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PURPOSE: The aim of this study was to determine whether the triglycerides and glucose (TyG) index is associated with the presence of metabolically obese normal-weight (MONW) phenotype and related cardiovascular risk factors. METHODS: Apparently healthy men and non-pregnant women aged 20-65 years were enrolled in a population-based cross-sectional study. Overweight, obesity, smoking, alcohol consumption, pregnancy, diagnosis of hypertension, diabetes, cardiovascular disease, liver disease, renal disease, malignancy, and medical treatment were exclusion criteria. Subjects were allocated into the MONW or normal-weight groups. MONW phenotype was defined by normal weight and the presence of at least one of the following cardiovascular risk factors: elevated blood pressure, hyperglycemia, hypertriglyceridemia, and low HDL cholesterol. RESULTS: A total of 542 subjects were enrolled and allocated into the MONW (n = 354) and normal-weight (n = 188) groups. The adjusted logistic regression analysis showed that the elevated TyG index is significantly associated with the presence of MONW phenotype (OR = 11.14; 95% CI 6.04-20.57), hyperglycemia (OR = 3.18; 95% CI 1.95-5.21), hypertriglyceridemia (OR = 399.19; 95% CI 94.01-1694.98), and low HDL-C (OR = 2.60; 95% CI 1.74-3.87), but not with elevated blood pressure (OR = 1.55; 95% CI 0.93-2.60). CONCLUSION: Results of this study support that the TyG index may be a useful indicator to detect MONW phenotype and associated cardiovascular risk factors.
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Glucemia/metabolismo , Factores de Riesgo de Enfermedad Cardiaca , Peso Corporal Ideal , Triglicéridos/sangre , Adulto , Anciano , Índice de Masa Corporal , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , HDL-Colesterol/sangre , Estudios Transversales , Femenino , Humanos , Hiperglucemia/complicaciones , Hiperglucemia/epidemiología , Hiperglucemia/metabolismo , Hipertensión/complicaciones , Hipertensión/epidemiología , Hipertensión/metabolismo , Hipertrigliceridemia/complicaciones , Hipertrigliceridemia/epidemiología , Hipertrigliceridemia/metabolismo , Peso Corporal Ideal/fisiología , Masculino , Persona de Mediana Edad , Obesidad/metabolismo , Fenotipo , Factores de Riesgo , Adulto JovenRESUMEN
Smoking increases susceptibility to becoming infected with and developing tuberculosis. Among the components of cigarette smoke, nicotine has been identified as the main immunomodulatory molecule; however, its effect on the innate immune system is unknown. In the present study, the effect of nicotine on molecules of the innate immune system was evaluated. Lung epithelial cells and macrophages were infected with Mycobacterium tuberculosis (Mtb) and/or treated with nicotine. The results show that nicotine alone decreases the expression of the Toll-like receptors (TLR)-2, TLR-4 and NOD-2 in all three cell types, as well as the production of the SP-D surfactant protein in type II pneumocytes. Moreover, it was observed that nicotine decreases the production of interleukin (IL)-6 and C-C chemokine ligand (CCL)5 during Mtb infection in epithelial cells (EpCs), whereas in macrophages derived from human monocytes (MDMs) there is a decrease in IL-8, IL-6, tumor necrosis factor (TNF)-α, IL-10, CCL2, C-X-C chemokine ligand (CXCL)9 and CXCL10 only during infection with Mtb. Although modulation of the expression of cytokines and chemokines appears to be partially mediated by the nicotinic acetylcholine receptor α7, blocking this receptor found no effect on the expression of receptors and SP-D. In summary, it was found that nicotine modulates the expression of innate immunity molecules necessary for the defense against tuberculosis.
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Células Epiteliales Alveolares/inmunología , Regulación de la Expresión Génica/efectos de los fármacos , Inmunidad Innata/efectos de los fármacos , Macrófagos/inmunología , Mycobacterium tuberculosis/inmunología , Nicotina/farmacología , Tuberculosis Pulmonar/inmunología , Células A549 , Células Epiteliales Alveolares/microbiología , Células Epiteliales Alveolares/patología , Citocinas/inmunología , Regulación de la Expresión Génica/inmunología , Humanos , Macrófagos/microbiología , Macrófagos/patología , Proteína Adaptadora de Señalización NOD2/inmunología , Receptor Toll-Like 2/inmunología , Receptor Toll-Like 4/inmunología , Tuberculosis Pulmonar/patologíaRESUMEN
Gingko biloba leaves have been used as herbal medicine in China for 5000 years, and the standardized leaf extract (GB-STE) has some beneficial effects in the treatment of age-related, cardiovascular, and neurological diseases. The aim of this study was to investigate the renoprotective effects of the Gingko biloba extract (GbE) against the toxicity of a single and relatively low dose of carbon tetrachloride (CCl4). In male adult Wistar rats, we determined the urine flux, the concentration of total proteins in urine, the concentration of glucose in urine, and the concentration of malondialdehyde (MDA) in renal cortex as well as two markers of renal function (clearance of inulin and p-aminohippurate); we also compared the histological lesions caused by CCl4. Carbon tetrachloride increased the urinary concentration of total proteins, and the renal concentration of MDA; however, it did not modify the urine flux, urinary concentration of glucose, nor the inuline or the p-aminohipurate clearances. Morphologically, CCl4 generated some tubular damage that was more intense in the inner cortex of kidneys. The GbE extract counteracted the effects of CCl4 on the concentration of total proteins in urine, the concentration of renal MDA, and the renal histological changes. In conclusion the main toxic effects produced by CCl4 were prevented by the GbE, probably due to their antioxidant properties and the inhibition of the main P450 isoenzyme (CYP2E1) that metabolize CCl4.
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Antioxidantes/farmacología , Tetracloruro de Carbono/toxicidad , Riñón/efectos de los fármacos , Extractos Vegetales/farmacología , Animales , Ginkgo biloba , Masculino , Ratas , Ratas WistarRESUMEN
Preeclampsia is a pregnancy-specific disorder in humans and a major cause of maternal and neonatal morbidity and mortality. Increasing evidence suggests that oxidative stress plays an important role in the pathogenesis of preeclampsia. The aim of this study was to investigate the relationship between null alleles of the glutathione S-transferases (GST) M1 and T1 genes and the risk of preeclampsia. This case-control study involved 112 preeclamptic and 233 normoevolutive pregnant women. The null polymorphisms were genotyped by multiplex polymerase chain reaction (PCR). Our results showed an increased risk of preeclampsia in patients with the GSTT1 null genotype [odds ratio (OR) = 2.21; 95% confidence interval (CI) = 1.14-4.27; P = 0.018]. Our data further showed that a combination of deletion genotypes of the GSTM1 and GSTT1 genes conferred an even higher risk of preeclampsia (OR = 4.56, 95%CI = 1.59-13.09; P = 0.005). Our results provide the first evidence suggesting that a GSTT1 null polymorphism might be associated with preeclampsia in the Mexican mestizo population, and that this risk increases with the combination of both GSTT1 and GSTM1 null polymorphisms.
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Predisposición Genética a la Enfermedad , Glutatión Transferasa/genética , Polimorfismo Genético , Preeclampsia/epidemiología , Preeclampsia/genética , Adolescente , Adulto , Alelos , Estudios de Casos y Controles , Femenino , Frecuencia de los Genes , Genotipo , Humanos , México/epidemiología , Oportunidad Relativa , Embarazo , Riesgo , Adulto JovenRESUMEN
OBJECTIVE: The effects of pharmacological and psychosocial treatment on remission and the functional outcome in outpatients with schizophrenia were evaluated. Remission was assessed according to the criteria proposed by the Remission in Schizophrenia Working group and psychosocial functioning according to the Global Assessment of Functioning with a score > 60. Functional outcome was the result of these two variables. METHOD: One hundred fifty two patients were randomized to receive either, antipsychotic treatment as usual (TAU) or social skills training and family psychoeducation in addition to TAU. A final sample of 119 patients: n = 68 in the social skills training group, and n = 51 in the TAU group completed the study protocol. Patients were assessed at baseline and at 6-month follow-up. RESULTS: At the end of the study, 80% of the patients fulfilled the criteria for symptomatic remission: 62 patients (91.2%) in the social skills training group in contrast to 34 patients (66.7%) in the TAU group. Functional improvement criteria were accomplished by 41 patients (34.5%) at the endpoint of the study. Forty of these patients (58.8%) belonged to social skills training and one patient to customary treatment (χ(2) = 41.7, df 1, p < 0.001) and when criteria for symptomatic remission and functional improvement were combined, 39 patients (97.5%) of the social skills training group and one patient (1.9%) of the customary treatment group achieved functional outcome. CONCLUSION: The results emphasize the need for psychosocial interventions as conjoint to pharmacological treatment to improve functional outcome in schizophrenia patients.
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Antipsicóticos/uso terapéutico , Terapia Cognitivo-Conductual/métodos , Esquizofrenia/tratamiento farmacológico , Esquizofrenia/rehabilitación , Ajuste Social , Resultado del Tratamiento , Adulto , Femenino , Humanos , Masculino , Pacientes Ambulatorios , Escalas de Valoración Psiquiátrica , Psicología del Esquizofrénico , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
Functional and morphological alterations were generated by p.o. (per os) administration of a single oral dose of carbon tetrachloride (CCl(4); 0.125 mL/kg b.w., equivalent to 293 mg/kg) to adult male Wistar rats. CCl(4) significantly increased (p < 0.05) the serum activities of alanine aminotransferase (ALT; 7478 ± 1044%) and aspartate aminotransferase (AST; 6964 ± 833%), compared to control rats; CCl(4) also significantly decreased serum concentration of albumin (23 ± 5.5%) and increased the concentration of malondialhdeyde (MDA) in liver (300 ± 33%). Furthermore, CCl(4) down-regulated the mRNA steady-state level of tumor necrosis factor a(TNF-a). CCl(4) produced necrosis in the central lobe area, extended to the periphery, nuclear alterations (pycnosis, karyolysis and karyorrhexis), and cytoplasmic acidophilia. The pretreatment with 4 mg/kg (p.o.) of Ginkgo biloba extract (GbE), for 5 days, prevented most of the damage caused by CCl(4): significantly decreased the serum activities of ALT and AST (54 and 65%, respectively), compared to CCl(4)-treated rats; GbE partially prevented the increase of liver MDA (55 ± 14%) and the decrease of albumin concentration to 12 ± 0.2%. This pretreatment prevented the down-regulation of TNF-a and up-regulated the interleukine 6 (IL-6) mRNA steady-state level. Moreover, the GbE reduced the amount of necrotic areas in the central lobe area, compared to CCl(4)-treated rats.
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Tetracloruro de Carbono/toxicidad , Enfermedad Hepática Inducida por Sustancias y Drogas/prevención & control , Ginkgo biloba/química , Extractos Vegetales/farmacología , Animales , Enfermedad Hepática Inducida por Sustancias y Drogas/sangre , Enfermedad Hepática Inducida por Sustancias y Drogas/metabolismo , Regulación de la Expresión Génica/efectos de los fármacos , Interleucina-6/metabolismo , Masculino , Malondialdehído , Extractos Vegetales/química , ARN Mensajero/genética , ARN Mensajero/metabolismo , Ratas , Ratas Wistar , Albúmina Sérica/metabolismo , Transaminasas/sangre , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
Aflatoxins (AF) have a high impact in both human and animal health, causing significant economic losses in the poultry industry, especially by diminution of avian growth, feed efficiency, and product quality. Aflatoxins affect the whole organism, particularly liver and kidney. The objective of this study was to evaluate renal function alterations in laying hens during chronic AF ingestion. Randomly, 84 Leghorn Hy-Line laying hens (13 wk old) were assigned into 4 experimental groups (n = 21): 0.0, 0.5, 1.0, and 1.5 mg of AF/kg of feed. The AF (B(1), B(2), G(1), and G(2)) was obtained from 2 toxicogenic local strains of Aspergillus flavus grown in corn grains; the grain was sterilized, ground, and added to basal diets to achieve the selected AF concentrations. Hens ingested, during 17 and 42 wk, feed contaminated with AF. Data were analyzed in a 4 x 2 factorial arrangement. Hens were anesthetized, ureteral urine samples were collected, and arterial blood samples were taken. The renal functional tests were evaluated by spectrophotometric and flame photometric methods, including a) Na, K, Ca, and phosphate fractional excretions; b) renal hemodynamic studies, glomerular filtration rate and renal plasma flow by inulin and p-aminohippurate clearances, respectively; and c) identification of macroscopic and histopathologic lesions. The hens intoxicated at all levels of AF showed significant (P < 0.05) increases in Ca, Na, and phosphate fraction excretions. Sodium and phosphates were excreted in a pattern of response time-dose. However, glomerular filtration rate exhibited a significant reduction (P < 0.05). The K fractional excretion and renal plasma flow remained unchanged. These results suggest that AF chronic ingestion affects renal functions of laying hens and induces Ca(++), (-3)PO(4), and Na(+) losses, which are of great concern to the poultry industry.
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Aflatoxinas/toxicidad , Riñón/efectos de los fármacos , Oviposición/efectos de los fármacos , Circulación Renal/efectos de los fármacos , Administración Oral , Aflatoxinas/administración & dosificación , Alimentación Animal , Animales , Peso Corporal , Calcio/orina , Pollos , Relación Dosis-Respuesta a Droga , Femenino , Contaminación de Alimentos , Tasa de Filtración Glomerular/efectos de los fármacos , Humanos , Riñón/fisiopatología , Pruebas de Función Renal , Fosfatos/orina , Potasio/orina , Sodio/orinaRESUMEN
INTRODUCTION: The launching of mycophenolate mofetil (MMF) has reduced the incidence of acute rejection episodes. We sought to evaluate the efficacy of decreasing the steroid dose. MATERIALS AND METHODS: This was a quasiexperimental, randomized, prospective trial. We enrolled 150 patients who received de novo renal transplantations from living or cadaveric donors, fulfilling the screening criteria. Patients were randomized to one of the following two arms: (A) MMF at a 2 g/d dose, cyclosporine (CsA) at a dose necessary to achieve target levels, and corticosteroids at the usual doses; (B) MMF at a 2 g/d dose, CsA at a dose necessary to achieve target levels, and corticosteroids at doses 50% lower than those of group A. RESULTS: Group A included 72 (48%) and group B, 78 patients (52%). There were no differences among the variables: leukopenia occurred in 11 patients in group A, and five patients in group B. Complications occurred in 67.4% (56) of group A, but only 32.6% (27) were related to infections. One case of urinary infection occurred in group B, while six occurred in group A. There was one case of acute rejection in group A, and none in group B. One graft loss occurred in group A. There were no differences in the remaining variables under study. DISCUSSION: The results showed an increased complication rate related to receiving usual steroid doses. There was no increase in acute rejection episodes among patients receiving 50% of the usual steroid dose.
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Corticoesteroides/uso terapéutico , Ciclosporina/uso terapéutico , Rechazo de Injerto/prevención & control , Trasplante de Riñón/inmunología , Ácido Micofenólico/análogos & derivados , Corticoesteroides/efectos adversos , Ciclosporina/efectos adversos , Quimioterapia Combinada , Humanos , Inmunosupresores/uso terapéutico , Infecciones/epidemiología , Leucopenia/epidemiología , Ácido Micofenólico/efectos adversos , Ácido Micofenólico/uso terapéutico , Complicaciones Posoperatorias/epidemiología , Trasplante Homólogo/inmunología , Resultado del TratamientoRESUMEN
The purpose of this phase II randomised trial was to determine which of two schemes, raltitrexed-irinotecan or raltitrexed-oxaliplatin, offered better activity and less toxicity in patients with advanced colorectal cancer (CRC). A total of 94 patients with previously untreated metastatic CRC were included and randomised to receive raltitrexed 3 mg m(-2) followed by oxaliplatin 130 mg m(-2) on day 1 (arm A), or CPT-11 350 mg m(-2) followed by raltitrexed 3 mg m(-2) (arm B). In both arms treatment was repeated every 3 weeks. Intent-to-treat (ITT) analysis showed an overall response rate of 46% (95% CI, 29.5-57.7%) for arm A, and 34% (95% CI, 19.8-48.4%) for arm B. Median time to progression was 8.2 months for arm A and 8.8 months for arm B. After a median follow-up of 14 months, 69% of patients included in arm A were still alive, compared to 59% of those included in arm B. Overall, 31 patients (65%) experienced some episode of toxicity in arm A and 32 patients (70%) in arm B, usually grade 1-2. The most common toxicity was hepatic, with 29 patients (60%) in arm A and 24 patients (62%) in arm B, and was grade 3-4 in four (8%) and four (9%) patients, respectively. In all, 14 patients (29%) from arm A and 24 patients (52%) from arm B had some grade of diarrhoea (P<0.03). Neurologic toxicity was observed in 31 patients (64%) in arm A, and was grade 3-4 in five patients (10%), while a cholinergic syndrome was detected in nine patients (19%) in arm B. There were no differences in haematologic toxicity. One toxic death (2%) occurred in arm A and three (6.5%) in arm B. In conclusion, both schemes have high efficacy as first-line treatment in metastatic CRC and their total toxicity levels are similar. Regimens with raltitrexed seem a reasonable alternative to fluoropyrimidines.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Colorrectales/tratamiento farmacológico , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Camptotecina/administración & dosificación , Camptotecina/análogos & derivados , Neoplasias Colorrectales/patología , Femenino , Humanos , Infusiones Intravenosas , Irinotecán , Masculino , Persona de Mediana Edad , Compuestos Organoplatinos/administración & dosificación , Oxaliplatino , Quinazolinas/administración & dosificación , Análisis de Supervivencia , Tiofenos/administración & dosificación , Resultado del TratamientoRESUMEN
A cave (102 m long) under the structure of the Sun pyramid of the prehispanic Teotihuacan City indicates the importance of the pyramid. Studies of the cave mortar samples using energy dispersive X-ray (EDX) fluorescence, scanning electron microscopy (SEM) and X-ray diffraction (XRD) showed no difference in the chemical elemental composition. The elements can be distributed in three groups: major, minor and trace elements. The minerals identified were compatible with the origins of the cave and with the magnetic pattern.
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OBJECTIVE: The goal of this work tries to evaluate the utility of the qualitative determination of NMP-22 in the evaluation of the superficial bladder carcinoma in asymptomatic patients, comparing it with its quantitative determination, the cytology and the cystoscopy. MATERIALS AND METHODS: A simple of urine just voided was taken in 88 asymptomatic patient follow-up for superficial bladder cell carcinoma. This dose was distributed in 3 parts, for performed cytology, for determination of NMP-22, and 4 drops of the third part are added to device bladder chek. Later, we performed cystoscopy and transurethral resection in patients with a suspicion of bladder cancer. RESULTS: 26 patients had tumor relapse and 62 patients were free of disease. The sensitivity for the bladder chek was of 28%, 34.62% for NMP-22, 34.62% for cytology and 100% for cystoscopy. The specificity was of 93.55%, 80.33%, 87.10% and 87.10% respectively. The sensitivity by degree was 25 in G1, 28.57 in G2 and 50 in G3 for Bladder chek; 29.41, 42.86 and 50 for NMP-22; 23.53, 71.43 and 0 for cytology. The sensitivity by stages was 27.7 in Ta-1 and 50 in T2 for Bladder chek; 34.78 and 50 for NMP-22; 39.13 and 0 for the cytology. CONCLUSIONS: The low sensitivity of bladder chek invalidates it like alternative method to the cystoscopy in the follow-up of the superficial asymptomatic bladder cell carcinoma.
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Carcinoma de Células Transicionales/diagnóstico , Cistoscopía , Pruebas Inmunológicas , Proteínas Nucleares/análisis , Neoplasias de la Vejiga Urinaria/diagnóstico , Orina/citología , Femenino , Humanos , Masculino , Sensibilidad y EspecificidadRESUMEN
Our previous acute toxicity studies with Karwinskia humboldtiana (Kh) in rats showed renal hemodynamic changes with a marked increase in the fractional excretion of sodium and morphological damage. To analyse the effects of Kh or 'tullidora' on energetic metabolism, a single dose of an oral preparation from the seed fruits was given to Wistar rats (1.25 g/kg). In tullidora-treated rats there was 8% mortality. ATP concentrations in renal tissue decreased significantly (control: 53.85+/-3.34, tullidora 38.28+/-5.31 micromol/g fresh tissue, P<0.05). Total blood (54.8+/-0.96, tullidora: 40.2+/-1.55 micromol/dL, P<0.01) and haemoglobin-ATP concentrations (3.69+/-0.12, tullidora: 2.56+/-0.11 micromol/g, P<0.01) were also significantly diminished. Moreover, the total protein in renal cortex from tullidora-treated rats decreased as compared to control group (control: 71.43+/-2.88, tullidora: 55.20+/-4.06 mg/g fresh tissue, P<0.05). In contrast, Na+-K+-ATPase activity in tullidora-treated animals was not different from control rats. These findings might partially explain the acute effects and mortality observed in the Kh treated rats.
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Adenosina Trifosfato/sangre , Adenosina Trifosfato/metabolismo , Karwinskia/toxicidad , Riñón/efectos de los fármacos , Riñón/metabolismo , Animales , Dosificación Letal Mediana , Masculino , Plantas Tóxicas , Ratas , Ratas WistarRESUMEN
Introducción. Se ha propuesto que algunas variables sociodemográficas pueden predecir el comportamiento violento en pacientes con esquizofrenia. El objetivo del presente estudio es investigar la relación de las variables sociodemográficas y clínicas del padecimiento con la conducta violenta en pacientes con esquizofrenia. Método. Se incluyeron 106 pacientes con el diagnóstico de esquizofrenia. Se registraron las principales características demográficas y clínicas de cada uno de los pacientes en un formato diseñado previamente. Se utilizó la Escala de Agresión Explícita (EAE) para la evaluación de la conducta violenta. Resultados. El 49,1 % de los pacientes fueron clasificados como violentos. El estado civil, el abuso de alcohol, el número de hospitalizaciones psiquiátricas previas y la edad de la primera hospitalización fueron variables predictoras para la conducta violenta en esquizofrenia. Discusión. Las variables sociodemográficas predictoras de violencia en esquizofrenia son fáciles de evaluar en la primera entrevista con el paciente y pueden ser de utilidad para prevenir conductas violentas posteriores
Introduction. It has been proposed that some sociodemographic variables may predict violent behavior in schizophrenic patients. The aim of this study was to investigate the relationship of violent behavior with sociodemographic and clinical features in schizophrenic patients. Method. We included 106 schizophrenic patients. Sociodemographic and clinical characteristics of each patient were recorded in a previously designed record. Violent behaviors were assessed with the Overt Aggression Scale (OAS). Results. From the total sample, 49.1 % of the patients were classified as violent. Marital status, alcohol abuse, number of previous psychiatric hospitalizations and age of first hospitalization were predictive variables for violent behavior in schizophrenia. Discussion. Predictive sociodemographic variables for violence in schizophrenia are easy to measure during the first interview with the patient and can be useful for the prevention of future violence
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Adulto , Anciano , Adolescente , Persona de Mediana Edad , Humanos , Esquizofrenia/epidemiología , Trastorno de la Conducta Social/epidemiología , Violencia/estadística & datos numéricos , Demografía , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Esquizofrenia/diagnóstico , Trastorno de la Conducta Social/diagnóstico , Factores SocioeconómicosRESUMEN
INTRODUCTION: It has been proposed that some sociodemographic variables may predict violent behavior in schizophrenic patients. The aim of this study was to investigate the relationship of violent behavior with sociodemographic and clinical features in schizophrenic patients. METHOD: We included 106 schizophrenic patients. Sociodemographic and clinical characteristics of each patient were recorded in a previously designed record. Violent behaviors were assessed with the Overt Aggression Scale (OAS). RESULTS: From the total sample, 49.1 % of the patients were classified as violent. Marital status, alcohol abuse, number of previous psychiatric hospitalizations and age of first hospitalization were predictive variables for violent behavior in schizophrenia. DISCUSSION: Predictive sociodemographic variables for violence in schizophrenia are easy to measure during the first interview with the patient and can be useful for the prevention of future violence.
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Esquizofrenia/epidemiología , Trastorno de la Conducta Social/epidemiología , Violencia/estadística & datos numéricos , Adolescente , Adulto , Anciano , Demografía , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esquizofrenia/diagnóstico , Trastorno de la Conducta Social/diagnóstico , Factores SocioeconómicosRESUMEN
The immunosuppressant mycophenolate mofetil (MMF; CellCept) has greatly improved transplant recipients' clinical outcomes, but its efficacy may be limited by dose adjustments due to adverse events (AEs). An enteric-coated formulation of mycophenolate sodium (EC-MPS; myfortic), designed to improve gastrointestinal tolerability is now available. This Latin-American, prospective, multicenter, open-label, 6-month trial assessed the safety and tolerability of converting renal transplant recipients from MMF to EC-MPS. In total, 237 renal transplant recipients (stable > or = 3 months' posttransplant) receiving MMF (< or =1000 mg b.i.d.) were enrolled. Adults (n = 218) were converted to EC-MPS 720 mg b.i.d. (equimolar to MMF 1000 mg b.i.d.) even if they were initially receiving <1000 mg MMF b.i.d. (ie, 47 adults received a higher than equimolar dose of EC-MPS). Children (n = 19) were converted to EC-MPS 450 or 432 mg/m2 b.i.d. Patients also received cyclosporine microemulsion (Neoral) and corticosteroids. There were three acute rejections and no graft failures. The incidence of AEs was 59.9% (in those receiving a higher than equimolar EC-MPS dose it was 57.4%). In all, 22% of patients had gastrointestinal AEs, 37% had infections, and 4.8% had hematological AEs. Only 24 patients (10%) had an AE-related dose reduction. Seven of these patients had received higher than equimolar doses of EC-MPS. Patients can be safely converted from different doses of MMF to a standard dose of EC-MPS. The requirement for EC-MPS dose reduction to manage AEs was relatively low. Use of EC-MPS is a valid alternative for renal transplant recipients receiving maintenance MMF treatment.
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Trasplante de Riñón/inmunología , Ácido Micofenólico/análogos & derivados , Adolescente , Adulto , Niño , Creatinina/sangre , Femenino , Humanos , Inmunosupresores/administración & dosificación , Inmunosupresores/efectos adversos , Inmunosupresores/uso terapéutico , América Latina , Masculino , Ácido Micofenólico/administración & dosificación , Ácido Micofenólico/efectos adversos , Ácido Micofenólico/uso terapéutico , Complicaciones Posoperatorias/epidemiología , Seguridad , Neoplasias Cutáneas/epidemiología , Comprimidos RecubiertosRESUMEN
Objetivo: Evaluar la utilidad de la determinación cualitativa del NMP-22 en el seguimiento del carcinoma vesical superficial en pacientes asintomáticos, comparándolo con su determinación cuantitativa, la citología y la cistoscopia. Material y Métodos: 88 pacientes asintomáticos en seguimiento por carcinoma vesical superficial se les recogió una muestra de orina recién emitida, repartiéndose en 3 alícuotas, para citología, NMP-22 y 4 gotas se añaden al dispositivo Bladder chek, para su lectura en 30 minutos. Posteriormente, cistoscopia y RTU-vesical en sospecha de recidiva. Resultados: 26 pacientes tenían recidiva tumoral y 62 estaban libres de enfermedad. La sensibilidad fue del 28% para el Bladder chek, 34.62% para el NMP-22, 34.62% para la citología y de 100%para la cistoscopia. La especificidad fue de 93.55%, 80.33%, 87.10% y 87.10% respectivamente. La sensibilidad por grado fue: 25 en G1, 28.57 en G2 y 50 para G3 en Bladder chek, de 29.41, 42.86, 50 para NMP-22 respectivamente, 23.53, 71.43, 0 para la citología. Por estadios la sensibilidad fue: 27.27 para Ta-1 y 50 en T2 para Bladder chek, 34.78, 50 para NMP-22 y 39.13, 0 para la citología. Conclusiones: La baja sensibilidad del Bladder chek lo invalida como método alternativo a la cistoscopia en el seguimiento del carcinoma vesical superficial asintomático (AU)
Objective: The goal of this work tries to evaluate the utility of the qualitative determination of NMP-22 in the evaluation of the superficial bladder carcinoma in asymptomatic patients, comparing it with its quantitative determination, the cytology and the cystoscopy. Materials and Methods: A simple of urine just voided was taken in 88 asymptomatic patient follow-up for superficial bladder cell carcinoma. This dose was distributed in 3 parts, for performed cytology, for determination of NMP-22, and 4 drops of the third part are added to device bladder chek. Later, we performered cystoscopy and transurethral resection in patients with a suspicion of bladder cancer. Results: 26 patients had tumor relapse and 62 patients were free of disease. The sensitivity for the bladder chek was of 28%, 34.62% for NMP-22, 34.62% for cytology and 100% for cystoscopy. The specificity was of 93.55%, 80.33%, 87.10% and 87.10% respectively. The sensitivity by degree was 25 in G1, 28.57 in G2 and 50 inG3 for Bladder chek; 29.41, 42.86and 50 for NMP-22; 23.53, 71.43 and 0 for cytology. The sensitivity by stages was 27.7 in Ta-1 and 50 in T2 for Bladder chek; 34.78 and 50 for NMP-22; 39.13 and 0 for the cytology. Conclusions: The low sensitivity of bladder chek invalidates it like alternative method to the cystoscopy in the follow-up of the superficial asymptomatic bladder cell carcinoma (AU)
Asunto(s)
Humanos , Neoplasias de la Vejiga Urinaria/diagnóstico , Estudios de Seguimiento , Carcinoma de Células Transicionales/diagnóstico , Diagnóstico por Computador/métodos , Cistoscopía/métodos , Biología Celular , Recurrencia Local de Neoplasia/diagnóstico , Estadificación de NeoplasiasRESUMEN
Enteric-coated mycophenolate sodium (EC-MPS) is designed to reduce mycophenolate acid (MPA)-related upper gastrointestinal (GI) adverse events (AEs). A multicenter, open-label, Latin American study in stable renal transplant patients is ongoing to assess the safety of the conversion from mycophenolate mofetil (MMF) to EC-MPS. An interim analysis was performed when 93 patients had completed 3 months. Prior to conversion, they had received MMF at a dose of 2 g/d, with the exception of eight adult patients who were receiving an average daily dose of 1.25 g. All adult patients were converted to EC-MPS (1.44 g/d; 0.450 g/m(2) bid for children). After conversion, the reported total incidence of AEs was 40.9%, including 28% infections, 1.1% hematologic, 19.4% GI, including 10.8% upper-GI AE (all mild) and 5.4% diarrhea. No patient discontinued the study medication due to adverse events. Only six patients (6%) required a dose adjustment. There were no episodes of acute rejection, death, or graft loss. During the period of analysis, the conversion from MMF to EC-MPS was safe, the enteric-coated tablet formulation prevented release of MPA in the upper GI tract, and only one patient had to reduce the dose due to an upper GI AE, concomitant with diarrhea. EC-MPS offers transplant physicians and their patients an alternative MPA therapy that is as effective and safe as MMF, but in a formulation that may provide GI tolerability benefits.
Asunto(s)
Inmunosupresores/uso terapéutico , Trasplante de Riñón/inmunología , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/uso terapéutico , Administración Oral , Adolescente , Adulto , Niño , Etnicidad , Femenino , Estudios de Seguimiento , Humanos , Inmunosupresores/administración & dosificación , América Latina , Masculino , Ácido Micofenólico/administración & dosificación , Ácido Micofenólico/efectos adversos , Grupos Raciales , Comprimidos Recubiertos , Factores de TiempoRESUMEN
Severe pre-eclampsia reduced significantly (P<0.05) by 68+/-6 per cent (mean+/-sem, n=10) the maximal velocity (V(max)) and, consequently, reduced significantly by 60+/-7 per cent the catalytic efficiency (C(E)) of placental glutathione transferase pi, assayed with ethacrynic acid. Mild and severe pre-eclampsia reduced significantly by 82+/-5 per cent (mean+/-sem, n=5) and by 41+/-5 per cent (mean+/-sem, n=10), respectively, the V(max)and, consequently, reduced significantly by 72+/-7 and by 33+/-13 per cent, respectively, the C(E)of esterase, assayed with p-nitrophenyl acetate. Furthermore, severe pre-eclampsia increased significantly by 296+/-78 per cent the Michaelis-Menten constant (K(m)) of total GST, assayed with chlorodinitrobenzene and, consequently, decreased significantly the C(E)by 83+/-3 per cent. On the other hand, the concentrations of total and non-protein thiols did not change significantly in placental homogenates from patients with mild or severe pre-eclampsia compared to normal pregnancies. These findings would indicate a decreased capacity of the glutathione transferases and esterase detoxification systems to protect the fetus from drugs prescribed to pregnant women suffering pre-eclampsia, mainly in the severe phase.
Asunto(s)
Esterasas/metabolismo , Glutatión Transferasa/metabolismo , Placenta/enzimología , Preeclampsia/enzimología , Adulto , Femenino , Humanos , Preeclampsia/fisiopatología , EmbarazoRESUMEN
In view of the high prevalence of malnutrition in hospitals as shown by some studies and in the light of its direct impact on the increase in morbidity and mortality among hospitalized patients, it is necessary to ensure the early identification of this condition. This would allow appropriate nutritional treatment to be instituted as soon as possible for patients at risk who require it. The present multi-centric study included the participation of hospitals in the northern region of the country which have a Nutrition Unit, with use of the Overall Subjective Assessment and a few basic parameters. The study analyzed the nutritional status on admission of 620 patients hospitalized in the Internal Medicine and General Surgery areas during the months of December, 1999, January, February and March, 2000. We detected moderate malnutrition or suspected malnutrition in 20% of the patients studied and severe malnutrition in 18.2%, with a greater incidence in Internal Medicine. Malnutrition was mainly evidenced by weight loss of more than 5% and a reduction in subcutaneous fat and muscle mass. In addition, there are functional limitations on performing everyday activities. Changes in dietary intake were present in 40.8% of the patients. The associated gastro-intestinal symptoms included anorexia, which affected 37.7% of the group studied. Malnutrition is most frequently linked with infectious diseases, problems in circulation and with the digestive apparatus. We feel that the Overall Subjective Assessment, together with the measurement of height and weight, should be used systematically with patients on admission, as it is a simple and effective method for the identification of patients with nutritional risk.