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1.
Int J Legal Med ; 138(5): 2157-2167, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38763927

RESUMO

In most experimental protocols, false starts are produced on dry bones obtained through a maceration process for anthropological analyses, for the sake of reproducibility. Although this allows for controlled experimental conditions, the absence of soft parts when experimentally creating false starts does not correspond to the real conditions of criminal dismemberment. The main objective of this study was to determine if the results of experimental work on the characteristics of false starts were valid under medico-legal conditions. In this experimental study, a hand saw (rip saw, wavy set, TPI 32) was used. 240 false starts were produced on human and pig bones. Randomly, the false starts were either produced on a dry bone or on a flesh bone. The criteria for microscopic analysis included the shape of the walls, the shape and visibility of striae on the floor, the shape of the profile, and the minimum width of the false start. On human bone, 100% of the false starts produced on a bone that had previously undergone a maceration process for anthropological analyses (dry bone) allowed the definition of all the blade characteristics. This was the case for 78.3% on bone in the presence of soft tissue (flesh bone). The striae on the floor of the false start are in some cases less visible with flesh bones, implying that it may be more difficult to conclude on the characteristics of a saw under medico-legal conditions.


Assuntos
Osso e Ossos , Desmembramento de Cadáver , Humanos , Suínos , Animais , Osso e Ossos/patologia , Antropologia Forense/métodos
2.
Nature ; 549(7672): 384-388, 2017 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-28902836

RESUMO

Long-term potentiation (LTP) of excitatory synaptic transmission has long been considered a cellular correlate for learning and memory. Early LTP (less than 1 h) had initially been explained either by presynaptic increases in glutamate release or by direct modification of postsynaptic AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptor function. Compelling models have more recently proposed that synaptic potentiation can occur by the recruitment of additional postsynaptic AMPA receptors (AMPARs), sourced either from an intracellular reserve pool by exocytosis or from nearby extra-synaptic receptors pre-existing on the neuronal surface. However, the exact mechanism through which synapses can rapidly recruit new AMPARs during early LTP remains unknown. In particular, direct evidence for a pivotal role of AMPAR surface diffusion as a trafficking mechanism in synaptic plasticity is still lacking. Here, using AMPAR immobilization approaches, we show that interfering with AMPAR surface diffusion markedly impairs synaptic potentiation of Schaffer collaterals and commissural inputs to the CA1 area of the mouse hippocampus in cultured slices, acute slices and in vivo. Our data also identify distinct contributions of various AMPAR trafficking routes to the temporal profile of synaptic potentiation. In addition, AMPAR immobilization in vivo in the dorsal hippocampus inhibited fear conditioning, indicating that AMPAR diffusion is important for the early phase of contextual learning. Therefore, our results provide a direct demonstration that the recruitment of new receptors to synapses by surface diffusion is a critical mechanism for the expression of LTP and hippocampal learning. Since AMPAR surface diffusion is dictated by weak Brownian forces that are readily perturbed by protein-protein interactions, we anticipate that this fundamental trafficking mechanism will be a key target for modulating synaptic potentiation and learning.


Assuntos
Condicionamento Clássico/fisiologia , Difusão , Hipocampo/fisiologia , Potenciação de Longa Duração/fisiologia , Receptores de AMPA/metabolismo , Animais , Avidina , Biotina , Membrana Celular/metabolismo , Reagentes de Ligações Cruzadas , Potenciais Pós-Sinápticos Excitadores , Medo , Feminino , Hipocampo/citologia , Imunoglobulina G/imunologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Ratos , Receptores de AMPA/imunologia , Sinapses/metabolismo , Transmissão Sináptica
3.
Int Wound J ; 20(6): 2062-2067, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36811264

RESUMO

Paediatric complex wounds pose a challenge to the reconstructive surgeon due to the intricacy of reconstructive options required. Developments in microsurgery and microsurgical technique have brought free tissue transfer ever closer to the comfort zone of the reconstructive surgeon for reconstruction of paediatric traumatic complex wounds. We present our experience of microsurgical reconstruction in Lebanon for complex traumatic wounds in paediatric patients under the age of 10 years using the free anterolateral thigh (ALT) flap. The ALT flap has proven its value as a safe, adaptable, and aesthetically acceptable reconstructive option in paediatric complex trauma.


