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1.
An Pediatr (Engl Ed) ; 101(4): 267-277, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39396896

RESUMO

Coeliac disease is a common condition for which the only current treatment is a gluten-free diet. Adherence to this diet is not always easy and is associated with a reduction in quality of life for the patient and their family. Non-adherence is associated with complications of varying severity. The lack of control at the outpatient care level in a high percentage of these patients evinces the need to improve follow-up protocols and the approach to care delivery with coordination of paediatric gastroenterology units (PGU) and primary care paediatricians. With this aim in mind, the present document was developed by consensus to offer a set of recommendations adapted to our region, based on the recent recommendations published by the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), and with participation of the pertinent scientific societies, including those concerning the adult population, for the management and follow-up of adolescents and the transition to adult care.


Assuntos
Doença Celíaca , Humanos , Doença Celíaca/terapia , Criança , Adolescente , Dieta Livre de Glúten , Assistência ao Convalescente/métodos , Assistência ao Convalescente/normas , Transição para Assistência do Adulto/normas , Sociedades Médicas , Cooperação do Paciente
2.
J Clin Med ; 13(19)2024 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-39407866

RESUMO

Background: The prevention and treatment of bone loss and osteoporotic fractures is a public health challenge. Combined with normobaric hypoxia, whole-body vibration has a high clinic potential in bone health and body composition. The effect of this therapy may be mediated by its action on bone marrow mesenchymal stem cells (MSCs). Objectives: Evaluate the effects of cyclic low-vibration stimuli and/or hypoxia on bone marrow-derived human MSC differentiation. Methods: MSCs were exposed four days per week, two hours/day, to hypoxia (3% O2) and/or vibration before they were induced to differentiate or during differentiation into osteoblasts or adipocytes. Gene and protein expression of osteoblastic, adipogenic, and cytoskeletal markers were studied, as well as extracellular matrix mineralization and lipid accumulation. Results: early osteoblastic markers increased in undifferentiated MSCs, pretreated in hypoxia and vibration. This pretreatment also increased mRNA levels of osteoblastic genes and beta-catenin protein in the early stages of differentiation into osteoblasts without increasing mineralization. When MSCs were exposed to vibration under hypoxia or normoxia during osteoblastic differentiation, mineralization increased with respect to cultures without vibrational stimuli. In MSCs differentiated into adipocytes, both in those pretreated as well as exposed to different conditions during differentiation, lipid formation decreased. Changes in adipogenic gene expression and increased beta-catenin protein were observed in cultures treated during differentiation. Conclusions: Exposure to cyclic hypoxia in combination with low-intensity vibratory stimuli had positive effects on osteoblastic differentiation and negative ones on adipogenesis of bone marrow-derived MSCs. These results suggest that in elderly or frail people with difficulty performing physical activity, exposure to normobaric cyclic hypoxia and low-density vibratory stimuli could improve bone metabolism and health.

3.
J Clin Med ; 13(19)2024 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-39408007

RESUMO

Background: Increased cardiovascular risk has been described in individuals with adrenal incidentalomas. The aim of the present study is to assess the effect of remnant cholesterol (RC) on the cardiovascular risk and mortality of patients with adrenal incidentalomas. Methods: A retrospective cohort study was conducted with patients with adrenal incidentalomas between 2001 and 2024. One hundred thirty-seven patients (mean age of 61.2 ± 11.5 years; 56.6% women) with non-functioning adrenal incidentalomas and with mild autonomous cortisol secretion (MACS) (cortisol post-dexamethasone suppression test ≥1.8 µg/mL) were included. The patients were divided into two groups using 30 mg/dL as the cut-off for RC. Logistic regression models were used to study the impact of RC on major adverse cardiovascular events and mortality (MACEs). Results: Patients with RC ≥ 30 mg/dL exhibited a higher prevalence of type 2 diabetes mellitus (T2D) (p < 0.001), lower HDL-C (p < 0.001) and LDL-C (p = 0.025) levels, a higher frequency of treatment with statins (p = 0.032), and a higher rate of non-fatal major cardiovascular events (p = 0.038) and MACEs (p = 0.038). Patients with MACS showed no differences in RC or complications during the follow-up. The relative risk of high RC was 2.65 (1.04-6.77) for cardiovascular events and 2.27 (1.05-4.92) for MACEs, with p < 0.05 in both cases. The only variables independently affecting MACEs were age ([odds ratio] OR = 1.13 [p = 0.004]), female sex (OR = 0.20; p = 0.016), LDL-C (OR = 1.02; p = 0.029), and RC (OR = 1.06; p = 0.014). T2D and HDL-C were not independently associated with MACEs. Conclusions: RC ≥30 mg/dL in patients with adrenal incidentalomas was associated with a higher prevalence of T2D, lower HDL-C levels, and a higher risk of MACEs. MACS was not associated with RC or MACEs during the follow-up.

