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1.
Mol Ther ; 2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38734899

RESUMEN

Vaccinia viruses (VACV) are versatile therapeutic agents and different features of various VACV strains allow for a broad range of therapeutic applications. Modified Vaccinia virus Ankara (MVA) is a particularly altered VACV strain that is highly immunogenic, incapable of replicating in mammalian hosts, and broadly used as a safe vector for vaccination. Alternatively, Western Reserve (WR) or Copenhagen (Cop) are VACV strains that efficiently replicate in cancer cells and therefore are used to develop oncolytic viruses. However, the immune evasion capacity of WR or Cop hinders their ability to elicit antitumor immune responses, which is crucial for efficacy in the clinic. Here, we describe a new VACV strain named Immune-Oncolytic Vaccinia virus Ankara (IOVA), which combines efficient replication in cancer cells with induction of immunogenic tumor cell death (ICD). IOVA was engineered from an MVA ancestor and shows superior cytotoxicity in tumor cells. In addition, the IOVA genome incorporates mutations that lead to massive fusogenesis of tumor cells, which contributes to improved antitumor effects. In syngeneic mouse tumor models, induction of ICD results in robust antitumor immunity directed against tumor neo-epitopes and eradication of large established tumors. These data present IOVA as an improved immunotherapeutic oncolytic vector.

2.
Front Public Health ; 12: 1384078, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38645451

RESUMEN

Background: The quality assessment of the home-based isolation and care program (HBIC) relies heavily on patient satisfaction and length of stay. COVID-19 patients who were isolated and received HBIC were monitored through telephone consultations (TC), in-person TC visits, and a self-reporting application. By evaluating patient satisfaction and length of stay in HBIC, healthcare providers could gauge the effectiveness and efficiency of the HBIC program. Methods: A cross-sectional study design enrolled 444 HBIC patients who answered a structured questionnaire. A binary logistic regression model assessed the association between independent variables and patient satisfaction. The length of stay in HBIC was analyzed using Cox regression analysis. The data collection started on April (1-30), 2022, in Addis Ababa, Ethiopia. Results: The median age was 34, and 247 (55.6%) were females. A greater proportion (313, 70.5%) of the participants had high satisfaction. Higher frequency of calls (>3 calls) (AOR = 2.827, 95% CI = 1.798, 4.443, p = 0.000) and those who were symptomatic (AOR = 2.001, 95% CI = 1.289, 3.106, p = 0.002) were found to be significant factors for high user satisfaction. Higher frequency of calls (>3 calls) (AHR = 0.537, 95% CI = 0.415, 0.696, p = 0.000) and more in-person visits (>1 visit) (AHR = 0.495, 95% CI = 0.322, 0.762, p = 0.001) had greater chances to reduce the length of stay in the COVID-19 HBIC. Conclusion: 70.5% of the participants had high satisfaction with the system, and frequent phone call follow-ups on patients' clinical status can significantly improve their satisfaction and length of recovery. An in-person visit is also an invaluable factor in a patient's recovery.


Asunto(s)
COVID-19 , Satisfacción del Paciente , Telemedicina , Humanos , Femenino , Masculino , Satisfacción del Paciente/estadística & datos numéricos , Adulto , Estudios Transversales , Telemedicina/estadística & datos numéricos , Persona de Mediana Edad , Etiopía , Encuestas y Cuestionarios , Tiempo de Internación/estadística & datos numéricos , SARS-CoV-2 , Adolescente , Servicios de Atención de Salud a Domicilio/estadística & datos numéricos , Adulto Joven , Cuarentena , Anciano
3.
J Neurol ; 2024 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-38630312

