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1.
J Infect Dis ; 229(6): 1796-1802, 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38206187

RESUMEN

BACKGROUND: Limited data are available regarding the susceptibility of the reverse transcriptase V106 polymorphism to doravirine. METHODS: Doravirine susceptibility was measured in site-directed mutants (SDMs) containing V106I, V106A, V106M, and Y188L mutations in subtype B (NL4-3, HXB2) and CRF02_AG background and in recombinant viruses with RT harboring V106I alone derived from 50 people with HIV. RESULTS: HIV-1 B subtype was detected in 1523 of 2705 cases. Prevalence of V106I was 3.2% in B and 2.5% in non-B subtypes, and was higher in subtype F (8.1%) and D (14.3%). Fold-changes (FC) in susceptibility for SDMs were below doravirine biological cutoff (3.0) for V106I, but not for V106A, V106M, and Y188L. Clinically derived viruses tested included 22 B (median FC, 1.2; interquartile range [IQR], 0.9-1.6) and 28 non-B subtypes (median FC, 1.8; IQR, 0.9-3.0). Nine (18%) viruses showed FC values equal or higher than the doravirine biological FC cutoff. CONCLUSIONS: The prevalence of the HIV-1 RT V106I polymorphism in MeditRes HIV consortium remains low, but significantly more prevalent in subtypes D and F. V106I minimally decreased the susceptibility to doravirine in SDMs and most clinical isolates. Reduced susceptibility seems to occur at increased frequency in subtype F1; however, the clinical impact remains to be investigated. CLINICAL TRIALS REGISTRATION: NCT04894357.


Asunto(s)
Fármacos Anti-VIH , Farmacorresistencia Viral , Infecciones por VIH , Transcriptasa Inversa del VIH , VIH-1 , Piridonas , Triazoles , Humanos , VIH-1/genética , VIH-1/efectos de los fármacos , VIH-1/clasificación , VIH-1/enzimología , Transcriptasa Inversa del VIH/genética , Infecciones por VIH/virología , Infecciones por VIH/epidemiología , Piridonas/farmacología , Farmacorresistencia Viral/genética , Fármacos Anti-VIH/farmacología , Triazoles/farmacología , Polimorfismo Genético , Prevalencia , Masculino , Femenino , Inhibidores de la Transcriptasa Inversa/farmacología , Adulto , Genotipo , Fenotipo , Persona de Mediana Edad
2.
J Clin Microbiol ; 62(5): e0002824, 2024 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-38639489

RESUMEN

The mpox outbreak, caused by monkeypox virus (MPXV), accelerated the development of molecular diagnostics. In this study, we detail the evaluation of the Research Use Only (RUO) NeuMoDx MPXV assay by multiple European and US sites. The assay was designed and developed by Qiagen for the NeuMoDx Molecular Systems. Primers and probes were tested for specificity and inclusivity in silico. The analytical sensitivity of the assay was determined by testing dilutions of synthetic and genomic MPXV DNA. A total of 296 clinical samples were tested by three sites; the Johns Hopkins University (US), UZ Gent (Belgium, Europe), and Hospital Universitario San Cecilio (Spain, Europe). The analytical sensitivity of the assay was 50 copies/mL for both clades I and II. The assay showed 100% in silico identity for 80 clade I and 99.98% in silico identity for 5,162 clade II genomes. Clade II primers and probes showed 100% in silico specificity; however, identity of at least one of the two sets of clade I primers and probes with variola, cowpox, camelpox, and vaccinia viruses was noticed. The clinical validation showed sensitivity of 99.21% [95% confidence interval (CI): 95.66-99.98%] and specificity of 96.64% (95% CI: 91.62-99.08%) for lesion swab samples. The NeuMoDx MPXV Test shows acceptable analytical and clinical performance. The assay improves the laboratory's workflow as it consolidates nucleic acid extraction, PCR, data analysis, and interpretation and can be interfaced. The Test Strip can differentiate clades I and II, which has important laboratory safety implications. IMPORTANCE: In this manuscript, we provide detailed in silico analysis and clinical evaluation of the assay using a large cohort of clinical samples across three academic centers in Europe and the United States. Because the assay differentiates MPXV clades I and II, this manuscript is timely due to the current need to rule out the regulated clade I by diagnostic clinical laboratories. In December 2023, and due to first report of cases of sexually transmitted clade I infections in the Democratic Republic of the Congo, when generic assays that do not differentiate the clades are used, samples are considered regulated. The assay meets the need of full automation and has a marked positive impact on the laboratory workflow.


