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1.
J Eur Acad Dermatol Venereol ; 34(7): 1464-1470, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31785169

RESUMO

BACKGROUND: Organ transplant recipients (OTR) have a higher risk of actinic keratosis (AK) and keratinocyte carcinomas (KC). There are no clinical trials assessing the effectiveness of daylight photodynamic therapy (DPDT) to prevent new AK and KC in OTR. OBJECTIVES: To determine whether repeated treatments of field cancerization with DPDT are effective in preventing new AK and KC in OTR. METHODS: A randomized, intra-subject controlled, evaluator-blind, split-face and/or scalp trial, from April 2016 to October 2018. Participants were OTR older than 18 years, 1-year posttransplant, with at least 5 AK on each hemi-face/hemi-scalp. One side received six field treatments with DPDT: two sessions 15 days apart at baseline, two at 3 months and two at 9 months after baseline. Control side received lesion-directed treatment with cryotherapy (double freeze-thaw) at baseline, 3 and 9 months. Total number of lesions (AK and KC) at 21 months, number of new AK and KC at 3, 9, 15 and 21 months and treatment preferences were analysed. RESULTS: Of 24 men included, 23 were analysed at 3 months; and 21, at 9, 15 and 21 months. Mean (SD) age was 69.8 years (9.2). The total number of lesions at 21 months was 4.7 (4.3) for DPDT and 5.8 (5.0) for control side; P = 0.09. DPDT showed significantly lower means [SD] of new lesions compared to control side at 3 months (4.2 [3.4] vs. 6.8 [4.8]; P < 0.001), 9 months (3.0 [3.3] vs. 4.3 [3.4]; P = 0.04) and 15 months (3.0 [4.6] vs. 4.8 [5.0]; P = 0.02), and non-significant at 21 months (3.7 [3.5] vs. 5.0 [4.5]; P = 0.06). Most participants preferred DPDT. CONCLUSION: DPDT showed potential effectiveness in preventing new AK and KC in OTR by consecutive treatments of field cancerization. The preference for DPDT could facilitate adherence to the long-term treatment necessary in these patients.


Assuntos
Carcinoma , Ceratose Actínica , Transplante de Órgãos , Fotoquimioterapia , Idoso , Ácido Aminolevulínico/uso terapêutico , Crioterapia , Humanos , Queratinócitos , Ceratose Actínica/tratamento farmacológico , Ceratose Actínica/prevenção & controle , Masculino , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/uso terapêutico , Resultado do Tratamento
3.
Antimicrob Agents Chemother ; 59(12): 7316-9, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26369956

RESUMO

Extensively drug-resistant (XDR) Acinetobacter spp. have emerged as a cause of nosocomial infections, especially under conditions of intensive care. Unfortunately, resistance to colistin is increasing and there is a need for new therapeutic options. We aimed to study the effect of some novel combinations against XDR Acinetobacter baumannii in an in vitro pharmacokinetics-pharmacodynamics (PK/PD) model. Three nonrelated clinical strains of XDR A. baumannii were investigated. Antibiotic-simulated regimens were colistin at 3 MU every 8 h (q8h) (first dose, 6 MU), daptomycin at 10 mg/kg of body weight q24h, imipenem at 1 g q8h, and ertapenem at 1 g q24h. Combination regimens included colistin plus daptomycin, colistin plus imipenem, and imipenem plus ertapenem. Samples were obtained at 0, 1, 2, 4, 8, and 24 h. Among the single-agent regimens, only the colistin regimen resulted in significant reductions in log10 CFU per milliliter compared to the control for all the strains tested. Although colistin achieved bactericidal activity at 4 h, it was not able to reach the limit of detection (1 log10 CFU/ml). One strain had significant regrowth at 24 h without the emergence of resistance. Daptomycin-colistin combinations led to a significant reduction in levels of log10 CFU per milliliter that were better than those achieved with colistin as a single-agent regimen, reaching the limit of detection at 24 h against all the strains. The combination of imipenem plus ertapenem outperformed the colistin regimen, although the results did not reach the limit of detection, with significant regrowth at 24 h. Similarly, colistin-plus-imipenem combinations reduced the levels of log10 CFU per milliliter at 8 h, with significant regrowth at 24 h but with development of resistance to colistin. We have shown some potentially useful alternatives for the treatment of extensively drug-resistant A. baumannii. Among them, the daptomycin-colistin combination was the most effective and should be investigated in future studies.


