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1.
Clin Exp Immunol ; 200(1): 61-72, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31799703

RESUMO

In addition to their detection in typical X-linked severe combined immunodeficiency, hypomorphic mutations in the interleukin (IL)-2 receptor common gamma chain gene (IL2RG) have been described in patients with atypical clinical and immunological phenotypes. In this leaky clinical phenotype the diagnosis is often delayed, limiting prompt therapy in these patients. Here, we report the biochemical and functional characterization of a nonsense mutation in exon 8 (p.R328X) of IL2RG in two siblings: a 4-year-old boy with lethal Epstein-Barr virus-related lymphoma and his asymptomatic 8-month-old brother with a Tlow B+ natural killer (NK)+ immunophenotype, dysgammaglobulinemia, abnormal lymphocyte proliferation and reduced levels of T cell receptor excision circles. After confirming normal IL-2RG expression (CD132) on T lymphocytes, signal transducer and activator of transcription-1 (STAT-5) phosphorylation was examined to evaluate the functionality of the common gamma chain (γc ), which showed partially preserved function. Co-immunoprecipitation experiments were performed to assess the interaction capacity of the R328X mutant with Janus kinase (JAK)3, concluding that R328X impairs JAK3 binding to γc . Here, we describe how the R328X mutation in IL-2RG may allow partial phosphorylation of STAT-5 through a JAK3-independent pathway. We identified a region of three amino acids in the γc intracellular domain that may be critical for receptor stabilization and allow this alternative signaling. Identification of the functional consequences of pathogenic IL2RG variants at the cellular level is important to enable clearer understanding of partial defects leading to leaky phenotypes.


Assuntos
Códon sem Sentido , Subunidade gama Comum de Receptores de Interleucina/genética , Fator de Transcrição STAT5/metabolismo , Linfócitos T/metabolismo , Doenças por Imunodeficiência Combinada Ligada ao Cromossomo X/genética , Animais , Células COS , Pré-Escolar , Chlorocebus aethiops , Análise Mutacional de DNA/métodos , Feminino , Humanos , Lactente , Masculino , Fenótipo , Fosforilação , Irmãos , Doenças por Imunodeficiência Combinada Ligada ao Cromossomo X/diagnóstico
2.
Phys Rev Lett ; 120(3): 034502, 2018 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-29400491

RESUMO

The stress generation on pore walls due to the growth of a sodium chloride crystal in a confined aqueous solution is studied from evaporation experiments in microfluidic channels in conjunction with numerical computations of crystal growth. The study indicates that the stress buildup on the pore walls is a highly transient process taking place over a very short period of time (in less than 1 s in our experiments). The analysis makes clear that what matters for the stress generation is not the maximum supersaturation at the onset of the crystal growth but the supersaturation at the interface between the solution and the crystal when the latter is about to be confined between the pore walls. The stress generation is summarized in a simple stress diagram involving the pore aspect ratio and the Damkhöler number characterizing the competition between the precipitation reaction kinetics and the ion transport towards the growing crystal. This opens up the route for a better understanding of the damage of porous materials induced by salt crystallization, an important issue in Earth sciences, reservoir engineering, and civil engineering.

