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The effective utilization of natural variation has become essential in addressing the challenges that climate change and population growth pose to global food security. Currently adopted protracted approaches to introgress exotic alleles into elite cultivars need substantial transformation. Here, through a strategic three-way crossing scheme among diverse exotics and the best historical elites (exotic/elite1//elite2), 2,867 pre-breeding lines were developed, genotyped and screened for multiple agronomic traits in four mega-environments. A meta-genome-wide association study, selective sweeps and haplotype-block-based analyses unveiled selection footprints in the genomes of pre-breeding lines as well as exotic-specific associations with agronomic traits. A simulation with a neutrality assumption demonstrated that many pre-breeding lines had significant exotic contributions despite substantial selection bias towards elite genomes. National breeding programmes worldwide have adopted 95 lines for germplasm enhancement, and 7 additional lines are being advanced in varietal release trials. This study presents a great leap forwards in the mobilization of GenBank variation to the breeding pipelines.
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⢠The international committee on taxonomy of viruses declared the "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2) as the new virus which has quickly transmitted from human to human and speed expeditiously across the globe causing Coronavirus Disease 2019 (COVID-19) pandemic. ⢠At present, COVID-19 is treated using chloroquine, hydroxychloroquine, remdesivir, etc,; however, these drugs have demonstrated inadequate clinical response while causing serious adverse effects. This facilitates the study of inhibition of COVID-19 protease by traditional herbal plants and dietary therapy. ⢠India has always been a rich reservoir of medicinal plants because of several agro-climatic zones. Indian herbal plants such as harsingar (night jasmine or parijat), giloy (moonseed plant or guduchi) and aloe vera (ghrit kumari) are particularly interesting in terms of their inhibition potentials. Chinese Herbal medicines (CHM) has been recommended and included in the interim guidelines for the treatment of COVID-19 as Chinese medicine is on the mainstream health care system in China. ⢠The key functional food plants with immunomodulatory and antiviral; antibacterial; antifungal; anti-inflammatory; antioxidant; anticancer activity included liquorice (Glycyrrhiza glabra L.), garlic (Allium sativum L.), tea (Camellia sinensis [L.] Kuntez), ginger (Zingiber officinale Roscoe), turmeric (Curcuma longa L.) pomegranate (Punica granatum L.), black pepper (Pipper nigram L.) etc. ⢠The present study explores the scientific data to provide exclusive analysis and establish the prospects of traditional medicine (TM) and dietary therapy (DT) in treatment and prevention of Coronavirus Disease 2019 (COVID-19) patients.
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Humanos , Preparaciones de Plantas/uso terapéutico , COVID-19/tratamiento farmacológico , Fitoterapia , Medicina Tradicional , Trinidad y Tobago , Medicamentos Herbarios Chinos/uso terapéutico , SARS-CoV-2/efectos de los fármacos , COVID-19/prevención & controlRESUMEN
Ovalbumin is considered a protein of high nutritional value because it contains essential amino acids and is highly digestible. Therefore, it has a high biological value. Currently, the high food demand requires worldwide attention because food production is insufficient. Therefore, other alternatives are necessary to satisfy food demands, such as protein engineering. In this work, a protein with a high essential amino acid content similar to ovalbumin was synthesized by protein engineering, expressed, and digested in vitro. The assembly and sequential overlap extension PCR strategy was used to synthesize a 345-bp gene that encodes a high essential amino acid content protein (HEAAP). The 345-bp product was cloned into the vector pBAD TOPO®, and expressed in Escherichia coli BL21. PCR reactions and sequencing demonstrated the presence, orientation, and correct sequence of the insert. HEAAP expression was induced by L-arabinose and then purified using Ni-NTA affinity chromatography. The expression in E. coli was low and barely detected by Western blot assay. The in vitro multienzyme digestibility of HEAAP was around 79%, which suggests that the protein is potentially nutritious. Virtual analysis classifies the protein as unstable and hydrophilic, with a half-life in E. coli of 10 h. The recombinant HEAAP was successfully synthesized, but it is necessary to improve the digestibility and to optimize expression including selecting other expression models.
