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1.
J Phys Chem A ; 2024 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-38981043

RESUMEN

Broadband microwave spectra of N-ethyl maleimide (NEM) and N-ethyl succinimide (NES) have been recorded using chirped pulse Fourier transform microwave spectroscopy in the Ka-band (26.5-40 GHz). The spectra for both molecules were fit to a Watson A-reduced Hamiltonian in the Ir representation to obtain best fit experimental rotational constants (NEM: A0 = 2143.1988(29), B0 = 1868.7333(22), C0 = 1082.98458(36); NES: A0 = 2061.47756(14), B0 = 1791.73517(12), C0 = 1050.31263(11)), centrifugal distortion constants, and nuclear quadrupole coupling constants. While the heavy atoms of the five-membered ring of both molecules are planar, the ethyl chain has its terminal methyl group perpendicular to the ring. Along the relaxed potential energy curve for the ethyl dihedral angle (θ1 = C(6)-C(5)-N-C(4)), the ethyl group experiences significant steric strain when it is in the plane of the ring, associated with the interaction of the ethyl group with the two carbonyl oxygens. This leads to calculated barriers of θ1 = 1469 cm-1 and θ1 = 1680 cm-1 in N-ethyl maleimide and N-ethyl succinimide, respectively.

2.
Nanoscale Horiz ; 2024 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-38808602

RESUMEN

2D materials, given their form-factor, high surface-to-volume ratio, and chemical functionality have immense use in sensor design. Engineering 2D heterostructures can result in robust combinations of desirable properties but sensor design methodologies require careful considerations about material properties and orientation to maximize sensor response. This study introduces a sensor approach that combines the excellent electrical transport and transduction properties of graphite film with chemical reactivity derived from the edge sites of semiconducting molybdenum disulfide (MoS2) through a two-step chemical vapour deposition method. The resulting vertical heterostructure shows potential for high-performance hybrid chemiresistors for gas sensing. This architecture offers active sensing edge sites across the MoS2 flakes. We detail the growth of vertically oriented MoS2 over a nanoscale graphite film (NGF) cross-section, enhancing the adsorption of analytes such as NO2, NH3, and water vapor. Raman spectroscopy, density functional theory calculations and scanning probe methods elucidate the influence of chemical doping by distinguishing the role of MoS2 edge sites relative to the basal plane. High-resolution imaging techniques confirm the controlled growth of highly crystalline hybrid structures. The MoS2/NGF hybrid structure exhibits exceptional chemiresistive responses at both room and elevated temperatures compared to bare graphitic layers. Quantitative analysis reveals that the sensitivity of this hybrid sensor surpasses other 2D material hybrids, particularly in parts per billion concentrations.

3.
Adv Biol (Weinh) ; 8(6): e2400069, 2024 06.
Artículo en Inglés | MEDLINE | ID: mdl-38548661

RESUMEN

Engagement in physical activity, across various sports, promotes a diverse microbiota in active individuals. This study examines the gut microbiota of Colombian athletes, specifically weightlifters (n = 16) and road cyclists (n = 13), compared to non-athletes (n = 15). Using Kruskal-Wallis tests, the physical activity level of a group of non-athletic individuals and the sports experience of a group of professional athletes is analyzed. The median age of participants is 24 years, comprising 25 men and 19 women. The microbiota is collected using fecal samples. Participants provided these samples during their pre-competitive stage, specifically during the concentration phase occurring two weeks prior to national competitions. This timing is chosen to capture the microbial composition during a period of heightened physical preparation. Questionnaire responses and microbial composition assessments identify disparities among groups. Microbial composition analysis explores core microbiome, abundance, and taxonomy using Pavian, MicrobiomeAnalyst 2.0, and GraPhlAn. ANCOM-BC2 reveals differentially abundant species. Road cyclists exhibit decreased Bacteria and increased Archaea abundance. Phylum-level variations included Planctomycetes, Acidobacteria, and Proteobacteria, while Bacteroidetes prevailed. Key families influencing gut microbiota are Bacteroidaceae, Muribaculaceae, and Selenomonadaceae. Weightlifters exhibit unique viral and archaeal community connections, while cyclists showed specialized microbial interplay influenced by endurance exercise. Correlation network analysis emphasizes distinctive microbial interactions within athlete groups, shedding light on the impact of physical activities on gut microbiota and athlete health.


