RESUMO
Resumen Introducción la caries dental es una de las enfermedades de mayor prevalencia a escala mundial, cuyas consecuencias clínicas se encuentran relacionadas directamente con la calidad de vida de los individuos. Asimismo, la atención odontológica exige un elevado costo y muchas veces lejos del alcance de ciertas comunidades. Si bien esta enfermedad se produce por la confluencia de distintos factores, uno de ellos es el económico, por lo que se busca una opción medicinal de bajo costo, y el abordaje a su vez de otro factor, tal vez el más importante, que implica el desarrollo y multiplicación del microorganismo iniciador de esta enfermedad, que es Streptococcus mutans. Actualmente se conoce el consumo de medicinas de origen natural para el tratamiento de algunas enfermedades, entre ellas, la caries. El uso y mecanismo de acción de aceites esenciales que impidan el desarrollo de S. mutans en el biofilm dental está siendo investigado. El objetivo de este trabajo es actualizar los conocimientos sobre la acción biocida de aceites esenciales y sus posibles aplicaciones en odontología. Resultados. Los aceites esenciales provenientes de los cítricos como limón, mandarina, naranja, como así también de eucalipto y orégano, presentan actividad bacteriostática, y en algunos casos, bactericida frente a bacterias Gram + y Gram -. Conclusión de acuerdo con la información recopilada, el uso de estos aceites mediante la biotecnología sería beneficioso y contribuiría al manejo de la salud bucal sin alterar la microflora oral normal del ser humano.
Abstract Dental caries is one of the most prevalent diseases worldwide, whose clinical consequences are directly related to the quality of life of individuals. Likewise, dental care requires a high cost and is often beyond the reach of certain communities. Although this disease is produced by the confluence of different factors, one of them is the economic factor, which is why a low-cost medicinal alternative is sought, and the approach in turn of another factor, perhaps the most important, which implies the development and multiplication of the initiating microorganism of this disease that is Streptococcus mutans. Currently, the consumption of medicines of natural origin is known for the treatment of some diseases, including tooth decay. The use of essential oils that prevent the development of St. mutans in dental biofilm is being investigated and the objective of this work is to update the knowledge about its biocidal action and its applications in dentistry. The objective of this work is to update the knowledge on the biocidal action of essential oils and their possible applications in dentistry. Results The essential oils from citrus fruits such as lemon, mandarin, orange, as well as eucalyptus and oregano, show bacteriostatic activity, and in some cases, bactericidal against Gram + and Gram - bacteria. Conclusion according to the information collected, the use of these oils through biotechnology would be beneficial and would contribute to the management of oral health without altering the normal oral microflora of the human being.
Assuntos
Humanos , Streptococcus mutans/efeitos dos fármacos , Óleos/uso terapêutico , Cárie Dentária/tratamento farmacológico , Anti-InfecciososRESUMO
El objetivo de este trabajo fue establecer la relación entre el grado de enfermedad periodontal y el control metabólico de la glucemia en pacientes que padecen diabetes tipo 2. Es un estudio de tipo observacional, descriptivo, transversal. Se seleccionaron 42 pacientes con diagnóstico de diabetes mellitus tipo 2 de ambos sexos, entre 25 y 75. Se realizó odontograma y se evaluó el grado de enfermedad periodontal para determinar el grado de compensación metabólica de los pacientes se tomaron muestras de sangre venosa y se midieron los valores de hemoglobina glicosilada. Un 23,55% de los pacientes no presentaron enfermedad periodontal y el resto se dividió en leve, moderada y severa presentándose la enfermedad leve en primer orden. Los pacientes con mayor grado de enfermedad periodontal presentaron mayor número de piezas dentarias perdidas (p 0,0334). La enfermedad periodontal se distribuye de la misma manera en ambos grupos de control glucémico (p=0,1211). En el grupo estudiado, el grado de enfermedad periodontal es independiente del control glucémico de los pacientes (AU)
