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1.
Immun Ageing ; 20(1): 51, 2023 Oct 11.
Artículo en Inglés | MEDLINE | ID: mdl-37821967

RESUMEN

BACKGROUND: Adipose-derived stem cells (ADSC) are multipotent cells implicated in tissue homeostasis. Obesity represents a chronic inflammatory disease associated with metabolic dysfunction and age-related mechanisms, with progressive accumulation of senescent cells and compromised ADSC function. In this study, we aimed to explore mechanisms associated with the inflammatory environment present in obesity in modulating ADSC to a senescent phenotype. We evaluated phenotypic and functional alterations through 18 days of treatment. ADSC were cultivated with a conditioned medium supplemented with a pool of plasma from eutrophic individuals (PE, n = 15) or with obesity (PO, n = 14), and compared to the control. RESULTS: Our results showed that PO-treated ADSC exhibited decreased proliferative capacity with G2/M cycle arrest and CDKN1A (p21WAF1/Cip1) up-regulation. We also observed increased senescence-associated ß-galactosidase (SA-ß-gal) activity, which was positively correlated with TRF1 protein expression. After 18 days, ADSC treated with PO showed augmented CDKN2A (p16INK4A) expression, which was accompanied by a cumulative nuclear enlargement. After 10 days, ADSC treated with PO showed an increase in NF-κB phosphorylation, while PE and PO showed an increase in p38MAPK activation. PE and PO treatment also induced an increase in senescence-associated secretory phenotype (SASP) cytokines IL-6 and IL-8. PO-treated cells exhibited decreased metabolic activity, reduced oxygen consumption related to basal respiration, increased mitochondrial depolarization and biomass, and mitochondrial network remodeling, with no superoxide overproduction. Finally, we observed an accumulation of lipid droplets in PO-treated ADSC, implying an adaptive cellular mechanism induced by the obesogenic stimuli. CONCLUSIONS: Taken together, our data suggest that the inflammatory environment observed in obesity induces a senescent phenotype associated with p38MAPK/NF-κB axis, which stimulates and amplifies the SASP and is associated with impaired mitochondrial homeostasis.

2.
Osteoarthritis Cartilage ; 30(12): 1647-1657, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36049665

RESUMEN

OBJECTIVE: To describe the protocol of a multi-vendor, multi-site quantitative MRI study for knee post-traumatic osteoarthritis (PTOA), and to present preliminary results of cartilage degeneration using MR T1ρ and T2 imaging 10 years after anterior cruciate ligament reconstruction (ACLR). DESIGN: This study involves three sites and two MR platforms. The patients are from a nested cohort (termed as Onsite cohort) within the Multicenter Orthopaedic Outcomes Network (MOON) cohort 10 years after ACLR. Phantoms and controls were scanned for evaluating reproducibility. Cartilage was automatically segmented, and T1ρ and T2 were compared between operated, contralateral, and control knees. RESULTS: Sixty-eight ACL-reconstructed patients and 20 healthy controls were included. In phantoms, the intra-site coefficients of variation (CVs) of repeated scans ranged 1.8-2.1% for T1ρ and 1.3-1.7% for T2. The inter-site CVs ranged 1.6-2.1% for T1ρ and 1.1-1.4% for T2. In human subjects, the intra-site scan/rescan CVs ranged 2.2-3.5% for T1ρ and 2.6-4.9% for T2 for the six major compartments. In patients, operated knees showed significantly higher T1ρ and T2 values mainly in medial femoral condyle, medial tibia and trochlear cartilage compared with contralateral knees, and showed significantly higer T1ρ and T2 values in all six compartments compared to healthy control knees. The patient contralateral knees showed higher T1ρ and T2 values mainly in the lateral femoral condyle, lateral tibia, trochlear, and patellar cartilage compared to healthy control knees. CONCLUSION: A platform and workflow with rigorous quality control has been established for a multi-vendor multi-site quantitative MRI study in evaluating PTOA 10 years after ACLR. Our preliminary report suggests significant cartilage matrix changes in both operated and contralateral knees compared with healthy control knees.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior , Reconstrucción del Ligamento Cruzado Anterior , Cartílago Articular , Ortopedia , Osteoartritis , Humanos , Lesiones del Ligamento Cruzado Anterior/diagnóstico por imagen , Lesiones del Ligamento Cruzado Anterior/cirugía , Cartílago Articular/diagnóstico por imagen , Cartílago Articular/cirugía , Reproducibilidad de los Resultados , Reconstrucción del Ligamento Cruzado Anterior/métodos , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/cirugía , Imagen por Resonancia Magnética/métodos , Osteoartritis/cirugía , Estudios Multicéntricos como Asunto
3.
Allergol Immunopathol (Madr) ; 46(2): 175-180, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29279262

