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1.
Soft Matter ; 11(24): 4868-78, 2015 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-25994594

RESUMEN

Silk fibers from Argiope trifasciata and Nephila inaurata orb-web weaving spiders were UV irradiated to modify the molecular weight of the constituent proteins. Fibers were characterized either as forcibly silked or after being subjected to maximum supercontraction. The effect of irradiation on supercontraction was also studied, both in terms of the percentage of supercontraction and the tensile properties exhibited by irradiated and subsequently supercontracted fibers. The effects of UV exposure at the molecular level were assessed by polyacrylamide gel electrophoresis and mass spectrometry. It is shown that UV-irradiated fibers show a steady decrease in their main tensile parameters, most notably, tensile strength and strain. The combination of the mechanical and biochemical data suggests that the restricted conformational freedom of the proteins after UV irradiation is critical in the reduction of these properties. Consequently, an adequate topological organization of the protein chains emerges as a critical design principle in the performance of spider silk.


Asunto(s)
Proteínas de Insectos/química , Seda/química , Rayos Ultravioleta , Animales , Proteínas de Insectos/efectos de la radiación , Conformación Proteica , Seda/efectos de la radiación , Arañas , Resistencia a la Tracción
2.
Biomacromolecules ; 13(7): 2087-98, 2012 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-22668322

RESUMEN

The mechanical behavior and microstructure of minor ampullate gland silk (miS) of two orb-web spinning species, Argiope trifasciata and Nephila inaurata, were extensively characterized, enabling detailed comparison with other silks. The similarities and differences exhibited by miS when compared with the intensively studied major ampullate gland silk (MAS) and silkworm (Bombyx mori) silk offer a genuine opportunity for testing some of the hypotheses proposed to correlate microstructure and tensile properties in silk. In this work, we show that miSs of different species show similar properties, even when fibers spun by spiders that diverged over 100 million years are compared. The tensile properties of miS are comparable to those of MAS when tested in air, significantly in terms of work to fracture, but differ considerably when tested in water. In particular, miS does not show a supercontraction effect and an associated ground state. In this regard, the behavior of miS in water is similar to that of B. mori silk, and it is shown that the initial elastic modulus of both fibers can be explained using a common model. Intriguingly, the microstructural parameters measured in miS are comparable to those of MAS and considerably different from those found in B. mori. This fact suggests that some critical microstructural information is still missing in our description of silks, and our results suggest that the hydrophilicity of the lateral groups or the large scale organization of the sequences might be routes worth exploring.


Asunto(s)
Seda/química , Arañas , Resistencia a la Tracción , Animales , Módulo de Elasticidad , Femenino , Microscopía de Fuerza Atómica , Seda/ultraestructura , Espectrometría Raman , Agua/química , Difracción de Rayos X
3.
J Radiol ; 90(11 Pt 2): 1830-40, 2009 Nov.
Artículo en Francés | MEDLINE | ID: mdl-19953075

RESUMEN

Bronchiolitis may be encountered in numerous clinical circumstances. Previous history of smoking, infections, toxic exposure, immunodeficiency, chronic inflammatory disorders or transplantation must be known. CT findings consist in centrilobular micronodules with sharp or ill borders of various density and/or a mosaic attenuation with expiratory air trapping. Tree-in-bud pattern suggest an inflammatory or infectious bronchiolitis. The associated presence of bronchiectasis and bronchiolectasis must be considered. Imaging-pathologic correlations will be presented for inflammatory bronchiolitis (infectious bronchiolitis, hypersensitivity pneumonitis, respiratory bronchiolitis, follicular bronchiolitis, diffuse panbronchiolitis) and fibrosing bronchiolitis (constrictive bronchiolitis, post-infectious bronchiolitis, toxic fume exposure, transplant-related bronchiolitis).


