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1.
Membranes (Basel) ; 14(4)2024 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-38668110

RESUMO

The wine industry is a sector of great importance in the Spanish economy, contributing substantial annual revenues. However, one challenge facing the industry is the amount of waste generated, reaching millions of tons annually. These residues consist of organic matter of industrial interest, such as polyphenols. These substances are characterised by their excellent antioxidant properties, making them ideal for use in the food, cosmetic, and pharmaceutical industries. Modern techniques, such as membrane technology, are explored for their extraction based on separating compounds according to size. This work studies a sequential filtration process using ultrafiltration (UF) and nanofiltration (NF) membranes at different operating conditions (2 bar and 9.5 bar for UF and NF, respectively, at 20 °C) to extract polyphenols from wine lees. The results show a total polyphenols rejection rate for each process of 54% for UF and 90% for NF. Pore blocking models have been studied for the UF process and an intermediate pore blocking of the membrane upon wine lees filtration has been identified. A mathematical model that justifies the behavior of a polymeric NF membrane with the filtration of pre-treated vinasse residues has been validated. This study shows a viable process for extracting polyphenols from wine lees with sequential membrane technology.

2.
Artigo em Inglês | MEDLINE | ID: mdl-38639866

RESUMO

OBJECTIVES: This manuscript aims to understand the association between self-rated health and ethnic-racial characteristics (i.e., skin color, self-ascription, and Indigenous language) in the context of the Mexican population. DESIGN: Logistic regression analyses, using the 2019 PRODER (N = 7187)-a representative survey at the national level. We centered the analysis on two measures of skin color: the interviewer assessment of color skin (that has been used in previous studies), and the ITA scale, a measure constructed from optical digital colorimeter readings (a novel method in ethnoraciality studies in Mexico, included in the PRODER survey). RESULTS: In comparison to the interviewer's assessment of skin color, the ITA score shows a significant association with self-rated health, even in the presence of individual conditions, sociodemographic traits, and life-course events. In contrast, ethnic-racial self-ascriptions and speaking of an Indigenous language do not show any statistical associations. CONCLUSION: Contrary to previous research, our results suggest a positive association between skin color and self-rated health, when the former is assessed with the colorimeter readings; it means that those with lighter color skin are more prone to report a better health perception. It has methodological implications in the way skin color is observed.

3.
Chem Sci ; 15(14): 5056-5060, 2024 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-38577374

RESUMO

Chemistry plays a central role in science and is the basis of one of the major, more impactful, and diverse industries. However, to address the most pressing global challenges, we must learn to create connections in an effective and meaningful way, with other disciplines, industries, and society at large. Here, we present the IUPAC Top Ten Emerging Technologies in Chemistry as an example of an initiative that highlights the value of the most promising advances in chemistry and contributes to creating connections to accelerate sustainable solutions for our society and our planet.

4.
Phys Chem Chem Phys ; 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38563329

RESUMO

We characterize the effect of rubidium ions on water-ice nanoislands in terms of area, fractal dimension, and apparent height by low-temperature scanning tunneling microscopy. Water nanoislands on the pristine Cu(111) surface are compared to those at similar coverage on a Rb+ pre-covered Cu(111) surface to reveal the structure-giving effect of Rb+. The presence of Rb+ induces changes in the island shape, and hence, the water network, without affecting the nanoisland volume. The broad area distribution shifts to larger values while the height decreases from three bilayers to one or two bilayers. The nanoislands on the Rb+ pre-covered surface are also more compact, reflected in a shift in the fractal dimension distribution. We relate the changes to a weakening of the hydrogen-bond network by Rb+.

