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1.
Hipertens Riesgo Vasc ; 41(2): 78-86, 2024.
Artículo en Español | MEDLINE | ID: mdl-38418299

RESUMEN

INTRODUCTION: Hypertension (HTN) represents the primary individual risk factor, contributing significantly to the global burden of cardiovascular diseases (CVD). In our country, epidemiological research has highlighted substantial variations in the prevalence of these risk factors across different populations. However, there is a lack of epidemiological studies assessing exclusive cardiovascular risk factors within vulnerable neighborhoods characterized by extremely limited economic resources, sociocultural challenges, and inadequate healthcare access. METHODS: A multicenter cross-sectional observational study was conducted among individuals residing in economically deprived and marginalized communities, including informal settlements and underprivileged neighborhoods. Simple random sampling of households was employed. Blood pressure measurements, anthropometric assessments, and epidemiological, economic, and sociocultural questionnaires were administered. Results encompass prevalence rates, awareness levels, and blood pressure control across diverse regions. Logistic regression was utilized to identify independent variables influencing primary outcomes. RESULTS: A total of 989 participants were analyzed. The overall prevalence of hypertension was 48.2%. About 82% had a body mass index (BMI) >25. Approximately 45.3% had less than 6 years of formal education. Independent association was established between education levels below 6 years and higher hypertension prevalence. Among hypertensive individuals, 44% were unaware of their condition, with only 17.2% achieving control, correlated with having health insurance and a higher educational background. Merely 24% were receiving combined therapy. CONCLUSION: The prevalence of hypertension within vulnerable neighborhoods is alarmingly high, surpassing rates in other social strata. Knowledge, treatment, and control levels of hypertension are suboptimal, comparable to other populations. Inadequate use of combination therapy was observed. This study underscores the urgent need for targeted interventions addressing cardiovascular risk factors in poor areas to mitigate the burden of CVD.


Asunto(s)
Enfermedades Cardiovasculares , Hipertensión , Humanos , Estudios Transversales , Prevalencia , Argentina/epidemiología , Presión Sanguínea/fisiología , Factores de Riesgo , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control
4.
Ann Oncol ; 33(8): 786-793, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35462008

RESUMEN

BACKGROUND: The results of the RAPIDO trial have been accepted as evidence in favour of short-course radiotherapy (SC-RT) followed by chemotherapy before total mesorectal excision in high-risk locally advanced rectal cancer. A noteworthy concern is that the RAPIDO trial did not ensure that all patients in the control arm received adjuvant chemotherapy. This may bias statistical estimates in favour of the experimental arm if adjuvant chemotherapy is active in rectal cancer. Moreover, the 5-year update revealed an increase in the risk of local relapse in the experimental arm. MATERIALS AND METHODS: We carried out sensitivity analyses to determine how plausible effects of adjuvant chemotherapy, adjusted by the proportion of patients in the standard arm receiving adjuvant treatment, would have influenced the observed treatment effect estimate of the RAPIDO trial. The most plausible values for the benefit of adjuvant chemotherapy were determined by Bayesian re-analysis of a prior meta-analysis. RESULTS: The meta-analysis suggested that oxaliplatin/fluorouracil-based adjuvant chemotherapy may improve disease-free survival (DFS) in rectal cancer although the signal is weak [hazard ratio (HR) 0.84, 95% credible interval, 0.57-1.15]; probability of benefit (HR <1) was 91.2%. In the sensitivity analysis, the HR for disease-related treatment failure would remain <1, thus favouring total neoadjuvant therapy (TNT), on most occasions, but the null hypothesis would not have been rejected in various credible settings. For the RAPIDO data to be consistent with the null effect, a moderate benefit of adjuvant chemotherapy (HR for DFS between 0.75 and 0.80) and 70%-80% of exposed participants would suffice. CONCLUSION: The decision to make adjuvant chemotherapy optional in the standard arm may have biased the results in favour of the experimental arm, in a scenario in which TNT does not offset the increase in local recurrences after SC-RT.


Asunto(s)
Terapia Neoadyuvante , Neoplasias del Recto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Teorema de Bayes , Quimioradioterapia/métodos , Quimioterapia Adyuvante/métodos , Supervivencia sin Enfermedad , Fluorouracilo , Humanos , Terapia Neoadyuvante/métodos , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/radioterapia , Estadificación de Neoplasias , Neoplasias del Recto/tratamiento farmacológico , Neoplasias del Recto/radioterapia , Nivel de Atención
5.
Neurologia (Engl Ed) ; 37(2): 130-135, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35279226

