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1.
Aging (Albany NY) ; 16(12): 10657-10665, 2024 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-38942604

RESUMO

Two recent seminal works have untangled the intricate role of tumor-associated senescent cells in cancer progression, or regression, by guiding our immune system against cancer cells. The characterization of these unique, yet diverse cell populations, should be considered, particularly when contemplating the use of senolytics, which are drugs that selectively eliminate senescent cells, in a cancer framework. Here, we will describe the current knowledge in this field. In particular, we will discuss how the presence of senescent cells in tumors could be used as a therapeutic target in immunogenic cancers and how we may hypothetically design an adaptive anti-aging vaccine.


Assuntos
Envelhecimento , Vacinas Anticâncer , Senescência Celular , Neoplasias , Humanos , Neoplasias/imunologia , Senescência Celular/imunologia , Envelhecimento/imunologia , Vacinas Anticâncer/imunologia , Animais
2.
Virol J ; 21(1): 135, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38858684

RESUMO

The discovery of mimivirus in 2003 prompted the search for novel giant viruses worldwide. Despite increasing interest, the diversity and distribution of giant viruses is barely known. Here, we present data from a 2012-2022 study aimed at prospecting for amoebal viruses in water, soil, mud, and sewage samples across Brazilian biomes, using Acanthamoeba castellanii for isolation. A total of 881 aliquots from 187 samples covering terrestrial and marine Brazilian biomes were processed. Electron microscopy and PCR were used to identify the obtained isolates. Sixty-seven amoebal viruses were isolated, including mimiviruses, marseilleviruses, pandoraviruses, cedratviruses, and yaraviruses. Viruses were isolated from all tested sample types and almost all biomes. In comparison to other similar studies, our work isolated a substantial number of Marseillevirus and cedratvirus representatives. Taken together, our results used a combination of isolation techniques with microscopy, PCR, and sequencing and put highlight on richness of giant virus present in different terrestrial and marine Brazilian biomes.


Assuntos
Vírus Gigantes , Brasil , Vírus Gigantes/isolamento & purificação , Vírus Gigantes/genética , Vírus Gigantes/classificação , Vírus Gigantes/ultraestrutura , Filogenia , Reação em Cadeia da Polimerase , Acanthamoeba castellanii/virologia , Acanthamoeba castellanii/isolamento & purificação , Microbiologia do Solo , Esgotos/virologia , Análise de Sequência de DNA , Água do Mar/virologia , Microbiologia da Água
3.
Cells ; 13(5)2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38474372

RESUMO

Overexpression of the Runt-related transcription factor 2 (RUNX2) has been reported in several cancer types, and the C-X-C motif chemokine receptor 4 (CXCR4) has an important role in tumour progression. However, the interplay between CXCR4 and RUNX2 in melanoma cells remains poorly understood. In the present study, we used melanoma cells and a RUNX2 knockout (RUNX2-KO) in vitro model to assess the influence of RUNX2 on CXCR4 protein levels along with its effects on markers associated with cell invasion and autophagy. Osteotropism was assessed using a 3D microfluidic model. Moreover, we assessed the impact of CXCR4 on the cellular levels of key cellular signalling proteins involved in autophagy. We observed that melanoma cells express both RUNX2 and CXCR4. Restored RUNX2 expression in RUNX2 KO cells increased the expression levels of CXCR4 and proteins associated with the metastatic process. The protein markers of autophagy LC3 and beclin were upregulated in response to increased CXCR4 levels. The CXCR4 inhibitor WZ811 reduced osteotropism and activated the mTOR and p70-S6 cell signalling proteins. Our data indicate that the RUNX2 transcription factor promotes the expression of the CXCR4 chemokine receptor on melanoma cells, which in turn promotes autophagy, cell invasiveness, and osteotropism, through the inhibition of the mTOR signalling pathway. Our data suggest that RUNX2 promotes melanoma progression by upregulating CXCR4, and we identify the latter as a key player in melanoma-related osteotropism.


