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1.
Sci Rep ; 13(1): 3650, 2023 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-36871048

RESUMO

Degradation of pollutants in aqueous medium is of high interest due to the impact on environment and human health, therefore, design and study of the physico-chemical properties of photocatalysts for water remediation are of major significance. Among properties of photocatalyst, those related to the surface and electrical mechanism are crucial to the photocatalyst´s performance. Here we report the chemical and morphological characteristics of TiO2@zeolite photocatalyst by X-ray photoelectron spectroscopy (XPS) and scanning electron microscopy (SEM) respectively, and a coherent electrical conduction mechanism was proposed based on data obtained from assisted laser impedance spectroscopy (ALIS), in which the zeolite was synthesized from recycled coal fly ash. The results obtained by SEM and XPS verified the presence of spherical particles of TiO2 anatase with presence of Ti3+ state. ALIS results showed that impedance of the entire system increases when the amount of TiO2 increases and the samples with lower capacitive performance allowed a larger transfer of the charges between the solid-liquid interface. All results showed that higher photocatalytic performance of TiO2 growth over hydroxysodalite with 8.7 wt% and 25 wt% of TiO2 can be explained in terms of the morphology of TiO2 and the interactions between substrate-TiO2 mainly.

3.
Epidemiol Infect ; 147: e311, 2019 11 29.
Artigo em Inglês | MEDLINE | ID: mdl-31779718

RESUMO

Among the different existing types of bacterial meningitis, the one caused by Neisseria meningitidis is the main presentation of invasive meningococcal disease (IMD). IMD is a significant public health concern and has a reported incidence rate in Argentina of 0.44 cases per 100 000 inhabitants in 2015. However, the actual incidence is thought to be higher as passive surveillance systems neither report nor identify 100% of all cases. The aim of this study is to develop an estimation of the burden of IMD in Argentina closer to reality by adjusting/correcting several limitations observed in the surveillance data available. A retrospective observational study has been performed using four Argentinean national databases recording the number of IMD cases and deaths, serogroups of N. meningitidis and ages, between 2007 to 2016. The reported data were adjusted to account for underreporting and to also integrate the cases missed due to well-known limitations associated with the diagnosis of N. meningitidis detection methods. Data were further analysed by serogroups of N. meningitidis and by age groups. After these adjustments, the potential numbers of IMD cases and IMD-related deaths are estimated to be 3.1 and 1.9 higher than reported, respectively. The study corrects the previous underestimation of the disease burden and provides expectedly more robust estimates aligned with international evidence and highlights the importance of active surveillance, with high-quality methods, for a better definition of preventive strategies against IMD in Argentina.


Assuntos
Meningite Meningocócica/epidemiologia , Vigilância em Saúde Pública/métodos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Criança , Pré-Escolar , Bases de Dados Factuais , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Meningite Meningocócica/diagnóstico , Pessoa de Meia-Idade , Estudos Retrospectivos , Análise de Sobrevida , Adulto Jovem
4.
Epidemiol Infect ; 147: e308, 2019 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-31771674

RESUMO

Rotavirus (RV) is the main cause of acute gastroenteritis (AGE) in young children. The San Luis province of Argentina introduced RV vaccination in May 2013. We estimate vaccine impact (RVI) using real-world data. Data on all-cause AGE cases and AGE-related hospitalisations for San Luis and the adjacent Mendoza province (control group) were obtained and analysed by interrupted time-series methods. Regardless of the model used for counterfactual predictions, we estimated a reduction in the number of all-cause AGE cases of 20-25% and a reduction in AGE-related hospitalisations of 55-60%. The vaccine impact was similar for each age group considered (<1 year, <2 years and <5 years). RV vaccination was estimated to have reduced direct medical costs in the province by about 4.5 million pesos from May 2013 to December 2014. Similar to previous studies, we found a higher impact of RV vaccination in preventing severe all-cause AGE cases requiring hospitalisation than in preventing all-cases AGE cases presenting for medical care. An assessment of the economic value of RV vaccination could take other benefits into account in addition to the avoided medical costs and the costs of vaccination.


