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1.
Wiley Interdiscip Rev RNA ; 15(4): e1868, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38973000

RESUMEN

Pericentromeric heterochromatin is mainly composed of satellite DNA sequences. Although being historically associated with transcriptional repression, some pericentromeric satellite DNA sequences are transcribed. The transcription events of pericentromeric satellite sequences occur in highly flexible biological contexts. Hence, the apparent randomness of pericentromeric satellite transcription incites the discussion about the attribution of biological functions. However, pericentromeric satellite RNAs have clear roles in the organization of nuclear structure. Silencing pericentromeric heterochromatin depends on pericentromeric satellite RNAs, that, in a feedback mechanism, contribute to the repression of pericentromeric heterochromatin. Moreover, pericentromeric satellite RNAs can also act as scaffolding molecules in condensate subnuclear structures (e.g., nuclear stress bodies). Since the formation/dissociation of nuclear condensates provides cell adaptability, pericentromeric satellite RNAs can be an epigenetic platform for regulating (sub)nuclear structure. We review current knowledge about pericentromeric satellite RNAs that, irrespective of the meaning of biological function, should be functionally addressed in regular and disease settings. This article is categorized under: RNA Methods > RNA Analyses in Cells RNA in Disease and Development > RNA in Disease.


Asunto(s)
Heterocromatina , Satélite de ARN , Satélite de ARN/metabolismo , Satélite de ARN/genética , Humanos , Heterocromatina/metabolismo , Heterocromatina/genética , Animales , Núcleo Celular/metabolismo , Núcleo Celular/genética , Centrómero/metabolismo , Centrómero/genética , ADN Satélite/metabolismo , ADN Satélite/genética
2.
Transplant Cell Ther ; 2024 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-38971462

RESUMEN

BACKGROUND: In patients with multiple myeloma, the presence of high-risk cytogenetic abnormalities is associated with worse disease control and survival. Autologous stem cell transplant does benefit these patients. Tandem transplantation has been explored as a means to deepen responses and further improve survival however, its role remains controversial. This is particularly true in the era of novel agent induction and post-transplant maintenance therapy. OBJECTIVES: The aim of this study was to use the Canadian Myeloma Research Group database (CMRG-DB) and examine a large cohort of real-world patients comparing the outcomes of tandem versus single ASCT specifically in high-risk patients receiving novel agent-based induction and post-transplant maintenance. STUDY DESIGN: The data for this study was derived retrospectively from a comprehensive national-level database of Canadian patients with multiple myeloma. High-risk cytogenetics were defined as presence of del17p, t(4;14) or t(14;16). Those receiving allogeneic transplant were excluded. Tandem transplantation was defined as a second ASCT performed consecutively without interim relapse or progression after first ASCT. Those with relapse or progressive disease within three months of completing a first transplant were excluded. We compared response depth, progression free and overall survival based on single or tandem transplantation procedures. The impact of covariates of interest was also assessed. RESULTS: 381 patients with high-risk cytogenetics were identified. 242 received single and 139 patients received tandem transplants. All received post-transplant maintenance. The most common induction regimen for these patients was cyclophosphamide, bortezomib, and steroids (CyBorD, 87%). Forty-one patients (10.8%) required reinduction prior to first ASCT. The best overall responses at any time were 98.3% (90.5% ≥ VGPR) and 98.6% (89.9% ≥ VGPR) in the single and tandem ASCT groups respectively. Survival outcomes were similar with the median PFS for single or tandem ASCT of 35.2 and 35.3 months (p=0.88) and the median OS were 92.6 and 88.9 months respectively (p=0.72). No statistically significant differences were seen based on type of cytogenetic abnormality or type of maintenance. This was confirmed on multivariate analysis. CONCLUSION: In the real-world setting, tandem ASCT does not improve outcomes for MM patients with high-risk cytogenetics. This may be driven by the use of effective pre- and post-ASCT therapies. The development of more potent induction and consolidation along with current nearly ubiquitous continuous maintenance therapies until disease progression does not support the use of a second high dose procedure.

3.
Ocul Immunol Inflamm ; : 1-9, 2024 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-38916195

RESUMEN

PURPOSE: Vitamin D deficiency has been associated with higher rates of autoimmune disease, including noninfectious uveitis. This PRISMA-compliant review and meta-analysis aimed to analyze the correlation between noninfectious uveitis and vitamin D levels. METHODS: We searched PubMed, Embase, Cochrane, and Web of Science databases for studies, published in English, assessing vitamin D levels in patients diagnosed with noninfectious uveitis. The outcomes of interest were vitamin D deficiency, vitamin D mean level, vitamin D supplementation, and smoking rates. A subgroup analysis of inactive uveitis and active uveitis was performed. The heterogeneity was assessed with Cochrane Q-test and I2 statistics; p > 0.10 and I2 > 50% were considered significant for heterogeneity. Statistical analysis was conducted using Review Manager 5.3. RESULTS: 9 studies were included in the meta-analysis comprising a total of 10 711 patients, of whom 1,368 were diagnosed with noninfectious uveitis. Patients with noninfectious uveitis had worse results regarding vitamin D deficiency when compared with the control group (OR 0.58; CI 95% 0.44 to 0.77; p = 0.0002; I2 = 61%). Patients with inactive uveitis had better results towards vitamin D deficiency when compared with active uveitis (OR 5.00; CI 95% 2.84 to 8.81; p < 0.001; I2 = 0%). CONCLUSION: Our research supports the increasing evidence that associates vitamin D deficiency with noninfectious uveitis and its activity. Further investigation into the efficacy of vitamin D screening and supplementation in reducing the recurrence of uveitis is necessary.

4.
Artículo en Inglés | MEDLINE | ID: mdl-38870082

RESUMEN

OBJECTIVES: Primaquine is essential for the radical cure of Plasmodium vivax malaria and must be metabolized into its bioactive metabolites. Accordingly, polymorphisms in primaquine-metabolizing enzymes can impact the treatment efficacy. This pioneering study explores the influence of monoamine oxidase-A (MAO-A) on primaquine metabolism and its impact on malaria relapses. METHODS: Samples from 205 patients with P. vivax malaria were retrospectively analysed by genotyping polymorphisms in MAO-A and cytochrome P450 2D6 (CYP2D6) genes. We measured the primaquine and carboxyprimaquine blood levels in 100 subjects for whom blood samples were available on the third day of treatment. We also examined the relationship between the enzyme variants and P. vivax malaria relapses in a group of subjects with well-documented relapses. RESULTS: The median carboxyprimaquine level was significantly reduced in individuals carrying low-expression MAO-A alleles plus impaired CYP2D6. In addition, this group experienced significantly more P. vivax relapses. The low-expression MAO-A status was not associated with malaria relapses when CYP2D6 had normal activity. This suggests that the putative carboxyprimaquine contribution is irrelevant when the CYP2D6 pathway is fully active. CONCLUSIONS: We found evidence that the low-expression MAO-A variants can potentiate the negative impact of impaired CYP2D6 activity, resulting in lower levels of carboxyprimaquine metabolite and multiple relapses. The findings support the hypothesis that carboxyprimaquine may be further metabolized through CYP-mediated pathways generating bioactive metabolites that act against the parasite.