RESUMEN

INTRODUCTION: The use of low doses of recombinant tissue plasminogen activator (rt-PA) was initially proposed in Asian countries in response to racial peculiarities related to the functionality of fibrinogen and coagulation factors that potentially increased the risk of intracerebral haemorrhage, and with a view to saving costs. In view of the controversy over the use of rt-PA below the standard dose, we conducted a literature review of studies promoting the use of low doses or comparing different doses of rt-PA. DEVELOPMENT: We reviewed 198 abstracts related to the search terms and the full texts of 52 studies published in the last 30 years. We finally included 13 randomised clinical trials aiming to determine the efficacy and safety of the use of rt-PA at different doses in acute stroke, 14 observational cohort studies, 5 meta-analyses, and 3 systematic reviews. CONCLUSIONS: There is insufficient evidence to classify low doses of rt-PA as superior or at least not inferior to the standard treatment in the management of acute stroke in western populations. More clinical trials are required to determine whether the use of low doses is beneficial in patients with relative contraindications for thrombolytic therapy or other particular circumstances that may increase the risk of intracerebral haemorrhage.


Asunto(s)
Accidente Cerebrovascular , Activador de Tejido Plasminógeno , Hemorragia Cerebral/inducido químicamente , Hemorragia Cerebral/tratamiento farmacológico , Humanos , Accidente Cerebrovascular/tratamiento farmacológico , Terapia Trombolítica , Activador de Tejido Plasminógeno/efectos adversos
6.
Neurología (Barc., Ed. impr.) ; 37(2): 130-135, Mar. 2022. tab
Artículo en Inglés, Español | IBECS | ID: ibc-204648

RESUMEN

Introducción: El uso de activador tisular del plasminógeno (rt-PA) a dosis bajas fue propuesto inicialmente en países asiáticos en atención a particularidades raciales relacionadas con la funcionalidad del fibrinógeno y factores de coagulación que contribuyen al riesgo de hemorragias intracerebrales, así como a la intención de ahorrar costos. Ante la controversia sobre el uso de rt-PA por debajo de la dosis estándar, realizamos una revisión de la literatura sobre los estudios que motivaron su uso y aquellos dirigidos a comparar diferentes dosis de rt-PA. Desarrollo: Se revisaron 198 resúmenes relacionados con los términos de búsqueda. Se revisaron 52 publicaciones de texto completo de los últimos 30 años. Se incluyeron 13 ensayos clínicos aleatorizados dirigidos a determinar la eficacia y seguridad del uso de rt-PA a diferentes dosis en el ictus agudo, 14 estudios de cohorte observacionales, 5 metaanálisis y 3 revisiones sistemáticas. Conclusiones: No se cuenta con evidencia suficiente para catalogar la dosis baja de alteplase como superior o al menos no inferior que el tratamiento estándar en el manejo del ictus agudo en población occidental. Se requieren más ensayos clínicos para determinar, si el uso de dosis bajas es beneficioso en pacientes con contraindicaciones relativas de terapia trombolítica u otras circunstancias particulares que eleven el riesgo de hemorragias intracerebrales. (AU)


Introduction: The use of low doses of recombinant tissue plasminogen activator (rt-PA) was initially proposed in Asian countries in response to racial peculiarities related to the functionality of fibrinogen and coagulation factors that potentially increased the risk of intracerebral haemorrhage, and with a view to saving costs. In view of the controversy over the use of rt-PA below the standard dose, we conducted a literature review of studies promoting the use of low doses or comparing different doses of rt-PA. Development: We reviewed 198 abstracts related to the search terms and the full texts of 52 studies published in the last 30 years. We finally included 13 randomised clinical trials aiming to determine the efficacy and safety of the use of rt-PA at different doses in acute stroke, 14 observational cohort studies, 5 meta-analyses, and 3 systematic reviews. Conclusions: There is insufficient evidence to classify low doses of rt-PA as superior or at least not inferior to the standard treatment in the management of acute stroke in western populations. More clinical trials are required to determine whether the use of low doses is beneficial in patients with relative contraindications for thrombolytic therapy or other particular circumstances that may increase the risk of intracerebral haemorrhage. (AU)


Asunto(s)
Humanos , Accidente Cerebrovascular/tratamiento farmacológico , Terapia Trombolítica , Activador de Tejido Plasminógeno/efectos adversos , Hemorragia Cerebral/inducido químicamente , Hemorragia Cerebral/tratamiento farmacológico , Fibrinólisis
7.
Artículo en Inglés | MEDLINE | ID: mdl-35123064

