Chronic obstructive pulmonary disease (COPD) and occupational exposures

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality in both industrialized and developing countries. Cigarette smoking is the major risk factor for COPD. However, relevant information from the literature published within the last years, either on general population samples or on workplaces, indicate that about 15% of all cases of COPD is work-related. Specific settings and agents are quoted which have been indicated or confirmed as linked to COPD. Coal miners, hard-rock miners, tunnel workers, concrete-manufacturing workers, nonmining industrial workers have been shown to be at highest risk for developing COPD. Further evidence that occupational agents are capable of inducing COPD comes from experimental studies, particularly in animal models. In conclusion, occupational exposure to dusts, chemicals, gases should be considered an established, or supported by good evidence, risk factor for developing COPD. The implications of this substantial occupational contribution to COPD must be considered in research planning, in public policy decision-making, and in clinical practice

Supportive treatment for cast nephropathy in patients with multiple myeloma; a pilot study

Introduction: Cast nephropathy is a prevalent cause of acute kidney injury (AKI) in patients with myeloma. Objectives: The aim of this study is to define the outcome of a standardized supportive therapy for cast nephropathy. Patients and Methods: Retrospective analysis of the outcome of cast nephropathy in a University hospital for a period of five years. Data analysed; serum creatinine, estimated glomerular filtration rate (eGFR; mL/min/1.73 m2 BSA) and need for dialysis. Standardized therapy with the aim of preventing/removing tubular casts; fluid administration and mannitol to increase urine flow, sodium bicarbonate to alkalize the urine and low dose steroid to reduce peritubular inflammation. Statistical analysis: Student's t-test or the Mann-Whitney test according to data distribution. A two-tailed P value <0.05 was considered statistically significant. Survival curve was drawn according to Kaplan and Meier. Results: Twenty-seven cases were reviewed. Upon admission, mean serum creatinine was 7.1±4.9 mg/dL and mean eGFR 6±4 mL/min/1.73 m2 BSA; 30% of patients had oligo-anuria. Diagnosis of cast nephropathy was presumptive in 23 patients, and renal biopsy proven in four. Hemodialysis was required by 10 (37%) patients, two of whom continued dialysis after discharge. At discharge, serum creatinine was 3.7±2.5 mg/dL and eGFR 20±13 mL/min/1.73 m2 BSA (P=0.002), and after a median of 3.4 months, the values were 2.9±2.1 mg/dL and 35±32 mL/min/1.73 m2 BSA, respectively. Patient survival was 60% after 24 months. Conclusion: Administration of fluid, mannitol, sodium bicarbonate and low-dose steroid may improve the outcome of cast nephropathy. Despite the fact that the study has many limitations, its findings could be the base for prospective controlled trials on cast nephropathy and could be useful in those countries where the expensive extracorporeal treatments are not available

Prevalencia de TDAH, Relación con Reprobación Escolar y Estado Nutricional en Población Escolar del Distrito Central

Keywords: ADHD; School failure; nutritionDOI: http://dx.doi.org/10.5377/rmpm.v13i3.631 Revista de los Postgrados de Medicina UNAH Vol. 13 N&deg; 3 Agosto-Octubre 2010&nbsp;Palabras Clave: TDAH;&nbsp;Reprobaci&oacute;n Escolar; nutrici&oacute;n&nbsp;DOI: http://dx.doi.org/10.5377/rmpm.v13i3.631 Revista de los Postgrados de Medicina UNAH Vol. 13 N&deg; 3 Agosto-Octubre 2010&nbsp

Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant

BACKGROUND: Vaccine hesitancy and lack of access remain major issues in disseminating COVID-19 vaccination to liver patients globally. Factors predicting poor response to vaccination and risk of breakthrough infection are important data to target booster vaccine programs. The primary aim of the current study was to measure humoral responses to 2 doses of COVID-19 vaccine. Secondary aims included the determination of factors predicting breakthrough infection. METHODS: COVID-19 vaccination and Biomarkers in cirrhosis And post-Liver Transplantation is a prospective, multicenter, observational case-control study. Participants were recruited at 4-10 weeks following first and second vaccine doses in cirrhosis [n = 325; 94% messenger RNA (mRNA) and 6% viral vaccine], autoimmune liver disease (AILD) (n = 120; 77% mRNA and 23% viral vaccine), post-liver transplant (LT) (n = 146; 96% mRNA and 3% viral vaccine), and healthy controls (n = 51; 72% mRNA, 24% viral and 4% heterologous combination). Serological end points were measured, and data regarding breakthrough SARS-CoV-2 infection were collected. RESULTS: After adjusting by age, sex, and time of sample collection, anti-Spike IgG levels were the lowest in post-LT patients compared to cirrhosis (p < 0.0001), AILD (p < 0.0001), and control (p = 0.002). Factors predicting reduced responses included older age, Child-Turcotte-Pugh B/C, and elevated IL-6 in cirrhosis; non-mRNA vaccine in AILD; and coronary artery disease, use of mycophenolate and dysregulated B-call activating factor, and lymphotoxin-α levels in LT. Incident infection occurred in 6.6%, 10.6%, 7.4%, and 15.6% of cirrhosis, AILD, post-LT, and control, respectively. The only independent factor predicting infection in cirrhosis was low albumin level. CONCLUSIONS: LT patients present the lowest response to the SARS-CoV-2 vaccine. In cirrhosis, the reduced response is associated with older age, stage of liver disease and systemic inflammation, and breakthrough infection with low albumin level

Electrospun PVA matrices and self-assembling peptides for neural tissue engineering

embargoed_20250227I danni al sistema nervoso, e in particolare a quello periferico, sono molto comuni e dovuti alle più svariate cause, tra cui incidenti stradali, piccole lesioni o tagli. Il tessuto nervoso non possiede capacità di autorigenerazione se non in particolari casi, quindi trovare un modo per curarne i danni è di fondamentale importanza per migliorare la qualità di vita del paziente. Il polivinil alcol (PVA) è un polimero solubile in acqua molto studiato per le guide di nervo e per gli scaffold per il tessuto nervoso: il materiale ottenuto dal PVA per parziale ossidazione (OxPVA) risulta maggiormente biodegradabile. In questo lavoro di tesi, sono state sviluppate tre tipologie di scaffold: matrici elettrofilate di OxPVA, dischetti patternizzati di OxPVA funzionalizzate con 3 diversi peptidi auto-aggreganti (EAK, EAK-IKVAV e EAK-YIGSR) e uno scaffold composito di OxPVA/chitosano con incorporati i peptidi precedentemente menzionati. Le matrici elettrofilate sono state reticolate con due tipi di crosslinker per rallentare la degradazione delle fibre in acqua: anidride maleica e dicloruro di succinile. La prima ha dimostrato una scarsa efficienza nel preservare la struttura fibrosa dall’azione distruttiva dell’acqua. Al contrario, il dicloruro di succinile, nonostante favorisse un’adeguata reticolazione anche dopo l’immersione della matrice in acqua, durante la reazione di crosslinking ha provocato un restringimento della superficie del materiale superiore al 50% rispetto alla matrice di partenza. I saggi biologici sono stati condotti utilizzando la linea cellulare neuronale delle SH-SY5Y. Le cellule sono state seminate sia nei dischetti patternizzati che negli scaffold compositi. I risultati dimostrano un’iniziale adesione e proliferazione cellulare favorita dalla struttura dello scaffold, quindi dal pattern applicato sui dischetti e dalla porosità delle spugnette in chitosano. Dopo 7 giorni dalla semina si è invece potuta apprezzare l’azione dei peptidi auto-aggreganti, e in particolare quella dell’EAK e di EAK-IKVAV nel caso dei dischetti patternizzati. Il peptide autoassemblante EAK ha dimostrato di favorire maggiormente adesione e proliferazione anche negli scaffold compositi.Peripheral nervous system injuries are among the most common diseases. They can be caused by different reasons, including incidents, small damages, and cuts. The nervous tissue does not have auto regenerative capacities except in special cases, so finding a cure is fundamental to improve the quality of life of the patients. Polyvinyl alcohol (PVA) is a water-soluble polymer well studied for nerve guides and nervous tissue engineering scaffolds: its partial oxidation produces a more biodegradable material (OxPVA). In order to improve surface roughness and bioactivity, three scaffolds were developed: OxPVA electrospun matrices, OxPVA patterned disks functionalized with three different self-assembling peptides (EAK, EAK-IKVAV, and EAK-YIGSR), and composite OxPVA/Chitosan sponges with the incorporation of the previously mentioned peptides. Electrospun matrices were crosslinked with two organic compounds to slow down the degradation rate of fibers in water: maleic anhydride and succinyl dichloride. The former has demonstrated a scarce efficiency in safeguarding fibers from the erosive action of water. Conversely, succinyl dichloride has preserved the reticular structure resistance in the water, but the crosslink reaction provoked a dramatic shrinkage. Biological assays were performed with a neuronal cell line, the SH-SY5Y. Cells were seeded both on OxPVA patterned disks and OxPVA/Chitosan scaffolds. The MTT assay has shown a primary adhesion of cells encouraged by scaffolds ultrastructure (the pattern created in OxPVA disks and the porous structure of OxPVA/Chitosan sponges). After 7 days, cells adhesion and proliferation were promoted by the self-assembling peptides incorporation. In particular, the EAK SAP and the EAK-IKVAV sequence stimulated cell proliferation on OxPVA disks. EAK incorporation showed the best results in cells adhesion/proliferation also in OxPVA/Chitosan scaffolds

Usando Mineração de Textos como Suporte ao Desenvolvimento de Resumos no Ensino Médio

Este artigo apresenta o resultado de um experimento com o uso de uma ferramenta de mineração de textos como apoio à produção do gênero textual resumo com alunos de Ensino Médio, levando-se em consideração a abordagem realizada na escola a respeito das dificuldades que envolvem a expressão escrita dos alunos principalmente no que diz respeito ao gênero textual resumo. O objetivo foi investigar se o minerador de textos Sobek auxilia como apoio na elaboração de resumos. O estudo mostrou que houve melhora e aprimoramento nos resumos produzidos com o apoio da ferramenta, demonstrando a potencialidade do minerador de textos no auxilio a produção do gênero textual resumo aplicado no contexto escolar

CC Ligand 2 levels are increased in LPS-stimulated peripheral monocytes of patients with Non Small Cell Lung Cancer

Non-small cell lung cancer (NSCLC) shows a particular aggressive behaviour. Tumour associated macrophages (TAMs) play an important role in tumour growth and progression and CC ligand 2 (CCL2)/CCR2 axis is markedly involved in their recruitment in the tumour mass from the circulation. The aim of this study was to determine the plasma levels of CCL2 and the expression of CCR2 in the peripheral blood mononuclear cells (PBMCs) of 18 smokers with NSCLC, eight healthy smokers and nine non-smokers. Then, we investigated CCL2 levels in the supernatants of unstimulated and LPS-stimulated PBMC cultures of the same groups of patients. CCL2 levels in plasma and supernatants of PBMC cultures were determined by ELISA. CCR2 expression in PBMC cytospins was assessed by immunocytochemistry. CCL2 plasma levels and CCR2 expression by PBMCs were similar in patients with NSCLC, healthy smokers and non-smokers. In the supernatants of unstimulated PBMC cultures, CCL2 content was not different between the three groups of subjects. Supernatants of LPS-stimulated PBMCs of NSCLC patients showed a higher content of CCL2 as compared to supernatants of non-smokers (p&lt;0.005). CCL2 content increased 28.5-fold vs baseline production in the group of NSCLC patients, 15-fold in healthy smokers and 13-fold in the group of non-smokers. In conclusion, after LPS stimulation, PBMCs of patients with NSCLC release higher levels of CCL2 as compared to those of non-smokers, supporting the hypothesis of a CCL2 involvement in NSCLC biology