88 results on '"Dias LM"'
Search Results
2. ANALYZING DECELLULARIZED AND RECELLULARIZED LIVER SCAFFOLDS USING PROTEOMICS
- Author
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Paranhos, BA, primary, Dias, LM, additional, Faccioli, L, additional, Domont, GB, additional, Nogueira, FCS, additional, and Goldenberg, RCS, additional
- Published
- 2021
- Full Text
- View/download PDF
3. May measurement month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension (vol 40, pg 2006, 2019)
- Author
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Beaney, T, Burrell, LM, Castillo, RR, Charchar, FJ, Cro, S, Damasceno, A, Kruger, R, Nilsson, PM, Prabhakaran, D, Ramirez, AJ, Schlaich, MP, Schutte, AE, Tomaszewski, M, Touyz, R, Wang, JG, Weber, MA, Poulter, NR, Burazeri, G, Qirjako, G, Roshi, E, Cunashi, R, Fernandes, MJCC, Pereira, VSS, Neto, MFMP, Oliveira, PNM, Feijao, ACG, Cerniello, Y, Marin, MJ, Vasquez, GF, Espeche, WG, Stisman, D, Fuentes, IA, Zilberman, JM, Rodriguez, P, Babinyan, KY, Engibaryan, AH, Avagyan, AM, Minasyan, AA, Gevorkyan, AT, Carnagarin, R, Carrington, MJ, Sharman, JE, Lee, R, Perl, S, Niederl, E, Malik, FT, Choudhury, SR, Al Mamun, MA, Ishraquzzaman, M, Anthony, F, Connell, K, De Backer, TLM, Krzesinski, J, Houenassi, MD, Houehanou, CY, Sokolovic, S, Bahtijarevic, R, Tiro, MB, Mosepele, M, Masupe, TK, Barroso, WS, Gomes, MAM, Feitosa, ADM, Brandao, AA, Miranda, RD, Azevedo, VMAA, Dias, LM, Garcia, GDN, Martins, IPP, Dzudie, A, Kingue, S, Djomou, FAN, Njume, E, Khan, N, Lanas, FT, Garcia, MS, Paccot, MF, Torres, P, Li, Y, Liu, M, Xu, L, Li, L, Chen, X, Deng, J, Zhao, W, Fu, L, Zhou, Y, Lopez-Jaramillo, P, Otero, J, Camacho, PA, Accini, JL, Sanchez, G, Arcos, E, M'Buyamba-Kabangu, JR, Katamba, FK, Ngoyi, GN, Buila, NM, Bayauli, PM, Mbolla, EBF, Bakekolo, PR, Landa, KCM, Kaky, KGS, Kramoh, EK, Ngoran, YNK, Olsen, MH, Valoy, VL, Santillan, M, Rafael, AGM, Penaherrera, CE, Villalba, J, Ramirez, M, Arteaga, F, Delgado, P, Beistline, H, Cappuccio, FP, Keitley, J, Tay, T, Goshu, DY, Kassie, DM, Gebru, SA, Pathak, A, Denolle, T, Tsinamdzgvrishvili, B, Trapaidze, D, Sturua, L, Abesadze, T, Grdzelidze, N, Grabfelder, M, Kramer, BK, Schmeider, RE, Twumasi-Ankrah, B, Tannor, EK, Lincoln, MD, Deku, EM, Quintana, WFS, Kenerson, J, Baptiste, JED, Saintilmond, WW, Barrientos, AL, Jose, PA, More, A, Takalkar, A, Turana, Y, Widyantoro, B, Danny, SS, Djono, S, Handari, SD, Tambunan, M, Tiksnadi, BB, Hermiawaty, E, Tavassoli, E, Zolfaghari, M, Dolan, E, O'Brien, E, Borghi, C, Ferri, C, Torlasco, C, Parati, G, Nwokocha, CR, Nwokocha, M, Ogola, EN, Gitura, BM, Barasa, AL, Barasa, FA, Wairagu, AW, Nalwa, WZ, Najem, RN, Abu Alfa, AK, Fageh, HA, Msalam, OM, Derbi, HA, Bettamar, KA, Zakauskiene, U, Vickiene, A, Calmes, J, Alkerwi, A, Gantenbein, M, Ndhlovu, HLL, Masiye, JK, Chirwa, ML, Nyirenda, NM, Dhlamini, TD, Chia, YC, Ching, SM, Devaraj, NK, Ouane, N, Fane, T, Kowlessur, S, Ori, B, Heecharan, J, Alcocer, L, Chavez, A, Ruiz, G, Espinosa, C, Gomez-Alvarez, E, Neupane, D, Bhattarai, H, Ranabhat, K, Adhikari, TB, Koirala, S, Toure, IA, Soumana, KH, Wahab, KW, Omotoso, AB, Sani, MU, Okubadejo, NU, Nadar, SK, Al-Riyami, HA, Ishaq, M, Memon, F, Sidique, S, Choudhry, HA, Khan, RA, Ayala, M, Maidana, AJO, Bogado, GG, Ona, D, Atilano, A, Granada, C, Bartolome, R, Manese, L, Mina, A, Dumlao, MC, Villaruel, MC, Gomez, L, Jozwiak, J, Malyszko, J, Banach, M, Mastej, M, Rodrigues, DCMM, Martins, LL, Paval, A, Dorobantu, M, Konradi, AO, Chazova, IE, Rotar, O, Spoares, MC, Viegas, D, Almustafa, BA, Alshurafa, SA, Brady, A, Bovet, P, Viswanathan, B, Oladapo, OO, Russell, JW, Beheiry, HM, Ali, IA, Osman, AAA, Fahal, NAW, Osman, HA, Altahir, F, Persson, M, Wuerzner, G, Burkard, T, Wang, TD, Lin, HJ, Pan, HY, Chen, WJ, Lin, E, Mondo, CK, Ingabire, PM, Khomazyuk, TT, Krotova, VV, Negresku, E, Evstigneeva, O, Bazargani, NN, Agrawal, A, Bin Belaila, BA, Suhail, AM, Muhammed, KO, Shuri, HH, Wainford, RD, Levy, PD, Boggia, JJ, Garre, LL, Hernandez-Hernandez, R, Octavio-Seijas, JA, Lopez-Rivera, JA, Morr, I, Duin, A, Huynh, M, Cao, ST, Nguyen, VL, To, M, Phan, HN, Cockroft, J, McDonnell, B, Goma, FM, Syatalimi, C, Chifamba, J, Gwini, R, Tiburcio, O, and Xia, X
- Subjects
Science & Technology ,Cardiac & Cardiovascular Systems ,Cardiovascular System & Hematology ,Cardiovascular System & Cardiology ,1103 Clinical Sciences ,Life Sciences & Biomedicine ,1102 Cardiorespiratory Medicine and Haematology - Published
- 2019
4. May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension
- Author
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Beaney, T, Burrell, LM, Castillo, RR, Charchar, FJ, Cro, S, Damasceno, A, Kruger, R, Nilsson, PM, Prabhakaran, D, Ramirez, AJ, Schlaich, MP, Schutte, AE, Tomaszewski, M, Touyz, R, Wang, J-G, Weber, MA, Poulter, NR, Burazeri, G, Qirjako, G, Roshi, E, Cunashi, R, Fernandes, MJCC, Pereira, SSV, Neto, MFMP, Oliveira, PNM, Feijao, ACG, Cerniello, Y, Marin, MJ, Vasquez, FG, Espeche, WG, Stisman, D, Fuentes, IA, Zilberman, JM, Rodriguez, P, Babinyan, KY, Engibaryan, AH, Avagyan, AM, Minasyan, AA, Gevorkyan, AT, Carnagarin, R, Carrington, MJ, Sharman, JE, Lee, R, Perl, S, Niederl, E, Malik, F-T-N, Choudhury, SR, Al Mamun, MA, Ishraquzzaman, M, Anthony, F, Connell, K, De Backer, TLM, Krzesinski, J, Houenassi, MD, Houehanou, CY, Sokolovic, S, Bahtijarevic, R, Tiro, MB, Mosepele, M, Masupe, TK, Barroso, WS, Gomes, MAM, Feitosa, ADM, Brandao, AA, Miranda, RD, Azevedo, VMAA, Dias, LM, Garcia, GDN, Martins, IPP, Dzudie, A, Kingue, S, Djomou, FAN, Njume, E, Khan, N, Lanas, FT, Garcia, MS, Paccot, MF, Torres, PI, Li, Y, Liu, M, Xu, L, Li, L, Chen, X, Deng, J, Zhao, W, Fu, L, Zhou, Y, Lopez-Jaramillo, P, Otero, J, Camacho, PA, Accini, JL, Sanchez, G, Arcos, E, Buyamba-Kabangu, J-RM, Katamba, FK, Ngoyi, GN, Buila, NM, Bayauli, PM, Mbolla, BFE, Bakekolo, PR, Landa, CMK, Kaky, GSK, Kramoh, EK, Ngoran, YNK, Olsen, MH, Valoy, LV, Santillan, M, Medina, ARG, Penaherrera, CE, Villalba, J, Ramirez, MI, Arteaga, F, Delgado, P, Beistline, H, Cappuccio, FP, Keitley, J, Tay, T, Goshu, DY, Kassie, DM, Gebru, SA, Pathak, A, Denolle, T, Tsinamdzgvrishvili, B, Trapaidze, D, Sturua, L, Abesadze, T, Grdzelidze, N, Grabfelder, M, Kramer, BK, Schmeider, RE, Twumasi-Ankrah, B, Tannor, EK, Lincoln, MD, Deku, EM, Quintana, FSW, Kenerson, J, Baptiste, EDJ, Saintilmond, WW, Barrientos, AL, Peiger, B, Lagos, AR, Forgas, MA, Lee, VWY, Tomlinson, BWY, Jarai, Z, Pall, D, More, A, Maheshwari, A, Verma, N, Sharma, M, Mukherjee, TK, Patil, M, Jose, AP, Takalkar, A, Turana, Y, Widyantoro, B, Danny, SS, Djono, S, Handari, SD, Tambunan, M, Tiksnadi, BB, Hermiawaty, E, Tavassoli, E, Zolfaghari, M, Dolan, E, O'Brien, E, Borghi, C, Ferri, C, Torlasco, C, Parati, G, Nwokocha, CR, Nwokocha, MI, Ogola, EN, Gitura, BM, Barasa, AL, Barasa, FA, Wairagu, AW, Nalwa, WZ, Najem, RN, Abu Alfa, AK, Fageh, HA, Msalam, OM, Derbi, HA, Bettamar, KA, Zakauskiene, U, Vickiene, A, Calmes, J, Alkerwi, A, Gantenbein, M, Ndhlovu, HLL, Masiye, JK, Chirwa, ML, Nyirenda, NM, Dhlamini, TD, Chia, YC, Ching, SM, Devaraj, NK, Ouane, N, Fane, T, Kowlessur, S, Ori, B, Heecharan, J, Alcocer, L, Chavez, A, Ruiz, G, Espinosa, C, Gomez-Alvarez, E, Neupane, D, Bhattarai, H, Ranabhat, K, Adhikari, TB, Koirala, S, Toure, IA, Soumana, KH, Wahab, K, Omotoso, AB, Sani, MU, Okubadejo, NU, Nadar, SK, Al-Riyami, HA, Ishaq, M, Memon, F, Sidique, S, Choudhry, HA, Khan, RA, Ayala, M, Maidana, AJO, Bogado, GGG, Ona, DI, Atilano, A, Granada, C, Bartolome, R, Manese, L, Mina, A, Dumlao, MC, Villaruel, MC, Gomez, L, Jozwiak, J, Malyszko, J, Banach, M, Mastej, M, Rodrigues, MMDC, Martins, LL, Paval, A, Dorobantu, M, Konradi, AO, Chazova, IE, Rotar, O, Spoares, MC, Viegas, D, Almustafa, BA, Alshurafa, SA, Brady, A, Bovet, P, Viswanathan, B, Oladapo, OO, Russell, JW, Brguljan-Hitij, J, Bozic, N, Knez, J, Dolenc, P, Hassan, MM, Woodiwiss, AJ, Myburgh, C, Vally, M, Ruilope, LM, Molinero, A, Rodilla, E, Gijon-Conde, T, Beheiry, HM, Ali, IA, Osman, AAA, Fahal, NAW, Osman, HA, Altahir, F, Persson, M, Wuerzner, G, Burkard, T, Wang, T-D, Lin, H-J, Pan, H-Y, Chen, W-J, Lin, E, Mondo, CK, Ingabire, PM, Khomazyuk, TTA, Krotova, VV-Y, Negresku, E, Evstigneeva, O, Bazargani, NNB, Agrawal, A, Bin