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1.
Artigo em Inglês | MEDLINE | ID: mdl-38919132

RESUMO

Summary: Background. Food allergy can range from mild to severe, life-threatening reactions with various symptoms and organ involvement. The impact of asthma on severe food-induced allergic reactions is not completely understood. In the hypothesis that asthma increases the risk of severe food-induced allergic reactions, the aim of this study is to compare the incidence of severe food-induced allergic reactions in patients with history of asthma compared with patients without history of asthma. Methods. We performed a systematic research on electronic databases, including PubMed, Scopus, and Web of Science. Observational studies, studies reporting medical characteristics of patients diagnosed with food allergy, and studies reporting medical history of patients with allergic reactions were included. The primary outcome was the incidence of severe food-induced allergic reactions in patients with history of asthma compared with patients without history of asthma. The protocol of this review was registered in PROSPERO (CRD42023448293). Results. Eight studies with a total of 90,367 patients met the inclusion criteria and were included, with a total population of 28,166 of patients with food allergy. The incidence of severe food-induced allergic reactions in patients with history of asthma compared with patients without history of asthma was increased (OR = 1.28; 95% CI 1.03-1.59; p = 0.03; I2 = 59%). Conclusions. Individuals with both food allergy and asthma are at high risk of severe, potentially fatal allergic reactions. Healthcare professionals should prioritize prevention and management strategies for these subjects.

2.
Eur Ann Allergy Clin Immunol ; 56(1): 17-25, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36927838

RESUMO

Summary: Background. International guidelines suggested skin tests with Polyethylene-glycol (PEG) and polysorbate 80 (PS-80), to investigate a possible hypersensitivity to these excipients either to identify subjects at risk of developing allergic reactions to Covid-19 vaccines, or in patients with suspected IgE mediated hypersensitivity reactions (HR) to the Covid-19 vaccine. The main purpose of this study was to investigate the prevalence of PEG and PS sensitization in patients with a clinical history of HR to drugs containing PEG/PS and in patients with a suspected Covid-19 vaccine immediate HR. Methods. This was a multicenter retrospective study conducted by allergists belonging to 20 Italian medical centers. Skin testing was performed in 531 patients with either a clinical history of suspected hypersensitivity reaction (HR) to drugs containing PEG and/or PS-80 (group 1:362 patient) or a suspected HR to Covid-19 vaccines (group 2: 169 patient), as suggested by the AAIITO/SIAAIC guidelines for the "management of patients at risk of allergic reactions to Covid-19 vaccines" [1]. Results. 10/362 (0.02%) had positive skin test to one or both excipients in group 1, 12/169 (7.1%) in group 2 (p less than 0.01). In group 2 HRs to Covid-19 vaccines were immediate in 10/12 of cases and anaphylaxis occurred in 4/12 of patients. Conclusions. The positivity of skin test with PEG and or PS before vaccination is extremely rare and mostly replaceable by an accurate clinical history. Sensitization to PEG and PS has to be investigated in patients with a previous immediate HR to a Covid-19 vaccine, in particular in patients with anaphylaxis.


Assuntos
Anafilaxia , COVID-19 , Hipersensibilidade Imediata , Humanos , Polissorbatos/efeitos adversos , Polietilenoglicóis/efeitos adversos , Vacinas contra COVID-19/efeitos adversos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Excipientes/efeitos adversos , Anafilaxia/diagnóstico , Anafilaxia/epidemiologia , Estudos Retrospectivos , Programas de Imunização , Testes Cutâneos , Itália/epidemiologia
3.
Eur Ann Allergy Clin Immunol ; 54(2): 60-67, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34225444

RESUMO

SUMMARY: Objective. The purpose of the study was to describe the characteristics of patients experiencing hypersensitivity reactions (HRs) to iodinated contrast media (ICM) in a large Italian population and to investigate potential risks factors in order to obtain a risk stratification, helpful in the management of these patients. Methods. Data of 407 patients investigated in 9 Italian Allergy Centers for suspected HRs to ICM were analyzed and compared with a control group of 152 subjects that tolerated one or more ICM-enhanced examinations. The univariate and multivariate logistic regression model was used to evaluate associated factors. Results. The mean age of reactive patients was 61 years and 60% were female; 67% of patients reported immediate reactions and 35% experienced the reaction, more frequently with immediate onset, at the first examination in life. Iomeprol, iopromide and iodixanol were the most frequent culprit agents and 20% of patients showed a positive skin test result. Previous adverse reactions to ICM were reported by 15.6% of patients, whereas 35% of subjects experienced the reaction, more frequently immediate, after the first ICM-enhanced examination in their life. The multivariate analysis showed that male gender and age > 65 were associated with ICM reactions as protective factors [ORadja = 0.51; 95% CI: 0.33-0.77 and ORadja = 0.60; 95% CI: 0.39-0.92 respectively]. Cardio-vascular disease [ORadja = 2.06; 95% CI: 1.22-3.50)], respiratory allergy [ORadja = 2.30; 95% CI: 1.09-4.83)] and adverse drug reactions [ORadja = 1.99; 95% CI: 1.05-3.77)] were identified as risk factors for ICM reactions. Food allergy was not significantly associated with reactions [ORadja = 1.51; 5% CI: 0.41-5.56]. Conclusions. This is the largest study on Italian patients experiencing hypersensitivity reactions to ICM. Most results are in line with other studies, showing some association with factors that could influence the incidence of hypersensitivity reactions but not allowing an easy risk stratification.


Assuntos
Meios de Contraste , Hipersensibilidade a Drogas , Meios de Contraste/efeitos adversos , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/epidemiologia , Hipersensibilidade a Drogas/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Testes Cutâneos
4.
Scand J Rheumatol ; 50(1): 48-51, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32692264

RESUMO

Objective: Immunoglobulin G4-related disease (IgG4-RD) is considered a chronic condition with insidious presentation, but clinical experience suggests that disease onset prompts admission to the emergency department (ED) in a sizeable proportion of patients. We assessed the prevalence of acute manifestations associated with IgG4-RD onset requiring referral to the ED. Method: We revised our database and identified patients admitted to the ED because of symptoms latterly attributed to IgG4-RD onset (Group 1) and those who were referred to our outpatient clinic without previous urgent manifestations (Group 2). Acute manifestations were clustered based on the anatomical region affected by IgG4-RD. Epidemiological, clinical, and serological features of Groups 1 and 2 were compared. Results: The study included 141 patients with IgG4-RD. Of these, 76 (54%) presented to the ED at disease onset. The most common clinical manifestations requiring admission to the ED were jaundice (53%), abdominal pain (41%), and fever (10%). Gastrointestinal involvement was the most frequent cause of referral to the ED (71% of cases), followed by involvement of the retroperitoneum (14.5%) and the nervous system (6.6%). Pancreatobiliary involvement was significantly more frequent in Group 1 than in Group 2. Head and neck, and salivary and lacrimal gland involvement was more frequent in Group 2 than in Group 1. The diagnostic delay was significantly shorter in Group 1 than in Group 2. Conclusion: Clinical manifestations associated with IgG4-RD onset require referral to the ED in most cases. This finding contrasts with the general view of IgG4-RD as a condition with non-acute presentation.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Doença Relacionada a Imunoglobulina G4/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Tardio , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Humanos , Doença Relacionada a Imunoglobulina G4/sangue , Doença Relacionada a Imunoglobulina G4/diagnóstico , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
5.
Eur J Neurol ; 27(1): 113-e2, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31306535

RESUMO

BACKGROUND AND PURPOSE: Systemic lupus erythematosus (SLE) is an immune-mediated disease that may affect the nervous system. We explored the topographical organization of structural and functional brain connectivity in patients with SLE and its correlation with neuropsychiatric (NP) involvement and autoantibody profiles. METHODS: Graph theoretical analysis was applied to diffusion tensor magnetic resonance imaging (MRI) and resting-state functional MRI data from 32 patients with SLE and 32 age- and sex-matched healthy controls. Structural and functional connectivity matrices between 116 cortical/subcortical brain regions were estimated using a bivariate correlation analysis, and global and nodal network metrics were calculated. RESULTS: Structural, but not functional, global network properties (strength, transitivity, global efficiency and path length) were abnormal in patients with SLE versus controls (P < 0.0001), especially in patients with anti-double-stranded DNA (ADNA) autoantibodies (P = 0.03). No difference was found according to NP involvement or anti-phospholipid autoantibody status. Patients with SLE and controls shared identical structural hubs and the majority of functional hubs. In patients with SLE, all structural hubs showed reduced strength and clustering coefficient compared with controls (P from 0.001 to <0.0001), especially in patients with ADNA autoantibodies. Only a few differences in functional hub properties were found between patients with SLE and controls. Structural and functional hub measures did not differ according to NP involvement or anti-phospholipid autoantibody status. Significant correlations were found between clinical, MRI and network measures (r from -0.56 to 0.60, P from 0.0003 to 0.05). CONCLUSIONS: Abnormalities of global and nodal structural connectivity occur in patients with SLE, especially with ADNA autoantibodies, with a diffuse disruption of structural integrity. Functional network integrity may contribute to preserve clinical functions.


