Tumor cells must generate sufficient ATP and biosynthetic precursors in order to maintain cell proliferation requirements. Otto Warburg showed that tumor cells uptake high amounts of glucose ...producing large volumes of lactate even in the presence of oxygen, this process is known as “Warburg effect or aerobic glycolysis.” As a consequence of such amounts of lactate there is an acidification of the extracellular pH in tumor microenvironment, ranging between 6.0 and 6.5. This acidosis favors processes such as metastasis, angiogenesis and more importantly, immunosuppression, which has been associated to a worse clinical prognosis. Thus, lactate should be thought as an important oncometabolite in the metabolic reprogramming of cancer. In this review, we summarized the role of lactate in regulating metabolic microenvironment of cancer and discuss its relevance in the up-regulation of the enzymes lactate dehydrogenase (LDH) and monocarboxilate transporters (MCTs) in tumors. The goal of this review is to expose that lactate is not only a secondary product of cellular metabolic waste of tumor cells, but also a key molecule involved in carcinogenesis as well as in tumor immune evasion. Finally, the possible targeting of lactate production in cancer treatment is discussed.
Abstract Introduction This study aims to identify the causes for the incomplete donation process at a tertiary care hospital. Materials and Methods A descriptive, retrospective study was performed; ...all potential donors reported to the Transplant Service within the period of 2005 to 2014 were included. Descriptive statistics were used across frequencies and proportions for categorical variables, central tendency, and dispersion for continuous variables. Results The total number of deaths reported at the University Hospital (HU) was 8472, of which 815 (n = 815) were reported to COETRA (“Consejo Estatal de Trasplantes”). Among organ or tissue donors, the main known cause of death was head trauma (HT) in 26% (72). Cardiac arrest (CA) as cause of death provided the largest number of donations (141, 57%); of these, 102 (41%) were male and 39 (16%) were female. In comparison, brain death (BD) provided 104 (43%); of these, 65 (27%) were male, and 39 (16%) were female. The age interval was with a higher donation rate was 45 to 49 y (BD 18, CA 22). Donation request was not performed in 359 patients because of medical contraindication 60% (215), rapid deterioration 18% (64), and incomplete donation process 8% (27). Of 452 organ requests, 207 were not accomplished, because of body integrity 28% (57), family disagreement 20% (42), and no acceptance of BE 13% (26). Conclusions Opportunity areas: (1) Ensure the notification of all deaths to Transplant Department for identification of potential donors; (2) Reduce rapid deterioration and raise number of completed donation protocols; (3) Increase the donation rate.
Summary
Background
Cutaneous reactions after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines are poorly characterized.
Objective
To describe and classify cutaneous reactions ...after SARS‐CoV‐2 vaccination.
Methods
A nationwide Spanish cross‐sectional study was conducted. We included patients with cutaneous reactions within 21 days of any dose of the approved vaccines at the time of the study. After a face‐to‐face visit with a dermatologist, information on cutaneous reactions was collected via an online professional survey and clinical photographs were sent by email. Investigators searched for consensus on clinical patterns and classification.
Results
From 16 February to 15 May 2021, we collected 405 reactions after vaccination with the BNT162b2 (Pfizer‐BioNTech; 40·2%), mRNA‐1273 (Moderna; 36·3%) and AZD1222 (AstraZeneca; 23·5%) vaccines. Mean patient age was 50·7 years and 80·2% were female. Cutaneous reactions were classified as injection site (‘COVID arm’, 32·1%), urticaria (14·6%), morbilliform (8·9%), papulovesicular (6·4%), pityriasis rosea‐like (4·9%) and purpuric (4%) reactions. Varicella zoster and herpes simplex virus reactivations accounted for 13·8% of reactions. The COVID arm was almost exclusive to women (95·4%). The most reported reactions in each vaccine group were COVID arm (mRNA‐1273, Moderna, 61·9%), varicella zoster virus reactivation (BNT162b2, Pfizer‐BioNTech, 17·2%) and urticaria (AZD1222, AstraZeneca, 21·1%). Most reactions to the mRNA‐1273 (Moderna) vaccine were described in women (90·5%). Eighty reactions (21%) were classified as severe/very severe and 81% required treatment.
Conclusions
Cutaneous reactions after SARS‐CoV‐2 vaccination are heterogeneous. Most are mild‐to‐moderate and self‐limiting, although severe/very severe reactions are reported. Knowledge of these reactions during mass vaccination may help healthcare professionals and reassure patients.
What is already known about this topic?
In clinical trials, COVID‐19 vaccines were associated with cutaneous adverse events, especially local injection site reactions.
Previous descriptions of cutaneous reactions beyond the injection site were case reports or mostly reported by non‐dermatologists and lacked clinical images.
What does this study add?
We describe and classify a large, representative sample of patients with unexplained skin manifestations after COVID‐19 vaccination, using consensus to define associated morphological patterns.
We describe six morphological reaction patterns and herpesvirus reactivations, and their association with demographic factors and the medical record, and provide illustrations to allow for easy recognition.
Linked Comment: V. Bataille and S. Puig. Br J Dermatol 2022; 186:15.
Plain language summary available online
Aflatoxins (AF) are potent mycotoxins with carcinogenic, teratogenic, and mutagenic potential. There is no agreement on the safe AF maximum residue levels established in different countries (5.0 to ...>20.0 μg/kg) to avoid feed toxicity in dairy cows and to protect the food chain. The objective was to establish a diagnosis of subclinical aflatoxicosis via changes in biochemical values during long-term exposure of AF low concentrations under field conditions. A cohort of 90 Holstein heifers were selected (395±10 kg/BW; 14-15 months) in a large dairy farm in the central Mexico highlands. Monthly samples of blood serum, feedstuffs, total mixed ration, and raw milk were obtained (26 months) and analyzed via spectrophotometric and HPLC methods. Dairy diets were naturally contaminated with AF (8.1±5.2 µg/kg). No cow showed clinical disease, but significant changes in biochemistry values were associated to AF intake at levels >5.0 µg/kg, especially a serum concentrations decrease in albumin, total protein and reduced glutathione; furthermore, an increase in prothrombin time, and in specific activity of AF metabolizing enzymes (glutathione S-transferase, γ-glutamyl transferase, alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase). Raw milk samples were naturally contaminated with AF in milk (AFM1; 43.1±24.0 ng/kg). A linear dose-response relationship between AF in feed and AFM1 concentrations was observed (AFM1=19.2+2.70(AF); P<0.01; R2 :62.1%). Moreover, reproductive failure and inter-pregnancy interval rates of cows exposed to higher AF concentrations (>10.0 µg/kg) were increased. These results suggested that in the long term, low amounts of AF exposure may lead to significant adverse effects consistent with subclinical aflatoxicosis.
We report, the application of the photoacoustic technique for monitoring the photosynthesis evolution in aquatic lirium (Eichhornia Crassipes), before and after it was exposed to ultrasonic ...irradiations. We obtained the disappearance of the phototobaric contribution in the PA signal measured for the irradiated samples with ultrasound of 17kHz, and therefore of a possible damage in the centers producing the photosynthesis, due to the irradiation. These results show the utility of the ultrasonic irradiation, as well as, of the photosynthesis monitoring by means of the photoacoustic technique, for the elaboration and establishment of methodologies in the control of this aquatic plant, whose propagation causes many consequences extremely unfavorable for the environment, as well as for the diverse human activities that are developed in the bodies of water in the tropical and sub-tropical regions of the world.
The ability of microorganisms to generate resistance outcompetes with the generation of new and efficient antibiotics; therefore, it is critical to develop novel antibiotic agents and treatments to ...control bacterial infections. An alternative to this worldwide problem is the use of nanomaterials with antimicrobial properties. Silver nanoparticles (AgNPs) have been extensively studied due to their antimicrobial effect in different organisms. In this work, the synergistic antimicrobial effect of AgNPs and conventional antibiotics was assessed in Gram-positive and Gram-negative bacteria. AgNPs minimal inhibitory concentration was 10-12 μg mL-1 in all bacterial strains tested, regardless of their different susceptibility against antibiotics. Interestingly, a synergistic antimicrobial effect was observed when combining AgNPs and kanamycin according to the fractional inhibitory concentration index, FICI: <0.5), an additive effect by combining AgNPs and chloramphenicol (FICI: 0.5 to 1), whereas no effect was found with AgNPs and β-lactam antibiotics combinations. Flow cytometry and TEM analysis showed that sublethal concentrations of AgNPs (6-7 μg mL-1) altered the bacterial membrane potential and caused ultrastructural damage, increasing the cell membrane permeability. No chemical interactions between AgNPs and antibiotics were detected. We propose an experimental supported mechanism of action by which combinatorial effect of antimicrobials drives synergy depending on their specific target, facilitated by membrane alterations generated by AgNPs. Our results provide a deeper understanding about the synergistic mechanism of AgNPs and antibiotics, aiming to combat antimicrobial infections efficiently, especially those by multi-drug resistant microorganisms, in order to mitigate the current crisis due to antibiotic resistance.
Abstract Objectives To identify the main clinical manifestations, triggers, and treatment of severe allergic reactions (SAR) in children and adolescents ( n = 191, up to 18 years of age) seen by ...allergologists and registered in the Online Latin American Survey of Anaphylaxis (OLASA). Results 53.0% of the patients were males and the aetiological agent was identified in 85.5% of them as follows: foods (36.1%), drugs (27.7%), and insect stings (26.2%). The most common symptoms during an acute episode were cutaneous (94.2%), and respiratory (78.5%). Most patients were treated in emergency setting, yet only 34.6% received parenteral epinephrine and 14.3% had to be hospitalised. Conclusion Cutaneous symptoms ranked the order of clinical presentation of SAR. Food was the main triggering agent in the younger cases and insect sting and drugs in the adolescents. Treatment provided for SAR was not appropriate. It is necessary to improve educational programmes in order to enhance the knowledge on this potentially fatal emergency.
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