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1.
Lupus ; 26(11): 1157-1165, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28420067

ABSTRACT

Background Lupus nephritis (LN) is one of the most frequent complications of SLE and occurs in up to 50% of cases depending on the studied population. Of these, approximately 20% progress to end-stage renal disease (ESRD), with the treatment of choice being a kidney transplant. Objective The objective of this study was to describe the clinical outcome of patients transplanted due to LN, compared with patients transplanted for other causes, in a Latin American population from the Fundación Valle del Lili in Cali, Colombia. Methods Observational, retrospective case study with controls matched by age, sex and type of donor in a single center between 1996 and 2014. Results Sixty-five kidney transplants were performed in patients with LN and ESRD. The survival of patients with LN was 98% at 1, 10 and 15 years ( p = .99). For controls by age and sex, survival was also 98% at 15 years post-transplant, and for controls by donor, the survival rate was 100% at 5 years and 98% at 15 years. Graft survival in patients with LN to 1, 5 and 15 years was 92%, 83% and 71%, respectively; for controls by age and sex, it was 90%, 84% and 64%, respectively, and for the controls by donor, it was 89%, 86% and 79%, respectively ( p = .7718). There were no statistically significant differences found in the cumulative incidence of acute graft rejection in the first year, but it was found that acute rejection is a factor that relates to the loss of function of the renal graft ( p = .032). Of the patients transplanted for LN, two (3.1%) experienced a recurrence of the disease. One patient died after a diagnosis of recurrence of LN due to an infection. Conclusions Kidney transplantation is a good option for patients with ESRD due to LN. In this Hispanic population, the survival of patients, graft survival, and cumulative incidence of graft rejection are not different from those of other transplanted patients. In addition, recurrence of LN was rare, showing the benefits of renal transplantation in LN patients with ESRD.


Subject(s)
Kidney Failure, Chronic/surgery , Kidney Transplantation , Lupus Nephritis/surgery , Acute Disease , Adult , Colombia , Female , Graft Rejection/epidemiology , Graft Survival , Humans , Incidence , Kaplan-Meier Estimate , Kidney Failure, Chronic/diagnosis , Kidney Failure, Chronic/mortality , Kidney Transplantation/adverse effects , Kidney Transplantation/mortality , Lupus Nephritis/diagnosis , Lupus Nephritis/mortality , Male , Middle Aged , Patient Safety , Postoperative Complications/epidemiology , Prevalence , Recurrence , Retrospective Studies , Risk Factors , Time Factors , Treatment Outcome
2.
Lupus ; 26(8): 825-834, 2017 Jul.
Article in English | MEDLINE | ID: mdl-27852935

ABSTRACT

Blood-borne RNA circulating in association with autoantibodies is a potent stimulator of interferon production and immune system activation. RSLV-132 is a novel fully human biologic Fc fusion protein that is comprised of human RNase fused to the Fc domain of human IgG1. The drug is designed to remain in circulation and digest extracellular RNA with the aim of preventing activation of the immune system via Toll-like receptors and the interferon pathway. The present study describes the first clinical study of nuclease therapy in 32 subjects with systemic lupus erythematosus. The drug was well tolerated with a very favorable safety profile. The approximately 19-day serum half-life potentially supports once monthly dosing. There were no subjects in the study that developed anti-RSLV-132 antibodies. Decreases in B-cell activating factor correlated with decreases in disease activity in a subset of patients.


Subject(s)
Autoantibodies/blood , Lupus Erythematosus, Systemic/drug therapy , RNA/blood , Recombinant Fusion Proteins/therapeutic use , Adult , Autoantibodies/immunology , B-Cell Activating Factor/metabolism , Double-Blind Method , Drug Administration Schedule , Female , Half-Life , Humans , Immunoglobulin G/immunology , Lupus Erythematosus, Systemic/immunology , Male , Middle Aged , Recombinant Fusion Proteins/administration & dosage , Recombinant Fusion Proteins/adverse effects , Ribonucleases/immunology , Severity of Illness Index
3.
Rev Chil Pediatr ; 86(2): 103-11, 2015.
Article in Spanish | MEDLINE | ID: mdl-26235690

