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1.
Eur. j. psychol. appl. legal context (Internet) ; 12(1): 1-10, ene.-jun. 2020. tab, graf
Artigo em Inglês | IBECS-Express | ID: ibc-ET1-4538

RESUMO

Current emergent studies are seriously questioning if parental strictness contributes to adolescent adjustment. This study examined whether the relationship between authoritative (warmth and strictness), authoritarian (strictness without warmth), indulgent (warmth without strictness), and neglectful (neither warmth nor strictness) parenting styles shows equal or different pattern of adjustment and maladjustment for aggressive and non-aggressive adolescents. The sample consisted of 969 Spanish adolescents, 554 females (57.2%) and 415 males, ranging from 12 to 17 years old. Families were classified into one of four typologies by their scores on warmth and strictness, and the adolescents were grouped by their aggressiveness (low vs. high). Adolescent adjustment was captured with three self-esteem indicators (emotional, physical, and family) and personal maladjustment with five indicators (negative self-esteem, negative self-adequacy, emotional irresponsiveness, emotional instability, and negative worldview). It was tested main and interaction effects between parenting and aggressiveness considering also sex and age factors. Findings showed that aggressive adolescents always had the worst socialization outcomes (i.e., the lowest self-esteem and the highest personal maladjustment). Aggressive and non-aggressive adolescents have a common pattern: both, indulgent and authoritative parenting styles were always associated with better outcomes than either authoritarian or neglectful parenting, but indulgent parenting style was associated with the best outcomes across all the criteria. In contrast with previous evidence about the idea that parental strictness and imposition might be beneficial to raise aggressive adolescents, present findings highlight the positive impact of parental warmth even with aggressive adolescents. Implications for family interventions were considered


Investigaciones emergentes cuestionan que la severidad parental contribuya al ajuste del adolescente. Este estudio examina si la relación entre los estilos parentales autorizativo (afecto y severidad), autoritario (severidad sin afecto), indulgente (afecto sin severidad) y negligente (ni afecto ni severidad) presenta patrones de ajuste y desajuste iguales o diferentes en adolescentes agresivos y no agresivos. Participaron 969 adolescentes españoles, 554 mujeres (57.2%) y 415 varones, de 12 a 17 años. Las familias se clasificaron en un estilo parental según sus puntuaciones en afecto y severidad y los adolescentes se agruparon por agresividad (baja vs. alta). Se captó el ajuste mediante tres indicadores de autoestima (emocional, física y familiar) y el desajuste personal con cinco indicadores (autoestima negativa, autoeficacia negativa, falta de respuesta emocional, inestabilidad emocional y visión negativa del mundo). Se probaron efectos principales y de interacción para estilos parentales y agresividad, considerando también sexo y edad. Los análisis mostraron que los adolescentes agresivos siempre tenían los peores resultados (i.e., la menor autoestima y el mayor desajuste personal). Los adolescentes agresivos y no agresivos comparten un patrón común: los estilos indulgente y autorizativo siempre se asociaron con mejores resultados que el autoritario o el negligente, pero el estilo indulgente se asoció con los mejores resultados en todos los criterios. A diferencia de estudios previos que consideraban que el rigor y la severidad de los padres podrían ser beneficiosos en hijos agresivos, los presentes resultados resaltan el impacto positivo del afecto parental incluso en adolescentes agresivos. Se consideraron las implicaciones para las intervenciones familiares

2.
Transplant Proc ; 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32033832

RESUMO

Biliary complications after liver transplantation have a high incidence of and a significant impact on morbidity and mortality. The primary aim of this study was to assess the influence of bile duct diameter on biliary complications and to determine whether a critical diameter for such complications could be determined. The secondary aim was to identify additional factors associated with biliary complications. Two hundred and seventy-three recipients of liver transplantation with biliary anastomosis without a T-tube were analyzed from December 2013 to December 2018. Patients with a follow-up of less than 6 months were excluded, except for those with biliary complications (including death). Intraoperative measurements of bile duct diameter and other variables potentially related to complications were recorded prospectively, and their association with biliary complications was analyzed. Our results show that neither donor nor recipient bile duct diameters were risk factors for the development of biliary complications. However, bile duct size mismatch between recipient and donor was found to be a risk factor. Additional associated risk factors were arterial ischemia time, arterial complications, bench arterial reconstruction, and intraoperative blood transfusion.

