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1.
J Clin Gastroenterol ; 56(2): e98-e108, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33405435

RESUMO

BACKGROUND: Managing Helicobacter pylori infection requires constant decision making, and each decision is open to possible errors. AIM: The aim was to evaluate common mistakes in the eradication of H. pylori, based on the "European Registry on Helicobacter pylori management". METHODS: European Registry on Helicobacter pylori management is an international multicentre prospective noninterventional registry evaluating the decisions and outcomes of H. pylori management by European gastroenterologists in routine clinical practice. RESULTS: Countries recruiting more than 1000 patients were included (26,340 patients). The most common mistakes (percentages) were: (1) To use the standard triple therapy where it is ineffective (46%). (2) To prescribe eradication therapy for only 7 to 10 days (69%). (3) To use a low dose of proton pump inhibitors (48%). (4) In patients allergic to penicillin, to prescribe always a triple therapy with clarithromycin and metronidazole (38%). (5) To repeat certain antibiotics after eradication failure (>15%). (6) Failing to consider the importance of compliance with treatment (2%). (7) Not to check the eradication success (6%). Time-trend analyses showed progressive greater compliance with current clinical guidelines. CONCLUSION: The management of H. pylori infection by some European gastroenterologists is heterogeneous, frequently suboptimal and discrepant with current recommendations. Clinical practice is constantly adapting to updated recommendations, although this shift is delayed and slow.


Assuntos
Infecções por Helicobacter , Helicobacter pylori , Amoxicilina , Antibacterianos , Claritromicina/farmacologia , Claritromicina/uso terapêutico , Quimioterapia Combinada , Infecções por Helicobacter/tratamento farmacológico , Humanos , Metronidazol/farmacologia , Metronidazol/uso terapêutico , Estudos Prospectivos , Inibidores da Bomba de Prótons , Sistema de Registros
2.
Helicobacter ; 25(3): e12686, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32173974

RESUMO

BACKGROUND: Experience in Helicobacter pylori eradication treatment of patients allergic to penicillin is very scarce. A triple combination with a PPI, clarithromycin (C), and metronidazole (M) is often prescribed as the first option, although more recently the use of a quadruple therapy with PPI, bismuth (B), tetracycline (T), and M has been recommended. AIM: To evaluate the efficacy and safety of first-line and rescue treatments in patients allergic to penicillin in the "European Registry of H pylori management" (Hp-EuReg). METHODS: A systematic prospective registry of the clinical practice of European gastroenterologists (27 countries, 300 investigators) on the management of H pylori infection. An e-CRF was created on AEG-REDCap. Patients with penicillin allergy were analyzed until June 2019. RESULTS: One-thousand eighty-four patients allergic to penicillin were analyzed. The most frequently prescribed first-line treatments were as follows: PPI + C + M (n = 285) and PPI + B + T + M (classic or Pylera® ; n = 250). In first line, the efficacy of PPI + C + M was 69%, while PPI + B + T + M reached 91% (P < .001). In second line, after the failure of PPI + C + M, two rescue options showed similar efficacy: PPI + B + T + M (78%) and PPI + C + levofloxacin (L) (71%) (P > .05). In third line, after the failure of PPI + C + M and PPI + C + L, PPI + B + T + M was successful in 75% of cases. CONCLUSION: In patients allergic to penicillin, a triple combination with PPI + C + M should not be generally recommended as a first-line treatment, while a quadruple regimen with PPI + B + T + M seems to be a better option. As a rescue treatment, this quadruple regimen (if not previously prescribed) or a triple regimen with PPI + C + L could be used but achieved suboptimal (<80%) results.


Assuntos
Hipersensibilidade a Drogas , Quimioterapia Combinada , Infecções por Helicobacter/tratamento farmacológico , Penicilinas/efeitos adversos , Antibacterianos/uso terapêutico , Bismuto/uso terapêutico , Claritromicina/uso terapêutico , Helicobacter pylori/efeitos dos fármacos , Humanos , Levofloxacino/uso terapêutico , Metronidazol/uso terapêutico , Penicilinas/uso terapêutico , Estudos Prospectivos , Inibidores da Bomba de Prótons/uso terapêutico , Sistema de Registros/estatística & dados numéricos , Tetraciclina/uso terapêutico
3.
Environ Res ; 184: 109341, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32179266

