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1.
Eur Arch Paediatr Dent ; 24(4): 429-440, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37036643

RESUMO

PURPOSE: A scoping review to describe the use of enzyme replacement therapy (ERT) in the form of asfotase alfa to decrease the severity of oral manifestations in children with hypophosphatasia (HPP). METHODS: Six databases were searched using keywords and index terms related to "hypophosphatasia," "children," and "enzyme replacement therapy." Duplicates were removed and two independent reviewers screened the titles and abstracts to identify articles for full-text review. Extracted data was summarised narratively. RESULTS: The systematic search identified 3548 articles, with 171 suitable for full-text review and a final 22 that met inclusion criteria. Enzyme replacement therapy generally resulted in a reduction in the presence and severity of oral manifestations of HPP. However, numerous studies failed to report specific details regarding the nature of oral health outcomes and there were reported cases of further loss of primary teeth. CONCLUSIONS: The available evidence suggests that that ERT in the form of asfotase alfa for HPP in infants and young children leads to improved oral health outcomes. It is recommended that the outcomes are improved with earlier initiation of ERT. Further, well-designed clinical research is required to assess oral health improvements and decreased morbidity associated with the early loss of teeth.


Assuntos
Hipofosfatasia , Lactente , Criança , Humanos , Pré-Escolar , Hipofosfatasia/tratamento farmacológico , Terapia de Reposição de Enzimas/efeitos adversos , Terapia de Reposição de Enzimas/métodos , Saúde Bucal
2.
Aust Dent J ; 68(2): 92-97, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36811194

RESUMO

BACKGROUND: The Australian Health Practitioner Regulation Agency (AHPRA) requires general dental practitioners (GDPs) to agree to regulatory advertising guidelines on initial registration and annual renewal. The aim of this study was to determine the compliance of GDPs websites to these requirements. METHODS: A representative sample of GDPs websites from each state and territory in Australia was based on the total AHPRA registrant distribution. Assessment of compliance was used across five domains consisting of 17 criteria related to AHPRA's advertising of regulated health services guidelines, as well as section 133 of the National Law. Inter-rater reliability was estimated using Fleiss's Kappa. RESULTS: One hundred and ninety-two GDPs websites were reviewed with 85% non-compliant with at least one of the legal and regulatory requirements relating to advertising. Of these websites, 52% displayed false and misleading information, 12.8% had offers and inducement without clear terms and conditions, 11.5% used written testimonials, 33.9% created unrealistic expectation of benefit and 39.6% encouraged indiscriminate and unnecessary use of health services. CONCLUSIONS: More than 85% of GDP websites in Australia did not comply with legal and regulatory requirements related to advertising. A multi-stakeholder approach involving AHPRA, professional dental bodies and dental registrants is necessary to improve compliance.


Assuntos
Publicidade , Odontólogos , Humanos , Austrália , Reprodutibilidade dos Testes , Papel Profissional , Odontologia Geral
3.
Eur Arch Paediatr Dent ; 24(1): 117-123, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36348176

RESUMO

PURPOSE: Systemic diseases or drugs administered early in life may cause a disruption in amelogenesis and contribute to the qualitative defect of enamel described as molar-incisor hypomineralisation (MIH). Therefore, an increase in prevalence of MIH in children with type 1 diabetes (T1D) may be expected as this systemic disorder is commonly diagnosed in early childhood. The aim of this study was to determine the prevalence of MIH in a cohort of children with T1D and investigate diagnosis of MIH with T1D factors. METHODS: Cross-sectional study of children with T1D recruited from paediatric diabetes clinics at the Women's and Children's Hospital (South Australia). A detailed medical history, comprehensive dental and MIH examination according to the European Academy of Paediatric Dentistry (EAPD) long form classification was collected for each child. All upper and lower first permanent molars and central incisors were scored. RESULTS: A total number of 73 participants; 35 (47.95%) males were examined including 584 teeth. The mean age of the participants was 13.25 ± 2.58 years, with a mean age of diagnosis 7.75 ± 3.58 years, and a mean HbA1c of 8.5 ± 1.6%. 42 out of 73 children (54.8%) had enamel defects on at least one of the teeth examined. However, 19.2% met the criteria for MIH. Univariate and bivariate analyses were conducted but no significant associations were noted between MIH and risk factors including diabetes control (p > 0.1). CONCLUSION: There was a high prevalence of enamel defects and MIH amongst children with T1D. More research is required to establish association between T1D and MIH.


Assuntos
Hipoplasia do Esmalte Dentário , Diabetes Mellitus Tipo 1 , Hipomineralização Molar , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Austrália/epidemiologia , Estudos Transversais , Hipoplasia do Esmalte Dentário/epidemiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/epidemiologia , Dente Molar , Hipomineralização Molar/epidemiologia , Prevalência
4.
Curr Oncol ; 26(1): e70-e80, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30853812

RESUMO

Trastuzumab is the standard treatment in Canada for patients with breast cancer positive for her2 (human epidermal growth factor receptor 2), dramatically improving outcomes in that patient group. However, its current intravenous (IV) administration is associated with long infusion times that place a significant burden on health care resources and patient quality of life. In an effort to provide a faster and easier administration method, a subcutaneous (sc) formulation of trastuzumab has been developed. Data from comparative trials demonstrate that the two formulations are comparable with respect to pharmacokinetics and efficacy. They also have similar safety profiles, with the exception of mild local and administration reactions with the sc formulation. Furthermore, the sc formulation is preferred by patients and health care professionals, and greatly reduces administration and chair time. Additional advantages include easier preparation and dosing, reduced drug wastage, and reduced discomfort at the injection site. By using well-thought-out administration procedures, the sc formulation can be given safely and effectively, potentially reducing the burden on health care resources and improving quality of life for patients.


Assuntos
Antineoplásicos Imunológicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Trastuzumab/uso terapêutico , Antineoplásicos Imunológicos/farmacologia , Neoplasias da Mama/patologia , Humanos , Injeções Subcutâneas , Trastuzumab/administração & dosagem , Trastuzumab/farmacologia
5.
Plant Signal Behav ; 13(7): e1486146, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30160638

RESUMO

The basic Helix-Loop-Helix (bHLH) transcription factors SCREAM/ICE1 and SCREAM2 have well-characterized roles in the terminal differentiation of stomatal guard cells in Arabidopsis thaliana. Here we report on the characterization of the functional roles of the remaining members of sub-group IIIB, bHLH093 and bHLH061. The bhlh093/bhlh061 double mutant failed to produce a primary inflorescence shoot and displayed greater phenotypic severity than bhlh093 and bhlh061 single mutants. An ultrastructural investigation revealed structural defects that develop in tissues surrounding the meristem prior to inflorescence emergence. The transition to flowering was restored in bhlh093/bhlh061 with the application of gibberellin to the apex. We also demonstrate that gibberellin application alleviates structural defects that develop in tissues surrounding the meristem and restore meristem activity. Furthermore, the bhlh093/bhlh061 double mutant was affected by delayed flowering, and the severity of the phenotype correlated with photoperiod and light intensity. Our results indicate that bHLH093 and bHLH061 function in the gibberellin-mediated establishment of functional apical meristems during the transition from vegetative to reproductive growth.


Assuntos
Proteínas de Arabidopsis/metabolismo , Arabidopsis/metabolismo , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Inflorescência/metabolismo , Meristema/metabolismo , Arabidopsis/genética , Proteínas de Arabidopsis/genética , Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Regulação da Expressão Gênica de Plantas , Inflorescência/genética , Meristema/genética
6.
Curr Oncol ; 23(4): e332-9, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27536182

RESUMO

BACKGROUND: Screening clinical breast examination (cbe) is controversial; the use of cbe is declining not only as a screening tool, but also as a diagnostic tool. In the present study, we aimed to assess the value of cbe in breast cancer detection in a tertiary care centre for breast diseases. METHODS: This retrospective study of all breast cancers diagnosed between July 1999 and December 2010 at our centre categorized cases according to the mean of detection (cbe, mammography, or both). A cbe was considered "abnormal" in the presence of a mass, nipple discharge, skin or nipple retraction, edema, erythema, peau d'orange, or ulcers. RESULTS: During the study period, a complete dataset was available for 6333 treated primary breast cancers. Cancer types were ductal carcinoma in situ (15.3%), invasive ductal carcinoma (75.7%), invasive lobular carcinoma (9.0%), or others (2.2%). Of the 6333 cancers, 36.5% (n = 2312) were detected by mammography alone, 54.8% (n = 3470) by mammography and cbe, and 8.7% (n = 551) by physician-performed cbe alone (or 5.3% if considering ultrasonography). Invasive tumours diagnosed by cbe alone were more often triple-negative, her2-positive, node-positive, and larger than those diagnosed by mammography alone (p < 0.05). CONCLUSIONS: A significant number of cancers would have been missed if cbe had not been performed. Compared with cancers detected by mammography alone, those detected by cbe had more aggressive features. Clinical breast examination is a very low-cost test that could improve the detection of breast cancer and could prompt breast ultrasonography in the case of a negative mammogram.

7.
Ann Oncol ; 26(12): 2429-36, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26387142

RESUMO

BACKGROUND: To investigate in the NeoSphere trial the contribution of the immune system to pathologic complete response in the breast (pCRB) after neoadjuvant docetaxel with trastuzumab (TH), pertuzumab (TP), or both (THP), or monoclonal antibodies alone (HP). PATIENTS AND METHODS: Immune gene mRNA expression (n = 350, 83.8%), lymphocyte infiltration (TIL, n = 243, 58.3%), and PDL1 by immunohistochemistry (n = 305, 73.1%) were correlated with pCRB. We studied five selected genes (IFNG, PD1, PDL1, PDL2, CTLA4) and six immune metagenes corresponding to plasma cells (IGG), T cells (CD8A), antigen-presenting cells (MHC2), and to MHC1 genes (MHC1), STAT1 co-expressed genes (STAT1), and interferon-inducible genes (IF-I). Gene expression data from the NOAH trial were used for validation. RESULTS: TIL as continuous variable and PDL1 protein expression were not significantly associated with pCRB. Expression of immune genes/metagenes had different association with pCRB after THP than after other therapies. With THP, higher expression of PD1 and STAT1, or any among PDL1, CTLA4, MHC1, and IF-I were linked with lower pCRB. In the combined TH/TP/HP treatment group, in multivariate analysis, higher expression of PD1, MHC2, and STAT1 were linked with pCRB, and higher PDL1, MHC1, or IF-I to lower pCRB. In the NOAH, a similar association of higher STAT1 with higher pCRB, and higher MHC1 and IF-I with lower pCRB was found for trastuzumab/chemotherapy but not for chemotherapy treatment only. CONCLUSIONS: The immune system modulates response to therapies containing trastuzumab and pertuzumab. Greatest benefit from THP is observed for low expression of some immune markers (i.e. MHC1, CTLA4). The involvement of PDL1 in resistance supports testing combinations of HER2-directed antibodies and immune-checkpoint inhibitors.


Assuntos
Anticorpos Monoclonais/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/imunologia , Terapia Neoadjuvante/métodos , Receptor ErbB-2/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados/administração & dosagem , Feminino , Humanos , Imunidade Celular/efeitos dos fármacos , Imunidade Celular/imunologia , Pessoa de Meia-Idade , Receptor ErbB-2/antagonistas & inibidores , Trastuzumab/administração & dosagem , Resultado do Tratamento , Adulto Jovem
8.
J Acoust Soc Am ; 126(3): 1151-62, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19739729

RESUMO

An analytical three dimensional bicylindrical model is developed in order to take into account the effects of the saddle-shaped area for the interface of a n-Herschel-Quincke tube system with the main duct. Results for the scattering matrix of this system deduced from this model are compared, in the plane wave frequency domain, versus experimental and numerical data and a one dimensional model with and without tube length correction. The results are performed with a two-Herschel-Quincke tube configuration having the same diameter as the main duct. In spite of strong assumptions on the acoustic continuity conditions at the interfaces, this model is shown to improve the nonperiodic amplitude variations and the frequency localization of the minima of the transmission and reflection coefficients with respect to one dimensional model with length correction and a three dimensional model.

9.
Kidney Int ; 72(11): 1345-57, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17882151

RESUMO

Obesity is a major risk factor in the development of chronic renal failure. Rimonabant, a cannabinoid CB1 receptor antagonist, improves body weight and metabolic disorders; however, its effect on mortality and chronic renal failure associated with obesity is unknown. Obese Zucker rats received either rimonabant or vehicle for 12 months and were compared to a pair-fed but untreated group of obese rats. Mortality in the obese rats was significantly reduced by rimonabant along with a sustained decrease in body weight, transient reduction in food intake, and an increase in plasma adiponectin. This was associated with significant reduction in plasma total cholesterol, low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, glucose, norepinephrine, plasminogen activator inhibitor 1, and preservation of pancreatic weight and beta-cell mass index. The cannabinoid antagonist attenuated the increase in proteinuria, urinary N-acetylglucosaminidase excretion, plasma creatinine, and urea nitrogen levels while improving creatinine clearance. Renal hypertrophy along with glomerular and tubulointerstitial lesions were reduced by rimonabant. Although the drug did not modify hemodynamics, it normalized the pressor response to angiotensin II. Our study suggests that in a rat model of chronic renal failure due to obesity, rimonabant preserves renal function and increases survival.


Assuntos
Rim/fisiologia , Obesidade/tratamento farmacológico , Obesidade/metabolismo , Piperidinas/uso terapêutico , Pirazóis/uso terapêutico , Receptor CB1 de Canabinoide/antagonistas & inibidores , Adiponectina/sangue , Animais , Peso Corporal/efeitos dos fármacos , Peso Corporal/fisiologia , Modelos Animais de Doenças , Ingestão de Alimentos/efeitos dos fármacos , Ingestão de Alimentos/fisiologia , Rim/efeitos dos fármacos , Falência Renal Crônica/etiologia , Falência Renal Crônica/prevenção & controle , Lipídeos/sangue , Masculino , Obesidade/complicações , Piperidinas/farmacologia , Pirazóis/farmacologia , Ratos , Ratos Zucker , Receptor CB1 de Canabinoide/efeitos dos fármacos , Receptor CB1 de Canabinoide/fisiologia , Rimonabanto , Análise de Sobrevida
10.
Atherosclerosis ; 184(2): 330-41, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16051252

RESUMO

Strategies aimed at treating atherosclerosis by immunization protocols are emerging. Such protocols commonly use adjuvants as non-specific stimulators of immune responses. However, adjuvants are known to modify various disease processes. The aim of this study was to determine whether adjuvants alter the development of atherosclerosis. We performed immunization protocols in apolipoprotein E knockout mice (E degrees ) following chronic administration schedules commonly employed in experimental atherosclerosis. Our results point out a dramatic effect of several adjuvants on the development of atherosclerosis; three of the four adjuvants tested reduced lesion size. The Alum adjuvant, which is the adjuvant currently used in most vaccination protocols in humans, displayed a strong atheroprotective effect. Mechanisms accounting for atheroprotective effect of Freund's adjuvants included their capacity to increase both Th2 responses and anti-MDA-LDL IgM titers, and/or to impose atheroprotective lipoprotein profiles. The present study indicates that adjuvants have potent atheromodulating capabilities, and thus, implies that the choice of adjuvant is crucial in long-term immunization protocols in experimental atherosclerosis.


Assuntos
Adjuvantes Imunológicos/uso terapêutico , Compostos de Alúmen/uso terapêutico , Aterosclerose/tratamento farmacológico , Adjuvante de Freund/uso terapêutico , Imunização/métodos , Animais , Anticorpos Anti-Idiotípicos/imunologia , Apolipoproteínas E/deficiência , Aterosclerose/sangue , Aterosclerose/imunologia , Citocinas/sangue , Modelos Animais de Doenças , Seguimentos , Cromatografia Gasosa-Espectrometria de Massas , Imunoglobulina G/imunologia , Imunoglobulina M/imunologia , Masculino , Camundongos , Camundongos Knockout , Fatores de Tempo , Resultado do Tratamento
11.
Pharmeuropa Bio ; 2005(1): 13-8, 2005 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16336934

RESUMO

Upon suggestion of the French Official Medicines Control Laboratory, a collaborative study was initiated by the European Directorate for the Quality of Medicines with the goal of calibrating the candidate European Pharmacopoeia biological reference preparation (Ph. Eur. BRP) for anti-vaccinia immunoglobulin batch 1 in International Units (IU) against the 1(st) British standard (anti-smallpox serum). The candidate BRP batch 1 was obtained by lyophilising a pool of four plasma samples obtained from one donor who was multi-vaccinated with smallpox vaccine (Lister strain) and who had relatively high titres of neutralising anti-vaccinia antibodies. The plasma complied with the requirements of the Ph. Eur. monograph Human plasma for fractionation. For the candidate BRP the precision of fill and the residual moisture after lyophilisation comply with the requirements for biological reference preparations. The stability of the material was shown to be satisfactory for the intended purpose in an accelerated degradation test. Eight laboratories participated in the study. Two samples had to be assayed (candidate BRP batch 1 and 1(st) British standard). All participants were requested to test the samples using a common method (plaque reduction neutralisation) that had been validated beforehand, and their own in-house anti-vaccinia immunoglobulin titration method. From the raw data returned, the potency of the candidate BRP was calculated in IU/ml using the parallel lines method. The precision (intra-assay variation), repeatability (intra-laboratory variation) and reproducibility (inter-laboratory variation) were assessed. All laboratories used the Lister strain of vaccinia virus for the plaque reduction neutralisation assay. For laboratories using cell-adapted vaccinia virus, the results were satisfactory regarding intra-assay variability, intra-laboratory variability and inter-laboratory variability. For laboratories using vaccinia virus produced on animals, results were less satisfactory. The study suggests that the candidate BRP batch 1 is suitable as a reference preparation for the potency assay of vaccinia immunoglobulin by the plaque reduction neutralisation method, using cell-adapted vaccinia virus. For this purpose, a potency of 23 IU/vial could be assigned to the candidate BRP. Based on the results of the stability testing, storage of the reference material at -20 degrees C and shipment on ice is recommended. Furthermore, it is recommended to monitor the potency of the reference material once per year. The candidate material was adopted as Ph. Eur. BRP at the Ph. Eur. Commission session in March 2005.


Assuntos
Imunoglobulinas , Vaccinia virus/imunologia , Vacínia/virologia , Vacinas Virais/normas , Calibragem , Europa (Continente) , França , Humanos , Cooperação Internacional , Laboratórios/normas , Controle de Qualidade , Reprodutibilidade dos Testes
12.
Arterioscler Thromb Vasc Biol ; 25(8): e123-6, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15920033

RESUMO

OBJECTIVE: The contribution of thrombosis and coagulation in atherogenesis is largely unknown. We investigated the contribution of the coagulation intrinsic factor VIII (FVIII)-dependent pathway in atherogenesis. METHODS AND RESULTS: Apolipoprotein E and FVIII double-deficient mice (E degrees/FVIII degrees) were generated. Aortic root lesions were analyzed in 14-week-old and 22-week-old female mice maintained for 8 or 16 weeks, respectively, on a normal chow diet or a hypercholesterolemic diet. CONCLUSIONS: Despite a higher plasma total cholesterol concentration compared with E degrees mice, E degrees/FVIII degrees mice developed dramatically less early-stage atherosclerotic lesions. Whereas early lesions in E degrees mice contained abundant fibrin(ogen) deposits on which few platelets adhered, lesions in E degrees/FVIII degrees were almost devoid of fibrin(ogen), and no platelets could be detected. The genotype effect on development and composition of lesions tended to decrease with time. This study demonstrates that the activation of the intrinsic pathway of coagulation is potently proatherogenic at the early stage of atherogenesis.


Assuntos
Apolipoproteínas E/genética , Aterosclerose/fisiopatologia , Coagulação Sanguínea/fisiologia , Fator VIII/genética , Hemofilia A/fisiopatologia , Animais , Apolipoproteínas E/metabolismo , Aterosclerose/genética , Aterosclerose/patologia , Colesterol/biossíntese , Colesterol/sangue , Fator VIII/metabolismo , Feminino , Hemofilia A/genética , Hemofilia A/patologia , Camundongos , Camundongos Knockout
13.
Diabetes Obes Metab ; 7(1): 65-72, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15642077

RESUMO

We investigated the effects of chronic treatment with the CB1 receptor antagonist rimonabant (10 mg/kg/day p.o. for 10 weeks) in mice with established obesity (5-month high-fat diet). Untreated obese mice showed a weight gain of 46% (45.0 +/- 0.6 g vs. 30.8 +/- 0.5 g) compared with age-matched animals fed a standard diet. Rimonabant treatment, commencing after 5-month high-fat diet, produced a marked and sustained decrease in body weight (34.5 +/- 0.8 g vs. 47.2 +/- 0.5 g in the high-fat vehicle group, p < 0.001). The anti-obesity effect of rimonabant was similar to that obtained by switching obese mice from high-fat diet to standard laboratory diet during 10 weeks (final weight 33.7 +/- 0.6 g) and was associated with only transient (14 days) reduction in energy intake. Serum leptin, insulin and glucose levels were markedly elevated in obese animals. Rimonabant treatment significantly reduced these elevations (leptin -81%, insulin -78%, glucose -67%, p < 0.001 in all cases vs. high-fat vehicle group). In addition, rimonabant treatment modestly but significantly increased serum adiponectin levels (+18%, p < 0.05 vs. high-fat vehicle group). Obese mice demonstrated abnormal serum lipid profiles. Although rimonabant did not modify high-density lipoprotein cholesterol (HDLc) and had modest effects on total cholesterol, it significantly reduced triglycerides and low-density lipoprotein cholesterol (LDLc) and, notably, increased the HDLc/LDLc ratio (12.4 +/- 0.8 vs. 7.9 +/- 0.2 in high-fat vehicle group, p < 0.001). Therefore, in a model of established obesity, chronic rimonabant treatment produces a marked and sustained decrease in body weight (equivalent to that achieved by dietary change) which is associated with favourable modifications in serum biochemical and lipid profiles.


Assuntos
Fármacos Antiobesidade/uso terapêutico , Lipídeos/sangue , Obesidade/tratamento farmacológico , Piperidinas/uso terapêutico , Pirazóis/uso terapêutico , Adiponectina , Animais , Glicemia/análise , Colesterol/sangue , HDL-Colesterol/sangue , Insulina/sangue , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Leptina/sangue , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Obesidade/sangue , Rimonabanto
14.
Clin Microbiol Infect ; 9(4): 280-8, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12667237

RESUMO

OBJECTIVE: To describe the incidence of pneumococcal bacteremia not associated with infection of the central nervous system, investigate the susceptibility of bacterial isolates to beta-lactams, evaluate risk factors for antibiotic resistance, and determine factors predicting patient outcome. METHODS: Over a period of 1 year, 919 Streptococcus pneumoniae isolates were collected from 919 patients with bacteremia in eight French counties. Their clinical and microbiological features were recorded. Univariate and multivariate analyses were used to determine risk factors for penicillin-non-susceptible pneumococcal bacteremia and predictors of fatal outcome. RESULTS: Of the 919 patients in the study, 27% were infected with penicillin-non-susceptible pneumococci (PNSP): 17.8% of the isolates were intermediate to penicillin, 7.2% were resistant to penicillin, 16% were intermediate to amoxicillin, and 11% were intermediate to cefotaxime; no PNSP were resistant to either of the last two antibiotics. The most common PNSP serotypes isolated were 14 (41%) and 23 (24%). A statistically significant relationship between PNSP infection and age below 5 years or above 60 years in the different counties was observed by univariate and multivariate analysis. Gender, origin of bacteremia, co-morbidity, immunodeficiency, previous hospitalization and nosocomial infection were not predisposing factors associated with PNSP. The mortality rate was 20.6%: there was no increase in mortality among patients with PNSP bacteremia. Age was the strongest risk factor for mortality, but immunodeficiency also seemed to have had an impact on mortality. Clinical outcome was more closely related to clinical conditions than to the susceptibility status of S. pneumoniae. CONCLUSION: Among cases of bacteremia, 27% were caused by PNSP, but this level varies according to the counties and the age of the patients. Infection-related mortality was high, but there was no increase related to penicillin G non-susceptibility of the infecting strain.


Assuntos
Bacteriemia/epidemiologia , Infecções Pneumocócicas/epidemiologia , Streptococcus pneumoniae/isolamento & purificação , Adolescente , Adulto , Distribuição por Idade , Idoso , Amoxicilina/farmacologia , Bacteriemia/diagnóstico , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Cefotaxima/farmacologia , Criança , Pré-Escolar , Estudos de Coortes , Resistência Microbiana a Medicamentos , Feminino , França/epidemiologia , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Penicilina G/farmacologia , Resistência às Penicilinas , Infecções Pneumocócicas/diagnóstico , Infecções Pneumocócicas/tratamento farmacológico , Infecções Pneumocócicas/microbiologia , Estudos Retrospectivos , Fatores de Risco , Streptococcus pneumoniae/efeitos dos fármacos , Resultado do Tratamento
15.
Gene Ther ; 10(7): 569-79, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12646862

RESUMO

Gene electrotranfer is an attractive physical method to deliver genes to target tissues. The aim of this study was to evaluate in vivo gene electrotransfer into spleen, one of the most important lymphoid organ, in order to create a new tool to modulate the immuno-inflammatory system. C57Bl/6 mice were submitted either to intramuscular electrotransfer (IME) as a reference method or to intrasplenic (ISE) gene electrotransfer. In the naked injected plasmids, the CMV promoter controlled the expression of luciferase, secreted alkaline phosphatase, EGFP, or IFNgamma. The ISE optimal electrotransfer conditions were first determined and ISE was found to be an efficient gene transfer method, which can be used to express secreted or intracellular proteins transiently. Although transfected cells were still present in the spleen 30 days after ISE, transfected spleen cells could recirculate since they were detected in extrasplenic locations. Using a T-lymphocyte-specific promoter controlling the expression of EGFP, splenic T cells could be targeted. Finally, it appeared that ISE procedure does not impair by itself the immune response and does not result in a significant production of antibodies directed to the transgenic proteins in C57Bl/6 mice. This strategy constitutes a new method to manipulate the immune response that can be used in various experimental designs.