Asunto(s)
Bronquiolitis/diagnóstico por imagen , Radiografía Torácica , Tomografía Computarizada por Rayos X/métodos , Enfermedad Aguda , Adulto , Trasplante de Médula Ósea , Bronquiectasia/complicaciones , Bronquiectasia/diagnóstico por imagen , Bronquiolitis/complicaciones , Bronquiolitis Obliterante/diagnóstico por imagen , Bronquiolitis Viral/diagnóstico por imagen , Neumonía en Organización Criptogénica/diagnóstico por imagen , Diagnóstico Diferencial , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/diagnóstico por imagen , Humanos , Linfoma Folicular/complicaciones
4.
Nat Commun ; 10(1): 4549, 2019 10 07.
Artículo en Inglés | MEDLINE | ID: mdl-31591398

RESUMEN

Interhemispheric axons of the corpus callosum (CC) facilitate the higher order functions of the cerebral cortex. According to current views, callosal and non-callosal fates are determined early after a neuron's birth, and certain populations, such as cortical layer (L) 4 excitatory neurons of the primary somatosensory (S1) barrel, project only ipsilaterally. Using a novel axonal-retrotracing strategy and GFP-targeted visualization of Rorb+ neurons, we instead demonstrate that L4 neurons develop transient interhemispheric axons. Locally restricted L4 connectivity emerges when exuberant contralateral axons are refined in an area- and layer-specific manner during postnatal development. Surgical and genetic interventions of sensory circuits demonstrate that refinement rates depend on distinct inputs from sensory-specific thalamic nuclei. Reductions in input-dependent refinement result in mature functional interhemispheric hyperconnectivity, demonstrating the plasticity and bona fide callosal potential of L4 neurons. Thus, L4 neurons discard alternative interhemispheric circuits as instructed by thalamic input. This may ensure optimal wiring.


Asunto(s)
Axones/fisiología , Cuerpo Calloso/fisiología , Vías Nerviosas/fisiología , Neuronas/fisiología , Corteza Somatosensorial/fisiología , Animales , Animales Recién Nacidos , Axones/metabolismo , Cuerpo Calloso/citología , Cuerpo Calloso/metabolismo , Proteínas Fluorescentes Verdes/genética , Proteínas Fluorescentes Verdes/metabolismo , Ratones Endogámicos C57BL , Ratones Noqueados , Ratones Transgénicos , Microscopía Confocal , Neuronas/metabolismo , Células Receptoras Sensoriales/metabolismo , Células Receptoras Sensoriales/fisiología , Corteza Somatosensorial/citología , Corteza Somatosensorial/metabolismo , Tálamo/citología , Tálamo/metabolismo , Tálamo/fisiología
5.
Sci Rep ; 8(1): 14316, 2018 09 25.
Artículo en Inglés | MEDLINE | ID: mdl-30254284

RESUMEN

Cell cycle reentry followed by neuronal hyperploidy and synaptic failure are two early hallmarks of Alzheimer's disease (AD), however their functional connection remains unexplored. To address this question, we induced cell cycle reentry in cultured cortical neurons by expressing SV40 large T antigen. Cell cycle reentry was followed by hyperploidy in ~70% of cortical neurons, and led to progressive axon initial segment loss and reduced density of dendritic PSD-95 puncta, which correlated with diminished spike generation and reduced spontaneous synaptic activity. This manipulation also resulted in delayed cell death, as previously observed in AD-affected hyperploid neurons. Membrane depolarization by high extracellular potassium maintained PSD-95 puncta density and partially rescued both spontaneous synaptic activity and cell death, while spike generation remained blocked. This suggests that AD-associated hyperploid neurons can be sustained in vivo if integrated in active neuronal circuits whilst promoting synaptic dysfunction. Thus, cell cycle reentry might contribute to cognitive impairment in early stages of AD and neuronal death susceptibility at late stages.