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Ingeniería de Proteínas/métodos , Proteínas Recombinantes/síntesis química , Proteínas Recombinantes/aislamiento & purificación , Aminoácidos Esenciales/síntesis química , Aminoácidos Esenciales/fisiología , Cromatografía de Afinidad , Clonación Molecular/métodos , Suplementos Dietéticos , Escherichia coli/genética , Reacción en Cadena de la Polimerasa/métodos , Proteínas/síntesis química , Proteínas/aislamiento & purificación , Proteínas Recombinantes de Fusión/genética , Proteínas Recombinantes/genéticaRESUMEN
OBJECTIVE: Frontiers between pediatric bipolar disorder (PBD) and attention-deficit/hyperactivity disorder (ADHD) are not well defined. Few studies have addressed potentially different neurobiological factors between the two disorders. Brain-derived neurotrophic factor (BDNF) has been increasingly recognized for its etiologic and prognostic role in adult bipolar disorder (BD) studies. This study aimed to examine the BDNF gene polymorphism and potential alterations in BDNF serum levels in the pediatric ADHD patients with or without comorbid BD illness. METHOD: We assessed the non-synonymous single-nucleotide polymorphism in the BDNF gene (rs6265/Val66Met) and its serum levels in children and adolescents with BD comorbid with ADHD (BD + ADHD) and ADHD alone. Children and adolescents were assessed for psychiatric diagnoses using the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL). RESULTS: Using Analysis of covariance (ancova) we detected a significant group effect (patients with BD + ADHD had higher serum levels than those with ADHD - F80,3 = 8.73, P = 0.005). CONCLUSION: Although the Val66Met polymorphism at the BDNF gene does not seem to play a significant role in children and adolescents with BD or ADHD, BDNF serum levels deserve further attention in future research on neurobiological aspects of BD and ADHD.
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Trastorno por Déficit de Atención con Hiperactividad/genética , Trastorno Bipolar/genética , Factor Neurotrófico Derivado del Encéfalo/genética , Polimorfismo de Nucleótido Simple , Adolescente , Factor Neurotrófico Derivado del Encéfalo/sangre , Niño , Preescolar , Femenino , Humanos , Masculino , Escalas de Valoración PsiquiátricaRESUMEN
BACKGROUND: Multiple myeloma (MM) is a B-cell malignancy characterized by the accumulation of clonal population of plasma cells in the bone marrow (BM). A variety of angiogenic factors, proteases, reactive oxygen species and inflammatory cytokines induce the formation of an extensive and suitable BM microenvironment. Previous studies have established the importance of angiogenic factors, inflammatory molecules and oxidative stress in MM but their interplay and effect on each other are not being taken together. METHODS: Circulatory levels of VEGF, angiopoietin-2 (Ang-2), IL-6 and TNF-α along with the activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx) were investigated in 112 subjects including 62 MM patients and 50 healthy controls. Inter-stage analysis was done to evaluate the association of these molecules with the severity of disease. Pearson correlation was determined to find interrelationship, if any, between these molecules. RESULTS: We have observed elevated levels of VEGF, Ang-2, IL-6, TNF-α and decreased activity of SOD, GPx in MM patients in comparison to controls. All these molecules also showed a trend with the severity of disease. We have found strong association between these factors upon their correlation and regression analysis. CONCLUSION: This study is a step toward understanding the indepth contribution of angiogenesis, inflammation and oxidative stress together in making BM microenvironment suitable for growth, survival and proliferation of malignant plasma cells in MM.
