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1.
Arch Microbiol ; 206(1): 54, 2024 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-38180520

RESUMO

Pseudomonas aeruginosa is an opportunistic bacterium that can form a biofilm with the ability to colonize different surfaces and for increasing resistance to antibiotics. An alternative to solve this problem may be the use of non-glucose/mannose glycosylated proteins from Melipona beecheii honey, which are capable of inhibiting the growth of this pathogen. In this work, the antibiofilm activity of the conA-unbound protein fraction (F1) from M. beecheii was evaluated. The crude protein extract (CPE) and the F1 fraction inhibited the P. aeruginosa biofilm growth above 80% at 4 and 1.3 µg/mL, respectively. These proteins affected the structure of the biofilm, as well as fleQ and fleR gene expressions involved in the formation and regulation of the P. aeruginosa biofilm. The results demonstrated that the F1 fraction proteins of M. beecheii honey inhibit and affect the formation of the P. aeruginosa biofilm.


Assuntos
Mel , Infecções por Pseudomonas , Abelhas , Animais , Pseudomonas aeruginosa/genética , Antibacterianos/farmacologia , Biofilmes , Concanavalina A
2.
J Endocrinol Invest ; 46(6): 1187-1195, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36495439

RESUMO

PURPOSE: Adult growth hormone deficiency (aGHD) is characterized by an altered metabolic profile and increased cardiovascular risk. Neudesin is a newly discovered protein mainly secreted from adipose tissue and brain, under evaluation for its possible activity as a negative regulator of energy expenditure. Liver-expressed antimicrobial peptide (LEAP)-2 is a competitive antagonist of ghrelin on its receptor. An observational cross-sectional study was performed to test the hypothesis that plasma neudesin levels may be modified in aGHD. Given the role played in the energy balance, any possible relationships between neudesin, LEAP-2 and metabolic and anthropometric parameters were evaluated. SUBJECTS AND METHODS: Thirty-eight patients were included: 18 aGHD patients (7 females and 11 males, aged 59.7 ± 2.6 years, BMI 30.2 ± 2.2 kg/m2); 20 healthy controls (12 females and 8 males, aged 47.1 ± 2.5 years, BMI 24.1 ± 0.9 kg/m2). All patients were evaluated for glucose, insulin, HOMA and QUICKI index, total/LDL/HDL cholesterol, triglycerides, uric acid, and IGF-1. Plasma neudesin, LEAP-2, and ghrelin were measured by ELISA. Fat mass was evaluated by DEXA. RESULTS: Neudesin levels were significantly higher in aGHD versus controls. We confirmed the finding of significantly lower ghrelin levels and significantly higher LEAP-2/ghrelin ratio in aGHD patients and found a significant direct correlation between neudesin and LEAP-2 levels. A significant direct correlation between neudesin and fat mass percentage was found in the whole population. CONCLUSION: These results suggest the onset of adaptive responses to an altered metabolic picture in aGHD. The changes in two distinct pathways that modulate food intake and the still limited knowledge about neudesin suggest future developments in this field.


Assuntos
Grelina , Hepcidinas , Masculino , Feminino , Adulto , Humanos , Estudos Transversais , Índice de Massa Corporal , LDL-Colesterol , Hormônio do Crescimento
3.
Public Health ; 221: 50-59, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37406450

RESUMO

OBJECTIVES: The aim of this umbrella review of systematic reviews and meta-analyses was to address workplace violence (WPV) against healthcare workers (HCWs). Several systematic reviews exist in the literature, but the diversity of settings, population considered, and type of violence investigated make it difficult to gain insight and use the vast amount of available data to implement policies to tackle WPV. With this in mind, we conducted an umbrella review of systematic reviews and meta-analyses on WPV against HCWs to examine the global prevalence of the phenomena and its features. STUDY DESIGN AND METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, Scopus, and ISI Web of Science were searched for relevant systematic reviews and meta-analyses published in English up to November 2022. Data on authors, year, country, violence type, prevalence (pooled and not), setting, population, and specific considerations were extracted. RESULTS: A total of 32 systematic reviews were included, 19 of which performed a meta-analysis, investigating overall, physical, and non-physical violence. Even considering the variability of the data, the COVID-19 pandemic has exacerbated the scale of the problem. From our review, we found that overall violence prevalence among HCWs was reported to be as high as 78.9%, and nurses working in psychiatric wards were the professionals most impacted. CONCLUSION: In conclusion, this umbrella review revealed a high prevalence of WPV among HCWs, which varies between countries, population subgroups, and detection methods. Strengthening recognition of the problem could lead to appropriate local and international strategies to address it.


Assuntos
COVID-19 , Violência no Trabalho , Humanos , Pessoal de Saúde , Pandemias , Prevalência , Local de Trabalho , Revisões Sistemáticas como Assunto , Metanálise como Assunto
4.
J Environ Manage ; 345: 118784, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37611517

RESUMO

Magnetic bismuth ferrite (BiFO) microparticles were employed for the first time for the removal of polystyrene (PS) nano/microplastics from the drinking water. BiFO is formed by porous agglomerates with sizes of 5-11 µm, while the PS nano/microparticles have sizes in the range of 70-11000 nm. X-ray diffraction studies demonstrated that the BiFO microparticles are composed of BiFeO3/Bi25FeO40 (the content of Bi25FeO40 is ≈ 8.6%). Drinking water was contaminated with PS nano/microparticles (1 g L-1) and BiFO microparticles were also added to the contaminated water. Later, the mixture of PS-particles + BiFO was irradiated with NIR light (980 nm). Consequently, PS nano/microparticles melted on the BiFO microparticles due to the excessive heating on their surface. At the same time, the NIR (near infrared) light generated oxidizing agents (∙OH and h+), which degraded the by-products formed during the photocatalytic degradation of PS nano/microparticles. Subsequently, the NIR irradiation was stopped, and a Neodymium magnet was utilized to separate the BiFO microparticles from the water. This last procedure also permitted the removal of PS nano/microparticles by physical adsorption. Zeta potential measurements demonstrated that the BiFO surface was positively charged, allowing the removal of the negatively charged PS nano/microparticles by electrostatic attraction. The combination of the photocatalytic process and the physical adsorption permitted a complete removal of PS nano/microparticles after only 90 min as well as a high mineralization of by-products (≈95.5% as confirmed by the total organic carbon measurements). We estimate that ≈23.6% of the PS nano/microparticles were eliminated by photocatalysis and the rest of PS particles (≈76.4%) by physical adsorption. An outstanding adsorption capacity of 195.5 mg g-1 was obtained after the magnetic separation of the BiFO microparticles from the water. Hence, the results of this research demonstrated that using photocatalysis + physical-adsorption is a feasible strategy to quickly remove microplastic contaminants from the water.


Assuntos
Água Potável , Poluentes Químicos da Água , Poliestirenos , Plásticos , Bismuto , Microplásticos , Adsorção , Fenômenos Magnéticos , Poluentes Químicos da Água/análise
5.
Infection ; 50(5): 1373-1382, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35781785

