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1.
Artigo em Inglês | MEDLINE | ID: mdl-39207815

RESUMO

Importance: Asymmetric oropharynx uptake on positron emission tomography (PET)/computed tomography (CT) is a common incidental finding and often prompts otolaryngology referral to rule out malignancy; however, the true risk of malignancy based on this finding is unknown. Objective: To identify the incidence of oropharynx cancer in patients with incidental asymmetric oropharynx PET uptake. Design, Setting, and Participants: In this retrospective cohort study, patients 18 years and older undergoing PET/CT scans at Mayo Clinic between January 2001 and December 2018 were included. Patients with a history or pretest suspicion of oropharynx cancer were excluded. Data were analyzed from March 2021 to December 2023. Exposure: Blinded radiologic review of imaging studies, including measurement of maximum standardized uptake values (SUVmax) of the ipsilateral side of concern and contralateral side. Retrospective medical record review for associated clinical data. Main Outcomes and Measures: The primary study outcome was the incidence of oropharynx cancer diagnosis in patients with asymmetric oropharynx PET uptake. The primary outcome was formulated before data collection. Results: Of the 1854 patients identified with asymmetric oropharynx PET uptake, 327 (17.6%) met inclusion criteria. Of these, 173 (52.9%) were male, and the median (range) age was 65.0 (24.8-90.7) years. The mean (SD) follow-up interval was 52.1 (43.4) months. A total of 18 of 327 patients (5.5%) were newly diagnosed with oropharynx cancer. The most common diagnosis was squamous cell carcinoma (n = 9), followed by lymphoma (n = 8), and sarcoma (n = 1). Patients with an incidental diagnosis of oropharynx cancer had higher mean (SD) ipsilateral SUVmax (8.7 [3.7] vs 5.3 [1.9]) and SUVmax ratio (3.0 [1.6] vs 1.6 [0.6]) compared with patients with normal examination findings. SUVmax ratio and difference were found to be good discriminators of oropharynx cancer, with areas under the receiver operating characteristic curve of 86.3% (95% CI, 76.4-94.6) and 85.8% (95% CI, 74.8-94.6), respectively. Patients with a new diagnosis of oropharynx cancer were more likely to have a corresponding CT abnormality than those with normal examination findings (6 of 18 [33%] vs 24 of 295 [8.1%]). Patients with concerning lesions on oropharynx palpation by an otolaryngology health care professional were significantly more likely to be diagnosed with oropharynx cancer compared with patients with normal examination findings (odds ratio, 28.4; 95% CI, 6.6-145.8). Conclusions and Relevance: In this cohort study, while incidental asymmetric oropharynx PET uptake was common, a new diagnosis of oropharynx cancer was not and potentially results in a large volume of unnecessary referrals and work-up. Using SUVmax ratio, SUVmax difference, and CT correlation may increase the benefit of referral. Patients with a palpable oropharynx lesion and asymmetric oropharynx PET uptake should undergo confirmatory biopsy.

2.
J Appl Clin Med Phys ; : e14498, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39189817

RESUMO

BACKGROUND: Bolus materials have been used for decades in radiotherapy. Most frequently, these materials are utilized to bring dose closer to the skin surface to cover superficial targets optimally. While cavity filling, such as nasal cavities, is desirable, traditional commercial bolus is lacking, requiring other solutions. Recently, investigators have worked on utilizing 3D printing technology, including commercially available solutions, which can overcome some challenges with traditional bolus. PURPOSE: To utilize failure modes and effects analysis (FMEA) to successfully implement a comprehensive 3D printed bolus solution to replace commercial bolus in our clinic using a series of open-source (or free) software products. METHODS: 3D printed molds for bespoke bolus were created by exporting the DICOM structures of the bolus designed in the treatment planning system and manipulated to create a multipart mold for 3D printing. A silicone (Ecoflex 00-30) mixture is poured into the mold and cured to form the bolus. Molds for sheet bolus of five thicknesses were also created. A comprehensive FMEA was performed to guide workflow adjustments and QA steps. RESULTS: The process map identified 39 and 30 distinct steps for the bespoke and flat sheet bolus workflows, respectively. The corresponding FMEA highlighted 119 and 86 failure modes, with 69 shared between the processes. Misunderstanding of plan intent was a potential cause for most of the highest-scoring failure modes, indicating that physics and dosimetry involvement early in the process is paramount. CONCLUSION: FMEA informed the design and implementation of QA steps to guarantee a safe and high-quality comprehensive implementation of silicone bolus from 3D printed molds. This approach allows for greater adaptability not afforded by traditional bolus, as well as potential dissemination to other clinics due to the open-source nature of the workflow.

3.
Mayo Clin Proc ; 99(6): 1006-1012, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38839179

RESUMO

This case report describes the safety and utility of a noninvasive therapy, Purified Exosome Product (PEP), for poorly healing scalp wounds in the setting of prior chemoradiation and surgery. A man in his 60s with a history of high-grade angiosarcoma of the right temporoparietal scalp reconstruction had a 1-year history of 2 nonhealing scalp wounds after neoadjuvant chemotherapy followed by concurrent chemoradiation therapy, wide local excision, and latissimus dorsi free flap and split-thickness skin graft. The patient underwent débridement followed by 4 collagen (Bellafill)-PEP and 4 fibrin (Tisseel)-PEP applications during 7 months in 2022. Photographs of the area of exposed bone of the temporoparietal wound were measured and standardized by ImageJ open-source software. The frontal wound was not routinely measured and therefore was qualitatively assessed by reviewing photographs over time. The frontal wound completely healed, and the temporoparietal wound showed a 96% decrease in overall size. The patient had no adverse effects of treatment and continues to demonstrate ongoing healing. This case exhibits the safety and utility of topical PEP therapy for noninvasive treatment of poorly healing scalp wounds and offers the potential for an alternative treatment of patients who are poor candidates for additional surgical intervention.


Assuntos
Exossomos , Couro Cabeludo , Cicatrização , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/terapia , Quimiorradioterapia/métodos , Quimiorradioterapia/efeitos adversos , Hemangiossarcoma/terapia , Neoplasias de Cabeça e Pescoço/terapia , Desbridamento/métodos
4.
J Nutr ; 154(6): 1945-1958, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38582385

RESUMO

BACKGROUND: Docosahexaenoic acid (DHA) controls the biophysical organization of plasma membrane sphingolipid/cholesterol-enriched lipid rafts to exert anti-inflammatory effects, particularly in lymphocytes. However, the impact of DHA on the spatial arrangement of alveolar macrophage lipid rafts and inflammation is unknown. OBJECTIVES: The primary objective was to determine how DHA controls lipid raft organization and function of alveolar macrophages. As proof-of-concept, we also investigated DHA's anti-inflammatory effects on select pulmonary inflammatory markers with a murine influenza model. METHODS: MH-S cells, an alveolar macrophage line, were treated with 50 µM DHA or vehicle control and were used to study plasma membrane molecular organization with fluorescence-based methods. Biomimetic membranes and coarse grain molecular dynamic (MD) simulations were employed to investigate how DHA mechanistically controls lipid raft size. qRT-PCR, mass spectrometry, and ELISAs were used to quantify downstream inflammatory signaling transcripts, oxylipins, and cytokines, respectively. Lungs from DHA-fed influenza-infected mice were analyzed for specific inflammatory markers. RESULTS: DHA increased the size of lipid rafts while decreasing the molecular packing of the MH-S plasma membrane. Adding a DHA-containing phospholipid to a biomimetic lipid raft-containing membrane led to condensing, which was reversed with the removal of cholesterol. MD simulations revealed DHA nucleated lipid rafts by driving cholesterol and sphingomyelin into rafts. Downstream of the plasma membrane, DHA lowered the concentration of select inflammatory transcripts, oxylipins, and IL-6 secretion. DHA lowered pulmonary Il6 and Tnf-α mRNA expression and increased anti-inflammatory oxylipins of influenza-infected mice. CONCLUSIONS: The data suggest a model in which the localization of DHA acyl chains to nonrafts is driving sphingomyelin and cholesterol molecules into larger lipid rafts, which may serve as a trigger to impede signaling and lower inflammation. These findings also identify alveolar macrophages as a target of DHA and underscore the anti-inflammatory properties of DHA for lung inflammation.


