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1.
Scand J Surg ; 109(2): 166-173, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30991900

RESUMEN

BACKGROUND AND AIMS: Additive manufacturing or three-dimensional printing is a novel production methodology for producing patient-specific models, medical aids, tools, and implants. However, the clinical impact of this technology is unknown. In this study, we sought to characterize the clinical adoption of medical additive manufacturing in Finland in 2016-2017. We focused on non-dental usage at university hospitals. MATERIALS AND METHODS: A questionnaire containing five questions was sent by email to all operative, radiologic, and oncologic departments of all university hospitals in Finland. Respondents who reported extensive use of medical additive manufacturing were contacted with additional, personalized questions. RESULTS: Of the 115 questionnaires sent, 58 received answers. Of the responders, 41% identified as non-users, including all general/gastrointestinal (GI) and vascular surgeons, urologists, and gynecologists; 23% identified as experimenters or previous users; and 36% identified as heavy users. Usage was concentrated around the head area by various specialties (neurosurgical, craniomaxillofacial, ear, nose and throat diseases (ENT), plastic surgery). Applications included repair of cranial vault defects and malformations, surgical oncology, trauma, and cleft palate reconstruction. Some routine usage was also reported in orthopedics. In addition to these patient-specific uses, we identified several off-the-shelf medical components that were produced by additive manufacturing, while some important patient-specific components were produced by traditional methodologies such as milling. CONCLUSION: During 2016-2017, medical additive manufacturing in Finland was routinely used at university hospitals for several applications in the head area. Outside of this area, usage was much less common. Future research should include all patient-specific products created by a computer-aided design/manufacture workflow from imaging data, instead of concentrating on the production methodology.


Asunto(s)
Diseño Asistido por Computadora , Impresión Tridimensional , Prótesis e Implantes , Cirugía Asistida por Computador , Procedimientos Quirúrgicos Operativos , Finlandia , Encuestas de Atención de la Salud , Hospitales Universitarios , Humanos , Modelación Específica para el Paciente , Procedimientos de Cirugía Plástica
2.
Scand J Urol ; 52(5-6): 313-320, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30585526

RESUMEN

OBJECTIVE: To describe study design and procedures for a prospective randomized trial investigating whether radical prostatectomy (RP) ± radiation improves cause-specific survival in comparison with primary radiation treatment (RT) and androgen deprivation treatment (ADT) in patients with locally advanced prostate cancer (LAPC). MATERIALS AND METHODS: SPCG-15 is a prospective, multi-centre, open randomized phase III trial. Patients are randomized to either standard (RT + ADT) or experimental (RP with extended pelvic lymph-node dissection and with addition of adjuvant or salvage RT and/or ADT if deemed necessary) treatment. Each centre follows guidelines regarding the timing and dosing of postoperative RT and adjuvant treatment such as ADT The primary endpoint is cause-specific survival. Secondary endpoints include metastasis-free and overall survival, quality-of-life, functional outcomes and health-services requirements. Each subject will be followed up for a minimum of 10 years. RESULTS: Twenty-three centres in Denmark, Finland, Norway and Sweden, well established in performing RP and RT for prostate cancer participated. Each country's sites were coordinated by national coordinating investigators and sub-investigators for urology and oncology. Almost 400 men have been randomized of the stipulated 1200, with an increasing rate of accrual. CONCLUSIONS: The SPCG-15 trial aims to compare the two curatively intended techniques supplying new knowledge to support future decisions in treatment strategies for patients with LAPC The Scandinavian healthcare context is well suited for performing multi-centre long-term prospective randomized clinical trials. Similar care protocols and a history of entirely tax-funded healthcare facilitate joint trials.


