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1.
Amino Acids ; 56(1): 1, 2024 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-38285098

RESUMO

Breast cancer remains a pressing public health issue primarily affecting women. Recent research has spotlighted bioactive peptides derived from laminin-111, implicated in breast tumor development. Remarkably, the sequences IKVAV, YIGSR, and KAFDITYVRLKF from the α1, ß1, and γ1 chains, respectively, have garnered significant attention. This study aims to assess the potential of these radiolabeled peptides as targeting agents for breast cancer. The three peptides were synthesized using the Fmoc strategy, purified via reversed-phase high-performance liquid chromatography (RP-HPLC), and characterized through mass spectrometry. Iodine-131 (131I) radiolabeling was performed using the chloramine T method, exhibiting high radiochemical yield and stability for [131I]I-YIKVAV and [131I]I-YIGSR. Conversely, [131I]I-KAFDITYVRLKF demonstrated low radiochemical yield and stability and was excluded from the biological studies. The lipophilicity of the compounds ranged from - 2.12 to - 1.10. Serum protein binding assay for [131I]I-YIKVAV and [131I]I-YIGSR reached ≅ 48% and ≅ 25%, respectively. Affinity for breast cancer cells was evaluated using MDA-MB-231 and MCF-7 tumor cell lines, indicating the affinity of the radiopeptides with these tumor cells. Ex vivo biodistribution profiles of the radiopeptides were assessed in the MDA-MB-231 breast tumor animal model, revealing tumor tissue accumulation, supported by a high tumor-to-contralateral muscle ratio and autoradiography. These results signify the effective penetration of YIKVAV and YIGSR into tumor tissue. Therefore, the synthesized α1 and ß1 peptide fragments exhibit favorable characteristics as potential breast cancer-targeting agents, promising future exploration as radiopharmaceuticals for breast cancer.


Assuntos
Neoplasias da Mama , Animais , Feminino , Humanos , Neoplasias da Mama/tratamento farmacológico , Estudos Prospectivos , Distribuição Tecidual , Peptídeos/farmacologia , Laminina
2.
J Periodontal Res ; 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38757372

RESUMO

AIM: Evidence suggests that translocation of oral pathogens through the oral-gut axis may induce intestinal dysbiosis. This study aimed to evaluate the impact of a highly leukotoxic Aggregatibacter actinomycetemcomitans (Aa) strain on the gut microbiota, intestinal mucosal integrity and immune system in healthy mice. METHODS: Eight-week-old male C57BL6 mice were divided into control (n = 16) and JP2 groups (n = 19), which received intragastric gavage with PBS and with a suspension of Aa JP2 (HK921), respectively, twice a week for 4 weeks. Colonic lamina propria, fecal material, serum, gingival tissues, and mandibles were obtained for analyses of leukocyte populations, inflammatory mediators, mucosal integrity, alveolar bone loss, and gut microbiota. Differences between groups for these parameters were examined by non-parametric tests. RESULTS: The gut microbial richness and the number of colonic macrophages, neutrophils, and monocytes were significantly lower in Aa JP2-infected mice than in controls (p < .05). In contrast, infected animals showed higher abundance of Clostridiaceae, Lactobacillus taiwanensis, Helicobacter rodentium, higher levels of IL-6 expression in colonic tissues, and higher splenic MPO activity than controls (p < .05). No differences in tight junction expression, serum endotoxin levels, and colonic inflammatory cytokines were observed between groups. Infected animals presented also slightly more alveolar bone loss and gingival IL-6 levels than controls (p < .05). CONCLUSION: Based on this model, intragastric administration of Aa JP2 is associated with changes in the gut ecosystem of healthy hosts, characterized by less live/recruited myeloid cells, enrichment of the gut microbiota with pathobionts and decrease in commensals. Negligible levels of colonic pro-inflammatory cytokines, and no signs of mucosal barrier disruption were related to these changes.

