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1.
Rev Med Liege ; 77(5-6): 345-353, 2022 May.
Artigo em Francês | MEDLINE | ID: mdl-35657193

RESUMO

Acute and/or chronic graft-versus-host disease (GVHD) is a serious complication after allogeneic hematopoietic stem cell transplantation (alloHSCT). It is a multisystemic inflammatory and/or fibrotic disease that occurs when the immune cells derived from the graft (and therefore originating from the donor) recognize recipient's healthy tissues as foreign and react against them. Acute GVHD is one of the main causes of non-relapse mortality after alloHSCT. Chronic GVHD can be very disabling in its severe form and can also be responsible for late mortality, mainly due to long-term immune deficiency and opportunistic infections. In contrast, GVHD can be associated with certain beneficial effects in patients transplanted for hematological malignancies, through simultaneous «graft versus tumour¼ positive effects. Therefore, one of the challenges of alloHSCT is the prevention and treatment of severe forms of GVHD without losing the beneficial anti-tumour effects of the graft.


: La maladie du greffon contre l'hôte («greffe-versus-hôte¼, GVH) aiguë et/ou chronique est une complication sérieuse de l'allogreffe de cellules souches hématopoïétiques (CSH). Elle correspond à des manifestations inflammatoires et/ou fibrotiques multisystémiques qui se produisent lorsque les cellules immunitaires dérivées de la greffe (et donc originaires du donneur) reconnaissent les tissus sains du receveur comme étrangers et réagissent contre eux. La GVH aiguë est l'une des principales causes de mortalité hors rechute post-greffe. La GVH chronique peut être très invalidante dans sa forme sévère et peut également être responsable d'une mortalité tardive, principalement due à un déficit immunitaire à long terme et à des infections opportunistes. À l'opposé, la GVH est associée à certains effets bénéfiques chez les patients transplantés pour des hémopathies malignes, par les effets simultanés favorables du «greffon contre la tumeur¼. Par conséquent, l'un des défis de l'allogreffe de CSH est la prévention et le traitement des formes sévères de GVH, sans perdre les effets bénéfiques anti-tumoraux du greffon.


Assuntos
Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Doença Aguda , Doença Crônica , Doença Enxerto-Hospedeiro/etiologia , Doença Enxerto-Hospedeiro/prevenção & controle , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Transplante Homólogo/efeitos adversos
2.
Rev Med Liege ; 77(4): 206-211, 2022 Apr.
Artigo em Francês | MEDLINE | ID: mdl-35389003

RESUMO

Cellular immunotherapy consists in using the cells of the immune system as a therapeutic weapon. In this constantly evolving field, the therapeutic strategies developed at the University Hospital of Liege are hematopoietic stem cell transplantation, mesenchymal stromal cells and targeted therapy with CAR-T cells (Chimeric Antigen Receptor T cells). The first two modalities represent a form of non-targeted cell therapy that has been developed over the past decades. While hematopoietic stem cell transplantation is established as the reference treatment for many hematological diseases, mesenchymal stromal cells are still under investigation in various pathologies (notably Crohn's disease, organ transplantation, COVID-19 and pulmonary fibrosis). By contrast, CAR-T cells represent a recently developed and extremely promising targeted immunotherapy. This therapeutic approach has already revolutionized the treatment of B-cell lymphopathies, and has the potential to do the same for many other diseases in the near future.


L'immunothérapie cellulaire consiste en l'utilisation de cellules du système immunitaire comme arme thérapeutique. Dans ce domaine en évolution constante, les stratégies thérapeutiques développées au CHU de Liège sont la greffe de cellules souches hématopoïétiques, les cellules stromales mésenchymateuses et la thérapie ciblée par cellules CAR-T («Chimeric Antigen Receptor T cells¼). Les deux premières approches représentent une forme de thérapie cellulaire non ciblée, développées depuis de nombreuses années. Si la greffe de cellules souches hématopoïétiques est établie comme le traitement de référence de nombreuses hémopathies, les cellules stromales mésenchymateuses sont, quant à elles, toujours à l'étude dans diverses pathologies (notamment maladie de Crohn, transplantation d'organes, COVID-19 et fibrose pulmonaire). À l'opposé, les cellules CAR-T représentent une immunothérapie ciblée, développée récemment et extrêmement prometteuse. Cette modalité thérapeutique a déjà révolutionné le traitement des lymphopathies B, et elle possède le potentiel d'en faire de même pour de nombreuses autres pathologies dans un avenir proche.


Assuntos
COVID-19 , Transplante de Células-Tronco Hematopoéticas , Receptores de Antígenos Quiméricos , COVID-19/terapia , Hospitais , Humanos , Imunoterapia
3.
Rev Med Liege ; 76(5-6): 464-469, 2021 May.
Artigo em Francês | MEDLINE | ID: mdl-34080381

RESUMO

Hematopoietic stem cell transplantation is a potentially curative therapeutic option for many oncologic and non-oncologic hematological diseases. There is a constant evolution regarding donor choice, conditioning regimen intensity and immunosuppressive treatments, which leads to a reduction in morbidity and mortality during and after transplantation. In this article, we describe the general principles of hematopoietic stem cell transplantation and discuss the progress of global patient management after transplantation.


L'allogreffe de cellules souches hématopoïétiques constitue un traitement potentiellement curatif pour de nombreuses pathologies hématologiques cancéreuses ou non cancéreuses. Une évolution constante dans le choix du donneur, de l'intensité du conditionnement et des stratégies de traitements immunosuppresseurs, permet une réduction de la morbidité et de la mortalité durant et après la greffe. Cet article a pour but de réexpliquer les principes généraux d'une allogreffe et de discuter des nouvelles avancées et adaptations dans la prise en charge globale des patients greffés.


Assuntos
Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Humanos , Imunossupressores , Condicionamento Pré-Transplante , Transplante Homólogo
4.
Rev Med Liege ; 76(5-6): 476-481, 2021 May.
Artigo em Francês | MEDLINE | ID: mdl-34080383

RESUMO

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. Firstline immunochemotherapy cures approximatively 60 % of patients. The prognosis of patients with refractory disease or with relapsed disease within the first two years after the end of treatment is highly unfavourable. Since June 2019, a new third-line treatment with CAR T cells (chimeric antigen receptor T cells) seems to completely modify the prognosis of these patients. A significant proportion of long-lasting complete responses is obtained with this revolutionary treatment. Quick specialized intervention is required for the unique side effects of this therapy.


Le lymphome B diffus à grandes cellules (LBDGC) est le type histologique de lymphome non Hodgkinien le plus fréquent. Le traitement de première ligne par immunochimiothérapie ne permet de guérir qu'environ 60 % des patients. Les patients présentant une maladie réfractaire à une première ligne de traitement ou en rechute dans les deux premières années suivant le traitement présentent un mauvais pronostic. Disponible depuis juin 2019, un nouveau traitement de 3ème ligne sous forme d'immunothérapie par CAR T cells (acronyme anglais de «chimeric antigen receptor T cells¼) semble modifier complètement le pronostic de ces patients, avec l'obtention d'une proportion importante de réponses complètes de longue durée. Les effets indésirables spécifiques liés à ce traitement demandent une prise en charge rapide et spécialisée.


Assuntos
Linfoma Difuso de Grandes Células B , Receptores de Antígenos Quiméricos , Humanos , Imunoterapia Adotiva , Linfoma Difuso de Grandes Células B/terapia , Prognóstico , Receptores de Antígenos Quiméricos/genética , Linfócitos T
5.
Ann Oncol ; 29(3): 715-723, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29253087