ABSTRACT

INTRODUCTION: Malnutrition, growth retardation and opportunistic infections outlast the metabolic, immune and gastrointestinal disorders produced by HIV. Zinc deficiency has been associated with deteriorating nutritional status, growth failure, and risk of infection. The aim of this study is to determine the association between zinc levels in peripheral blood mononuclear cells (PBMC) and the nutritional status of HIV-infected and uninfected children exposed to the virus. PATIENTS AND METHODS: An analytical, observational, cross-sectional study was conducted on 17 infected and 17 exposed children, aged 2-10 years. Anthropometric measurements, clinical and nutritional history, 24h recall, measurement of physical activity, and zinc in PBMC by flow cytometry analysis were recorded. RESULTS: Height according to age, energy consumption and adequacy of energy, protein and dietary zinc were significantly higher in children exposed to the virus compared to those infected with HIV (P <.05). No significant differences were found in BMI, levels of zinc in monocytes, CD4 + and CD4- lymphocytes between the two study groups (P >.05). However, the median levels of zinc in monocytes of infected patients was higher (218.6) compared to the control group (217.0). No association was found between zinc intake and levels of intracellular zinc. CONCLUSIONS: The deterioration of nutritional status and growth retardation in children were associated with HIV, but not with the levels of intracellular zinc. The dietary intake of this nutrient was not associated with levels of zinc in monocytes or CD4 + and CD4- lymphocytes.


Subject(s)
HIV Infections/complications , Leukocytes, Mononuclear/metabolism , Nutritional Status , Zinc/metabolism , CD4-Positive T-Lymphocytes , Child , Child, Preschool , Cross-Sectional Studies , Flow Cytometry , Humans , Lymphocytes/metabolism , Monocytes/metabolism , Zinc/administration & dosage
4.
Rev. chil. pediatr ; 86(2): 103-111, abr. 2015. graf, tab
Article in Spanish | LILACS | ID: lil-752887

ABSTRACT

Introducción: Desnutrición, retardo en el crecimiento e infecciones oportunistas sobrevienen a alteraciones metabólicas, inmunológicas y gastrointestinales que produce el virus de la inmunodeficiencia humana (VIH). La deficiencia de zinc se ha asociado con deterioro nutricional, falla en el crecimiento y riesgo de infecciones. El objetivo de este estudio fue asociar los niveles de zinc en células mononucleares de sangre periférica (PBMC) con el estado nutricional en niños infectados por el VIH y en niños no infectados expuestos al virus. Pacientes y Método: Estudio analítico observacional, transversal, en 17 niños infectados y 17 expuestos, entre 2 y 10 años de edad. Se realizó valoración antropométrica, historia clínica-nutricional, recordatorio de 24 horas, medición de actividad física y determinación de zinc en PBMC por citometría de fiujo. Resultados: La talla para la edad, el consumo de energía, y la adecuación de energía, proteínas y zinc alimentario fueron significativamente mayores en los niños expuestos comparados con los niños infectados (p < 0,05). No se hallaron diferencias significativas en el índice de masa corporal, los niveles de zinc en monocitos, linfocitos CD4+ y CD4- entre los dos grupos de estudio (p > 0,05); sin embargo, la mediana de los niveles de zinc en monocitos de pacientes infectados fue mayor (218,6) comparado con el grupo control (217,0). No se encontró asociación entre consumo de zinc y niveles de zinc intracelular. Conclusiones: El deterioro del estado nutricional y el retardo en el crecimiento en niños estuvo asociado al VIH, pero no a los niveles de zinc intracelular. El consumo alimentario de este nutriente no se asoció a niveles de zinc en monocitos y linfocitos CD4+ y CD4-.


