RESUMEN
Human exposure to persistent organic pollutants (POPs) may contribute to obesogenic effects. We have previously shown that POP mixtures modelled on blood levels relevant to the Scandinavian population induces adipogenic effects in the mouse 3T3-L1 cell line. Luteolin is a flavone that has shown anti-lipogenic and anti-adipogenic effects on adipogenesis in in vitro models. In this study, luteolin has been applied to inhibit adipocyte formation and intracellular lipid content increase induced by a human relevant mixture of POPs. 3T3-L1 cells were exposed to a POP mixture consisting of 29 chemicals, including amongst others polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), perfluoroalkylated acids (PFAAs), and polybrominated diphenyl ethers (PBDEs). Rosiglitazone was applied as a positive lipogenic control. Luteolin was tested between 0.5 and 10 µM. High content analysis was used to assess changes in adipocyte formation and intracellular lipid content in the 3T3-L1 cell line. Luteolin significantly reduced POP-induced adipocyte formation at 2, 5 and 10 µM, and lipid accumulation at 10 µM. Interestingly, luteolin did not affect rosiglitazone induced adipo- and lipogenic effects, suggesting differences in mechanisms of action. In conclusion, this in vitro study shows that dietary polyphenols such as luteolin may protect against POP induced adipo- and lipogenic effects.
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Contaminantes Ambientales , Hidrocarburos Clorados , Plaguicidas , Bifenilos Policlorados , Animales , Ratones , Humanos , Adipogénesis , Células 3T3-L1 , Contaminantes Orgánicos Persistentes , Luteolina/farmacología , Rosiglitazona , Bifenilos Policlorados/análisis , Contaminantes Ambientales/análisis , Plaguicidas/análisis , Lípidos , Éteres Difenilos Halogenados/análisisRESUMEN
INTRODUCTION: Human exposure to persistent organic pollutants (POPs) has been linked to genitourinary health-related conditions such as decreased sperm quality, hypospadias, and prostate cancer (PCa). Conventional risk assessment of POPs focuses on individual compounds. However, in real life, individuals are exposed to many compounds simultaneously. This might lead to combinatorial effects whereby the global effect of the mixture is different from the effect of the single elements or subgroups. POP mixtures may act as endocrine disruptors via the androgen receptor (AR) and potentially contribute to PCa development. AIM: To determine the endocrine disrupting activity of a POP mixture and sub-mixtures based upon exposure levels detected in a human Scandinavian population, on AR transactivation and translocation in vitro. MATERIALS AND METHODS: The Total POP mixture combined 29 chemicals modelled on the exposure profile of a Scandinavian population and 6 sub-mixtures: brominated (Br), chlorinated (Cl), Clâ¯+â¯Br, perfluorinated (PFAA), PFAA + Br, PFAA + Cl, ranging from 1/10× to 500× relative to what is found in human blood. Transactivation was measured by reporter gene assay (RGA) and translocation activity was measured by high content analysis (HCA), each using stably transfected AR model cell lines. RESULTS: No agonist activity in terms of transactivation and translocation was detected for any POP mixtures. In the presence of testosterone the Clâ¯+â¯Br mixture at 100× and 500× blood level antagonised AR transactivation, whereas the PFAA mixture at blood level increased AR transactivation (Pâ¯<â¯0.05). In the presence of testosterone the Cl and PFAA + Br mixtures at 1/10×, 1×, and 50× blood level antagonised AR translocation (Pâ¯<â¯0.05). CONCLUSION: Taken together, some combinations of POP mixtures can interfere with AR translocation. However, in the transactivation assay, these combinations did not affect gene transactivation. Other POP combinations were identified here as modulators of AR-induced gene transactivation without affecting AR translocation. Thus, to fully evaluate the effect of environmental toxins on AR signalling, both types of assays need to be applied.
