BACKGROUND: Isolated gastrocnemius contracture has been associated with more than 30 lower limb disorders, including plantar heel pain/plantar fasciitis, Achilles tendinosis, equinus foot, adult flatfoot, and metatarsalgia. Although many techniques are available for gastrocnemius recession, potential anesthetic, cosmetic, and wound-related complications can lead to patient dissatisfaction. Open and endoscopic recession techniques usually require epidural or general anesthesia, exsanguination of the lower extremities and stitches and can damage the sural nerve, which is not under the complete control of the surgeon at all stages of the procedure. The purpose of this study is to evaluate the clinical results of a surgical technique for gastrocnemius lengthening with a needle, as previously described in cadaver specimens. METHODS AND RESULTS: We performed a prospective study of ultrasound-guided gastrocnemius tendon lengthening in level II using a needle in 24 cases (19 patients) of gastrocnemius contracture. The study population comprised 12 males and 7 females. Mean age was 41 years (18-64). All but 5 recessions were bilateral and occurred simultaneously. The indication for the procedure was gastrocnemius contracture; although the patients also presented other conditions such as non-insertional Achilles tendinopathy in 6 patients (2 were bilateral), insertional Achilles calcifying enthesitis in 4 (1 was bilateral), metatarsalgia in 4, flexible flat foot in 1 and plantar fasciitis in 5 (2 were bilateral). The inclusion criteria were the failure of a previous conservative protocol, that the Silfverskiöld test was positive, and that the pathology suffered by the patient was within the indications for surgical lengthening of the patients and were described in the scientific literature. The exclusion criteria were that the inclusion criteria were not met, and patients with surgical risk ASA 3 or more and children. In these patients, although possible, it is preferable to perform the procedure in the operating room with monitoring, as well as in children since they could be agitated during the procedure at the office. We used the beveled tip of an Abbocath needle as a surgical scalpel. All patients underwent recession of the gastrocnemius tendon, as in an incomplete Strayer release. We evaluated pre- and postoperative dorsiflexion, outcomes, and procedural pain (based on a visual analog scale and the American Orthopedic Foot and Ankle Society scores), as well as potential complications. No damage was done to the sural bundle. RESULTS: Ankle dorsiflexion increased on average by 17.89°. The average postoperative visual analog score for pain before surgery was 5.78, 5.53 in the first week, 1.89 at 1 month, and 0.26 at 3 months, decreasing to 0.11 at 9 months. The mean postoperative American Orthopedic Foot and Ankle Society Ankle-Hindfoot score the average was 50.52 before surgery, 43.42 at 1 week, 72.37 at 1 month, 87.37 at 3 months, and 90.79 at 9 months. CONCLUSION: Ultrasound-guided needle lengthening of the gastrocnemius tendon is a novel, safe, and effective technique that enables the surgeon to check all the structures clearly, thus minimizing the risk of neurovascular damage. The results are encouraging, and the advantages of this approach include absence of a wound and no need for stitches. Recovery is fast and relatively painless. A specific advantage of ultrasound-guided needle lengthening of the gastrocnemius tendon is the fact that it can be performed in a specialist's office, with a very basic instrument set and local anesthesia, thus reducing expenses.
Achilles Tendon , Contracture , Fasciitis, Plantar , Metatarsalgia , Tendinopathy , Adult , Male , Female , Child , Humans , Achilles Tendon/surgery , Prospective Studies , Tendinopathy/surgery , Muscle, Skeletal/surgery , Contracture/surgery , Ultrasonography, Interventional
Different eccentric strength assessments are used to identifying the risk of hamstring injury in athletes. However, there is scarce information to determine the association between Nordic-based measurements and the gold standard measurement of eccentric hamstring strength in an isokinetic dynamometer. To investigate the relationship of different measures of eccentric hamstring strength (break-point angle and eccentric strength during Nordic exercise) with eccentric hamstring peak torque measured with an isokinetic dynamometer. Forty-six participants volunteered to participate in this study. Eccentric peak force in the Smart-Nordic System and break-point angle measured as trunk lowering at >20°/s and >150°/s2 during the Nordic exercise via high-frequency video-analysis were compared to eccentric hamstring peak torque in an isokinetic dynamometer set to produce knee extension at 30°/s. There was a moderate association between peak eccentric strength with the Smart-Nordic and isokinetic eccentric hamstring peak torque (r = -0.65, p < 0.001, 95%CI = [-0.76-(-0.50)]). The association between Nordic break-point angle measured at 20°/s (r = 0.49, p < 0.001, 95%CI = [0.30-0.64]) and at 150°/s2 (r = 0.52, p < 0.001, 95%CI = [0.33-0.66]) presented statistically significant but lower associations with isokinetic eccentric hamstring peak torque. All Nordic-based measurements presented acceptable associations with the gold standard isokinetic eccentric hamstring peak torque. However, peak eccentric force measured on the Smart-Nordic device had a better agreement with eccentric peak torque measured with an isokinetic dynamometer than the video-based measurements.Highlights Peak eccentric force measured on the isometric strain-gauges device had a better agreement with eccentric hamstring peak torque measured with an isokinetic dynamometer than the break-point angle.The Nordic-based measurements are an alternative cost-effective method to assess eccentric muscle strength and weakness when the access to isokinetic dynamometry is not feasible.Caution should be taken with certain variables such as participants body mass, hip position and movement speed when interpreting the results of Nordic-based measurements.
Hamstring Muscles , Humans , Hamstring Muscles/physiology , Lower Extremity , Muscle Strength/physiology , Knee , Knee Joint , Torque , Muscle, Skeletal/physiology
BACKGROUND: This study aims to analyze the clinical outcome of a new ultrasound-guided surgery for partial plantar fasciotomy performed with a needle for treatment of plantar fasciitis. METHODS: We performed a retrospective review of 107 patients diagnosed with plantar fasciitis who underwent ultrasound-guided release of the plantar fascia. The series included 62 males (57.9%) and 45 females (42.1%) treated between April 2014 and February 2018, with a mean follow-up of 21.05 ± 10.96 months (7-66) and a minimum follow-up of 24 months. The mean age was 48.10 ± 10.27 years (27-72). Clinical assessments and ultrasound examination were carried out before treatment, after 1 week, and then after 1, 3, 12, and 24 months. The clinical assessment was based on a visual analog scale and the Foot and Ankle Disability Index. RESULTS: Heel pain improved in 92.5% (99) of patients, but not in 7.4% (8 patients). In the group of patients whose heel pain improved, 9 experienced overload on the lateral column and dorsum of the foot, which improved with the use of plantar orthoses and a rehabilitation program. We recorded no nerve complications (e.g., paresthesia), vascular injuries, or wound-related problems. CONCLUSION: Ultrasound-guided partial plantar fasciotomy with a needle is safe, since structures are under direct visualization of the surgeon and the risk of damage is minimal. Stitches are not necessary, and recovery is fast. Consequently, costs are low, and the patient can return to work quickly. This technique may represent a valid option for treatment of plantar fasciitis.
Fasciitis, Plantar/surgery , Fasciotomy/methods , Ultrasonography, Interventional/methods , Adult , Aged , Disability Evaluation , Female , Follow-Up Studies , Humans , Male , Middle Aged , Needles , Pain Measurement , Retrospective Studies
BACKGROUND: This study aims to analyse the clinical results of ultrasound-guided surgery for the decompression of the tibial nerve, including its distal medial and lateral branches, to treat tarsal tunnel syndrome. These structures are the complete flexor retinaculum and the deep fascia of the abductor hallucis muscle, including individualised release of the medial and lateral plantar nerve tunnels. METHOD: This is a retrospective review of 81 patients (36 men and 45 women) with an average age of 41 years old (32-62) and an average clinical course of 31 months (8-96) compatible with idiopathic tarsal tunnel syndrome, who underwent ultrasound-guided decompression of the proximal and distal tarsal tunnel between February 2015 and November 2017 (both months included), with a minimum follow-up of 18 months. RESULTS: Based on the Takakura et al. scale for the 81 patients, 76.54% obtained excellent results, 13.58% good results, and 9.87% poor results. The patients with the longest course of symptoms displayed the worst results. CONCLUSION: Although 9% of patients did not improve, ultrasound-guided tarsal tunnel release might be a viable alternative to conventional open approaches.
