Utilidad de la ECMO sobre el injerto pulmonar disfuncionante en un modelo porcino estandarizado de trasplante unipulmonar / [Usefulness of ECMO on dysfunctional lung graft in a standardized porcine model of one-lung transplant]

Objetivo: Establecer un modelo de muerte encefálica y trasplante pulmonar y analizar el posible papel protector del oxigenador de membrana extracorpóreo (ECMO).Métodos: Se emplearon 20 cerdos hembras, 10 donantes y 10 receptoras. Las receptoras del Grupo A (n = 5) fueron sometidas a un trasplante unipulmonar izquierdo (Tx-UPI) sin ECMO. Las receptoras del Grupo B (n = 5) se sometieron a un Tx-UPI con ECMO venoarterial (ECMO-VA). Se recopilaron datos funcionales e histológicos en situación basal, a los 10 minutos de clampar el hilio derecho (Tiempo 1) y a las 2 horas (Tiempo 2). Se analizó la expresión proteica de marcadores de inflamación y de la ruta de hipoxia.Resultados: El modelo de muerte encefálica empleado, seguido de un tiempo de isquemia frío prolongado (20 horas) dio lugar a la aparición de un edema pulmonar severo. Tras el implante, 3 receptores del grupo A sobrevivieron hasta el Tiempo 2, falleciendo 2 por edema pulmonar masivo. Por el contrario, todos los animales del Grupo B sobrevivieron, siendo la PaO2 en ese momento de 462,72 mmHg. Hubo un incremento de la expresión de IL6, TNF, PCR, AC IX y el VEGF, así como un descenso en la expresión de IL8 y GLUT1, al usar la ECMO.Conclusiones: Se ha desarrollado un modelo porcino estandarizado y reproducible de muerte encefálica, que simula el proceso clínico de la donación pulmonar. Este modelo puede servir de plataforma para investigar posibles dianas terapéuticas. (AU)

Objective: Establish a model of brain death and lung transplantation and analyze the possible protective role of extracorporeal membrane oxygenation (ECMO).Methods: 20 female pigs were used, 10 donors and 10 recipients. Group A recipients (n = 5) underwent left-sided single- lung transplantation (LUCT-Tx) without ECMO. Group B recipients (n = 5) underwent ICU-Tx with venoarterial ECMO (VA-ECMO). Functional and histological data were collected at baseline, 10 minutes after clamping the right hilum (Time 1) and 2 hours (Time 2). Protein expression of inflammation markers and the hypoxia pathway was analyzed.Results: The brain death model used, followed by a prolonged cold ischemia time (20 hours) gave rise to the appearance of severe pulmonary edema. After implantation, 3 group A recipients survived until Time 2, with 2 dying from massive pulmonary edema. In contrast, all the animals in Group B survived, with PaO2 at that time being 462.72 mmHg. There was an increase in the expression of IL6, TNFα, CRP, AC IX and VEGF, as well as a decrease in the expression of IL8 and GLUT1, when using ECMO.Conclusions: A standardized and reproducible porcine model of brain death has been developed, which simulates the clinical process of lung donation. This model can serve as a platform to investigate possible therapeutic targets. (AU)

Analysis of the sleep quality of elderly people using biomedical signals.

This paper presents a technical solution that analyses sleep signals captured by biomedical sensors to find possible disorders during rest. Specifically, the method evaluates electrooculogram (EOG) signals, skin conductance (GSR), air flow (AS), and body temperature. Next, a quantitative sleep quality analysis determines significant changes in the biological signals, and any similarities between them in a given time period. Filtering techniques such as the Fourier transform method and IIR filters process the signal and identify significant variations. Once these changes have been identified, all significant data is compared and a quantitative and statistical analysis is carried out to determine the level of a person's rest. To evaluate the correlation and significant differences, a statistical analysis has been calculated showing correlation between EOG and AS signals (p=0,005), EOG, and GSR signals (p=0,037) and, finally, the EOG and Body temperature (p=0,04). Doctors could use this information to monitor changes within a patient.

Vocal folds morphological pathologies detection using Gabor filtering and Principal Component Analysis.

BACKGROUND: Given the importance of the voice in our daily lives, any study focused on its pathologies and the way of caring and promoting the health of them is of common interest. OBJECTIVE: This paper describes a method to automatically aid indetecting vocal folds benign pathologies based on glottal space segmentation vocal fold video sequences captured by a laryngoscope. METHODS: The proposed algorithm is based on automatic segmentation supported by Gabor filters, and features classification with Principal Component Analysis (PCA) to achieve the expected results. RESULTS: The authors wish to emphasize that the proposed algorithm is independent from the images' resolution and zoom, but their quality depends on specialist experience with the instrumentation. Segmentation block provides good results for 95% of images and classification block distinguishes successfully between pathological and healthy images in 92.1% of cases. The proposed system's findings have been compared with the diagnosis made by doctors and it obtains the same results in all the 45 sequences. CONCLUSIONS: One of the proposed study's key elements has been which objective measurements are of significance for the specialist. In this case, it is those that enable the specialist to calculate the size of the pathology (previously classified automatically) that he/she is observing, thus enabling them to provide the patient with more information or to prescribe treatment and even measure its development.

Caregiver and social assistant robot for rehabilitation and coaching for the elderly.

BACKGROUND: Socially assistive robotics (SAR) has been a major field of investigation during the last decade and, as it develops, the groups the technology can be applied to and all ways in which these can be assisted are rapidly increasing. OBJECTIVE: The main objective is to design and develop a complete robotic agent, so that it performs physical and mental activities for elderly people to maintain their healthy life habits and, as a final result, improve their quality of life. METHODS: LEGO Mindstorms NXT® robot's unique capacity for adaptability and engaging its users to develop coaching activities and assistive rehabilitation for the elderly. Such activities will aim to enhance healthy habits and provide training in physical and mental rehabilitation. The robot is attached to an iPod Touch that acts as its interface. RESULTS: The robot has been tested by a voluntary group of residents, also from that retirement home. Results in the variables of the questionnaire show scores above 4 points out of 5 for all the categories. CONCLUSIONS: Based on the tests, an easy to use Robot is prepared to deliver basic coaching for physical activities as proposed by the client, the staff of La Misericordia, who confirmed their satisfaction regarding this aspect.

Melanomas non-invasive diagnosis application based on the ABCD rule and pattern recognition image processing algorithms.

In this paper an automated dermatological tool for the parameterization of melanomas is presented. The system is based on the standard ABCD Rule and dermatological Pattern Recognition protocols. On the one hand, a complete stack of algorithms for the asymmetry, border, color, and diameter parameterization were developed. On the other hand, three automatic algorithms for digital image processing have been developed in order to detect the appropriate patterns. These allow one to calculate certain quantitative features based on the aspect and inner patterns of the melanoma using simple-operation algorithms, in order to minimize response time. The database used consists of 160 500 x 500-pixel RGB images (20 images per pattern) cataloged by dermatologists, and the results have turned out to be successful according to assessment by medical experts. While the ABCD algorithms are mathematically reliable, the proposed algorithms for pattern recognition produced a remarkable rate of globular, reticular, and blue veil Pattern recognition, with an average above 85% of accuracy. It thus proves to be a reliable system when performing a diagnosis.

Amniocentesis genéticas durante los últimos 6 años en nuestro hospital / Genetic amniocentesis in our hospital in the last six years

Introducción La identificación de posibles alteraciones cromosómicas fetales es sin duda uno de los principales retos a los que ha de enfrentarse cualquier obstetra involucrado en el diagnóstico prenatal de anomalías congénitas. Objetivos Evaluar el rendimiento diagnóstico del procedimiento en nuestro servicio, así como sus complicaciones asociadas. Pacientes y métodos En el presente artículo realizamos un análisis retrospectivo de las amniocentesis realizadas en nuestro centro durante un periodo de 6 años, prestando atención a la rentabilidad diagnóstica del procedimiento, las complicaciones asociadas más frecuentes y las indicaciones que llevaron a la realización de la técnica, revisando finalmente las estrategias de cribado poblacional actualmente aplicadas. Resultados El riesgo de cromosomopatía asociado a la edad materna fue el motivo principal por el cual la técnica fue realizada. El 2,16% de amniocentesis condujeron al diagnóstico de una cromosomopatía, con una tasa de complicaciones asociadas a la técnica del 1,02%.Conclusiones Aunque nuestros resultados son similares a los comunicados en otras series, debemos reconsiderar las estrategias de cribado que hasta ahora se han venido aplicando, particularmente para las gestantes de mayor edad (AU)

Introduction Identification of fetal congenital chromosomal abnormalities is undoubtedly one of the main challenges faced by obstetricians involved in the prenatal diagnosis of congenital anomalies. Objective To evaluate the diagnostic yield of genetic amniocentesis in our hospital and its associated complications. Patients And Methods We performed a retrospective analysis of all genetic amniocenteses performed in our hospital in the last 6 years, focusing on diagnostic yield, the most common associated complications, and the indications for this procedure. We also reviewed the various population-based screening programs currently applied. Results The main indication for amniocentesis was maternal age-associated risk. A total of 2.161% of procedures led to diagnosis of chromosomal abnormalities, with a complications rate of 1.028%. Conclusion Although our results are similar to those reported in other published series, current screening strategies should be revised, mainly in older pregnant women (AU)

Vasculitis asociadas a ANCA en artritis reumatoide. Descripción de un caso de poliangeitis microscópica y otro de enfermedad de Wegener / Vasculitis associated with anti-neutrophil cytoplasmic autoantibodies in rheumatoid arthritis. Report of a case of microscopic polyangiitis and another case of Wegener’s granulomatosis

La vasculitis es una complicación infrecuente de la artritis reumatoide que se asocia con un aumento claro de la morbimortalidad, aunque son muy raras las manifestaciones sistémicas como glomerulonefritis, vasculitis cerebral o vasculitis pulmonar. A su vez, las vasculitis sistémicas con afectación renal se asocian en menos del 5% a poliartritis franca y la asociación con artritis reumatoide es excepcional. La determinación de los anticuerpos anticitoplasma de neutrófilo (ANCA), utilizados en el contexto clínico apropiado, se ha convertido en una importante herramienta diagnóstica de las vasculitis sistémicas de pequeño vaso. Presentamos 2 pacientes diagnosticados de artritis reumatoide que posteriormente desarrollaron vasculitis sistémica, en los que la determinación de ANCA fue decisiva en el diagnóstico precoz(AU)

Vasculitis is an uncommon complication of rheumatoid arthritis that is associated with a clear increase in morbidity and mortality, although systemic manifestations such as glomerulonephritis, cerebral vasculitis or pulmonary vasculitis are very rare. Systemic vasculitis with renal involvement is associated with overt polyarthritis in less than 5% and association with rheumatoid arthritis is exceptional. Determination of anti-neutrophil cytoplasmic autoantibodies (ANCA), used in the appropriate clinical context, has become an important diagnostic tool in small-vessel systemic vasculitides. We present two patients with rheumatoid arthritis who subsequently developed systemic vasculitis. ANCA determination was decisive in the early diagnosis of these patients(AU)

[Vasculitis associated with anti-neutrophil cytoplasmic autoantibodies in rheumatoid arthritis. Report of a case of microscopic polyangiitis and another case of Wegener's granulomatosis]. / Vasculitis asociadas a ANCA en artritis reumatoide. Descripción de un caso de poliangeitis microscópica y otro de enfermedad de Wegener.

Vasculitis is an uncommon complication of rheumatoid arthritis that is associated with a clear increase in morbidity and mortality, although systemic manifestations such as glomerulonephritis, cerebral vasculitis or pulmonary vasculitis are very rare. Systemic vasculitis with renal involvement is associated with overt polyarthritis in less than 5% and association with rheumatoid arthritis is exceptional. Determination of anti-neutrophil cytoplasmic autoantibodies (ANCA), used in the appropriate clinical context, has become an important diagnostic tool in small-vessel systemic vasculitides. We present two patients with rheumatoid arthritis who subsequently developed systemic vasculitis. ANCA determination was decisive in the early diagnosis of these patients.

Variabilidad en el manejo de la osteoporosis en pacientes con artritis reumatoide en España / Variability in the management of osteoporosis in patients with rheumatoid arthritis in Spain

Objetivo: Estudiar en España la variabilidad regional en el diagnóstico y tratamiento de la osteoporosis en los pacientes con artritis reumatoide (AR).Pacientes y métodos: El estudio emAR se realizó mediante la revisión de las historias clínicas de 1.379 sujetos seleccionados de forma aleatoria en 48 servicios clínicos de 15 comunidades autónomas españolas. Entre otros, se recogieron datos relacionados con el diagnóstico de osteoporosis, la prescripción de fármacos para el tratamiento o prevención de esta enfermedad, así como la presencia de tratamiento glucocorticoideo. Resultados: Se habían realizado estudios densitométricos en el 10,8 por ciento de los pacientes. En 549 pacientes (39,8 por ciento) se había prescrito algún tipo de tratamiento para la osteoporosis, con una gran variabilidad que osciló del 8,3 al 66,6 por ciento según la comunidad autónoma. El fármaco empleado con más frecuencia fue el calcio con o sin vitamina D (de 8,3 a 58,3 por ciento), seguido de bifosfonatos (de 0 a 23,1 por ciento) y calcitonina (de 0 a 16,7 por ciento). Todos los fármacos mostraron una marcada variabilidad regional en su uso, incluso en las poblaciones con mayor riesgo de osteoporosis: sexo femenino, tratamiento con glucocorticoides y edad superior a 65 años. Conclusión: Existe una escasa búsqueda activa del diagnóstico de osteoporosis en los pacientes con AR, y una baja prescripción de fármacos antirresortivos, incluso en aquellas subpoblaciones de mayor riesgo (AU)

Seroepidemiological and molecular studies of human T cell lymphotropic virus type II, subtype b, in isolated groups of Mataco and Toba Indians of northern Argentina.

We studied plasma samples from 2082 Mataco Indians living in 22 different communities in the western part of Formosa Province, northern Argentina. Samples were screened for HTLV-I/II antibodies by particle agglutination assay. All positive or borderline samples were then tested by an immunofluorescence assay (IFA) on C19 HTLV-II-producing cells. Western blot was used for confirmation of all IFA-positive plasma samples. The crude HTLV-II seroprevalence was 3.0% (62 of 2051), and 0.9% (5 of 588) in children less than 10 years old. The latter result suggests ongoing mother-to-child transmission, probably by breast feeding. There was a marked increase in HTLV-II seroprevalence with age (0.9%, 0-10 years; 1.6%, 11-20 years; 4.4%, 21-30 years; 3.4%, 31-40 years; 7.2%, 41-50 years; 5.7%, >50 years) in both male (p = 0.002) and female subjects (p = 0.00002). None of the 80 non-Indian inhabitants tested was HTLV-I/II seropositive. In a second study, among 105 Toba Indians from a village (Primavera) of the eastern part of this region, 23 were HTLV-II seropositive with a seroprevalence of 59% in those more than 40 years old. From seven of the Indians from Primavera, three others from neighboring regions (including two Tobas and one Pilaga), and one intravenous drug user (IVDU) from Rosario, DNA was extracted from peripheral blood mononuclear cells, and the gp21 transmembrane-encoding gene (590 bp) was amplified by PCR, cloned, and sequenced. LTR sequences were also obtained from the Pilaga, the IVDU, and one Toba. Molecular and phylogenetic analyses revealed that the Indians were all infected with closely related HTLV-II molecular strains belonging to the b subtype, while the IVDU was infected with an HTLV-II subtype a variant. Such data help to make a phylogenetic atlas of HTLV-II among Amerindian tribes and are crucial to gain new insights into the origin and modes of dissemination of this human retrovirus in the Americas.

Camptothecin induces differentiation and stimulates the expression of differentiation-related genes in U-937 human promonocytic leukemia cells.

We have studied the effect of the DNA topoisomerase I inhibitor camptothecin on growth, differentiation, and gene expression in U-937 human promonocytic leukemia cells. At a concentration of 20 nM, camptothecin caused significant DNA strand breakage and decreased the growth activity by accumulating cells preferentially at the G2 phase of the cycle. The growth arrest occurred concomitantly with an increase in cell size. Under those conditions, camptothecin induced differentiation, as demonstrated by (a) the capacity of the cells to generate reactive oxygen species, (b) the increase in the surface expression of the leukocyte integrins CD11b/CD18 and CD11c/CD18, (c) the increase in the cellular content of the intermediate filament protein vimentin, and (d) the decrease in the surface expression of the transferrin receptor. Camptothecin also induced the expression of differentiation markers in other human myeloid cells, namely, the promonocytic THP-1 and the myelomonocytic HL-60 cell lines. Northern blot assays revealed that camptothecin stimulated the expression of CD11b, CD11c, and vimentin at the mRNA level. Moreover, the drug increased the transcription rate of the vimentin gene, as shown by "run-on" transcription assays.

Differentiation of human promonocytic leukemia U-937 cells with DNA topoisomerase II inhibitors: induction of vimentin gene expression.

The administration of the DNA topoisomerase II inhibitors 4'-(9-acridinylamino)methanesulfon-m-anisidide (m-AMSA) (10(-7) M), VP-16 (2 x 10(-7) M), or novobiocin (1.5 x 10(-4) M) reduces the growth activity of human promonocytic leukemia U-937 cells, by arresting them preferentially at the G2 (m-AMSA and VP-16) or at the G1 and G2 (novobiocin) phases of the cell cycle. Under these conditions, m-AMSA and VP-16 induce the differentiation of the cells efficiently, as proved both by an increase in the production of reactive oxygen species and by the activation of the surface expression of CD11b and CD11c, two differentiation-specific antigens. Novobiocin also induces the expression of those differentiation markers, but to a lesser extent. Analyses by Northern blot indicate that the topoisomerase II inhibitors reduce the levels of c-myc and beta-actin mRNA and increase the levels of vimentin mRNA. The expression of vimentin is also stimulated at the protein level, as indicated by immunofluorescence assays. This represents one of the few known instances in which topoisomerase inhibitors stimulate gene expression in eukaryotic cells.

Comparative effects of butyrate and N6, 2'-O-dibutyryladenosine-3':5'-cyclic monophosphate on growth, differentiation and gene expression in U937 human monoblastoid cells.

Administration of 1mM sodium butyrate or N6,2'-O-dibutyryladenosine 3':5'-cyclic monophosphate (dbcAMP) inhibits the growth activity of U937 human monoblastoid cells by blocking them at the G1 or at the G1 + G2 phases of the cell cycle, respectively. Both agents induce the differentiation of U937 cells, as proved by the increased expression of the maturation-associated CD11b antigen and by the increased capacity to reduce nitroblue tetrazolium. RNA blot assays indicate that butyrate and dbcAMP decrease the expression of ornithine decarboxylase and c-myc genes, and stimulate the expression of the vimentin gene. However, while dbcAMP induces c-fos mRNA accumulation, butyrate did not affect the expression of this proto-oncogene.