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1.
Connect Tissue Res ; 65(4): 313-329, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38982804

RESUMO

AIM: As osteoblasts deposit a mineralized collagen network, a subpopulation of these cells differentiates into osteocytes. Biochemical and mechanical stimuli, particularly fluid shear stress (FSS), are thought to regulate this, but their relative influence remains unclear. Here, we assess both biochemical and mechanical stimuli on long-term bone formation and osteocytogenesis using the osteoblast-osteocyte cell line IDG-SW3. METHODS: Due to the relative novelty and uncommon culture conditions of IDG-SW3 versus other osteoblast-lineage cell lines, effects of temperature and media formulation on matrix deposition and osteocytogenesis were initially characterized. Subsequently, the relative influence of biochemical (ß-glycerophosphate (ßGP) and ascorbic acid 2-phosphate (AA2P)) and mechanical stimulation on osteocytogenesis was compared, with intermittent application of low magnitude FSS generated by see-saw rocker. RESULTS: ßGP and AA2P supplementation were required for mineralization and osteocytogenesis, with 33°C cultures retaining a more osteoblastic phenotype and 37°C cultures undergoing significantly higher osteocytogenesis. ßGP concentration positively correlated with calcium deposition, whilst AA2P stimulated alkaline phosphatase (ALP) activity and collagen deposition. We demonstrate that increasing ßGP concentration also significantly enhances osteocytogenesis as quantified by the expression of green fluorescent protein linked to Dmp1. Intermittent FSS (~0.06 Pa) rocker had no effect on osteocytogenesis and matrix deposition. CONCLUSIONS: This work demonstrates the suitability and ease with which IDG-SW3 can be utilized in osteocytogenesis studies. IDG-SW3 mineralization was only mediated through biochemical stimuli with no detectable effect of low magnitude FSS. Osteocytogenesis of IDG-SW3 primarily occurred in mineralized areas, further demonstrating the role mineralization of the bone extracellular matrix has in osteocyte differentiation.


Assuntos
Glicerofosfatos , Osteoblastos , Osteócitos , Estresse Mecânico , Glicerofosfatos/farmacologia , Glicerofosfatos/metabolismo , Osteoblastos/metabolismo , Osteoblastos/citologia , Animais , Osteócitos/metabolismo , Osteócitos/citologia , Linhagem Celular , Camundongos , Osteogênese/efeitos dos fármacos , Calcificação Fisiológica/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , Ácido Ascórbico/farmacologia , Ácido Ascórbico/metabolismo , Ácido Ascórbico/análogos & derivados
2.
J Comput Chem ; 44(6): 788-800, 2023 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-36471909

RESUMO

An integrated design environment (IDE) has been developed that allows the capture of design ideas, virtual compounds, and design hypotheses for medicinal chemistry projects. Specific consideration for rational molecular design, including design strategy and tactics, as well as comparator reference compounds have been incorporated to more easily convey the proposed design idea. A hierarchical tree architecture and customizable layouts allow for facile browsing across multiple programs and rapid examination of both ongoing and newly designed virtual compounds enabling centralized team discussions to ensure the most efficient prosecution of a queue of these target compounds. Additionally, a "whiteboard" module was incorporated for the rapid evaluation of virtual compounds against a suite of computational models enabling real-time design and triage. Finally, aggregation of cross-project design data enables broader analyses that can indicate portfolio-wide design challenges.


Assuntos
Química Farmacêutica , Software
3.
J Comput Chem ; 43(15): 1053-1062, 2022 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-35394655

RESUMO

Pfizer's Crystal Structure Database (CSDB) is a key enabling technology that allows scientists on structure-based projects rapid access to Pfizer's vast library of in-house crystal structures, as well as a significant number of structures imported from the Protein Data Bank. In addition to capturing basic information such as the asymmetric unit coordinates, reflection data, and the like, CSDB employs a variety of automated methods to first ensure a standard level of annotations and error checking, and then to add significant value for design teams by processing the structures through a sequence of algorithms that prepares the structures for use in modeling. The structures are made available, both as the original asymmetric unit as submitted, as well as the final prepared structures, through REST-based web services that are consumed by several client desktop applications. The structures can be searched by keyword, sequence, submission date, ligand substructure and similarity search, and other common queries.


