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1.
Nature ; 531(7595): 466-70, 2016 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-26982729

RESUMO

Microbial viruses can control host abundances via density-dependent lytic predator-prey dynamics. Less clear is how temperate viruses, which coexist and replicate with their host, influence microbial communities. Here we show that virus-like particles are relatively less abundant at high host densities. This suggests suppressed lysis where established models predict lytic dynamics are favoured. Meta-analysis of published viral and microbial densities showed that this trend was widespread in diverse ecosystems ranging from soil to freshwater to human lungs. Experimental manipulations showed viral densities more consistent with temperate than lytic life cycles at increasing microbial abundance. An analysis of 24 coral reef viromes showed a relative increase in the abundance of hallmark genes encoded by temperate viruses with increased microbial abundance. Based on these four lines of evidence, we propose the Piggyback-the-Winner model wherein temperate dynamics become increasingly important in ecosystems with high microbial densities; thus 'more microbes, fewer viruses'.


Assuntos
Antozoários/virologia , Ecossistema , Interações Hospedeiro-Patógeno , Vírus/patogenicidade , Animais , Antozoários/fisiologia , Bacteriófagos/patogenicidade , Bacteriófagos/fisiologia , Recifes de Corais , Genes Virais/genética , Lisogenia , Modelos Biológicos , Virulência/genética , Vírus/genética , Vírus/isolamento & purificação
2.
Geophys Res Lett ; 47(1): e2019GL085776, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-32713973

RESUMO

We investigate the launch of negative upward streamers from sprite glows. This phenomenon is readily observed in high-speed observations of sprites and underlies the classification of sprites into carrot or column types. First, we describe how an attachment instability leads to a sharply defined region in the upper part of the streamer channel. This region has an enhanced electric field, low conductivity and strongly emits in the first positive system of molecular nitrogen. We identify it as the sprite glow. We then show how, in the most common configuration of a carrot sprite, several upward streamers emerge close to the lower boundary of the glow, where negative charge gets trapped and the lateral electric field is high enough. These streamers cut off the current flowing toward the glow and lead to the optical deactivation of the glow above. Finally, we discuss how our results naturally explain angel sprites.

3.
Geophys Res Lett ; 47(15): e2020GL088755, 2020 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-32999518

RESUMO

Submicrosecond (0.476 µs per frame with an exposure time of 160 ns) high-resolution (0.38 nm) time-resolved spectra of laboratory-produced lightning-like electrical discharges have been recorded for the first time within the visible spectral range (645-665 nm). The spectra were recorded with the GrAnada LIghtning Ultrafast Spectrograph (GALIUS), a high-speed imaging spectrograph recently developed for lightning research in the IAA-CSIC. Unprecedented spectral time dynamics are explored for meter long laboratory electrical discharges produced with a 2.0 MV Marx generator. The maximum electron density and gas temperature measured in a timescale of ≤0.50 µs (160 ns) were, respectively, ≃1018 cm-3 and ≃32,000 K. Overpressure in the lightning-like plasma channel, black-body dynamics, and self-absorption in spectral lines were investigated.

4.
J Eur Acad Dermatol Venereol ; 34(10): 2414-2427, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32173915

RESUMO

BACKGROUND: There is not an ideal biomaterial for tissue-engineered skin substitutes (TESSs), and most of the studies or existing therapies use xenogeneic origin natural biomaterials or biosynthetic scaffolds. OBJECTIVE: To analyse clinical, histological integration and homeostasis parameters of a human TESS manufactured with fibrin-hyaluronic acid biomaterial (HA-Skin), grafted in immunodeficient mice for 8 weeks, and compared with the gold standard treatment (Autograft), a human TESS manufactured with fibrin-agarose biomaterial (AG-Skin) and secondary wound healing dressings. METHODS: Human TESSs and autografts were implanted into BALB/c mice after surgical excision. Secondary wound healing approach was achieved with biosynthetic collagen wound dressing (Biobrane® ) and fibrin-hyaluronic acid or fibrin-agarose biomaterial without cells (Total N = 44). Clinical integration and homeostasis parameters were evaluated every two weeks for two months. Histological and immunohistochemical analyses were performed four and eight weeks after grafting. RESULTS: HA-Skin, AG-Skin and Autograft groups showed a proper clinical integration and epithelization eight weeks later. Scar evaluation revealed better results for Autograft and HA-Skin. Homeostasis analysis indicated similar values of transepidermal water loss and elasticity between HA-Skin (6.42 ± 0.75 g/h/m2 , 0.42 ± 0.08 AU), Autograft (6.91 ± 1.28 g/h/m2 , 0.40 ± 0.08 AU) and healthy mouse skin (6.40 ± 0.43 g/h/m2 , 0.35 ± 0.03 AU). Histological results showed that human TESSs and autografts presented better skin structuration and higher expression of cytokeratins. CONCLUSIONS: This study suggests that human TESS based on fibrin-hyaluronic acid biomaterial could be suitable for clinical application in the treatment of several dermatological pathologies (wound healing).


