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1.
Health Policy Open ; 6: 100122, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38779080

RESUMO

Background: Socioeconomic conditions are strongly associated with breast and cervical cancer incidence and mortality patterns; therefore, social protection programmes (SPPs) might impact these cancers. This study aimed to evaluate the effect of SPPs on breast and cervical cancer outcomes and their risk/protective factors. Methods: Five databases were searched for articles that assessed participation in PPS and the incidence, survival, mortality (primary outcomes), screening, staging at diagnosis and risk/protective factors (secondary outcomes) for these cancers. Only peer-reviewed quantitative studies of women receiving SPPs compared to eligible women not receiving benefits were included. Independent reviewers selected articles, assessed eligibility, extracted data, and assessed the risk of bias. A harvest plot represents the included studies and shows the direction of effect, sample size and risk of bias. Findings: Of 17,080 documents retrieved, 43 studies were included in the review. No studies evaluated the primary outcomes. They all examined the relationship between SPPs and screening, as well as risk and protective factors. The harvest plot showed that in lower risk of bias studies, participants of SPPs had lower weight and fertility, were older at sexual debut, and breastfed their infants for longer. Interpretation: No studies have yet assessed the effect of SPPs on breast and cervical cancer incidence, survival, or mortality; nevertheless, the existing evidence suggests positive impacts on risk and protective factors.

2.
J Oral Maxillofac Surg ; 81(11): 1344-1352, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37640235

RESUMO

BACKGROUND: Complete unilateral cleft lip and palate (UCLP) creates a continuity defect on the nasal floor, which contributes to nasal asymmetry. Traditionally, piriform rim symmetry has been evaluated by comparing cleft and noncleft sides. No study has compared the magnitude of perinasal asymmetry in UCLP patients with a control group of patients without clefts. PURPOSE: To address the following question: In UCLP patients, whose alveolar clefts are reconstructed with alveolar bone grafts (ABGs), is the magnitude of remaining piriform rim asymmetry similar to that of patients without UCLP? STUDY DESIGN SETTING, SAMPLE: This is a retrospective cohort study that used the cone beam computed tomography of UCLP and non-UCLP patients to evaluate the piriform rim symmetry. The sample was derived from patients who presented for orthognathic surgery between January 2015 and December 2022. To be included, patients had to have a maxillary deficiency. The cleft group had ABG performed with symphyseal bone harvest and bone morphogenetic protein application. Patients were excluded from the control group if they had clinical asymmetry and nasal septum deviation. Patients from the UCLP group were excluded if they failed the first attempt of ABG or had a syndrome. Preorthognathic cone beam computed tomography was used to measure the distance from the inferior and lateral aspects of the piriform rim to reference lines. PREDICTOR VARIABLE: UCLP status grouped as present or absent (control). OUTCOME VARIABLES: The magnitude of piriform rim asymmetry defined as the millimetric distance from the inferior and lateral aspects of the piriform rim to reference lines. COVARIATES: The covariates were age, sex, tissue thickness at the level of the alar base, and turbinate size. ANALYSIS: Welch's two-sample t-test was utilized to compare means. A level of significance of 5% (P < .05) was used for all analyses. To analyze the reliability of the measurements intraexaminer and interexaminer errors were tested using the Weir method. RESULTS: A total of 60 patients were included, 30 in each group. The mean age of UCLP patients was 16.76 (range 13 to 25), and the control group was 17 (range 13 to 25), P = .71. The UCLP group had 12 girls, and the control had 18 girls (P = .12). In the UCLP group, the mean discrepancy between affected and unaffected sides at the inferior aspect of the piriform rim was 3.9 mm (range 0.9 to 7 mm, P < .01), and in the control group the discrepancy between right and left sides was 0.1 mm (0-2.1 mm, P = .87). The mean discrepancy between affected and unaffected sides at the lateral aspect of the piriform rim was 3.6 mm (range 0.7 to 7.6 mm, P < .01) in the UCLP group, and in the control group the discrepancy between right and left sides was 0.1 mm (range 0.1 to 5.8 mm, P = .78) in the control group. The mean alar base soft tissue thickness discrepancy was 3.1 mm (range 0.9 to 7.9 mm, P < .01) in the UCLP group and 0 mm (range -1.8 to 1.9 mm, P = .97) in the control group. The mean difference in the turbinate area in the UCLP group was 314 mm2 (range 797 to 2,898) and in the control group 35 mm2 (range 702 to 2,302) (P = .19). CONCLUSION: ABG with symphyseal bone and bone morphogenetic protein was not able to provide the same level of piriform symmetry observed in patients without a cleft. Alar base tissue was thicker on the cleft side, and the turbinate size demonstrated greater variability in the UCLP patients.


Assuntos
Fenda Labial , Fissura Palatina , Cirurgia Ortognática , Feminino , Humanos , Fenda Labial/diagnóstico por imagem , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/cirurgia , Estudos Retrospectivos , Reprodutibilidade dos Testes , Septo Nasal , Tomografia Computadorizada de Feixe Cônico/métodos
3.
Int J Cardiol ; 378: 48-54, 2023 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-36791967

RESUMO

BACKGROUND: Exercise training improves physical capacity in patients with heart failure with reduced ejection fraction (HFrEF), but the mechanisms involved in this response is not fully understood. The aim of this study was to determine if physical capacity increase in patients HFrEF is associated with muscle sympathetic nerve activity (MSNA) reduction and muscle blood flow (MBF) increase. METHODS: The study included 124 patients from a 17-year database, divided according to exercise training status: 1) exercise-trained (ET, n = 83) and 2) untrained (UNT, n = 41). MSNA and MBF were obtained using microneurography and venous occlusion plethysmography, respectively. Physical capacity was evaluated by cardiopulmonary exercise test. Moderate aerobic exercise was performed 3 times/wk. for 4 months. RESULTS: Exercise training increased peak oxygen consumption (V̇O2, 16.1 ± 0.4 vs 18.9 ± 0.5 mL·kg-1·min-1, P < 0.001), LVEF (28 ± 1 vs 30 ± 1%, P = 0.027), MBF (1.57 ± 0.06 vs 2.05 ± 0.09 mL.min-1.100 ml-1, P < 0.001) and muscle vascular conductance (MVC, 1.82 ± 0.07 vs 2.45 ± 0.11 units, P < 0.001). Exercise training significantly decreased MSNA (45 ± 1 vs 32 ± 1 bursts/min, P < 0.001). The logistic regression analyses showed that MSNA [(OR) 0.921, 95% CI 0.883-0.962, P < 0.001] was independently associated with peak V̇O2. CONCLUSIONS: The increase in physical capacity provoked by aerobic exercise in patients with HFrEF is associated with the improvement in MSNA.


Assuntos
Insuficiência Cardíaca , Humanos , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/terapia , Músculo Esquelético , Volume Sistólico , Exercício Físico , Terapia por Exercício , Sistema Nervoso Simpático , Pressão Sanguínea
4.
Biomedicines ; 10(11)2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36359265

RESUMO

The gut microbiota refers to bacteria lodges in the gastrointestinal tract (GIT) that interact through various complex mechanisms. The disturbance of this ecosystem has been correlated with several diseases, such as neurologic, respiratory, cardiovascular, and metabolic diseases and cancer. Therefore, the modulation of the gut microbiota has emerged as a potential therapeutic tool; of the various forms of gut microbiota modulation, fecal microbiota transplantation (FMT) is the most approached. This recent technique involves introducing fecal material from a healthy donor into the patient's gastrointestinal tract, aiming to restore the gut microbiota and lead to the resolution of symptoms. This procedure implies a careful donor choice, fine collection and handling of fecal material, and a balanced preparation of the recipient and consequent administration of the prepared content. Although FMT is considered a biological therapy with promising effects, side effects such as diarrhea and abdominal pain have also been claimed, making this a significant challenge in the application of FMT. Bearing this in mind, the present review aims to summarize the recent advances in understanding FMT mechanisms, their impact across different pathological conditions, and the associated side effects, emphasizing the most recent published data.

5.
Cancer Res ; 82(5): 819-830, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-35027467

RESUMO

Mutations in SF3B1 have been identified across several cancer types. This key spliceosome component promotes the efficient mRNA splicing of thousands of genes including those with crucial roles in the cellular response to DNA damage. Here, we demonstrate that depletion of SF3B1 specifically compromises homologous recombination (HR) and is epistatic with loss of BRCA1. More importantly, the most prevalent cancer-associated mutation in SF3B1, K700E, also affects HR efficiency and as a consequence, increases the cellular sensitivity to ionizing radiation and a variety of chemotherapeutic agents, including PARP inhibitors. In addition, the SF3B1 K700E mutation induced unscheduled R-loop formation, replication fork stalling, increased fork degradation, and defective replication fork restart. Taken together, these data suggest that tumor-associated mutations in SF3B1 induce a BRCA-like cellular phenotype that confers synthetic lethality to DNA-damaging agents and PARP inhibitors, which can be exploited therapeutically. SIGNIFICANCE: The cancer-associated SF3B1K700E mutation induces DNA damage via generation of genotoxic R-loops and stalled replication forks, defective homologous recombination, and increased replication fork degradation, which can be targeted with PARP inhibitors.


Assuntos
Neoplasias , Fosfoproteínas , Inibidores de Poli(ADP-Ribose) Polimerases , Fatores de Processamento de RNA , Replicação do DNA , Humanos , Mutação , Neoplasias/tratamento farmacológico , Neoplasias/genética , Fenótipo , Fosfoproteínas/genética , Inibidores de Poli(ADP-Ribose) Polimerases/farmacologia , Inibidores de Poli(ADP-Ribose) Polimerases/uso terapêutico , Fatores de Processamento de RNA/genética , Mutações Sintéticas Letais
6.
Artigo em Inglês | MEDLINE | ID: mdl-34518140

RESUMO

OBJECTIVE: To compare the 2 surgically assisted rapid maxillary expansion (SARME) techniques, the conventional 2-segment osteotomy between maxillary central incisors and the 3-segment osteotomy between maxillary lateral incisors and canines bilaterally. Authors hypothesized that the 3-piece would provide better bone expansion. STUDY DESIGN: A pilot study was conducted; 19 patients were divided into 2 groups: conventional 2-segment osteotomy (10 patients) and 3-segment osteotomy (9 patients). Dental and skeletal measurements of the preoperative and postoperative cone beam computed tomography images were analyzed. Pre- and postoperative periodontal probing was performed, patients' cosmetic perception was evaluated in a colored visual analog scale (VAS), and surgical time was measured with a regular chronometer. RESULTS: Three-segment SARME resulted in greater bone expansion (5.12 vs 6.20 mm; P = .016), less molar inclination (7.16 vs 3.57 degrees; P = .028), better patient cosmetic perception (3.13 vs 7.68 in a VAS; P = .000), and longer surgical time (43 vs 52 minutes; P = .026). Furthermore, the 2-segment group presented necrosis of 1 central incisor. CONCLUSIONS: Results suggest that 3-piece SARME is more effective for bone expansion of the maxilla.


Assuntos
Maxila , Técnica de Expansão Palatina , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Projetos Piloto , Estudos Retrospectivos
7.
Artigo em Inglês | MEDLINE | ID: mdl-34373214

RESUMO

OBJECTIVE: The present double-blind randomized clinical trial aimed to compare the efficacy of conservative treatment and articular lavage, either alone or combined, to reduce joint pain and improve mandibular opening. STUDY DESIGN: The sample consisted of patients presenting with limited mouth opening and joint pain. The diagnosis was made according to the diagnostic criteria for temporomandibular disorders guideline and confirmed by magnetic resonance imaging. Sixty patients were selected and randomly allocated to 4 groups of 15 patients each with different treatments: group A (conservative), group B (conservative + medication), group C (arthrocentesis), and group D (arthrocentesis + medication). The groups were compared in terms of maximal interincisal opening and pain. RESULTS: The average age of the patients was 34.17 ± 13.1 years, 88.1% were women, 72.9% had internal derangement, 54% had joint sounds, and 55.9% presented with locking. Clinical improvement was noted in all parameters compared with baseline in all groups (P < .005), but no significant differences were observed when the groups were compared (P > .05). CONCLUSIONS: Both arthrocentesis and conservative modalities were efficient treatments to reduce joint pain and increase mandibular opening.


Assuntos
Artrocentese , Articulação Temporomandibular , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Dor , Medição da Dor/métodos , Amplitude de Movimento Articular , Resultado do Tratamento , Adulto Jovem
8.
Life Sci ; 288: 120189, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34863798

RESUMO

The present study determined whether treatment during childhood with topiramate (TPM), a new generation antiepileptic drug, results in altered aortic reactivity in adult male and female rats. We also sought to understand the role of endothelium-derived contractile factors in TPM-induced vascular dysfunction. Male and female Wistar rats were treated with TPM (41 mg/kg/day) or water (TPM vehicle) by gavage during childhood (postnatal day, 16-28). In adulthood, thoracic aorta reactivity to phenylephrine (phenyl), as well as aortic thickness and expression of cyclooxygenases (COX-1 and COX-2), NOX2, and p47phox were evaluated. The aortic response to phenyl was increased in male and female rats from the TPM group when compared with the control group. In TPM male rats, the hyperreactivity to phenyl was abrogated by the inhibition of NADPH oxidase and COX-2, while in female rats, responses were restored only by inhibition of COX-2. In addition, TPM male rats presented aortic hypertrophy and increased expression of NOX-2 and p47phox, while TPM female rats showed increased COX-2 aortic expression. Taken together, for the first-time, the present study provides evidence that treatment with TPM during childhood causes vascular dysfunction in adulthood, and that the mechanism underlying the vascular effects of TPM is sex-specific.


Assuntos
Aorta/patologia , Regulação da Expressão Gênica/efeitos dos fármacos , NADPH Oxidase 2/metabolismo , NADPH Oxidases/metabolismo , Prostaglandina-Endoperóxido Sintases/metabolismo , Topiramato/toxicidade , Doenças Vasculares/patologia , Animais , Anticonvulsivantes/toxicidade , Aorta/efeitos dos fármacos , Aorta/metabolismo , Feminino , Masculino , NADPH Oxidase 2/genética , NADPH Oxidases/genética , Prostaglandina-Endoperóxido Sintases/genética , Ratos , Ratos Wistar , Fatores Sexuais , Doenças Vasculares/induzido quimicamente , Doenças Vasculares/metabolismo
9.
Neural Regen Res ; 17(5): 933-936, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34558504

RESUMO

Parkinson's disease is the second most prevalent neurodegenerative disorder worldwide. Clinically, it is characterized by severe motor complications caused by progressive degeneration of dopaminergic neurons. Current treatment is focused on mitigating the symptoms through the administration of levodopa, rather than on preventing dopaminergic neuronal damage. Therefore, the use and development of neuroprotective/disease-modifying strategies is an absolute need that can lead to promising gains on translational research of Parkinson's disease. For instance, N-acetylcysteine, a natural compound with strong antioxidant effects, has been shown to modulate oxidative stress, preventing dopamine-induced cell death. Despite the evidence of neuroprotective and modulatory effects of this drug, as far as we know, it does not induce per se any regenerative process. Therefore, it would be of interest to combine the latter with innovative therapies that induce dopaminergic neurons repair or even differentiation, as stem cell-based strategies. Stem cells secretome has been proposed as a promising therapeutic approach for Parkinson's disease, given its ability to modulate cell viability/preservation of dopaminergic neurons. Such approach represents a shift in the paradigm, showing that cell-transplantation free therapies based on the use of stem cells secretome may represent a potential alternative for regenerative medicine of Parkinson's disease. Thus, in this review, we address the current understanding of the potential combination of stem cell free-based strategies and neuroprotective/disease-modifying strategies as a new paradigm for the treatment of central nervous system neurodegenerative diseases, like Parkinson's disease.

10.
Molecules ; 26(20)2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34684743

RESUMO

With tuberculosis still being one of leading causes of death in the world and the emergence of drug-resistant strains of Mycobacterium tuberculosis (Mtb), researchers have been seeking to find further therapeutic strategies or more specific molecular targets. PknB is one of the 11 Ser/Thr protein kinases of Mtb and is responsible for phosphorylation-mediated signaling, mainly involved in cell wall synthesis, cell division and metabolism. With the amount of structural information available and the great interest in protein kinases, PknB has become an attractive target for drug development. This work describes the optimization and application of an in silico computational protocol to find new PknB inhibitors. This multi-level computational approach combines protein-ligand docking, structure-based virtual screening, molecular dynamics simulations and free energy calculations. The optimized protocol was applied to screen a large dataset containing 129,650 molecules, obtained from the ZINC/FDA-Approved database, Mu.Ta.Lig Virtual Chemotheca and Chimiothèque Nationale. It was observed that the most promising compounds selected occupy the adenine-binding pocket in PknB, and the main interacting residues are Leu17, Val26, Tyr94 and Met155. Only one of the compounds was able to move the active site residues into an open conformation. It was also observed that the P-loop and magnesium position loops change according to the characteristics of the ligand. This protocol led to the identification of six compounds for further experimental testing while also providing additional structural information for the design of more specific and more effective derivatives.