Asunto(s)
Encéfalo/citología , Ciclo Celular , Diferenciación Celular , Neuronas/citología , Sinapsis/fisiología , Animales , Calcio/metabolismo , Muerte Celular , Espacio Extracelular/metabolismo , Femenino , Masculino , Ratones , Estrés Oxidativo , Poliploidía
6.
Leukemia ; 20(1): 87-94, 2006 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-16281071

RESUMEN

Most patients with acute myeloid leukemia (AML) and t(8;21) or inv(16) have a good prognosis with current anthracycline- and cytarabine-based protocols. Tandem analysis with flow cytometry (FC) and real-time RT-PCR (RQ-PCR) was applied to 55 patients, 28 harboring a t(8;21) and 27 an inv(16), including one case with a novel CBFbeta/MYH11 transcript. A total of 31% (n=17) of CR patients relapsed: seven with t(8;21) and 10 with inv(16). The mean amount of minimal residual disease (MRD) detected by FC in relapsed and nonrelapsed patients was markedly different: 0.3 vs 0.08% (P=0.002) at the end of treatment. The mean number of fusion transcript copies/ ABL x 10(4) also differed between relapsed and non-relapsed patients: 2385 vs 122 (P=0.001) after induction, 56 vs 7.6 after intensification (P=0.0001) and 75 vs 3.3 (P=0.0001) at the end of chemotherapy. Relapses were more common in patients with FC MRD level >0.1% at the end of treatment than in patients with < or = 0.1%: cumulative incidence of relapse (CIR) was 67 and 21% (P=0.03), respectively. Likewise, using RQ-PCR, a cutoff level of >10 copies at the end of treatment correlated with a high risk of relapse: CIR was 75% for patients with RQ-PCR >10 compared to 21% for patients with RQ-PCR levels < or = 10 (P=0.04). Combined use of FC and RQ-PCR may improve MRD detection, and provide useful clinical information on relapse kinetics in AML patients.


Asunto(s)
Cromosomas Humanos Par 16/genética , Cromosomas Humanos Par 21/genética , Cromosomas Humanos Par 8/genética , Leucemia Mieloide/genética , Neoplasia Residual/genética , Enfermedad Aguda , Adolescente , Adulto , Anciano , Niño , Preescolar , Inversión Cromosómica , Análisis Citogenético , Femenino , Citometría de Flujo , Estudios de Seguimiento , Humanos , Cinética , Leucemia Mieloide/metabolismo , Leucemia Mieloide/terapia , Masculino , Persona de Mediana Edad , Neoplasia Residual/diagnóstico , Neoplasia Residual/terapia , Pronóstico , Recurrencia , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factores de Riesgo , Tasa de Supervivencia
7.
J Neural Eng ; 3(3): 245-9, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16921208

RESUMEN

We introduce a simple model to produce EEG-like signals. The model is based on the assumption that the number of active nerve cells that generate an electric field, at a given time, is essentially chaotic. In accordance, we use the logistic equation together with a spike-like function to simulate the neuronal activity processes. With this model, we are able to generate EEG-like patterns, with quite a short time of calculation. Real pre-recorded neuronal and simulated signals, as well as their power spectra, are compared in terms of the main conventional EEG frequency peaks.


Asunto(s)
Potenciales de Acción/fisiología , Encéfalo/fisiología , Electroencefalografía/métodos , Modelos Neurológicos , Red Nerviosa/fisiología , Neuronas/fisiología , Dinámicas no Lineales , Mapeo Encefálico/métodos , Simulación por Computador , Humanos , Modelos Logísticos
8.
Leuk Res ; 29(10): 1109-16, 2005 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-16095690

RESUMEN

BACKGROUND AND OBJECTIVES: A consecutive series of acute myeloid leukemias (AML) patients was analyzed in conditions which reduce the inter-assay variations (the same flow cytometer, the same observers and the same panel of monoclonal antibodies) in order to investigate the prognostic information provided by flow cytometry. DESIGN AND METHODS: Two hundred and sixty-six bone marrow (BM) samples from 326 patients enrolled in the LMA-99 protocol from the CETLAM group were studied by multiparametric flow cytometry. Immunophenotyping studies were performed on erythrocyte-lysed BM samples. Antigen expression of leukemic cells was analyzed using triple stainings with fluorochrome-conjugated combinations of monoclonal antibodies. RESULTS: CD2 was positive in 21 cases (8%); an associated inv(16) was detected in eight CD2+ cases (38%). Two-year overall survival (OS) rate for CD2+/inv(16)+ patients was 75%, whereas it was 0% for CD2+/inv(16)- patients and 47% for CD2- patients (p=0.0001). CD36 was expressed in 37% of patients (n=98). Two-year leukemia-free survival (LFS) rate was 34% for CD36+ patients and 55% for CD36- patients (p=0.001). In the multivariate analysis, CD2+ (RR=8.4; p=0.0001) and adverse karyotype (RR=10.2; p=0.0001) were associated with a lower CR rate, CD36+ (RR=1.5; p=0.03), CD2+ (RR=2; p=0.04) and adverse karyotype (RR=4; p=0.0001) were associated with a lower OS and CD36+ (RR=2; p=0.002) and adverse karyotype (RR=3.5; p=0.005) predicted a lower LFS. CONCLUSIONS: CD2+ patients had a very poor OS when CD2/inv(16)+ cases were excluded. CD36 and CD2 expression at diagnosis can provide prognostically important information in adult de novo AML.