RESUMEN

INTRODUCTION: We aimed to assess the frequency, duration, and severity of area postrema syndrome (APS) during follow-up in neuromyelitis optica spectrum disorder (NMOSD) patients, as well as its association with inflammatory activity and prognostic factors of APS severity in a real-world setting. METHODS: We conducted a retrospective study on a cohort of Latin American (LATAM) NMOSD patients who had experienced APS during their follow-up. Patients from Mexico, Peru, Brazil, Colombia, Panama, Chile and Argentina patients who met 2015 NMOSD criteria were included. We evaluated data on symptom type (nausea, vomiting and/or hiccups), frequency, duration, severity (measured by APS severity scale), association with other NMOSD core relapses, and acute treatments (symptomatic and immunotherapy or plasmapheresis). Logistic regression was conducted to evaluate factors associated with APS severity (vs. mild-moderate). RESULTS: Out of 631 NMOSD patients, 116 (18.3%) developed APS during their follow-up. The most common APS phenotype was severe. Inflammatory activity (i.e., relapses) significantly decreased after the onset of APS. Half of the patients experienced isolated APS with a median duration of 10 days, and the most frequently used acute treatment was IV steroids. All three symptoms were present in 44.6% of the patients. APS symptoms resolved following immunotherapy. Logistic regression did not identify independent factors associated with the severity of APS. CONCLUSIONS: Our findings indicate that 18.3% of NMOSD patients developed APS during the follow-up period, with most patients fulfilling criteria for severe APS. The inflammatory activity decreased after the onset of APS compared to the previous year.

4.
J Neurol ; 2024 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-38564056

RESUMEN

BACKGROUND: Cerebrospinal fluid (CSF) and spinal MRIs are often obtained in children with the radiologically isolated syndrome (RIS) for diagnosis and prognosis. Factors affecting the frequency and timing of these tests are unknown. OBJECTIVE: To determine whether age or sex were associated with (1) having CSF or spinal MRI obtained or (2) the timing of these tests. METHODS: We analyzed children (≤ 18 y) with RIS enrolled in an international longitudinal study. Index scans met 2010/2017 multiple sclerosis (MS) MRI criteria for dissemination in space (DIS). We used Fisher's exact test and multivariable logistic regression (covariates = age, sex, MRI date, MRI indication, 2005 MRI DIS criteria met, and race). RESULTS: We included 103 children with RIS (67% girls, median age = 14.9 y). Children ≥ 12 y were more likely than children < 12 y to have CSF obtained (58% vs. 21%, adjusted odds ratio [AOR] = 4.9, p = 0.03). Pre-2017, girls were more likely than boys to have CSF obtained (n = 70, 79% vs. 52%, AOR = 4.6, p = 0.01), but not more recently (n = 30, 75% vs. 80%, AOR = 0.2, p = 0.1; p = 0.004 for interaction). Spinal MRIs were obtained sooner in children ≥ 12 y (median 11d vs. 159d, p = 0.03). CONCLUSIONS: Younger children with RIS may be at continued risk for misdiagnosis and misclassification of MS risk. Consensus guidelines are needed.

5.
Mult Scler Relat Disord ; 85: 105543, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38520948

RESUMEN

The objective of this study was to describe and compare the burden of treatment (BOT) and the quality of life (QoL) in early high efficacy therapy (HET) vs. escalation therapy in relapsing remitting multiple sclerosis (RRMS) patients included in RelevarEM, the Argentinean registry of MS (RelevarEM, NCT 03,375,177). METHODS: cross sectional study conducted between September and December 2022. Participating patients were adults, RRMS patients who initiated (during the last three years) their treatment with a HET (natalizumab, ocrelizumab, alemtuzumab, cladribine) or with escalation treatment (beta interferon, glatiramer acetate, teriflunomide, dimethyl fumarate or fingolimod). Clinical and demographic aspect were collected. QoL and BOT was measured with the validated to Spanish MusiQol and BOT questionnaire. Propensity score (PS)-based nearest-neighbor matching was applied to homogenize groups. Comparisons were be done using a linear regression analysis model stratified by matched pairs, with BOT and QoL assessments as main outcomes. RESULTS: 269 patients were included in the analysis, mean age 33.7 ± 5.7 years, 193 (71.7 %) were female. A total of 136 patients were on early HET while 133 were on escalation therapy. In the entire group the mean total BOT score (±SD) was 48.5 ± 15.3 while in the group of patients receiving early HET we observed that the mean BOT score (±SD) was 43.5 ± 12.2 vs. 54.3 ± 13.3 in escalation treatment (p < 0.0001). Regarding the score QoL (±SD), in the entire sample we observed a global score of 77.4 ± 11.2. When we stratified groups, in HET (±SD) it was 81.3 ± 14 vs. 74.1 ± 18.3 in escalation therapy (p = 0.0003). CONCLUSION: in this multicenter study that included 269 patients from Argentina we observed in early HET a significantly lower BOT and higher QoL than patients receiving escalation therapy.