Assuntos
Gastroenterite/prevenção & controle , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus , Doença Aguda , Argentina/epidemiologia , Pré-Escolar , Análise Custo-Benefício , Feminino , Gastroenterite/economia , Gastroenterite/epidemiologia , Gastroenterite/virologia , Custos de Cuidados de Saúde/estatística & dados numéricos , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Infecções por Rotavirus/economia , Infecções por Rotavirus/epidemiologia , Vacinas contra Rotavirus/economia , Resultado do Tratamento , Vacinação/economia
5.
Acta Ortop Mex ; 33(3): 173-181, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-32246610

RESUMO

INTRODUCTION: It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico. MATERIAL AND METHODS: Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs. RESULTS: 1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year. CONCLUSIONS: The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and 90% without regular scientific production.


INTRODUCCIÓN: Es fundamental que los médicos residentes de ortopedia (traumatología) sean altamente competentes en todos los aspectos, considerando el equilibrio entre la oferta, demanda, necesidad y contexto. Es primordial identificar la capacidad y calidad instalada para su formación en México. MATERIAL Y MÉTODOS: Estudio observacional, transversal, muestreo no probabilístico-conglomerados, en dos fases. El instrumento tiene ocho dominios, 57 variables y 4,867 ítems. Sesenta profesores de postgrado de 20 estados, 50 sedes hospitalarias, 22 programas universitarios. RESULTADOS: 1,038 años de experiencia (inteligencia colectiva), 17 años de experiencia/profesor (01 a 50 años). Se identificó: patología aguda 30 (2 a 90%), patología crónica 30 (5 a 96%), pacientes 15 años, 10 (3 a 30%), pacientes entre 15 y 65 años, 47 (2 a 78%), pacientes 65 años, 20 (2 a 60%), número de camas/sede 20 (2 a 510), número de consultorios 3 (1 a 48), el número de procedimientos quirúrgicos/sede al año a nivel nacional fue de 960 (50 a 24,650). La media nacional por médico residente es de 362 cirugías/año con 1,450 momentos quirúrgicos/año. CONCLUSIONES: Las necesidades y recursos para la formación de médicos especialistas en ortopedia/traumatología son en alto grado heterogéneos, por lo cual se debería adaptar a las necesidades epidemiológicas de la región de influencia, en un ámbito de transición epidemiológica. Sesenta y dos punto dos por ciento expresó no tener o tener deficiente infraestructura académica y científica en su sede, más de 50% sin rotación al extranjero y 90% sin producción científica regular.


Assuntos
Internato e Residência , Procedimentos Ortopédicos , Ortopedia , Humanos , México , Inquéritos e Questionários
6.
Acta Ortop Mex ; 32(4): 203-208, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30549503

RESUMO

OBJECTIVE: To compare results of Plate-Graff, Plate-Cage and PEEK cage in patients with cervical stenosis. MATERIAL AND METHODS: Prospective, with before and after intervention and comparative study. From January 2005 to October 2011 we included 37 patients (male: 48.6%, female: 51.4%) post-surgery by anterior approach; 3 groups via: Group I, arthrodesis with Plate-Graff n = 12 (M 41.7%, F 58.3%) with 22 levels, group II, Plate-Cage n = 11 (M 63.6% 36.4% F) 19 levels, group III, PEEK cage, n = 14 (M 0% F 50%) with 25 levels. Functional assessment pre- and postoperative with neck disability index (NDI) and visual analogue scale for pain (VAS). The radiological assessment with X-rays only. Descriptive statistics were obtained. Wilcoxon method use according to data distribution, non parametric tests of ranges with sign of Kruskal-Wallis for comparison between more than two groups, and significance level with p 0.05. We used the statistical package SPSS version 15. RESULTS: The majority of patients was found between the sixth and eighth decade of life. At one year of follow up the NDI and pain with VAS shown improvement with statistical difference in three groups (p = 0.001). However, the radiographic measurements per year of follow-up showed a significant improvement of segmental lordosis (p = 0.02) only in patients with Plate-Graff. CONCLUSIONS: Using the graft offers best clinical and radiographic results compared with the Plate Cage and box peek to one year of follow-up.