5.
bioRxiv ; 2024 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-38586009

RESUMO

The nuclear pore complex (NPC) is the sole mediator of nucleocytoplasmic transport. Despite great advances in understanding its conserved core architecture, the peripheral regions can exhibit considerable variation within and between species. One such structure is the cage-like nuclear basket. Despite its crucial roles in mRNA surveillance and chromatin organization, an architectural understanding has remained elusive. Using in-cell cryo-electron tomography and subtomogram analysis, we explored the NPC's structural variations and the nuclear basket across fungi (yeast; S. cerevisiae), mammals (mouse; M. musculus), and protozoa (T. gondii). Using integrative structural modeling, we computed a model of the basket in yeast and mammals that revealed how a hub of Nups in the nuclear ring binds to basket-forming Mlp/Tpr proteins: the coiled-coil domains of Mlp/Tpr form the struts of the basket, while their unstructured termini constitute the basket distal densities, which potentially serve as a docking site for mRNA preprocessing before nucleocytoplasmic transport.

6.
Int J Infect Dis ; 143: 107034, 2024 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-38561041

RESUMO

OBJECTIVES: The aim of this study was to analyze the viral load (VL) using cycle threshold (Ct) in patients infected with influenza A (H3N2). METHODS: This prospective study was conducted during the 2022-2023 influenza season in sentinel, non-sentinel, and hospitalized patients of Castilla y León (Spain). Respiratory samples were obtained from nasopharyngeal swabs and analyzed by quantitative reverse transcription-polymerase chain reaction specific for influenza A (H3N2) to obtain the Ct value. RESULTS: A total of 1047 individuals were enrolled (174 [16.6%] sentinel, 200 [19.1%] non-sentinel, 673 [64.3%] hospitalized). The mean Ct value was lower in infants, young children, and in the elderly, with a sharp increase in the last from 65 years until 90 years. In addition, the lower Ct values were observed in non-sentinel patients and then in hospitalized patients, probably because non-sentinel are outpatients in the acute phase of the influenza infection. CONCLUSIONS: A higher VL (lower Ct value) is related to the extreme ages of life: children and the elderly. Furthermore, a higher VL is related with the care setting, being probably higher in outpatients because they are in the acute phase of the disease and slightly lower in hospitalized patients because they are attended during the post-acute phase.

7.
J Clin Med ; 13(5)2024 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-38592126

RESUMO

INTRODUCTION: Patients with heart failure (HF) are known to have an increased risk of pulmonary embolism (PE), but there is limited evidence regarding the prognostic implications of HF in patients with acute PE and the relationship between PE prognosis and left ventricular ejection fraction (LVEF). The primary objective of this study was the development of a composite outcome (mortality, major bleeding, and recurrence) within the first 30 days. The secondary objective was to identify the role of LVEF in predicting the development of early complications in patients with both HF and reduced LVEF. MATERIAL AND METHODS: A prospective study was conducted at two tertiary hospitals between January 2012 and December 2022 to assess differences among patients diagnosed with acute PE based on the presence or absence of a history of HF. Cox regression models were employed to assess the impact of HF and reduced LVEF on the composite outcome at 30 days. RESULTS: Out of 1991 patients with acute symptomatic PE, 7.13% had a history of HF. Patients with HF were older and had more comorbidities. The HF group exhibited higher mortality (11.27% vs. 4.33%, p < 0.001) and a higher incidence of major bleeding (9.86% vs. 4.54%, p = 0.005). In the multivariate analysis, HF was an independent risk factor for the development of the composite outcome (HR 1.93; 95% CI 1.35-2.76). Reduced LVEF was independently associated with a higher risk of major bleeding (HR 3.44; 95% CI 1.34-8.81). CONCLUSION: In patients with acute pulmonary embolism, heart failure is independently associated with a higher risk of early complications. Additionally, heart failure with reduced LVEF is an independent risk factor for major bleeding.

8.
JACS Au ; 4(2): 744-759, 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38425934

RESUMO

The tandem CO2 hydrogenation to hydrocarbons over mixed metal oxide/zeolite catalysts (OXZEO) is an efficient way of producing value-added hydrocarbons (platform chemicals and fuels) directly from CO2via methanol intermediate in a single reactor. In this contribution, two MAPO-18 zeotypes (M = Mg, Si) were tested and their performance was compared under methanol-to-olefins (MTO) conditions (350 °C, PCH3OH = 0.04 bar, 6.5 gCH3OH h-1 g-1), methanol/CO/H2 cofeed conditions (350 °C, PCH3OH/PCO/PH2 = 1:7.3:21.7 bar, 2.5 gCH3OH h-1 g-1), and tandem CO2 hydrogenation-to-olefin conditions (350 °C, PCO2/PH2 = 7.5:22.5 bar, 1.4-12.0 gMAPO-18 h molCO2-1). In the latter case, the zeotypes were mixed with a fixed amount of ZnO:ZrO2 catalyst, well-known for the conversion of CO2/H2 to methanol. Focus was set on the methanol conversion activity, product selectivity, and performance stability with time-on-stream. In situ and ex situ Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), solid-state nuclear magnetic resonance (NMR), sorption experiments, and ab initio molecular dynamics (AIMD) calculations were performed to correlate material performance with material characteristics. The catalytic tests demonstrated the better performance of MgAPO-18 versus SAPO-18 at MTO conditions, the much superior performance of MgAPO-18 under methanol/CO/H2 cofeeds, and yet the increasingly similar performance of the two materials under tandem conditions upon increasing the zeotype-to-oxide ratio in the tandem catalyst bed. In situ FT-IR measurements coupled with AIMD calculations revealed differences in the MTO initiation mechanism between the two materials. SAPO-18 promoted initial CO2 formation, indicative of a formaldehyde-based decarboxylation mechanism, while CO and ketene were the main constituents of the initiation pool in MgAPO-18, suggesting a decarbonylation mechanism. Under tandem CO2 hydrogenation conditions, the presence of high water concentrations and low methanol partial pressure in the reaction medium led to lower, and increasingly similar, methanol turnover frequencies for the zeotypes. Despite both MAPO-18 zeotypes showing signs of activity loss upon storage due to the interaction of the sites with ambient humidity, they presented a remarkable stability after reaching steady state under tandem reaction conditions and after steaming and regeneration cycles at high temperatures. Water adsorption experiments at room temperature confirmed this observation. The faster activity loss observed in the Mg version is assigned to its harder Mg2+-ion character and the higher concentration of CHA defects in the AEI structure, identified by solid-state NMR and XRD. The low stability of a MgAPO-34 zeotype (CHA structure) upon storage corroborated the relationship between CHA defects and instability.

9.
Hepatology ; 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38447019

RESUMO

BACKGROUND AND AIMS: The landscape in primary biliary cholangitis (PBC) has changed with the advent of second-line treatments. However, the use of obeticholic acid (OCA) and fibrates in PBC-related cirrhosis is challenging. We assessed the impact of receiving a second-line therapy as a risk factor for decompensated cirrhosis in a real-world population with cirrhosis and PBC, and identify the predictive factors for decompensated cirrhosis in these patients. APPROACH AND RESULTS: Multicenter study enrolling 388 patients with PBC-cirrhosis from the Spanish ColHai registry. Biopsy (20%), ultrasound (59%), or transient elastography (21%) defined cirrhosis, and the presence of varices and splenomegaly defined clinically significant portal hypertension (CSPH). Paris-II and PBC OCA international study of efficacy criteria determined the response to ursodeoxycholic acid (UDCA), fibrates (n=93), and OCA (n=104). The incidence of decompensated cirrhosis decreased for UDCA versus OCA or fibrates in the real-world population, but they were similar considering the propensity score-matched cohort (UDCA 3.77 vs. second-line therapy 4.5 100 persons-year, respectively), as patients on second-line therapy exhibited advanced liver disease. Consequently, GGT, albumin, platelets, clinically significant portal hypertension, and UDCA response were associated with a decompensating event. OCA response (achieved in 52% of patients) was associated with bilirubin (OR 0.21 [95% CI: 0.06-0.73]) and AST (OR 0.97 [95% CI: 0.95-0.99]), while fibrate response (achieved in 55% of patients) with AST [OR 0.96 (95% CI: 0.95-0.98]). In patients treated with OCA, drug response (sHR 0.23 [95% CI: 0.08-0.64]), diabetes (sHR 5.62 [95% CI: 2.02-15.68]), albumin (sHR 0.34 [95% CI: 0.13-0.89]), and platelets (sHR 0.99 [95% CI: 0.98-1.00]) were related to decompensation. In patients treated with fibrate, drug response (sHR 0.36 (95% CI: 0.14-0.95]), albumin (sHR 0.36 (95% CI: 0.16-0.81]), and clinically significant portal hypertension (sHR 3.70 (95% CI: 1.17-11.70]) were associated with decompensated cirrhosis. CONCLUSIONS: Advanced PBC, rather than OCA and fibrates, was found to be associated with decompensating events. Therefore, biochemical and clinical variables should be considered when making decisions about the management of these drugs. Moreover, a positive response to OCA and fibrates reduced the risk of decompensation.

