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1.
Int J Nanomedicine ; 14: 7399-7417, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31571858

RESUMO

Purpose: We studied the effects of silver nanoparticles (AgNPs) on human blood platelet function. We hypothesized that AgNPs, a known antimicrobial agent, can be used as blood-compatible, "ideal material'' in medical devices or as a drug delivery system. Therefore, the aim of the current study was to investigate if functionalized AgNPs affect platelet function and platelets as well as endothelial cell viability in vitro. Methods: AgNPs, functionalized with reduced glutathione (GSH), polyethylene glycol (PEG) and lipoic acid (LA) were synthesized. Quartz crystal microbalance with dissipation was used to measure the effect of AgNPs on platelet aggregation. Platelet aggregation was measured by changes in frequency and dissipation, and the presence of platelets on the sensor surface was confirmed and imaged by phase contrast microscopy. Flow cytometry was used to detect surface abundance of platelet receptors. Lactate dehydrogenase test was used to assess the potential cytotoxicity of AgNPs on human blood platelets, endothelial cells, and fibroblasts. Commercially available ELISA tests were used to measure the levels of thromboxane B2 and metalloproteinases (MMP-1, MMP-2) released by platelets as markers of platelet activation. Results: 2 nm AgNPs-GSH, 3.7 nm AgNPs-PEG both at 50 and 100 µg/mL, and 2.5 nm AgNPs-LA at 100 µg/mL reduced platelet aggregation, inhibited collagen-mediated increase in total P-selectin and GPIIb/IIIa, TXB2 formation, MMP-1, and MMP-2 release. The tested AgNPs concentrations were not cytotoxic as they did not affect, platelet, endothelial cell, or fibroblast viability. Conclusion: All tested functionalized AgNPs inhibited platelet aggregation at nontoxic concentrations. Therefore, functionalized AgNPs can be used as an antiplatelet agent or in design and manufacturing of blood-facing medical devices, such as vascular grafts, stents, heart valves, and catheters.

2.
Cancer ; 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31479529

RESUMO

BACKGROUND: The effectiveness of colorectal cancer screening with fecal immunochemical tests (FITs) of stool blood depends on high rates of colonoscopy follow-up for abnormal FITs and the use of high-quality tests. This study characterized colonoscopy referral and completion among patients with abnormal FITs and the types of FITs implemented in a sample of Southern California Federally Qualified Health Centers (FQHCs). METHODS: FQHCs in San Diego, Imperial, and Los Angeles Counties were invited to define a cohort of ≥150 consecutive patients with abnormal FITs in 2015-2016 and to provide data on sex, insurance status, diagnostic colonoscopy referrals and completion within 6 months of abnormal FITs, and the types (brands) of FITs implemented. The primary outcomes were the proportions with colonoscopy referrals and completion for all patients at each FQHC and in aggregate. RESULTS: Eight FQHCs provided data for 1229 patients with abnormal FITs; 46% were male, and 20% were uninsured. Among patients with abnormal FITs, 89% (1091 of 1229; 95% confidence interval [CI], 0.87-0.91) had a colonoscopy referral, and 44% (539 of 1229; 95% CI, 0.41-0.47) had colonoscopy completion. Across FQHCs, the range for colonoscopy referral was 73% to 96%, and the range for completion was 18% to 57%. Six of the 8 FQHCs (75%) reported FIT brands with limited data to support their effectiveness. CONCLUSIONS: In a sample of Southern California FQHCs, diagnostic colonoscopy completion after abnormal FITs was substantially below the nationally recommended benchmark to achieve 80% completion, and the use of FIT brands with limited data to support their effectiveness was high. These findings suggest a need for policies and multilevel interventions to promote diagnostic colonoscopy among individuals with abnormal FITs and the use of higher quality FITs.

3.
Dermatol Ther ; : e13086, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31513726

RESUMO

BACKGROUND: The management of chronic urticaria (CU) has been controversial. Recently updated international guidelines propose evidence-based diagnosis and treatment. Nevertheless, dermatologists have heterogeneous approaches to managing CU. PURPOSE: To estimate the percentage of dermatologists who have an optimal approach to CU according to the international guidelines, and to explore the variables associated with optimal management. METHOD: A cross-sectional study using a 17-question survey was delivered by email to dermatologists from Argentina. Optimal first, second and third line treatment were considered when dermatologists chose a non-sedative antihistamine; increased the dosage of non-sedative antihistamines, and added omalizumab, respectively. Logistic regression was used to identify variables associated with optimal management. RESULTS: A total of 165 questionnaires were available for analysis. An optimal first, second, and third-line treatment approach was identified in 50%, 35%, and 15% of the dermatologists, respectively. The dermatologists' age being above 55 years old (OR: 0.12, 95% CI: 0.01-0.99, p 0.005) and having more than five years of expertise (OR: 0.4, 95% CI: 0.19-0.81, p 0.001) were significantly associated with a suboptimal approach in second-line treatment. We could not find variables associated with an optimal first or third-line treatment. CONCLUSION: The real-life management of CU in Argentina is partly suboptimal according to the international guidelines. This article is protected by copyright. All rights reserved.

4.
Oxid Med Cell Longev ; 2019: 5641645, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31531184

RESUMO

Purpose: This study investigates whether functionality and/or expression changes of transient receptor potential vanilloid 1 (TRPV1) and transient receptor potential ankyrin 1 (TRPA1) channels, oxidative stress, and hydrogen sulfide (H2S) are involved in the bladder dysfunction from an insulin-resistant obese Zucker rat (OZR). Materials and Methods: Detrusor smooth muscle (DSM) samples from the OZR and their respective controls, a lean Zucker rat (LZR), were processed for immunohistochemistry for studying the expression of TRPA1 and TRPV1 and the H2S synthase cystathionine beta-synthase (CBS) and cysthathionine-γ-lyase (CSE). Isometric force recordings to assess the effects of TRPA1 agonists and antagonists on DSM contractility and measurement of oxidative stress and H2S production were also performed. Results: Neuronal TRPA1 expression was increased in the OZR bladder. Electrical field stimulation- (EFS-) elicited contraction was reduced in the OZR bladder. In both LZR and OZR, TRPA1 activation failed to modify DSM basal tension but enhanced EFS contraction; this response is inhibited by the TRPA1 blockade. In the OZR bladder, reactive oxygen species, malondialdehyde, and protein carbonyl contents were increased and antioxidant enzyme activities (superoxide dismutase, catalase, GR, and GPx) were diminished. CSE expression and CSE-generated H2S production were also reduced in the OZR. Both TRPV1 and CBS expressions were not changed in the OZR. Conclusions: These results suggest that an increased expression and functionality of TRPA1, an augmented oxidative stress, and a downregulation of the CSE/H2S pathway are involved in the impairment of nerve-evoked DSM contraction from the OZR.

5.
Rev Esp Enferm Dig ; 1112019 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-31538485

RESUMO

Ectopic hepatocellular carcinoma is a rare entity. Most cases are asymptomatic and are occasionally found during autopsy or laparoscopy. They may sometimes cause relevant clinical problems such as abdominal pain or intra-abdominal bleeding. In this clinical case report, we review the literature in order to decipher the case of a 68-year-old female with an ectopic hepatocellular carcinoma that arose from the peritoneum. The patient was diagnosed after being studied due to a mild asymptomatic hypertransaminasemia.

6.
Medicina (B Aires) ; 79(4): 276-279, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31487247

RESUMO

There is limited epidemiological information on AA amyloidosis in Argentina, so the objective of this study was to describe the epidemiological characteristics of this disease in a tertiary hospital in our country. We designed a prospective clinical cohort of all consecutive patients with AA amyloidosis confirmed by immunohistochemistry in tissue from the Institutional Registry of Amyloidosis of the Hospital Italiano de Buenos Aires, in the period 04/01/2012- 12/31/2017. Of the 121 patients in the registry, 18 were included with AA for the analysis. Of the total included, 50% (9) were female, with a median age of 53.5 (interquartile range, RII 46-61) years. The 88.9% (16) of cohort presented renal compromise, all had proteinuria, and 6 required dialysis. Six had amyloid infiltration of the digestive system. The latency between the onset of the underlying disease and the diagnosis of AA had a median of 27 (RII 8-35) years. The underlying disease was of inflammatory origin in 6 cases. In 50% (9) of the patients the cause of AA amyloidosis was unknown. In the remaining 50%, these causes resemble those observed in developed countries. Furthermore, our results highlight the importance of their differential diagnosis to identify the most appropriate treatment or follow-up according to the situation presented by each patient.


