RESUMO
Compounds containing the thiophene moiety find several applications in physics and chemistry, such as electrical conduction, which depends on specific conformations to properly exhibiting the desired properties. In turn, chalcogen bonding has found to modulate the conformation of some N-thiophen-2-ylfomamides. Since halogens participate in a kin interaction (halogen bonding) and are abundant in agrochemicals, pharmaceuticals, and materials, we have quantum-chemically explored the interaction between organic halogen and thiophene as a conformational modulator in some model compounds. Although such interaction indeed appears, as demonstrated by atoms in molecules and natural bond orbital analysis, it is inefficient to control the conformational equilibrium. An energy decomposition analysis scheme demonstrated that halomethane and thiophene tend to move away from one another due to a core component (Pauli repulsion and exchange), which is mainly due to a deformation term. Therefore, chalcogen bonds with halogens appear weaker than with other chalcogens.
RESUMO
PURPOSE: The treatment of urethral stenosis after a combination of prostatectomy and radiation therapy for prostate cancer is understudied. We evaluate the clinical and patient-related outcomes after dorsal onlay buccal mucosal graft urethroplasty (D-BMGU) in men who underwent prostatectomy and radiation therapy. MATERIALS AND METHODS: A multi-institutional, retrospective review of men with vesicourethral anastomotic stenosis or bulbomembranous urethral stricture disease after radical prostatectomy and radiation therapy from 8 institutions between 2013 to 2021 was performed. The primary outcomes were stenosis recurrence and development of de novo stress urinary incontinence. Secondary outcomes were surgical complications, changes in voiding, and patient-reported satisfaction. RESULTS: Forty-five men were treated with D-BMGU for stenosis following prostatectomy and radiation. There was a total of 7 recurrences. Median follow-up in patients without recurrence was 21 months (IQR 12-24). There were no incidents of de novo incontinence, 28 patients were incontinent pre- and postoperatively, and of the 6 patients managed with suprapubic catheter preoperatively, 4 were continent after repair. Following repair, men had significant improvement in postvoid residual, uroflow, International Prostate Symptom Score, and International Prostate Symptom Score quality-of-life domain. Overall satisfaction was +2 or better in 86.6% of men on the Global Response Assessment. CONCLUSIONS: D-BMGU is a safe, feasible, and effective technique in patients with urethral stenosis after a combination of prostatectomy and radiation therapy. Although our findings suggest this technique may result in lower rates of de novo urinary incontinence compared to conventional urethral transection and excision techniques, head-to-head comparisons are needed.
Assuntos
Estreitamento Uretral , Incontinência Urinária , Humanos , Masculino , Constrição Patológica/cirurgia , Mucosa Bucal/transplante , Prostatectomia/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento , Uretra/cirurgia , Estreitamento Uretral/etiologia , Estreitamento Uretral/cirurgia , Estreitamento Uretral/diagnóstico , Incontinência Urinária/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodosRESUMO
PURPOSE OF REVIEW: Devastating complications of the bladder outlet resulting from prostate cancer treatments are relatively uncommon. However, the combination of the high incidence of prostate cancer and patient longevity after treatment have raised awareness of adverse outcomes deteriorating patients' quality of life. This narrative review discusses the diagnostic work-up and management options for bladder outlet obstruction resulting from prostate cancer treatments, including those that require urinary diversion. RECENT FINDINGS: The devastated bladder outlet can be a consequence of the treatment of benign conditions, but more frequently from complications of pelvic cancer treatments. Regardless of etiology, the initial treatment ladder involves endoluminal options such as dilation and direct vision internal urethrotomy, with or without intralesional injection of anti-fibrotic agents. If these conservative strategies fail, surgical reconstruction should be considered. Although surgical reconstruction provides the best prospect of durable success, reconstructive procedures are also associated with serious complications. In the worst circumstances, such as prior radiotherapy, failed reconstruction, devastated bladder outlet with end-stage bladders, or patient's severe comorbidities, reconstruction may neither be realistic nor justified. Urinary diversion with or without cystectomy may be the best option for these patients. Thorough patient counseling before treatment selection is of utmost importance. Outcomes and repercussions on quality of life vary extensively with management options. Meticulous preoperative diagnostic evaluation is paramount in selecting the right treatment strategy for each individual patient. The risk of bladder outlet obstruction, and its severest form, devastated bladder outlet, after treatment of prostate cancer is not negligible, especially following radiation. Management includes endoluminal treatment, open or robot-assisted laparoscopic reconstruction, and urinary diversion in the worst circumstances, with varying success rates.
