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1.
Nutr Metab Cardiovasc Dis ; 32(5): 1308-1316, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35282983

RESUMO

BACKGROUND AND AIM: Uric acid (UA) is a product of the catabolism of purines, and its increase in blood may be related to the development of cardiometabolic diseases. Whether UA is the result or causal determinant of the appearance of risk factors for cardiometabolic disease is not yet known. UA levels among the young student population in San Luis Potosi have increased in recent years, which may be indicative of a serious future public health concern. Therefore, the objective of this study was to evaluate the association of sociodemographic, lifestyle and cardiometabolic determinants with UA levels in children and adolescents in San Luis Potosí. METHODS AND RESULTS: A total of 730 students (54.1% female and 45.9% male, 6-19 years old) participated in the study. The subjects attended one of five public schools located in San Luis Potosí. Venous blood samples were collected, blood serum was separated by centrifugation, and UA concentrations were measured with an automated analytical platform. UA was associated with most of the independent variables studied. It presented a positive correlation with body mass index (r = 0.363, p < 0.01). Male sex, socioeconomic status, total screen time, exercise, adequate sleep, systolic blood pressure, total cholesterol, and high-density lipoprotein cholesterol explained 23%-39% (p < 0.001) of the variability of plasma concentrations of UA in children and adolescents. CONCLUSION: Early detection of these determinants will prevent future diseases. Moreover, it will help with the implementation of preventive strategies that could improve the health of this population.


Assuntos
Doenças Cardiovasculares , Ácido Úrico , Adolescente , Índice de Massa Corporal , Criança , HDL-Colesterol , Feminino , Humanos , Masculino , México/epidemiologia , Adulto Jovem
2.
Nutr Metab Cardiovasc Dis ; 28(4): 393-401, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29422298

RESUMO

BACKGROUND AND AIMS: An increase in plasma branched-chain amino acids is associated with a higher risk of developing type 2 diabetes and cardiovascular diseases. However, little is known about the basal plasma amino acid concentrations in young adults. Our aim was to determine the plasma amino acid profiles of young adults and to evaluate how these profiles were modified by sex, body mass index (BMI) and insulin resistance (IR). METHODS AND RESULTS: We performed a transversal study with 608 Mexican young adults aged 19.9 ± 2.4 years who were applicants to the Universidad Autónoma de San Luis Potosí. The subjects underwent a physical examination and provided a clinical history and a blood sample for biochemical, hormonal and amino acid analyses. The women had higher levels of arginine, aspartate and serine and lower levels of α-aminoadipic acid, cysteine, isoleucine, leucine, methionine, proline, tryptophan, tyrosine, urea and valine than the men. The obese subjects had higher levels of alanine, aspartate, cysteine, ornithine, phenylalanine, proline and tyrosine and lower levels of glycine, ornithine and serine than the normal weight subjects. Subjects with IR (defined as HOMA > 2.5) had higher levels of arginine, alanine, aspartate, isoleucine, leucine, phenylalanine, proline, tyrosine, taurine and valine than the subjects without IR. Furthermore, we identified two main groups in the subjects with obesity and/or IR; one group was composed of amino acids that positively correlated with the clinical, biochemical and hormonal parameters, whereas the second group exhibited negative correlations. CONCLUSION: This study demonstrates that young adults with obesity or IR have altered amino acid profiles characterized by an increase in alanine, aspartate, proline and tyrosine and a decrease in glycine.


Assuntos
Aminoácidos/sangue , Índice de Massa Corporal , Resistência à Insulina , Obesidade Infantil/sangue , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Fatores Etários , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Masculino , México/epidemiologia , Estado Nutricional , Obesidade Infantil/diagnóstico , Obesidade Infantil/epidemiologia , Obesidade Infantil/fisiopatologia , Prevalência , Fatores de Risco , Fatores Sexuais , Adulto Jovem
3.
Am J Transplant ; 16(7): 2148-57, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26813515

RESUMO

Risk factors for invasive pulmonary aspergillosis (IPA) after kidney transplantation have been poorly explored. We performed a multinational case-control study that included 51 kidney transplant (KT) recipients diagnosed with early (first 180 posttransplant days) IPA at 19 institutions between 2000 and 2013. Control recipients were matched (1:1 ratio) by center and date of transplantation. Overall mortality among cases was 60.8%, and 25.0% of living recipients experienced graft loss. Pretransplant diagnosis of chronic pulmonary obstructive disease (COPD; odds ratio [OR]: 9.96; 95% confidence interval [CI]: 1.09-90.58; p = 0.041) and delayed graft function (OR: 3.40; 95% CI: 1.08-10.73; p = 0.037) were identified as independent risk factors for IPA among those variables already available in the immediate peritransplant period. The development of bloodstream infection (OR: 18.76; 95% CI: 1.04-339.37; p = 0.047) and acute graft rejection (OR: 40.73, 95% CI: 3.63-456.98; p = 0.003) within the 3 mo prior to the diagnosis of IPA acted as risk factors during the subsequent period. In conclusion, pretransplant COPD, impaired graft function and the occurrence of serious posttransplant infections may be useful to identify KT recipients at the highest risk of early IPA. Future studies should explore the potential benefit of antimold prophylaxis in this group.


Assuntos
Função Retardada do Enxerto/etiologia , Rejeição de Enxerto/etiologia , Aspergilose Pulmonar Invasiva/etiologia , Falência Renal Crônica/cirurgia , Transplante de Rim/efeitos adversos , Estudos de Casos e Controles , Função Retardada do Enxerto/patologia , Feminino , Seguimentos , Taxa de Filtração Glomerular , Rejeição de Enxerto/patologia , Sobrevivência de Enxerto , Humanos , Aspergilose Pulmonar Invasiva/patologia , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco , Transplantados
4.
Transpl Infect Dis ; 18(4): 575-84, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27373698

RESUMO

BACKGROUND: Antibiotic resistance is an emerging phenomenon in kidney transplantation (KT). METHODS: We compared species distribution and antimicrobial susceptibility patterns in 1052 isolates from urine cultures obtained in 2 different cohorts of kidney transplant recipients in a single center (Cohort A: 189 patients undergoing KT between January 2002 and December 2004 [336 isolates]; Cohort B: 115 patients undergoing KT between January 2011 and December 2013 [716 isolates]). RESULTS: Asymptomatic bacteriuria accounted for most of the isolates (86.9% in Cohort A and 92.3% in Cohort B). Klebsiella pneumoniae (9.5% vs. 15.6%), Pseudomonas aeruginosa (1.8% vs. 7.9%), and Enterobacter cloacae (0.6% vs. 3.1%) were significantly more common in Cohort B. The isolation of K. pneumoniae in Cohort B was associated with the occurrence of acute pyelonephritis (9.8% of all K. pneumoniae isolates vs. 2.8% of the remaining uropathogens; P = 0.001). Non-susceptibility rates among Enterobacteriaceae in Cohort B were higher for every class of antibiotics (P ≤ 0.003) with the exception of fosfomycin. Compared to Cohort A, significant increases were seen in isolates from Cohort B for multidrug-resistant (MDR) (43.9% vs. 67.8%, respectively; P = 0.001), extended-spectrum beta-lactamase (ESBL)-producing (6.6% vs. 26.1%; P = 0.001), and carbapenemase-producing Enterobacteriaceae strains (0.0% vs. 5.0%; P = 0.001). Such differences were mostly attributable to K. pneumoniae (as 54.5% and 13.4% of isolates in Cohort B were ESBL-producing and carbapenemase-producing, respectively). MDR isolates were responsible for 69.1% of episodes of symptomatic urinary tract infection in Cohort B. CONCLUSION: The increase in resistance rates among Enterobacteriaceae uropathogens is significant and may have an effect on KT programs.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Enterobacter cloacae/efeitos dos fármacos , Infecções por Enterobacteriaceae/microbiologia , Transplante de Rim/efeitos adversos , Infecções Urinárias/microbiologia , Adulto , Idoso , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Infecções Assintomáticas , Proteínas de Bactérias/metabolismo , Enterobacter cloacae/enzimologia , Enterobacter cloacae/isolamento & purificação , Infecções por Enterobacteriaceae/tratamento farmacológico , Infecções por Enterobacteriaceae/urina , Feminino , Fosfomicina/administração & dosagem , Fosfomicina/farmacologia , Fosfomicina/uso terapêutico , Humanos , Infecções por Klebsiella/microbiologia , Infecções por Klebsiella/urina , Klebsiella pneumoniae/isolamento & purificação , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Infecções por Pseudomonas/microbiologia , Infecções por Pseudomonas/urina , Pseudomonas aeruginosa/isolamento & purificação , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/urina , beta-Lactamases/metabolismo
5.
J Appl Microbiol ; 120(6): 1691-700, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26913982