4.
BMC Nurs ; 23(1): 705, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39354514

RESUMO

BACKGROUND: The Otago Exercise Programme is an effective intervention for falls prevention. However, there is limited evidence in relation to studies that compare efficacy for falls prevention when delivered Otago Exercise Programme in a group or individual format in a primary care context. OBJECTIVE: To compare the Otago Exercise Programme delivered as a group vs. individual format for community dwelling older adults, over a one year period. The hypothesis was that neither format would be inferior to the other. METHODS: DESIGN: A four-year multicentre, randomized, non-inferiority clinical trial, with two arms- Otago Exercise Programme group training and individual Otago exercise training. SETTING(S): 21 primary healthcare centers. PARTICIPANTS: A sample size of 728 participants was established. Participants were aged between 65 and 80 years; living in the community; able to walk independently; and agreed to take part in the study and provided signed informed consent. INTERVENTION: The Otago Exercise Programme was delivered mainly by nurses in primary care, with five face to face sessions, and a reinforcement 6 months later. Participants were encouraged to exercise at home between face to face sessions. DATA COLLECTION: at baseline and after 6 and 12 months from October 2017 to 2020. PRIMARY OUTCOME: people who reported at least one fall. SECONDARY OUTCOMES: number of falls, cause of falls, consequences and assistance, adherence and satisfaction. Group allocation was blinded to the researchers involved in analysis. Reporting: Consolidated Standards of Reporting Trials recommendations for the Statement for Randomized Trials of Nonpharmacologic Treatments. RESULTS: Eight hundred twenty-seven participants were randomized (226 were allocated in group training and 272 in individual training). The analysis of the proportion of people who reported at least one fall and number of falls showed no differences between individual and group training. Assessment of the equivalence between the interventions at 12 months showed that the confidence interval for the difference of people who reported at least one fall was found to be within the equivalence limit of 10% considered. However, in those participants with a previous history of falls, group format showed potentially greater benefit. The participants in individual training presented higher scores on the Exercise Adherence Rating Scale test. No differences were found in satisfaction between the groups. CONCLUSIONS: The group Otago Exercise Programme is equivalent to individually delivered Otago Exercise Programme in terms of prevention of falls over a 12-month follow up. Adherence was higher in individual training. IMPLICATIONS: Healthcare professionals could offer either Otago Exercise Programme format dependent on patient preference and be confident that that standardized intervention provides patient benefit. TRIAL REGISTRATION: ClinicalTrials.gov (NCT03320668). Data registration 31/10/2017.

5.
Artigo em Inglês | MEDLINE | ID: mdl-39472373

RESUMO

Mercury (Hg) is a non-essential trace metal, toxic to living beings and complex to quantify and mitigate in the environment. In this study, 25 plant species native to an Amazon-Cerrado transition area were tested for use in Hg remediation. Species identification, Hg quantification in plant biomass and soil at each sampling point, and evaluation of Hg compartmentalization in each plant were carried out. The results were subjected to statistical tests and evaluated using translocation coefficients (FT), bioconcentration (FBC), and bioaccumulation (FB). The results demonstrated that the distribution and accumulation of Hg differed between species and between the parts of the plant evaluated. Soil was the predominant source of Hg in the study area. The study highlighted seven species with Hg phytoremediation potential. Five translocator species were characterized, among these a preferentially bioaccumulating and bioconcentrating species, in addition to a bioconcentrating species and a preferentially bioconcentrating and bioaccumulating species of Hg. Potentially accumulating species stood out, Blechnum serrulatum Rich. (Blechnaceae), Mauritia flexuosa L.f. (Arecaceae), and Montrichardia arborescens (L.) Schott (Araceae), all widely distributed in tropical regions, characterized as rooted, terrestrial, or amphibious and associated with ruderal environments.