RESUMEN

BACKGROUND: Invariant natural killer T (iNKT) cells play complex functions in the immune system, releasing both Th1 and Th2 cytokines. The role of iNKT cells in human asthma is still controversial and never described in severe therapy-resistant asthma in children. The objective of this work was to analyse iNKT frequency in peripheral blood of children with severe therapy-resistant asthma (STRA), compared to children with milder asthma and healthy controls. METHODS: Children with asthma (n=136) (non-severe and STRA) from a referral centre and healthy controls (n=40) were recruited. Peripheral blood mononuclear cells were isolated, stained with anti-CD3 and anti-iNKT (Vα24Jα18), and analysed through flow cytometry. Atopic status was defined by measuring specific IgE in serum. Airway inflammation was assessed by induced sputum. RESULTS: Children with asthma presented an increased frequency of CD3+iNKT+ cells (median 0.38% IQR 0.18-1.9), compared to healthy controls (median 0.26% IQR 0.10-0.43) (p=0.025). Children with STRA also showed an increased frequency of iNKT cells (1.5% IQR 1.05-2.73) compared to healthy controls and non-severe asthmatic children (0.35% IQR 0.15-1.6; p=0.002). The frequency of iNKT cells was not different between atopic and non-atopic children. In addition, iNKT cells were not associated with any inflammatory pattern of induced sputum studied. CONCLUSION: Our data suggests that iNKT cells play a role in paediatric asthma, which is also associated with the severity of disease, but independent of the atopic status.


Asunto(s)
Asma/inmunología , Leucocitos Mononucleares/inmunología , Células T Asesinas Naturales/inmunología , Adolescente , Complejo CD3/metabolismo , Separación Celular , Células Cultivadas , Niño , Estudios Transversales , Progresión de la Enfermedad , Femenino , Citometría de Flujo , Humanos , Inmunoglobulina E/sangre , Masculino , Receptores de Antígenos de Linfocitos T/metabolismo , Esputo/inmunología
4.
Osteoarthritis Cartilage ; 25(6): 850-857, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-28043939

RESUMEN

OBJECTIVE: Meniscal tears occur frequently in patients with knee osteoarthritis (OA). The aim of our study was to determine whether meniscal damage identified on magnetic resonance imaging (MRI) is associated with the severity of knee pain or the frequency of meniscal symptoms in patients with knee OA. METHODS: We performed a cross-sectional study using data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial. We characterized meniscal damage hierarchically as: root tear; maceration; long and short complex or horizontal tears; and simple tears. Subjects completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Scale and a survey of frequency of meniscal symptoms. We used multivariable general linear models to assess the relationships between meniscal damage and 1) pain severity; and 2) meniscal symptoms, after adjusting for demographic and radiographic features. In further analysis root tear was considered as a binary variable. RESULTS: Analysis included 227 knees. Root tears were present in 19%, maceration in 14%, long complex or horizontal tears in 22%, short complex or horizontal tears in 30%, and simple tears in 14%. Root tears were associated with higher WOMAC pain scores. The adjusted mean WOMAC pain score was 45.2 (standard error (SE) 2.7) for those with root tear and 38.7 (SE 1.2) for subjects without root tear (P = 0.03). We did not find statistically significant associations between meniscal morphology and frequency of meniscal symptoms. CONCLUSION: Root tears were associated with greater pain than meniscal tears or maceration. We did not find a relationship between meniscal damage and meniscal symptoms.


Asunto(s)
Artralgia/fisiopatología , Osteoartritis de la Rodilla/fisiopatología , Lesiones de Menisco Tibial/fisiopatología , Anciano , Artralgia/etiología , Estudios Transversales , Femenino , Humanos , Modelos Lineales , Imagen por Resonancia Magnética , Masculino , Meniscos Tibiales/diagnóstico por imagen , Persona de Mediana Edad , Análisis Multivariante , Osteoartritis de la Rodilla/complicaciones , Osteoartritis de la Rodilla/diagnóstico por imagen , Dimensión del Dolor , Lesiones de Menisco Tibial/complicaciones , Lesiones de Menisco Tibial/diagnóstico por imagen
5.
Allergol Immunopathol (Madr) ; 45(5): 425-431, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28236541

RESUMEN

BACKGROUND: It is not quite well established how immune responses differ in term and preterm infants beyond the first year of life. This study aimed to evaluate aspects of the innate and adaptive immune responses in a group of preterm infants in comparison with their term peers. METHODS: In this cross-sectional study peripheral blood mononuclear cells (PBMC) were isolated from preterm and term children at age three years. Innate immune response was evaluated by the analysis of TLR receptors expression on CD11c+HLADRhigh cells and inflammatory cytokine production after PBMC stimulation with Toll like receptors (TLR) ligands. Adaptive immune response was evaluated by T cells' phenotyping and function after stimulation with polyclonal conventional T cell stimulus. CONCLUSION: We have found that the patterns of innate and adaptive immune responses at 3 years of age were not affected by the fact of the children having being born preterm or at term.