RESUMEN

Eleginops maclovinus is a native species with potential for Chilean aquaculture. Understanding the variations between the post-prandial and fasted metabolic responses can contribute to improving the aquaculture of this species. This study aimed to characterize variations in intermediate metabolism during the course of the day in the liver, serum, and gills of fed and unfed fish. For this, 72 fish were assigned to two experimental groups, "fed" and "fasted". The first group was fed "ad libitum" at 8.30, while the fasted group was not fed for 24 h. Samples were taken from both groups at 9:00, and every 2 h: 11:00, 13:00, 15:00, 17:00, and 19:00. In the fed group, food spent a long time in the gastrointestinal tract, with a large increase in stomach size and without evidence of complete emptying of the stomach at 19:00 (10.5 h post-feeding). In serum, the levels of amino acids, glucose, and triglycerides presented significant differences with peak levels at different times of day in the fed group. The cortisol in the fasted group presented a diurnal pattern with high levels during the morning and very low levels after 13:00, while in the fed group, the high cortisol variability did not allow a clear pattern to be established. In the liver, the effect of time on the enzymatic activity of the intermediary metabolism was greater compared to the effect of feeding. In the liver, enzyme activity decreased at later hours of the day, while glycogen levels increased at later hours of the day in both groups: but its levels were higher in the fed group. In gills, as well as in the liver, time had a greater effect than feeding on intermediate metabolism, since feeding only had a significant effect on the levels of hexokinase, lactate, and amino acids, suggesting an effect on carbohydrate metabolism. Meanwhile, time significantly affected the levels of Na+, K+-ATPase, glutamate dehydrogenase, aspartate aminotransferase, amino acids, and proteins, suggesting an effect on amino acid metabolism. In conclusion, the intermediate metabolism of E. maclovinus presents variations according to the time of day, with an increased metabolism during the morning and decreased metabolism as the day progresses, especially at the hepatic level. The gill tissue, despite not being a metabolic organ, presents feeding-dependent variations in its metabolism. Additional studies will be required to corroborate if coordinating a feeding strategy during the first hours of the day when metabolism is greater would improve the growth of E. maclovinus.


Asunto(s)
Hidrocortisona , Perciformes , Aminoácidos , Animales , Ayuno , Periodo Posprandial
8.
Artículo en Inglés | MEDLINE | ID: mdl-35114387

RESUMEN

In teleosts, peripheral serotonin (5-HT) and melatonin (MEL) are synthesised in the gastrointestinal tract (GIT) and regulate secretion and motility processes. Their production is regulated by diet and the passage of food through the GIT. This study aimed to evaluate how intestinal 5-HT, melatonin, and the activity of digestive enzymes varied with food passage time through GIT in Atlantic salmon (Salmo salar). We fed fish diets supplemented with tryptophan and melatonin (L-Trp 2.5% and MEL 0.01%) and measured the activity of digestive enzymes (amylase, lipase, and total protease) in the pyloric caeca, midgut, and hindgut at different times after feeding. 5-HT levels increased in all GIT portions and diets at 120 min post-intake and were highest in the pyloric caeca. Intestinal enzymatic activity was varied with diet, post-intake time and in different intestinal portions. In conclusion, food passage time directly affects GIT 5-HT secretion and digestive enzyme activity in S. salar, and diet composition regulates S. salar GIT function.


Asunto(s)
Melatonina , Salmo salar , Alimentación Animal/análisis , Animales , Dieta/veterinaria , Tracto Gastrointestinal , Serotonina , Triptófano
9.
Rev. chil. neuro-psiquiatr ; 59(3): 197-203, sept. 2021.
Artículo en Español | LILACS | ID: biblio-1388398

RESUMEN

INTRODUCCIÓN: La depresión es una patología de alta prevalencia en los adultos mayores, estando asociada a mayor morbimortalidad. Existen escasos estudios sobre prevalencia y caracterización de pacientes geriátricos hospitalizados con síntomas depresivos. MÉTODO: Se entrevistaron pacientes entre enero y marzo de 2020. Criterios de Inclusión: edad > 60 años, admitidos en las últimas 48 horas. CRITERIOS DE EXCLUSIÓN: Pfeiffer ≥ 3, Glasgow < 15, afasia, enfermedad mental, no hispanohablante. RESULTADOS: Se entrevistaron 59 pacientes, 32 mujeres y 27 varones, edad promedio 73,32 (DE 6,63). La prevalencia de test Yesavage-15 positivo fue 32,20% (19), 52,63% (10) en mujeres y 47,37% (9) en hombres. CONCLUSIONES: Los síntomas depresivos en adultos mayores admitidos en un Servicio de Medicina Interna son frecuentes, y no siempre pesquisados durante la hospitalización. La relación significativa entre Yesavage positivo e ideación suicida destaca el rol de los trastornos del ánimo en el suicidio en población geriátrica.