5.
Food Res Int ; 189: 114567, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38876609

RESUMEN

This work incorporated bioactives extracted from jabuticaba peel in the form of concentrated extract (JBE) and microencapsulated powders with maltodextrin (MDP) and gum arabic (GAP) in a dairy drink, evaluating its stability, in vitro bioaccessibility, and glycemic response. We evaluated the pH, acidity, colorimetry, total phenolics and anthocyanins, antioxidant capacity, degradation kinetics and half-life of anthocyanins, bioaccessibility, and postprandial glycemic physicochemical characteristics response in healthy individuals. The drinks incorporated with polyphenols (JBE, GAP, and MDP) and the control dairy drink (CDD) maintained stable pH and acidity over 28 days. In color, the parameter a*, the most relevant to the study, was reduced for all formulations due to degradation of anthocyanins. Phenolic and antioxidant content remained constant. In bioaccessibility, we found that after the gastrointestinal simulation, there was a decrease in phenolics and anthocyanins in all formulations. In the glycemic response, we observed that the smallest incremental areas of glucose were obtained for GAP and JBE compared to CDD, demonstrating that polyphenols reduced glucose absorption. Then, the bioactives from jabuticaba peel, incorporated into a dairy drink, showed good storage stability and improved the product's functional aspects.


Asunto(s)
Antocianinas , Antioxidantes , Goma Arábiga , Polifenoles , Polisacáridos , Polifenoles/análisis , Humanos , Polisacáridos/química , Antioxidantes/análisis , Goma Arábiga/química , Antocianinas/análisis , Extractos Vegetales/química , Productos Lácteos/análisis , Glucemia/metabolismo , Frutas/química , Disponibilidad Biológica , Concentración de Iones de Hidrógeno , Digestión , Myrtaceae/química , Composición de Medicamentos , Índice Glucémico , Femenino , Masculino , Adulto
6.
EJHaem ; 5(3): 474-484, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38895063

RESUMEN

Multiple myeloma remains an incurable cancer mostly affecting older adults and is characterized by a series of remission inductions and relapses. This study aims to evaluate the outcomes in newly diagnosed transplant-ineligible patients using bortezomib/lenalidomide-based regimens in the Canadian real world as well as their outcomes in the second line. The Canadian Myeloma Research Group Database (CMRG-DB) is a national database with input from multiple Canadian Centres with now up to 8000 patients entered. A total of 1980 transplant ineligible patients were identified in the CMRG-DB between the years of 2007-2021. The four most commonly used induction regimens are bortezomib/melphalan/prednisone (VMP) (23%), cyclophosphamide/bortezomib/dexamethasone (CyBorD) (47%), lenalidomide/dexamethasone (Rd) (24%), and bortezomib/lenalidomide/dexamethasone (VRd) (6%). After a median follow-up of 30.46 months (0.89-168.42), the median progression-free survival (mPFS) and median overall survival (mOS) of each cohort are 23.5, 22.9, 34.0 months, and not reached (NR) and 64.1, 51.1, 61.5 months, and NR respectively. At the time of data cut-off, 1128 patients had gone on to second-line therapy. The mPFS2 based on first-line therapy, VMP, CyBorD, Rd, and VRd is 53.3, 48.4, 62.7 months, and NR respectively. The most common second-line regimens are Rd (47.4%), DRd (12.9%), CyBorD (10.3%), and RVd (8.9%) with a mPFS and a mOS of 17.0, 31.1, 15.4, and 14.0 months and 34.7, NR, 47.6, 33.4 months, respectively. This study represents the real-world outcomes in newly diagnosed transplant-ineligible myeloma patients in Canada. The spectra of therapy presented here reflect the regimens still widely used around the world. While this is sure to change with anti-CD38 monoclonal antibodies now reflecting a new standard of care in frontline therapy, this cohort is reflective of the type of multiple myeloma patient currently experiencing relapse in the real-world setting.

7.
Methods Mol Biol ; 2825: 185-203, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38913310

RESUMEN

Molecular combing is a technique used to stretch hundreds of consistent DNA molecules in parallel on a glass surface, with a resolution of two kilo-basepairs per micrometer. The combination of this approach with fluorescent in situ hybridization (FISH) has enabled the direct visualization of DNA structure and variations at an unprecedent high resolution. This technique has been successfully used in various studies such as the identification of copy number and genomic structural variations and the precise measurements of overlap and gap sizing between contigs in genome assemblies. Here, we describe the procedure for the preparation of DNA fibers by molecular combing and its applications in multicolor fiber-FISH.


