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1.
Leuk Res ; 136: 107433, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38154193

RESUMO

Myelodysplastic neoplasms (MDS) are clonal disorders of bone marrow failure exhibiting a variable risk of progression to acute myeloid leukemia. MDS exhibit certain prognostic genetic or cytogenetic abnormalities, an observation that has led to both the pathologic reclassification of MDS in the 2022 World Health Organization (WHO) and International Consensus Classification (ICC) systems, as well as to an updated prognostic schema, the Molecular International Prognostic Scoring System (IPSS-M). This single-institution study characterized the molecular patterns and clinical outcomes associated with the 2022 WHO and ICC classification schemas to assess their clinical utility. Strikingly, with the exception of one individual, all 210 patients in our cohort were classified into analogous categories by the two pathologic/diagnostic schemas. Most patients (70%) were classified morphologically while the remaining 30% had genetically classified disease by both criteria. Prognostic risk, as assessed by the IPSS-M score was highest in patients with MDS with biallelic/multi-hit TP53 mutations and lowest in pts with MDS-SF3B1. Median leukemia-free survival (LFS) was shortest for those with MDS with biallelic/multi-hit TP53 (0.7 years) and longest for those with MDS with low blasts (LFS not reached). These data demonstrate the clear ability of the 2022 WHO and ICC classifications to organize MDS patients into distinct prognostic risk groups and further show that both classification systems share more similarities than differences. Incorporation of the IPSS-M and IPSS-R features provide additive prognostic and survival components to both the WHO and ICC classifications, which together enhance their utility for evaluating and treating MDS patients.


Assuntos
Leucemia Mieloide Aguda , Síndromes Mielodisplásicas , Humanos , Prognóstico , Consenso , Síndromes Mielodisplásicas/patologia , Leucemia Mieloide Aguda/genética , Organização Mundial da Saúde
2.
Leuk Res ; 119: 106907, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35772318

RESUMO

Since race/ethnicity and socioeconomic status (SES), including economic and educational disadvantage (EED), may impact overall survival (OS) in primary myelodysplastic syndromes (MDS), we analyzed the impact of these characteristics on OS in Non-Hispanic White (NHW), Non-Hispanic Black (NHB) and Hispanic patients. In this retrospective review using the SEER US population and American Community Survey data between 2001 and 2016, factor analysis was used for 23 county-level SES indicators to identify groups of interrelated measures of EED. For the 52,739 patients identified, increased age at diagnosis, male sex, higher prognostic risk category and higher EED were all associated with reduced OS. The most prominent SES factor extracted by factor analysis was EED. NHB patients had the highest OS compared to NHW and Hispanics. For all patients, EED analysis showed lower OS for most compared to least disadvantaged, most notably in lower-risk disease and Hispanics. More NHB and Hispanics (51% and 49%) were in the most disadvantaged category compared with NHW (30%). No significant differences were noted for causes of death by race/ethnicity. In conclusion, these data indicate that in addition to standard clinical measures for analyzing OS, race/ethnicity, SES and EED are critical determinants for assessing clinical outcomes in MDS patients.


Assuntos
Síndromes Mielodisplásicas , População Branca , Negro ou Afro-Americano , Minorias Étnicas e Raciais , Hispânico ou Latino , Humanos , Masculino , Síndromes Mielodisplásicas/epidemiologia , Síndromes Mielodisplásicas/terapia
3.
Nat Prod Res ; 36(20): 5353-5357, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34000929

RESUMO

Chloroperoxidase (CPO) is a haeme-thiolate enzyme able to catalyse the halogenation and oxidation of a wide range of organic substrates. In this work, the CPO-catalysed chlorination and bromination reaction of natural estrogens was characterised. Estradiol, estrone and equiline were efficiently converted to halogenated compounds in the presence of chloride or bromide and hydrogen peroxide. The catalytic efficiency of CPO in this reaction is similar to that measured for other aromatic substrates; as expected the bromination reaction proceeds more efficiently than the chlorination reaction. Three major products were detected for chlorination of estradiol; two of them were monohalogenated compounds while a third product was a dihalogenated compound at positions 2 and 4 of the aromatic ring A. Chlorinated compounds are not substrates for tyrosinase, suggesting that the halogenated form of estrogens is less susceptible to form o-quinones.