Assuntos
Ácidos Docosa-Hexaenoicos , Macrófagos Alveolares , Microdomínios da Membrana , Animais , Macrófagos Alveolares/metabolismo , Macrófagos Alveolares/efeitos dos fármacos , Ácidos Docosa-Hexaenoicos/farmacologia , Microdomínios da Membrana/metabolismo , Microdomínios da Membrana/efeitos dos fármacos , Camundongos , Inflamação/metabolismo , Pulmão/metabolismo , Infecções por Orthomyxoviridae , Camundongos Endogâmicos C57BL , Linhagem Celular , Colesterol/metabolismo
5.
J Cannabis Res ; 6(1): 10, 2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38429800

RESUMO

BACKGROUND: While the use of orally consumed Cannabis, cannabidiol (CBD) and tetrahydrocannabinol (THC) containing products, i.e. "edibles", has expanded, the health consequences are still largely unknown. This study examines the effects of oral consumption of whole Cannabis and a complex Cannabis extract on neurochemicals, endocannabinoids (eCB), and physiological parameters (body temperature, heart rate) in mice. METHODS: In this pilot study, C57BL/6 J mice were treated with one of the following every other day for 2 weeks: a complex Cannabis extract by gavage, whole Cannabis mixed with nutritional gel through free feeding, or purified THC/CBD by intraperitoneal (i.p.) injection. Treatments were conducted at 4 doses ranging from 0-100 mg/kg/day of CBD with THC levels of ≤ 1.2 mg/kg/day for free feeding and gavage and 10 mg/kg/day for i.p. Body temperature and heart rate were monitored using surgically implanted telemetry devices. Levels of neurochemicals, eCB, THC, CBD, and 11-OH-THC were measured using mass spectrometry 48 h after the final treatment. Statistical comparisons were conducted using ANOVA and t-tests. RESULTS: Differences were found between neurochemicals in the brains and plasma of mice treated by i.p. (e.g. dopamine, p < 0.01), gavage (e.g., phenylalanine, p < 0.05) and in mice receiving whole Cannabis (e.g., 3,4-dihydroxyphenylacetic DOPAC p < 0.05). Tryptophan trended downward or was significantly decreased in the brain and/or plasma of all mice receiving Cannabis or purified CBD/THC, regardless of dose, compared to controls. Levels of the eCB, arachidonoyl glycerol (2-AG) were decreased in mice receiving lowest doses of a complex Cannabis extract by gavage, but were higher in mice receiving highest doses compared to controls (p < 0.05). Plasma and brain levels of THC and 11-OH-THC were higher in mice receiving 1:1 THC:CBD by i.p. compared to those receiving 1:5 or 1:10 THC:CBD. Nominal changes in body temperature and heart rate following acute and repeated exposures were seen to some degree in all treatments. CONCLUSIONS: Changes to neurochemicals and eCBs were apparent at all doses regardless of treatment type. Levels of neurochemicals seemed to vary based on the presence of a complex Cannabis extract, suggesting a non-linear response between THC and neurochemicals following repeated oral dosing.

