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1.
Arch Womens Ment Health ; 27(3): 405-415, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38150150

RESUMEN

Early interventions may promote reductions in mothers' anxiety-depression (AD) symptoms and improvements in their offspring. This longitudinal randomized research was conducted to assess the effects of interdisciplinary online therapeutic groups (GIO) in at-risk mothers and babies during the COVID-19 pandemic in a disadvantaged neighborhood in Barcelona (Spain). A total of 135 babies were born from March 2020 to June 2021 in a primary healthcare center of Barcelona (Spain). Pregnant woman and new mothers were screened for AD symptomatology through EPDS and STAI questionnaires. Seventy-two of them met high-risk criteria for AD and were included in the study. They were randomly assigned into the two groups of the study: 40 participants were assigned to GIO, the therapeutic group (TG), while 32 of them were assigned to the control group (CG) and received treatment as usual. The course of the mothers' symptomatology was assessed, as well as the baby's development at 6 months old in a blind pediatric follow-up. No differences were found in AD between both groups before the intervention. However, we obtained a significant decrease in AD symptomatology (EPDS p < .001; STAI state p = .015 and STAI trait p < .001at 6 months of life) after the intervention in the TG compared to the CG. Pediatric follow-up at 6 months demonstrated significant differences between groups in babies' development assessment (manipulation p = .003; language p < .001; sociability p < .001). The GIO helped to ensure healthy development of the baby and reduction of the mothers' depressive-anxiety symptomatology.


Asunto(s)
Ansiedad , COVID-19 , Depresión , Humanos , Femenino , Embarazo , Adulto , COVID-19/psicología , COVID-19/epidemiología , COVID-19/terapia , Proyectos Piloto , Depresión/terapia , Depresión/psicología , España/epidemiología , Ansiedad/terapia , SARS-CoV-2 , Madres/psicología , Intervención basada en la Internet , Lactante , Psicoterapia de Grupo/métodos , Complicaciones del Embarazo/terapia , Complicaciones del Embarazo/psicología , Internet , Estudios Longitudinales , Recién Nacido
3.
Nephrol Dial Transplant ; 30 Suppl 1: i132-7, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25805744

RESUMEN

INTRODUCTION: Standard therapy with corticosteroids (CS) and cyclophosphamide (CYC) followed by azathioprine has been shown to improve renal and patient survival in ANCA-associated renal vasculitis (rAAV). Mycophenolate mofetil (MF) has been progressively introduced for the treatment of rAAV in the last years because of its immunosuppressive efficacy combined with a lower toxicity profile. In this study, we retrospectively analyse the results of the introduction of MF for maintenance and induction therapy in rAAV in our institution from 2001 to 2013. RESULTS: We reported 67 patients treated with MF as a maintenance treatment, divided by baseline serum creatinine (>500 µmol/L: Group 1 and <500 µmol/L: Group 2) and treatment schedule. Twenty-nine of the 67 patients were also treated with MF as induction treatment, mostly in Group 2. During the follow-up (2 years after the diagnosis) creatinine levels for serum glomerular filtration rate, ANCA titres, C-reactive protein and percentage of haematuria decreased in all groups. In Group 2, parameters and also relapse rates were similar at 24 months in patients treated with CYC or MF as an induction treatment (Subgroups 2a and 2b, respectively). Median dose of MF in maintenance treatment was 1000 mg daily and prednisone dose was tapered to 10 mg daily from Month 3. After 24 months, 82% of patients remained on MF therapy, 18% had discontinued the treatment, seven of them due to medical indication and two because of gastrointestinal intolerance. The percentage of patients that started renal replacement therapy was irregular in Group 1 depending on the subgroup (25-100%), and 10% in Group 2. Adverse effects, such as neutropenia, infections and neoplasia, were more prevalent in groups treated with CYC. CONCLUSION: In conclusion, in our patients with rAAV, MF demonstrated to be an effective and well-tolerated option for maintenance treatment. As an induction treatment, MF seems to be similar to CYC for patients with moderate renal failure in the diagnosis.


