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1.
bioRxiv ; 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38979180

RESUMO

Dietary restriction slows aging in many animals, while in some cases the sensory signals from diet alone are sufficient to retard or accelerate lifespan. The digestive tract is a candidate location to sense nutrients, where neuropeptides secreted by enteroendocrine cells (EEC) produce systemic signals in response to food. Here we measure how Drosophila neuropeptide F (NPF) is secreted into adult circulation by enteroendocrine cells and find that specific enteroendocrine cells differentially respond to dietary sugar and yeast. Lifespan is increased when gut NPF is genetically depleted, and this manipulation is sufficient to blunt the longevity benefit conferred by dietary restriction. Depletion of NPF receptors at insulin producing neurons of the brain also increases lifespan, consistent with observations where loss of gut NPF decreases neuronal insulin secretion. The longevity conferred by repressing gut NPF and brain NPF receptors is reversed by treating adults with a juvenile hormone (JH) analog. JH is produced by the adult corpora allata , and inhibition of the insulin receptor at this tissue decreases JH titer and extends lifespan, while this longevity is restored to wild type by treating adults with a JH analog. Overall, enteroendocrine cells of the gut modulate Drosophila aging through interorgan communication mediated by a gut- brain- corpora allata axis, and insulin produced in the brain impacts lifespan through its control of JH titer. These data suggest that we should consider how human incretins and their analogs, which are used to treat obesity and diabetes, may impact aging. Significance Statement: Neuropeptide F (NPF) produced in the Drosophila gut is an insulin-regulatory hormone (incretin) that is secreted into adult circulation in response to feeding and diet. Suppression of gut NPF extends Drosophila longevity, as does knockdown of Neuropeptide F receptors at the insulin-producing medial neurosecretory cells in the brain that control the titer of juvenile hormone. Gut hormones and brain insulin regulate lifespan because they control juvenile hormone titer, which itself is the master endocrine regulator of Drosophila aging. Gut NPF modulates Drosophila aging through the integration of nutrient sensing, insulin signaling and juvenile hormone. Given the role of incretin-mimetic drugs to treat diabetes and obesity, it may be time to consider how incretin analogs could impact human aging.

3.
Artigo em Inglês | MEDLINE | ID: mdl-38865700

RESUMO

In recent years, polysaccharides have emerged as a promising alternative for the development of environmentally friendly materials. Polysaccharide-based materials have been mainly studied for applications in the food, packaging, and biomedical industries. However, many investigations report processing routes and treatments that enable the modification of the inherent properties of polysaccharides, making them useful as materials for energy applications. The control of the ionic and electronic conductivities of polysaccharide-based materials allows for the development of solid electrolytes and electrodes. The incorporation of conductive and semiconductive phases can modify the permittivities of polysaccharides, increasing their capacity for charge storage, making them useful as active surfaces of energy harvesting devices such as triboelectric nanogenerators. Polysaccharides are inexpensive and abundant and could be considered as a suitable option for the development and improvement of energy devices. This review provides an overview of the main research work related to the use of both common commercially available polysaccharides and local native polysaccharides, including starch, chitosan, carrageenan, ulvan, agar, and bacterial cellulose. Solid and gel electrolytes derived from polysaccharides show a wide range of ionic conductivities from 0.0173 × 10-3 to 80.9 × 10-3 S cm-1. Electrodes made from polysaccharides show good specific capacitances ranging from 8 to 753 F g-1 and current densities from 0.05 to 5 A g-1. Active surfaces based on polysaccharides show promising results with power densities ranging from 0.15 to 16 100 mW m-2. These investigations suggest that in the future polysaccharides could become suitable materials to replace some synthetic polymers used in the fabrication of energy storage devices, including batteries, supercapacitors, and energy harvesting devices.

5.
JAMA ; 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38873723

RESUMO

Importance: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors improve outcomes in patients with type 2 diabetes, heart failure, and chronic kidney disease, but their effect on outcomes of critically ill patients with organ failure is unknown. Objective: To determine whether the addition of dapagliflozin, an SGLT-2 inhibitor, to standard intensive care unit (ICU) care improves outcomes in a critically ill population with acute organ dysfunction. Design, Setting, and Participants: Multicenter, randomized, open-label, clinical trial conducted at 22 ICUs in Brazil. Participants with unplanned ICU admission and presenting with at least 1 organ dysfunction (respiratory, cardiovascular, or kidney) were enrolled between November 22, 2022, and August 30, 2023, with follow-up through September 27, 2023. Intervention: Participants were randomized to 10 mg of dapagliflozin (intervention, n = 248) plus standard care or to standard care alone (control, n = 259) for up to 14 days or until ICU discharge, whichever occurred first. Main Outcomes and Measures: The primary outcome was a hierarchical composite of hospital mortality, initiation of kidney replacement therapy, and ICU length of stay through 28 days, analyzed using the win ratio method. Secondary outcomes included the individual components of the hierarchical outcome, duration of organ support-free days, ICU, and hospital stay, assessed using bayesian regression models. Results: Among 507 randomized participants (mean age, 63.9 [SD, 15] years; 46.9%, women), 39.6% had an ICU admission due to suspected infection. The median time from ICU admission to randomization was 1 day (IQR, 0-1). The win ratio for dapagliflozin for the primary outcome was 1.01 (95% CI, 0.90 to 1.13; P = .89). Among all secondary outcomes, the highest probability of benefit found was 0.90 for dapagliflozin regarding use of kidney replacement therapy among 27 patients (10.9%) in the dapagliflozin group vs 39 (15.1%) in the control group. Conclusion and Relevance: The addition of dapagliflozin to standard care for critically ill patients and acute organ dysfunction did not improve clinical outcomes; however, confidence intervals were wide and could not exclude relevant benefits or harms for dapagliflozin. Trial Registration: ClinicalTrials.gov Identifier: NCT05558098.

6.
Cardiovasc Diabetol ; 23(1): 221, 2024 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-38926835

RESUMO

BACKGROUND: The incidence of myocardial infarction (MI) and sudden cardiac death (SCD) is significantly higher in individuals with Type 2 Diabetes Mellitus (T2DM) than in the general population. Strategies for the prevention of fatal arrhythmias are often insufficient, highlighting the need for additional non-invasive diagnostic tools. The T-wave heterogeneity (TWH) index measures variations in ventricular repolarization and has emerged as a promising predictor for severe ventricular arrhythmias. Although the EMPA-REG trial reported reduced cardiovascular mortality with empagliflozin, the underlying mechanisms remain unclear. This study investigates the potential of empagliflozin in mitigating cardiac electrical instability in patients with T2DM and coronary heart disease (CHD) by examining changes in TWH. METHODS: Participants were adult outpatients with T2DM and CHD who exhibited TWH > 80 µV at baseline. They received a 25 mg daily dose of empagliflozin and were evaluated clinically including electrocardiogram (ECG) measurements at baseline and after 4 weeks. TWH was computed from leads V4, V5, and V6 using a validated technique. The primary study outcome was a significant (p < 0.05) change in TWH following empagliflozin administration. RESULTS: An initial review of 6,000 medical records pinpointed 800 patients for TWH evaluation. Of these, 412 exhibited TWH above 80 µV, with 97 completing clinical assessments and 90 meeting the criteria for high cardiovascular risk enrollment. Empagliflozin adherence exceeded 80%, resulting in notable reductions in blood pressure without affecting heart rate. Side effects were generally mild, with 13.3% experiencing Level 1 hypoglycemia, alongside infrequent urinary and genital infections. The treatment consistently reduced mean TWH from 116 to 103 µV (p = 0.01). CONCLUSIONS: The EMPATHY-HEART trial preliminarily suggests that empagliflozin decreases heterogeneity in ventricular repolarization among patients with T2DM and CHD. This reduction in TWH may provide insight into the mechanism behind the decreased cardiovascular mortality observed in previous trials, potentially offering a therapeutic pathway to mitigate the risk of severe arrhythmias in this population. TRIAL REGISTRATION: NCT: 04117763.


Assuntos
Compostos Benzidrílicos , Diabetes Mellitus Tipo 2 , Glucosídeos , Inibidores do Transportador 2 de Sódio-Glicose , Humanos , Compostos Benzidrílicos/uso terapêutico , Compostos Benzidrílicos/efeitos adversos , Glucosídeos/uso terapêutico , Glucosídeos/efeitos adversos , Masculino , Feminino , Pessoa de Meia-Idade , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Inibidores do Transportador 2 de Sódio-Glicose/efeitos adversos , Idoso , Diabetes Mellitus Tipo 2/mortalidade , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/fisiopatologia , Resultado do Tratamento , Fatores de Tempo , Potenciais de Ação/efeitos dos fármacos , Arritmias Cardíacas/mortalidade , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/fisiopatologia , Frequência Cardíaca/efeitos dos fármacos , Doença das Coronárias/mortalidade , Doença das Coronárias/fisiopatologia , Doença das Coronárias/tratamento farmacológico , Doença das Coronárias/diagnóstico , Eletrocardiografia , Fatores de Risco
7.
Obes Surg ; 34(7): 2754, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38837021

RESUMO

Gastric bypass surgery is a common and effective procedure for obesity and associated comorbidities. However, long-term complications, such as internal hernias, can pose diagnostic and therapeutic challenges. Internal hernias after gastric bypass are rare but can lead to severe complications, including volvulus and bowel ischemia. Understanding the anatomical variations and employing laparoscopic techniques for resolution are crucial in managing these cases.


Assuntos
Derivação Gástrica , Hérnia Interna , Laparoscopia , Obesidade Mórbida , Humanos , Laparoscopia/métodos , Hérnia Interna/cirurgia , Derivação Gástrica/efeitos adversos , Derivação Gástrica/métodos , Feminino , Obesidade Mórbida/cirurgia , Herniorrafia/métodos , Resultado do Tratamento , Complicações Pós-Operatórias , Adulto
8.
J Dairy Sci ; 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38851567

RESUMO

The aim of this study was to evaluate the effects of different anti-mycotoxin feed additives on the concentration of mycotoxins in milk, urine, and blood plasma of dairy cows fed artificially multi-mycotoxin-contaminated diets. Secondarily, performance, total-tract apparent digestibility of nutrients, and blood parameters were evaluated. Twelve multiparous cows (165 ± 45 d in milk, 557 ± 49 kg body weight, and 32.1 ± 4.57 kg/d milk yield at the start of the experiment) were blocked according to parity, milk yield, and days in milk and used in a 4 × 4 Latin square design experiment with 21-d periods, where the last 7 d were used for sampling and data analysis. Treatments were: 1) Mycotoxin group (MTX), basal diet (BD) without anti-mycotoxin feed additives; 2) Hydrated sodium calcium aluminosilicate (HSCA), HSCA added to the BD at 25g/cow/d; 3) Mycotoxin deactivator 15 (MD15), MD (Mycofix® Plus, dsm-firmenich) added to the BD at 15 g/cow/d; and 4) Mycotoxin deactivator 30 (MD30), MD added to the BD at 30 g/cow/d. Cows from all treatments were challenged with a blend of mycotoxins containing 404 µg aflatoxins B1 (AFB1), 5,025 µg deoxynivalenol (DON), 8,046 µg fumonisins (FUM), 195 µg T2 toxin (T2), and 2,034 µg of zearalenone (ZEN) added daily to the BD during the last 7 d of each period. Neither performance (milk yield and composition) nor nutrient digestibility was affected by treatments. All additives reduced aflatoxin M1 (AFM1) concentration in milk, whereas MD15 and MD30 group had lower excretion of AFM1 in milk than HSCA. DON, FUM, T2, or ZEN were not detected in milk of MD15 and MD30. Concentrations in milk of DON, FUM, T2, and ZEN were similar between MTX and HSCA. Except for AFM1, none of the analyzed mycotoxins were detected in urine of MD30 group. Comparing HSCA to MD treatments, the concentration of AFM1 was greater for HSCA, whereas MD30 was more efficient at reducing AFM1 in urine than MD15. AFM1, DON, FUM, and ZEN were not detected in the plasma of cows fed MD30, and DON was also not detected in MD15 group. Plasma concentration of FUM was lower for MD15, similar plasma FUM concentration was reported for HSCA and MTX. Plasma concentration of ZEN was lower for MD15 than MTX and HSCA. Serum concentrations of haptoglobin and hepatic enzymes were not affected by treatments. Blood concentration of sodium was lower in HSCA compared with MD15 and MD30 groups. In conclusion, the mycotoxin deactivator proved to be effective in reducing the secretion of mycotoxins in milk, urine, and blood plasma, regardless of the dosage. This reduction was achieved without adverse effects on milk production or total-tract digestibility in cows fed multi-mycotoxin-contaminated diets over a short-term period. Greater reductions in mycotoxin secretion were observed with full dose of MD.

9.
Gac Sanit ; 38 Suppl 1: 102378, 2024.
Artigo em Espanhol | MEDLINE | ID: mdl-38806390

RESUMO

Healthcare workers are people who work in health activities, whether or not they have direct contact with citizens. Currently, around 1.3 million people (70% women) work in healthcare activities in Spain. This represents around 10% of the active population, having increased by 33% since 2008, especially the number of women, which has doubled. Healthcare organizations, especially hospitals, are extremely complex workplaces, with precarious working and employment conditions, especially in more hierarchical occupations, exposing healthcare workers to numerous occupational hazards, mainly from ergonomic and psychosocial conditions. These causes frequent musculoskeletal and mental disorders, highlighting burnout, which is estimated at 40% in some services such as intensive care units. This high morbidity is reflected in a high frequency of absences due to illness, around 9% after the pandemic. The pandemic, and its consequences in the last three years, has put extreme pressure on the health system and has clearly shown its deficiencies in relation to working and employment conditions. The hundreds of occupational health professionals, technicians and healthcare workers, who are part of the structures of health organizations, constitute very valuable resources to increase the resilience of the NHS. We recommend the strengthening in resources and institutionally of the occupational health services of health centers and the creation of an Observatory of working, employment and health conditions in the National Health Service, as an instrument for monitoring changes and proposing solutions.


Assuntos
COVID-19 , Pessoal de Saúde , Saúde Ocupacional , Humanos , Pessoal de Saúde/psicologia , Espanha , COVID-19/epidemiologia , Emprego , Feminino , Doenças Profissionais/epidemiologia , Doenças Profissionais/psicologia , Esgotamento Profissional/epidemiologia , Pandemias , Masculino , Local de Trabalho/psicologia , Condições de Trabalho
10.
Chest ; 2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38768777

RESUMO

BACKGROUND: ARDS is a heterogeneous condition with two subphenotypes identified by different methodologies. Our group similarly identified two ARDS subphenotypes using nine routinely available clinical variables. However, whether these are associated with differential response to treatment has yet to be explored. RESEARCH QUESTION: Are there differential responses to positive end-expiratory pressure (PEEP) strategies on 28-day mortality according to subphenotypes in adult patients with ARDS? STUDY DESIGN AND METHODS: We evaluated data from two prior ARDS trials (Higher vs Lower Positive End-Expiratory Pressures in Patients With the ARDS [ALVEOLI] and ARDS Trial [ART]) that compared different PEEP strategies. We classified patients into one of two subphenotypes as described previously. We assessed the differential effect of PEEP with a Bayesian hierarchical logistic model for the primary outcome of 28-day mortality. RESULTS: We analyzed data from 1,559 patients with ARDS. Compared with lower PEEP, a higher PEEP strategy resulted in higher 28-day mortality in patients with subphenotype A disease in the ALVEOLI study (OR, 1.61; 95% credible interval [CrI], 0.90-2.94) and ART (OR, 1.73; 95% CrI, 1.01-2.98), with a probability of harm resulting from higher PEEP in this subphenotype of 94.3% and 97.7% in the ALVEOLI and ART studies, respectively. Higher PEEP was not associated with mortality in patients with subphenotype B disease in each trial (OR, 0.95 [95% CrI, 0.51-1.73] and 1.00 [95% CrI, 0.63-1.55], respectively), with probability of benefit of 56.4% and 50.7% in the ALVEOLI and ART studies, respectively. These effects were not modified by Pao2 to Fio2 ratio, driving pressure, or the severity of illness for the cohorts. INTERPRETATION: We found evidence of differential response to PEEP strategies across two ARDS subphenotypes, suggesting possible harm with a higher PEEP strategy in one subphenotype. These observations may assist with predictive enrichment in future clinical trials.

11.
Intensive Care Med ; 50(6): 813-831, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38771364

RESUMO

PURPOSE: This is the first of three parts of the clinical practice guideline from the European Society of Intensive Care Medicine (ESICM) on resuscitation fluids in adult critically ill patients. This part addresses fluid choice and the other two will separately address fluid amount and fluid removal. METHODS: This guideline was formulated by an international panel of clinical experts and methodologists. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology was applied to evaluate the certainty of evidence and to move from evidence to decision. RESULTS: For volume expansion, the guideline provides conditional recommendations for using crystalloids rather than albumin in critically ill patients in general (moderate certainty of evidence), in patients with sepsis (moderate certainty of evidence), in patients with acute respiratory failure (very low certainty of evidence) and in patients in the perioperative period and patients at risk for bleeding (very low certainty of evidence). There is a conditional recommendation for using isotonic saline rather than albumin in patients with traumatic brain injury (very low certainty of evidence). There is a conditional recommendation for using albumin rather than crystalloids in patients with cirrhosis (very low certainty of evidence). The guideline provides conditional recommendations for using balanced crystalloids rather than isotonic saline in critically ill patients in general (low certainty of evidence), in patients with sepsis (low certainty of evidence) and in patients with kidney injury (very low certainty of evidence). There is a conditional recommendation for using isotonic saline rather than balanced crystalloids in patients with traumatic brain injury (very low certainty of evidence). There is a conditional recommendation for using isotonic crystalloids rather than small-volume hypertonic crystalloids in critically ill patients in general (very low certainty of evidence). CONCLUSIONS: This guideline provides eleven recommendations to inform clinicians on resuscitation fluid choice in critically ill patients.


Assuntos
Cuidados Críticos , Estado Terminal , Soluções Cristaloides , Hidratação , Ressuscitação , Humanos , Hidratação/métodos , Hidratação/normas , Estado Terminal/terapia , Adulto , Cuidados Críticos/métodos , Cuidados Críticos/normas , Soluções Cristaloides/administração & dosagem , Soluções Cristaloides/uso terapêutico , Ressuscitação/métodos , Ressuscitação/normas , Europa (Continente) , Albuminas/uso terapêutico , Albuminas/administração & dosagem , Sepse/terapia
12.
J Oral Rehabil ; 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38767032

RESUMO

BACKGROUND: The temporal tendon is a structure often compromised in patients suffering from temporomandibular disorders (TMD), yet its intraoral location makes a standardised assessment difficult. OBJECTIVES: To evaluate the variability and accuracy to target force of a newly designed intraoral extension for a palpometer device (Palpeter, Sunstar Suisse) when compared to manual palpation, in addition to clinically assessing the mechanical sensitivity and referred sensations of the temporal tendon in healthy individuals. METHODS: Experiment 1: 12 individuals were asked to target on a scale 0.5, 1 and 2 kg, for 2 and 5 s by using five different methods (Palpeter, Palpeter with three different extension shapes and manual palpation). Experiment 2: 10 healthy participants were recruited for a randomised double-blinded assessment by applying pressure of 0.5, 1 and 2 kg to the right temporal tendon with the three extensions and manual palpation. Participants rated the intensity of their sensation/pain on a 0-50-100 numeric rating scale (NRS), unpleasantness on a 0-100 NRS, and if present, they rated and drew the location of referred sensations. Repeated measures analysis of variance (ANOVA) was used in both experiments to compare differences between palpation methods. Tukey's HSD tests were used for the post hoc comparisons, and p values below .05 were considered significant. RESULTS: Experiment 1: The extensions showed no significant differences between them regarding reliability and accuracy for all forces and durations (p > .05). The manual method was significantly less reliable and accurate when compared to the other methods (p < .05). Experiment 2: There were no significant differences between the Palpeter extensions regarding pain intensity or unpleasantness NRS scores (p > .05), but all the extensions had significantly increased pain intensity and unpleasantness when compared to manual palpation (p < .05). Similarly, the frequency of referred sensations was similar between extensions but increased when compared to manual palpation. CONCLUSIONS: The new Palpeter extensions proved to be significantly more accurate and have lower test-retest variability than the manual method in a non-clinical setting. Clinically, they showed no significant differences in NRS scores for pain intensity nor unpleasantness, with no major differences in referred sensations, making any of the extensions suitable for clinical testing of the temporal tendon in future studies.

13.
Nat Ecol Evol ; 8(6): 1140-1153, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38622362

RESUMO

Regulation of gene expression is arguably the main mechanism underlying the phenotypic diversity of tissues within and between species. Here we assembled an extensive transcriptomic dataset covering 8 tissues across 20 bilaterian species and performed analyses using a symmetric phylogeny that allowed the combined and parallel investigation of gene expression evolution between vertebrates and insects. We specifically focused on widely conserved ancestral genes, identifying strong cores of pan-bilaterian tissue-specific genes and even larger groups that diverged to define vertebrate and insect tissues. Systematic inferences of tissue-specificity gains and losses show that nearly half of all ancestral genes have been recruited into tissue-specific transcriptomes. This occurred during both ancient and, especially, recent bilaterian evolution, with several gains being associated with the emergence of unique phenotypes (for example, novel cell types). Such pervasive evolution of tissue specificity was linked to gene duplication coupled with expression specialization of one of the copies, revealing an unappreciated prolonged effect of whole-genome duplications on recent vertebrate evolution.


Assuntos
Evolução Molecular , Insetos , Vertebrados , Animais , Insetos/genética , Vertebrados/genética , Especificidade de Órgãos , Transcriptoma , Filogenia
14.
Scand J Work Environ Health ; 50(4): 229-232, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38606624
15.
Elife ; 122024 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-38568859

RESUMO

To gain insights into how juvenile hormone (JH) came to regulate insect metamorphosis, we studied its function in the ametabolous firebrat, Thermobia domestica. Highest levels of JH occur during late embryogenesis, with only low levels thereafter. Loss-of-function and gain-of-function experiments show that JH acts on embryonic tissues to suppress morphogenesis and cell determination and to promote their terminal differentiation. Similar embryonic actions of JH on hemimetabolous insects with short germ band embryos indicate that JH's embryonic role preceded its derived function as the postembryonic regulator of metamorphosis. The postembryonic expansion of JH function likely followed the evolution of flight. Archaic flying insects were considered to lack metamorphosis because tiny, movable wings were evident on the thoraces of young juveniles and their positive allometric growth eventually allowed them to support flight in late juveniles. Like in Thermobia, we assume that these juveniles lacked JH. However, a postembryonic reappearance of JH during wing morphogenesis in the young juvenile likely redirected wing development to make a wing pad rather than a wing. Maintenance of JH then allowed wing pad growth and its disappearance in the mature juvenile then allowed wing differentiation. Subsequent modification of JH action for hemi- and holometabolous lifestyles are discussed.


Assuntos
Hormônios Juvenis , Metamorfose Biológica , Animais , Metamorfose Biológica/fisiologia , Insetos , Morfogênese
16.
Malar J ; 23(1): 126, 2024 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-38685081

RESUMO

INTRODUCTION: Introduction: Malaria continues to be the leading cause of hospitalization and death in Angola, a country in sub- Saharan Africa. In 2023, in the first quarter, 2,744,682 cases were registered, and of these 2,673 patients died due to malaria disease. Previous studies have shown that the ABO blood group can affect the progression of malaria to severe conditions after P. falciparum infection, while the sickle cell gene offers relative protection. OBJECTIVE: We investigated changes in the blood count according to blood groups (ABO/Rh) and sickle cell trait in patients with malaria in Luanda, capital of Angola. METHODOLOGY: This was a longitudinal, prospective and observational study with 198 patients hospitalized for malaria. RESULTS: Of the 198 patients studied, 13(6.6%) were ABRh(+), 4(2.0%) were ARh(-), 49(24.7%) were ARh(+), 42(21, 2%) were BRh (+), 5(2.5%) were ORh(-) and 85(42.9%) were ORh(+). For sickle cell trait, 145(73.2%) were AA, 37(18.7%) were AS and 16(8.1%) were SS. No statistical relationship was observed between age group, sex, parasitemia, clinical picture, hematocrit, MCV, HCM, MCHC, leukocytes, NEUT, LINF and PTL values with blood groups (p<0.05), but there was a relationship between values of hemoglobin and ABO/Rh blood groups (p>0.05). There was no relationship between age, parasitemia, clinical condition, MCV, HCM and MCHC values, leukocytes, NEUT and LINF with sickle cell trait (p<0.05), but there was a relationship between sex, hemoglobin and PTL and sickle cell values. sickle cell trait (p>0.05). CONCLUSION: It is imperative to differentiate patients with malaria based on blood groups and sickle cell trait, taking into account mainly the blood count parameters that demonstrate that there are patients who, depending on blood group or sickle cell trait, may react weakly to malaria infection regardless of the degree of parasitemia and medical prognosis.


Assuntos
Traço Falciforme , Humanos , Traço Falciforme/sangue , Masculino , Feminino , Estudos Prospectivos , Adulto , Criança , Adolescente , Pré-Escolar , Adulto Jovem , Estudos Longitudinais , Angola , Pessoa de Meia-Idade , Sistema ABO de Grupos Sanguíneos , Contagem de Células Sanguíneas/estatística & dados numéricos , Malária Falciparum/sangue , Sistema do Grupo Sanguíneo Rh-Hr , Lactente , Idoso
17.
Crit Care ; 28(1): 92, 2024 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-38515121

RESUMO

Acute kidney injury (AKI) often complicates sepsis and is associated with high morbidity and mortality. In recent years, several important clinical trials have improved our understanding of sepsis-associated AKI (SA-AKI) and impacted clinical care. Advances in sub-phenotyping of sepsis and AKI and clinical trial design offer unprecedented opportunities to fill gaps in knowledge and generate better evidence for improving the outcome of critically ill patients with SA-AKI. In this manuscript, we review the recent literature of clinical trials in sepsis with focus on studies that explore SA-AKI as a primary or secondary outcome. We discuss lessons learned and potential opportunities to improve the design of clinical trials and generate actionable evidence in future research. We specifically discuss the role of enrichment strategies to target populations that are most likely to derive benefit and the importance of patient-centered clinical trial endpoints and appropriate trial designs with the aim to provide guidance in designing future trials.


Assuntos
Injúria Renal Aguda , Sepse , Humanos , Injúria Renal Aguda/terapia , Injúria Renal Aguda/complicações , Estado Terminal/terapia , Sepse/complicações , Sepse/terapia , Ensaios Clínicos como Assunto
18.
Sci Adv ; 10(9): eadj9797, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38427739

RESUMO

We used N-ethyl-N-nitrosurea-induced germline mutagenesis combined with automated meiotic mapping to identify specific systolic blood pressure (SBP) and heart rate (HR) determinant loci. We analyzed 43,627 third-generation (G3) mice from 841 pedigrees to assess the effects of 45,378 variant alleles within 15,760 genes, in both heterozygous and homozygous states. We comprehensively tested 23% of all protein-encoding autosomal genes and found 87 SBP and 144 HR (with 7 affecting both) candidates exhibiting detectable hypomorphic characteristics. Unexpectedly, only 18 of the 87 SBP genes were previously known, while 26 of the 144 genes linked to HR were previously identified. Furthermore, we confirmed the influence of two genes on SBP regulation and three genes on HR control through reverse genetics. This underscores the importance of our research in uncovering genes associated with these critical cardiovascular risk factors and illustrate the effectiveness of germline mutagenesis for defining key determinants of polygenic phenotypes that must be studied in an intact organism.


Assuntos
Etilnitrosoureia , Camundongos , Animais , Pressão Sanguínea/genética , Frequência Cardíaca/genética , Mutagênese , Etilnitrosoureia/toxicidade , Alelos
19.
Mar Environ Res ; 197: 106443, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38507985

RESUMO

Natural disturbances can produce a mosaic of seagrass patches of different ages, which may affect the response to herbivory. These pressures can have consequences for plant performance. To assess how seagrass patch age affects the response to herbivory, we simulated the effect of herbivory by clipping leaves of Halodule wrightii in patches of 2, 4 and 6 years. All clipped plants showed ability to compensate herbivory by increasing leaf growth rate (on average 4.5-fold). The oldest patches showed resistance response by increasing phenolic compounds (1.2-fold). Contrastingly, the concentration of phenolics decreased in the youngest patches (0.26-fold), although they had a similar leaf carbon content to controls. These results suggest that younger plants facing herbivory pressure reallocate their phenolic compounds towards primary metabolism. Results confirm the H. wrightii tolerance to herbivory damage and provides evidence of age-dependent compensatory responses, which may have consequences for seagrass colonization and growth in perturbed habitats.


Assuntos
Alismatales , Herbivoria , Ecossistema , Alismatales/fisiologia , Plantas , Folhas de Planta/metabolismo
20.
Microb Pathog ; 190: 106608, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38503396

RESUMO

The occurrence of bacterial resistance has been increasing, compromising the treatment of various infections. The high virulence of Staphylococcus aureus allows for the maintenance of the infectious process, causing many deaths and hospitalizations. The MepA and NorA efflux pumps are transporter proteins responsible for expelling antimicrobial agents such as fluoroquinolones from the bacterial cell. Coumarins are phenolic compounds that have been studied for their diverse biological actions, including against bacteria. A pharmacokinetic in silico characterization of compounds C10, C11, C13, and C14 was carried out according to the principles of Lipinski's Rule of Five, in addition to searching for similarity in ChemBL and subsequent search for publications in CAS SciFinder. All compounds were evaluated for their in vitro antibacterial and modulatory activity against standard and multidrug-resistant Gram-positive and Gram-negative strains. The effect of coumarins C9, C10, C11, C13, and C14 as efflux pump inhibitors in Staphylococcus aureus strains was evaluated using the microdilution method (MepA or NorA) and fluorimetry (NorA). The behavior of coumarins regarding the efflux pump was determined from their interaction properties with the membrane and coumarin-protein using molecular docking and molecular dynamics simulations. Only the isolated coumarin compound C13 showed antibacterial activity against standard strains of Staphylococcus aureus and Escherichia coli. However, the other tested coumarins showed modulatory capacity for fluoroquinolone and aminoglycoside antibacterials. Compounds C10, C13, and C14 were effective in reducing the MIC of both antibiotics for both multidrug-resistant strains, while C11 potentiated the effect of norfloxacin and gentamicin for Gram-positive and Gram-negative bacteria and only norfloxacin for Gram-negative. Only coumarin C14 produced synergistic effects when associated with ciprofloxacin in MepA-carrying strains. All tested coumarins have the ability to inhibit the NorA efflux pump present in Staphylococcus aureus, both in reducing the MIC and inducing increased ethidium bromide fluorescence emission in fluorimetry. The findings of this study offer an atomistic perspective on the potential of coumarins as active inhibitors of the NorA pump, highlighting their specific mode of action mainly targeting protein inhibition. In molecular docking, it was observed that coumarins are capable of interacting with various amino acid residues of the NorA pump. The simulation showed that coumarin C10 can cross the bilayer; however, the other coumarins interacted with the membrane but were unable to cross it. Coumarins demonstrated their potentiating role in the effect of norfloxacin through a dual mechanism: efflux pump inhibition through direct interaction with the protein (C9, C10, C11, and C13) and increased interaction with the membrane (C10 and C13). In the context of pharmacokinetic prediction studies, the studied structures have a suitable chemical profile for possible oral use. We suggest that coumarin derivatives may be an interesting alternative in the future for the treatment of resistant bacterial infections, with the possibility of a synergistic effect with other antibacterials, although further studies are needed to characterize their therapeutic effects and toxicity.


Assuntos
Antibacterianos , Proteínas de Bactérias , Cumarínicos , Testes de Sensibilidade Microbiana , Simulação de Acoplamento Molecular , Simulação de Dinâmica Molecular , Proteínas Associadas à Resistência a Múltiplos Medicamentos , Staphylococcus aureus , Cumarínicos/farmacologia , Cumarínicos/química , Cumarínicos/metabolismo , Staphylococcus aureus/efeitos dos fármacos , Antibacterianos/farmacologia , Antibacterianos/química , Proteínas de Bactérias/metabolismo , Proteínas de Bactérias/antagonistas & inibidores , Proteínas Associadas à Resistência a Múltiplos Medicamentos/antagonistas & inibidores , Proteínas Associadas à Resistência a Múltiplos Medicamentos/metabolismo , Farmacorresistência Bacteriana Múltipla , Bactérias Gram-Negativas/efeitos dos fármacos , Proteínas de Membrana Transportadoras/metabolismo
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