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Soil contamination by antibiotics is a global issue of great concern that contributes to the rise of bacterial antibiotic resistance and can have toxic effects on non-target organisms. This study evaluated the variations of molecular, cellular, and histological parameters in Eisenia fetida earthworms exposed to sulfamethazine (SMZ) and tetracycline (TC), two antibiotics commonly found in agricultural soils. The earthworms were exposed for 14â¯days to a series of concentrations (0, 10, 100, and 1000â¯mg/kg) of both antibiotics. SMZ and TC did not affect the survival of E. fetida, however, other effects at different levels of biological complexity were detected. The two highest concentrations of SMZ reduced the viability of coelomocytes. At the highest TC concentration, there was a noticeable decline in cell viability, acetylcholinesterase activity (neurotoxicity), and the relative presence of mucopolysaccharides in the epidermis (mucous production). Glutathione S-transferase activity decreased in all TC treatments and at the highest SMZ concentration. However, levels of malondialdehyde and protein carbonyls did not change, suggesting an absence of oxidative stress. Tetracycline was neurotoxic to E. fetida and changed the integrity of the epidermis. Both antibiotics altered the intestinal microbiota of E. fetida, leading to a reduction in the relative abundance of bacteria from the phyla Proteobacteria and Bacteroidetes, while causing an increase in the phylum Actinobacteroidota. All observed changes indicate that both SMZ and TC can disrupt the earthworms' immune system and gut microbiome, while fostering the growth of bacteria that harbour antibiotic resistance genes. Finally, both antibiotics exerted additional metabolic and physiological effects that increased the vulnerability of E. fetida to pathogens.
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Ataxias are characterized by aberrant movement patterns closely related to cerebellar dysfunction. Purkinje cell axons are the sole outputs from the cerebellar cortex, and dysfunctional activity of Purkinje cells has been associated with ataxic movements. However, the synaptic characteristics of Purkinje cells in cases of ataxia are not yet well understood. The nicotinamide antagonist 3-acethylpyridine (3-AP) selectively destroys inferior olivary nucleus neurons so it is widely used to induce cerebellar ataxia. Five days after 3-AP treatment (65mg/kg) in adult male Sprague-Dawley rats, motor incoordination was revealed through BBB and Rotarod testing. In addition, in Purkinje cells from lobules V-VII of the cerebellar vermis studied by the Golgi method, the density of dendritic spines decreased, especially the thin and mushroom types. Western blot analysis showed a decrease in AMPA and PSD-95 content with an increase of the α-catenin protein, while GAD-67 and synaptophysin were unchanged. Findings suggest a limited capacity of Purkinje cells to acquire and consolidate afferent excitatory inputs and an aberrant, rigid profile in the movement-related output patterns of Purkinje neurons that likely contributes to the motor-related impairments characteristic of cerebellar ataxias.
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Cerebelo , Células de Purkinje , Ratos Sprague-Dawley , Animais , Células de Purkinje/efeitos dos fármacos , Células de Purkinje/patologia , Masculino , Ratos , Cerebelo/efeitos dos fármacos , Ataxia Cerebelar/induzido quimicamente , Piridinas/farmacologia , Plasticidade Neuronal/efeitos dos fármacosRESUMO
OBJECTIVE: Dysgeusia is characterized by a loss of taste perception, leading to malnutrition. This situation affects inflammatory conditions such as respiratory and neurological conditions, obesity, cancer, chemotherapy, aging, and many others. To date, there is not much information on the prevalence and risk of dysgeusia in an inflammatory condition; also, it is unclear which flavor is altered. MATERIALS AND METHODS: We systematically searched three databases from January 2018 to January 2023. Participants were children, adults, or elderly persons with an inflammatory condition and evaluated taste loss. A random effects model was used for statistical analysis to calculate the pooled odds ratio with its corresponding 95.0% confidence interval to estimate the probability of taste alteration (dysgeusia) in an inflammatory condition. RESULTS: The data allowed us to conduct a systematic review, including 63 original articles and 15 studies to perform the meta-analysis. The meta-analysis indicated a heterogenicity of 84.7% with an odds ratio of 3.25 (2.66-3.96), indicating a significant risk of Alzheimer's disease, SARS-CoV-2, chemotherapy, and rhinosinusitis. CONCLUSIONS: Inflammatory conditions and taste alterations are linked. Dysgeusia is associated with a higher risk of malnutrition and poorer general health status, especially in vulnerable populations.