Assuntos
Acinetobacter baumannii/efeitos dos fármacos , Antibacterianos/farmacocinética , Colistina/farmacocinética , Daptomicina/farmacocinética , Farmacorresistência Bacteriana Múltipla , Modelos Estatísticos , Infecções por Acinetobacter/tratamento farmacológico , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/crescimento & desenvolvimento , Antibacterianos/farmacologia , Área Sob a Curva , Colistina/farmacologia , Contagem de Colônia Microbiana , Daptomicina/farmacologia , Esquema de Medicação , Combinação de Medicamentos , Ertapenem , Humanos , Imipenem/farmacocinética , Imipenem/farmacologia , Limite de Detecção , Testes de Sensibilidade Microbiana , Modelos Biológicos , beta-Lactamas/farmacocinética , beta-Lactamas/farmacologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-26310043

RESUMO

OBJECTIVE: To compare the skin prick test (SPT) with in vitro techniques (single and multiplex fluorescence enzyme-immunoassay [FEIA]) for detecting sensitization to profilin and lipid transfer protein (LTP). METHODS: We retrospectively studied 181 patients with pollen and/or plant food allergy and 61 controls. SPT was performed with date palm profilin (Pho d 2) and peach LTP (Pru p 3), and specific IgE (sIgE) to Phl p 12 and Pru p 3 was analyzed using single FEIA and microarray. RESULTS: Fifteen of 201 patients with negative results for LTP in the SPT were sensitized to this allergen in the in vitro tests, and 18 of 41 patients with positive results for LTP in the SPT were not sensitized according to the in vitro tests. Seventeen of 186 patients with negative results for profilin in the SPT were sensitized to Phl p 12 by serum sIgE, and 30 out of 56 patients with positive results for profilin in SPT were not sensitized to Phl p 12 according to the other tests. Moderate agreement was observed between the 3 techniques studied. CONCLUSIONS: SPT is a sensitive technique for detecting sensitization to LTP and profilin. Its results are similar to those of in vitro techniques, especially in patients with negative SPT results for peach LTP and palm tree profilin.


Assuntos
Proteínas de Transporte/imunologia , Hipersensibilidade Alimentar/diagnóstico , Profilinas/imunologia , Prunus/imunologia , Rinite Alérgica Sazonal/diagnóstico , Testes Cutâneos , Humanos , Imunoglobulina E/sangue , Técnicas In Vitro , Estudos Retrospectivos
5.
Allergy ; 68(6): 820-2, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23646901

RESUMO

Allergic skin tests have to be performed 4-6 weeks after an allergic anesthetic reaction. Patients with allergic reactions during anesthesia were prospectively included (n = 44). Skin tests were performed in two stages: (i) Stage 1 (S1), 0-4 days after the reaction; and (ii) Stage 2 (S2), 4-8 weeks after. Five (11.5%) surgical procedures were suspended due to the reaction. Positive skin tests were obtained in 25/44 patients (57%). Allergic diagnosis was carried out at S1 in 15/25 (60%) and at S2 in 10/25 (40%). Three patients resulted positive only in S1. Overall agreement among S1 and S2 skin tests was 70.45%. The kappa statistic was 0.41 (P-value = 0.002). Odds ratio of obtaining a false negative in S1 (compared with S2) was 3.33. Early allergological study is useful, could minimize false negatives, but should be considered as a complement to late skin tests.