Asunto(s)
Leucocitos Mononucleares/inmunología , Nacimiento Prematuro/inmunología , Linfocitos T/inmunología , Inmunidad Adaptativa , Antígeno CD11c/metabolismo , Preescolar , Estudios Transversales , Citocinas/metabolismo , Femenino , Antígenos HLA-DR/metabolismo , Humanos , Inmunidad Innata , Inmunofenotipificación , Lactante , Recien Nacido Prematuro , Mediadores de Inflamación/metabolismo , Masculino , Receptores Toll-Like/metabolismo
6.
Allergol Immunopathol (Madr) ; 44(6): 504-511, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27707587

RESUMEN

BACKGROUND: OM-85 is an immunostimulant bacterial lysate, which has been proven effective in reducing the number of lower airways infections. We investigated the efficacy of the bacterial lysate OM-85 in the primary prevention of a murine model of asthma. METHODS: In the first phase of our study the animals received doses of 0.5µg, 5µg and 50µg of OM-85 through gavage for five days (days -10 to -6 of the protocol), 10 days prior to starting the sensitisation with ovalbumin (OVA), in order to evaluate the results of dose-response protocols. A single dose (5µg) was then chosen in order to verify in detail the effect of OM-85 on the pulmonary allergic response. Total/differential cells count and cytokine levels (IL-4, IL-5, IL-13 and IFN-γ) from bronchoalveolar lavage fluid (BALF), OVA-specific IgE levels from serum, lung function and lung histopathological analysis were evaluated. RESULTS: OM-85 did not reduce pulmonary eosinophilic response, regardless of the dose used. In the phase protocol using 5µg/animal of OM-85, no difference was shown among the groups studied, including total cell and eosinophil counts in BALF, serum OVA-specific IgE, lung histopathologic findings and lung resistance. However, OM-85 decreased IL-5 and IL-13 levels in BALF. CONCLUSIONS: OM-85, administered in early life in mice in human-equivalent doses, does not inhibit the development of allergic pulmonary response in mice.


Asunto(s)
Asma/prevención & control , Extractos Celulares/administración & dosificación , Eosinófilos/efectos de los fármacos , Animales , Asma/inmunología , Citocinas/metabolismo , Modelos Animales de Enfermedad , Eosinófilos/inmunología , Femenino , Humanos , Inmunización , Inmunoglobulina E/sangre , Ratones , Ratones Endogámicos BALB C
7.
Osteoarthritis Cartilage ; 23(4): 581-8, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25559582

RESUMEN

OBJECTIVE: To identify risk factors for radiographic signs of post-traumatic osteoarthritis (OA) 2-3 years after anterior cruciate ligament (ACL) reconstruction through multivariable analysis of minimum joint space width (mJSW) differences in a specially designed nested cohort. METHODS: A nested cohort within the Multicenter Orthopaedic Outcomes Network (MOON) cohort included 262 patients (148 females, average age 20) injured in sport who underwent ACL reconstruction in a previously uninjured knee, were 35 or younger, and did not have ACL revision or contralateral knee surgery. mJSW on semi-flexed radiographs was measured in the medial compartment using a validated computerized method. A multivariable generalized linear model was constructed to assess mJSW difference between the ACL reconstructed and contralateral control knees while adjusting for potential confounding factors. RESULTS: Unexpectedly, we found the mean mJSW was 0.35 mm wider in ACL reconstructed than in control knees (5.06 mm (95% CI 4.96-5.15 mm) vs 4.71 mm (95% CI 4.62-4.80 mm), P < 0.001). However, ACL reconstructed knees with meniscectomy had narrower mJSW compared to contralateral normal knees by 0.64 mm (95% C.I. 0.38-0.90 mm) (P < 0.001). Age (P < 0.001) and meniscus repair (P = 0.001) were also significantly associated with mJSW difference. CONCLUSION: Semi-flexed radiographs can detect differences in mJSW between ACL reconstructed and contralateral normal knees 2-3 years following ACL reconstruction, and the unexpected wider mJSW in ACL reconstructed knees may represent the earliest manifestation of post-traumatic osteoarthritis and warrants further study.