Assuntos
Amiloidose/diagnóstico , Proteína Amiloide A Sérica/análise , Adulto , Idoso , Argentina , Estudos de Coortes , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
7.
Artigo em Inglês | MEDLINE | ID: mdl-31494553

RESUMO

Boolean models are a powerful abstraction for qualitative modeling of gene regulatory networks. With the recent availability of advanced high-throughput technologies, Boolean models have increasingly grown in size and complexity, posing a challenge for existing software simulation tools that have not scaled at the same speed. Field Programmable Gate Arrays (FPGAs) are pow- erful reconfigurable integrated circuits that can offer massive performance improvements. Due to their highly parallel nature, FPGAs are well suited to simulate complex molecular networks. We present here a new simulation framework for Boolean models, which first converts the model to Verilog, a standardized hardware description language, and then connects it to an execution core that runs on an FPGA coherently attached to a POWER8 processor. We report an order of magnitude speedup over a multi-threaded software simulation tool running on the same processor on a selection of Boolean models. Analysis on a T-cell large granular lymphocyte leukemia (T-LGL) demonstrates that our framework achieves consistent performance improvements resulting in new biological insights. In addition, we show that our solution allows to perform attractor detection at an unprecedented speed, exhibiting a speedup ranging from one to three orders of magnitude compared to alternative software solutions.

8.
An Pediatr (Barc) ; 2019 Sep 02.
Artigo em Espanhol | MEDLINE | ID: mdl-31488383

RESUMO

INTRODUCTION: More than five million children have been conceived by assisted reproductive techniques (ART) around the world. Most authors agree that there are no differences in psychomotor development in comparison to naturally conceived children. However, these results are still contradictory. OBJECTIVE: To determine whether children born from a cohort of ART-clinical gestations have a higher risk of suffering neurodevelopmental disorders in comparison to a control group. The potential associated ART-factors associated were also determined. MATERIAL AND METHODS: The study included the assessment of children up to 3 years old conceived by ART, and born from a cohort of women treated by the reproduction unit of a public hospital from May 2012 to May 2014. A simultaneous assessment was made of matched controls, by following the newborn naturally conceived after the ART-case, of the same group of maternal age, gestational age, and type of gestation. RESULTS: There were 243 clinical gestations and 267 ART-newborns, of which 231 were assessed (87%). A simultaneous assessment was carried out in 208/230 controls (90%). There were no differences in neurodevelopmental disorders (global developmental delay, autism spectrum or language delay). Multivariate analysis of potential ART factors only showed an association between transfer of frozen embryos with language delay that has not been previously described. CONCLUSIONS: There were no differences between groups after adjusting the results according to maternal age, multiple pregnancy, and other possible confounding factors, supporting that the role of these factors may be more relevant than the ART itself. The association between frozen embryo transfer and language delay has not been previously described. Thus, more studies are needed to confirm or refute this relationship.

9.
Rev Esp Salud Publica ; 932019 Sep 06.
Artigo em Espanhol | MEDLINE | ID: mdl-31488808

RESUMO

OBJECTIVE: Chronic patients suffer a greater number of health problems and have greater needs for assistance and care. The objective was to describe the use of health services in Primary Care in patients with chronic conditions according to risk level by adjusted morbidity groups (AMG) and analyze the associated factors. METHODS: Cross-sectional study. We included patients ≥18 years-old identified as chronic by the stratification tool according to AMG in a basic health area in the Community of Madrid with an assigned population of 18,107 inhabitants. Sociodemographic, clinical-care and use of services variables were collected and were classified according to the "behavioral" model in predisposing, need or facilitators factors. Univariate, bivariate and multiple linear regression adjusted with robust estimators was performed. RESULTS: 9,443 chronic patients (52.1% of the population in the selected zone) were identified, mean age of 57.8 (SD=18.7); 62.1% women. According to their risk level 4.7% were high risk, 18.7% medium risk and 76.6% low risk. The mean number of contacts per year was 14.1 (SD=15.2); 34.4 (SD=27.9) in high risk; 21.8 (SD=17.2) in medium risk and 10.1 (SD=10.2) in low risk. 7.5 (SD=7.1) contacts were with the doctor and 12.9 (SD=12.9) were face-to-face. The factors associated with higher use of services were high risk (Coefficient B[CB]=12.6; IC95%=11-14.2), immobilization (CB=8.8; IC95%=7.3-10.4), polypharmacy (CB=6; IC95%=5-8.6), female sex (CB=1; IC95%=0.4-1.5), number of chronic diseases (CB=1; IC95%=0.8-1.2) and age (CB=0.03; IC95%=0.01-0.05). CONCLUSIONS: The health services utilization in Primary Care in chronic patients is high and increased according with the risk level by AMG. The contact with the doctor is superior to nurse and the most frequent type is face-to-face. The greater utilization of services responds to predisposing factors (female sex and age) and above all to need factors (high risk, immobility, multimorbidity and polypharmacy).

10.
Epigenetics ; : 1-21, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31512982

RESUMO

Epigenetic information is able to interact with the cellular environment and could be especially useful for reprograming gene expression in response to a physiological perturbation. In fact the genes induced or repressed by osmotic stress undergo significant changes in terms of the levels of various histone modifications, especially in the acetylation levels of histone H3. Exposing yeast to high osmolarity results in the activation of stress-activated protein kinase Hog1, which plays a central role in gene expression control. We evaluated the connection between the presence of Hog1 and changes in histone H3 acetylation in stress-regulated genes. We found a parallel increase in the acetylation of lysines 9 and 14 of H3 in induced genes during stress, which was largely dependent on Hog1 at the genome-wide level. Conversely, we observed that acetylation decreased in repressed genes and was not dependent on Hog1. However, lack of Hog1 sometimes produced different, and even opposite, effects on the induction and acetylation of H3 of each gene. We also found that the acetylation state of lysine 9 of H3 was altered in the strains deficient in Nut1 HAT and Hos1 HDAC in the genes up-regulated during osmotic stress in an Msn2/Msn4-independent manner, while lysine 9 acetylation of H3 varied in the strains deficient in Sas2 HAT and Rpd3 HDAC for the Msn2/Msn4-dependent induced genes. The results presented here show new, unexpected participants in gene regulation processes in response to environmental perturbations.

11.
Eur J Pharm Biopharm ; 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31493509

RESUMO

Itraconazole (ITR) is a broad-spectrum antifungal drug with a very low solubility. In this work, the application of a heat induced evaporative antisolvent nanoprecipitation process yielded disordered nanoparticles (NPs) of ITR. The inclusion of different types of poly(ethylene glycol) (PEG) allowed PEGylation of NPs by adsorption to be achieved. The NP dispersions were composed of monodispersed particles in a nanometric size range (<290 nm) and although PEGylation had no impact on the average particle size, the surface potential was partially neutralised in the modified NPs. The solid state analysis using powder X-ray diffraction and thermal analysis revealed a disordered, liquid crystalline smectic organisation of the non-PEGylated NPs, while some of the PEGylated NPs were more crystalline. The PEGylated NPs exhibited mucoadhesive potential in stationary conditions (dynamic light scattering analysis) but when flow conditions were applied (nanoparticle tracking analysis and quartz crystal microbalance with dissipation) the particles had mucopenetrative properties. The non-PEGylated ITR NPs did not interact with mucin and therefore, this system was considered as having mucopenetrative character. This study demonstrates that the properties of NPs made of organic drug molecules can be modified by polymers, which may impact on their interaction with mucin and therefore on their potential systemic absorption.

12.
Arch Argent Pediatr ; 117(5): e523-e526, 2019 Oct 01.
Artigo em Espanhol | MEDLINE | ID: mdl-31560505

RESUMO

Constrictive pericarditis is a rare entity in pediatrics in which there is a limitation for cardiac diastole due to fibrosis of the pericardium. The etiopathogenic origin of this pathology is multiple, finding idiopathic constrictive pericarditis firstly and Mycobacterium tuberculosis infection secondly. Diagnosis is a clinical challenge since it requires a high degree of suspicion. It usually presents as oligosymptomatic or with signs and symptoms of low cardiac output. The presence of edema, ascites and impaired liver function usually guides the study towards primary liver disease. A careful clinical history and physical examination together with adequate imaging studies are the cornerstones of the diagnosis. Surgical treatment is curative in the vast majority of patients. We present the case of a 16-yearold patient with hepatomegaly and dyspnea grade 1-2 found in a routine health check-up.

13.
Redox Biol ; 28: 101330, 2019 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-31563085

RESUMO

Oxidative stress-associated endothelial dysfunction is a key pathogenic factor underlying the microvascular complications of metabolic disease. NADPH oxidase (Nox) is a major source of oxidative stress in diabetic nephropathy and chronic kidney disease, despite Nox4 and Nox2 have been identified as relevant sources of vasodilator endothelial H2O2.The present study was sought to investigate the role of Nox enzymes in renal vascular oxidative stress and endothelial dysfunction in a rat model of genetic obesity. Endothelial function was assessed in intrarenal arteries of obese Zucker rats (OZR) and their counterparts lean Zucker rats (LZR) mounted in microvascular myographs, and superoxide (O2.-) and H2O2 production were measured. Impaired endothelium-dependent relaxations to acetylcholine (ACh) were associated to augmented O2.- generation, but neither ROS scavengers nor the Nox inhibitor apocynin significantly improved these relaxant responses in renal arteries of OZR. Whereas NO contribution to endothelial relaxations was blunted, catalase-sensitive non-NO non-prostanoid relaxations were enhanced in obese rats. Interestingly, NADPH-dependent O2.- production was augmented while NADPH-dependent H2O2 generation was reduced, and cytosolic and mitochondrial SOD were up-regulated in kidney of obese rats. Nox4 was down-regulated in renal arteries and Nox4-dependent H2O2 generation and endothelial relaxation were reduced in OZR. Up-regulation of both Nox2 and Nox1 was associated with augmented O2.- production but reduced H2O2 generation and blunted endothelial Nox2-derived H2O2-mediated in obese rats. Moreover, increased Nox1-derived O2.- contributed to renal endothelial dysfunction in OZR. In summary, the current data support a main role for Nox1-derived O2.- in kidney vascular oxidative stress and renal endothelial dysfunction in obesity, while reduced endothelial Nox4 expression associated to decreased H2O2 generation and H2O2-mediated vasodilatation might hinder Nox4 protective renal effects thus contributing to kidney injury. This suggests that effective therapies to counteract oxidative stress and prevent microvascular complications must identify the specific Nox subunits involved in metabolic disease.

14.
J Rheumatol ; 2019 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-31474598

RESUMO

OBJECTIVE: Genetic and environmental backgrounds influence the development of rheumatoid arthritis (RA). In Latin America epidemiologic data are scarce. We aimed to determine the prevalence of RA in Chile in a population-based study. METHODS: The National Health Survey was a cross-sectional household survey with a stratified multistage probability sample of 6,233 participants performed between August 2016 and March 2017. A screening instrument for RA was applied to a random sample of 3,700 subjects >30 years old. Positive screening was defined by at least one of the following: (i) 2 swollen joints for at least 4 consecutive weeks (past /present) and/or (ii) a diagnosis of arthritis in the past. Individuals with positive screening had Rheumatoid Factor, Anti-citrullinated protein antibodies, and C-reactive protein measured and clinical examination performed by a rheumatologist. Self-report of doctordiagnosed RA was also performed. RESULTS: The screening questionnaire was applied to 2,998 subjects. Seven hundred and thirty-eight (22.1%) had positive screening. Among subjects with positive screening 493 (66%) had a clinical evaluation performed by a rheumatologist. Using ACR/EULAR 2010 classification criteria prevalence was 0.6% (95%CI 0.3, 1.2). Prevalence was higher in female gender. Three point three percent of subjects self-reported having RA. CONCLUSION: According to this national population-based study RA prevalence in Chile is 0.6% (0.3, 1.2), a value similar to what has been found in developed Caucasian countries and slightly lower than some Latin American countries. Self-reporting leads to overestimating RA.

15.
Int J Med Inform ; 131: 103955, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31487575

RESUMO

INTRODUCTION: Social media networks have transformed the sources of information, including health information. In particular, the microblogging service Twitter has been used as a learning tool in the field of medicine as well as a tool for disease surveillance and outbreak management. As antimicrobial resistance is one of the biggest concerns of public health, we aimed to review how Twitter is being used as a tool for antimicrobial stewardship (AMS). METHODS: We used the software Kampal Social® to collect, analyze and monitor tweets from the whole Twitter network to assess the activity that takes place about antibiotics. The study was carried out in three phases: data acquisition, during which we collected data over a six-month period (from 21 September 2016 to 8 February 2017) by monitoring selected users, hashtags and keywords that we knew to be related to AMS; data cleansing, which involved identifying users who were not related to the topic, thus creating a new collection process to remove those users and add newly discovered ones; and, finally, data acquisition and analysis (From 1 April 2017 to 7 March 2018), during which we collected data using the new users obtained in the cleansing phase. We qualitatively characterized the most influential users, we analysed the use of hashtags and the flow of information (the most retweeted users and the global network formed by all the users). RESULTS: Using the tool Kampal Social®, and after a cleansing phase to remove irrelevant information, we worked with a dataset of 1,765,388 tweets. Studying the qualitative characterization of the top-ten influencers, we found that most of them are institutional users, but individual users, such as physicians, and an important medical journal also appeared. Regarding hashtags, '#antibiotics' was the one with the most occurrences. Hashtags follow a regular distribution over time, with some defined peaks connected to important dates and reports about antibiotics. As for the flow of information, we obtained a rather dense network of interconnections formed by all the users who had sent a message, which means that a strong relation exists between the different organizations, professionals and users in general. CONCLUSIONS: Institutions, medical journals, physicians and pharmacists are key opinion leaders in the topic of antibiotics, so they must incorporate social media into their communication strategy to spread the AMS message. More evidence is needed regarding the optimal method of communication to spread information throughout the general population. The development of tools capable of collecting and querying large amounts of Twitter data helped us to assess the impact of antibiotic awareness campaigns and to gain an idea of how Twitter is being used to spread the message about AMS.

16.
Hum Mutat ; 2019 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-31549748

RESUMO

Postaxial polydactyly (PAP) is a frequent limb malformation consisting in the duplication of the fifth digit of the hand or foot. Morphologically, this condition is divided into type A and B, with PAP-B corresponding to a more rudimentary extra-digit. Recently, bi-allelic truncating variants in the transcription factor GLI1 were reported to be associated with a recessive disorder, which in addition to PAP-A, may include syndromic features. Moreover, two heterozygous subjects carrying only one inactive copy of GLI1 were also identified with PAP. Herein, we aimed to determine the level of involvement of GLI1 in isolated PAP, a condition previously established to be autosomal dominantly inherited with incomplete penetrance. We analysed the coding region of GLI1 in 95 independent probands with non-syndromic PAP and found 11.57% of these subjects with single heterozygous pathogenic variants in this gene. The detected variants lead to premature termination codons or result in amino acid changes in the DNA-binding domain of GLI1 that diminish its transactivation activity. Family segregation analysis of these variants was consistent with dominant inheritance with incomplete penetrance. We conclude that heterozygous changes in GLI1 underlie a significant proportion of sporadic or familial cases of isolated PAP-A/B. This article is protected by copyright. All rights reserved.

17.
Artigo em Inglês | MEDLINE | ID: mdl-31529686

RESUMO

OBJECTIVE: To estimate the incidence and analyze any cancer-associated factors in patients with Systemic Lupus Erythematosus (SLE) differentiating between hormone-sensitive (HS) and non-HS cancers. METHODS: Retrospective multicentric study of a patient cohort from the SLE Registry of the Spanish Society of Rheumatology (RELESSER - Spanish acronym). Included are the following: the first cancer post-SLE diagnosis, clinical and sociodemographic information, cumulative damage, severity, comorbidities, treatments and refractoriness. Cancers were classified as HS (prostate, breast, endometrium and ovarian) and non-HS (the rest). Standardized Incidence Ratio (SIR) was calculated and logistic regression models were built. RESULTS: 3,539 patients (90.4% women) were included, 154 of whom presented cancer (91% women), 44 HS (100% women). Cancer SIR was 1.37 (CI 95%: 1.15-1.59), with higher values in women under 65s [2.38 (CI 95%: 1.84-2.91)]. SIR in women with HS vs. non-HS cancer was 1.02 (CI 95%: 0.13-1.91) and 1.93 (CI 95%: 0.98-2.89)], respectively. In HS vs. non-HS cancers, SLE diagnostic age [odds ratio (OR) 1.04 (p= 0.002) vs. 1.04 (p= 0.019), respectively] and period of disease evolution [OR 1.01 (p< 0.001) vs. 1.00 (p= 0.029), respectively] were associated with cancer. SLICC/ACR damage index [OR 1.27 (p= 0.022)] and ACE inhibitor prescriptions [OR 2.87 (p= 0.048)] were associated with non-HS cancers. CONCLUSION: Cancer incidence in SLE patients is higher than in the Spanish population, particularly among young women. This increase might be due to non-HS cancers, which would be associated with an SLE involving greater cumulative damage where more ACE inhibitors are prescribed.

18.
Parasitol Res ; 118(10): 2919-2924, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31493064

RESUMO

The transmission of diseases through parasites is a key mechanism in the regulation of plant and animal populations in ecosystems. Therefore, it is necessary to investigate the relative effect of the variables that can shape the specificity of host-parasite interactions. Previous studies have found that specialization of antagonistic interactions between fly ectoparasites and bats changes according to forest type, host richness, and roosting ecology of bats. In this study, we tested these hypotheses using data from 48 bat communities. In general, our results support previous findings that bat-fly interactions are specialized, resulting in lower niche overlap among bat flies species. In addition, we found that the specificity of bat-fly interactions is lower in tropical mountain forests and is positively related with the richness of bat host species of each study site. Finally, there was a higher bat flies niche overlap in smaller bat-fly interaction networks recorded in bat roosts in caves. We conclude that the roosting ecology of bats could be a key factor to understand the mechanisms related to the horizontal transmission of ectoparasitic flies among bats.

19.
Gac Sanit ; 2019 Sep 23.
Artigo em Espanhol | MEDLINE | ID: mdl-31558387

RESUMO

OBJECTIVE: To estimate the prevalence of medical visits due to osteoarticular problems by the adult general population in Spain and its association with sociodemographic, anthropometric and lifestyle variables. METHOD: Cross-sectional population-based study. Sample with 4916 subjects aged 20 years and over. A telephone questionnaire, with a question about medical visits due to osteoarticular problems, was used. To estimate the prevalence and its 95% confidence interval (95%CI), weights were calculated according to the probability of selection in each of the sampling stages. RESULTS: 28.9% (95%CI: 27.6-30.2) of the people reported having consulted a doctor in the last year because of osteoarticular problems. We observed an association with age, sex, level of education, and body mass index.

20.
J Alzheimers Dis ; 2019 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-31561372

RESUMO

BACKGROUND: Semantic dementia (SD) is a subtype of frontotemporal lobe degeneration characterized by semantic loss, with other cognitive functions initially preserved. SD requires differential diagnosis with Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Semantic knowledge can be evaluated through different tests; however, most of them depend on language. OBJECTIVE: We describe the development of a brief drawing task that may the helpful for the differential diagnosis of SD. METHODS: Seventy-two patients, including 32 AD, 19 bvFTD, and 21 SD were asked to draw 12 items with different age of acquisition and familiarity, belonging to four different semantic categories. We employed the drawings of healthy volunteers to build a scoring scheme. RESULTS: Turtle, strawberry, train, and envelope were the items of each category that best discriminated between groups and were selected for the Brief drawing task. The discriminatory power of the Brief drawing task between SD versus AD and bvFTD patients, estimated through the area under the curve was 0.84 (95% CI = 0.72-0.96, p = 0.000007). In a logistic model, the Brief drawing task (p = 0.003) and VOSP "number location" subtest (p = 0.016) were significant predictors of the diagnosis of SD versus AD and bvFTD after adjustment by the main covariates. The Brief drawing task provided clinically useful qualitative information. SD drawings were characterized by loss of the distinctive features, intrusions, tendency to prototype, and answers like "I don't know what this is". CONCLUSION: The Brief drawing task appears to reveal deficits in semantic knowledge among patients with SD that may assist in the differential diagnosis with other neurodegenerative diseases.

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