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Animals infected with Mycobacterium avium subspecies paratuberculosis show a variety of granulomatous lesions that range from focal forms, seen in the subclinical stages, to diffuse lesions associated with clinical signs. The aim of this study was to phenotypically characterize the macrophages present in the different lesion types using immunohistochemical methods. Lesions from a total of 23 animals with bovine paratuberculosis, natural and experimental, were examined by immunohistochemistry. Antibodies against inducible nitric oxide synthase (iNOS), tumor necrosis factor α (TNF-α), CD163, interleukin 10 (IL-10), transforming growth factor ß (TGF-ß), major histocompatibility complex (MHC) class II, natural resistance-associated macrophage protein 1 (Nramp-1), calprotectin, Ki-67, CD68, lysozyme, and ionized calcium-binding adaptor molecule 1 (Iba-1) molecules were employed. Samples were scored semiquantitatively using a complete histological score (H-score), reflecting the staining intensity and the percentage of immunolabeled macrophages. Differences in the H-score were seen depending on the lesion type. In focal lesions, with none or few acid-fast bacilli (AFB), macrophages were polarized toward M1 phenotype, with high H-scores for iNOS and TNF-α. Diffuse multibacillary lesions showed M2 differentiation, with high expression of CD163, IL-10, and TGF-ß as well as Nramp-1 and MHC class II antigens. Macrophages in diffuse paucibacillary forms showed high H-scores for iNOS but low ones for TNF-α. Diffuse lesions, either multibacillary or paucibacillary, showed high calprotectin and low Ki-67 expression, suggesting a progressive character, while focal forms, with low H-scores for these antigens, would be consistent with latency. Lysozyme and CD68 expression were related to the amount of AFB. H-score for Iba-1 antibody was similar among all types. The findings of this study provide insights into the polarization status of macrophages and lesion development in bovine paratuberculosis.
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Enfermedades de los Bovinos/patología , Intestinos/patología , Macrófagos/patología , Paratuberculosis/patología , Animales , Bovinos , Enfermedades de los Bovinos/microbiología , Femenino , Granuloma/patología , Granuloma/veterinaria , Interleucina-10/metabolismo , Intestinos/citología , Antígeno Ki-67/metabolismo , Óxido Nítrico Sintasa de Tipo II/metabolismo , Factor de Crecimiento Transformador beta/metabolismo , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
STUDY DESIGN: A prospective and a case-matched control study. OBJECTIVES: To study the lower urinary tract dysfunction associated with bladder lithiasis in patients with spinal cord injury (SCI). SETTING: Toledo (Spain). METHODS: We have carried out a urodynamic study in 30 patients with SCI with lithiasis in their bladder before and 3 months after bladder endoscopic lithotripsy. This second study was compared with the urodynamic findings of a different group of 30 patients with SCI, without a history of bladder lithiasis, paired with cases by gender and date of urodynamic study. RESULTS: We have found that the prevalence of neurogenic detrusor overactivity (NDO) was significantly different after bladder lithotripsy, although the cystomanometric capacity was significantly increased. A group of patients with lithiasis showed a maximum flow rate, a voiding maximum detrusor pressure and the detrusor contractility parameter Wmax lower than that in controls. On the other hand, a voiding abdominal straining was found to be significantly greater than that in controls. CONCLUSIONS: Bladder lithiasis affects the presence of NDO in patients with SCI. Patients with SCI who develop bladder lithiasis present a lower detrusor contractility power compared with those who do not.