Decompression, Surgical/statistics & numerical data , Tarsal Tunnel Syndrome/surgery , Ultrasonography, Interventional/statistics & numerical data , Adult , Decompression, Surgical/methods , Female , Humans , Male , Middle Aged , Retrospective Studies , Ultrasonography, Interventional/methods
We propose an ensemble of multilayer feedforward neural networks to estimate the 3D position of photoelectric interactions in monolithic detectors. The ensemble is trained with data generated from optical Monte Carlo simulations only. The originality of our approach is to exploit simulations to obtain reference data, in combination with a variability reduction that the network ensembles offer, thus, removing the need of extensive per-detector calibration measurements. This procedure delivers an ensemble valid for any detector of the same design. We show the capability of the ensemble to solve the 3D positioning problem through testing four different detector designs with Monte Carlo data, measurements from physical detectors and reconstructed images from the MindView scanner. Network ensembles allow the detector to achieve a 2-2.4 mm FWHM, depending on its design, and the associated reconstructed images present improved SNR, CNR and SSIM when compared to those based on the MindView built-in positioning algorithm.
Brain/diagnostic imaging , Image Processing, Computer-Assisted/methods , Neural Networks, Computer , Positron-Emission Tomography , Algorithms , Calibration , Computer Simulation , Humans , Imaging, Three-Dimensional , Light , Models, Statistical , Monte Carlo Method , Optics and Photonics , Phantoms, Imaging
CR-39 nuclear track material is frequently used for the detection of protons accelerated in laser-plasma interactions. The measurement of track densities allows for determination of particle angular distributions, and information on the kinetic energy can be obtained by the use of passive absorbers. We present a precise method of measuring spectral distributions of laser-accelerated protons in a single etching and analysis process. We make use of a one-to-one relation between proton energy and track size and present a precise calibration based on monoenergetic particle beams. While this relation is limited to proton energies below 1 MeV, we show that the range of spectral measurements can be significantly extended by simultaneous use of absorbers of suitable thicknesses. Examples from laser-plasma interactions are presented, and quantitative results on proton energies and particle numbers are compared to those obtained from a time-of-flight detector. The spectrum end points of continuous energy distributions have been determined with both detector types and coincide within 50-100 keV.
