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1.
J Virol ; 98(5): e0041124, 2024 May 14.
Article in English | MEDLINE | ID: mdl-38567952

ABSTRACT

Influenza A virus infection activates the NLRP3 inflammasome, a multiprotein signaling complex responsible for the proteolytic activation and release of the proinflammatory cytokine IL-1ß from monocytes and macrophages. Some influenza A virus (IAV) strains encode a short 90-amino acid peptide (PB1-F2) on an alternative open reading frame of segment 2, with immunomodulatory activity. We recently demonstrated that contemporary IAV PB1-F2 inhibits the activation of NLRP3, potentially by NEK7-dependent activation. PB1-F2 binds to NLRP3 with its C-terminal 50 amino acids, but the exact binding motif was unknown. On the NLRP3 side, the interface is formed through the leucine-rich-repeat (LRR) domain, potentially in conjunction with the pyrin domain. Here, we took advantage of PB1-F2 sequences from IAV strains with either weak or strong NLRP3 interaction. Sequence comparison and structure prediction using Alphafold2 identified a short four amino acid sequence motif (TQGS) in PB1-F2 that defines NLRP3-LRR binding. Conversion of this motif to that of the non-binding PB1-F2 suffices to lose inhibition of NLRP3 dependent IL-1ß release. The TQGS motif further alters the subcellular localization of PB1-F2 and its colocalization with NLRP3 LRR and pyrin domain. Structural predictions suggest the establishment of additional hydrogen bonds between the C-terminus of PB1-F2 and the LRR domain of NLRP3, with two hydrogen bonds connecting to threonine and glutamine of the TQGS motif. Phylogenetic data show that the identified NLRP3 interaction motif in PB1-F2 is widely conserved among recent IAV-infecting humans. Our data explain at a molecular level the specificity of NLRP3 inhibition by influenza A virus. IMPORTANCE: Influenza A virus infection is accompanied by a strong inflammatory response and high fever. The human immune system facilitates the swift clearance of the virus with this response. An essential signal protein in the proinflammatory host response is IL-1b. It is released from inflammatory macrophages, and its production and secretion depend on the function of NLRP3. We had previously shown that influenza A virus blocks NLRP3 activation by the expression of a viral inhibitor, PB1-F2. Here, we demonstrate how this short peptide binds to NLRP3 and provide evidence that a four amino acid stretch in PB1-F2 is necessary and sufficient to mediate this binding. Our data identify a new virus-host interface required to block one signaling path of the innate host response against influenza A virus.


Subject(s)
Influenza A virus , NLR Family, Pyrin Domain-Containing 3 Protein , Viral Proteins , Humans , Amino Acid Motifs , Amino Acid Sequence , HEK293 Cells , Inflammasomes/metabolism , Influenza A virus/genetics , Influenza A virus/metabolism , Influenza, Human/virology , Influenza, Human/immunology , Interleukin-1beta/metabolism , NLR Family, Pyrin Domain-Containing 3 Protein/chemistry , NLR Family, Pyrin Domain-Containing 3 Protein/metabolism , Protein Binding , Viral Proteins/metabolism , Viral Proteins/genetics , Viral Proteins/chemistry
2.
Trends Immunol ; 42(1): 76-88, 2021 01.
Article in English | MEDLINE | ID: mdl-33246882

ABSTRACT

NF-κB signaling is required at multiple stages of T cell development and function. The NF-κB pathway integrates signals from many receptors and involves diverse adapters and kinases. Recent advances demonstrate that kinases controlling NF-κB activation, such as the IKK complex, serve dual independent functions because they also control cell death checkpoints. Survival functions previously attributed to NF-κB are in fact mediated by these upstream kinases by novel mechanisms. This new understanding has led to a refined view of how NF-κB and cell death signaling are interlinked and how they regulate cell fate. We discuss how NF-κB activation and control of cell death signaling by common upstream triggers cooperate to regulate different aspects of T cell development and function.


Subject(s)
NF-kappa B , T-Lymphocytes , Animals , Cell Death , Humans , I-kappa B Kinase/metabolism , NF-kappa B/metabolism , Phosphorylation , T-Lymphocytes/metabolism
3.
Eur J Haematol ; 108(2): 118-124, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34599779

ABSTRACT

The ideal therapeutic regimen in primary mediastinal B-cell lymphoma (PMBCL) is controversial and may include consolidation radiotherapy (RT). An adequate strategy is essential in a population where long-term effects of RT are significant. We evaluated the prognostic value of end-of-treatment (EOT) FDG-PET in 50 patients receiving rituximab and anthracycline-containing chemotherapy and its implications for consolidative RT. Thirty patients (60%) obtained complete metabolic response (CMR), five received consolidation RT. The remaining patients had partial response (14) and progression (6). Of these, 12 received mediastinal RT, six salvage chemotherapy, and two no further treatment. Five-year progression free survival was 100% and 48% (95% CI 30%-77%) in patients with negative and positive EOT FDG-PET, respectively (P < .001). Five-year overall survival for negative and positive EOT FDG-PET was 100% and 67% (95% CI 48%-93%) respectively (P = .001). Within positive EOT FDG-PET cases, an association was found between Deauville score and survival. The negative predictive value (NPV) of EOT FDG-PET for disease relapse/progression was 100% (95% CI 0.88-1.00); the positive predictive value was 47% (95% CI 0.24-0.71). This study demonstrates the importance of metabolic assessment in PMBCL and is relevant for its high NPV. Our data favor the use of EOT FDG-PET for decisions concerning RT.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Fluorodeoxyglucose F18 , Lymphoma, B-Cell/diagnosis , Lymphoma, B-Cell/drug therapy , Mediastinal Neoplasms/diagnosis , Mediastinal Neoplasms/drug therapy , Positron-Emission Tomography , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Clinical Decision-Making , Combined Modality Therapy , Cyclophosphamide/adverse effects , Cyclophosphamide/therapeutic use , Disease Management , Doxorubicin/adverse effects , Doxorubicin/therapeutic use , Female , Humans , Lymphoma, B-Cell/mortality , Male , Mediastinal Neoplasms/mortality , Middle Aged , Prednisone/adverse effects , Prednisone/therapeutic use , Prognosis , Retreatment , Rituximab/adverse effects , Rituximab/therapeutic use , Treatment Outcome , Vincristine/adverse effects , Vincristine/therapeutic use
4.
EMBO Rep ; 21(12): e50421, 2020 12 03.
Article in English | MEDLINE | ID: mdl-33180976

ABSTRACT

Pyroptosis is a fulminant form of macrophage cell death, contributing to release of pro-inflammatory cytokines. In humans, it depends on caspase 1/4-activation of gasdermin D and is characterized by the release of cytoplasmic content. Pathogens apply strategies to avoid or antagonize this host response. We demonstrate here that a small accessory protein (PB1-F2) of contemporary H5N1 and H3N2 influenza A viruses (IAV) curtails fulminant cell death of infected human macrophages. Infection of macrophages with a PB1-F2-deficient mutant of a contemporary IAV resulted in higher levels of caspase-1 activation, cleavage of gasdermin D, and release of LDH and IL-1ß. Mechanistically, PB1-F2 limits transition of NLRP3 from its auto-repressed and closed confirmation into its active state. Consequently, interaction of a recently identified licensing kinase NEK7 with NLRP3 is diminished, which is required to initiate inflammasome assembly.


Subject(s)
Influenza A Virus, H5N1 Subtype , Influenza A virus , Humans , Inflammasomes/genetics , Influenza A Virus, H3N2 Subtype , Influenza A virus/genetics , Macrophages , NIMA-Related Kinases , NLR Family, Pyrin Domain-Containing 3 Protein/genetics , Pyroptosis
5.
Int J Mol Sci ; 23(20)2022 Oct 18.
Article in English | MEDLINE | ID: mdl-36293344

ABSTRACT

The present work aimed to study the role of dietary tryptophan supplementation in modulating the European seabass (Dicentrarchus labrax) immune condition during stressful rearing conditions (i.e., 15 days exposure to high density), as well as the immune response to acute inflammation after intraperitoneal injection of a bacterial pathogen. Stress alone did not compromise seabass health indicators. In contrast, a clear peripheral and local inflammatory response was observed in response to the inoculated bacteria. Moreover, exposure to a high stocking density seemed to exacerbate the inflammatory response at early sampling points, compared to fish stocked at a lower density. In contrast, stressed fish presented some immune-suppressing effects on the T-cell surface glycoprotein receptor expressions at a late sampling point following inflammation. Regarding the effects of dietary tryptophan, no changes were observed on seabass immune indicators prior to inflammation, while a small number of immunosuppressive effects were observed in response to inflammation, supporting tryptophan's role in the promotion of immune-tolerance signals during inflammation. Nonetheless, tryptophan dietary supplementation improved the inflammatory response against a bacterial pathogen during stressful conditions, supported by a reduction of plasma cortisol levels, an up-regulation of several immune-related genes at 48 h, and an inversion of the previously observed, stress-induced T-cell suppression. Finally, the involvement of tryptophan catabolism in macrophages was confirmed by the up-regulation of genes involved in the kynurenine pathway. The present study brings new insights regarding the immune modulatory role of tryptophan during stressful conditions in fish, thus allowing for the development of novel prophylactic protocols during vaccination by intraperitoneal injection in the European seabass.


Subject(s)
Bass , Animals , Bass/genetics , Tryptophan/metabolism , Animal Feed/analysis , Hydrocortisone/metabolism , Kynurenine/metabolism , Disease Resistance , Inflammation , Membrane Glycoproteins/metabolism
6.
Sensors (Basel) ; 21(18)2021 Sep 15.
Article in English | MEDLINE | ID: mdl-34577401

ABSTRACT

The ability to select, isolate, and manipulate micron-sized particles or small clusters has made optical tweezers one of the emergent tools for modern biotechnology. In conventional setups, the classification of the trapped specimen is usually achieved through the acquired image, the scattered signal, or additional information such as Raman spectroscopy. In this work, we propose a solution that uses the temporal data signal from the scattering process of the trapping laser, acquired with a quadrant photodetector. Our methodology rests on a pre-processing strategy that combines Fourier transform and principal component analysis to reduce the dimension of the data and perform relevant feature extraction. Testing a wide range of standard machine learning algorithms, it is shown that this methodology allows achieving accuracy performances around 90%, validating the concept of using the temporal dynamics of the scattering signal for the classification task. Achieved with 500 millisecond signals and leveraging on methods of low computational footprint, the results presented pave the way for the deployment of alternative and faster classification methodologies in optical trapping technologies.


Subject(s)
Lasers , Optical Tweezers , Spectrum Analysis, Raman
7.
Hum Genet ; 139(4): 531-543, 2020 Apr.
Article in English | MEDLINE | ID: mdl-32030560

ABSTRACT

We present a comprehensive clinically oriented workflow for large-insert genome sequencing (liGS)-based nucleotide level resolution and interpretation of de novo (dn) apparently balanced chromosomal abnormalities (BCA) in prenatal diagnosis (PND). Retrospective or concomitant with conventional PND and liGS, molecular and newly developed clinically inspired bioinformatic tools (TAD-GConTool and CNV-ConTool) are applied to analyze and assess the functional and phenotypic outcome of dn structural variants (dnSVs). Retrospective analysis of four phenotype-associated dnSVs identified during conventional PND precisely reveal the genomic elements disrupted by the translocation breakpoints. Identification of autosomal dominant disease due to the disruption of ANKS1B and WDR26 by t(12;17)(q23.1;q21.33)dn and t(1;3)(q24.11;p25.3)dn breakpoints, respectively, substantiated the proposed workflow. We then applied this workflow to two ongoing prenatal cases with apparently balanced dnBCAs: 46,XX,t(16;17)(q24;q21.3)dn referred for increased risk on combined first trimester screening and 46,XY,t(2;19)(p13;q13.1)dn referred due to a previous trisomy 21 pregnancy. Translocation breakpoints in the t(16;17) involve ANKRD11 and WNT3 and disruption of ANKRD11 resulted in KBG syndrome confirmed in postnatal follow-up. Breakpoints in the t(2;19) are within ATP6V1B1 and the 3' UTR of CEP89, and are not interpreted to cause disease. Genotype-phenotype correlation confirms the causative role of WDR26 in the Skraban-Deardorff and 1q41q42 microdeletion phenocopy syndromes, and that disruption of ANKS1B causes ANKS1B haploinsufficiency syndrome. In sum, we show that an liGS-based approach can be realized in PND care providing additional information concerning clinical outcomes of dnBCAs in patients with such rearrangements.


Subject(s)
Abnormalities, Multiple , Bone Diseases, Developmental , Chromosome Disorders , Chromosomes, Human/genetics , Facies , Genes, Dominant , Intellectual Disability , Prenatal Diagnosis , Tooth Abnormalities , Translocation, Genetic , Abnormalities, Multiple/diagnosis , Abnormalities, Multiple/genetics , Adolescent , Adult , Bone Diseases, Developmental/diagnosis , Bone Diseases, Developmental/genetics , Chromosome Disorders/diagnosis , Chromosome Disorders/genetics , Female , Humans , Intellectual Disability/diagnosis , Intellectual Disability/genetics , Male , Pregnancy , Tooth Abnormalities/diagnosis , Tooth Abnormalities/genetics , Workflow
8.
Heredity (Edinb) ; 125(5): 328-339, 2020 11.
Article in English | MEDLINE | ID: mdl-32792649

ABSTRACT

Many species are structured in social groups (SGs) where individuals exhibit complex mating strategies. Yet, most population genetic studies ignore SGs either treating them as small random-mating units or focusing on a higher hierarchical level (the population). Empirical studies acknowledging SGs have found an overall excess of heterozygotes within SGs and usually invoke inbreeding avoidance strategies to explain this finding. However, there is a lack of null models against which ecological theories can be tested and inbreeding avoidance quantified. Here, we investigate inbreeding (deviation from random mating) in an endangered forest-dwelling pair-living lemur species (Propithecus tattersalli). In particular, we measure the inbreeding coefficient (FIS) in empirical data at different scales: SGs, sampling sites and forest patches. We observe high excess of heterozygotes within SGs. The magnitude of this excess is highly dependent on the sampling scheme: while offspring are characterised by a high excess of heterozygotes (FIS < 0), the reproductive pair does not show dramatic departures from Hardy-Weinberg expectations. Moreover, the heterozygosity excess disappears at larger geographic scales (sites and forests). We use a modelling framework that incorporates details of the sifaka mating system but does not include active inbreeding avoidance mechanisms. The simulated data show that, although apparent "random mating" or even inbreeding may occur at the "population" level, outbreeding is maintained within SGs. Altogether our results suggest that social structure leads to high levels of outbreeding without the need for active inbreeding avoidance mechanisms. Thus, demonstrating and measuring the existence of active inbreeding avoidance mechanisms may be more difficult than usually assumed.


Subject(s)
Hierarchy, Social , Inbreeding , Indriidae , Animals , Endangered Species , Indriidae/genetics , Models, Genetic , Reproduction
9.
J Neurooncol ; 147(2): 459-463, 2020 Apr.
Article in English | MEDLINE | ID: mdl-32108293

ABSTRACT

BACKGROUND: Plexiform neurofibromas (PN) are the most frequent tumors associated with Neurofibromatosis type 1 (NF-1). PN can cause significant complications, including pain, functional impairment, and disfigurement. There is no efficient medical treatment and, surgical resection of large PN is frequently infeasible. Selumetinib (AZD6244/ARRY-142886) is a mitogen-activated protein kinase enzyme (MEK1/2) inhibitor and works by targeting the MAPK pathway. It is an investigational treatment option for inoperable symptomatic PN associated with NF-1. Herein, we describe a single institutional experience with selumetinib for inoperable PN in NF-1. METHODS: Case series study of demographics, clinical, baseline characteristics, treatment effect, and follow-up of consecutive genetically confirmed NF1 patients with inoperable PN associated with significant or potential significant morbidity treated with selumetinib (April 2018 to April 2019). RESULTS: Nineteen patients were treated with selumetinib. Predominant target locations were head and neck (31.6%, 6/19), chest (26.3%, 5/19) and pelvis (21%, 4/19) and the most important comorbidities were disfigurement (47.4%, 9/19) and pain (26.3%, 5/19). The mean follow-up time was 223 days (range 35-420 days). All but one had sustained clinical improvement, mainly in the first 60-90 days of treatment. In one patient, the treatment was suspended after 168 days (lack of clear benefit and left ventricular ejection fraction drop). There were no adverse effects leading to treatment suspension. CONCLUSIONS: In the first observational study of selumetinib for NF-1 associated PN we showed that the drug was associated with clinical and radiological improvement. Our study also confirms the safety described in the clinical trials.


Subject(s)
Benzimidazoles/therapeutic use , Neurofibroma, Plexiform/drug therapy , Neurofibromatosis 1/drug therapy , Adolescent , Adult , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Male , Neurofibroma, Plexiform/pathology , Neurofibromatosis 1/pathology , Prognosis , Stroke Volume , Young Adult
10.
Mol Ecol ; 26(4): 977-994, 2017 02.
Article in English | MEDLINE | ID: mdl-27914203

ABSTRACT

Elucidating patterns of population structure for species with complex life histories, and disentangling the processes driving such patterns, remains a significant analytical challenge. Humpback whale (Megaptera novaeangliae) populations display complex genetic structures that have not been fully resolved at all spatial scales. We generated a data set of nuclear markers for 3575 samples spanning the seven breeding stocks and substocks found in the South Atlantic and western and northern Indian Oceans. For the total sample, and males and females separately, we assessed genetic diversity, tested for genetic differentiation between putative populations and isolation by distance, estimated the number of genetic clusters without a priori population information and estimated rates of gene flow using maximum-likelihood and Bayesian approaches. At the ocean basin scale, structure is governed by geographical distance (IBD P < 0.05) and female fidelity to breeding areas, in line with current understanding of the drivers of broadscale population structure. Consistent with previous studies, the Arabian Sea breeding stock was highly genetically differentiated (FST 0.034-0.161; P < 0.01 for all comparisons). However, the breeding stock boundary between west South Africa and east Africa was more porous than expected based on genetic differentiation, cluster and geneflow analyses. Instances of male fidelity to breeding areas and relatively high rates of dispersal for females were also observed between the three substocks in the western Indian Ocean. The relationships between demographic units and current management boundaries may have ramifications for assessments of the status and continued protections of populations still in recovery from commercial whaling.


Subject(s)
Gastrointestinal Microbiome , Humpback Whale , Lizards , Africa, Eastern , Africa, Western , Animals , Bayes Theorem , Female , Genetic Structures , Indian Ocean , Male , South Africa
11.
Sleep Med ; 121: 258-265, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39029304

ABSTRACT

BACKGROUND: Obstructive sleep apnea (OSA), due to its high prevalence, has been associated with a number of comorbidities, frequently impacting the overall course of these other diseases if left untreated. Recent studies highlight a potential association between OSA and cancer. This study investigates how OSA severity and hypoxia affect cancer prognosis, aiming to elucidate how they interplay. METHODS: Retrospective study including patients with a diagnosis of OSA after any cancer type followed up in a tertiary center during a 10-year period. OSA was mainly diagnosed after level III polysomnographic studies. RESULTS: Nocturnal hypoxia was significantly more prevalent in patients presenting lung cancer versus other malignancies and was associated with higher rates of oncologic disease progression. Overall survival was significantly lower in severe OSA patients and also in patients presenting nocturnal hypoxia. A composite hypoxia score considering both OSA severity and significant hypoxia was an independent predictor of mortality regardless of clinical cancer staging and treatment. Shorter time between cancer and OSA diagnosis was also associated with worse prognosis. CONCLUSION: This study suggests an association between OSA severity and nocturnal hypoxia and increased cancer mortality independently from possible confounding factors such as age, cancer clinical staging at diagnosis, treatment modality and also progression. Neoplastic patients with severe OSA and/or complex hypoxia seem to have lower overall survival rates than those with less severe OSA and nocturnal hypoxia.


Subject(s)
Hypoxia , Neoplasms , Polysomnography , Sleep Apnea, Obstructive , Humans , Sleep Apnea, Obstructive/mortality , Sleep Apnea, Obstructive/complications , Male , Female , Retrospective Studies , Hypoxia/mortality , Hypoxia/complications , Middle Aged , Neoplasms/mortality , Neoplasms/complications , Aged , Prognosis , Severity of Illness Index , Comorbidity , Prevalence , Disease Progression
12.
Sci Rep ; 14(1): 7354, 2024 03 28.
Article in English | MEDLINE | ID: mdl-38548769

ABSTRACT

Immune nutrition is currently used to enhance fish health by incorporating functional ingredients into aquafeeds. This study aimed to investigate the connections between tryptophan nutrition and the network that regulates the communication pathways between neuroendocrine and immune systems in European seabass (Dicentrarchus labrax). When tryptophan was supplemented in the diet of unstressed fish, it induced changes in the hypothalamic-pituitary-interrenal axis response to stress. Tryptophan-mediated effects were observed in the expression of anti-inflammatory cytokines and glucocorticoid receptors. Tryptophan supplementation decreased pro-opiomelanocortin b-like levels, that are related with adrenocorticotropic hormone and cortisol secretion. When stressed fish fed a tryptophan-supplemented diet were subjected to an inflammatory stimulus, plasma cortisol levels decreased and the expression of genes involved in the neuroendocrine response was altered. Modulatory effects of tryptophan dietary intervention on molecular patterns seem to be mediated by altered patterns in serotonergic activity.


Subject(s)
Hydrocortisone , Tryptophan , Animals , Tryptophan/metabolism , Dietary Supplements , Inflammation/genetics , Diet
13.
Cureus ; 16(2): e55200, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38558694

ABSTRACT

Albright's hereditary osteodystrophy is a rare hereditary disease due to a mutation of the complex guanine nucleotide-binding protein, alpha-stimulating activity polypeptide. This condition is commonly associated with type 1A and 1C pseudohypoparathyroidism and pseudo-pseudohypoparathyroidism due to resistance of parathyroid hormone. Patients present with specific characteristics such as brachydactyly, short stature, round facies, subcutaneous ossifications, developmental delay, and obesity, associated with hypocalcemia and hyperphosphatemia. This case presents a 55-year-old woman with short stature and neurocognitive impairment, who was admitted to the emergency department with acute decompensated heart and respiratory failure. On admission, hypocalcemia and hyperphosphatemia were noted, which in combination with the patient's clinical history led to an etiological investigation. This case stresses the importance of not only treating the acute disease but also looking at the patient and their clinical and analytical features to diagnose this disease and prevent its complications.

14.
Neurology ; 102(2): e208040, 2024 Jan 23.
Article in English | MEDLINE | ID: mdl-38165341

ABSTRACT

A 66-year-old man developed diplopia, ataxia, and right-hand dexterity loss. Brain MRI revealed T2-hyperintensities in the right cerebellar peduncles, pons, medulla, and cerebellum (Figure 1, A-D).


Subject(s)
Ataxia , Cerebellum , Male , Humans , Aged , Diplopia , Hand , Neuroimaging
15.
Endocrine ; 86(1): 409-416, 2024 Oct.
Article in English | MEDLINE | ID: mdl-38849646

ABSTRACT

PURPOSE: Pheochromocytoma is a rare neuroendocrine tumor. Despite the low incidence, these tumors are of indisputable importance. This study aimed to analyze the management of pheochromocytoma in a referral center, with an emphasis on the minimally invasive adrenalectomy, which is the preferred therapeutic approach. METHODS: A retrospective analysis was performed on a cohort of patients diagnosed with pheochromocytoma who underwent adrenalectomy between January 2013 and December 2022. Clinical data including demographics, timelines, symptomatology, comorbidities, biochemical markers, genetic testing, surgical details, and follow-up outcomes, were collected and analyzed. RESULTS: The cohort included 44 patients, predominantly women (52.27%), with a median age of 53.39 years (range 13-83). Most of patients exhibited paroxysmal symptoms suggesting catecholamine excess. Documented hypertension was the most frequent (86.36%), along with glucose anomalies (40.01%) and anxiety disorder (31.82%). Genetic testing was performed in 36 (81.81%) patients and 14 (38.88%) revealed a positive result, predominantly RET pathogenic variant. Laparoscopic surgery was performed in 34 (79.07%) patients, showing significantly shorter operative time (2.5 h vs. 4.25 h, t-test p < 0,001) and fewer complications (23.53% vs 77.78%, p = 0.008). Postoperative complications occurred in 36.36% of the patients, mostly mild (grade I, 56.25%), with no mortality. SDHB pathogenic variant correlated with both recurrent and metastatic disease (p = 0.006). One-year follow-up reported 9.09% recurrence and 6.82% metastasis. CONCLUSIONS: Adrenalectomy demonstrated a high safety and effectiveness. This study exhibited a higher rate of genetic testing referral than other studies. Despite past advances, there is still a need for further studies to establish protocols and evaluate new techniques.


Subject(s)
Adrenal Gland Neoplasms , Adrenalectomy , Pheochromocytoma , Humans , Pheochromocytoma/surgery , Female , Adrenalectomy/methods , Middle Aged , Male , Adrenal Gland Neoplasms/surgery , Adult , Aged , Retrospective Studies , Adolescent , Portugal/epidemiology , Young Adult , Aged, 80 and over , Treatment Outcome , Laparoscopy/methods
16.
Cureus ; 16(9): e69456, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39421103

ABSTRACT

Protamine sulfate is a standard agent used to reverse heparin anticoagulation during cardiovascular procedures such as coronary artery bypass grafting (CABG). Although rare, it can be associated with severe adverse reactions. We present a case of a 68-year-old male with type 2 diabetes, who was on insulin lispro protamine and underwent elective CABG. Shortly after protamine administration to reverse heparin during extracorporeal circulation (ECC), the patient experienced anaphylactic shock, manifesting as tachycardia, hypotension, facial flushing, periorbital edema, and elevated serum tryptase levels. Despite prompt treatment with volume resuscitation, epinephrine, and corticosteroids, the patient's condition remained unstable, necessitating a second period of ECC for additional bypass grafting. The case contributes to the clinical literature by providing an illustrative example of how protamine hypersensitivity can complicate postoperative recovery, emphasizing the importance of vigilance and comprehensive management strategies in preventing and addressing such reactions.

17.
IEEE Trans Biomed Eng ; 71(7): 2243-2252, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38376980

ABSTRACT

OBJECTIVE: This work explores Hall effect sensing paired with a permanent magnet, in the context of pulmonary rehabilitation exercise training. METHODS: Experimental evaluation was performed considering as reference the gold-standard of respiratory monitoring, an airflow transducer, and performance was compared to another wearable device with analogous usability - a piezoelectric sensor. A total of 16 healthy participants performed 15 activities, representative of pulmonary rehabilitation exercises, simultaneously using all devices. Evaluation was performed based on detection of flow reversal events and key respiratory parameters. RESULTS: Overall, the proposed sensor outperformed the piezoelectric sensor with a mean ratio, precision, and recall of 0.97, 0.97, and 0.95, respectively, against 0.98, 0.90, and 0.88. Evaluation regarding the respiratory parameters indicates an adequate accuracy when it comes to breath cycle, inspiration, and expiration times, with mean relative errors around 4% for breath cycle and 8% for inspiration/expiration times, despite some variability. Bland-Altman analysis indicates no systematic biases. CONCLUSION: Characterization of the proposed sensor shows adequate monitoring capabilities for exercises that do not rely heavily on torso mobility, but may present a limitation when it comes to activities such as side stretches. SIGNIFICANCE: This work provides a comprehensive characterization of a magnetic field-based respiration sensor, including a discussion on its robustness to different algorithm thresholds. It proves the viability of the sensor in a range of exercises, expanding the applicability of Hall effect sensors as a feasible wearable approach to real-time respiratory monitoring.


Subject(s)
Wearable Electronic Devices , Humans , Male , Adult , Female , Magnetic Fields , Monitoring, Physiologic/instrumentation , Monitoring, Physiologic/methods , Young Adult , Equipment Design , Signal Processing, Computer-Assisted/instrumentation
18.
Article in English | MEDLINE | ID: mdl-39012306

ABSTRACT

BACKGROUND: Overweight and obesity are major public health issues with increasing incidence and prevalence, affecting more than 50% of the population in developed countries. Due to its complex pathophysiology and multifactorial etiology, disease understanding, diagnostic approach and management remain suboptimal. Together with a structured nutritional intervention and physical activity plan, pharmacological treatment has the potential to magnify weight loss and health related benefits. Liraglutide is one of the most effective and frequently prescribed weight loss medication. Its efficacy and safety have been demonstrated in randomized clinical trials, however, real world data in Portugal is scarce. The authors report on the experience of a University Hospital Endocrine Clinic in the management of patients with overweight and obesity with liraglutide on top of lifestyle intervention. The aim of the study was to evaluate the effectiveness of liraglutide in the management of overweight and obesity. METHODS: Retrospective, longitudinal observational study. Inclusion criteria were adult patients (>18 years old) with obesity (BMI>30 kg/m2) or overweight (≥27 kg/m2) with at least one obesity related co-morbidity (hypertension, dyslipidemia, obstructive sleep apnea, non-alcoholic fatty liver disease) with at least three months of liraglutide treatment. Diabetes diagnosis and prior bariatric surgery were exclusion criteria. Demographic and clinical variables were included and weight was recorded before and after at least 3 months of liraglutide treatment. RESULTS: One hundred forty-eight patients (85.8% females) with a mean age of 48.7±11.9 years were treated with liraglutide. Mean baseline BMI was 33.8±5.2 kg/m2 and median follow-up was 13 months. At the last appointment, 85.8% were still taking liraglutide. Among patients still taking liraglutide, mean weight loss was 7.6 kg (7.9%), with significantly greater losses in patients treated for more than 6 months (8.6kg vs. 6.2 kg, P=0.016). Patients with obesity lost significantly more weight than overweight patients (8.3 kg vs. 4.5 kg, P=0.028), despite similar treatment duration. The reasons for liraglutide withdrawal were gastrointestinal intolerance (7), medication cost (2), inefficacy (10) and physician instructions (1). CONCLUSIONS: The present study documents the long-term efficacy of liraglutide in the treatment of patients with overweight and obesity, with a low rate of drug withdrawal. Mean weight loss was significant and more evident from the 6th month of treatment on. Liraglutide, along with lifestyle intervention, is a good option for weight management in the majority of patients with obesity.

19.
Sci Immunol ; 9(99): eadp0344, 2024 Sep 06.
Article in English | MEDLINE | ID: mdl-39241057

ABSTRACT

Langerhans cells (LCs) are distinct among phagocytes, functioning both as embryo-derived, tissue-resident macrophages in skin innervation and repair and as migrating professional antigen-presenting cells, a function classically assigned to dendritic cells (DCs). Here, we demonstrate that both intrinsic and extrinsic factors imprint this dual identity. Using ablation of embryo-derived LCs in the murine adult skin and tracking differentiation of incoming monocyte-derived replacements, we found intrinsic intraepidermal heterogeneity. We observed that ontogenically distinct monocytes give rise to LCs. Within the epidermis, Jagged-dependent activation of Notch signaling, likely within the hair follicle niche, provided an initial site of LC commitment before metabolic adaptation and survival of monocyte-derived LCs. In the human skin, embryo-derived LCs in newborns retained transcriptional evidence of their macrophage origin, but this was superseded by DC-like immune modules after postnatal expansion. Thus, adaptation to adult skin niches replicates conditioning of LC at birth, permitting repair of the embryo-derived LC network.


Subject(s)
Cell Differentiation , Langerhans Cells , Monocytes , Skin , Langerhans Cells/immunology , Langerhans Cells/cytology , Animals , Monocytes/immunology , Monocytes/cytology , Cell Differentiation/immunology , Humans , Skin/immunology , Skin/cytology , Mice , Mice, Inbred C57BL , Female
20.
Data Brief ; 53: 110145, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38370918

ABSTRACT

The MONITOOL project (2017-2023) was carried out to describe the relationships between total dissolved and labile metal concentrations measured in spot water samples and in concurrently deployed Diffusive Gradients in Thin-films (DGTs) passive samplers, respectively. The ultimate aim was to adapt existing marine metal Environmental Quality Standards (EQS marine water) for DGTs, enabling their use in the context of the European Directives (the Water Framework Directive (WFD) and the Marine Strategy Framework Directive (MSFD)). Time-integrated metal concentrations provided by DGTs, representing several days, are an advantage compared to conventional spot sampling, especially in highly dynamic systems, such as transitional waters. Hence, the MONITOOL project aimed to provide a robust database of dissolved and labile metal concentrations in transitional and coastal waters, based upon co-deployments of DGTs and collection of spot water samples at several sampling sites (England, France, Ireland, Italy, Northern Ireland, Portugal, Scotland and Spain), followed subsequently by DGT and water metal analysis. Samplings were carried out in 2018 and 2022, following agreed protocols developed in the framework of the project. The MONITOOL dataset includes metal concentrations from DGTs, measured with Inductively Coupled Plasma Mass Spectrometry (ICP-MS: Cd, Co, Cu, Fe, Mn, Ni, Pb, Zn) and in concurrently collected spot water samples by ICP-MS (Al, Cd, Co, Cu, Mn, Ni, Pb, Zn) and Anodic/Cathodic Stripping Voltammetry (ASV/CSV: Cd, Pb, Ni). Moreover, data on seawater physical-chemical parameters (salinity, temperature, dissolved oxygen, pH, turbidity, total suspended solids, dissolved organic carbon, and total organic carbon) is provided. This database presents the results obtained using, concurrently, different forms of sampling and analytical techniques, enabling the comparison of the results obtained by these strategies and allowing the adaptation of EQS in marine water (EQS marine water) to DGTs (EQS DGT), in the context of the WFD. Moreover, due to the large number of sampling sites, it could also be used for other types of research, such as those dealing with metal speciation or the determination of baseline levels.

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