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1.
Int J Mol Sci ; 24(4)2023 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-36835617

RESUMO

Inactivation of the cyclin-dependent kinase inhibitor 2A (CDKN2A) gene is considerably more frequent in squamous cell lung cancer (SqCLC) than in other subtypes of lung cancer and may be a promising target for this histology. Here, we present the course of diagnosis and treatment of a patient with advanced SqCLC, harboring not only CDKN2A mutation but also PIK3CA amplification, Tumor Mutational Burden-High (>10 mutations/megabase), and a Tumor Proportion Score of 80%. After disease progression on multiple lines of chemotherapy and immunotherapy, he responded favorably to treatment with the CDK4/6i Abemaciclib and later achieved a durable partial response to immunotherapy rechallenge with a combination of anti-PD-1 and anti-CTLA-4, nivolumab, and ipilimumab.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Carcinoma de Células Escamosas , Neoplasias Pulmonares , Humanos , Masculino , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma de Células Escamosas/tratamento farmacológico , Classe I de Fosfatidilinositol 3-Quinases/genética , Inibidor p16 de Quinase Dependente de Ciclina/genética , Células Epiteliais , Imunoterapia , Ipilimumab/uso terapêutico , Neoplasias Pulmonares/genética , Mutação , Nivolumabe/uso terapêutico
2.
Trop Anim Health Prod ; 51(7): 2045-2055, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31069625

RESUMO

Twenty-seven Nellore cow-calf pairs were submitted for feed efficiency testing. The animals were weighed every 21 ± 5 days to obtain metabolic body weight (BW0.75) and average daily gain (ADG). Subcutaneous fat thickness (SFT; at 20, 83, 146, and 176 days post-calving); milk yield and components (63, 85, and 151 days); levels of glucose, cholesterol, triglycerides, ß-hydroxybutyrate, albumin, urea, creatinine, calcium, phosphorus, magnesium, insulin, and cortisol (15, 41, 62, and 124 days); and ingestive behavior were evaluated. Residual feed intake was calculated for the first stage (RFI1; 21 to 100 days post-calving) and the second stage of lactation (RFI2; 100 to 188 days post-calving), and the cows were classified based on RFI1 as most efficient (RFI1 < 0) and least efficient (RFI1 > 0). Negative RFI1 cows consumed 1.3 kg/day of dry matter, or 9.77%, less than positive RFI1 cows. Most- and least-efficient cows did not differ in terms of subcutaneous fat thickness traits and milk yield or energy-corrected milk (ECM). Glucose (P = 0.0785), triglycerides (P = 0.0795), and phosphorus (P = 0.0597) concentrations were higher in the first stage of lactation in most-efficient cows. Maternal characteristics such as calf weight at birth and at 205 days and ADG were similar in most- and least-efficient cows. The most-efficient cows are more economic as they consume less feed for the same level of production.


Assuntos
Ração Animal/análise , Peso Corporal , Dieta/veterinária , Lactação , Metaboloma , Ácido 3-Hidroxibutírico , Albuminas/análise , Animais , Glicemia/análise , Bovinos , Creatinina/análise , Indústria de Laticínios , Comportamento Alimentar , Feminino , Leite/metabolismo , Fósforo/sangue , Gravidez , Triglicerídeos/análise , Ureia/análise
3.
Mol Psychiatry ; 22(11): 1585-1593, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28167837

RESUMO

Schizophrenia is associated with cognitive deficits that reflect impaired cortical information processing. Mismatch negativity (MMN) indexes pre-attentive information processing dysfunction at the level of primary auditory cortex. This study investigates mechanisms underlying MMN impairments in schizophrenia using event-related potential, event-related spectral decomposition (ERSP) and resting state functional connectivity (rsfcMRI) approaches. For this study, MMN data to frequency, intensity and duration-deviants were analyzed from 69 schizophrenia patients and 38 healthy controls. rsfcMRI was obtained from a subsample of 38 patients and 23 controls. As expected, schizophrenia patients showed highly significant, large effect size (P=0.0004, d=1.0) deficits in MMN generation across deviant types. In ERSP analyses, responses to deviants occurred primarily the theta (4-7 Hz) frequency range consistent with distributed corticocortical processing, whereas responses to standards occurred primarily in alpha (8-12 Hz) range consistent with known frequencies of thalamocortical activation. Independent deficits in schizophrenia were observed in both the theta response to deviants (P=0.021) and the alpha-response to standards (P=0.003). At the single-trial level, differential patterns of response were observed for frequency vs duration/intensity deviants, along with At the network level, MMN deficits engaged canonical somatomotor, ventral attention and default networks, with a differential pattern of engagement across deviant types (P<0.0001). Findings indicate that deficits in thalamocortical, as well as corticocortical, connectivity contribute to auditory dysfunction in schizophrenia. In addition, differences in ERSP and rsfcMRI profiles across deviant types suggest potential differential engagement of underlying generator mechanisms.


Assuntos
Eletroencefalografia/métodos , Potenciais Evocados Auditivos/fisiologia , Esquizofrenia/fisiopatologia , Estimulação Acústica/métodos , Adulto , Atenção/fisiologia , Córtex Auditivo/metabolismo , Córtex Auditivo/fisiopatologia , Percepção Auditiva/fisiologia , Estudos de Casos e Controles , Transtornos Cognitivos/complicações , Transtornos Cognitivos/fisiopatologia , Feminino , Humanos , Masculino , Potenciais da Membrana/fisiologia , Pessoa de Meia-Idade , Esquizofrenia/complicações
4.
Exp Parasitol ; 188: 13-20, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29555416

RESUMO

This study was conducted to evaluate the metabolism and phosphorus (P) kinetics in lambs experimentally infected with Trichostrongylus colubriformis using the isotope dilution technique and modelling. Fifteen male lambs (21.1 ±â€¯1.50 kg) of the Santa Inês hair breed of approximately six months old, distributed in the treatments infected (I, n = 8) and control (C, n = 7) were used. The infected lambs received serial infections with 5000 T. colubriformis larvae, three times per week, for 3 weeks (45 000 T. colubriformis total larvae). After 66 days of the last inoculation of infective larvae, 6.6 MBq of 32P were injected in each lamb to evaluate the P kinetics. Blood, faeces and urine samples were collected in the following seven days and the slaughter of lambs were carried out on the last day in order to collect bone and soft tissues (Liver, kidney, heart and muscle) samples. To analyse P flows, the biomathematical model with four compartments (C1 - gastrointestinal tract, C2 - plasma, C3 - bone and C4 - soft tissue) was used. Similar P intake (VI) between treatments (C and I) was verified. Lower absorption of endogenous (Vaf) and dietary P (Vaa), as well as, lower amount of endogenous P (from saliva) that reaches the gastrointestinal tract (VIT), consequently, higher excretion of dietary P (VFD) were verified in infected lambs (P < 0.1). Additionally, in infected lambs, the P bioavailability was lower compared to control lambs. With the lower absorption (VaT) of P in infected lambs, there was, consequently, lower distribution to bones and soft tissues (VeD2) and lower P deposition in the bones (VO+D). It was concluded that P metabolism of lambs infected with T. colubriformis was altered, with reduced intestinal absorption and bioavailability, increased faecal loss and reduced P flow to the bone.


Assuntos
Radioisótopos de Fósforo/farmacocinética , Doenças dos Ovinos/metabolismo , Tricostrongilose/veterinária , Trichostrongylus/fisiologia , Animais , Disponibilidade Biológica , Osso e Ossos/metabolismo , Ingestão de Alimentos , Fezes/química , Fezes/parasitologia , Absorção Gastrointestinal , Trato Gastrointestinal/metabolismo , Rim/metabolismo , Fígado/metabolismo , Masculino , Modelos Biológicos , Músculos/metabolismo , Miocárdio/metabolismo , Contagem de Ovos de Parasitas/veterinária , Radioisótopos de Fósforo/administração & dosagem , Técnica de Diluição de Radioisótopos/veterinária , Distribuição Aleatória , Ovinos , Doenças dos Ovinos/parasitologia , Tricostrongilose/metabolismo
5.
BMC Pulm Med ; 18(1): 109, 2018 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-29970066

RESUMO

BACKGROUND: Multiple factors are involved in asthma exacerbations, including environmental exposure and viral infections. We aimed to assess the association between severe asthma exacerbations, acute respiratory viral infections and other potential risk factors. METHODS: Asthmatic children aged 4-14 years were enrolled for a period of 12 months and divided into two groups: those with exacerbated asthma (group 1) and non-exacerbated asthma (group 2). Clinical data were obtained and nasopharyngeal samples were collected through nasopharyngeal aspirate or swab and analysed via indirect fluorescent immunoassays to detect influenza A and B viruses, parainfluenza 1-3, adenovirus and respiratory syncytial virus. Rhinovirus was detected via molecular assays. Potential risk factors for asthma exacerbation were identified in univariate and multivariate analyses. RESULTS: In 153 children (group 1: 92; group 2: 61), median age 7 and 8 years, respectively, the rate of virus detection was 87.7%. There was no difference between groups regarding the frequency of virus detection (p = 0.68); however, group 1 showed a lower frequency (19.2%) of inhaled corticosteroid use (91.4%, p < 0.01) and evidence of inadequate disease control. In the multivariate analysis, the occurrence of three or more visits to the emergency room in the past 12 months (IRR = 1.40; p = 0.04) and nonadherence to inhaled corticosteroid (IRR = 4.87; p < 0.01) were the only factors associated with exacerbation. CONCLUSION: Our results suggest an association between asthma exacerbations, poor disease control and nonadherence to asthma medication, suggesting that viruses may not be the only culprits for asthma exacerbations in this population.


