Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 89
Filtrar
1.
Ann Oncol ; 35(6): 559-568, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38142939

RESUMO

BACKGROUND: Osteosarcoma stratification relies on clinical parameters and histological response. We developed a new personalized stratification using less invasive circulating tumor DNA (ctDNA) quantification. PATIENTS AND METHODS: Plasma from patients homogeneously treated in the prospective protocol OS2006, at diagnosis, before surgery and end of treatment, were sequenced using low-passage whole-genome sequencing (lpWGS) for copy number alteration detection. We developed a prediction tool including ctDNA quantification and known clinical parameters to estimate patients' individual risk of event. RESULTS: ctDNA quantification at diagnosis (diagCPA) was evaluated for 183 patients of the protocol OS2006. diagCPA as a continuous variable was a major prognostic factor, independent of other clinical parameters, including metastatic status [diagCPA hazard ratio (HR) = 3.5, P = 0.002 and 3.51, P = 0.012, for progression-free survival (PFS) and overall survival (OS)]. At the time of surgery and until the end of treatment, diagCPA was also a major prognostic factor independent of histological response (diagCPA HR = 9.2, P < 0.001 and 11.6, P < 0.001, for PFS and OS). Therefore, the addition of diagCPA to metastatic status at diagnosis or poor histological response after surgery improved the prognostic stratification of patients with osteosarcoma. We developed the prediction tool PRONOS to generate individual risk estimations, showing great performance ctDNA quantification at the time of surgery and the end of treatment still required improvement to overcome the low sensitivity of lpWGS and to enable the follow-up of disease progression. CONCLUSIONS: The addition of ctDNA quantification to known risk factors improves the estimation of prognosis calculated by our prediction tool PRONOS. To confirm its value, an external validation in the Sarcoma 13 trial is underway.


Assuntos
Biomarcadores Tumorais , Neoplasias Ósseas , DNA Tumoral Circulante , Osteossarcoma , Humanos , Osteossarcoma/genética , Osteossarcoma/sangue , Osteossarcoma/patologia , Osteossarcoma/cirurgia , Osteossarcoma/mortalidade , Osteossarcoma/diagnóstico , DNA Tumoral Circulante/genética , DNA Tumoral Circulante/sangue , Masculino , Feminino , Neoplasias Ósseas/genética , Neoplasias Ósseas/patologia , Neoplasias Ósseas/sangue , Neoplasias Ósseas/cirurgia , Neoplasias Ósseas/mortalidade , Adulto , Adolescente , Prognóstico , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/sangue , Estudos Prospectivos , Adulto Jovem , Criança , Variações do Número de Cópias de DNA , Gradação de Tumores , Pessoa de Meia-Idade , Sequenciamento Completo do Genoma , Intervalo Livre de Progressão
2.
Rev. esp. cardiol. (Ed. impr.) ; 75(7): 595-603, jul. 2022. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-205129

RESUMO

Introducción y objetivos: El lactato y su evolución se asocian con el pronóstico de los pacientes en shock, si bien es escasa la evidencia en aquellos asistidos con oxigenador extracorpóreo de membrana venoarterial (ECMO-VA). Nuestro objetivo es evaluar su valor pronóstico en shock cardiogénico asistido con ECMO-VA. Métodos: Estudio de pacientes tratados con ECMO-VA por shock cardiogénico de indicación médica entre julio de 2013 y abril de 2021. Se calculó el aclaramiento de lactato: (lactato inicial − lactato 6 h) / lactato inicial × tiempo exacto entre ambas determinaciones. Resultados: De 121 pacientes, 44 (36,4%) tenían infarto agudo de miocardio; 42 (34,7%), implante intraparada; 14 (11,6%), tromboembolia pulmonar, 14 (11,6%), tormenta arrítmica y 6 (5,0%), miocarditis fulminante. A los 30 días habían fallecido 60 pacientes (49,6%); la mortalidad fue mayor con el implante intraparada que con el implante en circulación espontánea (30 [71,4%] de 42 frente a 30 [38,0%] de 79; p=0,030). Se asociaron de manera independiente con la mortalidad a 30 días la alanina aminotransferasa (ALT) antes del implante y el lactato (tanto basal como a las 6 h y el aclaramiento). Los modelos de regresión que incluían el lactato presentaron mejor capacidad predictiva de la supervivencia que las puntuaciones ENCOURAGE y ECMO-ACCEPTS, con mayor área bajo la curva ROC en el modelo con lactato a las 6 h.Conclusiones: El lactato (basal y a las 6 h y el aclaramiento) es un predictor independiente para el pronóstico de los pacientes en shock cardiogénico asistidos con ECMO-VA que facilita una mejor estratificación del riesgo y tiene una capacidad predictiva superior (AU)


