RESUMO
The International Consensus Classification of Myeloid Neoplasms and Acute Leukemias (ICC) and the 5th edition of the WHO classification (WHO 2022) have refined the diagnosis of myelodysplastic syndromes (MDS). Both classifications segregate MDS subtypes based on molecular or cytogenetic findings but rely on the subjective assessment of blast cell percentage and dysplasia in hematopoietic cell lineages. This study aimed to evaluate interobserver concordance among 13 cytomorphologists from eight hospitals in assessing blast percentages and dysplastic features in 44 MDS patients. The study found fair interobserver agreement for the PB blast percentage and moderate agreement for the BM blast percentage, with the best concordance in cases with <5% BM blasts and >10% BM blasts. Monocyte count agreement was fair, and dysplasia assessment showed moderate concordance for megakaryocytic lineage but lower concordance for erythroid and granulocytic lineages. Overall, interobserver concordance for MDS subtypes was moderate across all classifications, with slightly better results for WHO 2022. These findings highlight the ongoing need for morphological evaluation in MDS diagnosis despite advances in genetic and molecular techniques. The study supports the blast percentage ranges established by the ICC but suggests refining BM blast cutoffs. Given the moderate interobserver concordance, a unified classification approach for MDS is recommended.
RESUMO
Pyridine, a compound with a heterocyclic structure, is a key player in medicinal chemistry and drug design. It is widely used as a framework for the design of biologically active molecules and is the second most common heterocycle in FDA-approved drugs. Pyridine is known for its diverse biological activity, including antituberculosis, antitumor, anticoagulant, antiviral, antimalarial, antileishmania, anti-inflammatory, anti-Alzheimer's, antitrypanosomal, antimalarial, vasodilatory, antioxidant, antimicrobial, and antiproliferative effects. This review, spanning from 2022 to 2012, involved the meticulous identification of pyridine derivatives with antiproliferative activity, as indicated by their minimum inhibitory concentration values (IC50) against various cancerous cell lines. The aim was to determine the most favorable structural characteristics for their antiproliferative activity. Using computer programs, we constructed and calculated the molecular descriptors and analyzed the electrostatic potential maps of the selected pyridine derivatives. The study found that the presence and positions of the -OMe, -OH, -C=O, and NH2 groups in the pyridine derivatives enhanced their antiproliferative activity over the cancerous cellular lines studied. Conversely, pyridine derivatives with halogen atoms or bulky groups in their structures exhibited lower antiproliferative activity.
Assuntos
Antineoplásicos , Proliferação de Células , Piridinas , Piridinas/química , Piridinas/farmacologia , Humanos , Proliferação de Células/efeitos dos fármacos , Antineoplásicos/farmacologia , Antineoplásicos/química , Relação Estrutura-Atividade , Linhagem Celular TumoralRESUMO
Nitrogen (N) is the most important nutrient in coffee, with a direct impact on productivity, quality, and sustainability. N uptake by the roots is dominated by ammonium (NH4+) and nitrates (NO3-), along with some organic forms at a lower proportion. From the perspective of mineral fertilizer, the most common N sources are urea, ammonium (AM), ammonium nitrates (AN), and nitrates; an appropriate understanding of the right balance between N forms in coffee nutrition would contribute to more sustainable coffee production through the better N management of this important crop. The aim of this research was to evaluate the influences of different NH4-N/NO3-N ratios in coffee from a physiological and agronomical perspective, and their interaction with soil water levels. Over a period of 5 years, three trials were conducted under controlled conditions in a greenhouse with different growing media (quartz sand) and organic soil, with and without water stress, while one trial was conducted under field conditions. N forms and water levels directly influence physiological responses in coffee, including photosynthesis (Ps), chlorophyll content, dry biomass accumulation (DW), nutrient uptake, and productivity. In all of the trials, the plants group in soils with N ratios of 50% NH4-N/50% NO3-N, and 25% NH4-N/75% NO3-N showed better responses to water stress, as well as a higher Ps, a higher chlorophyll content, a higher N and cation uptake, higher DW accumulation, and higher productivity. The soil pH was significantly influenced by the N forms: the higher the NO3--N share, the lower the acidification level. The results allow us to conclude that the combination of 50% NH4-N/50% NO3-N and 25% NH4-N/75% NO3-N N forms in coffee improves the resistance capacity of the coffee to water stress, improves productivity, reduces the soil acidification level, and improves ion balance and nutrient uptake.
RESUMO
Proteinuria is the main predictor of kidney graft loss. However, there is little information regarding the consequences of nephrotic proteinuria (NP) and nephrotic syndrome (NS) after a kidney transplant. We aimed to describe the clinical and histopathological characteristics of kidney recipients with nephrotic-range proteinuria and compare the graft surveillance between those who developed NS and those who did not. A total of 204 patients (18.6% of kidney transplants in the study period) developed NP, and 68.1% of them had NS. Of the 110 patients who underwent a graft biopsy, 47.3% exhibited ABMR, 21.8% the recurrence of glomerulonephritis, 9.1% IFTA, and 7.3% de novo glomerulonephritis. After a median follow-up of 97.5 months, 64.1% experienced graft loss. The graft survival after the onset of NP declined from 75.8% at 12 months to 38% at 5 years, without significant differences between those with and those without NS. Patients who developed NS fewer than 3 months after the onset of NP exhibited a significantly higher risk of death-censored graft loss (HR: 1.711, 95% CI: 1.147-2.553) than those without NS or those with late NS. In conclusion, NP and NS are frequent conditions after a kidney transplant, and they imply extremely poor graft outcomes. The time from the onset of NP to the development of NS is related to graft survival.
RESUMO
This work reports on two thiourea-based receptors with pyridine and amine units including 1-naphthyl (MT1N) and 4-nytrophenyl (MT4N) as signaling units. For both compounds, their affinity and signaling ability toward various anions of different geometry and basicity in DMSO were studied using UV-vis, fluorescence, and 1H NMR techniques. Anion recognition studies revealed that both MT1N and MT4N have, in general, high affinities toward basic anions. In this regard, a higher acidity of the MT4N receptor was demonstrated. Furthermore, MT4N has a higher affinity for fluoride (log K1 = 5.98) than for the other anions and can effectively detect it through colorimetric changes that can be monitored by the UV-vis technique. The interaction between receptors and anions mainly involves the hydrogens of the amino and thiourea groups of the former. Complementary single-crystal X-ray diffraction studies and molecular modeling at the DFT level were also performed.
RESUMO
BACKGROUND: In 2015, the Spanish National Transplant Organization developed a prioritization system (Program for Access to Transplantation for Highly Sensitized Patients [PATHI]) to increase transplant options for patients with calculated panel-reactive antibodies (cPRAs) ≥98%, based on virtual crossmatch. We describe the experience with the implementation of PATHI and assess its efficacy. METHODS: PATHI registry was used to collect characteristics of donors and patients between June 15, 2015, and March 1, 2018. One-year graft and patient survival and acute rejection were also measured. A Cox model was used to identify factors related to patient death and graft loss and logistical regression for those associated with rejection. RESULTS: One thousand eighty-nine patients were included, and 272 (25%) were transplanted. Transplant rate by cPRA was 54.9%, 40.5%, and 12.8% in patients with cPRA98%, cPRA99%, and cPRA100%, respectively. One-year patient survival was 92.5%. Recipient age ≥60, time under dialysis >7 y, and delayed graft function were mortality risk factors. One-year graft survival was 88.7%. The factor related to graft loss was delayed graft function. The rejection rate was 22%. Factors related to rejection were sex, older recipients, and posttransplant donor-specific antibodies. CONCLUSIONS: A prioritization approach increases transplant options for highly sensitized patients with appropriate short-term postransplant outcomes. Along with other programs, PATHI may inspire other countries to adopt strategies to meet transplant needs of these patients.
Assuntos
Transplante de Rim , Humanos , Transplante de Rim/efeitos adversos , Função Retardada do Enxerto/etiologia , Rejeição de Enxerto/prevenção & controle , Doadores de Tecidos , Sobrevivência de Enxerto , Anticorpos , Teste de Histocompatibilidade , Antígenos HLARESUMO
The growing interest in green ammonia production has spurred the development of new catalysts with the potential to carry out the Haber-Bosch process under mild pressure and temperature conditions. While there is a wide experimental background on new catalysts involving transition metals, supports and additives, the fundamentals behind ammonia synthesis performance on these catalysts remained partially unsolved. Here, we review the most important works developed to date and analyze the traditional catalysts for ammonia synthesis, as well as the influence of the electron transfer properties of the so-called 3rd-generation catalysts. Finally, the importance of metal-support interactions is highlighted as an effective pathway for the design of new materials with potential to carry out ammonia synthesis at low temperatures and pressures.
RESUMO
SARS-CoV-2 infection (COVID-19) has had a significant impact on transplant activity in our country. Mortality and the risk of complications associated with COVID-19 in kidney transplant recipients (KT) were expected to be higher due to their immunosuppressed condition and the frequent associated comorbidities. Since the beginning of the pandemic in March 2020 we have rapidly improved our knowledge about the epidemiology, clinical features and management of COVID-19 post-transplant, resulting in a better prognosis for our patients. KT units have been able to adapt their programs to this new reality, normalizing both donation and transplantation activity in our country. This manuscript presents a proposal to update the general recommendations for the prevention and treatment of infection in this highly vulnerable population such as KT.
Assuntos
COVID-19 , Transplante de Rim , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , Pandemias/prevenção & controle , ComorbidadeRESUMO
INTRODUCTION: Post transplant lymphoproliferative disorders (PTLD) are heterogeneous lymphoid proliferations in recipients of solid organs which seem to be related to Epstein Barr Virus (EBV). The use of antilymphocyte antibodies, EBV seronegativity in the recipient,acute rejection and CMV infection have been identified as classical risk factors. MATERIAL Y METHODS: We have studied in a retrospective observational study, the incidence of PTLD in a period of 22 years, its relationship with EBV, presence of classical risk factors and outcome in 21546 simple adult renal transplant recipients from cadaveric and living donors, transplanted in 21 hospitals from 1990 to 2009. RESULTS: A total of 275 recipients developed PTLD (1,2%),195 males (70,9%), 80 females (29,1%) aged 59.2 (p25 44.7 p75 68)years. Two hundred forty-five (89.0%) were 1st transplant recipients and 269 (97,8%) from cadaveric donors. EBV in the tissue was reported in 94 out of the 155 studied recipients (60.6%) and 86.0% of the proliferations were due to B lymphocytes. PTLD median appearance after transplant were 42.months (p25, 75, 12, 77, 5). One hundred eighty-eight recipients out of 275 patients (68.3%) had any classical risk factor and the use of antilymphocyte antibodies was the most frequent. During the follow-up, 172 patients died (62,5%) and 103 (37,5%) had a complete remission. The main cause of death was PTLD progression (nâ¯=â¯91, 52,9%), followed by sepsis (nâ¯=â¯24, 13,9%). The follow-up period post-transplant of the recipients was between 3 and 22 years. The incidence was 0,14% during the first year post-trasplant and 0.98% the cumulative incidence at 10 years. Patient survival after diagnosis was 51%, 44% and 39% after 1, 2 and 5 years, respectively. Finally, overall graft survival was 48%, 39% and 33% at the same periods. CONCLUSION: PTLD has a low incidence in renal transplant recipients. Most of the proliferations are due to B lymphocytes and seem to have a close relationship with EBV. PTLD can develop in the absence of classical risk factors. The prognosis is poor, mainly due to PTLD progression, but the survivors can even maintain their grafts.
Assuntos
Infecções por Vírus Epstein-Barr , Transplante de Rim , Transtornos Linfoproliferativos , Masculino , Adulto , Feminino , Humanos , Transplante de Rim/efeitos adversos , Infecções por Vírus Epstein-Barr/epidemiologia , Herpesvirus Humano 4 , Soro Antilinfocitário , Estudos Longitudinais , Transtornos Linfoproliferativos/epidemiologia , Transtornos Linfoproliferativos/etiologia , CadáverRESUMO
RESUMEN La incontinencia urinaria de esfuerzo es frecuente en las mujeres desde la adultez media. La técnica más frecuente para tratar estos casos es el cabestrillo sintético. Sin embargo, el cabestrillo autólogo tiene buenos resultados comparables con el material sintético en los diversos estudios publicados. Presentamos un caso tratado con cabestrillo de fascia lata, describiendo la técnica y evolución.
ABSTRACT Stress urinary incontinence is common in women from middle adulthood onwards. The most frequent technique to treat these cases is the synthetic sling. However, the autologous sling has good results comparable with the synthetic material in the various studies published. We present a case treated with fascia lata sling, describing the technique and evolution.
RESUMO
Objectives: Analyze the presence of acute stress response after adverse events in human talent in Colombian health institutions from 2017 to 2021. Methods: Cross-sectional study of prevalence, carried out on 838 members of the human talent in health (professionals, technicians, technologists, and auxiliaries) of Colombian health institutions in the study period with the application of the EASE instrument. Univariate analysis using descriptive statistical techniques, chi-square and Student's t-test, and bivariate analysis with a Poisson regression model using the institucional SPSS v. 26. Results: The prevalence of adverse events in the last 5 years was 33.8%, presenting levels of acute stress qualifying as Medium-high emotional overload at 21.91%, while extreme acute stress was at 3.53%. The prevalence of risk for presenting acute stress after being involved in an adverse event was PR: 1.30 (CI: 1.24-1.36). Conclusion: Acute stress in human talent after adverse events is limiting health and care capacity and must be efficiently addressed by health institutions. Psychosocial risk is linked within the framework of the patient safety program and the institutional occupational health and safety management systems.
Assuntos
Pessoal de Saúde , Mão de Obra em Saúde , Humanos , Estudos Transversais , Colômbia/epidemiologia , Correlação de DadosRESUMO
The formose reaction is an autocatalytic series of aldol condensations that allows one to obtain monosaccharides from formaldehyde. The formose reaction suffers from a lack of selectivity, which hinders practical applications at the industrial level. Over the years, many attempts have been made to overcome this selectivity issue, with modest results. Heterogeneous porous catalysts with acid-base properties, such as Metal-Organic Frameworks (MOFs), can offer advantages compared to homogeneous strong bases (e.g., calcium hydroxide) for increasing the selectivity of this important reaction. For the very first time, four different Zeolite Imidazolate Frameworks are presented in this work as catalysts for the formose reaction in liquid phase, and their catalytic performances were compared with those of the typical homogeneous catalyst (i.e., calcium hydroxide). The heterogeneous nature of the catalysis, the possible contribution of leached metal or linkers to the solution, and the stability of the materials were investigated. The porous structure of these solids and their mild basicity make them suitable for obtaining enhanced selectivity at 30% formaldehyde conversion. Most of the MOFs tested showed low structural stability under reaction conditions, thereby indicating the need to search for new MOF families with higher robustness. However, this important result opens the path for future research on porous heterogeneous basic catalysts for the formose reaction.
RESUMO
We evaluate the effectiveness of chelating resins (CR) derived from Merrifield resin (MR) and 1,2-phenylenediamine (PDA), 2,2'-dipyridylamine (DPA), and 2-(aminomethyl)pyridine (AMP) as adsorbent dosimeters for Ag+, Cu2+, Fe3+, and Pb2+ cations from water under competitive and noncompetitive conditions. MR-PDA, MR-DPA, and MR-AMP were obtained in a 95-97% yield and characterized by IR, fluorescence, and SEM. The ability of CRs as adsorbents was determined by batch and flow procedures. MR-PDA showed a batch adsorption capacity order of Fe3+ (29.8 mg/g) > Ag+ (2.7 mg/g) > Pb2+ (2.6 mg/g) at pH 3.4. The flow adsorption showed affinity towards the Ag+ cation at pH 7 (18.4 mg/g) and a reusability of 10 cycles. In MR-DPA, the batch adsorption capacity order was Ag+ (9.1 mg/g) > Pb2+ (8.2 mg/g) > Cu2+ (3.5 mg/g) at pH 5. The flow adsorption showed affinity to the Cu2+ cation at pH 5 (2.2 mg/g) and a reuse of five cycles. In MR-AMP, the batch adsorption capacity was Ag+ (17.1 mg/g) at pH 3.4. The flow adsorption showed affinity to the Fe3+ cation at pH 2 (4.3 mg/g) and a reuse of three cycles. The three synthesized and reusable CRs have potential as adsorbents for Ag+, Cu2+, Fe3+, and Pb2+ cations and showed versatility in metal removal for water treatment.