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1.
Lancet Reg Health Eur ; 43: 100971, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39040529

RESUMO

Background: Leishmaniases are neglected diseases transmitted by sand flies. They disproportionately affect vulnerable groups globally. Understanding the relationship between climate and disease transmission allows the development of relevant decision-support tools for public health policy and surveillance. The aim of this modelling study was to develop an indicator that tracks climatic suitability for Leishmania infantum transmission in Europe at the subnational level. Methods: Historical records of sand fly vectors, human leishmaniasis, bioclimatic indicators, and environmental variables were integrated in a machine learning framework (XGBoost) to predict suitability in two past periods (2001-2010 and 2011-2020). We further assessed if predictions were associated with human and animal disease data from selected countries (France, Greece, Italy, Portugal, and Spain). Findings: An increase in the number of climatically suitable regions for leishmaniasis was detected, especially in southern and eastern countries, coupled with a northward expansion towards central Europe. The final model had excellent predictive ability (AUC = 0.970 [0.947-0.993]), and the suitability predictions were positively associated with human leishmaniasis incidence and canine seroprevalence for Leishmania. Interpretation: This study demonstrates how key epidemiological data can be combined with open-source climatic and environmental information to develop an indicator that effectively tracks spatiotemporal changes in climatic suitability and disease risk. The positive association between the model predictions and human disease incidence demonstrates that this indicator could help target leishmaniasis surveillance to transmission hotspots. Funding: European Union Horizon Europe Research and Innovation Programme (European Climate-Health Cluster), United Kingdom Research and Innovation.

2.
PLoS One ; 19(6): e0304085, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38905190

RESUMO

In a clinical context, conventional optical microscopy is commonly used for the visualization of biological samples for diagnosis. However, the availability of molecular techniques and rapid diagnostic tests are reducing the use of conventional microscopy, and consequently the number of experienced professionals starts to decrease. Moreover, the continuous visualization during long periods of time through an optical microscope could affect the final diagnosis results due to induced human errors and fatigue. Therefore, microscopy automation is a challenge to be achieved and address this problem. The aim of the study is to develop a low-cost automated system for the visualization of microbiological/parasitological samples by using a conventional optical microscope, and specially designed for its implementation in resource-poor settings laboratories. A 3D-prototype to automate the majority of conventional optical microscopes was designed. Pieces were built with 3D-printing technology and polylactic acid biodegradable material with Tinkercad/Ultimaker Cura 5.1 slicing softwares. The system's components were divided into three subgroups: microscope stage pieces, storage/autofocus-pieces, and smartphone pieces. The prototype is based on servo motors, controlled by Arduino open-source electronic platform, to emulate the X-Y and auto-focus (Z) movements of the microscope. An average time of 27.00 ± 2.58 seconds is required to auto-focus a single FoV. Auto-focus evaluation demonstrates a mean average maximum Laplacian value of 11.83 with tested images. The whole automation process is controlled by a smartphone device, which is responsible for acquiring images for further diagnosis via convolutional neural networks. The prototype is specially designed for resource-poor settings, where microscopy diagnosis is still a routine process. The coalescence between convolutional neural network predictive models and the automation of the movements of a conventional optical microscope confer the system a wide range of image-based diagnosis applications. The accessibility of the system could help improve diagnostics and provide new tools to laboratories worldwide.


Assuntos
Microscopia , Microscopia/métodos , Microscopia/instrumentação , Microscopia/economia , Humanos , Impressão Tridimensional/instrumentação , Software , Robótica/instrumentação , Smartphone , Automação , Imageamento Tridimensional/métodos
3.
Urology ; 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38871305

RESUMO

OBJECTIVE: To assess the feasibility, safety, and predictive factors for the success of holmium laser enucleation of the prostate (HoLEP) with catheter removal and hospital discharge on the same day of the procedure. METHODS: This prospective study included 34 patients who underwent HoLEP using a 60-W holmium laser device and the Wolf Piranha morcellation system. Surgeries began at 10:30 am and the patients were expected to be discharged by 5 pm on the same day. The patients underwent a voiding trial to remove the urinary catheter before hospital discharge. Functional outcomes were assessed 90 days after the procedure. RESULTS: Mean (range) age, prostate-specific antigen value, and prostate weight were as follows: 63.4 (50-80) years, 4.81 (0.19-14) ng/mL, and 89.3 (33-258) g, respectively. The mean (range) enucleation and morcellation times were 56.2 (29-91) minutes and 14.67 (3-45) minutes, respectively. Thirty-one patients (91.1%) were discharged on the same day of the procedure after urinary catheter removal. CONCLUSION: The performance of HoLEP is safe on an outpatient basis. Same-day catheter removal is feasible and does not affect hospital discharge.