3.
Homo ; 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32053131

RESUMO

Objective. To test the hypothesis that assortative mating for physical characteristics differs before and after major secular increases in height in an indigenous community in the Valley of Oaxaca, Mexico. Methods. Spouse pairs were identified in household and anthropometric surveys of a Zapotec-speaking community in 1978 (n = 68-70 pairs) and 2000 (n = 99-100 pairs). Height, weight, arm circumference, triceps skinfold and grip strength were measured. Assortative mating was calculated as Pearson correlations. Results. Husband-wife correlations for age were high in both years (r = 0.96, 0.95). Assortative mating for height was significant in 1978 (r = 0.35, p < 0.001) and in 2000 (r = 0.21, p < 0.01), but decreased when ages were controlled (1978, 0.21, p < 0.05; 2000, 0.11). Correlations (zero and second order, respectively) were low for the BMI (1978, 0.02, 0.02; 2000, 0.04, 0.05). Spouse correlations for grip strength were significant in both surveys (r = 0.25 to 0.45), but were reduced (p > 0.05) when ages of spouses were controlled (r = -0.02 to 0.16). Conclusion. Assortative mating for physical characteristics did not differ between surveys conducted before (1978) and after (2000) major secular increases in height in the community, and any possible genetic effect of the secular trend on assortative was likely negligible.

4.
Transplant Proc ; 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32037068

RESUMO

BACKGROUND: Liver transplantation (LT) is a curative treatment for patients with hepatocellular carcinoma who are not candidates for resection. Despite the generalized use of the Milan criteria and up-to-seven criteria, new markers have been proposed to predict recurrence after LT. Biomarkers such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and scores such as the Model of Recurrence After Liver transplantation (MORAL) are used as predictors of post-LT recurrence. OBJECTIVE: We aim to compare NLR, PLR, and MORAL score with Milan criteria and up-to-seven criteria. METHODS: A descriptive study of 99 patients who underwent LT for hepatocellular carcinoma in our hospital between April 2010 and April 2016. The 5 prognostic models were applied to the patients to stratify them into risk groups. We used a Kaplan-Meier survival plot to measure recurrence-free survival in each model. Receiver operative curves were used to compare the models. RESULTS: Three-year recurrence-free survival in MORAL was 91.1% for the low-risk group, 89.8% for the moderate-risk group, 60% for the high-risk group, and 75% for the very high-risk group (P = .003). The combined MORAL score was superior in predicting 1- and 3-year recurrence with the area under the curve 0.684 (95% confidence interval [CI]: 0.52-0.85) compared with Milan (0.536 [95% CI: 0.37-0.70]), up-to-seven (0.601 [95% CI: 0.43-0.77]), PLR (0.452 [95% CI: 0.30-0.61]), and NLR (0.542 [95% CI: 0.37-0.71]). CONCLUSIONS: A model based only on pre-LT radiological signs leads to underdiagnosis of tumor load; therefore, the risk of recurrence must be recalculated after LT. The combined MORAL score was the best prognostic model of 1- and 3-year recurrence after LT in our study.

5.
PLoS One ; 15(1): e0228331, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31990955

RESUMO

Gastric cancer (GC) is a significant cancer-related cause of death worldwide. The most used chemotherapeutic regimen in GC is based on platinum drugs such as cisplatin (CDDP). However, CDDP resistance reduces advanced GC survival. In vitro drug-resistant cell model would help in the understanding of molecular mechanisms underlying this drug-resistance phenomenon. The aim of this study was to characterize new models of CDDP-resistant GC cell lines (AGS R-CDDP and MKN-28 R-CDDP) obtained through a stepwise increasing drug doses method, in order to understand the molecular mechanisms underlying chemoresistance as well as identify new therapeutic targets for the treatment of GC. Cell viability assays, cell death assays and the expression of resistance molecular markers confirmed that AGS R-CDDP and MKN-28 R-CDDP are reliable CDDP-resistant models. RNA-seq and bioinformatics analyses identified a total of 189 DEGs, including 178 up-regulated genes and 11 down-regulated genes, associated mainly to molecular functions involved in CDDP-resistance. DEGs were enriched in 23 metabolic pathways, among which the most enriched was the inflammation mediated by chemokine and cytokine signaling pathway. Finally, the higher mRNA expression of SERPINA1, BTC and CCL5, three up-regulated DEGs associated to CDDP resistance found by RNA-seq analysis was confirmed. In summary, this study showed that AGS R-CDDP and MKN-28 R-CDDP are reliable models of CDDP resistance because resemble many of resistant phenotype in GC, being also useful to assess potential therapeutic targets for the treatment of gastric cancers resistant to CDDP. In addition, we identified several DEGs associated with molecular functions such as binding, catalytic activity, transcription regulator activity and transporter activity, as well as signaling pathways associated with inflammation process, which could be involved in the development of CDDP resistance in GC. Further studies are necessary to clarify the role of inflammatory processes in GC resistant to CDDP and these models could be useful for these purposes.

6.
J Inorg Biochem ; 202: 110812, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31731096

RESUMO

Ureohydrolases form a conserved family of enzymes with a strict requirement for divalent metal ions for catalytic activity. They catalyze the hydrolysis of the guanidino group and produce urea. In their active sites six highly conserved amino acid residues form a binding pocket for two catalytically essential metal ions that are needed to activate a water molecule to initiate the hydrolysis of the guanidino group in a nucleophilic attack. Focus in this review is on two members of the ureohydrolase family, the Mn2+-dependent arginase and agmatinase, which play important roles in functions related to replication and cell survival. We will focus in particular on Mn2+ binding interactions, and on how this metal ion contributes to the reaction catalyzed by these enzymes. We also include the agmatinase-like protein (ALP) because it is functionally closely related to agmatinase, also requires at least one Mn2+ ion for catalytic activity, but may possess an active site that differs significantly from all other known ureohydrolases.

8.
Stem Cells ; 2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31778256

RESUMO

As new applications for human pluripotent stem cell-derived organoids in drug screenings and tissue replacement therapies emerge, there is a need to examine the mechanisms of tissue injury and repair recently reported for various organoid models. In most cases, organoids contain the main cell types and tissues present in human organs, spatially arranged in a manner that largely resembles the architecture of the organ. Depending on the differentiation protocol used, variations may exist in cell type ratios relative to the organ of reference, and certain tissues, including some parenchymal components and the endothelium, might be poorly represented, or lacking altogether. Despite those caveats, recent studies have shown that organoid tissue injury recapitulates major events and histopathological features of damaged human tissues. In particular, major mechanisms of parenchyma cell damage and interstitial fibrosis can be reproduced with remarkable faithfulness. Although further validation remains to be done in order to establish the relevance of using organoid for either mechanistic studies or drug assays, this technology is becoming a promising tool for the study of human tissue homeostasis, injury, and repair.

9.
Ann Hum Biol ; 46(6): 448-459, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31661341

RESUMO

Background: The prevalence of overweight (OWT) and obesity (OB), defined by the body mass index (BMI, kg/m2) among children and youth has increased worldwide in the last 30-40 years.Aim: To evaluate the weight status, defined by the BMI, of indigenous school children and youth resident in different regions of MexicoSubjects and methods: Students 6-18 years (31,448 boys, 27,306 girls) were enrolled in bilingual schools for indigenous children and youth in Mexico in 2012. Height and weight were measured; the BMI was calculated. The BMI of each student was classified relative to International Obesity Task Force (IOTF) age- and sex-specific criteria as thin (three grades), normal, overweight (OWT) or obese (OB). The sample was divided into five geographic regions for analysis: North, Central, South-Gulf, South-Pacific, and South-Southeast. Age- and sex-specific prevalence, 95% confidence intervals, and Chi-square tests were calculated.Results: Prevalence of OWT + OB was highest in the South-Gulf, South-Pacific and South-Southeast regions and lowest in the North and Central regions, while thinness was most prevalent in the North and Central regions.Conclusion: Prevalence of severe and moderate thinness was relatively low, while the combined prevalence of OWT + OB was generally more prevalent in indigenous boys than girls. However, the prevalence of thinness, OWT + OB among indigenous children and youth was lower than in the general population of children and youth in Mexico.

11.
Diagn Cytopathol ; 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31639290

RESUMO

Pancreatic pheochromocytomas are rare and typically diagnosed by local resection. We present the first reported case of metastatic pheochromocytoma to the pancreas diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and cytology. A 67-year-old female presented with 2 to 3 months of abdominal pain. A CT scan showed a large mass in the head of the pancreas engulfing the superior mesentery artery and vein, along with a large mass in the left adrenal gland. An EUS-FNA was performed on the pancreatic mass with a 22-gauge needle, yielding an adequate sample. Papanicolaou stain, Diff-Quik, and cell block showed loosely cohesive clustered tumor cells and singly dispersed pleomorphic naked tumor nuclei with anisonucleosis and cytoplasmic vacuolization. Tumor cells stained positive for synaptophysin, chromogranin A, and CD56 and negative for CK AE1/3 and CK AE1/3-CAM5.2 cytokeratin cocktail. Because of cytokeratin negativity, diffusely positive neuroendocrine markers, and the presence of an adrenal mass, a metastatic malignant pheochromocytoma was suspected. Additional testing showed elevations in plasma metanephrines and normetanephrines, urine metanephrine-to-creatinine and normetanephrine-to-creatinine ratios, and serum chromogranin A. An iodine123 -metaiodobenzylguanidine (MIBG) scan was obtained, which showed significantly increased MIBG uptake in the left adrenal lesion. A diagnosis of metastatic malignant pheochromocytoma was made. Surgical oncology was consulted, who recommended against resection of the adrenal mass in favor of outpatient management. Metastatic pheochromocytoma to the pancreas are rare tumors that may yield diagnostic material by EUS-FNA with a 22-gauge needle.

12.
Intractable Rare Dis Res ; 8(3): 206-209, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31523600

RESUMO

Lemièrre's syndrome (LS) is an uncommon disease characterized by septic thrombophlebitis of the jugular vein in the context of otorhinolaryngologic infections. These patients are often young and the pharyngotonsillar infection is the most frequent primary focus, but other foci like acute otitis media or otomastoiditis have been described. Although the internal jugular vein is the most commonly affected site, a few case reports have been published with thrombosis of other veins, such as the facial vein or transverse sinus. We report the case of a 93-year-old woman with an atypical presentation of LS presenting with thrombophlebitis of the internal jugular vein, transverse sinuses and Herophili torcula after an acute otitis media complicated with acute otomastoiditis. Infectious cerebral venous thrombosis (CVT) is rare and accounts for 6-12% of the total in large adult series and is usually associated to otorhinolaryngologic infections. CVT is an atypical presentation of LS that can be potentially lethal, especially during the acute phase. For this reason, clinical suspicion and early treatment are vital to improve the prognosis of these patients. Although surgical treatment is recommended in cases of LS complicated with CVT, conservative management with antibiotics and anticoagulation lead to ad integrum restitutio without neurological sequelae in our case, suggesting that surgical treatment may not be necessary in all cases of LS complicated with CVT.

13.
Medwave ; 19(4): e7637, 2019 May 23.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-31483132

RESUMO

Objetive: To describe health determinants in adults from the jurisdictions of the North and South Pacific Health Networks in the city of Chimbote. Methods: A non-controlled descriptive study was carried out. Health determinants were classified in the following categories: bio-socioeconomic characteristics, lifestyle, and social and community support. For the descriptive analysis of categorical variables, relative and absolute frequencies were used. Results: A total of 1 496 adults were included in the study. In the bio-socioeconomic determinants category, 62.2% were women and 53.3% were older adults. In the lifestyle determinants category, 52.4% did not smoke and had not ever smoked regularly, 50.5% did not consume alcoholic bever-ages, and 66.9% had 6 to 8 hours of sleep. In the social/community support determinants category, 53% had been treated at a health facility in the previous 12 months, 47.5% considered the distance between the health facility where they were treated and their home to be average, and 64.6% had public health insurance (SIS) from Perus Ministry of Health (MINSA). Conclusion: Most participants completed high school but this level of education did not result in access to higher-scale salaries. In addition, most partici-pants owned their own homes as well as access to basic services but lived in overcrowded conditions. A sedentary lifestyle and high-carbohydrate diet were predominant in this sample, highlighting the need for education to improve health.

14.
Clin Biochem ; 74: 69-72, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31473201

RESUMO

BACKGROUND: S100B protein is one of the most accurate biomarkers for diagnosis of neuroapoptosis and brain damage. The aim was to evaluate the lactate concentration and acid-base balance (pH, pCO2, pO2, HCO3c and BEb) in umbilical cord blood to predict high risk of neuroapoptosis and analyze the relationship between the levels of these biomarkers and umbilical cord blood S100B protein concentration at birth. METHODS: Apparently healthy newborns were included. S100B protein and blood gas test (lactate and acid-base balance) were determined in umbilical cord blood at birth. Newborns were classified into two groups: with and without high risk of neuroapoptosis. Newborns with high umbilical cord blood S100B protein concentration were considered newborns at high risk of neuroapoptosis. RESULTS: Sixty-one newborns were included, 12 had high risk of neuroapoptosis and 49 did not. S100B protein concentration correlate directly with pCO2 levels (Rho: 0.286, p = .0321) and lactate concentration (Rho: 0.278, p = .0315); and indirectly with pH (Rho: -0.332, p = .01). The analysis of the ROC curves yielded significant curves for pH and pCO2 to predict high risk of neuroapoptosis, pH optimal cutoff value was 7.19 (sensitivity: 50%, specificity: 83.7%, AUC: 0.708); and pCO2 optimal cutoff value was 60 mmHg (sensitivity: 30%, specificity: 85.4%, AUC: 0.705). CONCLUSIONS: Respiratory acidosis is associated to high concentrations of S100B protein in umbilical cord blood at birth. Umbilical cord blood pH and pCO2 may be useful in differentiating newborns at high risk of neuroapoptosis. Umbilical cord blood gas test may be valuable as risk indicator for neuroapoptosis at birth.


Assuntos
Acidose Respiratória/sangue , Acidose Respiratória/patologia , Apoptose , Encéfalo/patologia , Sangue Fetal/química , Adolescente , Adulto , Biomarcadores/sangue , Gasometria , Dióxido de Carbono/sangue , Estudos Transversais , Feminino , Hipóxia Fetal/sangue , Humanos , Concentração de Íons de Hidrogênio , Recém-Nascido , Ácido Láctico/sangue , Masculino , Neurônios/patologia , Curva ROC , Subunidade beta da Proteína Ligante de Cálcio S100/sangue , Sensibilidade e Especificidade , Adulto Jovem
15.
J Appl Gerontol ; : 733464819867554, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375054

RESUMO

Well-being is a complex construct related to sociodemographic and cultural aspects that vary across cultures. Latin America is a region with high social inequalities among population groups, although this varies significantly depending on the country. This article proposes a model that seeks to establish the relationship between psychosocial variables, psychological well-being, and life satisfaction in a sample of Colombian older adults. The model explores associations between resilience, socioeconomic status, life satisfaction, and psychological well-being. A study with a sample of 617 Colombian older adults was conducted. A structural equation modeling technique was performed. The results showed a model in which life satisfaction is positively explained by psychological well-being and resilience, whereas psychological well-being is explained by a higher socio-economic status. The results contribute to the evidence about how well-being is determined by psychosocial and cultural factors. The evidence found represents novel information about older adults in Colombia.

