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1.
Cells ; 13(10)2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38786092

RESUMO

The early stages of life, especially the period from conception to two years, are crucial for shaping metabolic health and the risk of obesity in adulthood. Adipose tissue (AT) plays a crucial role in regulating energy homeostasis and metabolism, and brown AT (BAT) and the browning of white AT (WAT) are promising targets for combating weight gain. Nutritional factors during prenatal and early postnatal stages can influence the development of AT, affecting the likelihood of obesity later on. This narrative review focuses on the nutritional programming of AT features. Research conducted across various animal models with diverse interventions has provided insights into the effects of specific compounds on AT development and function, influencing the development of crucial structures and neuroendocrine circuits responsible for energy balance. The hormone leptin has been identified as an essential nutrient during lactation for healthy metabolic programming against obesity development in adults. Studies have also highlighted that maternal supplementation with polyunsaturated fatty acids (PUFAs), vitamin A, nicotinamide riboside, and polyphenols during pregnancy and lactation, as well as offspring supplementation with myo-inositol, vitamin A, nicotinamide riboside, and resveratrol during the suckling period, can impact AT features and long-term health outcomes and help understand predisposition to obesity later in life.


Assuntos
Micronutrientes , Obesidade , Humanos , Animais , Obesidade/metabolismo , Micronutrientes/farmacologia , Micronutrientes/metabolismo , Tecido Adiposo Marrom/efeitos dos fármacos , Tecido Adiposo Marrom/metabolismo , Feminino , Gravidez , Tecido Adiposo/metabolismo , Tecido Adiposo/efeitos dos fármacos , Fármacos Antiobesidade/farmacologia , Fármacos Antiobesidade/uso terapêutico
2.
Viruses ; 13(6)2021 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-34071924

RESUMO

To analyze the clinical characteristics and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with sarcoidosis from a large multicenter cohort from Southern Europe and to identify the risk factors associated with a more complicated infection. We searched for patients with sarcoidosis presenting with SARS-CoV-2 infection (defined according to the European Centre for Disease Prevention and Control guidelines) among those included in the SarcoGEAS Registry, a nationwide, multicenter registry of patients fulfilling the American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and Other Granulomatous Disorders 1999 classification criteria for sarcoidosis. A 2:1 age-sex-matched subset of patients with sarcoidosis without SARS-CoV-2 infection was selected as control population. Forty-five patients with SARS-CoV-2 infection were identified (28 women, mean age 55 years). Thirty-six patients presented a symptomatic SARS-CoV-2 infection and 14 were hospitalized (12 required supplemental oxygen, 2 intensive care unit admission and 1 mechanical ventilation). Four patients died due to progressive respiratory failure. Patients who required hospital admission had an older mean age (64.9 vs. 51.0 years, p = 0.006), a higher frequency of baseline comorbidities including cardiovascular disease (64% vs. 23%, p = 0.016), diabetes mellitus (43% vs. 13%, p = 0.049) and chronic liver/kidney diseases (36% vs. 0%, p = 0.002) and presented more frequently fever (79% vs. 35%, p = 0.011) and dyspnea (50% vs. 3%, p = 0.001) in comparison with patients managed at home. Age- and sex-adjusted multivariate analysis identified the age at diagnosis of SARS-Cov-2 infection as the only independent variable associated with hospitalization (adjusted odds ratio 1.18, 95% conficence interval 1.04-1.35). A baseline moderate/severe pulmonary impairment in function tests was associated with a higher rate of hospitalization but the difference was not statistically significant (50% vs. 23%, p = 0.219). A close monitoring of SARS-CoV-2 infection in elderly patients with sarcoidosis, especially in those with baseline cardiopulmonary diseases and chronic liver or renal failure, is recommended. The low frequency of severe pulmonary involvement in patients with sarcoidosis from Southern Europe may explain the weak prognostic role of baseline lung impairment in our study, in contrast to studies from other geographical areas.


Assuntos
COVID-19/complicações , Sarcoidose/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/mortalidade , COVID-19/fisiopatologia , COVID-19/terapia , Estudos de Coortes , Comorbidade , Feminino , França , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Sarcoidose/mortalidade , Sarcoidose/fisiopatologia , Sarcoidose/terapia , Resultado do Tratamento
3.
Nutr Res Rev ; 34(2): 276-302, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34057057

