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AIM: To investigate whether high-intensity interval training (HIIT) improves physical performance, systolic blood pressure, and markers of oxidative stress and inflammation in skeletal muscle of spontaneously hypertensive rats (SHR). METHODS: Nineteen male SHR rats were randomly assigned to two groups: sedentary (SHRC) and trained (SHR+T). The SHR+T group trained five times a week for eight weeks on a treadmill, while the SHR group remained without any exercise stimulus throughout the experimental period. Maximum physical performance and systolic blood pressure (SBP) were assessed before and after the training period. The following variables were measured in the tibialis anterior (TA) muscle: gene expression of the NADPH oxidase complex (NOX2, NOX4, p22phox, p47phox) and the NF-kB pathway (NF-kB and Ik-B), lipid peroxidation (malonaldehyde; MDA), protein carbonylation, hydrophilic antioxidant capacity (HAC) and pro-inflammatory cytokines (IL-6 and TNF-α). RESULTS: SHR+T rats showed higher physical performance and levels of IL-6, and lower SBP and protein carbonylation (p<0.05), compared with SHRC rats. No significant differences (p>0.05) were observed in the other variables. SIGNIFICANCE: Our results indicate that HIIT is an effective non-pharmacologic strategy to improve physical performance, reduce SBP, and modulate the skeletal muscle oxidative damage and inflammation in hypertensive rats.

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Endometriosis is a common benign gynecological condition characterized by the growth of endometrial gland and stroma located outside the uterine cavity, which the current approaches for its detection are invasive and expensive, limiting their clinical utility. There is a need for cost-effective and minimally invasive approaches to facilitate the diagnosis of this disease. Attenuated total reflection Fourier-transform infrared and near infrared spectroscopy combined with multivariate classification were applied as a new tool to analyze blood plasma samples from women with endometriosis (n = 41) and healthy individuals (n = 34). In addition, the use of advanced data fusion strategies and multivariate analysis techniques improved the classification models and facilitated diagnostics segregation of both sample categories in a fast and non-destructive way, generating high levels of accuracy, sensitivity and specificity. 2D correlation analysis revealed strong positive correlations between the spectrochemical biomarkers identified in both IR regions. To the best of our knowledge, this is the first study demonstrating the efficacy of a new tool for fast and non-invasive diagnosis of endometriosis using blood plasma samples analyzed with IR spectroscopy combined with multivariate classification.

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People Living with HIV (PLWHIV) present an increased risk of developing non-communicable diseases, such as type 2 diabetes (T2D), making it crucial to optimize glycemic control and assess metabolic markers. HbA1c is considered the gold standard for evaluating glycemic control, while fructosamine (FA) offers advantages in assessing non-glycemic determinants. Discrepancies between HbA1c and FA are common and may be influenced by temporal factors. The Glycation Gap (G-gap) emerges as a tool to clarify these discrepancies. A cross-sectional analytical study was conducted involving PLWHIV with various glycemic statuses, as well as patients with T2D and controls. Sociodemographic data were collected along with blood samples to measure biochemical profiles and FA. HbA1c predicted from FA (pHbA1c) was calculated using a linear regression equation, facilitating G-gap determination. A positive correlation was found between G-gap and levels of VLDL-C and triglycerides (TG). Additionally, a negative correlation was observed between HDL-C levels < 40 mg/dL and a positive G-gap. These associations suggest that the G-gap may be a useful tool for metabolic evaluation in PLWHIV and a preventive method for identifying individuals at risk of developing chronic complications related to T2D.

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The use of herbicides is increasing because they are essential to ensure food safety, especially in the increasing need for food production. However, their misapplication leads to significant environmental problems. This study aimed to determine the cytotoxic effect of picloram on the bioindicator L. culinaris. Nine doses of picloram (0.1, 0.25, 0.5, 0.75, 1, 1.5, 1.5, 2.0, 2.5, and 5 mg/L) were evaluated for their impact on root growth, mitotic index, and frequency of chromosomal abnormalities. Treatment with 5 mg/L picloram significantly inhibited root growth (0.24 ± 0.1 cm, 0.4 ± 0.1 cm, and 0.5 ± 0.15 cm at 24, 48, and 72 h, respectively) and reduced the mitotic index (5.2 ± 10.8), evidencing an interference in cell division. The frequency of chromosomal abnormalities increased with higher concentrations of picloram, suggesting a genotoxic effect even at low concentrations. These findings highlight the need to thoroughly evaluate the effects of herbicides on various aspects of plant development and cellular integrity to gain a more complete understanding of their toxicity and the environmental risks associated with them.