4.
Mater Today Bio ; 26: 101100, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38854953

RESUMO

Objectives: Calcium phosphate-based biomaterials (CaP) are the most widely used biomaterials to enhance bone regeneration in the treatment of alveolar bone deficiencies, cranio-maxillofacial and periodontal infrabony defects, with positive preclinical and clinical results reported. This systematic review aimed to assess the influence of the physicochemical properties of CaP biomaterials on the performance of bone regeneration in preclinical animal models. Methods: The PubMed, EMBASE and Web of Science databases were searched to retrieve the preclinical studies investigating physicochemical characteristics of CaP biomaterials. The studies were screened for inclusion based on intervention (physicochemical characterization and in vivo evaluation) and reported measurable outcomes. Results: A total of 1532 articles were retrieved and 58 studies were ultimately included in the systematic review. A wide range of physicochemical characteristics of CaP biomaterials was found to be assessed in the included studies. Despite a high degree of heterogeneity, the meta-analysis was performed on 39 studies and evidenced significant effects of biomaterial characteristics on their bone regeneration outcomes. The study specifically showed that macropore size, Ca/P ratio, and compressive strength exerted significant influence on the formation of newly regenerated bone. Moreover, factors such as particle size, Ca/P ratio, and surface area were found to impact bone-to-material contact during the regeneration process. In terms of biodegradability, the amount of residual graft was determined by macropore size, particle size, and compressive strength. Conclusion: The systematic review showed that the physicochemical characteristics of CaP biomaterials are highly determining for scaffold's performance, emphasizing its usefulness in designing the next generation of bone scaffolds to target higher rates of regeneration.

6.
Biomedicines ; 12(5)2024 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-38791033

RESUMO

In our study, we investigated the prognostic significance of hematological markers-NLR (Neutrophil-to-Lymphocyte Ratio), PLR (Platelet-to-Lymphocyte Ratio), and RDW-CV (Red Blood Cell Distribution Width-Coefficient of Variation)-in 117 glioblastoma patients. The data collected from January 2016 to December 2018 included demographics, clinical scores, and treatment regimens. Unlike previous research, which often examined these markers solely before surgery, our unique approach analyzed them at multiple stages: preoperative, postoperative, and before adjuvant therapies. We correlated these markers with the overall survival (OS) and progression-free survival (PFS) using statistical tools, including ANOVA, Cox regression, and Kaplan-Meier survival analyses, employing SPSS version 29.0. Our findings revealed notable variations in the NLR, PLR, and RDW-CV across different treatment stages. The NLR and PLR decreased after surgery, with some stabilization post-STUPP phase (NLR: p = 0.007, η2p = 0.06; PLR: p = 0.001, η2p = 0.23), while the RDW-CV increased post-surgery and during subsequent treatments (RDW-CV: p < 0.001, η2p = 0.67). Importantly, we observed significant differences between the preoperative phase and other treatment phases. Additionally, a higher NLR and RDW-CV at the second-line treatment and disease progression were associated with an increased risk of death (NLR at 2nd line: HR = 1.03, p = 0.029; RDW-CV at progression: HR = 1.14, p = 0.004). We proposed specific marker cut-offs that demonstrated significant associations with survival outcomes when applied to Kaplan-Meier survival curves (NLR at 2nd line < 5: p < 0.017; RDW-CV at progression < 15: p = 0.007). An elevated NLR and RDW-CV at later treatment stages correlated with poorer OS and PFS. No significant preoperative differences were detected. These biomarkers may serve as non-invasive tools for glioblastoma management.

7.
Sci Rep ; 14(1): 7835, 2024 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-38570516

RESUMO

Cardiovascular risk increases during the aging process in women with atherosclerosis and exercise training is a strategy for management of cardiac risks in at-risk populations. Therefore, the aims of this study were to evaluate: (1) the influence of the aging process on cardiac function, hemodynamics, cardiovascular autonomic modulation, and baroreflex sensitivity in females with atherosclerosis at the onset of reproductive senescence; and (2) the impact of exercise training on age-related dysfunctions in this model. Eighteen Apolipoprotein-E knockout female mice were divided equally into young (Y), middle-aged (MA), and trained middle-aged (MAT). Echocardiographic exams were performed to verify cardiac morphology and function. Cannulation for direct recording of blood pressure and heart rate, and analysis of cardiovascular autonomic modulation, baroreflex sensitivity were performed. The MA had lower cardiac diastolic function (E'/A' ratio), and higher aortic thickness, heart rate and mean arterial pressure, lower heart rate variability and baroreflex sensitivity compared with Y. There were no differences between Y and MAT in these parameters. Positive correlation coefficients were found between aortic wall thickness with hemodynamics data. The aging process causes a series of deleterious effects such as hemodynamic overload and dysautonomia in female with atherosclerosis. Exercise training was effective in mitigating aged-related dysfunctions.


