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1.
PLoS One ; 16(1): e0245001, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33444392

RESUMO

BACKGROUND: The COVID-19 pandemic has posed a huge challenge to healthcare systems and their personnel worldwide. The study of the impact of SARS-CoV-2 infection among healthcare workers (HCW), through prevalence studies, will let us know viral expansion, individuals at most risk and the most exposed areas in healthcare organizations. The aim of this study is to gauge the impact of SARS-CoV-2 pandemic in our hospital workforce and identify groups and areas at increased risk. METHODS AND FINDINGS: This is a cross-sectional and incidence study carried out on healthcare workers based on molecular and serological diagnosis of SARS-CoV-2 infection. Of the 3013 HCW invited to participate, 2439 (80.9%) were recruited, including 674 (22.4%) who had previously consulted at the Occupational Health Service (OHS) for confirmed exposure and/or presenting symptoms suggestive of COVID-19. A total of 411 (16.9%) and 264 (10.8%) healthcare workers were SARS-CoV-2 IgG and rRT-PCR positive, respectively. The cumulative prevalence considering all studies (IgG positive HCW and/or rRT-PCR positive detection) was 485 (19.9%). SARS-CoV-2 IgG-positive patients in whom the virus was not detected were 221 (9.1%); up to 151 of them (68.3%) did not report any compatible symptoms nor consult at the OHS for this reason. Men became more infected than women (25% vs 18.5%, p = 0.0009), including when data were also classified by age. COVID-19 cumulative prevalence among the HCW assigned to medical departments was higher (25.2%) than others, as well as among medical staff (25.4%) compared with other professional categories (p<0.01). CONCLUSIONS: The global impact of the COVID-19 pandemic on HCW of our centre has been 19.9%. Doctors and medical services personnel have had the highest prevalence of SARS-CoV-2 infection, but many of them have not presented compatible symptoms. This emphasizes the performance of continuous surveillance methods of the most exposed health personnel and not only based on the appearance of symptoms.


Assuntos
/psicologia , Pessoal de Saúde/psicologia , Adulto , Estudos de Coortes , Estudos Transversais , Feminino , Hospitais de Ensino/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores de Risco , Espanha/epidemiologia
2.
Stem Cells Dev ; 30(4): 190-202, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33349121

RESUMO

Duchenne muscular dystrophy (DMD) is a lethal X-linked disorder caused by mutations in dystrophin gene. Currently, there is no cure for DMD. Cell therapies are challenged by limited engraftment and rejection. Thus, more effective and safer therapeutic approaches are needed for DMD. We previously reported increased dystrophin expression correlating with improved function after transplantation of dystrophin expressing chimeric (DEC) cells of myoblast origin in the mdx mouse models of DMD. This study established new DEC cell line of myoblasts and mesenchymal stem cells (MSC) origin and tested its efficacy and therapeutic potential in mdx/scid mouse model of DMD. Fifteen ex vivo cell fusions of allogenic human myoblast [normal myoblasts (MBN)] and normal human bone marrow-derived MSC (MSCN) from normal donors were performed using polyethylene glycol. Flow cytometry, confocal microscopy, polymerase chain reaction (PCR)-short tandem repeats, polymerase chain reaction-reverse sequence-specific oligonucleotide probe assessed chimeric state of fused MBN/MSCN DEC cells, whereas Comet assay assessed fusion procedure safety testing genotoxicity. Immunofluorescence and real-time PCR assessed dystrophin expression and myogenic differentiation. Mixed lymphocyte reaction (MLR) evaluated DEC's immunogenicity. To test MBN/MSCN DEC efficacy in vivo, gastrocnemius muscle of mdx/scid mice were injected with vehicle (n = 12), nonfused MBN and MSCN (n = 9, 0.25 × 106/each) or MBN/MSCN DEC (n = 9, 0.5 × 106). Animals were evaluated for 90 days using ex vivo and in vivo muscle strength tests. Histology and immunofluorescence staining assessed dystrophin expression, centrally nucleated fibers and scar tissue formation. Post-fusion, MBN/MSCN DEC chimeric state, myogenic differentiation, and dystrophin expression were confirmed. MLR reveled reduced DEC's immune response compared with controls (P < 0.05). At 90 days post-DEC transplant, increase in dystrophin expression (20.26% ± 2.5%, P < 0.05) correlated with improved muscle strength and function in mdx/scid mice. The created human MBN/MSCN DEC cell line introduces novel therapeutic approach combining myogenic and immunomodulatory properties of MB and MSC, and as such may open a universal approach for muscle regeneration in DMD.

3.
Polymers (Basel) ; 12(11)2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33171919

RESUMO

This work deals with the changes of the glass transition temperature (Tg) of the polymer in polypropylene/mica composites due to the combined and synergistic effect of the reinforcement and the interfacial modifier. In our case, we studied the effect on Tg of platy mica and an interfacial modifier with p-phenylen-bis-maleamic acid (pPBMA) grafted groups onto atactic polypropylene (aPP-pPBMA). This one contains 5.0 × 10-4 g·mol-1 (15% w/w) grafted pPBMA and was previously obtained by the author's labs by using industrial polymerization wastes (aPP). The objective of the article must be perceived as two-fold. On one hand, the determination of the changes in the glass transition temperature of the isotactic polypropylene phase (iPP) due to both the reinforcement and the agent as determined form the damp factor in DMA analysis. On the other hand, forecasting the variation of this parameter (Tg) as a function of both the interfacial agent and reinforcement content. For such purposes, and by assuming the complex character of the iPP/aPP-pPBMA/Mica system, wherein interaction between the components will define the final behaviour, a Box-Wilson experimental design considering the amount of mica particles and of interface agent as the independent variables, and the Tg as the dependent one, has been used. By taking in mind that the glass transition is a design threshold for the ultimate properties of parts based in this type of organic-inorganic hybrid materials, the final purpose of the work is the prediction and interpretation of the effect of both variables on this key parameter.

5.
Polymers (Basel) ; 12(6)2020 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-32471039

RESUMO

The present article adequately supports a twofold objective. On one hand, the study of the dynamic mechanical behavior of polypropylene/polyamide-6 blends modified by a novel compatibilizer was the objective. This was previously obtained by chemical modification of an atactic polypropylene polymerization waste. On the other hand, the accurate predictions of these properties in the experimental space scanned was the objective. As a novelty, this compatibilizer contains grafts rather than just maleated ones. Therefore, it consists precisely of an atactic polymer containing succinic anhydride (SA) bridges and both backbone and terminal grafted succinyl-fluorescein groups (SFSA) attached to the atactic backbone (aPP-SFSA). Therefore, it contains 6.2% of total grafting (2.5% as SA and 3.7% as SF), which is equivalent to 6.2·× 10-4 g·mol-1. This interfacial agent was uniquely designed and obtained by the authors themselves. Essentially, this article focuses on how the beneficial effect of both PA6 and aPP-SFSA varies the elastic (E') and the viscous (E'') behavior of the iPP/aPP-SFSA/PA6 blend at the iPP glass transition. Thus, we accurately measured the Dynamic Mechanical Analysis (DMA) parameters (E', E'') at this specific point considering it represents an extremely unfavorable scenario for the interfacial modifier due to mobility restrictions. Hence, this evidences the real interfacial modifications caused by aPP-SFSA to the iPP/PA6 system. Even more, and since each of the necessary components in the blend typically interacts with one another, we employed a Box-Wilson experimental design by its marked resemblance to the "agent-based models". In this manner, we obtained complex algorithms accurately forecasting the dynamic mechanical behavior of the blends for all the composition range of the iPP/aPP-SFSA/PA6 system at the glass transition of iPP.

6.
J Drug Assess ; 9(1): 66-71, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32341839

RESUMO

Purpose: To describe a standardized protocol of the dexamethasone intravitreal (DEX) implant Ozurdex (Allergan, Dublin, Ireland) performed in a controlled environment surgical cabin (CESC). Methods: Retrospective and observational study conducted on patients who underwent a DEX implant between May 2011 and June 2019, in a third level University Hospital. The controlled environment surgical cabin (ArcSterile, Imex, Valencia, Spain) used in this study was the MB 20 (2 m width, 1.60 m depth, and 2 m height) with an uninterrupted power system (ARSSAI1) to keep the cabin working for 20 min. The cabin was used in the open mode. A standardized protocol of intravitreal injections in controlled environment surgical cabin was designed. Results: From May 2011 to February 2015, a total of 454 DEX implants were performed in the operating room, whereas from March 2015 to June 2019, 1054 DEX devices were implanted using the CESC. The mean number of DEX implants/per week was significantly lower in the operating room than in the CESC [2.3 (2.1 to 2.5) versus 3.8 (3.6 to 4.1), mean difference 1.5 (1.2 to 1.8), p < 0.0001]. The incidence of endophthalmitis was similar in the two populations, 0/454 (0.0%; 95% CI 0.0 to 0.81%) and 0/1054 (0.0%; 95% CI 0.0 to 0.35%) in the operating room and in the CESC, respectively. Conclusions: The CESC may be a good alternative to the conventional operating room for the administration of the intravitreal DEX implant.

7.
PLoS Negl Trop Dis ; 14(4): e0008253, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32324738

RESUMO

BACKGROUND: In the Mediterranean basin, Leishmania infantum is the causative agent of visceral leishmaniasis (VL), a zoonosis in which the dog is the primary domestic reservoir, although wildlife may have a leading role in the sylvatic cycle of the disease in some areas. Infections without disease are very frequent. There is limited information regarding the role that VL patients and asymptomatic infected individuals could be playing in the transmission of L. infantum. Xenodiagnosis of leishmaniasis has been used in this descriptive study to explore the role of symptomatic and asymptomatic infected individuals as reservoirs in a recent focus of leishmaniasis in southwestern Madrid, Spain. METHODOLOGY AND MAIN FINDINGS: Asymptomatic blood donors (n = 24), immunocompetent patients who were untreated (n = 12) or treated (n = 11) for visceral leishmaniasis (VL), and immunocompromised patients with VL (n = 3) were enrolled in the study. Their infectivity to Phlebotomus perniciosus was studied by indirect xenodiagnosis on peripheral blood samples. Quantitative polymerase chain reaction of blood samples from immunocompetent patients untreated for VL and immunocompromised untreated, treated and under secondary prophylaxis for VL was performed. Antibodies against Leishmania were studied by indirect fluorescent antibody and rK39-immunochromatographic tests. A lymphoproliferative assay with a soluble Leishmania antigen was used to screen for leishmaniasis infection in the healthy population. Sixty-two xenodiagnostic tests were carried out and 5,080 sand flies were dissected. Positive xenodiagnosis was recorded in four patients, with different sand fly infection rates: 1 immunosuppressed HIV / L. infantum coinfected asymptomatic patient, 1 immunosuppressed patient with multiple myeloma and symptomatic active VL, and 2 immunocompetent patients with untreated active VL. All blood donors were negative for both xenodiagnosis and conventional PCR. CONCLUSIONS / SIGNIFICANCE: There is no consensus amongst authors on the definition of an 'asymptomatic case' nor on the tools for screening; we, therefore, have adopted one for the sake of clarity. Immunocompetent subjects, both infected asymptomatics and those treated for VL, are limited in number and appear to have no epidemiological relevance. The impact is limited for immunocompetent patients with untreated active VL, whilst immunosuppressed individuals undergoing immunosuppressive therapy and immunosuppressed individuals HIV / L. infantum coinfected were the most infectious towards sand flies. It is noteworthy that the HIV / L. infantum coinfected patient with asymptomatic leishmaniasis was easily infectious to sand flies for a long time, despite being under continuous prophylaxis for leishmaniasis. Accordingly, screening for latent Leishmania infection in HIV-infected patients is recommended in scenarios where transmission occurs. In addition, screening for VL in HIV-infected patients who have spent time in VL-endemic areas should also be implemented in non-endemic areas. More research is needed to better understand if some asymptomatic coinfected individuals contribute to transmission as 'super-spreaders'.


Assuntos
Reservatórios de Doenças , Transmissão de Doença Infecciosa , Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/epidemiologia , Leishmaniose Visceral/transmissão , Adulto , Animais , Anticorpos Antiprotozoários/sangue , Doenças Assintomáticas/epidemiologia , DNA de Protozoário/sangue , Feminino , Humanos , Leucócitos Mononucleares/imunologia , Masculino , Pessoa de Meia-Idade , Psychodidae/parasitologia , Espanha/epidemiologia
8.
Ophthalmologica ; 243(5): 379-390, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32015240

RESUMO

PURPOSE: To define and develop a model of excellence for the clinical management of diabetic macular edema (DME) patients in a real-world setting. METHODS: A multidisciplinary joint commission (5 ophthalmologists, 1 nurse, and 1 pharmaceutic) established a series of preliminary recommendations based on clinical guidelines and DME activity results from 8 Pilot Hospitals (PH). These were validated by members of each PH and a group of DME patients in discussion workshops. Thus, the validated guideline (VG) took into consideration different aspects, namely, main core points (ranging 0-100), criteria, and indicators. Finally, each PH own setting was compared to the VG in order to settle down a starting point to clinical excellence. RESULTS: Mean PH score was 51.5 (range 30-65). As compared to their maximum, main points that showed best scores were Clinical Guidelines and Protocols (78%) and Portfolio of Services (73%). Topics reaching close to 50% scoring included Resources (55%), Innovation (54%), Care Process (53%), Organization (52%), and Leadership (50%). Lowest scores were observed in the Strategic Alliances (46%) and Staff (37%) points. CONCLUSIONS: Analysis of each PH by the VG delivered a global vision of the starting situation, especially focused in the identification of the different improvement areas. In order to further extend this model into the Public Health System, the effect of implementing it in different hospitals should be assessed to analyze its impact on daily clinical practice and health economics.

9.
BMC Psychiatry ; 19(1): 327, 2019 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664965

RESUMO

BACKGROUND: Negative symptoms (NS) may be observed in the general population in an attenuated form and in high-risk mental states. However, they have been less studied in the general population than positive symptoms, in spite of their importance at the insidious onset of schizophrenia and their appearance before positive symptoms. This study aimed to analyze the empirical structure of the Spanish version of the Self-Evaluation of Negative Symptoms (SNS) Scale and find its psychometric properties and invariance of measurement across sex and age in a sample of adolescents. METHODS: The sample consisted of 4521 adolescents (53.6% female) from 11 to 18 years of age. RESULTS: Confirmatory Factor Analysis of the SNS confirmed an internal structure of five first-order factors by the characteristic dimensions of NS: avolition, social withdrawal, diminished emotional range, anhedonia, alogia, and one second-order factor which includes the total NS score. Multi-group confirmatory factor analysis showed that the scale was invariant across sex and age. Total scale reliability was adequate. A strong relationship was found between the SNS with depressive symptomatology, moderate with ideas of reference and low with aberrant salience. CONCLUSION: The results back use of the Spanish version of the SNS scale for detection of NS in the general population of adolescents.


Assuntos
Negativismo , Determinação da Personalidade/normas , Transtornos da Personalidade/diagnóstico , Escalas de Graduação Psiquiátrica/normas , Avaliação de Sintomas/normas , Adolescente , Criança , Autoavaliação Diagnóstica , Análise Fatorial , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Espanha , Traduções
10.
Eur J Intern Med ; 69: 42-49, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31466803

RESUMO

BACKGROUND: Visceral Leishmaniasis (VL) is a serious protozoal disease endemic in diverse areas, including the southern area of Madrid (Spain), where an outbreak was detected in 2009. The objective of this work is to analyze bone marrow alterations in VL patients and elaborate a diagnostic model with the aim to improve the early detection of this disease. The usual diagnostic methods, as the observation of the parasite on a bone marrow aspirate, have frequent false negatives, and the high sensitivity methods, as PCR and ELISA, are delayed or are not always available. METHODS: This observational study evaluated bone marrow parameters of adult patients with clinical suspicion of VL, in which a bone marrow aspiration was performed but Leishmania was not directly observed, during the period 2009-2014. The patients finally diagnosed of VL by other methods (VL group, n=41), and the patients in which the VL was not diagnosed (non-VL group, n=20) were compared. A multivariant model was elaborated and externally validated. RESULTS: The final multivariant model includes percentage of myeloid series, percentage of plasma cells and quantification of megakaryocytes in the bone marrow, with an area under the ROC curve of 0.87 (0.78-0.96). The model performed well in the external validation. CONCLUSION: In cases of VL suspicion and when the parasite is not observed in the bone marrow aspiration, the proposed model could be useful in discriminating between patients with and without VL, allowing to take a therapeutic decision while awaiting the definitive diagnosis.


Assuntos
Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/parasitologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Medula Óssea/parasitologia , Exame de Medula Óssea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Adulto Jovem
11.
Parasit Vectors ; 12(1): 359, 2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31340851

RESUMO

BACKGROUND: An outbreak of leishmaniasis caused by Leishmania infantum was declared in the southwest of the Madrid region (Spain) in June 2009. This provided a unique opportunity to compare the management of visceral leishmaniasis (VL) in immunocompetent adults (IC-VL), patients with HIV (HIV-VL) and patients receiving immunosuppressants (IS-VL). METHODS: A cohort of adults with VL, all admitted to the Hospital Universitario de Fuenlabrada between June 2009 and June 2018, were monitored in this observational study, recording their personal, epidemiological, analytical, diagnostic, treatment and outcome variables. RESULTS: The study population was made up of 111 patients with VL (10% HIV-VL, 14% IS-VL, 76% IC-VL). Seventy-one percent of the patients were male; the mean age was 45 years (55 years for the IS-VL patients, P = 0.017). Fifty-four percent of the IC-VL patients were of sub-Saharan origin (P = 0.001). Fever was experienced by 98% of the IC-VL patients vs 73% of the LV-HIV patients (P = 0.003). Plasma ferritin was > 1000 ng/ml in 77% of the IC-VL patients vs 17% of the LV-HIV patients (P = 0.007). Forty-two percent of patients fulfilled the criteria for haemophagocytic lymphohistiocytosis. RDT (rK39-ICT) serological analysis returned sensitivity and specificity values of 45% and 99%, respectively, and ELISA/iIFAT returned 96% and 89%, respectively, with no differences in this respect between patient groups. Fourteen (13.0%) patients with VL experienced treatment failure, eight of whom were in the IC-VL group. Treatment with < 21 mg/kg (total) liposomal amphotericin B (LAB) was associated with treatment failure in the IC-VL patients [P = 0.002 (OR: 14.7; 95% CI: 2.6-83.3)]. CONCLUSIONS: IS-VL was more common than HIV-VL; the lack of experience in dealing with IS-VL is a challenge that needs to be met. The clinical features of the patients in all groups were similar, although the HIV-VL patients experienced less fever and had lower plasma ferritin concentrations. RDT (rK39-ICT) analysis returned a good specificity value but a much poorer sensitivity value than reported in other scenarios. The patients with HIV-VL, IS-VL and IC-VL returned similar serological results. Current guidelines for treatment seem appropriate, but the doses of LAB required to treat patients with HIV-VL and IS-VL are poorly defined.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Infecções por HIV/parasitologia , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/epidemiologia , Adulto , Idoso , Antígenos de Protozoários/imunologia , Coinfecção/tratamento farmacológico , Coinfecção/epidemiologia , Coinfecção/parasitologia , Coinfecção/virologia , Diagnóstico Tardio , Surtos de Doenças/prevenção & controle , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Imunocompetência , Imunossupressores/uso terapêutico , Leishmania infantum , Leishmaniose Visceral/tratamento farmacológico , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Minorias Sexuais e de Gênero , Espanha/epidemiologia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
12.
Microb Cell ; 5(6): 262-268, 2018 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-29850463

RESUMO

CRISPR-Cas represents a prokaryotic defense mechanism against invading genetic elements. Although there is a diversity of CRISPR-Cas systems, they all share similar, essential traits. In general, a CRISPR-Cas system consists of one or more groups of DNA repeats named CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats), regularly separated by unique sequences referred to as spacers, and a set of functionally associated cas (CRISPR associated) genes typically located next to one of the repeat arrays. The origin of spacers is in many cases unknown but, when ascertained, they usually match foreign genetic molecules. The proteins encoded by some of the cas genes are in charge of the incorporation of new spacers upon entry of a genetic element. Other Cas proteins participate in generating CRISPR-spacer RNAs and perform the task of destroying nucleic acid molecules carrying sequences similar to the spacer. In this way, CRISPR-Cas provides protection against genetic intruders that could substantially affect the cell viability, thus acting as an adaptive immune system. However, this defensive action also hampers the acquisition of potentially beneficial, horizontally transferred genes, undermining evolution. Here we cover how the model bacterium Escherichia coli deals with CRISPR-Cas to tackle this major dilemma, evolution versus survival.

13.
Biopreserv Biobank ; 16(2): 128-137, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29369693

RESUMO

The conservation of microorganisms is essential for their in-depth study. However, today's most widely used conservation methods, based on the use of distilled water, soil, oils, or silica, do not guarantee the stability of fungal cells, especially dermatophytes. This problem led us to evaluate the conservation capacity of a cryogenic vials system containing glass beads covered in a cryopreservant hypertonic solution as an alternative method of storage of fungal cells at -80°C. Up to 570 strains of fungi belonging to 27 different species, isolated from clinical samples, were inoculated into cryotubes containing 25 glass beads covered in a cryopreserving hypertonic solution. Suspensions were mixed vigorously and the cryopreserving solution was discarded. The tubes were frozen at -80°C for a period of 42 months and periodically, a glass bead was removed from each cryotube and inoculated onto Sabouraud dextrose agar, and incubated at 30°C for 7-14 days to evaluate the number of colonies recovered, their purity, and phenotypic characteristics. All yeast isolates were recovered, unlike 2 isolates (4.4%) of the mold group and 21 (10.7%) of the dermatophytes. Survival rates were close to 100% for yeasts and molds, with expiration times being estimated for almost indefinite stocks, and 62% for dermatophytes, with an average expiration date of 25.5 years. The phenotypic characteristics remained comparable to those of the strains before storage. Conservation at -80°C using cryogenic vials is a reliable and efficient system for the conservation of fungal collections, and although the behavior differs by groups, stratified survival data are obtained to avoid extinction.


Assuntos
Arthrodermataceae/citologia , Criopreservação/métodos , Arthrodermataceae/metabolismo , Humanos , Fatores de Tempo
14.
J Ophthalmol ; 2017: 1573154, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29201456

RESUMO

Objective: To describe OCTA findings in choroidal melanocytic tumors, especially the microcirculation patterns, and to try to correlate with the histopathological studies. Methods: Cross-sectional, comparative, observational study. 70 cases, including 55 choroidal nevi and 15 choroidal melanomas. Three different observers evaluated specific variables in the choriocapillaris layer on AOCT images and searched for images which described histopathologic vascular patterns, and also, a general description of the images was made. Complementary multi-imaging studies included EDI SD-OCT, color and autofluorescence fundus imaging, Doppler ultrasound, and indocyanine/fluorescein angiography. Main Results: Good quality studies were acquired in 80% of the cases, with kappa indexes 0.768-0.958. Nevus OCTA images were described mainly as hyperreflective (72.7%), whereas choroidal melanoma as iso/hyporeflective (62.5%). Avascular areas were found in 50.96% and in 33.3% of choroidal nevus and choroidal melanomas, respectively. A neovascular membrane was found only in cases of choroidal nevus (16.3%). Only in cases of choroidal melanomas, we found vascular loops (6.6%) or vascular networks (6.6%). Conclusion: OCTA is a promising new technology that can be used to study in vivo the differential characteristics of microcirculations between posterior segment melanocytic lesions. Today, larger studies are needed to corroborate these findings and to correlate it with malignancy.

16.
Dig Liver Dis ; 48(10): 1237-42, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27481585

RESUMO

INTRODUCTION: The US Centers for Disease Control recommends hepatitis C virus (HCV) screening for baby boomers. Spain presents a similar distribution of infected patients. We performed a cross sectional prospective study to evaluate the prevalence of undiagnosed HCV infection in subjects born between 1949 and 1974. METHODS: All out-patients within the age range, both symptomatic and screening procedures, undergoing colonoscopy between December 2014 and June 2015 were offered a HCV antibody blood test and a survey including risk factors for HCV infection and attitude toward HCV screening. Patients with chronic HCV or with a previous negative HCV antibody test were excluded. RESULTS: A total of 570 subjects, 50% screening procedures, were analyzed. The median age was 55.7, 94.6% were born in Spain and 54.6% were women. Antibodies against HCV were found in 1.6% (95% CI: 0.8-3%) and HCV-RNA in 0.4% (0.1-1.3%). We found no statistically significant differences regarding HCV prevalence, risk factors or socioeconomic characteristics between subjects undergoing colorectal cancer screening and symptomatic subjects. CONCLUSION: Symptomatic and screening subjects undergoing colonoscopy support HCV screening and present a similar HCV risk profile. Results suggest linking colorectal and HCV screening would yield good results.


Assuntos
Atitude Frente a Saúde , Neoplasias Colorretais/diagnóstico , Anticorpos Anti-Hepatite C/sangue , Hepatite C/diagnóstico , Programas de Rastreamento/métodos , Colonoscopia/métodos , Estudos Transversais , Detecção Precoce de Câncer/métodos , Feminino , Hepacivirus , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Estudos Prospectivos , RNA Viral/isolamento & purificação , Fatores de Risco , Estudos Soroepidemiológicos , Espanha , Inquéritos e Questionários
17.
Nat Microbiol ; 1(8): 16081, 2016 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-27573106

RESUMO

Archaea and bacteria harbour clustered regularly interspaced short palindromic repeats (CRISPR) loci. These arrays encode RNA molecules (crRNA), each containing a sequence of a single repeat-intervening spacer. The crRNAs guide CRISPR-associated (Cas) proteins to cleave nucleic acids complementary to the crRNA spacer, thus interfering with targeted foreign elements. Notably, pre-existing spacers may trigger the acquisition of new spacers from the target molecule by means of a primed adaptation mechanism. Here, we show that naturally occurring orphan CRISPR arrays that contain spacers matching sequences of the cognate (absent) cas genes are able to elicit both primed adaptation and direct interference against genetic elements carrying those genes. Our findings show the existence of an anti-cas mechanism that prevents the transfer of a fully equipped CRISPR-Cas system. Hence, they suggest that CRISPR immunity may be undesired by particular prokaryotes, potentially because they could limit possibilities for gaining favourable sequences by lateral transfer.


Assuntos
Archaea/enzimologia , Archaea/genética , Bactérias/enzimologia , Bactérias/genética , Sistemas CRISPR-Cas/genética , Recombinação Genética
18.
J Ophthalmol ; 2015: 467814, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26425351

RESUMO

Macular peeling refers to the surgical technique for the removal of preretinal tissue or the internal limiting membrane (ILM) in the macula for several retinal disorders, ranging from epiretinal membranes (primary or secondary to diabetic retinopathy, retinal detachment…) to full-thickness macular holes, macular edema, foveal retinoschisis, and others. The technique has evolved in the last two decades, and the different instrumentations and adjuncts have progressively advanced turning into a safer, easier, and more useful tool for the vitreoretinal surgeon. Here, we describe the main milestones of macular peeling, drawing attention to its associated complications.

19.
Int. j. clin. health psychol. (Internet) ; 15(2): 139-148, mayo-ago. 2015. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-137472

RESUMO

Studies of the dimensionality of the Life Orientation Test-Revised (LOT-R), considered as the gold standard in the measurement of dispositional optimism, yield controversial results due to the various factorial solutions found. Consequently, the factorial structure of the test has not yet been fully established. The aim of this study is to determine the factorial structure of the LOT-R by comparing seven previous models and their empirical evidence. The test was administered to 906 Spanish participants, ages 18 to 61 (mean age: 23; 56% males). Confirmatory factor analyses were conducted using polychoric correlations. Considering the theoretical background and the best model fit indices (RMSEA=.038; CFI=.98), we conclude that the test presents a factorial structure of a second-order factor (life orientation) composed of two factors (optimism and pessimism). Thus, we recommend using a single global score that could be referred to as life orientation but which ultimately represents the level of dispositional optimism (AU)


Los estudios sobre la dimensionalidad del Test de Orientación Vital-Revisado (LOT-R), considerado el estándar en la medida del optimismo disposicional, resultan controvertidos al encontrar diversas soluciones factoriales. Así, no se ha establecido la estructura factorial definitiva de la prueba. El objetivo del presente estudio es determinar la estructura factorial del LOT-R mediante la comparación de los siete modelos empíricos existentes en la literatura. El instrumento fue administrado a 906 participantes españoles, de edades comprendidas entre los 18 y los 61 años (edad media = 23; 56% hombres). Se llevaron a cabo análisis factoriales confirmatorios sobre la matriz de correlaciones policóricas. Teniendo en cuenta los modelos teóricos existentes y los mejores índices de ajuste (RMSEA = 0,038; CFI = 0,98), concluimos que el LOT-R presenta una estructura factorial de segundo orden (orientación vital), compuesta por dos factores (Optimismo y Pesimismo). En consecuencia, recomendamos utilizar una única puntuación global que puede denominarse orientación vital y que, en último término, representa el nivel de optimismo disposicional (AU)


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Psicometria/instrumentação , Orientação , Intenção , Atitude , Enquadramento Psicológico , Análise Fatorial
20.
PLoS One ; 10(7): e0131935, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26136211

RESUMO

Guide RNA molecules (crRNA) produced from clustered regularly interspaced short palindromic repeat (CRISPR) arrays, altogether with effector proteins (Cas) encoded by cognate cas (CRISPR associated) genes, mount an interference mechanism (CRISPR-Cas) that limits acquisition of foreign DNA in Bacteria and Archaea. The specificity of this action is provided by the repeat intervening spacer carried in the crRNA, which upon hybridization with complementary sequences enables their degradation by a Cas endonuclease. Moreover, CRISPR arrays are dynamic landscapes that may gain new spacers from infecting elements or lose them for example during genome replication. Thus, the spacer content of a strain determines the diversity of sequences that can be targeted by the corresponding CRISPR-Cas system reflecting its functionality. Most Escherichia coli strains possess either type I-E or I-F CRISPR-Cas systems. To evaluate their impact on the pathogenicity of the species, we inferred the pathotype and pathogenic potential of 126 strains of this and other closely related species and analyzed their repeat content. Our results revealed a negative correlation between the number of I-E CRISPR units in this system and the presence of pathogenicity traits: the median number of repeats was 2.5-fold higher for commensal isolates (with 29.5 units, range 0-53) than for pathogenic ones (12.0, range 0-42). Moreover, the higher the number of virulence factors within a strain, the lower the repeat content. Additionally, pathogenic strains of distinct ecological niches (i.e., intestinal or extraintestinal) differ in repeat counts. Altogether, these findings support an evolutionary connection between CRISPR and pathogenicity in E. coli.


Assuntos
Sistemas CRISPR-Cas , Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas/genética , Escherichia coli/genética , Escherichia coli/patogenicidade , DNA Bacteriano/genética , Escherichia/genética , Genoma Bacteriano , Genômica , Hibridização de Ácido Nucleico , Filogenia , Shigella/genética , Especificidade da Espécie , Fatores de Virulência
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