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1.
Cureus ; 16(4): e58150, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38741819

ABSTRACT

Objective The objective of the study was to evaluate the use of the hepatospecific contrast agent, gadoxetic acid, for MRI in patients at a high-complexity hospital in Medellin, Colombia, from 2016 to 2022. Materials and methods This was an observational, descriptive, and retrospective cross-sectional study involving patients who had undergone MRI with gadoxetic acid from February 2016 to January 2022. The MRI studies were interpreted by two radiologists specializing in body imaging, each with at least 10 years of experience. The medical records of the identified patients were reviewed. Quantitative variables were presented using either means and standard deviations or medians and interquartile ranges, depending on the distribution of the variables. Qualitative variables were represented through absolute and relative frequencies. Results A total of 100 pharmacy records were collected, leading to a final sample of 75 patients aged between three and 91 years. The primary reason for imaging was to assess focal liver lesions in 58 patients (77.3%), with bile duct injury being the second most common indication in 16 patients (21.3%). A diagnostic alteration was noted in 69.3% of cases (52 patients). Among the 58 focal liver lesions analyzed using a hepatospecific agent, 31 cases (53.4%) were diagnosed as focal nodular hyperplasia. Conclusion Our study reinforces the clinical value of gadoxetic acid-enhanced MRI in refining diagnostic assessments, particularly in cases involving bile duct and focal hepatic lesions.

2.
Cureus ; 16(3): e55351, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38559534

ABSTRACT

Anastomosing hemangioma is a rare and benign subtype of capillary hemangioma, a soft tissue tumor. It tends to be asymptomatic, causes abdominal pain and hematuria, and is more common in the genitourinary tract. It can be confused with paragangliomas or ectopic pheochromocytomas. Pathology shares characteristics with angiosarcoma, particularly in well-differentiated areas. Diagnosis without a surgical specimen is difficult and is based on clinical characteristics, laboratories, and imaging behavior similar to hemangiomas in other locations. When in doubt, a diagnosis can be supported by a percutaneous biopsy. The prognosis is good, without relapses or metastases. Early identification with follow-up can avoid surgical interventions.

3.
Cureus ; 16(3): e56475, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38638706

ABSTRACT

OBJECTIVE: This study aimed to determine the diagnostic performance of contrasted magnetic resonance cholangiography for detecting bile duct lesions following cholecystectomy. MATERIALS AND METHODS: A retrospective case series study was conducted that included patients over 18 years of age with suspected bile duct injury after cholecystectomy, who underwent contrasted magnetic resonance cholangiography, and who also had endoscopic retrograde cholangiopancreatography, surgery, or subsequent clinical follow-up. The images were interpreted by two radiologists who assigned the type of lesion according to the Strasberg classification. Qualitative variables were represented by frequencies and proportions, while quantitative variables were described using measures of central tendency and dispersion. Sensitivity, specificity, and predictive values were assessed, along with interobserver variability, using the kappa index. RESULTS: We included 20 patients with a median age of 51.5 years (interquartile range: 35), and 14 (70%) were women. In all 20 patients, lesions were identified on magnetic resonance cholangiography, of which 19 were confirmed with the gold standard for a positive predictive value of 100% (hepatobiliary-specific contrast agents) and 92% (extracellular contrast). The most frequent lesions were Strasberg E2 and E4 in five patients each. The kappa index was 1 in determining the presence or absence of bile duct injury and 0.9 in the Strasberg classification. CONCLUSION: Contrasted magnetic resonance cholangiography is a method with high positive predictive value and almost perfect interobserver agreement for diagnosing bile duct lesions after cholecystectomy.

4.
Cureus ; 16(2): e54884, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38533151

ABSTRACT

Brown adipose tissue represents about 1% of the adult body mass and decreases with age. Under variable circumstances, this amount changes, for example, with age or environmental conditions. Pathological states with hypersecretion of catecholamines can induce hypertrophy and hyperplasia in mature brown adipocytes. Consequently, this response can have imaging representation as pseudonodules, a pitfall in imaging interpretation, and may be confused with neoplastic involvement. A case of pheochromocytoma with brown fat stimulation and catecholamine cardiomyopathy is presented.

