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1.
PLoS One ; 17(7): e0264566, 2022.
Article in English | MEDLINE | ID: mdl-35901034

ABSTRACT

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.


Subject(s)
COVID-19 , Monocytes , Apyrase/immunology , Cross-Sectional Studies , Cytokines , Female , Humans , Interleukin-6 , Pregnancy , SARS-CoV-2
2.
J Intern Med ; 289(6): 906-920, 2021 06.
Article in English | MEDLINE | ID: mdl-33274479

ABSTRACT

BACKGROUND: COVID-19 pandemic causes high global morbidity and mortality and better medical treatments to reduce mortality are needed. OBJECTIVE: To determine the added benefit of cyclosporine A (CsA), to low-dose steroid treatment, in patients with COVID-19. METHODS: Open-label, non randomized pilot study of patients with confirmed infection of SARS-CoV-2 hospitalized from April to May 2020 at a single centre in Puebla, Mexico. Patients were assigned to receive either steroids or CsA plus steroids. Pneumonia severity was assessed by clinical, laboratory, and lung tomography. The death rate was evaluated at 28 days. RESULTS: A total of 209 adult patients were studied, 105 received CsA plus steroids (age 55.3 ± 13.3; 69% men), and 104 steroids alone (age 54.06 ± 13.8; 61% men). All patients received clarithromycin, enoxaparin and methylprednisolone or prednisone up to 10 days. Patient's death was associated with hypertension (RR = 3.5) and diabetes (RR = 2.3). Mortality was 22 and 35% for CsA and control groups (P = 0.02), respectively, for all patients, and 24 and 48.5% for patients with moderate to severe disease (P = 0.001). Higher cumulative clinical improvement was seen for the CsA group (Nelson Aalen curve, P = 0.001, log-rank test) in moderate to severe patients. The Cox proportional hazard analysis showed the highest HR improvement value of 2.15 (1.39-3.34, 95%CI, P = 0.0005) for CsA treatment in moderate to severe patients, and HR = 1.95 (1.35-2.83, 95%CI, P = 0.0003) for all patients. CONCLUSION: CsA used as an adjuvant to steroid treatment for COVID-19 patients showed to improve outcomes and reduce mortality, mainly in those with moderate to severe disease. Further investigation through controlled clinical trials is warranted.


Subject(s)
COVID-19 Drug Treatment , Cyclosporine/therapeutic use , Glucocorticoids/therapeutic use , Methylprednisolone/therapeutic use , Prednisone/therapeutic use , COVID-19/mortality , COVID-19/pathology , Cyclosporine/adverse effects , Drug Therapy, Combination , Female , Glucocorticoids/administration & dosage , Humans , Lung/pathology , Male , Methylprednisolone/administration & dosage , Middle Aged , Pilot Projects , Prednisone/administration & dosage , Treatment Outcome
3.
Allergol. immunopatol ; 46(6): 539-545, nov.-dic. 2018. tab
Article in English | IBECS | ID: ibc-177892

ABSTRACT

BACKGROUND: Both breastfeeding and the moment at which introduction to solid food occurs have been associated with food allergy. OBJECTIVE: To evaluate whether prolonged breastfeeding and the delayed introduction of whole cow's milk into an infant's diet are factors that can be associated with egg sensitization. METHODS: This was a hospital-based case-control study, matched by age and sex: each study group comprised 97 atopic children. Additionally, logistic regression was used to identify the factors associated with egg protein sensitization. RESULTS: The most common type of allergic disease among both groups was allergic rhinitis. After adjusting for possible confounding variables, a delayed introduction to whole cow's milk decreased the odds of egg protein sensitization; OR = 0.16 (95% CI: 0.07-0.36, p < 0.0001). Notably, breastfeeding during the first six months of life, regardless of whether it was the only milk an infant drank, increased the risk for sensitization to chicken eggs; OR = 5.54 (95% CI: 2.41-12.7, p < 0.0001). CONCLUSION: Prolonged breastfeeding, regardless of whether it was the only milk an infant drank, greatly increased the risk of egg sensitization. Interestingly, a delayed introduction to whole cow's milk was associated with a reduced possibility of becoming sensitized to eggs. Further studies are required to elucidate these findings


