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1.
Front Psychiatry ; 15: 1386286, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38596629

RESUMO

Background: Aerobic capacity has shown to predict physical and mental health-related quality of life in bipolar disorder (BD). However, the correlation between exercise respiratory capacity and mitochondrial function remains understudied. We aimed to assess longitudinally intra-individual differences in these factors during mood episodes and remission in BD. Methods: This study included eight BD patients admitted to an acute psychiatric unit. Incremental cardiopulmonary exercise test (CPET) was conducted during acute episodes (T0), followed by constant work rate cycle ergometry (CWRCE) to evaluate endurance time, oxygen uptake at peak exercise (VO2peak) and at the anaerobic threshold. The second test was repeated during remission (T1). Mitochondrial respiration rates were assessed at T0 and T1 in peripheral blood mononuclear cells. Results: Endurance time, VO2peak, and anaerobic threshold oxygen consumption showed no significant variations between T0 and T1. Basal oxygen consumption at T1 tended to inversely correlate with maximal mitochondrial respiratory capacity (r=-0.690, p=0.058), and VO2peak during exercise at T1 inversely correlated with basal and minimum mitochondrial respiration (r=-0.810, p=0.015; r=-0.786, p=0.021, respectively). Conclusions: Our preliminary data showed that lower basal oxygen consumption may be linked to greater mitochondrial respiratory capacity, and maximum oxygen uptake during the exercise task was associated with lower basal mitochondrial respiration, suggesting that lower oxygen requirements could be associated with greater mitochondrial capacity. These findings should be replicated in larger samples stratified for manic and depressive states.

2.
Antioxidants (Basel) ; 12(8)2023 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-37627634

RESUMO

Inclusion body myositis (IBM) is an acquired inflammatory myopathy affecting proximal and distal muscles that leads to weakness in patients over 50. It is diagnosed based on clinical and histological findings in muscle related to inflammation, degeneration, and mitochondria. In relation to IBM, a shortage of validated disease models and a lack of biomarkers and effective treatments constitute an unmet medical need. To overcome these hurdles, we performed an omics analysis of multiple samples from IBM patients (saliva, fibroblasts, urine, plasma, and muscle) to gain insight into the pathophysiology of IBM. Degeneration was evident due to the presence of amyloid ß peptide 1-42 (Aß1-42) in the saliva of the analyzed IBM patients. The presence of metabolic disarrangements in IBM was indicated by an imbalanced organic acid profile in fibroblasts and urine. Specifically, abnormal levels of L-pyroglutamic and orotic acid were supported by the abnormal expression of related metabolites in plasma and urine (glutathione and pyrimidines) and the aberrant expression of upstream gene regulators (L2HGDH, IDH2, OPLAH, and ASL) in muscle. Combined levels of L-pyroglutamic and orotic acid displayed an outstanding biomarker signature in urine with 100% sensitivity and specificity. The confirmation of systemic metabolic disarrangements in IBM and the identification of novel biomarkers reported herein unveil novel insights that require validation in larger cohorts.

3.
J Cachexia Sarcopenia Muscle ; 14(2): 964-977, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36860172

RESUMO

BACKGROUND: Inclusion body myositis (IBM) is an inflammatory myopathy clinically characterized by proximal and distal muscle weakness, with inflammatory infiltrates, rimmed vacuoles and mitochondrial changes in muscle histopathology. There is scarce knowledge on IBM aetiology, and non-established biomarkers or effective treatments are available, partly due to the lack of validated disease models. METHODS: We have performed transcriptomics and functional validation of IBM muscle pathological hallmarks in fibroblasts from IBM patients (n = 14) and healthy controls (n = 12), paired by age and sex. The results comprise an mRNA-seq, together with functional inflammatory, autophagy, mitochondrial and metabolic changes between patients and controls. RESULTS: Gene expression profile of IBM vs control fibroblasts revealed 778 differentially expressed genes (P-value adj < 0.05) related to inflammation, mitochondria, cell cycle regulation and metabolism. Functionally, an increased inflammatory profile was observed in IBM fibroblasts with higher supernatant cytokine secretion (three-fold increase). Autophagy was reduced considering basal protein mediators (18.4% reduced), time-course autophagosome formation (LC3BII 39% reduced, P-value < 0.05), and autophagosome microscopic evaluation. Mitochondria displayed reduced genetic content (by 33.9%, P-value < 0.05) and function (30.2%-decrease in respiration, 45.6%-decline in enzymatic activity (P-value < 0.001), 14.3%-higher oxidative stress, 135.2%-increased antioxidant defence (P-value < 0.05), 11.6%-reduced mitochondrial membrane potential (P-value < 0.05) and 42.8%-reduced mitochondrial elongation (P-value < 0.05)). In accordance, at the metabolite level, organic acid showed a 1.8-fold change increase, with conserved amino acid profile. Correlating to disease evolution, oxidative stress and inflammation emerge as potential markers of prognosis. CONCLUSIONS: These findings confirm the presence of molecular disturbances in peripheral tissues from IBM patients and prompt patients' derived fibroblasts as a promising disease model, which may eventually be exported to other neuromuscular disorders. We additionally identify new molecular players in IBM associated with disease progression, setting the path to deepen in disease aetiology, in the identification of novel biomarkers or in the standardization of biomimetic platforms to assay new therapeutic strategies for preclinical studies.


Assuntos
Miosite de Corpos de Inclusão , Miosite , Humanos , Miosite de Corpos de Inclusão/diagnóstico , Miosite de Corpos de Inclusão/genética , Miosite de Corpos de Inclusão/metabolismo , Músculos/metabolismo , Inflamação/patologia , Biomarcadores/metabolismo
5.
Am J Hematol ; 98(6): E134-E138, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36882876

RESUMO

(A) Correlation matrix of unsupervised co-regulated genes, based on the 208 genes included in the NanoString platform. Some of the clusters of co-regulated genes corresponded to the following: Inflammatory cells; Epstein-Barr virus; B-cells; Cytotoxic T-cells; T-cells; and Proliferation. (B) Analysis of genomic alterations by targeted sequencing. Distribution of mutations in the 62 analyzed genes. Rows correspond to sequenced genes, columns represent individual patients. Color coding: green, missense; blue, synonymous; pink, frameshift; violet, Indel; red, stop gained; yellow, UTR.


Assuntos
Infecções por Vírus Epstein-Barr , Linfoma Extranodal de Células T-NK , Humanos , Herpesvirus Humano 4/genética , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/genética , Infecções por Vírus Epstein-Barr/patologia , Linfoma Extranodal de Células T-NK/terapia , Mutação , Células Matadoras Naturais/patologia
6.
Sci Rep ; 13(1): 2038, 2023 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-36739295

RESUMO

Complement proteins are deposited in the muscles of patients with myositis. However, the local expression and regulation of complement genes within myositis muscle have not been well characterized. In this study, bulk RNA sequencing (RNAseq) analyses of muscle biopsy specimens revealed that complement genes are locally overexpressed and correlate with markers of myositis disease activity, including the expression of interferon-gamma (IFNγ)-induced genes. Single cell and single nuclei RNAseq analyses showed that most local expression of complement genes occurs in macrophages, fibroblasts, and satellite cells, with each cell type expressing different sets of complement genes. Biopsies from immune-mediated necrotizing myopathy patients, who have the lowest levels of IFNγ-induced genes, also had the lowest complement gene expression levels. Furthermore, data from cultured human cells showed that IFNγ upregulates complement expression in macrophages, fibroblasts, and muscle cells. Taken together, our results suggest that in myositis muscle, IFNγ coordinates the local overexpression of complement genes that occurs in several cell types.


Assuntos
Interferon gama , Miosite , Humanos , Proteínas do Sistema Complemento/metabolismo , Interferon gama/metabolismo , Músculo Esquelético/metabolismo , Músculos/metabolismo , Miosite/metabolismo , RNA/metabolismo
7.
Artigo em Inglês | MEDLINE | ID: mdl-36834444

