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1.
PLoS One ; 19(4): e0297906, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38635512

RESUMO

The literature on leadership and personal competencies exhibits limitations in terms of construct definition, behavior specifications and valid theory-based measuring strategies. An explanatory design with latent variables and the statistical software SAS 9.4 were used for the validation and adaptation to Spanish of the Leadership Virtues Questionnaire applied to work and organizational psychologists and people who exercise leadership functions in Chile. The levels of agreement between judges for the adaptation to the Spanish language and the confirmatory factor analysis of first order with four dimensions shows insufficient statistical indices for the absolute, comparative and parsimonious adjustments. However, a second-order confirmatory factor analysis with two dimensions presents a satisfactory fit for the item, model, and parameter matrices. The measurement of Virtuous Leadership would provide relevant inputs for further evaluation and training based on ethical competencies aimed at improving management, which would, in turn, allow for its treatment as an independent variable to generate an ethical organizational culture.


Assuntos
Liderança , Virtudes , Humanos , Chile , Cultura Organizacional , Inquéritos e Questionários , Reprodutibilidade dos Testes
2.
Curr Microbiol ; 81(2): 62, 2024 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-38216774

RESUMO

Microbial contamination of coffee beans arises from various factors such as harvesting, handling, and storage practices, during which ochratoxin A (OTA)-producing fungi develop and proliferate. The presence of elevated concentrations of OTA poses a serious health risk to coffee consumers. Therefore, the implementation of a post-harvest treatment involving the use of bacteria known to antagonize OTA-producing fungi constitutes a safe alternative for reducing or eliminating the toxin's concentration in coffee beans. In this study, coffee beans (Coffea arabica L.) were inoculated with Bacillus licheniformis M2-7, after which we monitored fungal growth, in vitro antagonism, and OTA concentration. Our findings demonstrated that coffee beans inoculated with this bacterial strain exhibited a significant decrease in fungal populations belonging to the genera Aspergillus and Penicillium, which are known to produce OTA. Moreover, strain M2-7 decreased the growth rates of these fungi from 67.8% to 95.5% (P < 0.05). Similarly, inoculation with B. licheniformis strain M2-7 effectively reduced the OTA concentration from 24.35 ± 1.61 to 5.52 ± 1.69 µg/kg (P < 0.05) in stored coffee beans. These findings suggest that B. licheniformis M2-7 holds promise as a potential post-harvest treatment for coffee beans in storage, as it effectively inhibits the proliferation of OTA-producing fungi and lowers the toxin's concentration.


Assuntos
Bacillus licheniformis , Coffea , Ocratoxinas , Contaminação de Alimentos/análise , Coffea/microbiologia
3.
Nat Commun ; 14(1): 8070, 2023 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-38057312

RESUMO

Dung removal by macrofauna such as dung beetles is an important process for nutrient cycling in pasturelands. Intensification of farming practices generally reduces species and functional diversity of terrestrial invertebrates, which may negatively affect ecosystem services. Here, we investigate the effects of cattle-grazing intensification on dung removal by dung beetles in field experiments replicated in 38 pastures around the world. Within each study site, we measured dung removal in pastures managed with low- and high-intensity regimes to assess between-regime differences in dung beetle diversity and dung removal, whilst also considering climate and regional variations. The impacts of intensification were heterogeneous, either diminishing or increasing dung beetle species richness, functional diversity, and dung removal rates. The effects of beetle diversity on dung removal were more variable across sites than within sites. Dung removal increased with species richness across sites, while functional diversity consistently enhanced dung removal within sites, independently of cattle grazing intensity or climate. Our findings indicate that, despite intensified cattle stocking rates, ecosystem services related to decomposition and nutrient cycling can be maintained when a functionally diverse dung beetle community inhabits the human-modified landscape.


