Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 46
Filtrar
Mais filtros

País/Região como assunto
Tipo de documento
Intervalo de ano de publicação
1.
Cell ; 186(7): 1417-1431.e20, 2023 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-37001502

RESUMO

Senescent cell accumulation has been implicated in the pathogenesis of aging-associated diseases, including cancer. The mechanism that prevents the accumulation of senescent cells in aging human organs is unclear. Here, we demonstrate that a virus-immune axis controls the senescent fibroblast accumulation in the human skin. Senescent fibroblasts increased in old skin compared with young skin. However, they did not increase with advancing age in the elderly. Increased CXCL9 and cytotoxic CD4+ T cells (CD4 CTLs) recruitment were significantly associated with reduced senescent fibroblasts in the old skin. Senescent fibroblasts expressed human leukocyte antigen class II (HLA-II) and human cytomegalovirus glycoprotein B (HCMV-gB), becoming direct CD4 CTL targets. Skin-resident CD4 CTLs eliminated HCMV-gB+ senescent fibroblasts in an HLA-II-dependent manner, and HCMV-gB activated CD4 CTLs from the human skin. Collectively, our findings demonstrate HCMV reactivation in senescent cells, which CD4 CTLs can directly eliminate through the recognition of the HCMV-gB antigen.


Assuntos
Antineoplásicos , Infecções por Citomegalovirus , Humanos , Idoso , Citomegalovirus , Linfócitos T Citotóxicos , Antígenos HLA , Linfócitos T CD4-Positivos , Senescência Celular
2.
Proc Natl Acad Sci U S A ; 118(36)2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34480005

RESUMO

The development of high-performance photoacoustic (PA) probes that can monitor disease biomarkers in deep tissue has the potential to replace invasive medical procedures such as a biopsy. However, such probes must be optimized for in vivo performance and exhibit an exceptional safety profile. In this study, we have developed PACu-1, a PA probe designed for biopsy-free assessment (BFA) of hepatic Cu via photoacoustic imaging. PACu-1 features a Cu(I)-responsive trigger appended to an aza-BODIPY dye platform that has been optimized for ratiometric sensing. Owing to its excellent performance, we were able to detect basal levels of Cu in healthy wild-type mice as well as elevated Cu in a Wilson's disease model and in a liver metastasis model. To showcase the potential impact of PACu-1 for BFA, we conducted two blind studies in which we were able to successfully identify Wilson's disease animals from healthy control mice in each instance.


Assuntos
Cobre/metabolismo , Degeneração Hepatolenticular/metabolismo , Neoplasias Hepáticas/secundário , Técnicas Fotoacústicas/instrumentação , Animais , Biópsia , Modelos Animais de Doenças , Degeneração Hepatolenticular/patologia , Camundongos , Camundongos Endogâmicos BALB C , Distribuição Tecidual
3.
BMC Infect Dis ; 22(1): 618, 2022 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-35840902

RESUMO

BACKGROUND: Unlike SARS-CoV and MERS-C0V, SARS-CoV-2 has the potential to become a recurrent seasonal infection; hence, it is essential to compare the clinical spectrum of COVID-19 to the existent endemic coronaviruses. We conducted a retrospective cohort study of hospitalized patients with seasonal coronavirus (sCoV) infection and COVID-19 to compare their clinical characteristics and outcomes. METHODS: A total of 190 patients hospitalized with any documented respiratory tract infection and a positive respiratory viral panel for sCoV from January 1, 2011, to March 31, 2020, were included. Those patients were compared with 190 hospitalized adult patients with molecularly confirmed symptomatic COVID-19 admitted from March 1, 2020, to May 25, 2020. RESULTS: Among 190 patients with sCoV infection, the Human Coronavirus-OC93 was the most common coronavirus with 47.4% of the cases. When comparing demographics and baseline characteristics, both groups were of similar age (sCoV: 74 years vs. COVID-19: 69 years) and presented similar proportions of two or more comorbidities (sCoV: 85.8% vs. COVID-19: 81.6%). More patients with COVID-19 presented with severe disease (78.4% vs. 67.9%), sepsis (36.3% vs. 20.5%), and developed ARDS (15.8% vs. 2.6%) compared to patients with sCoV infection. Patients with COVID-19 had an almost fourfold increased risk of in-hospital death than patients with sCoV infection (OR 3.86, CI 1.99-7.49; p < .001). CONCLUSION: Hospitalized patients with COVID-19 had similar demographics and baseline characteristics to hospitalized patients with sCoV infection; however, patients with COVID-19 presented with higher disease severity, had a higher case-fatality rate, and increased risk of death than patients with sCoV. Clinical findings alone may not help confirm or exclude the diagnosis of COVID-19 during high acute respiratory illness seasons. The respiratory multiplex panel by PCR that includes SARS-CoV-2 in conjunction with local epidemiological data may be a valuable tool to assist clinicians with management decisions.


