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1.
Sci Rep ; 11(1): 3846, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33589682

RESUMO

To date, two randomized, controlled studies support the use of candesartan for migraine prophylaxis but with limited external validity. We aim to evaluate the effectiveness and tolerability of candesartan in clinical practice and to explore predictors of patient response. Retrospective cohort study including all patients with migraine who received candesartan between April 2008-February 2019. The primary endpoint was the number of monthly headache days during weeks 8-12 of treatment compared to baseline. Additionally, we evaluated the frequency during weeks 20-24. We analysed the percentage of patients with 50% and 75% response rates and the retention rates after three and 6 months of treatment. 120/4121 patients were eligible, aged 45.9 [11.5]; 100 (83.3%) female. Eighty-four patients (70%) had chronic migraine and 53 (42.7%) had medication-overuse headache. The median number of prior prophylactics was 3 (Inter-quartile range 2-5). At baseline, patients had 20.5 ± 8.5 headache days per month, decreasing 4.3 ± 8.4 days by 3 months (weeks 12-16) and by 4.7 ± 8.7 days by 6 months (paired Student's t-test, p < 0.001). The percentage of patients with a 50% response was 32.5% at 3 months and 31.7% at 6 months, while the retention rate was 85.0% and 58.3%. The number of prior treatments (Odds ratio 0.79, 95% CI 0.64-0.97) and the presence of daily headache (Odds ratio 0.39, 95% CI 0.16-0.97) were associated with a lower probability of response. Candesartan showed beneficial effects in the preventive treatment of migraine in clinical practice, including patients with chronic migraine, medication-overuse headache and resistance to prior prophylactics.

2.
Artigo em Inglês | MEDLINE | ID: mdl-33404659

RESUMO

OBJECTIVES: To investigate whether abnormal BMI is associated with adverse health-related quality of life (HRQoL) outcome, including severe fatigue, after 52 weeks of standard therapy (ST) plus belimumab or placebo in patients with SLE. METHODS: We analysed data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials (N = 1684). Adverse HRQoL was defined as SF-36 scores ≤ the 5th percentile in age- and sex-matched US population-based subjects, and FACIT-F scores <30. We compared BMI groups using the Pearson's χ2 test, and assessed independence with multivariable logistic regression analysis. RESULTS: Overweight (BMI ≥25 kg/m2) and obese (BMI ≥30 kg/m2) patients showed increased likelihood to exhibit adverse SF-36 physical component summary (OR: 1.8; 95% CI: 1.4-2.3; p< 0.001 and OR: 2.4; 95% CI: 1.8-3.2; p< 0.001, respectively) and FACIT-F (OR: 1.3; 95% CI: 1.1-1.6; p= 0.010 and OR: 1.5; 95% CI: 1.2-2.0; p= 0.002, respectively) scores at week 52. Underweight was associated with adverse SF-36 mental component summary scores, also after adjustment for sex, ancestry, age, disease duration, disease activity, organ damage and prednisone dose during the study period (OR: 2.1; 95% CI: 1.2-3.6; p= 0.007). Addition of belimumab to ST independently protected against adverse SF-36 general health (OR: 0.8; 95% CI: 0.6-1.0; p= 0.025) and FACIT-F < 30 (OR: 0.8; 95% CI: 0.6-1.0; p= 0.018). CONCLUSION: Overweight and obesity contributed to adverse physical and mental HRQoL outcomes after therapeutic intervention in SLE patients, and underweight contributed to adverse mental HRQoL outcome. A protective effect of belimumab against adverse general health and severe fatigue was implicated.

