The percentage of CD39+ monocytes is higher in pregnant COVID-19+ patients than in nonpregnant COVID-19+ patients.

Current medical guidelines consider pregnant women with COVID-19 to be a high-risk group. Since physiological gestation downregulates the immunological response to maintain "maternal-fetal tolerance", SARS-CoV-2 infection may constitute a potentially threatening condition to both the mother and the fetus. To establish the immune profile in pregnant COVID-19+ patients, a cross-sectional study was conducted. Pregnant women with COVID-19 (P-COVID-19+; n = 15) were analyzed and compared with nonpregnant women with COVID-19 (NP-COVID-19+; n = 15) or those with physiological pregnancy (P-COVID-19-; n = 13). Serological cytokine and chemokine concentrations, leucocyte immunophenotypes, and mononuclear leucocyte responses to polyclonal stimuli were analyzed in all groups. Higher concentrations of serological TNF-α, IL-6, MIP1b and IL-4 were observed within the P-COVID-19+ group, while cytokines and chemokines secreted by peripheral leucocytes in response to LPS, IL-6 or PMA-ionomicin were similar among the groups. Immunophenotype analysis showed a lower percentage of HLA-DR+ monocytes in P-COVID-19+ than in P-COVID-19- and a higher percentage of CD39+ monocytes in P-COVID-19+ than in NP-COVID-19+. After whole blood polyclonal stimulation, similar percentages of T cells and TNF+ monocytes between groups were observed. Our results suggest that P-COVID-19+ elicits a strong inflammatory response similar to NP-COVID19+ but also displays an anti-inflammatory response that controls the ATP/adenosine balance and prevents hyperinflammatory damage in COVID-19.

Degree models in biomedical engineering / Modelos de titulación en ingeniería biomédica / Modelos de grau em engenharia biomédica

Abstract In this paper, the authors have carried out a systematic study and review of a set of researches and publications, regarding the theme of how to improve training programs in biomedical engineering, and make a contribution to the specialization in the area of clinic engineering.

Resumen En este artículo, los autores han realizado un estudio y revisión sistemática de un conjunto de investigaciones y publicaciones sobre el tema de cómo mejorar los programas de capacitación en ingeniería biomédica y contribuir a la especialización en el área de ingeniería clínica.

Resumo Neste trabalho realizou-se um estudo e revisão sistemática de um conjunto de investigações e publicações sobre o tema de como melhorar os programas de capacitação em engenharia biomédica e contribuir à especialização na área de clínica Engenharia.

Association of serum pepsinogen with atrophic body gastritis in Costa Rica.

Individuals with atrophic gastritis (AG), especially atrophic body gastritis (ABG), are at increased risk of developing gastric cancer. Serum concentrations of pepsinogens (PG) have been proposed as markers for ABG. The aim of this study was to determine the risk factors for AG and ABG and the potential of using serum PG concentrations to detect ABG in a dyspeptic population in Costa Rica, which is one of the countries with the highest incidence and mortality rates of gastric cancer in the world. Seven biopsy specimens, a fasting blood sample and a questionnaire concerning sociodemographic factors were obtained from 501 consecutive dyspeptic patients. The serum PGI level and the PGI/PGII ratios were significantly lower in patients with ABG than in other groups (P<0.000). A cut-off point of 3.4 led to a sensitivity of 91.2% in identifying ABG, a negative predictive value of 98.1%, but a positive predictive value of only 11.2%. Helicobacter pylori were present in 93% of the patients and all those with peptic ulcers were positive. AG was associated with increased age, lower body mass index, high alcohol intake and low fruit consumption. ABG was associated with age, alcohol consumption and PGI/PGII<3.4. In dyspeptic patients with a high prevalence of H. pylori infection, serum PG levels provide an assessment of ABG but it is necessary to introduce other serological and genetic markers in order to achieve a better specificity. Those markers could be serum antibodies to H. pylori-CagA, cytokine gene polymorphisms or others.