6.
Pharmacoepidemiol Drug Saf ; 33(11): e70044, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39477694

RESUMO

AIM: Benzodiazepine prescription is a growing phenomenon among the elderly population. However, information related to the frequency of these drugs among the elderly population attending in emergency departments (ED) and its impact over prognosis is scarce. The aim of this study is to assess the prevalence of benzodiazepine prescription and to analyze its association with short-term prognosis in elderly patients attended in ED. METHODS: A retrospective analysis of the EDEN (Emergency Department Elderly in Need) cohort was conducted. This registry included all elderly patients attending in 52 Spanish EDs for any condition, between April 1st and 7th in 2019. Socio-demographic data, comorbidities, and medication were recorded by consulting the patient's electronic health records. The assessed outcomes consisted on new ED visit, hospitalization, and mortality at 30 days after the first ED visit, associated with the use of benzodiazepines at baseline in comparison with no prescription of benzodiazepines. Crude and adjusted logistic regression analyses including patient's comorbidities were performed. Two sensitivity analyses were performed considering concomitant prescription of other central nervous system depressants as well as direct discharge from the ED. RESULTS: 25 557 patients were evaluated (mean age 78 [IQR: 71-84]). 7865 (30.8%) patients were taken benzodiazepines at admission. After adjustment for comorbidities and other central nervous system drugs, benzodiazepine prescription was associated with ED revisit [OR: 1.10 (95%CI: 1.03-1.18)]. Similar results were found in the sensitivity analysis, eliminating patients with central nervous depressors [OR: 1.11 (1.03-1.25)] and patients discharged to home [OR: 1.13 (1.04-1.23)]. No association was found between the use of these drugs and new hospitalizations [OR: 0.90 (0.77-1.05)] or mortality 30 days after discharge [OR: 1.01 (0.88-1.18)]. The results held for all three outcomes in the sensitivity analyses. CONCLUSION: The use of benzodiazepines is a frequent phenomenon among the elderly population attended in the ED, being associated with an increased risk of new visits to the emergency room, but not with an increased risk of 30-day hospitalization or mortality.


Assuntos
Benzodiazepinas , Serviço Hospitalar de Emergência , Humanos , Benzodiazepinas/efeitos adversos , Benzodiazepinas/uso terapêutico , Serviço Hospitalar de Emergência/estatística & dados numéricos , Idoso , Masculino , Feminino , Estudos Retrospectivos , Idoso de 80 Anos ou mais , Prognóstico , Espanha/epidemiologia , Hospitalização/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Sistema de Registros/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos
7.
Biomedicines ; 12(10)2024 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-39457479

RESUMO

Background and objectives: The premanifest phase of Huntington's disease (HD) is characterized by the absence of motor symptoms and exhibits structural changes in imaging that precede clinical manifestation. This study aimed to analyze volumetric changes identified through brain magnetic resonance imaging (MRI) processed using artificial intelligence (AI) software in premanifest HD individuals, focusing on the relationship between CAG triplet expansion and structural biomarkers. Methods: The study included 36 individuals descending from families affected by HD in the Department of Atlántico. Sociodemographic data were collected, followed by peripheral blood sampling to extract genomic DNA for quantifying CAG trinucleotide repeats in the Huntingtin gene. Brain volumes were evaluated using AI software (Entelai/IMEXHS, v4.3.4) based on MRI volumetric images. Correlations between brain volumes and variables such as age, sex, and disease status were determined. All analyses were conducted using SPSS (v. IBM SPSS Statistics 26), with significance set at p < 0.05. Results: The analysis of brain volumes according to CAG repeat expansion shows that individuals with ≥40 repeats evidence significant increases in cerebrospinal fluid (CSF) volume and subcortical structures such as the amygdalae and left caudate nucleus, along with marked reductions in cerebral white matter, the cerebellum, brainstem, and left pallidum. In contrast, those with <40 repeats show minimal or moderate volumetric changes, primarily in white matter and CSF. Conclusions: These findings suggest that CAG expansion selectively impacts key brain regions, potentially influencing the progression of Huntington's disease, and that AI in neuroimaging could identify structural biomarkers long before clinical symptoms appear.

