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1.
Med Res Rev ; 43(5): 1701-1747, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37062876

RESUMO

The androgen receptor (AR) has been shown to be a key determinant in the pathogenesis of castration-resistant prostate cancer (CRPC). The current standard of care therapies targets the ligand-binding domain of the receptor and can afford improvements to life expectancy often only in the order of months before resistance occurs. Emerging preclinical and clinical compounds that inhibit receptor activity via differentiated mechanisms of action which are orthogonal to current antiandrogens show promise for overcoming treatment resistance. In this review, we present an authoritative summary of molecules that noncompetitively target the AR. Emerging small molecule strategies for targeting alternative domains of the AR represent a promising area of research that shows significant potential for future therapies. The overall quality of lead candidates in the area of noncompetitive AR inhibition is discussed, and it identifies the key chemotypes and associated properties which are likely to be, or are currently, positioned to be first in human applications.


Assuntos
Neoplasias de Próstata Resistentes à Castração , Receptores Androgênicos , Masculino , Humanos , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Neoplasias de Próstata Resistentes à Castração/patologia , Antagonistas de Androgênios/uso terapêutico , Linhagem Celular Tumoral
2.
BMC Public Health ; 21(1): 784, 2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-33892700

RESUMO

BACKGROUND: Public health organizations have been alerted to the high levels of sedentary behaviour (SB) among adolescents as well as to the health and social consequences of excess sedentary time. However, SB changes of the European Union (EU) adolescents over time have not been reported yet. This study aimed to identify SB of the EU adolescents (15-17 years) in four-time points (2002, 2005, 2013 and 2017) and to analyse the prevalence of SB according to the sex. METHODS: SB of 2542 adolescents (1335 boys and 1207 girls) as a whole sample and country-by-country was analysed in 2002, 2005, 2013, and 2017 using the Sport and Physical Activity EU Special Eurobarometers' data. SB was measured using the sitting time question from the short version of the International Physical Activity Questionnaire (IPAQ), such that 4h30min of daily sitting time was the delineating point to determine excess SB behaviour (≥4h30min of sitting time) or not (≤4h30min of sitting time). A χ2 test was used to compare the prevalence of SB between survey years. Furthermore, SB prevalence between sexes was analysed using a Z-Score test for two population proportions. RESULTS: The prevalence of SB among EU adolescents across each of the four survey years ranged from 74.2 and 76.8%, rates that are considered high. High levels of SB were also displayed by both sexes (girls: 76.8 to 81.2%; boys: 71.7 to 76.7%). No significant differences in the prevalence of SB among years (p > 0.05) were found for the whole sample, and for either girls or boys. Also, no significant differences in the prevalence of SB between girls and boys were found. CONCLUSION: The SB prevalence in European adolescents is extremely high (76.8% in 2017) with no differences between girls and boys. No significant improvements have been seen between 2002 and 2017. Eurobarometer should increase the adolescents' sample to make possible benchmarking comparisons among the EU countries and extend the survey to the younger children population.


Assuntos
Comportamento Sedentário , Esportes , Adolescente , Criança , Estudos Transversais , Europa (Continente) , Exercício Físico , Feminino , Humanos , Masculino , Saúde Pública
3.
Dis Aquat Organ ; 120(3): 231-40, 2016 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-27503919

RESUMO

This is the first report of ostreid herpesvirus 1 microvariant (OsHV-1 µVar) infecting natural oyster beds located in Huelva (SW Spain). The virus was detected in 3 oyster species present in the intertidal zone: Crassostrea gigas (Thunberg, 1793), C. angulata (Lamarck, 1819) and, for the first time, in Ostrea stentina Payraudeau, 1826. Oysters were identified by a specific polymerase chain reaction (PCR) and posterior restriction fragment length polymorphism (RFLP) analysis based on cytochrome oxidase I (COI) mitochondrial DNA. Results confirmed that C. angulata still remains the dominant oyster population in SW Spain despite the introduction of C. gigas for cultivation in the late 1970s, and its subsequent naturalization. C. angulata shows a higher haplotype diversity than C. gigas. OsHV-1 virus was detected by PCR with C2/C6 pair primers. Posterior RFLP analyses with the restriction enzyme MfeI were done in order to reveal the OsHV-1 µVar. Detections were confirmed by DNA sequencing, and infections were evidenced by in situ hybridization in C. gigas, C. angulata and O. stentina samples. The prevalence was similar among the 3 oyster species but varied between sampling locations, being higher in areas with greater harvesting activities. OsHV-1 µVar accounted for 93% of all OsHV-1 detected.