Asunto(s)
Antígenos CD2/metabolismo , Antígenos CD36/metabolismo , Leucemia Mieloide/metabolismo , Enfermedad Aguda , Adolescente , Adulto , Anticuerpos Monoclonales , Médula Ósea/metabolismo , Médula Ósea/patología , Aberraciones Cromosómicas , Inversión Cromosómica , Femenino , Citometría de Flujo , Humanos , Inmunofenotipificación , Cariotipificación , Leucemia Mieloide/genética , Leucemia Mieloide/patología , Masculino , Persona de Mediana Edad , Pronóstico , Tasa de Supervivencia
9.
Science ; 349(6249): 730-4, 2015 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-26273054

RESUMEN

Astrocytes are important regulatory elements in brain function. They respond to neurotransmitters and release gliotransmitters that modulate synaptic transmission. However, the cell- and synapse-specificity of the functional relationship between astrocytes and neurons in certain brain circuits remains unknown. In the dorsal striatum, which mainly comprises two intermingled subtypes (striatonigral and striatopallidal) of medium spiny neurons (MSNs) and synapses belonging to two neural circuits (the direct and indirect pathways of the basal ganglia), subpopulations of astrocytes selectively responded to specific MSN subtype activity. These subpopulations of astrocytes released glutamate that selectively activated N-methyl-d-aspartate receptors in homotypic, but not heterotypic, MSNs. Likewise, astrocyte subpopulations selectively regulated homotypic synapses through metabotropic glutamate receptor activation. Therefore, bidirectional astrocyte-neuron signaling selectively occurs between specific subpopulations of astrocytes, neurons, and synapses.


Asunto(s)
Astrocitos/fisiología , Ganglios Basales/fisiología , Glutamatos/metabolismo , Neuronas/fisiología , Sinapsis/fisiología , Transmisión Sináptica , Animales , Ganglios Basales/citología , Comunicación Celular , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Red Nerviosa/fisiología , Receptores de Glutamato Metabotrópico/agonistas , Receptores de Glutamato Metabotrópico/metabolismo , Receptores de N-Metil-D-Aspartato/agonistas , Receptores de N-Metil-D-Aspartato/metabolismo , Transducción de Señal
10.
Clin Epigenetics ; 7: 108, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26457123

RESUMEN

BACKGROUND: Given the implication of histone acetylation in memory processes, histone deacetylase inhibitors (HDACIs) have been postulated as potential modulators of cognitive impairment in Alzheimer's disease (AD). However, dose-dependent side effects have been described in patients with the currently available broad-spectrum HDACIs, explaining why their therapeutic potential has not been realized for chronic diseases. Here, by simultaneously targeting two independent enzyme activities, histone deacetylase (HDAC) and phosphodiesterase-5 (PDE5), we propose a novel mode of inhibitory action that might increase the therapeutic specificity of HDACIs. RESULTS: The combination of vorinostat, a pan-HDACI, and tadalafil, a PDE5 inhibitor, rescued the long-term potentiation impaired in slices from APP/PS1 mice. When administered in vivo, the combination of these drugs alleviated the cognitive deficits in AD mice, as well as the amyloid and tau pathology, and it reversed the reduced dendritic spine density on hippocampal neurons. Significantly, the combination of vorinostat and tadalafil was more effective than each drug alone, both against the symptoms and in terms of disease modification, and importantly, these effects persisted after a 4-week washout period. CONCLUSIONS: The results highlight the pharmacological potential of a combination of molecules that inhibit HDAC and PDE5 as a therapeutic approach for AD treatment.