El término trastorno del desarrollo es un concepto amplio dentro del cual se incluyen los trastornos del espectro autista. A efectos prácticos, abordaremos en este artículo la detección precoz de los trastornos del desarrollo y en un segundo artículo la de los trastornos del espectro autista. El trastorno del desarrollo se define como toda desviación en el neurodesarrollo por debajo de -1,5 desviaciones estándar de la media esperada para la edad. Es una limitación en el funcionamiento cognitivo o adaptativo que se inicia en la infancia y produce alteraciones de conducta en el hogar, la escuela o la comunidad, o un déficit intelectual que puede manifestarse como retraso del lenguaje, trastornos en el aprendizaje, en el razonamiento o en el juicio práctico, en la capacidad para solucionar problemas o una incapacidad para el razonamiento abstracto. En los últimos años, distintos grupos de expertos han enfatizado la importancia del diagnóstico precoz de los trastornos del espectro autista y de todos los trastornos del desarrollo en general. Esta recomendación obedece a la importancia del inicio temprano de las terapias encaminadas a mejorar los trastornos del desarrollo. En este documento y en el que se publicará, como colaboración del grupo PrevInfad, en un próximo número de la revista, el autor analiza la evidencia sobre el tema y el grupo se pronuncia sobre las recomendaciones en el cribado de los trastornos del desarrollo y de los trastornos del espectro autista
The expression development disorder is a wide concept that includes autism spectrum disorders. In this paper we will address the early detection of development disorders and in a second paper the autism spectrum disorders early detection. Development disorder is defined as any deviation in neurodevelopment below -1.5 standard deviations from the mean expected for the age. It is a limitation in the cognitive or adaptive functioning that starts in infancy and childhood and produces behavior disorders at home, school, or community. It can be also an intellectual handicap that can manifest as a language delay, or learning, reasoning or practical judgement disabilities, problem solution capacity impairment or abstract reasoning incapacity. In the last years, several expert groups have stressed the importance of the early detection of autism spectrum disorders and of all the development disorders in general. This recommendation in due to the relevance of the early start of therapies devoted to improving development disorders. In this paper and in the second one, that will be published in a next issue of this journal as the PrevInfad group collaboration, the author analyses the evidence and the group positions on the recommendations for the screening of development disorders and autism spectrum disorders
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Developmental Disabilities/diagnosis , Early Diagnosis , Autistic Disorder/diagnosis , Primary Health Care , Early Medical Intervention/methods , Child Development
El planteamiento del marco analítico, y su representación gráfica, forma parte del abordaje integral para la realización de las revisiones sistemáticas que el US Preventive Services Task Force utiliza en el proceso de elaboración de sus recomendaciones. Se incluye como parte de la metodología para el desarrollo del plan de trabajo. Junto a las preguntas clave, establecen los pasos necesarios en la lógica clínica que deben ser demostrados para evaluar la eficacia y los daños de un servicio preventivo en Atención Primaria. El objetivo de un marco analítico es presentar clara y esquemáticamente las preguntas específicas que relacionan intervenciones y resultados y que deben ser contestadas por la revisión bibliográfica. Se describe una convención para su diseño respecto a los ítems, enlaces, símbolos y representación gráfica (AU)
The analytic framework and its graphic representation, takes part of the integral approach in the systematic reviews that the US Preventive Services Task Force develop in the process of developing their recommendations. It is included as part of the methodology for the process of the working plan. Together with the key questions, the analytic framework establishes the needed steps in the logical process that should be demonstrated in order to assess the efficacy and the harms of a preventive service in primary care. The objective of an analytic framework is to present clearly and schematically the specific questions that relate interventions and results and that should be answered through the bibliographic review. A convention for its design, items, links, symbols and graphic representation is described (AU)
Humans , Infant , Child, Preschool , Child , Adolescent , Consensus , Preventive Health Services/methods , Preventive Health Services/organization & administration , Preventive Health Services/standards , Health Promotion/standards , Preventive Health Services/legislation & jurisprudence , Preventive Health Services/trends , Preventive Health Services
TITLE: Uso compasivo de cannabidiol en espray para el tratamiento de paraparesia espastica en un paciente con adrenomieloneuropatia.
Cannabidiol/administration & dosage , Dronabinol/administration & dosage , Paraparesis, Spastic/drug therapy , Adrenoleukodystrophy/complications , Adult , Aerosols , Compassionate Use Trials , Drug Combinations , Humans , Male , Paraparesis, Spastic/etiology
STUDY DESIGN: In the last years, there has been a change in the aetiology of spinal cord injury. There has been an increase in the number of elderly patients with spinal cord injuries caused by diseases or medical procedures. OBJECTIVE: The aim of this study is to investigate the frequency of the occurrence of iatrogenic spinal cord injury in our unit. The secondary aim is to study what variables can be associated with a higher risk of iatrogenesis. METHODS: A retrospective, descriptive, observational study of patients with acute spinal cord injury admitted from June 2009 to May 2014 was conducted. The information collected included the patient age, aetiology, neurological level and grade of injury when admitted and when discharged, cardiovascular risk factors, a previous history of depression and any prior treatment with anticoagulant or antiplatelet drugs. We applied a logistic regression. The grade of statistical significance was established as P<0.05. RESULTS: In total, 265 patients were included. In 48 of the cases, the cause was iatrogenic (18.18%±4.6% IC). The most frequent level of injury was the thoracic level (48%). The main aetiology of spinal cord injury caused by iatrogenesis was surgery for degenerative spine disease, in patients under the age of 30 were treated with intrathecal chemotherapy. CONCLUSIONS: Iatrogenic spinal cord injury is a frequent complication. A statistically significant association between a patient history of depression and iatrogenic spinal cord injury was found as well as with anticoagulant and antiplatelet drug use prior to iatrogenic spinal cord injury.
