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1.
QJM ; 116(2): 134-135, 2023 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-36106995

Assuntos
Pelagra , Humanos
2.
Br J Dermatol ; 183(1): 52-59, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31545506

RESUMO

BACKGROUND: Long-term efficacy and safety of ixekizumab [160 mg at week 0, then 80 mg every 2 weeks (Q2W) for 12 weeks, followed by every 4 weeks (Q4W) thereafter (i.e. Q2W/Q4W), which is the labelled psoriasis dosing where approved, except in Japan] have been established for the treatment of adults with moderate-to-severe plaque psoriasis. However, some patients may benefit from remaining on Q2W dosing beyond 12 weeks. METHODS: Among patients who had static Physician's Global Assessment (sPGA) > 1 at week 12, efficacy through week 52 of continuous Q2W dosing in the IXORA-P study was compared indirectly with Q2W/Q4W in the integrated data from the UNCOVER-1, UNCOVER-2 and UNCOVER-3 studies. The continuous Q4W dose group, which had comparable results across studies, was used as the common comparator. RESULTS: In the IXORA-P study, among patients with sPGA > 1 at week 12, 64% of patients in the continuous Q2W group achieved sPGA ≤ 1 at week 52, which was statistically significantly higher than the 36% of patients with sPGA > 1 in the Q2W/Q4W group based on the integrated data from the UNCOVER studies (P = 0·0007). There were no clinically meaningful differences in frequencies of safety events between patients with sPGA ≤ 1 and patients with sPGA > 1 at week 12 in the IXORA-P study. CONCLUSIONS: Among patients who did not have clear or almost clear skin at week 12, nearly 30% more patients who were treated continuously with ixekizumab Q2W in IXORA-P had clear or almost clear skin at week 52 when compared indirectly with those who were treated using the labelled psoriasis dosing in integrated UNCOVER studies. What's already known about this topic? Most patients with moderate-to-severe psoriasis who were given the labelled psoriasis dosing of ixekizumab [160-mg loading dose at week 0, 80 mg every 2 weeks (Q2W) through week 12, and 80 mg every 4 weeks (QW4) thereafter] respond quickly with a high percentage of skin clearance. Additionally, patients who achieve static Physician's Global Assessment (sPGA) ≤ 1 by week 12 tend to maintain this response, even after switching to Q4W. What does this study add? Here, we assessed whether patients with sPGA > 1 at week 12 benefited from receiving more frequent dosing beyond the first 12 weeks. The results showed that Q2W dosing beyond 12 weeks resulted in more patients achieving sPGA ≤ 1 by week 52 than the labelled psoriasis dosing among patients with sPGA > 1 at week 12.


Assuntos
Médicos , Psoríase , Adulto , Anticorpos Monoclonais Humanizados , Método Duplo-Cego , Humanos , Japão , Psoríase/tratamento farmacológico , Índice de Gravidade de Doença , Resultado do Tratamento
3.
Med. intensiva (Madr., Ed. impr.) ; 43(8): 457-463, nov. 2019. ilus, graf, tab
Artigo em Inglês | IBECS | ID: ibc-185882

RESUMO

Objectives: Although amiodarone may cause neurotoxicity that can affect patient outcomes when used during cardiopulmonary resuscitation (CPR), it has been commonly prescribed during CPR. This study investigated the possible neurotoxic effects of amiodarone in a rat model of transient forebrain ischemia. Design: A prospective laboratory animal study was carried out. Setting: Animal laboratory. Materials: Male Sprague-Dawley rats. Intervention: Eight minutes of forebrain ischemia was induced in rats by bilateral carotid occlusion and hypotension (mean arterial pressure=35mmHg) under isoflurane (1.5%) anesthesia. Amiodarone (0, 50, 100 and 150mg/kg) with saline was injected intraperitoneally 10min after ischemia. Rats given 0mg/kg of amiodarone were used as saline-treated controls. Sham operated rats received no treatment. Variables of interest: Animals were evaluated neurologically on postoperative days 4-7, and histologically after a one-week recovery period. Results: The greatest improvement in water maze test performance corresponded to the sham operated group (p=0.015 vs. saline-treated controls). No differences in performance were seen in amiodarone-treated rats compared with saline-treated controls. In the control group, 45% of the CA1 hippocampal neurons survived, compared with 78% in the sham operated group (p=0.009). Neuron survival after ischemia in the amiodarone treatment groups (50, 100 and 150mg/kg) (58%, 40% and 36%, respectively) and in the control rats did not differ significantly. Conclusions: The administration of amiodarone immediately after transient forebrain ischemia did not worsen spatial cognitive function or neuronal survival in the hippocampal CA1 region in rats. The current results must be applied with caution in humans. However, they indicate that the potential neurotoxicity induced by amiodarone during resuscitation after cardiac arrest may be negligible


