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2.
Nefrologia ; 2020 Aug 06.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32773327

RESUMO

Ultrasound is an essential tool in the management of the nephrological patient allowing the diagnosis, monitoring and performance of kidney intervention. However, the usefulness of ultrasound in the hands of the nephrologist is not limited exclusively to the ultrasound study of the kidney. By ultrasound, the nephrologist can also optimize the management of arteriovenous fistula for hemodialysis, measure cardiovascular risk (mean intimate thickness), implant central catheters for ultrasound-guided HD, as well as the patient's volemia using basic cardiac ultrasound, ultrasound of the cava inferior vein and lungs. From the Working Group on Interventional Nephrology (GNDI) of the Spanish Society of Nephrology (SEN) we have prepared this consensus document that summarizes the main applications of ultrasound to Nephrology, including the necessary basic technical requirements, the framework normative and the level of training of nephrologists in this area. The objective of this work is to promote the inclusion of ultrasound, both diagnostic and interventional, in the usual clinical practice of the nephrologist and in the Nephrology Services portfolio with the final objective of offering diligent, efficient and comprehensive management to the nephrological patient.

3.
Tumori ; : 300891620946841, 2020 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-32779517

RESUMO

BACKGROUND: Small cell lung cancer (SCLC) is one of the greatest therapeutic challenges of oncology. Potential associations between single nucleotide polymorphisms in heat shock protein ß1 (HSPB1) and transforming growth factor ß1 (TGFß1) and survival have been investigated. METHODS: A prospective multicenter study of 94 patients with SCLC treated between 2013 and 2016 was conducted. Clinical, tumour-related, therapeutic, and genetic (9 SNPs of TGFß1 gene and 5 of HSPB1 gene) variables were analyzed. RESULTS: The cohort included 77 men and 17 women with a median age of 61 years. Eighty percent presented with limited stage at diagnosis and received thoracic radiation with a median dose of 45 Gy (twice-daily radiation in 42%). Forty-seven percent received concurrent platinum-based chemotherapy and 57% received prophylactic cranial irradiation (PCI). Overall survival (OS) was 34% at 2 years and 16% at 3 years. In multivariate analysis, the rs4803455:CA genotype of the TGFß1 gene showed a statistically significant association with lower disease-free survival (DFS; hazard ratio [HR] 3.13; confidence interval [CI] 1.19-8.17; p = 0.020) and higher local recurrence (HR 3.80; CI 1.37-10.5; p = 0.048), and a marginal association with lower OS (HR 1.94; CI 0.98-3.83; p = 0.057). A combined analysis showed that patients receiving PCI and carrying the rs4803455:CA genotype had statistically significant lower OS (p < 0.001) and DFS (p < 0.001) than patients receiving PCI and carrying the rs4803455:AA genotype. CONCLUSIONS: Genetic analysis showed the CA genotype of TGFß1 SNP rs4803455 was associated with worse prognosis in patients with SCLC and could be considered as a potential biomarker.

4.
Thromb Res ; 192: 134-140, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32480167

RESUMO

BACKGROUND: The aim was to analyze the temporal relationship between short-term air pollution exposure and acute symptomatic unprovoked pulmonary embolism (PE). PATIENTS/METHODS: We performed a prospective, multicenter study in consecutive patients diagnosed with acute symptomatic unprovoked PE from February 2012 to January 2013. We analyzed demographic and clinical data, patients' addresses, meteorological and air pollutants data (PM10, SO2, CO, NO2, ozone emission data). We considered the number of days the patient had symptoms, and the study period constituted the previous 30 days. Likewise, the mean annual data of the reference season were calculated as well as the data of the 30-day study period corresponding to the same dates in the previous 3 years in order to obtain the monthly mean of the different pollutants for each period. RESULTS: A total of 162 patients with acute symptomatic PE were recruited (43.2% unprovoked PE). The air pollutants could be determined in 50% of the patients with unprovoked PE, and a final analysis was performed in 35 patients. In the multiple comparison analysis to verify a possible correlation between the study period and the annual median, only NO2 showed a statistically significant association (p = 0.009). When comparing the study period with the previous 3 years, only NO2 maintained a statistically significant association for the 3 study periods. CONCLUSIONS: We found a relationship between short-term exposure to NO2 and the presence of unprovoked PE.

5.
Genes (Basel) ; 11(5)2020 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-32422965

RESUMO

Primary congenital glaucoma (PCG) is a heterogeneous, inherited, and severe optical neuropathy caused by apoptotic degeneration of the retinal ganglion cell layer. Whole-exome sequencing analysis of one PCG family identified two affected siblings who carried a low-frequency homozygous nonsense GUCA1C variant (c.52G > T/p.Glu18Ter/rs143174402). This gene encodes GCAP3, a member of the guanylate cyclase activating protein family, involved in phototransduction and with a potential role in intraocular pressure regulation. Segregation analysis supported the notion that the variant was coinherited with the disease in an autosomal recessive fashion. GCAP3 was detected immunohistochemically in the adult human ocular ciliary epithelium and retina. To evaluate the ocular effect of GUCA1C loss-of-function, a guca1c knockout zebrafish line was generated by CRISPR/Cas9 genome editing. Immunohistochemistry demonstrated the presence of GCAP3 in the non-pigmented ciliary epithelium and retina of adult wild-type fishes. Knockout animals presented up-regulation of the glial fibrillary acidic protein in Müller cells and evidence of retinal ganglion cell apoptosis, indicating the existence of gliosis and glaucoma-like retinal damage. In summary, our data provide evidence for the role of GUCA1C as a candidate gene in PCG and offer new insights into the function of this gene in the ocular anterior segment and the retina.

6.
Hum Genet ; 139(10): 1209-1231, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32274568

RESUMO

Abnormal development of the ocular anterior segment may lead to a spectrum of clinical phenotypes ranging from primary congenital glaucoma (PCG) to variable anterior segment dysgenesis (ASD). The main objective of this study was to identify the genetic alterations underlying recessive congenital glaucoma with ASD (CG-ASD). Next-generation DNA sequencing identified rare biallelic CPAMD8 variants in four patients with CG-ASD and in one case with PCG. CPAMD8 is a gene of unknown function and recently associated with ASD. Bioinformatic and in vitro functional evaluation of the variants using quantitative reverse transcription PCR and minigene analysis supported a loss-of-function pathogenic mechanism. Optical and electron microscopy of the trabeculectomy specimen from one of the CG-ASD cases revealed an abnormal anterior chamber angle, with altered extracellular matrix, and apoptotic trabecular meshwork cells. The CPAMD8 protein was immunodetected in adult human ocular fluids and anterior segment tissues involved in glaucoma and ASD (i.e., aqueous humor, non-pigmented ciliary epithelium, and iris muscles), as well as in periocular mesenchyme-like cells of zebrafish embryos. CRISPR/Cas9 disruption of this gene in F0 zebrafish embryos (96 hpf) resulted in varying degrees of gross developmental abnormalities, including microphthalmia, pharyngeal maldevelopment, and pericardial and periocular edemas. Optical and electron microscopy examination of these embryos showed iridocorneal angle hypoplasia (characterized by altered iris stroma cells, reduced anterior chamber, and collagen disorganized corneal stroma extracellular matrix), recapitulating some patients' features. Our data support the notion that CPAMD8 loss-of-function underlies a spectrum of recessive CG-ASD phenotypes associated with extracellular matrix disorganization and provide new insights into the normal and disease roles of this gene.


Assuntos
Complemento C3/genética , Matriz Extracelular/metabolismo , Anormalidades do Olho/genética , Glaucoma/genética , Mutação com Perda de Função , Inibidor da Tripsina Pancreática de Kazal/genética , alfa-Macroglobulinas/genética , Adulto , Animais , Câmara Anterior/metabolismo , Câmara Anterior/patologia , Câmara Anterior/cirurgia , Sistemas CRISPR-Cas , Estudos de Casos e Controles , Complemento C3/deficiência , Embrião não Mamífero , Matriz Extracelular/patologia , Anormalidades do Olho/metabolismo , Anormalidades do Olho/patologia , Anormalidades do Olho/cirurgia , Feminino , Edição de Genes , Expressão Gênica , Genes Recessivos , Glaucoma/metabolismo , Glaucoma/patologia , Glaucoma/cirurgia , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Pessoa de Meia-Idade , Linhagem , Malha Trabecular/metabolismo , Malha Trabecular/patologia , Malha Trabecular/cirurgia , Trabeculectomia , Inibidor da Tripsina Pancreática de Kazal/deficiência , Peixe-Zebra , alfa-Macroglobulinas/deficiência
7.
Antiviral Res ; 179: 104717, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31982483

RESUMO

We present here one of the first cases of virological failure during treatment with bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF). On March 2019, an antiretroviral-experienced HIV-infected patient was admitted to hospital because of cerebral toxoplasmosis. After undergoing treatment with sulfadiazine-pyrimethamine for two weeks, the patient initiated a BIC/FTC/TAF treatment, with 6.01 HIV RNA Log copies/mL, and 37 CD4 cells/µL. After two months under antiretroviral therapy (ART), acute neurologic deterioration with epilepsy, right hemiparesis and dysphagia occurred, leading to nasogastric nutrition and treatment. After several weeks, virological failure was confirmed with 4.01 HIV RNA Log copies/mL and R263K and M184V resistance mutations were detected.

9.
Artigo em Inglês | MEDLINE | ID: mdl-31669953

RESUMO

Preparation for oxidative stress (POS), i.e., the upregulation of endogenous antioxidants, is a widespread response of animals exposed to extreme conditions. This response has been described for more than 80 animal species belonging to eight phyla during hypometabolism or situations that limit oxygen availability. The pattern of the typical POS-response, in which a mild redox imbalance triggers antioxidant adjustments that results in increased tolerance to subsequent oxidative insults, roughly follows the curve of hormetic phenomena. A similar pattern has been reported for various animal species exposed to ultraviolet radiation (UVR) - these studies, on animals from six phyla, are discussed herein. In the light of the similarities in the redox-response of animals exposed to either oxygen restriction or UVR, we argue in this essay that UVR elicits a type of response that fits the POS theory. Exposure to UVR induces both reactive species formation and antioxidant adaptation, which is the essence of typical POS-responses. Thus, antioxidant response to UVR in animals can be categorized as a POS-type mechanism. Moreover, considering that animals are exposed to multiple stressors simultaneously in nature, this would represent an ecologically relevant process, by which one stressor (e.g., UV or ionizing radiation) may enhance the tolerance to other. We also discuss a possible role of low doses of ionizing radiation as inductor of POS-like responses in animals.

10.
Comput Biol Med ; 114: 103440, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31521898

RESUMO

BACKGROUND: The curvature of the aortic arch is associated with the risk of endoleak formation after thoracic endovascular aortic repair (TEVAR). However, the adequate assessment of the angles of the aorta continues to represent a major difficulty. We developed a new program based on three-dimensional (3D) reconstructions of computed tomography (CT) scans to objectively identify the location of the aortic points of maximum curvature, and to automatically calculate the main aortic arch angles, comparing final values with visual assessment methods. METHODS: This is a cross-sectional validation study of a convenience sample of subjects with multislice CT angiography scans of the thoracic aorta from an institutional imaging database. The center lumen line (CLL) of the aorta was determined semi-automatically using Endosize software. The points of maximum curvature on the CLL were determined by two methods: visually by two physicians and through a custom program. RESULTS: The study enrolled 9 subjects: 4 with thoracic aneurysms and 5 with normal aortas. The inter-observer and inter-method correlation, agreement and reliability for each of the 3D spatial coordinates of the points of maximum curvature were appropriate. However, the aortic angles determined by visual assessment showed a very low to moderate correlation and reliability with those determined by our custom program. CONCLUSION: An automated custom program can reflect clinician's intuitive assessment of the location of points of maximum curvature and translate it into aortic angles with an apparently higher precision, reducing potential error and user time.

11.
J Surg Res ; 244: 587-598, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31521941

RESUMO

BACKGROUND: Immediate changes in vascular mechanics during aortic cross-clamping remain widely unknown. By using a numerical model of the arterial network, vascular compliance and resistance can be estimated and the time constant of pressure waves can be calculated and compared with results from the classic arterial waveform analysis. METHODS: Experimental data were registered from continuous invasive radial artery pressure measurements from 11 patients undergoing vascular surgery. A stable set of beats were chosen immediately before and after each clamping event. Through the arterial waveform analysis, the time constant was calculated for each individual beat and for a mean beat of each condition as to compare with numerical simulations. Overall proportional changes in resistance and compliance during clamping and unclamping were calculated using the numerical model. RESULTS: Arterial waveform analysis of individual beats indicated a significant 10% median reduction in the time constant after clamping, and a significant 17% median increase in the time constant after unclamping. There was a positive correlation between waveform analysis and numerical values of the time constant, which was moderate (ρ = 0.51; P = 0.01486) during clamping and strong (ρ = 0.77; P ≤ 0.0001) during unclamping. After clamping, there was a significant 16% increase in the mean resistance and a significant 23% decrease in the mean compliance. After unclamping, there was a significant 19% decrease in the mean resistance and a significant 56% increase in the mean compliance. CONCLUSIONS: There are significant hemodynamic changes in vascular compliance and resistance during aortic clamping and unclamping. Numerical computer models can add information on the mechanisms of injury due to aortic clamping.


Assuntos
Pressão Arterial , Modelos Teóricos , Monitorização Intraoperatória/métodos , Artéria Radial/fisiologia , Resistência Vascular , Procedimentos Cirúrgicos Vasculares , Idoso , Idoso de 80 Anos ou mais , Constrição , Estudos Transversais , Feminino , Humanos , Complicações Intraoperatórias/prevenção & controle , Masculino , Pessoa de Meia-Idade , Artéria Radial/lesões , Lesões do Sistema Vascular/etiologia , Lesões do Sistema Vascular/prevenção & controle
12.
Sensors (Basel) ; 19(13)2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31284514

RESUMO

This article addresses one of the main challenges related to the practical deployment of Internet of Things (IoT) solutions: the coordinated operation of entities at different infrastructures to support the automated orchestration of end-to-end Internet of Things services. This idea is referred to as "Internet of Things slicing" and is based on the network slicing concept already defined for the Fifth Generation (5G) of mobile networks. In this context, we present the architectural design of a slice orchestrator addressing the aforementioned challenge, based on well-known standard technologies and protocols. The proposed solution is able to integrate existing technologies, like cloud computing, with other more recent technologies like edge computing and network slicing. In addition, a functional prototype of the proposed orchestrator has been implemented, using open-source software and microservice platforms. As a first step to prove the practical feasibility of our solution, the implementation of the orchestrator considers cloud and edge domains. The validation results obtained from the prototype prove the feasibility of the solution from a functional perspective, verifying its capacity to deploy Internet of Things related functions even on resource constrained platforms. This approach enables new application models where these Internet of Things related functions can be onboarded on small unmanned aerial vehicles, offering a flexible and cost-effective solution to deploy these functions at the network edge. In addition, this proposal can also be used on commercial cloud platforms, like the Google Compute Engine, showing that it can take advantage of the benefits of edge and cloud computing respectively.

13.
Rep Pract Oncol Radiother ; 24(3): 298-305, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192999

RESUMO

Aim: The purpose of this study is to evaluate the long term tolerability of hypofractionated helical tomotherapy (HT) in localized prostate cancer patients. Background: Previous hypofractionated schedules with conventional RT were associated with excessive toxicity, likely due to inadequate sophistication of treatment delivery. There are few data about late toxicity after HT. Materials and methods: We evaluated 38 patients with primary adenocarcinoma of the prostate. There were 9 (24%), 15 (39%), and 14 (37%) patients with high, intermediate, and low risk, respectively. Patients were treated with hypofractionated HT from May 2008 to February 2011. Hypofractionation regimens included: 68.04 Gy at 2.52 Gy/fraction (N = 25; 66%), 70 Gy at 2.5 Gy/fraction (N = 4; 11%) and 70.2 Gy at 2.6 Gy/fraction (N = 9; 23%). Late genitourinary (GU) and gastrointestinal (GI) toxicity was scored using the Radiation Therapy Oncology Group scoring system. Results: Median age at diagnosis was 70 years (range 49-80) and median follow-up, 5.8 years. Late grade 1, 2 and 3 GI toxicity were 13%, 24%, and 2.6%, respectively. Late grade 1, 2, 3 GU toxicity were 29%, 21%, and 8%, respectively. Sexual toxicity was evaluated in 19 patients to be grade 1, 2 in 11% and grade 3 in 16%. Multivariate analysis showed that patients with higher values of rectum V50 associated with late GI toxicity (P = 0.025). Patients with PSA ≤8 (P = 0.048) or comorbidities (P = 0.013) at diagnosis were associated with higher late GU toxicity. Additionally, PSA ≤8 also associated with moderate (grade ≥2) late GU toxicity in the multivariate analysis (P = 0.028). Conclusions: Hypofractionated HT can be delivered safely with limited rates of moderate and severe late toxicity. The proportion of the rectum that receives a moderate and high dose, having comorbidities, and PSA at diagnosis seem to associate with long term toxicity.

14.
Rev. colomb. anestesiol ; 47(2): 84-91, Apr.-June 2019. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1003821

RESUMO

Abstract Introduction: Intravenous general anesthesia is an anesthetic technique that can be administered with TCI (target-controlled infusion) or closed-loop systems. The authors designed an automatic delivery system using clinical variables such as bispectral index (BIS), heart rate, and blood pressure. Objective: To evaluate the clinical and technical performance of this controller by comparing it to a TCI system. Methods: This was a single-blind, randomized, controlled clinical trial in which 150 patients were recruited: 75 for the TCI group and 75 for the closed loop with BIS. Clinical performance was determined according to the mean percentage of time spent in the BIS range of 40 to 60 during anesthetic maintenance. In addition, adequate intraoperative analgesia, technical performance, intraoperative awakening, and intraoperative recall were evaluated. Results: The primary outcome showed a mean BIS time between 40 and 60 for the closed loop of 75.24% (± 15.78) versus 59.5% (± 20.3) for the TCI system, with an absolute difference of 15.8%, 95% confidence interval (CI): 9.9 to 21.65, P < 0.0001. The mean time in intraoperative analgesia was 82.4% (25.1) in closed loop and 70.77% (± 32.8) in TCI, with a difference of 4.76 (95% CI: 2.23-21.06), P = 0.016. There was no difference in intraoperative recall. Conclusion: The closed-loop system was better at maintaining a BIS in the range of 40 to 60 during a general anesthetic than the open system or TCI.


Resumen Introducción: La anestesia total endovenosa es una técnica anestésica que puede administrarse con sistemas de TCI (Target Controlled Infusión) o de lazo cerrado. Los autores diseñaron un sistema de administración automática empleando variables clínicas como índice biespectral (BIS), frecuencia cardiaca y presión arterial. Objetivo: Evaluar el desempeño clínico y técnico de este controlador, comparándolo con un sistema de TCI. Métodos: Este fue un ensayo clínico controlado, aleatorizado y de ciego único, en el cual se reclutaron 150 pacientes: 75 en el grupo de TCI y 75 en lazo cerrado con BIS. El desempeño clínico fue determinado de acuerdo al porcentaje promedio de tiempo de permanencia en el rango de BIS entre 40-60 durante el mantenimiento anestésico. Adicionalmente se evaluó analgesia intraoperatoria adecuada, desempeño técnico, despertar intraoperatorio y recuerdo intraoperatorio. Resultados: Para el desenlace primario se encontró un tiempo promedio de BIS entre 40-60 para el lazo cerrado de un 75.24% (+/-15.78) vs. 59.5% (+/- 20.3) para el sistema TCI, con una diferencia del 15.8%, IC del 95%: 9.9 a 21.65, p < 0.0001. El promedio de tiempo en analgesia intraoperatoria adecuada fue del 82.4% (25.1) en lazo cerrado y 70.77% (+/- 32.8) en TCI, con una diferencia de 4.76 (IC del 95%: 2.23 a 21.06), p=0.016. No hubo diferencias en recuerdo intraoperatorio. Conclusión: El sistema de lazo cerrado fue mejor para mantener un BIS en rango de 40-60 durante un acto anestésico que el sistema abierto o TCI.

15.
Radiother Oncol ; 136: 29-36, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31015126

RESUMO

BACKGROUND AND PURPOSE: Definitive radiation therapy (RT) with or without chemotherapy has become the standard treatment for non-metastatic unresectable non-small cell lung cancer (NSCLC). However, treatment outcomes can differ substantially and patients' genetic background could play a crucial role. Potential associations between single-nucleotide polymorphisms (SNP) in Heat shock protein beta-1 (HSPB1) and survival have been reported in prior single-institution retrospective reports. MATERIALS AND METHODS: The current assay aims to validate such connection in a prospective multicenter study in a European cohort including 181 NSCLC patients. Median follow-up time for all patients was 13 months (range, 3-57 months). RESULTS: The results obtained show an association between the rs2868371 GG genotype and better overall survival (HR: 0.35; 95%CI: 0.13-0.96; p = 0.042) in multivariate analysis. Two-year overall survival rate was 72% for patients carrying the rs2868371 GG genotype versus 36% for those patients harboring the rs2868371 CC/CG genotypes (p = 0.013). Additionally, the rs2868371 GG genotype was found to be associated with better disease-free survival in the multivariate analysis (HR: 0.36; 95%CI: 0.13-0.99; p = 0.048). In silico analysis of the potential functional SNP suggested significant difference in the affinity of the Glucocorticoid Receptor binding site between alternative allelic variants, confirmed by chromatin immunoprecipitation analysis displaying stronger affinity for the risk allele (C). Furthermore, our findings indicate that the rs2868371 influences (mRNA) HSPB1 expression, offering insight into the regulation of HSPB1 transcription. CONCLUSION: The functional HSPB1 rs2868371 promoter variant may affect lung cancer survival by regulation of HSPB1 expression levels through glucocorticoid receptor interaction.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/genética , Proteínas de Choque Térmico/genética , Neoplasias Pulmonares/genética , Chaperonas Moleculares/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Intervalo Livre de Doença , Feminino , Humanos , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas , Modelos de Riscos Proporcionais , Estudos Prospectivos , Receptores de Glucocorticoides/metabolismo , Estudos Retrospectivos , Taxa de Sobrevida
16.
Radiother Oncol ; 135: 161-169, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31015163

RESUMO

BACKGROUND AND PURPOSE: Radiochemotherapy (RCT) success in lung cancer (LC) can be limited due to the onset of adverse effects in the adjacent normal tissue such as radiation-induced esophageal toxicity (RIET). Therefore, specific biomarkers to customize the RCT dose administration and esophageal toxicity prediction are necessary to improve treatment effectiveness. MATERIALS AND METHODS: 247 LC patients prospectively recruited between 2012 and 2016 from 3 institutions were genotyped for 7 SNPs along TGFB1 and HSPB1 genes seeking an association with RIET risk development. Kaplan-Meier cumulative probability and Cox proportional hazards analyses were used to evaluate the effect of TGFB1 and HSPB1 genotypes on such risk. RESULTS: Multivariate analyses showed that patients carrying the HSPB1 rs7459185 CC genotype were associated with a significantly higher risk of acute grade 3 RIET than those carrying the GG/GC genotypes (HR = 17.73; 95% CI = 2.896-108.49; p = 0.002). LC patients who received higher (>median) volume of esophagus exposed to 30 Gy and harboring the rs7459185 GG/GC genotypes showed a significantly lower RIET incidence (p < 0.001). Additionally, LC patients carrying the TGFB1 rs11466353 GG genotype were found to be associated with a lower risk of late grade 2 RIET compared with those with the TT/TG genotypes (HR = 0.29; 95% CI = 0.103-0.830; p = 0.021). Patients receiving a high (>60 Gy) radiation dose who presented the rs11466353 GG genotype had a significantly lower RIET incidence (p = 0.025). CONCLUSION: The presence of different rs7459185/rs11466353 genotypes in LC patients associated with RIET risk and may be useful biomarkers along with other risk factors for guiding therapy intensity in an individualized therapy.


Assuntos
Esofagite/etiologia , Proteínas de Choque Térmico/genética , Neoplasias Pulmonares/radioterapia , Chaperonas Moleculares/genética , Polimorfismo de Nucleotídeo Único , Lesões por Radiação/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Esofagite/genética , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Lesões por Radiação/etnologia , Fator de Crescimento Transformador beta1/genética
17.
J Food Sci ; 84(5): 980-989, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31012973

RESUMO

The aim of this work was to evaluate the cholesterol extraction process in ice cream mixes (ICMs) by using ß-cyclodextrin (ßCD) and to analyze the effect of this extraction on the ICM rheological, stability, and sensory characteristics. The effects of fat and whey protein (WP) additions on ICM stability were also evaluated. The maximum percentage obtained for cholesterol extraction was 93.6%. The flow curves indicated that ICM showed a thixotropic behavior before and after cholesterol extraction, which was enhanced when the fat content and/or percentage of ßCD increased. The stability of ICM with cholesterol-reduced content (RCho-ICM) was influenced by the fat content and/or the presence of WP. The RCho-ICM with the highest fat and/or WP addition showed less tendency to melt and had the smallest amount of accumulated molten liquid. These latter ICMs presented the slowest melting rates. Also, RCho-ICMs proved to be more stable than ICMs. RCho-ICM samples obtained with a ratio of ßCD/fat content of 1% w/w were evaluated by a trained sensory panel. In addition, an acceptability test of the sample with better sensory attributes was conducted. PRACTICAL APPLICATION: The effects of a cholesterol extraction process and fat and whey protein additions on the rheological and stability characteristics of ice cream mixes were evaluated. The extraction of cholesterol from an ice cream mix is interesting from a nutritional point of view and the extraction process of cholesterol itself may also help to improve the mix stability by controlling the fat and/or whey protein contents. These findings may prove useful as a starting point for the rational design of new functional ice cream mixes.


Assuntos
Colesterol , Gorduras na Dieta , Manipulação de Alimentos/métodos , Alimento Funcional , Sorvetes/análise , Proteínas do Soro do Leite , Comportamento do Consumidor , Congelamento , Humanos , Reologia , beta-Ciclodextrinas
18.
Ann Biomed Eng ; 47(3): 902-912, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30560305

RESUMO

Bone tissue engineering (BTE) has the general objective of restoring and improving damaged bone. A very interesting strategy for BTE is to combine an adequate polymeric scaffold with an osteoinductive compound. Strontium is a divalent cation that can substitute calcium in hydroxyapatite and induce both anabolic and anti-catabolic effects in bone. On the other hand, systemic increases in Sr2+ levels can provoke adverse cardiovascular effects. In the present study we have developed a compatibilized blend of poly-ε-caprolactone (PCL) and polydiisopropyl fumarate (PDIPF) enriched with 1% or 5% Sr2+ and evaluated the applicability of these biomaterials for BTE, both in vitro and in vivo. In vitro, whereas Blend + 5% Sr2+ was pro-inflammatory and anti-osteogenic, Blend + 1% Sr2+ released very low quantities of the cation; was not cytotoxic for cultured macrophages; and showed improved osteocompatibility when used as a substratum for primary cultures of bone marrow stromal cells. In vivo, implants with Blend + 1% Sr2+ significantly increased bone tissue regeneration and improved fibrous bridging (vs. Blend alone), while neither inducing a local inflammatory response nor increased serum levels of Sr2+. These results indicate that our compatibilized blend of PCL-PDIPF enriched with 1% Sr2+ could be useful for BTE.


Assuntos
Fumaratos , Poliésteres , Polímeros , Estrôncio , Engenharia Tecidual/métodos , Tecidos Suporte , Animais , Materiais Biocompatíveis , Osso e Ossos , Sobrevivência Celular , Células Cultivadas , Masculino , Camundongos , Óxido Nítrico/fisiologia , Células RAW 264.7 , Ratos , Células Estromais/fisiologia
19.
Rehabil Nurs ; 44(1): 47-51, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30586021

RESUMO

PURPOSE: Lumbago, or low back pain (LBP), is a common musculoskeletal complaint among older adults that may also be associated with depression. The study objective was to investigate differences in Beck Depression Inventory depression symptoms scores among older adult patients with and without LBP. DESIGN: This was a case-control study. METHODS: A total of 152 older adult patients, recruited at an outpatient healthcare clinic (47 men, 105 women; 74.81 ± 6.9 years), were classified as having subacute LBP (n = 76) or non-LBP (n = 76) according to clinic records. FINDINGS: Beck Depression Inventory scores (mean ± SD) among LBP patients (10.93 ± 6.18) were significantly higher compared to the non-LBP group (7.62 ± 5.70; p = .000085), whose scores indicated no depression symptoms. CONCLUSION: Subacute LBP may represent a potential risk for increased depression among older adults. CLINICAL RELEVANCE: Early detection of depression will assist rehabilitation nurses in prescribing the beneficial physical rehabilitation and exercise programs or provide the information and treatment recommendations to older adults with subacute LBP and their families. Also, it should be part of a nursing staff prevention strategy for patients who suffer this common musculoskeletal disorder.


Assuntos
Depressão/etiologia , Dor Lombar/complicações , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Estudos de Casos e Controles , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Dor Lombar/epidemiologia , Dor Lombar/psicologia , Masculino , Medição da Dor/métodos , Medição da Dor/psicologia
20.
Br J Cancer ; 119(8): 915-921, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30318508

RESUMO

BACKGROUND: Optimal duration of anticoagulation for cancer-associated thrombosis (CAT) remains unclear. This study assessed D-dimer (DD) and high-sensitivity C-reactive protein (hs-CRP) levels after the withdrawal of anticoagulation treatment to predict the risk of venous thromboembolism (VTE) recurrence among patients with CAT. METHODS: Prospective, multicentre study to evaluate CAT with ≥3 months of anticoagulation that was subsequently discontinued. Blood samples were taken when patients stopped the anticoagulation and 21 days later to determine the DD and hs-CRP levels. All patients were followed up for 6 months to detect VTE recurrence. RESULTS: Between 2013 and 2015, 325 patients were evaluated and 114 patients were ultimately enrolled in the study. The mean age was 62 ± 14 years and nearly 40% had metastasis. Ten patients developed VTE recurrence within 6 months (8.8%, 95% confidence interval [CI]: 4.3-15.5%). The DD and hs-CRP levels after 21 days were associated with VTE recurrence. The subdistribution hazard ratios were 9.82 for hs-CRP (95% CI: 19-52) and 5.81 for DD (95% CI: 1.1-31.7). CONCLUSIONS: This study identified that hs-CRP and DD were potential biomarkers of VTE recurrence after discontinuation of anticoagulation in CAT. A risk-adapted strategy could identify low-risk patients who may benefit from discontinuation of anticoagulation.


Assuntos
Anticoagulantes/administração & dosagem , Proteína C-Reativa/análise , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Neoplasias/patologia , Tromboembolia Venosa/prevenção & controle , Trombose Venosa/prevenção & controle , Suspensão de Tratamento/estatística & dados numéricos , Anticoagulantes/uso terapêutico , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/irrigação sanguínea , Estudos Prospectivos , Recidiva , Medição de Risco , Fatores de Risco , Prevenção Secundária/métodos , Tromboembolia Venosa/tratamento farmacológico , Trombose Venosa/tratamento farmacológico
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