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Biomedical subjects

L Delgado

Publications and source records attributed to L Delgado.

At least 19 recordsLinked to original sources
PubMed2006

Nutritional modulation of exercise-induced immunodepression in athletes: a systematic review and meta-analysis.

BACKGROUND: Heavy exercise induces marked immunodepression that is multifactorial in origin. Nutrition can modulate normal immune function. OBJECTIVE: To assess the efficacy of nutritional supplements in exercise-induced immunodepression in athletes. DESIGN: Systematic review. REVIEW METHODS: Randomised and/or controlled trials of athletes undertaking nutritional supplements to minimise the immunodepression after exercise were retrieved. The primary outcome measure was incidence of upper respiratory tract (URT) illness symptoms after exercise, and secondary outcomes included cortisol, cell counts, plasma cytokine concentration, cell proliferative response, oxidative burst, natural killer cell activity and immunoglobulins. When data were available for a pooled estimate of the effect of intervention, meta-analyses were conducted for direct comparisons. RESULTS: Forty-five studies were included (1603 subjects). The studies were heterogeneous in terms of exercise interventions, selection of athletes, settings and outcomes. The overall methodological quality of most of the trials was poor. Twenty studies addressed carbohydrate supplementation, eight glutamine, 13 vitamin C and four others interventions. Three trials assessed the effect of intervention on prevention of URT infections. The pooled rate ratio for URT infections after vitamin C supplementation against placebo was 0.49 (0.34-0.71). Carbohydrate supplementation attenuated the increase in cortisol and neutrophils after exercise; vitamin C attenuated the decrease in lymphocytes after exercise. No other interventions had significant or consistent effect on any of the studied outcomes. CONCLUSIONS: Although the prevention of URT infections by vitamin C was supported by two trials, further studies are needed. The available evidence failed to support a role for other nutritional supplements in preventing exercise-induced immune suppression. Larger trials with clinically relevant and uniform end points are necessary to clarify the role of these nutritional interventions.

Cytokines↗
PubMed2006

Apoptosis and extracellular matrix remodelling in human silicosis.

AIMS: Silicosis is a chronic occupational disease caused by the inhalation of free crystalline silica particles which produce inflammation and tissue destruction followed by remodelling of the extracellular matrix. Apoptosis has been implicated in the development of the initial inflammation that triggers the remodelling process. Our aim was to elucidate the importance of Fas-ligand (Fas-L) in this disorder and to study the relationship between Fas-L and several other inflammatory and fibrotic remodelling markers. METHODS AND RESULTS: We analysed 23 lung biopsies from silicotic patients and five controls, quantifying Fas-L and Bcl-2 expression by inflammatory cells as well as mast cells and collagen and elastic fibres. We used immunohistochemistry and morphometry to evaluate the amount of Fas-L and Bcl-2. Our analysis revealed that the silicotic lung stage was significantly related to Fas-L, mast cell and extracellular matrix remodelling. Fas-L expression was inversely associated with mast cells, collagen/elastic deposition and the silicotic lung. CONCLUSION: Fas-L, mast cell staining and collagen/elastic fibre quantities in silicotic lungs are strongly related to silicosis progression.

Apoptosis↗
PubMed2006

Rhinitis and asthma in athletes: an ARIA document in collaboration with GA2LEN.

This consensus document is aimed at reviewing evidence that the rhinitis-asthma links have peculiar features in athletes. Beside a review of epidemological data on the high prevalence of rhinitis and asthma in athletes, the effects on intense physical exercise on the immune system and repiratory functions are discussed, with special reference to the role of allergens and pollutants. In extending the Allergic Rhinitis and its Impact on Asthma (ARIA) recommendations to athletes, the issue is addressed of adapting diagnosis and management to criteria set by the International Olympic Committee (IOC) and regulations adopted by the World Anti-Doping Agency (WADA).

Asthma↗
PubMed2005

Geographical patterns of onchocerciasis in southern Venezuela: relationships between environment and infection prevalence.