Assuntos
Anafilaxia/diagnóstico , Anestesia , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade Imediata/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anafilaxia/induzido quimicamente , Criança , Hipersensibilidade a Drogas/etiologia , Diagnóstico Precoce , Reações Falso-Negativas , Feminino , Humanos , Hipersensibilidade Imediata/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Testes Cutâneos , Adulto Jovem
6.
Protein Sci ; 32(4): e4606, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36810829

RESUMO

Human pre-mRNA processing protein 40 homolog A (hPrp40A) is a splicing factor that interacts with the Huntington's disease protein huntingtin (Htt). Evidence has accumulated that both Htt and hPrp40A are modulated by the intracellular Ca2+ sensor calmodulin (CaM). Here we report characterization of the interaction of human CM with the third FF domain (FF3 ) of hPrp40A using calorimetric, fluorescence and structural approaches. Homology modeling, differential scanning calorimetry and small angle X-ray scattering (SAXS) data show FF3 forms a folded globular domain. CaM was found to bind FF3 in a Ca2+ -dependent manner with a 1:1 stoichiometry and a dissociation constant (Kd ) of 25 ± 3 µM at 25°C. NMR studies showed that both domains of CaM are engaged in binding and SAXS analysis of the FF3 -CaM complex revealed CaM occupies an extended configuration. Analysis of the FF3 sequence showed that the anchors for CaM binding must be buried in its hydrophobic core, suggesting that binding to CaM requires unfolding of FF3 . Trp anchors were proposed based on sequence analysis and confirmed by intrinsic Trp fluorescence of FF3 upon binding of CaM and substantial reductions in affinity for Trp-Ala FF3 mutants. The consensus model of the complex showed that binding to CaM binding occurs to an extended, non-globular state of the FF3 , consistent with coupling to transient unfolding of the domain. The implications of these results are discussed in the context of the complex interplay of Ca2+ signaling and Ca2+ sensor proteins in modulating Prp40A-Htt function.


Assuntos
Calmodulina , Simulação de Dinâmica Molecular , Humanos , Calmodulina/química , Espalhamento a Baixo Ângulo , Difração de Raios X , Ligação Proteica , Cálcio/metabolismo , Sítios de Ligação
7.
Eur J Intern Med ; 118: 49-58, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37544847

RESUMO

BACKGROUND: The aim of this study was to explore the impact of arthritis on liver function using different approaches in vivo and in vitro. METHODS: A cross-sectional study was performed on 330 non-obese/non-T2DM subjects: 180 RA patients, 50 NAFLD non-RA patients, and 100 healthy donors (HDs). A longitudinal study was conducted on 50 RA patients treated with methotrexate for six months. Clinical and laboratory parameters and markers of liver disease were collected. Mechanistic studies were carried out in both the CIA mouse model and hepatocytes treated with anti-citrullinated protein antibodies (ACPAs). RESULTS: RA patients have an increased risk of suffering from liver disease independent of obesity or T2DM. This risk was associated with factors such as insulin resistance, autoantibodies, inflammation, and component C3. Methotrexate treatment for six months was associated with liver abnormalities in those newly-diagnosed patients having CV risk factors. ACPAs induced a defective hepatocyte function, promoting IR and inflammation. The induction of arthritis in mice caused the infiltration of immune cells in the liver and increased inflammatory, apoptotic, and fibrotic processes. CONCLUSION: RA patients may experience mild to moderate liver inflammation due to the infiltration of T, B cells, and macrophages, and the action of ACPAs. This is independent of obesity or diabetes and linked to systemic inflammation, and disease activity levels. The negative effects of methotrexate on liver function could be restricted to the concomitant presence of cardiovascular risk factors.


Assuntos
Artrite Reumatoide , Hepatopatias , Humanos , Animais , Camundongos , Metotrexato/uso terapêutico , Estudos Longitudinais , Estudos Transversais , Peptídeos Cíclicos , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Autoanticorpos , Inflamação , Obesidade
8.
J Colloid Interface Sci ; 608(Pt 1): 1-12, 2022 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-34624760