Spinal Cord Injuries/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Cardiovascular Diseases/epidemiology , Child , Child, Preschool , Female , Humans , Iatrogenic Disease/epidemiology , Logistic Models , Male , Middle Aged , Odds Ratio , Retrospective Studies , Risk Factors , Spinal Cord Injuries/classification , Spinal Cord Injuries/etiology , Young Adult
Recent PCR studies indicate that asymptomatic L. infantum infection is common in people in southern Europe. Understanding its spatial distribution is a requisite to evaluate the public health implications and to design disease control schemes. We investigated infection in blood samples from 657 donors in southeast Spain using PCR and antibody ELISA. They came from 19 blood centers and were interviewed about their residence, occupation, dog ownership and Leishmaniosis awareness. The percentage of PCR and ELISA positives were 8% (49/618) and 2% (13/657). Donor's residences were spatially clustered around blood donning centers and PCR prevalence was 18% in rural municipalities with 20-1330 inhabitants, 12% in those with 1467-5088 inhabitants and 3% in larger communities, and was associated with dog ownership (p<0.05). Further analysis of data from rural donors indicated that PCR status was strongly related to the climate, altitude and soil type in the donor's residence area and not to other demographic or sociologic variables. Mixed logistic regression analysis predicted PCR prevalence to be greatest in the 200-300m altitude range with a mean spring-summer (time of highest vector activity) temperature of 18.4-19.0°C. A temperature and altitude risk map was generated that will provide the basis for elaborating evidence-based vector surveillance studies.
Leishmania infantum , Leishmaniasis, Visceral/epidemiology , Adolescent , Adult , Aged , Altitude , Animals , Asymptomatic Infections/epidemiology , Climate , Dogs , Europe , Female , Humans , Male , Middle Aged , Prevalence , Risk Factors , Rural Population , Seasons , Socioeconomic Factors , Spain/epidemiology , Young Adult
We suggest a symmetric-polar pixellation scheme which makes possible a reduction of the computational cost for expectation maximization (EM) iterative algorithms. The proposed symmetric-polar pixellation allows us to deal with 3D images as a whole problem without dividing the 3D problem into 2D slices approach. Performance evaluation of each approach in terms of stability and image quality is presented. Exhaustive comparisons between all approaches were conducted in a 2D based image reconstruction model. From these 2D approaches, that showing the best performances were finally implemented and evaluated in a 3D based image reconstruction model. Comparison to 3D images reconstructed with FBP is also presented. Although the algorithm is presented in the context of computed tomography (CT) image reconstruction, it can be applied to any other tomographic technique as well, due to the fact that the only requirement is a scanning geometry involving measurements of an object under different projection angles. Real data have been acquired with a small animal (CT) scanner to verify the proposed mathematical description of the CT system.