Assuntos
Besouros , Ecossistema , Animais , Bovinos , Biodiversidade , Clima , Fazendas , Fezes
4.
Viruses ; 15(12)2023 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-38140646

RESUMO

In its prefusion state, the SARS-CoV-2 spike protein (similarly to other class I viral fusion proteins) is metastable, which is considered to be an important feature for optimizing or regulating its functions. After the binding process of its S1 subunit (S1) with ACE2, the spike protein (S) undergoes a dramatic conformational change where S1 splits from the S2 subunit, which then penetrates the membrane of the host cell, promoting the fusion of the viral and cell membranes. This results in the infection of the host cell. In a previous work, we showed-using large-scale molecular dynamics simulations-that the application of external electric fields (EFs) induces drastic changes and damage in the receptor-binding domain (RBD) of the wild-type spike protein, as well of the Alpha, Beta, and Gamma variants, leaving a structure which cannot be recognized anymore by ACE2. In this work, we first extend the study to the Delta and Omicron variants and confirm the high sensitivity and extreme vulnerability of the RBD of the prefusion state of S to moderate EF (as weak as 104 V/m), but, more importantly, we also show that, in contrast, the S2 subunit of the postfusion state of the spike protein does not suffer structural damage even if electric field intensities four orders of magnitude higher are applied. These results provide a solid scientific basis to confirm the connection between the prefusion-state metastability of the SARS-CoV-2 spike protein and its susceptibility to be damaged by EF. After the virus docks to the ACE2 receptor, the stable and robust postfusion conformation develops, which exhibits a similar resistance to EF (damage threshold higher than 108 V/m) like most globular proteins.


Assuntos
Enzima de Conversão de Angiotensina 2 , Glicoproteína da Espícula de Coronavírus , Humanos , Enzima de Conversão de Angiotensina 2/química , Simulação de Dinâmica Molecular , Glicoproteína da Espícula de Coronavírus/química , Campos Eletromagnéticos , Conformação Proteica
5.
Front Chem ; 11: 1292541, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38025083

RESUMO

Donor-acceptor-substituted biphenyl derivatives are particularly interesting model compounds, which exhibit intramolecular charge transfer because of the extent of charge transfer between both substituents. The connection of a 4-[1,1'-biphenyl]-4-yl-2-pyrimidinyl) moiety to differently disubstituted amino groups at the biphenyl terminal can offer push-pull compounds with distinctive photophysical properties. Herein, we report a comprehensive study of the influence of the torsion angle of the disubstituted amino group on the emissive properties of two pull-push systems: 4-[4-(4-N,N-dimethylaminophenyl)phenyl]-2,6-diphenylpyrimidine (D1) and 4-[4-(4-N,N-diphenylaminophenyl)phenyl]-2,6-diphenylpyrimidine (D2). The torsion angle of the disubstituted amino group, either N,N-dimethyl-amine or N,N-diphenyl-amine, at the biphenyl end governs their emissive properties. A drastic fluorescence quenching occurs in D1 as the solvent polarity increases, whereas D2 maintains its emission independently of the solvent polarity. Theoretical calculations on D1 support the presence of a twisted geometry for the lowest energy, charge-transfer excited state (S1,90), which corresponds to the minimum energy structure in polar solvents and presents a small energy barrier to move from the excited to the ground state, thereby favoring the non-radiative pathway and reducing the fluorescence efficiency. In contrast, this twisted structure is absent in D2 due to the steric hindrance of the phenyl groups attached to the amine group, making the non-radiative decay less favorable. Our findings provide insights into the crucial role of the substituent in the donor moiety of donor-acceptor systems on both the singlet excited state and the intramolecular charge-transfer process.

6.
Int J Mol Sci ; 24(15)2023 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-37569883

RESUMO

The incidence of prostate cancer (PC) has risen annually. PC mortality is explained by the metastatic disease (mPC). There is an intermediate scenario in which patients have non-mPC but have initiated a metastatic cascade through epithelial-mesenchymal transition. There is indeed a need for more and better tools to predict which patients will progress in the future to non-localized clinical disease or already have micrometastatic disease and, therefore, will clinically progress after primary treatment. Biomarkers for the prediction of mPC are still under development; there are few studies and not much evidence of their usefulness. This review is focused on tissue-based genomic biomarkers (TBGB) for the prediction of metastatic disease. We develop four main research questions that we attempt to answer according to the current evidence. Why is it important to predict metastatic disease? Which tests are available to predict metastatic disease? What impact should there be on clinical guidelines and clinical practice in predicting metastatic disease? What are the current prostate cancer treatments? The importance of predicting metastasis is fundamental given that, once metastasis is diagnosed, quality of life (QoL) and survival drop dramatically. There is still a need and space for more cost-effective TBGB tests that predict mPC disease.