11.
Bone Marrow Transplant ; 26(2): 127-32, 2000 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-10918421

RESUMEN

We have explored the efficacy of salvage chemotherapy combination, IAPVP-16 (ifosfamide 5 g/m2 on day 1; VP-16 100 mg/m2 on days 1-3; ara-C 1.2 g/m2/12 h on days 1 and 2; methylprednisolone 80 mg/m2 on days 1-5) plus G-CSF for PBPC mobilization. This protocol was used in 45 patients with relapsed or refractory lymphoproliferative diseases who underwent 85 leukaphereses. In 41 patients > 2 x 106/kg CD34+ cells were obtained after a median of two procedures. The median number of CD34+ cells harvested was 3.2 x 106/kg per apheresis and 8.4 x 106/kg per patient. Seven of 10 patients who had failed previous mobilization attempts achieved more than 2 x 106 CD34+ cells/kg in a maximum of three aphereses. A history of previous mobilization failure and a low platelet count (<150 x 109/l) negatively influenced the CD34+ cell yield in univariate and multivariate analyses. A good correlation was found between the circulating CD34+ cells/microl and the CD34+ cells and CFU-GM in the leukaphereses products (r = 0.93 and r = 0.73, P < 0.001), and > or =17 CD34+ cells/microl predicted the achievement of > 2 x 106/kg CD34+ cells in a single leukapheresis in more than 90% of cases. IAPVP-16 plus G-CSF may be specially indicated in tandem transplantations or CD34+ selection and in patients who have failed previous mobilization attempts.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/farmacología , Factor Estimulante de Colonias de Granulocitos/farmacología , Movilización de Célula Madre Hematopoyética/métodos , Trastornos Linfoproliferativos/terapia , Terapia Recuperativa/métodos , Adulto , Anciano , Antígenos CD34/sangre , Antígenos CD34/efectos de los fármacos , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carmustina/administración & dosificación , Carmustina/farmacología , Recuento de Células/efectos de los fármacos , Ciclofosfamida/administración & dosificación , Ciclofosfamida/farmacología , Etopósido/administración & dosificación , Etopósido/farmacología , Femenino , Factor Estimulante de Colonias de Granulocitos/administración & dosificación , Humanos , Cinética , Leucaféresis , Linfoma/sangre , Linfoma/terapia , Masculino , Persona de Mediana Edad , Análisis de Regresión , Factores de Tiempo
12.
Rev Neurol ; 36(2): 137-44, 2003.
Artículo en Español | MEDLINE | ID: mdl-12589601

RESUMEN

INTRODUCTION AND METHOD: Astrocytes, a type of glial cell in the central nervous system (CNS), have been classically considered as trophic, structural and supportive cells for neurons. However, in recent years, accumulating evidence suggest a more active role of astrocytes in the physiology of neurons, being involved in the information processing of the CNS. Astrocytes exhibit both a form of excitability based on variations of the intracellular Ca2+ concentration, and a form of communication based on intercellular Ca2+ waves. Furthermore, synaptically released neurotransmitters mobilize Ca2+ from the astrocytic intracellular stores, i.e., the astrocytic cellular excitability can be triggered by the synaptic activity. Finally, astrocytes release the transmitter glutamate to the extracellular space through a Ca2+ dependent mechanism, modulating the neuronal electrical activity and the synaptic transmission. As a consequence of the demonstration of these new forms of cellular communication between astrocytes and neurons, the concept of tripartite synapse has been proposed, in which the synapse is functionally constituted by three elements, i.e., the pre and postsynaptic elements and the surrounding astrocytes. CONCLUSION: The novel results discussed in the present review support the presence of new and complex information pathways in the CNS, which are based on the existence of bidirectional communication between astrocytes and neurons, and which have relevant consequences on the cellular mechanisms responsible for the information processing of the CNS.