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Síntomas del Sistema Urinario Inferior/etiología , Traumatismos de la Médula Espinal/complicaciones , Urolitiasis/complicaciones , Adulto , Estudios de Casos y Controles , Endoscopía , Femenino , Humanos , Litotricia , Síntomas del Sistema Urinario Inferior/fisiopatología , Masculino , Estudios Prospectivos , Traumatismos de la Médula Espinal/fisiopatología , Resultado del Tratamiento , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria/fisiopatología , Vejiga Urinaria/cirugía , Urodinámica/fisiología , Urolitiasis/diagnóstico por imagen , Urolitiasis/fisiopatología , Urolitiasis/cirugíaRESUMEN
INTRODUCTION: The cystographic study of patients who have undergone radiotherapy (RT) and pelvic surgeries is uncommon in the literature, not described in patients without complications, and mostly related to urinary fistulae. OBJECTIVE: The study of the lower urinary tract (LUT) by cystography in these patients, with a description of some other types of radiation lesions. METHODS: 127 cystographies have been performed (88 men and 39 women) in consecutive patients undergoing radiotherapy (RT) (48 monotherapy and 79 cases combined with surgery), with a mean age of 69.6 years, and a mean time from radiation of 215 months (17 years). A General Electric X ray equipment has been used. We studied: behavior of the bladder neck at rest and during micturition, assessment of vesicoureteral reflux (VUR), bladder morphology (BM), urethral strictures (UE) and fistulas (F). RESULTS: We observed: Filling phase bladder neck incompetence (BNI) (37.8%), bladder smooth morphology (60.6%), coughing urinary incontinence (UI) (26.4%), basal cystocele (64.7%) and Valsalva cystocele (96.6%), a normal opening bladder neck (96,1%), reduction of the urethral diameter during voiding (41.3%), and vesicoureteral reflux (VUR) (13.2%). Five cases of filling BNI, were all related to prostate cancer (PC) (one of them with colon cancer as well). There were six cases of fistulae (4.14%), five of them women. Forty two patients (28.96%) had reduced urethral lumen, thirty five of them affecting the posterior urethra (83%), five (11.9%) the anterior and, finally, two cases of mixed lesion (5%). 95% were patients with PC without concurrent interventions (67%). Significant differences were found regarding the gender and the background of pelvic surgery. The filling BNI (p=0.007), the irregular bladder morphology (p=0.004) and the reduction of the urethral lumen (p<0.001) have been found to be more common in male patients, while the coughing UI was more common in women (p=0.007). The study shows that BNI (p=0.046), VUR (p=0.02) and the IU due to cough (p=0.03) were more frequent in operated patients, while reduced urethral lumen was less common (p<0.01). Patients with VUR present more time from radiotherapy, but not in other cystography variables. There was a relationship between RT and the BNI, stress urinary incontinence, anterior urethral stricture and VUR. The risk factor was increased by surgery. CONCLUSIONS: Bladder neck incompetence, stress UI, anterior urethral stricture and VUR have been related to radiotherapy. Surgery increased the risk factor in operated patients.
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Radioterapia/efectos adversos , Procedimientos Quirúrgicos Urogenitales/efectos adversos , Anciano , Cistografía , Femenino , Humanos , Masculino , Pelvis/cirugía , Uretra/patología , Estrechez Uretral/etiología , Incontinencia Urinaria de Esfuerzo/etiología , Urodinámica , Reflujo Vesicoureteral/etiologíaRESUMEN
STUDY DESIGN: A case-control study in a series of 55 males with urethral diverticula (UD) and their correspondent control, matched by age and time of radiological assessments. OBJECTIVES: To evaluate the risk factors to develop UD in males with spinal cord injury (SCI) and the place in the urethra where they are, most commonly, allocated. SETTING: Toledo, Spain. METHODS: Clinical histories and urodynamic studies, of all patients, were reviewed. The study was completed with a telephone survey according to an established protocol. RESULTS: The univariate analysis study showed the following risk factors: the age of onset of the spinal injury, the sphincterotomy procedure, personal history of lower urinary tract infections (LUTIs) and the chronic need of either indwelling catheter (IC) or the external condom drainage (ECD). Regarding the location of the UD, we have found the stress urinary incontinence as the only risk factor to develop UD in the prostatic urethra.On the other hand, we can conclude that the sphincterotomy, the ECD, the personal history of LUTIs and the detrusor external sphincter dyssynergia seem to be risk factors to develop diverticula in the bulbo-membranous urethra. Finally, we could point out the IC as the only risk factor for penile UD. Multivariate analysis showed that all of these risk factors were independent among them except the age of the onset of the injury and the ECD for UD in the bulbo-membranous urethra. CONCLUSION: According to our study, there is evidence of some specific risk factors for the development of UD in male patients with SCI, and therefore we should adopt the appropriate preventive measures to prevent them.