10.
J Clin Med ; 13(6)2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38541969

RESUMO

Background: Cylindrical fully-coated cobalt-chromium stems (CCS) have been widely used in femoral revisions. However, monoblock fluted conical tapered stems (FCTS) are growing in popularity. The present study seeks to determine whether there are any long-term differences between the two designs. Material and methods: A retrospective study of 38 CCS versus 40 FCTS was carried out. Demographic data, clinical variables and radiographic parameters were recorded. Results: Demographic data were comparable. A greater proportion of septic revisions, periprosthetic fractures and previous osteosynthesis failures was observed with FCTS versus CCS (p = 0.012). A greater use of FCTS was recorded in cases with bone defects of type IIIA and higher (p = 0.025). There were no significant differences in terms of in-hospital complications (p = 0.815), postoperative surgical complications or need for reoperation (p = 0.156). The CCS group presented a higher percentage of clinical thigh pain at the end of follow-up (p = 0.006). Additionally, a greater presence of radiolucencies was observed with CCS, especially in proximal zones (1, 7, 10 and 14). More subsidence, tip cortical hypertrophy and stress shielding were recorded in the CCS group. The overall survival at 120 months was 84.2% in the CCS group and 85% in the FCTS group (p = 0.520). When analyzing isolated aseptic loosening as the cause of failure, the survival rate was 94.7% in the CCS group and 95% in the FCTS group (p = 0.506). Conclusions: Both FCTS and CCS with diaphyseal anchorage afford excellent long-term survival rates, with no differences between the two designs. However, a higher incidence of stress shielding, radiolucencies and thigh pain with CCS seems to favor the use of FCTS.

11.
medRxiv ; 2024 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-38405699

RESUMO

Background and Objectives: GAA-FGF14 ataxia (SCA27B) is a recently reported late-onset cerebellar ataxia (LOCA) caused by a GAA repeat expansion in intron 1 of the FGF14 gene. Initial studies reviewing MR images of GAA-FGF14 ataxia patients revealed variable degree of cerebellar atrophy in 74-97% of them. A more detailed brain imaging characterization of GAA-FGF14 ataxia is now needed to provide 1) supportive diagnostic features and earlier disease recognition and 2) further information about the pathophysiology of the disease. Methods: We reviewed the brain MRIs of 35 patients (median age at MRI 63 years; range 28-88 years; 16 females) from Quebec (n=27), Nancy (n=3), Perth (n=3) and Bengaluru (n=2) including longitudinal studies for 7 subjects. We performed qualitative analyses to assess the presence and degree of atrophy in vermis, cerebellar hemispheres, brainstem, cerebral hemispheres, and corpus callosum, as well as white matter involvement. Following the identification of the superior cerebellar peduncles involvement, we verified its presence in 54 GAA-FGF14 ataxia patients from four independent cohorts (Tübingen n=29; Donostia n=12; Innsbruck n=7; Cantabria n=6). To assess lobular atrophy, we also performed quantitative cerebellar segmentation in 5 subjects and 5 age-matched controls. Results: Cerebellar atrophy of variable degree was documented in 33 subjects (94.3%); limited to the vermis in 11 subjects, extended to the hemispheres in 22. We observed bilateral involvement of the superior cerebellar peduncles (SCPs) in 22 subjects (62.8%). We confirmed this finding in 30/54 (55.6%) GAA-FGF14 positive subjects from the validation cohorts. Additional findings were: cerebral atrophy in 15 subjects (42.9%), ventricular enlargement in 13 (37.1%), corpus callosum thinning in 7 (20%), and brainstem atrophy in 1 (2.8%). Cerebellar segmentation showed reduced volumes of lobules X and IV in affected individuals. Discussion: Our study confirms that cerebellar atrophy is a key feature of GAA-FGF14 ataxia. The frequent SCP involvement observed in different cohorts may be specific to GAA-FGF14 ataxia, and its detection can support and accelerate the diagnosis. The predominant involvement of vestibulocerebellar lobule X correlates with the finding of downbeat nystagmus frequently observed in GAA-FGF14 ataxia patients.

12.
ACS Omega ; 9(4): 4138-4143, 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38313475

RESUMO

Science, including mathematics, physics, and, of course, chemistry, has its own language and symbols and names we learn in school. However, to teach it, communicate it, and use it, we use our own native languages. Most of the scientific literature, including this article, is in English, as are the texts published by the various scientific unions, including the International Union of Pure and Applied Chemistry (IUPAC), to define scientific nomenclature, terminology, and presentation. However, it is essential that these fundamental texts are available in as many languages as possible to facilitate their teaching, learning, and use throughout the world. It should be noted, however, that the translation of these texts into different languages is a complex task that requires some choices due to the lack of obvious alternatives or the cacophony of some terms. In this paper, we provide some details on the challenges, compromises, and difficult decisions involved in translating the IUPAC Nomenclature Brief Guides into Spanish.

14.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 35(1): 30-40, enero-febrero 2024. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-229500

RESUMO

Objetivo: El objetivo principal de este estudio ha sido demostrar por qué la impresión aditiva permite hacer más visibles y entendibles los procesos patológicos quirúrgicos complejos que afectan al raquis, aumentando la precisión, la seguridad y la fiabilidad del procedimiento quirúrgico.MetodologíaSe realizó una revisión sistemática de los trabajos publicados en los últimos 10 años, sobre la cirugía de raquis asistida por impresión 3D, de acuerdo con la declaración PRISMA 2020. Con las palabras clave «printing 3D» y «spine surgery» se hicieron búsquedas en las bases de datos Pubmed, Embase, Cochrane Database of Systematic Reviews, Google Scholar y Opengrey, que se completó con la búsqueda manual a través de la lista de referencias bibliográficas de los artículos que fueron seleccionados siguiendo los criterios de inclusión y exclusión definidos.ResultadosDel análisis de los 38 estudios seleccionados resultó que la impresión 3D es útil en la planificación quirúrgica, en la enseñanza médica, en la relación médico-paciente, así como en el diseño de plantillas de navegación e implantes de raquis y, en investigación, ofreciendo un magnífico apoyo al proceder quirúrgico.ConclusionesEl uso de biomodelos impresos de forma tridimensional permite: hacer más visibles y entendibles los procesos patológicos quirúrgicos complejos que afectan al raquis; aumentar la exactitud, precisión y seguridad del procedimiento quirúrgico; y abrir la posibilidad de poner en práctica tratamientos personalizados, fundamentalmente en la cirugía tumoral. (AU)