Asunto(s)
Reconstrucción del Ligamento Cruzado Anterior , Traumatismos en Atletas/cirugía , Traumatismos de la Rodilla/cirugía , Articulación de la Rodilla/diagnóstico por imagen , Meniscos Tibiales/cirugía , Adolescente , Adulto , Factores de Edad , Traumatismos en Atletas/complicaciones , Niño , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Traumatismos de la Rodilla/complicaciones , Articulación de la Rodilla/cirugía , Modelos Lineales , Estudios Longitudinales , Masculino , Meniscos Tibiales/diagnóstico por imagen , Osteoartritis de la Rodilla/epidemiología , Radiografía , Factores de Riesgo , Resultado del Tratamiento , Adulto Joven
8.
RNA Biol ; 12(8): 771-9, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26259533

RESUMEN

Over the past 10 years, it has emerged that pervasive transcription in mammalian genomes has a tremendous impact on several biological functions. Most of transcribed RNAs are lncRNAs and repetitive elements. In this review, we will detail the discovery of a new functional class of natural and synthetic antisense lncRNAs that stimulate translation of sense mRNAs. These molecules have been named SINEUPs since their function requires the activity of an embedded inverted SINEB2 sequence to UP-regulate translation. Natural SINEUPs suggest that embedded Transposable Elements may represent functional domains in long non-coding RNAs. Synthetic SINEUPs may be designed by targeting the antisense sequence to the mRNA of choice representing the first scalable tool to increase protein synthesis of potentially any gene of interest. We will discuss potential applications of SINEUP technology in the field of molecular biology experiments, in protein manufacturing as well as in therapy of haploinsufficiencies.


Asunto(s)
Biosíntesis de Proteínas , ARN sin Sentido/genética , ARN Largo no Codificante/genética , ARN Mensajero/genética , Animales , Sitios de Unión/genética , Humanos , Modelos Genéticos , ARN sin Sentido/metabolismo , ARN Largo no Codificante/metabolismo , ARN Mensajero/metabolismo , Secuencias Repetitivas de Ácidos Nucleicos/genética
9.
Exp Parasitol ; 156: 95-103, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26093162

RESUMEN

It is not currently clear whether different parasites have distinct effects on the airway inflammatory response in asthma and whether exposure in early life to helminths have a stronger impact in a potential inhibitory effect on asthma. The aim of this study is to evaluate the effect of exposure to different helminth extracts on the development of allergic pulmonary response in mice, including early-life exposure. Different helminth extracts (Angiostrongylus costaricensis, Angiostrongylus cantonensis and Ascaris lumbricoides) were studied in female adult BALB/c and C57BL/6 IL-10-deficient mice in a protocol of murine asthma, injected intraperitoneally in different periods of exposure (early, pre-sensitization and post-sensitization). Cell counts in bronchoalveolar lavage (BAL), eosinophil peroxidase (EPO) from lung tissue, cytokine levels from BAL/spleen cell cultures, and lung histology were analyzed. Airway cellular influx induced by OVA was significantly inhibited by extracts of A. cantonensis and A. lumbricoides. Extracts of A. lumbricoides and A. costaricensis led to a significant reduction of IL-5 in BAL (p < 0.001). Only the exposure to A. lumbricoides led to an increased production of IL-10 in the lungs (p < 0.001). In IL-10-deficient mice exposed to A. costaricensis pre-sensitization, eosinophil counts and IL-5 levels in BAL and EPO in lung tissue were significantly reduced. In the early exposure to A. cantonensis, lung inflammation was clearly inhibited. In conclusion, different helminth extracts inhibit allergic lung inflammation in mice. IL-10 may not play a central role in some helminth-host interactions. Early exposure to helminth extracts could be a potential strategy to explore primary prevention in asthma.


Asunto(s)
Angiostrongylus/inmunología , Ascariasis/inmunología , Ascaris lumbricoides/inmunología , Asma/inmunología , Interleucina-10/inmunología , Infecciones por Strongylida/inmunología , Factores de Edad , Angiostrongylus cantonensis/inmunología , Animales , Ascariasis/complicaciones , Asma/etiología , Asma/prevención & control , Líquido del Lavado Bronquioalveolar/citología , Líquido del Lavado Bronquioalveolar/inmunología , Recuento de Células , Citocinas/análisis , Modelos Animales de Enfermedad , Eosinófilos/citología , Femenino , Interleucina-10/deficiencia , Pulmón/patología , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Infecciones por Strongylida/complicaciones
10.
Caries Res ; 48(1): 63-8, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24217196

RESUMEN

AIM: To assess how consumption of yogurt containing Bifidobacterium animalis subsp. lactis DN-173010 probiotic for a period of 2 weeks affects salivary and dental plaque levels of mutans streptococci and lactobacilli in patients undergoing orthodontic treatment. METHODS: A crossover, double-blind, randomized and placebo-controlled clinical trial was performed with 26 volunteers. The study was divided into four periods. During periods 2 and 4, the volunteers ingested yogurt containing probiotic or control yogurt daily for 2 weeks. Periods 1 and 3 were a 1-week run-in period and 4-week washout period, respectively. Saliva and dental plaque samples were collected from each participant at the end of each period. Mutans streptococci, lactobacilli, and total cultivable microorganisms were counted. Values were compared between groups and across periods with the Wilcoxon's test. RESULTS: There was no difference between the yogurt containing probiotic and the control yogurt for any of the studied variables (all p > 0.05). A reduction in counts of total cultivable microorganisms was observed in dental plaque samples after ingestion of either yogurts (both p < 0.05 vs. baseline), but not in saliva (p < 0.05). CONCLUSION: Daily ingestion of yogurt with or without B. animalis subsp. lactis for a period of 2 weeks was beneficial in reducing total microbial counts in dental plaque. Therefore, no additional benefits were achieved by the use of the tested probiotic strain.


Asunto(s)
Bifidobacterium/fisiología , Placa Dental/microbiología , Probióticos/uso terapéutico , Saliva/microbiología , Yogur/microbiología , Adolescente , Adulto , Carga Bacteriana , Niño , Estudios Cruzados , Método Doble Ciego , Femenino , Humanos , Lactobacillus/fisiología , Masculino , Interacciones Microbianas , Placebos , Saliva/metabolismo , Tasa de Secreción/fisiología , Streptococcus mutans/fisiología , Adulto Joven
11.
Osteoarthritis Cartilage ; 21(9): 1185-90, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23973129

RESUMEN

OBJECTIVE: To evaluate if quantitative joint space width (JSW) measurements from radiographs correlate with 4-year Knee injury and Osteoarthritis Outcome Scores (KOOS) and clinical performance measures. METHOD: The study group consisted of 942 patients with symptomatic knee osteoarthritis (OA). 4-year outcomes for six measures (KOOS Pain, Symptom, Quality of Life, and Function scores, 20-m walk pace, and chair stand time) were used to create six multiple linear regression models. Primary predictors were baseline minimum JSW and 4-year change in JSW measured from fixed flexion radiographs. Age, gender, body mass index (BMI), race, knee alignment, and baseline measures of the outcomes of interest were covariates. RESULTS: Lower baseline minimum JSW and a greater decrease in 4-year JSW significantly correlated with worse 4-year KOOS Pain, Symptom, and Quality of Life. With all other factors constant, a 4.1, 4.8, and 5.6 mm lower baseline JSW correlated with a clinically significant eight-point drop in 4-year KOOS Pain, Symptom, and Quality of Life scores respectively. Additionally, a 3.5, 3.1, and 4.0 mm loss of JSW over 4 years correlated with a clinically significant eight-point drop in 4-year KOOS Pain, Symptom, and Quality of Life scores respectively. CONCLUSIONS: Our results indicate quantitative radiographic JSW measurements correlate with 4-year clinical outcomes. Since patients with narrower JSW at the onset of study had lower KOOS scores at 4 years even after controlling for 4-year change in JSW and baseline KOOS scores, clinical outcomes in knee OA may be predetermined once the disease process begins. These findings suggest early treatment with disease modifying therapies may be necessary to influence outcomes.


Asunto(s)
Artralgia/diagnóstico por imagen , Artralgia/terapia , Articulación de la Rodilla/diagnóstico por imagen , Osteoartritis de la Rodilla/diagnóstico por imagen , Osteoartritis de la Rodilla/terapia , Anciano , Artralgia/epidemiología , Índice de Masa Corporal , Bases de Datos Factuales/estadística & datos numéricos , Evaluación de la Discapacidad , Progresión de la Enfermedad , Femenino , Humanos , Modelos Lineales , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/epidemiología , Dimensión del Dolor , Calidad de Vida , Radiografía , Factores de Riesgo , Resultado del Tratamiento
12.
Osteoarthr Cartil Open ; 4(3)2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35991623

