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Introducción: El síndrome de la bolsa orina púrpura es una condición llamativa, que rara vez se presenta en la práctica clínica. Aparece en el contexto de infecciones urinarias en ancianos, pluripatológicos, con sonda vesical y factores de riesgo asociados. Se produce por una reacción química entre la orina, el material plástico de la bolsa colectora y enzimas sulfatasas/fosfatasas de bacterias que generan el color violáceo característico. Objetivo: Reportar un caso con síndrome de la bolsa orina púrpura, como forma de presentación inusual de infección urinaria. Caso Clínico: Paciente femenina, de 76 años de edad, con antecedentes de constipación habitual, acudió a urgencias por pérdida del conocimiento y hemiparesia derecha. Se realizó tomografía axial computarizada de cráneo y se diagnosticó una enfermedad cerebrovascular. Como parte de la conducta se indicó sonda vesical y 14 días después apareció orina de color violeta en la bolsa colectora. Se diagnosticó infección urinaria por Escherichia coli y se trató con ceftriaxona. Se normalizó el color de la orina al tercer día de tratamiento, la paciente evolucionó de forma favorable. Conclusiones: Aunque se puede identificar con facilidad, sin requerir exámenes costosos, constituye un reto para los médicos que atienden a pacientes geriátricos. Conocer este trastorno es fundamental, porque, aunque es infrecuente, puede ser la única manifestación de infección urinaria en pacientes con cateterismo uretral.
Introduction: Purple urine bag syndrome is a striking condition that rarely occurs in clinical practice. It appears in the context of urinary infections in the elderly, with multiple pathologies, with a bladder catheter and associated risk factors. It is produced by a chemical reaction between urine, the plastic material of the collection bag and sulfatase/phosphatase enzymes from bacteria that generate the characteristic purple color. Objective: To report a case with purple urine bag syndrome as an unusual presentation of urinary tract infection. Clinical Case: Female patient, 76 years old, health history, usual constipation, attended at Emergency due to loss of consciousness and right hemiparesis. Computed axial tomography of the skull was performed and a cerebrovascular disease was diagnosed. As part of the conduct, a bladder catheter was indicated and after 14 days, purple urine appeared in the collection bag. Urinary infection due to Escherichia coli was diagnosed and treated with ceftriaxone, normalizing the color of the urine on the third day of treatment, with patient favorable evolution. Conclusions: Although it can be easily identified and without requiring costly tests, it is a challenge for physicians who care for geriatric patients. Knowing this disorder is essential because, although rare, it may be the only manifestation of urinary infection in patients with urethral catheterization.
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Introduction: Recurrent Aphthous Stomatitis, also known as aphthous ulcers or simply aphthous, is considered the most common of oral mucosal lesions. Objective: To describe the prevalence of recurrent aphthous stomatitis. Methods: Descriptive, cross-sectional and prospective study. 847 patients who attended the Family Medical Office No. 28, San Francisco comunity, Manzanillo, from July 1, 2021 to June 30, 2022, Cuba, were evaluated. A calibrated and trained assistant investigator evaluated the following variables: Clinical classification of recurrent aphthous stomatitis (minor aphthosis, major aphthosis, or aphthosis herpetiformis), lesion pain intensity, lesion location, and risk factors (viral infection), bacterial infection, immunological alterations, psychosomatic alterations, oral trauma, gastrointestinal alterations, endocrine factors, allergic conditions, heredity, blood and nutritional deficiencies, smoking), age group, sex, race, and duration of the lesion. Results: Aphthous stomatitis occurred in 30.46%, with greater frequency in the age group 30 - 39 years (24.42%). Minor aphthosis was the most frequent with 91.09%. The duration of the lesion of 10 to 12 days predominated with 37.60%, the most frequent location corresponded to the edge and tip of the tongue with 32.94% and the most representative pain intensity was mild with a total of 63.18%. The highest frequency among the risk factors corresponded to psychosomatic alterations with 100%. Conclusions: Recurrent Aphthous Stomatitis had a prevalence greater than 30% with a predominance of the female sex and young adults. Minor Aphtosis and a stay time of more than 10 days were the most frequent. The most common location is the tongue and bottom of the vestibular sulcus with the possible existence of a relationship between the mobile parts of the mouth. Stress, the main risk factor, exacerbated by Covid-19.