RESUMO

Access to detailed information on cells loaded with nanoparticles with nanoscale precision is of a long-standing interest in many areas of nanomedicine. In this context, designing a single experiment able to provide statistical mean data from a large number of living unsectioned cells concerning information on the nanoparticle size and aggregation inside cell endosomes and accurate nanoparticle cell up-take is of paramount importance. Small-angle X-ray scattering (SAXS) is presented here as a tool to achieve such relevant data. Experiments were carried out in cultures of B16F0 murine melanoma and A549 human lung adenocarcinoma cell lines loaded with various iron oxide nanostructures displaying distinctive structural characteristics. Five systems of water-dispersible magnetic nanoparticles (MNP) of different size, polydispersity and morphology were analyzed, namely, nearly monodisperse MNP with 11 and 13 nm mean size coated with meso-2,3-dimercaptosuccinic acid, more polydisperse 6 nm colloids coated with citric acid and two nanoflowers (NF) systems of 24 and 27 nm in size resulting from the aggregation of 8 nm MNP. Up-take was determined for each system using B16F0 cells. Here we show that SAXS pattern provides high resolution information on nanoparticles disposition inside endosomes of the cytoplasm through the structure factor analysis, on nanoparticles size and dispersity after their incorporation by the cell and on up-take quantification from the extrapolation of the intensity in absolute scale to null scattering vector. We also report on the cell culture preparation to reach sensitivity for the observation of MNP inside cell endosomes using high brightness SAXS synchrotron source. Our results show that SAXS can become a valuable tool for analyzing MNP in cells and tissues.


Assuntos
Nanopartículas de Magnetita , Animais , Humanos , Magnetismo , Camundongos , Espalhamento a Baixo Ângulo , Difração de Raios X , Raios X
9.
J Nanosci Nanotechnol ; 11(4): 3493-8, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21776729

RESUMO

The synthesis of spherical copper nanoparticles with extremely narrow size distribution by electroless copper deposition on mesoporous silica support is described. The materials were characterized by nitrogen sorption, transmission electron microscopy, x-ray diffractometry and Fourier transform infrared spectroscopy. The copper nanoparticles have a cubic crystalline structure and an average particle size of 5.5 +/- 0.8 nm. The copper nanoparticles are stable, without detectable oxidation or further agglomeration under ambient conditions even after months. These results demonstrate that electroless copper reduction can be conducted and constrained within the mesoporous silica framework, which pave the way for engineered mesoreactors.


Assuntos
Cobre/química , Cristalização/métodos , Nanoestruturas/química , Nanoestruturas/ultraestrutura , Dióxido de Silício/química , Substâncias Macromoleculares/química , Teste de Materiais , Conformação Molecular , Tamanho da Partícula , Propriedades de Superfície
10.
Clin Exp Allergy ; 40(12): 1760-6, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20718781

RESUMO

BACKGROUND: We have demonstrated previously mast cell histamine release upon incubation with chronic urticaria (CU) sera, presumably by degranulation. OBJECTIVE: To explore total and mature tryptase in order to assess whether any increase in total tryptase levels is due in part to mast cell degranulation or to mast cell burden. We also wanted to explore differences between the autoimmune groups called idiopathic (serum unable to activate basophils), and to correlate total and mature tryptase levels with different urticaria features. METHODS: We measured total and mature tryptase serum levels in 81 CU patients, 16 atopic donors and 21 healthy control sera. We assessed autoimmunity by measuring the CD63 expression in normal basophil donors upon incubation with CU sera. RESULTS: We found significantly higher levels of total tryptase in the sera of CU patients (6.6 ±4.1 µg/L) than in sera from healthy non-atopic subjects (4.4 ±2.8 µg/L) and from atopic subjects (4.5 ±1.7 µg/L). Mature tryptase levels were undetectable (<1 ng/mL). Total tryptase levels in the autoimmune urticaria group were significantly higher (9.8 ±5.4 µg/L) than the idiopathic urticaria group (4.4 ±2.2 µg/L). A significant difference in total tryptase was found between symptomatic patients (7.3 ±4.1 µg/L) compared with asymptomatic ones (5.7 ±4.1 µg/L) at the time of venesection. No difference was found in mature tryptase levels either. CONCLUSION: Total elevated tryptase levels are not accompanied by an elevated mature tryptase levels, as might be expected if the serum levels reflected mast cell degranulation.


