Immune cells from patients with psoriasis are defective in inducing indoleamine 2,3-dioxygenase expression in response to inflammatory stimuli.

BACKGROUND: Indoleamine 2,3-dioxygenase (IDO) is an inducible enzyme that suppresses the immune response. The role of IDO as a negative regulator of inflammatory responses has been documented in several experimental autoimmune diseases. OBJECTIVES: To explore the regulation of IDO by immune cells in psoriasis and its relation with disease severity. METHODS: The expression and activity of IDO were assessed by reverse-transcriptase polymerase chain reaction, flow cytometry and high-performance liquid chromatography in peripheral blood of patients with moderate-to-severe plaque-type psoriasis. The ability of immune cells to express IDO in response to inflammatory stimuli was studied. The functional role of IDO expression was evaluated in a regulatory T cell (Treg) differentiation assay, using cocultures of immature monocyte-derived dendritic cells with autologous peripheral CD4+ T cells. RESULTS: Analysis of the kynurenine-to-tryptophan ratio in serum samples indicated higher IDO activity in patients with psoriasis than in healthy controls. However, correlation studies showed lower IDO activity in those patients with higher Psoriasis Area and Severity Index (PASI). Although myeloid dendritic cells from patients with psoriasis expressed higher levels of IDO than those from healthy controls, these cells did not upregulate IDO in response to a combination of tumour necrosis factor-α, interleukin (IL)-1ß and IL-6 cytokines. The defective expression of IDO correlated with PASI. Immature monocyte-derived dendritic cells from patients with psoriasis also expressed low levels of IDO and induced CD4+ Treg differentiation poorly. CONCLUSIONS: Immune cells from patients with psoriasis have a defect in upregulating IDO in response to inflammation associated with the severity of psoriasis.

Fraxinus pollen and allergen concentrations in Ourense (South-western Europe).

In temperate zones of North-Central Europe the sensitization to ash pollen is a recognized problem, also extended to the Northern areas of the Mediterranean basin. Some observations in Switzerland suggest that ash pollen season could be as important as birch pollen period. The allergenic significance of this pollen has been poorly studied in Southern Europe as the amounts of ash pollen are low. Due to the high degree of family relationship with the olive pollen major allergen (backed by a sequence identity of 88%), the Fraxinus pollen could be a significant cause of early respiratory allergy in sensitized people to olive pollen as consequence of cross-reactivity processes. Ash tree flowers in the Northwestern Spain during the winter months. The atmospheric presence of Ole e 1-like proteins (which could be related with the Fra a 1 presence) can be accurately detected using Ole e 1 antibodies. The correlation analysis showed high Spearman correlation coefficients between pollen content and rainfall (R(2)=-0.333, p<0.01) or allergen concentration and maximum temperature (R(2)=-0.271, p<0.01). In addiction CCA analysis showed not significant differences (p<0.05) between the component 1 and 2 variables. PCFA analysis plots showed that the allergen concentrations are related to the presence of the Fraxinus pollen in the air, facilitating the wind speed its submicronic allergen proteins dispersion. In order to forecast the Fraxinus allergy risk periods, two regression equations were developed with Adjusted R(2) values around 0.48-0.49. The t-test for dependent samples shows no significant differences between the observed data and the estimated by the equations. The combination of the airborne pollen content and the allergen quantification must be assessed in the epidemiologic study of allergic respiratory diseases.

Oleaceae cross-reactions as potential pollinosis cause in urban areas.

It is worth noting the allergological problems induced by a not accurate design of the ornamental vegetation in the parks and streets of the cities. Usually, in the Oleaceae family, only the olive pollen is considered an important aeroallergen but other species of the family could be an important source of airborne pollen allergens. Pollen from Fraxinus, Olea and Ligustrum and its main aeroallergens were sampled in the atmosphere of an urban area in North-Western Spain during 2011. The allergen bioaerosol content was quantified by using specific 2-site ELISA and Ole e 1 antibodies. The Fra e 1 and Lig v 1 allergens were detected by means Ole e 1 antibodies. This fact demonstrates the cross-reactivity between the main allergens of Fraxinus, Olea and Ligustrum, plants widely species used as ornamental in the cities. Therefore, the urban allergenic people sensitized to Olea pollen could present allergenic reactions during the winter (due to ash pollen allergens), the spring (caused by olive pollen allergens) and the early summer (triggered by the privet flowering). As a consequence, sensitivity to the pollen of one species may favour development of sensitivity to all three species as consequence of the priming effect. The combination of pollen count and the allergen quantification must be assessed in the epidemiologic study of allergic respiratory diseases.