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Inflamación/patología , Mieloma Múltiple/patología , Neovascularización Patológica/patología , Estrés Oxidativo/fisiología , Microambiente Tumoral/fisiología , Adulto , Anciano , Médula Ósea/patología , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , India , Masculino , Persona de Mediana Edad , Mieloma Múltiple/irrigación sanguíneaRESUMEN
OBJECTIVE: To estimate the prevalence of self-reported Type 2 diabetes mellitus, hypertension and dyslipidaemiain a nationally representative sample of adults aged ¡Ý 40years in Trinidad and Tobago. SUBJECTS AND METHODS: The National Eye Survey of Trinidad and Tobago (NESTT) was a population-based, nationally representative cross-sectional survey conductedin 2013¨C2014. Randomized multistage cluster sampling with probability-proportionate-to-size methods was used to select 4200 people aged ¡Ý 40 years from 120 clusters. A standardized interview included socio-economic and demographic variables. Comprehensive ophthalmic examination included anthropometry with measurement of fasting blood glucose, blood pressure, capillary blood glucose,HbA1c (if diabetic) and waist circumference. RESULTS: A total of 3592 (84.6%) adults aged ¡Ý 40 years participated in a basic screening interview and 2801 (61%)had a comprehensive clinic assessment. The demographic characteristics of participants were similar to the 2011 national census. The crude prevalence of self-reported hypertension was 34.4% (95% CI: 32.8, 36%), diabetes was 21.0% (95% CI: 19.72, 22.38%) and hypercholesterolaemiawas 21.2% (95% CI: 19.7, 22.7%). Combining self-reported and newly diagnosed diabetes, prevalence increased to 23.94% (95% CI: 22.57, 25.36%). The meanHbA1c in patients with diabetes was 8.25 (SD 2.25); 43% never had a retinal examination and about one-third was onlipid-lowering therapy. CONCLUSION: The self-reported prevalence of diabetes, hypertension and dyslipidaemia in Trinidad and Tobago remains high and acceptable targets for control of diabetes and hypertension are not currently being achieved. There is a strong case for improved screening for and treatmentof risk factors in the population ¡Ý 40 years
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Humanos , Diabetes Mellitus Tipo 2 , Hipertensión , Trinidad y TobagoRESUMEN
The aim of the study was to comparatively evaluate the antibacterial activity of six Indian plant extracts and 0.2% chlorhexidine against clinical strains of Streptococcus mutans, which were isolated from the plaque samples of 45 pediatric patients. Six plant extracts were prepared in three different forms, namely aqueous extracts, organic solvent-based extracts and crude (raw) extracts. The antimicrobial sensitivity testing was done by agar well diffusion method. Antimicrobial activity of the extracts was determined by measuring the mean zones of inhibition (mm) produced against the bacterial isolates. Results showed that crude garlic extract exhibited greater antibacterial activity than chlorhexidine. Aqueous extract of amla and organic solvent-based extract of ginger showed the maximum antibacterial activity against S. mutans, whereas aqueous extract of tulsi and organic solvent based extract of amla showed the minimum antibacterial activity. This study suggests that plant extracts like garlic in crude form, amla as aqueous infusion and ginger as alcoholic tincture have potential for the control of S. mutans. These extracts can be used as an alternative remedy for dental caries prevention or in the form of mouthwash, which is safe and economical.
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Placa Dental/microbiología , Extractos Vegetales/química , Extractos Vegetales/farmacología , Streptococcus mutans/efectos de los fármacos , Adolescente , Aloe/química , Niño , Preescolar , Clorhexidina/farmacología , Femenino , Ajo/química , Zingiber officinale/química , Glicéridos/química , Humanos , India , Masculino , Pruebas de Sensibilidad Microbiana , Ocimum/química , Phyllanthus emblica/química , Terpenos/químicaRESUMEN
The present study was carried out to find the effect of fruit harvesting stage (October, November and December) on the physicochemical and antioxidant properties in five kiwi cultivars (Abbot, Bruno, Allison, Hayward, Monty). Results showed that soluble solid content (SSC) and pH increased while ascorbic acid (Vit C), titrated acidity (TAD) and SSC/TAD decreased in all the cultivars with delay in harvesting. Total polyphenols (TP) were decreased while total flavonoids (TF) increased in all tested cultivars with delay in harvesting. The highest concentration of TP (2.02 mg gallic acid equivalent/g fresh weight) and TF (51.12 mg catechin equivalent/100g FW) were found in cultivar 'Allison' in the month of October and December, respectively. Antioxidant activities (AA) were genotype depended and no trend was observed with month of harvesting. Principal component analysis (PCA) showed strong correlation between Vit C, TP and antioxidant activities. Two major clusters were computed using agglomerative hierarchical clustering (AHC). All the studied important traits may be used in the breeding programmes to increase the variability for different physiochemical and antioxidative characteristics and to make suitable selections that could be acceptable to consumers.