RESUMO

BACKGROUND: We evaluated clinical features and risk factors for mortality in patients with haematological malignancies and COVID-19. METHODS: Retrospective, case-control (1:3) study in hospitalized patients with COVID-19. Cases were patients with haematological malignancies and COVID-19, controls had COVID-19 without haematological malignancies. Patients were matched for sex, age and time of hospitalization. RESULTS: Overall, 66 cases and 198 controls were included in the study. Cases had higher prior corticosteroid use, infection rates, thrombocytopenia and neutropenia and more likely received corticosteroids and antibiotics than controls. Cases had higher respiratory deterioration than controls (78.7% vs 65.5%, p = 0.04). Notably, 29% of cases developed respiratory worsening > 10 days after hospital admission, compared to only 5% in controls. Intensive Care Unit admission and mortality were higher in cases than in controls (27% vs 8%, p = 0.002, and 35% vs 10%, p < 0.001). At multivariable analysis, having haematological malignancy [OR4.76, p < 0.001], chronic corticosteroid therapy [OR3.65, p = 0.004], prior infections [OR57.7, p = 0.006], thrombocytopenia [OR3.03, p < 0.001] and neutropenia [OR31.1, p = 0.001], low albumin levels [OR3.1, p = 0.001] and ≥ 10 days from hospital admission to respiratory worsening [OR3.3, p = 0.002] were independently associated with mortality. In cases, neutropenia [OR3.1, p < 0.001], prior infections [OR7.7, p < 0.001], ≥ 10 days to respiratory worsening [OR4.1, p < 0.001], multiple myeloma [OR1.5, p = 0.044], the variation of the CT lung score during hospitalization [OR2.6, p = 0.006] and active treatment [OR 4.4, p < 0.001] all were associated with a worse outcome. CONCLUSION: An underlying haematological malignancy was associated with a worse clinical outcome in COVID-19 patients. A prolonged clinical monitoring is needed, since respiratory worsening may occur later during hospitalization.


Assuntos
COVID-19 , Neoplasias Hematológicas , Neutropenia , Trombocitopenia , Corticosteroides/uso terapêutico , Albuminas , Antibacterianos , COVID-19/epidemiologia , Estudos de Casos e Controles , Neoplasias Hematológicas/complicações , Humanos , Neutropenia/complicações , Estudos Retrospectivos , SARS-CoV-2 , Trombocitopenia/complicações
6.
Infection ; 49(5): 965-975, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34036458

RESUMO

BACKGROUND: Little is known in distinguishing clinical features and outcomes between coronavirus disease-19 (COVID-19) and influenza (FLU). MATERIALS/METHODS: Retrospective, single-centre study including patients with COVID-19 or FLU pneumonia admitted to the Intensive care Unit (ICU) of Policlinico Umberto I (Rome). Aims were: (1) to assess clinical features and differences of patients with COVID-19 and FLU, (2) to identify clinical and/or laboratory factors associated with FLU or COVID-19 and (3) to evaluate 30-day mortality, bacterial superinfections, thrombotic events and invasive pulmonary aspergillosis (IPA) in patients with FLU versus COVID-19. RESULTS: Overall, 74 patients were included (19, 25.7%, FLU and 55, 74.3%, COVID-19), median age 67 years (58-76). COVID-19 patients were more male (p = 0.013), with a lower percentage of COPD (Chronic Obstructive Pulmonary Disease) and chronic kidney disease (CKD) (p = 0.001 and p = 0.037, respectively) than FLU. SOFA score was higher (p = 0.020) and lymphocytes were significantly lower in FLU than in COVID-19 [395.5 vs 770.0 cells/mmc, p = 0.005]. At multivariable analysis, male sex (OR 6.1, p < 0.002), age > 65 years (OR 2.4, p = 0.024) and lymphocyte count > 725 cells/mmc at ICU admission (OR 5.1, p = 0.024) were significantly associated with COVID-19, whereas CKD and COPD were associated with FLU (OR 0.1 and OR 0.16, p = 0.020 and p < 0.001, respectively). No differences in mortality, bacterial superinfections and thrombotic events were observed, whereas IPA was mostly associated with FLU (31.5% vs 3.6%, p = 0.0029). CONCLUSIONS: In critically ill patients, male sex, age > 65 years and lymphocytes > 725 cells/mmc are related to COVID-19. FLU is associated with a significantly higher risk of IPA than COVID-19.