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Cancer cells often display impaired mitochondrial function, reduced oxidative phosphorylation, and augmented aerobic glycolysis (Warburg effect) to fulfill their bioenergetic and biosynthetic needs. Caveolin-1 (CAV1) is a scaffolding protein that promotes cancer cell migration, invasion, and metastasis in a manner dependent on CAV1 phosphorylation on tyrosine-14 (pY14). Here, we show that CAV1 expression increased glycolysis rates, while mitochondrial respiration was reduced by inhibition of the mitochondrial complex IV. These effects correlated with increased reactive oxygen species (ROS) levels that favored CAV1-induced migration and invasion. Interestingly, pY14-CAV1 promoted the metabolic switch associated with increased migration/invasion and augmented ROS-inhibited PTP1B, a phosphatase that controls pY14 levels. Finally, the glycolysis inhibitor 2-deoxy-D-glucose reduced CAV1-enhanced migration in vitro and metastasis in vivo of murine melanoma cells. In conclusion, CAV1 promotes the Warburg effect and ROS production, which inhibits PTP1B to augment CAV1 phosphorylation on tyrosine-14, thereby increasing the metastatic potential of cancer cells.
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The vertebrate neuromuscular junction (NMJ) is formed by a presynaptic motor nerve terminal and a postsynaptic muscle specialization. Cumulative evidence reveals that Wnt ligands secreted by the nerve terminal control crucial steps of NMJ synaptogenesis. For instance, the Wnt3 ligand is expressed by motor neurons at the time of NMJ formation and induces postsynaptic differentiation in recently formed muscle fibers. However, the behavior of presynaptic-derived Wnt ligands at the vertebrate NMJ has not been deeply analyzed. Here, we conducted overexpression experiments to study the expression, distribution, secretion, and function of Wnt3 by transfection of the motor neuron-like NSC-34 cell line and by in ovo electroporation of chick motor neurons. Our findings reveal that Wnt3 is transported along motor axons in vivo following a vesicular-like pattern and reaches the NMJ area. In vitro, we found that endogenous Wnt3 expression increases as the differentiation of NSC-34 cells proceeds. Although NSC-34 cells overexpressing Wnt3 do not modify their morphological differentiation towards a neuronal phenotype, they effectively induce acetylcholine receptor clustering on co-cultured myotubes. These findings support the notion that presynaptic Wnt3 is transported and secreted by motor neurons to induce postsynaptic differentiation in nascent NMJs.
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Neurônios Motores/citologia , Proteína Wnt3/genética , Proteína Wnt3/metabolismo , Animais , Diferenciação Celular , Linhagem Celular , Embrião de Galinha , Técnicas de Cocultura , Eletroporação , Ligantes , Camundongos , Neurônios Motores/metabolismo , Junção Neuromuscular/metabolismo , Receptores Colinérgicos/metabolismoRESUMO
Amyotrophic lateral sclerosis (ALS) is a progressive fatal neurodegenerative disease that affects motoneurons. Mutations in superoxide dismutase 1 (SOD1) have been described as a causative genetic factor for ALS. Mice overexpressing ALS-linked mutant SOD1 develop ALS symptoms accompanied by histopathological alterations and protein aggregation. The protein disulfide isomerase family member ERp57 is one of the main up-regulated proteins in tissue of ALS patients and mutant SOD1 mice, whereas point mutations in ERp57 were described as possible risk factors to develop the disease. ERp57 catalyzes disulfide bond formation and isomerization in the endoplasmic reticulum (ER), constituting a central component of protein quality control mechanisms. However, the actual contribution of ERp57 to ALS pathogenesis remained to be defined. Here, we studied the consequences of overexpressing ERp57 in experimental ALS using mutant SOD1 mice. Double transgenic SOD1G93A/ERp57WT animals presented delayed deterioration of electrophysiological activity and maintained muscle innervation compared to single transgenic SOD1G93A littermates at early-symptomatic stage, along with improved motor performance without affecting survival. The overexpression of ERp57 reduced mutant SOD1 aggregation, but only at disease end-stage, dissociating its role as an anti-aggregation factor from the protection of neuromuscular junctions. Instead, proteomic analysis revealed that the neuroprotective effects of ERp57 overexpression correlated with increased levels of synaptic and actin cytoskeleton proteins in the spinal cord. Taken together, our results suggest that ERp57 operates as a disease modifier at early stages by maintaining motoneuron connectivity.