RESUMEN

Objective: To summarize the literature investigating management, treatment strategies, short- and longer-term outcomes of treatment for meniscal tear in middle-aged and older adults. Design: We performed a literature search using PubMed to identify relevant articles and selected 15 for a narrative summary on the available evidence. Results: The literature suggests that middle-age and older adults with meniscal tear may benefit from initial physical therapy (PT) potentially followed by arthroscopic partial meniscectomy (APM) for those who do not experience sufficient benefit after PT and in whom other sources of pain are deemed unlikely. There is moderate evidence to suggest that some factors at baseline, such as radiographic OA, meniscal tear type, and pain at baseline may influence outcomes after APM. Over time, APM appears to increase the risk of degenerative changes in cartilage, bone, and other knee structures as evidenced by radiograph and MRI-based assessments. Conclusion: Evidence from research investigating outcomes of treatment for meniscal tear in middle-aged and older adults demonstrates that PT is a reasonable initial treatment. More research is needed to investigate the best treatment for those who do not benefit substantially from initial PT. The evidence also demonstrates that APM may be associated with greater risk of radiographic osteoarthritic changes, though more research and the addition of enhanced quantitative MRI-assessments are needed to further detail any compositional changes in the knee. Focusing on these areas of further study will clarify whether these imaging findings are clinically meaningful.

13.
J Obstet Gynaecol ; 31(8): 743-5, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22085067

RESUMEN

Ultrasound, and in particular transvaginal sonography (TVS), plays an important role in the management of women with acute gynaecology conditions. This study compared the cost-effectiveness of two models of out-of-hours care for women in an acute gynaecology setting. In the ultrasound-based model, the on-call registrar with ultrasound experience managed such patients after performing pelvic ultrasound as a part of the initial assessment. On the other hand, in the traditional model of care the on-call registrar managed the patients without the use of ultrasound. The conclusion is that the use of ultrasound by the on-call registrars has significant cost implications through reduced hospital admissions. It leads to improved outcomes of such patients through timely diagnosis and treatment.


Asunto(s)
Enfermedades de los Genitales Femeninos/diagnóstico por imagen , Enfermedades de los Genitales Femeninos/economía , Ginecología/economía , Costos de Hospital/estadística & datos numéricos , Cuidados Nocturnos/economía , Ultrasonografía/economía , Enfermedad Aguda , Adulto , Análisis Costo-Beneficio , Femenino , Humanos , Admisión del Paciente/economía , Embarazo , Estudios Prospectivos
14.
Clin Exp Allergy ; 40(12): 1755-9, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20874832

RESUMEN

BACKGROUND: Asthma is characterized by chronic inflammation of the airways with significant changes in leucocyte trafficking, cellular activation and tissue remodelling. Brain-derived neurotrophic factor (BDNF) has been involved with asthma and allergic diseases but its role as a severity marker in paediatric asthma has not been clinically assessed. OBJECTIVES: To evaluate plasma BDNF and inflammatory markers in order to address their relationships with disease severity in children (6-15 years) with controlled persistent asthma. METHODS: Children with persistent asthma were selected and lung function and skin prick tests were performed in all patients. Plasma BDNF levels and various inflammatory markers (CCL3, CCL11, CCL22, CCL24, CXCL8, CXCL9, CXCL10, soluble TNF receptors) were assessed by ELISAs. RESULTS: Subjects with moderate and severe asthma had higher BDNF levels than mild asthma and controls (P<0.001). The chemokines studied and soluble TNF receptors did not differ between the studied groups. CONCLUSION AND CLINICAL RELEVANCE: Our results indicate BDNF as a potential biomarker for clinical severity in children with asthma.


Asunto(s)
Asma/sangre , Asma/fisiopatología , Factor Neurotrófico Derivado del Encéfalo/sangre , Índice de Severidad de la Enfermedad , Adolescente , Biomarcadores/sangre , Quimiocinas CC/sangre , Niño , Humanos , Receptores del Factor de Necrosis Tumoral/sangre
15.
Allergy ; 64(11): 1597-601, 2009 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19392986