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The aim of the study was to comparatively evaluate the antibacterial activity of six Indian plant extracts and 0.2% chlorhexidine against clinical strains of Streptococcus mutans, which were isolated from the plaque samples of 45 pediatric patients. Six plant extracts were prepared in three different forms, namely aqueous extracts, organic solvent-based extracts and crude (raw) extracts. The antimicrobial sensitivity testing was done by agar well diffusion method. Antimicrobial activity of the extracts was determined by measuring the mean zones of inhibition (mm) produced against the bacterial isolates. Results showed that crude garlic extract exhibited greater antibacterial activity than chlorhexidine. Aqueous extract of amla and organic solvent-based extract of ginger showed the maximum antibacterial activity against S. mutans, whereas aqueous extract of tulsi and organic solvent based extract of amla showed the minimum antibacterial activity. This study suggests that plant extracts like garlic in crude form, amla as aqueous infusion and ginger as alcoholic tincture have potential for the control of S. mutans. These extracts can be used as an alternative remedy for dental caries prevention or in the form of mouthwash, which is safe and economical.
O objetivo do estudo foi avaliar comparativamente a atividade antibacteriana de seis plantas indianas contra linhagens clínicas de Streptococcus mutans, que foram isoladas das amostras de biofilme dental de 45 pacientes pediátricos, com 0,2% de clorexidina. Seis extratos vegetais foram preparados em três formas diferentes, a saber, extratos aquosos, extratos à base de solventes orgânicos e extratos brutos. Os testes de sensibilidade antimicrobiana foram realizados por método de difusão em agar. A atividade antimicrobiana dos extratos foi determinada através da medição da zona de inibição, em milímetros, produzida contra os isolados bacterianos. Os resultados mostraram que o extrato de alho cru apresentou maior atividade antibacteriana do que a clorexidina. O extrato aquoso de amla e o extrato à base de solventes orgânicos de gengibre mostraram a máxima atividade antibacteriana contra S. mutans, enquanto o extrato aquoso de tulsi (manjericão) e o extrato à base de solventes orgânicos de amla mostraram mínima atividades antibacteriana. Este estudo sugere que extratos de plantas como o alho em forma bruta, amla como infusão aquosa e gengibre como tintura alcoólica tem um potencial para o controle de S. mutans. Estes extratos podem ser utilizados como uma via alternativa para a prevenção de cáries dentárias ou sob a forma de bochechos, que são seguros e econômicos.