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/tratamiento farmacológico , Inmunosupresores/uso terapéutico , Enfermedades Renales/tratamiento farmacológico , Ácido Micofenólico/análogos & derivados , Anciano , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones , Anticuerpos Anticitoplasma de Neutrófilos/sangre , Anticuerpos Anticitoplasma de Neutrófilos/inmunología , Proteína C-Reactiva/metabolismo , Femenino , Tasa de Filtración Glomerular , Hospitales Universitarios , Humanos , Enfermedades Renales/etiología , Pruebas de Función Renal , Masculino , Persona de Mediana Edad , Ácido Micofenólico/uso terapéutico , Recurrencia , Estudios Retrospectivos
4.
Am J Transplant ; 12(10): 2781-8, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22702444

RESUMEN

In our old-for-old program, we discard or allocate older extended criteria donor kidneys to single (SKT) or dual kidney transplantation (DKT) depending on histological Remuzzi's score in recipients older than 60 years. Here, we analyze the long-term results of this program and try to identify independent predictors of patient and graft survival. Between December 1996 and January 2008, we performed 115 SKT and 88 DKT. Discard rate was 15%. Acute rejection incidence was higher in SKT than in DKT (22.6% vs. 11.4%, p = 0.04). Renal function was better in DKT than in SKT up to 5 years after transplantation. Surgical complications were frequent in DKT. Ten-year cumulative graft survival was significantly lower in the SKT group (31% vs. 53%, p = 0.03). In SKT, histological score 4 provided similar graft survival than 3 or less, whereas in DKT score 4, 5 or 6 displayed similar outcome. Finally, independent predictors of graft survival were history of major adverse cardiac event and 1-year serum creatinine, rather than SKT or DKT. In conclusion, this biopsy-guided old-for-old strategy resulted in acceptable long-term graft survival. Our results suggest that DKT should be considered for scores of 5 or 6 only.


Asunto(s)
Asignación de Recursos para la Atención de Salud , Trasplante de Riñón , Donantes de Tejidos , Anciano , Biopsia , Femenino , Humanos , Masculino , Persona de Mediana Edad
5.
Am J Transplant ; 11(10): 2162-72, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21749644

RESUMEN

Presence of subclinical rejection (SCR) with IF/TA in protocol biopsies of renal allografts has been shown to be an independent predictor factor of graft loss. Also, intragraft Foxp3+ T(reg) cells in patients with SCR has been suggested to differentiate harmful from potentially protective infiltrates. Nonetheless, whether presence of Foxp3 T(reg) cells in patients with SCR and IF/TA may potentially protect from a deleterious graft outcome has not yet been evaluated. This is a case-control study in which 37 patients with the diagnosis of SCR and 68 control patients with no cellular infiltrates at 6-month protocol biopsies matched for age and time of transplantation were evaluated. We first confirmed that numbers of intragraft Foxp3-expressing T cells in patients with SCR positively correlates with Foxp3 demethylation at the T(reg) -specific demethylation region. Patients with SCR without Foxp3+ T(reg) cells within graft infiltrates showed significantly worse 5-year graft function evolution than patients with SCR and Foxp3+ T(reg) cells and those without SCR. When presence of SCR and IF/TA were assessed together, presence of Foxp3+ T(reg) could discriminate a subgroup of patients showing the same graft outcome as patients with a normal biopsy. Thus, presence of Foxp3+ T(reg) cells in patients with SCR even with IF/TA is associated with a favorable long-term allograft outcome.


Asunto(s)
Biomarcadores/metabolismo , Factores de Transcripción Forkhead/metabolismo , Rechazo de Injerto , Trasplante de Riñón , Linfocitos T Reguladores/inmunología , Adulto , Biopsia , Estudios de Casos y Controles , Femenino , Humanos , Inmunosupresores/administración & dosificación , Masculino , Metilación , Persona de Mediana Edad , Estudios Retrospectivos
6.
Head Neck Pathol ; 14(3): 768-770, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32040821

RESUMEN

The original version of this article unfortunately contained a mistake. Three values in Table 1 were incorrect. In "months of recurrence", range row, the intervals should be in numbers. They should read as 3-83 instead of Mar-83, 9-83 instead of Sep-83 and 3-36 instead of Mar-36. The corrected Table 1 is given below. The original article has been corrected.