RESUMO

Dietary intake and tissue levels of carotenoids have been associated with a reduced risk of several chronic diseases, including cardiovascular diseases, type 2 diabetes, obesity, brain-related diseases and some types of cancer. However, intervention trials with isolated carotenoid supplements have mostly failed to confirm the postulated health benefits. It has thereby been speculated that dosing, matrix and synergistic effects, as well as underlying health and the individual nutritional status plus genetic background do play a role. It appears that our knowledge on carotenoid-mediated health benefits may still be incomplete, as the underlying mechanisms of action are poorly understood in relation to human relevance. Antioxidant mechanisms - direct or via transcription factors such as NRF2 and NF-κB - and activation of nuclear hormone receptor pathways such as of RAR, RXR or also PPARs, via carotenoid metabolites, are the basic principles which we try to connect with carotenoid-transmitted health benefits as exemplified with described common diseases including obesity/diabetes and cancer. Depending on the targeted diseases, single or multiple mechanisms of actions may play a role. In this review and position paper, we try to highlight our present knowledge on carotenoid metabolism and mechanisms translatable into health benefits related to several chronic diseases.


Assuntos
Diabetes Mellitus Tipo 2 , Antioxidantes , Carotenoides , Suplementos Nutricionais , Humanos , Estado Nutricional
4.
Clin Transl Oncol ; 23(11): 2344-2349, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34013493

RESUMO

BACKGROUND: The use of low dose radiotherapy (LD-RT) for the treatment of COVID-19 pneumonia is supported by biological rationale for its immunomodulatory effect. Some institutions have started to treat these patients showing encouraging results. To shorten procedure times is crucial for the comfort of symptomatic patients receiving respiratory support and to optimize institutional facilities. PATIENTS AND METHODS: At our institution, LD-RT is offered to hospitalized patients with COVID-19 pneumonia and signs of early cytokine-released syndrome on behalf of a multicenter study. We designed a coordinated process flow starting from the patient transfer to the simulation CT-scan (first-step), to the end of the LD-RT treatment (last step). The times spent on each step of the process flow were evaluated. RESULTS: Mean age of treated patients was 83 (72-91) years-old. The timing parameters of the first 10 consecutive patients were analyzed. Except for the first (dummy run), patients were managed from the first to the last step in a median of 38 min (25-58, SD 10.67). The most time-consuming sub-process was the contouring of the treatment volumes and dosimetry. CONCLUSIONS: LD-RT is not only an encouraging option for COVID-19 pneumonia patients, but a convenient and feasible procedure if performed in a coordinated way by reducing procedure times.


Assuntos
COVID-19/radioterapia , SARS-CoV-2 , Idoso , Idoso de 80 Anos ou mais , Humanos , Fatores de Tempo
5.
J Nutr Biochem ; 95: 108770, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34000411

RESUMO

Metabolic programming by dietary chemicals consumed in early life stages is receiving increasing attention. We here studied long-term effects of mild resveratrol (RSV) supplementation during lactation on muscular and hepatic lipid metabolism in adulthood. Newborn male mice received RSV or vehicle from day 2-20 of age, were weaned onto a chow diet on day 21, and were assigned to either a high-fat diet (HFD) or a normal-fat diet on day 90 of age for 10 weeks. RSV-treated mice showed in adulthood protection against HFD-induced triacylglycerol accumulation in skeletal muscle, enhanced muscular capacities for fat oxidation and mitochondria activity, signs of enhanced sirtuin 1 and AMP-dependent protein kinase signaling in muscle, and increased fat oxidation capacities and a decreased capacity for lipogenesis in liver compared with controls. Thus, RSV supplementation in early postnatal life may help preventing later diet-related disorders linked to ectopic lipid accumulation in muscle and liver tissues.


Assuntos
Metabolismo Energético/efeitos dos fármacos , Fígado/efeitos dos fármacos , Fígado/metabolismo , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/metabolismo , Resveratrol/farmacologia , Adenilato Quinase/genética , Adenilato Quinase/metabolismo , Animais , Animais Lactentes , Antioxidantes/farmacologia , Dieta Hiperlipídica , Suplementos Nutricionais , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Metabolismo dos Lipídeos/efeitos dos fármacos , Fígado/crescimento & desenvolvimento , Masculino , Fenômenos Fisiológicos da Nutrição Materna , Camundongos , Músculo Esquelético/crescimento & desenvolvimento , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Sirtuína 1/genética , Sirtuína 1/metabolismo
6.
Nutrients ; 12(2)2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32059412

