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Nagarajan R, Carpenter CL, Lee CC, Michael N, Sarma MK, Souza R, Xu E, Velan SS, Hahn TJ, Go VL, Thomas MA. Assessment of Lipid and Metabolite Changes in Obese Calf Muscle Using Multi-Echo Echo-planar Correlated Spectroscopic Imaging. Sci Rep 2017; 7:17338. [PMID: 29229948 PMCID: PMC5725420 DOI: 10.1038/s41598-017-17529-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 11/23/2017] [Indexed: 12/13/2022] Open
Abstract
Obesity-related conditions including heart disease, stroke, and type 2 diabetes are leading causes of preventable death. Recent evidence suggests that altered myocellular lipid metabolism in obesity may lead to increased insulin resistance (IR) that predisposes to these disorders. To test the hypothesis that muscles rich in type I vs. type II muscle fibers would exhibit similar changes in intramyocellular lipid (IMCL) and extramyocellular lipid (EMCL) content in obesity, we utilized a new four-dimensional multi echo echo-planar correlated spectroscopic imaging technique that allows separate determination of IMCL and EMCL content in individual calf muscles in obese vs. normal healthy human subjects. Calf muscles were scanned in 32 obese and 11 healthy subjects using a 3T MRI/MRS scanner, and IR in the obese subjects was documented by glucose tolerance testing. In obese subjects, elevation of both IMCL and EMCL content was observed in the gastrocnemius and tibialis anterior muscles (with mixed type I and II fiber content), while a significant increase in only IMCL content (+48%, p < 0.001) was observed in the soleus muscle (predominantly type I fibers). These observations indicate unexpected differences in changes in myolipid metabolism in type I vs. type II rich muscle regions in obesity, perhaps related to IR, and warrant further investigation.
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Teixeira M, Moreno L, Stielow B, Muszewska A, Hainaut M, Gonzaga L, Abouelleil A, Patané J, Priest M, Souza R, Young S, Ferreira K, Zeng Q, da Cunha M, Gladki A, Barker B, Vicente V, de Souza E, Almeida S, Henrissat B, Vasconcelos A, Deng S, Voglmayr H, Moussa T, Gorbushina A, Felipe M, Cuomo C, de Hoog GS. Exploring the genomic diversity of black yeasts and relatives ( Chaetothyriales, Ascomycota). Stud Mycol 2017; 86:1-28. [PMID: 28348446 PMCID: PMC5358931 DOI: 10.1016/j.simyco.2017.01.001] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The order Chaetothyriales (Pezizomycotina, Ascomycetes) harbours obligatorily melanised fungi and includes numerous etiologic agents of chromoblastomycosis, phaeohyphomycosis and other diseases of vertebrate hosts. Diseases range from mild cutaneous to fatal cerebral or disseminated infections and affect humans and cold-blooded animals globally. In addition, Chaetothyriales comprise species with aquatic, rock-inhabiting, ant-associated, and mycoparasitic life-styles, as well as species that tolerate toxic compounds, suggesting a high degree of versatile extremotolerance. To understand their biology and divergent niche occupation, we sequenced and annotated a set of 23 genomes of main the human opportunists within the Chaetothyriales as well as related environmental species. Our analyses included fungi with diverse life-styles, namely opportunistic pathogens and closely related saprobes, to identify genomic adaptations related to pathogenesis. Furthermore, ecological preferences of Chaetothyriales were analysed, in conjuncture with the order-level phylogeny based on conserved ribosomal genes. General characteristics, phylogenomic relationships, transposable elements, sex-related genes, protein family evolution, genes related to protein degradation (MEROPS), carbohydrate-active enzymes (CAZymes), melanin synthesis and secondary metabolism were investigated and compared between species. Genome assemblies varied from 25.81 Mb (Capronia coronata) to 43.03 Mb (Cladophialophora immunda). The bantiana-clade contained the highest number of predicted genes (12 817 on average) as well as larger genomes. We found a low content of mobile elements, with DNA transposons from Tc1/Mariner superfamily being the most abundant across analysed species. Additionally, we identified a reduction of carbohydrate degrading enzymes, specifically many of the Glycosyl Hydrolase (GH) class, while most of the Pectin Lyase (PL) genes were lost in etiological agents of chromoblastomycosis and phaeohyphomycosis. An expansion was found in protein degrading peptidase enzyme families S12 (serine-type D-Ala-D-Ala carboxypeptidases) and M38 (isoaspartyl dipeptidases). Based on genomic information, a wide range of abilities of melanin biosynthesis was revealed; genes related to metabolically distinct DHN, DOPA and pyomelanin pathways were identified. The MAT (MAting Type) locus and other sex-related genes were recognized in all 23 black fungi. Members of the asexual genera Fonsecaea and Cladophialophora appear to be heterothallic with a single copy of either MAT-1-1 or MAT-1-2 in each individual. All Capronia species are homothallic as both MAT1-1 and MAT1-2 genes were found in each single genome. The genomic synteny of the MAT-locus flanking genes (SLA2-APN2-COX13) is not conserved in black fungi as is commonly observed in Eurotiomycetes, indicating a unique genomic context for MAT in those species. The heterokaryon (het) genes expansion associated with the low selective pressure at the MAT-locus suggests that a parasexual cycle may play an important role in generating diversity among those fungi.