Assuntos
Asma/fisiopatologia , Asma/virologia , Infecções Respiratórias/complicações , Infecções Respiratórias/virologia , Viroses/complicações , Adolescente , Corticosteroides/administração & dosagem , Corticosteroides/uso terapêutico , Asma/tratamento farmacológico , Brasil , Criança , Pré-Escolar , Estudos Transversais , Progressão da Doença , Feminino , Humanos , Masculino , Adesão à Medicação , Análise Multivariada , Análise de Regressão , Sistema Respiratório/virologia
6.
Andrologia ; 50(3)2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28972266

RESUMO

This study evaluated the thermoregulation and spermatogenic changes by scrotal temperature gradient using infrared thermography in testicular compromised bulls. Bulls were insulated (n = 6) for 72 hr and control animals (n = 3) remained without insulation during all the experimental period. Seminal evaluation was performed prior, at insult removal and once per week for 13 consecutive weeks. Mean temperature gradient in insulated animals was lower at the time of insulation removal compared to the week prior and after the insult (p < .05). Two weeks after insult, sperm motility was lower in insulated compared to control animals (p < .01) and spermatozoa total defects were higher in insulated compared to control animals (p < .05). Two and seven weeks after insult, the major defects were higher in insulated compared to control animals (p < .05). Scrotal temperature gradient showed a positive correlation with sperm mass motion (p < .01) and a negative correlation with ocular globe temperature (p < .01) in insulated animals. The infrared thermography can be used to evaluate ocular globe temperature in bulls; however, it is only effective to detect changes in scrotal temperature gradient at the insult removal.


Assuntos
Escroto/diagnóstico por imagem , Espermatogênese/fisiologia , Testículo/diagnóstico por imagem , Termografia/métodos , Animais , Bovinos , Masculino , Motilidade dos Espermatozoides/fisiologia , Espermatozoides/fisiologia , Testículo/fisiologia
7.
Clin Exp Immunol ; 190(2): 251-257, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28707730

RESUMO

Recent experimental data indicate a pathogenic role of complement activation in congestive heart failure (CHF). The aim of this study was to evaluate contact and complement systems activation in patients hospitalized for an acute episode of CHF. Forty-two of 80 consecutive patients admitted at our hospital with confirmed diagnosis of acute CHF were enrolled. They underwent blood sampling within 24 h from admission (T0) and at clinical stability (T1). Patients were stratified for ejection fraction (EF) based on echocardiographic test. We measured plasma levels of C3, C4, sC5b-9 and cleaved high molecular weight kininogen (contact activation marker). At T1, C3 levels increased significantly compared to T0 (97 ± 2 versus 104 ± 3% of total pooled plasma, P < 0·01). Classifying patients according to EF, only patients with preserved EF presented a significant increase of C3 from T0 to T1 (99 ± 3 versus 108 ± 4%, P = 0·03). When the sample was stratified according to clinical outcome, C3 (98 ± 3 versus 104 ± 4%, P = 0·03) and sC5b-9 levels (204 ± 10 versus 230 ± 11 ng/ml, P = 0·03) were increased in patients who had positive outcome after hospitalization. CHF patients with preserved EF and positive outcome after hospitalization showed higher levels of sC5b-9 in the T1 period compared with T0 (211 ± 14 versus 243 ± 14 ng/ml, P = 0·04). Our results suggest that the complement system reacts differently if CHF occurs with preserved or reduced EF. This finding is interesting if we consider the difference in epidemiology, pathogenesis and possible therapeutic approaches of these two clinical entities.