Asunto(s)
Esclerosis Múltiple Recurrente-Remitente , Calidad de Vida , Sistema de Registros , Humanos , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Femenino , Masculino , Argentina , Adulto , Estudios Transversales , Factores Inmunológicos/administración & dosificación , Inmunosupresores/uso terapéutico , Costo de Enfermedad
6.
Front Public Health ; 12: 1323481, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38347927

RESUMEN

Background: Global and national surveillance efforts have tracked COVID-19 incidence and clinical outcomes, but few studies have compared comorbid conditions and clinical outcomes across each wave of the pandemic. We analyzed data from the COVID-19 registry of a large urban healthcare system to determine the associations between presenting comorbidities and clinical outcomes during the pandemic. Methods: We analyzed registry data for all inpatients and outpatients with COVID-19 from March 2020 through September 2022 (N = 44,499). Clinical outcomes were death, hospitalization, and intensive care unit (ICU) admission. Demographic and clinical outcomes data were analyzed overall and for each wave. Unadjusted and multivariable logistic regressions were performed to explore the associations between age, sex, race, ethnicity, comorbidities, and mortality. Results: Waves 2 and 3 (Alpha and Delta variants) were associated with greater hospitalizations, ICU admissions, and mortality than other variants. Chronic pulmonary disease was the most common comorbid condition across all age groups and waves. Mortality rates were higher in older patients but decreased across all age groups in later waves. In every wave, mortality was associated with renal disease, congestive heart failure, cerebrovascular disease, diabetes, and chronic pulmonary disease. Multivariable analysis found that liver disease and renal disease were significantly associated with mortality, hospitalization, and ICU admission, and diabetes was significantly associated with hospitalization and ICU admission. Conclusion: The COVID-19 registry is a valuable resource to identify risk factors for clinical outcomes. Our findings may inform risk stratification and care planning for patients with COVID-19 based on age and comorbid conditions.


Asunto(s)
COVID-19 , Diabetes Mellitus , Enfermedades Renales , Humanos , Anciano , COVID-19/epidemiología , SARS-CoV-2 , Registros Electrónicos de Salud
7.
Genome Med ; 16(1): 21, 2024 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-38308367

RESUMEN

BACKGROUND: The immune system has a central role in preventing carcinogenesis. Alteration of systemic immune cell levels may increase cancer risk. However, the extent to which common genetic variation influences blood traits and cancer risk remains largely undetermined. Here, we identify pleiotropic variants and predict their underlying molecular and cellular alterations. METHODS: Multivariate Cox regression was used to evaluate associations between blood traits and cancer diagnosis in cases in the UK Biobank. Shared genetic variants were identified from the summary statistics of the genome-wide association studies of 27 blood traits and 27 cancer types and subtypes, applying the conditional/conjunctional false-discovery rate approach. Analysis of genomic positions, expression quantitative trait loci, enhancers, regulatory marks, functionally defined gene sets, and bulk- and single-cell expression profiles predicted the biological impact of pleiotropic variants. Plasma small RNAs were sequenced to assess association with cancer diagnosis. RESULTS: The study identified 4093 common genetic variants, involving 1248 gene loci, that contributed to blood-cancer pleiotropism. Genomic hotspots of pleiotropism include chromosomal regions 5p15-TERT and 6p21-HLA. Genes whose products are involved in regulating telomere length are found to be enriched in pleiotropic variants. Pleiotropic gene candidates are frequently linked to transcriptional programs that regulate hematopoiesis and define progenitor cell states of immune system development. Perturbation of the myeloid lineage is indicated by pleiotropic associations with defined master regulators and cell alterations. Eosinophil count is inversely associated with cancer risk. A high frequency of pleiotropic associations is also centered on the regulation of small noncoding Y-RNAs. Predicted pleiotropic Y-RNAs show specific regulatory marks and are overabundant in the normal tissue and blood of cancer patients. Analysis of plasma small RNAs in women who developed breast cancer indicates there is an overabundance of Y-RNA preceding neoplasm diagnosis. CONCLUSIONS: This study reveals extensive pleiotropism between blood traits and cancer risk. Pleiotropism is linked to factors and processes involved in hematopoietic development and immune system function, including components of the major histocompatibility complexes, and regulators of telomere length and myeloid lineage. Deregulation of Y-RNAs is also associated with pleiotropism. Overexpression of these elements might indicate increased cancer risk.