8.
Nutr Rev ; 2024 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-39405177

RESUMO

CONTEXT: There is scarce evidence about which probiotic, prebiotic, or synbiotic supplementation is the most appropriate to improve sarcopenia parameters, and this presents a challenge. OBJECTIVE: The effects of consumption of probiotics, prebiotics, and synbiotics on sarcopenia, muscle strength, muscle mass, and physical performance and function were assessed in this study. In addition, another aim of the study was to determine the best probiotic, prebiotic, and/or synbiotic for the management of sarcopenia in older adults. DATA SOURCES: A systematic search was conducted in the MEDLINE/PubMed, Cochrane Library, SCOPUS databases, and other sources (eg, references obtained from articles identified in databases). DATA EXTRACTION: The search was limited from 2000 to 2023 and was based on sarcopenia parameters, and probiotics, prebiotics, or synbiotics supplementation. The quality of each included study also was assessed. DATA ANALYSIS: A meta-analysis was performed with the Review Manager program and publication bias and sensitivity analysis were performed. RESULTS: Eight randomized controlled trials (RCTs) were included in the systematic review and 4 in the meta-analysis. Results showed that probiotics supplementation improved muscle strength and physical performance and function and suggested a beneficial effect on muscle mass. Prebiotics are suggested to be effective on muscle strength. The meta-analysis also determined that probiotic interventions were effective in increasing muscle strength by handgrip strength (mean difference [MD], 2.50 kg [95% CI, 1.33-3.66]; P < .0001) and physical performance and function by gait speed (MD, 0.10 m/s [95% CI, 1.33-3.66]; P < .0001) and physical performance and function by gait speed (MD, 0.10 m/s [95%CI, 0.03-0.16]; P = .003), but when sensitivity analysis was applied, the effectiveness was only maintained for gait speed. CONCLUSION: Nutritional strategies based on probiotic supplementation seem to improve muscle strength and physical function. More robust research is needed with high-quality RCTs to confirm probiotics' effects. There is still limited evidence about prebiotic and synbiotic strategies, and more evidence is needed to elucidate their effects on sarcopenia parameters. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42022360514.

9.
Mol Neurobiol ; 2024 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-39375286

RESUMO

In humans and mice, Nkx2-1 and Pax8 are crucial morphogenic transcription factors defining the early development of the thyroid and specific extrathyroidal tissues. By using 3-month-old single or double heterozygotes for Nkx2-1- and Pax8-null mutations (DHTP) mice, we studied brain abnormalities under different human-like dysthyroidisms, focusing on putative alterations of specific neurotransmitter systems, expression of markers of pre- and post-synaptic function and, given the physio-pathological role mitochondria have in controlling the bioenergetic status of neurons, of mitochondrial dynamics and oxidative balance. Compared to Wt controls, DHTP mice, bearing both systemic and brain hypothyroidism, showed altered expression of synaptic markers, generic and cholinergic (corroborated by immunohistochemistry in caudate, putamen, hippocampus, and basal forebrain) and glutamatergic ones, and reduced expression of key proteins of synaptic plasticity potency and several isoforms of glutamate receptors. The brain of DHTP mice was characterized by lower levels of H2O2 and imbalanced mitochondrial dynamics. Nkx2-1 + / - mice showed dopaminergic neuron-specific alterations, morphologically, more evident in the substantia nigra of DHTP mice. Nkx2-1 + / - mice also showed enhanced mitochondrial biogenesis and oxidative capacity likely as a global response of the brain to Nkx2-1 haploinsufficiency and/or to their elevated T3 circulating levels. Reduced transcription of both tyrosine hydroxylase and dopamine transporter was observed in Pax8 + / - euthyroid mice, suggesting a dopaminergic dysfunction, albeit likely at an early stage, but consistent with the deregulated glucose homeostasis observed in such animals. Overall, new information was obtained on the impact of haploinsufficiency of Pax8 and NKx2-1 on several brain neuroanatomical, molecular, and neurochemical aspects, thus opening the way for future targeting brain dysfunctions in the management of both overt and subclinical thyroid dysfunctions.