Assuntos
COVID-19 , Adulto , Idoso , COVID-19/epidemiologia , Mortalidade Hospitalar , Humanos , Estudos Retrospectivos , SARS-CoV-2 , Estações do Ano
4.
Environ Sci Technol ; 55(4): 2511-2521, 2021 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-33499599

RESUMO

This study provides molecular insights into the light absorption properties of biomass burning (BB) brown carbon (BrC) through the chemical characterization of tar condensates generated from heated wood pellets at oxidative and pyrolysis conditions. Both liquid tar condensates separated into "darker oily" and "lighter aqueous" immiscible phases. The molecular composition of these samples was investigated using reversed-phase liquid chromatography coupled with a photodiode array detector and a high-resolution mass spectrometer. The results revealed two sets of BrC chromophores: (1) common to all four samples and (2) specific to the "oily" fractions. The common BrC chromophores consist of polar, monoaromatic species. The oil-specific BrC chromophores include less-polar and nonpolar polyaromatic compounds. The most-light-absorbing pyrolysis oily phase (PO) was aerosolized and size-separated using a cascade impactor to compare the composition and optical properties of the bulk versus the aerosolized BrC. The mass absorption coefficient (MAC300-500 nm) of aerosolized PO increased compared to that of the bulk, due to gas-phase partitioning of more volatile and less absorbing chromophores. The optical properties of the aerosolized PO were consistent with previously reported ambient BB BrC measurements. These results suggest the darkening of atmospheric BrC following non-reactive evaporation that transforms the optical properties and composition of aged BrC aerosols.


Assuntos
Carbono , Madeira , Aerossóis , Biomassa , Água
6.
Parasitology ; 145(12): 1594-1599, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29587896

RESUMO

The use of chimeric molecules fusing several antigenic determinants is a promising strategy for the development of low-cost, standardized and reliable kits to determine specific antibodies. In this study, we designed and assessed a novel recombinant chimera that complements the performance of our previously developed chimera, CP1 [FRA and SAPA antigens (Ags)], to diagnose chronic Chagas disease. The new chimeric protein, named CP3, is composed of MAP, TcD and TSSAII/V/VI antigenic determinants. We compared the performance of both chimeric Ags using a panel of 67 Trypanosoma cruzi-reactive sera and 67 non-reactive ones. The sensitivity of CP3 vs CP1 was 100 and 90.2%, and specificity was 92.5 and 100%, respectively. The mixture of CP1 + CP3 achieved 100% of sensitivity and specificity. More importantly, an additional subset of 17 sera from patients with discordant results of conventional serological methods was analysed; the CP1 + CP3 mixture allowed us to accurately classify 14 of them with respect to IIF, the usual technique used in most of the reference centres. These results show an improved performance of the CP1 + CP3 mixture in comparison with enzyme-linked immunosorbent assay and indirect haemagglutination commercial assays.


