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1.
Clin Rheumatol ; 43(1): 501-509, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37964076

RESUMEN

OBJECTIVE: To address the relationship between systemic lupus erythematosus (SLE) disease activity and the functional parameters of the innate immunity. METHODS: We evaluated a cohort of 26 adult SLE patients and 10 sex and age-paired healthy donors. When the patients had a disease flare (baseline) and when they achieve clinical response (follow-up), we assessed the systemic lupus erythematosus disease activity index 2 K (SLEDAI 2 K) and the following parameters with flow cytometry and confocal microscopy: monocyte subsets, their expression of TLR2, phagocytic monocytes and neutrophils using the pHrodo Red E. coli BioParticles, the respiratory burst with 123-dihydrorhodamine in neutrophils, and the spontaneous and lipopolysaccharide (LPS)-induced production of neutrophil extracellular traps (NETs). We used the Wilcoxon test to compare the paired medians with interquartile range (IQR) and the Mann-Whitney U test for independent medians. To assess the effect of prednisone and SLEDAI 2 K on the mentioned parameters, we applied a generalized mixed linear model. RESULTS: Twenty-three patients (88.4%) were women. The SLEDAI 2 K was higher at baseline 8 (6-14) in comparison to that at follow-up (6 (4-8), P = 0.028). At baseline, SLE patients had a decreased percentage of intermediate monocytes, a higher expression of TLR2 in total monocytes, increased phagocytosis in monocytes and neutrophils, a decreased respiratory burst intensity, and an increased production of NETs. In the mix model, the SLEDAI 2 K was the main factor influencing these functional innate immune parameters. CONCLUSION: Disease activity regulates the innate immune function in SLE which may contribute to the clinical features and infection predisposition. Key points • This is the first cohort study addressing the effect of disease activity and prednisone use on the innate immune function of lupus patients. • Our results show that the disease activity is a key regulator of the respiratory burst, phagocytosis, and the production of neutrophil extracellular traps. • Also, we observed a differential proportion of monocyte subsets according to SLE disease activity. • We consider that our manuscript contributes to the evidence addressing the intrinsic immune abnormalities of patients with SLE regardless of the use of immunosuppressants and set the bases for new research work considering the disease activity as an element to decide the prescription and duration of antibiotic prophylaxis in SLE patients, which is of interest to all rheumatologists.


Asunto(s)
Lupus Eritematoso Sistémico , Receptor Toll-Like 2 , Adulto , Humanos , Femenino , Masculino , Prednisona/uso terapéutico , Estudios de Cohortes , Escherichia coli , Lupus Eritematoso Sistémico/tratamiento farmacológico , Inmunidad
2.
Arch. cardiol. Méx ; Arch. cardiol. Méx;93(4): 405-416, Oct.-Dec. 2023. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1527717

RESUMEN

Abstract Introduction: In Mexico, cardiac rehabilitation (CR) as an interdisciplinary intervention with therapeutic impact in patients with heart disease is growing. There is the need to know actual conditions of CR in our country. Objectives: The objective of this National Registry is to follow-up those existing and new CR units in Mexico through the comparison between the two previous registries, RENAPREC-2009 and RENAPREC II-2015 studies. This is a descriptive study focused on diverse CR activities such as assistance training, and certification of health professionals, barriers, reference, population attended, interdisciplinarity, permanence over time, growth prospects, regulations, post-pandemic condition, integrative characteristics, and scientific research. Results: Data were collected from 45 CR centers in the 32 states, 75.5% are private practice units, 67% are new, 33% were part of RENAPREC II-2015, and 17 have continued since 2009. With a better distribution of CR units along the territory, the median reference of candidates for CR programs is 9% with a significant reduction into tiempo of enrollment to Phase II admission (19 ± 11 days). Regarding to previous registries, the coverance of Phases I, II, and III is 71%, 100%, and 93%, respectively; and a coverance increases in evaluation, risk stratification, and prescription, more comprehensive attendance and prevention strategies. Conclusions: CR in Mexico has grown in the past 7 years. Even there is still low reference and heterogeneity in specific processes, there are strengths such as interdisciplinarity, scientific professionalization of specialists, national diversification, and an official society that are consolidated over time.