Assuntos
Ativação do Complemento , Insuficiência Cardíaca/imunologia , Insuficiência Cardíaca/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Complemento C3/análise , Complemento C4/análise , Complexo de Ataque à Membrana do Sistema Complemento/análise , Feminino , Insuficiência Cardíaca/diagnóstico , Hospitalização , Humanos , Cininogênios/sangue , Masculino , Volume Sistólico
8.
Genet Mol Res ; 15(4)2016 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-27808385

RESUMO

Molecular studies of the evolutionary relationships among Leishmania species suggest the presence of high genetic variation within this genus, which has a direct effect on public health in many countries. The coexistence of species in a particular region can result in different leishmaniasis clinical forms and treatment responses. We aimed to standardize the kinetoplast DNA (kDNA) enterobacterial repetitive intergenic consensus (ERIC) sequence polymerase chain reaction (PCR) method for molecular epidemiological identification of Leishmania strains, and estimate existing inter-strain genomic differences and kDNA signatures using this technique. ERIC-PCR of genomic DNA revealed genetic polymorphisms between species, although some strains shared many DNA fragments. Leishmania guyanensis, L. amazonensis, and L. braziliensis clustered together in a dendrogram with similarities ranging from 42.0 to 61.0%, whereas L. chagasi grouped with these three species with a similarity of 28.0%. After amplification of kDNA, 780-bp bands were extracted from an agarose gel and purified for analysis of its genetic signature. kDNA ERIC-PCR electrophoretic patterns consisted of 100- to 600- bp fragments. Using these profiles, L. braziliensis and L. guyanensis grouped with a similarity of 26.0%, and L. amazonensis and L. chagasi clustered based on a similarity of 100%. The electrophoretic profiles and dendrograms showed that, for epidemiological identification by ERIC-PCR, genomic DNA had greater discriminatory power than kDNA did. More strains need to be analyzed to validate the kDNA ERIC-PCR method. The genomes of these strains should be sequenced for better epidemiological identification of Leishmania species.


Assuntos
Leishmania/classificação , Leishmania/genética , Leishmaniose/epidemiologia , Leishmaniose/parasitologia , Reação em Cadeia da Polimerase/métodos , Reação em Cadeia da Polimerase/normas , Sequência de Bases , DNA de Cinetoplasto/genética , Variação Genética , Humanos , Sequências Repetitivas Dispersas
9.
J Therm Biol ; 59: 39-46, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27264886

RESUMO

This study was conducted to evaluate the effect of multiple stress factors (thermal, nutritional and pregnancy type) on two different native track breeds of ewes as reflected by their adaptive capability under semi-arid environment. The multiple stressor experiment was conducted in twenty-four ewes (12 Santa Inês and 12 Morada Nova ewes). Both heat stress and pregnancy stress was common to all four groups. However, the animals were divided into further two groups within each breed on the basis of nutrition regimen. According the groupings were: Group 1 (Six Santa Ines ewes; heat stress; nutrition at 0.5% of BW; single pregnancy); Group 2 (Six Santa Ines ewes; heat stress; nutrition at 1.5% BW; twin pregnancy); groups Group 3 (Six Morada Nova ewes; heat stress; nutrition at 0.5% of BW; single pregnancy); Group 4 (Six Morada Nova ewes; heat stress; nutrition at 1.5% BW; twin pregnancy). All the animals in the experiment were pregnant. Heat stress was induced by exposing all animals to summer heat stress in outside environment while the nutritional regimen followed was at 0.5% and 1.5% level of body weight (BW) respectively in each breed. The experiment was conducted in a completely randomized design with two breeds, two nutritional treatments and two pregnancy types, 10 repetitions for physiological parameters and six for blood parameters, with repeated measures over time. Physiological parameters (respiratory rate, pulse rate and rectal temperature) were measured with the animals at rest in the morning and afternoon, 0600-0700 and 1300-1400h, respectively, every seven days. Blood samples were collected every 14d for determination of serum glucose, triglycerides, cholesterol, urea and creatinine. We found interaction effect between breed and pregnancy type on respiratory rate and rectal temperature with greater values in Santa Inês ewes than Morada Nova ewes. However, there was no significant fixed effect of pregnancy type and supplementation level on physiological responses of breeds. Environmental factor (period of the day) had influenced the physiological responses of ewes during all gestational period. Santa Inês ewes had greater serum glucose concentration at 105d and 120d of gestation compared to the Morada Nova ewes. Morada Nova ewes had greater concentrations of triglycerides, urea at 120d, 150d and also greater cholesterol at 105d, 135d and 150d of gestation compared with Santa Inês ewes. The present result indicates that thermal condition was most important factor that modified the physiological responses of ewes in a semi-arid tropical environment.