Asunto(s)
Antagonistas de Andrógenos/uso terapéutico , Antineoplásicos Hormonales/uso terapéutico , Prostatectomía , Neoplasias de la Próstata/terapia , Radioterapia/métodos , Braquiterapia/métodos , Dinamarca , Finlandia , Humanos , Escisión del Ganglio Linfático , Masculino , Noruega , Pelvis , Neoplasias de la Próstata/patología , Tasa de Supervivencia , Suecia
4.
Ann Oncol ; 29(2): 377-385, 2018 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-29161337

RESUMEN

Background: Old age at prostate cancer diagnosis has been associated with poor prognosis in several studies. We aimed to investigate the association between age at diagnosis and prognosis, and if it is independent of tumor characteristics, primary treatment, year of diagnosis, mode of detection and comorbidity. Patients and methods: We conducted a nation-wide cohort study including 121 392 Swedish men aged 55-95 years in Prostate Cancer data Base Sweden 3.0 diagnosed with prostate cancer in 1998-2012 and followed for prostate cancer death through 2014. Data were available on age, stage, grade, prostate-specific antigen (PSA)-level, mode of detection, comorbidity, educational level and primary treatment. We used Cox regression to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: With increasing age at diagnosis, men had more comorbidity, fewer PSA-detected cancers, more advanced cancers and were less often treated with curative intent. Among men with high-risk or regionally metastatic disease, the proportion of men with unknown M stage was higher among old men versus young men. During a follow-up of 751 000 person-years, 23 649 men died of prostate cancer. In multivariable Cox-regression analyses stratified by treatment, old age at diagnosis was associated with poorer prognosis among men treated with deferred treatment (HRage 85+ versus 60-64: 7.19; 95% CI: 5.61-9.20), androgen deprivation therapy (HRage 85+ versus 60-64: 1.72; 95% CI: 1.61-1.84) or radical prostatectomy (HRage 75+ versus 60-64: 2.20; 95% CI: 1.01-4.77), but not radiotherapy (HRage 75+ versus 60-64: 1.08; 95% CI: 0.76-1.53). Conclusion: Our findings argue against a strong inherent effect of age on risk of prostate cancer death, but indicate that in current clinical practice, old men with prostate cancer receive insufficient diagnostic workup and subsequent curative treatment.


Asunto(s)
Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/epidemiología , Neoplasias de la Próstata/terapia , Factores de Edad , Anciano , Anciano de 80 o más Años , Antagonistas de Andrógenos/uso terapéutico , Antineoplásicos/uso terapéutico , Estudios de Cohortes , Humanos , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Prostatectomía/mortalidad , Radioterapia/mortalidad , Suecia/epidemiología
5.
Res Vet Sci ; 117: 74-80, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29195227

RESUMEN

The neuroendocrine glycoprotein chromogranin A is a useful biomarker for stress in humans. Chromogranin A epitopes catestatin and vasostatin can be measured in dogs using radioimmunoassays. The objective of this study was to evaluate catestatin and vasostatin as canine stress biomarkers in a clinical setting. Blood and saliva were collected from 33 healthy dogs that were familiar with sampling procedures and the animal hospital environment (control group) and 30 healthy dogs that were unacquainted (stress group). During sampling, stress behavior was scored by the same observer using visual analog scale (VAS). Plasma was analyzed for catestatin and vasostatin, serum for cortisol, and saliva for catestatin. Differences between groups were analyzed using two-sample t-tests and P<0.05 was considered significant. Stress behavior VAS score in the control group was significantly lower than in the stress group during blood (P=0.002) and saliva (P=0.0009) sampling. Serum cortisol and saliva catestatin concentrations in the stress group were higher than the control group (P=0.003 and P<0.0001, respectively). Serum cortisol concentrations were correlated with those of saliva (r=0.34, P=0.04) and plasma catestatin (r=0.29, P=0.03). Plasma catestatin and vasostatin did not differ significantly between groups. In conclusion, concentrations of saliva catestatin, and serum cortisol, and stress behavior VAS scores were significantly higher in the stress group. The results indicate that saliva catestatin may be useful as a biomarker for acute psychological stress in dogs.


Asunto(s)
Calreticulina/sangre , Perros , Fragmentos de Péptidos/sangre , Saliva/química , Estrés Psicológico/metabolismo , Escala Visual Analógica , Animales , Biomarcadores/metabolismo , Cromogranina A/sangre , Perros/metabolismo , Hidrocortisona/sangre , Estrés Psicológico/diagnóstico
6.
Eur J Clin Microbiol Infect Dis ; 35(5): 829-38, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-26922068

