Quantitative analysis of Tr1 lymphocytes in patients with type 2 diabetes mellitus.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is usually accompanied by a low-grade inflammatory phenomenon, which participates in the pathogenesis of different complications of this condition. The inflammatory response is under the regulation of different mechanisms, including T regulatory (Treg) lymphocytes. However, the possible role of type 1 T regulatory (Tr1) cells in T2DM has not been explored so far. AIM: To carry out a quantitative analysis of Tr1 lymphocytes and other immune cell subsets in patients with T2DM and correlate these results with clinical findings and treatments. MATERIALS AND METHODS: Sixty patients with T2DM and twenty-three healthy controls were included in the study. Biochemical and anthropometric variables were evaluated, and Tr1 lymphocytes (CD4+CD49+LAG-3+IL-10+) and other cell subsets (Th17, Th22 and Foxp3 + Treg cells) were analyzed in peripheral blood samples by multiparametric flow cytometry. RESULTS: Significant increased levels of Tr1 cells were detected in patients with severe and mild disease, compared to healthy controls. In addition, CD4+IL-10+ lymphocytes were also increased in patients with T2DM. In contrast, similar levels of Foxp3+ Treg cells, Th17 and Th22 lymphocytes were observed in patients and controls. Likewise, no significant associations were detected between Tr1 cell levels and different clinical and laboratory parameters. However, those patients receiving glucagon-like peptide-1 receptor agonists (GLP-1-RA) showed similar levels of Tr1 cells than healthy controls, and significant lower numbers than untreated patients. CONCLUSION: We observed an increase in Tr1 and CD4+IL10+ lymphocyte levels in T2DM. Moreover, GLP1-RA treatment was significantly associated with normalization of the Tr1 levels. This highlights another potential immune dysfunction in patients with T2DM, which could participate in the pathogenesis of this condition.

Acceptability and feasibility of fecal microBIOME and serum metabolite sample collection in people with end-stage kidney disease and pain being treated with HemoDialysis: A pilot study (BIOME-HDp).

Pain is known to reduce hemodialysis treatment adherence, reduce quality of life, and increase mortality. The absence of effective strategies to treat pain without medications has contributed to poor health outcomes for people with end-stage kidney disease (ESKD) on hemodialysis. It is now recognized that symbiotic microbiota in the gut play a critical role in health and disease, and new evidence sheds light on the role of the microbiome in chronic pain. The pilot study protocol presented here (BIOME-HDp) employs a longitudinal repeated measures design to interrogate the effects of a nonpharmacological pain intervention on the composition and function of the gut microbiome and circulating metabolites. This pilot study is an ancillary study of the HOPE Consortium Trial to reduce pain and opioid use in hemodialysis, which is part of the NIH's Helping to End Addiction Long-term (HEAL) initiative. The BIOME-HDp pilot study will establish clinical microbiome research methods and determine the acceptability and feasibility of fecal microbiome and serum metabolite sample collection.

Multilevel barriers to using assistive technology devices among older hispanics from poor and disadvantaged communities: the relevance of a gender analysis.

PURPOSE: To get a rich description of the barriers to using assistive technology (AT) among men and women ≥65 years living in poor and disadvantaged communities in Puerto Rico, an issue not well described among older people. METHODS: We conducted qualitative interviews assisted by videos of AT and guided by the Matching Person and Technology Model and the Gender Analysis Framework with a purposive sample of 23 men and women. Participants were asked questions regarding reasons for not using AT, willingness for using AT, their identified gender roles and gender-related activities, and bargaining positions. They were also asked about their access to resources to acquire AT, bargaining positions, the stigma associated with AT use, and the characteristics of AT. Directed content analysis with input from a Community Advisory Board was used for the interpretation of the results. RESULTS: The predominant barrier (for both men and women) to using AT devices were: lack of information about AT s and access to money for their purchase, lack of availability and cost of such devices, and (self)-stigma. More women than men experienced limited access to AT services, limited access to and control of money, limited skills for using AT, and less bargaining power for making independent decisions. More men than women expressed a lack of functional need and personal preferences other than using AT devices for managing difficulties in activities. CONCLUSION: There are gender differences concerning the multilevel barriers to using AT devices among older Hispanics residing in low-income communities.IMPLICATIONS FOR REHABILITATIONOlder Hispanic men and women in this study experienced different obstacles to using assistive technology (AT) they need for compensating their functional disabilities in daily living activities.Women in this study reported having less access to money and AT services, diminished skills for using AT devices, and less power to make independent decisions to access AT devices compared to men.To ensure the equitable provision of AT, cultural as well as gender-related factors concerning AT use need to be considered.Future research should focus on women's functional health, also should focus on the development of gender-sensitive and culturally competent AT interventions to improve older Hispanics from poor communities function and opportunities for ageing at their homes and in their communities.

Organic carbon in soils with different systems of use in Tacarimena Yopal, Colombia / Carbono orgánico en suelos con diferentes sistemas de uso en Tacarimena Yopal, Colombia

ABSTRACT Soil is an important carbon reservoir as it can store twice the amount that atmosphere does and three times the biomass, which makes it a key component for climate change (CC) mitigation projects. It is important to know the potential of soil organic carbon storage (SOC) in the main uses of the soli and their expected dynamics due to potential use changes. SOCS is estimated in 7 of the dominant land use systems in the area of the study, with 5 replicas as follows: 1) banana with shade (SAF+banana); 2) cocoa with shade (Ca+S); 3) citrus (C); 4) low silvopastoral system (SSPB); 5) high silvopastoral system (SSPA); 6) gallery forests (BG); and 7) bush forest (MM). SOC concentration was analyzed in samples composed of 25 soil sub-samples per plot, and the DA was estimated with the cylinder method in a simple per plot. All land uses studied can mitigate CC when storing SOC. BG was the system that showed the highest carbon storage. On the other hand, SAF+banana stored the least SOC (72,7 vs 33,4Mg/ha, respectively). Changes in land use can cause CO2 emissions or an addition in carbon fixation. Changes in land use that increase SOC allow CC mitigation, which makes them feasible for funding, thus allowing an improvement in the livelihood of local producers.

RESUMEN El suelo es un reservorio importante de carbono, ya que puede almacenar el doble de lo contenido por la atmósfera y el triple de la biomasa. Esto lo constituye en un componente clave para proyectos de mitigación del cambio climático (CC). Es importante conocer el potencial de almacenamiento de carbono orgánico del suelo (COS) en los principales usos del suelo y su dinámica esperada, por potenciales cambios de uso. Se estima el COS en los siete de los sistemas de uso del suelo dominantes en el área de estudio, con cinco réplicas, así: 1) plátano con sombrío (SAF+plátano); 2) cacao con sombrío (Ca+S); 3) cítricos (C); 4) sistema silvopastoril bajo (SSPB); 5) sistema silvopastoril alto (SSPA); 6) bosques de galería (BG) y 7) mata de monte (MM). La concentración de COS fue analizada en muestras compuestas de 25 submuestras de suelo por parcela y la DA, se estimó con el método del cilindro en una muestra por parcela. Todos los usos del suelo estudiados pueden mitigar el CC al almacenar COS. El BG fue el sistema que presentó el mayor almacenamiento de carbono; por el contrario, el SAF+plátano almacenó el menor COS (72,7 vs 33,4Mg/ha, respectivamente). Cambios de uso del suelo pueden causar emisión de CO2 o adicionalidad en la fijación de carbono. Cambios de uso del suelo que incrementen el COS permiten la mitigación del CC, pudiendo ser susceptibles de financiamiento, lo que permite mejorar los medios de vida de los productores locales.

Emerging Patient-Centered Concepts in Pain Among Adults With Chronic Kidney Disease, Maintenance Dialysis, and Kidney Transplant.

Patient reports of moderate to severe pain are common across the spectrum of chronic kidney disease. The synergistic effects of comorbid depression and anxiety can lead to maladaptive coping responses to pain, namely pain catastrophizing and illness-related post-traumatic stress disorder. If underlying depression and anxiety and associated maladaptive coping responses are not treated, patients can experience an increased perception of pain, worsened disability, decreased quality of life, withdrawal from social activities, and increased morbidity and mortality. Meanwhile, interest in nonpharmacologic treatments for pain that targets coping as well as comorbid anxiety and depression has been increasing, particularly given the significant societal damage that has resulted from the opioid epidemic. Evidence-based, nonpharmacologic treatments have shown promise in treating pain in areas outside of nephrology. Currently, little is known about the effects of these treatments among adults with CKD, and particularly end-stage kidney disease, when chronic pain can become debilitating. In this review, we examine patient-centered concepts related to pain that have received little attention in the nephrology literature. We also describe emerging areas of research, including omics technologies for biomarker discovery and advanced symptom clustering methods for symptom phenotyping, which may be useful to future kidney disease research and treatment.

Listeria monocytogenes infections: Analysis of 41 patients / Infección por Listeria monocytogenes: análisis de 41 pacientes

OBJECTIVE: We describe and analyze Listeria-related demographics and clinical features to determine the predisposing conditions for severe infections. METHODS: We performed a retrospective study using positive isolation of Listeria monocytogenes from blood, cerebrospinal fluid, and other organic fluids. Electronic health records were used to determine the epidemiological and clinical features of infections caused by L. monocytogenes. Mortality and sepsis were considered dependent variables in the statistical analyses. RESULTS: We included 41 patients in an observation period of 15 years (2003-2018), with an annual incidence rate of 1.3 cases per 100,000 population. Three main population profiles were identified: newborns, pregnant women, and other adults (17.1%, 12.2%, and 82.9%, respectively). Neuroinvasive infection was present in 17 patients (41.5%). In both univariate and multivariate analyses, neurological infections, whether meningoencephalitis, rhombencephalitis, or brain abscesses, were the main risk factors for severe forms of Listeria-related infections (odds ratio 1.8, 95% CI 1.52-2.14, p = 0.01). Malignancies, whether solid tumors or hematological neoplasms, immunosuppression, and chronic diseases were not related to either mortality or severe clinical syndromes. CONCLUSION: Infections caused by L. monocytogenes were uncommon but could cause severe sepsis and mortality, especially in susceptible populations. Our study focused on neurological involvement and severe invasive forms of listeriosis. Neuroinvasive forms were the most important risk factors for severe illness but not for mortality

INTRODUCCIÓN: Describir y analizar las características demográficas y clínicas de las infecciones por Listeria para determinar los factores predisponentes para infecciones severas. MÉTODOS: Diseñamos un estudio retrospectivo utilizando los aislamientos positivos de Listeria monocytogenes en sangre, líquido cefalorraquídeo u otros fluidos orgánicos. Se obtuvieron los registros electrónicos para conseguir las características clínicas y epidemiológicas de las infecciones causadas por L. monocytogenes. Mortalidad y sepsis fueron las variables dependientes en los análisis estadísticos. RESULTADOS: Se incluyeron 41 pacientes en un período de 15 años (2003-2018), con una incidencia anual de 1,3 casos por cada 100.000 habitantes. Identificamos tres perfiles de población: neonatos, mujeres embarazadas y resto de adultos (el 17,1%, el 12,2% y el 82,9%, respectivamente). Las formas neuroinvasivas se identificaron en 17 pacientes (41,5%). Tanto en los análisis univariados como en los multivariados, las infecciones neurológicas, bien meningoencefalitis, rombencefalitis o abscesos cerebrales, fueron los principales factores de riesgo para considerar formas severas de infección por Listeria (odds ratio 1,8; IC 1,52-2,14, p = 0,01). Las neoplasias sólidas o hematológicas, la inmunosupresión o las enfermedades crónicas no estuvieron relacionadas ni con la mortalidad ni con la presencia de severidad en la infección. CONCLUSIÓN: Las infecciones causadas por L. monocytogenes son infrecuentes, pero son causa de sepsis severa y mortalidad en poblaciones susceptibles. Nuestro estudio estuvo dirigido a la infección neuroinvasiva y otras formas graves. La forma neuroinvasiva fue el factor de riesgo más importante asociado a la infección severa, pero no a la mortalidad

Captura de carbono en biomasa de sistemas de uso del suelo, municipio de Yopal, Casanare, Colombia / Carbon capture regarding biomass from rural land use systems near the municipality of Yopal, Casanare, Colombia / Captura de carbono na biomassa de sistemas de uso da terra, município de Yopal, Casanare, Colômbia

Resumen El cambio climático, ocasionado por el incremento en la concentración de gases efecto invernadero (GEI), genera alteraciones en el clima del planeta, aumentando la temperatura media global, lo que afecta patrones de precipitación. El área de estudio se ubicó en el Municipio de Yopal, corregimiento Tacarimena, compuesta por ocho veredas, la cual presenta clima cálido - húmedo con promedio de precipitación anual de 2270 mm; temporada seca de diciembre-marzo y lluviosa de abril-noviembre y alturas inferiores a 380 m. En concordancia con la necesidad del desarrollo bajo en carbono, la presente investigación estima la biomasa arriba y abajo del suelo y con éstas el carbono total almacenado en siete sistemas de uso del suelo: 1) plátano con sombrío (SAF+ plátano), 2) cacao con sombrío (Ca+S), 3) cítricos (C), 4) sistema silvopastoril bajo (SSPB), 5) sistema silvopastoril alto (SSPA), 6) bosques de galería (BG), y 7) mata de monte (MM). Se trabajó con diseño experimental completamente al azar con cinco repeticiones, para un total de 35 unidades experimentales. Se establecieron parcelas temporales de muestreo, tomando datos en 832 árboles de 66 especies botánicas. Se estimó la biomasa arriba del suelo mediante modelos alometricos, utilizando datos de campo (diámetro a la altura del pecho dap y la altura total). La biomasa abajo del suelo (raíces) se estimó empleando el modelo general para bosques tropicales. Todos los usos del suelo en estudio ofrecen el servicio ecosistémico de captura de carbono, siendo el BG y la MM los de mayor carbono, mientras que el SAF+plátano almacenó la menor cantidad de carbono. Potenciales cambios de sistemas productivos a sistemas forestales (BG y MM) implican una ganancia de carbono (adicionalidad), mientras que los cambios contrarios, es decir deforestación, representan emisiones de CO2. Estos resultados son claves para la orientación a políticas y proyectos de captura de carbono.

Abstract Climate change caused by increased greenhouse gas (GHG) concentration causes alterations in the planet's climate and increases the average global temperature, thereby affecting rainfall patterns. This study's target area was the town of Tacarimena in the municipality of Yopal; it has eight rural areas. The area is located around 380 masl and has a warm, humid climate, a mean annual rainfall of 2,270 mm, a dry season between December and March and a rainy season from April to November. This research has estimated seven land-use systems' above- and below-ground biomass and total carbon storage in line with a low-carbon development policy: 1) plantain with shade (SAF + plantain), 2) cocoa with shade (Ca + S), 3) citrus (C), 4) low-lying silvopastoral system (LSS), 5) high-lying silvopastoral system (HSS), 6) gallery forest (GF) and 7) bush (B). A completely randomised experimental design with five repetitions was used, giving 35 experimental units. Temporary sampling plots were established for taking information regarding 832 trees from 66 botanical species. Allometric models were used for estimating above-ground biomass using field data/measurements (diameter at breast height (DBH) and total height (TH). A general tropical forest model was used for estimating below-ground biomass. All the land-use systems being studied had the essential ecosystem service of carbon capture/CO2 sequestration where GF and B had the highest carbon storage; on the contrary, SAF + plantain stored the lowest amount of carbon. Changing from production to forestry systems (GF and B) implies increased carbon capture (additionality), whereas the opposite (i.e. deforestation) represents CO2 emission. Such results represent a key input for policy design and carbon capture projects.

Resumo A mudança climática, causada pelo aumento da concentração de gases de efeito estufa (GEEs), gera alterações no clima do planeta e um aumento na temperatura média global, afetando os padrões de precipitação. A área de estudo foi localizada no município de Yopal, distrito Tacarimena, composto por oito vilarejos, que tem um clima quente - úmido com precipitação anual média de 2.270 mm, além de uma estação seca de dezembro a março e uma estação chuvosa entre abril e novembro. De acordo com a necessidade de desenvolvimento baixo em carbono, esta pesquisa estima a biomassa acima e abaixo do solo e com eles o total de carbono armazenado em sete sistemas de uso da terra: 1) banana com sombra (SAF + banana), 2) cacau sombreado (Ca + S), 3) cítricos (C), 4) sistema silvopastoril baixo (SSPB), 5) sistema silvopastoril alto (SSPA), 6) floresta riparia (BG), e 7) fragmento de floresta (MM). Desenvolveu-se um desenho experimental inteiramente casualizado com cinco repetições, totalizando 35 unidades experimentais. Parcelas temporárias de amostragem foram estabelecidas, tomando dados de 832 árvores de 66 espécies botânicas. A biomassa acima do solo foi estimada com modelos alométricos, inserindo os dados de campo: diâmetro à altura do peito (dap) e a altura total. A biomassa abaixo do solo foi estimada usando um modelo geral para florestas tropicais. Todos os usos da terra em estudo oferecem o serviço ecossistêmico de captura de carbono, sendo BG e MM os que apresentam o maior carbono, enquanto que SAF + banana armazenou a menor quantidade de carbono. Mudanças potenciais de sistemas de produção para sistemas florestais (BG e MM) implicam em ganho de carbono (adicionalidade), entanto que as mudanças opostas, como o desmatamento, representam emissões de CO2. Esses resultados são chaves para orientar políticas e projetos de captura de carbono.

Listeria monocytogenes infections: Analysis of 41 patients.