Asunto(s)
Estudio de Asociación del Genoma Completo , Neoplasias , Humanos , Femenino , Fenotipo , Sitios de Carácter Cuantitativo , Pleiotropía Genética , Neoplasias/genética , Polimorfismo de Nucleótido Simple , Predisposición Genética a la Enfermedad
8.
Mult Scler ; 30(3): 336-344, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38247138

RESUMEN

BACKGROUND AND OBJECTIVES: Primary-progressive multiple sclerosis (PPMS) is characterized by gradual neurological deterioration without relapses. This study aimed to investigate the clinical impact of gender and age at disease onset on disease progression and disability accumulation in patients with this disease phenotype. METHODS: Secondary data from the RelevarEM registry, a longitudinal database in Argentina, were analyzed. The cohort comprised patients with PPMS who met inclusion criteria. Statistical analysis with multilevel Bayesian robust regression modeling was conducted to assess the associations between gender, age at onset, and Expanded Disability Status Scale (EDSS) score trajectories. RESULTS: We identified 125 patients with a confirmed diagnosis of PPMS encompassing a total of 464 observations. We found no significant differences in EDSS scores after 10 years of disease progression between genders (-0.08; credible interval (CI): -0.60, 0.42). A 20-year difference in age at onset did not show significant differences in EDSS score after 10 years of disease progression (0.281; CI: -0.251, 0.814). Finally, we also did not find any clinically relevant difference between gender EDSS score with a difference of 20 years in age at onset (-0.021; CI: -0.371, 0.319). CONCLUSION: Biological plausibility of gender and age effects does not correlate with clinical impact measured by EDSS score.


Asunto(s)
Esclerosis Múltiple Crónica Progresiva , Esclerosis Múltiple , Humanos , Masculino , Femenino , Niño , Esclerosis Múltiple Crónica Progresiva/diagnóstico , Edad de Inicio , Teorema de Bayes , Recurrencia Local de Neoplasia , Progresión de la Enfermedad
9.
High Blood Press Cardiovasc Prev ; 31(1): 31-41, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38252333

RESUMEN

AIM: To assess the relationship of cardiovascular risk factors (CRFs) with carotid intima media thickness (IMT) in adolescents with a parental history of premature coronary artery disease (PCAD). METHODS: This cross-sectional study included 50 healthy adolescents, aged 14-18 years, both sexes, with a parental history of PCAD, that were compared to 50 controls without this history. Questionnaires regarding information of CRFs were applied. Blood chemistry analyses, included lipid profile, lipoprotein (a), low density lipoprotein (LDL) susceptibility to oxidation, and inflammatory cytokine levels. The IMT was evaluated by ultrasound. RESULTS: The mean age of all participants was 15.9 years. Anthropometric measurements, blood pressure, and lipid profile were similar in both groups. However, the parental history of PCAD group exhibited lower high density lipoprotein cholesterol concentrations, shorter LDL particle oxidation time, and higher lipoprotein (a) levels compared to the control group. IMT was significantly higher in adolescents with a parental history of PCAD compared to controls, (0.53 ± 0.04 mm vs 0.47 ± 0.02 mm, p = 0.001). Among adolescents with a parental history of PCAD, those with ≥ 3 CRFs had significantly higher IMT values (0.56 mm) than those with < 3 CRFs (0.52 mm) and controls (0.48 mm). Multivariable analyses identified that systolic blood pressure and parental history of PCAD explained 26.8% and 16.1% of the variation in IMT. Furthermore, body mass index, LDL-C, ApoB-100, triglycerides and lipoprotein (a) interact with blood pressure levels to explain the IMT values. CONCLUSION: Adolescents with a parental history of PCAD had higher IMT values than the control group, primary explained by systolic blood pressure and the parental inheritance. Adolescents with parental history of PCAD and ≥ 3 CRFs exhibited the highest IMT values. Notably, lipids and systolic blood pressure jointly contribute to explain IMT in these adolescents.