Assuntos
Pele Artificial , Animais , Bandagens , Humanos , Ácido Hialurônico , Camundongos , Camundongos Endogâmicos BALB C , Cicatrização
5.
Acta Psychiatr Scand ; 140(6): 541-551, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31566713

RESUMO

AIMS: To study the temporal dynamics of depression symptom episodes in old-age and the related influence of risk factors. METHODS: Data from 41 362 old adults (54.61% women; mean age = 75.30, SD = 6.20) from the Ageing Trajectories of Health - Longitudinal Opportunities and Synergies (ATHLOS) project were used. Depressive symptoms were followed over an 18-year period. A multi-state model, comprising three statuses (no depression, new clinically relevant episode of symptoms and episode persistence), was fitted. Multinomial regression was used to study the role of risk factors in status transition. RESULTS: Almost 85% of participants showed no depression, but prevalence became lower over time (B = -0.25, P < 0.001). New episode point prevalence was over 5.30% with a significant probability of moving to persistence status (transition probability = 0.27). Episode persistence became evident in 9.86% of episode status transitions, with increasing rate over time (B = 0.54, P < 0.01). Loneliness was proven to be the strongest predictor of episode emergence (OR = 17.76) and persistence (OR = 5.93). CONCLUSIONS: The course of depression tends to become chronic and unremitting in old-age. This study may help to plan interventions to tackle symptom escalation and risk factor influence.


Assuntos
Envelhecimento/fisiologia , Depressão/fisiopatologia , Progressão da Doença , Solidão , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estudos Longitudinais , Masculino , Fatores de Risco
6.
Geophys Res Lett ; 46(7): 4029-4038, 2019 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-31244497

RESUMO

We investigate the emergence of space stems ahead of negative leaders. These are luminous spots that appear ahead of an advancing leader mediating the leader's stepped propagation. We show that space stems start as regions of locally depleted conductivity that form in the streamers of the corona around the leader. An attachment instability enhances the electric field leading to strongly inhomogeneous, bright, and locally warmer regions ahead of the leader that explain the existing observations. Since the attachment instability is only triggered by fields above 10 kV/cm and internal electric fields are lower in positive than in negative streamers, our results explain why, although common in negative leaders, space stems, and stepping are hardly observed if not absent in positive leaders. Further work is required to fully explain the streamer to leader transition, which requires an electric current persisting for timescales longer than the typical attachment time of electrons, around 100 ns.

7.
BMC Anesthesiol ; 19(1): 212, 2019 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-31735161

RESUMO

BACKGROUND: Some studies have been performed to assess the effects of levosimendan on cardiac function when administered to cardiac surgery patients with low cardiac output syndrome (LCOS) in the immediate postoperative period. Levosimendan is an inotropic agent for the treatment of low cardiac output syndrome that seems to have a protective effect on renal function. METHODS: It is a quasi-experimental study. A total of 100 patients with LCOS received either beta-agonists or levosimendan. We assessed the incidence of postoperative kidney failure in cardiac surgery patients. In patients who had kidney failure at diagnosis of LCOS, we examined whether differences existed in the evolution of kidney failure based on the treatment administered for LCOS. The parameters measured included haemodynamics, oxygen supply, and renal function as assessed by the AKI scale. ANOVA, Student's t-test and Wilcoxon or Friedman tests were used. RESULTS: Up to 30% of cardiac surgery patients had kidney failure at diagnosis of LCOS. Kidney failure at discharge from the ICU was more frequent in patients who received beta-agonist drugs as compared to those who received levosimendan (p < 0.05). CONCLUSION: The incidence of kidney failure decreased with the postoperative administration of levosimendan to cardiac surgery patients with LCOS, as compared to beta-agonists. TRIAL REGISTRATION: Current Controlled Trials ISRCTN 46058317. Date of registration: 7/10/2019. Retrospectively registered.


