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1.
Cancer Cell Int ; 23(1): 15, 2023 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-36726173

RESUMEN

While positive social-behavioral factors predict longer survival in cancer patients, the underlying mechanisms are unknown. Since tumor metastasis are the major cancer mortality factor, we investigated how an enriched environment (EE) conductive to enhanced sensory, cognitive and motor stimulation impact metastatic progression in lungs following intravasation in the circulation. We find that mice housed in EE exhibited reduced number of lung metastatic foci compared to control mice housed in a standard environment (SE). Compared to SE mice, EE mice increased lung inflammation as early as 4 days after circulating tumor cells extravasation. The impact of environmental signals on lung metastasis is independent of adrenergic receptors signaling. By contrast, we find that serum corticosterone levels are lower in EE mice and that glucocorticoid receptor (GR) antagonist reduces the number of lung metastasis in SE mice. In addition, the difference of the number of lung metastasis between SE and EE mice is abolished when inflammatory monocytes are rendered deficient in GR signaling. This decreased GR signaling in inflammatory monocytes of SE mice results in an exacerbated inflammatory profile in the lung. Our study shows that not only EE reduces late stages of metastatic progression in lungs but disclose a novel anti-tumor mechanism whereby GR-dependent reprogramming of inflammatory monocytes can inhibit metastatic progression in lungs. Moreover, while inflammatory monocytes have been shown to promote cancer progression, they also have an anti-tumor effect, suggesting that their role is more complex than currently thought.

2.
Sensors (Basel) ; 22(18)2022 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-36146136

RESUMEN

Using implicit responses to determine consumers' response to different stimuli is becoming a popular approach, but research is still needed to understand the outputs of the different technologies used to collect data. During the present research, electroencephalography (EEG) responses and self-reported liking and emotions were collected on different stimuli (odor, taste, flavor samples) to better understand sweetness perception. Artificial intelligence analytics were used to classify the implicit responses, identifying decision trees to discriminate the stimuli by activated sensory system (odor/taste/flavor) and by nature of the stimuli ('sweet' vs. 'non-sweet' odors; 'sweet-taste', 'sweet-flavor', and 'non-sweet flavor'; and 'sweet stimuli' vs. 'non-sweet stimuli'). Significant differences were found among self-reported-liking of the stimuli and the emotions elicited by the stimuli, but no clear relationship was identified between explicit and implicit data. The present research sums interesting data for the EEG-linked research as well as for EEG data analysis, although much is still unknown about how to properly exploit implicit measurement technologies and their data.


Asunto(s)
Odorantes , Gusto , Inteligencia Artificial , Árboles de Decisión , Electroencefalografía , Humanos , Odorantes/análisis , Percepción , Gusto/fisiología
3.
Mol Vis ; 27: 243-261, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34012227

RESUMEN

Purpose: This paper examines the tear concentration of cystatin S (CST4), calcyclin (S100A6), calgranulin A (S100A8), and matrix metalloproteinase 9 (MMP9), and the correlation between biomarker expression, clinical parameters, and disease severity in patients suffering from dry eye (DE). A comparison of the results is obtained via ELISA tests and customized antibody microarrays for protein quantification. Methods: This single-center, observational study recruited 59 participants (45 DE and 14 controls). Clinical evaluation included an Ocular Surface Disease Index (OSDI) questionnaire, a tear osmolarity (OSM) test, the Schirmer test (SCH), tear breakup time (TBUT), fluorescein (FLUO) and lissamine green (LG) corneal staining, and meibomian gland evaluation (MGE). Tear concentrations of CST4, S100A6, S100A8, and MMP9 were measured using standard individual ELISA assays. The levels of CST4, S100A6, and MMP9 were also measured using customized multiplexed antibody microarrays. Correlations between variables were evaluated, and a significance level was p value <0.05. Results: The quantification of tear protein biomarkers with ELISA showed that the concentration of CST4 was significantly (2.14-fold) reduced in tears of DE patients in comparison with control (CT) subjects (p < 0.001). S100A6 and S100A8 concentrations were significantly higher in the tears of DE patients (1.36- and 2.29-fold; p < 0.001 and 0.025, respectively) in comparison with CT. The MMP9 level was also higher in DE patients (5.83-fold), but not significantly (p = 0.22). The changes in CST4 and S100A6 concentrations were significantly correlated with dry eye disease (DED) severity. Quantification of CST4, S100A6, and MMP9, using antibody microarrays, confirmed the ELISA results. Similar trends were observed: 1.83-fold reduction for CST4 (p value 0.01), 8.63-fold increase for S100A6 (p value <0.001) and 9.67-fold increase for MMP9 (p value 0.94), but with higher sensitivity. The biomarker concentrations were significantly associated with the signs and symptoms related with DED. Conclusions: S100A6, S100A8, and CST4 diagnostic biomarkers strongly correlate with DED clinical parameters. S100A6 and CST4 are also useful for grading DE severity. The multiplexed antibody microarray technique, used here for tear multi-marker quantification, appears more sensitive than standard ELISA tests.


