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4.
Viral Immunol ; 33(9): 600-609, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32986530

RESUMO

We aimed to characterize the contribution of hepatitis E virus (HEV) in perpetuating the cytokine-mediated inflammatory setting related to liver damage in the context of obesity. Herein, serum samples from patients with liver disease were retrospectively analyzed and categorized as normal-weight patients (NW), overweight patients (OW), obese patients (ObP), and high alcohol consumer patients (HAC), and biochemical, anthropometrical, and transient elastography measurements were obtained. The positivity for immunoglobulin M (IgM) and immunoglobulin G (IgG) anti-HEV antibodies in samples was determined by enzyme-linked immunosorbent assay. Available samples from ObP were tested by reverse transcription-nested polymerase chain reaction for the presence of HEV-RNA. Cytokine profile in the serum of ObP was identified using a multiplexed immune assay. Globally, the highest frequency of IgG anti-HEV was found in ObP (57.5%), followed by HAC (20%), OW (15%), and NW (7.5%). A strong association between HEV serology and obesity was found (odds ratio = 4.21, confidence interval = 1.91.9.27) with a cutoff of 29.3 kg/m2 (area under curve [AUC] = 0-66; p = 0.003) and, a 23.7% of available samples of ObP provided amplification of HEV genome. Cytokine analysis revealed significantly higher levels of proinflammatory cytokines (interleukin [IL]-12, interferon [IFN]-γ, and IL-1ß) in IgG anti-HEV-positive ObP than in IgG anti-HEV-negative ObP. Moreover, a high proportion of patients with positive serology showed advanced liver damage. In conclusion, the high percentage of anti-HEV antibodies and viral RNA detection in the setting of an excess of fat, along with an associated proinflammatory cytokine profile found in IgG anti-HEV-positive ObP with more severe liver disease, support an interplay between HEV and obesity.

5.
Vaccine ; 38(41): 6381-6387, 2020 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-32826103

RESUMO

BACKGROUND: A sense of urgency exists to develop vaccines against SARS CoV-2, responsible for numerous global cases and deaths, as well as widespread social and economic disruption. Multiple approaches have been proposed to speed up vaccine development, including accelerated randomized controlled trials (RCT), controlled human challenge trials (CHI), and wide distribution through an emergency use authorization after collecting initial data. There is a need to examine how best to accelerate vaccine development in the setting of a pandemic, without compromising ethical and scientific norms. METHODS: Trade-offs in scientific and social value between generating reliable evidence about safety and efficacy while promoting rapid vaccine availability are examined along five ethically relevant dimensions: (1) confidence in and generalizability of data, (2) feasibility, (3) speed and cost, (4) participant risks, and (5) social risks. RESULTS: Accelerated individually randomized RCTs permit expeditious evaluation of vaccine candidates using established methods, expertise, and infrastructure. RCTs are more likely than other approaches to be feasible, increase speed and reduce cost, and generate reliable data about safety and efficacy without significantly increasing risks to participants or undermining societal trust. CONCLUSION: Ethical analysis suggests that accelerated RCTs are the best approach to accelerating vaccine development in a pandemic, and more likely than other approaches to enhance social value without compromising ethics or science. RCTs can expeditiously collect rigorous data about vaccine safety and efficacy. Innovative and flexible designs and implementation strategies to respond to shifting incidence and test vaccine candidates in parallel or sequentially would add value, as will coordinated data sharing across vaccine trials. CHI studies may be an important complementary strategy when more is known. Widely disseminating a vaccine candidate without efficacy data will not serve the public health nor achieve the goal of identifying safe and effective SARS Co-V-2 vaccines.


Assuntos
Betacoronavirus/imunologia , Pesquisa Biomédica/ética , Infecções por Coronavirus/prevenção & controle , Desenvolvimento de Medicamentos/ética , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Humanos , Vacinação/ética , Vacinas Virais/imunologia
6.
Rev. Soc. Esp. Dolor ; 26(4): 227-232, jul.-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-191039

RESUMO

Objetivo: Determinar el valor predictivo de las variables sintomatología depresiva, nivel de catastrofismo y expectativa en el éxito de la infiltración terapéutica de la articulación sacroilíaca para el tratamiento del dolor lumbar crónico. Material y métodos: Estudio piloto observacional, descriptivo de tipo transversal (mayo-junio de 2017) en pacientes nuevos con dolor lumbar crónico de origen sacroilíaco sin trastorno psicológico/psiquiátrico previo y a los que nunca se les había realizado ningún tipo de infiltración. Se hizo una valoración clínica inicial y se aplicó un cuestionario estructurado para determinar la presencia de las variables expectativa, catastrofismo y sintomatología depresiva. Se programó para la realización de una infiltración sacroilíaca ecoguiada y posteriormente se realizó una nueva valoración clínica comparativa a las 4 semanas. Resultados: Participaron 28 pacientes (75 % mujeres), con una media de edad de 60 +/- 11,8 años. La puntuación basal en la escala visual analógica (EVA) fue de 7,64 +/- 1,42 y la puntuación basal en el EuroQol fue de 0,451 +/- 0,202. A las 4 semanas del procedimiento la EVA fue de 6,32 +/- 1,66 y el EuroQol de 0,594 +/- 0,242. Si bien todas las variables estudiadas mostraron un papel relevante en la respuesta clínica, la variable catastrofismo fue la que presentó mayor asociación con una escasa mejoría clínica (p = 0,001). Conclusiones: La detección y tratamiento precoces de variables de vulnerabilidad como la sintomatología depresiva, el grado de catastrofismo y el nivel de expectativa son determinantes para la obtención de mejores resultados terapéuticos en los pacientes con dolor crónico


Objective: To determine the predictive value of psychological variables (depressive symptomatology, catastrophism and expectation) in the success of the therapeutic sacroiliac joint injection for the treatment of chronic low back pain. Methodology: An observational, descriptive crosssectional pilot study (May-June 2017) in new patients with chronic lumbar pain of sacroiliac origin without psychological/psychiatric previous disorder who had never undergone any type of infi ltration. An initial clinical assessment was made, a structured questionnaire was applied to determine the presence of the variables expectation, catastrophism and depressive symptomatology. An ultrasound-guided sacroiliac infiltration was scheduled and a new clinical comparative assessment was performed after 4 weeks. Results: 28 patients were obtained (75% women) with an average age of 60+/-11.8 years. A baseline VAS was 7.64+/-1.42 and basaline EuroQol of 0.451+/- 0.202. After 4 weeks of the procedure, the VAS was 6.32+/-1.66 and the EuroQol was 0.594+/-0.242. Although all the variables showed a relevant role in the clinical response, the catastrophism was the greatest associated with poor clinical improvement (p=0.001). Conclusions: The detection and early treatment of vulnerability variables such as depressive symptomatology, catastrophism and the level of expectation are determining factor to obtaining better therapeutic outcomes in patients with chronic pain


Assuntos
Humanos , Dor Lombar/psicologia , Dor Crônica/psicologia , Manejo da Dor/psicologia , Depressão/epidemiologia , Catastrofização/epidemiologia , Medição da Dor/métodos , Dor Lombar/terapia , Dor Crônica/terapia , Manejo da Dor/métodos , Estudos Transversais , Analgesia/métodos , Analgésicos/uso terapêutico
7.
Ann Hepatol ; 18(1): 14-22, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31113583

RESUMO

Hepatitis A virus (HAV) is the most common cause of acute viral hepatitis worldwide. The virus is mainly transmitted via the fecaloral route and, the incidence of infection is closely related to low socioeconomic conditions and poor sanitation. Mexico, previously categorized an area of high endemicity for HAV infection, is undergoing epidemiological transition. However, a limited number of HAV-related scientific reports regarding to virus burden is available. According to the local government health agency (Secretarla de Salud, SSA in Spanish), from 1994 to 2017 a reduction in the incidence of hepatitis related to HAV has been reported. However, HAV is still the most common cause of viral hepatitis in the country, and the pediatric population is the most prone to be infected with this virus. The analysis of the SSA data reveals that most of the reported cases from 1994 to 2017 were found in highly industrialized states. This information contradicts the documented relationship between the highest prevalence of infection and the lowest socio-economic status, and supports the necessity of viral detection and notification of HAV cases. Moreover, in spite that four HAV vaccines are available in Mexico and universal vaccination has been shown to be beneficial in developing countries in terms of declining endemicity, HAV vaccination is not mandatory in Mexico. In this review, preventive strategies including appropriate diagnosis, vaccination and public health policies on the basis of the epidemiologic status of HAV in Mexico are discussed.


Assuntos
Anticorpos Anti-Hepatite A/imunologia , Vacinas contra Hepatite A/uso terapêutico , Vírus da Hepatite A/imunologia , Hepatite A/epidemiologia , Vacinação/métodos , Hepatite A/terapia , Humanos , Incidência , México/epidemiologia , Prevalência , Estudos Soroepidemiológicos
8.
Ann Hepatol ; 18(4): 571-577, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31080055

RESUMO

INTRODUCTION AND OBJECTIVES: To characterize the virological features of hepatitis E virus (HEV) in serum from patients exhibiting chronic liver damage. METHODS: A data-base of 513 unrelated individuals from West-Mexico with liver-disease determined by clinical and biochemical tests and transient elastography between 2011 and 2016 were retrospectively analyzed. According to infectious etiologies, patients were classified as hepatitis B virus (HBV)-, hepatitis C virus (HCV)-infected patients, and patients exhibiting chronic liver damage with non-identified infectious etiological agent (NIIEA). Available serum samples from NIIEA-patients were tested by RT-nPCR for the presence of HEV-RNA and partially sequenced for genotyping. RESULTS: Out of the 513 cases, 5.85% were patients infected with HBV, 67.64% with HCV, and 26.51% were NIIEA-patients. Among 76 available samples from NIIEA-cases, 30.26% tested positive for HEV-RNA. Twelve (15.79%) partial HEV sequences allowed phylogenetic analysis, revealing the classification of HEV as HEV-Gt3. Advanced fibrosis (F3-F4 stage) was found in a 26.1% of patients with HEV-active infection. CONCLUSION: Although HCV is the main infectious agent related to chronic liver disease in Mexico, liver damage without an infectious etiology is common. Our findings reveal that an elevated rate of chronic liver disease might be represented by autochthonous infection of HEV-Gt3, whose detection makes Mexico unique in Latin-America with the circulation of HEV strains belonging to three genotypes (Gt1, Gt2, and Gt3). Thus, HEV infection should be a matter of health concern, and mandates for HEV screening to properly handle this commonly undiagnosed disease.


Assuntos
Vírus da Hepatite E/genética , Hepatite E/epidemiologia , Cirrose Hepática/virologia , RNA Viral/sangue , Adulto , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Bilirrubina/sangue , Doença Crônica , Técnicas de Imagem por Elasticidade , Feminino , Genótipo , Hepatite E/sangue , Hepatite E/diagnóstico , Hepatite E/virologia , Humanos , L-Lactato Desidrogenase/sangue , Cirrose Hepática/sangue , Hepatopatias/sangue , Hepatopatias/virologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Contagem de Plaquetas , Reação em Cadeia da Polimerase , RNA Viral/análise , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , gama-Glutamiltransferase/sangue
9.
J Neurosurg ; 128(1): 262-271, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28298047

RESUMO

OBJECTIVE Diagnosing nosocomial meningitis (NM) in neurosurgical patients is difficult. The standard CSF test is not optimal and when it is obtained, CSF cultures are negative in as many as 70% of cases. The goal of this study was to develop a diagnostic prediction rule for postoperative meningitis using a combination of clinical, laboratory, and CSF variables, as well as risk factors (RFs) for CNS infection. METHODS A cross-sectional study was performed in 4 intensive care units in Medellín, Colombia. Patients with a history of neurosurgical procedures were selected at the onset of febrile symptoms and/or after an increase in acute-phase reactants. Their CSF was studied for suspicion of infection and a bivariate analysis was performed between the dependent variable (confirmed/probable NM) and the identified independent variables. Those variables with a p value ≤ 0.2 were fitted in a multiple logistic regression analysis with the same dependent variable. After determining the best model according to its discrimination and calibration, the ß coefficient for each selected dichotomized variable obtained from the logistic regression model was used to construct the score for the prediction rule. RESULTS Among 320 patients recruited for the study, 154 had confirmed or probable NM. Using bivariate analysis, 15 variables had statistical associations with the outcome: aneurysmal subarachnoid hemorrhage (aSAH), traumatic brain injury, CSF leak, positioning of external ventricular drains (EVDs), daily CSF draining via EVDs, intraventricular hemorrhage, neurological deterioration, age ≥ 50 years, surgical duration ≥ 220 minutes, blood loss during surgery ≥ 200 ml, C-reactive protein (CRP) ≥ 6 mg/dl, CSF/serum glucose ratio ≤ 0.4 mmol/L, CSF lactate ≥ 4 mmol/L, CSF leukocytes ≥ 250 cells, and CSF polymorphonuclear (PMN) neutrophils ≥ 50%. The multivariate analysis fitted a final model with 6 variables for the prediction rule (aSAH diagnosis: 1 point; CRP ≥ 6 mg/dl: 1 point; CSF/serum glucose ratio ≤ 0.4 mmol/L: 1 point; CSF leak: 1.5 points; CSF PMN neutrophils ≥ 50%: 1.5 points; and CSF lactate ≥ 4 mmol/L: 4 points) with good calibration (Hosmer-Lemeshow goodness of fit = 0.71) and discrimination (area under the receiver operating characteristic curve = 0.94). CONCLUSIONS The prediction rule for diagnosing NM improves the diagnostic accuracy in neurosurgical patients with suspicion of infection. A score ≥ 6 points suggests a high probability of neuroinfection, for which antibiotic treatment should be considered. An independent validation of the rule in a different group of patients is warranted.


Assuntos
Infecção Hospitalar/diagnóstico , Meningite/diagnóstico , Meningite/etiologia , Procedimentos Neurocirúrgicos , Complicações Pós-Operatórias/diagnóstico , Adulto , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Infecção Hospitalar/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Meningite/epidemiologia , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Prognóstico , Curva ROC , Estudos Retrospectivos , Fatores de Risco
10.
J Endod ; 44(1): 4-8, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29079057

RESUMO

INTRODUCTION: A prospective, multicentered, randomized clinical trial was designed to assess if controlled irrigation with cold saline could result in less incidence and intensity of postoperative pain in patients presenting with pulp necrosis and symptomatic apical periodontitis. METHODS: A total of 210 patients (presenting with necrotic uniradicular teeth with a diagnosis of symptomatic apical periodontitis and a preoperative visual analog scale (VAS) score higher than 7) were randomly allocated in the control or experimental group after the completion of shaping and cleaning procedures. The experimental group received a final irrigation with 20 mL sterile cold (2.5°C) saline solution delivered to the working length with a sterile, cold (2.5°C) Endovac microcannula (Kerr Endo, Orange Country, CA) for 5 minutes. The same protocol was used in the control group with room temperature saline solution. Patients were instructed to record the presence, duration and level of postoperative pain, and analgesic medication intake. A logistic regression was used to compare the incidence of postoperative pain and the need for painkillers between groups. Differences in general pain intensity between groups were analyzed using the ordinal (linear) chi-square test. Postoperative pain after 6, 24, and 72 hours (recorded in a VAS scale) and the need for analgesic medication intake between the 2 groups were assessed using the Mann-Whitney U test. RESULTS: Patients in the control group presented a significantly higher incidence of postoperative pain, intensity, and need for medication intake (P < .05). CONCLUSIONS: Cryotherapy reduced the incidence of postoperative pain and the need for medication intake in patients presenting with a diagnosis of necrotic pulp and symptomatic apical periodontitis.