Assuntos
Encéfalo/patologia , Conectoma , Lúpus Eritematoso Sistêmico/patologia , Adulto , Anticorpos Antifosfolipídeos/análise , Anticorpos Antifosfolipídeos/imunologia , Autoanticorpos/imunologia , Encéfalo/diagnóstico por imagem , Córtex Cerebral/patologia , Análise por Conglomerados , DNA/imunologia , Imagem de Tensor de Difusão , Feminino , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico por imagem , Lúpus Eritematoso Sistêmico/imunologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Adulto Jovem
6.
Nutr Metab Cardiovasc Dis ; 28(1): 53-63, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29150407

RESUMO

BACKGROUND AND AIM: Patients with Systemic Lupus Erythematosus (SLE) present increased cardiovascular mortality compared to the general population. Few studies have assessed the long-term development and progression of carotid atherosclerotic plaque in SLE patients. Our aim was to investigate the association of clinical and laboratory markers of disease activity and classical cardiovascular risk factors (CVRF) with carotid atherosclerosis development in SLE patients in a prospective 5-year study. METHODS AND RESULTS: Clinical history and information on principal CVRFs were collected at baseline and after 5 years in 40 SLE patients (36 women, mean age 42 ± 9 years; 14.4 ± 7 years of mean disease duration) and 50 age-matched controls. Carotid Doppler ultrasonography was employed to quantify the atherosclerotic burden at baseline and at follow up. Clinimetrics were applied to assess SLE activity over time (SLEDAI). The association between basal circulating T cell subsets (including CD4+CCR5+; CD4+CXCR3+; CD4+HLADR+; CD4+CD45RA+RO-, CD4+CD45RO+RA- and their subsets) and atherosclerosis development was evaluated. During the 5-year follow up, 32% of SLE patients, developed carotid atherosclerosis compared to 4% of controls. Furthermore, considering SLEDAI changes over time, patients within the highest tertile were those with increased incidence of carotid atherosclerosis independently of CVRF. In addition, increased levels of CD4+CCR5+ T cells were independently associated with the development of carotid atherosclerosis in SLE patients. CONCLUSION: Serial clinical evaluations over time, rather than a single point estimation of disease activity or CVRF burden, are required to define the risk of carotid atherosclerosis development in SLE patients. Specific T cell subsets are associated with long-term atherosclerotic progression and may further be of help in predicting vascular disease progression.


Assuntos
Linfócitos T CD4-Positivos/imunologia , Doenças das Artérias Carótidas/imunologia , Proliferação de Células , Lúpus Eritematoso Sistêmico/imunologia , Receptores CCR5/imunologia , Adulto , Biomarcadores/sangue , Linfócitos T CD4-Positivos/metabolismo , Doenças das Artérias Carótidas/sangue , Doenças das Artérias Carótidas/diagnóstico , Progressão da Doença , Feminino , Humanos , Estudos Longitudinais , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Receptores CCR5/sangue , Medição de Risco , Fatores de Risco , Fatores de Tempo , Ultrassonografia Doppler
7.
Rev Gastroenterol Mex ; 82(3): 210-216, 2017.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28325647

