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1.
Sci Rep ; 10(1): 15598, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32973275

RESUMO

In recent times, the use of natural and harmless products for the environment and restorer is taking place in the field of Cultural Heritage restoration. In this sense, wheat, rice and corn starches as adhesives, have suitable characteristics without toxicity risks. A new starch in this field, is the Kudzu, an almost pure compound (99.5% starch) that is processed by a natural way from a plant called Pueraria lobata. This is a preliminary study of the potential use of Kudzu starch for the restoration of Cultural Heritage, focusing, firstly, in its capacity as adhesive through a comparative evaluation with common starches. The accelerated aging process carried out proved that Kudzu ensures optimal chromatic behaviour. On the other hand, the main problem in starch paste is the biological colonization. The daidzein, a natural antimicrobial compound implicit in Kudzu starch, confirmed the resistance to microorganism in this preliminary approach. The evaluation of the adhesive capacity, and the reversibility of the starches, suggest that Kudzu starch is a valid adhesive in the field of paper restoration. Thus, the potential of this starch in the conservation of Cultural Heritage is evidenced and its use as cleaner, resistance to biological colonization and consolidant is promising.

2.
Int Microbiol ; 23(1): 55-63, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31020477

RESUMO

Aspergillus fumigatus is a worldwide-distributed saprophytic fungus and the major cause of invasive aspergillosis. This fungus can produce two types of melanin-dihydroxynaphthalene melanin (DHN-melanin) and pyomelanin. These pigments are considered important resistance mechanisms to stress, as well as virulence factors. The aim of this review is to present the current knowledge of the genetic basis and metabolic pathways of melanin production, their activation, function, and interaction with the host immune system. The DHN-melanin pathway is encoded in a cluster that includes six genes (abr1, abr2, ayg1, arp1, arp2, and pksP/alb1 genes) whose encoded proteins seem to be the origin of the pigment in endosomes. These vesicles are secreted and the pigment is subsequently located in the wall of the conidium beneath the rodlet layer. Unlike DHN-melanin, pyomelanin does not have its own biosynthetic pathway but is related to the activation of the L-tyrosine/L-phenylalanine degradation pathway that includes a cluster of six genes (hppD, hmgX, hmgA, fahA, maiA, and hmgR). Its production is due to the polymerization of homogentisic acid and is linked to conidial germination. Despite the knowledge gained in recent years, further studies will be necessary to confirm the pathways that produce these pigments and their role in the virulence mechanisms of A. fumigatus.


Assuntos
Aspergilose/metabolismo , Aspergilose/microbiologia , Aspergillus fumigatus/fisiologia , Interações Hospedeiro-Patógeno , Melaninas/metabolismo , Aspergilose/genética , Aspergilose/imunologia , Regulação da Expressão Gênica , Interações Hospedeiro-Patógeno/genética , Interações Hospedeiro-Patógeno/imunologia , Sistema Imunitário/imunologia , Sistema Imunitário/metabolismo , Melaninas/genética , Redes e Vias Metabólicas , Ligação Proteica , Virulência
3.
J Am Soc Mass Spectrom ; 28(12): 2548-2560, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28879637

RESUMO

Phenylenevinylene oligomers (PVs) have outstanding photophysical characteristics for applications in the growing field of organic electronics. Yet, PVs are also versatile molecules, the optical and physicochemical properties of which can be tuned by manipulation of their structure. We report the synthesis, photophysical, and MS characterization of eight PV derivatives with potential value as electron transfer (ET) matrices for UV-MALDI. UV-vis analysis show the presence of strong characteristic absorption bands in the UV region and molar absorptivities at 355 nm similar or higher than those of traditional proton (CHCA) and ET (DCTB) MALDI matrices. Most of the PVs exhibit non-radiative quantum yields (φ) above 0.5, indicating favorable thermal decay. Ionization potential values (IP) for PVs, calculated by the Electron Propagator Theory (EPT), range from 6.88 to 7.96 eV, making these oligomers good candidates as matrices for ET ionization. LDI analysis of PVs shows only the presence of radical cations (M+.) in positive ion mode and absence of clusters, adducts, or protonated species; in addition, M+. threshold energies for PVs are lower than for DCTB. We also tested the performance of four selected PVs as ET MALDI matrices for analytes ranging from porphyrins and phthalocyanines to polyaromatic compounds. Two of the four PVs show S/N enhancement of 1961% to 304% in comparison to LDI, and laser energy thresholds from 0.17 µJ to 0.47 µJ compared to 0.58 µJ for DCTB. The use of PV matrices also results in lower LODs (low fmol range) whereas LDI LODs range from pmol to nmol. Graphical Abstract ᅟ.