RESUMO

AIMS: Several studies have suggested that abnormalities in the small-intestinal microbiota might be involved in the development or the pathogenesis of celiac disease (CD). The objective of this study was to characterize and compare the composition of the duodenal microbiota between CD patients and non-CD controls. METHOD AND RESULTS: Bacterial communities were identified by pyrosequencing of 16S rRNA extracted from duodenal biopsies. The sequences analysis showed that the majority of the reads were classified within two phyla: Firmicutes and Proteobacteria. Bacterial richness and diversity were higher in non-CD controls than in untreated CD patients, but the differences were not statistically significant. The principal coordinates analysis revealed that bacterial communities of non-CD controls and untreated CD patients were dispersed without forming a clear group according to diagnosis of CD. CONCLUSIONS: There are no statistically significant differences in the upper small intestinal composition of bacterial communities between untreated CD patients and non-CD controls. SIGNIFICANCE AND IMPACT OF THE STUDY: This pyrosequencing analysis reveals a global picture of the duodenal microbiota that could be useful in future trials investigating the role of the microbiota in CD.


Assuntos
Bactérias/isolamento & purificação , Doença Celíaca/microbiologia , Duodeno/microbiologia , Microbioma Gastrointestinal , RNA Ribossômico 16S/genética , Adulto , Bactérias/classificação , Bactérias/genética , Estudos de Casos e Controles , Feminino , Humanos , Intestino Delgado/microbiologia , Masculino , Pessoa de Meia-Idade
6.
J Dairy Sci ; 99(10): 7945-7955, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27497906

RESUMO

Few studies have examined the effects of fresh forage quality on enteric methane (CH4) emissions of dairy cows under grazing conditions. The aim of the current study was to evaluate the effects of 2 contrasting forage qualities induced by different pregrazing herbage masses in late spring on enteric CH4 emissions and milk production of grazing dairy cows. The experiment was conducted as a crossover design with 24 lactating Holstein Friesian dairy cows randomly assigned to 1 of 2 treatments in 2 experimental periods. Each period had a duration of 3wk (2wk for diet adaptation and 1wk for measurements), and the interval between them was 2wk. Treatments consisted of 2 target pregrazing herbage masses [2,200 and 5,000kg of dry matter (DM)/ha above 3cm], generated by different regrowth periods, corresponding to low (LHM) and high (HHM) herbage mass treatments, respectively. Daily herbage allowance (Lolium perenne) for both treatments was 20kg of DM per cow measured above 3cm. Enteric CH4 emissions were individually determined during the last week of each period using the sulfur hexafluoride tracer technique. Daily herbage intakes by individual cows during the CH4 measurement weeks were estimated using the n-alkanes technique. During the CH4 measurement weeks, milk yield and body mass were determined twice daily, whereas milk composition was determined once in the week. The LHM pasture had a higher crude protein concentration, lower neutral detergent fiber and acid detergent fiber concentrations, and higher in vitro digestibility, with a lower proportion of ryegrass pseudostems, than the HHM pasture. Cows offered the LHM pasture had greater herbage (+13%) and total DM (+12%) intakes, increased milk (+13%) and energy-corrected milk (+11%) yields, and tendencies toward higher milk protein (+4.5%) and higher milk urea nitrogen (+15%) concentrations than their counterparts offered the HHM pasture. No differences were found between treatments in total daily CH4 production. However, the LHM treatment reduced enteric CH4 emissions per unit of milk yield (-11%) and enteric CH4 energy as a percentage of ingested gross energy (-9%) and tended to reduce CH4 per unit of dry matter intake (-8.2%) and energy-corrected milk yield (-10%) compared with the HHM treatment. The results from this study suggest that a grazing management that favors better quality pasture, as was the case of the LHM pasture in late spring compared with the HHM pasture, increases milk production of grazing dairy cows and reduces enteric CH4 emissions per unit of milk produced, constituting a viable CH4 mitigation strategy.


