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Belaunzarán-Zamudio PF, Mateja A, Guerra-de-Blas PDC, Rincón-León HA, Navarro-Fuentes K, Ruiz-Hernández E, Caballero-Sosa S, Camas-Durán F, Priego-Smith Z, Nájera-Cancino JG, López-Roblero A, del Carmen Trujillo-Murillo K, Powers JH, Hunsberger S, Siddiqui S, Beigel JH, Valdés-Salgado R, Ruiz-Palacios G. Comparison of clinical characteristics of Zika and dengue symptomatic infections and other acute illnesses of unidentified origin in Mexico. PLoS Negl Trop Dis 2021; 15:e0009133. [PMID: 33591992 PMCID: PMC7909682 DOI: 10.1371/journal.pntd.0009133] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/26/2021] [Accepted: 01/12/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Our purpose was to provide a detailed clinical description, of symptoms and laboratory abnormalities, and temporality in patients with confirmed Zika and dengue infections, and other acute illnesses of unidentified origin (AIUO). METHODS/ PRINCIPAL FINDINGS This was a two-year, multicenter, observational, prospective, cohort study. We collected data from patients meeting the Pan American Health Organization's modified case-definition criteria for probable Zika infection. We identified Zika, dengue chikungunya by RT-PCR in serum and urine. We compared characteristics between patients with confirmed Zika and dengue infections, Zika and AIUO, and Dengue and AIUO at baseline, Days 3,7,28 and 180 of follow-up. Most episodes (67%) consistent with the PAHO definition of probable Zika could not be confirmed as due to any flavivirus and classified as Acute Illnesses of Unidentified Origin (AIUO). Infections by Zika and dengue accounted for 8.4% and 16% of episodes. Dengue patients presented with fever, generalized non-macular rash, arthralgia, and petechiae more frequently than patients with Zika during the first 10 days of symptoms. Dengue patients presented with more laboratory abnormalities (lower neutrophils, lymphocytosis, thrombocytopenia and abnormal liver function tests), with thrombocytopenia lasting for 28 days. Zika patients had conjunctivitis, photophobia and localized macular rash more frequently than others. Few differences persisted longer than 10 days after symptoms initiation: conjunctivitis in Zika infections, and self-reported rash and petechia in dengue infections. CONCLUSIONS Our study helps characterize the variety and duration of clinical features in patients with Zika, dengue and AIUO. The lack of diagnosis in most patients points to need for better diagnostics to assist clinicians in making specific etiologic diagnoses.
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Affiliation(s)
- Pablo F. Belaunzarán-Zamudio
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- * E-mail:
| | - Allyson Mateja
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, Maryland, United States of America
| | | | - Héctor A. Rincón-León
- Unidad de Medicina Familiar No.11, Instituto Mexicano del Seguro Social, Tapachula, Chiapas, Mexico
| | - Karla Navarro-Fuentes
- Unidad de Medicina Familiar No.11, Instituto Mexicano del Seguro Social, Tapachula, Chiapas, Mexico
| | | | - Sandra Caballero-Sosa
- Clínica Hospital Dr. Roberto Nettel Flores, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, Mexico
| | - Francisco Camas-Durán
- Clínica Hospital Dr. Roberto Nettel Flores, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, Mexico
| | - Zoila Priego-Smith
- Clínica Hospital Dr. Roberto Nettel Flores, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, Mexico
| | | | | | | | - John H. Powers
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Sally Hunsberger
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Sophia Siddiqui
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - John H. Beigel
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | | | - Guillermo Ruiz-Palacios
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Gouel-Cheron A, Lumbard K, Hunsberger S, Arteaga-Cabello FJ, Beigel J, Belaunzarán-Zamudio PF, Caballero-Sosa S, Escobedo-López K, Ibarra-González V, Nájera-Cancino JG, Rincón-León HA, Ruiz-Hernández E, Sepúlveda-Delgado J, Trujillo-Murillo K, Ruiz-Palacios G. Serial real-time RT-PCR and serology measurements substantially improve Zika and Dengue virus infection classification in a co-circulation area. Antiviral Res 2019; 172:104638. [PMID: 31672665 DOI: 10.1016/j.antiviral.2019.104638] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/04/2019] [Accepted: 10/20/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Real-time RT-PCR (Reverse Transcriptase Polymerase Chain Reaction) is considered the gold standard for Zika virus (ZIKV) infection diagnosis, despite its low sensitivity. Diagnosis using recommended serologic cutoffs in co-circulating Flaviviruses areas maybe inadequate due to in-vitro cross-reactivities of Flaviviruses-specific antibodies. We evaluated Zika diagnosis in symptomatic patients using serial RT-PCR and develop a classification model using serial Dengue virus (DENV) and ZIKV serologies. METHODS A prospective longitudinal multicentric study in Southern Mexico (NCT02831699) enrolled symptomatic and non-symptomatic participants. In the classification model, true positives were symptomatic (using a modified World Health Organization/Pan American Health Organization definition) with RT-PCR positive for ZIKV or DENV. True negatives were non-symptomatic with negative RT-PCR. Serial serology measurements were used to predict disease status. RESULTS Analyzing ZIKV and DENV RT-PCR at 3 timepoints between days 3 and 13 of symptom onset detected 25% more cases than a single RT-PCR analysis between day 0 and 6. When considering sensitivity and specificity together, the serial serology model predicted all categories of disease and negatives better than manufactures cutoffs. Their cutoffs optimized sensitivity or specificity but not both. CONCLUSIONS We demonstrated the importance of serial RT-PCR and antibody measurements to diagnose arbovirus infection in symptomatic patients living in regions with co-circulating flaviviruses.
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Affiliation(s)
- Aurelie Gouel-Cheron
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institute of Health, Rockville, MD, USA; Département d'Anesthésie et Réanimation Chirurgicale, Groupe Hospitalier Bichat Claude Bernard, Université de Paris, Assistance Publique Hôpitaux de Paris, Paris, France; Unit of Antibodies in Therapy and Pathology, Pasteur Institut, UMR 1222 INSERM, Paris, France.
| | - Keith Lumbard
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institute of Health, Rockville, MD, USA.
| | - Sally Hunsberger
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institute of Health, Rockville, MD, USA.
| | - Fernando J Arteaga-Cabello
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
| | - John Beigel
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA.
| | - Pablo F Belaunzarán-Zamudio
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
| | - Sandra Caballero-Sosa
- Clínica Hospital Dr. Roberto Nettel Flores, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Tapachula, Chiapas, Mexico.
| | - Kenia Escobedo-López
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
| | - Violeta Ibarra-González
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
| | | | | | | | | | | | - Guillermo Ruiz-Palacios
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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Nam L, Coll C, Erthal LCS, de la Torre C, Serrano D, Martínez-Máñez R, Santos-Martínez MJ, Ruiz-Hernández E. Drug Delivery Nanosystems for the Localized Treatment of Glioblastoma Multiforme. Materials (Basel) 2018; 11:E779. [PMID: 29751640 PMCID: PMC5978156 DOI: 10.3390/ma11050779] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 04/30/2018] [Accepted: 05/01/2018] [Indexed: 12/19/2022]
Abstract
Glioblastoma multiforme is one of the most prevalent and malignant forms of central nervous system tumors. The treatment of glioblastoma remains a great challenge due to its location in the intracranial space and the presence of the blood⁻brain tumor barrier. There is an urgent need to develop novel therapy approaches for this tumor, to improve the clinical outcomes, and to reduce the rate of recurrence and adverse effects associated with present options. The formulation of therapeutic agents in nanostructures is one of the most promising approaches to treat glioblastoma due to the increased availability at the target site, and the possibility to co-deliver a range of drugs and diagnostic agents. Moreover, the local administration of nanostructures presents significant additional advantages, since it overcomes blood⁻brain barrier penetration issues to reach higher concentrations of therapeutic agents in the tumor area with minimal side effects. In this paper, we aim to review the attempts to develop nanostructures as local drug delivery systems able to deliver multiple agents for both therapeutic and diagnostic functions for the management of glioblastoma.
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Affiliation(s)
- L Nam
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin (TCD), Dublin 2, Ireland.
- Trinity Biomedical Sciences Institute, TCD, Dublin 2, Ireland.
| | - C Coll
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin (TCD), Dublin 2, Ireland.
- Trinity Biomedical Sciences Institute, TCD, Dublin 2, Ireland.
| | - L C S Erthal
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin (TCD), Dublin 2, Ireland.
- Trinity Biomedical Sciences Institute, TCD, Dublin 2, Ireland.
| | - C de la Torre
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, 46010 València, Spain.
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain.
| | - D Serrano
- Departamento de Farmacia Galenica y Tecnologia Alimentaria, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - R Martínez-Máñez
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, 46010 València, Spain.
- CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain.
| | - M J Santos-Martínez
- Trinity Biomedical Sciences Institute, TCD, Dublin 2, Ireland.
- School of Medicine, Trinity College Dublin (TCD), Dublin 2, Ireland.
| | - E Ruiz-Hernández
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin (TCD), Dublin 2, Ireland.
- Trinity Biomedical Sciences Institute, TCD, Dublin 2, Ireland.
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Campos-Delgado DU, Bonilla I, Rodríguez-Martínez M, Sánchez-Briones ME, Ruiz-Hernández E. Closed-loop control of renal perfusion pressure in physiological experiments. IEEE Trans Biomed Eng 2013; 60:1776-84. [PMID: 23358945 DOI: 10.1109/tbme.2013.2241435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This paper presents the design, experimental modeling, and control of a pump-driven renal perfusion pressure (RPP)-regulatory system to implement precise and relatively fast RPP regulation in rats. The mechatronic system is a simple, low-cost, and reliable device to automate the RPP regulation process based on flow-mediated occlusion. Hence, the regulated signal is the RPP measured in the left femoral artery of the rat, and the manipulated variable is the voltage applied to a dc motor that controls the occlusion of the aorta. The control system is implemented in a PC through the LabView software, and a data acquisition board NI USB-6210. A simple first-order linear system is proposed to approximate the dynamics in the experiment. The parameters of the model are chosen to minimize the error between the predicted and experimental output averaged from eight input/output datasets at different RPP operating conditions. A closed-loop servocontrol system based on a pole-placement PD controller plus dead-zone compensation was proposed for this purpose. First, the feedback structure was validated in simulation by considering parameter uncertainty, and constant and time-varying references. Several experimental tests were also conducted to validate in real time the closed-loop performance for stepwise and fast switching references, and the results show the effectiveness of the proposed automatic system to regulate the RPP in the rat, in a precise, accurate (mean error less than 2 mmHg) and relatively fast mode (10-15 s of response time).
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Affiliation(s)
- D U Campos-Delgado
- Facultad de Ciencias, Av. Salvador Nava s/n, Zona Universitaria, San Luis Potosi, SLP 78290, Mexico.
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Abstract
Implantable thermoseeds are synthesised from mixtures of a melt-derived glass with composition SiO(2) (40)-CaO(40)-Fe(2)O(3)(20) (mol%) and a sol-gel glass with composition SiO(2)(58)-P(2)O(5)(6)-CaO(36) (mol%). Structural, textural and magnetic properties of the samples are evaluated. In vitro bioactivity is assessed in order to determine the potential capability to bond to living bone. In spite of the low textural properties of the material, a bioactive behavior is observed as a result of the sol-gel glass content. Although the crystallization of the glass ceramic provides the magnetic phase, the presence of sol-gel glass modifies the magnetic properties, improving the heating power. For the first time, hyperthermia heating experiments as well as preliminary biocompatibility assays have been carried out for this kind of material. The ability to reach hyperthermic temperature range together with the bioactive behavior makes this biomaterial a very promising candidate for bone cancer treatment.
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Affiliation(s)
- E Ruiz-Hernández
- Departamento de Química Inorgánica y Bioinorgánica, Facultad de Farmacia, Universidad Complutense, 28040 Madrid, Spain
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