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Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Placa Dental/diagnóstico , Extractos Vegetales/química , Extractos Vegetales/farmacología , Streptococcus mutans/efectos de los fármacos , Aloe/química , Clorhexidina/farmacología , Ajo/química , Zingiber officinale/química , Glicéridos/química , India , Pruebas de Sensibilidad Microbiana , Ocimum/química , Phyllanthus emblica/química , Terpenos/químicaRESUMEN
PURPOSE: Suppressor of cytokine signaling 7 (SOCS7) is a member of the SOCS family and is known to interact with phospholipase Cγ-1 (PLCγ-1), one of the insulin-like growth factor-I (IGF-I) receptor downstream molecules. In this study, we sought to observe the effect of knocking down SOCS7 gene on breast cancer cells in vitro growth and migration and to elucidate whether this involves IGF-I-PLCγ1 route using the PLCγ-1 blocker U73122. METHODS: Suitable breast cancer cells (MCF7 and MDA-MB-231) were transfected with anti-SOCS7 ribozymal transgene, to create sub-lines with SOCS7 knockdown verified by RT-PCR. The growth and migration of the cells were evaluated in the presence or absence of IGF-I and PLCγ-1 inhibitor using growth assay, scratch-wound and electrical cell impedance sensing (ECIS) migration assays. RESULTS: IGF-I treatment produced more pronounced influence on MCF7 growth and migration and on MDA-MB-231 migration when SOCS7 gene was knocked down in both lines (p < 0.05). The absence of IGF-I-induced growth response in MDA-MB-231 could be due to the intrinsic characteristics of these cells. PLCγ-1 pharmacological inhibition during their in vitro migration seemed to only occur when SOCS7 gene was knocked down. CONCLUSIONS: To the best of our knowledge, this is the first report of the SOCS7 regulatory role in IGF-I induced in vitro functions in ER-positive and ER-negative breast cancer cells. IGF-I treatment and SOCS7 loss have synergistically resulted in increased growth and migration of MCF7 and in increased migration of MDA-MB-231 cells. The migratory effects could be due to a precise anti-PLCγ-1 role.
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Neoplasias de la Mama/genética , Técnicas de Silenciamiento del Gen , Factor I del Crecimiento Similar a la Insulina/farmacología , Proteínas Nucleares/genética , Proteínas Supresoras de la Señalización de Citocinas/genética , Humanos , Células Tumorales Cultivadas/efectos de los fármacosRESUMEN
A few mixed ligand transition metal carbodithioate complexes of the general formula [M(4-MPipzcdt)x(phen)y]Y (M = Mn(II), Co(II), Zn(II); 4-MPipzcdt = 4-methylpiperazine-1-carbodithioate; phen = 1,10-phenanthroline; x = 1 and y = 2 when Y = Cl; x = 2 and y = 1 when Y = nil) were synthesized and screened for their antimicrobial activity against Candida albicans, Escherichia coli, Pseudomonas aeruginosa,Staphylococcus aureus andEnterococcusfaecalis by disk diffusion method. All the complexes exhibited prominent antimicrobial activity against tested pathogenic strains with the MIC values in the range <8-512 ìgmL-1. The complexes [Mn(4-MPipzcdt)2(phen)] and [Co(4-MPipzcdt)(phen)2]Cl inhibited the growth of Candida albicans at a concentration as low as 8 µgmL-1.The complexes were also evaluated for their toxicity towards human transformed rhabdomyosarcoma cells (RD cells). Moderate cell viability of the RD cells was exhibited against the metal complexes.
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Fenantrolinas/análisis , Metales/análisis , Toxicidad/análisis , LigandosRESUMEN
A few mixed ligand transition metal carbodithioate complexes of the general formula [M(4-MPipzcdt)x(phen)y]Y (M = Mn(II), Co(II), Zn(II); 4-MPipzcdt = 4-methylpiperazine-1-carbodithioate; phen = 1,10-phenanthroline; x = 1 and y = 2 when Y = Cl; x = 2 and y = 1 when Y = nil) were synthesized and screened for their antimicrobial activity against Candida albicans, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus faecalis by disk diffusion method. All the complexes exhibited prominent antimicrobial activity against tested pathogenic strains with the MIC values in the range <8-512 gmL(-1). The complexes [Mn(4-MPipzcdt)2(phen)] and [Co(4-MPipzcdt)(phen)2]Cl inhibited the growth of Candida albicans at a concentration as low as 8 µgmL(-1). The complexes were also evaluated for their toxicity towards human transformed rhabdomyosarcoma cells (RD cells). Moderate cell viability of the RD cells was exhibited against the metal complexes.