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Antagonistas de Receptores Androgénicos/sangre , Disruptores Endocrinos/sangre , Contaminantes Ambientales/sangre , Contaminantes Ambientales/toxicidad , Receptores Androgénicos , Activación Transcripcional/efectos de los fármacos , Antagonistas de Receptores Androgénicos/toxicidad , Células Cultivadas , Disruptores Endocrinos/toxicidad , Genes Reporteros , Humanos , Testosterona/farmacología , Translocación Genética/efectos de los fármacosRESUMEN
A multitude of cancer types, including breast, testicular, liver and colorectal cancer, have associations with exposure to Persistent Organic Pollutants (POPs). The present study aimed to investigate whether a mixture of POPs could affect intestinal tumorigenesis in the A/J Min/+ mouse, a model for human colorectal cancer (CRC). Pollutants were selected for their presence in Scandinavian food products and the mixture was designed based on defined human estimated daily intake levels. Mice were exposed through the diet, at control, low and high mixture concentrations, for 10 weeks. In a separate experiment, mice also received one subcutaneous injection of Azoxymethane (AOM) to explore whether this carcinogenic compound influenced the effect of the POPs. Intestinal tumorigenesis was examined by surface microscopy and histopathology. Moderate and dose-dependent increases in tumorigenesis were observed after dietary POP exposure. The AOM treatment alone stimulated the growth of colonic lesions, but did not increase the formation of new lesions. Combined AOM treatment and POP exposure demonstrated a synergistic effect on lesion formation in the colon, and to a lesser extent in the small intestine. This synergy was also evident by an increased number of malignant colonic tumors (carcinomas). In conclusion, the study shows that a mixture of POPs interacted synergistically with a known carcinogen (AOM), causing increased intestinal tumorigenesis in the A/J Min/+ mouse model.
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Azoximetano/toxicidad , Carcinogénesis/patología , Neoplasias del Colon/patología , Sinergismo Farmacológico , Contaminantes Ambientales/toxicidad , Intestinos/patología , Compuestos Orgánicos/química , Animales , Carcinogénesis/inducido químicamente , Carcinógenos/toxicidad , Neoplasias del Colon/inducido químicamente , Dieta/efectos adversos , Modelos Animales de Enfermedad , Femenino , Intestinos/efectos de los fármacos , Hígado/efectos de los fármacos , Hígado/patología , Masculino , Ratones , Ratones Endogámicos ARESUMEN
The temperature-humidity index (THI) is widely used to characterize heat stress in dairy cattle. Diet composition is known to induce variation in metabolic-associated heat production. However, the relationships between THI and diet are poorly characterized with regard to performance and intake behaviour. Therefore, the objectives were to evaluate the impact of THI on water intake (WI), dry matter intake (DMI) and the frequency of drinking and feeding bouts in lactating dairy cows offered four dietary treatments: each contained 20% grass silage and additionally (i) 20% maize silage, 60% concentrate (M-HC); (ii) 60% maize silage, 20% concentrate (M-LC); (iii) 20% pressed beet pulp silage, 60% concentrate (BPS-HC); or (iv) 60% pressed beet pulp silage, 20% concentrate (BPS-LC) (DM basis). Individual WI and DMI were recorded from April to July 2013. Furthermore, dietary effects on milk production and reticular pH were estimated. Milk yield was lowest for M-LC, while energy-corrected milk was similar for all diets. Milk fat percentage was higher and milk protein amount lower for cows offered both LC diets. Reticular pH below 6.3, 6.0 and 5.8 lasted longest for BPS-LC. WI was higher for HC diets. However, the frequency of drinking bouts was not influenced by the ration. Lower DMI occurred for BPS-LC compared to M-LC. Frequency of feeding bouts was significantly higher for LC diets. THI was significantly related to WI, DMI as well as drinking and feeding bouts. Per increasing THI, WI increased slightly more for LC diets and DMI decreased more for HC diets. Frequency of drinking bouts increased slightly higher for BPS rations per rising THI, while the decrease in feeding bouts was highest for M-HC. In conclusion, TMR composition and moderate heat stress impacted WI and DMI of dairy cows, while both dietary energy density and ruminal filling might intensify the THI impact.
