Severe traumatic brain injury (TBI) is associated with high rates of mortality and long‐term disability linked to neurochemical abnormalities. Although purine derivatives play important roles in TBI pathogenesis in preclinical models, little is known about potential changes in purine levels and their implications in human TBI. We assessed cerebrospinal fluid (CSF) levels of purines in severe TBI patients as potential biomarkers that predict mortality and long‐term dysfunction. This was a cross‐sectional study performed in 17 severe TBI patients (Glasgow Coma Scale <8) and 51 controls. Two to 4 h after admission to ICU, patients were submitted to ventricular drainage and CSF collection for quantification of adenine and guanine purine derivatives by HPLC. TBI patients’ survival was followed up to 3 days from admission. A neurofunctional assessment was performed through the modified Rankin Scale (mRS) 2 years after ICU admission. Purine levels were compared between control and TBI patients, and between surviving and non‐surviving patients. Relative to controls, TBI patients presented increased CSF levels of GDP, guanosine, adenosine, inosine, hypoxanthine, and xanthine. Further, GTP, GDP, IMP, and xanthine levels were different between surviving and non‐surviving patients. Among the purines, guanosine was associated with improved mRS (p = 0.042; r = −0.506). Remarkably, GTP displayed predictive value (AUC = 0.841, p = 0.024) for discriminating survival versus non‐survival patients up to 3 days from admission. These results support TBI‐specific purine signatures, suggesting GTP as a promising biomarker of mortality and guanosine as an indicator of long‐term functional disability.
Even though traumatic dissection of cervical arterial vessels is the major cause of stroke among adults, it is still an underdiagnosed disease in neurosurgical emergencies, since most patients do not have or present subtle clinical signs in the acute phase. The authors report two interesting cases of cervical artery dissection with different traumatic mechanisms and present a broad literature review about this subject.
Severe traumatic brain injury (TBI) is associated with high rates of mortality and long-term disability linked to neurochemical abnormalities. Although purine-derivatives play important roles in TBI pathogenesis in preclinical models, little is known about potential changes in purine levels and their implications in human TBI. We assessed cerebrospinal fluid (CSF) levels of purines in severe TBI patients as potential biomarkers that predict mortality and long-term dysfunction. This was a cross-sectional study performed in 17 severe TBI patients (Glasgow Coma Scale < 8) and 51 controls. Two to four hours after admission to ICU, patients were submitted to ventricular drainage, and CSF collection for quantification of adenine and guanine purine-derivatives by HPLC. TBI patients survival was followed up to 3 days from admission. A neurofunctional assessment was performed through modified Rankin Scale (mRS) two years after ICU admission. Purine levels were compared between control and TBI patients, and between surviving and non-surviving patients. Relative to controls, TBI patients presented increased CSF levels of GDP, guanosine, adenosine, inosine, hypoxanthine, and xanthine. Further, GTP, GDP, IMP, and xanthine levels were different between surviving and non-surviving patients. Among the purines, guanosine was associated with improved mRS (p=0.042; r= -0.506). Remarkably, GTP displayed predictive value (AUC=0.841, p=0.024) for discriminating survival vs. non-survival patients up to three days from admission. These results support TBI-specific purine signatures, suggesting GTP as a promising biomarker of mortality, and guanosine as an indicator of long-term functional disability.
Introduction: Kidney transplant is considered the method of choice in the treatment of end-stage chronic kidney disease, improving survival and quality of life, and often allowing the recovery of fertility among woman. Objective: This study aims to assess the outcomes of post-transplant pregnancy, newborn and patient graft survival, compared to a control group of transplanted women who were not pregnant. Methods: A retrospective case-control study was conducted at the Kidney Transplant Service of Santa Casa de Misericordia in Porto Alegre, among 1.253 female patients who underwent kidney transplantation and were of childbearing age between 1977 and 2016. They were compared to a control group matched for age, type of donor, date of transplant and immunological risk. Results: 76 (6,1%) of the patients became pregnant, resulting in a total of 93 pregnancies. Compared to the control group, at 10 years after transplantation there was no significant difference in relation to graft loss (74% vs 66%, p=0.524), and the survival of pregnant patients was higher (97% vs 79%, p=0.018). We found that 40% pregnancies progressed to abortion, 30% of the deliveries were preterm, and 26% happened at term. Three pregnancies progressed to stillbirth. Of the 56 pregnancies that evolved, 23 (41%) resulted in pre-eclampsia, and one in eclampsia. Conclusion: 6,1% of the women in the study became pregnant, and 56% of these pregnancies were successful. Compared to the control group, we found that those who got pregnant had similar graft survival outcomes and longer patient survival.
As manifestações oftalmológicas decorrentes da infecção pelo SARS-CoV-2 estão sendo estudadas no meio científico, entretanto, o conhecimento acerca das afecções relacionadas ao segmento ocular posterior ainda é escasso. Neste trabalho relatamos uma paciente jovem com queixa visual após infecção recente por COVID-19, evidenciando importantes hemorragias retinianas. O uso de bevacizumab foi o tratamento escolhido, levando à melhora do quadro. Destacamos, então, a importância do monitoramento fundoscópico em pacientes pós-COVID 19 para avaliação dos padrões circulatórios sistêmicos de forma não invasiva.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.