Influencia del tratamiento antirretroviral en los marcadores inflamatorios y la activación del sistema monocito macrofágico a través del stweak y scd163 en una población VIH naive

Texto completo descargado desde TeseoIntroducción: Los pacientes con infección por el virus de la inmunodeficiencia humana (VIH) tienen un riesgo cardiovascular incrementado debido a la interacción de varios factores: 1) La propia infección VIH que condiciona un estado proinflamatorio y activación inmune persistentes que causarían daño vascular, 2) El tratamiento antirretroviral que ocasiona alteraciones proaterogénicas del metabolismo lipídico e hidrocarbonado; y 3) Una elevada prevalencia de factores de riesgo cardiovascular tradicionales. En los últimos años se está enfocando la atención en la importancia de la infección VIH y la activación inmune persistente. El CD163 es un receptor de membrana relacionado con la activación de monocitos-macrófagos que interacciona con el TWEAK, un miembro de la superfamilia del receptor de necrosis tumoral (TNF) relacionado con el desarrollo de arteriosclerosis. Los niveles circulantes de ambos se han asociado consistentemente con la presencia de enfermedad cardiovascular. Objetivos: Los objetivos principales del estudio son: 1.- Evaluar el efecto del tratamiento antirretroviral sobre la activación del sistema inmune (sCD163, sTWEAK y ratio sCD163/sTWEAK), el estado inflamatorio (PCRus) y la función endotelial (ADMA, sVCAM-1) en pacientes con infección VIH basalmente y tras 48 semanas de tratamiento. 2.- Explorar el comportamiento en pacientes con infección VIH de dos nuevos marcadores relacionados con enfermedad cardiovascular, sTWEAK y sCD163, comparándolos con sujetos controles sin infección VIH. Material y métodos: 26 pacientes con infección VIH no expuestos previamente a tratamiento antirretroviral (naive) y 23 sujetos VIH negativos fueron incluidos en el estudio. Ninguno tenía enfermedad cardiovascular ni diabetes mellitus tipo 2. Mediante ELISA se determinaron las concentraciones séricas de sTWEAK, sCD163, sVCAM-1, ADMA y PCRus en los pacientes VIH basalmente y a las 48 semanas de haber iniciado tratamiento antirretroviral y en los controles sanos en el momento de inclusión en el estudio. Resultados: Los pacientes con infección VIH presentaron niveles reducidos de sTWEAK y elevados de sCD163, sVCAM-1, ADMA y PCRus comparado con sujetos no infectados. El tratamiento antirretroviral redujo significativamente la concentración de sCD163, sVCAM-1 y PCRus, aunque persistieron elevados comparados con los controles. El tratamiento antirretroviral por el contrario no produjo cambios en la concentración de ADMA ni sTWEAK. Conclusión: El tratamiento antirretroviral redujo la activación de los monocitos-macrófagos (sCD163), el estado de inflamación (PCRus) y la activación endotelial (sVCAM-1) en una cohorte de pacientes VIH previamente no tratados. A pesar de ello, los pacientes VIH bajo tratamiento antirretroviral eficaz, mantuvieron un estado de inflamación y activación inmune persistentes al compararlos con controles sin infección VIH

Autonomia profissional do dentista em instituições prestadoras de serviços públicos e privados de saúde, em Bogotá, no âmbito do sistema de saúde colombiano

Objective: To identify the influence of the Colombian health system on the professional autonomy of dentists who practice in public and private IPS (healthcare providing institutions) in Bogotá. Methodology: comprehensive qualitative study, carried out with ethnographic tools such as the semi-structured interview. The analysis categories were: professional autonomy, health care models, decision making and contract system. The information was analyzed according to its category, context and content. Results: it was found that professional autonomy is limited due to the time given per patient (twenty minutes). Another limitation is the restriction to carry out procedures and, sometimes, the care protocols. Due to these limitations, dentists lose the skills and knowledge acquired in the academia, their abilities and self-confidence. Discussion: the Colombian health system limits the professional autonomy of dentists who work in public and private IPS. Professional autonomy, related to decision making, is an important axis in the healthcare practice. Exercising professional autonomy allows achieving ethical-clinical reasonings, developing skills and promoting the patients ́ well-being, that is, the bioethical commitment (beneficence, non-maleficence and justice), and respect.Objetivo: identificar la influencia del sistema de salud colombiano sobre la autonomía profesional de odontólogos que ejercen en IPS públicas y privadas de Bogotá. Metodología: estudio cualitativo comprensivo, llevado a cabo con herramientas etnográficas como la entrevista semiestructurada. Las categorías de análisis fueron: autonomía profesional, modelos de atención, toma de decisiones y sistema contractual. La información se analizó de manera categorial, contextual y de contenido. Resultados: se evidenció que la autonomía profesional está limitada por el tiempo de atención para los pacientes (veinte minutos). Otra limitante es la restricción en la realización de procedimientos y, en ocasiones, los protocolos de atención. Por estas limitaciones, el odontólogo pierde habilidades y conocimientos adquiridos en la academia, sus habilidades y la seguridad en sí mismo. Discusión: el sistema de salud colombiano limita la autonomía profesional de los odontólogos que ejercen en IPS públicas y privadas. La autonomía profesional, relacionada con la toma de decisiones, es un eje importante del ejercicio asistencial. Ejercer la autonomía profesional permite lograr razonamientos ético-clínicos, desarrollar destrezas y promover el bienestar de los pacientes, es decir, el compromiso bioético (beneficencia, no maleficencia y justicia), y el respeto.Objetivo: identificar a influência do sistema de saúde colombiano na autonomia profissional dos dentistas que atuam nas instituições prestadoras de serviços de saúde (IPS) públicas e privadas, em Bogotá. Metodologia: estudo qualitativo compreensivo, realizado com ferramentas etnográficas, como a entrevista semiestruturada. As categorias de análise foram: autonomia profissional, modelos de atenção, tomada de decisão e sistema contratual. As informações foram analisadas de forma categórica, contextual e de conteúdo. Resultados: evidenciou-se que a autonomia profissional é limitada pelo tempo de atendimento aos pacientes (vinte minutos). Outra limitação é a restrição na execução de procedimentos e, às vezes, nos protocolos de atenção. Devido a essas limitações, o dentista perde as habilidades e os conhecimentos acadêmicos que foram adquiridos, além de suas próprias habilidades e sua autoconfiança. Discussão: o sistema de saúde colombiano limita a autonomia profissional dos dentistas que atuam nas IPS públicas e privadas. A autonomia profissional, relacionada à tomada de decisão, é um importante eixo de atenção à saúde. O exercício da autonomia profissional nos permite alcançar o raciocínio ético-clínico, desenvolver habilidades e promover o bem-estar dos pacientes, ou seja, o compromisso bioético (beneficência, não maleficência e justiça) e o respeito

Multielemental analysis of oils and animal fat by using deep eutectic solvents assisted by an aerosol phase extraction procedure