Introduction: Malnutrition, growth retardation and opportunistic infections outlast the metabolic, immune and gastrointestinal disorders produced by HIV. Zinc deficiency has been associated with deteriorating nutritional status, growth failure, and risk of infection. The aim of this study is to determine the association between zinc levels in peripheral blood mononuclear cells (PBMC) and the nutritional status of HIV-infected and uninfected children exposed to the virus. Patients and Methods: An analytical, observational, cross-sectional study was conducted on 17 infected and 17 exposed children, aged 2-10 years. Anthropometric measurements, clinical and nutritional history, 24 h recall, measurement of physical activity, and zinc in PBMC by fiow cytometry analysis were recorded. Results: Height according to age, energy consumption and adequacy of energy, protein and dietary zinc were significantly higher in children exposed to the virus compared to those infected with HIV (P < 0.05). No significant differences were found in BMI, levels of zinc in monocytes, CD4+ and CD4- lymphocytes between the two study groups (P > 0.05). However, the median levels of zinc in monocytes of infected patients was higher (218.6) compared to the control group (217.0). No association was found between zinc intake and levels of intracellular zinc. Conclusions: The deterioration of nutritional status and growth retardation in children were associated with HIV, but not with the levels of intracellular zinc. The dietary intake of this nutrient was not associated with levels of zinc in monocytes or CD4+ and CD4- lymphocytes.


Subject(s)
Humans , Child, Preschool , Child , Zinc/metabolism , Leukocytes, Mononuclear/metabolism , HIV Infections/complications , Nutritional Status , Zinc/administration & dosage , Lymphocytes/metabolism , Monocytes/metabolism , CD4-Positive T-Lymphocytes , Cross-Sectional Studies , Flow Cytometry
5.
Dis Aquat Organ ; 100(3): 263-7, 2012 Sep 12.
Article in English | MEDLINE | ID: mdl-22968793

ABSTRACT

The susceptibility of the coral-feeding crown-of-thorns starfish Acanthaster planci to disease may provide an avenue with which to effectively control population outbreaks that have caused severe and widespread coral loss in the Indo-Pacific. Injecting thiosulfate-citrate-bile-sucrose (TCBS) agar into A. planci tissues induced a disease characterized by dermal lesions, loss of skin turgor, collapsed spines, and accumulation of mucus on spine tips. Moreover, the symptoms (and presumably the agent) of this disease would spread rapidly intraspecifically, but interspecific transmission (to other species of echinoderms) is yet to be examined. Vibrio rotiferianus, which was previously reported as a pathogen isolated from lesions of experimentally infected A. planci, was also recovered from Linckia guildingi lesions after several days of direct contact with diseased A. planci, demonstrating disease transmission. However, all L. guildingi fully recovered after 31 ± 16 d. Further studies are in progress to understand the ecology of Vibrio infection in A. planci and the potential transmission risk to corals, fishes, and other echinoderms to evaluate whether injections of TCBS could be a viable tool for controlling A. planci outbreaks.


Subject(s)
Bile Acids and Salts/chemistry , Citric Acid/chemistry , Starfish/drug effects , Sucrose/chemistry , Thiosulfates/chemistry , Vibrio/physiology , Animals , Species Specificity
6.
Dis Aquat Organ ; 96(2): 113-23, 2011 Sep 09.
Article in English | MEDLINE | ID: mdl-22013751

ABSTRACT

We used a polyphasic approach for precise identification of bacterial flora (Vibrionaceae) isolated from crown-of-thorns starfish (COTS) from Lizard Island (Great Barrier Reef, Australia) and Guam (U.S.A., Western Pacific Ocean). Previous 16S rRNA gene phylogenetic analysis was useful to allocate and identify isolates within the Photobacterium, Splendidus and Harveyi clades but failed in the identification of Vibrio harveyi-like isolates. Species of the V harveyi group have almost indistinguishable phenotypes and genotypes, and thus, identification by standard biochemical tests and 16S rRNA gene analysis is commonly inaccurate. Biochemical profiling and sequence analysis of additional topA and mreB housekeeping genes were carried out for definitive identification of 19 bacterial isolates recovered from sick and wild COTS. For 8 isolates, biochemical profiles and topA and mreB gene sequence alignments with the closest relatives (GenBank) confirmed previous 16S rRNA-based identification: V. fortis and Photobacterium eurosenbergii species (from wild COTS), and V natriegens (from diseased COTS). Further phylogenetic analysis based on topA and mreB concatenated sequences served to identify the remaining 11 V harveyi-like isolates: V. owensii and V. rotiferianus (from wild COTS), and V. owensii, V. rotiferianus, and V. harveyi (from diseased COTS). This study further confirms the reliability of topA-mreB gene sequence analysis for identification of these close species, and it reveals a wider distribution range of the potentially pathogenic V. harveyi group.


