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1.
Cytotherapy ; 26(1): 25-35, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37897472

ABSTRACT

BACKGROUND AIMS: There are currently no effective anti-viral treatments for coronavirus disease 2019 (COVID-19)-hospitalized patients with hypoxemia. Lymphopenia is a biomarker of disease severity usually present in patients who are hospitalized. Approaches to increasing lymphocytes exerting an anti-viral effect must be considered to treat these patients. Following our phase 1 study, we performed a phase 2 randomized multicenter clinical trial in which we evaluated the efficacy of the infusion of allogeneic off-the-shelf CD45RA- memory T cells containing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific T cells from convalescent donors plus the standard of care (SoC) versus just the SoC treatment. METHODS: Eighty-four patients were enrolled in three Spanish centers. The patients were randomized into the infusion of 1 × 106/kg CD45RA- memory T cells or the SoC. We selected four unvaccinated donors based on the expression of interferon gamma SARS-CoV-2-specific response within the CD45RA- memory T cells and the most frequent human leukocyte antigen typing in the Spanish population. RESULTS: We analyzed data from 81 patients. The primary outcome for recovery, defined as the proportion of participants in each group with normalization of fever, oxygen saturation sustained for at least 24 hours and lymphopenia recovery through day 14 or at discharge, was met for the experimental arm. We also observed faster lymphocyte recovery in the experimental group. We did not observe any treatment-related adverse events. CONCLUSIONS: Adoptive cell therapy with off-the-shelf CD45RA- memory T cells containing SAR-CoV-2-specific T cells is safe, effective and accelerates lymphocyte recovery of patients with COVID-19 pneumonia and/or lymphopenia. TRIAL REGISTRATION: NCT04578210.


Subject(s)
COVID-19 , Lymphopenia , Humans , SARS-CoV-2 , COVID-19/therapy , Memory T Cells , Treatment Outcome , Lymphopenia/therapy , Antiviral Agents
2.
Neurol Sci ; 45(4): 1635-1643, 2024 Apr.
Article in English | MEDLINE | ID: mdl-37875597

ABSTRACT

Juvenile myoclonic epilepsy (JME) is the most common of the generalized genetic epilepsies, with multiple causal and susceptibility genes; however, its etiopathogenesis is mainly unknown. The toxic effects caused by xenobiotics in cells occur during their metabolic transformation, mainly by enzymes belonging to cytochrome P450. The elimination of these compounds by transporters of the ABC type protects the central nervous system, but their accumulation causes neuronal damage, resulting in neurological diseases. The present study has sought the association between single nucleotide genetic variants of the CYP2C9, CYP2C19, and ABCB1 genes and the development of JME in patients compared to healthy controls. The CC1236 and GG2677 genotypes of ABCB1 in women; allele G 2677, genotypes GG 2677 and CC 3435 in men; the CYP2C19*2A allele, and the CYP2C19*3G/A genotype in both sexes were found to be risk factors for JME. Furthermore, carriers of the TTGGCC genotype combination of the ABCB1 gene (1236/2677/3435) have a 10.5 times higher risk of developing JME than non-carriers. Using the STRING database, we found an interaction between the proteins encoded by these genes and other possible proteins. These findings indicate that the CYP450 system and ABC transporters could interact with other genes in the JME.


Subject(s)
Epilepsy, Generalized , Myoclonic Epilepsy, Juvenile , Male , Humans , Female , Myoclonic Epilepsy, Juvenile/genetics , Cytochrome P-450 CYP2C9/genetics , Cytochrome P-450 CYP2C19/genetics , Genotype , ATP Binding Cassette Transporter, Subfamily B/genetics
3.
Aesthetic Plast Surg ; 48(3): 491-500, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37775577