Objetivos: La amiodarona puede causar neurotoxicidad que afecte a los desenlaces de los pacientes si se usa durante la reanimación cardiopulmonar (RCP), si bien este fármaco se ha prescrito habitualmente a pacientes durante la RCP. Este estudio ha investigado los posibles efectos neurotóxicos de la amiodarona en un modelo de isquemia transitoria del prosencéfalo en ratas. Diseño: Estudio prospectivo con animales de laboratorio. Ámbito: Laboratorio de animales. Materiales: Ratas Sprague-Dawley macho. Intervención: Se produjo isquemia del prosencéfalo en ratas durante ocho minutos mediante oclusión bilateral de la carótida e hipotensión (mediana de la presión arterial=35 mmHg) bajo anestesia con isoflurano (1,5%). Se inyectó intraperitonealmente amiodarona (0, 50, 100, 150 mg/kg) con solución salina 10 minutos después de la isquemia. Se administraron 0 mg/kg de amiodarona a las ratas empleadas como controles tratados con solución salina. No se administró ningún producto a las ratas del grupo quirúrgico de referencia. Variables de interés: Los animales fueron evaluados neurológicamente durante los días 4-7 tras la intervención, e histológicamente tras un período de recuperación de una semana. Resultados: La mayor mejora del rendimiento en la prueba del laberinto acuático se observó en el grupo quirúrgico de referencia (p=0,015 frente a los controles tratados con solución salina). No se observaron diferencias en el rendimiento de las ratas tratadas con amiodarona respecto a los controles que recibieron solución salina. En el grupo control sobrevivió el 45% de las neuronas del hipocampo CA1, frente al 78% en el grupo quirúrgico de referencia (p=0,009). No se observaron diferencias significativas en cuanto a la supervivencia neuronal tras la isquemia entre los grupos tratados con amiodarona (50, 100 y 150 mg/kg, 58, 40 y 36% respectivamente) y las ratas del grupo control. Conclusiones: La administración de amiodarona inmediatamente después de la isquemia transitoria del prosencéfalo no empeoró la función cognitiva espacial ni la supervivencia neuronal en la región del hipocampo CA1 en ratas. Se debe tener precaución al aplicar los resultados actuales a los humanos. Sin embargo, dichos resultados señalan que la posible neurotoxicidad inducida por la amiodarona durante la reanimación tras parada cardíaca puede ser insignificante


Assuntos
Animais , Ratos , Masculino , Amiodarona/uso terapêutico , Isquemia Encefálica/tratamento farmacológico , Isquemia Encefálica/veterinária , Prosencéfalo/efeitos dos fármacos , Estudos Prospectivos , Ratos Sprague-Dawley , Injeções Intraperitoneais/veterinária
5.
J Mech Behav Biomed Mater ; 96: 144-151, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31035065

RESUMO

This study investigates the influence of a rapid heat treatment followed by water-quenching on the mechanical properties of Ti6Al4V ELI alloy to improve its strength for use in implants. Prior to the experiment, a dilatometry test was performed to understand the progressive α-to ß-phase transformation taking place during heating. The results were then used to carry out heat treatments. Microstructure was analysed using SEM, EBSD, EDX and XRD techniques. Vickers micro-hardness, tensile and high cycle rotating bending tests were used to analyse the influence of the $\alpha'$-phase fraction on the strength of the studied alloy. Results show that this process can provide a Ti6Al4V ELI alloy with a better Yield Strength (YS)/uniform deformation (εu) ratio and improved high cycle fatigue strength than those observed in the current microstructure used in medical implants. Lastly, cytotoxicity tests were performed on two types of human cells, namely MG63 osteoblast-like cells and fibroblasts. The results reveal the non-toxicity of the heat-treated Ti6Al4V ELI alloy.


