RESUMO
Alzheimer's disease (AD) is a neurodegenerative disease responsible for 60-70% of the 50 million cases of dementia worldwide. It is characterized by neuronal cell death, shrinkage of brain tissue, and progressive cognitive, motor, and behavioral impairment, which often leads to death. Although current treatment has helped improve the patient's quality of life, it has not been able to alter the underlying disease pathology of AD. Studies have shown that mesenchymal stem cells (MSCs)-a group of multipotent stem cells-have the ability to stimulate neuroregeneration and inhibit disease progression. More recently, extracellular vesicles (EVs) from cytokine-preconditioned MSCs have also shown to induce immunomodulatory and neuroprotective effects in AD models. This review will aim to compile pertinent preclinical AD research on transgenic mice as well as clinical trials on MSC-based therapy from diverse sources.
RESUMO
The routine use of granulocyte-colony stimulating factor (G-CSF) for 10 days during full-dose cyclophosphamide-doxorubicin-vincristine-prednisone (CHOP) chemotherapy in HIV-associated diffuse non-Hodgkin's lymphoma (NHL) patients is very expensive in developing countries. We treated 22 HIV-associated diffuse NHL patients with standard-dose CHOP and used G-CSF after an episode of febrile neutropenia until neutrophil count reached 1000/mm3. The clinical response was: complete response (36%), partial response (32%), stable disease (14%) and progression (18%). There were no toxicity-related deaths. Grade 3 or 4 neutropenia was observed in 16% of cycles, but only 8% were complicated with febrile neutropenia. Seventeen patients died (median survival 15 months; range 2-70). There are five patients alive (median survival 24+ months; range 17-36+). Our experience showed that we can treat HIV-related NHL patients with full-dose CHOP, achieve good responses and have an acceptable toxicity profile, with the use of G-CSF as needed.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Linfoma Relacionado a AIDS/tratamento farmacológico , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Doxorrubicina/administração & dosagem , Doxorrubicina/efeitos adversos , Feminino , Febre/induzido quimicamente , Febre/prevenção & controle , Fator Estimulador de Colônias de Granulócitos/administração & dosagem , Humanos , Masculino , Dose Máxima Tolerável , Pessoa de Meia-Idade , Neutropenia/induzido quimicamente , Neutropenia/prevenção & controle , Prednisona/administração & dosagem , Prednisona/efeitos adversos , Estudos Prospectivos , Resultado do Tratamento , Vincristina/administração & dosagem , Vincristina/efeitos adversosRESUMO
This study shows the results of an Anaerobic Membrane Bioreactor with immersed filtration cartridges for granular biomass retention working at high hydraulic loading rates. Biomass retention capabilities, granular biomass structure and activity, filtration cartridges flux and organic material degradation performance were evaluated. Four reactors with a volume of 0.005 m3 were tested. Two different filtration cartridges were used (10 and 100 microm) with effective surface area of 0.05 m2. The filtration cartridges were submerged in the reactors for suction type filtration. Three organic loading rates were tested in the first two reactors and seven in the other two. Selective biomass washout and an increment in the biomass methanogenic activity was observed in the reactors at hydraulic loading rates between 1.2 and 4.5 m/h. Analyses of biomass granulometry showed an increase of larger size granular biomass. The immersed membrane anaerobic bioreactor maintain most of the advantages without biomass activity loss.
Assuntos
Bactérias Anaeróbias/fisiologia , Reatores Biológicos , Eliminação de Resíduos Líquidos/métodos , Biomassa , Filtração , Membranas Artificiais , Tamanho da Partícula , Movimentos da ÁguaRESUMO
OBJECTIVE: To evaluate the tuberculin reactivity among medical students and the utility of RT-23 (2 tuberculin unit [TU] purified protein derivative [PPD]) produced in Mexico. DESIGN: A blind and comparative study was conducted in a school of medicine using simultaneously RT-23 and an American product (5 TU PPD) randomly assigned to each forearm and read 48 hours later. Ninety eight volunteers were included, 69 from the first year and 29 from the fifth year as medical students. RESULTS: Using 5 TU PPD, 16% of first year students and 41% of fifth grade students were positive (induration > or = 10 mm). The RT-23 worked well and showed a sensitivity of 87% and a specificity of 92%. There was a large difference in the positivity of fifth versus first year students (x2 = 6.00, P = 0.014) with an estimated annual conversion of 5.1%. The high tuberculin conversion rate urges the need to establish preventive and early diagnosis programs for tuberculosis. The utility of RT-23 was found to be comparable to 5 TU PPD in our population.
Assuntos
Teste Tuberculínico/métodos , Tuberculina , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , México/epidemiologia , Sensibilidade e Especificidade , Estudantes de Medicina , Tuberculose/epidemiologiaRESUMO
OBJECTIVES: To compare the slide microagglutination (SMA) test vs a gold standard test (tube agglutination test: SAT) for the detection of Brucella antibodies in order to evaluate the usefulness of SMA to discard transfusion blood units. DESIGN: Prospective, comparative, cross sectional survey. SETTING: City of Leon, State of Guanajuato, an endemic zone of brucellosis. SAMPLES: 48 sera from blood units discarded for transfusion by three blood banks due to Brucella antibodies detected by SMA and 48 controls of accepted units. METHODS: Determination of Brucella antibodies with the SMA and SAT tests. RESULTS: The 48 control samples were negative with both tests; of the 48 discarded samples, in only seven sera we confirmed a titer > or = 1:80 by SAT; thus, 41 blood units (85%) may have been improperly rejected because the only test used by the blood banks was the SMA. In our hands, the SMA showed a sensitivity and negative predictive value of 100%, a specificity of 81%, and positive predictive value of 29%. CONCLUSIONS: There was a high proportion of improper rejection of blood units for transfusion; Brucella antibodies at any titer detected by SMA should be followed by SAT testing.
Assuntos
Anticorpos Antibacterianos/sangue , Brucella/imunologia , Brucelose/sangue , Brucelose/imunologia , Testes de Aglutinação , Transfusão de Sangue/normas , Ensaio de Imunoadsorção Enzimática , Humanos , Eliminação de Resíduos de Serviços de SaúdeRESUMO
Hospital-acquired bacteremia is a common cause of morbidity and mortality, mainly in pediatric units. In a 25 month retrospective study, we analyzed the blood cultures from the Hospital General Regional of the city of Leon, Guanajuato State, Mexico, in order to establish the causal agents of nosocomial bacteremia and infer some associations with contaminated intravenous infusion fluids. In addition we performed a two month study to culture the flasks and intravenous tubing used in our infusions. Five hundred and fifty one blood cultures drawn from August 1990 to September 1992 were analyzed. A total of 135 (24.5%) were positive, most of them (51.8%) with strains of the Klebsielleae tribe (SKT) (Klebsiella, Enterobacter, Serratia). The global incidence of bacteremia in the two year period was 4.3%. In the infusion study, 230 intravenous fluids were cultured, with 68 isolates (30%) most from the SKT tribe. A final consideration is made on the role that inadequate management of intravenous liquids could play in the development of endemic and epidemic nosocomial bacteremia in our hospital, and the eventual utility of making cultures of the i.v. liquids.
Assuntos
Bacteriemia/prevenção & controle , Infecção Hospitalar/prevenção & controle , Controle de Infecções/métodos , Infusões Parenterais , Criança , Pré-Escolar , Contaminação de Equipamentos , Feminino , Humanos , Lactente , Masculino , Estudos RetrospectivosRESUMO
Aminoglycosides (AG) are excellent antibiotics against gram-negative bacilli infections, but their use implies potential ototoxicity and nephrotoxicity if an excessive dosage is prescribed. In this study we evaluated 105 episodes of AG treatment in 104 patients hospitalized in a specialty hospital in the city of Leon, Mexico. In each case a basal serum creatinine, weight and age were recorded. A single serum AG assay per episode of treatment was done. Either amikacin or gentamicin were one the AG prescribed. Prior to AG administration only 54 treatment episodes (51%) had a before treatment creatinine assay. The initial creatinine clearance showed normal values in 43% (23/54 episodes) and it was altered (below 80 mL/min) in 31 (57%) of the episodes. In the 31 cases with an altered renal function only 15 (48%) underwent dosage adjustment. In summary the AG were prescribed in excess in 54% (29/54) of the episodes. The serum AG levels within toxic range were observed in 11 episodes. These results suggest that in our hospital AG treatment is not adequately done and monitored.
Assuntos
Amicacina/efeitos adversos , Monitoramento de Medicamentos , Gentamicinas/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Amicacina/administração & dosagem , Creatinina/sangue , Overdose de Drogas , Feminino , Gentamicinas/administração & dosagem , Hospitais Especializados , Humanos , Estudos Longitudinais , Masculino , México , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
In order to assess the seroepidemiology of protective antibodies against rubella among women from León, Guanajuato, Mexico, a prospective study was done. The sample consisted in 176 serum samples from urban and rural women at reproductive age, drawn from June 1990 to June 1991. Samples were tested by the classic hemagglutination inhibition method, titers of 1:8 or higher were considered as positive. Global positivity was 71 per cent (125 sera). Seropositivity did not increase with women's age; the lowest values were seen at the rural zones (58.9%). This survey showed a lower seropositivity than the previously reported in Mexico, and confirms data from new official studies. With this information authors suggest that the utility and viability of a national vaccination program should be reviewed and propose that it could be risky that individual clinicians to recommend children vaccination because the lack of coordination could increase adult cases of rubella.
Assuntos
Rubéola (Sarampo Alemão)/epidemiologia , Adolescente , Adulto , Fatores Etários , Anticorpos Antivirais/sangue , Feminino , Testes de Inibição da Hemaglutinação , Humanos , México/epidemiologia , Estudos Prospectivos , Rubéola (Sarampo Alemão)/imunologia , Vírus da Rubéola/imunologia , População Rural/estatística & dados numéricos , Estudos Soroepidemiológicos , Fatores Sexuais , População Urbana/estatística & dados numéricosRESUMO
Se presenta un caso de fístula biliar espontánea, se analiza su historia e incidencia, etiopatogenia, diagnóstico y la conducta a seguir cuando se presenta un paciente con esta enfermedad