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1.
Int J Mol Sci ; 25(9)2024 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-38731905

RESUMEN

A novel rare mutation in the pore region of Nav1.5 channels (p.L889V) has been found in three unrelated Spanish families that produces quite diverse phenotypic manifestations (Brugada syndrome, conduction disease, dilated cardiomyopathy, sinus node dysfunction, etc.) with variable penetrance among families. We clinically characterized the carriers and recorded the Na+ current (INa) generated by p.L889V and native (WT) Nav1.5 channels, alone or in combination, to obtain further insight into the genotypic-phenotypic relationships in patients carrying SCN5A mutations and in the molecular determinants of the Nav1.5 channel function. The variant produced a strong dominant negative effect (DNE) since the peak INa generated by p.L889V channels expressed in Chinese hamster ovary cells, either alone (-69.4 ± 9.0 pA/pF) or in combination with WT (-62.2 ± 14.6 pA/pF), was significantly (n ≥ 17, p < 0.05) reduced compared to that generated by WT channels alone (-199.1 ± 44.1 pA/pF). The mutation shifted the voltage dependence of channel activation and inactivation to depolarized potentials, did not modify the density of the late component of INa, slightly decreased the peak window current, accelerated the recovery from fast and slow inactivation, and slowed the induction kinetics of slow inactivation, decreasing the fraction of channels entering this inactivated state. The membrane expression of p.L889V channels was low, and in silico molecular experiments demonstrated profound alterations in the disposition of the pore region of the mutated channels. Despite the mutation producing a marked DNE and reduction in the INa and being located in a critical domain of the channel, its penetrance and expressivity are quite variable among the carriers. Our results reinforce the argument that the incomplete penetrance and phenotypic variability of SCN5A loss-of-function mutations are the result of a combination of multiple factors, making it difficult to predict their expressivity in the carriers despite the combination of clinical, genetic, and functional studies.


Asunto(s)
Cricetulus , Canal de Sodio Activado por Voltaje NAV1.5 , Linaje , Penetrancia , Canal de Sodio Activado por Voltaje NAV1.5/genética , Canal de Sodio Activado por Voltaje NAV1.5/metabolismo , Humanos , Animales , Células CHO , Femenino , Masculino , Adulto , Persona de Mediana Edad , España , Mutación con Pérdida de Función , Fenotipo , Mutación
2.
Artículo en Inglés | MEDLINE | ID: mdl-38706413

RESUMEN

Tumors located at the heart base are rare in dogs and cats and aortic body tumors (chemodectoma/paraganglioma), hemangiosarcoma, ectopic thyroid carcinoma, lymphoma, and other uncommon neoplasia can be found at that location. The objective of this retrospective case series was to describe the CT characteristics of canine and feline heart base tumors. CT studies of 21 dogs and four cats with histologically or cytologically confirmed heart base tumors were reviewed for size, location, shape, margination, contrast enhancement, adjacent neovascularization, invasion, mass effect, cavitary effusions, and metastasis. Neuroendocrine tumors (15 aortic body tumors, three ectopic thyroid carcinoma, and three nonspecific neuroendocrine) were more commonly observed than hemangiosarcoma (4) and were frequently located between the cranial vena cava and aortic arch (12/21; 57%) and or dorsal to the pulmonary trunk bifurcation/pulmonary arteries (10/21; 48%). Hemangiosarcoma was more commonly found cranioventral to the aortic arch and cranial to the right auricular appendage (3/4; 75%). Mediastinal and peritumoral neovascularization was associated with 16/21 (76%) neuroendocrine tumors but none of the hemangiosarcoma. Median postcontrast attenuation in Hounsfield units (HU) was higher in neuroendocrine (110 HU) than in hemangiosarcoma (51 HU). Pericardial effusion was frequently observed with hemangiosarcoma (3/4; 75%) and infrequently in neuroendocrine (3/21; 14%). In four cases (all neuroendocrine), concurrent cranial mediastinal masses were present. CT provides useful information regarding the characteristics of heart base tumors, indicating differences between the appearance of neuroendocrine tumors and hemangiosarcoma. However, no differences were found between aortic body tumors and ectopic thyroid carcinoma.

3.
Gastroenterol Hepatol ; 46(6): 425-438, 2023.
Artículo en Inglés, Español | MEDLINE | ID: mdl-36243249

RESUMEN

BACKGROUND: Retrospective studies suggest that coronavirus disease (COVID-19) commonly involves gastrointestinal (GI) symptoms and complications. Our aim was to prospectively evaluate GI manifestations in patients hospitalized for COVID-19. METHODS: This international multicentre prospective cohort study recruited COVID-19 patients hospitalized at 31 centres in Spain, Mexico, Chile, and Poland, between May and September 2020. Patients were followed-up until 15 days post-discharge and completed comprehensive questionnaires assessing GI symptoms and complications. A descriptive analysis as well as a bivariate and multivariate analysis were performer using binary logistic regression. p<0.05 was considered significant. RESULTS: Eight hundred twenty-nine patients were enrolled; 129 (15.6%) had severe COVID-19, 113 (13.7%) required ICU admission, and 43 (5.2%) died. Upon admission, the most prevalent GI symptoms were anorexia (n=413; 49.8%), diarrhoea (n=327; 39.4%), nausea/vomiting (n=227; 27.4%), and abdominal pain (n=172; 20.7%), which were mild/moderate throughout the disease and resolved during follow-up. One-third of patients exhibited liver injury. Non-severe COVID-19 was associated with ≥2 GI symptoms upon admission (OR 0.679; 95% CI 0.464-0.995; p=0.046) or diarrhoea during hospitalization (OR 0.531; 95% CI 0.328-0.860; p=0.009). Multivariate analysis revealed that worse hospital outcomes were not independently associated with liver injury or GI symptoms. CONCLUSION: GI symptoms were more common than previously documented, and were mild, rapidly resolved, and not independently associated with COVID-19 severity. Liver injury was a frequent complication in hospitalized patients not independently associated with COVID-19 severity.


Asunto(s)
COVID-19 , Enfermedades Gastrointestinales , Humanos , COVID-19/complicaciones , Estudios Retrospectivos , SARS-CoV-2 , Estudios Prospectivos , Cuidados Posteriores , Alta del Paciente , Enfermedades Gastrointestinales/etiología , Enfermedades Gastrointestinales/complicaciones , Diarrea/epidemiología , Diarrea/etiología
4.
Clin Exp Immunol ; 209(2): 236-246, 2022 08 19.
Artículo en Inglés | MEDLINE | ID: mdl-35778909

RESUMEN

Optic neuritis, a primary clinical manifestation commonly observed in multiple sclerosis (MS), is a major factor leading to permanent loss of vision. Despite decreased vision (optic neuritis), diplopia, and nystagmus, the immunopathology of the optic nerve in MS is unclear. Here, we have characterized the optic nerve pathology in a large cohort of MS cases (n = 154), focusing on the immune responses in a sub-cohort of MS (n = 30) and control (n = 6) cases. Immunohistochemistry was used to characterize the myeloid (HLA-DR, CD68, Iba1, TMEM119, and P2RY12) and adaptive immune cells (CD4, CD8, and CD138) in the parenchyma, perivascular spaces, and meninges in optic nerve tissues from MS and control cases. Of the 154 MS cases, 122 (79%) reported visual problems; of which, 99 (81%) optic nerves showed evidence of damage. Of the 31 cases with no visual disturbances, 19 (61%) showed evidence of pathology. A pattern of myeloid cell activity and demyelination in the optic nerve was similar to white matter lesions in the brain and spinal cord. In the optic nerves, adaptive immune cells were more abundant in the meninges close to active and chronic active lesions, and significantly higher compared with the parenchyma. Similar to brain tissues in this Dutch cohort, B-cell follicles in the meninges were absent. Our study reveals that optic nerve pathology is a frequent event in MS and may occur in the absence of clinical symptoms.


Asunto(s)
Esclerosis Múltiple , Neuritis Óptica , Encéfalo/patología , Humanos , Esclerosis Múltiple/patología , Nervio Óptico , Neuritis Óptica/diagnóstico , Neuritis Óptica/patología , Médula Espinal/patología
5.
Chemistry ; 28(54): e202201644, 2022 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-35748487

RESUMEN

A nickel-catalysed reductive cross-coupling reaction between benzyl sulfonium salts and benzyl bromides is reported. Simple, stable and readily available sulfonium salts have shown their ability as leaving groups in cross-electrophile coupling, allowing the formation of challenging sp3 -sp3 carbon-carbon bonds, towards the synthesis of interesting dihydrostilbene derivatives. In addition, benzyl tosyl derivatives have been demonstrated to be suitable substrates for reductive cross-coupling by in-situ formation of the corresponding sulfonium salt.


Asunto(s)
Níquel , Sales (Química) , Compuestos de Bencilo , Bromuros/química , Carbono/química , Catálisis , Níquel/química
6.
Am J Respir Crit Care Med ; 203(10): 1290-1305, 2021 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-33306938

RESUMEN

Rationale: Cigarette smoke is considered the chief leading cause of chronic obstructive pulmonary disease (COPD). Its impact on the progressive deterioration of airways has been extensively studied, but its direct effects on the pulmonary vasculature are less known. Objectives: To prove that pulmonary arterial remodeling in patients with COPD is not just a consequence of alveolar hypoxia but also due to the direct effects of cigarette smoke on the pulmonary vascular bed. Methods: We have used different molecular and cell biology approaches, as well as traction force microscopy, wire myography, and patch-clamp techniques in human cells and freshly isolated pulmonary arteries. In addition, we relied on in vivo models and human samples to analyze the effects of cigarette smoke on pulmonary vascular tone alterations. Measurements and Main Results: Cigarette smoke extract exposure directly promoted a hypertrophic, senescent phenotype that in turn contributed, through the secretion of inflammatory molecules, to an increase in the proliferative potential of nonexposed cells. Interestingly, these effects were significantly reversed by antioxidants. Furthermore, cigarette smoke extract affected cell contractility and dysregulated the expression and activity of the voltage-gated K+ channel Kv7.4. This contributed to the impairment of vasoconstriction and vasodilation responses. Most importantly, the levels of this channel were diminished in the lungs of smoke-exposed mice, smokers, and patients with COPD. Conclusions: Cigarette smoke directly contributes to pulmonary arterial remodeling through increased cell senescence, as well as vascular tone alterations because of diminished levels and function in the Kv7.4 channel. Strategies targeting these pathways may lead to novel therapies for COPD.


Asunto(s)
Canales de Potasio KCNQ/metabolismo , Arteria Pulmonar/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Fumar/efectos adversos , Remodelación Vascular/fisiología , Animales , Modelos Animales de Enfermedad , Humanos , Ratones , Arteria Pulmonar/patología , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/metabolismo , Humo/efectos adversos , Nicotiana , Vasoconstricción , Vasodilatación
7.
Medicina (Kaunas) ; 58(4)2022 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-35454359

RESUMEN

BACKGROUND: The majority of patients with acute promyelocytic leukemia (APL) manifest a specific chromosomal translocation t(15;17)(q22;q21), characterized by the fusion of RARA and PML genes. However, a proportion of APL cases are due to variant translocations, being t(11;17) (q23;q21) the most common amongst them. With the major exception of ZBTB16-RARA t(11;17) APL, these variant APL cases present similar morphological features as classic APL and are characterized by a lack of differentiation response to retinoids. CASE SUMMARY: We describe the case of variant APL with the ZBTB16-RARA fusion gene, showing a distinct morphology of classical APL, characterized by crystalline intracytoplasmic inclusions in both peripheral blood (PB) and bone marrow (BM) patients' blasts. Our patient was treated with two courses of intensive chemotherapy, initiating maintenance treatment with all-trans retinoic acid (ATRA) on day twenty-eight of the second course. Our patient achieved complete remission (CR) once the intensive chemotherapy was combined with ATRA. CONCLUSIONS: This is the second case described of APL with t(11;17) that showed crystalline intracytoplasmic inclusions. The finding of these morphological features may suggest the presence of a variant translocation with RARA, being that both cases described are related to the presence of t(11;17). Despite induction treatment with intensive chemotherapy that included a seven-day continuous treatment with cytarabine (200 mg/m2), plus daily idarubicin (12 mg/m2) during the first three days, our patient did not achieve complete remission (CR) until scheduled 3 + 7 regimen combined with ATRA treatment was established. This observation suggests that ATRA may be partially effective in some ZBTB16-RARA APLs.


Asunto(s)
Leucemia Promielocítica Aguda , Médula Ósea , Humanos , Leucemia Promielocítica Aguda/tratamiento farmacológico , Leucemia Promielocítica Aguda/genética , Proteínas de Fusión Oncogénica/genética , Proteína de la Leucemia Promielocítica con Dedos de Zinc/genética , Translocación Genética/genética , Tretinoina/uso terapéutico
8.
Medicina (Kaunas) ; 58(2)2022 Feb 10.
Artículo en Inglés | MEDLINE | ID: mdl-35208587

RESUMEN

Extramedullary involvement of acute myeloid leukemia (AML) is infrequent, and ascitic infiltration is even more unusual. We present a case of a 48-year-old woman diagnosed with NPM1-mutated AML that debuted with ascites, for which morphological studies of the ascitic fluid did not detect leukemic infiltration, maybe due to technical problems in the sample preparation. Multiparameter flow cytometry (MFC) detected a blast population compatible with AML, and allele-specific PCR detected NPM1-mutated transcripts. Body fluid infiltrations are an infrequent initial manifestation or sign of progression in AML. As far as we know, this is the first reported case of an NPM1-mutated AML that debuted with ascites, and also the first description of the utilization of molecular techniques to detect the leukemic origin of the ascites. This case highlights that, given that allele-specific PCR and MFC increase the sensitivity of morphological studies, these techniques should be routinely applied in the study of any kind of effusion detected in an AML patient.


Asunto(s)
Líquido Ascítico , Infiltración Leucémica , Femenino , Citometría de Flujo , Humanos , Persona de Mediana Edad , Mutación , Proteínas Nucleares/genética , Nucleofosmina
10.
Pharmacogenet Genomics ; 29(9): 216-223, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31568130

RESUMEN

OBJECTIVE: To investigate if polymorphisms of some genes involved in folliculogenesis predict ovarian response. METHODS: This prospective randomized study includes 124 egg donors genotyped for six SNPs ESR1 (rs2234693), AMHR2 (rs2002555), GDF-9 (rs10491279 and rs254286), AMH (rs10407022) and LHCBR (rs229327) genes and four STRs in ESR1 rs3138774), SHBG (rs6761), CYP19A1 (rs60271534) and AR genes (CAG repeats in exon 1). All donors followed standard ovarian stimulation protocol using a daily dose of 225 UI. The genotypes obtained were compared with the ovarian stimulation outcome. RESULTS: Regarding the number of retrieved oocytes, we found statistical differences for the ESR1 SNP and STR (19.3 ± 8.9 for TT vs 15.3 ± 6.2 for CC/CT, P = 0.027; 19.1 ± 8.3 for <17repeats vs 14.7 ± 6.2 for >17repeats, P = 0.020). Moreover, women carrying TT in the ESR1 at position c.-397T>C with ESR1 (TA)n=17 retrieved the highest number of oocytes (20.4 ± 9.3) (P = 0.001). Concerning AMHR2, we observed an association with the length of stimulation (9.1 ± 1.4 d for AA vs 9.7 ± 1.3 d for AG/GG, P = 0.021) and gonadotropin received (2050 ± 319 for AA vs 2188 ± 299 for AG/GG, P = 0.017). No significant differences were observed for the other polymorphisms (P > 0.05). CONCLUSION: The polymorphisms in ESR1 and AMHR2 genes showed a clear association with the number of retrieved oocytes and the stimulation data, respectively. Our results suggest that polymorphisms in the genes for key reproductive hormones receptors could be used to predict the ovarian response and to personalize the stimulation prior the treatment.


Asunto(s)
Pruebas Genéticas , Variación Genética , Ovario/fisiología , Femenino , Humanos , Repeticiones de Microsatélite/genética , Polimorfismo de Nucleótido Simple/genética , Receptores de Estrógenos/metabolismo , Adulto Joven
11.
Artículo en Inglés | MEDLINE | ID: mdl-28910582

RESUMEN

A pilot-scale reverse osmosis (RO) followed behind a membrane bioreactor (MBR) was developed for the desalination to reuse wastewater in a PVC production site. The solution-diffusion-film model (SDFM) based on the solution-diffusion model (SDM) and the film theory was proposed to describe rejections of electrolyte mixtures in the MBR effluent which consists of dominant ions (Na+ and Cl-) and several trace ions (Ca2+, Mg2+, K+ and SO42-). The universal global optimisation method was used to estimate the ion permeability coefficients (B) and mass transfer coefficients (K) in SDFM. Then, the membrane performance was evaluated based on the estimated parameters which demonstrated that the theoretical simulations were in line with the experimental results for the dominant ions. Moreover, an energy analysis model with the consideration of limitation imposed by the thermodynamic restriction was proposed to analyse the specific energy consumption of the pilot-scale RO system in various scenarios.


Asunto(s)
Conservación de los Recursos Energéticos , Membranas Artificiales , Modelos Teóricos , Cloruro de Polivinilo/química , Reciclaje , Aguas Residuales/química , Purificación del Agua/métodos , Filtración , Ósmosis , Proyectos Piloto
12.
ACS Catal ; 14(9): 6413-6422, 2024 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-38721373

RESUMEN

Iridium complexes have been demonstrated to be highly active catalysts for a wide variety of transformations. Their unique photophysical and photochemical properties render them as one of the most established photocatalysts. Moreover, iridium complexes are widely acknowledged for their efficiency in transfer hydrogenation reactions. However, the development of iridium complexes able to promote both traditional organometallic catalysis and photocatalysis is scarce. Thus, the design of iridium-based catalysts is still an active area of research. In this context, we targeted the synthesis of a family of Ir-Cp* systems to explore their (photo)catalytic applications. Here, we describe the synthesis, structural characterization, and photophysical properties of iridium complexes of formula [IrCp*Cl(N^O)]. These complexes have been applied with a double catalytic function, in transfer hydrogenation for carbonyl reduction and in different photomediated transformations.

13.
J Pers Soc Psychol ; 2024 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-38753409

RESUMEN

If the consequences of identity fusion are well established, its psychological antecedents are not. To address this shortcoming, eight studies tested the hypothesis that self-verification (receiving evaluations that confirm one's self-views) increases fusion (a synergistic union with a group, individual, or cause), which, in turn, increases behavioral support for the target of fusion. Correlational studies showed that perceived self-verification was positively associated with fusion, which was positively associated with willingness to fight and die for a group (Study 1a), a value (Study 1b), and a leader (Study 1c). Study 2 revealed that increasing perceived self-verification fostered greater willingness to fight and die for the group but only indirectly through increases in fusion. Study 3 showed that 4 months after indicating the degree of fusion with a group, increasing perceived self-verification augmented endorsement of fighting and dying for the group indirectly through elevations in fusion. In Study 4, relational ties mediated the relationship between perceived self-verification and fusion. Finally, face-to-face interviews with incarcerated members of street gangs and organized crime gangs (Studies 5a-5b) showed that perceived self-verification was positively associated with fusion, which was positively associated with sacrifices for the gang (replicating Studies 1a-1c). No evidence emerged supporting a rival causal path in which fusion caused willingness to fight and die through perceived self-verification. Implications for related theoretical approaches and for conceptualizing the relationship between personal identities, social identities, and group processes are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

14.
Foods ; 13(6)2024 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-38540950

RESUMEN

In an animal production system, different stressors may cause the depletion of muscle glycogen stores, resulting in an elevated pH at 24 h post mortem (pH24), which leads to cell metabolism alterations that affect the conversion of muscle into meat, causing meat quality defects, such as dark-cutting beef, also known as dark, firm, and dry (DFD) beef. This process may involve the alteration of small non-coding RNAs (miRNAs), which play critical regulatory roles in cellular processes. Here, we determined whether differential miRNA expression in the Longissimus thoracis et lumborum muscle from the Asturiana de los Valles breed at 24 h post mortem could serve as an early indicator of beef quality defects. Following total RNA extraction, complete miRNAome sequencing revealed 12 miRNAs that were significantly upregulated (p < 0.001) in DFD beef compared to the levels in CONTROL beef. These miRNAs are mainly involved in the cellular responses to redox imbalances and apoptosis. Among these, four miRNAs known to be related to oxidative stress (bta-miR-1246, bta-miR-2332, bta-miR-23b-5p, and bta-miR-2411-3p) were validated via quantitative RT-PCR. Some of their target proteins were also analyzed using Western blotting. High 70 kDa heat shock protein and low Caspase-9 expressions (p < 0.01) were found in DFD beef, suggesting the downregulation of apoptosis. These results suggest the importance of miRNAs in regulating stress in muscle cells during early post mortem, as differences in the abundance of some of these miRNAs are still observed at 24 h post mortem. These changes lead to an inadequate conversion of muscle into meat, resulting in meats with quality defects.

15.
J Pain Symptom Manage ; 67(6): 501-511.e12, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38447622

RESUMEN

CONTEXT: Music listening (ML) has been shown to have a beneficial effect on patients with cancer. However, novel intervention approaches are needed. OBJECTIVES: We aimed to determine whether ML based on the iso-principle, conducted using a mobile application (GloMus), improves symptom burden, quality of life (QoL), anxiety, and depression in patients undergoing stem cell transplantation (SCT) and intensive induction chemotherapy for acute myeloid leukemia (AML). METHODS: In this randomized controlled clinical trial, we assigned 71 patients to the ML or standard care (SC) groups, stratified by the reason for admission (AML, allogeneic-SCT, or inpatient/outpatient autologous-SCT). Upon admission, participants in the ML groups were invited to undergo daily ML sessions designed to change negative moods into positive ones (iso-principle). The intervention consisted of listening to pre-recorded classical music ordered by beats per minute and tonality. Symptom burden (Edmonton Symptom Assessment System-Revised) was assessed in the ML groups before and after each session. Anxiety, depression (Hospital Anxiety and Depression Scale), and QoL (Functional Assessment of Cancer Therapy-Bone Marrow Transplantation/Leukemia) were measured weekly in the ML and SC groups. RESULTS: Symptom burden in both allogeneic- and inpatient autologous-SCT ML groups reduced after the intervention. In all experimental groups, clinically important improvements were observed after ML sessions. No differences were found between the groups (ML vs. SC) at different weeks of admission regarding anxiety, depression, and QoL. CONCLUSIONS: ML based on our innovative iso-principle strategy, conducted using GloMus, reduced the symptom burden in patients undergoing allogeneic- and inpatient autologous-SCT (ClinicalTrials.gov number, NCT05696457).


Asunto(s)
Ansiedad , Depresión , Leucemia Mieloide Aguda , Musicoterapia , Calidad de Vida , Trasplante de Células Madre , Humanos , Leucemia Mieloide Aguda/terapia , Masculino , Femenino , Persona de Mediana Edad , Ansiedad/terapia , Musicoterapia/métodos , Adulto , Depresión/terapia , Resultado del Tratamiento , Anciano
16.
J Cardiothorac Surg ; 19(1): 242, 2024 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-38632589

RESUMEN

BACKGROUND: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome is a severe adverse drug reaction marked by delayed hypersensitivity reactions causing skin and systemic complications. DRESS diagnosis is challenging due to the variety of clinical presentations and symptom overlap with other conditions. The perioperative period in these patients requires precise pharmacological strategies to prevent complications associated with this syndrome. The treatment of DRESS induced by unfractionated heparin during cardiopulmonary bypass (CPB) surgery presents some challenges that must be considered when selecting an anticoagulant to avoid side effects. In this case, bivalirudin, a direct thrombin inhibitor, is indicated as an alternative to heparin in patients undergoing CPB. However, in contrast to heparin/protamine, there is no direct reversal agent for bivalirudin. CASE PRESENTATION: We report the case of an 11-year-old male diagnosed with native aortic valve endocarditis and thrombosis in his left lower extremity. During valvular replacement surgery, systemic unfractionated heparin was administered. Postoperatively, the patient developed fever, eosinophilia and pruritic rash. Warm shock and elevated alanine transaminase (ALT) and aspartate transaminase (AST) levels followed, leading to the diagnosis of DRESS syndrome. Treatment with methylprednisolone resulted in complete resolution of symptoms. Seven years later, the patient was readmitted due to insufficient anticoagulation and a thrombus in the prosthetic aortic valve, presenting a recurrent DRESS episode due to the administration of unfractionated heparin, which was later replaced with low-molecular-weight heparin during hospitalization. Treatment with corticosteroids and antihistamines was initiated, resulting in the resolution of this episode. Ultimately, the patient required the Ross procedure. During this intervention the anticoagulation strategy was modified, unfractionated heparin was replaced with bivalirudin during the procedure and fondaparinux was administered during the postoperative period. This resulted in stable transaminases levels and no eosinophilia. CONCLUSION: The severity of DRESS Syndrome underscores the importance of early recognition, heightened monitoring, and a comprehensive approach tailored to each patient's needs. This particular case highlights the significance of this approach and may have a substantial clinical impact since it provides alternatives to heparin, such as bivalirudin and fondaparinux, in the anticoagulation strategy of CPB for patients who have a hypersensibility reaction to this medication; thus, enhancing clinical outcomes by minimizing risks linked to adverse drug reactions.


Asunto(s)
Anestésicos , Síndrome de Hipersensibilidad a Medicamentos , Eosinofilia , Masculino , Humanos , Niño , Heparina/uso terapéutico , Fondaparinux , Síndrome de Hipersensibilidad a Medicamentos/tratamiento farmacológico , Anticoagulantes/uso terapéutico , Hirudinas/efectos adversos , Eosinofilia/inducido químicamente , Eosinofilia/tratamiento farmacológico , Fragmentos de Péptidos , Proteínas Recombinantes
17.
Enferm Infecc Microbiol Clin ; 31(2): 97-9, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22341752

RESUMEN

OBJECTIVE: To assess a new immunochromatography (ICT) test that detects glutamate dehydrogenase (GDH) antigen and Clostridium difficile toxin A/B simultaneously, and to propose an algorithm for the diagnosis of C. difficile infection (CDI) based on this test. METHODS: We analysed 970 stool samples. Discrepant results between GDH and toxin A/B were resolved using toxigenic culture as the reference. RESULTS: This test enabled us to obtain a conclusive result in <30min in 93.8% of the samples. Among the discrepant results (GDH (+)/Toxin A/B (-)), 41.7% (25/60) were found to be toxigenic C. difficile by toxigenic culture. CONCLUSION: This test has a high sensitivity and specificity for the diagnosis of CDI.


Asunto(s)
Algoritmos , Colorantes Azulados , Cromatografía de Afinidad , Infecciones por Clostridium/diagnóstico , Azul de Metileno , Xantenos , Antígenos Bacterianos/análisis , Cromatografía de Afinidad/instrumentación , Glutamato Deshidrogenasa/inmunología , Humanos
18.
PeerJ ; 11: e15095, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37013145

RESUMEN

The rehabilitation of children with motor disorders is mainly focused on physical interventions. Numerous studies have demonstrated the benefits of upper function using robotic exoskeletons. However, there is still a gap between research and clinical practice, owing to the cost and complexity of these devices. This study presents a proof of concept of a 3D-printed exoskeleton for the upper limb, following a design that replicates the main characteristics of other effective exoskeletons described in the literature. 3D printing enables rapid prototyping, low cost, and easy adjustment to the patient anthropometry. The 3D-printed exoskeleton, called POWERUP, assists the user's movement by reducing the effect of gravity, thereby allowing them to perform upper limb exercises. To validate the design, this study performed an electromyography-based assessment of the assistive performance of POWERUP, focusing on the muscular response of both the biceps and triceps during elbow flexion-extension movements in 11 healthy children. The Muscle Activity Distribution (MAD) is the proposed metric for the assessment. The results show that (1) the exoskeleton correctly assists elbow flexion, and (2) the proposed metric easily identifies the exoskeleton configuration: statistically significant differences (p-value = 2.26 ⋅ 10-7 < 0.001) and a large effect size (Cohen's d = 3.78 > 0.8) in the mean MAD value were identified for both the biceps and triceps when comparing the transparent mode (no assistance provided) with the assistive mode (anti-gravity effect). Therefore, this metric was proposed as a method for assessing the assistive performance of exoskeletons. Further research is required to determine its usefulness for both the evaluation of selective motor control (SMC) and the impact of robot-assisted therapies.


Asunto(s)
Dispositivo Exoesqueleto , Trastornos Motores , Humanos , Niño , Electromiografía , Extremidad Superior/fisiología , Impresión Tridimensional
19.
Span J Psychol ; 26: e7, 2023 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-37121599

RESUMEN

Imagine that you are a researcher interested in disentangling the underlying mechanisms that motivate certain individuals to self-sacrifice for a group or an ideology. Now, visualize that you are one of a few privileged that have the possibility of interviewing people who have been involved in some of the most dramatic terrorist attacks in history. What should you do? Most investigations focused on terrorism do not include empirical data and just a handful of fortunate have made face-to-face interviews with these individuals. Therefore, we might conclude that most experts in the field have not directly met the challenge of experiencing studying violent radicalization in person. As members of a research team who have talked with individuals under risk of radicalization, current, and former terrorists, our main goal with this manuscript is to synopsize a series of ten potential barriers that those interested in the subject might find when making fieldwork, and alternatives to solve them. If all the efforts made by investigators could save the life of a potential victim, prevent an individual from becoming radicalized, or make him/her decide to abandon the violence associated with terrorism, all our work will have been worthwhile.


Asunto(s)
Terrorismo , Violencia , Masculino , Femenino , Humanos , Terrorismo/prevención & control
20.
Meat Sci ; 203: 109224, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37253285

RESUMEN

Defects in meat quality such as dark, firm and dry (DFD) beef have been related to high levels of oxidative stress that produce cellular alterations that may affect to the process of meat quality acquisition. Despite the important role of endoplasmic reticulum (ER) in the cellular response to oxidative stress, its function in the muscle-to-meat conversion process has not yet been studied. In this study, differences in muscular antioxidant defense and the unfolded protein response (UPR) of the ER in CONTROL (normal pH24) and dark, firm, and dry (DFD, pH24 ≥ 6.2) beef at 24 h post-mortem were analyzed to understand the changes in the muscle-to-meat conversion process related to meat quality defects. DFD meat showed poor quality, lower antioxidant activity (P < 0.05) and higher UPR activation (P < 0.05), which indicates higher oxidative stress what could partly explain the occurrence of meat quality defects. Therefore, the biomarkers of these cellular processes (IRE1α, ATF6α, and p-eIF2α) are putative biomarkers of meat quality.


Asunto(s)
Endorribonucleasas , Proteínas Serina-Treonina Quinasas , Animales , Bovinos , Proteínas Serina-Treonina Quinasas/metabolismo , Endorribonucleasas/metabolismo , Retículo Endoplásmico/metabolismo , Carne , Estrés del Retículo Endoplásmico
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