Asunto(s)
Aterosclerosis , Enfermedad de la Arteria Coronaria , Masculino , Femenino , Humanos , Adolescente , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Grosor Intima-Media Carotídeo , Estudios Transversales , Factores de Riesgo , Aterosclerosis/diagnóstico , Triglicéridos , Lipoproteína(a)
10.
Biomedicines ; 12(1)2024 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-38255245

RESUMEN

As cell culture supplements, human platelet lysate (PL) and human platelet lysate serum (PLS) are alternatives to fetal bovine serum (FBS) due to FBS-related issues such as ethical concerns, variability between batches, and the possible introduction of xenogenic contaminants. This study compared the composition and efficacy of PL, PLS, and FBS as supplements in the culture and cryopreservation of human dermal fibroblasts, Wharton's jelly-derived mesenchymal stem cells (WJ-MCS), and adipose tissue (AdMSC). Biochemical components, some growth factors, and cytokines present in each of them were analyzed; in addition, the cells were cultured in media supplemented with 5% PL, 5% PLS, and 10% FBS and exposed to different freezing and thawing solutions with the supplements under study. Biochemical parameters were found to be similar in PL and PLS compared to FBS, with some differences in fibrinogen and calcium concentration. Growth factors and cytokines were higher in PL and PLS compared to FBS. Cell proliferation and morphology showed no significant differences between the three culture media. Regarding the cryopreservation and thawing of cells, better results were obtained with PLS and FBS. In conclusion, PL and PLS are an excellent choice to replace the standard supplement of animal origin (FBS) in the media used for the culture and cryopreservation of fibroblasts, WJ-MSC, and AdMSC.

11.
BMC Genomics ; 25(1): 60, 2024 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-38225585

RESUMEN

BACKGROUND: Beyond the massive amounts of DNA and genes transferred from the protoorganelle genome to the nucleus during the endosymbiotic event that gave rise to the plastids, stretches of plastid DNA of varying size are still being copied and relocated to the nuclear genome in a process that is ongoing and does not result in the concomitant shrinking of the plastid genome. As a result, plant nuclear genomes feature small, but variable, fraction of their genomes of plastid origin, the so-called nuclear plastid DNA sequences (NUPTs). However, the mechanisms underlying the origin and fixation of NUPTs are not yet fully elucidated and research on the topic has been mostly focused on a limited number of species and of plastid DNA. RESULTS: Here, we leveraged a chromosome-scale version of the genome of the orphan crop Moringa oleifera, which features the largest fraction of plastid DNA in any plant nuclear genome known so far, to gain insights into the mechanisms of origin of NUPTs. For this purpose, we examined the chromosomal distribution and arrangement of NUPTs, we explicitly modeled and tested the correlation between their age and size distribution, we characterized their sites of origin at the chloroplast genome and their sites of insertion at the nuclear one, as well as we investigated their arrangement in clusters. We found a bimodal distribution of NUPT relative ages, which implies NUPTs in moringa were formed through two separate events. Furthermore, NUPTs from every event showed markedly distinctive features, suggesting they originated through distinct mechanisms. CONCLUSIONS: Our results reveal an unanticipated complexity of the mechanisms at the origin of NUPTs and of the evolutionary forces behind their fixation and highlight moringa species as an exceptional model to assess the impact of plastid DNA in the evolution of the architecture and function of plant nuclear genomes.


Asunto(s)
Genoma de Plastidios , Moringa oleifera , Moringa oleifera/genética , Evolución Molecular , Plastidios/genética , Genoma de Planta , ADN de Plantas/genética , Plantas/genética , Núcleo Celular/genética
12.
Mult Scler ; 30(3): 396-418, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38140852

