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2.
Sci Adv ; 6(20): eaaz9165, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32426502

RESUMO

Dopaminergic neuronal cell death, associated with intracellular α-synuclein (α-syn)-rich protein aggregates [termed "Lewy bodies" (LBs)], is a well-established characteristic of Parkinson's disease (PD). Much evidence, accumulated from multiple experimental models, has suggested that α-syn plays a role in PD pathogenesis, not only as a trigger of pathology but also as a mediator of disease progression through pathological spreading. Here, we have used a machine learning-based approach to identify unique signatures of neurodegeneration in monkeys induced by distinct α-syn pathogenic structures derived from patients with PD. Unexpectedly, our results show that, in nonhuman primates, a small amount of singular α-syn aggregates is as toxic as larger amyloid fibrils present in the LBs, thus reinforcing the need for preclinical research in this species. Furthermore, our results provide evidence supporting the true multifactorial nature of PD, as multiple causes can induce a similar outcome regarding dopaminergic neurodegeneration.

3.
Oecologia ; 192(3): 823-836, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31982953

RESUMO

Land-use intensification (LUI) and biological invasions are two of the most important global change pressures driving biodiversity loss. However, their combined impacts on biological communities have been seldom explored, which may result in misleading ecological assessments or mitigation actions. Based on an extensive field survey of 445 paired invaded and control plots of coastal vegetation in SW Spain, we explored the joint effects of LUI (agricultural and urban intensification) and invasion on the taxonomic and functional richness, mean plant height and leaf area of native plants. Our survey covered five invasive species with contrasting functional similarity and competitive ability in relation to the native community. We modeled the response of native communities for the overall and invader-specific datasets, and determined if invader-native functional differences could influence the combined impacts of LUI and invasion. Overall, we found that urban intensification reduced taxonomic richness more strongly at invaded plots (synergistic interactive effects). In contrast, functional richness loss caused by urban intensification was less pronounced at invaded plots (antagonistic interactive effects). Overall models showed also that urban intensification led to reduced mean leaf area, while agriculture was linked to higher mean plant height. When exploring invader-specific models, we observed that the combined effects of agricultural and urban intensification with invasion were heterogeneous. At invaded plots, invader-native functional differences accounted for part of this variability. Our findings demonstrate the importance of considering the interactive effects of global change pressures for a better assessment and management of ecosystems.


Assuntos
Ecossistema , Plantas , Biodiversidade , Espécies Introduzidas , Espanha
4.
Morphologie ; 103(343): 148-160, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31786098

RESUMO

For precision medicine to be implemented through the lens of in silico technology, it is imperative that biophysical research workflows offer insight into treatments that are specific to a particular illness and to a particular subject. The boundaries of precision medicine can be extended using multiscale, biophysics-centred workflows that consider the fundamental underpinnings of the constituents of cells and tissues and their dynamic environments. Utilising numerical techniques that can capture the broad spectrum of biological flows within complex, deformable and permeable organs and tissues is of paramount importance when considering the core prerequisites of any state-of-the-art precision medicine pipeline. In this work, a succinct breakdown of two precision medicine pipelines developed within two Virtual Physiological Human (VPH) projects are given. The first workflow is targeted on the trajectory of Alzheimer's Disease, and caters for novel hypothesis testing through a multicompartmental poroelastic model which is integrated with a high throughput imaging workflow and subject-specific blood flow variability model. The second workflow gives rise to the patient specific exploration of Aortic Dissections via a multi-scale and compliant model, harnessing imaging, computational fluid-dynamics (CFD) and dynamic boundary conditions. Results relating to the first workflow include some core outputs of the multiporoelastic modelling framework, and the representation of peri-arterial swelling and peri-venous drainage solution fields. The latter solution fields were statistically analysed for a cohort of thirty-five subjects (stratified with respect to disease status, gender and activity level). The second workflow allowed for a better understanding of complex aortic dissection cases utilising both a rigid-wall model informed by minimal and clinically common datasets as well as a moving-wall model informed by rich datasets.


Assuntos
Doença de Alzheimer/fisiopatologia , Aneurisma Dissecante/fisiopatologia , Sistema Glinfático/fisiopatologia , Modelos Biológicos , Fluxo Sanguíneo Regional/fisiologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/terapia , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma Dissecante/terapia , Aorta/diagnóstico por imagem , Aorta/fisiopatologia , Encéfalo/irrigação sanguínea , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Estudos de Coortes , Simulação por Computador , Conjuntos de Dados como Assunto , Feminino , Humanos , Hidrodinâmica , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Fluxo de Trabalho
6.
Rev Neurol ; 69(8): 332-336, 2019 Oct 16.
Artigo em Espanhol | MEDLINE | ID: mdl-31588987

RESUMO

INTRODUCTION: HaNDL (headache and neurological deficits with cerebrospinal fluid lymphocytosis) syndrome is a self-limiting benign condition which, as its name suggests, causes episodes of transient neurological deficits of a motor, sensory, aphasic and, less frequently, visual nature lasting several hours, accompanied or followed by moderate-to-severe headache and lymphocytosis of the cerebrospinal fluid. Its incidence is low in adulthood, and it is extremely uncommon in the paediatric age. Recurrence of episodes usually occurs in the first three months. It has an excellent prognosis. CASE REPORT: A 12-year-old female with intense frontal headache that suddenly begins on the tenth day, with clinical signs and symptoms of dysarthria and right hemiparesis with subsequent aphasia and generalised hypotonia. After ruling out other conditions by means of complementary examinations and the clinical course, the patient was finally diagnosed with HaNDL syndrome, since it fulfilled the clinical criteria of the International Headache Society (IHS). CONCLUSIONS: The patient met the criteria established by the IHS for the diagnosis of HaNDL syndrome. The main historical, epidemiological and clinical data are analysed and the differential diagnosis of HaNDL syndrome in the paediatric age is described.

7.
Sci Total Environ ; 690: 1151-1161, 2019 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-31470478

RESUMO

Shooting activities is an important source of Pb in contaminated soils. Lead accumulates in superficial soil horizons because of its low mobility, favouring its uptake by plants and representing a high transference risk to the trophic chain. A combination of phytoremediation with nanoremediation techniques can be used to recover firing range soils and decrease the mobility, bioavailability and toxicity of Pb. This study examines in depth the changes in Pb behaviour in firing range soils by adding hydroxyapatite nanoparticles (HANPs). These nanoparticles (NPs) may immobilise Pb and improve the quality of these areas. The use of HANPs and the Pb effects were assessed in three different species (Sinapis alba L., Lactuca sativa L. and Festuca ovina L.), focusing on their germination and early growth, through phytotoxicity assays. Single extractions with CaCl2 (0.01 M) in soils treated with HANPs show that these NPs retained Pb and reduced highly its availability and mobility. HR-TEM and TOF-SIMS were used to determine the interactions between HANPs and Pb, as well as with soil components. According to TOF-SIMS and HR-TEM/EDS analysis, Pb was mainly retained by HANPs but also associated lightly to organic matter, Fe compounds and silicates. Phytotoxicity assays exposed that S. alba, L. sativa and F. ovina were able to germinate and develop in the firing range soils despite the high available Pb contents before adding HANPs. After adding HANPs, Pb retention increased, favouring the germination and the growth of roots in the three species. These results suggest that HANPs can be used to decrease the availability and the toxicity of Pb without negative effects in the species growth. Accordingly, the combination of phytoremediation and nanoremediation techniques can be a great tool to stabilise these soils, avoiding the Pb transfer to nearby areas and its entry in the trophic chain.


Assuntos
Durapatita/química , Recuperação e Remediação Ambiental/métodos , Chumbo/toxicidade , Nanopartículas/química , Plantas/efeitos dos fármacos , Poluentes do Solo/toxicidade , Bioensaio , Solo , Armas
8.
Sci Rep ; 9(1): 9239, 2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-31239459

RESUMO

Macroscopic fibers of carbon nanotubes (CNT) have emerged as an ideal architecture to exploit the exceptional properties of CNT building blocks in applications ranging from energy storage to reinforcement in structural composites. Controlled synthesis and scalability are amongst the most pressing challenges to further materialize the potential of CNT fibers. This work shows that under floating catalyst chemical vapor conditions in the direct spinning method, used both in research and industry, the ceramic reactor tube plays an unsuspected active role in CNT growth, leading for example to doubling of reaction yield when mullite (Al4+2xSi2-2xO10-x(x ≈ 0:4)) is used instead of alumina (Al2O3), but without affecting CNT morphology in terms of number of layers, purity or degree of graphitization. This behaviour is confirmed for different carbon sources and when growing either predominantly single-walled or multi-walled CNTs by adjusting promotor concentration. Analysis of large Si-based impurities occasionally found in CNT fiber fabric samples, attributed to reactor tube fragments that end up trapped in the porous fibers, indicate that the role of the reactor tube is in catalyzing the thermal decomposition of hydrocarbons, which subsequently react with floating Fe catalyst nanoparticles and produce extrusion of the CNTs and formation of an aerogel. Reactor gas analysis confirms that extensive thermal decomposition of the carbon source occurs in the absence of Fe catalyst particles, and that the concentration of different carbon species (e.g. carbon dioxide and ethylene) is sensitive to the reactor tube type. These finding open new avenues for controlled synthesis of CNT fibers by decoupling precursor decomposition from CNT extrusion at the catalyst particle.

9.
Mater Sci Eng C Mater Biol Appl ; 100: 11-22, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30948045

RESUMO

Two-dimensional transition metal dichalcogenides (TMDCs), such as MoS2 and WS2, have recently emerged as nanomaterials with potential use in biomedicine. An attractive means to favor their interaction with biological media is the use of proper biomolecules as exfoliating/dispersing agents. Here, MoS2 flakes were stabilized with different small functional biomolecules such as adenosine monophosphate (AMP), guanosine monophosphate (GMP) and flavin mononucleotide (FMN) through the strong nucleotide-MoS2 interaction of Lewis acid-base type, rather than just on the weak dispersive and hydrophobic forces commonly associated with the use of many surfactants. The impact of the nucleotide-stabilized MoS2 flakes on the viability and cell proliferation, on the production of intracellular reactive oxygen species (ROS), and on the preosteoblast differentiation process (early stage) has been also evaluated, as well as the incorporation and intracellular localization of the nanomaterials by MC3T3-E1 and Saos-2 cells. The nucleotide-stabilized MoS2 flakes were found to exhibit excellent biocompatibility. Furthermore, their incorporation did not affect the integrity of the cell plasma membrane, which makes them ideal candidates for delivering drug/gene directly into cells. The in vitro cell response of tumor cells to these nanomaterials differs from that of undifferentiated cells, which provides the basis for their potential use in cancer therapy.


Assuntos
Monofosfato de Adenosina/química , Dissulfetos/química , Mononucleotídeo de Flavina/química , Guanosina Monofosfato/química , Molibdênio/química , Nanoestruturas/química , Animais , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Humanos , Camundongos , Nanoestruturas/toxicidade , Osteoblastos/citologia , Osteoblastos/efeitos dos fármacos , Osteoblastos/metabolismo , Espécies Reativas de Oxigênio/metabolismo
10.
Mater Sci Eng C Mater Biol Appl ; 96: 295-301, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30606535

RESUMO

Bulk titanium nitride (TiN) was synthesized by nitridation of TiO2 rutile substrates. TiN pellets were successfully achieved at 1100 °C in ammonia stream; these materials were characterized by the evaluation of their microstructure, surface, chemical composition and electrical and electrochemical properties, concluding that the synthesis promotes the creation of a TiNxOy surface, which shows high metallic conductivity (close to 102 S/cm) and a microstructure with micro- and nano-features. Electrochemical studies reveal high storage capacities which are delivered through an injection mechanism that involves the double charge layer and EIS show a high capacitive contribution to the mechanism. Neuron cell cultures assessed the biocompatibility of the sample prepared and put forward this material as a promising candidate for implantable stimulation electrode in neuroscience.


Assuntos
Teste de Materiais , Neurônios/metabolismo , Titânio/química , Animais , Estimulação Elétrica/instrumentação , Eletrodos , Neurônios/citologia , Ratos , Ratos Wistar
11.
Ann Oncol ; 29(10): 2121-2128, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30165419

RESUMO

Background: We hypothesized that the abundance of PD1 mRNA in tumor samples might explain the differences in overall response rates (ORR) observed following anti-PD1 monotherapy across cancer types. Patients and methods: RNASeqv2 data from 10 078 tumor samples representing 34 different cancer types was analyzed from TCGA. Eighteen immune-related gene signatures and 547 immune-related genes, including PD1, were explored. Correlations between each gene/signature and ORRs reported in the literature following anti-PD1 monotherapy were calculated. To translate the in silico findings to the clinical setting, we analyzed the expression of PD1 mRNA using the nCounter platform in 773 formalin-fixed paraffin embedded (FFPE) tumor samples across 17 cancer types. To test the direct relationship between PD1 mRNA, PDL1 immunohistochemistry (IHC), stromal tumor-infiltrating lymphocytes (sTILs) and ORR, we evaluated an independent FFPE-based dataset of 117 patients with advanced disease treated with anti-PD1 monotherapy. Results: In pan-cancer TCGA, PD1 mRNA expression was found strongly correlated (r > 0.80) with CD8 T-cell genes and signatures and the proportion of PD1 mRNA-high tumors (80th percentile) within a given cancer type was variable (0%-84%). Strikingly, the PD1-high proportions across cancer types were found strongly correlated (r = 0.91) with the ORR following anti-PD1 monotherapy reported in the literature. Lower correlations were found with other immune-related genes/signatures, including PDL1. Using the same population-based cutoff (80th percentile), similar proportions of PD1-high disease in a given cancer type were identified in our in-house 773 tumor dataset as compared with TCGA. Finally, the pre-established PD1 mRNA FFPE-based cutoff was found significantly associated with anti-PD1 response in 117 patients with advanced disease (PD1-high 51.5%, PD1-intermediate 26.6% and PD1-low 15.0%; odds ratio between PD1-high and PD1-intermediate/low = 8.31; P < 0.001). In this same dataset, PDL1 tumor expression by IHC or percentage of sTILs was not found associated with response. Conclusions: Our study provides a clinically applicable assay that links PD1 mRNA abundance, activated CD8 T-cells and anti-PD1 efficacy.


Assuntos
Antineoplásicos Imunológicos/uso terapêutico , Linfócitos T CD8-Positivos/efeitos dos fármacos , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Linfócitos do Interstício Tumoral/efeitos dos fármacos , Neoplasias/metabolismo , Receptor de Morte Celular Programada 1/metabolismo , RNA Mensageiro/metabolismo , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Linfócitos T CD8-Positivos/imunologia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Linfócitos do Interstício Tumoral/imunologia , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Neoplasias/imunologia , Neoplasias/patologia , Prognóstico , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Receptor de Morte Celular Programada 1/genética , RNA Mensageiro/genética , Taxa de Sobrevida
12.
Clin Epidemiol ; 10: 549-560, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29785141

RESUMO

Background: The validity of a cardiovascular risk self-screening method was assessed. The results obtained for self-measurement of blood pressure, a point-of-care system's assessment of lipid profile and glycated hemoglobin, and a self-administered questionnaire (sex, age, diabetes, tobacco consumption) were compared with the standard screening (gold standard) conducted by a health professional. Methods: Crossover clinical trial on a population-based sample from Girona (north-eastern Spain), aged 35-74, with no cardiovascular disease at recruitment. Participants were randomized to one of the two risk assessment sequences (standard screening followed by self-screening or vice versa). Cardiovascular risk was estimated with the Framingham-REGICOR function. Concordance between methods was estimated with the intraclass correlation coefficient (ICC). Sensitivity, specificity, and positive and negative predictive values were estimated, considering 5% cardiovascular risk as the cutoff point. ClinicalTrials.gov Registration #NCT02373319. Clinical Research Ethic Committee of the Parc de Salut Mar Registration #2014/5815/I. Results: The median cardiovascular risk in men was 2.56 (interquartile range: 1.42-4.35) estimated by standard methods and 2.25 (1.28-4.07) by self-screening with ICC=0.92 (95% CI: 0.90-0.93). In women, the cardiovascular risk was 1.14 (0.61-2.10) by standard methods and 1.10 (0.56-2.00) by self-screening, with ICC=0.89 (0.87-0.90). The sensitivity, specificity, and positive and negative predictive values for the self-screening method were 0.74 (0.63-0.82), 0.97 (0.95-0.99), 0.86 (0.77-0.93), and 0.94 (0.91-0.96), respectively, in men. In women, these values were 0.50 (0.30-0.70), 0.99 (0.98-1), 0.81 (0.54-0.96), and 0.97 (0.95-0.99), respectively. Conclusion: The self-screening method for assessing cardiovascular risk provided similar results to the standard method. Self-screening had high clinical performance to rule out intermediate or high cardiovascular risk.

14.
Ann Oncol ; 28(9): 2248-2255, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28911086

RESUMO

Background: In a significant percentage of advanced non-small-cell lung cancer (NSCLC) patients, tumor tissue is unavailable or insufficient for genetic analyses. We prospectively analyzed if circulating-free DNA (cfDNA) purified from blood can be used as a surrogate in this setting to select patients for treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). Patients and methods: Blood samples were collected in 119 hospitals from 1138 advanced NSCLC patients at presentation (n = 1033) or at progression to EGFR-TKIs (n = 105) with no biopsy or insufficient tumor tissue. Serum and plasma were sent to a central laboratory, cfDNA purified and EGFR mutations analyzed and quantified using a real-time PCR assay. Response data from a subset of patients (n = 18) were retrospectively collected. Results: Of 1033 NSCLC patients at presentation, 1026 were assessable; with a prevalence of males and former or current smokers. Sensitizing mutations were found in the cfDNA of 113 patients (11%); with a majority of females, never smokers and exon 19 deletions. Thirty-one patients were positive only in plasma and 11 in serum alone and mutation load was higher in plasma and in cases with exon 19 deletions. More than 50% of samples had <10 pg mutated genomes/µl with allelic fractions below 0.25%. Patients treated first line with TKIs based exclusively on EGFR positivity in blood had an ORR of 72% and a median PFS of 11 months. Of 105 patients screened after progression to EGFR-TKIs, sensitizing mutations were found in 56.2% and the p.T790M resistance mutation in 35.2%. Conclusions: Large-scale EGFR testing in the blood of unselected advanced NSCLC patients is feasible and can be used to select patients for targeted therapy when testing cannot be done in tissue. The characteristics and clinical outcomes to TKI treatment of the EGFR-mutated patients identified are undistinguishable from those positive in tumor.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/genética , Resistencia a Medicamentos Antineoplásicos/genética , Receptores ErbB/genética , Neoplasias Pulmonares/genética , Mutação , Inibidores de Proteínas Quinases/uso terapêutico , Adulto , Idoso , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Tomada de Decisões , Receptores ErbB/antagonistas & inibidores , Feminino , Testes Genéticos , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Resultado do Tratamento
15.
J Anim Sci ; 95(3): 1179-1190, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28380527

RESUMO

Feeding high-fiber diets decreases cost, but also caloric and nutritional efficiency by modifying intestinal morphology and function. We analyzed the changes in intestinal cell composition, nutrient transporters and receptors, and cell differentiation induced by fibers from different sources. Forty-six finishing pigs (BW 84 ± 7 kg) were fed 1 of 4 diets: corn-soybean (Control; = 12), 23% wheat straw (WS; = 11), 55% corn distillers dried grains with solubles (DDGS; = 11), and 30% soybean hulls (SBH; = 12). Pigs were fed 2 meals daily to an amount equivalent to 2.5% of initial BW for 14 d in metabolism cages. Ilea were collected for histological and gene expression analysis after euthanasia. Data were analyzed using the Kruskal-Wallis test followed by Dunn's multiple comparisons and differences considered significant when < 0.05. The enterocyte marker was increased ( < 0.03) by feeding SBH compared with Control and WS diets. Goblet cells presence was greater ( < 0.01) in pigs fed WS and DDGS compared with Control, and in pigs fed WS compared with SBH ( = 0.02). expression was greater ( < 0.05) in pigs fed DDGS and SBH compared with Control diet. No changes were observed for endocrine and Paneth cells markers, villus and crypt length, or proliferation index. Compared with the Control, gene expression of receptors for oligopeptides, calcium, glucose, fructose, , and and was increased ( < 0.05) by feeding WS and DDGS diets. Feeding SBH diet repressed ( < 0.005) the compared with WS and DDGS diets, while DDGS repressed ( = 0.02) its expression compared with Control. Pigs fed DDGS had reduced ( < 0.001) , and those fed SBH showed increased ( < 0.05) expression compared with WS and DDGS pigs. Feeding WS and DDGS diets induced ( < 0.01) the expression of stem cell marker r-spondin receptor (, while was reduced ( < 0.02) by feeding DDGS compared with Control. The expression of was induced ( < 0.05) by all fibers compared with Control. Transcription factors and were suppressed ( < 0.001) by WS and DDGS compared with Control. In conclusion, feeding diets containing WS and DDGS modulated intestinal differentiation by promoting goblet cells and altered expression of nutrient receptors and transporters in growing pigs, while feeding SBH had less effect.


Assuntos
Ração Animal/análise , Diferenciação Celular/efeitos dos fármacos , Fibras na Dieta/análise , Grão Comestível/química , Intestinos/citologia , Suínos/fisiologia , Fenômenos Fisiológicos da Nutrição Animal , Animais , Composição Corporal/efeitos dos fármacos , Dieta/veterinária , Fibras na Dieta/farmacologia , Mucosa Intestinal/metabolismo
16.
Enferm. intensiva (Ed. impr.) ; 28(1): 13-20, ene.-mar. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-161050

RESUMO

Objetivos: Determinar la incidencia de las lesiones cutáneas asociadas a la humedad (LESCAH) en el área del pañal, identificar los factores predisponentes y conocer las medidas preventivas y registros realizados. Metodología: Estudio descriptivo longitudinal (junio de 2014-abril de 2015) en una UCI polivalente. Se incluyeron pacientes con estancia > 48 h y sin lesiones cutáneas. Se valoró diariamente la piel hasta la aparición de LESCAH, alta o un máximo de 14 días. Se registraron datos demográficos, estancia, tipo de LESCAH, incontinencia, consistencia y número de deposiciones, obesidad, escala Braden y prevención. Resultados: Se estudiaron 145 pacientes (66,2% hombres), la mediana de edad fue 69 (P25 = 56,5-P75 = 76) años y la estancia de 5(P25 = 3-P75 = 11,25) días, el 29,9% presentó obesidad. Se detectó un 26,2% de dermatitis asociada a la incontinencia (DAI) y un 15,9% dermatitis intertriginosa (DI). Se registró el 23,8% de las LESCAH. Las variables relacionadas con la DAI fueron la incontinencia fecal, número de deposiciones, heces líquidas y estancia. Para la DI fueron la obesidad y la puntuación en la escala Braden. El análisis multivariable seleccionó la incontinencia fecal (OR = 5,4; IC 95%:1,1-26) y el número de deposiciones (OR = 1,1; IC:1,0-1,2) como variables independientes para desarrollar DAI y la obesidad (OR=2,8; IC95%:1,0-8,2) y escala Braden (OR =0,8; IC95%:0,7-1,0) para desarrollar DI. Se realizó prevención al 23,8% de los obesos y al 42,9% de los incontinentes. Conclusiones: Existe una elevada incidencia en LESCAH. Tener incontinencia fecal y mayor número de deposiciones son factores de riesgo para desarrollar DAI. La obesidad y una puntuación menor en la escala Braden predisponen a sufrir DI. El registro de las LESCAH y la prevención en pacientes de riesgo es insuficiente


Objectives: To determine the incidence of moisture-associated skin damage (MASD) in the nappy area, identify predisposing factors and know the preventive measures and nursing records. Method: Descriptive longitudinal study (June 2014-April 2015) in a general ICU. Patients whose stay >48 hours and without skin lesions were included. The skin was assessed daily until the appearance of MASD, discharge or a maximum of 14 days. Demographics, stay, MASD type, incontinence, number and consistency of stools, obesity, Braden scale and prevention were recorded. Results: 145 patients (66.2% male) were studied, median age was 69 (P25 = 56.5, P75 = 76) and median length of stay was five days (P25 = 3, P75 = 11.25), 29.9% were obese. Incontinence-associated dermatitis (IAD) was detected in 26.2% and intertriginous dermatitis (ITD) in 15.9%. MASD was recorded in 23.8%. The variables causing IAD to develop were faecal incontinence, number of stools, liquid stools, and stay. Those for ITD were obesity and score on the Braden scale. Multivariate analysis selected faecal incontinence (OR = 5.4, CI95%: 1.1-26) and the number of stools (OR = 1.1, CI 95%:1.0-1.2) as independent variables for developing IAD and obesity (OR = 2.8, CI 95%:1.0-8.2) and Braden (OR = 0.8, CI 95%:0.7-1.0) for developing ITD. Prevention to 23.8% of obese and 42.9% of incontinent was performed. Conclusions: There is a high incidence in MASD. Faecal incontinence and higher number of stools are the risk factors for developing IAD. Obesity and a lower score on the Braden scale may affect susceptibility to ITD. Recording of MASD and its prevention in patients at risk is insufficient


Assuntos
Humanos , Incontinência Urinária/complicações , Dermatite de Contato/epidemiologia , Umidade/efeitos adversos , Intertrigo/epidemiologia , Cuidados Críticos/métodos , Unidades de Terapia Intensiva/estatística & dados numéricos , Estudos Longitudinais
17.
Clin Microbiol Infect ; 23(10): 775.e1-775.e6, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28192235

RESUMO

OBJECTIVES: This study aimed to characterize the chronically infected general hepatitis C virus (HCV) population in Barcelona using a highly sensitive subtyping method that can identify the 67 recognized HCV subtypes and diagnose mixed infection by various genotypes/subtypes in a single individual. The resulting information has implications for selecting optimal direct-acting antiviral (DAA) treatment for each patient and establishing public healthcare policies in our setting. METHODS: Consecutive HCV patients (treatment-naïve or interferon-based failures) attending Vall d'Hebron Hospital outpatient clinics from February 2015 to May 2016 (N=1473) were included in the study. Patient samples were characterized using HCV subtyping by next-generation ultra-deep pyrosequencing. RESULTS: The following genotypes (G) were found: G1 (1126/1473 (76.4%)), G4 (145/1473 (9.8%)), G3 (135/1473 (9.2%)), G2 (51/1473 (3.5%)), and G5 (1/1473 (0.1%)). Twenty-two subtypes were seen: 1b (790/1473 (53.6%)), 1a (332/1473 (22.5%)), 3a (133/1473 (9.0%)), 4d (105/1473 (7.1%)), 4a (29/1473 (2.0%)), and 2c (25/1473 (1.7%)), with 16 low-prevalence subtypes accounting for the remaining 3.0% (44/1473). There was a worrisome 1.0% (15/1473) of mixed infections. G2 (51/1473 (3.5%)) showed a high level of heterogeneity. Analyses by age groups showed a predominance of G1b over G1a (428/506 (84.6%) vs. 24/506 (4.7%)) in patients born before 1950 (N=506/1473), and similar percentages of these subtypes in those born between 1951 and 1975 (N=834/1473) (315/834, 37.8% vs. 266/834, 31.9%) and after 1976 (N=133/1473) (47/133, 35.3% vs. 42/133, 31.6%). CONCLUSIONS: Subtype distribution showed a higher level of heterogeneity than was expected, particularly for G2. Prevalence of mixed infections was around 1%. HCV subtype distribution related to patient age group suggested that patients born from 1936 to 1975 in our setting should undergo screening for the infection. Next-generation sequencing enabled better classification of candidates for DAA-based treatment.


Assuntos
Variação Genética , Genótipo , Técnicas de Genotipagem/métodos , Hepacivirus/classificação , Hepacivirus/genética , Hepatite C Crônica/virologia , Adolescente , Adulto , Idoso , Coinfecção/epidemiologia , Coinfecção/virologia , Feminino , Hepacivirus/isolamento & purificação , Hepatite C Crônica/epidemiologia , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Prevalência , Espanha/epidemiologia , Adulto Jovem
18.
Enferm Intensiva ; 28(1): 13-20, 2017.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28110903

RESUMO

OBJECTIVES: To determine the incidence of moisture-associated skin damage (MASD) in the nappy area, identify predisposing factors and know the preventive measures and nursing records. METHOD: Descriptive longitudinal study (June 2014-April 2015) in a general ICU. Patients whose stay >48hours and without skin lesions were included. The skin was assessed daily until the appearance of MASD, discharge or a maximum of 14 days. Demographics, stay, MASD type, incontinence, number and consistency of stools, obesity, Braden scale and prevention were recorded. RESULTS: 145 patients (66.2% male) were studied, median age was 69 (P25=56.5, P75=76) and median length of stay was five days (P25=3, P75=11.25), 29.9% were obese. Incontinence-associated dermatitis (IAD) was detected in 26.2% and intertriginous dermatitis (ITD) in 15.9%. MASD was recorded in 23.8%. The variables causing IAD to develop were faecal incontinence, number of stools, liquid stools, and stay. Those for ITD were obesity and score on the Braden scale. Multivariate analysis selected faecal incontinence (OR=5.4, CI95%: 1.1-26) and the number of stools (OR=1.1, CI95%:1.0-1.2) as independent variables for developing IAD and obesity (OR=2.8, CI95%:1.0-8.2) and Braden (OR=0.8, CI95%:0.7-1.0) for developing ITD. Prevention to 23.8% of obese and 42.9% of incontinent was performed. CONCLUSIONS: There is a high incidence in MASD. Faecal incontinence and higher number of stools are the risk factors for developing IAD. Obesity and a lower score on the Braden scale may affect susceptibility to ITD. Recording of MASD and its prevention in patients at risk is insufficient.


Assuntos
Dermatite/epidemiologia , Dermatite/etiologia , Incontinência Fecal/complicações , Incontinência Urinária/complicações , Idoso , Feminino , Humanos , Incidência , Unidades de Terapia Intensiva , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Suor
19.
J Antimicrob Chemother ; 72(2): 504-510, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27789684

RESUMO

BACKGROUND: In Argentina, current national guidelines recommend starting with NNRTI-based regimens. Recently, there have been some local reports regarding concerning levels of NNRTI-transmitted resistance, but surveillance has never been carried out at a national level. OBJECTIVES: To determine the prevalence of HIV drug resistance in people starting ART in Argentina using a WHO-proposed methodology. METHODS: This was a cross-sectional, nationally representative study. Twenty-five antiretroviral-dispensing sites throughout the country were randomly chosen to enrol at least 330 persons starting ART, to generate a point prevalence estimate of resistance-associated mutations (RAMs) with a 5% CI (for the total population and for those without antiretroviral exposure). All consecutive patients older than 18 years starting or restarting ART in the chosen clinics were eligible. Samples were processed with Trugene and analysed using the Stanford algorithm. RESULTS: Between August 2014 and March 2015, we obtained 330 samples from people starting ART. The mean ±â€ŠSD age was 35 ±â€Š11 years, 63.4% were male, 16.6% had prior antiretroviral exposure and the median (IQR) CD4 count was 275 cells/mm3 (106-461). The prevalence of RAMs found was 14% (±4%) for the whole population (3% NRTI-RAMs; 11% NNRTI-RAMs and 2% PI-RAMs) and 13% (±4%) for those without prior antiretroviral exposure (3%, 10% and 2%, respectively). The most common mutation was K103N. CONCLUSIONS: This surveillance study showed concerning levels of HIV drug resistance in Argentina, especially to NNRTIs. Due to this finding, Argentina's Ministry of Health guidelines will change, recommending performing a resistance test for everyone before starting ART. If this is taken up properly, it also might function as a continuing surveillance tool.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Farmacorresistência Viral/genética , Infecções por HIV/tratamento farmacológico , HIV-1/efeitos dos fármacos , Timidina Monofosfato/análogos & derivados , Adulto , Argentina , Contagem de Linfócito CD4 , Estudos Transversais , Feminino , Humanos , Masculino , Inibidores da Transcriptase Reversa/uso terapêutico , Timidina Monofosfato/uso terapêutico
20.
ACS Appl Mater Interfaces ; 9(2): 1331-1342, 2017 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-28001360

RESUMO

The nanocarbon allotropes constitute valid alternatives when designing control and actuation devices for electrically assisted tissue regeneration purposes, gathering among them important characteristics such as chemical inertness, biocompatibility, extreme mechanical properties, and, importantly, low and tailorable electrical resistivity. In this work, coatings of thin (100 nm) vertically aligned nanoplatelets composed of diamond (5 nm) and graphite were produced via a microwave plasma chemical vapor deposition (MPCVD) technique and used as substrates for electrical stimulation of MC3T3-E1 preosteoblasts. Increasing the amount of N2 up to 14.5 vol % during growth lowers the coatings' electrical resistivity by over 1 order of magnitude, triggers the nanoplatelet vertical growth, and leads to the higher crystalline quality of the nanographite phase. When preosteoblasts were cultured on these substrates and subjected to two consecutive daily cycles of 3 µA direct current stimulation, enhanced cell proliferation and metabolism were observed accompanied by high cell viability. Furthermore, in the absence of DC stimulation, alkaline phosphatase (ALP) activity is increased significantly, denoting an up-regulating effect of preosteoblastic maturation intrinsically exerted by the nanoplatelet substrates.


Assuntos
Nanoestruturas , Proliferação de Células , Sobrevivência Celular , Diamante , Estimulação Elétrica , Grafite
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