Assuntos
Avaliação Pré-Clínica de Medicamentos/métodos , Inibidores de Proteínas Quinases/farmacologia , Proteínas Proto-Oncogênicas c-akt/antagonistas & inibidores , Proteínas de Bactérias/química , Biologia Computacional/métodos , Simulação por Computador , Ligantes , Simulação de Acoplamento Molecular , Simulação de Dinâmica Molecular , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/metabolismo , Mycobacterium tuberculosis/patogenicidade , Fosforilação/fisiologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais/efeitos dos fármacos , Tuberculose/tratamento farmacológico
11.
Artigo em Inglês | MEDLINE | ID: mdl-34511359

RESUMO

OBJECTIVE: To evaluate the impact of orthognathic surgery on quality of life (QoL) and to compare single- and double-jaw surgeries in terms of ratio and patient perceptions of the postoperative period. STUDY DESIGN: A prospective, longitudinal observational study was conducted. The short form Oral Health Impact Profile (OHIP-14) and the Orthognathic Quality of Life Questionnaire (OQLQ) were applied preoperatively and 6 months postoperatively to evaluate oral health-related QoL (OHRQoL). Additionally, patient perceptions of the immediate postoperative period were assessed at the first and fourth week after surgery. RESULTS: One hundred consecutive patients were recruited and assigned to the single-jaw group (n = 24) or the double-jaw group (n = 76) according to the characteristics of each facial or occlusal deformity. The questionnaires showed lower scores for both groups after surgery, indicating significant benefits to OHRQoL. The whole sample OHIP-14 mean total scores decreased from 10.5 to 2.8 (P < .001, d = 1.35), whereas OQLQ showed a decrease from 48.4 to 11.6 (P < .001, d = 1.75). CONCLUSIONS: Orthognathic surgery can improve OHRQoL, and long-term benefits outweigh the risks and discomfort associated with the treatment.


Assuntos
Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Humanos , Estudos Longitudinais , Saúde Bucal , Período Pós-Operatório , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários
12.
Biochimie ; 189: 87-98, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34182001

RESUMO

Human mesenchymal stem cells (hMSCs) secretome has been have been at the forefront of a new wave of possible therapeutic strategies for central nervous system neurodegenerative disorders, as Parkinson's disease (PD). While within its protein fraction, several promising proteins were already identified with therapeutic properties on PD, the potential of hMSCs-secretome vesicular fraction remains to be elucidated. Such highlighting is important, since hMSCs secretome-derived vesicles can act as biological nanoparticles with beneficial effects in different pathological contexts. Therefore, in this work, we have isolated hMSCs secretome vesicular fraction, and assessed their impact on neuronal survival, and differentiation on human neural progenitors' cells (hNPCs), and in a 6-hydroxydopamine (6-OHDA) rat model of PD when compared to hMSCs secretome (as a whole) and its protein derived fraction. From the results, we have found hMSCs vesicular fraction as polydispersity source of vesicles, which when applied in vitro was able to induce hNPCs differentiation at the same levels as the whole secretome, while the protein separated fraction was not able to induce such effect. In the context of PD, although distinct effects were observed, hMSCs secretome and its derived fractions displayed a positive impact on animals' motor and histological performance, thereby indicating that hMSCs secretome and its different fractions may impact different mechanisms and pathways. Overall, we concluded that the use of the secretome collected from hMSCs and its different fractions might be active modulators of different neuroregeneration mechanisms, which could open new therapeutical opportunities for their future use as a treatment for PD.


Assuntos
Células da Medula Óssea/metabolismo , Vesículas Extracelulares/metabolismo , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Neurais/metabolismo , Doença de Parkinson Secundária/metabolismo , Animais , Células da Medula Óssea/patologia , Modelos Animais de Doenças , Vesículas Extracelulares/patologia , Humanos , Masculino , Células-Tronco Mesenquimais/patologia , Células-Tronco Neurais/patologia , Oxidopamina/efeitos adversos , Oxidopamina/farmacologia , Doença de Parkinson Secundária/induzido quimicamente , Doença de Parkinson Secundária/patologia , Ratos , Ratos Wistar
13.
Cytotherapy ; 23(10): 894-901, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34059421

RESUMO

BACKGROUND AIMS: The capacity of the secretome from bone marrow-derived mesenchymal stem cells (BMSCs) to prevent dopaminergic neuron degeneration caused by overexpression of alpha-synuclein (α-syn) was explored using two Caenorhabditis elegans models of Parkinson's disease (PD). METHODS: First, a more predictive model of PD that overexpresses α-syn in dopamine neurons was subjected to chronic treatment with secretome. This strain displays progressive dopaminergic neurodegeneration that is age-dependent. Following chronic treatment with secretome, the number of intact dopaminergic neurons was determined. Following these initial experiments, a C. elegans strain that overexpresses α-syn in body wall muscle cells was used to determine the impact of hBMSC secretome on α-syn inclusions. Lastly, in silico analysis of the components that constitute the secretome was performed. RESULTS: The human BMSC (hBMSC) secretome induced a neuroprotective effect, leading to reduced dopaminergic neurodegeneration. Moreover, in animals submitted to chronic treatment with secretome, the number of α-syn inclusions was reduced, indicating that the secretome of MSCs was possibly contributing to the degradation of those structures. In silico analysis identified possible suppressors of α-syn proteotoxicity, including growth factors and players in the neuronal protein quality control mechanisms. CONCLUSIONS: The present findings indicate that hBMSC secretome has the potential to be used as a disease-modifying strategy in future PD regenerative medicine approaches.


Assuntos
Células-Tronco Mesenquimais , Doença de Parkinson , Animais , Caenorhabditis elegans , Modelos Animais de Doenças , Neurônios Dopaminérgicos , Humanos , Doença de Parkinson/terapia , alfa-Sinucleína
14.
Future Cardiol ; 17(5): 865-873, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33834847

RESUMO

Aim: Traditional percutaneous cardiovascular interventions require close physical proximity between the patients and the healthcare team, posing occupational hazards that range from radiation exposure to interpersonal air contamination. Materials & methods: Prospective single-arm pilot study (n = 10) to investigate robotic-assisted intervention as a strategy to reduce proximity during the procedure. Primary end point: composite of angiographic success, intervention performed with the team positioned >2 meters from the patient for ≥50% procedure duration, and absence of in-hospital death or acute target lesion occlusion. Results: The composite primary end point was achieved in 100% of cases. Conclusion: Robotic-assisted percutaneous intervention provided successful invasive treatment while reducing proximity and shared air space between the care-delivery team and the patient during the procedure. Trial registration number: NCT04379453 (Clinicaltrials.gov).


Lay abstract Minimally invasive therapies for cardiovascular diseases are techniques that limit the size of incisions needed and so lessen wound healing time, but traditionally require close contact between the patients and the healthcare team. This fact poses hazards that range from radiation exposure to the spread of airborne diseases. We developed a small study of ten patients to investigate whether a new method of robotic-assisted stent implantation for the treatment of a heart attack would reduce proximity between the patient and medical staff during the procedure. To evaluate the effectiveness of that strategy, we assessed the success of the procedure (by analyzing the images of the operation), the amount of time the team was positioned more than 2 meters from the patient and the occurrence of complications during the hospitalization. We concluded that this method of robotic-assisted stent implantation after a heart attack provided successful treatment while reducing proximity and shared air space between the care-delivery team and the patient.