RESUMO

Background: Peripheral T-cell lymphoma (PTCL) remains a therapeutic challenge. Due to the rarity and the heterogeneity of PTCL, no consensus has been achieved regarding even the type of first-line treatment. The benefit of autologous stem-cell transplantation (ASCT) is, therefore, still intensely debated. Patients and methods: In the absence of randomized trials addressing the role of ASCT, we performed a large multicentric retrospective study and used both a multivariate proportional hazard model and a propensity score matching approach to correct for sample selection bias between patients allocated or not to ASCT in intention-to-treat (ITT). Results: Among 527 patients screened from 14 centers in France, Belgium and Portugal, a final cohort of 269 patients ≤65 years old with PTCL-not otherwise specified (NOS) (N = 78, 29%), angioimmunoblastic T-cell lymphoma (AITL) (N = 123, 46%) and anaplastic lymphoma kinase-positive anaplastic large cell lymphoma (ALK-ALCL) (N = 68, 25%) with partial (N = 52, 19%) or complete responses (N = 217, 81%) after induction was identified and information about treatment allocation was carefully collected before therapy initiation from medical records. One hundred and thirty-four patients were allocated to ASCT in ITT and 135 were not. Neither the Cox multivariate model (HR = 1.02; 95% CI: 0.69-1.50 for PFS and HR = 1.08; 95% CI: 0.68-1.69 for OS) nor the propensity score analysis after stringent matching for potential confounding factors (logrank P = 0.90 and 0.66 for PFS and OS, respectively) found a survival advantage in favor of ASCT as a consolidation procedure for patients in response after induction. Subgroup analyses did not reveal any further difference for patients according to response status, stage disease or risk category. Conclusions: The present data do not support the use of ASCT for up-front consolidation for all patients with PTCL-NOS, AITL, or ALK-ALCL with partial or complete response after induction.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Transplante de Células-Tronco Hematopoéticas/métodos , Linfoma de Células T Periférico/terapia , Adulto , Idoso , Terapia Combinada , Intervalo Livre de Doença , Feminino , Humanos , Quimioterapia de Indução , Linfoma de Células T Periférico/mortalidade , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Transplante Autólogo , Adulto Jovem
7.
J Anim Physiol Anim Nutr (Berl) ; 100(1): 167-77, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25846259

RESUMO

In this study, we tested the hypothesis that in ovo feeding (IOF) of L-arginine (L-Arg) enhances nitric oxide (NO) production, stimulates the process of myogenesis, and regulates post-hatching muscle growth. Different doses of L-Arg were injected into the amnion of chicken embryos at embryonic day (ED) 16. After hatching, the body weight of individual male chickens was recorded weekly for 3 weeks. During in vitro experiments, myoblasts of the pectoralis major (PM) were extracted at ED16 and were incubated in medium containing 0.01 mm L-Arg, 0.05 mm L-Arg, and (or) 0.05 mm L-nitro-arginine-methyl-ester (L-NAME), an inhibitor of nitric oxide synthase (NOS). When 25 mg/kg L-Arg/initial egg weight was injected, no difference was observed in body weight at hatch, but a significant decrease was found during the following 3 weeks compared to that of the non-injected and saline-injected control, and this also affected the growth of muscle mass. L-NAME inhibited gene expression of myogenic differentiation antigen (MyoD), myogenin, NOS, and follistatin, decreased the cell viability, and increased myostatin (MSTN) gene expression. 0.05 mm L-Arg stimulated myogenin gene expression but also depressed muscle cell viability. L-NAME blocked the effect of 0.05 mm L-Arg on myogenin mRNA levels when co-incubated with 0.05 mm L-Arg. L-Arg treatments had no significant influence on NOS mRNA gene expression, but had inhibiting effect on follistatin gene expression, while L-NAME treatments had effects on both. These results suggested that L-Arg stimulated myoblast differentiation, but the limited number of myoblasts would form less myotubes and then less myofibers, while the latter limited the growth of muscle mass.


Assuntos
Arginina/administração & dosagem , Embrião de Galinha/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/crescimento & desenvolvimento , Mioblastos/fisiologia , Criação de Animais Domésticos/métodos , Animais , Diferenciação Celular , Embrião de Galinha/crescimento & desenvolvimento , Galinhas , Masculino , Mioblastos/efeitos dos fármacos , Tamanho do Órgão/efeitos dos fármacos
8.
J Anim Physiol Anim Nutr (Berl) ; 99 Suppl S1: 36-47, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25865421

RESUMO

Breeder age and nutrition are amongst the most important factors affecting progeny growth and development. The present experiment was carried out to evaluate the effects of n-3 fatty acid (FA), with special emphasis on the ratio of eicosapentaenoic (EPA, 20:5 n-3) and docosahexaenoic (DHA, 22:6 n-3) acid, provided to the diet of ageing broiler breeder hens at different ratios, on the incubation parameters and the performance of the offspring. Four hundred and eighty Ross-308 broiler breeder hens were fed one of four different diets (120/treatment), with an equal fat content. The control diet was a basal diet, rich in n-6 FAs (CON). Blends of fish oil were used to enrich the three other diets in n-3 FA and to obtain different EPA/DHA ratios of 1/1 (EPA=DHA), 1/2 (DHA) or 2/1 (EPA). Every 5 weeks, incubation parameters were assessed. Every 15 weeks, offspring was reared until slaughter age on a standard diet. Breeder age affected almost all incubation and post-hatch parameters, whereas n-3 FA treatment only lowered egg weight (p < 0.0001) and consequently hatched chick weight (p < 0.0001). Supplementation of EPA resulted in a higher proportional liver weight (p = 0.0219) at hatch, a lower body weight up to 28 days post-hatch (p = 0.0418), a lower daily weight gain (p = 0.0498) and a higher feed conversion ratio (p = 0.0395) during the starter period (p = 0.0498), resulting in a higher overall offspring feed conversion ratio (p = 0.0317) compared to the control diet. DHA supplementation, on the other hand, resulted in a lower residual yolk weight (p = 0.0220) and a higher overall offspring mortality (p = 0.0125). In conclusion, supplementation of n-3 FA could not counter the adverse effect of breeder flock age, but did not harm incubation or improve post-hatch performance, either. EPA and DHA affected offspring development differently during early post-hatch life.


Assuntos
Envelhecimento , Galinhas/crescimento & desenvolvimento , Ácidos Docosa-Hexaenoicos/farmacologia , Ácido Eicosapentaenoico/farmacologia , Ácidos Graxos Ômega-3/farmacologia , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Embrião de Galinha , Galinhas/fisiologia , Dieta/veterinária , Ácidos Docosa-Hexaenoicos/administração & dosagem , Ácido Eicosapentaenoico/administração & dosagem , Feminino , Fenômenos Fisiológicos da Nutrição Materna
9.
Poult Sci ; 93(3): 564-73, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24604849

RESUMO

When added to the feed of broiler breeder hens, dietary polyunsaturated fatty acids (FA) can be incorporated into the yolk and therefore become available to the progeny during their early development. The mechanism involved in lipid metabolism and deposition in the egg may be influenced by breeder age. Before the effect of an elevated concentration of certain polyunsaturated FA on the embryo can be investigated, the effect at breeder level and egg quality must be further assessed. The aim of the present experiment was to evaluate the effects of dietary n-6/n-3 ratios and dietary eicosapentaenoic acid (EPA, 20:5 n-3) and docosahexaenoic acid (DHA, 22:6 n-3) ratios, provided to broiler breeder hens, in terms of their zoo technical performance, egg quality, and yolk FA composition. Starting at 6 wk of age, 640 Ross-308 broiler breeder hens were fed 1 of 4 different diets. The control diet was a basal diet, rich in n-6 FA. The 3 other diets were enriched in n-3 FA, formulated to obtain a different EPA/DHA ratio of 1/1 (EPA = DHA), 1/2 (DHA), or 2/1 (EPA). In fact, after analysis the EPA/DHA ratio was 0.8, 0.4, or 2.1, respectively. Dietary EPA and DHA addition did not affect the performance of the breeder hens, except for egg weight. Egg weight was lower (P < 0.001) for all n-3 treatments. Dietary EPA improved number of eggs laid in the first 2 wk of the production cycle (P = 0.029). The absolute and relative yolk weight of eggs laid by EPA = DHA fed hens was lowest (P = 0.004 and P = 0.025, respectively). The EPA and DHA concentrations in the yolk were highly dependent on dietary EPA and DHA concentrations with a regression coefficient equal to 0.89. It can be concluded that dietary EPA and DHA can be incorporated in the breeder egg yolk to become available for the developing embryo, without compromising the performance and egg quality of the flock.


Assuntos
Galinhas/fisiologia , Ácidos Docosa-Hexaenoicos/metabolismo , Gema de Ovo/efeitos dos fármacos , Ácido Eicosapentaenoico/metabolismo , Reprodução/efeitos dos fármacos , Fatores Etários , Ração Animal/análise , Animais , Dieta/veterinária , Suplementos Nutricionais/análise , Ácidos Docosa-Hexaenoicos/administração & dosagem , Relação Dose-Resposta a Droga , Gema de Ovo/metabolismo , Ácido Eicosapentaenoico/administração & dosagem , Ácidos Graxos/administração & dosagem , Ácidos Graxos/metabolismo , Feminino , Óvulo/efeitos dos fármacos , Óvulo/fisiologia
10.
Eur J Clin Microbiol Infect Dis ; 32(4): 549-55, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23135757

RESUMO

Routine detection of extended-spectrum ß-lactamase (ESBL) production by AmpC-producing Enterobacteriaceae in microbiology laboratories is still a problem. The aim of this study was to compare the performance of four different phenotypic ESBL confirmation assays within this group of Enterobacteriaceae. A total of 83 AmpC-inducible Enterobacteriaceae were included in this study (58 clinical isolates with presumptive ESBL production and 25 molecularly characterized ESBL-producing isolates). Each isolate was tested for the presence of an ESBL enzyme by four phenotypic ESBL confirmation assays: ESBL Etests and combined double-disk synergy tests (CDDST), both on Mueller-Hinton (MH) agar with and without the use of cloxacillin, an AmpC inhibitor. Our study showed that performing a CDDST on MH agar with cefotaxime as the only indicator cephalosporin is not a reliable way to detect ESBL-encoding genes among chromosomal AmpC-producing Enterobacteriaceae due to its low sensitivity (52 %). The use of cloxacillin in this CDDST could only significantly increase the specificity of the CDDST when used with ceftazidime as the indicator [sensitivity (SN), 92 %; specificity (SP), 93 %]. Regarding ESBL Etest® strips, the sensitivity of the cefepime strip (80 %) was significantly higher compared to the cefotaxime and ceftazidime strips (16 % and 32 %, respectively). Adding cloxacillin to the MH agar improved the ESBL detection of each of these strips. We recommend the CDDST on MH agar supplemented with cloxacillin and ceftazidime or cefepime as the indicator cephalosporin as the most cost-efficient strategy to confirm ESBL production in inducible AmpC-producing Enterobacteriaceae.


Assuntos
Antibacterianos/farmacologia , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/enzimologia , beta-Lactamases/metabolismo , beta-Lactamas/farmacologia , Meios de Cultura/química , Enterobacteriaceae/isolamento & purificação , Infecções por Enterobacteriaceae/microbiologia , Humanos , Testes de Sensibilidade Microbiana/métodos , Sensibilidade e Especificidade
11.
Pathol Biol (Paris) ; 61(4): 155-7, 2013 Aug.
Artigo em Francês | MEDLINE | ID: mdl-24011960

RESUMO

In the attempt to harmonize clinical practices between different French transplantation centers, the French Society of Bone Marrow Transplantation and Cell Therapy (SFGM-TC) set up the third annual series of workshops which brought together practitioners from all member centers and took place in October 2012 in Lille. Here we report our results and recommendations regarding the management of pre-transplant donor's cytomegalovirus, Epstein-Barr virus, Toxoplasma gondii, or syphilis IgM positive serology test.


Assuntos
Infecções por Citomegalovirus/diagnóstico , Seleção do Doador/normas , Infecções por Vírus Epstein-Barr/diagnóstico , Transplante de Células-Tronco Hematopoéticas/normas , Achados Incidentais , Sífilis/diagnóstico , Toxoplasmose/diagnóstico , Doadores de Sangue , Consenso , Citomegalovirus/isolamento & purificação , Infecções por Citomegalovirus/sangue , Infecções por Vírus Epstein-Barr/sangue , França , Conhecimentos, Atitudes e Prática em Saúde , Herpesvirus Humano 4/isolamento & purificação , Humanos , Imunoglobulina M/sangue , Sífilis/sangue , Sífilis/imunologia , Toxoplasma/isolamento & purificação , Toxoplasmose/sangue , Transplante Homólogo
12.
Pathol Biol (Paris) ; 61(4): 158-9, 2013 Aug.
Artigo em Francês | MEDLINE | ID: mdl-24011965

RESUMO

In the attempt to harmonize clinical practices between different French transplantation centers, the French Society of Bone Marrow Transplantation and Cell Therapy (SFGM-TC) set up the third annual series of workshops which brought together practitioners from all member centers and took place in October 2012 in Lille. Here we report our results and recommendations regarding the management of common issues related to the donor: pre-transplant pregnancy and monoclonal gammopathy.


Assuntos
Doadores de Sangue , Seleção do Doador/normas , Conhecimentos, Atitudes e Prática em Saúde , Transplante de Células-Tronco Hematopoéticas/normas , Achados Incidentais , Paraproteinemias/diagnóstico , Testes de Gravidez , Consenso , Feminino , Idade Gestacional , Humanos , Paraproteinemias/sangue , Gravidez/sangue , Complicações na Gravidez/sangue , Complicações na Gravidez/prevenção & controle
13.
Poult Sci ; 92(7): 1905-15, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23776279

RESUMO

To examine the importance of albumen as a protein source during embryonic development on the posthatch performance of laying hens, 3 mL of the albumen was removed. At hatch, no difference in BW could be observed. Chicks from the albumen-deprived group had a lower residual yolk weight due to higher yolk utilization. During the rearing phase (hatch to 17 wk of age), the BW of the albumen-deprived pullets was lower compared with the control and sham pullets. The feed intake of the albumen-deprived pullets was also lower than the control pullets. However, during the laying phase (18 to 55 wk of age) these hens exceeded the control and sham hens in BW, although this was not accompanied by a higher feed intake. The albumen-deprived hens exhibited a lower egg production capacity as demonstrated by the reduced egg weight, laying rate, and egg mass and increased number of second grade eggs. In addition, the eggs laid by the albumen-deprived hens had a higher proportional yolk and lower proportional albumen weight. In conclusion, prenatal protein deprivation by albumen removal caused a long-lasting programming effect, possibly by differences in energy allocation, in favor of growth and maintenance and impairing reproductive performance.


Assuntos
Albuminas , Embrião de Galinha/crescimento & desenvolvimento , Galinhas/crescimento & desenvolvimento , Ovos/normas , Oviposição/fisiologia , Ração Animal , Fenômenos Fisiológicos da Nutrição Animal , Animais , Composição Corporal , Dieta/veterinária , Feminino , Aumento de Peso
14.
Rev Med Liege ; 68(1): 38-43, 2013 Jan.
Artigo em Francês | MEDLINE | ID: mdl-23444827

RESUMO

In the last decades, the upper age limit for allogeneic hematopoietic cell transplantation has increased from 50-60 years to 70-75 years of age, in part due to the development of allogeneic transplantation following reduced-intensity or truly nonmyeloablative conditioning. This review describes challenges and opportunities of allogeneic hematopoietic cell transplantation in the elderly.


Assuntos
Transplante de Células-Tronco Hematopoéticas/estatística & dados numéricos , Seleção de Pacientes , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doença Enxerto-Hospedeiro/etiologia , Doença Enxerto-Hospedeiro/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Condicionamento Pré-Transplante/métodos , Transplante Homólogo/estatística & dados numéricos
15.
J Robot Surg ; 17(1): 79-88, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35322342

RESUMO

The reproducibility of the implementation of robotic liver surgery (RLS) is still debated. The aim of the present study is to evaluate short-term outcomes and cost differences during the implementation of RLS, performed by an early adopter in laparoscopic liver surgery (LLS). Patients undergoing RLS between February 2020 and May 2021 were included. Short-term outcomes of the robotic group (RG) were compared to the "Initial Phase" group (IP) of 120 LLS cases and the 120 most recent laparoscopic cases or "Mastery Phase" group (MP). A cost analysis per procedure for the three groups was performed. Seventy-one patients underwent RLS during the study period. Median operative time in the RG was comparable to the IP, but significantly shorter in the MP (140 vs 138 vs 120 min, p < 0.001). Median intraoperative blood loss in the RG was lower than in both laparoscopic groups (40 ml [20-90 ml] vs 150 ml [50-250 ml] vs 80 ml [30-150 ml], p < 0.001). Median hospital stay in the RG was significantly shorter than the IP group (p < 0.001). There were no significant differences in postoperative complication, conversion, or readmission rates. Procedural cost analysis was in favor of robotic surgery (€5008) compared to the IP (€ 6913) and the MP (€6099). Surgeons with sufficient experience in LLS can rapidly overcome the learning curve for RLS. In our experience, the short-term outcomes of the implementation phase of RLS are similar to the mastery phase of LLS. The total average cost per procedure is lower for RLS compared to LLS.


Assuntos
Laparoscopia , Procedimentos Cirúrgicos Robóticos , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Curva de Aprendizado , Análise Custo-Benefício , Reprodutibilidade dos Testes , Resultado do Tratamento , Fígado , Laparoscopia/métodos , Duração da Cirurgia , Estudos Retrospectivos , Tempo de Internação , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia
16.
Mol Ecol ; 21(13): 3352-62, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22647036

RESUMO

Philopatry and sex-biased dispersal have a strong influence on population genetic structure, so the study of species dispersal patterns and evolutionary mechanisms shaping them are of great interest. Particularly nongregarious mammalian species present an underexplored field of study: despite their lower levels of sociality compared to group-living species, interactions among individuals do occur, providing opportunities for cryptic kin selection. Among the least gregarious primates are orang-utans (genus: Pongo), in which preferential associations among females have nevertheless been observed, but for which the presence of kin structures was so far unresolved because of the equivocal results of previous genetic studies. To clarify relatedness and dispersal patterns in orang-utans, we examined the largest longitudinal set of individuals with combined genetic, spatial and behavioural data. We found that males had significantly higher mitochondrial DNA (mtDNA) variation and more unique haplotypes, thus underscoring their different maternal ancestries compared to females. Moreover, pedigree reconstruction based on 24 highly polymorphic microsatellite markers and mtDNA haplotypes demonstrated the presence of three matrilineal clusters of generally highly related females with substantially overlapping ranges. In orang-utans and possibly other nongregarious species, comparing average biparental relatedness (r) of males and females to infer sex-biased dispersal is extremely problematic. This is because the opportunistic sampling regime frequently employed in nongregarious species, combined with overlapping space use of distinct matrilineal clusters, leads to a strong downward bias when mtDNA lineage membership is ignored. Thus, in nongregarious species, correct inferences of dispersal can only be achieved by combining several genetic approaches with detailed spatial information.


Assuntos
Variação Genética , Genética Populacional , Pongo pygmaeus/genética , Animais , DNA Mitocondrial/genética , Feminino , Haplótipos , Masculino , Dados de Sequência Molecular , Linhagem , Análise de Sequência de DNA
17.
Poult Sci ; 90(6): 1302-12, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21597072

RESUMO

Intermittent high (+3°C) and low (-3°C) temperature treatments for 4 h on embryonic day (E) 16, E17, and E18 showed differential effects on embryonic metabolism, without influencing embryonic growth or hatchability. Embryos in the high-temperature group shifted to a more anaerobic metabolism, as indicated by a lower partial pressure of O(2) and a higher partial pressure of CO(2) in the air cell, lower blood pH, and higher lactic acid production. Three hours after the end of the high-temperature treatment, a decrease in metabolism was observed, as indicated by the lower partial pressure of CO(2) and higher partial pressure of O(2) in the air cell and increased plasma triglyceride levels. The embryos in the low-temperature group responded by temporarily slowing down their metabolism, especially the metabolism of carbohydrates and lipids, as indicated by altered air cell gases, a higher relative yolk weight, higher plasma triglyceride level, and higher liver glycogen level. Three hours after the end of the temperature treatment, the metabolism of embryos in the low-temperature treatment had increased to the level of the control temperature group. However, for both temperature treatments, during the hatching process, all the shortages and excesses created were restored to control levels, which would explain the lack of change in embryo growth and hatchability and the slight delay in the hatching process. These mild consequences of the intermittent temperature treatment indicate that the different metabolic shifts made by the embryos seem to be efficient in overcoming the challenges of the intermittent high- or low-temperature treatment during late incubation.


Assuntos
Embrião de Galinha/fisiologia , Galinhas/fisiologia , Temperatura , Animais , Glicemia , Peso Corporal , Galinhas/sangue , Gema de Ovo/metabolismo , Glicogênio/metabolismo , Concentração de Íons de Hidrogênio , Fígado/metabolismo , Oxigênio , Fatores de Tempo
18.
Sci Rep ; 11(1): 15683, 2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344939

RESUMO

Recent studies find increasing evidence for vocal accommodation in nonhuman primates, indicating that this form of vocal learning is more prevalent than previously thought. Convergent vocal accommodation (i.e. becoming more similar to partners) indicates social closeness. At the same time, however, becoming too similar may compromise individual recognisability. This is especially problematic if individual recognisability is an important part of the call function, like in long-distance contact calls. In contrast, in calls with a different function, the trade-off between signalling social closeness and individual recognisability might be less severe. We therefore hypothesized that the extent and consequences of accommodation depend on the function of a given call, and expected (1) more accommodation in calls for which individual identity is less crucial and (2) that individual identity is less compromised in calls that serve mainly to transmit identity compared to calls where individual recognisability is less important. We quantified vocal accommodation in three call types over the process of pair formation in common marmoset monkeys (Callithrix jacchus, n = 20). These three call types have different functions and vary with the degree to which they refer to individual identity of the caller. In accordance with our predictions, we found that animals converged most in close contact calls (trill calls), but less in calls where individual identity is more essential (phee- and food calls). In two out of three call types, the amount of accommodation was predicted by the initial vocal distance. Moreover, accommodation led to a drop in statistical individual recognisability in trill calls, but not in phee calls and food calls. Overall, our study shows that patterns of vocal accommodation vary between call types with different functions, suggestive of trade-offs between signalling social closeness and individual recognisability in marmoset vocalizations.


Assuntos
Comportamento Animal , Callithrix/fisiologia , Reconhecimento Psicológico , Comportamento Social , Vocalização Animal , Animais
19.
Sci Adv ; 7(6)2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33536207

RESUMO

What information animals derive from eavesdropping on interactions between conspecifics, and whether they assign value to it, is difficult to assess because overt behavioral reactions are often lacking. An inside perspective of how observers perceive and process such interactions is thus paramount. Here, we investigate what happens in the mind of marmoset monkeys when they hear playbacks of positive or negative third-party vocal interactions, by combining thermography to assess physiological reactions and behavioral preference measures. The physiological reactions show that playbacks were perceived and processed holistically as interactions rather than as the sum of the separate elements. Subsequently, the animals preferred those individuals who had been simulated to engage in positive, cooperative vocal interactions during the playbacks. By using thermography to disentangle the mechanics of marmoset sociality, we thus find that marmosets eavesdrop on and socially evaluate vocal exchanges and use this information to distinguish between cooperative and noncooperative conspecifics.

20.
Rev Med Liege ; 65(2): 81-7, 2010 Feb.
Artigo em Francês | MEDLINE | ID: mdl-20344918

RESUMO

Chronic Graft-Versus-Host Disease (GVHD) is a frequent complication of allogeneic hematopoietic cell transplantation. This review article describes recent advances in the classification and treatment of chronic GVHD.


Assuntos
Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/terapia , Doença Crônica , Doença Enxerto-Hospedeiro/epidemiologia , Humanos , Prognóstico , Fatores de Risco
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