Objective: The main objective of this study has been to demonstrate why additive printing allows to make complex surgical pathological processes that affect the spine more visible and understandable, increasing precision, safety and reliability of the surgical procedure.MethodsA systematic review of the articles published in the last 10 years on 3D printing-assisted spinal surgery was carried out, in accordance with PRISMA 2020 declaration. Keywords «3D printing» and «spine surgery» were searched in Pubmed, Embase, Cochrane Database of Systematic Reviews, Google Scholar and Opengrey databases, which was completed with a manual search through the list of bibliographic references of the articles that were selected following the defined inclusion and exclusion criteria.ResultsFrom the analysis of the 38 selected studies, it results that 3D printing is useful in surgical planning, medical teaching, doctor–patient relationship, design of navigation templates and spinal implants, and research, optimizing the surgical process by focusing on the patient, offering magnificent support during the surgical procedure.ConclusionsThe use of three-dimensional printing biomodels allows: making complex surgical pathological processes that affect the spine more visible and understandable; increase the accuracy, precision and safety of the surgical procedure, and open up the possibility of implementing personalized treatments, mainly in tumor surgery. (AU)


Assuntos
Humanos , Relações Médico-Paciente , Impressão Tridimensional , Próteses e Implantes , Reprodutibilidade dos Testes
15.
J Headache Pain ; 25(1): 18, 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38331709

RESUMO

Headache is a common symptom of influenza infection; however, its causes and consequences remain uncertain. In this manuscript, we analyzed which demographic and clinical factors were associated with the presence of headache during the course of influenza infection and whether patients with headache had a different prognosis, evaluated by need of hospitalization, sick leave or school absenteeism. The influence study (NCT05704335) was an observational study that analyzed data routinely collected from the Health Sentinel Network between 2010 and 2020. During the study period, 7832 cases were considered, among which, 5275 (67.4%) reported headache. The presence of headache was independently associated with myalgia (2.753; 95%CI: 2.456-3.087, P < 0.001), asthenia (OR: 1.958; 95%CI: 1.732-2.214, P < 0.001), shivering (OR: 1.925; 95%CI: 1.718-2.156, P < 0.001), nasopharyngeal erythema (OR: 1.505; 95%CI: 1.293-1.753, P < 0.001), fever (OR: 1.469; 95%CI: 1.159-1.861; P = 0.001), sudden onset of symptoms (OR: 1.380; 95%CI: 1.120-1.702, p = 0.004), female sex (OR: 1.134; 95%CI: 1.023-1.257, P = 0.018), and gastrointestinal symptoms (OR: 1.169; 95%CI: 1.039-1.315; P = 0.01). Patients with headache had a sex and age adjusted lower odds of being referred to the hospital (OR: 0.463; 95%CI: 0.264-0.812, P = 0.007) and a higher odd of having a sick leave and/or school absenteeism (absenteeism (OR: 1.342; 95%CI: 1.190-1.514, P < 0.001). In conclusion, the presence of headache seems associated with symptoms caused by the innate immune response. These findings support a headache pathophysiology linked with the innate immune response. Due to the potential negative consequences and its treatable nature, clinicians should systematically evaluate it and, whenever necessary, treat it too.


Assuntos
Influenza Humana , Humanos , Feminino , Influenza Humana/complicações , Influenza Humana/epidemiologia , Cefaleia/epidemiologia , Cefaleia/etiologia , Prognóstico , Hospitalização , Absenteísmo
16.
Int J Hyg Environ Health ; 257: 114325, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38330729

RESUMO

Post-COVID-19, schools urgently need to enhance infection control and prevention (IPC) measures, including water, sanitation, and hygiene (WASH), to prepare for future outbreaks and pandemics. Particularly in Brazil, that is of particular concern, as students are still recovering from the 20th longest school closure in the world. Hence, the current study had two goals: (i) to describe WASH solutions outlined in policies released at the federal, state, and capital city levels in Brazil during the COVID-19 pandemic for the safe reopening of schools and (ii) to discuss their potential to enhance school's capacity to remain operational during a new pandemic or outbreak. With a qualitative exploratory approach, we performed content analysis to discuss the direction (what, where, how and for whom?) of 66 public policies by integrating four frameworks. Solutions were discussed in the light of the principles of human rights and the human rights to water and sanitation, international guidelines for WASH and IPC in schools and the Sphere minimum standards for humanitarian aid. One hundred and fifty-nine solutions, spanning five thematic areas and five population groups, including software and hardware interventions, were compiled for potential use in Brazil and beyond. While suggested solutions have the potential to provide a cleaner and safer learning environment, it is essential to exercise caution when implementing these measures and adapt them to the specific circumstances of each school.


