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1.
Ther Drug Monit ; 2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38648652

RESUMO

BACKGROUND: Tacrolimus is the primary calcineurin inhibitor used in immunosuppressive regimens to prevent allograft rejection (AR) after organ transplantation. Recent studies have linked intrapatient variability (IPV) of tacrolimus with AR occurrence and reduced survival, especially in kidney transplant recipients. However, limited data are available on the impact of tacrolimus IPV on adverse outcomes after liver transplantation (LT). AIMS: The aim of this study was to assess the association between tacrolimus IPV using various methodologies with acute AR and long-term patient survival after LT. METHODS: All patients who underwent LT from January 2010 to July 2021 were retrospectively evaluated. Tacrolimus IPV was calculated for each patient using the mean and SD, mean absolute deviation (MAD), coefficient of variation (CV), and time in therapeutic range (TTR). These measures were then compared with AR within the first 24 months after LT and to long-term survival. RESULTS: Out of 234 patients, 32 (13.7%) developed AR and 183 (78.2%) survived, with a mean follow-up of 101 ± 43 months. Tacrolimus IPV, assessed by mean, SD, MAD, and CV, was 8.3 ± 2.1, 2.7 ± 1.3, 32.0% ± 11.7%, and 39.4% ± 15.4%, respectively. There was no statistically significant correlation between Tacrolimus IPV and AR or survival post-LT. CONCLUSIONS: In a large cohort of patients from diverse racial backgrounds, tacrolimus IPV was not associated with clinically relevant outcomes such as AR and survival after LT.

2.
J Public Health Manag Pract ; 30(1): 89-98, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37350621

RESUMO

OBJECTIVE: To assess the impact of a multicomponent intervention in women with cervical dysplasia who were treated with loop electrosurgical excision procedure (LEEP), as well as the time between colposcopy and treatment. DESIGN: Retrospective cohort study. INTERVENTION: Clinic participation in a multicomponent cervical cancer prevention program that included community outreach, patient in-reach, and navigation, as well as provider capacity building with in-person training and ongoing telementoring through Project ECHO. MAIN OUTCOME MEASURES: Medical records were reviewed to evaluate women with cervical dysplasia undergoing treatment with LEEP within 90 days of colposcopy, as well as time between colposcopy and treatment. Baseline data from year 1 were compared with each subsequent year of implementation. Additional variables examined included patient's age, history of abnormal screening results, and percentage of families living below poverty line based on county of residence, parity, and clinic site. We performed logistic regression and multiple linear regression analyses to assess the programmatic impact in the outcomes of interest by year of program implementation. RESULTS: A total of 290 women were included in the study. The proportion of women undergoing treatment within 90 days of colposcopy increased from 76.2% at baseline to 91.3% in year 3 and 92.9% in year 4 of program implementation. The odds of undergoing treatment within 90 days were 5.11 times higher in year 4 of program implementation than at baseline. The mean time between colposcopy and LEEP decreased from 62 days at baseline to 45 days by year 4 of program implementation. CONCLUSIONS: Implementation of our multicomponent cervical cancer prevention program increased the proportion of women undergoing LEEP within 90 days of colposcopy and decreased the time between colposcopy and LEEP. This program has the potential to support cervical cancer prevention efforts and could be implemented in other low-resource settings.


Assuntos
Lesões Pré-Cancerosas , Displasia do Colo do Útero , Neoplasias do Colo do Útero , Gravidez , Feminino , Humanos , Neoplasias do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/diagnóstico , Estudos Retrospectivos , Texas/epidemiologia , Eletrocirurgia/métodos , Displasia do Colo do Útero/patologia , Displasia do Colo do Útero/cirurgia , Lesões Pré-Cancerosas/cirurgia
3.
JAMA ; 329(20): 1757-1767, 2023 05 23.
Artigo em Inglês | MEDLINE | ID: mdl-37120800