Asunto(s)
Técnicas de Diagnóstico Molecular , Monkeypox virus , Mpox , Reacción en Cadena en Tiempo Real de la Polimerasa , Sensibilidad y Especificidad , Humanos , Monkeypox virus/genética , Monkeypox virus/aislamiento & purificación , Monkeypox virus/clasificación , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Mpox/diagnóstico , Mpox/virología , Técnicas de Diagnóstico Molecular/métodos , Europa (Continente) , Estados Unidos , Automatización de Laboratorios/métodos , Cartilla de ADN/genética , Bélgica
3.
Gastroenterol Hepatol ; : 502229, 2024 Jul 09.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38992423

RESUMEN

INTRODUCTION AND OBJECTIVES: TPE drastically reduces serum triglyceride (sTG), but its role in the treatment of hypertriglyceridemia-induced acute pancreatitis (HTG-AP) or at risk of developing it, is not well established. The objectives were to assess the effectiveness and safety of TPE in the treatment of severe HTG (sHTG), as well as to evaluate the severity of HTG-AP treated with TPE. MATERIALS AND METHODS: Observational-retrospective-single-center study, in which a descriptive analysis of sHTG treated with TPE was conducted, with the aim of treating HTG-AP or preventing its recurrence. TPE was performed if sTG≥ 1000 mg/dL after 24 hours of admission. RESULTS: 42 TPE were performed to treat 35 sHTG in 23 patients: 29 HTG-AP, and 6 sHTG with previous HTG-AP. Among the patients, 37% (13/55) were women, with 37±14 years-old, 74.3% had normal BMI (25/35), 34% (12/35) were drinking >40 g/alcohol/day and 54% (19/35) were diabetics. TPE significantly reduced the baseline sTG (4425±2782 mg/dL vs. 709±353 mg/dL, p<0.001) in a single session, achieving a mean percentage reduction of 79±13%; 20% (7/35) of sHTG cases required two TPE sessions to reduce sTG to <1000 mg/dL. Adverse effects were reported in 4/42 TPE sessions (9,5%). sHTG-AP was observed in 3% of cases (1/29), and there were no deaths. sTG at 24 hours of admission showed no relation with the severity of APs. CONCLUSION: The treatment of sHTG with TPE, with the aim of treating HTG-AP or preventing its recurrence, reduces sTG quickly and safety.

4.
Clin Infect Dis ; 76(9): 1628-1635, 2023 05 03.
Artículo en Inglés | MEDLINE | ID: mdl-36571282

RESUMEN

BACKGROUND: We evaluated the prevalence of transmitted drug resistance (TDR) to integrase strand-transfer inhibitors (INSTIs) and nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) and of clinically relevant resistance (CRR) in newly diagnosed people with human immunodeficiency virus (HIV; PWH) naive to antiretroviral therapy (ART) in Europe. METHODS: MeditRes is a consortium that includes ART-naive PWH newly diagnosed in France, Greece, Italy, Portugal, and Spain during 2018-2021. Reverse transcriptase and INSTI sequences were provided by participating centers. To evaluate the prevalence of surveillance drug resistance mutations (SDRM), we used the calibrated population resistance tools from the Stanford HIV website. To evaluate CRR, defined as any resistance level ≥3, we used the Stanford HIV Drug Resistance Database v.9.1 algorithm. RESULTS: We included 2705 PWH, 72% men, median age of 37 years (interquartile range, 30-48); 43.7% were infected by non-B subtypes. The prevalence of INSTI-SDRMs was 0.30% (T66I, T66A, E92Q, E138T, E138K, Y143R, S147G, R263K; all n=1) and the prevalence of NRTI-SDRMs was 5.77% (M184V: 0.85%; M184I: 0.18%; K65R/N: 0.11%; K70E: 0.07%; L74V/I: 0.18%; any thymidine analog mutations: 4.36%). INSTI-CRR was 2.33% (0.15% dolutegravir/bictegravir, 2.29% raltegravir/elvitegravir) and 1.74% to first-line NRTIs (0.89% tenofovir/tenofovir alafenamide, 1.74% abacavir, 1.07% lamivudine/emtricitabine). CONCLUSIONS: We present the most recent data on TDR to integrase-based first-line regimens in Europe. Given the low prevalence of CRR to second-generation integrase inhibitors and to first-line NRTIs during 2018-2021, it is unlikely that newly diagnosed PWH in MeditRes countries would present with baseline resistance to a first-line regimen based on second-generation integrase inhibitors.