RESUMO

Cervical cancer is the fourth most frequent cancer in women worldwide, and the 11th most frequent neoplasm in Spain. Despite the optimization of treatments and a 5-year survival rate of 70%, side effects and sequelae are described after treatment. The treatments have physical, psychological and sociocultural consequences that deteriorate the quality of life of patients. One of the sequelae that worries patients is the impairment of sexual function and satisfaction, considered a fundamental dimension of the human being. The aim of this study was to examine quality of life and sexual function and satisfaction among Spanish cervical cancer survivors. A retrospective case-control study was conducted between 2019 and 2022. The sample consisted of 66 patients who completed the Female Sexual Function Index, the Golombok Rust Sexual Satisfaction Inventory and European Organization for Research and Treatment of Cancer quality of life questionnaire. The control group consisted of women without cervical cancer and gynecological pathologies obtained using the so-called online virtual sampling method. The patient group consisted of women with cervical cancer who completed treatment. Cervical cancer survivors reported sexual dysfunction and impaired sexual satisfaction in almost half of the domains. Quality of life was also affected, with pain and fatigue being the most frequent symptoms in these patients. Our results indicate that there is dysfunction, sexual dissatisfaction and a lower level of quality of life in cervical cancer survivors than in healthy women without pathology.


Assuntos
Neoplasias do Colo do Útero , Feminino , Humanos , Estudos de Casos e Controles , Estudos Retrospectivos , Qualidade de Vida , Comportamento Sexual/psicologia , Sexualidade/psicologia , Sobreviventes/psicologia , Inquéritos e Questionários
8.
Nat Commun ; 13(1): 6836, 2022 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-36369219

RESUMO

Neurodevelopmental disorders of genetic origin delay the acquisition of normal abilities and cause disabling phenotypes. Nevertheless, spontaneous attenuation and even complete amelioration of symptoms in early childhood and adolescence can occur in many disorders, suggesting that brain circuits possess an intrinsic capacity to overcome the deficits arising from some germline mutations. We examined the molecular composition of almost a trillion excitatory synapses on a brain-wide scale between birth and adulthood in mice carrying a mutation in the homeobox transcription factor Pax6, a neurodevelopmental disorder model. Pax6 haploinsufficiency had no impact on total synapse number at any age. By contrast, the molecular composition of excitatory synapses, the postnatal expansion of synapse diversity and the acquisition of normal synaptome architecture were delayed in all brain regions, interfering with networks and electrophysiological simulations of cognitive functions. Specific excitatory synapse types and subtypes were affected in two key developmental age-windows. These phenotypes were reversed within 2-3 weeks of onset, restoring synapse diversity and synaptome architecture to the normal developmental trajectory. Synapse subtypes with rapid protein turnover mediated the synaptome remodeling. This brain-wide capacity for remodeling of synapse molecular composition to recover and maintain the developmental trajectory of synaptome architecture may help confer resilience to neurodevelopmental genetic disorders.


Assuntos
Transtornos do Neurodesenvolvimento , Sinapses , Animais , Humanos , Camundongos , Encéfalo/metabolismo , Transtornos do Neurodesenvolvimento/genética , Transtornos do Neurodesenvolvimento/metabolismo , Fator de Transcrição PAX6/genética , Fator de Transcrição PAX6/metabolismo , Fenótipo , Sinapses/metabolismo
9.
EJHaem ; 3(3): 722-733, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36051055

RESUMO

Diffuse large B-cell lymphoma (DLBCL), the most frequent non-Hodgkin's lymphoma subtype, is characterized by strong biological, morphological, and clinical heterogeneity, but patients are treated with immunochemotherapy in a relatively homogeneous way. Here, we have used a customized NanoString platform to analyze a series of 197 homogeneously treated DLBCL cases. The platform includes the most relevant genes or signatures known to be useful for predicting response to R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) in DLBCL cases. We generated a risk score that combines the International Prognostic Index with cell of origin and double expression of MYC/BCL2, and stratified the series into three groups, yielding hazard ratios from 0.15 to 5.49 for overall survival, and from 0.17 to 5.04 for progression-free survival. Group differences were highly significant (p < 0.0001), and the scoring system was applicable to younger patients (<60 years of age) and patients with advanced or localized stages of the disease. Results were validated in an independent dataset from 166 DLBCL patients treated in two distinct clinical trials. This risk score combines clinical and biological data in a model that can be used to integrate biological variables into the prognostic models for DLBCL cases.

10.
Womens Health (Lond) ; 18: 17455057221112237, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35833668

RESUMO

BACKGROUND: Menstrual disorders were not reported as a possible secondary effect in any of the clinical trials for the SARS-CoV-2 vaccines. AIM: To describe the prevalence of perceived premenstrual and menstrual changes after COVID-19 vaccine administration. DESIGN: Cross-sectional study. METHODS: A total of 14,153 women (mean age 31.5 ± 9.3 years old) who had received the full course of vaccination at least three months earlier were included in this cross-sectional study. Data including the type of vaccine administered, perceived changes in the amount and duration of menstrual bleeding, presence of clots, cycle length, and premenstrual symptoms were collected through a retrospective online survey from June to September 2021. RESULTS: Of the women who participated in this study, 3136 reported no menstrual changes and 11,017 (78% of the study sample) reported experiencing menstrual cycle changes after vaccination. In summary, women who reported menstrual changes after vaccination were older (overall p < 0.001) and slightly more smokers (p = 0.05) than women who did not report any changes. The most prevalent changes in relation to premenstrual symptoms were increased fatigue (43%), abdominal bloating (37%), irritability (29%), sadness (28%), and headaches (28%). The most predominant menstrual changes were more menstrual bleeding (43%), more menstrual pain (41%), delayed menstruation (38%), fewer days of menstrual bleeding (34.5%), and shorter cycle length (32%). CONCLUSION: Women vaccinated against COVID-19 usually perceive mild menstrual and premenstrual changes. Future studies are warranted to clarify the physiological mechanisms behind these widely reported changes.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Distúrbios Menstruais , Síndrome Pré-Menstrual , Adulto , Feminino , Humanos , Adulto Jovem , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Estudos Transversais , Ciclo Menstrual/fisiologia , Menstruação , Distúrbios Menstruais/etiologia , Síndrome Pré-Menstrual/diagnóstico , Síndrome Pré-Menstrual/tratamento farmacológico , Síndrome Pré-Menstrual/epidemiologia , Estudos Retrospectivos , SARS-CoV-2 , Vacinação
11.
PLoS One ; 17(3): e0265256, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35290400

RESUMO

Neurodegenerative diseases, such as Parkinson's disease, are heterogeneous disorders with a multifactorial nature involving impaired bioenergetics. Stem-regenerative medicine and bioenergetics have been proposed as promising therapeutic targets in the neurologic field. The rationale of the present study was to assess the potential of human-derived adipose stem cells (hASCs) to transdifferentiate into neuronal-like cells (NhASCs and neurospheres) and explore the hASC bioenergetic profile. hASC neuronal transdifferentiation was performed through neurobasal media and differentiation factor exposure. High resolution respirometry was assessed. Increased MAP-2 neuronal marker protein expression upon neuronal induction (p<0.05 undifferentiated hASCs vs. 28-36 days of differentiation) and increased bIII-tubulin neuronal marker protein expression upon neuronal induction (p<0.05 undifferentiated hASCs vs. 6-28-36 days of differentiation) were found. The bioenergetic profile was detectable through high-resolution respirometry approaches in hASCs but did not lead to differential oxidative capacity rates in healthy or clinically diagnosed PD-hASCs. We confirmed the capability of transdifferentiation to the neuronal-like profile of hASCs derived from the forearms of human subjects and characterized the bioenergetic profile. Suboptimal maximal respiratory capacity trends in PD were found. Neuronal induction leading to positive neuronal protein expression markers is a relevant issue that encourages the suitability of NhASC models in neurodegeneration.


Assuntos
Doença de Parkinson , Tecido Adiposo/metabolismo , Diferenciação Celular , Células Cultivadas , Metabolismo Energético , Antebraço , Humanos , Doença de Parkinson/metabolismo , Células-Tronco
12.
Arch Dis Child ; 107(7): 686-691, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35288419