RESUMO

Autism spectrum disorder (ASD) is a complex neurodevelopmental pathology characterized by altered verbalizations, reduced social interaction behavior, and stereotypies. Environmental factors have been associated with its development. Some researchers have focused on pesticide exposure. Chlorpyrifos (CPF) is the most used Organophosphate. Previous developmental studies with CPF showed decreased, enhanced or no effect on social outcomes eminently in mice. The study of CPF exposure during preweaning stages on social behavior is sparse in mice and non-existent in rats. d stressors could be at the basis of ASD development, and around postnatal day 10 in the rat is equivalent to the human birthday in neurodevelopmental terms. We explored the effects of exposure to low doses (1mg/kg/mL/day) of CPF during this stage regarding: sociability, dominance gut microbiome and plasma metabolomic profile, since alterations in these systems have also been linked to ASD. There was a modest influence of CPF on social behavior in adulthood, with null effects during adolescence. Dominance and hierarchical status were not affected by exposure. Dominance status explained the significant reduction in reaction to social novelty observed on the sociability test. CPF induced a significant gut microbiome dysbiosis and triggered a hyperlipidemic, hypoglycemic/hypogluconeogenesis and a general altered cell energy production in females. These behavioral results in rats extend and complement previous studies with mice and show novel influences on gut metagenomics and plasma lipid profile and metabolomics, but do not stablish a relation between the exposure to CPF and the ASD phenotype. The effects of dominance status on reaction to social novelty have an important methodological meaning for future research on sociability.


Assuntos
Transtorno do Espectro Autista , Clorpirifos , Microbioma Gastrointestinal , Inseticidas , Adulto , Animais , Transtorno do Espectro Autista/induzido quimicamente , Clorpirifos/toxicidade , Feminino , Humanos , Inseticidas/toxicidade , Camundongos , Ratos , Comportamento Social
4.
J Phys Chem A ; 123(4): 943-950, 2019 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-30649880

RESUMO

Most of the algorithms employed in diffusion NMR are optimization methods based on diverse regularized methods such as Tikhonov's, which decomposes the multiexponential detected signal attenuation as a sum of mono exponential signals. Our approach uses projections over hyperplanes of the Hilbert space using a Laplace transform kernel, which is a special case of projection onto convex sets. This new application of an algebraic reconstruction technique for diffusion NMR experiments (dART) has been applied for the first time in both simulated and real systems, and then compared with established methods such as ITAMeD and TRAIn. The new algorithm provides excellent results in systems with overlapped signals and more importantly performs more rapidly than any other one assayed. One of the main advantages is that the reported method does not need a regularization parameter, which allows one to explore the largest spaces. In addition, we have provided the calibration curve for weight-average Mw prediction of poly(propylene) polymers with no dependence on the solvent used.

5.
Plant Foods Hum Nutr ; 74(1): 40-46, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30324543

RESUMO

Plants, including most food and feed plants, produce a broad range of bioactive chemical compounds. Among these compounds, polyphenols are reported to provide beneficial effects as anti-carcinogenic, anti-atherogenic, anti-inflammatory, immune modulating, anti-microbial, vasodilatory and analgesic. Cocoa (Theobroma cacao), a major, economically important, international crop, has been related to several nutritional benefits, which have been associated with the phenolic fraction. The main subclass of flavonoids found in cocoa is flavanols, particularly (epi)catechins monomers, and their oligomers, also known as procyanidins. In this study, these compounds were isolated by different methodologies as solid phase extraction (SPE), semi-preparative high-performance liquid chromatography (HPLC) and membrane technologies to obtain different polyphenolic profiles by HPLC coupled to electrospray time-of-flight mass spectrometry (ESI-TOF-MS) and to test their cytotoxicity. Finally, different polyphenolic profiles were collected, where the combination of both semi-preparative HPLC and SPE technologies provided the most purified fractions. Filtration with membranes and SPE provide extracts with different composition depending on the pore size of membranes and on the solvent, respectively. In addition, the results of toxicity assay indicated low levels in all fractions.


