Red Quinoa Hydrolysates with Antioxidant Properties Improve Cardiovascular Health in Spontaneously Hypertensive Rats.

In recent years, quinoa has been postulated as an emerging crop for the production of functional foods. Quinoa has been used to obtain plant protein hydrolysates with in vitro biological activity. The aim of the present study was to evaluate the beneficial effect of red quinoa hydrolysate (QrH) on oxidative stress and cardiovascular health in an in vivo experimental model of hypertension (HTN) in the spontaneously hypertensive rat (SHR). The oral administration of QrH at 1000 mg/kg/day (QrHH) showed a significant reduction in SBP from baseline (-9.8 ± 4.5 mm Hg; p < 0.05) in SHR. The mechanical stimulation thresholds did not change during the study QrH groups, whereas in the case of SHR control and SHR vitamin C, a significant reduction was observed (p < 0.05). The SHR QrHH exhibited higher antioxidant capacity in the kidney than the other experimental groups (p < 0.05). The SHR QrHH group showed an increase in reduced glutathione levels in the liver compared to the SHR control group (p < 0.05). In relation to lipid peroxidation, SHR QrHH exhibited a significant decrease in plasma, kidney and heart malondialdehyde (MDA) values compared to the SHR control group (p < 0.05). The results obtained revealed the in vivo antioxidant effect of QrH and its ability to ameliorate HTN and its associated complications.

Immunologic Abnormalities Associated With Health Status of Heart Recipients Long Term After Transplantation.

BACKGROUND: With improvements in survival rates, health-related quality of life is an important outcome parameter to evaluate the effectiveness of transplantation. We aimed to identify potential immunologic abnormalities as factors associated with poorer health-related quality of life at distinct scales of the 36-Item Short Form Health Survey in heart transplant recipients long term after transplantation. METHODS: One hundred heart transplant recipients were evaluated in a single center. Short-form 36 questionnaires were sent by mail to participants. All patients were clinically and immunologically evaluated after the first year of heart transplantation. RESULTS: A high prevalence of several immunologic abnormalities persisted even after the first year of transplantation, including IgG hypogammaglobulinemia, low IgG-specific antipneumococcal antibodies, C4 hypocomplementemia, CD8 T-cell lymphocytopenia, and CD19 B-cell lymphocytopenia. Older recipients (>55 years), posttransplant diabetes, digestive complications, and posttransplant infections were associated with lower physical functioning scores (scale < 60). Older recipients (>55 years), pretransplant diabetes, pretransplant arterial hypertension, posttransplant digestive complications, and lower CD8 counts were associated with lower physical role scores (scale <25). CONCLUSION: In a single center study, lower CD8 cell counts were found to be associated with poorer health status in heart recipients after the first year of transplantation.

Protective Effect of Melatonin Administration against SARS-CoV-2 Infection: A Systematic Review.

INTRODUCTION: according to the World Health Organization (WHO), COVID-19 is an infectious disease caused by the SARS-CoV-2 virus, responsible for an increasing number of cases and deaths. From a preventive and therapeutic point of view, there are two concerns that affect institutions and healthcare professionals: global immunization (which is still far from being achieved) and the availability of drugs capable of preventing its consequences in the infected patient. In this sense, the role that melatonin can play is has been assessed in the recent literature. Justification and Objectives: the serious health, social and economic consequences of COVID-19 have forced an urgent search for preventive methods, such as vaccines, among others, and therapeutic methods that could be alternatives to the drugs currently used. In this sense, it must be accepted that one of the most recommended has been the administration of melatonin. The present study proposes to carry out a systematic review of its possible role in the treatment and/or prevention of COVID-19. Material and methods: a systematic review of the literature related to the prevention of COVID-19 through the administration of melatonin was carried out, following the sequence proposed by the Prisma Declaration regarding the identification and selection of documents, using the specialized health databases Trip Medical Database, Cochrane Library, PubMed, Medline Plus, BVS, Cuiden and generic databases such as Dialnet, Web of Science and Google Scholar for their retrieval. Appropriate inclusion and exclusion criteria are described for the articles assessed. The main limitation of the study has been the scarcity of works and the lack of defining a specific protocol in terms of dosage and administration schedule. Results: once the selection process was completed, and after an in-depth critical analysis, 197 papers were selected, and 40 of them were finally used. The most relevant results were: (1) melatonin prevents SARS-CoV-2 infection, (2) although much remains to be clarified, at high doses, it seems to have a coadjuvant therapeutic effect in the treatment of SARS-CoV-2 infection and (3) melatonin is effective against SARS-CoV-2 infection. Discussion: until group immunization is achieved in the population, it seems clear that we must continue to treat patients with SARS-CoV-2 infection, and, in the absence of a specific and effective antiviral therapy, it is advisable to continue researching and providing drugs that demonstrate validity based on the scientific evidence. In this regard, we believe that the available studies recommend the administration of melatonin for its anti-inflammatory, antioxidant, immunomodulatory, sleep-inducing, CD147, Mpro, p65 and MMP9 protein suppressing, nephrotoxicity-reducing and highly effective and safe effects. Conclusions: (1) melatonin has anti-inflammatory, antioxidant, immunomodulatory, and Mpro and MMP9 protein-inhibitory activity. (2) It has been shown to have a wide margin of safety. (3) The contributions reviewed make it an effective therapeutic alternative in the treatment of SARS-CoV-2 infection. (4) Further clinical trials are recommended to clearly define the administration protocol.

