Infliximab en pacientes con artritis reumatoide que fracasaron a drogas modificadoras de enfermedad en el periodo 2008 – 2012 en el servicio de reumatología del Hospital Nacional Edgardo Rebagliati Martins

Publicación a texto completo no autorizada por el autorEl documento digital no refiere asesorEvalua la respuesta clínica al tratamiento con infliximab en pacientes con Artritis Reumatoide en el servicio de Reumatología del HNERM. Estudio de diseño descriptivo, realizado en el Servicio de Reumatología del Hospital Rebagliati, de los 35 pacientes registrados, se evaluó a 28. El promedio de edad fue de 52 años con una media del tiempo de duración de enfermedad de 14.46 años. El uso previo de metotrexate alcanzó el 100% y de leflunomida un 53.8%, ya sea como monoterapia o en terapia combinada. Se confirmó la disminución de los parámetros clínicos de actividad según el DAS28VSG desde 5.88 +-1.13 a 4.63+- 1.57 con un p= 0.0001 y CDAI de 29.4 +-12.04 a 18.61+-12.61 con un p=0.0001. La respuesta según los criterios EULAR fue buena en 21.4%, moderada en 35.7% e insatisfactoria en 42.8%. En el 25% de pacientes se suspendió el uso de infliximab por reacciones de hipersensibilidad. La respuesta clínica favorable medidos por DAS28VSG y respuesta EULAR fue menor a la esperada en los pacientes con artritis reumatoide. Se encontró alto porcentaje de pacientes que suspendieron el tratamiento por reacciones de hipersensibilidad.Trabajo de investigació

Phytoplankton dynamics in relation to seasonal variability and upwelling and relaxation patterns at the mouth of Ria de Aveiro (West Iberian Margin) over a four-year period

From June 2004 to December 2007, samples were weekly collected at a fixed station located at the mouth of Ria de Aveiro (West Iberian Margin). We examined the seasonal and inter-annual fluctuations in composition and community structure of the phytoplankton in relation to the main environmental drivers and assessed the influence of the oceano-graphic regime, namely changes in frequency and intensity of upwelling events, over the dynamics of the phytoplankton assemblage. The samples were consistently handled and a final subset of 136 OTUs (taxa with relative abundance > 0.01%) was subsequently submitted to various multivariate analyses. The phytoplankton assemblage showed significant changes at all temporal scales but with an overriding importance of seasonality over longer-(inter-annual) or shorter-term fluctuations (upwelling-related). Sea-surface temperature, salinity and maximum upwelling index were retrieved as the main driver of seasonal change. Seasonal signal was most evident in the fluctuations of chlorophyll a concentration and in the high turnover from the winter to spring phytoplankton assemblage. The seasonal cycle of production and succession was disturbed by upwelling events known to disrupt thermal stratification and induce changes in the phytoplankton assemblage. Our results indicate that both the frequency and intensity of physical forcing were important drivers of such variability, but the outcome in terms of species composition was highly dependent on the available local pool of species and the timing of those events in relation to the seasonal cycle. We conclude that duration, frequency and intensity of upwelling events, which vary seasonally and inter-annually, are paramount for maintaining long-term phytoplankton diversity likely by allowing unstable coexistence and incorporating species turnover at different scales. Our results contribute to the understanding of the complex mechanisms of coastal phytoplankton dynamics in relation to changing physical forcing which is fundamental to improve predictability of future prospects under climate change.Portuguese Foundation for Science and Technology (FCT, Portugal) [SFRH/BPD/ 94562/2013]; FEDER funds; national funds; CESAM [UID/AMB/50017]; FCT/MEC through national funds; FEDERinfo:eu-repo/semantics/publishedVersio

Type 1 IP3 receptors activate BKCa channels via local molecular coupling in arterial smooth muscle cells

