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1.
Hepatology ; 2024 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-38687604

RESUMEN

BACKGROUND: HBV and HIV co-infection is a common occurrence globally, with significant morbidity and mortality. Both viruses lead to immune dysregulation including changes in NK cells, a key component of antiviral defense and a promising target for HBV cure strategies. Here we used high-throughput single cell analysis to explore the immune cell landscape in people with HBV mono-infection and HIV/HBV co-infection, on antiviral therapy, with emphasis on identifying the distinctive characteristics of NK cell subsets that can be therapeutically harnessed. RESULTS: Our data show striking differences in the transcriptional programs of NK cells. HIV/HBV co-infection was characterized by an overrepresentation of adaptive, KLRC2 expressing NK cells, including a higher abundance of a chemokine enriched (CCL3/CCL4) adaptive cluster. The NK cell remodeling in HIV/HBV co-infection was reflected in enriched activation pathways, including CD3ζ phosphorylation and ZAP-70 translocation that can mediate stronger ADCC responses and a bias towards chemokine/cytokine signaling. By contrast HBV mono-infection imposed a stronger cytotoxic profile on NK cells and a more prominent signature of 'exhaustion' with higher circulating levels of HBsAg. Phenotypic alterations in the NK cell pool in co-infection were consistent with increased 'adaptiveness' and better capacity for ADCC compared to HBV mono-infection. Overall, an adaptive NK cell signature correlated inversely with circulating levels of HBsAg and HBV-RNA in our cohort. CONCLUSIONS: This study provides new insights into the differential signature and functional profile of NK cells in HBV and HIV/HBV co-infection, highlighting pathways that can be manipulated to tailor NK cell-focused approaches to advance HBV cure strategies in different patient groups.

2.
J Evol Biol ; 37(4): 471-485, 2024 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-38350467

RESUMEN

Critical thermal limits (CTLs) gauge the physiological impact of temperature on survival or critical biological function, aiding predictions of species range shifts and climatic resilience. Two recent Drosophila species studies, using similar approaches to determine temperatures that induce sterility (thermal fertility limits [TFLs]), reveal that TFLs are often lower than CTLs and that TFLs better predict both current species distributions and extinction probability. Moreover, many studies show fertility is more sensitive at less extreme temperatures than survival (thermal sensitivity of fertility [TSF]). These results present a more pessimistic outlook on the consequences of climate change. However, unlike CTLs, TFL data are limited to Drosophila, and variability in TSF methods poses challenges in predicting species responses to increasing temperature. To address these data and methodological gaps, we propose 3 standardized approaches for assessing thermal impacts on fertility. We focus on adult obligate sexual terrestrial invertebrates but also provide modifications for other animal groups and life-history stages. We first outline a "gold-standard" protocol for determining TFLs, focussing on the effects of short-term heat shocks and simulating more frequent extreme heat events predicted by climate models. As this approach may be difficult to apply to some organisms, we then provide a standardized TSF protocol. Finally, we provide a framework to quantify fertility loss in response to extreme heat events in nature, given the limitations in laboratory approaches. Applying these standardized approaches across many taxa, similar to CTLs, will allow robust tests of the impact of fertility loss on species responses to increasing temperatures.


Asunto(s)
Cambio Climático , Invertebrados , Animales , Temperatura , Fertilidad , Drosophila
3.
Health Expect ; 27(1): e13917, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38375962

RESUMEN

INTRODUCTION: Patient and public involvement (PPI) initiatives involving patients with chronic respiratory disease (CRD) are rare. Therefore, this study aimed to explore the perspectives of patients with CRD, carers and interested citizens regarding the relevance and need for a PPI network and suggestions for its implementation. METHODS: A qualitative study based on focus groups was conducted. Recruitment occurred through invitations on social media platforms and to patients who have participated in previous asthma studies of the team. Three focus groups were conducted, via video conference, using a semi-structured guide. Thematic analysis was performed by two independent researchers and discussed with the extended team. RESULTS: Fifteen patients with CRD, one carer and one interested citizen (13 females, median 36 (range: 18-72) years) participated. All participants acknowledged the importance of implementing a collaborative network and demonstrated interest in being integrated. Participants acknowledged the importance of their involvement in several phases of the research cycle. The main aim identified for this network was to facilitate communication between patients and researchers. Participants regarded the integration of patients, carers, researchers and healthcare professionals from different scientific areas as relevant. The use of digital platforms to attract members and support the work, together with group dynamics and regular meetings, were some of the most relevant practical considerations for implementing the network. The identified facilitators for their engagement were sharing experiences, researchers' and healthcare professionals' support and feedback and schedule flexibility. The identified barriers included the amount of time dedicated, low health/digital literacy and the potential detachment of nondiagnosed patients or those with low symptom impact in daily life. CONCLUSION: Patients, carers and citizens acknowledged the relevance of implementing a collaborative network and demonstrated interest in active participation in every stage of the health research cycle. A deeper knowledge of the barriers and facilitators identified in this study could support implementing these initiatives in Portugal. PATIENT OR PUBLIC CONTRIBUTION: This study was designed by a research team that included one patient with asthma and one carer. They were specifically involved in building the study protocol and the interview guide. They also gave feedback regarding the electronic consent form and the short sociodemographic questionnaire created, namely by removing noncontributing words or phrases and rewording expressions. The lay summary was written by another patient with asthma. All participants of this study were invited to implement and integrate the ConectAR network-a collaborative network of research in respiratory health. PUBLIC SUMMARY: In Portugal, chronic respiratory patients do not have an active role as 'coinvestigators'. This study aimed to acknowledge if patients and citizens considered a patient and public involvement network useful, whose main purpose would be to facilitate communication between patients and researchers. A study based on online group interviews was carried out with patients with chronic respiratory diseases and interested citizens, both recruited on social media platforms. Participants considered that bringing together patients, carers, researchers and healthcare professionals is valuable because sharing different experiences and perspectives may help patients to improve their daily lives and increase research quality. In conclusion, patients agree that implementing a collaborative network with researchers and healthcare professionals and participating in the health research cycle is quite preponderant. Acknowledging what can help and deter this network may be beneficial to implementing this type of initiative in Portugal.


Asunto(s)
Asma , Enfermedades Respiratorias , Femenino , Humanos , Cuidadores , Investigación Cualitativa , Personal de Salud , Asma/terapia
4.
Phys Chem Chem Phys ; 26(9): 7865-7876, 2024 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-38376442

RESUMEN

Carotenoids are very effectively delivered by albumin to adipocytes. The uptake of carotenoids to the cells occurs in the form of self-aggregates that localize in the vicinity of the adipocyte membrane, as shown by high spatial resolution Raman spectroscopy. The binding of carotenoids to albumin and the mechanism of their transport were elucidated with the help of chiroptical spectroscopies, in tandem with molecular docking and molecular dynamics simulations. In particular, apart from the recognized high affinity pocket of albumin that binds a carotenoid monomer in domain I, we have identified a hydrophobic periphery area in domain IIIB that loosely bounds the self-aggregated carotenoid in aqueous media and enables its easy detachment in hydrophobic environments. This explains the effectiveness of albumins as nanocarriers of carotenoids to adipocytes in vitro.


Asunto(s)
Albúminas , Carotenoides , Carotenoides/química , Simulación del Acoplamiento Molecular , Transporte Biológico , Adipocitos/metabolismo , Espectrometría Raman/métodos
5.
Int J Biol Macromol ; 259(Pt 2): 129157, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38199539

RESUMEN

Oral cancer incidence and mortality are increasing over time. The most common therapies for oral cancers are surgery and radiotherapy, either used alone or combined, and immunotherapy can be also an option. Although there are several therapeutic options, none of them are completely effective, and in addition, there are numerous associated side effects. To overcome these limitations, researchers have been trying to reduce these drawbacks by using drug delivery systems that carry drugs for specific delivery to cancer cells. For that purpose, RNA-coated liposomes to selectively deliver the ligands C8 (acridine orange derivative) and dexamethasone to oral cancer cells were produced, characterized, and biologically evaluated. Firstly, the RNA structure and binding interaction with ligands (C8 and dexamethasone) were evaluated by circular dichroism (CD), thermal difference spectroscopy (TDS), nuclear magnetic resonance (NMR) and fluorescence titrations. The biophysical assays evidenced the formation of an RNA hairpin and duplex structure. Moreover, steady-state and time-resolved fluorescence intensity and anisotropy experiments show that C8 forms a complex with RNA and adopts an open conformation upon RNA binding. Then, RNA-coated liposomes were characterized by dynamic light scattering, and diameters near 160 nm were observed. Time-resolved anisotropy measurements of C8 loaded in RNA-functionalized liposomes indicate the co-existence of free C8 in solution (inside the liposome) and C8 bound to RNA at the external liposome surface. The RNA-functionalized liposomes loaded with C8 or dexamethasone mediated a significant reduction in the cell viability of malignant UPCI-SCC-154 cells while maintaining viable non-malignant NHDF cells. Additionally, the liposomes were able to internalize the cells, with higher uptake by the malignant cell line. Overall, the results obtained in this work can contribute to the development of new drug delivery systems based on RNA-coated liposomes.


Asunto(s)
Liposomas , Neoplasias de la Boca , Humanos , Liposomas/química , Sistemas de Liberación de Medicamentos , Línea Celular , Neoplasias de la Boca/tratamiento farmacológico , Dexametasona/farmacología
6.
Palliat Med ; : 2692163231219682, 2024 Jan 16.
Artículo en Inglés | MEDLINE | ID: mdl-38226491

RESUMEN

BACKGROUND: Evidence suggests that involving General Practitioners in the care of patients with palliative care needs may improve patient outcomes. AIM: To evaluate whether a two-tiered intervention involving training in palliative care and a new consultation model in primary care for patients with palliative care needs is feasible and could reduce patients' symptom burden. DESIGN: Before-after study including an internal pilot. SETTING/PARTICIPANTS: Nine general practitioners working in a health region in Portugal and 53 patients with palliative care needs from their patient lists were recruited. General Practitioners received training in palliative care and used a new primary palliative care consultation model, with medical consultations every 3 weeks for 12 weeks. The primary outcome was physical symptom burden, self-reported using the Integrated Palliative care Outcome Scale (IPOS) patient version (min.0-max.1000). Secondary outcomes included emotional symptoms (min.0-max.400) and communication/practical issues (min.0-max.300). RESULTS: Of the 35/53 patients completed the 12-week intervention (mean age 72.53 years, SD = 13.45; 54.7% female). All had advanced disease: one third had cancer (n = 13), one third had congestive heart failure (n = 12); others had chronic kidney disease and chronic obstructive pulmonary disease. After the 12 weeks of intervention, there was a reduction in physical symptom burden [mean difference from baseline of 71.42 (95%CI 37.01-105.85) with a medium-large effect size (0.71], and in emotional symptom burden [mean difference 42.86 (95%CI 16.14-69.58), with a medium effect size (0.55)]. No difference was found for communication/practical issues. CONCLUSIONS: Our intervention can be effective in reducing patients' physical and emotional symptoms. TRIAL REGISTRATION: ClinicalTrials.gov ID - NCT05244590. Registration: 14th February 2022.

7.
Oncologist ; 29(3): e337-e344, 2024 Mar 04.
Artículo en Inglés | MEDLINE | ID: mdl-38071748

RESUMEN

BACKGROUND: Liquid biopsy (LB) is a non-invasive tool to evaluate the heterogeneity of tumors. Since RAS mutations (RAS-mut) play a major role in resistance to antiepidermal growth factor receptor inhibitors (EGFR) monoclonal antibodies (Mabs), serial monitoring of RAS-mut with LB may be useful to guide treatment. The main aim of this study was to evaluate the prognostic value of the loss of RAS-mut (NeoRAS-wt) in LB, during the treatment of metastatic colorectal cancer (mCRC). METHODS: A retrospective study was conducted on patients with mCRC between January 2018 and December 2021. RAS-mut were examined in tissue biopsy, at mCRC diagnosis, and with LB, during treatment. RESULTS: Thirty-nine patients with RAS-mut mCRC were studied. LB was performed after a median of 3 lines (0-7) of systemic treatment including anti-vascular endothelial growth factor (anti-VEGF) Mabs. NeoRAS-wt was detected in 13 patients (33.3%); 9 (69.2%) of them received further treatment with anti-EGFR Mabs with a disease control rate of 44.4%. Median overall survival (OS), from the date of LB testing, was 20 months in the NeoRAS-wt group and 9 months in the persistent RAS-mut group (log-rank 2.985; P = .08), with a 12-month OS of 84.6% and 57.7%, respectively. NeoRAS-wt was identified as a predictor of survival (HR = 0.29; P = .007), with an 11-month improvement in median OS and a 71% decrease in risk of death, in heavily pretreated patients. CONCLUSIONS: In conclusion, monitoring clonal evolution in mCRC by LB may provide an additional treatment line for patients with NeoRAS-wt in advanced disease.


Asunto(s)
Antineoplásicos , Neoplasias del Colon , Neoplasias Colorrectales , Neoplasias del Recto , Humanos , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/patología , Estudios Retrospectivos , Antineoplásicos/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Biopsia Líquida , Mutación
8.
BMC Ecol Evol ; 23(1): 64, 2023 11 02.
Artículo en Inglés | MEDLINE | ID: mdl-37919666

RESUMEN

BACKGROUND: The negative impacts of climate change on biodiversity are consistently increasing. Developmental stages are particularly sensitive in many ectotherms. Moreover, sex-specific differences in how organisms cope with thermal stress can produce biased sex ratios upon emergence, with potentially major impacts on population persistence. This is an issue that needs investigation, particularly testing whether thermal selection can alleviate sex ratio distortions in the long-term is a critical but neglected issue. Here, we report an experiment analyzing the sex ratio patterns at different developmental temperatures in Drosophila subobscura populations subjected to long-term experimental evolution (~ 30 generations) under a warming environment. RESULTS: We show that exposure to high developmental temperatures consistently promotes sex ratio imbalance upon emergence, with a higher number of female than male offspring. Furthermore, we found that thermal selection resulting from evolution in a warming environment did not alleviate such sex ratio distortions generated by heat stress. CONCLUSIONS: We demonstrate that heat stress during development can lead to clear sex ratio deviations upon emergence likely because of differential survival between sexes. In face of these findings, it is likely that sex ratio deviations of this sort occur in natural populations when facing environmental perturbation. The inability of many insects to avoid thermal shifts during their (more) sessile developmental stages makes this finding particularly troublesome for population subsistence in face of climate warming events.


Asunto(s)
Drosophila , Razón de Masculinidad , Animales , Masculino , Femenino , Temperatura , Cambio Climático , Insectos
9.
Front Public Health ; 11: 1159172, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37583890

RESUMEN

Background: Since 2019, Europe has experienced ongoing stressors with the emergence of the COVID-19 pandemic and the Russian-Ukrainian War, which have had social, financial, physical, and psychological impacts. Studies suggest that anxiety, fear, post-traumatic stress disorder, depression, and other psychological disorders are common in such situations, and there is a need for more research on the impact of the war on mental health in Portugal. The main goal of the present study was to assess the impact of the fear of COVID-19 and anxiety related to nuclear war on the general anxiety levels of adult individuals living in Portugal. Methods: A cross-sectional study was conducted from May to July 2022 using an online questionnaire built on the Google Forms platform. Portuguese-speaking male and female individuals aged 18 years or older, who provided informed consent and agreed to participate, were included. The outcome variable was defined using the Portuguese version of the GAD-7 scale, while the main predictors were the FCV-19S and the NWA Scale in Portuguese. Linear and logistic regression models were used to test associations between predictors and outcome variable. Results: The study included 1,182 participants, with a mean age of 46.5 (±11.7) years, mostly women (80.6%). The global mean GAD-7 score was 5.8 (±4.5) points, and 17.9% of the participants scored above the 10-point cutoff. Higher scores were found in both the FCV-19S and the NWA scale among participants with anxiety, as measured by both a 10-point cutoff (p < 0.001), and GAD-7 scale mean scores (p < 0.001). The study showed that fear of COVID-19 [OR of 1.133 (95%CI: 1.097-1.170)] and, at a lesser extent, nuclear war anxiety [OR of 1.020 (95%CI, 1.009-1.031)] contribute to anxiety in the general population. This is also true for those with a personal history of anxiety, revealed by multiple regression. Discussion: This study contributes to the research on COVID-19's impact on anxiety and provides the first comprehensive assessment of nuclear war anxiety in Portugal. Results highlight the need for long-term care for anxiety, as prevalence is expected to increase due to the pandemic and war, even in non-conflict areas like Portugal.


Asunto(s)
COVID-19 , Humanos , Adulto , Masculino , Femenino , Persona de Mediana Edad , COVID-19/epidemiología , Portugal/epidemiología , Estudios Transversales , Pandemias , SARS-CoV-2 , Depresión/epidemiología , Ansiedad/epidemiología , Ansiedad/psicología , Europa (Continente)
10.
Evolution ; 77(8): 1842-1851, 2023 07 27.
Artículo en Inglés | MEDLINE | ID: mdl-37306280

RESUMEN

Current rising temperatures are threatening biodiversity. It is therefore crucial to understand how climate change impacts male and female fertility and whether evolutionary responses can help in coping with heat stress. We use experimental evolution to study male and female fertility during the real-time evolution of two historically differentiated populations of Drosophila subobscura under different thermal selection regimes for 23 generations. We aim to (a) tease apart sex-specific differences in fertility after exposure to warming conditions during development, (b) test whether thermal selection can enhance fertility under thermal stress, and (c) address the role of historically distinct genetic backgrounds. Contrary to expectations, heat stress during development had a higher negative impact on female fertility than on male fertility. We did not find clear evidence for enhanced fertility in males or females evolving under warming conditions. Population history had a clear impact on fertility response under thermal stress, particularly in males with those from lower latitude presenting better performance than their higher latitude counterparts. We show that the impact of thermal stress on fertility varies between traits, sexes, and genetic backgrounds. Incorporating these several levels of variation is crucial for a deeper understanding of how fertility evolves under climate change.


Asunto(s)
Drosophila , Reproducción , Animales , Masculino , Femenino , Temperatura , Drosophila/fisiología , Cambio Climático , Fertilidad
11.
Sci Rep ; 13(1): 9700, 2023 06 15.
Artículo en Inglés | MEDLINE | ID: mdl-37322066

RESUMEN

Adaptation to increasingly warmer environments may be critical to avoid extinction. Whether and how these adaptive responses can arise is under debate. Though several studies have tackled evolutionary responses under different thermal selective regimes, very few have specifically addressed the underlying patterns of thermal adaptation under scenarios of progressive warming conditions. Also, considering how much past history affects such evolutionary response is critical. Here, we report a long-term experimental evolution study addressing the adaptive response of Drosophila subobscura populations with distinct biogeographical history to two thermal regimes. Our results showed clear differences between the historically differentiated populations, with adaptation to the warming conditions only evident in the low latitude populations. Furthermore, this adaptation was only detected after more than 30 generations of thermal evolution. Our findings show some evolutionary potential of Drosophila populations to respond to a warming environment, but the response was slow and population specific, emphasizing limitations to the ability of ectotherms to adapt to rapid thermal shifts.


Asunto(s)
Aclimatación , Adaptación Fisiológica , Animales , Drosophila/fisiología , Temperatura
12.
Sensors (Basel) ; 23(9)2023 Apr 27.
Artículo en Inglés | MEDLINE | ID: mdl-37177514

RESUMEN

Machine vision systems are widely used in assembly lines for providing sensing abilities to robots to allow them to handle dynamic environments. This paper presents a comparison of 3D sensors for evaluating which one is best suited for usage in a machine vision system for robotic fastening operations within an automotive assembly line. The perception system is necessary for taking into account the position uncertainty that arises from the vehicles being transported in an aerial conveyor. Three sensors with different working principles were compared, namely laser triangulation (SICK TriSpector1030), structured light with sequential stripe patterns (Photoneo PhoXi S) and structured light with infrared speckle pattern (Asus Xtion Pro Live). The accuracy of the sensors was measured by computing the root mean square error (RMSE) of the point cloud registrations between their scans and two types of reference point clouds, namely, CAD files and 3D sensor scans. Overall, the RMSE was lower when using sensor scans, with the SICK TriSpector1030 achieving the best results (0.25 mm ± 0.03 mm), the Photoneo PhoXi S having the intermediate performance (0.49 mm ± 0.14 mm) and the Asus Xtion Pro Live obtaining the higher RMSE (1.01 mm ± 0.11 mm). Considering the use case requirements, the final machine vision system relied on the SICK TriSpector1030 sensor and was integrated with a collaborative robot, which was successfully deployed in an vehicle assembly line, achieving 94% success in 53,400 screwing operations.

13.
Cureus ; 15(2): e34851, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36923195

RESUMEN

There is an unclear association between the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and amyotrophic lateral sclerosis (ALS), with few reports in the literature. We report the case of an 80-year-old man admitted to our emergency room with asthenia, dysphonia, dysphagia, weight loss, and euvolemic hyponatremia, indicating a SIADH. Posteriorly, the patient also developed respiratory failure, which, in association with the previous clinical presentation, led to the diagnosis of ALS. During her permanence at the hospital, the hyponatremia improved with noninvasive positive-pressure ventilation, and the association between these two identities was made. This case also shows that patients with ALS commonly suffer from chronic respiratory failure and still have a reserved prognosis.

14.
J Therm Biol ; 112: 103478, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36796921

RESUMEN

Adaptive evolution is critical for animal populations to thrive in the fast-changing natural environments. Ectotherms are particularly vulnerable to global warming and, although their limited coping ability has been suggested, few real-time evolution experiments have directly accessed their evolutionary potential. Here, we report a long-term experimental evolution study addressing the evolution of Drosophila thermal reaction norms, after ∼30 generations under different dynamic thermal regimes: fluctuating (daily variation between 15 and 21 °C) or warming (daily fluctuation with increases in both thermal mean and variance across generations). We analyzed the evolutionary dynamics of Drosophila subobscura populations as a function of the thermally variable environments in which they evolved and their distinct background. Our results showed clear differences between the historically differentiated populations: high latitude D. subobscura populations responded to selection, improving their reproductive success at higher temperatures whereas their low latitude counterparts did not. This suggests population variation in the amount of genetic variation available for thermal adaptation, an aspect that needs to be considered to allow for better predictions of future climate change responses. Our results highlight the complex nature of thermal responses in face of environmental heterogeneity and emphasize the importance of considering inter-population variation in thermal evolution studies.


Asunto(s)
Evolución Biológica , Calentamiento Global , Animales , Reproducción , Drosophila/genética , Aclimatación , Temperatura
15.
AIDS ; 37(5): 785-788, 2023 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-36728219

RESUMEN

BACKGROUND: Since 2015, we prescribed dolutegravir (DTG)-based two drug regimens (DTG-2DR) for 620 people [total cohort 3133 (19.8%)]. METHOD: Clinic database search 1 January 15 to 31 October 21. Demographic, tolerability and HIV related data analysed. RESULTS: In total, 620 people identified; 561 had complete data. 446 male (79.5%); median age 54 years (interquartile range 46, 59). 343 (61.1%) MSM. Nine people who initiated naïvely achieved viral suppression (100%). 546/552 (99.0%) switched or continued and were suppressed at data censor. 460/552 (83.3%) received DTG-lamivudine (DTG/3TC), 74/552 (13.4%) received DTG-rilpivirine (DTG/RPV) and 18/552 (3.3%) received DTG-emtricitabine (DTG/FTC). 70 (12.5%) switched off DTG-2DR (55 DTG/3TC, 13 DTG/RPV, two DTG/FTC) due to side-effects. 41 episodes of blip (1 off >50 copies/ml) occurred in 30 people (5.3%). 11/41 on DTG-RPV [ n  = 7 multi-tablet regimen (MTR), n  = 4 single tablet regimen (STR)]. 27/41 DTG-3TC, 3/41 DTG/FTC ( n  = 26 MTR, n  = 4 STR). Six people (1.1%) failed (confirmed viral load >200 copies/ml or persistent low level viraemia) ( n  = 4 DTG-3TC STR, n  = 1 DTG-3TC MTR, n  = 1 DTG-RPV MTR). Four failures due to low level viraemia, one due to non-adherence and one due to high viral load. Resistance tests performed for 5/6 - mutations detected only in latter person with high viral load failure (on DTG-3TC MTR) who developed triple class resistance. CONCLUSION: Majority of experience is in DTG/3TC stable switch. Minority of patients developed side-effects. Low number of virological failures, one developed integrase inhibitor resistance. Viral failure associated with MTR, commensurate with trial data showing no failure with resistance if DTG/3TC STR used. Overall DTG-2DR demonstrates high efficacy in real-world setting.


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Minorías Sexuales y de Género , Humanos , Masculino , Persona de Mediana Edad , Fármacos Anti-VIH/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Homosexualidad Masculina , Viremia/tratamiento farmacológico , Lamivudine/uso terapéutico , Compuestos Heterocíclicos con 3 Anillos/efectos adversos , Piridonas/uso terapéutico , Emtricitabina/uso terapéutico , Comprimidos/uso terapéutico
16.
Cancers (Basel) ; 16(1)2023 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-38201589

RESUMEN

(1) Background: Relapsed HGSOC with ascites and/or pleural effusion is a poor-prognostic population and poorly represented in clinical studies. We questioned if these patients are worth treating. In other words, if these patients received the most effective treatment, would it change the course of this disease? To our knowledge this is the first real-life study to evaluate this question in this low-survival population. (2) Methods: To tackle this question we performed a retrospective, multi-centric, real-life study, that reviewed relapsed HGSOC patients with ascites and/or pleural effusion. Our rationale was to compare the OS of two groups of patients: responders, i.e., patients who had an imagological response to treatment (complete/partial response/stable disease, RECIST criteria) versus non-responders (no response/progression upon treatment). We evaluated the predictive value of clinical variables that are available in a real-life setting (e.g., staging, chemotherapy, surgery, platinum-sensitivity). Multivariate logistic regression and survival analysis was conducted. A two-step cluster analysis SPSS tool was used for subgroup analysis. Platinum sensitivity/resistance was also analyzed, as well as multivariate and cluster analysis. (3) Results: We included 57 patients, 41.4% first line responders and 59.6% non-responders. The median OS of responders was 23 months versus 8 months in non-responders (p < 0.001). This difference was verified in platinum-sensitive (mOS 28 months vs. 8 months, p < 0.001) and platinum-resistant populations (mOS 16 months vs. 7 months, p < 0.001). Thirty-one patients reached the second line, of which only 10.3% responded to treatment. Three patients out of thirty-one who did not respond in the first line of relapse, responded in the second line. In the second line, the mOS for the responders' group vs. non-responders was 31 months versus 13 months (p = 0.02). The two step cluster analysis tool found two different subgroups with different prognoses based on overall response rate, according to consolidation chemotherapy, neoadjuvant chemotherapy, FIGO staging and surgical treatment. Cluster analysis showed that even patients with standard clinical and treatment variables associated with poor prognosis might achieve treatment response (the opposite being also true). (4) Conclusions: Our data clearly show that relapsed HGSOC patients benefit from treatment. If given an effective treatment upfront, this can lead to a ~3 times increase in mOS for these patients. Moreover, this was irrespective of patient disease and treatment characteristics. Our results highlight the urgent need for a sensitivity test to tailor treatments and improve efficacy rates in a personalized manner.

17.
Antioxidants (Basel) ; 11(10)2022 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-36290648

RESUMEN

The fishery industry generates large amounts of waste (20-75% (w/w) of the total caught fish weight). The recovery of bioactive compounds from residues and their incorporation in cosmetics represents a promising market opportunity and may contribute to a sustainable valorisation of the sector. In this work, protein-rich extracts obtained by high-pressure technologies (supercritical CO2 and subcritical water) from sardine (Sardina pilchardus) waste and codfish (Gadus morhua) frames were characterized regarding their cosmeceutical potential. Antioxidant, anti-inflammatory and antibacterial activities were evaluated through chemical (ORAC assay), enzymatic (inhibition of elastase and tyrosinase), antimicrobial susceptibility (Klebsiella pneumoniae, Staphylococcus aureus and Cutibacterium acnes) and cell-based (in keratinocytes-HaCaT) assays. Sardine extracts presented the highest antibacterial activity, and the extract obtained using higher extraction temperatures (250 °C) and without the defatting step demonstrated the lowest minimum inhibitory concentration (MIC) values (1.17; 4.6; 0.59 mg/mL for K. pneumoniae, S. aureus and C. acnes, respectively). Codfish samples extracted at lower temperatures (90 °C) were the most effective anti-inflammatory agents (a concentration of 0.75 mg/mL reduced IL-8 and IL-6 levels by 58% and 47%, respectively, relative to the positive control). Threonine, valine, leucine, arginine and total protein content in the extracts were highlighted to present a high correlation with the reported bioactivities (R2 ≥ 0.7). These results support the potential application of extracts obtained from fishery industry wastes in cosmeceutical products with bioactive activities.

18.
BMJ Case Rep ; 15(10)2022 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-36316052

RESUMEN

We report the case of a woman in her 70s with a stage IVA small cell neuroendocrine carcinoma of the vagina. The patient started chemotherapy with cisplatin and etoposide followed by concurrent chemoradiotherapy and adjuvant chemotherapy. Pelvic MRI after completion of treatment did not show residual disease. Three years and 8 months after definitive treatment, the patient remains on regular follow-up without evidence of disease.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica , Carcinoma Neuroendocrino , Femenino , Humanos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Estadificación de Neoplasias , Quimioradioterapia , Cisplatino/uso terapéutico , Quimioterapia Adyuvante , Carcinoma Neuroendocrino/diagnóstico por imagen , Carcinoma Neuroendocrino/tratamiento farmacológico , Vagina
19.
BMC Psychol ; 10(1): 192, 2022 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-35922866

RESUMEN

BACKGROUND: The COVID-19 pandemic introduced a global need to explore the potential and challenges of online education. OBJECTIVE: To evaluate the presence of depression and anxiety in university students and their level of satisfaction with online learning during the period of social isolation caused by the COVID-19 pandemic. METHOD: A cross-sectional design was used to evaluate 152 online learning students from six different university courses: Medicine, Psychology, Law, Engineering, Physiotherapy, and Business. The evaluation of the participants was carried out through an online survey in Rio de Janeiro, Brazil. Also, the Hospital Anxiety and Depression Scale was used to assess participants mental health. RESULTS: Most of the participants reported emotional impact, followed by learning impact, financial impact, social impact, and technological impact, with a significant difference in the presence of depressive symptoms, but no significant difference in anxiety. The participants presented moderate anxiety levels, with no significant differences between genders, and mild levels of depressive symptoms with significant differences between genders. Also, younger students were more anxious than older students. In addition, female students with less social contact presented more depressive symtoms. CONCLUSION: From a clinical perspective, the findings provide insights into mental health among university students during the COVID-19 pandemic. These findings may help in the development of effective screening strategies and in the formulation of interventions that improve the mental health of students.


Asunto(s)
COVID-19 , Educación a Distancia , Ansiedad/psicología , Brasil/epidemiología , COVID-19/epidemiología , Estudios Transversales , Depresión/psicología , Femenino , Humanos , Masculino , Pandemias/prevención & control , SARS-CoV-2 , Estudiantes/psicología , Universidades
20.
J Virus Erad ; 8(2): 100078, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35784677
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