Subject(s)
Starfish/microbiology , Vibrio/classification , Vibrio/isolation & purification , Animals , Gene Expression Regulation, Bacterial , Phylogeny , Vibrio/genetics
7.
Dis Aquat Organ ; 97(2): 85-94, 2011 Dec 06.
Article in English | MEDLINE | ID: mdl-22303625

ABSTRACT

This is the first report of the successful induction of a transmissible disease in the coral-eating crown-of-thorns starfish Acanthaster planci (COTS). Injection of thiosulfate-citrate-bile-sucrose agar (TCBS) culture medium into COTS induced a disease characterized by discoloured and necrotic skin, ulcerations, loss of body turgor, accumulation of colourless mucus on many spines especially at their tip, and loss of spines. Blisters on the dorsal integument broke through the skin surface and resulted in large, open sores that exposed the internal organs. Oedema and reddened digestive tissues and destruction of connective fibers were common. Moreover, healthy COTS in contact with these infected animals also displayed signs of disease and died within 24 h. TCBS induced 100% mortality in injected starfish. There was no introduction of new pathogens into the marine environment. TCBS promoted the growth of COTS' naturally occurring Vibrionales to high densities with subsequent symbiont imbalance followed by disease and death.


Subject(s)
Agar/chemistry , Agar/toxicity , Citric Acid/chemistry , Starfish , Sucrose/chemistry , Thiosulfates/chemistry , Animals
8.
Dis Aquat Organ ; 97(2): 95-102, 2011 Dec 06.
Article in English | MEDLINE | ID: mdl-22303626

ABSTRACT

We assessed histological changes in the tissues of the crown-of-thorns starfish Acanthaster planci (COTS) after injection of thiosulfate-citrate-bile-sucrose agar (TCBS) which was used as a disease inducer (potential outbreak control method), by conventional and scanning electron microscopy. Digestive glands were processed and stained with hematoxylin and eosin to describe the histological architecture of the intestinal epithelium. Subsequently comparison of healthy versus infected tissues and Gram stains were carried out to confirm bacterial occurrence on infected tissues, characterize the structural changes induced by bacterial communities in COTS tissues, and to determine if the histopathological changes of intestinal tissues were consistent with vibrio infection. TCBS injections induced marked epithelial desquamation, hypertrophy and hypersecretion of glandular cells, epithelial cell destruction, pyknosis, reduction of thickness and disorganization of connective tissue and associated nerve plexus, presence of bacterial colonies, irregular eosinophilic foci in glandular cells, brush border disruption, atrophy and detachment of intestinal microvilli and cell debris in the lumen. All these changes were attributed to a fulminating systemic dysbiosis and were consistent with vibrio infections.


Subject(s)
Agar/chemistry , Agar/toxicity , Citric Acid/chemistry , Starfish , Sucrose/chemistry , Thiosulfates/chemistry , Animals , Starfish/ultrastructure
9.
Nefrología (Madr.) ; 30(5): 584-587, sept.-oct. 2010. ilus, tab
Article in Spanish | IBECS | ID: ibc-104616

ABSTRACT

El síndrome de Goodpasture (SGP) es una rara entidad de base inmunológica, caracterizada por la asociación de una glomerulonefritis rápidamente progresiva (GNRP) y hemorragia alveolar en presencia de anticuerpos antimembrana basal. La afectación del sistema nervioso central (SNC) enel SGP es extremadamente infrecuente en ausencia de ANCA. Presentamos el caso de un paciente de 20 años que comenzó con una GNRP acompañada de esputos hemoptoicos y dos episodios de crisis convulsivas tónico-clónicas generalizadas, en presencia de elevados títulos de anticuerpos antimembrana basal glomerular (Ac-anti-MBG).Tras tratamiento inmunosupresor asociado con plasmaféresis, el paciente presentó descenso de los títulos de Acanti-MBG, así como mejoría de los síntomas neurológicos y respiratorios, aunque sin recuperación de la función renal, permaneciendo en programa de hemodiálisis. Veinte meses más tarde, con la enfermedad en remisión, el paciente recibió un trasplante renal de cadáver (AU)