In the present study, thirteen elements (Ag, Al, Ba, Cd, Cr, Cu, Fe, K, Li, Mg, Mn, Ni, Pb) have been extracted from used cooking oils, olive oils and animal fat. Either inductively coupled plasma optical emission spectrometry (ICP-OES) or tandem mass spectrometry (ICP-MS/MS) have been chosen as detection techniques. Due to the difficulty of directly introducing highly viscous organic samples into the spectrometer, a fast dispersive liquid – liquid aerosol phase extraction (DLLAPE) method has been selected to isolate the analytes from the sample matrix. The DLLAPE is based on the generation of an aerosol from the extracting phase with the help of a pneumatic nebulizer. This high velocity aerosol impacts and penetrates in the liquid sample. Consequently, the liquid – liquid exchange surface area becomes high, thus leading to high extraction yields. A hydrophilic deep eutectic solvent (DES) consisting of choline chloride and ethylene glycol (1:2 mass ratio) has been selected as the extracting solvent. Prior to undertaking the experiments, the extraction method has been evaluated in terms of precision under suitable conditions. In comparison with conventional methods based on sample digestion, sample dilution and shot analysis or extraction assisted by vortex agitation, the DLLAPE shows several advantages, because it is faster, and it provides lower limits of detection than the reference methodologies. The procedural limits of quantification for the determined elements with the DLLAPE in ICP-OES were 0.046 (Ag), 0.396 (Al), 0.013 (Cd), 0.033 (Cr), 0.040 (Cu), 0.20 (Fe), 0.026 (K), 0.026 (Li), 0.33 (Mg), 0.013 (Mn), 2.64 (Ni) and 0.53 (Pb) mg kg−1. Meanwhile, pLOQ in ICP-MS/MS lowered by roughly one order of magnitude. The accuracy of the aerosol phase extraction method has been evaluated through the determination of the recoveries for four representative analytes (Ca, Cu, Mg and Ni) from spiked real samples. For these elements, recovery has taken values of (100 ± 20)%. Moreover, a comparison of the multielemental concentration obtained with conventional methods (c.a., sample dilution and shot ICP analysis and liquid-liquid extraction using a vortex agitator) against that measured with the DLLAPE has been carried out. Multiemelemental concentrations have been obtained for real samples and the found levels have been similar to those encountered in previously published works.The authors wish to thank to the Spanish Ministry of Science, Innovation and Universities for the financial support (Projects Ref. PID2021-127566NB-I00 and PID2021-127322NB-100)

Proposal for the Implementation of a Geography Curriculum in Colombia.

En Colombia la educación geográfica, enmarcada en la política educativa, ha tenido cambios significativos. Se ha dado la transición de área autónoma a un área integrada con la historia, la democracia y la Constitución política, bajo la denominación de Ciencias Sociales, a partir de 1994 con la Ley 115 de Educación y, recientemente, con la expedición de la Ley 1874 del 2017, que le dio a la historia un estatus diferente al de las demás ciencias sociales escolares. Estos cambios evidencian una geografía escolar disminuida y cada vez más difuminada. Desde el Grupo Interinstitucional de Investigación Geopaideia, buscando responder al porqué y al para qué de la educación geográfica escolar, se han sistematizado algunas experiencias cuyo propósito ha sido definir unas temáticas curriculares para la enseñanza de la geografía. El presente artículo es producto de estas reflexiones y de la práctica de los tres autores en políticas educativas, currículo, formación docente y enseñanza escolar.In Colombia, geographic education, in the framework of an educational policy, has experienced significant changes, with little curricular and formative support. It has undergone a transition from an autonomous to an integrated area—along with history, democracy and the political Constitution—under the name of social sciences, starting in 1994 with Law 115 of Education, and recently, with Law 1874 of 2017—which assigns History a different status to the other school social sciences—. Such changes show a diminished and increasingly blurred school geography. The Inter-Institutional Research Group Geopaideia, seeking to answer the why and what in school geographical education, has systematized some experiences aimed at defining curricular topics for the teaching of geography. This article is the product of these reflections and the practice of the three authors in educational policies, curriculum, teacher training, and school education

