Renal Transplantation in Second-Level Private Hospitals in the State of Mexico.

BACKGROUND: Kidney transplantation (KT) is the replacement therapy of choice in patients with end-stage renal disease (ESRD). Here we show a cohort of kidney transplant recipients from the period of May 1994 to May 2016 in 2 2nd-level private hospitals from the city of Toluca in the state of Mexico. METHODS: We checked the clinical files of all the patients that received KT in the period of study. RESULTS: We report 25 KT: 23 performed in Sanatorio Toluca and 2 in Sanatorio Florencia; 16 (64%) male and 9 (26%) female; mean age 36.03 ± 15.9 years (range, 10-66); 19 (76%) hemodialysis and 9 (24%) continuous ambulatory peritoneal dialysis before KT; ESRD etiology unknown in 16 (64%), diabetes in 5 (20%), IgA nephropathy in 2 (8%), and other in 2 (8%); living donors in 13 (52%) and deceased donors in 12 (48%); blood group 0+ in 18 (72%), A+ in 5 (20%), and B+ in 2 (8%); 21 (84%) with 0 and 4 (16%) with 1 HLA mismatch; and delayed graft function in 8 (32%), of which 7 were from deceased donors and 1 from a living donor. All 25 (100%) had a functional kidney at 1 year of follow-up. Immunosuppression regime consisted of multitarget maintenance therapy in all 25 (100%): cyclosporine in 18 (72%) and tacrolimus in 7 (28%). We used only methylprednisolone (MTP) as induction therapy. There were only 2 cases (8%) of acute rejection during the 1st 6 months of follow-up, and both responded to treatment with MTP. CONCLUSIONS: KT is the treatment of choice for patients with ESRD. The obtained results using only an MTP induction regime are satisfactory, with graft and patient survivals of 100% in the 1st year of follow-up.

Infiltrating cellular pattern in kidney graft biopsies translates into forkhead box protein 3 up-regulation and p16INK4α senescence protein down-regulation in patients treated with belatacept compared to cyclosporin A.

Renal allograft survival is related directly to cell senescence. In the transplantation scenario many cellular events - participating as immunological and non-immunological factors - could contribute to accelerate this biological process, responsible for the ultimate fate of the graft. Mechanisms concerned in tolerance versus rejection are paramount in this outcome. For this reason, immunosuppressive treatment constitutes an extremely important decision to prevent organ dysfunction and, finally, graft loss. This study was conducted to document the proportion of CD4(+) /interleukin (IL)-17A(+) -, CD16(+) /indoleamine 2, 3-dioxygenase (IDO(+) )-, forkhead box protein P3 (FoxP3(+))-expressing cells, senescent cells (p16(INK) (4α)) and the percentage of interstitial fibrosis (IF) in graft biopsies of kidney transplant recipients participating in the BENEFIT (Bristol-Myers Squibb IM103008) study. CD4(+) /IL-17A(+) , CD16(+) /IDO(+), FoxP3(+) and p16(INK) (4α+) cells were evaluated by immunohistochemistry, and the percentage of IF by morphometry on graft biopsies obtained at time 0 (pre-implantation) and at 12 months post-transplant. Senescent cells and CD4(+) /IL-17A(+) cells were increased among graft biopsies in subjects receiving cyclosporin A (CsA) compared to those under belatacept treatment. Meanwhile, CD16(+) /IDO(+) and FoxP3(+) -expressing cells were lower in biopsies from CsA treatment compared to patients treated with Belatacept. Histological morphometric analyses disclosed more IF in 12-month CsA-treated patients in comparison to pre-implantation biopsy findings. Summing up, renal biopsies from patients receiving belatacept showed greater amounts of FoxP3(+) cells and lower amounts of CD4(+) /IL-17A(+) and senescent cells compared to patients under CsA treatment. Along with these findings, an increase in IF in annual CsA-treated-patients biopsies compared to pre-implantation and belatacept-treated patients were observed.

[Increased knowledge of ARIA and GINA guides 2006 to general physicians by an educational intervention]. / Incremento del conocimiento de las guías ARIA y GINA 2006 para médicos generales mediante una intervención educativa.

BACKGROUND: Educational strategies look for the increase of knowledge in physicians; they are a useful resourse for the diffusion among physicians of guides GINA and ARIA. OBJECTIVE: To evaluate a course shop-like for physicians as an educative strategy. PARTICIPANTS AND METHODS: A transversal study was performed, where knowledge was evaluated to primary contact physicians about recent currents of guides of GINA and ARIA 2006. RESULTS: There was a participation of 69 primary contact physicians who applied a questionnaire of 30 questions: 20 about asthma (GINA) and 10 about allergic rhinitis (ARIA) before and after a course shop-like for physicians; there was improvement on calification after educative strategy on knowledge about asthma and allergic rhinitis with a p = < 0.05. CONCLUSION: The educative strategy proposed as course shop-like for primary contact physicians is effective for teaching the guides of GINA and ARIA 2006.

Cell protection induced by beta-sitosterol: inhibition of genotoxic damage, stimulation of lymphocyte production, and determination of its antioxidant capacity.

Beta-sitosterol (BS) is a compound that has shown various activities potentially useful for human health. In the present study, we determined its antigenotoxic capacity and lymphocyte induction potential in mouse as well as its capacity to trap free radicals in vitro. BS, in doses from 200 to 1,000 mg/kg, was able to significantly reduce the frequency of sister chromatid exchanges induced by 10 mg/kg of doxorubicin (DX) in bone marrow cells. The same range of BS doses also gave rise to a strong reduction in the rate of micronucleated, polychromatic erythrocytes induced by DX. In addition, we determined an increase in the production of lymphocytes in mice administered with BS. By means of the DPPH assay, the compound was shown to trap free radicals in a concentration dependent manner as high as 78.12% using 250 mug/ml. Our research established three relevant biological activities of BS which show its potential as a chemopreventive agent.

Anti-prolactin autoantibodies in pregnant women with systemic lupus erythematosus: maternal and fetal outcome.

The aim of this study was to determine in pregnant women with systemic lupus erythematosus (SLE) the frequency of anti-prolactin autoantibodies and to compare the outcome of pregnancy in SLE women with and without anti-prolactin autoantibodies. Ninety-nine consecutive SLE pregnant women and 151 healthy pregnant women were studied prospectively. Patients with or without anti-prolactin autoantibodies were identified by gel filtration chromatography and affinity chromatography for IgG. Serum total and free prolactin (PRL) levels and molecular heterogeneity of PRL at each trimester of pregnancy were determined. The frequency of anti-PRL autoantibodies in SLE pregnant women was 13.1%. Serum total PRL levels were significantly higher in women with anti-PRL autoantibodies compared with SLE women without anti-PRL autoantibodies and in healthy pregnant women; and serum free PRL levels were lower in the third trimester in women with anti-PRL autoantibodies than in healthy pregnant women. In contrast, serum total and free PRL levels were significantly lower in the second and third trimester in SLE pregnant women without anti-PRL autoantibodies compared with healthy pregnant women. All adverse outcomes of pregnancy studied were more frequent in SLE women without anti-PRL autoantibodies than anti-PRL autoantibody-positive SLE women. Moreover, both maternal and fetal main complications were significantly higher in SLE women without anti-PRL autoantibodies than anti-PRL autoantibody-positive SLE women (P

Optical brightener Tinopal C1101 as an ultraviolet protectant for a nucleopolyhedrovirus.

Baculoviruses are arthropod-specific viruses currently used as biological insecticides in several countries of the world. One important factor limiting the efficacy of these bioinsecticides is related to the inactivation of the virus by solar ultraviolet (UV) radiation. This has motivated studies focused on the use of optical brightener compounds that can protect the virus from UV inactivation. The effects of the optical brightener Tinopal C1101 (ethenedyl benzenesulfonic derivative) on the persistance of a nucleopolyhedrovirus (SfMNPV) was quantified in third instar Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae), the principal pest of maize in the Americas. For this, laboratory studies were performed to determine the relationship between virus concentrations and radiation-caused inactivation of SfMNPV alone or in mixtures with 1.25 or 0.1% (vol/vol) Tinopal C1101 using a UV system [radiation was provided by a 15 W UV tube (emission maxima at 312 nm)]. SfMNPV alone was more sensitive to UV than in mixtures with 1.25 or 0.1% Tinopal C1101. For instance, at concentrations of 2.22 x 10(8) and 2.75 x 10(6) occlusion bodies (OBs)/ml, SfMNPV alone-caused mortality was reduced from 88 and 44% (without UV radiation) to 0%, in both cases, after 30 and 15 min exposure to the UV tube, respectively. In contrast, the incorporation of 1.25% Tinopal C1101 into the SfMNPV inoculum at 2.22 x 10(8) and 2.75 x 10(6) OBs/ml caused a mortality of 86.6 and 96.6% after 240 min, respectively. UV-caused inactivation of SfMNPV was directly related to the optical brightener concentration. We conclude that optical brighteners are likely to represent valuable components of nucleopolyhedrovirus formulations.

Serum free prolactin concentrations in patients with systemic lupus erythematosus are associated with lupus activity.