Assuntos
Eletroporação/métodos , Terapia Genética/métodos , Linfócitos T/metabolismo , Fosfatase Alcalina/genética , Animais , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Expressão Gênica , Proteínas de Fluorescência Verde , Interferon gama/genética , Luciferases/genética , Proteínas Luminescentes/genética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Músculo Esquelético/metabolismo , Transgenes
16.
Dev Biol (Basel) ; 111: 37-46, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12678223

RESUMO

In the three Rs rule context, we have developed a method to quantify tetanus toxoid by ELISA detection of the specific Hc fragment. This fragment and several anti Hc fragment antibodies have been described as protective in mice models. By developing this assay, we have detected Hc presence in tetanus toxoid. Therefore, this functional in vitro assay could replace in vivo potency assays. We have evaluated the analytical performances of this ELISA in specificity, sensitivity, precision, and linearity tests on different combined vaccine formulations. This in vitro assay has been applied to various multi-component vaccines. Results are expressed in Lf Hc/ml with reference to a purified tetanus toxoid standard expressed in Lf/ml.


Assuntos
Ensaio de Imunoadsorção Enzimática/métodos , Toxoide Tetânico/análise , Alternativas aos Testes com Animais , Animais , Anticorpos/imunologia , Anticorpos/metabolismo , Vacinas Anti-Haemophilus/análise , Haemophilus influenzae/imunologia , Cadeias Pesadas de Imunoglobulinas/química , Cadeias Pesadas de Imunoglobulinas/metabolismo , Camundongos , Sensibilidade e Especificidade , Toxoide Tetânico/imunologia
17.
Nephrol Dial Transplant ; 16(8): 1598-606, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11477161

RESUMO

BACKGROUND: We assessed whether a differential oxidizability of apolipoprotein B (apo B)-containing lipoproteins (LDL and VLDL) may explain the oxidative stress that we had observed at the onset of renal fibrosis in Zucker obese (ZO) rats (Nephrol Dial Transplant 2000, 15: 467--476). METHODS: Ex vivo copper-induced oxidation of lipoproteins was performed in 1-, 3-, and 9-month-old ZO and age-matched lean (ZL) rats. LDL/VLDL oxidizability was determined by spectrophotometry at 234 nm by monitoring the formation of conjugated diene hydroperoxides. RESULTS: A significant increase in lag time (reflecting the resistance to oxidation) was observed in ZO rats at 3 months while the maximal diene production (reflecting the amount of hydroperoxides formed during oxidation) was higher in ZO than in ZL rats as early as 1 month. Lipoproteins were larger in ZO than in ZL rats, as shown by their core to surface component ratio. Furthermore, ZO lipoproteins had increased vitamin E and polyunsaturated fatty acid (PUFA) content, with no change in vitamin E/PUFA ratio. CONCLUSIONS: Rather than oxidizability of apo B-containing lipoproteins, the ability of these molecules to produce high levels of conjugated dienes, which can act as toxic tissue messengers, appears to be a critical trait in the development of renal fibrosis in this rat model of obesity and renal fibrosis.


Assuntos
Alcenos/metabolismo , Nefropatias/metabolismo , Lipoproteínas/metabolismo , Animais , Apolipoproteínas B/metabolismo , Ácidos Graxos Insaturados/metabolismo , Fibrose , Rim/patologia , Lipoproteínas/química , Masculino , Obesidade/genética , Obesidade/metabolismo , Oxirredução , Ratos , Ratos Zucker , Magreza , Vitamina E/metabolismo
18.
Circulation ; 104(2): 197-202, 2001 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-11447086

RESUMO

BACKGROUND: A chronic immune response involving proinflammatory T helper cell 1 (Th1) lymphocyte activation occurs in the atherosclerotic lesion, but whether this activation is protective or deleterious remains unclear. Methods and Results-- We modulated the immune response of the atherosclerosis-prone apolipoprotein E-deficient (apoE(-/-)) mouse. Eight-week-old apoE(-/-) mice were treated daily with pentoxifylline (PTX), a known inhibitor of the Th1 differentiation pathway, or PBS (control) for 4 weeks or 12 weeks. Twelve-week PTX treatment reduced atherosclerotic lesion size by 60% (P<0.01). PTX-treated mice developed lesions that were limited to the degree of fatty streaks. In contrast, control mice developed mature fibrofatty atherosclerotic lesions. In parallel, the proportion of interferon (IFN)-gamma-producing Th1 splenic lymphocytes was significantly reduced by PTX, and lesion size was correlated to the proportion of IFN-gamma(+) T cells. In vitro addition of PTX to cultured spleen cells did not modify the production of IFN-gamma but increased the production of IL-10 by T cells, indicating that PTX does not suppress IFN-gamma production but rather blocks Th1 polarization while promoting Th2 polarization. CONCLUSIONS: Thus, PTX protected mice from atherosclerosis by reducing the Th1 polarization of T helper lymphocytes. This study demonstrates that the Th1 immune response associated with atherosclerosis is deleterious and that a modulation of the Th1 differentiation pathway may provide a new pharmacological tool to treat this disease.


Assuntos
Apolipoproteínas E/deficiência , Arteriosclerose/imunologia , Regulação para Baixo/imunologia , Células Th1/imunologia , Animais , Apolipoproteínas E/genética , Arteriosclerose/sangue , Peso Corporal/efeitos dos fármacos , Contagem de Células , Diferenciação Celular/efeitos dos fármacos , Diferenciação Celular/imunologia , Células Cultivadas , HDL-Colesterol/sangue , Modelos Animais de Doenças , Progressão da Doença , Interferon gama/biossíntese , Interleucina-10/biossíntese , Ativação Linfocitária/genética , Ativação Linfocitária/imunologia , Masculino , Camundongos , Camundongos Knockout , Pentoxifilina/farmacologia , Inibidores de Fosfodiesterase/farmacologia , Baço/citologia , Baço/efeitos dos fármacos , Baço/imunologia , Baço/metabolismo , Células Th1/efeitos dos fármacos , Células Th1/metabolismo , Células Th2/imunologia , Triglicerídeos/sangue
19.
Am J Physiol Renal Physiol ; 280(4): F683-94, 2001 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11249860

RESUMO

We examined the role of inflammation in the development of renal interstitial fibrosis in Zucker obese rats, which rapidly present kidney lesions in the absence of hypertension and hyperglycemia. Type I and III collagens were quantified using a polarized light and computer-assisted image analyzer. The expression of mRNA encoding matrix components, adhesion molecules, chemokines, and growth factors was followed by RT-PCR. The presence of synthesized proteins as well as lymphocytes and macrophages was determined by immunohistochemistry. Interstitial fibrosis developed in two phases. The first phase occurred as early as 3 mo and resulted from a neosynthesis of type III collagen and fibronectin and a reduction of extracellular matrix catabolism, in parallel with an overexpression of transforming growth factor-beta(1) and in the absence of any lymphocyte or macrophage infiltration. After 6 mo, interstitial fibrosis worsened with a large accumulation of type I collagen, concomitantly with a large macrophage infiltration. Thus inflammation cannot explain the onset of interstitial fibrosis that developed in young, insulinoresistant, normoglycemic, obese Zucker rats but aggravated this process afterward.


Assuntos
Glomerulosclerose Segmentar e Focal/imunologia , Glomerulosclerose Segmentar e Focal/patologia , Obesidade/imunologia , Obesidade/patologia , Fator de Crescimento Transformador beta/genética , Animais , Glicemia , Colágeno/análise , Colágeno/genética , Creatinina/sangue , Fibronectinas/genética , Fibrose , Expressão Gênica/fisiologia , Hiperinsulinismo/imunologia , Hiperinsulinismo/patologia , Hiperlipidemias/imunologia , Hiperlipidemias/patologia , Processamento de Imagem Assistida por Computador , Imuno-Histoquímica , Linfócitos/imunologia , Macrófagos/imunologia , Masculino , RNA Mensageiro/análise , Ratos , Ratos Zucker , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Inibidor Tecidual de Metaloproteinase-1/genética , Fator de Crescimento Transformador beta1
20.
Biologicals ; 28(1): 33-40, 2000 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10799054

RESUMO

Quality control of Yellow Fever vaccines performed by Control Authorities prior to marketing vaccines batches requires in vitro potency assays. The two currently available methods are the plaque formation assay and the cytopathic effect assay based on the use of porcine kidney PS cells or monkey kidney Vero cells. Among several sources of variation in virus titration, the cell systems are considered as important issues and Quality Assurance strongly recommends working with cell banks from certified suppliers. The aim of our study was to compare the behaviour and the sensitivity of three Vero cell sources obtained from ATCC, WHO and EP used at different passage levels in a plaque formation test. The conclusion of this work was that the yellow fever live attenuated virus titration, adapted in Vero cell lines appeared as a reliable method applicable for routine in vitro potency assay. The comparison of Vero cell lines, originated from three different sources, showed that they could be equally used as substrates by laboratories having the basic facility of cell culture, without influence on the final viral titre.


Assuntos
Vacinas Virais , Vírus da Febre Amarela/patogenicidade , Animais , Chlorocebus aethiops , Qualidade de Produtos para o Consumidor , Controle de Qualidade , Vacinas Atenuadas , Células Vero , Ensaio de Placa Viral
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