Introduction and objectives: Lactate and its evolution are associated with the prognosis of patients in shock, although there is little evidence in those assisted with an extracorporeal venoarterial oxygenation membrane (VA-ECMO). Our objective was to evaluate its prognostic value in cardiogenic shock assisted with VA-ECMO. Methods: Study of patients with cardiogenic shock treated with VA-ECMO for medical indication between July 2013 and April 2021. Lactate clearance was calculated: [(initial lactate − 6 h lactate) / initial lactate × exact time between both determinations]. Results: From 121 patients, 44 had acute myocardial infarction (36.4%), 42 implant during cardiopulmonary resuscitation (34.7%), 14 pulmonary embolism (11.6%), 14 arrhythmic storm (11.6%), and 6 fulminant myocarditis (5.0%). After 30 days, 60 patients (49.6%) died, mortality was higher for implant during cardiopulmonary resuscitation than for implant in spontaneous circulation (30 of 42 [71.4%] vs 30 of 79 [38.0%], P=.030). Preimplantation GPT and lactate (both baseline, at 6hours, and clearance) were independently associated with 30-day mortality. The regression models that included lactate clearance had a better predictive capacity for survival than the ENCOURAGE and ECMO-ACCEPTS scores, with the area under the ROC curve being greater in the model with lactate at 6 h. Conclusions: Lactate (at baseline, 6h, and clearance) is an independent predictor of prognosis in patients in cardiogenic shock supported by VA-ECMO, allowing better risk stratification and predictive capacity (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Choque Cardiogênico/sangue , Choque Cardiogênico/terapia , Ácido Láctico/sangue , Estudos Retrospectivos , Prognóstico
3.
J Agric Food Chem ; 69(15): 4550-4560, 2021 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33823588

RESUMO

Coffee cupping includes both aroma and taste, and its evaluation considers several different attributes simultaneously to define flavor quality and therefore requires complementary data from aroma and taste. This study investigates the potential and limits of a data-driven approach to describe the sensory quality of coffee using complementary analytical techniques usually available in routine quality control laboratories. Coffee flavor chemical data from 155 samples were obtained by analyzing volatile (headspace-solid-phase microextraction-gas chromatography-mass spectrometry (HS-SPME-GC-MS)) and nonvolatile (liquid chromatography-ultraviolet/diode array detector (LC-UV/DAD)) fractions, as well as from sensory data. Chemometric tools were used to explore the data sets, select relevant features, predict sensory scores, and investigate the networks between features. A comparison of the Q model parameter and root-mean-squared error prediction (RMSEP) highlights the variable influence that the nonvolatile fraction has on prediction, showing that it has a higher impact on describing acid, bitter, and woody notes than on flowery and fruity. The data fusion emphasized the aroma contribution to driving sensory perceptions, although the correlative networks highlighted from the volatile and nonvolatile data deserve a thorough investigation to verify the potential of odor-taste integration.


Assuntos
Odorantes , Compostos Orgânicos Voláteis , Café , Cromatografia Gasosa-Espectrometria de Massas , Odorantes/análise , Microextração em Fase Sólida , Paladar , Compostos Orgânicos Voláteis/análise
4.
Heliyon ; 5(3): e01423, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30976695

RESUMO

Cloud forest is a sensitive and vulnerable ecosystem that is threatened by human activities as well as climate change. Previous studies have shown how transitional ecosystems such as cloud forests will be the most negatively impacted by the global increase in temperature. Therefore, the niche modeling framework was used in this study to geographically identify the areas with the climatic potential to host the largest number of key tree species in this ecosystem and to propose them as priority conservation areas. A total of 19 species were modeled using the MaxEnt algorithm; binary maps were generated for each species and combined to produce one potential suitability map and identify climatic priority areas. Thus, 7% of the national area of Mexico shows suitability for the cloud forest ecosystem, although it is currently distributed in less than 1% of the country. Finally, potential suitability areas were compared with natural protected areas, current land use and priority conservation areas. We found that of the current suitable area, only 5% coincides with some federal or state protection regime. Natural protected areas have proven to be a mechanism for forest conservation, so we must consider increasing the number and area of those protected areas that favor the conservation of these key cloud forest species.