Proposal for the Implementation of a Geography Curriculum in Colombia

In Colombia, geographic education, in the framework of an educational policy, has experienced significant changes, with little curricular and formative support. It has undergone a transition from an autonomous to an integrated area—along with history, democracy and the political Constitution—under the name of social sciences, starting in 1994 with Law 115 of Education, and recently, with Law 1874 of 2017—which assigns History a different status to the other school social sciences—. Such changes show a diminished and increasingly blurred school geography. The Inter-Institutional Research Group Geopaideia, seeking to answer the why and what in school geographical education, has systematized some experiences aimed at defining curricular topics for the teaching of geography. This article is the product of these reflections and the practice of the three authors in educational policies, curriculum, teacher training, and school education.En Colombia la educación geográfica, enmarcada en la política educativa, ha tenido cambios significativos. Se ha dado la transición de área autónoma a un área integrada con la historia, la democracia y la Constitución política, bajo la denominación de Ciencias Sociales, a partir de 1994 con la Ley 115 de Educación y, recientemente, con la expedición de la Ley 1874 del 2017, que le dio a la historia un estatus diferente al de las demás ciencias sociales escolares. Estos cambios evidencian una geografía escolar disminuida y cada vez más difuminada. Desde el Grupo Interinstitucional de Investigación Geopaideia, buscando responder al porqué y al para qué de la educación geográfica escolar, se han sistematizado algunas experiencias cuyo propósito ha sido definir unas temáticas curriculares para la enseñanza de la geografía. El presente artículo es producto de estas reflexiones y de la práctica de los tres autores en políticas educativas, currículo, formación docente y enseñanza escolar.Na Colômbia, a educação geográfica, enquadrada na política educacional, sofreu mudanças significativas, mas com pouco apoio curricular e formativo. A transição da área autônoma para uma área integrada com a história, a democracia e a constituição política sob o nome de ciências sociais, a partir de 1994 com a Lei 115 da Educação e, recentemente, a Lei 1874 de 2017, da qual é dada para a história um status diferente das outras ciências sociais da escola, elas mostram uma geografia escolar reduzida e cada vez mais turvas. Do Grupo de Pesquisa Interinstitucional Geopaideia, procurando responder o porquê? e para quê? Na educação escolar geográfica, algumas experiências foram sistematizadas, cujo propósito foi definir disciplinas curriculares para o ensino da geografia. Este artigo é o produto dessas reflexões e da prática dos três autores em políticas educacionais, currículo, formação de professores e educação escolar

Microsomal prostaglandin E synthase-1 is involved in the metabolic and cardiovascular alterations associated with obesity

Background and Purpose: Microsomal prostaglandin E synthase-1 (mPGES-1) is an inducible isomerase responsible for prostaglandin E2 production in inflammatory con ditions. We evaluated the role of mPGES-1 in the development and the metabolic and cardiovascular alterations of obesity. Experimental Approach: mPGES-1+/+ and mPGES-1 / mice were fed with normal or high fat diet (HFD, 60% fat). The glycaemic and lipid profile was evaluated by glu cose and insulin tolerance tests and colorimetric assays. Vascular function, structure and mechanics were assessed by myography. Histological studies, q-RT-PCR, and western blot analyses were performed in adipose tissue depots and cardiovascular tissues. Gene expression in abdominal fat and perivascular adipose tissue (PVAT) from patients was correlated with vascular damage. Key Results: Male mPGES-1 / mice fed with HFD were protected against body weight gain and showed reduced adiposity, better glucose tolerance and insulin sensi tivity, lipid levels and less white adipose tissue and PVAT inflammation and fibrosis, compared with mPGES-1+/+ mice. mPGES-1 knockdown prevented cardiomyocyte hypertrophy, cardiac fibrosis, endothelial dysfunction, aortic insulin resistance, and vascular inflammation and remodelling, induced by HFD. Obesity-induced weight gain and endothelial dysfunction of resistance arteries were ameliorated in female mPGES-1 / mice. In humans, we found a positive correlation between mPGES-1 expression in abdominal fat and vascular remodelling, vessel stiffness, and systolic blood pressure. In human PVAT, there was a positive correlation between mPGES-1 expression and inflammatory markers. Conclusions and Implications: mPGES-1 inhibition might be a novel therapeutic approach to the management of obesity and the associated cardiovascular and meta bolic alterations

Growth of Escherichia coli in human milk and powdered infant formula under various treatments and feeding conditions in neonatal units

