17 research outputs found

    Receptores de reconocimiento de la microbiota intestinal en situaciones fisiopatológicas del epitelio intestinal. Alteraciones del sistema serotoninérgico.

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    El sistema serotoninérgico intestinal es un modulador fundamental de la fisiología gastrointestinal, incluida su función inmunológica de barrera que desarrolla el epitelio. Dentro de la inmunidad innata, el sistema de reconocimiento de patógenos mediante receptores tipo Toll (TLR) es crucial, y recientes resultados han demostrado la activación de estos TLR inhiben el transportador de serotonina (SERT). Asimismo, en las enfermedades inflamatorias intestinales (EII) crónicas, como la colitis ulcerosa o la enfermedad de Crohn, donde el sistema inmune innato está implicado, también se encuentra alterado el sistema serotoninérgico, con un incremento de los niveles de serotonina (5-HT), y una disminución de la actividad y la expresión de SERT. Por ello, se planteó como objetivo el estudio del posible efecto, e interacción entre sí, de varios agentes implicados en los procesos inflamatorios sobre la función transportadora de SERT, como elemento clave de la actividad serotoninérgica. Para la realización de este estudio se utilizó la línea celular Caco-2/TC7, que desarrolla una diferenciación morfológica y funcional de tipo enterocitario, y además expresa SERT constitutivamente, lo que la convierte en excelente modelo “in vitro” para estudios sobre células epiteliales intestinales. Las células fueron tratadas durante 24 h con LPS 30 μg/ml (activador de TLR4), melatonina 0,1 mM, IL-10 25 ng/ml, o bien conjuntamente con LPS+ melatonina o LPS+IL-10. Finalmente, se midió el transporte tras 6 minutos de incubación con 5-HT. Los resultados muestran que el LPS y la melatonina inhiben el transportador SERT (aunque no significativamente), mientras que la IL-10 no afecta al transporte de 5-HT. Por otro lado, los tratamientos aditivos (LPS+ Melatonina y LPS+IL-10) no muestran ninguna modificación respecto al efecto previamente observado del LPS, sugiriendo que no se produce interacción entre ellas, ni para aumentar ni revertir dicho efecto

    Conceptos y herramientas para transitar hacia la sostenibilidad : avances a 2020

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    En este contexto institucional, desde las líneas de investigación de sostenibilidad en paisajes urbano-rurales, gestión ambiental sectorial y conflictos socioecológicos, los autores de esta publicación se plantearon el reto de generar una serie de documentos denominada “Conceptos y herramientas para transitar hacia la sostenibilidad” que recoja el conocimiento y la experiencia del Instituto entorno a los cambios transformacionales necesarios a nivel nacional para lograr el establecimiento de unos sistemas socioecológicos sostenibles en el país. En el caso de este primer documento de la serie, se busca recoger los avances conceptuales y las herramientas generadas por el Instituto hasta 2020 para apalancar TSS planteadas.Bogotá D.C

    SARS-CoV-2-reactive antibody detection after SARS-CoV-2 vaccination in hematopoietic stem cell transplant recipients: Prospective survey from the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group

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    This is a multicenter prospective observational study that included a large cohort (n = 397) of allogeneic (allo-HSCT; (n = 311) and autologous (ASCT) hematopoietic stem cell transplant (n = 86) recipients who were monitored for antibody detection within 3–6 weeks after complete severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination from February 1, 2021, to July 20, 2021. Most patients (n = 387, 97.4%) received mRNA-based vaccines. Most of the recipients (93%) were vaccinated more than 1 year after transplant. Detectable SARS-CoV-2-reactive antibodies were observed in 242 (78%) of allo-HSCT and in 73 (85%) of ASCT recipients. Multivariate analysis in allo-HSCT recipients identified lymphopenia < 1 × 109/ml (odds ratio [OR] 0.33, 95% confidence interval [95% CI] 0.16–0.69, p = .003), active graft versus host disease (GvHD; OR 0.51, 95% CI 0.27–0.98, p = .04) and vaccination within the first year of transplant (OR 0.3, 95% CI 0.15–0.9, p = .04) associated with lower antibody detection whereas. In ASCT, non-Hodgkin's lymphoma (NHL; OR 0.09, 95% CI 0.02–0.44, p = .003) and active corticosteroid therapy (OR 0.2, 95% CI 0.02–0.87, p = .03) were associated with lower detection rate. We report an encouraging rate of SARS-CoV-2-reactive antibodies detection in these severe immunocompromised patients. Lymphopenia, GvHD, the timing of vaccine, and NHL and corticosteroids therapy should be considered in allo-HSCT and ASCT, respectively, to identify candidates for SARS-CoV-2 antibodies monitoring.Peer reviewe

    Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

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    Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

    Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

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    Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

    Epidemiología de ostomías de eliminación en diferentes unidades de salud del Distrito Federal

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    Bowel and urinary diversion surgeries are a common procedure in hospitals and the health outcomes are reflected in increased life expectancy of patients that require specific and standardize care. The purpose of this study is to describe the epidemiology of intestine and urinary ostomies in different health institutions of Mexico City. Method: This is a multi centric, descriptive, retrolective and transverse study; it was done in 11 hospitals from 5 Mexico City health service institutions, the sample was constituted by 1688 patients. The instrument was developed with 9 epidemiological variables and validated by experts in the area. Results: It was found that 53% are male, predominant age group is from 19 to 62 years old with 54%. Colon, rectum and uterus cancer (35%) as well as inflammatory bowel disease (11%) are the most frequent. 38% are flat and 7% are protruded. In relation to occupation 85% are active. Discussion: This study contributes with a general view of bowel and urinary diversion surgeries noting that inflammatory bowel disease, colon and rectum cancer are the most frequent diagnoses 45% of patients do not have a stoma with normal characteristics with the implications that this condition has; this is why the relevance of standardizing registers to unify epidemiological data that will offer information to plan nursing interventions as well as noting the importance that this health problem represents to the Mexican population.Las ostomías de eliminación son un procedimiento frecuente en los hospitales y los resultados de salud se ven reflejados en la sobrevida de los pacientes, que requieren de atención específica y estandarizada. El propósito de este estudio es describir cuál es la epidemiología de ostomías de eliminación en hospitales del I.M.S.S. del I.S.S.S.T.E. de la Secretaría de Salud, PEMEX y hospitales privados del Distrito Federal. Método: Se trata de un estudio multicéntrico, descriptivo, retrolectivo y transversal; se realizó en 11 hospitales de segundo y tercer nivel de atención en cinco instituciones de salud del Distrito Federal. La muestra estuvo constituida por 1688 pacientes. El instrumento fue elaborado con nueve variables epidemiológicas y validado por expertos en el área. Resultados: Se encontró que el 53% de los pacientes fueron del género masculino, el grupo de edad donde predominaron fue de 19 a 62 años con el 54%. Destaca que los diagnósticos de cáncer de colon, recto y útero (35%), así como las enfermedades inflamatorias del intestino (11%) fueron las más frecuentes. El 38% de los estomas fueron planos y el 7% fueron protuidos. En relación a la ocupación, el 85% se encuentran activos. Discusión: Este estudio aporta una visión general del comportamiento de las ostomías de eliminación, resaltando que las enfermedades inflamatorias, el cáncer de colon y recto fueron los diagnósticos más frecuentes. El 45% de los pacientes no tuvieron un estoma de características normales con las implicaciones que esto tiene; de ahí la importancia de estandarizar los registros para unificar datos epidemiológicos, que aporten información para planificar las intervenciones de enfermería, así como resaltar la importancia que este problema de salud representa en la población mexicana
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