Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.039
Filtrar
Mais filtros











Intervalo de ano de publicação
1.
Trop Anim Health Prod ; 56(4): 152, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38722369

RESUMO

Supplementing livestock grazing communal rangelands with leaf-meals from Acacia trees, which are currently considered as problematic invasive alien plants globally, may be a sustainable way of exploiting their desirable nutritional and anthelmintic properties. The current study evaluated worm burdens and growth performance of lambs grazing low-quality communal rangelands supplemented with leaf-meals prepared from the invasive alien plant species; Acacia mearnsii or A. dealbata. Forty, three-month-old ewe lambs weighing an average of 18.9 ± 0.60 kg were randomly allocated to four supplementary diets: (1) rangeland hay only (control), (2) commercial protein supplement plus rangeland hay, (3) A. mearnsii leaf-meal plus rangeland hay and (4) A. dealbata leaf-meal plus rangeland hay. All the supplementary diets were formulated to meet the lambs' minimum maintenance requirements for protein. All the lambs were grazed on communal rangelands daily from 0800 to 1400 after which they were penned to allow them access to their respective supplementary diets until 08:00 the following morning. The respective supplementary diets were offered at the rate of 400 g ewe- 1 day- 1 for 60 days. Lambs fed the commercial protein supplement had the highest dry matter intake followed by those fed the Acacia leaf-meals and the control diet, respectively (P ≤ 0.05). Relative to the other supplementary diets, lambs fed the commercial protein supplement and A. dealbata leaf-meal had higher (P ≤ 0.05) final body weight and average daily gains. Dietary supplementation did not affect lamb faecal worm egg counts over the study period (P > 0.05). There was no association between supplementary diets and lamb FAMACHA© scores (P > 0.05). It was concluded that supplementation of Acacia dealbata versus Acacia mearnsii has the potential to emulate commercial protein in maintaining growth performance of lambs grazing communal rangelands in the dry season.


Assuntos
Acacia , Ração Animal , Dieta , Suplementos Nutricionais , Folhas de Planta , Animais , Ração Animal/análise , Folhas de Planta/química , Suplementos Nutricionais/análise , Feminino , África do Sul , Dieta/veterinária , Carneiro Doméstico/crescimento & desenvolvimento , Carneiro Doméstico/fisiologia , Doenças dos Ovinos/prevenção & controle , Doenças dos Ovinos/parasitologia , Ovinos/crescimento & desenvolvimento , Ovinos/fisiologia , Fezes , Distribuição Aleatória , Contagem de Ovos de Parasitas/veterinária , Fenômenos Fisiológicos da Nutrição Animal
2.
Cell Host Microbe ; 32(3): 411-424.e10, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38307020

RESUMO

Intracellular Salmonella experiencing oxidative stress downregulates aerobic respiration. To maintain cellular energetics during periods of oxidative stress, intracellular Salmonella must utilize terminal electron acceptors of lower energetic value than molecular oxygen. We show here that intracellular Salmonella undergoes anaerobic respiration during adaptation to the respiratory burst of the phagocyte NADPH oxidase in macrophages and in mice. Reactive oxygen species generated by phagocytes oxidize methionine, generating methionine sulfoxide. Anaerobic Salmonella uses the molybdenum cofactor-containing DmsABC enzymatic complex to reduce methionine sulfoxide. The enzymatic activity of the methionine sulfoxide reductase DmsABC helps Salmonella maintain an alkaline cytoplasm that supports the synthesis of the antioxidant hydrogen sulfide via cysteine desulfuration while providing a source of methionine and fostering redox balancing by associated dehydrogenases. Our investigations demonstrate that nontyphoidal Salmonella responding to oxidative stress exploits the anaerobic metabolism associated with dmsABC gene products, a pathway that has accrued inactivating mutations in human-adapted typhoidal serovars.


Assuntos
Metionina/análogos & derivados , NADPH Oxidases , Fagócitos , Animais , Camundongos , Humanos , Anaerobiose , Fagócitos/metabolismo , Metionina/metabolismo , Salmonella typhimurium/metabolismo , Respiração
3.
Int J Clin Pharm ; 46(2): 515-521, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38315306

