Favorável de infecção por SARS-COV-2 em paciente com insuficiência hipofisária

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outbreak originated in Wuhan (China) rapidly turned into a pandemic. Due to a national compulsive decree of quarantine, office visits for chronic disease control were delay.Hypopituitarism includes all clinical conditions that result in partial or complete failure of the pituitary gland's ability to secrete hormones. Pituitary insufficiency per sehas been associated with an increase in both morbidity and mortality, particularly due tocardiovascular disease, which is an important risk factor for COVID-19 disease severity. Objective: To report the first case of SARS-CoV-2 infection in a patient with hypopituitarism, discuss the implications of the treatments the patient was taking and grade up the value of telemedicine in the present scenario. Methods: Report of the clinical record of a patient with hypopituitarism and infection with SARS-CoV-2. Results: During the span of the infection, the patient remained on the same hormonal therapeutic scheme (thyroid, gonadal and adrenal axis). The dose of hydrocortisone was not changed during the course of the infection as she was asymptomatic. We use telemedicine to control and advise her on the treatment. Conclusion: Health care professionals should carefully follow up on the evolution of patients with hypopituitarism to provide them a safer outcome. The use of telemedicine as a methodology for selected patients acquires relevance in the present epidemiological context.Introducción: El nuevo coronavirus 2 del Síndrome Respiratorio Agudo Grave (SARS-CoV-2), la cepa viral que está causando la enfermedad pandémica conocida como COVID-19, está generando un desafío sin precedentes para los sistemas de salud de todo el mundo. Dicho escenario puede favorecer el deterioro de las patologías crónicas por la dificultad en el acceso al sistema sanitario. El hipopituitarismo es una condición clínica que se asocia a comorbilidades desfavorables en la evolución de la infección por coronavirus. Objetivo: reportar el primer caso de infección por SARS-CoV-2 en una paciente con hipopituitarismo. Métodos: se describe el primer caso de una mujer con insuficiencia hipofisaria e infección por SARS-CoV-2. Se destaca el aporte de la telemedicina como estrategia para seguir al paciente en forma remota. Resultados: la paciente permaneció con el mismo esquema de terapia de reemplazo hormonal (eje tiroideo, gonadal y adrenal). Se implementó la telemedicina para asesorar sobre la adaptación del tratamiento. Debido a que cursó el proceso infeccioso en forma asintomática no se modificó la dosis de hidrocortisona, evidenciando una evolución favorable. Conclusiones: los profesionales de la salud deben permanecer atentos y vigilar la evolución de los pacientes con insuficiencia hipofisaria e infección por SARS-CoV-2. El uso de la telemedicina, en pacientes seleccionados, se jerarquiza en el contexto epidemiológico actual.Introdução: O novo coronavírus 2 da Síndrome Respiratória Aguda Grave (SARS-CoV-2), a cepa viral que está causando a doença pandêmica conhecida como COVID-19, está criando um desafio sem precedentes para os sistemas de saúde em todo o mundo. Esse cenário pode favorecer o agravamento das patologias crônicas devido à dificuldade de acesso ao sistema de saúde. O hipopituitarismo é uma condição clínica associada a comorbidades desfavoráveis na evolução da infecção por coronavírus. Objetivo:relatar o primeiro caso de infecção por SARS-CoV-2 em paciente com hipopituitarismo. Métodos: é descrito o primeiro caso de uma mulher com insuficiência hipofisária e infecção por SARS-CoV-2. A contribuição da telemedicina é destacada como estratégia para acompanhar o paciente à distância. Resultados: a paciente permaneceu com o mesmo esquema de terapia de reposição hormonal (eixo tireoidiano, gonadal e adrenal). A telemedicina foi implantada para orientar sobre a adaptação do tratamento. Devido ao processo infeccioso assintomático, a dose de hidrocortisona não foi modificada, apresentando evoluçãofavorável. Conclusões: os profissionais de saúde devem permanecer vigilantes e acompanhar a evolução dos pacientes com insuficiência hipofisária e infecção por SARS-CoV-2. O uso da telemedicina, em pacientes selecionados, é hierárquico no contexto epidemiológico atual.publishedVersionFil: Fux Otta, Carolina. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Moreno, Laura. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina.Fil: Vitaloni, Roberto. Dirección de Epidemiología del Departamento Castellanos de la Provincia de Santa Fe; Argentina.Fil: Iraci, Gabriel S. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas; Argentina

