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Carmen Herrero

Publications and source records attributed to Carmen Herrero.

At least 19 recordsLinked to original sources
PubMed2007

Pyoderma vegetans associated with severe psoriatic arthritis: good response to etanercept.

Pyoderma vegetans (PV) is an inflammatory dermatosis, characterized clinically by large exudative vegetating plaques, and histopathologically by epidermal pseudoepitheliomatous hyperplasia and dense inflammatory infiltrates. Although PV is a very rare condition, it is a chronic disorder that may accompany any systemic process that compromises immunity. Treatment is very difficult, and correction of predisposing causes may be useful. We present a 49-year-old woman affected by severe psoriatic arthritis since she was 19, with giant verrucous plaques on her lower limbs that had worsened progressively during the last 15 years. After ruling out other vegetating cutaneous disorders, PV was diagnosed in association with psoriasis. Despite numerous previous systemic and topical therapeutic attempts no response was observed. Etanercept was introduced, which resulted in a marked improvement within 3 weeks. Herein, we report a diagnostic and therapeutic challenge of the first case of PV associated with psoriasis that presented a good response to etanercept.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2006

Selective regulation of IL-10 signaling and function by zymosan.

Balanced activity of pro- and anti-inflammatory cytokines during innate immune responses is required to allow effective host defense while avoiding tissue damage and autoimmunity. Induction of cytokine production after recognition of pathogen-associated molecular patterns (PAMPs) by innate immune cells has been well demonstrated, but modulation of cytokine function by PAMPs is not well understood. In this study we show that stimulation of macrophages with zymosan, which contains PAMPs derived from yeast, rapidly extinguished macrophage responses to IL-10, a suppressive cytokine that limits inflammatory tissue damage but also compromises host defense. The mechanism of inhibition involved protein kinase Cbeta and internalization of IL-10R, and was independent of TLR2 and phagocytosis. Inhibition of IL-10 signaling and function required direct contact with zymosan, and cells in an inflammatory environment that had not contacted zymosan remained responsive to the paracrine activity of zymosan-induced IL-10. These results reveal a mechanism that regulates IL-10 function such that antimicrobial functions of infected macrophages are not suppressed, but the activation of surrounding noninfected cells and subsequent tissue damage are limited. The fate of individual cells in an inflammatory microenvironment is thus specified by dynamic interactions among host cells, microbes, and cytokines that determine the balance between protection and pathology.

Animals↗
PubMed2006

Atypical pemphigus: discordance between clinicopathological findings and the antigenic profile in four cases.

BACKGROUND: The diagnosis of pemphigus vulgaris and pemphigus foliaceus is usually based on clinical, histological, and immunofluorescence (IF) findings. In recent years, the antigenic profile of both diseases has been further defined by immunobiochemical techniques (ELISA, immunoblot, and immunoprecipitation). METHODS: A retrospective study of 40 pemphigus patients was performed to determine the clinical, histological, and antigenic profile in patients with pemphigus followed at our Department. Charts review, clinical data, histological and IF findings, and antigenic analysis by ELISA were performed in all patients. RESULTS: In most patients, there was a perfect correlation between the clinical and histological findings and their antigenic profile. In four patients (10%), clinicopathological features and antigenic findings were discordant. CONCLUSIONS: The antigenic profiles in pemphigus do not always correlate with the clinical diagnosis. Therefore, clinical and histological features should be considered as the mainstay for the diagnosis of pemphigus.

Aged↗
PubMed2005

Biochemical and genetic characterization of four cases of hereditary coproporphyria in Spain.

We report a biochemical and genetic characterization of four cases of hereditary coproporphyria (HCP) in Spain. All patients showed a typical HCP porphyrin excretion pattern with a high concentration of coproporphyrins in feces and inverted I:III isomer ratio. The porphyrin precursors in urine were found elevated in two patients who showed acute symptoms. The analysis of the CPO gene showed that three cases harboured novel mutations: V135A (404T>C; exon 1); L214R (641T>G; exon 2); and P249R (746C>G; exon 3) and in the fourth, a previously described R426X mutation in exon 6.

Adult↗
PubMed2005

A semi-separable utility function for health profiles.

Under expected utility, the individual preferences over lotteries on health profiles can be represented either by a multiplicative utility function, when mutual utility independence is claimed, or, an additive one (known as QALY), when it is claimed additive independence. In this paper, we impose a weaker condition, i.e., utility independence with respect to the initial health states of an individual decision maker, initial independence, and we derive a semi-separable utility function. In addition, we assess its parameters by a Standard Gamble procedure. Our results could be useful in cost-utility analysis for carrying out health care program evaluations.

Cost-Benefit Analysis↗
PubMed2005

Paraneoplastic pemphigus associated with non-Hodgkin B-cell lymphoma and good response to prednisone.

Paraneoplastic pemphigus is a life-threatening autoimmune bullous disease associated with neoplasia, generally of lymphoid origin. Immunosuppressive therapy is often disappointing and there are only a few reports of patients surviving more than 2 years. These cases were generally associated with benign neoplasms. We report here the case of a patient with paraneoplastic pemphigus associated with non-Hodgkin B-cell lymphoma who had a surprisingly good response to systemic corticosteroids and remains free of lesions more than 3 years later despite progression of her neoplasm.

Aged↗
PubMed2004

Bullous pemphigoid associated with mantle cell lymphoma.

BACKGROUND: Bullous pemphigoid has developed in association with different types of malignant diseases, including a few cases of B-cell lymphoproliferative disorders. However, the paraneoplastic significance of this association is still controversial. OBSERVATIONS: We describe a 39-year-old patient who presented with a bullous eruption and generalized lymphadenopathy. The results of histologic, immunofluorescence, and antigenic studies confirmed the diagnosis of bullous pemphigoid. The histopathologic and immunophenotypic features of a lymph node biopsy specimen were consistent with mantle cell lymphoma. There was total resolution of the mucocutaneous lesions when mantle cell lymphoma went into remission. CONCLUSION: The age of the patient and the concomitant appearance and simultaneous remission of both diseases strongly suggest that bullous pemphigoid was a paraneoplastic phenomenon in the present case.

Adult↗
PubMed2004

Using a point system in the management of waiting lists: the case of cataracts.

In the management of waiting lists, point systems could be a useful mechanism to establish priorities amongst patients. In this paper we explore the possibility of using Conjoint Analysis (CA) in order to implement a point system based on social preferences. We conducted an experiment for the specific case of cataract extraction. In spite of the pilot nature of the study the results seems to suggest that CA is a feasible method in order to estimate a point system.

Adolescent↗
PubMed2004

Cutaneous vasculitis in primary Sjögren syndrome: classification and clinical significance of 52 patients.

To analyze the different clinical and histologic types of cutaneous vasculitis in patients with primary Sjögren syndrome (SS), we investigated the clinical and immunologic characteristics of 558 consecutive patients with primary SS from our units and selected those with clinical evidence of cutaneous lesions, excluding drug reactions and xeroderma. All patients fulfilled 4 or more of the diagnostic criteria for SS proposed by the European Community Study Group in 1993. A total of 89 (16%) patients presented with cutaneous involvement (88 female patients and 1 male; mean age, 51.8 yr). The main cutaneous involvement was cutaneous vasculitis, present in 52 (58%) patients. There were 51 (98%) female patients and 1 (2%) male, with a mean age at diagnosis of cutaneous vasculitis of 51 years (range, 20-80 yr). Fourteen presented with cryoglobulinemic vasculitis, 11 with urticarial vasculitis, and the remaining 26, with cutaneous purpura not associated with cryoglobulins. A skin biopsy specimen was obtained in 38 patients (73%). Involvement of small-sized vessels was observed in 36 (95%) patients (leukocytoclastic vasculitis), while the remaining 2 (5%) presented with medium-sized vessel vasculitis (necrotizing vasculitis). Patients with cutaneous vasculitis had a higher prevalence of articular involvement (50% vs 29%, p = 0.044), peripheral neuropathy (31% vs 4%, p < 0.001), Raynaud phenomenon (40% vs 15%, p = 0.008), renal involvement (10% vs 0%, p = 0.028), antinuclear antibodies (88% vs 60%, p = 0.002), rheumatoid factor (78% vs 48%, p = 0.004), anti-Ro/SS-A antibodies (70% vs 43%, p = 0.011), and hospitalization (25% vs 4%, p = 0.005) compared with SS patients without vasculitis. Six (12%) patients died, all of whom had multisystemic cryoglobulinemia.In conclusion, cutaneous involvement was detected in 16% of patients with primary SS, with cutaneous vasculitis being the most frequent process. The main characteristics of SS-associated cutaneous vasculitis were the overwhelming predominance of small versus medium vessel vasculitis and leukocytoclastic versus mononuclear vasculitis, with a higher prevalence of extraglandular and immunologic SS features. Small vessel vasculitis manifested as palpable purpura, urticarial lesions, or erythematosus maculopapules, with systemic involvement in 44% of patients in association with cryoglobulins in 30%. Life-threatening vasculitis was closely related to cryoglobulinemia.