RESUMO

BACKGROUND: Women have been under-represented in trials of antipsychotic medications. AIM: Our primary objective was to evaluate five adverse events (AE) associated with first-generation antipsychotics (FGAs) among women relative to men through an analysis of the FDA Adverse Event Reporting System (FAERS). METHOD: We queried 24.6 million AE reports from 2000 to 2023 involving FGAs. The study cohort consisted of chlorpromazine (n = 3317), fluphenazine (n = 1124), haloperidol (n = 16,709), loxapine (n = 3151), perphenazine (n = 816), thioridazine (n = 665), thiothixene (n = 244), and trifluoperazine (n = 360). Cases of neuroleptic malignant syndrome (NMS), tardive dyskinesia (TD), Torsades de Pointes (TdP), agranulocytosis (AG), and cerebrovascular adverse events (CVAE) were identified. Reporting odds ratios (ROR) and associated 95% confidence intervals (CI) were calculated with logistic regression for each AE among women relative to men. RESULTS: A total of 2,857 serious AEs were evaluated in the study cohort (NMS = 1810, TD = 434, TdP = 260, AG = 149, CVAE = 204). The ROR for women compared to men was 0.79 (95% CI, 0.71-0.87) for NMS, 0.83 (0.68-1.01) for TD, 1.21 (0.94-1.53) for TdP, 0.71 (0.51-0.98) for AG, and 0.91 (0.68-1.19) for CVAE. A secondary analysis revealed a higher odds in women compared to men of hospitalization associated with reports of TD (ROR = 1.95, 1.29-2.94) and death associated with reports of AG (ROR = 2.46, 1.15-5.24). A subgroup analysis of haloperidol revealed an ROR = 1.67 (1.26-2.21) for women relative to men for TdP. CONCLUSION: The subgroup analysis of haloperidol AEs revealed a significantly higher reporting odds ratio for TdP. Additionally, the secondary study findings suggest that women were more vulnerable to worse outcomes associated with certain AEs of FGAs.


Assuntos
Antipsicóticos , Torsades de Pointes , Masculino , Humanos , Feminino , Estados Unidos/epidemiologia , Antipsicóticos/efeitos adversos , Haloperidol/efeitos adversos , Farmacovigilância , Estudos Retrospectivos , Proteínas de Ligação a DNA , Sistemas de Notificação de Reações Adversas a Medicamentos , United States Food and Drug Administration
4.
J Transl Med ; 21(1): 748, 2023 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-37875924

RESUMO

INTRODUCTION: The promising potential of adeno-associated virus (AAV) gene delivery strategies to treat genetic disorders continues to grow with an additional three AAV-based therapies recently approved by the Food and Drug Administration and dozens of others currently under evaluation in clinical trials. With these developments, it has become increasingly apparent that the high doses currently needed for efficacy carry risks of toxicity and entail enormous manufacturing costs, especially for clinical grade products. Strategies to increase the therapeutic efficacy of AAV-mediated gene delivery and reduce the minimal effective dose would have a substantial impact on this field. We hypothesized that an exercise-induced redistribution of tissue perfusion in the body to favor specific target organs via acute aerobic exercise prior to systemic intravenous (IV) AAV administration could increase efficacy. BACKGROUND: Aerobic exercise triggers an array of downstream physiological effects including increased perfusion of heart and skeletal muscle, which we expected could enhance AAV transduction. Prior preclinical studies have shown promising results for a gene therapy approach to treat Barth syndrome (BTHS), a rare monogenic cardioskeletal myopathy, and clinical studies have shown the benefit of low intensity exercise in these patients, making this a suitable disease in which to test the ability of aerobic exercise to enhance AAV transduction. METHODS: Wild-type (WT) and BTHS mice were either systemically administered AAV9 or completed one episode of low intensity treadmill exercise immediately prior to systemic administration of AAV9. RESULTS: We demonstrate that a single episode of acute low intensity aerobic exercise immediately prior to IV AAV9 administration improves marker transgene delivery in WT mice as compared to mice injected without the exercise pre-treatment. In BTHS mice, prior exercise improved transgene delivery and additionally increased improvement in mitochondrial gene transcription levels and mitochondrial function in the heart and gastrocnemius muscles as compared to mice treated without exercise. CONCLUSIONS: Our findings suggest that one episode of acute low intensity aerobic exercise improves AAV9 transduction of heart and skeletal muscle. This low-risk, cost effective intervention could be implemented in clinical trials of individuals with inherited cardioskeletal disease as a potential means of improving patient safety for human gene therapy.