16.
Clin J Am Soc Nephrol ; 14(8): 1183-1192, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31311818

RESUMO

BACKGROUND AND OBJECTIVES: Some studies suggest that the incidence of IgA nephropathy is increasing in older adults, but there is a lack of information about the epidemiology and behavior of the disease in that age group. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this retrospective multicentric study, we analyzed the incidence, forms of presentation, clinical and histologic characteristics, treatments received, and outcomes in a cohort of 151 patients ≥65 years old with biopsy-proven IgA nephropathy diagnosed between 1990 and 2015. The main outcome was a composite end point of kidney replacement therapy or death before kidney replacement therapy. RESULTS: We found a significant increase in the diagnosis of IgA nephropathy over time from six patients in 1990-1995 to 62 in 2011-2015 (P value for trend =0.03). After asymptomatic urinary abnormalities (84 patients; 55%), AKI was the most common form of presentation (61 patients; 40%). Within the latter, 53 (86%) patients presented with hematuria-related AKI (gross hematuria and tubular necrosis associated with erythrocyte casts as the most important lesions in kidney biopsy), and eight patients presented with crescentic IgA nephropathy. Six (4%) patients presented with nephrotic syndrome. Among hematuria-related AKI, 18 (34%) patients were receiving oral anticoagulants, and this proportion rose to 42% among the 34 patients older than 72 years old who presented with hematuria-related AKI. For the whole cohort, survival rates without the composite end point were 74%, 48%, and 26% at 1, 2, and 5 years, respectively. Age, serum creatinine at presentation, and the degree of interstitial fibrosis in kidney biopsy were risk factors significantly associated with the outcome, whereas treatment with renin-angiotensin-aldosterone blockers was associated with a lower risk. Immunosuppressive treatments were not significantly associated with the outcome. CONCLUSIONS: The diagnosis of IgA nephropathy among older adults in Spain has progressively increased in recent years, and anticoagulant therapy may be partially responsible for this trend. Prognosis was poor. PODCAST: This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2019_07_16_CJASNPodcast_19_08_.mp3.

17.
Eur J Clin Invest ; 49(8): e13150, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31192451

RESUMO

BACKGROUND: Helicobacter pylori infection is associated with chronic gastritis, ulcers and gastric cancer. Antimicrobial resistance has increased worldwide affecting the efficacy of current treatments. Most guidelines recommend implementation of regional surveillance of primary antibiotic resistance of H pylori. Only a fraction of individuals infected with H pylori develop gastric diseases which are related to virulence factors of the bacteria. The aims of the study were to determine the primary antimicrobial resistance rates of H pylori and to know the virulence factors prevalence of strains circulating in Southern Europe. MATERIALS AND METHODS: Susceptibility testing by Etest to clarithromycin, levofloxacin, metronidazole, amoxicillin and tetracycline was performed in 102 isolates (99 naïve patients). The prevalence of virulence factors (cagA, vacA, oipA, babA and dupA) was evaluated in 102 H pylori isolates from patients with mild-disease symptoms and in 22 isolates from patients with severe-disease symptoms. RESULTS: Primary resistance rates were 12.1% to clarithromycin, 13.1% to levofloxacin, 24.2% to metronidazole and 0% to amoxicillin and tetracycline. Combined resistance to clarithromycin and levofloxacin was 3% and to clarithromycin and metronidazole 4%. Prevalence of virulence factors in the mild- and severe-disease group was 35.3% and 81.8% for cagA, 20.6% and 54.5% for cagA/vacAs1m1, 94.1% and 95.4% for babA2, 78.4% and 100% for oipA and 30.4% and 18.2% for dupA. CONCLUSIONS: Primary antimicrobial resistance rates were under 15% for clarithromycin and levofloxacin. The prevalence of H pylori carrying the virulent genotype cagA/vacAs1m1 was higher than 20% in the mild-disease and 54% in the severe-disease symptom group.

18.
Rev Alerg Mex ; 66 Suppl 1: 1-105, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31200597

RESUMO

BACKGROUND: In Mexico, allergen immunotherapy (AIT) and immunotherapy with hymenoptera venom (VIT) is traditionally practiced combining aspects of the European and American school. In addition, both types of extracts (European and American) are commercially available in Mexico. Moreover, for an adequate AIT/VIT a timely diagnosis is crucial. Therefore, there is a need for a widely accepted, up-to-date national immunotherapy guideline that covers diagnostic issues, indications, dosage, mechanisms, adverse effects and future expectations of AIT (GUIMIT 2019). METHOD: With nationwide groups of allergists participating, including delegates from postgraduate training-programs in Allergy/Immunology-forming, the guideline document was developed according to the ADAPTE methodology: the immunotherapy guidelines from European Academy of Allergy and Clinical Immunology, German Society for Allergology and Clinical Immunology, The American Academy of Allergy, Asthma and Immunology and American College of Allergy, Asthma, and Immunology were selected as mother guidelines, as they received the highest AGREE-II score among international guidelines available; their evidence conforms the scientific basis for this document. RESULTS: GUIMIT emanates strong or weak (suggestions) recommendations about practical issues directly related to in vivo or in vitro diagnosis of IgE mediated allergic diseases and the preparation and application of AIT/VIT and its adverse effects. GUIMIT finishes with a perspective on AIT modalities for the future. All the statements were discussed and voted on until > 80 % consensus was reached. CONCLUSIONS: A wide and diverse group of AIT/VIT experts issued transculturized, evidence-based recommendations and reached consensus that might improve and standardize AIT practice in Mexico.