Assuntos
Algoritmos , Bases de Dados de Proteínas , Humanos , Ligantes
4.
J Cardiothorac Vasc Anesth ; 36(4): 940-951, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34801393

RESUMO

This special article is the fourteenth in an annual series for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the Editor-in-Chief, Dr. Kaplan, and the editorial board for the opportunity to continue this series; namely, the research highlights of the past year in the specialty of cardiothoracic and vascular anesthesiology. The major themes selected for 2021 are outlined in this introduction, and each highlight is reviewed in detail in the main body of the article. The literature highlights in the specialty for 2021 begin with an update on structural heart disease, with a focus on updates in arrhythmia and aortic valve disorders. The second major theme is an update on coronary artery disease, with discussion of both medical and procedural management. The third major theme is focused on the perioperative management of patients with COVID-19, with the authors highlighting literature discussing the impact of the disease on the right ventricle and thromboembolic events. The fourth and final theme is an update in heart failure, with discussion of diverse aspects of this area. The themes selected for this fourteenth special article are only a few of the diverse advances in the specialty during 2021. These highlights will inform the reader of key updates on a variety of topics, leading to improvement of perioperative outcomes for patients with cardiothoracic and vascular disease.


Assuntos
Anestesia , Anestesiologia , COVID-19 , Humanos , SARS-CoV-2
5.
J Chem Inf Model ; 61(7): 3696-3707, 2021 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-34251810

RESUMO

Biased agonists, which selectively stimulate certain signaling pathways controlled by a G protein-coupled receptor (GPCR), hold great promise as drugs that maximize efficacy while minimizing dangerous side effects. Biased agonists of the µ-opioid receptor (µOR) are of particular interest as a means to achieve analgesia through G protein signaling without dose-limiting side effects such as respiratory depression and constipation. Rational structure-based design of biased agonists remains highly challenging, however, because the ligand-mediated interactions that are key to activation of each signaling pathway remain unclear. We identify several compounds for which the R- and S-enantiomers have distinct bias profiles at the µOR. These compounds serve as excellent comparative tools to study bias because the identical physicochemical properties of enantiomer pairs ensure that differences in bias profiles are due to differences in interactions with the µOR binding pocket. Atomic-level simulations of compounds at µOR indicate that R- and S-enantiomers adopt different poses that form distinct interactions with the binding pocket. A handful of specific interactions with highly conserved binding pocket residues appear to be responsible for substantial differences in arrestin recruitment between enantiomers. Our results offer guidance for rational design of biased agonists at µOR and possibly at related GPCRs.


Assuntos
Receptores Opioides mu , Transdução de Sinais , Proteínas de Ligação ao GTP , Humanos , Ligantes , Dor , Ligação Proteica , Receptores Opioides mu/metabolismo
6.
An Acad Bras Cienc ; 93(suppl 4): e20210406, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34878049

RESUMO

Synthetic antioxidants (e.g.butylhydroxytoluene, BHT) are routinely used for to restrict oxidative processes of meat products, but they are implicated as harmful to the health of humans. Therefore natural alternatives, such as plant antioxidants, have been sought as replacements. Plant antioxidants when added to the diet can be incorporated into meat and reduce the need for the addition of synthetic antioxidants during processing. The objective of this study was to evaluate the effects of ethanol extracts of mango seeds (EEMS) in the diet of pigs on qualitative parameters and total antioxidant capacity of mortadella produced from these animals. Thirty-two pigs with an average 60 days of age were distributed among four treatments: control=no antioxidant; BHT=200ppm BHT; EEMS200=200ppm of EEMS and EEMS400=400ppm of EEMS. At 145 days of age the animals were slaughtered and loin was removed for the preparation of mortadella, which was analyzed during 90 days of storage at 4°C. A higher content of polyphenolic compounds and, total antioxidant capacity in mortadellas processed with meat of animals which consumed the EEMS400 ration after 60 and 90 days of storage was observed. EEMS polyphenolic antioxidants incorporated into pork through the diet results in an increase of total antioxidant capacity in the processed product.