Assuntos
Técnicas de Transferência de Genes , Músculo Esquelético , Humanos , Camundongos , Animais , Transgenes , Terapia Genética/métodos , Coração , Dependovirus/genética , Vetores Genéticos
5.
J Thorac Cardiovasc Surg ; 166(6): 1746-1755, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37527726

RESUMO

BACKGROUND: We conducted this phase I, open-label safety and feasibility trial of autologous cord blood (CB) stem cell (CBSC) therapy via a novel blood cardioplegia-based intracoronary infusion technique during the Norwood procedure in neonates with an antenatal diagnosis of hypoplastic left heart syndrome (HLHS). CBSC therapy may support early cardiac remodeling with enhancement of right ventricle (RV) function during the critical interstage period. METHODS: Clinical grade CB mononucleated cells (CBMNCs) were processed to NetCord-FACT International Standards. To maximize yield, CBSCs were not isolated from CBMNCs. CBMNCs were stored at 4 °C (no cryopreservation) for use within 3 days and delivered after each cardioplegia dose (4 × 15 mL). RESULTS: Of 16 patients with antenatal diagnosis, 13 were recruited; of these 13 patients, 3 were not treated due to placental abruption (n = 1) or conditions delaying the Norwood for >4 days (n = 2) and 10 received 644.9 ± 134 × 106 CBMNCs, representing 1.5 ± 1.1 × 106 (CD34+) CBSCs. Interstage mortality was 30% (n = 3; on days 7, 25, and 62). None of the 36 serious adverse events (53% linked to 3 deaths) were related to CBMNC therapy. Cardiac magnetic resonance imaging before stage 2 (n = 5) found an RV mass index comparable to that in an exact-matched historical cohort (n = 22), with a mean RV ejection fraction of 66.2 ± 4.5% and mean indexed stroke volume of 47.4 ± 6.2 mL/m2 versus 53.5 ± 11.6% and 37.2 ± 10.3 mL/m2, respectively. All 7 survivors completed stage 2 and are alive with normal RV function (6 with ≤mild and 1 with moderate tricuspid regurgitation). CONCLUSIONS: This trial demonstrated that autologous CBMNCs delivered in large numbers without prior cryopreservation via a novel intracoronary infusion technique at cardioplegic arrest during Norwood palliation on days 2 to 3 of life is feasible and safe.


Assuntos
Síndrome do Coração Esquerdo Hipoplásico , Procedimentos de Norwood , Gravidez , Recém-Nascido , Humanos , Feminino , Sangue Fetal , Estudos de Viabilidade , Placenta , Procedimentos de Norwood/efeitos adversos , Procedimentos de Norwood/métodos , Síndrome do Coração Esquerdo Hipoplásico/diagnóstico por imagem , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Terapia Baseada em Transplante de Células e Tecidos , Ventrículos do Coração , Resultado do Tratamento , Estudos Retrospectivos , Cuidados Paliativos
6.
Am J Surg ; 224(6): 1417-1420, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36272825

RESUMO

BACKGROUND: Accuracy of imaging modalities for gallbladder disease(GBD) remains questionable. We hypothesize ultrasonography(US), computed tomography(CT), and magnetic resonance imaging(MRI) poorly correlate with final pathologic analysis. METHODS: This was a retrospective review of all patients who underwent cholecystectomy at our institution. Primary outcome was agreement between US, CT, and MRI, and final pathology report of the gallbladder. Cohen's Kappa statistic was used to describe the level of agreement (0 = agreement equivalent to chance, 0.1-0.2 = slight agreement, 0.21-0.40 = minimal/fair agreement, 0.41-0.60 = moderate agreement, 0.61-0.80 = substantial agreement, 0.81-0.99 = near perfect agreement, 1 = perfect agreement). Significance was set at p < 0.05. RESULTS: 1107 patients were enrolled. Average age was 48.6(±17.6); 64.2% were female. There was minimal agreement between the three imaging modalities and final pathology (US = 0.363; CT = 0.223; MRI = 0.351;p < 0.001). CONCLUSION: Poor agreement exists between imaging modalities and final pathology report for GBD. Urgent surgical intervention for patients presenting with symptoms of GBD should be considered, despite imaging results.


Assuntos
Doenças da Vesícula Biliar , Tomografia Computadorizada por Raios X , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Tomografia Computadorizada por Raios X/métodos , Doenças da Vesícula Biliar/diagnóstico por imagem , Doenças da Vesícula Biliar/cirurgia , Imageamento por Ressonância Magnética/métodos , Ultrassonografia/métodos , Estudos Retrospectivos
7.
Histopathology ; 81(3): 280-296, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35395118

RESUMO

Mesonephric lesions in the female genital tract are uncommon, with those arising from the upper tract being much less frequent than those developing in the lower tract (mesonephric hyperplasia and carcinoma). The most common upper tract lesions include rete cyst/cystadenoma and female adnexal tumour of Wolffian origin (FATWO). The integration of morphological, immunohistochemical and molecular studies on FATWOs has enabled recognition of a novel entity, the STK11 adnexal tumour, which is often associated with Peutz-Jeghers syndrome (~50%) and frequently has a salivary gland morphology but an unknown origin. Similarly, 'mesonephric-like' adenocarcinoma, an entity with striking similarities to mesonephric carcinoma but currently favoured to be of Müllerian derivation based on its association with other Müllerian tumours and molecular findings, has also been recently described, and may histologically mimic both FATWOs and STK11 adnexal tumours. In this review, we provide a historical overview of upper female genital tract mesonephric proliferations and discuss mesonephric lesions, STK11 adnexal tumour, mesonephric-like adenocarcinoma, and mimickers, the most common being endometrioid carcinoma.


Assuntos
Adenocarcinoma , Adenoma , Ligamento Largo , Carcinoma Endometrioide , Neoplasias dos Genitais Femininos , Neoplasias de Anexos e de Apêndices Cutâneos , Quinases Proteína-Quinases Ativadas por AMP , Adenocarcinoma/patologia , Adenoma/patologia , Ligamento Largo/patologia , Carcinoma Endometrioide/patologia , Feminino , Neoplasias dos Genitais Femininos/patologia , Humanos , Neoplasias de Anexos e de Apêndices Cutâneos/patologia , Proteínas Serina-Treonina Quinases , Ductos Mesonéfricos/patologia
8.
J Virol ; 96(9): e0006422, 2022 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-35416719

RESUMO

Alphaviruses infect cells by a low pH-dependent fusion reaction between viral and host cell membranes that is mediated by the viral E1 glycoprotein. Most reported alphavirus E1 sequences include two phenylalanines (F87 and F95) in the fusion loop, yet the role of these residues in viral infectivity remains to be defined. Following introduction of wild type (WT), E1-F87A, and E1-F95A chikungunya virus (CHIKV) RNA genomes into cells, viral particle production was similar in magnitude. However, CHIKV E1-F87A and E1-F95A virions displayed impaired infectivity compared with WT CHIKV particles. Although WT, E1-F87A, and E1-F95A particles bound cells with similar efficiencies, E1-F87A and E1-F95A particles were unable to undergo fusion and entry into cells. Introduction of an F95A mutation in the E1 fusion loop of Mayaro virus or Venezuelan equine encephalitis virus also resulted in poorly infectious virions. We further tested whether an E1-F87A or E1-F95A mutation could be incorporated into a live-attenuated vaccine strain, CHIKV 181/25, to enhance vaccine safety. Infection of immunocompromised Ifnar1-/- and Irf3-/-Irf5-/-Irf7-/- mice with 181/25E1-F87A or 181/25E1-F95A resulted in 0% mortality, compared with 100% mortality following 181/25 infection. Despite this enhanced attenuation, surviving Ifnar1-/- and Irf3-/-Irf5-/-Irf7-/- mice were protected against virulent virus re-challenge. Moreover, single-dose immunization of WT mice with either 181/25, 181/25E1-F87A, or 181/25E1-F95A elicited CHIKV-specific antibody responses and protected against pathogenic CHIKV challenge. These studies define a critical function for residues E1-F87 and E1-F95 in alphavirus fusion and entry into target cells and suggest that incorporation of these mutations could enhance the safety of live-attenuated alphavirus vaccine candidates. IMPORTANCE Alphaviruses are human pathogens that cause both debilitating acute and chronic musculoskeletal disease and potentially fatal encephalitis. In this study, we determined that two highly conserved phenylalanine residues in the alphavirus E1 glycoprotein are required for fusion of viral and host cell membranes and viral entry into target cells. We further demonstrated that mutation of these phenylalanines results in a substantial loss of viral virulence but not immunogenicity. These data enhance an understanding of the viral determinants of alphavirus entry into host cells and could contribute to the development of new antivirals targeting these conserved phenylalanines or new live-attenuated alphavirus vaccines.


Assuntos
Febre de Chikungunya , Vírus Chikungunya , Proteínas do Envelope Viral , Vacinas Virais , Animais , Anticorpos Antivirais , Febre de Chikungunya/virologia , Vírus Chikungunya/patogenicidade , Vírus Chikungunya/fisiologia , Fatores Reguladores de Interferon/metabolismo , Camundongos , Camundongos Knockout , Fenilalanina/química , Domínios Proteicos , Vacinas Atenuadas/imunologia , Proteínas do Envelope Viral/química , Vacinas Virais/imunologia , Replicação Viral
10.
Gynecol Oncol ; 164(3): 498-504, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35063276

RESUMO

OBJECTIVE: The phase IIIb OPINION trial (NCT03402841) investigated olaparib maintenance monotherapy in patients without a deleterious or suspected deleterious germline BRCA1/BRCA2 mutation (gBRCAm) who had platinum-sensitive relapsed ovarian cancer (PSROC) and had received ≥2 previous lines of platinum-based chemotherapy. METHODS: In this single-arm, open-label, international study, patients who had responded to platinum-based chemotherapy received maintenance olaparib tablets (300 mg twice daily) until disease progression or unacceptable toxicity. The primary endpoint was investigator-assessed progression-free survival (PFS) (modified RECIST version 1.1). A key secondary endpoint was PFS by homologous recombination deficiency (HRD) and somatic BRCAm (sBRCAm) status. The primary analysis of PFS was planned for 18 months after the last patient received their first dose. RESULTS: Two hundred and seventy-nine patients were enrolled and received olaparib. At data cutoff (October 2, 2020), 210 PFS events had occurred (75.3% maturity) and median PFS was 9.2 months (95% confidence interval [CI], 7.6-10.9) in the overall population. At 12 and 18 months, 38.5% and 24.3% of patients were progression-free, respectively. In the predefined biomarker subgroups, median PFS was 16.4, 11.1, 9.7, and 7.3 months in sBRCAm, HRD-positive including sBRCAm, HRD-positive excluding sBRCAm, and HRD-negative patients, respectively. The most common treatment-emergent adverse events (TEAEs) were nausea (48.4%) and fatigue/asthenia (44.1%). TEAEs led to dose interruption, dose reduction, and treatment discontinuation in 47.0%, 22.6%, and 7.5% of patients, respectively. CONCLUSION: Maintenance olaparib demonstrated clinical benefit in patients without a gBRCAm, and across all subgroups, compared with historical placebo controls. There were no new safety signals.


Assuntos
Recidiva Local de Neoplasia , Neoplasias Ovarianas , Ftalazinas , Piperazinas , Proteína BRCA1/genética , Proteína BRCA2/genética , Carcinoma Epitelial do Ovário/tratamento farmacológico , Carcinoma Epitelial do Ovário/genética , Feminino , Células Germinativas , Mutação em Linhagem Germinativa , Humanos , Quimioterapia de Manutenção , Mutação , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/genética , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/genética , Ftalazinas/efeitos adversos , Piperazinas/efeitos adversos , Platina/uso terapêutico
11.
Leuk Res ; 112: 106757, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34864369

RESUMO

We studied 79 patients with AML-MRC or RAEB-T, who were later reclassified according to the WHO classification. Marrow slides were examined cytomorphologically with regard to dysplasia. Patients were followed up until March 2020. Thirty-one patients underwent allogeneic stem cell transplantation (median survival (ms) 16 months), 14 were treated with induction chemotherapy (ms 8.4 months), 18 received hypomethylating agents (ms 9.2 months), 16 received low dose chemotherapy or best supportive care (ms 2.4 months). Only 30.4 % fulfilled the morphologic WHO criteria. 46.8 % were classified as AML-MRC by an antecedent MDS, 54.4 % of the pts were classified by MDS-related chromosomal abnormalities. 5 % did not fulfill any of the criteria and were entered based on 20-29 % medullary blasts. There was no difference in ms between pts presenting with > 50 % dysplasia as compared to pts with dysplasia between 10 % and 50 % (ms 9.1 vs 9.9 months, p = n.s.) or for pts with antecedent MDS (ms 9.1 vs 8.9 months, p = n.s.). Myelodysplasia-related cytogenetic abnormalities were associated with a worse outcome (ms 8.1 vs 13.5 months, p = 0.026). AML-MRC in its current definition is a heterogenous entity. Dysplasia of ≥ 50 % in ≥ two lineages is not helpful for diagnostics and prognostication and therefore should be deleted in future classifications. We recommend utilizing the WHO guidelines for defining dysplasia (10 % or greater in ≥ 1 of the three myeloid cell lines) assisting in establishing the diagnosis of MDS.