Asunto(s)
Astrocitos/metabolismo , Fenómenos Fisiológicos del Sistema Nervioso , Neuronas/metabolismo , Transducción de Señal/fisiología , Astrocitos/citología , Calcio/metabolismo , Humanos , Neuronas/citología , Neurotransmisores/metabolismo , Sinapsis/fisiología
13.
Sci Rep ; 3: 3061, 2013 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-24162473

RESUMEN

Spider silks combine a significant number of desirable characteristics in one material, including large tensile strength and strain at breaking, biocompatibility, and the possibility of tailoring their properties. Major ampullate gland silk (MAS) is the most studied silk and their properties are explained by a double lattice of hydrogen bonds and elastomeric protein chains linked to polyalanine ß-nanocrystals. However, many basic details regarding the relationship between composition, microstructure and properties in silks are still lacking. Here we show that this relationship can be traced in flagelliform silk (Flag) spun by Argiope trifasciata spiders after identifying a phase consisting of polyglycine II nanocrystals. The presence of this phase is consistent with the dominant presence of the -GGX- and -GPG- motifs in its sequence. In contrast to the passive role assigned to polyalanine nanocrystals in MAS, polyglycine II nanocrystals can undergo growing/collapse processes that contribute to increase toughness and justify the ability of Flag to supercontract.


Asunto(s)
Nanopartículas/química , Péptidos/química , Proteínas/química , Seda/química , Arañas/metabolismo , Secuencias de Aminoácidos , Animales , Enlace de Hidrógeno , Microscopía de Fuerza Atómica , Proteínas/metabolismo , Seda/metabolismo
15.
Int J Biol Macromol ; 46(5): 555-7, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20359492

RESUMEN

Supercontraction is commonly considered as a functional adaptation of major ampullate gland (MA) silk to its role as the main structural material in orb-webs. However, the observation of supercontraction in the dragline silk of a lynx spider species, as it is shown in this work, offers a strong support to the hypothesis that the appearance of supercontraction preceded the advent of capture webs. Moreover, the absence of proline in the sequence of dragline silk spidroin in Oxyopidae and related spiders indicates that the presence of this amino acid may not be required for the existence of supercontraction. In this regard, the presence of particular subrepeats--in orb-web and non-orb-web building spiders--adds new clues for the understanding of supercontraction and associated effects.


Asunto(s)
Fibroínas/química , Fenómenos Mecánicos , Arañas/química , Animales , Ensayo de Materiales , Resistencia a la Tracción
16.
J Neural Transm (Vienna) ; 112(1): 127-35, 2005 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-15599611

RESUMEN

During the last years, a great amount of evidence demonstrates the existence of bidirectional communication between astrocytes and neurons, which has revealed an important active role of astrocytes in the physiology of the nervous system. As a consequence of this evidence, a new concept of the synaptic physiology--"the tripartite synapse"--has been proposed, in which the synapse is formed by three functional elements, i.e., the pre- and postsynaptic elements and the surrounding astrocytes. In this scenario astrocytes play an active role as dynamic regulatory elements in neurotransmission by reciprocally exchanging information with the pre- and postsynaptic elements. The control of the Ca2+ excitability in astrocytes is a key element in this loop of information exchange. In the present article we review and discuss our current knowledge of the properties of the astrocyte intracellular Ca2+ signal and its modulation by the synaptic activity.


Asunto(s)
Astrocitos/fisiología , Señalización del Calcio/fisiología , Sinapsis/fisiología , Animales , Humanos , Líquido Intracelular/fisiología
17.
Ann Oncol ; 16(9): 1508-13, 2005 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-15939718