RESUMO

BACKGROUND: In relation to the number of new cases diagnosed, gastric cancer is the fourth most common cancer worldwide, and the second cause of cancer death. The development of multidetector tomography has improved the preoperative staging of gastric cancer. AIM: To correlate preoperative tomographic studies with the definitive pathologic results according to the TNM staging system. METHODS: A retrospective, cross-sectional study within the time frame of January 2009 to December 2013 was conducted that included the case records of 67 patients. They all had upper endoscopy and preoperative multidetector tomography examinations, underwent surgical resection, and had the corresponding histopathology study. Statistical analysis was carried out with the SPSS version 15.0 software and the sensitivity and specificity calculations were made using the Excel 2011 program for Mac. RESULTS: The majority of the patients included in the case series had clinical stage iii and iv disease. When compared with the histopathologic result, the overall accuracy of multidetector CT was 83% (T0 96%, T1 94%, T2 93%, T3 67%, and T4 67%) for tumor size (T) and was 70% (N0 72%, N1 73%, N2 70%, and N3 66%) for lymph node involvement (N). Overall sensitivity was 48% (T0 100%, T1 0%, T2 33%, T3 44%, and T4 65%) for T and was 41% (N0 58%, N1 56%, N2 15%, and N3 35%) for N. A strong association between the multidetector CT results and the pathology results was demonstrated through the Spearman's correlation, especially in T4 and N3. CONCLUSIONS: Multidetector computed tomography showed greater congruency in detecting stages T4, N0, and N3 in gastric cancer, when compared with the definitive histopathologic results.


Assuntos
Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Tomografia Computadorizada Multidetectores , Cuidados Pré-Operatórios , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/patologia , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Hospitais Militares , Humanos , Masculino , México , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Sensibilidade e Especificidade , Neoplasias Gástricas/cirurgia
8.
Scand J Rheumatol ; 45(2): 135-45, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26398142

RESUMO

OBJECTIVES: To describe the clinical features, treatment response, and follow-up of a large cohort of Italian patients with immunoglobulin (Ig)G4-related disease (IgG4-RD) referred to a single tertiary care centre. METHOD: Clinical, laboratory, histological, and imaging features were retrospectively reviewed. IgG4-RD was classified as 'definite' or 'possible' according to international consensus guidelines and comprehensive diagnostic criteria for IgG4-RD. Disease activity was assessed by means of the IgG4-RD Responder Index (IgG4-RD RI). RESULTS: Forty-one patients (15 females, 26 males) were included in this study: 26 with 'definite' IgG4-RD and 15 with 'possible' IgG4-RD. The median age at diagnosis was 62 years. The median follow-up was 36 months (IQR 24-51). A history of atopy was present in 30% of patients. The pancreas, retroperitoneum, and major salivary glands were the most frequently involved organs. Serum IgG4 levels were elevated in 68% of cases. Thirty-six patients were initially treated with glucocorticoids (GCs) to induce remission. IgG4-RD RI decreased from a median of 7.8 at baseline to 2.9 after 1 month of therapy. Relapse occurred in 19/41 patients (46%) and required additional immunosuppressive drugs to maintain long-term remission. Multiple flares occurred in a minority of patients. A single case of orbital pseudotumour did not respond to medical therapy and underwent surgical debulking. CONCLUSIONS: IgG4-RD is an elusive inflammatory disease to be considered in the differential diagnosis of isolated or multiple tumefactive lesions. Long-term disease control can be achieved with corticosteroids and immunosuppressive drugs in the majority of cases.


Assuntos
Doenças Autoimunes/imunologia , Glucocorticoides/uso terapêutico , Imunoglobulina G/imunologia , Imunossupressores/uso terapêutico , Pancreatite/imunologia , Sialadenite/imunologia , Idoso , Doenças Autoimunes/complicações , Doenças Autoimunes/tratamento farmacológico , Estudos de Coortes , Procedimentos Cirúrgicos de Citorredução , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Pseudotumor Orbitário/etiologia , Pseudotumor Orbitário/imunologia , Pseudotumor Orbitário/cirurgia , Pancreatite/tratamento farmacológico , Pancreatite/etiologia , Recidiva , Indução de Remissão , Espaço Retroperitoneal , Estudos Retrospectivos , Sialadenite/tratamento farmacológico , Sialadenite/etiologia
9.
Vet Pathol ; 52(6): 1019-26, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25883121

RESUMO

Cartilaginous tumors of the larynx and trachea are uncommon in the dog. The authors describe 10 cases diagnosed between 1995 and 2014 and review 16 cases in the literature. Seven of our cases were tracheal and 3 were laryngeal. Two of the laryngeal tumors were chondromas, which have not been previously reported in this site. The third laryngeal tumor was a myxochondroma. Of the 7 tracheal tumors, 6 arose from the ventral tracheal wall, including 2 that were extraluminal. Tracheal tumor types included chondrosarcoma (n = 3), chondroma (n = 2), and osteochondroma (n = 2). All of the laryngeal tumors and 5 of 7 of the tracheal tumors occurred in adult dogs (aged 5-11 years). The 2 tracheal osteochondromas were in young dogs (3-4 months) and were intrathoracic, while the remaining tracheal tumors were cervical. Surgical excision had a good outcome in most cases. Combining our 10 cases with the 16 previously reported cases showed that 6 (27%) of the affected dogs were Arctic breeds (Alaskan Malamute or Siberian Husky) suggesting a predisposition in this type of dog.


Assuntos
Neoplasias Ósseas/veterinária , Condroma/veterinária , Condrossarcoma/veterinária , Doenças do Cão/patologia , Neoplasias Laríngeas/veterinária , Animais , Neoplasias Ósseas/patologia , Condroma/patologia , Condrossarcoma/patologia , Cães , Feminino , Neoplasias Laríngeas/patologia , Laringe/patologia , Masculino , Pescoço/patologia , Traqueia/patologia
10.
Reprod Domest Anim ; 50(1): 172-6, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25472870

RESUMO

Polyorchidism is a rare congenital anomaly defined as the presence of more than two histologically proven testes. We report a case of a 9-month-old European cat with four intra-abdominal testes. The diagnosis was performed by means of ultrasonography, intra-operative examination and histological confirmation. The case reported here presents an extremely rare anomaly, as no previous studies in veterinary medicine have reported the presence of four testes. This case suggests that supernumerary testes should be included as differential diagnoses for intra-abdominal masses.


Assuntos
Doenças do Gato/patologia , Criptorquidismo/veterinária , Testículo/anormalidades , Testículo/patologia , Animais , Doenças do Gato/diagnóstico por imagem , Doenças do Gato/cirurgia , Gatos , Criptorquidismo/patologia , Masculino , Orquiectomia/veterinária , Ultrassonografia
11.
Clin Exp Immunol ; 175(2): 150-66, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24128276

RESUMO

Vascular inflammation contributes to the defence against invading microbes and to the repair of injured tissues. In most cases it resolves before becoming apparent. Vasculitis comprises heterogeneous clinical entities that are characterized by the persistence of vascular inflammation after it has served its homeostatic function. Most underlying mechanisms have so far remained elusive. Intravascular immunity refers to the surveillance of the vasculature by leucocytes that sense microbial or sterile threats to vessel integrity and initiate protective responses that entail most events that determine the clinical manifestations of vasculitis, such as end-organ ischaemia, neutrophil extracellular traps generation and thrombosis, leucocyte extravasation and degranulation. Understanding how the resolution of vascular inflammation goes awry in patients with systemic vasculitis will facilitate the identification of novel pharmacological targets and bring us a step closer in each patient to the selection of more effective and less toxic treatments.


Assuntos
Vasos Sanguíneos/imunologia , Vasculite Sistêmica/imunologia , Vasculite Sistêmica/microbiologia , Linfócitos B/imunologia , Infecções Bacterianas/imunologia , Vasos Sanguíneos/patologia , Proteína C-Reativa/imunologia , Humanos , Inflamassomos/imunologia , Componente Amiloide P Sérico/imunologia , Linfócitos T/imunologia , Trombose/imunologia , Trombose/patologia
12.
Food Microbiol ; 43: 16-9, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24929877

RESUMO

In the U.S., chicken-breeder farms that supply hatcheries typically store and transport eggs intended for broiler production at a temperature of 18.3 °C (65 °F). However, in case of surplus, some of these eggs may be diverted to human consumption. According to the U.S. Food and Drug Administration's 'Egg Safety Final Rule,' shell eggs intended for human consumption are required to be held or transported at or below 7.2 °C (45 °F) ambient temperature beginning 36 h after time of lay. We adapted a risk assessment model developed by the U.S. Department of Agriculture's Food Safety Inspection Service, to quantify human exposure to Salmonella Enteritidis and the risk of human salmonellosis if eggs are held and transported at 18.3 °C for up to 5.5 days after time of lay, as has been observed when hatchery eggs are diverted to human consumption, rather than held and transported at 7.2 °C within 36 h after time of lay. Storage at 18.3 °C leads to considerable bacterial growth in internally contaminated eggs. The model predicted that more than 10% of internally contaminated eggs would remain contaminated after in-shell pasteurization resulting in a 5-log10 reduction, and that some bacteria would survive after home-cooking. The model predicted that, alternatively, eggs stored at 7.2 °C after lay would have limited bacterial growth prior to pasteurization, and Salmonella would be very unlikely to be present after pasteurization. The predicted risk of salmonellosis from the consumption of eggs held and transported at 18.3 °C and subsequently diverted to human consumption is 25 times higher than the risk when eggs are held and transported at 7.2 °C.


Assuntos
Casca de Ovo/microbiologia , Armazenamento de Alimentos/métodos , Infecções por Salmonella/microbiologia , Salmonella/crescimento & desenvolvimento , Animais , Galinhas , Ovos/microbiologia , Manipulação de Alimentos , Humanos , Salmonella/genética , Salmonella/isolamento & purificação , Temperatura
13.
Am J Transplant ; 13(11): 2875-83, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24047110

RESUMO

The Belatacept Evaluation of Nephroprotection and Efficacy as First-line Immunosuppression Trial randomized patients receiving a living or standard criteria deceased donor kidney transplant to a more (MI) or less intensive (LI) regimen of belatacept or cyclosporine A (CsA). The 5-year results of the long-term extension (LTE) cohort are reported. A total of 456 (68.5% of intent-to-treat) patients entered the LTE at 36 months; 406 patients (89%) completed 60 months. Between Months 36 and 60, death occurred in 2%, 1% and 5% of belatacept MI, belatacept LI and CsA patients, respectively; graft loss occurred in 0% belatacept and 2% of CsA patients. Acute rejection between Months 36 and 60 was rare: zero belatacept MI, one belatacept LI and one CsA. Rates for infections and malignancies for Months 36-60 were generally similar across belatacept groups and CsA, respectively: fungal infections (14%, 15%, 12%), viral infections (21%, 18%, 16%) and malignancies (6%, 6%, 9%). No new posttransplant lymphoproliferative disorder cases occurred after 36 months. Mean calculated GFR (MDRD, mL/min/1.73 m(2) ) at Month 60 was 74 for belatacept MI, 76 for belatacept LI and 53 for CsA. These results show that the renal function benefit and safety profile observed in belatacept-treated patients in the early posttransplant period was sustained through 5 years.


Assuntos
Ciclosporina/uso terapêutico , Rejeição de Enxerto/prevenção & controle , Imunoconjugados/uso terapêutico , Imunossupressores/uso terapêutico , Falência Renal Crônica/cirurgia , Transplante de Rim , Abatacepte , Adulto , Estudos de Coortes , Feminino , Seguimentos , Taxa de Filtração Glomerular , Humanos , Agências Internacionais , Testes de Função Renal , Transtornos Linfoproliferativos/prevenção & controle , Masculino , Complicações Pós-Operatórias/prevenção & controle , Prognóstico , Segurança , Fatores de Tempo
14.
Vet Pathol ; 50(1): 188-90, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22692623

RESUMO

A high prevalence of leishmaniosis has been reported from an increasing number of domestic and wild mammals around the world. In Australian macropods, Leishmania spp infection has been occasionally described in its cutaneous form only. The purpose of this report is to present a case of fatal visceral leishmaniosis in a captive Bennett's wallaby in Madrid, Spain, which was investigated by detailed macroscopic, histologic, and immunohistochemical examinations.


Assuntos
Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/veterinária , Macropodidae/parasitologia , Animais , Animais de Zoológico , Evolução Fatal , Feminino , Imuno-Histoquímica/veterinária , Leishmaniose Visceral/patologia , Fígado/parasitologia , Fígado/patologia , Espanha , Baço/parasitologia , Baço/patologia
15.
Vaccine ; 41(9): 1554-1566, 2023 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-36653223

RESUMO

Brucellosis, a worldwide zoonotic disease, is endemic in many developing countries. Besides causing significant economic losses for the livestock industry, it has severe consequences for human health. In endemic regions, small ruminants infected by Brucella melitensis are the main source of human brucellosis. Rev1, the only vaccine currently recommended to control the disease in sheep and goats, has several drawbacks. Rough lipopolysaccharide (R-LPS) mutants have been tested as alternatives, but most lack efficacy. Those in the Wzm/Wzt system responsible for O-polysaccharide export to the periplasm have been proposed as promising vaccine candidates, although to date they have been scarcely investigated in the natural host. In the present work, we studied the biological properties of a 16MΔwzm in-frame deletion mutant, including its safety in pregnant mice and sheep. In mice, 16MΔwzm prevented placental and fetal infections before parturition and protected against B. melitensis and Brucella ovis infections. In sheep, 16MΔwzm was equally safe in lambs, rams, and non-pregnant ewes, inducing some transient Rose Bengal reactions (<7 weeks). The serological reactions occurred earlier and more strongly in pregnant than in non-pregnant ewes and were significantly reduced when conjunctival rather than subcutaneous vaccination was used. In ewes vaccinated at mid-pregnancy, 16MΔwzm was not shed in vaginal discharges during the pregnancy and did not induce abortions/stillbirths. However, some ewes showed a transitory reactivation of infection in placentas and/or milk at parturition, accompanied by a seroconversion in smooth LPS (S-LPS) and/or R-LPS tests. Overall, 16MΔwzm can be considered as a safe vaccine for lambs, rams, and non-pregnant ewes, but its use at mid-pregnancy should be avoided to prevent vaccine dissemination at parturition. If the efficacy results against B. melitensis and B. ovis observed in mice are confirmed by further studies in the natural host, 16MΔwzm could constitute a useful vaccine.


Assuntos
Aborto Espontâneo , Vacina contra Brucelose , Brucella melitensis , Brucelose , Doenças dos Ovinos , Humanos , Ovinos , Animais , Feminino , Masculino , Gravidez , Camundongos , Lipopolissacarídeos , Placenta , Brucelose/prevenção & controle , Carneiro Doméstico , Doenças dos Ovinos/prevenção & controle , Anticorpos Antibacterianos
16.
Rev Gastroenterol Mex (Engl Ed) ; 88(1): 50-56, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34863643

RESUMO

INTRODUCTION: Methane (CH4) is an inert gas produced by colonic anaerobes and has been associated with different intestinal diseases, including irritable bowel syndrome (IBS). According to geographic region, the prevalence of methanogens varies, being higher in Africa (80%) and lower in the United States (35-40%). In Mexico, the prevalence of methanogens is unknown. AIM: To evaluate the prevalence of CH4 producers and associated factors in a group of patients with IBS and controls in a Mexican population. MATERIALS AND METHODS: A baseline fasting measurement of alveolar H2 and CH4 gas was carried out, by gas chromatography (stationary phase), in consecutive patients diagnosed with IBS and a control group. Subjects with baseline levels of H2 of 0 ppm and CH4 ≥ 5 ppm were classified as methanogenic. RESULTS: A total of 132 controls (53.8% women) and 67 patients with IBS (76% women) were included. The overall prevalence (n = 199) of methanogenic subjects was 38% (n = 76) (95% CI: 0.31-0.45) and they had a greater prevalence of overweight/obesity (56.5 vs 39.8%, P = .028). The prevalence of methanogens in the healthy controls was 41.6% (95% CI: 0.33-0.49), whereas, in the patients with IBS, it was 31.4% (n = 21, 71% IBS-C and 29% IBS-M). CONCLUSIONS: The prevalence of methanogens in our study on a Mexican population was comparable to that reported in other populations and was associated with overweight/obesity. One-third of the patients with IBS presented with methanogens. Said microorganisms were particularlyassociated with the constipation-predominant IBS subtype.


Assuntos
Síndrome do Intestino Irritável , Humanos , Feminino , Masculino , Síndrome do Intestino Irritável/epidemiologia , Prevalência , México/epidemiologia , Sobrepeso , Obesidade
17.
Lupus ; 21(7): 810-2, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22635241

RESUMO

The impact of hypertension in the pregnancies from autoimmune patients is not unequivocally defined. We have prospectively followed 168 pregnancies from 135 patients from four Italian centres to verify the potential impact of hypertension in the antiphospholipid syndrome (APS). The rate of preeclampsia, mean neonatal weight and gestational age at delivery were significantly lower in patients with both APS and hypertension than in patients with hypertension or APS alone. This information may be relevant for counselling and care of these patients.