Abundância e riqueza de mariposas Arctiinae ao longo da noite em uma área de Cerrado

The main goal of this work was to investigate how the abundance and richness of Arctiinae moths varies over time, during the night. Specifically, we analyzed the following questions: (1) Is there a relationship between Arctiinae abundance and richness with the temperature and relative humidity? (2) What are the hours of activity of each species of moth? (3) Does the species composition differ over night? (4) Is it necessary to sample this group of moths throughout the night to have a representative sample of the species? We sampled the moths in Emas National Park (17°49’-18°28’S and 52°39’-53°10’W), Brazil. We selected seven sampling points in an area of savanna. At each sampling point, we collected the Arctiinae moths with a light trap (with a 15-W black light fluorescent light bulb), reflected in a white cloth (2 x 3 m) extended vertically. We sampled the moths in seven consecutive nights (one night in each sampling point, from December 13 to December 19, 2012, from 7 p.m. until 7 a.m.). We divided the samplings in twelve periods over the night, with an hour each. At each period of time, we measured the temperature and the relative humidity with a digital termohygrometer. We sampled 149 individuals belonging to 17 species of Arctiinae moths. Most species (70.5%) were active only for one or two hours at night. The species differed in terms of time activity. The higher abundance occurred at 8 p. m. (44 individuals), followed by 38 individuals at 9 p. m. and 23 at 10 p. m. The species richness was also higher in the early hours of the night. The temperature was the only variable that showed a positive and significative relationship with the Arctiinae moth abundance. The species richness was not influenced neither by the temperature nor by the relative air humidity. The possible causes of the peak of abundance and species richness in specific hours of the night are discussed.Este trabalho teve como objetivo principal investigar como a abundância e a riqueza de mariposas Arctiinae variam temporalmente, ao longo do período noturno. Especificamente, analisamos as seguintes questões: (1) existe relação entre a abundância e a riqueza de Arctiinae e a umidade relativa do ar e a temperatura? (2) qual é o horário de atividade de cada espécie de mariposa? (3) a composição de espécies difere ao longo da noite? (4) é necessário amostrar esse grupo de mariposas ao longo de toda a noite para ter uma amostra representativa das espécies? Realizamos as amostragens no Parque Nacional das Emas (17°49’-18°28’S e 52°39’-53°10’W), Brasil. Selecionamos sete pontos amostrais em uma área de campo cerrado. Em cada ponto, coletamos as mariposas Arctiinae utilizando uma fonte luminosa (lâmpada UV de 15 W) refletida em um pano branco (2 x 3 m) estendido na vertical. Coletamos as mariposas durante sete noites consecutivas (uma noite por ponto, entre os dias 13 e 19 de dezembro de 2012, das 19:00 até as 07:00). Dividimos o período noturno em doze faixas de uma hora. Medimos a temperatura e a umidade relativa do ar com auxílio de um termohigrômetro digital. Amostramos 149 indivíduos pertencentes a 17 espécies de mariposas Arctiinae. A maioria das espécies (70,5%) esteve ativa apenas por uma ou duas horas durante a noite. As espécies diferiram em termos de horário de atividade. O horário das 20 h apresentou uma maior abundância (44 indivíduos), seguido do horário das 21 (38) e das 22 h (23). A riqueza também foi maior nas primeiras horas da noite. Somente a temperatura foi positivamente correlacionada com a abundância de mariposas. A riqueza de mariposas não foi influenciada nem pela temperatura nem pela umidade relativa do ar. As possíveis causas das diferenças em termos de horários de atividade são discutida