7.
Head Neck Pathol ; 14(3): 758-767, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31916205

RESUMEN

Sinonasal inverted papilloma (SNIP) is a benign but locally aggressive tumor that has a tendency for recurrence and malignant transformation. The role of human papillomavirus (HPV) in SNIP is controversial. To determine the HPV-DNA prevalence and type distribution in SNIP in two different geographic areas and assess the association between SNIP recurrence and HPV infection, as well as additional potential etiologic factors. Two retrospective cohorts of SNIP patients from Poland and Spain were evaluated. Demographic, tobacco/alcohol use, clinical, and follow-up data were collected. All samples were subject to histopathologic evaluation, DNA quality control, and HPV-DNA detection by PCR. HPV-DNA positive samples and a random sample of HPV-DNA negative cases were further subject to p16INK4a analysis. Proportional-hazards models were used to evaluate the risk of recurrence by selected variables. Seventy-nine SNIP patients (46 from Spain diagnosed between 1995 and 2014, and 33 from Poland diagnosed between 2012 and 2017) were included in the study. HPV-DNA was detected in four patients (5.1%), two from each region, and all four were positive for the HPV11 subtype. Seventeen patients (21.5%) experienced recurrence, with a median time to recurrence of 14 months. No association was identified between lesional HPV-DNA positivity, toxic habits, Krouse stage, or malignant transformation and a higher risk of recurrence. The low prevalence of HPV-DNA in SNIPs suggests that HPV is not a main etiology for development of these lesions. With a lack of association between the evaluated factors and recurrence, further research with larger number of patients and additional biomarkers is warranted to further understand predisposing risk factors.


Asunto(s)
Recurrencia Local de Neoplasia/virología , Papiloma Invertido/patología , Papiloma Invertido/virología , Infecciones por Papillomavirus/complicaciones , Neoplasias de los Senos Paranasales/patología , Neoplasias de los Senos Paranasales/virología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Nasales/patología , Neoplasias Nasales/virología , Papillomaviridae , Infecciones por Papillomavirus/epidemiología , Polonia/epidemiología , Prevalencia , Estudios Retrospectivos , España/epidemiología , Adulto Joven
8.
Am J Transplant ; 9(6): 1477-83, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19459807

RESUMEN

Kidney transplantation in patients with atypical hemolytic uremic syndrome (aHUS) carrying mutations in the soluble complement regulators factor H (CFH) or factor I (CFI) is associated with elevated risk of disease recurrence and almost certain graft loss. In contrast, recurrence is unusual in patients with mutations in the membrane-associated complement regulator membrane cofactor protein (MCP) (CD46). Therefore, a panel of experts recently recommended the combined liver-kidney transplantation to minimize aHUS recurrence in patients with mutations in CFH or CFI. There was, however, very limited information regarding transplantation in patients carrying mutations in both soluble and membrane-associated complement regulators to support a recommendation. Here, we report the case of an aHUS patient with a heterozygous mutation in both CFI and MCP who received an isolated kidney transplant expressing normal MCP levels. Critically, the patient suffered from a severe antibody-mediated rejection that was successfully treated with plasmapheresis and IvIgG. Most important, despite the complement activation in the allograft, there was no evidence of thrombotic microangiopathy, suggesting that the normal MCP levels in the grafted kidney were sufficient to prevent the aHUS recurrence. Our results suggest that isolated kidney transplantation may be a good first option for care in aHUS patients carrying CFI/MCP combined heterozygous mutations.


Asunto(s)
Factor I de Complemento/genética , Síndrome Hemolítico-Urémico/genética , Síndrome Hemolítico-Urémico/cirugía , Trasplante de Riñón , Proteína Cofactora de Membrana/genética , Adulto , Rechazo de Injerto/tratamiento farmacológico , Humanos , Masculino , Mutación
9.
Transplant Proc ; 39(7): 2095-8, 2007 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-17889104

RESUMEN

INTRODUCTION: Epidemiological studies have shown that demographic, clinical, and histological donor characteristics influence renal function after transplantation, but whether these variables are independent predictors has not been established. The aim of this study was to evaluate the relative contribution of different donor variables on glomerular filtration rates (GFRs) at 3 months. PATIENTS AND METHODS: We analyzed single renal transplants performed at our center from January 2000 to July 2004. Donor variables included age, gender, weight and height, cause of death, duration of brain death, serum creatinine at admission and preprocurement, history of arterial hypertension or diabetes mellitus, and smoking habit. Donor chronic damage score was calculated in preimplantation biopsies as was the addition of interstitial fibrosis, fibrous intimal thickening, and glomerulosclerosis (<10% = 0, >10% = 1). Donor and recipient GFRs were calculated according to the Cockroft-Gault formula. RESULTS: We analyzed 202 transplants obtained from 113 deceased donors. A renal biopsy was available in 111 transplants. Recipient GFR at 3 months correlated negatively with donor age (R = -0.32, P < .01) and donor chronic damage score (R = 0.32, P < .01). GFR was lower among recipients of female versus male donors (50 +/- 15 vs 60 +/- 20 mL/min; P < .01). Donor cerebrovascular accident death (53 +/- 19 vs 63 +/- 19 mL/min; P < .01) and hypertension (48 +/- 16 vs 59 +/- 20 mL/min; P < .01) were also associated with lower GFR at 3 months. There was a positive correlation between GFR at admission, GFR preprocurement, and GFR at 3 months (R = 0.32 and R = 0.18 respectively; P < .01). Stepwise regression analysis included chronic damage score, GFR at admission, and donor gender but not donor age as independent predictors of GFR at 3 months (R = 0.50; P < .01). CONCLUSION: Donor structural and functional parameters are independent predictors of renal function at 3 months.


Asunto(s)
Tasa de Filtración Glomerular/fisiología , Trasplante de Riñón/fisiología , Donantes de Tejidos , Adolescente , Adulto , Anciano , Biopsia , Cadáver , Causas de Muerte , Femenino , Humanos , Riñón/patología , Trasplante de Riñón/patología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Trasplante Homólogo , Resultado del Tratamiento
10.
Neurosci Lett ; 137(2): 185-8, 1992 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-1584459

RESUMEN

The present study shows that postnatal handling (H: consisting of removing the pups from the nest twice daily and placing them individually in plastic cages lined with paper towel for a period of 10 min, between postnatal days 1 and 21) and/or environmental enrichment (E: for a period of 6 months) of Roman high- and low-avoidance (RHA/Verh and RLA/Verh) rats induced long-lasting decreases in emotional reactivity (i.e. reduced defecations in the open field, OF, and hole-board, HB, tests) as well as increases in exploratory behavior (i.e. head-dipping) in a manner dependent upon the rat line (there were 'line x H' and 'line x E' interactions). It is reported for the first time that RHA/Verh rats show more head-dipping behavior than RLA/Verh rats, and that the environmental treatments can increase head-dipping of RLA/Verh animals to the level shown by RHA/Verh rats.


Asunto(s)
Conducta Animal/fisiología , Emociones/fisiología , Animales , Defecación/fisiología , Ambiente , Conducta Exploratoria/fisiología , Miedo/fisiología , Masculino , Actividad Motora/fisiología , Ratas , Ratas Endogámicas
11.
Pharmacol Biochem Behav ; 35(2): 481-4, 1990 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-2320660

RESUMEN

The effects of chronic haloperidol treatment (0.5 mg/kg/day for 21 days) on maze learning in the rat were studied. There were no differences between haloperidol- and saline-treated groups in percentage of correct responses, but the latency to respond was longer and extinction was faster in the haloperidol-treated group. We speculated that differences between both groups were due to a decrease of appetitive motivation in haloperidol-treated animals, probably caused by a decrease of dopaminergic neurotransmission.


Asunto(s)
Condicionamiento Operante/efectos de los fármacos , Habituación Psicofisiológica/efectos de los fármacos , Haloperidol/farmacología , Actividad Motora/efectos de los fármacos , Conducta Estereotipada/efectos de los fármacos , Animales , Alimentos , Masculino , Distribución Aleatoria , Ratas , Ratas Endogámicas , Tiempo de Reacción/efectos de los fármacos
12.
Arch Soc Esp Oftalmol ; 89(1): 17-21, 2014 Jan.
Artículo en Español | MEDLINE | ID: mdl-24269414

RESUMEN

PURPOSE: To investigate the presence of known cytogenetic alterations of choroidal melanoma in a series of patients diagnosed and treated in our Ocular Oncology Service. A review of the present literature on this topic is also presented. METHODS: Microsatellite analysis (MSA) studies on loss of heterozygosity (LOH) of chromosome 3, as well as multiplex ligation prove amplification (MLPA) on chromosomes 1, 3, 6 and 8, were performed on enucleation or local resection samples obtained from a total of 27 patients, over a 2 year period. RESULTS: Twenty patients showed at least one of the cytogenetic alterations looked for. A total of 11 cases were found that showed LOH of chromosome 3 (44%), 8 gains of chromosome 8 (30%), 8 gains of chromosome 6p (30%), and 7 partial or total losses of chromosome 1 (26%). CONCLUSIONS: This is the first study on the cytogenetics of choroidal melanoma performed in our country. The results are similar to that published in the literature. Cytogenetic analysis provides more accurate knowledge on a vital individual prognosis. It also may become a valuable tool for establishing the most adequate follow-up regimes, and the need for adjuvant therapies.


Asunto(s)
Neoplasias de la Coroides/genética , Aberraciones Cromosómicas , Pérdida de Heterocigocidad , Melanoma/genética , Repeticiones de Microsatélite , Anciano , Aneuploidia , Braquiterapia , Neoplasias de la Coroides/patología , Neoplasias de la Coroides/terapia , Cromosomas Humanos/ultraestructura , Enucleación del Ojo , Femenino , Humanos , Masculino , Melanoma/patología , Melanoma/terapia , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa Multiplex , Pronóstico , Carga Tumoral
14.
Actas Esp Psiquiatr ; 35(6): 382-6, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-18004675

RESUMEN

INTRODUCTION: The serotoninergic system seems to be implicated in characteristic symptoms of borderline personality disorder (BPD) such as affective instability, impulsivity or suicide. Some studies suggest an association between serotonin transporter gene (5-HTT) polymorphisms and some BPD symptoms. Short allele (S) of the 5-HTTLPR polymorphism in the promoter region has been shown to be associated with impulsivity, aggressive behavior, anxiety and neuroticism. Of the variable number of tandem repeat (VNTR) polymorphism in intron 2, BPD patients showed higher frequencies of the allele with the 10 repeats. The aim of this study was to determine the association between 5- HTTLPR and VNTR polymorphism of 5-HTT and personality traits in borderline personality disorder. METHOD: A total of 65 BPD patients diagnosed by means of semi-structured interviews SCID-II and DIB-R were included. Two common polymorphisms of 5-HTT were genotyped: the 5-HTTLPR in the promoter region and VNTR in intron 2. Personality traits were assessed by the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). RESULTS: Patients with L allele (L/S or L/L) in the 5-HTTLPR polymorphism showed lower scores on the subscale of liking parties and friends. Patients with the allele with 10 repeat of the VNTR polymorphism, showed lower scores in impulsivity, sensation seeking and in the subscale liking of parties and friends. CONCLUSIONS: The results suggest a significant association between the 5-HTT gene and some personality traits in BPD. This gene may play a role in the etiology of borderline personality disorder.


Asunto(s)
Trastorno de Personalidad Limítrofe/diagnóstico , Trastorno de Personalidad Limítrofe/genética , Expresión Génica/genética , Proteínas de Transporte de Serotonina en la Membrana Plasmática/genética , Encuestas y Cuestionarios , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad
15.
Am J Transplant ; 7(12): 2739-47, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17949456

RESUMEN

Patients with a protocol renal allograft biopsy simultaneously displaying interstitial fibrosis/tubular atrophy (IF/TA) and subclinical rejection (SCR) have a shortened graft survival than patients with a normal biopsy, or with a biopsy only displaying IF/TA or SCR. The poor outcome of these patients could be related with a more severe inflammation. We evaluate the immunophenotype of infiltrating cells in these diagnostic categories. Nonexhausted paraffin blocks from protocol biopsies done during the first year were stained with anti-CD45, CD3, CD20, CD68 and CD15 monoclonal antibodies. Glomerular and interstitial positive cells were counted. C4d deposition in peritubular capillaries was evaluated. Histological diagnoses were: normal (n = 80), SCR (n = 17), IF/TA (n = 42) and IF/TA + SCR (n = 17). Only interstitial CD20 positive cells were significantly increased in patients displaying IF/TA + SCR; normal (137 +/- 117), SCR (202 +/- 145), IF/TA (208 +/- 151) and IF/TA + SCR (307 +/- 180 cells/mm(2)), p < 0.01. The proportion of biopsies displaying C4d deposition was not different among groups. The upper tertile of CD20 positive interstitial cells was associated with a decreased death-censored graft survival (relative risk: 3.01, 95% confidence interval: 1.23-7.35; p = 0.015). These data suggest that B-cell interstitial infiltrates are associated with histological damage and outcome, but do not distinguish whether these infiltrates were the cause or the consequence of chronic tubulo-interstitial damage.


Asunto(s)
Rechazo de Injerto/diagnóstico , Rechazo de Injerto/patología , Inmunofenotipificación , Glomérulos Renales/patología , Trasplante de Riñón/patología , Células del Estroma/patología , Adulto , Anciano , Atrofia/diagnóstico , Atrofia/patología , Linfocitos B/inmunología , Linfocitos B/patología , Biopsia , Femenino , Fibrosis/diagnóstico , Fibrosis/patología , Estudios de Seguimiento , Supervivencia de Injerto , Humanos , Glomérulos Renales/inmunología , Masculino , Persona de Mediana Edad , Pronóstico , Células del Estroma/inmunología
16.
Lupus ; 16(1): 18-24, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17283580

RESUMEN

Renal involvement in systemic lupus erythematosus is a common complication that significantly worsens morbidity and mortality. Although treatment with corticosteroids and cytotoxic drugs may be useful in many cases, morbidity associated with these drugs and the relapsing nature of the disease make it necessary to develop new treatment strategies. Five-month old female NZB/W F1 mice were divided into the following groups: CYP group (n = 10), cyclophosphamide (CYP) 50 mg/kg intraperitoneally every 10 days; RAPA 1 group (n = 10) oral daily sirolimus (SRL), 1 mg/kg; RAPA 12 group (n = 13), oral daily SRL, 12mg/kg; FTY group (n = 10), oral fingolimod (FTY720), 2 mg/kg three times per week. An additional group of 13 non-treated mice were used as a control (control group). Follow-up was performed over four months. Animal survival, body weight, anti-DNA antibodies and proteinuria were determined. Kidneys were processed for conventional histology and immunofluorescence for IgG and complement. Total histological score (HS) was the sum of mesangial expansion, endocapillary proliferation glomerular deposits, extracapillary proliferation, interstitial infiltrates, tubular atrophy and interstitial fibrosis. All treated groups had lower proteinuria at the end of the follow-up with respect to the control group (P < 0.0001). Serum anti-DNA antibodies were appropriately controlled in RAPA 1 and CYP groups, but not in FTY or RAPA 12 groups. SRL and CYP arrested, and perhaps reversed almost all histological lesions. FTY720 ameliorated histological lesions but did not control mesangial expansion or interstitial infiltrates. SRL produces great improvement in murine lupus nephritis, while FTY720 seems a promising alternative if used in appropriate doses.


Asunto(s)
Inmunosupresores/uso terapéutico , Nefritis Lúpica/tratamiento farmacológico , Glicoles de Propileno/uso terapéutico , Sirolimus/uso terapéutico , Esfingosina/análogos & derivados , Administración Oral , Animales , Anticuerpos Antinucleares/sangre , Apoptosis/inmunología , Autoantígenos/inmunología , Movimiento Celular/efectos de los fármacos , Cromatina/inmunología , Complemento C3/análisis , Factor Nefrítico del Complemento 3/análisis , Ciclofosfamida/administración & dosificación , Ciclofosfamida/uso terapéutico , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Evaluación Preclínica de Medicamentos , Femenino , Clorhidrato de Fingolimod , Mesangio Glomerular/patología , Inmunoglobulina G/análisis , Inmunosupresores/farmacología , Inyecciones Intraperitoneales , Glomérulos Renales/inmunología , Glomérulos Renales/patología , Nefritis Lúpica/genética , Nefritis Lúpica/inmunología , Nefritis Lúpica/patología , Linfocitos/efectos de los fármacos , Ratones , Ratones Endogámicos NZB , Nucleosomas/inmunología , Glicoles de Propileno/administración & dosificación , Glicoles de Propileno/farmacología , Proteinuria/etiología , Receptores de Lisoesfingolípidos/efectos de los fármacos , Sirolimus/administración & dosificación , Sirolimus/farmacología , Esfingosina/administración & dosificación , Esfingosina/farmacología , Esfingosina/uso terapéutico
17.
Kidney Int ; 70(3): 557-61, 2006 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16788696

RESUMEN

After transplantation, glomerular volumes increases and large glomerular volume at 4 months is associated with better renal function. The aim is to characterize glomerular adaptation after the fourth month in two serial protocol biopsies and its relationship with subclinical rejection and chronic allograft nephropathy (CAN). Mean glomerular volume (Vg) was estimated according to the Weibel and Gomez method in a 4-month and 1-year serial protocol biopsies in 61 stable grafts. Glomerular enlargement (deltaVg) was calculated as the Vg difference between both biopsies. Banff schema was used to evaluate renal biopsies. Vg increased from 4.4+/-2.4 to 5.7+/-2.6 x 10(6) microm3 (P<0.001). Mean deltaVg was 1.0 x 10(6) microm3. Patients with deltaVg<1 were considered as patients with impaired glomerular enlargement (n=29). Impaired glomerular enlargement was associated with increased acute index score in the 4-month (1.83+/-1.56 vs 1.06+/-1.48; P<0.05) and 1-year protocol biopsies (1.52+/-1.59 vs 0.62+/-1.07; P<0.05). Impaired glomerular enlargement was also associated with increased progression of chronic lesions between the 4-month and 1-year biopsy in the glomerular (0.17+/-0.38 vs 0.55+/-0.63; P<0.01), tubular (0.38+/-0.56 vs 0.83+/-0.85; P<0.01), and interstitial compartment (0.41+/-0.57 vs 0.90+/-0.86; P<0.01). The proportion of sclerotic glomeruli between both biopsies increased in patients with impaired glomerular enlargement (1.5+/-3.9 to 5.3+/-10.1, P<0.05) while it did not modify in patients with glomerular enlargement (2.1+/-7.3 vs 2.6+/-4.5; P=NS). During the first year, glomeruli enlarge but this adaptation mechanism is impaired in patients with subclinical rejection. Moreover, impaired glomerular enlargement is associated with progression of CAN.


Asunto(s)
Rechazo de Injerto/patología , Rechazo de Injerto/fisiopatología , Glomérulos Renales/patología , Glomérulos Renales/fisiopatología , Trasplante de Riñón , Enfermedad Aguda , Adaptación Fisiológica , Adolescente , Adulto , Anciano , Biopsia , Enfermedad Crónica , Femenino , Glomeruloesclerosis Focal y Segmentaria/patología , Glomeruloesclerosis Focal y Segmentaria/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad
18.
Am J Transplant ; 6(4): 747-52, 2006 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-16539631

RESUMEN

Chronic allograft nephropathy (CAN) in protocol biopsies is associated with graft loss while the association between subclinical rejection (SCR) and outcome has yielded contradictory results. We analyze the predictive value of SCR and/or CAN in protocol biopsies on death-censored graft survival. Since 1988, a protocol biopsy was done during the first 6 months in stable grafts with serum creatinine <300 micromol/L and proteinuria <1 g/day. Biopsies were evaluated according to Banff criteria. Borderline changes and acute rejection were grouped as SCR. CAN was defined as presence of interstitial fibrosis and tubular atrophy. Mean follow-up was 91 +/- 46 months. Sufficient tissue was obtained in 435 transplants. Biopsies were classified as normal (n = 186), SCR (n = 74), CAN (n = 110) and SCR with CAN (n = 65). Presence of SCR with CAN was associated with old donors, percentage of panel reactive antibodies and presence of acute rejection before protocol biopsy. Cox regression analysis showed that SCR with CAN (relative risk [RR]: 1.86, 95% confidence interval [CI]: 1.11-3.12; p = 0.02) and hepatitis C virus (RR: 2.27, 95% CI: 1.38-3.75; p = 0.01) were independent predictors of graft survival. In protocol biopsies, the detrimental effect of interstitial fibrosis/tubular atrophy on long-term graft survival is modulated by SCR.


Asunto(s)
Rechazo de Injerto/patología , Supervivencia de Injerto , Fallo Renal Crónico/patología , Trasplante de Riñón/patología , Adolescente , Adulto , Anciano , Biopsia , Niño , Femenino , Rechazo de Injerto/diagnóstico , Rechazo de Injerto/epidemiología , Humanos , Riñón/patología , Fallo Renal Crónico/diagnóstico , Masculino , Persona de Mediana Edad , Pronóstico , Factores de Riesgo
19.
Am J Transplant ; 5(12): 2877-82, 2005 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16303000