Assuntos
Neoplasias da Próstata , Obstrução do Colo da Bexiga Urinária , Humanos , Masculino , Obstrução do Colo da Bexiga Urinária/etiologia , Obstrução do Colo da Bexiga Urinária/terapia , Neoplasias da Próstata/terapia , Prostatectomia/métodos , Prostatectomia/efeitos adversos , Complicações Pós-Operatórias/terapia , Complicações Pós-Operatórias/etiologia , Derivação Urinária/métodosRESUMO
Ticks are blood-sucking arthropods that can transmit pathogens to their host. As insular ecosystems can enhance tick-host interactions, this study aimed to understand tick diversity, pathogen presence, and their respective associations in the Azores and Madeira archipelagos. Unfed or partially engorged ticks (n = 120) were collected from 58 cats and dogs in the Azores (n = 41 specimens) and Madeira (n = 79 specimens) from November 2018 to March 2019. Vector identification was based on morphology and molecular criteria. For pathogen sequencing, 18S gene fragment for Babesia/Hepatozoon and gltA for Rickettsia were performed. Sequence data was explored using BLAST and BLAST and phylogenetic inference tools. In the Azores, Ixodes hexagonus, I. ventalloi, and Rhipicephalus sanguineus (n = 6; 14.6%, n = 6; 14.6%, and n = 29; 70.7% respectively) were found and in Madeira I. ricinus and R. sanguineus (n = 78, 98.7%; and n = 1, 1.3%; respectively) were identified. Tick COI markers confirmed species highlighting confirmation of R. sanguineus s.s. and genotype A of I. ventalloi. In the Azores Islands, the detected Rickettsia massiliae was linked to R. sanguineus (dogs and cats) and I. hexagonus (dogs), and in Madeira Island, R. monacensis (dogs) and Hepatozoon silvestris (cats) were found associated with I. ricinus. Further, I. ventalloi presence in the Azores expands west its known range, and Hepatozoon silvestris in Madeira may suggest that I. ricinus could have a role as a potential vector. Finally, as R. massiliae and R. monacensis presence underlines public health risks, surveillance by health authorities is crucial as pathogen-tick interactions may drive disease spread, therefore monitoring remains pivotal for disease prevention.
Assuntos
Babesia , Rickettsia , Animais , Açores , Gatos , Rickettsia/isolamento & purificação , Rickettsia/genética , Rickettsia/classificação , Babesia/genética , Babesia/isolamento & purificação , Babesia/classificação , Cães , Doenças do Cão/parasitologia , Doenças do Cão/microbiologia , Filogenia , Doenças do Gato/parasitologia , Doenças do Gato/microbiologia , Ixodes/microbiologia , Ixodes/parasitologia , Infestações por Carrapato/veterinária , Infestações por Carrapato/parasitologia , Rhipicephalus sanguineus/microbiologia , Rhipicephalus sanguineus/parasitologia , Coccídios/genética , Coccídios/isolamento & purificação , Coccídios/classificação , Eucoccidiida/genética , Eucoccidiida/isolamento & purificação , Eucoccidiida/classificaçãoRESUMO
BACKGROUND: Fluorine plays a significant role in agrochemical science because approximately 25% of herbicides licensed worldwide contain this element. In a pool of previously synthesized benzoxazinones, some compounds contained fluorine and demonstrated inhibitory activities against protoporphyrinogen IX oxidase (PPO). Therefore, three data sets of benzoxazinone derivatives with known inhibitory activity against PPO were employed to build a multivariate image analysis applied to a quantitative structure-activity relationships (MIA-QSAR) model to identify improved analogs with at least one fluorine substituent. RESULTS: The QSAR model was vigorously validated and demonstrated to be highly predictive (r2 = 0.85, q2 = 0.71, and r2 pred = 0.88); thus, the model can provide reliable estimations for the PPO inhibitory activity of unknown derivatives. From these compounds, a couple of N-substituted benzoxazinones that contained the -CH2CHF2 group were found with predicted pKi values larger than 8 (Ki in mol L-1) and higher lipophilicity than the most active data set compounds. In addition, we carried out a systematic investigation of the binding mode of PPO by performing computational docking followed by molecular dynamics simulations. The proposed binding mode was consistent with experimental studies, and several potential key residues were identified. CONCLUSION: Two new proposed benzoxazinones exhibited better performance than compounds of the data set, and fluorine substituents played pivotal roles in describing the biological activities. © 2024 Society of Chemical Industry.
