Factores clínicos e inmunológicos asociados a la nefritis lúpica en pacientes del noroeste de Colombia.

Este estudio transversal y multicéntrico investigó las características clínicas e inmunológicas asociadas con la nefritis lúpica en pacientes colombianos de Medellín. Se incluyeron treinta y nueve pacientes con nefritis lúpica y se compararon sus características con las de 100 pacientes con lupus eritematoso sistémico (LES) sin compromiso renal. Se realizó un análisis multivariado para evaluar los factores asociados con la nefritis lúpica. Los pacientes que desarrollaron nefritis presentaron, al inicio, más úlceras orales (41% vs. 21%, OR=3,1, IC95%: 1,3-7,5, p=0,01)y eritema malar (77% vs. 45%, OR=4,4, IC95%: 1,8-10,8, p=0,001) que aquellos pacientes sin nefropatía. La nefritis lúpica se observó en 77% de los casos durante el primer año de evolución del LES. La frecuencia de anticuerpos anti-ADN fue mayor en los pacientes con nefritis; sine mbargo, las diferencias no fueron significativas (83% vs. 64%, OR=2,57, IC95%:1,03-6,41,p=0,06). La presencia de otros anticuerpos (anti-Ro, anti-La, anti-RNP, anti-Sm y anticardiolipina)en el momento del diagnóstico fue similar en ambos grupos. El perfil de los autoanticuerpos permaneció sin modificación significativa durante el curso del LES. Los pacientes con nefritis lúpica presentaron una mayor prevalencia de hipertensión arterial (60% vs 10%, OR=13,7,IC95%: 5-37, p=0,00001) y dislipidemia (30% vs 7%, OR=8,1, IC95%: 2,5-27, p=0,0006) al inicio de la enfermedad que aquellos pacientes sin nefropatía. Los pacientes con nefritis lúpica requirieron más hospitalizaciones (>1) durante el curso de la enfermedad (89% vs 60%, OR=7,8,IC95%: 2,1-29, p=0,002). En conclusión, la nefritis lúpica se presenta tempranamente en el LES. El eritema malar, las úlceras orales, la hipertensión arterial y la dislipidemia son factores asociados. A su vez, la nefritis lúpica es un factor de riesgo de hospitalizaciones repetidas. Este estudio puede ser útil en la toma de decisiones de políticas de salud para beneficio de los pacientes y reducción de costos.A cross-sectional and multicenter study was undertaken to analyze the clinical andimmunological characteristics at diagnosis associated with nephritis in northwesternColombian patients with systemic lupus erythematosus (SLE). Thirty nine patients with lupusnephritis were included and were compared to 100 SLE patients without nephritis. A multivariateanalysis was performed. The patients who developed nephritis had a higher frequency of oralulcers (41% vs. 21%, OR=3.1, 95%CI: 1.3-7.5 p= 0.01) and malar erythema (77% vs. 45%,OR=4.4, 95%CI: 1.8-10.8 p=0.001). Lupus nephritis was observed in 77% of cases during thefirst year of the disease. The frequency of anti-DNA antibodies was higher in patients withnephritis, however, differences were not statistically significant (83% vs 64%, OR=2.6, 95%CI:1.03-6.41, p=0.06). The presence of other autoantibodies (anti-Ro, anti-La, anti-RNP, anti-Smand anticardiolipin) at diagnosis was similar in both groups. This autoantibody profile remainedunchanged throughout the evolution of the disease. Patients with lupus nephritis had a higherprevalence of arterial hypertension (60% vs 10%, OR=13.7, 95%IC: 5-37, p=0.00001) andhyperlipidemia (30% vs 7%, OR=8.1, 95%IC: 2.5-27, p=0.0006) at onset. Finally, patients withlupus nephritis required more hospitalizations (>1) over the course of disease (89% vs 60%,OR=7.8, 95%CI: 2.1–29, p=0.002). In conclusion, lupus nephritis appears early during thecourse of SLE. Malar erythema, oral ulcers, hypertension and hyperlipidemia at onset of diseaseare associated factors. Lupus nephritis is a major risk factor leading to repeatedhospitalizations. This study may help to assist in public health policies in our population inorder to improve patient outcomes while simultaneously reducing disease costs

Factores clínicos y epidemiológicos asociados con nefritis lúpica en pacientes del noroccidente colombiano

A cross-sectional and multicenter study was undertaken to analyze the clinical and immunological characteristics at diagnosis associated with nephritis in northwestern Colombian patients with systemic lupus erythematosus (SLE). Thirty-nine patients with lupus nephritis were included and were compared to 100 SLE patients without nephritis. A multivariate analysis was performed. The patients who developed nephritis had a higher frequency of oral ulcers (41% vs. 21%, OR = 3.1, 95% CI: 1.3-7.5 p = 0.01) and malar erythema (77% vs. 45%, OR = 4.4, 95% CI: 1.8-10.8 p = 0.001). Lupus nephritis was observed in 77% of cases during the first year of the disease. The frequency of anti-DNA antibodies was higher in patients with nephritis, however, differences were not statistically significant (83% vs 64%, OR = 2.6, 95% CI: 1.03-6.41, p = 0.06). The presence of other autoantibodies (anti-Ro, anti-La, anti-RNP, anti-Sm and anticardiolipin) at diagnosis was similar in both groups. This autoantibody profile remained unchanged throughout the evolution of the disease. Patients with lupus nephritis had a higher prevalence of arterial hypertension (60% vs 10%, OR = 13.7, 95% IC: 5-37, p = 0.00001) and hyperlipidemia (30% vs 7%, OR = 8.1, 95% IC: 2.5-27, p = 0.0006) at onset. Finally, patients with lupus nephritis required more hospitalizations (> 1) over the course of disease (89% vs 60%, OR = 7.8, 95% CI: 2.1-29, p = 0.002). In conclusion, lupus nephritis appears early during the course of SLE. Malar erythema, oral ulcers, hypertension and hyperlipidemia at onset of disease are associated factors. Lupus nephritis is a major risk factor leading to repeated hospitalizations. This study may help to assist in public health policies in our population in order to improve patient outcomes while simultaneously reducing disease costs.Este estudio transversal y multicéntrico investigó las características clínicas e inmunológicas asociadas con la nefritis lúpica en pacientes colombianos de Medellín. Se incluyeron treinta y nueve pacientes con nefritis lúpica y se compararon sus características con las de 100 pacientes con lupus eritematoso sistémico (LES) sin compromiso renal. Se realizó un análisis multivariado para evaluar los factores asociados con la nefritis lúpica. Los pacientes que desarrollaron nefritis presentaron, al inicio, más úlceras orales (41% vs. 21%, OR=3,1, IC95%: 1,3-7,5, p=0,01) y eritema malar (77% vs. 45%, OR=4,4, IC95%: 1,8-10,8, p=0,001) que aquellos pacientes sin nefropatía. La nefritis lúpica se observó en 77% de los casos durante el primer año de evolución del LES. La frecuencia de anticuerpos anti-ADN fue mayor en los pacientes con nefritis; sin embargo, las diferencias no fueron significativas (83% vs. 64%, OR=2,57, IC95%:1,03-6,41, p=0,06). La presencia de otros anticuerpos (anti-Ro, anti-La, anti-RNP, anti-Sm y anticardiolipina) en el momento del diagnóstico fue similar en ambos grupos. El perfil de los autoanticuerpos permaneció sin modificación significativa durante el curso del LES. Los pacientes con nefritis lúpica presentaron una mayor prevalencia de hipertensión arterial (60% vs 10%, OR=13,7, IC95%: 5-37, p=0,00001) y dislipidemia (30% vs 7%, OR=8,1, IC95%: 2,5-27, p=0,0006) al inicio de la enfermedad que aquellos pacientes sin nefropatía. Los pacientes con nefritis lúpica requirieron más hospitalizaciones (>1) durante el curso de la enfermedad (89% vs 60%, OR=7,8, IC95%: 2,1-29, p=0,002). En conclusión, la nefritis lúpica se presenta tempranamente en el LES. El eritema malar, las úlceras orales, la hipertensión arterial y la dislipidemia son factores asociados. A su vez, la nefritis lúpica es un factor de riesgo de hospitalizaciones repetidas. Este estudio puede ser útil en la toma de decisiones de políticas de salud para beneficio de los pacientes y reducción de costos

Label-free wavelength and phase detection based SMS fiber immunosensors optimized with cladding etching

The performance of E-SMS (Etched Singlemode-Multimode-Singlemode) optical fiber structures as immunosensors has been assessed by the implementation of antibody/antigen immunoassays. Through this procedure it has been proven that E-SMS structures are effective and suitable optical platforms for label-free biosensing. Using the phase shift and tracking the wavelength response it was found that the fabricated E-SMS devices exhibited limits of detection (LOD) down up to concentrations of 0.2 mg/L of antigens in solution. This was achieved by coating the E-SMS with an antibody-based biolayer (goat IgG) that is able to determine the presence of anti-goat IgG antigen. Both a wavelength detection and a fast Fourier transform (FFT) analysis technique were used to perform this analysis. The FFT method showed similar results to those observed with the most traditional wavelength analysis, but with the advantage of a simpler detection system that makes unnecessary the use of sophisticated optical interrogators

Design, development and validation of a new laryngo-pharyngeal endoscopic esthesiometer and range-finder based on the assessment of air-pulse variability determinants

BACKGROUND: Laryngo-pharyngeal mechano-sensitivity (LPMS) is involved in dysphagia, sleep apnea, stroke, irritable larynx syndrome and cough hypersensitivity syndrome among other disorders. These conditions are associated with a wide range of airway reflex abnormalities. However, the current device for exploring LPMS is limited because it assesses only the laryngeal adductor reflex during fiber-optic endoscopic evaluations of swallowing and requires a high degree of expertise to obtain reliable results, introducing intrinsic expert variability and subjectivity. METHODS: We designed, developed and validated a new air-pulse laryngo-pharyngeal endoscopic esthesiometer with a built-in laser range-finder (LPEER) based on the evaluation and control of air-pulse variability determinants and on intrinsic observer variability and subjectivity determinants of the distance, angle and site of stimulus impact. The LPEER was designed to be capable of delivering precise and accurate stimuli with a wide range of intensities that can explore most laryngo-pharyngeal reflexes. RESULTS: We initially explored the potential factors affecting the reliability of LPMS tests and included these factors in a multiple linear regression model. The following factors significantly affected the precision and accuracy of the test (P < 0.001): the tube conducting the air-pulses, the supply pressure of the system, the duration of the air-pulses, and the distance and angle between the end of the tube conducting the air-pulses and the site of impact. To control all of these factors, an LPEER consisting of an air-pulse generator and an endoscopic laser range-finder was designed and manufactured. We assessed the precision and accuracy of the LPEER's stimulus and range-finder according to the coefficient of variation (CV) and by looking at the differences between the measured properties and the desired values, and we performed a pilot validation on ten human subjects. The air-pulses and range-finder exhibited good precision and accuracy (CV < 0.06), with differences between the desired and measured properties at <3 % and a range-finder measurement error of <1 mm. The tests in patients demonstrated obtainable and reproducible thresholds for the laryngeal adductor, cough and gag reflexes. CONCLUSIONS: The new LPEER was capable of delivering precise and accurate stimuli for exploring laryngo-pharyngeal reflexes

RESOLUCIÓN DE CONFLICTOS AL INTERIOR DEL ORGANISMO: EL PAPEL DEL SISTEMA INMUNE

<p>El sistema inmune de los animales está constituido por una gran variedad de células y moléculas que colectivamente reconocen, neutralizan y eliminan potenciales agentes nocivos, tanto bióticos como abióticos. El estudio del sistema inmune ha estado tradicionalmente sesgado hacía algunas especies de importancia médica o económica, a expensas de la gran mayoría de especies que constituyen la diversidad animal. Con la actual facilidad de secuenciar genomas y transcriptomas, se ha abierto la posibilidad de estudiar los sistemas inmunes de muy variados grupos animales. Uno de estos grupos es los cnidarios, que incluye a los corales, anémonas y medusas, en los que el estudio del sistema inmune ha probado ser de gran utilidad para entender dos tipos de conflictos de relevancia en la supervivencia de estos organismos. El primero es la respuesta de los corales a enfermedades de carácter infeccioso y el segundo hace referencia a las reacciones de histocompatibilidad que median la competencia intraespecífica por el espacio habitable. Este artículo de reflexión trata en detalle el papel del sistema inmune de los cnidarios en la resolución de estos conflictos.</p><p> </p><p>Abstract</p><p>The immune system of animals is constituted by a large diversity of cells and molecules that collectively recognize, neutralize, and eliminate potential damaging agents, both biotic and abiotic. The study of the immune system has been traditionally biased towards some species with medical or economic importance, at the expense of the vast majority of species that constitute the animal diversity. With the current possibility of easily sequencing genomes and transcriptomes, there is an opportunity to study the immune systems of a wide variety of animal groups. One of these groups is the cnidarians, which include corals, anemones and jellyfishes, in which the study of the immune system has proved useful to understand two types of conflicts that are relevant for the survival of these organisms. The first one is the response of corals to diseases of infectious nature and the second relates to histocompatibility reactions, which mediate intraspecific competitions for habitable space. This article details the role of the cnidarian immune system to mediate the resolution of these two conflicts.</p><p> </p