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Traumatismos de la Médula Espinal/complicaciones , Enfermedades Uretrales/complicaciones , Adulto , Estudios de Casos y Controles , Catéteres de Permanencia , Electromiografía , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , España/epidemiología , Traumatismos de la Médula Espinal/epidemiología , Enfermedades Uretrales/epidemiología , Enfermedades Uretrales/cirugía , Urodinámica/fisiologíaRESUMEN
OBJECTIVE: To compare the data obtained through video urodynamics (VUD) with those obtained through one voiding cycle ambulatory urodynamics monitoring (AUM) in patients with spinal cord injury (SCI). METHODS: A comparative study was conducted in 69 patients with SCI (mean age±s.d. 44±16.9 years), 51 men and 18 women, who were subjected to AUM and VUD. RESULTS: A lack of agreement was observed between the two tests with respect to the cystometric capacity (CC) (ml) (275±197.2 AUM versus 416±198.3 VUD), filling pressure (cm H2O) (4±5.3 AUM versus 9±12.5 VUD), bladder compliance (ml cm(-1) H2O) (116±114.9 AUM versus 161±179.4 VUD), maximum detrusor contraction pressure (cm H2O) (87±65.2 AUM versus 47±35.0 VUD), post-void residual (ml) (206±201.5 AUM versus 308±237.7 VUD) and stress urinary incontinence (kappa index: -0.052). Only the CC obtained in the AUM was in agreement with the mean bladder volume gathered from the frequency-volume chart. Agreement was observed with respect to the presence of neurogenic detrusor overactivity (kappa index: 0.307) and bladder outlet obstruction index (cm H2O) (17±48.0 AUM versus 15±18.7 VUD). There was no clear association between AUM parameters and bladder neck morphology, the presence of radiological detrusor-external sphincter dyssynergy or vesicoureteral reflux observed in the VUD. CONCLUSION: The differences between both methods discourage the use of AUM with just one voiding cycle in the evaluation of patients with SCI.
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Monitoreo Ambulatorio , Traumatismos de la Médula Espinal/diagnóstico , Traumatismos de la Médula Espinal/fisiopatología , Urodinámica , Grabación en Video , Adulto , Femenino , Humanos , Masculino , Tamaño de los Órganos , Presión , Traumatismos de la Médula Espinal/patología , Vejiga Urinaria/patología , Vejiga Urinaria/fisiopatología , MicciónRESUMEN
Mycobacterium avium subsp paratuberculosis (Map) is assumed to infect young ruminants; however, little is known concerning the possibility of adult animals becoming infected. An experimental infection was conducted to establish the effect of age and doses of Map on susceptibility to paratuberculosis in sheep. Sixteen of twenty-four 1.5-month-old Churra lambs and 23 of 30 adult ewes (from 2-11 years old) were orally challenged with an ovine field strain of Map. Thirteen ewes and 8 lambs were infected with a high dose (HD) and 10 adult sheep and 8 lambs with a low dose (LD) of Map. The remaining animals were unchallenged controls. Animals were euthanized at 110 to 120 and 210 to 220 days postinfection. Histological, bacteriological, and nested polymerase chain reaction (PCR) studies were conducted in samples of intestine and related lymphoid tissue (Peyer patches, lymph nodes). Animals were classified according to their lesions. The number of granulomas was counted in 3 tissue sections from each sample. Only the HD groups showed lesions associated with paratuberculosis (92.3% of ewes and 100% of lambs). Adults had lesions characterized by few small demarcated focal granulomas restricted to the lymphoid tissue, whereas granulomas were more numerous and larger, appearing in the lamina propria unrelated to lymphoid tissue, in the lambs. Only HD-infected lambs were positive to culture, whereas nested PCR also detected positive HD ewes and some LD animals. These results suggest that adult sheep can become infected by Map, as seen by the development of lesions, but they are focal and restricted to the lymphoid tissue.
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Mycobacterium avium subsp. paratuberculosis , Paratuberculosis/microbiología , Paratuberculosis/patología , Enfermedades de las Ovejas/microbiología , Enfermedades de las Ovejas/patología , Factores de Edad , Análisis de Varianza , Animales , Recuento de Células , Granuloma/patología , Inmunohistoquímica/veterinaria , Intestinos/microbiología , Tejido Linfoide/microbiología , Reacción en Cadena de la Polimerasa/veterinaria , OvinosRESUMEN
Despite the high incidence of urinary incontinence (UI), health professional awareness of this disease is low, which in itself is not serious but significantly limits the lives of the patients. The Primary Care associations, Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) along with the Asociación Española de Urología (EAU) have developed this consensus with the proposal of making GPs aware, and to help them in the diagnosis, treatment and referral to Urologists. The first goal in primary care must be the detection of UI, thus an opportunistic screening at least once in the lifetime of asymptomatic women > 40 years old and asymptomatic men > 55 years old. The diagnosis, based on medical history and physical examination, must determine the type and severity of the UI in order to refer severe cases to the Urologist. Except for overactive bladder (OAB), non-pharmacological conservative treatment is the first approach to uncomplicated UI in females and males. Antimuscarinics are the only drugs that have demonstrated efficacy and safety in urge urinary incontinence (UUI) and OAB. In men with mixed symptoms, excluding severe obstruction cases, a combination therapy of alpha-blockers and antimuscarinics should be chosen.
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Atención Primaria de Salud , Derivación y Consulta/normas , Incontinencia Urinaria/diagnóstico , Incontinencia Urinaria/terapia , Algoritmos , Femenino , Humanos , Masculino , RegistrosRESUMEN
Ultrahigh-frequency acoustic-phonon resonators usually require atomically flat interfaces to avoid phonon scattering and dephasing, leading to expensive fabrication processes, such as molecular beam epitaxy. Mesoporous thin films are based on inexpensive wet chemical fabrication techniques that lead to relatively flat interfaces regardless the presence of nanopores. Here, we report mesoporous titanium dioxide-based acoustic resonators with resonances up to 90 GHz, and quality factors from 3 to 7. Numerical simulations show a good agreement with the picosecond ultrasonics experiments. We also numerically study the effect of changes in the speed of sound on the performance of the resonator. This change could be induced by liquid infiltration into the mesopores. Our findings constitute the first step towards the engineering of building blocks based on mesoporous thin films for reconfigurable optoacoustic sensors.
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BACKGROUND: Once HIV/HCV-coinfection microelimination has been virtually achieved in some countries, there is no information about the burden of liver disease among people living with HIV (PLWH). The aim of this study was to define the current prevalence and causes of significant liver damage (SLD) in PLWH. METHODS: Cross-sectional study including 619 PLWH. SLD was defined as liver stiffness (LS) ≥ 7.2 kPa measured by transient elastography. Nonviral liver damage (NVLD) was considered if there was no evidence injury due to chronic hepatitis C virus (HCV) infection, active hepatitis B (HBV) or E virus infections. RESULTS: One hundred and twelve of 619 (18.2%) PLWH showed SLD, including 34/112 (5.5%) with LS ≥14 kPa. 72/112 (64.3%) had cured HCV infection, 4/112 (3.6%) active HBV infection, and 2/112 HBV/prior HCV coinfection. Thus, 40 (35.7%) showed NVLD. Metabolic associated steatohepatitis (MASH) was present in 29/40 (72.5%) of patients with NVLD, alcoholic liver damage in 2/40 (2.5%) and mixed steatohepatitis in 5/40 (12.5%). CONCLUSIONS: After HIV/HCV microelimination the burden of liver damage is high among PLWH. Persistent injury after HCV is a very frequent cause of SLD. However, NVLD, mainly due to MASH, is also a common condition in this population.