INTRODUCTION: Depression is a highly prevalent pathology in the elderly, associated to higher morbimortality. There are few studies on prevalence and characterization of hospitalized geriatric patients with depressive symptoms. METHOD: Patients were interviewed between january and april 2020. Inclusion criteria: age over 60 years old, admitted in the last 48 hours. EXCLUSION CRITERIA: Pfeiffer ≥ 3, Glasgow < 15, aphasias, mental diseases, no spanish-speaker. RESULTS: 59 patients were interviewed, 32 women and 27 men, mean age of 73,32 (DE 6.63) years old. Positive Yesavage score prevalence was 32,20% (19), 52,63% (10) in women and 47,37% (9) in men. CONCLUSIONS: Depressive symptoms in patients admitted to an Internal Medicine service are frequent, and often undetected during hospitalization.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Depresión/epidemiología , Geriatría , Hospitalización , Prevalencia , Entrevistas como Asunto , Depresión/diagnóstico
10.
Sci Total Environ ; 800: 149653, 2021 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-34426350

RESUMEN

This work critically reviews the present knowledge about the use of Raceway Pond Reactors (RPR) to treat municipal wastewater treatment plant (MWWTP) secondary effluents by solar photo-Fenton process. The possibility of using RPR to treat industrial wastewater, which has been barely explored, is also reviewed. Initially, the general concepts and operation principles of RPR are described as well as their origin for photo-Fenton applications. Then, the main results and advances related to contaminants of emerging concern (CECs) removal, inactivation of microorganisms, industrial wastewater treatment and kinetic modelling are presented. Key aspects such as the impact of liquid depth, the continuous flow operation feasibility, the increase in treatment capacity, and the kinetic modelling are addressed along the review. At the end, main challenges and research gaps are identified, which should be the focuses of future research.


Asunto(s)
Contaminantes Químicos del Agua , Purificación del Agua , Peróxido de Hidrógeno , Luz Solar , Aguas Residuales , Contaminantes Químicos del Agua/análisis
13.
J Therm Biol ; 96: 102835, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33627273

RESUMEN

Over the last decades, climate change has intensified. Temperatures have increased and seawater has become "fresher" in Antarctica, affecting fish such as Harpagifer antarcticus. Thus, this study aimed to evaluate changes in the osmoregulatory response of the Antarctic notothenioid fish Harpagifer antarcticus and evaluate how it will cope with the future climate change and environmental conditions in the Antarctic, and in the hypothetical case that its geographical distribution will be extended to the Magellanes region. The present study was undertaken to determine the interaction between temperature and salinity tolerance (2 °C and 33 psu as the control group, the experimental groups were 5, 8, and 11 °C and 28 and 23 psu) and their effect on the osmoregulatory status of H. antarcticus. We evaluated changes in gill-kidney-intestine NKA activity, gene expression of NKAα, NKCC, CFTR, Aquaporins 1 and 8 in the same tissues, muscle water percentage, and plasma osmolality to evaluate osmoregulatory responses. Plasma osmolality decreased with high temperature, also the gill-kidney-intestine NKA activity, gene expression of NKA α, NKCC, CFTR, Aquaporins 1, and 8 were modified by temperature and salinity. We demonstrated that H. antarcticus can not live in the Magallanes region, due to its incapacity to put up with temperatures over 5 °C and with over 8 °C being catastrophic.


Asunto(s)
Cambio Climático , Osmorregulación , Perciformes/fisiología , Salinidad , Temperatura , Animales , Proteínas de Peces/fisiología , Branquias/fisiología , Intestinos/fisiología , Riñón/fisiología , Proteínas de Transporte de Membrana/fisiología , Concentración Osmolar
14.
Bioinspir Biomim ; 16(4)2021 05 11.
Artículo en Inglés | MEDLINE | ID: mdl-33571974

RESUMEN

This work investigates the possible integration of an energy harvester in a bioinspired fish-like aquatic unmanned vehicle. The defined fish-like system utilizes a reduced complexity prescribed motion as the representation for energy harvester to be subjected to. Nonlinear electromechanical modeling is performed by considering the geometric and piezoelectric nonlinearities. A convergence analysis is carried out in order to determine the required modes in the Galerkin discretization due to the presence of nonlinear interactions between the prescribed and relative motions. The utilization of higher-order modeling for the strain and material leads to the identification of impactful prescribed motions terms that can activate the nonlinearities in the system, results in more harmonics to consider, and leads to the presence parametric excitation terms. Considering a reduced-complex model by decreasing the value of the quadratic constraint envelope that the fish-like system would be forced with, the soft-robotic system behaves more with a base excitation characteristic. Small damping would allow this prescribed motion with reduced quadratic envelope forcing still induces a hardening behavior, but the other harmonics and parametric resonance seen are greatly reduced. Considering this reduced complexity system, the interaction between the prescribed and base excitations is also investigated to demonstrate that when the two excitations are of similar nature constructive and destructive build of the response waveform can occur when looking at near the first natural resonance. It is shown that the quenching phenomenon can take place which may result in a destructive response of the piezoelectric energy harvester. The results show that the robustness of the fish-like robot is directly dependent on the design parameters including the damping of the structure, importance of the undulatory motion, and activation of the resonances.