Assuntos
Aterosclerose , Doenças do Sistema Nervoso Autônomo , Sistema Cardiovascular , Humanos , Pessoa de Meia-Idade , Feminino , Camundongos , Animais , Idoso , Coração , Hemodinâmica , Pressão Sanguínea/fisiologia , Frequência Cardíaca , Aterosclerose/terapia
8.
Cureus ; 16(2): e53641, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38449965

RESUMO

Background Several studies point to metabolic syndrome as a risk factor for the development and progression of several types of cancer. Its association with glioblastoma has yet to be determined, and only two studies investigate the impact of metabolic syndrome on the survival of glioblastoma patients, indicating a trend toward decreased survival in patients with metabolic syndrome. The aim of this study was to determine whether patients with glioblastoma and metabolic syndrome had a worse clinical outcome. Methods We retrospectively reviewed the clinical records of 180 patients diagnosed with glioblastoma. Metabolic syndrome was defined according to the American Heart Association, as the presence of at least three of the following criteria: diabetes, hypertension, hyperlipidemia, and obesity. We analyzed the overall survival and progression-free survival of patients with and without metabolic syndrome. Results Of 180 patients, 20 (11.1%) met the diagnostic criteria for metabolic syndrome. The overall survival of patients with metabolic syndrome was 19.8 months, and without metabolic syndrome was 17.7 months (p-value=0.085). The progression-free survival of patients with metabolic syndrome was 9.9 months, and without metabolic syndrome was 7.9 months (p-value=0.076). Conclusion Our results showed no prognostic relevance of metabolic syndrome in patients with glioblastoma, although there was a trend towards increased overall survival and progression-free survival in patients with metabolic syndrome.

9.
Theriogenology ; 220: 77-83, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38490112

RESUMO

The present study evaluated follicular and endocrine dynamics during ReBreed21, a reproductive strategy that allows resynchronization of ovulation every 21 days in Bos indicus (Nelore) heifers. A synchronized estrous cycle was induced using a standard timed ovulation protocol (d -10: P4 implant inserted + 2 mg estradiol benzoate; d -2: P4 removed+ 0.5 mg cloprostenol + 0.6 mg estradiol cypionate + 200 IU equine chorionic gonadotropin (eCG); d0: 8.4 µg buserelin) without AI to ensure nonpregnancy in heifers. Day of GnRH was designated d0 of estrous cycle. On d12, heifers (n = 80) were randomized into three experimental groups: (1) ReBreed21 (n = 28) d12 P4 device inserted, d19 P4 device withdrawal plus 200 IU eCG, and d21 8.4 µg buserelin (GnRH); (2) ReBreed21+G (n = 26) same as ReBreed21 plus GnRH (16.8 µg) treatment on d12; and (3) Control (n = 26) no treatment. ReBreed21+G increased two-fold (62.9%; 18/26) percentage of heifers with synchronized follicular wave emergence compared to Control (34.6%; 9/26) whereas ReBreed21 (53.6%; 15/28) was intermediate. The ReBreeed21 groups (eCG on d19) increased (P < 0.01) follicular growth between d19 and d21 in ReBreed21 (2.3 ± 0.2 mm) and ReBreed21+G (3.4 ± 0.2 mm) compared with Control (1.2 ± 0.3 mm), resulting in greater (P < 0.01) follicle diameter on d21 for ReBreed21 (10.7 ± 0.4 mm) and ReBreed21+G (10.8 ± 0.4 mm) compared with Control (9.1 ± 0.5 mm). Structural luteolysis was similar among groups (P = 0.51), although the average day when P4 was <1 ng/mL was later (P < 0.01) for ReBreed21 (20.5 ± 0.2) and ReBreed21+G (20.7 ± 0.2) compared to Control (19.2 ± 0.4). Overall ovulation at the end of the estrous cycle was increased (P = 0.03) for ReBreed21 groups (83.3%; 45/54) compared with Control (57.7%; 15/26). Synchronized ovulation on day 22-23 was greater (P < 0.01) for ReBreed21 (78.6%; 22/28) and ReBreed21+G (76.9%; 20/26) compared with Control (30.8%; 8/26). Thus, the ReBreed21 resynchronization program produced acceptable endocrine and follicular dynamics, including synchronized ovulation at the end of the protocol in nonpregnant heifers providing good rationale for testing the fertility and practical implementation of this protocol under field conditions.