3.
Cereb Cortex ; 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33406245

RESUMO

Inhibitory control is considered a compromised cognitive function in obsessive-compulsive (OCD) patients and likely linked to corticostriatal circuitry disturbances. Here, 9 refractory OCD patients treated with deep brain stimulation (DBS) were evaluated to address the dynamic modulations of large-scale cortical network activity involved in inhibitory control after nucleus accumbens (NAc) stimulation and their relationship with cortical thickness. A comparison of DBS "On/Off" states showed that patients committed fewer errors and exhibited increased intraindividual reaction time variability, resulting in improved goal maintenance abilities and proactive inhibitory control. Visual P3 event-related potentials showed increased amplitudes during Go/NoGo performance. Go and NoGo responses increased cortical activation mainly over the right inferior frontal gyrus and medial frontal gyrus, respectively. Moreover, increased cortical activation in these areas was equally associated with a higher cortical thickness within the prefrontal cortex. These results highlight the critical role of NAc DBS for preferentially modulating the neuronal activity underlying sustained speed responses and inhibitory control in OCD patients and show that it is triggered by reorganizing brain functions to the right prefrontal regions, which may depend on the underlying cortical thinning. Our findings provide updated structural and functional evidence that supports critical dopaminergic-mediated frontal-striatal network interactions in OCD.

4.
Artigo em Inglês | MEDLINE | ID: mdl-33502473

RESUMO

OBJECTIVES: To investigate the discriminative ability of EQ-5D-3L full health state (FHS) in clinical trials of SLE, and identify factors associated with FHS after treatment. METHODS: Data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials of belimumab (N = 1684) were utilised. FHS was defined as a response of no problems in all five EQ-5D-3L dimensions, yielding an index score of 1. The Pearson's chi-square or Fisher's exact test was employed for comparisons, and logistic regression for adjustments and assessment of independence. RESULTS: We demonstrated higher EQ-5D-3L FHS frequencies among patients given standard therapy (ST) plus the licensed belimumab dose versus ST alone (26.1% versus 19.4%; P = 0.001; week 52), and within SRI-4 responders versus non-responders (27.0% versus 19.8%; P < 0.001; week 52) from week 36 to 52. In multivariable regression analysis, SLEDAI-2K (OR: 0.90; 95% CI: 0.87 - 0.94; P < 0.001) and SLICC/ACR Damage Index (OR: 0.79; 95% CI: 0.69 - 0.91; P = 0.001) scores were independently associated with lower FHS frequencies at week 52, while adding monthly infusions of belimumab 10 mg/kg to ST favoured FHS perception (OR: 1.60; 95% CI: 1.15 - 2.24; P = 0.006). Add-on belimumab 10 mg/kg yielded higher FHS frequencies in antimalarial users versus non-users (29.9% versus 20.1%; P = 0.011), and in anti-dsDNA and anti-Sm positive versus negative patients (31.4% versus 13.4%; P < 0.001 and 33.0% versus 22.6%; P = 0.010, respectively), whereas no significant differences were observed in patients given ST alone. CONCLUSION: EQ-5D-3L FHS distinguished belimumab from placebo and responders from non-responders, and exhibited known-group validity in subgroup analysis. FHS may prove a useful patient-reported outcome in SLE studies.

5.
Methods Mol Biol ; 2217: 47-56, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33215376

RESUMO

Integrins are adhesion receptors that mediate many intercellular and cell-extracellular matrix interactions with relevance in physiology and pathology. Unlike other cellular receptors, integrins critically require activation for ligand binding. Through interaction in cis with other molecules and the formation of tetraspanin-enriched membrane microdomains (TEMs), the tetraspanin CD9 regulates integrin activity and avidity. Here we present three techniques used to study CD9-integrin interactions and integrin activation.

6.
Rev. neurol. (Ed. impr.) ; 71(11): 399-406, 1 dic., 2020. tab, graf, ilus
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-ET6-1558

RESUMO

INTRODUCCIÓN: El topiramato es el único tratamiento preventivo oral con nivel de evidencia I para la migraña crónica. OBJETIVO: Evaluar los parámetros de la sustancia gris, obtenidos mediante resonancia magnética, como marcadores de respuesta al tratamiento con topiramato en pacientes con migraña crónica. PACIENTES Y MÉTODOS: La muestra se compuso de 57 pacientes con migraña crónica atendidos por primera vez en una unidad de cefaleas como consecuencia de migraña crónica, a los que se realizó una resonancia magnética de 3 T. Posteriormente, se inició el tratamiento preventivo con topiramato. Se evaluaron la respuesta y la tolerancia a los tres meses y se definió respuesta como disminución de al menos un 50% en el número de días de cefalea al mes. Mediante procesamiento de imágenes de resonancia magnética ponderadas en T1 y difusión, se obtuvieron los parámetros de la sustancia gris (68 estructuras corticales y 16 subcorticales). Se obtuvo un modelo de regresión logística para la valoración predictiva. RESULTADOS: Se analizó a 42 pacientes que toleraron el tratamiento, con respuesta terapéutica en 23 de ellos (54,7%). El modelo final de predicción se construyó con parámetros de la sustancia gris con resultados significativos. En dicho modelo, a mayor curvatura del cúneo izquierdo y área de la ínsula derecha, mayor probabilidad de respuesta, y menor probabilidad a mayor volumen de la corteza inferior parietal derecha y área del giro temporal superior izquierdo. La precisión del modelo predictivo fue del 95%. CONCLUSIÓN: Los parámetros de la sustancia gris pueden ser marcadores útiles de respuesta al tratamiento preventivo con topiramato en la migraña crónica Historia y Humanidades Origen y evolución histórica del término «prefrontal»


INTRODUCTION. Topiramate is the only oral preventative with level of evidence I for the treatment of chronic migraine. AIM. To evaluate gray matter parameters, obtained with magnetic resonance imaging (MRI), as biomarkers of the response to topiramate in chronic migraine patients. PATIENTS AND METHODS. The sample was composed by 57 chronic migraine patients, screened for first time in a Headache Unit due to chronic migraine. MRI acquisitions were performed at a 3 T unit. Afterwards, topiramate preventive treatment began. Response and tolerability were evaluated after three months, defining response as at least 50% reduction in headache days per month. We included patients that tolerated topiramate. T1- and diffusion-weighted MRI were processed to obtain gray matter (68 cortical and 16 subcortical regions) descriptive parameters. A logistic regression model was employed for the predictive assessment. RESULTS. Forty-two patients tolerated the treatment and were analyzed, responding 23 of them (54.7%). The final prediction model was built with gray matter parameters with significant results. In this model, higher left cuneus curvature and right insula area values were associated with a higher probability of response, while higher right inferior parietal cortex volume and left superior temporal gyrus area values were associated with a lower probability. The accuracy of the predictive model was 95%. CONCLUSION. The gray matter parameters may be useful biomarkers of preventive treatment response with topiramate in chronic migraine

7.
Schizophr Res ; 2020 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-33221149

RESUMO

Schizophrenia and bipolar disorder include patients with different characteristics, which may hamper the definition of biomarkers. One of the dimensions with greater heterogeneity among these patients is cognition. Recent studies support the identification of different patients' subgroups along the cognitive domain using cluster analysis. Our aim was to validate clusters defined on the basis of patients' cognitive status and to assess its relation with demographic, clinical and biological measurements. We hypothesized that subgroups characterized by different cognitive profiles would show differences in an array of biological data. Cognitive data from 198 patients (127 with chronic schizophrenia, 42 first episodes of schizophrenia and 29 bipolar patients) were analyzed by a K-means cluster approach and were compared on several clinical and biological variables. We also included 155 healthy controls for further comparisons. A two-cluster solution was selected, including a severely impaired group and a moderately impaired group. The severely impaired group was associated with higher illness duration and symptoms scores, lower thalamus and hippocampus volume, lower frontal connectivity and basal hypersynchrony in comparison to controls and the moderately impaired group. Moreover, both patients' groups showed lower cortical thickness and smaller functional connectivity modulation than healthy controls. This study supports the existence of different cognitive subgroups within the psychoses with different neurobiological underpinnings.

8.
Cephalalgia ; 40(13): 1432-1442, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33146037

RESUMO

INTRODUCTION: Headache is a common symptom of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this study, we aimed to characterize the phenotype of headache attributed to SARS-CoV-2 infection and to test the International Classification of Headache Disorders (ICHD-3) phenotypic criteria for migraine and tension-type headache. METHODS: The study design was a cross-sectional study nested in a cohort. We screened all consecutive patients that were hospitalized and had a positive SARS-CoV-2 test. We included patients that described headache if the headache was not better explained by another ICHD-3 diagnosis. Patients were interviewed by two neurologists. RESULTS: We screened 580 patients and included 130 (mean age 56 years, 64% female). Headache was the first symptom of the infection in 26% of patients and appeared within 24 hours in 62% of patients. The headache was bilateral in 85%, frontal in 83%, and with pressing quality in 75% of patients. Mean intensity was 7.1, being severe in 64%. Hypersensitivity to stimuli occurred in 57% of patients. ICHD-3 criteria for headache attributed to systemic viral infection were fulfilled by 94% of patients; phenotypic criteria for migraine were fulfilled by 25% of patients, and tension-type headache criteria by 54% of patients. CONCLUSION: Headache attributed to SARS-CoV-2 infection in hospitalized patients has severe intensity, frontal predominance and oppressive quality. It occurs early in the course of the disease. Most patients fulfilled ICHD-3 criteria for headache attributed to systemic viral infection; however, the phenotype might resemble migraine in a quarter of cases and tension-type headache in half of the patients.


Assuntos
Infecções por Coronavirus/complicações , Cefaleia/classificação , Cefaleia/diagnóstico , Cefaleia/virologia , Pneumonia Viral/complicações , Adulto , Idoso , Betacoronavirus , Estudos Transversais , Feminino , Humanos , Classificação Internacional de Doenças , Masculino , Pessoa de Meia-Idade , Pandemias , Fenótipo
9.
J Health Psychol ; : 1359105320967086, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33124471

RESUMO

We studied the short-term psychological effects of the COVID-19 crisis and the quarantine on 3550 adults from the Spanish population in a cross-sectional survey. Symptoms of anxiety, depression, and stress were analyzed using the 21-item version of the Depression Anxiety Stress Scale. Symptoms of posttraumatic stress disorder were analyzed using the Impact of Event Scale. Symptomatic scores of anxiety, depression, and stress were observed in 20% to 30% of respondents. Symptomatic scores indicating psychological stress were found in 47.5% of respondents. Similar to the findings of other multiple studies, confinement has been found to have significant emotional impact in the Spanish population.

10.
Brain Sci ; 10(10)2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33036306

RESUMO

The white matter state in migraine has been investigated using diffusion tensor imaging (DTI) measures, but results using this technique are conflicting. To overcome DTI measures, we employed ensemble average diffusion propagator measures obtained with apparent measures using reduced acquisitions (AMURA). The AMURA measures were return-to-axis (RTAP), return-to-origin (RTOP) and return-to-plane probabilities (RTPP). Tract-based spatial statistics was used to compare fractional anisotropy, mean diffusivity, axial diffusivity and radial diffusivity from DTI, and RTAP, RTOP and RTPP, between healthy controls, episodic migraine and chronic migraine patients. Fifty healthy controls, 54 patients with episodic migraine and 56 with chronic migraine were assessed. Significant differences were found between both types of migraine, with lower axial diffusivity values in 38 white matter regions and higher RTOP values in the middle cerebellar peduncle in patients with a chronic migraine (p < 0.05 family-wise error corrected). Significantly lower RTPP values were found in episodic migraine patients compared to healthy controls in 24 white matter regions (p < 0.05 family-wise error corrected), finding no significant differences using DTI measures. The white matter microstructure is altered in a migraine, and in chronic compared to episodic migraine. AMURA can provide additional results with respect to DTI to uncover white matter alterations in migraine.

11.
Pain Med ; 2020 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-33040149

RESUMO

OBJECTIVE: This study evaluates different parameters describing the gray matter structure to analyze differences between healthy controls, patients with episodic migraine, and patients with chronic migraine. DESIGN: Cohort study. SETTING: Spanish community. SUBJECTS: Fifty-two healthy controls, 57 episodic migraine patients, and 57 chronic migraine patients were included in the study and underwent T1-weighted magnetic resonance imaging acquisition. METHODS: Eighty-four cortical and subcortical gray matter regions were extracted, and gray matter volume, cortical curvature, thickness, and surface area values were computed (where applicable). Correlation analysis between clinical features and structural parameters was performed. RESULTS: Statistically significant differences were found between all three groups, generally consisting of increases in cortical curvature and decreases in gray matter volume, cortical thickness, and surface area in migraineurs with respect to healthy controls. Furthermore, differences were also found between chronic and episodic migraine. Significant correlations were found between duration of migraine history and several structural parameters. CONCLUSIONS: Migraine is associated with structural alterations in widespread gray matter regions of the brain. Moreover, the results suggest that the pattern of differences between healthy controls and episodic migraine patients is qualitatively different from that occurring between episodic and chronic migraine patients.

12.
J Affect Disord ; 277: 842-849, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33065825

RESUMO

BACKGROUND: Strict confinement and social distancing measures have been imposed due to the COVID-19 pandemic in many countries. The aim was to assess the temporal evolution of the psychological impact of the COVID-19 crisis and lockdown from two surveys, separated by one month, performed in Spain. METHODS: Symptoms of depression, anxiety and stress, and the psychological impact of the situation were longitudinally analyzed using the Depression Anxiety and Stress Scale (DASS-21) and the Impact of Event Scale (IES) respectively. RESULTS: There was a total of 4,724 responses from both surveys. Symptomatic scores of anxiety, depression and stress were exhibited by 37.22%, 46.42% and 49.66% of the second survey respondents, showing a significant increase compared to the first survey (32.45%, 44.11% and 37.01%, respectively). There was no significant longitudinal change of the IES scores, with 48.30% of the second survey participants showing moderate to severe impact of the confinement. Constant news consumption about COVID-19 was found to be positively associated with symptomatic scores in the different scales, and daily physical activity to be negatively associated with DASS-21 scores. CONCLUSIONS: Results indicated a temporal increase of anxiety, depression and stress scores during the COVID-19 lockdown. Factors such as age, consumption of information about COVID-19 and physical activity seem to have an important impact on the evolution of psychological symptoms.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus , Depressão/epidemiologia , Pandemias , Pneumonia Viral , Estresse Psicológico/epidemiologia , Adolescente , Adulto , Idoso , Ansiedade/psicologia , Betacoronavirus , Depressão/psicologia , Exercício Físico/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adulto Jovem
13.
Polymers (Basel) ; 12(10)2020 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-33066244

RESUMO

The removal of Cu(II) ions from aqueous solutions at a pH of 5.0 was carried out using fixed-bed columns packed with alginate-chitosan (Alg-Ch) or alginate-chitosan sulfate (Alg-ChS) hydrogel beads. The effect of the initial Cu(II) concentration, flow rate, pH, and height of the column on the amount of Cu removed by the column at the breakpoint and at the exhaustion point is reported. The pH of the solution at the column's exit was initially higher than that at the entrance, and then decreased slowly. This pH increase was attributed to proton transfer from the aqueous solution to the amino and COO- groups of the hydrogel. The effect of operating conditions on the mass transfer zone (MTZ) and the length of the unused bed (HLUB) is reported. At the lower flow rate and lower Cu(II) concentration used, the MTZ was completely developed and the column operated efficiently; by increasing column height, the MTZ has a better opportunity to develop fully. Experimental data were fitted to the fixed-bed Thomas model using a non-linear regression analysis and a good correspondence between experimental and Thomas model curves was observed.