Goodpasture's syndrome is a rare autoimmune disorder characterized by rapidly progressive glomerulonephritis (RPGN) and alveolar hemorrhage in the presence of antiglomerular basement membrane (anti-GBM) antibodies. Central nervous system involvement is highly unusual in the absence of anti-neutrophil cytoplasmic antibodies. Were port the case of a 20-year-old man with RPGN accompanied by bloody sputum, tonic-clonic seizure and high titers of anti-GBM antibody. After treatment with immune suppressants and plasmapheresis, the patient showed reduced anti-GBM antibody titers and improved neurologic and respiratory symptoms, but renal failure persisted, requiring hemodialysis. Twenty months later, with the disease in remission, he underwent deceased-donor renal transplantation (AU)


Subject(s)
Humans , Male , Young Adult , Anti-Glomerular Basement Membrane Disease/complications , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications , Acute Kidney Injury/complications , Hemoptysis/etiology , Immunosuppressive Agents/therapeutic use , Plasmapheresis , Kidney Transplantation
10.
J Fish Biol ; 77(4): 822-40, 2010 Sep.
Article in English | MEDLINE | ID: mdl-20840614

ABSTRACT

This study attempts to predict and verify possible spawning aggregation sites and times in the Los Roques Archipelago National Park, Venezuela, based on physical reef characteristics and the knowledge of experienced local fishermen. Three possible aggregation sites were selected for monitoring based on satellite images, low-cost bathymetric mapping and interviews with experienced local fishermen. Abundances and sizes of 18 species that are known to form reproductive aggregations were monitored at these sites using underwater visual census for 7 days after each full moon from February to August, 2007. While spawning events were not observed, possible indirect evidence of spawning aggregations was found for Lutjanus analis at Cayo Sal and Boca de Sebastopol, Lutjanus apodus at Cayo Sal, Lutjanus cyanopterus at Cayo Sal and Piedra La Guasa and Epinephelus guttatus at Bajo California and Cayo de Agua. Additionally, indirect evidence was identified for the past existence of a spawning aggregation of Epinephelus striatus in the northern part of the archipelago, which may have been eliminated by overfishing c.15 years ago. Bathymetric mapping showed that the shelf edge at sites monitored in this study was shallower than at spawning aggregation sites in other parts of the Caribbean, and that sites were not proximal to deep water. While this study does not prove the existence or locations of spawning aggregations of reef fishes in the archipelago, it does add insight to a growing understanding of generalities in the relationship between seafloor characteristics and the locations of transient reef-fish spawning aggregations in the Caribbean.


Subject(s)
Fishes , Reproduction , Animals , Caribbean Region , Conservation of Natural Resources , Geography , Humans , Interviews as Topic , Venezuela
11.
Nefrologia ; 30(5): 584-7, 2010.
Article in Spanish | MEDLINE | ID: mdl-20613848

ABSTRACT

Goodpasture's syndrome is a rare autoimmune disorder characterized by rapidly progressive glomerulonephritis (RPGN) and alveolar hemorrhage in the presence of antiglomerular basement membrane (anti-GBM) antibodies. Central nervous system involvement is highly unusual in the absence of anti-neutrophil cytoplasmic antibodies. We report the case of a 20-year-old man with RPGN accompanied by bloody sputum, tonic-clonic seizure and high titers of anti-GBM antibody. After treatment with immunosuppressants and plasmapheresis, the patient showed reduced anti-GBM antibody titers and improved neurologic and respiratory symptoms, but renal failure persisted, requiring hemodialysis. Twenty months later, with the disease in remission, he underwent deceased-donor renal transplantation.