Onchocerciasis is a chronic filarial infection transmitted by Simulium flies that has a focal geographical distribution in Latin America. The southern Venezuelan focus has a gradient of endemicity that includes the largest number of hyperendemic communities in the continent, many of them in remote forest and mountainous areas, where it is an important public health problem among the Yanomami indigenous population. The recent introduction of Geographical Information Systems (GIS) tools and a landscape epidemiology approach for study of vector borne diseases is helping to understand relationships between environment and transmission dynamics of onchocerciasis. Striking differences in the transmission dynamics of onchocerciasis between different river courses were detected. A significant relationship between onchocerciasis and temperature was also demonstrated. The geologic substrate, kind of landscape and vegetation seemed also to influence the transmission of onchocerciasis. In the Venezuelan Amazon, different kinds of landscapes associated with distinctive vector species, show different intensities of transmission of onchocerciasis. In this sense, landscape analysis aided by GIS, may prove to be a useful tool for better identification of the spatial distribution of onchocerciasis risk in the Orinoco basin.

Altitude↗
PubMed2004

Antigen characterization of major cork moulds in Suberosis (cork worker's pneumonitis) by immunoblotting.

BACKGROUND: We characterized by immunoblotting the antigenicity of the most frequent fungi colonizing cork during its industrial processing, Penicillium glabrum and Chrysonilia sitophila. Penicillium glabrum is the main causative agent of Suberosis, a hypersensitivity pneumonitis of cork workers. Chrysonilia sitophila induces both IgE sensitization and occupational asthma in the wood processing industry. METHODS: Serum-specific IgG, IgG4 and IgE to P. glabrum and C. sitophila from nine cork workers with hypersensitivity pneumonitis (HP) and seven with asthma (four with occupational asthma) were analysed by immunoblotting. RESULTS: Both HP and asthmatic patients' sera showed immunoreactivity to several proteins resolved in the specific immunoblot strips. The frequency of specific IgG recognition to 12-13.5 and 33 kDa proteins of P. glabrum was significantly higher in HP patients. The sera of HP patients had significantly higher specific IgG recognition to 16 and 51-55 kDa proteins of C. sitophila. There was no specific IgE recognition in the sera of HP or asthmatic patients to both fungi. CONCLUSIONS: Different patterns of antibody reactivity to P. glabrum and C. sitophila are seen in cork workers with hypersensitivity pneumonitis or asthma. The 12-13.5 and 33 kDa proteins of P. glabrum and the 16 and 51-55 kDa proteins of C. sitophila may be major antigens in Suberosis.

Adult↗
PubMed2004

Evaluation of the Asthma Life Quality test for the screening and severity assessment of asthma.

BACKGROUND: Asthma Life Quality (ALQ) test, a 20-question questionnaire developed by the American College of Allergy, Asthma and Immunology, has been shown to be useful for asthma diagnosis. We aimed to determine the relation between ALQ scores and (a) diagnosis of asthma; (b) physician's classification of asthma severity according to National Institutes of Health/Global Initiative for Asthma (GINA). METHODS: Standard translation and cultural adaptation to Portuguese was performed. Patients self-administered the ALQ in the waiting room; the attending allergist classified them, blindly for the test. The scores of nonasthmatics were compared with those of asthma patients. Asthma patients were analyzed in two severity groups: intermittent and mild persistent asthma (IMPA), and moderate and severe persistent asthma (MSPA); sensitivity, specificity, positive and negative predictive values were calculated and receiver operating characteristic curve plotted. Logistic regression analysis models were computed. RESULTS: From 283 patients, 237 tests were analyzed. Non-asthmatic patients ALQ scores (mean +/- SD) were 6 +/- 4 and, for asthmatics, 10 +/- 5 [mean difference 4.6 (95%CI 3.3-5.9)]. The odds of positive diagnosis increased 1.27 times (95%CI 1.17-1.38) for each one-unit increase in the test. For asthma severity ALQ scores were 9 +/- 4 for IMPA, 15 +/- 3 for MSPA [difference 6.0 (95%CI 4.8-7.1)]; with a sensitivity of 88% and specificity of 74% for a score of 12. The odds of MSPA increased 1.49 times (95%CI 1.28-1.74) per unit increase in ALQ. CONCLUSIONS: ALQ can help both to identify patients with asthma and to differentiate those more likely to have moderate/severe asthma. These are relevant characteristics for the possible use of this simple, self-administered questionnaire in the assessment of asthma patients needing additional medical management.