Algorithms , Image Processing, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Phantoms, Imaging , Tomography, X-Ray Computed/instrumentation
Objetivo: evaluar la influencia de la asistencia a la guardería sobre la morbilidad y elconsumo de recursos sanitarios en los niños menores de 2 años.Material y métodos: diseño: estudio longitudinal prospectivo. Centros participantes: centrosde Atención Primaria, coordinados por el Grupo de Investigación de la Asociación Españolade Pediatría de Atención de Primaria (AEPap). Sujetos: niños menores de 2 años que acudena las consultas de pediatría de los centros de salud participantes. Muestra: niños nacidosentre el 1 de abril y el 30 de octubre de 2009 que cumplan los criterios de inclusión. Variables:la variable independiente será asistencia o no a la guardería. Como variables dependientes seanalizarán el número y el tipo de infecciones, los tratamientos recibidos y la asistencia a centrossanitarios. Se recogerán variables de caracterización familiares y personales que pudieranactuar como factores de confusión. Recogida de datos: entrevistas realizadas en la primera visitay a los 6, 12, 18 y 24 meses de edad. Análisis estadístico: para analizar las diferencias entreel número de infecciones dependiendo de la edad del niño al entrar en la guardería se realizaráun test de Anova. Para comparar el consumo de antibióticos y de broncodilatadores, asícomo la utilización de recursos sanitarios entre los niños que acuden a la guardería y aquellosque no lo hacen se aplicará el test de la T de Student o el test U de Mann-Whitney. Se realizaráun análisis multivariante de regresión lineal paso a paso para identificar factores personalesy familiares que pueden considerarse como variables predictoras del número de infecciones,controlando los posibles factores de confusión e interacciones(AU)
Objective: to evaluate the influence of child day-care centres on morbidity and consumptionof health resources in children younger than 2 years.Methods: design: prospective longitudinal study. Participating institutions: Primary HealthCare centers, coordinated by Grupo de Investigación de la Asociación Española de Pediatríade Atención Primaria (AEPap) (Research Group of the Spanish Primary Care PediatricsAssociation). Subjects: children aged 0 to 2 years attending pediatric appointments ofthe participating health centres. Sample: all children born between April 1st and October30th, 2009, that meet the inclusion criteria. Variables: independent variable will be Childday-care center or not. As dependent variables it will be analyzed the number and type ofinfection, treatments received and assistance to Health Care centers. Characterization personaland family variables that could act as confounding factors will be also collected. Datacollection: interviews conducted during the first visit and at 6, 12, 18 and 24 months of age.Statistical analysis: to analyze the differences between number of infections depending onage of child when entering child day-care center, an Anova test will be done. We will applyStudents T test or Mann-Whitney´s U test to compare antibiotic consumption, use of bronchodilators,health resource utilization among children attending child day-care center andthose who dont. A multivariate lineal regression analysis will be done step by step to identifypersonal and family factors that may be considered as predictors of the number of infectionsafter controlling potential confounders and interaction factors(AU)
Humans , Male , Female , Infant , Child, Preschool , Schools, Nursery , Schools, Nursery/organization & administration , Accident Prevention/methods , Primary Prevention/organization & administration , Primary Prevention/trends , Epidemiological Monitoring , Schools, Nursery/standards , Morbidity , Prospective Studies , Longitudinal Studies , Primary Health Care/methods , Primary Health Care/trends , Multivariate Analysis , Analysis of Variance , Data Collection , Informed Consent
An appropriate local environment is necessary for successful implantation. Oxidative stress is implicated in the pathogenesis of several pathologies, and may contribute to early pregnancy failure. Antioxidant therapies have been studied in infertility. In this study, we have assessed the antioxidant activity of N-acetylcysteine (NAC), flavonoids (quercetin, catechin) and alpha-tocopherol in an oxidative model of endometrial cells (RL95). Endometrial cells were incubated at several hydrogen peroxide concentrations. Antioxidant effects of NAC (15 mM), quercetin (150 microM), catechin (150 microM) and alpha-tocopherol included in liposomes (1.6 microg) were assessed by measuring cell viability by the MTT assay. Alpha-tocopherol-liposomes taken up by endometrial cells were assessed by HPLC. All liposomes used were able to introduce alpha-tocopherol into cells. The antioxidant effect of NAC and quercetin improved the viability of oxidised cells, and this effect was observed when the oxidant and antioxidant were coincubated. No viability change occurred when the antioxidant was added before or after the oxidant. The antioxidant effect of NAC was better than that of quercetin. When catechin or alpha-tocopherol were used in the same conditions, no antioxidant effect was detected in cells in culture. These results demonstrate that NAC and quercetin are good H2O2 scavengers.
