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PURPOSE OF REVIEW: To highlight novel findings in the detection of monosodium urate deposits in vessels using dual energy computed tomography, and to discuss the potential clinical implications for gout and hyperuricemia patients. RECENT FINDINGS: Gout is an independent risk factor for cardiovascular disease. However, classical risk calculators do not take into account these hazards, and parameters to identify patients at risk are lacking. Monosodium urate measured by dual energy computed tomography is a well-established technology for the detection and quantification of monosodium urate deposits in peripheral joints and tendons. Recent findings also suggest its applicability to identify vascular urate deposits. Dual energy computed tomography is a promising tool for detection of cardiovascular monosodium urate deposits in gout patients, to better delineate individuals at increased risk for cardiovascular disease.
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Gota , Tomografia Computadorizada por Raios X , Ácido Úrico , Humanos , Ácido Úrico/análise , Tomografia Computadorizada por Raios X/métodos , Gota/diagnóstico por imagem , Hiperuricemia/diagnóstico por imagem , Doenças Cardiovasculares/diagnóstico por imagemRESUMO
The indirect immunofluorescence assay (IIFA) on HEp-2 cells is widely used for detection of antinuclear antibodies (ANA). The dichotomous outcome, negative or positive, is integrated in diagnostic and classification criteria for several systemic autoimmune diseases. However, the HEp-2 IIFA test has much more to offer: besides the titre or fluorescence intensity, it also provides fluorescence pattern(s). The latter include the nucleus and the cytoplasm of interphase cells as well as patterns associated with mitotic cells. The International Consensus on ANA Patterns (ICAP) initiative has previously reached consensus on the nomenclature and definitions of HEp-2 IIFA patterns. In the current paper, the ICAP consensus is presented on the clinical relevance of the 29 distinct HEp-2 IIFA patterns. This clinical relevance is primarily defined within the context of the suspected disease and includes recommendations for follow-up testing. The discussion includes how this information may benefit the clinicians in daily practice and how the knowledge can be used to further improve diagnostic and classification criteria.
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Anticorpos Antinucleares/análise , Doenças Autoimunes/diagnóstico , Técnica Indireta de Fluorescência para Anticorpo/normas , Doenças Autoimunes/imunologia , Biomarcadores/análise , Humanos , Cooperação InternacionalRESUMO
Atyid shrimps, a key component of tropical freshwater ecosystems, face multiple anthropogenic threats and thus need special attention. With more than 300 described species, the genus Caridina is the most speciose of all the Caridea infra-order. Caridina spp. occupy diverse habitats in tropical freshwaters of the Indo-West Pacific region. Several species complexes have been recognized, based on common morphological features, but little is known about how well these morphological characteristics align with phylogenetic characteristics. Furthermore, no phylogeny of the genus Caridina published so far has provided well-resolved and supported relationships among different species, thus impeding the possibility of proposing evolutionary hypotheses. In this study we used next generation sequencing (NGS) to provide new insights into the phylogenetic relationships among the genus Caridina, focusing on two complexes: 'Caridina nilotica' and 'Caridina weberi'. We collected 92 specimens belonging to these two groups from most of their known geographical range, representing 50 species, for which we sequenced seven mitochondrial genes and two nuclear markers using ion torrent NGS. We performed a phylogenetic analysis, which yielded the first well-supported tree for the genus Caridina. On this tree were mapped the geographic ranges and the habitats used by the different species, and a time calibration was tested. We found the driving factors that most likely account for separation of clades are differences in habitat and to a lesser extent geography. This work provides new insights into the taxonomy of this group and identifies opportunities for further studies in order to fill knowledge gaps that currently impede the management and conservation of atyid species.