Nefropatía lúpica en niños Correlación clínico patológica en una institución pediátrica de Bogotá - Colombia / Lupus nephrophaty in childhood. Clinical and histological correlations in a pediatric Institution of Bogotá - Colombia

Antecedentes. El lupus eritematoso sistémico es una enfermedad autoinmune que ocasiona depósitos de complejos antígeno-anticuerpo incluso en los tejidos renales. Objetivo. Describir la relación entre las lesiones observadas en la biopsia renal y las manifestaciones clínicas, el tratamiento y la evolución de la enfermedad en un grupo de pacientes pediátricos con lupus eritematoso sistémico. Material y métodos. Estudio retrospectivo de 11 pacientes atendidos en la Fundación Hospital de la Misericordia, de Bogotá Colombia entre marzo de 2002 y abril de 2003, a quienes se practicó biopsia renal . El material histológico se clasificó de acuerdo a la propuesta de la Organización Mundial de la Salud para la nefropatía lúpica. Resultados. El rango de edad fue de 5-11 años, 10 pacientes fueron del género femenino. La mayoría tenían compromiso renal al momento de realizar el diagnóstico clínico. En nueve hubo manifestaciones sistémicas. Las lesiones histológicas, en su mayoría nefropatía lúpica tipo IV de la clasificación propuesta por la Organización Mundial de la Salud; correlacionaron bien con el cuadro clínico, su tratamiento y evolución. Conclusiones . La biopsia renal ayuda a caracterizar el tipo de compromiso renal y define el diagnóstico y facilita el manejo terapéutico de los pacientes pediátricos con lupus eritematoso sistémico

Effects of glucose intolerance on myocardial function and collagen-linked glycation.

In experimental diabetes, diastolic dysfunction of the left ventricle has been associated with collagen-linked glycation. To determine whether less severe hyperglycemia may have similar effects, we gave alloxan to mongrel dogs (group 2) to induce impaired glucose tolerance (IGT) for comparison with normal subjects (group 1). After 6 months, hemodynamic studies were performed in the anesthetized animals. Basal heart rate, aortic pressure, and ejection fraction were comparable in the two groups, but calculated chamber stiffness was increased in group 2, associated with a reduced end diastolic volume and increased pressure. During infusion of dextran, the volume and pressure responses were similarly abnormal in group 2. In the myocardium, the collagen concentration rose with an increased interstitial distribution histologically. To assess glycation, collagen was extracted, digested with collagenase, and measured for fluorescence. Advanced glycation end products were increased in group 2 to 10.6 +/- 1.6 vs. 6.9 +/- 0.7 fluorescent units (FU)/mg collagen in group 1 (P < 0.01). To assess whether this could be pharmacologically prevented, we administered enalapril to inhibit ACE during the 6 months of glucose intolerance to group 3. This resulted in normal glycation and significant reduction in chamber stiffness increment. We gave group 4 animals aminoguanidine daily for 6 months, which prevented abnormal collagen glycation and chamber stiffness. Thus, in animals with IGT, collagen-linked glycosylation appeared to be a major factor affecting diastolic function and was shown to be amenable to pharmacological intervention.

Toma de muestra para cultivo por succión traqueal abierta, cerrada y por fibroboncoscopía: informe preliminar / Sample collection for culture by open and closed tracheal suction and by fiber-bronchoscopy: preliminar report

La succión de secreciones, dentro de los procedimiento de la kinesiterapia respiratoria, es esencial en la toma de muestras cultivables para la tipificación de gérmenes e inicio del tratamiento antibiótico específico y adecuado. Se realizó un seguimiento de siete pacientes internados en la UCI del Hospital Mutual de Seguridad entre el 9 de nunio y 12 de diciembre de 1997. Se utilizaron tres métodos: a) toma de muestra convencional, b) toma de muestra cerrada, c) fibrobroncoscopía protegida (FBCP) selectiva por arrastre. Todas las muestras, recolectadas por kinesiólogos, se realizaron posterior a procedimientos de kinesiterapia respiratoria. Se analizaron 15 muestras: 7 convencionales, 5 cerradas, 3 FBCP. Los gérmenes aislados correspondieron a St. Aureus (7), Ac, Baumannii (6), Kl. Pneumoniae (2), Ps. Aeruginosa (2), Str. Viridans (2). El antibiograma no demostró diferencias significativas entre los tres métodos realizados. La correlación en términos de aislamiento del germen y la cantidad fue alta para los tres métodos. Según este estudio preliminar, limitado por la muestra, se pudo agregar que no existió diferencia en la tipificación bacteriana, independiente del método utilizado en la obtención de la muestra de secreción bronquial. Existiría una tendencia a evidenciar que la muestra post kinesiterapia respiratoria es tan representativa como la realizada con FBCP, además de ser más barata y menos invasiva. Por otra parte, la muestra a través de un sistema cerrado es válida para ser utilizada en pacientes con soporte ventilatorio completo y agresivo, y/o inestables a a la desconexión del circuito paciente del ventilador