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OBJECTIVES: The ubiquitin proteasome system is the main mediator of inflammation-induced muscle atrophy through the expression of TRIM63 and Atrogin-1. The aim of this study was to address the expression of these ubiquitin ligases and their relationship with inflammatory and atrophy parameters of patients with idiopathic inflammatory myopathies (IIM). METHODS: We recruited 37 adult IIM patients, and 10 age and sex-matched healthy donors. We assessed the proportion of different peripheral blood mononuclear cells (PBMC) subsets expressing TRIM63 and Atrogin-1 and the serum amount of theses ubiquitin ligases, cytokines, and chemokines, using multiparametric flow-cytometry, ELISA and luminometry respectively. The muscle expression of TRIM63 and Atrogin-1 was assessed by confocal microscopy. We compared the quantitative variables with the Mann-Whitney U test and assessed the correlations with Spearman Rho. RESULTS: IIM patients had a higher proportion of TRIM63+ CD4+ T cells (24.56 (7.71-53.23) vs. 2.55 (0.42-4.51), p<0.0001), TRIM63+ CD8+ T cells (15.1 (3.22-37.40) vs. 1.06 (0.83-2.45), p=0.0002), TRIM63+ monocytes (14.09 (3.25-29.80) vs. 1.97 (0.59-7.64), p=0.011), Atrogin-1+ CD4+ T cells (27.30 (6.61-64.19) vs. 2.55 (0.42-4.51), p<0.0001), Atrogin-1+ CD8+ T cells (14.88 (5.99-34.30) vs. 2.33 (0.60-8.01), p=0.001), and Atrogin1+ monocytes (17.38 (8.93-47.37) vs. 1.41 (0.79-3.77), p<0.0001). Muscle from IIM patients had a higher expression of TRIM63 and Atrogin-1. TRIM63+ CD8+ T cells mainly correlated with serum IL-2, IL-4, IL-8, IL-10, G-CSF, and TNF-a. CONCLUSIONS: TRIM63 and Atrogin-1 are expressed in PBMC and muscle from patients with IIM and correlate with serum cytokines, and chemokines. This mechanism may contribute to the inflammation-induced muscle atrophy in IIM.

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BACKGROUND: Systemic sclerosis (SSc) is a complex disease whose diagnosis is based on clinical manifestations, serological testing for autoantibodies, and nailfold capillaroscopy. Although some proteins have been proposed as biomarkers, the diagnosis of SSc remains a challenge for clinicians. The soluble oncostatin M receptor (sOSMR) is a potential biomarker for the diagnosis of SSc, as it appears to act as an antagonist of oncostatin M (OSM)-mediated signaling, which is involved in biological and inflammatory processes, including tissue injury and fibrosis. Therefore, this study aimed to evaluate the diagnostic performance of sOSMR in systemic sclerosis. METHODOLOGY: Serum samples were collected from 105 patients with SSc, 50 with rheumatoid arthritis (RA), 64 with systemic lupus erythematosus (SLE), and 130 healthy controls (HC). The sOSMR levels were measured using an ELISA kit, and a receiver operating characteristic (ROC) curve was used to analyze the biomarker's potential for diagnosing SSc. RESULTS: sOSMR levels are significantly elevated in the serum of patients with SSc when compared to patients with RA and SLE, as well as healthy controls (p < 0.0001 for all comparisons). The area under the curve (AUC) of ROC curve analysis revealed the ability of sOSMR serum levels to distinguish patients with SSc from those with RA (0.901 [95 % CI 0.842-0.943]; p < 0.0001), with a sensitivity of 89.52 % and specificity of 78.00 %, and from patients with SLE (0.897 [95 % CI 0.841-0.938]; p < 0.0001), with a sensitivity of 81.90 % and specificity of 89.06 %, as well as from healthy controls (0.876 [95 % CI 0.827 - 0.916]; p < 0.0001), with a sensitivity of 82.86 % and specificity of 81.54 %. When comparing patients with SSc to patients with other diseases (RA and SLE combined), an AUC of 0.898 ([95 % CI 0.851-0.935]; p < 0.0001) was found, with a sensitivity of 82.86 % and specificity of 85.09 %. CONCLUSION: Serum sOSMR levels are elevated in patients with SSc and have shown a good ability to distinguish between SSc patients, patients with other autoimmune rheumatologic diseases (RA and SLE), and healthy controls. Thus, sOSMR is a promising marker for diagnosing SSc.