Efeito do estresse luminoso sobre Crotalaria spectabilis (Fabaceae) e seu inseto herbívoro, a mariposa Utetheisa ornatrix (Erebidae:Arctiinae)

The Plant Stress Hypothesis predicts that stressed plants are more attacked by herbivorous insects. In this work, we investigated the influence of light stress on Crotalaria spectabilis Roth (Fabaceae) and on its main herbivore, the moth Utetheisa ornatrix (L., 1758) (Erebidae: Arctiinae). Specifically, we verified whether plants stressed by shading differ from non-stressed plants in terms of productivity, morphological characteristics and water percentage. We also evaluated the performance of moths in stressed and non-stressed plants. Seeds were sown in pots. When the plants reached 50 cm in height, they were randomly divided into two groups: stressed plants (treatment group) and non-stressed plants (control group). The stressed plants were covered by a black mesh, providing 50% of shading. Eight characteristics of stressed and non-stressed C. spectabilis plants were evaluated: height, fresh and dry aerial biomass, number of pods and seeds, leaf hardness, number of trichomes, leaf area, specific leaf mass and percentage of leaf water. Moths were raised individually on leaves of stressed and non-stressed plants and we obtained the larval survival, larval development time, pupal weight and female fecundity. The non-stressed plants had significantly higher percentage of water in the leaves, greater fresh aerial biomass and a higher number of trichomes than the stressed plants. The survival rate was 98% for larvae raised on leaves from stressed plants and 92% on leaves from nonstressed plants. The larval developmental time was significantly shorter and the weight of female pupae significantly higher in non-stressed plants than in stressed plants. Thus, the Plant Stress Hypothesis was only corroborated by two tested variables: number of trichomes (lower in stressed plants) and larval survival (higher in stressed plants). Trichomes are among the main types of plant defenses against herbivory and reducing their number on leaves would make stressed plants more susceptible to attack by moth larvae, a fact corroborated by a greater larval survival. One of the possible explanations for the lack of corroboration of the Plant Stress Hypothesis for most of the variables tested is that other characteristics can be changed under stress conditions, such as the concentration of secondary compounds.A hipótese do estresse da planta prevê que as plantas estressadas são mais atacadas por insetos herbívoros. Neste trabalho, investigamos a influência do estresse luminoso em Crotalaria spectabilis Roth (Fabaceae) e em seu principal herbívoro, a mariposa Utetheisa ornatrix (L., 1758) (Erebidae: Arctiinae). Especificamente, verificamos se as plantas estressadas por sombreamento diferem das plantas não estressadas em termos de produtividade, características morfológicas e porcentagem de água. Também avaliamos o desempenho das mariposas em plantas estressadas e não estressadas. As sementes foram semeadas em vasos. Quando as plantas atingiram 50 cm de altura, foram divididas aleatoriamente em dois grupos: plantas estressadas (grupo de tratamento) e plantas sem estresse (grupo controle). As plantas estressadas foram cobertas por uma malha preta, proporcionando 50% de sombreamento. Foram avaliadas oito características de plantas estressadas e não estressadas de C. spectabilis: altura, biomassa aérea fresca e seca, número de vagens e sementes, dureza foliar, número de tricomas, área foliar, massa foliar específica e porcentagem de água foliar. As mariposas foram criadas individualmente em folhas de plantas estressadas e não estressadas. Obtivemos a sobrevivência larval, o tempo de desenvolvimento larval, o peso pupal e a fecundidade das fêmeas As plantas não estressadas apresentaram porcentagem significativamente maior de água nas folhas, maior biomassa aérea fresca e um maior número de tricomas do que as plantas estressadas. A taxa de sobrevivência foi de 98% para larvas criadas em folhas de plantas sob estresse e 92% em folhas de plantas sem estresse. O tempo de desenvolvimento larval foi significativamente menor e o peso das pupas femininas significativamente maior em plantas sem estresse do que em plantas estressadas. Assim, a hipótese de estresse em plantas foi corroborada apenas por duas variáveis testadas: número de tricomas (menor nas plantas estressadas) e sobrevivência larval (maior nas plantas estressadas). Os tricomas estão entre os principais tipos de defesa das plantas contra a herbivoria e a redução do seu número nas folhas tornaria as plantas estressadas mais suscetíveis ao ataque de larvas de mariposas, fato corroborado por uma maior sobrevivência larval. Uma das possíveis explicações para a falta de corroboração da hipótese de estresse de planta para a maioria das variáveis testadas é que outras características podem ser alteradas sob condições de estresse, como a concentração de compostos secundários