RESUMEN

Typing of bacterial isolates using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) potentially provides an efficient on-site method to monitor the spread of antibiotic-resistant bacteria and rapidly detect outbreaks. We compared MALDI-MS typing results to those of amplified fragment length polymorphism (AFLP) in a collection of 52 ESBL-producing Escherichia coli, isolated in a Dutch nursing home with an on-going outbreak of ST131 E. coli. Specific MALDI types were defined based on spectral data from four replicate colony samples of isolates grown on Columbia agar using multivariate statistical procedures. Type-specific superspectra were computed for four E .coli MALDI-types and tested for the potential of rapid and automated typing. The effect of different incubation conditions on typing performance was tested by analysing five isolates incubated for 24 h and 48 h on five different media. Types defined based on MALDI spectra were largely in agreement with the AFLP results, although some MALDI types comprised of more than one AFLP type. In particular, isolates belonging to ST131 showed distinct mass patterns. The proportion of isolates correctly assigned was substantially lower for isolates incubated on Sabouraud-dextrose and Drigalski agars for 24 h, and for those incubated for 48 h (all media). Our results show that the identification of type-specific peaks potentially allows direct typing of isolates belonging to specific clonal lineages. Both incubation time and media affected type assignment, suggesting that there is a need for a careful standardization of incubation time and culturing conditions when developing MALDI-typing schemes for E. coli.


Asunto(s)
Análisis del Polimorfismo de Longitud de Fragmentos Amplificados , Escherichia coli/clasificación , Escherichia coli/genética , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , beta-Lactamasas/genética , Análisis del Polimorfismo de Longitud de Fragmentos Amplificados/métodos , Análisis por Conglomerados , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Humanos , Reproducibilidad de los Resultados , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción/métodos
7.
J Clin Microbiol ; 53(12): 3919-21, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26447117

RESUMEN

Mucosal biopsy samples from individuals not suspected of having Whipple's disease were tested for the presence of Tropheryma whipplei. A sensitive and specific real-time PCR assay targeting a sequence present seven times in the T. whipplei genome was used. T. whipplei DNA was detected in 2.0 and 3.8% of the patients undergoing gastroduodenoscopy and colonoscopy, respectively, who were tested.


Asunto(s)
Portador Sano/microbiología , Colon/microbiología , Colonoscopía , Mucosa Intestinal/microbiología , Tropheryma/aislamiento & purificación , Adulto , Anciano , Biopsia , Portador Sano/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Reacción en Cadena en Tiempo Real de la Polimerasa
8.
J Comp Pathol ; 153(1): 50-7, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25979683

RESUMEN

Between January and December 2013, the dental and periodontal health of 99 Swedish wild boars (Sus scrofa) was investigated. Sampling occurred in conjunction with routine hunting at six large estates in the southern and middle parts of Sweden. All six of the estates use supplemental feeding. The weight of the animals, their sex and their dates of death were noted. Age was estimated using tooth eruption and tooth replacement patterns. The oral cavity was inspected and abnormalities were recorded on a dental chart modified for wild boars. The findings included supernumerary teeth, absence of teeth, mild class II malocclusion, severe tooth wear, periodontitis, calculus, caries, tooth fractures and the presence of enamel defects. Swedish wild boars suffer from different dental lesions and the impact of supplemental feeding on dental and periodontal health is still to be investigated.


Asunto(s)
Caries Dental/veterinaria , Enfermedades Periodontales/veterinaria , Diente Supernumerario/veterinaria , Animales , Caries Dental/epidemiología , Femenino , Masculino , Enfermedades Periodontales/epidemiología , Sus scrofa , Suecia/epidemiología , Anomalías Dentarias/epidemiología , Anomalías Dentarias/veterinaria , Diente Supernumerario/epidemiología
9.
Prostate Cancer Prostatic Dis ; 18(1): 1-12, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25384337