RESUMEN

BACKGROUND: As of September 2022, there was no globally recommended set of core data elements for use in multiple sclerosis (MS) healthcare and research. As a result, data harmonisation across observational data sources and scientific collaboration is limited. OBJECTIVES: To define and agree upon a core dataset for real-world data (RWD) in MS from observational registries and cohorts. METHODS: A three-phase process approach was conducted combining a landscaping exercise with dedicated discussions within a global multi-stakeholder task force consisting of 20 experts in the field of MS and its RWD to define the Core Dataset. RESULTS: A core dataset for MS consisting of 44 variables in eight categories was translated into a data dictionary that has been published and disseminated for emerging and existing registries and cohorts to use. Categories include variables on demographics and comorbidities (patient-specific data), disease history, disease status, relapses, magnetic resonance imaging (MRI) and treatment data (disease-specific data). CONCLUSION: The MS Data Alliance Core Dataset guides emerging registries in their dataset definitions and speeds up and supports harmonisation across registries and initiatives. The straight-forward, time-efficient process using a dedicated global multi-stakeholder task force has proven to be effective to define a concise core dataset.


Asunto(s)
Esclerosis Múltiple , Humanos , Sistema de Registros
13.
J Clin Sleep Med ; 20(5): 681-687, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38156422

RESUMEN

STUDY OBJECTIVES: To determine the prevalence of preadmission insomnia symptoms among hospitalized patients and assess the association of insomnia symptoms with objective in-hospital sleep and clinical outcomes. METHODS: We conducted a prospective cohort study of medicine inpatients (age ≥ 50, no previously diagnosed sleep disorders). Participants answered the Insomnia Severity Index (ISI) questionnaire to assess for preadmission insomnia symptoms (scored 0-28; higher scores suggest more insomnia symptoms). Sleep duration and efficiency were measured with actigraphy. Participants self-reported 30-day postdischarge readmissions and emergency department and/or urgent care visits. RESULTS: Of 568 participants, 49% had ISI scores suggestive of possible undiagnosed insomnia (ISI ≥ 8). Higher ISI scores were associated with shorter sleep duration [ß = -2.6, 95% confidence interval (CI) -4.1 to -1.1, P = .001] and lower sleep efficiency (ß = -0.39, 95% CI -0.63 to -0.15, P = .001). When adjusted for age, sex, body mass index, and comorbidities, higher ISI scores were associated with longer length of stay (incidence rate ratio 1.01, 95% CI 1.00-1.02, P = .011), increased risk of 30-day readmission (odds ratio 1.04, 95% CI 1.01-1.07, P = .018), and increased risk of 30-day emergency department or urgent care visit (odds ratio 1.04, 95% CI 1.00-1.07, P = .043). CONCLUSIONS: Among medicine inpatients, there was a high prevalence of preadmission insomnia symptoms suggestive of possible undiagnosed insomnia. Participants with higher ISI scores slept less with lower sleep efficiency during hospitalization. Higher ISI scores were associated with longer length of stay, increased risk of a 30-day postdischarge readmission, and increased risk of a 30-day postdischarge emergency department or urgent care visit. CITATION: Neborak JM, Press VG, Parker WF, et al. Association of preadmission insomnia symptoms with objective in-hospital sleep and clinical outcomes among hospitalized patients. J Clin Sleep Med. 2024;20(5):681-687.


Asunto(s)
Hospitalización , Pacientes Internos , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/complicaciones , Masculino , Femenino , Estudios Prospectivos , Persona de Mediana Edad , Hospitalización/estadística & datos numéricos , Pacientes Internos/estadística & datos numéricos , Readmisión del Paciente/estadística & datos numéricos , Anciano , Encuestas y Cuestionarios , Prevalencia , Actigrafía/estadística & datos numéricos , Índice de Severidad de la Enfermedad , Estudios de Cohortes
14.
Neurol Sci ; 45(2): 379-389, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38159147

RESUMEN

We aimed to evaluate the incidence of SARS-CoV-2 breakthrough infection of SARS-CoV-2 vaccines in people with MS (PwMS) on high-efficacy disease-modifying therapies (HET) included in the national MS registry in Argentina (RelevarEM). METHODS: Non-interventional, retrospective cohort study that collected information directly from RelevarEM. Adult PwMS who had been treated for at least 6 months with a HET (ocrelizumab, natalizumab, alemtuzumab, cladribine) who had received at least two doses of SARS-CoV-2 vaccines available in Argentina were included. Full course of vaccination was considered after the second dose of the corresponding vaccines. Cumulative incidence of SARS-CoV-2 infection was reported for the whole cohort by Kaplan-Meier survival curves (which is expressed in percentage) as well as incidence density (which is expressed per 10.000 patients/day with 95% CI). RESULTS: Two hundred twenty-eight PwMS were included. Most frequent first and second dose received was AstraZeneca vaccine, followed by Sputnik vaccine. Most frequent HETs used in included patients were cladribine in 79 (34.8%). We found an incidence density of breakthrough COVID-19 infection of 3.5 × 10.000 patients/day (95% CI 2.3-6.7) after vaccination in Argentina. We described the incidence rate after vaccination for every HET used, it being significantly higher for ocrelizumab compared with other HETs (p = 0.005). Only five patients presented a relapse during the follow-up period with no differences regarding the pre-vaccination period. CONCLUSIONS: We found an incidence density of breakthrough COVID-19 infection of 3.5 × 10.000 patients/day (95% CI 2.3-6.7) after vaccination in Argentina.


Asunto(s)
Infección Irruptiva , COVID-19 , Esclerosis Múltiple , Adulto , Humanos , Vacunas contra la COVID-19/uso terapéutico , Incidencia , Cladribina , Argentina/epidemiología , Tratamiento Insuficiente , Estudios Retrospectivos , SARS-CoV-2
15.
Chimia (Aarau) ; 77(4): 192-195, 2023 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38047794

RESUMEN

4-Membered heterocycles are low molecular weight polar scaffolds with intriguing potential for drug discovery. Despite their unquestionable value, methods to access such heterocycles remain scant. Here, we describe the generation of oxetane- and azetidine- benzylic carbocations as a general strategy to access valuable 3,3-disubstituted derivatives.

16.
Children (Basel) ; 10(12)2023 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-38136082

RESUMEN

Spinal muscular atrophy (SMA) is a devastating genetic neurodegenerative disease caused by the insufficient production of Survival Motor Neuron (SMN) protein. It presents different phenotypes with frequent contractures and dislocations, scoliosis, and pain. This study aims to report the prevalence and description of pain and how it affects daily life by analyzing a new ad hoc questionnaire. An observational study of patients under 18 years of age with SMA was conducted at two referral centers in Spain. Data were analyzed using a descriptive analysis and a Bayesian ordinal regression model to assess the association with clinical and demographic variables. Fifty-one individuals were included in this study, 27% of whom reported pain with a median duration of 5.2 years and a mean Visual Analogic Scale (VAS) score of 5. Notably, 77% were receiving disease-modifying treatment, with more than 50% receiving analgesic treatment. The Bayesian model showed that functional status, lower limb contractures, and number of visits have a high probability (>90%) of influencing pain. Thus, the prevalence of pain in the SMA population under 18 years is substantial, and its presence could be associated with lower limb contractures, better functional status, and higher RULM (Revised Upper Limb Module) scores.

17.
PeerJ ; 11: e16132, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37786577

RESUMEN

Background: Recent studies have suggested that metabolic syndrome (MS) encompasses a group of risk factors for developing chronic kidney disease (CKD). This work aimed to evaluate the antioxidant and anti-inflammatory effects of allicin in the kidney from an experimental model of MS. Methods: Male Wistar rats (220-250 g) were used, and three experimental groups (n = 6) were formed: control (C), metabolic syndrome (MS), and MS treated with allicin (16 mg/Kg/day, gastric gavage) (MS+A). MS was considered when an increase of 20% in at least three parameters (body weight, systolic blood pressure (SBP), fasting blood glucose (FBG), or dyslipidemia) was observed compared to the C group. After the MS diagnosis, allicin was administered for 30 days. Results: Before the treatment with allicin, the MS group showed more significant body weight gain, increased SBP, and FBG, glucose intolerance, and dyslipidemia. In addition, increased markers of kidney damage in urine and blood. Moreover, the MS increased oxidative stress and inflammation in the kidney compared to group C. The allicin treatment prevented further weight gain, reduced SBP, FBG, glucose intolerance, and dyslipidemia. Also, markers of kidney damage in urine and blood were decreased. Further, the oxidative stress and inflammation were decreased in the renal cortex of the MS+A compared to the MS group. Conclusion: Allicin exerts its beneficial effects on the metabolic syndrome by considerably reducing systemic and renal inflammation as well as the oxidative stress. These effects were mediated through the Nrf2 pathway. The results suggest allicin may be a therapeutic alternative for treating kidney injury induced by the metabolic syndrome risk factors.


Asunto(s)
Intolerancia a la Glucosa , Síndrome Metabólico , Insuficiencia Renal Crónica , Ratas , Animales , Masculino , Antioxidantes/farmacología , Síndrome Metabólico/tratamiento farmacológico , Intolerancia a la Glucosa/tratamiento farmacológico , Ratas Wistar , Riñón , Insuficiencia Renal Crónica/tratamiento farmacológico , Peso Corporal , Modelos Teóricos , Inflamación/tratamiento farmacológico , Antiinflamatorios/farmacología
18.
Heliyon ; 9(9): e19642, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37810128

RESUMEN

In recent years, the avocado has been one of the most dynamic fruits in the world market. In particular, cv. Hass stands out due to its productivity, nutritional quality, and acceptance. Under tropical conditions, weather elements, especially air temperature, and precipitation, affect the productivity and quality of cv. Hass. However, in tropical environments, many relationships between weather and phenological aspects of this cultivar are still unknown. Given this situation, our aim was to identify the variation and degree of association between the phenology of avocado cv. Hass and thermal time (TT) under low-latitude conditions. Eight commercial fields planted with cv. Hass grafted onto Antillean genotypes, located in an altitudinal transect between 1,700 and 2,500 m, were evaluated. The evaluation was carried out for three years and was focused on determining the differences in avocado phenological patterns associated with different environmental variables monitored by weather stations at each location. Air temperature data were used to calculate the base temperature (BT) using different methods for all phenological stages. Later the TT was determined for each stage and all locations. The results show that the duration of each phenological stage varies as a function of elevation (air temperature) and that the phenological stages overlap at the regional, crop field, and plant levels at different periods of the year, generating a high phenological variability but with specific patterns associated with temperature and precipitation. The BT for each phenological stage varied between 0.3 and 7.5 °C, and TT was found to vary depending on the method of calculation. Our work suggests that the generalization of a BT of 10 °C is not applicable for avocado cv. Hass crops under tropical conditions, specifically in the case of Colombia. Detailed studies of phenological relationships with respect to climatic variables will allow a better approximation of the productive behavior of avocado cv. Hass.

19.
Mult Scler J Exp Transl Clin ; 9(4): 20552173231205444, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37854639

RESUMEN

We aimed to evaluate mortality and causes of death among Argentinean neuromyelitis optica spectrum disorder (NMOSD) patients and identify predictors of death. Retrospective study included 158 NMOSD patients and 11 (7%) patients died after 11 years of follow-up for a total exposure time of 53,345 days with an overall incidence density of 2.06 × 10.000 patients/day (95% CI 1.75-2.68). Extensive cervical myelitis with respiratory failure (45%) was the most frequent cause of death. Older age (HR = 2.05, p = 0.002) and higher disability score (HR = 2.30, p < 0.001) at disease onset were independent predictors of death. We found an 11-year mortality rate of 7% in Argentinean NMOSD patients.

20.
J Med Chem ; 66(18): 12697-12709, 2023 09 28.
Artículo en Inglés | MEDLINE | ID: mdl-37676858

RESUMEN

The oxetane ring is an emergent, underexplored motif in drug discovery that shows attractive properties such as low molecular weight, high polarity, and marked three-dimensionality. Oxetanes have garnered further interest as isosteres of carbonyl groups and as molecular tools to fine-tune physicochemical properties of drug compounds such as pKa, LogD, aqueous solubility, and metabolic clearance. This perspective highlights recent applications of oxetane motifs in drug discovery campaigns (2017-2022), with emphasis on the effect of the oxetane on medicinally relevant properties and on the building blocks used to incorporate the oxetane ring. Based on this analysis, we provide an overview of the potential benefits of appending an oxetane to a drug compound, as well as potential pitfalls, challenges, and future directions.


Asunto(s)
Descubrimiento de Drogas , Éteres Cíclicos , Éteres Cíclicos/química , Cinética , Solubilidad
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