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1.
Curr Issues Mol Biol ; 46(6): 5744-5776, 2024 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-38921015

RESUMEN

In the SARS-CoV-2 lineage, RNA elements essential for its viral life cycle, including genome replication and gene expression, have been identified. Still, the precise structures and functions of these RNA regions in coronaviruses remain poorly understood. This lack of knowledge points out the need for further research to better understand these crucial aspects of viral biology and, in time, prepare for future outbreaks. In this research, the in silico analysis of the cis RNA structures that act in the alpha-, beta-, gamma-, and deltacoronavirus genera has provided a detailed view of the presence and adaptation of the structures of these elements in coronaviruses. The results emphasize the importance of these cis elements in viral biology and their variability between different viral variants. Some coronavirus variants in some groups, depending on the cis element (stem-loop1 and -2; pseudoknot stem-loop1 and -2, and s2m), exhibited functional adaptation. Additionally, the conformation flexibility of the s2m element in the SARS variants was determined, suggesting a coevolution of this element in this viral group. The variability in secondary structures suggests genomic adaptations that may be related to replication processes, genetic regulation, as well as the specific pathogenicity of each variant. The results suggest that RNA structures in coronaviruses can adapt and evolve toward different viral variants, which has important implications for viral adaptation, pathogenicity, and future therapeutic strategies.

2.
Plant Biotechnol J ; 22(6): 1610-1621, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38243882

RESUMEN

Muscat flavour represents a group of unique aromatic attributes in some grape varieties. Biochemically, grape berries with muscat flavour produce high levels of monoterpenes. Monoterpene biosynthesis is mainly through the DOXP/MEP pathway, and VvDXS1 encodes the first enzyme in this plastidial pathway of terpene biosynthesis in grapevine. A single-point mutation resulting in the substitution of a lysine with an asparagine at position 284 in the VvDXS1 protein has previously been identified as the major cause for producing muscat flavour in grapes. In this study, the same substitution in the VvDXS1 protein was successfully created through prime editing in the table grape Vitis vinifera cv. 'Scarlet Royal'. The targeted point mutation was detected in most of the transgenic vines, with varying editing efficiencies. No unintended mutations were detected in the edited alleles, either by PCR Sanger sequencing or by amplicon sequencing. More than a dozen edited vines were identified with an editing efficiency of more than 50%, indicating that these vines were likely derived from single cells in which one allele was edited. These vines had much higher levels of monoterpenes in their leaves than the control, similar to what was found in leaf samples between field-grown muscat and non-muscat grapes.


Asunto(s)
Edición Génica , Vitis , Vitis/genética , Vitis/metabolismo , Edición Génica/métodos , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Plantas Modificadas Genéticamente/genética , Aromatizantes/metabolismo , Monoterpenos/metabolismo , Frutas/genética , Frutas/metabolismo , Mutación Puntual
3.
Int J Mol Sci ; 25(18)2024 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-39337321

RESUMEN

The existing in vitro and in vivo models for studying osteoarthritis have significant limitations in replicating the complexity of joint tissues. This research aims to validate a Tissue-On-a-Chip system for osteoarthritis research. Osteochondral tissues obtained from knee replacement surgeries of patients with osteoarthritis were cultured in an Organ-On-a-Chip system. This system was designed to supply oxygen and glucose to the cartilage from the bone. The distribution of oxygen and glucose was evaluated by fluorescence using Image-iT Green Hypoxia and 2-NBDG, respectively. Cytotoxicity was measured using lactate dehydrogenase (LDH) levels in chip cultures compared to plate cultures (12 tissues per method). Glycosaminoglycans (GAGs), alkaline phosphatase (ALP), Coll2-1, and procollagen type II N-terminal propeptide (PIINP) were measured in the perfused medium of the Tissue-On-a-Chip over a period of 70 days. Fluorescence of Image-iT Green Hypoxia was observed only in the cartilage area, while 2-NBDG was distributed throughout the tissue. An increase in LDH levels was noted in the plate cultures on day 24 and in the Tissue-On-a-Chip cultures on day 63. Compared to the start of the culture, GAG content increased on day 52, while ALP showed variations. A notable increase in GAG, ALP, and Coll2-1 levels was observed on day 59. PIINP levels remained stable throughout the experiment. The validated osteochondral Tissue-On-a-Chip system can replicate the joint microenvironment, with hypoxic conditions in cartilage and normoxic conditions in bone. Tissue survival and component stability were maintained for approximately two months. This platform is a useful tool for evaluating new drugs and represents a viable alternative to animal models.