RESUMEN

BACKGROUND: The role of global DNA methylation in prostate cancer (PCa) remains largely unknown. Our aim was to summarize evidence on the role of global DNA hypomethylation in PCa development and progression. METHODS: We searched PubMed through December 2013 for all studies containing information on global methylation levels in PCa tissue and at least one non-tumor comparison tissue and/or studies reporting association between global methylation levels in PCa tissue and survival, disease recurrence or at least one clinicopathological prognostic factor. We summarized results using non-parametric comparisons and P-value summary methods. RESULTS: We included 15 studies in the review: 6 studies with both diagnostic and prognostic information, 5 studies with only diagnostic information and 4 studies with only prognostic information. Quantitative meta-analysis was not possible because of the large heterogeneity in molecular techniques, types of tissues analyzed, aims and study designs. Summary statistical tests showed association of DNA hypomethylation with PCa diagnosis (P<0.006) and prognosis (P<0.001). Restriction to studies assessing 5-methylcytosine or long interspersed nucleotide element-1 revealed results in the same direction. Analyses restricted to specific clinicopathological features showed association with the presence of metastasis and tumor stage in all tests with P<0.03, and no association with Gleason score (all tests P>0.1 except for the weighted Z-test, P=0.05). CONCLUSION: DNA hypomethylation was associated with PCa development and progression. However, due to the heterogeneity and small sample sizes of the included studies, along with the possibility of publication bias, this association requires additional assessment.


Asunto(s)
Metilación de ADN/genética , Recurrencia Local de Neoplasia/genética , Pronóstico , Neoplasias de la Próstata/genética , Progresión de la Enfermedad , Humanos , Elementos de Nucleótido Esparcido Largo/genética , Masculino , Clasificación del Tumor , Recurrencia Local de Neoplasia/patología , Neoplasias de la Próstata/patología , PubMed
10.
J Clin Microbiol ; 52(7): 2454-60, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24789184

RESUMEN

Next-generation sequencing (NGS) has the potential to provide typing results and detect resistance genes in a single assay, thus guiding timely treatment decisions and allowing rapid tracking of transmission of resistant clones. We evaluated the performance of a new NGS assay (Hospital Acquired Infection BioDetection System; Pathogenica) during an outbreak of sequence type 131 (ST131) Escherichia coli infections in a nursing home in The Netherlands. The assay was performed on 56 extended-spectrum-beta-lactamase (ESBL) E. coli isolates collected during 2 prevalence surveys (March and May 2013). Typing results were compared to those of amplified fragment length polymorphism (AFLP), whereby we visually assessed the agreement of the BioDetection phylogenetic tree with clusters defined by AFLP. A microarray was considered the gold standard for detection of resistance genes. AFLP identified a large cluster of 31 indistinguishable isolates on adjacent departments, indicating clonal spread. The BioDetection phylogenetic tree showed that all isolates of this outbreak cluster were strongly related, while the further arrangement of the tree also largely agreed with other clusters defined by AFLP. The BioDetection assay detected ESBL genes in all but 1 isolate (sensitivity, 98%) but was unable to discriminate between ESBL and non-ESBL TEM and SHV beta-lactamases or to specify CTX-M genes by group. The performance of the hospital-acquired infection (HAI) BioDetection System for typing of E. coli isolates compared well with the results of AFLP. Its performance with larger collections from different locations, and for typing of other species, was not evaluated and needs further study.


Asunto(s)
Brotes de Enfermedades , Farmacorresistencia Bacteriana , Infecciones por Escherichia coli/epidemiología , Escherichia coli/genética , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Tipificación Molecular/métodos , beta-Lactamasas/genética , Análisis por Conglomerados , Estudios Transversales , Escherichia coli/clasificación , Escherichia coli/efectos de los fármacos , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/diagnóstico , Genes Bacterianos , Humanos , Pruebas de Sensibilidad Microbiana/métodos , Epidemiología Molecular/métodos , Países Bajos/epidemiología , Casas de Salud , Filogenia
11.
Clin Exp Immunol ; 176(3): 363-72, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24666336

RESUMEN

Anti-neutrophil cytoplasmic antibodies (ANCA) are thought to be pathogenic in ANCA-associated vasculitis (AAV) by stimulating polymorphonuclear leucocytes (PMNs) to degranulate and produce reactive oxygen species (ROS). The aim of this study was to investigate if PMNs from AAV patients are stimulated more readily by ANCA compared with PMNs from healthy controls (HCs). Differences in ANCA characteristics that can account for different stimulation potential were also studied. PMNs from five AAV patients and five HCs were stimulated with 10 different immunoglobulins (Ig)Gs, purified from PR3-ANCA-positive patients, and ROS production, degranulation and neutrophil extracellular trap (NET) formation was measured. ANCA levels, affinity and clinical data of the AAV donors were recorded. The results show that PMNs from AAV patients produce more intracellular ROS (P = 0·019), but degranulate to a similar extent as PMNs from HCs. ROS production correlated with NET formation. Factors that may influence the ability of ANCA to activate PMNs include affinity and specificity for N-terminal epitopes. In conclusion, our results indicate that PMNs from AAV patients in remission behave quite similarly to HC PMNs, with the exception of a greater intracellular ROS production. This could contribute to more extensive NET formation and thus an increased exposure of the ANCA autoantigens to the immune system.