Assuntos
Mangifera , Carne de Porco , Carne Vermelha , Animais , Antioxidantes , Dieta , Etanol , Oxirredução , Extratos Vegetais/farmacologia , Sementes , Suínos
7.
J Anesth ; 35(3): 366-373, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33006071

RESUMO

In March 2020, the New York City metropolitan area became the epicenter of the United States' SARS-CoV-2 pandemic and the surge of new cases threatened to overwhelm the area's hospital systems. This article describes how an anesthesiology department at a large urban academic hospital rapidly adapted and deployed to meet the threat head-on. Topics included are preparatory efforts, development of a team-based staffing model, and a new strategy for resource management. While still maintaining a fully functioning operating theater, discrete teams were deployed to both COVID-19 and non-COVID-19 intensive care units, rapid response/airway management team, the difficult airway response team, and labor and delivery. Additional topics include the creation of a temporary 'pop-up' anesthesiology-run COVID-19 intensive care unit utilizing anesthesia machines for monitoring and ventilatory support as well as the development of a simulation and innovation team that was instrumental in the rapid prototyping of a controlled split-ventilation system and conversion of readily available BIPAP units into emergency ventilators. As the course of the disease is uncertain, the goal of this article is to assist others in preparation for what may come next with COVID-19 as well as potential future pandemics.


Assuntos
COVID-19 , Humanos , Unidades de Terapia Intensiva , Cidade de Nova Iorque , Pandemias , SARS-CoV-2 , Estados Unidos
8.
Molecules ; 25(24)2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33317120

RESUMO

The main objectives of this study were to evaluate the chemical constitution and allergenic potential of red propolis extract (RPE). They were evaluated, using high performance liquid chromatography (HPLC) and the release of ß-hexosaminidase, respectively. A plethora of biologically active polyphenols and the absence of allergic responses were evinced. RPE inhibited the release of ß-hexosaminidase, suggesting that the extract does not stimulate allergic responses. Additionally, the physicochemical properties and antibacterial activity of hydrogel membranes loaded with RPE were analyzed. Bio-polymeric hydrogel membranes (M) were obtained using 5% carboxymethylcellulose (M1 and M2), 1.0% of citric acid (M3) and 10% RPE (for all). Their characterization was performed using thermal analysis, Fourier transform infrared (FTIR), total phenolic content, phenol release test and, antioxidant activity through 2,2-diphenyl-1-picrylhydrazyl radical (DPPH) and Ferric Reducing Antioxidant Power (FRAP). The latter appointed to the similar antioxidant capacity of the M1, M2 and M3. The degradation profiles showed higher thermostability to M3, followed by M2 and M1. The incorporation of RPE into the matrices and the crosslinking of M3 were evinced by FTIR. There were differences in the release of phenolic compounds, with a higher release related to M1 and lower in the strongly crosslinked M3. The degradation profiles showed higher thermostability to M3, followed by M2 and M1. The antibacterial activity of the membranes was determined using the disc diffusion assay, in comparison with controls, obtained in the same way, without RPE. The membranes elicited antibacterial activity against Staphylococcus aureus and Staphylococcus epidermidis, with superior performance over M3. The hydrogel membranes loaded with RPE promote a physical barrier against bacterial skin infections and may be applied in the wound healing process.


Assuntos
Própole/química , Administração Tópica , Alérgenos/química , Animais , Antibacterianos/administração & dosagem , Antibacterianos/química , Antibacterianos/farmacologia , Antioxidantes/administração & dosagem , Antioxidantes/química , Antioxidantes/farmacologia , Bandagens , Materiais Biocompatíveis/administração & dosagem , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Biopolímeros/administração & dosagem , Biopolímeros/química , Biopolímeros/farmacologia , Brasil , Linhagem Celular , Fenômenos Químicos , Cromatografia Líquida de Alta Pressão , Composição de Medicamentos , Estabilidade de Medicamentos , Humanos , Hidrogéis , Técnicas In Vitro , Mastócitos/efeitos dos fármacos , Mastócitos/enzimologia , Mastócitos/imunologia , Membranas Artificiais , Fenóis/química , Própole/administração & dosagem , Própole/farmacologia , Ratos , Espectroscopia de Infravermelho com Transformada de Fourier , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus epidermidis/efeitos dos fármacos , Termogravimetria , beta-N-Acetil-Hexosaminidases/metabolismo
9.
Mammalia ; 84(3): 227-238, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-34290454

