RESUMEN
BACKGROUND: Substantial progress has been made toward unraveling the genetic architecture of multiple sclerosis (MS) within populations of European ancestry, but few genetic studies have focused on Hispanic and African American populations within the United States. OBJECTIVE: We sought to test the relevance of common European MS risk variants outside of the major histocompatibility complex (n = 200) within these populations. METHODS: Genotype data were available on 2652 Hispanics (1298 with MS, 1354 controls) and 2435 African Americans (1298 with MS, 1137 controls). We conducted single variant, pathway, and cumulative genetic risk score analyses. RESULTS: We found less replication than statistical power suggested, particularly among African Americans. This could be due to limited correlation between the tested and causal variants within the sample or alternatively could indicate allelic and locus heterogeneity. Differences were observed between pathways enriched among the replicating versus all 200 variants. Although these differences should be examined in larger samples, a potential role exists for gene-environment or gene-gene interactions which alter phenotype differentially across racial and ethnic groups. Cumulative genetic risk scores were associated with MS within each study sample but showed limited diagnostic capability. CONCLUSION: These findings provide a framework for fine-mapping efforts in multi-ethnic populations of MS.
Asunto(s)
Negro o Afroamericano , Esclerosis Múltiple , Negro o Afroamericano/genética , Alelos , Variación Genética , Hispánicos o Latinos/genética , Humanos , Esclerosis Múltiple/genética , Polimorfismo de Nucleótido Simple , Estados Unidos/epidemiologíaRESUMEN
Graft-versus-host disease (GVHD) remains the greatest source of morbidity-mortality in allogenic transplant patients. Although in most cases the more easily obtainable clinical and laboratory test parameters suffice to confirm the diagnosis and establish the stage of the disease biopsies of the affected organ are sometimes needed. At present there is great Interest in the study of factors allowing a prognosis of the course and type of response to treatment in patients with CVHD. In this sense, It would be necessary to objectively Identify and validate biomarkers capable of predicting biological or pathological processes in patients with cVHD. To this effect we have performed serial analyses of skin tissue using peripheral blood and tissue biomarkers in a prospective observational study conducted in three transplant centers. The still preliminary results Indicate that certain histopathological findings classically attributed to CVHD ore also seen in patients not clinically affected by the disease--this probably being related to other physiopathological phenomena occurring during transplantation. The study of these findings, combined with biomarker analysis, will allow improved understanding of the underlying etiopathogenesis, as well as the definition of new diagnostic, prognostic and response-evaluating criteria.
Asunto(s)
Enfermedad Injerto contra Huésped/etiología , Trasplante de Órganos/efectos adversos , Enfermedades de la Piel/etiología , Piel/química , Piel/patología , Biomarcadores/análisis , Biopsia , Enfermedad Injerto contra Huésped/metabolismo , Enfermedad Injerto contra Huésped/patología , Humanos , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Enfermedades de la Piel/metabolismo , Enfermedades de la Piel/patología , España , Trasplante HomólogoAsunto(s)
Anticoagulantes/efectos adversos , Anticoagulantes/uso terapéutico , Heparina/efectos adversos , Hirudinas/farmacología , Diálisis Renal , Trombocitopenia/inducido químicamente , Trombocitopenia/complicaciones , Trombosis/tratamiento farmacológico , Trombosis/etiología , Anciano , Humanos , MasculinoRESUMEN
Forty-five patients receiving at least 5 sessions of hyperbaric oxygenation treatment were studied. Mean values of pulse rate were calculated during the different regimes of the session, as well as mean values of blood pressure before and after each treatment in order to assess the influence of hyperbaric oxygenation upon these parameters. With the hyperbaric oxygenation dosages employed in the group of patients studied, the variations of these parameters are not statistically significant. However, the behavior observed corresponds directly with the pressures used.
Asunto(s)
Presión Sanguínea , Oxigenoterapia Hiperbárica , Pulso Arterial , HumanosRESUMEN
The work of nursing personnel with patients receiving treatment with hyperbaric oxygenation is intended mainly to prepare the patients and provide care and psychological support. Hyperbaric oxygenation as a therapeutic method was included in Cuba's Health System in 1986. Hyperbaric oxygenation is applied in different diseases, both alone and as supportive treatment for clinical or surgical therapy and it is based on the significant increased oxygen dissolved in the plasma when gas pressure is increased to a proper dosage using hyperbaric chambers. Nursing personnel plays a very important role in providing care to patients and the team is in charge of the security measures and techniques. Hyperbaric oxygenation has proved to be effective for the treatment of anaerobic sepsis, intoxication due to carbon monoxide, peritonitis, gastroduodenal ulcers, liver diseases, osteomyelitis, as a support for grafting and transplants and other diseases.