5.
Cureus ; 16(2): e54672, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38523932

ABSTRACT

The endovascular treatment of acute lower limb ischemia associated with cocaine use is an underexplored topic. This scoping review aims to map existing information and point out potential knowledge gaps for future research. We searched databases with a strategy of terms and keywords (Cocaine, Acute, Lower Limb, and Ischemia) for articles related to acute ischemia in the lower limbs and cocaine use. We established eligibility and exclusion criteria and searched without restrictions on language or date of publication. We obtained five case reports published between 2004 and 2015. Most of the patients were men with an average age of 38 years. Treatments were heterogeneous. Most patients showed improvement after surgical thrombectomy. The sample size and variety of interventions limit the generalizability of the results, so it is necessary to do more studies with robust methodologies to standardize treatments and improve the understanding of the condition.

6.
Article in English | MEDLINE | ID: mdl-38317457

ABSTRACT

BACKGROUND: Clinical variability among individuals with heterozygous pathogenic/likely pathogenic (P/LP) variants in the COL4A3/COL4A4 genes (also called autosomal dominant Alport syndrome or COL4A3/COL4A4 related disorder) is huge; many individuals are asymptomatic or show microhematuria, while others may develop proteinuria and chronic kidney disease (CKD). The prevalence of simple kidney cysts (KC) in the general population varies according to age, and patients with advanced CKD are prone to have them. A possible association between heterozygous COL4A3, COL4A4, and COL4A5 P/LP variants and KC has been described in small cohorts. The presence of KC in a multicenter cohort of individuals with heterozygous P/LP variants in the COL4A3/COL4A4 genes is assessed in this study. METHODS: We evaluated the presence of KC by ultrasound in 157 individuals with P/LP variants in COL4A3 (40.7%) or COL4A4 (53.5%) without kidney replacement therapy. The association between presence of KC and age, proteinuria, eGFR, and causative gene was analyzed. Prevalence of KC was compared with historical case series in the general population. RESULTS: Half of the individuals with P/LP variants in COL4A3/COL4A4 showed KC, which is a significantly higher percentage than in the general population. Only 3.8% (6/157) had cystic nephromegaly. Age and eGFR showed an association with the presence of KC (p<0.001). No association was found between KC and proteinuria, sex, or causative gene. CONCLUSIONS: Individuals with COL4A3/COL4A4 P/LP variants are prone to develop KC more frequently than the general population, and their presence is related to age and to eGFR. Neither proteinuria, sex nor the causative gene influences the presence of KC in these individuals.

7.
Astrobiology ; 23(8): 846-861, 2023 08.
Article in English | MEDLINE | ID: mdl-37192487

ABSTRACT

The Sample Tubes on the Mars 2020 Perseverance rover were required to meet strict cleanliness standards for possible organic and inorganic contamination introduction to collected samples. There were also strict planetary protection cleanliness standards required to limit possible biological contamination. Together, these sets of standards also applied to associated hardware, like the Sample Tube hermetic seals. This created unique challenges to manufacturing, cleaning, and verifying the final cleanliness state of the Sample Tubes, which are the main focus of this publication. Documenting the final cleanliness state of the Sample Tubes is critical for future analysis of collected martian samples, of significant interest to the scientific community, and will have implications for possible future missions like Mars Sample Return. An accounting of events that led to the final delivered state of the Sample Tubes on Earth with regard to contamination control cleanliness requirements, precision cleaning, processing, and verification are provided.


Subject(s)
Mars , Space Flight , Extraterrestrial Environment , Spacecraft , Exobiology , Containment of Biohazards
8.
Clin Kidney J ; 16(4): 735-744, 2023 Apr.
Article in English | MEDLINE | ID: mdl-37007697