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Decápodes/classificação , Ecossistema , Filogenia , Filogeografia , Animais , Teorema de Bayes , Calibragem , Fatores de TempoRESUMO
Despite significant therapeutic advances in recent years, treatment of metastatic prostate cancer (PCa) remains palliative, owing to the inevitable occurrence of drug resistance. There is increasing evidence that epithelial glucocorticoid receptor (GR) signaling and changes in the tumor-microenvironment (TME) play important roles in this process. Since glucocorticoids (GCs) are used as concomitant medications in the course of PCa treatment, it is essential to investigate the impact of GCs on stromal GR signaling in the TME. Therefore, general GR mRNA and protein expression was assessed in radical prostatectomy specimens and metastatic lesions. Elevated stromal GR signaling after GC treatment resulted in altered GR-target gene, soluble protein expression, and in a morphology change of immortalized and primary isolated cancer-associated fibroblasts (CAFs). Subsequently, these changes affected proliferation, colony formation, and 3D-spheroid growth of multiple epithelial PCa cell models. Altered expression of extra-cellular matrix (ECM) and adhesion-related proteins led to an ECM remodeling. Notably, androgen receptor pathway inhibitor treatments did not affect CAF viability. Our findings demonstrate that GC-mediated elevated GR signaling has a major impact on the CAF secretome and the ECM architecture. GC-treated fibroblasts significantly influence epithelial tumor cell growth and must be considered in future therapeutic strategies.
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Fibroblastos Associados a Câncer , Neoplasias da Próstata , Masculino , Humanos , Glucocorticoides/farmacologia , Glucocorticoides/uso terapêutico , Glucocorticoides/metabolismo , Próstata/patologia , Receptores de Glucocorticoides/genética , Receptores de Glucocorticoides/metabolismo , Microambiente Tumoral , Linhagem Celular Tumoral , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/genética , Neoplasias da Próstata/metabolismo , Fibroblastos/metabolismo , Fibroblastos Associados a Câncer/metabolismoAssuntos
Anticorpos Antinucleares/análise , Técnica Indireta de Fluorescência para Anticorpo/métodos , Doenças Autoimunes/diagnóstico , Linhagem Celular , Consenso , Células Epiteliais/citologia , Células Epiteliais/metabolismo , Reações Falso-Negativas , Técnica Indireta de Fluorescência para Anticorpo/normas , Humanos , Sociedades CientíficasAssuntos
Anticorpos Antinucleares/análise , DNA Topoisomerases Tipo I/imunologia , Técnica Indireta de Fluorescência para Anticorpo/métodos , Algoritmos , Linhagem Celular , Consenso , Células Epiteliais/citologia , Células Epiteliais/metabolismo , Técnica Indireta de Fluorescência para Anticorpo/normas , Humanos , Sociedades CientíficasRESUMO
Elephantis, new genus, is established for Caridina natalensis Bouvier, 1925 hitherto known only from South Africa with one male specimen. Recently, three surveys by electric fishing (2004, 2008 and 2010) of some eastern rivers from Madagascar have permitted to discover numerous specimens of this species. Caridina natalensis is different from all other known species of Caridina by its remarkably broad endopod of the male first pleopod, a long clubbed appendix masculina on the male second pleopod reaching beyond distal end of endopod and strong third pereiopods. Therefore a new genus name is proposed for this species. In addition to detailed description of diagnostic morphological characters, molecular sequences obtained from mitochondrial 16S gene are provided for six specimens of this species. These DNA sequences are integrated to the 16S molecular phylogeny of atyid freshwater shrimps recently published by von Rintelen et al. (2012). Elephantis natalensis comb. nov. sequences formed a divergent group supported in maximum likelihood analysis. The availability of DNA samples could be used as reference and integrated in further phylogenetic studies on atyid freshwater shrimps.
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Decápodes/anatomia & histologia , Decápodes/classificação , Rios , Animais , Feminino , Madagáscar , MasculinoRESUMO
Three atyid shrimp species of the genus Caridina Milne Edwards, 1837, Caridina boehmei n. sp., C. laroeha and C. butonensis n. sp., are described from the Indonesian islands Sulawesi and Buton. Caridina boehinei n. sp. differs from its apparently next congener C. sulawesi Cai & Ng, 2009 by the shape of the spinulation of the male sexual appendages. Caridina laroeha resembles C. mahalona and C. opaensis, but can be distinguished by the length and armature of the rostrum, the length ratio of segments of the third maxilliped and the number of spinules on the uropodal diaeresis. Caridina butonensis n. sp. resembles to C. boehmei n. sp. and C. opaensis but can be distinguished by its peculiar truncated rostrum and by a more reduced podobranch on the second maxilliped.