Asunto(s)
Robótica , Animales , Movimiento (Física)
15.
Trials ; 22(1): 116, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33546739

RESUMEN

OBJECTIVES: Baricitinib is supposed to have a double effect on SARS-CoV2 infection. Firstly, it reduces the inflammatory response through the inhibition of the Januse-Kinase signalling transducer and activator of transcription (JAK-STAT) pathway. Moreover, it reduces the receptor mediated viral endocytosis by AP2-associated protein kinase 1 (AAK1) inhibition. We propose the use of baricinitib to prevent the progression of the respiratory insufficiency in SARS-CoV2 pneumonia in onco-haematological patients. In this phase Ib/II study, the primary objective in the safety cohort is to describe the incidence of severe adverse events associated with baricitinib administration. The primary objective of the randomized phase (baricitinib cohort versus standard of care cohort) is to evaluate the number of patients who did not require mechanical oxygen support since start of therapy until day +14 or discharge (whichever it comes first). The secondary objectives of the study (only randomized phase of the study) are represented by the comparison between the two arms of the study in terms of mortality and toxicity at day+30. Moreover, a description of the immunological related changes between the two arms of the study will be reported. TRIAL DESIGN: The trial is a phase I/II study with a safety run-in cohort (phase 1) followed by an open label phase II randomized controlled trial with an experimental arm compared to a standard of care arm. PARTICIPANTS: The study will be performed at the Institut Català d'Oncologia, a tertiary level oncological referral center in the Catalonia region (Spain). The eligibility criteria are: patients > 18 years affected by oncological diseases; ECOG performance status < 2 (Karnofsky score > 60%); a laboratory confirmed infection with SARS-CoV-2 by means of real -time PCR; radiological signs of low respiratory tract disease; absence of organ dysfunction (a total bilirubin within normal institutional limits, AST/ALT≤2.5 X institutional upper limit of normal, alkaline phosphatase ≤2.5 X institutional upper limit of normal, coagulation within normal institutional limits, creatinine clearance >30 mL/min/1.73 m2 for patients with creatinine levels above institutional normal); absence of HIV infection; no active or latent HBV or HCV infection. The exclusion criteria are: patients with oncological diseases who are not candidates to receive any active oncological treatment; hemodynamic instability at time of study enrollment; impossibility to receive oral medication; medical history of recent or active pulmonary embolism or deep venous thrombosis or patients at high-risk of suffering them (surgical intervention, immobilization); multi organ failure, rapid worsening of respiratory function with requirement of fraction of inspired oxygen (FiO2) > 50% or high-flow nasal cannula before initiation of study treatment; uncontrolled intercurrent illness (ongoing or severe active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements); allergy to one or more of study treatments; pregnant or breastfeeding women; positive pregnancy test in a pre-dose examination. Patients should have the ability to understand, and the willingness to sign, a written informed consent document; the willingness to accept randomization to any assigned treatment arm; and must agree not to enroll in another study of an investigational agent prior to completion of Day +28 of study. An electronic Case Report Form in the Research Electronic Data Capture (REDCap) platform will be used to collect the data of the trial. Removal from the study will apply in case of unacceptable adverse event(s), development of an intercurrent illness, condition or procedural complication, which could interfere with the patient's continued participation and voluntary patient withdrawal from study treatment (all patients are free to withdraw from participation in this study at any time, for any reasons, specified or unspecified, and without prejudice). INTERVENTION AND COMPARATOR: Treatment will be administered on an inpatient basis. We will compare the experimental treatment with baricitinib plus the institutional standard of care compared with the standard of care alone. During the phase I, we will define the dose-limiting toxicity of baricitinib and the dose to be used in the phase 2 part of the study. The starting baricitinib dose will be an oral tablet 4 mg-once daily which can be reduced to 2 mg depending on the observed toxicity. The minimum duration of therapy will be 5 days and it can be extended to 7 days. The standard of care will include the