Assuntos
Benzoxazinas , Inibidores Enzimáticos , Simulação de Acoplamento Molecular , Simulação de Dinâmica Molecular , Protoporfirinogênio Oxidase , Relação Quantitativa Estrutura-Atividade , Protoporfirinogênio Oxidase/antagonistas & inibidores , Protoporfirinogênio Oxidase/química , Protoporfirinogênio Oxidase/metabolismo , Benzoxazinas/química , Inibidores Enzimáticos/química , Inibidores Enzimáticos/farmacologia , Herbicidas/química , Herbicidas/farmacologia , Halogenação , Estrutura Molecular , Desenho de FármacosRESUMO
Selective fluorination of the pyrrolidine ring in proline motifs has been found to induce significant conformational changes that impact the structure and biological roles of modified peptides and proteins. Vicinal difluorination of fluoroproline, for example, in (3S,4R)-3,4-difluoroproline, serves to mitigate the inherent conformational bias of the pyrrolidine ring by inducing stereoelectronic effects that attenuate this conformational bias. In this investigation, we present a quantumchemical analysis of the conformational equilibrium and effects that are induced in difluorinated pyrrolidines, with a particular focus on exploring the impact of gauche and anomeric effects on the conformer stabilities of different stereo- and regioisomers. Initially, we conducted a benchmark assessment comparing the optimal density functional theory method with coupled cluster with single and double excitations (CCSD) calculations and crystallographic data using the 3-fluoropyrrolidinium cation and 3-fluoropyrrolidine. Subsequently, we explored the relative energy of all favored conformations of all different stereoisomers of 2,3-, 2,4-, and 3,4-difluoropyrrolidines at the B3LYP-D3BJ/6-311++G** level. A generalized anomeric effect, arising from nNâσ*CF electron delocalization, is particularly important in modulating the energetics of the α-fluoro isomers and imparts a strong conformational bias. In contrast, the fluorine gauche effect assumes a secondary role, as it is overshadowed by steric and electrostatic interactions, referred to as Lewis interactions from a natural bond orbital perspective.
Assuntos
Psoríase , Humanos , Psoríase/patologia , Psoríase/complicações , Masculino , Pessoa de Meia-Idade , Feminino , Dor/etiologiaRESUMO
In soccer, knee and hip muscle strength assessments have been recommended for injury prevention. The aims of this study were threefold: (1) to compare knee and hip muscle strength between professional players competing at different levels; (2) to compare strength performance according to the preferred leg (PL) and the non-preferred leg (NPL); and (3) to compare knee and hip muscle strength performance at two moments of the season. This study included 33 professional soccer players: 13 were in the elite group (EG), and 20 were in the sub-elite group (SEG). Body composition, isokinetic knee strength at 60º/s, and hip adduction strength were assessed at two different moments (M1 and M2). Values of peak torque (PT), peak torque/bodyweight (PT/BW), and the hamstring-to-quadriceps strength ratio (H:Q) for knee extensors (KEs) and knee flexors (KFs) for both legs were used for analysis. The statistical analysis included the Mann-Whitney U and the Wilcoxon Signed Rank tests. At M1, the EG presented a significantly better performance in KF PT/BW and in the squeeze strength test for the PL and the NPL (p ≤ 0.01). At M2, the EG performed substantially better in KE PT/BW and KF PT/BW (p ≤ 0.01). No substantial strength differences were observed in knee and hip muscle performance between the PL and the NPL. From M1 to M2, significant increases were found in knee strength in both groups (p ≤ 0.01). Overall, the EG players outperformed significantly their lower-division peers in strength assessments. The results indicate significant knee and hip muscle strength increases during the season, probably as a response to the exposure to training and competition.
RESUMO
Speed and agility have been described as crucial abilities for soccer players. The purpose of this study was to analyze, in detail, the variance in speed and agility tasks explained by lower-body power after controlling for age and body composition. The participants were 96 male soccer players aged 16.1 ± 1.6 years. Body composition (stature, body fat percentage-BF%, body mass, and fat-free mass-FFM), lower-body power (countermovement jump-CMJ, and squat jump-SJ), speed (5-, 10-, and 35 m sprints), and agility (t-test) were assessed. Among body composition parameters, BF% presented the highest number of significant relationships with speed and agility, with the strength of correlations ranging from small (5 m sprint, r = 0.25) to large (35 m sprint, r = 0.52). The strongest correlation coefficient emerged between FFM and the 35 m sprint (r = -0.65). Significant correlations were found between vertical jump performance and the 35 m sprint (CMJ: r = -0.68; SJ: r = -0.69), followed by the t-test (CMJ: r = -0.35; SJ: r = -0.47). The hierarchical multiple regression model could explain 22% to 67% of the variance observed in agility scores and speed. BF% remained the most statistically significant negative predictor of all regression models. The CMJ remained a statistically significant positive predictor of the 35 m sprint (ß = -0.581, p ≤ 0.01) after controlling for age and body composition. Integrating programs targeting lower-body power might be important to enhance speed and agility performance in youth soccer. On the other hand, future research based on multidisciplinary approaches to investigate the effects of nutritional strategies in reducing or preventing gains in BF% is still needed, which remained a significant predictor of sprint and agility performance in the final models.