3.
Breast Cancer Res ; 25(1): 78, 2023 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-37386484

RESUMO

BACKGROUND: New drugs for locally advanced or metastatic breast cancer have led to clinical benefits, aside with increasing costs to healthcare systems. The current financing model for health technology assessment (HTA) privileges real-world data. As part of the ongoing HTA, this study aimed to evaluate the effectiveness of palbociclib with aromatase inhibitors (AI) and compare it with the efficacy reported in PALOMA-2. METHODS: A population-based retrospective exposure cohort study was conducted including all patients initiating treatment in Portugal with palbociclib under early access use and registered in the National Oncology Registry. The primary outcome was progression free survival (PFS). Secondary outcomes considered included time to palbociclib failure (TPF), overall survival (OS), time to next treatment (TTNT), and proportion of patients discontinuing treatment due to  adverse events (AEs). The Kaplan-Meier method was used and median, 1- and 2-year survival rates were computed, with two-sided 95% confidence intervals (95%CI). STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines for reporting observational studies were used. RESULTS: There were 131 patients included. Median follow-up was 28.3 months (IQR: 22.7-35.2) and median duration of treatment was 17.5 months (IQR: 7.8-29.1). Median PFS was 19.5 months (95%CI 14.2-24.2), corresponding to a 1-year PFS rate of 67.9% (95%CI 59.2-75.2) and a 2-year PFS rate of 42.0% (95%CI 33.5-50.3). Sensitivity analysis showed median PFS would increase slightly when excluding those not initiating treatment with the recommended dose, raising to 19.8 months (95%CI 14.4-28.9). By considering only patients meeting PALOMA-2 criteria, we could observe a major difference in treatment outcomes, with a mean PFS of 28.8 months (95%CI 19.4-36.0). TPF was 19.8 months (95%CI 14.2-24.9). Median OS was not reached. Median TTNT was 22.5 months (95%CI 18.0-29.8). A total of 14 patients discontinued palbociclib because of AEs (10.7%). CONCLUSIONS: Data suggest palbociclib with AI to have an effectiveness of 28.8 months, when used in patients with overlapping characteristics to those used in PALOMA-2. However, when used outside of these eligibility criteria, namely in patients with less favorable prognosis (e.g., presence of visceral disease), the benefits are inferior, even though still favorable.


Assuntos
Inibidores da Aromatase , Neoplasias da Mama , Humanos , Feminino , Inibidores da Aromatase/efeitos adversos , Estudos Retrospectivos , Neoplasias da Mama/tratamento farmacológico , Estudos de Coortes
4.
J Periodontal Res ; 58(2): 283-295, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36575324

RESUMO

BACKGROUND AND OBJECTIVES: Periodontitis is a highly prevalent disease in psychiatric patients, including those undergoing symptomatic treatment with second-generation antipsychotics. Some of these drugs, such as clozapine (CLO) and olanzapine (OLA), have prominent metabolic effects such as weight gain, hyperglycemia, and dyslipidemia, which are risk factors for periodontitis. In addition to the metabolic effects, there are reports of changes in salivary flow, gingival bleeding, and caries. In this context, we aimed to evaluate if the metabolic effects of OLA and CLO alter periodontal parameters in an animal model of periodontitis without the environmental and psychosocial biases inherent to human diseases. METHODS: In the first set of experiments, male and female adult Wistar rats received oral administration of CLO, OLA, or vehicle for 45 days. They were evaluated for body mass composition and weight gain, blood glucose parameters (fasting and glucose tolerance and insulin resistance tests), and lipid profile (HDL, total cholesterol, and triglycerides). In a second set of experiments, the same measurements were performed in female rats exposed to the antipsychotics for 45 days and ligature-induced periodontitis on the 30th day of treatment. Macroscopic measurements of exposed roots, microtomography in the furcation region of the first molar, and histological evaluation of the region between the first and second molars were evaluated to assess bone loss. Additionally, gingival measurements of myeloperoxidase activity and pro-inflammatory cytokine TNF-α were made. RESULTS: Only females exposed to OLA had more significant weight gain than controls. They also exhibited differences in glucose metabolism. Ligature-induced periodontitis produced intense bone retraction without changing the density of the remaining structures. The bone loss was even higher in rats with periodontitis treated with OLA or CLO and was accompanied by a local increase in TNF-α caused by CLO. These animals, however, did not exhibit the same metabolic impairments observed for animals without periodontitis. CONCLUSION: The use of clozapine and olanzapine may be a risk factor for periodontal disease, independent of systemic metabolic alterations.


Assuntos
Antipsicóticos , Doenças Ósseas Metabólicas , Clozapina , Periodontite , Humanos , Adulto , Ratos , Masculino , Feminino , Animais , Antipsicóticos/efeitos adversos , Clozapina/efeitos adversos , Olanzapina/efeitos adversos , Fator de Necrose Tumoral alfa/metabolismo , Ratos Wistar , Periodontite/complicações , Doenças Ósseas Metabólicas/induzido quimicamente , Doenças Ósseas Metabólicas/complicações , Doenças Ósseas Metabólicas/tratamento farmacológico , Aumento de Peso
5.
An Acad Bras Cienc ; 95(suppl 1): e20220914, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37585970