4.
Eur J Vasc Endovasc Surg ; 51(6): 824-30, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27133389

RESUMO

OBJECTIVE/BACKGROUND: To assess the outcomes of infrainguinal bypass performed for acute limb ischaemia, as well as the predictors of patency, mortality, and amputation. METHODS: This was a retrospective cohort study of patients undergoing infrainguinal bypass between 1998 and 2014. The cohort was stratified according to the indication for surgery into two groups: group A (acute limb ischaemia) and group B (chronic lower extremity ischaemia). Comparative analysis was performed on comorbidities, surgical technique, and outcomes, as well as prognostic factors in group A. RESULTS: In total, 702 bypasses were performed (group A, n = 107; group B, n = 595). Differences between groups were detected in age (65.9 vs. 70.9 years; p = .03), diabetes (16% vs. 49%; p < .01), renal insufficiency (6% vs. 13%; p = .05), stroke (7% vs. 14%; p = .04), and coronary artery disease (13% vs. 28%; p < .01). Patients with acute limb ischaemia more often required general anaesthesia (47% vs. 12%; p < .01) and a short bypass was more often performed (32% vs. 7%; p < .01). Median follow up was 23 and 24 months for groups A and B, respectively. No differences were found in patency rates at 1, 12, and 24 months between groups, but group B had a higher re-intervention rate during follow up. Primary patency in group A was 84%, 63%, and 58%, and in group B it was 88%, 62%, and 53% at 1, 12, and 24 months, respectively (p = .77). Assisted primary patency in group A was 85%, 72%, and 67%, and in group B it was 90%, 74%, and 66% at 1, 12, and 24 months, respectively (p = .61). Secondary patency in group A was 90%, 78%, and 75%, and in group B it was 94%, 80%, and 74% at 1, 12, and 24 months, respectively (p = .80). The freedom from re-intervention rate in group A was 91%, 74%, and 68%, and in group B it was 92%, 76%, and 71%, respectively (p = .04). Acute limb ischaemia was an independent risk factor for amputation (odds ratio [OR] 4.96, 95% confidence interval [CI] 1.74-14.09; p < .01) and mortality (OR 4.13, 95% CI 1.53-11.14; p = .01) at 30 days. In group A, female sex, prosthetic conduit, and need of distal thrombectomy were independently associated with worse patency rates. Poor intra-operative runoff was correlated with higher amputation rates. CONCLUSION: Among those undergoing infrainguinal bypass, patients who present with acute limb ischaemia constitute a subset showing higher early rates of amputation and death. In this subset of patients, worse outcomes may be expected for women, prosthetic conduits, need for distal thrombectomy, and patients with poor intra-operative runoff.


Assuntos
Isquemia/cirurgia , Extremidade Inferior/cirurgia , Doenças Vasculares Periféricas/cirurgia , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Implante de Prótese Vascular/métodos , Feminino , Oclusão de Enxerto Vascular/mortalidade , Humanos , Extremidade Inferior/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/mortalidade , Estudos Retrospectivos , Fatores de Risco , Caracteres Sexuais , Resultado do Tratamento
5.
Clin Transl Oncol ; 17(4): 330-8, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25301404