Asunto(s)
Infecciones por VIH , Inhibidores de Integrasa VIH , Integrasa de VIH , VIH-1 , Masculino , Humanos , Adulto , Femenino , Integrasas/genética , Inhibidores de Integrasa VIH/farmacología , Inhibidores de Integrasa VIH/uso terapéutico , Antirretrovirales/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Inhibidores de la Transcriptasa Inversa/farmacología , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Mutación , Europa (Continente)/epidemiología , VIH-1/genética , Adenina , Farmacorresistencia Viral/genética , Integrasa de VIH/genética , Compuestos Heterocíclicos con 3 Anillos/uso terapéutico
5.
J Med Virol ; 95(12): e29287, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-38084763

RESUMEN

To evaluate the prevalence of transmitted drug resistance (TDR) to nucleoside and nonnucleoside reverse transcriptase inhibitors (NRTI, NNRTI), protease inhibitors (PI), and integrase strand transfer inhibitors (INSTI) in Spain during the period 2019-2021, as well as to evaluate transmitted clinically relevant resistance (TCRR) to antiretroviral drugs. Reverse transcriptase (RT), protease (Pro), and Integrase (IN) sequences from 1824 PLWH (people living with HIV) were studied. To evaluate TDR we investigated the prevalence of surveillance drug resistance mutations (SDRM). To evaluate TCRR (any resistance level ≥ 3), and for HIV subtyping we used the Stanford v.9.4.1 HIVDB Algorithm and an in-depth phylogenetic analysis. The prevalence of NRTI SDRMs was 3.8% (95% CI, 2.8%-4.6%), 6.1% (95% CI, 5.0%-7.3%) for NNRTI, 0.9% (95% CI, 0.5%-1.4%) for PI, and 0.2% (95% CI, 0.0%-0.9%) for INSTI. The prevalence of TCRR to NRTI was 2.1% (95% CI, 1.5%-2.9%), 11.8% for NNRTI, (95% CI, 10.3%-13.5%), 0.2% (95% CI, 0.1%-0.6%) for PI, and 2.5% (95% CI, 1.5%-4.1%) for INSTI. Most of the patients were infected by subtype B (79.8%), while the majority of non-Bs were CRF02_AG (n = 109, 6%). The prevalence of INSTI and PI resistance in Spain during the period 2019-2021 is low, while NRTI resistance is moderate, and NNRTI resistance is the highest. Our results support the use of integrase inhibitors as first-line treatment in Spain. Our findings highlight the importance of ongoing surveillance of TDR to antiretroviral drugs in PLWH particularly with regard to first-line antiretroviral therapy.


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Humanos , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , España/epidemiología , Filogenia , Fármacos Anti-VIH/farmacología , Fármacos Anti-VIH/uso terapéutico , Antirretrovirales/farmacología , Antirretrovirales/uso terapéutico , Integrasas/genética , Integrasas/uso terapéutico , Mutación , Farmacorresistencia Viral/genética , Inhibidores de la Transcriptasa Inversa/farmacología , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Prevalencia
6.
Epidemiol Infect ; 151: e201, 2023 Nov 24.
Artículo en Inglés | MEDLINE | ID: mdl-37997654

RESUMEN

This study aimed to assess the ability of a real-time reverse transcription polymerase chain reaction (RT-PCR) with multiple targets to detect SARS-CoV-2 and its variants in a single test. Nasopharyngeal specimens were collected from patients in Granada, Spain, between January 2021 and December 2022. Five allele-specific RT-PCR kits were used sequentially, with each kit designed to detect a predominant variant at the time. When the Alpha variant was dominant, the kit included the HV69/70 deletion, E and N genes. When Delta replaced Alpha, the kit incorporated the L452R mutation in addition to E and N genes. When Omicron became dominant, L452R was replaced with the N679K mutation. Before incorporating each variant kit, a comparative analysis was carried out with SARS-CoV-2 whole genome sequencing (WGS). The results demonstrated that RT-PCR with multiple targets can provide rapid and effective detection of SARS-CoV-2 and its variants in a single test. A very high degree of agreement (96.2%) was obtained between the comparison of RT-PCR and WGS. Allele-specific RT-PCR assays make it easier to implement epidemiological surveillance systems for effective public health decision making.


Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/genética , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/genética , Alelos , Sensibilidad y Especificidad , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Prueba de COVID-19
7.
Int J Mol Sci ; 24(3)2023 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-36768752

RESUMEN

Recombination is an evolutionary strategy to quickly acquire new viral properties inherited from the parental lineages. The systematic survey of the SARS-CoV-2 genome sequences of the Andalusian genomic surveillance strategy has allowed the detection of an unexpectedly high number of co-infections, which constitute the ideal scenario for the emergence of new recombinants. Whole genome sequence of SARS-CoV-2 has been carried out as part of the genomic surveillance programme. Sample sources included the main hospitals in the Andalusia region. In addition to the increase of co-infections and known recombinants, three novel SARS-CoV-2 delta-omicron and omicron-omicron recombinant variants with two break points have been detected. Our observations document an epidemiological scenario in which co-infection and recombination are detected more frequently. Finally, we describe a family case in which co-infection is followed by the detection of a recombinant made from the two co-infecting variants. This increased number of recombinants raises the risk of emergence of recombinant variants with increased transmissibility and pathogenicity.


Asunto(s)
COVID-19 , Coinfección , Humanos , Coinfección/epidemiología , COVID-19/epidemiología , SARS-CoV-2/genética , Evolución Biológica , Genómica
8.
Clin Infect Dis ; 74(3): 479-489, 2022 02 11.
Artículo en Inglés | MEDLINE | ID: mdl-33988226

RESUMEN

BACKGROUND: Increased inflammation has been well defined in coronavirus disease 2019 (COVID-19), while definitive pathways driving severe forms of this disease remain uncertain. Neutrophils are known to contribute to immunopathology in infections, inflammatory diseases, and acute respiratory distress syndrome, a primary cause of morbidity and mortality in COVID-19. Changes in neutrophil function in COVID-19 may give insight into disease pathogenesis and identify therapeutic targets. METHODS: Blood was obtained serially from critically ill COVID-19 patients for 11 days. Neutrophil extracellular trap formation (NETosis), oxidative burst, phagocytosis, and cytokine levels were assessed. Lung tissue was obtained immediately postmortem for immunostaining. PubMed searches for neutrophils, lung, and COVID-19 yielded 10 peer-reviewed research articles in English. RESULTS: Elevations in neutrophil-associated cytokines interleukin 8 (IL-8) and interleukin 6, and general inflammatory cytokines IFN-inducible protien-19, granulocyte macrophage colony-stimulating factor (GM-CSF), interleukin 1ß, interleukin 10, and tumor necrosis factor, were identified both at first measurement and across hospitalization (P < .0001). COVID-19 neutrophils had exaggerated oxidative burst (P < .0001), NETosis (P < .0001), and phagocytosis (P < .0001) relative to controls. Increased NETosis correlated with leukocytosis and neutrophilia, and neutrophils and NETs were identified within airways and alveoli in lung parenchyma of 40% of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected lungs available for examination (2 of 5). While elevations in IL-8 and absolute neutrophil count correlated with disease severity, plasma IL-8 levels alone correlated with death. CONCLUSIONS: Literature to date demonstrates compelling evidence of increased neutrophils in the circulation and lungs of COVID-19 patients. Importantly, neutrophil quantity and activation correlates with severity of disease. Similarly, our data show that circulating neutrophils in COVID-19 exhibit an activated phenotype with enhanced NETosis and oxidative burst.


Asunto(s)
COVID-19 , Trampas Extracelulares , Enfermedad Crítica , Humanos , Activación Neutrófila , Neutrófilos , Fenotipo , SARS-CoV-2
9.
Ecotoxicol Environ Saf ; 238: 113601, 2022 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-35533449

RESUMEN

The toxicological properties of different silica particles functionalised with essential oil components (EOCs) were herein assessed using the in vivo model C. elegans. In particular, the effects of the acute and long-term exposure to three silica particle types (SAS, MCM-41 micro, MCM-41 nano), either bare or functionalised with eugenol or vanillin, were evaluated on different biological parameters of nematodes. Acute exposure to the different particles did not reduce nematodes survival, brood growth or locomotion, but reproduction was impaired by all the materials, except for vanillin-functionalised MCM-41 nano. Moreover, long-term exposure to particles led to strongly inhibited nematodes growth and reproduction. The eugenol-functionalised particles exhibited higher functionalisation yields and had the strongest effects during acute and long-term exposures. Overall, the vanillin-functionalised particles displayed milder acute toxic effects on reproduction than pristine materials, but severer toxicological responses for the 96-hour exposure assays. Our findings suggest that the EOC type anchored to silica surfaces and functionalisation yield are crucial for determining the toxicological effects of particles on C. elegans. The results obtained with this alternative in vivo model can help to anticipate potential toxic responses to these new materials for human health and the environment.