3.
Age Ageing ; 46(3): 401-407, 2017 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-28064172

RESUMO

Background: evidence on the effectiveness of interventions to prevent frailty is scarce. Objective: to assess the effect of an intervention in preventing frailty progression in pre-frail older people. Study design: a randomised, open label, controlled trial with two parallel arms. Population: community-dwelling pre-frail older people (≥70 years) consulting in primary care. Intervention: nutritional assessment (and derivation to a Nutritional Unit for usual care in the event of nutritional risk) and a physical activity programme including aerobic exercise and a set of mixed strengthening, balance and coordination exercises. Control group: patients receiving the usual care. Main outcome measure: prevalence of frailty (Fried criteria) at 12 months. Secondary outcomes measures: functional capacity (Barthel index), falls and nutritional status (Short-Form Mini Nutritional Assessment) on follow-up at 12 months. Results: one hundred and seventy-two participants were recruited and randomised (mean age: 78.3 years; mean number of Fried criteria: 1.45). Thirty-nine participants (22.6%) were dropped out during the study. At follow-up, 4.9% of the intervention group and 15.3% of the control group had evolved to frailty, for a crude odds ratio (OR) of 0.29 (95% confidence interval [CI]: 0.08-1.08; P = 0.052) and an adjusted (by age, gender and number of co-morbidities) OR of 0.19 (95% CI: 0.04-0.95; P = 0.044). Intervention group showed a higher outdoors walking hour per day (0.97 versus 0.73; P = 0.019) but no difference was observed in muscle strength, gait speed or other functional indicators. Conclusion: an intervention focused on physical exercise and maintaining good nutritional status may be effective in preventing frailty in community-dwelling pre-frail older individuals. ClinicalTrials.gov identifier: NCT02138968.


Assuntos
Terapia por Exercício/métodos , Exercício Físico , Fragilidade/prevenção & controle , Envelhecimento Saudável , Vida Independente , Atenção Primária à Saúde , Encaminhamento e Consulta , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Feminino , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Fragilidade/fisiopatologia , Avaliação Geriátrica , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Força Muscular , Avaliação Nutricional , Estado Nutricional , Razão de Chances , Pacientes Desistentes do Tratamento , Equilíbrio Postural , Prevalência , Desempenho Psicomotor , Espanha/epidemiologia , Fatores de Tempo , Resultado do Tratamento
4.
Br J Nutr ; 115(9): 1623-31, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26961225

RESUMO

I deficiency is still a worldwide public health problem, with children being especially vulnerable. No nationwide study had been conducted to assess the I status of Spanish children, and thus an observational, multicentre and cross-sectional study was conducted in Spain to assess the I status and thyroid function in schoolchildren aged 6-7 years. The median urinary I (UI) and thyroid-stimulating hormone (TSH) levels in whole blood were used to assess the I status and thyroid function, respectively. A FFQ was used to determine the consumption of I-rich foods. A total of 1981 schoolchildren (52 % male) were included. The median UI was 173 µg/l, and 17·9 % of children showed UI<100 µg/l. The median UI was higher in males (180·8 v. 153·6 µg/l; P<0·001). Iodised salt (IS) intake at home was 69·8 %. IS consumption and intakes of ≥2 glasses of milk or 1 cup of yogurt/d were associated with significantly higher median UI. Median TSH was 0·90 mU/l and was higher in females (0·98 v. 0·83; P<0·001). In total, 0·5 % of children had known hypothyroidism (derived from the questionnaire) and 7·6 % had TSH levels above reference values. Median TSH was higher in schoolchildren with family history of hypothyroidism. I intake was adequate in Spanish schoolchildren. However, no correlation was found between TSH and median UI in any geographical area. The prevalence of TSH above reference values was high and its association with thyroid autoimmunity should be determined. Further assessment of thyroid autoimmunity in Spanish schoolchildren is desirable.


Assuntos
Deficiências Nutricionais/epidemiologia , Doença de Hashimoto/epidemiologia , Hipotireoidismo/epidemiologia , Iodo/deficiência , Estado Nutricional , Glândula Tireoide , Tireotropina/sangue , Estudos Transversais , Laticínios , Deficiências Nutricionais/urina , Dieta , Inquéritos sobre Dietas , Família , Feminino , Doença de Hashimoto/sangue , Humanos , Hipotireoidismo/sangue , Iodo/administração & dosagem , Iodo/urina , Masculino , Prevalência , Fatores Sexuais , Cloreto de Sódio na Dieta/administração & dosagem , Espanha/epidemiologia
5.
J Aging Phys Act ; 24(3): 363-8, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26540738