Assuntos
Melanoma , Humanos , Melanoma/patologia , Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Linhagem Celular Tumoral , Transdução de Sinais , Serina-Treonina Quinases TOR/metabolismo , Receptores CXCR4
4.
Cells ; 13(2)2024 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-38247811

RESUMO

Overcoming senescence with tissue engineering has a promising impact on multiple diseases. Here, we provide an overview of recent studies in which cellular senescence was inhibited through the up/downregulation of specific lncRNAs. This approach prevented senescence in the bones, joints, nervous system, heart, and blood vessels, with a potential impact on regeneration and the prevention of osteoarthritis and osteoporosis, as well as neurodegenerative and cardiovascular diseases. Senescence of the skin and liver could also be prevented through the regulation of cellular levels of specific lncRNAs, resulting in the rejuvenation of cells from these organs and their potential protection from disease. From these exciting achievements, which support tissue regeneration and are not restricted to stem cells, we propose lncRNA regulation through RNA or gene therapies as a prospective preventive and therapeutic approach against aging and multiple aging-related diseases.


Assuntos
Doenças Cardiovasculares , RNA Longo não Codificante , Humanos , RNA Longo não Codificante/genética , Estudos Prospectivos , Pele
5.
Dalton Trans ; 53(7): 3039-3051, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38111362

RESUMO

We report the synthesis, characterization and anticancer activity of a new Schiff base (H2L) derived from the condensation of pyridoxamine with pyridoxal and its novel copper(II) and oxidovanadium(IV) complexes: [Cu(HL)Cl] (1), [Cu(LH2)(phen)]Cl2 (2), [Cu(LH2)(amphen)]Cl2 (3), [VIVO(HL)Cl] (4), and [VIVO(LH2)(phen)]Cl2 (5), where phen is 1,10-phenanthroline and amphen is its 5-amino derivative. All compounds were characterized by analytical and spectroscopic techniques, namely FTIR, UV-vis and EPR spectroscopy. Their stability in aqueous media was evaluated, revealing that the presence of the phen co-ligand significantly increases the stability. The ternary Cu(II) complexes (2 and 3) impaired cell viability of osteosarcoma cells (MG-63) (IC50 values of 3.6 ± 0.6 and 7 ± 1.9 µM for 2 and 3), while 1 and the VIVO complexes did not show relevant anticancer activity. Complexes 2 and 3 are also more active than cisplatin (CDDP). Synergistic studies between 2 and sorafenib showed significant synergism on MG-63 cells for the following combinations: 2 (2.0 µM) + sorafenib (10.0 µM) and 2 (2.5 µM) + sorafenib (12.5 µM), whilst the combination of 2 and CDDP did not show synergy. Complex 2 interacts with DNA, inducing significant genotoxic effects on MG-63 cells from 1.0 to 2.5 µM and it increases the ROS levels 880% over basal. Moreover, 2 induces apoptosis at 1.0 and 2.0 µM, while its combination with sorafenib induces apoptosis and necrosis. Finally, compound 2 reduces the cell viability of MG-63 spheroids showing an IC50 value 7-fold lower than that of CDDP (8.5 ± 0.4 µM vs. 65 ± 6 µM). The combination of 2 and sorafenib also showed synergism on spheroids, suggesting that the combination of these drugs improves the anticancer effect against bone cancer cells.


Assuntos
Antineoplásicos , Complexos de Coordenação , Osteossarcoma , Humanos , Cobre/química , Bases de Schiff/farmacologia , Bases de Schiff/química , Antineoplásicos/química , Vitamina B 6/farmacologia , Sorafenibe , Cisplatino/farmacologia , Vitaminas , Complexos de Coordenação/química
6.
Arq Bras Cir Dig ; 36: e1746, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37729279

RESUMO

BACKGROUND: After validation in multiple types of liver disease patients, the MELD score was adopted as a standard by which liver transplant candidates with end-stage liver disease were prioritized for organ allocation in the United States since 2002, and in Brazil, since 2006. AIMS: To analyze the mortality profile of patients on the liver transplant waiting list correlated to MELD score at the moment of transplantation. METHODS: This study used the data from the Secretary of Health of the São Paulo State, Brazil, which listed 22,522 patients, from 2006 (when MELD score was introduced in Brazil) until June 2009. Patients with acute hepatic failure and tumors were included as well. We also considered the mortality of both non-transplanted and transplanted patients as a function of the MELD score at presentation. RESULTS: Our model showed that the best MELD score for patients on the liver transplant waiting list associated to better results after liver transplantation was 26. CONCLUSIONS: We found that the best score for applying to liver transplant waiting list in the State of São Paulo was 26. This is the score that minimizes the mortality in both non-transplanted and liver transplanted patients.


Assuntos
Doença Hepática Terminal , Transplante de Fígado , Humanos , Brasil , Listas de Espera , Doença Hepática Terminal/cirurgia
7.
Molecules ; 28(18)2023 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-37764313

RESUMO

The structural determination and characterization of molecules, namely proteins and enzymes, is crucial to gaining a better understanding of their role in different chemical and biological processes. The continuous technical developments in the experimental and computational resources of X-ray diffraction (XRD) and, more recently, cryogenic Electron Microscopy (cryo-EM) led to an enormous growth in the number of structures deposited in the Protein Data Bank (PDB). Bioinorganic chemistry arose as a relevant discipline in biology and therapeutics, with a massive number of studies reporting the effects of metal complexes on biological systems, with vanadium complexes being one of the relevant systems addressed. In this review, we focus on the interactions of vanadium compounds (VCs) with proteins. Several types of binding are established between VCs and proteins/enzymes. Considering that the V-species that bind may differ from those initially added, the mentioned structural techniques are pivotal to clarifying the nature and variety of interactions of VCs with proteins and to proposing the mechanisms involved either in enzymatic inhibition or catalysis. As such, we provide an account of the available structural information of VCs bound to proteins obtained by both XRD and/or cryo-EM, mainly exploring the more recent structures, particularly those containing organic-based vanadium complexes.

8.
Transplant Proc ; 55(6): 1346-1351, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37537077

RESUMO

BACKGROUND: Map Interventions is capable of supporting the multidisciplinary team that works in organ and tissue donation to disseminate quality in this process. METHODS: A scoping review study that was conducted through the steps proposed by the Joanna Briggs Institute. RESULTS: Fifty-six studies made up the sample. 2018 (no. 07, 12.5%) had the highest number of publications. The country that published the most was the United States (no. 16, 28.56%). The database with the most publications was the Cumulative Index to Nursing and Allied Health Literature - CINAHL (no. 15, 26.78%). The most used interventions, which had the most significant impact on the improvement of results and quality, were the use of indicators in all stages of the organ and tissue donation process; the use of real goals that can be achieved; frequent audits, validation of instruments to track opportunities for improvement; as well as methodologies to implement quality and education among professionals who work in this process. Such interventions reveal important changes in the organ donation process, especially in the notification of potential and effective donors, as well as providing an opportunity for safety in the stages of the organ and tissue donation process. CONCLUSION: The interventions tracked suggest the implementation of a set of actions formed by the continuous use of auditing, indicators, continuing education with the team that works in the process of organ and tissue donation, combined with the management of the results obtained through the indicators, where it is generated from these data, actions that have a direct impact on the weaknesses identified.


Assuntos
Transplante de Órgãos , Obtenção de Tecidos e Órgãos , Humanos , Estados Unidos , Doadores de Tecidos
10.
Nutrients ; 15(9)2023 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-37432234

RESUMO

Describing diet-related effects on the gut microbiome is essential for understanding its interactions with fat and/or sugar-rich diets to promote obesity-related metabolic diseases. Here, we sequenced the V3-V4 hypervariable region of the bacterial 16S rRNA gene to study the composition and dynamics of the gut microbiome of adult mice fed diets rich in fat and/or sugar, at 9 and 18 weeks of diet. Under high-fat, high-sugar diet, the abundances of Tuzzerella and Anaerovorax were transiently increased at 9 weeks, while Lactobacillus remained elevated at 9 and 18 weeks. The same diet decreased the abundances of Akkermansia, Paludicola, Eisenbergiella, and Butyricicoccus at 9 and 18 weeks, while Intestinimonas and UCG-009 of the Butyricicoccaceae family responded only at 18 weeks. The high-fat diet decreased the abundances of UBA1819 at 9 weeks, and Gastranaerophilales, Clostridia UCG-014, and ASF356 at 9 and 18 weeks. Those of Marvinbryantia, Harryflintia, Alistipes, Blautia, Lachnospiraceae A2, Eubacterium coprostanoligenes group, and Eubacterium brachy group were lowered only at 18 weeks. Interestingly, these genera were not sensitive to the high-sugar diet. The mouse gut microbiome was differentially affected by diets rich in fat or fat and sugar. The differences observed at 9 and 18 weeks indicate a progressive microbiome response.