Assuntos
Cacau/química , Flavonoides/isolamento & purificação , Compostos Fitoquímicos/isolamento & purificação , Extração em Fase Sólida/métodos , Cromatografia Líquida de Alta Pressão , Flavonoides/toxicidade , Inocuidade dos Alimentos , Análise de Perigos e Pontos Críticos de Controle , Humanos , Compostos Fitoquímicos/toxicidade , Polifenóis/isolamento & purificação , Polifenóis/toxicidade , Proantocianidinas/isolamento & purificação , Proantocianidinas/toxicidade , Espectrometria de Massas por Ionização por Electrospray
6.
Analyst ; 143(19): 4707-4714, 2018 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-30183032

RESUMO

Quantitative boron-11 NMR (11B qNMR) spectroscopy has been introduced for the first time as a method to determine boric acid content in commercial biocides. Validation of the method affords a limit of detection of 0.02% w/w and a limit of quantification of 0.04% w/w, which are low enough to determine boric acid in commercial biocides. Other figures of merit such as linearity (R2 > 0.99), recovery (93.6%-106.2%), intra- and inter-day precision (from 0.7 to 2.0%), uncertainty (3.7 to 4.4%) and matrix effects were also evaluated. This method was successfully applied to determine boric acid in five different commercial biocides in a wide range of concentrations (<0.05 to 10% w/w) providing excellent results when they were compared with those obtained using inductively coupled plasma-mass spectrometry (ICP-MS). The suitability of this method for a fast and reliable quantification of boric acid in commercial biocide preparations has been demonstrated. The absence of the matrix effect allows the application of this validated method for the determination of boric acid in other matrices of diverse composition.

7.
Anal Bioanal Chem ; 410(15): 3607-3619, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29629503

RESUMO

Annona cherimola Mill. (cherimoya) has widely been used as food crop. The leaves of this tree possess several health benefits, which are, in general, attributed mainly to its bioactive composition. However, literature concerning a comprehensive characterization based on a combined approach, which consists of nuclear magnetic resonance (NMR) and high-performance liquid chromatography coupled with time-of-flight mass spectrometry (HPLC-TOF-MS), from these leaves is scarce. Thus, the aim of this work was to study the polar profile of full extracts of cherimoya leaves by using these tools. Thus, a total of 77 compounds have been characterized, 12 of which were identified by both techniques. Briefly, 23 compounds were classified as amino acids, organic acids, carbohydrates, cholines, phenolic acid derivatives, and flavonoids by NMR, while 66 metabolites were divided into sugars, amino acids, phenolic acids and derivatives, flavonoids, phenylpropanoids, and other polar compounds by HPLC-TOF-MS. It is worth mentioning that different solvent mixtures were tested and the total phenolic content in the extracts quantified (TPC via HPLC-TOF-MS). The tendency observed was EtOH/water 80/20 (v/v) (17.0 ± 0.2 mg TPC/g leaf dry weight (d.w.)) ≥ acetone/water 70/30 (v/v) (16.1 ± 0.7 mg TPC/g leaf d.w.) > EtOH/water 70/30 (v/v) (14.0 ± 0.3 mg TPC/g leaf d.w.) > acetone/water 80/20 (v/v) (13.5 ± 0.4 mg TPC/g leaf d.w.). Importantly, flavonoids derivatives were between 63 and 76% of the TPC in those extracts. Major compounds were sucrose, glucose (α and ß), and proline, and chlorogenic acid and rutin for NMR and HPLC-TOF-MS, respectively. Graphical abstract The combined use of LC-HRMS and NMR is a potential synergic combination for a comprehensive metabolite composition of cherimoya leaves.


Assuntos
Annona/química , Cromatografia Líquida de Alta Pressão/métodos , Espectroscopia de Ressonância Magnética/métodos , Extratos Vegetais/química , Folhas de Planta/química , Espectrometria de Massas por Ionização por Electrospray/métodos , Flavonoides/análise , Fenóis/análise
8.
BMC Cancer ; 16: 664, 2016 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-27549406

RESUMO

BACKGROUND: Disparate and contradictory results make studies necessary to investigate in more depth the relationship between diagnostic delay and survival in colorectal cancer (CRC) patients. The aim of this study is to analyse the relationship between the interval from first symptom to diagnosis (SDI) and survival in CRC. METHODS: Retrospective study of n = 942 CRC patients. SDI was calculated as the time from the diagnosis of cancer and the first symptoms of CRC. Cox regression was used to estimate five-year mortality hazard ratios as a function of SDI, adjusting for age and gender. SDI was modelled according to SDI quartiles and as a continuous variable using penalized splines. RESULTS: Median SDI was 3.4 months. SDI was not associated with stage at diagnosis (Stage I = 3.6 months, Stage II-III = 3.4, Stage IV = 3.2; p = 0.728). Shorter SDIs corresponded to patients with abdominal pain (2.8 months), and longer SDIs to patients with muchorrhage (5.2 months) and rectal tenesmus (4.4 months). Adjusting for age and gender, in rectum cancers, patients within the first SDI quartile had lower survival (p = 0.003), while in colon cancer no significant differences were found (p = 0.282). These results do not change after adjusting for TNM stage. The splines regression analysis revealed that, for rectum cancer, 5-year mortality progressively increases for SDIs lower than the median (3.7 months) and decreases as the delay increases until approximately 8 months. In colon cancer, no significant relationship was found between SDI and survival. CONCLUSIONS: Short diagnostic intervals are significantly associated with higher mortality in rectal but not in colon cancers, even though a borderline significant effect is also observed in colon cancer. Longer diagnostic intervals seemed not to be associated with poorer survival. Other factors than diagnostic delay should be taken into account to explain this "waiting-time paradox".


Assuntos
Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/mortalidade , Diagnóstico Tardio/mortalidade , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Fatores de Tempo
9.
Clin Exp Rheumatol ; 33(4 Suppl 91): S31-5, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26314374

RESUMO

OBJECTIVES: The current knowledge of the influence of systemic sclerosis (SSc) risk loci in the clinical sub-phenotypes is still limited. The main limitation lies in the low frequency of some sub-phenotypes which could be solved by replication studies in independent cohorts and meta-analysis between studies. In this regard, CCR6 gene variants have been recently associated with anti-topoisomerase I positive (ATA+) production in SSc patients in a candidate gene study. This gene has been proposed to have a critical role in IL-17-driven autoimmunity in human diseases. METHODS: In order to confirm the association between CCR6 and ATA+ SSc patients, we performed an independent replication study in populations of European ancestry. We studied two CCR6 genetic variants (rs968334 and rs3093024) in a total of 901 ATA+ SSc cases, 3,258 ATA- SSc cases and 7,865 healthy controls and compared allelic frequencies for those SNPs in ATA+ SSc with healthy controls and also with ATA- SSc patients. RESULTS: The comparison performed between ATA+ SSc patients and healthy controls showed significant association with SNP rs968334 (p=4.88x10(-2), OR=1.11). When we compared ATA+ SSc cases with ATA- SSc, both SNPs, rs3093024 and rs968334, showed significant associations (p=2.89x10(-2), OR=1.13; p=1.69x10(-2), OR=1.15). Finally, in order to increase even more sample size and statistical power, we meta-analysed our study with the previous reported and found a significant association between SNP rs3093024 and ATA+ SSc patients (p=1.00x10(-4), OR=1.16) comparing with healthy controls. CONCLUSIONS: Our work confirms the association of CCR6 gene and ATA+ SSc patients.


Assuntos
Autoanticorpos/sangue , DNA Topoisomerases Tipo I/imunologia , Polimorfismo de Nucleotídeo Único , Receptores CCR6/genética , Escleroderma Sistêmico/genética , Biomarcadores/sangue , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Europa (Continente) , Frequência do Gene , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Razão de Chances , Fenótipo , Fatores de Risco , Escleroderma Sistêmico/sangue , Escleroderma Sistêmico/diagnóstico , Escleroderma Sistêmico/epidemiologia , Escleroderma Sistêmico/etnologia , Estados Unidos/epidemiologia , População Branca/genética
10.
Dig Dis Sci ; 57(9): 2278-85, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22562536

RESUMO

BACKGROUND: Toll-like receptors (TLRs) have achieved an extraordinary amount of interest in inflammatory diseases due to their role in the inflammatory activation. By activating the production of several biological factors, TLRs induce type I interferons and other cytokines, which drive the inflammatory response and activate the adaptive immune system. AIMS: The aim of this study was to investigate and compare the expression and clinical relevance of TLRs and interleukins in pediatric and adult celiac disease (CD), defined as intolerance to dietary proteins found in wheat, barley, and rye. METHODS: The expression levels of TLR3, TLR4, and TLR7, interleukins, and different transcription factors were analyzed on duodenal biopsies from ten children and 31 adults with CD, and 21 duodenal controls biopsies without CD (ten children and 11 adults). The analyses were performed by immunohistochemistry and real-time PCR. RESULTS: There were no significant differences in the studied parameters between adults and children. TLR4 expression level was increased twofold in CD specimens compared to controls. CD patients with high levels of TLR4 also showed high levels of interleukins (IL1, IL6, IL8, and IL17) as well as transcription factors (IRAK4, MyD88, and NF-κB). CONCLUSIONS: TLR4 expression is associated with CD independently of age at diagnosis. Pediatric patients and adult patients have a similar inflammatory profile, making it possible to treat both with the same immunological therapy in the future.


Assuntos
Doença Celíaca/metabolismo , Duodeno/metabolismo , Interleucinas/metabolismo , Receptores Toll-Like/metabolismo , Adulto , Estudos de Casos e Controles , Doença Celíaca/patologia , Criança , Feminino , Humanos , Inflamação/genética , Inflamação/metabolismo , Interleucinas/genética , Masculino , RNA/genética , RNA/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Receptores Toll-Like/genética
11.
Gastroenterol Hepatol ; 35(7): 468-75, 2012.
Artigo em Espanhol | MEDLINE | ID: mdl-22542917

RESUMO

BACKGROUND: Mortality related to nonvariceal upper gastrointestinal bleeding (NVUGIB) has not changed. More information is needed to improve the management of this entity. The aims of this study were: a) to determine the characteristics of bleeding episodes, b) to describe the clinical approaches routinely used in NVUGIB, and c) to identify adverse outcomes related to endoscopic or medical treatments in Spain. METHODS: The European survey of nonvariceal upper GI bleeding (ENERGiB) was an observational, retrospective cohort study on NVUGIB with endoscopic evaluation carried out across Europe. The present study focused on Spanish patients in the ENERGiB study. The patients were managed according to routine care. The mean and standard deviation were calculated for quantitative variables and absolute and relative frequencies were calculated for categorical variables. RESULTS: Patients (n=403) were mostly men (71%), with a mean age of 65 years, and co-morbidities (62.5%). Most of the patients were managed by gastroenterologists (57.1%) or internal medicine teams (25.1%). A proton pump inhibitor was used empirically in 80% before endoscopy. Bleeding persistence occurred in 6.4% and recurrence in 6.7%. The mortality rate at 30 days was 3.5%. CONCLUSIONS: This study contributes to the characterization of Spanish patients and NVUGIB episodes in a real clinical setting and identifies the routine management of this entity, which is in line with the standards proposed by recent clinical practice guidelines. A notable finding was that age and the number of comorbidities in NVUGIB patients were increasing. These factors could explain the persistent mortality rate, despite the evident advances in the management of this entity.


Assuntos
Gerenciamento Clínico , Hemorragia Gastrointestinal/terapia , Idoso , Terapia Combinada , Comorbidade , Endoscopia do Sistema Digestório , Feminino , Gastroenterologia , Hemorragia Gastrointestinal/tratamento farmacológico , Hemorragia Gastrointestinal/epidemiologia , Técnicas Hemostáticas , Humanos , Medicina Interna , Fotocoagulação a Laser , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Inibidores da Bomba de Prótons/uso terapêutico , Recidiva , Estudos Retrospectivos , Fatores de Risco , Soluções Esclerosantes/uso terapêutico , Espanha/epidemiologia , Adesivos Teciduais/uso terapêutico
12.
J Vis Exp ; (182)2022 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-35467665

RESUMO

In this manuscript, three different step-by-step protocols to generate highly monodisperse emulsion drops using glass-based microfluidics are described. The first device is built for the generation of simple drops driven by gravity. The second device is designed to generate emulsion drops in a coflowing scheme. The third device is an extension of the coflowing device with the addition of a third liquid that acts as an electric ground, allowing the formation of electrified drops that subsequently discharge. In this setup, two of the three liquids have an appreciable electrical conductivity. The third liquid mediates between these two and is a dielectric. A voltage difference applied between the two conducting liquids creates an electric field that couples with hydrodynamic stresses of the coflowing liquids, affecting the jet and drop formation process. The addition of the electric field provides a path to generate smaller drops than in simple coflow devices and for generating particles and fibers with a wide range of sizes.

13.
Food Chem ; 372: 131263, 2022 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-34818730

RESUMO

A combination of FTIR- and NMR-based metabolomics approaches coupled to multivariate data analysis techniques was used for the first time to characterize and explore the metabolic changes along the ripening of two Spanish melon landraces (Jimbee N and Jimbee XL). Furthermore, the fatty acids profile and the antioxidant capacity were investigated by GC-FID and ORAC method, respectively. Despite FTIR was able to identify changes in the sugars content between fruits of different maturity stages, it failed to discriminate between both varieties, being exceeded by NMR in both situations. Increased fruit maturation led to an increase of sucrose, fatty acids and ß-carotene, accompanied by a decrease of glucose, fructose, citrate, amino acids, and polyphenols (which were positively correlated with fruits antioxidant activity).


Assuntos
Cucumis melo , Cucurbitaceae , Frutas , Espectroscopia de Ressonância Magnética , Metabolômica
14.
Rev Esp Enferm Dig ; 103(7): 349-54, 2011 Jul.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-21770680

RESUMO

INTRODUCTION: refractory iron-deficiency anemia has a multifactorial origin related to various gastrointestinal conditions, with celiac disease plus malabsorption and IBD together with isolated gluten intolerance being most common. OBJECTIVES: to determine the prevalence of serum, genetic, and histological markers for gluten intolerance, and to analyze the response to gluten withdrawal from the diet in these patients. METHODS: a number of patients with refractory anemia were prospectively and consecutively enrolled. A protocol to measure serum (TGt-2), genetic (HLA-DQ2/DQ8), and histological markers for celiac disease was applied. All followed a gluten-free diet for a median 3.6 years. Sustained remission of anemia during follow-up was interpreted as positive response. RESULTS: ninety-eight patients (84% females) with a mean age of 54 years were studied. Anti-TGt2 antibodies were positive in 5% of cases. A total of 67 cases (68%) were haplotype HLA-DQ2 or -DQ8 (+). We found villous atrophy (Marsh III) in 13% of patients, and an inflammatory pattern (Marsh I or II) in 13%. All remaining 72 patients (74%) had no histological duodenal changes.Age, anemia duration, number of transfusions, number of parenteral iron doses, and time on a gluten-free diet were all compared according to the presence or absence of villous atrophy and HLA-DQ2/8 positivity, and no significant differences were found for any of the analyzed variables. Response was positive in 92% of subjects. CONCLUSIONS: celiac disease with villous atrophy is rarely a cause of refractory anemia. Gluten intolerance with no histological lesions is seen in almost 75% of patients, and therefore plays a relevant role in its development.


Assuntos
Anemia Hipocrômica/dietoterapia , Doença Celíaca/dietoterapia , Dieta Livre de Glúten , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia Hipocrômica/complicações , Anemia Hipocrômica/genética , Atrofia , Biópsia , Análise Química do Sangue , Doença Celíaca/complicações , Doença Celíaca/genética , Colonoscopia , Feminino , Genes MHC da Classe II/genética , Predisposição Genética para Doença , Humanos , Imunoglobulinas/análise , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
15.
Rev Esp Enferm Dig ; 103(5): 238-44, 2011 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-21619387

RESUMO

INTRODUCTION: Celiac disease (CD) is a common autoimmune condition (involves 1-2% of the general population) that develops at any age in life but manifests differently in children and adults. OBJECTIVES: To analyze clinical differences in disease expression between both groups, as well as findings at the time of diagnosis. METHODS: A retrospective study of a series of patients diagnosed with CD during childhood (< 14 years) versus a series of adult patients (> 14 years). RESULTS: a total of 187 patients were included, of which 43 were children and 144 were adults. Among clinical manifestations in children classic presentation forms predominated -34 patients(79%) versus 20 adult patients (14%) (p < 0.001) (OR = 23.4;95% CI: 9.8-56.1). In contrast, atypical forms were predominant in the latter, and anemia was the most common finding in 61 patients (42%) versus 8 pediatric patients (19%) (p < 0.01). Adults had a greater diagnostic delay with a mean 10 ± 9 years versus 1 ± 2 years in children (p < 0.001). In adults, we found a higher frequency of associated autoimmune diseases (24.3 versus 9.3% in children) (p < 0.05). Regarding serum markers, TGt-2 was more commonly positive among children (88%) as compared to adults (31%) (p < 0.001); (OR = 21.4: 95% CI: 7.2-63.6). We found similar results with regard to the presence of villous atrophy, which was more common in children (95%) than in adults (33%) (p < 0.001) (OR = 41.0;95% CI: 9.5-76.7). As regards genetic markers, DQ2 was somewhat more common in children (97.7%) than in adults (90.3%) whereas DQ8 wasless common in children (2.3%) than in adults (9.7%), with no significant differences between groups. Patients negative for both markers were not included. CONCLUSIONS: Pediatric CD has clear differences when compared to adult CD, with classic forms predominating in the former, who also display a higher occurrence of positive serology and villous atrophy, and less diagnostic delay. In contrast, atypical forms predominate in the adult, with a lower occurrence of positive serology and milder histological forms. In these patients associated autoimmune conditions are more common and diagnostic delay is longer.


Assuntos
Doença Celíaca/diagnóstico , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
16.
Front Med (Lausanne) ; 8: 808608, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35155485

RESUMO

OBJECTIVES: COVID-19 outcomes in population with systemic autoimmune diseases (SAD) remain poorly understood. The aim was to examine demographic and clinical factors associated with COVID-19 infection in people with rheumatic disease. METHODS: Two phases cross-sectional survey of individuals with rheumatic disease in April 2020 and October 2020. COVID infection, severity of disease, age, sex, smoking status, underlying rheumatic disease diagnosis, comorbidities and rheumatic disease medications taken immediately prior to infection were analyzed. RESULTS: A total of 1,529 individuals with autoimmunity disease diagnosis were included. Out of 50 positive patients, 21 required telephone medical assistance, 16 received assessment by primary care physician, 9 were evaluated in Emergency Department and 4 patient required hospitalization. Multivariate analysis was performed without obtaining differences in any of the systemic autoimmune diseases. Regarding the treatments, significant differences were found (p 0.011) in the treatment with anti-TNF-alpha agents with OR 3.422 (1.322-8.858) and a trend to significance (p 0.094) was observed in patients receiving mycophenolate treatment [OR 2.016 (0.996-4-081)]. CONCLUSIONS: Anti-TNF-alpha treatment was associated with more than 3-fold risk of suffering from SARS-CoV-2 infection, although in all cases infection was mild. Cumulative incidence in patients with SAD was up to 5 times higher than general population but with great differences between autoimmune diseases.

17.
BMC Cancer ; 10: 528, 2010 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-20920369

RESUMO

BACKGROUND: Controversy exists with regard to the impact that the different components of diagnosis delay may have on the degree of invasion and prognosis in patients with colorectal cancer. The follow-up strategies after treatment also vary considerably. The aims of this study are: a) to determine if the symptoms-to-diagnosis interval and the treatment delay modify the survival of patients with colorectal cancer, and b) to determine if different follow-up strategies are associated with a higher survival rate. METHODS/DESIGN: Multi-centre study with prospective follow-up in five regions in Spain (Galicia, Balearic Islands, Catalonia, Aragón and Valencia) during the period 2010-2012. Incident cases are included with anatomopathological confirmation of colorectal cancer (International Classification of Diseases 9th revision codes 153-154) that formed a part of a previous study (n = 953).At the time of diagnosis, each patient was given a structured interview. Their clinical records will be reviewed during the follow-up period in order to obtain information on the explorations and tests carried out after treatment, and the progress of these patients.Symptoms-to-diagnosis interval is defined as the time calculated from the diagnosis of cancer and the first symptoms attributed to cancer. Treatment delay is defined as the time elapsed between diagnosis and treatment. In non-metastatic patients treated with curative intention, information will be obtained during the follow-up period on consultations performed in the digestive, surgery and oncology departments, as well as the endoscopies, tumour markers and imaging procedures carried out.Local recurrence, development of metastases in the follow-up, appearance of a new tumour and mortality will be included as outcome variables.Actuarial survival analysis with Kaplan-Meier curves, Cox regression and competitive risk survival analysis will be performed. DISCUSSION: This study will make it possible to verify if the different components of delay have an impact on survival rate in colon cancer and rectal cancer. In consequence, this multi-centre study will be able to detect the variability present in the follow-up of patients with colorectal cancer, and if this variability modifies the prognosis. Ideally, this study could determine which follow-up strategies are associated with a better prognosis in colorectal cancer.


