RESUMO
Quail housing and diet significantly impact egg yield and quality. This study assessed the impact of diets and housing arrangements on Japanese quail's egg production, egg index, and quality. In two trials, birds were reared in cages and on the floor with a commercial layer diet (CLD), and an experimental diet (ED) for 32 weeks. Compared to floor-reared birds, cage birds achieved 50% egg production and sexual maturity first. With dietary effects, the CLD diet showed similar results. Furthermore, their feed efficiency, hen house egg production (HHEP), and hen day egg production (HDEP) were significantly higher in cage birds that consumed CLD. Bird livability was unaffected by the housing system, while birds fed CLD had longer lifespans. The housing system had no discernible effects on egg dry matter (DM), crude protein (CP), crude fat (CF), or ash percentage. Nevertheless, the egg albumen's DM, CP, ash%, yolk's DM, CP, and CF were greater in the birds fed CLD. Barring shell thickness, weight, and Haugh unit, birds raised in cages exhibited higher egg exterior index values. Besides the yolk ratio, yolk index, and albumen weight ratio, birds given CLD exhibited enhanced egg interior quality. Ultimately, the most optimal egg production performance, improved egg quality, and prolonged lifespan of Japanese quail were obtained with cage raising and feeding practices utilizing CLD.
RESUMO
Lentil yield is a complicated quantitative trait; it is significantly influenced by the environment. It is crucial for improving human health and nutritional security in the country as well as for a sustainable agricultural system. The study was laid out to determine the stable genotype through the collaboration of G × E by AMMI and GGE biplot and to identify the superior genotypes using 33 parametric and non-parametric stability statistics of 10 genotypes across four different conditions. The total G × E effect was divided into two primary components by the AMMI model. For days to flowering, days to maturity, plant height, pods per plant, and hundred seed weight, IPCA1 was significant and accounted for 83%, 75%, 100%, and 62%, respectively. Both IPCA1 and IPCA2 were non-significant for yield per plant and accounted for 62% of the overall G × E interaction. An estimated set of eight stability parameters showed strong positive correlations with mean seed yield, and these measurements can be utilized to choose stable genotypes. The productivity of lentils has varied greatly in the environment, ranging from 786 kg per ha in the MYM environment to 1658 kg per ha in the ISD environment, according to the AMMI biplot. Three genotypes (G8, G7, and G2) were shown to be the most stable based on non-parametric stability scores for grain yield. G8, G7, G2, and G5 were determined as the top lentil genotypes based on grain production using numerical stability metrics such as Francis's coefficient of variation, Shukla stability value (σi2), and Wrick's ecovalence (Wi). Genotypes G7, G10, and G4 were the most stable with the highest yield, according to BLUP-based simultaneous selection stability characteristics. The findings of graphic stability methods such as AMMI and GGE for identifying the high-yielding and stable lentil genotypes were very similar. While the GGE biplot indicated G2, G10, and G7 as the most stable and high-producing genotypes, AMMI analysis identified G2, G9, G10, and G7. These selected genotypes would be used to release a new variety. Considering all the stability models, such as Eberhart and Russell's regression and deviation from regression, additive main effects, multiplicative interactions (AMMI) analysis, and GGE, the genotypes G2, G9, and G7 could be used as well-adapted genotypes with moderate grain yield in all tested environments.
RESUMO
PURPOSE: Our study validated the Ten Question Questionnaire (TQQ+) for Bangladeshi children between 10 and 16 years. The TQQ + is a rapid screening tool for disability and was previously validated in children below 9 years of age. MATERIALS AND METHODS: The study was carried out in Chattogram, Bangladesh. One hundred children aged 10-16 years, 10 with mild or moderate disabilities, 40 with severe disabilities, and 50 children without a disability were identified. Children with disability (n = 50) had previously undergone Wechsler Intelligence Scale-Revised (WISC-R) assessments by psychologists as a reference standard. Each child was evaluated using Rapid Neurodevelopmental Assessment (RNDA) by physicians and TQQ + was administered by researchers. Sensitivities and specificities of TQQ + were evaluated in comparison with RNDA and WISC-R. RESULTS: The sensitivity of TQQ + was 98% in comparison with either RNDA or WISC-R. The specificity of TQQ was 76.5% compared with RNDA and 78% with WISC-R. TQQ + successfully picked up cognitive (98%) and motor (75%) disabilities as well as behavioural problems (88.9%). Specificity was good to excellent in all other domains. Logistic regression showed that TQQ + could reliably predict disability by RNDA and WISC-R. The area under the Receiver Operating Characteristic Curve (ROC) curve was 0.88 which denoted good diagnostic accuracy of the questionnaire. CONCLUSION: The TQQ + is valid for screening disabilities in 10-16 year old Bangladeshi children.IMPLICATIONS FOR REHABILITATIONIf children with neurodevelopmental disabilities are screened early, the benefit of intervention will be greater.TQQ + is an easy to administer and low-cost tool that has been validated internationally.The TQQ + is now validated and can be used for children aged 10 to 16 years in Bangladesh.