Assuntos
Anemia Refratária com Excesso de Blastos/genética , Transplante de Células-Tronco Hematopoéticas/métodos , Leucemia Mieloide/genética , Síndromes Mielodisplásicas/genética , Doença Aguda , Idoso , Anemia Refratária com Excesso de Blastos/diagnóstico , Anemia Refratária com Excesso de Blastos/terapia , Aberrações Cromossômicas/estatística & dados numéricos , Feminino , Humanos , Leucemia Mieloide/diagnóstico , Leucemia Mieloide/terapia , Masculino , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/diagnóstico , Síndromes Mielodisplásicas/terapia , Avaliação de Resultados em Cuidados de Saúde/métodos , Estudos Retrospectivos , Análise de Sobrevida , Organização Mundial da Saúde
12.
Case Rep Hematol ; 2021: 5574766, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34285820

RESUMO

Acute eosinophilic leukemia (AEL) is a rare form of acute myeloid leukemia (AML) that requires prompt exclusion of reactive etiologies of eosinophilia and identification of an underlying acute myeloid neoplasm. Myeloid neoplasms with prominent eosinophilia often have rearrangements in the platelet-derived growth factor receptor α (PDGFRA) or ß (PDGFRB) or are associated with core-binding factor AML. In this report, we describe a 35-year-old male presenting with chest discomfort and altered mental status, found to have marked leukocytosis with eosinophilic predominance and an elevated blast count. Bone marrow aspirate and biopsy findings were morphologically consistent with AEL. Fluorescence in situ hybridization (FISH) and standard karyotype analysis did not reveal any abnormalities, and mutation analysis using next generation sequencing (NGS) revealed a pathogenic mutation in PHF6. Cardiac work-up revealed findings suggestive of eosinophilic myocarditis. High-dose glucocorticoid therapy was initiated followed by standard intensive induction chemotherapy with cytarabine and idarubicin. He experienced a rapid reduction in peripheral blood eosinophil and blast count and was found to be in a complete remission at the time of his postinduction bone marrow examination. He underwent allogeneic stem cell transplantation with a matched sibling donor after consolidative high-dose cytarabine and remains in remission at the time of this report, 6 months following his initial diagnosis. The rarity of this condition has resulted in a paucity of data to guide management. Additional studies are needed to better characterize this entity and inform optimal management strategies to attain a long-term sustained remission in these patients.

13.
Ann R Coll Surg Engl ; 103(3): 203-207, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33645277

RESUMO

INTRODUCTION: Patients with suspected appendicitis remain a diagnostic challenge. The aim of this study was to validate risk prediction models, and to investigate diagnostic accuracy of ultrasonography and computed tomography (CT) in adults undergoing appendicectomy. METHODS: A retrospective case review was performed of patients aged 16-45 years having an appendicectomy between January 2019 and January 2020 at a tertiary referral centre. Primary outcomes were the accuracy of a high risk appendicitis risk score and ultrasonography and CT imaging modalities compared with histological reports following appendicectomy. RESULTS: A total of 206 patients (52% female) were included in the study. Removal of a histologically normal appendix was equally likely in men and women (13.1% vs 11.2% respectively, relative risk: 1.17, 95% confidence interval: 0.56-2.44, p=0.674). A high risk appendicitis score correctly identified 84.0% (79/94) of cases in men and 85.9% (67/78) of cases in women. Ultrasonography was reported as equivocal in 85.7% (18/21) of low risk women and 59.0% (23/39) of high risk women. CT correctly detected or excluded appendicitis in 75.0% (6/8) of low risk women and 88.5% (23/26) of high risk women. CONCLUSIONS: This study suggests that risk prediction models may be useful in both women and men to identify appendicitis. Ultrasonography gave high rates of equivocal results and should not be relied on for the diagnosis of appendicitis. CT is a highly accurate diagnostic tool and could be considered in those at low risk where clinical suspicion remains to reduce negative appendicectomy rates.


Assuntos
Apendicite/diagnóstico por imagem , Apêndice/patologia , Regras de Decisão Clínica , Adolescente , Adulto , Apendicectomia , Neoplasias do Apêndice/patologia , Apendicite/patologia , Apendicite/cirurgia , Erros de Diagnóstico , Reações Falso-Positivas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/patologia , Readmissão do Paciente , Estudos Retrospectivos , Fatores Sexuais , Tomografia Computadorizada por Raios X , Ultrassonografia , Adulto Jovem
14.
Br J Surg ; 108(4): 441-447, 2021 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-33615351