Assuntos
Retalho Perfurante , Procedimentos de Cirurgia Plástica , Humanos , Criança , Retalho Perfurante/cirurgia , Coxa da Perna/cirurgia , Microcirurgia/métodos , Líbano
4.
Antimicrob Agents Chemother ; 66(7): e0011422, 2022 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-35727057

RESUMO

The rate at which parasitemia declines in a host after treatment with an antimalarial drug is a major metric for assessment of antimalarial drug activity in preclinical models and in early clinical trials. However, this metric does not distinguish between viable and nonviable parasites. Thus, enumeration of parasites may result in underestimation of drug activity for some compounds, potentially confounding its use as a metric for assessing antimalarial activity in vivo. Here, we report a study of the effect of artesunate on Plasmodium falciparum viability in humans and in mice. We first measured the drug effect in mice by estimating the decrease in parasite viability after treatment using two independent approaches to estimate viability. We demonstrate that, as previously reported in humans, parasite viability declines much faster after artesunate treatment than does the decline in parasitemia (termed parasite clearance). We also observed that artesunate kills parasites faster at higher concentrations, which is not discernible from the traditional parasite clearance curve and that each subsequent dose of artesunate maintains its killing effect. Furthermore, based on measures of parasite viability, we could accurately predict the in vivo recrudescence of infection. Finally, using pharmacometrics modeling, we show that the apparent differences in the antimalarial activity of artesunate in mice and humans are partly explained by differences in host removal of dead parasites in the two hosts. However, these differences, along with different pharmacokinetic profiles, do not fully account for the differences in activity. (This study has been registered with the Australian New Zealand Clinical Trials Registry under identifier ACTRN12617001394336.).


Assuntos
Antimaláricos , Artemisininas , Malária Falciparum , Parasitos , Animais , Antimaláricos/farmacocinética , Antimaláricos/uso terapêutico , Artemisininas/farmacocinética , Artemisininas/uso terapêutico , Artesunato/farmacologia , Artesunato/uso terapêutico , Austrália , Humanos , Malária Falciparum/tratamento farmacológico , Camundongos , Parasitemia/tratamento farmacológico , Parasitemia/parasitologia , Plasmodium falciparum
5.
Phys Rev Lett ; 128(25): 252002, 2022 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-35802440

RESUMO

We report high-precision measurements of the deeply virtual Compton scattering (DVCS) cross section at high values of the Bjorken variable x_{B}. DVCS is sensitive to the generalized parton distributions of the nucleon, which provide a three-dimensional description of its internal constituents. Using the exact analytic expression of the DVCS cross section for all possible polarization states of the initial and final electron and nucleon, and final state photon, we present the first experimental extraction of all four helicity-conserving Compton form factors (CFFs) of the nucleon as a function of x_{B}, while systematically including helicity flip amplitudes. In particular, the high accuracy of the present data demonstrates sensitivity to some very poorly known CFFs.

6.
Int J Mol Sci ; 23(9)2022 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-35563121

RESUMO

In case of an incident in the nuclear industry or an act of war or terrorism, the dissemination of plutonium could contaminate the environment and, hence, humans. Human contamination mainly occurs via inhalation and/or wounding (and, less likely, ingestion). In such cases, plutonium, if soluble, reaches circulation, whereas the poorly soluble fraction (such as small colloids) is trapped in alveolar macrophages or remains at the site of wounding. Once in the blood, the plutonium is delivered to the liver and/or to the bone, particularly into its mineral part, mostly composed of hydroxyapatite. Countermeasures against plutonium exist and consist of intravenous injections or inhalation of diethylenetetraminepentaacetate salts. Their effectiveness is, however, mainly confined to the circulating soluble forms of plutonium. Furthermore, the short bioavailability of diethylenetetraminepentaacetate results in its rapid elimination. To overcome these limitations and to provide a complementary approach to this common therapy, we developed polymeric analogs to indirectly target the problematic retention sites. We present herein a first study regarding the decontamination abilities of polyethyleneimine methylcarboxylate (structural diethylenetetraminepentaacetate polymer analog) and polyethyleneimine methylphosphonate (phosphonate polymeric analog) directed against Th(IV), used here as a Pu(IV) surrogate, which was incorporated into hydroxyapatite used as a bone model. Our results suggest that polyethylenimine methylphosphonate could be a good candidate for powerful bone decontamination action.


Assuntos
Elementos da Série Actinoide , Plutônio , Quelantes/química , Descontaminação/métodos , Durapatita , Humanos , Plutônio/química , Polietilenoimina , Polímeros
7.
Phys Rev Lett ; 127(15): 152301, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34678020

RESUMO

We report measurements of the exclusive neutral pion electroproduction cross section off protons at large values of x_{B} (0.36, 0.48, and 0.60) and Q^{2} (3.1 to 8.4 GeV^{2}) obtained from Jefferson Lab Hall A experiment E12-06-014. The corresponding structure functions dσ_{T}/dt+εdσ_{L}/dt, dσ_{TT}/dt, dσ_{LT}/dt, and dσ_{LT^{'}}/dt are extracted as a function of the proton momentum transfer t-t_{min}. The results suggest the amplitude for transversely polarized virtual photons continues to dominate the cross section throughout this kinematic range. The data are well described by calculations based on transversity generalized parton distributions coupled to a helicity flip distribution amplitude of the pion, thus providing a unique way to probe the structure of the nucleon.

8.
Arch Toxicol ; 95(3): 1023-1037, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33426622

RESUMO

Uranium is widely spread in the environment due to its natural and anthropogenic occurrences, hence the importance of understanding its impact on human health. The skeleton is the main site of long-term accumulation of this actinide. However, interactions of this metal with biological processes involving the mineralized extracellular matrix and bone cells are still poorly understood. To get a better insight into these interactions, we developed new biomimetic bone matrices containing low doses of natural uranium (up to 0.85 µg of uranium per cm2). These models were characterized by spectroscopic and microscopic approaches before being used as a support for the culture and differentiation of pre-osteoclastic cells. In doing so, we demonstrate that uranium can exert opposite effects on osteoclast resorption depending on its concentration in the bone microenvironment. Our results also provide evidence for the first time that resorption contributes to the remobilization of bone matrix-bound uranium. In agreement with this, we identified, by HRTEM, uranium phosphate internalized in vesicles of resorbing osteoclasts. Thanks to the biomimetic matrices we developed, this study highlights the complex mutual effects between osteoclasts and uranium. This demonstrates the relevance of these 3D models to further study the cellular mechanisms at play in response to uranium storage in bone tissue, and thus better understand the impact of environmental exposure to uranium on human bone health.


Assuntos
Matriz Óssea/efeitos dos fármacos , Modelos Biológicos , Osteoclastos/efeitos dos fármacos , Urânio/metabolismo , Animais , Biomimética , Matriz Óssea/metabolismo , Reabsorção Óssea/metabolismo , Linhagem Celular Tumoral , Humanos , Camundongos , Osteoclastos/metabolismo , Células RAW 264.7 , Distribuição Tecidual , Urânio/administração & dosagem
9.
Agron Sustain Dev ; 38(6): 57, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30873222

RESUMO

Soil degradation in semi-arid West Africa can be reversed through an intensified application of organic matter, especially on coarse soils. Woody perennials have been promoted in the region to secure organic matter sources and improve soil productive capacity, yet the mechanisms by which perennials provide benefits to soils and crops remain poorly understood, and no effective, generalizable agronomic recommendations exist. Here, we reviewed the effects of trees and shrubs on soil properties and on crop yields in semi-arid West Africa (< 1000 mm year-1). Specific objectives of this meta-analysis were to (i) describe and (ii) quantify the effects of the presence of woody perennials and of ramial wood amendments on crop productivity and soil characteristics, and (iii) identify general recommendations on the integration of perennials with crops. An iterative keyword search was conducted to gather relevant literature. The search string consisted of four parts: source, practice, responses, and countries of interest. In total, 26 references on agroforestry parklands and 21 on woody amendments were included in the meta-database (314 entries, 155 for parklands, and 159 for ramial wood). We show that (1) the presence of shrubs and trees on agricultural fields had an overall positive but variable effect on soil total C (i.e. + 20 to 75%); (2) millet and sorghum yields were often higher in the presence of shrubs (- 25 to + 120%); (3) more variability was observed in the presence of trees (- 100 to + 200%); and (4) the use of shrub- and tree-based ramial wood resulted in equal or higher cereal yields as compared to the control (- 30 to + 100%). Upscaling the use of biodiversity-driven processes in farming systems of West Africa may provide benefits to overall ecosystems, but species' choice and trade-offs perceived at the farm level, including labour management and low ramial wood availability, should be addressed through future research.

10.
Biochim Biophys Acta Gen Subj ; 1861(4): 715-726, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28089586

RESUMO

BACKGROUND: Uranium is a naturally occurring radionuclide ubiquitously present in the environment. The skeleton is the main site of uranium long-term accumulation. While it has been shown that natural uranium is able to perturb bone metabolism through its chemical toxicity, its impact on bone resorption by osteoclasts has been poorly explored. Here, we examined for the first time in vitro effects of natural uranium on osteoclasts. METHODS: The effects of uranium on the RAW 264.7 monocyte/macrophage mouse cell line and primary murine osteoclastic cells were characterized by biochemical, molecular and functional analyses. RESULTS: We observed a cytotoxicity effect of uranium on osteoclast precursors. Uranium concentrations in the µM range are able to inhibit osteoclast formation, mature osteoclast survival and mineral resorption but don't affect the expression of the osteoclast gene markers Nfatc1, Dc-stamp, Ctsk, Acp5, Atp6v0a3 or Atp6v0d2 in RAW 274.7 cells. Instead, we observed that uranium induces a dose-dependent accumulation of SQSTM1/p62 during osteoclastogenesis. CONCLUSIONS: We show here that uranium impairs osteoclast formation and function in vitro. The decrease in available precursor cells, as well as the reduced viability of mature osteoclasts appears to account for these effects of uranium. The SQSTM1/p62 level increase observed in response to uranium exposure is of particular interest since this protein is a known regulator of osteoclast formation. A tempting hypothesis discussed herein is that SQSTM1/p62 dysregulation contributes to uranium effects on osteoclastogenesis. GENERAL SIGNIFICANCE: We describe cellular and molecular effects of uranium that potentially affect bone homeostasis.


Assuntos
Diferenciação Celular/efeitos dos fármacos , Osteoclastos/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Urânio/efeitos adversos , Animais , Reabsorção Óssea/genética , Diferenciação Celular/genética , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Sobrevivência Celular/genética , Marcadores Genéticos/genética , Camundongos , Osteoclastos/metabolismo , Osteogênese/genética , Células RAW 264.7
11.
Arch Toxicol ; 91(4): 1903-1914, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27585666

RESUMO

Natural uranium (U), which is present in our environment, exerts a chemical toxicity, particularly in bone where it accumulates. Generally, U is found at oxidation state +VI in its oxocationic form [Formula: see text] in aqueous media. Although U(VI) has been reported to induce cell death in osteoblasts, the cells in charge of bone formation, the molecular mechanism for U(VI) effects in these cells remains poorly understood. The objective of our study was to explore U(VI) effect at doses ranging from 5 to 600 µM, on mineralization and autophagy induction in the UMR-106 model osteoblastic cell line and to determine U(VI) speciation after cellular uptake. Our results indicate that U(VI) affects mineralization function, even at subtoxic concentrations (<100 µM). The combination of thermodynamic modeling of U with EXAFS data in the culture medium and in the cells clearly indicates the biotransformation of U(VI) carbonate species into a meta-autunite phase upon uptake by osteoblasts. We next assessed U(VI) effect at 100 and 300 µM on autophagy, a survival process triggered by various stresses such as metal exposure. We observed that U(VI) was able to rapidly activate autophagy but an inhibition of the autophagic flux was observed after 24 h. Thus, our results indicate that U(VI) perturbs osteoblastic functions by reducing mineralization capacity. Our study identifies for the first time U(VI) in the form of meta-autunite in mammalian cells. In addition, U(VI)-mediated inhibition of the autophagic flux may be one of the underlying mechanisms leading to the decreased mineralization and the toxicity observed in osteoblasts.


Assuntos
Autofagia/efeitos dos fármacos , Calcificação Fisiológica/efeitos dos fármacos , Osteoblastos/efeitos dos fármacos , Urânio/toxicidade , Animais , Linhagem Celular , Linhagem Celular Tumoral , Relação Dose-Resposta a Droga , Osteoblastos/metabolismo , Osteoblastos/patologia , Osteossarcoma/metabolismo , Ratos , Termodinâmica , Urânio/administração & dosagem
12.
Curr Opin Rheumatol ; 28(4): 442-7, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27077891

RESUMO

PURPOSE OF REVIEW: Until recently, osteoporotic pelvic fractures have not been specifically studied. This review presents an update on epidemiological data of pelvic fracture, including morbidity, mortality and healthcare costs, the role of surgery and new data on sacroplasty in acute phase management. RECENT FINDINGS: All studies underline the burden of osteoporotic pelvic fractures. Risk factors associated with these fractures are age, sex (women), and previous loss of autonomy. An increased mortality has been reported in all publications, similar to hip fracture for in-patient mortality and at 5 years of follow-up. Pelvic fractures often lead to transient or permanent autonomy loss, reflecting the high costs because of extended hospital stay, combined with nursing home requirement. However, recent studies report a decrease in the length of stay. Sacroplasty displays promising results to control pain and improve functional outcome. Early surgery begins to be discussed to also improve the outcome. SUMMARY: Pelvic fractures display all the features of severe osteoporotic fractures: increased incidence, high morbidity, mortality, and healthcare costs that justify awareness of the practitioner on these fractures. Further studies on sacroplasty and surgery are necessary to improve pain control, functional improvement, thereby reducing the length of hospital stay and cost.


Assuntos
Fraturas por Osteoporose/epidemiologia , Ossos Pélvicos/lesões , Conservadores da Densidade Óssea/uso terapêutico , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Incidência , Tempo de Internação/estatística & dados numéricos , Fraturas por Osteoporose/economia , Fraturas por Osteoporose/terapia , Ossos Pélvicos/cirurgia , Fatores de Risco , Sacro/cirurgia , Vertebroplastia/métodos
13.
J Pediatr Orthop ; 35(6): 576-82, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25333905

RESUMO

BACKGROUND: Lower limb rotational anomalies in spastic diplegic children with cerebral palsy (CP) are common and difficult to identify through physical examination alone. The identification and treatment of the overall rotational disorders must be considered to restore physiological lever-arms lengths and lever-arms orientation.The aims of the study were to assess the prevalence of lower limb rotational malalignment and to describe the distribution of the different kinematic torsional profiles in children with spastic diplegia. METHODS: Instrumented gait analysis data from 188 children with spastic diplegia were retrospectively reviewed. None of the patients had undergone surgery previously or received botulinum toxin treatment within 6 months before the review. Kinematic data, collected at the midstance phase, included: pelvic, hip, and ankle rotation and foot progression angle. RESULTS: The prevalence of kinematic rotational deviations was 98.4%. Sixty-one percent of the children walked with an internal foot progression angle and 21% exhibited external alignment. The pelvis was internally rotated in 41% of the cases and externally in another 27%. Hip rotation was internal in 29% and external in 27% of the cases. Ankle rotation was internal in 55% and external in 16% of the cases. Lower limb rotational anomalies involved more than one level in 77% of the limbs. A kinematic compensatory deviation was identified in at least one level in 48% of the limbs. CONCLUSIONS: Kinematic rotational anomalies were identified in nearly all the 188 children in the study. The multilevel involvement of lower limb malalignment was not systematically associated with compensatory mechanisms between the levels. Ankle rotational anomalies were the most frequent cause of lower limb torsional deviations followed by pelvic malalignment. LEVEL OF EVIDENCE: Level IV.


Assuntos
Paralisia Cerebral/fisiopatologia , Marcha/fisiologia , Extremidade Inferior/fisiopatologia , Adolescente , Adulto , Articulação do Tornozelo/fisiopatologia , Fenômenos Biomecânicos , Paralisia Cerebral/complicações , Criança , Pré-Escolar , Feminino , Pé/fisiopatologia , Articulação do Quadril/fisiopatologia , Humanos , Masculino , Pelve/fisiopatologia , Estudos Retrospectivos , Rotação , Anormalidade Torcional , Adulto Jovem
14.
Stem Cells ; 31(3): 423-32, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23193035

RESUMO

Cancer stem cells (CSCs) represent a minor population of self-renewing cancer cells that fuel tumor growth. As CSCs are generally spared by conventional treatments, this population is likely to be responsible for relapses that are observed in most cancers. In this work, we analyzed the preventive efficiency of a CSC-based vaccine on the development of liver metastasis from colon cancer in a syngeneic rat model. We isolated a CSC-enriched population from the rat PROb colon carcinoma cell line on the basis of the expression of the aldehyde dehydrogenase-1 (ALDH1) marker. Comparative analysis of vaccines containing lysates of PROb or ALDH(high) cells by mass spectrometry identifies four proteins specifically expressed in the CSC subpopulation. The expression of two of them (heat shock protein 27-kDa and aldose reductase) is already known to be associated with treatment resistance and poor prognosis in colon cancer. Preventive intraperitoneal administration of vaccines was then performed before the intrahepatic injection of PROb cancer cells. While no significant difference in tumor occurrence was observed between control and PROb-vaccinated groups, 50% of the CSC-based vaccinated animals became resistant to tumor development. In addition, CSC-based vaccination induced a 99.5% reduction in tumor volume compared to the control group. To our knowledge, this study constitutes the first work analyzing the potential of a CSC-based vaccination to prevent liver metastasis development. Our data demonstrate that a CSC-based vaccine reduces efficiently both tumor volume and occurrence in a rat colon carcinoma syngeneic model.


Assuntos
Vacinas Anticâncer/farmacologia , Neoplasias do Colo/terapia , Neoplasias Hepáticas/prevenção & controle , Neoplasias Hepáticas/secundário , Células-Tronco Neoplásicas/imunologia , Família Aldeído Desidrogenase 1 , Animais , Vacinas Anticâncer/imunologia , Testes de Carcinogenicidade , Linhagem Celular Tumoral , Neoplasias do Colo/enzimologia , Neoplasias do Colo/imunologia , Neoplasias do Colo/patologia , Modelos Animais de Doenças , Neoplasias Hepáticas/enzimologia , Neoplasias Hepáticas/patologia , Masculino , Células-Tronco Neoplásicas/enzimologia , Ratos , Retinal Desidrogenase/biossíntese
15.
Ophthalmic Plast Reconstr Surg ; 30(6): 459-67, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24814277

RESUMO

PURPOSE: To describe a surgical technique of en bloc resection of lacrimal sac tumors by the shared expertise of 2 specialists to achieve optimal tumor margin clearance and the simultaneous reconstruction of the bony defect to preserve ocular functions and cosmesis. METHODS: All patients who had resection of malignant nasolacrimal drainage system tumors using the combined technique and posttreatment protocol between 1997 and 2011 were studied in this retrospective, noncomparative, interventional case series. A combined medial maxillectomy and medial orbitotomy for en bloc resection of the lacrimal sac tumor was followed by reconstruction with a tailored contoured titanium mesh to support the globe and eyelid. Disease relapse, disease survival, ocular functions (vision loss, motility, globe dystopia, and diplopia), and cosmesis (medial canthal tendon dystopia and eyelid retraction) were documented. RESULTS: Fourteen patients with malignant lacrimal sac tumors underwent en bloc resection. Postoperative radiation was ultimately administered to 9 patients. All patients but one were alive at last follow up. Tumor recurred locally in 2 patients with a regional recurrence in a third patient. Complications from radiation therapy included skin breakdown over the mesh (9/14 patients) with nasocutaneous fistula, medial canthal tendon dystopia (2/14 patients), and corneal perforation in a patient with recurrent disease. Despite removal of the tear drainage system, only 7 of 14 patients reported epiphora. None of the patients developed diplopia after resection and radiation therapy. CONCLUSIONS: The combined sinus-orbit approach is an effective method of managing lacrimal sac tumors to achieve optimal tumor clearance from the orbit and nasal cavity. Simultaneous reconstruction of the bony defect with a contoured titanium mesh provides a fixation anchor for the medial canthal tendon and globe support and serves as a supporting platform for the lower eyelid and cheek to minimize midface collapse. Postoperative radiation is associated with skin flap breakdown and nasocutaneous fistula formation.


Assuntos
Neoplasias Oculares/cirurgia , Doenças do Aparelho Lacrimal/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Adenoma/patologia , Adenoma/cirurgia , Adulto , Idoso , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/cirurgia , Carcinoma Mucoepidermoide/patologia , Carcinoma Mucoepidermoide/cirurgia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/cirurgia , Neoplasias Oculares/patologia , Feminino , Humanos , Doenças do Aparelho Lacrimal/patologia , Masculino , Seio Maxilar/cirurgia , Pessoa de Meia-Idade , Órbita/cirurgia , Radioterapia Adjuvante , Procedimentos de Cirurgia Plástica , Estudos Retrospectivos , Retalhos Cirúrgicos
16.
J Pediatr Orthop ; 34(1): 123-8, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23812139

RESUMO

BACKGROUND: Hematogenous osteoarticular infections of the hand and the wrist in children with sickle cell anemia are rare and no specific studies for this location have been published. METHODS: This retrospective and comparative study reviewed 34 children who carry the diagnosis of osteoarticular infections of the wrist and the hand at our institution during a 10-year period extending from January 2000 to December 2010. The first group included 8 patients with sickle cell anemia (Hg SS). The second group or control group included 26 children without sickle cell disease or any immune deficiency. Differences between groups were established by χ tests. RESULTS: The most common site of osteomyelitis for the sickle cell group was the metacarpals and the fingers phalanx (87.5%) whereas the most common site for the control group was the wrist and the carpus (96.2%; P<0.005).The most common pathogens responsible for osteomyelitis was Salmonella sp. (37.5%) for children with SCD, whereas it was Staphylococcus aureus (70%) for the nonsicklers. There was a significant difference between both groups regarding the treatment. Indeed, a surgical procedure was needed for the sickle cell group in all cases (100%) whereas a surgical debridement was needed in only 19.2% patients in the control group (P<0.001). At long-term follow-up, there were more long-term complications in the sickle cell group (62.5%) with epiphysiodesis of the metacarpals and metacarpophalangeal joint destruction whereas only 11.5% cases with complications were present in the control group including distal ulna epiphysiodesis, proximal interphalangeal joint stiffness, and a central radius epiphysiodesis (P<0.004). CONCLUSIONS: Our results confirm the severity of hand osteomyelitis in patients with sickle cell disease. A systematic approach is needed to perform early diagnosis and treatment. Identification of the causative organism is required (blood culture, bone aspiration). With antibiotic therapy, surgical treatment is the rule. Parents have to be advised about frequent complications like shortening or deformation due to premature fusion. LEVEL OF EVIDENCE: Level III.


Assuntos
Anemia Falciforme/epidemiologia , Anemia Falciforme/terapia , Osteomielite/epidemiologia , Osteomielite/terapia , Distribuição por Idade , Anemia Falciforme/diagnóstico , Antibacterianos/uso terapêutico , Estudos de Casos e Controles , Criança , Pré-Escolar , Terapia Combinada , Desbridamento/métodos , Feminino , Seguimentos , Articulação da Mão/diagnóstico por imagem , Articulação da Mão/fisiopatologia , Humanos , Incidência , Lactente , Masculino , Osteomielite/diagnóstico por imagem , Radiografia , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Resultado do Tratamento , Articulação do Punho/diagnóstico por imagem , Articulação do Punho/fisiopatologia
17.
Cureus ; 16(2): e55137, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38558707

RESUMO

A closed spontaneous rupture of the extensor hallucis longus (EHL) tendon is an infrequent yet challenging clinical occurrence, typically associated with systemic conditions (diabetes mellitus or rheumatoid arthritis). A closed EHL rupture, however, exists but is only reported as scattered cases in the literature. This article presents a unique case of a traumatic EHL tendon rupture in a patient without underlying predisposing factors. A 66-year-old woman, previously healthy, presented with an inability to dorsiflex her big toe following trauma, showcasing the clinical triad of pain, edema, and deficit in big toe extension. Magnetic resonance imaging confirmed a 5.9 cm EHL tendon gap that was treated by primary end-to-end repair of the ruptured tendon. The aim of this case report is to provide an overview of the literature available concerning the classification and treatment of EHL rupture and to assist in the early diagnosis and treatment of this rare condition.

18.
Cureus ; 16(3): e56677, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38646318

RESUMO

OBJECTIVES: Carpal tunnel syndrome is a common condition seen in daily clinical practice. Multiple minimally invasive techniques have emerged in the last decades for median nerve decompression. However, many research are needed to study the outcome on the patients and their safety profile. METHODS: We will compare group A that includes patients operated on using the minimally invasive transverse incision (number of patients = n = 221, females 76.7% and males 22.8%) versus group B that includes patients operated on using the longitudinal incision (n = 194, female 70.1% and male 29.9%) in term of clinical satisfaction and safety. The mean age of group A is 58.1±5.1 and that of group B is 58.8±4.8. The male and female distribution in both groups and the mean age were both similar with no statistically significant difference for the age (p = 0.79) or the gender distribution (p = 0.1). Data collected prospectively at regular intervals in time (preoperatively and at one month, three months, and six months post-carpal tunnel release (CTR)) between January 2006 and December 2021 were reviewed retrospectively. Patients' clinical findings, grip strength measurement using a hand dynamometer, and postoperative satisfaction measured using the BCTQ (Boston Carpal Tunnel Syndrome Questionnaire) scoring system were recorded and analyzed for each technique. RESULTS: A total of 415 patients were included in our study. All patients included had moderate to severe median nerve compression documented by nerve-conducted studies with positive Tinel's and Phalen's signs. Baseline demographics between group A (CTR through a longitudinal palmar mini-incision) and group B (CTR with a mini-transverse incision at the palmar crease) didn't show a statistically significant difference. Both groups showed improved grip strength and BCTQ scores at the post-operative follow-up. CONCLUSIONS: Median nerve decompression using both types of incisions has resulted in the same functional outcomes and patient satisfaction.

19.
J Econ Entomol ; 117(3): 907-917, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38634599

RESUMO

The number, timing, and fitness of colonizing parasitoids in fields of ephemeral crops often depend on factors external to the fields. We investigated cereal aphid parasitism in 23 winter wheat fields using sentinel plants infested with bird cherry-oat aphids, Rhopalosiphum padi (L.) (Hemiptera: Aphididae), and we investigated the effect of parasitoids on cereal aphid population growth using exclusion and parasitoid-accessible cages infested with bird cherry-oat aphids. Lysiphlebus testaceipes (Cresson) (Hymenoptera: Braconidae), Aphelinus nigritus (Howard) (Hymenoptera: Aphelinidae), and Diaeretiella rapae (McIntosh) (Hymenoptera: Braconidae), in decreasing order of abundance, parasitized R. padi on sentinel plants. The mean percent parasitism in parasitoid-accessible cages was 5.2% in autumn and 35.0% in spring. Aphid population intensity was greater in complete exclusion than in parasitoid-accessible cages. Measures of landscape composition and configuration were quantified, and aphid parasitism in autumn by L. testaceipes and A. nigritus was positively associated with % landcover by summer crops and patch density. Parasitism by both species was negatively associated with contagion and % woodlands. Parasitism during spring was positively associated with % grassland and fractal dimension and negatively associated with % canola. The number of braconid mummies per sentinel plant was positively correlated to the number of braconid mummies on wheat stems from parasitoid-accessible cages. Results indicate that cereal aphid mortality caused by parasitoids and their ability to exert effective biological control is related to landscape structure. Comparing this study to an earlier study in the same agroecosystem demonstrated temporal stability of the landscape influence on aphid parasitism by L. testaceipes in winter wheat.


Assuntos
Afídeos , Estações do Ano , Triticum , Vespas , Afídeos/parasitologia , Animais , Triticum/parasitologia , Vespas/fisiologia , Interações Hospedeiro-Parasita , Controle Biológico de Vetores
20.
Cancer Lett ; 597: 217024, 2024 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-38871244

RESUMO

Lysosomes are single membrane bounded group of acidic organelles that can be involved in a process called lysosomal exocytosis which leads to the extracellular release of their content. Lysosomal exocytosis is required for plasma membrane repair or remodeling events such as bone resorption, antigen presentation or mitosis, and for protection against toxic agents such as heavy metals. Recently, it has been showed that to fulfill this protective role, lysosomal exocytosis needs some autophagic proteins, in an autophagy-independent manner. In addition to these crucial physiological roles, lysosomal exocytosis plays a major protumoral role in various cancers. This effect is exerted through tumor microenvironment modifications, including extracellular matrix remodeling, acidosis, oncogenic and profibrogenic signals. This review provides a comprehensive overview of the different elements released in the microenvironment during lysosomal exocytosis, i.e. proteases, exosomes, and protons, and their effects in the context of tumor development and treatment.


Assuntos
Exocitose , Neoplasias , Microambiente Tumoral , Lisossomos/metabolismo , Autofagia , Humanos , Animais
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