Belaila, BA, Suhail, AM, Muhammed, KO, Shuri, HH, Wainford, RD, Levy, PD, Boggia, JJG, Garre, LL, Hernandez-Hernandez, R, Octavio-Seijas, JA, Lopez-Rivera, JA, Morr, I, Duin, A, Huynh, MV, Cao, ST, Nguyen, VL, To, M, Phan, HN, Cockroft, J, McDonnell, B, Goma, FM, Syatalimi, C, Chifamba, J, Gwini, R, Xia, X, Tiburcio, OV, Beaney, T, Burrell, LM, Castillo, RR, Charchar, FJ, Cro, S, Damasceno, A, Kruger, R, Nilsson, PM, Prabhakaran, D, Ramirez, AJ, Schlaich, MP, Schutte, AE, Tomaszewski, M, Touyz, R, Wang, J-G, Weber, MA, Poulter, NR, Burazeri, G, Qirjako, G, Roshi, E, Cunashi, R, Fernandes, MJCC, Pereira, SSV, Neto, MFMP, Oliveira, PNM, Feijao, ACG, Cerniello, Y, Marin, MJ, Vasquez, FG, Espeche, WG, Stisman, D, Fuentes, IA, Zilberman, JM, Rodriguez, P, Babinyan, KY, Engibaryan, AH, Avagyan, AM, Minasyan, AA, Gevorkyan, AT, Carnagarin, R, Carrington, MJ, Sharman, JE, Lee, R, Perl, S, Niederl, E, Malik, F-T-N, Choudhury, SR, Al Mamun, MA, Ishraquzzaman, M, Anthony, F, Connell, K, De Backer, TLM, Krzesinski, J, Houenassi, MD, Houehanou, CY, Sokolovic, S, Bahtijarevic, R, Tiro, MB, Mosepele, M, Masupe, TK, Barroso, WS, Gomes, MAM, Feitosa, ADM, Brandao, AA, Miranda, RD, Azevedo, VMAA, Dias, LM, Garcia, GDN, Martins, IPP, Dzudie, A, Kingue, S, Djomou, FAN, Njume, E, Khan, N, Lanas, FT, Garcia, MS, Paccot, MF, Torres, PI, Li, Y, Liu, M, Xu, L, Li, L, Chen, X, Deng, J, Zhao, W, Fu, L, Zhou, Y, Lopez-Jaramillo, P, Otero, J, Camacho, PA, Accini, JL, Sanchez, G, Arcos, E, Buyamba-Kabangu, J-RM, Katamba, FK, Ngoyi, GN, Buila, NM, Bayauli, PM, Mbolla, BFE, Bakekolo, PR, Landa, CMK, Kaky, GSK, Kramoh, EK, Ngoran, YNK, Olsen, MH, Valoy, LV, Santillan, M, Medina, ARG, Penaherrera, CE, Villalba, J, Ramirez, MI, Arteaga, F, Delgado, P, Beistline, H, Cappuccio, FP, Keitley, J, Tay, T, Goshu, DY, Kassie, DM, Gebru, SA, Pathak, A, Denolle, T, Tsinamdzgvrishvili, B, Trapaidze, D, Sturua, L, Abesadze, T, Grdzelidze, N, Grabfelder, M, Kramer, BK, Schmeider, RE, Twumasi-Ankrah, B, Tannor, EK, Lincoln, MD, Deku, EM, Quintana, FSW, Kenerson, J, Baptiste, EDJ, Saintilmond, WW, Barrientos, AL, Peiger, B, Lagos, AR, Forgas, MA, Lee, VWY, Tomlinson, BWY, Jarai, Z, Pall, D, More, A, Maheshwari, A, Verma, N, Sharma, M, Mukherjee, TK, Patil, M, Jose, AP, Takalkar, A, Turana, Y, Widyantoro, B, Danny, SS, Djono, S, Handari, SD, Tambunan, M, Tiksnadi, BB, Hermiawaty, E, Tavassoli, E, Zolfaghari, M, Dolan, E, O'Brien, E, Borghi, C, Ferri, C, Torlasco, C, Parati, G, Nwokocha, CR, Nwokocha, MI, Ogola, EN, Gitura, BM, Barasa, AL, Barasa, FA, Wairagu, AW, Nalwa, WZ, Najem, RN, Abu Alfa, AK, Fageh, HA, Msalam, OM, Derbi, HA, Bettamar, KA, Zakauskiene, U, Vickiene, A, Calmes, J, Alkerwi, A, Gantenbein, M, Ndhlovu, HLL, Masiye, JK, Chirwa, ML, Nyirenda, NM, Dhlamini, TD, Chia, YC, Ching, SM, Devaraj, NK, Ouane, N, Fane, T, Kowlessur, S, Ori, B, Heecharan, J, Alcocer, L, Chavez, A, Ruiz, G, Espinosa, C, Gomez-Alvarez, E, Neupane, D, Bhattarai, H, Ranabhat, K, Adhikari, TB, Koirala, S, Toure, IA, Soumana, KH, Wahab, K, Omotoso, AB, Sani, MU, Okubadejo, NU, Nadar, SK, Al-Riyami, HA, Ishaq, M, Memon, F, Sidique, S, Choudhry, HA, Khan, RA, Ayala, M, Maidana, AJO, Bogado, GGG, Ona, DI, Atilano, A, Granada, C, Bartolome, R, Manese, L, Mina, A, Dumlao, MC, Villaruel, MC, Gomez, L, Jozwiak, J, Malyszko, J, Banach, M, Mastej, M, Rodrigues, MMDC, Martins, LL, Paval, A, Dorobantu, M, Konradi, AO, Chazova, IE, Rotar, O, Spoares, MC, Viegas, D, Almustafa, BA, Alshurafa, SA, Brady, A, Bovet, P, Viswanathan, B, Oladapo, OO, Russell, JW, Brguljan-Hitij, J, Bozic, N, Knez, J, Dolenc, P, Hassan, MM, Woodiwiss, AJ, Myburgh, C, Vally, M, Ruilope, LM, Molinero, A, Rodilla, E, Gijon-Conde, T, Beheiry, HM, Ali, IA, Osman, AAA, Fahal, NAW, Osman, HA, Altahir, F, Persson, M, Wuerzner, G, Burkard, T, Wang, T-D, Lin, H-J, Pan, H-Y, Chen, W-J, Lin, E, Mondo, CK, Ingabire, PM, Khomazyuk, TTA, Krotova, VV-Y, Negresku, E, Evstigneeva, O, Bazargani, NNB, Agrawal, A, Bin Belaila, BA, Suhail, AM, Muhammed, KO, Shuri, HH, Wainford, RD, Levy, PD, Boggia, JJG, Garre, LL, Hernandez-Hernandez, R, Octavio-Seijas, JA, Lopez-Rivera, JA, Morr, I, Duin, A, Huynh, MV, Cao, ST, Nguyen, VL, To, M, Phan, HN, Cockroft, J, McDonnell, B, Goma, FM, Syatalimi, C, Chifamba, J, Gwini, R, Xia, X, and Tiburcio, OV
- Abstract
AIMS: Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. METHODS AND RESULTS: Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. CONCLUSION: May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk.
- Published
- 2019
5. An Outbreak of Bacillus Species in a Cancer Hospital
- Author
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de Faria Lm, de Souza Martins Ca, da Fonseca Np, Eduardo Velasco, Dias Lm, Luiz Claudio Santos Thuler, and Gonçalves Vm
- Subjects
Adult ,Male ,Microbiology (medical) ,Catheterization, Central Venous ,Adolescent ,Epidemiology ,Matched-Pair Analysis ,Bacillus ,chemistry.chemical_element ,Bacillaceae Infections ,Cancer Care Facilities ,Calcium ,Vial ,Disease Outbreaks ,Microbiology ,chemistry.chemical_compound ,Odds Ratio ,medicine ,Humans ,Child ,Aged ,Cross Infection ,biology ,business.industry ,Infant ,Outbreak ,Odds ratio ,Middle Aged ,biology.organism_classification ,medicine.disease ,Calcium Gluconate ,Bacillales ,Solutions ,Infectious Diseases ,chemistry ,Case-Control Studies ,Child, Preschool ,Bacteremia ,Immunology ,Gluconic acid ,Female ,Drug Contamination ,business ,Brazil - Abstract
Bacillus species were recovered from the blood cultures of 39 oncology patients over 14 weeks. A matched case-control study showed a strong association of Bacillus species bacteremia with use of calcium gluconate solution (odds ratio=25.0) and of central venous lines (odds ratio=8.8). Stopping use of the implicated calcium gluconate vials controlled the outbreak.
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- 1998
- Full Text
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6. TheMSH2c.388_389del mutation shows a founder effect in Portuguese Lynch syndrome families
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Pinheiro, M, primary, Pinto, C, additional, Peixoto, A, additional, Veiga, I, additional, Mesquita, B, additional, Henrique, R, additional, Lopes, P, additional, Sousa, O, additional, Fragoso, M, additional, Dias, LM, additional, Baptista, M, additional, Marinho, C, additional, Mangold, E, additional, Vaccaro, C, additional, Evans, DG, additional, Farrington, S, additional, Dunlop, MG, additional, and Teixeira, MR, additional
- Published
- 2012
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7. The MSH2 c.388_389del mutation shows a founder effect in Portuguese Lynch syndrome families.
- Author
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Pinheiro, M, Pinto, C, Peixoto, A, Veiga, I, Mesquita, B, Henrique, R, Lopes, P, Sousa, O, Fragoso, M, Dias, LM, Baptista, M, Marinho, C, Mangold, E, Vaccaro, C, Evans, DG, Farrington, S, Dunlop, MG, and Teixeira, MR
- Subjects
GENETIC mutation ,LYNCH syndrome II ,HAPLOTYPES ,GERM cells - Abstract
The MSH2 c.388_389del mutation has occasionally been described in Lynch families worldwide. At the Portuguese Oncology Institute in Porto, Portugal, we have identified 16 seemingly unrelated families with this germline mutation. To evaluate if this alteration is a founder or a recurrent mutation we performed haplotype analysis in the 16 Portuguese index cases and 55 relatives, as well as in four index cases and 13 relatives reported from Germany, Scotland, England, and Argentina. In the Portuguese families we observed a shared haplotype of approximately 10 Mb and all were originated from the north of Portugal. These results suggest that this alteration is a founder mutation in Portugal with a relatively recent origin. In the reported families outside Portugal with this mutation different haplotype backgrounds were observed, supporting the hypothesis that it occurred de novo on multiple occasions. We also conclude that the high proportion of families with the MSH2 c.388_389del mutation indicates that screening for this alteration as a first step may be cost-effective in the genetic testing of Lynch syndrome suspects of Portuguese ancestry, especially those originating from the north of Portugal. [ABSTRACT FROM AUTHOR]
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- 2013
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8. High-intensity interval training impacts skeletal muscle core clock in overweight and obese men with insulin resistance.
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Dias LM and Antonio GCF
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- 2024
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9. Effects of changing ions on the crystal design, non-covalent interactions, antimicrobial activity, and molecular docking of Cu(II) complexes with a pyridoxal-hydrazone ligand.
- Author
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Gatto CC, Dias LM, Paiva CA, da Silva ICR, Freire DO, Tormena RPI, Nascimento ÉCM, and Martins JBL
- Abstract
The present work reports the influence of the presence of different ions (Cl
- , Br- , NO3 - , or SO4 2- ) on the formation and proprieties of Cu(II) complexes with pyridoxal-benzoylhydrazone (PLBHZ). Four new complexes were successfully synthesized, [CuCl2 (PLBHZ)] (1), [CuBr2 (PLBHZ)] (2), [CuCl(PLBHZ)H2 O]⋅NO3 ⋅H2 O (3), and [CuSO4 (PLBHZ)H2 O]⋅3H2 O (4), and characterized by spectroscopic and physicochemical methods. A single-crystal X-ray study reveals the Schiff base coordinated to the metal center tridentate by the ONS -donor system, resulting in distorted square pyramidal coordination geometries. Noncovalent interactions were investigated by 3D Hirshfeld surface analysis by the dnorm function, 2D fingerprint plots, and full interaction maps. The ion exchange is important in forming three-dimensional networks with π⋅⋅⋅π stacking interactions and intermolecular hydrogen bonds. The in vitro biological activity of the free ligand and metal complexes was evaluated against Gram-positive and Gram-negative bacterial strains and the free pyridoxal-hydrazone ligand showed higher activity than their Cu(II) complexes. Molecular docking was used to predict the inhibitory activity of the ligand and complexes against Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli bacteria., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Gatto, Dias, Paiva, da Silva, Freire, Tormena, Nascimento and Martins.)- Published
- 2024
- Full Text
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10. Antibiofilm Activity and Biocompatibility of Temporin-SHa: A Promising Antimicrobial Peptide for Control of Fluconazole-Resistant Candida albicans .
- Author
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Dias LM, Cilli EM, Medeiros KS, Brasil MCOA, Marin LM, Siqueira WL, and Pavarina AC
- Abstract
The aim of the study was to investigate the effect of antimicrobial peptides (AMPs) Hylin-a1, KR-12-a5, and Temporin-SHa in Candida albicans as well as the biocompatibility of keratinocytes spontaneously immortalized (NOK-si) and human gingival fibroblasts (FGH) cells. Initially, the susceptible (CaS-ATCC 90028) and fluconazole-resistant (CaR-ATCC 96901) C. albicans strains were grown to evaluate the effect of each AMP in planktonic culture, biofilm, and biocompatibility on oral cells. Among the AMPs evaluated, temporin-SHa showed the most promising results. After 24 h of Temporin-SHa exposure, the survival curve results showed that CaS and CaR suspensions reduced 72% and 70% of cell viability compared to the control group. The minimum inhibitory/fungicide concentrations (MIC and MFC) showed that Temporin-SHa was able to reduce ≥50% at ≥256 µg/mL for both strains. The inhibition of biofilm formation, efficacy against biofilm formation, and total biomass assays were performed until 48 h of biofilm maturation, and Temporin-SHa was able to reduce ≥50% of CaS and CaR growth. Furthermore, Temporin-SHa (512 µg/mL) was classified as non-cytotoxic and slightly cytotoxic for NOK-si and FGH, respectively. Temporin-SHa demonstrated an anti-biofilm effect against CaS and CaR and was biocompatible with NOK-si and FGH oral cells in monolayer.
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- 2024
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11. Long-term assessment of functional capacity, muscle function, lung function, and quality of life in survivors of ventilator-associated pneumonia.
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Dias LM, da Cruz JA, and Lopes AJ
- Abstract
Background and Objective: The many patients who develop ventilator-associated pneumonia (VAP) have generated numerous VAP survivors who are not followed up in the long term. This study aimed, primarily, to evaluate the long-term functional capacity, as measured using the Glittre-ADL test (TGlittre), of VAP survivors and, secondarily, to calculate the correlations of TGlittre with muscle and lung function., Methods: This cross-sectional study evaluated 30 VAP survivors 10 months after discharge from the intensive care unit. The participants underwent the following assessments: TGlittre; respiratory muscle strength; handgrip strength (HGS); spirometry; Functional Assessment of Chronic Therapy (FACIT-F); and Short Form-36 (SF-36)., Results: The median TGlittre time was 95 (81-130)% of predicted, and 30 % of the participants performed poorly on TGlittre. One-third of the participants had abnormal spirometry results. TGlittre time was correlated with weight (r
s = -0.412, P = 0.023), body index mass (BMI, rs = -0.400, P = 0.029), forced vital capacity (FVC, rs = -0.401, P = 0.030), HGS (rs = -0.571, P = 0.0009), FACIT-F score (rs = -0.405, P = 0.026), and different SF-36 domain scores. Participants who returned to work had a shorter TGlittre time than those who did not (89 (69-104) vs. 129 (102-183)% predicted). Multiple linear regression indicated that FVC and BMI explained 39 % of TGlittre variability., Conclusion: VAP survivors had suboptimal functional capacity, low lung function, and general fatigue 10 months after discharge. The longer the TGlittre time was, the worse the lung function, muscle function, general fatigue, and quality of life were and the less likely the patient was to have returned to work., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)- Published
- 2023
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12. Dietary Patterns in Pregnancy and the Postpartum Period and the Relationship with Maternal Weight up to One Year after Pregnancy Complicated by Gestational Diabetes.
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Dias LM, Schmidt MI, Vigo Á, and Drehmer M
- Subjects
- Pregnancy, Female, Humans, Cohort Studies, Postpartum Period, Obesity, Weight Gain, Body Mass Index, Diabetes, Gestational
- Abstract
This multicentric cohort study aimed to describe changes in dietary patterns during pregnancy and postpartum and the association with BMI variation at six and twelve months postpartum in women with gestational diabetes mellitus (GDM). Between 2014 and 2018, we enrolled women with GDM in prenatal clinics of the Brazilian National Health System and followed them for one year postpartum. The dietary patterns during pregnancy and the postpartum period were obtained by factorial analysis. The relationship between these patterns and variation in postpartum BMI was evaluated by Poisson regression with robust variance adjusted for confounders. We identified three dietary patterns in 584 women, two healthy (generally healthy and Dash type), which were associated with less weight gain (RR 0.77 CI 95% 0.62-0.96 and RR 0.71 CI 95% 0.57-0.88, respectively). The high-risk pattern (based on ultra-processed, high-calorie foods and sweetened drinks) was associated with weight gain (RR 1.31 CI 95% 1.07-1.61 and RR 1.26 CI 95% 1.01-1.59) in six and twelve months postpartum, respectively. Although the participants learned about healthy dieting during pregnancy, dietary habits worsened from pregnancy to postpartum, especially, with lower consumption of fruits and dairy and higher consumption of sweetened beverages, with consequent weight gain postpartum. Postpartum support is needed to prevent weight gain and obesity.
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- 2023
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13. Advance Care Planning and Goals of Care Discussion: Barriers from the Perspective of Medical Residents.
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Dias LM, Frutig MA, Bezerra MR, Barra WF, Castro L, and Rego F
- Subjects
- Humans, Cross-Sectional Studies, Communication, Palliative Care, Internship and Residency, Advance Care Planning, Neoplasms
- Abstract
Background: Advance care planning (ACP) and goals of care discussion involve the exploration of what is most important to a person to prepare for health-care decision making. Despite their well-established benefits, they are still not frequently performed in clinical oncology practice. This study aims to describe the barriers to discussion goals of care with oncology patients from the perspective of medical residents., Methods: This cross-sectional and qualitative study applied the "Decide-Oncology" questionnaire, adapted to Portuguese language, to assess barriers to goals of care discussion among medical residents from three university hospitals in Brazil. Residents were asked to rank the importance of various barriers to discuss goals of care (ranging from 1-extremely unimportant to 7-extremely important)., Results: Twenty-nine residents answered the questionnaire (30.9%). The most reported barriers were related to patients and their families' difficulty in understanding and accepting the diagnosis and the prognosis as well as patients' desire to receive full active treatment. Furthermore, the physician and external factors such as lack of training and lack of time to have these conversations were also very important barriers. The identification of the key barriers that limit the discussion of ACP and early palliative care referrals can certainly help to prioritize the next steps for future studies aimed at improving ACP and goals of care discussions.
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- 2023
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14. The Effect of Sub-Lethal Successive Applications of Photodynamic Therapy on Candida albicans Biofilm Depends on the Photosensitizer.
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Dias LM, Klein MI, Ferrisse TM, Medeiros KS, Jordão CC, Bellini A, and Pavarina AC
- Abstract
This study aimed to evaluate the potential of successive applications of sub-lethal doses of the antimicrobial photodynamic therapy (aPDT) mediated by Photodithazine
® (PDZ) and curcumin (CUR) associated with LED in the viability, reactive oxygen species (ROS) production, and gene expression of Candida albicans . The microbial assays were performed using planktonic cultures and biofilms. Ten successive applications (Apl#) were performed: aPDT (P+L+; C+L+), photosensitizer (P+L-; C+L-), and LED (P-L+; C-L+). Control groups were used (P-L-; C-L-). The viability of C. albicans was determined by cultivating treated cultures on agar plates with or without fluconazole (FLU). In addition, the ROS detection and expression of SOD1 , CAP1, and ERG11 genes were determined. For planktonic cultures, no viable colonies were observed after Apl#3 (without FLU) and Apl#2 (with FLU) for either photosensitizer. Biofilm treated with P+L+ resulted in the absence of cell viability after Apl#7, while C+L+ showed ~1.40 log10 increase in cell viability after Apl#2, regardless of FLU. For both photosensitizers, after the last application with viable colonies, the production of ROS was higher in the biofilms than in the planktonic cultures, and SOD1 expression was the highest in P+L+. A reduction of CAP1 and ERG11 expression occurred after P+L+, regardless of FLU. C+L+ had a higher level of ROS, and the treatments were non-significant for gene expression. Sub-lethal doses of aPDT mediated by CUR could induce C. albicans resistance in biofilms, while C. albicans cells in biofilms were susceptible to aPDT mediated by PDZ.- Published
- 2023
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15. Efficacy of Antimicrobial Photodynamic Therapy Mediated by Photosensitizers Conjugated with Inorganic Nanoparticles: Systematic Review and Meta-Analysis.
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Ferrisse TM, Dias LM, de Oliveira AB, Jordão CC, Mima EGO, and Pavarina AC
- Abstract
Antimicrobial photodynamic therapy (aPDT) is a method that does not seem to promote antimicrobial resistance. Photosensitizers (PS) conjugated with inorganic nanoparticles for the drug-delivery system have the purpose of enhancing the efficacy of aPDT. The present study was to perform a systematic review and meta-analysis of the efficacy of aPDT mediated by PS conjugated with inorganic nanoparticles. The PubMed, Scopus, Web of Science, Science Direct, Cochrane Library, SciELO, and Lilacs databases were searched. OHAT Rob toll was used to assess the risk of bias. A random effect model with an odds ratio (OR) and effect measure was used. Fourteen articles were able to be included in the present review. The most frequent microorganisms evaluated were Staphylococcus aureus and Escherichia coli , and metallic and silica nanoparticles were the most common drug-delivery systems associated with PS. Articles showed biases related to blinding. Significant results were found in aPDT mediated by PS conjugated with inorganic nanoparticles for overall reduction of microorganism cultured in suspension (OR = 0.19 [0.07; 0.67]/ p -value = 0.0019), E. coli (OR = 0.08 [0.01; 0.52]/ p -value = 0.0081), and for Gram-negative bacteria (OR = 0.12 [0.02; 0.56/ p -value = 0.0071). This association approach significantly improved the efficacy in the reduction of microbial cells. However, additional blinding studies evaluating the efficacy of this therapy over microorganisms cultured in biofilm are required.
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- 2022
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16. Position statement of ANCP and SBGG on shared decision-making in palliative care.
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Vidal EIO, Kovacs MJ, Silva JJD, Silva LMD, Sacardo DP, Bersani ALF, Tommaso ABGD, Dias LM, Melo ACMA, Iglesias SBO, and Lopes FG
- Subjects
- Brazil, Decision Making, Health Personnel, Humans, Geriatrics, Palliative Care methods
- Abstract
Health care for patients with serious illnesses usually implies the need to make a large number of decisions, ranging from how information is shared to which diagnostic or therapeutic procedures will be adopted. The method of such decision-making has important implications from an individual and collective point of view and may contribute to either relieving or aggravating suffering. In this consensus document, the Bioethics Committee of the Brazilian National Academy of Palliative Care (ANCP) and the Permanent Committee on Palliative Care of the Brazilian Geriatrics and Gerontology Society (SBGG) adopt the principles of compassionate listening proposed by Saunders, of the nature of suffering proposed by Cassel, of dignity-preserving care proposed by Chochinov, and of cultural humility as a starting point for the construction of an official position of ANCP and SBGG on shared decision-making in palliative care. The position statement posits that, unlike paternalistic and consumerist models, the decision-making process in the sphere of palliative care must follow the mutualistic model of shared decision, where decisions are built based on dialogue between healthcare professionals and patients/family. The document sets forth the assumptions of this process, the limits of autonomy of patients/family and healthcare professionals and the distinction between futile and potentially inappropriate treatments, besides ratifying its incompatibility with any forms of coercion and conflict of interest foreign to the best interests of patients.
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- 2022
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17. Advance care planning and goals of care discussion: the perspectives of Brazilian oncologists.
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Dias LM, Bezerra MR, Barra WF, Carvalho AEV, Castro L, and Rego F
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- Brazil, Cross-Sectional Studies, Humans, Palliative Care, Advance Care Planning, Oncologists
- Abstract
Background: Advance care planning (ACP) and goals of care discussions are important instruments that enable respect for patient autonomy, especially in patients with a life-threatening disease, such as cancer. Despite their well-established benefits, ACP and goals of care discussions are still not frequently performed in clinical oncology practice. Understanding the barriers to this topic is the first step toward developing future interventions that are more likely to improve professional practice and patient satisfaction with care., Aim: To explore Brazilian oncologists' barriers to discuss goals of care and advance care planning., Methods: A cross-sectional study was developed to identify Brazilian oncologists' barriers to discussing goals of care and ACP. The Decide-Oncology questionnaire was used to identify the importance of these barriers according to oncologists' perceptions. Participants were asked to rank the importance of various barriers to discussing goals of care, ranging from 1 (extremely unimportant) to 7 (extremely important). A quantitative analysis using descriptive statistics was used, including median and interquartile intervals and a qualitative analysis based on Bardin content analysis of the two open questions., Results: Sixty-six oncologists participated in this study. Most of them perceived the patient and family's related barriers as the most important, such as patients' difficulty in understanding their diagnosis and accepting their prognosis. Physician and external related factors, such as lack of training and lack of time for this conversation, were also described as important barriers. Participants with formal training regarding goals of care communication and with experience in palliative care perceived the lack of patients' advanced directives as a significant barrier and manifested more willingness to participate in decision-making about goals of care. The lack of access and of support for referral to palliative care was also considered a significant barrier for ACP and goals of care discussion., Conclusion: The identification of barriers that limit the discussion of ACP and early palliative care referrals can certainly help to prioritise the next steps for future studies aimed at improving ACP and helping clinicians to better support patients through shared decision-making based on the patient's values and experiences., (© 2022. The Author(s).)
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- 2022
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18. Metallated phthalocyanines and their hydrophilic derivatives for multi-targeted oncological photodynamic therapy.
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Dias LM, de Keijzer MJ, Ernst D, Sharifi F, de Klerk DJ, Kleijn TG, Desclos E, Kochan JA, de Haan LR, Franchi LP, van Wijk AC, Scutigliani EM, Fens MH, Barendrecht AD, Cavaco JEB, Huang X, Xu Y, Pan W, den Broeder MJ, Bogerd J, Schulz RW, Castricum KC, Thijssen VL, Cheng S, Ding B, Krawczyk PM, and Heger M
- Subjects
- Animals, Cell Line, Tumor, Chick Embryo, Endothelial Cells, Humans, Liposomes, Mice, Mice, Nude, Photosensitizing Agents pharmacology, Photosensitizing Agents therapeutic use, Tumor Microenvironment, Zebrafish, Cholangiocarcinoma, Organometallic Compounds pharmacology, Organometallic Compounds therapeutic use, Photochemotherapy methods
- Abstract
Background and Aim: A photosensitizer (PS) delivery and comprehensive tumor targeting platform was developed that is centered on the photosensitization of key pharmacological targets in solid tumors (cancer cells, tumor vascular endothelium, and cellular and non-cellular components of the tumor microenvironment) before photodynamic therapy (PDT). Interstitially targeted liposomes (ITLs) encapsulating zinc phthalocyanine (ZnPC) and aluminum phthalocyanine (AlPC) were formulated for passive targeting of the tumor microenvironment. In previous work it was established that the PEGylated ITLs were taken up by cultured cholangiocarcinoma cells. The aim of this study was to verify previous results in cancer cells and to determine whether the ITLs can also be used to photosensitize cells in the tumor microenvironment and vasculature. Following positive results, rudimentary in vitro and in vivo experiments were performed with ZnPC-ITLs and AlPC-ITLs as well as their water-soluble tetrasulfonated derivatives (ZnPCS4 and AlPCS4) to assemble a research dossier and bring this platform closer to clinical transition., Methods: Flow cytometry and confocal microscopy were employed to determine ITL uptake and PS distribution in cholangiocarcinoma (SK-ChA-1) cells, endothelial cells (HUVECs), fibroblasts (NIH-3T3), and macrophages (RAW 264.7). Uptake of ITLs by endothelial cells was verified under flow conditions in a flow chamber. Dark toxicity and PDT efficacy were determined by cell viability assays, while the mode of cell death and cell cycle arrest were assayed by flow cytometry. In vivo systemic toxicity was assessed in zebrafish and chicken embryos, whereas skin phototoxicity was determined in BALB/c nude mice. A PDT efficacy pilot was conducted in BALB/c nude mice bearing human triple-negative breast cancer (MDA-MB-231) xenografts., Results: The key findings were that (1) photodynamically active PSs (i.e., all except ZnPCS4) were able to effectively photosensitize cancer cells and non-cancerous cells; (2) following PDT, photodynamically active PSs were highly toxic-to-potent as per anti-cancer compound classification; (3) the photodynamically active PSs did not elicit notable systemic toxicity in zebrafish and chicken embryos; (4) ITL-delivered ZnPC and ZnPCS4 were associated with skin phototoxicity, while the aluminum-containing PSs did not exert detectable skin phototoxicity; and (5) ITL-delivered ZnPC and AlPC were equally effective in their tumor-killing capacity in human tumor breast cancer xenografts and superior to other non-phthalocyanine PSs when appraised on a per mole administered dose basis., Conclusions: AlPC(S4) are the safest and most effective PSs to integrate into the comprehensive tumor targeting and PS delivery platform. Pending further in vivo validation, these third-generation PSs may be used for multi-compartmental tumor photosensitization., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
- Published
- 2022
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19. Efficacy of curcumin-mediated antibacterial photodynamic therapy for oral antisepsis: A systematic review and network meta-analysis of randomized clinical trials.
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Ferrisse TM, Dias LM, de Oliveira AB, Jordão CC, Mima EGO, and Pavarina AC
- Subjects
- Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Antisepsis, Biofilms, Network Meta-Analysis, Photosensitizing Agents therapeutic use, Randomized Controlled Trials as Topic, Anti-Infective Agents therapeutic use, Curcumin pharmacology, Curcumin therapeutic use, Photochemotherapy methods
- Abstract
Background: The presence of oral microorganisms resistant to traditional treatment is increasing, thus a search for new therapies is needed. In this context, antimicrobial photodynamic therapy (aPDT) is an approach for the treatment of antibiotic resistant andnon resistant microorganisms. Therefore, the aim of the present study was to conduct a systematic review and meta-analysis of randomized clinical trials of aPDT for oral antisepsis against oral polymicrobial biofilms., Methods: PubMed, Science Direct, Scopus, SciELO, Lilacs, Cochrane Library and Embase databases were searched. In total, five articles were included for qualitative analysis and four articles were used for quantitative analyses. Bias assessment of the eligible articles was made using the RoB 2 criteria. Network meta-analysis was performed using the random-effect model. Subgroup's analysis was also conducted. The groups evaluated were aPDT, exposure to light only and no treatment at all (control group). The quality of evidence was assessed by CINeMA approach., Results: aPDT mediated by curcumin had significant results in the reducing bacterial load (0.31-0.49 log
10 UFC/ I2 =0%) when compared with the control group. The included articles were classified as low risk of bias, despite biases detected by allocation and blinding. Moreover, quantitative analysis between aPDT and control group and between light and control group were classified with low risk of confidence rating, while the results from aPDT versus light were classified as moderate risk of confidence rating., Conclusion: aPDT has significant efficacy for oral antisepsis, however more randomized clinical trials will be needed to validate the present results., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022. Published by Elsevier B.V.)- Published
- 2022
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20. Xylanase Production by Talaromyces amestolkiae Valuing Agroindustrial Byproducts.
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Barbieri GS, Bento HBS, de Oliveira F, Picheli FP, Dias LM, Masarin F, and Santos-Ebinuma VC
- Abstract
In general, agroindustrial byproducts can be easily assimilated by several microorganisms due to their composition, which is rich in carbohydrates. Therefore, they could be appropriate for use as raw materials in a sustainable refinery concept, including the production of hydrolytic enzymes with industrial applicability. In this work, xylanase production by the filamentous fungi Talaromyces amestolkiae in submerged culture was evaluated using five agroindustrial byproducts, namely, wheat bran, citrus pulp, rice bran, peanut skin, and peanut shell. Firstly, the aforementioned byproducts were characterized in terms of cellulose, xylan, lignin, and extractives. Next, production studies were performed, and wheat bran generated the highest enzymatic activity (5.4 U·mL
-1 ), probably because of its large amount of xylan. Subsequently, a factorial design was performed to evaluate the independent variables yeast extract, wheat bran, K2 HPO4 , and pH, aiming to improve the variable response, xylanase activity. The condition that promoted the highest production, 13.02 U·mL-1 (141% higher than the initial condition), was 20 g·L-1 wheat bran, 2.5 g·L-1 yeast extract, 3 g·L-1 K2 HPO4 , and pH 7. Thus, industrial byproducts with a high content of xylan can be used as a culture medium to produce xylanase enzymes with a Talaromyces strain through an economical and sustainable approach.- Published
- 2022
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21. Use of Photodynamic Therapy Associated with Antimicrobial Peptides for Bacterial Control: A Systematic Review and Meta-Analysis.
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Dias LM, Ferrisse TM, Medeiros KS, Cilli EM, and Pavarina AC
- Subjects
- Anti-Bacterial Agents, Antimicrobial Peptides, Biofilms, Gram-Negative Bacteria, Gram-Positive Bacteria, Photosensitizing Agents pharmacology, Photosensitizing Agents therapeutic use, Anti-Infective Agents therapeutic use, Photochemotherapy methods
- Abstract
Considering the challenges related to antimicrobial resistance, other strategies for controlling infections have been suggested, such as antimicrobial photodynamic therapy (aPDT) and antimicrobial peptides (AMP). This study aims to perform a systematic review and meta-analysis to obtain evidence on the antimicrobial effectiveness of aPDT associated with AMP and establish in vitro knowledge on this topic for further study designs. The PubMed, Scopus, Web of Science, Science Direct, Scielo, and Cochrane Library databases were searched. Two independent and calibrated researchers (Kappa = 0.88) performed all the systematic steps according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The odds ratio (OR) was used as the effect measure. The Peto method was used to perform the meta-analysis due to the sparse data. Twenty studies were included in the present review. The result was significant (OR = 0.14/ p = 0.0235/I-squared = 0%), showing better outcomes of aPDT associated with peptides than those of aPDT alone for controlling the microbial load. Only 20% of the studies included evaluated this approach in a biofilm culture. Combined treatment with aPDT and AMP highly increased the ability of microbial reduction of Gram-positive and Gram-negative bacteria. However, additional blind studies are required to evaluate the efficacy of this therapy on microbial biofilms.
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- 2022
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22. CTX-M-15-producing Klebsiella pneumoniae ST273 associated with nasal infection in a domestic cat.
