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1.
J Bioenerg Biomembr ; 56(2): 101-115, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38231368

ABSTRACT

During their long evolutionary history, jellyfish have faced changes in multiple environmental factors, to which they may selectively fix adaptations, allowing some species to survive and inhabit diverse environments. Previous findings have confirmed the jellyfish's ability to synthesize large ATP amounts, mainly produced by mitochondria, in response to environmental challenges. This study characterized the respiratory chain from the mitochondria of the jellyfish Stomolophus sp2 (previously misidentified as Stomolophus meleagris). The in-gel activity from isolated jellyfish mitochondria confirmed that the mitochondrial respiratory chain contains the four canonical complexes I to IV and F0F1-ATP synthase. Specific additional activity bands, immunodetection, and mass spectrometry identification confirmed the occurrence of four alternative enzymes integrated into a branched mitochondrial respiratory chain of Stomolophus sp2: an alternative oxidase and three dehydrogenases (two NADH type II enzymes and a mitochondrial glycerol-3-phosphate dehydrogenase). The analysis of each transcript sequence, their phylogenetic relationships, and each protein's predicted models confirmed the mitochondrial alternative enzymes' identity and specific characteristics. Although no statistical differences were found among the mean values of transcript abundance of each enzyme in the transcriptomes of jellyfish exposed to three different temperatures, it was confirmed that each gene was expressed at all tested conditions. These first-time reported enzymes in cnidarians suggest the adaptative ability of jellyfish's mitochondria to display rapid metabolic responses, as previously described, to maintain energetic homeostasis and face temperature variations due to climate change.


Subject(s)
Mitochondrial Membranes , Scyphozoa , Animals , Electron Transport , Phylogeny , Mitochondrial Membranes/metabolism , Scyphozoa/chemistry , Scyphozoa/metabolism , Mitochondria/metabolism , Electron Transport Complex IV
2.
PLoS One ; 18(9): e0291546, 2023.
Article in English | MEDLINE | ID: mdl-37708134

ABSTRACT

The white potato worm Premnotrypes vorax (Hustache) (Coleoptera: Curculionidae) is one of the most destructive insect pests of potato crops in South America. Like many coleopteran insects, P. vorax shows low susceptibility to Cry insecticidal proteins produced by the bacterium Bacillus thuringiensis (Bt). However, the presence of Cry toxin receptors in the midgut of this this insect has never been studied. The main Cry-binding proteins described in other insect species are cadherin (CAD), aminopeptidase N (APN), alkaline phosphatase (ALP) and ATP-binding cassette (ABC) transporters. In this study, we analyzed and validated a de novo assembled transcriptome of Illumina sequencing data to identify and to characterize homologs of Cry toxin receptors. We identified the protein sequences in P. vorax that show high identity with their orthologous sequences of the Cry toxin binding proteins in other coleopteran larvae such as APN, ALP, CAD and ABC transporter. This study provides preliminary identification of putative receptor genes of Cry proteins that would be useful for future studies involving biocontrol of this important potato crop pest.


Subject(s)
Coleoptera , Weevils , Animals , Weevils/genetics , Transcriptome , Insect Proteins/genetics , ATP-Binding Cassette Transporters , Alkaline Phosphatase , CD13 Antigens/genetics , Cadherins , Coloring Agents
3.
J Med Entomol ; 59(2): 681-692, 2022 03 16.
Article in English | MEDLINE | ID: mdl-35022773

ABSTRACT

Trypanosomatids (Kinetoplastida:Trypanosomatidae) protozoa are a diverse group of obligate parasites. The genera Trypanosoma and Leishmania are the most studied because of their medical importance. This work aims to evaluate the effects of anthropization processes on the composition of the phlebotomine sand fly fauna and the natural infection by Trypanosomatids, with emphasis on Leishmania. At all 3,186 sand flies were collected, distributed in 13 genera and 52 species, being Ny. umbratilis the most abundant species. There was no difference in the diversity between canopy and soil environments. The species abundance and richness were higher in the forest environment while species diversity and evenness were highest in the forest edge. The ITS1 region was used by PCR-RFLP to identify the fragment profiles of Leishmania species, followed by genetic sequencing. Here were analyzed 100 pools of female sand flies, being six positive for DNA parasite. PCR-RFLP fragment patterns similar to Endotrypanum sp. were observed in Nyssomyia anduzei, Psychodopygus amazonensis and Lutzomyia gomezi, and those fragments similar to Leishmania (Leishmania) amazonensis were observed in Bichromomyia flaviscutellata. ITS1 sequencing confirmed the presence of Leishmania sp. in Bi. flaviscutellata, and Leishmania (Viannia) naiffi in Ny. anduzei, Psychodopygus amazonensis, and Lu. gomezi. This is the first record of Lu. gomezi and Ps. amazonensis infection by L. naiffi in the State of Amazonas. These results show the trypanosomatid infection in sandflies from different landscapes in a rural settlement, and the finding of species infected with L.(V.) naiffi suggest that they can develop a role in the transmission cycle of leishmaniasis.


Subject(s)
Leishmania , Leishmaniasis, Cutaneous , Psychodidae , Animals , Brazil , Female , Insect Vectors/parasitology , Leishmania/genetics , Psychodidae/parasitology
6.
Infect Drug Resist ; 12: 2363-2377, 2019.
Article in English | MEDLINE | ID: mdl-31447566

ABSTRACT

Background : Escherichia coli is the main bacterium associated with urinary tract infections (UTIs), including cystitis and pyelonephritis. Uropathogenic E. coli (UPEC) harbors numerous genes that encode diverse virulence factors contributing to its pathogenicity. The treatment of UTIs has become complicated due to the natural selection of E. coli strains that are multiresistant to several groups of antibiotics regularly used in clinical settings such as hospitals. Genomic reports of the global composition and distribution of the antibiotic resistance and virulence genes of these pathogenic strains are lacking in the Mexican population. Purpose and methods : The aim of this study was to globally characterize the genomes of a group of UPEC strains by massive parallel sequencing to determine the prevalence and distribution of virulence and antibiotic resistance genes associated with different serotypes and phylogenetic groups. Results: The strains exhibited 138-197 virulence genes and 29 antibiotic resistance genes related to antibiotics that are commonly used in clinical practice.  Conclusions: These findings are relevant to the definition of new strategies for treating urinary tract infections in public hospitals and private practice. To further define the epidemiological distribution and composition of these virulence and antibiotic resistance genes, larger studies are needed.

7.
AJNR Am J Neuroradiol ; 40(4): 634-640, 2019 04.
Article in English | MEDLINE | ID: mdl-30923085

ABSTRACT

BACKGROUND AND PURPOSE: Multifocal glioblastomas (ie, glioblastomas with multiple foci, unconnected in postcontrast pretreatment T1-weighted images) represent a challenge in clinical practice due to their poor prognosis. We wished to obtain imaging biomarkers with prognostic value that have not been found previously. MATERIALS AND METHODS: A retrospective review of 1155 patients with glioblastomas from 10 local institutions during 2006-2017 provided 97 patients satisfying the inclusion criteria of the study and classified as having multifocal glioblastomas. Tumors were segmented and morphologic features were computed using different methodologies: 1) measured on the largest focus, 2) aggregating the different foci as a whole, and 3) recording the extreme value obtained for each focus. Kaplan-Meier, Cox proportional hazards, correlations, and Harrell concordance indices (c-indices) were used for the statistical analysis. RESULTS: Age (P < .001, hazard ratio = 2.11, c-index = 0.705), surgery (P < .001, hazard ratio = 2.04, c-index = 0.712), contrast-enhancing rim width (P < .001, hazard ratio = 2.15, c-index = 0.704), and surface regularity (P = .021, hazard ratio = 1.66, c-index = 0.639) measured on the largest focus were significant independent predictors of survival. Maximum contrast-enhancing rim width (P = .002, hazard ratio = 2.05, c-index = 0.668) and minimal surface regularity (P = .036, hazard ratio = 1.64, c-index = 0.600) were also significant. A multivariate model using age, surgery, and contrast-enhancing rim width measured on the largest foci classified multifocal glioblastomas into groups with different outcomes (P < .001, hazard ratio = 3.00, c-index = 0.853, median survival difference = 10.55 months). Moreover, quartiles with the highest and lowest individual prognostic scores based on the focus with the largest volume and surgery were identified as extreme groups in terms of survival (P < .001, hazard ratio = 18.67, c-index = 0.967). CONCLUSIONS: A prognostic model incorporating imaging findings on pretreatment postcontrast T1-weighted MRI classified patients with glioblastoma into different prognostic groups.