6.
Anticancer Res ; 44(4): 1491-1497, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38537978

RESUMO

BACKGROUND/AIM: Total skin electron beam therapy (TSEBT) is an effective treatment for managing cutaneous T-cell lymphoma (CTCL), but may result in unnecessary toxicity. With the production of a custom rolling shield holding a configurable stack of plastic slats to block uninvolved skin, we implemented a program for subtotal skin electron beam therapy (STSEBT). We report our preliminary experience with STSEBT vs. TSEBT to manage CTCL. PATIENTS AND METHODS: A retrospective review of 32 CTCL patients who were treated at a single institution between February 28th, 2017, and May 25th, 2022, was completed. Of these cases, seven patients received STSEBT and 25 received TSEBT. RESULTS: Thirty-two patients underwent a course of STSEBT or TSEBT. The median follow-up was 465 days and the median age at diagnosis was 70.8 years. Stage distribution was as follows: one (3%) IA, 16 (50%) IB, 6 (19%) IIB, two (6%) IIIA, five (16%) IVA, and two (6%) IVB. The overall response rate was 96%. For patients receiving TSEBT (n=25), three (12%), 10 (40%), and 11 (44%) had a CR, NCR, and PR, respectively. For the patients receiving STSEBT, four (57.1%), three (42.9%), and zero (0%) had a CR, NCR, and PR, respectively. There was one patient (4%) with no response. Cumulative incidence of progressive skin disease requiring additional electron therapy at three months was 21.1% [IQR=8.6, 51.5%], 36.8% [IQR=20, 68%] at six months, and 57.9% [IQR=38.5, 87.1%] at one year. Low rates of toxicities were recorded. CONCLUSION: This analysis demonstrated that treatment of CTCL patients with low disease burden with STSEBT results in similar overall response and time to progression compared to treatment with TSEBT.


Assuntos
Linfoma Cutâneo de Células T , Micose Fungoide , Neoplasias Cutâneas , Humanos , Idoso , Micose Fungoide/radioterapia , Micose Fungoide/tratamento farmacológico , Micose Fungoide/patologia , Neoplasias Cutâneas/radioterapia , Neoplasias Cutâneas/patologia , Elétrons , Linfoma Cutâneo de Células T/radioterapia , Linfoma Cutâneo de Células T/patologia , Pele/patologia
7.
Laryngoscope ; 134(3): 1356-1358, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37622726

RESUMO

We present a case of subglottic thrombus formation after administration of nebulized tranexamic acid (TXA) for postoperative hemoptysis following CO2 laser wedge excision of subglottic stenosis. Although other factors certainly could have resulted in postoperative bleeding and subsequent thrombus formation, the patient's rapid decompensation following administration of nebulized TXA suggests a direct effect. We recommend implementing an airway action plan regarding TXA use for patients presenting to the emergency department with postoperative hemorrhage following otolaryngology procedures. Laryngoscope, 134:1356-1358, 2024.


Assuntos
Antifibrinolíticos , Trombose , Ácido Tranexâmico , Humanos , Ácido Tranexâmico/efeitos adversos , Antifibrinolíticos/efeitos adversos , Hemorragia Pós-Operatória , Tórax , Trombose/induzido quimicamente , Trombose/tratamento farmacológico
8.
Ann Otol Rhinol Laryngol ; 133(1): 22-29, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37365768

RESUMO

OBJECTIVES: The purpose of this study was to evaluate visual gaze patterns and the ability to correctly identify cancer among participants of different experience levels when viewing benign and malignant vocal cord lesions. METHODS: Thirty-one participants were divided into groups based on level of experience. These included novice (medical students, PGY1-2 otolaryngology residents), intermediate (PGY3-5 otolaryngology residents, gastroenterology fellow), advanced practice providers (physician assistants, nurse practitioners, and speech language pathologists), and experts (board-certified otolaryngologists). Each participant was shown 7 images of vocal cord pathology including glottic cancer, infectious laryngitis, and granuloma and asked to determine the likelihood of cancer on a scale of certain, probable, possible, and unlikely. Eye tracking data were collected and used to identify the area of interest (AOI) that each participant fixated on first, fixated on the longest, and had the greatest number of fixations. RESULTS: No significant differences were seen among groups when comparing AOI with first fixation, AOI with longest fixation, or AOI with most fixations. Novices were significantly more likely to rate a low likelihood of cancer when viewing infectious laryngitis compared to more experienced groups (P < .001). There was no difference in likelihood of cancer rating among groups for the remaining images. CONCLUSIONS: There was no significant difference in gaze targets among participants of different experience levels evaluating vocal cord pathology. Symmetric appearance of vocal cord lesions may explain differences seen in likelihood of cancer rating among groups. Future studies with larger sample sizes will better elucidate gaze targets that lead to accurate diagnosis of vocal cord pathology.


