Diabetes as an outcome predictor after heart transplantation

We aimed to compare post-transplantation morbidity and survival among heart transplant recipients with and without diabetes mellitus. A retrospective review of 141 adult patients submitted to heart transplantation from November 2003 to June 2009 (with a minimum follow-up of one year) was undertaken. The patients were divided into two groups: those with (29%) and those without (71%) pre-transplantation diabetes. Those with diabetes were older (57.6±6.1 vs. 52.3±11.1 years; P=0.020) and had lower creatinine clearance (53.6±15.1 vs. 63.7±22.1; P=0.029). Nine patients died in hospital (6.4%; P=non-significant). No significant differences in lipid profiles (diabetes vs. no diabetes) existed before transplantation or at one year afterwards. Patients with diabetes showed a significant deterioration in their one-year lipid profile (158±43 vs.192±38 mg/dL; P=0.001), although one-year fasting diabetic was lower than before (178±80 vs. 138±45 mg/dL; P=0.016). During the first year, 17 (17%) patients previously free of diabetes developed new-onset diabetes. No significant differences were seen in rejection at one year (14% vs. 20%), infection (31% vs. 33%), new-onset renal dysfunction (8% vs. 14%) or mortality (17% vs. 7%). One-year survival was not significantly different (83% vs. 94%), but there was a significant decrease in the survival of individuals with diabetes at three years (73% vs. 91%; P=0.020). No significant difference was found in one-year survival or in terms of higher morbidity in the heart transplant patients with diabetes, but a longer follow-up showed a significant decrease in survival. Nonetheless, the patients with diabetes benefited significantly from transplantation and should not be excluded from it

Treino da resistência psicológica na recruta militar em Portugal: o papel da coesão militar, da autoestima e da ansiedade na resiliência

The present study aims to explore the impact of military training on the psychological resilience of army recruits; the moderator role of other variables relevant for the military training (namely, group cohesion, self-esteem, and anxiety proneness) is also considered. A convenience sample of 104 military recruits was evaluated before and after the first six weeks of the Enlisted Basic General Military training. Although results showed a non significant global effect of the recruit training on resilience, individual changes in resilience levels between the beginning and the final of the training period seem to be moderately associated with participants' self-esteem and group cohesion perception. The results are discussed regarding to their implications in military training context.Este trabalho investiga o impacto do processo de treino militar de resistência psicológica na resiliência dos recrutas, considerando o papel moderador da coesão de grupo militar, da autoestima e da predisposição para a ansiedade. Uma amostra de conveniência de 104 militares foi avaliada antes e depois do Curso de Formação Geral Comum dos Praças do Exército Português, seguindo um desenho metodológico de medidas repetidas. Os resultados revelam que, embora não se possa atribuir ao processo de recruta alterações significativas nos níveis globais de resiliência, as variações individuais observadas na resiliência entre o início e o final da recruta se associam moderadamente à autoestima e à perceção da coesão do grupo. Estes resultados são discutidos quanto às implicações no contexto do treino militar. Palavras-chave: resiliência, coesão de grupo militar, autoestima, ansiedade, treino militar.Fundação para a Ciência e a Tecnologia [FCT UID/PSI/00050/2013]; EU FEDER e COMPETE [POCI-01-0145-FEDER-007294]

Interference of the T cell and antigen-presenting cell costimulatory pathway using CTLA4-Ig (abatacept) prevents Staphylococcal enterotoxin B pathology

Abstract Staphylococcal enterotoxin B (SEB) is a bacterial superantigen that binds the receptors in the APC/T cell synapse and causes increased proliferation of T cells and a cytokine storm syndrome in vivo. Exposure to the toxin can be lethal and cause significant pathology in humans. The lack of effective therapies for SEB exposure remains an area of concern, particularly in scenarios of acute mass casualties. We hypothesized that blockade of the T cell costimulatory signal by the CTLA4-Ig synthetic protein (abatacept) could prevent SEB-dependent pathology. In this article, we demonstrate mice treated with a single dose of abatacept 8 h post SEB exposure had reduced pathology compared with control SEB-exposed mice. SEB-exposed mice showed significant reductions in body weight between days 4 and 9, whereas mice exposed to SEB and also treated with abatacept showed no weight loss for the duration of the study, suggesting therapeutic mitigation of SEB-induced morbidity. Histopathology and magnetic resonance imaging demonstrated that SEB mediated lung damage and edema, which were absent after treatment with abatacept. Analysis of plasma and lung tissues from SEB-exposed mice treated with abatacept demonstrated significantly lower levels of IL-6 and IFN-γ (p &amp;lt; 0.0001), which is likely to have resulted in less pathology. In addition, exposure of human and mouse PBMCs to SEB in vitro showed a significant reduction in levels of IL-2 (p &amp;lt; 0.0001) after treatment with abatacept, indicating that T cell proliferation is the main target for intervention. Our findings demonstrate that abatacept is a robust and potentially credible drug to prevent toxic effects from SEB exposure.</jats:p

Transport through an impurity tunnel coupled to a Si/SiGe quantum dot

Achieving controllable coupling of dopants in silicon is crucial for operating donor-based qubit devices, but it is difficult because of the small size of donor-bound electron wavefunctions. Here we report the characterization of a quantum dot coupled to a localized electronic state, and we present evidence of controllable coupling between the quantum dot and the localized state. A set of measurements of transport through this device enable the determination of the most likely location of the localized state, consistent with an electronically active impurity in the quantum well near the edge of the quantum dot. The experiments we report are consistent with a gate-voltage controllable tunnel coupling, which is an important building block for hybrid donor and gate-defined quantum dot devices.Comment: 5 pages, 3 figure

Modulation of bax mitochondrial insertion and induced cell death in yeast by mammalian protein kinase calpha

Protein kinase Cα (PKCα) is a classical PKC isoform whose involvement in cell death is not completely understood. Bax, a major member of the Bcl-2 family, is required for apoptotic cell death and regulation of Bax translocation and insertion into the outer mitochondrial membrane is crucial for regulation of the apoptotic process. Here we show that PKCα increases the translocation and insertion of Bax c-myc (an active form of Bax) into the outer membrane of yeast mitochondria. This is associated with an increase in cytochrome c (cyt c) release, reactive oxygen species production (ROS), mitochondrial network fragmentation and cell death. This cell death process is regulated, since it correlates with an increase in autophagy but not with plasma membrane permeabilization. The observed increase in Bax c-myc translocation and insertion by PKCα is not due to Bax c-myc phosphorylation, and the higher cell death observed is independent of the PKCα kinase activity. PKCα may therefore have functions other than its kinase activity that aid in Bax c-myc translocation and insertion into mitochondria. Together, these results give a mechanistic insight on apoptosis regulation by PKCα through regulation of Bax insertion into mitochondria.RDS is supported by the FCT grant SFRH/BD/23774/200

First report of acute autochthonous hepatitis E in Portugal

Hepatitis E infection is usually a self-limiting disease. In industrialized countries, sporadic cases of acute hepatitis E virus (HEV) infections have been described; their number seems to be increasing in European countries. We report the first human case of autochthonous acute hepatitis E confirmed in Portugal. Patients with acute non-A-C hepatitis should be tested for HEV in Portugal and hepatitis E infection should be considered in the differential diagnosis of unexplained hepatitis cases

Plasmodium falciparum malaria, bilateral sixth cranial nerve palsy and delayed cerebellar ataxia

We describe the case of a 14-year-old Caucasian male, a resident in the Democratic Republic of the Congo, who was observed in Portugal with severe Plasmodium falciparum malaria with high-level parasitemia and severe thrombocytopenia. The course was complicated by bilateral sixth cranial nerve palsy during acute malaria, followed by the appearance of delayed cerebellar ataxia during the recovery phase. This occurred after successful treatment with quinine plus doxycycline over seven days. Different levels of thrombocytopenia and C-reactive protein were observed during both neurologic events in the presence of HRP-2 positive tests for Plasmodium falciparum antigen. The patient recovered completely after three months