Assuntos
Síndrome Antifosfolipídica/complicações , Hipertensão Induzida pela Gravidez/epidemiologia , Adulto , Síndrome Antifosfolipídica/epidemiologia , Peso ao Nascer , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Itália/epidemiologia , Pré-Eclâmpsia/epidemiologia , Gravidez , Resultado da Gravidez , Estudos Prospectivos
18.
Vet Pathol ; 49(6): 979-87, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22337774

RESUMO

Feline mammary carcinomas are highly aggressive neoplasms. Several mechanisms are thought to be involved in their progression, including the loss of epithelial adhesion molecules. The present study was carried out on 21 adenomas and 139 mammary carcinomas. Of the carcinomas, 66 were not reported to have metastasized, while the remaining 73 had evidence of regional lymph node metastasis at the moment of diagnosis. The relationship was examined between the expression of the E-cadherin-ß-catenin complex and basal (CK5/6, CK14) and luminal (CK8/18) cytokeratin expression. In the medical literature, carcinomas expressing basal cytokeratins are reported as having a poor prognosis in human breast cancer. Results revealed that preservation of the expression of E-cadherin and ß-catenin is a significant feature of carcinomas without metastasis, whereas carcinomas with metastasis reveal the loss of one or both adhesion molecules. Additionally, basal cytokeratin expression was statistically associated with the presence of regional metastasis. Furthermore, the expression of E-cadherin-ß-catenin was significantly correlated with the high expression of CK18 and low expression of CK5/6.


Assuntos
Adenoma/veterinária , Biomarcadores Tumorais/metabolismo , Carcinoma/veterinária , Doenças do Gato/patologia , Queratinas/metabolismo , Neoplasias Mamárias Animais/patologia , Adenoma/metabolismo , Adenoma/patologia , Animais , Caderinas/metabolismo , Carcinoma/metabolismo , Carcinoma/patologia , Doenças do Gato/metabolismo , Gatos , Feminino , Imuno-Histoquímica/veterinária , Metástase Linfática , Neoplasias Mamárias Animais/metabolismo , Gradação de Tumores/veterinária , Vimentina/metabolismo , beta Catenina/metabolismo
19.
Vet Pathol ; 49(4): 612-5, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21768603

RESUMO

Mammary Paget disease, characterized by diffuse infiltration of the nipple and areolar epidermis by carcinoma cells, develops in 1% to 3% of human mammary carcinomas. The purpose of this article is to present 2 cases of intraepidermal adenocarcinoma that resembled human mammary Paget disease, histologically and immunohistochemically, in dogs with underlying mammary carcinoma.


Assuntos
Adenocarcinoma/veterinária , Doenças do Cão/patologia , Glândulas Mamárias Animais/patologia , Doença de Paget Mamária/veterinária , Adenocarcinoma/patologia , Animais , Cães , Feminino , Masculino
20.
Artigo em Inglês | MEDLINE | ID: mdl-35810091

RESUMO

INTRODUCTION AND AIM: In recent years, probiotics have been used in functional gastrointestinal disorders, including chronic constipation (CC). The effect of Bifidobacterium infantis strain 35624 on the gut microbiota of CC patients has not been previously studied. Our aim was to analyze the fecal microbiota of constipated patients, before and after consuming a single-strain probiotic (B. infantis strain 35624). MATERIALS AND METHODS: We used 16S rRNA gene high-throughput sequencing to analyze the fecal microbiota of female patients (n=13) with CC. Patients were instructed to ingest one capsule of Alflorex® (containing 1×109 CFUs/g B. infantis strain 35624) daily for eight weeks. Fecal samples were obtained at the baseline and end (final) of probiotic administration. RESULTS: Alpha diversity metrics did not differ between the baseline and final periods. The butyrate producer, Oscillospira, was the taxon most strongly correlated with amplicon sequence variants (R2=0.55, p<0.0001). Except for a few bacterial taxa, there were no significant differences in relative abundance between the baseline and final periods. Beta-diversity measures also showed limited evidence for the differences between the two time periods. CONCLUSIONS: The results suggest that the fecal bacterial microbiota remains stable in constipated women consuming a single-strain probiotic. Those findings may be helpful in better understanding probiotic functioning in patients with digestive disorders.

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