Assuntos
Metano/biossíntese , Leite/metabolismo , Animais , Bovinos , Dieta/veterinária , Feminino , Lactação , Lolium/metabolismo
7.
Antimicrob Agents Chemother ; 59(12): 7707-14, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26438503

RESUMO

Tuberculosis (TB) remains a major public health issue due to the increasing incidence of type 2 diabetes mellitus (T2DM), which exacerbates the clinical course of TB and increases the risk of poor long-term outcomes. The aim of this study was to characterize the pharmacokinetics of rifampin (RIF) and its relationship with biochemical and immunological parameters in patients with TB and T2DM. The biochemical and immunological parameters were assessed on the same day that the pharmacokinetic evaluation of RIF was performed. Factors related to the metabolic syndrome that is characteristic of T2DM patients were not detected in the TB-T2DM group (where predominant malnutrition was present) or in the TB group. Percentages of CD8(+) T lymphocytes and NK cells were diminished in the TB and TB-T2DM patients, who had high tumor necrosis factor alpha (TNF-α) and low interleukin-17 (IL-17) levels compared to healthy volunteers. Delayed RIF absorption was observed in the TB and TB-T2DM patients; absorption was poor and slower in the latter group due to poor glycemic control. RIF clearance was also slower in the diabetic patients, thereby prolonging the mean residence time of RIF. There was a significant association between glycemic control, increased TNF-α serum concentrations, and RIF pharmacokinetics in the TB-T2DM patients. These altered metabolic and immune conditions may be factors to be considered in anti-TB therapy management when TB and T2DM are concurrently present.


Assuntos
Antituberculosos/farmacocinética , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/metabolismo , Rifampina/farmacocinética , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/metabolismo , Adolescente , Adulto , Idoso , Antituberculosos/uso terapêutico , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD8-Positivos/efeitos dos fármacos , Diabetes Mellitus Tipo 2/imunologia , Feminino , Meia-Vida , Humanos , Interleucina-17/metabolismo , Células Matadoras Naturais/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Rifampina/uso terapêutico , Tuberculose Pulmonar/imunologia , Fator de Necrose Tumoral alfa/metabolismo , Adulto Jovem
8.
Transpl Infect Dis ; 17(2): 314-21, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25728936

RESUMO

BACKGROUND: Safety concerns have been raised about the use of adjuvanted vaccines after kidney transplantation. METHODS: We retrospectively analyzed 65 kidney transplant (KT) recipients who received ≥1 dose of influenza vaccine (pandemic or seasonal) during the 2009-2010 campaign. Participants were classified into 2 groups: those who received a squalene-based AS03- or MF59-adjuvanted vaccine ("adjuvanted vaccination" [AV] group, n = 37) and those who exclusively received non-adjuvanted vaccines ("non-adjuvanted vaccination" [NAV] group, n = 28). Primary outcomes included occurrence of biopsy-proven acute graft rejection (BPAR) and graft function at months 6 and 12 after vaccination. Patients were followed up until graft loss, death, or October 2010. RESULTS: Four episodes of BPAR occurred during post-vaccination follow-up, with no differences between the AV and NAV groups, in terms of cumulative incidence (5.4% vs. 7.1%, respectively; P = 0.581), incidence rate (0.22 vs. 0.18 episodes per 1000 transplant-days; P = 0.950), or occurrence of severe episodes (T-cell-mediated BPAR of grade ≥2a) (2.7% vs. 3.6%; P = 0.680). No between-group differences were seen in graft function after vaccination. CONCLUSION: Adjuvanted influenza vaccination in KT recipients seems to be safe regarding graft outcome.


Assuntos
Adjuvantes Imunológicos/uso terapêutico , Rejeição de Enxerto/epidemiologia , Vacinas contra Influenza/uso terapêutico , Influenza Humana/prevenção & controle , Falência Renal Crônica/cirurgia , Transplante de Rim , Esqualeno/uso terapêutico , Adulto , Idoso , Estudos de Coortes , Feminino , Rejeição de Enxerto/patologia , Rejeição de Enxerto/prevenção & controle , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Transplantados
9.
Ecol Lett ; 17(8): 924-31, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24811575

RESUMO

The restricted area of space used by most mobile animals is thought to result from fitness-rewarding decisions derived from gaining information about the environment. Yet, assessments of how animals deal with uncertainty using memory have been largely theoretical, and an empirically derived mechanism explaining restricted space use in animals is still lacking. Using a patch-to-patch movement analysis, we investigated predictions of how free-ranging bison (Bison bison) living in a meadow-forest matrix use memory to reduce uncertainty in energy intake rate. Results indicate that bison remembered pertinent information about location and quality of meadows, and they used this information to selectively move to meadows of higher profitability. Moreover, bison chose profitable meadows they had previously visited, and this choice was stronger after visiting a relatively poor quality meadow. Our work demonstrates a link between memory, energy gains and restricted space use while establishing a fitness-based integration of movement, cognitive and spatial ecology.


Assuntos
Adaptação Fisiológica/fisiologia , Bison/fisiologia , Meio Ambiente , Comportamento Alimentar/fisiologia , Memória/fisiologia , Modelos Biológicos , Animais , Feminino , Estações do Ano
10.
Clin Transplant ; 28(10): 1155-66, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25109314

RESUMO

In the recent years, more than 60% of available deceased donors are either older than 50 yr or have significant vascular comorbidities. This makes the acceptance and rejection criteria of renal allografts very rigorous, especially in cases of younger recipients, and at the same time encourages live donations. In our country, there is a lack of homogeneity in the percentages of use of expanded criteria donor (ECD) allografts between the different autonomous communities. Furthermore, the criteria vary greatly, and in some cases, great importance is given to the biopsy while in others very little. In this study, we present a unified and homogenous criteria agreed upon by consensus of a 10-member Panel representing major scientific societies related to renal transplantation in Spain. The criteria are to be used in accepting and/or rejecting kidneys from the so-called ECDs. The goal was to standardize the use of these organs, to optimize the results, and most importantly to provide for the maximum well being of our patients. Finally, we believe that after taking into account the Panel's thorough review of specific scientific literature, this document will be adaptable to other national renal transplant programmes.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim/normas , Seleção de Pacientes , Doadores de Tecidos , Obtenção de Tecidos e Órgãos/métodos , Consenso , Sobrevivência de Enxerto , Humanos , Prontuários Médicos , Pessoa de Meia-Idade , Prognóstico , Espanha , Listas de Espera
11.
Front Genet ; 15: 1278201, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38645486

RESUMO

The high prevalence of obesity in Mexico starting from the early stages of life is concerning and represents a major public health problem. Genetic association studies have reported that single nucleotide variants (SNVs) in SIRT1, an NAD+-dependent deacetylase that plays an important role in the regulation of metabolic cellular functions, are associated with multiple metabolic disorders and the risk of obesity. In the present study, we analyzed the effect that the SNVs rs1467568 and rs7895833 of the SIRT1 gene may have on cardiometabolic risk factors in a young adult population from Mexico. A cross-sectional study was carried out with young adults between the ages of 18 and 25 who had a body mass index (BMI) greater than 18.5 kg/m2. This study included 1122 young adults who were classified into the normal weight (n = 731), overweight group (n = 277), and obesity group (n = 114) according to BMI of whom 405 and 404 volunteers were genotyped for rs1467568 and rs7895833 respectively using TaqMan probes through allelic discrimination assays. We found that the male sex carrying the G allele of rs7895833 had slightly lower BMI levels (p = 0.009). Furthermore, subjects carrying rs1467568 (G allele) showed a 34% lower probability of presenting with hyperbetalipoproteinemia where female carrying rs1467568 had lower levels of total cholesterol (p = 0.030), triglycerides (p = 0.026) and LDL cholesterol (p = 0.013). In conclusion, these findings suggest that the presence of both SNVs could have a non-risk effect against dyslipidemia in the Mexican population.

12.
Am J Transplant ; 13(3): 685-94, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23311502

RESUMO

The usefulness of monitoring of complement levels in predicting the occurrence of infection in kidney transplant (KT) recipients remains largely unknown. We prospectively assessed serum complement levels (C3 and C4) at baseline and at months 1 and 6 in 270 patients undergoing KT. Adjusted hazard ratios (aHRs) for infection in each posttransplant period were estimated by Cox regression. The prevalence of C3 hypocomplementemia progressively decreased from 21.5% at baseline to 11.6% at month 6 (p = 0.017), whereas the prevalence of C4 hypocomplementemia rose from 3.7% at baseline to 9.2% at month 1 (p = 0.004). Patients with C3 hypocomplementemia at month 1 had higher incidences of overall (p = 0.002), bacterial (p = 0.004) and fungal infection (p = 0.019) in the intermediate period (months 1-6). On multivariate analysis C3 hypocomplementemia at month 1 emerged as a risk factor for overall (aHR 1.911; p = 0.009) and bacterial infection (aHR 2.130; p = 0.014) during the intermediate period, whereas C3 hypocomplementemia at month 6 predicted the occurrence of bacterial infection (aHR 3.347; p = 0.039) in the late period (>6 month). A simple monitoring strategy of serum C3 levels predicts the risk of posttransplant infectious complications in KT recipients.


Assuntos
Complemento C3/deficiência , Rejeição de Enxerto/etiologia , Infecções/etiologia , Nefropatias/complicações , Transplante de Rim/efeitos adversos , Complicações Pós-Operatórias , Feminino , Rejeição de Enxerto/mortalidade , Sobrevivência de Enxerto , Humanos , Infecções/mortalidade , Nefropatias/cirurgia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Fatores de Risco , Taxa de Sobrevida , Centros de Atenção Terciária
13.
Transpl Infect Dis ; 15(6): 600-11, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24011120

RESUMO

BACKGROUND: The impact of iron metabolism on the risk of infectious complications has been demonstrated in various immunosuppressed populations. However, no previous studies have assessed this potential association in kidney transplant (KT) recipients. METHODS: We prospectively analyzed 228 patients undergoing KT at our institution from November 2008 to February 2011. Serum iron parameters (iron level, ferritin, total iron-binding capacity, unsaturated iron-binding capacity, transferrin, and transferrin saturation) were assessed within the first 2 weeks after transplantation (median interval, 3 days; interquartile [Q1 -Q3 ] range, 1-6 days), and before the occurrence of the first infectious episode (median interval, 26 days; Q1 -Q3 range, 11-76 days). Primary outcome was the occurrence of any episode of infection during the first year. Multivariate-adjusted hazard ratios (aHRs) were estimated by Cox regression models. RESULTS: Patients with ferritin level ≥ 500 ng/mL had higher incidence rates (per 1000 transplant-days) of overall infection (P = 0.017), bacterial infection (P = 0.002), and bloodstream infection (P = 0.011) during the first post-transplant year. One-year infection-free survival rate was lower in these recipients (26% vs. 41%; P = 0.004). On multivariate analysis, after adjusting for potential confounders, ferritin emerged as an independent predictor of overall infection (aHR [per unitary increment], 1.001; P = 0.006), and bacterial infection (aHR [per unitary increment], 1.001; P = 0.020). CONCLUSION: Monitoring of serum iron parameters in the early post-transplant period may be useful in predicting the occurrence of infection in KT recipients, although further studies should be carried out to confirm this preliminary finding.


Assuntos
Infecções Bacterianas/epidemiologia , Ferritinas/sangue , Ferro/sangue , Transplante de Rim/efeitos adversos , Sepse/epidemiologia , Transferrina/metabolismo , Adulto , Idoso , Infecções Bacterianas/sangue , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco , Sepse/sangue
14.
Nat Genet ; 17(2): 171-8, 1997 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9326936

RESUMO

Analysis of patients with inherited hypokalaemic alkalosis resulting from salt-wasting has proved fertile ground for identification of essential elements of renal salt homeostasis and blood-pressure regulation. We now demonstrate linkage of this phenotype to a segment of chromosome 1 containing the gene encoding a renal chloride channel, CLCNKB. Examination of this gene reveals loss-of-function mutations that impair renal chloride reabsorption in the thick ascending limb of Henle's loop. Mutations in seventeen kindreds have been identified, and they include large deletions and nonsense and missense mutations. Some of the deletions are shown to have arisen by unequal crossing over between CLCNKB and the nearby related gene, CLCNKA. Patients who harbour CLCNKB mutations are characterized by hypokalaemic alkalosis with salt-wasting, low blood pressure, normal magnesium and hyper- or normocalciuria; they define a distinct subset of patients with Bartter's syndrome in whom nephrocalcinosis is absent. These findings demonstrate the critical role of CLCNKB in renal salt reabsorption and blood-pressure homeostasis, and demonstrate the potential role of specific CLCNKB antagonists as diuretic antihypertensive agents.


Assuntos
Síndrome de Bartter/genética , Canais de Cloreto/genética , Mutação , Síndrome de Bartter/classificação , Síndrome de Bartter/metabolismo , Sequência de Bases , Canais de Cloreto/química , Canais de Cloreto/metabolismo , Cromossomos Humanos Par 1/genética , Troca Genética , Primers do DNA/genética , Éxons , Feminino , Ligação Genética , Humanos , Íntrons , Alça do Néfron/metabolismo , Masculino , Linhagem , Fenótipo , Reação em Cadeia da Polimerase , Deleção de Sequência
15.
Dermatol Online J ; 19(10): 20030, 2013 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-24139370

RESUMO

Acute generalized exanthematous pustulosis (AGEP) is a rare, severe, pustular, cutaneous reaction. We report a case in which a patient developed AGEP after the intake of 3 different antitussive agents containing dextromethorphan as the only ingredient in common.


Assuntos
Pustulose Exantematosa Aguda Generalizada/etiologia , Antitussígenos/efeitos adversos , Dextrometorfano/efeitos adversos , Pustulose Exantematosa Aguda Generalizada/patologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Psoríase/diagnóstico
16.
Benef Microbes ; 14(2): 153-164, 2023 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-36856122

RESUMO

Dysbiosis has been implicated in childhood obesity. Oral intake of fermented milk containing Lacticaseibacillus casei strain Shirota preserves gut microbiota (GM) diversity in children and adults. This study was a double-blind trial involving 37 overweight or obese children aged 6-10 years. Children were followed over a 6-week intervention period in which they received different fermented milk products containing L. casei Shirota: 10 in the first group received just L. casei Shirota; 13 received L. casei Shirota with 3 g/day of inulin (L. casei+inulin); and 14 received L. casei Shirota with 3 g/day of fructans from Agave salmiana (L. casei+fructans). Principal component analysis showed the relationship between microbial abundance, GM metabolites, and other obesity-related markers. Supplementation with probiotics and synbiotics improved the HDL-cholesterol levels of overweight and obese children, although no changes in body composition were detected. We observed an increase in butyrate or propionate concentrations in the L. casei+fructans group compared to the end of the intervention (P<0.03). A diminished level of ANGPTL4 within the L. casei+fructans group (P=0.04) was also found, but no differences when lipopolysaccharide-binding protein was evaluated. The FFAR2+ cell frequency decreased between baseline and at the end of 6-week intervention in L. casei+inulin (P=0.02) and L. casei+fructans groups (P=0.04). In contrast, the percentage of CD14+FFAR3+ frequency increased in the same groups (P=0.04). The L. casei Shirota with inulin or fructans modulates GM, which improves the lipid profile and changes at a molecular level, such as expression of FFAR3 and FFAR2, ANGPTL4, propionate, and butyrate. It, therefore, could be considered an interesting therapeutic possibility for treating childhood overweight and obesity. The study was registered at ClinicalTrials.gov (ID: NCT05423015).


Assuntos
Agave , Produtos Fermentados do Leite , Obesidade Infantil , Probióticos , Criança , Adulto , Humanos , Frutanos , Agave/química , Inulina/farmacologia , Sobrepeso/tratamento farmacológico , Obesidade Infantil/tratamento farmacológico , Propionatos , Biomarcadores
17.
Front Pediatr ; 11: 1172837, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37266538

RESUMO

Aims: In this study, we evaluated the association of sociodemographic, lifestyle and cardiometabolic factors with blood glucose levels in children and adolescents in Mexico. Methods: An analytical cross-sectional study of 642 children and adolescents aged 6 to 19 years from different educational centers located in municipalities of the state of San Luis Potosí, Mexico, was carried out. Pearson χ2 and Spearman correlation tests and multiple linear regression models were used to evaluate the associations of the variables with glycemia. Results: The prevalence of prediabetes was 8.0% in both sexes. Male participants were more likely to develop hyperglycemia than female participants (OR 2.7, 95% CI: 1.5-5.0). The variables associated with glucose levels were male sex, high socioeconomic status, inadequate diet, high blood pressure, and increased total cholesterol, LDL cholesterol, and triglycerides, which also explained up to 15.6% (p < 0.05) of the variability in glucose concentrations. Conclusion: The detection of sociodemographic, lifestyle and cardiometabolic factors in children and adolescents will contribute to the implementation of prevention strategies for cardiometabolic diseases, among which prediabetes is common.

18.
Am J Transplant ; 12(10): 2763-73, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22823002

RESUMO

We aimed to analyze the incidence, risk factors and impact of hypogammaglobulinemia (HGG) in 226 kidney transplant (KT) recipients in which serum immunoglobulin (Ig) levels were prospectively assessed at baseline, month 1 (T(1) ), and month 6 (T(6) ). The prevalence of IgG HGG increased from 6.6% (baseline) to 52.0% (T(1) ) and subsequently decreased to 31.4% (T(6) ) (p < 0.001). The presence of IgG HGG at baseline (odds ratio [OR] 26.9; p = 0.012) and a positive anti-HCV status (OR 0.17; p = 0.023) emerged as risk factors for the occurrence of posttransplant IgG HGG. Patients with HGG of any class at T(1) had higher incidences of overall (p = 0.018) and bacterial infection (p = 0.004), bacteremia (p = 0.054) and acute pyelonephritis (p = 0.003) in the intermediate period (months 1-6). Patients with HGG at T(6) had higher incidences of overall (p = 0.004) and bacterial infection (p < 0.001) in the late period (>6 month). A complementary log-log model identified posttransplant HGG as an independent risk factor for overall (hazard ratio [HR] 2.03; p < 0.001) and bacterial infection (HR 2.68; p < 0.0001). Monitoring of humoral immunity identifies KT recipients at high risk of infection, offering the opportunity for preemptive immunoglobulin replacement therapy.


Assuntos
Imunoglobulinas/sangue , Infecções/etiologia , Transplante de Rim/efeitos adversos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
19.
Public Health ; 126(6): 535-40, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22546507

RESUMO

OBJECTIVE: Increasing overweight and obesity rates in Mexico have been associated with increases in mortality from cardiovascular disease (CVD). This study assessed changes in body mass index (BMI) and body weight over 1 year, and explored whether these were associated with changes in CVD risk factors of blood pressure and fasting glucose in a cohort of young Mexican adults. STUDY DESIGN: Longitudinal data were obtained from a cohort of young Mexican adults applying to college. METHODS: Data were collected from college applicants for the 2008 academic year who re-applied in 2009. In total, 795 college applicants aged 18-20 years, of both sexes (48% males and 52% females), were included in the study. The screen included height, weight, and systolic (SBP) and diastolic (DBP) blood pressure measurements plus a blood draw following an overnight fast for fasting glucose. RESULTS: At baseline, 31.8% of the participants were overweight or obese. The mean 1-year change in body weight and BMI were 0.80 kg and 0.35 kg/m(2), respectively. One-year changes in body weight and BMI were associated with increased SBP and DBP for both men and women (P < 0.05), independent of baseline BMI. A weight gain of 5% or more was positively associated with increases in blood pressure among women (P < 0.05), but not among men. A weight loss of 5% or more was associated with reductions in SBP among women. CONCLUSIONS: One-year changes in weight were associated with changes in blood pressure.


Assuntos
Pressão Sanguínea , Peso Corporal , Adulto , Glicemia , Índice de Massa Corporal , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , México/epidemiologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Fatores de Risco , Aumento de Peso , Redução de Peso , Adulto Jovem
20.
Clin Immunol ; 169: 80-84, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27236002
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