Assuntos
Ligas/química , Temperatura Alta , Teste de Materiais , Fenômenos Mecânicos , Titânio/química , Titânio/toxicidade , Água/química , Linhagem Celular , Humanos , Osteoblastos/efeitos dos fármacos
7.
Med Intensiva (Engl Ed) ; 43(8): 457-463, 2019 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30029951

RESUMO

OBJECTIVES: Although amiodarone may cause neurotoxicity that can affect patient outcomes when used during cardiopulmonary resuscitation (CPR), it has been commonly prescribed during CPR. This study investigated the possible neurotoxic effects of amiodarone in a rat model of transient forebrain ischemia. DESIGN: A prospective laboratory animal study was carried out. SETTING: Animal laboratory. MATERIALS: Male Sprague-Dawley rats. INTERVENTION: Eight minutes of forebrain ischemia was induced in rats by bilateral carotid occlusion and hypotension (mean arterial pressure=35mmHg) under isoflurane (1.5%) anesthesia. Amiodarone (0, 50, 100 and 150mg/kg) with saline was injected intraperitoneally 10min after ischemia. Rats given 0mg/kg of amiodarone were used as saline-treated controls. Sham operated rats received no treatment. VARIABLES OF INTEREST: Animals were evaluated neurologically on postoperative days 4-7, and histologically after a one-week recovery period. RESULTS: The greatest improvement in water maze test performance corresponded to the sham operated group (p=0.015 vs. saline-treated controls). No differences in performance were seen in amiodarone-treated rats compared with saline-treated controls. In the control group, 45% of the CA1 hippocampal neurons survived, compared with 78% in the sham operated group (p=0.009). Neuron survival after ischemia in the amiodarone treatment groups (50, 100 and 150mg/kg) (58%, 40% and 36%, respectively) and in the control rats did not differ significantly. CONCLUSIONS: The administration of amiodarone immediately after transient forebrain ischemia did not worsen spatial cognitive function or neuronal survival in the hippocampal CA1 region in rats. The current results must be applied with caution in humans. However, they indicate that the potential neurotoxicity induced by amiodarone during resuscitation after cardiac arrest may be negligible.


Assuntos
Amiodarona/efeitos adversos , Região CA1 Hipocampal/efeitos dos fármacos , Ataque Isquêmico Transitório/tratamento farmacológico , Aprendizagem em Labirinto/efeitos dos fármacos , Prosencéfalo/irrigação sanguínea , Vasodilatadores/efeitos adversos , Anestésicos Inalatórios , Animais , Reanimação Cardiopulmonar , Estenose das Carótidas/complicações , Sobrevivência Celular/efeitos dos fármacos , Isoflurano , Masculino , Atividade Motora/efeitos dos fármacos , Neurônios/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Solução Salina/administração & dosagem , Fatores de Tempo
8.
Transplant Proc ; 50(8): 2388-2391, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30316363

RESUMO

OBJECTIVES: We investigated the correlation between class II HLA epitope mismatch and antibody-mediated rejection (AMR) episodes in kidney transplant recipients. In patients with AMR, epitope mismatch was also examined for each class II HLA mismatch to determine development of de novo donor-specific antibodies (DSAs). METHODS: We conducted a retrospective study of 167 kidney recipients. The numbers of eplet mismatches were compared between those with (n = 12) and without (n = 155) AMR, and the numbers of eplet mismatches for each type of mismatch in class II HLA among the AMR patients was also compared. RESULTS: Twelve AMR episodes were diagnosed. The total number of eplet mismatches in AMR patients with either HLA-DR or HLA-DQ was greater than those in non-AMR patients (P = .0085 and P = .0041, respectively), though the incidence of HLA class II (DRB1 + DQB) mismatch was not significantly different between the groups (P = .095). The rate of non-AMR status in patients with ≥15 was lower than those with <15 HLA class II (DR or DQ) eplet mismatches (P = .0299 and P = .0128, respectively). Twelve AMR patients had 30 HLA-DRB1/3/4/5 and 32 HLA-DQA/B mismatches. In both HLA-DR and -DQ, de novo DSAs developed against HLAs in association with a greater number of eplet mismatches (P = .0046 and P = .0044, respectively). CONCLUSION: Class II HLA eplet mismatch is a risk factor for de novo DSA and AMR in kidney transplantation recipients. Furthermore, the number of HLA class II eplet mismatches has greater significance as a risk factor than the number of conventional HLA class II mismatches.


