AMPK in Pathogens

During host–pathogen interactions, a complex web of events is crucial for the outcome of infection. Pathogen recognition triggers powerful cellular signaling events that is translated into the induction and maintenance of innate and adaptive host immunity against infection. In opposition, pathogens employ active mechanisms to manipulate host cell regulatory pathways toward their proliferation and survival. Among these, subversion of host cell energy metabolism by pathogens is currently recognized to play an important role in microbial growth and persistence. Extensive studies have documented the role of AMP-activated protein kinase (AMPK) signaling, a central cellular hub involved in the regulation of energy homeostasis, in host–pathogen interactions. Here, we highlight the most recent advances detailing how pathogens hijack cellular metabolism by suppressing or increasing the activity of the host energy sensor AMPK. We also address the role of lower eukaryote AMPK orthologues in the adaptive process to the host microenvironment and their contribution for pathogen survival, differentiation, and growth. Finally, we review the effects of pharmacological or genetic AMPK modulation on pathogen growth and persistence.CIHR -Canadian Institutes of Health Researc

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p<00001), age 70 years or older versus younger than 70 years (230 [165-322], p<00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p<00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Épocas de colheita de umbelas e comprimento da haste floral no rendimento e no potencial fisiológico de sementes de cebola Harvesting period of umbels and seed stalk length on seed yield and on physiological potential of onion seed

O estado do Paraná contribui significativamente para o abastecimento de cebola no Brasil. Apesar disso, ainda não ocorre produção de sementes, o que demanda necessidade de pesquisa nessa área. Avaliou-se épocas de colheita e presença ou não de haste floral nas umbelas sobre o rendimento e potencial fisiológico de sementes de cebola. Os tratamentos resultaram da combinação de três épocas de colheita (com cápsulas ainda verdes, no início de abertura das cápsulas e com 10% de sementes expostas), combinadas com umbelas de haste floral com comprimento de 15 cm ou sem haste floral, arranjados em esquema fatorial 3x2. O delineamento experimental foi de blocos casualizados, com quatro repetições. Os bulbos da cultivar Crioula foram provenientes da EPAGRI (SC) e plantados em julho/2002, em Imbituva (PR), sob cultivo protegido de plástico de polietileno, usando estrutura modelo Londrina. Na fase de florescimento, quatro umbelas por parcela foram etiquetadas para as avaliações. Em cada uma das umbelas colhidas, foram separados e contados o número total de flores fecundadas (cápsulas) e de flores não fecundadas. As sementes foram retiradas das cápsulas e posteriormente contadas, obtendo-se o número total de sementes e de sementes por cápsula. Foram avaliadas a massa total de sementes por umbela, massa de 100 sementes e conduzidos os testes de germinação e vigor. A colheita das umbelas com haste de 15 cm não influiu no rendimento nem no potencial fisiológico das sementes. A época de colheita das umbelas influiu na quantidade e na qualidade das sementes. A colheita realizada no início de abertura das cápsulas ou com 10% de sementes expostas resultou em maior número de sementes por umbela, mais semente por cápsula, maior rendimento por umbela e maior massa de sementes. O rendimento médio foi de 2,9 g/umbela. Além disso, resultou em maior vigor e germinação (90,25% e 85,25%, respectivamente). Na prática, é desejável proceder-se à colheita das umbelas no início da abertura das cápsulas, para evitar perdas por degrana ou doenças.<br>The Paraná State (Brazil) contributes significantly to the Brazilian onion production. However, this State imports all needed onion seeds. The effect of umbel's harvest period, and harvesting with or without the seed stalk were evaluated. Treatments resulted from the combination of three harvesting periods (with green capsules, at the beginning of capsule opening and with 10% opened capsules), combined with umbels on 15 cm long stalks or without stalks, arranged in a factorial scheme 3x2. The experimental design was a randomized blocks, with four replications. The bulbs of Crioula cultivar proceeded from EPAGRI, Santa Catarina State, and were planted on July/2002, in Imbituva, Paraná State, under protected cultivation. At flowering, four umbels per plot were marked to future use in the evaluations. The number of total of fertile flowers (capsules) and unfertile flowers were counted on each harvested umbel. Seeds were detached from capsules and the number of seeds per capsule obtained, besides the yield per umbel, weight of 100 seeds, germination and vigor of the seeds. Harvesting umbels with the seed stalk had no effect on the seed yield and on seed physiological potential. The harvesting period presented significant effect on the amount and quality of the harvested seeds. The best harvesting period was at the beginning of capsule opening or when 10% of capsules were opened, resulting in higher number of seeds/umbel, higher seed yield/umbel and higher seed weight per capsule. The average yield was 2.9 g/umbel besides higher vigor (90.25%) and germinability (85.25%). Harvesting at the beginning of capsule opening helps to avoid the lost of seeds by thresh or diseases