Assuntos
Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/terapia , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Oncologia/métodos , Invasividade Neoplásica , Metástase Neoplásica , Prognóstico , Estudos Prospectivos , Recidiva , Espanha , Taxa de Sobrevida , Fatores de Tempo , Resultado do Tratamento
19.
Phytochemistry ; 158: 110-119, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30502594

RESUMO

We have introduced the use of multivariate NMR analysis in the development of accurate and robust prediction models, potentially arising from a correlation between soluble metabolite profiles and cell wall composition, for the determination of hemicellulose, cellulose and lignin contents in 8 species of greenhouse crop residues. The present paper demonstrates that discriminant buckets coming from a PLS-DA model in combination with linear models provide a useful and rapid tool for the determination of cell wall composition of these plant wastes. Regularized linear regression methods have also been applied to avoid overfitting, producing improved models specifically for lignin and cellulose determinations. The predictive models are also presented in a desktop application available at http://www2.ual.es/NMRMBC/solutions. To verify the rationality and reliability of the models, control experiments following generally accepted protocols have been performed and compared to our predicted values.


Assuntos
Celulose/análise , Produtos Agrícolas/química , Lignina/análise , Espectroscopia de Ressonância Magnética/métodos , Polissacarídeos/análise , Agricultura/métodos , Parede Celular/química , Análise dos Mínimos Quadrados , Espectroscopia de Ressonância Magnética/estatística & dados numéricos , Modelos Teóricos , Análise Multivariada , Software , Espanha
20.
J Agric Food Chem ; 67(46): 12972-12985, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31709797

RESUMO

Controlling the temperature inside a greenhouse during the summer is a problem of increasing importance in the Mediterranean countries, especially in the Spanish southeast. The metabolic profile of greenhouse tomatoes and leaves grown under conventional conditions and within the presence of a shade mesh (∼50% reduction of sunlight radiation) has been monitored. Tomatoes were weekly harvested from May to July 2017 and analyzed by NMR spectroscopy coupled to multivariate data analysis techniques, together with oxygen radical absorbance capacity (ORAC) assays (for antioxidant activity). Fatty acids and carotenoids profiles were unraveled by GC-FID and HPLC-DAD, respectively. To verify whether it would be possible to take advantage of different light growing conditions to potentiate a plant's defense system, leaves of the corresponding plants were collected and their methanolic extracts were analyzed by NMR toward deciphering new biomarkers, which were used to assess their antibacterial and antibiofilm activities. The presence of a shading mesh resulted in a reduction in tomato production and in smaller fruits with lower contents of sugars (glucose and fructose) and carotenoids (lycopene and ß-carotene) and higher contents of organic acids, amino acids, and polyunsaturated fatty acids (linoleic and oleic acids) and of phenylpropanoids and flavonoids (which contributed to an increased antioxidant activity). Methanolic extracts of leaves of nonshaded plants showed a higher antibiofilm activity than that from shaded plants. This activity was well-correlated with an increase of phenolic compounds, together with some specific amino acids and organic acids from tomato leaves.


Assuntos
Frutas/química , Folhas de Planta/química , Solanum lycopersicum/efeitos da radiação , Antioxidantes/metabolismo , Alimentos Orgânicos/análise , Alimentos Orgânicos/efeitos da radiação , Frutas/crescimento & desenvolvimento , Frutas/metabolismo , Frutas/efeitos da radiação , Solanum lycopersicum/química , Solanum lycopersicum/crescimento & desenvolvimento , Solanum lycopersicum/metabolismo , Espectroscopia de Ressonância Magnética , Metaboloma/efeitos da radiação , Metabolômica , Valor Nutritivo/efeitos da radiação , Extratos Vegetais/química , Folhas de Planta/crescimento & desenvolvimento , Folhas de Planta/metabolismo , Folhas de Planta/efeitos da radiação , Luz Solar
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