Nutrición de yodo en escolares de cuatro zonas censorias de Chile / Iodine nutrition in school age children of four censorial areas of Chile

Background: although endemic goiter is an easily controlled chronic disease, it continues to be a serious global public health problem. Aim: To study iodine nutrition in school age children from different areas of Chile. Subjects and methods: Thyroid gland was palpated in 4181 school age children from Calama, Santiago, Temuco and Punta Arenas. Urinariy iodine excretion was measured to 9 percent of these children and iodine concentration in salt for human consumption obtained in each of these areas was determined. Results: A 9 percent goiter prevalence in boys and 11 percent prevalence in girls was detected. The prevalence of goiter Ia was 6.5 percent and the figure in different geographic areas was similar. Iodine concentration in salt for human consumption was adequate according to Chilean legislation (82.6, 95.7, 96.8 and 93.2 ug ugI/g salt in Calama, Santiago, Temuco and Punta Arenas respectively). Urinary iodine excretion in boys and girls was 1695 and 1802 ug l/g creatinine in Calama, 680 and 732 in Santiago, 574 and 690 in Temuco, 570 and 528 in Punta Arenas. These values are well above recommendations. Conclusions: Endemic goiter is no longer a problem in Chile, the importance of a continuous surveillance of iodine nutrition in Chile and the reduction of salt iodine concentration required by Chilean legislation is underscored

Influence of nicotine on myocardial stiffness and fibrosis during chronic ethanol use.

Cardiomyopathy related to ethanol abuse is often accompanied by cigarette use. To examine if the major cardioactive component may intensify the abnormal function and composition induced by chronic ethanol, nicotine was administered orally, 2.5 mg bid, to a canine model receiving 36% of calories as ethanol for 6 months (group III). These animals were compared with group II receiving ethanol alone, group IV on nicotine alone, and controls (group I). In the intact, ventilated, anesthetized dog, left ventricular pressures and volumes were measured before and after dextran infusion and related to left ventricular collagen alterations. Basal heart rate, aortic pressure, and ejection fraction were comparable with controls. End-diastolic pressure and diastolic chamber stiffness (KPV) were significantly higher in the basal state and during dextran infusion in the three experimental groups, compared with group I. The increment was largest in the ethanol-nicotine group. Analysis of left ventricular myocardium revealed a rise of collagen concentrations in all three experimental groups, with an interstitial distribution on histochemical examination. Moreover, determination of advanced glycosylation endproducts, as a measure of alterations in collagen cross-links, revealed higher concentrations versus controls. The greater increase of diastolic stiffness in the nicotine-ethanol group occurred despite a similar concentration of fluorescent products as group II. Because the former had a larger increase of collage concentration, total cross-linked collagen content was presumably greater after the combined use of nicotine-ethanol. Thus, nicotine in relatively high dose when combined with ethanol, elicited a modest further increase in the left ventricular chamber stiffness and collagen concentration.

Left ventricular diastolic function in hypertension and role of plasma glucose and insulin. Comparison with diabetic heart.