Adolescent↗
PubMed2004

Suberosis and bird fancier's disease: a comparative study of radiological, functional and bronchoalveolar lavage profiles.

Hypersensitivity Pneumonitis (HP) is an immunologically mediated interstitial lung disease that may result from repeated inhalation of many different environmental agents. Heterogeneity of the clinical presentation and bronchoalveolar lavage profiles have been described, possibly related to different occupational exposures. The aim of our study was to compare bronchoalveolar lavage fluid (BALF), clinical, functional and radiological characteristics of the two most frequent forms of HP seen in our practice: Suberosis (an HP related to moldy cork dust exposure) and bird fancier's disease (BFD). We included 81 patients with Suberosis, with a mean age of 38.8 +/- 11.3 years and a mean exposure of 20.0 +/- 10.5 years and 32 patients with BFD, with a mean age of 46.3 +/- 11.8 years and mean exposure of 10.5 +/- 1.0 years. Patients with BFD had more acute forms, while subacute and chronic presentations predominated in Suberosis. Restrictive defect was the most frequent pattern of lung function impairment, and more severe in BFD. Ground glass opacities were the most frequent pattern in high-resolution computed tomography. A normal chest x-ray was more frequently seen in Suberosis. Both types of HP had lymphocytic alveolitis in BALF: Suberosis - 6.6 +/- 5.7 x 10(5) ml-l cells, 58.8 +/- 18.9% lymphocytes; bird fancier's disease - 9.0 +/- 6.5 x 105 ml-l cells, 61.7 +/- 22.2% lymphocytes. Although BALF CD8+ lymphocytes predominated in both diseases, the proportion of CD4+ and CD4/CD8 ratios were significantly higher in bird fancier's disease (Suberosis: 0.47 +/- 0.33 versus BFD: 1.1 +/- 1.5; p < 0.005). Moreover, BALF cellularity and mast cell counts were also significantly higher in BFD. In conclusion, Suberosis and bird fancier's disease are HP with different clinical and laboratory profiles, suggesting that despite their pathophysiological similarities, different antigenic exposures may cause different immune and inflammatory response dynamics in the lung.

Adult↗
PubMed2002

Predictive value of (99m)Tc sestamibi scintigraphy in the evaluation of doxorubicin based chemotherapy response in patients with advanced breast cancer.

Resistance to doxorubicin based chemotherapy is a major therapeutic problem limiting advanced breast cancer treatment. 99mTc hexakis-2-methoxyisobutylisonitrile ((99m)Tc-MIBI) has been reported to be extruded from tumour cells by the P-glycoprotein and multidrug resistance protein encoded by MDR1 and MRP1 genes, respectively. These proteins are involved in the cellular efflux of several chemotherapeutic agents including doxorubicin. The aim of this study was to investigate the clinical value of a standard (99m)Tc-MIBI scintimammography technique in the prediction of response to chemotherapy in advanced breast cancer patients. Fifty-six lesions from 33 female patients with locally advanced (n=27) or recurrent breast cancer (n=6) were included in the study. MIBI scintigraphy was performed 2-8 days prior to chemotherapy (FAC regimen). Images were acquired 10 min and 1 h post-injection of 740-1110 MBq of (99m)Tc-MIBI. Tumour-to-normal background tissue uptake ratios were calculated on each lesion in the early (T/B(e)) and delayed phase of the study (T/B(d)). Both T/B(e) and T/B(d) ratios were significantly higher (P<0.0001) in responders (n=43) than nonresponders (n=13). Diagnostic values of (99m)Tc-MIBI in the prediction of chemotherapy response were evaluated using the arbitrary cut-off values of 1.5 for T/B(e) and 1.4 forT/B(d). Sensitivity, specificity, positive and negative predictive values were 88.4%, 92.3%, 97.4%, 70.6%; and 90.7%, 100.0%, 100.0%, 76.6%, for T/B(e) and T/B(d), respectively. We conclude that (99m)Tc-MIBI scintigraphy may be a clinically valuable tool for guiding chemotherapy in advanced breast cancer patients.

Adult↗
PubMed2002

Broncho-alveolar inflammation in cork worker's asthma.

UNLABELLED: Suberosis is an occupational lung disease of cork workers associated with repeated exposure to mouldy cork dust in the cork industry, usually presenting as an interstitial lung disorder (Extrinsic Allergic Alveolitis). However, Occupational Asthma can also be associated with cork dust exposure and demonstrated by serial peak expiratory flow changes. AIM: To investigate broncho-alveolar inflammation in patients with cork work-related occupational asthma, evaluated by Broncho-alveolar fluid cellular profiles and serial peak expiratory flow (PEF) rates monitoring. RESULTS: We studied 14 patients with respiratory symptoms associated with occupational exposure in the cork industry. Positive PEF monitoring occurred in 7 cases (Occupational Asthma-OA), and in 7 (Non-occupational asthmatics-NOA) PEF records were negative. There were no differences in age, lung function (FEV1%, RV%), bronchial hyperresponsiveness, years of exposure, and atopy between the two patients groups. However, patients with work-related asthma had higher BAL eosinophil counts than NOA (1.9 +/- 2.6% versus 0.2 +/- 0.3%; p < 0.05, Wilcoxon test). CONCLUSIONS: Cork worker's asthma, demonstrated by work related changes in serial PEF recordings, is associated with eosinophilic lung inflammation as described in other forms of occupational asthma.

Adult↗
PubMed2001

Monitoring of peak expiratory flow rates in cork workers' occupational asthma.

Suberosis is an occupational lung disorder of cork industry workers usually presenting as an extrinsic allergic alveolitis, but airway involvement in some cases makes the diagnostic approach complex. We assessed peak expiratory flow rates (PEF) in 17 cork workers with asthma symptoms that worsened at work, comparing three methods of PEF graph analysis. Complete agreement (three observers) was found in 12 of 17 cases (70.6%) with the visual inspection of mean daily values and in 11 of 17 cases (64.7%) with the minimum, maximum, and mean daily values (without any consensus in two cases). According to the mean PEF graph, there were eight positive readings (47%), five negative readings (29%), and four dubious readings (24%); with the other graphic analysis, two of the dubious cases were reclassified as negative. When we analyzed daily variability >20%, we found only three positive results, one of which was in absolute disagreement with the visual analysis. Our results suggest that it is possible to demonstrate occupational asthma in cork work exposure. The visual inspection of PEF monitoring shows a greater number of positive results than the index of daily variability; however, the latter may help to sort out dubious cases.

Adult↗
PubMed2001

CD8+ lymphocytes in the blister fluid of severe acute cutaneous graft-versus-host disease: further similarities with toxic epidermal necrolysis.

BACKGROUND: Graft-versus-host disease (GvHD) remains the major toxicity of allogeneic bone marrow transplantation (BMT). In the acute form of the disease, the differential diagnosis includes viral rash and drug eruptions. METHODS: We report two patients with chronic myeloid leukemia submitted to allogeneic BMT who developed a severe form of acute cutaneous GvHD, with clinical and histological pictures mimicking toxic epidermal necrolysis (TEN). RESULTS: We found a predominance of peripheral CD8+ T lymphocytes and, at the same time, studying the cellular profile of the blister fluid, just in the beginning of blister eruption, we also found a high proportion of CD8+ T lymphocytes, mainly CD8+CD57-. CONCLUSION: These data are in agreement with previous reports of the presence of CD8+ T cells in the blister fluid of patients with TEN, further emphasizing similar immunoinflammatory pathways in both diseases.

Acute Disease↗
PubMed2000

Gangrene of the fingertips after bleomycin and methotrexate.

The increased use of cytostatic drugs, which are sometimes used in combination chemotherapy, may result in new and unusual cutaneous side effects. We describe a 57-year-old man with acral erythrocyanosis progressing to acute digital ischemia and gangrene that developed after combined chemotherapy (bleomycin and methotrexate) used to treat a metastatic squamous cell carcinoma of the hypopharynx. A leukocytoclastic vasculitis was found in both the acute phase and in the amputated fingertips. This supports the well-reported potential of bleomycin to trigger acral vascular toxicity.

Antineoplastic Combined Chemotherapy Protocols↗