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/inmunología , Anticuerpos Anticitoplasma de Neutrófilos/inmunología , Neutrófilos/inmunología , Anciano , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/metabolismo , Degranulación de la Célula/inmunología , Epítopos/inmunología , Humanos , Inmunoglobulina G/inmunología , Persona de Mediana Edad , Neutrófilos/metabolismo , Especies Reactivas de Oxígeno/metabolismo
12.
Neth J Med ; 72(10): 551-3, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26219763

RESUMEN

A 62-year-old patient with peritoneal dialysis (PD)-associated peritonitis is described. Identical strains of Pasteurella multocida and Streptococcus minor were cultured from the dialysate, and from the saliva of her recently adopted stray cat. Pasteurella is not often encountered as pathogen in PD-associated peritonitis, Streptococcus minor has never been cultured in human infection before. We emphasise the importance of hygiene in peritoneal dialysis and the need for testing pets when zoonotic pathogens are cultured.


Asunto(s)
Infecciones por Pasteurella/microbiología , Pasteurella multocida/aislamiento & purificación , Peritonitis/microbiología , Infecciones Estreptocócicas/microbiología , Streptococcus/clasificación , Zoonosis/microbiología , Animales , Antibacterianos/administración & dosificación , Enfermedades de los Gatos/microbiología , Enfermedades de los Gatos/transmisión , Gatos , Femenino , Humanos , Persona de Mediana Edad , Infecciones por Pasteurella/tratamiento farmacológico , Infecciones por Pasteurella/transmisión , Diálisis Peritoneal , Peritonitis/tratamiento farmacológico , Saliva/microbiología , Infecciones Estreptocócicas/tratamiento farmacológico , Infecciones Estreptocócicas/transmisión , Streptococcus/aislamiento & purificación , Combinación Trimetoprim y Sulfametoxazol/administración & dosificación , Zoonosis/transmisión
13.
Diabetologia ; 56(9): 2044-54, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23765184

RESUMEN

AIMS/HYPOTHESIS: Obesity increases the risk of developing type 2 diabetes mellitus, characterised by impaired insulin-mediated glucose uptake in peripheral tissues. Liver X receptor (LXR) is a positive regulator of adipocyte glucose transport in murine models and a possible target for diabetes treatment. However, the levels of LXRα are increased in obese adipose tissue in humans. We aimed to investigate the transcriptome of LXR and the role of LXR in the regulation of glucose uptake in primary human adipocytes. METHODS: The insulin responsiveness of human adipocytes differentiated in vitro was characterised, adipocytes were treated with the LXR agonist GW3965 and global transcriptome profiling was determined by microarray, followed by quantitative RT-PCR (qRT-PCR), western blot and ELISA. Basal and insulin-stimulated glucose uptake was measured and the effect on plasma membrane translocation of glucose transporter 4 (GLUT4) was assayed. RESULTS: LXR activation resulted in transcriptional suppression of several insulin signalling genes, such as AKT2, SORBS1 and CAV1, but caused only minor changes (<15%) in microRNA expression. Activation of LXR impaired the plasma membrane translocation of GLUT4, but not the expression of its gene, SLC2A4. LXR activation also diminished insulin-stimulated glucose transport and lipogenesis in adipocytes obtained from overweight individuals. Furthermore, AKT2 expression was reduced in obese adipose tissue, and AKT2 and SORBS1 expression was inversely correlated with BMI and HOMA index. CONCLUSIONS/INTERPRETATION: In contrast to murine models, LXR downregulates insulin-stimulated glucose uptake in human adipocytes from overweight individuals. This could be due to suppression of Akt2, c-Cbl-associated protein and caveolin-1. These findings challenge the idea of LXR as a drug target in the treatment of diabetes.