Asunto(s)
Archaea , Atletas , Bacterias , Ciclismo , Microbioma Gastrointestinal , Humanos , Microbioma Gastrointestinal/fisiología , Masculino , Femenino , Colombia , Adulto , Atletas/estadística & datos numéricos , Archaea/aislamiento & purificación , Adulto Joven , Bacterias/clasificación , Bacterias/aislamiento & purificación , Bacterias/genética , Levantamiento de Peso/fisiología , Heces/microbiología
4.
Hipertens Riesgo Vasc ; 41(2): 132-134, 2024.
Artículo en Español | MEDLINE | ID: mdl-38472008

RESUMEN

Hypertriglyceridemia encompasses a set of lipid disorders common in clinical practice, generally defined as a fasting concentration above 150mg/dL. There are various classifications of the severity of hypertriglyceridaemia based on serum values, with levels generally considered moderate when below 500mg/dL and severe when above 1000mg/dL. Its importance lies in its association with other alterations in the lipid profile, contributing to increased cardiovascular risk and increased risk of acute pancreatitis, mainly with concentrations above 500mg/dL.


Asunto(s)
Hipertrigliceridemia , Pancreatitis , Humanos , Pancreatitis/genética , Pancreatitis/complicaciones , Enfermedad Aguda , Triglicéridos , Hipertrigliceridemia/genética , Hipertrigliceridemia/complicaciones
5.
Artículo en Inglés | MEDLINE | ID: mdl-38530791

RESUMEN

OBJECTIVES: The European Alliance of Associations for Rheumatology (EULAR) supports the use of nailfold videocapillaroscopy (NVC) to identify disease patterns (DPs) associated with systemic sclerosis (SSc) and Raynaud's phenomenon (RP). Recently, EULAR proposed an easy-to-manage procedure, a so-called Fast Track algorithm, to differentiate SSc from non-SSc patterns in NVC specimens. However, subjectivity among capillaroscopists remains a limitation. Our aim was to perform a software-based analysis of NVC peculiarities in a cohort of samples from SSc and RP patients and, subsequently, build a Fast Track-inspired algorithm to identify DPs without the constraint of interobserver variability. METHODS: NVCs were examined by 9 capillaroscopists. Those NVCs whose DPs were consensually agreed (≥2 out of 3 interobservers) were subsequently analysed with an in-house developed software. Each variable's results were grouped according to the consensually agreed DPs in order to identify useful hallmarks to categorise them. RESULTS: Eight-hundred and fifty-one NVCs (21 957 images) whose DPs had been consensually agreed were software-analysed. Appropriate cut-offs set in capillary density and percentage of abnormal and giant capillaries, tortuosities and hemorrhages allowed DP categorization and the development of the CAPI-Score algorithm. This consisted of 4 rules: Rule 1, SSc vs non-SSc, accuracy 0.88; Rules 2 and 3, SSc-early vs SSc-active vs SSc-late, accuracy 0.82; Rule 4, non-SSc normal vs non-SSc non-specific, accuracy 0.73. Accuracy improved when the analysis was limited to NVCs whose DPs had achieved full consensus among interobservers. CONCLUSIONS: The CAPI-Score algorithm may become a useful tool to assign DPs by overcoming the limitations of subjectivity.

6.
Nanoscale Horiz ; 9(4): 589-597, 2024 03 25.
Artículo en Inglés | MEDLINE | ID: mdl-38329118

RESUMEN

Brain states such as sleep, anesthesia, wakefulness, or coma are characterized by specific patterns of cortical activity dynamics, from local circuits to full-brain emergent properties. We previously demonstrated that full-spectrum signals, including the infraslow component (DC, direct current-coupled), can be recorded acutely in multiple sites using flexible arrays of graphene solution-gated field-effect transistors (gSGFETs). Here, we performed chronic implantation of 16-channel gSGFET arrays over the rat cerebral cortex and recorded full-band neuronal activity with two objectives: (1) to test the long-term stability of implanted devices; and (2) to investigate full-band activity during the transition across different levels of anesthesia. First, we demonstrate it is possible to record full-band signals with stability, fidelity, and spatiotemporal resolution for up to 5.5 months using chronic epicortical gSGFET implants. Second, brain states generated by progressive variation of levels of anesthesia could be identified as traditionally using the high-pass filtered (AC, alternating current-coupled) spectrogram: from synchronous slow oscillations in deep anesthesia through to asynchronous activity in the awake state. However, the DC signal introduced a highly significant improvement for brain-state discrimination: the DC band provided an almost linear information prediction of the depth of anesthesia, with about 85% precision, using a trained algorithm. This prediction rose to about 95% precision when the full-band (AC + DC) spectrogram was taken into account. We conclude that recording infraslow activity using gSGFET interfaces is superior for the identification of brain states, and further supports the preclinical and clinical use of graphene neural interfaces for long-term recordings of cortical activity.


Asunto(s)
Grafito , Ratas , Animales , Encéfalo , Corteza Cerebral/fisiología , Neuronas/fisiología , Vigilia/fisiología
7.
Rev Esp Quimioter ; 37(1): 93-96, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37925628

RESUMEN

OBJECTIVE: Non-albicans Candida species, such as Candida kefyr, are emerging pathogens. Chromogenic media are highly useful for the diagnosis of urinary tract infections (UTIs). The aim was to describe the behavior of this specie on a non-specific chromogenic medium. METHODS: A retrospective study of cases of candiduria detected in the Microbiology laboratory of the Virgen de las Nieves Hospital in Granada (Spain) between 2016 and 2021 (N=2,130). Urine samples were quantitatively seeded on non-selective UriSelect™4 chromogenic agar. RESULTS: Between 2016 and 2021, C. kefyr was the seventh most frequent Candida species responsible for candiduria in our setting (n=15). The macroscopic appearance of C. kefyr colonies, punctiform and bluish, allowed the direct identification of these microorganisms. CONCLUSIONS: This study provides the first description of the specific behavior of C. kefyr on UriSelect™4 agar, which differentiates it from other Candida species based on its enzymatic characteristics.


Asunto(s)
Candidiasis , Kluyveromyces , Infecciones Urinarias , Humanos , Agar , Medios de Cultivo , Estudios Retrospectivos , Candida , Candidiasis/diagnóstico , Candidiasis/microbiología , Infecciones Urinarias/microbiología
8.
Autoimmun Rev ; 22(11): 103441, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37708984

RESUMEN

OBJECTIVE: To analyze the effectiveness and safety of intravenous immunoglobulin (IVIG) given in routine care to patients with systemic sclerosis (SSc). METHODS: A retrospective multicenter observational study was conducted in SSc patients treated with IVIG. We collected data on epidemiological parameters and clinical outcomes. Firstly, we assessed changes in organ manifestations during IVIG treatment. Secondly, we analyzed the frequency of adverse effects. The following parameters were collected from baseline to the last follow-up: the patient's weight, modified Rodnan Skin Score (mRSS), modified manual muscle strength scale (MRC), laboratory test(creatine kinase(CK), hemoglobin and protein levels), The University of California Los Angeles Scleroderma Clinical Trials Consortium gastrointestinal tract 2.0 (UCLA GIT 2.0) questionnaire, pulmonary function tests, and echocardiography. RESULTS: Data were collected on 78 patients (82% females; 59% with diffuse SSc). Inflammatory idiopathic myopathy was the most frequent concomitant overlap disease (41%). The time since Raynaud's phenomenon and SSc onset were 8.8 ± 18 and 6.2 ± 6.7 years respectively. The most frequent IVIG indication was myositis (38/78), followed by gastrointestinal (27/78) and cutaneous (17/78) involvement. The median number of cycles given were 5. 54, 53 and 9 patients have been treated previously with glucocorticoids, synthetic disease-modifying antirheumatic drugs and biologic therapies respectively. After IVIG use we found significant improvements in muscular involvement (MRC ≥ 3/5 92% IVIG, p = 0.001 and CK levels from 1149 ± 2026 UI to 217 ± 224 UI, p = 0.02), mRSS (15 ± 12.4 to 13 ± 12.5, p = 0.015) and improvement in total score of UCLA GIT 2.0 (p = 0.05). None Anti-RNA polymerase III patients showed an adequate response in gastrointestinal involvement (0/7) in comparison with other antibodies (0 vs. 25, p = 0,039). Cardiorespiratory involvement remained stable. A total of 12 adverse events were reported with only one withdrawn due to serious adverse effect. CONCLUSIONS: this study suggest that IVIG may improve myositis, gastrointestinal and skin involvement in SSc patients treated in routine care and seems to have a good safety profile.


