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1.
Eur J Pediatr ; 183(9): 3933-3942, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38916739

ABSTRACT

An early prediction of outcomes of neonatal hypoxic-ischemic encephalopathy (NE) is of key importance in reducing neonatal mortality and morbidity. The objectives were (i) to analyze the characteristics of miRNA expression and metabolic patterns of neonates with NE and (ii) to assess their predictive performance for neurodevelopmental outcomes. Plasma samples from moderate/severe NE patients (N = 92) of the HYPOTOP study were collected before, during, and after therapeutic hypothermia (TH) and compared to a control group (healthy term infants). The expression of miRNAs and concentrations of metabolites (hypoxia-related and energy, steroid, and tryptophan metabolisms) were analyzed. Neurodevelopmental outcomes were evaluated at 24 months postnatal age using Bayley Scales of Infant Development, ed. III, BSID-III. Differences in miRNA and metabolic profiles were found between NE vs. control infants, abnormal (i.e., mildly and moderately abnormal and severe) vs. normal, and severe vs. non-severe (i.e., normal and mildly and moderately abnormal) BSID-III. 4-Androstene-3,17-dione, testosterone, betaine, xanthine, and lactate were suitable for BSID-III outcome prediction (receiver operating characteristic areas under the curve (AUCs) ≥ 0.6), as well as 68 miRNAs (AUCs of 0.5-0.9). Significant partial correlations of xanthine and betaine levels and the expression of several miRNAs with BSID-III sub-scales were found. Conclusion: We have identified metabolites/miRNAs that might be useful to support the prediction of middle-term neurodevelopmental outcomes of NE. What is known and what is new: • The early prediction of outcomes of neonatal hypoxic-ischemic encephalopathy (NE) is of key importance in reducing neonatal mortality and morbidity. • Alterations of the metabolome and miRNAs had been observed in NE. • We performed miRNA sequencing and quantified selected metabolites (i.e., lactate, pyruvate, ketone bodies, Krebs cycle intermediates, tryptophan pathway, hypoxia-related metabolites, and steroids) by GC- and LC-MS. • Specific miRNAs and metabolites that allow prediction of middle-term neurodevelopmental outcomes of newborns with NE undergoing hypothermia treatment were identified.


Subject(s)
Biomarkers , Hypoxia-Ischemia, Brain , MicroRNAs , Humans , Hypoxia-Ischemia, Brain/therapy , Hypoxia-Ischemia, Brain/blood , Hypoxia-Ischemia, Brain/genetics , Male , Female , Infant, Newborn , Biomarkers/blood , MicroRNAs/blood , Case-Control Studies , Infant , Hypothermia, Induced , Child, Preschool
2.
Transplant Cell Ther ; 2024 Jun 12.
Article in English | MEDLINE | ID: mdl-38871055

ABSTRACT

Invasive fungal infections (IFI) pose a significant complication after hematopoietic stem cell transplantation (HSCT). Isavuconazole (ISV) is a new generation azole with a favourable adverse effect and interaction profile approved for the treatment of invasive aspergillosis and mucormycosis. We analyzed the indications, effectiveness, adverse event profile and drug interaction management of ISV in the real-world setting in adults who received allogeneic-HSCT (allo-HSCT) within the Spanish Group of HSCT and Cell Therapy (GETH-TC). We conducted a multicenter retrospective study of all consecutive adult allo-HSCT recipients (≥18 years) who received ISV either for IFI treatment or prophylaxis, from December 2017 to August 2021, in 20 centers within the Spanish Group of Hematopoietic Stem Cell Transplantation and Cell Therapy (GETH-TC). A total of 166 adult allografted patients who received ISV from 2017 to 2021 were included. Median age was 48 years with 43% females. In 81 (49%) patients, ISV was used for treatment of IFI, and in 85 (51%) for prophylaxis. Median duration of ISV administration for IFI treatment was 57 days (range 31-126) and 86 days (range 33-196) for prophylaxis. Most frequent indication for treatment was invasive aspergillosis (78%), followed by mucormycosis (6%). Therapeutic success (45%) was the most frequent reason for ISV withdrawal. In the prophylaxis group, the resolution of IFI risk factors was the most frequent reason for withdrawal (62%). Six (7%) breakthrough IFI were reported. The majority of patients (80%) presented pharmacologic interactions. Twenty-one patients (13%) reported adverse events related to ISV, mainly liver biochemistry abnormalities, which led to ISV withdrawal in 7 patients (4%). ISV was effective and well tolerated for IFI treatment and prophylaxis, with a manageable interaction profile.