OBJECTIVE: We describe and analyze Listeria-related demographics and clinical features to determine the predisposing conditions for severe infections. METHODS: We performed a retrospective study using positive isolation of Listeria monocytogenes from blood, cerebrospinal fluid, and other organic fluids. Electronic health records were used to determine the epidemiological and clinical features of infections caused by L. monocytogenes. Mortality and sepsis were considered dependent variables in the statistical analyses. RESULTS: We included 41 patients in an observation period of 15 years (2003-2018), with an annual incidence rate of 1.3 cases per 100,000 population. Three main population profiles were identified: newborns, pregnant women, and other adults (17.1%, 12.2%, and 82.9%, respectively). Neuroinvasive infection was present in 17 patients (41.5%). In both univariate and multivariate analyses, neurological infections, whether meningoencephalitis, rhombencephalitis, or brain abscesses, were the main risk factors for severe forms of Listeria-related infections (odds ratio 1.8, 95% CI 1.52-2.14, p=0.01). Malignancies, whether solid tumors or hematological neoplasms, immunosuppression, and chronic diseases were not related to either mortality or severe clinical syndromes. CONCLUSION: Infections caused by L. monocytogenes were uncommon but could cause severe sepsis and mortality, especially in susceptible populations. Our study focused on neurological involvement and severe invasive forms of listeriosis. Neuroinvasive forms were the most important risk factors for severe illness but not for mortality.

[Vibrio cholerae NO-O1/NO-O139 bacteremia in a cirrhotic patient. First case report in Peru and literatura review]. / Bacteremia por Vibrio cholerae NO-O1/NO-O139 en un paciente cirrótico. Primer reporte de caso en el Perú y revisión de la literatura.

Non-O1, non-O139 Vibrio cholerae (NOVC) strains are an uncommon cause of gastroenteritis. However, they have been recently associated with severe extraintestinal infections in immunocompromised hosts. Among them, bacteremia in cirrhotic patients is noteworthy. We present the case of a 58-year-old woman with cirrhosis that developed septic shock, multiple organ failure and died four days after admission. Blood cultures yielded Gram-negative rods identified as Vibrio cholerae. Further serogrouping by slide agglutination and a negative PCR for ctxA gen confirmed the strain to be NOVC. Antimicrobial susceptibility testing showed sensitivity to ampicillin, chloramphenicol, tetracycline and ciprofloxacin; and resistance to trimethoprim-sulfamethoxazole. To the best of our knowledge, this is first report in Peru, described in the Hospital Nacional Dos de Mayo, of NOVC bacteremia.

Bacteremia por Vibrio cholerae NO-O1/NO-O139 en un paciente cirrótico: Primer reporte de caso en el Perú y revisión de la literatura / Vibrio cholerae NO-O1/NO-O139 bacteremia in a cirrhotic patient: First case report in Peru and literatura review

Vibrio cholerae serogrupo NO-O1/NO-O139 (VCNO) es causa infrecuente de gastroenteritis. Sin embargo, se le asocia a infección extra-intestinal severa en huéspedes inmunocomprometidos, y entre ellas, la bacteremia en pacientes con cirrosis hepática es digna de mención. A continuación, presentamos el caso de una mujer de 58 años, con el diagnóstico de cirrosis hepática de fondo, que desarrolló progresivamente choque séptico, disfunción orgánica múltiple y desenlace fatal al cuarto día de su admisión. Los resultados obtenidos post mortem, de los hemocultivos previamente tomados, aislaron bacilos gram negativos compatibles con Vibrio cholerae. Posteriormente, se identificó el serogrupo NO-O1/NO-O139, a través de aglutinación en placa y PCR negativo para el gen ctxA. El antibiograma mostró susceptibilidad conservada a ampicilina, cloranfenicol, tetraciclina y ciprofloxacino, con resistencia al trimetoprim-sulfametoxazol. El presente caso, descrito en el Hospital Nacional Dos de Mayo, es hasta la fecha, el primer reporte de bacteremia VCNO en el Perú.

Non-O1, non-O139 Vibrio cholerae (NOVC) strains are an uncommon cause of gastroenteritis. However, they have been recently associated with severe extraintestinal infections in immunocompromised hosts. Among them, bacteremia in cirrhotic patients is noteworthy. We present the case of a 58-year-old woman with cirrhosis that developed septic shock, multiple organ failure and died four days after admission. Blood cultures yielded Gram-negative rods identified as Vibrio cholerae. Further serogrouping by slide agglutination and a negative PCR for ctxA gen confirmed the strain to be NOVC. Antimicrobial susceptibility testing showed sensitivity to ampicillin, chloramphenicol, tetracycline and ciprofloxacin; and resistance to trimethoprim-sulfamethoxazole. To the best of our knowledge, this is first report in Peru, described in the Hospital Nacional Dos de Mayo, of NOVC bacteremia.

Is Microarray Analysis Really Useful and Sufficient to Diagnose Nut Allergy in the Mediterranean Area?

BACKGROUND: Component-based diagnosis on multiplex platforms is widely used in food allergy but its clinical performance has not been evaluated in nut allergy. OBJECTIVE: To assess the diagnostic performance of a commercial protein microarray in the determination of specific IgE (sIgE) in peanut, hazelnut, and walnut allergy. METHODS: sIgE was measured in 36 peanut-allergic, 36 hazelnut-allergic, and 44 walnut-allergic patients by ISAC 112, and subsequently, sIgE against available components was determined by ImmunoCAP in patients with negative ISAC results. ImmunoCAP was also used to measure sIgE to Ara h 9, Cora 8, and Jug r 3 in a subgroup of lipid transfer protein (LTP)-sensitized nut-allergic patients (positive skin prick test to LTP-enriched extract). sIgE levels by ImmunoCAP were compared with ISAC ranges. RESULTS: Most peanut-, hazelnut-, and walnut-allergic patients were sensitized to the corresponding nut LTP (Ara h 9, 66.7%; Cor a 8, 80.5%; Jug r 3, 84% respectively). However, ISAC did not detect sIgE in 33.3% of peanut-allergic patients, 13.9% of hazelnut-allergic patients, or 13.6% of walnut-allergic patients. sIgE determination by ImmunoCAP detected sensitization to Ara h 9, Cor a 8, and Jug r 3 in, respectively, 61.5% of peanut-allergic patients, 60% of hazelnut-allergic patients, and 88.3% of walnut-allergic patients with negative ISAC results. In the subgroup of peach LTP-sensitized patients, Ara h 9 sIgE was detected in more cases by ImmunoCAP than by ISAC (94.4% vs 72.2%, P < .05). Similar rates of Cora 8 and Jug r 3 sensitization were detected by both techniques. CONCLUSIONS: The diagnostic performance of ISAC was adequate for hazelnut and walnut allergy but not for peanut allergy. sIgE sensitivity against Ara h 9 in ISAC needs to be improved.

Is microarray analysis really useful and sufficient to diagnose nut allergy in the mediterranean area?

Background: Component-based diagnosis on multiplex platforms is widely used in food allergy but its clinical performance has not been evaluated in nut allergy. Objective: To assess the diagnostic performance of a commercial protein microarray in the determination of specific IgE (sIgE) in peanut, hazelnut, and walnut allergy. Methods: sIgE was measured in 36 peanut-allergic, 36 hazelnut-allergic, and 44 walnut-allergic patients by ISAC 112, and subsequently, sIgE against available components was determined by ImmunoCAP in patients with negative ISAC results. ImmunoCAP was also used to measure sIgE to Ara h 9, Cor a 8, and Jug r 3 in a subgroup of lipid transfer protein (LTP)-sensitized nut-allergic patients (positive skin prick test to LTP-enriched extract). sIgE levels by ImmunoCAP were compared with ISAC ranges. Results: Most peanut-, hazelnut-, and walnut-allergic patients were sensitized to the corresponding nut LTP (Ara h 9, 66.7%; Cor a 8, 80.5%; Jug r 3, 84% respectively). However, ISAC did not detect sIgE in 33.3% of peanut-allergic patients, 13.9% of hazelnut-allergic patients, or 13.6% of walnut-allergic patients. sIgE determination by ImmunoCAP detected sensitization to Ara h 9, Cor a 8, and Jug r 3 in, respectively, 61.5% of peanut-allergic patients, 60% of hazelnut-allergic patients, and 88.3% of walnut-allergic patients with negative ISAC results. In the subgroup of peach LTP-sensitized patients, Ara h 9 sIgE was detected in more cases by ImmunoCAP than by ISAC (94.4% vs 72.2%, P<.05). Similar rates of Cor a 8 and Jug r 3 sensitization were detected by both techniques. Conclusions: The diagnostic performance of ISAC was adequate for hazelnut and walnut allergy but not for peanut allergy. sIgE sensitivity against Ara h 9 in ISAC needs to be improved (AU)