Assuntos
COVID-19 , Influenza Humana , Idoso , Humanos , Influenza Humana/complicações , Influenza Humana/epidemiologia , Unidades de Terapia Intensiva , Masculino , Estudos Retrospectivos , SARS-CoV-2
7.
Bioinformatics ; 35(21): 4290-4297, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30977781

RESUMO

MOTIVATION: The reconstruction of ancestral genetic sequences from the analysis of contemporaneous data is a powerful tool to improve our understanding of molecular evolution. Various statistical criteria defined in a phylogenetic framework can be used to infer nucleotide, amino-acid or codon states at internal nodes of the tree, for every position along the sequence. These criteria generally select the state that maximizes (or minimizes) a given criterion. Although it is perfectly sensible from a statistical perspective, that strategy fails to convey useful information about the level of uncertainty associated to the inference. RESULTS: The present study introduces a new criterion for ancestral sequence reconstruction, the minimum posterior expected error (MPEE), that selects a single state whenever the signal conveyed by the data is strong, and a combination of multiple states otherwise. We also assess the performance of a criterion based on the Brier scoring scheme which, like MPEE, does not rely on any tuning parameters. The precision and accuracy of several other criteria that involve arbitrarily set tuning parameters are also evaluated. Large scale simulations demonstrate the benefits of using the MPEE and Brier-based criteria with a substantial increase in the accuracy of the inference of past sequences compared to the standard approach and realistic compromises on the precision of the solutions returned. AVAILABILITY AND IMPLEMENTATION: The software package PhyML (https://github.com/stephaneguindon/phyml) provides an implementation of the Maximum A Posteriori (MAP) and MPEE criteria for reconstructing ancestral nucleotide and amino-acid sequences.


Assuntos
Análise de Sequência , Sequência de Aminoácidos , Biometria , Evolução Molecular , Funções Verossimilhança , Filogenia
8.
J Mater Sci Mater Med ; 31(8): 61, 2020 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-32696259

RESUMO

In this work, pH-sensitive hydrogel nanoparticles based on N-isopropyl acrylamide (NIPAM) and methacrylic acid (MAA) at various molar ratios, were synthesized and characterized in terms of physicochemical and biological properties. FTIR and 1HNMR spectra confirmed the successful synthesis of the copolymer that formed nanoparticles. AFM images and FE-SEM micrographs showed that nanoparticles were spherical, but their round-shape was slightly compromised with MAA content; besides, the size of particles tends to decrease as MAA content increased. The hydrogels nanoparticles also exhibited an interesting pH-sensitivity, displaying changes in its particle size when changes in pH media occurred. Biological characterization results indicate that all the synthesized particles are non-cytotoxic to endothelial cells and hemocompatible, although an increase of MAA content leads to a slight increase in the hemolysis percentage. Therefore, the pH-sensitivity hydrogels may serve as a versatile platform as self-regulated drug delivery systems in response to environmental pH changes.


Assuntos
Acrilamidas/síntese química , Hidrogéis/síntese química , Ácidos Polimetacrílicos/síntese química , Acrilamidas/química , Acrilamidas/farmacologia , Animais , Células Sanguíneas/efeitos dos fármacos , Células Sanguíneas/fisiologia , Bovinos , Células Cultivadas , Liofilização , Hemólise/efeitos dos fármacos , Humanos , Hidrogéis/química , Hidrogéis/farmacologia , Concentração de Íons de Hidrogênio , Teste de Materiais , Metacrilatos/síntese química , Metacrilatos/química , Nanopartículas/química , Tamanho da Partícula , Ácidos Polimetacrílicos/química , Ácidos Polimetacrílicos/farmacologia , Testes de Toxicidade
9.
Artigo em Inglês | MEDLINE | ID: mdl-34712102

RESUMO

The precise measurement of cosmic-ray antinuclei serves as an important means for identifying the nature of dark matter and other new astrophysical phenomena, and could be used with other cosmic-ray species to understand cosmic-ray production and propagation in the Galaxy. For instance, low-energy antideuterons would provide a "smoking gun" signature of dark matter annihilation or decay, essentially free of astrophysical background. Studies in recent years have emphasized that models for cosmic-ray antideuterons must be considered together with the abundant cosmic antiprotons and any potential observation of antihelium. Therefore, a second dedicated Antideuteron Workshop was organized at UCLA in March 2019, bringing together a community of theorists and experimentalists to review the status of current observations of cosmic-ray antinuclei, the theoretical work towards understanding these signatures, and the potential of upcoming measurements to illuminate ongoing controversies. This review aims to synthesize this recent work and present implications for the upcoming decade of antinuclei observations and searches. This includes discussion of a possible dark matter signature in the AMS-02 antiproton spectrum, the most recent limits from BESS Polar-II on the cosmic antideuteron flux, and reports of candidate antihelium events by AMS-02; recent collider and cosmic-ray measurements relevant for antinuclei production models; the state of cosmic-ray transport models in light of AMS-02 and Voyager data; and the prospects for upcoming experiments, such as GAPS. This provides a roadmap for progress on cosmic antinuclei signatures of dark matter in the coming years.

10.
Skin Res Technol ; 24(2): 187-195, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29131416

RESUMO

BACKGROUND/PURPOSE: The elimination of the pain associated with needle picking is a strong motivation for the development of clinical non-invasive diagnostic methods. Sweat has been described as an alternative biological sample that may have a direct relation to the plasma composition. MATERIALS AND METHODS: In this study, analysis of sweat of human volunteers obtained by induction with pilocarpine is compared with sweat samples obtained by physical exercise and by passive collection along 7 hours. The sweat samples have been analyzed by 1H nuclear magnetic resonance spectroscopy. RESULTS: A range of 34 different metabolites has been detected in sweat samples, including lactate, several amino acids, pyroglutamate, and urocanate. Most of the metabolites identified were quantified. The majority of the amino acids detected in sweat seem to have origin in the epidermis surface. No significant differences in sweat samples from female and male were observed by 1H NMR metabolomic analysis. CONCLUSIONS: Principal component analysis (PCA) shows that both physical exercise and pilocarpine methods seem to be equally reproducible methods in terms of sweat metabolite composition presenting better repeatability than natural sweat collection. Nevertheless, this difference is mainly originated from amino acids with origin from the skin surface.


Assuntos
Exercício Físico/fisiologia , Pilocarpina/farmacologia , Suor/química , Adulto , Feminino , Voluntários Saudáveis , Humanos , Espectroscopia de Ressonância Magnética , Masculino , Metabolômica , Reprodutibilidade dos Testes , Manejo de Espécimes , Suor/metabolismo
11.
J Antimicrob Chemother ; 72(7): 1981-1984, 2017 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-28369424

RESUMO

Objectives and methods: We evaluated the in vitro activity of different antimicrobial combinations with and without colistin against 39 carbapenem-resistant Klebsiella pneumoniae (CR-Kp) strains (colistin + meropenem/doripenem, colistin + tigecycline, colistin + rifampicin, gentamicin + meropenem, gentamicin + tigecycline and the double-carbapenem regimen meropenem + ertapenem) using the chequerboard method. The triple combination colistin + meropenem + tigecycline was also tested. In addition, killing studies were performed for meropenem + ertapenem. Results: Gentamicin-based combinations showed a high level of synergy. Meropenem + ertapenem was synergic in 12/39 (30.7%) of the strains, whereas based on killing studies 1 × MIC meropenem + 1 × MIC ertapenem and 2 × MIC meropenem + 1 × MIC ertapenem combinations were bactericidal and synergic at 24 h [mean area under the bactericidal curve (AUBC) 54.9 ±âŸ26.1 and 44.2 ±âŸ15.3 compared with 1 × MIC meropenem (134.5 ±âŸ40.1) and 2 × MIC meropenem (126.4 ±âŸ5.4), respectively, P < 0.0001]. When the results were stratified according to meropenem MIC, we found that the degree of synergy significantly increased for isolates with lower meropenem (and not ertapenem) MICs, up to an MIC of 128 mg/L. Among colistin-containing combinations, synergy was observed in 18/39 (46.1%), 33/34 (97%), 24/39 (61.5%) and 17/39 (43.5%) of the strains for colistin + meropenem, colistin + rifampicin, colistin + tigecycline and colistin + doripenem, respectively, including colistin-resistant strains. Colistin + meropenem + tigecycline at subinhibitory concentrations resulted in the absence of growth of 37/39 strains (94.8%). Conclusions: Our in vitro data suggest that colistin might be a valid therapeutic option against CR-Kp, even in the presence of colistin resistance, whereas the double-carbapenem regimen represents a viable option when colistin is not recommended, especially if the meropenem MIC is ≤ 128 mg/L. Since traditional antimicrobial susceptibility reports are not sufficiently informative for clinicians, synergy testing as well as actual meropenem MIC evaluation should always be performed in the case of CR-Kp infections.


Assuntos
Antibacterianos/farmacologia , Proteínas de Bactérias/biossíntese , Carbapenêmicos/farmacologia , Klebsiella pneumoniae/efeitos dos fármacos , Tienamicinas/farmacologia , beta-Lactamases/biossíntese , Enterobacteriáceas Resistentes a Carbapenêmicos , Colistina/farmacologia , Doripenem , Farmacorresistência Bacteriana Múltipla , Humanos , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/enzimologia , Meropeném , Testes de Sensibilidade Microbiana
12.
Clin Genet ; 92(1): 91-98, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28067412

RESUMO

Processing of Precursor 1 (POP1) is a large protein common to the ribonuclease-mitochondrial RNA processing (RNase-MRP) and RNase-P (RMRP) endoribonucleoprotein complexes. Although its precise function is unknown, it appears to participate in the assembly or stability of both complexes. Numerous RMRP mutations have been reported in individuals with cartilage-hair hypoplasia (CHH) but, to date, only three POP1 mutations have been described in two families with features similar to anauxetic dysplasia (AD). We present two further individuals, one with severe short stature and a relatively mild skeletal dysplasia and another in whom AD was suspected. Biallelic POP1 mutations were identified in both. A missense mutation and a novel single base deletion were detected in proband 1, p.[Pro582Ser]:[Glu870fs*5]. Markedly reduced abundance of RMRP and elevated levels of pre5.8s rRNA was observed. In proband 2, a homozygous novel POP1 mutation was identified, p.[(Asp511Tyr)];[(Asp511Tyr)]. These two individuals show the phenotypic extremes in the clinical presentation of POP1-dysplasias. Although CHH and other skeletal dysplasias caused by mutations in RMRP or POP1 are commonly cited as ribosomal biogenesis disorders, recent studies question this assumption. We discuss the past and present knowledge about the function of the RMRP complex in skeletal development.


Assuntos
Proteínas Reguladoras de Apoptose/genética , Nanismo/genética , Predisposição Genética para Doença , Anormalidades Musculoesqueléticas/genética , Osteocondrodisplasias/genética , Ribonucleoproteínas/genética , Criança , Pré-Escolar , Nanismo/diagnóstico por imagem , Nanismo/fisiopatologia , Feminino , Homozigoto , Humanos , Masculino , Anormalidades Musculoesqueléticas/diagnóstico por imagem , Anormalidades Musculoesqueléticas/fisiopatologia , Mutação de Sentido Incorreto/genética , Osteocondrodisplasias/diagnóstico por imagem , Osteocondrodisplasias/fisiopatologia , Fenótipo , RNA Longo não Codificante/genética
13.
Mol Pharm ; 14(6): 1980-1987, 2017 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-28441873

RESUMO

The family of concentrative Na+/nucleoside cotransporters in humans is constituted by three subtypes, namely, hCNT1, hCNT2, and hCNT3. Besides their different nucleoside selectivity, hCNT1 and hCNT2 have a Na+/nucleoside stoichiometry of 1:1, while for hCNT3 it is 2:1. This distinct stoichiometry of subtype 3 might hint the existence of a secondary sodium-binding site that is not present in the other two subtypes, but to date their three-dimensional structures remain unknown and the residues implicated in Na+ binding are unclear. In this work, we have identified and characterized the Na+ binding sites of hCNT3 by combining molecular modeling and mutagenesis studies. A model of the transporter was obtained by homology modeling, and key residues of two sodium-binding sites were identified and verified with a mutagenesis strategy. The structural model explains the altered sodium-binding properties of the hCNT3C602R polymorphic variant and supports previously generated data identifying the determinant residues of nucleoside selectivity, paving the way to understand how drugs can target this plasma membrane transporter.


Assuntos
Proteínas de Membrana Transportadoras/metabolismo , Sítios de Ligação/genética , Sítios de Ligação/fisiologia , Western Blotting , Células HEK293 , Humanos , Proteínas de Membrana Transportadoras/química , Simulação de Acoplamento Molecular , Simulação de Dinâmica Molecular , Estrutura Terciária de Proteína
15.
Radiologia ; 59(2): 115-127, 2017.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27979433

RESUMO

Acute pelvic pain is a common condition in emergency. The sources of acute pelvic pain are multifactorial, so it is important to be familiar with this type of pathologies. The purpose of this article is review the main causes of gynecological acute pelvic pain and their radiologic appearances to be able to make an accurate diagnosis and provide objective criteria for patient management.


Assuntos
Dor Aguda/diagnóstico por imagem , Doenças dos Genitais Femininos/diagnóstico por imagem , Dor Pélvica/diagnóstico por imagem , Dor Aguda/etiologia , Diagnóstico Diferencial , Emergências , Endometriose/complicações , Feminino , Doenças dos Genitais Femininos/complicações , Humanos , Cistos Ovarianos/complicações , Doença Inflamatória Pélvica/complicações , Dor Pélvica/etiologia , Gravidez , Gravidez Ectópica , Anormalidade Torcional/complicações
18.
Actas Dermosifiliogr ; 107(1): 55-61, 2016.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-26548299

RESUMO

BACKGROUND: Current guidelines call for baseline imaging only for very high-risk (T4b) primary cutaneous melanomas. OBJECTIVES: To estimate the frequency of computed tomography (CT) at baseline staging of primary cutaneous melanoma and the diagnostic yield of CT; and to describe the types and frequencies of incidentaloma findings. MATERIAL AND METHODS: Cross-sectional study of cutaneous melanoma cases (tumor classifications Tis to T4bN0M0) attended between 2008 and 2014 in a specialized melanoma unit. Reports of CT scans performed during baseline staging were reviewed to determine the frequency of positive scan results, incidentaloma findings, unit cost for detection of metastasis, and factors associated with the decision to order CT. RESULTS: CT results were available for 310 of the 419 patients included (73.99%). The tumor classifications were as follows: Tis, 17; T1, 137; T2, 71; T3, 48; and T4, 37. The CT results were negative in 81.61%, and incidentalomas were found in 18.06%. Additional primary tumors were found in 2 patients (0.64%), and metastasis was identified in one patient (0.32%). The cost of finding the case of metastasis was €71,234.90. A T2 tumor classification (odds ratio [OR], 8.73) and age under 70 years (OR, 3.53) were associated with greater likelihood of CT being ordered. Excision of the primary tumor in the melanoma unit (OR, 0.08) was associated with less likelihood of ordering CT. CONCLUSIONS: The results for this patient series support current recommendations restricting CT at baseline to cases where there is high risk of metastasis (stagesiiC-iii).


Assuntos
Melanoma/diagnóstico , Estadiamento de Neoplasias/métodos , Tomografia Computadorizada por Raios X , Custos e Análise de Custo , Estudos Transversais , Humanos , Estadiamento de Neoplasias/economia , Tomografia Computadorizada por Raios X/economia
19.
J Clin Microbiol ; 53(1): 248-54, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25392351

