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Campos Munoz L.,Hospital Clinico San Carlos | De Unamuno Bustos B.,Hospital General Universitario Of Valencia | Herranz Pinto P.,Hospital Universitario La Paz | El Ahmed H.H.,University of Granada | And 2 more authors.
American Journal of Clinical Dermatology | Year: 2014

Psoriasis is a systemic chronic inflammatory disease that affects 1-3% of the world's population. Knowledge of the pathogenesis of psoriasis, particularly in the understanding of the role of T cells and tumor necrosis factor α (TNFα), and advances in immunology have led to the development of biological agents, which, due to their great effectiveness, speed of response and good tolerability, have revolutionized patient management. One of these is infliximab, a human chimeric immunoglobulin G1 monoclonal antibody composed of human antibody constant regions and murine variable regions that was developed specifically to target TNFα. The six cases presented in this series highlight the feasibility, efficacy and safety of infliximab for psoriasis when administered in a variety of patients in several infusion centers across Spain. All six patients showed improvement in their psoriasis after the initiation of infliximab and no significant tolerability issues or injection site reactions were reported, despite the presence of several comorbid conditions or patient characteristics that traditionally reduce the efficacy of psoriasis treatments. This suggests that while the management of psoriasis patients with comorbid conditions and various unfavorable prognostic characteristics requires a multidisciplinary approach to ensure the patient obtains the best therapeutic response, infliximab is an effective and well tolerated treatment in these patients. © Springer International Publishing 2014. Source


Martin Cano F.,Complejo Hospitalario de Jaen
Cirugía pediátrica : organo oficial de la Sociedad Española de Cirugía Pediátrica | Year: 2012

Caustic or peptic esophageal strictures in children are the main cause of multiple dilations, which involve an important anesthetic risk and esophageal trauma. The placement of an esophageal stent can be an advance in the treatment of these patients. The objective of our work is to analiyze the efficacy of self-expanding stents for the treatment of esophageal strictures in children. Three patients with esophageal strictures, one due to caustic and two to peptic esophageal injuries have been treated with esophageal stents. Metal stent covered with nitinol has been used in the first patient, and biodegradable material stent in the rest. After a year of serial dilations, we placed two consecutive metal stents in one patient with caustic stricture. After its withdrawal, new dilations have been needed, but with longer asymptomatic period. The other two patients had peptic strictures; biodegradable stents were placed after months of serial dilations, before performing antireflux surgery. None of them needed further dilation. Esophageal stent placement has solved the problem without further dilation in peptic esophageal strictures. Asymptomatic period was significantly increased in caustic stricture. The results obtained with self-expanding stents are promising. Source


Mas S.,Complutense University of Madrid | Barderas R.,Complutense University of Madrid | Colas C.,Hospital Clinico Universitario Lozano Blesa | Quiralte J.,Complejo Hospitalario de Jaen | And 2 more authors.
FEBS Journal | Year: 2012

Chenopodiaceae pollens such as those from Salsola kali and Chenopodium album are important causes of allergy in Mediterranean areas because of the progress of desertification in European countries. Among the various allergenic protein families, profilins constitute a group of pan-allergens that are involved in polysensitization and pollen-food allergy syndrome. Two-dimensional electrophoresis analysis of S. kali profilin highlighted a polymorphic pattern, with several isoforms that have different molecular features (isoelectric point and molecular mass) and immunological features. Two isoforms have been cloned and sequenced. Sal k 4.02 and Sal k 4.03 displayed non-conservative amino acid changes in critical positions of the IgE epitopes. Both isoforms were produced in Escherichia coli and structurally and spectroscopically characterized. Changes in the electrophoretic mobility and in their IgG and IgE immunological behavior were observed in comparison with Che a 2, their counterpart from C. album. The IgE-binding ability of Sal k 4.03 is similar to that of Che a 2, whereas Sal k 4.02 showed a 35% reduction in IgE binding in 86% of patients, suggesting a hypoallergenic character. Three-dimensional modeling allowed us to propose which amino acid residues are involved in those immunological changes based on epitope mapping studies previously performed in other profilins. These profilin isoforms constitute suitable candidates for specific immunotherapy with recombinant allergens. Profilins constitute panallergens involved in polysensitization and pollen-food allergy syndrome. We expressed two isoforms of Salsola kali profilin with different immunological features, suggesting a hypoallergenic character for one of them. The analysis of their three-dimensional structures allowed us proposing the amino acid residues involved in the immunological changes. These isoforms constitute suitable candidates for specific immunotherapy with recombinant allergens © 2012 The Authors Journal compilation © 2012 FEBS. Source


Andrade Ortega J.A.,Complejo Hospitalario de Jaen | Delgado Martinez A.D.,Complejo Hospitalario de Jaen | Ruiz R.A.,Occupational Medicine Unit
Spine | Year: 2010

STUDY DESIGN. Observational prospective study. OBJECTIVE. Validate the Spanish version of the Neck Disability Index (NDI). SUMMARY OF BACKGROUND DATA. The NDI is the most widely used neck pain scale in the largest number of populations and has been validated most often against multiple measurements of function, pain, and clinical signs and symptoms. METHODS. The Spanish version of the NDI was administered 2 or 3 times to 175 individuals with neck pain (including those requesting or not requesting specific healthcare at a given time and those with acute and subacute/chronic nonspecific or post-traumatic neck pain). After establishing the factorial structure by extracting the main components, the internal consistency was assessed with the Cronbach alpha method, the test-retest reliability was assessed with the Bland-Altman plot and the intraclass correlation coefficient methods, and the validity was established by calculating Pearson correlation coefficient with pain visual analogue scale values and with Northwick Park Neck Pain Questionnaire (Spanish version) values. Sensitivity to change was estimated while comparing the mean difference between the first application of the NDI score and the one after the treatment in the patients who improved, felt the same, or worsened. RESULTS. A single factor explained 51.6% of the variance, the Cronbach alpha score was 0.89, the intraclass correlation coefficient was 0.98, the Pearson correlation coefficient with pain visual analogue scale was r = 0.65 and with Northwick Park Neck Pain Questionnaire was r = 0.89. In the subgroup of 147 subjects in whom the sensitivity to change was studied, those who reported an improvement in neck pain showed a decrease in the NDI score of 8.20, those who felt the same showed a decrease of 0.23, and those who felt worse showed an increase of 5.55. CONCLUSION. This first Spanish version of the Neck Disability Index is reliable, valid, and sensitive to change. © 2010 Lippincott Williams & Wilkins, Inc. Source


Granados-Principal S.,University of Granada | Quiles J.L.,University of Granada | Ramirez-Tortosa C.L.,Complejo Hospitalario de Jaen | Sanchez-Rovira P.,Complejo Hospitalario de Jaen | Ramirez-Tortosa M.,University of Granada
Food and Chemical Toxicology | Year: 2010

Anthracyclines (doxorubicin, daunorubicin, epirubicin, and idarubicin) are currently the most effective group of anti-neoplastic drugs used in clinical practice. Of these, doxorubicin (also called adriamycin) is a key chemotherapeutic agent in cancer treatment, although its use is limited as a consequence of the chronic and acute toxicity associated with this drug. The molecular mechanisms of doxorubicin account for both the anti-cancer and the toxic side effects. Many antioxidants have been assayed, with positive or negative results, to prevent the toxicity of doxorubicin. The present review has two main goals: (1) to report the latest findings regarding the molecular mechanisms of doxorubicin toxicity; (2) to update our understanding of the role of natural antioxidants in preventive therapy against doxorubicin-induced toxicity. This review provides new evidence for the chemoprevention of doxorubicin toxicity, making use of natural antioxidants - in particular vitamin E, vitamin C, coenzyme Q, carotenoids, vitamin A, flavonoids, polyphenol, resveratrol, antioxidant from virgin olive oil and selenium - and offers new insights into the molecular mechanisms of doxorubicin toxicity with respect to DNA damage, free radicals and other parameters. © 2010 Elsevier Ltd. Source

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