Asunto(s)
Miositis , Esclerodermia Sistémica , Femenino , Humanos , Masculino , Inmunoglobulinas Intravenosas/uso terapéutico , Esclerodermia Sistémica/complicaciones , Esclerodermia Sistémica/tratamiento farmacológico , Estudios Retrospectivos , Piel , Miositis/tratamiento farmacológico , Estudios Multicéntricos como Asunto , Estudios Observacionales como Asunto
10.
Horiz. med. (Impresa) ; 23(3)jul. 2023.
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1514223

RESUMEN

Objetivo: Identificar las causas de exclusión de los donantes renales vivos en un centro hospitalario de tercer nivel en el noroeste de México. Materiales y métodos: Estudio de tipo observacional, transversal, descriptivo, retrospectivo. Se realizó la evaluación de los expedientes clínicos de los candidatos vivos para donación renal, que abarcó el periodo comprendido entre el 1 de enero de 2019 y el 31 de diciembre de 2021. Resultados: De los 30 expedientes seleccionados, solo se eligieron 2 (6,6 %) donadores, es decir, existió un índice de rechazo de 28 (93,3 %) de los potenciales candidatos. La edad promedio fue de 40,7 años; al dividirlos en grupos de edad, se observó que el 7,44 % fueron ≤39 años; el 5,31 %, ≥50 años; y el 4,25 %, de 40 a 49 años. Dentro de las principales patologías que originaron el rechazo del donador vivo se encuentran las enfermedades crónicas, como afección renal desconocida, obesidad, diabetes mellitus, hipertensión arterial sistémica y cardiopatías, que representaron el 60,7 %. El deseo de donar es más frecuente entre consanguíneos que en no consanguíneos. En el caso de los consanguíneos, es decir, hermanos, padres, hijos, tíos, etc., el 64,2 % fue rechazado; en los no consanguíneos, el 34,7 %, que incluía a esposos y amigos. Conclusiones: Los resultados obtenidos sobre el índice de masa corporal (IMC) mostraron que el sobrepeso y la obesidad fueron las principales causas de exclusión, circunstancia que es particular en nuestro país respecto a su perfil epidemiológico. La cantidad de donantes vivos en nuestro centro se redujo porque la mayor parte de la población no es sana, padece obesidad y ello repercute al momento de presentarse como candidato a donante.