OBJETIVO: Comparar resultados de placa-injerto, caja-placa y caja-PEEK, en pacientes con conducto cervical estrecho. MATERIAL Y MÉTODOS: Estudio prospectivo, en panel antes y después, de intervención y comparativo. De Enero de 2005 a Octubre de 2011, muestra de 37 pacientes (masculino: 48.6%, femenino: 51.4%) postoperados por vía anterior; formando tres grupos: grupo I, artrodesis con placa-injerto n = 12 (M 41.7%, F 58.3%) con 22 niveles; grupo II, caja-placa n = 11 (M 63.6%, F 36.4%) con 19 niveles; grupo III, caja-PEEK, n = 14 (M 50%, F 50%) con 25 niveles. La evaluación funcional pre- y postoperatoria mediante la escala de discapacidad cervical y escala visual análoga de dolor. La evaluación radiológica con radiografías de columna cervical. Se obtuvo estadística descriptiva. De acuerdo con la distribución de los datos se usaron pruebas no paramétricas de rangos con signo de Wilcoxon, y Kruskal-Wallis para comparación entre más de dos grupos. Con nivel de significancia de p0.05. Se utilizó el paquete estadístico SPSS versión 15. RESULTADOS: La mayoría de los pacientes se encontró entre la sexta y octava década de la vida. Al año de postoperados el índice de discapacidad cervical y mejoría del dolor con EVA mostraron mejoría con diferencia estadística en los tres grupos (p = 0.001). Sin embargo, las mediciones radiográficas al año de seguimiento mostraron una mejoría significativa de la lordosis segmentaria (p = 0.02) sólo en pacientes operados con placa-injerto. CONCLUSIONES: El uso de la placa-injerto ofrece mejores resultados clínicos y radiográficos en comparación con la caja-placa y caja-PEEK, al año de seguimiento.


Assuntos
Discotomia , Cetonas , Polietilenoglicóis , Fusão Vertebral , Benzofenonas , Vértebras Cervicais , Discotomia/instrumentação , Feminino , Humanos , Masculino , Polímeros , Estudos Prospectivos , Estudos Retrospectivos , Fusão Vertebral/instrumentação , Resultado do Tratamento
7.
Clin Exp Immunol ; 191(2): 229-239, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28963724

RESUMO

Itolizumab is a humanized anti-CD6 monoclonal antibody (mAb) that has previously shown encouraging results, in terms of safety and positive clinical effects, in a 6-week monotherapy clinical trial conducted in rheumatoid arthritis (RA) patients. The current Phase I study evaluated the safety and clinical response for a longer treatment of 12 itolizumab intravenous doses in subjects with active RA despite previous disease-modifying anti-rheumatic drug (DMARD) therapy. Twenty-one subjects were enrolled into four dosage groups (0·1, 0·2, 0·4 and 0·8 mg/kg). Efficacy end-points including American College of Rheumatology (ACR)20, ACR50 and ACR70 response rates and disease activity score in 28 joints (DAS28) were monitored at baseline and at specific time-points during a 10-week follow-up period. Itolizumab was well tolerated up to the highest tested dose. No related serious adverse events were reported and most adverse events were mild. Remarkably, itolizumab treatment did not produce lymphopenia and, therefore, was not associated with infections. All patients achieved a clinical response (ACR20) at least once during the study. Eleven subjects (55%) achieved at least a 20% improvement in ACR just 1 week after the first itolizumab administration. The clinical response was observed from the beginning of the treatment and was sustained during 24 weeks. The efficacy profile of this 12-week treatment was similar to that of the previous study (6-week treatment). These results reinforce the safety profile of itolizumab and provide further evidence on the clinical benefit from the use of this anti-CD6 mAb in RA patients.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Adolescente , Adulto , Idoso , Antígenos CD/imunologia , Antígenos de Diferenciação de Linfócitos T/imunologia , Cuba , Progressão da Doença , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Feminino , Seguimentos , Humanos , Linfopenia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
Acta Ortop Mex ; 29(1): 28-33, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-26999923

