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1.
Nature ; 619(7969): 311-316, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37438592

RESUMO

Coral reefs are losing the capacity to sustain their biological functions1. In addition to other well-known stressors, such as climatic change and overfishing1, plastic pollution is an emerging threat to coral reefs, spreading throughout reef food webs2, and increasing disease transmission and structural damage to reef organisms3. Although recognized as a global concern4, the distribution and quantity of plastics trapped in the world's coral reefs remains uncertain3. Here we survey 84 shallow and deep coral ecosystems at 25 locations across the Pacific, Atlantic and Indian ocean basins for anthropogenic macrodebris (pollution by human-generated objects larger than 5 centimetres, including plastics), performing 1,231 transects. Our results show anthropogenic debris in 77 out of the 84 reefs surveyed, including in some of Earth's most remote and near-pristine reefs, such as in uninhabited central Pacific atolls. Macroplastics represent 88% of the anthropogenic debris, and, like other debris types, peak in deeper reefs (mesophotic zones at 30-150 metres depth), with fishing activities as the main source of plastics in most areas. These findings contrast with the global pattern observed in other nearshore marine ecosystems, where macroplastic densities decrease with depth and are dominated by consumer items5. As the world moves towards a global treaty to tackle plastic pollution6, understanding its distribution and drivers provides key information to help to design the strategies needed to address this ubiquitous threat.


Assuntos
Recifes de Corais , Plásticos , Plásticos/efeitos adversos , Plásticos/análise , Cadeia Alimentar , Oceano Pacífico , Oceano Atlântico , Oceano Índico , Tamanho da Partícula , Atividades Humanas , Caça
2.
Nucleic Acids Res ; 51(W1): W198-W206, 2023 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-36987846

RESUMO

Proteins form complex interactions in the cellular environment to carry out their functions. They exhibit a wide range of binding modes depending on the cellular conditions, which result in a variety of ordered or disordered assemblies. To help rationalise the binding behavior of proteins, the FuzPred server predicts their sequence-based binding modes without specifying their binding partners. The binding mode defines whether the bound state is formed through a disorder-to-order transition resulting in a well-defined conformation, or through a disorder-to-disorder transition where the binding partners remain conformationally heterogeneous. To account for the context-dependent nature of the binding modes, the FuzPred method also estimates the multiplicity of binding modes, the likelihood of sampling multiple binding modes. Protein regions with a high multiplicity of binding modes may serve as regulatory sites or hot-spots for structural transitions in the assembly. To facilitate the interpretation of the predictions, protein regions with different interaction behaviors can be visualised on protein structures generated by AlphaFold. The FuzPred web server (https://fuzpred.bio.unipd.it) thus offers insights into the structural and dynamical changes of proteins upon interactions and contributes to development of structure-function relationships under a variety of cellular conditions.


Assuntos
Computadores , Proteínas , Conformação Proteica , Proteínas/química , Domínios Proteicos , Software
3.
Bioinformatics ; 39(12)2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-38060268

RESUMO

SUMMARY: The Local Disordered Region Sampling (LDRS, pronounced loaders) tool is a new module developed for IDPConformerGenerator, a previously validated approach to model intrinsically disordered proteins (IDPs). The IDPConformerGenerator LDRS module provides a method for generating all-atom conformations of intrinsically disordered protein regions at N- and C-termini of and in loops or linkers between folded regions of an existing protein structure. These disordered elements often lead to missing coordinates in experimental structures or low confidence in predicted structures. Requiring only a pre-existing PDB or mmCIF formatted structural template of the protein with missing coordinates or with predicted confidence scores and its full-length primary sequence, LDRS will automatically generate physically meaningful conformational ensembles of the missing flexible regions to complete the full-length protein. The capabilities of the LDRS tool of IDPConformerGenerator include modeling phosphorylation sites using enhanced Monte Carlo-Side Chain Entropy, transmembrane proteins within an all-atom bilayer, and multi-chain complexes. The modeling capacity of LDRS capitalizes on the modularity, the ability to be used as a library and via command-line, and the computational speed of the IDPConformerGenerator platform. AVAILABILITY AND IMPLEMENTATION: The LDRS module is part of the IDPConformerGenerator modeling suite, which can be downloaded from GitHub at https://github.com/julie-forman-kay-lab/IDPConformerGenerator. IDPConformerGenerator is written in Python3 and works on Linux, Microsoft Windows, and Mac OS versions that support DSSP. Users can utilize LDRS's Python API for scripting the same way they can use any part of IDPConformerGenerator's API, by importing functions from the "idpconfgen.ldrs_helper" library. Otherwise, LDRS can be used as a command line interface application within IDPConformerGenerator. Full documentation is available within the command-line interface as well as on IDPConformerGenerator's official documentation pages (https://idpconformergenerator.readthedocs.io/en/latest/).