Asunto(s)
ADN , Hibridación Fluorescente in Situ , Hibridación Fluorescente in Situ/métodos , ADN/genética , ADN/química
8.
Chronobiol Int ; 41(6): 780-788, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38722065

RESUMEN

The bimodal preference is a fourth diurnal preference proposed by re-scoring the Morningness-Eveningness Questionnaire. The present work aimed to describe the prevalence of the bimodal preference in a sample of undergraduate students and to characterize the bimodal type in terms of their health and sleep-related outcomes. A web-based cross-sectional study conducted between September 2018 and March 2021 (convenience sampling method). The sample was composed of undergraduate students who completed an electronic form that included the Morningness and Eveningness Questionnaire, the Pittsburgh Sleep Quality Index, the Self-Compassion Scale, the Epworth Sleepiness Scale, the Hospital Anxiety and Depression Scale, and the World Health Organization Subjective Well-Being Index. The final sample consisted of 615 students (82% female, mean age: 23.4 ± 6.5 years), of whom 108 (18%) had positive bimodality indexes. Bimodal subjects comprised 48 students, 8% of the total sample. Bimodal subjects had poorer subjective sleep quality, more daytime sleepiness, lower subjective well-being, greater anxiety and depression symptoms, and lower self-compassion than morning and/or intermediate types; they did not differ from evening types. The description of bimodal diurnal preference in this population may be of interest for the design of academic policies more in line with the circadian reality of students.


Asunto(s)
Ritmo Circadiano , Calidad del Sueño , Sueño , Estudiantes , Humanos , Femenino , Masculino , Ritmo Circadiano/fisiología , Adulto Joven , Estudios Transversales , Adulto , Encuestas y Cuestionarios , Sueño/fisiología , Depresión , Ansiedad , Adolescente , Universidades
9.
Clinics (Sao Paulo) ; 79: 100375, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38723579

RESUMEN

INTRODUCTION: Low-Level Red-Light (LLRL) Therapy is a safe and natural way to promote healing and reduce inflammation in the body. When it comes to treating myopia in children, LLRL therapy is recent, and its efficacy and safety still are not clear. METHODS: A systematic review and meta-analysis of the literature for LLRL was conducted in accordance with the PRISMA guidelines on November 5, 2022. Databases, including PUBMED, Cochrane Library, Web of Science, and Embase were queried. A meta-analysis of random effects was conducted. Inclusion criteria included Randomized Controlled Trials (RCTs) or observational studies where LLRL therapy was used in children (3‒15 years old) with myopia. Exclusion criteria were studies with other ocular abnormalities. Efficacy was evaluated through the mean change in Axial Length (AL) and cycloplegic Spherical Equivalent Error (SER), while safety was evaluated by monitoring adverse effects. RESULTS: A total of 5 final studies were included (4 RCTs, and 1 observational), in which 685 total patients were analyzed. The mean age was 9.7 ± 0.66 years, with 48,2% female patients. The number of eyes in the LRLL arm is 714 and, in the control, arm is 656. LLRL showed better results in SER and AL mean change (OR = 0.58; 95% CI 0.33 to 0.83; p < 0.00001, and MD -0.33; 95% CI -0.52 to -0.13; p = 0.001, respectively), in comparison to the control group. There was no significant difference in adverse effects between groups (MD = 5.76; 95% CI 0.66 to 50.14; p = 0.11). CONCLUSION: LLRL therapy is a non-invasive, effective, and safe short-term treatment option; however, long-term evaluation, particularly in comparison to other therapies, requires additional investigation.


