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Torres JP, Ibañez C, Valenzuela R, Bahamondes S, De la Maza V, Villarroel M, Coria P, Contardo V, Álvarez AM, Zubieta M, Gutierrez V, Ducasse K, Martínez D, Santolaya ME. Efficacy and safety of withholding antimicrobial therapy in children with cancer, fever and neutropenia, with a demonstrated viral respiratory infection: a randomized clinical trial. Clin Microbiol Infect 2024:S1198-743X(24)00201-5. [PMID: 38648896 DOI: 10.1016/j.cmi.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 01/12/2024] [Revised: 04/03/2024] [Accepted: 04/13/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES To validate the efficacy and safety of withholding antimicrobial therapy in a new cohort of children with cancer and febrile neutropenia (FN) having a demonstrated viral respiratory tract infection (RTI). METHODS Prospective, multicenter, non-inferiority, randomized study, approved by the ethical committee, in children presenting with FN at seven hospitals in Chile, evaluated at admission for diagnosis of bacterial and viral pathogens. Children who were positive for a respiratory virus (RV), negative for a bacterial pathogen and had a favorable evolution after 48-72 hours of antimicrobial therapy were randomized to either maintain or withhold antimicrobial therapy. The primary endpoint was the percentage of episodes with uneventful resolution, whereas the secondary endpoints were days of fever/hospitalization, requirement of antimicrobial treatment readministration, sepsis, pediatric intensive care unit (PICU) admission and death. RESULTS A total of 301 of 939 children with FN episodes recruited between March 2021 and December 2023 had a RV as a unique identified microorganism, of which 139 had a favorable evolution at 48-72 hours and were randomized, 70 to maintain and 69 to withdraw antimicrobial therapy. The median days of antimicrobial therapy was 5 (IQR 3-6) versus 3 (IQR 3-6) days (p<0.001), with similar frequency of uneventful resolution (66/70 (94%) and 66/69 (96%), RR 1.01, (95% CI 0.93-1.09), absolute risk difference 0.01, (95% CI -0.05-0.08) and similar number of days of fever and days of hospitalization. No cases of sepsis, PICU admission or death were reported. CONCLUSIONS We validated the strategy of withdrawal antimicrobial therapy in children with FN and viral RTI, based on clinical and microbiological/molecular diagnostic criteria. This will enable advances in antimicrobial stewardship strategies with a possible future impact on antimicrobial resistance.
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Affiliation(s)
- J P Torres
- Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Program of Antineoplastics Drugs Network (PINDA)
| | - C Ibañez
- Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - R Valenzuela
- Research Unit, Department of Pediatrics, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - S Bahamondes
- Research Unit, Department of Pediatrics, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - V De la Maza
- Research Unit, Department of Pediatrics, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - M Villarroel
- Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Program of Antineoplastics Drugs Network (PINDA)
| | - P Coria
- Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - V Contardo
- Department of Pediatrics, Hospital Dr. Roberto del Rio, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Program of Antineoplastics Drugs Network (PINDA)
| | - A M Álvarez
- Department of Pediatrics, Hospital San Juan de Dios, Santiago, Chile; Committee of Infectious Diseases, National Child Program of Antineoplastics Drugs Network (PINDA)
| | - M Zubieta
- Department of Pediatrics, Hospital Dr. Exequiel González Cortés, Santiago, Chile
| | - V Gutierrez
- Department of Pediatrics, Hospital Dr. Sótero del Río, Santiago, Chile; Committee of Infectious Diseases, National Child Program of Antineoplastics Drugs Network (PINDA)
| | - K Ducasse
- Department of Pediatrics, Hospital Gustavo Fricke, Viña del Mar, Chile; Committee of Infectious Diseases, National Child Program of Antineoplastics Drugs Network (PINDA)
| | - D Martínez
- Department of Pediatrics, Hospital San Borja Arriarán, Santiago, Chile; Committee of Infectious Diseases, National Child Program of Antineoplastics Drugs Network (PINDA)
| | - M E Santolaya
- Department of Pediatrics, Hospital Dr. Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Program of Antineoplastics Drugs Network (PINDA).
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Zisman A, Razdan S, Siegal A, Sljivich M, Bieber C, Ho P, Valenzuela R. Midline submuscular penile prosthesis reservoir placement for patients with bilateral inaccessible inguinal rings: Technique and outcomes. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Zapata J, Gallardo A, Romero C, Valenzuela R, Garcia-Diaz DF, Duarte L, Bustamante A, Gasaly N, Gotteland M, Echeverria F. n-3 polyunsaturated fatty acids in the regulation of adipose tissue browning and thermogenesis in obesity: Potential relationship with gut microbiota. Prostaglandins Leukot Essent Fatty Acids 2022; 177:102388. [PMID: 34995899 DOI: 10.1016/j.plefa.2021.102388] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 10/03/2021] [Accepted: 12/27/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Obesity is a worldwide public health problem characterized by fat tissue accumulation, favouring adipose tissue and metabolic alterations. Increasing energy expenditure (EE) through brown adipose tissue activation and white adipose tissue (WAT) browning has gained relevance as a therapeutic approach. Different bioactive compounds, such as n-3 polyunsaturated fatty acids (PUFA), have been shown to induce those thermogenic effects. This process is regulated by the gut microbiota as well. Nevertheless, obesity is characterized by gut microbiota dysbiosis, which can be restored by weight loss and n-3 PUFA intake, among other factors. Knowledge gap: However, the role of the gut microbiota on the n-3 PUFA effect in inducing thermogenesis in obesity has not been fully elucidated. OBJECTIVE This review aims to elucidate the potential implications of this interrelation on WAT browning adiposw sittue (BAT), BAT activity, and EE regulation in obesity models.