Asunto(s)
Adipocitos/efectos de los fármacos , Adipocitos/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Receptores Nucleares Huérfanos/metabolismo , Benzoatos/farmacología , Bencilaminas/farmacología , Transporte Biológico/efectos de los fármacos , Células Cultivadas , Ensayo de Inmunoadsorción Enzimática , Glucosa/metabolismo , Humanos , Receptores X del Hígado , Receptores Nucleares Huérfanos/agonistas , Reacción en Cadena en Tiempo Real de la Polimerasa
14.
J Chem Phys ; 138(5): 054306, 2013 Feb 07.
Artículo en Inglés | MEDLINE | ID: mdl-23406118

RESUMEN

We present theoretical absolute charge exchange cross sections for multiply charged cations interacting with the Polycyclic Aromatic Hydrocarbon (PAH) molecules pyrene C(14)H(10), coronene C(24)H(12), or circumcoronene C(54)H(18). These planar, nearly circular, PAHs are modelled as conducting, infinitely thin, and perfectly circular discs, which are randomly oriented with respect to straight line ion trajectories. We present the analytical solution for the potential energy surface experienced by an electron in the field of such a charged disc and a point-charge at an arbitrary position. The location and height of the corresponding potential energy barrier from this simple model are in close agreement with those from much more computationally demanding Density Functional Theory (DFT) calculations in a number of test cases. The model results compare favourably with available experimental data on single- and multiple electron transfer reactions and we demonstrate that it is important to include the orientation dependent polarizabilities of the molecules (model discs) in particular for the larger PAHs. PAH ionization energy sequences from DFT are tabulated and used as model inputs. Absolute cross sections for the ionization of PAH molecules, and PAH ionization energies such as the ones presented here may be useful when considering the roles of PAHs and their ions in, e.g., interstellar chemistry, stellar atmospheres, and in related photoabsorption and photoemission spectroscopies.


Asunto(s)
Hidrocarburos Policíclicos Aromáticos/química , Compuestos Policíclicos/química , Pirenos/química , Transporte de Electrón , Iones/química , Modelos Moleculares , Teoría Cuántica
15.
Clin Exp Immunol ; 170(1): 47-56, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22943200

RESUMEN

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of autoimmune diseases, including granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). It is not known why ANCA develop, but it has been shown that they participate in pathogenesis by activating polymorphonuclear neutrophils (PMNs). In this study we hypothesize that dysregulation of phagocytosis in AAV leads to the accumulation of apoptotic neutrophils seen in association with blood vessels in AAV. These cells progress into secondary necrosis, contributing to tissue damage and autoantibody formation. Peripheral blood cells were counted, and phagocytosis was investigated using monocyte-derived macrophages (MØ) and PMNs from healthy blood donors (HBD), AAV patients and systemic lupus erythematosus (SLE) patients. Furthermore, the effect of serum was assessed. Phagocytosis was measured using flow cytometry. The results showed no deviation in monocyte subpopulations for AAV patients compared to HBDs, although there was a decrease in lymphocyte and pDC (plasmacytoid dendritic cell) populations (4·2 × 10(6) cells/l versus 10·4 × 10(6) cells/l, P < 0·001). The number of neutrophils was increased (6·0 × 10(9) cells/l versus 3·8 × 10(9) cells/l, P < 0·001). There were no differences found in the ability of MØs to engulf apoptotic cells, nor when comparing apoptotic PMNs to become engulfed. However, serum from AAV donors tended to decrease the phagocytosis ability of MØs (36%) compared to serum from HBDs (43%). In conclusion, there is no intrinsic dysfunction in the MØs or in the PMNs that have an effect on phagocytic activity, but ANCA may play a role by decreasing phagocytic ability.


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/inmunología , Anticuerpos Anticitoplasma de Neutrófilos/inmunología , Apoptosis/inmunología , Neutrófilos/patología , Fagocitosis/inmunología , Adulto , Anciano , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/sangre , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/patología , Anticuerpos Anticitoplasma de Neutrófilos/metabolismo , Estudios de Casos y Controles , Células Dendríticas/inmunología , Células Dendríticas/patología , Citometría de Flujo , Humanos , Lupus Eritematoso Sistémico/inmunología , Lupus Eritematoso Sistémico/patología , Linfocitos/inmunología , Linfocitos/patología , Macrófagos/inmunología , Macrófagos/metabolismo , Poliangitis Microscópica/inmunología , Poliangitis Microscópica/patología , Persona de Mediana Edad , Necrosis/inmunología , Neutrófilos/inmunología
16.
Ned Tijdschr Geneeskd ; 156(37): A4698, 2012.
Artículo en Holandés | MEDLINE | ID: mdl-22971429

RESUMEN

Whipple's disease is a multisystem, and often chronic, disease caused by infection with the bacterium Tropheryma whipplei, and mainly occurs in middle-aged Caucasian men. In most cases, histological detection of large numbers of bacteria-laden macrophages in the mucosa of the small intestine confirms the diagnosis. Less commonly, these macrophages may be sparse and predominantly located beneath the mucosa. In these submucosally presenting cases, endoscopic and classic histological clues are absent and, therefore, the diagnosis can be missed. As a result, further periodic acid-Schiff (PAS) staining and PCR analysis are of great importance in arriving at the correct diagnosis.


Asunto(s)
Tropheryma/aislamiento & purificación , Enfermedad de Whipple/patología , Anciano , Anciano de 80 o más Años , Biopsia , Diagnóstico Diferencial , Humanos , Masculino , Enfermedad de Whipple/microbiología
17.
J Med Microbiol ; 61(Pt 5): 746-749, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22301611

RESUMEN

We describe a case of gastroenteritis caused by Campylobacter concisus. The pathogenic potential of C. concisus has yet to be elucidated. Recent studies indicate an association with enteric disease in immunocompromised patients and inflammatory bowel disease in children. Molecular identification methods may be necessary for identifying certain Campylobacter species because of phenotypic similarity.


Asunto(s)
Infecciones por Campylobacter/diagnóstico , Infecciones por Campylobacter/microbiología , Campylobacter/aislamiento & purificación , Gastroenteritis/diagnóstico , Gastroenteritis/microbiología , Campylobacter/clasificación , Campylobacter/genética , Infecciones por Campylobacter/patología , Análisis por Conglomerados , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Ribosómico/química , ADN Ribosómico/genética , Gastroenteritis/patología , Humanos , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Filogenia , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADN
18.
Reprod Domest Anim ; 47 Suppl 6: 347-50, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23279535

RESUMEN

Dogs enrolled in a Swedish insurance company (during 1995-2006) were studied for development of pyometra and mammary tumours (MTs), with special attention to breed and age. There were over 260,000 female dogs with over 1,000,000 dog-years at risk (DYAR) in the database, using data on bitches up to 10 years of age and 110 breeds with over 1000 DYAR. In total, 20 423 bitches were diagnosed with pyometra and 11,758 with MTs and 30,131 with either or both of the two diseases. The incidence rate (IR) for pyometra was 199 (95% CI 196-202), for MTs 112 (95% CI 110-114) and for either or both of the two diseases 297 (95% CI 294-301) dogs per 10,000 DYAR. The mean age of diagnosis pyometra was 7.0 years (SD ± 2.2), MTs 8.0 years (SD ± 1.6). In all breeds, the overall proportion of the bitches that developed disease by 10 years of age was for pyometra 19%, MTs 13%, and either or both of two diseases 30%. The top 10 breeds diagnosed with either or both of the two diseases were the Leonberger (73%), Irish Wolfhound (69%), Bernese Mountain Dog (69%), Great Dane (68%), Staffordshire Bull Terrier (66%), Rottweiler (65%), Bullterrier (62%), Doberman (62%), Bouvier des Flandres (60%), Airdaleterrier (60%). These data provide information of the combined disease incidence in a large number of different breeds. Breed variations in incidence rate suggests genetic components in disease development. Our study may be valuable in the search for genetic risk-factors or protective factors.


Asunto(s)
Enfermedades de los Perros/genética , Neoplasias Mamarias Animales/genética , Piómetra/veterinaria , Animales , Enfermedades de los Perros/epidemiología , Perros , Femenino , Neoplasias Mamarias Animales/epidemiología , Piómetra/epidemiología , Piómetra/genética , Suecia/epidemiología
19.
Vox Sang ; 102(1): 22-31, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21732948