RESUMO

Neonatal supplementation with resveratrol (RSV) or nicotinamide riboside (NR) programs in male mice brown adipocyte-like features in white adipose tissue (WAT browning) together with improved metabolism in adulthood. We tested the involvement in this programming of long-term epigenetic changes in two browning-related genes that are overexpressed in WAT of supplemented mice, Slc27a1 and Prdm16. Suckling mice received orally the vehicle, RSV or NR from postnatal days 2-to-20. After weaning (d21) onto a chow diet, male mice were habituated to a normal-fat diet (NFD) starting d75, and split on d90 into continuation on the NFD or switching to a high-fat diet (HFD) until euthanization on d164. CpG methylation by bisulfite-sequencing was analyzed on inguinal WAT. Both treatments modified methylation marks in Slc27a1 and Prdm16 and the HFD-dependent dynamics of these marks in the adult WAT, with distinct and common effects. The treatments also affected gene expression of de novo DNA methylases in WAT of young animals (euthanized at d35 in independent experiments). Studies in 3T3-L1 adipocytes indicated the direct effects of RSV and NR on the DNA methylation machinery and favoring browning features. The results support epigenetic effects being involved in WAT programming by neonatal RSV or NR supplementation in male mice.


Assuntos
Tecido Adiposo Marrom/metabolismo , Tecido Adiposo Branco/metabolismo , Fenômenos Fisiológicos da Nutrição Animal/genética , Fenômenos Fisiológicos da Nutrição Animal/fisiologia , Metilação de DNA , Suplementos Nutricionais , Epigênese Genética , Niacinamida/análogos & derivados , Resveratrol/administração & dosagem , Resveratrol/farmacologia , Células 3T3-L1 , Administração Oral , Fenômenos Fisiológicos da Nutrição Animal/efeitos dos fármacos , Animais , Animais Recém-Nascidos , Metilação de DNA/efeitos dos fármacos , Masculino , Camundongos , Niacinamida/administração & dosagem , Niacinamida/farmacologia , Compostos de Piridínio
7.
Clin Transl Oncol ; 22(8): 1407-1413, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31927720

RESUMO

BACKGROUND: Given the lack of evidence on the best adjuvant approach, this review closely examines optimal adjuvant management for resected true ampullary cancer and its histological subtypes. MATERIALS AND METHODS: A comprehensive literature search of PubMed was performed to identify studies on resected true ampullary cancers, published between January 2010 and December 2018. Data including the use of radiation, chemotherapy or chemoradiation and the outcomes were extracted. RESULTS: A total of 116 records were identified, of which 65 screened were selected. Finally, nine studies were included. Only two of the studies reported separately the outcomes of pancreatobiliary and intestinal subtypes. Patients in the selected studies were treated with a pancreaticoduodenectomy with negative margins. Patients treated with adjuvant therapy were more likely to be pT3-4 and have positive nodes; median survival ranged from 30 to 47 months. A significant benefit for adjuvant treatment was observed in four of the studies, restricted to patients at stage IIB or higher. Likewise, patients with positive nodes may have a longer median survival with adjuvant chemoradiation compared to observation. CONCLUSIONS: The present review suggests a benefit for adjuvant treatment for patients with locally advanced tumors. Randomized trials are needed to ascertain the topic, as well as studies reporting toxicity and quality of life of resected true ampullary cancer patients.


Assuntos
Ampola Hepatopancreática , Neoplasias do Ducto Colédoco/terapia , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adenocarcinoma/terapia , Ampola Hepatopancreática/patologia , Ampola Hepatopancreática/cirurgia , Carcinoma/patologia , Carcinoma/cirurgia , Carcinoma/terapia , Carcinoma Ductal Pancreático/patologia , Carcinoma Ductal Pancreático/cirurgia , Carcinoma Ductal Pancreático/terapia , Quimiorradioterapia Adjuvante , Quimioterapia Adjuvante , Neoplasias do Ducto Colédoco/patologia , Neoplasias do Ducto Colédoco/cirurgia , Neoplasias Duodenais/patologia , Neoplasias Duodenais/cirurgia , Neoplasias Duodenais/terapia , Humanos , Pancreaticoduodenectomia , Radioterapia Adjuvante , Estudos Retrospectivos , Resultado do Tratamento
8.
Eur J Intern Med ; 69: 77-85, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31521474

RESUMO

BACKGROUND: To analyze the association between Scadding radiological stages of sarcoidosis at diagnosis and the disease phenotype (epidemiology, clinical presentation and extrathoracic involvement) in one of the largest cohorts of patients with sarcoidosis reported from southern Europe. METHODS: The SARCOGEAS-Study Group includes a multicenter database of consecutive patients diagnosed with sarcoidosis according to the WASOG 1999 criteria. Extrathoracic disease at diagnosis was defined according to the 2014 instrument and the clusters proposed by Schupp et al. RESULTS: We analyzed 1230 patients (712 female, mean age 47 yrs.) who showed the following Scadding radiologic stages at diagnosis: stage 0 (n = 98), stage I (n = 395), stage II (n = 500), stage III (n = 195) and stage IV (n = 42). Women were overrepresented in patients presenting with extrathoracic/extrapulmonary disease, while the diagnosis was made at younger ages in patients presenting with BHL, and at older ages in those presenting with pulmonary fibrosis (q values <0.05). Multivariable adjusted analysis showed that patients presenting with pulmonary involvement (especially those with stages II and III) had a lower frequency of concomitant systemic involvement in some specific extrathoracic clusters (cutaneous-adenopathic/musculoskeletal, ENT and neuro-ocular/OCCC) but a higher frequency for others (hepatosplenic), in comparison with patients with extrapulmonary involvement (stages 0 and I). The presence of either BHL or fibrotic lesions did not influence the systemic phenotype of patients with pulmonary involvement. CONCLUSIONS: The key determinant associated with a differentiated systemic phenotype of sarcoidosis at diagnosis was interstitial pulmonary involvement rather than the individual Scadding radiological stage.


Assuntos
Sarcoidose/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Radiografia , Sarcoidose/complicações , Sarcoidose/genética
9.
Front Physiol ; 10: 83, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30800077

RESUMO

Nutritional programming of the thermogenic and fuel oxidation capacity of white adipose tissue (WAT) through dietary interventions in early life is a potential strategy to enhance future metabolic health. We previously showed that mild neonatal supplementations with the polyphenol resveratrol (RSV) and the vitamin B3 form nicotinamide riboside (NR) have sex-dependent, long-term effects on the thermogenic/oxidative phenotype of WAT of mice in adulthood, enhancing this phenotype selectively in male animals. Here, we tested the hypothesis that these dietary interventions may impact the commitment of progenitor cells resident in the developing WAT toward brown-like (beige) adipogenesis. NMRI mice received orally from postnatal day 2-20 (P2-20) a mild dose of RSV or NR, in independent experiments; control littermates received the vehicle. Sex-separated primary cultures were established at P35 from the stromovascular fraction of inguinal WAT (iWAT) and of brown adipose tissue (BAT). Expression of genes related to thermogenesis and oxidative metabolism was assessed in the differentiated cultures, and in vivo in the iWAT depot of young (P35) animals. Neonatal RSV and NR treatments had little impact on the animals' growth during early postnatal life and the expression of thermogenesis- and oxidative metabolism-related genes in the iWAT depot of young mice. However, the expression of brown/beige adipocyte marker genes was upregulated in the iWAT primary cultures from RSV supplemented and NR supplemented male mice, and downregulated in those from supplemented female mice, as compared to cultures derived from sex-matched control littermates. RSV supplementation had similar sex-dependent effects on the expression of thermogenesis-related genes in the BAT primary cultures. A link between the sex-dependent short-term effects of neonatal RSV and NR supplementations on primary iWAT preadipocyte differentiation observed herein and their previously reported sex-dependent long-term effects on the thermogenic/oxidative capacity of adult iWAT is suggested. The results provide proof-of-concept that the fate of preadipocytes resident in WAT of young animals toward the beige adipogenesis transcriptional program can be modulated by specific food bioactives/micronutrients received in early postnatal life.

10.
Clin Transl Oncol ; 20(7): 936, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29546594

RESUMO

In the original version of this article the figure captions of Figs. 1 and 2 were interchanged.

11.
Cell Physiol Biochem ; 46(1): 187-202, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29587291

RESUMO

BACKGROUND/AIMS: All-trans retinoic acid (ATRA) has protective effects against obesity and metabolic syndrome. We here aimed to gain further insight into the interaction of ATRA with skeletal muscle metabolism and secretory activity as important players in metabolic health. METHODS: Cultured murine C2C12 myocytes were used to study direct effects of ATRA on cellular fatty acid oxidation (FAO) rate (using radioactively-labelled palmitate), glucose uptake (using radioactively-labelled 2-deoxy-D-glucose), triacylglycerol levels (by an enzymatic method), and the expression of genes related to FAO and glucose utilization (by RT-real time PCR). We also studied selected myokine production (using ELISA and immunohistochemistry) in ATRA-treated myocytes and intact mice. RESULTS: Exposure of C2C12 myocytes to ATRA led to increased fatty acid consumption and decreased cellular triacylglycerol levels without affecting glucose uptake, and induced the expression of the myokine irisin at the mRNA and secreted protein level in a dose-response manner. ATRA stimulatory effects on FAO-related genes and the Fndc5 gene (encoding irisin) were reproduced by agonists of peroxisome proliferator-activated receptor ß/δ and retinoid X receptors, but not of retinoic acid receptors, and were partially blocked by an AMP-dependent protein kinase inhibitor. Circulating irisin levels were increased by 5-fold in ATRA-treated mice, linked to increased Fndc5 transcription in liver and adipose tissues, rather than skeletal muscle. Immunohistochemistry analysis of FNDC5 suggested that ATRA treatment enhances the release of FNDC5/irisin from skeletal muscle and the liver and its accumulation in interscapular brown and inguinal white adipose depots. CONCLUSION: These results provide new mechanistic insights on how ATRA globally stimulates FAO and enhances irisin secretion, thereby contributing to leaning effects and improved metabolic status.