Asunto(s)
Dispositivos Laboratorio en un Chip , Osteoartritis , Humanos , Osteoartritis/metabolismo , Osteoartritis/patología , Glicosaminoglicanos/metabolismo , Cartílago Articular/metabolismo , Cartílago Articular/patología , Oxígeno/metabolismo , Glucosa/metabolismo , L-Lactato Deshidrogenasa/metabolismo , Fosfatasa Alcalina/metabolismo
4.
Curr Microbiol ; 80(10): 338, 2023 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-37672120

RESUMEN

The incidence of antibiotics and transcriptional regulation of ARGs in isolated bacteria from wastewater needs to be explored. By HPLC, in samples of untreated wastewater, ampicillin (49.74 ± 5.70 µg/mL), chloramphenicol (0.60 ± 0.03 µg/mL), tylosin (72.95 ± 2.03 µg/mL), and oxytetracycline (0.22 ± 0.01 µg/mL) was determined. Through metagenomic analysis identified 58 bacterial species belonging to 9 phyla and at least 14 species have shown resistance to a variety of antibiotics. Twenty-two bacterial isolates were proved to be resistant to fifteen antibiotics of new generation and used in medical research to combat infectious diseases. Fourteen strains were shown to harbor plasmids in size ranges of 2-5 Kb, 6-10 Kb and plasmids with size greater than 10 Kb. By quantitative PCR it was possible to identify genes sul, qnr, cat1, aadA1, and sat-1 gene were shown to be present in gDNA samples from treated and untreated samples of wastewater and by relative expression analysis, differential expression of cat1, ermB, act, and tetA genes was demonstrated in strains that showed identity with Escherichia coli, Bacteroides fragilis, and Salmonella thyphi, and that were stressed with different concentrations of antibiotics. The presence of ARGs in untreated water samples, as well as in bacterial isolates, was indicative that in these habitats there are microorganisms that can resist ß-lactams, aminoglycosides, tetracyclines, sulfonamides, and quinolones.


Asunto(s)
Antibacterianos , Aguas Residuales , Bacterias , Sulfanilamida , Farmacorresistencia Microbiana
5.
Int J Mol Sci ; 24(24)2023 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-38139179

RESUMEN

Seedlessness is one of the highest valued agronomic traits in grapes. Embryo rescue in combination with marker-assisted selection have been widely applied in seedless grape breeding due to the advantages of increasing the ratio of seedless progenies and shortening the breeding cycle. However, the large number of deformed seedlings produced during embryo rescue and the lack of fast, efficient, and low-cost markers severely inhibit the process of seedless grape breeding. In this study, a total of eighty-three grape cultivars (51 seedless and 32 seeded) with diverse genetic backgrounds and two populations derived from embryo rescue, including 113 F1 hybrid individuals (60 seedless and 53 seeded), were utilized. We screened suitable media for converting malformed seedlings into normal seedlings, analyzed the association between the SNP in VviAGL11 and seeded/seedless phenotype, and developed a KASP marker related to stenospermocarpic seedlessness. Our results indicated that the transformation rate of 37.8% was obtained with MS medium supplemented with 2.0 mg·L-1 of 6-BA and 0.5 mg·L-1 of IBA. The presence of an A nucleotide allele at position chr18:26889437 was further confirmed to be fully associated with the stenospermocarpic seedlessness phenotype. The developed KASP marker, based on the verified SNP locus in VviAGL11, successfully distinguished the seedless and seeded genotypes with high precision and throughput. The results will contribute to enhancing the efficiency of embryo rescue and facilitate parent selection and early selection of seedless offspring with molecular markers, thereby accelerating the breeding process in seedless table grapes.


Asunto(s)
Vitis , Humanos , Vitis/genética , Alelos , Fitomejoramiento , Semillas/genética , Reacción en Cadena de la Polimerasa
6.
Clin Exp Rheumatol ; 39 Suppl 130(3): 170-173, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34161227

RESUMEN

OBJECTIVES: To the scarce information on dietary habits in fibromyalgia (FM), it is added that there are no comparative studies with other rheumatic diseases. The objective of this study was to characterise the dietary habits of patients with FM by comparing, for the first time, with healthy controls (HC) and rheumatoid arthritis (RA). METHODS: This cross-sectional, observational study was based on data obtained from the Dietfibrom project for FM and from the IMID Consortium for RA and HC. All participants completed a food frequency questionnaire evaluating their weekly dietary intake of main food groups. The three cohorts were compared using a multiple logistic regression model adjusted for age, sex, and body mass index. RESULTS: After quality control, n=287 FM, n=1,983 HC and n=1,942 RA patients were analysed. We found that FM had a profound impact in the diet compared to HC, reducing the consumption of dairy (OR=0.32, p<0.0001), bread and/or whole grain cereals (OR=0.59, p=0.0006), fresh fruit (OR=0.66, P=0.008), and fish (OR=0.64, p=0.002). These same four food groups were also significantly reduced in FM patients in comparison to RA patients (p<0.0005 in all cases). Additionally, a lower consumption of pasta, rice and/or potatoes was also observed in FM compared to RA (OR=0.72, p=0.028). CONCLUSIONS: The present cross-sectional study shows that FM is associated to a significant change in the normal dietary patterns. These results underscore the importance of diet in this prevalent disease and are a warning of the potential long-range effects of a deficient nutritional status.


Asunto(s)
Artritis Reumatoide , Fibromialgia , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/epidemiología , Estudios Transversales , Dieta/efectos adversos , Conducta Alimentaria , Fibromialgia/diagnóstico , Fibromialgia/epidemiología , Humanos
7.
Ann Rheum Dis ; 79(11): 1393-1399, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32769150

RESUMEN

OBJECTIVES: To describe patients with autoimmune inflammatory rheumatic diseases (AIRD) who had COVID-19 disease; to compare patients who required hospital admission with those who did not and assess risk factors for hospital admission related to COVID-19. METHODS: An observational longitudinal study was conducted during the pandemic peak of severe acute respiratory syndrome coronavirus 2 (1 March 2020 to 24 April). All patients attended at the rheumatology outpatient clinic of a tertiary hospital in Madrid, Spain with a medical diagnosis of AIRD and with symptomatic COVID-19 were included. The main outcome was hospital admission related to COVID-19. The covariates were sociodemographic, clinical and treatments. We ran a multivariable logistic regression model to assess risk factors for the hospital admission. RESULTS: The study population included 123 patients with AIRD and COVID-19. Of these, 54 patients required hospital admission related to COVID-19. The mean age on admission was 69.7 (15.7) years, and the median time from onset of symptoms to hospital admission was 5 (3-10) days. The median length of stay was 9 (6-14) days. A total of 12 patients died (22%) during admission. Compared with outpatients, the factors independently associated with hospital admission were older age (OR: 1.08; p=0.00) and autoimmune systemic condition (vs chronic inflammatory arthritis) (OR: 3.55; p=0.01). No statistically significant findings for exposure to disease-modifying antirheumatic drugs were found in the final model. CONCLUSION: Our results suggest that age and having a systemic autoimmune condition increased the risk of hospital admission, whereas disease-modifying antirheumatic drugs were not associated with hospital admission.


Asunto(s)
Enfermedades Autoinmunes/epidemiología , Infecciones por Coronavirus/terapia , Hospitalización/estadística & datos numéricos , Neumonía Viral/terapia , Enfermedades Reumáticas/epidemiología , Factores de Edad , Anciano , Anciano de 80 o más Años , Atención Ambulatoria , Antirreumáticos/uso terapéutico , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/epidemiología , Enfermedades Autoinmunes/tratamiento farmacológico , Betacoronavirus , COVID-19 , Diabetes Mellitus/epidemiología , Femenino , Glucocorticoides/uso terapéutico , Cardiopatías/epidemiología , Humanos , Hipertensión/epidemiología , Tiempo de Internación/estadística & datos numéricos , Estudios Longitudinales , Enfermedades Pulmonares/epidemiología , Lupus Eritematoso Sistémico/tratamiento farmacológico , Lupus Eritematoso Sistémico/epidemiología , Masculino , Persona de Mediana Edad , Enfermedad Mixta del Tejido Conjuntivo/tratamiento farmacológico , Enfermedad Mixta del Tejido Conjuntivo/epidemiología , Análisis Multivariante , Pandemias , Polimialgia Reumática/tratamiento farmacológico , Polimialgia Reumática/epidemiología , Factores Protectores , Enfermedades Reumáticas/tratamiento farmacológico , Factores de Riesgo , SARS-CoV-2 , Factores Sexuales , Síndrome de Sjögren/tratamiento farmacológico , Síndrome de Sjögren/epidemiología , España/epidemiología , Espondiloartropatías/tratamiento farmacológico , Espondiloartropatías/epidemiología , Inhibidores del Factor de Necrosis Tumoral/uso terapéutico
8.
Ann Rheum Dis ; 79(9): 1170-1173, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32532753

RESUMEN

BACKGROUND: The susceptibility of patients with rheumatic diseases and the risks or benefits of immunosuppressive therapies for COVID-19 are unknown. METHODS: We performed a retrospective study with patients under follow-up in rheumatology departments from seven hospitals in Spain. We matched updated databases of rheumatology patients with severe acute respiratory syndrome coronavirus 2-positive PCR tests performed in the hospital to the same reference populations. Rates of PCR+ confirmed COVID-19 were compared among groups. RESULTS: Patients with chronic inflammatory diseases had 1.32-fold higher prevalence of hospital PCR+ COVID-19 than the reference population (0.76% vs 0.58%). Patients with systemic autoimmune or immune-mediated disease (AI/IMID) showed a significant increase, whereas patients with inflammatory arthritis (IA) or systemic lupus erythematosus did not. COVID-19 cases in some but not all diagnostic groups had older ages than cases in the reference population. Patients with IA on targeted-synthetic or biological disease-modifying antirheumatic drugs (DMARDs), but not those on conventional-synthetic DMARDs, had a greater prevalence despite a similar age distribution. CONCLUSION: Patients with AI/IMID show a variable risk of hospital-diagnosed COVID-19. Interplay of ageing, therapies and disease-specific factors seem to contribute. These data provide a basis to improve preventive recommendations to rheumatic patients and to analyse the specific factors involved in COVID-19 susceptibility.


Asunto(s)
Enfermedades Autoinmunes/epidemiología , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Hospitalización/estadística & datos numéricos , Neumonía Viral/epidemiología , Enfermedades Reumáticas/epidemiología , Adulto , Distribución por Edad , Anciano , Antirreumáticos/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/epidemiología , Artritis Reumatoide/virología , Enfermedades Autoinmunes/tratamiento farmacológico , Enfermedades Autoinmunes/virología , COVID-19 , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/virología , Femenino , Humanos , Lupus Eritematoso Sistémico/tratamiento farmacológico , Lupus Eritematoso Sistémico/epidemiología , Lupus Eritematoso Sistémico/virología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/virología , Reacción en Cadena de la Polimerasa , Prevalencia , Estudios Retrospectivos , Enfermedades Reumáticas/tratamiento farmacológico , Enfermedades Reumáticas/virología , SARS-CoV-2 , España/epidemiología
9.
Virus Genes ; 56(3): 380-385, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32065328

RESUMEN

Contigs with the highest sequence similarity (73%) to Apricot pseudo-chlorotic leaf spot virus (genus Trichovirus, family Betaflexiviridae) were identified by high-throughput sequencing from a symptomless sweet cherry accession. The complete genome sequence of this new virus is 7460 nucleotides, excluding the 3' poly(A) tail. Its genome organization is very similar to several trichoviruses infecting fruit trees, with three open reading frames encoding putative replicase, movement protein and coat protein (CP). The virus shares amino acid sequence identities of 60-73% at replicase and 53-76% at CP with other trichoviruses. Phylogenetic analyses group it and other trichoviruses in a cluster. These results support that this virus, which is tentatively named cherry latent virus 1, should be considered a new member in the genus Trichovirus.


Asunto(s)
Flexiviridae/clasificación , Flexiviridae/genética , Enfermedades de las Plantas/virología , Prunus avium/virología , Genoma Viral , Secuenciación de Nucleótidos de Alto Rendimiento , Filogenia , Recombinación Genética , Secuenciación Completa del Genoma
10.
J Opt Soc Am A Opt Image Sci Vis ; 37(9): 1417-1422, 2020 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-32902429

RESUMEN

When encoding diffractive lenses onto a spatial light modulator (SLM), there is a Nyquist limit to the smallest focal length that can be formed. When this limit is surpassed, a two-dimensional array of lenslets is formed. There have been very few discussions on the performance of these lenslets. In this work, we focus on the phase distribution of these lenses in the array. We show that, for certain values of the focal length, the lenslets are all in perfect phase. We show that this situation happens for a total number of N/4 different discrete equidistant sub-Nyquist focal lengths, where N×N is the number of pixels in the SLM. We find other distances in between where the array is composed of two sets of lenslets with a relative π phase among them. Finally, we illustrate these phase distributions in the application to generate an array of vortex producing lenses. We expect that these results might be useful for high-accuracy interferometric or multiple imaging where this phase must be exactly the same for each replica.

12.
Ann Rheum Dis ; 78(3)2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30552173

RESUMEN

OBJECTIVE: Psoriatic arthritis (PsA) is a chronic inflammatory arthritis affecting up to 30% of patients with psoriasis (Ps). To date, most of the known risk loci for PsA are shared with Ps, and identifying disease-specific variation has proven very challenging. The objective of the present study was to identify genetic variation specific for PsA. METHODS: We performed a genome-wide association study in a cohort of 835 patients with PsA and 1558 controls from Spain. Genetic association was tested at the single marker level and at the pathway level. Meta-analysis was performed with a case-control cohort of 2847 individuals from North America. To confirm the specificity of the genetic associations with PsA, we tested the associated variation using a purely cutaneous psoriasis cohort (PsC, n=614) and a rheumatoid arthritis cohort (RA, n=1191). Using network and drug-repurposing analyses, we further investigated the potential of the PsA-specific associations to guide the development of new drugs in PsA. RESULTS: We identified a new PsA risk single-nucleotide polymorphism at B3GNT2 locus (p=1.10e-08). At the pathway level, we found 14 genetic pathways significantly associated with PsA (pFDR<0.05). From these, the glycosaminoglycan (GAG) metabolism pathway was confirmed to be disease-specific after comparing the PsA cohort with the cohorts of patients with PsC and RA. Finally, we identified candidate drug targets in the GAG metabolism pathway as well as new PsA indications for approved drugs. CONCLUSION: These findings provide insights into the biological mechanisms that are specific for PsA and could contribute to develop more effective therapies.


Asunto(s)
Artritis Psoriásica/genética , Glicosaminoglicanos/genética , N-Acetilglucosaminiltransferasas/genética , Psoriasis/genética , Transducción de Señal/genética , Adulto , Artritis Psoriásica/epidemiología , Artritis Reumatoide/epidemiología , Artritis Reumatoide/genética , Estudios de Casos y Controles , Estudios de Cohortes , Femenino , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Humanos , Masculino , América del Norte/epidemiología , Polimorfismo de Nucleótido Simple , Psoriasis/epidemiología , España/epidemiología
13.
Opt Lett ; 44(13): 3398-3401, 2019 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-31259970

RESUMEN

Liquid crystal displays allow the easy implementation of diffractive optical elements. However, the shortest focal lengths for lenses are limited by Nyquist conditions. In this work, we show that focal lengths much lower than this Nyquist limit can be encoded onto devices having a large phase-dynamic range. Experimental results are included with a display showing 10π phase modulation reducing the Nyquist limit by a factor of about 1/10.

14.
Clin Exp Rheumatol ; 37(5): 774-782, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30789151

RESUMEN

OBJECTIVES: Cardiovascular (CV) disease is one of the main causes of morbi-mortality in spondyloarthritis (SpA), partially explained by traditional CV risk factors. Information on lipoprotein(a) [Lp(a)], a non-conventional risk factor, in SpA is scarce. In this study we assessed the prevalence of hyperlipoproteinaemia(a) in SpA patients and analysed the possible related factors. METHODS: A baseline analysis was made of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients and controls included in the CARMA project (CARdiovascular in RheuMAtology), a 10-year prospective study evaluating the risk of CV events in chronic inflammatory rheumatic diseases. A multivariate logistic regression model was performed using hyperlipoproteinaemia(a) (Lp(a) >50 mg/dl) as a dependent variable and adjusting for confounding factors. RESULTS: 19.2% (95% CI: 16.80-22.05) of the SpA patients [20.7% (95% CI: 16.91-24.82) of those with AS and 17.7% (95% CI: 14.15-21.75) of those with PsA] and 16.7% (95% CI: 13.23-20.86) of the controls had hyperlipoproteinaemia(a) (p=0.326). Adjusting for age and sex, SpA patients were more likely to have hyperlipoproteinaemia(a) than controls (OR: 1.43, 95%CI: 1.00-2.04; p=0.05), especially those with AS (OR: 1.81, 95%CI: 1.18-2.77; p=0.007). In the adjusted model, apolipoprotein B in all patients, non-steroidal anti-inflammatory drugs in AS, and female sex in PsA, were associated with hyperlipoproteinaemia(a). No disease-specific factors associated with hyperlipoproteinaemia(a) were identified. CONCLUSIONS: SpA patients show a moderately increased risk of hyperlipoproteinaemia(a) compared to controls, especially those with AS. Lp(a) determination may be of interest to improve the CV risk assessment in SpA patients.


Asunto(s)
Hiperlipoproteinemias , Espondiloartritis , Artritis Psoriásica , Estudios de Casos y Controles , Comorbilidad , Femenino , Humanos , Hiperlipoproteinemias/epidemiología , Masculino , Estudios Prospectivos , Factores de Riesgo , Espondiloartritis/sangre , Espondiloartritis/epidemiología
15.
Gen Comp Endocrinol ; 281: 1-6, 2019 09 15.
Artículo en Inglés | MEDLINE | ID: mdl-31095943

RESUMEN

In this study we have monitored the stress of Iberian ibex at individual level within the course of an experimental infection with Sarcoptes scabiei mites. For this purpose we have measured faecal 11-ketoetiocholanolone (11-k) using high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS). We used linear mixed models to explore the effects of host sex and age, clinic (mange status) and time (number of days post-infection) on the concentration of faecal 11-k. The most parsimonious model included clinic, time and host age, which explained 76.6% of the variance of the response variable. Moreover, the concentration of faecal 11-k varied greatly between individuals. Our results evidence the stressor nature of the disease and highlight the negative effects on hosts due to cortisol release and activity.


Asunto(s)
Enfermedades de las Cabras/parasitología , Cabras/parasitología , Cabras/psicología , Sarcoptes scabiei/fisiología , Escabiosis/veterinaria , Estrés Psicológico/complicaciones , Animales , Etiocolanolona/análogos & derivados , Etiocolanolona/metabolismo , Femenino , Modelos Lineales , Masculino
18.
Clin Exp Rheumatol ; 36 Suppl 111(2): 121-128, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29303708

RESUMEN

OBJECTIVES: To assess the incidence and the risk of relapses in giant cell arteritis (GCA) patients treated with and without methotrexate (MTX) in clinical practice. Other associated factors were also investigated. METHODS: An inception cohort of GCA was assembled in the out-patient clinic at Hospital Clínico San Carlos, including patients from the date of diagnosis (Jan-1991 until Sept-2013), and followed-up until lost of follow up or Sept-2014. MAIN OUTCOME: relapse defined as recurrence of symptoms or signs of GCA with high ESR and the need to increase glucocorticoids at least 10mg over the previous dose. The independent variable was exposure to MTX over time. Covariables: Sociodemographic, clinical, and treatment. Incidence rates of relapses (IR) per 100 patient-year with their 95% confidence intervals [CI] were estimated using survival techniques. MTX influence on relapses was analysed by Cox models. RESULTS: 168 patients were included (675 patient-year). 31% of patients had relapses (IR of 12 [9.6-14.9]), and the median number of relapses was 1[1-2]. 65% of the patients were on MTX, (mean dose: 10mg). In the bivariate analysis, the risk of relapses in patients with and without MTX did not achieve statistical signification (p=0.1). After adjusting in the multivariate analysis, exposure to MTX had 72% less risk of relapse compared to those without MTX (p<0.05). Other variables included in the final model were: visual alterations and malaise at clinical presentation of GCA. CONCLUSIONS: The use of MTX seems to decrease the risk of recurrences. We also found other factors influencing on relapses.


Asunto(s)
Antirreumáticos/uso terapéutico , Arteritis de Células Gigantes/tratamiento farmacológico , Metotrexato/uso terapéutico , Anciano , Anciano de 80 o más Años , Sedimentación Sanguínea , Quimioterapia Combinada , Femenino , Arteritis de Células Gigantes/sangre , Glucocorticoides/administración & dosificación , Humanos , Incidencia , Masculino , Análisis Multivariante , Modelos de Riesgos Proporcionales , Recurrencia , Riesgo
19.
Ophthalmologica ; 239(2-3): 151-158, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29241207

RESUMEN

PURPOSE: To report the incidence rate (IR) of remission in pediatric noninfectious intermediate uveitis (IU). METHODS: Longitudinal retrospective cohort study, including 19 patients (32 eyes) between 1985 and 2014, followed-up until loss or January 2016. Remission was defined following the Standardization of Uveitis Nomenclature workshop criteria, prolonged remission as a remission spanning 12 months and until the end of follow-up, and relapse as recurrence of inflammatory activity in an eye in remission. RESULTS: Median follow-up time was 6.3 years. IRs (95% confidence interval) for remission, relapse, and prolonged remission were 18.6 (13.1-26.5), 32.3 (20.6-50.7), and 6.7 (3.8-11.9) episodes per 100 eye-years, respectively. 48% of eyes relapsed in the first year following remission. 25 and 50% of eyes achieved prolonged remission after 5 and 10 years of follow-up, respectively. CONCLUSIONS: Inflammatory relapses may be frequent in noninfectious IU affecting children and adolescents, appearing early after remission. Also, prolonged remission seems infrequent, being achieved late during follow-up.


Asunto(s)
Uveítis Intermedia/epidemiología , Agudeza Visual , Adolescente , Niño , Enfermedad Crónica , Femenino , Estudios de Seguimiento , Humanos , Masculino , Morbilidad/tendencias , Recurrencia , Remisión Espontánea , Estudios Retrospectivos , Factores de Riesgo , España/epidemiología , Análisis de Supervivencia , Factores de Tiempo , Uveítis Intermedia/diagnóstico , Uveítis Intermedia/fisiopatología
20.
Clin Exp Rheumatol ; 35(5): 816-822, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28516881

RESUMEN

OBJECTIVES: To explore the remission concept in rheumatoid arthritis (RA) and to compare remission definitions and related concepts between rheumatologists and patients with the purpose of identifying similarities and disparities to comprehend the different perspectives of the disease. METHODS: This was a qualitative study of discourse and content analysis through focus groups, conducted from February to March 2016. Four focus groups were set up, each one with different interests: rheumatologists involved in basic research (BR), rheumatologists with high specialisation in imaging techniques (IR), clinical rheumatologists (CR), and patients (PA). RESULTS: There is no consensus in a remission definition in RA; differences exist between-groups, rheumatologists and patients value remission differently, and there are discrepancies within the group of rheumatologists. Rheumatologists highlight quantifiable objective parameters, in contrast, patients did not consider objective measures as the best instruments, and they prefer subjective measures of remission. The data confirmed the existence of two sources of knowledge of the disease, technical (physicians) and experiential (patients). These sources of knowledge should concur in order to establish new remission criteria well-adjusted to reality. CONCLUSIONS: The lack of consensus between key groups implicated in defining remission and remission criteria suggests a new strategy for its operational definition. Our group proposes that subjects with a balance between experiential and technical knowledge, should be the ones in charge of this assignment.


Asunto(s)
Antirreumáticos/uso terapéutico , Artritis Reumatoide/tratamiento farmacológico , Conocimientos, Actitudes y Práctica en Salud , Pacientes/psicología , Reumatólogos/psicología , Terminología como Asunto , Artritis Reumatoide/diagnóstico , Actitud del Personal de Salud , Comunicación , Comprensión , Consenso , Grupos Focales , Humanos , Relaciones Médico-Paciente , Investigación Cualitativa , Inducción de Remisión , Resultado del Tratamiento
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