Assuntos
Proteínas Intrinsicamente Desordenadas , Software , Biblioteca Gênica , Proteínas de Membrana , Documentação
5.
Dig Dis Sci ; 2024 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-39215868

RESUMO

BACKGROUND: Data to guide dialysis decision-making for transplant-ineligible patients with cirrhosis are lacking. AIMS: We aimed to describe the processes, predictors, and outcomes of renal replacement therapy (RRT) initiation for transplant-ineligible patients with cirrhosis at a single liver transplantation center. METHODS: We conducted a mixed-methods study of a retrospective cohort of 372 transplant-ineligible inpatients with cirrhosis with acute kidney injury (AKI) due to hepatorenal syndrome (HRS-AKI) or acute tubular necrosis (ATN) between 2008 and 2015. We performed survival analyses to evaluate 6-month survival and renal recovery and examined end-of-life care outcomes. We used a consensus-driven medical record review to characterize processes leading to RRT initiation. RESULTS: We identified 266 (71.5%) patients who received RRT and 106 (28.5%) who did not receive RRT (non-RRT). Median survival was 12.5 days (RRT) vs. 2.0 days (non-RRT) (HR 0.36, 95%CI 0.28-0.46); 6-month survival was 15% (RRT) vs. 0% (non-RRT). RRT patients were more likely to die in the intensive care unit (88% vs. 32%, p < 0.001). HRS-AKI patients were more likely to be RRT dependent at 6 months than ATN patients (86% vs. 27%, p = 0.007). The most common reasons for RRT initiation were unclear etiology of AKI on presentation (32%) and belief of likely reversibility of ATN (82%). CONCLUSION: Most transplant-ineligible patients who were initiated on RRT experienced very short-term mortality and received intensive end-of-life care. However, approximately 1 in 6 were alive at 6 months. Our findings underscore the critical need for structured clinical processes to support high-quality serious illness communication and RRT decision-making for this population.

6.
Contact Dermatitis ; 2024 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-39233520

RESUMO

BACKGROUND: Existing literature has questioned the sensitivity of patch testing (PT) with cotrimoxazole (CTX) in the study of drug hypersensitivity. OBJECTIVES: Assess the sensitivity of PT with CTX in non-immediate cutaneous adverse drug reactions (CADR). PATIENTS/MATERIALS/METHODS: Retrospective analysis (2000-2022) of PT with an antibiotic series including CTX 10% pet (Chemotechnique Diagnostics©) performed according to ESCD guidelines in patients with suspected non-immediate CADR reactions to CTX. Some patients were additionally tested with in-house preparations of CTX from Bactrim DS® tablets at 10% in pet or water and trimethoprim 10% pet (Laboratórios Edol©). RESULTS: Sixty-four patients (48F/16M; mean age 47 ± 18) were included, mostly with maculopapular exanthema (51, 80%). Notably, CTX was sole suspect in 24 patients. There was no positive reaction to CTX at 10% from Chemotechnique or Bactrim DS® tablets prepared at 10% pet for patch testing. One patient reacted exclusively to trimethoprim with 1+ reaction. Two patients had a faint reaction (1+) only with the powder of Bactrim DS® tablets in water at D2, but as the reactions faded completely in 24 or 48 h, they were interpreted as irritant non-specific reactions. CONCLUSION: These findings suggest that patch testing may lack sufficient sensitivity to diagnose CTX-induced non-immediate CADR. Therefore, clinicians should be cautious interpreting CTX patch test results.