Asunto(s)
Biomarcadores/metabolismo , Síndromes de Ojo Seco/metabolismo , Proteínas del Ojo/metabolismo , Lágrimas/metabolismo , Adulto , Anciano , Calgranulina A/metabolismo , Estudios de Casos y Controles , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Masculino , Metaloproteinasa 9 de la Matriz/metabolismo , Análisis por Micromatrices , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Proteína A6 de Unión a Calcio de la Familia S100/metabolismo , Cistatinas Salivales/metabolismo
4.
Mol Vis ; 25: 12-21, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30804658

RESUMEN

Purpose: The purpose of this work was to analyze the expressions of matrix metalloproteinase 9 (MMP-9), calcyclin (S100A6), and cystatin S (CST4) in the tears of keratoconus (KC) patients. The correlations between the expressions of these proteins and the values of various ocular surface parameters were examined after accelerated corneal crosslinking (A-CXL) with pulsed ultraviolet light. Methods: This prospective, observational study enrolled patients with different grades of KC, scheduled to undergo the A-CXL procedure, as well as healthy subjects. Tear samples were analyzed by employing customized antibody microarray assays for MMP-9, S100A6, and CST4 proteins. The keratometry readings at the maximum keratometry (Kmax) and the simulated keratometry (SimK) values were obtained for examining the postoperative evolution of corneal topography. The state of the ocular surface was evaluated using the results of the Ocular Surface Disease Index (OSDI) questionnaire, tear osmolarity (OSM) test, Schirmer test (SCH), Tear Break Up Time (TBUT), tear clearance (CLR), and fluorescein (FLUO) and lissamine green (LG) corneal staining. Results: A total of 18 patients (22 eyes) and 10 healthy subjects were studied. The concentrations of MMP-9 and S100A6 decreased in tears, from 104.5 ± 78.98 ng/ml and 350.20 ± 478.08 ng/ml before the surgery to 48.7 ± 24.20 ng/ml and 55.70 ± 103.62 ng/ml, respectively, after 12 months of follow up. There were no changes in the CST4 concentration after 12 months of follow up (2202.75 ± 2863.70 versus 2139.68 ±2719.89 ng/ml). When the patients were divided into three groups according to the evolutive stage of KC, the trends for the three biomarkers in each group were the same as in the general group. Basal concentrations of MMP-9 and S100A6 from healthy subjects and KC patients were compared. The levels of MMP-9 and S100A6 in tears were (9.8 ± 5.11 and 104.55 ± 78.98 ng/ml, p<0.01; and 11.35 ± 3.18 and 350.26 ± 478.06 ng/ml, respectively, p<0.01). This was not the case for CST4, which did not exhibit statistically significant differences between the two groups (2261.94 ± 510.65 and 2176.73 ± 2916.27 ng/ml respectively, p=0.07). Conclusions: A-CXL promoted a decrease in the concentrations of MMP-9 and S100A6 in the tear film. This effect may be related to the restoration of corneal homeostasis and the consequent repair of the tissue damage caused by KC. Moreover, the A-CXL treatment did not produce lasting alterations in the ocular surface, and the values of the evaluated clinical parameters did not change significantly.


Asunto(s)
Proteínas de Ciclo Celular/genética , Córnea/metabolismo , Queratocono/genética , Metaloproteinasa 9 de la Matriz/genética , Proteína A6 de Unión a Calcio de la Familia S100/genética , Cistatinas Salivales/genética , Adolescente , Adulto , Biomarcadores/metabolismo , Estudios de Casos y Controles , Proteínas de Ciclo Celular/metabolismo , Córnea/diagnóstico por imagen , Córnea/fisiopatología , Córnea/cirugía , Topografía de la Córnea/métodos , Femenino , Regulación de la Expresión Génica , Humanos , Queratocono/diagnóstico por imagen , Queratocono/fisiopatología , Queratocono/cirugía , Masculino , Metaloproteinasa 9 de la Matriz/metabolismo , Concentración Osmolar , Estudios Prospectivos , Proteína A6 de Unión a Calcio de la Familia S100/metabolismo , Cistatinas Salivales/metabolismo , Transducción de Señal , Lágrimas/química , Lágrimas/metabolismo , Rayos Ultravioleta , Terapia Ultravioleta/métodos
5.
Exp Eye Res ; 167: 31-43, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-28336260

RESUMEN

Conjunctival impression cytology samples from patients with meibomian gland dysfunction (MGD), dry eye (DE), and healthy subjects (CT) were collected for determination of the degree of squamous metaplasia (SM) by PAS-hematoxylin staining and for comparative proteomic analyses by 2D-DIGE. The protein spots with discriminant expression were identified by MALDI-TOF/TOF mass spectrometry. Three independent statistical studies were conducted: i). Analysis of differential protein expression between study groups: We observed increased expression of proteins S100A4, S100A8, retinal dehydrogenase-1, peroxiredoxin-1, annexin-A1, annexin-A2, α-enolase, and glutathione S-transferase-P in DE, whereas the highest expression of peroxiredoxin-6, actin cytoplasmic-1, peroxiredoxin-2, and heat shock protein HSP-90-α was observed in MGD; ii). Correlation between changes in the proteome profile and the grade of SM: The expression of 5 different cytokeratins (KRT1, KRT4, KRT8, KRT10, and KRT13) correlated with the degree of SM; iii). Proteome profile differences between pathological and CT groups: An overall proteome analysis revealed upregulation of 9 proteins in the pathological groups (Annexin-A1, α-enolase, Annexin-A2, S100A8, cytokeratin-1, Peroxiredoxin-2 and Leukocyte elastase inhibitor) and downregulation of 2 proteins (Galectin-3 and Lipocalin-1). In conclusion, a sensitive proteomic approach to study conjunctival tissue collected from minimally invasive impression cytology was implemented. Differential proteomics analyses showed that in comparison with the MGD, the DE patients presented higher overexpression of proteins related to antimicrobial defense, tissue-damage response, and regulation of body fluid secretions. Changes in MGD proteome were associated with oxidative stress and anti-apoptotic processes. We found a correlation between the grade of SM and expression of proteins associated with cytoskeleton and keratinization. The studied pathological groups shared elements related to the defense and inflammatory responses. Dot blot assays of proteins ANXA1, S100A8, and S100A4 validated the proteomic results obtained from 2D-DIGE experiments and confirmed the correlation between the expression of these proteins and the clinical parameters.


Asunto(s)
Conjuntiva/metabolismo , Síndromes de Ojo Seco/metabolismo , Células Epiteliales/metabolismo , Proteínas del Ojo/metabolismo , Enfermedades de los Párpados/metabolismo , Glándulas Tarsales/metabolismo , Proteoma/metabolismo , Adulto , Estudios de Casos y Controles , Biología Celular , Conjuntiva/patología , Síndromes de Ojo Seco/patología , Células Epiteliales/patología , Epitelio/metabolismo , Epitelio/patología , Enfermedades de los Párpados/patología , Femenino , Humanos , Immunoblotting , Masculino , Glándulas Tarsales/patología , Metaplasia , Persona de Mediana Edad , Estudios Prospectivos , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Electroforesis Bidimensional Diferencial en Gel
6.
J Proteome Res ; 14(6): 2649-58, 2015 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-25946035

RESUMEN

Endogenous peptides are valuable targets in the analysis of biological processes. The tear film contains proteins and peptides released by the tear duct mucosal cells, including antimicrobial peptides involved in the protection against exogenous pathogens; however, the peptide content of the tear liquid remains poorly characterized. We analyzed naturally occurring peptides isolated from human basal tears. Mass spectrometry analysis of endogenous peptides presents a number of drawbacks, including size heterogeneity and nonpredictable fragmentation patterns, among others. Therefore, CID, ETD, and HCD methods were used for the characterization of the tear peptide content. The contribution of DMSO as an additive of the chromatographic solvents was also evaluated. We identified 157, 131, and 122 peptides using CID-, ETD-, and HCD-based methods, respectively. Altogether, 234 different peptides were identified, leading to the generation of the biggest data set of endogenous tear peptides to date. The antimicrobial activity prediction analysis performed in silico revealed different putative antimicrobial peptides. Two of the extracellular glycoprotein lacritin peptides were de novo synthesized, and their antimicrobial activity was confirmed in vitro. Our findings demonstrate the benefits of using different fragmentation methods for the analysis of endogenous peptides and provide a useful approach for the discovery of peptides with antimicrobial activity.


Asunto(s)
Antibacterianos/química , Péptidos/química , Proteoma , Lágrimas/química , Secuencia de Aminoácidos , Antibacterianos/farmacología , Humanos , Pruebas de Sensibilidad Microbiana , Datos de Secuencia Molecular , Péptidos/farmacología
7.
Mol Vis ; 21: 451-60, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25999673

RESUMEN

PURPOSE: The etiology of keratoconus (KC) and the factors governing its progression are not well understood. It has been suggested that this disease might be caused by biochemical alterations in the cornea; changes in the expression profiles of human aqueous humor (hAH) proteins have been observed in some diseases. To gain a new insight into the molecular mechanisms of KC pathology, we examined the hAH proteomes of those in the advanced stages of this disease. We used a high-throughput mass spectrometry approach to compare hAH protein expression in patients with KC and in control subjects. METHODS: Aqueous humor samples were acquired from five keratoconus patients during keratoplasty surgery and from five myopic control subjects during phakic intraocular lens implantation. Quantitative mass spectrometry analysis using spectral counting was performed to determine the relative amounts of hAH proteins in the samples from KC patients and control individuals. RESULTS: All KC patients included in the study presented severe keratoconus (K2 >52 D), and slit-lamp examination revealed microfolds in Descemet's membrane, without clinical signs of hydrops. We found significant differences between the expression levels of 16 proteins in the two groups. In KC samples, seven proteins were overexpressed and nine were underexpressed in comparison with the control group. Gene ontology analysis revealed that these deregulated proteins are implicated in several biologic processes, such as the regulation of proteolysis, responses to hypoxia, and responses to hydrogen peroxide, among others. CONCLUSIONS: The protein expression profiles in hAH from KC patients and myopic control subjects differ significantly. This result suggests that some components of the hAH proteome are involved in this disease. Further in-depth analysis of the hAH proteome should provide a better understanding of the mechanisms governing the pathophysiology of KC.


Asunto(s)
Humor Acuoso/química , Queratocono/metabolismo , Adulto , Humor Acuoso/metabolismo , Estudios de Casos y Controles , Cromatografía Liquida , Regulación hacia Abajo , Proteínas del Ojo/genética , Proteínas del Ojo/metabolismo , Femenino , Ontología de Genes , Humanos , Queratocono/etiología , Queratocono/genética , Masculino , Mapas de Interacción de Proteínas , Proteómica , Valores de Referencia , Espectrometría de Masas en Tándem , Regulación hacia Arriba
8.
Sensors (Basel) ; 15(8): 19819-29, 2015 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-26287192

RESUMEN

The specificity and affinity of antibody-antigen interactions is a fundamental way to achieve reliable biosensing responses. Different proteins involved with dry eye dysfunction: ANXA1, ANXA11, CST4, PRDX5, PLAA and S100A6; were validated as biomarkers. In this work several antibodies were tested for ANXA1, ANXA11 and PRDX5 to select the best candidates for each biomarker. The results were obtained by using Biophotonic Sensing Cells (BICELLs) as an efficient methodology for label-free biosensing and compared with the Enzyme-Linked Immuno Sorbent Assay (ELISA) technique.