RESUMEN

BACKGROUND: Bacterial contamination of platelet concentrates (PCs) still remains a significant problem in transfusion with potential important clinical consequences, including death. The International Society of Blood Transfusion Working Party on Transfusion-Transmitted Infectious Diseases, Subgroup on Bacteria, organised an international study on Transfusion-Relevant Bacteria References to be used as a tool for development, validation and comparison of both bacterial screening and pathogen reduction methods. MATERIAL AND METHODS: Four Bacteria References (Staphylococcus epidermidis PEI-B-06, Streptococcus pyogenes PEI-B-20, Klebsiella pneumoniae PEI-B-08 and Escherichia coli PEI-B-19) were selected regarding their ability to proliferate to high counts in PCs and distributed anonymised to 14 laboratories in 10 countries for identification, enumeration and bacterial proliferation in PCs after low spiking (0·3 and 0·03 CFU/ml), to simulate contamination occurring during blood donation. RESULTS: Bacteria References were correctly identified in 98% of all 52 identifications. S. pyogenes and E. coli grew in PCs in 11 out of 12 laboratories, and K. pneumoniae and S. epidermidis replicated in all participating laboratories. The results of bacterial counts were very consistent between laboratories: the 95% confidence intervals were for S. epidermidis: 1·19-1·32 × 10(7) CFU/ml, S. pyogenes: 0·58-0·69 × 10(7) CFU/ml, K. pneumoniae: 18·71-20·26 × 10(7) CFU/ml and E. coli: 1·78-2·10 × 10(7) CFU/ml. CONCLUSION: The study was undertaken as a proof of principle with the aim to demonstrate (i) the quality, stability and suitability of the bacterial strains for low-titre spiking of blood components, (ii) the property of donor-independent proliferation in PCs, and (iii) their suitability for worldwide shipping of deep frozen, blinded pathogenic bacteria. These aims were successfully fulfilled. The WHO Expert Committee Biological Standardisation has approved the adoption of these four bacteria strains as the first Repository for Transfusion-Relevant Bacteria Reference Strains and, additionally, endorsed as a project the addition of six further bacteria strain preparations suitable for control of platelet contamination as the next step of enlargement of the repository.


Asunto(s)
Plaquetas/microbiología , Transfusión Sanguínea , Infecciones Bacterianas/prevención & control , Técnicas de Tipificación Bacteriana/métodos , Técnicas Bacteriológicas , Bancos de Muestras Biológicas , Transfusión de Componentes Sanguíneos/métodos , Plaquetas/citología , Escherichia coli/metabolismo , Humanos , Cooperación Internacional , Klebsiella pneumoniae/metabolismo , Garantía de la Calidad de Atención de Salud/métodos , Reproducibilidad de los Resultados , Staphylococcus epidermidis/metabolismo , Streptococcus pyogenes/metabolismo
20.
Cont Lens Anterior Eye ; 34(1): 12-6; quiz 50-1, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-20926333

RESUMEN

INTRODUCTION: The aim of the present study was to evaluate changes in spherical aberration and their effect on visual quality (visual acuity and contrast sensitivity) in both distance and near with different non-custom-made contact lenses. METHODS: A wavefront analyser was used to measure the aberrations in each subject's eyes uncorrected and with the contact lenses: a standard lens and two aspherical contact lenses. High-contrast visual acuity at distance was measured with Test-Chart 2000 (100% contrast) and at near with Sloan ETDRS Near Point chart (100% contrast). Low-contrast visual acuity at distance was measured with Test-Chart 2000 (10% contrast) and contrast measurements at near with Mars letter contrast sensitivity chart. RESULTS: Mean spherical aberration was positive for all pupil sizes in the uncorrected eye, residual spherical aberration was close to zero with the standard lens for all pupil sizes, whereas the two aspheric contact lenses over-corrected spherical aberration. The changes in aberration were statistically significant (p < 0.05) with all lenses. No significant difference could be detected between trial frame correction, spherical and aspherical soft contact lens designs with respect to visual quality. This was the case for both distance and near. CONCLUSION: The results are in line with previous studies and indicate that non-custom-made spherical aberration control contact lenses have little effect on visual quality as defined in this study.


Asunto(s)
Lentes de Contacto , Errores de Refracción/diagnóstico , Errores de Refracción/rehabilitación , Adolescente , Adulto , Equipos Desechables , Análisis de Falla de Equipo , Femenino , Humanos , Masculino , Diseño de Prótesis , Resultado del Tratamiento , Agudeza Visual , Adulto Joven
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