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Coinfección , Hígado Graso , Infecciones por VIH , Hepatitis C Crónica , Hepatitis C , Humanos , Hepacivirus , Hepatitis C Crónica/complicaciones , Hepatitis C Crónica/epidemiología , Coinfección/epidemiología , Coinfección/complicaciones , Estudios Transversales , Hepatitis C/complicaciones , Hepatitis C/epidemiología , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Hígado Graso/complicaciones , Cirrosis Hepática/complicaciones , Cirrosis Hepática/epidemiologíaRESUMEN
OBJECTIVES: To assess the diagnostic concordance of overactive bladder (OAB) and detrusor overactivity (DO) in male patients with predominant storage lower urinary tract symptoms (LUTS) and evaluate their clinical and urodynamic profile according to DO presence and degree of obstruction. MATERIAL AND METHODS: Epidemiological, cross-sectional multicenter study. A 3-day bladder diary (3dBD), International Prostate Symptom Score (IPSS) and Bladder Control Self-Assessment Questionnaire (B-SAQ) questionnaires were analyzed. Prostate volume was determined by ultrasound. Urodynamic study (UDS) tests were performed. The prevalence of OAB and DO and the degree of clinical concordance (kappa index) were investigated. Descriptive analysis of clinical variables and UDS results was performed, followed by comparisons based on the presence of DO and degree of obstruction. RESULTS: A total of 445 patients were included. The mean age was (SD) 54.8 (9.9) years. According to 3dBD, 89.9% presented increased urinary frequency, 87.9% nocturia, 72.1% urgency, and 31.9% urge urinary incontinence (UUI). Obstruction was present in 36.8%. Concomitant OAB and DO were present in 54.5%. The degree of diagnostic concordance between OAB and DO was low (κâ¯=â¯0.1772). There were more patients with DO presenting urgency (3dBD and B-SAQ; pâ¯<â¯0.001), UUI (3dBD; pâ¯=â¯0.008) and nocturia (B-SAQ; pâ¯<â¯0.001). Differences were found in terms of prostate volume, IPSS-voiding, maximum flow (Qmax) and post-void residual (pâ¯<â¯0.05) according to the obstruction degree. CONCLUSIONS: Approximately 50% of male patients aged 18-65 years old with predominant storage LUTS, referred to specialized units, have both OAB and DO. Obstruction is present on 1/3. Diagnostic concordance between OAB and DO is poor.
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Vejiga Urinaria Hiperactiva , Urología , Adolescente , Adulto , Anciano , Estudios Transversales , Humanos , Masculino , Persona de Mediana Edad , Vejiga Urinaria Hiperactiva/diagnóstico , Vejiga Urinaria Hiperactiva/epidemiología , Incontinencia Urinaria de Urgencia/diagnóstico , Incontinencia Urinaria de Urgencia/epidemiología , Urodinámica , Adulto JovenRESUMEN
INTRODUCTION AND OBJECTIVE: Cancer-specific anxiety is the most frequently reported psychological response after radical prostatectomy (RP). We evaluated the prevalence of pretreatment psychiatric pathology in patients with prostate cancer undergoing RP and identified the effects of psychiatric diagnoses on their survival and prognosis. MATERIAL AND METHODS: Retrospective multicenter observational study including 1078 men treated with RP for organ-confined prostate cancer. Groups: GP: patients with psychiatric pathology prior to RP; GNP: patients without psychiatric pathology prior to RP. Urological, oncological and psychiatric variables, descriptive statistics and multivariate analysis were included. RESULTS: 37.94% of patients presented a psychiatric diagnosis. Adjuvant radiotherapy was required in 27.83% and hormone therapy in 23.38%; being more frequent in GP. Cancer-specific survival was higher in GNP. Anxiety, depression, insomnia, smoking, psychosis and alcoholism were the most frequent. Low TNM and low presence of LUTS and SUI increased the probability of absence of psychiatric pathology. Fatigue, erectile dysfunction and cognitive impairment after RP with RT and/or HT were higher in GP. Older age and higher PSA at diagnosis increased the relative risk of psychiatric pathology and worse outcome. The most frequently related factors were RP, PSA, age and survival time. CONCLUSIONS: Psychiatric pathology is present in patients undergoing radical prostatectomy for prostate cancer, with a high impact on survival and prognostic outcomes.
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Neoplasias de la Próstata , Humanos , Masculino , Neoplasias de la Próstata/cirugíaRESUMEN
OBJECTIVE: To assess the diagnostic concordance of overactive bladder (OAB) and detrusor overactivity (DO) in male patients with predominant storage lower urinary tract symptoms (LUTS) and evaluate their clinical and urodynamic profile according to DO presence and degree of obstruction. MATERIAL AND METHODS: Epidemiological, cross-sectional multicenter study. A 3-day bladder diary (3dBD), International Prostate Symptom Score (IPSS) and Bladder Control Self-Assessment Questionnaire (B-SAQ) questionnaires were analyzed. Prostate volume was determined by ultrasound. Urodynamic study (UDS) tests were performed. The prevalence of OAB and DO and the degree of clinical concordance (kappa index) were investigated. Descriptive analysis of clinical variables and UDS results was performed, followed by comparisons based on the presence of DO and degree of obstruction. RESULTS: A total of 445 patients were included. The mean age was (SD) 54.8 (9.9) years. According to 3dBD, 89.9% presented increased urinary frequency, 87.9% nocturia, 72.1% urgency, and 31.9% urge urinary incontinence (UUI). Obstruction was present in 36.8%. Concomitant OAB and DO were present in 54.5%. The degree of diagnostic concordance between OAB and DO was low (κ=0.1772). There were more patients with DO presenting urgency (3dBD and B-SAQ; p<0.001), UUI (3dBD; p=0.008) and nocturia (B-SAQ; p<0.001). Differences were found in terms of prostate volume, IPSS-voiding, maximum flow (Qmax) and post-void residual (p<0.05) according to the obstruction degree. CONCLUSIONS: Approximately 50% of male patients aged 18-65 years old with predominant storage LUTS, referred to specialized units, have both OAB and DO. Obstruction is present on 1/3. Diagnostic concordance between OAB and DO is poor.
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Primary aim was to assess prevalence and severity of potential and real drug-drug interactions (DDIs) among therapies for COVID-19 and concomitant medications in hospitalized patients with confirmed SARS-CoV-2 infection. The secondary aim was to analyze factors associated with rDDIs. An observational single center cohort study conducted at a tertiary hospital in Spain from March 1st to April 30th. rDDIs refer to interaction with concomitant drugs prescribed during hospital stay whereas potential DDIs (pDDIs) refer to those with domiciliary medication. DDIs checked with The University of Liverpool resource. Concomitant medications were categorized according to the Anatomical Therapeutic Chemical classification system. Binomial logistic regression was carried out to identify factors associated with rDDIs. A total of 174 patients were analyzed. DDIs were detected in 152 patients (87.4%) with a total of 417 rDDIs between COVID19-related drugs and involved hospital concomitant medication (60 different drugs) while pDDIs were detected in 105 patients (72.9%) with a total of 553 pDDIs. From all 417 rDDIs, 43.2% (n = 180) were associated with lopinavir/ritonavir and 52.9% (n = 221) with hydroxychloroquine, both of them the most prescribed (106 and 165 patients, respectively). The main mechanism of interaction observed was QTc prolongation. Clinically relevant rDDIs were identified among 81.1% (n = 338) ('potential interactions') and 14.6% (n = 61) (contraindicated) of the patients. Charlson index (OR 1.34, 95% IC 1.02-1.76) and number of drugs prescribed during admission (OR 1.42, 95% IC 1.12-1.81) were independently associated with rDDIs. Prevalence of patients with real and pDDIs was high, especially those clinically relevant. Both comorbidities and polypharmacy were found as risk factors independently associated with DDIs development.
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Tratamiento Farmacológico de COVID-19 , Interacciones Farmacológicas , Hidroxicloroquina/química , Lopinavir/química , Ritonavir/química , Anciano , Analgésicos/química , Analgésicos/uso terapéutico , COVID-19/patología , COVID-19/virología , Enfermedades Cardiovasculares/tratamiento farmacológico , Estudios de Cohortes , Diuréticos/química , Diuréticos/uso terapéutico , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Lopinavir/uso terapéutico , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/tratamiento farmacológico , Polifarmacia , Factores de Riesgo , Ritonavir/uso terapéutico , SARS-CoV-2/aislamiento & purificación , Índice de Severidad de la Enfermedad , EspañaRESUMEN
A robust and straightforward strategy allowing the controlled confinement of metal nanoparticles within the 3D framework of mesoporous films is presented. The chemical methodology is based on the inner surface modification of mesoporous silica films with polyelectrolyte brushes. We demonstrate that the macromolecular building blocks significantly enhance the site-selective preconcentration of nanoparticle precursors in the inner environment of the mesoporous film. Then, chemical reduction of the preconcentrated precursors led to the formation of metal nanoparticles locally addressed in the mesoporous structure. We show that the synergy taking place between two versatile functional nanobuilding blocks (ordered mesocavities and polymer brushes) can produce stable embedded nanoparticles with tuned optical properties in a very simple manner. As a general framework, the strategy can be easily adapted to different sets of polymer brushes and mesoporous films in order to regulate the monomer-precursor interactions and, consequently, manipulate the site-selective character of the different chemistries taking place in the film. We consider that the "integrative chemistry" approach described in this work provides new pathways to manipulate the physicochemical characteristics of hybrid organic-inorganic advanced functional assemblies based on the rational design of chemistry and topology in confined environments.
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Enfermedad de Castleman/etiología , Enfermedad de Hodgkin/complicaciones , Enfermedad Mixta del Tejido Conjuntivo/etiología , Rituximab/uso terapéutico , Corticoesteroides/uso terapéutico , Antimaláricos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Enfermedad de Castleman/tratamiento farmacológico , Enfermedad de Castleman/inmunología , Quimioterapia Combinada , Enfermedad de Hodgkin/tratamiento farmacológico , Humanos , Masculino , Metilprednisolona/uso terapéutico , Persona de Mediana Edad , Enfermedad Mixta del Tejido Conjuntivo/tratamiento farmacológico , Enfermedad de Raynaud/etiología , Inducción de RemisiónRESUMEN
CONTEXT: Pygeum africanum(P. africanum) is still being employed in urology practice for the treatment of lower urinary tract symptoms secondary to benign prostate hyperplasia. EVIDENCE ACQUISITION: A non-exhaustive review has been carried out about P. africanum, its mechanisms of action "in vitro" as well as "in vivo", clinical trials and routine clinical practice. EVIDENCE SYNTHESIS: The conclusions of the review and the reflections of the authors on the use of P. africanum are described. CONCLUSIONS: Although with an evidence level IV (based on expert opinion) the use of P. africanum seems to be an option in the urological therapeutic arsenal.
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Síntomas del Sistema Urinario Inferior/tratamiento farmacológico , Fitoterapia , Extractos Vegetales/uso terapéutico , Prunus africana , Humanos , Síntomas del Sistema Urinario Inferior/etiología , Masculino , Hiperplasia Prostática/complicaciones , Resultado del TratamientoRESUMEN
OBJECTIVE: To study the influence of clean intermittent catheterization (CIC) on the lower urinary tract function in patients with urinary retention (UR) due to detrusor underactivity (DU). MATERIAL AND METHODS: A longitudinal study was carried out on 49 patients (28 men, 21 women) of mean age 55years, who underwent CIC for UR secondary to DU. The mean CIC frequency was 3.15 times/day. Patients' clinical data were collected, and they underwent urodynamic study before and after CIC, with a mean interval of 4years. Fisher's exact test was used for the analysis of categorical variables and Student's t test for parametric variables. The level of significance was set at 0.05 for a two-tailed test. RESULTS: The second urodynamic study showed a significantly increased bladder compliance, the Bladder Outlet Obstruction Index (BOOI) and the Bladder Contractility Index (BCI) also increased but without reaching statistical significance. There was a significantly higher percentage of benign prostatic hyperplasia (BPH) and acontractile detrusor cases among the group of patients whose BCI improved after CIC, with significantly lower CIC time. CONCLUSIONS: CIC improved bladder compliance in the patients of our series. The BCI improved in BPH patients and in patients with acontractile detrusor.
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Cateterismo Uretral Intermitente , Uretra/fisiopatología , Vejiga Urinaria de Baja Actividad/complicaciones , Vejiga Urinaria/fisiopatología , Retención Urinaria/etiología , Retención Urinaria/terapia , Adulto , Anciano , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Hepatic steatosis (HS) is frequently observed in HIV-infected patients. It is not known whether HIV infection is an independent risk factor for HS development. We aimed to analyze whether HIV coinfection was associated with a higher frequency of HS in patients with chronic hepatitis C. This was a retrospective cross-sectional study. 574 subjects with chronic hepatitis C virus (HCV) infection were included, 246 (43%) of them coinfected with HIV. All of them underwent transient elastography with controlled attenuation parameter (CAP) measurement. HS was defined as CAP ≥ 248 dB/m. 147 individuals (45%) showed HS in the HCV-monoinfected group and 100 (40.7%) in the HIV/HCV-coinfected group (p = 0.318). HS was associated with body mass index (BMI) [<25 Kg/m2 vs. ≥25 Kg/m2, 67 (23.5%) vs. 171 (62.9%); p = 0.001], with plasma HDL-cholesterol [<50 mg/dL vs. ≥50 mg/dL, 122 (48.6%) vs. 95 (37.5%), p = 0.012], with plasma triglycerides [<150 mg/dL vs. ≥150 mg/dL, 168 (40.2%) vs. 65 (52.4%); p = 0.016] and with plasma total cholesterol [<200 mg/dL vs. ≥200 mg/dL, 181 (41%) vs. 53 (52.5%); p = 0.035]. In the multivariate analysis, HS was associated with BMI [adjusted OR (AOR) = 1.264 (1.194-1.339); p = 0.001], age [AOR = 1.029 (1.001-1.058); p = 0.047] and HCV genotype 3 infection [AOR = 1.901 (1.081-2.594); p = 0.026]. HIV coinfection was not associated with HS [AOR = 1.166 (0.719-1.892); p = 0.534]. In conclusion, HIV coinfection is not related with an increased frequency of HS in HCV-infected patients.
Asunto(s)
Hígado Graso/epidemiología , Infecciones por VIH/epidemiología , VIH/patogenicidad , Hepacivirus/patogenicidad , Hepatitis C Crónica/epidemiología , Hígado/patología , Índice de Masa Corporal , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Coinfección , Estudios Transversales , Diagnóstico por Imagen de Elasticidad , Hígado Graso/diagnóstico por imagen , Hígado Graso/patología , Hígado Graso/virología , Femenino , VIH/crecimiento & desarrollo , Infecciones por VIH/diagnóstico por imagen , Infecciones por VIH/patología , Infecciones por VIH/virología , Hepacivirus/crecimiento & desarrollo , Hepatitis C Crónica/diagnóstico por imagen , Hepatitis C Crónica/patología , Hepatitis C Crónica/virología , Humanos , Hígado/diagnóstico por imagen , Hígado/virología , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , España/epidemiología , Triglicéridos/sangreRESUMEN
Silver nanoparticle assemblies are embedded within mesoporous oxide thin films by an in situ mild reduction leading to nanoparticle-mesoporous oxide thin-film composites (NP@MOTF). A quantitative method based on X-ray reflectivity is developed and validated with energy dispersive spectroscopy in order to assess pore filling. The use of dilute formaldehyde solutions leads to control over the formation of silver nanoparticles within mesoporous titania films. Inclusion of silver nanoparticles in mesoporous silica requires more drastic conditions. This difference in reactivity can be exploited to selectively synthesize nanoparticles in a predetermined layer of a multilayered mesoporous stack leading to complex 1D-ordered multilayers with precise spatial location of nanometric objects. The metal oxide nanocomposites synthesized have potential applications in catalysis, optical devices, surface-enhanced Raman scattering, and metal enhancement fluorescence.
Asunto(s)
Nanopartículas del Metal/química , Nanotecnología/métodos , Plata/química , Metales/química , Microscopía Electrónica de Transmisión , Nanopartículas/química , Óptica y Fotónica , Óxidos/química , Dióxido de Silicio/química , Espectrometría de Fluorescencia/métodos , Espectrometría Raman/métodos , Propiedades de Superficie , Titanio/química , Rayos XRESUMEN
Lesions were examined at different levels of the central nervous system (CNS) in 64 sheep with natural maedi-visna (MV) meningoencephalitis. All animals showed lesions in more than one of the CNS locations examined; the lesions in the cranial regions were periventricular, while those in the spinal cord affected the white matter funicles. Lesions were found particularly in the cerebellar peduncles (non-suppurative meningoencephalitis), followed by the corpus callosum, hippocampus and thoracic spinal cord. Vascular, infiltrative and malacic histopathological patterns were recognized. One pattern predominated in each section examined, although mixed forms occurred. Vascular lesions occurred with similar frequency at all CNS levels, but infiltrative and malacic lesions predominated at rostral and caudal levels, respectively. Cells consistent with macrophages and shown immunohistochemically to be associated with MV virus were seen in malacic and infiltrative lesions, at the periphery of damaged areas.