RESUMO

Immunoprecipitin detection (IPD) is the current reference confirmatory technique for anti-Aspergillus antibody detection; however, the lack of standardization is a critical drawback of this assay. In this study, we evaluated the performance of the Aspergillus Western blot (Asp-WB) IgG kit (LDBio Diagnostics, Lyon, France), a recently commercialized immunoblot assay for the diagnosis of various clinical presentations of chronic aspergillosis. Three hundred eight serum samples from 158 patients with aspergillosis sensu lato (s.l.) were analyzed. More specifically, 267 serum samples were derived from patients with Aspergillus disease, including 89 cases of chronic pulmonary aspergillosis, 10 of aspergilloma, and 32 of allergic bronchopulmonary aspergillosis, while 41 samples were from patients with Aspergillus colonization, including 15 cystic fibrosis (CF) and 12 non-CF patients. For blood donor controls, the Asp-WB specificity was 94%, while the kit displayed a sensitivity for the aspergillosis s.l. diagnosis of 88.6%, with a diagnostic odds ratio (DOR) of 119 (95% confidence interval [CI], 57 to 251). The DOR values were 185.22 (95% CI,78.79 to 435.45) and 43.74 (95% CI, 15.65 to 122.20) for the diagnosis of Aspergillus disease and Aspergillus colonization, respectively. Among the patients, the sensitivities of the Asp-WB in the diagnosis of Aspergillus colonization were 100% and 41.7% in CF and non-CF patients, respectively. The Asp-WB yielded fewer false-negative results than did IPD. In conclusion, the Asp-WB kit performed well for the diagnosis of various clinical presentations of aspergillosis in nonimmunocompromised patients, with an enhanced standardization and a higher sensitivity than with IPD, which is the current reference method.


Assuntos
Anticorpos Antifúngicos/imunologia , Aspergilose/diagnóstico , Aspergilose/imunologia , Aspergillus/imunologia , Imunoglobulina G/imunologia , Kit de Reagentes para Diagnóstico , Western Blotting , Estudos de Casos e Controles , Doença Crônica , Humanos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
20.
Int J Legal Med ; 129(1): 1-10, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24832006

RESUMO

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare cardiac disease characterized by myocardial fibrofatty replacement, which can lead to sudden death. Previous studies have described a reduction of plakoglobin (PKG) protein at the level of intercalated disks as the hallmark of ARVC. The main objective of this study was to investigate the involvement of desmosome mutations in the histological phenotype of ARVC. We performed a genetic analysis of ARVC cases, and histological characterization of ARVC heart tissue samples. We genetically analyzed 48 ARVC cases distributed into two groups: 42 human tissue heart samples with conclusive diagnoses of ARVC after post-mortem examination; and six DNA samples from peripheral blood of living patients who were clinically diagnosed. Sequenom MassARRAY analysis revealed three ARVC-associated variants in three patients in 42 tissue samples (7.14 %). Three individuals carried one single pathogenic mutation, p.R811S _PKP2, p.S824L_DSC2, and p.T526M_PKP2 in postmortem samples. In the living patients group, Sequenom MassARRAY revealed no mutation, however, later Sanger sequencing analysis identified three ARVC mutations in 2/6 patients not included in the Sequenom design. In post-mortem tissue samples we performed immunohistochemical labeling for desmosomal proteins and Connexin 43. This study revealed that PKP2 carriers present either absent or clearly reduced PKG immunolabeling, while the DSC2 carrier showed PKG immunolabeling similar to control samples. Immunolabeling for Cx43 did not show any differences compared to controls. The present Sequenom MassARRAY design is a useful tool for post-mortem genetic diagnosis of ARVC. Plakoglobin reduction occurs at intercalated disks, while other desmosome proteins and Cx43 remain unaltered.


Assuntos
Displasia Arritmogênica Ventricular Direita/genética , Displasia Arritmogênica Ventricular Direita/patologia , Análise Mutacional de DNA , Desmossomos/genética , Miocárdio/patologia , Análise de Sequência com Séries de Oligonucleotídeos/métodos , Adulto , Conexina 43/genética , Feminino , Genética Forense , Patologia Legal , Heterozigoto , Humanos , Imuno-Histoquímica , Masculino , Mutação , Placofilinas/genética
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