Introducción: La utilidad clínica del diagnóstico por componentes no ha sido evaluada en el estudio de la alergia a frutos secos (FS). Objetivo: Evaluar la capacidad diagnóstica de una micromatriz comercial de proteínas alergénicas en la alergia a cacahuete, avellana y nuez. Métodos: Se determinó la sIgE en pacientes alérgicos a FS mediante la micromatriz ISAC 112, e ImmunoCAP en los pacientes con sIgE negativa frente a los componentes de ISAC. Además, se realizó ImmunoCAP frente a Ara h 9, Cor a 8 y Jug r 3 en un subgrupo de pacientes sensibilizados a LTP. La sIgE detectada por ImmunoCAP fue comparada con los rangos de ISAC. Resultados: La mayoría de los alérgicos a cacahuete (66,7%), avellana (80,5%) y nuez (84%) estaba sensibilizados a su LTP. Sin embargo, no se detectó sIgE frente a los componentes de ISAC en el 33,3% de alérgicos a cacahuete, 13,9% de alérgicos a avellana y 13,6% de los alérgicos a nuez. El ImmunoCAP permitió detectar sIgE a Ara h 9 en 61,5%, Cor a 8 en 60% y Jug r 3 en 83,3% de los ISAC negativo. En el subgrupo LTP, ImmunoCAP (94,4%) fue superior a ISAC (72,2%) en la detección de sIgE a Ara h 9 (p<0,05). La sIgE frente a Cor a 8 y Jug r 3 fue detectada de forma similar por ambas técnicas. Conclusiones: La micromatriz ISAC es adecuada para el diagnóstico de alergia a avellana y nuez. La sensibilidad del componente Ara h 9 de ISAC debe ser mejorada (AU)

Detailed characterization of Act d 12 and Act d 13 from kiwi seeds: implication in IgE cross-reactivity with peanut and tree nuts.

BACKGROUND: Act d 12 (11S globulin) and Act d 13 (2S albumin) are two novel relevant allergens from kiwi seeds that might be useful to improve the diagnostic sensitivity and the management of kiwifruit-allergic patients. OBJECTIVE: To perform a comprehensive structural and immunological characterization of purified Act d 12 and Act d 13 from kiwi seeds. METHODS: Sera from 55 well-defined kiwifruit-allergic patients were used. Act d 12 and Act d 13 were purified by chromatographic procedures. Circular dichroism, mass spectrometry, concanavalin A detection, immunoblotting, enzyme-linked immunosorbent assays, basophil activation tests, and IgE-inhibition experiments were used. RESULTS: Act d 12 and Act d 13 were purified from kiwi seeds to homogeneity by combining size-exclusion, ion-exchange, and RP-HPLC chromatographies. Both purified allergens preserve the structural integrity and display typical features of their homologous counterparts from the 11S globulin and 2S albumin protein families, respectively. These allergens are released from kiwi seeds after oral and gastric digestion of whole kiwifruit, demonstrating their bioavailability after ingestion. The allergens retain the capacity to bind serum IgE from kiwifruit-allergic patients, induce IgE cross-linking in effector-circulating basophils, and display in vitro IgE cross-reactivity with homologous counterparts from peanut and tree nuts. CONCLUSION: Purified Act d 12 and Act d 13 from kiwi seeds are well-defined molecules involved in in vitro IgE cross-reactivity with peanut and tree nuts. Their inclusion in component-resolved diagnosis of kiwifruit allergy might well contribute to improve the diagnostic sensitivity and the management of kiwifruit-allergic patients.

Application of the chiral acyl anion equivalent, trans-1,3-dithiane 1,3-dioxide, to an asymmetric synthesis of (R)-salbutamol.

An enantioselective synthesis of (R)-salbutamol has been carried out using the chiral, C2 symmetric acyl anion equivalent, (1R,3R)-1,3-dithiane 1,3-dioxide, which undergoes addition to an aromatic aldehyde with very high stereocontrol at 0 degrees C. Pummerer reaction and work-up with lithium ethanethiolate generated the alpha-hydroxy thiolester in high yield and further transformations led to the target compound with high enantiomeric excess.

Studies on the Asymmetric Oxidation of Ester Derivatives of 1,3-Dithiane-2-carboxylates. Asymmetric Synthesis of trans-1,3-Dithiane 1,3-Dioxide.

Asymmetric oxidation of a range of 1,3-dithianes was studied using the Kagan protocol [CHP (4 equiv), (+)-DET (2 equiv), Ti(OiPr)(4) (1 equiv), and H(2)O (1 equiv) at -35 degrees C for 48 h]. 1,3-Dithiane itself gave monoxide (30% ee) and the trans bis-sulfoxide (59% ee) but with low enantioselectivity. In contrast, ester derivatives (Me, Et, t-Bu, Ph) of 1,3-dithiane-2-carboxylates gave monoxides (80-95% ee) and trans bis-sulfoxides (>97% ee) in high enantioselectivity. Optimum conditions for the oxidation of ethyl 1,3-dithiane-2-carboxylate required the Modena protocol [CHP (4 equiv), (+)-DET (2 equiv), and Ti(OiPr)(4) (0.5 equiv) at -22 degrees C for 24 h], and this gave the trans bis-sulfoxide in 60% yield and high enantioselectivity. The bis-sulfoxides were found to be acid sensitive and required rapid workup and purification for optimum yields. The differences between the Modena and Kagan oxidants are discussed together with a discussion on the origin of the high enantio- and diastereoselectivity of the reaction. Finally, hydrolysis and decarboxylation furnished trans-1,3-dithiane 1,3-dioxide.

A new methodology to solve the problem of characterizing 2-D biomedical shapes.

In this paper, a new approach to solve the problem of characterizing 2-D biomedical shapes is introduced. Two-dimensional biomedical contours are described through a 'degrees of smoothing' vector in which each component determines the proper degree of detail for representing each curve part isolating a single structure. A segmentation process is designed based on a clustering procedure applied to vectors of texture measures which are obtained from the graph of curvatures. To solve the problem of characterizing biomedical shapes, a suitable interpolation procedure between the most outstanding perceptual points from the smoothed contours is given.

Detecting nematode features from digital images.

Procedures for estimating and calibrating nematode features from digitial images are described and evaluated by illustration and mathematical formulae. Technical problems, such as capturing and cleaning raw images, standardizing the grey level range of images, and the detection of characteristics of the body habitus, presence or absence of stylet knobs, and tail and lip region shape are discussed. This study is the first of a series aimed at developing a set of automated methods to permit more rapid, objective characterizations of nematode features than is achievable by cumbersome conventional methods.

Line detection and texture analysis for automatic nematode identification.

This paper is the second in a series studying procedures for estimating and calibrating features of nematodes from digital images. Two kinds of features were analyzed for recognition: those with a directional component and those with a textural component. Features that have a directional component (lateral field and annules) were preprocessed with classic algorithms and modified by directional filters. Features having texture (esophagus and intestine) were analyzed with vectors of measures to define them and the statistical technique CART (classification and regression trees) to explain the role that each measure plays in the identification and discrimination process.

Efectos secundarios de la vacuna contra difteria, tétanos y tosferina / Secundary effects of the vaccine for the diphteria, tetanus and pertussis

En un estudio prospectivo, se investigaron las reaccionessistémicas y locales posteriores a la inmunización con vacuna contra difteria, tétanos y tosferina (DTP). Se determinaron los efectos secundarios en 730 niños con edades comprendidas entre 1 mes y 6 años, quienes recibieron la dosis correspondiente de vacuna DTP (alguna de las tres primeras o refuerzos), en las 48 horas siguientes a la inmunización. Se encontró que el 13 por ciento de los niños vacunados, no presentó reacciones adversas. El 87 por ciento de los niños inmunizados presentó efectos adversos, siendo la incidencia: fiebre, 66,03 por ciento; malestar, 37,81 por ciento; disminución del apetito, 25,07 por ciento; trastornos del sueño, 20,41 por ciento;vómitos, 7,94 por ciento; llanto contínuo, 7,67 por ciento. En relación a efectos locales: dolor, 41,64 por ciento; enrojecimiento, 28,08 por ciento y nódulos subcutáneos, 20,14 por ciento. Ninguno de los niñospresentó comvulsiones, episodios hipotónicos o daño neurológico. Se colocaron dos tipos de vacuna DTP de manufactura diferente: la del Laboratorio Connaught (canadiense) y la del Instituto Nacional de Higiene (venezolana). No hubo diferencia significativa en la aparición de efectos secundarios entre ambas, excepto para el dolor local, el cual se presentó en forma significativamente mayor (p < 0,01) con la vacuna nacional, lo cual fue atribuído a diferencias en los componentes inertes de la vacuna ó a su procesamiento. Analizamos los efectos obtenidos en relación con la edad y número de dosis. Hubo aumento significativo de los vómitos a menor edad (p < 0,01), así como incremento significativo del dolor local y nódulos subcutáneos a mayor edad (p < 0,01). Se obtuvo aumento significativo del dolor local y nódulos subcutáneos a mayor número de dosis (p < 0,01). Comparamos nuestros resultados con los hallazgos internacionales. Recomendamos la inmunización rutinaria con vacuna DTP por considerar que los beneficios producidos superan ampliamente los riesgos atribuídos a ella