Asunto(s)
Caenorhabditis elegans , Eugenol , Animales , Benzaldehídos/toxicidad , Eugenol/toxicidad , Humanos , Dióxido de Silicio/toxicidad
10.
Actas Esp Psiquiatr ; 50(2): 120-121, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35312998

RESUMEN

Hepatitis C Virus (HCV) affects approximately 71 million people infected, with 1.75 million people being diagnosed each year, according to the World Health Organization (WHO) estimates. HCV infection leads to cirrhosis, hepatocellular carcinoma (HCC), liver failure and death.


Asunto(s)
Carcinoma Hepatocelular , Hepatitis C , Neoplasias Hepáticas , Carcinoma Hepatocelular/prevención & control , Hepacivirus , Hepatitis C/diagnóstico , Hepatitis C/terapia , Humanos , Neoplasias Hepáticas/prevención & control , Salud Mental
11.
Eur J Clin Microbiol Infect Dis ; 40(6): 1343-1349, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33512616

RESUMEN

AIM: To evaluate the serological response against SARS-CoV-2 in a multicenter study representative of the Spanish COVID pandemic. METHODS: IgG and IgM + IgA responses were measured on 1466 samples from 1236 Spanish COVID-19 patients admitted to the hospital, two commercial ELISA kits (Vircell SL, Spain) based on the detection of antibodies against the viral spike protein and nucleoprotein, were used. RESULTS: Approximately half of the patients presented antibodies (56.8% were IgM + IgA positive and 43.0% were IgG positive) as soon as 2 days after the first positive PCR result. Serological test positivity increased with time from the PCR test, and 10 days after the first PCR result, 91.5% and 88.0% of the patients presented IgM + IgA and IgG antibodies, respectively. CONCLUSION: The high values of sensitivity attained in the present study from a relatively early period of time after hospitalization support the use of the evaluated serological assays as supplementary diagnostic tests for the clinical management of COVID-19.


Asunto(s)
Anticuerpos Antivirales/sangre , Formación de Anticuerpos , COVID-19/inmunología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Prueba Serológica para COVID-19 , Proteínas de la Nucleocápside de Coronavirus/inmunología , Ensayo de Inmunoadsorción Enzimática , Femenino , Hospitalización , Humanos , Inmunoglobulina A , Inmunoglobulina G , Inmunoglobulina M , Masculino , Persona de Mediana Edad , Fosfoproteínas/inmunología , Sensibilidad y Especificidad , Factores Sexuales , España , Glicoproteína de la Espiga del Coronavirus/inmunología , Adulto Joven
12.
J Dairy Sci ; 104(3): 2822-2833, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33358816

RESUMEN

Growing consumer demand for healthy and nutritious products has motivated scientists and food manufacturers to design novel dairy products with higher fiber levels and lower fat content that are free of chemical additives. Chia seed mucilage (CSM) is a healthy natural gel extensively used as a dietary source of soluble fiber, a bulking agent, and a fat replacer in a large variety of foods. In this study, we evaluated the effect of CSM on the nutritional, technological, and sensory properties of skimmed yogurts. The addition of 7.5% CSM to a yogurt formula lowered the degree of syneresis of the resulting yogurt during storage compared with full-fat yogurts. The nutritive value of the enriched yogurts improved due to higher levels of dietary fiber compared with full-fat and skimmed yogurts. Moreover, rheological measurements revealed greater consistency, firmness, and viscosity, as well as the formation of a highly structured network and better resistance to stress in yogurts containing 7.5% CSM. The sensory acceptance of the yogurts enriched with 7.5% CSM was similar to the reference samples in acidity, creaminess, and viscosity terms. These results confirm the feasibility of using CSM as a fat replacer to design novel skimmed yogurts.


Asunto(s)
Salvia , Yogur , Animales , Manipulación de Alimentos , Semillas , Viscosidad , Yogur/análisis
13.
Toxicol Mech Methods ; 31(8): 559-565, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34112059

RESUMEN

Phenolic compounds carvacrol, thymol, eugenol, and vanillin are four of the most thoroughly investigated essential oil components given their relevant biological properties. These compounds are generally considered safe for consumption and have been used in a wide range of food and non-food applications. Significant biological properties, including antimicrobial, antioxidant, analgesic, anti-inflammatory, anti-mutagenic, or anti-carcinogenic activity, have been described for these components. They are versatile molecules with wide-ranging potential applications whose use may substantially increase in forthcoming years. However, some in vitro and in vivo studies, and several case reports, have indicated that carvacrol, thymol, and eugenol may have potential toxicological effects. Oxidative stress has been described as the main mechanism underlying their cytotoxic behavior, and mutagenic and genotoxic effects have been occasionally observed. In vivo studies show adverse effects after acute and prolonged carvacrol and thymol exposure in mice, rats, and rabbits, and eugenol has caused pulmonary and renal damage in exposed frogs. In humans, exposure to these three compounds may cause different adverse reactions, including skin irritation, inflammation, ulcer formation, dermatitis, or slow healing. Toxicological vanillin effects have been less reported, although reduced cell viability after exposure to high concentrations has been described. In this context, the possible risks deriving from increased exposure to these components for human health and the environment should be thoroughly revised.