Milk supplied to neonates in neonatal units is kept at room temperature for some time, which could influence microbial growth. This study aims to evaluate the growth of Escherichia coli in HM and PIF under various treatments and conditions, as well as to determine the influence of different thawing methods on microbial growth in HM. The number of E. coli generations appearing over a 4 h period at 22 °C in HM (frozen; frozen and pasteurized; and frozen, pasteurized, and fortified) and in PIF (four brands) was determined. E. coli counts in HM inoculated and thawed using different methods were also compared. In frozen HM and in pasteurized and frozen HM, significant differences were found after 2.5 h and 1.5 h, respectively. In PIF, differences were found between 1.5 and 3 h. With regard to the thawing process, the lowest microorganism counts were obtained at 4 °C overnight; thus, it seems advisable to store milk at room temperature for a maximum of 1 h during administration in neonatal units. Thawing HM at 4 °C overnight should be the method of choice

Reduced sTWEAK and Increased sCD163 Levels in HIVInfected Patients: Modulation by Antiretroviral Treatment, HIV Replication and HCV Co-Infection

Background: Patients infected with the human immunodeficiency virus (HIV) have an increased risk of cardiovascular disease due to increased inflammation and persistent immune activation. CD163 is a macrophage scavenger receptor that is involved in monocyte-macrophage activation in HIV-infected patients. CD163 interacts with TWEAK, a member of the TNF superfamily. Circulating levels of sTWEAK and sCD163 have been previously associated with cardiovascular disease, but no previous studies have fully analyzed their association with HIV. Objective: The aim of this study was to analyze circulating levels of sTWEAK and sCD163 as well as other known markers of inflammation (hsCRP, IL-6 and sTNFRII) and endothelial dysfunction (sVCAM-1 and ADMA) in 26 patients with HIV before and after 48 weeks of antiretroviral treatment (ART) and 23 healthy subjects. Results: Patients with HIV had reduced sTWEAK levels and increased sCD163, sVCAM-1, ADMA, hsCRP, IL-6 and sTNFRII plasma concentrations, as well as increased sCD163/sTWEAK ratio, compared with healthy subjects. Antiretroviral treatment significantly reduced the concentrations of sCD163, sVCAM-1, hsCRP and sTNFRII, although they remained elevated when compared with healthy subjects. Antiretroviral treatment had no effect on the concentrations of ADMA and sTWEAK, biomarkers associated with endothelial function. The use of protease inhibitors as part of antiretroviral therapy and the presence of HCV-HIV co-infection and/or active HIV replication attenuated the ART-mediated decrease in sCD163 plasma concentrations. Conclusion: HIV-infected patients showed a proatherogenic profile characterized by increased inflammatory, immuneactivation and endothelial-dysfunction biomarkers that partially improved after ART. HCV-HIV co-infection and/or active HIV replication enhanced immune activation despite ART.Redes Temáticas de Investigación en SIDA (ISCIII RETIC RD12/0017/0029 and RD12/0017/0037)Junta de Andalucía, Incentivos a proyectos de investigación de excelencia (CTS-6313, to Manolo Leal)Consejería de Salud (PI-0278)FIS PI10/00234 to LMBC and Programa Miguel Servet: CP10/00479 and PI13/00802 to JAMFundacion Lilly, FRIAT and ISCIII fund PI10/0007

Estudio de la estabilidad física, propiedades reológicas y microestructura de sistemas Aerosil 200/agua. Influencia de un tensioactivo no iónico

Se han estudiado las propiedades reológicas, la estabilidad física y la microestructura de suspensiones de una sílice hidrofílica (Aerosil 200) en agua con potencial aplicación como fase continua de emulsiones ecológicas. Además, se analizó la influencia de la adición de Amidet N, un tensioactivo no iónico derivado del aceite de Colza, en las propiedades viscoelásticas y la microestructura de las dispersiones. Se muestran diferentes comportamientos reológicos dependiendo de la concentración de Aerosil 200 en los sistemas binarios. Existe un aumento importante del carácter gel del 8% al 9% de Aerosil 200 mejorando la estabilidad física. Este cambio está relacionado con el grado de interacción de las partículas, como se muestra en la microscopia electrónica de barrido (Cryo-SEM). La adición de Amidet N a la suspensión provocó un incremento de los módulos viscosos y elásticos mostrándose una estructura más compacta. El sistema que contiene 6% de Aerosil 200 y 3% de Amidet N mostró adecuadas propiedades reológicas para su uso como fase continua de emulsiones que respetan el medio ambiente. Finalmente, cabe destacar el interés del estudio de este tipo de sistemas intermedios como punto de partida para el desarrollo de emulsiones.Aerosil 200/water dispersions and Aerosil 200/water/Amidet N were studied by means of rheological, microstructural and multiple light scattering techniques. These systems can find application as continuous phase in emulsions. Rheological tests such as flow curve and small amplitude oscillatory shear tests detected an abrupt change of behaviour related to microstructural interaction grade reflected through the Cryo-SEM micrographs. The most concentrated systems turned out to be more physically stable. An increase of viscoelastic properties was detected as a consequence of addition of Amilet N, which led to more compact microstructure. Finally, it is worth noting the interest of studying this type of intermediate systems as a starting point for the development of emulsions.Plan Propio de la Universidad de Sevilla Proyecto: 2017/00000962Ministerio de Economía y Competitividad (España) / FEDER, UE CTQ2015-70700-

Methodology for development of ecological emulsions formulated with green solvents or essential oils

Las emulsiones ecológicas se formulan y preparan idealmente siguiendo los principios del desarrollo sostenible o la química verde. Estas emulsiones verdes poseen un gran número de aplicaciones, ya que por ejemplo son utilizadas en la industria alimentaria. La industria química está mostrando especial atención a la sustitución de los disolventes sintéticos por disolventes ecológicos en el desarrollo de emulsiones aceite-en-agua para usos agroquímicos, como pinturas, tintas de impresión, desengrasantes y como limpiadores. Los disolventes ecológicos se utilizan cada vez más como consecuencia de la prohibición de algunos disolventes orgánicos tradicionales y sintéticos. Por este motivo, los científicos e ingenieros responsables del desarrollo de productos están afrontando el desafío de formular emulsiones que contienen nuevos disolventes, tensioactivos o aditivos obtenidos a partir de fuentes renovables y con buenas propiedades ecológicas. En este capítulo se desarrolla una metodología para el desarrollo de emulsiones ecológicas con componentes obtenidos a partir de fuentes renovables, de nula toxicidad y biodegradables como una alternativa sostenible a aquellos productos que contienen disolventes orgánicos tradicionales.Green emulsions are formulated and ideally prepared under the principles of the so-called sustainable development or green chemistry and find a great variety of applications. These systems are increasingly used by the food industry insofar as there is an increasing tendency to reduce the number of synthetic additives and to increase the use of biomaterials and ingredients with functional properties. For similar reasons they are more and more used by the pharmaceutical and cosmetic industries. The chemical industry is also paying attention to the substitution of synthetic solvents by green solvents in water-based emulsions used as agrochemicals, paints, printing inks, fat removers and all-purpose cleaners. Green solvents are increasingly used since many synthetic solvents have been banned due to their carcinogenic or toxic properties and to their poor biodegradability. For this reason, scientists and engineers responsible for product development face the challenge to formulate emulsions containing new solvents, surfactants and additives obtained from renewable raw materials and exhibiting enhanced ecological properties.Plan Propio de la Universidad de Sevilla Proyecto: 2017/00000962Ministerio de Economía y Competitividad (España) / FEDER, UE CTQ2011-27371Ministerio de Economía y Competitividad (España) / FEDER, UE CTQ2015-7070