No disponible


Subject(s)
Humans , Animals , Female , Infant , Child, Preschool , Cattle , Breast Feeding/statistics & numerical data , Case-Control Studies , Diet Therapy/statistics & numerical data , Egg Hypersensitivity/epidemiology , Rhinitis, Allergic/epidemiology , Egg Hypersensitivity/immunology , Milk Proteins/immunology , Rhinitis, Allergic/immunology , Risk
4.
Allergol Immunopathol (Madr) ; 46(6): 539-545, 2018.
Article in English | MEDLINE | ID: mdl-29739686

ABSTRACT

BACKGROUND: Both breastfeeding and the moment at which introduction to solid food occurs have been associated with food allergy. OBJECTIVE: To evaluate whether prolonged breastfeeding and the delayed introduction of whole cow's milk into an infant's diet are factors that can be associated with egg sensitization. METHODS: This was a hospital-based case-control study, matched by age and sex: each study group comprised 97 atopic children. Additionally, logistic regression was used to identify the factors associated with egg protein sensitization. RESULTS: The most common type of allergic disease among both groups was allergic rhinitis. After adjusting for possible confounding variables, a delayed introduction to whole cow's milk decreased the odds of egg protein sensitization; OR=0.16 (95% CI: 0.07-0.36, p<0.0001). Notably, breastfeeding during the first six months of life, regardless of whether it was the only milk an infant drank, increased the risk for sensitization to chicken eggs; OR=5.54 (95% CI: 2.41-12.7, p<0.0001). CONCLUSION: Prolonged breastfeeding, regardless of whether it was the only milk an infant drank, greatly increased the risk of egg sensitization. Interestingly, a delayed introduction to whole cow's milk was associated with a reduced possibility of becoming sensitized to eggs. Further studies are required to elucidate these findings.


Subject(s)
Breast Feeding/statistics & numerical data , Diet Therapy/statistics & numerical data , Egg Hypersensitivity/epidemiology , Milk Hypersensitivity/epidemiology , Rhinitis, Allergic/epidemiology , Allergens/immunology , Animals , Case-Control Studies , Cattle , Child, Preschool , Egg Hypersensitivity/immunology , Egg Proteins/immunology , Female , Humans , Immunization , Infant , Mexico/epidemiology , Milk Hypersensitivity/immunology , Milk Proteins/immunology , Rhinitis, Allergic/immunology , Risk
5.
Allergol. immunopatol ; 45(2): 127-133, mar.-abr. 2017. tab
Article in English | IBECS | ID: ibc-160517

ABSTRACT

INTRODUCTION: The oral allergy syndrome (OAS) is a particular type of food allergy rarely explored in the paediatric population that is already considered an adult problem. OBJECTIVE: Identify the prevalence of OAS, symptoms and pollen species associated with its presence in children affected by allergic diseases. METHODS: A cross-sectional study was conducted. Consecutive sampling included children from 6 to 14 years who needed allergy treatment for the first time. A structured questionnaire was carried out to collect demographic and clinical data and history of OAS. Besides sensitisation to various allergens, the skin prick-by-prick test was performed to corroborate sensitisation to food related to OAS. Prevalence of OAS and its association with pollens was established following the covariate adjusted logistic regression. RESULTS: 267 subjects were included. Overall prevalence of OAS was 8.9% (95%CI 6.1-13.1%). Prevalence of OAS for allergic rhinitis and asthma were 8.8% and 9.1%, respectively. In patients sensitised to pollen, the prevalence ranged from 9.6% to 12.2% depending on the type of pollen. 62.5% of children with OAS were sensitive to pineapple. After adjusting for gender and family history of atopic disease, trees from the Quercus species showed an association with OAS (OR=2.7, 95%CI 1.2-6.2). CONCLUSIONS: OAS is not uncommon in our environment. Pineapple, a typical fruit from the region, was the main food related. Quercus sp., but not birch nor olive, was the pollen associated with this syndrome


