Kidney transplantation in a patient with preformed and exclusively anti-HLA-Cw donor specific antibody

We report a patient who had received a first kidney transplant and had preformed DSA anti-HLA-Cw, developing AMR C4d+ soon after transplant. Classically anti-HLA-Cw are considered less immunogenic and are not considered in many organ allocation systems or immunologic risk stratification algorithms, including in Portugal. However, data from literature confirms that their presence is as deleterious as DSA anti-HLA A/B/DR/DQ. Thus we should take HLA-C typing and respective antibody identification into account in sensitized patients, in order to access risk stratification and establish the need for correct induction or desensitization therapies.info:eu-repo/semantics/publishedVersio

Cervical cerclage for prevention of preterm birth: review of 13 cases

O parto pré-termo é o principal responsável pela morbilidade e mortalidade perinatal em países industrializados. Entre as diferentes causas, destaca-se um conjunto de situações caracterizado pela dilatação indolor do colo uterino com prolapso das membranas no canal cervical (funnelling), que ocorre mais frequentemente durante o segundo trimestre da gestação, dando origem a abortos tardios ou partos pré-termo muito precoces e, consequentemente, situações clínicas com um prognóstico perinatal muito reservado

The genomic environment around the Aromatase gene: evolutionary insights

BACKGROUND: The cytochrome P450 aromatase (CYP19), catalyses the aromatisation of androgens to estrogens, a key mechanism in vertebrate reproductive physiology. A current evolutionary hypothesis suggests that CYP19 gene arose at the origin of vertebrates, given that it has not been found outside this clade. The human CYP19 gene is located in one of the proposed MHC-paralogon regions (HSA15q). At present it is unclear whether this genomic location is ancestral (which would suggest an invertebrate origin for CYP19) or derived (genomic location with no evolutionary meaning). The distinction between these possibilities should help to clarify the timing of the CYP19 emergence and which taxa should be investigated. RESULTS: Here we determine the "genomic environment" around CYP19 in three vertebrate species Homo sapiens, Tetraodon nigroviridis and Xenopus tropicalis. Paralogy studies and phylogenetic analysis of six gene families suggests that the CYP19 gene region was structured through "en bloc" genomic duplication (as part of the MHC-paralogon formation). Four gene families have specifically duplicated in the vertebrate lineage. Moreover, the mapping location of the different paralogues is consistent with a model of "en bloc" duplication. Furthermore, we also determine that this region has retained the same gene content since the divergence of Actinopterygii and Tetrapods. A single inversion in gene order has taken place, probably in the mammalian lineage. Finally, we describe the first invertebrate CYP19 sequence, from Branchiostoma floridae. CONCLUSION: Contrary to previous suggestions, our data indicates an invertebrate origin for the aromatase gene, given the striking conservation pattern in both gene order and gene content, and the presence of aromatase in amphioxus. We propose that CYP19 duplicated in the vertebrate lineage to yield four paralogues, followed by the subsequent loss of all but one gene in vertebrate evolution. Finally, we suggest that agnathans and lophotrocozoan protostomes should be investigated for the presence of aromatase

Acute tubulointersticial nephritis with uveitis: A report of two cases

Tubulointersticial nephritis and uveitis syndrome is an idiopathic and rare cause of acute kidney injury that should not overlooked, because it usually requires specific therapeutic interventions. We report two distinct cases: a young and an elder female. Both cases presented with unspecific constitutional symptoms but had different onset of renal and ocular involvement. Both were treated with topical and systemic corticoids and although there was a good initial response in both cases, an early relapse after steroids taper was observed in the younger patient and a persistent renal dysfunction in the older one. A high clinical suspicion and understanding of this disease is necessary for an adequate management and treatment of these patients. Recent data associates a worse renal prognosis when the disease appears in advanced age. In both of our cases the outcome was good but we had a short follow-up. The histological presentation of this disease in our older patient was similar to that reported in the literature, with a high percentage of fibrosis and chronicity of renal tissue that can contribute to the higher grade of renal dysfunction in this type of patients.info:eu-repo/semantics/publishedVersio

Visceral Obesity and Metabolic Syndrome Are Associated with Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors

The determinants for gastroenteropancreatic neuroendocrine tumors (GEP-NET) recent burden are matters of debate. Obesity and metabolic syndrome (MetS) are well established risks for several cancers even though no link with GEP-NETs was yet established. Our aim in this study was to investigate whether well-differentiated GEP-NETs were associated with obesity and MetS. Patients with well-differentiated GEP-NETs (n = 96) were cross-matched for age, gender, and district of residence with a control group (n = 96) derived from the general population in a case-control study. Patients presented gastro-intestinal (75.0%) or pancreatic (22.9%) tumors, grade G1 (66.7%) or G2 (27.1%) with localized disease (31.3%), regional metastasis (16.7%) or distant metastasis (43.8%) at diagnosis, and 45.8% had clinical hormonal syndromes. MetS was defined according to Joint Interim Statement (JIS) criteria. Well-differentiated GEP-NETs were associated with MetS criteria as well as the individual components' waist circumference, fasting triglycerides, and fasting plasma glucose (p = 0.003, p = 0.002, p = 0.011 and p < 0.001, respectively). The likelihood of the association was higher when the number of individual MetS components was greater than four. MetS and some individual MetS components including visceral obesity, dyslipidemia, and increased fasting glucose are associated with well-differentiated GEP-NET. This data provides a novel insight in unraveling the mechanisms leading to GEP-NET disease.This project was funded by a grant from Research Center of IPO-Porto (CI-IPOP 32-2015)info:eu-repo/semantics/publishedVersio

Transversal effects on the ground-state of hard-core dipolar bosons in one-dimensional optical lattices

Polar lattice gases are usually assumed to have an inter-site interaction that decays with the inter-particle distance $r$ as $1/r^3$. However, a loose-enough transversal confinement may strongly modify the dipolar decay in one-dimensional lattices. We show that this modification alters significantly the ground-state properties of hard-core dipolar bosons. For repulsive inter-site interactions, the corrected decay alters the conditions for devil's staircase insulators, affecting significantly the particle distribution in the presence of an overall harmonic confinement. For attractive interactions, it results in a reduction of the critical dipole interaction for the formation of self-bound clusters, and for a marked enhancement of the region of liquefied lattice droplets.Comment: 6 pages, 5 figure

Life table analysis and consumption capacity for Harmonia axyridis (Coleoptera: Coccinellidae), feeding on Cinara atlantica (Hemiptera: Aphididae).

he objective of this study was to analyze the development, reproductive parameters and consumption capacity of Harmonia axyridis, using Cinara atlantica as food. The average time of egg incubation was 3 d, duration of larval instars was 3.5, 2, 2.2 and 4.1 d, respectively, and duration of the pupal stage was 5.8 d. Longevity was 85.6 d and the life cycle lasted 107.2 d. Egg viability was 92.7% and all stages had 100% survival. Adults consumed, on average, 1.892 aphids. Pre-oviposition, oviposition and post-oviposition periods lasted 6.8, 44.3, and 32.9 d, respectively. Fertility was 633.2 eggs per female. Each instar consumed, on average, 19.4, 24.8, 49.7 and 188.9 aphids, respectively. The life table results, together with biological data, indicated that Harmonia axyridis is an efficient predator of C. atlantica, having high fertility, egg viability, rapid development and high levels of predation

Anatomy, chlorophyll content and photosynthetic potential in grapevine leaves under plastic cover.

o presente trabalho avaliou a anatomia, o teor de clorofila e as respostas fotossintéticas em diferentes níveis de radiação solar em folhas de videiras cultivadas sob cobertura plástica. o experimento foi realizado em vinhedo com a cultivar Moscato Giallo, com e sem cobertura plástica. A avaliação da anatomia foliar foi realizada em 10 plantas, nas áreas coberta e descoberta. No estádio fenológico de mudança de cor das bagas, em cada área, foram coletadas seis folhas expostas à radiação solar e seis sombreadas, as quais foram fixadas e micrografadas (espessuras das epidermes adaxiais e abaxiais e dos parênquimas paliçádicos e lacunosos). O teor de clorofila e o potencial fotossintético foram avaliados na mudança de cor das bagas e após a colheita. A diminuição da radiação solar pela cobertura plástica propicia um incremento da espessura do parênquima paliçádico em folhas expostas e sombreadas. As epidermes adaxiais e abaxiais e o parênquima lacunoso não variam suas espessuras em função da diminuição de radiação solar. O teor de clorofila aumenta nas folhas das plantas cultivadas sob cobertura plástica. o potencial fotossintético das videiras não é afetado pela restrição de radiação solar da cobertura plástica devido à modificação na anatomia das folhas