RESUMO

Small mammal communities in the Neotropics are composed largely of sigmodontine rodents. However, many questions regarding these communities remain unanswered, especially those pertaining to fine-scale sympatry and habitat selection. To address this, we examined sigmodontine community structure and vegetation in the western margin of the Upper Paraná Atlantic Forest and the southwestern-most extent of the Cerrado (CE) (an extensive South American savanna ecoregion) of Paraguay. Vegetation classifications were derived from satellite imagery combined with maps based on extensive ground-based surveys. The three most abundant species (Akodon montensis, Hylaeamys megacephalus, and Oligoryzomys nigripes) were found most often in microsympatry with conspecifics, and were negatively associated with other species. Akodon montensis was associated with high forest (HF), and H. megacephalus with bamboo understory (BU), whereas O. nigripes did not exhibit a habitat preference. The first two species' distributions within the landscape were found to be driven primarily by habitat selection, and O. nigripes by a behavioral response (avoidance) to the presence of the other two species. Moreover, habitat influences whether or not a particular species associates with, or avoids, conspecifics or other species.

10.
J Neurol Neurosurg Psychiatry ; 89(5): 518-525, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29101253

RESUMO

BACKGROUND: Clinical brain MRI is normal in the majority of patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. However, extensive deep white matter damage wasrecently identifiedin these patients using diffusion weighted imaging. Here, our aim was to study a particularly vulnerable brain compartment, the late myelinating superficial white matter. METHODS: Forty-six patients with anti-NMDAR encephalitis were included. Ten out of these were considered neurologically recovered (modified Rankin scale of zero), while 36 patients were non-recovered. In addition, 30 healthy controls were studied. MRI data were collected from all subjects and superficial white matter mean diffusivity derived from diffusion tensor imaging was compared between groups in whole brain, lobar and vertex-based analyses. Patients underwent comprehensive cognitive testing, and correlation analyses were performed between cognitive performance and superficial white matter integrity. RESULTS: Non-recovered patients showed widespread superficial white matter damage in comparison to recovered patients and healthy controls. Vertex-based analyses revealed that damage predominated in frontal and temporal lobes. In contrast, the superficial white matter was intact in recovered patients. Importantly, persistent cognitive impairments in working memory, verbal memory, visuospatial memory and attention significantly correlated with damage of the superficial white matter in patients. CONCLUSIONS: Anti-NMDAR encephalitis is associated with extensive superficial white matter damage in patients with incomplete recovery. The strong association with impairment in several cognitive domains highlights the clinical relevance of white matter damage in this disorder and warrants investigations of the underlying pathophysiological mechanisms.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato/patologia , Substância Branca/patologia , Adulto , Encefalite Antirreceptor de N-Metil-D-Aspartato/complicações , Estudos de Casos e Controles , Disfunção Cognitiva/complicações , Disfunção Cognitiva/patologia , Imagem de Tensor de Difusão , Feminino , Lobo Frontal/patologia , Humanos , Masculino , Neuroimagem , Indução de Remissão , Lobo Temporal/patologia , Adulto Jovem
11.
Parasitol Res ; 117(1): 257-264, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29222666

RESUMO

We evaluated morphometric variation of the mite Periglischrus torrealbai (Spinturnicidae) on three species of host bats: Phyllostomus discolor, P. hastatus, and Tonatia bidens (Phyllostomidae). A total of 67 females and 74 males of P. torrealbai were collected from 41 host individuals of these three bat species that were sampled in Brazil, Paraguay, and Peru. Twenty-one measurements from the dorsal side and 28 from the ventral side were recorded from female mites and 21 dorsal and 34 ventral measurements were taken from males. To evaluate morphological variation of P. torrealbai on different species of host bats, principal component analysis and unweighted pair-group method using arithmetic averages cluster analysis with Euclidean distances were used. Both analyses showed three groups of mites clearly separated: group 1 comprised all ectoparasites collected from T. bidens, group 2 included all mites from P. hastatus, and group 3 had all those from P. discolor. This result indicates that P. torrealbai varies morphologically by host bat species and suggests that this nominal species comprises three morphologically distinct species. In the present study, we record for the first time, the association between P. torrealbai and T. bidens. Our data reinforce the high relationship of specificity between Periglischrus mites and phyllostomid bat species.


Assuntos
Quirópteros/parasitologia , Interações Hospedeiro-Parasita , Infestações por Ácaros/veterinária , Ácaros/anatomia & histologia , Animais , Brasil/epidemiologia , Feminino , Especificidade de Hospedeiro , Masculino , Infestações por Ácaros/epidemiologia , Infestações por Ácaros/parasitologia , Paraguai/epidemiologia , Peru/epidemiologia
12.
BMC Emerg Med ; 18(1): 47, 2018 11 26.
Artigo em Inglês | MEDLINE | ID: mdl-30477423

RESUMO

BACKGROUND: Emergency Care has previously been identified as an area of significant concern regarding the prevalence of Adverse Events (AEs). However, the majority of this focus has been on the in-hospital setting, with little understanding of the identification and incidence of AEs in the prehospital environment. METHOD: The early development and testing of Emergency Medical Services (EMS) specific triggers for the identification of AEs and Harm has been previously described. To operationalise the Emergency Medical Services Trigger Tool (EMSTT), the processes developed by the Institute for Healthcare Improvement for use with the Global Trigger Tool were adapted to a prehospital emergency care setting. These were then applied using a stepwise approach to the analysis of 36 consecutive samples of patient care records over an 18-month period (n = 710). Inter-rater reliability was measured for each trigger item and level of Harm classification. Total Triggers per 10,000 Patient Encounters, AEs per 10,000 Patient Encounters and Harm per 10,000 Patient Encounters were measured. All measures were plotted on Statistical Process Control Charts. RESULTS: There was a high level of inter-rater agreement across all items (range: 85.6-100%). The EMSTT found an average rate of 8.20 Triggers per 10,000 Patient Encounters, 2.48 AEs per 10,000 Patient Encounters and 0.34 Harm events per 10,000 Patient Encounters. Three triggers: Change in Systolic Blood Pressure Greater Than 20%; Temp > 38 °C without subsequent reduction; and SpO2 < 94% without supplemental Oxygen or SpO2 < 85% without assisted ventilation accounted for 93% (n = 180) of the triggers found throughout the longitudinal analysis. DISCUSSION: With sufficient focus on implementation and data collection, as well as the inclusion of a contextually relevant system for classifying AE/Harm, the EMSTT represents a potentially successful strategy towards identifying the rate of AEs within EMS across a large patient population with limited commitment of time and resources.


Assuntos
Serviços Médicos de Emergência , Erros Médicos , Humanos , Auditoria Médica , Erros Médicos/estatística & dados numéricos , Segurança do Paciente , Estudos Retrospectivos , Fatores de Tempo
13.
Nutr Cancer ; 69(2): 229-237, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28094599

RESUMO

Physical activity (PA) and vitamin D are thought to affect colorectal cancer prognosis. The present study investigates associations between 25(OH)D3 and PA in prospectively followed colorectal cancer patients in the ColoCare study. At 6, 12, and 24 mo after surgery, patients donated a blood sample, wore an accelerometer for 10 consecutive days, and completed a PA questionnaire. Plasma 25-hydroxyvitamin D3 (25(OH)D3) levels were measured by high-performance liquid chromatography. We tested associations using partial correlations and multivariate linear regression analysis, adjusted for season, age, and body mass index. A total of 137 assessments of 25(OH)D3 levels and PA were conducted (58 at 6 mo, 51 at 12 mo, and 28 at 24 mo). More than 60% of the patients were vitamin D-deficient (25(OH)D3 ≤20 ng/ml), independent of study time point. At 6-mo follow-up, accelerometry-based vigorous and moderate-to-vigorous PAs were positively associated with 25(OH)D3 levels (P = 0.04; P = 0.006,). PA together with season was a significant predictor of elevated 25(OH)D3 levels. Our results suggest that the majority of colorectal cancer patients may suffer from vitamin D deficiency. Engaging in PA may be an effective approach to increase their 25(OH)D3 levels.


Assuntos
Calcifediol/sangue , Neoplasias Colorretais/sangue , Acelerometria , Idoso , Neoplasias Colorretais/cirurgia , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Deficiência de Vitamina D/sangue
14.
Eur J Epidemiol ; 32(11): 961-971, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28884317

RESUMO

To investigate the association of serum 25-hydroxyvitamin D (25(OH)D3) with survival in a large prospective cohort study of colorectal cancer (CRC) patients. The study population consisted of 2,910 patients diagnosed with CRC between 2003 and 2010 who participated in the DACHS study, a multicenter study from Germany with comprehensive long-term follow-up. 25(OH)D3 was determined in serum samples collected shortly after cancer diagnosis by High Performance Liquid Chromatography-Electro Spray Ionization-Mass Spectrometry. Analyses of survival outcomes were performed using Cox regression with comprehensive adjustment for relevant confounders. The majority (59%) of CRC patients were vitamin D deficient (serum 25(OH)D3 levels <30 nmol/L). During a median follow-up of 4.8 years, 787 deaths occurred, 573 of which were due to CRC. Compared to patients in the highest 25(OH)D3 quintile (>45.20 nmol/L), those in the lowest 25(OH)D3 quintile (<11.83 nmol/L) had a strongly increased mortality. Adjusted hazard ratios (95% Confidence Interval) were 1.78 (1.39-2.27), 1.65 (1.24-2.21), 1.32 (1.03-1.71) and 1.48 (1.18-1.85) for all-cause mortality, CRC-specific mortality, recurrence-free and disease-free survival, respectively. Subgroup analyses did not show any significant effect modification across strata defined by sex, age, stage, body mass index, or the late entry. Dose-response analyses showed a strong inverse relationship between serum 25(OH)D3 levels and survival endpoints at 25(OH)D3 levels <30 nmol/L, and no association with mortality at higher 25(OH)D3 levels. Vitamin D deficiency is highly prevalent in CRC patients and a strong independent predictor of poor prognosis. The possibility of enhancing CRC prognosis by vitamin D supplementation, ideally combined with outdoor physical activity, should be evaluated by randomized controlled trials focusing on patients with vitamin D deficiency.


Assuntos
Calcifediol/sangue , Neoplasias Colorretais/epidemiologia , Sobreviventes , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Adulto , Idoso , Neoplasias Colorretais/sangue , Suplementos Nutricionais , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Vitamina D/análogos & derivados
15.
J Pediatr Orthop ; 37(2): 92-97, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26214327

RESUMO

INTRODUCTION: Hospital stay after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) has decreased only modestly over time despite a healthy patient population. The purpose of this study was to evaluate the impact of a novel postoperative pathway on length of stay (LOS) and complications. METHODS: A retrospective review of patients undergoing PSF for AIS in 2011 to 2012 was performed at 2 institutions evaluating demographics, preoperative Cobb angles, surgical duration, blood loss, LOS, and postoperative complications. Patients at one center were managed using an accelerated discharge (AD) pathway emphasizing early transition to oral pain medications mobilization with physical therapy 2 to 3 times/d, and discharge regardless of return of bowel function. Expectations were set with the family before surgery for early discharge. Patients at the other center were managed without a standardized pathway. RESULTS: One hundred five patients underwent PSF and were treated by an AD pathway, whereas 45 patients were managed using a traditional discharge (TD) pathway. There was no difference in proximal thoracic and main thoracic Cobb magnitudes and a small difference in thoracolumbar curve magnitudes (35.2±13.0 degrees AD vs. 40.6±11.4 degrees TD, P=0.004) between groups. Surgical time was slightly shorter in AD patients (median 3.1 vs. 3.9 h, P=0.0003) with no difference in estimated blood loss. LOS was 48% shorter in the AD group (2.2 vs. 4.2 d, P<0.0001). There was no difference in readmissions or wound complications between groups. CONCLUSIONS: Hospital stay was nearly 50% shorter in patients managed by the AD pathway without any increase in readmissions or early complications. SIGNIFICANCE: Discharge after PSF for AIS may be expedited using a coordinated postoperative pathway. No increase in complications was seen using the AD pathway. Earlier discharge may reduce health care costs and allow an earlier return to normalcy for families. LEVEL OF EVIDENCE: Level III-case control study.


Assuntos
Procedimentos Clínicos , Alta do Paciente , Escoliose/cirurgia , Fusão Vertebral , Adolescente , Estudos de Casos e Controles , Humanos , Tempo de Internação , Duração da Cirurgia , Complicações Pós-Operatórias , Estudos Retrospectivos
16.
Emerg Med J ; 34(6): 391-397, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28153866

RESUMO

BACKGROUND: Adverse event(AE) detection in healthcare has traditionally relied upon several methods including: patient care documentation review, mortality and morbidity review, voluntary reporting, direct observation and complaint systems. A novel sampling strategy, known as the trigger tool (TT) methodology, has been shown to provide a more robust and valid method of detection. The aim of this research was to develop and assess a TT specific to ground-based Emergency Medical Services, to identify cases with the potential risk for adverse events and harm. METHODS: The study was conducted between March and December 2015. A literature review identified 57 potential triggers, which were grouped together by experts using an affinity process. Triggers for other areas of potential AE/harm were additionally considered for inclusion. An interim TT consisting of nine triggers underwent five iterative rounds of derivation tests of 20 random patient care records (n=100) in two emergency medical services. A final eight-item trigger list underwent a large sample (n=9836) assessment of test characteristics. RESULTS: The final eight-item TT consisted of triggers divided amongst four categories: Clinical, Medication, Procedural and Return-Call. The TT demonstrated an AE identification rate of 41.5% (sensitivity 79.8% (95% CI, 69.9% to 87.6%); specificity 58.5% (95% CI, 52% to 64.8%)). When identifying potential risk for harm, the TT demonstrated a harm identification rate of 19.3% (sensitivity 97.1% (95% CI, 84.7% to 99.9%); specificity 53.5% (95% CI, 47.7% to 59.3%)). DISCUSSION: The Emergency Medical Services Trigger Tool (EMSTT) may be used as a sampling strategy similar to the Global Trigger Tool, to identify and measure AE and harm over time, and monitor the success of improvement initiatives within the Emergency Medical Services setting.


Assuntos
Serviços Médicos de Emergência/tendências , Previsões/métodos , Erros Médicos , Segurança do Paciente/normas , Medição de Risco/métodos , Serviços Médicos de Emergência/métodos , Humanos , Fatores Desencadeantes , Prevalência , Gestão da Segurança/métodos , Sensibilidade e Especificidade
17.
Int J Mol Sci ; 18(11)2017 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-29084170

RESUMO

This review summarizes available data on argan fruit botany, geographical distribution, traditional uses, environmental interest, socioeconomic role, phytochemistry, as well as health beneficial effects and examination of future prospects. In particular, ethnomedical uses of argan fruits are carried out throughout Morocco where it has been used against various diseases. Different classes of bioactive compounds have been characterized including essential oils, fatty acids, triacylglycerols, flavonoids and their newly reported acylglycosyl derivatives, monophenols, phenolic acids, cinnamic acids, saponins, triterpenes, phytosterols, ubiquinone, melatonin, new aminophenols along with vitamin E among other secondary metabolites. The latter have already shown a wide spectrum of in vitro, and ex vivo biologicalactivities including antioxidant, anti-inflammatory, anti-diabetic, antihypertensive, anti-hypercholesterolemia, analgesic, antimicrobial, molluscicidal anti-nociceptive and anticancer potential. Argan flesh (pulp) contains a broad spectrum of polyphenolic compounds which may have utility for incorporation into nutraceuticals and cosmeceuticals relevant to the food, cosmetic and health industries. Further research is recommended, especially on the health beneficial effects of the aminophenols.


Assuntos
Frutas/química , Compostos Fitoquímicos/química , Compostos Fitoquímicos/farmacologia , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Sapotaceae/química , Frutas/metabolismo , Humanos , Metaboloma , Metabolômica/métodos , Marrocos , Fenóis/química , Óleos de Plantas/química , Sapotaceae/metabolismo
18.
EMBO J ; 31(1): 29-43, 2012 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-21952048

RESUMO

Snail1 is a central regulator of epithelial cell adhesion and movement in epithelial-to-mesenchymal transitions (EMTs) during embryo development; a process reactivated during cancer metastasis. While induction of Snail1 transcription precedes EMT induction, post-translational regulation of Snail1 is also critical for determining Snail1's protein level, subcellular localization, and capacity to induce EMT. To identify novel post-translational regulators of Snail1, we developed a live cell, bioluminescence-based screen. From a human kinome RNAi screen, we have identified Lats2 kinase as a novel regulator of Snail1 protein level, subcellular localization, and thus, activity. We show that Lats2 interacts with Snail1 and directly phosphorylates Snail1 at residue T203. This occurs in the nucleus and serves to retain Snail1 in the nucleus thereby enhancing its stability. Lats2 was found to positively influence cellular EMT and tumour cell invasion, in a Snail1-dependent manner. Indeed during TGFß-induced EMT Lats2 is activated and Snail1 phosphorylated at T203. Analysis in mouse and zebrafish embryo development confirms that Lats2 acts as a positive modulator of Snail1 protein level and potentiates its in vivo EMT activity.