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A few mixed ligand transition metal carbodithioate complexes of the general formula [M(4-MPipzcdt)x(phen)y]Y (M = Mn(II), Co(II), Zn(II); 4-MPipzcdt = 4-methylpiperazine-1-carbodithioate; phen = 1,10-phenanthroline; x = 1 and y = 2 when Y = Cl; x = 2 and y = 1 when Y = nil) were synthesized and screened for their antimicrobial activity against Candida albicans, Escherichia coli, Pseudomonas aeruginosa,Staphylococcus aureus andEnterococcusfaecalis by disk diffusion method. All the complexes exhibited prominent antimicrobial activity against tested pathogenic strains with the MIC values in the range 8-512 gmL-1. The complexes [Mn(4-MPipzcdt)2(phen)] and [Co(4-MPipzcdt)(phen)2]Cl inhibited the growth of Candida albicans at a concentration as low as 8 µgmL-1.The complexes were also evaluated for their toxicity towards human transformed rhabdomyosarcoma cells (RD cells). Moderate cell viability of the RD cells was exhibited against the metal complexes.
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The molecular structure and infrared spectrum of the atmospheric pollutant 3,3-dichloro-1,1,1-trifluoropropane (HCFC-243) were characterized experimentally and theoretically. The theoretical calculations show the existence of two conformers, with the gauche (G) and trans (T) orientation around the HCCC dihedral angle. Conformer G was calculated to be more stable than form T by more than 10 kJ mol (-1). In consonance with the large predicted relative energy of conformer T, only the G form was identified spectroscopically in cryogenic argon (10 K) and xenon (20 K) matrices prepared from room-temperature equilibrium vapor of the compound. The observed infrared spectra of the matrix-isolated HCFC-243 were interpreted with the aid of high-level density functional theory calculations and normal coordinate analysis. For experimental identification of the weakest IR absorption bands, the spectrum of HCFC-243 in the neat solid state at 145 K was obtained. This spectrum also confirmed the sole presence of the G conformer in the sample. Natural bond orbital and atomic charge analyses were carried out for the two conformers to shed light on the most important intramolecular interactions in the two conformers, in particular those responsible for their relative stability.
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Hymenoptera is a class of insects that sting in order to subdue their prey. Humans coming into accidental contact with these insects results in stings that may cause from mild local reaction like weal formation around the sting site to severe systemic reactions such as intravascular hemolysis, acute renal failure, pulmonary edema, cerebral edema, and rarely pancreatitis. We report here the clinical course of a patient who developed concurrent acute pancreatitis and pigment-induced acute renal failure after multiple hornet stings.
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Hymenoptera is a class of insects that sting in order to subdue their prey. Humans coming into accidental contact with these insects results in stings that may cause from mild local reaction like weal formation around the sting site to severe systemic reactions such as intravascular hemolysis, acute renal failure, pulmonary edema, cerebral edema, and rarely pancreatitis. We report here the clinical course of a patient who developed concurrent acute pancreatitis and pigment-induced acute renal failure after multiple hornet stings.
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OBJECTIVE: To analyze the incidence and severity of cardiovascular disease in patients with Williams syndrome (WS) and to identify factors contributing to its variable expression. METHODS: Clinical data on patients with WS were collected from several WS centers. Elastin gene deletions were confirmed in all patients. Age at diagnosis, growth data, and cardiovascular diagnoses were recorded retrospectively. Cardiac diagnoses were made on the basis of echocardiographic data. The severity of supravalvular aortic stenosis was recorded by using a 4-step scale (none, mild, moderate, severe). RESULTS: Statistical analysis of the data revealed that the severity of both supravalvular aortic stenosis and total cardiovascular disease was significantly greater in male patients than female patients (P <.002 and P <.002, respectively; Kruskal-Wallis rank-sum test). This difference was not accounted for by differences in height, weight, body mass index, or head circumference. The clinical diagnosis of WS was made at a significantly younger age in male patients (P <.01, Student t test). Earlier diagnosis was partly because of increased incidence and severity of cardiovascular disease. Another determinant of early diagnosis was low body mass index. CONCLUSION: Penetrance and severity of the elastin arteriopathy in patients with WS is affected by sex. We hypothesize that differences by sex in arterial stenoses may be related to prenatal hormonal effects. Future epidemiologic and in vitro studies may provide additional insight into the pathogenetic mechanisms of these observed differences.
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Enfermedades Cardiovasculares/etiología , Síndrome de Williams/complicaciones , Adolescente , Adulto , Enfermedades Cardiovasculares/diagnóstico por imagen , Enfermedades Cardiovasculares/genética , Niño , Preescolar , Elastina/genética , Femenino , Eliminación de Gen , Expresión Génica/genética , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Factores Sexuales , Factores de Tiempo , Ultrasonografía , Síndrome de Williams/genéticaRESUMEN
OBJECTIVES: To validate a scoring system to assess the severity of renal lesions and to correlate histology with clinical findings. We also examined the efficacy of treatment with prednisone (1 to 2 mg/kg/d) and azathioprine (1 to 2 mg/kg/d) for severe Henoch-Schonlein purpura (HSP) nephritis. METHODS: Twenty patients were evaluated retrospectively. All underwent biopsy before treatment, and 13 underwent biopsy after therapy. We developed a scale based on glomerular, tubulointerstitial (TI), and vascular changes and assigned all specimens acuity, chronicity, and TI scores. The outcomes of 17 patients were compared with those of a historical control group. RESULTS: Chronicity score at initial biopsy increased with increasing delay between onset of renal involvement and first biopsy (rho = 0.55, P =.016) but did not progress after treatment was initiated. Both acuity (rho = 0.57,P =. 016) and TI (rho = 0.69, P =.003) scores correlated with clinical severity at first biopsy. The TI score correlated negatively with serum albumin (rho = -.60, P <.01). Significantly more patients in the study group than in the control group had a favorable outcome (15 [88%] of 17 vs 32 [54%] of 59, P =.011). CONCLUSIONS: Our scale reflects disease activity and highlights the importance of TI changes in severe HSP nephritis. Outcome comparisons indicate that early treatment with prednisone and azathioprine prevents progression of chronic changes and improves outcome.
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Antiinflamatorios/uso terapéutico , Azatioprina/uso terapéutico , Vasculitis por IgA/tratamiento farmacológico , Vasculitis por IgA/patología , Inmunosupresores/uso terapéutico , Nefritis/tratamiento farmacológico , Nefritis/patología , Prednisona/uso terapéutico , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Vasculitis por IgA/complicaciones , Masculino , Nefritis/complicaciones , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
Growth of children during maintenance hemodialysis has been reported to be uniformly poor, with a mean annual loss of 0.4 to 0.8 SD in height. We adopted an intensive program of closely monitored energy and protein intake with dialysis urea clearances exceeding conventional recommendations. Twelve prepubertal or early pubertal children (aged 7 months to 14 years) were monitored for an average of 2.2 years (range 4 to 81 months) while receiving maintenance hemodialysis. These children received an average of 90.6% and 155.9% of their recommended energy and protein nutritional intake, respectively. With a prescribed urea clearance of 5 mL/kg/min, we achieved a mean single treatment urea clearance normalized for total body water of 2.00, a urea reduction ratio of 84.7%, and an average time of hemodialysis of 14.8 h/wk, all well beyond current guidelines. Over the course of dialysis treatment, the improvement in height SD score was+0.31 SD/y (+0.32 excluding the 2 children treated with recombinant human growth hormone). Normal growth was achieved without overt obesity and was associated with normal pubertal growth spurt. These findings suggest that the combination of increased dialysis and adequate nutrition can promote normal growth in children treated with long-term hemodialysis.