RESUMEN

BACKGROUND: Asthma phenotypes are well described among children. However, there are few studies comparing airway inflammation in different clinical presentations of pediatric asthma. We tested the hypothesis that nonatopic asthma is associated with a predominant noneosinophilic inflammation in the airways, as assessed by induced sputum. The objective of this study was to evaluate the cytological characteristics of induced sputum (IS) in atopic (AA), nonatopic asthmatics (NAA) and nonatopic nonasthmatic children (NANA). METHODS: Of 90 selected children, 77 met eligibility criteria for performing IS and were classified as: AA, n = 28, NAA, n = 29 and NANA, n = 19. Subjects answered to a set of ISAAC-based questions and were skin-tested for common aeroallergens. A defined series of exclusion criteria was applied. RESULTS: Induced sputum was obtained from 54 (70.1%) subjects (21 AA, 20 NAA and 13 NANA). Demographic data and mean FEV(1) were similar in the three groups. The proportion of eosinophils [median, inter quartile range (IQR)] was significantly higher in the sputum of AA [(6.0.)12)] compared with NAAs [0 (2)] and NANAs [0 (1)], P < 0.001. The proportion of children with sputum eosinophilia (eos > 3%) was also significantly higher in AA (71.4%) when compared with NAA (28.6%); none of the NANA had sputum eosinophilia. Nonatopic asthmatic children had significantly higher proportions and absolute number of neutrophils than AA and controls. CONCLUSIONS: The results suggest that nonatopic children present IS with a cell pattern that is predominantly neutrophilic while eosinophilia is the hallmark of airway inflammation in the majority of atopic wheezing children not treated with inhaled steroids.


Asunto(s)
Asma/inmunología , Inflamación/inmunología , Neutrófilos/inmunología , Esputo/inmunología , Adolescente , Asma/fisiopatología , Estudios de Casos y Controles , Niño , Femenino , Humanos , Hipersensibilidad Inmediata/inmunología , Hipersensibilidad Inmediata/fisiopatología , Inflamación/fisiopatología , Masculino , Neutrófilos/citología , Esputo/citología
16.
Science ; 156(3777): 986-8, 1967 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-6023272

RESUMEN

Children of three ages were compared with adults in a recognition experiment requiring continuous processing of information. The growth in precision for visually presented words is steeper than for auditorially presented words, largely because the former are harder for the first graders and, to a lesser extent, for the third graders. In adults, visual processing of information is at least as good as auditory. The use of receiver operating characteristic curves in describing the data permit greater precision in estimating the capacity of the individual subjects and are particularly useful since the errors of failure to recognize were different from ordinary errors of false recognition, and they occurred in large numbers.


Asunto(s)
Audición , Percepción , Aprendizaje Verbal , Percepción Visual , Adulto , Percepción Auditiva , Niño , Preescolar , Humanos
17.
Science ; 237(4821): 1484-7, 1987 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-3306922

RESUMEN

Previous experiments indicated that only a small subset of the approximately equal to 24 small nuclear RNAs (snRNAs) in Saccharomyces cerevisiae have binding sites for the Sm antigen, a hallmark of metazoan small nuclear ribonucleoproteins (snRNPs) involved in pre-messenger RNA splicing. Antibodies from human serum to Sm proteins were used to show that four snRNAs (snR7, snR14, snR19, and snR20) can be immunoprecipitated from yeast extracts. Three of these four, snR7, snR14, and snR20, have been shown to be analogs of mammalian U5, U4, and U2, respectively. Several regions of significant homology to U1 (164 nucleotides) have now been found in cloned and sequenced snR19 (568 nucleotides). These include ten out of ten matches to the 5' end of U1, the site known to interact with the 5' splice site of mammalian introns. Surprisingly, the precise conservation of this sequence precludes perfect complementarity between snR19 and the invariant yeast 5' junction (GTATGT), which differs from the mammalian consensus at the fourth position (GTPuAGT).


Asunto(s)
ARN Nuclear Pequeño/análisis , Ribonucleoproteínas Nucleares Pequeñas , Saccharomyces cerevisiae/genética , Animales , Anticuerpos , Autoantígenos/metabolismo , Secuencia de Bases , Sitios de Unión , Clonación Molecular , Humanos , Conformación de Ácido Nucleico , ARN de Hongos/análisis , Proteínas Nucleares snRNP
18.
J Obstet Gynaecol ; 29(8): 681-5, 2009 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19821656

RESUMEN

Miscarriage is the most common complication of pregnancy, which creates a significant workload for health-care professionals. For decades, surgical evacuation of the uterus has remained the conventional treatment of first-trimester miscarriage. Recently, non surgical treatments have been introduced with increasing popularity. This review explores the evidence in support of expectant management of first-trimester miscarriage. It is safe, effective and well-tolerated by women. It enhances women's choice and control. It generates significant cost savings compared with the traditional surgical management. Accurate diagnosis, counselling, 24/7 telephone advice and follow-up are among the important aspects of expectant management. More studies are needed to develop methods for identifying miscarriages suitable for expectant management.