following therapies. Antibiotics will be individualized based on clinical suspicion, including the management of febrile neutropenia. Prophylaxis of thromboembolic disease will be administered to all participants. Remdesivir administration will be considered only in patients with severe pneumonia (SatO2 <94%) with less than 7 days of onset of symptoms and with supplemental oxygen requirements but not using high-flow nasal cannula, non-invasive or invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO). In the randomized phase, tocilizumab or interferon will not be allowed in the experimental arm. Tocilizumab can be used in patients in the standard of care arm at the discretion of the investigator. If it is prescribed it will be used according to the following criteria: patients who, according to his baseline clinical condition, would be an ICU tributary, interstitial pneumonia with severe respiratory failure, patients who are not on mechanical ventilation or ECMO and who are still progressing with corticoid treatment or if they are not candidates for corticosteroids. Mild ARDS (PAFI <300 mmHg) with radiological or blood gases deterioration that meets at least one of the following criteria: CRP >100mg/L D-Dimer >1,000µg/L LDH >400U/L Ferritin >700ng/ml Interleukin 6 ≥40ng/L. The use of tocilizumab is not recommended if there are AST/ALT values greater than 10 times the upper limit of normal, neutrophils <500 cells/mm3, sepsis due to other pathogens other than SARS-CoV-2, presence of comorbidity that can lead to a poor prognosis, complicated diverticulitis or intestinal perforation, ongoing skin infection. The dose will be that recommended by the Spanish Medicine Agency in patients ≥75Kg: 600mg dose whereas in patients <75kg: 400mg dose. Exceptionally, a second infusion can be assessed 12 hours after the first in those patients who experience a worsening of laboratory parameters after a first favourable response. The use of corticosteroids will be recommended in patients who have had symptoms for more than 7 days and who meet all the following criteria: need for oxygen support, non-invasive or invasive mechanical ventilation, acute respiratory failure or rapid deterioration of gas exchange, appearance or worsening of bilateral alveolar-interstitial infiltrates at the radiological level. In case of indication, it is recommended: dexamethasone 6mg/d p.o. or iv for 10 days or methylprednisolone 32mg/d orally or 30mg iv for 10 days or prednisone 40mg day p.o. for 10 days. MAIN OUTCOMES: Phase 1 part: to describe the toxicity profile of baricitinib in COVID19 oncological patients during the 5-7 day treatment period and until day +14 or discharge (whichever it comes first). Phase 2 part: to describe the number of patients in the experimental arm that will not require mechanical oxygen support compared to the standard of care arm until day +14 or discharge (whichever it comes first). RANDOMISATION: For the phase 2 of the study, the allocation ratio will be 1:1. Randomization process will be carried out electronically through the REDcap platform ( https://www.project-redcap.org/ ) BLINDING (MASKING): This is an open label study. No blinding will be performed. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): The first part of the study (safety run-in cohort) will consist in the enrollment of 6 to 12 patients. In this population, we will test the toxicity of the experimental treatment. An incidence of severe adverse events grade 3-4 (graded by Common Terminology Criteria for Adverse Events v.5.0) inferior than 33% will be considered sufficient to follow with the next part of the study. The second part of the study we will perform an interim analysis of efficacy at first 64 assessed patients and a definitive one will analyze 128 assessed patients. Interim and definitive tests will be performed considering in both cases an alpha error of 0.05. We consider for the control arm this rate is expected to be 0.60 and for the experimental arm of 0.80. Considering this data, a superiority test to prove a difference of 0.20 with an overall alpha error of 0.10 and a beta error of 0.2 will be performed. Considering a 5% of dropout rate, it is expected that a total of 136 patients, 68 for each study arm, will be required to complete study accrual. TRIAL STATUS: Version 5.0. 14th October 2020 Recruitment started on the 16th of December 2020. Expected end of recruitment is June 2021. TRIAL REGISTRATION: AEMPs: 20-0356 EudraCT: 2020-001789-12, https://www.clinicaltrialsregister.eu/ctr-search/search (Not publically available as Phase I trial) Clinical trials: BARCOVID19, https://www.clinicaltrials.gov/ (In progress) FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol."