Incremental Unsupervised Domain-Adversarial Training of Neural Networks.

In the context of supervised statistical learning, it is typically assumed that the training set comes from the same distribution that draws the test samples. When this is not the case, the behavior of the learned model is unpredictable and becomes dependent upon the degree of similarity between the distribution of the training set and the distribution of the test set. One of the research topics that investigates this scenario is referred to as domain adaptation (DA). Deep neural networks brought dramatic advances in pattern recognition and that is why there have been many attempts to provide good DA algorithms for these models. Herein we take a different avenue and approach the problem from an incremental point of view, where the model is adapted to the new domain iteratively. We make use of an existing unsupervised domain-adaptation algorithm to identify the target samples on which there is greater confidence about their true label. The output of the model is analyzed in different ways to determine the candidate samples. The selected samples are then added to the source training set by self-labeling, and the process is repeated until all target samples are labeled. This approach implements a form of adversarial training in which, by moving the self-labeled samples from the target to the source set, the DA algorithm is forced to look for new features after each iteration. Our results report a clear improvement with respect to the non-incremental case in several data sets, also outperforming other state-of-the-art DA algorithms.

Semi-quantitative determination of ash element content for freeze-dried, defatted, sulfated and pyrolysed biomass of Scenedesmus sp.

BACKGROUND: Energy demand by mankind has become one of the most important aspects of our society. A promising technology that seeks to provide part of the energy demand and to obtain high-value products is the thermochemical conversion of microalgae biomass. Inorganic species presented in microalgae biomass may act as catalysts for thermochemical reactions and are responsible for notorious ash-related issues during thermochemical decomposition. RESULTS: In this study, the freeze-dried biomass of Scenedesmus sp. was used to evaluate the lipid extraction methodology regarding a sonication bath as pretreatment technique for cell disruption followed by vortex mixing and n-hexane as solvent. It is also presented the lipid and amino acid profiles for Scenedesmus sp. The freeze-dried biomass was pyrolysed through a TGA (thermogravimetric analysis), with heating rates of 20 °C/min, from 100 to 650 °C. The ash and sulfated ash contents were accurately determined by combustion of biomass in a muffle furnace. The element component of ashes of the freeze-dried, defatted, pyrolysed and sulfated biomasses was determined by means of scanning electron microscope (SEM) fitted with energy dispersive spectroscopy (EDS). The lipid content obtained for Scenedesmus sp. dry biomass was 16.72% (± 0.03). The content of the sulfated ash obtained was 17.81 ± 0.15%. The SEM-EDS technique identified different mineral compounds in ashes, allowing to quantify Mg, P, S, K, Ca, Fe, Co and Br, as well as oxides. CONCLUSION: The results suggest a possible strategy to evaluate in a semi-quantitative manner the ash composition of freeze-dryed, defatted, sulfated and pyrolysed biomass of Scenedesmus sp. and its feasibility in using Scenedesmus sp. biomass in different thermochemical conversion strategies to achieve processes with positive energy ratio, representing potential use both environmental and energetically.