14.
Sci Rep ; 10(1): 18937, 2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33122664

RESUMO

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

15.
Artigo em Inglês | MEDLINE | ID: mdl-32918459

RESUMO

OBJECTIVES: Associations between BMI and health-related quality of life (HRQoL) in SLE have been implied, but data are scarce. We determined the impact of overweight and obesity on HRQoL in a large SLE population. METHODS: We pooled cross-sectional baseline data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials (N = 1684). HRQoL was evaluated using the 36-item Short Form Health Survey (SF-36), Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale and the European Quality of Life 5-dimension questionnaire (EQ-5D). Comparisons between BMI groups were conducted using the Mann-Whitney U test and adjustments using linear regression. Clinical relevance was determined by minimal clinically important differences (MCIDs). RESULTS: In total, 43.2% of the patients had BMI above normal and 17.4% were obese. Overweight and obese patients reported worse SF-36 physical component summary (PCS), physical functioning, role physical, bodily pain and FACIT-Fatigue scores than normal weight patients. Divergences were greater than corresponding MCIDs and more prominent with increasing BMI. Despite no clinically important difference in SF-36 mental component summary scores across BMI categories, patients experienced progressively diminished vitality and social functioning with increasing BMI. In linear regression analysis, BMI above normal and obesity were associated with worse PCS (standardized coefficient ß = -0.10, P < 0.001 and ß = -0.17, P < 0.001, respectively), FACIT-Fatigue (ß = -0.11, P < 0.001 and ß = -0.16, P < 0.001) and EQ-5D (ß = -0.08, P = 0.001 and ß = -0.12, P < 0.001) scores, independently of demographic and disease-related factors. The impact of BMI on the PCS and FACIT-Fatigue was more pronounced than that of SLE activity. CONCLUSION: Patients with SLE and BMI above normal experienced clinically important HRQoL diminutions in physical aspects, fatigue and social functioning. A survey of potential causality underlying this association is warranted.

16.
Sci Rep ; 10(1): 12953, 2020 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-32737332

RESUMO

Sex differences in 116 local gray matter volumes (GMVOL) were assessed in 444 males and 444 females without correcting for total intracranial volume (TIV) or after adjusting the data with the scaling, proportions, power-corrected proportions (PCP), and residuals methods. The results confirmed that only the residuals and PCP methods completely eliminate TIV-variation and result in sex-differences that are "small" (∣d∣ < 0.3). Moreover, as assessed using a totally independent sample, sex differences in PCP and residuals adjusted-data showed higher replicability ([Formula: see text] 93%) than scaling and proportions adjusted-data [Formula: see text] 68%) or raw data ([Formula: see text] 45%). The replicated effects were meta-analyzed together and confirmed that, when TIV-variation is adequately controlled, volumetric sex differences become "small" (∣d∣ < 0.3 in all cases). Finally, we assessed the utility of TIV-corrected/ TIV-uncorrected GMVOL features in predicting individuals' sex with 12 different machine learning classifiers. Sex could be reliably predicted (> 80%) when using raw local GMVOL, but also when using scaling or proportions adjusted-data or TIV as a single predictor. Conversely, after properly controlling TIV variation with the PCP and residuals' methods, prediction accuracy dropped to [Formula: see text] 60%. It is concluded that gross morphological differences account for most of the univariate and multivariate sex differences in GMVOL.

17.
J Headache Pain ; 21(1): 94, 2020 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-32727345

RESUMO

INTRODUCTION: Headache is one of the most frequent neurologic manifestations in COVID-19. We aimed to analyze which symptoms and laboratory abnormalities were associated with the presence of headache and to evaluate if patients with headache had a higher adjusted in-hospital risk of mortality. METHODS: Retrospective cohort study. We included all consecutive patients admitted to the Hospital with confirmed SARS-CoV-2 infection between March 8th and April 11th, 2020. We collected demographic data, clinical variables and laboratory abnormalities. We used multivariate regression analysis. RESULTS: During the study period, 576 patients were included, aged 67.2 (SD: 14.7), and 250/576 (43.3%) being female. Presence of headache was described by 137 (23.7%) patients. The all-cause in-hospital mortality rate was 127/576 (20.0%). In the multivariate analysis, patients with headache had a lower risk of mortality (OR: 0.39, 95% CI: 0.17-0.88, p = 0.007). After adjusting for multiple comparisons in a multivariate analysis, variables that were independently associated with a higher odds of having headache in COVID-19 patients were anosmia, myalgia, female sex and fever; variables that were associated with a lower odds of having headache were younger age, lower score on modified Rankin scale, and, regarding laboratory variables on admission, increased C-reactive protein, abnormal platelet values, lymphopenia and increased D-dimer. CONCLUSION: Headache is a frequent symptom in COVID-19 patients and its presence is an independent predictor of lower risk of mortality in COVID-19 hospitalized patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Cefaleia/epidemiologia , Mortalidade Hospitalar , Pneumonia Viral/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Feminino , Cefaleia/etiologia , Cefaleia/mortalidade , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
18.
J Clin Med ; 9(6)2020 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-32532059

RESUMO

Impaired health-related quality of life (HRQoL) is a major problem in patients with systemic lupus erythematosus (SLE). Antimalarial agents (AMA) are the cornerstone of SLE therapy, but data on their impact on HRQoL are scarce. We investigated this impact using baseline data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials (n = 1684). HRQoL was self-reported using the Medical Outcomes Study short-form 36 (SF-36), functional assessment of chronic illness therapy (FACIT)-Fatigue and 3-level EuroQoL 5-Dimension (EQ-5D) questionnaires. Patients on AMA (n = 1098/1684) performed better with regard to SF-36 physical component summary, physical functioning, role physical, bodily pain, FACIT-Fatigue, EQ-5D utility index and EQ-5D visual analogue scale scores. The difference in SF-36 physical functioning (mean ± standard deviation (SD): 61.1 ± 24.9 versus 55.0 ± 26.5; p < 0.001) exceeded the minimal clinically important difference (≥5.0). This association remained significant after adjustment for potential confounding factors in linear regression models (standardised coefficient, ß = 0.07; p = 0.002). Greater proportions of AMA users than non-users reported no problems in the mobility, self-care, usual activities and anxiety/depression EQ-5D dimensions. AMA use was particularly associated with favourable HRQoL in physical aspects among patients with active mucocutaneous and musculoskeletal disease, and mental aspects among patients with active renal SLE. These results provide support in motivating adherence to AMA therapy. Exploration of causality in the relationship between AMA use and favourable HRQoL in SLE has merit.

19.
Front Immunol ; 11: 738, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32425937

RESUMO

Phagocytic integrins are endowed with the ability to engulf and dispose of particles of different natures. Evolutionarily conserved from worms to humans, they are involved in pathogen elimination and apoptotic and tumoral cell clearance. Research in the field of integrin-mediated phagocytosis has shed light on the molecular events controlling integrin activation and their effector functions. However, there are still some aspects of the regulation of the phagocytic process that need to be clarified. Here, we have revised the molecular events controlling phagocytic integrin activation and the downstream signaling driving particle engulfment, and we have focused particularly on αMß2/CR3, αXß2/CR4, and a brief mention of αVß5/αVß3integrins.

20.
Cells ; 9(5)2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32397169

RESUMO

The phagocytic integrins and complement receptors αMß2/CR3 and αXß2/CR4 are classically associated with the phagocytosis of iC3b-opsonized particles. The activation of this receptor is dependent on signals derived from other receptors (inside-out signaling) with the crucial involvement of the Rap1-RIAM-Talin-1 pathway. Here, we analyze the implication of RIAM and its binding partner VASP in the signaling events occurring downstream of ß2 integrins (outside-in) during complement-mediated phagocytosis. To this end, we used HL-60 promyelocytic cell lines deficient in RIAM or VASP or overexpressing EGFP-tagged VASP to determine VASP dynamics at phagocytic cups. Our results indicate that RIAM-deficient HL-60 cells presented impaired particle internalization and altered integrin downstream signaling during complement-dependent phagocytosis. Similarly, VASP deficiency completely blocked phagocytosis, while VASP overexpression increased the random movement of phagocytic particles at the cell surface, with reduced internalization. Moreover, the recruitment of VASP to particle contact sites, amount of pSer157-VASP and formation of actin-rich phagocytic cups were dependent on RIAM expression. Our results suggested that RIAM worked as a relay for integrin complement receptors in outside-in signaling, coordinating integrin activation and cytoskeletal rearrangements via its interaction with VASP.

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