Assuntos
COVID-19 , Saneamento , Humanos , Água , Pandemias/prevenção & controle , Brasil , Abastecimento de Água , Higiene , COVID-19/prevenção & controle , Instituições Acadêmicas , Políticas
17.
J Clin Med ; 13(3)2024 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-38337471

RESUMO

Kidneys have an amazing ability to adapt to adverse situations, both acute and chronic. In the presence of injury, the kidney is able to activate mechanisms such as autoregulation or glomerular hyperfiltration to maintain the glomerular filtration rate (GFR). While these adaptive mechanisms can occur in physiological situations such as pregnancy or high protein intake, they can also occur as an early manifestation of diseases such as diabetes mellitus or as an adaptive response to nephron loss. Although over-activation of these mechanisms can lead to intraglomerular hypertension and albuminuria, other associated mechanisms related to the activation of inflammasome pathways, including endothelial and tubular damage, and the hemodynamic effects of increased activity of the renin-angiotensin-aldosterone system, among others, are recognized pathways for the development of albuminuria. While the role of albuminuria in the progression of chronic kidney disease (CKD) is well known, there is increasing evidence of its negative association with cardiovascular events. For example, the presence of albuminuria is associated with an increased likelihood of developing heart failure (HF), even in patients with normal GFR, and the role of albuminuria in atherosclerosis has recently been described. Albuminuria is associated with adverse outcomes such as mortality and HF hospitalization. On the other hand, it is increasingly known that the systemic effects of congestion are mainly preceded by increased central venous pressure and transmitted retrogradely to organs such as the liver or kidney. With regard to the latter, a new entity called congestive nephropathy is emerging, in which increased renal venous pressure can lead to albuminuria. Fortunately, the presence of albuminuria is modifiable and new treatments are now available to reverse this common risk factor in the cardiorenal interaction.

18.
NPJ Parkinsons Dis ; 10(1): 26, 2024 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-38263165

RESUMO

Retinal thickness may serve as a biomarker in Parkinson's disease (PD). In this prospective longitudinal study, we aimed to determine if PD patients present accelerated thinning rate in the parafoveal ganglion cell-inner plexiform layer (pfGCIPL) and peripapillary retinal nerve fiber layer (pRNFL) compared to controls. Additionally, we evaluated the relationship between retinal neurodegeneration and clinical progression in PD. A cohort of 156 PD patients and 72 controls underwent retinal optical coherence tomography, visual, and cognitive assessments between February 2015 and December 2021 in two Spanish tertiary hospitals. The pfGCIPL thinning rate was twice as high in PD (ß [SE] = -0.58 [0.06]) than in controls (ß [SE] = -0.29 [0.06], p < 0.001). In PD, the progression pattern of pfGCIPL atrophy depended on baseline thickness, with slower thinning rates observed in PD patients with pfGCIPL below 89.8 µm. This result was validated with an external dataset from Moorfields Eye Hospital NHS Foundation Trust (AlzEye study). Slow pfGCIPL progressors, characterized by older at baseline, longer disease duration, and worse cognitive and disease stage scores, showed a threefold increase in the rate of cognitive decline (ß [SE] = -0.45 [0.19] points/year, p = 0.021) compared to faster progressors. Furthermore, temporal sector pRNFL thinning was accelerated in PD (ßtime x group [SE] = -0.67 [0.26] µm/year, p = 0.009), demonstrating a close association with cognitive score changes (ß [SE] = 0.11 [0.05], p = 0.052). This study suggests that a slower pattern of pfGCIPL tissue loss in PD is linked to more rapid cognitive decline, whereas changes in temporal pRNFL could track cognitive deterioration.

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