RESUMO

INTRODUCTION: A variety of systems have been developed to fix and perform arthrodesis of the cervical spine, with the advantages of reducing the risk of pseudoarthrosis, extrusion and graft collapse and achieving a more precise sagittal alignment. We therefore need to compare the results of the following approaches to patients with cervical stenosis: plate-graft, cage-plate and PEEK cage. MATERIAL AND METHODS: Prospective, interventional, comparative trial involving three groups: group I, arthrodesis with plate-graft; group II, cage-plate, and group III, PEEK cage. The pre- and postoperative assessments included the cervical disability scale, the pain visual analog scale (VAS), and cervical spine X-rays. The results were analyzed with non-parametric tests such as the Wilcoxon sign test and the Kruskal-Wallis test for the comparison of more than two groups. Significance level was 0.05. RESULTS: The sample included a total of 37 patients: n = 12 in group I, with 22 levels; n = 11 in group II, with 19 levels, and n = 14 in group III, with 25 levels. Patient age ranged between 60 and 80. One year after surgery there was an improvement in cervical disability and the pain VAS score, with a statistically significant difference among the three groups (p = 0.001). However, radiographic measurements at that time showed a significant improvement in segmental lordosis (p = 0.02) only in plate-graft patients. CONCLUSIONS: The plate-graft approach provides better clinical and radiographic results compared to the cage-plate and PEEK cage techniques, at the one-year follow- up.


Assuntos
Vértebras Cervicais/cirurgia , Pseudoartrose/prevenção & controle , Fusão Vertebral/métodos , Estenose Espinal/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Vértebras Cervicais/patologia , Avaliação da Deficiência , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Medição da Dor , Estudos Prospectivos , Estenose Espinal/patologia
9.
Bratisl Lek Listy ; 115(9): 579-84, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25318919

RESUMO

AIMS: The aim of this work is to identify cardiovascular risk factors in a population of ethnic Gypsy diagnosed with type 2 diabetes mellitus (T2DM) and to compare this population with a control group of non-Gypsy patients also diagnosed with T2DM and with a similar sociological background. DESIGN: Observational descriptive cross-cutting study. METHODS: Using a systematic random sampling, we selected a sample of 220 Gypsy patients diagnosed with T2DM and another sample of 230 non-Gypsy patients, also diagnosed with T2DM. Both samples were composed of patients registered at the Almanjáyar and Cartuja health centres, in Granada (Spain). The data were collected between October 2010 and October 2011. RESULTS: There were statistically significant differences between the Gypsy and non-Gypsy patients in the following variables concerning the control of cardiovascular risk: systolic blood pressure, diastolic blood pressure, HDL cholesterol, triglycerides and cardiovascular risk. CONCLUSIONS: The factors of cardiovascular risk presented by Gypsy patients diagnosed with T2DM were more acute than those of non-Gypsy patients (Tab. 7, Ref. 26).


Assuntos
Doenças Cardiovasculares/etnologia , Diabetes Mellitus Tipo 2/etnologia , Roma (Grupo Étnico) , Adulto , Idoso , Doenças Cardiovasculares/metabolismo , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Espanha
10.
Rev Neurol ; 59(6): 249-54, 2014 Sep 16.
Artigo em Espanhol | MEDLINE | ID: mdl-25190337

RESUMO

INTRODUCTION. Pharmacological treatment is the first therapeutic step towards controlling pain in trigeminal neuralgia, but 25-50% of patients become medication resistant. There are currently several surgical alternatives for treating these patients. AIM. To evaluate the effectiveness and safety of stereotactic radiosurgery for the treatment of patients with trigeminal neuralgia. PATIENTS AND METHODS. A follow-up study was conducted on 30 patients who underwent radiosurgery using a Novalis linear accelerator. Eighty per cent of the dosage was calculated at the isocentre, the entry zone of the root of the trigeminal nerve. The mean follow-up time was 27.5 months (range: 1-65 months). RESULTS. The mean age was 66 years (range: 36-87 years), with a time to progression of 7.1 years (range: 4-27 years). The distribution of the pain was from the right side (63.3%). Of the 30 patients, 27 experienced an improvement (90%) 1.6 months (range: 1 week-4 months) after the treatment; 10 patients (33.3%) scored grade I, and 17 patients (56.6%) obtained a score of grade II. During the follow-up, four patients (14.2%) suffered a relapse; two underwent re-irradiation. Time without recurrence was 62.7 months (range: 54.6-70.8 months). The rate of side effects was 76.7% and only three patients developed facial anaesthesia with loss of the corneal reflex. CONCLUSIONS. The use of the linear accelerator is an effective therapeutic option in the treatment of trigeminal neuralgia, since it provides adequate long-term control of the pain, reduces the use of medication and improves the quality of life.


TITLE: Radiocirugia estereotactica con acelerador lineal para el tratamiento de la neuralgia trigeminal. Experiencia de nueve años en una sola institucion.Introduccion. El tratamiento farmacologico constituye el primer escalon terapeutico para el control del dolor en la neuralgia del trigemino, pero entre el 25-50% de los pacientes se hace farmacorresistente. Actualmente existen varias alternativas quirurgicas para tratar a estos pacientes. Objetivo. Evaluar la efectividad y seguridad de la radiocirugia estereotactica para el tratamiento de pacientes con neuralgia del trigemino. Pacientes y metodos. Se dio seguimiento a 30 pacientes que se sometieron a radiocirugia con acelerador lineal Novalis. Se calculo el 80% de la dosis en el isocentro, la zona de raiz de entrada del nervio trigemino. El tiempo medio de seguimiento fue de 27,5 meses (rango: 1-65 meses). Resultados. La edad media fue de 66 años (rango: 36-87 años), con un tiempo de evolucion de 7,1 años (rango: 4-27 años). La distribucion del dolor fue del lado derecho (63,3%). De los 30 pacientes, 27 tuvieron mejoria (90%) 1,6 meses (rango: 1 semana-4 meses) despues del tratamiento; 10 pacientes (33,3%) tuvieron una valoracion de grado I y 17 pacientes (56,6%) una valoracion de grado II. Durante el seguimiento, cuatro pacientes (14,2%) tuvieron recidiva; dos se sometieron a reirradiacion. El tiempo sin recurrencia fue de 62,7 meses (rango: 54,6-70,8 meses). La tasa de efectos secundarios fue del 76,7%, y solo tres pacientes desarrollaron anestesia facial con perdida del reflejo corneal. Conclusiones. El uso del acelerador lineal es una opcion terapeutica efectiva en el tratamiento de la neuralgia del trigemino, proporciona a largo plazo adecuado control del dolor, reduce el uso de medicamentos y mejora la calidad de vida.


Assuntos
Aceleradores de Partículas , Radiocirurgia/instrumentação , Neuralgia do Trigêmeo/cirurgia , Academias e Institutos/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Piscadela/efeitos da radiação , Feminino , Seguimentos , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Qualidade de Vida , Lesões por Radiação/etiologia , Radiocirurgia/efeitos adversos , Radiocirurgia/estatística & dados numéricos , Recidiva , Reflexo Anormal , Estudos Retrospectivos , Transtornos de Sensação/etiologia , Zumbido/etiologia , Resultado do Tratamento , Neuralgia do Trigêmeo/epidemiologia , Neuralgia do Trigêmeo/psicologia
13.
Food Chem ; 141(3): 1860-4, 2013 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-23870902

RESUMO

Electron spin resonance (ESR) spectra of irradiated gum Arabic with doses between 0.5 and 5 kGy were studied. A linear relationship between the absorbed dose and the intensities of the ESR spectra was observed. ESR spectra of irradiated gum Arabic showed a decay of relative concentrations of free radicals originated by radiation and the production of at least two species of free radicals with half-times: 3.3 and 125.4 h. The results of spectral simulations for these radical groups were giso=2.0046; A=1.2 mT and gx=gy=2.0062, gz=2.0025. Hydration and dehydration of irradiated gum Arabic returns the ESR spectrum to its initial state before irradiation. The results show that ESR can be used as simple and reliable method to detect irradiated gum Arabic up to 60 days after initial radiation with doses on the order of 5 kGy.


Assuntos
Espectroscopia de Ressonância de Spin Eletrônica/métodos , Goma Arábica/química , Radicais Livres/química , Raios gama , Goma Arábica/efeitos da radiação , Cinética
14.
Mult Scler ; 19(2): 145-52, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22492129

RESUMO

A very high prevalence of multiple sclerosis (MS) has been reported in some Western European and North American countries. The few surveys of MS epidemiology in South America reveal lower prevalence rates, implying that susceptibility varies between distinct ethnic groups, thus forming an important determinant of the geographic distribution of the disease. The objective of this study is to review MS prevalence estimates in different Latin American and Caribbean countries. We reviewed surveys of regional MS prevalence from 1991 to 2011. Sources included an online database, authors' reports and proceedings or specific lectures from regional conferences. We obtained a total of 30 prevalence surveys from 15 countries, showing low/medium MS prevalence rates. Both the number and the quality of prevalence surveys have greatly improved in this region over recent decades. This is the first collaborative study to map the regional frequency of MS. Establishment of standardized methods and joint epidemiological studies will advance future MS research in Latin America and the Caribbean.


Assuntos
Esclerose Múltipla/epidemiologia , Região do Caribe/epidemiologia , Coleta de Dados , Notificação de Doenças , Etnicidade , Geografia , Humanos , América Latina/epidemiologia , Prevalência , América do Sul/epidemiologia , Raios Ultravioleta
15.
Eur J Neurol ; 19(6): 812-9, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22040258

RESUMO

BACKGROUND AND PURPOSE: Numerous case series have demonstrated that lesions on brain MRI are common in neuromyelitis optica (NMO), but there has not been an attempt to survey and synthesize the literature on neuro-radiology of brain findings in NMO. OBJECTIVES: To review the studies on conventional brain MRI in NMO and to propose to incorporate characteristic brain MRI lesions into the diagnostic criteria of NMO. METHODS: We searched for articles with descriptions of brain MRI findings in NMO in EBSCO, EMBASE, PubMed/Medline, Science Citation Index, and SCOPUS. RESULTS: Brain abnormalities are seen in majority of NMO patients as disease duration increases. A minority of NMO patients meet Barkhof criteria for space dissemination in multiple sclerosis (MS), and these criteria should not be used to exclude NMO diagnosis. Distinctive brain lesions of NMO are cataloged and described. CONCLUSIONS: Brain lesions in NMO are a consistent feature of the disease. International consensus MRI criteria are needed for NMO analogous to the existing criteria for MS.


Assuntos
Encéfalo/patologia , Imageamento por Ressonância Magnética , Neuromielite Óptica/diagnóstico , Bases de Dados Factuais/estatística & dados numéricos , Humanos
16.
Radiat Res ; 176(2): 259-63, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21631287

RESUMO

Using an experimental model and PENELOPE Monte Carlo simulations, the effects of resin and amalgam on the absorbed doses in tooth enamel were studied to evaluate the feasibility of using restored teeth in electron spin resonance (ESR) dose reconstruction. The model consisted of a phantom containing a plate of these restorative materials placed between powered enamel layers exposed to X rays and a 6°Co beam. The experimental results and simulations agreed, showing that the attenuation produced by amalgam and resin with a thickness of 1, 2, and 4 mm is similar to that produced by the enamel itself in the case of the radiation sources employed. For X rays and 6°Co γ radiation the attenuation reached almost 100% and 40%, respectively. These results show that for ESR dose reconstruction, the use of all available enamel of a tooth leads to errors in the estimated dose due to attenuation effects in both healthy and restored teeth. Thus the importance of an enamel selection from different sides of the tooth surface to apply ESR dose reconstruction in the case of a practical situation is shown.


Assuntos
Esmalte Dentário/efeitos da radiação , Restauração Dentária Permanente , Radiometria/métodos , Amálgama Dentário , Espectroscopia de Ressonância de Spin Eletrônica , Estudos de Viabilidade , Doses de Radiação , Resinas Sintéticas
17.
Mult Scler ; 16(8): 899-908, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20463038

RESUMO

Few studies report a protective role of childhood solar exposure to multiple sclerosis. Our objective was to confirm the protective role of childhood solar exposure in multiple sclerosis in Cuba, Martinique and Sicily. This was a matched case- control study, and cases met Poser criteria for clinically, laboratory (definite, probable) multiple sclerosis. Controls were resident population, without neurological disorder, living close to cases (within 100 km), matched for sex, age (+/-5 years), residence before age 15. We recruited 551 subjects during a 1-year period (193 cases, Cuba n = 95, Sicily n = 50, Martinique n = 48; 358 controls). Some (89%) met definite clinical multiple sclerosis criteria (relapsing remitting form (with and without sequel) (74%), secondary progressive (21%), primary progressive (5%)). Odds ratios in a uni-variate analysis were: family history of multiple sclerosis (5.1) and autoimmune disorder (4.0); wearing shirt (3.5), hat (2.7), pants (2.4); sun exposure causing sunburn (1.8); sun exposure duration (1 h more/day; weekends 0.91, weekdays 0.86); bare-chested (0.6); water sports (0.2). Independent factors in the multivariate analysis were family history of multiple sclerosis (4.8 (1.50-15.10)), wearing pants under sunlight (1.9 (1.10-3.20)), sun exposure duration (1 h more/ day, weekdays 0.90 (0.85-0.98), weekends 0.93 (0.87-0.99)), water sports (0.23 (0.13-0.40)). We conclude that outdoor leisure activities in addition to sun exposure reports are associated with a reduced multiple sclerosis risk, with evidence of dose response.


Assuntos
Esclerose Múltipla/epidemiologia , Esclerose Múltipla/prevenção & controle , Luz Solar , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Cuba/epidemiologia , Feminino , Humanos , Masculino , Martinica/epidemiologia , Pessoa de Meia-Idade , Sicília/epidemiologia , Raios Ultravioleta , Adulto Jovem
18.
Mult Scler ; 15(7): 828-33, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19498017

RESUMO

BACKGROUND: In Caucasian populations neuromyelitis optica (NMO-IgG) antibody has been detected in 27.1% / 78.2% of patients with relapsing-NMO (R-NMO). The prevalence reported for the disease in the Caribbean is 3.1/100,000 in the French West Indies (FWI) and 0.52 /100,000 in Cuba, but the NMO antibody status is unknown. OBJECTIVE: To assess the NMO-IgG antibody status of Cuban/FWI RNMO patients, comparing with European cases tested at the same laboratories. METHODS: Serum NMO-IgG antibodies were assayed in 48 R-NMO patients (Wingerchucks 1999 criteria): Cuba (24)/FWI (24), employing Lennon et als method. We compared the demographic, clinical, disability and laboratory data between NMO-IgG +/- patients. All the data were reviewed and collected blinded to the NMO-IgG status. RESULTS: Seropositivity of the NMO-IgG antibody demonstrated a lower rate in the Caribbean (33.3%), as compared with Caucasian patients from Spain/Italy (62.5%) and France (53.8%). Caribbean patients with NMO-IgG (+) displayed more attacks, more spinal attacks and a higher EDSS than NMO-IgG (-) cases, while brain and spinal cord MRI lesions were more frequent during remission, with more vertebral segments, more gray, white matter and holocord involvement. CONCLUSIONS: NMO IgG positive antibodies in NMO patients had a lower rate in the Caribbean area - where the population has a predominant African ancestry - than in Caucasian Europeans, suggesting the influence of a possible ethnic factor in the pathogenesis of the disease, but they confer a worse course with more attacks, more disability and MRI lesions.


Assuntos
Autoanticorpos/sangue , População Negra , Imunoglobulina G/sangue , Neuromielite Óptica/etnologia , Neuromielite Óptica/imunologia , População Branca , Adulto , Encéfalo/patologia , Cuba/epidemiologia , Avaliação da Deficiência , Progressão da Doença , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Martinica/epidemiologia , Neuromielite Óptica/diagnóstico , Recidiva , Índice de Gravidade de Doença , Medula Espinal/patologia , Adulto Jovem
19.
Mult Scler ; 15(2): 269-71, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18922832

RESUMO

INTRODUCTION: The association of neuromyelitis optica (NMO) and multiple sclerosis (MS) has been reported, but details of the cases were not described. We report two Venezuelan Caucasian sisters with human leukocyte antigen (HLA) typing. RESULTS: Patient 1 fulfilled McDonald, et al. criteria with HLA A*24; B*07,*15; DRB1*01,*16 (DR2 positive). Patient 2 fulfilled the NMO revised criteria of Wingerchuck, et al. with HLA A*02,*24; B*07,*40; DRB1*04,*08, similar to Canadian aboriginal NMO cases and the Yukpa population from Venezuela. CONCLUSION: These cases confirmed the coexistence of NMO and MS in sisters, and further studies are needed to understand the genetic linkage between these diseases.


Assuntos
Teste de Histocompatibilidade , Esclerose Múltipla/genética , Neuromielite Óptica/genética , Adulto , Saúde da Família , Feminino , Humanos , Imageamento por Ressonância Magnética , Esclerose Múltipla/etnologia , Esclerose Múltipla/patologia , Neuromielite Óptica/etnologia , Neuromielite Óptica/patologia , Irmãos , Venezuela , População Branca/genética
20.
Int Immunopharmacol ; 8(6): 881-6, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18442793

RESUMO

Type I Interferon (IFN-alpha/beta) therapy has altered the natural course of multiple sclerosis. In this paper we evaluate the possible molecular mechanisms involved in the in vitro effects of IFN-alpha/beta on peripheral blood mononuclear cells from patients with clinically definite Relapsing-Remitting Multiple Sclerosis. The total RNA from IFN-alpha, IFN-beta treated cells and untreated cells was extracted and amplified for CD86, CD28, CTLA-4, TNF-alpha, IFN-gamma, CCL2, CCR5, IL-13, MMP-9, TIMP-1, CD25, TGF-beta, IL-10 and the transcriptional factor Foxp3 by Reverse Transcription-Polymerase Chain Reaction and the CD4+CD25high subset was evaluated using flow cytometry. In general, there were no significant differences concerning the modulation of the genes studied in the response to IFN-alpha and IFN-beta treatments, which suggest a similar mechanism of action for both interferons. However, we found a significant increment in IFN-gamma expression after IFN-alpha but not after IFN-beta treatments. The in vitro treatment of mononuclear cells from multiple sclerosis patients with both interferons significantly increased the CD25 mRNA. Furthermore, we observed a CD25/Foxp3 correlation and an increment of the CD4+CD25high subset, indicating that the induction of regulatory T cells could be a crucial mechanism involved in the type I interferon effects.


Assuntos
Citocinas/metabolismo , Interferon Tipo I/imunologia , Leucócitos Mononucleares/imunologia , Esclerose Múltipla/imunologia , Subpopulações de Linfócitos T/imunologia , Linfócitos T Reguladores/imunologia , Apresentação de Antígeno , Barreira Hematoencefálica , Células Cultivadas , Citocinas/imunologia , Expressão Gênica , Humanos , Interferon Tipo I/farmacologia , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/metabolismo , Esclerose Múltipla/metabolismo , Subpopulações de Linfócitos T/efeitos dos fármacos , Subpopulações de Linfócitos T/metabolismo , Linfócitos T Reguladores/efeitos dos fármacos , Linfócitos T Reguladores/metabolismo
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