RESUMO

BACKGROUND: Ganciclovir/valganciclovir is currently indicated during the first 6 months of life in symptomatic children with congenital cytomegalovirus (CMV) infection. However, this treatment may have the potential to induce mitochondrial toxicity due to off-target inhibition of DNA-polymerases. Similar anti-HIV drugs have been associated with mitochondrial toxicity but this has never been explored in CMV. OBJECTIVE: To determine the potential mitochondrial toxicity profile at the genetic, functional and biogenesis level in peripheral blood mononuclear cells from a cohort of newborns and infants with symptomatic congenital CMV infection (treated with valganciclovir, untreated and uninfected controls). DESIGN: Longitudinal, observational and controlled study. SETTING AND PATIENTS: Subjects were recruited at the tertiary referral Hospital Sant Joan de Déu and experiments were conducted at IDIBAPS-Hospital Clínic of Barcelona, Spain. CMV-infected newborns underwent comprehensive monthly clinical follow-up. METHODS: Mitochondrial parameters, audiometry and neurological assessment were measured at baseline, 3-6 and 12 months after inclusion in the study. The Kruskal-Wallis test for k-independent samples and Friedman tests for repeated measurements were applied. RESULTS: Complex IV, citrate synthase enzymatic activities and mtDNA remained preserved in congenital CMV-infected infants treated with valganciclovir compared with controls (p>0.05 in all cases). CONCLUSIONS: No evidence of mitochondrial toxicity was found in infants treated with valganciclovir for congenital CMV.


Assuntos
Fármacos Anti-HIV , Infecções por Citomegalovirus , Fármacos Anti-HIV/uso terapêutico , Antivirais/efeitos adversos , Criança , Infecções por Citomegalovirus/congênito , Ganciclovir/efeitos adversos , Humanos , Lactente , Recém-Nascido , Leucócitos Mononucleares , Estudos Longitudinais , Valganciclovir/uso terapêutico
13.
J Matern Fetal Neonatal Med ; 35(8): 1419-1425, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32372671

RESUMO

OBJECTIVE: The aim of the study was to investigate the influence of ethnicity and cerebroplacental ratio (CPR) on the birth weight (BW) of first generation Indo-Pakistan immigrants' newborns. METHODS: This was a retrospective study in a mixed population of 620 term Caucasian and Indo-Pakistan pregnancies, evaluated in two reference hospitals of Spain and Italy. All fetuses underwent a scan and Doppler examination within two weeks of delivery. The influence of fetal gender, ethnicity, GA at delivery, CPR, maternal age, height, weight and parity on BW was evaluated by multivariable regression analysis. RESULTS: Newborns of first generation Indo-Pakistan immigrants were smaller than local Caucasian newborns (mean BW mean= 3048 ± 435 g versus 3269 ± 437 g, p < .001). Multivariable regression analysis demonstrated that all studied parameters, but maternal age and ethnicity, were significantly associated with BW. The most important were GA at delivery (partial R2 = 0.175, p < .001), CPR (partial R2 = 0.032, p < .001), and fetal gender (partial R2 = 0,029, p < .001). CONCLUSIONS: The propensity to a lower BW, explained by placental dysfunction but not by maternal ethnicity is transmitted to newborns of first generation immigrants. Whatever are the factors implied they persist in the new residential setting.


Assuntos
Emigrantes e Imigrantes , Etnicidade , Peso ao Nascer , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Artéria Cerebral Média/diagnóstico por imagem , Parto , Placenta , Gravidez , Estudos Retrospectivos , Ultrassonografia Pré-Natal , Artérias Umbilicais/diagnóstico por imagem
14.
Blood Adv ; 5(24): 5588-5598, 2021 12 28.
Artigo em Inglês | MEDLINE | ID: mdl-34592752

RESUMO

Peripheral T-cell lymphoma (PTCL) is a clinically aggressive disease, with a poor response to therapy and a low overall survival rate of approximately 30% after 5 years. We have analyzed a series of 105 cases with a diagnosis of PTCL using a customized NanoString platform (NanoString Technologies, Seattle, WA) that includes 208 genes associated with T-cell differentiation, oncogenes and tumor suppressor genes, deregulated pathways, and stromal cell subpopulations. A comparative analysis of the various histological types of PTCL (angioimmunoblastic T-cell lymphoma [AITL]; PTCL with T follicular helper [TFH] phenotype; PTCL not otherwise specified [NOS]) showed that specific sets of genes were associated with each of the diagnoses. These included TFH markers, cytotoxic markers, and genes whose expression was a surrogate for specific cellular subpopulations, including follicular dendritic cells, mast cells, and genes belonging to precise survival (NF-κB) and other pathways. Furthermore, the mutational profile was analyzed using a custom panel that targeted 62 genes in 76 cases distributed in AITL, PTCL-TFH, and PTCL-NOS. The main differences among the 3 nodal PTCL classes involved the RHOAG17V mutations (P < .0001), which were approximately twice as frequent in AITL (34.09%) as in PTCL-TFH (16.66%) cases but were not detected in PTCL-NOS. A multivariate analysis identified gene sets that allowed the series of cases to be stratified into different risk groups. This study supports and validates the current division of PTCL into these 3 categories, identifies sets of markers that can be used for a more precise diagnosis, and recognizes the expression of B-cell genes as an IPI-independent prognostic factor for AITL.


Assuntos
Linfadenopatia Imunoblástica , Linfoma de Células T Periférico , Humanos , Linfoma de Células T Periférico/diagnóstico , Linfoma de Células T Periférico/genética , Mutação , Fenótipo , Prognóstico
16.
Sci Rep ; 10(1): 14014, 2020 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-32814795

RESUMO

Determining the number of synapses that are present in different brain regions is crucial to understand brain connectivity as a whole. Membrane-associated guanylate kinases (MAGUKs) are a family of scaffolding proteins that are expressed in excitatory glutamatergic synapses. We used genetic labeling of two of these proteins (PSD95 and SAP102), and Spinning Disc confocal Microscopy (SDM), to estimate the number of fluorescent puncta in the CA1 area of the hippocampus. We also used FIB-SEM, a three-dimensional electron microscopy technique, to calculate the actual numbers of synapses in the same area. We then estimated the ratio between the three-dimensional densities obtained with FIB-SEM (synapses/µm3) and the bi-dimensional densities obtained with SDM (puncta/100 µm2). Given that it is impractical to use FIB-SEM brain-wide, we used previously available SDM data from other brain regions and we applied this ratio as a conversion factor to estimate the minimum density of synapses in those regions. We found the highest densities of synapses in the isocortex, olfactory areas, hippocampal formation and cortical subplate. Low densities were found in the pallidum, hypothalamus, brainstem and cerebellum. Finally, the striatum and thalamus showed a wide range of synapse densities.


Assuntos
Encéfalo/fisiologia , Proteína 4 Homóloga a Disks-Large/fisiologia , Guanilato Quinases/fisiologia , Hipocampo/fisiologia , Proteínas de Membrana/fisiologia , Sinapses/fisiologia , Animais , Encéfalo/ultraestrutura , Hipocampo/ultraestrutura , Masculino , Camundongos , Camundongos Knockout , Microscopia Eletrônica , Sinapses/ultraestrutura
17.
Rev. Soc. Andal. Traumatol. Ortop. (Ed. impr.) ; 37(2): 44-57, abr.-jun. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-198466

RESUMO

El tratamiento de los defectos óseos y pseudoartrosis recalcitrante es siempre exigente. Y cuando ocurren en la mano la exigencia es aún mayor por la dificultad técnica añadida y los especialmente exigentes requisitos funcionales. Basados en su experiencia con la técnica aplicada a diversas áreas anatómicas, los autores presentan sus resultados en el área de la mano. Se presentan 8 casos de defectos óseos reconstruidos con colgajos libres periósticos/corticoperiósticos de cóndilo femoral medial y se analizan los resultados no tanto desde el punto de vista estadístico sino de la calidad de los resultados obtenidos en términos de función real conseguida. Todos los colgajos fueron un éxito desde el punto de vista vascular y todos los defectos fueron exitosamente reconstruidos desde el punto de vista óseo. No obstante, el éxito funcional estuvo únicamente en algunos casos (6 casos) y no en todos. La reconstrucción funcional de la mano es exigente y su éxito se define casi exclusivamente por la función obtenida/recuperada. Los autores reflexionan sobre las indicaciones del colgajo libre perióstico que, para ellos, son razonables en la reconstrucción ósea de la mano