Reduced expression of galectin-1 and galectin-9 by leucocytes in asthma patients.

Accumulating evidence shows that galectins play roles in the initiation and resolution phases of inflammatory responses by promoting anti- or proinflammatory effects. This study investigated the presence of three members of the galectin family (galectin-1, -3 and -9) in induced sputum samples of asthma patients, as well as their possible implication in the immunopathogenesis of human asthma. Levels of interleukin (IL)-5, IL-13, and galectins were determined in leucocytes isolated from induced sputum samples by reverse transcription-polymerase chain reaction (RT-PCR) immunofluorescence and flow cytometry. High levels of IL-5 and IL-13 mRNA were detected in sputum cells from asthma patients. In parallel, immunoregulatory proteins galectin-1 and galectin-9 showed a reduced expression on macrophages from sputum samples compared with cells from healthy donors. In-vitro immunoassays showed that galectin-1 and galectin-9, but not galectin-3, are able to induce the production of IL-10 by peripheral blood mononuclear cells from healthy donors. These findings indicate that macrophages from sputum samples of asthma patients express low levels of galectin-1 and galectin-9, favouring the exacerbated immune response observed in this disease.

[Jejunal mucormycosis in a patient with Hodgkin's lymphoma]. / Mucormicosis yeyunal en paciente con linfoma de Hodgkin.

We report a case of intestinal mucormycosis in a 46-year-old male diagnosed with classical Hodgkin's disease, IV-B stage. During the first phase of chemotherapy he had a massive digestive bleeding event secondary to a jejunal ulcer, and zygomicosis mucor-type was diagnosed by endoscopic biopsy. The patient was treated with antifungal drugs and surgical resection of the intestine involved. At surgery a double covered perforation of the jejunum was seen. Pathological examination confirmed the previous diagnosis. After one year of follow-up the patient is doing well, and his lymphoma is on remission. To our best knowledge this is the second case of intestinal mucormycosis in a patient with Hodgkin's lymphoma reported in the medical literature.

Mucormicosis yeyunal en paciente con linfoma de Hodgkin / No disponible

Comunicamos un caso de mucormicosis intestinal en un hombrede 46 años de edad, diagnosticado de enfermedad de Hodgkinclásica, estadio IV-B. Durante la primera fase de la quimioterapia,sufrió una hemorragia digestiva masiva secundaria a unaúlcera yeyunal por zigomicosis tipo mucor, diagnosticada porbiopsia endoscópica. El paciente fue tratado con antifúngicos yresección quirúrgica del intestino afectado. En la cirugía, se aprecióuna doble perforación yeyunal cubierta. El estudio anatomopatológicode la pieza confirmó el diagnóstico previo. Tras un añode seguimiento, el paciente está recuperado y su linfoma deHodgkin en remisión completa. Tras una extensa revisión de la literatura,según nuestro conocimiento, este es el segundo caso publicadoen la literatura de mucormicosis intestinal en un pacientecon linfoma de Hodgkin

We report a case of intestinal mucormycosis in a 46-year-oldmale diagnosed with classical Hodgkin’s disease, IV-B stage. Duringthe first phase of chemotherapy he had a massive digestivebleeding event secondary to a jejunal ulcer, and zygomicosis mucor-type was diagnosed by endoscopic biopsy. The patient wastreated with antifungal drugs and surgical resection of the intestineinvolved. At surgery a double covered perforation of the jejunumwas seen. Pathological examination confirmed the previous diagnosis.After one year of follow-up the patient is doing well, andhis lymphoma is on remission. To our best knowledge this is thesecond case of intestinal mucormycosis in a patient with Hodgkin’slymphoma reported in the medical literature

Consumo de energía y nutrientes, características socioeconómicas, pobreza y área de residencia de mujeres peruanas en edad fértil / Energy and nutrient consumption, socio-economic characteristics, poverty and living places fertile peruvian women

Objetivo: Determinar la relación entre el consumo de energía y nutrientes de mujeres peruanas en edad fértil, sus características socioeconómicas, pobreza y área de residencia. Materiales y métodos: La información fue obtenida de la Encuesta Nacional de Consumo de Alimentos en Mujeres en Edad Fértil y Niños entre 12 y 35 meses en el año 2003. La muestra fue de 2909 mujeres entre 15 a 49 años. El consumo de energía y nutrientes se obtuvo por el método de encuesta de recordatorio de 24 horas. Se incluyó información del área de residencia, características y servicios básicos del hogar. Se agrupó a la población de acuerdo con el método de necesidades básicas insatisfechas (NBI). Se estableció como consumo deficiente una adecuación por debajo de 50 por ciento. Se aplicaron pruebas estadísticas de Chi-cuadrado, Mann Whitney y Kruskall Wallis. Resultados: El 67,6 por ciento de las mujeres vivía en hogares pobres, la pobreza afecta mayormente a las mujeres del área rural. Más de 20 por ciento de mujeres presentan deficiencias en el consumo de energía y nutrientes. Conforme se incrementan las NBI las adecuaciones del consumo van disminuyendo, a excepción de carbohidratos y hierro. Los carbohidratos contribuyen en mayor porcentaje a la energía total de la dieta de las mujeres pobres. Conclusiones: Las condiciones de pobreza en que se encuentran las mujeres influyen sobre su consumo de energía y nutrientes disminuyéndolo, lo cual traería serias consecuencias sobre su estado de salud y nutrición y el de sus niños.

Objectives: To determine the relationship between energy and nutrient consumption in fertile Peruvian women, as well as their socioeconomic characteristics, poverty condition, and living places. Materials and methods: Data were obtained from the National Food Consumption Survey for Fertile Women and 12 to 35 Month Old Children for 2003. The sample consisted in 2909 women between 15 to 49 years old. Energy and nutrient consumption information was obtained using a 24-hour reminder survey. Collected information included living places, as well as households characteristics and basic services. The population was grouped according to the unmet basic needs method. A deficient consumption was established as a less than 50 per cent adequation. Statistical tests used were chi-square, Mann-Whitney, and Kruskall-Wallis. Results: 67.6 per cent of surveyed women lived in poor households, and poverty mainly affects women from rural areas. More than 20 of women had deficiencies in energy and nutrient consumption. As long as unmet basic needs increase, adequate consumption is reduced, except carbohydrate and iron consumption. Carbohydrates are the major contributors for total energy intake in poor women. Conclusions: Poverty in women negatively influences energy and nutrient consumption, which may lead to serious consequences on their health status and their childrenÆs health condition as well.

Trombosis venosa cerebral y anticonceptivos orales: estudio de 1 caso / Cerebral venous thrombosis and oral contraceptives: a case study

La enfermedad cerebrovascular es la tercera causa de muerte en el mundo occidental y una de las que tienen mayor morbilidad. Aunque generalmente predomina en grupos de edad avanzada, en los últimos años está creciendo la incidencia de trombosis vascular cerebral en las mujeres menores de 45 años, en muchos casos asociada con el uso de anticonceptivos orales (ACO).La Agencia Española del Medicamento estima el riesgo de tromboembolia venosa en mujeres sanas entre 15 y 44 años de edad que no toman ACO en 5-10 casos por 100.000 mujeres/año. Sin embargo, en las mujeres de ese grupo de edad que toman ACO que contienen al menos 20 µg de etinilestradiol en combinación con desogestrel o gestodeno, este riesgo aumenta hasta cifras de 30-40 casos por 100.000 mujeres/año. Presentamos el caso de una paciente de 26 años de edad que fue diagnosticada de trombosis cerebral del seno sigmoideo con hipertensión intracraneal, en la que el único factor de riesgo encontrado fue el inicio en la toma de ACO (AU)

Profilaxis y tratamiento del angioedema hereditario y adquirido en el HUB; utilización del inhibidor de la C1-esterasa / Profhylaxis and treatment of hereditary and acquired angioedema at HUB; use of the C1-esterase inhibitor

Introducción: El angioedema hereditario o adquirido está producido por el déficit del inhibidor de la esterasa del primer componente del complemento (C1-INH). Se caracteriza por síntomas transitorios de hinchazón de tejidos subcutáneos, pared intestinal y vías respiratorias superiores, que puede derivar en muerte por asfixia. Se presenta la fisiopatología, clasificación, diagnóstico y tratamiento, así como un seguimiento de los pacientes diagnosticados, a los que se les entrega 1 vial de concentrado de C1-INH (Berinert®), valorando la aportación del Servicio de Farmacia en el circuito de dispensación y control de dicho fármaco. Material y métodos: Se realizó una búsqueda a través de PubMed y otras fuentes relevantes. Mediante las recetas controladas se tomaron los datos del paciente y de las dispensaciones e indicación de Berinert®; se completó el seguimiento mediante la historia clínica, los datos de laboratorio y la entrevista al paciente cuando fue preciso. Resultados: Del total de 9 casos, 8 fueron angioedema hereditario y 1 adquirido. El danazol se utilizó como profilaxis a largo plazo en 8 casos, pero sus efectos secundarios obligaron a discontinuarlo en alguno de ellos. El concentrado de C1-INH fue efectivo en los 6 brotes agudos detectados en el estudio, así como en las 3 profilaxis quirúrgicas (consumo global de 6.500 U).Conclusión: El danazol fue un fármaco eficaz como profilaxis, pero con efectos secundarios importantes. El concentrado de C1-INH ha sido eficaz tanto en la profilaxis como en el tratamiento de los brotes agudos. El Servicio de Farmacia dispondrá de un stock suficiente de producto (AU)

Dolor agudo postoperatorio (DAP) en cirugía general / Postoperative acute pain (PAP) in general surgery

No disponible

[Profhylaxis and treatment of hereditary and acquired angioedema at HUB; use of the C1-esterase inhibitor]. / Profilaxis y tratamiento del angioedema hereditario y adquirido en el HUB; utilización del inhibidor de la C1-esterasa.

INTRODUCTION: Hereditary and acquired angioedema result from a deficiency in first complement component esterase (C1-esterase) inhibitor. It is characterized by transient subcutaneous tissue, intestinal wall, and upper airway swelling, which may lead to asphyxia and death. The pathophysiology, classification, diagnosis, and treatment of this condition are discussed, as is the follow-up of patients diagnosed with angioedema who received 1 vial of concentrated C1-INH (Berinert); the contribution of the Pharmacy Department in the dispensation and control of said drug is also assessed. MATERIAL AND METHODS: PubMed and other relevant sources were searched. Patient, dispensation, and Berinert(R) indication data were collected from controlled prescriptions; follow-up was completed by performing a medical history, collecting laboratory data, and patient interview when needed. RESULTS: Eight out of 9 cases were of hereditary angioedema, and 1 case was of acquired angioedema. Danazol was used as long-term prophylaxis in 8 patients, but side effects forced discontinuation in some of them. The C1-INH concentrate was effective in 6 acute episodes that were detected during the study, as well as in 3 surgical prophylaxis cases (overall use 6,500 U). CONCLUSION: Danazol was effective as prophylactic treatment, but had severe side effects. The C1-INH concentrate was effective both as prophylactic therapy and treatment for acute episodes. An adequate stock of this product will be available at the Pharmacy Department.

[Idiopathic retroperitoneal fibrosis]. / Fibrosis retroperitoneal idiopática.

OBJECTIVE: A case of idiopathic retroperitoneal fibrosis in a 34-year-old man with anemia and elevated erythrocyte sedimentation rate is presented. METHODS/RESULTS: Ultrasound, CT and MRI evaluation and pathological study were performed. These diagnostic imaging techniques demonstrated an infiltrating mass in the upper portion of the abdomen which was resected. Histological and immunohistochemical studies of the surgical specimen demonstrated sclerosing retroperitonitis. CONCLUSIONS: Idiopathic retroperitoneal fibrosis (Ormond's disease) is a rare disease entity whose etiology is obscure and is characterized by retroperitoneal fibrosis with inflammatory infiltrates composed of plasma cells, lymphocytes and eosinophils. This case is of interest due to its atypical location, and because the patient was young with no remarkable clinical history and only mild anemia and an elevated erythrocyte sedimentation rate.

Evidence for the involvement of diacylglycerol kinase in the activation of hypoxia-inducible transcription factor 1 by low oxygen tension.

Hypoxia-inducible factor 1 (HIF-1) induces a gene expression program essential for the cellular adaptation to lowered oxygen environments. The intracellular mechanisms by which hypoxia induces HIF-1 remain poorly understood. Here we show that exposure of various cell types to hypoxia raises the intracellular level of phosphatidic acid primarily through the action of diacylglycerol kinase (DGK). Pharmacological inhibition of DGK activity through use of the specific DGK inhibitors and abrogated specifically HIF-1-dependent transcription analyzed with a HIF-1-responsive reporter plasmid. A more detailed analysis revealed that pharmacological inhibition of DGK activity prevented the hypoxia-dependent accumulation of the HIF-1alpha subunit and the subsequent HIF-1-DNA complex formation as well as hypoxia-induced activity of the HIF-1 transactivation domains localized to amino acids 530-582 and 775-826 of the HIF-1alpha subunit. Our results demonstrate for the first time that accumulation of phosphatidic acid through DGK underlines oxygen sensing and provide evidence for the involvement of this lipid kinase in the intracellular signaling that leads to HIF-1 activation.

Apraxia buco-facial y anartria, forma de comienzo excepcional de degeneración córticobasal / Anarthria, and buccofacial apraxia. A exceptional onset of corticobasal degeneration

No disponible

Shiga toxin 1: damage to DNA in vitro.

Shiga toxins share with plant ribosome-inactivating proteins the same enzymatic mechanism of action: the removal of a specific adenine from 28S RNA when acting on ribosomes and the removal of multiple adenines when acting on DNA in vitro. The activity on DNA, only recently reported, is particularly evident, and has been studied mostly at acidic pH. For the in vitro activity, on both ribosomes and DNA, Shiga toxins require activation by trypsin, urea and dithiothreitol which release the enzymatically active A(1) fragment. Activation by the classical procedure leaves large amounts of urea and DTT which interfere in the DNA depurination assay and completely abolish depurination at physiological pH. A consistent release of [3H]adenine from DNA at neutral pH is instead observed when the toxin is activated in vitro by an improved method which removes most of the drastic reagents required for proteolytic cleavage and reduction. Damage to single-stranded DNA by Shiga toxin 1 (Stx1) primarily involves depurination. A spontaneous DNA breakdown appears in fact only after extensive base removal, a behavior similar to that observed with uracil-DNA glycosylase, a simple glycosylase devoid of lyase activity. NaCl inhibits the activity of Stx1, probably by minimizing the sliding distance traveled by the enzyme along DNA in search of its target sites and promoting dissociation of the substrate-enzyme complex.

Nocardiosis en dos pacientes inmunocompetentes / Nocardiosis in two immunocompetent patients

Se presentan dos casos diagnosticados de nocardiosis en pacientes inmunocompetentes, diferentes en su clínica, evolución y tratamiento. El primero, un varón de 55 años con nocardiosis diseminada y el segundo otro varón de 32 años, esplenectomizado diagnosticado de nocardiosis pulmonar. Se revisa la literatura haciendo hincapié en los distintos cuadros clínicos y tratamiento de la nocardiosis (AU)

Insuficiencia suprarrenal aguda secundaria a hemorragia suprarrenal bilateral / Acute adrenal insufficiency from bilateral adrenal hemorrhage

No disponible

[Nocardiosis in 2 immunocompetent patients]. / Nocardiosis en dos pacientes inmunocompetentes.

Two diagnosed clinical cases of nocardiosis in immunocompetent patients are presented, different in their clinical aspects, evolution and treatment. We report a 55 years-old man with disseminated nocardiosis and a 32 years-old man with splenectomy diagnosed of pulmonary nocardiosis. The medical literature is reviewed and emphasis is placed on the different illness and treatment of the nocardiosis.