Objective: To identify the causes for exclusion of living kidney donors at a third-level hospital in northwestern Mexico. Materials and methods: An observational, cross-sectional, descriptive and retrospective study, in which the medical records of candidates for living kidney donation were evaluated from January 1, 2019 to December 31, 2021. Results: Out of the 30 selected records, only 6.6 % (2) were chosen as donors, i.e., the rejection rate of the potential candidates was 93.3 % (28). The average age was 40.7 years; when divided into age groups, it was observed that 7.44 % were ≤ 39 years, 5.31 % were ≥ 50 years and 4.25 % were in the 40-49 age range. The main pathologies that caused the rejection of living donors were chronic diseases such as unknown renal disease, obesity, diabetes mellitus, systemic hypertension and heart diseases, which accounted for 60.7 %. The desire to donate was more frequent among blood relatives than non-blood relatives. In the case of blood relatives, i.e., siblings, parents, children, uncles, aunts, etc., 64.2 % were rejected, while 34.7 % of non-blood relatives, including spouses and friends, were rejected. Conclusions: Based on the body mass index (BMI), the results showed that overweight and obesity were the main causes of exclusion, a situation that is consistent with the Mexican epidemiological profile. The number of living donors at our center has been reduced because most of the population is not healthy and has obesity, which affects the willingness to be a candidate for living kidney donation.

11.
Braz J Microbiol ; 54(2): 691-701, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37131105

RESUMEN

Bacterial resistance to multiple drugs is a worldwide problem that afflicts public health. Various studies have shown that silver nanoparticles are good bactericidal agents against bacteria due to the adherence and penetration of the external bacterial membrane, preventing different vital functions and subsequently bacterial cell death. A systematic review of ScienceDirect, PubMed, and EBSCOhost was conducted to synthesize the literature evidence on the association between the bactericidal property of silver nanoparticles on both resistant Gram-positive and Gram-negative bacteria. Eligible studies were original, comparative observational studies that reported results on drug-resistant bacteria. Two independent reviewers extracted the relevant information. Out of the initial 1 420, 142 studies met the inclusion criteria and were included to form the basis of the analysis. Full-text screening led to the selection of 6 articles for review. The results of this systematic review showed that silver nanoparticles act primarily as bacteriostatic agents and subsequently as bactericides, both in Gram-positive and Gram-negative drug-resistant bacteria.


Asunto(s)
Antibacterianos , Nanopartículas del Metal , Antibacterianos/farmacología , Plata/farmacología , Bacterias Gramnegativas , Bacterias Grampositivas , Bacterias , Pruebas de Sensibilidad Microbiana
12.
Food Chem ; 423: 136303, 2023 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-37182489

RESUMEN

Recently, pulse ingredients with (partial) cellular intactness are put forward as promising innovative food ingredients with slowed macronutrient digestibility. This study compared cooking quality and nutrient (starch, protein, and mineral) digestibility/bioaccessibility of lentil-based pasta prepared from 100% raw-milled flour, and by substituting 30% of the formulation by isolated cotyledon cell powder or whole precooked powder. Formulation had little effect on cooking properties. Both amylolysis and proteolysis were significantly slowed by incorporating cellular ingredients: towards the end of simulated digestion, amylolysis was lowered by 16-25%, while differences in proteolysis became small. Cellular ingredient incorporation slightly decreased Zn and Mg but did not affect Ca and Fe bioaccessibility, overall yielding a low mineral bioaccessibility comparable to cooked whole pulses. To conclude, lentil-based pasta substituted with cellular ingredients showed improved nutritional properties (i.e., high in digestible protein and slowed amylolysis), with perspectives for the development of different innovative foods with targeted nutritional properties.


Asunto(s)
Lens (Planta) , Polvos , Nutrientes , Culinaria , Harina/análisis , Minerales , Almidón , Digestión
13.
Hipertens Riesgo Vasc ; 40(4): 222-224, 2023.
Artículo en Español | MEDLINE | ID: mdl-37169712

RESUMEN

Approximately 10% of cases of arterial hypertension are due to a secondary cause, being among the most frequent primary hyperaldosteronism, characterized by hypertension, metabolic alkalosis and hypokalemia. However, on rare occasions it can present in an atypical way, in the form of muscle weakness and myalgia secondary to rhabdomyolysis due to severe hypokalemia, as in the case described.


Asunto(s)
Hiperaldosteronismo , Hipertensión , Hipopotasemia , Rabdomiólisis , Humanos , Hipopotasemia/etiología , Hiperaldosteronismo/complicaciones , Hiperaldosteronismo/diagnóstico , Hipertensión/complicaciones , Rabdomiólisis/complicaciones
15.
Rev Esp Quimioter ; 36(3): 275-281, 2023 Jun.
Artículo en Español | MEDLINE | ID: mdl-36869611

RESUMEN

OBJECTIVE: Chronic bacterial prostatitis (CBP) is an entity of difficult clinical diagnosis and treatment, being the microbiological study of semen the main diagnostic test. This study aimed to determine the etiology and antibiotic resistance in patients with symptomatic bacteriospermia (SBP) in our environment. METHODS: A cross-sectional and retrospective descriptive study has been carried out from a Regional Hospital of the Spanish Southeast. The participants were patients assisted in the consultations of the Hospital with clinic compatible with CBP, between 2016 and 2021. The interventions were collection and analysis of the results derived from the microbiological study of the semen sample. The main determinations were the etiology and rate of antibiotic resistance of BPS episodes are analyzed. RESULTS: The main isolated microorganism is Enterococcus faecalis (34.89%), followed by Ureaplasma spp. (13.74%) and Escherichia coli (10.98%). The rate of antibiotic resistance of E. faecalis to quinolones (11%) is lower than previous studies, while for E. coli it has been higher (35%). The low rate of resistance shown by E. faecalis and E. coli to fosfomycin and nitrofurantoin stands out. CONCLUSIONS: In the SBP, gram-positive and atypical bacteria are established as the main causative agents of this entity. This forces us to rethink the therapeutic strategy used, which will avoid the increase in antibiotic resistance, recurrences, and chronicity of this pathology.


Asunto(s)
Antibacterianos , Prostatitis , Masculino , Humanos , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Escherichia coli , Estudios Retrospectivos , Estudios Transversales , España/epidemiología , Prostatitis/tratamiento farmacológico , Prostatitis/epidemiología , Prostatitis/microbiología , Farmacorresistencia Microbiana
16.
Mikrochim Acta ; 190(4): 160, 2023 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-36973585

RESUMEN

Two colorimetric nanostructured sensor phases (Color-NSPs) for the determination of low concentrations of acid vapors in the atmosphere of paper storage rooms have been designed and characterized. The acid vapor determination is based on the color change that occurs in polyaniline (PANI) in the presence of acids when it goes from its emeraldine base form (blue) to its emeraldine salt form (green). To synthesize the Color-NSPs, two methods have been used, a one-step method performed by grafting polyaniline onto a cellulose membrane (Cellu-PANI) and a two-step method in which in the first step, polyaniline is grafted onto the surface of polymeric nanoparticles (NPs-PANI), and in a second step, NPs-PANI are immobilized into the pores of a nylon membrane (Nylon-NPs PANI). The response of the sensors versus acid vapor was measured by color coordinates with a photographic camera. A linear response range from 1 ppmv to 7 ppmv was found for both sensors, and the detection limits were 0.95 ppmv (1.2 % RSD) and 0.40 ppmv (0.8 % RSD) for Cellu-PANI and Nylon-NPs PANI, respectively. In addition, both sensors showed complete reversibility and a short exposition time (5 min). The potential applicability of the Color-NSPs in the control of the exposure of paper heritage collections to outdoor- and indoor-generated gaseous pollutants was demonstrated by determining acid vapors in museums. The method was validated with an external reference method; the paired test was applied, and p-values greater than 5% were obtained, indicating an excellent correlation and showing that the Color-NSPs reported are simple, fast, and an economical alternative to control and protect cultural heritage materials in indoor environments.