Acetylcysteine/pharmacology , Antioxidants/pharmacology , Endometrium/cytology , Endometrium/metabolism , Flavonoids/pharmacology , alpha-Tocopherol/pharmacology , Acetylcysteine/metabolism , Antioxidants/metabolism , Cell Line, Tumor , Cell Survival/drug effects , Endometrial Neoplasms/metabolism , Endometrium/drug effects , Female , Flavonoids/metabolism , Humans , Hydrogen Peroxide/metabolism , Hydrogen Peroxide/toxicity , Liposomes , Oxidants/metabolism , Oxidative Stress/drug effects , alpha-Tocopherol/metabolism
The aim of this study was to evaluate single and double centrifugation tube methods for concentrating equine platelets. Whole blood samples were collected from clinically normal horses and processed by use of single and double centrifugation tube methods to obtain four platelet concentrates (PCs): PC-A, PC-B, PC-C, and PC-D, which were analyzed using a flow cytometry hematology system for hemogram and additional platelet parameters (mean platelet volume, platelet distribution width, mean platelet component concentration, mean platelet component distribution width). Concentrations of transforming growth factor beta 1 (TGF-beta(1)) were determined in all the samples. Platelet concentrations for PC-A, PC-B, PC-C, and PC-D were 45%, 44%, 71%, and 21% higher, respectively, compared to the same values for citrated whole blood samples. TGF-beta(1) concentrations for PC-A, PC-B, PC-C, and PC-D were 38%, 44%, 44%, and 37% higher, respectively, compared to citrated whole blood sample values. In conclusion, the single and double centrifugation tube methods are reliable methods for concentrating equine platelets and for obtaining potentially therapeutic TGF-beta(1) levels.
Blood Platelets/cytology , Centrifugation/veterinary , Horses/blood , Animals , Centrifugation/methods , Enzyme-Linked Immunosorbent Assay/veterinary , Female , Flow Cytometry/veterinary , Male , Platelet Count/veterinary , Statistics, Nonparametric , Transforming Growth Factor beta/analysis
Polycystic ovary syndrome (PCOS) affects 5-10% of women of reproductive age. Free radicals, as a product of oxidative stress, impair cells and tissue properties related to human fertility. These free radicals, together with the oxidized molecules, may have a cytotoxic or deleterious effects on sperm and oocytes, on early embryo development or on the endometrium. Aldehyde-modified proteins are highly immunogenic and circulating autoantibodies to new epitopes, such as malondialdehyde (MDA), may affect the reproductive system. Autoantibodies or elevated reactive oxygen species (ROS) in serum are often associated with inflammatory response. The purpose of this work is to investigate whether PCOS women show increased levels of oxidized proteins (protein-MDA) and anti-endometrial antibodies (AEA) in their sera, compared with control patients, and to determine whether AEA specificity is related to oxidized protein derivatives. Sera from 31 women [10 patients with PCOS (PCOS group) and 21 women with male factor of infertility (control group)] were chosen from patients attending for infertility. Anti-endometrial antibodies were determined by enzyme-linked immunosorbent assay (ELISA) with an endometrial cell line (RL-95). Antibodies against MDA modified human serum albumin (HSA-MDA) were also determined by ELISA. Oxidized proteins (protein-MDA) in serum were determined by a colorimetric assay. Patients with PCOS have significantly higher levels of AEA and anti-HSA-MDA, as well as oxidized proteins (protein-MDA) in serum than control patients. For the first time, we describe an autoimmune response in PCOS patients, in terms of AEA. The evidence of protein-MDA in the serum of these patients, together with the increased antibody reactivity to MDA-modified proteins (HSA-MDA) in vitro, supports the conclusion that oxidative stress may be one of the important causes for abnormal endometrial environment with poor embryo receptivity in PCOS patients.