Assuntos
Cloreto Peroxidase , Brometos , Catálise , Cloreto Peroxidase/química , Cloreto Peroxidase/metabolismo , Cloretos , Estradiol , Estrogênios , Estrona , Halogenação , Peróxido de Hidrogênio , Monofenol Mono-Oxigenase , Quinonas
4.
Food Chem ; 370: 131261, 2022 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-34788948

RESUMO

Clenbuterol is present in animal tissues and organs and, therefore, potentially present in gelatin derived from animal sources. The objective of this study was to develop a method for identify an quantify traces of clenbuterol in gelatin and jellies. The clenbuterol calibration curve showed linearity in the range of 20-1000 pg mL-1. The detection and quantification limits were 5 pg g-1 and 10 pg g-1, respectively. The recovery of the analyte ranged from 93.4 to 98.7% with an intra-day RSD% (n = 4) of 1.25%-3.25%, and an inter-day RSD% (n = 12) of 0.5%-2.25%, with good linearity (R2 = 0.99). The method developed and validated was successfully applied in 54 gelatin samples, 57.4% of which showed clenbuterol. This UHPLC-MS/MS method combines high sensitivity with good selectivity and short chromatographic run time.


Assuntos
Clembuterol , Animais , Cromatografia Líquida de Alta Pressão , Gelatina , Pós , Espectrometria de Massas em Tandem
5.
Life (Basel) ; 11(7)2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34357057

RESUMO

Bursera fagaroides is a medicinal tree endemic to México, it belongs to the Burseraceae family and has proven antitumor activity. Modern research, performed principally with the bark extracts, have indicated that lignans are the main active constituents of B. fagaroides, with a high content of aryltetralin, aryldihydronaphtalene, dibenzylbutirolactone, and dibenzylbutane-type lignans as the constituents of the active extracts. In general, lignans from B. fagaroides exhibited potent anti-cancer activity, although antitumor, anti-bacterial, anti-protozoal, anti-inflammatory, and anti-viral properties have also been described. This review covers literature-reported lignans from B. fagaroides, chemical structures, nomenclature, chromatographic techniques of isolation, characterization strategies, and highlights the anti-cancer molecular mechanisms of lignans. Evaluation of the anticancer function of lignans has been extensively investigated since the cytotoxic in vitro results and in vivo assays in mice and zebrafish models to the tubulin molecular recognition by NMR. Also, we discuss the future direction for studying this important plant species and its lignan metabolites.

6.
Transplantation ; 105(3): 586-592, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-32301905

RESUMO

BACKGROUND: Patients with end-stage liver disease and pretransplant Aspergillus colonization are problematic for determining liver transplant candidacy and timing of transplantation because of concerns for posttransplant invasive aspergillosis. METHODS: We performed a retrospective review of the medical and laboratory records of all adult patients (aged ≥18 y) who underwent liver transplantation with pretransplant Aspergillus colonization at the Ronald Reagan University of California, Los Angeles, Medical Center from January 1, 2010, to December 31, 2015. RESULTS: A total of 27 patients who had Aspergillus colonization (respiratory tract 26, biliary tract 1) before liver transplantation were identified. Pretransplant characteristics included previous liver transplant (11 of 27, 40.7%), dialysis (22 of 27, 81.5%), corticosteroid therapy (12 of 27, 44.4%), intensive care unit stay (27 of 27, 100%), and median model for end-stage liver disease score of 39. Only 22.2% (6 of 27) received pretransplant antifungal agents (median duration, 5 d), whereas 100% (27 of 27) received posttransplant antifungal prophylaxis (voriconazole 81.4%, 22 of 27; echinocandin 14.8%, 4 of 27; voriconazole plus echinocandin 3.7%, 1 of 27) for median duration of 85 d. Posttransplant invasive fungal infection occurred in 14.8% (4 of 27; aspergillosis 3, mucormycosis 1). Both 6-month and 12-month survival were 66.7% (18 of 27), but only 1 death was due to fungal infection. Other causes of death were liver graft failure, intraabdominal complications, and malignancy. CONCLUSIONS: A substantial number of patients with pretransplant Aspergillus colonization can still undergo successful liver transplantation if they are otherwise suitable candidates and receive appropriate antifungal prophylaxis. Posttransplant outcome in these patients is determined mostly by noninfectious complications and not fungal infection. Pretransplant Aspergillus colonization alone should not necessarily preclude or delay liver transplantation.


Assuntos
Aspergilose/complicações , Aspergillus/isolamento & purificação , Doença Hepática Terminal/cirurgia , Transplante de Fígado/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Aspergilose/microbiologia , Doença Hepática Terminal/complicações , Doença Hepática Terminal/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
7.
Int J Mol Sci ; 20(21)2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31683666

RESUMO

Deep Eutectic Solvents (DES) were investigated as new reaction media for the synthesis of alkyl glycosides catalyzed by the thermostable α-amylase from Thermotoga maritima Amy A. The enzyme was almost completely deactivated when assayed in a series of pure DES, but as cosolvents, DES containing alcohols, sugars, and amides as hydrogen-bond donors (HBD) performed best. A choline chloride:urea based DES was further characterized for the alcoholysis reaction using methanol as a nucleophile. As a cosolvent, this DES increased the hydrolytic and alcoholytic activity of the enzyme at low methanol concentrations, even when both activities drastically dropped when methanol concentration was increased. To explain this phenomenon, variable-temperature, circular dichroism characterization of the protein was conducted, finding that above 60 °C, Amy A underwent large conformational changes not observed in aqueous medium. Thus, 60 °C was set as the temperature limit to carry out alcoholysis reactions. Higher DES contents at this temperature had a detrimental but differential effect on hydrolysis and alcoholysis reactions, thus increasing the alcoholyisis/hydrolysis ratio. To the best of our knowledge, this is the first report on the effect of DES and temperature on an enzyme in which structural studies made it possible to establish the temperature limit for a thermostable enzyme in DES.


Assuntos
Proteínas de Bactérias/metabolismo , Glicosídeos/metabolismo , Solventes/química , Thermotoga maritima/enzimologia , alfa-Amilases/metabolismo , Proteínas de Bactérias/química , Biocatálise , Colina/química , Dicroísmo Circular , Estabilidade Enzimática , Temperatura Alta , Ligação de Hidrogênio , Hidrólise , Metanol/química , Conformação Proteica , Ureia/química , alfa-Amilases/química
9.
Biol Blood Marrow Transplant ; 24(8): 1715-1720, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29555315

RESUMO

Nocardial infections have been rare after allogeneic hematopoietic stem cell transplantation (HSCT). We report 10 recent cases of late-onset nocardiosis (median time of onset of 508 days after transplantation) primarily in patients on high doses of corticosteroids for graft-versus-host disease. All 10 patients had pulmonary infection caused by Nocardia species susceptible to trimethoprim-sulfamethoxazole (TMP-SMX). At time of diagnosis 8 of 10 patients were not receiving TMP-SMX for prophylaxis of Pneumocystis jiroveci pneumonia (PJP; 7 on atovaquone, 1 on i.v. pentamidine). After the initiation of atovaquone prophylaxis for PJP in place of TMP-SMX for many UCLA allogeneic HSCT patients in 2012, 9 cases of nocardiosis occurred in 411 patients (2.2%) over the next 6 years (2012 to 2017) compared with only 1 case in 575 patients (0.17%) during the previous 12 years (2000 to 2011). Although there were no deaths directly related to nocardial infection treated primarily with TMP-SMX, overall mortality in this group of patients was 40%. Based on this experience, the use of atovaquone for PJP prophylaxis in place of TMP-SMX may be associated with an increased risk for previously rare nocardial infections after allogeneic HSCT.


Assuntos
Atovaquona/uso terapêutico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Nocardiose/prevenção & controle , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Adulto , Idoso , Aloenxertos , Atovaquona/farmacologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Nocardiose/tratamento farmacológico , Pneumonia por Pneumocystis/prevenção & controle , Transplantados , Combinação Trimetoprima e Sulfametoxazol/farmacologia
10.
Food Chem ; 227: 202-210, 2017 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-28274423