RESUMO

OBJECTIVE: To determine the prevalence of five physical frailty phenotype components and to assess the relationship between them and other clinical factors. METHOD: A population-based cross-sectional study was performed. Subjects 75 years and older were randomly selected from primary care databases (with sampling stratified by gender). Physical frailty phenotypes were assessed using Fried's criteria. Sociodemographic data, comorbidities, nutritional status, and functional capacity were assessed. RESULTS: 126 subjects were recruited (47% women). Prevalence rates were poor muscle strength: 50%; low physical activity: 29%; slow gait: 28%; exhaustion: 27%; and weight loss: 5%. Prefrailty and frailty prevalence rates were 35.7% and 29.4%, respectively. Poor muscle strength and low physical activity showed a close relationship and concordance (kappa = 0.92). Most frailty components were associated with outdoor activity, hours walked daily, and certain comorbidities. CONCLUSIONS: Poor muscle strength was the most prevalent frailty component and was closely associated with physical activity, suggesting that training programs may revert or prevent the frailty process.


Assuntos
Exercício Físico/fisiologia , Idoso Fragilizado , Força Muscular/fisiologia , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Estudos Transversais , Fadiga/fisiopatologia , Feminino , Marcha/fisiologia , Humanos , Vida Independente , Masculino , Estado Nutricional , Redução de Peso
6.
Biochim Biophys Acta ; 1840(7): 2152-61, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24631652

RESUMO

BACKGROUND: The heart is unable to regenerate its tissues after severe injuries. Stem cell therapy appears to be one of the most promising approaches, though preclinical results are hitherto contradictory and clinical trials scanty and/or limited to phase-I. The limited knowledge about stem cell early homing in infarcted cardiac tissues can concur to this scenario. METHODS: The stem cell migration was assessed in in-vitro and ex-vivo models of heart ischemia, employing a rat dental pulp stem cell line (MUR-1) that shares the same ontogenic progenitors with portions of the heart, expresses markers typical of cardiac/vascular-like progenitors and is able to differentiate into cardiomyocytes in-vitro. RESULTS: Here, we demonstrated that the MUR-1 can reach the injured cells/tissue and make contacts with the damaged cardiomyocytes, likely through Connexin 43, N-cadherin and von Willebrand Factor mediated cell-cell interactions, both in in-vitro and ex-vivo models. Furthermore, we found that SDF-1, FGF-2 and HGF, but not VEGF are involved as chemotactic factors in MUR-1 migration, notifying a similarity with neural crest cell behavior during the organogenesis of both the splanchnocranium and the heart. CONCLUSIONS: Herein we found a similarity between what happens during the heart organogenesis and the early migration and homing of MUR-1 cells in ischemic models. GENERAL SIGNIFICANCE: The comprehension of molecular aspects underlying the early phases of stem cell migration and interaction with damaged organ contributes to the future achievement of the coveted stem cell-mediated organ regeneration and function preservation in-vivo.


Assuntos
Traumatismos Cardíacos/terapia , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/citologia , Regeneração , Animais , Polpa Dentária/citologia , Traumatismos Cardíacos/patologia , Humanos , Isquemia/patologia , Isquemia/terapia , Células-Tronco Mesenquimais/metabolismo , Infarto do Miocárdio/metabolismo , Infarto do Miocárdio/terapia , Miócitos Cardíacos/metabolismo , Miócitos Cardíacos/patologia , Ratos
7.
Biotechnol Bioeng ; 111(7): 1452-63, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24473977