Assuntos
Crassostrea/virologia , Herpesviridae/isolamento & purificação , Animais , Haplótipos , Herpesviridae/genética , Interações Hospedeiro-Patógeno , Espanha , Especificidade da Espécie
4.
Neurologia ; 29(3): 168-83, 2014 Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-21937151

RESUMO

BACKGROUND AND OBJECTIVE: To update the ad hoc Committee of the Cerebrovascular Diseases Study Group of The Spanish Neurological Society guidelines on prevention of ischaemic stroke (IS) and Transient Ischaemic Attack (TIA). METHODS: We reviewed the available evidence on ischaemic stroke and TIA prevention according to aetiological subtype. Levels of evidence and recommendation levels are based on the classification of the Centre for Evidence-Based Medicine. RESULTS: In atherothrombotic IS, antiplatelet therapy and revascularization procedures in selected cases of ipsilateral carotid stenosis (70%-90%) reduce the risk of recurrences. In cardioembolic IS (atrial fibrillation, valvular diseases, prosthetic valves and myocardial infarction with mural thrombus) prevention is based on the use of oral anticoagulants. Preventive therapies for uncommon causes of IS will depend on the aetiology. In the case of cerebral venous thrombosis oral anticoagulation is effective. CONCLUSIONS: We conclude with recommendations for clinical practice in prevention of IS according to the aetiological subtype presented by the patient.


Assuntos
Isquemia Encefálica/prevenção & controle , Ataque Isquêmico Transitório/prevenção & controle , Acidente Vascular Cerebral/prevenção & controle , Isquemia Encefálica/classificação , Isquemia Encefálica/etiologia , Medicina Baseada em Evidências , Humanos , Ataque Isquêmico Transitório/classificação , Ataque Isquêmico Transitório/etiologia , Acidente Vascular Cerebral/classificação , Acidente Vascular Cerebral/etiologia
5.
Neurologia ; 29(2): 102-22, 2014 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-22152803

RESUMO

INTRODUCTION: Update of Acute Ischaemic Stroke Treatment Guidelines of the Spanish Neurological Society based on a critical review of the literature. Recommendations are made based on levels of evidence from published data and studies. DEVELOPMENT: Organized systems of care should be implemented to ensure access to the optimal management of all acute stroke patients in stroke units. Standard of care should include treatment of blood pressure (should only be treated if values are over 185/105 mmHg), treatment of hyperglycaemia over 155 mg/dl, and treatment of body temperature with antipyretic drugs if it rises above 37.5 °C. Neurological and systemic complications must be prevented and promptly treated. Decompressive hemicraniectomy should be considered in cases of malignant cerebral oedema. Intravenous thrombolysis with rtPA should be administered within 4.5 hours from symptom onset, except when there are contraindications. Intra-arterial pharmacological thrombolysis can be considered within 6 hours, and mechanical thrombectomy within 8 hours from onset, for anterior circulation strokes, while a wider window of opportunity up to 12-24 hours is feasible for posterior strokes. There is not enough evidence to recommend routine use of the so called neuroprotective drugs. Anticoagulation should be administered to patients with cerebral vein thrombosis. Rehabilitation should be started as early as possible. CONCLUSION: Treatment of acute ischaemic stroke includes management of patients in stroke units. Systemic thrombolysis should be considered within 4.5 hours from symptom onset. Intra-arterial approaches with a wider window of opportunity can be an option in certain cases. Protective and restorative therapies are being investigated.


Assuntos
Isquemia Encefálica/terapia , Acidente Vascular Cerebral/terapia , Terapia Trombolítica/métodos , Isquemia Encefálica/etiologia , Humanos , Embolia Intracraniana/complicações , Embolia Intracraniana/terapia , Acidente Vascular Cerebral/etiologia , Trombectomia
6.
Neurologia ; 29(7): 387-96, 2014 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-24035294