5.
Pediatr Blood Cancer ; 64(12)2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28696051

RESUMO

High-dose etoposide phosphate, a water-soluble prodrug of etoposide, may be used after total body irradiation (TBI) in pediatric allogeneic bone marrow transplantation for lymphoblastic leukemia. In a retrospective study of 21 children treated at the Nancy University Hospital (2000-2014), we identified unprecedentedly an unexpectedly high incidence (57%) of acute renal injury following etoposide phosphate infusion. Patients who developed renal function impairment experienced more severe mucositis but had outcomes similar to those who did not. No risk factors were identified. We speculate that the etoposide phosphate diluent, dextran 40, may have been the causative agent in these post-TBI renal toxicity cases.


Assuntos
Injúria Renal Aguda/induzido quimicamente , Antineoplásicos/efeitos adversos , Etoposídeo/análogos & derivados , Transplante de Células-Tronco Hematopoéticas , Compostos Organofosforados/efeitos adversos , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Irradiação Corporal Total , Adolescente , Criança , Pré-Escolar , Etoposídeo/efeitos adversos , Feminino , Humanos , Masculino , Estudos Retrospectivos
6.
Sci Total Environ ; 598: 657-668, 2017 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-28454038

RESUMO

Electromagnetic radiowave exposure is a major concern in most countries due to possible adverse health effects. Over the last 10years, many technological changes (digital television, mobile technologies, wireless networks…) have led to variations in the electromagnetic field (EMF) levels. A large number of studies devoted to the analysis of EMF levels with personal dosimeters or computer models of the exposure of mobile stations have been conducted. However, the study of the exposure values, taking into account all the existing sources, and their evolution in a wide area, using measurements, has rarely been performed. In this paper, we provide a comparison of the EMF exposure levels for the city of Alcalá de Henares (Spain) over a ten-year period using a broadband isotropic probe in the range from 100kHz to 3GHz. A statistical and spatial analysis of the measurements and their variations are also presented for the study of the global and local variations. The measured values in the period from 2006 to 2015 were ranging from 0.02 to 2.05V/m. Our global results show a moderate increase from 2006 to 2010 and they are almost invariant from 2010 to 2015. Although the whole dataset does not have relevant statistical difference, we have found marked local differences. In the city areas where the population density has remained unaltered, we have measured lower exposure levels. Conversely, new urban and industrial developments have demanded new resources, which have potentially contributed to the observed increase in the measured electric field levels within these areas.


Assuntos
Campos Eletromagnéticos , Exposição Ambiental/análise , Ondas de Rádio , Cidades , Humanos , Espanha
8.
Phytomedicine ; 21(6): 866-70, 2014 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-24581747

RESUMO

BACKGROUND: The low efficacy of cancer therapy for the treatment of patients with advanced disease makes the development of new anticancer agents necessary. Because natural products are a significant source of anticancer drugs, it is important to explore cytotoxic activity of novel compounds from natural origin. PURPOSE: The aim of this work is to evaluate the cytotoxic capacity of hirsutanone, a diarylheptanoid isolated from Alnus glutinosa leaves. Hirsutanone cytotoxic way of action was also studied. MATERIAL AND METHODS: The cytotoxic ability of Alnus glutinosa leaves ethyl acetate extract was studied over HeLa and PC-3 cell lines, with the MTT colorimetric assay. Hirsutanone was isolated from this extract using chromatographic methods, and its structure elucidated by spectroscopic analysis. HT-29 cell viability after hirsutanone treatment was determined using SRB assay. In order to understand hirsutanone way of action, cytotoxicity was evaluated adding the diarylheptanoid and antioxidants. DNA topoisomerase II (topo II) poison activity, was also evaluated using purified topo II and a supercoiled form of DNA that bears specific topo II recognition and binding region; topo II poisons stabilize normally transient DNA-topo II cleavage complexes, and lead an increased yield of linear form as a consequence of a lack of double-strand breaks rejoining. RESULTS: The diarylheptanoid hirsutanone was isolated from Alnus glutinosa (L.) Gaertn. (Betulaceae) leaves extract that showed cytotoxic activity against PC-3 and HeLa cell lines. Hirsutanone showed cytotoxic activity against HT-29 human colon carcinoma cells. Pre-treatment with the antioxidants NAC (N-acetylcysteine) and MnTMPyP (Mn(III)tetrakis-(1-methyl-4-pyridyl)porthyrin) reduced this activity, suggesting that reactive oxygen species (ROS) participate in hirsutanone-induced cancer cell death. Using human topo II and a DNA supercoiled form, hirsutanone was found to stabilize topo II-DNA cleavage complexes, acting as a topo II poison. CONCLUSION: Our data suggest that, like curcumin, an induction of oxidative stress and topo II-mediated DNA damage may play a role in hirsutanone-induced cancer cell death. Since both compounds share similar structure and cytotoxic profile, and curcumin is in clinical trials for the treatment of cancer, our results warrant further studies to evaluate the anticancer potential of hirsutanone.