Assuntos
Triptases/sangue , Urticária/sangue , Adulto , Idoso , Antígenos CD/análise , Antígenos CD/imunologia , Autoimunidade , Basófilos/imunologia , Degranulação Celular , Doença Crônica , Humanos , Mastócitos/fisiologia , Pessoa de Meia-Idade , Glicoproteínas da Membrana de Plaquetas/análise , Glicoproteínas da Membrana de Plaquetas/imunologia , Tetraspanina 30 , Urticária/imunologia , Adulto Jovem
11.
Food Microbiol ; 26(6): 578-86, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19527832

RESUMO

The efficiency of mitochondrial DNA (mtDNA) restriction analysis, RAPD-PCR and volatile compounds analysis to differentiate yeast biotypes involved in flavour development of dry-cured Iberian ham throughout the ripening process is evaluated. For this purpose, 86 yeasts isolated from Iberian hams in the main ripening stages at different industries of the four Protected Designations of Origin of this product, were used. The combination of mtDNA restriction analysis and RAPD-PCR using the primer (GACA)4 showed a higher variability in the yeast species detected than obtained using only mtDNA restriction analysis. Only two species, Debaryomyces hansenii and Candida zeylanoides, were identified throughout the whole ripening process and a wide diversity of biotypes was found in these two species, with those of D. hansenii predominating. Clear differences between biotypes were detected in the generation of volatile compounds, with the biotype C2-2 of D. hansenii showing the highest concentrations of volatiles. The combined use of mtDNA restriction analysis and RAPD-PCR distinguishes yeast biotypes with different production of volatile compounds. In addition, analysis of the production profile of volatile compounds is needed to differentiate yeast strains of the same biotype recovered at different stages of ripening. Thus, the combination of these three methods could be very useful to select or monitor yeasts as starter cultures in dry-cured meat products.


Assuntos
DNA Fúngico/análise , Microbiologia de Alimentos , Produtos da Carne/microbiologia , Filogenia , Leveduras/classificação , Candida/classificação , Candida/genética , Candida/isolamento & purificação , DNA Mitocondrial/análise , Debaryomyces/classificação , Debaryomyces/genética , Debaryomyces/isolamento & purificação , Conservação de Alimentos , Técnicas de Tipagem Micológica , Técnica de Amplificação ao Acaso de DNA Polimórfico , Sensibilidade e Especificidade , Especificidade da Espécie , Volatilização , Leveduras/genética , Leveduras/isolamento & purificação
12.
Genet Mol Res ; 8(1): 345-53, 2009 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-19440970

RESUMO

Acute lymphoblastic leukemia (ALL) accounts for approximately 80% of all acute leukemias during childhood. Chromosomal anomalies resulting from gene fusion, which are frequent in leukemias, create hybrid transcripts, the great majority of which encode transcription factors. We analyzed 88 pediatric patients (median age 7.3 years) who had B-lineage acute lymphoblastic leukemia (B-ALL), using reverse transcriptase-polymerase chain reaction, to look for gene fusion transcripts of TEL/AML1, E2A/PBX1, BCR/ABL p190, and MLL/AF4. The frequencies of these transcripts were 21.21, 9.68, 3.03, and 0%, respectively. All positive cases had a common B-ALL immunophenotype. The low frequency of the TEL/AML1 transcript that is found in developing countries, such as Brazil, may be due to the low incidence of leukemia; this would support Greaves' hypothesis.


Assuntos
Aberrações Cromossômicas , Mutação , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Brasil , Linhagem da Célula , Criança , Bases de Dados Genéticas , Feminino , Humanos , Imunofenotipagem , Masculino , Proteínas Recombinantes de Fusão/genética , Proteínas Recombinantes de Fusão/metabolismo
13.
Actas Urol Esp ; 32(6): 662-5, 2008 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-18655355

