Psychiatric polygenic risk as a predictor of COVID-19 risk and severity: insight into the genetic overlap between schizophrenia and COVID-19

Despite the high contagion and mortality rates that have accompanied the coronavirus disease-19 (COVID-19) pandemic, the clinical presentation of the syndrome varies greatly from one individual to another. Potential host factors that accompany greater risk from COVID-19 have been sought and schizophrenia (SCZ) patients seem to present more severe COVID-19 than control counterparts, with certain gene expression similarities between psychiatric and COVID-19 patients reported. We used summary statistics from the last SCZ, bipolar disorder (BD), and depression (DEP) meta-analyses available on the Psychiatric Genomics Consortium webpage to calculate polygenic risk scores (PRSs) for a target sample of 11,977 COVID-19 cases and 5943 subjects with unknown COVID-19 status. Linkage disequilibrium score (LDSC) regression analysis was performed when positive associations were obtained from the PRS analysis. The SCZ PRS was a significant predictor in the case/control, symptomatic/asymptomatic, and hospitalization/no hospitalization analyses in the total and female samples; and of symptomatic/asymptomatic status in men. No significant associations were found for the BD or DEP PRS or in the LDSC regression analysis. SNP-based genetic risk for SCZ, but not for BD or DEP, may be associated with higher risk of SARS-CoV-2 infection and COVID-19 severity, especially among women; however, predictive accuracy barely exceeded chance level. We believe that the inclusion of sexual loci and rare variations in the analysis of genomic overlap between SCZ and COVID-19 will help to elucidate the genetic commonalities between these conditions.

The genomics of visuospatial neurocognition in obsessive-compulsive disorder: A preliminary GWAS

BACKGROUND

The study of Obsessive-Compulsive Disorder (OCD) genomics has primarily been tackled by Genome-wide association studies (GWAS), which have encountered troubles in identifying replicable single nucleotide polymorphisms (SNPs). Endophenotypes have emerged as a promising avenue of study in trying to elucidate the genomic bases of complex traits such as OCD.

METHODS

We analyzed the association of SNPs across the whole genome with the construction of visuospatial information and executive performance through four neurocognitive variables assessed by the Rey-Osterrieth Complex Figure Test (ROCFT) in a sample of 133 OCD probands. Analyses were performed at SNP- and gene-level.

RESULTS

No SNP reached genome-wide significance, although there was one SNP almost reaching significant association with copy organization (rs60360940; P = 9.98E-08). Suggestive signals were found for the four variables at both SNP- (P < 1E-05) and gene-levels (P < 1E-04). Most of the suggestive signals pointed to genes and genomic regions previously associated with neurological function and neuropsychological traits.

LIMITATIONS

Our main limitations were the sample size, which was limited to identify associated signals at a genome-wide level, and the composition of the sample, more representative of rather severe OCD cases than a population-based OCD sample with a broad severity spectrum.

CONCLUSIONS

Our results suggest that studying neurocognitive variables in GWAS would be more informative on the genetic basis of OCD than the classical case/control GWAS, facilitating the genetic characterization of OCD and its different clinical profiles, the development of individualized treatment approaches, and the improvement of prognosis and treatment response.

Effects of caffeine on central and peripheral fatigue following closed- and open-loop cycling exercises

We examined whether endurance performance and neuromuscular fatigue would be affected by caffeine ingestion during closed- and open-loop exercises. Nine cyclists performed a closed-loop (4,000-m cycling time trial) and an open-loop exercise (work rate fixed at mean power of the closed-loop trial) 60 min after ingesting caffeine (CAF, 5 mg/kg) or placebo (PLA, cellulose). Central and peripheral fatigue was quantified via pre- to post-exercise decrease in quadriceps voluntary activation and potentiated twitch force, respectively. Test sensitivity for detecting caffeine-induced improvements in exercise performance was calculated as the mean change in time divided by the error of measurement. Caffeine ingestion reduced the time of the closed-loop trial (PLA: 375.1±14.5 s vs CAF: 368.2±14.9 s, P=0.024) and increased exercise tolerance during the open-loop trial (PLA: 418.2±99.5 s vs CAF: 552.5±106.5 s, P=0.001), with similar calculated sensitivity indices (1.5, 90%CI: 0.7-2.9 vs 2.8, 90%CI: 1.9-5.1). The reduction in voluntary activation was more pronounced (P=0.019) in open- (-6.8±8.3%) than in closed-loop exercises (-1.9±4.4%), but there was no difference between open- and closed-loop exercises for the potentiated twitch force reduction (-25.6±12.8 vs -26.6±12.0%, P>0.05). Caffeine had no effect on central and peripheral fatigue development in either mode of exercise. In conclusion, caffeine improved endurance performance in both modes of exercise without influence on post-exercise central and peripheral fatigue, with the open-loop exercise imposing a greater challenge to central fatigue tolerance.

Population structure and relatedness estimates in a Mexican sample

Population stratification (PS) is a confounding factor in genome-wide association studies (GWASs) and also an interesting process itself. Latin American populations have mixed genetic ancestry, which may account for PS. We have analyzed the relatedness, by means of the identity-by-descent (IBD) estimations, in a sample of 1805 individuals and 1.006.703 autosomal mutations from a case-control study of colorectal cancer in Mexico. When using the recommended protocol for quality control assessment, 402 should have been removed due to relatedness. Our purpose was to analyze this value in the context of an admixed population. For that aim, we reanalyzed the sample using two software designed for admixed populations, obtaining estimates of 110 and 70 related individuals to remove. The results showed that the first estimation of relatedness was an effect of the higher Native American contribution in part of the data samples, being a confounding factor for IBD estimations. We conclude in the importance of considering PS and genetic ancestry in order to avoid spurious results, not only in GWAS but also in relatedness analysis.

Footwear designed to enhance energy return improves running economy compared to a minimalist footwear: does it matter for running performance?

The present study compared the effects of a footwear designed to enhance energy return (thermoplastic polyurethane, TPU) vs minimalist shoes on running economy (RE) and endurance performance. In this counterbalanced and crossover design study, 11 recreational male runners performed two submaximal constant-speed running tests and two 3-km time-trials with the two shoe models. Oxygen uptake was measured during submaximal constant-speed running tests in order to determine the RE at 12 km/h and oxygen cost of running (CTO2) at individual average speed sustained during the 3-km running time-trials wearing either of the two shoes. Our results revealed that RE was improved (2.4%) with TPU shoes compared with minimalist shoes (P=0.01). However, there was no significant difference for CTO2 (P=0.61) and running performance (P=0.52) comparing the TPU (710±60 s) and the minimalist (718±63 s) shoe models. These novel findings demonstrate that shoes with enhanced mechanical energy return (i.e. TPU) produced a lower energy cost of running at low (i.e., 12 km/h) but not at high speeds (i.e., average speed sustained during the 3-km running time-trial, ∼15 km/h), ultimately resulting in similar running performance compared to the minimalist shoe.

The Surfaces of the Ceratonia siliqua L. (Carob) Leaflet: Insights from Physics and Chemistry

The production of superhydrophobic coatings inspired by the surface of plant leaves is a challenging goal. Such coatings hold a bright technological future in niche markets of the aeronautical, space, naval, building, automobile, and biomedical sectors. This work is focused on the adaxial (top) and abaxial (bottom) surfaces of the leaflet of the Ceratonia silique L. (carob), a high-commercial-value Mediterranean tree cultivated in many regions of the world. The adaxial and abaxial surfaces feature hydrophobic and superhydrophobic behaviors, respectively. Their chemical composition is very simple: monopalmitin ester and palmitic acid are protuberant in the epicuticular and intracuticular wax layers of the adaxial surface, respectively, whereas 1-octacosanol dominates in the abaxial wax layers. In both surfaces, epicuticular wax is organized along a randomly oriented and intricate network of nanometer-thick and micrometer-long plates, whose density and degree of interconnection are significantly higher in the abaxial surface. The measured tilting angles for the abaxial surface (12-70°) reveal unusual variable density and water adhesion of the nanostructured plate-based texture. Optical measurements demonstrate that light reflectance/absorbance of the glaucous abaxial surface is significantly higher/lower than that of the nonglaucous adaxial surface. In both surfaces, diffuse reflectance is dominant, and the absorbance is weakly dependent on the light incidence angle. We show that the highly dense nanostructured platelike texture of the epicuticular abaxial layer of the C. siliqua leaflet works as a sophisticated light and water management system: it reflects solar radiation diffusely to lower the surface temperature, and it has superhydrophobic character to keep the surface dry. Such attributes enable efficient gas exchange (photosynthesis and respiration), transpiration, and evaporation. To mimic for the first time the abaxial surface, a templation approach was adopted using poly(dimethylsiloxane) (PDMS)/poly(methylphenylsiloxane) (PMPS) positive/negative replicas and a soft polymer/siloxane negative replica produced by the sol-gel process. Because high topographical variations of the biotemplate and wax adhesion to the biohybrid film affected the replication quality, the reproduction of the wax texture via the synthesis of 1-octacosanol-grafted siloxane-based hybrid materials is proposed as a suitable route to duplicate the abaxial surface with high fidelity. The natural chemical/physical strategy adopted by the C. siliqua leaflet to face the harsh Mediterranean climate is a powerful source of bioinspiration for the development of diffuse reflecting and superhydrophobic material systems with foreseen applications as dual-functional antiglare and water-repelling coatings.

Changes in the eye contour signs due to age among Mexican women: Comparison with women of other ethnic origins

OBJECTIVE

To evaluate the changes in certain ocular signs because of age, among Mexican women and to compare these with those previously obtained on women of other ethnicities.

MATERIAL AND METHODS

Photographs were taken of the faces of 203 Mexican women of different ages, under standardized conditions. These photographs allowed us to focus and define nine ocular signs, which were then graded by 15 experts and dermatologists, using standardized scales provided by a reference Skin Aging Atlas. Hence, the same protocol, previously used on 3240 women of four other ethnic origins (Caucasian: 600; Chinese: 990; Japanese: 1010; Indian: 300; African: 340), allowed us to compare the results obtained on Mexican women.

RESULTS

The severity of crow's feet wrinkles for Mexican women shows a more intense progression with age than those of women from other ancestries. The lower eyelid wrinkles of Mexican women, that show weak or erratic changes with time, were however found to have higher and significant severity at a young age. Pigmentation disorders of their ocular area were found less pronounced as compared to those of Asian or Indian women. Eye bags were observed with similar slight changes in all five ancestries.

CONCLUSION

The present work confirms that the clinical signs of age for the female eye area develop differently depending on the ethnic origins of the volunteer.

Prostate cancer, new treatment advances - immunotherapy

Prostate cancer (PCa) is the fourth most common cancer in the world and treatment is currently based on surgical removal and/or radiotherapy and/or hormone therapy. In the last few years' immunotherapy has become an important cancer treatment option. While the principles of immunotherapy evolved, only sipuleucel-T was approved by the Food and Drug Administration (FDA) which lead to further studies with other agents, starting a new era in immuno-oncology. A number of vaccines are under clinical investigation as well as checkpoint inhibitors. Despite the current enthusiasm, it is unlikely that any of the approaches alone can dramatically change PCa outcomes, but strategies combination is more promising and provide a reason for optimism. The goal of immunotherapy in PCa does not have to be the complete eradication of advanced disease, but rather the return to an immunologic equilibrium with an indolent disease state. With such concerted efforts, the future of immunotherapy in PCa looks brighter than ever, with many clinical trial results being published soon.

Current Point-of-Care testing in cancer and future perspectives: a systematic review

Introduction Cancer is the most prevalent disease worldwide, causing a major impact on society. Early detection and monitorization of the tumour can provide a more effective treatment. Point-of-care (POC) testing allows the patient to have a handheld test that gives the results rapidly. No expertise or special knowledge is required which is vital namely when carried out in low-resource areas. Recent studies analysed established and emerging biomarkers and how to incorporate them into POC devices, but a systematic review reporting the existing POC platforms for cancer is still not available.

Objectives This systematic review aims to report current and recent advances for point-of-care testing in cancer.

Methodology A literature review was conducted through research in the databases “PubMed” and “B-On” for relevant reviews published in the last ten years, using the keywords “Point-of-care testing” AND “Cancer” AND “Rapid Test” AND “Cancer detection”.

Results In 2015 there were eight commercially available POC tests for prostate, bladder, colorectal, cervical, HPV-causing head and neck cancer, liver, breast and lung cancer. After 2018 a small number of POC devices were tested in screening programs and multicentric studies, and more recently, promising novel POC prototypes for early detection of cancer, namely a 3D prototype micro device for multiple singleplex RNA expression analysis in liver cancer and a POC microscopy prototype for digital diagnostics of breast cancer lymph node metastases, with potential to be used in resource-limited settings.

Conclusion The use of POC testing can deliver accurate, fast results, and in the case of cancer it is no exception, contributing to the progression of treatment and reduction in cancer-related deaths. In low-resource settings a POC test is fundamental and it should be simple and low-cost. But there are limitations in the tests which is a challenge for improvement and investigation in the future.

Big data and machine learning in health

Introduction Big data is defined as the amount of data that once organized and analysed, can make a value, make decisions, make predictions and discover patterns in order to reduce costs, avoid risks and optimize services. Machine Learning (ML) is a field of artificial intelligence and is characterized as a method of machine learning, which uses algorithms that learn from data analysis, allowing computers to find patterns, draw conclusions and make predictions. These tools can be used in different areas of human knowledge, particularly in the health sector which are generated daily a huge amount of information, allowing the creation of algorithms that learn and gain understanding to assist in various clinical practices.

Objectives The purpose of this paper is to analyse the benefits of Big Data and Machine Learning in providing overall health care.

Methodology We conducted a review of the scientific literature published in the electronic databases PubMed/MEDLINE and Google Scholar, according to specific criteria, using keywords: Big Data”, “Machine Learning".

Results In the field of oncology (skin cancer, breast, lung, leukaemia) ML and Big Data have contributed to early diagnosis of different pathologies and their evolution, as well as optimizing therapies. In ophthalmology (diabetic retinopathy and congenital cataract) has shown high efficacy in rapid diagnosis and appropriate treatment crucial to prevent the progress of the disease. The tested algorithms achieved very favourable results in cases of Parkinson’s and cardiovascular diseases. In the pharmaceutical industry these computer and digital tools have contributed to the optimization of clinical trials, genome sequencing of tumours to then identify and develop specific drugs to fight it.

Conclusion Advances of MIL and Big data are notorious and development opportunities are immense and can come to revolutionize tasks such as diagnosis, treatment and health care in general.

Impact of adverse effects to oral antidiabetics on adherence and quality of life in patients with type 2 diabetes

Introduction Diabetes is a metabolic disorder with many comorbidities, microvascular and macrovascular complications. In Portugal the prevalence was 13,3% which corresponds to 1 million Portuguese diagnosed, but the forecasts are for a big increase. The various therapeutic options currently available have been shown to be effective in controlling glycaemia and HbA1 levels. Adherence with this therapeutic is essential for optimization and control of chronic conditions. However, they present side effects that may compromise adherence to therapy and the quality of life of the patients.

Objectives The objective of this study is to evaluate the impact of the adverse effects of oral antidiabetic medicines on patient’s quality of life and adherence to therapy.

Methodology We developed a cross-sectional study in a sample of 65 patients with type 2 diabetes recruited in several Portuguese pharmacies. Data collected through a questionnaire previously validated with MAT Scale and EQ-5D-3L questionnaire.

Results In total, 36 men (55,4%) and 29 women (44,6%) participated in the study, the mean age was 65 years. 73,8 % take oral medication and 92,30% of people have high adherence. The adverse events with more impact in the patients’ perception are "Discomfort in the genital area", "Dry mouth" and gastrointestinal events such as "Abdominal distention", "Flatulence" and "Constipation". The number of adverse events have a negative impact on patients’ quality of life (rs=-0,479; p≤0,01). The satisfaction with the therapeutic regime is significantly associated with adherence (rs = 0,348; p≤0,01)and their quality of life (rs = 0,316; p=0,01).

Conclusion We concluded that the adverse events have a negative impact on adherence and quality of life. The presence of adverse events, the type of medication and the therapeutic regimen are factors that negatively influence the patients’ quality of life, especially in the polymedicated elderly people.

Are experienced and high-level race walking athletes able to match pre-programmed with executed pacing?

The objective of this study was to verify the agreement between pre-programmed and executed pacing during race walking and whether level of the athletes experience and performance influenced this relationship. Twenty-nine national and international race walkers participated in this study (14 males, 24.0±7.1 years old, and 15 females, 23.3±7.3 years old). Pre-programmed pacing for 10- and 20-km official walking races was self-selected via demonstrative pacing charts prior to races, while executed pacing was analyzed by a specialist investigator via an individual plot of current velocity versus distance. There was no agreement between pre-programmed and executed pacing (P=0.674). There was no association between the ability to match the pre-programmed pace with the executed pace and race walking experience or level of performance. Low- and high-performance athletes pre-programmed a similar pacing profile (P=0.635); however, high-performance athletes generally executed an even pacing strategy, while low-performance athletes generally adopted a positive pacing strategy (P=0.013). Race walkers did not faithfully match their pre-programmed with their executed pacing, and this seemed to be independent of previous experience and level of performance. High-performance athletes, however, tended to execute an even pacing strategy, even though this had not been pre-programmed.

Fungal Planet description sheets: 868-950

Novel species of fungi described in this study include those from various countries as follows: Australia, Chaetomella pseudocircinoseta and Coniella pseudodiospyri on Eucalyptus microcorys leaves, Cladophialophora eucalypti, Teratosphaeria dunnii and Vermiculariopsiella dunnii on Eucalyptus dunnii leaves, Cylindrium grande and Hypsotheca eucalyptorum on Eucalyptus grandis leaves, Elsinoe salignae on Eucalyptus saligna leaves, Marasmius lebeliae on litter of regenerating subtropical rainforest, Phialoseptomonium eucalypti (incl. Phialoseptomonium gen. nov.) on Eucalyptus grandis × camaldulensis leaves, Phlogicylindrium pawpawense on Eucalyptus tereticornis leaves, Phyllosticta longicauda as an endophyte from healthy Eustrephus latifolius leaves, Pseudosydowia eucalyptorum on Eucalyptus sp. leaves, Saitozyma wallum on Banksia aemula leaves, Teratosphaeria henryi on Corymbia henryi leaves. Brazil, Aspergillus bezerrae, Backusella azygospora, Mariannaea terricola and Talaromyces pernambucoensis from soil, Calonectria matogrossensis on Eucalyptus urophylla leaves, Calvatia brasiliensis on soil, Carcinomyces nordestinensis on Bromelia antiacantha leaves, Dendryphiella stromaticola on small branches of an unidentified plant, Nigrospora brasiliensis on Nopalea cochenillifera leaves, Penicillium alagoense as a leaf endophyte on a Miconia sp., Podosordaria nigrobrunnea on dung, Spegazzinia bromeliacearum as a leaf endophyte on Tilandsia catimbauensis, Xylobolus brasiliensis on decaying wood. Bulgaria, Kazachstania molopis from the gut of the beetle Molops piceus. Croatia, Mollisia endocrystallina from a fallen decorticated Picea abies tree trunk. Ecuador, Hygrocybe rodomaculata on soil. Hungary, Alfoldia vorosii (incl. Alfoldia gen. nov.) from Juniperus communis roots, Kiskunsagia ubrizsyi (incl. Kiskunsagia gen. nov.) from Fumana procumbens roots. India, Aureobasidium tremulum as laboratory contaminant, Leucosporidium himalayensis and Naganishia indica from windblown dust on glaciers. Italy, Neodevriesia cycadicola on Cycas sp. leaves, Pseudocercospora pseudomyrticola on Myrtus communis leaves, Ramularia pistaciae on Pistacia lentiscus leaves, Neognomoniopsis quercina (incl. Neognomoniopsis gen. nov.) on Quercus ilex leaves. Japan, Diaporthe fructicola on Passiflora edulis × P. edulis f. flavicarpa fruit, Entoloma nipponicum on leaf litter in a mixed Cryptomeria japonica and Acer spp. forest. Macedonia, Astraeus macedonicus on soil. Malaysia, Fusicladium eucalyptigenum on Eucalyptus sp. twigs, Neoacrodontiella eucalypti (incl. Neoacrodontiella gen. nov.) on Eucalyptus urophylla leaves. Mozambique, Meliola gorongosensis on dead Philenoptera violacea leaflets. Nepal, Coniochaeta dendrobiicola from Dendriobium lognicornu roots. New Zealand, Neodevriesia sexualis and Thozetella neonivea on Archontophoenix cunninghamiana leaves. Norway, Calophoma sandfjordenica from a piece of board on a rocky shoreline, Clavaria parvispora on soil, Didymella finnmarkica from a piece of Pinus sylvestris driftwood. Poland, Sugiyamaella trypani from soil. Portugal, Colletotrichum feijoicola from Acca sellowiana. Russia, Crepidotus tobolensis on Populus tremula debris, Entoloma ekaterinae, Entoloma erhardii and Suillus gastroflavus on soil, Nakazawaea ambrosiae from the galleries of Ips typographus under the bark of Picea abies. Slovenia, Pluteus ludwigii on twigs of broadleaved trees. South Africa, Anungitiomyces stellenboschiensis (incl. Anungitiomyces gen. nov.) and Niesslia stellenboschiana on Eucalyptus sp. leaves, Beltraniella pseudoportoricensis on Podocarpus falcatus leaf litter, Corynespora encephalarti on Encephalartos sp. leaves, Cytospora pavettae on Pavetta revoluta leaves, Helminthosporium erythrinicola on Erythrina humeana leaves, Helminthosporium syzygii on a Syzygium sp. bark canker, Libertasomyces aloeticus on Aloe sp. leaves, Penicillium lunae from Musa sp. fruit, Phyllosticta lauridiae on Lauridia tetragona leaves, Pseudotruncatella bolusanthi (incl. Pseudotruncatellaceae fam. nov.) and Dactylella bolusanthi on Bolusanthus speciosus leaves. Spain, Apenidiella foetida on submerged plant debris, Inocybe grammatoides on Quercus ilex subsp. ilex forest humus, Ossicaulis salomii on soil, Phialemonium guarroi from soil. Thailand, Pantospora chromolaenae on Chromolaena odorata leaves. Ukraine, Cadophora helianthi from Helianthus annuus stems. USA, Boletus pseudopinophilus on soil under slash pine, Botryotrichum foricae, Penicillium americanum and Penicillium minnesotense from air. Vietnam, Lycoperdon vietnamense on soil. Morphological and culture characteristics are supported by DNA barcodes.

Effects of a 4-week high-intensity interval training on pacing during 5-km running trial

This study analyzed the influence of a 4-week high-intensity interval training on the pacing strategy adopted by runners during a 5-km running trial. Sixteen male recreational long-distance runners were randomly assigned to a control group (CON, n=8) or a high-intensity interval training group (HIIT, n=8). The HIIT group performed high-intensity interval-training twice per week, while the CON group maintained their regular training program. Before and after the training period, the runners performed an incremental exercise test to exhaustion to measure the onset of blood lactate accumulation, maximal oxygen uptake (VO2max), and peak treadmill speed (PTS). A submaximal constant-speed test to measure the running economy (RE) and a 5-km running trial on an outdoor track to establish pacing strategy and performance were also done. During the 5-km running trial, the rating of perceived exertion (RPE) and time to cover the 5-km trial (T5) were registered. After the training period, there were significant improvements in the HIIT group of ∼7 and 5% for RE (P=0.012) and PTS (P=0.019), respectively. There was no significant difference between the groups for VO2max (P=0.495) or onset of blood lactate accumulation (P=0.101). No difference was found in the parameters measured during the 5-km trial before the training period between HIIT and CON (P>0.05). These findings suggest that 4 weeks of HIIT can improve some traditional physiological variables related to endurance performance (RE and PTS), but it does not alter the perception of effort, pacing strategy, or overall performance during a 5-km running trial.

Early and late analysis of postpartum stress in newborn foals

ABSTRACT The aim of this study was to evaluate newborn foals stress in the first 48 hours of life. Heart rate (HR), heart rate variability (HRV) and serum cortisol concentrations, blood glucose, and lactate were determined in foals (n = 20, Paint Horse). Cortisol concentrations decreased significantly between four and 48 hours, with the highest concentration at 4 hours after birth. Positive correlations between cortisol and lactate occurred between 12 and 16 hours. And there was a negative correlation between cortisol and lactate 4 hours after birth. Among the values obtained for HR, there was significantly difference between the the value obtained at twelve hours of life moment and all the other moments measured, the highest values were at birth, 24 and 48 hours of life. Among HRV indexes, there were no statistical differences between the variables analysed. The cortisol, HR and HRV alterations were consistent to neonatal stress, but might be related to extrauterine environment adaptation associated to sympathoadrenal response, since those foals were healthy.

Análise da variabilidade da frequência cardíaca em cordeiros da raça Bergamácia, do nascimento aos 35 dias de idade

RESUMO A atividade do sistema nervoso autônomo sobre o coração pode ser verificada pela variabilidade da frequência cardíaca (VFC), método que quantifica e assim infere sobre a modulação autonômica cardíaca, refletindo o funcionamento do sistema nervoso autônomo. Durante o período neonatal, diferenças significativas no que se refere à maturação autonômica são descritas em diversas espécies. Embora a espécie ovina venha sendo utilizada como modelo experimental em diversos protocolos em neonatologia e cardiologia em humanos, estudos descritivos sobre a VFC utilizando animais saudáveis e não sedados são escassos na literatura. O objetivo do estudo foi descrever a VFC em cordeiros da raça Bergamácia durante os primeiros 35 dias de idade. Foram realizados exames eletrocardiográficos em 20 cordeiros da raça Bergamácia a partir do nascimento e semanalmente até o 35° dia de idade. A VFC foi analisada pelo intervalo RR normal (batimentos sinusais), pela frequência cardíaca, pelo índice de tônus vasovagal (iTVV), pela raiz quadrada da média do quadrado das diferenças entre intervalos RR normais adjacentes (RMSSD) e pela raiz quadrada da somatória do quadrado das diferenças dos valores individuais em relação ao valor médio, dividido pelo número de iR-R em 90 segundos - VFC global (RMSM). Todos os parâmetros se alteraram ao longo das semanas. A frequência cardíaca média elevou-se entre o nascimento e os primeiros sete dias de idade, com decréscimo nas quatro semanas subsequentes, sendo o menor valor encontrado aos 35 dias de idade (145,63±37,80bpm). Entre 21, 28 e 35 dias de idade, o iTVV elevou-se significativamente, o RMSM a partir do 28º dia, e, aos 35 dias, o RMSSD, reflexo da ativação parassimpática, exibiu diferenças em relação aos momentos subsequentes. O início da predominância parassimpática, refletida nos índices da VFC, particularmente o iTVV, ocorre aos 21 dias de idade. A partir dos 35 dias de idade, os índices RMSM e RMSSD podem ser utilizados como marcadores fidedignos das mudanças nos efeitos simpático e parassimpático sobre o coração de cordeiros.

Response of high-risk of recurrence/progression bladder tumours expressing sialyl-Tn and sialyl-6-T to BCG immunotherapy

Background:

High risk of recurrence/progression bladder tumours is treated with Bacillus Calmette-Guérin (BCG) immunotherapy after complete resection of the tumour. Approximately 75% of these tumours express the uncommon carbohydrate antigen sialyl-Tn (Tn), a surrogate biomarker of tumour aggressiveness. Such changes in the glycosylation of cell-surface proteins influence tumour microenvironment and immune responses that may modulate treatment outcome and the course of disease. The aim of this work is to determine the efficiency of BCG immunotherapy against tumours expressing sTn and sTn-related antigen sialyl-6-T (s6T).

Methods:

In a retrospective design, 94 tumours from patients treated with BCG were screened for sTn and s6T expression. In vitro studies were conducted to determine the interaction of BCG with high-grade bladder cancer cell line overexpressing sTn.

Results:

From the 94 cases evaluated, 36 had recurrence after BCG treatment (38.3%). Treatment outcome was influenced by age over 65 years (HR=2.668; (1.344–5.254); P=0.005), maintenance schedule (HR=0.480; (0.246–0.936); P=0.031) and multifocallity (HR=2.065; (1.033–4.126); P=0.040). sTn or s6T expression was associated with BCG response (P=0.024; P<0.0001) and with increased recurrence-free survival (P=0.001). Multivariate analyses showed that sTn and/or s6T were independent predictive markers of recurrence after BCG immunotherapy (HR=0.296; (0.148–0.594); P=0.001). In vitro studies demonstrated higher adhesion and internalisation of the bacillus to cells expressing sTn, promoting cell death.

Conclusion:

s6T is described for the first time in bladder tumours. Our data strongly suggest that BCG immunotherapy is efficient against sTn- and s6T-positive tumours. Furthermore, sTn and s6T expression are independent predictive markers of BCG treatment response and may be useful in the identification of patients who could benefit more from this immunotherapy.

Tauroursodeoxycholic acid protects retinal neural cells from cell death induced by prolonged exposure to elevated glucose

Diabetic retinopathy is one of the most frequent causes of blindness in adults in the Western countries. Although diabetic retinopathy is considered a vascular disease, several reports demonstrate that retinal neurons are also affected, leading to vision loss. Tauroursodeoxycholic acid (TUDCA), an endogenous bile acid, has proven to be neuroprotective in several models of neurodegenerative diseases, including models of retinal degeneration. Since hyperglycemia is considered to play a central role in retinal cell dysfunction and degeneration, underlying the progression of diabetic retinopathy, the purpose of this study was to investigate the neuroprotective effects of TUDCA in rat retinal neurons exposed to elevated glucose concentration. We found that TUDCA markedly decreased cell death in cultured retinal neural cells induced by exposure to elevated glucose concentration. In addition, TUDCA partially prevented the release of apoptosis-inducing factor (AIF) from the mitochondria, as well as the subsequent accumulation of AIF in the nucleus. Biomarkers of oxidative stress, such as protein carbonyl groups and reactive oxygen species production, were markedly decreased after TUDCA treatment as compared to cells exposed to elevated glucose concentration alone. In conclusion, TUDCA protected retinal neural cell cultures from cell death induced by elevated glucose concentration, decreasing mito-nuclear translocation of AIF. The antioxidant properties of TUDCA might explain its cytoprotection. These findings may have relevance in the treatment of diabetic retinopathy patients.

A clinical evaluation of the Maquet Quadrox-i Neonatal oxygenator with integrated arterial filter

High-performance, low-prime-volume oxygenators for the pediatric patient population have become a growing market among manufacturers. In the summer of 2011, our institution clinically evaluated the performance of the newly released Maquet Quadrox-i Neonatal oxygenator with integrated arterial filter. The static priming volume, including the integrated arterial filter, is 40 ml and the maximum rated blood flow is 1.5 liters per minute (LPM). The device was used on seven pediatric patients, ranging from 3.2 to 14 kg, undergoing various congenital heart defect repairs. Data were collected to calculate gas transfer, trans-oxygenator pressure drop, and heat exchange performance. The mean cardiopulmonary bypass time was 85 minutes and the mean cross-clamp time was 56 minutes. The average oxygen transfer was 34.3 ± 22.8 ml/O2/min and increased with both blood flow and FiO2. The average carbon dioxide transfer was 22.3 ± 17.8 ml/min and increased with both blood flow and gas sweep to blood flow ratio. The average trans-oxygenator pressure drop per blood flow was 53.3 ± 15.5 mmHg/L/min and increased with flow. The average heat exchanger performance factor was 47.6 ± 11.6% and decreased with flow. The heat exchange performance factor at maximum observed clinical flow, 1.42 LPM, was 36.4%. During this evaluation, the Maquet Quadrox-i Neonatal oxygenator adequately performed within its operational flow in the clinical setting.