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Bovinos/fisiología , Ingestión de Líquidos , Ingestión de Alimentos , Humedad , Lactancia/fisiología , Temperatura , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Dieta/veterinaria , Digestión , Femenino , Concentración de Iones de Hidrógeno , Leche , Reticulum/fisiología , Ensilaje/análisis , AguaRESUMEN
BACKGROUND: Omalizumab is a successfully implemented supplementary therapy for improving asthma control in children aged 6 years and older with severe persistent allergic asthma. The dosage of omalizumab depends on body weight and IgE level, yet no parameter has been established to guide dosage changes during therapy. Clinical studies in patients with allergic asthma or allergic rhinitis revealed a clinically relevant improvement by using omalizumab leading to concentrations of free serum IgE reported to be lower than 50 ng/ml. Therefore, only the question concerning the concentrations of free IgE used in a therapy with omalizumab is regarded of clinical importance, while total IgE (free and omalizumab-bound IgE) increases during treatment. PATIENTS AND METHODS: Ten patients, 8 to 17 years of age, received therapy with omalizumab due to severe allergic asthma. In addition, the patients had pronounced rhinoconjunctivitis, food allergy, insect sting allergy, and/or neurodermitis. The total IgE in the serum was measured in the patients 3 - 6 months before each omalizumab injection as a potential progress parameter (Sandwich-Immunoassay ADVIA Centaur). RESULTS: Six months after beginning of the therapy with omalizumab, a significant decrease of the total IgE concentration was found, in comparison to the baseline values (p < 0.003). In all patients the tolerability of omalizumab was very good: there was a reduction in the frequency of the asthma exacerbations and rescue medications. All patients reported a clearly improved quality of life. CONCLUSIONS: A general increase in IgE was not observed in any of the children we treated with omalizumab. Apart from the development of routine assays to determine free serum IgE levels, the significance of the total serum IgE as a suitable control of an omalizumab therapy should be further investigated in controlled studies with regard to sensitivity and specificity. In order to only administer the lowest necessary dose of omalizumab especially in children and adolescents, the establishment of laboratory parameters (free IgE and/or total IgE) to adequately monitor the therapy is urgently needed. Patients undergoing an omalizumab therapy require medical supervision at close intervals.
RESUMEN
BACKGROUND: Celiac disease (CD) is a frequent inflammatory intestinal disease, with a genetic background, caused by gliadin-containing food. Some gliadin peptides are not digested by intestinal proteases and can have different biological effects. Gliadin peptides can induce innate and adaptive T cell-mediated immune responses. The major mediator of the stress and innate immune response to gliadin peptides (i.e., peptides 31-43 and 31-55) is the cytokine interleukin-15 (IL-15). Other peptides such as the 33 mer containing the P57-68 sequence, after tissue transglutaminase deamidation, are well presented to T cell in the intestine and can induce an adaptive immune response. FINDINGS: In this paper, we review the recent studies on the digestion of gliadin and the peptides released by the digestion process. We will also discuss the mechanisms responsible for the internalization and transcytosis of indigested gliadin peptides in the intestinal epithelium. CONCLUSIONS: Gliadin is not completely digested by the intestinal proteases producing bioactive peptides that have different biological effects. These peptides are internalized in the cells by an active process of endocytosis and can traverse the intestinal mucosa with different kinetics and immunological effects. In vivo findings will also be discussed.
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Cloruros/análisis , Fibrosis Quística/diagnóstico , Insuficiencia Pancreática Exocrina/diagnóstico , Insuficiencia Pancreática Exocrina/etiología , Sudor/química , Niño , Preescolar , Fibrosis Quística/genética , Fibrosis Quística/terapia , Regulador de Conductancia de Transmembrana de Fibrosis Quística/genética , Análisis Mutacional de ADN , Errores Diagnósticos , Insuficiencia Pancreática Exocrina/genética , Insuficiencia Pancreática Exocrina/terapia , Genotipo , Humanos , Estudios Longitudinales , MasculinoRESUMEN
When treating children or adolescents with chronic disease one should take the specific age-related features of the course of disease, differential diagnosis, and the psychosocial environment, as well as the avoidance of complications and side effects of therapy into account. These may impair the patient's physical and psychosocial development and quality of life in the context of family, school and occupational life. Continued care of growing children from the start of the disease when they are infants to the point when they assume personal responsibility as adults is one of the major concerns of the pediatrician. This concept requires interdisciplinary cooperation and a large body of personnel which would include training programs, inclusion of family members and in some cases psychosomatic therapy. Given the increasing prevalence of chronic diseases in this age group and their sociopolitical significance it is important to activate preventive potentials in terms of content and structure - by quality assurance - especially to avoid long-term complications. Various care structures are used in Europe to achieve this goal. Asthma is the most common chronic disease in children and adolescents. It influences quality of life as well as the child's personal, educational and occupational development to a significant extent. The special aspects of the treatment of these patients will be addressed to illustrate the therapy of chronic disease.
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Asma/psicología , Asma/terapia , Enfermedad Crónica/psicología , Enfermedad Crónica/terapia , Pediatría/métodos , Adolescente , Asma/diagnóstico , Niño , HumanosRESUMEN
Laser scribing of functional thin-film stacks attracts increasing attention especially for applications of flexible electronics or photovoltaics. Laser can perform selective removal of the thin-film stacks that is essential for the isolation and interconnection of the solar cells. The optimization of the laser scribing process concerning the functional properties of the device requires customized characterization techniques minimizing side effects. The proposed and demonstrated nested circular laser scribing technique allows the in-process measurement of the electrical characteristics, e.g., the shunt formation due to laser scribing of the thin-film stack, minimizing secondary effects originating from aging, contacting, changing of sample characteristics, or alterations of the measurement conditions. This technique enables the identification of reliable and quick information on the changes of the solar cell characteristics by laser scribing as this is demonstrated in this work.
RESUMEN
Data on incidence of intracerebral haemorrhage (ICH) vary widely. Population-based data on predictors of ICH survival and functional outcome are rare. The Ludwigshafen Stroke Study is a prospective, population-based stroke registry which started in January 2006. All residents of the city of Ludwigshafen, Germany, who suffer from acute stroke or transient ischaemic attack are registered. Patients with first-ever primary intracerebral haemorrhage (FE-pICH) between 2006 and 2010 were included in the present analysis. Between January 1st, 2006 and December 31st, 2010, 152 patients suffered a FE-pICH. Crude and age-adjusted incidence rates per 100,000 for FE-pICH were 18.7 (95 % CI 15.9-21.9) and 11.9 (95 % CI 10.2-14.0), respectively, and remained stable over time. Case-fatality rates for FE-pICH were 27.0, 34.9 and 44.1 % at days 28, 90 and 365, respectively. In 21 patients, an (21.3 %) early do-not resuscitate-order was documented. Excluding these patients from multivariate analyses, National Institute of Health Stroke Scale (NIHSS) (OR 1.22, 95 % CI 1.08-1.36), hypercholesterolemia (OR 0.16, 95 % CI 0.05-0.55) and modified Rankin Scale (mRS) prior to stroke (OR 1.56, 95 % CI 1.06-2.3) were independently associated with risk of 1-year mortality, whereas NIHSS (OR 1.41, 95 % CI 1.20-1.66) and leukocyte count on admission (OR 1.48, 95 % CI 1.16-1.89) were independently associated with good or moderate functional outcome (mRS ≤ 3) after 1 year. Incidence of FE-ICH is in the lower range of those reported from other registries and remained stable over the observation period. Higher treatment rates for hypertension might partly account for this. Stroke severity as indicated by NIHSS was independently associated with mortality and functional outcome after 1 year. We found no association between aetiology and outcome in ICH patients.