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Affiliation(s)
- J Zapata
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - A Gallardo
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - C Romero
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - R Valenzuela
- Departamento de Nutricion, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Nutritional Sciences Department, Faculty of Medicine, University of Toronto, Toronto ON, Canada
| | - D F Garcia-Diaz
- Departamento de Nutricion, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - L Duarte
- Departamento de Nutricion, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - A Bustamante
- Departamento de Nutricion, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - N Gasaly
- Departamento de Nutricion, Facultad de Medicina, Universidad de Chile, Santiago, Chile; ICBM: Laboratory of Innate Immunity, Program of Immunology, Institute of Biomedical Sciences, Facultad de Medicina, Universidad de Chile, Chile
| | - M Gotteland
- Departamento de Nutricion, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - F Echeverria
- Departamento de Nutricion, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Carrera de Nutricion y Dietetica, Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Tomer N, Razdan S, Kent M, Valenzuela R. 163 Evaluation of Safety and Outcomes in Rezum® with an Inflatable Penile Prosthesis. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hillelsohn J, Tokar S, Valenzuela R. 262 Peri-Urethral Neurolysis at the Time of Penile Prosthesis Placement for Premature Ejaculation. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Echeverría F, Valenzuela R, Espinosa A, Bustamante A, Álvarez D, Gonzalez-Mañan D, Ortiz M, Soto-Alarcon SA, Videla LA. Reduction of high-fat diet-induced liver proinflammatory state by eicosapentaenoic acid plus hydroxytyrosol supplementation: involvement of resolvins RvE1/2 and RvD1/2. J Nutr Biochem 2018; 63:35-43. [PMID: 30321750 DOI: 10.1016/j.jnutbio.2018.09.012] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [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: 06/19/2018] [Revised: 08/13/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
High-fat diet (HFD)-fed mice show obesity with development of liver steatosis and a proinflammatory state without establishing an inflammatory reaction. The aim of this work was to assess the hypothesis that eicosapentaenoic acid (EPA) plus hydroxytyrosol (HT) supplementation prevents the inflammatory reaction through enhancement in the hepatic resolvin content in HFD-fed mice. Male C57BL/6J mice were fed an HFD or a control diet and supplemented with EPA (50 mg/kg/day) and HT (5 mg/kg/day) or their respective vehicles for 12 weeks. Measurements include liver levels of EPA, DHA and palmitate (gas chromatography), liver resolvins and triglyceride (TG) and serum aspartate transaminase (AST) (specific kits) and hepatic and serum inflammatory markers (quantitative polymerase chain reaction and enzyme-linked immunosorbent assay). Compared to CD, HFD induced body weight gain, liver steatosis and TG accumulation, with up-regulation of proinflammatory markers in the absence of histological inflammation or serum AST changes; these results were accompanied by higher hepatic levels of resolvins RvE1, RvE2, RvD1 and RvD2, with decreases in EPA and DHA contents. EPA+HT supplementation in HFD feeding synergistically reduced the steatosis score over individual treatments and increased the hepatic levels of EPA, DHA and resolvins, with attenuation of proinflammatory markers. Lack of progression of HFD-induced proinflammatory state into overt inflammation is associated with resolvin up-regulation, which is further increased by EPA+HT supplementation eliciting steatosis attenuation. These findings point to the importance of combined protocols in hepatoprotection due to the involvement of cross-talk mechanisms, which increase effectiveness and diminish dosages, avoiding undesirable effects.
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Affiliation(s)
- F Echeverría
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - R Valenzuela
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile.
| | - A Espinosa
- Department of Medical Technology, Faculty of Medicine, University of Chile, Santiago, Chile
| | - A Bustamante
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - D Álvarez
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - D Gonzalez-Mañan
- Núcleo de Química y Bioquímica, Facultad de Ciencias, Universidad Mayor, Chile
| | - M Ortiz
- Nutrition and Dietetics School, Faculty of Health Sciences, Catholic University of Maule, Curicó, Chile
| | - S A Soto-Alarcon
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - L A Videla
- Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
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Rothwax J, Griffith J, Valenzuela R. 335 Preoperative administration of a long-acting local anesthetic block to limit narcotic use after inflatable penile prosthesis insertion. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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8
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Valenzuela R, Roehrborn C, Gange S, Bolton D, Chin P, Rashid P, Rukstalis D, McVary K. 192 Five Year Sexual Function Results of the Multi-Center, Prospective, Randomized Study of the Prostatic Urethral Lift (PUL). J Sex Med 2018. [DOI: 10.1016/j.jsxm.2017.11.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Arevalo O, Valenzuela R, Esquenazi Y, Rao M, Tran B, Zhu J, Bhattacharjee M, Fonseca P, Doyle N, Riascos R. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: A Practical Approach for Gliomas, Part 1. Basic Tumor Genetics. ACTA ACUST UNITED AC 2017. [DOI: 10.3174/ng.9170230] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Santolaya ME, Alvarez AM, Acuña M, Avilés CL, Salgado C, Tordecilla J, Varas M, Venegas M, Villarroel M, Zubieta M, Toso A, Bataszew A, Farfán MJ, de la Maza V, Vergara A, Valenzuela R, Torres JP. Efficacy and safety of withholding antimicrobial treatment in children with cancer, fever and neutropenia, with a demonstrated viral respiratory infection: a randomized clinical trial. Clin Microbiol Infect 2017; 23:173-178. [PMID: 27856269 PMCID: PMC7129180 DOI: 10.1016/j.cmi.2016.11.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/03/2016] [Accepted: 11/04/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine efficacy and safety of withholding antimicrobials in children with cancer, fever and neutropenia (FN) with a demonstrated respiratory viral infection. METHODS Prospective, multicentre, randomized study in children presenting with FN at five hospitals in Santiago, Chile, evaluated at admission for diagnosis of bacterial and viral pathogens including PCR-microarray for 17 respiratory viruses. Children positive for a respiratory virus, negative for a bacterial pathogen and with a favourable evolution after 48 h of antimicrobial therapy were randomized to either maintain or withhold antimicrobials. Primary endpoint was percentage of episodes with uneventful resolution. Secondary endpoints were days of fever/hospitalization, bacterial infection, sepsis, admission to paediatric intensive care unit (PICU) and death. RESULTS A total of 319 of 951 children with FN episodes recruited between July 2012 and December 2015 had a respiratory virus as a unique identified microorganism, of which 176 were randomized, 92 to maintain antimicrobials and 84 to withdraw. Median duration of antimicrobial use was 7 days (range 7-9 days) versus 3 days (range 3-4 days), with similar frequency of uneventful resolution (89/92 (97%) and 80/84 (95%), respectively, not significant; OR 1.48; 95% CI 0.32-6.83, p 0.61), and similar number of days of fever (2 versus 1), days of hospitalization (6 versus 6) and bacterial infections throughout the episode (2%-1%), with one case of sepsis requiring admission to PICU in the group that maintained antimicrobials, without any deaths. CONCLUSIONS The reduction of antimicrobials in children with FN and respiratory viral infections, based on clinical and microbiological/molecular diagnostic criteria, should favour the adoption of evidence-based management strategies in this population.
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Affiliation(s)
- M E Santolaya
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - A M Alvarez
- Department of Paediatrics, Hospital San Juan de Dios, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - M Acuña
- Department of Paediatrics, Hospital Dr Roberto del Río, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - C L Avilés
- Department of Paediatrics, Hospital San Borja Arriarán, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - C Salgado
- Department of Paediatrics, Hospital Dr Exequiel González Cortés, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - J Tordecilla
- Department of Paediatrics, Hospital Dr Roberto del Río, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - M Varas
- Department of Paediatrics, Hospital San Juan de Dios, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - M Venegas
- Department of Paediatrics, Hospital San Juan de Dios, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - M Villarroel
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - M Zubieta
- Department of Paediatrics, Hospital Dr Exequiel González Cortés, Santiago, Chile; Committee of Infectious Diseases, National Child Programme of Antineoplastic Drugs Network, Santiago, Chile
| | - A Toso
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - A Bataszew
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - M J Farfán
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - V de la Maza
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - A Vergara
- Centre for Molecular Studies, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - R Valenzuela
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - J P Torres
- Department of Paediatrics, Hospital Dr Luis Calvo Mackenna, Faculty of Medicine, Universidad de Chile, Santiago, Chile.
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Mallon WK, Valenzuela R, Salway RJ, Shoenberger JM, Swadron SP. LA ESPECIALIDAD DE MEDICINA DE URGENCIA EN CHILE: 20 AÑOS DE HISTORIA. Revista Médica Clínica Las Condes 2017. [DOI: 10.1016/j.rmclc.2017.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Salway RJ, Valenzuela R, Shoenberger JM, Mallon WK, Viccellio A. CONGESTIÓN EN EL SERVICIO DE URGENCIA: RESPUESTAS BASADAS EN EVIDENCIAS A PREGUNTAS FRECUENTES. Revista Médica Clínica Las Condes 2017. [DOI: 10.1016/j.rmclc.2017.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mallon WK, Valenzuela R, Salway RJ, Shoenberger JM, Swadron SP. THE SPECIALTY OF EMERGENCY MEDICINE IN CHILE: 20 YEARS OF HISTORY. Revista Médica Clínica Las Condes 2017. [DOI: 10.1016/j.rmclc.2017.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Zahalsky M, Dessources G, Marchand M, Valenzuela R, Blick S, Carrion R. 120 A Multi-Institutional Retrospective Study on Safety, Usage, and Quantity of ProFlo, an Amniotic Fluid Injectable, used in the treatment of Erectile Dysfunction and Peyronie’s Disease. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2016.12.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Weinberg A, Pagano M, Zhao L, Valenzuela R. 067 Multi-Institutional and Lasting Results with the MoST (Modified Sliding Technique) for Penile Lengthening with Penile Prosthesis Insertion. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Weinberg A, Pagano M, Valenzuela R. 150 A Streamline Approach to Inflatable Penile Prosthesis Placement. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Weinberg A, Pagano M, Valenzuela R. 142 Preoperative Local Anesthetic Block Reduces the Need for Narcotic Medications Following Penile Prosthesis Surgery. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Valenzuela R, Hernandez-Rodas MC, Espinosa A, Rincón MA, Romero N, Barrera C, Marambio M, Vivero J, Valenzuela A. Extra virgin olive oil reduces liver oxidative stress and tissue depletion of long-chain polyunsaturated fatty acids produced by a high saturated fat diet in mice. Grasas y Aceites 2016. [DOI: 10.3989/gya.0753152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Cataldo LR, Mizgier ML, Busso D, Olmos P, Galgani JE, Valenzuela R, Mezzano D, Aranda E, Cortés VA, Santos JL. Serotonin- and Dopamine-Related Gene Expression in db/db Mice Islets and in MIN6 β-Cells Treated with Palmitate and Oleate. J Diabetes Res 2016; 2016:3793781. [PMID: 27366756 PMCID: PMC4913013 DOI: 10.1155/2016/3793781] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/26/2016] [Accepted: 05/10/2016] [Indexed: 12/20/2022] Open
Abstract
High circulating nonesterified fatty acids (NEFAs) concentration, often reported in diabetes, leads to impaired glucose-stimulated insulin secretion (GSIS) through not yet well-defined mechanisms. Serotonin and dopamine might contribute to NEFA-dependent β-cell dysfunction, since extracellular signal of these monoamines decreases GSIS. Moreover, palmitate-treated β-cells may enhance the expression of the serotonin receptor Htr2c, affecting insulin secretion. Additionally, the expression of monoamine-oxidase type B (Maob) seems to be lower in islets from humans and mice with diabetes compared to nondiabetic islets, which may lead to increased monoamine concentrations. We assessed the expression of serotonin- and dopamine-related genes in islets from db/db and wild-type (WT) mice. In addition, the effect of palmitate and oleate on the expression of such genes, 5HT content, and GSIS in MIN6 β-cell was determined. Lower Maob expression was found in islets from db/db versus WT mice and in MIN6 β-cells in response to palmitate and oleate treatment compared to vehicle. Reduced 5HT content and impaired GSIS in response to palmitate (-25%; p < 0.0001) and oleate (-43%; p < 0.0001) were detected in MIN6 β-cells. In conclusion, known defects of GSIS in islets from db/db mice and MIN6 β-cells treated with NEFAs are accompanied by reduced Maob expression and reduced 5HT content.
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Affiliation(s)
- L. R. Cataldo
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, 8331150 Santiago, Chile
- Facultad de Medicina, Universidad de los Andes, 7620001 Santiago, Chile
| | - M. L. Mizgier
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, 8331150 Santiago, Chile
| | - D. Busso
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, 8331150 Santiago, Chile
| | - P. Olmos
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, 8331150 Santiago, Chile
| | - J. E. Galgani
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, 8331150 Santiago, Chile
- UDA-Ciencias de la Salud, Carrera de Nutrición y Dietética, Escuela de Medicina, Pontificia Universidad Católica de Chile, 8331150 Santiago, Chile
| | - R. Valenzuela
- Departamento de Nutrición, Facultad de Medicina, Universidad de Chile, 7550367 Santiago, Chile
| | - D. Mezzano
- Laboratorio de Hemostasia, Escuela de Medicina, Pontificia Universidad Católica de Chile, 8331150 Santiago, Chile
| | - E. Aranda
- Laboratorio de Hemostasia, Escuela de Medicina, Pontificia Universidad Católica de Chile, 8331150 Santiago, Chile
| | - V. A. Cortés
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, 8331150 Santiago, Chile
| | - J. L. Santos
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, 8331150 Santiago, Chile
- *J. L. Santos:
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Castellón E, Valenzuela R, Cifuentes F, Contreras H. 188 Knock down of SOX2, KLF4 and MYC genes increase sensitization to chemotherapeutic drugs and decrease metastasis in prostate cancer stem cells. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30085-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Amada Bascuñán K, Chamorro R, Valenzuela R, Valencia A, Barrera C, Mayer S, Vivero J, Sandoval J, Puigrredon C. PP219-SUN: Evaluation of Dietary and Phospholipids Erythrocytes Profile of N-3 Long-Chain Polyunsaturated Fatty Acids (PUFA) Status in Chilean Pregnant Women. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50261-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Valenzuela R, Barrera C, Ayala JM, Sanhueza J, Valenzuela A. Vegetable oils rich in alpha linolenic acid allow a higher accretion of n-3 LCPUFA in the plasma, liver and adipose tissue of the rat. Grasas y Aceites 2014. [DOI: 10.3989/gya.110113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kusovitsky L, Tellerman R, Valenzuela R, McCarthy S, Harris M. Urban Farming and the New York City Emergency Food System. J Acad Nutr Diet 2012. [DOI: 10.1016/j.jand.2012.06.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Valenzuela R, Zallek C, Nersesyan H, Kattah J, Blume G, Patel P, Pula J. Increasing Awareness in the Diagnosis and Treatment of NMDA Encephalitis (P05.212). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Amalfi M, Raymundo T, Valenzuela R, Decock C. Fomitiporia cupressicola sp. nov., a parasite on Cupressus arizonica, and additional unnamed clades in the southern USA and northern Mexico, determined by multilocus phylogenetic analyses. Mycologia 2012; 104:880-93. [DOI: 10.3852/11-196] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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27
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Contreras D, Rodríguez J, Basaez L, Freer J, Valenzuela R, Mansilla H, Vanýsek P. New insights in the dihydroxybenzenes-driven Fenton reaction: electrochemical study of interaction between dihydroxybenzenes and Fe(III). Water Sci Technol 2011; 64:2103-2108. [PMID: 22105135 DOI: 10.2166/wst.2011.420] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
It has been reported that the dihydroxybenzene (DHB) driven Fenton reaction is more efficient to degrade recalcitrant substrates than the simple Fenton reaction. The enhanced reactivity of the DHB driven Fenton reaction is not clear, but it could be explained by the formation of oxidant species different from the ones formed by classical Fenton reaction or by the shift of the redox potential of the complex formed by DHB and Fe(III). The redox reaction between Fe(III) and the DHBs 1,2-dihydroxybenzene (catechol, CAT), 2,3-dihydroxybenzoic acid (2,3-DHBA), 3,4-dihydroxybenzoic acid (3,4-DHBA), and 1,2-dihydroxy-3,5-benzenedisulfonate (TIRON) was studied by cyclic voltammetry to better understand the enhanced reactivity of the DHB driven Fenton reaction. It was determined that the amount of Fe(II) produced by the redox reaction between Fe(III) and DHBs was insufficient to explain the enhanced reactivity. Cyclic voltammograms (CV) of the DHBs/Fe(III) systems show a quasi-reversible or irreversible behavior and also shifting and splitting the anodic peaks. This effect can be related to DHBs oxidation by Fe(III), but not to a real interaction.
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Affiliation(s)
- D Contreras
- University of Concepción, Casilla 160-C, Concepción, Chile.
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Scott S, Kassem J, Nagurka R, Velasco W, Valenzuela R, Grant W, Lamba S. 157: Patient Perceived Alcohol and Substance Abuse Treatment Needs: An Urban Emergency Department Pilot Study. Ann Emerg Med 2009. [DOI: 10.1016/j.annemergmed.2009.06.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Valenzuela R, Alvarez G, Mata-Zamora ME. Microwave properties of ferromagnetic nanostructures. J Nanosci Nanotechnol 2008; 8:2827-2835. [PMID: 18681018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A review of the dynamic properties of nanostructured ferromagnetic materials at microwave frequencies (1-40 GHz) is presented. Since some confusion has recently appeared between giant magnetoimpedance (GMI) and ferromagnetic resonance (FMR), a detailed analysis is made in order to establish their differences. A brief review of a novel microwave absorption mode, the low-field microwave absorption (LFA) is then presented, together with a discussion about its similarities with GMI. Recent results on high-frequency measurements on nanogranular thin films and FMR in nanowire arrays are finally addressed.
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Affiliation(s)
- R Valenzuela
- Departamento de Materiales Metálicos y Cerámicos, Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Coyoacán, México DF, Mexico
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García-Palomero E, Muñoz P, Usan P, Garcia P, Delgado E, De Austria C, Valenzuela R, Rubio L, Medina M, Martínez A. Potent beta-amyloid modulators. NEURODEGENER DIS 2008; 5:153-6. [PMID: 18322376 DOI: 10.1159/000113688] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Currently, the potential to interfere with the pathology of beta-amyloid targeting a well-known drugable enzyme, the acetylcholinesterase (AChE), is opened. Peripheral or dual binding site inhibitors of AChE may simultaneously alleviate the cognitive and behavioral deficits in Alzheimer's disease (AD) patients and, more importantly, act as disease-modifying agents delaying amyloid plaque formation. As part of a rational drug design program directed to find dual binding site AChE inhibitors, several families of compounds have been synthesized as potent AChE inhibitors. From these series, several drug candidates were selected based on their potent and selective inhibition of AChE (subnanomolar activity) and their interference with the beta-amyloid aggregation in vitro (IC(50) in the low micromolar range). First in vivo data confirm our initial hypothesis. Oral treatment with NP-61 for 3 months is able to reverse the cognitive impairment (Morris water maze test) and to reduce plaque load in the brains of human amyloid precursor protein transgenic mice (Swedish mutation). These results suggest that NP-61, a potent beta-amyloid modulator, is able to reverse the AD-like neurodegenerative phenotype in transgenic mice, indicating a promising disease-modifying agent for clinical application.
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Pinelli-Saavedra A, Calderón de la Barca AM, Hernández J, Valenzuela R, Scaife JR. Effect of supplementing sows' feed with alpha-tocopherol acetate and vitamin C on transfer of alpha-tocopherol to piglet tissues, colostrum, and milk: aspects of immune status of piglets. Res Vet Sci 2007; 85:92-100. [PMID: 17904172 DOI: 10.1016/j.rvsc.2007.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Revised: 07/12/2007] [Accepted: 08/11/2007] [Indexed: 10/22/2022]
Abstract
The aim of this study was to investigate the effects of dietary supplementation of sows with alpha-tocopherol acetate (ATA) and vitamin C on deposition of alpha-tocopherol (AT) in piglet lymphoid organs, such as bone marrow, thymus, and spleen at birth and at weaning, as well as on indicators of immune response in piglets. Sows were given the following treatment diets: control, vitamin C 10 g/day, ATA 500 mg/kg feed, and combined vitamins (ATA 500+Vit-C 10). Supplementation with vitamins started at the beginning of pregnancy and lasted until weaning at 21+/-3 days of age. AT was determined in colostrum, milk, piglet plasma (cord blood) and tissues at birth and on day 21. Immunoglobulins were measured in piglet plasma, milk, and colostrum. Lymphocyte proliferation in response to PHA and ConA was determined in sow and piglet blood. ATA supplementation resulted in a significant increase (P<0.001) in the AT content of colostrum, milk, piglet plasma, liver, thymus, bone marrow, and spleen at weaning. The AT content of colostrum and milk significantly (P<0.001) influenced the AT content of piglet plasma and tissues at weaning (day 21). Total Ig and IgG concentrations in piglet plasma were significantly increased in piglets given the combined vitamin treatment. No effect of AT supplementation was observed on IgG and IgA in colostrum and milk. In sows, vitamin C given alone significantly increased lymphocyte response to ConA and PHA; whereas, in piglets, there was no significant effect of treatments on lymphocyte response to PHA and ConA.
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Affiliation(s)
- A Pinelli-Saavedra
- Centro de Investigación en Alimentación y Desarrollo, A.C., Carretera a la Victoria, Km 0.6, P.O. Box 1735, Hermosillo, Sonora 83000, Mexico.
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Abstract
OBJECTIVE To assess the efficacy of sildenafil in increasing penile glans tumescence and improving patient satisfaction in men with a penile prosthesis, as this remains a major treatment for erectile dysfunction but a common complaint is the lack of glans engorgement. PATIENTS AND METHODS To determine whether sildenafil combined with a penile prosthesis improves satisfaction, patients used an implant alone for at least 1 month, after which they completed the International Index of Erectile Function (IIEF) questionnaire. The same patients were then given sildenafil citrate and completed the IIEF questionnaire after using the sildenafil/implant combination. RESULTS Patients who responded to sildenafil with glans engorgement reported significantly greater satisfaction scores than with an implant alone. CONCLUSION We currently offer sildenafil citrate after implantation to all men who have a penile prosthesis placed.
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Affiliation(s)
- J P Mulhall
- Department of Urology, Weill Medical College of Cornell University, New York Presbyterian Hospital, NY, USA.
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Cedillo E, Ocampo J, Rivera V, Valenzuela R. An apparatus for the measurement of initial magnetic permeability as a function of temperature. ACTA ACUST UNITED AC 2000. [DOI: 10.1088/0022-3735/13/4/005] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Affiliation(s)
- A Splaver
- Albert Einstein College of Medicine, Bronx, New York, USA
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35
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Maher K, Klimas N, Fletcher MA, Cohen V, Maggio CM, Triplett J, Valenzuela R, Dickinson G. Disease progression, adherence, and response to protease inhibitor therapy for HIV infection in an Urban Veterans Affairs Medical Center. J Acquir Immune Defic Syndr 1999; 22:358-63. [PMID: 10634197 DOI: 10.1097/00126334-199912010-00006] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Indinavir therapy has demonstrated promise in the treatment of HIV-1 infection in clinical trials; however, its efficacy in a U.S. Veterans Affairs Medical Center, where access to therapy is generally unimpeded, is unknown. A review of the Miami cohort was conducted for the year beginning May 1996 to evaluate response to indinavir plus two nucleoside analogues. Of 483 HIV-1-positive patients (97% male; mean age, 46.7+/-9.7 years), 266 were offered indinavir based on their having CD4 counts <200 cells/microl or viral loads >10,000 copies/ml. Of these patients, 36% were adherent and experienced significant reductions in viral loads (-93,325+/-147,911 copies/ml) and elevations in CD4+ (111+/-103 cells/microl) and CD8+ (225+/-338 cells/microl) T cell counts. Adherent patients with baseline CD4 counts <100 cells/microl were 4.5 times more likely to have follow-up viral loads >10,000 copies/ml than those with CD4 >200 cells/microl. Adherent patients with CD4 counts <100 cells/microl did not show evidence of immune "exhaustion" because they were equal to those with CD4 counts >200 cells/microl in their capacity to replenish CD4 cells. Nonadherence to the regimen resulted in loss of therapeutic benefit and suggested that strategies to enhance adherence may become an essential component of treatment.
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Affiliation(s)
- K Maher
- Pathology Service, Department of Veterans Affairs Medical Center, Miami, Florida, USA
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36
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Silva C, Loyola G, Valenzuela R, García-Huidobro T, Monasterio O, Bronfman M. High-affinity binding of fatty acyl-CoAs and peroxisome proliferator-CoA esters to glutathione S-transferases effect on enzymatic activity. Eur J Biochem 1999; 266:143-50. [PMID: 10542059 DOI: 10.1046/j.1432-1327.1999.00838.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Acyl-CoAs are present at high concentrations within the cell, yet are strongly buffered by specific binding proteins in order to maintain a low intracellular unbound acyl-CoA concentration, compatible with their metabolic role, their importance in cell signaling, and as protection from their detergent properties. This intracellular regulation may be disrupted by nonmetabolizables acyl-CoA esters of xenobiotics, such as peroxisome proliferators, which are formed at relatively high concentration within the liver cell. The low molecular mass acyl-CoA binding protein (ACBP) and fatty acyl-CoA binding protein (FABP) have been proposed as the buffering system for fatty acyl-CoAs. Whether these proteins also bind xenobiotic-CoA is not known. Here we have identified new liver cytosolic fatty acyl-CoA and xenobiotic-CoA binding sites as glutathione S-transferase (GST), using fluorescent polarization and a acyl-etheno-CoA derivative of the peroxisome proliferator nafenopin as ligand. Rat liver GST and human liver recombinant GSTA1-1, GSTP1-1 and GSTM1-1 were used. Only class alpha rat liver GST and human GSTA1-1 bind xenobiotic-CoAs and fatty acyl-CoAs, with Kd values ranging from 200 nM to 5 microM. One mol of acyl-CoA is bound per mol of dimeric enzyme, and no metabolization or hydrolysis was observed. Binding results in strong inhibition of rat liver GST and human recombinant GSTA1-1 (IC50 at the nanomolar level for palmitoyl-CoA) but not GSTP1-1 and GSTM1-1. Acyl-CoAs do not interact with the GSTA1-1 substrate binding site, but probably with a different domain. Results suggest that under increased acyl-CoA concentration, as occurs after exposure to peroxisome proliferators, acyl-CoA binding to the abundant class alpha GSTs may result in strong inhibition of xenobiotic detoxification. Analysis of the binding properties of GSTs and other acyl-CoA binding proteins suggest that under increased acyl-CoA concentration GSTs would be responsible for xenobiotic-CoA binding whereas ACBP would preferentially bind fatty acyl-CoAs.
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Affiliation(s)
- C Silva
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, P.Universidad Católica de Chile, Santiago, Chile
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Arcos D, Valenzuela R, Vázquez M, Vallet-Regı́ M. Chemical Homogeneity of Nanocrystalline Zn–Mn Spinel Ferrites Obtained by High-Energy Ball Milling. J SOLID STATE CHEM 1998. [DOI: 10.1006/jssc.1998.7882] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
The purpose of this study was to investigate the effects of cohort size on maximum likelihood estimates of mortality parameters. Recent experimental investigations have stressed the importance of large cohorts for detecting leveling off of mortality rates at older ages. In the present study, emphasis was placed on evaluation of relatively small cohorts (about 150-300 individuals). Deaths were simulated under the assumption of the frailty mortality model. Two different parameter sets that resulted in differences in mean life span of more than twofold were used for simulations. Our smallest cohorts yielded parameter estimates that had generally good statistical properties, but relatively large standard errors. For tests of hypotheses concerning equality of parameters among populations or experimental treatments, empirical standard errors (obtained from several cohorts) were preferable to asymptotic standard errors (obtained for single cohorts). In particular, empirical standard errors yielded reliable type I error rates.
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Affiliation(s)
- P M Service
- Department of Biological Sciences, Northern Arizona University, Flagstaff 86011, USA.
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39
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Valenzuela R, Valdivia G. 2-36-08 Underestimation of the importance of neurologic diseases in mortality statistics. J Neurol Sci 1997. [DOI: 10.1016/s0022-510x(97)85460-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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40
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Valenzuela R, Donoso M, García-Huidobro J. 5-42-04 Migraneous headaches, but not subarachnoid hemorrhage (SAH), increase cerebrospinal fluid (CSF) content of NPY-like immunoreactivity. J Neurol Sci 1997. [DOI: 10.1016/s0022-510x(97)86534-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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Hochberg F, Prados M, Russell C, Weissman D, Evans R, Cook P, Burton G, Eisenberg PD, Valenzuela R, Verkh L. Treatment of recurrent malignant glioma with BCNU-fluosol and oxygen inhalation. A phase I-II study. J Neurooncol 1997; 32:45-55. [PMID: 9049862 DOI: 10.1023/a:1005727204169] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To evaluate the toxicity and response rate following BCNU with oxygen inhalation and escalating dosages of fluosol administered to patients with radiographic progression of malignant glioma after definitive surgery and radiotherapy. METHOD This single arm, phase I-II multicenter trial, enrolled 99 patients with malignant gliomas recurrent after definitive surgery and radiotherapy. All patients received a fixed dose (200 mg/m2) of BCNU along with 100% oxygen and fluosol, a perfluorochemical. Fluosol doses were escalated between patients (150, 275, 400 and 600 ml/m2). Treatment was repeated every 6 weeks for a maximum of 6 cycles. Patients were assessed for toxicity at the time of infusion and sequentially thereafter. Response was evaluated clinically and radiologically at least every 6 weeks. RESULTS Treatment was well tolerated. Dose reductions were required at least once in 18 patients, treatment delays were necessary at least once in 33 patients. Grade 3-4 leukopenia occurred in 6 patients (12 events), grade 3-4 thrombocytopenia in 10 patients (25 events) and grade 3-4 liver enzymes elevations in 18 patients (31 events). Higher fluosol dosages did not produce increases in toxicity or responses. Response or stabilization was seen in 57% (38% were stabilizations) of the patients who entered the trial with progressive disease. The median time to progression was 45 weeks, and median survival was 66 weeks for patients who had response or stabilization. For patients with glioblastoma response/stabilization was seen in 45% with a mean duration of 24 weeks, for patients with anaplastic astrocytoma response/stabilization was seen in 68% with a mean duration of 50 weeks. CONCLUSION This treatment regimen is well tolerated. Our results suggest fluosol may enhance the effectiveness of BCNU for the treatment of recurrent malignant gliomas. Future studies will be performed using fluosol at the dose of 400 ml/m2.