Plasma membrane large-conductance Ca2+-activated K+ (BKCa) channels and sarcoplasmic reticulum inositol 1,4,5-trisphosphate (IP3) receptors (IP3Rs) are expressed in a wide variety of cell types, including arterial smooth muscle cells. Here, we studied BKCa channel regulation by IP3 and IP3Rs in rat and mouse cerebral artery smooth muscle cells. IP3 activated BKCa channels both in intact cells and in excised inside-out membrane patches. IP3 caused concentration-dependent BKCa channel activation with an apparent dissociation constant (Kd) of ∼4 µM at physiological voltage (−40 mV) and intracellular Ca2+ concentration ([Ca2+]i; 10 µM). IP3 also caused a leftward-shift in BKCa channel apparent Ca2+ sensitivity and reduced the Kd for free [Ca2+]i from ∼20 to 12 µM, but did not alter the slope or maximal Po. BAPTA, a fast Ca2+ buffer, or an elevation in extracellular Ca2+ concentration did not alter IP3-induced BKCa channel activation. Heparin, an IP3R inhibitor, and a monoclonal type 1 IP3R (IP3R1) antibody blocked IP3-induced BKCa channel activation. Adenophostin A, an IP3R agonist, also activated BKCa channels. IP3 activated BKCa channels in inside-out patches from wild-type (IP3R1+/+) mouse arterial smooth muscle cells, but had no effect on BKCa channels of IP3R1-deficient (IP3R1−/−) mice. Immunofluorescence resonance energy transfer microscopy indicated that IP3R1 is located in close spatial proximity to BKCa α subunits. The IP3R1 monoclonal antibody coimmunoprecipitated IP3R1 and BKCa channel α and β1 subunits from cerebral arteries. In summary, data indicate that IP3R1 activation elevates BKCa channel apparent Ca2+ sensitivity through local molecular coupling in arterial smooth muscle cells

Association of Variants in the SPTLC1 Gene With Juvenile Amyotrophic Lateral Sclerosis

Importance: Juvenile amyotrophic lateral sclerosis (ALS) is a rare form of ALS characterized by age of symptom onset less than 25 years and a variable presentation.Objective: To identify the genetic variants associated with juvenile ALS.Design, Setting, and Participants: In this multicenter family-based genetic study, trio whole-exome sequencing was performed to identify the disease-associated gene in a case series of unrelated patients diagnosed with juvenile ALS and severe growth retardation. The patients and their family members were enrolled at academic hospitals and a government research facility between March 1, 2016, and March 13, 2020, and were observed until October 1, 2020. Whole-exome sequencing was also performed in a series of patients with juvenile ALS. A total of 66 patients with juvenile ALS and 6258 adult patients with ALS participated in the study. Patients were selected for the study based on their diagnosis, and all eligible participants were enrolled in the study. None of the participants had a family history of neurological disorders, suggesting de novo variants as the underlying genetic mechanism.Main Outcomes and Measures: De novo variants present only in the index case and not in unaffected family members.Results: Trio whole-exome sequencing was performed in 3 patients diagnosed with juvenile ALS and their parents. An additional 63 patients with juvenile ALS and 6258 adult patients with ALS were subsequently screened for variants in the SPTLC1 gene. De novo variants in SPTLC1 (p.Ala20Ser in 2 patients and p.Ser331Tyr in 1 patient) were identified in 3 unrelated patients diagnosed with juvenile ALS and failure to thrive. A fourth variant (p.Leu39del) was identified in a patient with juvenile ALS where parental DNA was unavailable. Variants in this gene have been previously shown to be associated with autosomal-dominant hereditary sensory autonomic neuropathy, type 1A, by disrupting an essential enzyme complex in the sphingolipid synthesis pathway.Conclusions and Relevance: These data broaden the phenotype associated with SPTLC1 and suggest that patients presenting with juvenile ALS should be screened for variants in this gene.</p

Pathogenic Huntingtin Repeat Expansions in Patients with Frontotemporal Dementia and Amyotrophic Lateral Sclerosis.