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Hemorragia Cerebral/epidemiología , Hemorragia Cerebral/etiología , Accidente Cerebrovascular/complicaciones , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Glucemia , Proteína C-Reactiva/metabolismo , Hemorragia Cerebral/mortalidad , Planificación en Salud Comunitaria , Femenino , Estudios de Seguimiento , Alemania , Humanos , Incidencia , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Sistema de Registros , Factores de Riesgo , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/mortalidad , Adulto JovenRESUMEN
BACKGROUND: Studies in animals and in man have demonstrated that excessive consumption of fructose can cause all components of the metabolic syndrome. OBJECTIVE: To investigate the impact of a condition resulting in decreased absorption of fructose, on obesity. METHODS: In a multicentre study, we analyzed a cohort of paediatric patients with suspected primary fructose malabsorption (FM). Patients with chronic intestinal diseases were excluded. The final cohort comprised 628 patients. RESULTS: 302 patients were diagnosed with primary FM (48.1%). The proportion of obese patients was lower among FM patients, compared to non-FM patients (2.3 vs. 6.1%, P = 0.029). Logistic regression analysis with inclusion of various covariates showed that FM was negatively associated with obesity (OR 0.35, 95% CI [0.13; 0.97]). We discuss several mechanisms involving the metabolic, endocrine and gastrointestinal system. CONCLUSIONS: Our data indicate that primary FM is negatively associated with childhood obesity.
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Fructosa/metabolismo , Síndromes de Malabsorción/complicaciones , Obesidad Infantil/epidemiología , Obesidad Infantil/etiología , Adolescente , Índice de Masa Corporal , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Absorción Intestinal/fisiología , Modelos Logísticos , Masculino , Prevalencia , Estudios RetrospectivosRESUMEN
In the present study, we examined a German sample to determine whether anxiety symptoms during pregnancy had an impact on the duration and method of childbirth. Data of N = 88 women recruited at the Heidelberg University Hospital were used in the analyses. Prepartum anxiety symptoms were assessed with the State-Trait Anxiety Inventory (STAI, general anxiety) and the Pregnancy Related Anxiety Questionnaire (PRAQ-R, pregnancy-specific anxiety). Obstetric outcome was taken from birth records and operationalized by two parameters: the total duration of birth (dilation and fetal expulsion) and the incidence of pregnancy or birth-related interventions (ventouse, planned, and unplanned Cesarean section). The data show that childbirth-specific anxiety assessed by the PRAQ-R is an important predictor of total birth duration. In contrast, general anxiety measured by the STAI had no effect. The incidence of birth intervention was explained by parity. Anxiety, however, had no predictive value. In addition to medical factors, childbirth-specific anxiety during pregnancy plays an important role in the process of childbirth. The findings of the present study point to the need of implementing psychological interventions to reduce childbirth-specific anxiety and thereby positively influencing birth outcome.
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Ansiedad/etiología , Parto Obstétrico/métodos , Parto Obstétrico/psicología , Trabajo de Parto/psicología , Parto/psicología , Mujeres Embarazadas/psicología , Adolescente , Adulto , Ansiedad/diagnóstico , Ansiedad/psicología , Cesárea/psicología , Cesárea/estadística & datos numéricos , Miedo/psicología , Femenino , Alemania , Hospitales Universitarios , Humanos , Complicaciones del Trabajo de Parto/psicología , Paridad , Embarazo , Resultado del Embarazo , Estudios Prospectivos , Análisis de Regresión , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Standard for diagnosis of inflammatory bowel disease (IBD) is the endoscopy of the stomach and the intestine. Aim of this study was to determine the value of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in pediatric patients with mild to moderate IBD.We included 23 children and adolescents between 8 and 17 years (median 15 years, 13 boys, 10 girls) in this retrospective study in a routine clinical setting. Diagnoses were Crohn's disease in 19 and ulcerative colitis in 4 cases.3 children had a conventional FDG-PET, 20 patients a combined FDG-PET-computed tomography exam. All children had upper and lower intestinal endoscopy with biopsy and a Hydro-MRI exam to assess the jejunum and proximal ileum. The gastrointestinal tract was divided in 7 segments: Stomach plus duodenum, jejunum and proximal ileum, terminal ileum, cecum plus ascending colon, transverse colon, descending colon, and rectosigmoid.Superficial gastric lesions were missed, gastric ulcerations were detected. For the stomach, the sensitivity was 0.25, the specificity was 1.00, the positive predictive value was 1.00, for the lower intestine (terminal ileum and colon) the values were 0.74, 0.88, and 0.96; for the terminal ileum 0.89, 0.75 and 0.94, respectively.The sensitivity and specificity for of ileal and colonic lesions is high. FDG-PET has to be discussed as a tool for the determination of extent and degree of inflammation, especially in those parts of the small bowel that are not accessible to endoscopy. This has to be weighed against the additional radiation exposure administrated.
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Colitis Ulcerosa/diagnóstico por imagen , Enfermedad de Crohn/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Tomografía de Emisión de Positrones , Adolescente , Niño , Endoscopía Gastrointestinal , Femenino , Humanos , Aumento de la Imagen , Intestinos/diagnóstico por imagen , Masculino , Sensibilidad y Especificidad , Estómago , Tomografía Computarizada por Rayos XRESUMEN
Research on microbiota in cattle tick and the evaluation of its activity against other microorganisms can contribute to identify new molecules potentially useful to control infections caused by bacteria and protozoa. Biofilms pose increasing problems worldwide, mainly due to their resistance to antimicrobial therapies and host immune response. In this study we investigate the ability Rhipicephalus (Boophilus) microplus-associated bacteria may exhibit to produce anti-biofilm and trichomonicidal compounds. Gut, ovary, salivary glands, and Gené organ were collected from engorged R. microplus female. Homogenates of each tissue were inoculated onto 15 distinct culture media. Anti-biofilm and trichomonicidal activities were analyzed by culturing each bacterium isolated in a liquid medium. Results showed that R. microplus cattle tick microflora varies for different tissues. Bacteria belonging to different genera (Aeromonas, Bacillus, Brevibacillus, Castelaniella, Comamonas, Kocuria, and Microbacterium) were identified. Interestingly, all bacterial species found displayed pronounced activity against Staphylococcus epidermidis and Pseudomonas aeruginosa biofilms, and also against the cattle pathogen Tritrichomonas foetus, confirming the hypothesis that cattle tick could be a source of bacteria active against pathogens. This is the first study showing that bacteria isolated from a tick exert anti-biofilm and trichomonicidal activities.
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Antibiosis , Bacterias/química , Bovinos/parasitología , Microbiota , Rhipicephalus/microbiología , Tritrichomonas foetus/fisiología , Animales , Bacterias/clasificación , Bacterias/aislamiento & purificación , Biopelículas , Femenino , Pseudomonas aeruginosa/fisiología , Staphylococcus aureus/fisiologíaRESUMEN
BACKGROUND AND OBJECTIVES: A revision of criteria for diagnosing coeliac disease (CD) is being conducted by The European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). In parallel, we have performed a survey aimed to evaluate present practices for CD among paediatric gastroenterologists and to learn their views on the need for modification of present criteria for CD diagnosis. PATIENTS AND METHODS: Questionnaires were distributed to experienced paediatric gastroenterologists (ESPGHAN members) via the Internet. RESULTS: Overall, 95 valid questionnaires were available for analysis, pertaining to 28 different countries, with the majority of responders treating patients with CD for >15 years. Only about 12% of the responders comply with present criteria, noncompliance being related mainly to the challenge policy. Approximately 90% request a revision and modification of the present criteria. Forty-four percent want to omit the small bowel biopsy in symptomatic children with positive anti-tissue transglutaminase immunoglobulin (Ig) A or endomysial IgA antibodies, especially if they are DQ2/DQ8 positive. For silent cases detected by screening with convincingly positive anti-tissue transglutaminase IgA or EMA IgA, about 30% consider that no small bowel biopsy should be required in selected cases. Adding human leukocyte antigen typing in the diagnostic workup was asked for by 42% of the responders. As for gluten challenge, a new policy is advocated restricting its obligation to cases whenever the diagnosis is doubtful or unclear. CONCLUSIONS: Based on these opinions, revision of the ESPGHAN criteria for diagnosing CD is urgently needed.
