RESUMEN

El aneurisma de aorta abdominal (AAA) es una patología vascular que consiste en una dilatación superior al 50% del diámetro normal del vaso o un diámetro mayor o igual a 3 cm, debido a un debilitamiento de su pared vascular. Su localización más frecuente esen la porción infrarrenal de la aorta ya que es una zona sometida a importantes fuerzas hemodinámicas 1,2.La prevalencia varía en función de la edad, el sexo (6 veces más frecuente en varones), los antecedentes familiares de aneurisma(aumenta el riesgo 2 veces de padecer un AAA), el tabaquismo (hasta 7 veces más riesgo), la hipertensión arterial, la dislipemia y laenfermedad arterial periférica. Existen estudios que sugieren que la diabetes mellitus tipo 2 tiene un efecto protector y que el peso yalgunas patologías respiratorias, como la enfermedad pulmonar obstructiva crónica (EPOC), no influyen en el crecimiento aneurismático3,4.A continuación presentamos el caso de un paciente con un destacable antecedente oncológico que presentó un aneurisma de aortaabdominal poniéndose de manifiesto a través de un dolor lumbar. Se trata de un caso clínico que nos obliga a establecer un amplioabanico de diagnósticos diferenciales del dolor lumbar y cómo abordar con nuevas técnicas terapéuticas un aneurisma de aortaabdominal. (AU)

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Abdominal aortic aneurysm (AAA) is a vascular pathology that consists of a dilation greater than 50% of the normal diameter ofthe vessel or a diameter greater than or equal to 3 cm, due to a weakening of its vascular wall. Its most frequent location is in theinfrarenal portion of the aorta since it is an area subjected to important hemodynamic forces 1,2.Prevalence varies depending on age, sex (6 times more frequent in males), family history of aneurysm (increases the risk of AAA 2times), smoking (up to 7 times more risk), high blood pressure, dyslipidemia and peripheral artery disease. There are studies that suggest that type 2 diabetes mellitus has a protective effect and that weight and some respiratory pathologies, such as chronic obstructivepulmonary disease (COPD), do not influence aneurysmal growth 3,4.Below we present the case of a patient with a remarkable oncological history who presented an abdominal aortic aneurysm manifesting itself through low back pain. This is a clinical case that forces us to establish a wide range of differential diagnoses of low backpain and how to approach an abdominal aortic aneurysm with new therapeutic techniques. (AU)

Asunto(s)

Humanos , Masculino , Anciano , Dolor de la Región Lumbar , Aneurisma de la Aorta , Terapéutica , Tabaquismo , Enfermedad Pulmonar Obstructiva Crónica , Pacientes

RESUMEN

Clinical informatics is a young, diverse and rapidly growing field. We asked eight clinical informaticians from a variety of oncology specialties, training pathways and careers for personal narratives to illustrate the wide spectrum of clinical informatics careers. Primary clinical specialties included radiation oncology, medical/haematology oncology and palliative care. Training pathways included fellowship, non-fellowship formal training and informal training. Careers included clinical care, research, operations and industry. We summarised common themes and advice for trainees. We hope to raise awareness of clinical informatics among trainees and oncologists to reveal new career opportunities and to avoid inadvertently taking clinical informatics and informaticians for granted.

Asunto(s)

Becas , Informática Médica , Humanos , Oncología Médica

RESUMEN

Introducción. La anemia falciforme es una enfermedad de herencia autosómica recesiva que constituye una de las alteraciones genéticas más frecuentes del noroeste de Europa. Las complicaciones secundarias en los pacientes homocigotos son frecuentes durante los primeros 3 años de vida, y debido a ello, desde el 12 de julio de 2017, se ha incluido dicha patología dentro de las enfermedades objetivo de cribado neonatal de Castilla y León (CyL). Con tal fin, se pretende detectar aquellos pacientes que se beneficiarán de un diagnóstico y tratamiento precoz. Objetivos. Calcular la incidencia de hemoglobinopatía S, C, D, E u otra cadena de hemoglobina anómala en todo recién nacido vivo en CyL desde el inicio del programa de cribado hasta el 12 deoctubre de 2018 (15 meses), determinando en los distintos pacientes el sexo, lugar de origen del padre y la madre, hospital de nacimiento y fenotipo encontrado. Material y métodos. Estudio retrospectivo y descriptivo de los pacientes con cribado neonatal de hemoglobinopatías patológico nacidos en la Comunidad Autónoma de Castilla y León, del 12 de julio de 2017 al 12 de octubre de 2018. La muestra de sangre se obtuvo de la prueba del talón realizada en las maternidades de forma sistemática, a partir de las 48 horas de vida del niño. Se analizó por cromatografía líquida de alta resolución (Bio-Rad VARIANTnbs System) en Laboratorio de Referencia de Valladolid, detectándose fenotipos S, C, D, E o asociados a cualquier otra cadena de hemoglobina anómala sin tipificar. Resultados. Se incluyeron en el estudio 18.998 recién nacidos durante ese periodo, con un total de 18.975 muestras analizadas (99,8%). Se detectaron un total de 94 muestras positivas, con 1 resultado coincidente con fenotipo FS (1/18.975), 61 para fenotipo FAS (1/311), 14 FAC (1/1.355), 2 FAD (1/9.487), 1 FC (1/18.975), 11 FAX (1/1.725), y 4 FAXX (1/4.743) (AU)