Asunto(s)
Afinidad de Anticuerpos/inmunología , Antígenos/metabolismo , Biomarcadores/análisis , Técnicas Biosensibles/métodos , Síndromes de Ojo Seco/diagnóstico , Ensayo de Inmunoadsorción Enzimática/métodos , Animales , Anexinas/inmunología , Anticuerpos Monoclonales/metabolismo , Calibración , Femenino , Cinética , Ratones Endogámicos BALB C , Fenómenos Ópticos , Coloración y Etiquetado
9.
FASEB J ; 27(1): 299-312, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23073832

RESUMEN

Microglial cells are phagocytes in the central nervous system (CNS) and become activated in pathological conditions, resulting in microgliosis, manifested by increased cell numbers and inflammation in the affected regions. Thus, controlling microgliosis is important to prevent pathological damage to the brain. Here, we evaluated the contribution of Toll-like receptor 2 (TLR2) to microglial survival. We observed that activation of microglial cells with peptidoglycan (PGN) from Staphylococcus aureus and other TLR2 ligands results in cell activation followed by the induction of autophagy and autophagy-dependent cell death. In C57BL/6J mice, intracerebral injection of PGN increased the autophagy of microglial cells and reduced the microglial/macrophage cell number in brain parenchyma. Our results demonstrate a novel role of TLRs in the regulation of microglial cell activation and survival, which are important for the control of microgliosis and associated inflammatory responses in the CNS.


Asunto(s)
Autofagia , Muerte Celular/fisiología , Microglía/citología , Polisacáridos/fisiología , Receptor Toll-Like 2/metabolismo , Animales , Western Blotting , Citometría de Flujo , Ligandos , Masculino , Ratones , Ratones Endogámicos C57BL , Microscopía Confocal , Microscopía Electrónica de Transmisión , Polisacáridos/metabolismo
10.
Eur J Emerg Med ; 30(2): 91-101, 2023 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-36787242

RESUMEN

BACKGROUND AND IMPORTANCE: Deterioration of renal function with respect to baseline during an acute heart failure (AHF) episode is frequent, but impact on outcomes is still a matter of debate. OBJECTIVE: To investigate the association of creatinine deterioration detected at emergency department (ED) arrival and short-term outcomes in patients with AHF. DESIGN: Secondary analysis of a large multipurpose registry. SETTINGS AND PARTICIPANTS: Patients with AHF were diagnosed in 10 Spanish ED for whom a previous baseline creatinine was available. EXPOSURE: Difference between creatinine at ED arrival and at baseline was calculated (∂-creatinine). OUTCOME MEASURES AND ANALYSIS: Primary outcome was 30-day all-cause death, and secondary outcomes were inhospital all-cause death, prolonged hospitalization (>7 days) and 7-day postdischarge adverse events. Associations between ∂-creatinine and outcomes were explored using logistic regression by restricted cubic spline (RCS) curves and expressed as odds ratio (OR) with 95% confidence interval (CI), taking ∂-creatinine = 0 mg/dl as reference. Curves were adjusted by age, sex, comorbidities, patient baseline status, chronic treatments, and vitals and laboratory results at ED arrival. Interactions for the primary outcome also were investigated. MAIN RESULTS: We analyzed 3036 patients (median age = 82 years; IQR = 75-87; women = 55%), with ∂-creatinine ranged from -0.3 to 3 mg/dl. The 30-day mortality was 11.6%. Increments of ∂-creatinine were associated with progressive increase in risk of 30-day death, although adjustment attenuated this association: ∂-creatinine of 0.3/1/2/3 mg/dl were, respectively, associated with adjusted OR of 1.41 (1.02-1.95), 1.69 (1.02-2.80), 1.46 (0.56-3.80) and 1.27 (0.27-5.83). Distinctively significant higher risk was found for patients over 80 years old, female, nondiabetic, functionally disabled and on digoxin therapy. With respect to secondary outcomes, inhospital mortality was 8.1%, prolonged hospitalization was 33.6% and 7-day postdischarge adverse event was 9.7%. Inhospital death steadily increased with increments in ∂-creatinine [from 1.50 (1.04-2.17) with ∂-creatinine = 0.3 to 3.78 (0.78-18.3) with ∂-creatinine = 3], as well as prolonged hospitalization did [from 1.41 (1.11-1.77) to 2.24 (1.51-3.33), respectively]. Postdischarge adverse events were not associated with ∂-creatinine. CONCLUSION: WRF detected at ED arrival has prognostic value in AHF, being associated with increased risk of death and prolonged hospitalization. These associations showed different patterns of risk but, remarkably, risk started with increments as low as 0.3 mg/dl.


Asunto(s)
Insuficiencia Cardíaca , Alta del Paciente , Humanos , Femenino , Anciano de 80 o más Años , Creatinina , Cuidados Posteriores , Enfermedad Aguda , Insuficiencia Cardíaca/diagnóstico , Riñón/fisiología , Servicio de Urgencia en Hospital
11.
Ophthalmology ; 119(5): 923-9, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22297031