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Enfermedad Celíaca/diagnóstico , Adhesión a Directriz , Guías como Asunto , Pautas de la Práctica en Medicina , Adolescente , Adulto , Biopsia , Enfermedad Celíaca/inmunología , Niño , Preescolar , Glútenes/inmunología , Encuestas de Atención de la Salud , Humanos , Inmunoglobulina A/análisis , Intestino Delgado , Sociedades Médicas , Encuestas y Cuestionarios , Transglutaminasas/inmunología , Adulto JovenRESUMEN
OBJECTIVE: Diagnostic criteria for coeliac disease (CD) from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) were published in 1990. Since then, the autoantigen in CD, tissue transglutaminase, has been identified; the perception of CD has changed from that of a rather uncommon enteropathy to a common multiorgan disease strongly dependent on the haplotypes human leukocyte antigen (HLA)-DQ2 and HLA-DQ8; and CD-specific antibody tests have improved. METHODS: A panel of 17 experts defined CD and developed new diagnostic criteria based on the Delphi process. Two groups of patients were defined with different diagnostic approaches to diagnose CD: children with symptoms suggestive of CD (group 1) and asymptomatic children at increased risk for CD (group 2). The 2004 National Institutes of Health/Agency for Healthcare Research and Quality report and a systematic literature search on antibody tests for CD in paediatric patients covering the years 2004 to 2009 was the basis for the evidence-based recommendations on CD-specific antibody testing. RESULTS: In group 1, the diagnosis of CD is based on symptoms, positive serology, and histology that is consistent with CD. If immunoglobulin A anti-tissue transglutaminase type 2 antibody titers are high (>10 times the upper limit of normal), then the option is to diagnose CD without duodenal biopsies by applying a strict protocol with further laboratory tests. In group 2, the diagnosis of CD is based on positive serology and histology. HLA-DQ2 and HLA-DQ8 testing is valuable because CD is unlikely if both haplotypes are negative. CONCLUSIONS: The aim of the new guidelines was to achieve a high diagnostic accuracy and to reduce the burden for patients and their families. The performance of these guidelines in clinical practice should be evaluated prospectively.
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Enfermedad Celíaca/diagnóstico , Duodeno/patología , Antígenos HLA-DQ/sangre , Inmunoglobulina A/sangre , Transglutaminasas/inmunología , Adolescente , Enfermedad Celíaca/inmunología , Enfermedad Celíaca/patología , Niño , HumanosRESUMEN
Crude cod liver oil and liver oil supplements are consumed as a source of vitamin A, D and polyunsaturated fatty acids; during winter and early pregnancy. Crude cod liver oil however constitutes a considerable source of persistent organic pollutants (POPs). This paper aimed at characterizing and quantifying the influence of POP mixtures extracted from three different steps in the cod liver oil industrial process on hormone production and the expression of steroidogenesis-related genes in H295R cells. Exposure to extracts from crude cod liver oil and from its industrial waste increased progesterone (P4), cortisol (Cort), testosterone (T) and estradiol (E2) production; and among others, the expression of MC2R, CYP11B1 and HSD3B2 genes. Observed effects after exposure to pharmaceutical cod liver oil extract were considerably lower. The type of effects on gene expression and hormone production were similar to those induced by forskolin and PCBs, the latter being the major contaminants within the extracts. Additional research is required to further unveil the mechanisms behind the observed steroidogenic effects and to assess whether the potential risk might outweigh the potential benefits of crude and processed cod liver oil consumption.
