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1.
Dermatol Ther ; : e14135, 2020 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-32761749

RESUMO

The current systematic review aimed to evaluate the efficacy and safety of dabrafenib plus trametinib (dabrafenib-trametinib) with those of other therapeutic alternatives in the treatment of patients with BRAF V600 mutation unresectable or metastatic melanoma. The search was carried out on four databases up to July-2018. Two separate network meta-analyses (NMA) were performed using the frequentist method (random effects): one with an exclusive population with BRAF V600 mutation (NMA-pBRAFV600) and another with a mixed population (with or without the mutation: NMA-pMixed). An evidence profile was included using the GRADE method for NMA. The validity of the final estimator in the NMA-pMixed was assessed via sensitivity analysis. Five clinical trials were included in the NMA-pBRAFV600. In the NMA-pBRAFV600 population, dabrafenib-trametinib had a favorable effect on overall survival (OS) and progression-free survival (PFS) compared with dabrafenib, vemurafenib, and dacarbazine, and on partial response rate (PRR) and overall response rate (ORR) compared with dacarbazine and vemurafenib. In the NMA-pMixed population, dabrafenib-trametinib had a positive effect on OS vs ipilimumab 3 mg/kg and on PFS and PRR vs ipilimumab (3 and 10 mg/kg), nivolumab, and pembrolizumab. However, dabrafenib-trametinib, and vemurafenib-cobimetinib were comparable in terms of clinical efficacy. In addition, dabrafenib-trametinib was associated with less grades 3 and 4 adverse events.

2.
Dermatol Ther ; 33(2): e13145, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31664762

RESUMO

The current systematic review aimed to evaluate and compare the efficacy and safety of dabrafenib-trametinib with those of other therapeutic alternatives in the treatment of patients with unresectable advanced/metastatic melanoma with BRAF-V600 mutation. The search was carried out on four databases up to July 2018. Two separate network meta-analyses (NMA) were performed using the frequentist method (random effects): one with an exclusive population with BRAF-V600 mutation (NMA-pBRAFV600) and another with mixed population (with or without the mutation: NMA-pMixed). An evidence profile was included using the GRADE method for NMA. The validity of the final estimator in the NMA-pMixed was assessed via a sensitivity analysis. Nine clinical trials were included in the NMA-pBRAFV600. Dabrafenib-trametinib was found to have a favorable effect on overall survival (OS) and progression-free survival (PFS) compared with dabrafenib, vemurafenib, and dacarbazine and on partial response rate (PRR) and overall response rate compared with dacarbazine and vemurafenib. In the NMA-pMixed, dabrafenib-trametinib was found to have a positive effect on OS versus ipilimumab 3 mg/kg and on PFS and PRR versus ipilimumab, nivolumab, and pembrolizumab. However, dabrafenib-trametinib and vemurafenib-cobimetinib significantly differed in terms of efficacy. In addition, dabrafenib-trametinib has a favorable effect on Grades 3 and 4 adverse events.


Assuntos
Melanoma , Neoplasias Cutâneas , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Humanos , Imidazóis , Melanoma/tratamento farmacológico , Melanoma/genética , Mutação , Metanálise em Rede , Oximas , Proteínas Proto-Oncogênicas B-raf/genética , Piridonas , Pirimidinonas , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/genética
3.
J Sci Food Agric ; 100(13): 4782-4790, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32459006

RESUMO

BACKGROUND: This study evaluated the acceptability (by sensorial and visual analyses) of meat from 40 Nellore heifers (finished in feedlots for 73 days) fed with different diets supplemented with essential oils (EOs) and an active principle blend. The five diets tested were: CON - a diet without essential oil and active principle blend (eugenol, thymol, and vanillin); ROS - a diet supplemented with rosemary EO; BLE - supplemented with a blend; BCL - a diet with clove EO+ blend; and BRC - a diet with rosemary, clove EOs + blend. The acceptability of diet and aging time was evaluated by consumers. RESULTS: Diet affected consumer acceptability and visual analysis (meat color). The diets with EO and the blend showed better sensory acceptance by the consumers; meat aged for 7 days received higher scores than meat aged for 1 day. Meat from heifers that received both EOs + blend (BCL, BRC) obtained the highest scores in the visual evaluation. CONCLUSION: The use of natural compounds in ruminant diets improves the sensory characteristics of meat without damaging visual acceptability and may be an alternative to the conventional additive market. © 2020 Society of Chemical Industry.


Assuntos
Ração Animal/análise , Bovinos/metabolismo , Carne/análise , Paladar , Animais , Dieta/veterinária , Eugenol/metabolismo , Feminino , Aditivos Alimentares/metabolismo , Humanos , Óleos Voláteis/metabolismo , Syzygium/metabolismo , Timol/metabolismo
4.
Glia ; 66(2): 396-412, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29076551

RESUMO

Adult neural progenitor cells (NPCs) are capable of differentiating into neurons, astrocytes, and oligodendrocytes throughout life. Notch and transforming growth factor ß1 (TGF-ß) signaling pathways play critical roles in controlling these cell fate decisions. TGF-ß has been previously shown to exert pro-neurogenic effects on hippocampal and subventricular zone (SVZ) NPCs in vitro and to interact with Notch in different cellular types. Therefore, the aim of our work was to study the effect of TGF-ß on adult rat brain SVZ NPC glial commitment and its interaction with Notch signaling. Initial cell characterization revealed a large proportion of Olig2+, Nestin+, and glial fibrillary acidic protein (GFAP+) cells, a low percentage of platelet-derived growth factor receptor α (PDGFRα+) or NG2+ cells, and <1% Tuj1+ cells. Immunocytochemical analyses showed a significant increase in the percentage of PDGFRα+, NG2+, and GFAP+ cells upon four-day TGF-ß treatment, which demonstrates the pro-gliogenic effect of this growth factor on adult brain SVZ NPCs. Real-time polymerase chain reaction analyses showed that TGF-ß induced the expression of Notch ligand Jagged1 and downstream gene Hes1. Notch signaling inhibition in cultures treated with TGF-ß produced a decrease in the proportion of PDGFRα+ cells, while TGF-ß receptor II (TßRII) inhibition also rendered a decrease in the proportion of PDGFRα+ cells, concomitantly with a decrease in Jagged1 levels. These findings demonstrate the participation of Notch signaling in TGF-ß effects and illustrate the impact of TGF-ß on glial cell fate decisions of adult brain SVZ NPCs, as well as on oligodendroglial progenitor cell proliferation and maturation.


Assuntos
Ventrículos Laterais/citologia , Ventrículos Laterais/metabolismo , Células-Tronco Neurais/metabolismo , Oligodendroglia/metabolismo , Receptores Notch/metabolismo , Fator de Crescimento Transformador beta1/farmacologia , Fatores Etários , Animais , Células Cultivadas , Humanos , Ventrículos Laterais/efeitos dos fármacos , Células-Tronco Neurais/efeitos dos fármacos , Oligodendroglia/efeitos dos fármacos , Ratos , Ratos Wistar , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/fisiologia
5.
World J Microbiol Biotechnol ; 34(8): 105, 2018 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-29971504

RESUMO

Vale dos Vinhedos appellation of origin has a very recent history as industrial wine making region. In this study we investigated the genetic and phenotypic variability of Saccharomyces cerevisiae strains isolated from South-Brazilian vineyards in order to evaluate strain fermentation aptitude and copper and sulphites tolerance. Merlot grape bunches were collected from three vineyards and yeast isolation was performed after single bunch fermentation. High genotypic variability was found and most of the genotypes revealed to be vine-specific. No industrial strain dissemination was present in the sampled vineyards, although it has been wildly reported in traditional winemaking countries. From the phenotypic traits analysis these Brazilian native strains showed good fermentation performances, good tolerance to sulphites and, in particular, a high copper tolerance level. Copper is the most important metal in the formulation of fungicides against downy mildew (Plasmopara viticola), one of the most harmful disease of the vines, and other fungal pests. The high tolerance to copper suggests an environmental adaptation to the strong use of copper-based fungicides, requested by the wet subtropical climate.


Assuntos
Variação Genética , Genótipo , Fenótipo , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/fisiologia , Agricultura , Brasil , Cobre/toxicidade , Sulfato de Cobre/toxicidade , DNA Fúngico/genética , Tolerância a Medicamentos , Fazendas , Fermentação , Fungicidas Industriais/química , Fungicidas Industriais/toxicidade , Genes Fúngicos , Mapeamento Geográfico , Sulfeto de Hidrogênio/metabolismo , Sulfeto de Hidrogênio/toxicidade , Cinética , Saccharomyces cerevisiae/efeitos dos fármacos , Saccharomyces cerevisiae/isolamento & purificação , Dióxido de Enxofre/toxicidade , Vitis/química , Vitis/microbiologia , Vinho/microbiologia
7.
bioRxiv ; 2024 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-39211150

RESUMO

The turnover and re-establishment of peripheral taste synapses is vital to maintain connectivity between the primary taste receptor cells and the gustatory neurons which relay taste information from the tongue to the brain. Despite the importance of neuron-taste cell reconnection, mechanisms governing synapse assembly and the specificity of synaptic connections is largely unknown. Here we use the expression of presynaptic proteins, CALHM1 and Bassoon, to probe whether nerve fiber connectivity is an initiating factor for the recruitment of presynaptic machinery in different populations of taste cells. Under homeostatic conditions, the vast majority (>90%) of presynaptic sites are directly adjacent to nerve fibers. In the days immediately following gustatory nerve transection and complete denervation, Bassoon and CALHM1 puncta are markedly reduced. This suggests that nerve fiber innervation is crucial for the recruitment and maintenance of presynaptic sites. In support of this, we find that expression of Bassoon and Calhm1 mRNA transcripts are significantly reduced after denervation. During nerve fiber regeneration into the taste bud, presynaptic sites begin to replenish, but are not as frequently connected to nerve fibers as intact controls (∼50% compared to >90%). This suggests that gustatory neuron proximity, rather than direct contact, likely drives taste receptor cells to express and aggregate presynaptic proteins at the cell membrane. Together, these data support the idea that trophic factors secreted by gustatory nerve fibers prompt taste receptor cells to produce presynaptic specializations at the cell membrane, which in turn may guide neurons to form mature synapses. These findings provide new insights into the mechanisms driving synaptogenesis and synaptic plasticity within the rapidly changing taste bud environment.

8.
J Pers Med ; 14(9)2024 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-39338229

RESUMO

BACKGROUND: Comprehensive genomic profiling (CGP) identifies genetic alterations and patterns that are crucial for therapy selection and precise treatment development. In Colombia, limited access to CGP tests underscores the necessity of documenting the prevalence of treatable genetic alterations. This study aimed to describe the somatic genetic profile of specific cancer types in Colombian patients and assess its impact on treatment selection. METHODS: A retrospective cohort study was conducted at Clínica Colsanitas S.A. from March 2023 to June 2024. Sequencing was performed on the NextSeq2000 platform with the TruSight Oncology 500 (TSO500) assay, which simultaneously evaluates 523 genes for DNA analysis and 55 for RNA; additionally, analyses were performed with the SOPHiA DDM software. The tumor mutational burden (TMB), microsatellite instability (MSI), and programmed cell death ligand 1 (PDL1) were assessed. RESULTS: Among 111 patients, 103 were evaluated, with gastrointestinal (27.93%), respiratory (13.51%), and central nervous system cancers (10.81%) being the most prevalent. TP53 (37%), KMT2C (28%), and KRAS (21%) were frequent mutations. Actionable findings were detected in 76.7% of cases, notably in digestive (20 patients) and lung cancers (8 patients). MSI was stable at 82.52% and high at 2.91%, whilst TMB was predominantly low (91.26%). CONCLUSIONS: The test has facilitated access to targeted therapies, improving clinical outcomes in Colombian patients. This profiling test is expected to increase opportunities for personalized medicine in Colombia.

9.
Poult Sci ; 103(12): 104234, 2024 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-39299016

RESUMO

For 2160 broilers, were raised from 1 to 42 d of age, was evaluated the consequences of microencapsulated blend of organic acids and bioactive compounds on dietary supplementation in broilers on meat quality and consumer acceptance during 200 d. Broilers were randomly distributed in a completely randomized design with 6 treatments: Negative control (NC): basal diet; Positive control (PC): NC+ Zinc bacitracin 15%; B150: NC+150 g/t of the microencapsulated blend of organic acids and bioactive compounds; B300: NC+300 g/t of the microencapsulated blend of organic acids and bioactive compounds; B450:NC+450 g/t of the microencapsulated blend of organic acids and bioactive compounds; and B600:NC+600 g/t of the microencapsulated blend of organic acids and bioactive compounds. The poultry meat characteristics (thawing loss, cooking loss, shear force, color and microstructure of the meat), oxidative stability (lipid oxidation, antioxidant activity DPPH and ABTS) and consumer acceptance (visual appraisal and willingness to buy) were evaluated. Color parameters (L and b), thawing losses and shear force were not significantly different among the treatments (NC, PC, B150, B300, B450 and B600; P > 0.05). The highest level of a was in the PC. The cooking losses were the greatest in B600. No treatment showed changes in muscle fibers. The antioxidant activity for DPPH was higher for B600. For ABTS, B150 and B300 presented the least lipid oxidation. When evaluating consumers' visual preference, B300 had the greatest in consumer preference and B150 and B300 had the greatest purchase intention on the first day of storage. After 6 d, B300 continued to be the most preferred and B150 and B450 began to show the greatest purchase intention. The B300 treatment showed a protective effect on lipid stability and consumer preference. These results highlight the importance of using a precise additive dosage during animal production to guarantee the meat's quality and satisfy consumers' demands.

10.
BMJ Open Ophthalmol ; 9(1)2024 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-39043575

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of faricimab compared with other anti-vascular endothelial growth factor (anti-VEGF) agents in treating neovascular age-related macular degeneration (nAMD) patients. METHODS AND ANALYSIS: A systematic review (SR) was conducted up to January 2023. Network meta-analyses (NMA) were performed, including sensitivity and subgroup analyses for naïve population. Outcomes included changes in visual acuity (Early Treatment of Diabetic Retinopathy Study [ETDRS] letters), anatomical changes, frequency of injections and adverse events. The Cochrane Collaboration guidelines and the Confidence in Network Meta-Analysis framework were used for the SR and the certainty of evidence, respectively. RESULTS: From 4128 identified records through electronic databases and complementary searches, 63 randomised controlled trials (RCTs) met the eligibility criteria, with 42 included in the NMA. Faricimab showed a significant reduction in the number of annual injections compared with most fixed and flexible anti-VEGF treatment regimens, while showing no statistically significant differences in visual acuity through ETDRS letter gain, demonstrating a comparable efficacy. Retinal thickness results showed comparable efficacy to other anti-VEGF agents, and inferior only to brolucizumab. Results also showed that more patients treated with faricimab were free from post-treatment retinal fluid compared with aflibercept every 8 weeks, and both ranibizumab and bevacizumab, in the fixed and pro re nata (PRN) assessed schedules. Faricimab showed a comparable safety profile regarding the risk of ocular adverse events and serious ocular adverse events (SOAE), except for the comparison with brolucizumab quarterly, in which faricimab showed a significant reduction for SOAE risk. CONCLUSION: Faricimab showed a comparable clinical benefit in efficacy and safety outcomes, with a reduction in annual injections compared with fixed and flexible anti-VEGF drug regimens, representing a valuable treatment option for nAMD patients. PROSPERO REGISTRATION NUMBER: CRD42023394226.


Assuntos
Inibidores da Angiogênese , Injeções Intravítreas , Metanálise em Rede , Fator A de Crescimento do Endotélio Vascular , Acuidade Visual , Degeneração Macular Exsudativa , Humanos , Inibidores da Angiogênese/uso terapêutico , Inibidores da Angiogênese/efeitos adversos , Inibidores da Angiogênese/administração & dosagem , Acuidade Visual/efeitos dos fármacos , Degeneração Macular Exsudativa/tratamento farmacológico , Degeneração Macular Exsudativa/fisiopatologia , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Resultado do Tratamento , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/administração & dosagem
11.
Acta Paediatr ; 102(9): 857-62, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23631461

RESUMO

UNLABELLED: Current American Academy of Pediatrics Guidelines recommended that statins should be considered as a first-line agent in children as early as 8 years of age. The aim of our work is to assess the safety of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors in children with hypercholesterolaemia. CONCLUSION: Controlled studies in children show that statin monotherapy is efficacious, well tolerated and safe in the short-time. Unfortunately, these studies have relatively short-term follow-up periods, and therefore, long-term safety remains unclear.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/tratamento farmacológico , Adolescente , Fatores Etários , Criança , LDL-Colesterol/sangue , Relação Dose-Resposta a Droga , Esquema de Medicação , Medicina Baseada em Evidências , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Estilo de Vida , Masculino , Segurança do Paciente , Seleção de Pacientes , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Índice de Gravidade de Doença
12.
J Econ Entomol ; 106(6): 2585-94, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24498761

RESUMO

Plant expression of the entomopathogenic bacteria Bacillus thuringiensis cry gene has reduced the damage created by insect pests in several economically important cultures. For this study, we have conducted genetic transformation of the indica rice "IRGA 424", via Agrobacterium tumefaciens, using the B. thuringiensis cry1Aa and cry1B genes, with the objective of obtaining rice plants resistant to the insect pests from this culture. The gene constructions harbor the promoters maize proteinase inhibitor and ubiquitin. The results showed that high concentration of the hormone 2,4-dichlorophenoxyacetic acid and agarose as the gelling agent helped the production of embryogenic calli for the analyzed cultivar. More than 80% of the obtained transformed plants revealed the integration, using polymerase chain reaction, of the cry1Aa and cry1B genes. Analysis of the expression of the heterologous protein by Western blotting revealed the expression of the Cry1B delta-endotoxin in IRGA 424 plants transformed with the ubiquitin promoter. Data showed the production and dissemination of a high number of embryogenic calli in addition to obtaining plants transformed with the cry1Aa and cry1B genes until the reproductive phase. The feed bioassays with the transformed plants and Spodoptera frugiperda (JE Smith) larvae indicated high rates of mortality to the insect target. The highest corrected mortality rate achieved under laboratory conditions with Bt-rice plants transformed with the cry1B and cry1Aa genes was 94 and 84%, respectively. Thus, our results demonstrated the great potential of transformed Bt-rice plants in controlling the damage caused by these insect pests in rice paddy fields.


Assuntos
Proteínas de Bactérias/genética , Endotoxinas/genética , Proteínas Hemolisinas/genética , Herbivoria , Oryza/genética , Controle Biológico de Vetores , Plantas Geneticamente Modificadas/genética , Spodoptera/fisiologia , Agrobacterium/genética , Animais , Bacillus thuringiensis/genética , Bacillus thuringiensis/metabolismo , Toxinas de Bacillus thuringiensis , Proteínas de Bactérias/metabolismo , Western Blotting , Endotoxinas/metabolismo , Proteínas Hemolisinas/metabolismo , Larva/crescimento & desenvolvimento , Larva/fisiologia , Oryza/metabolismo , Reação em Cadeia da Polimerase , Spodoptera/crescimento & desenvolvimento
13.
J Comp Psychol ; 137(3): 167-177, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37639234

RESUMO

Many animals respond to and use social cues emitted by other species (e.g., head direction). In the context of human-animal communication, these capacities have been attributed to regular and longstanding exposure to humans. We presented wild brown skuas (Catharacta antarctica ssp. lonnbergi) with two versions of an object-choice paradigm. In the cooperative version (Experiment 1), one human experimenter provided a simple and salient cue indicating which of two containers covered a food reward. The cues administered consisted of touching, looking at, pointing at, or pointing and looking at the container hiding food. In Experiment 1, skuas could thus cooperate with an experimenter by using the cues provided to locate the rewarded container. In the competitive version (Experiment 2), two human experimenters presented a platform with a visible food reward. In six experimental conditions, we varied experimenters' body orientation, head orientation, eye-gaze direction, face occlusion, and mouth occlusion, as well as the platform's location, ensuring that in each case only one experimenter had visual access to the rewarded platform. Here, birds could compete with the experimenters by robbing the human who does not see the food. Skuas failed to use human-given cues spontaneously in Experiment 1, and took the reward regardless of whether the experimenters could see in Experiment 2. Our results contrast with those obtained on other wild birds with pre-experience with humans. Hopefully, our findings will stimulate further research in order to illuminate the potential role of such experience in the capacity to respond to and use human-given cues. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Sinais (Psicologia) , Face , Animais , Humanos , Regiões Antárticas , Fixação Ocular , Meio Social
14.
Expert Rev Pharmacoecon Outcomes Res ; 23(9): 1017-1026, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37665685

RESUMO

INTRODUCTION: Cancer imposes a high economic burden with medical care and medication costs. We evaluate the costs, the use of resources, the administration time, and the patient preferences associated with the use of biotechnological drugs in SC and IV presentations. METHODOLOGY: A systematic literature search was conducted in PubMed, Embase, and seven additional databases. The search was carried out in September 2021 and included only studies directly comparing SC and IV presentations. Evidence was synthesized narratively. RESULTS: 34 references were included, which only analyzed bortezomib, daratumumab, rituximab, and trastuzumab. Reduction in preparation costs of SC compared to IV presentations ranged from 6.6% to 50.1%, and in administration costs from 4.5% to 95.3%. SC administration of rituximab and trastuzumab resulted in less productivity loss. More than 68% of patients reported greater satisfaction with the SC route. A reduction of time in the infusion chair, lower costs of resources for preparation, and health personnel for the administration process were identified with SC administration. CONCLUSIONS: The use of SC daratumumab, rituximab, and trastuzumab in patients with cancer reduces direct and indirect costs and adverse events compared to IV use. Patients prefer the SC administration, perceiving more comfort, and less pain at the administration site.


Assuntos
Neoplasias , Preferência do Paciente , Humanos , Rituximab , Preparações Farmacêuticas , Administração Intravenosa , Trastuzumab , Neoplasias/tratamento farmacológico , Injeções Subcutâneas
15.
Lung Cancer Manag ; 12(2): LMT59, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37287941

RESUMO

Aim: To compare the efficacy and safety of alectinib with other ALK inhibitors in treating patients with metastatic or locally advanced ALK-positive NSCLC. Methods: A systematic literature review was conducted up to November 2021. Network meta-analyses were performed using the frequentist method (random effects). GRADE evidence profile was conducted. Results: 13 RCTs were selected. For overall survival, alectinib was found to reduce the risk of death compared with crizotinib. In progression-free survival, alectinib reduced the risk of death or progression compared with crizotinib and ceritinib. Subgroup analysis by brain metastasis at baseline showed the superiority of alectinib over crizotinib and a similar effect compared with second-and third-generation inhibitors. Alectinib showed a good safety profile compared with the other ALK inhibitors.


This article reports the results of a systematic literature review with network meta-analysis (NMA) that aimed to compare the efficacy and safety of alectinib with other ALK inhibitors in treating patients with metastatic or locally advanced ALK-positive NSCLC. The results show that alectinib reduces the risk of death and the risk of progression compared with crizotinib. For progression-free survival, further significant reductions were observed when compared with ceritinib. For the other ALK inhibitors, no statistically significant differences were found. Subgroup analysis according to the presence of CNS metastases at baseline were consistent in showing the superiority of alectinib over crizotinib and the absence of statistically significant differences compared with second-and third-generation inhibitors. Alectinib showed a good safety profile compared with the other ALK inhibitors, reducing the frequency of adverse events (AEs) compared with ceritinib, and with no statistically significant differences compared with lorlatinib, brigatinib, ensartinib and crizotinib for the frequency of serious AEs or discontinuation of treatment due to AEs. The results of this study suggest clinically relevant insights in decision-making based on patient survival and progression-free survival. Furthermore, considering the importance of reducing the risk of intracranial progression and the need for available therapies for patients who will inevitably progress, alectinib could be considered as a first-line treatment for patients with ALK-positive NSCLC.

16.
JMIR Res Protoc ; 12: e47524, 2023 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-37351933

RESUMO

BACKGROUND: Innovative approaches are needed to address the self-management needs of youths with osteogenesis imperfecta (OI) transitioning into adult-oriented health care systems. Using a sequentially phased research approach, the goal is to design, develop, and test the usability of an innovative eHealth program called "Teens Taking Charge: Managing OI Online," hereafter named "Teens OI." This program seeks to optimize self-management, facilitate a successful transition to adult care, and address a critical gap in the quality of care for youths with OI. OBJECTIVE: The study objectives are to (1) design and develop an English and French version of the Teens OI and (2) test the usability of the Teens OI in terms of efficiency, effectiveness, and satisfaction from the perspectives of youths with OI and their parents. METHODS: A user-centered design is presently in progress to design and develop Teens OI. A "Website Design and Development Council" (ie, Council) has been convened, with 20 youths and parent dyads recruited and global experts surveyed at an international meeting. With unanimous support from the Council, usability testing of the Teens OI will ensue in 4 iterative cycles with 32 youth-parent dyads. All sociodemographic and usability metrics will be descriptively analyzed. All recorded interview and focus group data are analyzed using content analysis techniques involving an iterative process of data reduction, data display, conclusion drawing, and verification. RESULTS: As of December 2022, an 8-person, interdisciplinary Teens OI council, comprising 4 health care professionals, 3 youths and young adults with OI, and 1 parent, has been convened to oversee the design and development of Teens OI. Two cycles of interviews have been conducted with 10 youths with OI with or without their parents (n=6) from December 2021 to September 2022. Data analysis has been in progress since April 2022. Aim 2 is ethically approved and will commence following the completion of content development, expected by late July 2023. Preliminary analysis indicates that the following topics need to be prioritized for the youths: mental health, pain, accessibility, medical care, education, community, and parental care. CONCLUSIONS: The proposed study will design and develop a self-management and transitional care program for youths with OI in partnership with patients, caregivers, and health care professionals. This study leverages youths' openness to adopt eHealth technologies to meet their needs and has the potential to actively engage them to autonomously manage their lifelong conditions, and facilitate a successful transition to adult health care. Finally, the proposed study will also address a critical gap in the quality of care and the growing concern that the OI population transitioning from pediatric to adult care is at risk of various adverse events associated with the transition. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/47524.

17.
Front Neurosci ; 17: 1195840, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38027526

RESUMO

Neurodegenerative diseases (NDs) are characterized by a progressive deterioration of neuronal function, leading to motor and cognitive damage in patients. Astrocytes are essential for maintaining brain homeostasis, and their functional impairment is increasingly recognized as central to the etiology of various NDs. Such impairment can be induced by toxic insults with palmitic acid (PA), a common fatty acid, that disrupts autophagy, increases reactive oxygen species, and triggers inflammation. Although the effects of PA on astrocytes have been addressed, most aspects of the dynamics of this fatty acid remain unknown. Additionally, there is still no model that satisfactorily explains how astroglia goes from being neuroprotective to neurotoxic. Current incomplete knowledge needs to be improved by the growing field of non-coding RNAs (ncRNAs), which is proven to be related to NDs, where the complexity of the interactions among these molecules and how they control other RNA expressions need to be addressed. In the present study, we present an extensive competing endogenous RNA (ceRNA) network using transcriptomic data from normal human astrocyte (NHA) cells exposed to PA lipotoxic conditions and experimentally validated data on ncRNA interaction. The obtained network contains 7 lncRNA transcripts, 38 miRNAs, and 239 mRNAs that showed enrichment in ND-related processes, such as fatty acid metabolism and biosynthesis, FoxO and TGF-ß signaling pathways, prion diseases, apoptosis, and immune-related pathways. In addition, the transcriptomic profile was used to propose 22 potential key controllers lncRNA/miRNA/mRNA axes in ND mechanisms. The relevance of five of these axes was corroborated by the miRNA expression data obtained in other studies. MEG3 (ENST00000398461)/hsa-let-7d-5p/ATF6B axis showed importance in Parkinson's and late Alzheimer's diseases, while AC092687.3/hsa-let-7e-5p/[SREBF2, FNIP1, PMAIP1] and SDCBP2-AS1 (ENST00000446423)/hsa-miR-101-3p/MAPK6 axes are probably related to Alzheimer's disease development and pathology. The presented network and axes will help to understand the PA-induced mechanisms in astrocytes, leading to protection or injury in the CNS under lipotoxic conditions as part of the intricated cellular regulation influencing the pathology of different NDs. Furthermore, the five corroborated axes could be considered study targets for new pharmacologic treatments or as possible diagnostic molecules, contributing to improving the quality of life of millions worldwide.

18.
Artigo em Inglês | MEDLINE | ID: mdl-37096565

RESUMO

OBJECTIVE: This article estimates the disease burden of 5q-SMA in Colombia by using the disability-adjusted life years (DALYs) metric. METHODS: Epidemiological data were obtained from local databases and medical literature and were adjusted in the DisMod II tool. DALYs were obtained by adding years of life lost due to premature death (YLL) and years lived with disability (YLD). RESULTS: The modeled prevalence of 5q-SMA in Colombia was 0.74 per 100,000 population. The fatality rate for all types was 14.1%. The disease burden of 5q-SMA was estimated at 4,421 DALYs (8.6 DALYs/100,000), corresponding to 4,214 (95.3%) YLLs and 207 (4.7%) YLDs. Most of the DALYs were accounted in the 2-17 age group. Of the total burden, 78% correspond to SMA type 1, 18% to type 2, and 4% to type 3. CONCLUSIONS: Although 5q-SMA is a rare disease, it is linked to a significant disease burden due to premature mortality and severe sequelae. The estimates shown in this article are important inputs to inform public policy decisions on how to ensure adequate health service provision for patients with 5q-SMA.


Assuntos
Efeitos Psicossociais da Doença , Mortalidade Prematura , Humanos , Anos de Vida Ajustados por Qualidade de Vida , Colômbia/epidemiologia , Cromossomos
19.
Photodiagnosis Photodyn Ther ; 42: 103337, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36813143

RESUMO

Good management practices such as post-dipping applications (post-milking immersion bath) contribute to the dairy cattle health during lactation and minimize the appearance of mastitis (an infection in the mammary gland). The post-dipping procedure is performed conventionally using iodine-based solutions. The search for therapeutic modalities that are not invasive and do not cause resistance to the microorganisms that cause bovine mastitis instigates the interest of the scientific community. In this regard, antimicrobial Photodynamic Therapy (aPDT) is highlighted. The aPDT is based on combining a photosensitizer (PS) compound, light of adequate wavelength, and molecular oxygen (3O2), which triggers a series of photophysical processes and photochemical reactions that generate reactive oxygen species (ROS) responsible for the inactivation of microorganisms. The present investigation explored the photodynamic efficiency of two natural PS: Chlorophyll-rich spinach extract (CHL) and Curcumin (CUR), both incorporated into the Pluronic® F127 micellar copolymer. They were applied in post-dipping procedures in two different experiments. The photoactivity of formulations mediated through aPDT was conducted against Staphylococcus aureus, and obtained a minimum inhibitory concentration (MIC) of 6.8 mg mL-1 for CHL-F127 and 0.25 mg mL-1 for CUR-F127. Only CUR-F127 inhibited Escherichia coli growth with MIC 0.50 mg mL-1. Concerning the count of microorganisms during the days of the application, a significant difference was observed between the treatments and control (Iodine) when the teat surface of cows was evaluated. For CHL-F127 there was a difference for Coliform and Staphylococcus (p < 0.05). For CUR-F127 there was a difference for aerobic mesophilic and Staphylococcus (p < 0.05). Such application decreased bacterial load and maintained the milk quality, being evaluated via total microorganism count, physical-chemical composition, and somatic cell count (SCC).


Assuntos
Criação de Animais Domésticos , Bovinos , Mastite Bovina , Micelas , Fotoquimioterapia , Feminino , Animais , Mastite Bovina/prevenção & controle , Mastite Bovina/terapia , Sistemas de Liberação de Medicamentos/veterinária , Criação de Animais Domésticos/métodos , Fármacos Fotossensibilizantes/administração & dosagem , Fotoquimioterapia/métodos , Fotoquimioterapia/veterinária , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/efeitos da radiação , Staphylococcus aureus/ultraestrutura , Escherichia coli/efeitos dos fármacos , Escherichia coli/efeitos da radiação , Escherichia coli/ultraestrutura , Luz , Leite/microbiologia , Microscopia Eletrônica de Varredura
20.
Transplant Proc ; 55(8): 1815-1821, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37330340

RESUMO

BACKGROUND: Infections by SARS-CoV-2 in liver transplant recipients (LT) patients are of particular concern, notably due to perceived added risks related to immunosuppression and comorbidity burden. Current literature on this topic often relies on small, non-standardized, and geographically limited studies. This manuscript describes COVID-19 presentations and causes for elevated mortality in a large cohort of LT recipients. METHODS: This study was designed as a multicentric historical cohort, including LT recipient patients with COVID-19 in 25 study centers, with the primary endpoint being COVID-related death. We also collected demographic, clinical, and laboratory data regarding presentation and disease progression. RESULTS: Two hundred and thirty-four cases were included. The study population was predominantly male and White and had a median age of 60 years. The median time from transplantation was 2.6 years (IQR 1-6). Most patients had at least one comorbidity (189, 80.8%). Patient age (P = .04), dyspnea (P < .001), intensive care unit admission (P < .001), and mechanical ventilation (P < .001) were associated with increased mortality. Modifications of immunosuppressive therapy (P < .001), specifically the suspension of tacrolimus, maintained significance in multivariable analysis. CONCLUSIONS: Attention to risk factors and the individualization of patient care, especially regarding immunosuppression management, is crucial for delivering more precise interventions to these individuals.


Assuntos
COVID-19 , Transplante de Fígado , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , COVID-19/epidemiologia , SARS-CoV-2 , Transplante de Fígado/efeitos adversos , Brasil/epidemiologia , Terapia de Imunossupressão/efeitos adversos , Transplantados
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