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1.
Acta Neurochir Suppl ; 135: 361-366, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38153494

RESUMO

The aim of this study was to determine the relationship between cervical spine sagittal alignment and clinical outcomes after using a standalone intersomatic titanium cage CeSPACE for anterior cervical discectomy and arthrodesis. We present our clinical experience in a group of 180 patients with a mean follow-up for at least 2 years. Patients were evaluated by clinical and radiological assessment preoperatively, immediately after surgery and at regular follow-up. There were 97 male and 83 female patients (average age: 56.6 years) who were preoperatively affected by cervical radiculomyelopathy that was due to spondylosis or cervical disk herniation and who underwent surgical treatment. All patients underwent an anterior discectomy and interbody fusion through the positioning of one or more levels of the CeSPACE device. Compared with the preoperative scores, improvement was seen in postoperative visual analog scale (VAS) scores and Neck Disability Index (NDI) values. The standalone intersomatic titanium cage CeSPACE for anterior cervical discectomy and arthrodesis improved radiculomyelopathy and increased the probability of cervical kyphotic alignment. However, cervical sagittal alignment after surgery was not significantly associated with clinical outcomes in terms of postoperative improvement in VAS scores and NDI values. Similarly, the change in cervical sagittal alignment was not related to visual analog scale scores or Neck Disability Index values.


Assuntos
Espondilose , Titânio , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Discotomia , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Pescoço , Espondilose/diagnóstico por imagem , Espondilose/cirurgia
2.
An Acad Bras Cienc ; 94(1): e20190410, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35170627

RESUMO

Anacardic acid is naturally found in various parts of the cashew tree (Anacardium occidentale L.) and marketed as calcium anacardate. This product has antibacterial, antifungal and antioxidant activity, and has been used in humans in the treatment and prevention of cardiovascular and cerebrovascular diseases and tumors. In meat and egg production systems, anacardic acid is used as a substitute for growth-promoting antibiotics. The study objective was to evaluate effects of adding calcium anacardate as source of anacardic acid in laying Japanese quail diet on bird performance and eggs quality. A total of 252 Japanese quail with 22 week-old were studied, using a completely randomized design composed of six treatments with six replicates and seven quails per experimental unit. Treatments applied were: diet without growth promoter; diet with 0,1% growth promoter; and four diets without growth promoter and addition of 0.25; 0.50; 0.75 and 1.0% calcium anacardate (CA), respectively. The data were submitted to analysis of variance and treatment means compared with a SNK test (5%). The data from treatments containing CA were submitted to regression analysis. Treatments did not influence feed intake, egg production, egg weight, egg volume, feed conversion ratio and eggs quality parameters. The addition up to 1% of calcium anacardate in laying Japanese quail diet, does not influence their performance and egg quality.


Assuntos
Cálcio , Coturnix , Ácidos Anacárdicos , Ração Animal/análise , Animais , Dieta , Suplementos Nutricionais , Humanos
3.
An Acad Bras Cienc ; 94(4): e20200138, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35946743

RESUMO

We examined the effects of including sunflower cake (SC) associated with an enzyme complex (EC) in the diet of meat quails on nutrient metabolism, performance, carcass characteristics, bone parameters and economic viability. In total, 432 meat quails (7 to 42 days old) were assigned to six treatments in a completely randomised design with 6 replicates with 12 birds each. A 2 × 3 factorial arrangement was adopted (two levels of SC: 10 and 20%; three diet formulation strategies: normal, reduction in the nutrient and energy matrix considering the enzymatic contribution and reduced diet with EC). No interaction effect was observed. The increased levels of SC from 10% to 20% promoted in decrease in the metabolisability coefficients of dry matter and gross energy and in the value of AMEn and increased relative weight of gizzard. The addition of EC in diets containing SC allows a better metabolization of nitrogen and energy, equalize to the normal diet. The best breast yield was obtained in the birds fed the reduced diet with EC, in relation to normal diet. The reduced diet and the reduced diet with EC provided the lowest cost of food and the best economic efficiency index. Up to 20% of the sunflower cake can be included in the diet of cut quail, with or without enzyme supplementation. However, the use of the enzyme complex composed of carbohydrases, proteases and phytase can favor the metabolization of nitrogen and energy from the diet containing sunflower cake.