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Disgeusia , Inflamação , Percepção Gustatória , Humanos , Disgeusia/epidemiologia , COVID-19/epidemiologia , Doença de Alzheimer/epidemiologia , Paladar/fisiologia , Desnutrição/epidemiologia , SARS-CoV-2RESUMO
Research has evolved on aerobic granular sludge (AGS) process, but still there are very few studies on the treatment of excess AGS sludge, with almost none considering its aerobic digestion. Here therefore, the aerobic digestibility of typical AGS sludge was assessed. Granules were produced from acetate-based synthetic wastewater (WW) and were subjected to aerobic digestion for 64 d. The stabilization process was monitored over time through physical-chemical parameters, oxygen uptake rates (OUR) and 16S rRNA gene sequencing. The microbial analyses revealed that the cultivated granules were dominated by slow-growing bacteria, mainly ordinary heterotrophic organisms with potential for polyhydroxyalkanoates (PHA) aerobic storage (PHA-OHOs), polyphosphate and glycogen accumulating organisms (PAOs and GAOs), fermentative anaerobes and nitrifiers (AOB and NOB). Differential abundance analysis of the bacterial data (before versus after digestion) discriminated between the most vulnerable microbiome genera and those most resistant to aerobic digestion. Furthermore, modeling of the stabilization process determined that the endogenous decay rate constant (bH) for the heterotrophs present in the granules was notably low; bH = 0.05 d-1 (average), four times less than for common activated sludge (AS), which is rated at 0.2 d-1. For first time, the research reveals another important feature of AGS sludge, i.e. the slow-decaying character of its bacteria (along with their known slow-growing character). This results in slower stabilization, need of bigger digesters and reconsideration of the specific OUR limits in biosolids regulations (SOUR limit of 1.5 mg/gTSS.h), for waste AGS compared to conventional waste AS. The study suggests that aerobic digestion of waste AGS (fully-granulated) could differ from that of conventional AS. Future work is needed on aerobic digestibility of real AGS sludges from municipal and industrial WWs, compared to synthetic WWs.
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Esgotos , Eliminação de Resíduos Líquidos , Esgotos/química , RNA Ribossômico 16S/genética , Eliminação de Resíduos Líquidos/métodos , Genes de RNAr , Reatores Biológicos/microbiologia , Bactérias/genética , Aerobiose , NitrogênioRESUMO
In this work, an accurate analytical method was developed for the simultaneous analysis of twenty-seven antimicrobials (AMs) in earthworms using liquid chromatography coupled to a triple quadrupole mass spectrometry detector (UHPLC-MS/MS). Adequate apparent recoveries (80-120 %) and limits of quantification (LOQ) (1 µg·kg-1 - 10 µg·kg-1) were obtained, with the exception of norfloxacin (34 µg·kg-1). The method was applied to evaluate the accumulation of sulfamethazine (SMZ) and tetracycline (TC) in earthworms after performing OECD-207 toxicity test, in which Eisenia fetida (E. fetida) organisms were exposed to soils spiked with 10 mg·kg-1, 100 mg·kg-1 or 1000 mg·kg-1 of SMZ and TC, individually. The results confirmed the bioaccumulation of both AMs in the organisms, showing a greater tendency to accumulate SMZ since higher bioconcentration factor values were obtained for this compound at the exposure concentrations tested. In addition, the degradation of both AMs in both matrices, soils and earthworms was studied using liquid chromatography coupled to a q-Orbitrap high resolution mass spectrometry detector. Thirteen transformation products (TPs) were successfully identified, eight of them being identified for the first time in soil/earthworm (such as 4-Amino-3-chloro-n-(4,6-dimethylpyrimidin-2-yl)benzenesulfonamide or 4-(dimethylamino)-1,11,12a-trihydroxy-6,6-dimethyl-3,7,10,12-tetraoxo-3,4,4a,5,5a,6,7,10,12,12a-decahydrotetracene-2-carboxamide, among others) and their formation/degradation trend over time was also studied. Regarding the biological effects, only SMZ caused changes in earthworm growth, evidenced by weight loss in earthworms exposed to concentrations of 100 mg·kg-1 and 1000 mg·kg-1. Riboflavin decreased at all concentrations of SMZ, as well as at the highest concentration of TC. This indicates that these antibiotics can potentially alter the immune system of E. fetida. This research represents a significant advance in improving our knowledge about the contamination of soil by AM over time. It investigates the various ways in which earthworms are exposed to AMs, either by skin contact or ingestion. Furthermore, it explores how these substances accumulate in earthworms, the processes by which earthworms break them down or metabolise them, as well as the resulting TPs. Finally, it examines the potential effects of these substances on the environment.