Assuntos
Neoplasias Laríngeas , Laringite , Humanos , Laringite/diagnóstico , Prega Vocal/patologia , Neoplasias Laríngeas/cirurgia
9.
Foods ; 12(16)2023 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-37627983

RESUMO

Mushrooms contain multiple essential nutrients and health-promoting bioactive compounds, including the amino acid L-ergothioneine. Knowledge of the chemical composition of different mushroom varieties will aid research on their health-promoting properties. We compared the metabolomes of fresh raw white button, crimini, portabella, lion's mane, maitake, oyster, and shiitake mushrooms using untargeted liquid chromatography mass spectrometry (LC/MS)-based metabolomics. We also quantified amino acid concentrations, including L-ergothioneine, a potential antioxidant which is not synthesized by plants or animals. Among the seven mushroom varieties, more than 10,000 compounds were detected. Principal Component Analysis indicated mushrooms of the same species, Agaricus Bisporus (white button, portabella, crimini), group similarly. The other varieties formed individual, distinct clusters. A total of 1344 (520 annotated) compounds were detected in all seven mushroom varieties. Each variety had tens-to-hundreds of unique-to-mushroom-variety compounds. These ranged from 29 for crimini to 854 for lion's mane. All three Agaricus bisporus varieties had similar amino acid profiles (including detection of all nine essential amino acids), while other varieties had less methionine and tryptophan. Lion's mane and oyster mushrooms had the highest concentrations of L-ergothioneine. The detection of hundreds of unique-to-mushroom-variety compounds emphasizes the differences in chemical composition of these varieties of edible fungi.

12.
Adv Radiat Oncol ; 8(6): 101289, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37457824

RESUMO

Purpose: Purpose: Subtotal skin electron beam therapy may be an option for patients with cutaneous lymphoma receiving radiation therapy to treat large areas of their skin but may benefit from sparing specific areas that may have had previous radiation therapy, are of specific cosmetic concern, and/or show no evidence of disease. We report here on the design, implementation, and dosimetric characteristics of a reusable and transparent customizable shield for use with the large fields used to deliver total skin electron beam therapy at extended distance with a conventional linear accelerator. Methods and Materials: A shield was designed and manufactured consisting of acrylic blocks that can be mounted on a steel frame to allow patient-specific shielding. The dosimetry of the device was measured using radiochromic film. Results: The shield is easy to use and well-tolerated for patient treatment, providing minimal electron transmission through the shield with a sharp penumbra at the field edge, with no increase in x-ray dose. We report on the dosimetry of a commercial device that has been used to treat more than 30 patients to date. Conclusions: The customizable shield is well suited to providing patient-specific shielding for subtotal skin electron beam therapy.

13.
Cogn Res Princ Implic ; 8(1): 22, 2023 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-37074525

RESUMO

When an audience member becomes immersed, their attention shifts towards the media and story, and they allocate cognitive resources to represent events and characters. Here, we investigate whether it is possible to measure immersion using continuous behavioural and physiological measures. Using television and film clips, we validated dual-task reaction times, heart rate, and skin conductance against self-reported narrative engagement. We find that reaction times to a secondary task were strongly positively correlated with self-reported immersion: slower reaction times were indicative of greater immersion, particularly emotional engagement. Synchrony in heart rate across participants was associated with self-reported attentional and emotional engagement with the story, although we found no such relationship with skin conductance. These results establish both dual-task reaction times and heart rate as candidate measures for the real-time, continuous, assessment of audience immersion.


Assuntos
Atenção , Imersão , Humanos , Autorrelato , Atenção/fisiologia , Emoções/fisiologia , Tempo de Reação
14.
J Voice ; 2023 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-37005128

RESUMO

OBJECTIVES: Interpretation of laryngoscopy is an important diagnostic skill in otolaryngology. There is, however, limited understanding of the specific visual strategies used while assessing flexible laryngoscopy video. Eye-tracking technology allows for objective study of eye movements during dynamic tasks. The purpose of the present study was to explore visual gaze strategies during laryngoscopy interpretation of unilateral vocal fold paralysis (UVFP) across clinician experience from novice to expert. METHODS: Thirty individuals were shown five flexible laryngoscopy videos, each 10 seconds long. After viewing each video, participants reported their impressions of "left vocal fold paralysis," "right vocal fold paralysis," or "no vocal fold paralysis." Eye tracking data were collected and analyzed for duration of fixation and number of fixations on select areas of interest (AOI). Diagnostic accuracy and visual gaze patterns were compared between novice, experienced, and expert groups. RESULTS: Diagnostic accuracy among learners in the novice group was significantly lower than those in the more experienced groups (P = 0.04). All groups demonstrated similar visual gaze patterns when viewing the video with normal bilateral vocal fold mobility, spending the greatest percentage of time viewing the trachea. There were differences among groups when viewing the videos of left or right VFP, but the trachea was always in the top three structures for greatest fixation duration and highest number of fixations. CONCLUSIONS: Eye-tracking is a novel tool in the setting of laryngoscopy interpretation. With further study it has the potential to be useful for the training of otolaryngology learners to improve diagnostic skills.

15.
Anal Chim Acta ; 1249: 340909, 2023 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-36868765

RESUMO

Analysis of GC×GC-TOFMS data for large numbers of poorly-resolved peaks, and for large numbers of samples remains an enduring problem that hinders the widespread application of the technique. For multiple samples, GC×GC-TOFMS data for specific chromatographic regions manifests as a 4th order tensor of I mass spectral acquisitions, J mass channels, K modulations, and L samples. Chromatographic drift is common along both the first-dimension (modulations), and along the second-dimension (mass spectral acquisitions), while drift along the mass channel is for all practical purposes nonexistent. A number of solutions to handling GC×GC-TOFMS data have been proposed: these involve reshaping the data to make it amenable to either 2nd order decomposition techniques based on Multivariate Curve Resolution (MCR), or 3rd order decomposition techniques such as Parallel Factor Analysis 2 (PARAFAC2). PARAFAC2 has been utilised to model chromatographic drift along one mode, which has enabled its use for robust decomposition of multiple GC-MS experiments. Although extensible, it is not straightforward to implement a PARAFAC2 model that accounts for drift along multiple modes. In this submission, we demonstrate a new approach and a general theory for modelling data with drift along multiple modes, for applications in multidimensional chromatography with multivariate detection. The proposed model captures over 99.9% of variance for a synthetic data set, presenting an extreme example of peak drift and co-elution across two modes of separation.

16.
Health Policy ; 128: 28-33, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36443110

RESUMO

The extent to which legalizing cannabis use might lead to increased or decreased alcohol use has important implications for public health, economic growth, and government policy. This study analyzed Canada's monthly per capita sales of alcohol and legal medical cannabis using fixed effect panel data linear regressions. The data covered seven Canadian regions from January 2011 to September 2018, and controlled for changing levels of retail activity, alcohol prices, tertiary education, unemployment, and impaired driving penalties. The analysis estimated that each dollar of legal medical cannabis sold was associated with an average alcohol sales decrease of roughly $0.74 to $0.84. This suggests that medical cannabis was an economic substitute for alcohol in Canada, and that the country's 2017-2018 alcohol sales were roughly 1.8% lower than they would have been without legal medical cannabis. The results therefore indirectly imply that reduced alcohol consumption might have partly offset cannabis legalization's health and economic impacts.


Assuntos
Cannabis , Maconha Medicinal , Humanos , Canadá , Legislação de Medicamentos , Consumo de Bebidas Alcoólicas/epidemiologia , Etanol
17.
Nutrients ; 14(24)2022 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-36558362