RESUMEN

PURPOSE: To evaluate a limbal stem cell deficiency (LSCD) diagnosis method based on the detection of the MUC5AC transcript by reverse transcription-polymerase chain reaction (RT-PCR) in comparison with the standard diagnostic method based on goblet cell detection by periodic acid-Schiff (PAS)-hematoxylin staining, using samples obtained from corneal epithelium impression cytology (IC). DESIGN: Transversal, comparative case series. PARTICIPANTS: We studied 59 eyes from 43 patients clinically diagnosed with LSCD. METHODS: Impression cytology was used to gather cells from corneal and conjunctival epithelium from the same eye. The presence of goblet cells in the cornea was determined by PAS-hematoxylin staining, whereas the presence of the MUC5AC transcript was detected by RT-PCR using a custom-designed primer pair. MAIN OUTCOME MEASURES: Goblet cells in the corneal epithelium were detected by light microscopy, and the MUC5AC transcript was detected as the corresponding PCR amplicon in agarose gels. RESULTS: Our study included 59 corneal samples, together with their respective conjunctival samples for RT-PCR assays. Of these, 47 samples were also available for comparative PAS-hematoxylin staining. The MUC5AC amplicon was detected in 56 of 59 (94.9%) corneal epithelium samples. In contrast, conventional IC staining detected goblet cells in only 17 of 47 (36.2%) samples; these were not found in 27 of 47 (57.4%) samples (negative results), and 3 of 47 (6.4%) showed inconclusive results. CONCLUSIONS: The detection of the MUC5AC transcript in corneal epithelium is a more sensitive method to diagnose LSCD than the conventional PAS-hematoxylin method, although a minimum RNA concentration of 1.2 ng/µl is required for negative results to be reliable. Moreover, RT-PCR is a highly specific and more objective technique. Overall, these findings indicate that molecular analysis facilitates a more precise clinical diagnosis of LSCD, thereby reducing the risk of surgical failure.


Asunto(s)
Enfermedades de la Córnea/diagnóstico , Epitelio Corneal/patología , Células Caliciformes/patología , Limbo de la Córnea/patología , Mucina 5AC/genética , ARN Mensajero/análisis , Células Madre/patología , Anciano , Enfermedades de la Córnea/genética , Electroforesis en Gel de Agar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reacción del Ácido Peryódico de Schiff , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Adulto Joven
12.
Emergencias ; 34(5): 377-387, 2022 10.
Artículo en Inglés, Español | MEDLINE | ID: mdl-36217933

RESUMEN

TEXT: Recent years have seen great advances in the use of clinical ultrasound imaging in both hospital emergency departments and out-of-hospital settings. However, all new techniques require up-to-date definitions of competencies relevant to the clinical realities of different specialties and the geographic settings in which specialists work. To that end, a group of experts in clinical ultrasound reviewed the evidence available in the literature and strictly applied the Delphi method to define the competencies relevant to emergency physicians. The group worked with the starting premise that clinical ultrasound imaging should be a common competency across the specialty.


TEXTO: En los últimos años, la ecografía clínica (EC) ha sufrido un avance muy importante en su implantación dentro de los servicios de urgencias, tanto hospitalarios como extrahospitalarios, pero como toda técnica requiere un ámbito competencial definido, actualizado y enmarcado, tanto en la realidad clínica de la especialidad que desempeñamos como en la geográfica del país donde ejercemos. Por ello, un grupo de expertos en la materia ha desarrollado el presente documento en el que basándose por un lado en la evidencia disponible en la bibliografía científica y por otro en una metodología Delphi, planteó el objetivo de establecer un claro marco competencial base para todos los urgenciólogos, asumiendo como premisa inicial que la EC debería ser una competencia transversal común.


Asunto(s)
Competencia Clínica , Servicio de Urgencia en Hospital , Humanos , Especialización , Ultrasonografía
13.
Emergencias ; 34(6): 418-427, 2022 12.
Artículo en Inglés, Español | MEDLINE | ID: mdl-36625691

RESUMEN

OBJECTIVES: To describe the sociodemographic characteristics of and the health care resources used to treat patients aged 65 years or older who come to hospital emergency departments (EDs) in Spain, according to age groups. MATERIAL AND METHODS: We studied the phase-1 data for the EDEN cohort (Emergency Department and Elder Needs). Forty Spanish EDs collected data on all patients aged 65 years or older who were treated on the first 7 days in April 2019. We registered information on 6 sociodemographic and 5 function variables for all patients. For health resource use we used 6 diagnostic, 13 therapeutic, and 5 physical structural variables, for a total of 24 variables. Differences were analyzed according to age in blocks of 5 years. RESULTS: A total of 18 374 patients with a median age of 78 years were included; 55% were women. Twenty-seven percent arrived by ambulance, 71% had not previously been seen by a physician, and 13% lived alone without assistance. Ten percent had a high level of functional dependence, and 14% had serious comorbidity. Resources used most often were blood analysis (in 60%) and radiology (59%), analgesics (25%), intravenous fluids (21%), antibiotics (14%), oxygen (13%), and bronchodilators (11%). Twenty-six percent were kept under observation in the ED, 26% were admitted to wards, and 2% were admitted to intensive care units (ICUs). The median stay in the ED was 3.5 hours, and the median hospital stay was 7 days. Sociodemographic characteristics changed according to age. Functional dependence worsened with age, and resource requirements increased in general. However, benzodiazepine use was unaffected, while the use of nonsteroidal anti-inflammatory drugs and ICU admission decreased. CONCLUSION: The functional dependence of older patients coming to EDs increases with age and is associated with a high level of health care resource use, which also increases with age. Planners should take into consideration the characteristics of the older patients and the proportion of the caseload they represent when arranging physical spaces and designing processes for a specific ED.


