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1.
Chemphyschem ; 24(3): e202200685, 2023 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-36197761

RESUMEN

The importance of and the difference between molecular versus structural core chirality of substances that form nanomaterials, and their ability to transmit and amplify their chirality to and within a surrounding condensed medium is yet to be exactly understood. Here we demonstrate that neat as well as disodium cromoglycate (DSCG) surface-modified cellulose nanocrystals (CNCs) with both molecular and morphological core chirality can induce homochirality in racemic nematic lyotropic chromonic liquid crystal (rac-N-LCLC) tactoids. In comparison to the parent chiral organic building blocks, D-glucose, endowed only with molecular chirality, both CNCs showed a superior chirality transfer ability. Here, particularly the structurally compatible DSCG-modified CNCs prove to be highly effective since the surface DSCG moieties can insert into the DSCG stacks that constitute the racemic tactoids. Overall, this presents a highly efficient pathway for chiral induction in an aqueous medium and thus for understanding the origins of biological homochirality in a suitable experimental system.

2.
J Sex Med ; 19(1): 54-63, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34758929

RESUMEN

BACKGROUND: Female sexual dysfunction has a high prevalence in women in the postmenopausal period. Not only factors like comorbidities and chronic illnesses are responsible for this high prevalence, but also psychological and interpersonal factors play a significant role. Sexual counselling educational programs have shown positive sexual behavioral changes and they should be considered the first line approach to female sexual dysfunction in this group of women. AIM: To review the evidence of the efficacy of sexual counselling educational programs for sexual dysfunction in postmenopausal women. METHODS: A systematic search was performed in February 2021 from electronic databases (MEDLINE, CENTRAL, and Scopus), unpublished studies, ongoing clinical trials, conference abstracts and journal archives, dissertations and theses, gray literature and free search on the Google Scholar search engine. Studies that evaluate the effectiveness of sexual educational programs in postmenopausal women were selected. Study selection and data extraction were performed by 2 independent researchers. Extracted data included author identification, publication date, geographic location, study population and sample size, type of intervention, sexual function evaluation tool and outcome. Studies that evaluate sexual function by using the Female Sexual Function Index (FSFI) were included in the meta-analysis, calculating the mean difference. OUTCOMES: Improvement of sexual function in postmenopausal women. RESULTS: We included 8 studies in the systematic review, 6 randomized and 2 nonrandomized controlled trials, with a total sample size of 619 women, aged between 39 and 75 years old, all in menopause for less than 5 years. The studies described sexual education programs, with 4-10 sessions, 45-60 minutes each, including themes like sexual anatomy, physiological sexual response, menopause, methods of stimulation, and common sexual myths. Five studies also included cognitive-behavior therapy and 3 studies assessed mindfulness techniques. Six studies evaluated the effectiveness of sexual educational programs using FSFI. The results showed that sexual counselling educational programs had statistically significant effects on enhancing the total FSFI score (mean difference = +7.14, 95% confidence interval = 3.70-10.6, P < .0001) in comparison to routine care. Results were also significant in all evaluated sex domains: pain, arousal, lubrication, desire, orgasm and satisfaction (P < .05). CONCLUSION: Our meta-analysis shows that sexual counselling educational programs are effective in improving sexual dysfunction in postmenopausal women when compared to routine care. These are simple approaches, easily administered with minimal resources that help prevent the psychological and social consequences of sexual dysfunction at this age. IMS Silva, MP Pinto, D Gonçalves. Educational Programs and Sexual Counselling for Postmenopausal Sexual Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med 2022;19:54-63.


Asunto(s)
Posmenopausia , Disfunciones Sexuales Fisiológicas , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Orgasmo , Consejo Sexual , Conducta Sexual , Disfunciones Sexuales Fisiológicas/terapia
3.
Angew Chem Int Ed Engl ; 60(32): 17344-17349, 2021 08 02.
Artículo en Inglés | MEDLINE | ID: mdl-33949085

RESUMEN

The vast majority of nanomaterials studied in light of their ability to transmit chirality to or amplify their chirality in a surrounding medium, constitute an achiral core with chirality solely installed at the surface by conjugation or encapsulation with optically active ligands. Here we present the inverse approach focusing on surface-modified cellulose nanocrystals (CNCs) with core chirality at both the molecular and the morphological level to quantify transmission and amplification of core chirality through space using a host nematic liquid crystal (N-LC) as reporter. We find that CNCs functionalized at the surface with achiral molecules, structurally related to the N-LC, exhibit better N-LC solubility, thereby serving as highly efficient chiral inducers. Moreover, functionalization with chiral molecules only marginally enhances the efficacy of helical distortion in the host N-LC matrix, indicating the high propensity of CNCs to transfer chirality from an inherently chiral core.

4.
Angew Chem Int Ed Engl ; 55(8): 2738-42, 2016 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-26805928

RESUMEN

The ability of three different bifunctional azobenzene linkers to enable the photoreversible formation of a defined intermolecular two-tetrad G-quadruplex upon UV/Vis irradiation was investigated. Circular dichroism and NMR spectroscopic data showed the formation of G-quadruplexes with K(+)  ions at room temperature in all three cases with the corresponding azobenzene linker in an E conformation. However, only the para-para-substituted azobenzene derivative enables photoswitching between a nonpolymorphic, stacked, tetramolecular G-quadruplex and an unstructured state after E-Z isomerization.


Asunto(s)
G-Cuádruplex , Modelos Moleculares , Conformación de Ácido Nucleico , Fotoquímica , Espectroscopía de Protones por Resonancia Magnética
5.
Adv Healthc Mater ; : e2304012, 2024 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-38545848

RESUMEN

The stimulation of mesenchymal stromal cells (MSCs) with inflammatory molecules is often used to boost their therapeutic effect. Prolonged exposure to inflammatory molecules has been explored to improve their action because MSCs therapies seem to be improved transiently with such stimuli. However, the possibility of cyclically stimulating MSCs to recover their optimized therapeutic potential is still to be elucidated, although the efficacy of cell-based therapies may be dependent on the ability to readapt to the relapse pathological conditions. Here, the response of MSCs, encapsulated in alginate hydrogels and cultured for 22 d, is explored using three different regimes: single, continuous, and intermittent stimulation with IFNγ. Exposure to IFNγ leads to a decrease in the secretion of IL-10, which is cyclically countered by IFNγ weaning. Conditioned media collected at different stages of pulsatile stimulation show an immunomodulatory potential toward macrophages, which directly correlates with IL-10 concentration in media. To understand whether the correlation between cyclic stimulation of MSCs and other biological actions can be observed, the effect on endothelial cells is studied, showcasing an overall modest influence on tube formation. Overall, the results describe the response of encapsulated MSCs to unusual pulsatile simulation regimens, exploring encapsulated MSCs as a living on-demand release system of tailored secretomes with recoverable immunomodulatory action.

6.
Surg Oncol ; 51: 102015, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38016381

RESUMEN

INTRODUCTION: Breast-conserving surgery associated with adjuvant radiotherapy is the state of the art in the surgical treatment of breast cancer. Oncoplastic surgery through dermo-adipose flaps based in perforating arteries (muscle sparing flaps) for partial reconstruction is increasingly used as a good option for avoiding musculocutaneous flaps. In this study we evaluate the outcomes of the use of chest wall perforator flaps in the replacement of partial breast volume. METHODS: A prospective cohort study of female patients that underwent a conservative oncoplastic surgery procedure with partial breast reconstruction using a dermo-adipose flap of perforating arteries of the chest wall was conducted between November 2020 and March 2022 at our centre. Primary outcomes were surgical morbidity, positive margins and reoperation rates. Characteristics associated with the occurrence of complications were further identified. RESULTS: Forty-five patients underwent the procedure of interest during the study period. The mean age was 55 years. The median larger dimension of the tumor was 23 mm. Lateral intercostal artery perforator (LICAP), lateral thoracic artery perforator (LTAP), a combined flap and Anterior Intercostal Artery Perforator/Medial Intercostal Artery Perforator (AICAP)/(MICAP) were performed in 22, 16, 2 and 5 patients, respectively. The mean operative time was 126 min. A total of 9 (20.0%) patients required a reoperation after definitive diagnosis, 4 due to positive margins and 5 due to immediate/early surgical morbidity. CONCLUSIONS: Local perforator flaps in oncoplastic breast-conserving surgery are a good option for immediate reconstruction after conservative surgery, showing low morbidity and favourable outcomes.


Asunto(s)
Neoplasias de la Mama , Mamoplastia , Arterias Mamarias , Colgajo Perforante , Pared Torácica , Femenino , Humanos , Persona de Mediana Edad , Colgajo Perforante/irrigación sanguínea , Pared Torácica/cirugía , Pared Torácica/patología , Estudios Prospectivos , Reproducibilidad de los Resultados , Mamoplastia/métodos , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/patología , Arterias Mamarias/patología
7.
ACS Nanosci Au ; 3(4): 295-309, 2023 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-37601923

RESUMEN

In our continuing pursuit to generate, understand, and control the morphology of organic nanofilaments formed by molecules with a bent molecular shape, we here report on two bent-core molecules specifically designed to permit a phase or morphology change upon exposure to an applied electric field or irradiation with UV light. To trigger a response to an applied electric field, conformationally rigid chiral (S,S)-2,3-difluorooctyloxy side chains were introduced, and to cause a response to UV light, an azobenzene core was incorporated into one of the arms of the rigid bent core. The phase behavior as well as structure and morphology of the formed phases and nanofilaments were analyzed using differential scanning calorimetry, cross-polarized optical microscopy, circular dichroism spectropolarimetry, scanning and transmission electron microscopy, UV-vis spectrophotometry, as well as X-ray diffraction experiments. Both bent-core molecules were characterized by the coexistence of two nanoscale morphologies, specifically helical nanofilaments (HNFs) and layered nanocylinders, prior to exposure to an external stimulus and independent of the cooling rate from the isotropic liquid. The application of an electric field triggers the disappearance of crystalline nanofilaments and instead leads to the formation of a tilted smectic liquid crystal phase for the material featuring chiral difluorinated side chains, whereas irradiation with UV light results in the disappearance of the nanocylinders and the sole formation of HNFs for the azobenzene-containing material. Combined results of this experimental study reveal that in addition to controlling the rate of cooling, applied electric fields and UV irradiation can be used to expand the toolkit for structural and morphological control of suitably designed bent-core molecule-based structures at the nanoscale.

8.
Rev Gaucha Enferm ; 44: e20220046, 2023.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-37283430

RESUMEN

OBJECTIVE: To analyze the social representations of nursing students about transsexuality and the health demands of transsexual people. METHODS: Qualitative, descriptive research with undergraduate nursing students from a public university in Rio de Janeiro/Brazil. The data came from a semi-structured interview and lexical analysis using Alceste 2012 software. RESULTS: Transsexuality was represented as a transgression, with the transsexual person being objectified as unnatural because they do not identify with their biological sex. Hormone therapy and sex reassignment surgeries were understood as the main demands, being anchored in a pathologizing and medicalizing health sphere. However, the theme is not addressed during graduation, generating unpreparedness for professional life. FINAL CONSIDERATIONS: The need to update the academic curriculum, as well as the way of thinking about the care of transsexual people, is essential and urgent for an integral and equitable care.


Asunto(s)
Bachillerato en Enfermería , Estudiantes de Enfermería , Humanos , Brasil , Investigación Cualitativa , Curriculum
9.
Front Health Serv ; 3: 1190357, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38116534

RESUMEN

Objectives: The current European crisis in human resources in health has opened the debate about working conditions and fair wages. This is the case with Resident doctors, which have faced challenges throughout Europe. In Portugal, they account for about a third of the doctors in the Portuguese National Health Service. No studies to date objectively demonstrate the working conditions and responsibilities undertaken. This study aims to quantify the residents' workload and working conditions. Methods: Observational, retrospective cross-sectional study which involved a survey on the clinical and training activity of Portuguese residents, actively working in September 2020. The survey was distributed through e-mail to residents' representatives and directly to those affiliated with the Independent Union of Portuguese Doctors. The descriptive analysis assessed current workload, and logistic regression models analyzed associations with geographical location and residency seniority. Results: There were a total of 2,012 participants (19.6% of invited residents). Of the residents giving consultations, 85.3% do so with full autonomy. In the emergency department, 32.1% of the residents work 24 h shifts and 25.1% work shifts without a specialist doctor present. Regarding medical training, 40.8% invest over EUR 1,500 annually. Autonomy in consultations was associated with being a Family Medicine resident (OR 4.219, p < 0.001), being a senior resident (OR 5.143, p < 0.001), and working in the Center (OR 1.685, p = 0.009) and South regions (OR 2.172, p < 0.001). Seniority was also associated with investing over EUR 1,500 in training annually (OR 1.235, p = 0.021). Conclusion: Residents work far more than the contracted 40 h week, often on an unpaid basis. They present a high degree of autonomy in their practice, make a very significant personal and financial investment in medical training, with almost no time dedicated to studying during working hours. There is a need to provide better working conditions for health professionals, including residents, for the sake of the sustainability of health systems across Europe.

10.
J Am Chem Soc ; 134(34): 14070-7, 2012 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-22803805

RESUMEN

The reversible switching of a water-soluble spiropyran compound is recorded over 1 ns by means of femtosecond vis-pump/vis- and IR-probe spectroscopy under aqueous conditions. Our investigations reveal that the photochemical conversion from the closed spiropyran to the open merocyanine takes 1.6 ps whereas the reversed photoreaction is accomplished within 25 ps. The combination of time-resolved and steady-state observations allows us to reveal central parts of the reaction pathway leading to either form. The enhanced water solubility, its fast and efficient switching behavior, and its stability against hydrolysis over a time range of several weeks make this compound an attractive and versatile tool for biological applications.

11.
Cancers (Basel) ; 14(13)2022 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-35805026

RESUMEN

Hereditary breast and ovarian cancer (HBOC) syndrome is a condition in which individuals have an increased risk of developing different types of cancer when compared to the general population. BRCA1 repair associated (BRCA1) and BRCA2 repair associated (BRCA2) genes are tumor suppressor genes that play a crucial role in cell, by repairing DNA damage. Mutations in these genes are responsible for 25% of HBOC cases. Individuals with this syndrome are often subjected to diagnostic imaging techniques, as well as therapeutic options, that use ionizing radiation, so it is crucial to understand whether these individuals may present higher radiosensitivity and, therefore, its consequences. Several studies have been carried out to understand if the exposure to different ionizing radiation doses can induce cancer in individuals with HBOC. Some of these studies have shown that individuals with HBOC are hypersensitive to the ionizing radiation and, therefore, have neoplasms resulting from mutations in genes that are important in maintaining genomic stability. When mutated, genes no longer guarantee this stability and promote the induction of carcinogenesis. Oppositely, other studies show that there is no association between exposure to ionizing radiation and an increased risk of developing cancer. Thus, the results are inconsistent, and there is a great need to clarify this relationship. In this review, we present the characteristics of HBOC syndrome and the effects that ionizing radiation can induce in individuals who have it. In addition, we review the studies that have already been carried out on this subject.

12.
Pharmaceutics ; 14(3)2022 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-35335927

RESUMEN

Local drug delivery offers a means of achieving a high concentration of therapeutic agents directly at the tumor site, whilst minimizing systemic toxicity. For heterogenous cancers such as glioblastoma, multimodal therapeutic approaches hold promise for better efficacy. Herein, we aimed to create a well-defined and reproducible drug delivery system that also incorporates gold nanorods for photothermal therapy. Solvent-assisted micromolding was used to create uniform sacrificial templates in which microscale hydrogels were formed with and without gold nanorods throughout their structure. The microscale hydrogels could be loaded with doxorubicin, releasing it over a period of one week, causing toxicity to glioma cells. Since these microscale hydrogels were designed for direct intratumoral injection, therefore bypassing the blood-brain barrier, the highly potent breast cancer therapeutic doxorubicin was repurposed for use in this study. By contrast, the unloaded hydrogels were well tolerated, without decreasing cell viability. Irradiation with near-infrared light caused heating of the hydrogels, showing that if concentrated at an injection site, these hydrogels maybe able to cause anticancer activity through two separate mechanisms.

13.
ARP Rheumatol ; 1(2): 137-141, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35810372

RESUMEN

BACKGROUND: Musculoskeletal symptoms represent the most common extraintestinal manifestations of inflammatory bowel disease (IBD) and a major cause of impaired quality of life in these patients. Spondyloarthritis (SpA) is classically associated with IBD, but other rheumatic manifestations may occur. OBJECTIVE: To characterize musculoskeletal symptoms and rheumatic diseases in an IBD cohort. METHODS: Retrospective monocentric descriptive study including all the patients with IBD consecutively referred from Gastroenterology to the Reumatology Department (from January of 2013 to April of 2021) in a Portuguese tertiary university hospital. Demographic and clinical data were collected and musculoskeletal symptoms and rheumatic diseases diagnosed in the Rheumatology outpatient center were registered. RESULTS: A total of 235 patients were included: 177 (75.3%) with Crohn´s disease (CD) and 58 (24.7%) with ulcerative colitis. Musculoskeletal symptoms were observed in 142 (60.4%) patients and 105 (44.7%) had some rheumatic condition. Regarding spondyloarthritis, 46 (19.6%) patients fulfilled ASAS (Assessment of SpondyloArthritis international Society) criteria for axial SpA and 5 (2.1%) for peripheral SpA. Osteoarthritis (n=70, 29.8%) and osteoporosis (n=33, 14%) were the most frequent non-inflammatory rheumatic conditions observed, mostly previously undiagnosed. No significant differences were observed between CD and UC. CONCLUSION: Rheumatic conditions are frequent in IBD patients and are not limited to SpA features. They remain mostly undiagnosed and the collaboration between gastroenterologists and rheumatologists is important for their best management.


Asunto(s)
Enfermedad de Crohn , Enfermedades Inflamatorias del Intestino , Enfermedades Reumáticas , Espondiloartritis , Enfermedad Crónica , Enfermedad de Crohn/complicaciones , Humanos , Enfermedades Inflamatorias del Intestino/complicaciones , Portugal/epidemiología , Calidad de Vida , Estudios Retrospectivos , Enfermedades Reumáticas/etiología , Espondiloartritis/etiología
14.
Rev Bras Enferm ; 75Suppl 2(Suppl 2): e20210830, 2022.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-35674537

RESUMEN

OBJECTIVES: to analyze the possibilities of support that the social support network offers to women in situations of intimate partner violence. METHODS: qualitative research anchored in Sanicola's social network framework. A total of 21 women attended at a specialized social assistance service in Porto Velho-Rondônia, Brazil, participated in a semi-structured interview. RESULTS: the analysis of network maps showed that the secondary social support network mobilized had a central character in the lives of women in situations of violence. These women sought the third sector's secondary network, the churches, from which they received emotional-affective and spiritual support. FINAL CONSIDERATIONS: understanding the social network setting and the type of support offered can contribute to improving care for women and strengthening interpersonal and institutional ties that help in the search for breaking the situation of violence.


Asunto(s)
Violencia de Pareja , Brasil , Femenino , Humanos , Violencia de Pareja/psicología , Investigación Cualitativa , Apoyo Social , Violencia
15.
Sci Adv ; 8(4): eabl4385, 2022 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-35080976

RESUMEN

Chirality, as a concept, is well understood at most length scales. However, quantitative models predicting the efficacy of the transmission of chirality across length scales are lacking. We propose here a modus operandi for a chiral nanoshape solute in an achiral nematic liquid crystal host showing that that chirality transfer may be understood by unusually simple geometric considerations. This mechanism is based on the product of a pseudoscalar chirality indicator and of a geometric shape compatibility factor based on the two-dimensional isoperimetric quotients for each nanoshape solute. The model is tested on an experimental set of precisely engineered gold nanoshapes. These libraries of calculated and in-parallel acquired experimental data among related nanoshapes pave the way for predictive calculations of chirality transfer in nanoscale, macromolecular, and biological systems, from designing chiral discriminators and enantioselective catalysts to developing chiral metamaterials and understanding nature's innate ability to transfer homochirality across length scales.

16.
Ther Apher Dial ; 26(5): 992-998, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34981641

RESUMEN

INTRODUCTION: Hemodialysis (HD) patients should be trained to develop self-care behaviors in order to prevent and preserve their arteriovenous fistula (AVF). The aim of this study was identifying the factors that affect the levels of self-care behavior with AVF by HD patients. METHODS: A cross-sectional study was conducted involving 89 patients. RESULTS: Self-care levels were negatively affected by patients' location (Azores) and positively affected by marital status, education, employment, AVF duration, and absence of complications with the AVF. Concerning the management of signs and symptoms, self-care levels were negatively affected by patients' location. Regarding prevention of complications, self-care levels were negatively affected by age and marital status and positively affected by marital status, employment, chronic kidney disease etiology, AVF duration, and previous AVF. CONCLUSION: Further studies are required in order to confirm whether the considered factors affect levels of self-care behaviors with AVF, or whether other factors are needed as well.


Asunto(s)
Fístula Arteriovenosa , Derivación Arteriovenosa Quirúrgica , Fallo Renal Crónico , Estudios Transversales , Demografía , Humanos , Fallo Renal Crónico/diagnóstico , Fallo Renal Crónico/terapia , Modelos Logísticos , Diálisis Renal , Estudios Retrospectivos , Autocuidado
17.
Eur J Case Rep Intern Med ; 8(8): 002796, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34527629

RESUMEN

INTRODUCTION: Vaccination against COVID-19 is essential to control the pandemic. The vaccines developed so far have good safety profiles but full knowledge of adverse effects will only be acquired with time and through case reports. CASE DESCRIPTION: We present the case of a man admitted with rhabdomyolysis 3 days after receiving his first dose of the Pfizer coronavirus vaccine Comirnaty® Other traumatic, infectious, endocrine, electrolyte disturbance and autoimmune causes of rhabdomyolysis were excluded. The temporal relationship between vaccine administration and disease onset indicated possible causality. The patient had a favourable evolution after receiving fluids and completely recovered. To our knowledge, there have been only 69 reports of rhabdomyolysis following Comirnaty® administration in Europe, as stated by the European Medicines Agency, and this is the first case report in Portugal. DISCUSSION: When a patient presents with rhabdomyolysis without an obvious traumatic or exertional cause, other aetiologies need to be excluded. Drug use is one of the most common causes of rhabdomyolysis in adults. CONCLUSION: We present a case compatible with an adverse effect of Comirnaty® in order to raise awareness of this condition in vaccinated patients. LEARNING POINTS: Rhabdomyolysis is frequently due to pharmacological causes.COVID-19 vaccines are safe but their adverse effects have not yet been fully elucidated and more case reporting would be beneficial.Rhabdomyolysis secondary to administration the Pfizer anti-COVID-19 vaccine Comirnaty® can be a severe adverse effect and should be considered in the relevant clinical scenario.

18.
Minim Invasive Surg ; 2021: 8828091, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34055409

RESUMEN

INTRODUCTION: Laparoscopic repair of perforated peptic ulcer (PPU) remains controversial mainly due to its safety and applicability in critically ill patients. The aim of this study is to compare the outcomes of laparoscopy versus laparotomy in the treatment of PPU. METHODS: Single-institutional, retrospective study of all patients submitted to surgical repair of PPU between 2012 and 2019. RESULTS: During the study period, 169 patients underwent emergent surgery for PPU. A laparoscopic approach was tried in 60 patients and completely performed in 49 of them (conversion rate 18.3%). The open group was composed of 120 patients (included 11 conversions). Comparing the laparoscopic with the open group, there were significant differences in gender (male/female ratio 7.2/1 versus 2.2/1, respectively; p=0.009) and in the presence of sepsis criteria (12.2% versus 38.3%, respectively; p=0.001), while the Boey score showed no differences between the two groups. The operative time was longer in the laparoscopic group (median 100' versus 80', p=0.01). Laparoscopy was associated with few early postoperative complications (18.4% versus 41.7%, p=0.004), mortality (2.0% versus 14.2%; p=0.02), shorter hospital stay (median 6 versus 7 days, p=0.001), and earlier oral intake (median 3 versus 4 days, p=0.021). CONCLUSION: Laparoscopic repair of PPU may be considered the procedure of choice in patients without sepsis criteria if expertise and resources are available. This kind of approach is associated with a shorter length of hospital stay and earlier oral intake. In patients with sepsis criteria, more data are required to access the safety of laparoscopy in the treatment of PPU.

19.
Medicines (Basel) ; 8(11)2021 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-34822358

RESUMEN

INTRODUCTION: Breast cancer is the most incident cancer in the world, accounting for 25% of new cancers per year in females. It is the most frequent malignancy in women, being the fifth cause of death from cancer worldwide. Approximately 5 to 10% of patients already present with metastases at diagnosis, and the liver is the site of metastases in half of these cases. Liver metastasis (LM) resection, performed after neoadjuvant systemic treatment, has been reported to increase median overall survival in this population. AIM: The aim of this analysis is to assess the outcomes of patients undergoing breast cancer liver metastasis surgical resection, including impact on survival, compared to patients where metastasectomy was not performed. METHODS: retrospective review of 55 female patients with breast cancer liver metastases, diagnosed and treated in a single tertiary university hospital from January 2011 to December 2016 was performed. RESULTS: In 32/55 patients (58.2%), multi-organ metastases were identified (the most common sites being bone, lungs, and lymph nodes). Of the remaining 23 patients, the liver was the unique metastatic site; thirteen patients had diffuse bilobar hepatic metastases. The remaining ten patients were proposed for surgical treatment; three of them had peritoneal carcinomatosis identified during surgery, and no hepatic metastasectomy was performed. As a result, only seven (12.7%) patients underwent liver metastasectomy. Overall survival was higher in patients who had LM surgery (65 months [Interquartile Range (IQR) 54-120]), in comparison to those diagnosed with diffuse bilobar hepatic metastases (17.5 months [IQR 11-41]), and with those showing concurrent liver and bone metastases (16.5 months [IQR 6-36]) (p = 0.012). In univariable analysis, the latter two groups showed worse overall survival outcomes (Hazard Ratio (HR) = 3.447, 95%CI: 1.218-9.756, p = 0.02 and HR = 3.855, 95% Confidence Interval (CI): 1.475-10.077, p = 0.006, respectively) when compared to patients with LM. CONCLUSION: In our series, patients submitted to metastasectomy had a median overall survival after diagnosis of LM three times greater than the non-operated patients with isolated LM, or concurrent LM and bone metastases (65 vs. 17.5 and 16.5 months, respectively). As is vastly known for colorectal cancer liver metastasis, resection of breast cancer liver metastasis may reduce tumor burden, and therefore may improve patient outcome.

20.
Small ; 6(12): 1347-52, 2010 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-20486229

RESUMEN

G-quadruplexes are becoming reliable alternative interaction modules for the construction of DNA nanoarchitectures due to their prompt inducibility by salts. In this Full Paper, we report the design and synthesis of two different DNA minicircles equipped with G-rich appendixes that can self-hybridize into a G-quadruplex, which acts as a DNA recruiter and glue. Both minicircles, one containing a hairpin-like G-rich region and the other an open tuning-fork-like G-rich region, have the potential to form DNA G-nanoconstructs but only the tuning-fork minicircle does so. Incubation of the tuning-fork minicircle with Na(+) and Ni(2+) results in the formation of minicircle dimers, while K(+) and Sr(2+) unexpectedly induce the formation of multimers. Moreover, a catenated DNA nanoconstruct is obtained when the components of the hairpin minicircle are incubated with K(+) or Na(+) and assembled in a stepwise sequence. All nanoconstructs are visualized by atomic force microscopy.


Asunto(s)
ADN/química , G-Cuádruplex , Microscopía de Fuerza Atómica , Nanotecnología
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