BACKGROUND: Experimental production of glucose intolerance has been associated with increased diastolic stiffness of the left ventricle, accompanied by interstitial fibrosis. Because carbohydrate metabolism is altered in hypertension, we undertook the present study to assess the relation of diastolic dysfunction in hypertension to plasma glucose and insulin concentrations. The latter are also affected by obesity. To facilitate this analysis, we studied moderately obese hypertensives. Elucidation of these relations was then sought in diabetic subjects. METHODS AND RESULTS: Subjects undergoing catheterization for chest pain were included in the study when significant coronary disease was not present. In groups 1 (lean), 2 (obese), 3 (lean hypertensive), and 4 (obese hypertensives), intraventricular pressures and volumes were determined. Fasting plasma glucose, insulin, hemoglobinAIC, and glucose tolerance were assessed. Basal ejection fraction and end-systolic wall stress were normal in the four groups. Chamber stiffness was significantly elevated in the hypertensives and was higher in group 4 than in group 3 (P < .05). Diastolic dysfunction was correlated with fasting blood glucose (r = .69, P < .006) but not with plasma insulin or left ventricular mass. Chamber stiffness was also increased in diabetics, with a larger effect in the obese. CONCLUSIONS: Hypertension is associated with increased diastolic stiffness of the left ventricle, which is enhanced by moderate obesity, and abnormal carbohydrate metabolism. Experimentally and in humans, hypertension is associated with interstitial fibrosis of mycardium, the presumed basis for the diastolic dysfunction. Chamber stiffness in group 4 hypertensives was similar to that in the lean diabetics but less than that in the obese diabetics. Although the latter exhibited a correlation with plasma hemoglobinAIC, the large rise in stiffness suggests a potential role for growth factors in further alteration of myocardial composition.

Melatonin biosynthesis in photoreceptor-enriched chick retinal cell cultures: role of cyclic AMP in the K(+)-evoked, Ca(2+)-dependent induction of serotonin N-acetyltransferase activity.

The roles of cyclic AMP and calcium in the regulation of serotonin N-acetyltransferase (NAT) activity were studied in low density monolayer cultures of chick retinal photoreceptors and neurons. Photoreceptor-enriched retinal cell cultures were prepared from embryonic day 6 retinas and cultured for 6 days. NAT activity in these cultures could be induced by treatment with cyclic AMP protagonists, 8Br-cyclic AMP, forskolin, and 3-isobutyl-1-methylxanthine (IBMX), or by treatment with depolarizing concentrations of extracellular K+. The stimulatory effect of K+, which involves Ca2+ influx through dihydropyridine-sensitive channels, was mediated at least in part by cyclic AMP, as indicated by the following observations. Depolarizing concentrations of K+ stimulated the formation of cyclic AMP, and the stimulatory effects of K+ on both cyclic AMP formation and on NAT activity were synergistically potentiated by the cyclic nucleotide phosphodiesterase inhibitor 3-isobutyl-1-methylxanthine (IBMX). MDL 12,330A, a putative adenylate cyclase inhibitor, inhibited K(+)-evoked cyclic AMP accumulation and induction of NAT activity over the identical concentration range. In contrast, MDL 12,300A failed to inhibit the induction of NAT elicited by 8Br-cyclic AMP. H-89, an inhibitor of cyclic AMP-dependent protein kinase, antagonized the induction of NAT activity by either forskolin or K+ with equal potency for both stimuli. These results suggest that cyclic AMP plays an essential role in the induction of NAT activity that occurs as a consequence of membrane depolarization. Cyclic AMP and Ca2+ may also interact at a step distal to adenylate cyclase.(ABSTRACT TRUNCATED AT 250 WORDS)

K(+)-evoked depolarization stimulates cyclic AMP accumulation in photoreceptor-enriched retinal cell cultures: role of calcium influx through dihydropyridine-sensitive calcium channels.