10.
J Gastrointest Surg ; 2024 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-39368648

RESUMO

BACKGROUND: Signet ring cell (SRC) gastric carcinoma is traditionally associated with a poor prognosis. However, the literature has presented contradictory results. Linear models are the standard statistical tools typically used to study these conditions. However, machine learning (ML) models have the potential to replace or even outperform linear models in terms of predictive performance. METHODS: This study analyzed 608 patients diagnosed with gastric cancer at our institution. The analysis compared traditional linear models and ML models. Variables examined included demographic data, presence of an SRC component, lymph nodes (LNs) resected and affected (ratio), stage of the disease, body mass index, pathologic features, type of surgery, tumor location, and carcinoembryonic antigen levels to evaluate their influence on 5-year mortality and 2-year recurrence rates. RESULTS: SRC carcinoma was associated with poorer prognosis in terms of 5-year overall survival than non-SRC carcinoma. In addition, SRC exhibited higher rates of LN metastasis and a higher LN ratio (resected/affected) and was more prevalent in younger patients (<65 years). However, SRC was not an independent factor in the multivariate analysis. Linear models showed worse predictions for 5-year mortality and 2-year recurrence than ML models. The ML models did not consider the presence of the SRC component as an important variable. CONCLUSION: SRC gastric carcinoma continues to present an uncertain prognosis. ML models can evaluate prognosis more accurately than traditional linear models. Large-scale studies using ML algorithms are necessary to elucidate the predictive potential of such models.

11.
Mult Scler Relat Disord ; 91: 105907, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39366169

RESUMO

BACKGROUND: The European Cross-Cultural Neuropsychological Test Battery (CNTB) has been proposed as a comprehensive battery for cognitive assessment, reducing the potential impact of cultural variables. In this validation study, we aimed to evaluate the diagnostic capacity of CNTB for the assessment of participants with multiple sclerosis (pwMS) compared to the Neuronorma battery (NN) according to the International Classification of Cognitive Disorders in MS criteria, and to develop machine learning (ML) algorithms to improve the diagnostic capacity of CNTB and to select the most relevant tests. METHODS: Sixty pwMS and 60 healthy controls (HC) with no differences in sex, age, or years of education were enrolled. All participants completed the CNTB and pwMS were also examined with NN, depression, and fatigue scales. Impaired domains and cognitive phenotypes were defined following ICCoDiMS based on CNTB scores and compared to NN, according to -1SD and -1.5SD cutoff scores. To select the most relevant tests, random forest (RF) was performed for different binary classifications. RESULTS: PwMS showed a lower performance compared to HC with medium-large effect sizes, in episodic memory, executive function, attention, and processing speed, in accordance with their characteristic cognitive profile. There were no differences in impaired domains or cognitive phenotypes between CNTB and NN, highlighting the role of episodic memory, executive function, attention, and processing speed tests. The most relevant tests identified by RF were consistent with inter-group comparisons and allowed a better classification than SD cutoff scores. CONCLUSION: CNTB is a valid test for cognitive diagnosis in pwMS, including key tests for the most frequently impaired cognitive domains in MS. The use of ML techniques may also be useful to improve diagnosis, especially in some tests with lower sensitivity.