RESUMO

Vitamin D deficiency is common in the United States and leads to altered immune function, including T cell and macrophage activity that may impact responses to SARS-CoV-2 infection. This study investigated 131 adults with a history of a positive SARS-CoV-2 nasopharyngeal PCR and 18 adults with no COVID-19 diagnosis that were recruited from the community or hospital into the Northern Colorado Coronavirus Biorepository (NoCo-COBIO). Participants consented to enrollment for a period of 6 months and provided biospecimens at multiple visits for longitudinal analysis. Plasma 25-hydroxyvitamin D levels were quantified by LC-MS/MS at the initial visit (n = 149) and after 4 months (n = 89). Adults were classified as deficient (<30 nM or <12 ng/mL), insufficient (<30−50 nM or 12−20 ng/mL), or optimal (50−75 nM or >20 ng/mL) for 25-hydroxyvitamin D status. Fisher's exact test demonstrated an association between disease severity, gender, and body mass index (BMI) at baseline. Mixed model analyses with Tukey-Kramer were used for longitudinal analysis according to BMI. Sixty-nine percent (n = 103) of the entire cohort had optimal levels of total 25(OH)D, 22% (n = 32) had insufficient levels, and 9% (n = 14) had deficent levels. Participants with severe disease (n = 37) had significantly lower 25-hydroxyvitamin D (total 25(OH)D) when compared to adults with mild disease (p = 0.006) or no COVID-19 diagnosis (p = 0.007). There was 44% of the cohort with post-acute sequalae of COVID-19 (PASC) as defined by experiencing at least one of the following symptoms after 60 days' post-infection: fatigue, dyspnea, joint pain, chest pain, forgetfulness or absent-mindedness, confusion, or difficulty breathing. While significant differences were detected in 25-hydroxyvitamin D status by sex and BMI, there were no correlations between 25-hydroxyvitamin D for those without and without PASC. This longitudinal study of COVID-19 survivors demonstrates an important association between sex, BMI, and disease severity for 25-hydroxyvitamin D deficiency during acute stages of infection, yet it is not clear whether supplementation efforts would influence long term outcomes such as developing PASC.


Assuntos
COVID-19 , Deficiência de Vitamina D , Adulto , Humanos , Colecalciferol , Estudos Longitudinais , Cromatografia Líquida , Colorado/epidemiologia , Espectrometria de Massas em Tandem , COVID-19/epidemiologia , Suplementos Nutricionais , SARS-CoV-2 , Vitamina D , Calcifediol , Gravidade do Paciente
18.
eNeuro ; 9(6)2022.
Artigo em Inglês | MEDLINE | ID: mdl-36316118

RESUMO

Neurons express overlapping homeostatic mechanisms to regulate synaptic function and network properties in response to perturbations of neuronal activity. Endocannabinoids (eCBs) are bioactive lipids synthesized in the postsynaptic compartments to regulate synaptic transmission, plasticity, and neuronal excitability primarily through retrograde activation of presynaptic cannabinoid receptor type 1 (CB1). The eCB system is well situated to regulate neuronal network properties and coordinate presynaptic and postsynaptic activity. However, the role of the eCB system in homeostatic adaptations to neuronal hyperactivity is unknown. To address this issue, we used Western blotting and targeted lipidomics to measure adaptations in eCB system to bicuculline (BCC)-induced chronic hyperexcitation in mature cultured rat cortical neurons, and used multielectrode array (MEA) recording and live-cell imaging of glutamate dynamics to test the effects of pharmacological manipulations of eCB on network activities. We show that BCC-induced chronic hyperexcitation triggers homeostatic downscaling and a coordinated adaptation to enhance tonic eCB signaling. Hyperexcitation triggers first the downregulation of fatty acid amide hydrolase (FAAH), the lipase that degrades the eCB anandamide, then an accumulation of anandamide and related metabolites, and finally a delayed upregulation of surface and total CB1. Additionally, we show that BCC-induced downregulation of surface AMPA-type glutamate receptors (AMPARs) and upregulation of CB1 occur through independent mechanisms. Finally, we show that endocannabinoids support baseline network activities before and after downscaling and is engaged to suppress network activity during adaptation to hyperexcitation. We discuss the implications of our findings in the context of downscaling and homeostatic regulation of in vitro oscillatory network activities.


