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2.
Diabetol Metab Syndr ; 12: 66, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32774470

RESUMO

BACKGROUND: In type I diabetes mellitus (T1DM) pancreatic ß cells are destroyed. Treatment entails exogenous insulin administration and strict diet control, yet optimal glycemic control is hardly attainable. Islet transplant could be an alternative in patients with poor glycemic control, but inefficient islet purification and autoimmune response of patients is still a challenge. For these reasons, it is necessary to explore new cellular sources and immunological isolation methods oriented to develop T1DM cell-based therapies. AIMS: We postulate human adipose-derived stem cell (hASC) as an adequate source to generate pancreatic islet cells in vitro, and to produce islet-like structures. Furthermore, we propose microencapsulation of these aggregates as an immunological isolation strategy. METHODS: hASC obtained from lipoaspirated fat tissue from human donors were differentiated in vitro to insulin (Ins) and glucagon (Gcg) producing cells. Then, insulin producing cells (IPC) and glucagon producing cells (GPC) were cocultured in low adhesion conditions to form cellular aggregates, and later encapsulated in a sodium alginate polymer. Expression of pancreatic lineage markers and secretion of insulin or glucagon in vitro were analyzed. RESULTS: The results show that multipotent hASC efficiently differentiate to IPC and GPC, and express pancreatic markers, including insulin or glucagon hormones which they secrete upon stimulation (fivefold for insulin in IPC, and fourfold for glucagon, compared to undifferentiated cells). In turn, calculation of the Feret diameter and area of cellular aggregates revealed mean diameters of ~ 80 µm, and 65% of the aggregates reached 4000 µm2 at 72 h of formation. IPC/GPC aggregates were then microencapsulated in sodium-alginate polymer microgels, which were found to be more stable when stabilized with Ba2+, yielding average diameters of ~ 300 µm. Interestingly, Ba2+-microencapsulated aggregates respond to high external glucose with insulin secretion. CONCLUSIONS: The IPC/GPC differentiation process from hASC, followed by the generation of cellular aggregates that are later microencapsulated, could represent a possible treatment for T1DM.

3.
Artigo em Inglês | IBECS | ID: ibc-171416

RESUMO

In a global world, knowledge of imported infectious diseases is essential in daily practice, both for the microbiologist-parasitologist and the clinician who diagnoses and treats infectious diseases in returned travelers. Tropical and subtropical countries where there is a greater risk of contracting an infectious disease are among the most frequently visited tourist destinations. The SEIMC considers it appropriate to produce a consensus document that will be useful to primary care physicians as well as specialists in internal medicine, infectious diseases and tropical medicine who help treat travelers returning from tropical and sub-tropical areas with infections. Preventive aspects of infectious diseases and infections imported by immigrants are explicitly excluded here, since they have been dealt with in other SEIMC documents. Various types of professionals (clinicians, microbiologists, and parasitologists) have helped produce this consensus document by evaluating the available evidence-based data in order to propose a series of key facts about individual aspects of the topic. The first section of the document is a summary of some of the general aspects concerning the general assessment of travelers who return home with potential infections. The main second section contains the key facts (causative agents, diagnostic procedures and therapeutic measures) associated with the major infectious syndromes affecting returned travelers [gastrointestinal syndrome (acute or persistent diarrhea); febrile syndrome with no obvious source of infection; localized cutaneous lesions; and respiratory infections]. Finally, the characteristics of special traveler subtypes, such as pregnant women and immunocompromised travelers, are described (AU)


En el mundo global, el conocimiento de las enfermedades infecciosas importadas es esencial en la práctica diaria, tanto para el microbiólogo-parasitólogo como para el clínico en enfermedades infecciosas que atiende a viajeros internacionales. Entre los destinos turísticos más visitados se encuentran muchos países tropicales o subtropicales, donde el riesgo de contraer una enfermedad infecciosa es más elevado. La SEIMC ha considerado pertinente la elaboración de un documento de consenso que sirva de ayuda tanto a médicos de Atención Primaria como a especialistas en Medicina Interna, Enfermedades Infecciosas y Medicina Tropical que atienden a viajeros que regresan con infecciones tras un viaje a zonas tropicales y subtropicales. Se han excluido de forma explícita los aspectos de prevención de estas y las infecciones importadas por inmigrantes, objeto de otros documentos de la SEIMC. Varios tipos de profesionales (clínicos, microbiólogos y parasitólogos) han desarrollado este documento de consenso tras evaluar los datos disponibles basados en la evidencia para proponer una serie de datos clave acerca de este aspecto. Inicialmente se revisan los aspectos generales acerca de la evaluación general del viajero que regresa con una potencial infección. En un segundo bloque se señalan los datos clave (agentes causales, procedimientos diagnósticos y medidas terapéuticas) de los síndromes infecciosos principales en el viajero que regresa (síndrome gastrointestinal (diarrea aguda o persistente), síndrome febril sin foco aparente, lesiones cutáneas localizadas e infecciones respiratorias). Finalmente se describen las características en viajeros especiales como la viajera embarazada y el viajero inmunodeprimido (AU)


Assuntos
Humanos , Masculino , Feminino , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/microbiologia , Consenso , Eosinofilia/epidemiologia , Doenças do Sistema Nervoso/epidemiologia , Sociedades Médicas/organização & administração , Sociedades Médicas/normas , Microbiologia , Microbiologia/organização & administração , Saúde do Viajante , Medicina de Viagem/organização & administração
4.
Enferm Infecc Microbiol Clin (Engl Ed) ; 36(3): 187-193, 2018 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28396090

RESUMO

In a global world, knowledge of imported infectious diseases is essential in daily practice, both for the microbiologist-parasitologist and the clinician who diagnoses and treats infectious diseases in returned travelers. Tropical and subtropical countries where there is a greater risk of contracting an infectious disease are among the most frequently visited tourist destinations. The SEIMC considers it appropriate to produce a consensus document that will be useful to primary care physicians as well as specialists in internal medicine, infectious diseases and tropical medicine who help treat travelers returning from tropical and sub-tropical areas with infections. Preventive aspects of infectious diseases and infections imported by immigrants are explicitly excluded here, since they have been dealt with in other SEIMC documents. Various types of professionals (clinicians, microbiologists, and parasitologists) have helped produce this consensus document by evaluating the available evidence-based data in order to propose a series of key facts about individual aspects of the topic. The first section of the document is a summary of some of the general aspects concerning the general assessment of travelers who return home with potential infections. The main second section contains the key facts (causative agents, diagnostic procedures and therapeutic measures) associated with the major infectious syndromes affecting returned travelers [gastrointestinal syndrome (acute or persistent diarrhea); febrile syndrome with no obvious source of infection; localized cutaneous lesions; and respiratory infections]. Finally, the characteristics of special traveler subtypes, such as pregnant women and immunocompromised travelers, are described.


Assuntos
Doenças Transmissíveis Importadas/diagnóstico , Doenças Transmissíveis Importadas/terapia , Humanos , Viagem
5.
Cir. Esp. (Ed. impr.) ; 72(4): 192-195, oct. 2002. tab
Artigo em Es | IBECS | ID: ibc-14785

RESUMO

Introducción. La infección por Candida sp. está caracterizada por una elevada mortalidad. El objetivo de este artículo es conocer las características de los pacientes con infecciones nosocomiales en las que se aísla Candida sp., con el fin de facilitar un diagnóstico temprano y mejorar su pronóstico. Material y método. En el trienio 1998-2000 hemos intervenido a 3.579 pacientes por procedimientos de cirugía mayor. Analizamos a 42 pacientes que han presentado una infección de sitio quirúrgico (SSI) en las que se ha aislado Candida sp., siguiendo los criterios de los Centers for Disease Control (CDC) y los factores de riesgo que componen el índice National Nososcomial Infection Surveillance (NNIS). Se comparan con el resto de los pacientes con SSI. Resultados. Se ha aislado Candida sp. en el 14,5 por ciento de los 289 pacientes con SSI. Ésta era de la variedad Candida albicans en 35 casos (83,3 por ciento) y en 29 estaba asociada con otros gérmenes (69 por ciento). El 83,3 por ciento de los casos (35 pacientes) presentaba una infección de órgano-espacio, asociada con una fístula o dehiscencia de sutura en el 65,7 por ciento de los mismos (23 pacientes), cifras significativamente superiores a las del resto de SSI. Se presentan con mayor frecuencia tras intervenciones urgentes (18,6 por ciento), en pacientes con índice NNIS alto (18,2 por ciento) y en pacientes intervenidos por cirugía gastroduodenal o hepatobiliopancreática (33,8 por ciento). También se caracterizan por una mayor estancia media y mayor tasa de reintervenciones y mortalidad que el resto de las SSI (diferencias significativas).Conclusiones. El aislamiento de Candida sp. es frecuente en infecciones de órgano-espacio en pacientes con elevado índice NNIS, intervenidos por patología gastroduodenal o hepatobiliopancreática y con una tasa de reintervenciones y una mortalidad superior a la del resto de SSI (AU)


Assuntos
Idoso , Feminino , Masculino , Pessoa de Meia-Idade , Humanos , Prognóstico , Fatores de Risco , Infecção Hospitalar/complicações , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/epidemiologia , Candida/isolamento & purificação , Candida/patogenicidade , Endoscopia Gastrointestinal/métodos , Endoscopia Gastrointestinal/instrumentação , Sistema Digestório/cirurgia , Neoplasias Gastrointestinais/cirurgia , Neoplasias Gastrointestinais/complicações
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