Assuntos
Disfunção Cognitiva , Aprendizado de Máquina , Esclerose Múltipla , Testes Neuropsicológicos , Humanos , Masculino , Feminino , Testes Neuropsicológicos/normas , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Adulto , Esclerose Múltipla/complicações , Esclerose Múltipla/diagnóstico , Pessoa de Meia-Idade , Fenótipo , Comparação Transcultural , Europa (Continente)
12.
Int J Artif Organs ; : 3913988241274252, 2024 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-39221571

RESUMO

Hepatopulmonary syndrome (HPS) poses a significant challenge in liver transplant patients, affecting between 10% and 30% of candidates. Historically, HPS was considered a contraindication for liver transplantation due to its association with high mortality rates. However, recent studies have shown improvements in pulmonary function post-transplant, leading to the inclusion of these patients as candidates. Despite this progress, approximately one-fifth of liver transplant recipients develop severe postoperative hypoxia, further complicating their clinical course and contributing to increased mortality. The management of post-transplant HPS involves various strategies, including extracorporeal membrane oxygenation (ECMO), although its use remains infrequently reported. Theoretical models suggest that oxygenation typically improves within 10 days post-transplant, while resolution of HPS may take 6-12 months, making ECMO an attractive possibility as a bridge to recovery in this population. We present a case were ECMO was used in this context.

13.
Plant Cell Environ ; 2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-39253952

RESUMO

Endoplasmic reticulum-plasma membrane contact sites (ER-PM CSs) are evolutionarily conserved membrane domains found in all eukaryotes, where the ER closely interfaces with the PM. This short distance is achieved in plants through the action of tether proteins such as synaptotagmins (SYTs). Arabidopsis comprises five SYT members (SYT1-SYT5), but whether they possess overlapping or distinct biological functions remains elusive. SYT1, the best-characterized member, plays an essential role in the resistance to abiotic stress. This study reveals that the functionally redundant SYT1 and SYT3 genes, but not SYT5, are involved in salt and cold stress resistance. We also show that, unlike SYT5, SYT1 and SYT3 are not required for Pseudomonas syringae resistance. Since SYT1 and SYT5 interact in vivo via their SMP domains, the distinct functions of these proteins cannot be caused by differences in their localization. Interestingly, structural phylogenetic analysis indicates that the SYT1 and SYT5 clades emerged early in the evolution of land plants. We also show that the SYT1 and SYT5 clades exhibit different structural features in their SMP and Ca2+ binding of their C2 domains, rationalizing their distinct biological roles.

14.
Cytopathology ; 2024 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-39248044

RESUMO

INTRODUCTION: Striated duct adenoma is a benign salivary gland tumour recently recognized by the World Health Organization. To date, no report has described the cytological features of this entity. MATERIALS AND METHODS: We report the case of a 60-year-old woman with a tumour in the right parotid gland with a diameter greater than 2.4 cm confirmed by imaging tests. RESULTS: Two fine-needle aspiration cytologies (FNAC) were performed with inconclusive results, reporting epithelioid and spindle-shaped cellularity, with little stroma, and nuclei with abundant pseudoinclusions. Myoepithelioma and Schwannoma were proposed as differential diagnoses. An immunocytochemical panel was performed, showing positivity for S-100, SOX10, CK7 and vimentin, and negativity for both myoepithelial (p63 and calponin) and thyroid markers. In the absence of a conclusive diagnosis, the patient accepted surgery. The biopsy results confirmed diagnosis of striated duct adenoma, with immunohistochemical features superimposable to cytology. CONCLUSION: Little information is available in the literature, both on biopsy and, more strikingly, on cytology of this neoplasm. The aim of this work is to provide cytological characteristics that allow diagnosis of this entity with FNAC and thus avoid unnecessary surgeries.