RESUMO

Blastose, a natural disaccharide found in honey, is usually found as a byproduct of fructo-oligosaccharide synthesis from sucrose with fructosyltransferases. In this study, we describe a novel two-step biosynthetic route to obtain blastose, designed from a detailed observation of B. subtilis levansucrase (SacB) acceptor structural requirements for fructosylation. The strategy consisted first in the synthesis of the trisaccharide O-ß-d-Fruf-(2↔6)-O-α-d-Glcp-(1↔1)-α-d-Glcp, through a regioselective ß-d-transfructosylation of trehalose (Tre) which acts as acceptor in a reaction catalyzed by SacB using sucrose or levan as fructosyl donor. In this reaction, levansucrase (LS) transfers regioselectively a fructosyl residue to either C6-OH group of the glucose residues in Tre. The resulting trisaccharide obtained in 23% molar yield based on trehalose, was purified and fully characterized by extensive NMR studies. In the second step, the trisaccharide is specifically hydrolyzed by trehalase, to obtain blastose in 43.2% molar yield based on the trisaccharide. This is the first report describing the formation of blastose through a sequential transfuctosylation-hydrolysis reaction.


Assuntos
Dissacaridases/metabolismo , Hexosiltransferases/metabolismo , Trealose/metabolismo , Trissacarídeos/metabolismo , Bacillus subtilis/enzimologia , Proteínas de Bactérias/metabolismo , Frutanos/metabolismo , Hidrólise , Sacarose/metabolismo
11.
Rev. cuba. farm ; 49(4)oct.-dic. 2015. ilus
Artigo em Espanhol | LILACS, CUMED | ID: lil-780744

RESUMO

Introducción: el tractus urinario es la localización más frecuente de las infecciones hospitalarias, la mayor parte ocasionadas por instrumentación del tracto urinario, y los agentes antimicrobianos constituyen una intervención importante en la terapéutica. Objetivo: determinar la incidencia de infecciones y las prácticas de utilización de antimicrobianos en pacientes del Servicio de Urología de un hospital especializado. Método: estudio prospectivo, exploratorio, realizado en el período enero a junio de 2013, con observación mensual a pacientes hospitalizados en el servicio de Urología con indicación de antimicrobianos. Se obtuvo la información sobre la presencia de sepsis, diagnóstico de Infección Asociada a la Asistencia Sanitaria, procedimientos quirúrgicos y las características de la prescripción de antimicrobianos. Resultados: la enfermedad litiásica fue el antecedente patológico más reportado. Se constató la presencia de infección al ingreso en un 81,2 por ciento, en el 24,2 por ciento como infección relacionada a los procesos quirúrgicos endourológicos. Las cefalosporinas de tercera generación fueron los antimicrobianos más indicados para el control de la infección y coincidentemente para la profilaxis quirúrgica. Conclusiones: la prescripción de antimicrobianos fue empírica con elevada proporción de prescripción adecuada(AU)


Introduction: the most frequent location of nosocomial infections is the urinary tract, most of them caused by its manipulation, so antibiotic agents constitute an important therapeutic intervention. Objective: to define infectios incidence and the protocols of use of antibiotics in patients admitted to the urology service at a specialized hospital. Method: prospective and exploratory study carried out from January to June 2013, with monthly observation to hospitalized patients using antibiotics at the Urology service. Information about presence of sepsis, Health Assistance Related Infection, diagnosis, surgical procedures and antibiotics prescription characteristics was obtained. Results: personal history of nephrolithiasis was reported as the most frequently medical history. Presence of infection at admission was confirmed in 81,2 percent of the patients, 24,2 percent of them related with endourological surgical procedures. Third generation cephalosporins were the most indicated antibiotics to control infections and for surgical prophylaxis. Conclusions: antibiotics prescription was empiric with high rate of adequate prescription(AU)


Assuntos
Humanos , Doenças Urológicas/tratamento farmacológico , Cefalosporinas/uso terapêutico , Antibacterianos/uso terapêutico , Estudos Prospectivos
12.
Rev. cuba. cir ; 54(1): 25-33, ene.-mar. 2015. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-754883

RESUMO

Introducción: en los últimos años se ha observado un incremento de pacientes ancianos en los servicios de hemodiálisis. Este hecho, unido al número creciente de pacientes diabéticos con lecho vascular deteriorado, ha aumentado la dificultad para la creación de un acceso vascular en esta población en riesgo. Objetivo: observar el comportamiento de las fístulas arteriovenosas en pacientes de 65 años o más en régimen de hemodiálisis. Métodos: se realizó un estudio observacional descriptivo prospectivo en pacientes de 65 años o más a los que se le construyó una fístula arteriovenosa entre marzo de 2011 y marzo de 2013 en el servicio de Hemodiálisis del Instituto de Nefrología de La Habana. El grupo de estudio fue de 58 pacientes. Resultados: Hubo predominio del sexo masculino (55,2 por ciento). Las enfermedades de base que más se observaron fueron la Diabetes mellitus (43,1 por ciento) y la Hipertensión arterial (37,9 por ciento). Las complicaciones que más se registraron fueron: flujo insuficiente (15,2 por ciento) y trombosis (12,1 por ciento). Mostraron mayor supervivencia las fístulas arteriovenosas en hombres (78 %), en pacientes no diabéticos (73 por ciento) y las de localización radiocefálica (73 por ciento). La supervivencia primaria global al año de las fístulas arteriovenosas en nuestros pacientes fue de 69,0 por ciento. Conclusiones: Las fístulas arteriovenosas autólogas pueden ser realizadas como primera opción en pacientes de 65 años o más y se obtienen tasas de supervivencia adecuadas, comparables a las de otros grupos de pacientes(AU)


Introduction: In the last few years, the number of old patients in the hemodialysis service has increased. This fact along with this growing number of diabetic patients that show damaged vascular bed has brought about more difficulties in creating a vascular access in their risk population. Objective: To observe the behavior of arteriovenous fistulae in patients aged 65 years or more subjected to hemodialysis. Methods: Prospective, descriptive and observational study conducted in 65 years old and over whom an arteriovenous fistula was created from March 2011 to March 2013 at the hemodialysis service of the Institute of Nephrology in Havana. The study group was made up of 58 patients. Results: The male sex predominated (55.2 percent). The most observed underlying diseases were diabetes mellitus (43.1 percent) and hypertension (37.9 percent). The most found complications were insufficient flow (15.2 percent) and thrombosis (12.1 percent). The highest survival rate was seen in arteriovenous fistulae in men (78 percent); non-diabetic patients (73 percent) and radiocephalic location (73 percent). The global primary survival rate after one year of the arteriovenous fistulae in our patients was 69 percent. Conclusions: The autologous arteriovenous fistulae may be performed as a first option in patients aged 65 years or more, and adequate survival rates, comparable to those of other groups of patients, were reached(AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Derivação Arteriovenosa Cirúrgica/métodos , Diálise Renal/instrumentação , Dispositivos de Acesso Vascular , Epidemiologia Descritiva , Estudo Observacional , Estudos Prospectivos
13.
Carbohydr Res ; 404: 46-54, 2015 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-25665778

RESUMO

Cyclodextrin glycosyltransferases (CGTase) are reported to selectively catalyze α(1 → 4)-glycosyl transfer reactions besides showing low hydrolytic activity. Here, the effect of the anomeric configuration of the glycosyl acceptor on the regioselectivity of CGTase catalyzed glycosylations was investigated. For this purpose, the α and ß anomers of p-nitrophenyl-D-glucopyranoside were used as glycosyl acceptors, Bacillus macerans and Thermoanaerobacter sp. CGTases were used as biocatalysts and ß-cyclodextrin as the glycosyl donor. As expected, p-nitrophenyl-α-D-glucopyranosyl-(1 → 4)-O-α-D-glucopyranoside was produced when p-nitrophenyl-α-D-glucopyranoside was used as acceptor with B. macerans CGTase. Surprisingly, when p-nitrophenyl-ß-D-glucopyranoside was used as glycosyl acceptor, besides the expected α(1 → 4)-glycosylation products both α(1 → 3)- and α(1 → 6)-transfer products were also obtained. This unexpected change in B. macerans CGTase regioselectivity leading to α(1 → 4)-, α(1 → 3)- and α(1 → 6)-glycosylation products was also observed for Thermoanaerobacter sp. CGTase with the ß anomer. It is shown, applying time course analyses, that all isomers can be synthesized efficiently by adequate selection of enzyme and reaction conditions. In fact, when using Thermoanaerobacter sp. CGTase the yield of p-nitrophenyl-ß-D-isomaltoside (the α(1 → 6)-transfer product) was the highest at long reaction time (19% yield). The previously unknown capacity of α(1 → 6)-glycosidic linkages formation by CGTases demonstrates an unexpected broader regioselectivity of CGTases in glycosyl-transfer reactions as well as an acceptor dependent transfer selectivity.


Assuntos
Glucosídeos/síntese química , Glucosiltransferases/metabolismo , Bacillus/enzimologia , Proteínas de Bactérias/metabolismo , Catálise , Glucosídeos/química , Glicosilação , Especificidade por Substrato , Thermoanaerobacter/enzimologia , beta-Ciclodextrinas/química
14.
Springerplus ; 3: 583, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25332883

RESUMO

We report the screening and characterization of EPS produced by LAB identified as Leuconostoc kimchii isolated from pulque, a traditional Mexican fermented, non-distilled alcoholic beverage produced by the fermentation of the sap extracted from several (Agave) maguey species. EPS-producing LAB constitutes an abundant bacterial group relative to total LAB present in sap and during fermentation, however, only two EPS-producing colony phenotypes (EPSA and EPSB, respectively) were detected and isolated concluding that despite the high number of polymer-producing LAB their phenotypic diversity is low. Scanning electron microcopy analysis during EPS-producing conditions revealed that both types of EPS form a uniform porous structure surrounding the bacterial cells. The structural characterization of the soluble and cell-associated EPS fractions of each polymer by enzymatic and acid hydrolysis, as by 1D- and 2D-NMR, showed that polymers produced by the soluble and cell-associated fractions of EPSA strain are dextrans consisting of a linear backbone of linked α-(1→6) Glcp in the main chain with α-(1→2) and α-(1→3)-linked branches. The polymer produced by the soluble fraction of EPSB strain was identified as a class 1 dextran with a linear backbone containing consecutive α-(1→6)-linked D-glucopyranosyl units with few α-(1→3)-linked branches, whereas the cell-associated EPS is a polymer mixture consisting of a levan composed of linear chains of (2→6)-linked ß-D-fructofuranosyl residues with ß-(2→6) connections, and a class 1 dextran. According to our knowledge this is the first report of dextrans and a levan including their structural characterization produced by L. kimchii isolated from a traditional fermented source.

15.
Rev. cuba. cir ; 52(3): 211-217, jul.-sep. 2013.
Artigo em Espanhol | LILACS | ID: lil-696697

RESUMO

Los aneurismas de fístulas arteriovenosas para hemodiálisis constituyen una complicación que aparece en algunos pacientes y que no siempre se toma una conducta con relación a ellos. En este trabajo presentamos un caso de una mujer de 29 años de edad con nueve años en hemodiálisis a través de una fístula arteriovenosa braquiocefálica izquierda que desarrolló aneurisma gigante con peligro de ruptura espontánea, la cual fue sometida a tratamiento quirúrgico. Se describe la técnica y se revisa la literatura al respecto(AU)


Hemodialysis arteriovenous fistula aneurisms represent a complication that we can observe in some patients and not always is taken a procedure in relation to them. Herein, we report the case of 29 year old woman with nine years of hemodialysis treatment through left brachiocephalic arteriovenous fistula which developed a giant aneurism with the possibility of spontaneous rupture. The patient was submitted to surgical treatment. The technique was described and the literature was review(AU)


Assuntos
Humanos , Feminino , Adulto , Aneurisma/cirurgia , Aneurisma/etiologia , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Diálise Renal
16.
Rev. cuba. cir ; 51(4): 307-317, oct.-dic. 2012.
Artigo em Espanhol | LILACS | ID: lil-662287

RESUMO

Introducción: el tratamiento sustitutivo de la insuficiencia renal crónica en su estadio terminal requiere la creación previa de un acceso vascular permanente cuando se elige como método depurador la hemodiálisis, siendo la fístula arteriovenosa autóloga el angioacceso más usado por las ventajas que ofrece. El objetivo de este estudio fue conocer las características generales de esta población de pacientes y cómo ellas se relacionaron con la supervivencia anual de las fístulas arteriovenosas realizadas en este grupo de enfermos. Métodos: se llevó a cabo un estudio prospectivo, descriptivo y longitudinal para el que se tomaron 109 pacientes en los que se realizaron 115 fístulas arteriovenosas. Estos pacientes asistieron al Instituto de Nefrología de La Habana para realizarse un acceso vascular para hemodiálisis, estos accesos vasculares fueron construidos por el Grupo Básico de Trabajo de Cirugía de dicha institución, en el período comprendido de marzo de 2005 a marzo de 2007. Se analizaron los factores de riesgo que podían influir en la supervivencia de las fístulas. Resultados: en el estudio realizado se observó un ligero predominio del sexo maculino (59 hombres y 50 mujeres), con una edad media de 52,5 años, y en los que predominaron como causa de insuficiencia renal crónica la nefroangioesclerosis seguida de la nefropatía diabética y la enfermedad renal poliquística autosómica dominante. La cifra promedio de filtrado glomerular con que se enviaron los pacientes a realizarse la fístula fue de 18,73 ml/min. De nuestros pacientes, 59 presentaban algún tipo de acceso vascular previo. Encontramos una menor supervivencia o tasa de permeabilidad primaria en los pacientes diabéticos y en las fístulas de localización braquial, fundamentalmente las humerobasílicas, sin presentar una relación estadísticamente significativa este último aspecto (p < 0,05). El 35 por ciento de nuestros pacientes se encontraba en régimen de hemodiálisis al realizarse la fístula arteriovenosa. Conclusiones: la fístula arteriovenosa autóloga continúa siendo el acceso vascular preferido por su menor índice de complicaciones. Es importante la selección previa del sitio adecuado para su creación. La diabetes mellitus es un importante factor de riesgo que influye significativamente en una menor supervivencia de los angioaccesos(AU)


Introduction: in the replacement therapy of end-stage renal disease, the previous creation of a permanent vascular access is required when hemodialysis is chosen as a depurative method. Autologous arteriovenous fistula is the most widely used angioaccess because of its advantages. The objective of the present study was to assess the demographic data of this population and their relationship with the annual survival of arteriovenous fistulae in this group. Methods: a longitudinal prospective and descriptive study was conducted in 109 patients in whom 115 arteriovenous fistulae were created. They had been referred to the Department of Surgery of the Nephrology Institute of Havana in order to create vascular access for hemodialysis in the period from March 2005 through March 2007. The risk factors in the fistula survival were analyzed. Results: males slightly predominated (59 males and 50 females). The average age was 52.5 years. Nephroangiosclerosis followed by diabetic nephropathy and polycystic kidney disease were the predominant causes of end-stage renal disease. Glomerular filtration average for these patients was 18.73 ml/min. Fifty nine had a previous vascular access. A lower survival or primary patency rate was found in diabetic patients and in cases of humerobasilic fistulae, without any statistically significant relation in this last aspect (p>0.05). Thirty five percent of the patients were under hemodialysis therapy at the time of arteriovenous fistula placement. Conclusions: autologous arteriovenous fistula remains as a preferred vascular access due to its lower rate of complications. The selection of the correct placement site prior to the procedure is critical. Diabetes mellitus is an important risk factor which may have a significant effect on lower survival rates of vascular accesses


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Fístula Arteriovenosa/epidemiologia , Diálise Renal/métodos , Insuficiência Renal Crônica/terapia , Dispositivos de Acesso Vascular/efeitos adversos , Angioplastia Coronária com Balão/métodos , Epidemiologia Descritiva , Estudos Prospectivos , Estudos Longitudinais
17.
Carbohydr Res ; 360: 93-101, 2012 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-22940181

RESUMO

Monoglucosylated products of L-chiro-, D-chiro-, muco-, and allo-inositol were synthesized by regioselective α-D-glucosylation with cyclodextrin glucosyl transferase from Thermoanaerobacter sp. after hydrolysis of by products with Aspergillus niger glucoamylase. While the reactions carried out with D-chiro-, muco-, and allo-inositol resulted in the regioselective formation of monoglucosylated products, two products were obtained in the reaction with L-chiro-inositol. Through the structural characterization of the glucosylated inositols here we demonstrated that the selectivity observed in the glucosylation of several inositols by Thermoanaerobacter sp. CGTase, is analogous to the specificity observed for the glucosylation of ß-D-glucopyranose and equivalent glucosides.


Assuntos
Glucosiltransferases/metabolismo , Inositol/biossíntese , Thermoanaerobacter/enzimologia , Biocatálise , Configuração de Carboidratos , Glicosilação , Inositol/química , Estereoisomerismo
18.
J Bacteriol ; 193(22): 6295-304, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21926226

RESUMO

FadD is an acyl coenzyme A (CoA) synthetase responsible for the activation of exogenous long-chain fatty acids (LCFA) into acyl-CoAs. Mutation of fadD in the symbiotic nitrogen-fixing bacterium Sinorhizobium meliloti promotes swarming motility and leads to defects in nodulation of alfalfa plants. In this study, we found that S. meliloti fadD mutants accumulated a mixture of free fatty acids during the stationary phase of growth. The composition of the free fatty acid pool and the results obtained after specific labeling of esterified fatty acids with a Δ5-desaturase (Δ5-Des) were in agreement with membrane phospholipids being the origin of the released fatty acids. Escherichia coli fadD mutants also accumulated free fatty acids released from membrane lipids in the stationary phase. This phenomenon did not occur in a mutant of E. coli with a deficient FadL fatty acid transporter, suggesting that the accumulation of fatty acids in fadD mutants occurs inside the cell. Our results indicate that, besides the activation of exogenous LCFA, in bacteria FadD plays a major role in the activation of endogenous fatty acids released from membrane lipids. Furthermore, expression analysis performed with S. meliloti revealed that a functional FadD is required for the upregulation of genes involved in fatty acid degradation and suggested that in the wild-type strain, the fatty acids released from membrane lipids are degraded by ß-oxidation in the stationary phase of growth.


Assuntos
Proteínas de Bactérias/metabolismo , Coenzima A Ligases/metabolismo , Ácidos Graxos/metabolismo , Lipídeos de Membrana/metabolismo , Sinorhizobium meliloti/enzimologia , Proteínas de Bactérias/genética , Transporte Biológico , Coenzima A Ligases/genética , Mutação , Sinorhizobium meliloti/genética , Sinorhizobium meliloti/metabolismo
19.
PLoS One ; 6(6): e20115, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21674039

RESUMO

Phenylpropanoid glycosides (PPGs) are natural compounds present in several medicinal plants that have high antioxidant power and diverse biological activities. Because of their low content in plants (less than 5% w/w), several chemical synthetic routes to produce PPGs have been developed, but their synthesis is a time consuming process and the achieved yields are often low. In this study, an alternative and efficient two-step biosynthetic route to obtain natural PPG analogues is reported for the first time. Two galactosides were initially synthesized from vanillyl alcohol and homovanillyl alcohol by a transgalactosylation reaction catalyzed by Kluyveromyces lactis ß-galactosidase in saturated lactose solutions with a 30%-35% yield. To synthesize PPGs, the galactoconjugates were esterified with saturated and unsaturated hydroxycinnamic acid derivatives using Candida antarctica Lipase B (CaL-B) as a biocatalyst with 40%-60% yields. The scavenging ability of the phenolic raw materials, intermediates and PPGs was evaluated by the 2,2-diphenyl-1-picrylhydrazyl radical (DPPH•) method. It was found that the biosynthesized PPGs had higher scavenging abilities when compared to ascorbic acid, the reference compound, while their antioxidant activities were found similar to that of natural PPGs. Moreover, density functional theory (DFT) calculations were used to determine that the PPGs antioxidant mechanism proceeds through a sequential proton loss single electron transfer (SPLET). The enzymatic process reported in this study is an efficient and versatile route to obtain PPGs from different phenylpropanoid acids, sugars and phenolic alcohols.


Assuntos
Sequestradores de Radicais Livres/química , Sequestradores de Radicais Livres/síntese química , Glicosídeos/química , Glicosídeos/síntese química , Lipase/metabolismo , Teoria Quântica , beta-Galactosidase/metabolismo , Álcoois Benzílicos/química , Ácidos Cafeicos/química , Ácidos Cumáricos/química , Proteínas Fúngicas , Galactose/química , Hidróxidos/química , Kluyveromyces/enzimologia
20.
Rev. cuba. med ; 45(3)jul.-sep. 2006.
Artigo em Espanhol | LILACS | ID: lil-465576

RESUMO

Se hizo la presentación clínica de un paciente de 59 años de edad atendido en el Instituto de Nefrología de Cuba con antecedentes de insuficiencia renal crónica terminal que después de haber estado 73 d en método dialítico recibió un trasplante renal, el 2 de mayo de 1970, de donante cadáver, sin realizarse prueba cruzada ni tipaje HLA como se realiza en la actualidad, solo con estudios de grupo sanguíneo; se usó terapia inmunosupresora imurán y prednisona. Actualmente se encuentra con buena función del injerto por lo que es el trasplantado renal con estas características de mayor tiempo de evolución


Assuntos
Transplante de Rim
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