No disponible


Subject(s)
Humans , Male , Female , Child , Hypersensitivity/epidemiology , Hypersensitivity/prevention & control , Syndrome , Food Hypersensitivity/complications , Food Hypersensitivity/diagnosis , Food Hypersensitivity/immunology , Risk Factors , Cross Reactions , Cross Reactions/immunology , Skin Tests/methods , Rhinitis, Allergic, Seasonal/immunology , Logistic Models , Hypersensitivity, Immediate/complications
6.
Allergol. immunopatol ; 45(1): 69-76, ene.-feb. 2017. graf, tab
Article in English | IBECS | ID: ibc-158977

ABSTRACT

BACKGROUND: In our country, the prevalence and the factors associated to peanut allergy are unknown, a health problem that has been emerging worldwide. OBJECTIVE: To establish the prevalence and the factors that are associated to peanut allergy amongst school children. METHODS: This is a population-based cross-sectional study. We included 756 children aged 6-7 years. The children's parents were questioned about their peanut intake habits. A structured questionnaire was applied, it included questions regarding peanut intake; family and personal history of asthma; rhinitis; and atopic dermatitis. Allergic reactions to peanuts were registered as: probable, convincing and systematic. The statistical analyses included logistical regression models to look for associated factors. RESULTS: Males were 356/756 (47.1%). Peanut allergy prevalence: probable reaction: 14/756 (1.8%), convincing reaction: 8/756 (1.1%) and systemic reaction: 3/756 (0.4%). Through multivariate analysis, the presence of symptoms of allergic rhinitis (OR = 4.2 95% CI 1.3-13.2) and atopic dermatitis (OR = 5.2; 95% CI 1.4-19.5) during the previous year, showed significant association to probable peanut reaction. The former year, the presence of atopic dermatitis was the only variable that was substantially associated to a convincing reaction (OR = 7.5; 95% CI 1.4-38.4) and to a systematic reaction (OR = 45.1; 95% CI 4.0-510.0), respectively. CONCLUSIONS: The reported prevalence of peanut allergy was consistent with that found in previous studies; symptoms of allergic rhinitis and atopic dermatitis were identified as associated factors to peanut allergy


No disponible


Subject(s)
Humans , Child , Food Hypersensitivity/epidemiology , Peanut Hypersensitivity/epidemiology , Mexico/epidemiology , Hypersensitivity, Immediate/epidemiology , Rhinitis, Allergic/epidemiology , Risk Factors , Prevalence
7.
Allergol Immunopathol (Madr) ; 45(1): 69-76, 2017.
Article in English | MEDLINE | ID: mdl-27475774

ABSTRACT

BACKGROUND: In our country, the prevalence and the factors associated to peanut allergy are unknown, a health problem that has been emerging worldwide. OBJECTIVE: To establish the prevalence and the factors that are associated to peanut allergy amongst school children. METHODS: This is a population-based cross-sectional study. We included 756 children aged 6-7 years. The children's parents were questioned about their peanut intake habits. A structured questionnaire was applied, it included questions regarding peanut intake; family and personal history of asthma; rhinitis; and atopic dermatitis. Allergic reactions to peanuts were registered as: probable, convincing and systematic. The statistical analyses included logistical regression models to look for associated factors. RESULTS: Males were 356/756 (47.1%). Peanut allergy prevalence: probable reaction: 14/756 (1.8%), convincing reaction: 8/756 (1.1%) and systemic reaction: 3/756 (0.4%). Through multivariate analysis, the presence of symptoms of allergic rhinitis (OR=4.2 95% CI 1.3-13.2) and atopic dermatitis (OR=5.2; 95% CI 1.4-19.5) during the previous year, showed significant association to probable peanut reaction. The former year, the presence of atopic dermatitis was the only variable that was substantially associated to a convincing reaction (OR=7.5; 95% CI 1.4-38.4) and to a systematic reaction (OR=45.1; 95% CI 4.0-510.0), respectively. CONCLUSIONS: The reported prevalence of peanut allergy was consistent with that found in previous studies; symptoms of allergic rhinitis and atopic dermatitis were identified as associated factors to peanut allergy.


Subject(s)
Dermatitis, Atopic/epidemiology , Peanut Hypersensitivity/epidemiology , Population , Rhinitis, Allergic/epidemiology , Allergens/immunology , Arachis/immunology , Child , Cross-Sectional Studies , Female , Humans , Male , Mexico/epidemiology , Prevalence , Regression Analysis , Risk Factors , Surveys and Questionnaires
8.
Allergol Immunopathol (Madr) ; 45(2): 127-133, 2017.
Article in English | MEDLINE | ID: mdl-27567321

ABSTRACT

INTRODUCTION: The oral allergy syndrome (OAS) is a particular type of food allergy rarely explored in the paediatric population that is already considered an adult problem. OBJECTIVE: Identify the prevalence of OAS, symptoms and pollen species associated with its presence in children affected by allergic diseases. METHODS: A cross-sectional study was conducted. Consecutive sampling included children from 6 to 14 years who needed allergy treatment for the first time. A structured questionnaire was carried out to collect demographic and clinical data and history of OAS. Besides sensitisation to various allergens, the skin prick-by-prick test was performed to corroborate sensitisation to food related to OAS. Prevalence of OAS and its association with pollens was established following the covariate adjusted logistic regression. RESULTS: 267 subjects were included. Overall prevalence of OAS was 8.9% (95%CI 6.1-13.1%). Prevalence of OAS for allergic rhinitis and asthma were 8.8% and 9.1%, respectively. In patients sensitised to pollen, the prevalence ranged from 9.6% to 12.2% depending on the type of pollen. 62.5% of children with OAS were sensitive to pineapple. After adjusting for gender and family history of atopic disease, trees from the Quercus species showed an association with OAS (OR=2.7, 95%CI 1.2-6.2). CONCLUSIONS: OAS is not uncommon in our environment. Pineapple, a typical fruit from the region, was the main food related. Quercus sp., but not birch nor olive, was the pollen associated with this syndrome.


Subject(s)
Asthma/epidemiology , Food Hypersensitivity/epidemiology , Rhinitis, Allergic/epidemiology , Administration, Oral , Adolescent , Adult , Allergens/immunology , Ananas/immunology , Child , Cross-Sectional Studies , Female , Humans , Male , Mexico/epidemiology , Pollen/immunology , Quercus/immunology , Surveys and Questionnaires
9.
Medisur ; 14(6): 717-726, nov.-dic. 2016.
Article in Spanish | LILACS | ID: biblio-829224

ABSTRACT

Fundamento: las personas discapacitadas presentan condiciones que limitan sus posibilidades para desarrollar la vida cotidiana y por consiguiente requieren de una atención de salud integral; sin embargo se considera que a nivel mundial la mayoría de esta población no recibe atención bucodental acorde a sus requerimientos.Objetivo: determinar el estado de salud bucal en pacientes discapacitados.Métodos: estudio de serie de casos realizado de junio a septiembre de 2015, sobre 88 discapacitados que cumplieron con los criterios de inclusión. Se analizó: edad, sexo, nivel de escolaridad, ocupación, clasificación epidemiológica en cuanto a salud bucal, problemas de salud bucal, enfermedades crónicas, factores de riesgo, tratamientos realizados en atención primaria y secundaria. Resultados: predominó el sexo masculino sobre el femenino y el grupo de edades de 35 a 59 años; prevalecieron los técnicos medios y los de nivel preuniversitario; el 38, 6 % poseía empleo. Fueron más numerosas las discapacidades mentales. El 72, 2 % padecía de hipertensión arterial. La clasificación epidemiológica del estado de salud bucal mostró que 54, 5 % estaban enfermos; 19, 3 % sanos con riesgo y 26,1 % deficientes discapacitados. Dentro de los factores de riesgo sobresalieron los antecedentes de caries y cepillado incorrecto. En atención primaria predominaron las restauraciones (47,7 % ) y en la atención secundaria la ortodoncia (13,6 %). Conclusiones: la salud bucal en el grupo estudiado fue deficiente, lo que pudiera estar dado porque tanto pacientes como familiares dan más importancia a la condición física como discapacitado que a la salud bucal.