Assuntos
Busserrelina , Sincronização do Estro , Animais , Bovinos , Feminino , Busserrelina/farmacologia , Estradiol/farmacologia , Sincronização do Estro/métodos , Gonadotropinas Equinas/farmacologia , Cavalos , Inseminação Artificial/veterinária , Inseminação Artificial/métodos , Folículo Ovariano , Ovário , Ovulação , Progesterona/farmacologia
10.
Fertil Steril ; 121(6): 1031-1039, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38316207

RESUMO

OBJECTIVE: To report pregnancy and live birth resulting from intracytoplasmic sperm injection of ex vivo-retrieved mature oocytes from a woman with bilateral ovarian carcinoma. DESIGN: Case report. SETTING: Fertility clinic. PATIENT: A 34-year-old nulliparous woman with bilateral ovarian tumor, with a risk of malignancy of 96.1% according to International Ovarian Tumor Analysis Group recommendations for adnexal tumors, who desired fertility preservation before definitive surgical treatment. INTERVENTION(S): Cryopreservation of ex vivo-retrieved mature metaphase II oocytes is followed by fertilization with donor sperm and embryo transfer to a gestational carrier. MAIN OUTCOME MEASURE(S): Fertility preservation. RESULTS: After controlled ovarian stimulation, 12 metaphase II oocytes were retrieved from oophorectomized specimens and vitrified. Intracytoplasmic sperm injection with donor sperm was performed in remission, resulting in 9 cleavage-stage embryos, 2 of which were transferred to a gestational carrier, resulting in a normal, healthy singleton pregnancy, and the live birth of a healthy infant. CONCLUSION(S): Ex vivo oocyte retrieval after oophorectomy may be a safe alternative to standard oocyte retrieval for fertility preservation in women with ovarian malignancies.


Assuntos
Preservação da Fertilidade , Nascido Vivo , Metáfase , Recuperação de Oócitos , Neoplasias Ovarianas , Injeções de Esperma Intracitoplásmicas , Humanos , Feminino , Gravidez , Adulto , Preservação da Fertilidade/métodos , Neoplasias Ovarianas/cirurgia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/diagnóstico , Criopreservação , Oócitos , Transferência Embrionária , Ovariectomia , Resultado do Tratamento
11.
Front Oncol ; 14: 1286910, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38322413

RESUMO

Breast cancer is a significant global health concern, contributing to substantial morbidity and mortality among women. Hormone receptor-positive (HR+)/HER2-negative (HER2-) breast cancer constitutes a considerable proportion of cases, and significant advancements have been made in its management. CDK4/6 inhibitors (CDK4/6is) are a new targeted therapy that has demonstrated efficacy in adjuvant, advanced and metastatic settings. The propensity of lobular breast carcinomas for estrogen-rich sites, such as periocular tissues and orbital fat, may explain their tendency for orbital metastases. Current treatment strategies for these cases are predominantly palliative, and the prognosis remains poor. This article presents a unique case of a 51-year-old female with progressive right periorbital edema, pain, and limited ocular motility. An imaging work-up showed bilateral intra and extraconal orbital infiltration, which was biopsied. The histopathologic analysis disclosed mild chronic inflammatory infiltrate with thickened fibrous tissue and moderately differentiated lobular carcinoma cells, positive for GATA3 and CK7 markers, with 100% of tumor nuclei expressing estrogen receptors (ER+). A systemic evaluation showed a multicentric nodular formation in both breasts. Further diagnostic assessments unveiled an HR+/HER2- bilateral lobular breast carcinoma with synchronous bilateral orbital metastases. Systemic treatment was initiated with abemaciclib 150mg twice daily and letrozole 2.5mg once a day. However, this regimen was interrupted due to toxicity. After two weeks, treatment was resumed with a reduced abemaciclib dose (100mg twice daily) alongside letrozole, with a reasonable tolerance. Nearly two years after the initial diagnosis of inoperable metastatic cancer, the patient remains on the same systemic treatment regimen with no signs of invasive disease. This case report is the first of a patient presenting with bilateral orbital metastases from bilateral lobular breast cancer, showing an impressive and sustained response to a first-line treatment regimen combining abemaciclib and letrozole. A literature review on bilateral orbital metastases from breast cancer is also presented.

12.
Anat Histol Embryol ; 53(1): e12988, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37850415

RESUMO

The white-eared opossum (Didelphis albiventris) is a Neotropical marsupial that occurs in the Brazilian territory. The larynx is an important organ of vocalization in mammals, although, other laryngeal functions are more fundamental for survival of mammals than phonation. The anatomical knowledge of respiratory structures is pivotal for a better understanding of the species. Thus, this study aimed to examine the larynx of the white-eared opossum by gross anatomy, computed tomography and histological description. For this, 10 adult (six females and four males) white-eared opossums (D. albiventris) were used. The white-eared opossum larynx was formed by epiglottis, thyroid, cricoids and arytenoid cartilages and a corniculate process. There is a similarity between the larynx of this marsupial and those reported in other wild mammals, regarding the number of cartilages and their location. Histologically, the epiglottis consisted of elastic cartilage and thyroid, cricoid and arytenoid cartilages were composed of hyaline cartilage. The epiglottis protruded rostrally into the nasal part of the pharynx, above the soft palate, and this is probably a marsupial characteristic as the fact that the thyroid and cricoid cartilages were ventrally fused. The hyoid apparatus was similar to that of other animals, with the same bony constitution, but with a greatly reduced stylohyoid bone. Histologically, the larynx was similar to those of other species such as koala, armadillo, crab-eating foxes and giant anteaters. The knowledge of the larynx morphology is important for the anatomical features of the species and clinical and surgical procedures, such as endotracheal intubation.


Assuntos
Didelphis , Laringe , Feminino , Masculino , Animais , Didelphis/anatomia & histologia , Laringe/diagnóstico por imagem , Laringe/anatomia & histologia , Tomografia Computadorizada por Raios X/veterinária , Faringe , Brasil
13.
Clin Implant Dent Relat Res ; 26(1): 183-196, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37789642

RESUMO

OBJECTIVES: This preclinical model study aims to evaluate the performance and safety of a novel hydroxyapatite biomaterial (Wishbone Hydroxyapatite, WHA) on guided bone regeneration compared to a commercially available deproteinized bovine bone mineral (Bio-Oss, BO). MATERIAL AND METHODS: Twenty-four beagle dogs were allocated to three timepoint cohorts (4, 12, and 26 weeks) of eight animals each. In all animals, four critical-sized, independent wall mandibular defects were created (32 defects/cohort). Each animal received all four treatments, allocated randomly to separated defects: WHA + collagen membrane (M), BO + M, no treatment (Sham, Sh), and Sh + M. At each timepoint, the specimens were harvested for histologic and histomorphometric analyses to determine the newly formed bone and osteoconductivity. RESULTS: At 4 weeks, bone regeneration was significantly higher for WHA + M (46.8%) when compared to BO + M (21.4%), Sh (15.1%), and Sh + M (23.1%) (p < 0.05); at 12 and 26 weeks, regeneration was similar for WHA and BO. Bone-to-material contact increased over time similarly for WHA + M and BO + M. From a safety point of view, inflammation attributed to WHA + M or BO + M was minimal; necrosis or fatty infiltrate was absent. CONCLUSIONS: WHA + M resulted in higher bone regeneration rate than BO + M at 4 weeks. Both BO + M and WHA + M were more efficient than both Sh groups at all timepoints. Safety and biocompatibility of WHA was favorable and comparable to that of BO.


Assuntos
Substitutos Ósseos , Durapatita , Animais , Bovinos , Cães , Materiais Biocompatíveis/uso terapêutico , Regeneração Óssea , Substitutos Ósseos/uso terapêutico , Durapatita/uso terapêutico , Mandíbula/cirurgia , Minerais , Osteogênese
14.
RGO (Porto Alegre) ; 72: e20240001, 2024. tab
Artigo em Inglês | LILACS-Express | LILACS, BBO - Odontologia | ID: biblio-1550639

RESUMO

ABSTRACT One of the most common dental procedures is tooth extraction; however, the bone defect resulting from the process is only partially restored, leading to considerable bone loss. To rehabilitate a fully or partially edentulous patient, we must handle these sites with delicate surgical procedures. There is a large literature presenting attempts to overcome the negative effects of a dental extraction, with the aim of reducing tissue volume loss or restoring the alveolar architecture. In this context, Partial Extraction Therapy (PET) represents a subgroup of interventions to prevent bone loss after extraction using the tooth itself to prevent alveolar bone loss. This literature review aims to make a survey of the published articles on PET, with an emphasis on socket shield technique, and to explain the other techniques such as root burial, pontic-shield and proximal socket-shield, their indications and counter indications in order to deepen the knowledge of these techniques. To identify the included or considered studies, we adopted a detailed search strategy for MEDLINE and Cochrane Library focused in the last 31 years, whose language was English, Spanish or Portuguese. This text presents an analysis of current data regarding the alternatives for alveolar preservation and the installation of immediate implants in these areas, presenting the possibility of a different surgical technique. However, due to the immaturity and lack of conclusive scientific evidence regarding the predictability of the procedures, it is considered that the use of the socket shield technique must be done in an extremely cautious way.


RESUMO Um dos procedimentos odontológicos mais comuns é a extração dentária, contudo, , o defeito ósseo decorrente do processo é apenas parcialmente restaurado, levando a uma perda ossea volumétrica consideravel. Para reabilitar um paciente totalmente ou parcialmente desdentado, devemos manusear estes sitios com intervenções cirúrgicas delicadas. Há uma vasta literatura apresentando tentativas de transpor os efeitos negativos de uma extração dentária, com o objetivo de diminuir a perda volumétrica tecidual ou restaurar a arquitetura alveolar. Neste contexto, a Terapia de Extração Parcial (TEP) representa um subgrupo de intervenções para prevenir a perda óssea após exodontia, usando o próprio dente para prevenir a perda óssea alveolar. Essa revisão de literatura tem por objetivo fazer um levantamento dos artigos publicados sobre as TEP, com ênfase na técnica de socket shield, e explanar a cerca das demais técnicas como sepultamento radicular, pontic-shield e proximal socket-shield, suas indicações e contra-indicações, a fim de aprofundar o conhecimento dessas técnicas. Para a identificação dos estudos inclui?dos ou considerados, adotamos a estrate?gia de busca detalhada para os bancos MEDLINE e Biblioteca Cochrane nos u?ltimos 31 anos, cujo idioma fosse o ingle?s, espanhol ou o portugue?s. Este texto, apresenta uma análise de dados atuais a respeito das alternativas para a preservação alveolar e instalação de implantes imediatos nestas áreas, apresentando a possibilidade de uma técnica cirúrgica diferenciada. No entanto, devido a imaturidade e falta de comprovação cientifica contundente a respeito da previsibilidade dos procedimentos, considera-se que o emprego da técnica de socket shield deve ser feito de forma cautelosa.

16.
Clin Breast Cancer ; 23(8): 835-846, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37806915

RESUMO

Vulvo-vaginal atrophy (VVA) or genitourinary syndrome of menopause (GSM) is a common condition among breast cancer (BC) patients, especially those undergoing antiestrogen therapy. Despite being an option in refractory cases, the safety of hormonal treatment remains uncertain in this population. The aim of this study was to review the safety and serum estrogen levels of hormonal therapy in patients with BC history presenting with VVA symptoms. Pubmed, Embase, and Cochrane were searched for studies comparing different hormonal treatment options for VVA in breast cancer survivors. Statistical analysis was performed using a random effects model and heterogeneity using Cochran's Q-statistic and the I2 index. We included 17 studies, of which 5 were randomized controlled trials (RCTs). Treatment modalities included in this study were topical vaginal estradiol and estriol preparations, vaginally applied testosterone, DHEA, and ospemifene. We found that, among patients treated with the estriol and estradiol preparations, there was an average increase of 7.67 pg/mL (SMD 7.67 pg/mL; 95% CI -1.00, 16.35; p < .001). Analysis of the testosterone group found temporary peaks of serum estradiol levels, but 1 study showed persistent elevation above normal postmenopausal levels. One study with prasterone revealed no elevation of serum estradiol concentration. One study with ospemifene demonstrated no increase in the risk of BC recurrence. In conclusion, among treatments available for BC survivors, low-dose vaginal estrogen showed the smallest changes in serum estradiol levels and had the most evidence, but safety remains unclear, especially for patients on aromatase inhibitors. Alternative treatments such as ospemifene need more data supporting safety and efficacy. These results suggest that concerns related to cancer recurrence should keep aiming for the lowest possible concentration.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Doenças Vaginais , Feminino , Humanos , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Recidiva Local de Neoplasia/patologia , Doenças Vaginais/patologia , Vagina/patologia , Estradiol , Sobreviventes , Testosterona/uso terapêutico , Estrogênios/uso terapêutico , Atrofia/tratamento farmacológico , Estriol/efeitos adversos
17.
Psicol. rev ; 32(1): 102-122, 17/10/2023.
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1518218

RESUMO

O presente trabalho apresenta uma pesquisa de estado da arte, de caráter quantitativo, que objetivou realizar o mapeamento das publicações científicas nacionais sobre o tema da medicalização do comportamento entre os anos 2000 e 2018. Neste levantamento, foram identificados os autores, seus respectivos estados, regiões e instituições de origem, número de publicações por ano, periódicos nos quais os artigos foram publicados e áreas de conhecimento desses periódicos, sujeitos-alvo das pesquisas, tipo de pesquisa e a ênfase da medicalização envolvida. Para isso, a base Periódico-CAPES ofereceu o material analítico, a partir da seguinte estratégia de busca: medicalização AND (comportament* OR desvio OR conduta OR transtorno OR sofrimento). A partir dos dados coletados, foram construídos gráficos com o fim de obter um panorama das investigações sobre o tema em questão. Os dados encontrados sinalizam, dentre outras coisas: o aumento do número de publicações a partir do ano de 2009; a concentração de autores nos estados das regiões Sudeste e Sul; a maior prevalência de publicações em revistas de Saúde Coletiva e Interdisciplinar; a predominância de pesquisa teórica relativamente aos estudos empíricos; a prevalência das mulheres como sujeito-alvo de quantidade importante de pesquisas sobre medicalização do comportamento. (AU)


This study presents quantitative state-of-the-art research aimed at mapping Brazilian scientific publications on the topic of medicalization of behaviors between the years 2000 and 2018. The research identified authors, their respec-tive states, regions, and institutions of origin, the number of publications per year, the journals in which the articles were published, the fields of knowledge of these journals, the target subjects of the research, the type of research, and the emphasis on the involved medicalization. Data from the Periodic Portal from CAPES provided the analytical material using the following search strategy: medicalization AND (behavior* OR deviation OR conduct OR disorder OR suffering). The collected data were used to create graphs in order to provide an overview of the research on the subject. The findings indicate, among other things: an increase in the number of publications since 2009; a concentration of authors in Brazilian states from the southeastern and southern regions; a higher prevalence of publications in journals related to Collective and Inter-disciplinary Health fields; a predominance of theoretical research compared to empirical studies; and a significant focus on women as the subject of research on medicalization of behaviors. (AU)


En el presente trabajo fue realizada una investigación cuantitativa del Estado del Arte que objetivó el mapeado de las publicaciones científicas sobre el tema de la medicalización del comportamiento, entre los años 2000 y 2018. En este levantamiento, fueron identificados los autores, sus respectivos estados, regiones e instituciones de origen, número de publicaciones por año, periódicos en los cuales los artículos fueron publicados y las áreas de conocimiento de estos periódicos, tema objetivo de las investigaciones, tipo de investigación y énfasis de la medicalización involucrada. Para ello, fue utilizado el Periódico-CAPES, aplicando los siguientes descriptores: medicalización AND (comportamient* OR desvío OR conducta OR trastorno OR sufrimiento). A partir de los datos colectados, fueron construidos gráficos con el fin de ofrecer un panorama de las investigaciones sobre el tema en cuestión. Los datos encontrados señalan, entre otras cosas: el aumento del número de publicaciones a partir del año de 2009; la concentración de los autores en los estados de las regiones del Sudeste y Sur; la mayor prevalencia de publicaciones en revistas de Salud Colectiva e Interdisciplinaria; la predominancia de la investigación teórica relativa a los estudios empíricos; la prevalencia de las mujeres como objeto de investi-gación de cantidad importante de investigaciones sobre la medicalización del comportamiento. (AU)


Assuntos
Humanos , Comportamento , Indicadores de Produção Científica , Medicalização , Brasil , Literatura de Revisão como Assunto , Publicações Científicas e Técnicas , Comunicação Acadêmica , Transtornos Mentais/tratamento farmacológico
18.
Nanoscale Adv ; 5(18): 5131-5136, 2023 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-37705804

RESUMO

We can shape the electronic and phonon properties of Bi2Te3 crystals via the variation of the number of layers. Here, we report a Raman study with the aid of first-principles calculations on few-layered Bi2Te3 systems ranging from 5 to 24 nm layer thickness using 1.92, 2.41 and 2.54 eV excitation energies. We examine how the frequency position, intensity and lineshape of the main Raman modes (A11g, E2g, and A21g) behave by the variation of the layer thickness and excitation energy. We observed a frequency dispersion on the number of layers of the main modes, indicating changes in the inter- and intra-layers interaction. A resonant Raman condition is reached for all modes for samples with 11 and 18 nm thickness because of van Hove singularities at the electronic density of states. Also, the Breit-Wigner-Fano line shape of the A21g mode shows an increase of electron-phonon coupling for thick layers. These results suggest a relevant influence of numbers of layers on the Raman scattering mechanics in Bi2Te3 systems.

19.
Anim Reprod ; 20(2): e20230060, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37720728

RESUMO

Methane emission from beef and dairy cattle combined contributes around 4.5-5.0% of total anthropogenic global methane. In addition to enteric methane (CH4) produced by the rumen, cattle production also contributes carbon dioxide (CO2) (feed), nitrous oxide (N2O) (feed production, manure) and other CH4 (manure) to the total greenhouse gas (GHG) budget of beef and dairy production systems. The relative contribution in standard dairy systems is typically enteric CH4 58%, feed 29% and manure 10%. Herds with low production efficiency can have an enteric CH4 contribution up to 90%. Digestibility of feed can impact CH4 emission intensity. Low fertility herds also have a greater enteric CH4 contribution. Animals with good feed conversion efficiency have a lower emission intensity of CH4/kg of meat or milk. Feed efficient heifers tend to be lean and have delayed puberty. Fertility is a major driver of profit in both beef and dairy cattle, and it is highly important to apply multi-trait selection when shifting herds towards improved efficiency and reduced CH4. Single nucleotide polymorphisms (SNPs) have been identified for feed efficiency in cattle and are used in genomic selection. SNPs can be utilized in artificial insemination and embryo transfer to increase the proportion of cattle that have the attributes of efficiency, fertility and reduced enteric CH4. Prepubertal heifers genomically selected for favourable traits can have oocytes recovered to produce IVF embryos. Reproductive technology is predicted to be increasingly adopted to reduce generation interval and accelerate the rate of genetic gain for efficiency, fertility and low CH4 in cattle. The relatively high contribution of cattle to anthropogenic global methane has focussed attention on strategies to reduce enteric CH4 without compromising efficiency and fertility. Assisted reproductive technology has an important role in achieving the goal of multiplying and distributing cattle that have good efficiency, fertility and low CH4.

20.
Proc Natl Acad Sci U S A ; 120(33): e2302661120, 2023 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-37549288

RESUMO

Polycystic Echinococcosis (PE), a neglected life-threatening zoonotic disease caused by the cestode Echinococcus vogeli, is endemic in the Amazon. Despite being treatable, PE reaches a case fatality rate of around 29% due to late or missed diagnosis. PE is sustained in Pan-Amazonia by a complex sylvatic cycle. The hunting of its infected intermediate hosts (especially the lowland paca Cuniculus paca) enables the disease to further transmit to humans, when their viscera are improperly handled. In this study, we compiled a unique dataset of host occurrences (~86000 records) and disease infections (~400 cases) covering the entire Pan-Amazonia and employed different modeling and statistical tools to unveil the spatial distribution of PE's key animal hosts. Subsequently, we derived a set of ecological, environmental, climatic, and hunting covariates that potentially act as transmission risk factors and used them as predictors of two independent Maximum Entropy models, one for animal infections and one for human infections. Our findings indicate that temperature stability promotes the sylvatic circulation of the disease. Additionally, we show how El Niño-Southern Oscillation (ENSO) extreme events disrupt hunting patterns throughout Pan-Amazonia, ultimately affecting the probability of spillover. In a scenario where climate extremes are projected to intensify, climate change at regional level appears to be indirectly driving the spillover of E. vogeli. These results hold substantial implications for a wide range of zoonoses acquired at the wildlife-human interface for which transmission is related to the manipulation and consumption of wild meat, underscoring the pressing need for enhanced awareness and intervention strategies.


Assuntos
Equinococose , Echinococcus , Animais , Humanos , Hotspot de Doença , Equinococose/epidemiologia , Zoonoses/epidemiologia , Fatores de Risco , El Niño Oscilação Sul
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