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Aceite de Hígado de Bacalao/química , Esteroides/biosíntesis , Contaminantes Químicos del Agua/farmacología , Animales , Secuencia de Bases , Línea Celular , Cartilla de ADN , Cromatografía de Gases y Espectrometría de Masas , Reacción en Cadena en Tiempo Real de la Polimerasa , Contaminantes Químicos del Agua/aislamiento & purificaciónRESUMEN
Neonatal haemochromatosis (NH) is a connatal hepatopathy that is lethal in 32% and necessitates liver transplantation in 63% of the survivors. The classical diagnostic criteria of extrahepatic siderosis do not apply in all patients who are suspected to have NH. The hypothesis of NH as an alloimmune disease is supported by the quantitative immunohistochemical proof of C5b-9 complement complexes on the hepatocytes of liver biopsy material. This has opened a new perspective in the therapy and prophylaxis for this severe disease. Prophylactic therapy with intravenous immunoglobulins (IVIG) for mothers at risk can prevent a relevant NH in most cases.
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Hemocromatosis/prevención & control , Inmunoglobulinas Intravenosas/administración & dosificación , Humanos , Factores Inmunológicos/administración & dosificación , Recién Nacido , Inyecciones Intravenosas , Masculino , Factores de Riesgo , Prevención Secundaria/métodos , Resultado del TratamientoRESUMEN
PROBLEM: In young patients with hypersplenism splenectomy implies a lifelong increased risk for post-splenectomy infection. Especially in children, whose immune system is not yet completely matured, the risk for some bacterial infection may increase after splenectomy because the spleen helps to defend against encapsulated bacteria like pneumococci, meningococci and haemophilus influenzae. We present partial splenic embolization as an alternative to surgical splenectomy. METHOD: Partial splenic embolization was performed in 17 patients from 1-31 years with hypersplenism of various etiologies and was achieved by selective catheterization of splenic arteries and injection of 150-355 µm polyvinyl alcohol particles (Ivalon (®)). After the intervention the patients received an intensified analgesic regimen and antibiotics to avoid concurrent infectious complications. RESULTS: Partial splenic embolization represented between 30-60% of the splenic volume and was followed in general by an immediate increase of all blood cells and symptoms of hypersplenism were reduced. In 2 patients the procedure was repeated because the result of the first embolization was insufficient in one patient and became necessary in another in the long run. Post-procedural side effects included fever, abdominal pain, ascites and pleural effusions. There were no acute infections in any patient. CONCLUSION: Our monoinstitutional experiences over 16 years offer, partial splenic embolization in patients with hypersplenism from miscellaneous reasons as a low-risk alternative to surgical splenectomy. The procedure can be repeated as necessary, but it is always a temporary palliation depending on the underlying disease which often leads to liver transplantation. Using intensive analgesia and antibiotics side effects were tolerable, and patients could be discharged after a few days.
Asunto(s)
Embolización Terapéutica , Hiperesplenismo/terapia , Bazo/irrigación sanguínea , Esplenectomía , Adolescente , Adulto , Niño , Preescolar , Femenino , Hemoglobinometría , Humanos , Hiperesplenismo/diagnóstico por imagen , Lactante , Recuento de Leucocitos , Masculino , Cuidados Paliativos , Recuento de Plaquetas , Ultrasonografía Intervencional , Adulto JovenRESUMEN
Pseudorabies virus (PrV) infections appear to be more widely distributed in the European wild boar (Sus scrofa) population than assumed. In Europe, attempts to isolate and characterize the causative agents have been limited so far. We therefore collected and examined a total of 35 PrV isolates obtained from wild boar or hunting dogs in Germany, France, Spain, Italy, Slovakia and Hungary between 1993 and 2008. Restriction enzyme analysis of genomic DNA using BamHI showed that all isolates, except one, belonged to genogroup I but different subtypes were evident. For further investigations of the phylogenetic relationships, a 732-bp fragment of the glycoprotein C (gC) gene was amplified by PCR. Sequence analysis revealed about 40 variant positions within this fragment. Comparison of the nucleotide sequences supported the separation into a clade containing isolates from North-Rhine Westphalia, Rhineland-Palatinate (Germany), France and Spain (clade B) and an apparently more variable clade comprising isolates from Brandenburg, Baden-Wurttemberg, Saxony, Saxony-Anhalt (Germany), Slovakia, Hungary, Italy and France (clade A).