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Jacob FG, Baracho MS, Nääs IA, Lima NSD, Salgado DD, Souza R. Risk of Incidence of Hock Burn and Pododermatitis in Broilers Reared under Commercial Conditions. BRAZILIAN JOURNAL OF POULTRY SCIENCE 2016. [DOI: 10.1590/1806-9061-2015-0183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Jacob FG, Baracho MS, Nääs IA, Salgado DA, Souza R. Incidence of Pododermatitis in Broiler Reared under Two Types of Environment. BRAZILIAN JOURNAL OF POULTRY SCIENCE 2016. [DOI: 10.1590/1806-9061-2015-0047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Souza R, Gastaldi V, Rodríguez Y, Pereira C, Fernades J, Carlos R, Bueno O, Fontanetti C. Genotoxic action of a metallic-insecticide using Tradescantia pallida as test organism. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Souza R, Saito A, Sanches S, Guimarãees A, Ribeiro A, Costa AD. 2762 Platinum rechallenge in second line chemotherapy for metastatic endometrial carcinoma. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31528-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Marostica P, Souza R, Baptista R, Filho JH, Pinto L, Epifanio M, Donadio M. 226 Ultrasound and adipometer body fat measurement of cystic fibrosis (CF) children and adolescents. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30401-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Crome P, Hood C, Souza R. 59 * NATIONAL AUDIT OF DEMENTIA: PROGRESS REPORT. Age Ageing 2014. [DOI: 10.1093/ageing/afu036.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Salles F, Zambom M, Alcalde C, Macedo F, Souza R, Gomes L, Dias F, Molina B. Características de carcaça de cabritos criados em dois sistemas de terminação. ARQ BRAS MED VET ZOO 2013. [DOI: 10.1590/s0102-09352013000600039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Avaliaram-se as características da carcaça de cabritos Saanen confinados, Saanen e 7/8 Boer - 1/8 Saanen semiconfinados, bem como a influência de grupo genético e sistema de terminação sobre o rendimento comercial, índice de compacidade, não constituintes, área de olho de lombo, força de cisalhamento, gordura, teor de umidade e teor de extrato etéreo. Utilizaram-se 31 machos inteiros, com aproximadamente 128 dias de idade e 22,9±2,4kg de peso vivo. Destes, 22 eram da raça Saanen e nove animais eram mestiços 7/8 Boer - 1/8 Saanen. Os animais da raça Saanen foram divididos em dois grupos de 11 animais, sendo um grupo mantido em confinamento e outro em semiconfinamento, enquanto os mestiços foram mantidos em semiconfinamento. Compararam-se os sistemas de terminação na raça Saanen, e os grupos genéticos no sistema semiconfinado. Os animais confinados receberam 3,5% do PV em ração completa peletizada; os semiconfinados tiveram acesso à pastagem e suplementação de 1,5% do PV em ração concentrada peletizada. Aos 47 dias de terminação, os animais foram abatidos e as características de carcaça determinadas por meio de uma amostra de lombo dissecado. Foram observadas diferenças entre sistemas de terminação para rendimento comercial de carcaça, índice de compacidade da carcaça, não constituintes de carcaça, área de olho de lombo, força de cisalhamento, gordura, teor de umidade e de extrato etéreo. Entre os grupos genéticos, foram observadas diferenças para área de olho de lombo, espessura de gordura e matéria mineral. O sistema de terminação exerceu influência sobre as características de carcaça avaliadas. A raça Saanen pode ser utilizada para a produção de carne quando submetida ao confinamento.
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Souza R, Hood C. Persisting deficits in comprehensive assessment for people with dementia in general hospitals in the UK. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Torbicki A, Mehta S, Perchenet L, Pulido T, Sastry BKS, Sitbon O, Souza R, Rubin LJ, Simonneau G. Effect of macitentan on haemodynamics in patients with pulmonary arterial hypertension: results from the long-term, randomised, placebo-controlled SERAPHIN trial. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.1062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Baars H, Ansmann A, Althausen D, Engelmann R, Heese B, Müller D, Artaxo P, Paixao M, Pauliquevis T, Souza R. Aerosol profiling with lidar in the Amazon Basin during the wet and dry season. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2012jd018338] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Jürgens S, Meyer F, Spechler SJ, Souza R. The role of bile acids in the neoplastic progression of Barrett's esophagus - a short representative overview. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2012; 50:1028-34. [PMID: 22965634 DOI: 10.1055/s-0032-1312922] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Barrett's esophagus (BE) is an intestinal metaplasia of the distal esophagus in which squamous cells are replaced by a columnar epithelium. It is considered as a premalignant lesion, which can lead to esophageal adenocarcinoma, a very aggressive type of cancer, and can often be found in patients with gastro-esophageal reflux disease (GERD). In spite of the widespread use of acid-suppressing therapy with proton pump inhibitors, the incidence of adenocarcinoma has been steadily rising during the last 30 years. So, it can strongly be suggested that refluxed material other than acid might contribute to the progression of cancer within Barrett's esophagus. Along with gastric acid, bile acids enter the esophagus during an episode of reflux, and bile acids may be important in carcinogenesis. In their refluxates, patients with GERD and BE show high concentrations of the hydrophobic bile salt deoxycholic acid (DCA), which has cytotoxic effects and is able to induce DNA damage in different cell types. Other bile acids, like the hydrophilic urodeoxycholic acid (UDCA), have been therapeutically used to treat cholestatic liver diseases and to prevent colon carcinoma. This article reviews the effects of bile acids and points out new perceptions in the progression of Barrett's-associated carcinogenesis.
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Braz L, Nicodemo A, Souza R, Santos N, Godoy N, Okay T, Amato V. Visceral leishmaniasis reactivation diagnosed by molecular technique in blood sample. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Lima L, Alcalde C, Gomes L, Souza R, Rigolon L, Nakamura C. Effect of inactive dry yeast from sugar cane as protein source on rumen fermentation in Saanen goats. ARQ BRAS MED VET ZOO 2012. [DOI: 10.1590/s0102-09352012000100021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Five castrated and ruminally cannulated Saanen goats (±48.19kg) were used to evaluate intake, digestibility and rumen fermentation parameters of diets with inactive dry yeast as a soybean meal substitute (0, 25, 50, 75 and 100%). Goats were randomly assigned to a 5×5 (five levels of dry yeast x five periods) Latin square design. Diets were composed of corn silage (40%), ground corn, soybean meal and/or dry yeast and mineral supplement. The intake and digestibility of DM, OM, CP, NDF and TC were not influenced by the treatments. However, EE intake showed negative linear effect. The TDN content did not change with the inclusion of dry yeast in the diets. The pH, N-NH3 concentration and rumen short-chain fatty acids content did not differ among diets. Rumen content scanning electron microscopy observations did not suggest microbial colonization and degradation changes. Dry yeast from sugar cane can replace soybean meal in diets for Saanen goats without changing the rumen fermentation pattern, intake and digestibility.
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Callisto M, Ribeiro AS, Santana VB, França JS, Ligeiro R, Ferreira WR, Silva D, Castro D, Tupinambás TH, Santana D, Souza B, Gonçalves F, Rodrigues L, Andrade CB, Sales SCM, Souza R. Rapid ecological assessment of benthic indicators of water quality: a successful capacity-building experience for Brazilian postgraduate students in ecology. BRAZ J BIOL 2011. [DOI: 10.1590/s1519-69842011000500014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Rapid Ecological Assessment protocols are important tools for the training of postgraduate students, as well as the collection of data on poorly-known and protected areas with the potential for the preservation of water supplies for urban areas. The objective of this study was to perform a survey of water quality and diversity of benthic macroinvertebrates in two sub-basins at the Mata do Junco Wildlife Refuge in the Brazilian state of Sergipe. The collection of data in the field, laboratory processing, and the interpretation and discussion of data were conducted in groups by students from two postgraduate programmes in Ecology and Conservation (UFMG and UFS), personnel of the state environment agency (SEMARH), school teachers from the local town of Capela, and members of the reserve's voluntary fire brigade. The results of the assessment were organised, analysed, and presented at the reserve headquarters in the form of posters, for the development of environmental education activities with pupils from local schools, as well as contributing to a SEMARH seminar. Samples were characterised by distinct taxonomic compositions and diversity, as confirmed by MDS and additive partitioning of diversity analyses. The gravel substrate presented the lower mean taxonomic richness in each sampling unit (a1 = 28%), while the average difference among samples (b1 diversity) was elevated for both substrates (39% for leaf litter, 41% for gravel), reflecting the pronounced variation among samples, even adjacent ones within the same stream. Diversity between streams was lower in the case of leaf litter in comparison with gravel (b2 = 21 and 31%, respectively). A total of 57 fish specimens were collected with a predominance of individuals of the orders Characiformes (62%) and Perciformes (21%). This rapid ecological assessment confirmed the importance of the conservation unit and emphasised the need for its continuation, given its importance for the maintenance of water quality and its other ecological services, such as the conservation of the region's aquatic biodiversity and providing the local town of Capela (circa 20,000 inhabitants) with its water supply, the Mata do Junco being its only source.
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Fonseca GHH, Souza R, Salemi VMC, Jardim CVP, Gualandro SFM. Pulmonary hypertension diagnosed by right heart catheterisation in sickle cell disease. Eur Respir J 2011; 39:112-8. [PMID: 21778170 DOI: 10.1183/09031936.00134410] [Citation(s) in RCA: 181] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Recent studies have recognised the importance of pulmonary hypertension (PH) in sickle cell disease (SCD). The aim of this study was to determine the prevalence and prognostic impact of PH and its features in patients with SCD. 80 patients with SCD underwent baseline clinical evaluation, laboratory testing, 6-min walk tests (6MWTs) and echocardiography. Patients with a peak tricuspid regurgitant jet velocity (TRV) of ≥ 2.5 m·s(-1) were further evaluated through right heart catheterisation (RHC) to assure the diagnosis of PH. Our study evidenced a 40% prevalence of patients with elevated TRV at echocardiography. RHC (performed in 25 out of 32 patients) confirmed PH in 10% (95% CI 3.4-16.5%) of all patients, with a prevalence of post-capillary PH of 6.25% (95% CI 0.95-11.55%) and pre-capillary PH of 3.75% (95% CI -0.4-7.9%). Patients with PH were older, had worse performance in 6MWTs, and more pronounced anaemia, haemolysis and renal dysfunction. Survival was shorter in patients with PH. Our study reinforced the use of echocardiography as a screening tool for PH in SCD and the mandatory role of RHC for proper diagnosis. Our findings confirmed the prognostic significance of PH in SCD as its association to pronounced haemolytic profile.
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McQuaid KR, Laine L, Fennerty MB, Souza R, Spechler SJ. Systematic review: the role of bile acids in the pathogenesis of gastro-oesophageal reflux disease and related neoplasia. Aliment Pharmacol Ther 2011; 34:146-65. [PMID: 21615439 DOI: 10.1111/j.1365-2036.2011.04709.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Factors other than acid may play a role in gastro-oesophageal reflux disease (GERD) and its complications. AIM To assessed the role of bile acids in the pathogenesis of GERD, Barrett's oesophagus and Barrett's-related neoplasia. METHODS We conducted a systematic review of computerised bibliographic databases for original articles involving humans or human oesophageal tissue or cells that assessed exposure to or manipulation of bile acids. Outcomes assessed included GERD symptoms; gross oesophageal injury; Barrett's oesophagus and related neoplasia; and intermediate markers of inflammation, proliferation or neoplasia. RESULTS Eighty-three original articles were included. In in vivo studies, bile acids concentrations were higher in the oesophageal aspirates of patients with GERD than controls, and bile acids infusions triggered GERD symptoms, especially in high concentrations or in combination with acid. In ex vivo/in vitro studies, bile acids stimulated squamous oesophageal cells and Barrett's epithelial cells to produce inflammatory mediators (e.g., IL-8 and COX-2) and caused oxidative stress, DNA damage and apoptosis. They also induced squamous cells to change their gene expression pattern to resemble intestinal-type cells and caused Barrett's cells to increase expression of intestinal-type genes. CONCLUSIONS In aggregate, these studies suggest that bile acids may contribute to the pathogenesis of symptoms, oesophagitis and Barrett's metaplasia with related carcinogenesis in patients with GERD. However, all study results are not uniform and substantial differences in study parameters may explain at least some of this variation.
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Humbert M, Sitbon O, Montani D, Jais X, Yaici A, O'Callaghan DS, Souza R, Simonneau G. From the authors:. Eur Respir J 2011. [DOI: 10.1183/09031936.00188910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Jardim C, Hoette S, Souza R. Contemporary issues in pulmonary hypertension. Eur Respir Rev 2011; 19:266-71. [PMID: 21119184 DOI: 10.1183/09059180.00008810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Price LC, Wort SJ, Montani D, Tcherakian C, Dorfmuller P, Souza R, Shao D, Simonneau G, Howard LS, Adcock I, Humbert M, Perros F. S152 Dexamethasone reverses established monocrotaline-induced pulmonary hypertension in rats and increases pulmonary BMPR2 expression. Thorax 2010. [DOI: 10.1136/thx.2010.150953.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Provencher S, Souza R. Predicting survival in pulmonary arterial hypertension: time to move forward. Eur Respir J 2010; 35:958-9. [PMID: 20436172 DOI: 10.1183/09031936.00007110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Price LC, Montani D, Tcherakian C, Dorfmuller P, Souza R, Gambaryan N, Chaumais MC, Shao DM, Simonneau G, Howard LS, Adcock IM, Wort SJ, Humbert M, Perros F. Dexamethasone reverses monocrotaline-induced pulmonary arterial hypertension in rats. Eur Respir J 2010; 37:813-22. [DOI: 10.1183/09031936.00028310] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Humbert M, Sitbon O, Yaïci A, Montani D, O'Callaghan DS, Jaïs X, Parent F, Savale L, Natali D, Günther S, Chaouat A, Chabot F, Cordier JF, Habib G, Gressin V, Jing ZC, Souza R, Simonneau G. Survival in incident and prevalent cohorts of patients with pulmonary arterial hypertension. Eur Respir J 2010; 36:549-55. [PMID: 20562126 DOI: 10.1183/09031936.00057010] [Citation(s) in RCA: 439] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Pulmonary arterial hypertension (PAH) is a progressive, fatal disease. We studied 674 consecutive adult patients who were prospectively enrolled in the French PAH registry (121 incident and 553 prevalent cases). Two survival analyses were performed. First, the cohort of 674 patients was followed for 3 yrs after study entry and survival rates described. Then, we focused on the subset with incident idiopathic, familial and anorexigen-associated PAH (n = 56) combined with prevalent patients who were diagnosed <3 yrs prior to study entry (n = 134). In the cohort of 674 patients, 1-, 2-, and 3-yr survival rates were 87% (95% CI 84-90), 76% (95% CI 73-80), and 67% (95% CI 63-71), respectively. In prevalent idiopathic, familial and anorexigen-associated PAH, 1-, 2-, and 3-yr survival rates were higher than in incident patients (p = 0.037). In the combined cohort of patients with idiopathic, familial and anorexigen-associated PAH, multivariable analysis showed that survival could be estimated by means of a novel risk-prediction equation using patient sex, 6-min walk distance, and cardiac output at diagnosis. This study highlights survivor bias in prevalent cohorts of PAH patients. Survival of idiopathic, familial and anorexigen-associated PAH can be characterised by means of a novel risk-prediction equation using patients' characteristics at diagnosis.
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Avouac J, Walker U, Tyndall A, Kahan A, Matucci-Cerinic M, Allanore Y, Miniati I, Muller A, Iannone F, Distler O, Becvar R, Sierakowsky S, Kowal-Bielecka O, Coelho P, Cabane J, Cutolo M, Shoenfeld Y, Valentini G, Rovensky J, Riemekasten G, Vlachoyiannopoulos P, Caporali R, Jiri S, Inanc M, Zimmermann Gorska I, Carreira P, Novak S, Czirjak L, Oliveira Ramos F, Jendro M, Chizzolini C, Kucharz EJ, Richter J, Cozzi F, Rozman B, Mallia CM, Gabrielli A, Farge D, Kiener HP, Schöffel D, Airo P, Wollheim F, Martinovic D, Trotta F, Jablonska S, Reich K, Bombardieri S, Siakka P, Pellerito R, Bambara LM, Morovic-Vergles J, Denton C, Hinrichs R, Van den Hoogen F, Damjanov N, Kötter I, Ortiz V, Heitmann S, Krasowska D, Seidel M, Hasler P, Van Laar JM, Kaltwasser JP, Foeldvari I, Juan Mas A, Bajocchi G, Wislowska M, Pereira Da Silva JA, Jacobsen S, Worm M, Graniger W, Kuhn A, Stankovic A, Cossutta R, Majdan M, Damjanovska Rajcevska L, Tikly M, Nasonov EL, Steinbrink K, Herrick A, Müller-Ladner U, Dinc A, Scorza R, Sondergaard K, Indiveri F, Nielsen H, Szekanecz Z, Silver RM, Antivalle M, Espinosa IB, García de la Pena Lefebvre P, Midtvedt O, Launay D, Valesini F, Tuvik P, Ionescu RM, Del Papa N, Pinto S, Wigley F, Mihai C, Sinziana Capranu M, Sunderkötter C, Jun JB, Alhasani S, Distler JH, Ton E, Soukup T, Seibold J, Zeni S, Nash P, Mouthon L, De Keyser F, Duruöz MT, Cantatore FP, Strauss G, von Mülhen CA, Pozzi MR, Eyerich K, Szechinski J, Keiserman M, Houssiau FA, Román-Ivorra JA, Krummel-Lorenz B, Aringer M, Westhovens R, Bellisai F, Mayer M, Stoeckl F, Uprus M, Volpe A, Buslau M, Yavuz S, Granel B, Valderílio Feijó A, Del Galdo F, Popa S, Zenone T, Ricardo Machado X, Pileckyte M, Stebbings S, Mathieu A, Tulli A, Tourinho T, Souza R, Acayaba de Toledo R, Stamp L, Solanki K, Veale D, Francisco Marques Neto J, Bagnato GF, Loyo E, Toloza S, Li M, Ahmed Abdel Atty Mohamed W, Cobankara V, Olas J, Salsano F, Oksel F, Tanaseanu CM, Foti R, Ancuta C, Vonk M, Caramashi P, Beretta L, Balbir A, Chiàla A, Pasalic Simic K, Ghio M, Stamenkovic B, Rednic S, Host N, Pellerito R, Hachulla E, Furst DE. Characteristics of joint involvement and relationships with systemic inflammation in systemic sclerosis: results from the EULAR Scleroderma Trial and Research Group (EUSTAR) database. J Rheumatol 2010. [PMID: 20551097 DOI: 10.3899/jrheum.091165.] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the prevalence of and independent factors associated with joint involvement in a large population of patients with systemic sclerosis (SSc). METHODS This study was cross-sectional, based on data collected on patients included in the European League Against Rheumatism (EULAR) Scleroderma Trials and Research (EUSTAR) registry. We queried this database to extract data regarding global evaluation of patients with SSc and the presence of any clinical articular involvement: synovitis (tender and swollen joints), tendon friction rubs (rubbing sensation detected as the tendon was moved), and joint contracture (stiffness of the joints that decreased their range of motion). Overall joint involvement was defined by the occurrence of synovitis and/or joint contracture and/or tendon friction rubs. RESULTS We recruited 7286 patients with SSc; their mean age was 56 +/- 14 years, disease duration 10 +/- 9 years, and 4210 (58%) had a limited cutaneous disease subset. Frequencies of synovitis, tendon friction rubs, and joint contractures were 16%, 11%, and 31%, respectively. Synovitis, tendon friction rubs, and joint contracture were more prevalent in patients with the diffuse cutaneous subset and were associated together and with severe vascular, muscular, renal, and interstitial lung involvement. Moreover, synovitis had the highest strength of association with elevated acute-phase reactants taken as the dependent variable. CONCLUSION Our results highlight the striking level of articular involvement in SSc, as evaluated by systematic examination in a large cohort of patients with SSc. Our data also show that synovitis, joint contracture, and tendon friction rubs are associated with a more severe disease and with systemic inflammation.
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