RESUMO
BACKGROUND: IL-13 has been implicated in the pathogenesis of asthma and in the regulation of IgE synthesis in humans. Single nucleotide polymorphisms (SNPs) in the IL-13 gene have been associated with asthma and total serum IgE level in Caucasian populations. OBJECTIVE: To test for genetic association between an SNP in exon 4 of the IL-13 gene (IL-13 + 2044 or Arg130Gln) and total serum IgE level and asthma-related phenotypes in a population with high prevalence of asthma living in Costa Rica. METHODS: Family-based association study. RESULTS: Among 83 Costa Rican school children with asthma and their parents (249 individuals), there was no evidence of linkage disequilibrium between the IL-13 + 2044 SNP and any of the outcomes of interest (total serum IgE level on a logarithmic scale, number of positive skin tests to aeroallergens, and asthma). These results were not significantly changed after adjustment for age and gender. CONCLUSIONS: No significant evidence of linkage disequilibrium between an SNP in exon 4 of the IL-13 gene and total serum IgE level, sensitization to allergens or asthma was found in a family-based association study in Costa Rica.
Assuntos
Imunoglobulina E/sangue , Imunoglobulina E/genética , Interleucina-13/genética , Núcleo Familiar , Polimorfismo Genético/genética , Alérgenos/genética , Alérgenos/imunologia , Asma/genética , Asma/imunologia , Criança , Proteção da Criança , Costa Rica/epidemiologia , Saúde da Família , Feminino , Frequência do Gene , Genótipo , Humanos , Imunoglobulina E/imunologia , Interleucina-13/imunologia , Desequilíbrio de Ligação/genética , Desequilíbrio de Ligação/imunologia , Masculino , Polimorfismo Genético/imunologia , Testes CutâneosRESUMO
Alterations in the synthesis or enhanced inactivation of nitric oxide (NO) and an increase in endothelin-1 production lead to an imbalance that can induce arterial hypertension. Type II diabetes is characterized by impaired endothelium-dependent vasodilation and vascular disease. NO is produced through L-arginine pathway by three different isoforms of nitric oxide synthase (NOS), an inducible form that can be activated by cytokines such as tumor necrosis factor alpha (TNFalpha). We evaluated NO plasmatic levels, endothelial damage markers such as von Willebrand factor (vWF), platelet activation, soluble P-selectin (sP-Sel), TNFalpha levels, insulinaemia (I), glycosylated haemoglobin (HbA1c), glycaemia and blood pressure in 32 hypertensive diabetic type II patients (Group A), 37 hypertensive patients (Group B) and 35 healthy subjects (Group C) matched in sex, age, body mass index and dietary habits. The level of I was increased in patients compared to the controls and correlated with their NO levels. vWF plasmatic levels were increased in Group A compared to Groups B and C. We also found significant differences in platelet activation among all the groups. In diabetic patients, increased NO levels correlated with TNFalpha, HbA1c and platelet activation showed greater endothelial damage than in Group B. These parameters described a prothrombotic state associated with an insulin resistance state, an increased vWF release, raised sP-Sel and TNFalpha levels and, maybe, low NO bioavailability, which could lead to a higher risk of development of thrombotic events in hypertensive diabetic patients (Group A) than in the hypertensive patients in Group B.
Assuntos
Diabetes Mellitus Tipo 2/sangue , Endotélio Vascular/fisiopatologia , Hipertensão/sangue , Óxido Nítrico/sangue , Ativação Plaquetária , Idoso , Pressão Sanguínea , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/complicações , Endotélio Vascular/metabolismo , Feminino , Humanos , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Trombofilia/sangue , Fator de Necrose Tumoral alfa/metabolismo , Fator de von Willebrand/metabolismoRESUMO
OBJECTIVES: (1) To assess the feasibility and tolerability of the therapeutic transdermal fentanyl system (TTS-fentanyl) by using a clinical protocol developed for children with cancer pain. (2) To estimate the pediatric pharmacokinetic parameters of TTS-fentanyl. METHODS: The drug was administered in open-label fashion; and measures of analgesia, side effects, and skin changes were obtained for a minimum of 2 doses (6 treatment days). Blood specimens were analyzed for plasma fentanyl concentrations. The pharmacokinetics of TTS-fentanyl were estimated by using a mixed effect modeling approach. RESULTS: Treatment was well tolerated. Ten of the 11 patients who completed the 2 doses continued treatment with TTS-fentanyl. The duration of treatment ranged from 6 to 275 days. The time to reach peak plasma concentration ranged from 18 hours to >66 hours in patients receiving the 25 microg/h patch. Compared with published pharmacokinetic data from adults, the mean clearance and volume of distribution of transdermal fentanyl were the same, but the variability was less. CONCLUSIONS: Treatment of children with TTS-fentanyl is feasible and well tolerated and yields fentanyl pharmacokinetic parameter estimates similar to those for adults. A larger study is required to confirm these findings and further test the clinical protocol.
Assuntos
Analgésicos Opioides/administração & dosagem , Fentanila/administração & dosagem , Neoplasias/complicações , Dor Intratável/tratamento farmacológico , Administração Cutânea , Adolescente , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/sangue , Analgésicos Opioides/farmacocinética , Criança , Estudos de Viabilidade , Fentanila/efeitos adversos , Fentanila/sangue , Fentanila/farmacocinética , Humanos , Neoplasias/sangue , Medição da Dor , Dor Intratável/sangue , Dor Intratável/etiologia , Resultado do TratamentoRESUMO
Five workers at a precious metal refinery developed granulomatous lung disease between 1972 and 1985. The original diagnosis was sarcoidosis, but 4 of the workers were subsequently proved to have hypersensitivity to beryllium by in vitro proliferative responses of lymphocytes obtained by bronchoalveolar lavage. Review of medical records of coworkers and extensive industrial hygiene surveillance of the plant demonstrated that 4 cases occurred in the furnace area where air concentrations of beryllium fume were consistently below the permissible exposure limit of 2 micrograms/M3. A single case has been recognized from parts of the refinery where exposures to cold beryllium dust often exceeded the standard by as much as 20-fold. These data demonstrate that chronic beryllium disease still occurs and confirm the importance of specific immunologic testing in patients suspected of having sarcoidosis but with potential exposure to beryllium. The data raise concern about the adequacy of modern industrial controls, especially in the setting of exposure to highly respirable beryllium fume.
Assuntos
Beriliose/epidemiologia , Metalurgia , Adulto , Poluentes Ocupacionais do Ar/análise , Beriliose/imunologia , Beriliose/patologia , Berílio/análise , Biópsia , Doença Crônica , Connecticut , Poeira/análise , Hispânico ou Latino , Humanos , Pulmão/imunologia , Pulmão/patologia , Masculino , Porto Rico/etnologia , Risco , Linfócitos T/imunologiaRESUMO
Presentamos una leucemia monoblástica aguda con múltiples infiltrados dérmicos específicos iniciales rebeldes a la quimioterapia, hematológicamente eficaz. Insistimos en la necesidad de diagnosticar (impronta) y evaluar la magnitud de los mismos con fines diagnósticos (biopsia), así como en la detección de posibles santuarios cutáneos, para lo cual la inmunomarcación de muramidasa resultó de gran valor
Assuntos
Adolescente , Humanos , Masculino , Leucemia Monocítica Aguda/patologia , Biópsia , Leucemia Monocítica Aguda/tratamento farmacológico , Muramidase/uso terapêuticoRESUMO
Presentamos una leucemia monoblástica aguda con múltiples infiltrados dérmicos específicos iniciales rebeldes a la quimioterapia, hematológicamente eficaz. Insistimos en la necesidad de diagnosticar (impronta) y evaluar la magnitud de los mismos con fines diagnósticos (biopsia), así como en la detección de posibles santuarios cutáneos, para lo cual la inmunomarcación de muramidasa resultó de gran valor (AU)
Assuntos
Adolescente , Humanos , Masculino , Leucemia Monocítica Aguda/patologia , Biópsia , Leucemia Monocítica Aguda/tratamento farmacológico , Muramidase/uso terapêuticoRESUMO
Utilizando el metodo inmunohistoquimico de anticuerpos libres peroxidasa-antiperoxidasa, se realizo la caracterizacion de inmunoglobulinas intracitoplasmaticas, en material de biopsia de medula osea incluida en parafina de once pacientes portadores de mieloma multiple. Se obtuvo franca correlacion entre la inmunomarcacion plasmocitaria y el componente "M" serico, demostrandose la eficacia de la tecnica a pesar de los procedimientos agresivos que sufre el tejido medular para su procesamiento histologico. Esta marcacion inmunologica realza su valor en los casos de plasmocitomas no secretores, o con bajo componente plasmocitario proliferante y el diagnostico diferencial de plasmocitosis reactivas, al ser altamente especifica para la demonstracion de mono o policlonalidad celular
Assuntos
Humanos , Técnicas Imunoenzimáticas , Imunoglobulinas , Mieloma MúltiploRESUMO
Utilizando el metodo inmunohistoquimico de anticuerpos libres peroxidasa-antiperoxidasa, se realizo la caracterizacion de inmunoglobulinas intracitoplasmaticas, en material de biopsia de medula osea incluida en parafina de once pacientes portadores de mieloma multiple. Se obtuvo franca correlacion entre la inmunomarcacion plasmocitaria y el componente "M" serico, demostrandose la eficacia de la tecnica a pesar de los procedimientos agresivos que sufre el tejido medular para su procesamiento histologico. Esta marcacion inmunologica realza su valor en los casos de plasmocitomas no secretores, o con bajo componente plasmocitario proliferante y el diagnostico diferencial de plasmocitosis reactivas, al ser altamente especifica para la demonstracion de mono o policlonalidad celular