RESUMO

Importance: An intervention model (the Parent-focused Redesign for Encounters, Newborns to Toddlers; the PARENT intervention) for well-child care that integrates a community health worker into preventive care services may enhance early childhood well-child care. Objective: To examine the effectiveness of the PARENT intervention vs usual care for parents with children younger than 2 years of age. Design, Setting, and Participants: A cluster randomized clinical trial was conducted between March 2019 and July 2022. Of the 1283 parents with a child younger than 2 years of age presenting for a well-child visit at 1 of the 10 clinic sites (2 federally qualified health centers in California and Washington) approached for trial participation, 937 were enrolled. Intervention: Five clinics implemented the PARENT intervention, which is a team-based approach to care that uses a community health worker in the role of a coach (ie, health educator) as part of the well-child care team to provide comprehensive preventive services, and 5 clinics provided usual care. Main Outcomes and Measures: There were 2 primary outcomes: score for parent-reported receipt of recommended anticipatory guidance during well-child visits (score range, 0-100) and emergency department (ED) use (proportion with ≥2 ED visits). The secondary outcomes included psychosocial screening, developmental screening, health care use, and parent-reported experiences of care. Results: Of the 937 parents who were enrolled, 914 remained eligible to participate (n = 438 in the intervention group and n = 476 in the usual care group; 95% were mothers, 73% reported Latino ethnicity, and 63% reported an annual income <$30 000). The majority (855/914; 94%) of the children (mean age, 4.4 months at parental enrollment) were insured by Medicaid. Of the 914 parents who remained eligible and enrolled, 785 (86%) completed the 12-month follow-up interview. Parents of children treated at the intervention clinics (n = 375) reported receiving more anticipatory guidance than the parents of children treated at the usual care clinics (n = 407) (mean score, 73.9 [SD, 23.4] vs 63.3 [SD, 27.8], respectively; adjusted absolute difference, 11.01 [95% CI, 6.44 to 15.59]). There was no difference in ED use (proportion with ≥2 ED visits) between the intervention group (n = 376) and the usual care group (n = 407) (37.2% vs 36.1%, respectively; adjusted absolute difference, 1.2% [95% CI, -5.5% to 8.0%]). The effects of the intervention on the secondary outcomes included a higher amount of psychosocial assessments performed, a greater number of parents who had developmental or behavioral concerns elicited and addressed, increased attendance at well-child visits, and greater parental experiences with the care received (helpfulness of care). Conclusions and Relevance: The intervention resulted in improvements in the receipt of preventive care services vs usual care for children insured by Medicaid by incorporating community health workers in a team-based approach to early childhood well-child care. Trial Registration: ClinicalTrials.gov Identifier: NCT03797898.


Assuntos
Cuidado da Criança , Saúde da Criança , Agentes Comunitários de Saúde , Medicaid , Feminino , Humanos , Lactente , Recém-Nascido , Mães , Estados Unidos , Medicina Preventiva , Renda , Hispânico ou Latino , Equipe de Assistência ao Paciente
4.
Fetal Pediatr Pathol ; 42(1): 149-155, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35535954

RESUMO

Background: Lipofibromatosis is a relatively new entity, considered in the differential diagnosis of soft tissue tumors in children, involving mainly the extremities. Most cases can be completely resected without recurrence. Atypical forms have been described and their highly infiltrative capability can lead to severe clinical impairment. Case report: We report an infant with rapidly growing posterior cervicothoracic tumor, extending from the bulbo-medullary junction to T6 vertebra, leading to loss of spontaneous breathing, quadriparesis and devastating long-term consequences. Spinal tomography scan at 35 days suggested myelomeningocele. Prenatal and early postnatal ultrasounds were reviewed and no central nervous system involvement or fusion defects were present. Magnetic resonance at 40 days showed infiltrative mass, later confirmed by pathology as lipofibromatosis. Two resections failed to completely remove the tumor. Discussion: Lipofibromatosis can involve critical structures in the central nervous system and is difficult to treat surgically in those circumstances.


Assuntos
Fibroma , Lipoma , Neoplasias de Tecidos Moles , Lactente , Criança , Gravidez , Feminino , Humanos , Lipoma/diagnóstico , Lipoma/patologia , Neoplasias de Tecidos Moles/diagnóstico , Imageamento por Ressonância Magnética/métodos , Extremidades/patologia , Fibroma/diagnóstico , Sistema Nervoso/patologia
5.
Emerg Infect Dis ; 28(13): S197-S202, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36502392

RESUMO

Annually, ≈30,000 Hasidic and Orthodox Jews travel to Uman, Ukraine, during the Jewish New Year to pray at the burial place of the founder of the Breslov Hasidic movement. Many pilgrims come from the northeastern United States. The global health implications of this event were seen in 2019 when measles outbreaks in the United States and Israel were linked to the pilgrimage. The 2020 pilgrimage was cancelled as part of the COVID-19 travel restrictions imposed by the government of Ukraine. To prepare for the 2021 event, the National Public Health Institute, the Public Health Center of Ukraine, organized mitigation measures for pilgrims arriving in Uman, and the CDC COVID-19 International Task Force assisted with mitigation measures for pilgrims coming from the United States. We describe efforts to support COVID-19 mitigation measures before, during, and after this mass gathering and lessons learned for future mass gatherings during pandemics.