4.
Rev. cuba. salud pública ; 40(1): 26-39, ene.-mar. 2014.
Article in Spanish | LILACS | ID: lil-711049

ABSTRACT

Introducción: el proyecto Determinantes individuales y sociales de salud en la medicina familiar, concebido con una duración de dos años, se propone desarrollar la opción de evitar la aparición de enfermedades crónicas no trasmisibles interviniendo en los determinantes sociales e individuales de la salud. Objetivo: describir los resultados preliminares después de un año de trabajo en el citado proyecto. Métodos: estudio descriptivo prospectivo en 1 496 individuos dispensarizados en el policlínico universitario Tomás Romay. La muestra se dividió en dos grupos homogéneos: el grupo intervenido, cuyos miembros fueron invitados cuatro veces en el año a una consulta salutogénica y un grupo control, al que se le realizó dos consultas, una al inicio y otra al final del mismo año. Se utilizó una entrevista que actualiza el estado de los determinantes individuales y sociales y permite ofrecer orientaciones salutogénicas. Resultados: en el grupo intervenido disminuyó la frecuencia del tabaquismo (p< 0,0001), el bebedor de riesgo (p< 0,05), el peso (p< 0,05) y el valor del índice de masa corporal (p< 0,05), así como el número de personas con sobrepeso (p< 0,001), la presión arterial diastólica (p< 0,05), y la presión arterial sistólica (p< 0,001). Por otro lado, durante el período de intervención, aumentó la incidencia de diabetes mellitus en el grupo control en comparación con el grupo intervenido (p< 0,05). Conclusiones: los resultados son aun modestos, pero avalan una posibilidad racional para disminuir el riesgo de la aparición de enfermedades crónicas no trasmisibles...


Introduction: the project Individual and social determinants of health in family medicine conceived for two years, is aimed at developing the option of preventing the occurence of non-communicable chronic diseases by intervening in the individual and social determinants of health. Objective: to describe the preliminary results after one-year work in the mentioned project. Methods: prospective and descriptive study of 1 496 subjects classified in Tomas Romay university polyclinics. The sample was divided into two homogeneous groups: the intervened group whose members were invited to salutogenic consultation four times a year, and a control group which went to two consultations, one at the beginning and other at the end of the year. An interview was made to update the state of the individual and social determinants and allowed providing salutogenic guiding. Results: the intervened group reduced the frequency of smoking (p< 0.001), risky drinking (p< 0.05), weight (p< 0.05) and the body mass index (p< 0.05) as well as the number of overweighed persons (p< 0.001), diastolic blood pressure ((p< 0.005), and systolic blood pressure (p< 0.001). On the other hand, the incidence of diabetes mellitus rose during the intervention period in the control group compared with that of the intervened group (p< 0.05). Conclusions: the results are still modest, but they support a rational possibility to diminish the risk of emergence of non-communicable chronic diseases...


Subject(s)
Humans , Chronic Disease , Family Practice , Program Evaluation , Epidemiology, Descriptive , Prospective Studies
5.
Rev. esp. nutr. comunitaria ; 19(2): 120-127, abr.-jun. 2013. tab
Article in Spanish | IBECS (Spain) | ID: ibc-142782

ABSTRACT

Objetivo: Analizar la ingesta de energía y nutrientes de los inmigrantes marroquíes en Almería con respecto al país de origen, Marruecos, comparando su adecuación a las ingestas dietéticas recomendadas (IDRS) y al consumo nutricional de los españoles. Metodología: Estudio epidemiológico transversal en 95 marroquíes en Almería (MA) y 30 en Marruecos (MM). Para determinar la ingesta alimentaria se ha utilizado un cuestionario de frecuencia de consumo de alimentos semanal y un recuerdo de consumo de 24 horas, con valoración de la ingesta de calorías y nutrientes mediante programa informatizado. Resultados: Los inmigrantes residentes en Almería tienen una ingesta calórica y de grasas significativamente mayor que en Marruecos (p<0.01). Presentan déficit de micronutrientes y vitamina D respecto a la IDR y al consumo de los españoles. Conclusiones: Los inmigrados marroquíes, cuando se trasladan a Almería, realizan una “dieta de transición” que se adapta mejor a las ingestas recomendadas internacionalmente y al patrón alimentario de la dieta mediterránea, con aumento del consumo de hidratos de carbono y menos grasas saturadas y proteínas de origen animal que la dieta occidental (AU)


Objectives: To compare calorie, macronutrient and micronutrient intake among Moroccan immigrants in Almeria, Spain to the intake in their country of origin (Morocco), international recommendations and intake among the host population. Methods: Cross-sectional study including 95 Moroccan in Almeria (MA) and 30 in Morocco (MM). Dietary intake was recorded by using a weekly food frequency questionnaire and a 24-recall questionnaire; intake of calories and nutrients was calculated using computer software. Results: Fat and calorie intake among immigrants residing in Almeria is significantly higher than that in Morocco (p <0.01); protein intake was the same, whereas carbohydrate intake was less (p <0.01). They present micronutrient and vitamin D deficiencies according to the RDI and to Spanish consumption patterns (p <0.01). Conclusions: When Moroccan immigrants move to Almeria, they follow a “transitional diet” which is closer to the internationally recommended intake and to the patterns of the Mediterranean diet, which has increased carbohydrates consumption and less saturated fat and animal protein consumption than that found in the Western diet (AU)


Subject(s)
Humans , Feeding Behavior , Eating , Micronutrients/administration & dosage , Cross-Cultural Comparison , Emigrants and Immigrants/statistics & numerical data , Feeding Behavior
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