Assuntos
Ácidos Araquidônicos , Endocanabinoides , Animais , Ratos , Endocanabinoides/metabolismo , Receptores de Canabinoides , Ácidos Araquidônicos/farmacologia , Alcamidas Poli-Insaturadas , Ácido Glutâmico , Receptor CB1 de Canabinoide , Moduladores de Receptores de Canabinoides/farmacologia
19.
J Chromatogr A ; 1682: 463499, 2022 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-36126562

RESUMO

There are many challenges associated with analysing gas chromatography - mass spectrometry (GC-MS) data. Many of these challenges stem from the fact that electron ionization (EI) can make it difficult to recover molecular information due to the high degree of fragmentation with concomitant loss of molecular ion signal. With GC-MS data there are often many common fragment ions shared among closely-eluting peaks, necessitating sophisticated methods for analysis. Some of these methods are fully automated, but make some assumptions about the data which can introduce artifacts during the analysis. Chemometric methods such as Multivariate Curve Resolution (MCR), or Parallel Factor Analysis (PARAFAC/PARAFAC2) are particularly attractive, since they are flexible and make relatively few assumptions about the data - ideally resulting in fewer artifacts. These methods do require expert user intervention to determine the most relevant regions of interest and an appropriate number of components, k, for each region. Automated region of interest selection is needed to permit automated batch processing of chromatographic data with advanced signal deconvolution. Here, we propose a new method for automated, untargeted region of interest selection that accounts for the multivariate information present in GC-MS data to select regions of interest based on the ratio of the squared first, and second singular values from the Singular Value Decomposition (SVD) of a window that moves across the chromatogram. Assuming that the first singular value accounts largely for signal, and that the second singular value accounts largely for noise, it is possible to interpret the relationship between these two values as a probabilistic distribution of Fisher Ratios. The sensitivity of the algorithm was tested by investigating the concentration at which the algorithm can no longer pick out chromatographic regions known to contain signal. The algorithm achieved detection of features in a GC-MS chromatogram at concentrations below 10 pg on-column. The resultant probabilities can be interpreted as regions that contain features of interest.


Assuntos
Algoritmos , Análise Fatorial , Cromatografia Gasosa-Espectrometria de Massas/métodos
20.
J Lipid Res ; 63(10): 100267, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36028048

RESUMO

Obesity exacerbates inflammation upon lung injury; however, the mechanisms by which obesity primes pulmonary dysregulation prior to external injury are not well studied. Herein, we tested the hypothesis that obesity dysregulates pulmonary PUFA metabolism that is central to inflammation initiation and resolution. We first show that a high-fat diet (HFD) administered to C57BL/6J mice increased the relative abundance of pulmonary PUFA-containing triglycerides and the concentration of PUFA-derived oxylipins (particularly prostaglandins and hydroxyeicosatetraenoic acids), independent of an increase in total pulmonary PUFAs, prior to onset of pulmonary inflammation. Experiments with a genetic model of obesity (ob/ob) generally recapitulated the effects of the HFD on the pulmonary oxylipin signature. Subsequent pulmonary next-generation RNA sequencing identified complex and unique transcriptional regulation with the HFD. We found the HFD increased pathways related to glycerophospholipid metabolism and immunity, including a unique elevation in B cell differentiation and signaling. Furthermore, we conducted computational integration of lipidomic with transcriptomic data. These analyses identified novel HFD-driven networks between glycerophospholipid metabolism and B cell receptor signaling with specific PUFA-derived pulmonary oxylipins. Finally, we confirmed the hypothesis by demonstrating that the concentration of pulmonary oxylipins, in addition to inflammatory markers, were generally increased in mice consuming a HFD upon ozone-induced acute lung injury. Collectively, these data show that a HFD dysregulates pulmonary PUFA metabolism prior to external lung injury, which may be a mechanism by which obesity primes the lungs to respond poorly to infectious and/or inflammatory challenges.


Assuntos
Ácidos Graxos Ômega-3 , Lesão Pulmonar , Ozônio , Animais , Camundongos , Oxilipinas/metabolismo , Lipidômica , Ácidos Graxos Ômega-3/metabolismo , Transcriptoma , Camundongos Endogâmicos C57BL , Ácidos Graxos Insaturados/metabolismo , Obesidade/genética , Inflamação/genética , Inflamação/metabolismo , Triglicerídeos , Pulmão/metabolismo , Prostaglandinas , Ácidos Hidroxieicosatetraenoicos , Glicerofosfolipídeos , Receptores de Antígenos de Linfócitos B , Dieta Hiperlipídica/efeitos adversos
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