Assuntos
Doença de Chagas/diagnóstico , Epitopos/imunologia , Trypanosoma cruzi/imunologia , Sequência de Aminoácidos , Doença de Chagas/parasitologia , Ensaio de Imunoadsorção Enzimática , Humanos , Imunoensaio , Dados de Sequência Molecular , Proteínas Recombinantes/imunologia , Sensibilidade e Especificidade
7.
Clin Chem Lab Med ; 55(4): 595-604, 2017 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-27658149

RESUMO

BACKGROUND: P35 and P22 Toxoplasma gondii proteins are recognized by specific IgG at the early infection stage, making them ideal for acute toxoplasmosis pregnancy control. Both proteins have been studied to discriminate between acute and chronic toxoplasmosis. However, results were hardly comparable because different protein obtainment procedures led to different antigens, the reference panels used were not optimally typified, and avidity tests were either not performed or narrowly examined. METHODS: We bioinformatically predicted P35 and P22 regions with the highest density of epitopes, and expressed them in pET32/BL21DE3 alternative expression system, obtaining the soluble proteins rP35a and rP22a. We assessed their diagnostic performance using pregnant woman serum samples typified as: not infected, NI (IgG-, IgM-), typical-chronic, TC (IgM-, IgG+), presumably acute, A (IgG+, IgM+, low-avidity IgG), and recently chronic, RC (IgG+, IgM+, high-avidity IgG). RESULTS: rP35a performed better than rP22a to differentiate A from RC, the areas under the curve (AUC) being 0.911 and 0.818, respectively. They, however, performed similarly to differentiate A from TC+RC (AUC: 0.915 and 0.907, respectively). rP35a and rP22a evaluation by avidity ELISA to discriminate A from RC rendered AUC values of 0.974 and 0.921, respectively. The indirect ELISA and avidity ELISA results analyzed in tandem were consistent with those obtained using commercial kits. CONCLUSIONS: rP35a and rP22a features suggest that, with complementary use, they could replace parasite lysate for toxoplasmosis infection screening and for acute toxoplasmosis diagnosis. Our proposal should be validated by a longitudinal study and may lead to a reliable toxoplasmosis pregnancy control, performing tests in only one serum sample.


Assuntos
Antígenos de Protozoários/sangue , Ensaio de Imunoadsorção Enzimática/métodos , Complicações Parasitárias na Gravidez/diagnóstico , Proteínas de Protozoários/sangue , Toxoplasmose/diagnóstico , Antígenos de Protozoários/genética , Antígenos de Protozoários/imunologia , Antígenos de Protozoários/metabolismo , Feminino , Humanos , Imunoglobulina G/sangue , Gravidez , Proteínas de Protozoários/genética , Proteínas de Protozoários/imunologia , Proteínas de Protozoários/metabolismo , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Toxoplasma/patogenicidade
8.
BMC Womens Health ; 17(1): 63, 2017 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-28830391

RESUMO

BACKGROUND: Poor endometrial quality is associated with more than a third of embryo implantation failures. Current ultrasonography technology lacks the capacity to determine efficiently the endometrial receptivity during ongoing cycle transfers. We analyzed the relationship between the gene expression profile associated with implantation and clinical pregnancy from endometrial cells taken during embryo transfer. METHODS: Seventy-six patients submitted to a standard ovarian stimulation protocol, in vitro fertilization, and good quality embryos were collected (morphological assessment). Endometrial samples were taken with ultrasonography guidance and cells were Hematoxylin and Eosin stained for morphological identification. Total RNA was extracted and the expression of Mucin 1 (MUC1), Homeobox A10 (HOXA-10), Leukemia Inhibitor Factor (LIF), Colony Stimulating Factor-1 (CSF-1), and ribosomal 18 s (endogenous control) were analyzed using RT-qPCR. Presence of a gestational sac, ß-hGC (≥10 mIU/mL on Day 20), and a fetal heartbeat were used to determine a positive embryo implantation and pregnancy. RESULTS: Samples collected from same cycle embryo transfer showed clear morphological staining for endometrial cells (80-90% of the cells). Cells in the sample were molecularly identified as the endometrium (HOXA-10 positive and MUC-1 negative). CSF-1 expression was 4.55-fold and LIF expression was 12.25-fold higher in patients who became pregnant. Both increases were statistically significant (p < 0.05). CONCLUSIONS: Here, we provide evidence of a new method to assess endometrial receptivity. Furthermore, we demonstrate that the expression profile, based on LIF and CSF-1, showed a difference between a receptive and a non-receptive endometrium.


Assuntos
Implantação do Embrião , Fertilização in vitro/métodos , Fator Inibidor de Leucemia/metabolismo , Fator Estimulador de Colônias de Macrófagos/metabolismo , Indução da Ovulação/métodos , Transferência Embrionária/métodos , Endométrio/metabolismo , Feminino , Humanos , Gravidez
9.
Exp Parasitol ; 182: 9-15, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28867354

RESUMO

Visceral leishmaniasis is a public health problem worldwide. The early diagnosis in dogs is crucial, since they are an epidemiologically relevant reservoir of the disease. The aim of a field study is to early identify the disease allowing rapid intervention to reduce its effects. We propose an immunoagglutination test as a visual in situ method for diagnosis of canine visceral leishmaniasis. Latex-protein complexes were sensitized by covalent coupling of a chimeric recombinant antigen of Leishmania spp. onto polystyrene latex with carboxyl functionality. The reaction time and the antigen concentration under which the immunoagglutination assay shows greater discrimination between the responses of a positive control serum and a negative control serum were determined. Then, the latex-protein complexes were evaluated as a visual diagnostic tool with a panel of 170 sera. The test may be read between 2 and 5 min and can be performed even using sera with elevated concentration of lipids, bilirubin or with variable percentage of hemolysis. The sensitivity, the specificity and the diagnostic accuracy were 78%; 100% and >80%, respectively. The visual immunoagglutination test is of potential application as a method for field studies because it shows results in less than 5 min, it is easy to implement and does not require sophisticated equipment.


Assuntos
Anticorpos Antiprotozoários/sangue , Doenças do Cão/diagnóstico , Testes de Fixação do Látex/veterinária , Leishmania infantum/imunologia , Leishmaniose Visceral/veterinária , Animais , Antígenos de Protozoários/imunologia , Western Blotting/veterinária , Reservatórios de Doenças , Doenças do Cão/parasitologia , Cães , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/parasitologia , Proteínas Recombinantes/imunologia , Sensibilidade e Especificidade
11.
Trop Med Int Health ; 19(1): 37-46, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24219561

RESUMO

OBJECTIVE: To determine the conditions under which the immunoagglutination assay to detect Chagas disease, obtained from a novel latex-(chimeric recombinant antigen) complex, shows greater discrimination between the responses of a positive control serum and a negative control serum. METHODS: The following variables were determined: (i) the sensitisation mechanism, (ii) the emulsifier employed for protein desorption, (iii) the reaction time, (iv) the ionic strength of the reaction medium, (v) the particle concentration, (vi) the presence of blocking agents, (vii) the presence of polyethyleneglycol as potentiator of reaction and (viii) the antigen and antibody concentrations. The search of optimal conditions was investigated by varying one variable at a time. To this effect, monodisperse latex particles sensitised with a recombinant chimeric protein (CP1) were subjected to different conditions. The agglutination reaction was followed by measuring the changes in the optical absorbance by turbidimetry. RESULTS: The maximum discrimination between negative and positive sera was obtained at a reaction time of 5 min, when latex complexes with a concentration of covalently coupled protein of 2.90 mg/m(2) were put in contact with undiluted sera in buffer borate pH 8-20 mm containing glycine (0.1 m) and polyethyleneglycol 8000 (3% w/v). Finally, the latex-protein complex was tested under the obtained optimal conditions, with a panel of Trypanosoma cruzi-positive sera, leishmaniasis-positive sera and -negative sera for both parasites. CONCLUSION: The immunoagglutination test based on the latex-CP1 complex could be used as a screening method for detecting Chagas disease. This test is rapid, easy to implement and could be used under field conditions; but its results should be confirmed by reference techniques like ELISA, HAI, and IFI.