ABSTRACT

BACKGROUND: The injection of illicit, non-regulated foreign materials may trigger an autoimmune autoinflammatory syndrome induced by adjuvants (ASIA). METHODS: A retrospective review of health records was performed to identify patients' epidemiological and clinical characteristics. The issues analyzed were age and gender of cases, occupation, the person who administered the substance, anatomical site, type and volume of the injected substance, time from injection to the onset of symptoms, chief complaint, measures taken to alleviate symptoms, local complications, systemic manifestations, and imaging method to aid in diagnosis. RESULTS: More than 70% of patients were female and dedicated to household activities; the mean age was 44 years for females and 40.7 years for males. One-quarter of patients reported some comorbidity. The most commonly reported substance was mineral oil, whereas the most frequent anatomical site was the gluteal region with volumes around one liter. Signs and symptoms occurred almost exclusively at a local level, pain (40%) and swelling (18%) being the predominant manifestations with a peak incidence after three years. Treatment was mainly medical; surgery, primarily en bloc resection, was performed in 20% of patients. CONCLUSIONS: A myriad of substances may induce autoimmune autoinflammatory syndrome induced by adjuvants (ASIA) when injected for cosmetic purposes. Since effective treatments are scarce, public policies should be enforced to alert the community and limit the consequences of this healthcare problem. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Subject(s)
Cosmetic Techniques , Gender Identity , Male , Humans , Female , Adult , Retrospective Studies , Treatment Outcome , Injections , Syndrome
4.
Aesthet Surg J ; 44(2): 183-191, 2024 Jan 16.
Article in English | MEDLINE | ID: mdl-37863473

ABSTRACT

BACKGROUND: The injection of illicit, nonregulated foreign materials is increasingly common and has negative consequences relative to the inflammatory process that ensues. OBJECTIVES: The aim of this study was to identify anatomical and imaging characteristics after the cosmetic injection of illicit foreign materials. METHODS: A retrospective review of clinical and imaging records was performed. The issues analyzed were the anatomical site, type of injected substance, imaging method for diagnosis, and patterns of migration. RESULTS: Data on 413 patients were collected. Most patients were female, with a mean age of 44 years. The most commonly infiltrated region was the buttocks (n = 284; 53.58%) followed by the breast (n = 99; 18.67%). Magnetic resonance imaging was the most common method of diagnosis in those patients who had an imaging study (159 out of 168). The most frequent depth of foreign material detected by imaging was the muscular plane (n = 103; 61.30%). Migration was detected in 56.55% of patients who had an imaging study. Most infiltrated substances were unknown; biopolymers were the most commonly identified substances. Depending on the type of substance, migration rates varied from 13% to 29%; rate differences were not statistically significant (P = .712). Migration was more common when the depth of infiltration was in muscle (77.66%) than in subcutaneous tissue (23.4%); this difference was statistically significant (P < .0001). CONCLUSIONS: Deep infiltration is related to greater migration rates, apparently regardless of the substance injected.


Subject(s)
Breast , Foreign Bodies , Humans , Female , Adult , Male , Breast/diagnostic imaging , Foreign Bodies/diagnostic imaging , Foreign Bodies/etiology , Buttocks/diagnostic imaging , Retrospective Studies , Injections
5.
Int Wound J ; 21(2): e14713, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38356326

ABSTRACT

Foot problems are very common in the community. Studies indicate that between 18% and 63% of people have foot pain or stiffness and that foot problems have a large impact on people's functional decline and a significant detrimental impact on measures of quality of life related to health. The general objective of this research was to compare foot health in people from the rural population compared to people from the urban population and its relationship with quality of life. A case-control descriptive study was developed with a sample of 304 patients, 152 patients from the rural population and 152 patients from the urban population. Quality of life was measured through the SF-36 Health Questionnaire in its Spanish version. The rural population group had a mean age of 46.67 ± 13.69 and the urban population group 49.02 ± 18.29. Regarding the score of the lowest levels of quality of life related to foot problems, the rural population group compared to the urban population group showed: for body pain (52.21 ± 30.71 vs. 67.80 ± 25.28, p < 0.001); and for mental health (69.58 ± 18.98 vs. 64.60 ± 14.88, p < 0.006). Differences between groups were analysed using Student's t-test for independent samples, which showed statistical significance (p < 0.05). This research offers evidence that the rural population presents better levels of mental health and lower levels of bodily pain in the domains of the SF-36 Health Questionnaire comparing with the urban population.


Subject(s)
Quality of Life , Rural Population , Humans , Adult , Middle Aged , Quality of Life/psychology , Urban Population , Surveys and Questionnaires , Pain
6.
Eur Respir J ; 61(2)2023 02.
Article in English | MEDLINE | ID: mdl-36265878

ABSTRACT

BACKGROUND: In patients with obstructive sleep apnoea (OSA), intermittent hypoxia induces overexpression of paraspeckle component (PSPC)1, a master modulator of transforming growth factor (TGF)-ß signalling, which promotes cell cancer progression through epithelial-mesenchymal transition (EMT) and acquisition of cancer stem cell (CSC)-like features. However, the persistence of intermittent hypoxia-induced effects on PSPC1, and their consequences in cancer patients are not known. To this effect, circulating PSPC1 levels were compared in patients with cutaneous melanoma with or without OSA, and their relationship with tumour aggressiveness along with the in vitro effects of soluble PSPC1 and intermittent hypoxia on melanoma cell aggressiveness mechanisms were assessed. METHODS: In 292 cutaneous melanoma patients, sleep studies and serum levels of PSPC1 and TGF-ß were evaluated. The effect of PSPC1 on expression of EMT and CSC transcription factors was assessed using melanoma cell lines with patient sera under both normoxia and intermittent hypoxia conditions. RESULTS: PSPC1 levels were higher in patients with moderate-severe OSA compared with mild OSA or non-OSA patients. Serum levels of PSPC1 were associated with several cutaneous melanoma clinical aggressiveness indicators. Both intermittent hypoxia exposures and serum from OSA patients upregulated TGF-ß expression and amplified the expression of transcription factors associated with EMT activation and acquisition of CSC characteristics. CONCLUSION: In cutaneous melanoma patients, OSA severity is associated with higher PSPC1 serum levels, which jointly with intermittent hypoxia would enhance the self-reprogramming capabilities of EMT and CSC feature acquisition of melanoma cells, promoting their intrinsic aggressiveness.


Subject(s)
Melanoma , RNA-Binding Proteins , Skin Neoplasms , Sleep Apnea, Obstructive , Humans , Hypoxia , Melanoma/pathology , Paraspeckles , RNA-Binding Proteins/metabolism , Skin Neoplasms/complications , Transforming Growth Factor beta/metabolism , Up-Regulation , Melanoma, Cutaneous Malignant
7.
Eur Respir J ; 62(6)2023 12.
Article in English | MEDLINE | ID: mdl-37734857

ABSTRACT

BACKGROUND: Hypoxic burden (HB) has emerged as a strong predictor of cardiovascular risk in obstructive sleep apnoea (OSA). We aimed to assess the potential of HB to predict the cardiovascular benefit of treating OSA with continuous positive airway pressure (CPAP). METHODS: This was a post hoc analysis of the ISAACC trial (ClinicalTrials.gov: NCT01335087) including non-sleepy patients with acute coronary syndrome (ACS) diagnosed with OSA (apnoea-hypopnoea index ≥15 events·h-1) by respiratory polygraphy. Patients were randomised to CPAP or usual care and followed for a minimum of 1 year. HB was calculated as the total area under all automatically identified desaturations divided by total sleep time. Patients were categorised as having high or low baseline HB according to the median value (73.1%min·h-1). Multivariable Cox regression models were used to assess whether the effect of CPAP on the incidence of cardiovascular outcomes was dependent on the baseline HB level. RESULTS: The population (362 patients assigned to CPAP and 365 patients assigned to usual care) was middle-aged (mean age 59.7 years), overweight/obese and mostly male (84.5%). A significant interaction was found between the treatment arm and the HB categories. In the high HB group, CPAP treatment was associated with a significant reduction in the incidence of cardiovascular events (HR 0.57, 95% CI 0.34-0.96). In the low HB group, CPAP-treated patients exhibited a trend toward a higher risk of cardiovascular outcomes than those receiving usual care (HR 1.33, 95% CI 0.79-2.25). The differential effect of the treatment depending on the baseline HB level followed a dose-response relationship. CONCLUSION: In non-sleepy ACS patients with OSA, high HB levels were associated with a long-term protective effect of CPAP on cardiovascular prognosis.


Subject(s)
Acute Coronary Syndrome , Sleep Apnea, Obstructive , Middle Aged , Humans , Male , Female , Continuous Positive Airway Pressure , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/therapy , Proportional Hazards Models , Acute Coronary Syndrome/complications , Hypoxia/complications
8.
J Endovasc Ther ; : 15266028221144586, 2023 Jan 07.
Article in English | MEDLINE | ID: mdl-36609162

ABSTRACT

PURPOSE: Carotid artery stenting (CAS) is an effective and minimally invasive method for the treatment of extracranial carotid artery stenosis. The aim of the present study was to explore independent risk factors to predict cerebrovascular events following CAS to identify high-risk patients and improve the safety of CAS in this population. MATERIALS AND METHODS: HISPANIAS is a national prospective multicenter study that included 14 hospitals that collected data from patients who underwent CAS. We analyzed morbidity and mortality within 30 days after CAS, looking for factors that might be associated with cerebrovascular events (stroke and transient ischemic attack [TIA]). RESULTS: The HISPANIAS cohort included 757 patients: 80.32% were men, the mean age was 70.73 years, and 82.96% underwent symptomatic CAS. Cerebrovascular complications occurred in 42 patients (5.6%), including TIA in 24 patients (70.8% ipsilateral; mean 2.79 days after CAS) and stroke in 18 patients (72.2% ipsilateral; mean 6.72 days after CAS). The main independent clinical predictors of stroke/TIA identified by logistic regression were female sex (odds ratio [OR] 2.29, 95% CI 1.15-4.54) and diabetes (OR 3.29, 95% CI 1.71-6.40). Survival analysis showed that diabetic women, compared with the rest of the patients, had a higher number of events concentrated mainly in the first days after the intervention (p=0.003). CONCLUSION: Cerebrovascular ischemic complications after CAS continue to be a challenge for the management of these patients. Although there are other factors, female sex and the presence of diabetes are emerging as strong risk factors for the development of complications after symptomatic CAS. CLINICAL IMPACT: Carotid artery stenting (CAS) is an effective and minimally invasive method for the treatment of extracranial carotid artery stenosis. Although CAS has been regarded as a reliable and safety approach, some studies reported that CAS was associated with a higher risk of procedure-related stroke. Cerebrovascular complications after CAS continue to be a main problem and a challenge for the management of these patients. Therefore, it is essential to identify the factors involved in the development of these complications. Our study shows that the combination of female sex and diabetes is associated with a clearly worse outcome, with a greater number of events concentrated mainly in the first days. This is different from other studies that have explored each factor separately. It would be interesting to perform separate interventions for this group given the increased risk of complications.

9.
Epilepsy Behav ; 144: 109268, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37245482

ABSTRACT

BACKGROUND: People with epilepsy (PWE) have been subject to stigma throughout history, a factor that could compromise their performance in daily life. In Mexico, little is known about the factors that may be affecting internalized stigma. OBJECTIVE: To evaluate the internalized stigma in adult PWE, its relationship with the quality of life, cognitive and depressive symptomatology, and clinical-demographic characteristics. MATERIAL AND METHODS: We conducted a cross-sectional study with a consecutive sampling approach in patients with epilepsy treated at the National Institute of Neurology and Neurosurgery Manuel Velasco Suárez (NINNMVS). Sociodemographic and clinical data, depressive symptomatology (Beck's depression inventory, DBI), cognition (MoCA test), quality of life (QOLIE-31 scale), and internalized stigma (King's internalized stigma scale, ISS) were evaluated. Correlations were made between the continuous variables and the ISS to select those with statistical significance and include them in a multiple linear regression model, along with the dummy variables, to explain internalized stigma. RESULTS: Of 128 patients, 74 (58%) were women; 38% of the patients had more than 20 years of epilepsy evolution. In addition, 39% presented depressive symptoms, and around 60% manifested a possible cognitive impairment. The variables that showed statistical significance concerning the ISS were selected along with dummy variables for multiple linear regression analysis. The resultant model considers the QOLIE-31 total score (ß = -0.489), the number of anti-seizure drugs (ASD, ß = 0.253), and those patients without caregiver support (ß = -0.166) with an adjusted R2 value of 0.316. CONCLUSIONS: A diminishing quality of life, an increased number of ASD, and patients without caregiver support influence a slight to moderate variation of internalized stigma in Mexican PWE. Therefore, it is necessary to continue studying other possible factors that influence internalized stigma to generate effective strategies to reduce its negative effects on PWE.


Subject(s)
Epilepsy , Quality of Life , Humans , Adult , Female , Male , Quality of Life/psychology , Mexico , Cross-Sectional Studies , Caregivers/psychology , Social Stigma , Epilepsy/psychology
10.
J Asthma ; 60(11): 1935-1941, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37071539

ABSTRACT

OBJECTIVE: To analyze the relationship between asthma and bronchiectasis, as well as the necessary conditions that this connection must meet for this group of patients to be considered a special phenotype. DATA SOURCES: We performed a PubMed search using the MeSH terms "asthma" and "bronchiectasis." The literature research was limited to clinical trials, meta-analyses, randomized controlled trials, cohort studies, and systematic reviews, involving adult patients, published until November 30th, 2022. STUDY SELECTIONS: Selected papers were initially evaluated by the Authors, to assess their eligibility in contributing to the statements. RESULTS: The prevalence of bronchiectasis is higher than expected in patients with asthma, particularly in those with more severe disease, and in some patients, between 1.4% and 7% of them, asthma alone could be the cause of bronchiectasis. Both diseases share etiopathogenic mechanisms, such as neutrophilic and eosinophilic inflammation, altered airway microbiota, mucus hypersecretion, allergen sensitization, immune dysfunction, altered microRNA, dysfunctional neutrophilic activity, and variants of the HLA system. Besides that, they also share comorbidities, such as gastroesophageal reflux disease and psychiatric illnesses. The clinical presentation of asthma is very similar to patients with bronchiectasis, which could cause mistakes with diagnoses and delays in being prescribed the correct treatment. The coexistence of asthma and bronchiectasis also poses difficulties for the therapeutic focus. CONCLUSIONS: The evidence available seems to support that the asthma-bronchiectasis phenotype really exists although longitudinal studies which consistently demonstrate that asthma is the cause of bronchiectasis are still lacking.

11.
Postgrad Med J ; 99(1172): 599-604, 2023 Jun 15.
Article in English | MEDLINE | ID: mdl-37319154

ABSTRACT

INTRODUCTION: Performance and selection rate of non-newly graduated physicians in a medical residency admission test as an indicator for the need of continuing education. METHODS: A database comprising 153 654 physicians who took a residency admission test in the period 2014-2018 was analysed. Performance and selection rates were assessed in relation to year of graduation and performance in medical school. RESULTS: The whole sample scored at a mean of 62.3 (SD ±8.9; range 1.11-91.11). Examinees who took the test in their year of graduation performed better (66.10) than those who took the test after their year of graduation (61.84); p<0.001.Selection rates differed accordingly; 33.9% for newly graduated physicians compared with 24.8% in those who took the test at least 1 year after graduation; p<0.001. An association between selection test performance and medical school grades was established using Pearson's correlation: r=0.40 for newly graduated physicians and r=0.30 for non-newly graduated physicians. There were statistically significant differences in selection rates for every ranking group of grades in medical school based on the χ2 test (p<0.001). The selection rates are decreased years after graduation even for candidates with high grades in medical school. DISCUSSION: There is an association between performance in a medical residency admission test and academic variables of the candidates: medical school grades and time elapsed from graduation to test taking. The evidence of decrease in retention of medical knowledge since graduation highlights the pertinence of continuing education interventions.


Subject(s)
Academic Performance , Internship and Residency , Physicians , Humans , Schools, Medical
12.
ScientificWorldJournal ; 2023: 4724606, 2023.
Article in English | MEDLINE | ID: mdl-37065773

ABSTRACT

In this work, the capacity of the Fenton oxidation process for the degradation of color and organic matter contained in the wastewater generated in the leather dyeing stage (WWDS) of an industrial tannery was evaluated. The wastewater characteristics included, among others, high toxicity (lethal concentration for Artemia salina, 24 h test, 50% of population = 93.71 ppm), high dye concentration (36 mg/L, yellow color), high chromium concentration (3.34 mg/L), and low biodegradability index (BOD5/COD ratio = 0.083). From an experimental design, the response surface methodology, and the multiobjective optimization analysis, the following optimal operating conditions were established: initial pH = 3.15, [Fe2+] = 0.981 mM, and [H2O2] = 5.38 mM. After 10 min of oxidation (determined from kinetic studies), it reached approximately 97% decolorization, COD reduction of approximately 82%, and TOC mineralization of approximately 92%. A synergistic effect of Fenton's reagents for TOC removal (S TOC = 0.8) and decolorization (S CN = 0.28) of the WWDS under study was confirmed experimentally. An increase in the biodegradability index, to a value of approximately 0.3, was confirmed. The cost of the treatment was estimated at 0.0112 USD/m3. Thus, the Fenton oxidation process allowed compliance with current Colombian environmental regulations and considerably improved the biodegradability and toxicity characteristics of the studied industrial effluent. It can be considered as an efficient alternative, easy to carry out on an industrial batch scale, and economically viable for the treatment of wastewater from the leather dyeing stage of an industrial tannery.

13.
Sensors (Basel) ; 23(18)2023 Sep 07.
Article in English | MEDLINE | ID: mdl-37765802

ABSTRACT

The purpose was to assess the concurrent validity and reliability of two portable powermeters (PowerTap vs. Power2Max) in different types of cycling efforts. Ten cyclists performed two submaximal, one incremental maximal and two supramaximal sprint tests on an ergometer, while pedaling power and cadence were registered by both powermeters and a cadence sensor (GarminGSC10). During the submaximal and incremental maximal tests, significant correlations were found for power and cadence data (r = 0.992-0.997 and 0.996-0.998, respectively, p < 0.001), with a slight power underestimation by PowerTap (0.7-1.8%, p < 0.01) and a high reliability of both powermeters (p < 0.001) for measurement of power (ICC = 0.926 and 0.936, respectively) and cadence (ICC = 0.969 and 0.970, respectively). However, during the supramaximal sprint test, their agreement to measure power and cadence was weak (r = 0.850 and -0.253, p < 0.05) due to the low reliability of the cadence measurements (ICC between 0.496 and 0.736, and 0.574 and 0.664, respectively; p < 0.05) in contrast to the high reliability of the cadence sensor (ICC = 0.987-0.994). In conclusion, both powermeters are valid and reliable for measuring power and cadence during continuous cycling efforts (~100-450 W), but questionable during sprint efforts (>500 W), where they are affected by the gear ratio used (PowerTap) and by their low accuracy in cadence recording (PowerTap and Power2Max).

14.
Entropy (Basel) ; 25(12)2023 Dec 03.
Article in English | MEDLINE | ID: mdl-38136496

ABSTRACT

Bradycardia, frequently observed in preterm infants, presents significant risks due to the immaturity of their autonomic nervous system (ANS) and respiratory systems. These infants may face cardiorespiratory events, leading to severe complications like hypoxemia and neurodevelopmental disorders. Although neonatal care has advanced, the influence of bradycardia on cardiorespiratory coupling (CRC) remains elusive. This exploratory study delves into CRC in preterm infants, emphasizing disparities between events with and without bradycardia. Using the Preterm Infant Cardio-Respiratory Signals (PICS) database, we analyzed interbeat (R-R) and inter-breath intervals (IBI) from 10 preterm infants. The time series were segmented into bradycardic (B) and non-bradycardic (NB) segments. Employing information theory measures, we quantified the irregularity of cardiac and respiratory time series. Notably, B segments had significantly lower entropy values for R-R and IBI than NB segments, while mutual information was higher in NB segments. This could imply a reduction in the complexity of respiratory and cardiac dynamics during bradycardic events, potentially indicating weaker CRC. Building on these insights, this research highlights the distinctive physiological characteristics of preterm infants and underscores the potential of emerging non-invasive diagnostic tools.

15.
Eur Respir J ; 59(4)2022 04.
Article in English | MEDLINE | ID: mdl-34561285

ABSTRACT

Due in part to overall improvements in health, the population of elderly individuals is increasing rapidly. Similarly, obstructive sleep apnoea (OSA) is both gaining increased recognition and also increasing due to the worldwide obesity epidemic. The overlap of OSA and ageing is large, but there is strong plausibility for causation in both directions: OSA is associated with pathological processes that may accelerate ageing and ageing-related processes; ageing may cause physical and neurological changes that predispose to obstructive (and central) apnoea. In addition, the common symptoms (e.g. excessive daytime sleepiness, and defects in memory and cognition), possible physiological consequences of OSA (e.g. accelerated cardiovascular and cerebrovascular atherosclerosis), and changes in metabolic and inflammatory markers overlap with the symptoms and associated conditions seen in ageing. There is also the possibility of synergy in the effects of these symptoms and conditions on quality of life, as well as a need to separate treatable consequences of OSA from age-related complaints. Taken together, the aforementioned considerations make it essential to review the interaction of OSA and ageing, both proven and suspected. The present review examines some aspects of what is known and points to the need for further investigation of the relationships, given the large number of potentially affected subjects.


Subject(s)
Disorders of Excessive Somnolence , Sleep Apnea Syndromes , Sleep Apnea, Obstructive , Aged , Disorders of Excessive Somnolence/etiology , Humans , Obesity/complications , Quality of Life , Sleep Apnea Syndromes/complications , Sleep Apnea, Obstructive/complications , Sleep Apnea, Obstructive/diagnosis , Sleep Apnea, Obstructive/epidemiology
16.
Ann Pharmacother ; 56(4): 401-411, 2022 Apr.
Article in English | MEDLINE | ID: mdl-34382435

ABSTRACT

BACKGROUND: Few studies describe the use of dolutegravir (DTG)-based dual therapies under routine clinical practice. OBJECTIVES: To report real-life data on the use of DTG-based dual therapies in treatment-experienced patients. METHODS: This was an observational, retrospective study. It included all treatment-experienced HIV patients starting a DTG-based dual therapy from 2014 to 2018. The primary end point was to identify the incidence and reasons for the switch. The secondary end points were to assess the effectiveness, safety, adherence, and costs after 48 weeks of treatment (W48). RESULTS: The incidence of the switch to a DTG-based dual therapy increased from 1.6 patients per 1000 patient-years in 2014 to 38.6 in 2018. A total of 241 patients initiated this therapy: 113 (46.9%) patients started DTG plus rilpivirine (RPV), 72 (29.9%), DTG plus lamivudine (3TC), and 68 (28.2%), DTG plus boosted-darunavir (b-DRV). A total of 170 patients completed W48 of follow-up. By intention-to-treat analysis, 89.3% of virologically suppressed (VS) patients (94.3% with DTG plus b-DRV, 91.3% with DTG plus 3TC, and 87.2% with DTG plus RPV) and 56.7% of non-VS patients (71.4% with DTG plus RPV and 52.2% with DTG plus b-DRV) achieved a viral load <50 copies/mL at W48. The protocol-defined virological failure was 6.5%. Overall, 8.8% of patients had early discontinuation. The annual cost increased by €800 per patient ($916). CONCLUSIONS AND RELEVANCE: The use of DTG-based dual therapies has increased in real life, showing a favorable effectiveness and safety profile. Treatment costs increased, except for the switch to DTG plus 3TC.


Subject(s)
Anti-HIV Agents , HIV Infections , HIV-1 , HIV Infections/drug therapy , Heterocyclic Compounds, 3-Ring/adverse effects , Humans , Oxazines , Piperazines , Pyridones/therapeutic use , Retrospective Studies , Viral Load
17.
Neurodegener Dis ; 22(1): 34-42, 2022.
Article in English | MEDLINE | ID: mdl-35926480

ABSTRACT

INTRODUCTION: There are reports of different clinical statuses in carriers of intermediate alleles (IAs) of CAG trinucleotide repeats in the HTT gene, from individuals affected by a clinical picture indistinguishable from Huntington's disease (HD) to those without manifestations. Therefore, the possible clinical significance of these alleles has been widely debated. OBJECTIVES: The aim of this study was to describe general and clinical features and discard HD phenocopies by molecular assessment in a case series of IA carriers on the HTT gene of a laboratory sample from a neurological center in Mexico. METHODS: We selected individuals who had previously been tested for the HTT gene expansion, which resulted in IAs. Clinical information was obtained from medical records, and molecular analysis of the JPH3, PRNP, and TBP genes was performed only in IA carriers with clinical manifestations. In addition, two patients with IA and acanthocytes were evaluated by whole-exome sequencing. The scientific and ethical committees of the National Institute of Neurology and Neurosurgery Manuel Velasco Suárez (NINNMVS) approved this study. RESULTS: From 1994 to 2019, the Genetics Department of the NINNMVS confirmed 34 individuals with IAs, 15 of whom belonged to 11 families with HD (IA-HD) and 19 of whom had no family history of HD (IA-non-HD). We found a high proportion of manifestations of the HD phenotypic spectrum in the IA-non-HD subgroup. In addition, among the 20 samples of IA carriers with manifestations molecularly evaluated, we identified two unrelated subjects with CAG/CTG repeat expansions on the JPH3 gene, confirming HD-like 2 (HDL2), and one patient with the homozygous pathogenic c.3232G>T variant (p.Glu1078Ter) in the VPS13A gene, demonstrating choreoacanthocytosis. DISCUSSION/CONCLUSION: Our results show the most extensive series of subjects with IAs and clinical manifestations. In addition, we identify three HD phenocopies, two HDL2 cases, and one choreoacanthocytosis case. Therefore, we emphasize evaluating other HD phenocopies in IA carriers with clinical manifestations whose family background is not associated with HD.


Subject(s)
Huntington Disease , Neuroacanthocytosis , Humans , Huntingtin Protein/genetics , Alleles , Trinucleotide Repeat Expansion/genetics , Neuroacanthocytosis/genetics , Mexico , Huntington Disease/genetics , Huntington Disease/epidemiology
18.
Sensors (Basel) ; 22(20)2022 Oct 16.
Article in English | MEDLINE | ID: mdl-36298216

ABSTRACT

The saving and re-use of energy has acquired great relevance in recent years, being of great importance in the automotive sector. In the literature, it is possible to find different proposals for energy-harvesting damper systems (EHSA)-the electromagnetic damper being a highly recurrent but still poorly defined proposal. This article specifically focuses on studying the concept and feasibility of an electromagnetic suspension system that is capable of recovering energy, using a damper formed by permanent magnets and a system of coils that collect the electromotive force generated by the variation of the magnetic field. To study the feasibility of the system, it is necessary to know the maximum energy that can be recovered through the winding system; however, the difficulties in obtaining the derivative of the magnetic flux and its derivative for each position make the analytical method very tedious. This paper presents an experimental method with which to maximize energy recovery by defining the optimum relative position between magnet and coil.

19.
Sensors (Basel) ; 22(23)2022 Nov 26.
Article in English | MEDLINE | ID: mdl-36501909

ABSTRACT

Within this paper, a PLC system that takes advantage of the loop resonance of an entire DC-PV string configured as a circular signal path is developed and implemented. Low cost and extremely simple transceivers intended to be installed within each PV module of a string have been designed and successfully tested. In addition, an anti-saturation coil has been conceived to avoid saturation of the core when the entire DC current of the string flows through it. Bi-directional half-duplex communication was successfully executed with up to a 1 MHz carrier frequency (150 kbps bitrate), using a simple ASK modulation scheme. The transmission and reception performance are presented, along with the overall system cost in comparison to the previous literature.


Subject(s)
Communication , Equipment Design
20.
Nano Lett ; 21(1): 769-777, 2021 01 13.
Article in English | MEDLINE | ID: mdl-33382624

ABSTRACT

Nanoparticle-mediated thermal treatments have demonstrated high efficacy and versatility as a local anticancer strategy beyond traditional global hyperthermia. Nanoparticles act as heating generators that can trigger therapeutic responses at both the cell and tissue level. In some cases, treatment happens in the absence of a global temperature rise, damaging the tumor cells even more selectively than other nanotherapeutic strategies. The precise determination of the local temperature in the vicinity of such nanoheaters then stands at the heart of thermal approaches to better adjust the therapeutic thermal onset and reduce potential toxicity-related aspects. Herein, we describe an experimental procedure by X-ray absorption spectroscopy, which directly and accurately infers the local temperature of gold-based nanoparticles, single and hybrid nanocrystals, upon laser photoexcitation, revealing significant nanothermal gradients. Such nanothermometric methodology based on the temperature-dependency of atomic parameters of nanoparticles can be extended to any nanosystem upon remote hyperthermal conditions.


Subject(s)
Hyperthermia, Induced , Nanoparticles , Gold , Lasers , Temperature , X-Ray Absorption Spectroscopy
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