Assuntos
Neoplasias dos Genitais Femininos , Neoplasias da Próstata , Masculino , Feminino , Humanos , Qualidade de Vida , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/genética , Neoplasias da Próstata/patologia , Biomarcadores , Metástase Neoplásica
7.
Psychol Methods ; 2023 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-36795436

RESUMO

This article discusses the robustness of the multivariate analysis of covariance (MANCOVA) test for an emergent variable system and proposes a modification of this test to obtain adequate information from heterogeneous normal observations. The proposed approach for testing potential effects in heterogeneous MANCOVA models can be adopted effectively, regardless of the degree of heterogeneity and sample size imbalance. As our method was not designed to handle missing values, we also show how to derive the formulas for pooling the results of multiple-imputation-based analyses into a single final estimate. Results of simulated studies and analysis of real-data show that the proposed combining rules provide adequate coverage and power. Based on the current evidence, the two solutions suggested could be effectively used by researchers for testing hypotheses, provided that the data conform to normality. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

8.
PLoS One ; 18(2): e0281483, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36757920

RESUMO

The biodiversity of assemblages that experience the introduction and extinction of species may lead to responses in two important facets: The taxonomic and functional diversity. The way in which these facets are associated may reveal important implications and consequences for the conservation of those assemblages. Considering the critical situation of freshwater fishes in continental Chile (30° - 56° S), we analyzed how the taxonomic (TDß) and functional (FDß) facets of ß-diversity, and their components of turnover and nestedness, are associated. We evaluated changes in ß-diversity (ΔTDß and ΔFDß), turnover (ΔTDtur and ΔFDtur), and nestedness (ΔTDnes and ΔFDnes) in 20 fish assemblages from their historical (pre-European) to current composition. We also simulated future trends of these changes, assuming that native species with conservation issues would become extinct. Our results show that the fish assemblages studied are in a process of loss of ß-diversity, both in taxonomic and functional facets (ΔTDß = -3.9%; ΔFDß = -30.4%); also, that these facets are positively correlated in the assemblages studied (r = 0.617; P < 0.05). Both components showed by loss in nestedness (ΔTDnes = -36.9%; ΔFDnes = -60.9%) but gain in turnover (ΔTDtur = 9.2%; ΔFDtur = 12.3%). The functional ß-diversity decreased more than the taxonomic (ΔFDß > ΔTDß), which was caused chiefly by six exotic species of Salmonidae, whose geographical spread was wider and that at the same time shared several morpho-functional traits. Our forecasts, assuming an intensification in the extinction of Endangered and Vulnerable native species, indicate that the process of homogenization will continue, though at a lower rate. Our study shows that the freshwater ichthyofauna of continental Chile is undergoing biotic homogenization, and that this process involves the facets of taxonomic and functional ß-diversity, which are show high correlation between historical and current compositions. Both facets show that process is influenced by nestedness, and while turnover contributes to differentiation (both taxonomic and functional), its importance is overshadowed by nestedness.


Assuntos
Biodiversidade , Salmonidae , Animais , Chile , Água Doce , Ecossistema
9.
IJU Case Rep ; 5(6): 511-514, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36341196

RESUMO

Introduction: Emphysematous pyelonephritis is an acute necrotizing infection of the renal parenchyma. The management is variable, extending to total nephrectomy in severe or refractory cases. Post-nephrectomy complications are numerous and common, necrotizing fasciitis, and sepsis being among them. Case presentation: We present a case of a 37-year-old woman with obesity and a previous left emphysematous pyelonephritis episode managed conservatively. The patient presented with a second left emphysematous pyelonephritis and underwent a left total nephrectomy. Two weeks later, the patient presented with a contralateral necrotizing fasciitis of the abdominal wall. Subsequently, the patient required several surgical debridement procedures and a vacuum-assisted closure system treatment. Conclusion: Emphysematous pyelonephritis is an aggressive infectious disease that requires high suspicion in patients at risk.