Assuntos
Núcleo Celular/metabolismo , Proteínas Serina-Treonina Quinases/metabolismo , Fatores de Transcrição/metabolismo , Proteínas Supressoras de Tumor/metabolismo , Sequência de Aminoácidos , Animais , Células Cultivadas , Cães , Embrião de Mamíferos/metabolismo , Embrião não Mamífero/metabolismo , Transição Epitelial-Mesenquimal , Células HCT116 , Células HEK293 , Humanos , Camundongos , Dados de Sequência Molecular , Fosforilação , Proteínas Serina-Treonina Quinases/genética , Interferência de RNA , Fatores de Transcrição da Família Snail , Fatores de Transcrição/genética , Transfecção , Proteínas Supressoras de Tumor/genética , Peixe-Zebra
19.
Mol Pharm ; 13(11): 4001-4012, 2016 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-27704838

RESUMO

Selective modulators of the γ-amino butyric acid (GABAA) family of receptors have the potential to treat a range of disease states related to cognition, pain, and anxiety. While the development of various α subunit-selective modulators is currently underway for the treatment of anxiety disorders, a mechanistic understanding of the correlation between their bioactivity and efficacy, based on ligand-target interactions, is currently still lacking. In order to alleviate this situation, in the current study we have analyzed, using ligand- and structure-based methods, a data set of 5440 GABAA modulators. The Spearman correlation (ρ) between binding activity and efficacy of compounds was calculated to be 0.008 and 0.31 against the α1 and α2 subunits of GABA receptor, respectively; in other words, the compounds had little diversity in structure and bioactivity, but they differed significantly in efficacy. Two compounds were selected as a case study for detailed interaction analysis due to the small difference in their structures and affinities (ΔpKi(comp1_α1 - comp2_α1) = 0.45 log units, ΔpKi(comp1_α2 - comp2_α2) = 0 log units) as compared to larger relative efficacies (ΔRE(comp1_α1 - comp2_α1) = 1.03, ΔRE(comp1_α2 - comp2_α2) = 0.21). Docking analysis suggested that His-101 is involved in a characteristic interaction of the α1 receptor with both compounds 1 and 2. Residues such as Phe-77, Thr-142, Asn-60, and Arg-144 of the γ chain of the α1γ2 complex also showed interactions with heterocyclic rings of both compounds 1 and 2, but these interactions were disturbed in the case of α2γ2 complex docking results. Binding pocket stability analysis based on molecular dynamics identified three substitutions in the loop C region of the α2 subunit, namely, G200E, I201T, and V202I, causing a reduction in the flexibility of α2 compared to α1. These amino acids in α2, as compared to α1, were also observed to decrease the vibrational and dihedral entropy and to increase the hydrogen bond content in α2 in the apo state. However, freezing of both α1 and α2 was observed in the ligand-bound state, with an increased number of internal hydrogen bonds and increased entropy. Therefore, we hypothesize that the amino acid differences in the loop C region of α2 are responsible for conformational changes in the protein structure compared to α1, as well as for the binding modes of compounds and hence their functional signaling.


Assuntos
Receptores de GABA/metabolismo , Sequência de Aminoácidos , Animais , Benzodiazepinas/farmacologia , Ácido Butírico/farmacologia , Agonistas de Receptores de GABA-A/farmacologia , Humanos , Ligação de Hidrogênio , Simulação de Dinâmica Molecular , Dados de Sequência Molecular , Análise de Componente Principal , Estrutura Secundária de Proteína , Receptores de GABA/química
20.
Z Naturforsch C J Biosci ; 69(9-10): 363-7, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25711036

RESUMO

A new phenolic-type compound containing a nitrogenous, heterocyclic-fused ring from the fruit of the argan tree, Argania spinosa (Skeels L.), is described. This and another already known compound also isolated in the course of the work belong to an obscure and rare class of natural products, the amino phenolics.


Assuntos
Fenóis/química , Extratos Vegetais/química , Sapotaceae/química , Frutas/química , Espectroscopia de Ressonância Magnética , Espectrometria de Massas , Estrutura Molecular , Óleos de Plantas/química , Árvores
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