Resección histeroscópica de septo uterino conformado por mioma submucoso / Hysteroscopy Resection of the Uterine Septum Due To Submucosal Myoma

Las malformaciones uterinas congénitas presentan una baja prevalencia en la población general (0,5-6,7 por ciento), el útero septo es la más frecuente. Estas enfermedades pueden afectar a los resultados reproductivos de las pacientes, así como aumentar la incidencia de abortos de repetición, presentaciones fetales anómalas o partos pretérminos. De la misma forma, los miomas uterinos submucosos también pueden producir alteraciones de la fertilidad, aunque la sintomatología más relacionada con los mismos es el sangrado. Constituyen el tumor benigno más frecuente del aparato genital femenino. El diagnóstico de estas patologías puede realizarse mediante pruebas de imagen como la ecografía transvaginal y la resonancia magnética, aunque la visualización directa vía histeroscópica sigue siendo de elección. Esta técnica constituye, además, la primera opción terapéutica, ya que se puede realizar tanto la resección del septo uterino como la miomectomía, sin apenas complicaciones y mediante una técnica quirúrgica segura y poco invasiva. El tratamiento histeroscópico está especialmente indicado en pacientes sintomáticas, con esterilidad o abortos de repetición, incluso antes de iniciar terapias de reproducción asistida. En el siguiente trabajo exponemos el caso de una paciente que presentaba un septo uterino constituido en su mayor parte por un leiomioma submucoso tratado vía histeroscópica; siendo un caso muy raro, dada la infrecuente asociación entre ambas patologías(AU)

Congenital uterine malformations present low prevalence in the general population (0.5-6.7 percent), and uterus septum is the most frequent. These pathologies can affect the reproductive outcomes of patients, as well as increase the incidence of repeating abortions, abnormal fetal presentations or preterm deliveries. In the same way, submucosal uterine fibroids can also produce alterations in fertility, although the most related symptomatology is bleeding. They are the most frequent benign tumor of the female genital tract. Diagnosis can be carried out through imaging tests such as transvaginal ultrasound and magnetic resonance imaging, although direct visualization, via hysteroscopy, is still the preferred option. This technique is also the first therapeutic option, since both, resection of the uterine septum and myomectomy can be performed with few complications and a safe and minimally invasive surgical technique. Hysteroscopy is especially indicated in symptomatic patients, with sterility or repeated abortions, even before initiating assisted reproduction therapies. In the following paper, we present the case of a patient who presented a uterine septum formed mostly by a submucosal leiomyoma. She was treated by hysteroscopy. This case is very rare given the infrequent association between both pathologies(AU)

Segmentation of Oil Spills on Side-Looking Airborne Radar Imagery with Autoencoders.

In this work, we use deep neural autoencoders to segment oil spills from Side-Looking Airborne Radar (SLAR) imagery. Synthetic Aperture Radar (SAR) has been much exploited for ocean surface monitoring, especially for oil pollution detection, but few approaches in the literature use SLAR. Our sensor consists of two SAR antennas mounted on an aircraft, enabling a quicker response than satellite sensors for emergency services when an oil spill occurs. Experiments on TERMA radar were carried out to detect oil spills on Spanish coasts using deep selectional autoencoders and RED-nets (very deep Residual Encoder-Decoder Networks). Different configurations of these networks were evaluated and the best topology significantly outperformed previous approaches, correctly detecting 100% of the spills and obtaining an F 1 score of 93.01% at the pixel level. The proposed autoencoders perform accurately in SLAR imagery that has artifacts and noise caused by the aircraft maneuvers, in different weather conditions and with the presence of look-alikes due to natural phenomena such as shoals of fish and seaweed.

Safety and patients' satisfaction after hysteroscopic sterilisation.

The aim of this study was to understand the potential complications of the Essure® device as well as the factors influencing its onset and patient satisfaction. We present a 9-year descriptive prospective study that included 1068 patients. The device was placed in 1056 of them (98.8%); 894 had no pain or mild pain during the insertion and only 12 patients experienced pain greater than menstrual pain. The proportion of patients without pain was greater in the group that took NSAIDs or NSAIDs and BZD and the unmedicated group had the highest rate of severe pain (p = .00). In all, 161 of the 1064 patients who had the Essure® inserted reported having an adverse effect during the 3-months post-insertion (pelvic pain or discomfort). The mean score out of 10 attributed to this method was 9.06 (S = 1.11). We concluded that the Essure® shows a low rate of complications and users showed a high degree of satisfaction. Impact statement What is already known on this subject: There are few international publications on Essure®. When we conducted a search in PubMed for the term 'Essure', we obtained 221 publications. When we added the terms 'Essure and complications', we obtained 20 publications, and when we increased the restriction including 'satisfaction', we obtained seven; thus, the uniqueness of our study. What the results of this study add: We present a 9-year descriptive prospective study that included 1068 patients. The aim of this study was to understand the potential complications of the Essure® device (Bayer, Whippany, NJ), as well as factors that can influence its onset and the patient satisfaction. The device was placed in 1056 of the patients (98.8%); 894 had no pain or mild pain during the insertion and only 12 patients experienced pain greater than menstrual pain. The proportion of patients without pain was greater in the group that took NSAIDs or NSAIDs and BZD and the unmedicated group had the highest rate of severe pain (p=.00). What the implications are of these findings for clinical practice and/or further research: Our study shows a low rate of complications with Essure®, mild and transient in most cases, as well as a high degree satisfaction. Nevertheless, given the few published studies on this device, we believe that long-term follow-up is needed.

Clinical Considerations Derived From the Administration of Melatonin to Children With Sleep Disorders.

BACKGROUND AND OBJECTIVES: Despite the numerous investigations carried out in relation to melatonin, there is a lack of knowledge about the specific melatonin secretion patterns in the diverse primary sleep disturbances. The objective of this study was to analyze the plasma melatonin concentrations in children with primary sleep disorders and the effects of melatonin therapy on their serum levels and their actigraphic sleep parameters. METHODS: Fourteen participants (nine girls; seven to 14 years old) diagnosed with diverse primary sleep disorders were recruited. Four different melatonin secretion patterns were identified: low plasma melatonin levels, absence of a circadian rhythm, advanced acrophase, and delayed acrophase. A placebo (one week) was administered followed by three months of melatonin therapy (3 mg/night). Urinary 6-sulfatoxymelatonin levels, 24-hour plasma melatonin concentrations, and a seven-day actigraphic record were collected after both treatments. RESULTS: After melatonin therapy, a significant increase (P < 0.001) of urinary 6-sulfatoxymelatonin excretion with a clear circadian variation was observed. Plasma melatonin concentrations were also significantly higher with a recovery in the circadian rhythm. Actual sleep time was significantly longer, with a substantial reduction in the sleep onset latency and night awakenings. No severe side effects were reported. CONCLUSIONS: The main clinical implication of this study is to demonstrate the efficacy of melatonin in three main circumstances: an insufficient hormone production, a disturbed circadian rhythm, and an advanced or delayed acrophase. As ongoing work, we are exploring the effect of different doses of melatonin on the regulation of its concentrations and of its secretion rhythm.

Evaluation of two different alternatives of energy recovery from municipal solid waste in Brazil.

Brazil has a large population with a high waste generation. The municipal solid waste (MSW) generated is deposited mainly in landfills. However, a considerable fraction of the waste is still improperly disposed of in dumpsters. In order to overcome this inadequate deposition, it is necessary to seek alternative routes. Between these alternatives, it is possible to quote gasification and incineration. The objective of this study is to compare, from an energetic and economic point of view, these technologies, aiming at their possible implementation in Brazilian cities. A total of two configurations were evaluated: (i) waste incineration with energy recovery and electricity production in a steam cycle; and (ii) waste gasification, where the syngas produced is used as fuel in a boiler of a steam cycle for electricity production. Simulations were performed assuming the same amount of available waste for both configurations, with a composition corresponding to the MSW from Santo André, Brazil. The thermal efficiencies of the gasification and incineration configurations were 19.3% and 25.1%, respectively. The difference in the efficiencies was caused by the irreversibilities associated with the gasification process, and the additional electricity consumption in the waste treatment step. The economic analysis presented a cost of electrical energy produced of 0.113 (US$ kWh-1) and 0.139 (US$ kWh-1) for the incineration and gasification plants respectively.

Analysis of Different Melatonin Secretion Patterns in Children With Sleep Disorders: Melatonin Secretion Patterns in Children.

The objective of this study was to analyze circadian patterns of urinary 6-sulphatoxymelatonin (aMT6s) excretion in children with primary sleep disorders in comparison with healthy controls. A total of 124 control children and 124 patients (aged 4-14 years) diagnosed with diverse primary sleep disorders were recruited. aMT6s concentrations were measured in diurnal and nocturnal urine, as well as in 24-hour urine. aMT6s levels were significantly higher and showed significantly more evident circadian variations in the control group ( P < .001). Four different melatonin (aMT) production and excretion patterns were distinguished in the group with sleep disorders: (1) standard aMT production pattern, (2) low aMT production pattern, (3) aMT production pattern with absence of circadian variation, and (4) aMT hyperproduction pattern. This study highlights the importance of analyzing specific alterations of aMT secretion in each sleep disorder and provides evidences to explain why not all children with sleep disturbances do respond to aMT treatment.

Electricity production from municipal solid waste in Brazil.

Brazil has an increasing production of municipal solid waste that, allied to the current waste management system, makes the search for alternatives of energy recovery essential. Thus, this work aims to study the incineration of municipal solid waste and the electricity production through steam cycles evaluating the influence of municipal solid waste composition. Several scenarios were studied, in which it was assumed that some fractions of municipal solid waste were removed previously. The municipal solid waste generated in Santo André city, São Paulo State, Brazil, was adopted for this study. Simulation results showed that the removal of organic matter and inert components impacts advantageously on the cycle performance, improving their parameters in some cases; in addition, there is the possibility of reusing the separated fractions. The separation of some recyclables, as plastic material, showed disadvantages by the reduction in the electricity generation potential owing to the high calorific value of plastics. Despite the high energy content of them, there are other possible considerations on this subject, because some plastics have a better recovery potential by recycling.

Peripheral blood T- and B-cell immunophenotypic abnormalities in selected women with unexplained recurrent miscarriage.

We aimed to investigate if women with recurrent miscarriage disclosed abnormalities in the maturation and activation status of peripheral blood lymphocyte subsets. In a case control study, 24 women with recurrent miscarriage, 37 women with children but no history of miscarriage and 39 women without previous pregnancies were evaluated. Lymphocyte subsets were evaluated using three-colour flow-cytometry. Selected women with recurrent miscarriage had significantly higher absolute counts of central memory CD4+ T-cells, CD8+DR+ T-cells and memory non-switched B-cells than the control groups. Recurrent miscarriage may be associated with abnormalities of the maturation and activation status of peripheral blood T and B lymphocytes.

Intrathecal Ziconotide and Morphine for Pain Relief: A Case Series of Eight Patients with Refractory Cancer Pain, Including Five Cases of Neuropathic Pain.

INTRODUCTION: Studies have shown that, at low doses and with careful titration, combination therapy with intrathecal ziconotide and morphine results in rapid control of opioid-refractory cancer pain. However, there is a lack of published data regarding the efficacy and safety of intrathecal ziconotide specifically for the treatment of neuropathic cancer pain. CASE SERIES: Case reports of ziconotide intrathecal infusion in eight patients (age 45-71 years; 75% male) with chronic, uncontrolled cancer pain during therapy with intrathecal morphine plus bupivacaine were reviewed. Neuropathic pain was confirmed in five patients. Treatment was initiated with adjunctive ziconotide when pain ≥5 on a visual analog scale persisted in spite of 3 successive 20% dose increases of intrathecal morphine. Ziconotide was initiated at 0.5-1.0 µg/day, with mean increases of 0.5 µg every 4-7 days if required (maximum dose 10 µg/day; mean dose 4.9 µg/day). Pain intensity was reduced in all patients after 3-5 days. Of the eight patients, three died for reasons unrelated to ziconotide, three discontinued treatment due to adverse effects (predominantly psychoneurological disorders), and one patient is still receiving treatment. One patient discontinued ziconotide due to confusion and delirium. Due to continued lack of pain control with intrathecal morphine, intrathecal fentanyl was initiated; however, effective pain relief was not achieved with 1500 µg/day. Ziconotide was restarted and the patient then achieved pain control. CONCLUSION: On the basis of our clinical experience, we recommend adding ziconotide to intrathecal opioid-based therapy in cancer patients with neuropathic pain inadequately controlled by intrathecal morphine alone. FUNDING: Eisai, Spain.

CD8+DR+ T-Cells and C3 Complement Serum Concentration as Potential Biomarkers in Thrombotic Antiphospholipid Syndrome.

Purpose. To assess complement factors and T lymphocyte activation subset abnormalities in patients with thrombotic antiphospholipid syndrome (APS) as potential biomarkers for development of clinical complications. Methods. We assessed C3, C4, factor B concentrations (nephelometry), complement haemolytic functional activity (CH100, radial immune diffusion), and the activation status of CD4+ and CD8+ T-cells (three-colour flow cytometry) in patients with thrombotic APS. Antiphospholipid (aPL) positive patients without APS-related clinical criteria, systemic lupus erythematosus (SLE) patients, and healthy individuals were evaluated as controls. A clinical followup was performed to assess the potential relationship between the immunological parameters and development of APS-related complications. Results. Lower concentrations of C3 and higher levels of CD8+DR+ cells were risk factors for development of APS-related complications during followup, including rethrombosis and neuropsychiatric symptoms. Patients with diagnosed thrombotic APS had significantly lower levels of C3, C4, and CH100 as well as higher percentages of activated CD4+DR+ and of CD8+DR+ T-cells than healthy controls but similar to that observed in autoimmune disease controls. Conclusion. Lower C3 and C4 complement levels and higher percentages of CD8+DR+ T-cells were observed in thrombotic APS patients. The potential role of these abnormalities as biomarkers of clinical outcome warrants further evaluation in a multicenter study.

Alterations of naïve and memory B-cell subsets are associated with risk of rejection and infection in heart recipients.

Rejection and infection are relevant causes of mortality in heart recipients. We evaluated the kinetics of the maturation status of B lymphocytes and its relationship with acute cellular rejection and severe infection in heart recipients. We analyzed B-cell subsets using 4-color flow cytometry in a prospective follow-up study of 46 heart recipients. Lymphocyte subsets were evaluated at specific times before and up to 1 year after transplantation. Higher percentages of pretransplant class-switched memory B cells (CD19+CD27+IgM-IgD- >14%) were associated with a 74% decrease in the risk of severe infection [Cox regression relative hazard (RH) 0.26, 95% confidence interval (CI), 0.07-0.86; P = 0.027]. Patients with higher percentages of naïve B cells at day 7 after transplantation (CD19+CD27-IgM+IgD+ >58%) had a 91% decrease in the risk of developing acute cellular rejection (RH 0.09; 95% CI, 0.01-0.80; P = 0.02). Patients with infections showed a strong negative correlation between baseline serum B-cell-activating factor (BAFF) concentration and absolute counts of memory class-switched B cells (R = -0.81, P = 0.01). The evaluation of the immunophenotypic maturation status of B lymphocytes could prove to be a useful marker for identifying patients at risk of developing rejection or infection after heart transplantation.

Simultaneous monitoring of cytomegalovirus-specific antibody and T-cell levels in seropositive heart transplant recipients.

PURPOSE: Human cytomegalovirus (CMV) active infection (CMV infection) poses serious risks to CMV-seropositive heart transplant recipients. We evaluated the usefulness of simultaneous assessment of CMV-specific values for parameters of the humoral (antibodies) and cellular (CD4+ and CD8+ T-cells) immune responses in the identification of heart recipients at risk of developing CMV infection after transplantation. METHODS: We prospectively studied 38 CMV-seropositive heart recipients. Anti-CMV antibody titers were assessed using enzyme-linked immunosorbent assays. CD4+ and CD8+ T-cell responses to overlapping peptide pools of the CMV proteins pp65 and immediate early protein-1 (IE1) were evaluated by flow cytometry. Immunological studies were performed before transplantation and at 30 days after transplantation. Patients with CMV infection were compared with heart recipients without CMV infection. RESULTS: During the 6-month follow-up period, 13 (34.2%) patients developed CMV infection. At baseline, the mean anti-CMV-IgG antibody titer was lower in patients who developed CMV infection. This difference remained at 30 days after transplantation. One month after transplantation, the mean percentage of IE1-specific CD8+ T cells that are IFNg-positive (CD8/IFNg + IE1) was lower in CMV-infected patients. The predictive value of these variables at 30 days was increased when they were combined. Cox regression analysis revealed an association between the risk of developing CMV infection and the combination marker (low anti-CMV titer [<16,100] and low CD8/IFNg + IE1 percentages [<0.40%], relative hazard, 6.07; p = 0.019). The combination marker remained significant after adjustment for clinical variables. CONCLUSIONS: This novel approach of a simultaneous assessment of specific anti-CMV antibody titers and CD8/IFNg + IE1 percentages might help identify heart transplant recipients with an increased risk of developing CMV infection.

