ABSTRACT
Background: The RAPID [Renal (urea), Age, fluid Purulence, Infection source, Dietary (albumin)] score is a validated scoring system which allows risk stratification in patients with pleural infection at presentation. Surgical intervention plays a key role in managing pleural empyema. Methods: A retrospective study of patients with complicated pleural effusions and/or empyema undergoing thoracoscopic or open decortication admitted to multiple affiliated Texas hospitals from September 1, 2014 to September 30, 2018. The primary outcome was all-cause 90-day mortality. The secondary outcomes were organ failure, length of stay and 30-day readmission rate. The outcomes were compared between early surgery (≤3 days from diagnosis) and late surgery (>3 days from diagnosis) and low [0-3] vs. high [4-7] RAPID scores. Results: We enrolled 182 patients. Late surgery was associated with increased organ failure (64.0% vs. 45.6%, P=0.0197) and longer length of stay (16 vs. 10 days, P<0.0001). High RAPID scores were associated with a higher 90-day mortality (16.3% vs. 2.3%, P=0.0014), and organ failure (81.6% vs. 49.6%, P=0.0001). High RAPID scores with early surgery were associated with higher 90-day mortality (21.4% vs. 0%, P=0.0124), organ failure (78.6% vs. 34.9%, P=0.0044), 30-day readmission (50.0% vs. 16.3%, P=0.027) and length of stay (16 vs. 9 days, P=0.0064). High vs. low RAPID scores with late surgery was associated with a higher rate of organ failure (82.9% vs. 56.7%, P=0.0062), but there was not a significant association with mortality. Conclusions: We found a significant association between RAPID scores and surgical timing with new organ failure. Patients with complicated pleural effusions who had early surgery and low RAPID scores experienced better outcomes including decreased length of stay and organ failure compared with those who had late surgery and low RAPID scores. This suggests that using the RAPID score may help identify those who would benefit from early surgery.
ABSTRACT
La diabetes mellitus tipo 2 (DM2) es una de las patologías con más prevalencia a nivel mundial, se estima que alrededor de 425 millones de habitantes viven actualmente con DM2 según la OMS, la importancia de realizar pruebas moleculares que permitan realizar un diagnóstico temprano conlleva el análisis de varios grupos de genes implicados en el fenotipo diabético con una marcada resistencia a la insulina y en la mayoría de los casos obesidad, entre los cuales están el polimorfismo de CAG(n) en el ATXN2 gen encontrado en el cromosoma 12q24. Objetivo. Conocer el estado actual del gen ATXN2 en relación al número variable de repeticiones en tándem (VNTR) del trinucleótido CAG(n) y su posible asociación con el desarrollo de la diabetes mellitus tipo 2. Metodología. Se llevó a cabo una revisión sistemática mediante la búsqueda de información en las bases de datos de PubMed, Google Scholar y Elsevier. Para ello, se combinaron palabras clave relevantes, como "diabetes mellitus tipo 2", "polimorfismo CAG" y "ATXN2 gen", junto con "Epigenética de la DM2". Se seleccionaron artículos originales y estudios experimentales publicados en revistas de alto impacto utilizando Scimago Journal Ranks para garantizar la calidad de la literatura revisada. Conclusión. Se determinó la relación entre el ATXN2 y el VNTR CAG(n) y la actividad transcripcional del gen en la DM2 y otras patologías neurodegenerativas es evidente. Sin embargo, para profundizar en este tema, es necesario ampliar el campo de estudio en Ecuador y en otros países latinoamericanos, a fin de analizar la variabilidad genética y su posible relación con la DM2 en esta población.
Diabetes mellitus type 2 (DM2) is one of the most prevalent pathologies worldwide, it is estimated that about 425 million inhabitants currently live with DM2 according to WHO, the importance of molecular tests that allow early diagnosis involves the analysis of several groups of genes involved in the diabetic phenotype with marked insulin resistance and in most cases obesity, among which are the CAG(n) polymorphism in the ATXN2 gene found on chromosome 12q24. Objective. To know the current status of the ATXN2 gene in relation to the variable number of tandem repeats (VNTR) of the CAG(n) trinucleotide and its possible association with the development of type 2 diabetes mellitus. Methodology. A systematic review was carried out by searching for information in PubMed, Google Scholar and Elsevier databases. For this purpose, relevant keywords, such as "type 2 diabetes mellitus", "CAG polymorphism" and "ATXN2 gene" were combined with "Epigenetics of DM2". Original articles and experimental studies published in high impact journals were selected using Scimago Journal Ranks to ensure the quality of the reviewed literature. Conclusion. The relationship between ATXN2 and VNTR CAG(n) was determined and the transcriptional activity of the gene in DM2 and other neurodegenerative pathologies is evident. However, in order to go deeper into this topic, it is necessary to expand the field of study in Ecuador and in other Latin American countries, in order to analyze the genetic variability and its possible relationship with DM2 in this population.
La diabetes mellitus tipo 2 (DM2) es una de las patologías con más prevalencia a nivel mundial, se estima que alrededor de 425 millones de habitantes viven actualmente con DM2 según la OMS, la importancia de realizar pruebas moleculares que permitan realizar un diagnóstico temprano conlleva el análisis de varios grupos de genes implicados en el fenotipo diabético con una marcada resistencia a la insulina y en la mayoría de los casos obesidad, entre los cuales están el polimorfismo de CAG(n) en el ATXN2 gen encontrado en el cromosoma 12q24. Objetivo. Conocer el estado actual del gen ATXN2 en relación al número variable de repeticiones en tándem (VNTR) del trinucleótido CAG(n) y su posible asociación con el desarrollo de la diabetes mellitus tipo 2. Metodología. Se llevó a cabo una revisión sistemática mediante la búsqueda de información en las bases de datos de PubMed, Google Scholar y Elsevier. Para ello, se combinaron palabras clave relevantes, como "diabetes mellitus tipo 2", "polimorfismo CAG" y "ATXN2 gen", junto con "Epigenética de la DM2". Se seleccionaron artículos originales y estudios experimentales publicados en revistas de alto impacto utilizando Scimago Journal Ranks para garantizar la calidad de la literatura revisada. Conclusión. Se determinó la relación entre el ATXN2 y el VNTR CAG(n) y la actividad transcripcional del gen en la DM2 y otras patologías neurodegenerativas es evidente. Sin embargo, para profundizar en este tema, es necesario ampliar el campo de estudio en Ecuador y en otros países latinoamericanos, a fin de analizar la variabilidad genética y su posible relación con la DM2 en esta población.
ABSTRACT
Pemphigus herpetiformis (PH) is a rare and unique clinical form of pemphigus foliaceus and pemphigus vulgaris. Patients show autoantibodies against desmoglein 1 and less frequently against desmoglein 3 and desmocollins. We report a 24-year-old woman with a 3-year history of recurrent intensely pruritic erythematous papules and annular plaques localized on the trunk and extremities. In recent months she developed small vesicles around the annular lesions. The histological features showed eosinophilic spongiosis, and direct immunofluorescence demonstrated typical staining of the epidermal intercellular spaces characteristic for pemphigus. There was no mucosal involvement, and hence a diagnosis of PH was established. This patient was unresponsive to dapsone and methotrexate, but she finally experienced remission with prednisone and mycophenolate mofetil.
Subject(s)
Pemphigus , Adult , Autoantibodies , Female , Humans , Mycophenolic Acid/therapeutic use , Pemphigus/drug therapy , Young AdultABSTRACT
The present study is focused on the ultrafast and green synthesis, via the co-precipitation method, of magnetic nanoparticles (MNPs) based on iron oxides using design of experiments (DOE) and high energy sonochemical approach, considering two main factors: amplitude (energy) of the ultrasound probe and sonication time. The combination of these techniques allowed the development of a novel one-minute green synthesis, which drastically reduced the amount of consumed energy, solvents, reagents, time and produced residues. This green sonochemical synthesis permitted to obtain mean particle sizes of 11 ± 2 nm under the optimized conditions of amplitude = 40% (2826 J) and time = 1 min. Their composition, structure, size, morphology and magnetic properties were assessed through X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), scanning and transmission electron microscopy (SEM & TEM), and vibrating sample magnetometry (VSM). The characterization results indicate the proper formation of MNPs, and the correct functionalization of MNPs with different coating agents. The functionalized MNPs were used as: i) biosensor, which could detect mercury in water in the range of 0.030-0.060 ppm, and ii) support onto which polyclonal antibodies were anchored and successfully bound to an osteosarcoma cell line expressing the target protein (TRIB2-GFP), as part of an immunoprecipitation assay.