Assuntos
COVID-19 , Estados Unidos , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Eventos de Massa , Pandemias/prevenção & controle , Viagem , Surtos de Doenças
6.
Salud Publica Mex ; 64(5, sept-oct): 530-538, 2022 Aug 26.
Artigo em Espanhol | MEDLINE | ID: mdl-36130340

RESUMO

OBJETIVO: Proporcionar recomendaciones para la detección temprana de pacientes con alto riesgo de desarrollar cáncer de pulmón (CP) en el primer nivel de atención y su referencia oportuna. Material y métodos. Se realizó una búsqueda detallada de la evidencia científica disponible para responder las preguntas de investigación clínica y se utilizó el Panel Delphi modificado para lograr un consenso entre expertos. RESULTADOS: Se generaron 14 recomendaciones siguiendo los estándares de una GPC. Conclusión. El CP representa un problema de salud pública en México; por ello, esta guía establece recomendaciones que apoyan la toma de decisiones sobre la detección precoz y la referencia de pacientes con sospecha de CP en el primer nivel de atención.


Assuntos
Detecção Precoce de Câncer , Neoplasias Pulmonares , Humanos , México , Encaminhamento e Consulta , Estudos Retrospectivos
7.
Int J Mol Sci ; 23(14)2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35887127

RESUMO

The IgM and IgT classes were previously identified and characterized in the Antarctic teleost Trematomus bernacchii, a species belonging to the Perciform suborder Notothenoidei. Herein, we characterized the gene encoding the polymeric immunoglobulin receptor (pIgR) in the same species and compared it to the pIgR of multiple teleost species belonging to five perciform suborders, including 11 Antarctic and 1 non-Antarctic (Cottoperca gobio) notothenioid species, the latter living in the less-cold peri-Antarctic sea. Antarctic pIgR genes displayed particularly long introns marked by sites of transposable elements and transcription factors. Furthermore, analysis of T. bernacchii pIgR cDNA unveiled multiple amino acid substitutions unique to the Antarctic species, all introducing adaptive features, including N-glycosylation sequons. Interestingly, C. gobio shared most features with the other perciforms rather than with the cold-adapted relatives. T. bernacchii pIgR transcripts were predominantly expressed in mucosal tissues, as indicated by q-PCR and in situ hybridization analysis. These results suggest that in cold-adapted species, pIgR preserved its fundamental role in mucosal immune defense, although remarkable gene structure modifications occurred.


Assuntos
Perciformes , Receptores de Imunoglobulina Polimérica , Animais , Regiões Antárticas , DNA Complementar/genética , Perciformes/genética , Filogenia , Receptores de Imunoglobulina Polimérica/genética
8.
Cell Tissue Res ; 384(1): 149-165, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33433686

RESUMO

The CD3 coreceptor is a master T cell surface marker, and genes encoding CD3ζ, γδ, and ε chains have been reported in several teleost fish. Here, a complete cDNA sequence of CD3ɛ chain was identified from a sea bass (Dicentrarchus labrax L.) gill transcriptome. Its basal expression was quantified in both lymphoid and non-lymphoid organs of sea bass juveniles with real-time qPCR analysis. After either in vitro stimulation of head kidney leukocytes with the T-cell mitogen phytohaemagglutinin or in vivo stimulation with an orally administered Vibrio anguillarum vaccine, CD3ε expression levels increased in head kidney leukocytes, confirming that CD3ε T cells may play important roles in fish systemic protection against pathogens. Further, three peptides were designed on the CD3ɛ cytoplasmic tail region and employed as immunogens for antibody production in rabbit. One antiserum so obtained, named RACD3/1, immunostained a band of the expected size in a western blot of a sea bass thymocyte lysate. The distribution of CD3ε+ lymphocyte population in the lymphoid organs and mucosal tissues was addressed in healthy fish by IHC. In decreasing percentage order, CD3ε+ lymphocytes were detected by flow cytometry in thymus, peripheral blood leukocytes, gills, head kidney, gut, and spleen. Finally, a significant in vivo enhancement of CD3ε+ T intestinal lymphocytes was found in fish fed on diets in which 100% fish meal was replaced by the microalgae Nannochloropsis sp. biomass. These results indicate that CD3ε+ T cells are involved in nutritional immune responses.