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Affiliation(s)
- F Hochberg
- Massachusetts General Hospital, Boston, USA
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42
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Hochberg F, Miller G, Valenzuela R, McNelis S, Crump KS, Covington T, Valdivia G, Hochberg B, Trustman JW. Late motor deficits of Chilean manganese miners: a blinded control study. Neurology 1996; 47:788-95. [PMID: 8797481 DOI: 10.1212/wnl.47.3.788] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
High-level chronic manganese (Mn) exposure produces dystonic rigidity and proximal tremor. The late effects of asymptomatic exposure are uncertain. To evaluate hand movements of asymptomatic Chilean miners, we utilized a manual tremormeter (EAP) and a digitizing tablet (MOVEMAP). In Andacollo, Chile, we examined 59 individuals aged > 50 years (mean age, 64.4 years). Twenty-seven exposed miners had heavy Mn dust exposure in Mn mines for more than 5 years (mean duration, 20.25 years), ending at least 5 years previously. Thirty-two control miners had never worked in Mn mines or had short-term Mn employment. Tests of resting tremor (EAP Tremormeter, MOVEMAP Steady paradigm), action tremor (MOVEMAP Square paradigm), and repetitive hand movements (EAP Tapping Test and Orthokinesimeter) differentiated performance of exposed miners from that of controls. Chronic asymptomatic Mn exposure results in detectable late-life abnormalities of movement.
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Affiliation(s)
- F Hochberg
- Massachusetts General Hospital, Boston, USA
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Sibal J, Valenzuela R, Tubbs R, Hodge E, Nally J. Successful renal transplantation in a patient with large granular lymphocytic leukemia with natural killer cell proliferation. Nephron Clin Pract 1996; 72:292-7. [PMID: 8684542 DOI: 10.1159/000188857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
A patient with advancing renal failure attributed to focal segmental glomerulosclerosis was found to have marked NK (CD56+) cell expansion and large granular lymphocytic leukemia. Subsequent living-related renal transplantation was accomplished with two early bouts of acute cellular rejection requiring therapy with methylprednisolone and monoclonal antibody OKT3. Chronic triple drug immunosuppressive therapy has substantially reduced the marked NK (CD56+) proliferation. The renal transplantation remains successful after 15 months despite persistent but reduced numbers of circulating NK cells, the potential role of which in the pathogenesis of the underlying nephropathy or the cellular rejection process remains speculative.
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Affiliation(s)
- J Sibal
- Department of Nephrology, Cleveland Clinic Foundation, Ohio, USA
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44
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Godbole MS, Valenzuela R, Deodhar SD, Calabrese L, Tubbs RR. Comparative study of ELISA and indirect immunofluorescence for the detection of anti-neutrophil cytoplasmic antibodies. Evaluation of the SCIMEDX/EURO Diagnostica ELISA assay in a clinical setting. Am J Clin Pathol 1995; 104:667-72. [PMID: 8526211 DOI: 10.1093/ajcp/104.6.667] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
This study evaluates the performance of a commercial ELISA assay for detection of anti-neutrophil cytoplasmic antibodies (ANCA). Anti-proteinase 3 (anti-PR3) and anti-myeloperoxidase (anti-MPO) ELISA by (SCIMEDX/EURO Diagnostica, Denville, NJ) were compared with the indirect immunofluorescence (IIF) method using ethanol-fixed neutrophils. Three hundred sixty serum samples were examined. There was complete correlation of results in 357 (99.2%) cases between cANCA pattern and anti-PR3 results, and in 356 (98.9%) cases between pANCA pattern and anti-MPO ELISA results. The specificity of ELISA for detection of vasculitis was 95.7% and sensitivity was 60%, whereas for IIF, they were 95.7% and 65%, respectively. The ELISA showed good reproducibility with interassay variation (CV), ranging from 7.1% to 13.2%. Our results show that SCIMEDX/EURO Diagnostica ELISA for ANCA is a reliable and reproducible method that is as good as IIF for detection of ANCA.
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Affiliation(s)
- M S Godbole
- Department of Clinical Pathology, Cleveland Clinic Foundation, Ohio, USA
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Gupta S, Slaughter S, Akriviadis EA, Valenzuela R, Deodhar SD. Serial measurement of serum C-reactive protein facilitates evaluation in alcoholic hepatitis. Hepatogastroenterology 1995; 42:516-21. [PMID: 8751208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND/AIMS An ability to measure inflammatory activity in alcoholic hepatitis is desirable for assessing its natural history and therapeutic responses, but convenient and simple parameters are lacking. To determine whether acute phase proteins could be useful for this purpose, we studied serum CRP and several other acute phase proteins in a series of patients with alcoholic hepatitis. MATERIALS AND METHODS We examined sequential sera from 72 patients with serum bilirubin greater than 5 mg/dl. RESULTS The short-term mortality during the approximately 30 day study period was 18%. There was moderate to marked elevation of serum c-reactive protein at initial testing in all patients with alcoholic hepatitis. In consecutive sera within the first week of testing, a further rise in c-reactive protein was noted significantly more frequently among patients that did not survive subsequently. Serum c-reactive protein levels gradually declined in recovering patients but were still abnormal at the end of the study period. In contrast, serum haptoglobin levels were subnormal initially, as well as throughout the subsequent short-term course. Among other acute phase proteins, serum ceruloplasmin, transferrin, a-1 acid glycoprotein and a-2 macroglobulin remained in the normal range. CONCLUSIONS These results suggest that the expression of c-reactive protein but not haptoglobin is upregulated in alcohol-induced acute liver injury. Serial measurements of serum c-reactive protein should be useful in assessing the clinical activity of alcoholic hepatitis.
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Affiliation(s)
- S Gupta
- Marion Bessin Liver Research Center, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
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46
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Broughan TA, Valenzuela R, Escorcia E, Secic M, Vogt DP. Mouse antibody-coated lymphocytes during OKT3 therapy in liver transplantation. Clin Transplant 1994; 8:488-91. [PMID: 7819617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Flow cytometry has been a technique in search of a use in transplantation. With each new monoclonal antibody, it has been hoped that the secrets of rejection would be unlocked. The usefulness of CD3+ T-lymphocyte counts to predict successful treatment of organ transplant rejection has been called into question. CD2+, CD3+, and mouse antibody-coated CD3 lymphocytes were followed by flow cytometry in 44 liver transplant patients during OKT3 therapy for induction or rejection. CD3+ lymphocyte counts did not predict successful management of rejection by OKT3. When expressed as percentages of the total lymphocyte count, an increasing trend in CD2+ and mouse antibody-coated CD3+ lymphocytes after day 7 of OKT3 therapy portended persistent or recurrent rejection within 2 months of treatment. It is uncertain if the increasing population of mouse antibody-coated CD3 cells is due to an immune phenomen or decreased clearance by an ailing liver. Care should be taken when using CD3 lymphocyte counts as indicators of adequate OKT3 therapy in liver transplantation.