OBJECTIVE: To determine in patients with systemic lupus erythematosus (SLE) the relationships among serum total and free prolactin (PRL) levels, isoforms of PRL and lupus activity. METHODS: In a cross-sectional study, 259 patients with SLE were tested for serum total PRL, serum free PRL, and PRL in fractions obtained after gel filtration chromatography (in 70 sera taken at random) by immunoradiometric assay based on disease activity. RESULTS: A significant correlation between direct PRL and free PRL levels was found in patients with and without lupus activity (r = 0.475, P<0.001); however, this was less so for non-active patients than for active patients (r=0.433, P<0.001 and r=0.909, P<0.001, respectively). SLE Disease Activity Index (SLEDAI) scores correlated positively with serum free PRL levels (r=0.314, P<0.001) and percentage of little PRL (r=0.33, P=0.005) and negatively with percentage of big big PRL (r=-0.3, P=0.012). Patients with active disease had higher serum free PRL levels (median 12.6 vs 9.3 ng/ml, P<0.001), higher percentages of little PRL (83.1 +/- 21.2 vs 63.6 +/- 24.8%, P=0.011) and lower percentages of big big PRL (9.4 +/- 18.0 vs 25.2 +/- 24.3%, P=0.031). Different clinical manifestations and serological parameters of lupus disease activity were more frequent in patients with free hyperprolactinaemia than in patients with normal serum free PRL levels (such as neurological manifestations, renal involvement, serositis, haematological manifestations, anti-double-stranded DNA and hypocomplementaemia; P<0.021). CONCLUSION: An increase in serum free PRL levels, higher percentages of little PRL and lower percentages of big big PRL proved to be factors related to lupus activity in a subset of patients with SLE. These novel data must be taken into account in future studies aiming to establish a relationship between PRL and disease activity in SLE.

Major suppression of pro-alpha1(I) type I collagen gene expression in the dermis after keloid excision and immediate intrawound injection of triamcinolone acetonide.

BACKGROUND: A keloid is a benign tumor that contains excess collagen, primarily type I collagen. A common therapy is intralesional injection of a glucocorticosteroid, such as triamcinolone acetonide (TA). Surgical excision is also common; often a glucocorticosteroid is injected weeks after excision when wound repair has already begun. OBJECTIVE: Our purpose was to determine the efficacy of TA in reducing the pro-alpha1(I) type I collagen mRNA in the dermis, when TA is injected into the wound bed immediately after surgical excision of the keloid. METHODS: Six patients with previously untreated keloids were studied. Three were treated with 10 mg/ml of TA immediately after excision of the keloid (experimental group); the other three patients were not treated with TA until 2 weeks after excision (control). Punch biopsy specimens were obtained from the TA-treated sites 2 weeks after removal of the keloid and from the wounds of the control group of patients before they were treated with TA. Sections were prepared for in situ hybridization analysis of the pro-alpha1(I) collagen mRNA, as well as for histochemical analysis of collagen fibers. RESULTS: All keloids showed greatly elevated levels of pro-alpha1(I) type I collagen mRNA in the dermis. Postsurgical wounds injected with TA after removal of the keloid expressed decreased pro-alpha1(I) collagen transcripts, compared with skin not treated with TA. The collagen bundles were also thinner and less dense in the TA-treated skin. CONCLUSION: Downregulation of the type I collagen gene expression is elicited by immediate TA injection after keloid excision. This suggests that prevention of recurrent keloid growth is possible if surgical excision is accompanied by immediate TA injection into the wound bed and that healing of the wound is not apparently compromised by inhibition of type I collagen gene expression.

Enterocolitis neutropénica. Estudio de 16 casos en pacientes con leucemia en un periodo de 12 años / Neutropenic enterocolitis. a study of 16 cases in patients with leukemia during a 12 years period

La enterocolitis neutropénica es una complicación que se observa principalmente en pacientes con leucemia tratados con inmunosupresores citotóxicos que posteriormente, debido a su estado de inmunodepresión, presentan infección por agentes oportunistas como bacterias, virus u hongos. En este estudio se encontró que el 4 por ciento de 325 casos de leucemia en material de autopsias del Hospital General de México, presentaron esta complicación. En todos los casos hubo afección extensa del colon e ileon; en dos casos la muerte se debió a perforación y peritonitis. Además se encontraron casos con afección en sitios extraintestinales como lengua, esófago, bronquio y cérvix, por lo que consideramos que esta complicación no es exclusiva de la región enterocólica y proponemos el término de ®lesión neutropénica sistémica¼ cuando exista afección fuera de este sitio en múltiples órganos

Chest pain duration in myocardial infarction.

Routine clinical and laboratory data were collected from 70 patients with first myocardial infarcts. Compared with the 35 patients whose chest pain duration was less than eight hours, those with chest pain eight hours or longer had higher rises in creatine phosphokinase and SGOT levels, greater summed ST segments (taken from the 12-lead ECG), more transmural infarcts, greater cardiac volumes (measured from subsequent chest roentgenograms), higher temperature rises, and higher WBC counts. These reuslts suggest that pain duration may be an indicator of infarct size.