Assuntos
Adaptação Fisiológica , Ovinos/fisiologia , Estresse Fisiológico , Criação de Animais Domésticos , Fenômenos Fisiológicos da Nutrição Animal , Animais , Temperatura Corporal , Peso Corporal , Cruzamento , Mudança Climática , Feminino , Temperatura Alta , Gravidez , Estações do Ano
10.
J Eur Acad Dermatol Venereol ; 29(3): 533-6, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25073550

RESUMO

BACKGROUND: The association between benign migratory glossitis (BMG) and psoriasis (PS) has been reported in the literature. OBJECTIVE: This study aimed to determinate the environmental factors related to BMG and PS and to investigate their interactions. METHODS: The study population included 129 patients with PS, 399 patients with BMG and a control group (CG) of 5472 individuals with neither PS nor BMG. The environmental factors evaluated in this study included alcohol and tobacco consumption and emotional stress. The Pearson's chi-squared test was used for analysing the association of the environmental factors with PS and BMG. RESULTS: The prevalence of alcohol consumption in the PS group was significantly higher than that in the CG. Tobacco consumption had a weak negative association with the BMG group. With respect to the PS group, no statistically significant association was observed. Emotional stress was the most important factor in the two study groups. Emotional stress and alcohol use together presented a higher incidence in the study groups than in the CG. Emotional stress and tobacco consumption together had a three times higher incidence in the PS group than in the BMG group. The association of emotional stress, alcohol and tobacco consumption in the PS group was four times higher than that in the CG. LIMITATIONS: This study was limited by the lack of the information about frequency, type and length time of use of tobacco and alcohol, and by difficult to measure stress thought self-report questionnaire. CONCLUSION: The interactions between PS and environmental factors differ from those between BMG and environmental factors. These differences among interactions may be responsible for different forms of manifestations of these diseases, considering being both the same disease.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Exposição Ambiental , Glossite Migratória Benigna/etiologia , Psoríase/etiologia , Fumar/efeitos adversos , Estresse Psicológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
11.
J Eur Acad Dermatol Venereol ; 29(5): 865-74, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25176018

RESUMO

BACKGROUND: Geographic tongue (GT) is the most frequent oral lesion in psoriatic patients (PP), and genetic involvement in these conditions has been described. The association of psoriasis with GT is still not clear, and the study of human leucocyte antigen (HLA) may help clarify this relation. OBJECTIVE: The aim of this study was to investigate the association of HLA alleles with psoriasis vulgaris and GT. METHODS: Fifty-eight Brazilian PP, 29 GT patients and 125 healthy controls individuals were selected. Information on demographic and clinical characteristics was collected. All patients underwent an oral examination and blood collection for HLA typing. RESULTS: HLA-A did not show significant differences in frequencies among the groups. HLA-B*57 allele was more frequently found in PP and was not found in GT. HLA-B*58 allele was more frequently found in GT. HLA-C*06 and -C*18 alleles were associated with psoriasis. No significant differences in HLA-DRB1 and HLA-DQB1 were observed. CONCLUSION: HLA-B*58 was associated with GT and HLA-B*57 was possibly associated with psoriasis. This suggested that some GT cases may represent true oral psoriasis and some may represent only GT. Therefore, it is necessary to make this distinction and increase our sample size to improve the correct diagnosis and treatment of these conditions.


Assuntos
Glossite Migratória Benigna/genética , Antígenos HLA/genética , Psoríase/genética , Adolescente , Adulto , Alelos , Estudos de Casos e Controles , Feminino , Glossite Migratória Benigna/imunologia , Antígenos HLA-A/genética , Antígenos HLA-B/genética , Antígenos HLA-C/genética , Cadeias beta de HLA-DQ/genética , Cadeias HLA-DRB1/genética , Humanos , Masculino , Pessoa de Meia-Idade , Psoríase/imunologia , Adulto Jovem
12.
Foot Ankle Surg ; 20(2): 140-3, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24796835

RESUMO

BACKGROUND: The aim of this study is to evaluate the role of hyperbaric oxygen in the treatment of diabetic foot ulcers. METHODS: We performed a retrospective observational study of all patients with diabetic foot ulcers treated at the Institution's hyperbaric chamber between January 2010 and August 2012. Patient data was obtained upon patient hospital visit and prospective clinical record consultation. RESULTS: Twenty-six foot lesions including 13 foot ulcers Wagner grade 2 or greater and 13 amputation stump ulcers were submitted to hyperbaric oxygen therapy between January 2010 and August 2012 in our Institution. Of these, 23 foot lesions completed treatment and complete epithelialization of the primary lesion was achieved in 15 (65%). The mean healing period since the first hyperbaric oxygen therapy session was 16 weeks. Above-ankle amputations were performed in 3 limbs and transmetatarsal amputations in 2 limbs. CONCLUSION: Hyperbaric oxygen may be associated with ulcer healing in selected diabetic foot ulcers with impaired cicatrization.