Foundation: Disbale people present conditions which limit their abilties to develop an everyday life and therefore require comprehensive health care; however it is considered that worldwide most of this population does not receive oral care according to their requirements. Objective: To determine status of Oral Health in disabled patients. Methods: A study of case series carried out from june to September 2015, about 88 disabled patients who achieved inclusion criteria. It was analyzed age, sex, scholarship, occupation, epidemiological classification regarding Oral Health, problems of Oral health, chronic diseases, risk factors, recieved treatments in primary and secundary health systems.Results: Male sex prevailed over the female one and age group from 35 to 59 years old; They prevailed technicians and senior high school level;; 38% had an employment. Mental disabilities were more frequent. 72.2% suffered from arterial hypertension. Epidemiological classification of Oral Health State showed that 54.5% were sick.; 19.3% were healthy and 26.1% defficent disabled. Among the risk factors, antecedents of caries and incorrect brushing stood out. In Primary Care restaurations prevailed (47.7%) and in Secondary Health care Orthodontics( 13.6%).Conclusion: There was a deficient oral health in the studied group, which could be given because both patients and relatives give more importance to the physical condition as disabled than to oral health.

10.
Toxicon ; 119: p. 1-7, 2016.
Article | Sec. Est. Saúde SP, SESSP-IBPROD, Sec. Est. Saúde SP | ID: but-ib14319

ABSTRACT

Jellyfish venoms are of medical and biotechnological importance, with toxins displaying antimicrobial, analgesic and anti-tumor activities. Although proteolytic enzymes have also been described, detailed characterisation of these proteins is scant in Olindias spp. High throughput mass spectrometry profiling of cnidarian venoms has become increasingly popular since the first description of the proteomic profile of putative toxins isolated from nematocysts of the hydrozoan jellyfish Olindias sambaquiensis describing the presence of orthologous enzymes as presented in venoms of advanced species as snakes. Rigorous bioinformatics analyses can aid functional annotation, but biochemical assays are prerequisite to unambiguously assign toxic function to a peptide or protein. Here we present results that experimentally confirm previously predicted proteomic analysis that crude venom extracts from tentacles of O. sambaquiensis are composed of polypeptides with metalloproteinase, serine proteinase and phospholipases A(2) activities. Surprisingly, levels of serine proteinase and phospholipase A(2) activities were comparable to those observed in venoms of Bothrops snakes which were used as positive controls in this study. Hence, these data offer new opportunities to explore serine proteinase and phospholipase A2 activities in the clinical sequelae following O. sambaquiensis envenomation, with future possible biopharmaceutical applications. (C) 2016 Elsevier Ltd. All rights reserved.


Subject(s)
Toxicology , Pharmacology
14.
Rev Chilena Infectol ; 29(1): 55-61, 2012 Feb.
Article in Spanish | MEDLINE | ID: mdl-22552513

ABSTRACT

The presence of virulence genes (VG) and bacteriocins from different clinical samples was studied in Enterococcus faecalis isolated from urinary tract infections (UTI), bacteremia and endodontitis and was correlated with haemolysin and gelatinase activity. We evaluated the presence of VG by PCR in 150 strains of E. faecalis including cylA, aggA, efaA, eep, gelE, esp, as-48, bac31, entL50A/B, entA, entP, entB, enlA andentl071. Haemolysin and gelatinase activity was studied. gelE and cylA genes expressed hemolysin and gelatinase, respectively. This activity was observed in some strains of bacteremia, UTI and endodontitis. The highest number of VG was detected in bacteremic strains, being aggA and entA genes the most frequent. efaA, esp, entA, entL50A/B were associated with their clinical origin (p < 0.05). The most common genetic profile was aggA-eep-enlA-entL50A/B. E. faecalis from UTI, bacteremia and endodontitis presented different gene combinations. Some of the genes studied were related to their clinical origin. The results obtained in this study are similar to those reported in other countries.


Subject(s)
Bacterial Proteins/genetics , Bacteriocins/genetics , Enterococcus faecalis/genetics , Gelatinases/genetics , Hemolysin Proteins/genetics , Virulence Factors/genetics , Chile , Enterococcus faecalis/enzymology , Enterococcus faecalis/pathogenicity , Female , Gelatinases/biosynthesis , Hemolysin Proteins/biosynthesis , Humans , Male , Oligonucleotide Array Sequence Analysis/methods
15.
Rev. chil. infectol ; Rev. chil. infectol;29(1): 55-61, feb. 2012. tab
Article in Spanish | LILACS | ID: lil-627216

ABSTRACT

The presence of virulence genes (VG) and bacteriocins from different clinical samples was studied in Enterococcus faecalis isolated from urinary tract infections (UTI), bacteremia and endodontitis and was correlated with haemolysin and gelatinase activity. We evaluated the presence of VG by PCR in 150 strains of E. faecalis including cylA, aggA, efaA, eep, gelE, esp, as-48, bac31, entL50A/B, entA, entP, entB, enlA andentl071. Haemolysin and gelatinase activity was studied. gelE and cylA genes expressed hemolysin and gelatinase, respectively. This activity was observed in some strains of bacteremia, UTI and endodontitis. The highest number of VG was detected in bacteremic strains, being aggA and entA genes the most frequent. efaA, esp, entA, entL50A/B were associated with their clinical origin (p < 0.05). The most common genetic profile was aggA-eep-enlA-entL50A/B. E. faecalis from UTI, bacteremia and endodontitis presented different gene combinations. Some of the genes studied were related to their clinical origin. The results obtained in this study are similar to those reported in other countries.


Desde diferentes muestras clínicas se determinó la presencia de genes codificantes de factores de virulencia (FV) y bacteriocinas en Enterococcus faecalis aislados desde infecciones del tracto urinario (ITU), bacteriemias y endodontitis, correlacionándose con la actividad hemolisina y gelatinasa. En 150 cepas de E. faecalis fue evaluada mediante RPC la presencia de cylA, aggA, efaA, eep, gelE, esp, as-48, bac31, entL50A/B, entA, entP, entB, enlA, y ent1071 determinándose actividad hemolisina y gelatinasa. Los genes cylA y gelE expresaron hemolisina y gelatinasa, respectivamente. Esta actividad fue observada en algunas de las cepas causantes de bacteriemia, ITU y endodontitis. El mayor número de genes estudiados se detectó en cepas bacteriémicas. Los genes aggA y entA, fueron los más frecuentes. Los genes efaA, esp, entL50/AB y entA se asociaron a su origen clínico (p < 0,05). El perfil genético más recurrente fue aggA-eep-enlA-entL50A/B. Enterococcusfaecalis de ITU, bacteriemias y endodontitis presentaron distintas combinaciones génicas. AAlgunos de los genes estudiados se relacionaron con su origen clínico. Los resultados obtenidos son similares a los reportados en otros países.


Subject(s)
Female , Humans , Male , Bacterial Proteins/genetics , Bacteriocins/genetics , Enterococcus faecalis/genetics , Gelatinases/genetics , Hemolysin Proteins/genetics , Virulence Factors/genetics , Chile , Enterococcus faecalis/enzymology , Enterococcus faecalis/pathogenicity , Gelatinases/biosynthesis , Hemolysin Proteins/biosynthesis , Oligonucleotide Array Sequence Analysis/methods
16.
J Perinatol ; 31(8): 514-8, 2011 Aug.
Article in English | MEDLINE | ID: mdl-21546938

ABSTRACT

OBJECTIVE: To assess antibiotic use as a complementary neonatal intensive care unit (NICU) infection measure to the central line-associated blood stream infection (CLABSI) rate. STUDY DESIGN: Patient days (PDs), line days, antibiotic (AB) use, CLABSI and other proven infections were analyzed in consecutive admissions to two NICUs over 3 and 6 months, respectively, from 1 January 2008 until discharge. An antibiotic course (AC) consisted of one or more uninterrupted antibiotic days (AD), classified as perinatal or neonatal, if started ≤3 d or ≥4 d post birth and as rule-out sepsis or presumed infection (PI) if treated ≤4 d or ≥5d, respectively. Events were expressed per 1000 PD and aggregated by conventional treatment categories and by clinical perception of infection certainty: possible, presumed or proven. RESULT: The cohort included 754 patients, 18,345 PD, 6637 line days, 718 AC and 4553 AD. Of total antibiotic use, neonatal use constituted 39.2% of ACs, and 29.0% of ADs, When analyzed per 1000 PD, antibiotic use to treat PIs vs CLABSIs, was either 14 fold (CI 6.6-30) higher for ACs (5.40 vs 0.38/1000 PD, P<0.0001) or 8.8 fold (CI 7.1-11) higher for ADs (48.3 vs 5.5/1000 PD, P<0.0001). CONCLUSION: CLABSI rates, present a lower limit of NICU-acquired infections, whereas antibiotic-use measures, about 10-fold higher, may estimate an upper limit of that burden. Antibiotic-use metrics should be evaluated further for their ability to broaden NICU infection assessment and to guide prevention and antibiotic stewardship efforts.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Catheterization, Central Venous/adverse effects , Cross Infection/drug therapy , Cross Infection/epidemiology , Intensive Care Units, Neonatal , Practice Patterns, Physicians'/statistics & numerical data , Catheters, Indwelling/adverse effects , Cross Infection/prevention & control , Drug Utilization , Humans , Infant, Newborn , Quality Indicators, Health Care
17.
J Mol Biol ; 390(2): 245-61, 2009 Jul 10.
Article in English | MEDLINE | ID: mdl-19422834

ABSTRACT

Interestingly, our previously published structure of the coil 1A fragment of the human intermediate filament protein vimentin turned out to be a monomeric alpha-helical coil instead of the expected dimeric coiled coil. However, the 39-amino-acid-long helix had an intrinsic curvature compatible with a coiled coil. We have now designed four mutants of vimentin coil 1A, modifying key a and d positions in the heptad repeat pattern, with the aim of investigating the molecular criteria that are needed to stabilize a dimeric coiled-coil structure. We have analysed the biophysical properties of the mutants by circular dichroism spectroscopy, analytical ultracentrifugation and X-ray crystallography. All four mutants exhibited an increased stability over the wild type as indicated by a rise in the melting temperature (T(m)). At a concentration of 0.1 mg/ml, the T(m) of the peptide with the single point mutation Y117L increased dramatically by 46 degrees C compared with the wild-type peptide. In general, the introduction of a single stabilizing point mutation at an a or a d position did induce the formation of a stable dimer as demonstrated by sedimentation equilibrium experiments. The dimeric oligomerisation state of the Y117L peptide was furthermore confirmed by X-ray crystallography, which yielded a structure with a genuine coiled-coil geometry. Most notably, when this mutation was introduced into full-length vimentin, filament assembly was completely arrested at the unit-length filament (ULF) level, both in vitro and in cDNA-transfected cultured cells. Therefore, the low propensity of the wild-type coil 1A to form a stable two-stranded coiled coil is most likely a prerequisite for the end-to-end annealing of ULFs into filaments. Accordingly, the coil 1A domains might "switch" from a dimeric alpha-helical coiled coil into a more open structure, thus mediating, within the ULFs, the conformational rearrangements of the tetrameric subunits that are needed for the intermediate filament elongation reaction.


Subject(s)
Protein Multimerization , Vimentin/chemistry , Vimentin/metabolism , Amino Acid Sequence , Circular Dichroism , Crystallography, X-Ray , Humans , Models, Molecular , Molecular Sequence Data , Mutagenesis, Site-Directed , Mutation, Missense , Protein Stability , Protein Structure, Secondary , Protein Structure, Tertiary , Temperature , Ultracentrifugation , Vimentin/genetics
18.
J Econ Entomol ; 102(2): 767-73, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19449659

ABSTRACT

Kale (Brassica oleracea L. acephala group) crops are common in northwestern Spain, where they are severely damaged by different insect pests. The damage notably affects the value of this crop because it is freshly consumed and fresh processed. The objective of this work was to determine the abundance and relative importance of the main Lepidoptera pests of Brassica crops for 6 yr at five localities in northwestern Spain and to relate the seasonal changes of larval populations and environmental conditions. Pheromone traps were used as a method of monitoring adults. Larval populations were monitored on kales by counting the larvae for several years and locations at different sample dates. Five species were found: Mamestra brassicae (L.); imported cabbageworm, Pieris rapae (L.); Pieris brassicae (L.); diamondback moth, Plutella xyllostella (L.); and Autographa gamma L. Proportions of each insect fluctuated over the years and in the different locations. M. brassicae was the most abundant (48.5% of the total of Lepidoptera species) followed by P. xyllostella (25%) and P. rapae (15%). The use of pheromone traps combined with plant sampling permitted the detection of two generations of M. brassicae. However, adult counts were not correlated to the number of larvae on plants.


Subject(s)
Brassica/parasitology , Moths/classification , Animals , Larva , Moths/physiology , Population Density , Seasons , Spain , Time Factors
20.
Farm Hosp ; 28(4): 243-50, 2004.
Article in Spanish | MEDLINE | ID: mdl-15369434

ABSTRACT

OBJECTIVE: To financially assess a device for the preparation of intravenous mixtures (DPIVM) --Grifill system-- such as IV gammaglobulin, salbutamol, ondansetron/dexametasone, cisplatin rehydrating solution and mesna. MATERIAL AND METHODS: The most relevant resources used in the preparation and rebottling of each of the above-mentioned intravenous mixtures (for both the DPIVM and the commonly used alternative system) are assessed, as well as unitary costs (obtained from six Spanish hospitals enrolled), and an approach to the real cost by system used is obtained. A sensitivity analysis is performed considering most influencing variables. Results are calculated for one month of system operation. RESULTS: For IV gammaglobulin, mesna, salbutamol, ondansetron/dexametasone and polyionic solutions DPIVM resulted in financial benefit, but it did not in the preparation of cisplatin rehydrating solution. CONCLUSIONS: An individualized study in each center is needed to achieve reliable financial data on the system's profitability at hospital pharmacy departments. DPIVM may allow significant financial savings in centers and hospital departments using high-cost pharmaceuticals susceptible of customized dosing --e. g., IV gammaglobulin, other blood derivatives, monoclonal antibodies and/or antibiotics-- or intravenous mixtures requiring pharmaceuticals usually purchased directly from the manufacturer that may be prepared from low-cost raw materials (for instance, salbutamol and polyionic solution) requiring high-quality manipulation (e. g., sterility and precision).


Subject(s)
Drug Combinations , Drug Compounding/economics , Drug Compounding/instrumentation , Infusions, Intravenous/economics , Pharmacy Service, Hospital/economics , Albuterol , Cisplatin , Dexamethasone , Drug Costs , Hospital Costs , Humans , Mesna , Ondansetron , Spain , gamma-Globulins
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