Assuntos
Microbioma Gastrointestinal , Lactobacillales , Animais , Camundongos , Açúcares , Gorduras na Dieta , RNA Ribossômico 16S/genética , Dieta Hiperlipídica/efeitos adversos , Clostridiales , Clostridiaceae
11.
Inorg Chem ; 62(29): 11466-11486, 2023 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-37441730

RESUMO

We report the synthesis and characterization of three novel Schiff bases (L1-L3) derived from the condensation of 2-carbaldehyde-8-hydroxyquinoline with amines containing morpholine or piperidine moieties. These were reacted with CuCl2 and ZnCl2 yielding six new coordination compounds, with the general formula ML2, where M = Cu(II) or Zn(II) and L = L1-L3, which were all characterized by analytical, spectroscopic (Fourier transform infrared (FTIR), UV-visible absorption, nuclear magnetic resonance (NMR), or electron paramagnetic resonance (EPR)), and mass spectrometric techniques, as well as by single-crystal X-ray diffraction. In the solid state, two Cu(II) complexes, with L1 and L2, are obtained as dinuclear compounds, with relatively short Cu-Cu distances (3.146 and 3.171 Å for Cu2(L1)4 and Cu2(L2)4, respectively). The free ligands show moderate lipophilicity, while their complexes are more lipophilic. The pKa values of L1-L3 and formation constants of the complex (for ML and ML2) species were determined by spectrophotometric titrations, with the Cu(II) complexes showing higher stability than the Zn(II) complexes. EPR indicated the presence of several species in solution as pH varied and binding modes were proposed. The binding of the complexes to bovine serum albumin (BSA) was evaluated by fluorescence and circular dichroism (CD) spectroscopies. All complexes bind BSA, and as demonstrated by CD, the process takes several hours to reach equilibrium. The antiproliferative activity was evaluated in malignant melanoma cells (A375) and in noncancerous keratinocytes (HaCaT). All complexes display significant cytotoxicity (IC50 < 10 µM) but modest selectivity. The complexes show higher activity than the free ligands, the Cu(II) complexes being more active than the Zn(II) complexes, and approximately twice more cytotoxic than cisplatin. A Guava ViaCount assay corroborated the antiproliferative activity.


Assuntos
Complexos de Coordenação , Complexos de Coordenação/química , Bases de Schiff/química , Ligantes , Oxiquinolina/farmacologia , Zinco/química , Cobre/farmacologia , Cobre/química
12.
Transplant Proc ; 55(6): 1421-1424, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37295993

RESUMO

BACKGROUND: We aimed to identify the challenges and strategies experienced by patients undergoing liver transplantation during the COVID-19 pandemic. METHODS: This was a descriptive study with a qualitative approach conducted in a large liver transplant hospital in southern Brazil. RESULTS: The participants included liver transplant patients between the years 2011 and 2022. Data collection was performed using a semi-structured interview. Data analysis comprised approximation of information and calculation of percentages. RESULTS: A total of 23 patients participated. Challenges identified included an increased dependence on others for daily activities, fear and stress due to the possibility of contamination, and the need for isolation from family and friends. Strategies included adaptation to the daily routine, reorganization of tasks inside and outside the home, formation of a support network, and reduced attendance to consultations and exams. CONCLUSIONS: Evidence of anguish and suffering of patients facing isolation and separation from family members was observed. Still, the study revealed the strength and determination of the patients to create strategies for preventing the SARS-CoV-2 virus and caring for themselves and their families. The study demonstrates the need for support from the health team in the face of such a scenario.


Assuntos
COVID-19 , Transplante de Fígado , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , Pandemias/prevenção & controle , Transplante de Fígado/efeitos adversos , Família
13.
Front Oncol ; 13: 1106667, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37223676

RESUMO

Introduction: Cervical cancer is a worldwide health problem due to the number of deaths caused by this neoplasm. In particular, in 2020, 30,000 deaths of this type of tumor were reported in Latin America. Treatments used to manage patients diagnosed in the early stages have excellent results as measured by different clinical outcomes. Existing first-line treatments are not enough to avoid cancer recurrence, progression, or metastasis in locally advanced and advanced stages. Therefore, there is a need to continue with the proposal of new therapies. Drug repositioning is a strategy to explore known medicines as treatments for other diseases. In this scenario, drugs used in other pathologies that have antitumor activity, such as metformin and sodium oxamate, are analyzed. Methods: In this research, we combined the drugs metformin and sodium oxamate with doxorubicin (named triple therapy or TT) based on their mechanism of action and previous investigation of our group against three CC cell lines. Results: Through flow cytometry, Western blot, and protein microarray experiments, we found TT-induced apoptosis on HeLa, CaSki, and SiHa through the caspase 3 intrinsic pathway, including the critical proapoptotic proteins BAD, BAX, cytochrome-C, and p21. In addition, mTOR and S6K phosphorylated proteins were inhibited in the three cell lines. Also, we show an anti-migratory activity of the TT, suggesting other targets of the drug combination in the late CC stages. Discussion: These results, together with our former studies, conclude that TT inhibits the mTOR pathway leading to cell death by apoptosis. Our work provides new evidence of TT against cervical cancer as a promising antineoplastic therapy.

14.
Inorg Chem ; 62(20): 7932-7953, 2023 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-37154533

RESUMO

A series of mononuclear non-oxido vanadium(IV) complexes, [VIV(L1-4)2] (1-4), featuring tridentate bi-negative ONS chelating S-alkyl/aryl-substituted dithiocarbazate ligands H2L1-4, are reported. All the synthesized non-oxido VIV compounds are characterized by elemental analysis, spectroscopy (IR, UV-vis, and EPR), ESI-MS, as well as electrochemical techniques (cyclic voltammetry). Single-crystal X-ray diffraction studies of 1-3 reveal that the mononuclear non-oxido VIV complexes show distorted octahedral (1 and 2) or trigonal prismatic (3) arrangement around the non-oxido VIV center. EPR and DFT data indicate the coexistence of mer and fac isomers in solution, and ESI-MS results suggest a partial oxidation of [VIV(L1-4)2] to [VV(L1-4)2]+ and [VVO2(L1-4)]-; therefore, all these three complexes are plausible active species. Complexes 1-4 interact with bovine serum albumin (BSA) with a moderate binding affinity, and docking calculations reveal non-covalent interactions with different regions of BSA, particularly with Tyr, Lys, Arg, and Thr residues. In vitro cytotoxic activity of all complexes is assayed against the HT-29 (colon cancer) and HeLa (cervical cancer) cells and compared with the NIH-3T3 (mouse embryonic fibroblast) normal cell line by MTT assay and DAPI staining. The results suggest that complexes 1-4 are cytotoxic in nature and induce cell death in the cancer cell lines by apoptosis and that a mixture of VIV, VV, and VVO2 species could be responsible for the biological activity.


Assuntos
Complexos de Coordenação , Camundongos , Humanos , Animais , Complexos de Coordenação/química , Fibroblastos , Células HeLa , Vanádio/química , Quelantes , Ligantes
15.
Front Chem ; 11: 1106349, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37025548

RESUMO

We report the synthesis and characterization of a group of benzoylhydrazones (Ln) derived from 2-carbaldehyde-8-hydroxyquinoline and benzylhydrazides containing distinct para substituents (R = H, Cl, F, CH3, OCH3, OH and NH2, for L1-7, respectively; in L8 isonicotinohydrazide was used instead of benzylhydrazide). Cu(II) complexes were prepared by reaction of each benzoylhydrazone with Cu(II) acetate. All compounds were characterized by elemental analysis and mass spectrometry as well as by FTIR, UV-visible absorption, NMR or electron paramagnetic resonance spectroscopies. Complexes isolated in the solid state (1-8) are either formulated as [Cu(HL)acetate] (with L1 and L4) or as [Cu(Ln)]3 (n = 2, 3, 5, 6, 7 and 8). Single crystal X-ray diffraction studies were done for L5 and [Cu(L5)]3, confirming the trinuclear formulation of several complexes. Proton dissociation constants, lipophilicity and solubility were determined for all free ligands by UV-Vis spectrophotometry in 30% (v/v) DMSO/H2O. Formation constants were determined for [Cu(LH)], [Cu(L)] and [Cu(LH-1)] for L = L1, L5 and L6, and also [Cu(LH-2)] for L = L6, and binding modes are proposed, [Cu(L)] predominating at physiological pH. The redox properties of complexes formed with L1, L5 and L6 are investigated by cyclic voltammetry; the formal redox potentials fall in the range of +377 to +395 mV vs. NHE. The binding of the Cu(II)-complexes to bovine serum albumin was evaluated by fluorescence spectroscopy, showing moderate-to-strong interaction and suggesting formation of a ground state complex. The interaction of L1, L3, L5 and L7, and of the corresponding complexes with calf thymus DNA was evaluated by thermal denaturation. The antiproliferative activity of all compounds was evaluated in malignant melanoma (A-375) and lung (A-549) cancer cells. The complexes show higher activity than the corresponding free ligand, and most complexes are more active than cisplatin. Compounds 1, 3, 5, and 8 were selected for additional studies: while these complexes induce reactive oxygen species and double-strand breaks in both cancer cells, their ability to induce cell-death by apoptosis varies. Within the set of compounds tested, 8 emerges as the most promising one, presenting low IC50 values, and high induction of oxidative stress and DNA damage, which eventually lead to high rates of apoptosis.

16.
Transplant Proc ; 55(6): 1359-1361, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37105826

RESUMO

BACKGROUND: This study was designed to discuss the time elapsed between cell, tissue, and organ donation and transplantation and detection of adverse events notified in São Paulo, Brazil. METHODS: This is a descriptive study with a quantitative approach. Data were provided by the Transplant Center of the state of São Paulo from the "Individual notification form of adverse reactions in Biovigilance" between 2016 and 2019. Analysis was performed using descriptive statistics. RESULTS: Fifty-two notifications were analyzed, and 3 categories were formed: (1) adverse events detected on the same day of the transplant, 8; (2) adverse events detected between 1 week and 1.5 years after transplant, 40; and (3) adverse events detected 2 years after transplant, 4. CONCLUSION: The discussion on the topic is beginning; however, it is important. Clinical management of transplant recipients and comprehending what is considered an adverse event and the natural course of a patient's life can impact clinical decision-making, public policies, and patient safety research. This study highlights the need to investigate related factors to adverse events, especially the time between the transplant procedure and adverse event detection, to establish clinical guidelines.


Assuntos
Transplante de Órgãos , Obtenção de Tecidos e Órgãos , Transplantes , Humanos , Brasil , Transplante de Órgãos/efeitos adversos , Segurança do Paciente
17.
Neural Regen Res ; 18(7): 1486-1488, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36571346
18.
ABCD (São Paulo, Online) ; 36: e1746, 2023. graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1513509

RESUMO

ABSTRACT BACKGROUND: After validation in multiple types of liver disease patients, the MELD score was adopted as a standard by which liver transplant candidates with end-stage liver disease were prioritized for organ allocation in the United States since 2002, and in Brazil, since 2006. AIMS: To analyze the mortality profile of patients on the liver transplant waiting list correlated to MELD score at the moment of transplantation. METHODS: This study used the data from the Secretary of Health of the São Paulo State, Brazil, which listed 22,522 patients, from 2006 (when MELD score was introduced in Brazil) until June 2009. Patients with acute hepatic failure and tumors were included as well. We also considered the mortality of both non-transplanted and transplanted patients as a function of the MELD score at presentation. RESULTS: Our model showed that the best MELD score for patients on the liver transplant waiting list associated to better results after liver transplantation was 26. CONCLUSIONS: We found that the best score for applying to liver transplant waiting list in the State of São Paulo was 26. This is the score that minimizes the mortality in both non-transplanted and liver transplanted patients.


RESUMO RACIONAL: Desde 2002, após validação em múltiplos tipos de hepatopatias, o escore MELD foi adotado como padrão pelo qual os candidatos a transplante de fígado com doença hepática terminal têm sido priorizados para alocação de órgãos nos Estados Unidos, e em 2006 no Brasil. OBJETIVOS: Analisar a mortalidade de pacientes em lista de espera para transplante de fígado correlacionando com o MELD, no momento do transplante. MÉTODOS: Foram utilizados os dados da Secretaria de Saúde do Estado de São Paulo, Brasil, onde foram listados 22.522 pacientes, desde 2006 (quando o escore MELD foi introduzido no Brasil) até junho de 2009. Foram incluídos pacientes com falência hepática e tumores. A mortalidade de pacientes não transplantados e transplantados também foi considerada em função do escore MELD. RESULTADOS: Nosso modelo mostrou que o melhor valor do MELD, em pacientes em lista de espera para transplante e com melhores resultados, foi de 26. Este valor minimiza mortalidade em pacientes não transplantados bem comem pacientes na lista de espera para transplante de fígado. CONCLUSÕES: O escore MELD ótimo para entrar na lista de espera para transplante de fígado, no estado de São Paulo, é em torno de 26. Esse é o valor que minimiza a mortalidade tanto dos pacientes não transplantados em lista de espera, quanto dos submetidos à transplante de fígado.

19.
Texto & contexto enferm ; 32: e20230042, 2023. graf
Artigo em Inglês | LILACS-Express | LILACS, BDENF - Enfermagem | ID: biblio-1530551

RESUMO

ABSTRACT Objective: to understand the experience of patients undergoing liver transplantation during the COVID-19 pandemic. Method: exploratory and qualitative research, developed in a reference hospital in liver transplantation, in the city of Florianópolis, Brazil. Participants were liver transplant patients between the years 2011 and 2021. Data collection conducted through a semi-structured script and data analysis performed according to content analysis. Results: from the participation of 23 patients, two categories of analysis emerged: "Perceptions about social isolation", with results related to coping and feelings related to social isolation; and "Actions and information: patients, support network and health services", revealing the meanings of strategies and changes developed in life activities of daily living as well as challenges faced with information and health services during the pandemic period. Conclusion: the study was able to understand liver transplant patients' experience in the face of the challenges they face during the pandemic. It allowed to visualize coping strategies, feelings and meanings based on recipients' perspective. As a contribution, it presents possibilities for achieving improvements in services and attention to weaknesses in health services, providing opportunities for reflections to improve this care and considering the specificities and complexities of the postoperative period of liver transplantation.


RESUMEN Objetivo: comprender la experiencia de los pacientes sometidos a trasplante hepático en la pandemia de COVID-19. Método: investigación exploratoria, con abordaje cualitativo, desarrollada en un hospital de referencia para trasplante hepático, en la ciudad de Florianópolis, Brasil. Los participantes fueron pacientes trasplantados de hígado entre los años 2011 y 2021. La recolección de datos se realizó a través de un guión semiestructurado y el análisis de datos se realizó de acuerdo con el análisis de contenido. Resultados: de la participación de 23 pacientes surgieron dos categorías de análisis: "Percepciones sobre el aislamiento social", con resultados relacionados al afrontamiento y sentimientos relacionados al aislamiento social; y "Acciones e información: paciente, red de apoyo y servicios de salud", revelando los significados de las estrategias y cambios desarrollados en las actividades de la vida diaria, así como los desafíos enfrentados con la información y los servicios de salud durante el período de la pandemia. Conclusión: el estudio logró comprender la experiencia de los pacientes trasplantados de hígado frente a los desafíos que enfrentan durante la pandemia. Permitido visualizar estrategias de afrontamiento, sentimientos y significados basados ​​en la propia perspectiva del receptor. Como aporte, presenta posibilidades para lograr mejoras en los servicios y atención a las debilidades de los servicios de salud, brindando espacios de reflexión para mejorar esa atención, considerando las especificidades y complejidades del postoperatorio del trasplante hepático.


RESUMO Objetivo: compreender a vivência do paciente submetido ao transplante hepático na pandemia da COVID-19. Método: pesquisa exploratória, de abordagem qualitativa desenvolvida em hospital de referência em transplante hepático, na cidade de Florianópolis, Brasil; os participantes foram pacientes transplantados hepáticos entre os anos de 2011 e 2021. Coleta de dados conduzida por meio de roteiro semiestruturado e análise dos dados realizada conforme análise de conteúdo. Resultados: da participação dos 23 pacientes, duas categorias de análise emergiram: "percepções acerca do isolamento social" com resultados relacionados aos enfrentamentos e sentimentos referentes ao isolamento social e "e "ações e informações: paciente, rede de apoio e serviços de saúde" desvelando os significados das estratégias e mudanças desenvolvidas nas atividades de vida diária bem como os desafios em face das informações e dos serviços de saúde durante o período da pandemia. Conclusão: o estudo foi capaz de compreender a vivência dos pacientes transplantados hepáticos ante os desafios enfrentados por eles durante a pandemia. Permitiu visualizar estratégias de enfrentamento, sentimentos e significados com base na perspectiva do próprio receptor. Como contribuição, apresenta possibilidades de alcance de melhorias nos serviços e de atenção às fragilidades dos serviços de saúde, oportunizando reflexões para a melhoria desse cuidado, considerando as especificidades e complexidades do pós-operatório do transplante hepático.

20.
Rev. bras. queimaduras ; 22(2): 55-60, 2023.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1552884

RESUMO

OBJETIVO: Comparar a avaliação clínica presencial, com fotos e imagens térmicas obtidas no dispositivo FLIR ONE® para o diagnóstico de profundidade das queimaduras, avaliar concordância intragrupos e descrever o perfil epidemiológico da população estudada. MÉTODO: Estudo transversal de acurácia. Foram incluídos pacientes adultos com queimaduras agudas, submetidos a balneoterapia, selecionados aleatoriamente e avaliados isoladamente por dois grupos de avaliadores (avaliação clínica presencial X fotos do dispositivo térmico), no período de 14 de fevereiro a 14 de março de 2018 no Centro de Tratamento de Queimados do Hospital Geral do Estado da Bahia. Nas análises estatísticas foi utilizado o programa IBM-SPSS-Statistics versão 23, realizando análises descritivas e distribuição de frequências. A significância estatística (p<0,05) foi avaliada pelo teste de Spearman. RESULTADOS: No total, 39 diferentes áreas de queimadura, e suas respectivas fotos em VGA. 19 pacientes foram incluídos no estudo, 57,9% pertenciam ao sexo masculino, com média de idade de 35 anos. A média de superfície corporal queimada foi de 16,32%. Das 39 áreas queimadas avaliadas, 14 (35,9%) foram classificadas como profundas e 25 (64,1%) como superficiais pelo FLIR ONE®. O grupo 1 apresentou percentual de concordância no diagnóstico de 89,8%. O grupo 2 apresentou percentual de concordância no diagnóstico de 48,7%. CONCLUSÕES: A avaliação clínica presencial apresentou melhor concordância intragrupos do que a avaliação fotográfica. Quando os grupos foram comparados com o dispositivo térmico FLIR ONE® não ocorreu correlação significativa, com taxa de concordância de 35,9%.


OBJECTIVE: To compare in-person clinical assessment with photos and thermal images obtained on FLIR ONE® device to diagnose burn depth, evaluate intragroup agreement and describe the epidemiological profile of the studied population. METHODS: Accuracy cross-sectional study. Adult patients with acute burns, undergoing balneotherapy, were included, randomly selected and evaluated separately by two groups of evaluators (in-person clinical assessment versus photos of the thermal device), from February 14 to March 14, 2018 at the Burn Treatment Center of the General Hospital of the State of Bahia. In statistical analyses, the IBM-SPSS-Statistics version 23 program was used, performing descriptive analyzes and frequency distribution, statistical significance (p<0.05) was assessed using Spearman's test. RESULTS: In total, 39 different burn areas, and their respective VGA photos. 19 patients were included in the study, 57.9% of whom were male, with an average age of 35 years. The average body surface area burned was 16.32%. Of the 39 burned areas evaluated, 14 (35.9%) were classified as deep and 25 (64.1%) as superficial by the FLIR ONE®. Group 1 had a percentage of agreement in the diagnosis of 89.8%. Group 2 had a percentage of agreement in the diagnosis of 48.7%. CONCLUSIONS: The in-person clinical assessment showed better intragroup agreement than the photographic assessment. When the groups were compared with the FLIR ONE® thermal device, there was no significant correlation with an agreement rate of 35.9%.

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