Assuntos
Rejeição de Enxerto/imunologia , Antígenos de Histocompatibilidade Classe II/imunologia , Transplante de Rim , Adulto , Anticorpos/imunologia , Epitopos/imunologia , Feminino , Teste de Histocompatibilidade , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Doadores de Tecidos
9.
Transplant Proc ; 50(8): 2545-2547, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30316395

RESUMO

PURPOSE: Renal transplant patients with vascular rejection type acute T cell-mediated rejection (ATCMR) grade II have a poor prognosis. Vascular lesions in those cases are thought to randomly occur, thus we searched for a novel pathological marker related to vascular rejection in kidney transplantation. METHODS: We determined pathological characteristics in 14 ATCMR grade II patients treated during an acute phase from 2004 to 2013. We then examined whether those findings appeared in transplant kidney biopsy specimens, except for cases of vascular rejection, in patients examined from 2010 to 2014. RESULTS: In 9 of the 14 ATCMR grade II patients, phlebitis was accompanied by inflammatory cells that formed polypoid projections in the venous lumen and partial disappearance of vascular endothelium. Further investigation showed those inflammatory cells to be T cells and macrophages. Histological findings revealed coexisting phlebitis in 2 of 13 patients with ATCMR grade I, 3 of 24 with borderline changes, and none with normal findings. Phlebitis occurred at a significantly greater rate than the other findings in cases of vascular rejection (P < .05). However, there was no significant difference in regard to graft survival between patients with and without phlebitis (P = .1829). CONCLUSION: Our results suggest severe phlebitis as a novel finding associated with the pathology of vascular rejection in patients with a renal allograft.


Assuntos
Rejeição de Enxerto/imunologia , Rejeição de Enxerto/patologia , Transplante de Rim/efeitos adversos , Flebite/complicações , Adulto , Feminino , Sobrevivência de Enxerto/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Flebite/patologia , Linfócitos T/imunologia , Transplante Homólogo
10.
J Eur Acad Dermatol Venereol ; 31(1): 158-162, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27519469

RESUMO

BACKGROUND: Mutations in FLG, which encodes profilaggrin, cause ichthyosis vulgaris (IV) and are an important predisposing factor for atopic dermatitis (AD). IV shows autosomal hemidominant (semidominant) inheritance, and patients with bi-allelic FLG mutations tend to have severe IV phenotypes. However, the effect of bi-allelic FLG mutations on AD incidence and severity remains a subject of controversy. OBJECTIVE: In this study, we studied individuals with bi-allelic null FLG mutations to elucidate the effect of bi-allelic FLG mutations on AD incidence and severity. METHODS: Six individuals with bi-allelic FLG null mutations from three families of IV/AD were investigated. We report the detailed clinical features of the individuals. The phenotype was confirmed by the clinical examinations and the severity of IV and AD was scored using ichthyosis score and Eczema Area and Severity Index (EASI). RESULT: It was found that five of the six patients had severe IV, and the remaining patient showed moderate IV. Two of the six had moderate AD and three of the six had mild AD. The remaining patient had no AD. CONCLUSION: Our results suggest that individuals with bi-allelic FLG mutations do not always have severe AD and confirm that not all individuals with bi-allelic FLG mutations have AD.


Assuntos
Dermatite Atópica/genética , Heterozigoto , Mutação , Adulto , Feminino , Proteínas Filagrinas , Humanos , Masculino
11.
Br J Dermatol ; 174(6): 1191-2, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27317284
12.
Transplant Proc ; 48(3): 781-5, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27234735

RESUMO

BACKGROUND: Utilization of everolimus (EVR) has been increasing in recent years for patients undergoing renal transplantation to reduce calcineurin inhibitor (CNI) levels. However, an optimum regimen has yet to be established. METHODS: We retrospectively examined 12 renal transplant recipients who underwent an induction immunosuppressive protocol; the protocol comprises 5 agents, including EVR plus low-dose tacrolimus extended-release (TAC-ER) treatment. We compared those findings from those of 14 patients who underwent a conventional protocol without EVR. Clinical outcome and pathologic changes were assessed by using protocol graft biopsy findings obtained at 3 months and 1 year after transplantation. RESULTS: The estimated glomerular filtration rate was significantly higher for the EVR group at both 3 months and 1 year compared with the conventional group (P < .01 and P = .03, respectively). TAC-ER trough levels were also significantly lower at 3 months and 1 year (both, P < .01). Histologic findings of the 3-month protocol biopsy samples in the EVR group revealed 4 cases of borderline change and 2 of acute cellular-mediated rejection. The findings from the 1-year biopsy samples revealed 10 cases with normal findings with no evidence of CNI toxicity. Patients in the EVR group developed subclinical borderline change and acute cellular-mediated rejection after 3 months at a significantly higher rate than the conventional group (P = .02). CONCLUSIONS: Use of the present therapeutic strategy successfully maintained the trough of each drug at a lower level, and it also kept renal function stable up to 1 year after transplantation.


Assuntos
Everolimo/uso terapêutico , Sobrevivência de Enxerto , Imunossupressores/uso terapêutico , Transplante de Rim , Tacrolimo/uso terapêutico , Adulto , Idoso , Preparações de Ação Retardada/uso terapêutico , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Feminino , Seguimentos , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
13.
Transplant Proc ; 48(3): 878-83, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27234757

RESUMO

BACKGROUND: Post-transplant anemia (PTA) is a risk factor for mortality and graft loss in kidney transplant patients. METHODS: In all, 172 patients were included in this study. PTA was defined as hemoglobin <13.0 g/dL in men and 12.0 g/dL in women. The primary outcome of interest was the renal outcome, defined as a 50% increase in serum levels of creatinine, a return to chronic dialysis, and subsequent kidney transplantation (KTx). The secondary outcome was a composite of the primary outcome and death. RESULTS: At baseline, 75 patients (43.6%) had PTA. During follow-up of a median of 7.3 years, 52 patients (30.2%) had 2-fold higher creatinine levels than at baseline, 24 patients (14.0%) had to return to chronic dialysis or subsequent KTx, and 11 patients (6.4%) died; 8 (4.7%) of the deceased patients had functioning allografts. Univariate regression analyses showed that a lower hemoglobin level and positive proteinuria were significantly associated with both outcomes. After adjusting for important clinical variables, a lower hemoglobin level remained a strong predictor for both outcomes. Restricted cubic splines showed an almost linear inverse association with a hemoglobin level ≥12 g/dL. The risk of the outcomes increased with decreasing tertiles of the baseline hemoglobin level for both men and women, but the associations in women were much weaker than those in men, suggesting a different prognostic value of the hemoglobin level between men and women. CONCLUSIONS: PTA strongly influenced the renal and patient outcomes in living kidney transplant patients.


Assuntos
Anemia/etiologia , Creatinina/sangue , Hemoglobinas/metabolismo , Transplante de Rim/efeitos adversos , Doadores Vivos , Adulto , Anemia/sangue , Anemia/mortalidade , Feminino , Humanos , Japão/epidemiologia , Transplante de Rim/mortalidade , Masculino , Prognóstico , Fatores de Risco , Taxa de Sobrevida/tendências
14.
Transplant Proc ; 48(3): 890-2, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27234760

RESUMO

OBJECTIVES: Current adherence to dietary recommendations for chronic kidney disease was evaluated in kidney transplant patients in the maintenance phase. METHODS: A total of 268 maintenance phase kidney transplant patients were included in the study. Estimated daily intakes of oral protein and salt were calculated from 24-h urinary excretion of nitrogen and sodium, respectively. Dietary recommendations for chronic kidney disease, as issued in 2014 by the Japanese Society of Nephrology, were used as the basis for assessing diet. RESULTS: The study included 114 female patients and 154 male patients. The mean age, posttransplantation years, body mass index, estimated glomerular filtration rate, and 24-h urinary excretion of protein were 56.3 years, 11.2 years, 22.0 kg/m(2), 42.6 mL/min/1.73 m(2), and 321 mg/d, respectively. Estimated daily protein and salt intakes were 0.98 ± 0.26 g/kg/d and 9.3 ± 3.9 g/d. Only 47 patients (17.5%) in the case of salt intake and 105 patients (39.2%) in the case of protein intake were within reference values. The 24-h urinary protein excretion of the daily salt intake-adherent group (<6 g) was significantly less than that of the nonadherent group (≥6 g) (P = .021). CONCLUSIONS: The adherence rate to dietary recommendations for chronic kidney disease in kidney transplant patients was low. The 24-h urinary protein excretion of the daily salt intake-adherent group was significantly less than that of the nonadherent group. Dietary therapy for these patients may have the potential to improve kidney graft function and survival.


Assuntos
Dieta/normas , Taxa de Filtração Glomerular/fisiologia , Fidelidade a Diretrizes , Transplante de Rim , Insuficiência Renal Crônica/dietoterapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/urina , Sódio/urina
15.
Transplant Proc ; 47(3): 672-4, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25891708