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Introduction. Sickle cell disease is an autosomal recessive hereditary disease that constitutes one of the most frequent genetic alterations in the Northeast of Europe. The second ary complications in the homozygous patients are frequent during the first three years of life, and due to it, this condition has been included within the diseases targeted for neonatal screening of Castilla y Leon (CyL) since 12 July 2017. With that in mind, it is aimed to detect those patients who would benefit from and early diagnosis and treatment. Objectives. To calculate the incidence of hemoglobin diseases S, C, D, E or other abnormal hemoglobin chain, in all live newborn in CyL from the onset of the screening program until 12 October 2018 (15 months), determining gender, place of origin of the father and mother, hospital where born and phenotype found in the different patients. Material and methods. A retrospective and descriptive study of the patients with neonatal screening for pathological hemoglobin disease in the Regional Community of Castilla y León, from 17 July 2017 to 12 October 2018. The blood sample was obtained from the heel test conducted in the maternity wards systematically, beginning at 48 hours of life of the child. It was analyzed during rapid resolution liquid chromatography (Bio-Rad VARIANTnbs System) in the Reference laboratory of Valladolid, detecting the S, C, D, E or phenotypes or those associated to any other non-typified abnormal hemoglobin chain. Results. A total of 18,998 newborns were enrolled in the study during this period, with a total of 18,975 samples analyzed (99.8%). A total of 94 positive samples were detected, with 1 result coinciding with FS phenotype (1/18,975), 61 for FAS phenotype (1/311), 14 FAC (1/1,355), 2 FAD (1/9,487), 1 FC (1/18,975), 11 FAX (1/1,725), and 4 FAXX (1/4,743). No screening was conducted in 23 newborns out of all the children, due to death in the first hours or transfer prior to 48 hours of life (AU)

Asunto(s)

Humanos , Masculino , Femenino , Recién Nacido , Anemia de Células Falciformes/diagnóstico , Enfermedades del Recién Nacido/diagnóstico , Tamizaje Neonatal , Anemia de Células Falciformes/epidemiología , Enfermedades del Recién Nacido/epidemiología , Estudios Retrospectivos , Incidencia , España

RESUMEN

In efforts to better characterize incidence and predictors of 30- and 90-day mortality following operative versus nonoperative approaches for locally advanced esophageal cancer (EC), we conducted a novel investigation of a large, contemporary US database. The National Cancer Database was queried for newly-diagnosed T1-3N0-1 squamous cell or adenocarcinoma receiving surgical-based therapy (esophagectomy alone or preceded by chemotherapy and/or radiotherapy) versus definitive chemoradiotherapy (dCRT). Statistics included graphing cumulative incidences of mortality before and following propensity score matching (PSM), based on age-based intervals. Cox regression determined factors independently predictive of 30- and 90-day mortality. Of 15,585 patients, 9,278 (59.5%) received surgical-based therapy and 6,307 (40.5%) underwent dCRT. In the unadjusted population, despite nonsignificant differences at 30 days (3.3% dCRT, 3.6% surgical-based), the dCRT cohort experienced higher 90-day mortality (11.0% vs. 7.5%, P < 0.001). Following PSM, however, dCRT patients experienced significantly lower 30-day mortality (P < 0.001), with nonsignificant differences at 90 days (P = 0.092). Surgical-based management yielded similar (or better) mortality as dCRT in ≤70-year-old patients; however, dCRT was associated with reduced mortality in subjects > 70 years old. In addition to the intervention group, factors predictive for 30- and 90-day mortality included age, gender, insurance status, facility type, comorbidity index, tumor location, histology, and T/N classification. In summary, surgical-based therapy for EC is associated with higher 30-day mortality, which becomes statistically similar to dCRT by 90 days. Differences between surgery and dCRT were most pronounced in patients > 70 years of age. These data may better inform shared decision-making between multidisciplinary providers and patients.