RESUMO

Chromophobe renal cell carcinoma (CRCC) is a rare variant of renal carcinomas arising from the intercalated cells of the distal renal tubule and representing 5% among all renal tumors. Its biological behaviour is variable, less aggresive than clear cell renal carcinoma. Histochemical, ultrastructural and molecular genetic characteristics are different from other renal carcinomas. Age at presentation is about the 6th decade of life. We report an exceptional 10 year-old boy case with a CRCC. Diagnostic and therapeutic aspects for the management of this tumor are reviewed.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/cirurgia , Criança , Humanos , Neoplasias Renais/diagnóstico , Neoplasias Renais/cirurgia , Masculino
14.
J Nutr Health Aging ; 22(4): 526-533, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29582893

RESUMO

OBJECTIVES: To examine the association between a dietary fat quality index (FQI), and the risk of incident cardiovascular events or deaths in the Seguimiento Universidad de Navarra (SUN) cohort. DESIGN: Longitudinal analysis during 10.1 years of median follow-up. Cox models were used to estimate adjusted hazard ratios (HR) of incident cardiovascular diseases (CVD) according to tertiles of FQI and of different fat subtypes. SETTING: University of Navarra, Spain. PARTICIPANTS: 19,341 middle-aged adults. MEASUREMENTS: Fat intake was measured with a validated food-frequency questionnaire. The FQI was calculated according to the ratio: (monounsaturated+polyunsaturated) / (saturated+trans fatty acids). RESULTS: We observed 140 incident cases of CVD. No association was found for FQI (HR=0.94, 95 %CI 0.61-1.47 for the highest vs the lowest tertile, p for trend=0.884). No significant associations were found for different dietary fat subtypes on CVD risk. The results suggest no clear association between a higher FQI and a higher amount of energy from fat and incidence of CVD (p for interaction: 0.259 and p for trend only among participants with a percentage of energy from fat ≥35% of total energy: 0.272). CONCLUSION: In this Mediterranean cohort, the FQI was not associated with cardiovascular events. A "heart-healthy diet" should focus its attention on dietary fat sources and should use an overall dietary pattern approach, rather than limiting the focus on fat subtypes. More research is needed to validate dietary advice on specific fatty acids intake or saturated fatty acids replacements for reducing CVD risk.


Assuntos
Doenças Cardiovasculares/etiologia , Gorduras na Dieta/efeitos adversos , Adulto , Doenças Cardiovasculares/patologia , Feminino , Humanos , Estudos Longitudinais , Masculino
15.
Aliment Pharmacol Ther ; 26(6): 859-67, 2007 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-17767470

RESUMO

AIM: To develop a scale to assess the severity of hepatic encephalopathy using simple dichotomic items. METHODS: A list of 48 items was created by selecting items that are simple to recognize and categorize; it was applied to thirty-six cirrhotic in-patients with episodic encephalopathy, in addition to the adapted-West-Haven Criteria and the Glasgow Coma Score. The list underwent an item reduction process and principal component analysis; the metric characteristics were evaluated. RESULTS: Multiple neurological abnormalities were observed and a Clinical Hepatic Encephalopathy Staging Scale of nine items was constructed. The principal component analysis of the Clinical Hepatic Encephalopathy Staging Scale obtained two factors that explained 77% of the variance. The Clinical Hepatic Encephalopathy Staging Scale exhibited adequate internal consistency and reproducibility. The scores of the Clinical Hepatic Encephalopathy Staging Scale correlated to those of adapted-West-Haven Criteria and the Glasgow Coma Score. CONCLUSIONS: This study confirms that the evaluation of multiple neurological manifestations is not necessary to classify hepatic encephalopathy adequately, which can be simply undertaken by an assessment of the patient's orientation, alertness, ability to respond to commands and to talk. A list of nine items is proposed as a linear scale from normality (Clinical Hepatic Encephalopathy Staging Scale = 0) to deep coma (Clinical Hepatic Encephalopathy Staging Scale = 9).