Assuntos
Agonistas Adrenérgicos beta/administração & dosagem , Baixo Débito Cardíaco/tratamento farmacológico , Procedimentos Cirúrgicos Cardíacos/métodos , Cardiotônicos/administração & dosagem , Simendana/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Baixo Débito Cardíaco/fisiopatologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Insuficiência Renal/epidemiologia , Insuficiência Renal/prevenção & controle
9.
Int J Obes (Lond) ; 39(5): 828-33, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25311083

RESUMO

BACKGROUND/OBJECTIVES: Timing of food intake associates with body weight regulation, insulin sensitivity and glucose tolerance. However, the mechanism is unknown. The aim of this study was to investigate the effects of changes in meal timing on energy-expenditure, glucose-tolerance and circadian-related variables. SUBJECTS/METHODS: Thirty-two women (aged 24±4 years and body mass index 22.9±2.6 kg m(-2)) completed two randomized, crossover protocols: one protocol (P1) including assessment of resting-energy expenditure (indirect-calorimetry) and glucose tolerance (mixed-meal test) (n=10), the other (P2) including circadian-related measurements based on profiles in salivary cortisol and wrist temperature (Twrist) (n=22). In each protocol, participants were provided with standardized meals (breakfast, lunch and dinner) during the two meal intervention weeks and were studied under two lunch-eating conditions: Early Eating (EE; lunch at 13:00) and Late Eating (LE; lunch 16:30). RESULTS: LE, as compared with EE, resulted in decreased pre-meal resting-energy expenditure (P=0.048), a lower pre-meal protein-corrected respiratory quotient (CRQ) and a changed post-meal profile of CRQ (P=0.019). These changes reflected a significantly lower pre-meal utilization of carbohydrates in LE versus EE (P=0.006). LE also increased glucose area under curve above baseline by 46%, demonstrating decreased glucose tolerance (P=0.002). Changes in the daily profile of cortisol and Twrist were also found with LE blunting the cortisol profile, with lower morning and afternoon values, and suppressing the postprandial Twrist peak (P<0.05). CONCLUSIONS: Eating late is associated with decreased resting-energy expenditure, decreased fasting carbohydrate oxidation, decreased glucose tolerance, blunted daily profile in free cortisol concentrations and decreased thermal effect of food on Twrist. These results may be implicated in the differential effects of meal timing on metabolic health.


Assuntos
Metabolismo Basal , Glicemia/metabolismo , Carboidratos da Dieta/metabolismo , Ingestão de Energia , Refeições , Adulto , Área Sob a Curva , Índice de Massa Corporal , Calorimetria Indireta/métodos , Estudos Cross-Over , Metabolismo Energético , Jejum , Feminino , Humanos , Hidrocortisona/metabolismo , Fenômenos Fisiológicos da Nutrição , Oxirredução , Período Pós-Prandial , Saliva/metabolismo
10.
Phys Rev Lett ; 114(15): 157701, 2015 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-25933339

RESUMO

We report, for the first time, about an intermediate band solar cell implemented with InAs/AlGaAs quantum dots whose photoresponse expands from 250 to ∼6000 nm. To our knowledge, this is the broadest quantum efficiency reported to date for a solar cell and demonstrates that the intermediate band solar cell is capable of producing photocurrent when illuminated with photons whose energy equals the energy of the lowest band gap. We show experimental evidence indicating that this result is in agreement with the theory of the intermediate band solar cell, according to which the generation recombination between the intermediate band and the valence band makes this photocurrent detectable.

11.
Med Intensiva ; 39(9): 552-62, 2015 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-26183121

RESUMO

In recent years, several safety alerts have questioned or restricted the use of some pharmacological alternatives to allogeneic blood transfusion in established indications. In contrast, there seems to be a promotion of other alternatives, based on blood products and/or antifibrinolytic drugs, which lack a solid scientific basis. The Multidisciplinary Autotransfusion Study Group and the Anemia Working Group España convened a multidisciplinary panel of 23 experts belonging to different healthcare areas in a forum for debate to: 1) analyze the different safety alerts referred to certain transfusion alternatives; 2) study the background leading to such alternatives, the evidence supporting them, and their consequences for everyday clinical practice, and 3) issue a weighted statement on the safety of each questioned transfusion alternative, according to its clinical use. The members of the forum maintained telematics contact for the exchange of information and the distribution of tasks, and a joint meeting was held where the conclusions on each of the items examined were presented and discussed. A first version of the document was drafted, and subjected to 4 rounds of review and updating until consensus was reached (unanimously in most cases). We present the final version of the document, approved by all panel members, and hope it will be useful for our colleagues.


Assuntos
Anemia/terapia , Estado Terminal/terapia , Hemorragia/terapia , Anemia/tratamento farmacológico , Antifibrinolíticos/efeitos adversos , Antifibrinolíticos/uso terapêutico , Aprotinina/efeitos adversos , Aprotinina/uso terapêutico , Fatores de Coagulação Sanguínea/efeitos adversos , Fatores de Coagulação Sanguínea/uso terapêutico , Transfusão de Sangue/normas , Ensaios Clínicos como Assunto , Soluções Cristaloides , Eritropoetina/efeitos adversos , Eritropoetina/uso terapêutico , Hematínicos/efeitos adversos , Hematínicos/uso terapêutico , Humanos , Derivados de Hidroxietil Amido/efeitos adversos , Derivados de Hidroxietil Amido/uso terapêutico , Ferro/efeitos adversos , Ferro/uso terapêutico , Soluções Isotônicas/efeitos adversos , Soluções Isotônicas/uso terapêutico , Metanálise como Assunto , Estudos Observacionais como Assunto , Substitutos do Plasma/efeitos adversos , Substitutos do Plasma/uso terapêutico , Proteínas Recombinantes/efeitos adversos , Proteínas Recombinantes/uso terapêutico , Ácido Tranexâmico/efeitos adversos , Ácido Tranexâmico/uso terapêutico , Reação Transfusional
12.
Phys Rev Lett ; 112(4): 045003, 2014 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-24580462

RESUMO

We investigate the first example of self-consistent impact ionization fronts propagating at relativistic speeds and involving interacting, high-energy electrons. These fronts, which we name relativistic runaway ionization fronts, show remarkable features such as a bulk speed within less than one percent of the speed of light and the stochastic selection of high-energy electrons for further acceleration, which leads to a power-law distribution of particle energies. A simplified model explains this selection in terms of the overrun of Coulomb-scattered electrons. Appearing as the electromagnetic interaction between electrons saturates the exponential growth of a relativistic runaway electron avalanche, relativistic runaway ionization fronts may occur in conjunction with terrestrial gamma-ray flashes and thus explain recent observations of long, power-law tails in the terrestrial gamma-ray flash energy spectrum.

13.
Clin Exp Rheumatol ; 32(6 Suppl 86): S-177-82, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25372801

RESUMO

OBJECTIVES: To date, the diagnostic utility of anti-SSA/Ro52 autoantibodies in scleroderma and the association of them with certain clinical manifestations, particularly inflammatory myositis, are still controversial. This paper aims to assess the correlation between the presence of anti-SSA/Ro52 antibodies and the demographic, clinical and prognosis characteristics of patients with systemic sclerosis (SSc). METHODS: This is a retrospective, cross-sectional and observational study in patients with SSc. Baseline demographic and clinical characteristics were recorded. Presence of anti-SSA/Ro52, anti-SSA/Ro, anti-SSB/La, snRNP/Sm, anti-centromere, anti-Scl-70 and anti-PM-Scl were analysed by immunoblot, and antinuclear antibodies (ANA) by indirect immunofluorescence. Statistical analysis was performed with PASW Statics 18 software. RESULTS: A total of 132 consecutive patients with analysis of anti-SSA/Ro52 antibodies were selected from a Spanish cohort of 408 patients with SSc, 87.1% of them being women. About half of patients had the limited form (51.5%), followed by diffused form (18.9%), sclerosis sine scleroderma (22.7%), and pre-scleroderma (6.8%). Prevalence of anti-SSA/Ro52 was 35.6%. No association between anti-SSA/Ro52 and clinical manifestations was found, while detection of anti-SSA/Ro52 was significantly associated with the presence of anti-Ro. CONCLUSIONS: The results of our study show that anti-SSA/Ro52 antibodies are often found in SSc patients. No clinical manifestations, including inflammatory myopathy, were related with anti-SSA/Ro antibodies.


Assuntos
Anticorpos Antinucleares/imunologia , Escleroderma Sistêmico/imunologia , Adulto , Idoso , Autoanticorpos/imunologia , Estudos Transversais , DNA Topoisomerases Tipo I , Exorribonucleases/imunologia , Complexo Multienzimático de Ribonucleases do Exossomo/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Proteínas Nucleares/imunologia , Estudos Retrospectivos , Ribonucleoproteínas/imunologia , Ribonucleoproteínas Nucleares Pequenas/imunologia , Espanha
14.
Can J Microbiol ; 60(2): 73-84, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24498984

RESUMO

The aim of this study was to investigate the influence of agricultural intensification on soil microbial diversity, chemical and physical parameters, and the decrease of the incidence of sudden death syndrome (Fusarium crassistipitatum) and charcoal rot (Macrophomina phaseolina) in soybean. Soils under different management systems were evaluated during 2 crop cycles: soybean monoculture for 24 and 11 years, soybean-maize rotation for 15 and 4 years, 1 year of soybean, and native vegetation. The incidence of both soil-borne diseases was higher under monoculture than under rotation. Increased populations of potential biocontrol agents (Trichoderma spp., Gliocladium spp., fluorescent pseudomonads) were associated with rotation treatments, especially in 2010-2011. The comparison of agricultural vs. native vegetation soil and the average of agricultural cycles showed that microbial biomass carbon and glomalin-related soil protein were higher in the rotation system than in monoculture (50% and 77%, respectively). Furthermore, from the community-level functional diversity (Biolog Eco plates), McIntosh index showed lower functional diversity in monoculture than in rotation and native vegetation plots. Agricultural intensification reduced microbial biomass carbon, glomalin-related soil protein, organic matter, total nitrogen, aggregate stability, and yield, and increased bulk density. Soil quality degradation was associated with the establishment of soil-borne pathogens and increased soybean plant susceptibility to disease.


Assuntos
Agricultura , Ascomicetos/fisiologia , Fusarium/fisiologia , Glycine max/fisiologia , Microbiologia do Solo , Biodiversidade , Biomassa , Carbono/análise , Nitrogênio/análise , Solo/química , Glycine max/microbiologia , Zea mays/fisiologia
15.
Plant Dis ; 98(2): 277, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30708740

RESUMO

The fungus Ramularia collo-cygni B. Sutton & J. M. Waller (Rcc) was identified as the causal agent of this emerging disease on barley (Hordeum vulgare L.) based on symptoms and signs on leaves and attributes of the fungus. The common name given to the disease was "necrotic sprinkling." This disease was found for the first time on barley in fields of Buenos Aires Province, Argentina, in 2001, with severities ranging from 60 to 100% (2). During the spring of 2012, the disease spread throughout most barley growing areas of the Pampean region, affecting almost all varieties of barley in the Buenos Aires, Entre Ríos, and Santa Fe provinces. The disease showed typical symptoms of small, brown spots on leaves, sheaths, and awns, and caused rapid loss of green leaf area and significant economic damage. The diagnosis of this disease is difficult by conventional techniques and has caused some confusion. In order to obtain appropriate information about the incidence of this pathogen in the most important barley growing region of Argentina, as well as to confirm its presence on seed, 39 seed samples containing 200 seeds each and eight leaf samples were analyzed using a real-time PCR diagnostic test (4). Thirty-five of the 37 seed samples had Rcc DNA levels above the minimum detection level (0.13 pg DNA). Ramularia has been described as a seedborne fungus previously (1) and seed infection could hasten the spread of the fungus to new geographically distinct areas. Moreover, leaf samples were microscopically assessed for conidophore presence and then ground for DNA extraction. Rcc DNA was detected by PCR in all eight leaf samples. To our knowledge, this is the first report about molecular detection of R. collo-cygni in barley seed of harvested samples from Argentina. Seeds infected/infested may also lead to new strains of the fungus arriving in barley fields and provide a source of inoculum for future epidemics (3). References: (1) N. D. Havis et al. FEMS Microbiol. Lett. 256:217, 2006. (2) M. Khier et al. Salpicado necrótico, nueva enfermedad de la cebada en Argentina causada por Ramularia collo-cygni. Page 47 in: Resúmenes XI Jornadas Fitosanitarias Argentinas, 26-29 June 2002, Río Cuarto, Córdoba, 2002. (3) P. Matusinsky et al. J. Plant Pathol. 3:679, 2011. (4) J. M. G. Taylor et al. Lett. Appl. Microbiol. 50:493, 2010.

16.
Rev Esp Anestesiol Reanim (Engl Ed) ; 71(1): 34-47, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37678450

RESUMO

Recent publications have questioned the efficacy of using therapeutic or intermediate doses of low molecular weight heparin (LMWH) in COVID-19 patients, especially in the most severe patients. In order to update these recommendations, a non-systematic review has been carried out in the main medical databases. A total of 14 randomized clinical trials, 14 meta-analyses and the recommendations of 12 scientific societies were selected, stratified according to the type of patient (outpatient, hospitalized, admitted to critical care or post-discharge). The efficacy of LMWH and other therapeutic approaches (rivaroxaban, apixaban, sulodexide, acetylsalicylic acid and P2Y12 inhibitors) has been analyzed. The findings recommend using standard doses of LMWH as thromboprophylaxis in critically hospitalized COVID-19 patients and therapeutic doses in non-critically hospitalized patients if the risk of bleeding is low. In outpatients and those discharged from the hospital, LMWH could be used at a prophylactic dose if there are thrombotic risk factors, and the bleeding risk is low. It is not recommended to associate antiplatelet agents with LMWH unless previously indicated.


Assuntos
COVID-19 , Tromboembolia Venosa , Humanos , Heparina de Baixo Peso Molecular/uso terapêutico , Anticoagulantes/uso terapêutico , COVID-19/complicações , Assistência ao Convalescente , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/prevenção & controle , Tromboembolia Venosa/tratamento farmacológico , Alta do Paciente
17.
Neurologia (Engl Ed) ; 39(2): 196-208, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38237804

RESUMO

The last consensus statement of the Spanish Society of Neurology's Demyelinating Diseases Study Group on the treatment of multiple sclerosis (MS) was issued in 2016. Although many of the positions taken remain valid, there have been significant changes in the management and treatment of MS, both due to the approval of new drugs with different action mechanisms and due to the evolution of previously fixed concepts. This has enabled new approaches to specific situations such as pregnancy and vaccination, and the inclusion of new variables in clinical decision-making, such as the early use of high-efficacy disease-modifying therapies (DMT), consideration of the patient's perspective, and the use of such novel technologies as remote monitoring. In the light of these changes, this updated consensus statement, developed according to the Delphi method, seeks to reflect the new paradigm in the management of patients with MS, based on the available scientific evidence and the clinical expertise of the participants. The most significant recommendations are that immunomodulatory DMT be started in patients with radiologically isolated syndrome with persistent radiological activity, that patient perspectives be considered, and that the term "lines of therapy" no longer be used in the classification of DMTs (> 90% consensus). Following diagnosis of MS, the first DMT should be selected according to the presence/absence of factors of poor prognosis (whether epidemiological, clinical, radiological, or biomarkers) for the occurrence of new relapses or progression of disability; high-efficacy DMTs may be considered from disease onset.


Assuntos
Esclerose Múltipla , Neurologia , Humanos , Esclerose Múltipla/tratamento farmacológico , Sociedades , Consenso
18.
J Psychiatr Res ; 170: 200-206, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38157667

RESUMO

INTRODUCTION: This study aims to enhance the understanding of the association between the phenotypic and endophenotypic characteristics of impulsive-aggressive disorders, through the study of plasma oxytocin (OXT) and oxytocin receptor (OXTR) levels in patients with borderline personality disorder (BPD) and patients with eating disorders (ED), as well as to examine the relationship of OXT system with aggressive behavior in these disorders. METHODS: 68 patients with BPD, 67 patients with ED and 57 healthy control subjects were examined for plasma oxytocin levels and protein expression of OXTR in blood mononuclear cells. Aggressive behavior was assessed using the State-Trait Anger Expression Inventory (STAXI-2). Other self and hetero-aggressive behaviors were also evaluated through interviews. RESULTS: BPD and ED patients exhibited significantly lower plasma oxytocin levels than control subjects. Furthermore, BPD patients demonstrated significantly reduced expression of OXTR compared to controls. Plasma oxytocin levels negatively correlated with verbal aggression, while OXTR expression was inversely associated with the STAXI trait subscale. CONCLUSIONS: The findings validate the existence of oxytocin system dysfunction in impulsive-aggressive disorders. They also support the link between low OXT levels in plasma and OXTR expression and the impulsive-aggressive behavior that characterizes these patients in both state and trait situations.


Assuntos
Ocitocina , Receptores de Ocitocina , Humanos , Agressão/fisiologia , Expressão Gênica , Fenótipo , Receptores de Ocitocina/genética
19.
Artigo em Inglês | MEDLINE | ID: mdl-38151169

RESUMO

INTRODUCTION: Alterations in inflammatory processes have previously been reported in impulsive and unstable disorders, as well as in other psychiatric conditions. In order to investigate transdiagnostic biomarkers associated with various phenotypic features of these disorders, this study is designed to identify biomarkers of inflammatory and oxidative endophenotypes related to autolytic behavior. METHODS: Peripheral blood mononuclear cells were collected from 35 patients with borderline personality disorder (BPD), 29 patients with restrictive eating disorder (rED), 21 patients with purging eating disorder (pED) and 23 control subjects. Plasma levels of different inflammatory and oxidative factors were measured by ELISA and the expression of selected proteins was by Western Blot. Principal component analysis (PCA) was performed to categorize the different inflammatory factors. Additionally, Ancova was performed to observe the differences in the principal components among the different groups and logistic regression analysis was conducted to assess the predictive capacity of these components for autolytic behaviors. RESULTS: We found two inflammatory/oxidative components were associated with BPD, characterized by high levels of JNK and ERK and low levels of GPx, SOD and Keap1; and two other inflammatory/oxidative components were linked to pED, associated with more JNK, TBARS and TNF-α and less GPx and SOD. Two components, with more JNK and ERK and less GPx, SOD and Keap1, predicted non-suicidal self-injury and three components, with higher JNK, TBARS and TNF-α levels and lower GPx, SOD and iNOS levels, predicted suicide attempts. CONCLUSIONS: These results strongly support the endophenotypic characterization of impulsivity and the identification of transdiagnostic inflammatory/oxidative biomarkers relevant to autolytic behavior in impulsive and unstable disorders. These dates lay the groundwork for developing of screening tests for these biomarker components to rapidly detect biological risk factors for specific impulse control disorders and future self-injurious behaviors.


Assuntos
Transtorno da Personalidade Borderline , Comportamento Autodestrutivo , Humanos , Proteína 1 Associada a ECH Semelhante a Kelch/metabolismo , Leucócitos Mononucleares/metabolismo , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Fator 2 Relacionado a NF-E2/metabolismo , Comportamento Autodestrutivo/diagnóstico , Comportamento Impulsivo , Transtorno da Personalidade Borderline/psicologia , Biomarcadores/metabolismo , Estresse Oxidativo , Superóxido Dismutase/metabolismo
20.
J Psychiatr Res ; 171: 30-37, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38241967

RESUMO

BACKGROUND: Childhood trauma is intimately related with suicidal behaviour. Patients who have suffered childhood trauma develop impaired Reflective Functioning (RF), which refers to the capacity to understand ourselves and others in terms of intentional mental states. An improvement in RF has been associated with a reduction in suicidal attempts, but the mediating role of RF between childhood trauma and suicidal behaviour has not been addressed so far. OBJECTIVE: We aim to examine the potential mediating effect of RF among childhood trauma and suicide attempts. METHOD: We included 748 patients who had attempted suicide at least once. They were asked to complete the Reflective Functioning Questionnaire (RFQ-8), the Columbia-Suicide Severity Rating scale (CSSRS), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We conducted linear regressions by simple mediating model to examine the role of RF in the indirect association between childhood trauma and the number of suicide attempts. RESULTS: Our results show significant indirect effects through hypo and hypermentalizing between Emotional Abuse (EA) and Sexual Abuse (SA) in childhood and the number of suicide attempts in lifetime. These results indicate that ineffective RF significantly mediates the association between childhood trauma and suicidality. CONCLUSION: This is the first study supporting the mediational role of RF in the relationship between EA and SA, and the number of suicide attempt in lifetime. These findings have important implications for reducing suicide rates and preventing future re-attempts. Further studies analysing this mediating role and focusing efforts on increasing RF-based interventions are required.


Assuntos
Experiências Adversas da Infância , Testes Psicológicos , Tentativa de Suicídio , Humanos , Autorrelato , Ideação Suicida , Fatores de Risco
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