Asunto(s)
Antivirales/efectos adversos , Azetidinas/efectos adversos , Tratamiento Farmacológico de COVID-19 , Neoplasias Hematológicas/complicaciones , Purinas/efectos adversos , Pirazoles/efectos adversos , Insuficiencia Respiratoria/prevención & control , SARS-CoV-2/genética , Sulfonamidas/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/complicaciones , COVID-19/epidemiología , COVID-19/mortalidad , COVID-19/virología , Ensayos Clínicos Fase I como Asunto , Ensayos Clínicos Fase II como Asunto , Estudios de Cohortes , Femenino , Neoplasias Hematológicas/epidemiología , Neoplasias Hematológicas/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Terapia por Inhalación de Oxígeno , Ensayos Clínicos Controlados Aleatorios como Asunto , Reacción en Cadena en Tiempo Real de la Polimerasa , Insuficiencia Respiratoria/epidemiología , España/epidemiología , Resultado del Tratamiento , Adulto Joven
16.
Sci Total Environ ; 761: 143204, 2021 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-33162125

RESUMEN

This work deals with the remediation of a soil that has been enriched with Quinclorac (QNC), one of the herbicides most used in Chile for weed control in rice fields. Quinclorac damages the microflora and macrofauna of soils and is toxic to some susceptible crops, which results in economic loses during crop rotation. Furthermore, Quinclorac a potential contaminant of water resources and soils, given its high mobility and persistence. This has created the need to lower its concentrations in soils intensively cultivated. In this study, an electro-kinetic soil washing system (EKSW) for mobilizing this pesticide in the soil was explored. The performance of this technology was compared by assessing the effect of direct (DP) and reverse (RP) polarity during 15 days under potentiostatic conditions and applying an electric field of 1 V cm-1 between electrodes. Among the main results, the highest removal of QNC was obtained through the EKSW-RP process, which also contributed to the prevention of acidity and alkaline fronts in the soil, compared to the EKSW-DP system. In both cases, the highest accumulation of QNC occurred in the cathodic well by mobilizing the non-ionized contaminant through the electroosmotic flow (EOF) from anode to cathode. After the treatment with EKSW, the wash water accumulated in the anodic and cathodic wells, which contained an important concentration of pesticide, was subjected to electro-oxidation (EO) by applying different current densities (j). The high generation of •OH on the surface of a boron-doped diamond electrode (BDD) allowed for the complete degradation and mineralization of QNC and its major intermediate compounds to CO2. The results of this study show that the application of both coupled stages in this type of remediation technologies would enable the removal of QNC from the soil without altering its chemical and physical properties, constituting an environmentally friendly process.

17.
Fish Shellfish Immunol ; 106: 1042-1051, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32950678

RESUMEN

Oncorhynchus kisutch is the third most cultivated salmonid species in the Chilean salmon industry and its farming conditions are characterised by high stocking density leading to the generation of high levels of organic matter (food - feces) and decomposition. In addition to the increasingly frequent hypoxic oceanographic events, these inappropriate farming conditions increase the demand for oxygen within the fish farm pen and lead to the appearance of hypoxic events that are harmful to fish.This study aimed to evaluate the stress response (cortisol) and transcription of genes involved in the immune response in head kidney and spleen of Oncorhynchus kisutch subjected to chronic hypoxic stress conditions. The fish were exposed to 100%, 60%, 50%, 35%, and 25% of DO for 28 days, then the blood (plasma), head kidney and spleen were removed. We observed mortality in the 25% DO group at days 15 and 20. Plasma cortisol increased significantly under 35% and 25% DO conditions compared to control. Transcription of Toll-like receptors (TLR1, TLR5M, TLR8, and TLR9) and cytokines (IL-1ß, IL6, IL10, TNF-α) increased in the head kidney only in the 50% DO group, while in spleen there was an increase of these markers in the conditions of 60%, 35%, and 25% DO. As for the markers involved in cell-mediated immunity, CD4-MHCII and CD8-MHCI do not have a clear expression pattern, although there was down-regulation in MHCII transcription in the head kidney, in all the hypoxia conditions evaluated. Finally, IgM transcription was increased in the spleen in all hypoxia conditions, although it wasn't always statistically significant compared to the control. These results indicate that chronic hypoxia induces the stress response, increasing plasma cortisol levels and modulating the transcription of genes involved in the innate and adaptive immune response. The expression patterns were tissue-specific, indicating that the degree of hypoxia differentially affects the transcription of genes involved in the immune response of Oncorhynchus kisutch.


Asunto(s)
Oncorhynchus kisutch/inmunología , Inmunidad Adaptativa , Anaerobiosis/inmunología , Animales , Citocinas/genética , Proteínas de Peces/genética , Riñón Cefálico/inmunología , Hidrocortisona/sangre , Inmunidad Innata/genética , Oncorhynchus kisutch/sangre , Oncorhynchus kisutch/genética , Oxígeno/análisis , Bazo/inmunología , Receptores Toll-Like/genética
19.
Clin Transl Oncol ; 22(11): 1976-1991, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32418154

RESUMEN

In this update of the consensus of the Spanish Society of Medical Oncology (Sociedad Española de Oncología Médica-SEOM) and the Spanish Society of Pathology (Sociedad Española de Anatomía Patológica-SEAP), advances in the analysis of biomarkers in advanced colorectal cancer (CRC) as well as susceptibility markers of hereditary CRC and molecular biomarkers of localized CRC are reviewed. Recently published information on the essential determination of KRAS, NRAS and BRAF mutations and the convenience of determining the amplification of human epidermal growth factor receptor 2 (HER2), the expression of proteins in the DNA repair pathway and the study of NTRK fusions are also evaluated. From the pathological point of view, the importance of analysing the tumour budding and poorly differentiated clusters, and its prognostic value in CRC is reviewed, as well as the impact of molecular lymph node analysis on lymph node staging in CRC. The incorporation of pan-genomic technologies, such as next-generation sequencing (NGS) and liquid biopsy in the clinical management of patients with CRC is also outlined. All these aspects are developed in this guide, which, like the previous one, will remain open to any necessary revision in the future.