10.
Rev Med Chil ; 150(2): 172-177, 2022 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-36156642

RESUMO

BACKGROUND: Upper urinary tract urothelial carcinoma (UTUC) represents 5-10% of urothelial carcinomas. It is managed with nephroureterectomy (NUR); however, kidney-sparing techniques are growingly used. AIM: To report the results of a 20-year series of NUR conducted in an academic center. PATIENTS AND METHODS: Review of clinical and pathological characteristics of patients undergoing NUR between 1999 and 2020. Patients were followed for 63 months. Global survival curves (OS) and mortality predictors were established through Cox regression. RESULTS: We included 90 patients with a median age of 68 years undergoing NUR, of whom 68 (75%) had a pelvic tumor and 22 (25%) had a proximal ureteral tumor. A laparoscopic NUR was performed in 60 patients (66%). Thirty-three patients (37%) had tumors confined to the urothelium (pTa), penetrating the lamina propria (pT1) or carcinoma in situ (CIS), 10 patients (11%) had a tumor spreading to the muscle layer (pT2) and 47 (52%) had a tumor spreading to nearby organs (pT3 / T4). Average tumor size was 3.69 cm, nodal disease (pN) was present 12 patients (13%). Twelve patients (13%) received adjuvant chemotherapy. A higher mortality was observed among smokers (Hazard ratio (HR) 8.79, 95% confidence intervals (CI) 1.5-49.0, p = 0.01), patients with tumors classfied as pT≥ 2 (HR 1.09, 95% CI 0.01-1.0, p = 0.04) and those with tumors larger than 2 cm (HR 14.79, CI 95% 1.5-272, p = 0.01). CONCLUSIONS: Smoking patients, those with invasive tumors (T2-T4) and greater than 2 cm have higher mortality. Therefore, they should not be candidates for conservative management.


Assuntos
Carcinoma de Células de Transição , Neoplasias Renais , Neoplasias Ureterais , Neoplasias da Bexiga Urinária , Idoso , Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/cirurgia , Humanos , Rim/patologia , Neoplasias Renais/cirurgia , Nefroureterectomia , Prognóstico , Estudos Retrospectivos , Neoplasias Ureterais/patologia , Neoplasias Ureterais/cirurgia , Neoplasias da Bexiga Urinária/cirurgia
11.
Rev. med. Chile ; 150(8): 994-999, ago. 2022. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1431880

RESUMO

BACKGROUND: Vena cava (VC) involvement in kidney tumors occurs in 4 to 10% of cases, and is associated with a higher mortality. Nephrectomy with thrombectomy of the VC, performed by a multidisciplinary team, improves survival. Aim: To report a series of consecutive nephrectomies with caval thrombectomy performed in an academic center. PATIENTS AND METHODS: We report 32 patients with cT3b and 3c renal tumors, who underwent radical nephrectomy with VC thrombectomy between 2001 and 2021. A descriptive analysis of clinical, surgical and pathological variables was performed. Overall survival (OS) and cancer-specific survival (CSS) was calculated using Kaplan-Meier curves. Results: The mean tumor size was 9.7 cm. According to Mayo classification 3/32 (9%) patients had a type I thrombus, 10/32 (31%) had a type II thrombus, 8/32 (25%) had a type III thrombus, and 5/32 (16%) had a type IV thrombus. The mean bleeding was 2000 cc. There was one intraoperative death. Nineteen percent of patients had complications >= 3 according to Clavien-Dindo classification. Reoperations occurred in 9%. Pre and postoperative creatinine levels were 1.17 and 1.91 mg/dl respectively (p < 0.01). Pre and postoperative Hematocrit levels were 47.9 and 31% respectively (p = 0.02). Sixty six percent of tumors were clear cell renal cancer, 9% were papillary and 3% were chromophobic. Mean OS was 10 months. Two-year SCE was 40%. CONCLUSIONS: Our results are similar to those reported elsewhere. Despite being an unusual pathology, the surgical technique has been improving, thanks to the multidisciplinary work of urologists and surgeons.