Assuntos
Fibronectinas/metabolismo , Tretinoína/farmacologia , Proteínas Quinases Ativadas por AMP/metabolismo , Animais , Linhagem Celular , Ensaio de Imunoadsorção Enzimática , Ácidos Graxos/metabolismo , Fatores de Crescimento de Fibroblastos/metabolismo , Fibronectinas/sangue , Fibronectinas/genética , Glucose/metabolismo , Interleucina-6/metabolismo , Metabolismo dos Lipídeos/efeitos dos fármacos , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Masculino , Camundongos , Músculo Esquelético/citologia , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/metabolismo , Músculo Esquelético/patologia , Neuropeptídeos/análise , Neuropeptídeos/metabolismo , PPAR delta/agonistas , PPAR delta/metabolismo , PPAR beta/agonistas , PPAR beta/metabolismo , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/metabolismo , Receptores X de Retinoides/agonistas , Receptores X de Retinoides/metabolismo , Triglicerídeos/metabolismo
12.
Biomed Pharmacother ; 101: 501-509, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29501772

RESUMO

The Mediterranean buckthorn, Rhamnus alaternus L., is a plant used in traditional medicine in Mediterranean countries. We aimed at characterizing its phenolic compounds and explore potential antihyperlipidemic activity of this plant. The profile of phenolic compounds in R. alaternus leaf crude methanolic extract (CME) and its liquid-liquid extraction-derived fractions were analyzed by high-performance liquid chromatography/electrospray ionization tandem mass spectrometry (HPLC/ESI-MS2). Effects of CME on: circulating lipids in rats with Triton WR-1339-induced hyperlipidemia, intracellular lipid accumulation and expression of genes of fatty acid metabolism in human hepatoma HepG2 cells, and adipogenesis in the 3T3-L1 murine adipocyte cell model were assessed. The HPLC/ESI-MS2 analytical profile revealed a total of fifteen compounds, of which eleven were identified. Oral CME administration decreased blood levels of cholesterol and triacylglycerols in hyperlipidemic rats (by 60% and 70%, respectively, at 200 mg CME/kg). In HepG2 cells, CME exposure dose-dependently decreased intracellular lipids and up-regulated gene expression of carnitine palmitoyltransferase 1 involved in fatty acid oxidation. In the 3T3-L1 model, CME favored preadipocyte proliferation and adipogenesis, pointing to positive effects on adipose tissue expandability. These results suggest novel uses of R. alaternus by showing that its leaves are rich in flavonoids and flavonoid derivatives with an antihyperlipidemic effect in vivo and in hepatic cells.


Assuntos
Hiperlipidemias/tratamento farmacológico , Hipolipemiantes/farmacologia , Extratos Vegetais/farmacologia , Folhas de Planta/química , Rhamnus/química , Células 3T3 , Tecido Adiposo/efeitos dos fármacos , Tecido Adiposo/metabolismo , Animais , Linhagem Celular , Linhagem Celular Tumoral , Colesterol/metabolismo , Feminino , Flavonoides/farmacologia , Células Hep G2 , Humanos , Hiperlipidemias/metabolismo , Masculino , Medicina Tradicional/métodos , Camundongos , Ratos , Ratos Wistar , Triglicerídeos/metabolismo
13.
Clin Transl Oncol ; 20(5): 576-583, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-28900813

