Brown tumor mimicking metastases-the late manifestation of hyperparathyroidism

Brown tumors are uncommon manifestations of hyperparathyroidism (HPT) that without awareness are easily misdiagnosed as metastases. This short report highlights the importance of clinical context and clear communication between medical specialties when interpreting complex radiologic findings

Murine nephrotoxic nephritis as a model of chronic kidney disease

Using the nonaccelerated murine nephrotoxic nephritis (NTN) as a model of chronic kidney disease (CKD) could provide an easily inducible model that enables a rapid test of treatments. Originally, the NTN model was developed as an acute model of glomerulonephritis, but in this study we evaluate the model as a CKD model and compare CD1 and C57BL/6 female and male mice. CD1 mice have previously showed an increased susceptibility to CKD in other CKD models. NTN was induced by injecting nephrotoxic serum (NTS) and evaluated by CKD parameters including albuminuria, glomerular filtration rate (GFR), mesangial expansion, and renal fibrosis. Both strains showed significant albuminuria on days 2-3 which remained significant until the last time point on days 36-37 supporting dysfunctional filtration also observed by a significantly declined GFR on days 5-6, 15–17, and 34–37. Both strains showed early progressive mesangial expansion and significant renal fibrosis within three weeks suggesting CKD development. CD1 and C57BL/6 females showed a similar disease progression, but female mice seemed more susceptible to NTS compared to male mice. The presence of albuminuria, GFR decline, mesangial expansion, and fibrosis showed that the NTN model is a relevant CKD model both in C57BL/6 and in CD1 mice

A comprehensive epigenomic analysis of phenotypically distinguishable, genetically identical female and male Daphnia pulex

Background Daphnia species reproduce by cyclic parthenogenesis involving both sexual and asexual reproduction. The sex of the offspring is environmentally determined and mediated via endocrine signalling by the mother. Interestingly, male and female Daphnia can be genetically identical, yet display large differences in behaviour, morphology, lifespan and metabolic activity. Our goal was to integrate multiple omics datasets, including gene expression, splicing, histone modification and DNA methylation data generated from genetically identical female and male Daphnia pulex under controlled laboratory settings with the aim of achieving a better understanding of the underlying epigenetic factors that may contribute to the phenotypic differences observed between the two genders. Results In this study we demonstrate that gene expression level is positively correlated with increased DNA methylation, and histone H3 trimethylation at lysine 4 (H3K4me3) at predicted promoter regions. Conversely, elevated histone H3 trimethylation at lysine 27 (H3K27me3), distributed across the entire transcript length, is negatively correlated with gene expression level. Interestingly, male Daphnia are dominated with epigenetic modifications that globally promote elevated gene expression, while female Daphnia are dominated with epigenetic modifications that reduce gene expression globally. For examples, CpG methylation (positively correlated with gene expression level) is significantly higher in almost all differentially methylated sites in male compared to female Daphnia. Furthermore, H3K4me3 modifications are higher in male compared to female Daphnia in more than 3/4 of the differentially regulated promoters. On the other hand, H3K27me3 is higher in female compared to male Daphnia in more than 5/6 of differentially modified sites. However, both sexes demonstrate roughly equal number of genes that are up-regulated in one gender compared to the other sex. Since, gene expression analyses typically assume that most genes are expressed at equal level among samples and different conditions, and thus cannot detect global changes affecting most genes. Conclusions The epigenetic differences between male and female in Daphnia pulex are vast and dominated by changes that promote elevated gene expression in male Daphnia. Furthermore, the differences observed in both gene expression changes and epigenetic modifications between the genders relate to pathways that are physiologically relevant to the observed phenotypic differences.Peer reviewe

Columnea caudata and columnea megafolia, two new species of gesneriaceae

Two new species of Columnea belonging to section Collandra (Gesneriaceae) from the “cordillera Occidental” in the Colombian Andes are described and illustrated. Columnea caudata is distributed along the Biogeographical Chocó in the Departments of Antioquia, Chocó, Risaralda, and Valle del Cauca, whereas Columnea megafolia is restricted to Antioquia, and probably is an endemic species of the National Natural Park Las Orquídeas

TWO NEW SPECIES AND TWO NEW VARIETIES OF COLUMNEA (GESNERIACEAE)

In this paper two new species of Gesneriaceae (genus Columnea) are described and illustrated. Columnea chocoensis is distributed in the Colombian departments of Chocó and Valle del Cauca, while its variety, C. chocoensis var. altaquerensis is restricted to the Department of Nariño, Colombia. Columnea stilesiana was found in La Serranía de Los Paraguas located in the Cordillera Occidental between the Chocó and Valle del Cauca Departments in Colombia. Further, Columnea archidonae is here considered a variety of C. ericae; Columnea ericae var. archidonae is distributed in Colombia and Ecuador, in forests at elevations higher than those in which the typical variety is found

Cardiovascular safety profile of romosozumab: a pharmacovigilance analysis of the US Food and Drug Administration Adverse Event Reporting System (FAERS)

Background: Cardiovascular safety concerns for major cardiovascular events (MACE) were raised during the clinical trials of romosozumab. We aimed to evaluate the cardiovascular safety profile of romosozumab in a large pharmacovigilance database. Methods: All cases reported between January 2019 and December 2020 where romosozumab was reported were extracted from the Food and Drug Administration Adverse Event Reporting System (FAERS). The outcome of interest was MACE (myocardial infarction (MI), stroke, or cardiovascular death). A disproportionality analysis was conducted by estimating the reporting odds ratios (RORs) and 95% confidence intervals. Disproportionality analyses were stratified by sex and reporting region (US, Japan, other). Results: Of the 1995 eligible cases with romosozumab, the majority (N = 1188; 59.5%) originated from Japan. Overall, 206 suspected MACE reports were identified, of which the majority (n = 164; 13.8%) were from Japan, and 41 (5.2%) were from the United States (US). Among Japanese reports, patients were older and more frequently male than reports from the US. Similarly, cases with a reported MACE were older and had higher reports of cardioprotective drugs than those without cardiovascular events. Elevated reports for MACE (ROR 4.07, 95% CI: 2.39-6.93) was identified overall, which was primarily driven by the significant disproportionality measures in the Japanese reports. Conclusions: The current pharmacovigilance study identified a potential signal for elevated MACE, particularly in Japan. The results support the current safety warnings from the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) to avoid use in high-risk patients.Diabetes mellitus: pathophysiological changes and therap

Por que o paciente submetido a reconstrucao do Ligamento Cruzado Anterior no Brasil permanece internado por um periodo superior a outros paises? Avaliacao Prospectiva de 30 pacientes e apresentacao de possiveis criterios de alta hospitalar

OBJECTIVE:Evaluate a better moment by the medical team and patient to be discharged and relate to possible medical discharge criteria.METHODS:31 anterior cruciate ligament reconstructed patients under similar conditions prospectively evaluated about the possibility of discharge with 24 and 48 hours after surgery and possibles discharges criteria such as pain, range of motion and capacity quadriceps contraction, besides the use of a validated scale to measure the patient's functional independence.RESULTS:50% and 6.4% of patients prefer remain hospitalized after 24 and 48 hours of surgery, respectively. The average of the visual analogue scale of pain was 2.63 and 1.76 points, and the range of motion of 79º and 86,7º after 24 and 48 hours, respectively. 100% of patients were able to quadriceps contraction in every evaluated moments.CONCLUSION:In Brazil, possible discharged criteria as pain, range of motion, quad contraction and motor independence motor function scale show that anterior cruciate reconstruction reconstructed patients could be discharged after 24 hours of surgery. However, 50% of patients still prefer to remain hospitalized for longer periods.OBJETIVO:Avaliar o momento considerado ideal pela equipe médica e pelo paciente para receber alta e relacioná-lo com possíveis critérios de alta médica.MÉTODOS:Foram submetidos à reconstrução do ligamento cruzado anterior sob condições semelhantes 31 pacientes avaliados prospectivamente sobre a possibilidade de alta médica com 24 e 48 horas de cirurgia e possíveis critérios de alta, como dor, arco de movimento e capacidade de contração do quadríceps, além do uso de uma escala validada para medir a independência funcional motora do paciente.RESULTADOS:A permanência hospitalar após 24 horas de cirurgia é preferida por 50% dos pacientes, enquanto que 6,3% preferem permanecer por mais de 48 horas após a cirurgia. A média do valor da escala visual analógica de dor foi de 2,63 e 1,76 pontos; e o arco de movimento de 79º e 86,7º após 24 e 48 horas, respectivamente. Todos os pacientes foram capazes de contrair o quadríceps em todos os momentos avaliados. CONCLUSÃO:No Brasil, critérios possíveis de alta, como avaliação da dor, do arco de movimento, do controle do quadríceps e da independência funcional motora, mostram que seria possível o paciente submetido à reconstrução artroscópica do LCA receber alta com 24 horas. Entretanto, 50% dos pacientes ainda preferem permanecer internados no hospital por período mais prolongado.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of Orthopedics and TraumatologyInstituto CohenSanta Casa de Misericordia de São Paulo School of Medical SciencesUNIFESP, EPM, Department of Orthopedics and TraumatologySciEL