7.
Proc Natl Acad Sci U S A ; 118(10)2021 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-33608481

RESUMO

The current rate of species extinction is rapidly approaching unprecedented highs, and life on Earth presently faces a sixth mass extinction event driven by anthropogenic activity, climate change, and ecological collapse. The field of conservation genetics aims at preserving species by using their levels of genetic diversity, usually measured as neutral genome-wide diversity, as a barometer for evaluating population health and extinction risk. A fundamental assumption is that higher levels of genetic diversity lead to an increase in fitness and long-term survival of a species. Here, we argue against the perceived importance of neutral genetic diversity for the conservation of wild populations and species. We demonstrate that no simple general relationship exists between neutral genetic diversity and the risk of species extinction. Instead, a better understanding of the properties of functional genetic diversity, demographic history, and ecological relationships is necessary for developing and implementing effective conservation genetic strategies.


Assuntos
Variação Genética , Genoma , Endogamia , Modelos Genéticos , Animais , Genética Populacional
8.
Pediatr Dermatol ; 41(3): 556-557, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38556801

RESUMO

Lymphoplasmocytic plaque in children (LPC) is a rare and distinctive skin disorder primarily affecting the pediatric population. Characterized by its unique histopathological features, the condition manifests as well-defined plaques with a predominance of lymphocytes and plasma cells infiltrating the dermis. Despite its limited prevalence, recognizing this entity is crucial for accurate diagnosis and appropriate management of affected patients. We report the case of a 10-year-old male presenting with LPC in the extensor surface of the upper arm, a rarely reported location, treated with both topical and intralesional corticosteroids resulting in partial improvement.


Assuntos
Dermatopatias , Humanos , Masculino , Criança , Dermatopatias/patologia , Dermatopatias/diagnóstico , Dermatopatias/tratamento farmacológico , Linfócitos/patologia , Braço/patologia , Plasmócitos/patologia
9.
Molecules ; 29(15)2024 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-39124938

RESUMO

Citrus medica L. is a traditional citrus fruit that is rich in bioactive compounds and has the potential to be used as a natural source of food additives. This study aims to evaluate the antioxidant capacity and characterize the phenolic compounds present in the peels (including flavedo and albedo), pulp, and seeds of citron. The results showed that, compared to the other parts, the pulp had a substantially higher Antioxidant Activity Coefficient (AAC) of 168.2. The albedo and the seeds had significantly lower AAC values, while the green and yellow flavedo showed noteworthy results. O-coumaric acid was the predominant phenolic acid in all of the citron fractions; it was found in the highest concentration in albedo (37.54 µg/g FW). Flavanones and flavanols were the primary flavonoids in the pulp, peel, and seeds, with total flavonoid concentration ranging from ~9 µg/g FW in seeds to 508 µg/g FW in the pulp. This research offers significant insights into the antioxidant properties of this ancient fruit, emphasizing its potential applications as a natural source of antioxidants to be used in different applications.


Assuntos
Antioxidantes , Citrus , Flavonoides , Frutas , Fenóis , Extratos Vegetais , Sementes , Citrus/química , Antioxidantes/química , Antioxidantes/farmacologia , Fenóis/análise , Fenóis/química , Sementes/química , Frutas/química , Flavonoides/análise , Flavonoides/química , Extratos Vegetais/química
10.
Entropy (Basel) ; 26(8)2024 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-39202104

RESUMO

Deep learning approaches have been gaining importance in several applications. However, the widespread use of these methods in safety-critical domains, such as Autonomous Driving, is still dependent on their reliability and trustworthiness. The goal of this paper is to provide a review of deep learning-based uncertainty methods and their applications to support perception tasks for Autonomous Driving. We detail significant Uncertainty Quantification and calibration methods, and their contributions and limitations, as well as important metrics and concepts. We present an overview of the state of the art of out-of-distribution detection and active learning, where uncertainty estimates are commonly applied. We show how these methods have been applied in the automotive context, providing a comprehensive analysis of reliable AI for Autonomous Driving. Finally, challenges and opportunities for future work are discussed for each topic.

