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1.
Transplant Proc ; 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32029311

RESUMO

BACKGROUND: Renal transplant (RT) recipients are especially susceptible to carbapenem-resistant Klebsiella pneumoniae carbapenemase (KPC) infections. However, published experience is limited. OBJECTIVE: To analyze the characteristics and evolution of RT recipients with KPC infection in our hospital. METHODS: We performed a retrospective cohort study of all RT recipients with KPC infection in our hospital from December 1, 2017 (first case), to July 31, 2019. For each RT recipient infected with KPC, 3 controls were selected. RESULTS: During the study period, 8 RT recipients presented KPC infection. Seven were detected in the first year post-RT. The most common site of infection was urine. In 2 cases the germ was isolated in blood. The number of patients with diabetes was significantly higher in the group with KPC infection (P = .023), and urologic interventions were more frequent in those patients (P = .039). No differences were found in the immunosuppressive treatment. A total of 62.5 % of patients required readmission after the KPC infection. One patient died of septicemia by KPC. In all these cases, the clone of KPC isolated was KPC ST512. CONCLUSION: KPC infection is more frequent in the first months after the RT and causes an important number of hospital admissions. It can be cause of death in RT recipients, especially in those with isolation of the germ in blood. Diabetes and urologic interventions were more frequent in this population. The analysis by molecular typing suggests exposure to a common source, highlighting the importance of preventive isolation measures and surveillance for limiting the transmission of this bacteria.

2.
PLoS One ; 15(2): e0229019, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32053687

RESUMO

The development of new antimicrobial peptides has become an attractive alternative to conventional antibiotics due to the increasing rates of microbial drug resistance. Ib-M corresponds to a family of cationic synthetic peptides, 20 amino acids in length, that have shown inhibitory effect against the non-pathogenic strain Escherichia coli K-12. This work evaluated the antimicrobial potential of Ib-M peptides against the pathogenic E. coli O157: H7 using a reference strain and a clinical isolate. The Ib-M peptides showed antibacterial activity against both strains of E. coli O157: H7; the minimum inhibitory concentration of Ib-M peptides ranged from 1.6 to 12.5 µM and the minimum bactericidal concentration ranged from 3.7 to 22.9 µM, being Ib-M1 and Ib-M2 the peptides that presented the highest inhibitory effect. Time-kill kinetics assay showed a reduction of the bacterial population by more than 95% after 4 hours of exposure to 1xMIC of Ib-M1. Low cytotoxicity was observed in VERO cells with 50% cytotoxic concentration in the range from 197.5 to more than 400 µM. All peptides showed a random structure in hydrophilic environments, except Ib-M1, and all of them transitioned to an α-helical structure when the hydrophobicity of the medium was increased. In conclusion, these findings support the in vitro antimicrobial effect of Ib-M peptides against the pathogenic bacteria E. coli O157: H7 and prove to be promising molecules for the development of new therapeutic alternatives.

3.
Clin Chem ; 2020 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-32068788

RESUMO

BACKGROUND: The specific characteristics of copy number variations (CNVs) require specific methods of detection and characterization. We developed the Easy One-Step Amplification and Labeling procedure for CNV detection (EOSAL-CNV), a new method based on proportional amplification and labeling of amplicons in 1 PCR. METHODS: We used tailed primers for specific amplification and a pair of labeling probes (only 1 labeled) for amplification and labeling of all amplicons in just 1 reaction. Products were loaded directly onto a capillary DNA sequencer for fragment sizing and quantification. Data obtained could be analyzed by Microsoft Excel spreadsheet or EOSAL-CNV analysis software. We developed the protocol using the LDLR (low density lipoprotein receptor) gene including 23 samples with 8 different CNVs. After optimizing the protocol, it was used for genes in the following multiplexes: BRCA1 (BRCA1 DNA repair associated), BRCA2 (BRCA2 DNA repair associated), CHEK2 (checkpoint kinase 2), MLH1 (mutL homolog 1) plus MSH6 (mutS homolog 6), MSH2 (mutS homolog 2) plus EPCAM (epithelial cell adhesion molecule) and chromosome 17 (especially the TP53 [tumor protein 53] gene). We compared our procedure with multiplex ligation-dependent probe amplification (MLPA). RESULTS: The simple procedure for CNV detection required 150 min, with <10 min of handwork. After analyzing >240 samples, EOSAL-CNV excluded the presence of CNVs in all controls, and in all cases, results were identical using MLPA and EOSAL-CNV. Analysis of the 17p region in tumor samples showed 100% similarity between fluorescent in situ hybridization and EOSAL-CNV. CONCLUSIONS: EOSAL-CNV allowed reliable, fast, easy detection and characterization of CNVs. It provides an alternative to targeted analysis methods such as MLPA.

4.
Cien Saude Colet ; 25(2): 673-682, 2020 Feb.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32022207

RESUMO

The aim of this study was to describe and analyze history of toothache and associated factors among adolescent students enrolled in public schools of a city in Northeastern Brazil. An observational, descriptive, quantitative and cross-sectional study was conducted through the application of 4 questionnaires with 458 adolescents. By bivariate analysis, the prevalence of toothache in life was higher among younger adolescents (76.9%; p = 0.004), who have visited the dentist at least once (74.8%; p = 0.001) and who reported fear (74.9%; p = 0.006). The occurrence of dental pain in the last 6 months was low, where male (77.4%; p = 0,001) and older adolescents (73.1%; p = 0.031) reported no occurrence of pain. Through multivariate analysis, the highest prevalence of dental pain in life remained among younger adolescents (76.9%; p = 0.003) and who reported dental fear (74.9%; p = 0.006). The prevalence of toothache in the last 6 months remained low through multivariate analysis, among male and older adolescents. It could be concluded that the prevalence of toothache in life was higher than in the last 6 months, showing significant association with gender, age, visit to the dentist and dental fear.

5.
ESC Heart Fail ; 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32022485

RESUMO

AIMS: Current guidelines recommend sacubitril/valsartan for patients with heart failure and reduced left ventricular ejection fraction (LVEF), but there is lack of evidence of its efficacy and safety in cancer therapy-related cardiac dysfunction (CTRCD). Our aim was to analyse the potential benefit of sacubitril/valsartan in patients with CTRCD. METHODS AND RESULTS: We performed a retrospective multicentre registry (HF-COH) in six Spanish hospitals with cardio-oncology clinics including all patients treated with sacubitril/valsartan. Demographic and clinical characteristics and laboratory and echocardiographic data were collected. Median follow-up was 4.6 [1; 11] months. Sixty-seven patients were included (median age was 63 ± 14 years; 64% were female, 87% had at least one cardiovascular risk factor). Median time from anti-cancer therapy to CTRD was 41 [10; 141] months. Breast cancer (45%) and lymphoma (39%) were the most frequent neoplasm, 31% had metastatic disease, and all patients were treated with combination antitumor therapy (70% with anthracyclines). Thirty-nine per cent of patients had received thoracic radiotherapy. Baseline median LVEF was 33 [27; 37], and 21% had atrial fibrillation. Eighty-five per cent were on beta-blocker therapy and 76% on mineralocorticoid receptor antagonists; 90% of the patients were symptomatic NYHA functional class ≥II. Maximal sacubitril/valsartan titration dose was achieved in 8% of patients (50 mg b.i.d.: 60%; 100 mg b.i.d.: 32%). Sacubitril/valsartan was discontinued in four patients (6%). Baseline N-terminal pro-B-type natriuretic peptide levels (1552 pg/mL [692; 3624] vs. 776 [339; 1458]), functional class (2.2 ± 0.6 vs. 1.6 ± 0.6), and LVEF (33% [27; 37] vs. 42 [35; 50]) improved at the end of follow-up (all P values ≤0.01). No significant statistical differences were found in creatinine (0.9 mg/dL [0.7; 1.1] vs. 0.9 [0.7; 1.1]; P = 0.055) or potassium serum levels (4.5 mg/dL [4.1; 4.8] vs. 4.5 [4.2; 4.8]; P = 0.5). Clinical, echocardiographic, and biochemical improvements were found regardless of the achieved sacubitril-valsartan dose (low or medium/high doses). CONCLUSIONS: Our experience suggests that sacubitril/valsartan is well tolerated and improves echocardiographic functional and structural parameters, N-terminal pro-B-type natriuretic peptide levels, and symptomatic status in patients with CTRCD.

6.
Med Phys ; 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-32031263

RESUMO

PURPOSE: The objective of this study was to characterize the Best Medical Canada microMOSFET detectors for their application in in vivo dosimetry for high-dose-rate brachytherapy (HDRBT) with 192 Ir. We also developed a mathematical model to correct dependencies under the measurement conditions of these detectors. METHODS: We analyzed the linearity, reproducibility, and interdetector variability and studied the microMOSFET response dependence on temperature, source-detector distance, and angular orientation of the receptor with respect to the source. The correction model was applied to 19 measurements corresponding to 5 simulated treatments in a custom phantom specifically designed for this purpose. RESULTS: The detectors (high bias applied in all measurements) showed excellent linearity up to 160 Gy. The response dependence on source-detector distance varied by (8.65 ± 0.06)% (k=1) for distances between 1 and 7 cm, and the variation with temperature was (2.24 ± 0.05)% (k=1) between 294 K and 310 K. The response difference due to angular dependence can reach (10.3 ± 1.3)% (k=1). For the set of measurements analyzed, regarding angular dependences, the mean difference between administered and measured doses was -4.17% (standard deviation of 3.4%); after application of the proposed correction model, the mean difference was -0.1% (standard deviation of 2.2%). For the treatments analyzed, the average difference between calculations and measures was 4.7% when only the calibration coefficient was used, but it is reduced to 0.9% when the correction model is applied. CONCLUSION: Important response dependencies of microMOSFET detectors used for in vivo dosimetry in HDRBT treatments, especially the angular dependence, can be adequately characterized by a correction model that increases the accuracy of this system in clinical applications.

7.
Transplant Proc ; 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32033833

RESUMO

The compression of the renal parenchyma due to a subcapsular hematoma, also known as the "Page kidney," is a potentially serious but treatable complication of renal biopsy. Hypertension is very common and, in some cases, renal failure may be present. In kidney transplantation, it is a not well-described entity. Rapid intervention is essential to avoid irreversible damage of the graft and preserve its function. We report 2 cases of acute renal failure due to Page kidney in patients with renal transplant after a percutaneous biopsy with successful recovery after surgical treatment. In addition, we conducted a literature review in order to describe the clinical characteristics of this infrequent complication in patients with a history of renal transplant.

8.
Res Nurs Health ; 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32048749

RESUMO

Young adults continue to have very low rates of human immunodeficiency virus (HIV) testing, which contribute to transmission, late diagnoses, and poor health outcomes. The access and uptake of HIV testing among young adults can be improved by promoting self-initiated testing (i.e., testing without the immediate recommendation of a clinician). Little is known, however, about how young adults self-initiate HIV testing. The purpose of this study was to explore the decision-making process of young adults who self-initiated HIV testing. A qualitative descriptive study was conducted with 30 young adults aged 18-24 years. The findings from this study describe how young adults acknowledge their vulnerability to HIV infection and navigate the process of deciding to self-initiate testing. Some subcategories include Self-Convincing, Conversation Prompts, and The Right Place and Right Time. Findings from this study are pivotal for subsequent studies to further understand self-initiated HIV testing among young adults and design targeted interventions that will improve testing uptake.

9.
Enzyme Microb Technol ; 134: 109477, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32044024

RESUMO

In this work, the expression of an α-amylase from Bacillus megaterium on the cell surface of Escherichia coli strains WDHA (Δ hycA and Δ ldhA) and WDHFP (Δ hycA, Δ frdD and Δ pta) by the autodisplay adhesin involved in diffuse adherence (AIDA) system was carried out with the purpose to confer the ability to E. coli strains to degrade starch and thus produce hydrogen, ethanol and succinic acid. For the characterization of the biocatalyst, the effect of temperature (30-70 °C), pH (3-6) and CaCl2 concentration (0-25 mM), as well as the thermostability of the biocatalyst (55-80 °C) at several time intervals (15-60 min) were evaluated. The results showed that the biocatalyst had a maximum activity at 55 °C and pH 4.5. Calcium was required for the activity as well for the thermal stability of the biocatalyst. The calculated Vmax and Km values were 0.24 U/cm3 and 5.8 mg/cm3, respectively. Furthermore, a set of anaerobic batch fermentations was carried out using 10 g/dm3 of starch and 1 g/dm3 of glucose as carbon sources in 120 cm3 serological bottles, using WDHA and WDHFP strains harboring the pAIDA-amyA plasmid. The hydrogen production for WDHA was 1056.06 cm3/dm3 and the succinic acid yield was 0.68 g/gstarch, whereas WDHFP strain produced 1689.68 cm3/dm3 of hydrogen and an ethanol yield of 0.28 g/gstarch. This work represents a promising strategy to improve the exploitation of starchy biomass for the production of biofuels (hydrogen and ethanol) or succinate without the need of a pre-saccharification process.

10.
Artigo em Inglês | MEDLINE | ID: mdl-32009250

RESUMO

OBJECTIVES: The aim of this study was to evaluate the association between the prevalence of cavitated dental caries and oral health literacy (OHL), family characteristics and sociodemographic factors in early adolescence. METHODS: A cross-sectional study was conducted with 740 twelve-year-old students. The students' guardians provided information on sociodemographic data, and the students provided information on family characteristics and OHL. Two trained dentists examined the participants for dental caries and administered the Brazilian version of the Rapid Estimate of Oral Health Literacy in Dentistry (BREALD-30). Control variables were selected using a directed acyclic graph. Descriptive analysis was performed; this was followed by robust Poisson regression analysis for complex samples to evaluate the association between dental caries and socioeconomic and family predictors (α = 5%). RESULTS: The following variables were associated with a greater number of cavitated caries lesions: low level of education completed by the mother (RR = 1.58; 95% CI: 1.12-2.24), less privileged social class (RR = 1.89; 95% CI: 1.28-2.80), non-White ethnicity (RR = 1.64; 95% CI: 1.0-2.48), larger number of residents in the home (RR = 1.87; 95% CI: 1.25-2.81), low level of OHL (RR = 2.02; 95% CI: 1.28-3.18), and the 'connected' (RR = 4.72; 95% CI: 1.17-18.90), 'separated' (RR = 4.09; 95% CI: 1.05-15.86) and 'disengaged' (RR = 4.20; 95% CI: 1.09-16.18) types of family cohesion. CONCLUSIONS: A low level of oral health literacy, sociodemographic factors, and a low level of family cohesion are predictors of cavitated caries lesions in early adolescence.

11.
Aging (Albany NY) ; 122020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31974316

RESUMO

Several signaling pathways may be affected during aging. All are regulated by nutrient levels leading to a decline in mitochondrial function and autophagy and to an increase in oxidative stress. PAS Domain Kinase (PASK) is a nutrient and bioenergetic sensor. We have previously found that PASK plays a role in the control of hepatic metabolic balance and mitochondrial homeostasis. To investigate PASK's role in hepatic oxidative stress during aging, we analyzed the mitochondrial function, glucose tolerance, insulin resistance, and lipid-related parameters in aged PASK-deficient mice. Hepatic Pask mRNA decreased in step with aging, being undetectable in aged wild-type (WT) mice. Aged PASK-deficient mice recorded lower levels of ROS/RNS compared to aged WT. The regulators of mitochondrial biogenesis, PGC1a, SIRT1 and NRF2, decreased in aged WT, while aged PASK-deficient mice recorded a higher expression of NRF2, GCLm and HO1 proteins and CS activity under fasted conditions. Additionally, aged PASK-deficient mice recorded an overexpression of the longevity gene FoxO3a, and maintained elevated PCNA protein, suggesting that hepatic cell repair mechanisms might be functional. PASK-deficient mice have better insulin sensitivity and no glucose intolerance, as confirmed by a normal HOMA-IR index. PASK may be a good target for reducing damage during aging.

12.
Psicothema ; 32(1): 138-144, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31954427

RESUMO

BACKGROUND: The transition to motherhood is sometimes characterized by ambivalent emotions. This paper attempts to explore whether this transition may be triggering attachment insecurities in first-time pregnant women during their first trimester, and thus affecting their prenatal expectations and caregiving representations. METHOD: A sample of 100 first-time pregnant women during their first trimester was studied. Prenatal expectations were explored in terms of desire to have children (DTC), perceived ability to relate to children (PARC), personal meaning ascribed to motherhood, and preoccupations regarding becoming a mother. RESULTS: The estimated Bayesian network shows that attachment style is a predictor for prenatal expectations, either directly or indirectly. Results also suggest that PARC mediates the relationship between attachment and the preoccupations related to motherhood. Pregnant women with an insecure attachment style reported lower PARC and higher preoccupations about becoming a mother. CONCLUSION: Pregnant women with secure attachment have more positive pre-parenthood expectations and parenting representations than those with insecure attachment. These results may be useful in clinical settings to help women have a smoother transition to motherhood.

13.
Food Chem ; 313: 126123, 2020 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31923871

RESUMO

Calcium supplements have increasingly been used at pre- and post-harvest stages for improving fruit firmness, but elevated calcium levels in grape cells were shown to reduce total anthocyanin content. In this study, we hypothesized that exogenous calcium influences specific polyphenolic compounds, and performed targeted UPLC-MS analysis in fruits collected from vines cv. "Vinhão" sprayed with 2% (w/v) CaCl2 throughout the fruiting season, in two consecutive vintages, and in grape cell cultures elicited with calcium. Results showed that anthocyanin content is reduced upon calcium treatment, while stilbenoid synthesis is generally stimulated, in line with UFGT and STS expression patterns. The main metabolites involved in this response were malvidin-3-O-glucoside, E-piceid, E-ε-viniferin and E-resveratrol. The accumulation of phenolic acids, catechin and some quercetin derivatives was also favored by calcium, while other flavonols and flavan-3-ols were affected according to the vintage and berry developmental stage. In cell cultures, the entire flavonoid pathway was repressed.

14.
Neuropharmacology ; 165: 107917, 2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-31926456

RESUMO

Prenatal ethanol exposure (PEE) promotes ethanol consumption in the adolescent offspring accompanied by the transcriptional regulation of kappa opioid receptor (KOR) system genes. This study analysed if environmental enrichment (EE, from gestational day 20 to postnatal day 26) exerts protective effects upon PEE-modulation of gene expression, ethanol intake and anxiety responses. Pregnant rats were exposed to PEE (0.0 or 2.0 g/kg ethanol, gestational days 17-20) and subsequently the dam and offspring were reared under EE or standard conditions. PEE upregulated KOR mRNA levels in amygdala (AMY) and prodynorphin (PDYN) mRNA levels in ventral tegmental area (VTA) with the latter effect associated with lower DNA methylation at the gene promoter. These effects were normalized by exposure to EE. PEE modulated BDNF mRNA levels in VTA and Nucleus accumbens (AcbN), and EE mitigated the changes in AcbN. EE induced a protective effect on ethanol intake and preference, an effect more noticeable in males than in females, and in prenatal vehicle-treated (PV) than in PEE rats. The male offspring drank significantly less ethanol than the female offspring. The latter result suggests that the protective effect of EE on ethanol drinking may only emerge at lower levels of drinking. In the dams, PEE induced an upregulation of PDYN and KOR in AcbN. PDYN gene expression was normalized by exposure to EE. These results suggest that EE is a promising treatment to inhibit the effects of PEE. The results confirm that PEE effects are mediated by alterations in the transcriptional regulation of KOR system genes.

15.
J Zoo Wildl Med ; 50(4): 1021-1025, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31926541

RESUMO

Hematology and serum biochemistry profiles are used to evaluate the health status of animals ongoing rehabilitation. The aim of this project was to develop blood and biochemistry ranges for harbor seal pups (Phoca vitulina) after rehabilitation; thus, 22 different blood parameters in 60 animals were tested before release. The second goal was to test for differences due to sex, stranding location, body condition at admission, and presence or absence of umbilical cord. The alanine aminotransferase, ALT (or glutamate pyruvate transaminase, GPT), (ALT-GPT) differed significantly (P bq = 0.00851) between sexes. Lower leukocyte counts and higher liver enzyme values were the most remarkable findings when comparing the results of this study to other published data. This is the first study to report blood reference ranges for harbor seal pups in the Dutch Wadden Sea after rehabilitation.


Assuntos
Contagem de Eritrócitos/veterinária , Hematócrito/veterinária , Contagem de Leucócitos/veterinária , Phoca/sangue , Contagem de Plaquetas/veterinária , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Animais , Glicemia , Nitrogênio da Ureia Sanguínea , Creatinina , Feminino , Hemoglobinas , Masculino
16.
Pharmacoepidemiol Drug Saf ; 29(1): 57-68, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31749191

RESUMO

PURPOSE: There has been a notable progress on the development of methods for identification of pregnancies using primary care databases. We aimed to evaluate the prescription of medications during pregnancy applying a novel algorithm. METHODS: We identified pregnancies in women aged 15 to 49 years registered in the Database for Pharmacoepidemiological Research in Primary Care (BIFAP) between 2002 and 2015. The algorithm applied sequential cycles that searched in hierarchical order for indicators of conception, delivery or pregnancy loss, and other codes suggestive of pregnancy. Length of pregnancy was assessed by searching for last menstrual period (LMP) date, gestational age, and outcomes of pregnancy. Prescription of specific drugs during the pre-pregnancy period and first trimester and time trends during pregnancy were evaluated. RESULTS: We identified a total of 155 419 pregnancies during the study period (77.5% completed pregnancies, 21.5% pregnancies losses, 0.8% ectopic pregnancies, and 0.2% stillbirths). Excluding vitamins and supplements, 43.8% of women received at least one prescription during the pre-pregnancy period and 68.4% during the first trimester. During the first trimester, the most commonly drugs prescribed were analgesics (16.3%) followed by antibiotics (11.8%). From 2002/2003 to 2014/2015, there was an increase of prescriptions for thyroid hormones (1.0% vs 4.7%), H2 blockers (1.0% vs 2.2%), and PPIs (1.4% vs 2.2%). While antidepressants (2.0% vs 1.5%) and benzodiazepines (3.1% vs 2.4%) decreased in the last period. CONCLUSION: Having in mind the challenges of identifying pregnancies in health care databases, this study demonstrates the usefulness of BIFAP database for studies on drug utilization during pregnancy.

17.
J Clin Apher ; 35(1): 9-17, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31663632

RESUMO

Low-density lipoprotein (LDL) apheresis has been considered the last option to treat refractory hyperlipidemia in patients with familiar hypercholesterolemia (FH). Evolocumab is a monoclonal antibody which has shown significant reduction of low-density lipoprotein cholesterol (LDL-C) serum levels and cardiovascular events. The aim of the study was to examine the comparative impact of LDL-apheresis vs Evolocumab vs the combination of both LDL-apheresis and Evolocumab on lipid and lipoprotein parameters, and other metabolic/inflammatory measures. DESIGN OF THE STUDY: Non-randomized open case series study of 10 adult patients diagnosed with FH already on long-term LDL-apheresis therapy. The study was developed in three consecutive phases to compare LDL-apheresis, Evolocumab treatment and the combination of both. Laboratory parameters were collected pre and post LDL-apheresis and before Evolocumab administration. The primary endpoint was the reduction of LDL-C during the three phases. RESULTS: Reduction of LDL-C levels with Evolocumab were 31.4% vs LDL-apheresis from 153 ± 35 mg/dL to 105 ± 56 mg/dL (P < .001). Reduction of Lp(a) was also significantly higher with Evolocumab (45.5%) than LDL-apheresis from 36 (6-119) to 20 (3-41) mg/dL, P = .027. In addition, HDL-C and apo-A increased after Evolocumab treatment, from 41 ± 6 to 46 ± 8 mg/dL (P = .003) and from 124 ± 13 to 144 ± 25 mg/dL (P = .001), respectively. No changes in immunological or inflammatory parameters were observed and no serious adverse events were recorded. CONCLUSION: Evolocumab reduces LDL-C and Lp(a) more effectively than LDL-apheresis and combination of Evolocumab plus LDL-apheresis could be a therapeutic alternative to get lower LDL-C and Lp(a) levels in patients with very high cardiovascular risk.

18.
Eur Arch Otorhinolaryngol ; 277(2): 313-321, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31673778

RESUMO

OBJECTIVE: Olfaction is an important sense in children, but its measurement is usually disregarded or neglected. There has been increasing interest in olfaction in recent years, and many olfaction assessment tests have been developed to assess pediatric patients. In this systematic review, we identify and compare different olfaction assessment tests used in the pediatric population DATA SOURCES: Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database. REVIEW METHODS: The main outcome was review of the tests used to assess olfaction. The secondary outcomes were review of differences between tests regarding sex, age, exercises and odorants. RESULTS: A total of 18 articles fulfilled the established inclusion criteria. CONCLUSIONS: Olfaction assessment in children should combine different methods of evaluation, and not rely only on identification tasks. There are still many questions to answer. There is a great need for a specific test for children under 5 years old. Also, there is not a real cutoff value to define hyposmia yet; real cutoff values and values adapted to children's development are keenly needed.

19.
Plant Physiol ; 182(2): 707-720, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31744934

RESUMO

Root hydraulic conductivity is a limiting factor along the water pathways between the soil and the leaf, and root radial conductivity is itself defined by cell-scale hydraulic properties and anatomical features. However, quantifying the influence of anatomical features on the radial conductivity remains challenging due to complex time-consuming experimental procedures. We present an open-source computational tool, the Generator of Root Anatomy in R (GRANAR; http://granar.github.io), that can be used to rapidly generate digital versions of contrasted monocotyledon root anatomical networks. GRANAR uses a limited set of root anatomical parameters, easily acquired with existing image analysis tools. The generated anatomical network can then be used in combination with hydraulic models to estimate the corresponding hydraulic properties. We used GRANAR to reanalyze large maize (Zea mays) anatomical datasets from the literature. Our model was successful at creating virtual anatomies for each experimental observation. We also used GRANAR to generate anatomies not observed experimentally over wider ranges of anatomical parameters. The generated anatomies were then used to estimate the corresponding radial conductivities with the hydraulic model MECHA (model of explicit cross-section hydraulic architecture). Our simulations highlight the large importance of the width of the stele and the cortex. GRANAR is a computational tool that generates root anatomical networks from experimental data. It enables the quantification of the effect of individual anatomical features on the root radial conductivity.

20.
Autoimmun Rev ; 19(2): 102455, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31838162

RESUMO

BACKGROUND AND OBJECTIVE: Drug-induced myopathy is among the most common causes of muscle disease. An association has recently been described between programmed death-1 (PD-1)/PD-1 ligand (PD-L1) inhibitors and immune-related adverse events (irAE) affecting the muscle. Here, we report the clinical and pathological findings of nine unrelated patients with PD-1 and PD-L1 inhibitors-associated myopathy. METHODS: We retrospectively analyzed 317 muscle biopsies performed for diagnostic purposes from January 2017 to June 2019. Patients were attended in two tertiary centers and muscle biopsies were performed and analyzed by two myology experts. Muscle biopsies were frozen in cooled isopenthane, cryostat sectioned and stained. Immunohistochemistry studies were also performed as a routine procedure in our lab. RESULTS: We identified 9 patients receiving anti-PD-1 or PD-L1 inhibitors consulting for either muscle weakness, asthenia, myasthenic-like syndrome or other muscle related-symptoms, along with biopsy-proven inflammatory myopathy. One had concomitant myocarditis. In most of the cases muscle biopsy showed a marked phenomenon of necrosis, macrophagy and muscle regeneration with perivascular inflammatory infiltrates with a large component of macrophagic cells. A tendency to perifascicular atrophy was also noticed. The expression of MHC class I antigens predominated in the perifascicular zones. Raised muscle enzymes were detected in 7 patients. CONCLUSION: A characteristic clinic-pathological pattern, including a myasthenia gravis-like syndrome plus myositis was found in patients receiving PD-1 and PD-1 L inhibitors. A large component of macrophages resembling granulomas seems to be the pathological hallmark of the syndrome. Further information is required to understand the wide spectrum of immune-related adverse events involving the muscle during or after treatment with anti-PD-1 inhibitors, but the pathological picture seems to be characteristic.

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