Asunto(s)
Aceites Volátiles , Animales , Antibacterianos , Eugenol/efectos adversos , Eugenol/toxicidad , Ratones , Monoterpenos/efectos adversos , Monoterpenos/toxicidad , Aceites Volátiles/efectos adversos , Aceites Volátiles/toxicidad , Conejos , Ratas , Timol/efectos adversos , Timol/toxicidad
14.
Arch Orthop Trauma Surg ; 140(1): 51-58, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31515620

RESUMEN

INTRODUCTION: The purpose of this study is to analyze the mid-term outcomes of a modular monopolar type of radial head arthroplasty in the treatment of complex fractures associated with acute elbow joint instability. We postulated that radiographic changes are related to the development of clinical complications. MATERIALS AND METHODS: We evaluated at last follow-up 26 radial head arthroplasties in 26 consecutive patients who were followed for at least one and a half year. All patients had suffered radial head fractures (Mason III) in the context of unstable elbow injuries. Definitive treatment of the radial fracture was performed with modular and monopolar prosthesis which was inserted as a press fit. All patients were evaluated preoperatively and postoperatively. The evaluation included a clinical examination and a protocolized imaging study (standard X-Rays and CT) of the elbow. We analyzed the incidence of: heterotopic ossifications, secondary radiocapitellar joint osteoarthritis, hardware loosening, hardware disengagement, and joint infection. Diagnosis of clinical failure of the implant was defined as the time to the second surgery due to major complications related to the prosthesis, such as persistent lateral side pain or elbow stiffness and any kind of implant instability or dislocation. RESULTS: The implant-specific reoperation rate was 15% (four reoperations). The need for the second surgery was statistically associated with heterotopic ossifications, radiocapitellar osteoarthritis and cortical resorption around radial neck (p = 0.054, p = 0.033, and p = 0.019, respectively), being periprosthetic osteolysis the most likely factor related to failure, and radial pain the main symptom leading to surgical revision. CONCLUSIONS: Our study shows a positive association between radiographic findings and patient symptoms for postoperative complications after radial head arthroplasty. Failed radial head replacements may lead to reoperation mainly due to pain, and this can be distinguished from other causes of pain in elbow region based on its radial location. Radiological loosening was prevalent in this group of failed replacement.


Asunto(s)
Artroplastia , Fracturas del Radio , Radio (Anatomía) , Artroplastia/efectos adversos , Artroplastia/estadística & datos numéricos , Estudios de Seguimiento , Humanos , Prótesis Articulares , Radio (Anatomía)/diagnóstico por imagen , Radio (Anatomía)/fisiopatología , Radio (Anatomía)/cirugía , Fracturas del Radio/diagnóstico por imagen , Fracturas del Radio/epidemiología , Fracturas del Radio/fisiopatología , Fracturas del Radio/cirugía , Tomografía Computarizada por Rayos X , Insuficiencia del Tratamiento
15.
Am J Respir Cell Mol Biol ; 61(2): 209-218, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-30742476

RESUMEN

Helper T effector cytokines implicated in asthma modulate the contractility of human airway smooth muscle (HASM) cells. We have reported recently that a profibrotic cytokine, transforming growth factor (TGF)-ß1, induces HASM cell shortening and airway hyperresponsiveness. Here, we assessed whether TGF-ß1 affects the ability of HASM cells to relax in response to ß2-agonists, a mainstay treatment for airway hyperresponsiveness in asthma. Overnight TGF-ß1 treatment significantly impaired isoproterenol (ISO)-induced relaxation of carbachol-stimulated, isolated HASM cells. This single-cell mechanical hyporesponsiveness to ISO was corroborated by sustained increases in myosin light chain phosphorylation. In TGF-ß1-treated HASM cells, ISO evoked markedly lower levels of intracellular cAMP. These attenuated cAMP levels were, in turn, restored with pharmacological and siRNA inhibition of phosphodiesterase 4 and Smad3, respectively. Most strikingly, TGF-ß1 selectively induced phosphodiesterase 4D gene expression in HASM cells in a Smad2/3-dependent manner. Together, these data suggest that TGF-ß1 decreases HASM cell ß2-agonist relaxation responses by modulating intracellular cAMP levels via a Smad2/3-dependent mechanism. Our findings further define the mechanisms underlying ß2-agonist hyporesponsiveness in asthma, and suggest TGF-ß1 as a potential therapeutic target to decrease asthma exacerbations in severe and treatment-resistant asthma.