Subject(s)
Anti-Glomerular Basement Membrane Disease/complications , Antibodies, Antineutrophil Cytoplasmic/analysis , Seizures/etiology , Vasculitis, Central Nervous System/etiology , Acute Kidney Injury/etiology , Acute Kidney Injury/surgery , Acute Kidney Injury/therapy , Anti-Glomerular Basement Membrane Disease/drug therapy , Anti-Glomerular Basement Membrane Disease/immunology , Anti-Glomerular Basement Membrane Disease/surgery , Anti-Glomerular Basement Membrane Disease/therapy , Anticonvulsants/therapeutic use , Combined Modality Therapy , Cyclophosphamide/therapeutic use , Hemoptysis/etiology , Humans , Immunosuppressive Agents/therapeutic use , Kidney Transplantation , Male , Methylprednisolone/therapeutic use , Plasmapheresis , Renal Dialysis , Seizures/drug therapy , Valproic Acid/therapeutic use , Young Adult
12.
Nefrología (Madr.) ; 30(2): 252-257, mar.-abr. 2010. ilus, tab
Article in Spanish | IBECS | ID: ibc-104539

ABSTRACT

En el Hospital Universitario de Canarias pusimos en marcha, en mayo de 2008, un protocolo de tratamiento de inducción para pacientes hipersensibilizados que reciben injerto renal de cadáver utilizando inmunoglobulinas intravenosas, plasmaféresis y rituximab más una inmunosupresión triple con prednisona, tacrolimus y micofenolatomofetil. Presentamos los resultados de 4 pacientes. Todo sellos presentaban una tasa de anticuerpos anti-HLA (PARA por CDC) superior al 75%, llevaban en lista de espera de 4a 17 años, el tiempo de seguimiento posterior al trasplante fue de 10-14 meses y la supervivencia de paciente y del injerto en este período fue del 100%. Sólo un paciente sufrió un rechazo agudo mediado por anticuerpos y otro uno celular, en ambos casos reversibles con el tratamiento. En la evolución no se objetivó aparición de novo de anticuerpos donante-específicos. Todos los pacientes habían reducido significativamente el número de células CD19+ después de la infusión de rituximab. No se han detectado síntomas neurológicos indicativos de leucoencefalopatía multifocal progresiva ni infecciones virales graves después del trasplante y tampoco se han observado efectos secundarios inmediatos tras la administración de la medicación. En resumen, el tratamiento de inducción combinado con inmunoglobulinas, plasmaféresis y rituximab en pacientes (..) (AU)


In our Universitary Hospital of Canarias we iniciated in May2008 a induction therapy protocol for sensitized patients receiving cadaveric renal graft using intravenous immunoglobulins, plasmapheresis and rituximab plusimmuno suppression with prednisone, tacrolimus and mycophenolate mofetil. We present the results of four patients. Everyone had anti-HLA antibodies rate (PRA by CDC) more than 75%, were on a waiting list during 4 to 17 years and follow-up time was 10-14 months after transplantation. Patient and graft survival in this period was 100%. Only one patient suffered a humoral acute rejection and another one cellular rejection, in both cases reversible with treatment. During the first year, no evidence of de novo donor-specific antibodies was detected. All patients had significantly reduced the CD19+ cells percentage after infusion of rituximab. Neurological symptoms suggestive of progressive multifocal leukoencephalopathy or serious viral infections after transplantation have not been observed. Additionally, no immediate side effects were observed after administration of medication. In summary, induction therapy by combining immunoglobulin, plasmapheresis and rituximab in hypersensitive patients allows the realization of deceased kidney transplantation with good results in the short and medium-term without serious side effects. It remains to know whether this success will continue in the long term (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Kidney Transplantation/methods , Immunoglobulins/administration & dosage , Plasmapheresis/methods , Antibodies, Monoclonal/administration & dosage , Transplantation Conditioning/methods , Induction Chemotherapy/methods , Hypersensitivity/drug therapy , Nephritis, Interstitial/therapy , Diabetic Nephropathies/therapy , Polycystic Kidney Diseases/therapy
13.
Nefrologia ; 30(2): 252-7, 2010.
Article in Spanish | MEDLINE | ID: mdl-20098463