RESUMO

Zinc (Zn) is an essential micronutrient involved in the physiology of nervous system and pain modulation. There is little evidence for the role of nutritional Zn alternations to the onset and progression of neuropathic (NP) and inflammatory pain. The study investigated the effects of a zinc restricted diet on the development of pain. Weaned mice were submitted to a regular (38 mg/kg of Zn) or Zn deficient (11 mg/kg of Zn) diets for four weeks, pain responses evaluated (mechanical, cold and heat allodynia; formalin- and carrageenan-induced inflammatory hypernociception), plasma and tissues collected for biochemical and metabolomic analysis. Zn deficient diet inhibited animal growth (37%) and changed mice sensitivity pattern, inducing an intense allodynia evoked by mechanical, cold and heat stimulus for four weeks. The inflammatory pain behavior of formalin test was drastically reduced or absent when challenged by an inflammatory stimulus. Zn restriction also reduce plasma TNF, increase neuronal activation, oxidative stress, indicating a disruption of the immune response. Liver metabolomic analyses suggest a downregulation of lipid metabolism of arachidonic acid. Zn restriction since weaned disrupts pain signaling considerably and reduce inflammatory pain. Zn could be considered a predisposing factor for the onset of chronic pain such as painful neuropathies.


Assuntos
Hiperalgesia , Desnutrição , Animais , Camundongos , Nociceptividade , Dor , Fígado , Zinco/farmacologia
6.
Sensors (Basel) ; 23(4)2023 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-36850456

RESUMO

Within the scope of the Aveiro STEAM City project, an air quality monitoring network was installed in the city of Aveiro (Portugal), to evaluate the potential of sensors to characterize spatial and temporal patterns of air quality in the city. The network consists of nine sensors stations with air quality sensors (PM10, PM2.5, NO2, O3 and CO) and two meteorological stations, distributed within selected locations in the city of Aveiro. The analysis of the data was done for a one-year measurement period, from June 2020 to May 2021, using temporal profiles, statistical comparisons with reference stations and Air Quality Indexes (AQI). The analysis of sensors data indicated that air quality variability exists for all pollutants and stations. The majority of the study area is characterized by good air quality, but specific areas-associated with hotspot traffic zones-exhibit medium, poor and bad air quality more frequently. The daily patterns registered are significantly different between the affected and non-affected road traffic sites, mainly for PM and NO2 pollutants. The weekly profile, significative deltas are found between week and weekend: NO2 is reduced on the weekends at traffic sites, but PM10 is higher in specific areas during winter weekends, which is explained by residential combustion sources.

7.
Aten Primaria ; 55(10): 102710, 2023 10.
Artigo em Espanhol | MEDLINE | ID: mdl-37573820

RESUMO

OBJECTIVE: To review the latest published evidence on the vaccine used in our country against the herpes zoster virus, breaking down the results according to the efficacy, efficiency, effectiveness and safety of the vaccine. Include the current recommendations for vaccination. DESIGN: Secondary review. Descriptive qualitative review. Review using the search term "herpes zoster vaccine" and "Adjuvanted recombinant Herpes Zoster subunit vaccine". Retrospective observational study. DATA SOURCES: Embase, Medline and Google Scholar. Selection of studies Search criterion with the terms "Shingrix vaccine" and "Adjuvanted Herpes Zoster Subunit Vaccine". Search period 2013-2023. Studies classified as clinical trials or randomized clinical trials were selected. 21 published studies were evaluated. There were no exclusions. RESULTS: The evaluated studies were found to be coherent and in all of them efficacy in adult individuals in preventing viral reactivation and in preventing complications was higher than 80%. The effectiveness of the vaccine after two doses was also higher than 80%. Cost-effectiveness studies were always favourable in adults, immunodepressed patients and individuals with chronic pathology. The safety of the vaccine was evaluated in the pivotal studies and in the post-commercialization studies that were undertaken (although there were few of the latter due to the short period of time studied). The safety profile of the vaccine is very high and in the case of severe adverse effects, their frequency was similar to that of a placebo. CONCLUSIONS: We have a safe and effective vaccine against the herpes zoster virus that allows us to protect the most vulnerable population groups against this virus.


Assuntos
Vacina contra Herpes Zoster , Herpes Zoster , Adulto , Humanos , Herpesvirus Humano 3 , Herpes Zoster/prevenção & controle , Vacinação , Vacinas de Subunidades Antigênicas/efeitos adversos
8.
Br J Haematol ; 197(4): 431-441, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35255152

RESUMO

Selecting the most appropriate chronic lymphocytic leukaemia (CLL) treatment is challenging. Patient-reported health-related quality of life (HRQoL) is therefore a critical aspect to consider. This international study by the European Organization for Research and Treatment of Cancer (EORTC) tested the psychometric properties of a newly developed measure for CLL patients: the EORTC QLQ-CLL17 to supplement the core questionnaire (EORTC QLQ-C30). Patients with CLL (n = 341) from 12 countries completed the QLQ-C30, QLQ-CLL17 and a debriefing questionnaire. Sociodemographic and clinical data were recorded from medical records. A high percentage (30%-66%) reported symptoms and/or worries (e.g. aches/pains in muscles, lack of energy and worry/fears about health). Confirmatory factor analysis showed an acceptable to good fit of the 17 items on the three scales (i.e. symptom burden, physical condition/fatigue and worries/fears about health and functioning). Completion took on average 8 min. Test-retest and convergent validity was demonstrated. The QLQ-CLL17 differentiated between patients with an Eastern Cooperative Oncology group (ECOG) performance of 0 versus 1-3 (p's < 0.01 and clinically relevant). The newly developed EORTC QLQ-CLL17 will increase sensitivity of HRQoL assessment in patients with CLL. Implementation of this questionnaire both in clinical research and practice will help to generate unique clinically relevant data to better inform CLL treatment decision-making.


