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Montenegro L, Seraphim C, Tinano F, Piovesan M, Canton APM, McElreavey K, Brabant S, Boris NP, Magnuson M, Carroll RS, Kaiser UB, Argente J, Barrios V, Brito VN, Brauner R, Latronico AC. Familial central precocious puberty due to DLK1 deficiency: novel genetic findings and relevance of serum DLK1 levels. Eur J Endocrinol 2023; 189:422-428. [PMID: 37703313 PMCID: PMC10519858 DOI: 10.1093/ejendo/lvad129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/22/2023] [Accepted: 08/10/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Several rare loss-of-function mutations of delta-like noncanonical notch ligand 1 (DLK1) have been described in non-syndromic children with familial central precocious puberty (CPP). OBJECTIVE We investigated genetic abnormalities of DLK1 gene in a French cohort of children with idiopathic CPP. Additionally, we explored the pattern of DLK1 serum levels in patients with CPP and in healthy children at puberty, as well as in wild-type female mice. PATIENTS AND METHODS Genomic DNA was obtained from 121 French index cases with CPP. Automated sequencing of the coding region of the DLK1 gene was performed in all cases. Serum DLK1 levels were measured by enzyme linked immunosorbent assay (ELISA) in 209 individuals, including 191 with normal pubertal development and in female mice during postnatal pubertal maturation. RESULTS We identified 2 rare pathogenic DLK1 allelic variants: A stop gain variant (c.372C>A; p.Cys124X) and a start loss variant (c.2T>G; p.Met1?, or p.0) in 2 French girls with CPP. Mean serum DLK1 levels were similar between healthy children and idiopathic CPP children. In healthy individuals, DLK1 levels correlated with pubertal stage: In girls, DLK1 decreased between Tanner stages III and V, whereas in boys, DLK1 decreased between Tanner stages II and V (P = .008 and .016, respectively). Serum levels of Dlk1 also decreased in wild-type female mice. CONCLUSIONS Novel loss-of-function mutations in DLK1 gene were identified in 2 French girls with CPP. Additionally, we demonstrated a pattern of dynamic changes in circulating DLK1 serum levels in humans and mice during pubertal stages, reinforcing the role of this factor in pubertal timing.
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Affiliation(s)
- Luciana Montenegro
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Departamento de Clínica Médica, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, 05403-000, Brazil
| | - Carlos Seraphim
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Departamento de Clínica Médica, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, 05403-000, Brazil
| | - Flávia Tinano
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Departamento de Clínica Médica, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, 05403-000, Brazil
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 021115, United States
| | - Maiara Piovesan
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Departamento de Clínica Médica, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, 05403-000, Brazil
| | - Ana P M Canton
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Departamento de Clínica Médica, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, 05403-000, Brazil
| | - Ken McElreavey
- Human Developmental Genetics Unit, Institute Pasteur, Paris, 75724, France
| | - Severine Brabant
- Assistance Publique Hopitaux de Paris, Department of Functional Explorations, Necker Enfants Malades Hospital, Paris-Centre University, Paris Cedex, 75015, France
| | - Natalia P Boris
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 021115, United States
| | - Melissa Magnuson
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 021115, United States
| | - Rona S Carroll
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 021115, United States
| | - Ursula B Kaiser
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 021115, United States
| | - Jesús Argente
- Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, 28049, Spain
- Department of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, 28009, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain
- IMDEA Food Institute, CEIUAM+CSIC, Madrid, 28049, Spain
| | - Vicente Barrios
- Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, 28049, Spain
- Department of Pediatrics & Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Madrid, 28009, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain
- IMDEA Food Institute, CEIUAM+CSIC, Madrid, 28049, Spain
| | - Vinicius N Brito
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Departamento de Clínica Médica, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, 05403-000, Brazil
| | - Raja Brauner
- Pediatric Endocrinology Unit, Hôpital Fondation Adolphe de Rothschild and Université Paris Cité, Paris, 75019, France
| | - Ana Claudia Latronico
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Departamento de Clínica Médica, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, 05403-000, Brazil
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Magnotto JC, Mancini A, Bird K, Montenegro L, Tütüncüler F, Pereira SA, Simas V, Garcia L, Roberts SA, Macedo D, Magnuson M, Gagliardi P, Mauras N, Witchel SF, Carroll RS, Latronico AC, Kaiser UB, Abreu AP. Novel MKRN3 Missense Mutations Associated With Central Precocious Puberty Reveal Distinct Effects on Ubiquitination. J Clin Endocrinol Metab 2023; 108:1646-1656. [PMID: 36916482 PMCID: PMC10653150 DOI: 10.1210/clinem/dgad151] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/02/2023] [Accepted: 03/10/2023] [Indexed: 03/15/2023]
Abstract
CONTEXT Loss-of-function mutations in the maternally imprinted genes, MKRN3 and DLK1, are associated with central precocious puberty (CPP). Mutations in MKRN3 are the most common known genetic etiology of CPP. OBJECTIVE This work aimed to screen patients with CPP for MKRN3 and DLK1 mutations and analyze the effects of identified mutations on protein function in vitro. METHODS Participants included 84 unrelated children with CPP (79 girls, 5 boys) and, when available, their first-degree relatives. Five academic medical institutions participated. Sanger sequencing of MKRN3 and DLK1 5' upstream flanking and coding regions was performed on DNA extracted from peripheral blood leukocytes. Western blot analysis was performed to assess protein ubiquitination profiles. RESULTS Eight heterozygous MKRN3 mutations were identified in 9 unrelated girls with CPP. Five are novel missense mutations, 2 were previously identified in patients with CPP, and 1 is a frameshift variant not previously associated with CPP. No pathogenic variants were identified in DLK1. Girls with MKRN3 mutations had an earlier age of initial pubertal signs and higher basal serum luteinizing hormone and follicle-stimulating hormone compared to girls with CPP without MRKN3 mutations. Western blot analysis revealed that compared to wild-type MKRN3, mutations within the RING finger domain reduced ubiquitination whereas the mutations outside this domain increased ubiquitination. CONCLUSION MKRN3 mutations were present in 10.7% of our CPP cohort, consistent with previous studies. The novel identified mutations in different domains of MKRN3 revealed different patterns of ubiquitination, suggesting distinct molecular mechanisms by which the loss of MRKN3 results in early pubertal onset.
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Affiliation(s)
- John C Magnotto
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Alessandra Mancini
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Keisha Bird
- Division of Endocrinology, Diabetes, and Metabolism, Nemours Children's Health, Jacksonville, FL 32207, USA
| | - Luciana Montenegro
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Disciplina de Endocrinologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, Brazil
| | - Filiz Tütüncüler
- Department of Pediatrics and Pediatric Endocrinology Unit, Trakya University Faculty of Medicine, Edirne 22030, Turkey
| | - Sidney A Pereira
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Vitoria Simas
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Leonardo Garcia
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Stephanie A Roberts
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Division of Endocrinology, Boston Children's Hospital, Boston, MA 02115, USA
| | - Delanie Macedo
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Melissa Magnuson
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Priscila Gagliardi
- Division of Endocrinology, Diabetes, and Metabolism, Nemours Children's Health, Jacksonville, FL 32207, USA
| | - Nelly Mauras
- Division of Endocrinology, Diabetes, and Metabolism, Nemours Children's Health, Jacksonville, FL 32207, USA
| | - Selma F Witchel
- Pediatric Endocrinology, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Rona S Carroll
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Ana Claudia Latronico
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Disciplina de Endocrinologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, Brazil
| | - Ursula B Kaiser
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Ana Paula Abreu
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Argente J, Brito V, Guimaraes A, Latronico AC, Leal A, Mendonça B, Montenegro L, Piovesan M, Ramos C, Seraphim C, Tinano F, Canton A. OR18-2 Clinical, Hormonal and Genetic Characterization of Familial Central Precocious Puberty. J Endocr Soc 2022. [DOI: 10.1210/jendso/bvac150.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Context: Familial central precocious puberty (CPP) is a prevalent form (about 27.5%) of precocious puberty. Loss-of-function mutations in two maternally imprinted genes, MKRN3 and DLK1, were identified in families with CPP showing dominant autosomal inheritance with paternal transmission. Maternally transmitted CPP was previously demonstrated in up to 60% of families using pedigree analysis, however, no definitive genetic abnormality has been identified so far.
Objectives
To estimate the prevalence of familial cases in a multiethnic cohort with CPP. To characterize the genetic basis and the mode of inheritance of the affected families. To compare clinical and hormonal features of patients with familial CPP due to different modes of transmission.
Patients and Methods
Clinical and hormonal data were obtained from medical registries of 495 patients with CPP and no brain MRI alterations. Familial CPP was defined as the presence of one or more close relatives with CPP or precocious menarche (≤9 yr). Sanger sequencing of MKRN3 and DLK1 was performed in 427 index cases. Targeted gene panel sequencing was performed in 79 cases, while whole exome sequencing was performed in 101 cases from 36 families
Results
Among 495 index cases, 159 had familial CPP (31%). The mode of transmission of CPP was identified as paternal in 58 (35%), maternal in 59 (38%), indeterminate in 34 (22%), and both maternal and paternal transmission in 8 (5%). Most families with paternal or maternal transmission had 2 generations known to be affected (51 and 77%, respectively). Notably, 67% of index cases with maternally transmitted CPP had their mother affected. In girls with CPP, the median age of thelarche was 6.5 yr in the paternally transmitted group, 6.9 yr in the maternally transmitted group, and 7.3 yr in the indeterminate group (p= 0.547). Median bone age advancement was 2.1, 2.3 and 1.2 yr, respectively (p= 0.013). Basal LH levels were higher in girls with paternally transmitted CPP (p= 0.047). Among those with paternally transmitted CPP, MKRN3 and DLK1 mutations were identified in, respectively, 63.8% and 10.3% of the families.
Conclusions
A significant prevalence (31%) of familial CPP was demonstrated in a multiethnic cohort. Maternally transmitted CPP represented the most frequent form of familial CPP (38%). MKRN3 loss-of-function mutations were responsible for most paternally transmitted CPP cases (63.8%), followed by DLK1 loss-of-function mutations (10.3%).
Presentation: Monday, June 13, 2022 11:15 a.m. - 11:30 a.m.
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Assumpção C, Montenegro L, Solberg P, Gilban D, Bordallo AP, Medeiros C, Latrônico AC, Madeira I. Familial central precocious puberty due to inactivation of the MKRN3 gene: case report. Resid Pediatr 2022. [DOI: 10.25060/residpediatr-2022.v12n1-281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Central precocious puberty results from premature activation of the hypothalamic-pituitary-gonadal axis. The factors involved in central early puberty are still poorly understood. Recently, mutations in the makorin ring finger protein 3 (MKRN3) gene have been identified in familial cases. We report the case of two sisters with central precocious puberty. The diagnosis, carried out by molecular analysis, showed an inactivating mutation of the MKRN3 gene.
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Guzman K, Montenegro L, Pazos A. P-213 Helicobacter pylori babA gene evolution and adaptation in Colombian populations. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Seraphim CE, Canton APM, Montenegro L, Piovesan MR, Macedo DB, Cunha M, Guimaraes A, Ramos CO, Benedetti AFF, de Castro Leal A, Gagliardi PC, Antonini SR, Gryngarten M, Arcari AJ, Abreu AP, Kaiser UB, Soriano-Guillén L, Escribano-Muñoz A, Corripio R, Labarta JI, Travieso-Suárez L, Ortiz-Cabrera NV, Argente J, Mendonca BB, Brito VN, Latronico AC. Genotype-Phenotype Correlations in Central Precocious Puberty Caused by MKRN3 Mutations. J Clin Endocrinol Metab 2021; 106:1041-1050. [PMID: 33383582 PMCID: PMC7993586 DOI: 10.1210/clinem/dgaa955] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Indexed: 12/12/2022]
Abstract
CONTEXT Loss-of-function mutations of makorin RING finger protein 3 (MKRN3) are the most common monogenic cause of familial central precocious puberty (CPP). OBJECTIVE To describe the clinical and hormonal features of a large cohort of patients with CPP due to MKRN3 mutations and compare the characteristics of different types of genetic defects. METHODS Multiethnic cohort of 716 patients with familial or idiopathic CPP screened for MKRN3 mutations using Sanger sequencing. A group of 156 Brazilian girls with idiopathic CPP (ICPP) was used as control group. RESULTS Seventy-one patients (45 girls and 26 boys from 36 families) had 18 different loss-of-function MKRN3 mutations. Eight mutations were classified as severe (70% of patients). Among the 71 patients, first pubertal signs occurred at 6.2 ± 1.2 years in girls and 7.1 ± 1.5 years in boys. Girls with MKRN3 mutations had a shorter delay between puberty onset and first evaluation and higher follicle-stimulating hormone levels than ICPP. Patients with severe MKRN3 mutations had a greater bone age advancement than patients with missense mutations (2.3 ± 1.6 vs 1.6 ± 1.4 years, P = .048), and had higher basal luteinizing hormone levels (2.2 ± 1.8 vs 1.1 ± 1.1 UI/L, P = .018) at the time of presentation. Computational protein modeling revealed that 60% of the missense mutations were predicted to cause protein destabilization. CONCLUSION Inherited premature activation of the reproductive axis caused by loss-of-function mutations of MKRN3 is clinically indistinct from ICPP. However, the type of genetic defect may affect bone age maturation and gonadotropin levels.