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Anti-Infecciosos , Oligoquetos , Poluentes do Solo , Animais , Oligoquetos/metabolismo , Espectrometria de Massas em Tandem , Poluentes do Solo/análise , Anti-Infecciosos/toxicidade , Anti-Infecciosos/metabolismo , Sulfametazina/análise , Antibacterianos/farmacologia , Solo/química , Tetraciclina/análiseRESUMO
Lithium has been approved and used for several decades in the treatment of psychiatric disorders, and its potential effect in neurodegenerative diseases has been subject to increasing research interest in recent years. Nanolithium is a new experimental product using a novel drug-delivery technology (Aonys®), which optimizes its bioavailability while reducing its toxicity profile. Therapeutic doses of lithium used in Nanolithium are more than 50 times lower than the minimal dose of classical lithium salts. In this review we report data from non-clinical pharmacology studies supporting Nanolithium efficacy and the mechanism of action in Alzheimer's disease. GSK-3ß inhibition is thought to be central to Nanolithium's mechanism of action, triggering a reduction of the production of toxic amyloid plaques and decrease in tau hyperphosphorylation, which could potentially benefit both neuropsychiatric symptoms and cognitive decline. We then summarize outcomes from non-clinical proof-of-concept studies. These data supported the initiation of a currently ongoing phase II proof-of-concept study to evaluate the safety and efficacy of Nanolithium in patients with mild-to-severe Alzheimer's disease. We highlight key aspects of the study design. We finish this review with a discussion on the potential place of Nanolithium in the current and future Alzheimer's disease treatment landscape.
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Doença de Alzheimer , Disfunção Cognitiva , Humanos , Doença de Alzheimer/diagnóstico , Lítio/uso terapêutico , Glicogênio Sintase Quinase 3 beta , CogniçãoRESUMO
The International CTAD Task Force (TF) addressed challenges related to designing clinical trials for agitation in dementia, presenting accomplishments from the two previous TFs on neuropsychiatric symptoms (NPS). In addition, this TF proposed a paradigm shift in NPS assessment and management, presenting Mild Behavioral Impairment (MBI) as a clinical syndrome. MBI is marked by later-life emergent and persistent NPS in dementia-free older persons (ranging from cognitively unimpaired to subjective cognitive decline to mild cognitive impairment), which facilitates earlier detection and better prognostication of Alzheimer's disease (AD). The TF has made the following recommendations for incorporation of NPS into AD preventative trials: (1) clinical trials targeting improvement in MBI symptoms should be undertaken; (2) treatment trials for MBI should be disease specific and confirm the diagnosis of participants using biomarkers; trials should include measures sensitive to cognitive changes in preclinical AD, which can serve as outcome measures, in addition to changes in biomarker levels; (3) as a first step, pharmacotherapeutic trials should address the full MBI complex as well as the specific symptoms/domains that constitute MBI; (4) clinical trials using problem-adaptation psychotherapy to target affective MBI should be considered; and (5) MBI should be considered in AD trials of disease modifying therapies. The well-validated and widely-used MBI Checklist (MBI-C) is an appropriate symptom rating scale for these studies, as it was developed specifically to identify and measure MBI in dementia-free persons. Other scales such as the Neuropsychiatric Inventory (NPI) may be used, although administration at two timepoints may be necessary to operationalize the MBI criterion of symptom persistence.
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Doença de Alzheimer , Disfunção Cognitiva , Humanos , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico , Testes Neuropsicológicos , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Atenção , Sintomas ComportamentaisRESUMO
Systems for managing municipal solid waste are typically ineffective in developing nations because of governments' deficient financial and administrative frameworks, poor rules, and a lack of suitable infrastructure and human resources. The informal sector plays an essential role in these systems by reprocessing waste into secondary raw materials, reducing collection and disposal costs, and, most importantly, benefiting the environment by avoiding incineration and landfilling. However, their actual contributions remain unknown. The present paper aims to understand the role of informal waste pickers (IWPs) in the waste management system of Guayaquil City and their environmental impact through the calculations of the carbon footprint (CF) avoided due to their aid. The survey design gathered information on their personal profiles, types, and rates of collected recyclables, market conditions, their main barriers, and troubles regarding their formalization. The results of the survey demonstrate that waste picking is mostly a male-driven activity, the average daily mass collected per IWP is 13 kg, the most collected recyclable waste is polyethylene terephthalate, their average monthly income is $179, and the total avoided CF of the entire informal waste picking process is almost 14 thousand tons of CO2 eq yearly. Further, IWPs prefer to operate alone, and only 16% of them would join a cooperative, despite their numerous financial, logistical, and personal challenges.
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Teratomas are gonadal or extragonadal neoplasms, derived from the three embryonic tissues, composed of germ cells of the neuroectoderm, mesoderm and ectoderm. Congenital orbital teratoma (OCT) commonly affects the left orbit, primarily affecting women over men at a ratio of 2:1. We present the case of a female patient of 9 days of extrauterine life with a left mature congenital orbital teratoma. The orbit and oculoplastic service performed an orbital exenteration and total resection of the tumor mass.
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Neoplasias Orbitárias , Teratoma , Masculino , Humanos , Feminino , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/cirurgia , Teratoma/diagnóstico por imagem , Teratoma/cirurgia , Teratoma/congênito , Órbita , Exenteração OrbitáriaRESUMO
OBJECTIVES: To conduct brainstem MRI shape analysis across neurodegenerative parkinsonisms and control subjects (CS), along with its association with clinical and cerebrospinal fluid (CSF) correlates. METHODOLOGY: We collected demographic and clinical variables, performed planimetric and shape MRI analyses, and determined CSF neurofilament-light chain (NfL) levels in 84 participants: 11 CS, 12 with Parkinson's disease (PD), 26 with multiple system atrophy (MSA), 21 with progressive supranuclear palsy (PSP), and 14 with corticobasal degeneration (CBD). RESULTS: MSA featured the most extensive and significant brainstem shape narrowing (that is, atrophy), mostly in the pons. CBD presented local atrophy in several small areas in the pons and midbrain compared to PD and CS. PSP presented local atrophy in small areas in the posterior and upper midbrain as well as the rostral pons compared to MSA. Our findings of planimetric MRI measurements and CSF NfL levels replicated those from previous literature. Brainstem shape atrophy correlated with worse motor state in all parkinsonisms and with higher NfL levels in MSA, PSP, and PD. CONCLUSION: Atypical parkinsonisms present different brainstem shape patterns which correlate with clinical severity and neuronal degeneration. In MSA, shape analysis could be further explored as a potential diagnostic biomarker. By contrast, shape analysis appears to have a rather limited discriminant value in PSP. KEY POINTS: ⢠Atypical parkinsonisms present different brainstem shape patterns. ⢠Shape patterns correlate with clinical severity and neuronal degeneration. ⢠In MSA, shape analysis could be further explored as a potential diagnostic biomarker.
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Atrofia de Múltiplos Sistemas , Doença de Parkinson , Transtornos Parkinsonianos , Humanos , Projetos Piloto , Estudos Retrospectivos , Transtornos Parkinsonianos/diagnóstico , Mesencéfalo/diagnóstico por imagem , Doença de Parkinson/diagnóstico por imagem , Ponte/diagnóstico por imagem , Imageamento por Ressonância Magnética , Atrofia de Múltiplos Sistemas/diagnóstico , Atrofia , Biomarcadores , Diagnóstico DiferencialRESUMO
INTRODUCTION: Clostridioides difficile (C. difficile) infection is the main cause of nosocomial diarrhea. First-line treatment is oral vancomycin, but that presentation is not commercially available in Latin America. Our aim was to determine the fecal concentration of the oral administration of the conventional dose of an intravenous vancomycin preparation (VCM), in an experimental model. METHODS: A preclinical trial was conducted on 18 male mice (Balb/c strain), in three batches. The following doses of VCM were administered: 125 mg in batch A; 500 mg in batch B; and VCM-placebo in batch C. After receiving the doses, the mice were placed in metabolic cages, by batch. Feces were collected and the fecal concentration of VCM was analyzed through high pressure liquid chromatography 2, 4 and 6 h after drug administration. RESULTS: The 125 mg dose of VCM reached the minimum inhibitory concentration (MIC) for C. difficile, without reaching the minimum bactericidal concentration (MBC90), at 2, 4, and 6 h (521, 688, and 280 mg/L, respectively). Likewise, the 500 mg dose of VCM reached the MIC at 2 h, increased gradually, and reached MBC90 between 4 and 6 h, in feces (1,062 and 1,779 mg/L, respectively), ANOVA, p = 0.0005. CONCLUSION: The fecal concentration of vancomycin was dependent on the intragastric dose administered. Only the 500 mg dose of VCM reached therapeutic concentration for C. difficile (MIC and MBC90), in the mice. We suggest starting a dose of 500 mg QID for achieving therapeutic concentration against C. difficile, as soon as 4 h after the first dose.