RESUMO

In tissue engineering, several factors play key roles in providing adequate stimuli for cells differentiation, in particular biochemical and physical stimuli, which try to mimic the physiological microenvironments. Since electrical stimuli are important in the developing heart, we have developed an easy-to-use, cost-effective cell culture platform, able to provide controlled electrical stimulation aimed at investigating the influence of the electric field in the stem cell differentiation process. This bioreactor consists of an electrical stimulator and 12 independent, petri-like culture chambers and a 3-D computational model was used to characterize the distribution and the intensity of the electric field generated in the cell culture volume. We explored the effects of monophasic and biphasic square wave pulse stimulation on a mouse adipose-derived stem cell line (m17.ASC) comparing cell viability, proliferation, protein, and gene expression. Both monophasic (8 V, 2 ms, 1 Hz) and biphasic (+4 V, 1 ms and -4 V, 1 ms; 1 Hz) stimulation were compatible with cell survival and proliferation. Biphasic stimulation induced the expression of Connexin 43, which was found to localize also at the cell membrane, which is its recognized functional mediating intercellular electrical coupling. Electrically stimulated cells showed an induced transcriptional profile more closely related to that of neonatal cadiomyocytes, particularly for biphasic stimulation. The developed platform thus allowed to set-up precise conditions to drive adult stem cells toward a myocardial phenotype solely by physical stimuli, in the absence of exogenously added expensive bioactive molecules, and can thus represent a valuable tool for translational applications for heart tissue engineering and regeneration.


Assuntos
Eletricidade , Células-Tronco/fisiologia , Engenharia Tecidual/métodos , Tecido Adiposo/citologia , Animais , Reatores Biológicos , Perfilação da Expressão Gênica , Camundongos , Células-Tronco/citologia
8.
Aging Clin Exp Res ; 26(2): 161-9, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24619886

RESUMO

BACKGROUND AND AIMS: Cognitive state and brain volume have been related to body mass index, abdominal fat, waist-hip ratio, components of metabolic syndrome (MS) and ghrelin. Genetic variations within the ghrelin gene have been recently associated to MS. The aim of our study was to investigate cognitive state by Mini-Mental State Examination (MMSE) in relation to MS components (ATP-III criteria) and ghrelin gene polymorphisms in dwelling individuals aged ≥70. METHODS: 280 subjects (137 men/143 women, age 77.03 ± 5.92) from the Mataró Ageing Study were included. Individuals were phenotypically characterized by anthropometric variables, lipids, glucose, blood pressure and MMSE. SNPs -501AC (rs26802), -994CT (rs26312), -604GA (rs27647), M72L (rs696217) and L90G (rs4684677) of the ghrelin gene were studied. Genotypes were determined by polymerase chain reaction and SNapshot minisequencing. RESULTS: 22.1 % had MMSE <24. MMSE <24 was associated with age (p < 0.001), female gender (p = 0.016), low education (p < 0.001) and glucose impairment or diabetes (p = 0.040). MMSE was influenced by obesity, central obesity, MS and glucose impairment. This latter association remained significant after adjustment by gender, age, alcohol, educational level, GDS and ApoE genotype (p = 0.009). Ghrelin SNPs were associated to MMSE: M72L C/A genotype showed lower score than C/C (p = 0.032, after adjusting for confounders 0.049); L90G A/T genotype showed lower score than A/A (p = 0.054, after adjusting 0.005). MMSE <24 was associated to L90G (39.1 % in A/T genotype vs 19.3 % in A/A, p = 0.026, after adjusting for confounders p = 0.002, OR 6.18 CI 1.93-21.75). CONCLUSIONS: Glucose impairment and L90G Ghrelin gene variant influence cognitive function in old dwelling individuals participating in the Mataró Ageing Study.


Assuntos
Glicemia/metabolismo , Transtornos Cognitivos/sangue , Transtornos Cognitivos/genética , Grelina/genética , Polimorfismo de Nucleotídeo Único , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/sangue , Envelhecimento/genética , Envelhecimento/psicologia , Apolipoproteínas E/genética , Transtornos Cognitivos/etiologia , Estudos de Coortes , Estudos Transversais , Feminino , Estudos de Associação Genética , Humanos , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/complicações , Escalas de Graduação Psiquiátrica , Espanha
9.
Anal Bioanal Chem ; 405(14): 4777-86, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23535744

RESUMO

An analytical method for determination and confirmation of nine coccidiostatics in eggs is reported. Ethyl acetate is used as extraction solvent, with satisfactory results, and simple automated clean-up is based on gel-permeation chromatography (GPC) . The target compounds are then analysed by liquid chromatography-electrospray ionization-tandem mass spectrometry. The method was validated in-house in accordance with Commission Decision 2002/657/EC. Trueness and precision were determined at four concentrations, and the mean errors obtained were <10 %, with relative standard deviations ranging from 3 to 18 %. For three non-authorized coccidiostatics (clopidol, ethopabate, and ronizadole), decision limit and detection capability were in the ranges 0.12-0.16 and 0.18-0.23 µg kg(-1), respectively. The results obtained prove the suitability of this new analytical method for routine monitoring of these substances in eggs.