The treatment of the bone gaps and recalcitrant nonunions is always highly complex. And it is even more demanding when this occurs in the hand due to the added technical difficulty and high functional requirements. Based on their technical knowledge and experience, the authors present their results of the corticoperiosteal flap on the hand. 8 cases with bone gaps defect reconstructed with corticoperiosteal/periosteal free flaps from the medial femoral con dyle are presented. The results were analyzed from the achieved function point of view, and not that much from a statistical perspective. All flaps succeeded in revascularising the bone and 100% union rate was achieved. However, functional success was only present in some cases (6 cases), not all of them. The functional reconstruction of the hand is highly demanding and the success is defined almost exclusively by the achieved function. The authors reflect about indications of these corticoperiosteal/periosteal free flaps, which for them are reasonable and acceptable in bone reconstructions of the hand


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Retalhos de Tecido Biológico/cirurgia , Fêmur/transplante , Procedimentos de Cirurgia Plástica/métodos , Pseudoartrose/cirurgia , Traumatismos da Mão/cirurgia , Resultado do Tratamento , Reprodutibilidade dos Testes , Radiografia , Traumatismos da Mão/diagnóstico por imagem , Pseudoartrose/diagnóstico por imagem
18.
Cir. plást. ibero-latinoam ; 45(1): 37-44, ene.-mar. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-182676

RESUMO

Introducción y Objetivo: La reconstrucción mamaria inmediata en la paciente portadora de prótesis de aumento difiere en su planteamiento respecto al resto de pacientes. Presentamos nuestra experiencia en reconstrucción mamaria inmediata en pacientes portadoras de prótesis de aumento y sometidas a mastectomía conservadora de piel, mediante implante protésico definitivo asociado a una novedosa técnica de colgajo capsular periprotésico. Material y Método: Entre diciembre de 2014 y febrero de 2016 seleccionamos las pacientes con cáncer de mama que previamente eran portadoras de prótesis mamarias de aumento y que fueron sometidas a mastectomía conservadora de piel. Excluimos los implantes de menos de 1 año, los subglandulares, las contracturas III y IV, las roturas protésicas, las pacientes fumadoras y las subsidiarias de radioterapia. El periodo mínimo de seguimiento fue de 1 año. Valoramos el resultado estético y las complicaciones: contractura, seroma, hematoma e infección. La mastectomía preservó la cápsula periprotésica, quedando el nuevo implante cubierto en su polo inferior por la cápsula retropectoral previamente abatida y en su polo superior por el músculo pectoral mayor. Resultados: Seleccionamos 4 pacientes, con edad media 44 años. El volumen medio de los implantes fue de 410 cc. Tras el periodo de seguimiento (17 meses de media) ninguna paciente sufrió complicaciones mayores y los resultados estéticos fueron satisfactorios, sin contractura capsular. Conclusiones: El colgajo capsular retropectoral permite crear un plano independiente del subcutáneo. Es de fácil realización y consigue un buen resultado estético y seguro. No obstante, son datos preliminares que requieren un mayor seguimiento y un mayor número de pacientes para tener mayor validez


Background and Objective: The increasing number of previously augmented patients undergoing a mastectomy and the special features of these patients requires the use of a specific approach for breast reconstruction in this setting. We present our experience with the following capsuloplasty technique, achieving total coverage of the implant using the previously formed capsule, in previously subpectoral augmented patients undergoing skin-sparing mastectomy and immediate reconstruction. Methods: From December 2014 to February 2016 we performed our technique in selected previously augmented patients who underwent a skin-sparing mastectomy. We excluded those patients having the implants for less than a year, subglandular placement, capsular contracture grades III and IV, broken implants, smoker patients and those who were going to receive radiotherapy. The minimum follow-up period was 1 year. We measured the aesthetic result and complications such as capsular contracture, seroma, hematoma and infection. The skin-sparing mastectomy must preserve periprosthetic capsule. The lower pole of the new implant will be covered with the previously folded retropectoral capsule and the superior pole with the pectoralis major. Results: Four patients were selected, mean age was 44 year-old, and mean volume of the new implant placed was 410cc. After the follow-up period (mean of 17 months) no patient suffered any major complications and no capsular contracture was identified, achieving satisfactory aesthetic results. Conclusions: The use of a retropectoral capsular flap creates an independent plane below the subcutaneous. It is an easy and safe technique that achieves a pleasing aesthetic result. Nevertheless, we present preliminary results and more studies are needed with a longer follow-up as well as a larger number of patients to achieve more validity


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Mamoplastia/métodos , Retalhos Cirúrgicos/cirurgia , Neoplasias da Mama/cirurgia , Implantes de Mama , Mastectomia/métodos , Músculos Peitorais/cirurgia , Procedimentos de Cirurgia Plástica/métodos
19.
Genet Med ; 21(5): 1199-1208, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30287925

RESUMO

PURPOSE: To characterize new molecular factors implicated in a hereditary congenital facial paresis (HCFP) family and otosclerosis. METHODS: We performed exome sequencing in a four-generation family presenting nonprogressive HCFP and mixed hearing loss (HL). MEPE was analyzed using either Sanger sequencing or molecular inversion probes combined with massive parallel sequencing in 89 otosclerosis families, 1604 unrelated affected subjects, and 1538 unscreened controls. RESULTS: Exome sequencing in the HCFP family led to the identification of a rare segregating heterozygous frameshift variant p.(Gln425Lysfs*38) in MEPE. As the HL phenotype in this family resembled otosclerosis, we performed variant burden and variance components analyses in a large otosclerosis cohort and demonstrated that nonsense and frameshift MEPE variants were significantly enriched in affected subjects (p = 0.0006-0.0060). CONCLUSION: MEPE exerts its function in bone homeostasis by two domains, an RGD and an acidic serine aspartate-rich MEPE-associated (ASARM) motif inhibiting respectively bone resorption and mineralization. All variants associated with otosclerosis are predicted to result in nonsense mediated decay or an ASARM-and-RGD-truncated MEPE. The HCFP variant is predicted to produce an ASARM-truncated MEPE with an intact RGD motif. This difference in effect on the protein corresponds with the presumed pathophysiology of both diseases, and provides a plausible molecular explanation for the distinct phenotypic outcome.


Assuntos
Proteínas da Matriz Extracelular/genética , Paralisia Facial/congênito , Glicoproteínas/genética , Otosclerose/genética , Fosfoproteínas/genética , Adulto , Osso e Ossos/metabolismo , Proteínas da Matriz Extracelular/metabolismo , Paralisia Facial/etiologia , Paralisia Facial/genética , Paralisia Facial/metabolismo , Família , Feminino , Doenças Genéticas Ligadas ao Cromossomo X/genética , Variação Genética/genética , Glicoproteínas/metabolismo , Perda Auditiva/genética , Heterozigoto , Humanos , Masculino , Linhagem , Fenótipo , Fosfoproteínas/metabolismo , Sequenciamento do Exoma/métodos
20.
Proteomics Clin Appl ; 11(1-2)2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27600370

RESUMO

PURPOSE: Arginine methylation (ArgMe) is one of the most ubiquitous PTMs, and hundreds of proteins undergo ArgMe in, for example, brain. However, the scope of ArgMe in many tissues, including the heart, is currently underexplored. Here, we aimed to (i) identify proteins undergoing ArgMe in human organs, and (ii) expose the relevance of ArgMe in cardiac disease. EXPERIMENTAL DESIGN: The publicly available proteomic data is used to search for ArgMe in 13 human tissues. To induce H9c2 cardiac-like cell hypertrophy glucose is used. RESULTS: The results show that ArgMe is mainly tissue-specific; nevertheless, the authors suggest an embryonic origin of core ArgMe events. In the heart, 103 mostly novel ArgMe sites in 58 nonhistone proteins are found. The authors provide compelling evidence that cardiac protein ArgMe is relevant to cardiomyocyte ontology, and important for proper cardiac function. This is highlighted by the fact that genetic mutations affecting methylated arginine positions are often associated with cardiac disease, including hypertrophic cardiomyopathy. The pilot experimental data suggesting significant changes in ArgMe profiles of H9c2 cells upon induction of cell hypertrophy using glucose is provided. CONCLUSIONS AND CLINICAL RELEVANCE: The work calls for in-depth investigation of ArgMe in normal and diseased tissues using methods including clinical proteomics.


Assuntos
Arginina/metabolismo , Miocárdio/metabolismo , Cardiomiopatia Hipertrófica/metabolismo , Cardiomiopatia Hipertrófica/patologia , Linhagem Celular , Feto/metabolismo , Humanos , Metilação , Modelos Biológicos , Mioblastos/citologia , Mioblastos/metabolismo
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