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Esclerose Lateral Amiotrófica/enzimologia , Esclerose Lateral Amiotrófica/prevenção & controle , Isomerases de Dissulfetos de Proteínas/genética , Isomerases de Dissulfetos de Proteínas/metabolismo , Esclerose Lateral Amiotrófica/genética , Esclerose Lateral Amiotrófica/patologia , Animais , Modelos Animais de Doenças , Eletromiografia , Camundongos , Camundongos Transgênicos , Neurônios Motores/metabolismo , Denervação Muscular , Músculo Esquelético/metabolismo , Músculo Esquelético/patologia , Junção Neuromuscular/metabolismo , Proteômica , Medula Espinal/patologia , Superóxido Dismutase-1/genética , Superóxido Dismutase-1/metabolismoRESUMO
The neuromuscular junction (NMJ) is the peripheral synapse that controls the coordinated movement of many organisms. The NMJ is also an archetypical model to study synaptic morphology and function. As the NMJ is the primary target of neuromuscular diseases and traumatic injuries, the establishment of suitable models to study the contribution of specific postsynaptic muscle-derived proteins on NMJ maintenance and regeneration is a permanent need. Considering the unique experimental advantages of the levator auris longus (LAL) muscle, here we present a method allowing for efficient electroporation-mediated gene transfer and subsequent detailed studies of the morphology and function of the NMJ and muscle fibers. Also, we have standardized efficient facial nerve injury protocols to analyze LAL muscle NMJ degeneration and regeneration. Our results show that the expression of a control fluorescent protein does not alter either the muscle structural organization, the apposition of the pre- and post-synaptic domains, or the functional neurotransmission parameters of the LAL muscle NMJs; in turn, the overexpression of MuSK, a major regulator of postsynaptic assembly, induces the formation of ectopic acetylcholine receptor clusters. Our NMJ denervation experiments showed complete reinnervation of LAL muscle NMJs four weeks after facial nerve injury. Together, these experimental strategies in the LAL muscle constitute effective methods to combine protein expression with accurate analyses at the levels of structure, function, and regeneration of the NMJ.
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INTRODUCTION: Poor metabolic control in patients with Type 1 Diabetes Mellitus (T1DM) is associated with short- and long-term complications. Adolescents with T1DM present poorer metabolic control than pa tients of other age groups. Few studies have shown an association between mothers with depressive symptoms and the metabolic control of their adolescent children. OBJECTIVE: To evaluate the associa tion between maternal depressive symptoms and metabolic control of their adolescents with T1DM. SUBJECTS AND METHOD: Cross-sectional observational study carried out with adolescents aged between 10 and 18 years, with T1DM diagnosis of at least 1 year ago and their mothers. The Beck Depression Inventory-II and the SALUFAM questionnaire were applied, and sociodemographic data were co llected. Glycosylated hemoglobin from capillary blood was used as a marker of metabolic control. RESULTS: 86 couples (mother-adolescent children) were studied. The average age of the adolescents was 14.04 years and the average evolution time of T1DM was 5.95 years. 27.325.6% of mothers had depressive symptoms, which was associated with worse metabolic control of their children (HbA1c of 7.66% and 8.91%, p-value <0.001). 17.9% of adolescents had depressive symptoms, which was not associated with maternal depressive symptoms or worse metabolic control. Maternal depressive symptoms were also associated with lower maternal and paternal educational levels, high number of children in the family, presence of other siblings with chronic illnesses, and high health vulnera bility (SALUFAM). CONCLUSIONS: The mother's depressive symptoms can be associated with worst metabolic control in T1MD adolescents. It is fundamental a multidisciplinary family approach to get better metabolic controls in T1DM adolescents.
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Depressão/psicologia , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/psicologia , Hemoglobinas Glicadas/metabolismo , Relações Mãe-Filho/psicologia , Mães/psicologia , Adolescente , Adulto , Biomarcadores/sangue , Criança , Estudos Transversais , Depressão/diagnóstico , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação PsiquiátricaRESUMO
Resumen: Introducción: Un mal control metabólico en pacientes con Diabetes Mellitus tipo 1 (DM1) se asocia a complica ciones a corto y largo plazo. Los adolescentes con Diabetes tipo 1 presentan peor control metabólico comparado con pacientes de otros grupos etarios. Escasos estudios han demostrado una asociación entre síntomas depresivos de las madres con el control metabólico de sus hijos adolescente. Objetivo: Evaluar la asociación entre síntomas depresivos maternos y control metabólico de adolescentes con DM1. Sujetos y Método: Estudio observacional transversal realizado en adolescentes, edades 10 a 18 años, con diagnóstico de DM1 de más de un año de evolución y sus madres. Se aplicó test de Beck II, cuestionario de depresión infantil, cuestionario SALUFAM y cuestionario de datos sociodemográficos. Se realizó hemoglobina glicosilada capilar, como marcador de control metabólico. Resultados: Se estudiaron 86 parejas (madre-hijo adolescente), adolescentes de edad media 14.04 años y 5.95 años de evolución de DM1. El 25.6% (n 22) de las madres presentó síntomas depresivos, asociándose a peor control metabólico en sus hijos (HbA1c: 7.66% y 8.91%, p < 0.001). El 17.9% de adolescentes presentó síntomas depresivos, no asociándose a síntomas depresivos maternos ni a peor control metabólico. Los síntomas depresivos maternos se asociaron a menor nivel educacional materno y pater no, mayor número de hijos en la familia, presencia de otros hermanos con enfermedades crónicas y a mayor vulnerabilidad en salud (SALUFAM). Conclusiones: La presencia de síntomas depresivos maternos se asocia a peor control metabólico en el adolescente con DM1, siendo fundamental un enfoque multidisciplinario familiar para obtener mejores resultados metabólicos en los adolescentes.
Abstract: Introduction: Poor metabolic control in patients with Type 1 Diabetes Mellitus (T1DM) is associated with short- and long-term complications. Adolescents with T1DM present poorer metabolic control than patients of other age groups. Few studies have shown an association between mothers with depressive symptoms and the metabolic control of their adolescent children. Objective: To evaluate the associa tion between maternal depressive symptoms and metabolic control of their adolescents with T1DM. Subjects and Method: Cross-sectional observational study carried out with adolescents aged between 10 and 18 years, with T1DM diagnosis of at least 1 year ago and their mothers. The Beck Depression Inventory-II and the SALUFAM questionnaire were applied, and sociodemographic data were co llected. Glycosylated hemoglobin from capillary blood was used as a marker of metabolic control. Results: 86 couples (mother-adolescent children) were studied. The average age of the adolescents was 14.04 years and the average evolution time of T1DM was 5.95 years. 27.325.6% of mothers had depressive symptoms, which was associated with worse metabolic control of their children (HbA1c of 7.66% and 8.91%, p-value <0.001). 17.9% of adolescents had depressive symptoms, which was not associated with maternal depressive symptoms or worse metabolic control. Maternal depressive symptoms were also associated with lower maternal and paternal educational levels, high number of children in the family, presence of other siblings with chronic illnesses, and high health vulnera bility (SALUFAM). Conclusions: The mother's depressive symptoms can be associated with worst metabolic control in T1MD adolescents. It is fundamental a multidisciplinary family approach to get better metabolic controls in T1DM adolescents.
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Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Hemoglobinas Glicadas/metabolismo , Depressão/psicologia , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/sangue , Relações Mãe-Filho/psicologia , Mães/psicologia , Escalas de Graduação Psiquiátrica , Biomarcadores/sangue , Estudos Transversais , Depressão/diagnóstico , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/diagnósticoRESUMO
Caveolin-1 (CAV1) enhanced migration, invasion, and metastasis of cancer cells is inhibited by co-expression of the glycoprotein E-cadherin. Although the two proteins form a multiprotein complex that includes ß-catenin, it remained unclear how this would contribute to blocking the metastasis promoting function of CAV1. Here, we characterized by mass spectrometry the protein composition of CAV1 immunoprecipitates from B16F10 murine melanoma cells expressing or not E-cadherin. The novel protein tyrosine phosphatase PTPN14 was identified by mass spectrometry analysis exclusively in co-immunoprecipitates of CAV1 with E-cadherin. Interestingly, PTPN14 is implicated in controlling metastasis, but only few known PTPN14 substrates exist. We corroborated by western blotting experiments that PTPN14 and CAV1 co-inmunoprecipitated in the presence of E-cadherin in B16F10 melanoma and other cancer cells. Moreover, the CAV1(Y14F) mutant protein was shown to co-immunoprecipitate with PTPN14 even in the absence of E-cadherin, and overexpression of PTPN14 reduced CAV1 phosphorylation on tyrosine-14, as well as suppressed CAV1-enhanced cell migration, invasion and Rac-1 activation in B16F10, metastatic colon [HT29(US)] and breast cancer (MDA-MB-231) cell lines. Finally, PTPN14 overexpression in B16F10 cells reduced the ability of CAV1 to induce metastasis in vivo. In summary, we identify here CAV1 as a novel substrate for PTPN14 and show that overexpression of this phosphatase suffices to reduce CAV1-induced metastasis.
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Caderinas/genética , Caveolina 1/genética , Melanoma Experimental/genética , Proteínas Tirosina Fosfatases não Receptoras/genética , Animais , Linhagem Celular Tumoral , Movimento Celular , Proliferação de Células/genética , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Melanoma Experimental/patologia , Camundongos , Invasividade Neoplásica , Metástase Neoplásica , Fosforilação/genética , beta Catenina/genéticaRESUMO
The coordinated movement of organisms relies on efficient nerve-muscle communication at the neuromuscular junction. After peripheral nerve injury or neurodegeneration, motor neurons and Schwann cells increase the expression of the p75NTR pan-neurotrophin receptor. Even though p75NTR targeting has emerged as a promising therapeutic strategy to delay peripheral neuronal damage progression, the effects of long-term p75NTR inhibition at the mature neuromuscular junction have not been elucidated. We performed quantitative neuroanathomical analyses of the neuromuscular junction in p75NTR null mice by laser confocal and electron microscopy, which were complemented with electromyography, locomotor tests, and pharmacological intervention studies. Mature neuromuscular synapses of p75NTR null mice show impaired postsynaptic organization and ultrastructural complexity, which correlate with altered synaptic function at the levels of nerve activity-induced muscle responses, muscle fiber structure, force production, and locomotor performance. Our results on primary myotubes and denervated muscles indicate that muscle-derived p75NTR does not play a major role on postsynaptic organization. In turn, motor axon terminals of p75NTR null mice display a strong reduction in the number of synaptic vesicles and active zones. According to the observed pre and postsynaptic defects, pharmacological acetylcholinesterase inhibition rescued nerve-dependent muscle response and force production in p75NTR null mice. Our findings revealing that p75NTR is required to organize mature neuromuscular junctions contribute to a comprehensive view of the possible effects caused by therapeutic attempts to target p75NTR.
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Neurônios Motores/fisiologia , Junção Neuromuscular/fisiologia , Receptores de Fator de Crescimento Neural/fisiologia , Vesículas Sinápticas/fisiologia , Animais , Camundongos Endogâmicos C57BL , Camundongos Knockout , Atividade Motora , Neurônios Motores/ultraestrutura , Junção Neuromuscular/ultraestrutura , Receptores de Fator de Crescimento Neural/genética , Vesículas Sinápticas/ultraestruturaRESUMO
Acetylcholine receptor (AChR) clustering on the surface of muscle cells is a hallmark of postsynaptic differentiation at the vertebrate neuromuscular junction (NMJ). Even though the assembly of complex postsynaptic apparatuses is known to rely on both, pre- and postsynaptic signals, the identity of muscle-derived proteins modulating postsynaptic assembly and maintenance is still to be fully elucidated. Efficient gene transfer into muscle cells represents a powerful tool to analyze the contribution of muscle proteins on postsynaptic assembly and maintenance. Here, we describe a protocol that combines efficient electroporation of primary muscle satellite cells with the formation of aneural complex postsynaptic structures on the surface of myotubes. In vitro formed postsynaptic structures share various similarities with in vivo postsynaptic NMJ domains. While primary myotubes express increasing amounts of the ε AChR subunit, associated with NMJ maturation, surface AChR aggregates lack this AChR subunit. Our results also validate the functional expression of a luciferase reporter gene, as well as the response of complex postsynaptic structures to pharmacological treatment. Together, these methods in primary muscle cells are a valuable tool to perform a detailed and accurate analysis of the potential role of muscle-derived proteins on the maintenance of complex postsynaptic structures and to identify nerve-derived signals regulating functional NMJ maturation.
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Potenciais Pós-Sinápticos Excitadores/fisiologia , Técnicas de Transferência de Genes , Fibras Musculares Esqueléticas/fisiologia , Músculo Esquelético/inervação , Músculo Esquelético/fisiologia , Animais , Diferenciação Celular/genética , Sobrevivência Celular , DNA/genética , Eletroporação , Mioblastos , Junção Neuromuscular/fisiologia , Junção Neuromuscular/ultraestrutura , Cultura Primária de Células , Ratos , Receptores Colinérgicos/metabolismo , Células Satélites de Músculo EsqueléticoRESUMO
New adjuvant formulations, based on proteoliposomes <40â¯nm and cochleates <100â¯nm, without Al(OH)3 adjuvant, were evaluated regarding their ability to generate Th1 immune response through a Delayed -Type Hypersensitivity Test, at the mouse model, by using a Neisseria meningitidis B protein complex as antigen. The formulations were administered by intramuscular (IM) (2 inoculations - at baseline and after 14â¯days) and intranasal (IN) (3 inoculations at 7â¯days) immunization pathways. All IM immunized groups were able to induce similar response to these formulations as well as to VA-MENGOC-BC® vaccine - containing Al(OH)3 adjuvant (used as positive control of the trial). In all groups, the induced inflammation (IP) rate was statistically higher than in the negative control group (CN) (pâ¯<â¯0.05). Immunogenicity, measured by HSR and CD4+ lymphocyte increase was equivalent to the control vaccine and most important, granuloma reactogenicity at the site of injection was eliminated, fact demonstrated by histological study. All groups of animals immunized by IN route showed HSR reactions and statistically significant differences with respect to the CN group. However, IP values were lower, with statistical differences (pâ¯<â¯0.05) for the same adjuvant formulation IM administered, except the AIF2-nCh formulation that generated statistically similar induction (pâ¯>â¯0.05) by both immunization pathways, suggesting it to be the best candidate for the next IN trial. Proteoliposome and cochleate formulations tested were able to mount potent Th-1 immune response, equivalent to the original vaccine formulation, with the advantage of less reactogenicity in the site of the injection, caused by the toxicity of Al(OH)3 adjuvant gel.