Adult↗
PubMed2004

[Right ventricular dysfunction and ischemia in pulmonary embolism].

Patients with pulmonary embolism and right ventricle dysfunction (determined with clinical, hemodynamic or echocardiographic methods) are a subgroup at high risk for complications. One of the pathogenic factors of right ventricular dysfunction in pulmonary embolism is myocardial ischemia, usually secondary to hemodynamic overload, and sometimes worsened by underlying coronary artery disease. We described a patient with pulmonary embolism and dyskinesia of the right ventricular free wall, related to chronic atherosclerotic occlusion of the right coronary artery proximal to the acute marginal branches that irrigate the free wall.

Aged↗
PubMed2003

Reprogramming of IL-10 activity and signaling by IFN-gamma.

One important mechanism of cross-regulation by opposing cytokines is inhibition of signal transduction, including inhibition of Janus kinase-STAT signaling by suppressors of cytokine signaling. We investigated whether IFN-gamma, a major activator of macrophages, inhibited the activity of IL-10, an important deactivator. Preactivation of macrophages with IFN-gamma inhibited two key anti-inflammatory functions of IL-10, the suppression of cytokine production and of MHC class II expression. Gene expression profiling showed that IFN-gamma broadly suppressed the ability of IL-10 to induce or repress gene expression. Although IFN-gamma induced expression of suppressor of cytokine signaling proteins, IL-10 signal transduction was not suppressed and IL-10 activation of Janus kinases and Stat3 was preserved. Instead, IFN-gamma switched the balance of IL-10 STAT activation from Stat3 to Stat1, with concomitant activation of inflammatory gene expression. IL-10 activation of Stat1 required the simultaneous presence of IFN-gamma. These results demonstrate that IFN-gamma operates a switch that rapidly regulates STAT activation by IL-10 and alters macrophage responses to IL-10. Dynamic regulation of the activation of different STATs by the same cytokine provides a mechanism by which cells can integrate and balance signals delivered by opposing cytokines, and extends our understanding of cross-regulation by opposing cytokines to include reprogramming of signaling and alteration of function.

Adjuvants, Immunologic↗
PubMed2003

Antioxidant effect of gamma-tocopherol supplied by propofol preparations (Diprivan) during ischemia-reperfusion in experimental lung transplantation.

Free radicals are involved in ischemia-reperfusion injury and inflammatory processes. The commercial formulation of the anesthetic propofol contains gamma-tocopherol and delta-tocopherol, which may exert antioxidant effects during transplantation. Animals were randomly assigned to a control group or experimental groups for lung transplantation after 3 and 24 h of ischemia. Individual tocopherols, malondialdehyde, biochemical indices, and hemodynamic, blood gas, and ventilatory parameters were determined during reperfusion. Results showed that administration of commercially available propofol provoked a time- and dose-dependent increment in serum gamma-tocopherol and delta-tocopherol in control animals and in the group receiving lungs subjected to 3 h of ischemia, but not in the group with 24 h of ischemia. Malondialdehyde levels increased during reperfusion and did not differ significantly between the two experimental groups, which did not differ with respect to lung function either. gamma-Tocopherol, supplied by the anesthetic, may act as an antioxidant that is consumed during reperfusion. This potential effect could be relevant to the choice of anesthetic agents in situations where free radical damage to tissues is expected.

Analysis of Variance↗
PubMed2003

Facial appearance and judgments of credibility: the effects of facial babyishness and age on statement credibility.

Researchers have found that facial appearance influences social judgments. For example, evidence has shown that facial babyishness and age affect perceivers' impressions of the stimulus person's veracity. In this experiment, the researchers examined whether these variables also influenced the credibility attributed to written statements purportedly made by these people in addition to several topics of interest in deception-detection research. Undergraduates (N = 270) were presented babyfaced or mature-faced photographs that depicted a child, an adult, or an older individual, in addition to a written truthful or deceptive statement purportedly made by the person in the photograph. Results showed that, as predicted, when the statements were accompanied by babyfaced pictures, participants tended to judge them as truthful, but only if the pictures did not depict children. Also, when the statements were accompanied by childen's pictures, participants tended to judge them as deceptive, but only if the pictures depicted a babyish face. Overall detection accuracy was close to chance and did not correlate with either judgmental confidence or with the respondents' estimated lie-detection accuracy. However, confidence and estimated ability were significantly correlated. Also, more confidence was placed in judgments of truthfulness than in judgments of deceptiveness. Respondents' truth bias and the existence of a veracity effect in the diverse experimental conditions were examined as well.

Adolescent↗