Asunto(s)
Biomarcadores de Tumor/análisis , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/patología , Consenso , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Biopsia Líquida , Oncología Médica , Mutación , Patología , Sociedades Médicas , España
20.
Rev Sci Tech ; 39(3): 923-945, 2020 Jan.
Artículo en Español, Inglés | MEDLINE | ID: mdl-35275124

RESUMEN

The aim of this study was to determine the seroprevalence of Salmonella spp., Mycobacterium bovis and Brucella spp., together with associated risk factors, in pigs from various farms in seven regions of Colombia. A total of 350 blood samples were obtained from pigs at different stages in the production cycle of 23 farms, which were tested using the enzyme-linked immunosorbent assay (ELISA) diagnostic kits Pigtype®-Salmonella Ab (Qiagen®, Hilden, Germany), INgezim TB porcine and INgezim Brucella porcine (Ingenasa®, Madrid, Spain). The overall seroprevalence for Salmonella spp. was 42.85% (n = 150) and, for M. bovis, it was 5.42% (n = 19). No positive samples were detected for Brucella spp. In the farms evaluated, the presence of pests, such as rodents, was found to be the management variable with a statistically significant association with seropositivity for Salmonella spp. and M. bovis. The results suggest that, at some point in the primary production cycle, pigs came into contact with zoonotic bacteria, resulting in seropositivity, which may pose a risk to public health and national pig production.


Les auteurs présentent les résultats d'une étude menée en Colombie pour déterminer la prévalence sérologique de Salmonella spp., de Mycobacterium bovis et de Brucella spp. et d'identifier les facteurs de risques associés chez les porcs de différents élevages répartis dans sept régions du pays. Au total, 350 prélèvements sanguins de porcs en différentes phases du cycle de production et provenant de 23 exploitations ont été analysés en utilisant les kits de diagnostic suivants : test immuno-enzymatique (ELISA) Pigtype®-Salmonella Ab (Qiagen®, Hilden, Allemagne), INgezim TB porcina et INgezim Brucella porcina (Ingenasa®, Madrid, Espagne). La prévalence sérologique globale de Salmonella spp. était de 42,85 % (n = 150) et celle de M. bovis de 5,42 % (n = 19) ; aucun échantillon n'a été trouvé positif pour Brucella spp. En ce qui concerne les facteurs en lien avec la gestion des élevages, une corrélation significative au plan statistique a été observée dans les exploitations étudiées entre la présence de ravageurs (rongeurs notamment) et l'apparition d'anticorps dirigés contre Salmonella spp. et M. bovis. Les résultats obtenus laissent penser que les porcs ont été exposés à ces bactéries zoonotiques à un moment ou un autre du cycle de production primaire, ce qui a déclenché l'apparition d'anticorps ; il s'agit d'une situation à risque tant pour la santé publique que pour la filière porcine du pays.


El objetivo del presente estudio fue determinar la seroprevalencia respectoa Salmonella spp., Mycobacterium bovis y Brucella spp., junto con los factores de riesgo asociados, en porcinos de diferentes explotaciones de producción en siete regiones de Colombia. Se obtuvieron 350 muestras sanguíneas de porcinos de diferentes etapas del ciclo productivo provenientes de 23 explotaciones,y estas fueron analizadas utilizando los estuches de ensayo inmunoenzimático (ELISA) para diagnóstico Pigtype®-Salmonella Ab (Qiagen®, Hilden, Alemania), INgezim TB porcina e INgezim Brucella porcina (Ingenasa®, Madrid, España). La seroprevalencia general respecto a Salmonella spp. fue del 42,85% (n = 150),y para M. bovis, del 5,42% (n = 19); no se detectó ninguna muestra positiva respecto a Brucella spp. Se determinó que en las explotaciones evaluadas, la presencia de plagas, como los roedores, fue la variable de manejo con asociación estadísticamente significativa a la seropositividad respecto a Salmonella spp.y a M. bovis. Los resultados obtenidos sugieren que, en algún momento del ciclo de producción primaria, los cerdos estuvieron en contacto con las bacterias zoonóticas frente a las que se obtuvo seropositividad, lo cual puede representar un riesgo para la salud pública y la producción porcina a nivel nacional.

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