ABSTRACT

In our Universitary Hospital of Canarias we iniciated in May 2008 a induction therapy protocol for sensitized patients receiving cadaveric renal graft using intravenous immunoglobulins, plasmapheresis and rituximab plus immunosuppression with prednisone, tacrolimus and mycophenolate mofetil. We present the results of four patients. Everyone had anti-HLA antibodies rate (PRA by CDC) more than 75%, were on a waiting list during 4 to 17 years and follow-up time was 10-14 months after transplantation. Patient and graft survival in this period was 100%. Only one patient suffered a humoral acute rejection and another one cellular rejection, in both cases reversible with treatment. During the first year, no evidence of de novo donor-specific antibodies was detected. All patients had significantly reduced the CD19+ cells percentage after infusion of rituximab. Neurological symptoms suggestive of progressive multifocal leukoencephalopathy or serious viral infections after transplantation have not been observed. Additionally, no immediate side effects were observed after administration of medication. In summary, induction therapy by combining immunoglobulin, plasmapheresis and rituximab in hypersensitive patients allows the realization of deceased kidney transplantation with good results in the short and medium-term without serious side effects. It remains to know whether this success will continue in the long term.


Subject(s)
Antibodies, Monoclonal/therapeutic use , Graft Rejection/prevention & control , HLA Antigens/immunology , Immunoglobulins, Intravenous/therapeutic use , Immunosuppressive Agents/therapeutic use , Kidney Transplantation/immunology , Plasmapheresis , Premedication , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal, Murine-Derived , Cadaver , Combined Modality Therapy , Female , Histocompatibility , Humans , Immunization , Immunoglobulins, Intravenous/administration & dosage , Immunosuppressive Agents/administration & dosage , Isoantibodies/blood , Kidney Failure, Chronic/immunology , Kidney Failure, Chronic/surgery , Male , Middle Aged , Mycophenolic Acid/administration & dosage , Mycophenolic Acid/analogs & derivatives , Mycophenolic Acid/therapeutic use , Prednisone/administration & dosage , Prednisone/therapeutic use , Reoperation , Rituximab , Tacrolimus/administration & dosage , Tacrolimus/therapeutic use , Tissue Donors
14.
J Virol Methods ; 164(1-2): 88-95, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20025904

ABSTRACT

A mathematical model was developed to predict the viability of airborne viruses. The model uses water activity as the primary independent variable and an exponential decay function for the viability of the virus. This model was tested using published experimental data obtained by different investigators for influenza, Langat and polio viruses. The aerosolized media were modelled as a binary solution of water and sodium chloride. The water activity is related directly to the solute concentration in the binary solution. The minimum viability usually occurred just above the efflorescence point, which is the relative humidity at which the solution crystallizes. The relationship between water activity and relative humidity is based on the Köhler theory, whereby the Kelvin term was taken into account. Physical explanations are provided on the variation of viral viability at different relative humidity levels. The predictions obtained by the proposed mathematical model compare well with most of the published experimental data.


Subject(s)
Air Microbiology , Microbial Viability , Virus Physiological Phenomena , Aerosols , Animals , Chick Embryo , Encephalitis Viruses, Tick-Borne/physiology , Humans , Models, Theoretical , Orthomyxoviridae/physiology , Poliovirus/physiology , Salts , Water Microbiology
15.
Acta Chir Belg ; 109(5): 620-2, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19994806

ABSTRACT

INTRODUCTION: Internal hernia is a visceral protrusion through a defect or aperture, either mesenteric or peritoneal and is an uncommon cause of intestinal obstruction. Within this group, the congenital mesenteric (transmesenteric) hernia is extremely rare, being more common in the pediatric population. OBJECTIVE: To present the case of a 38-year-old woman with intestinal obstruction and acute abdomen who underwent surgery. A giant mesenteric (transmesenteric) hernia was found. The hernia was reduced and the defect closed. Discharge was made without complications. CONCLUSIONS: Congenital mesenteric hernias are an infrequent pathology that may cause intestinal obstruction, predominantly in the pediatric population. Occurrence in adults is extremely rare.