Assuntos
Crioterapia , Necrose da Polpa Dentária/terapia , Dor Pós-Operatória/prevenção & controle , Periodontite Periapical/terapia , Adulto , Crioterapia/métodos , Cavidade Pulpar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Cloreto de Sódio/administração & dosagem , Irrigação Terapêutica
11.
Viral Immunol ; 31(3): 223-232, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29099687

RESUMO

Bilirubin (BR), a metabolite with increased concentrations in plasma during viral hepatitis, has been recognized as a potential immune-modulator. We recently reported that conjugated BR (CB) augments regulatory T cell (Treg) suppressor activity during acute hepatitis A virus (HAV) infection. However, the mechanisms related to the effects of CB on Treg function in the course of hepatotropic viral diseases have not been elucidated. T cell immunoglobulin domain and mucin domain 3 (TIM-3), via its interactions with galectin-9 (GAL-9), is a receptor associated with enhanced Treg function. Thus, TIM-3 expression may be related to the crosstalk between CB and Tregs during HAV infection. Herein, in vitro treatment with high concentrations of CB upregulated TIM-3 expression on Tregs from healthy donors. CB treatment in vitro did not induce de novo Treg generation, and in vitro stimulation with TGF-ß, which shows increased secretion during HAV infection, resulted in a trend toward increased TIM-3 expression on Tregs and CD4+ T lymphocytes (TLs) from healthy donors. Interestingly, an upregulation of TIM-3 expression on CD4+CD25+ T cells and an increase in the proportion of CD4+ TLs expressing GAL-9 were found in HAV-infected patients with abnormal CB values relative to healthy controls. In addition, a statistically significantly reduction in IL-17F production was observed after treatment of CD4+ TLs from healthy donors with high doses of CB in vitro. In summary, our results suggest that CB might regulate Treg activity via a TIM-3-mediated mechanism, ultimately leading to an anti-inflammatory hepatoprotective effect.


Assuntos
Bilirrubina/metabolismo , Receptor Celular 2 do Vírus da Hepatite A/biossíntese , Hepatite A/patologia , Fatores Imunológicos/metabolismo , Linfócitos T Reguladores/efeitos dos fármacos , Regulação para Cima , Adolescente , Antígenos CD4/análise , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Interleucina-17/análise , Subunidade alfa de Receptor de Interleucina-2/análise , Masculino , Linfócitos T Reguladores/química
12.
Injury ; 49(2): 230-235, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29224905

RESUMO

Penetrating eye injuries are surgical emergencies with guarded visual prognosis. The purpose of the current study was to determine the force required to rupture the cornea with a penetrating object, and to study how this force is affected by the object geometry. Thirty-six human cadaveric eyes from donors of various ages were characterized for diameter, axial length, and pre-test intraocular pressure. In order to investigate the effects of specimen storage time on the tissue response, half of the specimens were tested within two weeks of donor expiration, and half of the specimens were stored at -4°C for 12-18 months. Indenters of three different diameters (1.0, 1.5, and 2.0mm) were lowered into the apex of the cornea until rupture. Resistance to displacement (stiffness), displacement at failure, and the force at failure were determined. Multi-variable regression analysis was used to determine associations of the input variables (indenter size, test speed, and tissue postmortem time) on the mechanics of the tissue response. Twenty-nine of the 36 specimens failed at the indenter location in the cornea, four failed at the limbus, and three failed in the sclera near sites of muscle attachment. The average force at failure caused by the 1.0mm, 1.5mm, and 2.0mm indenters increased from 30.5±5.5N to 40.5±8.3N to 58.2±14.5N, respectively (p<0.002). The force at failure was associated with the donor age (p<0.001), and globe diameter (p<0.041), but was not associated with pre-test intraocular pressure, tissue postmortem time, axial length, or speed of the indenter. This study has quantified the force-displacement and failure response of a large series of human cadaveric eyes subjected to penetrating indentation loads on the cornea. The results provide useful data for characterizing the relationship between corneal rupture and the geometry of a penetrating object.


Assuntos
Córnea/patologia , Ferimentos Oculares Penetrantes/patologia , Órbita/patologia , Adulto , Idoso , Cadáver , Córnea/fisiologia , Elasticidade/fisiologia , Humanos , Pressão Intraocular/fisiologia , Pessoa de Meia-Idade , Fenômenos Fisiológicos Oculares , Estresse Mecânico , Doadores de Tecidos
13.
Pediatr Infect Dis J ; 36(7): 689-692, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28604562

RESUMO

The frequency of hepatitis A virus and hepatitis E virus infections and their cytokine profiles were analyzed in Mexican pediatric patients with acute hepatitis. A high frequency of coinfections was found. Significant overexpression of interleukin (IL)-4, IL-12, IL-13 and interferon-gamma during hepatitis A virus monoinfections and limited secretion of cytokines in hepatitis E virus infections were observed.


Assuntos
Coinfecção/imunologia , Citocinas/sangue , Hepatite A/complicações , Hepatite A/imunologia , Hepatite E/complicações , Hepatite E/imunologia , Doença Aguda/epidemiologia , Adolescente , Criança , Pré-Escolar , Coinfecção/epidemiologia , Coinfecção/virologia , Hepatite A/epidemiologia , Hepatite A/virologia , Vírus da Hepatite A/imunologia , Anticorpos Anti-Hepatite/sangue , Hepatite E/epidemiologia , Hepatite E/virologia , Vírus da Hepatite E/imunologia , Humanos , Lactente , Recém-Nascido , México/epidemiologia , Estudos Retrospectivos
14.
J Mech Behav Biomed Mater ; 66: 104-110, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27863285

RESUMO

Penetration injuries of the eye are among the most frequent causes of permanent visual impairment resulting from trauma. The purpose of this study was to determine the peak strain at which rupture occurs in the cornea due to a penetrating object. Probes of varying diameters (1.0, 1.5, and 2.0mm) were pressed into the apex of the cornea of 36 human cadaveric eye specimens until perforation or rupture of the specimen at the cornea, limbus, or sclera occurred. An axisymmetric finite element model of the human globe was created to replicate the experimental set-up. The models were used to map the force-displacement response of the experiments and quantitatively determine a peak strain at which the eye ruptures. For the experiments, the average force at failure increased from the smallest to largest probe (p<0.002). The average forces at failure are as follows: 30.5±5.5N (1.0mm probe); 40.5±8.3N (1.5mm probe); 58.2±14.5N (2.0mm probe). The force-displacement responses of the finite element models of all three probe sizes bounded and tracked the experimental data. In all cases, the peak strain at failure in the cornea was located on the posterior surface of the cornea, directly adjacent to the corneal apex. This strain was in the range of 29% to 33% for all models analyzed. In addition to determining an objective failure strain of corneal tissue, the model developed in this study can provide quantitative information for understanding the risk of penetrating eye injuries.


Assuntos
Lesões da Córnea , Ferimentos Oculares Penetrantes , Cadáver , Córnea/patologia , Análise de Elementos Finitos , Humanos , Esclera/patologia
15.
Mediators Inflamm ; 2016: 1759027, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27578921

RESUMO

We recently reported an immune-modulatory role of conjugated bilirubin (CB) in hepatitis A virus (HAV) infection. During this infection the immune response relies on CD4+ T lymphocytes (TLs) and it may be affected by the interaction of HAV with its cellular receptor (HAVCR1/TIM-1) on T cell surface. How CB might affect T cell function during HAV infection remains to be elucidated. Herein, in vitro stimulation of CD4+ TLs from healthy donors with CB resulted in a decrease in the degree of intracellular tyrosine phosphorylation and an increase in the activity of T regulatory cells (Tregs) expressing HAVCR1/TIM-1. A comparison between CD4+ TLs from healthy donors and HAV-infected patients revealed changes in the TCR signaling pathway relative to changes in CB levels. The proportion of CD4+CD25+ TLs increased in patients with low CB serum levels and an increase in the percentage of Tregs expressing HAVCR1/TIM-1 was found in HAV-infected patients relative to controls. A low frequency of 157insMTTTVP insertion in the viral receptor gene HAVCR1/TIM-1 was found in patients and controls. Our data revealed that, during HAV infection, CB differentially regulates CD4+ TLs and Tregs functions by modulating intracellular pathways and by inducing changes in the proportion of Tregs expressing HAVCR1/TIM-1.


Assuntos
Bilirrubina/farmacologia , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD4-Positivos/metabolismo , Vírus da Hepatite A/metabolismo , Linfócitos T Reguladores/efeitos dos fármacos , Linfócitos T Reguladores/metabolismo , Adolescente , Adulto , Células Cultivadas , Feminino , Receptor Celular 1 do Vírus da Hepatite A/genética , Humanos , Interleucina-17/metabolismo , Subunidade alfa de Receptor de Interleucina-2/metabolismo , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético , Transdução de Sinais/efeitos dos fármacos , Adulto Jovem
16.
Open Biomed Eng J ; 10: 62-71, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27583035

RESUMO

BACKGROUND: Creating appropriately-sized, lethal isotherms during cryoablation of renal tumors is critical in order to achieve sufficiently-sized zones of cell death. To ensure adequate cell death in target treatment locations, surgeons must carefully select the type, size, location, and number of probes to be used, as well as various probe operating parameters. OBJECTIVE: The current study investigates the effects of probe type, operating pressure, and clinical method on the resulting sizes of isotherms in an in vitro gelatin model. METHOD: Using a total of four cryoprobes from two manufacturers, freeze procedures were conducted in gelatin in order to compare resulting sizes of constant temperature zones (isotherms). The effects of certain procedural parameters which are clinically adjustable were studied. RESULTS: Test results show that the sizes of 0 °C,-20 °C and -40 °C isotherms created by similarly-sized probes from two different manufacturers were significantly different for nearly all comparisons made, and that size differences resulting from changing the operating pressure were not as prevalent. Furthermore, isotherm sizes created using a multiple freeze procedure (a ten minute freeze, followed by a five minute passive thaw, followed by another ten minute freeze) did not result in statistically-significant differences when compared to those created using a single freeze procedure in all cases. CONCLUSION: These results indicate that selection of the probe manufacturer and probe size may be more important for dictating the size of kill zones during cryoablation than procedural adjustments to operating pressures or freeze times.

17.
Rev. méd. hondur ; 83(1/2): 33-37, ene.-jun. 2015. tab
Artigo em Espanhol | LILACS | ID: biblio-942

RESUMO

Objetivo: Describir las características clínicas de los Trauma Vascular Periférico en pacientes atendidos en el Hospital Escuela Universitario. Metodología: Estudio descriptivo, retrospectivo incluyendo a todos los pacientes atendidos en el Hospital desde 01 de febrero de 2014 hasta el 28 de febrero de 2015. La información se obtuvo de las historias clínicas. Resultados: Se encontraron 21 pacientes con trauma vascular periférico, de los cuales el 100% pertenecen al sexo masculino, la edad frecuentemente afectada es entre los 20 a 29 años 38.1 %. El tipo de trauma encontrado fue trauma abierto en un 100%. La causa de lesión vascular más frecuente fue la agresión 66.67%. Los mecanismos de lesión encontrados fueron: herida por arma de fuego 76.19%, herida por arma blanca 19.05% e iatrogénico en un paciente 4.76%. Los miembros inferiores fueron la parte más afectada con un 52.38%. No hubo mortalidad. Conclusión: Las heridas por traumas vasculares periféricos son cada vez más frecuentes en nuestro medio y el diagnóstico y tratamiento no es difícil en la mayoría de los casos...(AU)


Assuntos
Humanos , Masculino , Adulto , Traumatismo Cerebrovascular , Traumatismo Múltiplo/complicações , Traumatismos dos Nervos Periféricos , Ferimentos Penetrantes/classificação
18.
Mem Inst Oswaldo Cruz ; 110(2): 263-6, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25946253

RESUMO

We determined the serum IgE levels and T-helper (Th)17-related cytokines during distinct hepatitis A virus (HAV)-induced clinical courses in children. A significantly higher concentration of macrophage inflammatory protein 3α, interleukin (IL)-17E and IL-17F in HAV-infected children with intermediate liver injury compared with those with minor liver damage was found. A reduction in the IgE levels in those patients who showed the highest levels of IL-17F in the group of intermediate liver injury was found. The data suggested that the Th17-related profile is associated with the severity of HAV infection and might play a role on the modulation achieved by HAV during allergies.


Assuntos
Vírus da Hepatite A Humana/imunologia , Hepatite A/imunologia , Imunoglobulina E/sangue , Interleucina-17/sangue , Células Th17/imunologia , Adolescente , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Fígado/enzimologia , Masculino , Estudos Retrospectivos , Índice de Gravidade de Doença , Células Th17/metabolismo
19.
Mem Inst Oswaldo Cruz ; 110(2): 267-71, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25946254

RESUMO

The mechanisms related to the spontaneous clearance of hepatitis C virus (HCV) have been primarily studied in regions where the infection is endemic. Results of prior studies have been extrapolated to populations with low endemicity, such as Mexico. Herein, we determined the cytokine profiles in serum samples from Mexican patients who spontaneously cleared HCV and patients chronically infected with HCV genotype 1a. Chronic HCV-infected patients displayed increased interleukin (IL)-8 and regulated upon activation, normal T-cell expressed and secreted (CCL-5) secretion, whereas patients who spontaneously cleared HCV showed augmented levels of IL-1 alpha, tumour necrosis factor-alpha, transforming growth factor-beta, monocyte chemoattractant protein-2 (CCL-8), IL-13 and IL-15. Our study suggests that cytokine profiles may predict disease outcome during HCV infection.


Assuntos
Citocinas/sangue , Hepacivirus/imunologia , Hepatite C Crônica/imunologia , Fígado/virologia , RNA Viral/isolamento & purificação , Carga Viral/imunologia , Adulto , Citocinas/imunologia , Feminino , Fibrose , Humanos , Immunoblotting , Masculino , México , Pessoa de Meia-Idade , Remissão Espontânea
20.
Clin Transl Immunology ; 4(12): e54, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26719800

RESUMO

Communication between the immune system and metabolic components can be exemplified by the process of heme catabolism. The immunomodulatory functions of the enzymes, substrates and active products related to catabolism of the heme group have been extensively studied. Bilirubin (BR), the final breakdown product of heme, is primarily considered to be a toxic waste product but has recently been considered to be an immunomodulatory metabolite. Through mechanisms that include intracellular signaling and transcriptional control, BR affects those immune cell functions that regulate cell proliferation, differentiation and apoptosis. During the pathogenesis of viral hepatitis, the heme degradation pathway is disrupted, resulting in changes to normal BR concentrations. These alterations have been previously studied mainly as a consequence of the infection. However, little is known about the potential immunomodulatory role played by BR in the development of infectious hepatocellular diseases. Differences in BR levels in the context of viral hepatitis are likely to provide important insights into the metabolite-mediated mechanisms controlling the immune responses underlying both the long-term persistence of hepatitis C virus (HCV) infection and the resolution of hepatitis A virus (HAV) infection during the acute phase. In this review, the cross-talk between heme catabolism and immune function is described in detail. Special emphasis is given to discoveries that hold promise for identifying immunologic features of metabolic products in the resolution of viral diseases.

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