Autoantibodies/blood , Endometrium/immunology , Malondialdehyde/immunology , Polycystic Ovary Syndrome/blood , Adult , Antibody Specificity/immunology , Blood Proteins/analysis , Cell Line , Epithelium/immunology , Female , Humans , Malondialdehyde/blood , Middle Aged , Oxidation-Reduction , Oxidative Stress/immunology , Polycystic Ovary Syndrome/immunology , Serum Albumin/immunology
PROBLEM: Many sterility outcomes may be associated to the presence of an inflammatory response that would lead to an inability of the endometrium to support implantation and maintain viable embryos. We have established an animal model of inflammation in which the systemic administration of lipopolysaccharyde (LPS) results in a low embryo implantation rate. The purpose of this work was to investigate the effect of the inflammatory agent LPS on embryo viability and to verify the ability of vitamin E to modulate the inflammatory effect of LPS on embryo viability. METHOD OF STUDY: For pre-implantation studies B6CBAF1 mice, which were intraperitoneally inoculated with LPS (4-10 mg/kg), were used. Mice were also treated with vitamin E (4-10 mg/kg) before or after LPS injection. Embryos were obtained from the oviduct after each treatment. RESULTS: The LPS produces a decrease in the number of pre-implantational embryos in a concentration dependent manner. The LPS effect can be partially reversed or prevented by vitamin E. Preliminary results show that inflammatory cytokines are secreted by intraperitoneal macrophages in LPS treated mice. CONCLUSION: Our results demonstrate the ability of vitamin E to avoid an inflammatory environment and to allow viability of embryos.
Disease Models, Animal , Inflammation/chemically induced , Inflammation/prevention & control , Lipopolysaccharides/pharmacology , Vitamin E/pharmacology , Animals , Embryo Loss , Female , Inflammation/metabolism , Interleukin-1/genetics , Male , Mice , RNA, Messenger/genetics , Reactive Oxygen Species/metabolism
In the female reproductive tract, the complement system represents a defense mechanism that can act directly against pathogens and cells, and mediates inflammatory response. Endometrial cells are protected from autologous complement attack by membrane-bound complement regulatory proteins (CRPs) that prevent complement activation: membrane cofactor protein (CD46), decay accelerating factor (CD55), and protectin (CD59). In this work we show that all CRPs were overexpressed after LPS exposure. Maximal stimulatory effect was detected after 6h, and was declining after 12h, reaching control levels in 24h. CD59 was the protein showing the more prominent effect. There seems to be a slight increase of CRP expression in the endometrium of sterile patients that have anti-endometrial antibodies (AEA) in their serum. Our results suggest that under stress, the high expression of CRPs (CD46, CD55, and CD59) could protect endometrial injured cells against complement mediated lysis. The survival of these cells with some biochemical modifications would enable autoimmune response.
Antigens, CD/biosynthesis , CD55 Antigens/biosynthesis , CD59 Antigens/biosynthesis , Complement Inactivator Proteins/biosynthesis , Endometrium/immunology , Membrane Glycoproteins/biosynthesis , Antigens, CD/immunology , Autoantibodies/blood , Autoantibodies/immunology , Blotting, Western , CD55 Antigens/immunology , CD59 Antigens/immunology , Complement Inactivator Proteins/immunology , Electrophoresis, Polyacrylamide Gel , Endometrium/pathology , Female , Flow Cytometry , Gene Expression Regulation/immunology , Humans , Infertility, Female/immunology , Lipopolysaccharides/immunology , Membrane Cofactor Protein , Membrane Glycoproteins/immunology , Membrane Proteins/immunology , Microscopy, Fluorescence , Tumor Cells, Cultured