- Author
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Silva CP, Oliveira CJB, Leite EL, Cibulski SP, Fernandes M, Vasconcelos PC, Dias LM, Silva NMVD, Garino Júnior F, and Fernandes ACC
- Subjects
- Animals, Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents therapeutic use, Cats, Drug Resistance, Multiple, Bacterial genetics, Male, Multilocus Sequence Typing, beta-Lactamases genetics, Klebsiella Infections drug therapy, Klebsiella Infections veterinary, Klebsiella pneumoniae
- Abstract
Objectives: The aim of this study was to investigate the genetic context of expanded-spectrum β-lactam resistance in a Klebsiella pneumoniae strain causing a hard-to-treat nasal infection in a domestic cat., Methods: A K. pneumoniae isolate was recovered from a 4-year-old male cat hospitalised in a veterinary hospital in Paraíba, Northeastern Brazil. Following phenotypic confirmation of multidrug resistance by the disk diffusion method, the genome was sequenced using an Illumina MiSeq system. Multilocus sequence typing (MLST) and structural features related to antimicrobial resistance were determined by downstream bioinformatics analyses., Results: The strain was confirmed as sequence type 273 (ST273) K. pneumoniae harbouring a variety of genes conferring antimicrobial resistance to phenicols tetracyclines, aminoglycosides, β-lactams, fosfomycin, sulfonamides and quinolones. Two plasmids were identified. Plasmid p114PB_I co-harboured a set of plasmid-borne resistance genes [bla
CTX-M-15 , blaTEM-1 , qnrS1, tetD, tetR, sul2, aph(6)-Id, aph(3'') and cat2]. Notably, the multiresistance region was characterised as a chimeric plasmid structure sharing high sequence homology with several plasmids from Enterobacteriaceae. The second plasmid (p114PB_II) was characterised as a plasmid present in many genomes belonging to K. pneumoniae., Conclusion: The genetic context of the plasmid sequences harboured by a veterinary pathogenic K. pneumoniae isolate reveals the high complexity of horizontal gene transfer mechanisms in the acquisition of antimicrobial resistance genes. The emergence, dissemination and evolution of antimicrobial resistance must be investigated from a One Health perspective., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)- Published
- 2022
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23. Strategies for Improving Photodynamic Therapy Through Pharmacological Modulation of the Immediate Early Stress Response.
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de Klerk DJ, de Keijzer MJ, Dias LM, Heemskerk J, de Haan LR, Kleijn TG, Franchi LP, and Heger M
- Subjects
- Cell Death, Humans, Reactive Oxygen Species metabolism, Signal Transduction, Neoplasms pathology, Photochemotherapy methods
- Abstract
Photodynamic therapy (PDT) is a minimally to noninvasive treatment modality that has emerged as a promising alternative to conventional cancer treatments. PDT induces hyperoxidative stress and disrupts cellular homeostasis in photosensitized cancer cells, resulting in cell death and ultimately removal of the tumor. However, various survival pathways can be activated in sublethally afflicted cancer cells following PDT. The acute stress response is one of the known survival pathways in PDT, which is activated by reactive oxygen species and signals via ASK-1 (directly) or via TNFR (indirectly). The acute stress response can activate various other survival pathways that may entail antioxidant, pro-inflammatory, angiogenic, and proteotoxic stress responses that culminate in the cancer cell's ability to cope with redox stress and oxidative damage. This review provides an overview of the immediate early stress response in the context of PDT, mechanisms of activation by PDT, and molecular intervention strategies aimed at inhibiting survival signaling and improving PDT outcome., (© 2022. Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2022
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24. Inhibition of the HIF-1 Survival Pathway as a Strategy to Augment Photodynamic Therapy Efficacy.
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de Keijzer MJ, de Klerk DJ, de Haan LR, van Kooten RT, Franchi LP, Dias LM, Kleijn TG, van Doorn DJ, and Heger M
- Subjects
- Cell Survival, Humans, Hypoxia-Inducible Factor 1 genetics, Photosensitizing Agents pharmacology, Photosensitizing Agents therapeutic use, Reactive Oxygen Species metabolism, Neoplasms drug therapy, Neoplasms pathology, Photochemotherapy methods
- Abstract
Photodynamic therapy (PDT) is a non-to-minimally invasive treatment modality that utilizes photoactivatable drugs called photosensitizers to disrupt tumors with locally photoproduced reactive oxygen species (ROS). Photosensitizer activation by light results in hyperoxidative stress and subsequent tumor cell death, vascular shutdown and hypoxia, and an antitumor immune response. However, sublethally afflicted tumor cells initiate several survival mechanisms that account for decreased PDT efficacy. The hypoxia inducible factor 1 (HIF-1) pathway is one of the most effective cell survival pathways that contributes to cell recovery from PDT-induced damage. Several hundred target genes of the HIF-1 heterodimeric complex collectively mediate processes that are involved in tumor cell survival directly and indirectly (e.g., vascularization, glucose metabolism, proliferation, and metastasis). The broad spectrum of biological ramifications culminating from the activation of HIF-1 target genes reflects the importance of HIF-1 in the context of therapeutic recalcitrance. This chapter elaborates on the involvement of HIF-1 in cancer biology, the hypoxic response mechanisms, and the role of HIF-1 in PDT. An overview of inhibitors that either directly or indirectly impede HIF-1-mediated survival signaling is provided. The inhibitors may be used as pharmacological adjuvants in combination with PDT to augment therapeutic efficacy., (© 2022. Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2022
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25. Lactobacillus casei reduces the extracellular matrix components of fluconazole-susceptible Candida albicans biofilms.
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Panariello BHD, Klein MI, Dias LM, Bellini A, Costa VB, Barbugli PA, and Pavarina AC
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- Biofilms, Extracellular Matrix, Fluconazole pharmacology, Candida albicans, Lacticaseibacillus casei
- Abstract
Fluconazole-sensitive (CaS) and -resistant (CaR) C. albicans were grown as single-species and dual-species biofilms with Lactobacillus casei (Lc) and Lactobacillus rhamnosus (Lr). Single-species Lc and Lr were also evaluated. Biofilm analysis included viable plate counts, the extracellular matrix components, biomass, and structural organization. Lc reduced the viability of CaS, water-soluble polysaccharides, and eDNA in CaS + Lc biofilm. Lc biofilm presented more eDNA than CaS. The total biomass of CaS + Lc biofilm was higher than the single-species biofilms. The viability of Lc and Lr was reduced by CaR dual-species biofilms. The total and insoluble biomass in CaS + Lr was higher than in single-species CaS biofilms. Lc hindered the growth of CaS, and their association hampered matrix components linked to the structural integrity of the biofilm. These findings allow understanding of how the implementation of probiotics influences the growth of C. albicans biofilms and thereby helps with the development of novel approaches to control these biofilms.
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- 2021
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26. First report of a livestock-associated methicillin-resistant Staphylococcus aureus ST126 harbouring the mecC variant in Brazil.
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Silva JG, Araujo WJ, Leite EL, Dias LM, Vasconcelos PC, Silva NMV, Oliveira RP, Sena MJ, Oliveira CJB, and Mota RA
- Subjects
- Animals, Brazil epidemiology, Cattle, Female, Penicillin-Binding Proteins genetics, Staphylococcal Infections diagnosis, Staphylococcal Infections epidemiology, Virulence genetics, Cattle Diseases diagnosis, Cattle Diseases epidemiology, Methicillin-Resistant Staphylococcus aureus genetics, Methicillin-Resistant Staphylococcus aureus isolation & purification, Methicillin-Resistant Staphylococcus aureus pathogenicity, Staphylococcal Infections veterinary
- Abstract
Staphylococcus aureus is a versatile and highly adaptable pathogen associated with a wide range of infectious diseases in humans and animals. In the last decades, concern has increased worldwide due to the emergence and spread of methicillin-resistant S. aureus (MRSA) strains shortly after this drug became a therapeutic option. In this study, we report the genomic features of the first mecC-mediated, β-lactam resistant MRSA strain associated with livestock in Brazil and in the American continent. Three clonally related phenotypic MRSA isolates originated from a dairy herd were confirmed by polymerase chain reaction as mecC-harbouring MRSA isolates. Whole-genome sequencing was performed by Illumina Miseq platform. Downstream analyses showed that the strain was identified as the sequence type 126 (ST126) and spa type t605. In silico analysis revealed a mecC homolog gene in the orfX region associated with different penicillin-binding proteins. Moreover, genes encoding for efflux pump systems (arlR, mepR, LmrS, norA and mgrA), and antibiotic inactivation enzymes (blaZ and FosB) were also detected. Virulence analyses revealed that the strain harbours genes encoding for exoenzymes (aur, splA, splB and splE), toxin (hlgA, hlgB, hlgC, lukD and lukE) and enterotoxin (sea). The epidemiologic and genomic information provided by this study will support further epidemiological and evolutionary investigations to understand the origin and dissemination of mecC-MRSA among animals and its impact on public health., (© 2020 Wiley-VCH GmbH.)
- Published
- 2021
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27. Refusal of medical treatment by older adults with cancer: a systematic review.
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Dias LM, Bezerra MR, Barra WF, and Rego F
- Subjects
- Aged, Databases, Factual, Humans, Neoplasm Staging, Breast Neoplasms, Treatment Refusal
- Abstract
The literature about the factors associated with cancer treatment refusal, especially by the older patients is scarce. Therefore, this study aimed to identify predictive factors associated with treatment refusal by older patients with cancer. A systematic review was conducted using three databases, Medline, Web of Science, and Scopus with the key concepts, "refusal treatment" and "cancer" and "decision making" and "elderly" or "aged". The search took place in July 2020 and it included articles published in the last 5 years. Of the 211 articles found, 22 were included in the review. Most studies have focused on head and neck and breast cancer treatment decisions and used a quantitative design. The majority of studies evaluated refusal of surgery interventions. Important factors associated with refusal cancer treatment include gender, marital status, race, having government insurance, advanced cancer, poor performance status (cancer stage III or IV) and Charlson Comorbidity Index ≥2. Thus, there are socio-demographic and clinical variables associated with treatment refusal. More studies with the elderly are needed. Understanding these factors may be useful to recognize situations where active education and support can help elderly patients accept optimal care.
- Published
- 2021
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28. CODON-Software to manual curation of prokaryotic genomes.
- Author
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Merlin B, Castro Alves JT, de Sá PHCG, de Oliveira MS, Dias LM, da Silva Moia G, Cardoso Dos Santos V, and Veras AAO
- Subjects
- Databases, Genetic, User-Computer Interface, Bacteria genetics, Genomics methods, Molecular Sequence Annotation methods, Software
- Abstract
Genome annotation conceptually consists of inferring and assigning biological information to gene products. Over the years, numerous pipelines and computational tools have been developed aiming to automate this task and assist researchers in gaining knowledge about target genes of study. However, even with these technological advances, manual annotation or manual curation is necessary, where the information attributed to the gene products is verified and enriched. Despite being called the gold standard process for depositing data in a biological database, the task of manual curation requires significant time and effort from researchers who sometimes have to parse through numerous products in various public databases. To assist with this problem, we present CODON, a tool for manual curation of genomic data, capable of performing the prediction and annotation process. This software makes use of a finite state machine in the prediction process and automatically annotates products based on information obtained from the Uniprot database. CODON is equipped with a simple and intuitive graphic interface that assists on manual curation, enabling the user to decide about the analysis based on information as to identity, length of the alignment, and name of the organism in which the product obtained a match. Further, visual analysis of all matches found in the database is possible, impacting significantly in the curation task considering that the user has at his disposal all the information available for a given product. An analysis performed on eleven organisms was used to test the efficiency of this tool by comparing the results of prediction and annotation through CODON to ones from the NCBI and RAST platforms., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2021
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29. Health personnel, family relationships and codependency of psychoactive substances: a phenomenological approach.
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Dias LM, Alves MDS, Pereira MO, Melo LD, Assis CCG, and Spindola T
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- Brazil, Family, Health Personnel, Humans, Codependency, Psychological, Family Relations
- Abstract
Objectives: to reflect on the daily life of family members dependent on psychoactive substances and the role of health professionals in Primary Care., Methods: a descriptive investigation outlined in Maffesoli's phenomenological approach, carried out at a Basic Health Unit in Minas Gerais with eight family members dependent on psychoactive substances. Sociodemographic characterization data and in-depth interviews were collected and analyzed with support of NVivo Pro11® software. All ethical and legal aspects were met., Results: physicians were the professionals most mentioned in participants' statements, who took on a dubious role with other health professionals: welcoming (positive perceptions about care received) and neglect (negative perceptions)., Final Considerations: dependence on psychoactive substances imposes a burden on persons, their family members and health professionals. The role of establishing good relationships in the triad professionals-users-family members of primary care is inseparable in favor of treatment and preservation of their mental health.
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- 2021
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30. Attritional evaluation of lipophilic and hydrophilic metallated phthalocyanines for oncological photodynamic therapy.
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Dias LM, Sharifi F, de Keijzer MJ, Mesquita B, Desclos E, Kochan JA, de Klerk DJ, Ernst D, de Haan LR, Franchi LP, van Wijk AC, Scutigliani EM, Cavaco JEB, Tedesco AC, Huang X, Pan W, Ding B, Krawczyk PM, and Heger M
- Subjects
- Antineoplastic Agents pharmacology, Apoptosis radiation effects, Cell Line, Tumor, Cell Membrane Permeability, Dose-Response Relationship, Radiation, Drug Liberation, Humans, Indoles pharmacology, Isoindoles, Photochemotherapy, Photosensitizing Agents pharmacology, Structure-Activity Relationship, Time Factors, Antineoplastic Agents chemistry, Drug Carriers chemistry, Indoles chemistry, Liposomes chemistry, Photosensitizing Agents chemistry
- Abstract
Background and Aim: Oncological photodynamic therapy (PDT) relies on photosensitizers (PSs) to photo-oxidatively destroy tumor cells. Currently approved PSs yield satisfactory results in superficial and easy-to-access tumors but are less suited for solid cancers in internal organs such as the biliary system and the pancreas. For these malignancies, second-generation PSs such as metallated phthalocyanines are more appropriate. Presently it is not known which of the commonly employed metallated phtahlocyanines, namely aluminum phthalocyanine (AlPC) and zinc phthalocyanine (ZnPC) as well as their tetrasulfonated derivatives AlPCS4 and ZnPCS4, is most cytotoxic to tumor cells. This study therefore employed an attritional approach to ascertain the best metallated phthalocyanine for oncological PDT in a head-to-head comparative analysis and standardized experimental design., Methods: ZnPC and AlPC were encapsulated in PEGylated liposomes. Analyses were performed in cultured A431 cells as a template for tumor cells with a dysfunctional P53 tumor suppressor gene and EGFR overexpression. First, dark toxicity was assessed as a function of PS concentration using the WST-1 and sulforhodamine B assay. Second, time-dependent uptake and intracellular distribution were determined by flow cytometry and confocal microscopy, respectively, using the intrinsic fluorescence of the PSs. Third, the LC
50 values were established for each PS at 671 nm and a radiant exposure of 15 J/cm2 following 1-h PS exposure. Finally, the mode of cell death as a function of post-PDT time and cell cycle arrest at 24 h after PDT were analyzed., Results: In the absence of illumination, AlPC and ZnPC were not toxic to cells up to a 1.5-μM PS concentration and exposure for up to 72 h. Dark toxicity was noted for AlPCS4 at 5 μM and ZnPCS4 at 2.5 μM. Uptake of all PSs was observed as early as 1 min after PS addition to cells and increased in amplitude during a 2-h incubation period. After 60 min, the entire non-nuclear space of the cell was photosensitized, with PS accumulation in multiple subcellular structures, especially in case of AlPC and AlPCS4. PDT of cells photosensitized with ZnPC, AlPC, and AlPCS4 yielded LC50 values of 0.13 μM, 0.04 μM, and 0.81 μM, respectively, 24 h post-PDT (based on sulforhodamine B assay). ZnPCS4 did not induce notable phototoxicity, which was echoed in the mode of cell death and cell cycle arrest data. At 4 h post-PDT, the mode of cell death comprised mainly apoptosis for ZnPC and AlPC, the extent of which was gradually exacerbated in AlPC-photosensitized cells during 8 h. ZnPC-treated cells seemed to recover at 8 h post-PDT compared to 4 h post-PDT, which had been observed before in another cell line. AlPCS4 induced considerable necrosis in addition to apoptosis, whereby most of the cell death had already manifested at 2 h after PDT. During the course of 8 h, necrotic cell death transitioned into mainly late apoptotic cell death. Cell death signaling coincided with a reduction in cells in the G0 /G1 phase (ZnPC, AlPC, AlPCS4) and cell cycle arrest in the S-phase (ZnPC, AlPC, AlPCS4) and G2 phase (ZnPC and AlPC). Cell cycle arrest was most profound in cells that had been photosensitized with AlPC and subjected to PDT., Conclusions: Liposomal AlPC is the most potent PS for oncological PDT, whereas ZnPCS4 was photodynamically inert in A431 cells. AlPC did not induce dark toxicity at PS concentrations of up to 1.5 μM, i.e., > 37 times the LC50 value, which is favorable in terms of clinical phototoxicity issues. AlPC photosensitized multiple intracellular loci, which was associated with extensive, irreversible cell death signaling that is expected to benefit treatment efficacy and possibly immunological long-term tumor control, granted that sufficient AlPC will reach the tumor in vivo. Given the differential pharmacokinetics, intracellular distribution, and cell death dynamics, liposomal AlPC may be combined with AlPCS4 in a PS cocktail to further improve PDT efficacy., (Copyright © 2021 Elsevier B.V. All rights reserved.)- Published
- 2021
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31. Consecutive treatments with photodynamic therapy and nystatin altered the expression of virulence and ergosterol biosynthesis genes of a fluconazole-resistant Candida albicans in vivo.
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Jordão CC, Klein MI, Carmello JC, Dias LM, and Pavarina AC
- Subjects
- Animals, Antifungal Agents pharmacology, Antifungal Agents therapeutic use, Candida albicans genetics, Ergosterol, Mice, Nystatin pharmacology, Photosensitizing Agents pharmacology, Photosensitizing Agents therapeutic use, Virulence, Fluconazole pharmacology, Photochemotherapy methods
- Abstract
This investigation assessed the effect of five consecutive daily topical treatments of antimicrobial photodynamic therapy (aPDT), nystatin (NYS), and an association of treatments on a fluconazole-resistant strain of Candida albicans colonizing the tongues of mice. After the last treatments application, colonies of C. albicans were recovered from the tongues and used to determine their fluconazole susceptibility. After 24 hours of the last treatment, the mice tongues were processed to evaluate the expression of C. albicans genes related to the virulence and ergosterol production. The fluconazole susceptibility test yielded a resistance profile similar for all treatment groups and the control group (no treatment). The treatments aPDT, NYS, NYS+aPDT, and aPDT+NYS promoted a reduction in ALS1, EFG1, CAP1, SOD1, SAP1, and LIP3 expression. The expression of HWP1 was higher in the three groups containing nystatin. In contrast, the treatments produced a significative increase in CAT1 gene expression, mainly in the groups in which aPDT was performed. The expression of genes related to ergosterol production was significantly reduced by the treatments evaluated (aPDT, NYS, NYS+aPDT, and aPDT+NYS). Thus, the consecutive topical treatments performed on mice tongues promoted a reduction in the expression of virulence and ergosterol biosynthesis genes of a fluconazole-resistant C. albicans., (Copyright © 2021 Elsevier B.V. All rights reserved.)
- Published
- 2021
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32. Successive applications of Antimicrobial Photodynamic Therapy effects the susceptibility of Candida albicans grown in medium with or without fluconazole.
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Dias LM, Klein MI, Jordão CC, Carmello JC, Bellini A, and Pavarina AC
- Subjects
- Antifungal Agents pharmacology, Biofilms, Candida albicans, Fluconazole pharmacology, Photosensitizing Agents pharmacology, Anti-Infective Agents, Photochemotherapy methods
- Abstract
Antimicrobial Photodynamic Therapy (aPDT) was introduced as a therapy due to resistance that microorganisms have developed to conventional drugs. The study aimed to evaluate the potential of successive applications of aPDT in effecting Candida albicans susceptibility and also whether the presence of fluconazole effected the recovery of the fungi in the culture medium. Planktonic cultures and biofilm were subjected to successive applications of Photodithazine-mediated (25 mg/L) LED-associated aPDT (660 nm, 34 mW/cm
2 ). Plating was performed on Sabouraud Dextrose Agar supplemented or not with fluconazole to recover colony-forming units per milliliter (CFU/mL). Surviving cells were recovered, recultivated, and again exposed to the treatment. The treatments were performed until not enough colonies were available for recultivation and continuation of the protocol. The complete inactivation of the fungus was obtained after three and five applications for planktonic culture and biofilm, respectively. A reduction of 6.3 log10 was observed after third applications in the planktonic cultures grown on medium without fluconazole, while there was a 7 log10 reduction of these cultures grown on fluconazole medium. However, a reduction of 6.1 log10 occurred for biofilms after fifth applications for cultures grown on medium without fluconazole, while a reduction of 6.7 log10 was observed for cultures grown on medium with the antifungal. Thus, aPDT was potentiated by fluconazole. C. albicans in planktonic and biofilm cultures are susceptible to successive applications of PDZ-mediated aPDT, and tolerance to aPDT is higher in the biofilm., (Copyright © 2020 Elsevier B.V. All rights reserved.)- Published
- 2020
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33. Antimicrobial photodynamic therapy effectiveness against susceptible and methicillin-resistant Staphylococcus aureus biofilms.
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Teixeira CGS, Sanitá PV, Ribeiro APD, Dias LM, Jorge JH, and Pavarina AC
- Subjects
- Dose-Response Relationship, Drug, Microscopy, Confocal, Biofilms drug effects, Curcumin pharmacology, Methicillin-Resistant Staphylococcus aureus drug effects, Photochemotherapy methods, Photosensitizing Agents pharmacology
- Abstract
Background: Staphylococcus aureus have a great ability to become rapidly resistant to conventional antimicrobial therapies. This study evaluated the efficacy of antimicrobial photodynamic therapy (aPDT) mediated by Curcumin (Cur) and light-emitting diode (LED) in the inactivation of biofilms of methicillin susceptible and resistant S. aureus (MSSA and MRSA, respectively)., Methods: Biofilms were treated with Cur (20, 40 or 80 μM) and illuminated with LED source (455 ± 3 nm; 5.28 J/cm
2 ) (aPDT groups), or treated either with Cur or LED only. Other samples were not exposed to Cur or LED (negative control). The biofilms viability after all experimental conditions were evaluated by counting the number of colonies (CFU/mL) and XTT assay. Additional samples were also evaluated by LIVE/DEAD® staining using confocal laser scanning microscopy (CLSM). Data were analyzed by ANOVAs followed by the Games-Howell post hoc test (α = 0.05)., Results: For both strains, all aPDT groups significantly reduced both CFU/mL and metabolic activity of biofilms compared to the negative control (p < 0.001). The results were enhanced when 80 μM of Cur was used. CLSM images showed that both bacteria biofilms submitted to aPDT had a large number of red-stained colonies, especially at aPDT80. In general, MRSA biofilms tended to be less susceptible to aPDT than MSSA biofilms., Conclusions: It can be concluded that aPDT mediated by Cur and LED was an efficient method to inactivate 48 -h biofilms of both S. aureus strains., Competing Interests: Declarations of interest All authors declare that they have no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)- Published
- 2020
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34. Functional annotation of hypothetical proteins from the Exiguobacterium antarcticum strain B7 reveals proteins involved in adaptation to extreme environments, including high arsenic resistance.
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da Costa WLO, Araújo CLA, Dias LM, Pereira LCS, Alves JTC, Araújo FA, Folador EL, Henriques I, Silva A, and Folador ARC
- Subjects
- Bacterial Proteins genetics, Biotechnology methods, Computational Biology, Extreme Environments, Genes, Bacterial genetics, Sequence Analysis, DNA, Adaptation, Physiological, Arsenic toxicity, Bacillaceae physiology, Bacterial Proteins physiology, Molecular Sequence Annotation
- Abstract
Exiguobacterium antarcticum strain B7 is a psychrophilic Gram-positive bacterium that possesses enzymes that can be used for several biotechnological applications. However, many proteins from its genome are considered hypothetical proteins (HPs). These functionally unknown proteins may indicate important functions regarding the biological role of this bacterium, and the use of bioinformatics tools can assist in the biological understanding of this organism through functional annotation analysis. Thus, our study aimed to assign functions to proteins previously described as HPs, present in the genome of E. antarcticum B7. We used an extensive in silico workflow combining several bioinformatics tools for function annotation, sub-cellular localization and physicochemical characterization, three-dimensional structure determination, and protein-protein interactions. This genome contains 2772 genes, of which 765 CDS were annotated as HPs. The amino acid sequences of all HPs were submitted to our workflow and we successfully attributed function to 132 HPs. We identified 11 proteins that play important roles in the mechanisms of adaptation to adverse environments, such as flagellar biosynthesis, biofilm formation, carotenoids biosynthesis, and others. In addition, three predicted HPs are possibly related to arsenic tolerance. Through an in vitro assay, we verified that E. antarcticum B7 can grow at high concentrations of this metal. The approach used was important to precisely assign function to proteins from diverse classes and to infer relationships with proteins with functions already described in the literature. This approach aims to produce a better understanding of the mechanism by which this bacterium adapts to extreme environments and to the finding of targets with biotechnological interest., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2018
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35. Biomass sorghum as a novel substrate in solid-state fermentation for the production of hemicellulases and cellulases by Aspergillus niger and A. fumigatus.
- Author
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Dias LM, Dos Santos BV, Albuquerque CJB, Baeta BEL, Pasquini D, and Baffi MA
- Subjects
- Biomass, Cellulases metabolism, Cellulose metabolism, Dietary Fiber metabolism, Xylosidases metabolism, beta-Glucosidase metabolism, Aspergillus fumigatus metabolism, Aspergillus niger metabolism, Cellulase biosynthesis, Fermentation, Glycoside Hydrolases biosynthesis, Sorghum metabolism
- Abstract
Aims: We investigated the role of carbon and nitrogen sources in the production of cellulase and hemicellulase by Aspergillus strains., Methods and Results: The strains Aspergillus niger SCBM1 and Aspergillus fumigatus SCBM6 were cultivated under solid-state fermentation (SSF), with biomass sorghum (BS) and wheat bran (WB) as lignocellulosic substrates, in different proportions, along with variable nitrogen sources. The best SSF condition for the induction of such enzymes was observed employing A. niger SCBM1 in BS supplemented with peptone; maximum production levels were achieved as follows: 72 h of fermentation for xylanase and exoglucanase (300·07 and 30·64 U g
-1 respectively), 120 h for β-glucosidase and endoglucanase (54·90 and 41·47 U g-1 respectively) and 144 h for β-xylosidase (64·88 U g-1 )., Conclusions: This work demonstrated the viability of the use of BS for the production of hemi- and cellulolytic enzymes; the high concentration of celluloses in BS could be associated with the significant production of cellulases, mainly exoglucanase., Significance and Impact of the Study: This is the first study which presents the promising use of biomass sorghum (genetically modified sorghum to increase its biomass content) as an alternative carbon source for the production of enzymes by SSF., (© 2017 The Society for Applied Microbiology.)- Published
- 2018
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36. Genomic Architecture of the Two Cold-Adapted Genera Exiguobacterium and Psychrobacter: Evidence of Functional Reduction in the Exiguobacterium antarcticum B7 Genome.
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Dias LM, Folador ARC, Oliveira AM, Ramos RTJ, Silva A, and Baraúna RA
- Subjects
- Cold Temperature, Phylogeny, Sequence Analysis, DNA, Adaptation, Physiological genetics, Bacillales genetics, Genome, Bacterial genetics, Psychrobacter genetics
- Abstract
Exiguobacterium and Psychrobacter are bacterial genera with several cold-adapted species. These extremophiles are commonly isolated from the same habitats in Earth's cryosphere and have great ecological and biotechnological relevance. Thus, through comparative genomic analyses, it was possible to understand the functional diversity of these psychrotrophic and psychrophilic species and present new insights into the microbial adaptation to cold. The nucleotide identity between Exiguobacterium genomes was >90%. Three genomic islands were identified in the E. antarcticum B7 genome. These islands contained genes involved in flagella biosynthesis and chemotaxis, as well as enzymes for carotenoid biosynthesis. Clustering of cold shock proteins by Ka/Ks ratio suggests the occurrence of a positive selection over these genes. Neighbor-joining clustering of complete genomes showed that the E. sibiricum was the most closely related to E. antarcticum. A total of 92 genes were shared between Exiguobacterium and Psychrobacter. A reduction in the genomic content of E. antarcticum B7 was observed. It presented the smallest genome size of its genus and a lower number of genes because of the loss of many gene families compared with the other genomes. In our study, eight genomes of Exiguobacterium and Psychrobacter were compared and analysed. Psychrobacter showed higher genomic plasticity and E. antarcticum B7 presented a large decrease in genomic content without changing its ability to grow in cold environments.
- Published
- 2018
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37. Whole-Genome Sequence of Corynebacterium pseudotuberculosis PA04, Isolated from the Lymph Node of a Sheep in the Amazon, Brazil.
- Author
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Costa WLO, Alves JTC, Dias LM, Araújo CLA, Morais E, Silva AGM, Andrade SS, Ramos RTJ, Silva A, and Folador ARC
- Abstract
This study reports the complete genome sequence of Corynebacterium pseudotuberculosis strain PA04, isolated from a sheep in the Amazon, Brazil. This bacterium is the etiological agent of caseous lymphadenitis. This genome contains 2,338,093 bp, 52.2% G+C content, and a total of 2,104 coding sequences (CDSs), 41 pseudogenes, 12 rRNAs, and 49 tRNAs., (Copyright © 2017 Costa et al.)
- Published
- 2017
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38. Experimental Model for Sutureless Proximal Anastomosis by the Viabahn Open Revascularization TEChnique (VORTEC).
- Author
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Freire LM, Gobbi GB, Dal Fabbro IM, and Menezes FH
- Subjects
- Animals, Feasibility Studies, Female, Models, Animal, Swine, Tensile Strength, Anastomosis, Surgical methods, Aorta, Abdominal surgery, Blood Vessel Prosthesis Implantation methods, Suture Techniques
- Abstract
Introduction: In the treatment of complex aneurysms, debranching is an extra-anatomical revascularization of visceral arteries followed by endograft coverage of the thoracoabdominal aorta. It eliminates the need for a thoracotomy and aortic clamping, but requires the performance of several technically demanding visceral anastomosis. In 2008, Lachat described visceral revascularization with the use of a sutureless distal anastomosis, performed by the telescoping of an endograft in the visceral branch, named VORTEC (Viabahn Open Revascularization TEChnique)., Objective: An experimental model was created to test the feasibility and short term results of performing a telescoped proximal anastomosis to the abdominal aorta., Methods: Swine model. The abdominal aorta was dissected and ligated between the renal arteries and the iliac vessels. Three centimeters bellow the renal arteries a Viabahn endograft was telescoped for 2 cm into the proximal aorta. The other extremity was conventionally anastomosed to the distal aorta. Patency, sealing and tensile strength of the anastomosis were tested., Results: Time for performing the telescoped anastomosis was shorter (5.4±2.8 min versus 10.3±3.4 min, P<0.05). All grafts were patent and both types of anastomosis presented no bleeding. Immediate tensile strength showed a higher strength of the conventional suture (22.7 x 14.3 N, P<0.09). After 30 days there was no pseudo-aneurysms and the strength of the conventional and VORTEC anastomosis were similar (37.3 x 40.8 N, respectively, P=0.17)., Conclusion: Telescoped proximal anastomosis by the technique of VORTEC is feasible. After 30 days the tensile strength of the both anastomosis were similar.
- Published
- 2016
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39. Blocking of CD1d Decreases Trypanosoma cruzi-Induced Activation of CD4-CD8- T Cells and Modulates the Inflammatory Response in Patients With Chagas Heart Disease.
- Author
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Passos LS, Villani FN, Magalhães LM, Gollob KJ, Antonelli LR, Nunes MC, and Dutra WO
- Subjects
- Adult, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Young Adult, Antigens, CD1d metabolism, CD4-Positive T-Lymphocytes immunology, CD8-Positive T-Lymphocytes immunology, Chagas Cardiomyopathy pathology, Lymphocyte Activation, Trypanosoma cruzi immunology
- Abstract
The control of inflammatory responses to prevent the deadly cardiac pathology in human Chagas disease is a desirable and currently unattained goal. Double-negative (DN) T cells are important sources of inflammatory and antiinflammatory cytokines in patients with Chagas heart disease and those with the indeterminate clinical form of Chagas disease, respectively. Given the importance of DN T cells in immunoregulatory processes and their potential as targets for controlling inflammation-induced pathology, we studied the involvement of CD1 molecules in the activation and functional profile of Trypanosoma cruzi-specific DN T cells. We observed that parasite stimulation significantly increased the expression of CD1a, CD1b, CD1c, and CD1d by CD14(+) cells from patients with Chagas disease. Importantly, among the analyzed molecules, only CD1d expression showed an association with the activation of DN T cells, as well as with worse ventricular function in patients with Chagas disease. Blocking of CD1d-mediated antigen presentation led to a clear reduction of DN T-cell activation and a decrease in the expression of interferon γ (IFN-γ) by DN T cells. Thus, our results showed that antigen presentation via CD1d is associated with activation of DN T cells in Chagas disease and that CD1d blocking leads to downregulation of IFN-γ by DN T cells from patients with Chagas heart disease, which may be a potential target for preventing progression of inflammation-mediated dilated cardiomyopathy., (© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.)
- Published
- 2016
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40. Characterization of a variant of t(14;18) negative nodal diffuse follicular lymphoma with CD23 expression, 1p36/TNFRSF14 abnormalities, and STAT6 mutations.
- Author
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Siddiqi IN, Friedman J, Barry-Holson KQ, Ma C, Thodima V, Kang I, Padmanabhan R, Dias LM, Kelly KR, Brynes RK, Kamalakaran S, and Houldsworth J
- Subjects
- Adult, Aged, 80 and over, Biomarkers, Tumor analysis, Chromosome Deletion, Chromosome Disorders immunology, Chromosome Disorders pathology, Chromosomes, Human, Pair 1 genetics, Chromosomes, Human, Pair 1 immunology, DNA Mutational Analysis methods, Female, Genes, Immunoglobulin Heavy Chain, Genetic Predisposition to Disease, High-Throughput Nucleotide Sequencing, Humans, Immunohistochemistry, In Situ Hybridization, Fluorescence, Lymphoma, Follicular chemistry, Lymphoma, Follicular immunology, Lymphoma, Follicular pathology, Male, Middle Aged, Phenotype, Phosphorylation, Proto-Oncogene Proteins c-bcl-2 genetics, STAT6 Transcription Factor analysis, Biomarkers, Tumor genetics, Chromosome Disorders genetics, Chromosomes, Human, Pair 14, Chromosomes, Human, Pair 18, Lymphoma, Follicular genetics, Mutation, Receptors, IgE analysis, Receptors, Tumor Necrosis Factor, Member 14 genetics, STAT6 Transcription Factor genetics, Translocation, Genetic
- Abstract
A predominantly diffuse growth pattern and CD23 co-expression are uncommon findings in nodal follicular lymphoma and can create diagnostic challenges. A single case series in 2009 (Katzenberger et al) proposed a unique morphologic variant of nodal follicular lymphoma, characterized by a predominantly diffuse architecture, lack of the t(14;18) IGH/BCL2 translocation, presence of 1p36 deletion, frequent inguinal lymph node involvement, CD23 co-expression, and low clinical stage. Other studies on CD23+ follicular lymphoma, while associating inguinal location, have not specifically described this architecture. In addition, no follow-up studies have correlated the histopathologic and cytogenetic/molecular features of these cases, and they remain a diagnostic problem. We identified 11 cases of diffuse, CD23+ follicular lymphoma with histopathologic features similar to those described by Katzenberger et al. Along with pertinent clinical information, we detail their histopathology, IGH/BCL2 translocation status, lymphoma-associated chromosomal gains/losses, and assessment of mutations in 220 lymphoma-associated genes by massively parallel sequencing. All cases showed a diffuse growth pattern around well- to ill-defined residual germinal centers, uniform CD23 expression, mixed centrocytic/centroblastic cytology, and expression of at least one germinal center marker. Ten of 11 involved inguinal lymph nodes, 5 solely. By fluorescence in situ hybridization analysis, the vast majority lacked IGH/BCL2 translocation (9/11). Deletion of 1p36 was observed in five cases and included TNFRSF14. Of the six cases lacking 1p36 deletion, TNFRSF14 mutations were identified in three, highlighting the strong association of 1p36/TNFRSF14 abnormalities with this follicular lymphoma variant. In addition, 9 of the 11 cases tested (82%) had STAT6 mutations and nuclear P-STAT6 expression was detectable in the mutated cases by immunohistochemistry. The proportion of STAT6 mutations is higher than recently reported in conventional follicular lymphoma (11%). These findings lend support for a clinicopathologic variant of t(14;18) negative nodal follicular lymphoma and suggests importance of the interleukin (IL)-4/JAK/STAT6 pathway in this variant.
- Published
- 2016
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41. Whole-Genome Sequence of Corynebacterium pseudotuberculosis 262 Biovar equi Isolated from Cow Milk.
- Author
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Araújo CL, Dias LM, Veras AA, Alves JT, Cavalcante AL, Dowson CG, Azevedo V, Ramos RT, Silva A, and Carneiro AR
- Abstract
We report the complete genome sequence ofCorynebacterium pseudotuberculosis262, isolated from a bovine host.C. pseudotuberculosisis an etiological agent of diseases with medical and veterinary relevance. The genome contains 2,325,749 bp, 52.8% G+C content, 2,022 coding sequences (CDS), 50 pseudogenes, 48 tRNAs, and 12 rRNAs., (Copyright © 2016 Araújo et al.)
- Published
- 2016
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42. Erratum for Alves et al., Complete Genome Sequence of Corynebacterium pseudotuberculosis Strain PA01, Isolated from Sheep in Pará, Brazil.
- Author
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Alves JT, Veras AA, Cavalcante AL, de Sá PH, Dias LM, Guimarães LC, Morais E, Silva AG, Azevedo V, Ramos RT, Silva A, and Carneiro AR
- Published
- 2016
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43. Whole-Genome Sequence of Corynebacterium pseudotuberculosis Strain 226, Isolated from the Abscess of a Goat in California.
- Author
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Dias LM, Alves JT, Veras AA, Baraúna RA, Sá PH, Spier S, Edman JM, Guimarães LC, Rocha FS, Ramos RT, Azevedo V, Silva A, and Carneiro AR
- Abstract
Corynebacterium pseudotuberculosis is the etiological agent of a caseous lymphadenitis disease. Herein, we present the first complete genome sequencing of C. pseudotuberculosis strain 226, isolated from an abscess of the sub-iliac lymph node of a goat from California (USA). The genome contains 2,138 coding sequences (CDSs), 12 rRNAs, 49 tRNAs, and 72 pseudogenes., (Copyright © 2016 Dias et al.)
- Published
- 2016
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44. Complete Genome Sequence of Corynebacterium pseudotuberculosis Strain PA01, Isolated from Sheep in Pará, Brazil.
- Author
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Alves JT, Veras AA, Cavalcante AL, de Sá PH, Dias LM, Guimarães LC, Morais E, Silva AG, Azevedo V, Ramos RT, Silva A, and Carneiro AR
- Abstract
Corynebacterium pseudotuberculosis is the etiological agent of caseous lymphadenitis disease. In this work, we present the first complete genome sequence of Corynebacterium pseudotuberculosis strain PA01, isolated in northern Brazil from an infected sheep. The genome length is 2,337,920 bp, and 2,003 coding sequences (CDS), 12 rRNAs, and 49 tRNAs were predicted., (Copyright © 2016 Alves et al.)
- Published
- 2016
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45. Cross-platform assessment of genomic imbalance confirms the clinical relevance of genomic complexity and reveals loci with potential pathogenic roles in diffuse large B-cell lymphoma.
- Author
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Dias LM, Thodima V, Friedman J, Ma C, Guttapalli A, Mendiratta G, Siddiqi IN, Syrbu S, Chaganti RS, and Houldsworth J
- Subjects
- Antibodies, Monoclonal, Murine-Derived therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Chromosome Aberrations, Comparative Genomic Hybridization, Cyclophosphamide therapeutic use, DNA Copy Number Variations, Doxorubicin therapeutic use, Female, Gene Expression Regulation, Neoplastic, Genetic Testing, Humans, Lymphoma, Large B-Cell, Diffuse drug therapy, Lymphoma, Large B-Cell, Diffuse metabolism, Lymphoma, Large B-Cell, Diffuse mortality, Male, Oligonucleotide Array Sequence Analysis, Polymorphism, Single Nucleotide, Prednisone therapeutic use, Prognosis, Rituximab, Signal Transduction, Transcriptome, Vincristine therapeutic use, Genetic Variation, Genomics methods, Lymphoma, Large B-Cell, Diffuse genetics, Quantitative Trait Loci
- Abstract
Genomic copy number alterations (CNAs) in diffuse large B-cell lymphoma (DLBCL) have roles in disease pathogenesis, but overall clinical relevance remains unclear. Herein, an unbiased algorithm was uniformly applied across three genome profiling datasets comprising 392 newly-diagnosed DLBCL specimens that defined 32 overlapping CNAs, involving 36 minimal common regions (MCRs). Scoring criteria were established for 50 aberrations within the MCRs while considering peak gains/losses. Application of these criteria to independent datasets revealed novel candidate genes with coordinated expression, such as CNOT2, potentially with pathogenic roles. No one single aberration significantly associated with patient outcome across datasets, but genomic complexity, defined by imbalance in more than one MCR, significantly portended adverse outcome in two of three independent datasets. Thus, the standardized scoring of CNAs currently developed can be uniformly applied across platforms, affording robust validation of genomic imbalance and complexity in DLBCL and overall clinical utility as biomarkers of patient outcome.
- Published
- 2016
- Full Text
- View/download PDF
46. Complete Genome Sequence of Corynebacterium pseudotuberculosis Strain E19, Isolated from a Horse in Chile.
- Author
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Cavalcante AL, Dias LM, Alves JT, Veras AA, Guimarães LC, Rocha FS, Gala-García A, Retamal P, Ramos RT, Azevedo V, Silva A, and Carneiro AR
- Abstract
Corynebacterium pseudotuberculosis is related to several diseases infecting horses and small ruminants, causing economic losses to agribusiness. Here, we present the genome sequence of C. pseudotuberculosis strain E19. The genome includes one circular chromosome 2,367,956 bp (52.1% G+C content), with 2,112 genes predicted, 12 rRNAs, and 48 tRNAs., (Copyright © 2015 Cavalcante et al.)
- Published
- 2015
- Full Text
- View/download PDF
47. Effect of a new device for sustained progesterone release on the progesterone concentration, ovarian follicular diameter, time of ovulation and pregnancy rate of ewes.
- Author
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Dias LM, de Barros MB, Viau P, Sales JN, Valentim R, dos Santos FF, da Cunha MC Jr, Marino CT, and de Oliveira CA
- Subjects
- Administration, Intravaginal, Animals, Estrus Synchronization methods, Female, Insemination, Artificial veterinary, Ovarian Follicle anatomy & histology, Pregnancy, Progesterone administration & dosage, Progesterone blood, Ovarian Follicle drug effects, Ovulation drug effects, Progesterone pharmacology, Sheep physiology
- Abstract
This study evaluated the effectiveness of a new progesterone intravaginal device (DPR) in ewes through four experiments: Experiment 1 compared the circulating progesterone concentration of ovariectomized ewes that received either a new or a re-used DPR. Experiment 2 compared the progesterone concentration between DPR-estrous-synchronized ewes and naturally estrous-cycling ewes. Experiment 3 evaluated the effect of new and re-used DPRs on ovarian follicular dynamics and time of ovulation of estrous cycling ewes. Experiment 4 compared the pregnancy rate after the use of a DPR and Controlled Internal Drug Releasing Device (CIDR). The mean concentration of progesterone released by the DPR device during its first use (New Group: 5.1 ± 0.5 ng/ml) was greater than that during the second use (Re-used Group: 2.4 ± 0.3 ng/ml). There was no difference between the animals that received DPR devices for first and second use in terms of ovulatory follicle diameter, follicular wave emergence day for ovulatory follicle and period of ovulatory wave of ovarian follicular development. However, there was a significant difference between groups regarding the time between DPR device removal and first ovulation (New Group: 71.7 ± 2.5h and Re-Used Group: 63.9 ± 2.7h). Pregnancy rates were similar between ewes with DPR and CIDR devices. It was concluded that DPR is effective in increasing and maintaining progesterone concentrations, controlling follicular dynamics, promoting synchronized times of ovulation from healthy follicles, promoting development of a competent corpus luteum and when used results in pregnancy rates similar to that with use of the CIDR., (Copyright © 2015 Elsevier B.V. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
48. Draft Genome Sequences of Vibrio fluvialis Strains 560 and 539, Isolated from Environmental Samples.
- Author
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de Oliveira Veras AA, da Silva ML, Gomes JC, Dias LM, de Sá PC, Alves JT, Castro W, Miranda F, Kazuo E, Marinho D, Rodrigues M, Freire M, Zahlouth R, Renan W, Lopes TS, Matté MH, da Silva Mayer CC, de Almeida Vasconcelos Barboni S, Matté GR, Carneiro AR, Silva A, and Ramos RT
- Abstract
Vibrio fluvialis is a halophilic bacterium found in many environments and is mainly associated with sporadic cases and outbreaks of gastroenteritis in humans. Here, we describe the genome sequences of environmental strains of V. fluvialis 560 (Vf560) and V. fluvialis 539 (Vf539) possessing a variant of the integrative and conjugative element (ICE) SXT for the first time in Brazil and South America., (Copyright © 2015 de Oliveira Veras et al.)
- Published
- 2015
- Full Text
- View/download PDF
49. Draft Genome Sequence of Non-O1 and Non-O139 Vibrio cholerae Strain VCC19.
- Author
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de Sá PC, Da Silva ML, Carneiro AR, Gomes JC, Dias LM, Alves JT, De Oliveira Veras AA, Baraúna RA, Das Graças DA, Matté MH, Sato MI, Hachich EM, Matté GR, Ramos RT, and Silva A
- Abstract
Vibrio cholerae O1 is the causative agent of cholera and is ubiquitous in the aquatic environment, while V. cholerae strains non-O1 and non-O139 are recognized as causative agents of sporadic and localized outbreaks of diarrhea. Here, we report the complete sequence of a non-O1 and non-O139 V. cholerae strain (VCC19), which was isolated from the environment in Brazil. The sequence includes the integrative conjugative element (ICE). This paper is the first report of the presence of such an element in a V. cholerae strain isolated in Brazil., (Copyright © 2014 de Sá et al.)
- Published
- 2014
- Full Text
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50. Tracheobronchial Polyflex stents for the management of benign refractory hypopharyngeal strictures.
- Author
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Silva RA, Mesquita N, Nunes PP, Cardoso E, Pinto RM, and Dias LM
- Subjects
- Adult, Aged, Constriction, Pathologic complications, Constriction, Pathologic pathology, Deglutition Disorders etiology, Deglutition Disorders surgery, Humans, Laryngeal Neoplasms therapy, Male, Middle Aged, Treatment Outcome, Constriction, Pathologic surgery, Hypopharynx pathology, Hypopharynx surgery, Stents
- Abstract
Aim: To describe a modified technique for placement of a tracheobronchial self-expanding plastic stent (SEPS) in patients with benign refractory hypopharyngeal strictures in order to improve dysphagia and allow stricture remodeling., Methods: A case series of four consecutive patients with complex hypopharyngeal strictures after combined therapy for laryngeal cancer, previously submitted to multiple sessions of dilation without lasting improvement, is presented. All patients underwent placement of a small diameter and unflared tracheobronchial SEPS. Main outcome measurements were improvement of dysphagia and avoiding of repeated dilation., Results: The modified introducer system allowed an easy and technically successful deployment of the tracheobronchial Polyflex stent through the stricture. All four patients developed complications related to stent placement. Two patients had stent migration (one proximal and one distal), two patients developed phanryngocutaneous fistulas and all patients with stents in situ for more than 8 wk had hyperplastic tissue growth at the upper end of the stent. Stricture recurrence was observed at 4 wk follow-up after stent removal in all patients., Conclusion: Although technically feasible, placement of a tracheobronchial SEPS is associated with a high risk of complications. Small diameter stents must be kept in place for longer than 3 mo to allow adequate time for stricture remodeling.
- Published
- 2012
- Full Text
- View/download PDF
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