RESUMO

BACKGROUND: Lipid abnormalities (LA) are related to an increased risk for cardiovascular diseases in kidney transplantation patients. PATIENTS AND METHODS: Multivariable logistic regression models were used to estimate the risk of LA associated with potential risk factors, including immunosuppressant use, patient background characteristics, and laboratory data. RESULTS: In total, 386 patients who were undergoing kidney transplantation were included in the study. Statins were prescribed to 43% of patients. The LA composite outcome was defined as statin use and/or low density lipoprotein cholesterol level ≥120 mg/dL, and 229 patients (59.3%) developed LA as a result. LA was significantly related to everolimus, corticosteroid, age, and estimated glomerular filtration ratio in the multiple logistic regression analysis. The odds ratios were 2.264, 3.119, 1.186, and 0.870, respectively. Mycophenolate mofetil, mizoribine, azathioprine, cyclosporine (CYA), tacrolimus, proteinuria, body mass index, and male sex were not related to LA. DISCUSSION: CYA influenced lipid metabolism but was not related to LA in our study. The mean post transplantation period was 8.4 years, and the CYA dose decreased over time. The CYA blood concentration was 70.0 ng/mL, which is relatively low, but it decreased the susceptibility to LA. Serum lipid levels were well controlled by statins, and the estimated glomerular filtration rate was maintained stably. CONCLUSIONS: Everolimus and corticosteroid use, as well as a lower estimated glomerular filtration rate and higher age, were significant risk factors for LA. CYA is known for its adverse LA effects, but it was not a significant risk factor for LA in patients undergoing maintenance phase kidney transplantation.


Assuntos
Dislipidemias/epidemiologia , Dislipidemias/etiologia , Imunossupressores/efeitos adversos , Transplante de Rim/efeitos adversos , Lipídeos/sangue , Corticosteroides/efeitos adversos , Corticosteroides/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Azatioprina/efeitos adversos , Azatioprina/sangue , Ciclosporina/efeitos adversos , Ciclosporina/sangue , Everolimo/efeitos adversos , Everolimo/sangue , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/sangue , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Imunossupressores/sangue , Masculino , Pessoa de Meia-Idade , Ácido Micofenólico/efeitos adversos , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/sangue , Ribonucleosídeos/efeitos adversos , Ribonucleosídeos/sangue , Fatores de Risco , Tacrolimo/efeitos adversos , Tacrolimo/sangue
16.
Eur J Vasc Endovasc Surg ; 50(1): 53-9, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25868606

RESUMO

OBJECTIVES: The aim was to evaluate computed tomography angiography (CTA) volumetric and diametric analysis after endovascular repair of descending thoracic aortic aneurysms (DTAAs) and its correlation with and applicability for clinical follow up. METHODS: Fifty-four consecutive endovascular repairs for DTAA were retrospectively evaluated from 2008 to 2014. All patients underwent pre-operative CTA and at least one post-operative CTA at 6 months. Fifty-four pre-operative and 137 post-operative CTAs were evaluated (using the Ziosoft 2 software) to analyze the aneurysm and thrombus volume, the maximum aneurysm diameter, and their changes at the last follow up CTA (mean 30.5 months; range 6.5-66.4 months). A statistical analysis was performed to assess the correlation between diameter and volume changes, as well as association with endoleaks. The cut off point to predict endoleaks was determined using a receiver operating characteristic (ROC) curve. The predictive accuracy of volume change versus diameter change for Type I endoleak was analyzed. RESULTS: The mean pre-operative aneurysm diameter, aneurysm volume, and thrombus volume were 56.7 ± 11.7 mm, 145.8 ± 120.0 mL, and 48.8 ± 54.8 mL, respectively. Within the observational period, a mean decrease of -27.9 ± 30.5% in the aortic volume and -15.9 ± 15.4% in diameter was observed. Correlation between aneurysm diameter and volume changes was good (r = 0.854). Volume and diameter changes were significantly different between groups with and without endoleaks (volume change 16.9 ± 38.8% vs. -35.6 ± 23.1%, p < .001; diameter change 8.0 ± 12.1% vs. -18.8 ± 14.3%, p < .001). A pre-operative thrombus volume percentage of <11.3% and increase in aneurysm volume +11.6% were predictive factors for Type II and Type I endoleak, respectively. The accuracy of a >10% volume increase in predicting a Type I endoleak was higher (accuracy 96.3%, sensitivity 75%, and specificity 98%) than a >5 mm diameter increase (accuracy 92.6%, sensitivity 25%, and specificity 98%). CONCLUSIONS: CT volumetric analysis is a more reliable modality for predicting endoleaks after endovascular repair for DTAA than diameter analysis.


Assuntos
Aneurisma da Aorta Torácica/patologia , Aneurisma da Aorta Torácica/cirurgia , Procedimentos Endovasculares , Idoso , Angiografia , Aneurisma da Aorta Torácica/diagnóstico por imagem , Feminino , Humanos , Masculino , Tamanho do Órgão , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
17.
Cell Death Dis ; 5: e1497, 2014 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-25356866

RESUMO

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by the selective and progressive loss of motor neurons. Cystatin C (CysC), an endogenous cysteine protease inhibitor, is a major protein component of Bunina bodies observed in the spinal motor neurons of sporadic ALS and is decreased in the cerebrospinal fluid of ALS patients. Despite prominent deposition of CysC in ALS, the roles of CysC in the central nervous system remain unknown. Here, we identified the neuroprotective activity of CysC against ALS-linked mutant Cu/Zn-superoxide dismutase (SOD1)-mediated toxicity. We found that exogenously added CysC protected neuronal cells including primary cultured motor neurons. Moreover, the neuroprotective property of CysC was dependent on the coordinated activation of two distinct pathways: autophagy induction through AMPK-mTOR pathway and inhibition of cathepsin B. Furthermore, exogenously added CysC was transduced into the cells and aggregated in the cytosol under oxidative stress conditions, implying a relationship between the neuroprotective activity of CysC and Bunina body formation. These data suggest CysC is an endogenous neuroprotective agent and targeting CysC in motor neurons may provide a novel therapeutic strategy for ALS.


Assuntos
Cistatina C/metabolismo , Neurônios Motores/patologia , Proteínas Mutantes/toxicidade , Fármacos Neuroprotetores/metabolismo , Superóxido Dismutase/toxicidade , Adenilato Quinase/metabolismo , Animais , Autofagia/efeitos dos fármacos , Catepsina B/metabolismo , Células Cultivadas , Clatrina/metabolismo , Endocitose/efeitos dos fármacos , Lisossomos/efeitos dos fármacos , Lisossomos/metabolismo , Camundongos , Neurônios Motores/efeitos dos fármacos , Neurônios Motores/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Agregados Proteicos/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Solubilidade , Medula Espinal/efeitos dos fármacos , Medula Espinal/metabolismo , Serina-Treonina Quinases TOR/metabolismo , Transdução Genética
18.
Cell Death Dis ; 5: e990, 2014 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-24407243

RESUMO

24(S)-hydroxycholesterol (24S-OHC), which is enzymatically produced in the brain, has an important role in maintaining brain cholesterol homeostasis. We have previously reported that 24S-OHC induces necroptosis in human neuroblastoma SH-SY5Y cells. In the present study, we investigated the mechanisms by which 24S-OHC-induced cell death occurs. We found that lipid droplets formed at the early stages in the treatment of SH-SY5Y cells with 24S-OHC. These lipid droplets could be almost completely eliminated by treatment with a specific inhibitor or by siRNA knockdown of acyl-CoA:cholesterol acyltransferase 1 (ACAT1). In association with disappearance of lipid droplets, cell viability was recovered by treatment with the inhibitor or siRNA for ACAT1. Using gas chromatography-mass spectrometry, we confirmed that 24S-OHC-treated cells exhibited accumulation of 24S-OHC esters but not of cholesteryl esters and confirmed that accumulation of 24S-OHC esters was reduced when ACAT1 was inhibited. 24S-OHC induced apoptosis in T-lymphoma Jurkat cells, which endogenously expressed caspase-8, but did not induce apoptosis in SH-SY5Y cells, which expressed no caspase-8. In Jurkat cells treated with the pan-caspase inhibitor ZVAD and in caspase-8-deficient Jurkat cells, 24S-OHC was found to induce caspase-independent cell death, and this was partially but significantly inhibited by Necrostatin-1. Similarly, knockdown of receptor-interacting protein kinase 3, which is one of the essential kinases for necroptosis, significantly suppressed 24S-OHC-induced cell death in Jurkat cells treated with ZVAD. These results suggest that 24S-OHC can induce apoptosis or necroptosis, which of the two is induced being determined by caspase activity. Regardless of the presence or absence of ZVAD, 24S-OHC treatment induced the formation of lipid droplets and cell death in Jurkat cells, and this was suppressed by treatment with ACAT1 inhibitor. Collectively, these results suggest that it is ACAT1-catalyzed 24S-OHC esterification and the resulting lipid droplet formation that is the initial key event which is responsible for 24S-OHC-induced cell death.


Assuntos
Apoptose , Hidroxicolesteróis/metabolismo , Neuroblastoma/enzimologia , Esterol O-Aciltransferase/metabolismo , Linhagem Celular Tumoral , Humanos , Necrose , Neuroblastoma/irrigação sanguínea , Neuroblastoma/genética
19.
PLoS One ; 8(8): e71083, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23990926

RESUMO

The boundaries between oceanographic domains often function as dispersal barriers for many temperate marine species with a dispersive pelagic larval phase. Yelloweye rockfish (Sebastes ruberrimus, YR) are widely distributed across the northeastern Pacific Ocean, inhabiting coastal rocky reefs from the Aleutian Islands in Alaska through southern California. This species exhibits an extended pelagic larval duration and has the capacity for long distance larval transport. We assayed 2,862 YR individuals from 13 general areas in the northeast Pacific Ocean for allelic variation at nine microsatellite loci. Bayesian model-based clustering analyses grouped individuals from the Strait of Georgia (SG) into a distinct genetic cluster, while individuals from outer coastal water locations (OCLs) were partitioned equally across two genetic clusters, including the cluster associated with the SG fish. Pairwise FST values were consistently an order of magnitude higher for comparisons between the SG and OCLs than they were for all OCL-OCL comparisons (∼0.016 vs. ∼0.001). This same pattern was observed across two time points when individuals were binned into an "old" and "young" group according to birth year (old: ∼0.020 vs. 0.0003; young: ∼0.020 vs. ∼0.004). Additionally, mean allelic richness was markedly lower within the SG compared to the OCLs (8.00 vs. 10.54-11.77). These results indicate that the Strait of Georgia "deep-basin" estuary oceanographic domain acts as a dispersal barrier from the outer coastal waters via the Juan de Fuca Strait. Alternatively, selection against maladapted dispersers across this oceanographic transition may underlie the observed genetic differentiation between the Georgia basin and the outer coastal waters, and further work is needed to confirm the SG-OCL divide acts as a barrier to larval dispersal.


Assuntos
Peixes/genética , Peixes/fisiologia , Genética Populacional , Alaska , Alelos , Animais , Teorema de Bayes , Colúmbia Britânica , Análise por Conglomerados , Conservação dos Recursos Naturais , Genótipo , Geografia , Repetições de Microssatélites , Oceano Pacífico , Fatores de Tempo
20.
Reproduction ; 146(4): 407-17, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23898216

RESUMO

Cathepsin B was found to be correlated inversely with the quality of bovine oocytes and embryos. The aims of this study were to evaluate i) the relationship between heat shock during in vitro maturation (IVM) of bovine cumulus-oocyte complexes (COCs) and cathepsin B activity in relation to apoptosis and ii) the effect of supplementation of cathepsin B inhibitor (E-64) during IVM of heat-shocked COCs on embryonic development. After IVM at 38.5 °C for 22 h (control group) or at 38.5 °C for 5 h followed by 41 °C for 17 h (heat shock group) either with or without 1 µM E-64, activities and protein expression of cathepsin B and caspase 3 were evaluated as well as TUNEL staining. After IVF, developmental rate, total cell number, and the percentage of apoptotic cells in blastocysts were evaluated on day 8 (day 0, IVF day). Heat-shocked IVM COCs showed significantly high activities and expressions of both cathepsin B, and caspase 3 accompanied by a significant increase in number of TUNEL-positive cells. Addition of E-64 significantly decreased the activities of cathepsin B and caspase 3, and TUNEL-positive cells in heat-shocked IVM COCs. Moreover, addition of 1 µM E-64 during IVM under heat shock conditions significantly improved both developmental competence and quality of the produced embryos. These results indicate that heat shock induction of cathepsin B is associated with apoptosis of COCs, and inhibition of cathepsin B activity can improve the developmental competence of heat-shocked COCs during IVM.


Assuntos
Blastocisto/citologia , Catepsina B/metabolismo , Células do Cúmulo/citologia , Resposta ao Choque Térmico , Oócitos/citologia , Folículo Ovariano/citologia , Animais , Apoptose , Blastocisto/efeitos dos fármacos , Blastocisto/fisiologia , Bovinos , Células do Cúmulo/efeitos dos fármacos , Células do Cúmulo/fisiologia , Inibidores de Cisteína Proteinase/farmacologia , Desenvolvimento Embrionário/efeitos dos fármacos , Feminino , Fertilização In Vitro , Temperatura Alta , Marcação In Situ das Extremidades Cortadas , Leucina/análogos & derivados , Leucina/farmacologia , Oócitos/efeitos dos fármacos , Oócitos/fisiologia , Folículo Ovariano/efeitos dos fármacos , Folículo Ovariano/fisiologia , Gravidez
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