OBJETIVO: Investigar las características sociodemográficas y consumo de recursos de los pacientes de 65 o más años que consultan en servicios de urgencias hospitalarios (SUH) en España, y su modificación por grupos etarios. METODO: Se utilizaron datos de la cohorte EDEN obtenidos en fase 1 (Emergency Department and Elder Needs). Cuarenta SUH españoles incluyeron todos los pacientes de $ 65 años atendidos del 1-4-2019 al 7-4-2019 (7 días). Se analizaron 6 características sociodemográficas, 5 funcionales y 24 referidas a consumo de recursos (6 diagnósticos, 13 terapéuticos, 5 estructurales) y sus cambios a medida que avanza la edad (agrupada en bloques de 5 años). RESULTADOS: Se analizaron 18.374 pacientes (mediana edad: 78 años; 55% mujeres). El 27% acude a urgencias en ambulancia, el 71% sin consulta médica previa y el 13% vive solo sin cuidadores. Funcionalmente, el 10% tiene dependencia grave y el 14% comorbilidad grave. La solicitud de analítica sanguínea (60% de casos) y radiología (59%) destaca entre el consumo de recursos diagnósticos, y el uso de analgésicos (25%), sueroterapia (21%), antibioticoterapia (14%), oxigenoterapia (13%) y broncodilatadores (11%), entre los terapéuticos. El 26% requiere observación en urgencias, el 26% hospitalización y el 2% cuidados intensivos. La mediana de estancia en urgencias es de 3:30 horas y la de hospitalización es de 7 días. Las características sociodemográficas se modifican con la edad, las funcionales empeoran y el consumo de recursos aumenta (excepto benzodiacepinas, que no se modifica, y antinflamatorios no esteroideos y cuidados intensivos, que disminuye). CONCLUSIONES: Las características funcionales de la población mayor que consulta en los SUH empeora a medida que su edad avanza, y se asocia a un consumo de recursos alto que también se incrementa con la edad. Las características de esta población y su proporción en un determinado SUH deben tenerse en cuenta en su planificación estructural y funcional.


Asunto(s)
Servicio de Urgencia en Hospital , Estado Funcional , Humanos , Femenino , Anciano , Masculino , Hospitalización , Tiempo de Internación , Recursos en Salud
14.
Neurobiol Dis ; 43(3): 616-24, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21624466

RESUMEN

Microglial cells are resident macrophages in the central nervous system (CNS) and become activated in many pathological conditions. Activation of microglial cells results in reactive microgliosis, manifested by an increase in cell number in the affected CNS regions. The control of microgliosis may be important to prevent pathological damage to the brain. The type 2 cytokine IL-4 has been reported to be protective in brain inflammation. However, its effect on microglial cell survival was not well understood. In this study, we report a dual effect of IL-4 on the survival of mouse microglial cells. In a 6h short term culture, IL-4 reduced the death of microglial cells induced by staurosporine. In contrast, in long term treatment (more than 48h), IL-4 increased the apoptotic death of both primary mouse microglial cells and a microglial cell line N9. Mechanistic studies revealed that, in microglial cells, IL-4 increased the levels of cleaved caspase 3 and PARP, which is down-stream of activated caspase 3. In addition, IL-4 down regulated the autophagy and the antiapoptotic protein Bcl-xL in microglial cells. On the other hand, the pre-incubation of microglial cells with IL-4 for 24h, attenuated the cell death induced by the neurotoxic peptide amyloid beta 1-42 (Aß42). Our observations demonstrate a novel function of IL-4 in regulating the survival of microglial cells, which may have important significance in reduction of undesired inflammatory responses in the CNS.


Asunto(s)
Apoptosis/inmunología , Caspasa 3/fisiología , Interleucina-4/fisiología , Microglía/inmunología , Péptidos beta-Amiloides/toxicidad , Animales , Inhibidores de Caspasas , Supervivencia Celular/inmunología , Células Cultivadas , Mediadores de Inflamación/antagonistas & inhibidores , Mediadores de Inflamación/fisiología , Ratones , Ratones Endogámicos C57BL , Microglía/enzimología , Microglía/patología , Fragmentos de Péptidos/toxicidad , Poli(ADP-Ribosa) Polimerasa-1 , Poli(ADP-Ribosa) Polimerasas/biosíntesis , Poli(ADP-Ribosa) Polimerasas/metabolismo , Estaurosporina/farmacología
15.
J Nanosci Nanotechnol ; 19(12): 7810-7818, 2019 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-31196293

RESUMEN

The modification of the structural and surface characteristics of Ti1-xZrxO2 nanocrystallites by postsynthesis treatments is revealed as an effective way to enhance their photocatalytic activity. Starting with the same batch of mixed oxide prepared from reverse microemulsions, different photocatalysts have been obtained by either solvothermal treatment, calcination or a combination of both. Extensive physicochemical characterization of the resulting materials shows that solvothermally treated oxides present lower crystallite size and larger surface area, although without previous calcination these samples appear to have a higher degree of structural disorder. These differences are sharply reflected in the changes in photocatalytic activity for the removal of methylcyclohexane (MCH) and toluene vapours at relatively high concentrations. Thus, the best performance for MCH elimination is obtained with the photocatalysts prepared by calcination and subsequent solvothermal treatment. Following this procedure, the resulting Ti1-xZrxO2 material presents larger surface area and high Zr surface concentration with minimal disturbance of the anatase structure. In contrast, for toluene photooxidation, the solvothermally prepared sample shows improved performance, most likely due to its larger surface area, which contributes to hinder deactivation.

16.
Emergencias ; 31(3): 167-172, 2019 Jun.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31210448

RESUMEN

OBJECTIVES: To assess the accuracy, safety, and efficiency of ultrasound images obtained by emergency physician to diagnose deep vein thrombosis (DVT). patients with acute heart failure (AHF) attended in a hospital emergency department (ED). MATERIAL AND METHODS: Prospective multicenter cohort study. We assigned patients suspected of having DVT to an intervention or control group. Emergency physicians took ultrasound images that were later evaluated by a radiologist in the intervention group. In the control group, images were evaluated only by the radiologist. We analyzed patient, physician, and episode variables. Test results, times until imaging, and 30-day adverse events were also analyzed. Sensitivity, specificity, positive and negative likelihood ratios, and agreement between physicians and radiologists (κ statistic) were calculated. RESULTS: A total of 304 patients (209 in the intervention group and 95 controls) were included. The groups were comparable. The overall prevalence of DVT was 35.5% (95% CI, 30.3-41.0). The sensitivity of ultrasound images obtained by emergency physicians was superior in relation to experience: 71.4 (95% CI, 50.0-86.0) for those in a training course, 75.0 (95% CI, 80.0-95.4) for those with at least 2 months' practical experience, and 94.7 (95% CI, 82.7-98.5) for routine users. Specificity statistics for the 3 levels of physician experience were 83.3 (95% CI 55.2- 95.2), 100 (95% CI 83.0-100), and 96.6 (95% CI 88.4-99.0), respectively. The positive and negative likelihood ratios for ultrasound imaging by physicians were 27.94 and 0.054, respectively. The κ statistic was 0.80. Mean (SD) time until a physician took ultrasound images was 1.81 (1.46) hours versus 4.39 (1.81) hours until a radiologist obtained images (P = .007). Three deaths occurred within 30 days. They were not attributable to recurrence or bleeding. CONCLUSION: Ultrasound images taken by emergency physicians to diagnose DVT are accurate and safe and may be efficient. However, routine experience with ultrasound is necessary.


OBJETIVO: Evaluar la precisión, la seguridad y la eficiencia de la ecografía realizada por urgenciólogos para el diagnóstico de la trombosis venosa profunda (TVP). METODO: Estudio prospectivo multicéntrico de cohortes que incluyó pacientes con sospecha de TVP asignados a un grupo intervención (evaluados ecográficamente por el urgenciólogo y posteriormente por el radiólogo) y a un grupo control (evaluados únicamente por el radiólogo). Se analizaron las variables relacionadas con el paciente, el urgenciólogo, el episodio, el resultado de la prueba y los tiempos de estancia y acontecimientos a 30 días. Se calcularon la sensibilidad, la especificidad, las razones de verosimilitud positiva y negativa, y el índice kappa. RESULTADOS: Se incluyeron 304 pacientes (95 control, 209 intervención). Ambos grupos fueron comparables. La prevalencia de TVP en la cohorte global fue de 35,5% (IC 95% 30,3-41,0). La sensibilidad de la ecografía realizada por urgenciólogos fue superior según la experiencia-curso vs meses vs uso habitual: 71,4 (IC 95% 50,0-86,0) vs 75,0 (IC 95% 80,0-95,4) vs 94,7 (IC 95% 82,7-98,5), así como la especificidad 83,3 (IC 95% 55,2-95,2) vs 100 (IC 95% 83,0- 100) vs 96,6 (IC 95% 88,4-99,0). Las razones de verosimilitud positiva y negativa para la ecografía realizada por urgenciólogos fueron del 27,94 y del 0,054, respectivamente. El índice de kappa fue de 0,80. El tiempo hasta la realización de la ecografía por el urgenciólogo fue de 1,81 (DE 1,46) frente a 4,39 (DE 1,81) horas del radiólogo (p = 0,007). Durante el seguimiento a 30 días, se registraron 3 muertes, ninguna de ellas por recurrencia o hemorragia. CONCLUSIONES: La ecografía realizada por urgenciólogos para el diagnóstico de TVP es precisa, segura y podría resultar eficiente. Sin embargo, se requiere de experiencia basada en el uso habitual de esta técnica.


Asunto(s)
Medicina de Emergencia/normas , Servicio de Urgencia en Hospital , Trombosis de la Vena/diagnóstico por imagen , Anciano , Estudios de Casos y Controles , Eficiencia , Femenino , Humanos , Tiempo de Internación , Masculino , Prevalencia , Estudios Prospectivos , Radiólogos/normas , Sensibilidad y Especificidad , Ultrasonografía/efectos adversos , Ultrasonografía/normas , Trombosis de la Vena/epidemiología
18.
Biochim Biophys Acta ; 1760(2): 172-81, 2006 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-16442736

RESUMEN

Most cyanobacteria take up nitrate or nitrite through a multisubunit ABC transporter (ATP-binding cassette) located in the cytoplasmic membrane. Nitrate and nitrite transport activity is instantaneously blocked by the presence of ammonium in the medium. Previous biochemical studies reported the existence of phosphorylation/dephosphorylation events of the nitrate transporter (NRT) related to the presence of ammonium-sensitive kinase/phosphatase activities in plasma membranes of the cyanobacterium Synechococcus elongatus PCC 6301. In this work, we have analyzed the biochemical properties of the periplasmic nitrate/nitrite-binding subunit (NrtA) of NRT from the thermophilic nondiazotrophic cyanobacterium Phormidium laminosum. Our results show that cyanobacterial NrtA is phosphorylated in vivo. However, substrate binding activity in vitro is not affected by the phosphorylation state of the protein, ruling out the possibility that phosphorylation/dephosphorylation of NrtA is involved in the regulation of the nitrate/nitrite uptake by NRT transporter. Moreover, NrtA is present as multiple isoforms showing the same molecular mass but different isoelectric points ranging from pI 5 to 6. Mass spectrometric characterization of NrtA isoforms shows that the protein is phosphorylated at residue Tyr203, and contains several methionine sulphoxide residues which account for the observed isoforms. Both phosphorylated and non-phosphorylated forms of NrtA are active in vitro, showing comparable binding affinity for nitrate and nitrite. Both substrates behave as pure competitive inhibitors with a binding stoichiometry of one molecule of anion per NrtA monomer.