Asunto(s)
Terapia por Luz de Baja Intensidad , Miopía , Humanos , Niño , Miopía/terapia , Terapia por Luz de Baja Intensidad/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Femenino , Adolescente , Masculino , Preescolar
10.
An Acad Bras Cienc ; 96(2): e20230007, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38808873

RESUMEN

This study aimed to recognize the biogeographic patterns, richness, and diversity levels of the Brazilian endemic genus Orthophytum and identify their biotic components through a parsimony analysis of endemicity (PAE), to better understand the evolutionary history of this group and develop strategies for the conservation of its species. We prepared a database for the 54 currently known species of Orthophytum, including their geographical locations as obtained from digital databases of the principal herbaria of Brazil, Europe, and the USA. A parsimony analysis of endemicity (PAE) was used to delimit the areas of endemism based on two grids' sizes (1º x 1º and 2º × 2º). The majority rule consensus tree resulting from the PAE indicated three areas of endemism with high bootstrap, diversity, and richness indices: the northern portion of the Espinhaço Range, the southern portion of the Espinhaço Range, and the central portion of the Atlantic Forest. The recognition of those distribution patterns reveals a high number of microendemic species, which is discussed here.


Asunto(s)
Biodiversidad , Bromeliaceae , Brasil , Bromeliaceae/clasificación
11.
Sci Rep ; 14(1): 10994, 2024 05 14.
Artículo en Inglés | MEDLINE | ID: mdl-38744832

RESUMEN

In this paper, we propose a novel pricing model for delivery insurance in a food delivery company in Latin America, with the aim of reducing the high costs associated with the premium paid to the insurer. To achieve this goal, a thorough analysis was conducted to estimate the probability of losses based on delivery routes, transportation modes, and delivery drivers' profiles. A large amount of data was collected and used as a database, and various statistical models and machine learning techniques were employed to construct a comprehensive risk profile and perform risk classification. Based on the risk classification and the estimated probability associated with it, a new pricing model for delivery insurance was developed using advanced mathematical algorithms and machine learning techniques. This new pricing model took into account the pattern of loss occurrence and high and low-risk behaviors, resulting in a significant reduction of insurance costs for both the contracting company and the insurer. The proposed pricing model also allowed for greater flexibility in insurance contracting, making it more accessible and appealing to delivery drivers. The use of estimated loss probabilities and a risk score for the pricing of delivery insurance proved to be a highly effective and efficient alternative for reducing the high costs associated with insurance, while also improving the profitability and competitiveness of the food delivery company in Latin America.


Asunto(s)
Costos y Análisis de Costo , Humanos , América Latina , Algoritmos , Aprendizaje Automático , Seguro/economía , Modelos Económicos
13.
Pensar Prát. (Online) ; 27abr.2024. Tab, Ilus
Artículo en Portugués, Francés | LILACS | ID: biblio-1556331

RESUMEN

A equidade é um dos princípios constitucionais e doutrinários do Sistema Único de Saúde (SUS), assim como da Política Nacional de Promoção da Saúde, principal marco das Práticas Corporais e Atividades Físicas (PCAF) no referido sistema. Considerando as desigualdades sociais gerais e as iniquidades em saúde, a equidade deve ser prioritária. Assim, o trabalho, de caráter ensaístico, teve como objetivo apresentar a experiência do Serviço de Orientação ao Exercício na operacionalização deste princípio. Foram abordados aspectos relacionados ao acesso, recursos, resultados e desafios para indicar possibilidades e caminhos para a efetivação da equidade na promoção das PCAF no SUS, visando o seu fortalecimento e qualificação como sistema de saúde universal, integral e equânime (AU).


Equity is one of the constitutional and doctrinal principles of the Unified Health System (SUS), as well as of the National Health Promotion Policy, the main framework for Body Practices and Physical Activities (PCAF) in this system. Considering the general social inequalities and inequities in health, equity must be a priority. The aim of this essay was to present the experience of the Exercise Guidance Service in operationalizing this principle. Aspects related to access, resources, results and challenges were addressed in order to indicate possibilities and paths towards the realization of equity in the promotion of PCAF in the SUS, with a view to strengthening and qualifying it as a universal, comprehensive and equitable health system (AU).