The effect of membrane depolarization on cyclic AMP synthesis was studied in glia-free, low-density, monolayer cultures of chick retinal photoreceptors and neurons. In photoreceptor-enriched cultures prepared from embryonic day 6 retinas and cultured for 6 days, elevated K+ concentrations increased the intracellular concentration of cyclic AMP and stimulated the conversion of [3H]adenine to [3H]cyclic AMP. The K(+)-evoked increase of cyclic AMP accumulation was blocked by omitting CaCl2 from the incubation medium, indicating a requirement for extracellular Ca2+. Stimulation of cyclic AMP accumulation was also inhibited by nifedipine, methoxyverapamil, Cd2+, Co2+, and Mg2+, and was enhanced by the dihydropyridine Ca2+ channel agonist Bay K 8644. The enhancement of K(+)-evoked cyclic AMP accumulation by Bay K 8644 was antagonized by nifedipine. Thus, Ca2+ influx through dihydropyridine-sensitive channel is required for depolarization-evoked stimulation of cyclic AMP accumulation in photoreceptor-enriched cultures.

Cyclic AMP-dependent induction of serotonin N-acetyltransferase activity in photoreceptor-enriched chick retinal cell cultures: characterization and inhibition by dopamine.

The activity of serotonin N-acetyltransferase (NAT), a key regulatory enzyme in the melatonin biosynthetic pathway, was examined in low-density monolayer cultures of chick embryo retinal cells prepared with three levels of photoreceptor enrichment. In cultures prepared from embryonic day 8 retinas (E8), photoreceptors represented approximately 30% of the total cell population, whereas in those prepared from embryonic day 6 retinas (E6), approximately 70% of the cells were photoreceptors. In E8 retinas treated with kainic acid to destroy neurons (E8K), the relative content of photoreceptors was increased to approximately 50%. NAT activity was detectable in the cultures under all conditions studied, and was markedly increased by drugs that increase intracellular cyclic AMP levels and cyclic AMP-dependent protein kinase activity: 8-bromocyclic AMP, forskolin, and 3-isobutyl-1-methylxanthine (IBMX). Consistent with the hypothesis that NAT is localized in photoreceptors, the effects of the stimulatory treatments were significantly greater in E6 and E8K cultures than in E8 cultures. The stimulation of NAT activity in E6 cultures was inhibited by actinomycin D and cycloheximide, suggesting the involvement of RNA and protein synthesis. Dopamine inhibited the induction of NAT activity by forskolin and IBMX, but not that elicited by 8-bromocyclic AMP. The dopamine-mediated suppression of activity was significantly inhibited by pertussis toxin and by spiperone and sulpiride, both D2-dopamine receptor antagonists, but not by SCH 23390, a D1-dopamine receptor blocker, or antagonists of alpha-adrenergic, beta-adrenergic, or serotonergic receptors. Because the inhibitory effect of dopamine on E6 and E8K cultures was at least as great as that on E8 cultures, the results suggest that dopamine acts on D2-like receptors on photoreceptors. The receptors appear to be coupled to adenylate cyclase through an inhibitory GTP-binding protein and to mediate inhibition of cyclic AMP synthesis and consequent induction of NAT activity.

K(+)-evoked depolarization induces serotonin N-acetyltransferase activity in photoreceptor-enriched retinal cell cultures. Involvement of calcium influx through l-type channels.

The roles of membrane depolarization and calcium influx in the regulation of retinal serotonin N-acetyltransferase (NAT) activity were investigated in low-density monolayer cultures of chick retinal cells, in which photoreceptors represented approximately 70% of the total cell population. NAT activity expressed by the cells in these cultures was markedly increased by elevating the concentration of extracellular K(+). Activity increased rapidly during the first 6 h of exposure to K(+), and remained elevated for at least 30 h. Chelation of calcium in the culture medium abolished the K(+)-evoked increase in NAT activity. Antagonists of voltage-sensitive calcium channels, nifedipine, methoxyverapamil (D600), Mn(2+), Mg(2+), and Cd(2+) inhibited the K(+)-evoked increase of NAT activity. Bay K 8644, a dihydropyridine calcium channel agonist, increased NAT activity when added alone and potentiated the K(+)-evoked increase of activity. The effect of Bay K 8644 was antagonized by nifedipine. Addition of nifedipine 18 h after addition of K(+), when NAT activity is elevated, caused activity to decrease to basal levels. These studies indicate that the increase of retinal NAT activity induced by K(+)-depolarization is mediated by a calcium-dependent process that involves sustained Ca(2+) influx through L-type voltage-sensitive Ca(2+)-channels.