Asunto(s)
Transportadoras de Casetes de Unión a ATP/metabolismo , Proteínas de Transporte de Anión/metabolismo , Cianobacterias/metabolismo , Transportadoras de Casetes de Unión a ATP/aislamiento & purificación , Secuencia de Aminoácidos , Proteínas de Transporte de Anión/aislamiento & purificación , Unión Competitiva , Electroforesis en Gel de Poliacrilamida , Punto Isoeléctrico , Cinética , Espectrometría de Masas , Datos de Secuencia Molecular , Transportadores de Nitrato , Nitratos/metabolismo , Nitritos/metabolismo , Fosforilación , Unión Proteica , Isoformas de Proteínas/química , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Tirosina/química
19.
J Proteomics ; 150: 359-367, 2017 01 06.
Artículo en Inglés | MEDLINE | ID: mdl-27184738

RESUMEN

Tears are a complex biological mixture containing electrolytes, metabolites, lipids, mucins, some small organic molecules, and proteins. The tear film has various roles in the lubrication, protection from the external environment, and nutrition of the cornea; it is also involved in the modulation of the optical properties of the eye. Tear composition reflects the physiological condition of the underlying tissues. Therefore, the tear fluid is useful in the evaluation of health and disease states and it is a valuable source of biomarkers for objective analysis of ocular and systemic diseases. The relatively high protein concentration of this fluid and the ease of noninvasive sample collection make it suitable for diagnostic and prognostic purposes. Efforts in proteomics research have positively affected to the field of ophthalmology, and the knowledge on the tear proteome has expanded considerably in the last few years. Nevertheless, despite a large amount of available data and the many biomarkers proposed for several eye and systemic diseases, the extent of translation to well-characterized and clinically useful tools has been largely insufficient. As for most of other biofluids, the road from discovery to clinical application is still long and full of pitfalls. In this review, we discuss the proteomic approaches used in the characterization of tear protein and peptide content, recapitulating the main studies and the progress done. We also present a brief summary of the path from discovery to clinical application of tear protein markers, with some representative examples of translation from the bench to the bedside. SIGNIFICANCE: In this review we cover the most relevant proteomic approaches used in the characterization of the tear proteome, and for the first time we also focus in advances performed in the nowadays emerging peptide content characterization. In this context, we recapitulate on the main studies and the progresses done in this field. We also present a concise overview of the course that may be happen from discovery to clinical application for tear protein markers. Finally we include some representative examples of translation from the bench to the bedside.


Asunto(s)
Oftalmopatías/diagnóstico , Proteínas del Ojo/análisis , Oftalmología/métodos , Proteómica/métodos , Investigación Biomédica Traslacional/métodos , Biomarcadores/análisis , Biomarcadores/metabolismo , Práctica Clínica Basada en la Evidencia/métodos , Práctica Clínica Basada en la Evidencia/tendencias , Oftalmopatías/metabolismo , Oftalmopatías/terapia , Proteínas del Ojo/metabolismo , Humanos , Oftalmología/tendencias , Péptidos/análisis , Proteoma/análisis , Lágrimas/química , Lágrimas/metabolismo , Investigación Biomédica Traslacional/tendencias
20.
PLoS One ; 12(3): e0174559, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28358901

RESUMEN

Excessive subconjunctival scarring is the main reason of failure of glaucoma filtration surgery. We analyzed conjunctival and systemic gene expression patterns after non penetrating deep sclerectomy (NPDS). To find expression patterns related to surgical failure and their correlation with the clinical outcomes. This study consisted of two consecutive stages. The first was a prospective analysis of wound-healing gene expression profile of six patients after NPDS. Conjunctival samples and peripheral blood samples were collected before and 15, 90,180, and 360 days after surgery. In the second stage, we conducted a retrospective analysis correlating the late conjunctival gene expression and the outcome of the NPDS for 11 patients. We developed a RT-qPCR Array for 88 key genes associated to wound healing. RT-qPCR Array analysis of conjunctiva samples showed statistically significant differences in 29/88 genes in the early stages after surgery, 20/88 genes between 90 and 180 days after surgery, and only 2/88 genes one year after surgery. In the blood samples, the most important changes occurred in 12/88 genes in the first 15 days after surgery. Correspondence analyses (COA) revealed significant differences between the expression of 20/88 genes in patients with surgical success and failure one year after surgery. Different expression patterns of mediators of the bleb wound healing were identified. Examination of such patterns might be used in surgery prognosis. RT-qPCR Array provides a powerful tool for investigation of differential gene expression wound healing after glaucoma surgery.


Asunto(s)
Enfermedades de la Conjuntiva/genética , Glaucoma/genética , Glaucoma/cirugía , Esclerótica/cirugía , Anciano , Conjuntiva/metabolismo , Conjuntiva/fisiopatología , Conjuntiva/cirugía , Enfermedades de la Conjuntiva/fisiopatología , Enfermedades de la Conjuntiva/cirugía , Femenino , Cirugía Filtrante/efectos adversos , Regulación de la Expresión Génica/genética , Glaucoma/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Esclerótica/metabolismo , Esclerótica/parasitología , Trabeculectomía/efectos adversos , Cicatrización de Heridas/genética
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