Assuntos
Microalgas/metabolismo , Linfócitos T/metabolismo , Animais , Bass , Suplementos Nutricionais , Peixes
9.
BMC Pediatr ; 21(1): 215, 2021 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-33941130

RESUMO

BACKGROUND: Adiposity status in adolescence is associated with various health outcomes in adulthood. Waist circumference [WC] and waist-to-height ratio [WHtR] are measures of abdominal obesity and have shown to be valid predictors of future chronic diseases. However, the relationship between sociodemographic characteristics and WC, as well as WHtR in U.S. adolescents remain unclear. Thus, the study aims to examine associations between sociodemographic characteristics and abdominal obesity among a nationally representative sample of U.S. adolescents. METHODS: The sample included 4712 adolescents (12-19 years) in the 2007-2016 National Health and Nutrition Examination Survey. Associations between sociodemographic characteristics and abdominal obesity (WC and WHtR) were examined using multiple logistic regression models, adjusted for age, physical activity level, and sedentary activity. RESULTS: Around 18% of adolescents had high-risk WC (≥90th percentile) and 34% had high-risk WHtR (≥0.5). Females had higher odds of high-risk WHtR compared to males (OR = 1.46, 95%CI = 1.23-1.72). Mexican American adolescents had higher odds of high-risk WHtR compared to non-Hispanic White (OR = 1.66, 95%CI = 1.24-2.20), non-Hispanic Black (OR = 1.73, 95%CI = 1.26-2.36), and other race/multi-racial adolescents (OR = 1.84, 95%CI = 1.21-2.80). When their parent were college graduates, adolescents had lower odds for high-risk WC compared to when the parent had some college education (OR = 0.68, 95%CI = 0.49-0.93) or a high school degree or less (OR = 0.70, 95%CI = 0.51-0.97). Similar associations were seen between parental education level and high-risk WHtR, as well as between household income and high-risk WHtR. CONCLUSIONS: Measures of abdominal obesity should be considered to assess burden of adiposity, especially among female adolescents, adolescents from racial/ethnic minority and low socioeconomic status backgrounds. Additionally, future health interventions should consider including changes in WC and WHtR to measure the impact of these interventions.


Assuntos
Etnicidade , Obesidade Abdominal , Adolescente , Adulto , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Grupos Minoritários , Inquéritos Nutricionais , Obesidade Abdominal/diagnóstico , Obesidade Abdominal/epidemiologia , Prevalência , Fatores de Risco , Circunferência da Cintura
10.
Int J Mol Sci ; 22(7)2021 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-33806063

RESUMO

In jawed vertebrates, adaptive immune responses are enabled by T cells. Two lineages were characterized based on their T cell receptor (TcR) heterodimers, namely αß or γδ peptide chains, which display an Ig domain-type sequence that is somatically rearranged. γδ T cells have been less extensively characterized than αß and teleost fish, in particular, suffer from a severe scarcity of data. In this paper, we worked on the well-known model, the European sea bass Dicentrarchus labrax, to broaden the understanding of teleost γδ-T cells. The T cell receptor chain (TR) γ transcript was expressed at a later developmental stage than TRß, suggesting a layered appearance of fish immune cells, and the thymus displayed statistically-significant higher mRNA levels than any other organ or lymphoid tissue investigated. The polyclonal antibody developed against the TRγ allowed the localization of TRγ-expressing cells in lymphoid organs along the ontogeny. Cell positivity was investigated through flow cytometry and the highest percentage was found in peripheral blood leukocytes, followed by thymus, gut, gills, spleen and head kidney. Numerous TRγ-expressing cells were localized in the gut mucosa, and the immunogold labelling revealed ultrastructural features that are typical of T cells. At last, microalgae-based diet formulations significantly modulated the abundance of TRγ+ cells in the posterior intestine, hinting at a putative involvement in nutritional immunity. From a comparative immunological perspective, our results contribute to the comprehension of the diversity and functionalities of γδ T cells during the development of a commercially relevant marine teleost model.


Assuntos
Imunidade Adaptativa , Bass/genética , Linfócitos Intraepiteliais/citologia , Receptores de Antígenos de Linfócitos T/genética , Ração Animal , Animais , Bass/imunologia , Linhagem da Célula , Ensaio de Imunoadsorção Enzimática , Sistema Imunitário/imunologia , Imunoglobulina G , Leucócitos/citologia , Tecido Linfoide , Microalgas , Multimerização Proteica , Receptores de Antígenos de Linfócitos T/imunologia , Timo/imunologia , Distribuição Tecidual
11.
J Hepatol ; 73(2): 328-341, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32240714