Assuntos
Cotos de Amputação , Pé Diabético/terapia , Oxigenoterapia Hiperbárica , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Úlcera da Perna/terapia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
13.
Cancer Treat Res Commun ; 39: 100804, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38508132

RESUMO

Despite the advancements in the treatment of localized pancreatic cancer, several unresolved issues persist in clinical practice, especially in the neoadjuvant setting. These include determining the criteria for selecting patients for treatment, identifying the most effective chemotherapy regimens, understanding the role of radiotherapy, and accurately assessing how patients respond to treatment. Current strategies for assessing patients before surgery involve thoroughly evaluating their overall health status, analyzing tumor markers, and using advanced imaging techniques. However, existing methods for staging the disease still have limitations when it comes to accurately detecting metastatic cancer. The ongoing debate between performing surgery upfront or administering neoadjuvant therapy highlights the need for robust clinical evidence to guide treatment decisions effectively. This review analyzes the evidence regarding controversial topics in neoadjuvant pancreatic cancer treatment and discusses further research efforts to enhance patient outcomes. To improve the outcomes found with surgery alone, multimodal treatment with chemotherapy.


Assuntos
Terapia Neoadjuvante , Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/terapia , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/tratamento farmacológico , Terapia Neoadjuvante/métodos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
14.
Hernia ; 28(4): 1451-1455, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38837073

RESUMO

Cord lipomas are frequent findings in laparoscopic inguinal hernia surgeries in male patients. The symptoms of lipoma and the potential benefits of removing them are often overlooked because the focus is on the primary pathology of the hernia itself. Current recommendations are to reduce this fatty content, when present. When inguinal cord lipomas are left untreated in inguinal hernia surgery they can potentially cause symptoms and be detected in follow-up imaging exams. The objective of this study was to study incidence of cord lipomas in a cohort operated on by a single group specializing in abdominal wall surgery, as well as to analyze the possible relationship of this finding with the patient's symptoms, the characteristics of the operated hernia and postoperative outcome. This is a prospective study of male patients operated on for inguinal hernia laparoscopically or robotically in a single reference center. Of the total of 141 hernias, the distribution according to European Hernia Society classification showed that 45.4% were lateral, 19.1% medial and 35.5% mixed, highlighting a variety in the presentation of hernias. Analysis of the size of the hernias revealed that the majority (35.5%) were ≤ 1.5 cm. Inguinal cord lipoma was present in 64.5% of the samples, with no statistically significant association between the presence of the lipoma and an indirect hernia sac or obesity. The incidence of surgical site occurrences (SSO) was 9,2%, with seroma and hematoma. No recurrences were observed during follow-up, indicating a successful approach. There were no statistically significant relationships between SSO, the presence of lipoma and indirect hernial sac.


Assuntos
Hérnia Inguinal , Herniorrafia , Laparoscopia , Lipoma , Humanos , Lipoma/cirurgia , Lipoma/patologia , Masculino , Estudos Prospectivos , Pessoa de Meia-Idade , Hérnia Inguinal/cirurgia , Idoso , Herniorrafia/métodos , Laparoscopia/métodos , Adulto , Procedimentos Cirúrgicos Robóticos , Idoso de 80 Anos ou mais
15.
Hernia ; 28(1): 53-61, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37563426

RESUMO

PURPOSE: Botulinum toxin type A (BTA) is an adjuvant tool used in the preoperative optimization of complex hernias before abdominal wall reconstruction (AWR). This study aims to investigate changes in the abdominal cavity and hernia sac dimensions after BTA application. METHOD: A prospective study with 27 patients with a hernia defect of ≥ 10 cm and loss of domain (LOD) ≥ 20% underwent AWR. Computed tomography (CT) measurements and volumetry before and after the application of BTA were performed. Intraoperative and postoperative outcomes were evaluated. RESULTS: Imaging post-BTA revealed hernia width reduction of 1.9 cm (p = 0.002), lateral abdominal wall muscle elongation of 3.1 cm (p < 0.001), hernia volume reduction (HV) from 2.9 ± 0.9L to 2.4 ± 0.8L (p < 0.001), increase in abdominal cavity volume (ACV) from 9.7 ± 2.5L to 10.3L ± 2.4L (p = 0.003), and a reduction in the HV/ACV ratio from 30.2 ± 5% to 23.4 ± 6% (p < 0.001). Fascial closure was achieved in 92.6% of cases and component separation was required in 78%. The average variation in pulmonary plateau pressure was 3.53 cmH2O, and there were no postoperative respiratory failure recorded. At the 90-day follow-up, the wound morbidity rate was 25%, unplanned readmissions were 11%, and hernia recurrence 7.4%. CONCLUSION: BTA produces measurable volumetric changes in abdominal wall and appears to facilitate fascial closure. Further studies are required to determine the role of BTA in the surgical armamentarium for complex hernia repair.


Assuntos
Parede Abdominal , Toxinas Botulínicas Tipo A , Hérnia Ventral , Humanos , Parede Abdominal/diagnóstico por imagem , Parede Abdominal/cirurgia , Hérnia Ventral/cirurgia , Estudos Prospectivos , Herniorrafia/métodos , Músculos Abdominais/cirurgia , Telas Cirúrgicas , Recidiva
16.
Res Sq ; 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38562683

RESUMO

Background: Cancer remains a leading cause of death worldwide and continues to disproportionately impact certain populations. Several frameworks have been developed that illustrate the multiple determinants of cancer. Expanding upon the work of others, we present an applied framework for cancer prevention and control designed to help clinicians, as well as public health practitioners and researchers, better address differences in cancer outcomes. Methods: The framework was developed by the Cancer Prevention and Control Research Network's Health Behaviors Workgroup. An initial framework draft was developed based on workgroup discussion, public health theory, and rapid literature review on the determinants of cancer. The framework was refined through interviews and focus groups with Federally Qualified Health Center providers (n=2) and cancer patients (n=2); participants were asked to provide feedback on the framework's causal pathways, completeness, and applicability to their work and personal life. Results: The framework provides an overview of the relationships between sociodemographic inequalities, social and structural determinants, and key risk factors associated with cancer diagnosis, survivorship, and cancer morbidity and mortality across the lifespan. The framework emphasizes how health-risk behaviors like cigarette smoking interact with psychological, psychosocial, biological, and psychosocial risk factors, as well as healthcare-related behavior and other chronic diseases. Importantly, the framework emphasizes addressing social and structural determinants that influence health behaviors to reduce the burden of cancer and improve health equity. Aligned with previous theory, our framework underscores the importance of addressing co-occurring risk factors and disease states, understanding the complex relationships between factors that influence cancer, and assessing how multiple forms of inequality or disadvantage intersect to increase cancer risk across the lifespan. Conclusions: This paper presents an applied framework for cancer prevention and control to address cancer differences. Because the framework highlights determinants and factors that influence cancer risk at multiple levels, it can be used to inform the development, implementation, and evaluation of interventions to address cancer morbidity and mortality.

17.
Transl Lung Cancer Res ; 13(5): 1163-1168, 2024 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-38854944

RESUMO

Background: MET rearrangements are infrequently observed in non-small cell lung cancer (NSCLC). Advanced genomic detection techniques have unveiled such infrequent genomic variations, particularly MET fusions in approximately 0.5% of NSCLC patients. Tyrosine kinase inhibitors (TKIs) have revolutionized the standard of care in lung cancer and more recently a second generation MET TKI tepotinib received Food and Drug Administration (FDA) approval for MET exon 14 alterations in metastatic NSCLC. Despite this, the therapeutic landscape for MET-rearranged NSCLC patients remains significantly unexplored. The aim of our report is to detail a unique case of a patient with metastatic lung adenocarcinoma with a novel HLA-DQB2::MET fusion detected by next-generation sequencing (NGS) following previous treatment resistance. Case Description: A 73-year-old female was initially started on carboplatin, pemetrexed and pembrolizumab with maintenance, but eventually had progression in the left upper lobe (LUL). Upon progression she was enrolled in a clinical trial of a monoclonal antibody with or without a PD-1 inhibitor, but brain metastasis progression was eventually detected by magnetic resonance imaging (MRI) requiring stereotactic radiosurgery (SRS) and a craniotomy. The trial drug was eventually discontinued due to progression and toxicity and NGS on bronchoscopy tissue revealed HLA-DQB2::MET fusion. The patient was initiated on tepotinib and continues with clinical and radiological stable disease for over 12 months. The patient's response to a MET inhibitor, tepotinib, underscores the potential efficacy of selective MET inhibitors for individuals with previously unexplored MET fusions. Conclusions: The positive response to tepotinib of a patient with NSCLC harboring a novel MET-Fusion underscores the importance of the use of comprehensive next-generational sequencing-based panels and highlights the necessity for additional research and clinical exploration of selective MET inhibitors for managing NSCLC with MET rearrangements.

18.
J Phys Condens Matter ; 36(13)2023 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-38086084

RESUMO

Ni-substituted Mn3Ga displays a weak ferromagnetism embedded in an antiferromagnetic (AF) phase. Upon field cooling, the alloy exhibits exchange bias and an open hysteresis loop, signifying kinetic arrest at room temperature. For the first time, a kinetic arrest is seen in a compound due to the first order transition of an embedded defect phase. A systematic study of crystal structure, local structure, and magnetic properties of Mn3-xNixGa (x= 0, 0.25) alloys reveal the origin of ferromagnetism in Mn2.75Ni0.25Ga is due to the segregation of a Heusler-type environment around Ni in the cubic Mn3Ga matrix. Upon temper annealing at 400∘C, these local structural defects around the Ni phase separate into a modulated ferromagnetic (FM) Ni-Mn-Ga Heusler phase. A strong interaction between the AF host and the FM defect phase gives rise to exchange bias. The first-order transition of the defect phase seems to be responsible for the observed kinetic arrest in Mn2.75Ni0.25Ga.

19.
Hernia ; 27(4): 807-818, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37329437

RESUMO

PURPOSE: Surgical repair of large hernia defects requires detailed pre-operative planning, particularly in cases with loss of domain. This situation often hampers mid-line reconstruction, even after component separation, when the size of the hernia is disproportional to the volume of the abdominal area. In this case, other strategies may be needed to place the viscera back into the abdominal cavity after reducing the hernia sac. The administration of botulinum toxin prior to the surgical procedure has been indicated as an adjunct for more complex cases. This results in stretching of the lateral musculature of the abdomen, allowing midline approximation. In addition, the application of botulinum toxin alone has been investigated as a means of downstaging in the management of ventral hernias, thereby precluding component separation and enabling primary closure of the midline by placement of mesh within the retromuscular space using the Rives Stoppa technique. METHODS: Systematic review of the literature for observational studies involving patients undergoing pre-operative application of botulinum toxin for ventral hernia repair was conducted according to the PRISMA guidelines. RESULTS: Advance of the lateral musculature of the abdomen by an average of 4.11 cm with low heterogeneity, as well as low rates of surgical site infection (SSI), surgical site occurrences (SSO) and recurrence, was shown. CONCLUSION: Pre-operative application of botulinum toxin for ventral hernia repair promoted an increase in the length of the lateral musculature of the abdomen which can help improve the outcomes of morbidity and recurrence.


Assuntos
Parede Abdominal , Toxinas Botulínicas Tipo A , Hérnia Ventral , Humanos , Parede Abdominal/cirurgia , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Telas Cirúrgicas , Hérnia Ventral/cirurgia , Recidiva
20.
JDS Commun ; 4(5): 406-411, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37727238

RESUMO

Two experiments were designed to evaluate the effects of altering body condition score (BCS) and the profile of a fatty acid (FA) supplement on the metabolism of Bos indicus Nellore females. In experiment 1, 16 and 24 B. indicus heifers and nonlactating cows, respectively, were assigned to (1) maintenance diet (MNT-MNT; n = 10), (2) maintenance diet and BCS loss (MNT-LSS; n = 10), (3) maintenance diet supplemented with calcium salts of soybean oil for 30 d and BCS loss for 40 d (MNT+CFA-LSS; n = 10), and (4) maintenance diet for 30 d and BCS loss for 40 d with a diet containing calcium salts of soybean oil (MNT-LSS+CFA; n = 10). Following the BCS loss period, MNT-LSS, MNT+CFA-LSS, and MNT-LSS+CFA were fed a diet to promote the gain of BCS. In experiment 2, 40 Bos indicus nulliparous heifers were assigned to (1) maintenance diet (MNT-MNT; n = 10), (2) BCS loss followed by a BCS gain (LSS-REM; n = 10), (3) BCS loss followed by a BCS gain diet with CFA of palm oil (LSS-REM+PLM; n = 10), and (4) BCS loss followed by a BCS gain diet with CFA of soybean oil (LSS-REM+SOY; n = 10). Blood samples were obtained for serum haptoglobin and fecal samples for pH (experiment 2 only). In experiment 1, a treatment × day interaction was observed for BCS during the 60-d BCS loss and gain period. Animals assigned to MNT-MNT had a greater BCS than the other treatment groups on d 40 and 60 of the experiment, but no other differences were observed. Moreover, a treatment × day interaction was observed for serum haptoglobin, as on d 60, MNT-LSS had a greater mean serum haptoglobin concentration. In experiment 2, a treatment × day interaction was also observed for BCS. From d -4 to 0, LSS-REM and LSS-REM+SOY had a reduced BCS versus MNT-MNT, but also lower for LSS-REM versus MNT-MNT on d 1, and LSS-REM+PLM versus MNT-MNT on d -1 and 0. For serum haptoglobin, no treatment or treatment × day interaction was observed. A treatment × day interaction was observed for fecal pH. From d -10 to 0, MNT often had a lower fecal pH, but during realimentation, LSS-REM heifers had a reduced fecal pH on d 1, 4, and 10. In summary, we failed to demonstrate an increase in serum haptoglobin due to a BCS loss. Still, supplementation with calcium salts of FA alleviated the increase in haptoglobin and maintained fecal pH at more stable values during realimentation, regardless of the FA profile of the supplement.

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