La equidad es uno de los principios constitucionales y doctrinales del Sistema Único de Salud (SUS), así como de la Política Nacional de Promoción de la Salud, marco principal de las Prácticas Corporales y Actividades Físicas (PCAF) de este sistema. Considerando las desigualdades sociales generales y las inequidades en salud, la equidad debe ser priorizada. El objetivo de este ensayo era, por tanto, presentar la experiencia del Servicio de Orientación para el Ejercicio en la puesta en práctica de este principio. Se analizaron aspectos relacionados con el acceso, los recursos, los resultados y los desafíos, a fin de indicar posibilidades y formas de hacer realidad la equidad en la promoción del PCAF en el SUS, con miras a fortalecerlo y calificarlo como sistema de salud universal, integral y equitativo (AU).


Asunto(s)
Humanos
14.
Biochem Pharmacol ; 224: 116245, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38685281

RESUMEN

Cardiovascular disease (CVD) is the leading cause of death in rheumatoid arthritis (RA). Resistin is an adipokine that induces adipose tissue inflammation and activation of monocytes/macrophages via adenylate cyclase-associated protein-1 (CAP1). Resistin levels are increased in RA and might cause perivascular adipose tissue (PVAT) dysfunction, leading to vascular damage and CVD. This study aimed to investigate the role of resistin in promoting PVAT dysfunction by increasing local macrophage and inflammatory cytokines content in antigen-induced arthritis (AIA). Resistin pharmacological effects were assessed by using C57Bl/6J wild-type (WT) mice, humanized resistin mice expressing human resistin in monocytes-macrophages (hRTN+/-/-), and resistin knockout mice (RTN-/-) with AIA and respective controls. We investigated AIA disease activity and functional, cellular, and molecular parameters of the PVAT. Resistin did not contribute to AIA disease activity and its concentrations were augmented in the PVAT and plasma of WT AIA and hRTN+/-/- AIA animals. In vitro exposure of murine arteries to resistin impaired vascular function by decreasing the anti-contractile effect of PVAT. WT AIA mice and hRTN+/-/- AIA mice exhibited PVAT dysfunction and knockdown of resistin prevented it. Macrophage-derived cytokines, markers of types 1 and 2 macrophages, and CAP1 expression were increased in the PVAT of resistin humanized mice with AIA, but not in knockout mice for resistin. This study reveals that macrophage-derived resistin promotes PVAT inflammation and dysfunction regardless of AIA disease activity. Resistin might represent a translational target to reduce RA-driven vascular dysfunction and CVD.


Asunto(s)
Tejido Adiposo , Artritis Experimental , Macrófagos , Ratones Endogámicos C57BL , Resistina , Animales , Resistina/metabolismo , Resistina/genética , Humanos , Tejido Adiposo/metabolismo , Ratones , Macrófagos/metabolismo , Artritis Experimental/metabolismo , Ratones Noqueados , Masculino
15.
Sci Total Environ ; 926: 172127, 2024 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-38569965

RESUMEN

River avulsions drive important changes in the Pantanal wetlands, owing to their role in the hydro-sedimentology of the region. Although relevant to numerous ecosystem services, few studies have analyzed the influence of river avulsions on soil fertility in the Pantanal. Here, we use the largest ongoing avulsion in the Taquari River (Caronal region) to evaluate the effects on soil fertility, considering two factors: avulsion stage (1) and aquatic-terrestrial succession (2). Since both factors are influenced by macrophyte abundance, an incident map was created through tasseled cap indices from Sentinel 2 images to guide sampling efforts in flooded soils. The mapped area was split into two zones of alluvial processes, the first from the apex of the Caronal lobe corresponding to the Taquari River megafan (TRM), and the second as the distal Paraguay River floodplain (PRF). Soil macro- and micronutrient levels were evaluated from 42 surface samples (0-0.2 m) distributed across the two alluvial process zones. The macrophyte map's overall accuracy (OA) was analyzed by a confusion matrix using the Sentinel 2 imagery. Finally, we used Random Forest regressions to determine the influence of response variables on soil attributes, including tassel indices, distance from the Caronal crevasse, macrophyte density, and an existing soil fertility map. The macrophyte map obtained an OA of 93 %. Some parameters such as pH (r = -0.62; R2 = 0.57), effective cation exchange capacity (r = -0.49; R2 = 0.79), Mn (r = -0.71; R2 = 0.6), Zn (r = -0.69; R2 = 0.54), and base saturation (r = -0.7; R2 = 0.93) were influenced by the distance or level of maturation of the avulsion stage in the TRM. Our scattering of soil collections was insufficient to test the terrestrialization hypothesis (2). The study results show that river channel avulsions influence the accumulation of mineral and organic nutrients in tropical floodplain soils, which has implications for fertility and biodiversity.

16.
Leuk Lymphoma ; : 1-8, 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38625039

RESUMEN

There is limited knowledge regarding the prevalence of geriatric impairments and frailty among patients with multiple myeloma (MM) in a real-world setting. This study evaluated the distribution of frailty profiles among 116 patients with newly diagnosed or relapsed MM, using four common frailty scales. The proportion of patients classified as frail varied significantly, ranging from 15.5% to 56.9%, due to differences in how frailty was operationalized between each frailty measure. Functional, cognitive, and mobility impairments were common overall and irrespective of performance status. Analyses between frailty and treatment selection (dose reduction and doublet vs. triplet therapy) demonstrated significant differences in non-steroid MM drug dose reductions between frail vs. non-frail patients, as scored by the International Myeloma Working Group (IMWG) Frailty Index and Simplified Frailty Score (p < .05). A standardized approach to frailty assessment that is practical in application, and beneficial in guiding treatment selection and minimizing treatment related toxicity is necessary to provide optimal tailored care.

17.
Lancet Glob Health ; 12(5): e875-e881, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38614635

RESUMEN

The Guiana Shield, a small region of South America, is currently one of the main hotspots of malaria transmission on the continent. This Amazonian area is characterised by remarkable socioeconomic, cultural, health, and political heterogeneity and a high degree of regional and cross-border population mobility, which has contributed to the increase of malaria in the region in the past few years. In this context, regional cooperation to control malaria represents both a challenge and an indispensable initiative. This Viewpoint advocates for the creation of a regional cooperative mechanism for the elimination of malaria in the Guiana Shield. This strategy would help address operational and political obstacles to successful technical cooperation in the region and could contribute to reversing the regional upsurge in malaria incidence through creating a functional international control and elimination partnership.


Asunto(s)
Malaria , Humanos , Malaria/epidemiología , Malaria/prevención & control , Equipos de Seguridad
18.
Vascular ; : 17085381241246322, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38597580

RESUMEN

OBJECTIVE: Robot-assisted endovascular surgery has emerged as a new alternative to interventional procedures, with its application expanding to peripheral and visceral approaches. The objective of this paper is to describe a robot-assisted endovascular treatment in splanchnic arteries. METHODS: A case report of an asymptomatic male patient with an incidental finding of a saccular aneurysm of the proper hepatic artery measuring 3.7 × 2.7 cm and distant 0.6 cm from the origin of the gastroduodenal artery. RESULTS: Using a robot-assisted endovascular technique (CorPath GRX platform - Siemens), 2 guidewires were advanced in parallel: the first one was placed inside the aneurysm sac, while the second one was placed in the proper hepatic artery distal to the aneurysm; through the first guidewire, a balloon was advanced, positioned distally to the aneurysm, and through the second one, a microcatheter was advanced. Embolization of the aneurysm was performed with the use of coils and Onyx. Control exam performed 120 days after embolization revealed treated aneurysm and preserved distal arterial flow. CONCLUSION: Using a robotic platform for navigation in splanchnic territory is safe and effective.