Asunto(s)
Asma/fisiopatología , Músculo Liso/metabolismo , Proteína Smad2/metabolismo , Proteína smad3/metabolismo , Factor de Crecimiento Transformador beta1/metabolismo , Factor de Crecimiento Transformador beta2/agonistas , Asma/tratamiento farmacológico , Asma/metabolismo , Broncodilatadores/farmacología , Carbacol/farmacología , AMP Cíclico/metabolismo , Fosfodiesterasas de Nucleótidos Cíclicos Tipo 4/metabolismo , Citocinas/metabolismo , Regulación de la Expresión Génica , Humanos , Isoproterenol/farmacología , Pulmón/metabolismo , Músculo Liso/efectos de los fármacos , Cadenas Ligeras de Miosina/metabolismo , Fosforilación , ARN Interferente Pequeño/metabolismo , Tráquea/efectos de los fármacos , Tráquea/metabolismo , Factor de Crecimiento Transformador beta2/metabolismo
16.
Pediatr Blood Cancer ; 66(6): e27647, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30729661

RESUMEN

BACKGROUND: At least 80% of children with cancer live in low- and middle-income countries where the prevalence of malnutrition and socioeconomic disadvantage is high. We examined the relationship between nutritional status (NS), assessed by arm anthropometry, and socioeconomic status (SES) in children diagnosed with cancer at Unidad Nacional de Oncologia Pediatrica (UNOP) in Guatemala over a three-year period. METHOD: Patients aged 0 to 18 years of age diagnosed between January 2015 and December 2017 were included. NS was evaluated by mid-upper arm circumference, triceps skin fold thickness, and serum albumin level, and subjects were classified as adequately nourished, moderately depleted, and severely depleted nutritionally. SES was measured by a 15-item instrument developed at UNOP. RESULTS: Of 1365 patients diagnosed in the study period, 1060 (78%) fulfilled the eligibility criteria. Only 6% of patients were classified as medium to high, the remainder as medium-low to extremely low SES. Almost 47% were severely depleted at diagnosis, 19% moderately depleted, and 34% adequately nourished. SES was shown to be a determinant of NS; with progressively lower SES, the probability of a decline in NS increased by a factor of 1.04 points (P < 0.0001). Leukemia and lymphoma were also important predictors of nutritional depletion with odds ratios of 6.08 (95% CI, 1.74-28.28; P = 0.008) for leukemias and 4.83 (95% CI, 1.33-23.03; P = 0.03) for lymphomas. CONCLUSION: Both low SES and a diagnosis of leukemia or lymphoma are strong predictors of poor NS at diagnosis in children with cancer in Guatemala.


Asunto(s)
Trastornos de la Nutrición del Niño/fisiopatología , Neoplasias/diagnóstico , Neoplasias/epidemiología , Clase Social , Factores Socioeconómicos , Adolescente , Niño , Fenómenos Fisiológicos Nutricionales Infantiles , Preescolar , Femenino , Estudios de Seguimiento , Guatemala/epidemiología , Humanos , Lactante , Recién Nacido , Masculino , Estado Nutricional , Pronóstico , Estudios Retrospectivos
17.
J Sep Sci ; 42(11): 2053-2061, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30945416

RESUMEN

The growing use of antidepressants in recent years has led to their increasing presence in forensic analyses. In this work, microextraction by packed sorbent followed by ultra-performance liquid chromatography with photodiode array detection provided a fast method for determining the antidepressants mirtazapine, venlafaxine, escitalopram, fluoxetine, fluvoxamine, and sertraline in human urine. The microextraction conditions (viz., type of sorbent, number of draw-eject extraction cycles or strokes, sample volume and pH, and type and volume of washing solution and eluent) were optimized by using an experimental design. The ensuing analytical method was validated in terms of linearity (25-1000 ng/mL urine), limit of detection (lower than 7.1 ng/mL), limit of quantification (25 ng/mL), precision (4.7-15.1% as relative standard deviation), and accuracy (80.4-126.1% as mean recovery for four replicate determinations). The proposed method allowed the six target antidepressants to be determined at concentrations from therapeutic to toxic levels. The application to small volumes (300 µL) of urine afforded fast extraction of the analytes and provided results on a par with those of existing clinical and forensic alternatives.


Asunto(s)
Antidepresivos/aislamiento & purificación , Antidepresivos/orina , Microextracción en Fase Líquida/métodos , Cromatografía Líquida de Alta Presión , Fluoxetina/análisis , Fluoxetina/aislamiento & purificación , Humanos , Límite de Detección
18.
J Assist Reprod Genet ; 36(10): 2111-2119, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31446545

RESUMEN

PURPOSE: To investigate if the vaginal microbiome influences the IVF outcome. METHODS: Thirty-one patients undergoing assisted reproductive treatment (ART) with own or donated gametes and with cryotransfer of a single euploid blastocyst were recruited for this cohort study. Two vaginal samples were taken during the embryo transfer procedure, just before transferring the embryo. The V3 V4 region of 16S rRNA was used to analyze the vaginal microbiome, and the bioinformatic analysis was performed using QIIME2, Bioconductor Phyloseq, and MicrobiomeAnalyst packages. Alpha diversity was compared between groups according to the result of the pregnancy test. RESULTS: Fourteen (45.2%) patients did not and seventeen (54.8 %) did achieve pregnancy under ART. A greater index of alpha diversity was found in patients who did not achieve pregnancy comparing to those who did, although this difference was not significant (p = 0.088). In the analysis of beta diversity, no statistically significant differences were observed between groups established as per the pregnancy status. Samples from women who achieved pregnancy showed a greater presence of Lactobacillus spp. The cluster analysis identified two main clusters: the first encompassed the genera Lactobacillus, Gardnerella, Clostridium, Staphylococcus, and Dialister, and the second included all other genera. Women who achieved pregnancy were mainly detected microorganisms from the first cluster. CONCLUSIONS: The vaginal microbiome can influence the results of ART. The profiles dominated by Lactobacillus were associated with the achievement of pregnancy, and there was a relationship between the stability of the vaginal microbiome and the achievement of pregnancy.


Asunto(s)
Índice de Embarazo , Reproducción/fisiología , Técnicas Reproductivas Asistidas , Vagina/microbiología , Adulto , Transferencia de Embrión/métodos , Femenino , Fertilización In Vitro/métodos , Humanos , Microbiota/genética , Embarazo , ARN Ribosómico 16S/genética
19.
Popul Environ ; 40(3): 257-282, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31485094

RESUMEN

This study investigated disparities in residential exposure to carcinogenic air pollutants among Asian Americans, including Asian ancestry subgroups, in four US metro areas with high proportions of Asians, i.e., Honolulu, Los Angeles, San Francisco Bay Area, and Seattle. Generalized estimating equations adjusting for socioeconomic status, population density and clustering show that a greater proportion of Asian Americans in census tracts was associated with significantly greater health risk in all four metro areas. Intracategorical disparities were uncovered for Asian ancestry. A greater proportion Korean was positively associated with risk in four metro areas; greater proportion Chinese and Filipino were positively associated with risk in three of the four metro areas. While Asian Americans are infrequently examined in environmental justice research, these results demonstrate that Asian Americans experience substantial distributional environmental injustices in these four metro areas and that ancestry is an important dimension of intracategorical complexity.

20.
Crit Rev Food Sci Nutr ; 58(12): 2002-2016, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-28394635

RESUMEN

The kingdom Fungi is the most important group of microorganism contaminating food commodities, and chemical additives are commonly used in the food industry to prevent fungal spoilage. However, the increasing consumer concern about synthetic additives has led to their substitution by natural compounds in foods. The current review provides an overview of using natural agents isolated from different sources (plants, animals, and microorganisms) as promising antifungal compounds, including information about their mechanism of action and their use in foods to preserve and prolong shelf life. Compounds derived from plants, chitosan, lactoferrin, and biocontrol agents (lactic acid bacteria, antagonistic yeast, and their metabolites) are able to control the decay caused by fungi in a wide variety of foods. Several strategies are employed to reduce the drawbacks of some antifungal agents, like their incorporation into oil-in-water emulsions and nanoemulsions, edible films and active packaging, and their combination with other natural preservatives. These strategies facilitate the addition of volatile agents into food products and, improve their antifungal effectiveness. Moreover, biological agents have been investigated as one of the most promising options in the control of postharvest decay. Numerous mechanisms of action have been elucidated and different approaches have been studied to enhance their antifungal effectiveness.


Asunto(s)
Productos Biológicos/farmacología , Conservación de Alimentos , Conservantes de Alimentos/farmacología , Hongos/fisiología , Productos Biológicos/química , Microbiología de Alimentos , Conservantes de Alimentos/química
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