Assuntos
Antígenos de Protozoários/sangue , Doença de Chagas/diagnóstico , Trypanosoma cruzi/imunologia , Doença de Chagas/sangue , Doença de Chagas/imunologia , Ensaio de Imunoadsorção Enzimática/métodos , Humanos , Testes de Fixação do Látex/métodos , Proteínas Recombinantes/sangue , Proteínas Recombinantes/imunologia
12.
Trop Med Int Health ; 19(11): 1346-54, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25175083

RESUMO

OBJECTIVE: To evaluate the diagnostic performance of novel latex-protein complexes obtained from different antigens of Trypanosoma cruzi through immunoagglutination test using a panel of T. cruzi-positive sera, leishmaniasis-positive sera and negative sera for both parasites. METHODS: Complexes' behaviour using total parasite homogenate (TPH), two simple recombinant proteins (RP1 and RP5) and two chimeric recombinant proteins (CP1 and CP2) was comparatively evaluated. The area under ROC curves was used as an index of accuracy. Sensitivity, specificity and discrimination efficiency were assessed. RESULTS: All recombinant antigens showed higher specificity than TPH. The lower specificity of TPH was mainly due to cross-reacting peptides between T. cruzi and Leishmania spp. In turn, all performance indicators were higher for CP1 and CP2 than for RP1 and RP5. The carboxylated latex-CP2 (C2-CP2) complex was able to detect antibodies against T. cruzi. The values of area under ROC curve (0.96), sensitivity (92.3%, 95% CI: 79.4-100.0%) and specificity (84.0%, 95% CI: 67.6-100.0%) indicate that the assay could be used as a screening test. CONCLUSION: The C2-CP2 complex could be an important tool to carry out sero-epidemiological studies.


Assuntos
Anticorpos Antiprotozoários/sangue , Antígenos de Protozoários/sangue , Doença de Chagas/diagnóstico , Trypanosoma cruzi/imunologia , Doença de Chagas/imunologia , Reações Cruzadas/imunologia , Humanos , Testes de Fixação do Látex , Leishmania/imunologia , Curva ROC , Proteínas Recombinantes/sangue , Proteínas Recombinantes/imunologia , Sensibilidade e Especificidade
13.
Nat Biotechnol ; 42(4): 608-616, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37217750

RESUMO

Little is known about the biological roles of glycosylated RNAs (glycoRNAs), a recently discovered class of glycosylated molecules, because of a lack of visualization methods. We report sialic acid aptamer and RNA in situ hybridization-mediated proximity ligation assay (ARPLA) to visualize glycoRNAs in single cells with high sensitivity and selectivity. The signal output of ARPLA occurs only when dual recognition of a glycan and an RNA triggers in situ ligation, followed by rolling circle amplification of a complementary DNA, which generates a fluorescent signal by binding fluorophore-labeled oligonucleotides. Using ARPLA, we detect spatial distributions of glycoRNAs on the cell surface and their colocalization with lipid rafts as well as the intracellular trafficking of glycoRNAs through SNARE protein-mediated secretory exocytosis. Studies in breast cell lines suggest that surface glycoRNA is inversely associated with tumor malignancy and metastasis. Investigation of the relationship between glycoRNAs and monocyte-endothelial cell interactions suggests that glycoRNAs may mediate cell-cell interactions during the immune response.


Assuntos
Oligonucleotídeos , RNA , Linhagem Celular
14.
Rev Paul Pediatr ; 42: e2023084, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38126604

RESUMO

OBJECTIVE: To describe two different degrees of clinical commitment and results in the evolution of infectious endarteritis in patients without a previous diagnosis of aortic coarctation. CASE DESCRIPTION: Two male patients aged 13 and 9 years old were admitted. The first due to a fever for 2 months, which started after dental cleaning, and the second due to high blood pressure, both patients with asthenia and weight loss. In the first case, the transthoracic echocardiogram showed aortic coarctation, and the transesophageal echocardiogram showed the presence of vegetations in the post-coarctation area, without pseudoaneurysms, with blood culture positive for Streptococcus mitis. This patient was treated for six weeks with crystalline penicillin, resolving the infection without complications. The second case was assessed for high blood pressure with a history of fever, and was treated with antibiotics. When performing a transthoracic echocardiogram, aortic coarctation was observed with a saccular image classified as a pseudoaneurysm by angiography and tomography. Blood culture was negative, and the patient developed an episode of hematemesis whose initial etiology could not be determined. Before surgical repair, he had a second episode of copious hematemesis with hypovolemic shock and death. COMMENTS: We need to have a high index of clinical suspicion to establish the diagnosis of aortic coarctation complicated by endarteritis and start the appropriate antibiotic treatment, always maintaining surveillance for the early detection of pseudoaneurysms.


Assuntos
Falso Aneurisma , Coartação Aórtica , Endarterite , Hipertensão , Humanos , Masculino , Coartação Aórtica/diagnóstico , Coartação Aórtica/diagnóstico por imagem , Endarterite/complicações , Falso Aneurisma/diagnóstico , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Hematemese/complicações , Antibacterianos/uso terapêutico , Hipertensão/complicações
15.
Res Vet Sci ; 155: 69-75, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36641975

RESUMO

Visceral leishmaniasis is a zoonotic infectious disease with a severe impact on humans and animals. Infection is transmitted by phlebotomine sand flies. The dogs are main reservoir for human infection. A rapid and accurate diagnosis of canine visceral leishmaniasis is essential for an efficient surveillance program. The aim of this study was to assess the performance of a rapid immunochromatographic strip test based on functionalized colored particles and a new recombinant antigenic protein, as a visual "in situ" method for the diagnosis of canine visceral leishmaniasis. The results were evaluated using an in-house ELISA assay with the same antigen. Both tests produced concordant results and the immunochromatographic strip test showed good diagnostic sensitivity (98%) and specificity (95%). Finally, meta-analysis was used to compare the sensitivity and specificity of the here developed test with the results of commercial immunochromatographic strip tests obtained from literature.


Assuntos
Doenças do Cão , Leishmania infantum , Leishmaniose Visceral , Cães , Animais , Humanos , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/veterinária , Microesferas , Antígenos de Protozoários , Imunoensaio/veterinária , Imunoensaio/métodos , Ensaio de Imunoadsorção Enzimática/veterinária , Ensaio de Imunoadsorção Enzimática/métodos , Sensibilidade e Especificidade , Doenças do Cão/diagnóstico , Doenças do Cão/epidemiologia
16.
Neuropharmacology ; 240: 109681, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-37611823

RESUMO

Nicotine vapor consumption via electronic nicotine delivery systems has increased over the last decade. While prior work has shed light on the health effects of nicotine vapor inhalation, its unique effects on the brain and behavior have not been thoroughly explored. In this study we assessed markers of withdrawal following 14 days of nicotine vapor exposure. For Experiment 1, 21 adult male rats were exposed to ambient air or 6, 12, or 24 mg/mL nicotine vapor for 14 consecutive days. Following exposure on day 14, rats were injected with the nicotinic receptor antagonist mecamylamine (3.0 mg/mL) and assessed for somatic withdrawal signs and anxiety-like behavior in the elevated plus maze. For Experiment 2, 12 adult male rats were tested for intracranial self-stimulation (ICSS) immediately following exposure to vehicle vapor (50%/50%, vegetable glycerin/propylene glycol) or 24 mg/mL nicotine vapor, for 14 consecutive days. ICSS behavior was assessed for an additional 14 days, following cessation of repeated vapor exposure. Results reveal that rats with repeated nicotine vapor exposure display an increase in behavioral indicators of withdrawal following injection of mecamylamine (precipitated withdrawal). Additionally, increases in ICSS stimulation thresholds, indicative of reduced brain reward sensitivity, persist following cessation of repeated nicotine vapor exposure (spontaneous withdrawal). These data suggest that repeated e-cigarette use leads to nicotine dependence and withdrawal that affects behavior and brain reward function. Further characterization of the health effects of nicotine vapor is necessary to improve treatment strategies for nicotine use disorder and public health policies related to novel nicotine delivery systems.

17.
Arch Argent Pediatr ; 121(4): e202202772, 2023 08 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36706025

RESUMO

Introduction. During hospitalization, patients may develop significant clinical deterioration and require unplanned admission to the pediatric intensive care unit (PICU). This may result in increased morbidity and mortality. These events are often preceded by a deterioration phase that may go unnoticed. Objective. To determine the frequency, analyze the causes, and describe the clinical characteristics and outcomes of unplanned transfers of hospitalized pediatric patients from the general pediatric ward (GPW) to the PICU, and analyze the differences between urgent and emergent transfers. Population and methods. Prospective, descriptive study; all unplanned transfers from the GPW to the PICU occurring between January 1st , 2014 and December 31st, 2019 were analyzed. Results. There were 212 unplanned transfers (21 transfers per 1000 admissions). An associated comorbidity was present in 76% of transferred patients -being cancer the most frequent one (36%)- and they had been hospitalized for more than 24 hours in the GPW. The most frequent causes of transfer were respiratory distress (43%), sepsis (20%), and neurological/neurosurgical complications (20%). The overall mortality rate was 8.96% (19 patients). Conclusions. The analysis of unplanned transfers is a critical component in the assessment of the quality of care and patient safety of an area, and should be an indicator integrated into the control panel. The interpretation of unplanned transfers as a preventable event is a key paradigm shift.


Introducción. Durante la internación, los pacientes pueden presentar un deterioro clínico significativo y requerir el ingreso no programado a la unidad de cuidados intensivos pediátricos (UCIP). Esto puede conllevar un aumento de la morbilidad y la mortalidad. Frecuentemente, estos eventos están precedidos por una fase de deterioro que podría pasar desapercibida. Objetivo. Determinar la frecuencia, analizar las causas, describir las características clínicas y los resultados de los traslados no programados en pacientes pediátricos hospitalizados, desde el área de internación general pediátrica (IGP) a la UCIP, y analizar las diferencias entre traslados urgentes y emergentes. Población y métodos. Estudio descriptivo prospectivo; se analizaron todos los traslados no programados desde IGP a la UCIP ocurridos entre el 1 de enero de 2014 y el 31 de diciembre 2019. Resultados. Se constataron 212 traslados no programados (21 traslados cada 1000 ingresos). El 76 % de los pacientes trasladados presentaban una comorbilidad asociada ­la más frecuente fue la patología oncológica (36 %)­ y llevaban más de 24 horas internados en IGP. Las causas más frecuentes de traslado fueron dificultad respiratoria (43 %), sepsis (20 %) y complicaciones neurológicas/neuroquirúrgicas (20 %). La tasa de mortalidad global fue del 8,96 % (19 pacientes). Conclusiones. El análisis de los traslados no programados es un elemento esencial en la evaluación de la calidad de atención y seguridad del paciente de un área, y debe constituir un indicador integrado al tablero de control. La interpretación de los traslados no programados como un evento prevenible constituye un cambio de paradigma clave.


Assuntos
Transferência de Pacientes , Quartos de Pacientes , Humanos , Criança , Estudos Prospectivos , Transferência de Pacientes/métodos , Unidades de Terapia Intensiva , Hospitalização , Unidades de Terapia Intensiva Pediátrica , Estudos Retrospectivos
18.
Sci Adv ; 8(26): eabo0902, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35767607

RESUMO

DNA aptamers have been widely used as biosensors for detecting a variety of targets. Despite decades of success, they have not been applied to monitor any targets in plants, even though plants are a major platform for providing oxygen, food, and sustainable products ranging from energy fuels to chemicals, and high-value products such as pharmaceuticals. A major barrier to progress is a lack of efficient methods to deliver DNA into plant cells. We herein report a thiol-mediated uptake method that more efficiently delivers DNA into Arabidopsis and tobacco leaf cells than another state-of-the-art method, DNA nanostructures. Such a method allowed efficient delivery of a glucose DNA aptamer sensor into Arabidopsis for sensing glucose. This demonstration opens a new avenue to apply DNA aptamer sensors for functional studies of various targets, including metabolites, plant hormones, metal ions, and proteins in plants for a better understanding of the biodistribution and regulation of these species and their functions.


Assuntos
Aptâmeros de Nucleotídeos , Arabidopsis , Técnicas Biossensoriais , Aptâmeros de Nucleotídeos/química , Técnicas Biossensoriais/métodos , DNA/química , Glucose , Células Vegetais , Compostos de Sulfidrila , Distribuição Tecidual
19.
Proc (Bayl Univ Med Cent) ; 35(4): 410-414, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35754600

RESUMO

Ventilator-associated pneumonia (VAP) is a major cause of healthcare-associated mortality and morbidity in critically ill patients who are mechanically ventilated. The purpose of this study was to describe the various primary discharge diagnoses of hospitalizations with VAP, to identify their demographic characteristics, and to identify risk factors for mortality in hospitalizations with VAP. Hospitalizations with a diagnosis of VAP with mechanical ventilation for over 24 hours were selected from the National Inpatient Sample in 2016 and 2017. In total, 33,140 hospitalizations with VAP were analyzed. The leading principal discharge diagnoses for hospitalizations leading to VAP were sepsis due to an unspecified organism (16.92%), respiratory failure (8.09%), and VAP (6.38%). Mortality among hospitalizations with VAP was 20.9%. Independent risk factors for mortality in hospitalizations with VAP were uninsured status (adjusted odds ratio [aOR] 2.13, 95% confidence interval [CI] 1.49-3.06, P < 0.001), acute renal failure (aOR 2.00, 95% CI 1.75-2.30, P < 0.001), and liver disease (aOR 1.82, 95% CI 1.52-2.18, P < 0.001). In conclusion, VAP is associated with significant mortality. Infective, traumatic, cardiovascular, and respiratory conditions accounted for over 85% of hospitalizations with VAP. Acute renal failure, the presence of liver disease, and lack of insurance are associated with higher mortality in hospitalizations with VAP.

20.
Front Oncol ; 12: 980694, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36226048

RESUMO

Breast cancer (BC) is the most common cancer in women worldwide. This highly heterogeneous disease is molecularly stratified into luminal A, luminal B, HER2, triple-negative/basal-like, and normal-like subtypes. An important aspect in BC progression is the activation of inflammatory processes. The activation of CD8+/Th1, NK, and M1 tumor associated macrophages (TAMs), leads to tumor destruction. In contrast, an anti-inflammatory response mediated by CD4+/Th2 and M2 TAMs will favor tumor progression. Inflammation also stimulates the production of inflammatory mediators like reactive oxygen species (ROS). In chronic inflammation, ROS activates oxidative stress and endothelial dysfunction. In cancer, ROS plays a dual role with anti-tumorigenic and pro-tumorigenic effects in cell signaling pathways that control proliferation, survival, apoptosis, and inflammation. MicroRNAs (miRNAs), which are known to be involved in BC progression and inflammation, can be regulated by ROS. At the same time, miRNAs regulate the expression of genes modulating oxidative stress. In this review, we will discuss the interplay between inflammation, ROS, and miRNAs as anticancer and tumor promoter molecules in BC. A clear understanding of the role of miRNAs in the regulation of ROS production and inflammation, may lead to new opportunities for therapy in BC.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA