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Until recently, most ecological network analyses investigating the effects of species' declines and extinctions have focused on a single type of interaction (e.g. feeding). In nature, however, diverse interactions co-occur, each of them forming a layer of a 'multilayer' network. Data including information on multiple interaction types has recently started to emerge, giving us the opportunity to have a first glance at possible commonalities in the structure of these networks. We studied the structural features of 44 tripartite ecological networks from the literature, each composed of two layers of interactions (e.g. herbivory and pollination), and investigated their robustness to species losses. Considering two interactions simultaneously, we found that the robustness of the whole community is a combination of the robustness of the two ecological networks composing it. The way in which the layers of interactions are connected to each other affects the interdependence of their robustness. In many networks, this interdependence is low, suggesting that restoration efforts would not automatically propagate through the whole community. Our results highlight the importance of considering multiple interactions simultaneously to better gauge the robustness of ecological communities to species loss and to more reliably identify key species that are important for the persistence of ecological communities.
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Biota , Polinização , Herbivoria , EcossistemaRESUMO
BACKGROUND: Intraoperative parathyroid hormone (PTH) monitoring is a proven and reliable adjunct to parathyroid surgery, able to improve the outcomes and efficiency of the diagnostic and therapeutic pathway for patients with primary hyperparathyroidism. This study evaluated the innovative, compact, fully automated NBCL CONNECT Analyzer, which can measure whole-blood PTH in 5â min. METHODS: A prospective multicentre study was conducted in stages: results reviews, recommendations, and implementation of improvements to the mechanical design, components of cartridges, calibration, and sampling protocols. Patients undergoing parathyroidectomy had PTH levels measured on the Analyzer and main laboratory platforms, either Roche or Abbott. The Miami criterion of a 50% drop in PTH concentration was used to define biochemical cure during surgery, and normal postoperative calcium level as cure of primary hyperparathyroidism. Measurements on the Analyzer were done by laboratory staff in London and nurses in Stuttgart. The Pearson coefficient (R) and Wilcoxon test were used for statistical analysis. RESULTS: Some 234 patients (55 male, 179 female) with a median age of 58.5 (age full range 15-88) years underwent parathyroidectomy (195 minimally invasive, 38 bilateral neck exploration, 1 thoracoscopic; 12 conversions) for primary hyperparathyroidism between November 2021 and July 2022. Primary hyperparathyroidism was cured in 225 patients (96.2%). The sensitivity, specificity, and overall accuracy of the Analyzer assay in predicting biochemical cure were 83.9, 100, and 84.8% in phase 1; 91.2, 100, and 91.3% in phase 2; and 98.6, 100, and 98.6% in phase 3. There were no false-positive results (positive predictive value 100%). Correlations between Analyzer measurements and those obtained using the Roche device were very strong (R = 0.98, P < 0.001 in phase 1; R = 0.92, P < 0.001 in phase 2; R = 0.94, P < 0.001 in phase 3), and correlations for Analyzer readings versus those from the Abbott platform were strong (R = 0.82, P < 0.001; R = 0.89, P < 0.001; R = 0.91, P < 0.001). The Analyzer showed continued good mechanical performance, with stable and repeatable operations (calibrations, quality controls). Introducing a stricter sampling protocol and improvements in the clot-detecting system led to a decrease in the number of clotted samples and false-negative results. Outcomes were not affected by measurements performed either by nurses or laboratory staff. CONCLUSION: Intraoperative PTH monitoring during parathyroid surgery can be done accurately, simply, and quickly in whole blood using the Analyzer.
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Hiperparatireoidismo Primário , Monitorização Intraoperatória , Hormônio Paratireóideo , Paratireoidectomia , Humanos , Pessoa de Meia-Idade , Feminino , Hormônio Paratireóideo/sangue , Masculino , Estudos Prospectivos , Adulto , Idoso , Monitorização Intraoperatória/métodos , Adolescente , Idoso de 80 Anos ou mais , Hiperparatireoidismo Primário/cirurgia , Hiperparatireoidismo Primário/sangue , Hiperparatireoidismo Primário/diagnóstico , Adulto JovemRESUMO
Yeasts from cold environments have a wide range of strategies to prevent the negative effects of extreme conditions, including the production of metabolites of biotechnological interest. We investigated the growth profile and production of metabolites in yeast species isolated from cold environments. Thirty-eight strains were tested for their ability to grow at different temperatures (5-30 °C) and solute concentrations (3-12.5% NaCl and 50% glucose). All strains tested were able to grow at 5 °C, and 77% were able to grow with 5% NaCl at 18 °C. We were able to group strains based on different physicochemical/lifestyle profiles such as polyextremotolerant, osmotolerant, psychrotolerant, or psychrophilic. Five strains were selected to study biomass and metabolite production (glycerol, trehalose, ergosterol, and mycosporines). These analyses revealed that the accumulation pattern of trehalose and ergosterol was related to each lifestyle profile. Also, our findings would suggest that mycosporines does not have a role as an osmolyte. Non-conventional fermentative yeasts such as Phaffia tasmanica and Saccharomyces eubayanus may be of interest for trehalose production. This work contributes to the knowledge of non-conventional yeasts with biotechnological application from cold environments, including their growth profile, metabolites, and biomass production under different conditions.
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Basidiomycota , Trealose , Trealose/metabolismo , Cloreto de Sódio/metabolismo , Leveduras , Ergosterol/metabolismo , Temperatura BaixaRESUMO
Background: The purpose of this study was to explore the usage patterns and profiles of social media (SM) platforms among Radiation Oncologists (RO) and Physicists in the scope of the Catalan-Occitan Oncology Group (GOCO). Materials and methods: From November 2022 to March 2023, a comprehensive survey was sent to Radiation Oncology professionals within the GOCO group, comprising 31 questions that covered demographics (4) and general inquiries (9), user behavior on social media (7), profile of SM activity (7), and participants' opinions (4) regarding professional use of SM. The survey reached professionals from 12 centers, encompassing 10 in Catalonia and 2 in French Occitania. Results: The survey achieved a 61.37% response rate (178/290 professionals) with an average age of 41.9 years. 120 (67%) were ROs, and 58 (33%) were Physicists. Instagram led in usage (n = 116), followed by Facebook (n = 107) and Twitter (n = 77). Age correlated inversely with the number of platforms used (Spearman's rank correlation coefficient -0.238, p = 0.001). 28% (n = 42) changed clinical practices based on SM information. A 78.5% (n = 117) didn't counter inappropriate content. Most (71.7%, n = 109) spent < 1 hour daily on professional SM use, however more Physicians exceeded 2 hours compared to Physicists (Cohen's kappa 2 = 0.07). 41.8% (n = 64) weren't emotionally concerned while 22.9% (n = 35) felt overwhelmed by SM overload. Conclusions: The study offers valuable insights into the usage patterns, preferences, and attitudes of Radiation Oncology professionals towards SM platforms. This understanding is crucial for optimizing content quality and delivering relevant information, thereby enabling more effective marketing strategies and enhancing emotional management among these professionals.
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BACKGROUND: The SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) pandemic changed the distribution of healthcare resources, leading in many cases to the suspension of all non-essential treatments and procedures and representing a challenge for medical professionals. The objective of this study was to evaluate whether clinical protocols in gynecologic oncology care were modified as a result of the pandemic and to assess surgeons' perceptions regarding the management of gynecologic cancers". METHODS: Data were collected through an anonymous and voluntary survey sent via email to healthcare professionals in the field of gynecologic oncology in Spain. RESULTS: A total of 75 gynecologic oncologists completed the online survey. Of these, 93.2% (69) reported working in public hospitals and 62.5% (45) in tertiary care hospitals. 97.3% (71) were affiliated with hospitals treating patients infected with SARS-CoV-2. 85.1% (63) of the respondents expressed concern about the SARS-CoV-2 pandemic and 52.1% (38) indicated that the pandemic impacted the diagnostic and therapeutic quality of care for oncology patients. SARS-CoV-2 nasopharyngeal swab PCR (Polymerase Chain Reaction) testing was always performed before surgical interventions by 97.3% (71), being considered a best practice in triage by 94.4% (68). 87.5% (63) reported no change in the type of surgical approach during the pandemic. 62.5% (45) experienced limitations in accessing special personal protective equipment for SARS-CoV-2. An impact on the follow-up of patients with gynecologic cancers due to the pandemic was reported by 70.4% (50). CONCLUSIONS: Most of the Spanish gynecologic oncologists who responded to our survey reported that the SARS-CoV-2 pandemic had affected their clinical practice. The primary measures implemented were an increase in telemedicine, restricting outpatient visits to high-risk or symptomatic patients and the use of SARS-CoV-2 screening prior to surgery. No major changes in the surgical approach or management of the treatment of ovarian, endometrial or cervical cancer during the pandemic were reported.
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COVID-19 , Neoplasias dos Genitais Femininos , Neoplasias do Colo do Útero , Humanos , Feminino , Neoplasias dos Genitais Femininos/epidemiologia , Neoplasias dos Genitais Femininos/terapia , SARS-CoV-2 , PandemiasRESUMO
Perry is a beverage obtained by fermentation of pear juice, popular in the North Hemisphere. In Argentina it is an emerging market, particularly in the Patagonian region. The aim of this work is to describe and to evaluate the spoilage yeasts associated to six perry samples showing signs of microbiological contamination from a local craft perry company in North Patagonian region. Eighteen yeasts were isolated from four of the six perry samples where Brettanomyces custersianus, Brettanomyces bruxellensis and Zygosaccharomyces parabailii were identified. The growth capacity of these isolates in the presence of antimicrobial agents (sulfite and potassium sorbate) was analyzed in solid media. Growth parameters in sterile perry must was evaluated and the production of undesirable compounds were evaluated, products were characterized in terms of their aromatic and physicochemical features. The yeasts Z. parabailii NPCC1791 was able to grow on plates containing sulfite concentrations of up to 4 mM and produced high methanol concentrations in perry. Additionally, B. bruxellensis NPPC1792 was able to produce methanol as well as high concentrations of volatile phenols including 4-ethylphenol and 4-ethylguaiacol. These results demonstrate the potential of these species as perry contaminants. Given the lack of studies describing the contaminating yeasts in perry production, this work represents the first report about perry spoilage yeasts in Argentina, with this knowledge, control strategies can be developed to prevent microbiological contamination and minimize product loss.
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Bebidas , Metanol , Argentina , FermentaçãoRESUMO
Aortoesophageal fistula is a very rare cause of upper gastrointestinal bleeding, however its interest lies in the high mortality rate associated with it. Due to this, early diagnosis and treatment of this entity is essential to increase survival. The typical symptoms known as the Chiari´s triad are only present in 45% of reported cases. We present the case of a patient with upper gastrointestinal bleeding due to an aortoesophageal fistula as well as the importance of endoscopic use for its differential diagnosis.
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Doenças da Aorta , Fístula Esofágica , Perfuração Esofágica , Fístula Vascular , Humanos , Perfuração Esofágica/diagnóstico por imagem , Perfuração Esofágica/etiologia , Fístula Vascular/complicações , Fístula Vascular/diagnóstico por imagem , Fístula Esofágica/etiologia , Fístula Esofágica/complicações , Hemorragia Gastrointestinal/complicações , Doenças da Aorta/etiologia , Doenças da Aorta/complicaçõesRESUMO
The brewing activity in Andean Patagonia plays a very important role in the region's economy, being microbial contamination one of the main problems in terms of quality. The presence of contaminant bacteria and wild yeasts in beer generate microbiological, physical and chemical changes that impact on its sensory attributes. However, few breweries establish criteria and policies to guarantee the quality of their products in a microbiological sense. The purpose of this work was to study for the first time the incidence of microbial contaminants in bottled craft beers from Andean Patagonia, identify the main microorganisms involved and establish relationships between contamination and the physicochemical variables of beer. We analyzed 75 beers from 37 breweries from 12 different Patagonian cities. Our results showed that 69.3% of the analyzed beer exhibited contaminant microorganism growth. Bacteria Levilactobacillus brevis and wild yeasts of Saccharomyces were the main microorganisms responsible for these contaminations. In addition, we found that microbial contamination had an impact on beer sensory profile and also that pH was correlated with the presence of lactic acid bacteria in beer, being an indicator of contamination for these bacteria. In conclusion, we observed that 8 out of 10 breweries studied showed contamination problems, highlighting the need to design prevention and control strategies in microbreweries.
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Cerveja , Leveduras , Cerveja/análise , Argentina , Bactérias , FermentaçãoRESUMO
Spinal cord injury (SCI) has substantial impacts on autonomic function. In part, SCI results in loss of normal autonomic activity that contributes to injury-associated pathology such as neurogenic bladder, bowel, and sexual dysfunction. Yet little is known of the impacts of SCI on peripheral autonomic neurons that directly innervate these target organs. In this study, we measured changes in synaptic properties of neurons of the mouse major pelvic ganglion (MPG) associated with acute and chronic SCI. Our data show that functional and physiological properties of synapses onto MPG neurons are altered after SCI and differ between acute and chronic injury. After acute injury excitatory postsynaptic potentials (EPSPs) show increased rise and decay time constants leading to overall broader and longer EPSPs, whereas in chronic-injured animals EPSPs are reduced in amplitude and show faster rise and decay leading to shorter EPSPs. Synaptic depression and low-pass filtering are also altered in injured animals. Finally, cholinergic currents are smaller in acute-injured animals but larger in chronic-injured animals relative to control animals. These changes in synaptic properties are associated with differences in nicotinic receptor subunit expression as well. MPG CHRNA3 mRNA levels decreased after injury, whereas CHRNA4 mRNAs increased. Furthermore, changes in the correlations of α- and ß-subunit mRNAs suggest that nicotinic receptor subtype composition is altered after injury. Taken together, our data demonstrate that peripheral autonomic neurons are fundamentally altered after SCI, suggesting that longer-term therapeutic approaches could target these neurons directly to potentially help ameliorate neurogenic target organ dysfunction.NEW & NOTEWORTHY Spinal cord injury (SCI) has substantial impacts on autonomic function, yet little is known of the impacts of SCI on autonomic neurons that directly innervate effectors impacted by injury. Here we investigated changes at the cellular level associated with SCI in neurons that are "downstream" of the central injury. An understanding of these off-target impacts of SCI ultimately will be critical in the context of effective restoration of function through neuromodulation of pharmacological therapeutic approaches.
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Receptores Nicotínicos , Traumatismos da Medula Espinal , Animais , Colinérgicos , Potenciais Pós-Sinápticos Excitadores/fisiologia , Camundongos , RNA Mensageiro , Medula EspinalRESUMO
Exosomes are cell-derived nanovesicles with a proven intercellular signaling role in inflammation processes and immune response. Due to their natural origin and liposome-like structure, these nanometer-scale vesicles have emerged as novel platforms for therapy and diagnosis. In this work, goat milk exosomes are isolated and fully characterized in terms of their physicochemical properties, proteomics, and biochemical profile in healthy mice, and used to detect inflammatory processes by optical imaging. For the in vitro and in vivo experiments, the exosomes are covalently labeled with the commercial fluorophores sulfo-Cyanine 5 and BODIPY-FL to create nanoprobes. In vitro studies using confocal imaging, flow cytometry, and colorimetric assays confirm the internalization of the nanoprobes as well their lack of cytotoxicity in macrophage populations RAW 264.7. Optical imaging in the mouse peritoneal region confirms the in vivo ability of one of the nanoprobes to localize inflammatory processes. In vivo imaging shows exosome uptake in the inflamed peritoneal region, and flow-cytometric analysis of peritonitis exudates confirms the uptake by macrophage and neutrophil populations. These results support the promising use of goat milk exosomes as natural probes in the detection of inflammatory processes.
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Exossomos , Leite/química , Nanopartículas , Animais , Cabras , Camundongos , Imagem ÓpticaRESUMO
Basidiomycetous yeasts remain an almost unexplored source of enzymes with great potential in several industries. Tausonia pullulans (Tremellomycetes) is a psychrotolerant yeast with several extracellular enzymatic activities reported, although the responsible genes are not known. We performed the genomic sequencing, assembly and annotation of T. pullulans strain CRUB 1754 (Perito Moreno glacier, Argentina), a gene survey of carbohydrate-active enzymes (CAZymes), and analyzed its secretome by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) after growth in glucose (GLU) or starch (STA) as main carbon sources. T. pullulans has 7210 predicted genes, 3.6% being CAZymes. When compared to other Tremellomycetes, it contains a high number of CAZy domains, and in particular higher quantities of glucoamylases (GH15), pectinolytic enzymes (GH28) and lignocellulose decay enzymes (GH7). When the secretome of T. pullulans was analyzed experimentally after growth in starch or glucose, 98 proteins were identified. The 60% of total spectral counts belonged to GHs, oxidoreductases and to other CAZymes. A 65 kDa glucoamylase of family GH15 (TpGA1) showed the highest fold change (tenfold increase in starch). This enzyme contains a conserved active site and showed extensive N-glycosylation. This study increases the knowledge on the extracellular hydrolytic enzymes of basidiomycetous yeasts and, in particular, establishes T. pullulans as a potential source of carbohydrate-active enzymes. KEY POINTS: ⢠Tausonia pullulans genome harbors a high number of genes coding for CAZymes. ⢠Among CAZy domains/families, the glycoside hydrolases are the most abundant. ⢠Secretome analysis in glucose or starch as main C sources identified 98 proteins. ⢠A 65 kDa GH15 glucoamylase showed the highest fold increase upon culture in starch.
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Glucana 1,4-alfa-Glucosidase , Proteômica , Basidiomycota , Cromatografia Líquida , Glucana 1,4-alfa-Glucosidase/genética , Glucana 1,4-alfa-Glucosidase/metabolismo , Glucose , Hidrólise , Amido , Espectrometria de Massas em TandemRESUMO
Understanding the stability of ecological communities is a matter of increasing importance in the context of global environmental change. Yet it has proved to be a challenging task. Different metrics are used to assess the stability of ecological systems, and the choice of one metric over another may result in conflicting conclusions. Although each of the multitude of metrics is useful for answering a specific question about stability, the relationship among metrics is poorly understood. Such lack of understanding prevents scientists from developing a unified concept of stability. Instead, by investigating these relationships we can unveil how many dimensions of stability there are (i.e., in how many independent components stability metrics can be grouped), which should help build a more comprehensive concept of stability. Here we simultaneously measured 27 stability metrics frequently used in ecological studies. Our approach is based on dynamical simulations of multispecies trophic communities under different perturbation scenarios. Mapping the relationships between the metrics revealed that they can be lumped into 3 main groups of relatively independent stability components: early response to pulse, sensitivities to press, and distance to threshold. Selecting metrics from each of these groups allows a more accurate and comprehensive quantification of the overall stability of ecological communities. These results contribute to improving our understanding and assessment of stability in ecological communities.
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The role of Ureaplasma diversum in the porcine respiratory disease complex (PRDC), its circulation among herds and prevalence in live pigs is unknown; thus, the objectives of this study were: to determine the presence of U. diversum in indoor intensive pig herds and to determine the individual frequency of pigs with U. diversum from pooled samples. A cross sectional study was carried out in 16 indoor intensive herds from Córdoba and La Pampa provinces, collecting eight nasal swabs specimens that were further processed by two pools of four specimens each by a PCR targeting a fragment of 16S ribosomal RNA gene. Four PCR products were sequenced and aligned against data bases. U. diversum - Ureaplasma sp. were detected in 56.3% of the analyzed herds, with 16.5% (95% CI 8.2-30.8) of positive pigs. It was concluded that U. diversum - Ureaplasma sp. are present in the nasal cavity of live pigs, being widely distributed among herds.
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Doenças dos Bovinos , Infecções por Ureaplasma , Animais , Bovinos , Estudos Transversais , Cavidade Nasal , Suínos , Ureaplasma , Infecções por Ureaplasma/epidemiologia , Infecções por Ureaplasma/veterináriaRESUMO
PTEN is a phosphatase which metabolises PIP3, the lipid product of PI 3-Kinase, directly opposing the activation of the oncogenic PI3K/AKT/mTOR signalling network. Accordingly, loss of function of the PTEN tumour suppressor is one of the most common events observed in many types of cancer. Although the mechanisms by which PTEN function is disrupted are diverse, the most frequently observed events are deletion of a single gene copy of PTEN and gene silencing, usually observed in tumours with little or no PTEN protein detectable by immunohistochemistry. Accordingly, with the exceptions of glioblastoma and endometrial cancer, mutations of the PTEN coding sequence are uncommon (<10%) in most types of cancer. Here we review the data relating to PTEN loss in seven common tumour types and discuss mechanisms of PTEN regulation, some of which appear to contribute to reduced PTEN protein levels in cancers.
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Suscetibilidade a Doenças , Mutação com Perda de Função , Neoplasias/etiologia , Neoplasias/metabolismo , PTEN Fosfo-Hidrolase/genética , Animais , Biomarcadores Tumorais , Regulação Neoplásica da Expressão Gênica , Genes Supressores de Tumor , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Mutação , Neoplasias/patologia , PTEN Fosfo-Hidrolase/metabolismo , Transdução de SinaisRESUMO
Twenty-one psychrophilic yeast isolates related to the Camptobasidiaceae family in the Microbotryomycetes class were obtained from ice collected from cold environments worldwide. A new psychrophilic species from the recently described genus Cryolevonia, Cryolevania giraudoae is proposed to accommodate 18 isolates from Patagonia (Argentina) and Antarctica (holotype CRUB 2086T). In addition, a new psychrophilic species in the genus Camptobasidium is described as Camptobasidium gelus sp. nov. (holotype CBS 8941T), based on three isolates from glacial ice in the Russel glacier (Greenland ice sheet) and Antarctica. The strict psychrophilic profile is the salient feature of both novel species.
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Basidiomycota/classificação , Camada de Gelo/microbiologia , Filogenia , Regiões Antárticas , Argentina , Basidiomycota/isolamento & purificação , DNA Fúngico/genética , Técnicas de Tipagem Micológica , Análise de Sequência de DNARESUMO
INTRODUCTION: The role of radiation therapy (RT) for patients with bone-only metastatic (BOM) breast cancer has not been investigated sufficiently. The aim of this survey was to evaluate current clinical practice in treating breast cancer patients with BOM in Radiation Therapy Departments in Catalonia and Occitania within the scope of the GOCO group. MATERIALS AND METHODS: An electronic questionnaire was completed by experienced radiation oncologists from fourteen RT centers. The items surveyed the professional experience, therapeutic approach, technique, dose stereotactic body RT (SBRT) availability. RESULTS: All Radiation Oncology Departments (ROD) in Catalonia (12) and Occitania (2) responded to the survey. Eleven (78.5%) of the RODs advise RT for BOM as initial treatment in the oligometastatic setting. RT to asymptomatic bone oligometastases is more often restricted for "risky lesions". The most inconsistent approaches were the treatment for asymptomatic lesions, when to treat bone metastases with respect to systemic treatment (ST) and the indication for RT after a complete response to ST. CONCLUSION: While BOM breast cancer patients have a relatively good prognosis, there is a lack of consistency in their approach with RT. This can be explained by the absence of evidence-based guidelines and an incomplete availability of SBRT.
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The concept of ecological stability occupies a prominent place in both fundamental and applied ecological research. We review decades of work on the topic and examine how our understanding has progressed. We show that our understanding of stability has remained fragmented and is limited largely to simple or simplified systems. There has been a profusion of metrics proposed to quantify stability, of which only a handful are used commonly. Furthermore, studies typically quantify one to two metrics of stability at a time and in response to a single perturbation, with some of the main environmental pressures of today being the least studied. We argue that we need to build on the existing consensus and strong theoretical foundation of the stability concept to better understand its multidimensionality and the interdependencies between metrics, levels of organisation and types of perturbations. Only by doing so can we make progress in the quantification of stability in theory and in practice, and eventually build a more comprehensive understanding of how ecosystems will respond to ongoing environmental change.
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Ecologia , Ecossistema , Monitoramento AmbientalRESUMO
Sinonasal intestinal-type adenocarcinomas (SNS-ITAC) are very rare tumors that resemble colorectal cancer in many of their pathological and molecular characteristics. Indeed, in most published series, 10%-14% of SNS-ITAC harbor mutations in KRAS. There is no standard systemic treatment in recurrent or metastatic SNS-ITAC, and there is no evidence of the use of any targeted agent in this entity. We present the case of a recurrent nasoethmoidal ITAC informed as RAS and BRAF wild-type by standard real-time polymerase chain reaction methods and treated with first-line cetuximab and irinotecan without response. Circulating tumor cells coupled to highly sensitive DNA analyses unveiled a mutation in KRAS exon 2 codon 12. Subsequent studies in the primary tumor using BEAMing detected a mutation in the same codon, confirming the KRAS mutated status of the tumor, and possibly explaining the absence of treatment response. This case exemplifies how liquid biopsy can aid in the correct and real-time molecular characterization of tumors even in a rare nonmetastatic cancer of the head and neck. KEY POINTS: Sinonasal intestinal type adenocarcinomas (SNS-ITAC) are rare tumors that commonly develop after a prolonged exposure to organic dusts (wood, leather, etc.), and that resemble colorectal cancer in some of their morphological and molecular characteristics.KRAS mutations have been described in 10%-14% in most series. However, its predictive value for guiding treatment decisions with targeted therapies (i.e., anti-epidermal growth factor receptor [EGFR] therapy) has not been defined.The first case of an SNS-ITAC treated with anti-EGFR therapy (cetuximab) is reported. Analysis of DNA from circulating tumor cells (CTCs) unveiled a mutation in KRAS not detected by standard methods in the primary tumor. However, RAS analysis using BEAMing detected a mutation in the primary tumor in the same codon of KRAS originally detected in CTCs, altogether possibly explaining the lack of treatment response.Liquid biopsy may allow for an accurate molecular diagnosis in rare, organ-confined tumors where few therapeutic options exist. Highly sensitive molecular diagnostics may aid in better characterizing rare entities harboring potentially druggable targets.
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Adenocarcinoma/tratamento farmacológico , Antineoplásicos Imunológicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cetuximab/uso terapêutico , Receptores ErbB/uso terapêutico , Neoplasias Intestinais/tratamento farmacológico , Biópsia Líquida/métodos , Neoplasias dos Seios Paranasais/tratamento farmacológico , Idoso de 80 Anos ou mais , Antineoplásicos Imunológicos/farmacologia , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Carmustina/farmacologia , Carmustina/uso terapêutico , Cetuximab/farmacologia , Citarabina/farmacologia , Citarabina/uso terapêutico , Receptores ErbB/farmacologia , Etoposídeo/farmacologia , Etoposídeo/uso terapêutico , Genótipo , Humanos , Masculino , Melfalan/farmacologia , Melfalan/uso terapêuticoRESUMO
The aim of this study is to compare the efficacy and safety of biological therapy with cyclosporin A (CsA), azathioprine (AZA), or placebo in uveitis flares and other ocular outcomes in patients with Behçet disease. A comprehensive and sensitive search in MEDLINE, EMBASE, and the Cochrane Library was performed. We selected articles including: (1) adult patients with Behçet's and uveitis; (2) on biological therapies; (3) placebo or active control with CsA or AZA; (4) analyzing efficacy (number of uveitis flares, macular edema, etc.) and/or safety outcomes. Meta-analyses, systematic reviews, clinical trials, and observational studies with > 10 patients were included. The selection, data collection and quality assessment (Oxford scale) was carried out by 2 reviewers independently. Nine articles of moderate quality were included (6 randomized clinical trials and 3 retrospective studies) involving 378 patients. Most of them, apart from the study drugs received systemic corticosteroids and other immunosuppressant drugs. Infliximab was more effective than CsA in reducing short-term uveitis flares and severe complications of retinal vasculitis in the long term. Rituximab was similar to a combination of cytotoxic drugs in improving inflammatory activity. In patients with active uveitis adalimumab was associated with a lower risk of uveitic flare or visual impairment, and in patients with inactive uveitis to a significantly lowered the risk of flare upon corticosteroid withdrawal. Secukinumab and daclizumab were not superior to placebo in reducing uveitis flares, like interferonα compared to other drugs. Our results highlight the need for better designed comparative studies on Behçet's uveitis.
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Síndrome de Behçet/complicações , Produtos Biológicos/uso terapêutico , Imunossupressores/uso terapêutico , Medicamentos Sintéticos/uso terapêutico , Uveíte/tratamento farmacológico , Produtos Biológicos/efeitos adversos , Humanos , Imunossupressores/efeitos adversos , Medicamentos Sintéticos/efeitos adversos , Resultado do Tratamento , Uveíte/etiologiaRESUMO
Toxicity within superoxide dismutase-1 (SOD1)-associated familial amyotrophic lateral sclerosis (ALS) is non-cell autonomous with direct contribution from microglia. Microglia exhibit variable expression of neuroprotective and neurotoxic molecules throughout disease progression. The mechanisms regulating microglial phenotype within ALS are not well understood. This work presents a first study to examine the specific microglial phenotypic response in close association to motor neurons in a naturally occurring disease model of ALS, canine degenerative myelopathy (DM). Microglia closely associated with motor neurons were increased in all stages of DM progression, although only DM Late reached statistical significance. Furthermore, the number of arginase-1 expressing microglia per motor neuron were significantly increased in early stages of DM, whereas the number of inducible nitric oxide synthase (iNOS)-expressing microglia per motor neuron was indistinguishable from aged controls at all stages of disease. Fractalkine, a chemotactic molecule for microglia, was expressed in motor neurons, and the fractalkine receptor was specifically localized to microglia. However, we found no correlation between microglial response and lumbar spinal cord fractalkine levels. Taken together, these data suggest that arginase-1-expressing microglia are recruited to the motor neuron early in DM disease through a fractalkine-independent mechanism.