Assuntos
Testes de Inteligência , Humanos , Criança , Idoso , Adolescente , Inquéritos e Questionários , Sensibilidade e Especificidade , Curva ROC , BangladeshRESUMO
The cucumber (Cucumis sativus L.) is one of the most important vegetables in Bangladesh as well as across the globe. However, many of the important cucumber landraces have disappeared in Bangladesh due to climate change, particularly erratic rainfall, extreme temperature, salinity, and drought. Therefore, to protect against the extinction of the cucumber landraces, we collected 103 landraces in different geographical regions of Bangladesh, including drought and saline-prone areas, and studied their divergence for the future breeding programme for the development of cultivars suitable for the climate-changing situations. Data on morphological features, yield, and its components, which include 17 qualitative and quantitative traits, were recorded during the observation. Among the cucumber landraces, the Shannon-Weaver diversity index analysis revealed the presence of genetic diversity in these landraces. The biggest diversity appeared in the fruit-related characteristics, i.e., stem end fruit shape, bottom end fruit shape, fruit shape, and fruit skin colour at the table and harvest maturity. The descriptive statistics and analysis of variance expressed a wide range of variability for quantitative traits. A broad phenotypic variation was also observed for traits such as yield plant-1 [CV (%) 31.88, ranges 0.96 to 3.11 kg] and fruits plant-1 (CV (%), 28.71, ranges, 2.58 to 9.75). High heritability (broad sense) coupled with a high genetic gain was observed for yield and yield-contributing characteristics, indicating that these characteristics are controlled by additive gene effects, and they are more reliable for effective selection. The phenotypic correlation studies showed that fruit yield plant-1 exhibited a positive and significant correlation with fruits plant-1, fruit length, fruit weight, fruit width, branches plant-1, and plant height. All landraces were grouped into six clusters, and the maximum number of landraces were accommodated in cluster VI (30), followed by cluster V (22), cluster III (22), cluster IV (14), cluster I (13), and cluster II (2). Comparing cluster means with studied traits revealed that cluster III with landraces AC-14, AC-97, AC-471, AC-451, and RAI-209 were more divergent for improving average fruit weight, fruit length, and fruit width. On the other hand, cluster IV with landraces AC-201, TT-161, RAI- 217, RAI-215, and TRMR-103 were more divergent for improving average vine length, internode length, and the number of primary branches plant-1, the number of fruits plant-1, and yield plant-1. According to the MGIDI index, AC-14 (G1), AC-201 (G7), AC-471 (G24), AC-97 (G30), RAI-215 (G68) and TT-161 (G 94) may be considered to be the best parents based on their qualitative and quantitative characteristics for the future breeding programme. Moreover, crossing between the landraces, which were collected from saline and drought areas, in clusters I, V, and VI with those in other clusters could produce suitable cucumber varieties for the climatic changing situation.
RESUMO
Six mungbean parental lines and their fifteen F1s produced from half-diallel mating design were investigated for combining ability and heterosis in terms of a yield and its components. Results showed highly significant variations among the parents and F1s, suggesting a wide genetic variability for the studied characters. Analysis of variance indicated that genotypes mean square values, general combining ability (GCA) and specific combining ability (SCA) were highly significant (p ≤ 0.001) for all measured traits except for days to flowering, days to maturity, and pod length indicating genetic diversity of parents and both additive and non-additive gene effects in the inheritance of the measured traits. A higher effect of SCA than GCA for plant height and seeds per pod suggests the preponderance of non-additive gene effects in the expression of characters. Based on per se performance and GCA, BARI Mung-1, PS-7, and BMXK1-14004 were the best general combiners for yield per plant. In the context of SCA, hybrids BMXK1-14004 × Sonali mung, BMXK1-14004 × PS-7, BMXK1-14004 × BINA Mung-8, Sukumar × PS-7, and BARI Mung-1 × BINA Mung-8 were good specific combiners. BMXK1-14004 × Sonali mung and BMXK1-14004 × PS-7 were the best heterotic hybrids for yield and yield-contributing traits. These parents and crosses could be utilized for further use in breeding programs to improve yields in mungbean crops.
RESUMO
Background: National Malaria Control Programmes (NMCPs) currently make limited use of parasite genetic data. We have developed GenRe-Mekong, a platform for genetic surveillance of malaria in the Greater Mekong Subregion (GMS) that enables NMCPs to implement large-scale surveillance projects by integrating simple sample collection procedures in routine public health procedures. Methods: Samples from symptomatic patients are processed by SpotMalaria, a high-throughput system that produces a comprehensive set of genotypes comprising several drug resistance markers, species markers and a genomic barcode. GenRe-Mekong delivers Genetic Report Cards, a compendium of genotypes and phenotype predictions used to map prevalence of resistance to multiple drugs. Results: GenRe-Mekong has worked with NMCPs and research projects in eight countries, processing 9623 samples from clinical cases. Monitoring resistance markers has been valuable for tracking the rapid spread of parasites resistant to the dihydroartemisinin-piperaquine combination therapy. In Vietnam and Laos, GenRe-Mekong data have provided novel knowledge about the spread of these resistant strains into previously unaffected provinces, informing decision-making by NMCPs. Conclusions: GenRe-Mekong provides detailed knowledge about drug resistance at a local level, and facilitates data sharing at a regional level, enabling cross-border resistance monitoring and providing the public health community with valuable insights. The project provides a rich open data resource to benefit the entire malaria community. Funding: The GenRe-Mekong project is funded by the Bill and Melinda Gates Foundation (OPP11188166, OPP1204268). Genotyping and sequencing were funded by the Wellcome Trust (098051, 206194, 203141, 090770, 204911, 106698/B/14/Z) and Medical Research Council (G0600718). A proportion of samples were collected with the support of the UK Department for International Development (201900, M006212), and Intramural Research Program of the National Institute of Allergy and Infectious Diseases.
Assuntos
Controle de Doenças Transmissíveis/estatística & dados numéricos , Erradicação de Doenças/estatística & dados numéricos , Resistência a Medicamentos/genética , Malária/prevenção & controle , Plasmodium/genética , Animais , Sudeste Asiático , Bangladesh , República Democrática do Congo , Índia , Plasmodium/efeitos dos fármacosRESUMO
Benign prostatic hyperplasia (BPH) is a common disease that can cause uncomfortable lower urinary tract symptoms. The occurrence of symptomatic BPH develops after the age of 40 years and increases gradually with age to reach more than 50% at the age of 60 years and severely disturbs the quality of life of the patients. Alpha-blockers and 5alpha reductase inhibitors are first-line agents used for the treatment of BPH. Due to the adverse effects of these conventional therapies, many patients turn to phytotherapy and other alternative therapies. This review covers alternative therapies, i.e., phytotherapy (cernilton, eviprostat, quercetin, saw palmetto and pumpkin seed) and physical therapy (acupuncture, aquablation, pulsed electromagnetic field, prostate urethral lift, radial extracorporeal shock wave therapy, thermobalancing therapy, and transurethral needle ablation) commonly used in the management of BPH.
Assuntos
Sintomas do Trato Urinário Inferior , Hiperplasia Prostática , Antagonistas Adrenérgicos alfa/uso terapêutico , Adulto , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/terapia , Masculino , Pessoa de Meia-Idade , Fitoterapia , Hiperplasia Prostática/terapia , Qualidade de VidaRESUMO
This study explored the association between socio-demographic factors and the body mass index (BMI) of women of reproductive age (15-49 years) in Bangladesh. Data from the 2014 Bangladesh Demographic and Health Survey (BDHS-14) were analysed using Multiple Linear Regression (MLR) and Quantile Regression (QR) analyses. The study sample comprised 15,636 non-pregnant women aged 15-49. The mean BMI of the women was 22.35±4.12 kg/m2. Over half (56.75%) had a BMI in the normal range (18Assuntos
Índice de Massa Corporal
, Adolescente
, Adulto
, Bangladesh/epidemiologia
, Feminino
, Humanos
, Modelos Lineares
, Pessoa de Meia-Idade
, Análise Multivariada
, Obesidade/epidemiologia
, Sobrepeso/epidemiologia
, Análise de Regressão
, Fatores Socioeconômicos
, Magreza/epidemiologia
, Adulto Jovem
RESUMO
Immunotherapy has revolutionized the treatment of cancer in recent years and achieved overall success and long-term clinical benefit in patients with a wide variety of cancer types. However, there is still a large proportion of patients exhibiting limited or no responses to immunotherapeutic strategy, some of which were even observed with hyperprogressive disease. One major obstacle restricting the efficacy is that tumor-reactive CD8+ T cells, which are central for tumor control, undergo exhaustion, and lose their ability to eliminate cancer cells after infiltrating into the strongly immunosuppressive tumor microenvironment. Thus, as a potential therapeutic rationale in the development of cancer immunotherapy, targeting or reinvigorating exhausted CD8+ T cells has been attracting much interest. Hitherto, both intrinsic and extrinsic mechanisms that govern CD8+ T-cell exhaustion have been explored. Specifically, the transcriptional and epigenetic landscapes have been depicted utilizing single-cell RNA sequencing or mass cytometry (CyTOF). In addition, cellular metabolism dictating the tumor-infiltrating CD8+ T-cell fate is currently under investigation. A series of clinical trials are being carried out to further establish the current strategies targeting CD8+ T-cell exhaustion. Taken together, despite the proven benefit of immunotherapy in cancer patients, additional efforts are still needed to fully circumvent limitations of exhausted T cells in the treatment. In this review, we will focus on the current cellular and molecular understanding of metabolic changes, epigenetic remodeling, and transcriptional regulation in CD8+ T-cell exhaustion and describe hypothetical treatment approaches based on immunotherapy aiming at reinvigorating exhausted CD8+ T cells.
Assuntos
Neoplasias , Microambiente Tumoral , Linfócitos T CD8-Positivos , Humanos , Imunoterapia , Neoplasias/terapia , Linfócitos T CitotóxicosRESUMO
BACKGROUND AND AIMS: Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide, hence a major public health threat. Pleomorphic adenoma gene like-2 (PLAGL2) has been reported to play a role in tumorigenesis. However, its precise function in HCC remains poorly understood. APPROACH AND RESULTS: In this study, we demonstrated that PLAGL2 was up-regulated in HCC compared with that of adjacent nontumorous tissues and also correlated with overall survival times. We further showed that PLAGL2 promoted HCC cell proliferation, migration, and invasion both in vitro and in vivo. PLAGL2 expression was positively correlated with epidermal growth factor receptor (EGFR) expression. Mechanistically, this study demonstrated that PLAGL2 functions as a transcriptional regulator of EGFR and promotes HCC cell proliferation, migration, and invasion through the EGFR-AKT pathway. Moreover, hypoxia was found to significantly induce high expression of PLAGL2, which promoted hypoxia inducible factor 1/2 alpha subunit (HIF1/2A) expression through EGFR. Therefore, this study demonstrated that a PLAGL2-EGFR-HIF1/2A signaling loop promotes HCC progression. More importantly, PLAGL2 expression reduced hepatoma cells' response to the anti-EGFR drug erlotinib. PLAGL2 knockdown enhanced the response to erlotinib. CONCLUSIONS: This study reveals the pivotal role of PLAGL2 in HCC cell proliferation, metastasis, and erlotinib insensitivity. This suggests that PLAGL2 can be a potential therapeutic target of HCC.
Assuntos
Carcinoma Hepatocelular/genética , Proteínas de Ligação a DNA/metabolismo , Cloridrato de Erlotinib/farmacologia , Neoplasias Hepáticas/genética , Proteínas de Ligação a RNA/metabolismo , Fatores de Transcrição/metabolismo , Adulto , Idoso , Animais , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células/genética , Proteínas de Ligação a DNA/genética , Progressão da Doença , Resistencia a Medicamentos Antineoplásicos/genética , Receptores ErbB/antagonistas & inibidores , Receptores ErbB/metabolismo , Cloridrato de Erlotinib/uso terapêutico , Retroalimentação Fisiológica , Feminino , Regulação Neoplásica da Expressão Gênica , Técnicas de Silenciamento de Genes , Humanos , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Estimativa de Kaplan-Meier , Fígado/patologia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Camundongos , Pessoa de Meia-Idade , Invasividade Neoplásica/genética , Proteínas de Ligação a RNA/genética , RNA-Seq , Transdução de Sinais/genética , Fatores de Transcrição/genética , Hipóxia Tumoral , Regulação para Cima , Ensaios Antitumorais Modelo de XenoenxertoRESUMO
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a frustrating and often debilitating disease. Current studies have shown that Traditional Chinese Medicine (TCM) can improve patients' quality of life and alleviate CP/CPPS symptoms. In this study, the efficacy of Hedyotis diffusa Willd aqueous extraction in experimental autoimmune prostatitis (EAP) mice models was revealed. The C57BL/6 mice were randomly assigned to three groups. Except for the control group, all other groups were subcutaneously injected with 0.2 ml emulsion of T2 peptide, on day 0 and day 14, for inducing EAP models. After the EAP modelling, oral saline was given to the model group, while the H. diffusa group was treated with aqueous extract of H. diffusa Willd. Micturition habits and withdrawal response frequencies were measured. Haematoxylin and eosin staining and immunohistochemistry were used to investigate inflammatory cell infiltration and TNF-α in the prostate tissue respectively. TNF-α levels in the serum were evaluated by ELISA. The H. diffusa Willd aqueous extraction considerably reduced the urine spots number and increased the pain threshold in H. diffusa group. H. diffusa group showed significantly reduced inflammatory lesion and inflammatory cell infiltration than the model group. The levels of TNF-α in H. diffusa group were considerably reduced.
Assuntos
Hedyotis , Prostatite , Animais , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Dor Pélvica , Prostatite/tratamento farmacológico , Qualidade de VidaRESUMO
BACKGROUND: Genetic polymorphisms in DNA repair genes, XRCC1 (Arg399Gln) and XRCC3 (Thr241Met), may affect their DNA repair capacity leading to individual variation in breast cancer susceptibility among Bangladeshi females. METHODS: The case-control study comprised 121 breast cancer patients and 133 healthy controls. Genomic DNA isolated from peripheral blood was genotyped for target SNPs using PCR-RFLP method. RESULTS: For XRCC1, heterozygous Arg/Gln and homozygous Gln/Gln genotypes showed 1.78-fold (95% CI 1.0084 to 3.1442, p = 0.0467) and 2.41-fold (95% CI 1.0354 to 5.5914, p = 0.0413) increased risk of breast cancer, respectively, when compared with Arg/Arg genotype. The presence of any XRCC1 Gln showed association with 1.93-fold increased risk. The variant Gln allele was associated with increased risk of breast cancer (95% CI 1.1885 to 2.6805, p = 0.0052). For XRCC3, Thr/Met heterozygous and combined Thr/Met + Met/Met genotypes were associated with 1.85-fold (95% CI 1.0815 to 3.1834, p = 0.0248) and 1.89-fold (95% CI 1.1199 to 3.1908, p = 0.0171) higher risk, respectively, compared to Thr/Thr genotypes. The variant Met allele showed significant association with increased breast cancer susceptibility. Among cases genotype frequencies were significantly different in patients with age 55 or above, and with menopause and diabetes. CONCLUSION: XRCC1 (Arg399Gln) and XRCC3 (Thr241Met) polymorphisms may be associated with increased breast cancer risk in Bangladeshi females.
Assuntos
Neoplasias da Mama/genética , Reparo do DNA , Proteínas de Ligação a DNA/genética , Proteína 1 Complementadora Cruzada de Reparo de Raio-X/genética , Adolescente , Adulto , Idoso , Bangladesh/epidemiologia , Biomarcadores Tumorais/genética , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Estudos de Casos e Controles , Feminino , Seguimentos , Predisposição Genética para Doença , Genótipo , Humanos , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Prognóstico , Fatores de Risco , Adulto JovemRESUMO
Chimeric antigen receptor T (CAR-T) therapy faces at least two major obstacles in solid tumors, including to find specific antigen among the heterogeneous tumor mass and to overcome the inhibitory microenvironment. Developing novel strategies to overcome these difficulties has been the burning issue in immunotherapy. Here we came up with the concept of tagging cancer cells by tumor-targeting adenoviruses (Ad). We constructed recombinant Ads expressing CD19 tag driven by tumor-specific promoters, which could label antigenically different tumors for single anti-CD19 CAR-T recognition. One Ad, namely AdC68-TMC-tCD19 could mediate universal tag expression and functional immunological synapse formation between CAR-T and cancer cells. In premixed mice model, all tagged mice survived after CAR-T infusion and tumor volume were inhibited by 91.78%. Furthermore, we combined the tumor tagging ability with oncolysis and generated the replicative AdC68-Sur-E1A-TMC-tCD19. Oncolytic tagging system could diminish established tumors in vivo and prolong mice survival significantly. Therefore, we suggest the universal oncolytic Ad-tagging system in combination with single target CAR-T cells could be a powerful complement in immunotherapy against antigenically mismatched solid tumors.
Assuntos
Antígenos de Neoplasias/imunologia , Imunoterapia Adotiva , Receptores de Antígenos de Linfócitos T/imunologia , Receptores de Antígenos Quiméricos/imunologia , Adenoviridae/genética , Animais , Antígenos CD19/genética , Antígenos CD19/imunologia , Antígenos CD19/uso terapêutico , Antígenos de Neoplasias/genética , Antígenos de Neoplasias/uso terapêutico , Linhagem Celular Tumoral , Terapia Combinada , Humanos , Sinapses Imunológicas/efeitos dos fármacos , Sinapses Imunológicas/genética , Sinapses Imunológicas/imunologia , Camundongos , Terapia Viral Oncolítica/tendências , Vírus Oncolíticos/genética , Receptores de Antígenos de Linfócitos T/genética , Receptores de Antígenos Quiméricos/genética , Receptores de Antígenos Quiméricos/uso terapêutico , Linfócitos T/imunologia , Linfócitos T/virologia , Ensaios Antitumorais Modelo de XenoenxertoRESUMO
BACKGROUND: Liberal fluid resuscitation has proved harmful in adults with severe malaria, but the level of restriction has not been defined. METHODS: In a prospective observational study in adults with severe falciparum malaria, restrictive fluid management was provided at the discretion of the treating physician. The relationships between the volume of fluid and changes in renal function or tissue perfusion were evaluated. RESULTS: A total of 154 patients were studied, 41 (26.6%) of whom died. Median total fluid intake during the first 6 and 24 hours from enrollment was 3.3 (interquartile range [IQR], 1.8-5.1) mL/kg per hour and 2.2 (IQR, 1.6-3.2) mL/kg per hour, respectively. Total fluid intake at 6 hours was not correlated with changes in plasma creatinine at 24 hours (n = 116; rs = 0.16; P = .089) or lactate at 6 hours (n = 94; rs = -0.05; P = .660). Development of hypotensive shock or pulmonary edema within 24 hours after enrollment were not related to the volume of fluid administration. CONCLUSIONS: Restrictive fluid management did not worsen kidney function and tissue perfusion in adult patients with severe falciparum malaria. We suggest crystalloid administration of 2-3 mL/kg per hour during the first 24 hours without bolus therapy, unless the patient is hypotensive.
Assuntos
Hidratação/métodos , Malária Falciparum/tratamento farmacológico , Injúria Renal Aguda/etiologia , Adulto , Feminino , Hidratação/efeitos adversos , Humanos , Testes de Função Renal , Ácido Láctico/sangue , Malária Falciparum/mortalidade , Masculino , Estudos Prospectivos , Edema Pulmonar/etiologia , Adulto JovemRESUMO
BACKGROUND: Impaired microvascular perfusion is central to the development of coma and lactic acidosis in severe falciparum malaria. Refractory hypotension is rare on admission but develops frequently in fatal cases. We assessed cardiac function and volume status in severe falciparum malaria and its prognostic significance. METHODS: Patients with severe (N = 101) or acute uncomplicated falciparum malaria (N = 83) were recruited from 2 hospitals in India and Bangladesh, and healthy participants (N = 44) underwent echocardiography. RESULTS: Patients with severe malaria had 38% shorter left ventricular (LV) filling times and 25% shorter LV ejection times than healthy participants because of tachycardia; however, stroke volume, LV internal diameter in diastole (LVIDd), and LV internal diameter in systole (LVIDs) indices were similar. A low endocardial fraction shortening (eFS) was present in 17% (9 of 52) of severe malaria patients. Adjusting for preload and afterload, eFS was similar in health and severe malaria. Fatal cases had smaller baseline LVIDd and LVIDs indices, more collapsible inferior vena cavae (IVC), and higher heart rates than survivors. The LVIDs and IVC collapsibility were independent predictors for mortality, together with base excess and Glasgow Coma Scale. CONCLUSIONS: Patients with severe malaria have rapid ejection of a normal stroke volume. Fatal cases had features of relative hypovolemia and reduced cardiac index reserve.
Assuntos
Hipovolemia/parasitologia , Malária Falciparum/fisiopatologia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Adulto , Bangladesh , Estudos de Casos e Controles , Ecocardiografia , Feminino , Hemodinâmica , Humanos , Hipovolemia/fisiopatologia , Índia , Modelos Lineares , Modelos Logísticos , Malária Falciparum/diagnóstico por imagem , Malária Falciparum/mortalidade , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Disfunção Ventricular Esquerda/parasitologia , Função Ventricular Esquerda , Adulto JovemRESUMO
BACKGROUND: In severe falciparum malaria, unlike sepsis, hypotension on admission is uncommon. We hypothesized that low nitric oxide bioavailability due to the presence of cell-free hemoglobin (CFH) increases vascular tone in severe malaria. METHODS: Patients with severe malaria (n = 119), uncomplicated malaria (n = 91), or suspected bacterial sepsis (n = 56), as well as healthy participants (n = 50), were recruited. The systemic vascular resistance index (SVRI) was estimated from the echocardiographic cardiac index and the mean arterial pressure. RESULTS: SVRI and hematocrit levels were lower and plasma CFH and asymmetric dimethylarginine levels were higher in patients with malaria, compared with healthy participants. In multivariate linear regression models for mean arterial pressure or SVRI in patients with severe malaria, hematocrit and CFH but not asymmetric dimethylarginine were significant predictors. The SVRI was lower in patients with suspected bacterial sepsis than in those with severe malaria, after adjustment for hematocrit and age. Plasma CFH levels correlated positively with the core-peripheral temperature gradient and plasma lactate levels and inversely with the perfusion index. Impaired peripheral perfusion, as reflected by a low perfusion index or a high core-peripheral temperature gradient, predicted mortality in patients with severe malaria. CONCLUSIONS: CFH is associated with mean arterial pressure, SVRI, and peripheral perfusion in patients with severe malaria. This may be mediated through the nitric oxide scavenging potency of CFH, increasing basal vascular tone and impairing tissue perfusion.
Assuntos
Pressão Arterial , Hemoglobinas/metabolismo , Malária Falciparum/fisiopatologia , Fluxo Sanguíneo Regional , Resistência Vascular , Adulto , Arginina/análogos & derivados , Arginina/sangue , Bacteriemia/fisiopatologia , Estudos de Casos e Controles , Ecocardiografia , Feminino , Hematócrito , Humanos , Masculino , Pessoa de Meia-Idade , Óxido Nítrico , Gravidade do Paciente , Adulto JovemRESUMO
Among one of the four category prostatitis, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the disease with unknown etiology and having 90-95% prevalence in prostatitis. CP/CPPS poses adverse psychological effects and weakens the quality of life (QoL) of the patients. Due to its multifactorial etiology, various types of treatment are available with different management efficacies. The conventional treatment like anti-inflammatory medications, antibiotics, and alpha-blockers have given the lack of verified efficacy that has turned the patients to alternative therapies such as acupuncture because of its efficacy, safety, and high compliance. Acupuncture is an alternative management accepted in several countries and is commonly used in traditional Chinese medicine for chronic pain. Acupuncture had the effect of immune modulation, anti-inflammatory, and neuromodulation. For chronic prostatitis, acupuncture can improve pain symptoms and can bring better results about National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and QoL. This review will discuss the efficacy of acupuncture in the treatment of CP/CPPS and effect of acupuncture on NIH-CPSI total score and its domains: pain, voiding, and QoL, as well as its effect on different biomarkers of CPPS.
Assuntos
Terapia por Acupuntura , Prostatite/terapia , Humanos , Masculino , Resultado do TratamentoRESUMO
For countries aiming for malaria elimination, travel of infected individuals between endemic areas undermines local interventions. Quantifying parasite importation has therefore become a priority for national control programs. We analyzed epidemiological surveillance data, travel surveys, parasite genetic data, and anonymized mobile phone data to measure the spatial spread of malaria parasites in southeast Bangladesh. We developed a genetic mixing index to estimate the likelihood of samples being local or imported from parasite genetic data and inferred the direction and intensity of parasite flow between locations using an epidemiological model integrating the travel survey and mobile phone calling data. Our approach indicates that, contrary to dogma, frequent mixing occurs in low transmission regions in the southwest, and elimination will require interventions in addition to reducing imported infections from forested regions. Unlike risk maps generated from clinical case counts alone, therefore, our approach distinguishes areas of frequent importation as well as high transmission.
Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Migração Humana , Malária/epidemiologia , Plasmodium/isolamento & purificação , Topografia Médica , Bangladesh/epidemiologia , Genótipo , Humanos , Incidência , Plasmodium/classificação , Plasmodium/genéticaRESUMO
The polymorphisms of invasion suppressor gene CDH1 and DNA mismatch repair gene Exo1 have been reported to play critical role in the development, tumorigenesis, and progression of several kinds of cancers including prostate cancer. This study was designed to analyze the contribution of single-nucleotide polymorphisms of the CDH1 (-160C/A) and Exo1 (K589E) to prostate cancer susceptibility in Bangladeshi population. The study included 100 prostate cancer cases and age-matched 100 healthy controls. Polymerase chain reaction-restriction fragment length polymorphism analysis was used to determine the genetic polymorphisms. A significant association was found between CDH1 -160C/A (rs16260) and Exo1 (rs1047840, K589E) polymorphisms and prostate cancer risk. In case of CDH1 -160C/A polymorphism, the frequencies of the three genotypes C/C,C/A, and A/A were 45%, 48%, and 7% in cases and 63%, 32%, and 5% in controls, respectively. The heterozygote C/A genotype and combined C/A + A/A genotypes showed 2.10-fold (odds ratio = 2.1000, 95% confidence interval = 1.2956-4.0905, p = 0.013) and 2.08-fold (odds ratio = 2.0811, 95% confidence interval = 1.1820-3.6641, p = 0.011) increased risk of prostate cancer, respectively, when compared with homozygous C/C genotypes. The variant A allele also was associated with increased risk of prostate cancer (odds ratio = 1.6901, 95% confidence interval = 1.0740-2.6597, p = 0.0233). In case of Exo1 (K589E) polymorphism, G/A heterozygote, A/A homozygote, and combined G/A + A/A genotypes were found to be associated with 2.30-, 4.85-, and 3.04-fold higher risk of prostate cancer, respectively (odds ratio = 2.3021, 95% confidence interval = 2.956-4.0905, p = 0.0031; odds ratio = 4.8462, 95% confidence interval = 1.0198-23.0284, p = 0.0291; OR = 3.0362, 95% confidence interval = 1.7054-5.4053, p = 0.0001, respectively). The "A" allele showed significant association with increased susceptibility (2.29-fold) to prostate cancer (odds ratio = 2.2955, 95% confidence interval = 1.4529-3.6270, p = 0.0004). Our results suggest that CDH1 -160C/A and Exo1 K589E polymorphisms are associated with increased susceptibility to prostate cancer in Bangladeshi population.
Assuntos
Antígenos CD/genética , Caderinas/genética , Enzimas Reparadoras do DNA/genética , Etnicidade/genética , Exodesoxirribonucleases/genética , Predisposição Genética para Doença/genética , Polimorfismo de Fragmento de Restrição/genética , Polimorfismo de Nucleotídeo Único/genética , Neoplasias da Próstata/genética , Idoso , Alelos , Bangladesh , Estudos de Casos e Controles , Genótipo , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Lactic acidosis with an elevated lactate-pyruvate ratio suggesting anoxia is a common feature of severe falciparum malaria. High lactate levels are associated with parasitized erythrocyte sequestration in the microcirculation. To assess if there is an additional contribution to hyperlactataemia from relatively inadequate total oxygen delivery, oxygen consumption and delivery were investigated in patients with malaria. METHODS: Adult Bangladeshi and Indian patients with uncomplicated (N = 50) or severe (N = 46) falciparum malaria or suspected bacterial sepsis (N = 27) and healthy participants as controls (N = 26) were recruited at Chittagong Medical College Hospital, Chittagong, Bangladesh and Ispat General Hospital, Rourkela, India. Oxygen delivery (DO2I) was estimated from pulse oximetry, echocardiographic estimates of cardiac index and haematocrit. Oxygen consumption (VO2I) was estimated by expired gas collection. RESULTS: VO2I was elevated in uncomplicated median (IQR) 185.1 ml/min/m2 (135-215.9) and severe malaria 192 ml/min/m2 (140.7-227.9) relative to healthy persons 107.9 ml/min/m2 (69.9-138.1) (both p < 0.001). Median DO2I was similar in uncomplicated 515 ml/min/m2 (432-612) and severe 487 ml/min/m2 (382-601) malaria and healthy persons 503 ml/min/m2 (447-517) (p = 0.27 and 0.89, respectively). The VO2/DO2 ratio was, therefore, increased by similar amounts in both uncomplicated 0.35 (0.28-0.44) and severe malaria 0.38 (0.29-0.48) relative to healthy participants 0.23 (0.17-0.28) (both p < 0.001). VO2I, DO2I and VO2/DO2 did not correlate with plasma lactate concentrations in severe malaria. CONCLUSIONS: Reduced total oxygen delivery is not a major contributor to lactic acidosis in severe falciparum malaria.