The objective of this work was to establish the relationship between the degree of periodontal disease and the metabolic control of glycemia in patients with type 2 diabetes. It is an observational, descriptive, cross-sectional study. 42 patients with a diagnosis of type 2 diabetes mellitus of both sexes, between 25 and 75, were selected. An odontogram was performed and the degree of periodontal disease was evaluated; venous blood samples were taken and glycosylated hemoglobin values were measured to determine the degree of metabolic compensation of the patients. 23.55% of the patients did not present periodontal disease and the rest were divided into mild, moderate, and severe, with mild disease presenting in the first order. The patients with a higher degree of periodontal disease had a higher number of missing teeth (p 0.0334). Periodontal disease is distributed in the same way in both glycemic control groups (p = 0.1211). In the group studied, the degree of periodontal disease is independent of the glycemic control of the patients (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Doenças Periodontais/etiologia , Periodontite/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Argentina/epidemiologia , Índice de Gravidade de Doença , Glicemia , Hemoglobinas Glicadas , Registros Odontológicos , Epidemiologia Descritiva , Estudos Transversais , Perda de Dente/epidemiologia , Distribuição por Sexo , Unidade Hospitalar de Odontologia/estatística & dados numéricos , Estudo ObservacionalRESUMO
RESUMEN Introducción: El síndrome de T3 baja se asocia con niveles elevados de interleucinas y citoquinas circulantes, lo que refuerza la hipótesis de una estrecha relación entre el sistema neuroendocrino y ciertos mecanismos inflamatorios e inmunológicos, involucrados en la insuficiencia cardíaca. Objetivo: Evaluar la evolución de pacientes ingresados por insuficiencia cardíaca descompensada según niveles de T3 al ingreso, y eventos durante la hospitalización y en el seguimiento. Material y métodos: Estudio prospectivo, observacional, analítico de 524 pacientes internados por primera vez con diagnóstico de insuficiencia cardíaca descompensada. Se evaluó la mortalidad intrahospitalaria, y al seguimiento y readmisiones de acuerdo con niveles de T3 normal o disminuida al ingreso. Se excluyeron 91 pacientes con distiroidismo conocido, hipotiroidismo o hipertiroidismo, cirugía tiroidea previa, sepsis o síndrome coronario agudo. Se realizó un análisis de subgrupo de pacientes según recibieran crónicamente amiodarona y se evaluaron variables pronosticas. Resultados: De 433 pacientes analizados, el 40,0% presentaban bajos niveles de T3 (BT3). La edad, albúmina, TFG y edad mayor de 75 años, fueron predictores independientes de BT3. Si bien se observó un aumento en ambos grupos en la adecuación de tratamientos recomendados por las guías, el grupo de BT3 mostró significativamente tasas menores de estos con respecto a aquellos con T3 normal (BT3 vs. NT3: betabloqueantes 81,5% vs. 89,4%, p = 0,02; IECA/ARAII 78,5% vs. 87,9% p <0,001; antialdosterónicos 29,2% vs. 40,5% p = 0,019). La mortalidad hospitalaria fue mayor en BT3 (5,8% vs. 1,5%) sin diferencias en readmisiones o mortalidad en el seguimiento. Del subgrupo de pacientes sin amiodarona al ingreso (353), 37,8% tenían BT3. Se halló que los pacientes de este subgrupo presentaron diferencias significativas en cuanto a mortalidad intrahospitalaria y mortalidad en seguimiento (5,3% en BT3 vs. 0,9% NT3; p = 0,03 y 40,2% vs. 26,6%; p = 0,023), respectivamente. Conclusiones: Los pacientes ingresados por insuficiencia cardíaca descompensada con T3 baja al ingreso representarían un subgrupo de pacientes con enfermedad más grave y peor pronóstico durante la internación.
ABSTRACT Background: Low T3 syndrome is associated with elevated circulating levels of cytokines and interleukins, reinforcing the hypothesis of a close relation between the neuroendocrine system and certain inflammatory and immunological mechanisms involved in heart failure. Objective: To assess the progress of patients admitted for decompensated heart failure according to T3 levels on admission, and events during hospitalization and follow-up. Materials and methods: It was a prospective, observational, analytical study of 524 patients hospitalized for the first time with a diagnosis of decompensated heart failure. In-hospital and follow-up mortality and readmissions were evaluated according to normal or low T3 levels on admission. Ninety-one patients with known dysthyroidism, hypo or hyperthyroidism, previous thyroid surgery, sepsis or acute coronary syndrome were excluded. A subgroup analysis of patients receiving chronic amiodarone therapy was conducted, and prognostic variables were evaluated. Results: Of the 433 patients analyzed, 40.0% had low T3 (LT3) levels. Age, albumin level, age >75 years, and glomerular filtration rate (GFR) were independent predictors of LT3. While adaptation of guideline-recommended treatments increased in both groups, treatment rates in the LT3 group were significantly lower than those in the normal T3 (NT3) group (LT3 vs. NT3: Betablockers 81.5% vs. 89.4%, p=0.02; ACEI/ARA II 78.5% vs. 87.9%, p=0.001; anti-aldosterone agents 29.2% vs. 40.5%; p=0.019). Hospital mortality was higher in the LT3 group (5.8 vs. 1.5%), with no difference in rehospitalizations or mortality rates at follow-up. Of the subgroup of patients without amiodarone on admission (353), 37.8% had LT3. Patients in this subgroup were found to have significant differences in follow-up and in-hospital mortality (5.3% in LT3 vs. 0.9% in NT3, p=0.03, and 40.2% vs. 26.6%, p=0.023) respectively. Conclusions: Decompensated heart failure patients with LT3 on admission would represent a subgroup with more severe disease and worse prognosis during hospitalization.
RESUMO
Introducción la caries dental es una de las enfermedades de mayor prevalencia a escala mundial, cuyas consecuencias clínicas se encuentran relacionadas directamente con la calidad de vida de los individuos. Asimismo, la atención odontológica exige un elevado costo y muchas veces lejos del alcance de ciertas comunidades. Si bien esta enfermedad se produce por la confluencia de distintos factores, uno de ellos es el económico, por lo que se busca una opción medicinal de bajo costo, y el abordaje a su vez de otro factor, tal vez el más importante, que implica el desarrollo y multiplicación del microorganismo iniciador de esta enfermedad, que es Streptococcus mutans. Actualmente se conoce el consumo de medicinas de origen natural para el tratamiento de algunas enfermedades, entre ellas, la caries. El uso y mecanismo de acción de aceites esenciales que impidan el desarrollo de S. mutans en el biofilm dental está siendo investigado. El objetivo de este trabajo es actualizar los conocimientos sobre la acción biocida de aceites esenciales y sus posibles aplicaciones en odontología. Resultados. Los aceites esenciales provenientes de los cítricos como limón, mandarina, naranja, como así también de eucalipto y orégano, presentan actividad bacteriostática, y en algunos casos, bactericida frente a bacterias Gram + y Gram -. Conclusión de acuerdo con la información recopilada, el uso de estos aceites mediante la biotecnología sería beneficioso y contribuiría al manejo de la salud bucal sin alterar la microflora oral normal del ser humano.
Dental caries is one of the most prevalent diseases worldwide, whose clinical consequences are directly related to the quality of life of individuals. Likewise, dental care requires a high cost and is often beyond the reach of certain communities. Although this disease is produced by the confluence of different factors, one of them is the economic factor, which is why a low-cost medicinal alternative is sought, and the approach in turn of another factor, perhaps the most important, which implies the development and multiplication of the initiating microorganism of this disease that is Streptococcus mutans. Currently, the consumption of medicines of natural origin is known for the treatment of some diseases, including tooth decay. The use of essential oils that prevent the development of St. mutans in dental biofilm is being investigated and the objective of this work is to update the knowledge about its biocidal action and its applications in dentistry. The objective of this work is to update the knowledge on the biocidal action of essential oils and their possible applications in dentistry. Results The essential oils from citrus fruits such as lemon, mandarin, orange, as well as eucalyptus and oregano, show bacteriostatic activity, and in some cases, bactericidal against Gram + and Gram - bacteria. Conclusion according to the information collected, the use of these oils through biotechnology would be beneficial and would contribute to the management of oral health without altering the normal oral microflora of the human being.
RESUMO
Malignant melanoma represents the fastest growing public health risk of all cancer types worldwide. Several strategies and anti-cancer drugs have been used in an effort to improve treatments, but the development of resistance to anti-neoplastic drugs remains the major cause of chemotherapy failure in melanomas. Previously, we showed that the sesquiterpene lactone, dehydroleucodine (DhL), promotes the accumulation of DNA damage markers, such as H2AX and 53BP1, in human tumor cells. Also DhL was shown to trigger either cell senescence or apoptosis in a concentration-dependent manner in HeLa and MCF7 cells. Here, we evaluated the effects of DhL on B16F0 mouse melanoma cells in vitro and in a pre-clinical melanoma model. DhL inhibited the proliferation of B16F0 cells by inducing senescence or apoptosis in a concentration-dependent manner. Also, DhL reduced the expression of the cell cycle proteins cyclin D1 and B1 and the inhibitor of apoptosis protein, survivin. In melanomas generated by subcutaneous injection of B16F0 cells into C57/BL6 mice, the treatment with 20 mg DhL /Kg/day in preventive, simultaneous and therapeutic protocols reduced tumor volumes by 70%, 60% and 50%, respectively. DhL treatments reduced the number of proliferating, while increasing the number of senescent and apoptotic tumor cells. To estimate the long-term effects of DhL, a mathematical model was applied to fit experimental data. Extrapolation beyond experimental time points revealed that DhL administration following preventive and therapeutic protocols is predicted to be more effective than simultaneous treatments with DhL in restricting tumor growth.
Assuntos
Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Pontos de Checagem do Ciclo Celular/efeitos dos fármacos , Senescência Celular/efeitos dos fármacos , Lactonas/farmacologia , Melanoma Experimental/tratamento farmacológico , Sesquiterpenos/farmacologia , Carga Tumoral/efeitos dos fármacos , Animais , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Ciclina B1/metabolismo , Ciclina D1/metabolismo , Relação Dose-Resposta a Droga , Feminino , Proteínas Inibidoras de Apoptose/metabolismo , Masculino , Melanoma Experimental/metabolismo , Melanoma Experimental/patologia , Camundongos , Camundongos Endogâmicos C57BL , Modelos Biológicos , Proteínas Repressoras/metabolismo , Transdução de Sinais/efeitos dos fármacos , Survivina , Fatores de TempoRESUMO
Objetivo: describir la incidencia y el pronóstico de la vasculopatía del injerto cardíaco (CAV: cardiac allograft vasculopathy, su sigla en Inglés), de acuerdo con la clasificación propuesta por la Sociedad Internacional de Trasplante de Corazón y Pulmón (ISHLT). Metodología: estudio de cohortes de trasplantados cardíacos, llevado a cabo entre febrero de 2003 y noviembre de 2011 con seguimiento angiográfico; el desenlace principal fue CAV de acuerdo con la ISHLT. Se utilizaron pruebas de chi-cuadrado para variables cualitativas y t de student para las cuantitativas. Se hizo análisis de supervivencia de Kaplan-Meier. Resultados: se incluyeron 118 pacientes; 83,1% fueron hombres con mediana de edad de 46,4 RIQ (38,4-55,6) años. El seguimiento promedio fue de 5 + 4,7 años con 2,4 + 1,6 coronariografías/paciente. La incidencia total de CAV fue de 23,7%; grado 1 (leve) 11,9%, grado 2 (moderada) 7,6% y grado 3 (severa) 4,2%. El único factor con una asociación modesta fue la hipertensión pulmonar con RR 2,54 (1,1-6,1) p=0,05. La mortalidad de los pacientes de acuerdo con el grado de vasculopatía fue: leve 0%; grado 2 (moderada) 42% RR 2,59 IC95% (1,14-5,9) p=0,024; grado 3 (severa) 72% RR 4,44 IC95% (2,27-8,6) p<0,0005. Conclusiones: la incidencia de CAV fue de 23,7%. El único factor modestamente relacionado fue la hipertensión pulmonar. La escala propuesta por la ISHLT se asocia en sus grados 2 y 3 (moderada y severa) con mortalidad importante.
Objective: to describe the incidence and prognosis of cardiac allograft vasculopathy (CAV: cardiac allograft vasculopathy) according to the classification proposed by the International Society for Heart and Lung Transplantation (ISHLT). Methodology: cohort study of heart transplant recipients conducted between February 2003 and November 2011 with angiographic follow-up. The primary outcome was CAV according to the ISHLT. We used chi-square tests for categorical variables and Student t test for quantitative variables. Kaplan-Meier survival analysis was made. Results: 118 patients were included. 83.1% were male with a mean age of 46.4 IQR (38.4 to 55.6) years. The average follow-up was 5 + 4.7 years with 2.4 + 1.6 coronary angiograms / patient. The overall incidence of CAV was 23.7%. Grade 1 (mild) 11.9%, grade 2 (moderate) 7.6% and grade 3 (severe) 4.2%. The only factor with a modest association was pulmonary hypertension with RR 2.54 (1.1 to 6.1) p = 0.05. The mortality of patients according to the degree of vasculopathy was: mild 0%, grade 2 (moderate) 42% RR 2.59 CI 95% (1.14 to 5.9) p = 0.024; Grade 3 (severe) 72 % RR 4.44 95% CI (2.27 to 8.6) p <0.0005. Conclusions: the incidence of CAV was 23.7%. The only factor modestly related was pulmonary hypertension. The scale proposed by the ISHLT is associated in grades 2 and 3 (moderate and severe) with significant mortality.
Assuntos
Incidência , Fatores de Risco , Transplante de Coração , Angiografia , Estudos de Coortes , Angina MicrovascularRESUMO
In the mammalian testis, peritubular myoid cells (PM cells) surround the seminiferous tubules (STs), express cytoskeletal markers of true smooth muscle cells, and participate in the contraction of the ST. It has been claimed that PM cells contain bundles of actin filaments distributed orthogonally in an intermingled mesh. Our hypothesis is that these actin filaments are not forming a random intermingled mesh, but are actually arranged in contractile filaments in independent layers. The aim of this study is to describe the organization of the actin cytoskeleton in PM cells from adult rat testes and its changes during endothelin-1-induced ST contraction. For this purpose, we isolated segments of ST corresponding to the stages IX-X of the spermatogenic cycle (ST segments), and analyzed the actin and myosin filament distribution by confocal and transmission electron microscopy. We found that PM cells have actin and myosin filaments interconnected in thick bundles (AF-MyF bundles). These AF-MyF bundles are distributed in two independent layers: an inner layer toward the seminiferous epithelium, and an outer layer toward the interstitium, with the bundles oriented perpendicularly and in parallel to the main ST axis, respectively. In endothelin-1 contracted ST segments, PM cells increased their thickness and reduced their length in both directions, parallel and perpendicular to the main ST axis. The AF-MyF bundles maintained the same organization in two layers, although both layers appeared significantly thicker. We believe that this is the first time this arrangement of AF-MyF bundles in two independent layers has been shown in smooth muscle cells, and that this organization would allow the cell to generate contractile force in two directions.
Assuntos
Citoesqueleto de Actina/fisiologia , Músculo Liso/citologia , Miosinas/fisiologia , Túbulos Seminíferos/citologia , Animais , Endotelina-1/fisiologia , Masculino , Músculo Liso/fisiologia , Ratos , Túbulos Seminíferos/fisiologiaRESUMO
BACKGROUND: Extended-release (ER) paliperidone is an innovative atypical antipsychotic that allows minimal peak-to-through fluctuations with once-daily dosing. OBJECTIVE: To evaluate effectiveness, safety and tolerability of flexible, once-daily doses of paliperidone ER (3-12 mg/day) in patients with schizophrenia from Argentina and Colombia who had previously failed treatment with other antipsychotic agents. METHODS: The authors conducted a 6-month, open-label, prospective and multicentric study. Effectiveness was assessed with Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance scale (PSP). Other measures of effectiveness, safety and tolerability, were also conducted. RESULTS: Paliperidone ER 3-12 mg/day improved Positive and Negative Syndrome Scale (PANSS) total scores (primary endpoint) from baseline to study end (p < 0,001). In the PANSS total score, the mean change from baseline (83, 9 units) to end point (53,7 units) was significant (p < 0,001). Flexible doses of paliperidone ER demonstrated a ≥20% reduction in the PANSS total score (p<0.001) in almost two-thirds of patients. PSP mean change from baseline (52 units) to end point (85 units) was significant (p < 0,001). Secondary effectiveness assessments, as well as safety and tolerability measures, demonstrated favourable results throughout the study. CONCLUSIONS: Flexible doses of paliperidone ER over 6 months were effective, safe and well tolerated in patients with schizophrenia from Argentina and Colombia.
RESUMO
In the mammalian testis, peritubular myoid cells (PMCs) surround seminiferous tubules. These cells are contractile, express the cytoskeletal markers of true smooth muscle-alpha-isoactin and F-actin-and participate in the contraction of seminiferous tubules during the transport of spermatozoa and testicular fluid to the rete testis. Myosin from PMCs (PMC-myosin) was isolated from adult rat testis and purified by cycles of assembly-disassembly and sucrose gradient centrifugation. PMC-myosin was recognized by a monoclonal anti-smooth muscle myosin antibody, and the peptide sequence shared partial homology with rat smooth muscle myosin-II, MYH11 (also known as SMM-II). Most PMC-myosin (95%) was soluble in the PMC cytosol, and purified PMC-myosin did not assemble into filaments in the in vitro salt dialysis assay at 4 degrees C, but did at 20 degrees C. PMC-myosin filaments are stable to ionic strength to the same degree as gizzard MYH11 filaments, but PMC-myosin filaments were more unstable in the presence of ATP. When PMCs were induced to contract by endothelin 1, a fraction of the PMC-myosin was found to be involved in the contraction. From these results we infer that PMCs express an isoform of smooth muscle myosin-II that is characterized by solubility at physiological ionic strength, a requirement for high temperature to assemble into filaments in vitro, and instability at low ATP concentrations. PMC-myosin is part of the PMC contraction apparatus when PMCs are stimulated with endothelin 1.
Assuntos
Cadeias Pesadas de Miosina/química , Testículo/metabolismo , Adenosina Trifosfatases/metabolismo , Fosfatase Alcalina/metabolismo , Sequência de Aminoácidos , Animais , Western Blotting , Separação Celular , Eletroforese em Gel de Poliacrilamida , Masculino , Dados de Sequência Molecular , Cadeias Pesadas de Miosina/biossíntese , Mapeamento de Peptídeos , Peptídeos/química , Ratos , Ratos Wistar , Túbulos Seminíferos/fisiologia , Coloração pela Prata , Solubilidade , Cordão Espermático/fisiologia , Testículo/citologia , Tripsina/química , Túnica Íntima/fisiologiaRESUMO
Generalidades: la enfermedad del tronco común izquierdo como único criterio para la colocación de balón de contra-pulsación aórtica, es una indicación cuya evidencia se limita a la recomendación de expertos y, por lo tanto, se requieren estudios que puedan aportar mayor nivel de evidencia al respecto. Por este motivo, en nuestra institución se desarrolló un estudio que evaluó la experiencia del uso de balón de contra-pulsación aórtica preoperatorio, en pacientes sometidos a cirugía de revascularización cardiaca electiva, con enfermedad del tronco común izquierdo.Objetivo: describir la letalidad, el tiempo de estancia y el porcentaje de infecciones y sepsis en la unidad de cuidados intensivos, así como el tiempo de ventilación mecánica, en los pacientes sometidos a cirugía de revascularización coronaria electiva con y sin el uso preoperatorio de balón de contra pulsación aórtica.Métodos: estudio descriptivo retrospectivo, que se llevó a cabo en la Clínica Cardiovascular Santa María, con los pacientes que se sometieron a revascularización coronaria quirúrgica electiva acompañados o no de balón de contra-pulsación aórtica preoperatorio entre 1999 y 2003, y en el que se observó el comportamiento post-operatorio de los pacientes con enfermedad severa del tronco común izquierdo (entendida como estenosis mayor de 50 porciento) sometidos a dicha intervención.Resultados: se analizaron en total 79 pacientes sometidos a revascularización quirúrgica electiva, a 46 de los cuales se les implantó balón preoperatorio y a 33 se les practicó intervención quirúrgica sin balón. El promedio de edad fue de 62 años. El 67,4 porciento de los pacientes tenía 60 años o más.
Assuntos
Doença das Coronárias , Vasos Coronários , Balão Intra-Aórtico , Cirurgia TorácicaRESUMO
BACKGROUND: The meaning and clinical implications of the Quilty effect (QE) are not entirely clear. In some biopsies we have found complement split C4d deposition in QE areas, but we do fully comprehend the frequency or pathogenic relationships involved. The objective of this study was to gain insight into the immunologic events involved in the QE, and to understand if and how it relates to complement activation. METHODS: Protocol allograft biopsies (January to December 2005) with evidence of the QE, without cellular rejection or changes suspicious for antibody-mediated rejection, were selected for C4d, CD3, CD20 and CD68 immunohistochemistry. RESULTS: Among 128 allograft biopsies (42 patients), 17 (11 patients) fulfilled the inclusion criteria. Eleven of the 17 biopsies (64.7%), from 8 patients, showed C4d deposition in the endocardium; the positivity was interestingly linear in the endocardium and surrounded by the lymphocytes forming the Quilty lesion. In some cases, the linear C4d deposition extended to the endocardium surrounding the QE area. This pattern was not detected in any of 66 heart allograft biopsies without the QE. B cells were second to T cells in their contribution to the QE, comprising a median of 40% (range, 20% to 50%) of the cells. C4d deposition was not associated with clinical alterations. CONCLUSIONS: The QE is frequently associated with C4d deposition in the endocardium of patients without evidence of rejection. This event suggests a pathogenic relationship between the QE and complement activation. It is possible that the simultaneous presence of both features in an allograft heart biopsy, without evidence of rejection, indicates better adaptation of allograft to host ("accommodation"); however, the precise meaning and implications are not yet known.
Assuntos
Complemento C4b/análise , Endocárdio/imunologia , Rejeição de Enxerto/imunologia , Transplante de Coração/imunologia , Miocárdio/imunologia , Fragmentos de Peptídeos/análise , Antígenos CD , Antígenos CD20 , Antígenos de Diferenciação Mielomonocítica , Complexo CD3/análise , Endocárdio/patologia , Feminino , Rejeição de Enxerto/patologia , Transplante de Coração/patologia , Humanos , Imunoquímica , Masculino , Miocárdio/patologia , Estudos Retrospectivos , Transplante HomólogoRESUMO
BACKGROUND: Azinphos-methyl is the main insecticide used to control codling moth on apple and pears in Northern Patagonia. The aim of this study was to evaluate the toxicological and biochemical response of diapausing larvae of codling moth in orchards subjected to different insecticide selection pressure. RESULTS: Dose-mortality assays with azinphos-methyl in diapausing larvae of Cydia pomonella L. showed significant differences between the LD(95) from a population collected in one untreated orchard (2.52 microg moth(-1)) compared with that in a laboratory-susceptible population (0.33 microg moth(-1)). Toxicity to azinphos-methyl in field populations of diapausing larvae collected during 2003-2005 was evaluated by topical application of a discriminating dose (2.5 microg moth(-1)) that was obtained from larvae collected in the untreated orchard (field reference strain). Significantly lower mortality (37.71-84.21%) was observed in three out of eight field populations compared with that in the field reference strain. Most of the field populations showed higher esterase activity than that determined in both the laboratory susceptible and the field reference strains. Moreover, there was a high association between esterase activity and mortality (R(2)=0.64) among the field populations. On the other hand, a poor correlation was observed between glutathione S-transferase activity and mortality (R(2)=0.33) among larvae collected from different orchards. CONCLUSIONS: All the field populations evaluated exhibited some degree of azinphos-methyl tolerance in relation to the laboratory susceptible strain. Biochemical results demonstrated that esterases are at least one of the principal mechanisms involved in tolerance to this insecticide.
Assuntos
Azinfos-Metil/farmacologia , Controle de Insetos , Inseticidas/farmacologia , Mariposas/efeitos dos fármacos , Mariposas/enzimologia , Animais , Argentina , Esterases/metabolismo , Glutationa Transferase/metabolismo , Proteínas de Insetos/metabolismo , Larva/efeitos dos fármacos , Larva/enzimologia , Dose Letal MedianaRESUMO
Después de 20 años de experiencia y de 193 trasplantes cardiacos realizados, utilizando el modelo de riesgos proporcionales de Cox, fue posible evaluar las diferentes variables de riesgo, tanto pre como intra y post-operatorias, para construir un modelo de riesgo para la población sometida al procedimiento quirúrgico. Para determinar la significancia de cada una de las variables, se utilizó la ecuación de Breslow.Las variables identificadas como de riesgo fueron: enfermedad ácido-péptica, falla hepática, historia de tabaquismo, cirugía previa que comprometiera el pericardio, tiempo de ventilación prolongado, técnica quirúrgica de implantación, edad, sangrado asociado con anticoagulación y tiempo de inicio de la ciclosporina. Finalmente, las variables incluidas en el modelo de Cox fueron: presencia de enfermedad hepática, edad y tiempo de ventilación (mayor o igual a 48 horas)...
Assuntos
Transplante de Coração , Risco , SobrevidaRESUMO
Resumen: Aún cuando los resultados obtenidos en el área de trasplante cardíaco han evolucionado favorablemente durante los últimos años, existen necesidades médicas pendientes cuya resolución beneficiará a los pacientes en el futuro. Algunos de los problemas por resolver son: la vasculopatía del injerto, la insuficiencia renal crónica, la infección por citomegalovirus (CMV) y el rechazo agudo con compromiso hemodinámico. El everolimus es una nueva opción en la terapia inmunosupresora adyuvante; se trata de un fármaco inhibidor del mTOR, que básicamente ofrece un perfil farmacocinético diferente del de su predecesor: el sirolimus. Asimismo, el everolimus es el único fármaco adyuvante con el que se ha comprobado una mayor eficacia en la profilaxis del rechazo agudo, al menos en episodios de grado 3 A de la ISHLT (International Society of Heart and Lung Transplantation) (p<0,001), en la prevención de la vasculopatía del injerto (p<0,01) y en la incidencia de infección por CMV (p<0,01). Dado que la vasculopatía del injerto es el principal factor de riesgo de mortalidad después del primer año del trasplante y que el rechazo agudo y la infección por CMV desempeñan un papel fundamental en su desarrollo, estos hallazgos sugieren que el everolimus desempeñaría un papel importante como parte de la terapia primaria de inmunosupresión en los receptores de trasplante cardíaco. En junio de 2005, se celebraron en Bariloche (Argentina) las Jornadas Latinoamericanas de Consenso sobre el uso de everolimus en el trasplante cardíaco. Allí se reunieron destacados profesionales de la región para evaluar los datos disponibles y establecer, sobre la base de éstos y de su propia experiencia, lineamientos para el uso del everolimus en la práctica diaria.
Assuntos
Humanos , Transplante de Coração , Consenso , EverolimoRESUMO
Patients' opinions concerning the use of preimplantation genetic diagnosis were evaluated in a fertility clinic with a specially designed questionnaire. The results of this study suggest that for couples with fertility problems, an embryo with severe genetic abnormalities has a different moral status than a healthy one.
Assuntos
Diagnóstico Pré-Implantação/psicologia , Inquéritos e Questionários , Aborto Induzido/ética , Aborto Induzido/psicologia , Argentina , Feminino , Nível de Saúde , Humanos , GravidezRESUMO
BACKGROUND: Cytokines are important modulators of post-transplant, allogeneic immune responses. In heart transplantation, endomyocardial biopsies allow monitoring of histologic and immunologic events that occur inside the graft; their correlation with risk factors condition graft outcome. Recent reports indicate that various cytokine gene allelic polymorphisms control the number of cytokines produced and may be associated with graft outcome. METHODS: We studied 71 heart transplant recipients between December 1985 and December 2000. We used sequence-specific primers (SSP) polymerase chain reaction to study interleukin-10 (IL-10) polymorphisms at -1082 (G/A), -819 (C/T), and -592 (C/A); tumor necrosis factor alpha (TNF-alpha) at -308 (G/A) and -238 (G/A); transforming growth factor beta (TGF-beta) variants at codon 10 (C/T) and codon 25 (G/C); and interferon-gamma (IFN-gamma) polymorphisms at +874 (T/A). We determined the association of allele, genotype, and haplotype frequencies with the presence of histologically proven rejection episodes (according to International Society for Heart and Lung Transplantation criteria) and the presence of Quilty lesions in endomyocardial biopsy specimens. RESULTS: We found no association between the polymorphisms studied and the frequency and severity of acute and chronic rejection episodes. However, the gene frequency of allele A at IL-10 -1082, associated with decreased IL-10 production, was increased in patients with Quilty lesions (p = 0.0027, odds ratio = 2.98). Similarly, we found more AA homozygous individuals, compared with AG heterozygous and GG homozygous individuals (p = 0.0017), among patients with Quilty effect. The ATA and ACC IL-10 haplotypes also were associated with Quilty effect (p = 0.0051). CONCLUSIONS: These results suggest that genetically controlled decreased IL-10 production predisposes to the development of Quilty lesions. The decreased negative regulatory effect of IL-10 on T cells and macrophages may result in enhanced graft infiltration.
Assuntos
Rejeição de Enxerto/genética , Rejeição de Enxerto/patologia , Interferon gama/genética , Interleucina-10/genética , Polimorfismo Genético/genética , Fator de Crescimento Transformador alfa/genética , Fator de Crescimento Transformador beta/genética , Adolescente , Adulto , Idoso , Criança , Feminino , Rejeição de Enxerto/imunologia , Transplante de Coração/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Miocárdio/imunologia , Miocárdio/patologiaRESUMO
We describe the case of a diabetic patient who developed a severe invasive fungal infection due to Rhizopus species postoperatively after a dual heart/kidney transplantation with subsequent intensive immunosuppressive therapy. No improvement was noted with amphotericin B (deoxycholate) therapy, but salvage treatment with the new azole antifungal posaconazole (200 mg orally 4 times daily) resulted in dramatic clinical improvement as early as 1 week after the initiation of therapy that continued through 23 weeks of treatment, with marked clinical, mycological, and radiological improvements and no adverse events.