RESUMO

BACKGROUND: Complicated intra-abdominal infections (cIAIs) are associated with significant morbidity and mortality. The aim of this study was to describe the clinical characteristics of patients with cIAI in a multicentre study and to develop clinical prediction models (CPMs) to help identify patients at risk of mortality or relapse. METHODS: A multicentre observational study was conducted from August 2016 to February 2017 in the UK. Adult patients diagnosed with cIAI were included. Multivariable logistic regression was performed to develop CPMs for mortality and cIAI relapse. The c-statistic was used to test model discrimination. Model calibration was tested using calibration slopes and calibration in the large (CITL). The CPMs were then presented as point scoring systems and validated further. RESULTS: Overall, 417 patients from 31 surgical centres were included in the analysis. At 90 days after diagnosis, 17.3 per cent had a cIAI relapse and the mortality rate was 11.3 per cent. Predictors in the mortality model were age, cIAI aetiology, presence of a perforated viscus and source control procedure. Predictors of cIAI relapse included the presence of collections, outcome of initial management, and duration of antibiotic treatment. The c-statistic adjusted for model optimism was 0.79 (95 per cent c.i. 0.75 to 0.87) and 0.74 (0.73 to 0.85) for mortality and cIAI relapse CPMs. Adjusted calibration slopes were 0.88 (95 per cent c.i. 0.76 to 0.90) for the mortality model and 0.91 (0.88 to 0.94) for the relapse model; CITL was -0.19 (95 per cent c.i. -0.39 to -0.12) and - 0.01 (- 0.17 to -0.03) respectively. CONCLUSION: Relapse of infection and death after complicated intra-abdominal infections are common. Clinical prediction models were developed to identify patients at increased risk of relapse or death after treatment, these now require external validation.


Assuntos
Regras de Decisão Clínica , Infecções Intra-Abdominais/etiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Feminino , Humanos , Infecções Intra-Abdominais/diagnóstico , Infecções Intra-Abdominais/tratamento farmacológico , Infecções Intra-Abdominais/mortalidade , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Recidiva , Fatores de Risco
15.
RSC Adv ; 11(23): 14161-14168, 2021 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-35423905

RESUMO

The development of quick and efficient methods for the detection of pathogenic bacteria is urgently needed for the diagnosis of infectious diseases and the control of microbiological contamination in global waterways, potable water sources and the food industry. This contribution will describe the synthesis of gold nanoparticles and their conjugation to broad spectrum, polypeptide and ß-lactam antibiotics that function as both reducing agents and surface protectants (ATB@AuNP). Nanoparticle colloids examined using transmission electron microscopy are generally spherical in shape and range from 2-50 nm in size. Dynamic light scattering and infrared spectroscopy were also used to confirm encapsulation of the AuNP surface by antibiotic molecules. ATB@AuNP were then used to detect 3 common pathogenic bacterial species: Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. The colour of the AuNP colloid was monitored visually and using UV-visible spectroscopy. A red shift of the UV visible absorbance and a visible colour change following introduction of each pathogen is indicative of ATB binding to the bacteria surface, ascribed to AuNP agglomeration. This work demonstrates that ATB@AuNP may be an efficient and high throughput tool for the rapid detection of common bacterial contaminants.

16.
Nat Commun ; 11(1): 3479, 2020 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-32661250

RESUMO

Genetic factors contribute to the risk of thrombotic diseases. Recent genome wide association studies have identified genetic loci including SLC44A2 which may regulate thrombosis. Here we show that Slc44a2 controls platelet activation and thrombosis by regulating mitochondrial energetics. We find that Slc44a2 null mice (Slc44a2(KO)) have increased bleeding times and delayed thrombosis compared to wild-type (Slc44a2(WT)) controls. Platelets from Slc44a2(KO) mice have impaired activation in response to thrombin. We discover that Slc44a2 mediates choline transport into mitochondria, where choline metabolism leads to an increase in mitochondrial oxygen consumption and ATP production. Platelets lacking Slc44a2 contain less ATP at rest, release less ATP when activated, and have an activation defect that can be rescued by exogenous ADP. Taken together, our data suggest that mitochondria require choline for maximum function, demonstrate the importance of mitochondrial metabolism to platelet activation, and reveal a mechanism by which Slc44a2 influences thrombosis.


Assuntos
Proteínas de Membrana Transportadoras/metabolismo , Mitocôndrias/metabolismo , Ativação Plaquetária/fisiologia , Trombose/metabolismo , Trifosfato de Adenosina/metabolismo , Animais , Western Blotting , Modelos Animais de Doenças , Estudo de Associação Genômica Ampla , Masculino , Espectrometria de Massas , Proteínas de Membrana Transportadoras/genética , Camundongos , Camundongos Knockout , Mitocôndrias/genética , Ativação Plaquetária/genética , Agregação Plaquetária/genética , Agregação Plaquetária/fisiologia , Reação em Cadeia da Polimerase em Tempo Real , Trombose/genética
17.
Environ Pollut ; 260: 114044, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32004967

RESUMO

Aerobic performance in fish is linked to individual and population fitness and can be impacted by anthropogenic contaminants. Exposure to some engineered nanomaterials, including silver nanoparticles (nAg), reduces rates of oxygen consumption in some fish species, but the underlying mechanisms remain unclear. In addition, their effects on swim performance have not been studied. Our aim was to quantify the impact of exposure to functionalized nAg on aerobic scope and swim performance in rainbow trout (Oncorhychus mykiss) and to characterize the contribution of changing rates of protein synthesis to these physiological endpoints. Fish were exposed for 48 h to 5 nm polyvinylpyrolidone-functionalized nAg (nAgPVP; 100 µg L-1) or 0.22 µg L-1 Ag+ (as AgNO3), which was the measured quantity of Ag released from the nAgPVP over that time period. Aerobic scope, critical swimming speed (Ucrit), and fractional rates of protein synthesis (Ks), were then assessed, along with indicators of osmoregulation and cardiotoxicity. Neither nAgPVP, nor Ag+ exposure significantly altered aerobic scope, its component parts, or swim performance. Ks was similarly unaffected in 8 tissue types, though it tended to be lower in liver of nAgPVP treated fish. The treatments tended to decrease gill Na+/K+-ATPase activity, but effects were not significant. The latter results suggest that a longer or more concentrated nAgPVP exposure may induce significant effects. Although this same formulation of nAgPVP is bioactive in other fish, it had no effects on rainbow trout under the conditions tested. Such findings on common model animals like trout may thus misrepresent the safety of nAg to more sensitive species.


Assuntos
Nanopartículas Metálicas , Oncorhynchus mykiss , Povidona , Prata , Animais , Brânquias , Natação
19.
Orthop Clin North Am ; 51(1): 97-108, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31739884

RESUMO

Osteochondritis dissecans (OCD) of the capitellum is a relatively rare condition, with a higher incidence in adolescents who participate in repetitive overhead sports. The surgical treatment approach for this uncommon problem has varied from microfracture, loose body removal, abrasion chrondroplasty, lesion fixation, osteochondral allograft transplantation surgery, and osteochondral autologous transplantation surgery. The purpose of this study is to present the authors' preferred surgical technique for the treatment of unstable OCD lesions of the capitellum with osteochondral autologous transplantation surgery using autograft from the ipsilateral knee.


Assuntos
Cartilagem Articular/cirurgia , Articulação do Cotovelo/cirurgia , Úmero/cirurgia , Osteocondrite Dissecante/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Adolescente , Criança , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/patologia , Feminino , Fraturas de Estresse , Humanos , Úmero/diagnóstico por imagem , Úmero/patologia , Úmero/transplante , Incidência , Articulação do Joelho/cirurgia , Imageamento por Ressonância Magnética , Masculino , Osteocondrite Dissecante/diagnóstico por imagem , Osteocondrite Dissecante/epidemiologia , Osteocondrite Dissecante/patologia , Radiografia , Esportes , Transplante Autólogo/métodos , Resultado do Tratamento
20.
J Clin Invest ; 130(3): 1466-1478, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-31794434

RESUMO

Chikungunya virus (CHIKV) is an arbovirus capable of causing a severe and often debilitating rheumatic syndrome in humans. CHIKV replicates in a wide variety of cell types in mammals, which has made attributing pathologic outcomes to replication at specific sites difficult. To assess the contribution of CHIKV replication in skeletal muscle cells to pathogenesis, we engineered a CHIKV strain exhibiting restricted replication in these cells via incorporation of target sequences for skeletal muscle cell-specific miR-206. This virus, which we term SKE, displayed diminished replication in skeletal muscle cells in a mouse model of CHIKV disease. Mice infected with SKE developed less severe disease signs, including diminished swelling in the inoculated foot and less necrosis and inflammation in the interosseous muscles. SKE infection was associated with diminished infiltration of T cells into the interosseous muscle as well as decreased production of Il1b, Il6, Ip10, and Tnfa transcripts. Importantly, blockade of the IL-6 receptor led to diminished swelling of a control CHIKV strain capable of replication in skeletal muscle, reducing swelling to levels observed in mice infected with SKE. These data implicate replication in skeletal muscle cells and release of IL-6 as important mediators of CHIKV disease.


Assuntos
Febre de Chikungunya , Vírus Chikungunya/fisiologia , Citocinas/metabolismo , Músculo Esquelético , Replicação Viral/fisiologia , Animais , Linhagem Celular Tumoral , Febre de Chikungunya/metabolismo , Febre de Chikungunya/patologia , Cricetinae , Humanos , Camundongos , Músculo Esquelético/metabolismo , Músculo Esquelético/patologia , Músculo Esquelético/virologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA