Impact of Chronic Obstructive Pulmonary Disease in surgical outcomes of lung cancer patients undergoing curative intent surgery

Introdução: A doença pulmonar obstrutiva crónica (DPOC) e a neoplasia do pulmão são doenças extremamente prevalentes no mundo. Estas coexistem num elevado número de doentes, o que pode ser explicado pelos seus fatores de risco comuns. O melhor tratamento para o cancro do pulmão é a cirurgia de intenção curativa. No entanto, a DPOC é um desafio adicional no cuidado destes doentes. O objetivo deste artigo de revisão é mostrar quais as complicações a que um doente com DPOC está sujeito após cirurgia de ressecção, bem como avaliar as suas taxas de sobrevida. Por último procurou-se perceber também qual o impacto que a cirurgia pode ter na função pulmonar. Métodos: Os seguintes termos de pesquisa identificaram 282 artigos nas bases de dados Pubmed e Scopus: COPD AND ("Lung Cancer" OR "Lung Neoplasm") AND ("Postoperative Complications" OR "Surgical Outcomes"). Após triagem dos mesmos, 39 artigos foram incluídos na revisão. Resultados/Discussão: As principais complicações que podem surgir num doente com DPOC após cirurgia de ressecção pulmonar são pneumonia, fuga de ar, fibrilação auricular e atelectasia. Consequentemente, estes doentes estão sujeitos a maiores taxas de mortalidade. Ainda assim, certos doentes com alterações enfisematosas mais proeminentes podem experimentar melhorias ao nível da função pulmonar, devido ao efeito de redução de volume pulmonar. Conclusão: Apesar de conferir pior prognóstico, um doente com DPOC pode obter bons resultados cirúrgicos se for feita uma cuidadosa seleção pre-operatória dos doentes candidatos a cirurgia.Introduction: Chronic Obstructive Pulmonary Disease (COPD) and lung cancer are prevalent diseases worldwide that coexist in a significant number of patients, largely due to their common risk factors. The best treatment for lung cancer remains curative intent surgery, however concomitant COPD holds an additional challenge. The aim of this paper is to review the available literature on the outcomes that a COPD patient faces after surgery in terms of complications and survival, as well as the impact on their pulmonary function. Methods: With the following query: COPD AND ("Lung Cancer" OR "Lung Neoplasm") AND ("Postoperative Complications" OR "Surgical Outcomes") we identified 282 articles on Pubmed and Scopus. After screening, 39 articles were included in the review. Results/Discussion: The most common complications that a COPD patient faces after surgery are pneumonia, air leak, atrial fibrillation and atelectasis. Furthermore, survival rates of these patients may be diminished. Nevertheless, certain patients with emphysematous changes may experience an improvement of their pulmonary function after surgery, due to the volume reduction effect. Conclusion: COPD carries worse outcomes to patients requiring lung cancer resection surgery. A careful selection of the eligible patients helps to achieve good results both in terms of complications and survival

Towards a multivariate analysis of genome-scale metabolic models derived from the BiGG models database

First Online: 28 August 2021Genome-Scale metabolic models (GEMs) are a relevant tool in systems biology for in silico strain optimisation and drug discovery. An easier way to reconstruct a model is to use available GEMs as templates to create the initial draft, which can be curated up until a simulation-ready model is obtained. This approach is implemented in merlin's BiGG Integration Tool, which reconstructs models from existing GEMs present in the BiGG Models database. This study aims to assess draft models generated using models from BiGG as templates for three distinct organisms, namely, Streptococcus thermophilus, Xylella fastidiosa and Mycobacterium tuberculosis. Several draft models were reconstructed using the BiGG Integration Tool and different templates (all, selected and random). The variability of the models was assessed using the reactions and metabolic functions associated with the model's genes. This analysis showed that, even though the models shared a significant portion of reactions and metabolic functions, models from different organisms are still differentiated. Moreover, there also seems to be variability among the templates used to generate the draft models to a lower extent. This study concluded that the BiGG Integration Tool provides a fast and reliable alternative for draft reconstruction for bacteria.This study was supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UIDB/04469/2020 unit. A. Oliveira (DFA/BD/10205/2020), E. Cunha (DFA/BD/8076/2020), F. Cruz (SFRH /BD/139198/2018), J. Sequeira (SFRH/BD/147271/2019), and M. Sampaio (SFRH/BD/144643/2019) hold a doctoral fellowship provided by the FCT. Oscar Dias acknowledge FCT for the Assistant Research contract obtained under CEEC Individual 2018.info:eu-repo/semantics/publishedVersio

State of the art of blue light effects on hidradenitis suppurativa: a concise systematic review

Introduction: In the setting of inflammatory diseases, hidradenitis suppurativa (HS), or acne inversa, is an immune-mediated skin disease with a prevalence of 0.1-1% and characterized by nodules and abscesses in the armpits, groin, and inframammary areas, which may evolve for fistulas and scars. Still, an update is needed on the recent understanding of the pathogenesis of HS, including the central role of inflammatory cytokines and other contributing factors such as genetics, hormones, and pathogenic microorganisms. As an innovative approach, antimicrobial blue light in the 400-470 nm spectrum has demonstrated its intrinsic antimicrobial properties resulting from the presence of endogenous photosensitizing chromophores in pathogenic microorganisms. Objective: To carry out a narrative and systematic review of the literature to explore the main clinical and experimental results of the use of photobiomodulation with blue light for the treatment of hidradenitis suppurativa by antibacterial action. Methods: The present study followed a model of narrative and systematic review, according to PRISMA rules, to gather the main information about the efficiency and safety of blue light in the treatment of HS. The research was carried out from January 2018 to May 2019 and developed based on Google Scholar, Scopus, PubMed, Scielo, and Cochrane Library. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: Microorganisms are less able to develop resistance to antimicrobial blue light than to traditional antibiotics, due to the multi-targeting characteristics of antimicrobial blue light. Furthermore, it is well accepted that antimicrobial blue light is much less harmful to host cells than UV irradiation. Clinical studies have presented scientific evidence of treatment for HS with light-based therapy, showing efficacy and safety through articles published in quality journals in scientific evidence. A meta-analysis published in 2019, based on the quality of the evidence, showed that the most recommended treatments for HS include adalimumab and laser (blue light) therapy. For intense pulsed light with blue light, two RCTs reported improvements in HS-LASI scores and the Dermatology Quality of Life Index. Conclusion: The use of blue light for dermal treatments, particularly for HS, is finding an increasing role in dermatology. However, more robust and consistent studies are still needed to better demonstrate the antibacterial effects of blue light on HS

SOCIAL REPRESENTATIONS OF ADOLESCENTS ON THE PROCESS OF HAVING CANCER

Objetivo: describir las representaciones sociales de los adolescentes sobre el proceso depadecer cáncer.Método: estudio descriptivo con enfoque cualitativo basado en la Teoría de las RepresentacionesSociales y realizado con 31 adolescentes en tratamiento oncológico en un hospital públicode Belém do Pará. El estudio se efectuó con entrevistas individuales, sometidas a análisistemático inductivo.Resultados: se identificaron tres categorías temáticas: el cáncer como enfermedad psicosocial;la experiencia de padecer cáncer en la adolescencia y cómo hacer frente a los cambioscorporales devenidos por la enfermedad.Conclusión: el estudio contribuyó a comprender las representaciones sociales sobre el cánceren la adolescencia, ayudando al enfermero a elaborar conocimientos junto con el adolescenteque padece cáncer, para brindar una asistencia de mayor calidad.Purpose: To describe the social representations of adolescents about the cancer diseaseprocess.Method: A descriptive study with a qualitative approach, based on the Theory of SocialRepresentations, conducted with 31 adolescents undergoing cancer treatment in a publichospital in Belém do Pará. The study was performed with individual interviews, submitted toinductive thematic analysis.Results: Three thematic categories were identified: cancer as a psychosocial disease; theexperience of falling ill and suffering cancer; and coping with the body changes resultingfrom the disease.Conclusion: The study contributed to the understanding of the social representations aboutcancer in adolescence, supporting the nurse in the construction of knowledge with theadolescent with cancer, for a better quality care.Objetivo: descrever as representações sociais de adolescentes sobre o processo de adoecimentode câncer.Método: estudo descritivo, com abordagem qualitativa, embasado na Teoria das RepresentaçõesSociais, com 31 adolescentes em tratamento oncológico em um hospital público, em Belém doPará. Realizado com entrevistas individuais, submetidas à análise temática indutiva.Resultados: identificaram-se três categorias temáticas: o câncer como doença psicossocial; avivência do adoecer e adolescer com câncer; e o enfrentamento das alterações corporais advindasdo adoecimento.Conclusão: o estudo contribuiu para a compreensão das representações sociais sobre o câncer naadolescência, subsidiando o enfermeiro na construção de conhecimentos junto ao adolescentecom câncer, para assistência de maior qualidade

Clinical Manifestations and Complications of Children With COVID-19 Compared to Other Respiratory Viral Infections: A Cohort Inpatient Study From Rio de Janeiro, Brazil

IntroductionThe coronavirus disease-2019 (COVID-19) clinical manifestations in children and adolescents are diverse, despite the respiratory condition being the main presentation. Factors such as comorbidities and other respiratory infections may play a role in the initial presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aims to describe the epidemiological aspects, clinical, and laboratory manifestations of pediatric patients admitted to a tertiary pediatric hospital in Rio de Janeiro, diagnosed with COVID-19, and compare these with other viral conditions during the first year of the SARS-CoV-2 pandemic.MethodsAll patients under 18 years of age that were admitted with upper airway infection were enrolled and followed up for 30 days. The main dependent variable was the laboratorial diagnosis of SARS-CoV-2, and independent variables were studied through logistic regression.ResultsA total of 533 patients were recruited, and 105 had confirmed SARS-CoV-2 infection. Detection of other viruses occurred in 34% of 264 tested participants. Six patients died (two in SARS-CoV-2 infected group). The variables independently associated with COVID-19 were older age (OR = 1.1, 95% CI = 1.0–1.1), lower leukocytes count at entry (OR = 0.9, 95% CI = 0.8–0.9), and contact with suspected case (OR = 1.6, 95% CI = 1.0–2.6). Patients with COVID-19 presented higher odds to be admitted in an intensive care unit (OR = 1.99, 95% CI = 1.08–3.66).ConclusionsEven during the SARS-CoV-2 pandemic, several other respiratory viruses were present in admitted pediatric patients. Variables associated with COVID-19 infection were older age, lower leukocytes count at entry, and a domiciliary suspect contact. Although patients with COVID-19 were more frequently admitted to ICU, we did not observe higher mortality in this group

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

Genome of Rhodnius prolixus, an insect vector of Chagas disease, reveals unique adaptations to hematophagy and parasite infection

Rhodnius prolixus not only has served as a model organism for the study of insect physiology, but also is a major vector of Chagas disease, an illness that affects approximately seven million people worldwide. We sequenced the genome of R. prolixus, generated assembled sequences covering 95% of the genome ( approximately 702 Mb), including 15,456 putative protein-coding genes, and completed comprehensive genomic analyses of this obligate blood-feeding insect. Although immune-deficiency (IMD)-mediated immune responses were observed, R. prolixus putatively lacks key components of the IMD pathway, suggesting a reorganization of the canonical immune signaling network. Although both Toll and IMD effectors controlled intestinal microbiota, neither affected Trypanosoma cruzi, the causal agent of Chagas disease, implying the existence of evasion or tolerance mechanisms. R. prolixus has experienced an extensive loss of selenoprotein genes, with its repertoire reduced to only two proteins, one of which is a selenocysteine-based glutathione peroxidase, the first found in insects. The genome contained actively transcribed, horizontally transferred genes from Wolbachia sp., which showed evidence of codon use evolution toward the insect use pattern. Comparative protein analyses revealed many lineage-specific expansions and putative gene absences in R. prolixus, including tandem expansions of genes related to chemoreception, feeding, and digestion that possibly contributed to the evolution of a blood-feeding lifestyle. The genome assembly and these associated analyses provide critical information on the physiology and evolution of this important vector species and should be instrumental for the development of innovative disease control methods

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio