HE4 in the differential diagnosis of ovarian masses

Ovarian masses, a common finding among pre- and post-menopausal women, can be benign or malignant. Ovarian cancer is the leading cause of death from gynecologic malignancy among women living in industrialized countries. According to the current guidelines, measurement of CA125 tumor marker remains the gold standard in the management of ovarian cancer. Recently, HE4 has been proposed as emerging biomarker in the differential diagnosis of adnexal masses and in the early diagnosis of ovarian cancer. Discrimination of benign and malignant ovarian tumors is very important for correct patient referral to institutions specializing in care and management of ovarian cancer. Tumor markers CA125 and HE4 are currently incorporated into the Risk of Ovarian Malignancy Algorithm” (ROMA) with menopausal status for discerning malignant from benign pelvic masses. The availability of a good biomarker such as HE4, closely associated with the differential and early diagnosis of ovarian cancer, could reduce medical costs related to more expensive diagnostic procedures. Finally, it is important to note that HE4 identifies platinum non-responders thus enabling a switch to second line chemotherapy and improved survival

The protective effect of M40401, a superoxide dismutase mimetic, on post-ischemic brain damage in Mongolian gerbils

BACKGROUND: Overproduction of free radical species has been shown to occur in brain tissues after ischemia-reperfusion injury. However, most of free radical scavengers known to antagonize oxidative damage (e.g. superoxide dismutase, catalase), are unable to protect against ischemia-reperfusion brain injury when given in vivo, an effect mainly due to their difficulty to gain access to brain tissues. Here we studied the effect of a low molecular weight superoxide dismutase mimetic (M40401) in brain damage subsequent to ischemia-reperfusion injury in Mongolian gerbils. RESULTS: In animals undergoing ischemia-reperfusion injury, neuropathological and ultrastructural changes were monitored for 1–7 days either in the presence or in the absence of M40401 after bilateral common carotid artery occlusion (BCCO). Administration of M40401 (1–40 mg/kg, given i.p. 1 h after BCCO) protected against post-ischemic, ultrastructural and neuropathological changes occurring within the hippocampal CA1 area. The protective effect of M40401 was associated with a significant reduction of the levels of malondialdehyde (MDA; a marker of lipid peroxidation) in ischemic brain tissues after ischemia-reperfusion. CONCLUSION: Taken together, these results demonstrate that M40401 provides protective effects when given early after the induction of ischemia-reperfusion of brain tissues and suggest the possible use of such compounds in the treatment of neurological dysfunction subsequent to cerebral flow disturbances

Measuring Dislocation Density in Aluminum with Resonant Ultrasound Spectroscopy

Dislocations in a material will, when present in enough numbers, change the speed of propagation of elastic waves. Consequently, two material samples, differing only in dislocation density, will have different elastic constants, a quantity that can be measured using Resonant Ultrasound Spectroscopy. Measurements of this effect on aluminum samples are reported. They compare well with the predictions of the theory.Comment: 4 pages, 2 figure

Correlation between specific IgM levels and percentage IgG-class antibody avidity to Toxoplasma gondii

Toxoplasmosis is an usually asymptomatic worldwide disseminated infection. In its congenital presentation it may lead to abortion or fetal malformations. Antenatal evaluation is considered of paramount importance to identify seronegative women and allow for prophylaxis. Recent improvements in sensitivity of IgM tests has made IgM detection an extremely protracted acute phase marker, and IgG avidity evaluation test became necessary. Observation has shown that a correlation can be established between IgM levels and avidity percentages, suggesting that frequently the avidity test may not be necessary. In this study we analyzed Toxoplasma gondii IgM levels of 202 samples and their IgG avidity percentages, in order to define specific levels whose IgM quantification could by itself define serodiagnosis and therefore make the avidity evaluation unnecessary. We showed that for IgM levels bellow 2.0 and above 6.0 serodiagnosis of toxoplasmosis could be established without need of IgG avidity test. IgM levels between these two parameters are associated with varying avidity indexes highlighting the importance of its evaluation as a means to confirm toxoplasmosis. Following this demonstration it was possible to avoid the avidity test for 75% of the cases, to reduce the turnaround time and to reduce costs.A Toxoplasmose é uma infecção universal e usualmente assintomática. A forma congênita, entretanto, pode resultar em aborto ou mal formações. Testes sorológicos estão indicados em situações onde há suspeita clínica, e na triagem pré-natal, quando são extremamente importantes para rastrear a infecção e orientar a gestante. O aumento da sensibilidade das técnicas para detecção de IgM, tornou necessário o desenvolvimento de recursos, como a avidez de IgG, visando obter novo marcador de infecção aguda. Embora exista correlação entre níveis de IgM e grau de avidez de IgG, a maioria dos testes de avidez associa-se a níveis baixos de IgM, sugerindo que o teste de avidez não fosse necessário. Portanto, correlacionamos níveis de IgM de 202 amostras com seu respectivo nível de avidez de IgG, dirigidos contra o Toxoplasma, objetivando estabelecer valores claros para a sua indicação. Pôde-se observar que, para IgM ; 6,0, a definição sorológica pode ser feita independentemente da avidez. Níveis de IgM dentro desse intervalo associam-se a índices variados de avidez e, portanto, ressaltam a importância deste teste para definição sorológica do quadro. Com essa abordagem, foi possível diminuir a indicação do teste de avidez em 75%, reduzir o tempo para liberação dos resultados e o custo unitário do teste para IgM

The contribution of peroxynitrite generation in HIV replication in human primary macrophages

<p>Abstract</p> <p>Background</p> <p>Monocytes/Macrophages (M/M) play a pivotal role as a source of virus during the whole course of HIV-1 infection. Enhanced oxidative stress is involved in the pathogenesis of HIV-1 infection. HIV-1 regulatory proteins induce a reduction of the expression and the activity of MnSOD, the mitochondrial isoform leading to a sustained generation of superoxide anions and peroxynitrite that represent important mediators of HIV-1 replication in M/M. MnTBAP (Mn(III)tetrakis(4-benzoic acid)porphrin chloride), a synthetic peroxynitrite decomposition catalyst, reduced oxidative stress subsequent to peroxynitrite generation.</p> <p>Results</p> <p>Virus production was assessed by p24 ELISA, western blot, and electron microscopy during treatment with MnTBAP. MnTBAP treatment showed a reduction of HIV-1 replication in both acutely and chronically infected M/M: 99% and 90% inhibition of p24 released in supernatants compared to controls, respectively. Maturation of p55 and p24 was strongly inhibited by MnTBAP in both acutely and chronically infected M/M. EC₅₀and EC₉₀are 3.7 (± 0.05) μM and 19.5 (± 0.5) μM, in acutely infected M/M; 6.3 (± 0.003) μM and 30 (± 0.6) μM, in chronically infected M/M. In acutely infected peripheral blood limphocytes (PBL), EC₅₀and EC₉₀are 7.4 (± 0.06) μM and of 21.3 (± 0.6) μM, respectively. Treatment of acutely-infected M/M with MnTBAP inhibited the elevated levels of malonildialdehyde (MDA) together with the nitrotyrosine staining observed during HIV-1 replication. MnTBAP strongly reduced HIV-1 particles in infected M/M, as shown by electron microscopy. Moreover, in presence of MnTBAP, HIV-1 infectivity was reduced of about 1 log compared to control.</p> <p>Conclusion</p> <p>Results support the role of superoxide anions in HIV-1 replication in M/M and suggest that MnTBAP may counteract HIV-1 replication in combination with other antiretroviral treatments.</p

Valorização do patrimônio científico e tecnológico brasileiro: descobrindo conjuntos de objetos de C&T pelo Brasil

Most of Brazil's science and technology (S&amp;T) heritage has yet to be tracked down. The knowledge amassed on the topic is still limited, and there is a real risk that Brazilian science and technology objects may already have been modernized or discarded. A research project was developed in the last four years including several initiatives to preserve this kind of heritage, as such: a national survey to build up a picture of the current state of this heritage; studies concerning heritage protection legislation of some countries, including Brazil; and two case studies of collections of S&amp;T objects (Observatório do Valongo and Colégio Pedro II). This paper presents an overview of the results obtained in the several initiatives of preservation undertaken. The survey is divided into different areas of knowledge and different time frames. As such, we are interested in sets of objects from the exact sciences, the different engineering specialties, as well as geography, geology and oceanography, which were manufactured in or before the 1960s. A registration form was prepared which was adapted from a form used in surveys of collections of this kind in Portugal. Sets of objects have been identified at museums, universities and research institutes. From the results, it could be observed that: the best preserved collections are at the few museums devoted to the area, but the universities hold most of the artifacts and the overwhelming majority of the objects were made in the twentieth century.A maior parte dos bens que constituem o patrimônio cultural da Ciência e Tecnologia (C&amp;T) está para ser descoberta. O conhecimento acumulado sobre o tema ainda é limitado e há um risco real de que os objetos já tenham sido modernizados ou descartados. Nos últimos quatro anos, desenvolveu-se um projeto de pesquisa, envolvendo várias iniciativas para preservar este tipo de patrimônio: um levantamento nacional para construir um panorama do estado atual desse patrimônio; estudos sobre a legislação de proteção ao patrimônio de alguns países, inclusive o Brasil; e dois estudos de caso de coleções de objetos de C&amp;T (Observatório do Valongo e Colégio Pedro II, ambos no Rio de Janeiro). Este artigo apresenta uma visão geral dos resultados obtidos e, em especial, dos levantamentos de conjuntos de objetos de C&amp;T. Utilizou-se um recorte em relação a áreas do conhecimento e período histórico, compreendendo objetos pertencentes à s ciências exatas, à s diferentes especialidades de engenharia, bem como geografia, geologia e oceanografia, e fabricados até 1960. A partir da adaptação de um formulário usado em pesquisas similares em Portugal, elaborou-se uma ficha de registro, que permitiu identificar conjuntos de objetos em museus, universidades e institutos de pesquisa. Pôde-se, com isso, observar que as coleções mais bem preservadas estão nos poucos museus dedicados à área, enquanto as universidades detêm a maior parte dos artefatos, e que a esmagadora maioria dos objetos foi produzida no século XX

The use of HE4, CA125 and CA72-4 biomarkers for differential diagnosis between ovarian endometrioma and epithelial ovarian cancer

BACKGROUND: Endometriosis is frequently associated with high levels of CA125. This marker is therefore not useful for discriminating ovarian endometrioma from ovarian malignancy. The aim of this study was to establish a panel of complementary biomarkers that could be helpful in the differential diagnosis between ovarian endometriosis or other ovarian benign masses and ovarian cancer. METHODS: Blood samples from 50 healthy women, 17 patients with benign ovarian tumors, 57 patients with ovarian endometrioma and 39 patients with ovarian cancer were analyzed and serum values were measured for the following biomarkers: CA125, HE4 and CA72-4. RESULTS: Serum CA125 concentration was elevated in both patients with ovarian endometriosis and ovarian cancer but not in patients with other benign ovarian masses. HE4 was never increased in patients with endometriosis or benign masses whereas it was significantly higher in all patients with ovarian cancer (p < 0.05). A marked difference in CA72-4 values was observed between women with ovarian cancer (67%) and those with endometriosis (p < 0.05). CONCLUSIONS: The results of the study suggest that HE4 and CA72-4 determination is the best approach to confirm the benign nature of ovarian endometrioma in women with high CA125 levels

Decreased rotational flow and circumferential wall shear stress as early markers of descending aorta dilation in Marfan syndrome: a 4D flow CMR study

Marfan syndrome; 4D flow CMR; Helical flowSíndrome de Marfan; Flujo en 4D CMR; Flujo helicoidalSíndrome de Marfan; Flux en 4D CMR; Flux helicoïdalBackground: Diseases of the descending aorta have emerged as a clinical issue in Marfan syndrome following improvements in proximal aorta surgical treatment and the consequent increase in life expectancy. Although a role for hemodynamic alterations in the etiology of descending aorta disease in Marfan patients has been suggested, whether flow characteristics may be useful as early markers remains to be determined. Methods: Seventy-five Marfan patients and 48 healthy subjects were prospectively enrolled. In- and through-plane vortexes were computed by 4D flow cardiovascular magnetic resonance (CMR) in the thoracic aorta through the quantification of in-plane rotational flow and systolic flow reversal ratio, respectively. Regional pulse wave velocity and axial and circumferential wall shear stress maps were also computed. Results: In-plane rotational flow and circumferential wall shear stress were reduced in Marfan patients in the distal ascending aorta and in proximal descending aorta, even in the 20 patients free of aortic dilation. Multivariate analysis showed reduced in-plane rotational flow to be independently related to descending aorta pulse wave velocity. Conversely, systolic flow reversal ratio and axial wall shear stress were altered in unselected Marfan patients but not in the subgroup without dilation. In multivariate regression analysis proximal descending aorta axial (p = 0.014) and circumferential (p = 0.034) wall shear stress were independently related to local diameter. Conclusions: Reduced rotational flow is present in the aorta of Marfan patients even in the absence of dilation, is related to aortic stiffness and drives abnormal circumferential wall shear stress. Axial and circumferential wall shear stress are independently related to proximal descending aorta dilation beyond clinical factors. In-plane rotational flow and circumferential wall shear stress may be considered as an early marker of descending aorta dilation in Marfan patients.This study has been funded by Instituto de Salud Carlos III through the project PI14/0106 (co-founded by European Regional Development Fund), La Marato de TV3 (project number 20151330), by Ministerio de Economia y Competitividad through Retos-Colaboracion 2016 (RTC-2016-5152-1). Guala A. has received funding from the European Union Seventh Framework Programme FP7/People under grant agreement no 267128

The current role of echocardiography in acute aortic syndrome

Acute aortic syndrome (AAS) comprises a range of interrelated conditions caused by disruption of the medial layer of the aortic wall, including aortic dissection, intramural haematoma and penetrating aortic ulcer. Since mortality from AAS is high, a prompt and accurate diagnosis using imaging techniques is paramount. Both transthoracic (TTE) and transoesophageal echocardiography (TEE) are useful in the diagnosis of AAS. TTE should be the first imaging technique to evaluate patients with thoracic pain in the emergency room. Should AAS be suspected, contrast administration is recommended when images are not definitive. TEE allows high-quality images in thoracic aorta. The main drawback of this technique is that it is semi-invasive and the presence of a blind area that limits visualisation of the distal ascending aorta near. TEE identifies the location and size of the entry tear, secondary communications, true lumen compression and the dynamic flow pattern of false lumen. Although computed tomography (CT) is the most used imaging technique in the diagnosis of AAS, echocardiography offers complementary information relevant for its management. The best imaging strategy for appropriately diagnosing and assessing AAS is to combine CT, mainly ECG-gated contrast-enhanced CT, and TTE. Currently, TEE tends to be carried out in the operating theatre immediately before surgical or endovascular therapy and in monitoring their results. The aims of this review are to establish the current role of echocardiography in the diagnosis and management of AAS based on its advantages and limitations