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1.
Biochem Med (Zagreb) ; 30(1): 010502, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31839720

RESUMO

Extravascular body fluids (EBF) analysis can provide useful information in the differential diagnosis of conditions that caused their accumulation. Their unique nature and particular requirements accompanying EBF analysis need to be recognized in order to minimize possible negative implications on patient safety. This recommendation was prepared by the members of the Working group for extravascular body fluid samples (WG EBFS). It is designed to address the total testing process and clinical significance of tests used in EBF analysis. The recommendation begins with a chapter addressing validation of methods used in EBF analysis, and continues with specific recommendations for serous fluids analysis. It is organized in sections referring to the preanalytical, analytical and postanalytical phase with specific recommendations presented in boxes. Its main goal is to assist in the attainment of national harmonization of serous fluid analysis and ultimately improve patient safety and healthcare outcomes. This recommendation is intended to all laboratory professionals performing EBF analysis and healthcare professionals involved in EBF collection and processing. Cytological and microbiological evaluations of EBF are beyond the scope of this document.


Assuntos
Líquidos Corporais/química , Técnicas de Laboratório Clínico/normas , Líquidos Corporais/metabolismo , Exsudatos e Transudatos/química , Exsudatos e Transudatos/metabolismo , Guias como Assunto , Humanos , Segurança do Paciente , Derrame Pleural/diagnóstico , Garantia da Qualidade dos Cuidados de Saúde , Sociedades Médicas , Manejo de Espécimes/normas
2.
Plant Sci ; 284: 108-116, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31084863

RESUMO

Cannabinoids are terpenophenolic compounds produced by Cannabis sativa L., which accumulate in storage cavities of glandular trichomes as a part of the exudates. We investigated if tetrahydrocannabinolic acid synthase and cannabidiolic acid synthase, which are involved in the last step of cannabinoid biosynthesis, are also secreted into Cannabis trichome exudates. The exudates were collected by microsuction from storage cavities of Cannabis glandular trichomes and were subjected for proteomic and metabolomic analyses. The catalytic activity of the exudates was documented by cannabigerolic acid biotransformation studies under hydrophobic conditions. Electrophoretic separations revealed protein bands at ˜65 kDa, which were further identified as tetrahydrocannabinolic acid synthase and cannabidiolic acid synthase. The accumulation of the enzymes in trichome exudates increased substantially during the flowering period in the drug-type Cannabis plants. The content of cannabinoids increased significantly after incubating hexane-diluted trichome exudates with cannabigerolic acid. In this study, we showed that Cannabis glandular trichomes secrete and accumulate cannabinoid synthases in storage cavities, and the enzymes able to convert cannabigerolic acid under hydrophobic trichome-mimicking conditions. Metabolite profiling of the exudates revealed compounds with hydrophilic, osmoprotective and amphiphilic properties, which may play a role in providing a necessary aqueous microenvironment, which enables enzyme solubility and biocatalysis under hydrophobic conditions of glandular trichomes.


Assuntos
Canabinoides/metabolismo , Cannabis/metabolismo , Oxirredutases Intramoleculares/metabolismo , Tricomas/metabolismo , Exsudatos e Transudatos/metabolismo , Cromatografia Gasosa-Espectrometria de Massas , Osmorregulação
3.
Medicine (Baltimore) ; 98(14): e14979, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30946324

RESUMO

BACKGROUND: Soluble mesothelin-related peptide (SMRP) is a widely studied tumor marker for diagnosing malignant pleural mesothelioma (MPM). This study discussed the diagnostic value of SMRPs in pleural effusion (PE) for MPM. METHODS: Medline, Embase, Web of Science, and Cochrane library system were systematically searched on the data of SMRPs in PE for MPM diagnosis. Pooled diagnostic sensitivity, specificity, and symmetric receiver operating characteristic curve were calculated. RESULTS: Thirteen studies fulfilled the inclusion criteria and a total of 3359 cases including 759 MPM cases, 1061 non-MM (malignant mesothelioma) malignant PE, and 1539 benign PE were brought into this meta-analysis. The pooled results of SMRPs in PE for diagnosing MPM were as follows: sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.68 (95% confidence interval [CI]: 0.64-0.72), 0.91 (95% CI: 0.86-0.94), 7.8 (95% CI: 5.0-12.0), 0.35 (95% CI: 0.31-0.40), and 22 (95% CI: 14-35), respectively. The area under the summary receiver operating characteristic curves (AUC) was 0.75 (95% CI: 0.72-0.80). Subgroup analyzes revealed that the AUC of cohort group using histological diagnosis could be improved to 0.86 (95% CI: 0.83, 0.89). The Deek's funnel plot asymmetry test showed no publication bias. CONCLUSION: Although the sensitivity of SMRPs was low, PE-SMRPs can be a good indicator of the existence of MPM.


Assuntos
Proteínas Ligadas por GPI/metabolismo , Neoplasias Pulmonares/metabolismo , Mesotelioma/metabolismo , Proteínas Associadas à Resistência a Múltiplos Medicamentos/metabolismo , Derrame Pleural/metabolismo , Biomarcadores Tumorais/metabolismo , Exsudatos e Transudatos/metabolismo , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Mesotelioma/diagnóstico , Mesotelioma/patologia , Derrame Pleural/diagnóstico , Derrame Pleural/patologia , Derrame Pleural Maligno/diagnóstico , Derrame Pleural Maligno/metabolismo , Derrame Pleural Maligno/patologia , Neoplasias Pleurais/diagnóstico , Neoplasias Pleurais/metabolismo , Neoplasias Pleurais/patologia , Sensibilidade e Especificidade
4.
AJR Am J Roentgenol ; 213(2): 473-481, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30995101

RESUMO

OBJECTIVE. The objective of this article is to define the clinical significance of asymmetric ductal ectasia by a review of literature and to describe the imaging findings. CONCLUSION. Asymmetric ductal ectasia has a significant risk for malignancy and high-risk lesions. The findings on conventional imaging may be subtle and easily overlooked. Asymmetric ductal ectasia should be included in the search pattern during image interpretation. Tissue sampling is usually warranted. Ultrasound is critical in identifying ductal abnormalities to guide biopsy.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/diagnóstico por imagem , Doenças Mamárias/diagnóstico por imagem , Doenças Mamárias/patologia , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Diagnóstico Diferencial , Dilatação Patológica , Exsudatos e Transudatos/metabolismo , Feminino , Humanos , Mamografia , Mamilos/metabolismo , Ultrassonografia Mamária
5.
Eur Arch Otorhinolaryngol ; 276(7): 1889-1895, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30919059

RESUMO

PURPOSE: Some studies have demonstrated that vascular endothelial growth factor (VEGF) plays a critical role in the pathogenesis of otitis media with effusion (OME) in animal models. However, the levels of VEGF and its receptors in adult OME have not been clarified. Our study was designed to detect the levels of VEGF and its receptors in adult OME and explore their relationship with effusion types, duration and prognosis of OME. METHODS: 61 patients with secretory otitis media were enrolled including 21 males and 40 females, with an average age of 54.7 ± 17.5 years. The middle-ear effusions were collected by tympanocentesis or myringotomy. The protein concentrations were determined by enzyme-linked immunosorbent assay and messenger RNA by real-time quantitative PCR. RESULTS: VEGF level was higher in AOME group, but not correlated with the recurrence of OME. VEGFR1 and VEGFR2 levels were lower in recurrent group compared with non-recurrent group. VEGFR2 level was higher in serous effusions than mucoid effusions. VEGF messenger RNA was positively correlated both with HIF-1α and MUC5B. CONCLUSIONS: VEGF and its receptors function to induce the production of middle-ear effusions (MEEs) at acute stage of OME rather than chronic or recurrent stage, which is mainly mediated by HIF-1α pathway. The formation of mucoid effusions is associated with MUC5B and VEGFR2, but not with duration and recurrence of OME.


Assuntos
Exsudatos e Transudatos/metabolismo , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Mucina-5B/metabolismo , Otite Média com Derrame , Receptores de Fatores de Crescimento do Endotélio Vascular/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Adulto , Idoso , Correlação de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Otite Média com Derrame/diagnóstico , Otite Média com Derrame/metabolismo , Otite Média com Derrame/fisiopatologia , Gravidade do Paciente , Prognóstico , Recidiva , Timpanocentese/métodos
6.
J Diabetes Res ; 2019: 2695436, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30775384

RESUMO

Objectives: Chronic foot ulceration is a severe complication of diabetes, driving morbidity and mortality. The aim of our study was to identify novel biomarkers of impaired wound healing in diabetic foot ulcers. Methods: 109 patients with neuropathic diabetic foot ulcers and 30 burn victims otherwise healthy participated. Antibody-coated glass slide arrays were used to determine the levels of 80 human cytokines in pooled plasma or pooled wound exudate of diabetic foot ulcers with rapidly healing (RH, n = 12) and matched nonhealing (NH, n = 12) patients. Potential biomarkers were confirmed in an independent cohort by enzyme-linked immunosorbent assay (ELISA). Results: Protein array profiling identified 27 proteins or 15 proteins significantly altered in protein profiling of pooled plasma or pooled wound exudate of 12 RH patients compared with 12 matched NH patients, respectively. In an independent cohort, quantitative ELISA validation confirmed a decrease in MCP-2 and ENA-78 levels in NH patients versus RH patients or burn victims. After adjusting for the traditional risk factors (sex, age, body mass index, fasting plasma glucose, ulcer area, HbA1C, diabetes duration, hyperlipidemia, and antibiotic therapy), only wound exudate level of ENA-78 remained having a significant association with an increased odds ratio (OR) for wound healing by binary logistic regression analysis (P < 0.05). Conclusion: Decreased wound exudate ENA-78 was independently associated with wound healing of patients with diabetic foot. Exudate ENA-78 level is implicated as a novel predictor of wound healing in patients with diabetic foot ulcers.


Assuntos
Quimiocina CXCL5/metabolismo , Pé Diabético/metabolismo , Exsudatos e Transudatos/metabolismo , Cicatrização/fisiologia , Idoso , Biomarcadores/metabolismo , Quimiocina CXCL5/sangue , Pé Diabético/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
Eur Radiol ; 29(7): 3847-3853, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30715587

RESUMO

OBJECTIVES: To investigate the incidence of, clinical outcome of, and risk factors for perirenal subcapsular fluid collections in extremely preterm infants with acute kidney injury (AKI). METHODS: Extremely preterm infants with AKI who underwent renal ultrasonography (US) during neonatal intensive care unit stay were classified into two groups according to the presence of a perirenal subcapsular fluid collection at US. Clinical outcome was compared, and relevant data were analysed, including demographics and comorbidities of the infants, as well as maternal demographics. The risk factor of perirenal subcapsular fluid in infants with AKI was tested with univariate and multivariate logistic regression analysis. RESULTS: A perirenal subcapsular fluid collection was detected in 7 of 56 (13%) extremely preterm infants with AKI (male to female ratio, 5:2; mean gestational age, 23.6 ± 1.4 weeks) and it appeared bilaterally in most cases (86%, 6/7). The mortality rate was higher in infants with perirenal subcapsular fluid collections and AKI (86%, 6/7) than with AKI alone (35%, 17/49) (p = 0.015). Infants with perirenal subcapsular fluid collections and AKI were of a lower gestational age, and more frequently showed episodes of intestinal perforation, use of medication having potential to impair renal function, and a history of maternal chorioamnionitis (p < 0.05). Multivariate analysis revealed a significantly higher risk for perirenal subcapsular fluid collections in extremely preterm infants who were treated with anti-fungal agents (OR, 13.2 (95% CI: 1.5, 119.4); p = 0.022). CONCLUSIONS: Although a perirenal subcapsular fluid collection occurred in a small proportion of extremely preterm infants with AKI, its presence was associated with high mortality. The use of anti-fungal agents was an independent risk factor for a perirenal subcapsular fluid collection. KEY POINTS: • A perirenal subcapsular fluid collection may occur in association with acute kidney injury. • A perirenal subcapsular fluid collection has a grave prognostic implication in extremely preterm infants. • The use of anti-fungal agent might be associated with perirenal subscapular fluid collections in critically ill extremely preterm infants with AKI.


Assuntos
Exsudatos e Transudatos/metabolismo , Lesão Renal Aguda/diagnóstico por imagem , Lesão Renal Aguda/epidemiologia , Lesão Renal Aguda/etiologia , Creatinina/sangue , Feminino , Idade Gestacional , Humanos , Incidência , Lactente , Lactente Extremamente Prematuro , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Modelos Logísticos , Masculino , Gravidez , Estudos Retrospectivos , Fatores de Risco , Ultrassonografia/métodos
8.
Biomark Med ; 13(3): 167-174, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30605352

RESUMO

AIM: The aim of this study was to investigate the relationship between CXCL-6 levels in wound exudates and healing of diabetic foot ulcers (DFU). MATERIALS & METHODS: One hundred patients with neuropathic DFU were recruited. Wound exudate CXCL-6 levels were measured by enzyme-linked immunosorbent assay. Patients were followed for 24 weeks and divided into rapidly healing and nonhealing groups. RESULTS: Compared with the NH group, the mean CXCL-6 levels in the wound exudates of the rapidly healing group were significantly higher. After adjusting for traditional risk factors, wound exudate CXCL-6 levels were still significantly associated with wound healing. CONCLUSION: CXCL6 is an independent predictor of wound healing in DFU patients and may be a potentially novel therapeutic target for the treatment of DFU.


Assuntos
Biomarcadores/metabolismo , Quimiocina CXCL6/metabolismo , Diabetes Mellitus Tipo 2/complicações , Pé Diabético/metabolismo , Exsudatos e Transudatos/metabolismo , Cicatrização/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Pé Diabético/etiologia , Pé Diabético/terapia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Adulto Jovem
9.
Wound Repair Regen ; 27(2): 190-195, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30548524

RESUMO

Surgical site infections represent one of the most common surgical complications. Negative pressure wound therapy is considered an effective wound management system, based on the principle that a negative pressure inside the wound can suction fluids and approximate wound edges. With the negative pressure wound therapy systems commercially available it is assumed that the pressure inside the wound is stable at the set values. We conducted a prospective experimental study to investigate this. The negative pressure level achieved inside the dressing was investigated at a standard distance from the pad of suction and at specific times in patients with surgical site infections. Pressure measurements were performed in 28 dressings in 14 patients admitted to the Emergency Surgery Department between April 2016 and June 2017. In general, the machine was set at a pressure of -100 mmHg. Negative pressure was measured with a portable pressure reader in the dressing sponge at a distance of 0, 1.5, and 3 cm from the suction pad at the time of dressing change at 24 and 48 hours. The data suggest that there is a significant decrease in negative pressure at both 1.5 and 3 cm from the suction pad at 48 hours from the dressing change (p = 0.0001 and p < 0.0001, respectively). This preliminary study shows with statistical significance that the pressure inside the sponge of a negative pressure wound therapy system decreases after 48 hours, confirming that the pressure inside the system is not the same as the pressure reported by the machine and, instead of being stable, changes overtime.


Assuntos
Tratamento de Ferimentos com Pressão Negativa , Pressão , Infecção da Ferida Cirúrgica/patologia , Infecção da Ferida Cirúrgica/terapia , Ferimentos e Lesões/patologia , Ferimentos e Lesões/terapia , Exsudatos e Transudatos/metabolismo , Humanos , Tratamento de Ferimentos com Pressão Negativa/instrumentação , Estresse Mecânico , Sucção , Propriedades de Superfície , Tampões de Gaze Cirúrgicos , Infecção da Ferida Cirúrgica/metabolismo , Cicatrização
10.
BMC Ophthalmol ; 18(1): 321, 2018 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-30545324

RESUMO

BACKGROUND: Changes in retinal fluid patterns associated with circumscribed choroidal hemangioma (CCH) have not been investigated yet. A long-term follow-up study was performed to evaluate the changes of retinal fluid patterns and treatment responses. METHODS: We retrospectively reviewed medical records of all CCH patients diagnosed between November 2005 and March 2017. Enrolled patients had visual symptoms, were treatment-naïve, and had been followed-up for more than 2 years. Best corrected visual acuities (BCVA) and the presence, severity, and pattern change of the subretinal fluid (SRF) and intraretinal fluid (IRF) in the macula on optical coherence tomography (OCT) were analyzed at initial presentation and follow-up visits. RESULTS: Twenty-six patients were enrolled. All patients received one or more of the following treatments: PDT, TTT, and intravitreal bevacizumab (Avastin) injection (IVB). Primary therapy consisted of PDT in 9 patients (34.6%), TTT in 7 patients (26.9%) and IVB in 10 patients (38.5%). At initial presentation, the SRF-only pattern was mostly observed. Despite treatment, IRF occurred over time; eventually, advanced cystoid macular oedema (CME) developed. In terms of retinal fluid reduction, PDT was most efficacious (9/9, 100%), and TTT and IVB showed moderate efficacy (TTT: 4/7, 57.1%; IVB: 5/10, 50%) as a primary therapy. After advanced CME developed, IVB and TTT showed no or minimal effect (TTT: 0/1, 0%; IVB: 0/19, 0%), and PDT was the only effective therapy (6/10, 60%). CONCLUSION: The pattern of retinal fluid accompanied by CCH evolved from an SRF-only pattern initially to an advanced CME pattern. The effectiveness of treatments decreased over time, and advanced CME generally showed resistance to treatments. PDT would be the most recommended treatment.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Neoplasias da Coroide , Exsudatos e Transudatos/metabolismo , Hemangioma , Hipertermia Induzida/métodos , Fotoquimioterapia/métodos , Adulto , Idoso , Neoplasias da Coroide/metabolismo , Neoplasias da Coroide/terapia , Feminino , Seguimentos , Hemangioma/metabolismo , Hemangioma/terapia , Humanos , Macula Lutea/metabolismo , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Líquido Sub-Retiniano/metabolismo , Acuidade Visual , Adulto Jovem
11.
Br J Community Nurs ; 23(Sup12): S28-S32, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30521362
12.
BMC Pulm Med ; 18(1): 188, 2018 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-30522463

RESUMO

BACKGROUND: Hsp90-beta has been investigated to be correlated with the occurrence and development of tumor. The intention of this research was to test the level of Hsp90-beta in malignant pleural effusion (MPE) of patients with lung cancer and disclose the clinical significance of Hsp90-beta as a potential tumor marker for differential diagnosis of pleural effusion caused by lung cancer. METHODS: The level of Hsp90-beta was determined using enzyme-linked immunosorbent assay. Calculations of the Hsp90-beta threshold, the sensitivity and specificity for distinguishing MPE from benign pleural effusion were performed using receiver operator characteristic curve. RESULTS: The level of Hsp90-beta in MPE of lung cancer patients was higher than that in control individuals (P < 0.05) and increased MPE Hsp90-beta was correlated with the pathological differentiation, tumor size and lymphatic metastasis (P < 0.05). The cutoff value of Hsp90-beta produced by receiver operator characteristic curve for distinguishing lung cancer from control individuals were 1.659 ng/mL and the sensitivity and specificity were 93.46 and 79%. CONCLUSIONS: Increased Hsp90-beta in MPE was correlated with malignant biological behavior of lung cancer patients, indicating that the level of Hsp90-beta could be a tool of referential value for differential diagnosis of pleural effusion caused by lung cancer.


Assuntos
Proteínas de Choque Térmico HSP90 , Neoplasias Pulmonares , Derrame Pleural Maligno , Fatores Biológicos/metabolismo , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/metabolismo , China , Diagnóstico Diferencial , Exsudatos e Transudatos/metabolismo , Feminino , Proteínas de Choque Térmico HSP90/análise , Proteínas de Choque Térmico HSP90/metabolismo , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patologia , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Derrame Pleural Maligno/diagnóstico , Derrame Pleural Maligno/etiologia , Derrame Pleural Maligno/metabolismo , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Carga Tumoral
13.
JNMA J Nepal Med Assoc ; 56(211): 662-665, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30381760

RESUMO

INTRODUCTION: In pleural effusion, differentiating exudative and transudative fluid is an important clinical evaluation. The objective of the study was to determine the efficacy of pleural fluid serum bilirubin ratio in differentiating exudative and transudative effusions. In resource-limited settings with no facilities to measure lactate dehydrogenase levels, using pleural fluid bilirubin ratio may help in better clinical decision. METHODS: It was a cross sectional study, conducted in the emergency department of Tribhuvan University Teaching Hospital. All the patients attending for emergency care with pleural effusion from 6th Jan 2015 to 5th Jan 2016 were included. The cases were divided as exudates and transudates on basis of final diagnosis. Serum and pleural fluid specimen were collected and sent for investigations. The data for various laboratory parameters especially those of lights criteria and bilirubin ratio were then analyzed and fluid nature was compared with results from parameters and final diagnoses. RESULTS: Among 103 cases, 74 (71.84%) had exudate and 29 (28.16%) had transudate. The commonest cause of effusion was pneumonia 37 (35.92%), second being tubercular 24 (23.30%) followed by malignant effusion 13 (12.60%), congestive heart failure 12 (11.65%), chronic kidney disease 11 (10.67%) and liver cirrhosis 6 (5.82%). The mean bilirubin ratio for exudates exceeded that for transudates. Considering the cutoff point of 0.6, the sensitivity, specificity, positive predictive value and negative predictive value were respectively 88.00%, 93.00%, 97.00% & 75.00%. CONCLUSIONS: Pleural fluid serum bilirubin ratio can be utilized as a diagnostic tool for differentiating exudative and transudative effusions.


Assuntos
Bilirrubina , Exsudatos e Transudatos/metabolismo , Derrame Pleural , Idoso , Bilirrubina/análise , Bilirrubina/sangue , Estudos Transversais , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal , Derrame Pleural/sangue , Derrame Pleural/diagnóstico , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Coleta de Urina/métodos
14.
Expert Rev Proteomics ; 15(12): 967-982, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30348024

RESUMO

INTRODUCTION: Metalloproteinases play key roles in health and disease, by generating novel proteoforms with variable structure and function. Areas covered: This review focuses on the role of endogenous [a Disintegrin and Metalloproteinase (ADAMs), ADAMs with thrombospondin motifs (ADAMTS), and matrix metalloproteinases (MMPs)] and exogenous metalloproteinases in various disease conditions, and describes the application of mass spectrometry-based proteomics to detect qualitative and quantitative changes in protein profiles in tissues and body fluids in disease. Emphasis is placed on the proteomic analysis of exudates collected from affected tissues, including methods that enrich newly generated protein fragments derived from proteolysis in cells, stroma, or extracellular matrix. The use of proteomic analysis of exudates in the study of the local tissue damage induced by metalloproteinases derived from viperid snake venoms is discussed, particularly in relation to extracellular matrix degradation and to the overall pathology of these envenomings. Expert commentary: The information provided by these proteomics approaches is paving the way for the identification of biomarkers based on particular proteolytic signatures associated with different pathologies. Together with other methodological approaches, a comprehensive view of the mechanisms and dynamics of diseases can be achieved. Such basis of knowledge allows for the design of novel diagnostic and therapeutic approaches within the frame of 'precision' or 'personalized' medicine.


Assuntos
Metaloproteases/análise , Técnicas de Diagnóstico Molecular/métodos , Proteômica/métodos , Mordeduras de Serpentes/metabolismo , Biomarcadores/análise , Biomarcadores/metabolismo , Exsudatos e Transudatos/química , Exsudatos e Transudatos/metabolismo , Humanos , Metaloproteases/metabolismo , Mordeduras de Serpentes/patologia
15.
J Int Adv Otol ; 14(1): 48-52, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29764778

RESUMO

OBJECTIVES: The role of autophagy in the pathophysiology of otitis media with effusion (OME) remains unclear, particularly regarding the difference between pediatric and adult patients. The present study analyzed the expression levels of autophagy-associated mRNAs in effusion fluids obtained from pediatric and adult patients with OME. MATERIALS AND METHODS: Middle ear fluid samples were collected from 76 pediatric patients and 41 adult patients with OME, and the levels of mRNAs encoding autophagy-related genes were measured using real-time reverse transcription-polymerase chain reaction. The relationships between the levels of autophagy-associated mRNAs and the frequency of ventilation tube insertion, the characteristics of middle ear fluid, and the results of bacterial culture were analyzed. RESULTS: Autophagy-associated mRNAs were present in the effusion fluid of all patients. The level of Beclin-1 mRNA was significantly lower in pediatric than in adult patients, regardless of the frequency of surgery or fluid characteristics (p < 0.05). CONCLUSION: Autophagy-associated mRNAs were expressed in effusion fluids of both pediatric and adult patients with OME. However, the level of Beclin-1 mRNA was significantly lower in the effusion fluid of pediatric than adult patients.


Assuntos
Proteína Beclina-1/genética , Otite Média com Derrame/genética , RNA Mensageiro/genética , Adulto , Idoso , Autofagia/genética , Criança , Pré-Escolar , Orelha Média/patologia , Orelha Média/cirurgia , Exsudatos e Transudatos/metabolismo , Exsudatos e Transudatos/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ventilação da Orelha Média/efeitos adversos , Ventilação da Orelha Média/métodos , Otite Média/complicações , Otite Média/patologia , Otite Média/cirurgia , Otite Média com Derrame/diagnóstico , Otite Média com Derrame/microbiologia , Otite Média com Derrame/cirurgia , Reação em Cadeia da Polimerase em Tempo Real/métodos
16.
Technol Health Care ; 26(S1): 389-397, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29689762

RESUMO

BACKGROUND: Diabetic macular edema (DME) is one of the severe complication of diabetic retinopathy causing severe vision loss and leads to blindness in severe cases if left untreated. OBJECTIVE: To grade the severity of DME in retinal images. METHODS: Firstly, the macular is localized using its anatomical features and the information of the macula location with respect to the optic disc. Secondly, a novel method for the exudates detection is proposed. The possible exudate regions are segmented using vector quantization technique and formulated using a set of feature vectors. A semi-supervised learning with graph based classifier is employed to identify the true exudates. Thirdly, the disease severity is graded into different stages based on the location of exudates and the macula coordinates. RESULTS: The results are obtained with the mean value of 0.975 and 0.942 for accuracy and F1-scrore, respectively. CONCLUSION: The present work contributes to macula localization, exudate candidate identification with vector quantization and exudate candidate classification with semi-supervised learning. The proposed method and the state-of-the-art approaches are compared in terms of performance, and experimental results show the proposed system overcomes the challenge of the DME grading and demonstrate a promising effectiveness.


Assuntos
Retinopatia Diabética/diagnóstico , Interpretação de Imagem Assistida por Computador/métodos , Edema Macular/diagnóstico , Aprendizado de Máquina Supervisionado , Retinopatia Diabética/diagnóstico por imagem , Exsudatos e Transudatos/metabolismo , Humanos , Edema Macular/diagnóstico por imagem , Sensibilidade e Especificidade , Índice de Gravidade de Doença
17.
Lasers Med Sci ; 33(6): 1371-1379, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29627887

RESUMO

To compare the visualization of the lesions of diabetic retinopathy (DR) using multicolour scanning laser imaging (MSLI) and conventional colour fundus photography (CFP). The paired images of diabetic patients who underwent same-day MSLI and CFP examinations were reviewed. Combined multicolour (MC) images were acquired simultaneously using three laser wavelengths: blue reflectance (BR, λ = 488 nm), green reflectance (GR, λ = 518 nm) and infrared reflectance (IR, λ = 820 nm). The number of positive DR lesions was calculated using fundus fluorescein angiography as the reference standard. The visibility of the microaneurysms (Mas) was graded using a scale, and the number of Mas for each method was counted by two masked readers. Eighty eyes of 42 diabetic patients were included. The average grading score for Mas visualization was significantly higher with MC (1.50 ± 0.71) and GR (1.55 ± 0.69) than with CFP (0.95 ± 0.81). The average number of Mas was also significantly higher with MC (11.41 ± 14.02) and GR (11.93 ± 13.43) than with CFP (6.43 ± 9.39). The number of positive Mas, diabetic macular edema (DME) and epiretinal membranes (ERM) were significantly higher with MC than CFP (P < 0.05), while the numbers of cotton wool spots, haemorrhages, hard exudates, venous beading and abnormal new vessels were not significantly different (P > 0.05). Mas and ERM were most effectively detected on GR images, and an elevated greenish shift was clearly visualized in patients with DME on the MC images. MSLI can effectively visualize Mas and other pathological lesions of DR compared with CFP. MSLI with superior resolution may be a useful complement for DME and ERM detection.


Assuntos
Retinopatia Diabética/diagnóstico , Imagem Tridimensional , Lasers , Cor , Exsudatos e Transudatos/metabolismo , Feminino , Angiofluoresceinografia , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Fotografação , Reprodutibilidade dos Testes
18.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 43(3): 268-273, 2018 Mar 28.
Artigo em Chinês | MEDLINE | ID: mdl-29701188

RESUMO

OBJECTIVE: To evaluate the clinical value of surfactant protein-A (SP-A) in exudate pleural effusion (EPE).
 Methods: This clinical study was prospective, observational and cross-sectional. Two hundred and fifteen patients with pleural effusion were divided into the transudate pleural effusions (TPE) group and the EPE group. TPE patients served as the control group. The concentrations of pleural effusions SP-A (SP-Apl) and serum SP-A (SP-Ase) were measured by ELISA, and receiver operator characteristic (ROC) curve and multivarate Cox analysis of SP-A was analysed for its clinical value.
 Results: SP-Apl concentrations in the EPE group were significantly higher than that in the TPE group [(189.8±43.4) ng/mL vs (22.3±5.1) ng/mL, P<0.01]; SP-Ase concentrations in the EPE group were higher than that in the TPE group [(78.9±11.3) ng/mL vs (25.8±12.4) ng/mL, P<0.05]; SP-Apl concentrations were significantly higher than the concentrations of SP-Ase in the EPE group (P<0.01). In EPE group, SP-Apl and SP-Ase concentration in the patients with primary lung adenocarcinomas were the highest. The cut off value of SP-Apl concentrations was more than 484.5 ng/mL, yielding a 85.4% sensitivity and 95.2% specificity for diagnosing primary lung adenocarcinomas, with an area under the curve (AUC) of 0.943 (95% CI 0.852 to 0.934, P<0.01); when SP-Ase concentration was more than 84.2 ng/mL, it yielded a 76.4% sensitivity and 94.3% specificity for diagnosing primary lung adenocarcinomas, with an AUC of 0.910 (95% CI 0.921 to 0.953, P<0.01).
 Conclusion: While SP-Apl concentration is more than 484.5 ng/mL and/or SP-Ase concentration is more than 84.2 ng/mL, it may be helpful for the diagnosis of primary lung adenocarcinomas with the usage of pleural effusion.


Assuntos
Exsudatos e Transudatos/metabolismo , Derrame Pleural/metabolismo , Proteína A Associada a Surfactante Pulmonar/análise , Adenocarcinoma/metabolismo , Biomarcadores , Estudos Transversais , Diagnóstico Diferencial , Humanos , Neoplasias Pulmonares/metabolismo , Modelos de Riscos Proporcionais , Estudos Prospectivos , Proteína A Associada a Surfactante Pulmonar/sangue , Curva ROC , Sensibilidade e Especificidade , Tensoativos
19.
Niger J Clin Pract ; 21(1): 59-62, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29411725

RESUMO

INTRODUCTION: Pleural effusion is a common clinical problem with management difficulties. The aim of this study is to evaluate vascular endothelial growth factor (VEGF) in differential diagnosis of pleural effusions and the presence of correlation between radiological features and biochemical properties. MATERIALS AND METHODS: The study included patients with pleural effusion. VEGF levels in the pleural fluid were measured by enzyme-linked immunosorbent assay. RESULTS: A total of 97 patients who had exudative pleural effusion related to lung cancer (n = 17), nonpulmonary malignancies (n = 25), mesothelioma (n = 9), pneumonia (n = 14), tuberculosis (n = 8), miscellaneous causes (n = 6), and transudative effusion (n = 18) were included. Pleural VEGF levels were higher in exudative effusions with respect to transudative effusions (P < 0.001) and in effusions related to malignancies versus benign causes (P < 0.001). Pleural VEGF was inversely correlated with pleural fluid glucose and pH levels and had positive correlation with lactate dehydrogenase, protein levels (P < 0.001), hematocrit, and eosinophil values in the pleura (P < 0.05). Pleural VEGF levels were also higher in patients with massive effusions and pleural thickening (both P < 0.001). CONCLUSIONS: The overlap of pleural VEGF levels between the groups may limit the value of VEGF in discriminating between malignant versus benign and exudative versus transudative effusions; however, it may be a useful adjunct to various methods. The VEGF levels in pleural fluid seem to be related to the degree of inflammation and pleural invasion.


Assuntos
Neoplasias Pulmonares/complicações , Mesotelioma/complicações , Derrame Pleural Maligno/diagnóstico por imagem , Derrame Pleural Maligno/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Adolescente , Adulto , Idoso , Diagnóstico Diferencial , Ensaio de Imunoadsorção Enzimática , Eosinófilos , Exsudatos e Transudatos/metabolismo , Feminino , Glucose/metabolismo , Hematócrito , Humanos , Concentração de Íons de Hidrogênio , L-Lactato Desidrogenase/metabolismo , Masculino , Pessoa de Meia-Idade , Derrame Pleural Maligno/etiologia , Derrame Pleural Maligno/patologia , Pneumonia/complicações , Proteínas/metabolismo , Tuberculose Pulmonar/complicações , Adulto Jovem
20.
Sci Rep ; 8(1): 1217, 2018 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-29352206

RESUMO

This study assesses the efficacy and exposure-response relationship of omega-3-carboxylic acids (OM-3 CA) in models of crystal-based inflammation. Human THP-1 macrophages and primary peripheral blood mononuclear cells exposed to multiple inflammatory crystal types were used to determine the anti-inflammatory potential of omega-3 (OM-3) fatty acids in vitro. Anti-inflammatory effects of OM-3 CA in vivo were tested in rat monosodium urate (MSU) crystal air pouch and rat knee intra-articular MSU injection models. Acute treatment with the OM-3 fatty acid docosahexaenoic acid suppressed MSU-, cholesterol crystal-, and calcium pyrophosphate crystal-mediated interleukin-1ß (IL-1ß) production in vitro. In vivo, OM-3 CA dose-dependently reduced crystal-mediated cell migration, exudate volume, and levels of IL-1ß and prostaglandin E2. Following intra-articular injection of MSU, treatment with OM-3-CA (1 mL/kg) and indomethacin (1 mg/kg) resulted in similar mean reductions in pain (23% and 41%, respectively) and swelling (58% and 50%, respectively), compared with controls. Additionally, in complex formulations of OM-3 fatty acids, high levels of palmitic acid could reduce the in vivo effect on crystal-mediated IL-1ß elevation. OM-3 CA has a broadly efficacious anti-inflammatory effect with a strong exposure-response relationship that could be beneficial in prevention and treatment of crystal arthritis, with potential applications in other IL-1ß-mediated diseases.


Assuntos
Anti-Inflamatórios/farmacologia , Artrite Gotosa/etiologia , Artrite Gotosa/metabolismo , Ácidos Carboxílicos/farmacologia , Ácidos Graxos Ômega-3 , Animais , Anti-Inflamatórios/química , Artrite Gotosa/tratamento farmacológico , Artrite Gotosa/patologia , Ácidos Carboxílicos/química , Movimento Celular/efeitos dos fármacos , Citocinas/metabolismo , Dinoprostona/biossíntese , Modelos Animais de Doenças , Progressão da Doença , Exsudatos e Transudatos/metabolismo , Ácidos Graxos Ômega-3/química , Ácidos Graxos Ômega-3/metabolismo , Humanos , Mediadores da Inflamação/metabolismo , Interleucina-1beta/metabolismo , Leucócitos/efeitos dos fármacos , Leucócitos/metabolismo , Leucócitos/patologia , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Macrófagos/patologia , Ácido Palmítico/farmacologia , Ratos
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