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Affiliation(s)
- T A Broughan
- Cleveland Clinic Foundation Department of Surgery, OH
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King T, Helm TN, Valenzuela R, Bergfeld WF. Diffuse intraepidermal deposition of immunoreactants on direct immunofluorescence: a clue to the early diagnosis of epidermal necrolysis. Int J Dermatol 1994; 33:634-6. [PMID: 8002159 DOI: 10.1111/j.1365-4362.1994.tb02922.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Toxic epidermal necrolysis is a distinctive disorder that is readily identified clinically and histologically in advanced cases. Early on, however, toxic epidermal necrolysis may be difficult to identify. Some consider fixed drug eruption a limited form of toxic epidermal necrolysis. METHODS Direct immunofluorescence was performed on biopsy material of erythematous skin lesions. RESULTS Diffuse deposition of immunoreactants in the midmalpighian layer was noted. This finding has not been encountered in other disorders studied in our immunopathology laboratory. CONCLUSIONS Diffuse immunoreactant deposition in the mid-epidermis should suggest a diagnosis of epidermal necrolysis either from toxic epidermal necrolysis or fixed drug eruption. Additional cases will need to be assessed to document the usefulness of this pattern for prospective diagnosis.
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Affiliation(s)
- T King
- Department of Dermatopathology, Cleveland Clinic Foundation, Ohio 44195
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Diaz JI, Valenzuela R, Gephardt G, Novick A, Tubbs RR. Anti-glomerular and anti-tubular basement membrane nephritis in a renal allograft recipient with Alport's syndrome. Arch Pathol Lab Med 1994; 118:728-31. [PMID: 8024409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A 28-year-old deaf, white man with a clinical diagnosis of Alport's syndrome since 4 years of age experienced renal failure, fever, and mental status changes suggestive of vasculitis following his first cadaveric renal transplant; these symptoms and changes resolved after removal of the allograft. Immunohistological stains demonstrated intense linear deposition of IgG and C3 in glomerular and tubular basement membranes in the absence of glomerular crescents. One year later, a second renal transplant led to similar symptoms. A biopsy was performed 14 days after engraftment, which demonstrated intense linear deposition of IgG in glomerular and tubular basement membranes, but cellular crescents were not present. A serologic profile was ordered to evaluate the patient further for vasculitis, and during the evaluation, circulating anti-glomerular basement membrane and anti-tubular basement membrane antibodies were identified by indirect immunofluorescence microscopy (titer, > 1:320). An open biopsy specimen obtained during repair of a renal laceration demonstrated a crescentic glomerulonephritis with immunohistologic findings identical to those of previous biopsies. Anti-glomerular basement membrane nephritis should be suspected in any patient with Alport's syndrome in whom progressive renal failure develops following renal transplantation. Detection of anti-glomerular basement membrane/anti-tubular basement membrane antibodies will assure the diagnosis, and early initiation of plasmapheresis may be helpful to prevent further renal damage.
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Affiliation(s)
- J I Diaz
- Department of Pathology, H. Lee Moffitt Cancer Center, University of South Florida Health Sciences Center, Tampa 33612-0179
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Vaziri ND, Wang J, Cesario T, Yousefi S, Valenzuela R, Carandang G. Induction, transcription, synthesis, and adsorption of interleukin-1 by dialyzer membranes. J Am Soc Nephrol 1994; 4:1884-9. [PMID: 7919139 DOI: 10.1681/asn.v4111884] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
This study was designed to dissect the direct effect of dialyzer membrane on interleukin-1 (IL-1) induction from those of complement activation, mechanical stimulation, acetate/bicarbonate and endotoxin diffusion, and cell type interactions. To this end, a suspension of P388D1 murine macrophages in a complement-free culture medium containing 10% heat-inactivated serum, a closed-loop system consisting of tubing alone or with a hollow-fiber cuprammonium cellulose (CU) or polyacrylonitrile (PAN) dialyzer, and a roller pump were used. The dialysate compartment was filled with the same medium and capped. Cell suspension was recirculated at 300 mL/min for 3 h. Cells and supernates were separated, and adhering proteins were eluted. All samples tested negative for endotoxin. IL-1 mRNA was greatest with CU, followed by PAN and tubing alone. IL-1 in the supernate was greater with CU than with either tubing alone or PAN (P < 0.005; analysis of variance), which showed comparable values. IL-1 eluted from loops was greatest with PAN dialyzers, followed by sets with CU dialyzers and tubing alone (P < 0.001; analysis of variance). Thus, both CU and PAN membranes directly induce IL-1. However, avid adsorption by PAN attenuates the rise in circulating IL-1.
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Affiliation(s)
- N D Vaziri
- Department of Medicine, University of California, Irvine
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Abstract
BACKGROUND Discoid lupus erythematosus is a chronic skin disease characterized by well-demarcated papules and plaques. Mucous membrane changes are common; however, conjunctival involvement is unusual. We report a case of unilateral, chronic, isolated discoid lupus erythematosus of the conjunctiva. OBSERVATIONS A 32-year-old man presented for evaluation of chronic conjunctivitis of the right eye that had persisted for 9 years. A biopsy of the bulbar conjunctiva revealed a mixed mononuclear cellular infiltrate distributed along the epithelial basement membrane zone and around the stromal blood vessels. Immunohistopathologic examination revealed a diffuse, granular pattern of fluorescence corresponding to immunoglobulins and complement components along the epithelial basement membrane zone and in the walls of the stromal blood vessels. Electron microscopy demonstrated changes in the epithelial basal lamina consistent with discoid lupus erythematosus, including areas that were multilayered. Immunoelectron microscopy identified sub-basal lamina deposits of immunoglobulin G. CONCLUSIONS Discoid lupus erythematosus should be a suspected cause of chronic conjunctival inflammation; the diagnosis is substantiated by immunopathologic and ultrastructural studies.
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Affiliation(s)
- R E Foster
- Department of Ophthalmology, Cleveland Clinic Foundation, OH 44195
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