Asunto(s)
Aborto Espontáneo/terapia , Prioridad del Paciente , Primer Trimestre del Embarazo , Aborto Espontáneo/economía , Aborto Espontáneo/cirugía , Adulto , Conducta de Elección , Toma de Decisiones , Dilatación y Legrado Uterino/métodos , Femenino , Humanos , Selección de Paciente , Infección Pélvica/epidemiología , Infección Pélvica/prevención & control , Embarazo , Medición de Riesgo
19.
Braz J Med Biol Res ; 40(4): 569-76, 2007 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-17401501

RESUMEN

The role of airway inflammation in ventilated preterm newborns and the risk factors associated with the development of chronic lung disease are not well understood. Our objective was to analyze the association of the airway inflammatory response in ventilated preterm infants by serial measurements of TNF-alpha and IL-10 in tracheobronchial lavage (TBL) with perinatal factors and lung function measured early in life. A series of TBL samples were collected from ventilated preterm infants (less than 32 weeks of gestational age) and concentrations of TNF-alpha and IL-10 were measured by ELISA. Pulmonary function tests were performed after discharge by the raised volume rapid compression technique. Twenty-five subjects were recruited and 70 TBL samples were obtained. There was a significant positive association between TNF-alpha and IL-10 levels and length of time between the rupture of the amniotic membranes and delivery (r = 0.65, P = 0.002, and r = 0.57, P < 0.001, respectively). Lung function was measured between 1 and 22 weeks of corrected age in 10 patients. Multivariable analysis with adjustment for differences in lung volume showed a significant negative association between TNF-alpha levels and forced expiratory flow (FEF(50); r = -0.6; P = 0.04), FEF(75) (r = -0.76; P = 0.02), FEF(85) (r = -0.75; P = 0.03), FEF(25-75) (-0.71; P = 0.02), and FEV(0.5) (r = -0.39; P = 0.03). These data suggest that TNF-alpha levels in the airways during the first days of life were associated with subsequent lung function abnormalities measured weeks or months later.


Asunto(s)
Líquido del Lavado Bronquioalveolar/química , Interleucina-10/análisis , Respiración Artificial , Síndrome de Dificultad Respiratoria del Recién Nacido/terapia , Factor de Necrosis Tumoral alfa/análisis , Líquido del Lavado Bronquioalveolar/inmunología , Ensayo de Inmunoadsorción Enzimática , Femenino , Edad Gestacional , Humanos , Recién Nacido , Recien Nacido Prematuro , Masculino , Análisis Multivariante , Pruebas de Función Respiratoria , Factores de Riesgo
20.
Mol Biol Cell ; 10(7): 2377-91, 1999 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-10397771

RESUMEN

We have identified a mutant allele of the DAM1 gene in a screen for mutations that are lethal in combination with the mps1-1 mutation. MPS1 encodes an essential protein kinase that is required for duplication of the spindle pole body and for the spindle assembly checkpoint. Mutations in six different genes were found to be lethal in combination with mps1-1, of which only DAM1 was novel. The remaining genes encode a checkpoint protein, Bub1p, and four chaperone proteins, Sti1p, Hsc82p, Cdc37p, and Ydj1p. DAM1 is an essential gene that encodes a protein recently described as a member of a microtubule binding complex. We report here that cells harboring the dam1-1 mutation fail to maintain spindle integrity during anaphase at the restrictive temperature. Consistent with this phenotype, DAM1 displays genetic interactions with STU1, CIN8, and KAR3, genes encoding proteins involved in spindle function. We have observed that a Dam1p-Myc fusion protein expressed at endogenous levels and localized by immunofluorescence microscopy, appears to be evenly distributed along short mitotic spindles but is found at the spindle poles at later times in mitosis.


Asunto(s)
Proteínas Portadoras , Proteínas de Ciclo Celular/metabolismo , Proteínas Fúngicas/metabolismo , Proteínas Quinasas , Proteínas Serina-Treonina Quinasas/metabolismo , Proteínas Tirosina Quinasas/metabolismo , Proteínas Represoras , Proteínas de Saccharomyces cerevisiae , Huso Acromático/metabolismo , Levaduras/genética , Proteínas de Ciclo Celular/genética , Proteínas Fúngicas/genética , Genes Fúngicos , Cinesinas , Proteínas Asociadas a Microtúbulos/genética , Proteínas Asociadas a Microtúbulos/metabolismo , Mitosis , Mutación , Proteínas Nucleares/genética , Proteínas Nucleares/metabolismo , Fosfoproteínas/genética , Fosfoproteínas/metabolismo , Proteínas Serina-Treonina Quinasas/genética , Proteínas Tirosina Quinasas/genética , Temperatura , Levaduras/metabolismo
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