RESUMO

BACKGROUND AND PURPOSE: Pelvic radiotherapy for prostate cancer can be associated with bowel toxicity, which may have a significant impact on quality of life. Our aim was to assess the adequacy of the tools currently used to assess bowel symptoms after radiotherapy, including physician and patient reported outcomes. This sub-study on acute toxicity was part of a prospective trial assessing long-term bowel dysfunction. MATERIALS AND METHODS: Between February 2013 and July 2015, 75 patients with prostate cancer who received radiotherapy completed the LENT/SOMA and the EPIC questionnaires baseline and 2 weeks after the treatment. The Bristol stool scale and two additional questions on faecal urgency were added. Physicians assessed toxicity using Common Terminology Criteria for Adverse Events v.4.0. Agreement between patients and clinicians was assessed using the Cohen's κ coefficient. RESULTS: Acute toxicity during radiotherapy was very low. The pattern of overall bowel bother was similar before and after treatment. Faecal urgency significantly increased after radiotherapy compared to baseline but was only detected by the additional questions and not by the physicians or the patient-reported outcomes (PRO) questionnaires. Correlation between physician and PRO was poor for most symptoms. CONCLUSION: Bowel symptoms such as urgency may remain undetected by usual tools to assess toxicity after radiotherapy. Assessment of bowel toxicity should be reappraised in order to identify those patients who may have symptoms with an impact on their quality of life.


Assuntos
Intestino Grosso/efeitos da radiação , Neoplasias da Próstata/radioterapia , Lesões por Radiação/diagnóstico , Radioterapia Conformacional/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
14.
Clin Transl Oncol ; 20(7): 899-905, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29159793

RESUMO

PURPOSE: To report the outcomes of a cohort of very elderly muscle-invasive bladder cancer (MIBC) patients treated with contemporary 3D-conformal radiation therapy (3D-CRT) with or without concurrent chemotherapy, after transurethral resection of bladder tumor (TURBT). METHODS: From February 2010 to January 2014, a total of 41 patients older than 75 years, with T2-3 N0-1 high-grade MIBC, a Karnofsky index (KI) of at least 90% and/or a Barthel scale score of at least 95, were treated with TURBT followed by radiotherapy (RT) with or without chemotherapy, and were prospectively followed-up. RESULTS: The mean age of patients was 82 years (range 76-88). Median follow-up was 47 months for surviving patients. Mean Charlson Comorbidity Index (CCI) score was 5 points. 28 patients (68.29%) were T2N0. All received 3D-CRT to a mean dose of 60 Gy (range 48.6-66 Gy), and chemotherapy was delivered to 34 patients (83%). Cause-specific survival (CSS) was 86 and 78.8% at 1 and 5 years, respectively. Patients achieving a complete response lived longer (48 vs 14 m, p = 0.036) than those with a progressive disease, who were more likely to die from cancer than from other causes (HR 3.865, IC95% 1.562-9.562). Dead patients had a longest treatment time (mean 56.78 vs 48.91 days, p = 0.019) than survivors. CONCLUSION: RT with contemporary 3D-CRT techniques after TURBT for MIBC in elderly patients is feasible and well-tolerated. Achieving a maximal response and shortening the total radiation treatment time may improve outcomes and quality of life.


Assuntos
Neoplasias Musculares/radioterapia , Recidiva Local de Neoplasia/radioterapia , Qualidade de Vida , Radioterapia Conformacional/mortalidade , Neoplasias da Bexiga Urinária/radioterapia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Neoplasias Musculares/patologia , Recidiva Local de Neoplasia/patologia , Tratamentos com Preservação do Órgão , Prognóstico , Taxa de Sobrevida , Neoplasias da Bexiga Urinária/patologia
15.
Rev. argent. dermatol ; 97(3): 27-33, set. 2016. ilus
Artigo em Espanhol | LILACS | ID: biblio-843091

RESUMO

La púrpura de Schönlein-Henoch, es una vasculitis sistémica de pequeños vasos, con depósitos de IgA en las paredes vasculares, que se caracteriza clínicamente por: púrpura palpable, artritis o artralgias, dolor abdominal y compromiso renal. Es más frecuente en niños pero puede presentarse en adultos. La etiología es desconocida, pero se la ha relacionado a infecciones vacunas, fármacos y en adultos a neoplasias. Presentamos el caso de una mujer de 74 años, que había comenzado a tomar losartán diez días previos al comienzo de los síntomas. Para normalización de la tensión arterial, se suspendió el losartán. Al reiniciar la droga, la paciente presentó nuevamente una púrpura palpable, en miembros inferiores.


Schönlein-Henoch purpura is a systemic vasculitis of small vessels with IgA deposits in vessel walls. It presents with palpable purpura, arthritis or arthralgia, abdominal pain and renal involvement. It is more common in children, but it can also be seen in adults. Although, the etiology is unknown, the illness has been associated with infections, vaccines, drugs and, in adults, with neoplasias, as well. A 74 year-old woman who had started taking losartan ten days before she started with the onset of symptoms are reported. Days after, the arterial tension normalized, so losartan was suspended. When the drug was reintroduced, the patient presented once again a palpable purpura on lower limbs.

16.
Rev. argent. dermatol ; 97(2): 1-4, jun. 2016. ilus, graf
Artigo em Espanhol | LILACS | ID: biblio-843076

RESUMO

El pilomatrixoma es un tumor anexial benigno, que deriva de las células matriciales del folículo piloso. Tiene dos picos de incidencia: entre los 5 y los 15 años y entre los 50 y 65 años. Aproximadamente el 60-80% de los casos, se desarrolla en la primera década de la vida. En adultos, generalmente es sub-diagnosticado debido a su baja frecuencia. Presentamos el caso de un pilomatrixoma en edad adulta, de rápido crecimiento y realizamos una breve revisión sobre el tema.


Pilomatrixoma is a benign adnexal tumor derived from the matrix cells of the hair follicle. It has two peaks of incidence: between 5 and 15 years and between 50 and 65 years. Approximately 60-80% of cases develop in the first decade of life. In adults, it is generally under-diagnosed due to its low frequency. We report the case of a pilomatrixoma in adulthood of rapid growth and a brief review on the subject.

17.
Rev. argent. dermatol ; 97(2): 64-73, jun. 2016. ilus
Artigo em Espanhol | LILACS | ID: biblio-843083

RESUMO

El xantoganuloma juvenil es una enfermedad benigna, poco frecuente en el adulto, forma parte del grupo de las histiocitosis de células no Langerhans, representando el 90 % de las mismas y el 15 % de éstas, se presentan en el adulto. El compromiso de otros órganos es excepcional. La evolución suele ser benigna con autoresolución de las lesiones. Presentamos el caso de una paciente de sexo femenino de 27 años de edad, que presentaba lesiones papulares de 15 días de evolución, en zona periocular, asintomáticas, las que fueron biopsiadas con diagnóstico histopatológico de xantogranuloma juvenil.


Juvenile Xanthogranuloma (JX) is an uncommon benign disease in adults, is part of the group of non-Langerhans cells histiocytosis, representing 90 % of them and 15% of these occur in adults. The involvement of other organs is exceptional. The evolution is usually benign with resolution of disease. We present a case of a female patient of 27 years who had papules with 15 days of evolution, in periocular area, asymptomatic, which were biopsied with histopathologic diagnosis of juvenile xanthogranuloma.

18.
PLoS One ; 11(5): e0155361, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27163124

RESUMO

Blood cells are receiving an increasing attention as an easily accessible source of transcript-based biomarkers. We studied the feasibility of using mouse whole blood RNA in this context. Several paradigms were studied: (i) metabolism-related transcripts known to be affected in rat tissues and peripheral blood mononuclear cells (PBMC) by fasting and upon the development of high fat diet (HFD)-induced overweight were assessed in whole blood RNA of fasted rats and mice and of HFD-fed mice; (ii) retinoic acid (RA)-responsive genes in tissues were assessed in whole blood RNA of control and RA-treated mice; (iii) lipid metabolism-related transcripts previously identified in PBMC as potential biomarkers of metabolic health in a rat model were assessed in whole blood in an independent model, namely retinoblastoma haploinsufficient (Rb+/-) mice. Blood was collected and stored in RNAlater® at -80°C until analysis of selected transcripts by real-time RT-PCR. Comparable changes with fasting were detected in the expression of lipid metabolism-related genes when RNA from either PBMC or whole blood of rats or mice was used. HFD-induced excess body weight and fat mass associated with expected changes in the expression of metabolism-related genes in whole blood of mice. Changes in gene expression in whole blood of RA-treated mice reproduced known transcriptional actions of RA in hepatocytes and adipocytes. Reduced expression of Fasn, Lrp1, Rxrb and Sorl1 could be validated as early biomarkers of metabolic health in young Rb+/- mice using whole blood RNA. Altogether, these results support the use of whole blood RNA in studies aimed at identifying blood transcript-based biomarkers of nutritional/metabolic status or metabolic health. Results also support reduced expression of Fasn, Lrp1, Rxrb and Sorl1 in blood cells at young age as potential biomarkers of metabolic robustness.


Assuntos
Dieta Hiperlipídica , Metabolismo Energético/genética , Estado Nutricional/genética , RNA Mensageiro/genética , Transcriptoma , Adipócitos/citologia , Adipócitos/efeitos dos fármacos , Adipócitos/metabolismo , Animais , Peso Corporal/efeitos dos fármacos , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/metabolismo , Metabolismo Energético/efeitos dos fármacos , Jejum , Ácido Graxo Sintase Tipo I/genética , Ácido Graxo Sintase Tipo I/metabolismo , Feminino , Regulação da Expressão Gênica , Haploinsuficiência , Hepatócitos/citologia , Hepatócitos/efeitos dos fármacos , Hepatócitos/metabolismo , Leucócitos Mononucleares/citologia , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/metabolismo , Proteína-1 Relacionada a Receptor de Lipoproteína de Baixa Densidade , Masculino , Proteínas de Membrana Transportadoras/genética , Proteínas de Membrana Transportadoras/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Estado Nutricional/efeitos dos fármacos , RNA Mensageiro/metabolismo , Ratos , Ratos Wistar , Receptores de LDL/genética , Receptores de LDL/metabolismo , Proteína do Retinoblastoma/deficiência , Proteína do Retinoblastoma/genética , Tretinoína/administração & dosagem , Proteínas Supressoras de Tumor/genética , Proteínas Supressoras de Tumor/metabolismo
19.
Rev. argent. dermatol ; 97(1): 81-88, mar. 2016. ilus
Artigo em Espanhol | LILACS | ID: biblio-843073

RESUMO

Describimos el cuadro clínico de un paciente, que presenta placas y pápulas con aspecto de piel arrugada en papel de cigarrillo, localizadas en abdomen. El estudio histopatológico muestra ausencia de fibras elásticas, en una banda que compromete la porción media de la dermis. La elastolisis de la dermis media es una afección infrecuente, adquirida, idiopática o secundaria a un proceso inflamatorio previo, caracterizada por la pérdida focal de tejido elástico en la dermis media y sin compromiso extra cutáneo.


We describe a patient presenting plaques and papules -like wrinkled cigarette paper-, located in abdomen. Histopathological study shows absence of elastic fibers in a band that compromised the middle portion of the dermis. Mid dermal elastolysis is a rare, acquired idiopathic condition characterized by focal loss of elastic tissue in the middle dermis without extra cutaneous involment.

20.
J Cell Physiol ; 231(9): 1941-52, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-26727985

RESUMO

Mechanisms behind the emergence of brown adipocyte-like (brite or beige) adipocytes within white adipose tissue (WAT) are of interest. Retinoblastoma protein gene (Rb) haploinsufficiency associates in mice with improved metabolic regulation linked to a greater capacity for fatty acid oxidation and thermogenesis in WAT. We aimed to explain a feasible mechanism of WAT-to-BAT remodeling in this model. Differentiated primary adipocytes and Sca1-positive preadipocytes derived from adipose depots of Rb(+/-) mice and wild-type siblings were compared. Primary white Rb(+/-) adipocytes displayed under basal conditions increased glucose uptake and an enhanced expression of brown adipocyte-related genes (Pparg, Ppargc1a, Ppargc1b, Prdm16, Cpt1b) but not of purported beige/brite transcriptional markers (Cd137, Tmem26, Tbx1, Slc27a1, Hoxc9, Shox2). Lack of induction of beige markers phenocopied results in WAT of adult Rb(+/-) mice. Flow cytometry analysis evidenced an increased number of preadipocytes in WAT depots of Rb(+/-) mice. Sca1(+) preadipocytes from WAT of Rb(+/-) mice displayed increased gene expression of several transcription factors common to the brown and beige adipogenic programs (Prdm16, Pparg, Ppargc1a) and of receptors of bone morphogenetic proteins (BMPs); however, among the recently proposed beige markers, only Tbx1 was upregulated. Adult Rb(+/-) mice had increased circulating levels of BMP7. These results indicate that preadipose cells resident in WAT depots of Rb(+/-) mice retain an increased capacity for brown-like adipogenesis that appears to be different from beige adipogenesis, and suggest that the contribution of these precursors to the Rb(+/-) adipose phenotype is driven, at least in part, by interaction with BMP7 pathways. J. Cell. Physiol. 231: 1941-1952, 2016. © 2016 Wiley Periodicals, Inc.


Assuntos
Adipócitos Marrons/citologia , Adipogenia/fisiologia , Proteína do Retinoblastoma/metabolismo , Retinoblastoma/metabolismo , Fatores de Transcrição/metabolismo , Adipócitos Marrons/metabolismo , Tecido Adiposo Branco/citologia , Tecido Adiposo Branco/metabolismo , Animais , Diferenciação Celular/fisiologia , Feminino , Expressão Gênica/genética , Genes do Retinoblastoma/genética , Haplótipos , Masculino , Camundongos , Camundongos Knockout , Obesidade/metabolismo , Fenótipo , Retinoblastoma/genética , Proteína do Retinoblastoma/genética , Termogênese
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