Assuntos
Leucemia Linfocítica Crônica de Células B , Qualidade de Vida , Humanos , Dor , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
9.
Psychol Med ; 52(14): 3150-3158, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-33531098

RESUMO

BACKGROUND: A recent genome-wide association study (GWAS) identified 12 independent loci significantly associated with attention-deficit/hyperactivity disorder (ADHD). Polygenic risk scores (PRS), derived from the GWAS, can be used to assess genetic overlap between ADHD and other traits. Using ADHD samples from several international sites, we derived PRS for ADHD from the recent GWAS to test whether genetic variants that contribute to ADHD also influence two cognitive functions that show strong association with ADHD: attention regulation and response inhibition, captured by reaction time variability (RTV) and commission errors (CE). METHODS: The discovery GWAS included 19 099 ADHD cases and 34 194 control participants. The combined target sample included 845 people with ADHD (age: 8-40 years). RTV and CE were available from reaction time and response inhibition tasks. ADHD PRS were calculated from the GWAS using a leave-one-study-out approach. Regression analyses were run to investigate whether ADHD PRS were associated with CE and RTV. Results across sites were combined via random effect meta-analyses. RESULTS: When combining the studies in meta-analyses, results were significant for RTV (R2 = 0.011, ß = 0.088, p = 0.02) but not for CE (R2 = 0.011, ß = 0.013, p = 0.732). No significant association was found between ADHD PRS and RTV or CE in any sample individually (p > 0.10). CONCLUSIONS: We detected a significant association between PRS for ADHD and RTV (but not CE) in individuals with ADHD, suggesting that common genetic risk variants for ADHD influence attention regulation.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Disfunção Cognitiva , Adolescente , Adulto , Criança , Humanos , Adulto Jovem , Transtorno do Deficit de Atenção com Hiperatividade/genética , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Disfunção Cognitiva/genética , Estudo de Associação Genômica Ampla , Fenótipo , Tempo de Reação/fisiologia , Estudos de Casos e Controles
10.
Int Endod J ; 55(1): 103-112, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34561894

RESUMO

AIM: To evaluate the influence of the design of endodontic access cavities on the percentage of unprepared areas of canal walls and flexural fatigue of instruments activated by reciprocating movement in oval-shaped straight root canals of extracted teeth. METHODOLOGY: Forty-two mandibular incisors with oval canals were scanned by a microcomputed tomography (micro-CT) device for homogeneous selection and distribution of the samples. Then, the teeth were divided into two groups (n = 21) according to the design of access cavity being tested: ultraconservative endodontic access cavity (UltraAC) and traditional access cavity. The canals were accessed with the aid of a surgical microscope, instrumented with the WaveOne Gold Medium system and irrigated with 2.5% NaOCl and 17% EDTA. The unprepared areas of the canal wall were analysed by overlaying images before and after instrumentation and expressed as percentages. micro-CT data were analysed using t-test, Mann-Whitney and Wilcoxon tests. The endodontic instruments used during instrumentation were subjected to static flexural fatigue testing using an artificial stainless steel canal with a 60° angle of curvature and a radius of 5 mm, located 5 mm from the tip of the instrument. The instruments were activated until fracture occurred, and the time in seconds for the fracture was recorded using a digital timer. The number of cycles to fracture was calculated and analysed statistically. For flexural fatigue data, an anova test complemented by a Tukey range test was used. The significance level of 5% was used for all analyses. RESULTS: There was no significant difference between the groups related to unprepared areas by the instrument during canal preparation (p > .05). The difference in flexural fatigue resistance between the groups was not significant. CONCLUSION: The use of UltraAC did not interfere with the canal instrumentation of extracted mandibular incisors with straight and oval canals. There was no difference in the flexural fatigue resistance of the instruments in relation to access cavity design.


Assuntos
Cavidade Pulpar , Preparo de Canal Radicular , Cavidade Pulpar/diagnóstico por imagem , Incisivo/diagnóstico por imagem , Aço Inoxidável , Microtomografia por Raio-X
11.
J Environ Manage ; 315: 115154, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35500488

RESUMO

Autonomous vehicles (AVs) are pointed out as the technology that will reshape the concept of mobility, with significant implications for the economy, the environment, and society. This fact will bring new challenge to cities urban planning. Research to anticipate the AVs impacts, maximizing their benefits and reduce trade-offs are currently crucial. This work investigates the potential challenges and benefits of gradually replace internal combustion engine human driven vehicles with different penetration rates of AVs - 10%, 30%, 50%, 70%, 90%, and 100% - in urban roads of different characteristics, either in terms of traffic singularities or volumes, and its related implications on air quality. For that purpose, two urban areas with distinct features, Porto and Aveiro, were selected as case studies, and a modelling setup composed of a traffic model, an emission model, and a local air quality model was applied. The results revealed that the AVs benefits are directly linked with the urban design and the road characteristics. In the Aveiro case study, the AVs promoted positive changes with average reductions in daily NOx emissions (compared with the baseline scenario, without AVs) ranging between -2.1% (for C10%) and -7.7% (for C100%). In line with the emissions impacts, positive effects were found on air quality, with average reductions of NO2 concentrations up to -4% (for C100%). In Porto urban area, slight differences in NOx emissions were obtained (<2%), which implied no changes in the air quality levels. The distinct impact of AVs in the study areas is mostly explained by the traffic light coordination system and directional split distributions in the main roads. These results provide valuable insights to support decision-makers in the definition of strategies that allow the integration of these new emerging technologies in the road infrastructure, considering the features of the urban design, traffic profile and road characteristics.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Poluição do Ar/prevenção & controle , Veículos Autônomos , Ambiente Construído , Monitoramento Ambiental/métodos , Humanos , Emissões de Veículos/análise
12.
J Manipulative Physiol Ther ; 45(7): 508-514, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36922055

RESUMO

OBJECTIVES: The purpose of this study was to assess the influence of sex and body mass index (BMI) on the thoracic kyphosis and lumbar lordosis of adolescents and to assess the reliability and agreement of the flexicurve method for these measurements. METHODS: The study included 217 adolescents of both sexes, aged between 11 and 15 years, who were students from municipal schools in the city of São José dos Campos in São Paulo. The measurement of thoracic kyphosis and lumbar lordosis angles was performed using the flexicurve method. Descriptive analysis of the data, analysis of covariance for comparison between groups (by BMI and sex), assessment of reliability, and intrarater agreement were analyzed. RESULTS: There was a significant difference between the groups by BMI and sex only for lumbar lordosis. The obese group had greater lumbar angles for both sexes (female sex: 32.6° ± 7.8° [eutrophic]; 37.7° ± 7.3° [obese]; male sex: 25.3° ± 7.3° [eutrophic]; 32.2° ± 7.3° [obese]). In the comparison between the sexes, the greatest lumbar angles were found in the female sex (female sex: 32.6° ± 7.8°; male sex: 25.3° ± 7.3°) among the eutrophic. Excellent intrarater reliability was found for thoracic kyphosis (intraclass correlation coefficient, 0.86) and moderate for lumbar lordosis (intraclass correlation coefficient, 0.72). CONCLUSION: Sex and BMI were associated with lumbar lordosis in adolescents and were greater in individuals with obesity and female individuals. The flexicurve method was reliable and accurate for the assessment of thoracic kyphosis and lumbar lordosis in adolescents.


Assuntos
Cifose , Lordose , Adolescente , Masculino , Humanos , Feminino , Criança , Índice de Massa Corporal , Reprodutibilidade dos Testes , Brasil , Cifose/diagnóstico , Obesidade , Vértebras Lombares , Vértebras Torácicas
13.
Aten Primaria ; 54 Suppl 1: 102462, 2022 10.
Artigo em Espanhol | MEDLINE | ID: mdl-36435581

RESUMO

The update of the preventive activities for this year 2022 in the field of infectious diseases is of special relevance due to the importance that prevention has gained and more specifically, vaccination as a tool to control the pandemic caused by the SARS-CoV-2 virus declared on March 11, 2020. The pandemic has focused much of the prevention efforts on its containment, but the importance of maintaining high vaccination coverage of the rest of the recommended vaccines to maintain good control of vaccine-preventable diseases and avoid complications in particularly vulnerable patients should not be forgotten. In this year's review we present a practical document with the aim of providing tools to primary care professionals who work with adults, to make the indication of each vaccine whether it is systematically recommended or if it is because the patient belongs to some risk group due to their condition or underlying pathology. In this way, throughout the document, we will comment on the most innovative aspects of systematic vaccination (flu, pneumococcus, meningococcal vaccines and vaccines against the human papillomavirus [HPV]), the new vaccines (pandemic vaccines against COVID-19, vaccines against herpes zoster of subunits, vaccines against monkeypox) and the recommended vaccines according to risk condition (pregnancy and lactation, travelers, patients with immunosuppression or underlying pathology).


Assuntos
COVID-19 , Vacinas , Adulto , Gravidez , Feminino , Humanos , Vacinas contra COVID-19 , COVID-19/prevenção & controle , SARS-CoV-2 , Vacinação
14.
Lancet Oncol ; 22(7): 1002-1013, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34048685

RESUMO

BACKGROUND: Colorectal cancer screening programmes and uptake vary substantially across Europe. We aimed to compare changes over time in colorectal cancer incidence, mortality, and stage distribution in relation to colorectal cancer screening implementation in European countries. METHODS: Data from nearly 3·1 million patients with colorectal cancer diagnosed from 2000 onwards (up to 2016 for most countries) were obtained from 21 European countries, and were used to analyse changes over time in age-standardised colorectal cancer incidence and stage distribution. The WHO mortality database was used to analyse changes over time in age-standardised colorectal cancer mortality over the same period for the 16 countries with nationwide data. Incidence rates were calculated for all sites of the colon and rectum combined, as well as the subsites proximal colon, distal colon, and rectum. Average annual percentage changes (AAPCs) in incidence and mortality were estimated and relevant patterns were descriptively analysed. FINDINGS: In countries with long-standing programmes of screening colonoscopy and faecal tests (ie, Austria, the Czech Republic, and Germany), colorectal cancer incidence decreased substantially over time, with AAPCs ranging from -2·5% (95% CI -2·8 to -2·2) to -1·6% (-2·0 to -1·2) in men and from -2·4% (-2·7 to -2·1) to -1·3% (-1·7 to -0·9) in women. In countries where screening programmes were implemented during the study period, age-standardised colorectal cancer incidence either remained stable or increased up to the year screening was implemented. AAPCs for these countries ranged from -0·2% (95% CI -1·4 to 1·0) to 1·5% (1·1 to 1·8) in men and from -0·5% (-1·7 to 0·6) to 1·2% (0·8 to 1·5) in women. Where high screening coverage and uptake were rapidly achieved (ie, Denmark, the Netherlands, and Slovenia), age-standardised incidence rates initially increased but then subsequently decreased. Conversely, colorectal cancer incidence increased in most countries where no large-scale screening programmes were available (eg, Bulgaria, Estonia, Norway, and Ukraine), with AAPCs ranging from 0·3% (95% CI 0·1 to 0·5) to 1·9% (1·2 to 2·6) in men and from 0·6% (0·4 to 0·8) to 1·1% (0·8 to 1·4) in women. The largest decreases in colorectal cancer mortality were seen in countries with long-standing screening programmes. INTERPRETATION: We observed divergent trends in colorectal cancer incidence, mortality, and stage distribution across European countries, which appear to be largely explained by different levels of colorectal cancer screening implementation. FUNDING: German Cancer Aid (Deutsche Krebshilfe) and the German Federal Ministry of Education and Research.


Assuntos
Neoplasias Colorretais/epidemiologia , Detecção Precoce de Câncer , Adulto , Distribuição por Idade , Idoso , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Sistema de Registros , Distribuição por Sexo , Fatores de Tempo
15.
Int J Neuropsychopharmacol ; 24(9): 734-748, 2021 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-34165516

RESUMO

BACKGROUND: Minocycline (MIN) is a tetracycline with antioxidant, anti-inflammatory, and neuroprotective properties. Given the likely involvement of inflammation and oxidative stress (IOS) in schizophrenia, MIN has been proposed as a potential adjuvant treatment in this pathology. We tested an early therapeutic window, during adolescence, as prevention of the schizophrenia-related deficits in the maternal immune stimulation (MIS) animal model. METHODS: On gestational day 15, Poly I:C or vehicle was injected in pregnant Wistar rats. A total 93 male offspring received MIN (30 mg/kg) or saline from postnatal day (PND) 35-49. At PND70, rats were submitted to the prepulse inhibition test. FDG-PET and T2-weighted MRI brain studies were performed at adulthood. IOS markers were evaluated in frozen brain tissue. RESULTS: MIN treatment did not prevent prepulse inhibition test behavioral deficits in MIS offspring. However, MIN prevented morphometric abnormalities in the third ventricle but not in the hippocampus. Additionally, MIN reduced brain metabolism in cerebellum and increased it in nucleus accumbens. Finally, MIN reduced the expression of iNOS (prefrontal cortex, caudate-putamen) and increased the levels of KEAP1 (prefrontal cortex), HO1 and NQO1 (amygdala, hippocampus), and HO1 (caudate-putamen). CONCLUSIONS: MIN treatment during adolescence partially counteracts volumetric abnormalities and IOS deficits in the MIS model, likely via iNOS and Nrf2-ARE pathways, also increasing the expression of cytoprotective enzymes. However, MIN treatment during this peripubertal stage does not prevent sensorimotor gating deficits. Therefore, even though it does not prevent all the MIS-derived abnormalities evaluated, our results suggest the potential utility of early treatment with MIN in other schizophrenia domains.


Assuntos
Anti-Inflamatórios/farmacologia , Antioxidantes/farmacologia , Encefalopatias Metabólicas/tratamento farmacológico , Minociclina/farmacologia , Malformações do Sistema Nervoso/patologia , Transtornos do Neurodesenvolvimento/tratamento farmacológico , Estresse Oxidativo/efeitos dos fármacos , Efeitos Tardios da Exposição Pré-Natal/tratamento farmacológico , Inibição Pré-Pulso/efeitos dos fármacos , Esquizofrenia/tratamento farmacológico , Animais , Anti-Inflamatórios/administração & dosagem , Antioxidantes/administração & dosagem , Comportamento Animal/efeitos dos fármacos , Encefalopatias Metabólicas/etiologia , Modelos Animais de Doenças , Feminino , Imageamento por Ressonância Magnética , Masculino , Minociclina/administração & dosagem , Malformações do Sistema Nervoso/diagnóstico por imagem , Malformações do Sistema Nervoso/etiologia , Transtornos do Neurodesenvolvimento/induzido quimicamente , Transtornos do Neurodesenvolvimento/imunologia , Tomografia por Emissão de Pósitrons , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/imunologia , Ratos , Ratos Wistar , Esquizofrenia/induzido quimicamente , Esquizofrenia/imunologia
16.
Clin Sci (Lond) ; 135(1): 143-159, 2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-33355632

RESUMO

Myocardial infarction (MI) is associated with renal alterations resulting in poor outcomes in patients with MI. Renal fibrosis is a potent predictor of progression in patients and is often accompanied by inflammation and oxidative stress; however, the mechanisms involved in these alterations are not well established. Endoplasmic reticulum (ER) plays a central role in protein processing and folding. An accumulation of unfolded proteins leads to ER dysfunction, termed ER stress. Since the kidney is the organ with highest protein synthesis fractional rate, we herein investigated the effects of MI on ER stress at renal level, as well as the possible role of ER stress on renal alterations after MI. Patients and MI male Wistar rats showed an increase in the kidney injury marker neutrophil gelatinase-associated lipocalin (NGAL) at circulating level or renal level respectively. Four weeks post-MI rats presented renal fibrosis, oxidative stress and inflammation accompanied by ER stress activation characterized by enhanced immunoglobin binding protein (BiP), protein disulfide-isomerase A6 (PDIA6) and activating transcription factor 6-alpha (ATF6α) protein levels. In renal fibroblasts, palmitic acid (PA; 50-200 µM) and angiotensin II (Ang II; 10-8 to 10-6M) promoted extracellular matrix, superoxide anion production and inflammatory markers up-regulation. The presence of the ER stress inhibitor, 4-phenylbutyric acid (4-PBA; 4 µM), was able to prevent all of these modifications in renal cells. Therefore, the data show that ER stress mediates the deleterious effects of PA and Ang II in renal cells and support the potential role of ER stress on renal alterations associated with MI.


Assuntos
Estresse do Retículo Endoplasmático , Fibroblastos/patologia , Nefropatias/etiologia , Rim/patologia , Infarto do Miocárdio/complicações , Adulto , Animais , Células Cultivadas , Modelos Animais de Doenças , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Feminino , Fibroblastos/efeitos dos fármacos , Fibroblastos/metabolismo , Fibrose , Humanos , Mediadores da Inflamação/metabolismo , Rim/efeitos dos fármacos , Rim/metabolismo , Nefropatias/metabolismo , Nefropatias/patologia , Nefropatias/prevenção & controle , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo , Ácido Palmítico/farmacologia , Fenilbutiratos/farmacologia , Ratos Wistar , Transdução de Sinais
17.
Bioorg Med Chem ; 33: 115996, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33494011

RESUMO

In the present work, the radioimmunoconjugates 111In-DTPA-trastuzumab and 177Lu-DOTA-trastuzumab were evaluated regarding the influence of the chelating agents on the physical-chemical parameters and human epidermal growth factor receptor 2 (HER2) tumor cell binding. Data showed that both chelating agents, at predetermined molar ratios (antibody:chelator - 1:10 and 1:20), did not influence the immunoconjugates integrity, the radiolabeling process and the radiolabeled antibodies stability. However, differences were observed in the lipophilic feature between DOTA and DTPA radioimmunoconjugates and in the specific binding to SK-BR-3 tumor cells (HER2 positive). Therefore, this study showed the importance of assessing the influence of chelating agents and their molar ratios in the development process of radioimmunoconjugates.


Assuntos
Anticorpos Monoclonais/farmacologia , Quelantes/farmacologia , Imunoconjugados/farmacologia , Receptor ErbB-2/antagonistas & inibidores , Anticorpos Monoclonais/química , Quelantes/síntese química , Quelantes/química , Relação Dose-Resposta a Droga , Humanos , Imunoconjugados/química , Estrutura Molecular , Receptor ErbB-2/metabolismo , Relação Estrutura-Atividade , Células Tumorais Cultivadas
18.
Pharmacoepidemiol Drug Saf ; 30(3): 342-349, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33103788

RESUMO

OBJECTIVES: To evaluate the effectiveness and safety of pembrolizumab use in advanced melanoma in a real-life context; and to explore the existence of an efficacy-effectiveness gap, comparing registry data with the reference clinical trial. METHODS: This study followed the guidelines for good pharmacoepidemology practice. An ambispective cohort was constituted, initiating the observation upon drug approval (17/07/2015) and following exposed patients until death or cut-off date (15/11/2019). The primary outcome was overall survival (OS); secondary outcomes comprised progression-free survival (PFS), overall response rate (ORR) and the occurrence of adverse events (AE). For all survival analyses, the Kaplan-Meier estimator was used, considering a 95% confidence interval (CI), aside with one-year survival rates. RESULTS: A total of 125 patients constituted the cohort, originating from 16 hospitals in Portugal. Median OS was estimated to be 16.9 months (CI95% 11.3-25.5) and the probability of survival after 1 year was 57.5% (CI95% 48.4%-65.6%). Median PFS was estimated to be 4.8 months (CI95% 3.9-6.7) and the probability of remaining progression-free after 1 year was 32.8% (CI95% 24.8-41.1). ORR was 30.4% (CI95% 22.5%-39.3%). AEs were experienced by 82% of patients, and 27% experienced AE≥ grade 3. CONCLUSIONS: Our data suggest lower effectiveness in a real-life context than the efficacy reported in the clinical trial. Safety data seems, however, quite comparable to KEYNOTE-006.


Assuntos
Antineoplásicos Imunológicos , Melanoma , Anticorpos Monoclonais Humanizados , Antineoplásicos Imunológicos/efeitos adversos , Humanos , Melanoma/tratamento farmacológico , Portugal/epidemiologia , Sistema de Registros
19.
J Cosmet Laser Ther ; 23(3-4): 41-48, 2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34668826

RESUMO

Q-switched 1064 nm/532 nm Nd: YAG Lasers present important characteristics which can contribute toward the removal of tattoos, for having the ability to reach only specific targets with minimal damage to the tissue. Despite reports of their clinical benefits, only a few scientific studies demonstrate the efficacy and safety of these types of lasers in the short and long term. To substantiate the effects, benefits, and safety of the application of Q-switched 1064 nm/532 nm Nd: YAG lasers, a systematic review was carried out from September to December of 2019, about the studies which report their use in the removal of tattoos, published in the last 20 years. Randomized clinical trials in humans were considered, as long as they evaluated the efficacy, safety, and benefits of the application of Q-switched 1064 nm/532 nm Nd: YAG lasers in the removal of black and color tattoos in different skin phototypes. One hundred and twenty-two articles were identified after the titles, abstracts were read, and duplicates were removed; six articles were left, which were included in the research (188 individuals). The Q-switched 1064 nm/532 nm Nd: YAG lasers seem promising in the short term, with minimal adverse effects; however, the efficacy and safety in the long term still present limitations. Consequently, future research is necessary, with better methodological standardization applied and with a follow-up for a longer period of evaluation of possible permanent adverse effects, to determine the standardization and safety of the therapy with the lasers Nd: YAG de 1064 nm/532 nm Q-switched.


Assuntos
Terapia a Laser , Lasers de Estado Sólido , Tatuagem , Humanos , Lasers de Estado Sólido/efeitos adversos , Pele , Resultado do Tratamento
20.
Prev Sci ; 22(5): 658-669, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33063234

RESUMO

In 2013, Brazil's Ministry of Health adopted the Strengthening Families Program (SFP 10-14), developed internationally for preventing drug abuse by enhancing family bonds. The social validity of the objectives, procedures, and perceived impacts of the program were investigated for participants and facilitators in northeastern Brazil. Focus groups with parents/guardians (N = 199), adolescents (N = 111), and facilitators (N = 100) were implemented. Content analysis revealed that the program's objectives were considered socially relevant and that there was a positive short-term perceived impact on family cohesion, authoritative parenting style, adolescent life skills, and the facilitators' professional capacity. The parents/guardians and adolescents presented a positive perception of the appropriateness of the program's methodology, while facilitators indicated the need to adapt it to vulnerable families and improve its implementation conditions. Future studies may benefit from these findings when developing similarly viable and scalable interventions in low-resource settings. Brazilian Trial Register RBR-7q9xh5. Registered 5 August 2017, http://www.ensaiosclinicos.gov.br/rg/RBR-7q9xh5/.


Assuntos
Pais , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Brasil , Humanos , Poder Familiar
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