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1.
Medicina (B Aires) ; 85(1): 86-95, 2025.
Artigo em Espanhol | MEDLINE | ID: mdl-39900052

RESUMO

INTRODUCTION: The main objective of this study was to evaluate the association between the baseline level of Histoplasma capsulatum urinary antigen (AgU) and the severity of histoplasmosis in the context of HIV, as well as its utility for treatment monitoring. Secondary objectives included determining the appropriate cutoff point for AgU detection for the diagnosis of proven histoplasmosis. MATERIALS AND METHODS: The study was an analytical, retrospective cohort study in adults diagnosed with HIV, with at least one determination of AgU using ELISA. Sociodemographic, clinical, and laboratory variables were collected. Statistical analysis was performed using R-project® software. RESULTS: A total of 452 individuals with AgU were included from March 2018 to July 2022, with 42 (9.3%) positive results (25 proven histoplasmosis and 17 probable cases). An statistically significant correlation was found between the baseline concentration of AgU and positive cultures. However, the utility of AgU as a followup tool could not be evaluated. The optimal cutoff point for detecting proven histoplasmosis was an AgU value ≥2.2 ng/mL (specificity: 96.3% and sensitivity: 100%). DISCUSSION: Further studies are needed to evaluate the utility of AgU as a tool for monitoring antifungal treatment. A value of AgU ≥2.2 ng/mL could potentially correspond to a diagnosis of proven histoplasmosis.


Introducción: El objetivo principal del estudio fue evaluar la asociación entre el valor basal del antígeno urinario de Histoplasma capsulatum (AgU) y la gravedad del cuadro de histoplasmosis en contexto de HIV, así como su utilidad para seguimiento de tratamiento antifúngico. En los objetivos secundarios se incluyódeterminar el punto de corte adecuado en la detección del AgU para el diagnóstico de histoplasmosis probada. Materiales y métodos: Estudio de cohorte analítico, retrospectivo en adultos con diagnóstico de HIV con una determinación del AgU, mediante ELISA. Se recolectaron variables sociodemográficas, clínicas y de laboratorio. Se realizóel análisis estadístico mediante software Rproject®. Resultados: Se incluyeron 452 individuos con determinación de AgU desde marzo 2018 a julio 2022, con 42 (9.3%) resultados positivos (25 histoplasmosis probadas y 17 probables). Se hallóuna correlación estadísticamente significativa entre la concentración basal del AgU y los cultivos positivos. No pudo evaluarse la utilidad del AgU como herramienta de seguimiento. El mejor punto de corte para detectar histoplasmosis probada fue un valor de AgU ≥2.2 ng/mL (especificidad: 96.3% y sensibilidad: 100%). Discusión: Se requieren mayores estudios para evaluar la utilidad del AgU como herramienta para seguimiento del tratamiento antifúngico. Un valor de AgU ≥2.2 ng/mL, podría equivaler a un diagnóstico de histoplasmosis probada.


Assuntos
Antígenos de Fungos , Histoplasma , Histoplasmose , Humanos , Histoplasmose/urina , Histoplasmose/diagnóstico , Estudos Retrospectivos , Masculino , Feminino , Adulto , Antígenos de Fungos/urina , Pessoa de Meia-Idade , Prognóstico , Infecções por HIV/complicações , Infecções por HIV/urina , Ensaio de Imunoadsorção Enzimática , Infecções Oportunistas Relacionadas com a AIDS/urina , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Sensibilidade e Especificidade
2.
Curr Opin Nephrol Hypertens ; 34(2): 138-142, 2025 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-39878021

RESUMO

PURPOSE OF REVIEW: This review highlights the latest findings regarding hypocitraturia in autosomal dominant polycystic kidney disease (ADPKD), from both experimental and clinical studies, exploring the underlying pathophysiology and potential therapeutic approach. RECENT FINDINGS: Experimental studies have shown that the lodging of microcrystals in the tubules can trigger cyst formation and growth in polycystic kidney disease (PKD). ADPKD patients are prone to developing hypocitraturia in early stages, which could predispose to calcium microcrystal formation. Low urinary citrate excretion has been associated with a more rapid decline in eGFR and poorer renal survival in ADPKD patients. Animal studies employing citrate supplementation have shown promising effects on preserving the decline in estimated glomerular filtration rate (eGFR) and cyst growth. SUMMARY: Current knowledge suggests that urinary citrate could be incorporated into existing prognostic markers for disease progression and potential adjuvant therapy in ADPKD, but further clinical studies to support such hypothesis must be undertaken.


Assuntos
Biomarcadores , Ácido Cítrico , Rim Policístico Autossômico Dominante , Rim Policístico Autossômico Dominante/tratamento farmacológico , Rim Policístico Autossômico Dominante/fisiopatologia , Rim Policístico Autossômico Dominante/diagnóstico , Humanos , Animais , Ácido Cítrico/urina , Ácido Cítrico/uso terapêutico , Biomarcadores/urina , Taxa de Filtração Glomerular/efeitos dos fármacos , Progressão da Doença , Rim/efeitos dos fármacos , Rim/metabolismo , Rim/fisiopatologia , Rim/patologia
3.
Sao Paulo Med J ; 143(1): e2024103, 2025.
Artigo em Inglês | MEDLINE | ID: mdl-39879508

RESUMO

BACKGROUND: Insulin resistance often occurs in patients with chronic kidney disease (CKD) owing to mineral and bone metabolism disorders. Fibroblast growth factor (FGF)-23 and soluble klotho (s-KL) play crucial roles in linking CKD with mineral and bone metabolism. OBJECTIVE: This study aimed to examine the relationship between insulin resistance and FGF-23 and s-KL in patients with non-diabetic pre-dialysis patients with CKD. DESIGN AND SETTING: This research was conducted in the Ankara Bilkent City Hospital Nephrology Clinic. Ankara,Turkey. METHODS: This study included 133 male and 150 female patients with pre-dialysis CKD. The patients were compared with 80 healthy individuals. FGF-23 and s-KL levels were determined using enzyme-linked immunosorbent assay kits. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to determine insulin resistance. RESULTS: Creatinine, urine protein/creatinine ratio (UPCR), log10 FGF-23, log 10 s-KL, and HOMA-IR were notably higher, while glomerular filtration rate was notably lower, in patients than in healthy individuals. Stage 5 CKD, log10 FGF-23, creatinine, and UPCR were significantly higher in patients with HOMA-IR > 3.06 compared to those with HOMA-IR ≤ 3.06. No difference was observed in s-KL levels between the two groups. Univariate and multivariate logistic regression analyses revealed an increase in HOMA-IR and log10 FGF-23 values. CONCLUSIONS: Insulin resistance, serum FGF-23, and s-KL levels increased in patients compared with healthy individuals. Higher creatinine, proteinuria, and FGF-23 levels were associated with greater insulin resistance. The study highlighted a significant relationship between insulin resistance and FGF-23.


Assuntos
Fator de Crescimento de Fibroblastos 23 , Fatores de Crescimento de Fibroblastos , Taxa de Filtração Glomerular , Resistência à Insulina , Proteínas Klotho , Insuficiência Renal Crônica , Humanos , Fator de Crescimento de Fibroblastos 23/sangue , Resistência à Insulina/fisiologia , Masculino , Fatores de Crescimento de Fibroblastos/sangue , Feminino , Estudos Transversais , Pessoa de Meia-Idade , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/fisiopatologia , Adulto , Estudos de Casos e Controles , Idoso , Taxa de Filtração Glomerular/fisiologia , Proteínas Klotho/sangue , Creatinina/sangue , Creatinina/urina , Glucuronidase/sangue , Biomarcadores/sangue , Ensaio de Imunoadsorção Enzimática , Valores de Referência
4.
Adv Clin Chem ; 124: 197-211, 2025.
Artigo em Inglês | MEDLINE | ID: mdl-39818437

RESUMO

Preeclampsia (PE), a pregnancy-related syndrome, has motivated extensive research to understand its pathophysiology and develop early diagnostic methods. 'Omic' technologies, focusing on genes, mRNA, proteins, and metabolites, have revolutionized biological system studies. Urine emerges as an ideal non-invasive specimen for omics analysis, offering accessibility, easy collection, and stability, making it valuable for identifying biomarkers. A comprehensive exploration of urinary omics in preeclampsia is discussed in this review. Proteomic studies identified biomarkers such as SERPINA-1 and uromodulin, showing promise for early diagnosis and severity assessment. Metabolomic analyses revealed alterations in metabolites like glycine and hippurate, providing insights into molecular mechanisms underlying PE. Challenges include methodological inconsistencies and the need for standardized protocols. Urinary omics technologies have significantly advanced our understanding of PE pathophysiology and hold promise for improved diagnosis and management. Biomarkers identified through these approaches offer potential for early detection, severity stratification, and elucidation of underlying mechanisms.


Assuntos
Biomarcadores , Pré-Eclâmpsia , Humanos , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/urina , Pré-Eclâmpsia/metabolismo , Feminino , Biomarcadores/urina , Gravidez , Proteômica/métodos , Metabolômica/métodos
5.
Sci Prog ; 108(1): 368504241304205, 2025.
Artigo em Inglês | MEDLINE | ID: mdl-39763189

RESUMO

OBJECTIVE: The expansion of human activities in northern Colombia has increased human-snake encounters, particularly with venomous Porthidium lansbergii lansbergii. Given the limited knowledge of systemic envenomation effects and previous studies focusing only on early murine symptoms, this investigation aimed to describe the time-course physiopathology of P. lansbergii lansbergii envenomation following intramuscular injection in vivo. METHODS: Venom was inoculated in the gastrocnemius muscles of Swiss Webster mice, and blood, urine, and tissue samples were taken at different times to evaluate lethality and biochemical markers of renal function and oxidative stress. RESULTS: This study reports the first intramuscular LD50 for P. lansbergii lansbergii venom at 24.83 mg/Kg. Administering 80% of this LD50 induced early signs of renal injury, evidenced by urinary biomarkers over 24 h. The antioxidant activity was found at low levels in kidney tissue throughout the evaluated time post-envenomation. Malondialdehyde activity increased at the earliest point, while proinflammatory activity increased later. Urine metabolomics revealed elevated taurine and allantoin in the envenomed groups. DISCUSSION: Compensatory mechanisms in response to oxidative stress and tissue damage induced by the venom were evident in the envenomed mice over the evaluated time. However, histological analysis revealed evidence of pro-inflammatory processes occurring only at early times. Metabolomic analyses of urine samples identified taurine as a potential early biomarker of elevated oxidative stress and protein and creatinine levels. CONCLUSIONS: P. lansbergii lansbergii venom induces alterations in murine renal tissue, affecting urinary biomarkers of kidney function within hours post-envenomation. Delayed proinflammatory effects may suggest an antioxidant imbalance in the envenomed mice, with unknown long-term effects. Further research on the role of oxidative stress and inflammation in renal structure and function following envenomation is necessary, emphasizing the need for prompt clinical management.


Assuntos
Estresse Oxidativo , Mordeduras de Serpentes , Animais , Camundongos , Mordeduras de Serpentes/fisiopatologia , Estresse Oxidativo/efeitos dos fármacos , Viperidae , Rim/efeitos dos fármacos , Rim/patologia , Rim/metabolismo , Masculino , Biomarcadores/urina , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/metabolismo , Músculo Esquelético/patologia , Dose Letal Mediana
6.
Med Intensiva (Engl Ed) ; 49(1): 1-7, 2025 01.
Artigo em Inglês | MEDLINE | ID: mdl-38403531

RESUMO

OBJECTIVE: To evaluate the diagnostic performance of FENa (Fractional excretion of sodium), FEK (fractional excretion of potassium) and uSID (urinary strong ion difference) in predicting pAKI in sepsis and septic shock. DESIGN: Retrospective cohort study. SETTING: Two intensive care units in Argentina. PATIENTS: Adult patients with a confirmed diagnosis of sepsis or septic shock and AKI, and had a urinary biochemistry within 24h of the AKI diagnosis. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: We evaluated the diagnostic accuracy of FENa, FEK and uSID through a ROC (Receiver Operating Characteristic) curve analysis. RESULTS: 80 patients were included. 40 patients presented pAKI. pAKI group had higher APACHE, SOFA score, and mortality rate. In the ROC curve analysis, uSID had no diagnostic utility (AUC=0.52, p=0.69). FENa presented moderate accuracy showing an AUC of 0.71 (95% CI 0.60-0.83; p=0.001), while FEK presented low accuracy with an AUC of 0.69 (95% CI 0.57-0.80; p=0.04). The optimal Youden point for identifying pAKI was at a FENa higher than 0.51 % with a specificity of 72.5% and a sensitivity of 65.0%. In the case of FEK, a value higher than 21.9 % presented the best relation, with a specificity of 67.5% and a sensitivity of 65.0%. CONCLUSIONS: urine biochemistry interpretation in septic patients must be revised. FENa and FEK are related to the severity of AKI and could be helpful complementary tools for diagnosing pAKI.


Assuntos
Injúria Renal Aguda , Íons , Potássio , Sepse , Sódio , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Injúria Renal Aguda/complicações , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/urina , Argentina , Potássio/urina , Estudos Retrospectivos , Curva ROC , Sensibilidade e Especificidade , Sepse/urina , Sepse/complicações , Choque Séptico/urina , Sódio/urina , Íons/urina
7.
PLoS One ; 19(12): e0315949, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39693372

RESUMO

Two starch to protein ratios (high starch [HS], 25% starch and 36% protein; high protein [HP], 15% starch and 53% protein on DM basis) and two moisture contents (5%, dry kibbles; 80%, wet food) were compared in a 2 x 2 factorial arrangement totaling 4 diets. Each diet was evaluated in 9 cats, with 8 d of total collection of urine and feces. Results were subjected to an analysis of variance of the effects of starch to protein ratio, moisture content and their interactions (P<0.05). Urine density was lower and volume was higher in cats fed wet foods (P<0.01). Calcium (Ca) urine concentration was higher for dry and HP diets (P<0.05). The oxalate urine concentration was 60% higher for cats fed both HS formulations (dry and wet; P<0.05). The relative supersaturation (RSS) of urine for calcium oxalate was higher for dry foods and HS formulations (P<0.01), and for struvite, it was lower for both wet foods, and among the dry diets, it was lower for the HS than for the HP formulation (P<0.01). Foods with a high protein-to-starch ratio reduced urine oxalate and RSS for calcium oxalate in wet and dry diets, and wet foods reduced RSS for calcium oxalate and struvite.


Assuntos
Proteínas Alimentares , Amido , Água , Animais , Gatos , Amido/metabolismo , Água/química , Proteínas Alimentares/análise , Proteínas Alimentares/urina , Ração Animal/análise , Cálcio/urina , Cálcio/análise , Urina/química , Masculino , Oxalato de Cálcio/urina , Fosfatos/urina , Fosfatos/análise , Compostos de Magnésio/urina , Dieta/veterinária , Estruvita , Feminino
8.
Sensors (Basel) ; 24(23)2024 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-39686404

RESUMO

This paper offers a systematic review of advancements in electronic nose technologies for early cancer detection with a particular focus on the detection and analysis of volatile organic compounds present in biomarkers such as breath, urine, saliva, and blood. Our objective is to comprehensively explore how these biomarkers can serve as early indicators of various cancers, enhancing diagnostic precision and reducing invasiveness. A total of 120 studies published between 2018 and 2023 were examined through systematic mapping and literature review methodologies, employing the PICOS (Population, Intervention, Comparison, Outcome, and Study design) methodology to guide the analysis. Of these studies, 65.83% were ranked in Q1 journals, illustrating the scientific rigor of the included research. Our review synthesizes both technical and clinical perspectives, evaluating sensor-based devices such as gas chromatography-mass spectrometry and selected ion flow tube-mass spectrometry with reported incidences of 30 and 8 studies, respectively. Key analytical techniques including Support Vector Machine, Principal Component Analysis, and Artificial Neural Networks were identified as the most prevalent, appearing in 22, 24, and 13 studies, respectively. While substantial improvements in detection accuracy and sensitivity are noted, significant challenges persist in sensor optimization, data integration, and adaptation into clinical settings. This comprehensive analysis bridges existing research gaps and lays a foundation for the development of non-invasive diagnostic devices. By refining detection technologies and advancing clinical applications, this work has the potential to transform cancer diagnostics, offering higher precision and reduced reliance on invasive procedures. Our aim is to provide a robust knowledge base for researchers at all experience levels, presenting insights on sensor capabilities, metrics, analytical methodologies, and the transformative impact of emerging electronic nose technologies in clinical practice.


Assuntos
Nariz Eletrônico , Neoplasias , Compostos Orgânicos Voláteis , Humanos , Neoplasias/diagnóstico , Compostos Orgânicos Voláteis/análise , Compostos Orgânicos Voláteis/urina , Técnicas Biossensoriais/métodos , Detecção Precoce de Câncer/métodos , Cromatografia Gasosa-Espectrometria de Massas/métodos , Biomarcadores Tumorais/urina , Testes Respiratórios/métodos , Redes Neurais de Computação
9.
Med Mycol ; 63(1)2024 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-39701808

RESUMO

Histoplasmosis poses a significant risk to HIV patients, particularly in regions with limited access to antiretroviral therapy. Antigen detection assays are crucial in these settings for timely diagnosis and treatment, which can reduce mortality. While commercial antigen detection kits have performed well in diagnosing histoplasmosis, their effectiveness in monitoring treatment remains unclear. This study aimed to evaluate the correlation between urine antigen levels and clinical response using the clarus Histoplasma Galactomannan (GM) enzyme immunoassays (EIA) kit. The study followed 27 HIV patients diagnosed with histoplasmosis over 24 weeks, measuring urinary Histoplasma antigen (Ag) levels and clinical outcomes. Patients received amphotericin B as induction therapy, followed by maintenance with itraconazole. Results showed a significant decrease in Ag levels over time, with clinical scores improving in correlation with the decline in Ag levels. Four patients exhibited atypical Ag patterns due to immune reconstitution inflammatory syndrome or issues with itraconazole bioavailability. Despite these challenges, all patients showed improvement by week 24. The findings suggest that the clarus Histoplasma GM EIA kit could be a valuable tool for monitoring and evaluating the response to antifungal therapy in histoplasmosis patients.


This study explored the use of the clarus Histoplasma Galactomannan EIA kit for monitoring histoplasmosis in HIV patients. Follow-up showed clinical improvement in patients receiving antifungal treatment, with a correlation between decreasing urine antigen concentrations and better outcomes. The findings suggest that the clarus Histoplasma GM EIA kit could be useful for treatment monitoring.


Assuntos
Antifúngicos , Antígenos de Fungos , Infecções por HIV , Histoplasma , Histoplasmose , Técnicas Imunoenzimáticas , Itraconazol , Humanos , Histoplasmose/tratamento farmacológico , Histoplasmose/diagnóstico , Histoplasmose/urina , Antígenos de Fungos/urina , Antígenos de Fungos/sangue , Histoplasma/imunologia , Masculino , Técnicas Imunoenzimáticas/métodos , Adulto , Feminino , Itraconazol/uso terapêutico , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Argentina , Antifúngicos/uso terapêutico , Pessoa de Meia-Idade , Anfotericina B/uso terapêutico , Galactose/análogos & derivados , Seguimentos , Mananas/sangue , Mananas/urina , Resultado do Tratamento
10.
Open Vet J ; 14(11): 2901-2910, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39737037

RESUMO

Background: Urinary retention in obstructed male cats leads to changes in blood and urine compounds, which, combined with the time of obstruction, are linked to the worsening of the animal's clinical status. Aim: This study aimed to describe the primary laboratory changes in male cats with urethral obstruction (UO). Methods: Medical records of 386 male cats diagnosed with UO and treated at the Veterinary Teaching Hospital of the Faculty of Veterinary Medicine and Zootechnics (FMVZ), UNESP-Botucatu, between 2010 and 2020 were reviewed. Data on sex, age, breed, body weight, and reproductive status were evaluated. Results: Over the years, complete blood count, renal and hepatic biochemistry, blood gas analysis, electrolytes, urinalysis, and urine culture were performed upon request. Anaemia was not representative in obstructed cats. Thrombocytopenia was identified in 65.5% (169/258) of patients, and neutrophilic leukocytosis was identified in 52.4% (170/326) of patients. High urea and creatinine values were detected in 82.9% (273/329) and 77.1% (256/331) of the patients, respectively. Acidemia, increased PO2, metabolic acidosis, hypochloremia, hyperkalemia, hypernatremia, and hypocalcemia were observed in 37.6% (90/239), 51.5% (120/233), 69.3% (160/231), 50.2% (115/229), 58.5% (138/239), 40.2% (93/231), and 85.7% (84/98) of the cats, respectively. Urinalysis revealed an acidic pH, isosthenuria, a low proportion of proteins, and a high presence of occult blood and erythrocytes per field (> 1,000). Finally, 19.49% had positive cultures. Escherichia coli and Staphylococcus spp. are commonly isolated. Conclusion: This study provides a description of laboratory changes and those most prevalent in the population under study. UO may result mainly in isolated or combined laboratory changes such as azotemia, acidemia, metabolic acidosis, hyperkalemia, hypocalcemia, acidic pH, and occult blood in the urine. Additional laboratory changes may be present; however, they must be deeply investigated as comorbidities might be associated with them. Therefore, the description of laboratory changes in large populations, such as in male cats with UO, provides a reference for veterinarians regarding the hematological and urinary changes expected in obstructed male cats and instigates the search for further studies in the field.


Assuntos
Doenças do Gato , Obstrução Uretral , Urinálise , Animais , Masculino , Gatos , Obstrução Uretral/veterinária , Doenças do Gato/urina , Estudos Retrospectivos , Brasil/epidemiologia , Urinálise/veterinária
11.
Einstein (Sao Paulo) ; 22: eRW0611, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39630752

RESUMO

OBJECTIVE: MicroRNAs are small non-coding RNAs that are abundantly expressed in various biofluids, making them promising candidates for cancer biomarkers. This review aims to present current evidence on the use of miRNA as biomarkers for the non-invasive diagnosis of bladder cancer. METHODS: A systematic literature review, using the Medline database, was performed in July 2022 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All articles were required to satisfy the risk-of-bias assessment using the Joanna Briggs Institute Critical Assessment Tools. Data were collected based on miRNA expression, sample type, expression profiles, and accuracy. RESULTS: The initial search retrieved 437 studies, 21 of which were included in the final analysis. Most studies on miRNA expression in human fluids used urine samples for analysis. CONCLUSION: There is a trend to cluster the expressed miRNAs to build diagnostic panels or use them in association with other diagnostic methods to achieve reasonable accuracy.Prospero database registration: (https://www.crd.york.ac.uk/prospero/) under ID CRD42022351686.


Assuntos
Biomarcadores Tumorais , MicroRNAs , Neoplasias da Bexiga Urinária , Humanos , Neoplasias da Bexiga Urinária/genética , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/urina , MicroRNAs/análise , MicroRNAs/genética , MicroRNAs/urina , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/urina
12.
Brain Behav ; 14(11): e70156, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39552106

RESUMO

INTRODUCTION: The ability to objectively measure chronic stress has important implications for research, prevention, and treatment. Cortisol is currently the most used biological marker in the investigation of stress and can be measured via blood, saliva, and urine; however, these methods have disadvantages. The measurement of cortisol in hair is a more recently developed method that quantifies the cumulative production of cortisol over longer periods of time. Given the potential benefits of hair as a chronic stress biometric, research with this novel method is burgeoning, yet rarely involves transgender ("trans") populations, despite high levels of reported stress among trans people due to experiences of stigma and discrimination. Since hair is a key part of gender presentation, trans people might be less likely than cisgender people to donate hair for research. To explore the feasibility and acceptability of hair collection for use as a stress biometric with trans women, we nested a study into an ongoing clinical trial in São Paulo, Brazil, "Manas por Manas" (Sisters for Sisters). Here, we describe the hair biometric substudy protocol, as well as the feasibility and acceptability of collecting hair in the study cohort. METHODS: We randomly selected a subsample (n = 180) from the Manas por Manas cohort (n = 392), all of whom are trans women, age 18 or older. We messaged participants via phone, WhatsApp, or social media for at least three attempted contacts. Study visits included four components: (1) video introduction, including a demonstration of hair sampling; (2) informed consent; (3) a brief survey with the validated Short Stress Overload Scale (translated to Portuguese) and questions on hair care that could moderate stress hormone results; and (4) hair sample collection. Hair samples were collected and stored using validated protocols. Participants were reimbursed for travel costs. RESULTS: Between April and December 2022, we messaged with 143 individuals out of the 180 sampled (79%) and invited them to participate in the study. Of those invited to participate, we scheduled study visits with 102 people (71.3% of those invited to participate), of whom 100 attended their study visits and completed all activities. Two people did not attend their study visits and stopped communication. Of those who were invited to participate and declined a study visit, four individuals declined due to the hair sample collection procedures (2.8% of those invited to participate). Other reasons for declining to participate included having moved (n = 7), lack of time (n = 11), not interested in research participation (n = 8), or unknown/stopped responding to messages (n = 11). Most participants reported that they chemically treated their hair to bleach, color, or straighten it, which could impact laboratory assays. CONCLUSION: We found hair sampling for stress measurement to be feasible and acceptable to our participants. We successfully completed all study activities for our desired sample size, and most recruited individuals volunteered to participate. Reasons provided for declining study participation reflected general barriers to research participation, with only four people declining due to hair sample collection procedures.


Assuntos
Estudos de Viabilidade , Cabelo , Hidrocortisona , Estresse Psicológico , Pessoas Transgênero , Humanos , Feminino , Cabelo/química , Adulto , Brasil , Estresse Psicológico/diagnóstico , Hidrocortisona/análise , Hidrocortisona/metabolismo , Hidrocortisona/urina , Masculino , Adulto Jovem , Pessoa de Meia-Idade , Adolescente
13.
BMC Nephrol ; 25(1): 418, 2024 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-39574066

RESUMO

BACKGROUND: The 24-h urine protein (24-hUP) excretion is the gold standard for evaluating proteinuria. This study aimed to evaluate the diagnostic efficacy of protein/creatinine ratio (PCR) for estimating 24-hUP at various levels of renal function and proteinuria levels. METHODS: A cross-sectional study was conducted between December 2021 and December 2023 in Salvador, Bahia-Brazil, as an extension of previously published data from the TUNARI study. The study included 217 samples from 152 patients with various levels of renal function and proteinuria. PCR in isolated samples and 24-hUP were determined conventionally within a 24-h timeframe. Patients were classified into three groups according to the level of renal function (Group 1 = 10 to < 30 mL/min, Group 2 = 30-60 mL/min, and Group 3 = > 60 mL/min) and level of proteinuria (< 0.3 g/day, 0.3-3.5 g/day, and > 3.5 g/day). The data were analyzed using the Spearman correlation (rs), coefficient of determination (r2), Bland-Altman plots and receiver operating characteristic (ROC) curve. Likelihood ratios, positive (LR +), and negative (LR-) were derived from the sensitivity and specificity of PCR. RESULTS: Mean age was 41.5 ± 15.7 years, 61.8% were women, 36.8% Black and 52% Mixed-race. Glomerulopathies constituted 80.3%; 46.1% with lupus nephritis. Of the total urine samples, we observed a high correlation between PCR in the total sample of 24-hUP sample (rs = 0.86, p < 0.001) across different levels of renal function. However, agreement between PCR and 24-hUP was reduced at higher levels of proteinuria. The ROC analysis showed an AUC of 0.95 (95% CI = 0.92, 0.98), sensitivity of 91% and specificity of 86.5% (LR + 6.7; LR- 0.1), with an optimal cut-off of 0.77. These results were similar across renal function levels. Proteinuria ≤ 0.3 g/day showed a high sensitivity of 83.3% and specificity of 90%, with an area under (AUC) of 0.85 (95% CI = 0.71; 0.94). In the 24-hUP range > 0.3-3.5 g/day, the sensitivity was 64.1%, the specificity was 84.6%, and the AUC was 0.76 (95% CI = 0.67; 0.84), PCR detected all cases > 3.5 g/day. CONCLUSIONS: PCR is a suitable measure to be used as an indicator of 24-hUP at different levels of renal function, but may have limitations at higher levels of proteinuria. Analysis of PCR by proteinuria level found that agreement as well as sensitivity decreases at higher levels, but it maintains good specificity and is able to identify nephrotic range proteinuria.


Assuntos
Creatinina , Proteinúria , Humanos , Proteinúria/urina , Proteinúria/diagnóstico , Feminino , Masculino , Estudos Transversais , Creatinina/urina , Adulto , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade , Curva ROC , Rim/fisiopatologia , Rim/metabolismo , Taxa de Filtração Glomerular
14.
PLoS One ; 19(11): e0313545, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39561198

RESUMO

Major clusters of Guillain-Barré Syndrome (GBS) emerged during the Zika virus (ZIKV) outbreaks in the South Pacific and the Americas from 2014 to 2016. The factors contributing to GBS susceptibility in ZIKV infection remain unclear, although considerations of viral variation, patient susceptibility, environmental influences, and other potential factors have been hypothesized. Studying the role of viral genetic factors has been challenging due to the low viral load and rapid viral clearance from the blood after the onset of Zika symptoms. The prolonged excretion of ZIKV in urine by the time of GBS onset, when the virus is no longer present in the blood, provides an opportunity to unravel whether specific ZIKV mutations are related to the development of GBS in certain individuals. This study aimed to investigate the association between specific ZIKV genotypes and the development of GBS, taking advantage of a unique collection of ZIKV-positive urine samples obtained from GBS cases and controls during the 2016 ZIKV outbreak in Colombia. Utilizing Oxford-Nanopore technology, we conducted complete genome sequencing of ZIKV in biological samples from 15 patients with GBS associated with ZIKV and 17 with ZIKV infection without neurological complications. ZIKV genotypes in Colombia exhibited distribution across three clades (average bootstrap of 90.9±14.9%), with two clades dominating the landscape. A comparative analysis of ZIKV genomes from GBS and non-neurological complications, alongside 1368 previously reported genomes, revealed no significant distinctions between the two groups. Both genotypes were similarly distributed among observed clades in Colombia. Furthermore, no variations were identified in the amino acid composition of the viral genome between the two groups. Our findings suggest that GBS in ZIKV infection is perhaps associated with patient susceptibility and/or other para- or post-infectious immune-mediated mechanisms rather than with specific ZIKV genome variations.


Assuntos
Genoma Viral , Genótipo , Síndrome de Guillain-Barré , Infecção por Zika virus , Zika virus , Zika virus/genética , Zika virus/isolamento & purificação , Humanos , Colômbia/epidemiologia , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/virologia , Infecção por Zika virus/urina , Síndrome de Guillain-Barré/epidemiologia , Síndrome de Guillain-Barré/virologia , Feminino , Masculino , Genoma Viral/genética , Adulto , Surtos de Doenças , Pessoa de Meia-Idade , Filogenia , Variação Genética , Adulto Jovem
15.
Rev Bras Parasitol Vet ; 33(4): e016224, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39607277

RESUMO

Dioctophyme renale is a zoonotic nematode that parasitizes mainly right kidney of domestic and wild canines, and can affect humans, and its eggs are eliminated in urine. The duration of egg dissemination after surgical treatment is unknown. Therefore, the objective of this study was to identify, quantify, and verify the duration of the elimination of D. renale eggs in dog urine after the surgical removal of nematodes. The study involved 15 dogs in which female specimens of D. renale were detected in kidneys. Urine samples, preferably first-morning urine samples, were collected before and for the first ten days after nephrectomy. For egg quantification, 40 µL samples of urinary sediment were analyzed in triplicate. In laboratory analyses, between 900 and > 6,000 eggs/urine sample were detected in 86.7% of the dogs prior to surgery, and in 40% of the dogs on postoperative day 1. Of the 15 dogs evaluated, 14 (93.3%) eliminated D. renale eggs on each of the first ten postoperative days. Egg elimination peaked on postoperative day 1. Our results indicate that dogs can continue to be sources of D. renale infection even after the helminths have been removed from a parasitized kidney, underscoring the novelty of these findings and their importance for the One Health approach.


Assuntos
Dioctophymatoidea , Infecções por Enoplida , Nefrectomia , Animais , Cães , Dioctophymatoidea/isolamento & purificação , Feminino , Nefrectomia/veterinária , Infecções por Enoplida/veterinária , Infecções por Enoplida/diagnóstico , Infecções por Enoplida/parasitologia , Infecções por Enoplida/urina , Infecções por Enoplida/cirurgia , Contagem de Ovos de Parasitas/veterinária , Doenças do Cão/parasitologia , Doenças do Cão/urina , Doenças do Cão/cirurgia , Doenças do Cão/diagnóstico , Óvulo
16.
Chemosphere ; 366: 143468, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39369740

RESUMO

Polycyclic aromatic hydrocarbons (PAHs) are widespread environmental contaminants produced through the combustion of organic matter, with sources ranging from traffic pollution to diet. Although PAH exposure has been associated with adverse health effects, few studies have examined its impact on neurodevelopmental delay (NDD). Thus, our study aims to investigate the effect of prenatal PAH exposure on the odds of NDD. We measured 7 hydroxylated PAH metabolites in spot urine samples collected up to three times during pregnancy in the PROTECT birth cohort. NDD was identified using score cutoffs from the Ages and Stages Questionnaire, 3rd edition offered in Spanish, across five domains at 12, 24, 36, and 48 months. We utilized logistic regression and mixed effects logistic regression models to assess associations between prenatal PAH concentrations and NDD. Our results showed mostly lower odds of NDD with higher PAH exposure (p < 0.05). However, male children showed higher odds of NDD in relation to PAH exposure, particularly in the Fine Motor domain. For example, 1-hydroxypyrene was associated with 1.11 (1.01, 1.23) times odds of delay in fine motor function in male children versus 0.91 (0.82, 1.00) times odds in female children. Our preliminary sex-specific results suggest that PAH exposure may impact neurodevelopment in male children and prompt further investigation into the potential sex-specific mechanisms of PAHs on motor function.


Assuntos
Poluentes Ambientais , Hidrocarbonetos Policíclicos Aromáticos , Efeitos Tardios da Exposição Pré-Natal , Humanos , Hidrocarbonetos Policíclicos Aromáticos/toxicidade , Hidrocarbonetos Policíclicos Aromáticos/urina , Feminino , Gravidez , Masculino , Poluentes Ambientais/urina , Porto Rico , Pré-Escolar , Exposição Materna/estatística & dados numéricos , Lactente , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/induzido quimicamente , Desenvolvimento Infantil/efeitos dos fármacos , Exposição Ambiental/estatística & dados numéricos , Adulto
17.
J Nephrol ; 37(8): 2243-2253, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39367213

RESUMO

BACKGROUND: Prognostication in glomerulonephritis with severe kidney function impairment is critical for evaluating the benefit-to-risk ratio of immunosuppression. We hypothesized that the urine biomarker epidermal growth factor (EGF) could have good discrimination power to identify subjects who might ultimately recover kidney function. METHODS: We included 82 subjects with glomerulonephritis and severe kidney function impairment at admission (estimated glomerular filtration rate [eGFR] ≤ 30 mL/min/1.73m2): 58 with lupus nephritis (LN) and 24 with ANCA-associated vasculitis (AAV). Thirty-five subjects required kidney replacement therapy (KRT) at presentation. Urine epidermal growth factor was measured and corrected by urine creatinine (uEGF/Cr) and the population was analyzed by uEGF/Cr tertiles. The primary outcome was time to recovery of eGFR ≥ 30 mL/min/1.73m2 and time to recovery of kidney function with dialysis independence in those with initial KRT. RESULTS: Forty-four (54%) participants met the primary outcome of recovery of eGFR ≥ 30 mL/min/1.73m2. The 6-month recovery rates were 93%, 57%, and 0% for participants in the highest, middle, and lowest uEGF/Cr tertile, respectively. Recovery of the kidney function was faster and led to a higher post-therapy eGFR in the highest uEGF/Cr tertile. In the ROC analysis, uEGF/Cr was a predictor of recovery with an area under the curve (AUC) of 0.92 (95% CI 0.87-0.98), and a cutoff of 2.60 ng/mg had 100% sensitivity to detect patients who recovered kidney function. In the subgroup of participants with initial KRT, the cut-off of uEGF/Cr of 2.0 ng/mg had 100% sensitivity to detect participants who recovered kidney function with dialysis independence by 6 months. CONCLUSIONS: Urine EGF/Cr is a promising biomarker to aid in the prediction of recovery of kidney function in glomerulonephritis with severe kidney function impairment.


Assuntos
Biomarcadores , Fator de Crescimento Epidérmico , Taxa de Filtração Glomerular , Glomerulonefrite , Rim , Recuperação de Função Fisiológica , Humanos , Masculino , Biomarcadores/urina , Feminino , Pessoa de Meia-Idade , Adulto , Fator de Crescimento Epidérmico/urina , Glomerulonefrite/urina , Glomerulonefrite/fisiopatologia , Glomerulonefrite/complicações , Glomerulonefrite/diagnóstico , Rim/fisiopatologia , Prognóstico , Índice de Gravidade de Doença , Idoso , Nefrite Lúpica/urina , Nefrite Lúpica/fisiopatologia , Nefrite Lúpica/complicações , Nefrite Lúpica/diagnóstico , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/urina , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/complicações , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/fisiopatologia , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/diagnóstico , Creatinina/urina , Valor Preditivo dos Testes , Fatores de Tempo , Terapia de Substituição Renal
18.
Anal Methods ; 16(43): 7407-7412, 2024 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-39361013

RESUMO

This study introduces a cost-effective approach for quantifying uric acid (UA), the main antioxidant species in human physiology and implicated in inflammatory regulation. Using a PVC substrate and pencil drawing technique, electrodes were fabricated and modified with niobium oxide and graphene oxide via a straightforward "drop casting" method. The nanostructures of the substrate, electrode, and modified electrode were evaluated using SEM images. The synergistic effect between these materials significantly facilitated the uric acid oxidation process with a 400 mV peak potential shift and 45% current increase. The evaluation of the electrode's response to common blood and urine components showed minimal deviation. Among the components tested-ascorbic acid, glucose, nitrate, nitrite, cysteine, urea, creatinine, and ammonium ion-only the ammonium ion exhibited a 10% interference at concentrations commonly found in urine. The sensors showed a good detection limit of 8.7 µmol L-1, with a wide linear range from 8.7 to 2000 µmol L-1 with a correlation factor of 0.9993 for five different sensors. The reproducibility and repeatability of the produced sensors were estimated by the RSD at 4% and 1%, respectively. Synthetic urine samples spiked exhibited reliable analysis, with recovery values within a 5% error margin. This work presents a practical, simple, and affordable sensor platform for rapid and accurate UA quantification.


Assuntos
Eletrodos , Grafite , Limite de Detecção , Nióbio , Óxidos , Ácido Úrico , Grafite/química , Ácido Úrico/urina , Ácido Úrico/química , Humanos , Nióbio/química , Óxidos/química , Técnicas Eletroquímicas/métodos , Técnicas Eletroquímicas/instrumentação , Cloreto de Polivinila/química , Reprodutibilidade dos Testes , Análise Custo-Benefício , Oxirredução
19.
Anal Methods ; 16(43): 7397-7406, 2024 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-39359139

RESUMO

Verapamil is an L-type calcium channel blocker widely used in the treatment of cardiovascular diseases such as hypertension, angina and arrhythmias, requiring accurate therapeutic monitoring to maintain plasma, urine and saliva concentrations within a safe range. In this context, a novel analytical approach has been proposed to determine verapamil in biological samples, using bar adsorptive microextraction coated with reversed-phase polymers followed by high-performance liquid chromatography with diode array detection. Two adsorbents have been chosen, i.e. STRATA-CN and ENVI-18 polymers, showing recoveries from 56.01 ± 2.16% to 96.82 ± 0.61% under optimized experimental conditions, such as sample pH: 10.0 (STRATA-CN) and 8.0 (ENVI-18), 2 h of equilibrium time, stirring speed at 990 rpm, back-extraction solvent using methanol:acetonitrile (1 : 1 v/v), and 1 h under sonication. The analytical method showed linearity from 20 to 600 ng mL-1 (r ≥ 0.99), as well as adequate precision (with RSD% below 15%) and accuracy (with RE% within 15% of the nominal value). Finally, the analytical method was applied to plasma, urine and saliva samples and proved to be a promising alternative for the trace analysis of verapamil in biological matrices.


Assuntos
Saliva , Verapamil , Verapamil/análise , Verapamil/urina , Humanos , Saliva/química , Cromatografia Líquida de Alta Pressão/métodos , Microextração em Fase Sólida/métodos , Limite de Detecção , Adsorção , Bloqueadores dos Canais de Cálcio/análise , Reprodutibilidade dos Testes
20.
Environ Sci Technol ; 58(41): 18076-18087, 2024 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-39353139

RESUMO

Although phthalate exposure has been linked with multiple adverse pregnancy outcomes, their underlying biological mechanisms are not fully understood. We examined associations between biomarkers of phthalate exposures and metabolic alterations using untargeted metabolomics in 99 pregnant women and 86 newborns [mean (SD) gestational age = 39.5 (1.5) weeks] in the PROTECT cohort. Maternal urinary phthalate metabolites were quantified using isotope dilution high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS), while metabolic profiles in maternal and cord blood plasma were characterized via reversed-phase LC-MS. Multivariable linear regression was used in metabolome-wide association studies (MWAS) to identify individual metabolic features associated with elevated phthalate levels, while clustering and correlation network analyses were used to discern the interconnectedness of biologically relevant features. In the MWAS adjusted for maternal age and prepregnancy BMI, we observed significant associations between specific phthalates, namely, di(2-ethylhexyl) phthalate (DEHP) and mono(3-carboxypropyl) phthalate (MCPP), and 34 maternal plasma metabolic features. These associations predominantly included upregulation of fatty acids, amino acids, purines, or their derivatives and downregulation of ceramides and sphingomyelins. In contrast, fewer significant associations were observed with metabolic features in cord blood. Correlation network analysis highlighted the overlap of features associated with phthalates and those identified as differentiating markers for preterm birth in a previous study. Overall, our findings underscore the complex impact of phthalate exposures on maternal and fetal metabolism, highlighting metabolomics as a tool for understanding associated biological processes. Future research should focus on expanding the sample size, exploring the effects of phthalate mixtures, and validating identified metabolic features in larger, more diverse populations.


Assuntos
Metabolômica , Ácidos Ftálicos , Humanos , Feminino , Ácidos Ftálicos/urina , Gravidez , Adulto , Porto Rico , Exposição Materna , Recém-Nascido , Sangue Fetal/química , Sangue Fetal/metabolismo , Biomarcadores/sangue , Metaboloma , Exposição Ambiental
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