Assuntos
Hipersensibilidade/diagnóstico , Hipersensibilidade/terapia , Imunoglobulina E , Imunoterapia/normas , Humanos , Hipersensibilidade/imunologia , Imunoglobulina E/imunologia
19.
Int J Colorectal Dis ; 34(6): 1113-1119, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31037566

RESUMO

PURPOSE: To compare the clinical outcome of autologous platelet-rich growth factor (PRP) with commercial fibrin glue in the management of high cryptogenic fistulae-in-ano. METHOD: The study was conducted at a single center between July 2012 and July 2015 and performed as a phase III, randomized, double-blind comparison of autologously prepared PRP versus fibrin glue for cryptoglandular anal fistulae without active sepsis. Patients were assessed with clinical and endosonographic follow-up. Patients were followed up at 1 week and then at 3, 6, and 12 postoperative months. The primary outcome measure was the fistula healing rate (complete, partial, and non-healing) with secondary outcome measures assessing fistula recurrence, continence status, quality of life, and visual analog pain scores. RESULTS: Of the 56 enrolled patients, 32 were PRP-treated and 24 were fibrin-treated. The groups were well matched for fistula type with an improved overall healing rate for PRP-treated over fibrin-treated cases (71% vs. 58.3%, respectively; P = 0.608); a complete healing rate of 48.4% vs. 41.7%, respectively; and a partial healing rate of 22.6% vs. 16.7%, respectively. The median pain scores of PRP-treated patients were lower at the first visit with a greater initial pain decrease early during follow-up. Improvements in pain reduction impacted the quality of life measures (P = 0.035). All adverse events were minor and no patient experienced a negative impact on continence. CONCLUSION: Treatment of complex cryptoglandular anal fistula with autologous PRP is as effective as fibrin glue with less cost and no adverse effect on continence.


Assuntos
Adesivo Tecidual de Fibrina/uso terapêutico , Plasma Rico em Plaquetas/química , Fístula Retal/tratamento farmacológico , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente
20.
J Bone Miner Res ; 34(10): 1851-1861, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31099911

RESUMO

Renal transplantation (RTx) is an effective therapy to improve clinical outcomes in pediatric patients with terminal chronic kidney disease. However, chronic immunosuppression with glucocorticoids (GCs) reduces bone growth and BMD. The mechanisms causing GC-induced growth impairment have not been fully clarified. Fibroblast growth factor 23 (FGF23) is a peptide hormone that regulates phosphate homeostasis and bone growth. In pathological conditions, FGF23 excess or abnormal FGF receptors (FGFR) activity leads to bone growth impairment. Experimental data indicate that FGF23 expression is induced by chronic GC exposure. Therefore, we hypothesize that GCs impair bone growth by increasing FGF23 expression, which has direct effects on bone growth plate. In a post hoc analysis of a multicentric randomized clinical trial of prepubertal RTx children treated with early GC withdrawal or chronic GC treatment, we observed that GC withdrawal was associated with improvement in longitudinal growth and BMD, and lower plasma FGF23 levels as compared with a chronic GC group. In prepubertal rats, GC-induced bone growth retardation correlated with increased plasma FGF23 and bone FGF23 expression. Additionally, GC treatment decreased FGFR1 expression whereas it increased FGFR3 expression in mouse tibia explants. The GC-induced bone growth impairment in tibiae explants was prevented by blockade of FGF23 receptors using either a pan-FGFR antagonist (PD173074), a C-terminal FGF23 peptide (FGF23180-205) which blocks the binding of FGF23 to the FGFR-Klotho complex or a specific FGFR3 antagonist (P3). Finally, local administration of PD173074 into the tibia growth plate ameliorated cartilage growth impairment in GC-treated rats. These results show that GC treatment partially reduces longitudinal bone growth via upregulation of FGF23 and FGFR3 expression, thus suggesting that the FGF23/Klotho/FGFR3 axis at the growth plate could be a potential therapeutic target for the management of GC-induced growth impairment in children.

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