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Adjuvantes Imunológicos/uso terapêutico , Antígenos de Bactérias/imunologia , Imunidade Celular , Meningite Meningocócica/prevenção & controle , Vacinas Meningocócicas , Adjuvantes Imunológicos/administração & dosagem , Administração Intranasal , Animais , Injeções Intramusculares , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Neisseria meningitidis , ProteolipídeosRESUMO
Introducción: La artritis reumatoide es una enfermedad inflamatoria sistémica y crónica que, aunque suele tener su pico de incidencia en edades superiores, también puede presentar en edades más tempranas de la vida. La gestación es estas pacientes es considerada una situación de elevado riesgo debido a la misma actividad de la enfermedad y al posible efecto teratogénico que pueden devenirse del uso de muchos de los fármacos que generalmente se utilizan en estos casos. Sin embargo, una correcta planificación, un adecuado seguimiento ginecobstétrico y reumatológico y la valoración sistemática de la actividad de la enfermedad, constituyen los elementos básicos de la atención médica durante este periodo. Objetivo: dar a conocer los elementos fundamentales del seguimiento de la gestación en pacientes con artritis reumatoide. Caso clínico: se presenta el caso de una paciente de 23 años de edad con diagnóstico de artritis reumatoide de 5 años de evolución que concibe una gestación que con todos los cuidados médicos se logra llegar a un feliz término. Conclusiones: al ser la artritis reumatoide una enfermedad de compleja evolución las pacientes jóvenes tienen cierto temor a la gestación, sin embargo, durante el embarazo se produce cierta mejoría clínica de la artritis. Es imprescindible garantizar la menor actividad posible para que no afecte el pronóstico y la salud materna y fetal(AU)
Introduction: Rheumatoid arthritis is a systemic and chronic inflammatory disease that, although it usually has its peak of incidence in older ages, can also present at younger ages of life. The pregnancy is these patients is considered a situation of high risk due to the same activity of the disease and the possible teratogenic effect that can be derived from the use of many of the drugs that are generally used in these cases. However, proper planning, adequate gynecobysteometric and rheumatological follow-up, and systematic assessment of disease activity are the basic elements of medical care during this period. Objective: to present the fundamental elements of the pregnancy follow-up in patients with rheumatoid arthritis. Clinical case: We present the case of a 23-year-old patient with a diagnosis of rheumatoid arthritis of 5 years of evolution who conceives a pregnancy that with all medical care is achieved a happy term. Conclusions: as rheumatoid arthritis is a disease of complex evolution young patients have some fear of pregnancy, however, during pregnancy there is some clinical improvement of arthritis. It is essential to guarantee as little activity as possible so that it does not affect prognosis and maternal and fetal health(AU)
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Humanos , Feminino , Gravidez , Adulto Jovem , Complicações na Gravidez/prevenção & controle , Artrite Reumatoide/complicações , Saúde Materna , PlanejamentoRESUMO
Physical nanocomposite hydrogels composed of poly(2-hydroxyethylmethacrylate) and titanium oxide nanoparticles at low concentrations (<1.0â¯wt%) were synthesized. The effect of the nanoparticle content on the water swelling and mechanical properties of the hydrogels was investigated. Additionally, to study the influence of the polymer-nanoparticle interactions, a second type of nanocomposite was synthesized using surface functionalized nanoparticles with 3-methacryloxypropyltrimethoxysilane as the filler. The pristine nanoparticles increased the swelling capacity, especially at short time scales, and greater solvent diffusion coefficients and initial swelling rates were achieved. In contrast, the nanocomposite filled with functionalized nanoparticles exhibited a diminished swelling capacity, a constant diffusion coefficient and a significant decrease in the initial swelling rate. The mechanical properties were studied by dynamic mechanical analyses using stress-relaxation tests. Two Maxwell models in parallel agreed well with the curves of the relaxation modulus as a function of time and indicated that at short relaxation times, the nanoparticles did not cause an effect, but that at longer times, the nanoparticles decreased the relaxation time. Finally, hydrogel network parameters determined by swelling measurements and mechanical experiments indicated that the hydrogel with well distributed nanoparticles decreases the molar mass between crosslink point and the mesh size, while poorly distributed nanoparticles lead to larger mesh size. Our functional studies show that the addition of titanium oxide nanoparticles improves the ability of nanocomposite hydrogels to retain aggregates of skeletal muscle cells, revealing their potential use as suitable scaffolds for tissue repair strategies.
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Células Imobilizadas/metabolismo , Hidrogéis/química , Mioblastos/metabolismo , Nanocompostos/química , Nanopartículas/química , Titânio/química , Animais , Linhagem Celular , Células Imobilizadas/citologia , Camundongos , Mioblastos/citologiaRESUMO
In the central nervous system (CNS), senescent astrocytes have been associated with neurodegeneration. Senescent cells secrete a complex mixture of pro-inflammatory factors, which are collectively called Senescence Associated Secretory Phenotype (SASP). The SASP components can vary depending on the cell type, senescence inducer and time. The SASP has been mainly studied in fibroblasts and epithelial cells, but little is known in the context of the CNS. Here, the SASP profile in senescent astrocytes isolated from Wistar newborn rats induced to senescence by oxidative stress or by proteasome inhibition was analyzed. Senescent astrocytes secreted predominantly chemokines and IL-1α, but no IL-6. The effect of the anti-inflammatory drugs, sulforaphane (SFN) and dehydroepiandrosterone (DHEA), on the SASP profile was evaluated. Our results showed that SFN and DHEA decreased IL-1α secretion while increasing IL-10, thus modifying the SASP to a less anti-inflammatory profile. Primary neurons were subjected to the conditioned media obtained from drug-treated senescent astrocytes, and their mitochondrial membrane potential was evaluated.
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Astrócitos , Senescência Celular , Sistema Nervoso Central , Desidroepiandrosterona/farmacologia , Isotiocianatos/farmacologia , Neurônios , Animais , Animais Recém-Nascidos , Anti-Inflamatórios/farmacologia , Astrócitos/efeitos dos fármacos , Astrócitos/imunologia , Senescência Celular/efeitos dos fármacos , Senescência Celular/imunologia , Sistema Nervoso Central/efeitos dos fármacos , Sistema Nervoso Central/imunologia , Sistema Nervoso Central/metabolismo , Inflamação , Interleucina-1alfa/imunologia , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Modelos Animais , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Estresse Oxidativo/fisiologia , Ratos , Ratos Wistar , SulfóxidosRESUMO
Cellular senescence has been traditionally characterized by cell cycle arrest of pot-mitotic cells as a response to a cellular damage. Now is known that senescent cells secret a diverse array of cytokines, chemokines, growth factors and other that altogether are called senescence associates secretory phenotype (SASP), which might have beneficial or deleterious effects on neighbor cells. This review describes those effects as well as the relationship between the SASP and several age related diseases. We also analyze the direction that recent investigations are turning in order to modulate or avoid the effect of the SASP in those pathologies.
La senescencia celular es un fenómeno que tradicionalmente se ha caracterizado por la detención de la proliferación de células post-mitóticas como respuesta a algún tipo de daño. Ahora se sabe que las células senescentes secretan un conjunto de moléculas, entre las que se encuentran quimiocinas, citocinas, factores de crecimiento y otras que, en conjunto, han sido denominadas fenotipo secretor asociado a la senescencia (SASP). Estas moléculas pueden tener efectos benéficos o dañinos sobre las células vecinas a ellas. Esta revisión describe dichos efectos, así como la relación del SASP con diversas enfermedades asociadas a la edad. También se analiza el rumbo que han tomado las investigaciones recientes para tratar de modular o eliminar el efecto del SASP en dichas patologías.
Assuntos
Aterosclerose/fisiopatologia , Senescência Celular/fisiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Doenças Neurodegenerativas/fisiopatologia , Sarcopenia/fisiopatologia , Envelhecimento/fisiologia , Humanos , FenótipoRESUMO
Introducción: la anemia hemolítica autoinmune (AHAI) constituye un cuadro clínico heterogéneo caracterizado por la existencia de autoanticuerpos contra antígenos presentes en la membrana de los eritrocitos del paciente que provocan el acortamiento de su vida media. Objetivo: conocer las características clínicas y de laboratorio de las anemias hemolíticas autoinmunes diagnosticadas en el centro. Métodos: se realizó un estudio descriptivo, retrospectivo y de cohorte que incluyó 15 pacientes con el diagnóstico de AHAI en el Hospital Militar Central Dr. Carlos J. Finlay, entre enero de 2011 y diciembre de 2013. Resultados: el rango de edad de los pacientes estudiados fue de 34 a 75 años (mediana de 59 años); de ellos, 8 fueron del sexo femenino y 7 del masculino. El 87 por ciento presentó una AHAI idiopática y el 13 por ciento secundaria. Las secundarias se asociaron con lupus eritematoso sistémico (n = 1) y leucemia linfoide crónica de estirpe B (n = 1). Existió anemia grave de comienzo súbito en el 40 por ciento, e insidioso en el 60 por ciento, íctero en el 73 por ciento, esplenomegalia en el 13 por ciento y dolores articulares difusos en el 20 por ciento de los pacientes. La prueba de Coombs directa resultó positiva en 14 pacientes. Al mes de tratamiento con esteroides, el 33 por ciento presentó una respuesta completa, el 40 por ciento una respuesta parcial y el 27 por ciento no respondió. Conclusiones: este estudio muestra los hallazgos clínicos y de laboratorio de una pequeña serie de casos adultos con AHAI. La etiología primaria o idiopática fue la más frecuente pero se requiere evolucionar en el tiempo a los pacientes ya que esta entidad puede preceder la aparición de hemopatías malignas o enfermedades del colágeno(AU)
Introduction: autoimmune hemolytic anemia (AIHA) is a heterogeneous clinical picture characterized by the presence of autoantibodies against antigens present on the membrane of the patient's erythrocytes causing shortening of the average life. Objective: To determine the clinical and laboratory autoimmune hemolytic anemias diagnosed in our hospital. Methods: adescriptive, retrospective cohort study involving 15 patients with the diagnosis of AIHA was carried out at Dr. Carlos J. Finlay Central Military Hospital, between January, 2011 and December, 2013. Results: the mean age of the patients was 34 - 75 years (median 59 years), 8 were female and 7 male; 87 percent had idiopathic AIHA and 13 percent secondary AIHA. Secondary hemolytic anemias were associated with systemic lupus erythematosus SLE (n = 1) and B-cell chronic (n = 1) lymphoid leukemia. There was severe anemia (median Hb. 69 g / L) of sudden onset in 40 percent, insidious in 60 percent, jaundice in 73 percent, splenomegaly in 13 percent and diffuse joint pain in 20 percent of patients. The direct Coombs test was positive in 14 patients. After a month of steroid treatment, 33 percent had a complete response, 40 percent partial response and 27 percent did not respond. Conclusions: this study shows the clinical and laboratory characteristics of a small number of adults cases with AIHA findings. Primary or idiopathic etiology was the most frequent but evolve evolving patients over time it is required requires patients and that as this entity may precede the onset of hematological malignancies or collagen diseases(AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Anemia Hemolítica Autoimune/diagnóstico , Anemia Hemolítica Autoimune/tratamento farmacológico , Anemia Hemolítica Autoimune/epidemiologia , Estudos de Coortes , Epidemiologia Descritiva , Estudos RetrospectivosRESUMO
Mantener una adecuada relación médicopaciente a través de la formación e información del paciente, incentiva la prevención en salud y adherencia al tratamiento. En esta relación hay dos grandes actores, el médico quien tiene el conocimiento técnico y científico, y el paciente quien acude por ayuda. Para que esta relación funcione adecuadamente es necesaria la confianza mutua...
Maintaining a proper doctor-patient relationship through training and information of the patient encourages health prevention and treatment adherence. In this regard, there are two big players: the doctor, who has the technical and scientific knowledge, and the patient, who comes looking for help. For this relationship to work properly, mutual trust is needed...
Assuntos
Humanos , Colômbia , Comunicação , Relações Médico-PacienteRESUMO
Cumulative evidence indicates that Wnt pathways play crucial and diverse roles to assemble the neuromuscular junction (NMJ), a peripheral synapse characterized by the clustering of acetylcholine receptors (AChR) on postsynaptic densities. The molecular determinants of Wnt effects at the NMJ are still to be fully elucidated. We report here that the Wnt receptor Frizzled-9 (Fzd9) is expressed in developing skeletal muscles during NMJ synaptogenesis. In cultured myotubes, gain- and loss-of-function experiments revealed that Fzd9-mediated signaling impairs the AChR-clustering activity of agrin, an organizer of postsynaptic differentiation. Overexpression of Fzd9 induced the cytosolic accumulation of ß-catenin, a key regulator of Wnt signaling. Consistently, Fzd9 and ß-catenin localize in the postsynaptic domain of embryonic NMJs in vivo. Our findings represent the first evidence pointing to a crucial role of a Fzd-mediated, ß-catenin-dependent signaling on the assembly of the vertebrate NMJ.