Asunto(s)

Adenocarcinoma/terapia , Carcinoma de Células Escamosas/terapia , Quimioradioterapia/mortalidad , Neoplasias Esofágicas/terapia , Esofagectomía/mortalidad , Adenocarcinoma/mortalidad , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/mortalidad , Bases de Datos Factuales , Neoplasias Esofágicas/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Puntaje de Propensión , Modelos de Riesgos Proporcionales , Resultado del Tratamiento , Estados Unidos

RESUMEN

Cyanide is a toxic compound that is converted to the non-toxic thiocyanate by a rhodanese enzyme. Rhodaneses belong to the family of transferases (sulfurtransferases), which are largely studied. The sulfur donor defines the subfamily of these enzymes as thiosulfate:cyanide sulfurtransferases or rhodaneses (TSTs) or 3-mercaptopyruvate sulfurtransfeases (MSTs). In Mycobacterium tuberculosis, the causative agent of tuberculosis, the gene Rv0815c encodes the protein CysA2, a putative uncharacterized thiosulfate:cyanide sulfurtransferase that belongs to the essential sulfur assimilation pathway in the bacillus and is secreted during infection. In this work, we characterized the functional and structural properties of CysA2 and its kinetic parameters. The recombinant CysA2 is a α/ß protein with two rhodanese-like domains that maintains the functional motifs and a catalytic cysteine. Sulfurtransferase activity was determined using thiosulfate and 3-mercaptopyruvate as sulfur donors. The assays showed Km values of 2.89 mM and 7.02 mM for thiosulfate and 3-mercaptopyruvate, respectively, indicating the protein has dual activity as TST and MST. Immunological assays revealed that CysA2 interacted with pulmonary cells, and it was capable to activate macrophages and dendritic cells, indicating the stimulation of the immune response, which is important for its use as an antigen for vaccine development and immunodiagnostic.

Asunto(s)

Cisteína/análogos & derivados , Mycobacterium tuberculosis/enzimología , Sulfurtransferasas/química , Sulfurtransferasas/metabolismo , Tiosulfatos/metabolismo , Animales , Proteínas Bacterianas/química , Proteínas Bacterianas/genética , Proteínas Bacterianas/inmunología , Proteínas Bacterianas/metabolismo , Sitios de Unión , Línea Celular , Cisteína/química , Cisteína/metabolismo , Células Dendríticas/citología , Células Dendríticas/inmunología , Cinética , Macrófagos/citología , Macrófagos/inmunología , Ratones , Ratones Endogámicos C57BL , Modelos Moleculares , Mycobacterium tuberculosis/genética , Unión Proteica , Conformación Proteica , Especificidad por Sustrato , Sulfurtransferasas/genética , Sulfurtransferasas/inmunología

RESUMEN

Myotonic Dystrophy type 1 multisystem involvement leads to functional impairment with an increased risk of falling. This multinational study estimates the prevalence of falls and fall-associated fractures. A web-based survey among disease-specific registries (Germany, UK and The Netherlands) was carried out among DM1 ambulant adults with a total of 573 responses retrieved. Results provided a risk ratio estimation of 30%-72% for falls and of 11%-17% for associated fractures. There was no significant difference for falls between male and female, but there was for fall-related fractures with a higher prevalence in women. Balance and leg weakness were the most commonly reported causes for falling. This study is based on a voluntary retrospective survey with naturally inherent limitations; however, the sample size allows for robust comparisons. The estimated risk of falls in this cohort with a mean age of 46 years compares to a previous estimation for a healthy population of over 65 years of age. These results suggest a premature-ageing DM1 phenotype with an increased risk of falling depending on age and disease severity that, so far, might have been underestimated. This may have clinical implications for the development of care guidelines and when testing new interventions in this population.