Subject(s)
Hernia, Abdominal/congenital , Peritoneal Diseases/congenital , Peritoneal Diseases/surgery , Abdominal Pain/etiology , Adult , Female , Hernia, Abdominal/complications , Hernia, Abdominal/diagnosis , Hernia, Abdominal/surgery , Humans , Intestinal Obstruction/etiology , Mesentery , Peritoneal Diseases/complications
16.
Clin Nephrol ; 70(1): 82-6, 2008 Jul.
Article in English | MEDLINE | ID: mdl-18793556

ABSTRACT

We describe a severe case of hemophagocytic lymphohistiocytosis (HLH), secondary to a candida glabrata retroperitoneal abscess in a 41-year-old simultaneous pancreas-kidney transplantation (SPKT) recipient. Despite percutaneous abscess drainage and antifungal therapy, general status deteriorated with persistent fever, severe pancytopenia and liver dysfunction. Presence of hypertriglyceridemia, very high serum levels of ferritin and hemophagocytosis in a bone-marrow aspirate gave the diagnosis of HLH. Of note, change from tacrolimus to cyclosporine together with dexamethasone produced rapid response with status improvement. We concluded that HLH, a rare but often fatal condition characterized by excessive activation of lymphocytes and macrophages, is a diagnostic and therapeutic challenge in solid-organ transplanted patients and must be suspected in the presence of fever, blood cytopenia and liver dysfunction. Specific antiinfectious therapy together with cyclosporine and dexamethasone may be a therapeutic approach.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , Antifungal Agents/therapeutic use , Cyclosporine/therapeutic use , Dexamethasone/therapeutic use , Lymphohistiocytosis, Hemophagocytic/drug therapy , Adult , Candida glabrata , Candidiasis/complications , Candidiasis/diagnosis , Candidiasis/drug therapy , Humans , Kidney Transplantation/adverse effects , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/etiology , Male , Pancreas Transplantation/adverse effects
17.
Nefrologia ; 28(2): 218-21, 2008.
Article in Spanish | MEDLINE | ID: mdl-18454715

ABSTRACT

The effects of pregnancy on kidney transplant recipients have been widely described, although its impact on the mother, the fetus and the graft is still debated. Experience in simultaneous kidney-pancreas transplantation is limited, with few reported cases, which increases uncertainty about guidelines to follow in this situation. We describe a case of successful pregnancy in a 35 year-old patient who underwent simultaneous pancreas-kidney transplantation 34 months before delivery. After modifications in immunosuppressive therapy (with tacrolimus and mycophenolate, the latter being switched to azathioprine), pregnancy evolved favourably. Delivery was by caesarean section due to fetal distress at 38 weeks of gestational age. Five months after delivery the child shows normal development while both pancreas and kidney grafts show normal function.


Subject(s)
Kidney Transplantation , Pancreas Transplantation , Pregnancy Outcome , Adult , Female , Humans , Pregnancy
18.
Rev. colomb. cardiol ; 15(2): 67-74, mar.-abr. 2008. tab
Article in Spanish | LILACS | ID: lil-491808

ABSTRACT

No está claro si el consumo de café afecta la presión arterial y los niveles de homocisteína. El objetivo fue determinar el cambio en las concentraciones plasmáticas de homocisteína y presión arterial en un grupo de voluntarios sanos. Se realizó un estudio prospectivo, clínico controlado, en el que se conformaron cuatro grupos de 29 sujetos cada uno, quienes, durante un período de seis semanas, se sometieron al consumo diario de café filtrado. El grupo 1 no consumió café, el grupo 2 consumió 200 mL de café, el grupo 3 400 mL y el 4 600 mL. Antes de la intervención se midieron: presión arterial, homocisteína, índice arterial, ácido fólico eritrocitario y vitaminas B12 y B6. Al final de la intervención, se tomó la presión arterial y se midió la concentración de homocisteína. Los resultados mostraron grupos sin diferencias significativas en las condiciones basales. Después de la intervención, el cambio en los valores de homocisteína entre los grupos, no mostró diferencia significativa y permanecieron dentro de los valores de referencia (p = 0,098). El cambio en los niveles de presión arterial sistólica y diastólica, no fue significativo (p=0,510 y 0,430 respectivamente). En conclusión, el consumo de diferentes dosis de café filtrado, no mostró cambios significativos en los niveles séricos de homocisteína como tampoco en los niveles de presión arterial sistólica y diastólica en un grupo de sujetos sanos normotensos; en el grupo que se abstuvo de tomar café, no disminuyeron de manera significativa los niveles de homocisteína y presión arterial.


Subject(s)
Blood Pressure , Coffee , Homocysteine
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