Assuntos
Humanos , Trombose/cirurgia , Trombose/complicações , Carcinoma de Células Renais/cirurgia , Carcinoma de Células Renais/patologia , Neoplasias Renais/cirurgia , Neoplasias Renais/patologia , Veia Cava Inferior/cirurgia , Estudos Retrospectivos , Trombectomia/métodos , Nefrectomia/efeitos adversos , Nefrectomia/métodos
13.
Rev. méd. Chile ; 150(2): 172-177, feb. 2022. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1389638

RESUMO

BACKGROUND: Upper urinary tract urothelial carcinoma (UTUC) represents 5-10% of urothelial carcinomas. It is managed with nephroureterectomy (NUR); however, kidney-sparing techniques are growingly used. AIM: To report the results of a 20-year series of NUR conducted in an academic center. Patients and Methods: Review of clinical and pathological characteristics of patients undergoing NUR between 1999 and 2020. Patients were followed for 63 months. Global survival curves (OS) and mortality predictors were established through Cox regression. RESULTS: We included 90 patients with a median age of 68 years undergoing NUR, of whom 68 (75%) had a pelvic tumor and 22 (25%) had a proximal ureteral tumor. A laparoscopic NUR was performed in 60 patients (66%). Thirty-three patients (37%) had tumors confined to the urothelium (pTa), penetrating the lamina propria (pT1) or carcinoma in situ (CIS), 10 patients (11%) had a tumor spreading to the muscle layer (pT2) and 47 (52%) had a tumor spreading to nearby organs (pT3 / T4). Average tumor size was 3.69 cm, nodal disease (pN) was present 12 patients (13%). Twelve patients (13%) received adjuvant chemotherapy. A higher mortality was observed among smokers (Hazard ratio (HR) 8.79, 95% confidence intervals (CI) 1.5-49.0, p = 0.01), patients with tumors classfied as pT≥ 2 (HR 1.09, 95% CI 0.01-1.0, p = 0.04) and those with tumors larger than 2 cm (HR 14.79, CI 95% 1.5-272, p = 0.01). CONCLUSIONS: Smoking patients, those with invasive tumors (T2-T4) and greater than 2 cm have higher mortality. Therefore, they should not be candidates for conservative management.


Assuntos
Humanos , Idoso , Neoplasias Ureterais/cirurgia , Neoplasias Ureterais/patologia , Neoplasias da Bexiga Urinária/cirurgia , Carcinoma de Células de Transição/cirurgia , Carcinoma de Células de Transição/patologia , Neoplasias Renais/cirurgia , Prognóstico , Estudos Retrospectivos , Nefroureterectomia
14.
Rev Med Chil ; 150(8): 994-999, 2022 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-37358146

RESUMO

BACKGROUND: Vena cava (VC) involvement in kidney tumors occurs in 4 to 10% of cases, and is associated with a higher mortality. Nephrectomy with thrombectomy of the VC, performed by a multidisciplinary team, improves survival. AIM: To report a series of consecutive nephrectomies with caval thrombectomy performed in an academic center. PATIENTS AND METHODS: We report 32 patients with cT3b and 3c renal tumors, who underwent radical nephrectomy with VC thrombectomy between 2001 and 2021. A descriptive analysis of clinical, surgical and pathological variables was performed. Overall survival (OS) and cancer-specific survival (CSS) was calculated using Kaplan-Meier curves. RESULTS: The mean tumor size was 9.7 cm. According to Mayo classification 3/32 (9%) patients had a type I thrombus, 10/32 (31%) had a type II thrombus, 8/32 (25%) had a type III thrombus, and 5/32 (16%) had a type IV thrombus. The mean bleeding was 2000 cc. There was one intraoperative death. Nineteen percent of patients had complications >= 3 according to Clavien-Dindo classification. Reoperations occurred in 9%. Pre and postoperative creatinine levels were 1.17 and 1.91 mg/dl respectively (p < 0.01). Pre and postoperative Hematocrit levels were 47.9 and 31% respectively (p = 0.02). Sixty six percent of tumors were clear cell renal cancer, 9% were papillary and 3% were chromophobic. Mean OS was 10 months. Two-year SCE was 40%. CONCLUSIONS: Our results are similar to those reported elsewhere. Despite being an unusual pathology, the surgical technique has been improving, thanks to the multidisciplinary work of urologists and surgeons.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Trombose , Humanos , Veia Cava Inferior/cirurgia , Neoplasias Renais/cirurgia , Neoplasias Renais/patologia , Carcinoma de Células Renais/cirurgia , Carcinoma de Células Renais/patologia , Trombectomia/métodos , Trombose/complicações , Trombose/cirurgia , Nefrectomia/efeitos adversos , Nefrectomia/métodos , Estudos Retrospectivos
15.
Nat Commun ; 12(1): 5407, 2021 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-34518528

RESUMO

Most of the ongoing projects aimed at the development of specific therapies and vaccines against COVID-19 use the SARS-CoV-2 spike (S) protein as the main target. The binding of the spike protein with the ACE2 receptor (ACE2) of the host cell constitutes the first and key step for virus entry. During this process, the receptor binding domain (RBD) of the S protein plays an essential role, since it contains the receptor binding motif (RBM), responsible for the docking to the receptor. So far, mostly biochemical methods are being tested in order to prevent binding of the virus to ACE2. Here we show, with the help of atomistic simulations, that external electric fields of easily achievable and moderate strengths can dramatically destabilise the S protein, inducing long-lasting structural damage. One striking field-induced conformational change occurs at the level of the recognition loop L3 of the RBD where two parallel beta sheets, believed to be responsible for a high affinity to ACE2, undergo a change into an unstructured coil, which exhibits almost no binding possibilities to the ACE2 receptor. We also show that these severe structural changes upon electric-field application also occur in the mutant RBDs corresponding to the variants of concern (VOC) B.1.1.7 (UK), B.1.351 (South Africa) and P.1 (Brazil). Remarkably, while the structural flexibility of S allows the virus to improve its probability of entering the cell, it is also the origin of the surprising vulnerability of S upon application of electric fields of strengths at least two orders of magnitude smaller than those required for damaging most proteins. Our findings suggest the existence of a clean physical method to weaken the SARS-CoV-2 virus without further biochemical processing. Moreover, the effect could be used for infection prevention purposes and also to develop technologies for in-vitro structural manipulation of S. Since the method is largely unspecific, it can be suitable for application to other mutations in S, to other proteins of SARS-CoV-2 and in general to membrane proteins of other virus types.


Assuntos
SARS-CoV-2/metabolismo , Glicoproteína da Espícula de Coronavírus/química , Glicoproteína da Espícula de Coronavírus/metabolismo , Enzima de Conversão de Angiotensina 2 , Sítios de Ligação , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Humanos , Ligação Proteica/efeitos dos fármacos , Conformação Proteica , Conformação Proteica em Folha beta , Receptores Virais/metabolismo , Internalização do Vírus/efeitos dos fármacos
16.
J Endocr Soc ; 5(10): bvab073, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34377881

RESUMO

PURPOSE: Latin American reports on pheochromocytomas and paragangliomas (PPGLs) are scarce. Recent studies demonstrate changes in clinical presentation and management of these patients. Herein, we assessed the main characteristics of PPGL patients in our academic center over the past 4 decades. METHODS: Demographic, clinical, biochemical, and perioperative data from 105 PPGL patients were retrospectively and prospectively collected over the 1980-2019 period. Data were organized into 4 periods by decade. RESULTS: Age at diagnosis, gender, tumor size and percentage of bilaterality, percentage of paragangliomas, and metastases remained stable across the 4 decades. The proportion of genetic testing and incidentalomas increased in recent decades (all P < 0.001). Therefore, we compared PPGLs diagnosed as incidentalomas (36%) with those clinically suspected (64%). Incidentalomas had fewer adrenergic symptoms (38 vs. 62%; P < 0.001) and lower rates of hypertension (64% vs. 80%; P = 0.01) and hypertensive crisis (28% vs. 44%; P = 0.02); also, they had lower functionality (79% vs. 100%; P = 0.01) and lower catecholamines levels (8.4-fold vs. 12.5-fold above upper cutoffs; P = 0.04). Regarding management of all PPGLs over the decades, we observed significant increases in both perioperative doxazosin dose (P = 0.003) and laparoscopic approach rates (P < 0.001), along with a decrease in the length of hospital stays (P = 0.007). CONCLUSIONS: We observed a change in the clinical presentation of PPGL in recent decades, with a marked increase in incidental cases and milder symptoms. The implementation of a multidisciplinary program for adrenal disorders in our institution has translated into more timely diagnoses, more genetic testing, and improvements in perioperative management.

17.
Cancer Res ; 81(11): 2824-2832, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33762358

RESUMO

Clinical localization of primary tumors and sites of metastasis by PET is based on the enhanced cellular uptake of 2-deoxy-2-[18F]-fluoro-D-glucose (FDG). In prostate cancer, however, PET-FDG imaging has shown limited clinical applicability, suggesting that prostate cancer cells may utilize hexoses other than glucose, such as fructose, as the preferred energy source. Our previous studies suggested that prostate cancer cells overexpress fructose transporters, but not glucose transporters, compared with benign cells. Here, we focused on validating the functional expression of fructose transporters and determining whether fructose can modulate the biology of prostate cancer cells in vitro and in vivo. Fructose transporters, Glut5 and Glut9, were significantly upregulated in clinical specimens of prostate cancer when compared with their benign counterparts. Fructose levels in the serum of patients with prostate cancer were significantly higher than healthy subjects. Functional expression of fructose transporters was confirmed in prostate cancer cell lines. A detailed kinetic characterization indicated that Glut5 represents the main functional contributor in mediating fructose transport in prostate cancer cells. Fructose stimulated proliferation and invasion of prostate cancer cells in vitro. In addition, dietary fructose increased the growth of prostate cancer cell line-derived xenograft tumors and promoted prostate cancer cell proliferation in patient-derived xenografts. Gene set enrichment analysis confirmed that fructose stimulation enriched for proliferation-related pathways in prostate cancer cells. These results demonstrate that fructose promotes prostate cancer cell growth and aggressiveness in vitro and in vivo and may represent an alternative energy source for prostate cancer cells. SIGNIFICANCE: This study identifies increased expression of fructose transporters in prostate cancer and demonstrates a role for fructose as a key metabolic substrate supporting prostate cancer cells, revealing potential therapeutic targets and biomarkers.


Assuntos
Biomarcadores Tumorais/metabolismo , Dieta/efeitos adversos , Frutose/farmacologia , Regulação Neoplásica da Expressão Gênica , Proteínas Facilitadoras de Transporte de Glucose/metabolismo , Transportador de Glucose Tipo 5/metabolismo , Neoplasias da Próstata/patologia , Animais , Apoptose , Biomarcadores Tumorais/genética , Ciclo Celular , Movimento Celular , Proliferação de Células , Proteínas Facilitadoras de Transporte de Glucose/genética , Transportador de Glucose Tipo 5/genética , Masculino , Camundongos , Camundongos Endogâmicos NOD , Camundongos SCID , Neoplasias da Próstata/induzido quimicamente , Neoplasias da Próstata/genética , Neoplasias da Próstata/metabolismo , Células Tumorais Cultivadas , Ensaios Antitumorais Modelo de Xenoenxerto
18.
BMC Urol ; 21(1): 50, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33785004

RESUMO

OBJECTIVES: To establish the role of BCG instillations in the incidence and mortality of COVID-19. PATIENTS AND METHODS: NMIBC patients in instillations with BCG (induction or maintenance) during 2019/2020 were included, establishing a COVID-19 group (with a diagnosis according to the national registry) and a control group (NO-COVID). The cumulative incidence (cases/total patients) and the case fatality rate (deaths/cases) were established, and compared with the national statistics for the same age group. T-test was used for continuous variables and Fisher's exact test for categorical variables. RESULTS: 175 patients were included. Eleven patients presented CIS (11/175, 6.3%), 84/175 (48.0%) Ta and 68/175 (38.9%) T1. Average number of instillations = 13.25 ± 7.4. One hundred sixty-seven patients (95.4%) had complete induction. Forty-three patients (cumulative incidence 24.6%) were diagnosed with COVID-19. There is no difference between COVID-19 and NO-COVID group in age, gender or proportion of maintenance completed. COVID-19 group fatality rate = 1/43 (2.3%). Accumulated Chilean incidence 70-79 years = 6.3%. Chilean fatality rate 70-79 years = 14%. CONCLUSIONS: According to our results, patients with NMIBC submitted to instillations with BCG have a lower case-fatality rate than the national registry of patients between 70 and 79 years (2.3% vs. 14%, respectively). Intravesical BCG could decrease the mortality due to COVID-19, so instillation schemes should not be suspended in a pandemic.


Assuntos
Adjuvantes Imunológicos/administração & dosagem , Vacina BCG/administração & dosagem , COVID-19/epidemiologia , Neoplasias da Bexiga Urinária/tratamento farmacológico , Administração Intravesical , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Chile , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Índice de Gravidade de Doença , Neoplasias da Bexiga Urinária/patologia
19.
J Med Internet Res ; 23(2): e25283, 2021 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-33497350

RESUMO

BACKGROUND: The COVID-19 outbreak has affected the lives of millions of people by causing a dramatic impact on many health care systems and the global economy. This devastating pandemic has brought together communities across the globe to work on this issue in an unprecedented manner. OBJECTIVE: This case study describes the steps and methods employed in the conduction of a remote online health hackathon centered on challenges posed by the COVID-19 pandemic. It aims to deliver a clear implementation road map for other organizations to follow. METHODS: This 4-day hackathon was conducted in April 2020, based on six COVID-19-related challenges defined by frontline clinicians and researchers from various disciplines. An online survey was structured to assess: (1) individual experience satisfaction, (2) level of interprofessional skills exchange, (3) maturity of the projects realized, and (4) overall quality of the event. At the end of the event, participants were invited to take part in an online survey with 17 (+5 optional) items, including multiple-choice and open-ended questions that assessed their experience regarding the remote nature of the event and their individual project, interprofessional skills exchange, and their confidence in working on a digital health project before and after the hackathon. Mentors, who guided the participants through the event, also provided feedback to the organizers through an online survey. RESULTS: A total of 48 participants and 52 mentors based in 8 different countries participated and developed 14 projects. A total of 75 mentorship video sessions were held. Participants reported increased confidence in starting a digital health venture or a research project after successfully participating in the hackathon, and stated that they were likely to continue working on their projects. Of the participants who provided feedback, 60% (n=18) would not have started their project without this particular hackathon and indicated that the hackathon encouraged and enabled them to progress faster, for example, by building interdisciplinary teams, gaining new insights and feedback provided by their mentors, and creating a functional prototype. CONCLUSIONS: This study provides insights into how online hackathons can contribute to solving the challenges and effects of a pandemic in several regions of the world. The online format fosters team diversity, increases cross-regional collaboration, and can be executed much faster and at lower costs compared to in-person events. Results on preparation, organization, and evaluation of this online hackathon are useful for other institutions and initiatives that are willing to introduce similar event formats in the fight against COVID-19.


Assuntos
COVID-19/terapia , Atenção à Saúde/organização & administração , Internet , Adulto , COVID-19/epidemiologia , Humanos , SARS-CoV-2/isolamento & purificação
20.
BMC Urol ; 21(1): 4, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407316

RESUMO

BACKGROUND: Bladder tumors in pregnancy are extremely rare. No more than 50 cases have been published to date, including all histologic variants, and only three cases of bladder squamous cell carcinoma have been described. CASE PRESENTATION: We present a clinical case of a 31-year-old woman with bladder squamous cell carcinoma in the second trimester of pregnancy. After a C-section at 30 weeks, we performed radical cystectomy with extended bilateral lymphadenectomy, hysterectomy and right oophorectomy. The Studer neobladder technique was performed for urinary tract reconstruction. Definitive pathology showed invasive bladder squamous cell carcinoma, Grade 2, with microscopic infiltration of the perivesical fat, negative margins, and 3/28 lymph nodes with carcinoma (pT3aN2M0). The patient underwent 18 months of surveillance after radical cystectomy, without recurrence by PET-CT. CONCLUSIONS: Bladder cancer in pregnant women is extremely rare but must be considered in those with recurrent gross hematuria and/or recurrent urinary tract infection. To our knowledge, this case involves the longest recurrence-free survival of a pregnant woman with squamous cell bladder cancer published thus far.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Complicações Neoplásicas na Gravidez/cirurgia , Neoplasias da Bexiga Urinária/cirurgia , Adulto , Feminino , Humanos , Gravidez
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