine the factors associated with AR and CARAS in adults treated with immunotherapy who attended the allergy consult at the Fundación Santa Fe de Bogotá and Unimeq-Orl. RESULTS: Among 416 adults aged 18-68 years, 71.4% (n = 297) were women. Regarding the sensitization results obtained by skin prick test, the most frequent allergens were house dust mites (64.18%): 49.03% were positive for both Dermatophagoides pteronyssinus and Dermatophagoides farinae, while 28.61% were positive for Blomia tropicalis. Excluding house dust mites, the most frequent allergens were dog hair (31.01%), cat hair (15.1%), grasses (15.9%), and food (15.9%). The main factor associated with exclusive AR was regular acetaminophen use more than four times a year: Prevalence ratio (PR) = 1.77 (95% CI: 1.12-2.25). The main factor associated with CARAS was cesarean delivery PR: 1.44 (95% CI: 1.09-1.78). CONCLUSION: The main factor associated with AR was regular acetaminophen use, while that associated with CARAS was cesarean delivery. The ISAAC-III questionnaire can be a useful low-cost tool to assess the factors associated with allergic diseases in adults in tropical countries.
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Asma , Rinitis Alérgica , Adolescente , Adulto , Anciano , Animales , Perros , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Acetaminofén , Alérgenos/efectos adversos , Asma/epidemiología , Asma/terapia , Estudios Transversales , Inmunoterapia , Pyroglyphidae , Rinitis Alérgica/epidemiología , Pruebas Cutáneas/métodos , Encuestas y CuestionariosRESUMEN
CNTs/Fe-BTC composite materials were synthesized with the one-step solvothermal method. MWCNTs and SWCNTs were incorporated in situ during synthesis. The composite materials were characterized by different analytical techniques and used in the CO2-photocatalytic reduction to value-added products and clean fuels. In the incorporation of CNTs into Fe-BTC, better physical-chemical and optical properties were observed compared to Fe-BTC pristine. SEM images showed that CNTs were incorporated into the porous structure of Fe-BTC, indicating the synergy between them. Fe-BTC pristine showed to be selective to ethanol and methanol; although, it was more selective to ethanol. However, the incorporation of small amounts of CNTs into Fe-BTC not only showed higher production rates but changes in the selectivity compared with the Fe-BTC pristine were also observed. It is important to mention that the incorporation of CNTs into MOF Fe-BTC allowed for increasing the mobility of electrons, decreasing the recombination of charge carriers (electron/hole), and increasing the photocatalytic activity. In both reaction systems (batch and continuous), composite materials showed to be selective towards methanol and ethanol; however, in the continuous system, lower production rates were observed due to the decrease in the residence time compared to the batch system. Therefore, these composite materials are very promising systems to convert CO2 to clean fuels that could replace fossil fuels soon.
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BACKGROUND: The COVID-19 pandemic has placed an unprecedented physical and mental burden on healthcare workers who are frequently at high risk of infection, particularly in low-income countries. This study aimed to assess the prevalence and associated factors of anxiety, depression, and stress, as well as changes in daily and occupational activities among healthcare professionals due to the COVID-19 pandemic in Colombia. METHODS: An observational, cross-sectional study was conducted between February and June 2021. The survey incorporated validated mental health tools such as the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, and the Perceived Stress Scale-10. Multivariable ordinal logistic regression analysis was performed to determine the factors associated with severe mental health outcomes. RESULTS: Among 1345 healthcare workers the prevalence of anxiety, depression, and stress were 75.61, 59.18, and 53.09%, respectively. Anxiety (OR:1.44; 95%CI:1.16-1.8), depression (OR:1.74; 95%CI:1.27-2.37), and stress (OR:1.51; 95%CI:1.18-1.94) were more frequent in women, and individuals who expressed fear of a negative outcome (death, sequelae) (OR:2.25; 95%CI:1.60-3.25), (OR:1.49; 95%CI:1.03-2.16) and (OR:2.36; 95%CI:1.69-3.29) respectively. Age was negatively associated with anxiety (OR:0.98; 95%CI:0.98-0.99), stress (OR:0.98; 95%CI:0.97-0.99), and depression (OR:0.97; 95% CI:0.96-0.98). Reduction in consultations and surgeries (OR:1.01; 95%CI:1.0-1.01) was positively associated with anxiety. Due to the pandemic, most specialists expected to incorporate drastic long-term (> 1 year) changes in their clinical setting and daily activities. CONCLUSIONS: The prevalence of anxiety, depression, and stress is higher among Colombian healthcare workers compared to previous reports. Further research regarding these psychological outcomes is needed to achieve early mental health intervention strategies. TRIAL REGISTRATION: Hospital Universitario Fundación Santa Fe, Ethical Committee Registration ID: CCEI-12992-2021.
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COVID-19 , Humanos , Femenino , COVID-19/epidemiología , Pandemias , Salud Mental , Colombia/epidemiología , SARS-CoV-2 , Estudios Transversales , Depresión/epidemiología , Personal de Salud/psicología , Ansiedad/epidemiologíaRESUMEN
BACKGROUND: The allergic phenotype is responsible for more than 50% of severe asthma cases. In a stepwise approach, add-on treatments such as anti-IgE are used for severe allergic asthma (SAA). This study was aimed to describe the real-world effectiveness of omalizumab in adult and pediatric patients with SAA in Colombia. METHODS: This was an observational, non-interventional, retrospective study. Data from patients with SAA that received at least one month of treatment with omalizumab was obtained from medical records at eight sites in Colombia. Time-zero (t - 0) was defined as the date of initiation of omalizumab, and data was gathered for a 12-month period before t - 0 and a 12-month period after t - 0. Clinical outcomes, including exacerbations, were assessed at 6 and 12 months. Effectiveness of omalizumab was evaluated in terms of the reduction of the risk of exacerbations (annualized rate). RESULTS: We included 143 patients with SAA. There was a decrease of 72.4% of the annualized rate of clinically significant asthma exacerbations during the year after omalizumab (from 1.74 before to 0.48 after) with a substantial reduction of the risk of exacerbations by 56.7% (RR [95% CI] 0.43 [0.30-0.63] p < 0,001). CONCLUSION: The use of omalizumab in Colombia as a treatment for SAA notably reduced the risk of clinically significant exacerbations. This study is the first to evaluate omalizumab real-life effectiveness in pediatric and adult patients in the country.
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Antiasmáticos , Asma , Hipersensibilidad , Humanos , Omalizumab/uso terapéutico , Antiasmáticos/uso terapéutico , Estudios Retrospectivos , Colombia , Resultado del Tratamiento , Asma/tratamiento farmacológicoRESUMEN
INTRODUCTION: Chronic spontaneous urticaria (CSU) is an inflammatory skin disease related to poor quality of life. Previous studies have found that vitamin D deficiency and vitamin D receptor (VDR) TaqI, BsmI, FokI, and ApaI gene single-nucleotide polymorphisms (SNPs) influence immune response and susceptibility to skin disorders. AIM: To explore the role of VDR SNPs, and the association of vitamin D serum levels in a sample of Colombian Caribbean CSU patients. Methods: It is a case-control study. A group of CSU patients (n = 100) was compared with healthy individuals as a control group (n = 100). VDR polymorphisms were genotyped by quantitative polymerase chain reaction and Taqman® probes. Allelic, genotypic, and haplotype associations were estimated. Serum vitamin D levels were measured using enzyme-linked-immunosorbent serologic assay. RESULTS: Compared to the control group, the presence of G allele in TaqI and A allele in FokI SNPs of VDR gene was found to be a risk factor for CSU (odds ratio (OR) estimated using logistic regression adjusted by gender: 2.08 and 1.61, respectively, all P values < 0.05). The individuals who carry GCCA haplotype showed decrease in vitamin D levels (11.34 ng/mL; P = 0.002) with the G allele of TaqI and A allele of FokI gene SNPs. CONCLUSION: We reported for the first time the association of TaqI [rs731236] and FokI [rs2228570] VDR gene SNPs showing as a risk factor for CSU in a sample of multiethnic patients from the Colombian Caribbean population.
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Urticaria Crónica , Predisposición Genética a la Enfermedad , Humanos , Estudios de Casos y Controles , Calidad de Vida , Colombia/epidemiología , Polimorfismo de Nucleótido Simple , Genotipo , Vitamina D , Receptores de Calcitriol/genéticaRESUMEN
BACKGROUND: Hyperbaric oxygen (HBO2) therapy has been proposed to treat hypoxaemia and reduce inflammation in COVID-19. Our objective was to analyse safety and efficacy of HBO2 in treatment of hypoxaemia in patients with COVID-19 and evaluate time to hypoxaemia correction. METHODS: This was a multicentre, open-label randomised controlled trial conducted in Buenos Aires, Argentina, between July and November 2020. Patients with COVID-19 and severe hypoxaemia (SpO2 ≤90% despite oxygen supplementation) were assigned to receive either HBO2 treatment or the standard treatment for respiratory symptoms for 7 days. HBO2 treatment was planned for ≥5 sessions (1 /day) for 90 min at 1.45 atmosphere absolute (ATA). Outcomes were time to normalise oxygen requirement to SpO2 ≥93%, need for mechanical respiratory assistance, development of acute respiratory distress syndrome and mortality within 30 days. A sample size of 80 patients was estimated, with a planned interim analysis after determining outcomes on 50% of patients. RESULTS: The trial was stopped after the interim analysis. 40 patients were randomised, 20 in each group, age was 55.2±9.2 years. At admission, frequent symptoms were dyspnoea, fever and odynophagia; SpO2 was 85.1%±4.3% for the whole group. Patients in the treatment group received an average of 6.2±1.2 HBO2 sessions. Time to correct hypoxaemia was shorter in treatment group versus control group; median 3 days (IQR 1.0-4.5) versus median 9 days (IQR 5.5-12.5), respectively (p<0.010). OR for recovery from hypoxaemia in the HBO2 group at day 3 compared with the control group was 23.2 (95% CI 1.6 to 329.6; p=0.001) Treatment had no statistically significant effect on acute respiratory distress syndrome, mechanical ventilation or death within 30 days after admission. CONCLUSION: Our findings support the safety and efficacy of HBO2 in the treatment of COVID-19 and severe hypoxaemia. TRIAL REGISTRATION NUMBER: NCT04477954.
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COVID-19 , Oxigenoterapia Hiperbárica , Humanos , Hipoxia/etiología , Hipoxia/terapia , Persona de Mediana Edad , Oxígeno , SARS-CoV-2RESUMEN
Composite materials based on titania nanoparticles (TiO2 NPs) and three metal-organic frameworks (MOFs) called MIL-53 (Fe) ((Fe (III) (OH) (1,4-BDC)), MILs (Materials Institute Lavoisier)), MIL-100 (Fe) (Fe3O(H2O)2OH(BTC)2), and Fe-BTC (iron-benzenetricarboxylate) with different percentages of TiO2 NPs (0.5, 1, and 2.5% wt.) were synthesized using the solvothermal method and used as photocatalytic materials in the degradation of two dyes (Orange II and Reactive Black 5 (RB5)). The pristine and composite materials were characterized with X-ray diffraction, Raman, UV-Vis and Fourier transform infrared spectroscopy and scanning electron microscopy techniques. The 2.5TiO2/MIL-100 composite material showed the best results for the degradation of both dyes (Reactive Black 5 and Orange II dye, 99% and 99.5% degradation in 105 and 150 min, respectively). The incorporation of TiO2 NPs into MOFs can decrease the recombination of the change carrier in the MOF, increasing the photocatalytic activity of a pristine MOF. Results therefore indicated that the synthesized MOF nanocomposites have good potential for wastewater treatment.
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Estructuras Metalorgánicas , Nanopartículas , Colorantes/química , Hierro/química , Estructuras Metalorgánicas/químicaRESUMEN
Xanthosoma sagittifolium and Colocasia esculenta contain high levels of nutrients; but have naturally toxic compounds, oxalates and hydrocyanic acid (HCN). The objective of this work was to evaluate the effect of heat treatment on the concentration of antinutrients in malanga corms and its effect on mice. Malanga samples were heated to a boil for 0 to 120 min; oxalates and HCN were determined by spectrophotometry, at 710 and 510 nm, respectively. Pellets were prepared from raw malanga flour (15 and 50%), cooked malanga (15 and 50%) and wheat flour (control) and fed for nine weeks to five groups of six mice each. Cooking of X. sagittifolium corms for 80 min reduced oxalates present by 75% (143 to 35.6 mg/100 g sample), while oxalates in C. esculenta were reduced by 83% (345 to 57.8 mg/100 g sample). HCN levels became negligible after 20 min of cooking. During the nine weeks of feeding the different mice groups showed no significant difference (p > 0.05) between initial and final weight, with respect of the control; mice did not lose their appetite. The results indicate that the consumption of cooked malanga does not pose an evident risk to health, assessed by the reduced level of antinutrients, being an excellent alternative for feeding people in communities with prevalence of food insecurity.
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BACKGROUND: Epidemiological evidence associates chronic exposure to particulate matter (PM) with respiratory damage and lung cancer. Inhaled PM may induce systemic effects including inflammation and metastasis. This study evaluated whether PM induces expression of adhesion molecules in lung cancer cells promoting interaction with monocytes. METHODS: The expression of early and late adhesion molecules and their receptors was evaluated in A549 (human lung adenocarcinoma) cells using a wide range of concentrations of PM2.5 and PM10. Then we evaluated cellular adhesion between A549 cells and U937 (human monocytes) cells after PM exposure. RESULTS: We found higher expression of both early and late adhesion molecules and their ligands in lung adenocarcinoma cells exposed to PM2.5 and PM10 particles present in the air pollution at Mexico City from 0.03 µg/cm2 with a statistically significant difference (p ≤ 0.05). PM10 had stronger effect than PM2.5. Both PM also stimulated cellular adhesion between tumor cells and monocytes. CONCLUSIONS: This study reveals a comprehensive expression profile of adhesion molecules and their ligands upregulated by PM2.5 and PM10 in A549 cells. Additionally these particles induced cellular adhesion of lung cancer cells to monocytes. This highlights possible implications of PM in two cancer hallmarks i.e. inflammation and metastasis, underlying the high cancer mortality associated with air pollution.
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Adenocarcinoma del Pulmón , Contaminantes Atmosféricos , Contaminación del Aire , Neoplasias Pulmonares , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/análisis , Línea Celular , Ciudades , Humanos , México , Material Particulado/análisis , Material Particulado/toxicidadRESUMEN
INTRODUCTION: The prevalence of allergic diseases is increasing worldwide, affecting about 30% of the population in low to middle-income countries. Research trends on allergic diseases within rural pediatric populations of Latin American countries is scarce. This study aimed to determine the prevalence of allergic diseases (allergic rhinitis, asthma, and atopic dermatitis) and their associated factors using the International Study of Asthma and Allergies in Childhood-III (ISAAC-III) questionnaire in school-aged children from two rural municipalities in Colombia. MATERIALS AND METHODS: This is a cross-sectional study. The ISAAC-III questionnaire was applied to school-aged children attending elementary schools in the municipalities of Soracá and Palmas del Socorro during 2018. The questionnaires were applied to adolescents aged 13-14 years and the parents of 6-7 years old children. Associations were estimated via bivariate and multivariate analysis. RESULTS: Among 261 school-aged children (58.2% adolescents), the prevalence of allergic diseases was: allergic rhinitis 11.49% (95% CI: 8.05-15.78), asthma 8.81% (95% CI: 5.82-12.7), and atopic dermatitis 6.13% (95% CI: 3.69-9.53). Associated factors for allergic rhinitis included: female sex (PR: 2.68, 95% CI: 1.17-5.26), asthma (PR: 4.69, 95% CI: 1.96-8.31), atopic dermatitis (PR: 3.55, 95% CI: 1.09-7.83), and higher maternal education (PR: 4.16, 95% CI: 1.45-8.25). CONCLUSIONS: The prevalence of allergic diseases in this rural pediatric population was lower compared with that of the previous reports from urban populations. Associated factors found in this study support previous studies. Research addressing modifiable environmental associations is so far scarce in Latin America; further studies are needed to reduce the burden of these diseases in rural populations.
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Asma/epidemiología , Dermatitis Atópica/epidemiología , Rinitis Alérgica/epidemiología , Población Rural/estadística & datos numéricos , Adolescente , Análisis de Varianza , Niño , Colombia/epidemiología , Intervalos de Confianza , Estudios Transversales , Escolaridad , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Madres/educación , Prevalencia , Factores de Riesgo , Factores SexualesRESUMEN
BACKGROUND: The frequency of allergic diseases in tropical Latin American populations is poorly understood, and certain particularities can impact their natural history and risk factors. OBJECTIVE: The study aimed to determine the frequency of self-reported allergies (allergic diseases, drug, and food allergies) in patients who attended the Hospital Universitario Fundación Santa Fe de Bogotá, Colombia. MATERIAL AND METHODS: A retrospective study was conducted to assess the frequency of self- reported allergies reported by all the patients who attended an allergy referral center between June and December 2019. RESULTS: A total of 60978 patients were included. Allergic rhinitis was reported by 1.51% (n = 921), asthma by 1.28% (n = 782), and atopic dermatitis by 0.41% (n = 250) of the study population. A higher frequency of self-reported allergic diseases (rhinitis, asthma, and dermatitis) was found in the younger populations, while drug allergies were more frequently reported in adults. The most frequently self-reported drug allergies were penicillin allergy (4.07%, n = 2479), and non- steroidal anti-inflammatory drug (NSAID) allergy (1.85%, n = 1116). The most commonly reported food allergens included shellfish (0.58%), fruits (0.54%), cow's milk protein (0.37%), and eggs (0.21%). CONCLUSION: The distribution of food allergens showed a higher frequency of shrimp and fruit allergies compared to previous studies on African, Asian, and Arabic tropical populations that describe a higher predominance of egg and milk allergies. Patients reporting allergic diseases should always be referred to the allergology department for confirmatory testing.