11.
Proteins ; 91(12): 1658-1683, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37905971

RESUMO

We present the results for CAPRI Round 54, the 5th joint CASP-CAPRI protein assembly prediction challenge. The Round offered 37 targets, including 14 homodimers, 3 homo-trimers, 13 heterodimers including 3 antibody-antigen complexes, and 7 large assemblies. On average ~70 CASP and CAPRI predictor groups, including more than 20 automatics servers, submitted models for each target. A total of 21 941 models submitted by these groups and by 15 CAPRI scorer groups were evaluated using the CAPRI model quality measures and the DockQ score consolidating these measures. The prediction performance was quantified by a weighted score based on the number of models of acceptable quality or higher submitted by each group among their five best models. Results show substantial progress achieved across a significant fraction of the 60+ participating groups. High-quality models were produced for about 40% of the targets compared to 8% two years earlier. This remarkable improvement is due to the wide use of the AlphaFold2 and AlphaFold2-Multimer software and the confidence metrics they provide. Notably, expanded sampling of candidate solutions by manipulating these deep learning inference engines, enriching multiple sequence alignments, or integration of advanced modeling tools, enabled top performing groups to exceed the performance of a standard AlphaFold2-Multimer version used as a yard stick. This notwithstanding, performance remained poor for complexes with antibodies and nanobodies, where evolutionary relationships between the binding partners are lacking, and for complexes featuring conformational flexibility, clearly indicating that the prediction of protein complexes remains a challenging problem.


Assuntos
Algoritmos , Mapeamento de Interação de Proteínas , Mapeamento de Interação de Proteínas/métodos , Conformação Proteica , Ligação Proteica , Simulação de Acoplamento Molecular , Biologia Computacional/métodos , Software
12.
Cogn Affect Behav Neurosci ; 23(3): 522-542, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37173606

RESUMO

Risk and uncertainty are central concepts of decision neuroscience. However, a comprehensive review of the literature shows that most studies define risk and uncertainty in an unclear fashion or use both terms interchangeably, which hinders the integration of the existing findings. We suggest uncertainty as an umbrella term that comprises scenarios characterized by outcome variance where relevant information about the type and likelihood of outcomes may be somewhat unavailable (ambiguity) and scenarios where the likelihood of outcomes is known (risk).These conceptual issues are problematic for studies on the temporal neurodynamics of decision-making under risk and ambiguity, because they lead to heterogeneity in task design and the interpretation of the results. To assess this problem, we conducted a state-of-the-art review of ERP studies on risk and ambiguity in decision-making. By employing the above definitions to 16 reviewed studies, our results suggest that: (a) research has focused more on risk than ambiguity processing; (b) studies assessing decision-making under risk often implemented descriptive-based paradigms, whereas studies assessing ambiguity processing equally implemented descriptive- and experience-based tasks; (c) descriptive-based studies link risk processing to increased frontal negativities (e.g., N2, N400) and both risk and ambiguity to reduced parietal positivities (e.g., P2, P3); (d) experience-based studies link risk to increased P3 amplitudes and ambiguity to increased frontal negativities and the LPC component; (e) both risk and ambiguity processing seem to be related with cognitive control, conflict monitoring, and increased cognitive demand; (f) further research and improved tasks are needed to dissociate risk and ambiguity processing.

13.
Mutagenesis ; 38(5): 283-294, 2023 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-37228081

RESUMO

The comet assay is a simple and versatile method for measurement of DNA damage in eukaryotic cells. More specifically, the assay detects DNA migration from agarose gel-embedded nucleoids, which depends on assay conditions and the level of DNA damage. Certain steps in the comet assay procedure have substantial impact on the magnitude of DNA migration (e.g. electric potential and time of electrophoresis). Inter-laboratory variation in DNA migration levels occurs because there is no agreement on optimal assay conditions or suitable assay controls. The purpose of the hCOMET ring trial was to test potassium bromate (KBrO3) as a positive control for the formamidopyrimidine DNA glycosylase (Fpg)-modified comet assay. To this end, participating laboratories used semi-standardized protocols for cell culture (i.e. cell culture, KBrO3 exposure, and cryopreservation of cells) and comet assay procedures, whereas the data acquisition was not standardized (i.e. staining of comets and image analysis). Segregation of the total variation into partial standard deviation (SD) in % Tail DNA units indicates the importance of cell culture procedures (SD = 10.9), comet assay procedures (SD = 12.3), staining (SD = 7.9) and image analysis (SD = 0.5) on the overall inter-laboratory variation of DNA migration (SD = 18.2). Future studies should assess sources of variation in each of these steps. On the positive side, the hCOMET ring trial demonstrates that KBrO3 is a robust positive control for the Fpg-modified comet assay. In conclusion, the hCOMET ring trial has demonstrated a high reproducibility of detecting genotoxic effects by the comet assay, but inter-laboratory variation of DNA migration levels is a concern.

14.
Mutagenesis ; 38(5): 273-282, 2023 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-37357800

RESUMO

The comet assay is widely used in biomonitoring studies for the analysis of DNA damage in leukocytes and peripheral blood mononuclear cells. Rather than processing blood samples directly, it can be desirable to cryopreserve whole blood or isolated cells for later analysis by the comet assay. However, this creates concern about artificial accumulation of DNA damage during cryopreservation. In this study, 10 laboratories used standardized cryopreservation and thawing procedures of monocytic (THP-1) or lymphocytic (TK6) cells. Samples were cryopreserved in small aliquots in 50% foetal bovine serum, 40% cell culture medium, and 10% dimethyl sulphoxide. Subsequently, cryopreserved samples were analysed by the standard comet assay on three occasions over a 3-year period. Levels of DNA strand breaks in THP-1 cells were increased (four laboratories), unaltered (four laboratories), or decreased (two laboratories) by long-term storage. Pooled analysis indicates only a modest positive association between storage time and levels of DNA strand breaks in THP-1 cells (0.37% Tail DNA per year, 95% confidence interval: -0.05, 0.78). In contrast, DNA strand break levels were not increased by cryopreservation in TK6 cells. There was inter-laboratory variation in levels of DNA strand breaks in THP-1 cells (SD = 3.7% Tail DNA) and TK6 reference sample cells (SD = 9.4% Tail DNA), whereas the intra-laboratory residual variation was substantially smaller (i.e. SD = 0.4%-2.2% Tail DNA in laboratories with the smallest and largest variation). In conclusion, the study shows that accumulation of DNA strand breaks in cryopreserved mononuclear blood cell lines is not a matter of concern.


Assuntos
Dano ao DNA , Leucócitos Mononucleares , Ensaio Cometa/métodos , Leucócitos Mononucleares/metabolismo , Criopreservação/métodos , DNA/metabolismo
15.
Mutagenesis ; 38(5): 264-272, 2023 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-37357815

RESUMO

The formamidopyrimidine DNA glycosylase (Fpg)-modified comet assay is widely used for the measurement of oxidatively generated damage to DNA. However, there has not been a recommended long-term positive control for this version of the comet assay. We have investigated potassium bromate as a positive control for the Fpg-modified comet assay because it generates many Fpg-sensitive sites with a little concurrent generation of DNA strand breaks. Eight laboratories used the same procedure for the treatment of monocytic THP-1 cells with potassium bromate (0, 0.5, 1.5, and 4.5 mM) and subsequent cryopreservation in a freezing medium consisting of 50% foetal bovine serum, 40% RPMI-1640 medium, and 10% dimethyl sulphoxide. The samples were analysed by the Fpg-modified comet assay three times over a 3-year period. All laboratories obtained a positive concentration-response relationship in cryopreserved samples (linear regression coefficients ranging from 0.79 to 0.99). However, there was a wide difference in the levels of Fpg-sensitive sites between the laboratory with the lowest (4.2% Tail DNA) and highest (74% Tail DNA) values in THP-1 cells after exposure to 4.5 mM KBrO3. In an attempt to assess sources of inter-laboratory variation in Fpg-sensitive sites, comet images from one experiment in each laboratory were forwarded to a central laboratory for visual scoring. There was high consistency between measurements of %Tail DNA values in each laboratory and the visual score of the same comets done in the central laboratory (r = 0.98, P < 0.001, linear regression). In conclusion, the results show that potassium bromate is a suitable positive comet assay control.

16.
Mutagenesis ; 38(5): 253-263, 2023 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-37233347

RESUMO

Measurement of DNA migration in the comet assay can be done by image analysis or visual scoring. The latter accounts for 20%-25% of the published comet assay results. Here we assess the intra- and inter-investigator variability in visual scoring of comets. We include three training sets of comet images, which can be used as reference for researchers who wish to use visual scoring of comets. Investigators in 11 different laboratories scored the comet images using a five-class scoring system. There is inter-investigator variation in the three training sets of comets (i.e. coefficient of variation (CV) = 9.7%, 19.8%, and 15.2% in training sets I-III, respectively). However, there is also a positive correlation of inter-investigator scoring in the three training sets (r = 0.60). Overall, 36% of the variation is attributed to inter-investigator variation and 64% stems from intra-investigator variation in scoring between comets (i.e. the comets in training sets I-III look slightly different and this gives rise to heterogeneity in scoring). Intra-investigator variation in scoring was also assessed by repeated analysis of the training sets by the same investigator. There was larger variation when the training sets were scored over a period of six months (CV = 5.9%-9.6%) as compared to 1 week (CV = 1.3%-6.1%). A subsequent study revealed a high inter-investigator variation when premade slides, prepared in a central laboratory, were stained and scored by investigators in different laboratories (CV = 105% and 18%-20% in premade slides with comets from unexposed and hydrogen peroxide-exposed cells, respectively). The results indicate that further standardization of visual scoring is desirable. Nevertheless, the analysis demonstrates that visual scoring is a reliable way of analysing DNA migration in comets.

17.
J Toxicol Environ Health B Crit Rev ; 26(2): 67-96, 2023 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-36692141

RESUMO

Several studies have been conducted to address the potential adverse health risks attributed to exposure to nanoscale materials. While in vivo studies are fundamental for identifying the relationship between dose and occurrence of adverse effects, in vitro model systems provide important information regarding the mechanism(s) of action at the molecular level. With a special focus on exposure to inhaled (nano)particulate material toxicity assessment, this review provides an overview of the available human respiratory models and exposure systems for in vitro testing, advantages, limitations, and existing investigations using models of different complexity. A brief overview of the human respiratory system, pathway and fate of inhaled (nano)particles is also presented.


Assuntos
Nanopartículas , Sistema Respiratório , Humanos , Poeira , Exposição por Inalação/efeitos adversos , Nanopartículas/toxicidade
18.
J Chem Phys ; 158(17)2023 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-37144719

RESUMO

The structural characterization of proteins with a disorder requires a computational approach backed by experiments to model their diverse and dynamic structural ensembles. The selection of conformational ensembles consistent with solution experiments of disordered proteins highly depends on the initial pool of conformers, with currently available tools limited by conformational sampling. We have developed a Generative Recurrent Neural Network (GRNN) that uses supervised learning to bias the probability distributions of torsions to take advantage of experimental data types such as nuclear magnetic resonance J-couplings, nuclear Overhauser effects, and paramagnetic resonance enhancements. We show that updating the generative model parameters according to the reward feedback on the basis of the agreement between experimental data and probabilistic selection of torsions from learned distributions provides an alternative to existing approaches that simply reweight conformers of a static structural pool for disordered proteins. Instead, the biased GRNN, DynamICE, learns to physically change the conformations of the underlying pool of the disordered protein to those that better agree with experiments.


Assuntos
Proteínas Intrinsicamente Desordenadas , Proteínas , Ressonância Magnética Nuclear Biomolecular , Proteínas/química , Espectroscopia de Ressonância Magnética , Conformação Proteica , Proteínas Intrinsicamente Desordenadas/química
19.
Gerontology ; 69(6): 684-693, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36538907

RESUMO

INTRODUCTION: Immunosenescence and inflammaging have been implicated in the pathophysiology of frailty. Torquetenovirus (TTV), a single-stranded DNA anellovirus, the major component of the human blood virome, shows an increased replication rate with advancing age. An elevated TTV viremia has been associated with an impaired immune function and an increased risk of mortality in the older population. The objective of this study was to analyze the relation between TTV viremia, physical frailty, and cognitive impairment. METHODS: TTV viremia was measured in 1,131 nonfrail, 45 physically frail, and 113 cognitively impaired older adults recruited in the MARK-AGE study (overall mean age 64.7 ± 5.9 years), and then the results were checked in two other independent cohorts from Spain and Portugal, including 126 frail, 252 prefrail, and 141 nonfrail individuals (overall mean age: 77.5 ± 8.3 years). RESULTS: TTV viremia ≥4log was associated with physical frailty (OR: 4.69; 95% CI: 2.06-10.67, p < 0.0001) and cognitive impairment (OR: 3.49, 95% CI: 2.14-5.69, p < 0.0001) in the MARK-AGE population. The association between TTV DNA load and frailty status was confirmed in the Spanish cohort, while a slight association with cognitive impairment was observed (OR: 1.33; 95% CI: 1.000-1.773), only in the unadjusted model. No association between TTV load and frailty or cognitive impairment was found in the Portuguese sample, although a negative association between TTV viremia and MMSE score was observed in Spanish and Portuguese females. CONCLUSIONS: These findings demonstrate an association between TTV viremia and physical frailty, while the association with cognitive impairment was observed only in the younger population from the MARK-AGE study. Further research is necessary to clarify TTV's clinical relevance in the onset and progression of frailty and cognitive decline in older individuals.


Assuntos
Disfunção Cognitiva , Fragilidade , Torque teno virus , Feminino , Idoso , Humanos , Idoso de 80 Anos ou mais , Fragilidade/epidemiologia , Torque teno virus/fisiologia , Viremia/complicações , Idoso Fragilizado/psicologia , Avaliação Geriátrica , Disfunção Cognitiva/complicações , Disfunção Cognitiva/epidemiologia
20.
J Tissue Viability ; 32(2): 179-187, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36792441

RESUMO

AIM: To develop a systematic review on the prevalence and the incidence of pressure ulcers/injuries in adult patients in hospital emergency services. MATERIALS AND METHODS: Systematic review of prevalence and incidence studies developed according to the Preferred Reporting Items Form Systematic Review and Meta-Analysis Protocols and the Joanna Briggs Institute methodology. The inclusion criteria were based on the CoCoPop mnemonic. The main variables of interest were the "prevalence" and/or the "incidence" of "pressure ulcers/injuries" (Condition) reported in studies developed in hospital emergency services (Context) with adult participants (Population). The Systematic Review Protocol was registered in PROSPERO (CDR42021252906). RESULTS: The pressure ulcer/injury (point) prevalence ranged from 5.2% (at admission) to 12.3% (at discharge) and the pressure ulcer/injury incidence ranged from 4.5% to 78.4%. Most of the pressure ulcers/injuries documented were category/stage I. The most problematic anatomical locations were the sacrococcygeal region and the heels. The preventive measures should be implemented as soon as possible and are important in patients older than 75 years, with multiple comorbidities, high C-Reative Protein levels, cervical spine immobilization, presented to hospital emergency service by ambulance or with hypotension at the time of admission. CONCLUSIONS: The prevalence and incidence of pressure ulcers/injuries in hospital emergency services remains an understudied topic which could limit the generalization of our data. This systematic review highlighted that the management of pressure ulcers/injuries is a real and current challenge in hospital emergency services. It is important to identify the patients at (higher) risk to establish an (earlier) preventive care plan according to patients and emergency services' characteristics.


Assuntos
Lesões por Esmagamento , Úlcera por Pressão , Adulto , Humanos , Estudos de Coortes , Lesões por Esmagamento/complicações , Serviço Hospitalar de Emergência , Hospitalização , Úlcera por Pressão/prevenção & controle
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