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1.
J Chem Phys ; 160(23)2024 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-38884404

RESUMEN

Zinc tungstate is a semiconductor known for its favorable photocatalytic, photoluminescence, and scintillation properties, coupled with its relatively low cost, reduced toxicity, and high stability in biological and catalytic environments. In particular, zinc tungstate evinces scintillation properties, namely the ability to emit visible light upon absorption of energetic radiation such as x rays, which has led to applications not only as radiation detectors but also for biomedical applications involving the delivery of optical light to deep tissue, such as photodynamic therapy and optogenetics. Here, we report on the synthesis of zinc tungstate nanorods generated via an optimized but facile method, which allows for synthetic control over the aspect ratio of the as-synthesized anisotropic motifs via rational variation of the solution pH. We investigate the effect of aspect ratio on their resulting photoluminescent and radioluminescent properties. We further demonstrate the potential of these zinc tungstate nanorods for biomedical applications, such as photodynamic therapy for cancer treatment, by analyzing their toxicological profile within cell lines and neurons.


Asunto(s)
Nanotubos , Compuestos de Tungsteno , Compuestos de Tungsteno/química , Compuestos de Tungsteno/toxicidad , Nanotubos/química , Humanos , Animales , Fotoquimioterapia , Supervivencia Celular/efectos de los fármacos , Compuestos de Zinc/química , Ratones , Neuronas/efectos de los fármacos , Neuronas/metabolismo , Zinc/química
2.
Aust N Z J Psychiatry ; 57(1): 34-48, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-35786010

RESUMEN

OBJECTIVE: Attention deficit hyperactivity disorder is a frequent comorbid condition in adults with bipolar disorder. We performed a meta-analysis aimed at assessing sociodemographic and clinical correlates of attention deficit hyperactivity disorder in bipolar disorder. METHOD: We searched main electronic databases up to June 2021. Random-effects meta-analyses, with relevant meta-regression and quality-based sensitivity analyses, were carried out to estimate the association between attention deficit hyperactivity disorder and putative correlates, grading the quality of evidence. RESULTS: We included 43 studies, based on 38 independent samples. Attention deficit hyperactivity disorder participants were more likely to be males (odds ratio = 1.46; p < 0.001) and unemployed (odds ratio = 1.45; p = 0.045), and less likely to be married (odds ratio = 0.62; p = 0.014). They had an earlier onset of bipolar disorder (standardized mean difference = -0.36; p < 0.001); more mood episodes (standardized mean difference = 0.35; p = 0.007), particularly depressive (standardized mean difference = 0.30; p = 0.011) and mixed (standardized mean difference = 0.30; p = 0.031) ones; higher odds of using antidepressants (odds ratio = 1.80; p = 0.024) and attempted suicides (odds ratio = 1.83; p < 0.001) and lower odds of psychotic features (odds ratio = 0.63; p = 0.010). Moreover, they were more likely to have generalized anxiety disorder (odds ratio = 1.50; p = 0.019), panic disorder (odds ratio = 1.89; p < 0.001), social phobia (odds ratio = 1.61; p = 0.017), eating disorders (odds ratio = 1.91; p = 0.007), antisocial personality disorder (odds ratio = 3.59; p = 0.004) and substance (odds ratio = 2.29; p < 0.001) or alcohol (odds ratio = 2.28; p < 0.001) use disorders. Quality of the evidence was generally low or very low for the majority of correlates, except for bipolar disorder onset and alcohol/substance use disorders (high), and suicide attempts (moderate). CONCLUSION: Comorbid bipolar disorder/attention deficit hyperactivity disorder may have some distinctive clinical features including an earlier onset of bipolar disorder and higher comorbid alcohol/substance use disorder rates. Further research is needed to identify additional clinical characteristics of this comorbidity.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Trastorno Bipolar , Trastorno de Pánico , Masculino , Humanos , Adulto , Femenino , Trastorno Bipolar/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Comorbilidad , Trastornos de Ansiedad/epidemiología
3.
Int J Mol Sci ; 24(4)2023 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-36834477

RESUMEN

In acute myeloid leukemia (AML) many patients experience relapse, despite the achievement of morphological complete remission; therefore, conventional morphologic criteria are currently considered inadequate for assessing the quality of the response after treatment. Quantification of measurable residual disease (MRD) has been established as a strong prognostic marker in AML and patients that test MRD negative have lower relapse rates and better survival than those who test positive. Different techniques, varying in their sensitivity and applicability to patients, are available for the measurement of MRD and their use as a guide for selecting the most optimal post-remission therapy is an area of active investigation. Although still controversial, MRD prognostic value promises to support drug development serving as a surrogate biomarker, potentially useful for accelerating the regulatory approval of new agents. In this review, we will critically examine the methods used to detect MRD and its potential role as a study endpoint.


Asunto(s)
Leucemia Mieloide Aguda , Humanos , Leucemia Mieloide Aguda/tratamiento farmacológico , Inducción de Remisión , Biomarcadores , Neoplasia Residual/diagnóstico , Recurrencia
4.
Mycoses ; 65(2): 233-238, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34883533

RESUMEN

BACKGROUND: Several studies in immunocompromised patients, such as those with HIV infection, undergoing cancer chemotherapy or organ transplant, have led to the development of guidelines on the use of prophylaxis to prevent Pneumocystis jirovecii pneumonia (PJP), in these specific conditions. Instead, since the association between PJP and acute myeloid leukaemia (AML) is not clearly defined, the role of prophylaxis in patients with AML is not yet established. METHODS: We retrospectively analysed 251 consecutive patients with newly diagnosed non-M3-AML, admitted at the Hematology Unit of University Tor Vergata in Rome, during the period 2010-2020. The aim of the study was to evaluate the incidence of PJP among AML patients during their first hospital admission, and to identify subjects at a high risk to develop PJP. RESULTS: Among 251 consecutive patients with non-M3-AML, 67 bronchoalveolar lavages (BAL) were performed. PJP was proven in 11/67 (16.7%) subjects undergoing BAL (11 males, median age 71 years), with an incidence of 4.3%. The most common reason for BAL execution were radiological findings such as ground-glass opacities (6/11, 55%) and atypical patterns like consolidations and nodules (5/11, 45%). One patient died because of PJP after 11 days of trimethoprim/sulfamethoxazole therapy. In multivariate analysis older age and smoking habit were independent factors significantly associated with PJP (p = .021 and 0.017 respectively). CONCLUSION: We conclude that PJP infection is not uncommon among patients with AML. If intensive chemotherapy is planned, physicians should be aware of this risk and prophylaxis should be considered, particularly in older patients.


Asunto(s)
Leucemia Mieloide Aguda , Neumonía por Pneumocystis , Anciano , Femenino , Humanos , Leucemia Mieloide Aguda/complicaciones , Masculino , Pneumocystis carinii , Neumonía por Pneumocystis/epidemiología , Estudios Retrospectivos
5.
Int Rev Psychiatry ; 34(7-8): 770-782, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36786120

RESUMEN

In the last four decades, mental health services for people with Severe Mental Illness (SMI) have seen asylums replaced by a balanced model of Community Mental Healthcare (CMH). Innovative approaches and strategies in the field of CMH have been extensively researched. However, this research has been hampered by issues limiting their capacity to inform clinicians and policymakers. We conducted an overview of meta-analyses of the effectiveness of innovative CMH models focussing on clinical and psychosocial outcomes in comparisons with standard care in adults with SMI. Based on the 12 eligible studies, we appraised, synthesised and graded the resulting evidence. There was moderate quality evidence that case management, Early Intervention Services (EIS) and caregiver-directed interventions were superior to standard care in reducing hospital admission. In relation to psychosocial outcomes, EIS showed high quality evidence of a small effect on global functioning. There was moderate quality evidence for a similar effect of Intensive Case Management, and for a large effect of family intervention. For quality of life, both EIS and self-management education had a small effect, with moderate quality. The level of research about effective CMH models is therefore substantial. However, several gaps related to innovative CMH not yet covered in meta-analytic synthesis, need to be filled.


Asunto(s)
Trastornos Mentales , Servicios de Salud Mental , Automanejo , Adulto , Humanos , Trastornos Mentales/terapia , Salud Mental , Calidad de Vida , Metaanálisis como Asunto
6.
Medicina (Kaunas) ; 56(11)2020 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-33203127

RESUMEN

Background and objectives: Readmissions of youths hospitalized for a severe mental disorder are common events and bear a remarkable human, social, and economic burden. The current study aimed at evaluating predictors of 1-year rehospitalization in a sample of adolescents and young adults with severe mental disorders. Materials and Methods: Data for ≤25-year-old inpatients with a severe mental disorder and consecutively admitted between 1 January 2016 and 30 June 2019 were collected. Subjects were retrospectively assessed over a follow-up period of one year after the index discharge to track readmissions-i.e., the primary outcome variable. Standard descriptive statistics were used. The association between variables and 1-year rehospitalization was estimated using the univariate Cox proportional hazards regression model. We then carried out a multivariable Cox regression model, also estimating the covariate-adjusted survivor function. Hazard ratios (HRs) with related 95% confidence intervals (95% CIs) were provided. Results: The final sample included 125 individuals. The multivariable Cox regression model estimated that co-occurring substance use disorders (HR = 2.14; 95% CI: 1.08 to 4.26; p = 0.029) and being admitted for a suicide attempt (HR = 2.49; 95% CI: 1.13 to 5.49; p = 0.024) were both significant predictors of 1-year rehospitalization. Conclusions: Our study showed that comorbid substance use disorders and being admitted for a suicide attempt were predictors of early readmission in youths with severe mental disorders. Although their generalizability is limited, our findings could contribute to improve the quality of young patients' mental health care by identifying vulnerable subjects who may benefit from tailored interventions to prevent rehospitalizations.


Asunto(s)
Alta del Paciente , Readmisión del Paciente , Adolescente , Adulto , Hospitalización , Humanos , Estudios Retrospectivos , Factores de Riesgo , Intento de Suicidio , Adulto Joven
7.
Opt Lett ; 43(4): 903-906, 2018 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-29444023

RESUMEN

The results of irradiation tests on Ce-doped sol-gel silica using x- and γ-rays up to 10 kGy are reported in order to investigate the radiation hardness of this material for high-energy physics applications. Sol-gel silica fibers with Ce concentrations of 0.0125 and 0.05 mol. % are characterized by means of optical absorption and attenuation length measurements before and after irradiation. The two different techniques give comparable results, evidencing the formation of a main broad radiation-induced absorption band, peaking at about 2.2 eV, related to radiation-induced color centers. The results are compared with those obtained on bulk silica. This study reveals that an improvement of the radiation hardness of Ce-doped silica fibers can be achieved by reducing Ce content inside the fiber core, paving the way for further material development.

8.
J Allergy Clin Immunol ; 139(2): 634-642.e5, 2017 02.
Artículo en Inglés | MEDLINE | ID: mdl-27522155

RESUMEN

BACKGROUND: Signaling through the T-cell receptor (TCR) is critical for T-cell development and function. Linker for activation of T cells (LAT) is a transmembrane adaptor signaling molecule that is part of the TCR complex and essential for T-cell development, as demonstrated by LAT-deficient mice, which show a complete lack of peripheral T cells. OBJECTIVE: We describe a pedigree affected by a severe combined immunodeficiency phenotype with absent T cells and normal B-cell and natural killer cell numbers. A novel homozygous frameshift mutation in the gene encoding for LAT was identified in this kindred. METHODS: Genetic, molecular, and functional analyses were used to identify and characterize the LAT defect. Clinical and immunologic analysis of patients was also performed and reported. RESULTS: Homozygosity mapping was used to identify potential defective genes. Sanger sequencing of the LAT gene showed a mutation that resulted in a premature stop codon and protein truncation leading to complete loss of function and loss of expression of LAT in the affected family members. We also demonstrate loss of LAT expression and lack of TCR signaling restoration in LAT-deficient cell lines reconstituted with a synthetic LAT gene bearing this severe combined immunodeficiency mutation. CONCLUSION: For the first time, the results of this study show that inherited LAT deficiency should be considered in patients with combined immunodeficiency with T-cell abnormalities.


Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/metabolismo , Proteínas de la Membrana/metabolismo , Receptores de Antígenos de Linfocitos T/metabolismo , Eliminación de Secuencia/genética , Inmunodeficiencia Combinada Grave/genética , Linfocitos T/fisiología , Proteínas Adaptadoras Transductoras de Señales/genética , Apoptosis , Señalización del Calcio/genética , Diferenciación Celular , Consanguinidad , Femenino , Genotipo , Homocigoto , Humanos , Células Jurkat , Activación de Linfocitos , Masculino , Proteínas de la Membrana/genética , Pakistán , Linaje , Receptores de Antígenos de Linfocitos T/genética , Transgenes/genética
9.
J Clin Immunol ; 37(7): 626-637, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28842866

RESUMEN

Deficiency of adenosine deaminase (ADA, EC3.5.4.4), a housekeeping enzyme of purine metabolism encoded by the Ada gene, is a cause of human severe combined immune deficiency (SCID). Numerous deleterious mutations occurring in the ADA gene have been found in patients with profound lymphopenia (T- B- NK-), thus underscoring the importance of functional purine metabolism for the development of the immune defense. While untreated ADA SCID is a fatal disorder, there are multiple life-saving therapeutic modalities to restore ADA activity and reconstitute protective immunity, including enzyme replacement therapy (ERT), allogeneic hematopoietic stem cell transplantation (HSCT) and gene therapy (GT) with autologous gene-corrected hematopoietic stem cells (HSC). We review the pathogenic mechanisms and clinical manifestations of ADA SCID.


Asunto(s)
Adenosina Desaminasa/deficiencia , Adenosina Desaminasa/genética , Inmunodeficiencia Combinada Grave/genética , Animales , Modelos Animales de Enfermedad , Humanos
10.
Blood ; 126(24): 2592-600, 2015 Dec 10.
Artículo en Inglés | MEDLINE | ID: mdl-26438512

RESUMEN

Hematopoietic cells depend on integrin-mediated adhesion and signaling, which is induced by kindlin-3 and talin-1. To determine whether platelet and polymorphonuclear neutrophil (PMN) functions require specific thresholds of kindlin-3, we generated mouse strains expressing 50%, 10%, or 5% of normal kindlin-3 levels. We report that in contrast to kindlin-3-null mice, which die perinatally of severe bleeding and leukocyte adhesion deficiency, mice expressing as little as 5% of kindlin-3 were viable and protected from spontaneous bleeding and infections. However, platelet adhesion and aggregation were reduced in vitro and bleeding times extended. Similarly, leukocyte adhesion, extravasation, and bacterial clearance were diminished. Quantification of protein copy numbers revealed stoichiometric quantities of kindlin-3 and talin-1 in platelets and neutrophils, indicating that reduction of kindlin-3 in our mouse strains progressively impairs the cooperation with talin-1. Our findings show that very low levels of kindlin-3 enable basal platelet and neutrophil functions, whereas in stress situations such as injury and infection, platelets and neutrophils require a maximum of functional integrins that is achieved with high and stoichiometric quantities of kindlin-3 and talin-1.


Asunto(s)
Plaquetas/fisiología , Proteínas del Citoesqueleto/fisiología , Leucocitos/inmunología , Animales , Tiempo de Sangría , Plaquetas/química , Adhesión Celular , Proteínas del Citoesqueleto/sangre , Proteínas del Citoesqueleto/deficiencia , Proteínas del Citoesqueleto/genética , Gastritis/sangre , Gastritis/inmunología , Gastritis/microbiología , Infecciones por Helicobacter/sangre , Infecciones por Helicobacter/inmunología , Infecciones por Helicobacter/microbiología , Helicobacter pylori/inmunología , Helicobacter pylori/aislamiento & purificación , Trastornos Hemorrágicos/genética , Cadenas beta de Integrinas/fisiología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Ratones Transgénicos , Neutrófilos/química , Neutrófilos/inmunología , Fagocitosis/genética , Adhesividad Plaquetaria/genética , Agregación Plaquetaria/genética , Talina/sangre , Talina/genética
11.
Chemphyschem ; 18(5): 493-499, 2017 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-28006081

RESUMEN

The influence of Ca codoping on the optical absorption, photo-, radio-, and thermo-luminescence properties of YAlO3 :Ce (YAP:Ce) crystals has been studied for four different calcium concentrations ranging from 0 to 500 ppm. Ca codoping results in a partial oxidation of Ce3+ into Ce4+ , The luminescence time response under pulsed X-ray excitation of the Ce3+ /Ce4+ admixure clearly demonstrates the role of hole migration on both the rise time and the generally observed slow components. From an application point of view, Ca codoping significantly improves the timing performances, but the induced presence of Ce4+ ions is also the cause of a reduction in scintillation efficiency.

12.
Phys Chem Chem Phys ; 18(2): 1178-84, 2016 Jan 14.
Artículo en Inglés | MEDLINE | ID: mdl-26662042

RESUMEN

X-ray induced luminescence sensitization results have been obtained on three commercially relevant scintillators, namely CsI:Tl, YAG:Ce and LSO:Ce. The obtained curves have been used to validate a model based on the competition among trapping and recombination of free charge carriers. The model was able to accurately describe the complex phenomenology of the detected sensitization curves. We also used the model to predict the role of a high temperature and concentration trap in shaping the sensitization curves. Based on these modelling results we also proposed a novel, and rather counterintuitive, strategy to deal with the sensitization phenomenon based on the deliberate introduction of deep traps which can significantly reduce the bright burn effect.

14.
Proc Natl Acad Sci U S A ; 110(42): 17005-10, 2013 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-24089451

RESUMEN

Activated T cells use very late antigen-4/α4ß1 integrin for capture, rolling on, and firm adhesion to endothelial cells, and use leukocyte function-associated antigen-1/αLß2 integrin for subsequent crawling and extravasation. Inhibition of α4ß1 is sufficient to prevent extravasation of activated T cells and is successfully used to combat autoimmune diseases, such as multiple sclerosis. Here we show that effector T cells lacking the integrin activator Kindlin-3 extravasate and induce experimental autoimmune encephalomyelitis in mice immunized with autoantigen. In sharp contrast, adoptively transferred autoreactive T cells from Kindlin-3-deficient mice fail to extravasate into the naïve CNS. Mechanistically, autoreactive Kindlin-3-null T cells extravasate when the CNS is inflamed and the brain microvasculature expresses high levels of integrin ligands. Flow chamber assays under physiological shear conditions confirmed that Kindlin-3-null effector T cells adhere to high concentrations of vascular cell adhesion molecule-1 and intercellular adhesion molecule-1, albeit less efficiently than WT T cells. Although these arrested T cells polarize and start crawling, only few remain firmly adherent over time. Our data demonstrate that the requirement of Kindlin-3 for effector T cells to induce α4ß1 and αLß2 integrin ligand binding and stabilization of integrin-ligand bonds is critical when integrin ligand levels are low, but of less importance when integrin ligand levels are high.


Asunto(s)
Proteínas del Citoesqueleto/inmunología , Encefalomielitis Autoinmune Experimental/inmunología , Integrina alfa4beta1/inmunología , Antígeno-1 Asociado a Función de Linfocito/inmunología , Linfocitos T/inmunología , Animales , Adhesión Celular/genética , Adhesión Celular/inmunología , Proteínas del Citoesqueleto/genética , Encefalomielitis Autoinmune Experimental/genética , Encefalomielitis Autoinmune Experimental/patología , Integrina alfa4beta1/genética , Activación de Linfocitos/genética , Activación de Linfocitos/inmunología , Antígeno-1 Asociado a Función de Linfocito/genética , Ratones , Linfocitos T/patología , Molécula 1 de Adhesión Celular Vascular/genética , Molécula 1 de Adhesión Celular Vascular/inmunología
15.
Phys Chem Chem Phys ; 16(45): 24824-9, 2014 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-25319509

RESUMEN

We report the scintillation properties of BaAl4O7:Eu(2+), a transparent polycrystalline ceramic prepared by full and congruent crystallization of glass. We show that a small deviation from the stoichiometric composition as well as thermal treatment duration play a crucial role in the formation of charge carrier traps, leading to a strong influence on the scintillation yield. We demonstrate that when the traps are not entirely removed, X-ray irradiation allows them to be permanently filled in order to significantly enhance the scintillation output. Finally, the best sample obtained demonstrates performances able to compete with a commercially available scintillating material, CsI:Tl.

16.
Front Oncol ; 14: 1367393, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38444680

RESUMEN

In patients with Acute Myeloid Leukemia (AML), the assessment of disease risk plays a central role in the era of personalized medicine. Indeed, integrating baseline clinical and biological features on a case-by-case basis is not only essential to select which treatment would likely result in a higher probability of achieving complete remission, but also to dynamically customize any subsequent therapeutic intervention. For young high-risk patients with low comorbidities burden and in good general conditions (also called "fit" patients), intensive chemotherapy followed by allogeneic stem cell transplantation still represents the backbone of any therapeutic program. However, with the approval of novel promising agents in both the induction/consolidation and the maintenance setting, the algorithms for the management of AML patients considered eligible for intensive chemotherapy are in constant evolution. In this view, we selected burning issues regarding the identification and management of high-risk AML, aiming to provide practical advice to facilitate their daily clinical management in patients considered eligible for intensive chemotherapy.

17.
Braz J Psychiatry ; 46: e20233418, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38281311

RESUMEN

OBJECTIVE: Evidence on the relationship between depression and clinical dimensions of schizophrenia remains limited. This cross-sectional study investigated the association between depression and Positive and Negative Syndrome Scale (PANSS) dimensions in people with schizophrenia spectrum disorders. METHODS: Trained assessors administered the PANSS to measure symptoms of schizophrenia and the Calgary Depression Scale for Schizophrenia to measure depression. The association of depression with overall PANSS score and related dimensions was investigated in multiple logistic regression analyses. RESULTS: We included 231 inpatients with schizophrenia spectrum disorders (mean age: 42.4 (SD: 12.9) years; men: 58.9%; mean overall PANSS score: 82.5 (SD: 20.1); drug-free or naïve: 39.3%), including 78 (33.8%) with clinically significant depressive symptoms. Depression was associated with higher overall (regression coefficient, SE: 0.029, 0.008; p < 0.001) and general psychopathology (regression coefficient, SE: 0.118, 0.023; p < 0.001) PANSS scores. We found an inverse relationship between depression and positive symptoms (regression coefficient, SE: -0.088, 0.028; p = 0.002). No association between depression and negative symptoms was found. CONCLUSION: Despite some limitations, our study shows that people affected by schizophrenia spectrum disorders with depression are likely to show more overall and general psychopathology symptoms but lower positive symptoms. Additional studies are needed to explore the generalizability of our findings.


Asunto(s)
Depresión , Escalas de Valoración Psiquiátrica , Esquizofrenia , Psicología del Esquizofrénico , Humanos , Masculino , Adulto , Estudios Transversales , Femenino , Esquizofrenia/complicaciones , Persona de Mediana Edad , Depresión/psicología , Índice de Severidad de la Enfermedad
18.
Thromb Res ; 236: 30-36, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38387301

RESUMEN

Coagulation disorders frequently complicate the clinical course of acute myeloid leukemia (AML) patients. This study examined the frequency and prognostic significance, with regards of early mortality, of the presence of overt disseminated intravascular coagulation (DIC) at AML diagnosis and its correlation with clinical and biological characteristics. A retrospective analysis of 351 newly diagnosed non-promyelocytic AML patients was conducted, utilizing the 2018 ISTH DIC-Score criteria to evaluate the presence of overt DIC at AML onset. The study cohort had a median age of 65 years with a predominance of male gender (59 %). Overt DIC was present in 21 % of cases and was associated with advanced age, comorbidities, poor performance status, hyperleukocytosis, LDH levels, NPM1 mutations, expression of CD33 and CD4, and lack of expression of CD34. With a median follow-up of 72 months (3-147 months), the 6-year overall survival (OS) was 17.4 %, with patients having overt DIC showing significantly poorer outcomes (7.2 % compared to 20.3 % of those without DIC, p < 0.001). Patients with overt DIC showed markedly high early mortality rates at 30 (42.5 % vs 8 %), 60 (49.3 % vs 16.9 %), and 120 days (64.4 % vs 25.6 %) from disease onset. In multivariate analysis overt DIC retained its independent prognostic value for early mortality. In conclusion, the prevalence and clinical relevance of DIC in non-promyelocytic AML is not negligible, underlining its potential as an unfavorable prognostic marker. In newly diagnosed patients with AML, early recognition and measure to counteract coagulation disturbances might help mitigate the elevated mortality risk associated with DIC.


Asunto(s)
Coagulación Intravascular Diseminada , Leucemia Mieloide Aguda , Humanos , Masculino , Anciano , Femenino , Coagulación Intravascular Diseminada/etiología , Estudios Retrospectivos , Leucemia Mieloide Aguda/complicaciones , Pronóstico , Coagulación Sanguínea
19.
Neurosci Biobehav Rev ; 149: 105159, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37019247

RESUMEN

The brain-derived neurotrophic factor (BDNF) has received considerable attention as a potential biomarker of major depressive disorder (MDD) and antidepressant response. We conducted an overview of meta-analyses investigating the relationship of BDNF with MDD, related clinical features, and antidepressant treatment. Based on a systematic screening on main electronic databases, 11 systematic reviews with meta-analyses were included. Available evidence suggests that people with MDD have peripheral and central BDNF levels lower than non-depressed individuals. A negative correlation between blood BDNF and symptom severity emerged, while no association with suicidality was detected. Moreover, an increase in blood BDNF levels after antidepressant treatment, proportional to symptom improvement, was reported. BDNF levels seem to be increased in both treatment responders and remitters, remaining stable in non-responders. Conversely, no variations of BDNF concentrations after non-pharmacological interventions (electroconvulsive therapy, repetitive transcranial magnetic stimulation, and physical activity) were found. The findings of this overview appear consistent with the neurotrophic hypothesis of depression, suggesting that BDNF may play a role in both MDD pathophysiology and pharmacological treatment response.


Asunto(s)
Trastorno Depresivo Mayor , Humanos , Trastorno Depresivo Mayor/tratamiento farmacológico , Factor Neurotrófico Derivado del Encéfalo , Antidepresivos/uso terapéutico , Antidepresivos/farmacología , Estimulación Magnética Transcraneal , Ejercicio Físico
20.
Artículo en Inglés | MEDLINE | ID: mdl-36089162

RESUMEN

INTRODUCTION: Pteridines, such as neopterin, biopterin, and tetrahydrobiopterin (BH4), may be involved in depression pathophysiology owing to their links to immune-inflammatory response, oxidative and nitrosative stress, and monoaminergic transmission. Nonetheless, studies assessing pteridines in depression are inconsistent. We conducted a systematic review and meta-analysis of observational studies comparing blood pteridine concentrations between subjects with depression and healthy controls (HCs). METHODS: We searched Embase, MEDLINE, and PsycInfo for articles indexed through November 2021. Study quality was appraised, evaluating age and gender comparability between groups, sample representativeness, and methods to assess depression. Random-effects meta-analyses were carried out, generating pooled standardized mean differences (SMDs). Heterogeneity across studies was estimated using the I2 statistic. RESULTS: Twenty-four studies, involving 3075 subjects, were included. Individuals with depression showed blood neopterin concentrations higher than HCs (k = 19; SMD = 0.36; p < 0.001) with moderate heterogeneity across studies (I2 = 58.2%). No moderating role of age, gender, or type of blood sample was found. Sensitivity analyses showed no impact of inconsistency and quality of studies on findings. Neopterin concentrations were higher among individuals with major depressive disorder compared to HCs (SMD = 0.44; p < 0.001). This held true also when considering only drug-free subjects (SMD = 0.68; p = 0.003). No differences in biopterin concentrations were found between subjects with depression and HCs (k = 5; SMD = -0.35; p = 0.086), though this result was limited by inconsistency of findings (I2 = 77.9%) and quality of studies. Finally, no sufficient data were available for a meta-analysis on BH4. CONCLUSIONS: As a whole, our work partly supports the hypothesis of an imbalance of pteridine metabolism in depression.


Asunto(s)
Depresión , Trastorno Depresivo Mayor , Humanos , Neopterin , Biopterinas , Pteridinas
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