RESUMO

BACKGROUND & AIMS: Hepatoblastoma (HB) is a rare disease. Nevertheless, it is the predominant pediatric liver cancer, with limited therapeutic options for patients with aggressive tumors. Herein, we aimed to uncover the mechanisms of HB pathobiology and to identify new biomarkers and therapeutic targets in a move towards precision medicine for patients with advanced HB. METHODS: We performed a comprehensive genomic, transcriptomic and epigenomic characterization of 159 clinically annotated samples from 113 patients with HB, using high-throughput technologies. RESULTS: We discovered a widespread epigenetic footprint of HB that includes hyperediting of the tumor suppressor BLCAP concomitant with a genome-wide dysregulation of RNA editing and the overexpression of mainly non-coding genes of the oncogenic 14q32 DLK1-DIO3 locus. By unsupervised analysis, we identified 2 epigenomic clusters (Epi-CA, Epi-CB) with distinct degrees of DNA hypomethylation and CpG island hypermethylation that are associated with the C1/C2/C2B transcriptomic subtypes. Based on these findings, we defined the first molecular risk stratification of HB (MRS-HB), which encompasses 3 main prognostic categories and improves the current clinical risk stratification approach. The MRS-3 category (28%), defined by strong 14q32 locus expression and Epi-CB methylation features, was characterized by CTNNB1 and NFE2L2 mutations, a progenitor-like phenotype and clinical aggressiveness. Finally, we identified choline kinase alpha as a promising therapeutic target for intermediate and high-risk HBs, as its inhibition in HB cell lines and patient-derived xenografts strongly abrogated tumor growth. CONCLUSIONS: These findings provide a detailed insight into the molecular features of HB and could be used to improve current clinical stratification approaches and to develop treatments for patients with HB. LAY SUMMARY: Hepatoblastoma is a rare childhood liver cancer that has been understudied. We have used cutting-edge technologies to expand our molecular knowledge of this cancer. Our biological findings can be used to improve clinical management and pave the way for the development of novel therapies for this cancer.


Assuntos
Colina Quinase , Hepatoblastoma , Neoplasias Hepáticas , beta Catenina/genética , Biomarcadores Tumorais/análise , Proteínas de Ligação ao Cálcio/genética , Colina Quinase/antagonistas & inibidores , Colina Quinase/metabolismo , Metilação de DNA , Descoberta de Drogas/métodos , Epigênese Genética , Feminino , Perfilação da Expressão Gênica , Hepatoblastoma/genética , Hepatoblastoma/metabolismo , Hepatoblastoma/mortalidade , Hepatoblastoma/patologia , Ensaios de Triagem em Larga Escala , Humanos , Lactente , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Proteínas de Membrana/genética , Proteínas de Neoplasias/genética , Prognóstico , Medição de Risco/métodos
12.
FASEB J ; 32(7): 3878-3891, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29465313

RESUMO

CD5-like (CD5L) is a soluble scavenger cysteine-rich protein that modulates inflammatory responses. We studied the involvement of CD5L in liver cancer. Immunohistochemistry (IHC) of CD5L in 60 hepatocellular carcinomas and 34 adjacent nontumor livers, showed that CD5L staining was higher in tumor than in nontumor tissue (Mann-Whitney test; P = 0.0039). High CD5L correlated with elevated proliferation (Ki67, linear regression; P < 0.0001) and lower patient event-free survival (log-rank; P = 0.0185). Accordingly, CD5L expression was detected in the liver cancer cell lines Huh7, HepG2, and SNU-398. In vitro technologies using these cell lines, including small interfering RNA (siRNA) and cDNA transfection, showed that CD5L promoted colony formation and cell proliferation and protected against cisplatin-induced apoptosis. To find a molecular explanation for these roles, novel CD5L-interacting protein ligands in liver cancer cells were identified by immunoprecipitation followed by mass spectrometry. Among these, the molecular chaperone of the unfolded protein response (UPR), heat shock protein (HSP)-A5, was selected for validation. The interaction was confirmed by confocal microscopy in the Huh7 and HepG2 cell lines. Furthermore, functional experiments revealed that CD5L activates the UPR and autophagy mechanisms in Huh7 cells, thereby providing a novel molecular link between the UPR and autophagy in liver cancer.-Aran, G., Sanjurjo, L., Bárcena, C., Simon-Coma, M., Téllez, É., Vázquez-Vitali, M., Garrido, M., Guerra, L., Díaz, E., Ojanguren, I., Elortza, F., Planas, R., Sala, M., Armengol, C., Sarrias, M.-R. CD5L is upregulated in hepatocellular carcinoma and promotes liver cancer cell proliferation and antiapoptotic responses by binding to HSPA5 (GRP78).


Assuntos
Apoptose , Carcinoma Hepatocelular/metabolismo , Proliferação de Células , Neoplasias Hepáticas/metabolismo , Receptores Depuradores Classe B/metabolismo , Idoso , Idoso de 80 Anos ou mais , Proteínas Reguladoras de Apoptose , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/patologia , Chaperona BiP do Retículo Endoplasmático , Feminino , Proteínas de Choque Térmico/metabolismo , Células Hep G2 , Humanos , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Ligação Proteica , Receptores Depuradores , Receptores Depuradores Classe B/genética , Resposta a Proteínas não Dobradas , Regulação para Cima
13.
Gynecol Oncol ; 154(3): 558-564, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288949

RESUMO

OBJECTIVE: Cervical cancer rates in the United States have declined since the 1940's, however, cervical cancer incidence remains elevated in medically-underserved areas, especially in the Rio Grande Valley (RGV) along the Texas-Mexico border. High-resolution microendoscopy (HRME) is a low-cost, in vivo imaging technique that can identify high-grade precancerous cervical lesions (CIN2+) at the point-of-care. The goal of this study was to evaluate the performance of HRME in medically-underserved areas in Texas, comparing results to a tertiary academic medical center. METHODS: HRME was evaluated in five different outpatient clinical settings, two in Houston and three in the RGV, with medical providers of varying skill and training. Colposcopy, followed by HRME imaging, was performed on eligible women. The sensitivity and specificity of traditional colposcopy and colposcopy followed by HRME to detect CIN2+ were compared and HRME image quality was evaluated. RESULTS: 174 women (227 cervical sites) were included in the final analysis, with 12% (11% of cervical sites) diagnosed with CIN2+ on histopathology. On a per-site basis, a colposcopic impression of low-grade precancer or greater had a sensitivity of 84% and a specificity of 45% to detect CIN2+. While there was no significant difference in sensitivity (76%, p = 0.62), the specificity when using HRME was significantly higher than that of traditional colposcopy (56%, p = 0.01). There was no significant difference in HRME image quality between clinical sites (p = 0.77) or medical providers (p = 0.33). CONCLUSIONS: HRME imaging increased the specificity for detecting CIN2+ when compared to traditional colposcopy. HRME image quality remained consistent across different clinical settings.


Assuntos
Colonoscopia/economia , Colonoscopia/métodos , Área Carente de Assistência Médica , Lesões Pré-Cancerosas/diagnóstico por imagem , Neoplasias do Colo do Útero/diagnóstico por imagem , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Gradação de Tumores , Lesões Pré-Cancerosas/economia , Estudos Prospectivos , Sensibilidade e Especificidade , Texas , Estados Unidos , Neoplasias do Colo do Útero/patologia , Displasia do Colo do Útero/diagnóstico por imagem , Displasia do Colo do Útero/economia
14.
Fish Shellfish Immunol ; 85: 78-84, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29175472

RESUMO

This review summarizes the available knowledge on the immune defences of European sea bass against antigenic preparations derived from the viral encephalopathy and retinopathy virus (betanodavirus), which represents a major threat to the health of this fish species. The nodavirus is widely present and differentiates into several strains that infect invertebrates (in insects, alphanodavirus) and teleost fish, and thus may represent a great problem for farmed fish species. Many efforts have been directed to discovering new immunizations to induce protection in sea bass, especially at young stages, and these efforts have included employing diverse betanodavirus strains, antigen preparation, vaccination routes, and the addition of adjuvants and/or immunostimulants. The obtained results showed that inactivated preparations of betanodavirus that were administered intraperitoneally may induce both immune recognition and protection. Attempts at performing mucosal immunization by immersion and/or oral administration, which is a vaccination route that is highly preferred for sea bass, have shown intriguing results, and more studies are necessary for its improvement. Overall, the objective of identifying a reliable vaccine that also cross-protects against different genotypes or reassortant viruses for use in European sea bass against betanodavirus appears to be an attainable goal in the near future.


Assuntos
Bass , Doenças dos Peixes/prevenção & controle , Imunidade Inata , Imunidade nas Mucosas , Nodaviridae/imunologia , Infecções por Vírus de RNA/veterinária , Vacinação/veterinária , Animais , Doenças dos Peixes/imunologia , Doenças dos Peixes/virologia , Infecções por Vírus de RNA/imunologia , Infecções por Vírus de RNA/prevenção & controle , Infecções por Vírus de RNA/virologia
15.
Mar Drugs ; 17(11)2019 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-31752287

RESUMO

Plocabulin is a novel microtubule-disrupting antitumor agent of marine origin that is currently undergoing phase II clinical trials. Plocabulin has potent antiproliferative and antiangiogenic actions in carcinoma cell lines and has antitumor activity in xenografted mice. Here, we used three-dimensional (3D) tumor organoids derived from three colorectal cancer (CRC) patients to study the effect of plocabulin in a personalized assay system that ensures dose dependence and high reproducibility. The cytotoxicity of plocabulin was an order of magnitude higher than that of the active irinotecan derivative SN38 (7-ethyl-10-hydroxy-camptothecin) in tumor organoids at different passages. Moreover, plocabulin maintained its strong cytotoxic activity in wash-out experiments, in which a short pulse treatment of tumor organoids was as efficient as continuous treatment. Our data show that plocabulin has a very potent cytotoxic action in CRC patient-derived tumor organoids, supporting ongoing clinical trials with plocabulin and the use of organoid assays to provide personalized validation of antitumor drugs.


Assuntos
Antineoplásicos/farmacologia , Neoplasias Colorretais/tratamento farmacológico , Policetídeos/farmacologia , Pironas/farmacologia , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/administração & dosagem , Neoplasias Colorretais/patologia , Relação Dose-Resposta a Droga , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Irinotecano/farmacologia , Masculino , Organoides/efeitos dos fármacos , Organoides/patologia , Policetídeos/administração & dosagem , Medicina de Precisão , Pironas/administração & dosagem , Reprodutibilidade dos Testes
16.
Hum Mol Genet ; 25(19): 4157-4169, 2016 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-27466199

RESUMO

Disrupted in Schizophrenia-1 (DISC1) has been associated with a broad spectrum of mental disorders. DISC1 is a multi-compartmentalized protein found in the cytoplasm, centrosome, nuclei and mostly enriched in mitochondria. In order to shed light on DISC1 mitochondrial function, we have studied its topology within the organelle. We show in here that in mammals DISC1 resides in the 'Mitochondrial contact site and Cristae Organizing system' (MICOS) complex, involved in cristae organization. DISC1 knockdown in SH-SY5Y cells causes MICOS disassembly and fragmentation of the mitochondrial morphology network. Moreover, DISC1 depleted cells have decreased mitochondrial DNA (mtDNA) content and steady state levels of oxidative phosphorylation (OXPHOS) subunits. As a consequence, OXPHOS complexes and supercomplexes are partially disassembled in DISC1 knockdown cells, which suffer severe bioenergetic defects, evidenced by impaired oxygen consumption, adenosine triphosphate synthesis and mitochondrial membrane potential. Transfection of recombinant full-length human DISC1 restores MICOS complex assembly and rescues OXPHOS function, meanwhile overexpression of the DISC1 truncated form Δ597-854, known to be pathogenic, fails to rescue the bioenergetic impairment caused by DISC1 knockdown. These results should contribute to reveal DISC1 physiological function and potential pathogenic role in severe mental illnesses.


Assuntos
Metabolismo Energético/genética , Proteínas do Tecido Nervoso/genética , Fosforilação Oxidativa , Esquizofrenia/genética , Linhagem Celular , Centrossomo/metabolismo , DNA Mitocondrial/genética , Regulação da Expressão Gênica , Técnicas de Silenciamento de Genes , Humanos , Potencial da Membrana Mitocondrial/genética , Mitocôndrias/genética , Mitocôndrias/metabolismo , Complexos Multiproteicos/genética , Proteínas do Tecido Nervoso/biossíntese , Esquizofrenia/metabolismo , Esquizofrenia/patologia , Transfecção
17.
BMC Mol Biol ; 18(1): 8, 2017 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-28298204

RESUMO

BACKGROUND: Immunoglobulins (Igs) are fundamental components of the adaptive immune system of vertebrates, with the IgT/IgZ isotype specific of Teleosts. In this paper we describe the identification of an IgT heavy chain from the European sea bass (Dicentrarchus labrax L.), its molecular characterization and tissue mRNA localization by in situ hybridization. RESULTS: Sea bass IgT consists of 552 aa (Accession Number KM410929) and it contains a putative 19 amino acids long signal peptide and one potential N-glycosylation site. The C-region consists of four CH domains; each contains the cysteine and tryptophan residues required for their correct folding. Based on the recent sequencing of sea bass genome, we have identified five different genomic contigs bearing exons unequivocally pertaining to IgT (CH2, CH3 and CH4), but none corresponded to a complete IgH locus as IgT sequences were found in the highly fragmented assembled genomic regions which could not be assigned to any major scaffold. The 3D structure of sea bass IgT has been modelled using the crystal structure of a mouse Ig gamma as a template, thus showing that the amino acid sequence is suitable for the expected topology referred to an immunoglobulin-like architecture. The basal expression of sea bass IgT and IgM in different organs has been analysed: gut and gills, important mucosal organs, showed high IgT transcripts levels and this was the first indication of the possible involvement of sea bass IgT in mucosal immune responses. Moreover, sea bass IgT expression increased in gills and spleen after infection with nodavirus, highlighting the importance of IgT in sea bass immune responses. In situ hybridization confirmed the presence of IgT transcripts in the gut and it revealed a differential expression along the intestinal tract, with a major expression in the posterior intestine, suggesting the hindgut as a site for the recruitment of IgT+ cells in this species. IgT transcripts were also found in gill filaments and parallel lamellae and, for the first time, we identified scattered IgT positive cells in the liver, with a strong signal in the hepatic parenchyma. CONCLUSIONS: In conclusion, we performed a full molecular characterization of IgT in sea bass that points out its possible involvement in mucosal immune responses of this species.


Assuntos
Bass/imunologia , Bass/virologia , Doenças dos Peixes/imunologia , Proteínas de Peixes/imunologia , Imunoglobulinas/imunologia , Nodaviridae/imunologia , Infecções por Vírus de RNA/veterinária , Sequência de Aminoácidos , Animais , Bass/genética , Clonagem Molecular , Doenças dos Peixes/genética , Doenças dos Peixes/virologia , Proteínas de Peixes/química , Proteínas de Peixes/genética , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Imunidade nas Mucosas , Imunoglobulinas/química , Imunoglobulinas/genética , Modelos Moleculares , Filogenia , Infecções por Vírus de RNA/genética , Infecções por Vírus de RNA/imunologia , Infecções por Vírus de RNA/virologia , Alinhamento de Sequência
18.
J Community Health ; 41(2): 334-9, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26463082

RESUMO

The purpose of this study was to determine the rate of glove changing by mobile food vendors after monetary transactions, and the presence of bacterial contamination on a sample of dollar bills obtained from 25 food vendors near five hospitals in Manhattan, New York City. During 495 monetary transactions observed there were only seven glove changes performed by the workers. Eleven of 34 food workers wore no gloves at all while handling money and food. Nineteen of 25 one-dollar bills collected (76 %) had 400 to 42,000 total bacterial colony-forming units. Colonies were of varied morphology and size. Of these 19 samples, 13 were selected (based on level of growth), and tested for the presence of coliform bacteria, which was found in 10 of the 13 samples. Effective strategies to monitor and increase glove wearing and changing habits of mobile food vendors are needed to reduce risk of foodborne illness.


Assuntos
Serviços de Alimentação , Doenças Transmitidas por Alimentos/prevenção & controle , Luvas Protetoras , Cidade de Nova Iorque
19.
J Insect Sci ; 162016.
Artigo em Inglês | MEDLINE | ID: mdl-26798144

RESUMO

Using a serotonin antibody and confocal microscopy, this study reports for the first time direct serotonergic innervation of the muscle sheath covering the secretory region of the salivary glands of adult tsetse fly, Glossina pallidipes Austen. Reports to date, however, note that up until this finding, dipteran species previously studied lack a muscle sheath covering of the secretory region of the salivary glands. Direct innervation of the salivary gland muscle sheath of tsetse would facilitate rapid deployment of saliva into the host, thus delaying a host response. Our results also suggest that the neuronal and abnormal pattern seen in viral infected glands by the Glossina pallidipes salivary gland hypertrophy virus (GpSGHV) is due to a compensatory increased branching of the neurons of the salivary glands, which is associated with the increased size of the salivary glands in viral infected flies. This study shows for the first time serotonin in the cell bodies of the brain and thoracico-abdominal ganglion in adult tsetse, G. pallidipes Austen (Diptera: Glossinidae). A hypothesis is proposed as to whether innervation of the muscle sheath covering of the secretory region of the salivary glands is present in brachyceran compared with nematoceran dipterans; and, a plea is made that more research is needed to develop a blood feeding model, similar to that in the blow flies, for elucidating the various mechanisms involved in production and deployment of saliva.


Assuntos
Sistema Nervoso Central/ultraestrutura , Vírus de Insetos/fisiologia , Glândulas Salivares/inervação , Moscas Tsé-Tsé/ultraestrutura , Animais , Encéfalo/ultraestrutura , Encéfalo/virologia , Sistema Nervoso Central/virologia , Feminino , Masculino , Microscopia , Glândulas Salivares/ultraestrutura , Glândulas Salivares/virologia , Moscas Tsé-Tsé/virologia
20.
J Community Health ; 40(4): 699-701, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25559110

RESUMO

The aim of this study was to determine how often mobile food cart vendors in New York City (NYC) changed gloves after exchanging money, which is required by the current NYC health code as one of various measures to prevent foodborne illness. A total of 100 carts (10 carts in 10 zones) throughout Manhattan were observed. In the majority (56.9%, n = 1,026) of the 1,804 money exchanges, food cart vendors did not change their gloves. Not changing gloves after exchanging money was widespread regardless of food type served (46.6% for breakfast to 63.7% for lunch), and across all 10 zones. Not changing gloves after touching money may result in indirect transmission of agents of disease and pose health risks for consumers.


Assuntos
Serviços de Alimentação/estatística & dados numéricos , Luvas Protetoras/estatística & dados numéricos , Controle de Infecções/métodos , Controle de Infecções/estatística & dados numéricos , Estudos Transversais , Humanos , Cidade de Nova Iorque
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