RESUMEN

BACKGROUND: The International Prognostic Index (IPI), initially designed for aggressive lymphomas, is also used in follicular lymphoma (FL) and other indolent lymphomas. Two new prognostic indexes have recently been proposed for FL [the Italian Lymphoma Intergroup (ILI) Index and the Follicular Lymphoma International Prognostic Index (FLIPI)]. PATIENTS AND METHODS: Three indexes, IPI [age >60 years, extranodal involvement two or more sites, elevated lactate dehydrogenase (LDH), Eastern Cooperative Oncology Group performance status > or =2, stage > or =3], ILI (age >60 years, extranodal involvement two or more sites, elevated LDH, male sex, B symptoms, erythrocyte sedimentation rate > or =30 mm first hour) and FLIPI (age >60 years, stage > or =3, elevated LDH, nodal involvement five or more, haemoglobin level < or =12 g/dl) were calculated in 411 patients with FL. RESULTS: Overall concordance between the three indexes was 54%. A total of 126 (31%) patients were included in the high-risk group according to IPI, 131 (32%) according to ILI and 157 (38%) after FLIPI application. Ten-year overall survival rates after applying the prognostic indexes (IPI, ILI and FLIPI) were, respectively: 72%, 71% and 72%, in the low-risk group; 51%, 60% and 49% in the intermediate-risk group; and 24%, 16% and 31% in the high-risk group. CONCLUSIONS: In this series, all three indexes, IPI, ILI and FLIPI, were useful to classify FL patients into differentiated risk groups, although the FLIPI identified a larger proportion of high-risk patients than the IPI and ILI.


Asunto(s)
Linfoma Folicular/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Linfoma Folicular/clasificación , Masculino , Persona de Mediana Edad , Pronóstico , Análisis de Supervivencia
18.
Haematologica ; 85(9): 961-6, 2000 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-10980635

RESUMEN

BACKGROUND AND OBJECTIVES: High-resolution computed tomography (HRCT) of the chest is able to demonstrate the presence of pulmonary infiltrates in febrile neutropenic patients with normal chest X-rays. Fiberoptic bronchoscopy with bronchoalveolar lavage (BAL) is a safe procedure for the etiological diagnosis of pulmonary infiltrates in oncohematologic patients. The objective of this study was to determine the diagnostic yield and subsequent therapeutic changes of a protected BAL (p-BAL) guided by HRCT in febrile oncohematologic patients unresponsive to broad-spectrum antibiotics with a normal chest X-ray. DESIGN AND METHODS: Twenty-two episodes from 20 oncohematologic patients were included: group A, 9 episodes (8 patients) with no respiratory symptoms and group B, 13 episodes (12 patients) with signs or symptoms of pulmonary infection. HRCT and p-BAL were performed in all episodes within the first 24 hours. RESULTS: HRCT showed abnormalities in all 22 episodes (bilateral abnormalities in 14 of the 22 episodes [64%]) and the most frequent pattern was ground-glass infiltrate (7 out of 22 episodes). An infectious agent was isolated in 12 of the 22 episodes, 5 in group A and 7 in group B with a diagnostic yield of 54%. Antimicrobial therapy was modified in 12 of the 22 episodes (54%): 5 in group A and 7 in group B. In 6 episodes, treatment was changed according to HRCT results and in the remaining 6 due to positive microbiologic results. Modifications in empirical therapy were associated with a favorable response in 44% episodes of group A and in 31% of group B. INTERPRETATION AND CONCLUSIONS: Oncohematologic patients with fever of unknown origin unresponsive to empirical antibiotics and with a normal chest X-ray can be candidates to undergo a HRCT. This subgroup of high-risk patients can benefit from a combined strategy consisting of BAL guided by a previous HRCT.


Asunto(s)
Neoplasias Hematológicas/complicaciones , Infecciones del Sistema Respiratorio/diagnóstico , Tomografía Computarizada por Rayos X/métodos , Adolescente , Adulto , Anciano , Antiinfecciosos/uso terapéutico , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Broncoscopía , Femenino , Fiebre/etiología , Fiebre/microbiología , Neoplasias Hematológicas/microbiología , Neoplasias Hematológicas/terapia , Humanos , Masculino , Persona de Mediana Edad , Neutropenia/inducido químicamente , Radiografía Torácica/métodos , Infecciones del Sistema Respiratorio/diagnóstico por imagen , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/etiología
19.
Ann Hematol ; 81(11): 616-21, 2002 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-12454698

RESUMEN

A number of studies have identified elevated levels of homocysteine (Hcy) as a risk factor for thrombosis. Given the relationship between Hcy and thrombosis, a high prevalence of thrombosis would be expected in patients with megaloblastic anemia. The aim of our study was to determine whether an acquired vitamin B12/folate deficiency is a risk factor for thrombosis. A retrospective case and control study was performed that included 193 cases with reduced levels of vitamin B12/folate. The cases were divided initially into two groups (105 with serum vitamin B12 < or =150 pmol/l and/or low red cell folate < or = 450 nmol/l and 88 with serum vitamin B12 between 150 and 200 pmol/l and/or red cell folate between 450 and 590 nmol/l). The control group consisted of 87 additional patients who had normal levels of serum vitamin B12, red cell folate, and normal renal function. Serum Hcy, thrombotic events, and risk factors were evaluated in all participants. Eight patients (9%) in the control group had had previous vascular events although only three of these events (37.5%) were observed between the vitamin study and 2 years prior to the study. In the case group, 20% of the patients had a history of thrombosis. In contrast with controls, 85% of cases suffered thrombosis between the time they were diagnosed and 2 years prior to the time they were diagnosed as showing a vitamin deficiency. Multivariate analysis demonstrated that vitamin deficiency was a significant risk factor for arterial thrombosis [adjusted odds ratio (OR) 3.3, confidence interval (CI) 1.1-10.2]. However, when hyperhomocysteinemia was included in the analysis, vitamin deficiency was no longer a risk factor, suggesting that hyperhomocysteinemia was responsible for arterial thrombotic risk in these patients (adjusted OR 2.5, CI 1.1-5.8). As a consequence of hyperhomocysteinemia, patients with acquired vitamin deficiency of vitamin B12/folate had a high risk of thrombosis. However, a more extensive study that controls risk variables and genetic factors is needed to sort out the various contributing factors.


Asunto(s)
Deficiencia de Ácido Fólico/complicaciones , Hiperhomocisteinemia/complicaciones , Trombosis/etiología , Deficiencia de Vitamina B 12/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Deficiencia de Ácido Fólico/epidemiología , Humanos , Hiperhomocisteinemia/epidemiología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Prevalencia , Análisis de Regresión , Estudios Retrospectivos , Factores de Riesgo , Trombosis/sangre , Trombosis/epidemiología , Factores de Tiempo , Deficiencia de Vitamina B 12/epidemiología
20.
Histopathology ; 45(3): 268-74, 2004 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-15330805

RESUMEN

AIM: To determine the efficacy of flow cytometry (FC) in the assessment of bone marrow (BM) in B-cell non-Hodgkin lymphoma (B-NHL). FC is a common practice, but is far from being validated. METHODS AND RESULTS: Morphological analysis and FC immunophenotyping were performed on 421 samples. T-cell lymphomas, Hodgkin's disease, chronic lymphocytic leukaemia and hairy cell leukaemia were not included in the study. Clonality was assessed by the standard kappa/lambda/CD19 test. Aberrant immunophenotypes present in the B-cell subpopulation were also investigated. A double-step procedure was employed in all cases to increase the sensitivity of the FC procedure. Of 380 evaluable samples, 188 corresponded to follicular lymphoma (FL), 58 to diffuse large B-cell lymphoma (DLBCL), 57 to mantle cell lymphoma (MCL), seven to Burkitt's lymphoma and the remaining 70 samples to other low-grade lymphomas. Morphological marrow infiltration was found in 148 cases, and flow immunophenotyping identified 138 cases with BM involvement. A concordance between the two methods was detected in 298 cases (79%). There was a discordance in 82 cases (21%): morphology positive/FC negative in 46 cases and morphology negative/FC positive in 36 (61% of all cases with discordance were from FL). There was no difference in outcome when patients with discordances were compared with patients without discordances. CONCLUSIONS: Most samples showed concordance between morphological and FC results. FC identified BM involvement in the absence of morphological infiltration. Morphology/FC discordance seems to have no influence on the outcome of FL patients.


Asunto(s)
Médula Ósea/patología , Citometría de Flujo/métodos , Linfoma de Células B/patología , Linfoma no Hodgkin/patología , Médula Ósea/inmunología , Supervivencia sin Enfermedad , Humanos , Inmunofenotipificación , Linfoma de Células B/inmunología , Linfoma no Hodgkin/inmunología , Análisis Multivariante , Pronóstico
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