RESUMO
The development of coordination compounds with antineoplastic therapeutic properties is currently focused on non-covalent interactions with deoxyribonucleic acid (DNA). Additionally, the interaction profiles of these compounds with globular plasma proteins, particularly serum albumin, warrant thorough evaluation. In this study, we report on the interactions between biomolecules and complexes featuring hydrazone-type imine ligands coordinated with vanadium. The potential to enhance the therapeutic efficiency of these compounds through mitochondrial targeting is explored. This targeting is facilitated by the derivatization of ligands with triphenylphosphonium groups. Thus, this work presents the synthesis, characterization, interactions, and cytotoxicity of dioxidovanadium(V) complexes (C1-C5) with a triphenylphosphonium moiety. These VV-species are coordinated to hydrazone-type iminic ligands derived from (3-formyl-4-hydroxybenzyl)triphenylphosphonium chloride ([AH]Cl) and aromatic hydrazides ([H2L1]Cl-[H2L5]Cl). The structures of the five complexes were elucidated through single-crystal X-ray diffraction and vibrational spectroscopies, confirming the presence of dioxidovanadium(V) species in various geometries with degrees of distortion (τ = 0.03-0.50) and highlighting their zwitterionic characteristics. The molecular structural stability of C1-C5 in solution was ascertained using 1H, 19F, 31P, and 51V-nuclear magnetic resonance. Moreover, their interactions with biomolecules were evaluated using diverse spectroscopic methodologies and molecular docking, indicating moderate interactions (Kb ≈ 104 M-1) with calf thymus DNA in the minor groove and with human serum albumin, predominantly in the superficial IB subdomain. Lastly, the cytotoxic potentials of these complexes were assessed in keratinocytes of the HaCaT lineage, revealing that C1-C5 induce a reduction in metabolic activity and cell viability through apoptotic pathways.
Assuntos
Antineoplásicos , Complexos de Coordenação , DNA , Compostos Organofosforados , Vanádio , Humanos , Vanádio/química , Vanádio/farmacologia , Complexos de Coordenação/farmacologia , Complexos de Coordenação/química , Complexos de Coordenação/síntese química , Antineoplásicos/farmacologia , Antineoplásicos/química , Antineoplásicos/síntese química , Compostos Organofosforados/química , Compostos Organofosforados/farmacologia , DNA/metabolismo , DNA/química , Sobrevivência Celular/efeitos dos fármacos , Hidrazinas/química , Hidrazinas/farmacologia , Animais , Simulação de Acoplamento Molecular , Albumina Sérica Humana/química , Albumina Sérica Humana/metabolismo , Estrutura Molecular , Ligantes , Linhagem Celular Tumoral , Ensaios de Seleção de Medicamentos AntitumoraisRESUMO
Due to its physical demands, professional soccer is becoming a real challenge regarding players' exposure to high injury risk. Given its tight correlation with high-intensity actions, muscular strength is a crucial physical characteristic for soccer players. Therefore, the aims of this study are (a) to compare the vertical jumping performance during the season according to the injury profile, and (b) to investigate differences in isokinetic strength performance at the beginning and the end of the season. Twenty-one male professional soccer players (age: 26.0 ± 4.1 years, height: 181.0 ± 6.9â cm, body mass: 73.7 ± 6.9â kg) were assessed in isokinetic strength (Biodex System 4 Pro Dynamometer), and Optojump Next (Microgate, Bolzano, Italy). Isokinetic strength analyses considered the peak torque scores of knee flexors and knee extensors, according to the player's preferred and non-preferred limb. The countermovement and squat jump maximum height were assessed as lower body explosive strength indicators. No significant differences were found when comparing injured and non-injured players in vertical jump and isokinetic strength assessments. However, significant results were found when comparing both groups' initial and final evaluation in isokinetic strength assessment, with both groups significantly improving their performance. Our findings indicate that the overall lower body strength performance was not a discriminant factor between injured and non-injury players. Thus, muscular strength assessment performance increased throughout the season independently of the injury profile. Future research needs to integrate other variables related to sports injuries since they seem to result from multifactorial causes.