Assuntos
Encefalopatia Hepática/etiologia , Doenças do Sistema Nervoso/etiologia , Adulto , Feminino , Escala de Coma de Glasgow/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Índice de Gravidade de Doença
16.
AJNR Am J Neuroradiol ; 28(8): 1499-500, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17846199

RESUMO

MR imaging has found abnormalities compatible with low-grade edema in the brain of patients with cirrhosis that have been related to hepatic encephalopathy. We present 3 patients with hepatic encephalopathy who exhibit supratentorial focal or diffuse white matter lesions compatible with small-vessel brain disease. The volume and number of white matter lesions reduced with the improvement of hepatic encephalopathy, suggesting the participation of the blood-brain barrier in the pathogenesis of brain edema in hepatic encephalopathy.


Assuntos
Encéfalo/patologia , Encefalopatia Hepática/diagnóstico , Encefalopatia Hepática/fisiopatologia , Imageamento por Ressonância Magnética , Idoso , Aminoácidos de Cadeia Ramificada/uso terapêutico , Encefalopatia Hepática/tratamento farmacológico , Humanos , Masculino , Neomicina/uso terapêutico , Resultado do Tratamento
17.
Rev Esp Quimioter ; 20(3): 346-53, 2007 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-18080033

RESUMO

HIV resistance to antiretroviral drugs was studied in 348 samples taken from patients at the Molecular Biology Unit of the Microbiology Department of the Hospital La Fe, from January 2003 to July 2007. Once the viral load in plasma was determined, resistance was detected using complete gene sequencing for protease up to position 3464 of the HIV-1 reverse transcriptase gene. The results were analyzed using the Omiga 1.2 (Oxford Molecular Group) and HIV db Genotypic Resistance Interpretation Algorithm Version 4.3.0 (Stanford University) programs. The drugs least affected by the presence of mutations leading to resistance were the protease inhibitors darunavir, tripanavir and lopinavir (sensitivity >80%), the nucleoside reverse transcriptase inhibitors tenofovir and lamivudine (sensitivity >90%) and the non-nucleoside reverse transcriptase inhibitor TMC125 (sensitivity >80%).


Assuntos
Fármacos Anti-HIV/farmacologia , Farmacorresistência Viral Múltipla/genética , Infecções por HIV/microbiologia , HIV-1/efeitos dos fármacos , Algoritmos , Substituição de Aminoácidos , Fármacos Anti-HIV/uso terapêutico , Seguimentos , Genótipo , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Protease de HIV/genética , Inibidores da Protease de HIV/farmacologia , Transcriptase Reversa do HIV/genética , HIV-1/isolamento & purificação , Humanos , Mutação de Sentido Incorreto , Mutação Puntual , RNA Viral/genética , Inibidores da Transcriptase Reversa/farmacologia , Análise de Sequência de RNA , Espanha/epidemiologia , Carga Viral
18.
Rev Esp Quimioter ; 30(5): 350-354, 2017 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-28737025

RESUMO

OBJECTIVE: The aim of the study was to analyze the impact of steroid treatment in patients with community acquired pneumonia (CAP), both in length of stay and economical cost of admission at a clinical university hospital. METHODS: Prospective study of admitted patients with the diagnosis of CAP, both in Internal Medicine and Infectious diseases department. The study was conducted from January to march 2015; patients receiving steroids from diagnosis to end of antibiotic treatment were classified as group I; otherwise, they were considered in group II. Administration of steroids was done according to the criteria of the responsible. Cost was stablished according to CAP Diagnostic Related Group (DRG). RESULTS: Prevalence of patients younger than 65 year-old was higher in group I (p<0.05). In bivariate analyses, mean admission time was lower in group I (5.37 vs 8.88 days) (p<0.0005) and also economical cost (2,361 euros vs 3,907 euros) (p<0.0005). In multivariate analysis, factors independently associated to higher cost (>3,520 euros) were COPD (OR=2.602; 95% CI 1.074-6.305) and group II (patients with no steroids) (OR=6.2; p=0,007). CONCLUSIONS: No administration of steroids in patients with CAP was associated, together with COPD, with higher economical cost (evaluated by DRG/length of stay).


Assuntos
Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/economia , Pneumonia/tratamento farmacológico , Pneumonia/economia , Esteroides/economia , Esteroides/uso terapêutico , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Protocolos Clínicos , Infecções Comunitárias Adquiridas/epidemiologia , Custos e Análise de Custo , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pneumonia/epidemiologia , Prevalência , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/economia , Espanha/epidemiologia
19.
Rev Esp Anestesiol Reanim ; 64(4): 206-213, 2017 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27825666

RESUMO

INTRODUCTION: Dexdor® do not include the possibility of loading dose, which could increase time to achieve adequate sedation for ambulatory procedures. The objective of this study was to evaluate the effect of several loading dose of dexmedetomidine in the time to achieve and maintain an optimal level of sedation and its clinical hemodynamic repercussion. MATERIAL AND METHODS: The IRB approved this observational study for patients that underwent oral and maxillofacial ambulatory surgery under dexmedetomidine at the University of Navarra Clinic from February 2013 to November 2014. According to the loading dose the patients were grouped into 3 categories:<0.5, 0.5, and>0.5µg/kg. Optimal level of sedation was defined as bispectral index<85. Data were analyzed using survival analysis techniques. Vasoactive drugs requirements was evaluated using exact logistic regression. RESULTS: Eighty-one patients were evaluated. Hazard ratios for patients in 0.5 and >0.5µg/kg loading dose categories for achieving a bispectral index<85 were 1.5 (95% CI 0.9, 2.6) and 1.8 (95% CI 0.8, 3.9), respectively, compared with the lowest category. Five patients (6.2%) required atropine for bradycardia. Patients in the group>0.5µg/kg showed greater risk of requiring atropine compared with the group<0.5µg/kg (odds ratio 2.2; 95% CI 0.03, 183). CONCLUSION: Loading dose of dexmedetomidine>0.5µg/kg appears minimize the time to achieve and maintain an optimal level of sedation during the first 60min of procedure. Further investigation to elucidate the association between loading dose of dexmedetomidine and subsequent atropine requirements may be warranted.


Assuntos
Sedação Profunda/métodos , Dexmedetomidina/administração & dosagem , Hipnóticos e Sedativos/administração & dosagem , Procedimentos Cirúrgicos Bucais , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos Ambulatórios , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
20.
Int J Food Microbiol ; 107(1): 48-58, 2006 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-16257467

RESUMO

RFLP analysis of the ITS and 18S rDNA, RAPD-PCR using mini- and microsatellite primers and RFLP analysis of mitochondrial DNA were examined to discriminate yeasts related to dry-cured meat products at species and strain level. Seven species and 35 strains of yeasts usually found in dry-cured meat products were tested. RFLP analysis of the ITS1-5.8S rDNA-ITS2 and 18S rDNA did not allow the separation at species level of all of the species tested. RAPD with a M13 primer was found to be useful for differentiation of Rhodotorula mucilaginosa, Candida zeylanoides, Yarrowia lipolytica, Debaryomyces hansenii and Saccharomyces cerevisiae. However, no differences were observed between Debaryomyces polymorphus and Pichia carsonii. RAPD analysis with microsatellite primers (GACA)(4), (GTG)(5) and (GAC)(5) enabled discrimination at species and strain level. However, the degree of discrimination by means of RAPD-PCR depends highly on the primers used. Thus, the PCR fingerprinting with primer (GACA)(4) enabled a higher level of discrimination than primers (GAC)(5) and (GTG)(5). The RFLP analysis of mtDNA allowed the discrimination at the species and strain level except for R. mucilaginosa, where no polymorphisms were observed in the strains tested. RAPD analysis with primer (GACA)(4) and the restriction analysis of mtDNA used in the present work are useful for the differentiation at species and strain level of yeasts related to dry-cured meat products.


Assuntos
DNA Fúngico/análise , DNA Mitocondrial/análise , Produtos da Carne/microbiologia , Técnica de Amplificação ao Acaso de DNA Polimórfico/métodos , Leveduras , Primers do DNA , Genótipo , Técnicas de Tipagem Micológica , Filogenia , Polimorfismo de Fragmento de Restrição , Sensibilidade e Especificidade , Especificidade da Espécie , Leveduras/classificação , Leveduras/genética , Leveduras/isolamento & purificação
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