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3.
Sensors (Basel) ; 23(21)2023 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-37960667

RESUMEN

This research presents an experimental study focused on measuring temperature at the tool flank during the up-milling process at high cutting speed. The proposed system deals with emissivity compensation through a two-photodetector system and during calibration. A ratio pyrometer composed of two photodetectors and a multimode fiber-optic coupler is employed to capture the radiation emitted by the cutting insert. The pyrometer is calibrated using an innovative calibration system that addresses theoretical discrepancies arising from various factors affecting the measurement of cutting temperature. This calibration system replicates the milling process to generate a calibration curve. Experimentally, AISI 4140 steel is machined with coated tungsten carbide inserts, using cutting speeds of 300 and 400 m/min, and feed rates of 0.08 and 0.16 mm/tooth. The results reveal a maximum recorded cutting temperature of 518 °C and a minimum of 304 °C. The cutting temperature tends to increase with higher cutting speeds and feed rates, with cutting speed being the more influential factor in this increase. Both the pyrometer calibration and experimental outcomes yield satisfactory results. Finally, the results showed that the process and the device prove to be a convenient, effective, and precise method of measuring cutting temperature in machine processes.

4.
Rev Alerg Mex ; 70(2): 64-71, 2023 Jun 28.
Artículo en Español | MEDLINE | ID: mdl-37566769

RESUMEN

OBJECTIVE: To describe health relaed quality of life in a cohort of stable adult outpatients with hereditary an-gioedema (HAE) with validated tools. METHODS: An observational, cross-sectional, and descriptive study was performed, carried out in patients with hereditary angioedema, coming from the City of Buenos Aires and its provinces: Corrientes, Chubut, Entre Ríos and Santa Fe. The HAE-QoL and SF-12v2 health questionnaires were applied to assess the related quality of life. with health. RESULTS: 100 patients were included; median age: 41.5 years (range: 18-77); 65% were female, and 79% had type 1 HAE. Asymptomatic, mild, moderate and severe cases accounted for 6, 29, 38, and 27% of participants, respectively. Seventeen percent of patients were receiving long-term prophylaxis. Icatibant was the most fre-quent treatment for acute episodes. All health domains SF-12v2 scores were lower than expected in general population, excepting "vitality" and "physical functioning". Total and all specific domains HAE-QoL scores were reduced. Differences between women and men and in every age-defined group were demonstrated for sev-eral specific domains. CONCLUSIONS: Health relaed to quality life was notably reduced in Argentinean patients with HAE, when imple-menting the HAE.QoL, and SF-12v2 questionnaries. The need for multidisciplinary strategies approaching this complex disease is highlighted.


OBJECTIVO: Describir la calidad de vida relacionada con la saluden pacientes adultos, ambulatorios y estables con angioedema hereditario, mediante cuestionarios validados. MÉTODOS: Estudio descriptivo, transversal y observacional, llevado a cabo en pacientes con angioedema here-ditario, procedentes de la Ciudad de Buenos Aires y sus provincias: Corrientes, Chubut, Entre Ríos y Santa Fe. Se aplicaron los cuestionarios HAE-QoL y SF-12v2 para evaluar la calidad de vida relacionada con la salud. RESULTADOS: Se incluyeron 100 pacientes, con mediana de edad de 41.5 años (rango: 18-77), principalmente de género femenino (65%). La forma más frecuente de angioedema hereditario fue el tipo 1 (79%). Los casos asintomáticos, leves, moderados y severos representaron el 6, 29, 38 y 27%, respectivamente. El 17% recibía profilaxis a largo plazo. Icatibant fue el tratamiento más prescrito para los episodios agudos de angioedema. Todos los puntajes de los dominios de salud del SF-12v2 fueron menores de lo esperado, excepto "vitalidad" y "funcionamiento físico". Se observó disminución en los puntajes totales y en todos los dominios del HAE-QoL. Se reconocieron diferencias entre las mujeres y los hombres, y para grupo etario en los puntajes de los dominios específicos. CONCLUSIONES: La calidad de vida relacionada con la salud disminuyó considerablemente en pacientes argentinos con angioedema hereditario al aplicar los cuestionarios HAE-QoL y SF-12v2. Es importante desarrollar estra-tegias multidisciplinarias para abordar esta enfermedad compleja.


Asunto(s)
Angioedemas Hereditarios , Adulto , Masculino , Humanos , Femenino , Angioedemas Hereditarios/epidemiología , Angioedemas Hereditarios/tratamiento farmacológico , Calidad de Vida , Argentina/epidemiología , Estudios Transversales , Encuestas y Cuestionarios
6.
Arch Cardiol Mex ; 2023 Jun 06.
Artículo en Español | MEDLINE | ID: mdl-37355985

RESUMEN

Introduction: In Mexico, cardiac rehabilitation (CR) as an interdisciplinary intervention with therapeutic impact in patients with heart disease is growing. There is the need to know actual conditions of CR in our country. Objectives: The objective of this National Registry is to follow-up those existing and new CR units in Mexico through the comparison between the two previous registries, RENAPREC-2009 and RENAPREC II-2015 studies. This is a descriptive study focused on diverse CR activities such as assistance training, and certification of health professionals, barriers, reference, population attended, interdisciplinarity, permanence over time, growth prospects, regulations, post-pandemic condition, integrative characteristics, and scientific research. Results: Data were collected from 45 CR centers in the 32 states, 75.5% are private practice units, 67% are new, 33% were part of RENAPREC II-2015, and 17 have continued since 2009. With a better distribution of CR units along the territory, the median reference of candidates for CR programs is 9% with a significant reduction into tiempo of enrollment to Phase II admission (19 ± 11 days). Regarding to previous registries, the coverance of Phases I, II, and III is 71%, 100%, and 93%, respectively; and a coverance increases in evaluation, risk stratification, and prescription, more comprehensive attendance and prevention strategies. Conclusions: CR in Mexico has grown in the past 7 years. Even there is still low reference and heterogeneity in specific processes, there are strengths such as interdisciplinarity, scientific professionalization of specialists, national diversification, and an official society that are consolidated over time.


Introducción: En México, la Rehabilitación Cardíaca (RC) como intervención interdisciplinaria con impacto terapéutico en paciente con cardiopatía está en crecimiento. Existe la necesidad de conocer las condiciones actuales de la RC en nuestro país. Objetivo: El objetivo de este Registro es dar seguimiento comparativo de las unidades nuevas y existentes entre los registros anteriores, RENAPREC-2009 y RENAPREC II-2015. Se trata de un estudio descriptivo centrado en diversas actividades de la RC: formación asistencial y certificación de sus profesionales, barreras, referencia, población atendida, interdisciplinariedad, permanencia en el tiempo, perspectivas de crecimiento, normativa, condición pospandemia, características integradoras e investigación. Resultados: Se recolectaron datos de 45 centros en los 32 estados, 67% son nuevos 75.5% son de práctica privada, 33% fueron parte de RENAPREC II-2015 y 17 desde 2009. Con una mejor distribución de las unidades de RC a lo largo del territorio, la mediana de referencia de pacientes candidatos a RC es ahora del 9% con reducción significativa del tiempo de admisión a Fase II (19 ± 11 días). Respecto a registros anteriores las coberturas de las Fases I, II y III son del 71%, 100% y 93%, respectivamente; con un aumento de la cobertura en evaluación, estratificación de riesgo y prescripción, atención más integral y estrategias de prevención. Conclusiones: La RC en México ha crecido en los últimos 7 años. Si bien aún existe baja referencia y heterogeneidad en procesos específicos, existen fortalezas como la interdisciplinariedad, la profesionalización científica de los especialistas, la diversificación nacional y una sociedad oficial que se consolida en el tiempo.

7.
Brain Behav Immun ; 111: 270-276, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37149107

RESUMEN

Studies of cellular and cytokine profiles have contributed to the inflammation hypothesis of schizophrenia; however, precise markers of inflammatory dysfunction remain elusive. A number of proton magnetic resonance spectroscopy (1H-MRS) studies in patients with first-episode psychosis (FEP) have shown higher brain levels of metabolites such as glutamate, myo-inositol (mI) and choline-containing compounds (tCho), suggesting neuroinflammation. Here, we present peripheral inflammatory profiles in antipsychotic-naive FEP patients and age-and-sex matched healthy controls, as well as cortical glutamate, mI and tCho levels using 1H-MRS. Inflammatory profiles were analyzed using cytokine production by peripheral blood mononuclear cells, that were either spontaneous or stimulated, in 48 FEP patients and 23 controls. 1H-MRS of the medial prefrontal cortex was obtained in 29 FEP patients and 18 controls. Finally, 16 FEP patients were rescanned after 4 weeks of treatment (open-label) with Risperidone. FEP patients showed a higher proportion of proinflammatory Th1/Th17 subset, and an increased spontaneous production of Interleukin (IL)-6, IL-2 and IL-4 compared with the control group. Results obtained from 1H-MRS showed no significant difference in either glutamate, mI or tCho between FEP and control groups. At baseline, CD8% showed a negative correlation with glutamate in FEP patients; after 4 weeks of risperidone treatment, the FEP group exhibited a decrease in glutamate levels which positively correlated with CD4 + T cells. Nevertheless, these correlations did not survive correction for multiple comparisons. FEP patients show evidence of immune dysregulation, affecting both the innate and adaptive immune response, with a predominantly Th2 signature. These findings, along with the changes produced by antipsychotic treatment, could be associated with both systemic and central inflammatory processes in schizophrenia.


Asunto(s)
Antipsicóticos , Neuroquímica , Trastornos Psicóticos , Humanos , Risperidona/uso terapéutico , Antipsicóticos/uso terapéutico , Leucocitos Mononucleares/metabolismo , Ácido Glutámico/metabolismo , Interleucina-6 , Inflamación/complicaciones
8.
Front Immunol ; 14: 1080154, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36911711

RESUMEN

Introduction: Immunoglobulin A (IgA) is the main antibody isotype in body fluids such as tears, intestinal mucous, colostrum, and saliva. There are two subtypes of IgA in humans: IgA1, mainly present in blood and mucosal sites, and IgA2, preferentially expressed in mucosal sites like the colon. In clinical practice, immunoglobulins are typically measured in venous or capillary blood; however, alternative samples, including saliva, are now being considered, given their non-invasive and easy collection nature. Several autoimmune diseases have been related to diverse abnormalities in oral mucosal immunity, such as rheumatoid arthritis, Sjogren's syndrome, and systemic lupus erythematosus (SLE). Methods: We decided to evaluate the levels of both IgA subtypes in the saliva of SLE patients. A light chain capture-based ELISA measured specific IgA1 and IgA2 levels in a cohort of SLE patients compared with age and gender-matched healthy volunteers. Results: Surprisingly, our results indicated that in the saliva of SLE patients, total IgA and IgA1 subtype were significantly elevated; we also found that salivary IgA levels, particularly IgA2, positively correlate with anti-dsDNA IgG antibody titers. Strikingly, we also detected the presence of salivary anti-nucleosome IgA antibodies in SLE patients, a feature not previously reported elsewhere. Conclusions: According to our results and upon necessary validation, IgA characterization in saliva could represent a potentially helpful tool in the clinical care of SLE patients with the advantage of being a more straightforward, faster, and safer method than manipulating blood samples.


Asunto(s)
Inmunoglobulina A Secretora , Lupus Eritematoso Sistémico , Humanos , Inmunoglobulina A , Inmunoglobulina G , Mucosa Bucal , Biomarcadores
10.
Magn Reson Imaging ; 93: 62-72, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-35842196

RESUMEN

BACKGROUND AND AIMS: Chronic heart failure (CHF) represents a significant cause of morbidity and mortality globally. Metabolic maladaptation has proven to be critical in the progression of this condition. Preclinical studies have shown that irisin, an adipomyokine involved in metabolic regulations, can induce positive cardioprotective effects by improving cardiac remodeling, cardiomyocyte viability, calcium delivery, and reducing inflammatory mediators. However, data on clinical studies identifying the associations between irisin levels and functional imaging parameters are scarce in CHF patients. The objective of this study was to determine the association of irisin levels with cardiac imaging measurements through cardiac magnetic resonance, inflammatory markers, and biochemical parameters in patients with CHF compared with control subjects. METHODS AND RESULTS: Thirty-two subjects diagnosed with CHF and thirty-two healthy controls were evaluated in a cross-sectional study. Serum irisin levels were significantly lower in patients with CHF than in controls. This is the first study to report a significant positive correlation between irisin levels and cardiac magnetic resonance parameters such as left ventricular ejection fraction, fraction shortening, and global radial strain. A negative correlation was demonstrated between irisin levels and brain natriuretic peptide, insulin levels, and Homeostatic model assessment for insulin resistance index. We did not observe significant correlations between irisin levels and inflammatory cytokines. CONCLUSIONS: Given the importance of fraction shortening and global radial strain as accurate markers of ventricular wall motion, these results support the hypothesis that irisin may play an essential role in maintaining an adequate myocardial wall architecture, deformation, and thickness.


Asunto(s)
Fibronectinas , Insuficiencia Cardíaca , Biomarcadores , Estudios Transversales , Fibronectinas/sangre , Insuficiencia Cardíaca/diagnóstico por imagen , Humanos , Espectroscopía de Resonancia Magnética , Volumen Sistólico , Función Ventricular Izquierda
11.
Front Immunol ; 13: 892241, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35663936

RESUMEN

Lupus nephritis (LN) is one of the most common manifestations of systemic lupus erythematosus (SLE), characterized by abnormal B cell activation and differentiation to memory or plasma effector cells. However, the role of these cells in the pathogenesis of LN is not fully understood, as well as the effect of induction therapy on B cell subsets, possibly associated with this manifestation, like aged-associated B cells (ABCs). Consequently, we analyzed the molecules defining the ABCs subpopulation (CD11c, T-bet, and CD21) through flow cytometry of blood samples from patients with lupus presenting or not LN, following up a small sub-cohort after six months of induction therapy. The frequency of ABCs resulted higher in LN patients compared to healthy subjects. Unexpectedly, we identified a robust reduction of a CD21hi subset that was almost specific to LN patients. Moreover, several clinical and laboratory lupus features showed strong and significant correlations with this undefined B cell subpopulation. Finally, it was observed that the induction therapy affected not only the frequencies of ABCs and CD21hi subsets but also the phenotype of the CD21hi subset that expressed a higher density of CXCR5. Collectively, our results suggest that ABCs, and more importantly the CD21hi subset, may work to assess therapeutic response since the reduced frequency of CD21hi cells could be associated with the onset of LN.


Asunto(s)
Subgrupos de Linfocitos B , Lupus Eritematoso Sistémico , Nefritis Lúpica , Insuficiencia Renal , Anciano , Biomarcadores , Antígeno CD11c , Proteínas del Sistema Complemento/uso terapéutico , Humanos , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/tratamiento farmacológico , Nefritis Lúpica/diagnóstico
12.
Food Microbiol ; 106: 104040, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35690443

RESUMEN

Botrytis cinerea, the causal agent of the gray mold, is a filamentous fungus that infects blueberries and can cause important production losses in postharvest storage. Considering that the use of synthetic fungicides is not allowed on blueberries in postharvest conditions, alternative and natural strategies are needed to control gray mold. The objective of this work was to evaluate the capability of volatile organic compounds (VOCs) produced by Trichoderma atroviride IC-11 to control B. cinerea growth in blueberries after harvest. These VOCs inhibited almost completely B. cinerea growth in vitro. The most abundant volatile compound was 6-pentyl-α-pyrone (6PP). In vitro assays with pure 6PP confirmed its antifungal activity. The incidence of gray mold was evaluated in blueberries inoculated with B. cinerea and exposed to volatiles of T. atroviride IC-11. Gray mold incidence among those stored in air at 20 °C for 14 days was 100%, while the incidence among the volatile-treated fruit was 17%. Gray mold incidence among those stored in air at 4 °C for 31 days was 82%, while the incidence among the volatile-treated fruit was 11%. T. atroviride IC-11 VOCs inhibited mycelial growth and conidia germination of B. cinerea. The binding of VOCs to the surface of hyphae caused their vacuolation and deterioration. Selective cytotoxicity of 6PP on B. cinerea was observed but not on human intestinal cells at specific concentrations that controlled gray mold. The postharvest mycofumigation of blueberries with T. atroviride IC-11 VOCs is a promising approach to protect these fruits from gray mold.


Asunto(s)
Arándanos Azules (Planta) , Compuestos Orgánicos Volátiles , Arándanos Azules (Planta)/microbiología , Botrytis , Humanos , Hypocreales , Enfermedades de las Plantas/microbiología , Enfermedades de las Plantas/prevención & control , Compuestos Orgánicos Volátiles/metabolismo , Compuestos Orgánicos Volátiles/farmacología
13.
Saúde debate ; 46(133): 304-317, jan.-abr. 2022. tab
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1390356

RESUMEN

RESUMO O presente estudo analisa os efeitos da pandemia de Covid-19 sobre a saúde mental dos estudantes durante parte do período de suspensão das aulas presenciais. Trata-se de estudo transversal, aplicado entre outubro e dezembro de 2020, baseado em questionário on-line de autorrelato respondido por estudantes entre 13 e 20 anos, do 9º ano do Ensino Fundamental e do Ensino Médio, que acompanhavam as atividades escolares remotas em 21 escolas públicas estaduais e municipais, localizadas nas periferias dos municípios de São Paulo e Guarulhos. Para a análise dos dados, utilizaram-se dois modelos de regressão linear múltipla, tendo como variáveis dependentes os escores de depressão pelo Inventário de Depressão Infantil e de ansiedade pelo Scared (Screen for Child Anxiety Related Emotional Disorders). O tempo de exposição às telas, a inversão do sono e o sexo feminino, combinados com as dificuldades do ensino remoto e outros marcadores sociais (como cor/raça e casos de Covid-19 em casa), estão associados a sintomas de depressão e ansiedade durante a primeira onda da Covid-19 na Região Metropolitana de São Paulo, reforçando a importância da rotina escolar na vida desses jovens e os desafios colocados às escolas para a promoção da saúde mental dos estudantes no período pós-pandemia.


ABSTRACT This study analyzes the effects of the COVID-19 pandemic on students' mental health during part of the suspension of in-person classes. The study is a cross-sectional survey carried out from October2020 to December 2020. An online self-report questionnaire was answered by thirteen- to twenty-year old students, from the 9th grade (Middle School) to high school, who followed remote school activities in 21 state and municipal public schools located in peripheral areas of the cities of São Paulo and Guarulhos. Two linear regression models were used in the analysis, considering as dependent variables the depression scores as provided by the Child Depression Inventory and anxiety by the SCARED (Screen for Child Anxiety Related Emotional Disorders). The time of exposure to the screens, the inversion of sleep periods and the female gender, along with the difficulties of remote education and other social markers (such as color/race and cases of COVID-19 at home) are associated with symptoms of depression and anxiety during the first wave of the COVID-19 in the Metropolitan area of São Paulo. The findings reinforce the importance of school routine in the lives of those young people and the challenges posed to schools to promote students' mental health in the post-pandemic reality.

14.
J Investig Med ; 70(2): 415-420, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34620707

RESUMEN

Most COVID-19 mortality scores were developed at the beginning of the pandemic and clinicians now have more experience and evidence-based interventions. Therefore, we hypothesized that the predictive performance of COVID-19 mortality scores is now lower than originally reported. We aimed to prospectively evaluate the current predictive accuracy of six COVID-19 scores and compared it with the accuracy of clinical gestalt predictions. 200 patients with COVID-19 were enrolled in a tertiary hospital in Mexico City between September and December 2020. The area under the curve (AUC) of the LOW-HARM, qSOFA, MSL-COVID-19, NUTRI-CoV, and NEWS2 scores and the AUC of clinical gestalt predictions of death (as a percentage) were determined. In total, 166 patients (106 men and 60 women aged 56±9 years) with confirmed COVID-19 were included in the analysis. The AUC of all scores was significantly lower than originally reported: LOW-HARM 0.76 (95% CI 0.69 to 0.84) vs 0.96 (95% CI 0.94 to 0.98), qSOFA 0.61 (95% CI 0.53 to 0.69) vs 0.74 (95% CI 0.65 to 0.81), MSL-COVID-19 0.64 (95% CI 0.55 to 0.73) vs 0.72 (95% CI 0.69 to 0.75), NUTRI-CoV 0.60 (95% CI 0.51 to 0.69) vs 0.79 (95% CI 0.76 to 0.82), NEWS2 0.65 (95% CI 0.56 to 0.75) vs 0.84 (95% CI 0.79 to 0.90), and neutrophil to lymphocyte ratio 0.65 (95% CI 0.57 to 0.73) vs 0.74 (95% CI 0.62 to 0.85). Clinical gestalt predictions were non-inferior to mortality scores, with an AUC of 0.68 (95% CI 0.59 to 0.77). Adjusting scores with locally derived likelihood ratios did not improve their performance; however, some scores outperformed clinical gestalt predictions when clinicians' confidence of prediction was <80%. Despite its subjective nature, clinical gestalt has relevant advantages in predicting COVID-19 clinical outcomes. The need and performance of most COVID-19 mortality scores need to be evaluated regularly.


Asunto(s)
COVID-19 , Mortalidad Hospitalaria , Anciano , Área Bajo la Curva , COVID-19/mortalidad , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Curva ROC , Centros de Atención Terciaria
16.
Cells ; 10(10)2021 09 26.
Artículo en Inglés | MEDLINE | ID: mdl-34685525

RESUMEN

The coronavirus disease 2019 (COVID-19) is related to enhanced production of NETs, and autoimmune/autoinflammatory phenomena. We evaluated the proportion of low-density granulocytes (LDG) by flow cytometry, and their capacity to produce NETs was compared with that of conventional neutrophils. NETs and their protein cargo were quantified by confocal microscopy and ELISA. Antinuclear antibodies (ANA), anti-neutrophil cytoplasmic antibodies (ANCA) and the degradation capacity of NETs were addressed in serum. MILLIPLEX assay was used to assess the cytokine levels in macrophages' supernatant and serum. We found a higher proportion of LDG in severe and critical COVID-19 which correlated with severity and inflammatory markers. Severe/critical COVID-19 patients had higher plasmatic NE, LL-37 and HMGB1-DNA complexes, whilst ISG-15-DNA complexes were lower in severe patients. Sera from severe/critical COVID-19 patients had lower degradation capacity of NETs, which was reverted after adding hrDNase. Anti-NET antibodies were found in COVID-19, which correlated with ANA and ANCA positivity. NET stimuli enhanced the secretion of cytokines in macrophages. This study unveils the role of COVID-19 NETs as inducers of pro-inflammatory and autoimmune responses. The deficient degradation capacity of NETs may contribute to the accumulation of these structures and anti-NET antibodies are related to the presence of autoantibodies.


Asunto(s)
Autoinmunidad , COVID-19/sangre , COVID-19/inmunología , Trampas Extracelulares/inmunología , Inmunidad Humoral , Inflamación , Neutrófilos/inmunología , Anticuerpos Antinucleares , Péptidos Catiónicos Antimicrobianos/sangre , Autoanticuerpos/metabolismo , Estudios Transversales , Citocinas/metabolismo , Citocinas/farmacología , Citometría de Flujo , Granulocitos/metabolismo , Proteína HMGB1/sangre , Voluntarios Sanos , Humanos , Microscopía Confocal , Monocitos/citología , Neutrófilos/citología , SARS-CoV-2 , Ubiquitinas/farmacología , Catelicidinas
17.
Biosensors (Basel) ; 11(9)2021 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-34562914

RESUMEN

In recent years, the chemical modification of optical fibers (OFs) has facilitated the manufacture of sensors because OFs can identify several analytes present in aqueous solutions or gas phases. Nevertheless, it is imperative better to understand the chemical interactions in this molecular system to generate low-cost and efficient sensors. This work presents a theoretical and experimental study of organic polymeric functionalized OF structures and proposes a cost-effective alternative to monitor breathing and humidity. The device is based on silicon optical fibers functionalized with (3-Aminopropyl) triethoxysilane (APTES) and alginate. The theoretical analysis is carried out to validate the activation of the silicon dioxide fiber surface; moreover, the APTES-alginate layer is discussed. The computational simulation suggests that water can be absorbed by alginate, specifically by the calcium atom linked to the carboxylic acid group of the alginate. The analysis also demonstrates a higher electrostatic interaction between the water and the OF-APTES-alginate system; this interaction alters the optical fiber activated surface's refractive index, resulting in transmission power variation. The humidity analysis shows a sensitivity of 3.1288 mV/RH, a time response close to 25 s, and a recovery time around 8 s. These results were achieved in the range of 50 to 95% RH. Moreover, the recovery and response time allow the human breath to be studied. The proposed mechanism or device is competitive with prior works, and the components involved made this sensor a cost-effective alternative for medical applications.


Asunto(s)
Pruebas Respiratorias , Tecnología de Fibra Óptica , Fibras Ópticas , Diseño de Equipo , Humanos , Humedad , Polímeros , Refractometría , Dióxido de Silicio , Agua
18.
Rev Alerg Mex ; 68 Suppl 2: s1-s22, 2021.
Artículo en Español | MEDLINE | ID: mdl-34371527

RESUMEN

OBJECTIVES: Hereditary angioedema (HAE) is a rare disease. During the last years, many studies and advances have been developed with the aim of better understanding the pathophysiology, as well as optimizing patient management. Several international working groups have attempted to clarify and standardize the care of HAE communicated as guidelines and consensus recommendations. We considered necessary to provide recommendations for the diagnosis and treatment of patients with HAE in Argentina. METHODS: A group of specialists of allergy and immunology from Argentina by using the online surveys methodology as well as face to face meetings developed the intended consensus. RESULTS: Recommendations were established based on published evidence and the expert opinion. The consensus focused on diagnosis, acute management of attacks, short and long-term prophylaxis, special situations (pediatrics and pregnancy) and disease management considering the health care system in Argentina. CONCLUSION: The recommendations established in this consensus guidelines will optimize the management of patients with HAE in Argentina.


Objetivos: El angioedema hereditario es una enfermedad poco frecuente. Durante los últimos años se han desarrollado muchas investigaciones y registrado avances con el objetivo de entender mejor la fisiopatología y optimizar la atención a los pacientes. Diversos grupos de trabajo internacionales han intentado clarificar y normalizar el cuidado de pacientes con angioedema hereditario, lo que se ha reflejado en guías y consensos. Consideramos necesario desarrollar un documento de consenso con recomendaciones para el diagnóstico y tratamiento del angioedema hereditario en Argentina. Metodología: Un grupo de expertos de Argentina, conformado por especialistas en Alergia e Inmunología mediante metodología de ronda de encuestas a distancia y reuniones presenciales llevó adelante la elaboración del consenso pretendido. Resultados: Se establecieron recomendaciones basadas en la evidencia publicada y en el criterio de los expertos participantes. Las recomendaciones se enfocaron en el diagnóstico, tratamiento y profilaxis de las crisis a corto y largo plazo, control de situaciones especiales y consideraciones del sistema de salud en Argentina. Conclusión: Las recomendaciones establecidas en este consenso permitirán optimizar la atención médica de los pacientes con angioedema hereditario en Argentina.


Asunto(s)
Angioedemas Hereditarios , Algoritmos , Angioedemas Hereditarios/diagnóstico , Angioedemas Hereditarios/terapia , Argentina , Niño , Femenino , Humanos , Embarazo , Encuestas y Cuestionarios
19.
BMC Infect Dis ; 21(1): 518, 2021 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-34078320

RESUMEN

BACKGROUND: Lactobacillus is a genus of Gram-positive non-spore-forming rods usually found in the microbiota of the oral cavity, gastrointestinal tract, and female genitourinary tract. Also, they are commonly used in the food industry as supplements and probiotics. Lactobacilli are normally considered non-pathogenic to the human body, however, under certain circumstances such as immunosuppression, they can cause severe infections, with only a few cases of bacteremia, infective endocarditis, pneumonia, meningitis, and intra-abdominal infections reported. Among these presentations, a pyogenic liver abscess is rather rare. CASE PRESENTATION: We describe the case of a 59-year-old man with a history of diabetes mellitus and multiple abdominal surgeries with the latest being in 2014 presenting with bacteremia and multiple large pyogenic liver abscesses due to Lactobacillus gasseri, which did not appear to be related to the use of probiotics or immunosuppression. CONCLUSIONS: Given the high prevalence of diabetes mellitus and the increased use of probiotics, it is expected that in the future we will see an increase in infections caused by Lactobacilli. Medical management with antibiotics and percutaneous drainage were successful strategies for the treatment of this unusual case of pyogenic liver abscesses and bacteremia caused by Lactobacillus gasseri.


Asunto(s)
Bacteriemia/diagnóstico , Lactobacillus gasseri/aislamiento & purificación , Absceso Piógeno Hepático/diagnóstico , Antibacterianos/uso terapéutico , Bacteriemia/complicaciones , Bacteriemia/terapia , Complicaciones de la Diabetes/diagnóstico , Complicaciones de la Diabetes/terapia , Drenaje , Humanos , Lactobacillus gasseri/efectos de los fármacos , Lactobacillus gasseri/patogenicidad , Absceso Piógeno Hepático/complicaciones , Absceso Piógeno Hepático/terapia , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
20.
Sensors (Basel) ; 21(9)2021 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-33923114

RESUMEN

There are several tools, frameworks, and algorithms to solve information sharing from multiple tasks and robots. Some applications such as ROS, Kafka, and MAVLink cover most problems when using operating systems. However, they cannot be used for particular problems that demand optimization of resources. Therefore, the objective was to design a solution to fit the resources of small vehicles. The methodology consisted of defining the group of vehicles with low performance or are not compatible with high-level known applications; design a reduced, modular, and compatible architecture; design a producer-consumer algorithm that adjusts to the simultaneous localization and communication of multiple vehicles with UWB sensors; validate the operation with an interception task. The results showed the feasibility of performing architecture for embedded systems compatible with other applications managing information through the proposed algorithm allowed to complete the interception task between two vehicles. Another result was to determine the system's efficiency by scaling the memory size and comparing its performance. The work's contributions show the areas of opportunity to develop architectures focusing on the optimization of robot resources and complement existing ones.

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