Assuntos
Futebol , Humanos , Masculino , Adulto Jovem , Adulto , Extremidade Inferior , Itália , Articulação do JoelhoRESUMO
Objectives: This study aimed to compare the effectiveness and safety of the adjustable trans-obturator male system (ATOMS®) to treat post-prostatectomy incontinence (PPI) in radiated patients compared with non-radiated patients, using propensity score-matching analysis to enhance the validity of the comparison. Patients and methods: Consecutive men with PPI treated with silicone-covered scrotal port ATOMS (A.M.I., Feldkirch, Austria) in nine different institutions between 2016 and 2022 were included. Preoperative assessment evaluated 24-h pad usage, urethroscopy and urodynamics, if indicated. Propensity score-matching analysis was based on age, length of follow-up, previous PPI treatment, previous bladder neck stricture, androgen deprivation and pad usage. The primary endpoint was dry rate, defined as no pads post-operatively with a security pad allowed. The secondary endpoints were complications, device removal and self-perceived satisfaction with the Patient Global Impression of Improvement (PGI-I) scale. Results: Of the 710 included patients, 342 were matched, and the study groups were balanced for the baseline matched variables. The mean baseline 24-h pad was 4.8 in both groups (p = 0.48). The mean follow-up was 27.5 ± 18.6 months, which was also equivalent between groups (p = 0.36). The primary outcome was achieved in 73 (42.7%) radiated patients and in 115 (67.3%) non-radiated patients (p < 0.0001). The mean pad count at the last follow-up was 1.5 and 0.8, respectively (p < 0.0001). There was no significant difference in complications (p = 0.94), but surgical revision and device explant rates were higher (p = 0.03 and p = 0.01, respectively), and the proportion of patients highly satisfied (PGI-I = 1) was lower in the radiated group (p = 0.01). At sensitivity analysis, the study was found to be reasonably robust to hidden bias. Conclusion: ATOMS implantation significantly outperformed in patients without adjuvant radiation over radiated patients.
RESUMO
BACKGROUND: Inguinal lymph node dissection plays an important role in the management of melanoma, penile and vulval cancer. Inguinal lymph node dissection is associated with various intraoperative and postoperative complications with significant heterogeneity in classification and reporting. This lack of standardization challenges efforts to study and report inguinal lymph node dissection outcomes. The aim of this study was to devise a system to standardize the classification and reporting of inguinal lymph node dissection perioperative complications by creating a worldwide collaborative, the complications and adverse events in lymphadenectomy of the inguinal area (CALI) group. METHODS: A modified 3-round Delphi consensus approach surveyed a worldwide group of experts in inguinal lymph node dissection for melanoma, penile and vulval cancer. The group of experts included general surgeons, urologists and oncologists (gynaecological and surgical). The survey assessed expert agreement on inguinal lymph node dissection perioperative complications. Panel interrater agreement and consistency were assessed as the overall percentage agreement and Cronbach's α. RESULTS: Forty-seven experienced consultants were enrolled: 26 (55.3%) urologists, 11 (23.4%) surgical oncologists, 6 (12.8%) general surgeons and 4 (8.5%) gynaecology oncologists. Based on their expertise, 31 (66%), 10 (21.3%) and 22 (46.8%) of the participants treat penile cancer, vulval cancer and melanoma using inguinal lymph node dissection respectively; 89.4% (42 of 47) agreed with the definitions and inclusion as part of the inguinal lymph node dissection intraoperative complication group, while 93.6% (44 of 47) agreed that postoperative complications should be subclassified into five macrocategories. Unanimous agreement (100%, 37 of 37) was achieved with the final standardized classification system for reporting inguinal lymph node dissection complications in melanoma, vulval cancer and penile cancer. CONCLUSION: The complications and adverse events in lymphadenectomy of the inguinal area classification system has been developed as a tool to standardize the assessment and reporting of complications during inguinal lymph node dissection for the treatment of melanoma, vulval and penile cancer.
Assuntos
Consenso , Técnica Delphi , Canal Inguinal , Excisão de Linfonodo , Melanoma , Neoplasias Penianas , Complicações Pós-Operatórias , Neoplasias Vulvares , Humanos , Excisão de Linfonodo/efeitos adversos , Excisão de Linfonodo/métodos , Feminino , Masculino , Neoplasias Penianas/cirurgia , Neoplasias Penianas/patologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/epidemiologia , Neoplasias Vulvares/cirurgia , Neoplasias Vulvares/patologia , Melanoma/cirurgia , Melanoma/patologia , Canal Inguinal/cirurgia , Inquéritos e QuestionáriosRESUMO
A hipoplasia da veia cava inferior é uma patologia rara que integra o conjunto de anomalias do desenvolvimento da veia cava inferior. A sua incidência situa-se entre 0,3%-0,5% na população saudável e 5% nos adultos jovens sem fatores de risco para trombose venosa profunda, sendo considerada um importante fator de risco para o desenvolvimento de trombose dos membros inferiores. O principal objetivo deste trabalho é reportar a conduta obstétrica de um caso clínico de uma grávida diagnosticada com hipoplasia da veia cava inferior, prévia à gravidez. Trata-se de um caso clínico, de uma grávida, primigesta, com 37 anos, com hipoplasia da veia cava inferior e heterozigotia para o gene MTHFR677 diagnosticadas, na sequência de uma trombose venosa bilateral dos membros inferiores e do segmento infrarrenal da veia cava inferior. A gravidez foi seguida em consulta hospitalar na nossa instituição, tendo a grávida sido medicada com enoxaparina em dose profilática e ácido acetilsalicílico, com um período pré natal que decorreu sem intercorrências. Às 37 semanas e 6 dias de gestação, deu entrada no Serviço de Urgência de Obstetrícia por rotura prematura de membranas. Intraparto foram utilizadas meias de compressão pneumática intermitente, tendo o parto ocorrido às 38 semanas de gestação por via vaginal (parto eutócico), do qual nasceu um recém-nascido do sexo feminino, com 2620g e índice de Apgar 9/10/10. O presente caso clínico demonstra que em situações de hipoplasia da veia cava inferior com um seguimento obstétrico adequado é possível a realização de um parto vaginal, possibilitando um desfecho obstétrico favorável (AU).
Hypoplasia of the inferior vena cava is a rare condition that belongs to the group of developmental anomalies of the inferior vena cava. It has an incidence between 0.3% and 0.5% in the healthy population and 5% in young adults without risk factors for deep venous thrombosis, being considered an important risk factor for the development of lower limb thrombosis. This study aims to report the obstetric conduct of a clinical case of a pregnant woman diagnosed with hypoplasia of the inferior vena cava prior to pregnancy. This is a clinical case of a pregnant woman, primigravid 37 years old, with hypoplasia of the inferior vena cava and heterozygosity for MTHFR677, diagnosed following a bilateral venous thrombosis of the lower limbs and the infrarenal segment of the inferior vena cava. The pregnancy was followed up in our institution. The pregnant woman was medicated with a prophylatic dose of low molecular weight heparin and acetylsalicylic acid with an uneventful prenatal period. At 37 weeks and 6 days of gestation, she was admitted to the Obstetrics Emergency Service due to premature rupture of membranes. Intermittent pneumatic compression sockings were used intrapartum, and at 38 weeks of gestation, a female newborn was vaginally delivered (eutocic delivery) with 2620g and an Apgar score of 9/10/10. The present clinical case demonstrates that in situations of hypoplasia of the inferior vena cava with an adequate obstetric follow-up, it is possible to perform a vaginal delivery, enabling a favourable obstetric outcome (AU).
Assuntos
Humanos , Feminino , Gravidez , Adulto , Trombose/terapia , Veia Cava Inferior/anormalidades , Conhecimentos, Atitudes e Prática em Saúde , PartoRESUMO
Analisar a correlação entre estresse, ansiedade e depressão com a síndrome de Burnout em estudantes de graduação de uma universidade pública federal. Trata-se de um estudo exploratório-descritivo, com abordagem quantitativa, que utilizou um questionário on-line para coleta de dados, que ocorreu entre dezembro de 2021 e março de 2022, disponibilizado por e-mail. Participaram 169 discentes, e a correlação entre as variáveis sociodemográficas e as dimensões estresse, ansiedade e depressão evidenciou que os brasileiros, principalmente as mulheres e praticantes de alguma religião, mostraram escores mais elevados. Quanto à síndrome de Burnout, notaram-se valores altos para as dimensões exaustão emocional e eficácia profissional, mas escores baixos para a dimensão descrença. Ao verificar-se a correlação entre a escala de ansiedade, depressão e estresse e a síndrome de Burnout, percebeu-se uma relação negativa entre seus domínios e a eficácia estudantil. Revelou-se também uma correlação entre a depressão e a exaustão emocional.
To analyze the correlation between stress, anxiety, and depression with the Burnout syndrome in undergraduate students at a federal public university. This is an exploratory descriptive study, with a quantitative approach, which used an online questionnaire for data collection, which took place from December 2021 to March 2022, available by email. 169 students participated in the study, in which the correlation between sociodemographic variables and the dimensions stress, anxiety and depression showed that Brazilians, especially women and practitioners of some religion, showed higher scores. As for the Burnout syndrome, high values were observed for the emotional exhaustion and professional efficacy dimensions, but low scores for the disbelief dimension. When verifying the correlation between the anxiety, depression and stress scale and the Burnout syndrome, a negative relationship between its domains and student effectiveness was noticed. A correlation was also revealed between depression and emotional exhaustion.
RESUMO
Objetivo:Esta pesquisa buscou avaliar os impactos da pandemia do vírus SARS-CoV-2 nosono de acadêmicos de universidade do interior do Ceará.Métodos:Trata-se de pesquisa quantitativa, com abordagem analítica, realizada em 2022, por intermédio de um questionário sociodemográfico associado ao instrumento de análise da qualidade do sono. Participaram do estudo 225 estudantes maiores de 18 anos e com matrícula ativa nos cursos de graduação da Universidade da Integração Internacional da Lusofonia Afro-Brasileira (UNILAB). O questionário foi disponibilizado via e-mail. A análise foi realizada por meio de frequências absolutas e relativas das variáveis, além de medidas de tendência central e de dispersão.Resultados:A partir da análise dos dados, percebeu-se que,quando comparado o percentual da qualidade do sono de antes da pandemia (44,0%) com aqueledurante o período pandêmico (25,8%), no segundo caso houve diminuição desta boa qualidade, podendo estar relacionada à dificuldade de adormecer ou à insônia. Conclusão:Conclui-se que a qualidade do sono foi significativamente impactada, de modo negativo, durante a pandemia, sendo ainda possivelmente prejudicial ao desenvolvimento e rendimento acadêmico dos estudantes
Objective:This research evaluatedthe impact of the pandemic of the SARS-CoV-2 virus on the sleep of the students of a university inland Ceará,Brazil. Methods:This is a quantitative analytical research, carried out in 2022 using a sociodemographic questionnaire associated with an instrument to analyze the quality of sleep. The study counted on the participation of 225 students older than 18 years who were enrolled and active in graduation courses of the Universidade da Integração Internacional da Lusofonia Afro-Brasileira (UNILAB). The questionnaire was made available by e-mail. The analysis was carried out using the relative and absolute frequencies of the variables, in addition to central tendency and dispersion measures. Results:The analysis of the data showed that, sleep quality before the pandemic (44.0%) was much higher thanafter it (25.8%). This reduction can be related with trouble sleeping or insomnia.Conclusion:Sleep quality became significantly reduced during the pandemic, which may also have had negative effects on student performance and productivity.
Assuntos
Sono , Estudantes , COVID-19RESUMO
ABSTRACT Purpose: To evaluate efficacy of urorectal fistula (URF) repair using different approaches and the clinical factor determinant of success, and also the morbidity associated to the procedure and health-related quality of life (HRQoL) in male survivors of pelvic malignancies. Material and Methods: Retrospective evaluation of 39 patients with URF primarily intervened in three institutions using different surgical approaches. Success was defined as effective fistula closure. Variables evaluated included demographics, previous treatments, surgical approach, ancillary surgeries, complications and HRQoL by using a standardized non-validated specific questionnaire. Median follow-up from surgery to interview was 55 months (interquartile range 49, range 4-112). Factors determinant of success were investigated using logistic regression. Safety of the procedure was evaluated by Clavien-Dindo scale. Deterioration of continence and erectile function and other HRQoL issues were evaluated. Results: Prostate cancer treatment was the predominant etiology. The success rate for fistula repair was 89.5%. The surgical approach was not related to failed repair (p=0.35) or complications (p=0.29). Factors associated with failure were complications (p=0.025), radiotherapy (p=0.03), fistula location (p=0.04) and fistula size (p=0.007). Multivariate analysis revealed fistula size was the only independent determinant of failure (OR 6.904, 1.01-47.75). Complications occurred in 46.2% and severe complications in 12.8%. The mortality related to the procedure was 2.6%. Urinary incontinence was present before repair in 26.3% and erectile dysfunction in 89.5%. Fistula repair caused de novo urinary incontinence in 7.9% and deterioration of erectile status in 44.7%. Globally 79% were satisfied after repair and only 7.9% rated HRQoL as unhappy. Trans-sphincteric approach was related to less deterioration of erectile function (p=0.003), and higher perceived satisfaction in QoL (p=0.04). Conclusions: The surgical approach elected to correct URF is not determinant of success nor of complications. Fistula size appears as independent determinant for failure. Transsphincteric approach could be advantageous over other procedures regarding HRQoL issues.
Assuntos
Humanos , Masculino , Incontinência Urinária , Fístula Retal/cirurgia , Fístula Urinária/cirurgia , Fístula Urinária/etiologia , Qualidade de Vida , Estudos Retrospectivos , Resultado do TratamentoRESUMO
ABSTRACT: The objective of the present study was to assess the treatment of dogs with ehrlichiosis (tropical canine pancytopenia (TCP)) with doxycycline hydrochloride associated or not with prednisolone on the hematological profile and serum proteins. Ten dogs with TCP were selected in the Small Animal Medical Clinic Veterinary Hospital, Federal University of Campina Grande-UFCG-PB, Brazil. The diagnosis was obtained by clinical examination, hemogram and immunochromatographic test (with anti Ehrlichia canis antibodies). Samples were distributed randomly in two experimental groups of five animals each (n = 5), named GD and GDP. The GD group was treated with doxycycline (5 mg/kg, VO, BID for 28 days) and the GDP group was treated with doxycycline at the same dose and duration and prednisolone (2 mg/kg, VO, BID, for five days). Four blood collections were made during the treatment period: a base collection (M0), one at 10 days (M10), a second at 21 days (M21) and another at the end of the treatment (M28). These samples were used for the tests erythrogram, leucogram, plateletgram and proteinogram (dose of total proteins, pre-albumin, albumin, albumin, α-1 globulin, α-2 globulin, ß-globulin, ɣ-globulin and C- reactive protein) in the Clinical Pathology Laboratory, Veterinary Hospital-UFCG-PB. Results, that presented normal distribution, was submitted to the Tukey test (P<0.05). Comparison of treatments GD and GDP showed that both promoted discreet and similar response in the hematological parameters at different times. Results obtained allowed the conclusion that both therapeutic protocols resulted in clinical, hematological parameter and proteinogram improvement, but the use of prednisolone at the dose administered during the first five days of treatment did not show more beneficial effects than isolated administration of doxycycline.
RESUMO: Objetivou-se com este estudo avaliar os efeitos do tratamento de cães com erliquiose monocítica canina (EMC) com cloridrato de doxiciclina associada ou não à prednisolona sobre o perfil hematológico e de proteínas séricas. Foram selecionados, na Clínica Médica de Pequenos Animais do Hospital Veterinário da Universidade Federal de Campina Grande (UFCG), 10 cães com EMC. O diagnóstico foi obtido através de exame clínico, hemograma e teste de imunoensaio imunocromatográfico (com anticorpos anti Ehrlichia canis). As amostras foram distribuídas aleatoriamente em dois grupos experimentais, com cinco animais cada (n=5), denominados GD e GDP. O grupo GD foi tratado com doxiciclina (5 mg/kg, VO, BID durante 28 dias) e o grupo GDP, tratado com doxiciclina na mesma dose e duração e prednisolona (2 mg/kg, VO, BID, durante 5 dias). Durante o período de tratamento, foram realizadas quatro coletas de sangue; uma coleta basal (M0), uma com 10 dias (M10), uma aos 21 dias (M21) e outra ao final do tratamento (M28). Dessas amostras foram realizados eritrograma, leucograma, plaquetograma e proteinograma (dosagem de proteínas totais, pré-albumina, albumina, α-1 globulina, α-2 globulina, ß-globulina, ɣ-globulina e proteína C-reativa) no Laboratório de Patologia Clínica do Hospital Veterinário da UFCG. Os resultados que apresentaram distribuição normal foram submetidos ao teste de Tukey (P<0,05). Ao comparar os tratamentos GD e GDP, observou-se que os dois promoveram resposta discreta e semelhante dos parâmetros hematológicos nos diferentes momentos. Os resultados obtidos permitem concluir que ambos os protocolos terapêuticos resultaram em melhora clínica e dos parâmetros hematológicos e do proteinograma. Porém, o uso da prednisolona na dose empregada durante os primeiros cinco dias de tratamento não demonstrou efeitos mais benéficos do que a administração isolada da doxiciclina.