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Decápodes/classificação , Distribuição Animal , Estruturas Animais/anatomia & histologia , Estruturas Animais/crescimento & desenvolvimento , Animais , Tamanho Corporal , Lista de Checagem , Decápodes/anatomia & histologia , Decápodes/crescimento & desenvolvimento , Ecossistema , Feminino , Indonésia , Ilhas , Masculino , Tamanho do ÓrgãoRESUMO
The atyid genus Micratya Bouvier, 1913 was previously considered to be monotypic. The area in which the genus is dis-tributed is limited to the islands of the Antilles and Central America, with the type locality of Micratya poeyi being in Cuba. A recent molecular phylogenetic analysis of atyid shrimps from the Caribbean indicated the probable existence of a second species of Micratya from samples collected in Puerto Rico. Here it is described as the new species Micratya cooki sp. nov., differing from its congener in the armature of the dactyli on the fifth pereiopod, the uropodal diaeresis, the distal margin of the telson and by the spinulation of the appendix masculina in male specimens. Because the type specimens of M. poeyi are most probably lost, a neotype for M. poeyi was designated.
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Decápodes/anatomia & histologia , Decápodes/classificação , Animais , Proteínas de Artrópodes/genética , Código de Barras de DNA Taxonômico , Decápodes/genética , Feminino , Água Doce , Masculino , Porto RicoRESUMO
Reverse transcription polymerase chain reaction (RT-PCR) on respiratory tract swabs has become the gold standard for sensitive and specific detection of influenza virus, respiratory syncytial virus (RSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this retrospective analysis, we report on the successive implementation and routine use of multiplex RT-PCR testing for patients admitted to the Internal Medicine Emergency Department (ED) at a tertiary care center in Western Austria, one of the hotspots in the early coronavirus disease 2019 (COVID-19) pandemic in Europe. Our description focuses on the use of the Cepheid® Xpert® Xpress closed RT-PCR system in point-of-care testing (POCT). Our indications for RT-PCR testing changed during the observation period: From the cold season 2016/2017 until the cold season 2019/2020, we used RT-PCR to diagnose influenza or RSV infection in patients with fever and/or respiratory symptoms. Starting in March 2020, we used the RT-PCR for SARS-CoV-2 and a multiplex version for the combined detection of all these three respiratory viruses to also screen subjects who did not present with symptoms of infection but needed in-hospital medical treatment for other reasons. Expectedly, the switch to a more liberal RT-PCR test strategy resulted in a substantial increase in the number of tests. Nevertheless, we observed an immediate decline in influenza virus and RSV detections in early 2020 that coincided with public SARS-CoV-2 containment measures. In contrast, the extensive use of the combined RT-PCR test enabled us to monitor the re-emergence of influenza and RSV detections, including asymptomatic cases, at the end of 2022 when COVID-19 containment measures were no longer in place. Our analysis of PCR results for respiratory viruses from a real-life setting at an ED provides valuable information on the epidemiology of those infections over several years, their contribution to morbidity and need for hospital admission, the risk for nosocomial introduction of such infection into hospitals from asymptomatic carriers, and guidance as to how general precautions and prophylactic strategies affect the dynamics of those infections.
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COVID-19 , Influenza Humana , Orthomyxoviridae , Vírus Sincicial Respiratório Humano , Humanos , SARS-CoV-2/genética , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Estudos Retrospectivos , COVID-19/diagnóstico , COVID-19/epidemiologia , Vírus Sincicial Respiratório Humano/genética , Serviço Hospitalar de Emergência , Orthomyxoviridae/genéticaRESUMO
OBJECTIVE: To evaluate two different dual-energy computed tomography (DECT) post-processing protocols for the detection of MSU deposits in foot tendons of cadavers with verification by polarizing light microscopy as the gold standard. MATERIAL AND METHODS: A total of 40 embalmed cadavers (15 male; 25 female; median age, 82 years; mean, 80 years; range, 52-99; SD ± 10.9) underwent DECT to assess MSU deposits in foot tendons. Two postprocessing DECT protocols with different Hounsfield unit (HU) thresholds, 150/500 (=established) versus 120/500 (=modified). HU were applied to dual source acquisition with 80 kV for tube A and 140 kV for tube B. Six fresh cadavers (4 male; 2 female; median age, 78; mean, 78.5; range 61-95) were examined by DECT. Tendon dissection of 2/6 fresh cadavers with positive DECT 120 and negative DECT 150 studies were used to verify MSU deposits by polarizing light microscopy. RESULTS: The tibialis anterior tendon was found positive in 57.5%/100% (DECT 150/120), the peroneus tendon in 35%/100%, the achilles tendon in 25%/90%, the flexor halluces longus tendon in 10%/100%, and the tibialis posterior tendon in 12.5%/97.5%. DECT 120 resulted in increased tendon MSU deposit detection, when DECT 150 was negative, with an overall agreement between DECT 150 and DECT 120 of 80% (p = 0.013). Polarizing light microscope confirmed MSU deposits detected only by DECT 120 in the tibialis anterior, the achilles, the flexor halluces longus, and the peroneal tendons. CONCLUSION: The DECT 120 protocol showed a higher sensitivity when compared to DECT 150.
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Autoimmune diseases are a clinically heterogeneous group of disorders that represent a challenge for the general practitioner in daily routine. Except for rheumatoid arthritis, which is one of the most frequent autoimmune diseases with a prevalence of approximately 1 % of the population, systemic autoimmune disorders are rare. Thus outside specialized wards it might be a challenge to diagnose the underlying autoimmune disease considering the often kaleidoscopic clinical manifestations. Together with careful anamnesis and suspicious clinical symptoms determination of specific autoantibodies can support the suspected diagnosis. The Austrian group of the European autoimmune standardization initiative (EASI) firstly published this guide 2009 with the aim to provide a map through the jungle of the biomarkers for autoimmune diseases for the general practitioner.
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Autoanticorpos/sangue , Doenças Autoimunes/diagnóstico , Biomarcadores/sangue , Doenças Reumáticas/diagnóstico , Adolescente , Adulto , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/epidemiologia , Artrite Reumatoide/imunologia , Áustria , Doenças Autoimunes/epidemiologia , Doenças Autoimunes/imunologia , Criança , Comportamento Cooperativo , Estudos Transversais , Diagnóstico Diferencial , Seguimentos , Medicina Geral , Humanos , Comunicação Interdisciplinar , Doenças Reumáticas/epidemiologia , Doenças Reumáticas/imunologiaRESUMO
BACKGROUND: Dual-energy computed tomography (DECT) allows direct visualization of monosodium urate (MSU) deposits in joints and soft tissues. PURPOSE: To describe the distribution of MSU deposits in cadavers using DECT in the head, body trunk, and feet. MATERIALS AND METHODS: A total of 49 cadavers (41 embalmed and 8 fresh cadavers; 20 male, 29 female; mean age, 79.5 years; SD ± 11.3; range 52-95) of unknown clinical history underwent DECT to assess MSU deposits in the head, body trunk, and feet. Lens, thoracic aorta, and foot tendon dissections of fresh cadavers were used to verify MSU deposits by polarizing light microscopy. RESULTS: 33/41 embalmed cadavers (80.5%) showed MSU deposits within the thoracic aorta. 11/41 cadavers (26.8%) showed MSU deposits within the metatarsophalangeal (MTP) joints and 46.3% of cadavers demonstrated MSU deposits within foot tendons, larger than and equal to 5 mm. No MSU deposits were detected in the cranium/intracerebral vessels, or the coronary arteries. Microscopy used as a gold standard could verify the presence of MSU deposits within the lens, thoracic aorta, or foot tendons in eight fresh cadavers. CONCLUSIONS: Microscopy confirmed the presence of MSU deposits in fresh cadavers within the lens, thoracic aorta, and foot tendons, whereas no MSU deposits could be detected in cranium/intracerebral vessels or coronary arteries. DECT may offer great potential as a screening tool to detect MSU deposits and measure the total uric acid burden in the body. The clinical impact of this cadaver study in terms of assessment of MSU burden should be further proven.
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The establishment of the International Consensus on ANA Patterns (ICAP) in 2014-2015 was welcomed by members of the medical community as a significant improvement in guiding harmonization of ANA test interpretation and reporting. In the subsequent years, several itinerant meetings and continuous interaction with the community contributed to disseminate the ICAP harmonization on the immunofluorescence patterns observed in the indirect immunofluorescence assay on HEp-2 cells (HEp-2 IFA) and to promote progressive improvement in the classification of HEp-2 IFA patterns. The 6th ICAP Workshop was held in person on September 6, 2021 as a satellite meeting of the 15th Dresden Symposium on Autoantibodies. This article summarizes the major discussions at the meeting as well as outlining the current plans for the ICAP committee.
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Anticorpos Antinucleares , Doenças Autoimunes , Autoanticorpos , Consenso , Técnica Indireta de Fluorescência para Anticorpo , HumanosRESUMO
The CovILD study is a prospective, multicenter, observational cohort study to systematically follow up patients after coronavirus disease-2019 (COVID-19). We extensively evaluated 145 COVID-19 patients at 3 follow-up visits scheduled for 60, 100, and 180 days after initial confirmed diagnosis based on typical symptoms and a positive reverse transcription-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). We employed comprehensive pulmonary function and laboratory tests, including serum concentrations of IgG against the viral spike (S) glycoprotein, and compared the results to clinical data and chest computed tomography (CT). We found that at the 60 day follow-up, 131 of 145 (90.3%) participants displayed S-specific serum IgG levels above the cut-off threshold. Notably, the highly elevated IgG levels against S glycoprotein positively correlated with biomarkers of immune activation and negatively correlated with pulmonary function and the extent of pulmonary CT abnormalities. Based on the association between serum S glycoprotein-specific IgG and clinical outcome, we generated an S-specific IgG-based recovery score that, when applied in the early convalescent phase, accurately predicted delayed pulmonary recovery after COVID-19. Therefore, we propose that S-specific IgG levels serve as a useful immunological surrogate marker for identifying at-risk individuals with persistent pulmonary injury who may require intensive follow-up care after COVID-19.
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COVID-19/imunologia , Imunoglobulina G/imunologia , Pulmão/patologia , Glicoproteína da Espícula de Coronavírus/imunologia , COVID-19/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidade do Paciente , Estudos Prospectivos , Testes de Função Respiratória , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
Lake Poso, an ancient lake system on the Indonesian island Sulawesi, harbours an endemic species flock of six, four lacustrine and two riverine species of the freshwater shrimp genus Caridina. In this study, five new lacustrine species are described, bringing the total to eleven species altogether. The number of lacustrine species is more than doubled to nine species compared to the last taxonomic revision in 2009. One of them, Caridina mayamareenae Klotz, Wowor & von Rintelen, sp. nov., even represents the first case of an atyid shrimp associated with freshwater snails which is morphologically adapted to living in shells. An integrative approach was used by providing a combination of morphological, ecological, and molecular data. Based on standard morphological characters, distribution, substrate preferences, and colouration of living specimens in the field, five distinct undescribed species could be distinguished. To support our species-hypothesis based on the mitochondrial genes 16S and COI, a molecular phylogeny was used for all eleven species from Lake Poso. All species form a well-supported monophyletic group, but only four morphospecies consistently correspond to mtDNA clades - a possible reason could be introgressive hybridisation, incomplete lineage sorting, or not yet fixed species boundaries. These results are discussed further in the context of adaptive radiation, which turned out to be more diverse than previously described. Finally, yet importantly, subjecting all new species to similar threats and to the same IUCN category and criterion than the previously described species from the lake is recommended.
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BACKGROUND: Freshwater shrimp of the family Atyidae De Haan, 1849 have been studied in Vietnam for more than a century. A total of 24 species of atyid shrimps from the genera Caridina H. Milne Edwards, 1837, Neocaridina Kubo, 1938, Atyopsis Chace, 1983 have been recorded from Vietnam. With 22 species, the majority are from the genus Caridina. In 2013, Karge and Klotz mentioned the occurrence of four yet undescribed species belonging to Paracaridina Liang, Guo & Tang, 1999 in Vietnam without taxonomic details.In general, studies of freshwater atyids in Vietnam are limited and most Vietnamese taxa await a taxonomic revision. The available data do not fully reflect their estimated species diversity in the country and distribution data are deficient. Here, we focus on four species of atyid shrimps from two genera, viz. Caridinacantonensis Yu, 1938, C.lanceifrons Yu, 1936, C.serrata Stimpson, 1860 and Neocaridinapalmata (Shen, 1948), all described from China and have been reported to occur in Vietnam. The previous reports on the occurrence of these species in Vietnam are largely unreliable due to taxonomic confusion. To contribute to the knowledge of these taxa, we provide the first verified distribution records of the four species in the country with some taxonomic remarks. NEW INFORMATION: This study shows the first taxonomically-verified distribution data of four atyid shrimp species originally described from China, but also reported from Vietnam, albeit under various species names and, in some cases, erroneously. These data allow the first meaningful discussion of the distribution in light of the reproductive strategy of these four species and, in conjunction with the taxonomic remarks, will contribute to the knowledge of these taxa. As a result of this research and data from previous studies, we now consider all four species as widespread and non-endemic, but land-locked (with a complete freshwater life cycle). In Vietnam, all four species are confined to the northern half of the country. Beyond Vietnam, we provide the first records for Caridinalanceifrons from southern Thailand, which suggests a major sampling gap in Indochina.
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Results of the anti-nuclear antibodies-indirect immunofluorescence assay (anti-cell antibodies test) on HEp-2 cell substrates should be communicated to clinicians in a standardized way, adding value to laboratory findings and helping with critical clinical decisions. This paper proposes a test report based on the practices informed by 118 laboratories in 68 countries, with recommendations from the International Consensus on ANA Patterns (ICAP) group. Major focus is placed on the report format containing endpoint titers, immunofluorescence patterns together with anti-cell (AC) nomenclature, remarks on follow-up or reflex testing, and possible other autoantibody associations. ISO 15,189 directives were integrated into the test report. Special situations addressed include serum screening dilutions and endpoint titers, relevance of immunofluorescence patterns with special attention to cytoplasmic patterns, mixed and compound patterns, and how to report different titers corresponding to multiple patterns or autoantibodies in the same sample. This paper suggests a subtitle for the HEp-2-IIFA, namely anti-cell antibodies test, which could gradually substitute the original outdated ANA nomenclature. This ICAP pro forma report represents a further step in harmonizing the way relevant clinical information could be provided by laboratories.
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Anticorpos Antinucleares/imunologia , Doenças Autoimunes/imunologia , Linhagem Celular , Consenso , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Guias de Prática Clínica como AssuntoRESUMO
The diagnosis of COVID-19 relies on the direct detection of SARS-CoV-2 RNA in respiratory specimens by RT-PCR. The pandemic spread of the disease caused an imbalance between demand and supply of materials and reagents needed for diagnostic purposes including swab sets. In a comparative effectiveness study, we conducted serial follow-up swabs in hospitalized laboratory-confirmed COVID-19 patients. We assessed the diagnostic performance of an in-house system developed according to recommendations by the US CDC. In a total of 96 serial swabs, we found significant differences in the accuracy of the different swab systems to generate a positive result in SARS-CoV-2 RT-PCR, ranging from around 50 to 80%. Of note, an in-house swab system was superior to most commercially available sets as reflected by significantly lower Ct values of viral genes. Thus, a simple combination of broadly available materials may enable diagnostic laboratories to bypass global limitations in the supply of swab sets.