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BACKGROUND: Peptidyl arginine deiminases (PADs) and citrullinated H3 histone (H3Cit) play a crucial role in the inflammatory response. These components determine various clinical situations in COVID-2019 associated pneumonia. Single nucleotide polymorphisms (SNPs) in the genes PADI2 and PADI4 may influence the outcome of poorer patient outcomes. We analyze the association of circulating levels NETs biomarkers (PAD2, PAD4, and H3Cit) and the SNPs on PADI2 (rs1005753 and rs2235926) and PADI4 (rs11203366, rs11203367, and rs874881) in hospitalized patients with severe acute respiratory distress syndrome (ARDs) by SARS-CoV-2 pneumonia. METHODS: A cross-sectional study in 160 hospitalized patients with ARDs by SARS-CoV-2 pneumonia. The plasma levels of PAD2, PAD4, and H3Cit were determined by ELISA method. The SNPs were determined by qPCR using TaqMan probes. Logistic regression models and receiver operating characteristics (ROC) curve were used to assess the association and predictive value of PAD2, PAD4, and H3Cit plasma levels in outcome by ARDs by SARS-CoV-2 pneumonia. RESULTS: PAD2, PAD4, and H3Cit concentrations were predictors of invasive mechanical ventilation (IMV) requirement and non-survival. PAD2 were associated with non-survival, while PAD4 and H3Cit were associated with requirement IMV. In addition, PAD2 and PAD4 concentrations were related with inflammation markers such as NLR, MLR, dNLR, SII, SIRI, AISI, and NHL. In the carriers of TT genotype of rs1005753 of PADI2 were associated with increased of H3Cit, while, the carriers of GTG/GTG haplotype of PADI4 was related to the presence of increased of PAD4 circulating levels. CONCLUSION: SNPs in PADI2 and PADI4 have a significant influence on concentrations of PAD2, PAD4, and H3Cit, which are predictor markers of requirement IMV and non-survival in severe ARDS by SARS-CoV-2 pneumonia.

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OBJECTIVES: To evaluate the effectiveness of 18 different host biomarkers in differentiating bacterial from non-bacterial acute febrile illness (AFI) in resource-limited settings, specifically in Brazil, Malawi and Gabon. DESIGN: Multinational, cross-sectional study. SETTING: The study was carried out across multiple primary healthcare facilities, including urban and rural settings, with a total of three participating centres. Recruitment took place from October 2018 to July 2019 in Brazil, May to November 2019 in Gabon and April 2017 to April 2018 in Malawi. PARTICIPANTS: A total of 1915 participants, including children and adults aged 21-65 years with a fever of≤7 days, were recruited through convenience sampling from outpatient clinics in Brazil, Gabon and Malawi. Individuals with signs of severe illness were excluded. Written consent was obtained from all participants or their guardians. INTERVENTION: This is not applicable as the study primarily focused on biomarker evaluation without specific therapeutic interventions. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was the ability of each host biomarker to differentiate between bacterial and non-bacterial AFI, as evaluated by area under the receiver operating characteristic (AUROC) curves. Secondary outcomes included the performance of individual biomarkers across the different study sites and in a multivariable setting. RESULTS: A Kruskal-Wallis test, adjusted by Benjamini-Hochberg, was performed for each biomarker to identify covariates with a significant difference in the distribution of biomarker values. The analysis revealed that country of origin (Brazil, Gabon, Malawi), age, sex and malaria status significantly impacted biomarker distribution (p≤0.001). The most widely known biomarkers, such as white blood cell (WBC) count and C-reactive protein (CRP), demonstrated the best performance in distinguishing between bacterial and non-bacterial infections, with AUROCs reaching up to 0.83 (0.77-0.88) for WBC count and 0.71 (0.59-0.82) for CRP. However, none of the evaluated novel host biomarkers exhibited high performance (AUROC<0.70 in most cases) and variations in biomarker performance were observed across the three settings. Multivariable analyses demonstrated that while the best combination of biomarkers achieved higher AUROCs, the increase was modest (1-13%), suggesting that the interaction of biomarkers contributed minimally to predictive accuracy. CONCLUSIONS: There is a continued need for innovation in the host-biomarker space as the available markers do not meet the needs of diverse populations around the globe. This highlights the importance of targeted evaluations in non-severe patients in multiple settings to understand the true potential for real-life use. The findings highlight that not one-marker fits all settings and novel innovations remain urgently needed. TRIAL REGISTRATION NUMBER: Clinical trial number: NCT03047642.

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BACKGROUND: Despite progress in healthcare for people living with HIV/AIDS (PLWHA), many still present with advanced HIV, thus increasing their risk of death. Late initiation of treatment and poor adherence to antiretroviral therapy (ART) are key contributing factors. This study aimed to evaluate cytokines as mortality predictors among hospitalized PLWHA. It assessed the risk of death between ART-naïve and ART-non-adherent PLWHA with advanced HIV and quantified immunological markers in post-mortem samples to determine the influence of irregular ART use. METHODS: A longitudinal observational study was conducted at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus, Brazil, with 111 participants recruited between 2018 and 2019. Clinical and laboratory data were obtained from electronic medical records. Plasma samples were analyzed for 27 cytokines/chemokines using the Luminex® multiplex assay within 72 h of admission and 6 h after post-mortem. RESULTS: ART-naïve PLWHA had a higher risk of death. Most of the 27 immunological markers analyzed in the post-mortem were elevated in those who died compared to those who were discharged. Increased levels of IFNγ, CCL2, and CCL3 were associated with death. Elevated immunological markers in ART-naïve PLWHA correlated with CD4 cell counts. Notably, IL-17 increased in ART-naïve PLWHA, while IL-2 increased in ART-non-adherent PLWHA, indicating a dichotomy. T helper-2 responses were marked by IL-9 in ART-naïve and IL-5 in ART-non-adherent PLWHA. CONCLUSIONS: ART-naïve PLWHA hospitalized with advanced HIV have a higher risk of death. Some immunological markers are possible predictors of death upon hospital admission due to HIV/AIDS, and their levels were found to be increased in post-mortem blood samples. Our findings suggest a polarized response among ART-naïve and ART-non-adherent PLWHA.

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Early diagnosis can be a beneficial factor for minimizing health risks related to multimorbidity. This study aims to assess the association of multimorbidity with interleukin 6 (IL-6), C-reactive protein (CRP), and adiponectin in 22-year-old participants of the Pelotas (Brazil) birth cohort. A total of 3,578 subjects had serum measurements of IL-6, CRP, and adiponectin at the 22-year-old visit. For multimorbidity evaluation, a list of 15 morbidities was used and divided into subgroups (cardiometabolic, pulmonary, allergic diseases, and mental disorders). The occurrence of ≥ 2 morbidities was higher in females (55.1%) than in males (45.2%). A negative association between multimorbidity and adiponectin was found in females, whereas positive associations between the number of diseases and IL-6 and CRP were observed in males. For both sexes, cardiometabolic problem was the morbidity most associated with the markers. The analysis for isolated diseases identified dyslipidemia was the only cardiometabolic condition associated with physiological markers. Our findings suggest an inverse association between multimorbidity and adiponectin in females, as well as a direct cumulative association between the number of diseases and IL-6 and CRP in males at a young age.

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This study aimed to understand the facilitators, barriers, and strategies for the use of food intake markers by primary health care (PHC) professionals. The responses of 235 healthcare health care professionals to an electronic questionnaire were used to develop a script for virtually conducted focus groups. In 10 focus groups, 34 professionals from healthcare and management positions from all Brazilian macroregions were included, and the transcripts were thematically analyzed. Healthcare professionals and managers emphasized the need for infrastructure to properly use the markers, pointing to the lack of equipment and connection instabilities as the main barriers. Managers highlighted the possibility of its use by any professional as a facilitator, whereas healthcare professionals positively indicated the structure of the markers. However, participants mentioned the lack of awareness about their importance as a barrier. Despite its slowness, the accessibility of the platforms to register the markers emerged as a facilitator, as did its conditionality with public policies, especially when linked to financial incentives. The focus groups allowed the exchange of strategies, such as continuing education, training for typists, ways to use markers in health care spaces, and expansion of data dissemination. Investment in infrastructure, professional training, and collaboration between PHC teams, with the sharing of strategies, configured crucial factors to strengthen the use of food intake markers.

Este estudo buscou compreender facilitadores, barreiras e estratégias para o uso de marcadores do consumo alimentar por profissionais da atenção primária à saúde (APS). As respostas de 235 profissionais de saúde a um questionário eletrônico foram utilizadas para desenvolver um roteiro para grupos focais realizados virtualmente. Em 10 grupos focais, 34 profissionais de cargos assistenciais e gestão de todas as macrorregiões brasileiras foram incluídos e as transcrições das gravações foram analisadas tematicamente. Profissionais da assistência e gestores enfatizaram a necessidade de infraestrutura para o uso adequado dos marcadores, apontando falta de equipamentos e instabilidade na conexão como principais barreiras. Gestores destacaram a possibilidade de uso por qualquer profissional como facilitadora, ao passo que profissionais da assistência assinalaram positivamente a estrutura dos marcadores, mas a falta de sensibilização sobre sua importância foi mencionada como barreira pelos participantes. Apesar da lentidão, a acessibilidade das plataformas para registro dos marcadores foi apontada como facilidade, assim como a condicionalidade com políticas públicas, especialmente quando vinculadas a incentivos financeiros. Os grupos focais permitiram trocas de estratégias, como educação permanente, treinamentos para digitadores, formas de uso dos marcadores nos espaços de assistência à saúde e ampliação da divulgação dos dados. Investir em infraestrutura, qualificação profissional e colaboração entre equipes da APS, com compartilhamento de estratégias, foram fatores cruciais para fortalecer o uso dos marcadores do consumo alimentar.

Este estudio pretende identificar los facilitadores, las barreras y las estrategias para el uso de marcadores de consumo de alimentos por parte de los profesionales de la atención primaria de salud (APS). Las respuestas de 235 profesionales de la salud a un cuestionario electrónico se utilizaron para desarrollar un guion para los grupos focales que se realizaron virtualmente. En 10 grupos focales, se incluyeron a 34 profesionales de puestos de atención y gestión de todas las macrorregiones brasileñas, y las transcripciones se analizaron temáticamente. Los profesionales y gestores de la asistencia enfatizaron la necesidad de una infraestructura para el uso adecuado de los marcadores, señalando como principales barreras la falta de equipos y la inestabilidad en la conexión. Los gerentes destacaron la posibilidad de uso por parte de cualquier profesional como facilitador, mientras que los profesionales de la atención señalaron positivamente la estructura de los marcadores, pero la falta de conciencia sobre su importancia fue mencionada como una barrera por los participantes. A pesar de la lentitud, se señaló como fácil la accesibilidad a las plataformas de registro de los marcadores, así como la condicionalidad con las políticas públicas, especialmente cuando se vinculan a incentivos financieros. Los grupos focales permitieron intercambiar estrategias, como la educación permanente, la capacitación de digitadores, las formas de uso de marcadores en los espacios de atención a la salud y la ampliación de la difusión de datos. La inversión en infraestructura, la calificación profesional y la colaboración entre los equipos de APS, con el intercambio de estrategias, fueron factores cruciales para fortalecer el uso de marcadores de consumo de alimentos.

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Atrazine (ATZ) is an herbicide that can persist in terrestrial and aquatic environments and potentially cause significant harm to amphibian health. Therefore, the Brazilian National Environment Council (CONAMA) sets the limit concentration of ATZ in waters at 2µg/L. Our study evaluated the genotoxic, mutagenic, and biochemical alterations in Dendropsophus minutus tadpoles in the 25 Gosner stage, to acute exposure (96h) of ATZ (T1 - 0.02µg/L, T2 - 0.04µg/L, T3 - 0.08µg/L, T4 - 2µg/L). The comet assay showed all concentrations caused DNA damage with an increase to T2, T3, and T4. In the micronucleus test (MN) and Erythrocyte Nuclear Abnormality test (ENA), T3 and T4 accumulated more anucleated (AN), binucleated cells (BC) and ENAs. Redox imbalance was not detected. Therefore, we conclude that the concentrations tested are not safe for the health and development of D. minutus tadpoles, and the CONAMA limit needs to be reviewed since all tadpoles presented DNA damage. More studies are necessary to identify other alterations that ATZ can cause in the tadpole health of tropical species. Therefore, implementing public policies aimed at safeguarding the lives of both adult and juvenile amphibians is imperative for the conservation of biodiversity and ecosystem stability.

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BACKGROUND: A new formula for estimating small, dense, low-density lipoprotein cholesterol (sdLDL-C) based on the results of the standard lipid panel is proposed. OBJECTIVES: To assess the association between estimated sdLDL-C (EsdLDL-C) and atherosclerotic cardiovascular disease (ASCVD) risk. METHODS: A total of 12,192 participants from the Korea National Health and Nutrition Examination Survey (KNHANES) database between 2010 and 2020 were included in this cross-sectional study. EsdLDL-C was calculated as EsdLDL-C= LDL-C - [1.43 × LDL-C - (0.14 × (ln (TG) × LDL-C)) - 8.99]. Logistic regression analyses were utilized to assess the association between EsdLDL-C and ASCVD risk. Subgroup analyses were performed based on age, body mass index (BMI), hypertension, and diabetes. An odds ratio (OR) with a 95% confidence interval (CI) was used for evaluation. P<0.05 was considered statistically significant. RESULTS: Among 12,192 participants, 1,239 (10.16%) had ASCVD. The mean sdLDL-C of participants was estimated to be 42.43±14.75 mg/dL using the formula. Elevated EsdLDL-C levels (OR=1.33; 95%CI, 1.06-1.66) were associated with an increased risk of ASCVD. Subgroup analyses found that there may be an interaction between EsdLDL-C (Pinteraction= 0.001) or non-HDL-C (Pinteraction= 0.015) and hypertension on ASCVD risk. CONCLUSIONS: Elevated estimated sdLDL-C levels were associated with the risk of ASCVD, and estimated sdLDL-C might be an alternative to sdLDL-C measurement for ASCVD risk assessment.

FUNDAMENTO: Uma nova fórmula para estimar o colesterol de lipoproteínas pequenas, densas e de baixa densidade (sdLDL-C) com base nos resultados do painel lipídico padrão é proposto. OBJETIVOS: Para avaliar a associação entreestimado sdLDL-C (EsdLDL-C) e o risco de doença cardiovascular arterosclerótica (DCVA). MÉTODOS: Um total de 12.192 participantes do banco de dados do Korea National Health and Nutrition Examination Survey (KNHANES) entre 2010 e 2020 foram incluídos neste estudo transversal. EsdLDL-C foi calculada como EsdLDL-C = LDL-C- [1,43 × LDL-C - (0,14 × (ln (TG) × LDL-C)) - 8,99]. Análises de regressão logística foram utilizadas para avaliar a associação entre EsdLDL-C e risco de DCVA. As análises de subgrupos foram realizadas com base na idade, índice de massa corporal (IMC), hipertensão, e diabetes. Uma razão de possibilidades (OR) com um intervalo de confiança de 95% (IC) foi utilizado para avaliação. P<0,05 foi considerado estatisticamente significativo. RESULTADOS: Entre 12.192 participantes, 1.239 (10,16%) tinham DCVA. A média de sdLDL-C dos participantes foi estimada em 42,43±14,75 mg/dL usando a fórmula. Níveis elevados de EsdLDL-C (OR=1,33; IC 95%, 1,06-1,66) foram associados a um aumento do risco de DCVA. As análises de subgrupos descobriram que pode haver uma interação entre EsdLDL-C (Pinteração=0,001) ou não-HDL-C (Pinteração=0,015) e hipertensão no risco de DCVA. CONCLUSÕES: Níveis elevados estimados de sdLDL-C foram associados ao risco de DCVA, e o sdLDL-C estimado pode ser uma alternativa à medição do sdLDL-C para avaliação do risco de DCVA.

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BACKGROUND: Rapid progression of symptoms and development of Acute Respiratory Distress Syndrome (ARDS) frequently occurred during COVID-19 pandemic, while CT-Scan was useful to assess severity of lung damage, with classic patterns like early Ground Glass Opacity and/or late consolidation. Likewise, lung injury has been related to activation of the coagulation-fibrinolysis systems and pro-inflammatory mediators; where D-Dimer acquires prognostic relevance. The present study aimed to evaluate whether the extent of lung involvement and pattern of lung injury, as determined by chest CT-scan, are related with D-Dimer; and further impact clinical prognosis in patients with ARDS due to COVID-19. METHODS: Longitudinal, prospective, observational, multi-center study. Patients diagnosed with ARDS due to COVID-19, without previous lung damage, clotting disorder and/or anticoagulants use, who were attended at the Intensive Care Unit and Internal Medicine Department from March to June 2020. Tomographic extent of lung involvement was analyzed by image software, as well as damage patterns, assessed by experienced radiologists. Endpoints included relation of lung injury with coagulopathy markers like D-Dimer, and prognostic outcome including mortality, mechanical ventilation and hospitalization time. RESULTS: One-hundred and four patients mean aged 55 years old, 66% males, main comorbidities obesity, hypertension and diabetes mellitus. Larger lung damage was associated with older age, male gender and higher pro-inflammatory mediators like leukocytes and ferritin; whilst consolidation pattern was related to higher Body Mass Index. Higher values of D-Dimer were related either to a larger extent of lung involvement or late consolidation pattern. In addition, the extent of lung involvement was related with longer hospital stay, higher requirement of mechanical ventilation (HR 0.12, p < 0.01) and mortality rate (HR 0.13, p < 0.01); whereas late consolidation was mainly associated with requirement of mechanical ventilation (HR 0.23, p < 0.01). CONCLUSION: Tomographic extent of lung involvement and the pattern of lung injury are related with coagulopathy severity markers like D-Dimer, and own prognostic clinical ability in ARDS.

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Hepatitis B virus surface antigen (HBsAg), IgM and IgG antibodies to hepatitis B virus core antigen (anti-HBcIgM and anti-HBcIgG) comprise serological markers of hepatitis B virus (HBV) infection of great importance in the epidemiological surveillance of hepatitis B, since they have been routinely considered for classifying the acute and chronic clinical forms of HBV infection. This classification is established according to the expression and dynamics of these markers in the infected person's bloodstream, which serves as the basis for the differential diagnosis between the two clinical entities. However, in certain circumstances, both acute and chronic infection, the detection of these markers may not occur in the bloodstream, favoring the occurrence of atypical serological profiles of infection, and compromising the correct infection clinical classification. In addition, the complex and varied nature of hepatitis B serological profiles may compromise the health professional's ability to analyze the case and, thus, correctly classify the infection's clinical form. Since the expression of these markers in the bloodstream occurs dynamically, with consequent changes in the patient's serological profile as he progresses towards recovery or chronicity, the diagnosis of acute or chronic infection may also be compromised, if it is established based on the collection of a single sample and without knowing the patient's clinical history and their epidemiological antecedents. This manuscript addresses the sensitivity and specificity of HBsAg, anti-HBcIgM, and anti-HBcIgG serological markers detection in the clinical classification of HBV infection and in the epidemiological surveillance of hepatitis B. This review is covering the clinical and epidemiological interpretations of the markers in and of themselves, not in reference to any specific assays.

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PURPOSE: A vegan diet is associated with health benefits but may also lead to inadequate intake of essential nutrients. Due to the lower selenium content in plant-based compared to animal-based foods, many vegans do not reach the recommended selenium intake in Europe. The only plant-based food with high selenium content is the Brazil nut, even though there is also a high variability. Therefore, we investigated the effectiveness of Brazil nut butter compared to a dietary supplement as selenium source to improve the selenium status of vegans and omnivores. METHODS: 44 vegans and 42 omnivores were randomly assigned to one of three intervention groups, either receiving placebo or consuming additional 55 µg of selenium daily as Brazil nut butter or supplement for two weeks. Serum selenium concentrations, glutathione peroxidase 3 (GPX3), and selenoprotein P (SELENOP) were measured at baseline and after intervention. Additionally, dietary selenium intake was estimated using a five-day dietary protocol. RESULTS: The estimated selenium intake was significantly lower in vegans compared to omnivores and correlated with all three selenium biomarkers. Independent of the dietary pattern (vegan or omnivore), Brazil nut butter as well as supplement significantly increased serum selenium and SELENOP concentrations, while there were no changes in the placebo groups. Both interventions were equally effective in increasing selenium levels, but the upregulation of SELENOP was more pronounced in vegans than in omnivores. CONCLUSION: Brazil nuts are a plant-based source of selenium suitable for vegans and omnivores to improve their selenium status when consumed once in a while. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: Clinical trials registration number: NCT05814874, April 18 2023.

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BACKGROUND: Metabolomics is an analytical approach utilized to explore the metabolic profiles of biological systems. This process typically involves the application of techniques such as nuclear magnetic resonance (NMR) spectroscopy and mass spectrometry (MS). In the case of schistosomiasis, metabolomics has been employed to identify potential diagnostic biomarkers, examine the host's metabolic response, and explore more effective therapeutic strategies. The objective of this scoping review is to assess the scope and characteristics of metabolomic research on schistosomiasis conducted over the past decade. METHODS: To identify relevant original publications, a systematic search was conducted in the PubMed and Web of Science databases using the following search terms: ("Metabolomics" OR "Metabolomic" OR "Metabonomics" OR "Metabonomic") AND ("Schistosomiasis" OR "Schistosoma"). These terms were applied to the titles and abstracts of the publications, with a focus on the period from January 2014 to December 2024. RESULTS: The initial search yielded 48 articles. However, after a thorough evaluation of the abstracts, 14 articles were selected based on the established inclusion criteria. The selection process is visually depicted in the PRISMA flowchart. The majority of the studies included in this review were conducted in China (7 articles) and Brazil (3 articles). Approximately two-thirds of the studies utilized animal models, with serum serving as biofluid in 66% of the studies. The findings of this scoping review suggest that chromatographic techniques coupled with mass spectrometry are predominantly used in metabolomic research on schistosomiasis, accounting for 75% of the studies. The identified metabolites are associated with metabolic pathways related to glycolysis, the TCA cycle, and amino acid metabolism, as well as demonstrating alterations resulting from intestinal dysbiosis observed during the infection. As exemplified by succinate and citrate, which are present in the alterations of energy pathways in Schistosoma mansoni and Schistosoma japonicum species. The serum levels of these metabolites are modified, reflecting the host's metabolic and immunological responses induced by the infections. CONCLUSIONS: These studies successfully elucidated the metabolic pathways and key metabolites involved in schistosomiasis. The findings are significant for the future identification of diagnostic biomarkers and the development of novel antiparasitic agents targeting Schistosoma species. CLINICAL TRIAL: Not Applicable.

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The early sequence of respiratory failure events after the onset of sepsis is still unknown. We hypothesize that the lung should signal through circulating extracellular vesicles (EVs) when it is affected by a systemic inflammatory response. Blood samples were obtained from septic patients with (n = 5) and without acute respiratory distress syndrome (ARDS) (n = 13) at 24 h of intensive care unit admission and 3 days later at Sírio-Libanês Hospital. Pulmonary-originated sepsis was not considered. The characteristics of the plasma-isolated EVs were compatible with exosomes. 48 miRNAs were evaluated by real-time PCR. Comparing all samples from patients with sepsis + ARDS to sepsis only, 9 miRNAs are transported in smaller amounts: miR-766 (-35.7, p = 0.002), miR-127 (-23.8, p = 0.001), miR-340 (-13.5, p = 0.006), miR-29b (-12.8, p = 0.001), miR-744 (-7.1, p = 0.05), miR-618 (-4.0, p = 0.02), miR-598 (-3.8, p = 0.035), miR-1260 (-2.5, p = 0.035); and miR-885-5p is expressed at higher levels (9.5; p = 0.028). In paired samples, the set of altered miRNAs is generally different (p < 0.05) between sepsis + ARDS (miR-1183,-1267,-1290,-17,-192,-199a-3p,-25,-485-3p,-518d,-720) or sepsis only (miR-148a,-193a-5p,-199a-3p,-222,-25,-340,744). Bioinformatic analysis showed that when sepsis is associated with ARDS, those differentially expressed miRNAs potentially target messenger RNAs from the Glycoprotein VI/GP6 signaling pathway. Circulating EV-miRNA cargo could be potential biomarkers of lung inflammation during sepsis in patients requiring mechanical ventilation.

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BACKGROUND: Serum cardiac troponin (cTn) elevation is a well-established phenomenon in sepsis. However, the clinical significance of this phenomenon with high-sensitivity (hs) assays and the current sepsis definition needs to be settled. RESEARCH QUESTION: What is the association between early serum cTn levels measured by hs-assays and the risk of short-term mortality in septic patients? STUDY DESIGN AND METHODS: We conducted a systematic review using a comprehensive PubMed, Scopus, and Embase search. Studies were eligible if they reported association data on early hs-cTn and mortality in an adult sample with sepsis that met the Sepsis-3 definition. For the synthesis of the effect of hs-cTn on mortality, we applied random effect models on the pooled unadjusted and adjusted odds ratio (OR and aOR, respectively) of elevated vs. normal hs-cTn serum values, and on the crude standardized mean difference (SMD) of hs-cTn between survivors and non-survivors. RESULTS: In total, 6242 patients from 17 studies were included, with short-term mortality rates ranging from 16.9% to 53.8%. Using a crude analysis, non-survivor patients showed higher hs-cTn than survivors (SMD of 0.87, 95%CI: 0.41-1.33). Elevated hs-cTn was associated with increased mortality (OR = 1.78, 95% CI: 1.41-2.25). However, this prognostic effect was absent in studies that adjusted for different confounders (aOR = 1.06, 95% CI: 0.99-1.14). DISCUSSION AND CONCLUSIONS: Non-survivors of sepsis exhibited significantly elevated hs-cTn levels. While elevated hs-cTn levels are associated with an increased risk of mortality, they are not independently associated with this outcome in sepsis.

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Up to 30% of individuals with obesity may exhibit normal insulin sensitivity, a favorable lipid profile, and no signs of hypertension. This prompts the exploration of factors distinguishing cardiometabolically healthy individuals from those developing complications. This cross-sectional study included 116 individuals categorized into four groups by combining abdominal obesity and cardiometabolic health statuses. We compared circulating adipokines and gut microbiota composition between these groups. Individuals with abdominal obesity had higher levels of hs-CRP, TNF-α, MCP-1, IL-18, chemerin, and leptin, and a less favorable gut microbiota composition, including higher levels of potentially harmful bacteria (CAG-Pathogen) and lower levels of beneficial bacteria (CAG-Ruminococcaceae and CAG-Akkermansia), compared to those with adequate waist circumference. Those with obesity but cardiometabolically healthy displayed similar adipokine levels and microbiota composition to those with adequate waist. In contrast, individuals with abdominal obesity cardiometabolically abnormal exhibited significantly higher levels of hs-CRP, IL-18, chemerin, and leptin, and lower levels of adiponectin and CAG-Ruminococcaceae compared to those with abdominal obesity cardiometabolically healthy and adequate waist. Additionally, they differed in hs-CRP and adiponectin/leptin ratio from individuals with obesity cardiometabolically healthy. These findings suggest that altered adipokine profiles and gut microbiota may contribute to the development or persistence of cardiometabolic complications in obesity.