ABSTRACT

Background: Kt/Vurea is the most used marker to estimate dialysis adequacy; however, it does not reflect the removal of many other uraemic toxins, and a new approach is needed. We have assessed the feasibility of estimating intradialytic serum time-averaged concentration (TAC) of various uraemic toxins from their spent dialysate concentrations that can be estimated non-invasively online with optical methods. Methods: Serum and spent dialysate levels and total removed solute (TRS) of urea, uric acid (UA), indoxyl sulphate (IS) and ß2-microglobulin (ß2M) were evaluated with laboratory methods during 312 haemodialysis sessions in 78 patients with four different dialysis treatment settings. TAC was calculated from serum concentrations and evaluated from TRS and logarithmic mean concentrations of spent dialysate (MlnD). Results: Mean (± standard deviation) intradialytic serum TAC values of urea, UA, ß2M and IS were 10.4 ± 3.8 mmol/L, 191.6 ± 48.1 µmol/L, 13.3 ± 4.3 mg/L and 82.9 ± 43.3 µmol/L, respectively. These serum TAC values were similar and highly correlated with those estimated from TRS [10.5 ± 3.6 mmol/L (R 2 = 0.92), 191.5 ± 42.8 µmol/L (R 2 = 0.79), 13.0 ± 3.2 mg/L (R 2 = 0.59) and 82.7 ± 40.0 µmol/L (R 2 = 0.85)] and from MlnD [10.7 ± 3.7 mmol/L (R 2 = 0.92), 191.6 ± 43.8 µmol/L (R 2 = 0.80), 12.9 ± 3.2 mg/L (R 2 = 0.63) and 82.2 ± 38.6 µmol/L (R 2 = 0.84)], respectively. Conclusions: Intradialytic serum TAC of different uraemic toxins can be estimated non-invasively from their concentration in spent dialysate. This sets the stage for TAC estimation from online optical monitoring of spent dialysate concentrations of diverse solutes and for further optimization of estimation models for each uraemic toxin.

10.
Nucl Med Commun ; 43(12): 1163-1170, 2022 Dec 01.
Article in English | MEDLINE | ID: mdl-36266992

ABSTRACT

Cardiovascular diseases (CVDs) are the leading cause of mortality in Latin America and the Caribbean (LAC), with the risk in men being slightly higher than in women. The coronavirus disease 2019 (COVID-19) pandemic caused a significant reduction in the number of cardiac diagnostic procedures globally and in particular in LAC. Nuclear cardiology is available in the region, but there is variability in terms of existing technology, radiopharmaceuticals, and human resources. In the region, there are 2385 single photon emission computed tomography (SPECT) and 315 PET scanners, Argentina and Brazil have the largest number. There is an increasing number of new technologies such as cadmium-zinc-telluride (CZT) cardiac-dedicated gamma cameras, SPECT/computed tomography (CT), and PET/CT. All countries performed myocardial perfusion imaging studies, mainly gated-SPECT; the rest are multi-gated acquisition, mainly for cardiac toxicity; detection of viability; rest gated SPECT in patients with dilated cardiomyopathy, and bone-avid tracer cardiac scintigraphy for transthyretin cardiac amyloidosis diagnosis. Regarding other non-nuclear cardiac imaging modalities, Argentina, Colombia, and Chile have the highest ratio of CT scanners, while Brazil, Argentina, and Chile show the highest ratio of MRI scanners. The development of nuclear cardiology and other advanced imaging modalities is challenged by the high cost of equipment, lack of equipment maintenance and service, insufficient-specific training both for imaging specialists and referring clinicians, and lack of awareness of cardiologists or other referring physicians on the clinical applications of nuclear cardiology. Another important aspect to consider is the necessity of implementing cardiac imaging multimodality training. A joint work of nuclear medicine specialists, radiologists, cardiologists, and clinicians, in general, is mandatory to achieve this goal. National, regional, and international cooperation including support from scientific professional societies such as the American Society of Nuclear Cardiology and Latin American Association of Biology and Nuclear Medicine Societies, cardiological societies, and organizations such as the International Atomic Energy Agency, and Pan American Health Organization, as well as government commitment are key factors in the overall efforts to tackle the burden of cardiovascular diseases in the region.


Subject(s)
COVID-19 , Cardiology , Cardiovascular Diseases , Myocardial Perfusion Imaging , Male , Humans , Female , Latin America , Cardiovascular Diseases/diagnostic imaging , Positron Emission Tomography Computed Tomography , COVID-19/diagnostic imaging , Tomography, Emission-Computed, Single-Photon/methods , Caribbean Region
11.
Clin Kidney J ; 15(9): 1737-1746, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36003665

ABSTRACT

Background: C3 glomerulopathy is a rare and heterogeneous complement-driven disease. It is often challenging to accurately predict in clinical practice the individual kidney prognosis at baseline. We herein sought to develop and validate a prognostic nomogram to predict long-term kidney survival. Methods: We conducted a retrospective, multicenter observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases. The dataset was randomly divided into a training group (n = 87) and a validation group (n = 28). The least absolute shrinkage and selection operator (LASSO) regression was used to screen the main predictors of kidney outcome and to build the nomogram. The accuracy of the nomogram was assessed by discrimination and risk calibration in the training and validation sets. Results: The study group comprised 115 patients, of whom 46 (40%) reached kidney failure in a median follow-up of 49 months (range 24-112). No significant differences were observed in baseline estimated glomerular filtration rate (eGFR), proteinuria or total chronicity score of kidney biopsies, between patients in the training versus those in the validation set. The selected variables by LASSO were eGFR, proteinuria and total chronicity score. Based on a Cox model, a nomogram was developed for the prediction of kidney survival at 1, 2, 5 and 10 years from diagnosis. The C-index of the nomogram was 0.860 (95% confidence interval 0.834-0.887) and calibration plots showed optimal agreement between predicted and observed outcomes. Conclusions: We constructed and validated a practical nomogram with good discrimination and calibration to predict the risk of kidney failure in C3 glomerulopathy patients at 1, 2, 5 and 10 years.

12.
Nephrol Dial Transplant ; 37(7): 1270-1280, 2022 06 23.
Article in English | MEDLINE | ID: mdl-33779754

ABSTRACT

INTRODUCTION: The association between a change in proteinuria over time and its impact on kidney prognosis has not been analysed in complement component 3 (C3) glomerulopathy. This study aims to investigate the association between the longitudinal change in proteinuria and the risk of kidney failure. METHODS: This was a retrospective, multicentre observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases. Patients diagnosed with C3 glomerulopathy between 1995 and 2020 were enrolled. A joint modelling of linear mixed-effects models was applied to assess the underlying trajectory of a repeatedly measured proteinuria, and a Cox model to evaluate the association of this trajectory with the risk of kidney failure. RESULTS: The study group consisted of 85 patients, 70 C3 glomerulonephritis and 15 dense deposit disease, with a median age of 26 years (range 13-41). During a median follow-up of 42 months, 25 patients reached kidney failure. The longitudinal change in proteinuria showed a strong association with the risk of this outcome, with a doubling of proteinuria levels resulting in a 2.5-fold increase of the risk. A second model showed that a ≥50% proteinuria reduction over time was significantly associated with a lower risk of kidney failure (hazard ratio 0.79; 95% confidence interval 0.56-0.97; P < 0.001). This association was also found when the ≥50% proteinuria reduction was observed within the first 6 and 12 months of follow-up. CONCLUSIONS: The longitudinal change in proteinuria is strongly associated with the risk of kidney failure. The change in proteinuria over time can provide clinicians a dynamic prediction of kidney outcomes.


Subject(s)
Glomerulonephritis, Membranoproliferative , Glomerulonephritis , Kidney Failure, Chronic , Adolescent , Adult , Complement C3/analysis , Glomerulonephritis/complications , Glomerulonephritis/epidemiology , Humans , Kidney , Kidney Failure, Chronic/complications , Proteinuria/complications , Proteinuria/etiology , Retrospective Studies , Young Adult
13.
Remote Sens (Basel) ; 14(1): 146, 2021 Dec 29.
Article in English | MEDLINE | ID: mdl-36081813

ABSTRACT

Monitoring cropland phenology from optical satellite data remains a challenging task due to the influence of clouds and atmospheric artifacts. Therefore, measures need to be taken to overcome these challenges and gain better knowledge of crop dynamics. The arrival of cloud computing platforms such as Google Earth Engine (GEE) has enabled us to propose a Sentinel-2 (S2) phenology end-to-end processing chain. To achieve this, the following pipeline was implemented: (1) the building of hybrid Gaussian Process Regression (GPR) retrieval models of crop traits optimized with active learning, (2) implementation of these models on GEE (3) generation of spatiotemporally continuous maps and time series of these crop traits with the use of gap-filling through GPR fitting, and finally, (4) calculation of land surface phenology (LSP) metrics such as the start of season (SOS) or end of season (EOS). Overall, from good to high performance was achieved, in particular for the estimation of canopy-level traits such as leaf area index (LAI) and canopy chlorophyll content, with normalized root mean square errors (NRMSE) of 9% and 10%, respectively. By means of the GPR gap-filling time series of S2, entire tiles were reconstructed, and resulting maps were demonstrated over an agricultural area in Castile and Leon, Spain, where crop calendar data were available to assess the validity of LSP metrics derived from crop traits. In addition, phenology derived from the normalized difference vegetation index (NDVI) was used as reference. NDVI not only proved to be a robust indicator for the calculation of LSP metrics, but also served to demonstrate the good phenology quality of the quantitative trait products. Thanks to the GEE framework, the proposed workflow can be realized anywhere in the world and for any time window, thus representing a shift in the satellite data processing paradigm. We anticipate that the produced LSP metrics can provide meaningful insights into crop seasonal patterns in a changing environment that demands adaptive agricultural production.

14.
Mycoses ; 64(1): 66-77, 2021 Jan.
Article in English | MEDLINE | ID: mdl-32989796

ABSTRACT

BACKGROUND: Invasive mould diseases are associated with high morbidity, mortality and economic impact. Its treatment is often started prior to differential pathogen diagnosis. Isavuconazole is approved for treatment of invasive aspergillosis (IA) and invasive mucormycosis (IM) when amphotericin-B is not indicated. OBJECTIVES: To estimate the cost-effectiveness of isavuconazole vs voriconazole for the treatment of adult patients with possible IA prior to differential pathogen diagnosis, in Spain. METHODS: A decision tree analysis was performed using the Spanish Healthcare System perspective. Among all patients with possible IA, it was considered that 7.81% actually had IM. Costs for laboratory analysis, management of adverse events, hospitalisation and drugs per patient, deaths and long-term effects in life years (LYs) and quality-adjusted LYs (QALYs) were considered. Efficacy data were obtained from clinical trials and utilities from the literature. Deterministic and probabilistic sensitivity analyses (PSA) were conducted. RESULTS: In patients with possible IA and when compared to voricanozole, isavuconazole showed an incremental cost of 4758.53€, besides an incremental effectiveness of +0.49 LYs and +0.41 QALYs per patient. The Incremental Cost Effectiveness Ratio was 9622.52€ per LY gained and 11,734.79€ per QALY gained. The higher cost of isavuconazole was due to drug acquisition. Main parameters influencing results were mortality, treatment duration and hospitalisation days. The PSA results showed that isavuconazole has a probability of being cost-effective of 67.34%, being dominant in 24.00% of cases. CONCLUSIONS: Isavuconazole is a cost-effective treatment compared to voriconazole for patients with possible IA for a willingness to pay threshold of 25,000€ per additional QALY.


Subject(s)
Antifungal Agents/therapeutic use , Cost-Benefit Analysis , Diagnosis, Differential , Nitriles/therapeutic use , Pyridines/therapeutic use , Triazoles/therapeutic use , Voriconazole/therapeutic use , Antifungal Agents/economics , Aspergillosis/drug therapy , Aspergillosis/economics , Clinical Laboratory Techniques/economics , Fungi , Hospitalists/economics , Humans , Mucormycosis/drug therapy , Mucormycosis/economics , Spain , Standard of Care
15.
Am J Kidney Dis ; 77(5): 684-695.e1, 2021 05.
Article in English | MEDLINE | ID: mdl-33359150

ABSTRACT

RATIONALE & OBJECTIVE: A previous study that evaluated associations of kidney biopsy findings with disease progression in patients with C3 glomerulopathy (C3G) proposed a prognostic histologic index (C3G-HI) that has not yet been validated. Our objective was to validate the performance of the C3G-HI in a new patient population. STUDY DESIGN: Multicenter, retrospective cohort study. SETTING & PARTICIPANTS: 111 patients fulfilling diagnostic criteria of C3G between January 1995 and December 2019, from 33 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases (GLOSEN). PREDICTORS: Demographic, clinical parameters, C3G-HI total activity score, and the C3G-HI total chronicity score. OUTCOME: Time to kidney failure. ANALYTICAL APPROACH: Intraclass correlation coefficients and κ statistic were used to summarize inter-rater reproducibility for assessment of histopathology in kidney biopsies. The nonlinear relationships of risk of kidney failure with the total activity score and total chronicity score were modeled using Cox proportional hazards analysis that incorporated cubic splines. RESULTS: The study group included 93 patients with C3 glomerulonephritis and 18 with dense-deposit disease. Participants had an overall meanage of 35±22 (SD) years. Forty-eight patients (43%) developed kidney failure after a mean follow-up of 65±27 months. The overall inter-rater reproducibility was very good for the total activity score (intraclass correlation coefficient [ICC]=0.63) and excellent for total chronicity score (ICC=0.89). Baseline estimated glomerular filtration rate (eGFR), 24-hour proteinuria, and treatment with immunosuppression were the main determinants of kidney failure in a model with only clinical variables. Only tubular atrophy and interstitial fibrosis were identified as predictors in a model with histological variables. When the total activity score and total chronicity score were added to the model, only the latter was identified as an independent predictor of kidney failure. LIMITATIONS: Only a subset of the kidney biopsies was centrally reviewed. Residual confounding. CONCLUSIONS: We validated the performance of C3G-HI as a predictor of kidney failure in patients with C3G. The total chronicity score was the principal histologic correlate of kidney failure.


Subject(s)
Complement C3/immunology , Glomerulonephritis, Membranoproliferative/pathology , Kidney Tubules/pathology , Renal Insufficiency/pathology , Adolescent , Adult , Atrophy , Child , Cohort Studies , Disease Progression , Female , Fibrosis , Glomerular Filtration Rate , Glomerulonephritis/drug therapy , Glomerulonephritis/immunology , Glomerulonephritis/metabolism , Glomerulonephritis/pathology , Glomerulonephritis, Membranoproliferative/drug therapy , Glomerulonephritis, Membranoproliferative/immunology , Glomerulonephritis, Membranoproliferative/metabolism , Humans , Immunosuppressive Agents/therapeutic use , Kidney/pathology , Male , Middle Aged , Prognosis , Proportional Hazards Models , Proteinuria , Renal Insufficiency/immunology , Renal Insufficiency/metabolism , Reproducibility of Results , Retrospective Studies , Young Adult
16.
Clin J Am Soc Nephrol ; 15(9): 1287-1298, 2020 09 07.
Article in English | MEDLINE | ID: mdl-32816888

ABSTRACT

BACKGROUND AND OBJECTIVES: C3 glomerulopathy is a complement-mediated disease arising from abnormalities in complement genes and/or antibodies against complement components. Previous studies showed that treatment with corticosteroids plus mycophenolate mofetil (MMF) was associated with improved outcomes, although the genetic profile of these patients was not systematically analyzed. This study aims to analyze the main determinants of disease progression and response to this therapeutic regimen. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective, multicenter, observational cohort study in 35 nephrology departments belonging to the Spanish Group for the Study of Glomerular Diseases. Patients diagnosed with C3 glomerulopathy (n=81) or dense deposit disease (n=16) between January 1995 and March 2018 were enrolled. Multivariable and propensity score matching analyses were used to evaluate the association of clinical and genetic factors with response to treatment with corticosteroids and MMF as measured by proportion of patients with disease remission and kidney survival (status free of kidney failure). RESULTS: The study group comprised 97 patients (84% C3 glomerulopathy, 16% dense deposit disease). Forty-two patients were treated with corticosteroids plus MMF, and this treatment was associated with a higher rate of remission and lower probability of kidney failure (79% and 14%, respectively) compared with patients treated with other immunosuppressives (24% and 59%, respectively), or ecluzimab (33% and 67%, respectively), or conservative management (18% and 65%, respectively). The therapeutic superiority of corticosteroids plus MMF was observed both in patients with complement abnormalities and with autoantibodies. However, patients with pathogenic variants in complement genes only achieved partial remission, whereas complete remissions were common among patients with autoantibody-mediated forms. The main determinant of no remission was baseline proteinuria. Relapses occurred after treatment discontinuation in 33% of the patients who had achieved remission with corticosteroids plus MMF, and a longer treatment length of MMF was associated with a lower risk of relapse. CONCLUSIONS: The beneficial response to corticosteroids plus MMF treatment in C3 glomerulopathy appears independent of the pathogenic drivers analyzed in this study.


Subject(s)
Complement C3/analysis , Glomerulonephritis/drug therapy , Immunosuppressive Agents/therapeutic use , Mycophenolic Acid/therapeutic use , Adolescent , Adrenal Cortex Hormones/therapeutic use , Adult , Child , Disease Progression , Drug Therapy, Combination , Female , Glomerulonephritis/diagnosis , Glomerulonephritis/immunology , Humans , Immunosuppressive Agents/adverse effects , Male , Middle Aged , Mycophenolic Acid/adverse effects , Recurrence , Remission Induction , Retrospective Studies , Risk Factors , Spain , Time Factors , Treatment Outcome , Young Adult
17.
Int J Mol Sci ; 21(4)2020 Feb 23.
Article in English | MEDLINE | ID: mdl-32102247

ABSTRACT

Tryptophan is an essential dietary amino acid that originates uremic toxins that contribute to end-stage kidney disease (ESKD) patient outcomes. We evaluated serum levels and removal during haemodialysis and haemodiafiltration of tryptophan and tryptophan-derived uremic toxins, indoxyl sulfate (IS) and indole acetic acid (IAA), in ESKD patients in different dialysis treatment settings. This prospective multicentre study in four European dialysis centres enrolled 78 patients with ESKD. Blood and spent dialysate samples obtained during dialysis were analysed with high-performance liquid chromatography to assess uremic solutes, their reduction ratio (RR) and total removed solute (TRS). Mean free serum tryptophan and IS concentrations increased, and concentration of IAA decreased over pre-dialysis levels (67%, 49%, -0.8%, respectively) during the first hour of dialysis. While mean serum total urea, IS and IAA concentrations decreased during dialysis (-72%, -39%, -43%, respectively), serum tryptophan levels increased, resulting in negative RR (-8%) towards the end of the dialysis session (p < 0.001), despite remarkable Trp losses in dialysate. RR and TRS values based on serum (total, free) and dialysate solute concentrations were lower for conventional low-flux dialysis (p < 0.001). High-efficiency haemodiafiltration resulted in 80% higher Trp losses than conventional low-flux dialysis, despite similar neutral Trp RR values. In conclusion, serum Trp concentrations and RR behave differently from uremic solutes IS, IAA and urea and Trp RR did not reflect dialysis Trp losses. Conventional low-flux dialysis may not adequately clear Trp-related uremic toxins while high efficiency haemodiafiltration increased Trp losses.


Subject(s)
Hemodiafiltration/methods , Kidney Failure, Chronic/therapy , Renal Dialysis/methods , Tryptophan/blood , Tryptophan/toxicity , Tryptophan/urine , Adult , Aged , Aged, 80 and over , Female , Humans , Indican/blood , Indican/urine , Indoleacetic Acids/blood , Indoleacetic Acids/urine , Male , Middle Aged , Prospective Studies , Renal Insufficiency, Chronic
18.
Behav Brain Res ; 379: 112267, 2020 02 03.
Article in English | MEDLINE | ID: mdl-31593789

ABSTRACT

Ketamine significantly increases the locomotor activity of rodents, however this effect varies according to the sex and age of the animal being tested. To determine the role monoamine systems play in ketamine's locomotor activating effects: (a) male and female preweanling, adolescent, and adult rats were pretreated with vehicle or the monoamine depleting agent reserpine (1 or 5 mg/kg), and (b) the behavioral actions of ketamine (20 or 40 mg/kg) were then compared to d-amphetamine (2 mg/kg) and cocaine (10 or 15 mg/kg). The ability of reserpine to deplete dorsal striatal dopamine (DA) and serotonin (5-HT) in male and female rats was determined using HPLC. Ketamine caused substantial increases in the locomotion of preweanling rats and older female rats (adolescents and adults), but had only small stimulatory effects on adolescent and adult male rats. When compared to cocaine and d-amphetamine, ketamine was especially sensitive to the locomotor-inhibiting effects of monoamine depletion. Ketamine-induced locomotion is at least partially mediated by monoamine systems, since depleting DA and 5-HT levels by 87-96% significantly attenuated the locomotor activating effects of ketamine in male and female rats from all three age groups. When administered to reserpine-pretreated rats, ketamine produced a different pattern of behavioral effects than either psychostimulant, suggesting that ketamine does not stimulate locomotor activity via actions at the presynaptic terminal. Instead, our results are consistent with the hypothesis that ketamine increases locomotor activity through a down-stream mechanism, possibly involving ascending DA and/or 5-HT projection neurons.


Subject(s)
Behavior, Animal/drug effects , Biogenic Monoamines/metabolism , Excitatory Amino Acid Antagonists/pharmacology , Ketamine/pharmacology , Locomotion/drug effects , Neurotransmitter Uptake Inhibitors/pharmacology , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Synaptic Transmission/drug effects , Adrenergic Uptake Inhibitors/pharmacology , Age Factors , Animals , Cocaine/pharmacology , Dextroamphetamine/metabolism , Dopamine Uptake Inhibitors/pharmacology , Drug Interactions , Excitatory Amino Acid Antagonists/administration & dosage , Female , Ketamine/administration & dosage , Male , Neurotransmitter Uptake Inhibitors/administration & dosage , Rats , Rats, Sprague-Dawley , Reserpine/pharmacology , Selective Serotonin Reuptake Inhibitors/pharmacology , Sex Characteristics
19.
J Sci Food Agric ; 100(5): 2099-2109, 2020 Mar 30.
Article in English | MEDLINE | ID: mdl-31875967

ABSTRACT

BACKGROUND: Cruciferous foods rich in health-promoting metabolites are of particular interest to consumers as well as being a good source of bioactives-enriched ingredients. Several elicitors have been used to stimulate the biosynthesis and accumulation of secondary metabolites in foods; however, little is known about the response of new hybrid varieties, such as Bimi®, under field-crop production conditions. Therefore, this study was designed to evaluate the effect of salicylic acid (200 µmol L-1 , SA), methyl jasmonate (100 µmol L-1 , MeJA), and their combination on Bimi plant organs (inflorescences and aerial vegetative tissues - stems and leaves). For this, the composition of the glucosinolates present in the tissues was evaluated. Also, aqueous extracts of the plant material, obtained with different times of extraction with boiling water, were studied. RESULTS: The results indicate that the combined treatment (SA + MeJA) significantly increased the content of glucosinolates in the inflorescences and that MeJA was the most effective elicitor in leaves. Regarding the aqueous extracts, the greatest amount of glucosinolates was extracted at 30 min - except for the leaves elicited with MeJA, for which 15 min was optimal. CONCLUSION: The elicitation in the field enriched leaves in glucobrassicin (GB), 4-methoxyglucobrassicin (MGB), and neoglucobrassicin (NGB) and stems and inflorescences in glucoraphanin, 4-hydroxyglucobrassicin, GB, MGB, and NGB. In this way, this enhanced vegetable material favored the presence of bioactives in the extracts, which is of great interest regarding enriched foods and ingredients with added value obtained from them. © 2019 Society of Chemical Industry.


Subject(s)
Brassica/chemistry , Food Analysis , Acetates/pharmacology , Brassica/drug effects , Cyclopentanes/pharmacology , Glucosinolates/analysis , Imidoesters/analysis , Indoles/analysis , Inflorescence/chemistry , Inflorescence/drug effects , Oximes , Oxylipins/pharmacology , Plant Leaves/chemistry , Plant Leaves/drug effects , Plant Stems/chemistry , Plant Stems/drug effects , Salicylic Acid/pharmacology , Sulfoxides
20.
Eur Neuropsychopharmacol ; 29(6): 740-755, 2019 06.
Article in English | MEDLINE | ID: mdl-30981586

ABSTRACT

Although ketamine has long been known to increase locomotor activity, only recently was it realized that this behavioral effect varies according to both sex and age. The purpose of the present study was threefold: first, to measure the locomotor activating effects of ketamine in male and female rats across early ontogeny and into adulthood; second, to assess ketamine and norketamine pharmacokinetics in the dorsal striatum and hippocampus of the same age groups; and, third, to use curvilinear regression to determine the relationship between locomotor activity and dorsal striatal concentrations of ketamine and norketamine. A high dose of ketamine (80 mg/kg, i.p.) was administered in order to examine the complete cycle of locomotor responsiveness across a 280-min testing session. In separate groups of rats, the dorsal striata and hippocampi were removed at 10 time points (0-360 min) after ketamine administration and samples were assayed for ketamine, norketamine, and dopamine using HPLC. In female rats, ketamine produced high levels of locomotor activity that varied only slightly among age groups. Male preweanling rats responded like females, but adolescent and adult male rats exhibited lesser amounts of ketamine-induced locomotor activity. Ketamine and norketamine pharmacokinetics, especially peak values and area under the curve, generally mirrored age- and sex-dependent differences in locomotor activity. Among male rats and younger female rats, dorsal striatal ketamine and norketamine levels accounted for a large proportion of the variance in locomotor activity. In adult female rats, however, an additional factor, perhaps involving other ketamine and norketamine metabolites, was influencing locomotor activity.


Subject(s)
Excitatory Amino Acid Antagonists/pharmacology , Excitatory Amino Acid Antagonists/pharmacokinetics , Ketamine/pharmacology , Ketamine/pharmacokinetics , Locomotion/drug effects , Aging/metabolism , Aging/psychology , Animals , Animals, Newborn , Dopamine/metabolism , Female , Hippocampus/metabolism , Humans , Ketamine/analogs & derivatives , Ketamine/metabolism , Male , Neostriatum/metabolism , Rats , Rats, Sprague-Dawley , Sex Characteristics
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