Assuntos
Fenômenos Fisiológicos da Nutrição Animal , Helianthus , Codorniz , Ração Animal/análise , Animais , Dieta/veterinária , Suplementos Nutricionais/análise , Carne/análise , Nitrogênio/metabolismo , Sementes , Aumento de Peso
4.
Acta Neurochir (Wien) ; 163(2): 423-440, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33354733

RESUMO

BACKGROUND: Due to the lack of high-quality evidence which has hindered the development of evidence-based guidelines, there is a need to provide general guidance on cranioplasty (CP) following traumatic brain injury (TBI), as well as identify areas of ongoing uncertainty via a consensus-based approach. METHODS: The international consensus meeting on post-traumatic CP was held during the International Conference on Recent Advances in Neurotraumatology (ICRAN), in Naples, Italy, in June 2018. This meeting was endorsed by the Neurotrauma Committee of the World Federation of Neurosurgical Societies (WFNS), the NIHR Global Health Research Group on Neurotrauma, and several other neurotrauma organizations. Discussions and voting were organized around 5 pre-specified themes: (1) indications and technique, (2) materials, (3) timing, (4) hydrocephalus, and (5) paediatric CP. RESULTS: The participants discussed published evidence on each topic and proposed consensus statements, which were subject to ratification using anonymous real-time voting. Statements required an agreement threshold of more than 70% for inclusion in the final recommendations. CONCLUSIONS: This document is the first set of practical consensus-based clinical recommendations on post-traumatic CP, focusing on timing, materials, complications, and surgical procedures. Future research directions are also presented.


Assuntos
Lesões Encefálicas Traumáticas/cirurgia , Conferências de Consenso como Assunto , Craniotomia/normas , Procedimentos de Cirurgia Plástica/normas , Humanos , Hidrocefalia/cirurgia , Itália
5.
An Acad Bras Cienc ; 93(suppl 4): e20210406, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34878049

RESUMO

Synthetic antioxidants (e.g.butylhydroxytoluene, BHT) are routinely used for to restrict oxidative processes of meat products, but they are implicated as harmful to the health of humans. Therefore natural alternatives, such as plant antioxidants, have been sought as replacements. Plant antioxidants when added to the diet can be incorporated into meat and reduce the need for the addition of synthetic antioxidants during processing. The objective of this study was to evaluate the effects of ethanol extracts of mango seeds (EEMS) in the diet of pigs on qualitative parameters and total antioxidant capacity of mortadella produced from these animals. Thirty-two pigs with an average 60 days of age were distributed among four treatments: control=no antioxidant; BHT=200ppm BHT; EEMS200=200ppm of EEMS and EEMS400=400ppm of EEMS. At 145 days of age the animals were slaughtered and loin was removed for the preparation of mortadella, which was analyzed during 90 days of storage at 4°C. A higher content of polyphenolic compounds and, total antioxidant capacity in mortadellas processed with meat of animals which consumed the EEMS400 ration after 60 and 90 days of storage was observed. EEMS polyphenolic antioxidants incorporated into pork through the diet results in an increase of total antioxidant capacity in the processed product.


Assuntos
Mangifera , Carne de Porco , Carne Vermelha , Animais , Antioxidantes , Dieta , Etanol , Oxirredução , Extratos Vegetais/farmacologia , Sementes , Suínos
6.
Eur J Clin Pharmacol ; 75(9): 1219-1226, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31154476

RESUMO

PURPOSE: Vancomycin is commonly used for the management of severe infections; however, vancomycin dosing may be challenging in critically ill patients. This observational study aims to describe the population pharmacokinetics of vancomycin in adult patients with sepsis or septic shock. METHODS: A single-centre retrospective review of adult patients with sepsis or septic shock receiving vancomycin with therapeutic drug monitoring was undertaken. Blood samples taken 1 h after the vancomycin infusion cessation and 30 min prior to the next dose were assayed using the Vitros Crea Slide method. Vancomycin concentrations determined on different days were included. A pharmacokinetic model was developed using Pmetrics for R. Monte Carlo dosing simulations were performed using the final model. RESULTS: Vancomycin concentrations were available for 27 adult patients admitted to the intensive care unit with sepsis or septic shock. A one-compartment pharmacokinetic model with inter-occasion variability of clearance and volume of distribution before and after 72 h adequately described the data. Creatinine clearance normalized to body surface area was included as a covariate on vancomycin clearance. The clearance and volume of distribution within 72 h of admission were 7.29 L/h and 54.20 L, respectively. Monte Carlo simulations suggested that for patients with a creatinine clearance of ≥ 80 mL/min/1.73 m2, vancomycin doses of ≥ 2 g every 8 h are required to consistently achieve key therapeutic targets. CONCLUSIONS: Vancomycin doses ≥ 2 g every 8 h in adult patients with sepsis or septic shock with a creatinine clearance ≥ 80 mL/min/1.73 m2 are likely needed to achieve an optimal therapeutic exposure.


Assuntos
Antibacterianos/farmacocinética , Modelos Biológicos , Sepse/metabolismo , Vancomicina/farmacocinética , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Creatinina/metabolismo , Monitoramento de Medicamentos , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecium/efeitos dos fármacos , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Sepse/sangue , Sepse/tratamento farmacológico , Staphylococcus/efeitos dos fármacos , Vancomicina/administração & dosagem , Vancomicina/sangue
7.
An Acad Bras Cienc ; 89(3 Suppl): 2479-2484, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29166534

RESUMO

The aim of this study was to evaluate the effect of Syzygium cumini leaves (SCL) in laying hens diets on productive performance, egg quality and lipid oxidation of yolk. A total of 108 Hysex White laying hens were distributed in a completely randomized design with three treatments and six replicates of six birds each. The treatments consisted of SCL inclusion at dietary levels of 0, 5 and 10 g/kg. There was no significant effect of SCL inclusion on feed intake, laying percentage, weight and egg mass, feed conversion ratio, Haugh units, specific gravity, percentage of yolk, albumen and egg shells and shell thickness. However, the inclusion of SCL significantly influenced the yolk color and yolk lipid oxidation measured by TBARS values. Yolk color increased and TBARS values ​​decreased with the inclusion of SCL. The inclusion of SCL in laying hens diets improves pigmentation and lipid stability of yolk.


Assuntos
Ração Animal/análise , Galinhas/fisiologia , Suplementos Nutricionais/análise , Oviposição/efeitos dos fármacos , Extratos Vegetais/análise , Folhas de Planta , Syzygium , Fenômenos Fisiológicos da Nutrição Animal , Animais , Brasil , Dieta , Casca de Ovo , Gema de Ovo , Feminino
8.
Mol Cell Proteomics ; 11(12): 1898-912, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23001822

RESUMO

Lipid rafts are highly ordered membrane domains rich in cholesterol and sphingolipids that provide a scaffold for signal transduction proteins; altered raft structure has also been implicated in cancer progression. We have shown that 25 µm 10-(octyloxy) decyl-2-(trimethylammonium) ethyl phosphate (ODPC), an alkylphospholipid, targets high cholesterol domains in model membranes and induces apoptosis in leukemia cells but spares normal hematopoietic and epithelial cells under the same conditions. We performed a quantitative (SILAC) proteomic screening of ODPC targets in a lipid-raft-enriched fraction of leukemic cells to identify early events prior to the initiation of apoptosis. Six proteins, three with demonstrated palmitoylation sites, were reduced in abundance. One, the linker for activation of T-cell family member 2 (LAT2), is an adaptor protein associated with lipid rafts in its palmitoylated form and is specifically expressed in B lymphocytes and myeloid cells. Interestingly, LAT2 is not expressed in K562, a cell line more resistant to ODPC-induced apoptosis. There was an early loss of LAT2 in the lipid-raft-enriched fraction of NB4 cells within 3 h following treatment with 25 µm ODPC. Subsequent degradation of LAT2 by proteasomes was observed. Twenty-five µm ODPC inhibited AKT activation via myeloid growth factors, and LAT2 knockdown in NB4 cells by shRNA reproduced this effect. LAT2 knockdown in NB4 cells also decreased cell proliferation and increased cell sensitivity to ODPC (7.5×), perifosine (3×), and arsenic trioxide (8.5×). Taken together, these data indicate that LAT2 is an early mediator of the anti-leukemic activity of alkylphospholipids and arsenic trioxide. Thus, LAT2 may be used as a target for the design of drugs for cancer therapy.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Apoptose/efeitos dos fármacos , Fosfolipídeos/farmacologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais/efeitos dos fármacos , Proteínas Adaptadoras de Transdução de Sinal/biossíntese , Proteínas Adaptadoras de Transdução de Sinal/genética , Antineoplásicos/metabolismo , Antineoplásicos/farmacologia , Trióxido de Arsênio , Arsenicais/farmacologia , Caspase 3/metabolismo , Linhagem Celular , Proliferação de Células , Colesterol/metabolismo , Ativação Enzimática , Humanos , Leucemia/tratamento farmacológico , Leucemia/metabolismo , Microdomínios da Membrana , Óxidos/farmacologia , Fosfatidilinositol 3-Quinases/efeitos dos fármacos , Fosfolipídeos/metabolismo , Fosforilcolina/análogos & derivados , Fosforilcolina/farmacologia , Estrutura Terciária de Proteína , Proteoma/análise , Interferência de RNA , RNA Interferente Pequeno
9.
Int J Oral Maxillofac Surg ; 52(1): 51-59, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35934567

RESUMO

The aim of this systematic review and meta-analysis was to assess whether the presence of inferior third molars during sagittal split mandibular ramus osteotomy increases the risk of intraoperative and postoperative complications. The PRISMA protocol was followed in this study, and the review was registered in the PROSPERO database (CRD42020147642). A search was conducted in the MEDLINE (PubMed), Web of Science, Cochrane Central, and Scopus databases on November 1, 2021. Nineteen articles were included, and the variables analysed were unfavourable fractures, infection, neurosensory disturbance, removal of osteosynthesis material, and duration of surgery. Meta-analyses were performed for the variables unfavourable fractures (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.58-1.57, P = 0.84), infection (RR 0.75, 95% CI 0.48-1.18, P = 0.21), and neurosensory disturbance (RR 1.55, 95% CI 0.61-3.91, P = 0.35); no statistically significant difference in the risk of these variables was found between the groups with and without third molars. The third molars did not increase the need to remove fixation material, but increased the surgery time. The presence of the third molar during sagittal split mandibular ramus osteotomy appears not to increase the risk of intraoperative and postoperative complications. The results presented here must be interpreted with caution due to the heterogeneity presented by the observational studies included.


Assuntos
Dente Serotino , Osteotomia Sagital do Ramo Mandibular , Humanos , Osteotomia Sagital do Ramo Mandibular/efeitos adversos , Osteotomia Sagital do Ramo Mandibular/métodos , Dente Serotino/cirurgia , Mandíbula/cirurgia , Complicações Pós-Operatórias/epidemiologia , Duração da Cirurgia
10.
Antioxidants (Basel) ; 12(6)2023 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-37372027

RESUMO

Thymol (THY) and 24-epibrassinolide (24-EPI) are two examples of plant-based products with promising therapeutic effects. In this study, we investigated the anti-inflammatory, antioxidant and anti-apoptotic effects of the THY and 24-EPI. We used zebrafish (Danio rerio) larvae transgenic line (Tg(mpxGFP)i114) to evaluate the recruitment of neutrophils as an inflammatory marker to the site of injury after tail fin amputation. In another experiment, wild-type AB larvae were exposed to a well known pro-inflammatory substance, copper (CuSO4), and then exposed for 4 h to THY, 24-EPI or diclofenac (DIC), a known anti-inflammatory drug. In this model, the antioxidant (levels of reactive oxygen species-ROS) and anti-apoptotic (cell death) effects were evaluated in vivo, as well as biochemical parameters such as the activity of antioxidant enzymes (superoxide dismutase, catalase and glutathione peroxidase), the biotransformation activity of glutathione-S-transferase, the levels of glutathione reduced and oxidated, lipid peroxidation, acetylcholinesterase activity, lactate dehydrogenase activity, and levels of nitric acid (NO). Both compounds decreased the recruitment of neutrophils in Tg(mpxGFP)i114, as well as showed in vivo antioxidant effects by reducing ROS production and anti-apoptotic effects in addition to a decrease in NO compared to CuSO4. The observed data substantiate the potential of the natural compounds THY and 24-EPI as anti-inflammatory and antioxidant agents in this species. These results support the need for further research to understand the molecular pathways involved, particularly their effect on NO.

11.
Minerva Endocrinol ; 37(1): 9-23, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22382612

RESUMO

Adrenocortical carcinoma (ACC) is a rare aggressive endocrine neoplasm characterized by a 5-year survival of less than 50%. Due to the widespread use of imaging techniques in clinics, ACC is increasingly recognized as an incidentally discovered tumor. Mostly characterized by poor prognosis, ACC is often diagnosed at an advanced stage of disease. Early diagnosis is uncommon; when diagnosed, ACCs are usually large and have invaded adjacent organs, even if metastatic spread to distant sites can be absent. Complete surgical resection is the only potentially curative treatment for patients with localized disease; however, due to a recurrence rate of 50-70% after apparent radical surgery, there is a strong rationale for a concomitant systemic treatment. Adrenolytic therapy with mitotane (o,p>-DDD), administered alone or in combination with others antineoplastic agents, is the primary treatment for patients with advanced ACC and is increasingly used also in an adjuvant setting, even if controversy exists on this issue due to the limitations of the available literature. Despite being in use for many years, the rarity of ACC precluded the organization of randomized trials; thus, many areas of uncertainty and controversy remain regarding the role of this old drug in the clinical management of patients with ACC. The purpose of this paper is to review the current evidence on mitotane treatment in patients with advanced disease and in ACC patients after complete surgical resection as adjuvant treatment.


Assuntos
Neoplasias do Córtex Suprarrenal/tratamento farmacológico , Antineoplásicos Hormonais/uso terapêutico , Carcinoma/tratamento farmacológico , Mitotano/uso terapêutico , Subfamília B de Transportador de Cassetes de Ligação de ATP , Membro 1 da Subfamília B de Cassetes de Ligação de ATP/antagonistas & inibidores , Neoplasias do Córtex Suprarrenal/diagnóstico , Neoplasias do Córtex Suprarrenal/epidemiologia , Neoplasias do Córtex Suprarrenal/cirurgia , Insuficiência Adrenal/induzido quimicamente , Adrenalectomia , Antineoplásicos Hormonais/efeitos adversos , Antineoplásicos Hormonais/química , Antineoplásicos Hormonais/farmacocinética , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biotransformação , Carcinoma/diagnóstico , Carcinoma/epidemiologia , Carcinoma/cirurgia , Quimioterapia Adjuvante , Ensaios Clínicos como Assunto , Diagnóstico Tardio , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Feminino , Gastroenteropatias/induzido quimicamente , Humanos , Achados Incidentais , Masculino , Mitotano/administração & dosagem , Mitotano/efeitos adversos , Mitotano/química , Mitotano/farmacocinética , Estrutura Molecular , Proteínas de Neoplasias/antagonistas & inibidores , Pró-Fármacos/farmacocinética , Pró-Fármacos/uso terapêutico , Resultado do Tratamento
12.
Materials (Basel) ; 15(6)2022 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-35329479

RESUMO

Increasing awareness regarding fossil fuel dependence, waste valorization, and greenhouse gas emissions have prompted the emergence of new solutions for numerous markets over the last decades. The tire industry is no exception to this, with a global production of more than 1.5 billion tires per year raising environmental concerns about their end-of-life recycling or disposal. Pyrolysis enables the recovery of both energy and material from end-of-life tires, yielding valuable gas, liquid, and solid fractions. The latter, known as recovered carbon black (rCB), has been extensively researched in the last few years to ensure its quality for market applications. These studies have shown that rCB quality depends on the feedstock composition and pyrolysis conditions such as type of reactor, temperature range, heating rate, and residence time. Recent developments of activation and demineralization techniques target the production of rCB with specific chemical, physical, and morphological properties for singular applications. The automotive industry, which is the highest consumer of carbon black, has set specific targets to incorporate recycled materials (such as rCB) following the principles of sustainability and a circular economy. This review summarizes the pyrolysis of end-of-life tires for the production of syngas, oil, and rCB, focusing on the process conditions and product yield and composition. A further analysis of the characteristics of the solid material is performed, including their influence on the rCB application as a substitute of commercial CB in the tire industry. Purification and modification post-treatment processes for rCB upgrading are also inspected.

13.
Chemosphere ; 308(Pt 2): 136430, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36113654

RESUMO

The use of glyphosate-based herbicides (GBH) has increased dramatically, being currently the most used herbicides worldwide. Glyphosate acts as a chelating agent, capable of chelate metals. The synergistic effects of metals and agrochemicals may pose an environmental problem as they have been shown to induce neurological abnormalities and behavioural changes in aquatic species. However, as their ecotoxicity effects are poorly understood, evaluating the impacts of GBH complexed with metals is an ecological priority. The main objective of the study was to evaluate the potentially toxic effects caused by exposure to a GBH (1 µg a.i. mL-1), alone or complexed with metals (Copper, Manganese, and Zinc (100 µg L-1)), at environmentally relevant concentrations, during the early period of zebrafish (Danio rerio) embryo development (96 h post-fertilization), a promising model for in vivo developmental studies. To clarify the mechanisms of toxicity involved, lethal and sublethal development endpoints were assessed. At the end of the exposure, biochemical and cell death parameters were evaluated and, 24 h later, different behavioural responses were assessed. The results showed that metals induced higher levels of toxicity. Copper caused high mortality, low hatching, malformations, and changes in biochemical parameters, such as decreased Catalase (CAT) activity, increased Glutathione Peroxidase (GPx), Glutathione S-Transferase (GST), reduced Glutathione (GSH) and decreased Acetylcholinesterase (AChE) activity, also inducing apoptosis and changes in larval behaviour. Manganese increased the activity of SODs enzymes. Zinc increased mortality, reactive oxygen species (ROS) levels, superoxide dismutase activity (SODs) and caused a decrease in AChE activity. Embryos/larvae exposed to the combination of GBH/Metal also showed teratogenic effects during their development but in smaller proportions than the metal alone. Although more studies are needed, the results suggest that GBH may interfere with the mechanisms of metal toxicity at the biochemical, physiological, and behavioural levels of zebrafish.


Assuntos
Herbicidas , Poluentes Químicos da Água , Acetilcolinesterase/metabolismo , Animais , Antioxidantes/metabolismo , Catalase/metabolismo , Quelantes/metabolismo , Cobre/metabolismo , Embrião não Mamífero , Glutationa/metabolismo , Glutationa Peroxidase/metabolismo , Glutationa Transferase/metabolismo , Glicina/análogos & derivados , Herbicidas/metabolismo , Manganês/metabolismo , Estresse Oxidativo , Espécies Reativas de Oxigênio/metabolismo , Superóxido Dismutase/metabolismo , Poluentes Químicos da Água/metabolismo , Peixe-Zebra/metabolismo , Zinco/metabolismo , Glifosato
14.
Phys Sportsmed ; 39(4): 98-123, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22293773

RESUMO

Gout is a major health problem in the United States; it affects 8.3 million people, which is approximately 4% of the adult population. Gout is most often diagnosed and managed in primary care practices; thus, primary care physicians have a significant opportunity to improve patient outcomes. Following publication of the 2006 European League Against Rheumatism (EULAR) gout guidelines, significant new evidence has accumulated, and new treatments for patients with gout have become available. It is the objective of these 2011 recommendations to update the 2006 EULAR guidelines, paying special attention to the needs of primary care physicians. The revised 2011 recommendations are based on the Grading of Recommendations Assessment, Development, and Evaluation approach as an evidence-based strategy for rating quality of evidence and grading the strength of recommendation formulated for use in clinical practice. A total of 26 key recommendations, 10 for diagnosis and 16 for management, of patients with gout were evaluated, resulting in important updates for patient care. The presence of monosodium urate crystals and/or tophus and response to colchicine have the highest clinical diagnostic value. The key aspect of effective management of an acute gout attack is initiation of treatment within hours of symptom onset. Low-dose colchicine is better tolerated and is as effective as a high dose. When urate-lowering therapy (ULT) is indicated, the xanthine oxidase inhibitors allopurinol and febuxostat are the options of choice. Febuxostat can be prescribed at unchanged doses for patients with mild-to-moderate renal or hepatic impairment. The target of ULT should be a serum uric acid level that is ≤ 6 mg/dL. For patients with refractory and tophaceous gout, intravenous pegloticase is a new treatment option. This article is a summary of the 2011 clinical guidelines published in Postgraduate Medicine. This article provides a streamlined, accessible overview intended for quick review by primary care physicians, with the full guidelines being a resource for those seeking additional background information and expanded discussion.


Assuntos
Diagnóstico por Imagem/normas , Gerenciamento Clínico , Gota/diagnóstico , Gota/terapia , Hiperuricemia/diagnóstico , Hiperuricemia/terapia , Guias de Prática Clínica como Assunto , Humanos
15.
Br J Oral Maxillofac Surg ; 59(3): 362-367, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33358030

RESUMO

We used finite element analysis to assess stress on the cortical bone and plate fixation system, as well as mandibular resistance after sagittal split ramus osteotomy with different mandibular advancements and rotations of the occlusal plane. Three-dimensional mandibular models were obtained, and 6mm and 12mm advancements were planned associated with linear, clockwise, and counter-clockwise rotation of the angle of the occlusal plane. Each model was then fixed with one or two 2.0mm system plates and secured with four monocortical screws. A total of 12 models were built and subjected to a vertical load in the lower central incisor ranging from 50N to 500N in 50N increments. Results showed that the 12mm advancement was associated with higher stress on the bone and plate surface. Additionally, the models fixed with two plates exhibited lower plate stress than those fixed with a single plate. Counter-clockwise rotation of the angle of the mandibular plane in the 6mm advancement caused more plate stress, which did not occur in the 12mm advancement. This analysis has shown that change in the occlusal plane in large mandibular advancements does not act as an additional stress factor. These findings can help to better understand the tensions on bone and plate surfaces in patients who need large mandibular advancements that are associated with a change in the occlusal plane, and will aid better surgical planning.


Assuntos
Avanço Mandibular , Fenômenos Biomecânicos , Placas Ósseas , Parafusos Ósseos , Oclusão Dentária , Análise de Elementos Finitos , Humanos , Mandíbula/cirurgia , Osteotomia Sagital do Ramo Mandibular
16.
Biochim Biophys Acta Proteins Proteom ; 1869(6): 140623, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33607274

RESUMO

Ovarian cancer (OvCA) is the most lethal neoplasia among gynecologic malignancies and faces high rates of new cases particularly in South America. In special, the High Grade Serous Ovarian Carcinoma (HGSC) presents very poor prognosis with deaths caused mainly by metastasis. Among several mechanisms involved in metastasis, the Epithelial to Mesenchymal Transition (EMT) molecular reprogramming represents a model for latest stages of cancer progression. EMT promotes important cellular changes in cellular adhesion and cell-cell communication, which particularly depends on the paracrine signaling from neighbor cells. Considering the importance of cellular communication during EMT and metastasis, here we analyzed the changes in the secretome of the ovarian cancer cell line Caov-3 induced to EMT by Epidermal Growth Factor (EGF). Using a combination of GEL-LC-MS/MS and stable isotopic metabolic labelling (SILAC), we identified up-regulated candidates during EMT as a starting point to identify relevant proteins for HGSC. Based on public databases, our candidate proteins were validated and prioritized for further analysis. Importantly, several of the protein candidates were associated with cellular vesicles, which are important to the cell-cell communication and metastasis. Furthermore, the association of candidate proteins with gene expression data uncovered a subset of proteins correlated with the mesenchymal subtype of ovarian cancer. Based on this relevant molecular signature for aggressive ovarian cancer, supported by protein and gene expression data, we developed a targeted proteomic method to evaluate individual OvCA clinical samples. The quantitative information obtained for 33 peptides, representative of 18 proteins, was able to segregate HGSC from other tumor types. Our study highlighted the richness of the secretome and EMT to reveal relevant proteins for HGSC, which could be used in further studies and larger patient cohorts as a potential stratification signature for ovarian cancer tumor that could guide clinical conduct for patient treatment.


Assuntos
Biomarcadores Tumorais/metabolismo , Cistadenocarcinoma Seroso/patologia , Fator de Crescimento Epidérmico/farmacologia , Neoplasias Ovarianas/patologia , Proteômica/métodos , Regulação para Cima , Comunicação Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Cromatografia Líquida , Cistadenocarcinoma Seroso/metabolismo , Transição Epitelial-Mesenquimal/efeitos dos fármacos , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Marcação por Isótopo , Invasividade Neoplásica , Estadiamento de Neoplasias , Neoplasias Ovarianas/metabolismo , Mapas de Interação de Proteínas/efeitos dos fármacos , Espectrometria de Massas em Tandem
17.
Chemosphere ; 253: 126636, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32276117

RESUMO

The use of herbicides with glyphosate as an active ingredient (a.i.) has increased dramatically in recent years, with its residues often being found in either soil or water. Nevertheless, concerns have arisen about its harmful side effects for both ecosystems and wildlife health. Therefore, the objective of this work was to assess the effects of a commercial formulation of glyphosate (RoundUp® UltraMax), at environmentally relevant concentrations on zebrafish embryos through a set of behavioural patterns. Zebrafish embryos were exposed to 0, 1, 2 and 5 µg a.i. mL-1 concentrations of the glyphosate formulation for 72 h (from 2.5 to 75 h post-fertilization (hpf)). After exposure, larvae were washed and allowed to develop until 144 hpf. At this point, the larvae behaviour was evaluated using a battery of tests to assess the general exploratory motility, escape-like responses, anxiety-related behaviours and social interactions. In addition, cortisol levels were assessed. No significant changes were observed relative to the exploratory behaviour in the standard open field. The anxiety-related behaviours were similar among groups, and no social interference was observed following exposure to these glyphosate concentrations. Likewise, cortisol levels remained similar among treatments. Still, the larvae exposed to 5 µg a.i. mL-1 did not react to the presence of an aversive stimulus, supporting glyphosate-induced changes in the sensory-motor coordination during development. In general, these results indicate a possible neurotoxic effect of this glyphosate-based formulation that should be further evaluated. In addition, the results obtained could impose a risk for wildlife sensitive species that should not be neglected.


Assuntos
Glicina/análogos & derivados , Herbicidas/toxicidade , Poluentes Químicos da Água/toxicidade , Animais , Ecossistema , Embrião não Mamífero/efeitos dos fármacos , Desenvolvimento Embrionário , Glicina/toxicidade , Larva/efeitos dos fármacos , Peixe-Zebra/embriologia , Peixe-Zebra/fisiologia , Glifosato
18.
Int J Biol Macromol ; 133: 1249-1259, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31047930

RESUMO

Cellulose nanocrystals (CNCs) is a high-value and emerging bionanomaterial with an increasing number of applications. The action of endoglucanases (EGs) from fungal and bacterial sources belonging to three glycosyl hydrolase (GH) families were investigated on bleached eucalyptus kraft pulp as potential catalysts to prepare CNC. Fungal GH7EG was the most efficient in hydrolysis and fiber fragmentation without altering crystallinity and crystallite size. Fiber fragmentation promoted by fungal GH45EG was similar to that observed for GH7EG, although it released a smaller amount of sugar. Bacterial GH5EG resulted in very low hydrolysis yield and practically did not fragment the fibers, resulting in a hydrolysis residue with characteristics very similar to the initial material. GH45EG was the only EG that affected the crystallinity and crystallite size and also the only enzyme capable of isolating nanoparticles. The isolated nanoparticles had very narrow width distribution range of 6-10 nm and length distribution range of 400-600 nm. Supplementation of ß-glucosidase and conventional mechanical refining as a pretreatment did not improve the release of nanoparticles. Despite catalyzing the same biochemical reaction, different EGs displayed very distinct action during hydrolysis. The reported strong binding of GH45EG's CBM to the cellulose and the lack of increased accessibility of the enzyme to new substrate likely allowed continuous hydrolysis of the few fibers available, resulting in the isolation of cellulose nanoparticles.


Assuntos
Biocatálise , Celulase/metabolismo , Celulose/química , Celulose/isolamento & purificação , Eucalyptus/química , Nanopartículas/química , Hidrólise
19.
Chemosphere ; 223: 514-522, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30784758

RESUMO

The use of herbicides with glyphosate as an active ingredient, the so-called glyphosate-based herbicides (GBH), has increased dramatically in recent years currently being the most widely used in the world. Therefore, glyphosate residues have been detected in water and soils near the application sites. Recent studies indicate that GBH may cause adverse effects on vertebrates although these have been attributed to the presence of adjuvants in the commercial formulations rather than to the sole compound. Accordingly, the objective of this work was to investigate the lethal and sub-lethal developmental effects, neurotoxic potential and oxidative stress responses of zebrafish embryos to Roundup® Ultramax (RU) exposure. Embryos were exposed during 72 h to 0, 2, 5, 8.5 µg a.i. mL-1 of RU. Increased mortality was observed in embryos exposed to concentrations above 8.5 µg a.i. mL-1 as well as increased number of malformations. Decreased heart rate and hatchability were also observed. By contrast, exposure to concentrations that do not evoke teratogenic outcomes induced a dose-dependent decrease of heart rate although not inducing significant developmental changes. However, histological changes were not observed in the larvae exposed to these concentrations. Moreover, the generation of reactive oxygen species, the antioxidant enzymes activities (SOD and CAT), the GST biotransformation activity, the glutathione levels (GSH and GSSG), the oxidative damage (MDA) and the acetylcholinesterase and lactate dehydrogenase were similar among groups following exposure. Overall, available evidence suggests a dose-dependent toxicological effect of this formulation at concentrations that are not routinely detected in the environment. However, additional studies should be performed to better understand the underlying molecular mechanisms in favor of this formulation.


Assuntos
Desenvolvimento Embrionário/efeitos dos fármacos , Glicina/análogos & derivados , Herbicidas/efeitos adversos , Teratogênicos/química , Peixe-Zebra/embriologia , Animais , Glicina/efeitos adversos , Glifosato
20.
J Parasitol ; 93(3): 712-4, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17626371

RESUMO

The conventional methods for identification and typing of Leishmania species depend on previous culture isolation of the parasites. Not infrequently, culture is unsuccessful and may result in misrepresentation of the heterogeneity of the original isolate. Thus, more reliable and precise identification of genotypes of Leishmania spp. is important for a better clinical and epidemiological understanding of the disease. We evaluated the potential of LSSP-PCR targeting kDNA minicircles in discriminating different variants of the parasite with the use of clinical samples directly or cultivated parasites. The 1st step of this procedure consists of the amplification of the minicircles by conventional PCR; the 2nd step is low-stringency amplification of the minicircles previously amplified, with the use of 1 of the primers. Although LSSP-PCR produced complex and distinct kDNA signatures for isolates representing different species, further experiments demonstrated that the approach had the potential for discriminating intraspecific variants of L. braziliensis. Thus, the generated profiles were too variable to be useful as markers for species identification. Moreover, we demonstrated that the approach can be directly applied to clinical samples. In conclusion, LSSP-PCR targeting kDNA minicircles produces profiles that reflect polymorphisms of the predominant classes of minicircles, and can be useful for studies aimed at discriminating Leishmania braziliensis genotypes without the need for previous cultivation of the parasite.


Assuntos
DNA de Cinetoplasto/análise , Leishmania braziliensis/genética , Reação em Cadeia da Polimerase/métodos , Animais , Análise por Conglomerados , Primers do DNA , DNA de Cinetoplasto/química , Eletroforese em Gel de Poliacrilamida , Variação Genética , Genótipo , Humanos , Leishmania braziliensis/classificação , Leishmania braziliensis/isolamento & purificação , Leishmaniose Cutânea/parasitologia , Filogenia , Reprodutibilidade dos Testes , Especificidade da Espécie
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