Assuntos
Adenocarcinoma/tratamento farmacológico , Alnus/química , Antineoplásicos Fitogênicos/uso terapêutico , Neoplasias do Colo/tratamento farmacológico , Diarileptanoides/uso terapêutico , Fitoterapia , Extratos Vegetais/uso terapêutico , Antineoplásicos Fitogênicos/isolamento & purificação , Antineoplásicos Fitogênicos/farmacologia , Morte Celular , Neoplasias do Colo/metabolismo , DNA/efeitos dos fármacos , DNA Topoisomerases Tipo II/metabolismo , Diarileptanoides/isolamento & purificação , Diarileptanoides/farmacologia , Células HT29 , Humanos , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Folhas de Planta , Espécies Reativas de Oxigênio/metabolismo
9.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 58(1): 44-51, ene.-feb. 2014. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-118590

RESUMO

Objetivo. Estudiar los resultados del tratamiento de la seudoartrosis de escafoides, con dudosa viabilidad del fragmento proximal, pero sin deformidad ni colapso importante del mismo, mediante la utilización de un injerto óseo vascularizado de la arteria suprarretinacular 1,2 intercompartimental (1,2 ICSRA) y osteosíntesis posterior. Material y método. Estudio retrospectivo de 10 pacientes varones con diagnóstico radiográfico de seudoartrosis. Después del tratamiento se evaluó la funcionalidad, el dolor medido por la escala analógica visual (EVA), la fuerza de agarre, la satisfacción del paciente y la reintroducción a la vida laboral, utilizando las escalas de Mayo y QuickDASH específicas de muñeca y comprobándose radiográficamente la integración del injerto. Resultados. El seguimiento medio fue de 31,4 meses; un 90% de las encuestas fueron satisfactorias. La EVA descendió en 4,6 puntos y la ganancia de movilidad flexo-extensora fue de 5°. La tasa de consolidación completa del injerto alcanzó el 40% en 5,5 meses de media. Discusión. Diferentes estudios han demostrado mejores resultados utilizando injerto óseo vascularizado frente al no vascularizado. Desde la descripción por Zaidemberg en 1991, el injerto microvascularizado con arteria 1,2 ICSRA, de radio distal, ha sido el más utilizado para el tratamiento de seudoartrosis del escafoides. Conclusiones. Nuestros resultados, comparables con la bibliografía revisada, utilizando el injerto vascularizado de arteria 1,2 ICSRA y osteosíntesis con tornillo tipo Herbert, pueden ser una alternativa de tratamiento para la seudoartrosis proximal de escafoides, sin colapso ni deformidad importante (AU)


Objective. To analyze the results of treatment of scaphoid nonunion with questionable viability of the proximal fragment, but without significant deformity or collapse, using a vascularized bone graft of 1,2 intercompartmental supraretinacular artery (1.2 ICSRA) and subsequent osteosynthesis. Material and method. A retrospective study was performed on 10 male patients with a radiographic diagnosis of nonunion. Functionality, pain using Visual Analog Score (VAS), grip strength, patient satisfaction and reintroduction to working life, using QuickDASH and May specific wrist scales were assessed after the treatment. The integration of the graft was checked by radiography. Results. The mean follow-up was 31.4 months, and 90% of the questionnaires were satisfactory. The VAS decreased by 4.6 points and the flexor-extensor mobility gain was 5°. The total graft consolidation rate reached 40% in 5.5 months on average. Discussion. Several studies have demonstrated better results using vascularized bone graft versus non-vascularized. From the description by Zaidemberg in 1991, the vascularized graft with 1.2 ICSRA artery, distal radius, has been the most widely used for the treatment of scaphoid nonunion. Conclusions. Our results are comparable with the literature reviewed, thus using vascular graft of the 1.2 ICSRA and osteosynthesis with Herbert-type screw, may be an alternative treatment for proximal scaphoid nonunion, without collapse or significant deformity (AU)


Assuntos
Humanos , Masculino , Feminino , Pseudoartrose/complicações , Pseudoartrose/diagnóstico , Pseudoartrose/terapia , Fixação Interna de Fraturas/métodos , Fixação Interna de Fraturas , Fixação Intramedular de Fraturas/métodos , Avaliação de Resultado de Intervenções Terapêuticas/métodos , Osso Escafoide/patologia , Osso Escafoide , Microvasos/fisiologia , Transplante Ósseo/métodos , Transplante Ósseo , Estudos Retrospectivos , Avaliação de Processos e Resultados em Cuidados de Saúde/normas , Avaliação de Processos e Resultados em Cuidados de Saúde
10.
Rev Esp Cir Ortop Traumatol ; 58(1): 44-51, 2014.
Artigo em Espanhol | MEDLINE | ID: mdl-24331741

RESUMO

OBJECTIVE: To analyze the results of treatment of scaphoid nonunion with questionable viability of the proximal fragment, but without significant deformity or collapse, using a vascularized bone graft of 1,2 intercompartmental supraretinacular artery (1.2 ICSRA) and subsequent osteosynthesis. MATERIAL AND METHOD: A retrospective study was performed on 10 male patients with a radiographic diagnosis of nonunion. Functionality, pain using Visual Analog Score (VAS), grip strength, patient satisfaction and reintroduction to working life, using QuickDASH and May specific wrist scales were assessed after the treatment. The integration of the graft was checked by radiography. RESULTS: The mean follow-up was 31.4 months, and 90% of the questionnaires were satisfactory. The VAS decreased by 4.6 points and the flexor-extensor mobility gain was 5°. The total graft consolidation rate reached 40% in 5.5 months on average. DISCUSSION: Several studies have demonstrated better results using vascularized bone graft versus non-vascularized. From the description by Zaidemberg in 1991, the vascularized graft with 1.2 ICSRA artery, distal radius, has been the most widely used for the treatment of scaphoid nonunion. CONCLUSIONS: Our results are comparable with the literature reviewed, thus using vascular graft of the 1.2 ICSRA and osteosynthesis with Herbert-type screw, may be an alternative treatment for proximal scaphoid nonunion, without collapse or significant deformity.


Assuntos
Transplante Ósseo , Fixação Interna de Fraturas , Fraturas não Consolidadas/cirurgia , Osso Escafoide/lesões , Osso Escafoide/cirurgia , Artérias/cirurgia , Transplante Ósseo/métodos , Humanos , Masculino , Estudos Retrospectivos , Adulto Jovem
11.
J R Stat Soc Ser A Stat Soc ; 176(1): 227-249, 2013 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-24159255

RESUMO

Interviewer observations made during the process of data collection are currently used to inform responsive design decisions, to expand the set of covariates for nonresponse adjustments, to explain participation in surveys, and to assess nonresponse bias. However, little effort has been made to assess the quality of such interviewer observations. Using data from the Los Angeles Family and Neighbourhood Survey (L.A.FANS), this paper examines measurement error properties of interviewer observations of neighbourhood characteristics. Block level and interviewer covariates are used in multilevel models to explain interviewer variation in the observations of neighbourhood features.

12.
Oncol Lett ; 4(3): 461-466, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22970044

RESUMO

Acute myeloid leukaemia results from the neoplastic transformation of haematopoietic stem cells. Although advances have been made in its treatment, the mortality rate remains high. As a result, therapeutic alternatives continue to be explored. In this study, we present evidence that suggests that casein, the principal protein in milk, possesses significant antileukaemic properties. We investigated whether casein inhibited the in vitro proliferation and induced the apoptosis of the mouse myelomonocytic leukaemia cell line WEHI-3. By contrast, under identical conditions, casein markedly promotes the proliferation of mouse normal mononuclear bone marrow cells. Since the selective elimination of leukaemia cells is an ideal therapeutic strategy, we also evaluated the antileukaemic potential of casein in vivo. The results showed that casein increases the survival of mice bearing WEHI-3-induced tumours, suggesting that this molecule is also capable of inhibiting the proliferation of these cells in vivo. The evidence that casein inhibited cell proliferation and induced apoptosis in leukaemia cells in vitro, but increased survival in vivo in a leukaemia mouse model, indicates that casein may be useful in leukaemia therapy.

13.
Comput Methods Programs Biomed ; 108(1): 377-87, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22465639

RESUMO

The multifocal electroretinography technique consists of performing sectorized light excitation of the retina and capturing the resulting evoked potential. This provides functional localized information about the state of the retinal neurons. Analysis of multifocal electroretinography signals can be used for diagnosing different types of optic neuropathies (glaucomatous, demyelinating and ischemic ethiology). In order to obtain a reliable diagnosis, it is necessary to apply advanced processing algorithms (morphological, frequency and time-frequency analysis, etc.) to the multifocal electroretinography signal. This paper presents a software application developed in MATLAB(®) (MathWorks Inc., MA) designed to perform advanced multifocal electroretinography signal analysis and classification. This intuitive application, mfERG_LAB, is used to plot the signals, apply various algorithms to them and present the data in an appropriate format. The application's computational power and modular structure make it suitable for use in clinical settings as a powerful and innovative diagnostic tool, as well as in research and teaching settings as a means of assessing new algorithms.


Assuntos
Eletrorretinografia , Oftalmopatias/patologia , Diagnóstico Diferencial , Oftalmopatias/metabolismo , Humanos
14.
An. pediatr. (2003, Ed. impr.) ; 75(6): 401-408, dic. 2011. tab
Artigo em Espanhol | IBECS | ID: ibc-92371

RESUMO

Introducción: La pancreatitis es una rara complicación en la evolución de pacientes con fibrosis quística (FQ). Puede presentarse en forma de episodios agudos, aislados o repetidos, o evolucionar a cronicidad con progresiva destrucción de la glándula. El objetivo de este estudio fue describir las características de una cohorte de pacientes que habían padecido pancreatitis, conocer su frecuencia e intentar encontrar posibles factores de riesgo asociados. Metodología: Estudio retrospectivo descriptivo de pacientes controlados en unidades de FQ de cinco hospitales españoles que habían padecido pancreatitis. Se recogieron datos demográficos, clínicos y analíticos, y relativos al estado pancreático y el genotipo. Resultados: De 520 pacientes, 17 presentaron pancreatitis. Una prevalencia del 3,3%, superior a la descrita en la literatura. Analizando el estado pancreático, se observó que 8 de ellos eran insuficientes pancreáticos (47,06%), hecho que contrasta, en parte, con lo referido clásicamente al considerar esta complicación más típica de pacientes con cierto grado de reserva pancreática. No se encontraron factores de riesgo ni asociaciones significativas con la genética, edad, sexo u otras características. Conclusiones: En nuestra serie, la prevalencia de pancreatitis es superior a la descrita en la literatura, no tratándose de una complicación exclusiva de suficientes pancreáticos. Se produce más frecuentemente durante la adolescencia o en el inicio de la edad adulta. La enfermedad pulmonar es leve en la mayoría. La genética es variable, sin poder establecerse una clara relación genotipo-fenotipo. Se debe observar a largo plazo la evolución de esta patología intercurrente y diseñar estudios más amplios para obtener resultados más significativos (AU)


Introduction: Pancreatitis is an uncommon complication of cystic fibrosis (CF). Either single or recurrent acute episodes can occur and it occasionally may follow a protracted course with relentless destruction of the pancreas. Moreover mild mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) have been found in many cases of idiopathic chronic pancreatitis. We describe a group of patients with CF who had one or more episodes of pancreatitis. We have estimated its prevalence in a large population of patients with CF across Spain. Methods: A retrospective descriptive study was conducted by collecting the demographic, clinical and laboratory data, pancreatic status and genotype of CF patients who attended the CF Units in 5 Spanish hospitals. Results: The overall number of CF patients under follow-up in the five centres was 520, of which 17 cases with pancreatitis were identified. The prevalence of pancreatitis in this population was 3.3%, higher than previously reported. Noticeably eight of the 17 patients (47.06%) had pancreatic insufficiency. This appears to be, partly, in contrast with that classically found, as this complication is usually associated with patients with a certain level of pancreatic reserve. No associations with genotype, age, gender or other factors were found. Conclusions: The prevalence of pancreatitis in our CF patients was higher than that found in other CF populations, and was not limited to patients with pancreatic sufficiency. It occurred mostly in teenagers and young adults often with mild pulmonary disease. The CF genotype was variable. The course of the patients should be carefully monitored, and further information on the long-term outcome of larger cohorts of patients is needed (AU)


Assuntos
Humanos , Genótipo , Pancreatite/etiologia , Fibrose Cística/complicações , Estudos Retrospectivos , Fatores de Risco , Regulador de Condutância Transmembrana em Fibrose Cística/análise
15.
An Pediatr (Barc) ; 75(6): 401-8, 2011 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-21820373

RESUMO

INTRODUCTION: Pancreatitis is an uncommon complication of cystic fibrosis (CF). Either single or recurrent acute episodes can occur and it occasionally may follow a protracted course with relentless destruction of the pancreas. Moreover mild mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) have been found in many cases of idiopathic chronic pancreatitis. We describe a group of patients with CF who had one or more episodes of pancreatitis. We have estimated its prevalence in a large population of patients with CF across Spain. METHODS: A retrospective descriptive study was conducted by collecting the demographic, clinical and laboratory data, pancreatic status and genotype of CF patients who attended the CF Units in 5 Spanish hospitals. RESULTS: The overall number of CF patients under follow-up in the five centres was 520, of which 17 cases with pancreatitis were identified. The prevalence of pancreatitis in this population was 3.3%, higher than previously reported. Noticeably eight of the 17 patients (47.06%) had pancreatic insufficiency. This appears to be, partly, in contrast with that classically found, as this complication is usually associated with patients with a certain level of pancreatic reserve. No associations with genotype, age, gender or other factors were found. CONCLUSIONS: The prevalence of pancreatitis in our CF patients was higher than that found in other CF populations, and was not limited to patients with pancreatic sufficiency. It occurred mostly in teenagers and young adults often with mild pulmonary disease. The CF genotype was variable. The course of the patients should be carefully monitored, and further information on the long-term outcome of larger cohorts of patients is needed.


Assuntos
Fibrose Cística/complicações , Fibrose Cística/genética , Pancreatite/etiologia , Pancreatite/genética , Adolescente , Adulto , Criança , Pré-Escolar , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Feminino , Genótipo , Humanos , Masculino , Mutação , Estudos Retrospectivos , Adulto Jovem
16.
J Chromatogr A ; 1217(16): 2599-605, 2010 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-20074740

RESUMO

This study describes a method based on direct contact sorptive tape extraction followed by on-line thermal desorption gas chromatography-mass spectrometry (DC-STE-GC-MS) to detect and quantify a group of suspected volatile allergens on the European Union (E.U.) list and a related compound on the skin (the stratum corneum) of volunteers treated with a cream of known composition fortified with the reference allergens. The following compounds were tested: citronellol, Z-citral (neral), geraniol, cinnamaldehyde, anisyl alcohol, cinnamyl alcohol, eugenol, methyleugenol, coumarin, isoeugenol, alpha-isomethylionone, 2-(4-tert-butylbenzyl)propionaldehyde (lilial), alpha-amylcinnamaldehyde, alpha-hexylcinnamaldehyde. Sorptive tape extraction (STE) is a sorption-based sampling technique in which a flexible polydimethylsiloxane (PDMS) tape is used to recover analytes by direct contact with the surface of a solid matrix or from the headspace in equilibrium with it. The reliability of the method was confirmed by: (i) allergen recoveries varying from 52.3% for lilial to 95.7% for neral, (ii) linearity in the range 10-150ppm, with regression coefficient R(2) always above 0.97, (iii) repeatability of each analyte, RSD% never exceeding 10%, (iv) intermediate precision, always below 15%, and (v) LOD and LOQ in the ppb range, therefore fully compatible with E.U. prescriptions (ppm). Other parameters such as substantivity analyte, approximate permeation through skin and influence of different nature of stratum corneum on recovery were also investigated. The method was also successfully applied to five commercially available creams declared to contain some of the allergens in question spread on the skin of the same volunteers.


Assuntos
Alérgenos/análise , Cosméticos/química , Cromatografia Gasosa-Espectrometria de Massas/métodos , Pele/química , Compostos Orgânicos Voláteis/análise , Calibragem , Dimetilpolisiloxanos/química , Humanos , Modelos Lineares , Permeabilidade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Pele/metabolismo , Absorção Cutânea
18.
Sci Total Environ ; 407(6): 1842-51, 2009 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-19101021

RESUMO

Endocrine disrupting chemicals (EDCs) have become a major issue in the field of environmental science due to their ability to interfere with the endocrine system. Recent studies show that surface water is contaminated with EDCs, many released from wastewater treatment plants (WWTP). This pilot study used biological (E-screen assay) and chemical (stir bar sorptive extraction-GC-MS) analyses to quantify estrogenic activity in effluent water samples from a municipal WWTP and in water samples of the recipient river, upstream and downstream of the plant. The E-screen assay was performed on samples after solid phase extraction (SPE) to determine total estrogenic activity; the presence of estrogenic substances can be evaluated by measuring the 17-beta-estradiol equivalency quantity (EEQ). Untreated samples were also assayed with an acute toxicity test (Vibrio fischeri) to study the correlation between toxicity and estrogenic disruption activity. Mean EEQs were 4.7 ng/L (+/-2.7 ng/L) upstream and 4.4 ng/L (+/-3.7 ng/L) downstream of the plant, and 11.1 ng/L (+/-11.7 ng/L) in the effluent. In general the WWTP effluent had little impact on estrogenicity nor on the concentration of EDCs in the river water. The samples upstream and downstream of the plant were non-toxic or weakly toxic (0

Assuntos
Disruptores Endócrinos/análise , Esgotos/química , Poluentes Químicos da Água/análise , Aliivibrio fischeri/efeitos dos fármacos , Linhagem Celular Tumoral , Disruptores Endócrinos/toxicidade , Monitoramento Ambiental/métodos , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Projetos Piloto , Rios , Extração em Fase Sólida/métodos , Testes de Toxicidade , Eliminação de Resíduos Líquidos/métodos , Poluentes Químicos da Água/toxicidade
19.
An Pediatr (Barc) ; 66(5): 496-517, 2007 May.
Artigo em Espanhol | MEDLINE | ID: mdl-17517205

RESUMO

All guidelines, protocols and recommendations underline the importance of therapeutic education as a key element in asthma management and control. Considerable evidence supports the efficacy and effectiveness of this measure. Health personnel, as well as patients and their parents, can and should be educated with two main objectives: to achieve the best possible quality of life and to allow self control of the disease. These goals can be attained through an educational process that should be individually tailored, continuous, progressive, dynamic, and sequential. The process poses more than a few difficulties involving patients, health professionals, and the health systems. Knowledge of the various psychological factors that can be present in asthmatic patients, as well as the factors related to the highly prevalent phenomenon of non-adherence, is essential. Awareness of the factors influencing physician-patient-family communication is also highly important to achieve the objectives set in therapeutic education. The educational process helps knowledge and abilities to be acquired and allows attitudes and beliefs to be modified. Patients and caregivers should be provided with an individual written action plan based on symptoms and/or forced expiratory volume in 1 second. Periodic follow-up visits are also required.


Assuntos
Asma/terapia , Educação de Pacientes como Assunto , Criança , Humanos , Cooperação do Paciente , Educação de Pacientes como Assunto/métodos , Relações Médico-Paciente , Autocuidado
20.
An. pediatr. (2003, Ed. impr.) ; 66(5): 496-517, mayo 2007. ilus, tab
Artigo em Es | IBECS | ID: ibc-054544

RESUMO

Todas las recomendaciones, guías y protocolos establecen el papel de la educación terapéutica como elemento clave en el manejo y control del asma, disponiéndose de evidencias que demuestran su eficacia y efectividad. Tanto los profesionales sanitarios como los pacientes y sus familias pueden y han de ser formados y educados, con dos objetivos fundamentales: conseguir una óptima calidad de vida y una capacidad suficiente para manejar el asma de una forma autogestionada. Ello se puede conseguir a través de un proceso educativo que ha de ser individualizado, continuo, progresivo, dinámico y secuencial. En este proceso han de superarse no pocas dificultades, relacionadas con el paciente, con los profesionales y con el propio sistema sanitario. Es preciso conocer los diferentes aspectos psicológicos que pueden relacionarse con el paciente asmático, así como aquellos que están relacionados con el fenómeno tan prevalente de la falta de adherencia. El conocimiento de los factores que inciden en la comunicación médico-paciente-familia es de enorme importancia para conseguir los objetivos que se plantean en la educación terapéutica. El proceso educativo conduce, no sólo a la adquisición de conocimientos y habilidades, sino también a un cambio de actitudes y creencias. Es necesario proveer al paciente y a sus cuidadores de un plan de acción por escrito individualizado, basado en síntomas y/o flujo espiratorio máximo (FEM), ligado siempre a revisiones periódicas


All guidelines, protocols and recommendations underline the importance of therapeutic education as a key element in asthma management and control. Considerable evidence supports the efficacy and effectiveness of this measure. Health personnel, as well as patients and their parents, can and should be educated with two main objectives: to achieve the best possible quality of life and to allow self control of the disease. These goals can be attained through an educational process that should be individually tailored, continuous, progressive, dynamic, and sequential. The process poses more than a few difficulties involving patients, health professionals, and the health systems. Knowledge of the various psychological factors that can be present in asthmatic patients, as well as the factors related to the highly prevalent phenomenon of non-adherence, is essential. Awareness of the factors influencing physician-patient-family communication is also highly important to achieve the objectives set in therapeutic education. The educational process helps knowledge and abilities to be acquired and allows attitudes and beliefs to be modified. Patients and caregivers should be provided with an individual written action plan based on symptoms and/or forced expiratory volume in 1 second. Periodic follow-up visits are also required


Assuntos
Masculino , Feminino , Criança , Humanos , Asma/epidemiologia , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/tendências , Relações Médico-Paciente , Papel do Médico , Educação de Pacientes como Assunto/economia , Educação de Pacientes como Assunto/organização & administração , Educação de Pacientes como Assunto/normas , Efetividade , Análise Custo-Benefício/normas , Análise Custo-Benefício/tendências
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...