Subject(s)
Brain Neoplasms/classification , Brain Neoplasms/pathology , Glioblastoma/classification , Glioblastoma/pathology , Adult , Aged , Brain Neoplasms/diagnostic imaging , Female , Glioblastoma/diagnostic imaging , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Prognosis , Proportional Hazards Models , Retrospective Studies , Survival Analysis
8.
Rev. colomb. biotecnol ; 20(2): 89-100, jul.-dic. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-985447

ABSTRACT

RESUMEN Las toxinas Cry de Bacillus thuringiensis (Bt) han sido reconocidas por su acción biocontroladora contra insectos plaga. Recientemente se ha descrito que algunas cepas de Bt codifican proteínas que no presentan actividad insecticida, pero al ser enfrentadas a líneas celulares de cáncer de diferentes tipos han demostrado actividad citotóxica. Estas proteínas han sido denominadas parasporinas (PS) y surgen como una potencial alternativa para el tratamiento del cáncer debido a que presentan citotoxicidad hacia diferentes líneas celulares cancerígenas y baja o nula citotoxicidad hacia células normales.


ABSTRACT Cry toxins from Bacillus thuringiensis (Bt) have been recognized for their biocontrol action against insect pests. Recently it has been described some strains of Bt produce proteins without insecticidal activity, but when cancer cell lines of different types are exposed to these proteins they have demonstrated cytotoxic activity. These proteins have been called parasporins (PS) and are a potential alternative for the treatment of cancer because they have high cytotoxicity in different cancer cell lines, and null or low toxic activity in normal cells.

9.
Poult Sci ; 97(6): 2144-2152, 2018 Jun 01.
Article in English | MEDLINE | ID: mdl-29608757

ABSTRACT

Salmonella spp. are among the most common foodborne pathogens, and increase in the occurrence of antimicrobial drug-resistant Salmonella poses a severe risk to public health. The main objective of this study was to determine changes in Salmonella prevalence and their antimicrobial resistance on poultry farms following recommendations to changes in biosecurity practices. Four poultry farms were sampled by collecting cloacal swabs, drag swabs, and litter samples prior to recommended biosecurity changes (March-April) and post recommendations (October-November). Prevalence of Salmonella was 3 to 4% during pre-recommendations, while the prevalence was higher (P > 0.05), ranging from 5 to 14% during post recommendations. Higher Salmonella prevalence was observed for pre- and post-recommendation phases by sample type in cloacal and drag samples -5% for farm 1, drag swab -6% on farm 2, cloacal swab -6% for farm 3, and drag swab -17% on farm 4. The PCR confirmed Salmonella were serotyped and tested for antimicrobial resistance. Six serotypes of Salmonella were identified with S. Enteritidis (52%) being the most prevalent, followed by S. Berta (38%), S. Mbandaka (7%), S. Typhimurium (2%), S. Kentucky (0.4%), and S. Tennessee (0.4%). A total of 7% isolates exhibited resistance to at least one of the 8 antimicrobials. Higher resistance was observed for tetracycline, streptomycin, and nalidixic acid. A single isolate of S. Mbandaka exhibited multidrug resistance to tetracycline, amoxicillin/clavulanic acid, and ampicillin. Based on these prevalence results, it can be inferred that, irrespective of implementation of improved biosecurity practices, seasonal variation can cause changes in the prevalence of Salmonella on the farms. Resistance to clinically important antimicrobials used to treat salmonellosis is a concern to public health.


Subject(s)
Anti-Bacterial Agents/pharmacology , Drug Resistance, Bacterial , Poultry Diseases/epidemiology , Salmonella Infections, Animal/epidemiology , Salmonella/drug effects , Animals , Chickens , Poultry Diseases/microbiology , Prevalence , Salmonella/classification , Salmonella Infections, Animal/microbiology , Serogroup , Southeastern United States/epidemiology
10.
RSC Adv ; 8(6): 3108-3119, 2018 Jan 12.
Article in English | MEDLINE | ID: mdl-35541204

ABSTRACT

The photocatalytic activity in the degradation of 4-chlorophenol (4-ClPh) in aqueous medium (80 ppm) using 2.0 wt% Ag/Al2O3-Gd2O3 (Ag/Al-Gd-x; where x = 2.0, 5.0, 15.0, 25.0 and 50.0 wt% of Gd2O3) photocatalysts prepared by the sol-gel method was studied under UV light irradiation. The photocatalysts were characterized by N2 physisorption, X-ray diffraction, SEM, HRTEM, UV-Vis, XPS, FTIR and fluorescence spectroscopy. About 67.0% of 4-ClPh was photoconverted after 4 h of UV light irradiation using Ag/γ--Al2O3. When Ag/Al-Gd-x photocatalysts were tested, the 4-ClPh photoconversion was improved and more than 90.0% of 4-ClPh was photoconverted after 3 h of UV light irradiation in the materials containing 15.0 and 25.0 wt% of Gd2O3. Ag/Al-Gd-25 was the material with the highest efficacy to mineralize dissolved organic carbon, mineralizing more than 85.0% after 4 h of UV light irradiation. Silver nanoparticles and micro-particles of irregular pentagonal shape intersected by plane nanobelts of Al2O3-Gd2O3 composite oxide were detected in the Ag/Al-Gd-25 photocatalyst. This material is characterized by a lowest recombination rate of electron-hole pairs. The low recombination rate of photo-induced electron-hole pairs in the Ag/Al-Gd-x photocatalysts with high Gd2O3 contents (≥15.0 wt%) confirmes that the presence of silver nanoparticles and microparticles interacting with Al2O3-Gd2O3 composite oxide entities favors the separation of photo-induced charges (e- and h+). These materials could be appropriate to be used as highly efficient photocatalysts to eliminate high concentrations of 4-ClPh in aqueous medium.

11.
Oncogene ; 36(12): 1733-1744, 2017 03 23.
Article in English | MEDLINE | ID: mdl-27641332

ABSTRACT

Long-term survival remains low for most patients with glioblastoma (GBM), which reveals the need for markers of disease outcome and novel therapeutic targets. We describe that ODZ1 (also known as TENM1), a type II transmembrane protein involved in fetal brain development, plays a crucial role in the invasion of GBM cells. Differentiation of glioblastoma stem-like cells drives the nuclear translocation of an intracellular fragment of ODZ1 through proteolytic cleavage by signal peptide peptidase-like 2a. The intracellular fragment of ODZ1 promotes cytoskeletal remodelling of GBM cells and invasion of the surrounding environment both in vitro and in vivo. Absence of ODZ1 by gene deletion or downregulation of ODZ1 by small interfering RNAs drastically reduces the invasive capacity of GBM cells. This activity is mediated by an ODZ1-triggered transcriptional pathway, through the E-box binding Myc protein, that promotes the expression and activation of Ras homolog family member A (RhoA) and subsequent activation of Rho-associated, coiled-coil containing protein kinase (ROCK). Overexpression of ODZ1 in GBM cells reduced survival of xenografted mice. Consistently, analysis of 122 GBM tumour samples revealed that the number of ODZ1-positive cells inversely correlated with overall and progression-free survival. Our findings establish a novel marker of invading GBM cells and consequently a potential marker of disease progression and a therapeutic target in GBM.


Subject(s)
Gene Expression Regulation, Neoplastic , Glioblastoma/genetics , Glioblastoma/metabolism , Nerve Tissue Proteins/genetics , Proto-Oncogene Proteins c-myc/metabolism , Tenascin/genetics , Transcription, Genetic , rhoA GTP-Binding Protein/genetics , Animals , Cell Line, Tumor , Disease Models, Animal , Gene Knockout Techniques , Glioblastoma/mortality , Glioblastoma/pathology , Heterografts , Humans , Mice , Neoplastic Stem Cells/metabolism , Neoplastic Stem Cells/pathology , Nerve Tissue Proteins/deficiency , Nerve Tissue Proteins/metabolism , Prognosis , Protein Transport , Proteolysis , Signal Transduction , Tenascin/deficiency , Tenascin/metabolism , Up-Regulation , rho-Associated Kinases/metabolism
13.
Odontol. pediatr. (Lima) ; 14(1): 80-85, ene.-jul.2015. ilus
Article in Spanish | LILACS, LIPECS | ID: lil-790460

ABSTRACT

El síndrome de Marfan es un trastorno del tejido conectivo, hereditaria, con una gran variabilidad de expresión clínica. Afecta fundamentalmente, los sistemas esqueléticos, cardiovasculares y oculares. Las anomalías esqueléticas son los signos más fáciles de ver, pero las manifestaciones orales, como la caries dental y enfermedades periodontales, a pesar de que son comunes en la población general, también tienen una mayor incidencia en pacientes con el síndrome de Marfan. Por lo tanto, el objetivo de este trabajo fue mostrar el reporte de un caso de una niña de 4 años 6 meses de edad con una alteración genética diagnosticada como Síndrome de Marfan, la cual presentaba lesiones cariosas con compromiso pulpar, además de maloclusión. Se describe el tratamiento odontológico integral e intervención odontológica en el Centro quirúrgico. Las alteraciones del sistema estomatognatico, junto a las cardiovasculares y esquelética son de gran importancia para el odontopediatra no solo para reconocer esta condici6n sino también para la atenci6n adecuada de estos pacientes...


Marfan syndrome is a disorder of connective tissue inherited, with a great variability of clinical expression. Primarily affects the skeletal, cardiovascular and ocular systems. Skeletal abnormalities are easier to see signs, but oral manifestations, such as dental caries and periodontal diseases, although they are common in the general population, also have a higher incidence in patients with Marfan syndrome. Therefore, the objective of this study was to show a children case report of a 4 years and 6 months of age diagnosed with a genetic disorder such as Marfan syndrome, which had carious lesions with pulp commitment plus malocclusion. Comprehensive dental treatment and dental procedures at the surgical center is described. The alterations of the stomatognathic system, along with cardiovascular and skeletal are of great importance to the dentist not only to recognize this condition but also for the proper care of these patients...


Subject(s)
Humans , Female , Child, Preschool , Tooth Abnormalities , Pediatric Dentistry , Marfan Syndrome
14.
Int. j. odontostomatol. (Print) ; 8(1): 53-58, Apr. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-711546

ABSTRACT

El tratamiento restaurador atraumático (TRA) ha sido incorporado a la práctica clínica como un método definitivo o provisional para controlar los altos niveles de caries. Es de especial utilidad cuando se necesita prestar atención a comunidades aisladas con difícil acceso al sistema de salud público. El objetivo fue determinar la permanencia y estado de restauraciones realizadas con técnica restaurativa atraumática en dientes permanentes de niños entre 6 - 16 años en la comuna de Curarrehue, Región de la Araucanía, Chile. La población blanco la conformaron 249 niños entre 3 y 16 años residentes en la ciudad de Curarrehue. Luego de 7 meses de realizadas las obturaciones se realizó un examen clínico a los participantes, donde se evaluaron las restauraciones de acuerdo a los criterios establecidos por Frencken para la evaluación del TRA. Se examinaron 172 dientes restaurados con TRA; 142 estaban presentes exitosamente, correspondiente a un 82% de permanencia. En relación al estado de las restauraciones, 58% se encontraron óptimos, 24% aceptables y 18% no aceptable. El TRA es una herramienta útil para el control de la caries dental en poblaciones aisladas o con menor acceso a una atención odontológica


The atraumatic restorative treatment (ART) has been incorporated into clinical practice as a definitive and/or provisional method to control high levels of caries. It is particularly useful when you need to deliver care to isolated communities with limited access to public health care system. The aim of the study was to determine the permanence and status of fillings made with atraumatic restorative technique in permanent teeth of children aged 6-16 years in the commune of Curarrehue, Araucanía Region, Chile. The target population consisted of 249 children between 3 and 16 years living in Curarrehue. Seven months after performing fillings, a clinical examination was performed to participants where restorations were evaluated according to the criteria established by Frencken to evaluate the ART. One hundred seventy-two teeth restored with ART were examined, 142 of these restorations were successful, corresponding to 82% of permanence. Furthermore, regarding the status of the restorations, 58% were found to be in optimal condition, 24% were considered acceptable and 18% were considered unacceptable. According to observations during the course of this work, it becomes apparent that ART is a useful tool for the control of dental caries in isolated populations or with less access to dental care


Subject(s)
Humans , Male , Female , Child , Adolescent , Dental Caries/therapy , Dental Atraumatic Restorative Treatment/methods , Survival Analysis , Longitudinal Studies , Treatment Outcome , Patient Satisfaction , Dental Caries/prevention & control , Dental Restoration, Permanent/methods , Glass Ionomer Cements
15.
Arch Latinoam Nutr ; 64(4): 248-57, 2014 Dec.
Article in Spanish | MEDLINE | ID: mdl-26336720

ABSTRACT

Obesity produces greater circulation of free fatty acids (FFA). In adults, the FFA composition changes in states of obesity; in adolescents, the results are contradictory. This study compare the FFA profile of obese youth with and without Metabolic Syndrome (MetS) and explore the association between FFA and metabolic alterations of obesity and MetS. A cross-sectional study with 96 young people between 10 and 18 years old was divided into three groups: 1) obese youth with MetS, 2) obese youth without MetS; and 3) adequate weight (AW), matched according to age, gender, pubertal maturation and socioeconomic stratum. The nutritional status was classified according to the body-mass index (BMI), according to the World Health Organization 2007 (WHO, 2007); the waist circumference (WC), adiposity, lipid profile, highly-sensitive reactive C protein (hsRCP), glucose, insulin and insulin resistance (IR), according to the homeostatic model assessment (HOMA Calculator Version 2.2.2). The FFA serum concentration was determined by gas chromatography. Both obese groups had higher adiposity, inflamation (hsRCP), FFA totals and frequency palmitoleic-16:Jn7, compared to AW. The obese with MetS presented more metabolic alterations, a greater amount of dihomo-γ-linolenic (DHGL-20:3n6) and a 20:3n6/18:2n6 relation, indicative of increased activity of A6 desaturase (D6D). The FFA totals, palmitoleic-l6:1n7, DHGL-20:3n6, D6D activity and hsRCP significantly correlated with variables of adiposity, IR and triglicerides. The results in obese with MetS corroborate the association among central obesity, inflammation and increased lipolysis in visceral adipose tissue and metabolic alterations.


Subject(s)
Fatty Acids, Nonesterified/blood , Metabolic Syndrome/blood , Obesity/blood , Adiposity , Adolescent , Blood Glucose/analysis , Body Mass Index , C-Reactive Protein/analysis , Child , Cholesterol/blood , Chromatography, Gas , Colombia , Cross-Sectional Studies , Female , Humans , Male , Metabolic Syndrome/complications , Obesity/complications , Socioeconomic Factors , Triglycerides/blood , Waist Circumference
16.
An. Fac. Med. (Perú) ; 73(1): 51-54, ene.-mar. 2012. ilus
Article in Spanish | LILACS, LIPECS | ID: lil-656503

ABSTRACT

El virus sincicial respiratorio (VSR) es el principal patógeno causante de infecciones del tracto respiratorio bajo durante el primer año de vida y ocasiona un elevado índice de hospitalización en niños menores de 12 meses; la presentación clínica severa y su aparición como brotes epidemiológicos en las unidades con recién nacidos prematuros representa un riesgo elevado de morbimortalidad. Se realiza la presentación de dos casos y el análisis sobre la importancia del diagnóstico precoz, el manejo individualizado y las medidas de control de infecciones como factores que reducen la morbimortalidad en estas situaciones y previenen la diseminación de los casos en una unidad de cuidados intensivos neonatales (UCIN).


Respiratory syncytial virus (RSV) is the main pathogen causing lower respiratory tract infections during the first year of life and causes high rate of hospitalizations in children under 12 months. Its clinical presentation and emergence as severe outbreaks in preterm units represents high risk of morbidity and mortality. Two cases are presented and analysis of importance of early diagnosis, ventilatory management and hygienic measures is done in order to reduce hospitalization and prevent presentation of new cases in a Lima, PeruÆs neonatal intensive care unit.


Subject(s)
Humans , Male , Female , Infant, Newborn , Respiratory Tract Infections , Infant, Premature , Respiratory Syncytial Viruses
17.
Lupus ; 20(11): 1219-26, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21784778

ABSTRACT

Despite aggressive treatment for systemic lupus erythematosus (SLE) with high-dose glucocorticoids and immunosuppressive agents, a significant proportion of patients persist with activity or relapse. Although the results from randomized studies showed no beneficial effects of rituximab (RTX) in SLE, this treatment has proven promising results in open label trials including patients with severe and refractory disease. We report a prospective cohort of 42 Colombian patients with severe and refractory SLE treated with RTX after failure response to glucocorticoids and, at least, another immunosuppressive drug. We observed a reduction in steroid requirement [47.4 mg/day at 24 months (p < 0.001)]. Since the first three-month follow-up, 28% and 36% of the patients fulfilled criteria of complete or partial remission according to proteinuria, and 12.5% and 33% according to creatinine clearance, respectively. These response criteria remained at 12 months. Both neuropsychiatric and hematological sub-groups had a favorable clinical response. The median reinfusion-free survival time was 44 months (95% confidence interval: 10.1-50.1) and 80% of the patients did not require RTX reinfusion. Eleven adverse events were reported in 28 subjects. Most of these occurred during the first three-month follow-up, time during which patients were exposed to high-dose glucocorticoids.


Subject(s)
Antibodies, Monoclonal, Murine-Derived/therapeutic use , Lupus Erythematosus, Systemic/therapy , Adult , Antibodies, Monoclonal, Murine-Derived/adverse effects , Cohort Studies , Colombia , Creatinine/blood , Female , Glucocorticoids/therapeutic use , Humans , Immunosuppressive Agents/therapeutic use , Lupus Erythematosus, Systemic/drug therapy , Lupus Nephritis/therapy , Male , Prospective Studies , Proteinuria/therapy , Remission Induction , Rituximab , Treatment Failure , Treatment Outcome , Young Adult
20.
Rev Esp Med Nucl ; 27(2): 83-9, 2008.
Article in Spanish | MEDLINE | ID: mdl-18367045

ABSTRACT

INTRODUCTION AND OBJECTIVES: The correct interpretation of myocardial perfusion single photon emission computed tomography (SPECT) requires knowledge of the technique reproducibility. The objective was analyze the interobserver correlation of different experience in the interpretation of myocardial perfusion SPECT in patients following acute myocardial infarction (AMI) in order to improve the quality of our site. METHODS: Sixty cases (56 +/- 11 years, 87 % men) with transmural AMI who had recently undergone successful thrombolysis were included. Resting perfusion with (99m)Tc-sestamibi was performed at one week post-AMI. ANALYSIS: Semiquantitative interpretation using 17 segment-model by 2 independent specialists and 5 observers, was performed blindly. Left ventricular ejection fraction (LVEF) was measured with isotopic ventriculography one month after AMI, with a mean of 38 %. RESULTS: Using independent and then agreed on perfusion analysis, average involved segments/patient was 9.3 +/- 4 and the sum of severity 25 +/- 13. Readings of other observers ranged from 7 +/- 3.7 to 9.4 +/- 3.9 and 16.7 +/- 9.7 to 24.6 +/- 13, respectively, consistent with the reading of the specialists of between 0.779-0.871 (kappa: 0.565-0.741). There was no significant difference when the number of segments were analyzed in 40 % of the cases and for intensity in 60 % of them in more experienced observers. Correlation with consensus reading for the number of segments ranged from 0.84 to 0.94 and for severity from 0.79 to 0.89. Identification of culprit arteries was acceptable, with r values between 0.612 and 0.683 and kappas between 0.629 and 0.656. Correlation of the number of involved segments and severity with LVEF performed one month after AMI was 0.73 and 0.74, respectively. CONCLUSIONS: There was good correlation in the interpretation of myocardial perfusion SPECT, with a significantly better fit in more experienced observers. This academic exercise was also helpful in improving our residents' skills in cardiology.


Subject(s)
Myocardial Infarction/diagnostic imaging , Myocardial Infarction/surgery , Radiopharmaceuticals , Technetium Tc 99m Sestamibi , Tomography, Emission-Computed, Single-Photon , Adult , Aged , Female , Humans , Male , Middle Aged , Myocardial Reperfusion , Observer Variation
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