Asunto(s)

Accidentes por Caídas/estadística & datos numéricos , Fracturas Óseas/epidemiología , Distrofia Miotónica/fisiopatología , Adulto , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Equilibrio Postural/fisiología , Prevalencia , Sistema de Registros , Estudios Retrospectivos , Reino Unido/epidemiología

RESUMEN

Ganoderma lucidum, a traditional Chinese medicine, has been shown to target the Central Nervous System. In this work we analyze whether G. lucidum, collected in Mexico, has a protective effect in the hippocampus of rats treated with kainic acid, a neurotoxin that causes seizures and neuronal loss. The aqueous extract of G. lucidum (10 mg/Kg, i.p.) was administered to rats 30 min before kainic acid injection (5 mg/Kg, i.p.). Animals that had received prior treatment with G. lucidum showed no tonic-clonic seizure activity. Histopathological analysis showed a significant decrease in neuronal loss and cellular alterations in the hippocampal CA3 region. Immunohistochemical analysis shows that when using G. lucidum in rats, there is less immunoreactivity for GFAP as well as TNF-alpha and IL-1beta in the CA3 region when compared with rats treated with kainic acid. Our results demonstrate that G. lucidum protects against kainic acid-induced alterations of hippocampal cells and expression of immunological markers in this model of excitotoxicity.

Asunto(s)

Proteína Ácida Fibrilar de la Glía/análisis , Hipocampo/efectos de los fármacos , Interleucina-1beta/análisis , Ácido Kaínico/toxicidad , Reishi , Animales , Hipocampo/química , Masculino , Ratas , Ratas Wistar

RESUMEN

OBJECTIVE: Determine whether cocaine directly impairs ovarian steroid production and ovulation. METHODS: Normally cycling adult female rhesus monkeys received daily intravenous normal saline (control; n = 8) or cocaine (4 mg/kg; n = 8) through the follicular phase. Monkeys were injected daily with human menopausal gonadotropin (hMG; Pergonal) at a dose of 6 IU/kg intramuscularly beginning on cycle day 2. Daily blood samples were obtained, and serum estradiol (E(2)) and progesterone (P(4)) were measured by radioimmunoassay. When serum levels of E(2) declined, plateaued, or exceeded 600 pg/mL, laparoscopy was performed to count the number of follicles. If no new corpus luteum was present, monkeys were injected intramuscularly with 1000 IU of hCG. Laparoscopy was repeated 2 days later to document the number of ovulatory stigma. RESULTS: During ovarian stimulation, cocaine-treated monkeys required an average additional 1.5 days of hMG injections (P =.01), and this resulted in a greater total dose of hMG compared with control monkeys (351 +/- 16 IU versus 297 +/- 15 IU [mean +/- standard error of the mean], P =.03). For spontaneous and hCG-triggered ovulation, the number of ovulatory stigma was significantly lower (P <.003) in the cocaine-treated versus control monkeys (16 versus 31). Peak E(2) levels were significantly (P =.05) lower in cocaine-treated monkeys compared with controls. Luteal phase P(4) levels were lower in the cocaine-treated monkeys, but the difference was not statistically significant when compared with controls. CONCLUSION: Cocaine impaired ovarian responsiveness to exogenous gonadotropins and decreased ovulatory stigma in nonhuman primates. These findings suggest that cocaine has direct ovarian effects.

Asunto(s)

Cocaína/farmacología , Menotropinas/farmacología , Ovario/efectos de los fármacos , Animales , Cocaína/efectos adversos , Trastornos Relacionados con Cocaína/fisiopatología , Interacciones Farmacológicas , Estradiol/sangre , Femenino , Fase Folicular/efectos de los fármacos , Fase Folicular/fisiología , Macaca mulatta , Menotropinas/antagonistas & inhibidores , Inducción de la Ovulación , Progesterona/sangre , Distribución Aleatoria

RESUMEN

The objective was to evaluate the accuracy of the cytologic study of fine needle aspiration biopsy and to share the authors experiences. A prospective study was done in the Hospital Regional de Especialidades No. 23, Instituto Mexicano del Seguro Social, from March 1996 to June 1997. A solid mammary nodule was diagnosed in 250 women. A fine needle punction was done in all of them. One hundred seven had cysts. The remaining 143 patients were included in this report. The clinical diagnosis was benign pathology in 87 cases and malignancy in 56. They gad a fine needle aspiration and, in those older than 35 years, a mammography was also done. The cytologic result correlated with the clinical diagnosis in 141 cases with an accuracy of 98.61%. There was any false positive result. The mammographic report correlated with the diagnosis in 30.06% of the cases, and do not correlated in 41.96%. All patients with benign pathology had a transoperative biopsy and tumorectomy. Patients with diagnosis of malignancy had a preoperative staging, which showed that 62.06% were in a surgical stage. They had a transoperative biopsy and a modified radical mastectomy. The remaining 37.94% were in a nonsurgical stage, therefore, they were referred for chemotherapy and radiotherapy. In our experience, the cytology by fine needle aspiration biopsy in solid mammary nodules is a diagnostic method with an excellent sensitivity and specificity as well as low morbility and cost.

Asunto(s)

Biopsia con Aguja , Neoplasias de la Mama/diagnóstico , Adulto , Anciano , Biopsia con Aguja/instrumentación , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Carcinoma/diagnóstico , Carcinoma/patología , Diagnóstico Diferencial , Femenino , Fibroadenoma/diagnóstico , Fibroadenoma/patología , Humanos , Mamografía , Mastitis/diagnóstico , Mastitis/patología , Persona de Mediana Edad , Estudios Prospectivos , Índice de Severidad de la Enfermedad

RESUMEN

OBJECTIVE: Anticardiolipin antibodies (aCL) are associated with thrombosis in patients with systemic lupus erythematosus (SLE). Our aim was to determine whether there is an association between aCL, anti-Sm antibodies, and thrombosis in patients with SLE. METHODS: Sera from 153 patients with SLE were studied by ELISA, immunoblotting, and counter-immunoelectrophoresis (CIE) for anti-Sm antibodies, aCL and anti-dsDNA antibodies were detected by ELISA and radioimmunoassay, respectively. RESULTS: Anti-Sm antibodies were detected in 62 patients (40.5%) by ELISA and in 16 (10.4%) by CIE; IgG-anti-BB'-Sm in 44 (28.7%) by immunoblotting; IgG-aCL in 82 (53.5%), IgM-aCL in 44 (28.7%), and anti-dsDNA antibodies in 128 (83.6%). Anti-Sm and anti-dsDNA antibodies were significantly more frequent in patients with than in patients without aCL. Of the 89 patients with aCL, 36 (40.4%) showed IgG-anti-BB'-Sm antibodies (OR: 4.7; 95% CI: 2-10.5). Thrombosis was present in 20 (22.4%) SLE patients with aCL and in two (3.1 %) SLE patients without aCL (OR: 8.9; 95% CI: 2.4-31.8). Of the 22 patients with thrombosis, five (22.7%) had precipitating anti-Sm antibodies (OR: 3.2; 95% CI: 1.04-9.8) and 14 (63.6%) showed IgG-anti-BB'-Sm antibodies (OR: 5.8; 95% CI: 2.3-14). Anti-BB'-Sm and aCL were significantly more frequent in patients with anti-dsDNA antibodies (32 and 62%) than in patients without these antibodies (12 and 36%) (OR: 3.4 and 2.9; 95% CI: 1.03-11.1 and 1.2-6.7, respectively). CONCLUSION: IgG-anti-BB'-Sm antibodies are associated with aCL, anti-dsDNA, and thrombosis in patients with SLE. Our findings suggest a possible association between anti-Sm, anti-dsDNA, and aCL responses in these patients.

Asunto(s)

Anticuerpos Anticardiolipina/inmunología , Lupus Eritematoso Sistémico/inmunología , Trombosis/inmunología , Adulto , Anticuerpos Antinucleares/inmunología , Contrainmunoelectroforesis , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Inmunoglobulina G/inmunología , Lupus Eritematoso Sistémico/complicaciones , Masculino , Ribonucleoproteínas Nucleares Pequeñas/inmunología , Trombosis/etiología

RESUMEN

UNLABELLED: To the best of our knowledge, 10 cases of Ankylosing Spondylitis (AS) and Diffuse Idiopathic Skeletal Hyperostosis (DISH) coexisting in the same patient have been reported. A new case was found in a female patient at Los Angeles Medical Center in 1993, which we report in this paper. We also review the literature (Medline 1970-1994) and analyze the features of the reported cases. In order to study the incidence of this association in our population we have reviewed 106 cases of AS for radiological features of DISH. We found only one case. CONCLUSION: this is a rare association with an incidence of 0.94% in our patients with AS. From the known cases, patients showing this association present clinically mild AS in which radiologic findings are the basis for the diagnosis. Finally we question the validity of excluding the diagnosis of DISH in patients with radiological features of sacroiliac ankylosis.

Asunto(s)

Hiperostosis Esquelética Difusa Idiopática/complicaciones , Espondilitis Anquilosante/complicaciones , Adulto , Vértebras Cervicales/diagnóstico por imagen , Femenino , Humanos , Hiperostosis Esquelética Difusa Idiopática/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Articulación Sacroiliaca/diagnóstico por imagen , Espondilitis Anquilosante/diagnóstico por imagen , Tomografía Computarizada por Rayos X

RESUMEN

Las técnicas de contrainmunoelectroforesis (CIE) y ELISA son útiles para detectar anticuerpos anti-RNP y anti-Sm,pero no identifican los anticuerpos dirigidos contra los diferentes polipéptidos asociados a RNP/Sm.Estos anticuerpos pueden detectarse mediante immunoblotting (IB) con extractos de células HeLa u otras mantenidad en cultivo.Objetivos:Determinar si el mismo extracto de timo de conejo utilizado en la CIE puede ser una alternativa válida ppara detectar mediante IB los anticuerpos dirigidos contra los diferentes polipépticos asociados a RNP/Sm.Métodos:Hemos estudiado 342 sueros de 250 pacientes con enfermedades inflamatorias del tejido conjuntivo.Los anticuerpos anti-RNP y anti-Sm fueron detectados mediante CIE e IB utilizando como sustrato el mismo extracto comercial de timo de conejo.Resultados: Este IB permitió anticuerpos dirigidos contra los polipéptidos 70kD,A,BB',C y D,aunque el de 70D estaba degradado.Se detectaron anticuerpos anti-RNP y anti-Sm por CIE en el 7,3 por ciento (25 de 342) y de 6,1 (21 de 342) de los sueros , y mediante IB en el 14,9 por ciento (51 de 342) y de 14,3//(49 de 342) de los sueros,respectivamente.En 72 pacientes con lupus eritematoso sistémico la sensibilidad y especificidad de la CIE fueron del 19,1//y del 96,5//para anti-RNP,y del 11,1 del del 100//para anti-Sm.La sensibilidad y especificidad del IB fueron del 22,2 y del 96//para anti-RNP 70 kD y del 19,4 y del 100//para anti-SmD. Conclusiones: A pesar de la degradación proteolítica , el IB con un extracto soluble de timo de conejo puede ser una alternativa válida como complemento de la CIE o del ELISA en la detección de anticuerpos anti-RNP y anti-Sm,y está al alcance de cualquier laboratorio clínico.

Asunto(s)

Anticuerpos , Contrainmunoelectroforesis , Lupus Eritematoso Sistémico/diagnóstico

RESUMEN

Las técnicas de contrainmunoelectroforesis (CIE) y ELISA son útiles para detectar anticuerpos anti-RNP y anti-Sm,pero no identifican los anticuerpos dirigidos contra los diferentes polipéptidos asociados a RNP/Sm.Estos anticuerpos pueden detectarse mediante immunoblotting (IB) con extractos de células HeLa u otras mantenidad en cultivo.Objetivos:Determinar si el mismo extracto de timo de conejo utilizado en la CIE puede ser una alternativa válida ppara detectar mediante IB los anticuerpos dirigidos contra los diferentes polipépticos asociados a RNP/Sm.Métodos:Hemos estudiado 342 sueros de 250 pacientes con enfermedades inflamatorias del tejido conjuntivo.Los anticuerpos anti-RNP y anti-Sm fueron detectados mediante CIE e IB utilizando como sustrato el mismo extracto comercial de timo de conejo.Resultados: Este IB permitió anticuerpos dirigidos contra los polipéptidos 70kD,A,BB,C y D,aunque el de 70D estaba degradado.Se detectaron anticuerpos anti-RNP y anti-Sm por CIE en el 7,3 por ciento (25 de 342) y de 6,1 (21 de 342) de los sueros , y mediante IB en el 14,9 por ciento (51 de 342) y de 14,3//(49 de 342) de los sueros,respectivamente.En 72 pacientes con lupus eritematoso sistémico la sensibilidad y especificidad de la CIE fueron del 19,1//y del 96,5//para anti-RNP,y del 11,1 del del 100//para anti-Sm.La sensibilidad y especificidad del IB fueron del 22,2 y del 96//para anti-RNP 70 kD y del 19,4 y del 100//para anti-SmD. Conclusiones: A pesar de la degradación proteolítica , el IB con un extracto soluble de timo de conejo puede ser una alternativa válida como complemento de la CIE o del ELISA en la detección de anticuerpos anti-RNP y anti-Sm,y está al alcance de cualquier laboratorio clínico.

Asunto(s)

Lupus Eritematoso Sistémico/diagnóstico , Anticuerpos , Contrainmunoelectroforesis

RESUMEN

OBJECTIVE: The immune response to the Ro(SSA) antigen is heterogeneous. Anti-Ro(SSA) positive sera may contain antibodies recognizing either a 60 or a 52 kDa polypeptide component of the Ro(SSA) particle. Thus we sought to determine the profile of anti-Ro(SSA) antibodies defined by immunoblotting in patients with rheumatic diseases. METHODS: Immunoblotting against human placenta extract and ELISA against recombinant Ro(SSA) antigen as confirmatory tests were done to detect anti-Ro(SSA) antibodies in 563 sera from patients with systemic lupus erythematosus (SLE). Sjögren's syndrome (SS), rheumatoid arthritis (RA) and other connective tissue diseases. RESULTS: Anti-52 kDa antibodies were more common in primary patients with SS (9/22; 40.9%) than in patients with SLE (29/135; 21.4%) or patients with RA (7/315; 2.2%). Anti-60 kDa antibodies were more frequent in patients with SLE (26/135; 19.2%) than in patients with primary SS (2/22; 9%) or RA (17/315; 5.3%). None of the 22 patients with primary SS had only antibodies to the 60 kDa polypeptide. Among the 153 patients whose sera were positive by ELISA, 73 (47.7%) were negative by immunoblotting. The most frequent diagnoses in these sera were RA and SLE. The anti-52 kDa sera had higher optical density values compared to anti-60 kDa sera. CONCLUSIONS: Our observations indicate the existence of qualitatively and quantitatively different anti-Ro(SSA) responses in the rheumatic diseases. The major responses are anti-52 kDa antibodies in primary SS, both anti-52 and anti-60 kDa antibodies in SLE, and anti-60 kDa antibodies in RA and other connective tissue diseases.

Asunto(s)

Anticuerpos Antinucleares/sangre , Enfermedades Reumáticas/inmunología , Anticuerpos Antinucleares/inmunología , Estudios de Casos y Controles , Enfermedades del Tejido Conjuntivo/inmunología , Electroforesis en Gel de Poliacrilamida , Ensayo de Inmunoadsorción Enzimática , Humanos , Immunoblotting

RESUMEN

OBJECTIVE: It was the purpose of this study to examine the cause and effect relationship between alterations in peritoneal factors and the presence of ectopic endometrium in the rabbit model. DESIGN: Forty rabbits had autologous endometrial or omental (control) tissue surgically implanted. Peritoneal fluid (PF) volume, macrophage number, and macrophage activation, as well as the number of implants with adhesions, were compared with values obtained during the initial surgery. The effect of hormonal treatment on these factors was evaluated at a third laparotomy. RESULTS: There was a significant increase (P less than 0.05) of adhesions in animals with endometrial implants. Peritoneal fluid volume, macrophage number, or macrophage activation were not increased in rabbits with endometrial implants as compared with controls, nor was there a response to hormonal manipulation. CONCLUSIONS: These results demonstrate that PF volume, macrophage number, and macrophage activation are not altered by endometrial implants in the rabbit model. This suggests that the increase in these peritoneal factors in women with endometriosis may not be caused exclusively by the presence of ectopic endometrial tissue.

Asunto(s)

Líquido Ascítico/inmunología , Endometriosis/inmunología , Activación de Macrófagos , Neoplasias Peritoneales/inmunología , Análisis de Varianza , Animales , Líquido Ascítico/patología , Recuento de Células , Femenino , Conejos

RESUMEN

The decomposition of highly insoluble minerals (fluorspar and cryolite) by fusion with molten alkali-metal hydroxides is studied. The introduction of additives such as aluminium compounds or sodium peroxide to obtain total liberation of fluoride from calcium fluoride samples, is tested. The fusion is done in a silver crucible with a Bunsen burner. The cooled melt is easily soluble, giving solutions suitable for spectrophotometric fluoride determination by the Zr(IV)-fluoride-Erichrome Cyanine R method.