RESUMO

PURPOSE: To identify a novel system for scoring intratumoral immune response that can improve prognosis and therapy decisions in early stage non-small cell lung cancer (NSCLC). METHODS/PATIENTS: Eighty-four completely resected stage I/II NSCLC without adjuvant therapy were classified by expression profiling using whole genome microarrays. An external cohort of 162 tumors was used to validate the results. Immune cells present in tumor microenvironment were evaluated semiquantitatively by CD20, CD79, CD3, CD8, CD4 and CD57 immunostaining. Univariate and multivariate analyses of variables associated with recurrence-free survival were performed. RESULTS: Initial molecular classification identified three clusters, one with significantly better RFS. A reduced two-subgroup classification and a 50-gene predictor were built and validated in an external dataset: high and low risk of recurrence patients (HR = 3.44; p = 0.001). Analysis of the predictor´s genes showed that the vast majority were related to a B/plasma cell immune response overexpressed in the low-risk subgroup. The predictor includes genes coding for unique B lineage-specific genes, functional elements or other genes that, although non-restricted to this lineage, have strong influence on B-cell homeostasis. Immunostains confirmed increased B-cells in the low-risk subgroup. Gene signature (p < 0.0001) and CD20 (p < 0.05) were predictors for RFS, while CD79 and K-RAS mutations showed a tendency. CONCLUSIONS: Favorable prognosis in completely resected NSCLC is determined by a B-cell-mediated immune response. It can be differently scored by a 50-gene expression profile or by CD20 immunostaining. That prognosis information not reflected by traditional classifications may become a new tool for determining individualized adjuvant therapies.


Assuntos
Linfócitos B/imunologia , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/imunologia , Perfilação da Expressão Gênica , Neoplasias Pulmonares/genética , Linfócitos do Interstício Tumoral/imunologia , Proteínas de Neoplasias/genética , Idoso , Carcinoma Pulmonar de Células não Pequenas/patologia , Intervalo Livre de Doença , Feminino , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias
6.
Diagn Microbiol Infect Dis ; 80(2): 111-8, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25063549

RESUMO

Invasive aspergillosis is an opportunistic infection caused primarily by Aspergillus fumigatus. However, other common fungal pathogens belonging to section Fumigati are often misidentified as A. fumigatus. Thus, we have developed a multiplex real-time PCR (qPCR) assay with primers and specific TaqMan probes based on internal transcribed spacer regions or benA gene to discriminate, in less than 3 h, species of section Fumigati and, specifically, A. fumigatus. The multiplex qPCR showed a limit of detection of 20 and 50 fg of DNA for section Fumigati and A. fumigatus, respectively. Moreover, it enabled detection of a single germinated conidia. The inclusion of some PCR facilitators together with the dilution of samples makes it possible to completely avoid PCR inhibitions in all bronchoalveolar lavage (BAL) samples assayed. This technique may be a useful complementary tool in the diagnosis of invasive pulmonary aspergillosis caused by A. fumigatus using BAL fluid.


Assuntos
Aspergillus fumigatus/isolamento & purificação , Aspergilose Pulmonar Invasiva/diagnóstico , Reação em Cadeia da Polimerase Multiplex/métodos , Reação em Cadeia da Polimerase em Tempo Real/métodos , Primers do DNA/genética , DNA Fúngico/química , DNA Fúngico/genética , DNA Espaçador Ribossômico/genética , Proteínas Fúngicas/genética , Humanos , Aspergilose Pulmonar Invasiva/microbiologia , Sondas de Oligonucleotídeos/genética , Sensibilidade e Especificidade , Fatores de Tempo
7.
An Pediatr (Barc) ; 80(6): 404.e1-8, 2014 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-24767461

RESUMO

Between the 19th and 25th April 1914, the First Spanish Congress of Paediatrics was held in Palma de Mallorca under the slogan "Protect the Children". The specialty had broken away a few years earlier from its secular connection with Obstetrics and Gynaecology, both in its teaching aspect as well as regarding healthcare. With the newly created Chairs in Childhood Diseases, in a way this Congress meant the coming-of age and debut int society of paediatrics in our country. Prof. Martínez Vargas, a university professor in Barcelona, was the Chairman, and soul of the congress. There was a need to face a very high rate of infant mortality. The Congress responded to that social and sanitary/health demand with the participation of over three hundred pediatricians, including foreign representatives from Belgium, France, Russia and Latin America. The activities were divided into four sections: Childcare, Child Medicine, Surgery and Health, and accredited lecturers gave master classes on the most pressing issues of child pathology of the time. One hundred years on, what we are today is the fruit gathered by those who preceded us. Some were brilliant figures in paediatrics and others, the majority, anonymous paediatricians. They dedicated their lives, their science and their best smile to child care. The way we were and the way we are. With legitimate pride and satisfaction, it is an honour for the Group on the History of Paediatrics and AEP Documentation to celebrate this centennial commemoration in the framework of the Annals of Paediatrics.


Assuntos
Congressos como Assunto/história , Pediatria/história , História do Século XX , História do Século XXI , Espanha
10.
An Pediatr (Barc) ; 79(6): 367-73, 2013 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-23601477

RESUMO

INTRODUCTION: Malformation or dysmorphic syndromes are conditions that are defined by the combination of a set of major and minor malformations that generally have a genetic origin. We investigated the early Spanish descriptions of a large number of sydromes. MATERIAL AND METHODS: We started the study from the definition in a classic treatise on the subject. Among the 60 selected syndromes studied, at least two articles of each syndrome among those published in Spain and for the first time were listed in the Spanish Medical Index. For years prior to 1970, it expanded The search was expanded to PubMed, for the years before 1970. RESULTS: We collected 64 articles that referred to 58 syndromes. Four articles were written during the first half of the twentieth century. Almost half of the works (n=30) appeared in the 1970's. The papers were published in ten Spanish pediatric, nine Spanish non-pediatric, three pediatric non-Spanish and two non-Spanish non-pediatric Journals. The Journals with the most articles published were Anales de Pediatría y Revista Española de Pediatría. The hospitals where the articles originate more often were Hospital La Paz, Madrid and Hospital Clinic, Barcelona. The rest of the works were written in 30 pediatric hospitals and two more in non-Spanish hospitals. The number of authors increased with the passage of time. CONCLUSIONS: Although there were potential limitations, we have identified what may be the first descriptions of 58 syndromes, among the 60 chosen initially.


Assuntos
Anormalidades Congênitas , Editoração , Síndrome , Humanos , Publicações Periódicas como Assunto , Espanha
11.
Int Angiol ; 32(1): 61-6, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23435393

RESUMO

AIM: Traumatic aortic injury is usually lethal, most often because of serious associated wounds. The short- and midterm outcome of endovascular exclusion was assessed as the current treatment of choice due to a lower mortality and morbidity than open surgical treatment. METHODS: We reviewed the cases of 8 patients (5 male, mean age 33 years) undergoing endovascular repair of a traumatic thoracic aortic lesion, confirmed by computed tomographic angiography, at our centre. Most patients showed a contained lesion limited to the aortic isthmus and severe associated injuries. RESULTS: Intrahospital mortality was 37.5% (N.=3) and mostly due to posttraumatic brain injury (N.=2). Most patients were hemodynamically stable at the time of endovascular repair (N.=6). The median time to surgery was 12 hours (3-48 hours). The endografts used were TAG® (W.L. Gore and Associates, Flagstaff) in three patients, and Valiant® (Medtronic, Santa Rosa, CA) in four. The technical success rate was 100%. In one case, the left subclavian artery was occluded without signs of arm ischemia. There were no cases of paraplegia or stroke related to treatment. No revision procedures were needed during follow-up. CONCLUSION: Endovascular repair shortly after injury seems to be effective and safe with a low associated morbidity and mortality.


Assuntos
Aorta Torácica/lesões , Aorta Torácica/cirurgia , Prótese Vascular , Stents , Ferimentos não Penetrantes/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/métodos , Ferimentos não Penetrantes/mortalidade , Adulto Jovem
12.
Rev Esp Anestesiol Reanim ; 60(9): 528-30, 2013 Nov.
Artigo em Espanhol | MEDLINE | ID: mdl-22963762

RESUMO

Thoracoabdominal aneurysm requires multidisciplinary management due to its complexity both in surgical technique and anesthetic considerations. One of the most feared postoperative complication is spinal cord ischemia. It can be presented as different clinical patterns, and its recovery may be partial or complete. The postoperative management of spinal cord ischemia is mainly based on techniques to increase spinal cord perfusion, above all, hemodynamic stability and cerebrospinal fluid drainage. We present two cases of delayed paraplegia after an open repair of a thoracoabdominal aneurysm and a descending thoracic aortic aneurysm repair using an endovascular stent graft. They both had a complete neurological recovery after cerebrospinal fluid drainage.


Assuntos
Aneurisma da Aorta Torácica/cirurgia , Paraplegia , Complicações Pós-Operatórias , Humanos , Masculino , Pessoa de Meia-Idade , Paraplegia/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Fatores de Tempo
13.
Rev Esp Anestesiol Reanim ; 60(1): 16-22, 2013 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-23062570

RESUMO

OBJECTIVE: To review the results after thoracoabdominal aortic aneurysms repair performed by the same team of surgeons and anesthesiologists over a 17 year period. MATERIAL AND METHODS: A prospective and observational study carried out on 65 patients (97% male) who were operated on from 1995 until July 2011 for thoracoabdominal aneurysm, Crawford type i 5 (7.6%), ii 22 (33.8%), iii 17 (26.11%) and iv 21 (32.31%). RESULTS: The 30-day mortality was 9.2% (6/65 patients), which was the same as the incidence of paraplegia. This complication only occurred in the Crawford types ii and iii aneurysms. Paraplegia was present in 4.5% (1/22) of patients in whom "left bypass" was used, compared with 29% (5/17) in which the intervention was performed by cross-clamping without distal aortic perfusion (P=.068). The most frequent complication was respiratory, with prolonged mechanical ventilation (>48h) in 20% (13 patients) of cases. The mean hospital stay was 28 days (7-92). DISCUSSION: The average mortality in referral centers is 9.7%, ranging between 5% and 16%. In other centres the mortality at 30 days is between 19% and 31% per year. Our group had a 9.2% of mortality rate at 30 days. The incidence of paraplegia in hospitals with greater experience ranges between 2.7% and 16%. Nowadays, an incidence of less than 10% is accepted as good. We had 9.2%. The use of CSF drainage in these patients, as well as the use of left bypass and moderate hypothermia in the Crawford types i, ii and iii appear to be acceptable for prophylaxis of paraplegia.


Assuntos
Anestesia , Aneurisma da Aorta Torácica/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo
14.
Appl Environ Microbiol ; 75(5): 1345-54, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19124586

RESUMO

Flagellar extracts of Salmonella enterica serovars expressing phase 2 H1 antigenic complex (H:1,2, H:1,5, H:1,6, and H:1,7) and a mutant flagellin obtained by site-directed mutagenesis of the fljB gene from serovar Typhimurium at codon 218, transforming threonine to alanine, expressed in Escherichia coli (fljB218(A)) were used to analyze the H1 antigenic complex. Cross-reactions were detected by Western blotting and dot blotting using commercial polyclonal antibodies against the different wild-type extracts and mutant FljB218(A). Therefore, we produced a monoclonal antibody (MAb), 23D4, isotyped as immunoglobulin M, against H:1,2 S. enterica serovar Typhimurium flagellin. The mutant flagellin was not recognized by this MAb. When a large number of phase 1 and phase 2 flagellin antigens of different serovars were used to characterize the 23D4 MAb, only extracts of serovars Typhimurium and [4,5,12:i:-] reacted. The protein composition of phase 1 and phase 2 extracts and highly purified H:1,2 flagellin from serovar Typhimurium strain LT2 and extract of strain 286 (serovar [4,5,12:i:-]), which reacted with the MAb, was studied. Phase 2 flagellin (FljB(H:1,2)) was detected in phase 1 and phase 2 flagellar heat extracts of serovar Typhimurium and was the single protein identified in all spots of purified H:1,2 flagellin. FliC, FlgK, and other proteins were detected in some immunoreactive spots and in the flagellar extract of serovar [4,5,12:i:-]. Immunoelectron microscopy of complete bacteria with 23D4 showed MAb attachment at the base of flagella, although the MAb failed to recognize the filament of flagella. Nevertheless, the results obtained by the other immunological tests (enzyme-linked immunosorbent assay, Western blotting, and dot blotting) indicate a reaction against flagellins. The epitopes could also be shared by other proteins on spots where FljB is not present, such as aminopeptidase B, isocitrate lyase, InvE, EF-TuA, enolase, DnaK, and others. In conclusion, MAb 23D4 can be useful for detection and diagnostic purposes of S. enterica serovar Typhimurium and serovar [4,5,12:i:-] and could be also helpful for epitope characterization of flagellum-associated antigens.


Assuntos
Anticorpos Antibacterianos/imunologia , Anticorpos Monoclonais/imunologia , Antígenos de Bactérias/imunologia , Flagelina/imunologia , Salmonella typhimurium/imunologia , Anticorpos Antibacterianos/isolamento & purificação , Anticorpos Monoclonais/isolamento & purificação , Eletroforese em Gel Bidimensional , Escherichia coli/genética , Flagelos/imunologia , Flagelos/ultraestrutura , Flagelina/genética , Immunoblotting , Microscopia Imunoeletrônica , Análise de Sequência de Proteína
15.
Rev Neurol ; 45(5): 264-7, 2007.
Artigo em Espanhol | MEDLINE | ID: mdl-17876735

RESUMO

INTRODUCTION: Because the contralateral carotid artery occlusion has been considered a high risk factor for ipsilateral carotid endarterectomy, some authors indicate a stenting procedure in these cases. AIM: To evaluate whether there are different preoperative factors in patients with contralateral carotid occlusion and if the latter is associated to worse perioperative outcome. PATIENTS AND METHODS: We analysed 476 carotid endarterectomies performed in 1994-2004. 57 cases (12.0%) had contralateral carotid occlusion. We analysed the results in patients with contralateral carotid occlusion and we compared them with the patients with contralateral patency. Prospective cohort study. RESULTS: There were no differences in preoperative risk factors or comorbidity. Contralateral occlusion was associated to preoperative symptoms: 75.4-58.9%; OR: 1.2 (1.1-1.5); p = 0.02. The patients operated on under local anaesthesia who had contralateral occlusion and previous stroke, had a higher rate of cerebral ischaemia during carotid cross-clamping: 66.7-11.3%; RR: 5.8 (3.1-10.9); p = 0.002. Morbimortality was 2.3% in the global series and 0.0% in patients with contralateral carotid occlusion. Over 80-year-old patients with contralateral carotid occlusion had a higher global rate of cardiac complications: 28.6-0.0% (p = 0.01). CONCLUSIONS: In our series, patients with contralateral carotid occlusion do not have a higher risk preoperative profile o higher perioperative morbimortality. Contralateral carotid occlusion does not justify, by itself, the endovascular treatment of an ipsilateral carotid stenosis.


Assuntos
Estenose das Carótidas , Endarterectomia das Carótidas/efeitos adversos , Complicações Pós-Operatórias , Adulto , Idoso , Idoso de 80 Anos ou mais , Estenose das Carótidas/patologia , Estenose das Carótidas/cirurgia , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Stents , Resultado do Tratamento
16.
Rev Neurol ; 44(3): 134-8, 2007.
Artigo em Espanhol | MEDLINE | ID: mdl-17285516

RESUMO

AIMS: To compare the immediate results obtained after performing a carotid endarterectomy (cEDA) in patients in their eighties with those of younger patients, and to determine survival and stroke-free times following carotid surgery in the two groups. PATIENTS AND METHODS: Retrospective data was collected regarding a series of 319 cases of cEDA (302 patients) performed between January 1998 and December 2004. Group 1: patients aged 80 or above. Group 2: the rest of the series. Sample follow-up: clinical and by means of carotid duplex. RESULTS: Mean age of the sample: 70.7 years (41-86). Group 1 was made up of 30 patients (9.4% of the series). Mortality rate: group 1, 3.3%; group 2, 1%; p=0.32. Major stroke-death incidence: group 1, 6.7%; group 2, 1.4%; p= 0.1. Median follow-up time: 36 months (1-87). Total mortality of the series throughout follow-up: 36 patients (12.6%). Mortality rate: group 1, 25%; group 2, 11.3%; p=0.04; relative risk: 2.6 (1.02-6.7). Stroke: group 1, 14.3%; group 2, 2.3%; p=0.01; relative risk: 7 (1.8-26.4). At five years, 96.7% were free of strokes (group 1: 84%; group 2, 97.7%; p=0.0001). At five years, 82.4% survived free of strokes (group 1: 61%; group 2, 84.4%; p=0.004). CONCLUSIONS: The risk of perioperative complications is higher in patients in their eighties than in younger patients, although the increase is not statistically significant. Even though the risk of a stroke during follow-up was higher in the eighty-year-olds, 84% of the subjects in this group remained stroke-free at five years. The high stroke-free survival rate in the medium to long term means that cEDA can be especially beneficial for patients in their eighties.


Assuntos
Endarterectomia das Carótidas , Acidente Vascular Cerebral , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Endarterectomia das Carótidas/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Acidente Vascular Cerebral/mortalidade , Acidente Vascular Cerebral/terapia , Taxa de Sobrevida , Resultado do Tratamento
17.
Eur J Vasc Endovasc Surg ; 29(4): 334-41, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15749031

RESUMO

OBJECTIVES: To establish the incidence of restenosis (RES) following carotid endarterectomy (CEA) and evaluate clinical and technical factors related to its development. DESIGN: Prospective non-randomised cohort study. PATIENTS AND METHODS: Two hundred and twenty-four patients with 243 CEA between May 1998 and December 2002, were subjected to clinical and haemodynamic follow-up, median follow-up 23 months (1-56). There was selective use of a shunt (17.3%) and patch (61.7%). RES (> or =50%) and severe restenosis, > or =70%, (sRES) were defined as peak systolic velocities of > or =150 and > or =300cm/s (or > or =250cm/s with diastolic velocity >100cm/s), respectively. Rates of RES, symptom development and mortality were analysed using Kaplan-Meier curves. Cox's regression model (hazards ratio/95% CI) was used to evaluate prognostic factors. RESULTS: We detected 13 sRES (5.3%) (median time 6.1 months) and 30 (12.3%) moderate stenosis (mRES) (median time 3.7 months). Cumulative freedom from sRES at 23 months was 94.2%. Five sRES detected in the first 45 days after the procedure were deemed to be residual restenosis (rRES). Five (38.4%) sRES were symptomatic, 15.3% progressed to occlusion. Patient survival was 98.0 and 96.4% at 12 and 24 months, respectively. Independent risk factors for sRES: female sex (HR: 3.3, 95% CI 1.1-10 p=0.04) and diabetes (HR: 4.5, 95% CI 1.4-13.9 p=0.008). CONCLUSIONS: Carotid restenosis appears early, is usually low-grade and mostly asymptomatic. Although few stenoses progress to occlusion, women and diabetic patients were at highest risk.


Assuntos
Estenose das Carótidas/cirurgia , Endarterectomia das Carótidas , Oclusão de Enxerto Vascular/epidemiologia , Oclusão de Enxerto Vascular/etiologia , Idoso , Comorbidade , Feminino , Oclusão de Enxerto Vascular/diagnóstico por imagem , Humanos , Masculino , Prognóstico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Recidiva , Fatores de Risco , Ultrassonografia Doppler Dupla
18.
Ann Vasc Surg ; 18(1): 86-92, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14564550

RESUMO

The objective of this study was to compare patency rates following the repair of popliteal aneurysms according to the site of inflow, material of bypass graft and quality of distal runoff. Seventy bypasses were performed over an 11-year period. Autogenous saphenous vein was used in 53 procedures (75.7%) and prosthetic material was used in 17 (24.3%). Early mortality was 2.8%. Early primary and secondary patency rates were 95.7% and 97.1%, respectively. Autogenous vein showed better 10-year patency than prosthetic material (86% vs. 57%; p = 0.02). No significant differences in patency were observed according to the inflow site (87.8% groin vs. 74.7% supragenicular). Bypasses that originated in the groin showed improved patency when a saphenous vein was used (84.8% vs. 43.7%; p = 0.01). However, no influence of the graft material was noted in supragenicular bypasses (90.4% vs. 84.8%; p = 0.6). Bypasses in extremities with good runoff showed better patency than those in limbs showing poor runoff (86% vs. 55%; p = 0.003). The use of saphenous vein for the repair of popliteal aneurysms showed better results than those with prosthetic material, although in bypasses originating from the distal superficial femoral or above-knee popliteal artery, no significant differences in patency were observed. Good distal runoff was associated with improved overall outcome.


Assuntos
Aneurisma/cirurgia , Implante de Prótese Vascular/instrumentação , Prótese Vascular , Artéria Poplítea/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Materiais Biocompatíveis/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Politetrafluoretileno/uso terapêutico , Veia Safena/transplante , Resultado do Tratamento , Grau de Desobstrução Vascular
19.
Transplant Proc ; 35(8): 2953-7, 2003 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-14697948

RESUMO

OBJECTIVE: Although aortoiliac aneurysm in kidney transplant patients is uncommon, aortic clamping during the surgical repair of an aneurysm could pose a risk to the grafted kidney and might also increase the risk of vascular prosthesis infection due to immunosuppression. Herein, we present our results related to the treatment of the aortoiliac aneurysm subsequent to kidney transplant. MATERIAL AND METHODS: Four male kidney transplant recipients underwent surgery for aortoiliac aneurysm repair. RESULTS: In the first patient, we protected the kidney graft by perfusion with cold physiological saline. No such protective measures were taken in the remaining three patients other than reducing warm ischemia to a minimum. In one patient with occlusive disease and impaired graft function, renal function improved after surgery. In the other three patients renal function was unaffected by surgery. Despite immunosuppression, no infection of the prostheses was observed. CONCLUSIONS: Surgery for aortoiliac aneurysm can be safely performed in kidney transplant patients. No ischemic damage is incurred by the graft and perioperative infection can be easily avoided. The need to protect the graft during the surgical procedure should be evaluated in each individual case according to predicted times of ischemia and vascular reconstruction and preoperative graft function.


Assuntos
Aneurisma Aórtico/cirurgia , Aneurisma Ilíaco/cirurgia , Transplante de Rim , Complicações Pós-Operatórias/cirurgia , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Operatórios/métodos , Resultado do Tratamento
20.
Int J Food Microbiol ; 86(1-2): 201-7, 2003 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-12892935

RESUMO

The microbiota of eight spontaneous fermentation of white wine from different grape varieties and different wineries from the "Txakoli de Bizkaia" region (Basque country, North Spain), in 1996 and 1997 campaigns was studied. The yeast population was higher in grapes harvested in 1997, in which late summer and early autumn was warmer and drier. Eight species belonging to five genera were identified in total. The most frequent genera in grapes were Rhodotorula in 1996 and Kloeckera in 1997. Saccharomyces bayanus was the most frequent species during vigorous and final fermentation, and it was occasionally isolated from grapes and must. Only another Saccharomyces spp., i.e., S. kluyvery, was identified in some samples from 1997.


Assuntos
Fermentação , Vinho/microbiologia , Leveduras/metabolismo , Microbiologia de Alimentos , Espanha , Vitis/microbiologia , Leveduras/classificação , Leveduras/crescimento & desenvolvimento
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