15.
Eur Neuropsychopharmacol ; 89: 41-46, 2024 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-39332148

RESUMO

This prospective observational study aimed to evaluate the rate of change in forced expiratory volume in the first second (FEV1) and to explore the factors associated with changes in FEV1 in people with serious mental illness (SMI). Sixty subjects diagnosed with schizophrenia or bipolar disorder who were smokers and without history of respiratory illness agreed to participate. The mean (range) follow-up period was 3.54 (3.00-4.98) years. The mean (standard deviation) annual rate of change in FEV1 decreased by 39.1 (105.2) mL/year. Thirty-one (51.7 %) patients experienced a decrease in the FEV1 ≥40 mL/year (i.e. a rapid decline). The factors associated with the absolute change in FEV1 were the baseline International Physical Activity Questionnaire activity score in metabolic equivalents of tasks (ß 0.145, 95 % confidence interval [CI] 0.043 to 0.246; p = 0.005), baseline FEV1 (ß -0.025, 95 % CI -0.076 to 0.027; p = 0.352), and the interaction term of both variables (ß -3.172e-05, 95 % CI -6.025e-05 to -0.319e-05; p = 0.029). The factors associated with rapid FEV1 decline were income (odds ratio [OR] 0.999, 95 % CI 0.995 to 1.003; p = 0.572), the rate of change in abdominal circumference (OR 0.000, 95 % CI 0.000 to 0.890; p = 0.081), and the interaction term of both variables (OR 1.038, 95 % CI 1.010 to 1.082; p = 0.026). In conclusion, a substantial proportion of people with SMI experienced a rapid decrease in FEV1. If our results are confirmed in larger samples, the routine evaluation of lung function in people with SMI would be an opportunity to identify individuals at greater risk of morbidity and mortality.

16.
Front Endocrinol (Lausanne) ; 15: 1432819, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39301315

RESUMO

Maintaining a well-functioning mitochondrial network through the mitochondria quality control (MQC) mechanisms, including biogenesis, dynamics and mitophagy, is crucial for overall health. Mitochondrial dysfunction caused by oxidative stress and further exacerbated by impaired quality control can trigger inflammation through the release of the damage-associated molecular patterns (mtDAMPs). mtDAMPs act by stimulating the cyclic GMP-AMP synthase (cGAS) stimulator of interferon genes (STING) pathway. Recently, aberrant signalling of the cGAS-STING axis has been recognised to be closely associated with several sterile inflammatory diseases (e.g. non-alcoholic fatty liver disease, obesity). This may fit the pathophysiology of hypothyroidism, an endocrine disorder characterised by the reduction of thyroid hormone production associated with impaired metabolic fluxes, oxidative balance and inflammatory status. Both 3,5,3'-triiodo-L-tyronine (T3) and its derivative 3,5-diiodo-L-thyronine (3,5-T2), are known to mitigate processes targeting mitochondria, albeit the underlying mechanisms are not yet fully understood. Therefore, we used a chemically induced hypothyroidism rat model to investigate the effect of 3,5-T2 or T3 administration on inflammation-related factors (inflammatory cytokines, hepatic cGAS-STING pathway), oxidative stress, antioxidant defence enzymes, mitochondrial DNA (mtDNA) damage, release and repair, and the MQC system in the liver. Hypothyroid rats showed: i) increased oxidative stress, ii) accumulation of mtDNA damage, iii) high levels of circulating cytokines, iv) hepatic activation of cGAS-STING pathways and v) impairment of MQC mechanisms and autophagy. Both iodothyronines restored oxidative balance by enhancing antioxidant defence, preventing mtDNA damage through the activation of mtDNA repair mechanisms (OGG1, APE1, and POLγ) and promoting autophagy progression. Concerning MQC, both iodothyronines stimulated mitophagy and dynamics, with 3,5-T2 activating fusion and T3 modulating both fusion and fission processes. Moreover, only T3 enhanced mitochondrial biogenesis. Notably, 3,5-T2, but not T3, reversed the hypothyroidism-induced activation of the cGAS-STING inflammatory cascade. In addition, it is noteworthy that 3,5-T2 seems more effective than T3 in reducing circulating pro-inflammatory cytokines IL-6 and IL-1B and in stimulating the release of IL-10, a known anti-inflammatory cytokine. These findings reveal novel molecular mechanisms of hepatic signalling pathways involved in hypothyroidism, which could be targeted by natural iodothyronines, particularly 3,5-T2, paving the way for the development of new treatment strategies for inflammatory diseases.


Assuntos
Di-Iodotironinas , Hipotireoidismo , Inflamação , Fígado , Proteínas de Membrana , Nucleotidiltransferases , Estresse Oxidativo , Animais , Ratos , Hipotireoidismo/metabolismo , Hipotireoidismo/induzido quimicamente , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/patologia , Fígado/metabolismo , Fígado/efeitos dos fármacos , Fígado/patologia , Nucleotidiltransferases/metabolismo , Masculino , Inflamação/metabolismo , Inflamação/tratamento farmacológico , Inflamação/patologia , Di-Iodotironinas/farmacologia , Proteínas de Membrana/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Tri-Iodotironina , Mitocôndrias/metabolismo , Mitocôndrias/efeitos dos fármacos , Ratos Wistar , Mitocôndrias Hepáticas/metabolismo , Mitocôndrias Hepáticas/efeitos dos fármacos , Mitocôndrias Hepáticas/patologia , Transdução de Sinais/efeitos dos fármacos
19.
Plant Physiol Biochem ; 215: 109077, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39213946

RESUMO

Drought is a major challenge for the cultivation of durum wheat, a crucial crop for global food security. Plants respond to drought by adjusting their mineral nutrient profiles to cope with water scarcity, showing the importance of nutrient plasticity for plant acclimation and adaptation to diverse environments. Therefore, it is essential to understand the genetic basis of mineral nutrient profile plasticity in durum wheat under drought stress to select drought-tolerant varieties. The research study investigated the responses of different durum wheat genotypes to severe drought stress at the seedling stage. The study employed an ionomic, molecular, biochemical and physiological approach to shed light on distinct behaviors among different genotypes. The drought tolerance of SVEMS16, SVEVO, and BULEL was related to their capacity of maintaining or increasing nutrient's accumulation, while the limited nutrient acquisition capability of CRESO and S.CAP likely resulted in their susceptibility to drought. The study highlighted the importance of macronutrients such as SO42-, NO3-, PO43-, and K+ in stress resilience and identified variant-containing genes potentially influencing nutritional variations under drought. These findings provide valuable insights for further field studies to assess the drought tolerance of durum wheat genotypes across various growth stages, ultimately ensuring food security and sustainable production in the face of changing environmental conditions.


Assuntos
Secas , Minerais , Triticum , Triticum/genética , Triticum/fisiologia , Triticum/metabolismo , Minerais/metabolismo , Genótipo , Adaptação Fisiológica/genética , Resistência à Seca
20.
Adv Sci (Weinh) ; 11(40): e2405432, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39206821

RESUMO

Genetic studies have identified the voltage-gated sodium channel 1.7 (Nav1.7) as pain target. Due to the ineffectiveness of small molecules and monoclonal antibodies as therapeutics for pain, single-domain antibodies (VHHs) are developed against the human Nav1.7 (hNav1.7) using a novel antigen presentation strategy. A 70 amino-acid peptide from the hNav1.7 protein is identified as a target antigen. A recombinant version of this peptide is grafted into the complementarity determining region 3 (CDR3) loop of an inert VHH in order to maintain the native 3D conformation of the peptide. This antigen is used to isolate one VHH able to i) bind hNav1.7, ii) slow the deactivation of hNav1.7, iii) reduce the ability of eliciting action potentials in nociceptors, and iv) reverse hyperalgesia in in vivo rat and mouse models. This VHH exhibits the potential to be developed as a therapeutic capable of suppressing pain. This novel antigen presentation strategy can be applied to develop biologics against other difficult targets such as ion channels, transporters and GPCRs.


Assuntos
Modelos Animais de Doenças , Canal de Sódio Disparado por Voltagem NAV1.7 , Dor , Anticorpos de Domínio Único , Canal de Sódio Disparado por Voltagem NAV1.7/metabolismo , Canal de Sódio Disparado por Voltagem NAV1.7/imunologia , Canal de Sódio Disparado por Voltagem NAV1.7/genética , Animais , Ratos , Camundongos , Humanos , Anticorpos de Domínio Único/imunologia , Dor/imunologia , Masculino , Antígenos/imunologia , Ratos Sprague-Dawley
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