Immunological risk factors for infection after immunosuppressive and biologic therapies.

Immunosuppressive and biologic therapies are costly and can involve a considerable risk of infection. Noninvasive diagnostic tools for early prediction of infection before and after administration of these therapies are of major interest. Serial longitudinal immune monitoring would provide data on immunocompetence and complement clinical follow-up protocols. Biomarkers of immune response may be useful to identify patients at risk of developing infection and who could be candidates for immunosuppressant dose reduction. This article focuses on the potential use of biomarkers of immune response to predict development of infection after immunosuppressive and biologic therapies in selected settings of autoimmune disease (rituximab for treatment of rheumatoid arthritis) and solid organ transplantation.

Peripheral blood CD8+DR+ T-cell count: a potential new immunologic marker of unexplained recurrent abortion.

A case-control study was performed to assess whether T-cell activation profile of CD8+ T-cells is associated with unexplained recurrent abortion. Women with abortion had significantly higher percentages (32 +/- 11 vs. 24 +/- 13%) and absolute numbers (160 +/- 78 vs. 114 +/- 83 cells/mm(3)) of CD8+DR+ T-cells than controls.

Quantitative abnormalities of peripheral blood distinct T, B, and natural killer cell subsets and clinical findings in obstetric antiphospholipid syndrome.

OBJECTIVE: Few studies have assessed immunophenotypic abnormalities on lymphocyte subsets in patients with antiphospholipid syndrome (APS). We performed an extended immunological study to define alterations of distinct T, B, and natural killer (NK) cell subsets in obstetric patients with APS and their relationship with APS-associated complications. PATIENTS AND CONTROLS: 36 women with APS [Sydney criteria, Group A1 without thrombosis (n=26), Group A2 with thrombosis (n=10)]; and 36 age matched women with recurrent abortion without antiphospholipid antibodies (disease controls; Group B), 36 healthy parous women (healthy controls; Group C), and 36 healthy nonparous women (healthy controls; Group D). Thrombotic events occurred after history of abortions in all A2 women. Three-color whole-blood flow cytometry was used to characterize the distinct immunophenotypes. RESULTS: A1 patients had significantly higher percentages of CD4+CD45RA-CCR7+ central memory cells (A1 vs D), higher percentages of activated CD4+CD25+ T cells (A1 vs D), and lower percentages and absolute counts of CD4+CD45RA-CCR7- effector memory cells (A1 vs D). Group A2 patients had higher percentages and absolute numbers of CD19+CD27-IgD+ naive B cells (A2 vs A1 vs all controls), lower percentages and absolute numbers of CD3-CD56+CD16+ NK cells (A2 vs all controls), and higher percentages of activated CD4+DR+ (A2 vs all controls), CD8+DR+ (A2 vs A1 vs C vs D), CD4+CD38+DR+ (A2 vs D), and CD4+CD25+DR+ T cells (A2 vs all controls). Increased percentages of CD8+DR+ T cells [relative risk (RR) 2.43, 95% CI 1.09-5.44, p=0.02] and of naive B cells (RR 3.05, 95% CI 1.30-7.11, p=0.009) were associated with development of thrombosis. CONCLUSION: In obstetric patients with APS we documented significant changes in T, B, and NK cell homeostasis. Increased levels of CD8+DR+ and CD19+CD27-IgD+ cells might identify obstetric patients with APS at risk of having thrombosis.