RESUMEN

Long-term consequences of glomerular enlargement after transplantation are not well understood. The aim is to evaluate the relationship between glomerular volume (Vg) estimated in protocol biopsies, graft function and graft survival. Vg and Banff chronic damage score were evaluated in protocol biopsies at 4 months. Creatinine clearance (CrCl) was estimated by the Cockroft-Gault formula. Vg estimated in 144 patients was 4.8 +/- 2.0 x 10(6)mu(3). It was associated with donor age (r = 0.23, p < 0.01), recipient body mass index (r = 0.17, p = 0.04), delayed graft function (Vg = 5.9 +/- 2.3 vs. 4.6 +/- 1.9 x 10(6)mu(3), p < 0.01) and CrCl (r = 0.17, p = 0.04). The best cutoff of Vg, Banff chronic damage score and CrCl was determined by Cox regression analysis, being 5.0 x 10(6)mu(3) for Vg (relative risk (RR): 2.4, 95% confidence interval (CI): 1.03-5.6), >2 for chronic damage score (RR: 3.4, 95% CI: 1.03-8.9) and 60 mL/min for CrCl (RR: 3.5, 95% CI: 1.04-11.9). These variables were independent predictors of death-censored graft survival. According to Vg and CrCl, four groups of patients were defined. Patients with small glomeruli and high CrCl had a 95% graft survival while patients with large glomeruli and low CrCl had a 45% graft survival at 15 years (p < 0.01). Large glomerular volume, high Banff chronic score and poor early renal function in stable grafts are independently associated with death-censored graft survival.


Asunto(s)
Supervivencia de Injerto , Glomérulos Renales/patología , Trasplante de Riñón , Adolescente , Adulto , Anciano , Biopsia , Niño , Femenino , Humanos , Pruebas de Función Renal , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas
20.
Arch. Soc. Esp. Oftalmol ; Arch. Soc. Esp. Oftalmol;89(1): 17-21, ene. 2014. ilus, tab
Artículo en Español | IBECS (España) | ID: ibc-129249

RESUMEN

OBJETIVO: Investigar la presencia de las alteraciones citogenéticas conocidas del melanoma de coroides en una serie de pacientes diagnosticados y tratados en nuestra Unidad de Oncología Ocular. También exponemos una revisión de la literatura actual sobre este tema. MÉTODO: Durante dos años se han estudiado muestras procedentes de piezas de enucleación o de resección de melanoma coroideo de un total de 27 pacientes mediante análisis de microsatélites (MSA) para estudio de pérdida de heterocigosidad (LOH) del cromosoma 3 y mediante multiplex-ligation-prove amplification (MLPA) para los cromosomas 1, 3, 6 y 8. RESULTADOS: Entre los casos estudiados, 20 mostraron como mínimo una de las alteraciones citogenéticas que se buscaban, 11 LOH del cromosoma 3 (44%), 8 ganancias del cromosoma 6 p (30%), 8 ganancias en cromosoma 8 (30%) y 7 pérdidas totales o parciales del cromosoma 1 (26%). CONCLUSIONES: Este es el primer estudio citogenético del melanoma de úvea en nuestro país.La presencia y preponderancia de las distintas alteraciones citogenéticas se corresponden con las de las series publicadas en la literatura. El análisis citogenético nos permite conocer mejor el pronóstico vital individualizado. También puede resultar una herramienta valiosa para establecer el protocolo de seguimiento más adecuado y la necesidad de tratamientos adyuvantes en estos pacientes


PURPOSE: To investigate the presence of known cytogenetic alterations of choroidal melanoma in a series of patients diagnosed and treated in our Ocular Oncology Service. A review of the present literature on this topic is also presented. METHODS: Microsatellite analysis (MSA) studies on loss of heterozygosity (LOH) of chromosome 3, as well as multiplex ligation prove amplification (MLPA) on chromosomes 1, 3, 6 and 8, were performed on enucleation or local resection samples obtained from a total of 27 patients, over a 2 year period. RESULTS: Twenty patients showed at least one of the cytogenetic alterations looked for. A total of 11 cases were found that showed LOH of chromosome 3 (44%), 8 gains of chromosome 8 (30%), 8 gains of chromosome 6 p (30%), and 7 partial or total losses of chromosome 1 (26%). CONCLUSIONS: This is the first study on the cytogenetics of choroidal melanoma performed in our country. The results are similar to that published in the literature. Cytogenetic analysis provides more accurate knowledge on a vital individual prognosis. It also may become a valuable tool for establishing the most adequate follow-up regimes, and the need for adjuvant therapies


Asunto(s)
Humanos , Análisis Citogenético/métodos , Melanoma/patología , Neoplasias de la Coroides/patología , Neoplasias de la Úvea/patología , Repeticiones de Microsatélite , Pérdida de Heterocigocidad
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