RESUMO

INTRODUCTION: The Spanish Health System's stroke care strategy (EISNS) is a consensus statement that was drawn up by various government bodies and scientific societies with the aim of improving quality throughout the care process and ensuring equality among regions. Our objective is to analyse existing healthcare resources and establish whether they have met EISNS targets. MATERIAL AND METHODS: The survey on available resources was conducted by a committee of neurologists representing each of Spain's regions; the same committee also conducted the survey of 2008. The items included were the number of stroke units (SU), their resources (monitoring, neurologists on call 24h/7d, nurse ratio, protocols), SU bed ratio/100,000 inhabitants, diagnostic resources (cardiac and cerebral arterial ultrasound, advanced neuroimaging), performing iv thrombolysis, neurovascular interventional radiology (neuro VIR), surgery for malignant middle cerebral artery (MCA) infarctions and telemedicine availability. RESULTS: We included data from 136 hospitals and found 45 Stroke Units distributed unequally among regions. The ratio of SU beds to residents ranged from 1/74,000 to 1/1,037,000 inhabitants; only the regions of Cantabria and Navarre met the target. Neurologists performed 3,237 intravenous thrombolysis procedures in 83 hospitals; thrombolysis procedures compared to the total of ischaemic strokes yielded percentages ranging from 0.3 to 33.7%. Hospitals without SUs showed varying levels of available resources. Neuro VIR is performed in every region except La Rioja, and VIR is only available on a 24h/7 d basis in 17 cities. Surgery for malignant MCA infarction is performed in 46 hospitals, and 5 have telemedicine. CONCLUSION: Stroke care has improved in terms of numbers of participating hospitals, the increased use of intravenous thrombolysis and endovascular procedures, and surgery for malignant MCA infarction. Implementation of SUs and telemedicine remain insufficient. The availability of diagnostic resources is good in most SUs and irregular in other hospitals. Regional governments should strive to ensure better care and territorial equality, which would achieve the EISNS objectives.


Assuntos
Recursos em Saúde/provisão & distribuição , Disparidades em Assistência à Saúde/organização & administração , Acidente Vascular Cerebral/terapia , Procedimentos Endovasculares/métodos , Hospitais , Humanos , Neurologia , Qualidade da Assistência à Saúde , Espanha , Inquéritos e Questionários , Terapia Trombolítica/métodos , Recursos Humanos
7.
Neurologia ; 28(6): 332-9, 2013.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-22995527

RESUMO

INTRODUCTION: Patients with stroke associated with non-valvular atrial fibrillation (NVAF) are a specific group, and their disease has a considerable social and economic impact. The primary objective of the CONOCES study, the protocol of which is presented here, is to compare the costs of stroke in NVAF patients to those of patients without NVAF in Spanish stroke units from a societal perspective. MATERIALS AND METHODS: CONOCES is an epidemiological, observational, naturalistic, prospective, multicentre study of the cost of the illness in a sample of patients who have suffered a stroke and were admitted to a Spanish stroke unit. During a 12-month follow-up period, we record sociodemographic and clinical variables, score on the NIH stroke scale, level of disability, degree of functional dependency according to the modified Rankin scale, and use of healthcare resources (hospitalisation at the time of the first episode, readmissions, outpatient rehabilitation, orthotic and/or prosthetic material, medication for secondary prevention, medical check-ups, nursing care and formal social care services). Estimated monthly income, lost work productivity and health-related quality of life measured with the generic EQ-5D questionnaire are also recorded. We also administer a direct interview to the caregiver to determine loss of productivity, informal care, and caregiver burden. RESULTS AND CONCLUSIONS: The CONOCES study will provide more in-depth information about the economic and clinical impact of stroke according to whether or not it is associated with NVAF.


Assuntos
Fibrilação Atrial/complicações , Acidente Vascular Cerebral/economia , Acidente Vascular Cerebral/etiologia , Efeitos Psicossociais da Doença , Humanos , Estudos Prospectivos , Espanha
8.
Neurologia ; 28(4): 236-49, 2013 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-21570742

RESUMO

Intracerebral haemorrhage accounts for 10%-15% of all strokes; however it has a poor prognosis with higher rates of morbidity and mortality. Neurological deterioration is often observed during the first hours after onset and determines poor prognosis. Intracerebral haemorrhage, therefore, is a neurological emergency which must be diagnosed and treated properly as soon as possible. In this guide we review the diagnostic procedures and factors that influence the prognosis of patients with intracerebral haemorrhage and we establish recommendations for the therapeutic strategy, systematic diagnosis, acute treatment and secondary prevention for this condition.


Assuntos
Hemorragia Cerebral/tratamento farmacológico , Hemorragia Cerebral/terapia , Hemorragia Cerebral/complicações , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/cirurgia , Serviços Médicos de Emergência , Serviço Hospitalar de Emergência , Humanos , Neuroimagem , Procedimentos Neurocirúrgicos , Guias de Prática Clínica como Assunto , Prevenção Secundária , Acidente Vascular Cerebral/terapia
9.
ACS Med Chem Lett ; 14(12): 1800-1806, 2023 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-38116409

RESUMO

The androgen receptor (AR) is central to prostate cancer pathogenesis and has been extensively validated as a drug target. However, small-molecule anti-androgen therapies remain limited due to resistance and will eventually fail to suppress tumor growth, resulting in progression to castration-resistant prostate cancer (CRPC). The intrinsically disordered N-terminal domain (NTD) is crucial for AR transactivation and has been investigated as a suitable target in the presence of ligand binding domain mutations. A screening campaign identified biaryl isoxazole compound 7 as a weak inhibitor of the AR NTD. A library of biaryl analogues were synthesized, and their biological activities were assessed in a VCaP cell-based luciferase reporter gene assay. A structure-activity relationship (SAR) study revealed that indazole analogue 16 exhibited increased potency and favorable physicochemical properties with a benchmarked pharmacokinetic profile, providing a suitable starting point for further optimization of 16 as a CRPC therapeutic in the presence of AR mutations.

10.
Neurologia ; 27(9): 560-74, 2012.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-21890241

RESUMO

OBJECTIVE: To update the ad hoc Committee of the Cerebrovascular Diseases Study Group of The Spanish Neurological Society guidelines on prevention of ischaemic stroke (IS) and transient ischaemic attack (TIA). METHODS: We reviewed available evidence on risk factors and means of modifying them to prevent ischaemic stroke and TIA. Levels of evidence and recommendation grades are based on the classification of the Centre for Evidence-Based Medicine. RESULTS: This first section summarises the recommendations for action on the following factors: blood pressure, diabetes, lipids, tobacco and alcohol consumption, diet and physical activity, cardio-embolic diseases, asymptomatic carotid stenosis, hormone replacement therapy and contraceptives, hyperhomocysteinemia, prothrombotic states and sleep apnea syndrome. CONCLUSIONS: Changes in lifestyle and pharmacological treatment for hypertension, diabetes mellitus and dyslipidemia, according to criteria of primary and secondary prevention, are recommended for preventing ischemic stroke.


Assuntos
Isquemia Encefálica/prevenção & controle , Ataque Isquêmico Transitório/prevenção & controle , Estilo de Vida , Acidente Vascular Cerebral/prevenção & controle , Isquemia Encefálica/epidemiologia , Medicina Baseada em Evidências , Humanos , Ataque Isquêmico Transitório/epidemiologia , Fatores de Risco , Espanha/epidemiologia , Acidente Vascular Cerebral/epidemiologia
11.
Acta Ortop Mex ; 36(3): 159-165, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-36862930

RESUMO

INTRODUCTION: the final stage of rotator cuff tear arthropathy generates pain and disability, treatment with reverse shoulder arthroplasty shows in different published studies good rates of pain reduction and improvements in mobility. the objective of our study was to retrospectively evaluate the medium-term results of inverted shoulder replacement at our center. MATERIAL AND METHODS: retrospectively, we analyzed 21 patients (23 prosthetics) undergoing reverse shoulder arthroplasty with the diagnosis of rotator cuff tear arthropathy. The average age of patients was 75.21 years The minimum follow-up was 60 months. We analyzed in all preoperative ASES, DASH and CONSTANT patients, and a new functional assessment was made using these same scales at the last follow-up visit. We analyzed pre and postoperative VAS as well as pre and postoperative mobility range. RESULTS: we achieved a statistically significant improvement in all functional scale and pain values (p < 0.001). The ASES scale showed an improvement of 38.91 points (95% CI 30.97-46.84); the 40.89-point CONSTANT scale (95% 34.57-47.21) and the 52.65-point DASH scale (95% 46.31-59.0) p < 0.001. We found an improvement of 5.41 points (95% CI 4.31-6.50) on the VAS scale. We also achieved a statistically significant improvement in flexion values 66.52o to 113.91o degrees; abduction 63.69o to 105.85o degrees at the end of the follow-up. We did not get statistical significance in terms of external rotation but with a tendency to improve in the obtained values; instead in internal rotation we obtained results that showed a tendency to worsen. Complications occurred during follow-up in 14 patients; 11 in relation to notching glenoid, one patient with a chronic infection, one patient with a late infection and one intraoperative fracture of glenoid. CONCLUSIONS: reverse shoulder arthroplasty is an effective treatment of rotator cuff arthropathy. Pain relief and improvement in shoulder flexion and abduction can be expected especially; the gain in rotations is unpredictable.


INTRODUCCIÓN: el estadio final de la artropatía de manguito (AM) genera dolor e invalidez, el tratamiento mediante artroplastía invertida (AI) muestra buenos índices de reducción de dolor y mejoras en movilidad. El objetivo de nuestro trabajo fue evaluar de manera retrospectiva los resultados a mediano plazo de la artroplastía invertida de hombro en nuestro centro. MATERIAL Y MÉTODO: retrospectivamente analizamos 21 pacientes (23 prótesis) sometidos a AI con el diagnóstico de AM. La edad media fue de 75.21 años. El seguimiento mínimo fue de 60 meses. Analizamos las escalas ASES, DASH y CONSTANT preoperatorias y en la última visita de seguimiento. Se analizó la escala VAS preoperatoria y postoperatoria y rango de movilidad preoperatoria y postoperatoria. RESULTADOS: mejoraron todas las escalas funcionales y dolor (p < 0.001). ASES en 38.91 puntos (IC 95% 30.97-46.84); CONSTANT en 40.89 puntos (IC 95% 34.57-47.21); DASH en 52.65 puntos (IC 95% 46.31-59.0) p < 0.001; y 5.41 puntos (IC 95% 4.31-6.50) en VAS. Mejoraron con significación estadística la flexión (66.52o a 113.91o); y la abducción (63.69o a 105.85o). No obtuvimos significación estadística en rotación externa ni en rotación interna. Aparecieron complicaciones en 14 pacientes; 11 notching glenoideo, una infección crónica, una infección tardía y una fractura intraoperatoria de glenoides. CONCLUSIONES: la AI de hombro representa una alternativa eficaz para el tratamiento de la AM. Puede esperarse alivio del dolor y una mejoría en la flexión y abducción del hombro; la ganancia en rotaciones es poco predecible.


Assuntos
Artroplastia de Substituição , Artropatia de Ruptura do Manguito Rotador , Idoso , Humanos , Artroplastia de Substituição/métodos , Artropatias/complicações , Artropatias/cirurgia , Dor/etiologia , Estudos Retrospectivos , Artropatia de Ruptura do Manguito Rotador/complicações , Artropatia de Ruptura do Manguito Rotador/cirurgia , Amplitude de Movimento Articular , Avaliação da Deficiência , Recuperação de Função Fisiológica
12.
Org Lett ; 24(51): 9491-9496, 2022 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-36524745

RESUMO

We report the use of N-2,4-dinitrophenyltetrazoles as latent active esters (LAEs) in the synthesis of amide bonds. Activating the tetrazole generates an HOBt-type active ester without the requirement for exogenous coupling agents. The methodology was widely applicable to a range of substrates, with up to quantitative yields obtained. The versatility and functional group tolerance were exemplified with the one-step synthesis of various pharmaceutical agents and the N-acylation of resin-bound peptides.


Assuntos
Amidas , Ésteres , Peptídeos , Acilação , Tetrazóis/química
13.
Org Lett ; 24(1): 334-338, 2022 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-34964648

RESUMO

We report how the rearrangement of highly reactive nitrile imines derived from N-2-nitrophenyl hydrazonyl bromides can be harnessed for the facile construction of amide bonds. This amidation reaction was found to be widely applicable to the synthesis of primary, secondary, and tertiary amides and was used as the key step in the synthesis of the lipid-lowering agent bezafibrate. The orthogonality and functional group tolerance of this approach was exemplified by the N-acylation of unprotected amino acids.