Assuntos
Cromatografia em Gel/métodos , Coccidiostáticos/análise , Ovos/análise , Análise de Alimentos/métodos , Contaminação de Alimentos/análise , Espectrometria de Massas em Tandem/métodos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
10.
Sci Rep ; 13(1): 5132, 2023 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-36991008

RESUMO

The impact of salt crust formation over porous media on water evaporation is an important issue in relation with the water cycle, agriculture, building sciences and more. The salt crust is not a simple accumulation of salt crystals at the porous medium surface but undergoes complex dynamics with possible air gap formation between the crust and the porous medium surface. We report on experiments that allow to identify various crust evolution regimes depending on the competition between evaporation and vapor condensation. The various regimes are summarized in a diagram. We focus on the regime where dissolution-precipitation processes lead to the upward displacement of the salt crust and the generation of a branched pattern. It is shown that the branched pattern results from the crust upper surface destabilization whereas the crust lower surface remains essentially flat. We show that the resulting branched efflorescence salt crust is heterogeneous with a greater porosity in the salt fingers. This leads to the preferential drying of the salt fingers followed by a period in which the crust morphology change only occurs in the salt crust lower region. The salt crust eventually tends toward a frozen state where no visible change occurs in the salt crust morphology, but without blocking the evaporation. These findings provide in-depth insights into the salt crust dynamics and pave the way for the better understanding of the impact of efflorescence salt crusts on evaporation and the development of predictive models.

11.
Phys Rev Lett ; 108(5): 054502, 2012 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-22400935

RESUMO

Efflorescence refers to crystallized salt structures that form at the surface of a porous medium. The challenge is to understand why these structures do not form everywhere at the surface of the porous medium but at some specific locations and why there exists an exclusion distance around an efflorescence where no new efflorescence forms. These are explained from a visualization experiment, pore-network simulations and a simple efflorescence growth model.

12.
Rev Esp Cir Ortop Traumatol ; 66(5): T341-T347, 2022.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35843553

RESUMO

BACKGROUND: The vascular anatomy of the talus attracts intense research being not always easy to understand. The high intraosseous variability together with the anatomical characteristics makes some areas of the talus more prone to vascular compromise. The aim of this study is to describe the vascularisation of the talus, both intraosseous and extraosseous. MATERIAL AND METHODS: From the literature reviewed, we have developed a graphic scheme that allows easy observation of the irrigation distribution. To this end, nineteen anatomical dissections of human cadaveric feet have been carried out. Fifteen fresh-frozen slices have been cut in different planes and prepared using the modified Spalteholz technique and latex injection with blue and black ink to visualise the vascular network. In addition, the study has been complemented with a comprehensive literature review on this subject. RESULTS: The findings allowed us to conclude that the posterior tibial artery provides the most important blood supply to the neck and body of the talus through the tarsal canal artery and the deltoid branch. The anterior tibial artery splits in the dorsal pedis artery, for the head and neck, and the lateral tarsal artery which throughout anastomoses breeds the tarsal sinus artery. The perforating peroneal artery branches out from the peroneal artery, creating an intraosseous anastomosis for the body and the posterior process. CONCLUSION: The results obtained have contributed to develop a graphical representation that we present in this study, which allows a simple understanding of the intraosseus and extraosseus vascularisation of the talus.

13.
Rev Esp Cir Ortop Traumatol ; 66(5): 341-347, 2022.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34148811

RESUMO

BACKGROUND: The vascular anatomy of the talus attracts intense research being not always easy to understand. The high intraosseous variability together with the anatomical characteristics makes some areas of the talus more prone to vascular compromise. The aim of this study is to describe the vascularization of the talus, both intraosseous and extraosseous. MATERIAL AND METHODS: From the literature reviewed, we have developed a graphic scheme that allows easy observation of the irrigation distribution. To this end, nineteen anatomical dissections of human cadaveric feet have been carried out. Fifteen fresh-frozen slices have been cut in different planes and prepared using the modified Spalteholz technique and latex injection with blue and black ink to visualize the vascular network. In addition, the study has been complemented with a comprehensive literature review on this subject. RESULTS: The findings allowed us to conclude that the posterior tibial artery provides the most important blood supply to the neck and body of the talus through the tarsal canal artery and the deltoid branch. The anterior tibial artery splits in the dorsal pedis artery, for the head and neck, and the lateral tarsal artery which throughout anastomoses breeds the tarsal sinus artery. The perforating peroneal artery branches out from the peroneal artery, creating an intraosseous anastomosis for the body and the posterior process. CONCLUSION: The results obtained have contributed to develop a graphical representation that we present in this study, which allows a simple understanding of the intraosseus and extraosseus vascularization of the talus.

14.
Sci Rep ; 12(1): 7473, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35523854

RESUMO

Salt crusts forming at the surface of a porous medium are commonly observed in nature as well as on building materials and pieces of our cultural heritage where they represent a risk for the supporting substrate integrity. Previous research indicates that the salt crust can detach from the porous substrate and severely reduces the evaporation. However, the current understanding of the detachment mechanisms and the reduced evaporation is very limited. In the present experiment, we evidence dissolution-precipitation processes as key mechanisms in the detachment process. We also show that the crust remains wet and the observed reduced evaporation is explained by the formation of tiny pores in the nanometer range and the Kelvin effect. The resulting crust permeability is very low. Combined with previous results, this shows that the crust permeability is highly dependent on the crust formation conditions. More generally, salt structures in a water vapor concentration gradient are shown to be self-propelled systems capable to carry small objects such as, for instance, soil particles. Our study has significance for understanding the impact of salt crusts on evaporation and the associated important phenomena, such as soil salinization and porous material degradation inherent to salt crystallization.

15.
J Frailty Aging ; 11(1): 91-99, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35122096

RESUMO

BACKGROUND: Obesity is a risk factor for frailty and muscle weakness, so weight loss in obese older adults may prevent frailty and functional decline. OBJECTIVE: To assess the safety and efficacy of a multimodal weight-loss intervention in improving functional performance and reducing frailty risk in obese older adults. DESIGN: Randomized controlled trial with 2 parallel arms. SETTING AND PARTICIPANTS: Community-dwelling obese adults aged 65-75 years with body mass index (BMI) 30-39 kg/m2. INTERVENTION: 6-month multimodal intervention based on diet and a physical activity program. CONTROL GROUP: Usual care. Main and secondary outcome measures: Frailty (Fried criteria) rate and functional performance at 6, 12, and 24 months of follow-up, respectively. Intermediate outcome measures: Weight loss, body composition changes, and metabolic and inflammatory biomarker changes. RESULTS: N=305. The study intervention increased gait speed at 12 and 24 months of follow-up, but had no significant effect on frailty prevention. It was effective in reducing weight, BMI, fat mass, interleukin 6, and insulin resistance and improving self-reported quality of life. CONCLUSIONS: The study intervention was not demonstrated to be effective in preventing frailty in obese people aged 65-75 years at 24 months of follow-up. However, it allowed weight loss and a reduction in inflammatory and insulin resistance markers, which could have a long-term effect on frailty that requires further research.


Assuntos
Fragilidade , Idoso , Fragilidade/prevenção & controle , Humanos , Vida Independente , Obesidade/terapia , Qualidade de Vida , Redução de Peso
16.
Eur Respir J ; 38(1): 119-25, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21406512

RESUMO

We investigated whether discoloured sputum and feeling unwell were associated with antibiotic prescription and benefit from antibiotic treatment for acute cough/lower respiratory tract infection (LTRI) in a prospective study of 3,402 adults in 13 countries. A two-level model investigated the association between producing discoloured sputum or feeling generally unwell and an antibiotic prescription. A three-level model investigated the association between an antibiotic prescription and symptom resolution. Patients producing discoloured sputum were prescribed antibiotics more frequently than those not producing sputum (OR 3.2, 95% CI 2.1-5.0), unlike those producing clear/white sputum (OR 0.95, 95% CI 0.61-1.48). Antibiotic prescription was not associated with a greater rate or magnitude of symptom score resolution (as measured by a 13-item questionnaire completed by patients each day) among those who: produced yellow (coefficient 0.00; p = 0.68) or green (coefficient -0.01; p = 0.11) sputum; reported any of three categories of feeling unwell; or produced discoloured sputum and felt generally unwell (coefficient -0.01; p = 0.19). Adults with acute cough/LRTI presenting in primary care settings with discoloured sputum were prescribed antibiotics more often compared to those not producing sputum. Sputum colour, alone or together with feeling generally unwell, was not associated with recovery or benefit from antibiotic treatment.


Assuntos
Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Infecções Respiratórias/tratamento farmacológico , Escarro/efeitos dos fármacos , Doença Aguda , Adulto , Tosse , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica/estatística & dados numéricos , Atenção Primária à Saúde/métodos , Estudos Prospectivos , Inquéritos e Questionários
17.
Pathol Biol (Paris) ; 59(3): e49-56, 2011 Jun.
Artigo em Francês | MEDLINE | ID: mdl-20167439

RESUMO

Severe burned patients need definitive and efficient wound coverage. Outcome of massive burns has been improved by using cultured epithelial autografts (CEA). Despite fragility, percentages of success take, cost of treatment and long-term tendency to contracture, this surgical technique has been developed in few burn centres. First improvements were to combine CEA and dermis-like substitute. Cultured skin substitutes provide earlier skin closure and satisfying functional result. These methods have been used successfully in massive burns. Second improvement was to allow skin regeneration by using epidermal stem cells. Stem cells have capacity to differentiate into keratinocytes, to promote wound repair and to regenerate skin appendages. Human mesenchymal stem cells contribute to wound healing and were evaluated in cutaneous radiation syndrome. Skin regeneration and tissue engineering methods remain a complex challenge and offer the possibility of new treatment for injured and burned patients.


Assuntos
Queimaduras/terapia , Células Epiteliais/transplante , Transplante de Células-Tronco Mesenquimais , Células-Tronco Adultas/transplante , Animais , Queimaduras/cirurgia , Células Cultivadas/transplante , Previsões , Humanos , Queratinócitos/transplante , Modelos Animais , Estudos Prospectivos , Radiodermite/cirurgia , Regeneração , Estudos Retrospectivos , Transplante de Pele , Pele Artificial , Engenharia Tecidual , Transplante Autólogo , Transplante Homólogo
18.
J Healthc Qual Res ; 36(1): 27-33, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33342758

RESUMO

BACKGROUND: Incidence and clinical characteristics of foot pressure ulcers (FPU) in hospitalized elderly patients are not well known. The aim of the study was to determine the incidence of FPU during hospitalization, to describe main FPU characteristics and to assess main risk factors for FPU in hospitalised elderly subjects. METHODOLOGY: An observational prospective study was performed in which patients 65 years or older admitted to Vascular Surgery, Orthopaedic or Geriatric departments were followed from admission to discharge. Trained nurses evaluated all recruited patients on a daily basis for possible FPU. Main characteristics of the patient (age, sex and co-morbidities) and the ulcer (location, grade) were registered. RESULTS: 299 patients were recruited (62.2% women, mean age 82.3 years, mean number of co-morbidities 2.8). Prevalence of FPU was 30.1% at admission and 73.9% at discharge. Incidence of FPU during hospitalization was 9.5 new FPU/100 person-day. 97.0% of the new FPU were grade 1 (erythema) and the most common locations were in the heel (57.6%), the external lateral part of the foot (13.1%), and the hallux of the fist toe (11.8%). Apart from immobility, main risk factors for FPU are age, geriatric residence origin and not able to outdoor life. CONCLUSIONS: FPU has a high incidence among hospitalised elderly patients; most of them are grade 1 and located in the heel. More attention must be paid in the prevention of pressure ulcers in hospitalized frail subjects.


Assuntos
Úlcera por Pressão , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Masculino , Úlcera por Pressão/epidemiologia , Úlcera por Pressão/etiologia , Prevalência , Estudos Prospectivos , Fatores de Risco
19.
Eur Respir J ; 36(5): 1080-7, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20525710

RESUMO

The effect of inhaled drugs in community-acquired pneumonia (CAP) is unclear. This case-control study was designed to determine whether inhaled drugs were risk factors for CAP. All incident cases of confirmed CAP that occurred over 1 yr in patients with chronic bronchitis (CB), chronic obstructive pulmonary disease (COPD) or asthma were included, as well as CB, COPD and asthma controls. Risk factors for CAP and inhaled treatment were recorded during a personal interview. An effect of inhaled drugs on the risk of CAP was observed in COPD and asthma patients after adjusting for the effect of other respiratory diseases and their concomitant treatments. In COPD patients, inhaled steroids had a risk OR of 3.26 (95% CI 1.07-9.98) and in asthma patients inhaled anticholinergics had a risk OR of 8.80 (95% CI 1.02-75.7). In CB patients, no association with CAP was observed for any inhaler. These effects were independent of adjusting variables related to severity and other respiratory and non-respiratory risk factors for CAP, including vaccines. Inhaled ß(2)-adrenergic agonists did not show a significant effect on the risk of CAP in any of the respiratory diseases. Inhaled steroids may favour CAP in COPD patients, whereas anticholinergics may favour CAP in asthma patients. It is difficult to differentiate the effect of inhaled therapy from the effect of COPD or asthma severity on the risk of CAP, and these relationships may not be causal, but could call attention to inhaled therapy in COPD and asthma patients.


Assuntos
Broncodilatadores/efeitos adversos , Infecções Comunitárias Adquiridas/epidemiologia , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Esteroides/efeitos adversos , Administração por Inalação , Adulto , Idoso , Idoso de 80 Anos ou mais , Asma/tratamento farmacológico , Asma/epidemiologia , Broncodilatadores/administração & dosagem , Estudos de Casos e Controles , Antagonistas Colinérgicos/administração & dosagem , Antagonistas Colinérgicos/efeitos adversos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Nebulizadores e Vaporizadores/estatística & dados numéricos , Fatores de Risco , Índice de Gravidade de Doença , Esteroides/administração & dosagem
20.
Anal Bioanal Chem ; 397(2): 807-14, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20217396

RESUMO

The extraction of six sulfonamides (sulfadiazine, sulfadimidine, sulfathiazole, sulfachloropiridazine, sulfadimethoxine, and sulfaquinoxaline) from soils with different physicochemical characteristics and at several aging times was investigated. Conventional mechanical shaking, microwave-assisted extraction, ultrasound probe-assisted extraction and pressurized liquid extraction techniques were evaluated. The four techniques provided similar results when applied to freshly contaminated soils. However, microwave-assisted extraction was the most suitable to extract sulfonamide aged residues from soils. Microwave-assisted extraction was applied to eight soils aged for 3 months, using acetonitrile:buffer pH 9 (20:80) as the extraction solvent, and recoveries ranged from 15-25% for STZ to 42-64% for SDM.


Assuntos
Fracionamento Químico/métodos , Solo/análise , Sulfonamidas/isolamento & purificação , Cromatografia/métodos , Micro-Ondas , Ultrassom
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