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Clostridioides difficile , Infecções por Clostridium , Masculino , Humanos , Animais , Camundongos , Vancomicina/farmacologia , Vancomicina/uso terapêutico , Antibacterianos/uso terapêutico , Fezes , Administração OralRESUMO
Sediment toxicity testing has become a crucial component for assessing the risks posed by contaminated sediments and for the development of sediment quality assessment strategies. Commonly used organisms for bioassays with estuarine sediments include amphipods, Arenicola marina polychaetes and echinoids. Among the latter, the Sea Urchin Embryo test (SET) is the most widely used. However, one relevant limitation of this bioassay is the unavailability of gametes all year-round, particularly outside the natural spawning seasons. Consequently, the establishment of an appropriate and complementary model organism for a continuous assessment of sediment quality is recommended. A reliable assessment of the hazards resulting from pollutants in sediments or pore water, can be achieved with ecologically relevant species of sediment such as the polychaete Hediste diversicolor, which is widespread in estuaries and has the capacity to accumulate pollutants. The aim of this work was to develop reliable in vivo and in vitro bioassays with H. diversicolor and its coelomocytes (immune cells) to determine the toxicity thresholds of different contaminants bounded to sediments or resuspended into water. Polychaetes were exposed to sublethal concentrations of CuCl2 (in vivo) and a non-invasive method for collection of polychaetes coelomocytes was applied for the in vitro bioassay, exposing cells to a series of CuCl2 and AgNPs concentrations. Same reference toxicants were used to expose Paracentrotus lividus following the SET (ICES Nº 51; Beiras et al., 2012) and obtained toxicity thresholds were compared between the two species. In vivo exposure of polychaetes to high concentrations of Cu produced weight loss and histopathological alterations. After in vitro approaches, a significant decrease in coelomocytes viability was recorded for both toxicants, in a monotonic dose-response curve, at very short-exposure times (2 h). The toxicity thresholds obtained with polychaetes were in line with the ones obtained with the SET, concluding that their sensitivity is similar. In conclusion, in vivo and in vitro bioassays developed with H. diversicolor are accurate toxicity screenings of pollutants that could be bounded to sediments or dissolved in the pore water, and may complement the SET outside the spawning period of the echinoderms. The bioassays herein developed could be applied not only to establish the toxicity thresholds of individual compounds or mixtures, but also to assess the toxicity of field collected sediments.
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Poluentes Ambientais , Paracentrotus , Poliquetos , Poluentes Químicos da Água , Animais , Sedimentos Geológicos , Poluentes Químicos da Água/toxicidade , Poliquetos/fisiologia , Bioensaio , ÁguaRESUMO
OBJECTIVES: Compliance in outpatients with gastrointestinal (GI) malabsorption is key in nutritional treatment. The objective of this study was to assess compliance in patients with GI impairment and malnutrition taking a high-calorie, high-protein, peptide-based oral nutritional supplement (ONS-PBD). METHODS: A prospective, multicenter, observational study was conducted in 19 medical sites in Spain where ONS-PBD were prescribed as standard of care. Patients consumed ONS-PBD daily for 12 wk. Compliance was calculated as the percentage consumed of the prescribed amount of ONS per day. RESULTS: A total of 90 adult patients were included in the study, of whom 64 completed the 12-wk regimine. Mean compliance was 78.8% ± 24.5%. Risk of malnutrition decreased in 56.3% of patients at 12 wk, as measured with the malnutrition universal screening tool. A reduction in abdominal pain was observed and stool consistency improved, with a mean of 54.7% and 27.5%, respectively. Improvements in quality of life and a decrease in percentage of patients with severe functional impairment were observed. CONCLUSIONS: These data show that ONS-PBD compliance in malnourished patients with GI symptoms is high, reducing GI symptoms and improving patients' nutritional status.
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Desnutrição , Estado Nutricional , Adulto , Suplementos Nutricionais , Humanos , Cooperação do Paciente , Peptídeos/uso terapêutico , Estudos Prospectivos , Qualidade de VidaRESUMO
The Asociación Mexicana de Hepatología A.C. carried out the Consensus on the Management of Complications of Cirrhosis of the Liver in Pediatrics to provide physicians with useful information for treating said complications. A group of pediatric gastroenterologists and experts in nutrition, nephrology, and infectious diseases participated and reviewed the medical literature. The Delphi method was applied to obtain the level of agreement on the statements that were formulated. The statements were sent to the participants to be analyzed and voted upon, after which they were discussed in virtual sessions, and the final versions were produced. The aim of the consensus results was to issue indications for the management of pediatric patients with liver cirrhosis, to prevent or control complications.
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Cirrose Hepática , Pediatria , Humanos , Criança , Consenso , Cirrose Hepática/complicações , Cirrose Hepática/terapiaRESUMO
The removal of emerging pollutants from municipal wastewater was studied for the first time using a three-step pilot-scale system: 1) hybrid digester (HD) as first step, 2) subsurface vertical flow constructed wetland (VF) as second step, and 3) photodegradation (PD) unit as third step or post-treatment. The HD and VF units were built and operated in series with effluent recirculation at pilot scale. For the PD post-treatment, three alternatives were studied at lab-scale, i) UVC irradiation at 254 nm (0.5 h exposure time), ii) UVA irradiation at 365 nm using a TiO2-based photocatalyst and iii) sunlight irradiation using a TiO2-based photocatalyst, the last two for 1 and 2 h. Alternative iii) was also tested at pilot-scale. Degradation of nine compounds was evaluated: acetaminophen (ACE), caffeine (CAF), carbamazepine (CBZ), ketoprofen (KET), ibuprofen (IBU), diclofenac (DCL), clofibric acid (ACB), bisphenol A (BPA), and sotalol (SOT). Overall, the HD-VF-UVC system completely removed (>99.5 %) ACE, CAF, KET, IBU, DCL and ACB, and to a lesser extent SOT (98 %), BPA (83 %) and CBZ (51 %). On the other hand, the HD-VF-UVA/TiO2 system (at 2 h) achieved >99.5 % removal of ACE, CAF, KET, IBU and DCL while ACB, BPA, CBZ and SOT were degraded by 83 %, 81 %, 78 % and 68 %, respectively. Working also at 2 h of exposure time, in summer conditions, the HD-VF-Sol/TiO2 system achieved >99.5 % removal of ACE, CAF, KET, IBU, DCL and ACB, and to a minor extent BPA (80 %), SOT (74 %) and CBZ (69 %). Similar results, although slightly lower for SOT (60 %) and CBZ (59 %), were obtained in the pilot sunlight plus TiO2 catalyst unit. However, the use of sunlight irradiation with a TiO2-based photocatalyst clearly showed lower removal efficiency in autumn conditions (i.e., 47 % SOT, 31 % CBZ).
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Poluentes Ambientais , Poluentes Químicos da Água , Carbamazepina , Diclofenaco , Fotólise , Eliminação de Resíduos Líquidos/métodos , Águas Residuárias/análise , Poluentes Químicos da Água/análise , Áreas AlagadasRESUMO
INTRODUCTION: Differential diagnosis between Parkinson's disease (PD) and atypical parkinsonisms (APs: multiple system atrophy[MSA], progressive supranuclear palsy[PSP], corticobasal degeneration[CBD]) remains challenging. Lately, cerebrospinal fluid (CSF) studies of neurofilament light-chain (NFL) and RT-QuIC of alpha-synuclein (α-SYN) have shown promise, but data on their combination with MRI measures is lacking. OBJECTIVE: (1) to assess the combined diagnostic ability of CSF RT-QuIC α-SYN, CSF NFL and midbrain/pons MRI planimetry in degenerative parkinsonisms; (2) to evaluate if biomarker-signatures relate to clinical diagnoses and whether or not unexpected findings can guide diagnostic revision. METHODS: We collected demographic and clinical data and set up α-SYN RT-QuIC at our lab in a cross-sectional cohort of 112 participants: 19 control subjects (CSs), 20PD, 37MSA, 23PSP, and 13CBD cases. We also determined CSF NFL by ELISA and, in 74 participants (10CSs, 9PD, 26MSA, 19PSP, 10CBD), automatized planimetric midbrain/pons areas from 3T-MRI. RESULTS: Sensitivity of α-SYN RT-QuIC for PD was 75% increasing to 81% after revisiting clinical diagnoses with aid of biomarkers. Sensitivity for MSA was 12% but decreased to 9% with diagnostic revision. Specificities were 100% against CSs, and 89% against tauopathies raising to 91% with diagnostic revision. CSF NFL was significantly higher in APs. The combination of biomarkers yielded high diagnostic accuracy (PD vs. non-PD AUC = 0.983; MSA vs. non-MSA AUC = 0.933; tauopathies vs. non-tauopathies AUC = 0.924). Biomarkers-signatures fitted in most cases with clinical classification. CONCLUSIONS: The combination of CSF NFL, CSF RT-QuIC α-SYN and midbrain/pons MRI measures showed high discriminant ability across all groups. Results opposite to expected can assist diagnostic reclassification.
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Atrofia de Múltiplos Sistemas , Doença de Parkinson , Transtornos Parkinsonianos , Tauopatias , Biomarcadores/líquido cefalorraquidiano , Estudos Transversais , Humanos , Mesencéfalo/diagnóstico por imagem , Atrofia de Múltiplos Sistemas/líquido cefalorraquidiano , Atrofia de Múltiplos Sistemas/diagnóstico por imagem , Doença de Parkinson/líquido cefalorraquidiano , Doença de Parkinson/diagnóstico por imagem , Transtornos Parkinsonianos/diagnóstico , Ponte , alfa-Sinucleína/líquido cefalorraquidianoRESUMO
A 35-year-old woman arrived in the emergency department due to loss of vision in the left eye. She had a subfoveal yellowish-looking lesion that, on optical coherence tomography (OCT), corresponded to a hyper-reflective lesion from the external nuclear layer to the retinal pigment epithelium. The lesion was reabsorbed at 6 weeks, leaving a discontinuity in the photoreceptor and retinal pigment epithelium lines. The patient was diagnosed with acute retinal pigmentary epitheliitis (ARPE). ARPE is a self-limiting disease with a good prognosis. Emphasis is placed on the importance of a correct diagnosis using funduscopy, OCT, and fluorescent angiography, in order to avoid unnecessary treatments.
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Retinite , Doença Aguda , Adulto , Feminino , Angiofluoresceinografia , Humanos , Epitélio Pigmentado da Retina/diagnóstico por imagem , Epitélio Pigmentado da Retina/patologia , Pigmentos da Retina , Retinite/diagnóstico , Retinite/patologiaRESUMO
OBJECTIVES: To describe the preoperative characteristics of patients undergoing cataract surgery in our hospital, to determine the final visual and refractive results and to determine the preoperative characteristics that conditioned the presence of a residual refractive error (RRE) greater than one diopter. METHODS: Retrospective analysis of cataract surgeries performed at Araba University Hospital between February 2017 and December 2019. Sociodemographic, eye comorbidity, biometric, surgical and post-surgical characteristics were collected. RESULTS: A total of 1419 patients and 1578 surgeries were included for analysis. Of these, 9.07% had preoperative legal blindness, 31.69% eye comorbidity and 4.18% had previous surgery. Overall, 95.82% of patients achieved a corrected final visual acuity (VA)â¯≥â¯0.5 Snellen decimal and 63.12%â¯≥â¯1, and 96.70% of patients improved VA after surgery. RRE was between ±0.5 diopters in 77.82% of patients and between ±1 diopter in 94.74%. The most prominent risk factors that conditioned the presence of RRE greater than 1 diopter were the use of ultrasonic contact biometer, a history of glaucoma surgery, the presence of white or hard cataract, and prior legal blindness. CONCLUSIONS: The visual results of cataract surgery were excellent, with 63.12% of patients obtaining corrected VAâ¯≥â¯1 and an RRE of ±1 diopter in 94.74%. Different risk factors influenced the achievement of poor refractive outcomes: preoperative conditions (previous surgeries, white/hard cataract, previous VA) and biometrics.
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Extração de Catarata , Catarata , Erros de Refração , Catarata/etiologia , Extração de Catarata/efeitos adversos , Humanos , Erros de Refração/epidemiologia , Erros de Refração/etiologia , Estudos Retrospectivos , Fatores de RiscoRESUMO
Introducción: La enfermedad de Alzheimer (EA) es la principal causa de demencia, caracterizada por pérdida progresiva de memoria. Principal fuente de morbimortalidad en mayores de 65 años. En los últimos 20 años las muertes por EA han aumentado un 145% en el mundo. En Chile no hay estudios actuales que describan mortalidad por EA. El objetivo del presente trabajo es analizar y comparar las tasas de mortalidad (TM) por EA según sexo y grupo etario en Chile entre 2017-2021. Materiales y métodos: Estudio descriptivo, ecológico, sobre defunciones por EA entre 2017-2021 en Chile según sexo y grupo etario (n=10.223). Información obtenida de la base de datos del Departamento de Estadísticas e Información de Salud. Se realizó estadística descriptiva y cálculo de TM. No se requiere comité de ética. Resultados: La máxima TM del periodo fue 11,74 por cada 100.000 habitantes en 2021. El sexo femenino logró la mayor TM en este periodo. El grupo etario con mayor cantidad de defunciones fue el de 81 o más años con 76.6% (7.829) de las defunciones totales. Discusión: Se evidenció mantención y luego ascenso de TM por EA, podría deberse al aumento en la esperanza de vida. La mayor frecuencia de defunciones según sexo y edad, podría explicarse por mayor vulnerabilidad femenina a desarrollar EA y a cambios fisiológicos del envejecimiento. En conclusión, la TM por EA en Chile ha aumentado, probablemente secundario al aumento en la esperanza de vida. Se hace un llamado a continuar el estudio de la patología.
Introduction: Alzheimer's disease (AD) is the most common cause of dementia, characterized by progressive memory loss. It is the main source of morbidity and mortality in individuals over 65 years of age, with age being its primary non-modifiable risk factor. In the last 20 years, deaths from AD have increased by 145% worldwide. However, there are no current studies in Chile that describe mortality from AD. The objective of this study is to analyze and compare mortality rates due to AD according to sex and age group in the Chilean population during the years 2017-2021. Material and Methods: Descriptive, ecological study on deaths from AD between 2017-2021 in Chile, categorized by sex and age group (n=10,223). The database was obtained from the Department of Health Statistics and Information. Descriptive statistics and mortality rate calculations were performed. No ethics committee approval was required. Results: The maximum mortality rate (MR) was observed in 2021 with a value of 11.74 per 100,000 inhabitants. Women had the highest MR in this period. The age group with the highest number of deaths was 81 years or older, accounting for 76.6% (7,829) of the total deaths. Discussion: A plateau and subsequent increase in MR due to AD were observed, possibly explained by the increase in life expectancy. The higher frequency of deaths in women and specific age groups may be attributed to the higher vulnerability of women to developing AD and physiological changes related to aging. In conclusion, the MR from AD has increased in Chile, likely due to the rise in life expectancy, emphasizing the importance of continued research on this pathology.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Doença de Alzheimer/mortalidade , Doença de Alzheimer/epidemiologia , Chile/epidemiologia , Epidemiologia Descritiva , Distribuição por Idade e SexoRESUMO
Liquid phase exfoliation of graphite is currently one of the most promising graphene production methods at large scale. For this reason, an accurate calculation of the concentration in graphene dispersions is important for standardization and commercialization. Here, graphene dispersions, at high concentrations, were produced by electrochemical exfoliation. Furthermore, a cleaner methodology to obtain graphene oxide by electrochemical exfoliation at high acid concentrations was implemented. The absorption coefficient for graphene and graphene oxide was determined in the optical range (α660 nm= 1414 (±3%) ml mg-1 m-1andα660 nm= 648 (±7%) ml mg-1 m-1, respectively) with an exponential dependence with the wavelength. The difference inαfor both materials is attributed to an increased presence of C=O groups as evidenced by Fourier transform infrared spectroscopy (FTIR), UV-vis and Raman spectroscopy, as well as, in the calculation of the optical extinction coefficient and optical band-gap via Tauc-plots.