We examined the role of repeat expansions in the pathogenesis of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) by analyzing whole-genome sequence data from 2,442 FTD/ALS patients, 2,599 Lewy body dementia (LBD) patients, and 3,158 neurologically healthy subjects. Pathogenic expansions (range, 40-64 CAG repeats) in the huntingtin (HTT) gene were found in three (0.12%) patients diagnosed with pure FTD/ALS syndromes but were not present in the LBD or healthy cohorts. We replicated our findings in an independent collection of 3,674 FTD/ALS patients. Postmortem evaluations of two patients revealed the classical TDP-43 pathology of FTD/ALS, as well as huntingtin-positive, ubiquitin-positive aggregates in the frontal cortex. The neostriatal atrophy that pathologically defines Huntington's disease was absent in both cases. Our findings reveal an etiological relationship between HTT repeat expansions and FTD/ALS syndromes and indicate that genetic screening of FTD/ALS patients for HTT repeat expansions should be considered

Pest risk assessment of Eotetranychus lewisi for the EU territory

Based on the pest categorisation prepared by EFSA, E. lewisi has the potential to be both a quarantine pest, as it fulfils all ISPM 11 criteria, and a Non-Regulated Quarantine Pest, as it fulfils all ISPM 21 criteria. However, it is noted that information on the potential impact is very limited. At the same time, the organism is currently regulated only for plants of Citrus L., Fortunella Swingle, Poncirus Raf. and their hybrids. However, the affected host range is broader than what is currently covered. There are major hosts such as plants of Euphorbia, Rubus, Fragaria, Prunus, Vitis, etc. which are not regulated for this specific organism. In the European Union (EU), it has been found, for example, also on plants of Corokia cotoneaster in 1999. The pathways of spreading are numerous. The Working Group recommends to keep this organism as Union Quarantine Pest. To support further decisions on risk reduction options, the PRA process has to continue. In particular, EFSA is asked to focus further work on the probability of entry of the pest (identification of the pathways), its establishment, as well as further spread after its establishment in the EU. It is important to explore as well the reasons for its absence in the EU. Additional information as regards the degree of impact would be also relevant even though the Working Group above acknowledges the absence of data in this respect

Off Shelf Fluxes of Labile Materials by an Upwelling Filament in the NW Iberian Upwelling System

Daily changes in the concentrations of carbon and nitrogen species were monitored during the course of a Lagrangian drifter experiment in a recurrent upwelling filament south of Cape Finisterre (NW Iberian Upwelling System). A drifting buoy released at the southern edge of the upwelling centre generated by the Cape moved 60km southwestwards from 3 to 7 August 1998. Organic matter in the 50m deep study water mass (average 77±2 μM C) consisted of: 57μM C of dissolved organic matter (DOM) with a C/N molar ratio of 19±2; 6μM C of DOM with a C/N ratio of 9±2, and 14μM C of 50% DOM and 50% suspended organic matter (POMsusp) with a C/N ratio of 6.0±0.4. Net conversion of consumed inorganic salts into accumulated TOM=POMsusp+DOM was 40% for nitrogen and 30% for carbon. Since the parcel of water crossed the shelf-edge, these conversion efficiencies are equivalent to net horizontal export-ratio of 0.4 and 0.3 respectively. A second drifter was deployed in the offshore-end of the filament, and was displaced 20km west between 14 and 17 August 1998. Nitrate was exhausted in the surface water and no significant changes were observed in the variables measured during the course of the second experiment. Low C/N ratios (6.5±0.4) and rapid POMsusp/DOM inter-conversion in the 20 μM C excess observed in the study volume points to the persistence of the labile materials formed on the shelf during transport to the ocean. Our data demonstrate a) the key role of upwelling filaments in off-shelf export of organic materials and b) the major contribution of DOM to this horizontal export, a previously unaccounted amount