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Affiliation(s)
- Carlos Eduardo Seraphim
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Correspondence: Ana Claudia Latronico, MD, PhD, Hospital das Clínicas da FMUSP, Divisão de Endocrinologia e Metabologia, Av. Dr. Enéas de Carvalho Aguiar, 255, 7o andar, sala 7037—CEP: 05403-900—Cerqueira César—São Paulo, SP, Brazil. and
| | - Ana Pinheiro Machado Canton
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Luciana Montenegro
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Maiara Ribeiro Piovesan
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Delanie B Macedo
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Marina Cunha
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Aline Guimaraes
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Carolina Oliveira Ramos
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Anna Flavia Figueiredo Benedetti
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Andrea de Castro Leal
- Departamento de Saúde Integrada da Universidade do Estado do Pará (UEPA), Santarém, Pará, Brazil
| | - Priscila C Gagliardi
- Division of Endocrinology, Diabetes, and Metabolism, Nemours Children’s Clinic, Jacksonville, FL, USA
| | - Sonir R Antonini
- Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - Mirta Gryngarten
- Centro de Investigaciones Endocrinológicas “Dr. César Bergadá” (Consejo Nacional de Investigaciones Científicas y Técnicas – FEI - División de Endocrinología, Hospital de Niños Ricardo Gutiérrez), Buenos Aires, Argentina
| | - Andrea J Arcari
- Centro de Investigaciones Endocrinológicas “Dr. César Bergadá” (Consejo Nacional de Investigaciones Científicas y Técnicas – FEI - División de Endocrinología, Hospital de Niños Ricardo Gutiérrez), Buenos Aires, Argentina
| | - Ana Paula Abreu
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Ursula B Kaiser
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Leandro Soriano-Guillén
- Department of Pediatrics, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Spanish PUBERE Registry, Madrid, Spain
| | - Arancha Escribano-Muñoz
- Endocrinology Unit, Department of Pediatrics, University Hospital Virgen of Arrixaca, Spanish PUBERE Registry, Murcia, Spain
| | - Raquel Corripio
- Pediatric Endocrinology Department, Corporació Parc Taulí Hospital Universitari. Institut d’Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona. Spanish PUBERE Registry, Sabadell, Spain
| | - José I Labarta
- Pediatric Endocrinology Unit, Department of Pediatrics, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón, Spanish PUBERE Registry, Zaragoza, Spain
| | - Lourdes Travieso-Suárez
- Hospital Infantil Universitario Niño Jesús, Department of Endocrinology and Department of Pediatrics, Universidad Autónoma de Madrid, Spanish PUBERE Registry, CIBER of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, IMDEA Institute, Madrid, Spain
| | - Nelmar Valentina Ortiz-Cabrera
- Hospital Infantil Universitario Niño Jesús, Department of Endocrinology and Department of Pediatrics, Universidad Autónoma de Madrid, Spanish PUBERE Registry, CIBER of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, IMDEA Institute, Madrid, Spain
| | - Jesús Argente
- Hospital Infantil Universitario Niño Jesús, Department of Endocrinology and Department of Pediatrics, Universidad Autónoma de Madrid, Spanish PUBERE Registry, CIBER of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, IMDEA Institute, Madrid, Spain
| | - Berenice B Mendonca
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Vinicius N Brito
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ana Claudia Latronico
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM/42, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Martins T, Montenegro L, Silva A, Reis H, Pereira E, Lucas P. Spinal subarachnoid haematoma after neuraxial anaesthesia in a patient with polycythaemia vera. Anaesth Rep 2021; 9:8-11. [PMID: 33479701 DOI: 10.1002/anr3.12093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 11/08/2022] Open
Abstract
Polycythaemia vera is a common haematological proliferative disorder. It is characterised by uncontrolled red cell production with ensuing peri-operative vaso-occlusive and haemorrhagic complications. Spinal haematoma after neuraxial anaesthesia is rare; most cases are associated with technical difficulties or bleeding disorders. Current consensus opinion suggests that neuraxial anaesthesia in patients with polycythaemia vera is safe due to a lower risk of thrombotic events and hypoxaemia compared with general anaesthesia. We report a case of a spinal subarachnoid haematoma after uneventful neuraxial anaesthesia in a patient with optimised polycythaemia vera. Despite an emergent laminectomy, the patient developed permanent motor deficits. This report highlights that although neuraxial anaesthesia is recommended by many authors, patients with polycythaemia vera can paradoxically have an increased haemorrhagic risk from platelet dysfunction and acquired von Willebrand disease. Clinicians proceeding with surgery under neuraxial anaesthesia should appreciate these risks even in patients with normal or apparently elevated thrombotic states. This case also demonstrates that traditional coagulation tests may need to be complemented by pre-operative platelet function tests and screening for von Willebrand disease. Finally, the importance of the patient participation in the choice of the anaesthesia technique cannot be understated, with specific attention paid to this frequently unrecognised risk.
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Affiliation(s)
- T Martins
- Department of Anaesthesia Hospital Garcia de Orta Almada Portugal
| | - L Montenegro
- Department of Anaesthesia Hospital Garcia de Orta Almada Portugal
| | - A Silva
- Department of Anaesthesia Hospital Garcia de Orta Almada Portugal
| | - H Reis
- Department of Anaesthesia Hospital Garcia de Orta Almada Portugal
| | - E Pereira
- Department of Anaesthesia Hospital Garcia de Orta Almada Portugal
| | - P Lucas
- Department of Anaesthesia Hospital Garcia de Orta Almada Portugal
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Montenegro L, Labarta JI, Piovesan M, Canton APM, Corripio R, Soriano-Guillén L, Travieso-Suárez L, Martín-Rivada Á, Barrios V, Seraphim CE, Brito VN, Latronico AC, Argente J. Novel Genetic and Biochemical Findings of DLK1 in Children with Central Precocious Puberty: A Brazilian-Spanish Study. J Clin Endocrinol Metab 2020; 105:5872717. [PMID: 32676665 DOI: 10.1210/clinem/dgaa461] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 07/14/2020] [Indexed: 02/13/2023]
Abstract
BACKGROUND Central precocious puberty (CPP) has been associated with loss-of-function mutations in 2 paternally expressed genes (MKRN3 and DLK1). Rare defects in the DLk1 were also associated with poor metabolic phenotype at adulthood. OBJECTIVE Our aim was to investigate genetic and biochemical aspects of DLK1 in a Spanish cohort of children with CPP without MKRN3 mutations. PATIENTS A large cohort of children with idiopathic CPP (Spanish PUBERE Registry) was studied. Genomic deoxyribonucleic acid was obtained from 444 individuals (168 index cases) with CPP and their close relatives. Automatic sequencing of MKRN3 and DLK1 genes were performed. RESULTS Five rare heterozygous mutations of MKRN3 were initially excluded in girls with familial CPP. A rare allelic deletion (c.401_404 + 8del) in the splice site junction of DLK1 was identified in a Spanish girl with sporadic CPP. Pubertal signs started at 5.7 years. Her metabolic profile was normal. Familial segregation analysis showed that the DLK1 deletion was de novo in the affected child. Serum DLK1 levels were undetectable (<0.4 ng/mL), indicating that the deletion led to complete lack of DLK1 production. Three others rare allelic variants of DLK1 were also identified (p.Asn134=; g.-222 C>A and g.-223 G>A) in 2 girls with CPP. However, both had normal DLK1 serum levels. CONCLUSION Loss-of-function mutations of DLK1 represent a rare cause of CPP, reinforcing a significant role of this factor in human pubertal timing.
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Affiliation(s)
- Luciana Montenegro
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - José I Labarta
- Pediatric Endocrinology Unit, Department of Pediatrics, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - Maira Piovesan
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ana P M Canton
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Raquel Corripio
- Pediatric Endocrinology Department, Corporació Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Leandro Soriano-Guillén
- Pediatric Endocrinology Unit, Institute of Biomedical Research - Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid. Madrid, Spain
| | - Lourdes Travieso-Suárez
- Department of Pediatrics, Universidad Autónoma de Madrid. Departments of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, IMDEA Food Institute. Madrid, Spain
| | - Álvaro Martín-Rivada
- Department of Pediatrics, Universidad Autónoma de Madrid. Departments of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, IMDEA Food Institute. Madrid, Spain
| | - Vicente Barrios
- Department of Pediatrics, Universidad Autónoma de Madrid. Departments of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, IMDEA Food Institute. Madrid, Spain
| | - Carlos E Seraphim
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Vinicius N Brito
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ana Claudia Latronico
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular/LIM42, Hospital das Clínicas, Disciplina de Endocrinologia e Metabologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jesús Argente
- Department of Pediatrics, Universidad Autónoma de Madrid. Departments of Pediatrics and Pediatric Endocrinology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación La Princesa, Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, IMDEA Food Institute. Madrid, Spain
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Sánchez A, Perea J, Montenegro L, Espinoza I, Avellaneda J, Barba C. Cinética de degradación ruminal in situ de ensilado de rastrojo de maíz (Zea mays) con niveles crecientes de urea. ARCH ZOOTEC 2020. [DOI: 10.21071/az.v69i267.5351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Se estudió el efecto de la inclusión de urea sobre la composición y cinética de degradación ruminal in situ en el ensilado de rastrojo de maíz. Se partió de cuatro de tratamientos al adicionar el 0, 1, 2 y 3% de urea a una mezcla de rastrojo de maíz con el 10% de melaza. Se elaboraron 128 microsilos (3 kg/unidad y 4 repeticiones por tratamiento). La apertura de los silos se realizó a los 7, 14, 21, 28, 35, 42, 49 y 56 días. Se determinó el contenido de la materia seca (MS), materia orgánica (MO), proteína bruta (PB), FND y FAD. La degradabilidad in situ se obtuvo mediante el método de Mehrez y Orskov y la degradabilidad de MS y PB mediante el análisis de los residuos con el método Kjeldhal. Los datos se analizaron con el procedimiento GLM y el test de Tukey (P±
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10
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Granadillo JL, P A Stegmann A, Guo H, Xia K, Angle B, Bontempo K, Ranells JD, Newkirk P, Costin C, Viront J, Stumpel CT, Sinnema M, Panis B, Pfundt R, Krapels IPC, Klaassens M, Nicolai J, Li J, Jiang Y, Marco E, Canton A, Latronico AC, Montenegro L, Leheup B, Bonnet C, M Amudhavalli S, Lawson CE, McWalter K, Telegrafi A, Pearson R, Kvarnung M, Wang X, Bi W, Rosenfeld JA, Shinawi M. Pathogenic variants in TNRC6B cause a genetic disorder characterised by developmental delay/intellectual disability and a spectrum of neurobehavioural phenotypes including autism and ADHD. J Med Genet 2020; 57:717-724. [PMID: 32152250 DOI: 10.1136/jmedgenet-2019-106470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Rare variants in hundreds of genes have been implicated in developmental delay (DD), intellectual disability (ID) and neurobehavioural phenotypes. TNRC6B encodes a protein important for RNA silencing. Heterozygous truncating variants have been reported in three patients from large cohorts with autism, but no full phenotypic characterisation was described. METHODS Clinical and molecular characterisation was performed on 17 patients with TNRC6B variants. Clinical data were obtained by retrospective chart review, parent interviews, direct patient interaction with providers and formal neuropsychological evaluation. RESULTS Clinical findings included DD/ID (17/17) (speech delay in 94% (16/17), fine motor delay in 82% (14/17) and gross motor delay in 71% (12/17) of subjects), autism or autistic traits (13/17), attention deficit and hyperactivity disorder (ADHD) (11/17), other behavioural problems (7/17) and musculoskeletal findings (12/17). Other congenital malformations or clinical findings were occasionally documented. The majority of patients exhibited some dysmorphic features but no recognisable gestalt was identified. 17 heterozygous TNRC6B variants were identified in 12 male and five female unrelated subjects by exome sequencing (14), a targeted panel (2) and a chromosomal microarray (1). The variants were nonsense (7), frameshift (5), splice site (2), intragenic deletions (2) and missense (1). CONCLUSIONS Variants in TNRC6B cause a novel genetic disorder characterised by recurrent neurocognitive and behavioural phenotypes featuring DD/ID, autism, ADHD and other behavioural abnormalities. Our data highly suggest that haploinsufficiency is the most likely pathogenic mechanism. TNRC6B should be added to the growing list of genes of the RNA-induced silencing complex associated with ID/DD, autism and ADHD.
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Affiliation(s)
- Jorge Luis Granadillo
- Department of Pediatrics, Division of Genetics and Genomic Medicine, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri, USA
| | - Alexander P A Stegmann
- Department of Clinical Genetics and School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Hui Guo
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Kun Xia
- Center for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Brad Angle
- Advocate Lutheran General Hospital, Park Ridge, Illinois, USA
| | - Kelly Bontempo
- Advocate Lutheran General Hospital, Park Ridge, Illinois, USA
| | - Judith D Ranells
- Department of Pediatrics, University of South Florida, Tampa, Florida, USA
| | - Patricia Newkirk
- Department of Pediatrics, University of South Florida, Tampa, Florida, USA
| | | | | | - Constanze T Stumpel
- Department of Clinical Genetics and School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Margje Sinnema
- Department of Clinical Genetics and School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Bianca Panis
- Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands
| | - Rolph Pfundt
- Department of Human Genetics, Radboud University Medical Centre, Nijmgen, The Netherlands
| | - Ingrid P C Krapels
- Department of Clinical Genetics, Maastricht University, Maastricht, The Netherlands
| | - Merel Klaassens
- Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Joost Nicolai
- Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Jinliang Li
- Peking University First Hospital, Beijing, Beijing, China
| | - Yuwu Jiang
- Peking University First Hospital, Beijing, Beijing, China
| | - Elysa Marco
- UCSF Pediatric Brain Center, UCSF, San Francisco, California, USA
| | - Ana Canton
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ana Claudia Latronico
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Luciana Montenegro
- Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Bruno Leheup
- Service de Génétique clinique, Höpital Brabois, Centre Hospitalier Universitaire de Nancy, Nancy, Lorraine, France
| | - Celine Bonnet
- Centre Hospitalier Universitaire de Nancy, Nancy, Lorraine, France
| | | | | | | | | | | | - Malin Kvarnung
- Department of Clinical Genetics & Department of Molecular Medicine and Surgery, Karolinska University Hospital & Karolinska Institute, Stockholm, Sweden
| | - Xia Wang
- Baylor Genetics Laboratories, Houston, Texas, USA
| | - Weimin Bi
- Baylor College of Medicine Department of Molecular and Human Genetics, Houston, Texas, USA
| | - Jill Anne Rosenfeld
- Baylor Genetics Laboratories, Houston, Texas, USA.,Baylor College of Medicine Department of Molecular and Human Genetics, Houston, Texas, USA
| | - Marwan Shinawi
- Department of Pediatrics, Division of Genetics and Genomic Medicine, Washington University School of Medicine in Saint Louis, Saint Louis, Missouri, USA
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11
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Brondani VB, Montenegro L, Lacombe AMF, Magalhães BM, Nishi MY, Funari MFDA, Narcizo ADM, Cardoso LC, Siqueira SAC, Zerbini MCN, Denes FT, Latronico AC, Mendonca BB, Almeida MQ, Lerario AM, Soares IC, Fragoso MCBV. High Prevalence of Alterations in DNA Mismatch Repair Genes of Lynch Syndrome in Pediatric Patients with Adrenocortical Tumors Carrying a Germline Mutation on TP53. Cancers (Basel) 2020; 12:cancers12030621. [PMID: 32156018 PMCID: PMC7139318 DOI: 10.3390/cancers12030621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 12/13/2022] Open
Abstract
Adrenocortical cancer is a rare malignant neoplasm associated with a dismal prognosis. Identification of the molecular pathways involved in adrenal tumorigenesis is essential for a better understanding of the disease mechanism and improvement of its treatment. The aim of this study is to define the prevalence of alterations in DNA mismatch repair (MMR) genes in Lynch syndrome among pediatric patients with adrenocortical neoplasia from southern Brazil, where the prevalence of a specific TP53 germline mutation (p.Arg337His) is quite high. Thirty-six pediatric patients were retrospectively evaluated. Immunohistochemistry (IHC) for the MMR enzymes MLH1, MSH2, MSH6, and PMS2, as well as next-generation sequencing (NGS) were performed. For IHC, 36 pediatric tumors were tested. In all of them, the expression of all evaluated MMR proteins was well-preserved. For NGS, 35 patients with pediatric tumor were tested. Three patients (8.57%) with the TP53 p.Arg337His germline mutation presented pathogenic and likely pathogenic variants in the MMR genes (two in MLH1 and one in MSH6). The prevalence of altered MMR genes among pediatric patients was elevated (8.57%) and higher than in colorectal and endometrial cancer cohorts. Pediatric patients with adrenocortical tumors should, thus, be strongly considered as at genetic risk for Lynch syndrome.
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Affiliation(s)
- Vania Balderrama Brondani
- Laboratório de Hormônios e Genética Molecular LIM/42, Unidade de Suprarrenal, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil; (A.M.F.L.); (B.M.M.); (A.C.L.); (B.B.M.); (M.Q.A.)
- Correspondence: (V.B.B.); (L.M.); (M.C.B.V.F.); Tel.: +55-11-26617512e (M.C.B.V.F.)
| | - Luciana Montenegro
- Laboratório de Hormônios e Genética Molecular LIM/42, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil (M.F.d.A.F.)
- Correspondence: (V.B.B.); (L.M.); (M.C.B.V.F.); Tel.: +55-11-26617512e (M.C.B.V.F.)
| | - Amanda Meneses Ferreira Lacombe
- Laboratório de Hormônios e Genética Molecular LIM/42, Unidade de Suprarrenal, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil; (A.M.F.L.); (B.M.M.); (A.C.L.); (B.B.M.); (M.Q.A.)
| | - Breno Marchiori Magalhães
- Laboratório de Hormônios e Genética Molecular LIM/42, Unidade de Suprarrenal, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil; (A.M.F.L.); (B.M.M.); (A.C.L.); (B.B.M.); (M.Q.A.)
| | - Mirian Yumie Nishi
- Laboratório de Hormônios e Genética Molecular LIM/42, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil (M.F.d.A.F.)
| | - Mariana Ferreira de Assis Funari
- Laboratório de Hormônios e Genética Molecular LIM/42, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil (M.F.d.A.F.)
| | - Amanda de Moraes Narcizo
- Laboratório de Sequenciamento em Larga Escala (SELA), Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil; (A.d.M.N.); (L.C.C.)
| | - Lais Cavalca Cardoso
- Laboratório de Sequenciamento em Larga Escala (SELA), Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil; (A.d.M.N.); (L.C.C.)
| | - Sheila Aparecida Coelho Siqueira
- Departamento de Anatomia Patológica, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil; (S.A.C.S.); (M.C.N.Z.)
| | - Maria Claudia Nogueira Zerbini
- Departamento de Anatomia Patológica, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil; (S.A.C.S.); (M.C.N.Z.)
| | - Francisco Tibor Denes
- Serviço de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil;
| | - Ana Claudia Latronico
- Laboratório de Hormônios e Genética Molecular LIM/42, Unidade de Suprarrenal, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil; (A.M.F.L.); (B.M.M.); (A.C.L.); (B.B.M.); (M.Q.A.)
- Laboratório de Hormônios e Genética Molecular LIM/42, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil (M.F.d.A.F.)
| | - Berenice Bilharinho Mendonca
- Laboratório de Hormônios e Genética Molecular LIM/42, Unidade de Suprarrenal, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil; (A.M.F.L.); (B.M.M.); (A.C.L.); (B.B.M.); (M.Q.A.)
- Laboratório de Hormônios e Genética Molecular LIM/42, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil (M.F.d.A.F.)
| | - Madson Queiroz Almeida
- Laboratório de Hormônios e Genética Molecular LIM/42, Unidade de Suprarrenal, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil; (A.M.F.L.); (B.M.M.); (A.C.L.); (B.B.M.); (M.Q.A.)
- Laboratório de Hormônios e Genética Molecular LIM/42, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil (M.F.d.A.F.)
- Serviço de Endocrinologia, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil
| | - Antonio Marcondes Lerario
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Ibere Cauduro Soares
- Serviço de Anatomia Patológica, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil;
| | - Maria Candida Barisson Villares Fragoso
- Laboratório de Hormônios e Genética Molecular LIM/42, Unidade de Suprarrenal, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil; (A.M.F.L.); (B.M.M.); (A.C.L.); (B.B.M.); (M.Q.A.)
- Laboratório de Hormônios e Genética Molecular LIM/42, Serviço de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil (M.F.d.A.F.)
- Serviço de Endocrinologia, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo 0540396, Brasil
- Correspondence: (V.B.B.); (L.M.); (M.C.B.V.F.); Tel.: +55-11-26617512e (M.C.B.V.F.)
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Mosnier E, Nacher M, Parriault MC, Dao C, Bidaud B, Brousse P, Gaillet M, Epelboin L, Mendes AM, Montenegro L, Daniel CN, Botreau R, Rouseliere A, Rhodes S, Carbunar A. Knowledge, attitudes, practices about HIV and implications in risk and stigma prevention among French Guianese and Brazilian border inhabitants : Beliefs about HIV among border inhabitants. BMC Public Health 2019; 19:1633. [PMID: 31801512 PMCID: PMC6894142 DOI: 10.1186/s12889-019-7997-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The border area between French Guiana and Brazil is an active HIV-transmission zone. The aim of the present study was to describe HIV knowledge, risk and the level of stigma among inhabitants of this border area. METHODS A cross-sectional study was conducted among 621 inhabitants over 18 years of age in the border cities of Saint-Georges-de-l'Oyapock in French Guiana and Oiapoque in Brazil. It was conducted between October 2017 and February 2018. An anonymous standardized questionnaire was filled out by culturally-trained mediators, then analyzed using STATA 12. RESULTS Almost half (45.9%) of the individuals had a low education level. Participants whose native language was Portuguese or French demonstrated better HIV knowledge than other populations, notably native Amerindian and creole-speaking people. HIV risk behavior was more frequent in men and in younger age groups. People with good HIV knowledge reported having performed more HIV tests in the last year than participants with poor knowledge. The stigma level was high and reported in 74.8% of respondents. CONCLUSIONS These results illustrate the need for initiatives to improve HIV prevention among autochthonous populations on both sides of this border area. Cross-border collaboration on health policies could produce common key messages adapted to the education level and multi-linguistic populations who live in this area.
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Affiliation(s)
- E Mosnier
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana. .,Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.
| | - M Nacher
- Centre d'Investigation Clinique Antilles Guyane, CIC INSERM 1424, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - M C Parriault
- Centre d'Investigation Clinique Antilles Guyane, CIC INSERM 1424, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.,Ecosystèmes Amazoniens et Pathologie Tropicale, EA3593, Université de Guyane, Cayenne, French Guiana
| | - C Dao
- Dsanté NGO, Rémire Montjoly, Rémire Montjoly, French Guiana
| | - B Bidaud
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - P Brousse
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - M Gaillet
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.,Ecosystèmes Amazoniens et Pathologie Tropicale, EA3593, Université de Guyane, Cayenne, French Guiana
| | - L Epelboin
- Ecosystèmes Amazoniens et Pathologie Tropicale, EA3593, Université de Guyane, Cayenne, French Guiana.,Unité de Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - A M Mendes
- Universidade Federal do Amapá (UNIFAP), Oiapoque, Brazil
| | - L Montenegro
- Dsanté NGO, Rémire Montjoly, Rémire Montjoly, French Guiana
| | | | - R Botreau
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - A Rouseliere
- Dsanté NGO, Rémire Montjoly, Rémire Montjoly, French Guiana
| | - S Rhodes
- Dsanté NGO, Rémire Montjoly, Rémire Montjoly, French Guiana
| | - A Carbunar
- Pôle des Centres Délocalisés de Prévention et de Soins, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana.,Dsanté NGO, Rémire Montjoly, Rémire Montjoly, French Guiana
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D'Ascenzo V, Baran E, Calzona M, Montenegro L. P307 Findings on abdominal ultrasonography in adult cystic fibrosis patients. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30600-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Canton A, Brito V, Montenegro L, Krepischi A, Rosenberg C, Costa S, Ramos C, Cunha M, Seraphim C, Faria A, Funari M, Jorge A, de Zegher F, Mendonca B, Latronico AC. OR17-2 Comprehensive Genetic Investigation of Patients with Central Precocious Puberty Associated with Complex Phenotypes. J Endocr Soc 2019. [PMCID: PMC6555075 DOI: 10.1210/js.2019-or17-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Idiopathic central precocious puberty (CPP) is mostly described as an isolated entity. A few studies have shown its association with clinical syndromes and rare cases of chromosomal abnormalities. Objective: To clinically characterize and to genetically investigate a cohort of patients with CPP associated with complex phenotypes. Patients and methods: Two hundred patients with idiopathic CPP were retrospectively evaluated, including phenotypic, metabolic and hormonal characterization. Thirty-two of them presented at least 3 other clinical features and conditions, characterizing complex phenotypes. Genomic microarray was performed in all sporadic and index cases, and MLPA and whole-exome sequencing were performed in a subset of cases. Results: In the group of 32 idiopathic CPP patients with complex phenotypes (28 girls, 4 boys; 16 sporadic, 16 familial), mean age at puberty onset was 6.2 yr (±1.9) for girls and 8 yr (±0.1) for boys. There was a wide phenotypic spectrum. The more prevalent clinical features described included metabolic, neurocognitive and growth phenotypes; less prevalent features included dysmorphic features and congenital anomalies. Genetic investigation resulted as follows: 3 sporadic cases with maternal uniparental disomy of chromosome 14 (Temple syndrome), with disruption at the imprinted locus of DLK1; 1 sporadic patient with a 7q11.23 deletion (Williams syndrome); 7 patients from 3 unrelated families with Xp22.33 deletions, including SHOX, upstream regulatory regions, and 3 other coding-genes. Moreover, whole-exome sequencing analysis revealed candidate pathogenic variants in 2 CPP cases. One girl with sporadic CPP associated with imperforate anus and learning difficulties presented rare frameshift variants in a dominant de novo mode in 2 genes: AREL1 (14:75142990; p.S229fs) coding an ubiquitin ligase; and TNRC6B (22:40662223-40662224; p.S663fs) coding a molecule with a role in RNA-mediated gene silencing. Both genes are expressed in hypothalamus. In addition, one boy with maternal familial CPP and autism had 2 rare potentially pathogenic variants in a dominant autosomal inheritance mode: a frameshift deletion in MKKS (20:10393728-10393731; p.F144fs) coding a protein with a role in cytokinesis; and a missense variant (4:70359481; p.P267L) in UGT2B4, coding a protein involved in estrogen hydroxylation and related to menarche timing in genome-wide association studies. Conclusion: CPP might be associated with additional clinical conditions, characterizing complex phenotypes. Two chromosomal regions, Xp22.33 and 7q11.23, represent novel candidate loci implicated in CPP. In addition, distinct novel genetic abnormalities were identified in CPP patients with complex phenotypes.
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Affiliation(s)
- Ana Canton
- School of Medicine of the University of Sao Paulo, Sao Paulo, , Brazil
| | - Vinicius Brito
- School of Medicine of the University of Sao Paulo, Sao Paulo, , Brazil
| | | | - Ana Krepischi
- Institute of Biosciences of the University of Sao Paulo, Sao Paulo, , Brazil
| | - Carla Rosenberg
- Institute of Biosciences of the University of Sao Paulo, Sao Paulo, , Brazil
| | - Silvia Costa
- Institute of Biosciences of the University of Sao Paulo, Sao Paulo, , Brazil
| | - Carolina Ramos
- School of Medicine of the University of Sao Paulo, Sao Paulo, , Brazil
| | - Marina Cunha
- School of Medicine of the University of Sao Paulo, Sao Paulo, , Brazil
| | - Carlos Seraphim
- School of Medicine of the University of Sao Paulo, Sao Paulo, , Brazil
| | - Aline Faria
- School of Medicine of the University of Sao Paulo, Sao Paulo, , Brazil
| | - Mariana Funari
- School of Medicine of the University of Sao Paulo, Sao Paulo, , Brazil
| | - Alexander Jorge
- School of Medicine of the University of Sao Paulo, Sao Paulo, , Brazil
| | | | - Berenice Mendonca
- School of Medicine of the University of Sao Paulo, Sao Paulo, , Brazil
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Montenegro L, Lerario A, Nishi M, Mendonca B. SUN-035 Performance of Mutation Pathogenicity Prediction Tools on Missense Variants Associated with 46XY Disorders of Sex Development. J Endocr Soc 2019. [PMCID: PMC6553019 DOI: 10.1210/js.2019-sun-035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION: Single nucleotide variants (SNV) are the most common type of genetic variation among humans. The high-throughput sequencing methods increase the number of identified variants in the human genome but functional studies for disease-associated variants is laborious and time consuming. Different computational methods have been developed to predict SNP pathogenicity and phenotypic effect. They are based on different variant parameters, such as sequence homology, proteins structure and evolutionary conservation. OBJECTIVE/METHODS: To evaluate the performance of the 10 widely used pathogenicity prediction tools available in the internet in relation with functional studies: Fathmn, Mutation Acessor, Phanter and Sift sites (based on evolutionary information) and Mutation Taster, Polyphen-2, Align GVGD, CAAD, Provean and SNP-and-Go sites (based in a combination of protein structural, functional parameters and evolutionary information). We analyzed 40 described pathogenic mutation in 4 different genes associated with disorder of sex development (DSD): 17β-hydroxysteroid dehydrogenase (HSD17B3), Steroidogenic factor 1 (SF-1/NR5A1), Androgen receptor (AR) and Luteinizing hormone/chorionic gonadotropin receptor (LHCGR). All mutations are already published and functional studies showed loss of function proteins. To evaluate the false discovery rate of each tool, we analyzed 36 frequent (MAF >0.01) benign SNVs described in the same 4 DSD. The quality of the predictions was analyzed by five parameters: accuracy, precision, sensitivity, specificity and Matthews correlation coefficient (MCC). RESULTS: No method was in full accordance with the functional study. The best accuracy was observed in the Polyphen-2 and SNP-and-Go programs (0.81 and 0.82); the best precision was observed in Mutation Accessor and SNP-and-Go (0.96 and 0.84). The best specificity was observed for Mutation Accessor and SNP-and-GO (0.96 and 0.83). Five programs (Phanter, Sift, Mutation Taster, Polyphen-2 and CAAD) showed sensitivity > 0.80, but only SNP-and-GO program had specificity of 0.83. Performance ranged from poor (Align GVGD - MCC 0.13) to reasonably good (SNP-and-GO - MCC 0.63). CONCLUSION: Computational algorithms are important tools for SNV analysis but their correlation with functional studies is extremely variable. The overall best performing methods among the 10 prediction tools was SNP-and-GO, with accuracy reaching 0.82.
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Sales Barroso P, Lerario A, Montenegro L, Vasques G, Lima Amato L, Silveira L, Mendonca B, Jorge A, Latronico AC. OR17-5 Clinical and Genetic Features of Constitutional Delay of Growth and Puberty. J Endocr Soc 2019. [PMCID: PMC6555080 DOI: 10.1210/js.2019-or17-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Narcizo A, Cardoso L, Funari M, França M, Montenegro L, Nishi M, Mendonca B. SUN-031 Quantification of Pooled Libraries for Optimizing Cluster Density in Next Generation Sequencing. J Endocr Soc 2019. [PMCID: PMC6553271 DOI: 10.1210/js.2019-sun-031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Next-generation sequencing (NGS) consists of massive parallel processing libraries where millions of reads are generated in a single sequencing run. To ensure efficient sequencing, the amount of DNA pool libraries must be measured precisely because it influences the density of the clusters formation. There are different quantification methods aiming to obtain high density clusters with Q30>80%, avoiding the negative effects of overclustering. Our aim was to compare the density of the clusters in exome libraries quantified by two different methodologies qPCR and MiSeq Nano V2 method. Exome libraries were prepared using SureSelect Human All Exons kits (Agilent Technology) and sequenced on Illumina HiSeq2500 platform (Illumina) using the V4 high output sequencing kit. The pools were prepared in equimolar concentrations using qPCR (KAPA Library Quantification Kit), to achieve final pool library concentration of 10 nM. Three groups were defined: the original 10 nM group (n=16); a qPCR group (n=16) in which the pool concentrations were corrected by qPCR and the MiSeq Nano V2 group (n=12) where pool concentrations were corrected by clustering data of MiSeq Nano in a direct linear proportion. The statistics analysis was performed by Kruskal-Wallis followed by Dunn test. Cluster density values are reported as the absolute distance from the optimal density (1000 k/mm2 of flow cell) specified for V4 kit. Results: The 10 nM group showed a median of 191, iqr (interquartile range) = 48-273, the qPCR group the median was 80, iqr = 30-135 and the MiSeq Nano V2 group the median was 46, iqr = 13-78. Therefore, the MiSeq NanoV2 method was significantly better than the other groups at either generating closer distances from the target cluster density value (Kruskal-Wallis test, p<0.05, H=7.967, p=0.02 with Dunn’s test, mean rank difference=13.84, p=0.01). The rate of success in the generation of data without overclustering effects was also better in Miseq Nano V2 group (Kruskal-Wallis test, p<0.05, H=7.525, p=0.02, Dunn’s multiple comparison test, mean rank difference=-9.625, p=0.01. Conclusion: The MiSeq Nano V2 method is significantly more precise to quantify the pool library concentration, increasing data yield per run, reducing potential loss of data due to inadequate clustering and covering, saving time and money in clinical research laboratories.
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Seraphim C, Canton A, Montenegro L, Piovesan M, Cunha-Silva M, Macedo D, Guimarães A, Ramos C, Gagliardi P, Abreu AP, Kaiser U, Mendonca B, Brito V, Latronico AC. MON-251 Clinical Features of a Large Cohort of Patients with Familial Central Precocious Puberty Caused by Loss-of-Function Mutations in MKRN3. J Endocr Soc 2019. [PMCID: PMC6551101 DOI: 10.1210/js.2019-mon-251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Context: Loss-of-function mutations in Makorin RING-finger 3 (MKRN3), a maternal imprinted gene located on the long arm of chromosome 15, are the most prevalent cause of familial central precocious puberty (CPP). Objectives: To describe the clinical and hormonal features of 70 patients with CPP due to MKRN3 mutations and to establish the phenotype-genotype correlation. Setting and Participants: We studied 70 individuals from 31 families originating from different ethnic backgrounds. DNA sequencing analysis of MKRN3 coding region by Sanger method was performed and loss-of-function MKRN3 mutations were identified in all of them. Results: The genetic analysis of MKRN3 revealed 15 different mutations in 70 affected patients with CPP (27 boys; 43 girls) who were studied in two university centers from 2013 to 2018. We identified frameshift (61%), missense (26%) and nonsense mutations (13%). Frameshift mutations affecting codon 162 were the most frequent. Female patients developed thelarche at a mean age of 5.9 ± 1.2 years, adrenarche at 6.4 ± 0.9 years, had bone age advance of 2.3 ± 1.6 years, a height standard deviation score (SDS) of 1.6 ± 1.2, and a BMI-SDS in the overweight range (1.05 ± 0.7) in the initial diagnosis. Eight patients (11%) developed thelarche and adrenarche simultaneously. Male patients developed pubertal signs at a median age of 8.0 years (range 5.9-8.5 years) and had a bone age advance of 1.7 years (0-2.7). Girls who harbored frameshift mutations were more likely to have simultaneous thelarche and adrenarche and had a more advanced bone age (2.7 ± 1.6 vs 1.3 ± 1.1 years, p = 0.003), but were otherwise unremarkable. Notably, 74% of the male patients were diagnosed in adulthood, during familial segregation analysis, suggesting that male CPP was under-diagnosed. Basal laboratory evaluation showed LH levels of 1.8 ± 1.5 IU/L and FSH levels of 4.4 ± 2.4 IU/L (n=37). GnRH stimulation tests resulted in a LH peak of 25 ± 24 IU/L and a FSH peak of 13.2 ± 9.5 IU/L. Nineteen patients were treated with depot GnRH analogue for 3.3 ± 0.8 years, achieving a final height of -0.6 ± 1.1 SDS, within their target height of -1.1 ± 1.0 SDS. Among the 7 untreated adult patients, height SDS was -1.8 ± 1.1, noticeably lower than that of treated patients, although not statistically significant (p=0.06). Conclusions: Deleterious MKRN3 mutations represent a frequent genetic cause of non-syndromic familial CPP in both sexes. Clinical and hormonal features of CPP caused by these mutations are indistinguishable from idiopathic CPP.
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Affiliation(s)
- Carlos Seraphim
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, , Brazil
| | - Ana Canton
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, , Brazil
| | - Luciana Montenegro
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, , Brazil
| | - Maiara Piovesan
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, , Brazil
| | - Marina Cunha-Silva
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, , Brazil
| | - Delanie Macedo
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, , Brazil
| | - Aline Guimarães
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, , Brazil
| | | | - Priscila Gagliardi
- Div of Endo, Nemours Children's Health System, Jacksonville, FL, United States
| | - Ana Paula Abreu
- Endocrinology, Brigham Women's Hospital/Harvard Medical School, Boston, MA, United States
| | - Ursula Kaiser
- Division of Endocrinology, Brigham Women's Hospital/Harvard Medical School, Boston, MA, United States
| | - Berenice Mendonca
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, , Brazil
| | - Vinicius Brito
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, , Brazil
| | - Ana Claudia Latronico
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, , Brazil
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Kluyts HL, le Manach Y, Munlemvo DM, Madzimbamuto F, Basenero A, Coulibaly Y, Rakotoarison S, Gobin V, Samateh AL, Chaibou MS, Omigbodun AO, Amanor-Boadu SD, Tumukunde J, Madiba TE, Pearse RM, Biccard BM, Abbas N, Abdelatif AI, Abdoulaye T, Abd-rouf A, Abduljalil A, Abdulrahman A, Abdurazig S, Abokris A, Abozaid W, Abugassa S, Abuhdema F, Abujanah S, Abusamra R, Abushnaf A, Abusnina S, Abuzalout T, Ackermann H, Adamu Y, Addanfour A, Adeleke D, Adigun T, Adisa A, Adjignon SV, Adu-Aryee N, Afolabi B, Agaba A, Agaba P, Aghadi K, Agilla H, Ahmed B, Ahmed EZ, Ahmed AJ, Ahmed M, Ahossi R, Aji S, Akanyun S, Akhideno I, Akhter M, Akinyemi O, Akkari M, Akodjenou J, AL Samateh A, al Shams E, Alagbe-Briggs O, Alakkari E, Alalem R, Alashhab M, Alatise O, Alatresh A, Alayeb Alayeb M, Albakosh B, Albert F, Alberts A, Aldarrat A, Alfari A, Alfetore A, Algbali M, Algddar A, Algedar H, Alghafoud I, Alghazali A, Alhajj M, Alhendery Alhendery A, Alhoty F, Ali A, Ali Y, Ali A, Alioune BS, Alkassem M, Alkchr M, Alkesa T, Alkilani A, Alkobty Alkobty F, Allaye T, Alleesaib S, Alli A, Allopi K, Allorto N, Almajbery A, Almesmary R, Almisslati S, Almoraid F, Alobeidi H, Swaleh A, Swayeb E, Szpytko A, Taiwo N, Tarhuni A, Tarloff D, Tchaou B, Tchegnonsi C, Tchoupa M, Teeka M, Alomami M, Thakoor B, Theunissen M, Thomas B, Thomas M, Thotharam A, Tobiko O, Torborg A, Tshisekedi S, Tshisola S, Tshitangano R, Alphonsus CS, Tshivhula F, Tshuma H, Tumukunde J, Tun M, Udo I, Uhuebor D, Umeh K, Usenbo A, Uwiteyimbabazi J, Van der Merwe D, Alqawi O, van der Merwe F, van der Walt J, van Dyk D, Van Dyk J, van Niekerk J, van Wyk S, van Zyl H, Veerasamy B, Venter P, Vermeulen A, Alraheem A, Villarreal R, Visser J, Visser L, Voigt M, von Rahden RP, Wafa A, Wafula A, Wambugu P, Waryoba P, Waweru E, Alsabri S, Weideman M, Wise RD, Wynne E, Yahya A, Yahya A, Yahya R, Yakubu Y, Yanga J, Yangazov Y, Yousef O, Alsayed A, Yousef G, Youssouf C, Yunus A, Yusuf A, Zeiton A, Zentuti H, Zepharine H, Zerihun A, Zhou S, Zidan A, Alsellabi B, Zimogo Zié S, Zinyemba C, Zo A, Zomahoun L, Zoobei N, Zoumenou E, Zubia N, Al-Serksi M, Alshareef M, Altagazi A, Aluvale J, Alwahedi H, Alzahra E, Alzarouk M, Al-Zubaidy K, Amadou M, Amadou M, Amanor-Boadu SD, Amer AA, Amisi B, Amuthenu M, Anabah T, Anani F, Anderson P, Andriamampionona A, Andrianina L, Anele A, Angelin R, Anjar N, Antùnez O, Antwi-Kusi A, Anyanwu L, Aribi A, Arowolo O, Arrey O, Ashebir DZ, Assefa S, Assoum G, Athanse V, Athombo J, Atiku M, Atito-Narh E, Atomabe A, Attia A, Aungraheeta M, Aurélia D, Ayandipo O, Ayebale A, Azzaidey H, Babajee N, Badi H, Badianga E, Baghni R, Bahta M, Bai M, Baitchu Y, Baloyi A, Bamuza K, Bamuza M, Bangure L, Bankole O, Barongo M, Barow M, Basenero A, Bashiya L, Basson C, Bechan S, Belhaj S, Ben Mansour M, Benali D, Benamour A, Berhe A, Bertie J, Bester J, Bester M, Bezuidenhout J, Bhagwan K, Bhagwandass D, Bhat K, Bhuiyan M, Biccard BM, Bigirimana F, Bikuelo C, Bilby B, Bingidimi S, Bischof K, Bishop DG, Bitta C, Bittaye M, Biyase T, Blake C, Blignaut E, Blignaut F, BN Tanjong B, Bogoslovskiy A, Boloko P, Boodhun S, Bori I, Boufas F, Brand M, Brouckaert NT, Bruwer J, Buccimazza I, Bula Bula I, Bulamba F, Businge B, Bwambale Y, Cacala S, Cadersa M, Cairns C, Carlos F, Casey M, Castro A, Chabayanzara N, Chaibou M, Chaibva T, Chakafa N, Chalo C, Changfoot C, Chari M, Chelbi L, Chibanda J, Chifamba H, Chikh N, Chikumba E, Chimberengwa P, Chirengwa J, Chitungo F, Chiwanga M, Chokoe M, Chokwe T, Chrirangi B, Christian M, Church B, Cisekedi J, Clegg-Lamptey J, Cloete E, Coltman M, Conradie W, Constance N, Coulibaly Y, Cronje L, Da Silva M, Daddy H, Dahim L, Daliri D, Dambaki M, Dasrath A, Davids J, Davies GL, De Lange J, de Wet J, Dedekind B, Degaulle M, Dehal V, Deka P, Delinikaytis S, Desalu I, Dewanou H, Deye MM, Dhege C, Diale B, Dibwe D, Diedericks B, Dippenaar J, Dippenaar L, Diyoyo M, Djessouho E, Dlamini S, Dodiyi-Manuel A, Dokolwana B, Domoyyeri D, Drummond LW, du Plessis D, du Plessis W, du Preez L, Dube K, Dube N, Dullab K, Duvenhage R, Echem R, Edaigbini S, Egote A, Ehouni A, Ekwen G, Ekwunife N, El Hensheri M, Elfaghi I, Elfagieh M, Elfallah S, Elfiky M, Elgelany S, Elghallal A, Elghandouri M, Elghazal Z, Elghobashy A, Elharati F, Elkhogia AM, Elkhwildi R, Ellis S, Elmadani L, Elmadany H, Elmehdawi H, Elmgadmi A, Eloi H, Elrafifi D, Elsaadi G, Elsaity R, Elshikhy A, Eltaguri M, Elwerfelli A, Elyasir I, Elzoway A, Elzufri A, Enendu E, Enicker B, Enwerem E, Esayas R, Eshtiwi M, Eshwehdi A, Esterhuizen J, Esterhuizen TM, Etuk E, Eurayet O, Eyelade O, Fanjandrainy R, Fanou L, Farina Z, Fawzy M, Feituri A, Fernandes N, Ford L, Forget P, François T, Freeman T, Freeman Y, Gacii V, Gadi B, Gagara M, Gakenia A, Gallou P, Gama G, Gamal M, Gandy Y, Ganesh A, Gangaly D, Garcia M, Gatheru A, Gaya S, Gbéhadé O, Gerbel G, Ghnain A, Gigabhoy R, Giles D, Girmaye G, Gitau S, Githae B, Gitta S, Gobin V, Goga R, Gomati A, Gonzalez M, Gopall J, Gordon CS, Gorelyk O, Gova M, Govender K, Govender P, Govender S, Govindasamy V, Green-Harris J, Greenwood M, Grey-Johnson S, Grobbelaar M, Groenewald M, Grünewald K, Guegni A, Guenane M, Gueye S, Guezo M, Gunguwo T, Gweder M, Gwila M, Habimana L, Hadecon R, Hadia E, Hamadi L, Hammouda M, Hampton M, Hanta R, Hardcastle TC, Hariniaina J, Hariparsad S, Harissou A, Harrichandparsad R, Hasan S, Hashmi H, Hayes M, Hdud A, Hebli S, Heerah H, Hersi S, Hery A, Hewitt-Smith A, Hlako T, Hodges S, Hodgson RE, Hokoma M, Holder H, Holford E, Horugavye E, Houston C, Hove M, Hugo D, Human C, Hurri H, Huwidi O, Ibrahim A, Ibrahim T, Idowu O, Igaga I, Igenge J, Ihezie O, Ikandi K, Ike I, Ikuku J, Ilbarasi M, Ilunga I, Ilunga J, Imbangu N, Imessaoudene Z, Imposo D, Iraya A, Isaacs M, Isiguzo M, Issoufou A, Izquirdo P, Jaber A, Jaganath U, Jallow C, Jamabo S, Jamal Z, Janneh L, Jannetjies M, Jasim I, Jaworska MA, Jay Narain S, Jermi K, Jimoh R, Jithoo S, Johnson M, Joomye S, Judicael R, Judicaël M, Juwid A, Jwambi L, Kabango R, Kabangu J, Kabatoro D, Kabongo A, Kabongo K, Kabongo L, Kabongo M, Kady N, Kafu S, Kaggya M, Kaholongo B, Kairuki P, Kakololo S, Kakudji K, Kalisa A, Kalisa R, Kalufwelu M, Kalume S, Kamanda R, Kangili M, Kanoun H, Kapesa, Kapp P, Karanja J, Karar M, Kariuki K, Kaseke K, Kashuupulwa P, Kasongo K, Kassa S, Kateregga G, Kathrada M, Katompwa P, Katsukunya L, Kavuma K, Khalfallah, Khamajeet A, Khetrish S, Kibandwa, Kibochi W, Kilembe A, Kintu A, Kipng’etich B, Kiprop B, Kissoon V, Kisten TK, Kiwanuka J, Kluyts HL, Knox M, Koledale A, Koller V, Kolotsi M, Kongolo M, Konwuoh N, Koperski W, Koraz M, Kornilov A, Koto MZ, Kransingh S, Krick D, Kruger S, Kruse C, Kuhn W, Kuhn W, Kukembila A, Kule K, Kumar M, Kusel BS, Kusweje V, Kuteesa K, Kutor Y, Labib M, Laksari M, Lanos F, Lawal T, Le Manach Y, Lee C, Lekoloane R, Lelo S, Lerutla B, Lerutla M, Levin A, Likongo T, Limbajee M, Linyama D, Lionnet C, Liwani M, Loots E, Lopez AG, Lubamba C, Lumbala K, Lumbamba A, Lumona J, Lushima R, Luthuli L, Luweesi H, Lyimo T, Maakamedi H, Mabaso B, Mabina M, Maboya M, Macharia I, Macheka A, Machowski A, Madiba TE, Madsen A, Madzimbamuto F, Madzivhe L, Mafafo S, Maghrabi M, Mahamane DD, Maharaj A, Maharaj A, Maharaj A, Mahmud M, Mahoko M, Mahomedy N, Mahomva O, Mahureva T, Maila R, Maimane D, Maimbo M, Maina S, Maiwald DA, Maiyalagan M, Majola N, Makgofa N, Makhanya V, Makhaye W, Makhlouf N, Makhoba S, Makopa E, Makori O, Makupe AM, Makwela M, Malefo M, Malongwe S, Maluleke D, Maluleke M, Mamadou KT, Mamaleka M, Mampangula Y, Mamy R, Mananjara M, Mandarry M, Mangoo D, Manirimbere C, Manneh A, Mansour A, Mansour I, Manvinder M, Manyere D, Manzini V, Manzombi J, Mapanda P, Marais L, Maranga O, Maritz J, Mariwa F, Masela R, Mashamba M, Mashava DM, Mashile M, Mashoko E, Masia O, Masipa J, Masiyambiri A, Matenchi M, Mathangani W, Mathe R, Matola CY, Matondo P, Matos-Puig R, Matoug F, Matubatuba J, Mavesere H, Mavhungu R, Maweni S, Mawire C, Mawisa T, Mayeza S, Mbadi R, Mbayabu M, Mbewe N, Mbombo W, Mbuyi T, Mbuyi W, Mbuyisa M, Mbwele B, Mehyaoui R, Menkiti I, Mesarieki L, Metali A, Mewanou S, Mgonja L, Mgoqo N, Mhatu S, Mhlari T, Miima S, Milod I, Minani P, Mitema F, Mlotshwa A, Mmasi J, Mniki T, Mofikoya B, Mogale J, Mohamed A, Mohamed A, Mohamed A, Mohamed S, Mohamed S, Mohamed T, Mohamed A, Mohamed A, Mohamed A, Mohamed P, Mohammed I, Mohammed F, Mohammed M, Mohammed N, Mohlala M, Mokretar R, Molokoane F, Mongwe K, Montenegro L, Montwedi O, Moodie Q, Moopanar M, Morapedi M, Morulana T, Moses V, Mossy P, Mostafa H, Motilall S, Motloutsi S, Moussa K, Moutari M, Moyo O, Mphephu P, Mrara B, Msadabwe C, Mtongwe V, Mubeya F, Muchiri K, Mugambi J, Muguti G, Muhammad A, Mukama I, Mukenga M, Mukinda F, Mukuna P, Mungherera A, Munlemvo DM, Munyaradzi T, Munyika A, Muriithi J, Muroonga M, Murray R, Mushangwe V, Mushaninga M, Musiba V, Musowoya J, Mutahi S, Mutasiigwa M, Mutizira G, Muturi A, Muzenda T, Mvwala K, Mvwama N, Mwale A, Mwaluka C, Mwamba J, Mwanga H, Mwangi C, Mwansa S, Mwenda V, Mwepu I, Mwiti T, Mzezewa S, Nabela L, Nabukenya M, Nabulindo S, Naicker K, Naidoo D, Naidoo L, Naidoo L, Naidoo N, Naidoo R, Naidoo R, Naidoo S, Naidoo T, Naidu T, Najat N, Najm Y, Nakandungile F, Nakangombe P, Namata C, Namegabe E, Nansook A, Nansubuga N, Nantulu C, Nascimento R, Naude G, Nchimunya H, Ndaie M, Ndarukwa P, Ndasi H, Ndayisaba G, Ndegwa D, Ndikumana R, Ndonga AK, Ndung’u C, Neil M, Nel M, Neluheni E, Nesengani D, Nesengani N, Netshimboni L, Ngalala A, Ngari B, Ngari N, Ngatia E, Ngcobo G, Ngcobo T, Ngorora D, Ngouane D, Ngugi K, Ngumi ZW, Nibe Z, Ninise E, Niyondiko J, Njenga P, Njenga M, Njoroge M, Njoroge S, Njuguna W, Njuki P, Nkesha T, Nkuebe T, Nkuliyingoma N, Nkunjana M, Nkwabi E, Nkwine R, Nnaji C, Notoane I, Nsalamba S, Ntlhe L, Ntoto C, Ntueba B, Nyassi M, Nyatela-Akinrinmade Z, Nyawanda H, Nyokabi N, Nziene V, Obadiah S, Ochieng O, Odia P, Oduor O, Ogboli-Nwasor E, Ogendo S, Ogunbode O, Ogundiran T, Ogutu O, Ojewola R, Ojujo M, Ojuka D, Okelo O, Okiya S, Okonu N, Olang P, Omigbodun AO, Omoding S, Omoshoro-Jones J, Onyango R, Onyegbule A, Orjiako O, Osazuwa M, Oscar K, Osinaike B, Osinowo A, Othin O, Otman F, Otokwala J, Ouanes F, Oumar O, Ousseini A, Padayachee S, Pahlana S, Pansegrouw J, Paruk F, Patel M, Patel U, Patience A, Pearse RM, Pembe J, Pengemale G, Perez N, Aguilera Perez M, Peter AM, Phaff M, Pheeha R, Pienaar B, Pillay V, Pilusa K, Pochana M, Polishchuk O, Porrill OS, Post E, Prosper A, Pupyshev M, Rabemazava A, Rabiou M, Rademan L, Rademeyer M, Raherison R, Rajah F, Rajcoomar M, Rakhda Z, Rakotoarijaona A, Rakotoarisoa A, Rakotoarison SR, Rakotoarison R, Ramadan L, Ramananasoa M, Rambau M, Ramchurn T, Ramilson H, Ramjee RJ, Ramnarain H, Ramos R, Rampai T, Ramphal S, Ramsamy T, Ramuntshi R, Randolph R, Randriambololona D, Ras W, Rasolondraibe R, Rasolonjatovo J, Rautenbach R, Ray S, Rayne SR, Razanakoto F, Reddy S, Reed AR, Rian J, Rija F, Rink B, Robelie A, Roberts C, Rocher A, Rocher S, Rodseth RN, Rois I, Rois W, Rokhsi S, Roos J, Rorke NF, Roura H, Rousseau F, Rousseau N, Royas L, Roytowski D, Rungan D, Rwehumbiza S, Ryabchiy B, Ryndine V, Saaiman C, Sabwa H, Sadat S, Saed S, Salaheddin E, Salaou H, Saleh M, Salisu-Kabara H, Doles Sama H, Samateh AL, Sam-Awortwi W, Samuel N, Sanduku D, Sani CM, Sanyang L, Sarah H, Sarkin-Pawa A, Sathiram R, Saurombe T, Schutte H, Sebei M, Sedekounou M, Segooa M, Semenya E, Semo B, Sendagire C, Senoga S, Senusi F, Serdyn T, Seshibe M, Shah G, Shamamba R, Shambare C, Shangase T, Shanin S, Shefren I, Sheshe A, Shittu O, Shkirban A, Sholadoye T, Shubba A, Sigcu N, Sihope S, Sikazwe D, Sikombe B, Simaga Abdoul K, Simo W, Singata K, Singh A, Singh S, Singh U, Sinoamadi V, Sipuka N, Sithole N, Sitima S, Skinner DL, Skinner G, Smith O, Smits C, Sofia M, Sogoba G, Sohoub A, Sookun S, Sosinska O, Souhe R, Souley G, Souleymane T, Spicer J, Spijkerman S, Steinhaus H, Steyn A, Steyn G, Steyn H, Stoltenkamp HL, Stroyer S. The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications. Br J Anaesth 2018; 121:1357-1363. [PMID: 30442264 DOI: 10.1016/j.bja.2018.08.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 07/19/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. METHODS ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. RESULTS The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. CONCLUSIONS This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. CLINICAL TRIAL REGISTRATION NCT03044899.
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Affiliation(s)
- H-L Kluyts
- Department of Anaesthesiology, Sefako Makgatho Health Sciences University, Pretoria, Gauteng, South Africa
| | - Y le Manach
- Department of Anesthesia, Michael DeGroote School of Medicine, Faculty of Health Sciences, McMaster University and Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Perioperative Medicine and Surgical Research Unit, Hamilton, ON, Canada; Department of Clinical Epidemiology and Biostatistics, Michael DeGroote School of Medicine, Faculty of Health Sciences, McMaster University and Population Health Research Institute, David Braley Cardiac, Vascular and Stroke Research Institute, Perioperative Medicine and Surgical Research Unit, Hamilton, ON, Canada
| | - D M Munlemvo
- University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - F Madzimbamuto
- Department of Anaesthesia and Critical Care Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - A Basenero
- Ministry of Health and Social Services Namibia, Windhoek, Namibia
| | - Y Coulibaly
- Department, Faculté de médicine de Bamako, Bamako, Mali
| | | | - V Gobin
- Ministry of Health and Quality of Life, Jawaharlal Nehru Hospital, Rose Belle, Grand Port, Mauritius
| | - A L Samateh
- Department of Surgery, Edward Francis Small Teaching Hospital, Banjul, Gambia
| | - M S Chaibou
- Department of Anesthesiology, Intensive Care and Emergency, National Hospital of Niamey, Niamey, Niger
| | - A O Omigbodun
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - S D Amanor-Boadu
- Department of Anaesthesia, University College Hospital, Ibadan, Oyo State, Nigeria
| | - J Tumukunde
- Makerere University, Makerere, Kampala, Uganda
| | - T E Madiba
- Department of Surgery, University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - R M Pearse
- Intensive Care Medicine, Queen Mary University of London, London, UK
| | - B M Biccard
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Observatory, Western Cape, South Africa.
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Notarnicola A, Maccagnano G, Fiore A, Spinarelli A, Montenegro L, Paoloni M, Pastore F, Tafuri S, Moretti B. Baropodometry on patients after total knee arthroplasty. Musculoskelet Surg 2017; 102:129-137. [PMID: 28971359 DOI: 10.1007/s12306-017-0505-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 09/25/2017] [Indexed: 01/08/2023]
Abstract
PURPOSE It is well known that total knee replacement surgery decreases pain and improves function, but the effect on postural assessment needs to be studied better with the use of new technological devices. Total knee arthroplasty (TKA) improves motor coordination and stability of the knee. On the other hand, changing joint functionality can modify the balance. The aim of this trial is to record and analyze the static and dynamic baropodometric data of patients in the first few months following joint replacement. For the physiatrist, this tool can be useful to check if the rehabilitation treatment protocols and times are correct. METHODS We designed a prospective observation longitudinal study to assess postural stability following TKA. Between December 2014 and May 2015, sixty consecutive patients were recruited through local orthopedic physician offices and hospitals. The patients scheduled to undergo TKA were recruited and were monitored before surgery (T0) and at 1 (T1), 3 (T2) and 6 months (T3) after knee surgery. The correction of varus/valgus deviation at X-ray and the Knee Society Score were performed to verify the functional recovery. We used static and dynamic baropodometric analysis to evaluate postural assessment. RESULTS After surgery, there was a significant improvement in physiological alignment of knee axes (p < 0.0001) and of Knee and Function Scores (excellent, mean values 80.5 and 80.7, respectively, p < 0.0001). The static analysis showed that the center of gravity and the pressure on the foot of the operated limb were corrected toward the physiological center (p < 0.0001) and the body weight displaced to the forefeet and to the hindfeet reduced bilaterally (p < 0.0001). The type of footprint did not change. The dynamic analysis confirmed the significant normalization of the pressure on the foot of the operated limb at all follow-ups (p < 0.0001). The percentage of load was reduced on the operated limb (p = 0.0096) and speed of step, cadence and semi-step length increased (p < 0.0001). CONCLUSION These data show the progressive recovery of stability after TKA from the immediate postoperative to the subsequent months. The clinical and functional improvement correlated with a load redistribution between the two limbs. The baropodometry could be an excellent noninvasive method for monitoring effects of rehabilitation treatment.
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Affiliation(s)
- A Notarnicola
- Orthopedics Section, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Piazza Giulio Cesare 11, 70124, Bari, Italy. .,Course of Motor and Sports Sciences, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, Lungomare Starita 1, 70123, Bari, Italy.
| | - G Maccagnano
- Orthopedics Section, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - A Fiore
- Orthopedics Section, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - A Spinarelli
- Orthopedics Section, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - L Montenegro
- Orthopedics Section, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - M Paoloni
- Physical Medicine and Rehabilitation, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - F Pastore
- Orthopedics Section, Regional General Hospital Francesco Miulli, SP 127 Acquaviva-Santeramo Km 4.100, Acquaviva delle Fonti, Bari, Italy
| | - S Tafuri
- Department of Biomedical Sciences and Human Oncology, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - B Moretti
- Orthopedics Section, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Piazza Giulio Cesare 11, 70124, Bari, Italy
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Losurdo G, Leandro G, Principi M, Giorgio F, Montenegro L, Sorrentino C, Ierardi E, Di Leo A. Sequential vs. prolonged 14-day triple therapy for Helicobacter pylori eradication: the meta-analysis may be influenced by 'geographical weighting'. Int J Clin Pract 2015; 69:1112-20. [PMID: 26138290 DOI: 10.1111/ijcp.12687] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Sequential therapy is a first-line regimen obtaining satisfactory Helicobacter pylori eradication. Triple therapy prolongation improves the success rate even if a recent meta-analysis showed satisfying results only for the 14-day regimen. Studies from Africa and North America were unavailable in previous meta-analyses. AIM To perform a meta-analysis comparing sequential vs. prolonged 14-day triple therapy with regard to 'geographic weighting' by considering subgroups analysis according to metronidazole/clarithromycin low and high resistance areas. METHODS Based on PRISMA recommendations, we considered all first-line clinical studies from 2003 to November 2014. Randomised clinical trials (RCTs) were included by a search on PubMed, MEDLINE, Science Direct, EMBASE. Data on eradication rates were expressed as ITT. Risk ratio (RR), pooled RR and 95% confidence intervals were calculated by the Mantel-Haenszel method. Data were entered into RevMan 5.2 software (Nordic Cochrane Centre) using a random-effects model. RESULTS Databases identified 194 studies; seven met the inclusion criteria. Overall results showed a similar effectiveness of the two regimens considered (RR = 0.99; 95% CI = 0.94-1.05; p = 0.75). In areas with high resistance to clarithromycin, sequential was superior to 14-day triple therapy (RR = 0.95; 95% CI = 0.90-1.00; p = 0.03). In areas with high metronidazole resistance, sequential and 14-day triple therapy were equivalent (RR = 0.99; 95% CI = 0.91-1.08; p = 0.82). CONCLUSIONS 'Geographic weighting' could be the main factor affecting the lack of differences between sequential and 14-day triple therapy outcomes.
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Affiliation(s)
- G Losurdo
- Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - G Leandro
- Gastroenterological Department, IRCCS "De Bellis" Hospital, Castellana Grotte, Italy
| | - M Principi
- Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - F Giorgio
- Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - L Montenegro
- Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - C Sorrentino
- Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - E Ierardi
- Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - A Di Leo
- Gastroenterology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
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Montenegro L, Puglisi G. Evaluation of sunscreen safety by in vitro skin permeation studies: effects of vehicle composition. Pharmazie 2013; 68:34-40. [PMID: 23444778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
For sunscreens to be safe and effective, the lowest possible UV-filter percutaneous absorption should be achieved. In this paper, we evaluated in vitro release and permeation through human skin of two UV-filters, octyl methoxycinnammate (OMC) and butyl methoxydibenzoyl methane (BMBM) from six commercial O/W emulsions and we estimated their margin of safety (MoS). OMC and BMBM in vitro release and skin permeation were investigated in Franz-type diffusion cells and permeation data were used to calculate MoS. OMC in vitro skin permeation depended on both its concentration and vehicle composition while BMBM skin permeation depended on its release from the vehicle. MoS values were well beyond the lowest limit accepted for safe products. Although sunscreen skin permeation may depend on many factors, the commercial products investigated are safe under normal "in use" conditions.
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Affiliation(s)
- L Montenegro
- Department of Drug Sciences, University of Catania, V.le A .Doria 6, 95125 Catania, Italy.
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Montenegro L, Trapani A, Latrofa A, Puglisi G. In vitro evaluation on a model of blood brain barrier of idebenone-loaded solid lipid nanoparticles. J Nanosci Nanotechnol 2012; 12:330-7. [PMID: 22523983 DOI: 10.1166/jnn.2012.5174] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The aim of this study was to evaluate in vitro the permeation of the antioxidant agent Idebenone (IDE) loaded into solid lipid nanoparticles (SLN) across MDCKII-MDR1 cell monolayer, selected as an in vitro model of the Blood Brain Barrier (BBB). SLN were prepared using cetyl palmitate as solid lipid and different non-ionic surfactants, oleth-20, ceteth-20 and isoceth-20, by the phase inversion temperature (PIT) technique. The resulting SLN showed physiological pH and osmolarity values, a mean particle diameter in the range of 33-63 nm, a single peak in size distribution, and a zeta potential ranging from +3.14 to -2.89 mV. When incubating these SLN in Simulated Body Fluid (SBF), the particle size was maintained for all samples throughout the study. IDE permeability across MDCKII-MDR1 cell monolayers from the SLN under investigation was 0.40-0.53 fold lower than free IDE and no significant difference was observed comparing IDE permeation from all the SLN tested. It is noteworthy that IDE loading into SLN avoided the use of an organic solvent to solubilize IDE, a poor water soluble compound, allowing the parenteral administration of this drug in aqueous vehicles. Furthermore, the results of in vitro transport studies, performed using fluorescein-dextran 4000 (FD4) and diazepam (DZ) as markers of the paracellular pathway and the transcellular pathway, respectively, pointed out that IDE could permeate via a transcellular pathway. Therefore, these novel nanocarriers could be regarded as a promising strategy to design delivery systems for IDE administration to the brain, deserving further investigations under in vivo conditions.
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Affiliation(s)
- L Montenegro
- Department of Pharmaceutical Sciences, University of Catania, V.le A. Doria 6, 95125 Catania, Italy
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Napoli C, Tafuri S, Montenegro L, Cassano M, Notarnicola A, Lattarulo S, Montagna MT, Moretti B. Air sampling methods to evaluate microbial contamination in operating theatres: results of a comparative study in an orthopaedics department. J Hosp Infect 2011; 80:128-32. [PMID: 22138124 DOI: 10.1016/j.jhin.2011.10.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 10/11/2011] [Indexed: 12/01/2022]
Abstract
AIM To evaluate the level of microbial contamination of air in operating theatres using active [i.e. surface air system (SAS)] and passive [i.e. index of microbial air contamination (IMA) and nitrocellulose membranes positioned near the wound] sampling systems. METHODS Sampling was performed between January 2010 and January 2011 in the operating theatre of the orthopaedics department in a university hospital in Southern Italy. FINDINGS During surgery, the mean bacterial loads recorded were 2232.9 colony-forming units (cfu)/m(2)/h with the IMA method, 123.2 cfu/m(3) with the SAS method and 2768.2 cfu/m(2)/h with the nitrocellulose membranes. Correlation was found between the results of the three methods. Staphylococcus aureus was detected in 12 of 60 operations (20%) with the membranes, five (8.3%) operations with the SAS method, and three operations (5%) with the IMA method. CONCLUSION Use of nitrocellulose membranes placed near a wound is a valid method for measuring the microbial contamination of air. This method was more sensitive than the IMA method and was not subject to any calibration bias, unlike active air monitoring systems.
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Affiliation(s)
- C Napoli
- Department of Biomedical Sciences and Human Oncology, Section of Hygiene, University of Bari Aldo Moro, Bari, Italy.
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Tusset C, Trarbach ÉB, Silveira LFG, Beneduzzi D, Montenegro L, Latronico AC. Aspectos clínicos e moleculares do hipogonadismo hipogonadotrófico isolado congênito. ACTA ACUST UNITED AC 2011; 55:501-11. [DOI: 10.1590/s0004-27302011000800002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 10/21/2011] [Indexed: 11/22/2022]
Abstract
O hipogonadismo hipogonadotrófico isolado (HHI) congênito caracteriza-se pela falta completa ou parcial de desenvolvimento puberal em decorrência de defeitos na migração, síntese, secreção ou ação do hormônio liberador de gonadotrofinas (GnRH). Baixas concentrações de esteroides sexuais e valores reduzidos ou inapropriadamente normais de gonadotrofinas hipofisárias (LH e FSH) definem, do ponto de vista laboratorial, essa condição clínica. A secreção dos demais hormônios hipofisários encontra-se normal, bem como a ressonância magnética de região hipotalâmica-hipofisária, demonstrando a ausência de uma causa anatômica. Alterações olfatórias, como anosmia ou hiposmia, podem estar associadas ao HHI, caracterizando a síndrome de Kallmann. Uma lista crescente de genes está envolvida na etiologia do HHI, sugerindo a heterogeneidade e a complexidade da base genética dessa condição. Distúrbios na rota de migração dos neurônios secretores de GnRH e dos neurônios olfatórios formam a base clínico-patológica da síndrome de Kallmann. Mutações nos genes KAL1, FGFR1/FGF8, PROK2/PROKR2, NELF, CHD7, HS6ST1 e WDR11 foram associadas a defeitos de migração neuronal, causando a síndrome de Kallmann. É notável que defeitos nos genes FGFR1, FGF8, PROKR2, CHD7 e WDR11 foram também associados ao HHI sem alterações olfatórias (HHI normósmico), porém em menor frequência. Adicionalmente, defeitos nos KISS1R, TAC3/TACR3 e GNRH1/GNRHR foram descritos exclusivamente em pacientes com HHI normósmico. Neste trabalho, revisaremos as características clínicas, hormonais e genéticas do HHI.
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Montenegro L, Sarpietro M, Ottimo S, Puglisi G, Castelli F. Differential scanning calorimetry studies on sunscreen loaded solid lipid nanoparticles prepared by the phase inversion temperature method. Int J Pharm 2011; 415:301-6. [DOI: 10.1016/j.ijpharm.2011.05.076] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Revised: 05/27/2011] [Accepted: 05/28/2011] [Indexed: 10/18/2022]
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Montenegro L, Carbone C, Paolino D, Drago R, Stancampiano AH, Puglisi G. In vitro skin permeation of sunscreen agents from O/W emulsions. Int J Cosmet Sci 2008; 30:57-65. [DOI: 10.1111/j.1468-2494.2008.00417.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Santos M, Dias Pereira P, Montenegro L, Faustino AMR. Recurrent and metastatic canine urethral transitional cell carcinoma without bladder involvement. Vet Rec 2007; 160:557-8. [PMID: 17449714 DOI: 10.1136/vr.160.16.557] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- M Santos
- Institute of Biomedical Sciences of Abel Salazar, University of Porto, Porto 4099-003, Portugal
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Montenegro L, Carbone C, Giannone I, Puglisi G. Use of solid phase extraction (SPE) to evaluate in vitro skin permeation of aescin. Pharmazie 2007; 62:342-5. [PMID: 17557740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The aim of this work was to evaluate the feasibility of assessing aescin in vitro permeation through human skin by determining the amount of aescin permeated using conventional HPLC procedures after extraction of skin permeation samples by means of solid phase extraction (SPE). Aescin in vitro skin permeation was assessed from aqueous solutions and gels using both Franz-type diffusion cells and flow-through diffusion cells. The SPE method used was highly accurate (mean accuracy 99.66%), highly reproducible (intra-day and inter-day variations lower than 2.3% and 2.2%, respectively) and aescin recovery from normal saline was greater than 99%. The use of Franz-type diffusion cells did not allow us to determine aescin flux values through excised human skin, therefore aescin skin permeation parameters could be calculated only using flow-through diffusion cells. Plotting the cumulative amount of aescin permeated as a function of time, linear relationships were obtained from both aqueous solution and gel using flow-through diffusion cells. Aescin flux values through excised human skin from aqueous gel were significantly lower than those observed from aqueous solution (p < 0.05). Calculating aescin percutaneous absorption parameters we evidenced that aescin partition coefficient was lower from the aqueous gel with respect to the aqueous solution. Therefore, the SPE method used in this study was suitable to determine aescin in vitro skin permeation parameters from aqueous solutions and gels using a conventional HPLC method for the analysis of the skin permeation samples.
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Affiliation(s)
- L Montenegro
- Department of Pharmaceutical Sciences, University of Catania, Italy.
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Musumeci T, Ventura CA, Giannone I, Ruozi B, Montenegro L, Pignatello R, Puglisi G. PLA/PLGA nanoparticles for sustained release of docetaxel. Int J Pharm 2006; 325:172-9. [PMID: 16887303 DOI: 10.1016/j.ijpharm.2006.06.023] [Citation(s) in RCA: 292] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2006] [Revised: 06/09/2006] [Accepted: 06/17/2006] [Indexed: 11/25/2022]
Abstract
This study investigates the potentiality of nanosphere colloidal suspensions as sustained release systems for intravenous administration of docetaxel (DTX). Nanospheres were prepared by solvent displacement method using polylactic acids (PLA) at different molecular weight and polylactic-co-glycolic (PLGA) as biodegradable matrices. The systems were characterized by light scattering analysis for their mean size, size distribution and zeta potential and by scanning electron microscopy (SEM) for surface morphology. The average diameters of the nanoparticles ranged from 100 to 200 nm. Negative zeta potential values were observed for all systems, particularly the nanospheres produced with the lowest molecular weight PLA showed a zeta potential value of -28mV. Differential scanning calorimetry analysis (DSC) suggested that DTX was molecularly dispersed in the polymeric matrices. A biphasic release of DTX was observed for all colloidal suspensions, after a burst effect in which about 50% (w/w) of the loaded drug was released a sustained release profile for about 10 days was observed. To evaluate the influence of the polymeric carrier on the interaction of DTX with biological membranes, we performed an in vitro study using lipid vesicles made of dipalmitoylphosphatidylcholine (DPPC) as a biomembrane model. DSC was used as a simple and not invasive technique of analysis. DTX produced a depression of DPPC pretransition peak, no variation of the main phase transition temperature and a significative increase of DeltaH value, showing a superficial penetration of the drug into DPPC bilayer. Kinetic experiments demonstrated that the release process of DTX form nanospheres is affected by the molecular weight of the employed polymers.
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Affiliation(s)
- T Musumeci
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, University of Catania, Viale A. Doria 6, I-95125 Catania, Italy
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Abstract
A 9-year-old male Rottweiler was presented to the Veterinary Medical Hospital Montenegro, Porto, Portugal with a large mass medial to the left stifle and radiographic signs of bone lysis involving the proximal tibia, fibula, and distal femur. A fine-needle aspiration was obtained from left popliteal lymph node, which was markedly enlarged. Cytologic examination revealed a highly cellular sample consisting of pleomorphic cells with marked anisocytosis and anisokaryosis and other criteria of malignancy. Some cells contained intracytoplasmic, granular, dark brown material, consistent with hemosiderin. Histologic evaluation of the surgically-excised lymph node revealed a neoplastic proliferation of histiocytic cells, with marked pleomorphism; occasional cells were erythrophagocytic. Mitotic figures were frequently observed, and many were atypical. Histologic findings were consistent with malignant histiocytosis. Necropsy examination confirmed the diagnosis of malignant histiocytosis with systemic involvement affecting most organs examined. This case of malignant histiocytosis case had an atypical clinical presentation, mimicking a musculoskeletal disorder. It underlines the importance of cytology as a simple, inexpensive, rapid and noninvasive complementary exam in routine clinical practice that can permit early diagnosis of the disease and timely selection of the most adequate therapy.
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Affiliation(s)
- P Dias Pereira
- ICBAS, Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Portugal
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Montenegro L, Paolino D, Drago R, Pignatello R, Fresta M, Puglisi G. Influence of liposome composition on in vitro permeation of diosmin through human stratum corneum and epidermis. J Drug Deliv Sci Technol 2006. [DOI: 10.1016/s1773-2247(06)50020-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Adrover R, Cocozzella D, Borzi S, Montenegro L, Defelitto M, Bosia D, Fraquelli E, Curciarello J. ¿Cuándo sería más rentable realizar una endoscopia digestiva alta para establecer la presencia de varices esofágicas en pacientes con cirrosis? Gastroenterología y Hepatología 2004; 27:353-6. [PMID: 15207133 DOI: 10.1016/s0210-5705(03)70474-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Variceal hemorrhage occurs in 25 to 35% of cirrhotic patients and is associated with significant morbidity and mortality and elevated hospital costs. Endoscopic exploration of gastroesophageal varices (GEV) in cirrhotic patients increases costs and involves a certain degree of invasiveness and discomfort for patients. The association between the presence of GEV and spleen size, liver function and platelet count is controversial. The aim of this study was to determine the correlation between liver function, evaluated by Child-Pugh (Ch-P) classification, platelet count (PC) and spleen volume index (SVI) with the presence of GEV in patients with cirrhosis managed in the outpatient setting. PATIENTS AND METHOD Sixty-eight patients were included. In all patients, a medical history was taken and biochemical tests, mode B and Doppler abdominal ultrasonography, and upper digestive video-endoscopy were performed. RESULTS A total of 76.47% of the patients were men and 23.53% were women. The median age was 52.8 12.4 years. More than half (54.41%) of the patients were Ch-P grade A, 41.18% were grade B and 4.41% were grade C. The most frequent causes of cirrhosis were alcohol in 52.95% and hepatitis C virus in 17.65%. Esophageal varices (EV) were found in 85.29% of the patients. The median SVI was 50.5 9.2 and the median PC was 150 26 x 109/L. A correlation was found between the presence of EV, SVI >or= 45 and PC < or= 100 x 109/L (r = 0.327; p = 0.006). No correlation was found between the presence of EV and Ch-P grade A. In the multivariate analysis, only the presence of EV was associated with SVI >or= 45 (OR 7.4; 95% CI, 1.30-77.7; p = 0.02). CONCLUSION The presence of EV in cirrhotic patients managed in the outpatient setting was correlated with SVI >or= 45 and PC <or= 100 x 109/L.
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Affiliation(s)
- R Adrover
- Sección de Hepatología, Hospital Interzonal General de Agudos Prof Dr Rodolfo Rossi La Plata, Argentina.
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Franco M, Montenegro L, Lopedota A, Trapani G, Puglisi G, Liso G. Effect of some hydrophilic cyclodextrins on the solubility, dissolution rate and in vitro percutaneous penetration of oxazepam. J Drug Deliv Sci Technol 2004. [DOI: 10.1016/s1773-2247(04)50007-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Montenegro L, Bucolo C, Puglisi G. Enhancer effects on in vitro corneal permeation of timolol and acyclovir. Pharmazie 2003; 58:497-501. [PMID: 12889536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
The aim of this study was to evaluate the ability of two non-toxic skin penetration enhancers, N-methylpyrrolidone (NMP) and a positively charged phospholipid mixture (PS), to increase in vitro corneal permeation of timolol maleate (TM) and acyclovir (AC) in comparison with two corneal absorption promoters, polyethylene glycol octadecyl ether (Brij 78) and sodium taurocholate (TA). In vitro experiments were performed on corneas from albino rabbits which were mounted in a perfusion apparatus. The concentrations of the enhancers being tested were: Brij 78 1%, PS 1%, TA 1%, NMP 5%, NMP 10%. The safety of the enhancers being tested was assessed in vitro by determining their effects on corneal hydration and in vivo by means of a modified Draize test. Calculating the amount of drug permeated at different time points (90 and 180 min) we observed that TA, PS and NMP 5% significantly increased the cumulative amount of AC permeated after 90 min but only PS was effective after 180 min. TA, Brij 78 and PS were able to increase significantly the amount of TM permeated after 90 min but after 180 min only Brij 78 retained its effect. TA, Brij 78 and NMP 10% significantly increased the percent hydration levels (% HL) compared to the control while PS and NMP 5% did not affect % HL. The results of in vivo ocular tolerability studies showed that the enhancers which caused an in vitro increase of % HL produced in vivo conjunctival and/or corneal damages. The results of this study suggest that PS could be regarded as a potential corneal enhancer to increase the intraocular bioavailability of AC and TM.
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Affiliation(s)
- L Montenegro
- Department of Pharmaceutical Sciences, University of Catania, Catania, Italy.
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Abath FGC, Melo FL, Werkhauser RP, Montenegro L, Montenegro R, Schindler HC. Single-tube nested PCR using immobilized internal primers. Biotechniques 2002; 33:1210-2, 1214. [PMID: 12503300 DOI: 10.2144/02336bm05] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- F G C Abath
- Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Av. Moraes Rego s/n. Cidade Universitária, 50670-420, Recife, Brazil.
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Schindler HC, Montenegro L, Montenegro R, Carvalho AB, Abath FG, Jaureguiberry G. Development and optimization of polymerase chain reaction-based malaria diagnostic methods and their comparison with quantitative buffy coat assay. Am J Trop Med Hyg 2001; 65:355-61. [PMID: 11693884 DOI: 10.4269/ajtmh.2001.65.355] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Polymerase chain reaction (PCR)-based assays targeting the small-subunit rRNA were developed and evaluated, allowing for the simultaneous diagnosis of Plasmodium falciparum and Plasmodium vivax DNA in human blood samples. The PCR methods and quantitative buffy coat (QBC) were compared in 402 patients. The heminested PCR method showed a sensitivity of 97.4%, which was superior to the sensitivity of the QBC method (91.7%, P < 0.05), to simple PCR (84.6%, P < 0.001), and to PCR with digoxigenin labeling (PCR-DIG) (88.5%, P < 0.001). The PCR-DIG and QBC analyses were more sensitive than simple PCR (P < 0.003 and P < 0.05, respectively). There was no significant difference between the sensitivities of the QBC assay and the PCR-DIG assay. The specificity for the 3 PCR-based methods was 100%, superior to the specificity calculated for the QBC assay (88.95%, P < 0.009). The frequency of a positive result in groups from endemic areas but without detectable parasitemia increased, in order, from simple PCR, QBC test, PCR-DIG, to heminested PCR. An association between a positive PCR result and a history of malaria was also found. Taken together, these data suggest that this technology could be further developed to screen people with oligoparasitemia and to monitor malaria treatment.
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Affiliation(s)
- H C Schindler
- Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Pernambuco, Brazil
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Brito-Marques PR, Mello RV, Montenegro L. Classic Pick's disease type with ubiquitin-positive and tau-negative inclusions: case report. Arq Neuropsiquiatr 2001; 59:128-33. [PMID: 11299448 DOI: 10.1590/s0004-282x2001000100028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We report on a patient presenting Pick's disease similar to the one reported by Pick in 1892, with ubiquitin-positive and tau-negative inclusions. His diagnosis was made on the basis of clinical (language disturbance and behavioural disorders), neuropsychological (progressive aphasia of the expression type and late mutism), neuroimaging with magnetic resonance (bilateral frontal and temporal lobes atrophy) and brain single photon emission computed tomography (frontal and temporal lobes hypoperfusion) studies. Macroscopic examination showed atrophy on the frontal and temporal lobes. The left hippocampus displayed a major circumscribed atrophy. The diagnostic confirmation was made by the neuropathological findings of the autopsy that showed neuronal loss with gliosis of the adjacent white matter and apearance of status spongiosus in the middle frontal and especially in the upper temporal lobes. There were also neuronal swelling (ballooned cell) and argyrophilic inclusions (Pick's bodies) in the left and right hippocampi. Anti-ubiquitin reaction tested positive and anti-tau tested negative.
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Affiliation(s)
- P R Brito-Marques
- Behavioral Neurology Unit, Department of Neurology, Faculty of Medical Sciences, University of Pernambuco, Brazil.
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Palagiano F, Arenare L, Barbato F, La Rotonda M, Quaglia F, Bonina F, Montenegro L, de Caprarüs P. In vitro and in vivo evaluation of terpenoid esters of indomethacin as dermal prodrugs. Int J Pharm 1997. [DOI: 10.1016/s0378-5173(97)04884-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Palagiano F, Bonina FP, Montenegro L, Biondi A, Sorrentino L, Capasso A, de Caprariis P. Synthesis, stability and anticonvulsant activity of two new GABA prodrugs. Pharmazie 1997; 52:272-6. [PMID: 9140143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
4-(3,4-Dihydro-2,4-dioxo-2H-1,3-benzoxazin-3-yl)-butyric acid (7) and its ester 6, two potential gamma-aminobutyric acid (GABA) prodrugs, were synthesized and studied to determine their stability in aqueous buffer and their susceptibility to undergo enzymatic hydrolysis in vitro (mouse plasma). Both compounds were fairly stable in aqueous media, (t1/2 = 68.2 h and 25.7 h, respectively). The 3,4-dihydro-2,4-dioxo-2H-1,3-benzoxazine ring underwent enzymatic hydrolysis (t1/2 = 5.8 h) in compound 7, whereas in compound 6 it seemed not to be opened by mouse plasma esterases within the observation time (3h). Both compounds were tested for their anticonvulsant activity in pentetrazole (PTZ) treated mice, and showed significant activity. Compound 7, administered as sodium salt 8, was active at relatively low doses and can be considered a very interesting GABA prodrug.
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Affiliation(s)
- F Palagiano
- Department of Pharmaceutical Chemistry, University of Naples Federico II, Italy
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Abstract
This study examines the pharmacological profile of a new GABA mimetic drug, 4-[(2H)-1,3-benzoxazine-2,4(3H)-dione]-butyric acid (BXDBA), using both a behavioral and an anticonvulsive study. The behavior elements considered were locomotor activity, motor coordination, catalepsy, behavior and antinociception. The anticonvulsive study was performed using the convulsive agent bicuculline. BXDBA [10, 20 and 40 mg/kg, intraperitoneally (i.p.)] did not significantly modify animal behavior or the nociceptive threshold of the animals. The anticonvulsive study indicated that BXDBA (10, 20 and 40 mg/kg, i.p.), injected 60 min before bicuculline (10 micrograms/intracerebroventricular (i.c.v.)/mouse) induced a dose-dependent and significant reduction of the convulsive activity of bicuculline whereas it was ineffective if injected immediately before the convulsive agent. Our data indicate that this new GABA mimetic drug possesses good anticonvulsive activity and its ability to block bicuculline-induced convulsions suggests that it could be a GABAA mimetic drug. Furthermore, since BXDBA is able to act after systemic administration, our data suggest that this new GABA mimetic drug crosses the blood-brain barrier.
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Affiliation(s)
- A Capasso
- School of Pharmacy, University of Salerno, Italy
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Bonina F, Lanza M, Montenegro L, Salerno L, Smeriglio P, Trombetta D, Saija A. Transport of alpha-tocopherol and its derivatives through erythrocyte membranes. Pharm Res 1996; 13:1343-7. [PMID: 8893272 DOI: 10.1023/a:1016017832146] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the transport of alpha-tocopherol (T), tocopherol succinate (TS) and tocopherol succinate-3-glucose (a newly synthetized, less hydrophobic T ester; TSG) through bovine erythrocyte membranes. METHODS Our experiments were carried out on erythrocytes (obtained from heparinized fresh bovine blood), because they represent a suitable model for investigations of membrane transport. RESULTS T was shown to reside almost completely in the suspension medium, while the greater part of TS disappeared from the suspension medium and was mainly incorporated into erythrocyte membranes. In comparison with T, a larger amount of TSG was incorporated into erythrocyte membranes and taken up by cells; however the TSG intracellular accumulation was significantly lower than that observed with TS. Furthermore, the transport of TS and TSG was partially inhibited by p-chloromercuribenzenesulfonate (which inhibits monocarboxylate uptake; PCMBS) and by maltose (a competitive inhibitor of glucose transport) respectively, with a concomitant increase in drug membrane incorporation. No significant change in drug transport was observed in the presence of 4,4'-diisothiocyanostilbene-2,2'-disulfonate, a selective and irreversible blocker of band 3 protein (DIDS). CONCLUSIONS Our results show 1) the existence of large differences in membrane incorporation of T, TS and TSG (very likely caused by differing abilities to fill spaces in the lipid bilayer) and 2) a specific contribution of the monocarboxylate transport protein and of the glucose transport protein in the cellular uptake of TS and TSG, respectively. A tempting suggestion is that the unique cytoprotective properties of TS may be related to the differences in the transmembrane mobility observed between T and its succinate ester. Furthermore, T conjugation to a monocarboxylate or glycoside moiety could provide suitable substrates for active membrane transport, thus appearing as a promising pharmaceutical strategy for the improved delivery of tocopherol derivatives.
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Affiliation(s)
- F Bonina
- Department of Pharmaceutical Sciences, School Pharmacy, University of Catania, Italy
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Palagiano F, de Caprariis P, Bonina FP, Montenegro L, Capasso A, Sorrentino L. [Pharmacokinetic and pharmacodynamic profile of the trioxyethylene ester of indomethacin in a new oral prodrug]. Boll Chim Farm 1996; 135:89-91. [PMID: 9044565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- F Palagiano
- Dipartimento di Chimica Farmaceutica e Tossicologica. Facoltà di Farmacia, Napoli
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Armstrong C, Ruffer J, Hopwood C, Montenegro L, Mollman J, Judy K, Alavi J, Corn B. 74 Longterm neurocognitive sequellae of a prospectively followed cohort of low grade tumor patients treated by conformal irradiation. Int J Radiat Oncol Biol Phys 1996. [DOI: 10.1016/s0360-3016(97)85415-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bonina F, Montenegro L, Scrofani N, Esposito E, Cortesi R, Menegatti E, Nastruzzi C. Effects of phospholipid based formulations on in vitro and in vivo percutaneous absorption of methyl nicotinate. J Control Release 1995. [DOI: 10.1016/0168-3659(94)00125-e] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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De Caprariis P, Palagiano F, Bonina F, Montenegro L, D'Amico M, Rossi F. Synthesis and pharmacological evaluation of oligoethylene ester derivatives as indomethacin oral prodrugs. J Pharm Sci 1994; 83:1578-81. [PMID: 7891278 DOI: 10.1002/jps.2600831112] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Five indomethacin oligoethylene ester derivatives (3-7) were synthesized and evaluated for their anti-inflammatory, analgesic, and ulcerogenic activity after oral administration. The molecular weight of the oligoethylene glycols used for synthesizing esters 3-7 ranged from 106 to 282. The chemical and enzymatic stabilities of esters 3-7 were evaluated in pH 7.4 and 2.0 buffers and in human plasma, respectively. All the prodrugs showed a good stability both in pH 7.4 phosphate buffer and in pH 2.0 buffer, and they were readily hydrolyzed by human plasma. Esters 3-7 showed an anti-inflammatory activity, determined as the percent inhibition of carrageenan-induced edema, similar to that of indomethacin, although at higher doses. From writhing test results, we observed that all the prodrugs exhibited better or similar analgesic activity compared to indomethacin. Esters 3-7 were significantly less irritating to the gastric mucosa than indomethacin, after oral administration, and esters 3-5 did not show any ulcerogenic activity, although they were administered at higher doses than indomethacin.
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Affiliation(s)
- P De Caprariis
- Dipartimento di Chimica Farmaceutica e Tossicologica, Facoltà di Farmacia, Università di Napoli Federico II-Via Domenico Montesano, Italy
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