17.
Mar Pollut Bull ; 189: 114723, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36848787

RESUMEN

Environmental assessment in marine systems is difficult because most of the time their preindustrial characteristics are not available. Four sediment cores taken in Mejillones bay (northern Chile) were used to establish preindustrial metals concentrations, and to assess the environmental status of this industrialized zone. According to historical documents, the beginning of the industrial era start in 1850 CE. Considering this, the preindustrial concentration of some metals was established, by mean of a statistical approach. Most of the metals increase their concentration from the preindustrial to the industrial period. Environmental assessment showed an enrichment of Zr and Cr, a moderately polluted condition, and a low probability of toxic effect on the biological communities. The preindustrial values derived from sediment cores are a good tool to evaluate the environmental condition of Mejillones bay. However new information (backgrounds with a higher spatial representativity, toxicological threshold, and others) it is necessary to improve the environmental assessment of this environment.


Asunto(s)
Metales Pesados , Contaminantes Químicos del Agua , Humanos , Sedimentos Geológicos , Bahías , Chile , Contaminantes Químicos del Agua/análisis , Monitoreo del Ambiente , Metales/análisis , Medición de Riesgo , Metales Pesados/análisis , China
19.
Curr Treatm Opt Rheumatol ; 9(4): 151-167, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38737329

RESUMEN

Purpose of review: Systemic sclerosis (SSc) and myositis are two different entities that may coexist as an overlap syndrome. Immunological biomarkers such as anti-PM/Scl or anti-Ku reinforce the syndrome. This review is focused on the treatment of different and characteristic manifestations of this syndrome. Recent findings: Among the different phenotypes of muscle involvement in patients with SSc, the fibrotic pattern and the sporadic inclusion body myositis must be identified early to avoid a futile immunosuppressive treatment. Other forms such as dermatomyositis, non-specific myositis and immune-mediated necrotizing myopathy need to receive conventional immunosuppressive therapy considering that high dose of glucocorticoids may induce a scleroderma renal crisis in patients with SSc. Physicians must be aware of the existence of a "double trouble" association of hereditary myopathy with an autoimmune phenomenon. Several autoantibodies, mainly anti-PM/Scl and anti-Ku may help to define specific phenotypes with characteristic clinical manifestations that need a more specific therapy. Vasculopathy is one of the underlying mechanisms that link SSc and myositis. Recent advances in this topic are reviewed. Summary: Current treatment of SSc associated myopathy must be tailored to specific organs involved. Identifying the specific clinical, pathological, and immunological phenotypes may help to take the correct therapeutic decisions.

20.
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1515157

RESUMEN

Introducción: Si bien la primera causa de crisis epilépticas en la población adulta mayor es el accidente cerebrovascular, un importante diagnóstico diferencial corresponde al limb shaking syndrome, una manifestación clínica particular de un accidente isquémico transitorio. Caso clínico: Se describe entonces el caso de un hombre chileno de 62 años de edad que sufre una crisis focal motora sin alteración de conciencia con evidencia imagenológica de injuria isquémica de unos 10 días de antigüedad y de estenosis carotídea significativa, la cual es manejada quirúrgicamente. Discusión: Existen diferentes elementos que pueden distinguir una crisis epiléptica de un limb shaking sryndrome. La fisiopatología de la primera corresponde un fenómeno irritativo post isquémico con una clara manifestación electroencefalográfica, mientras que la segunda es producida por hipoperfusión relativa gatillada por ortostatismo en el contexto de una enfermedad carotídea oclusiva. El cuadro clínico del paciente se consideró más compatible con una crisis epiléptica que con un limb shaking syndrome.


Introduction: Although the leading cause of seizures in the older adult population is cerebrovascular accident, limb shaking syndrome is an important differential diagnosis, being a particular clinical manifestation of a transient ischemic attack. Clinical case: We thus describe a clinical case of a 62-year-old Chilean man who suffers a simple focal motor epileptic seizure, with imaging evidence of ischemic injury about 10 days old and significant carotid stenosis which is managed surgically. Discussion: There are different elements that can distinguish an epileptic seizure from a limb shaking syndrome. The pathophysiology of the first corresponds to a post-ischemic irritative phenomenon with a clear electroencephalographic manifestation, while the second is produced by relative hypoperfusion triggered by orthostatism in the context of carotid occlusive disease. The patient's clinical picture was considered more compatible with an epileptic seizure than with a limb shaking syndrome syndrome.

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