48 research outputs found
Valoração de resíduos agroindustriais pela ação de Rhizopus Oryzae na liberação de ácidos fenólicos
Rhizopus oryzae possui atividade metabólica intensa despolimerizando materiais lignocelulósicos, que resulta no aumento da disponibilidade de componentes característicos do substrato utilizado. Acompanhamos a variação do perfil de ácidos fenólicos presentes em biomassa produzida por Rhizopus oryzae em farelo de soja, trigo e arroz. Nas biomassas de farelo de arroz e soja foram detectados 70,2 e 120,0 μg de ácido clorogênico/g em 24 e 72 h de cultivo, respectivamente. Em todas as biomassas os níveis de ácido gálico aumentaram ao longo do cultivo, 23,8 μg/g, 55,8 μg/g e 63,5 μg/g, respectivamente, para o farelo de soja, trigo e arroz. Ficou demonstrado que o cultivo de fungos em substratos lignocelulósicos promove a alteração de perfis de metabólitos secundários que podem ser interessantes para otimizar o aproveitamento de resíduos da agroindústria na cadeia produtiva de alimentos, tais como o ácido gálico, clorogênico, cafeico, hidroxibenzóico e vanilina
Assessing the impact of COVID-19 on liver cancer management (CERO-19).
BACKGROUND & AIMS: The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems and it may have heavily impacted patients with liver cancer (LC). Herein, we evaluated whether the schedule of LC screening or procedures has been interrupted or delayed because of the COVID-19 pandemic. METHODS: An international survey evaluated the impact of the COVID-19 pandemic on clinical practice and clinical trials from March 2020 to June 2020, as the first phase of a multicentre, international, and observational project. The focus was on patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma, cared for around the world during the first COVID-19 pandemic wave. RESULTS: Ninety-one centres expressed interest to participate and 76 were included in the analysis, from Europe, South America, North America, Asia, and Africa (73.7%, 17.1%, 5.3%, 2.6%, and 1.3% per continent, respectively). Eighty-seven percent of the centres modified their clinical practice: 40.8% the diagnostic procedures, 80.9% the screening programme, 50% cancelled curative and/or palliative treatments for LC, and 41.7% modified the liver transplantation programme. Forty-five out of 69 (65.2%) centres in which clinical trials were running modified their treatments in that setting, but 58.1% were able to recruit new patients. The phone call service was modified in 51.4% of centres which had this service before the COVID-19 pandemic (n = 19/37). CONCLUSIONS: The first wave of the COVID-19 pandemic had a tremendous impact on the routine care of patients with liver cancer. Modifications in screening, diagnostic, and treatment algorithms may have significantly impaired the outcome of patients. Ongoing data collection and future analyses will report the benefits and disadvantages of the strategies implemented, aiding future decision-making. LAY SUMMARY: The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to healthcare systems globally. Herein, we assessed the impact of the first wave pandemic on patients with liver cancer and found that routine care for these patients has been majorly disrupted, which could have a significant impact on outcomes
Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry
Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P <.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes
Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry
Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients
Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry
Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p <.001. Over 24 months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10 ml/min/1.73 m2 decrease), that was most notable in patients with eGFR <30 ml/min/1.73 m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90 ml/min/1.73 m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF
A global experiment on motivating social distancing during the COVID-19 pandemic
Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges
Aplicação de carboxipeptidase obtida de Rhizopus na degradação de ocratoxina A
Micotoxinas são metabólitos secundários produzidos por fungos filamentosos
em diferentes etapas da cadeia produtiva de alimentos. Entre micotoxinas, ocratoxina A (OTA) é de grande importância, e apresenta efeitos carcinogênicos, nefrotóxicos e teratogênicos. Estes efeitos vêm motivando o desenvolvimento de métodos capazes de diminuir esta contaminação aos níveis permitidos pela legislação. Os métodos biológicos envolvendo o uso de enzimas e microorganismos para degradação da OTA tem se destacado, em função da especificidade reacional e das condições brandas para a detoxificação. Neste trabalho foram estabelecidas condições de extração de carboxipeptidase A a partir de biomassa fermentada por Rhizopus oryzae para empregá-la na degradação de OTA, tendo pancreatina como controle. A metodologia padronizada para extração enzimática consistiu em agitação ultrassônica durante 30 minutos numa potencia fixa de 150 W e 40kHz. O extrato enzimático do microorganismo apresentou uma capacidade de degradação de 19,4%, que ocasionou uma degradação 49% superior a ação da pancreatina. Este resultado confirma a vantagem da utilização de enzimas microbianas em detrimento as de origem vegetal inclusive para processos de biodegradação micotoxicologica.Mycotoxins are secondary metabolites produced by filamentous fungi in different food chain stages. Among mycotoxins, ochratoxin A (OTA) is of great importance, and presents carcinogenic, teratogenic and nephrotoxic effects. These effects have motivated the development of methods to reduce the contamination levels to the allowed levels. Biological methods involving the use of enzymes and microorganisms for OTA degradation has excelled due the specific reaction and mild conditions for detoxification. In this work we established conditions for the extraction of carboxypeptidase A from fermented biomass by Rhizopus oryzae in order to employ it in the OTA degradation, using pancreatin as control. The standardized methodology for enzymatic extraction consisted of ultrasonic agitation for 30 minutes in a fixed power of 150 W and 40 kHz. The enzyme extract of the microorganism showed a degradation capacity of 19.4%, which caused degradation higher (49%) than the one found during pancreatin action. This result confirms the advantage of using microbial enzymes over those from vegetables including micotoxycology biodegradation processes
Application of carboxypeptidase from Rhizopus on ochratoxin A degradation
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Previous issue date: 2013Micotoxinas são metabólitos secundários produzidos por fungos filamentosos
em diferentes etapas da cadeia produtiva de alimentos. Entre micotoxinas, ocratoxina A (OTA) é de grande importância, e apresenta efeitos carcinogênicos, nefrotóxicos e teratogênicos. Estes efeitos vêm motivando o desenvolvimento de métodos capazes de diminuir esta contaminação aos níveis permitidos pela legislação. Os métodos biológicos envolvendo o uso de enzimas e microorganismos para degradação da OTA tem se destacado, em função da especificidade reacional e das condições brandas para a detoxificação. Neste trabalho foram estabelecidas condições de extração de carboxipeptidase A a partir de biomassa fermentada por Rhizopus oryzae para empregá-la na degradação de OTA, tendo pancreatina como controle. A metodologia padronizada para extração enzimática consistiu em agitação ultrassônica durante 30 minutos numa potencia fixa de 150 W e 40kHz. O extrato enzimático do microorganismo apresentou uma capacidade de degradação de 19,4%, que ocasionou uma degradação 49% superior a ação da pancreatina. Este resultado confirma a vantagem da utilização de enzimas microbianas em detrimento as de origem vegetal inclusive para processos de biodegradação micotoxicologica.Mycotoxins are secondary metabolites produced by filamentous fungi in different food chain stages. Among mycotoxins, ochratoxin A (OTA) is of great importance, and presents carcinogenic, teratogenic and nephrotoxic effects. These effects have motivated the development of methods to reduce the contamination levels to the allowed levels. Biological methods involving the use of enzymes and microorganisms for OTA degradation has excelled due the specific reaction and mild conditions for detoxification. In this work we established conditions for the extraction of carboxypeptidase A from fermented biomass by Rhizopus oryzae in order to employ it in the OTA degradation, using pancreatin as control. The standardized methodology for enzymatic extraction consisted of ultrasonic agitation for 30 minutes in a fixed power of 150 W and 40 kHz. The enzyme extract of the microorganism showed a degradation capacity of 19.4%, which caused degradation higher (49%) than the one found during pancreatin action. This result confirms the advantage of using microbial enzymes over those from vegetables including micotoxycology biodegradation processes
Valoração de resíduos agroindustriais pela ação de Rhizopus Oryzae na liberação de ácidos fenólicos
Rhizopus oryzae possui atividade metabólica intensa despolimerizando materiais lignocelulósicos, que resulta no aumento da disponibilidade de componentes característicos do substrato utilizado. Acompanhamos a variação do perfil de ácidos fenólicos presentes em biomassa produzida por Rhizopus oryzae em farelo de soja, trigo e arroz. Nas biomassas de farelo de arroz e soja foram detectados 70,2 e 120,0 μg de ácido clorogênico/g em 24 e 72 h de cultivo, respectivamente. Em todas as biomassas os níveis de ácido gálico aumentaram ao longo do cultivo, 23,8 μg/g, 55,8 μg/g e 63,5 μg/g, respectivamente, para o farelo de soja, trigo e arroz. Ficou demonstrado que o cultivo de fungos em substratos lignocelulósicos promove a alteração de perfis de metabólitos secundários que podem ser interessantes para otimizar o aproveitamento de resíduos da agroindústria na cadeia produtiva de alimentos, tais como o ácido gálico, clorogênico, cafeico, hidroxibenzóico e vanilina