19.
J Clin Microbiol ; 62(6): e0010424, 2024 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-38661386

RESUMEN

Leishmaniasis is a vector-borne disease caused by many Leishmania spp. which infect humans and other mammalian hosts. Leishmania infantum is the main agent of canine leishmaniasis (CanL) whose diagnosis is usually confirmed by serological and molecular tests. This study aimed to evaluate the clinical and analytical sensitivities of a lab-on-chip (LOC) real-time PCR applied on the portable Q3-Plus V2 platform (Q3 qPCR) in the detection of L. infantum. The Q3 qPCR performance was assessed by comparing the quantification cycle (Cq) values with those obtained using the qPCR run on a CFX96 Real-Time System (CFX96 qPCR). A total of 173 DNA samples (extracted from bone marrow, lymph node, blood, buffy coat, conjunctival swab, and skin) as well as 93 non-extracted samples (NES) (bone marrow, lymph node, blood, and buffy coat) collected from dogs were tested with both systems. Serial dilutions of each representative DNA and NES sample were used to assess the analytical sensitivity of the Q3 qPCR system. Overlapping Cq values were obtained with the Q3 qPCR and CFX96 qPCR, both using DNA extracted from L. infantum promastigotes (limit of detection, <1 promastigote per milliliter) and from biological samples as well as with NES. However, the Q3 qPCR system showed a higher sensitivity in detecting L. infantum in NES as compared with the CFX96 qPCR. Our data indicate that the Q3 qPCR system could be a reliable tool for detecting L. infantum DNA in biological samples, bypassing the DNA extraction step, which represents an advance in the point-of-care diagnostic of CanL.


Asunto(s)
Enfermedades de los Perros , Leishmania infantum , Leishmaniasis Visceral , Reacción en Cadena en Tiempo Real de la Polimerasa , Sensibilidad y Especificidad , Perros , Animales , Leishmania infantum/genética , Leishmania infantum/aislamiento & purificación , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/parasitología , Leishmaniasis Visceral/diagnóstico , Leishmaniasis Visceral/veterinaria , Leishmaniasis Visceral/parasitología , Dispositivos Laboratorio en un Chip , Técnicas de Diagnóstico Molecular/métodos , ADN Protozoario/genética
20.
Clin Nutr ; 43(5): 1190-1199, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38613906

RESUMEN

BACKGROUND & AIMS: We aimed to analyze the prospective association between adherence to the ultra-processed dietary pattern and risk of depressive outcomes using original data from the NutriNet Brasil cohort and via a systematic review and meta-analysis of observational studies that have investigated the same association. METHODS: In our original research analysis, we used data from 15,960 adults (≥18 y) participating in the NutriNet Brasil cohort study, free of depression or depressive symptoms during the baseline (77.5% women, 45.8 ± 13.0 y). The mean dietary share of ultra-processed foods (%Kcal/d), calculated from two baseline 24-h dietary recalls, was used to measure the adherence to the ultra-processed dietary pattern. New cases of depressive symptoms were assessed using the Patient Health Questionnaire-9 over the follow-up period (mean: 18.3 months). Cox proportional hazards models were used for the main analyses. In our systematic review and meta-analysis, we incorporated effect estimates from six prospective cohort studies that have examined the same association, including ours. RESULTS: In the adjusted model, each 10% increase in the dietary share of ultra-processed foods was associated with a 10% increase in the hazard of incident cases of depressive symptoms (HR:1.10; 95%CI: 1.07-1.14). This association was slightly attenuated in the models including potential mediators. In our meta-analysis of six prospective studies, high versus low exposure to ultra-processed foods was associated with a summary hazard ratio of depressive outcomes of 1.32; 95%CI: 1.19-1.46; I2: 71%. CONCLUSION: A higher adherence to the ultra-processed dietary pattern was associated with a higher risk of developing depressive outcomes in the NutriNet Brasil cohort and in the meta-analysis.


Asunto(s)
Depresión , Comida Rápida , Humanos , Depresión/epidemiología , Femenino , Comida Rápida/estadística & datos numéricos , Comida Rápida/efectos adversos , Masculino , Persona de Mediana Edad , Adulto , Estudios Prospectivos , Dieta/estadística & datos numéricos , Cooperación del Paciente/estadística & datos numéricos , Estudios de Cohortes , Factores de Riesgo , Conducta Alimentaria/psicología , Patrones Dietéticos
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