14.
Int J Surg ; 97: 106168, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34785344

RESUMO

BACKGROUND AND AIMS: Emergency General Surgery (EGS) conditions account for millions of deaths worldwide, yet it is practiced without benchmarking-based quality improvement programs. The aim of this observational, prospective, multicenter, nationwide study was to determine the best benchmark cutoff points in EGS, as a reference to guide improvement measures. METHODS: Over a 6-month period, 38 centers (5% of all public hospitals) attending EGS patients on a 24-h, 7-days a week basis, enrolled consecutive patients requiring an emergent/urgent surgical procedure. Patients were stratified into cohorts of low (i.e., expected morbidity risk <33%), middle and high risk using the novel m-LUCENTUM calculator. RESULTS: A total of 7258 patients were included; age (mean ± SD) was 51.1 ± 21.5 years, 43.2% were female. Benchmark cutoffs in the low-risk cohort (5639 patients, 77.7% of total) were: use of laparoscopy ≥40.9%, length of hospital stays ≤3 days, any complication within 30 days ≤ 17.7%, and 30-day mortality ≤1.1%. The variables with the greatest impact were septicemia on length of hospital stay (21 days; adjusted beta coefficient 16.8; 95% CI: 15.3 to 18.3; P < .001), and respiratory failure on mortality (risk-adjusted population attributable fraction 44.6%, 95% CI 29.6 to 59.6, P < .001). Use of laparoscopy (odds ratio 0.764, 95% CI 0.678 to 0.861; P < .001), and intraoperative blood loss (101-500 mL: odds ratio 2.699, 95% CI 2.152 to 3.380; P < .001; and 500-1000 mL: odds ratio 2.875, 95% CI 1.403 to 5.858; P = .013) were associated with increased morbidity. CONCLUSIONS: This study offers, for the first time, clinically-based benchmark values in EGS and identifies measures for improvement.


Assuntos
Cirurgia Geral , Procedimentos Cirúrgicos Operatórios , Adulto , Idoso , Benchmarking , Estudos de Coortes , Emergências , Feminino , Mortalidade Hospitalar , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Prospectivos , Melhoria de Qualidade , Estudos Retrospectivos
15.
Horm Metab Res ; 43(11): 801-8, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22009376

RESUMO

The purpose of this study was to determine whether long-term modulation of inflammatory activity by tumor necrosis factor (TNF)-α inhibitors has some influence on insulin resistance (IR). 16 active rheumatoid arthritis (RA) patients without CV risk factors treated with anti-TNF-α agents were included in this study. RA activity by disease activity score 28, IR by HOMA2-IR, body composition by impedance analysis, physical activity by accelerometry, abdominal fat distribution by magnetic resonance imaging, and serum level of key adipokines by ELISA were measured at baseline and during a 1-year follow-up period. Patient body mass index increased significantly (26.94 ± 3.88 vs. 28.06 ± 4.57 kg/m2, p=0.02) after 1 year of treatment. Body composition, in terms of fat and fat-free mass, remained unchanged except for a significant elevation in body cell mass (25.50 ± 4.60 vs. 26.60 ± 3.17 kg, p=0.02). Basal levels of IR in the RA patients included in this study were significantly higher than healthy controls (1.6 ± 0.8 vs. 1.11 ± 0.56, p=0.011) but did not change during the follow-up. Nor did basal concentrations of adiponectin, visfatin, leptin, ghrelin, resistin, and apelin in response to anti-TNF-α treatment; only retinol-binding protein 4, showed a significant increase (51.7 ± 32.7 vs. 64.9 ± 28.4 µg/ml, p=0.03) at the end of the study. IR, adiposity distribution, and serum levels of most adipokines are not significantly affected by long-term inhibition of TNF-α in RA patients. Our data suggest that although systemic blockade of TNF-α exerts an anticachectic effect in RA patients, it does not seem to play a major role in IR.


Assuntos
Anabolizantes/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Resistência à Insulina , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adalimumab , Adulto , Idoso , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/imunologia , Artrite Reumatoide/metabolismo , Estudos de Coortes , Etanercepte , Feminino , Seguimentos , Humanos , Imunoglobulina G/uso terapêutico , Infliximab , Masculino , Síndrome Metabólica/tratamento farmacológico , Síndrome Metabólica/imunologia , Síndrome Metabólica/metabolismo , Pessoa de Meia-Idade , Estudos Prospectivos , Psoríase/tratamento farmacológico , Psoríase/imunologia , Psoríase/metabolismo , Receptores do Fator de Necrose Tumoral/uso terapêutico , Reprodutibilidade dos Testes
16.
Neurologia ; 26(4): 227-32, 2011 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-21163194

RESUMO

INTRODUCTION: The increase in the ageing population in the last decades has led to an increased frequency of cancer-associated complications. Among these, neurological disorders stand out, as they appear in 10-30% of patients with systemic neoplasia. Neoplastic meningitis accounts for 4-15% of patients with solid tumours and it has a poor prognosis. The objective of this paper is to describe the clinical, imaging and prognostic characteristics as well as cerebrospinal fluid findings in a series of neoplastic meningitis. BACKGROUND AND DEVELOPMENT: We performed a retrospective review of all patients admitted to the Hospital Universitario of Gran Canaria Dr. Negrín with clinical suspicion of neoplastic meningitis between 1990 and 2008. We selected 37 patients with an average age ranging from 15 to 75 years old. A total of 81.8% of the cases in which a primary tumour was found were associated with solid tumours (24.2% were located in the breast, and 24.2% in the lung). The most frequent sign of cranial nerve dysfunction was dyplopia, which was observed in 32.4% of the cases. The average survival rate after diagnosis was 87.9 days (12.6 weeks). The cerebrospinal fluid cytology was positive in 46.4% of the cases. CONCLUSION: Neoplastic meningitis is a severe complication of both solid and haematological tumours. We stress the importance of maintaining a high level of suspicion to achieve early diagnosis, since the average survival probability for neoplastic meningitis patients is low.


Assuntos
Leucemia , Carcinomatose Meníngea , Neoplasias , Adolescente , Adulto , Idoso , Líquido Cefalorraquidiano/citologia , Diagnóstico Diferencial , Feminino , Humanos , Leucemia/complicações , Leucemia/patologia , Leucemia/fisiopatologia , Masculino , Carcinomatose Meníngea/etiologia , Carcinomatose Meníngea/fisiopatologia , Carcinomatose Meníngea/secundário , Pessoa de Meia-Idade , Neoplasias/complicações , Neoplasias/patologia , Neoplasias/fisiopatologia , Prognóstico , Estudos Retrospectivos , Adulto Jovem
17.
Neurologia ; 26(8): 449-54, 2011 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-21440962

RESUMO

INTRODUCTION: Stroke is currently a major social health problem. For this reason, the Spanish Ministry of Health approved the Stroke National Strategy (SNS) in 2008 to improve the prevention, treatment and rehabilitation of stroke patients. This plan intends to guarantee 24-hour, 365-days neurological assistance in the whole country by the end of 2010. Our aim was to analyse the situation of stroke assistance in Spain in 2009. MATERIAL AND METHODS: A committee of neurologists practicing in the different autonomous communities (AC), and who had not participated in the preparation of the SNS, was created. A national survey was performed including the number of stroke units (SU) and their characteristics (monitoring, 24-h/7-day on-call neurology service, nursing staff ratio and the use of protocols), bed ratio of SU/100,000 people, availability of intravenous thrombolysis therapy, neurovascular intervention (NI) and telemedicine. RESULTS: We included data from 145 hospitals. There are 39 SU in Spain, unevenly distributed. The ratio between SU bed/number of people/AC varied from 1/75,000 to 1/1,037,000 inhabitants; Navarra and Cantabria met the goal. Intravenous thrombolysis therapy is used in 80 hospitals; the number of treatments per AC was between 7 and 536 in 2008. NI was performed in the 63% of the AC, with a total of 28 qualified hospitals (although only 1 hospital performed it 24h, 7 days a week in 2009). There were 3 hospitals offering clinical telemedicine services. CONCLUSIONS: Assistance for stroke patients has improved in Spain compared to previous years, but there are still some important differences between the AC that must be eliminated to achieve the objectives of the SNS.


Assuntos
Transtornos Cerebrovasculares , Atenção à Saúde , Recursos em Saúde , Acidente Vascular Cerebral/terapia , Coleta de Dados , Fibrinolíticos/uso terapêutico , Hospitais , Humanos , Infusões Intravenosas , Neurologia , Sociedades , Espanha , Telemedicina , Terapia Trombolítica/métodos , Recursos Humanos
18.
Astron Astrophys ; 6452021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33408420

RESUMO

CONTEXT: Yebes 40m radio telescope is the main and largest observing instrument at Yebes Observatory and it is devoted to Very Long Baseline Interferometry (VLBI) and single dish observations since 2010. It has been covering frequency bands between 2 GHz and 90 GHz in discontinuous and narrow windows in most of the cases, to match the current needs of the European VLBI Network (EVN) and the Global Millimeter VLBI Array (GMVA). AIMS: Nanocosmos project, a European Union funded synergy grant, opened the possibility to increase the instantaneous frequency coverage to observe many molecular transitions with single tunnings in single dish mode. This reduces the observing time and maximises the output from the telescope. METHODS: We present the technical specifications of the recently installed 31.5 - 50GHz (Q band) and 72 - 90.5 GHz (W band) receivers along with the main characteristics of the telescope at these frequency ranges. We have observed IRC+10216, CRL 2688 and CRL 618, which harbour a rich molecular chemistry, to demonstrate the capabilities of the new instrumentation for spectral observations in single dish mode. RESULTS: The results show the high sensitivity of the telescope in the Q band. The spectrum of IRC+10126 offers a signal to noise ratio never seen before for this source in this band. On the other hand, the spectrum normalised by the continuum flux towards CRL 618 in the W band demonstrates that the 40 m radio telescope produces comparable results to those from the IRAM 30 m radio telescope, although with a smaller sensitivity. The new receivers fulfil one of the main goals of Nanocosmos and open the possibility to study the spectrum of different astrophysical media with unprecedented sensitivity.

19.
Acta Ortop Mex ; 34(2): 71-76, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-33244904

RESUMO

INTRODUCTION: Glenohumeral osteoarthritis leads to a functional loss and a decrease in the quality of life of many patients that suffers it. Currently there is no agreement on the use of hemiarthroplasty or total arthroplasty as definitive treatment. The objective is to show the results of the treatment of primary glenohumeral osteoarthritis through hemiarthroplasty in our service. MATERIAL AND METHODS: We reviewed 14 patients (19 hemiarthroplasties) performed between 2004 and 2013 in patients diagnosed with primary glenohumeral osteoarthritis without glenoid morphological anomaly. We managed to collect data from eight patients (11 hemiarthroplasties), assessing functional status, pain, and performing activities of daily living using the Constant, ASES and DASH scores preoperatively and at five years of minimum follow-up (range 5-11 years), as well as related complications. The preoperative status was compared to the end of the follow-up. RESULTS: A significant improvement was found in all the parameters analyzed in the study (p. CONCLUSION: < 0.05). The average pain in EVA score decreased from 8.89 to 2.67. The ASES improved from 13.51 to 63. 51 half point. The Constant increase of 20.11 points to 65.11 points. The mean preoperative score in the DASH score was 73.68 and 28.30 postoperatively. The average survival of the implant was 81.82% in the seven years of average follow-up. Shoulder hemiarthroplasty obtains good functional results in the treatment of primary glenohumeral osteoarthritis with few complications. The cause of the failure were glenoid erosion in all the cases.


INTRODUCCIÓN: La artrosis glenohumeral conlleva a una pérdida funcional y a una disminución de la calidad de vida de muchos pacientes. Actualmente, no existe consenso en cuanto al uso de la hemiartroplastía o la artroplastía total como tratamiento definitivo para este padecimiento. El objetivo es mostrar los resultados del tratamiento de la artrosis glenohumeral primaria mediante hemiartroplastía en nuestro servicio. MATERIAL Y MÉTODOS: Revisamos 19 hemiartroplastías (14 pacientes) realizadas entre 2004 y 2013 en pacientes con artrosis glenohumeral primaria sin alteración morfológica glenoidea. Se recabaron los datos de ocho pacientes (11 hemiartroplastías), valorándose el estado funcional, el dolor y la realización de actividades de la vida diaria mediante las escalas Constant, ASES y DASH preoperatorias, a los cinco años de seguimiento mínimo (rango 5-11 años), así como las complicaciones presentadas. Se comparó el estado preoperatorio y al final del seguimiento. RESULTADOS: Se encontró una mejoría estadísticamente significativa (p. CONCLUSIÓN: < 0.05) en todos los parámetros analizados en el estudio. La media del dolor en la escala EVA disminuyó de 8.89 a 2.67. La escala ASES mejoró de 13.51 a 63.51 puntos de media. El Constant aumentó de 20.11 a 65.11 puntos. La puntuación media preoperatoria en la escala DASH fue de 73.68 y la postoperatoria de 28.30 puntos. La supervivencia media del implante fue de 81.82% a los siete años de seguimiento medio. Obtuvimos buenos resultados funcionales con la artrosis glenohumeral primaria, presentándose pocas complicaciones. La causa del fracaso fue la erosión glenoidea.


Assuntos
Hemiartroplastia , Osteoartrite , Articulação do Ombro , Atividades Cotidianas , Seguimentos , Humanos , Osteoartrite/cirurgia , Qualidade de Vida , Amplitude de Movimento Articular , Estudos Retrospectivos , Articulação do Ombro/cirurgia , Resultado do Tratamento
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