Bulk and single-molecule analysis of a bacterial DNA2-like helicase-nuclease reveals a single-stranded DNA looping motor

DNA2 is an essential enzyme involved in DNA replication and repair in eukaryotes. In a search for homologues of this protein, we identified and characterised Geobacillus stearothermophilus Bad, a bacterial DNA helicase-nuclease with similarity to human DNA2. We show that Bad contains an Fe-S cluster and identify four cysteine residues that are likely to co-ordinate the cluster by analogy to DNA2. The purified enzyme specifically recognises ss-dsDNA junctions and possesses ssDNA-dependent ATPase, ssDNA binding, ssDNA endonuclease, 5' to 3' ssDNA translocase and 5' to 3' helicase activity. Single molecule analysis reveals that Bad is a processive DNA motor capable of moving along DNA for distances of >4 kb at a rate of ∼200 bp per second at room temperature. Interestingly, as reported for the homologous human and yeast DNA2 proteins, the DNA unwinding activity of Bad is cryptic and can be unmasked by inactivating the intrinsic nuclease activity. Strikingly, our experiments show that the enzyme loops DNA while translocating, which is an emerging feature of processive DNA unwinding enzymes. The bacterial Bad enzymes will provide an excellent model system for understanding the biochemical properties of DNA2-like helicase-nucleases and DNA looping motor proteins in general.Wellcome Trust [100401/Z/12/Z to M.D.]; EuropeanResearch Council [681299 to F.M.-H.]; Spanish Min-istry of Economy and Competitiveness [BFU2017-83794-PAEI/FEDER, UE to F.M.-H.]; Comunidad de MadridTec4Bio [S2018/NMT-4443 to F.M.-H.]; NanoBioCancer[Y2018/BIO-4747 to F.M.-H.]. Funding for open accesscharge: Wellcome Trust [100401/Z/12/Z].Peer reviewe

Chi hotspots trigger a conformational change in the helicase-like domain of AddAB to activate homologous recombination

In bacteria, the repair of double-stranded DNA breaks is modulated by Chi sequences. These are recognised by helicase-nuclease complexes that process DNA ends for homologous recombination. Chi activates recombination by changing the biochemical properties of the helicase-nuclease, transforming it from a destructive exonuclease into a recombination-promoting repair enzyme. This transition is thought to be controlled by the Chi-dependent opening of a molecular latch, which enables part of the DNA substrate to evade degradation beyond Chi. Here, we show that disruption of the latch improves Chi recognition efficiency and stabilizes the interaction of AddAB with Chi, even in mutants that are impaired for Chi binding. Chi recognition elicits a structural change in AddAB that maps to a region of AddB which resembles a helicase domain, and which harbours both the Chi recognition locus and the latch. Mutation of the latch potentiates the change and moderately reduces the duration of a translocation pause at Chi. However, this mutant displays properties of Chi-modified AddAB even in the complete absence of bona fide hotspot sequences. The results are used to develop a model for AddAB regulation in which allosteric communication between Chi binding and latch opening ensures quality control during recombination hotspot recognition

Pulmonary exacerbations in patients with primary ciliary dyskinesia: an expert consensus definition for use in clinical trials

Pulmonary exacerbations; Primary ciliary dyskinesia; DefinitionEmpitjorament pulmonar; Discinèsia ciliar primària; DefinicióEmpeoramiento pulmonar; Discinesia ciliar primaria; DefiniciónPulmonary exacerbations are a cause of significant morbidity in patients with primary ciliary dyskinesia (PCD) and are frequently used as an outcome measure in clinical research into chronic lung diseases. So far, there has been no consensus on the definition of pulmonary exacerbations in PCD. 30 multidisciplinary experts and patients developed a consensus definition for children and adults with PCD. Following a systematic review, the panel used a modified Delphi process with a combination of face-to-face meetings and e-surveys to develop a definition that can be used in research settings for children and adults with PCD. A pulmonary exacerbation was defined by the presence of three or more of the following seven items: 1) increased cough, 2) change in sputum volume and/or colour, 3) increased shortness of breath perceived by the patient or parent, 4) decision to start or change antibiotic treatment because of perceived pulmonary symptoms, 5) malaise, tiredness, fatigue or lethargy, 6) new or increased haemoptysis, and 7) temperature >38°C. The consensus panel proposed that the definition should be used for future clinical trials. The definition should be validated and the usability assessed during these studies

Acute Liver Failure In A Term Neonate After Repeated Paracetamol Administration.

Severe hepatotoxicity caused by paracetamol is rare in neonates. We report a case of paracetamol-induced acute liver failure in a term neonate. A 26-day-old boy was admitted with intestinal bleeding, shock signs, slight liver enlargement, coagulopathy, metabolic acidosis (pH=7.21; bicarbonate: 7.1 mEq/L), hypoglycemia (18 mg/dL), increased serum aminotransferase activity (AST=4,039 IU/L; ALT=1,087 IU/L) and hyperbilirubinemia (total: 9.57 mg/dL; direct: 6.18 mg/dL) after receiving oral paracetamol (10 mg/kg/dose every 4 hours) for three consecutive days (total dose around 180 mg/kg; serum concentration 36-48 hours after the last dose of 77 µg/ mL). Apart from supportive measures, the patient was successfully treated with intravenous N-acetylcysteine infusion during 11 consecutive days, and was discharged on day 34. The follow-up revealed full recovery of clinical and of laboratory findings of hepatic function. The paracetamol pharmacokinetics and pharmacodynamics in neonates and infants differ substantially from those in older children and adults. Despite the reduced rates of metabolism by the P-450 CYP2E1 enzyme system and the increased ability to synthesize glutathione--which provides greater resistance after overdoses--, it is possible to produce hepatotoxic metabolites (N-acetyl-p-benzoquinone) that cause hepatocellular damage, if glutathione sources are depleted. Paracetamol clearance is reduced and the half-life of elimination is prolonged. Therefore, a particular dosing regimen should be followed due to the toxicity risk of cumulative doses. This report highlights the risk for severe hepatotoxicity in neonates after paracetamol multiple doses for more than two to three days.32144-

Dietary patterns and diet quality during pregnancy and low birthweight: The PRINCESA cohort

Although the isolated effects of several specific nutrients have been examined, little is known about the relationship between overall maternal diet during pregnancy and fetal development and growth. This study evaluates the association between maternal diet and low birthweight (LBW) in 660 pregnant women from the Pregnancy Research on Inflammation, Nutrition,& City Environment: Systematic Analyses (PRINCESA) cohort in Mexico City. Using prior day dietary intake reported at multiple prenatal visits, diet was assessed prospectively using a priori (Maternal Diet Quality Score [MDQS]) and a posteriori (dietary patterns extracted by factor analysis) approaches. The association between maternal diet and LBW was investigated by logistic regression, controlling for confounders. Adherence to recommended guidelines (higher MDQS) was associated with a reduced risk of LBW (OR, 0.22; 95% confidence interval [0.06, 0.75], P < .05, N = 49) compared with the lowest adherence category (reference group), controlling for maternal age, education, height, marital status, pre- pregnancy body mass index, parity, energy intake, gestational weight gain, and preterm versus term birth; a posteriori dietary patterns were not associated with LBW risk. Higher adherence to MDQS was associated with a lower risk of having an LBW baby in this sample. Our results support the role of advocating a healthy overall diet, versus individual foods or nutrients, in preventing LBW.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155934/1/mcn12972_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155934/2/mcn12972.pd