Assuntos
Doença da Artéria Coronariana , Intervenção Coronária Percutânea , Procedimentos Cirúrgicos Robóticos , Mortalidade Hospitalar , Humanos , Projetos Piloto , Estudos Prospectivos , Resultado do Tratamento
15.
Nat Struct Mol Biol ; 28(2): 190-201, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33479542

RESUMO

NUP98 fusion proteins cause leukemia via unknown molecular mechanisms. All NUP98 fusion proteins share an intrinsically disordered region (IDR) in the NUP98 N terminus, featuring repeats of phenylalanine-glycine (FG), and C-terminal fusion partners often function in gene control. We investigated whether mechanisms of oncogenic transformation by NUP98 fusion proteins are hardwired in their protein interactomes. Affinity purification coupled to mass spectrometry (MS) and confocal imaging of five NUP98 fusion proteins expressed in human leukemia cells revealed that shared interactors were enriched for proteins involved in biomolecular condensation and that they colocalized with NUP98 fusion proteins in nuclear puncta. We developed biotinylated isoxazole-mediated condensome MS (biCon-MS) to show that NUP98 fusion proteins alter the global composition of biomolecular condensates. An artificial FG-repeat-containing fusion protein phenocopied the nuclear localization patterns of NUP98 fusion proteins and their capability to drive oncogenic gene expression programs. Thus, we propose that IDR-containing fusion proteins combine biomolecular condensation with transcriptional control to induce cancer.


Assuntos
Núcleo Celular/metabolismo , Proteínas de Homeodomínio , Leucemia , Complexo de Proteínas Formadoras de Poros Nucleares , Proteínas de Fusão Oncogênica , Animais , Expressão Gênica , Regulação Leucêmica da Expressão Gênica , Células HEK293 , Células HL-60 , Proteínas de Homeodomínio/química , Proteínas de Homeodomínio/fisiologia , Humanos , Leucemia/metabolismo , Leucemia/patologia , Camundongos , Células NIH 3T3 , Complexo de Proteínas Formadoras de Poros Nucleares/química , Complexo de Proteínas Formadoras de Poros Nucleares/fisiologia , Proteínas de Fusão Oncogênica/química , Proteínas de Fusão Oncogênica/fisiologia
16.
Intensive Care Med ; 47(2): 170-179, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32770267

RESUMO

PURPOSE: To describe trends in outcomes of cancer patients with unplanned admissions to intensive-care units (ICU) according to cancer type, organ support use, and performance status (PS) over an 8-year period. METHODS: We retrospectively analyzed prospectively collected data from all cancer patients admitted to 92 medical-surgical ICUs from July/2011 to June/2019. We assessed trends in mortality through a Bayesian hierarchical model adjusted for relevant clinical confounders and whether there was a reduction in ICU length-of-stay (LOS) over time using a competing risk model. RESULTS: 32,096 patients (8.7% of all ICU admissions; solid tumors, 90%; hematological malignancies, 10%) were studied. Bed/days use by cancer patients increased up to more than 30% during the period. Overall adjusted mortality decreased by 9.2% [95% credible interval (CI), 13.1-5.6%]. The largest reductions in mortality occurred in patients without need for organ support (9.6%) and in those with need for mechanical ventilation (MV) only (11%). Smallest reductions occurred in patients requiring MV, vasopressors, and dialysis (3.9%) simultaneously. Survival gains over time decreased as PS worsened. Lung cancer patients had the lowest decrease in mortality. Each year was associated with a lower sub-hazard for ICU death [SHR 0.93 (0.91-0.94)] and a higher chance of being discharged alive from the ICU earlier [SHR 1.01 (1-1.01)]. CONCLUSION: Outcomes in critically ill cancer patients improved in the past 8 years, with reductions in both mortality and ICU LOS, suggesting improvements in overall care. However, outcomes remained poor in patients with lung cancer, requiring multiple organ support and compromised PS.


Assuntos
Neoplasias , Diálise Renal , Teorema de Bayes , Estudos de Coortes , Estado Terminal , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Neoplasias/terapia , Estudos Retrospectivos
18.
Acta biol. colomb ; 25(3): 431-433, sep.-dic. 2020. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1149024

RESUMO

RESUMEN Kinosternon chimalhuaca (Casquito de Jalisco) es una tortuga kinosternida endémica de México. La talla máxima de longitud de caparazón (CL) es de 160 mm en machos y de 130 mm en hembras. Tiene un pequeño rango de distribución en la costa del Pacífico de Jalisco y Colima (México), desde el río Tuito en Jalisco hasta el río Cihuatlán en el noroeste de Colima. Este nuevo registro en Puerto Vallarta, Jalisco, extiende su distribución al menos 32 km al norte de la localidad más septentrional conocida. Se registra un nuevo tamaño máximo (CL) para la especie de 172,00 mm (un macho).


ABSTRACT Kinosternon chimalhuaca (Jalisco Mud Turtle) is a kinosternid turtle endemic to Mexico. The previously recorded maximun carapace length (CL) is 160 mm in males and 130 mm in females. It has a small distribution range along the Pacific coast of Jalisco and Colima, Mexico, from the rio Tuito in Jalisco to the rio Cihuatlán in northwestern Colima. This new record in Puerto Vallarta, Jalisco, extends its distribution at least 32 km north from the northernmost known locality. A new maximun size (CL) for the species of 172.00 mm (one male) is recorded.

19.
J Transl Med ; 18(1): 339, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32883299

RESUMO

BACKGROUND: The cohesin complex plays a major role in folding the human genome into 3D structural domains. Mutations in members of the cohesin complex are known early drivers of myelodysplastic syndromes (MDS) and acute myeloid leukaemia (AML), with STAG2 the most frequently mutated complex member. METHODS: Here we use functional genomics (RNA-seq, ChIP-seq and HiChIP) to investigate the impact of chronic STAG2 loss on three-dimensional genome structure and transcriptional programming in a clinically relevant model of chronic STAG2 loss. RESULTS: The chronic loss of STAG2 led to loss of smaller loop domains and the maintenance/formation of large domains that, in turn, led to altered genome compartmentalisation. These changes in genome structure resulted in altered gene expression, including deregulation of the HOXA locus and the MAPK signalling pathway, resulting in increased sensitivity to MEK inhibition. CONCLUSIONS: The altered genomic architecture driven by the chronic loss of STAG2 results in altered gene expression that may contribute to leukaemogenesis and may be therapeutically targeted.


Assuntos
Leucemia Mieloide Aguda , Síndromes Mielodisplásicas , Proteínas de Ciclo Celular/genética , Cromatina/genética , Humanos , Leucemia Mieloide Aguda/genética , Mutação
20.
Int J Mol Sci ; 21(10)2020 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-32422916

RESUMO

Parkinson's disease (PD) is the second most common age-related neurodegenerative disorder. The neurodegeneration leading to incapacitating motor abnormalities mainly occurs in the nigrostriatal pathway due to the loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc). Several animal models have been developed not only to better understand the mechanisms underlying neurodegeneration but also to test the potential of emerging disease-modifying therapies. However, despite aging being the main risk factor for developing idiopathic PD, most of the studies do not use aged animals. Therefore, this study aimed at assessing the effect of aging in the unilateral 6-hydroxydopamine (6-OHDA)-induced animal model of PD. For this, female young adult and aged rats received a unilateral injection of 6-OHDA into the medial forebrain bundle. Subsequently, the impact of aging on 6-OHDA-induced effects on animal welfare, motor performance, and nigrostriatal integrity were assessed. The results showed that aging had a negative impact on animal welfare after surgery. Furthermore, 6-OHDA-induced impairments on skilled motor function were significantly higher in aged rats when compared with their younger counterparts. Nigrostriatal histological analysis further revealed an increased 6-OHDA-induced dopaminergic cell loss in the SNpc of aged animals when compared to young animals. Overall, our results demonstrate a higher susceptibility of aged animals to 6-OHDA toxic insult.


Assuntos
Dopamina/metabolismo , Neurônios Dopaminérgicos/metabolismo , Doença de Parkinson Secundária/fisiopatologia , Doença de Parkinson/metabolismo , Envelhecimento/metabolismo , Envelhecimento/patologia , Animais , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/metabolismo , Corpo Estriado/patologia , Modelos Animais de Doenças , Neurônios Dopaminérgicos/efeitos dos fármacos , Neurônios Dopaminérgicos/patologia , Feminino , Humanos , Masculino , Transtornos Motores/induzido quimicamente , Transtornos Motores/metabolismo , Transtornos Motores/patologia , Oxidopamina/toxicidade , Doença de Parkinson/fisiopatologia , Doença de Parkinson Secundária/induzido quimicamente , Doença de Parkinson Secundária/metabolismo , Ratos , Substância Negra/efeitos dos fármacos , Substância Negra/metabolismo , Substância Negra/patologia
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