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1.
Bull Entomol Res ; 109(1): 43-53, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29463321

RESUMO

The olive fly, Bactrocera oleae (Rossi) (Diptera: Tephritidae), is a key-pest in the main olives producing areas worldwide, and displays distinct preference to different olive cultivars. The present work intended to study oviposition preference towards three Portuguese cultivars (Cobrançosa, Madural, and Verdeal Transmontana) at different maturation indexes. Multiple oviposition bioassays (multiple-choice and no-choice) were conducted to assess cultivar preference. No-choice bioassays were conducted to assess the influence of different maturation indexes (MI 2; MI 3, and MI 4) in single cultivars. The longevity of olive fly adults according to the cultivar in which its larvae developed was also evaluated through survival assays.Cultivar and maturation are crucial aspects in olive fly preference. Field and laboratory assays revealed a preference towards cv. Verdeal Transmontana olives and a lower susceptibility to cv. Cobrançosa olives. A higher preference was observed for olives at MI 2 and MI 3. The slower maturation process in cv. Verdeal Transmontana (still green while the other cultivars are reddish or at black stage) seems to have an attractive effect on olive fly females, thus increasing its infestation levels. Olive fly adults from both sexes live longer if emerged from pupae developed from cv. Verdeal Transmontana fruits and live less if emerged from cv. Cobrançosa. Therefore, olive cultivar and maturation process are crucial aspects in olive fly preference, also influencing the longevity of adults.


Assuntos
Olea/crescimento & desenvolvimento , Oviposição , Tephritidae/fisiologia , Animais , Feminino , Frutas/crescimento & desenvolvimento , Masculino , Especificidade da Espécie
2.
BMC Surg ; 19(1): 103, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391112

RESUMO

BACKGROUND: Recurrence after incisional hernia repair is one of the major problems related with this operation. Our objective is to analyze the influence of abdominal wall surgery expertise in the results of the open elective repair of incisional hernia. METHODS: We have compiled the data of a cohort of patients who received surgery for an incisional hernia from July 2012 to December 2015 in a University Hospital. Data were collected prospectively and registered in the Spanish Register of Incisional Hernia (EVEREG). The short- and long-term complications between the groups of patients operated on by the Abdominal Wall Surgery (AWS) unit and groups operated on by surgeons outside of the specialized abdominal wall group (GS) were compared. RESULTS: During the study period, a total of 237 patients were operated on by the open approach (114 AWS; 123 GS). One hundred seventy-five patients completed a median follow-up of 36.6 months [standard deviation (SD) = 6]. Groups were comparable in terms of age, sex, body mass index (BMI), comorbidities, and complexity of hernia. Complications were similar in both groups. Patients in the AWS group presented fewer recurrences (12.0% vs. 28.9%; P = 0.005). The cumulative incidence of recurrence was higher in the GS group [log rank 13.370; P < 0.001; odds ratio (OR) = 37.8; 95% confidence interval (CI) = 30.3-45.4]. In the multivariate analysis, surgery performed by the AWS unit was related to fewer recurrences (OR = 0.19; 95%CI = 0.07-0.58; P < 0.001). CONCLUSION: Incisional hernia surgery is associated with better results in terms of recurrence when it is performed in a specialized abdominal wall unit.


Assuntos
Parede Abdominal/cirurgia , Competência Clínica , Procedimentos Cirúrgicos Eletivos/métodos , Herniorrafia/métodos , Hérnia Incisional/cirurgia , Especialização , Adulto , Idoso , Procedimentos Cirúrgicos Eletivos/normas , Feminino , Seguimentos , Herniorrafia/normas , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Estudos Prospectivos , Recidiva , Resultado do Tratamento
3.
Bull Entomol Res ; 106(6): 701-709, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27063655

RESUMO

Carabid beetles are important predators in agricultural landscapes feeding on a range of prey items. However, their role as predators of the olive fruit fly, Bactrocera oleae (Rossi) (Diptera: Tephritidae), one of the most serious pests of olives, is unknown. In this context, the feeding preferences and the functional responses of two carabid beetle species, Calathus granatensis (Vuillefroy) and Pterostichus globosus (Fabricius), were studied under laboratory conditions. Feeding preference assays involved exposing carabid beetles to different ratios of B. oleae pupae and an alternative prey, the Mediterranean fruit fly, Ceratitis capitata (Wiedemann). Both species fed on B. oleae pupae however, C. granatensis always showed a significant preference for that prey whereas P. globosus switched to C. capitata pupae when the offered ratio was below 0.5. The total prey biomass consumed was significantly higher for P. globosus than for C. granatensis. Functional response curves were estimated based on different densities of B. oleae pupae and both carabid beetle species exhibited a type II functional response using Rogers' random-predator equation. P. globosus showed shorter handling time (1.223 ± 0.118 h) on B. oleae pupae than C. granatensis (3.230 ± 0.627 h). Our results suggest that both species can be important in reducing the densities of B. oleae in olive groves, although P. globosus was more efficient than C. granatensis.


Assuntos
Besouros/fisiologia , Comportamento Predatório , Tephritidae/fisiologia , Animais , Comportamento Alimentar , Controle Biológico de Vetores , Pupa/fisiologia , Especificidade da Espécie
4.
Bull Entomol Res ; 106(5): 695-9, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27296773

RESUMO

Bactrocera oleae (Rossi) (Diptera: Tephritidae) is considered the most devastating pest of the olive tree worldwide. In an effort to develop management and biological control strategies against this pest, new molecular tools are urgently needed. In this study, we present the design of B. oleae-specific primers based on mitochondrial DNA sequences of cytochrome oxidase subunit I (COI) gene. Two pairs of B. oleae-specific primers were successfully designed and named as SBo1-F/SBo1-R and SBo2-F/SBo1-R, being able to amplify 108 and 214 bp COI fragments, respectively. The specificity of designed primers was tested by amplifying DNA from phylogenetically related (i.e. Diptera order) and other non-pest insects living in olive groves from the Mediterranean region. When using these primers on a PCR-based diagnostic assay, B. oleae DNA was detected in the gut content of a soil-living insect, Pterostichus globosus (Fabricius) (Coleoptera: Carabidae). The detection of B. oleae DNA in the guts of arthropods was further optimized by adding bovine serum albumin enhancer to the PCR reaction, in order to get a fast, reproducible and sensitive tool for detecting B. oleae remains in the guts of soil-living arthropods. This molecular tool could be useful for understanding pest-predator relationships and establishing future biological control strategies for this pest.


Assuntos
Besouros/fisiologia , Reação em Cadeia da Polimerase/métodos , Tephritidae/genética , Animais , Primers do DNA , DNA Mitocondrial/análise , DNA Mitocondrial/química , Comportamento Alimentar , Olea , Controle Biológico de Vetores , Comportamento Predatório , Reprodutibilidade dos Testes , Solo , Especificidade da Espécie
5.
Hernia ; 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38771440

RESUMO

BACKGROUND: The aim of this study is to analyze the data collected on lateral incisional hernias (LIH) in the National Incisional Hernia Registry (EVEREG) and assess current practices and outcomes in LIH repair. METHODS: A retrospective cohort study was conducted using LIH data recorded over 10 years (2012-2022). Comorbidities, hernia characteristics, short-term complications, and recurrences were studied, along with their association with the type of approach used, either open or laparoscopic, in elective surgery. RESULTS: 1742 LIH cases were studied. According to the EHS classification, these included L1 409 (23.5%), L2 388 (22.3%), L3 565 (32.4%), L4 150 (8.6%) and combined 230 (13.2%). An open approach was performed in 1528 (87.7%) cases and laparoscopic in 214 (12.3%). The median age was 66 ± 12.45 years, with a majority of males, 934 (53.6%). The median body mass index was 29 ± 5.18 kg/m2. The most observed comorbidity was arterial hypertension (957 patients, 55%). A specialist was present in 638 interventions (56%). The 24-month follow-up was 17.9%, and recurrence in those cases was 27.2%, with a higher incidence when there was no specialist present during the intervention, onlay mesh position, and larger defect size. CONCLUSIONS: Surgery for LIH is common, although laparoscopic approach remains infrequent. Furthermore, it is associated with a high percentage of recurrences that increases when there is no specialist in abdominal wall surgery present.

6.
J Periodontal Res ; 47(6): 695-700, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22537145

RESUMO

BACKGROUND AND OBJECTIVE: A report describing the software Dental Image Analyzer (DIA) was published in this journal in 2009. A new function - measurement of the periodontal intrabony defect angle - was added to the software in 2010. The purpose of this study was to investigate whether measurements of the radiographic intrabony defect angle using digital radiographs and the newly developed DIA tool were comparable with measurements obtained using the conventional protractor method. MATERIAL AND METHODS: The baseline radiographic defect angle of intrabony defects was measured conventionally, using a protractor, in 60 selected teeth from 47 patients and then digitally using the newly developed DIA tool. The measurements were made independently by four experienced dentists. The radiographic defect angle of intrabony defects was measured after the three anatomical landmarks were identified, namely the cemento-enamel junction, the top of the crest and the bottom of the defect. RESULTS: Both methods showed a high interexaminer reliability for measurements of the radiographic defect angle of intrabony defects (intraclass correlation coefficient > 0.97). Moreover, both methods showed high reliability (intraclass correlation coefficient > 0.96). On the other hand, the new DIA tool, compared with the conventional method, exhibited high sensitivity (0.92) and high specificity (0.91) in selecting defects of ≥ 37° or < 37°. Analysis of the time taken for measurements revealed significant differences between the two methods, with the protractor method being more time consuming. CONCLUSIONS: This study provided evidence for the lack of a significant difference between the conventional method and the DIA tool for radiographic measurement of intrabony defects. However, digital analysis was significantly faster.


Assuntos
Perda do Osso Alveolar/diagnóstico por imagem , Periodontite Crônica/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/instrumentação , Radiografia Dentária Digital/instrumentação , Adulto , Precisão da Medição Dimensional , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Estatísticas não Paramétricas
7.
Eur Surg Res ; 49(3-4): 107-12, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23095250

RESUMO

PURPOSE: To assess the mental effort and physical discomfort of placement of a prosthetic mesh into the abdominal cavity with single-incision laparoscopic surgery (SILS) or multi-port laparoscopic access for incisional ventral hernia repair. METHODS: A total of 10 surgeons with previous experience in conventional laparoscopic surgery performed four surgical tasks through a multi-port laparoscopic access and a SILS access in a porcine model during a first 4-hour working session and a second 2-hour working session. These tasks included (a) introduction of a prosthetic mesh for abdominal wall surgery, (b) manipulation of the mesh inside the abdomen, (c) manipulation of the laparoscopic instruments and (d) mesh insertion to the intraperitoneal abdominal wall and fixation with tackers. The level of mental effort was assessed with the Subjective Mental Effort Questionnaire (SMEQ) and physical discomfort with the Local Experienced Discomfort Scale (LED). RESULTS: Seventy percent were men, with a mean age of 45 years and a mean of 18 years of experience in practicing surgery. The SMEQ questionnaire showed a median physical effort of 24.4 (range 9-36.1) points for the multi-port laparoscopic access and 107.4 (range 74.7-128.4) for SILS (p < 0.01). Statistically significant differences between multi-port laparoscopic surgery and SILS were consistently demonstrated in all tasks as well as in both the 4-hour and 2-hour working sessions. The median (interquartile range) score of the LED scale was 12.5 (2-34.5) for tasks during multi-port laparoscopic surgery and 53.5 (29-89.2) for SILS (p < 0.001). All individual tasks were associated with a significantly higher physical effort for SILS than for conventional laparoscopic access, which were also independent of being performed during the 4-hour or 2-hour working periods. CONCLUSIONS: Placement and manipulation of a prosthetic mesh for incisional ventral hernia repair is more difficult with SILS than using multi-port laparoscopic access, independently of previous experience with standard laparoscopic techniques. This greater difficulty was observed both in terms of mental effort and physical discomfort. More experimental and clinical studies are needed to define specific training aspects and clinical advantages of incisional ventral hernia repair through SILS.


Assuntos
Hérnia Ventral/cirurgia , Laparoscopia/métodos , Implantação de Prótese/métodos , Cavidade Abdominal/cirurgia , Adulto , Animais , Ergonomia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Telas Cirúrgicas , Suínos
8.
Hernia ; 26(5): 1231-1239, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34057625

RESUMO

INTRODUCTION: The objective was to assess the effectiveness and safety of a bioabsorbable mesh at the time of closure of a midline laparotomy for IH prevention. MATERIALS AND METHODS: A multicenter, randomized clinical trial including patients undergoing abdominal surgical procedures through a midline laparotomy incision was designed. In the group of mesh (n = 167) the incision was closed using a continuous polydioxanone suture (PDS) plus a bioabsorbable mesh. In the control group (n = 165) a continuous PDS single layer suture was only used. Patients were randomly assigned (1:1) to the two groups. The primary outcome was the incidence of IH at 6, 12 and 24 months. Assessment of IH was done using a CT scan. RESULTS: At 6 months, the rates of IH were 15.2% and 24.8% in the experimental and control groups, respectively (relative risk [RR] 0.66, 95% confidence interval [CI] 0.38-0.98, P = 0.042). At 12 months, the rate of IH continued to be significantly lower in the experimental group (21.4% vs. 33.1%, P = 0.033), but at 24 months, there were no significant differences between the study groups with a follow-up rate of only 37.5%. The number needed to treat (NNT) was 11 and 9 at 6 and 12 months, respectively. CONCLUSION: The bioabsorbable mesh significantly prevented IH during the first year. Not reliable conclusions can be drawn across the second year. This may suggest that the any of the closing technique assessed in this study would have a "palliative" transient effect for preventing IH in the long-term.


Assuntos
Técnicas de Fechamento de Ferimentos Abdominais , Hérnia Incisional , Técnicas de Fechamento de Ferimentos Abdominais/efeitos adversos , Implantes Absorvíveis , Herniorrafia/efeitos adversos , Humanos , Hérnia Incisional/epidemiologia , Hérnia Incisional/etiologia , Hérnia Incisional/prevenção & controle , Laparotomia/efeitos adversos , Polidioxanona , Telas Cirúrgicas/efeitos adversos
9.
Food Sci Technol Int ; 16(3): 209-16, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21339136

RESUMO

The antioxidant properties of almond green husks (Cvs. Duro Italiano, Ferraduel, Ferranhês, Ferrastar and Orelha de Mula), chestnut skins and chestnut leaves (Cvs. Aveleira, Boa Ventura, Judia and Longal) were evaluated through several chemical and biochemical assays in order to provide a novel strategy to stimulate the application of waste products as new suppliers of useful bioactive compounds, namely antioxidants. All the assayed by-products revealed good antioxidant properties, with very low EC(50) values (lower than 380 µg/mL), particularly for lipid peroxidation inhibition (lower than 140 µg/mL). The total phenols and flavonoids contents were also determined. The correlation between these bioactive compounds and DPPH (2,2-diphenyl-1-picrylhydrazyl) radical scavenging activity, reducing power, inhibition of ß-carotene bleaching and inhibition of lipid peroxidation in pig brain tissue through formation of thiobarbituric acid reactive substances, was also obtained. Although, all the assayed by-products proved to have a high potential of application in new antioxidants formulations, chestnut skins and leaves demonstrated better results.


Assuntos
Antioxidantes/química , Fagaceae/química , Extratos Vegetais/química , Folhas de Planta/química , Prunus/química , Peroxidação de Lipídeos
10.
BJS Open ; 4(3): 357-368, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32057193

RESUMO

BACKGROUND: Incisional hernia is a frequent complication after abdominal surgery. The aim of this study was to assess the efficacy of prophylactic mesh reinforcement (PMR) after midline laparotomy in reducing the incidence of incisional hernia. METHODS: A meta-analysis was conducted following PRISMA guidelines. The primary outcome was the incidence of incisional hernia after follow-up of at least 12 months. Secondary outcomes were postoperative complications. Only RCTs were included. A random-effects model was used for the meta-analysis, and trial sequential analysis was conducted. RESULTS: Twelve RCTs were included, comprising 1815 patients. The incidence of incisional hernia was significantly lower after PMR compared with sutured closure (risk ratio (RR) 0·35, 95 per cent c.i. 0·21 to 0·57; P < 0·001). Both onlay (RR 0·26, 0·11 to 0·67; P = 0·005) and retromuscular (RR 0·28, 0·10 to 0·82; P = 0·02) PMR led to a significant reduction in the rate of incisional hernia. The occurrence of seroma was higher in patients who had onlay PMR (RR 2·23, 1·10 to 4·52; P = 0·03). PMR did not result in an increased rate of surgical-site infection. CONCLUSION: PMR of a midline laparotomy using an onlay or retromuscular technique leads to a significant reduction in the rate of incisional hernia in high-risk patients. Individual risk factors should be taken into account to select patients who will benefit most. [Correction added on 19 February 2020, after first online publication: J. García Alamino has been amended to J. M. Garcia-Alamino].


ANTECEDENTES: La eventración (hernia incisional) es una complicación frecuente de la cirugía abdominal. El objetivo es evaluar la eficacia de la inserción de una malla profiláctica de refuerzo (prophylactic mesh reinforcement, PMR) después de la laparotomía media para reducir la incidencia de eventración. MÉTODOS: Se realizó un metaanálisis siguiendo las recomendaciones PRISMA. La variable principal fue la incidencia de eventración después de un seguimiento mínimo de 12 meses. Las variables secundarias fueron las complicaciones postoperatorias. Solo se incluyeron ensayos controlados aleatorizados. Se utilizó un modelo de efectos aleatorios para el metaanálisis y se realizó un análisis secuencial de los ensayos. RESULTADOS: Se incluyeron 12 ensayos aleatorizados y controlados con 1.815 pacientes. La incidencia de eventración fue significativamente menor después de la PMR en comparación con el cierre simple (riesgo relativo, RR 0,35; i.c. del 95%: 0,21-0,57, P < 0,0001). Hubo una reducción significativa de la tasa de eventración tanto si la PMR se colocó en posición supra-aponeurótica (RR 0,26; i.c. del 95% 0,11-0,67, P = 0,005) como retromuscular (RR 0,28; i.c. del 95% 0,0-0,82, P = 0,02). La aparición de seromas fue mayor en los pacientes con RPM supra-aponeurótica (RR 2,23; i.c. del 95% 1,10-4,52, P = 0,03). La PMR no conllevó una mayor tasa de infecciones de la herida quirúrgica. CONCLUSIÓN: Una PMR en una laparotomía de la línea media, tanto en posición supra-aponeurótica como retromuscular, reduce de forma significativa el desarrollo de eventraciones en pacientes de alto riesgo. Se deben considerar los factores de riesgo individuales para seleccionar a los pacientes que más puedan beneficiarse.


Assuntos
Técnicas de Fechamento de Ferimentos Abdominais/instrumentação , Hérnia Abdominal/prevenção & controle , Hérnia Incisional/prevenção & controle , Telas Cirúrgicas , Técnicas de Sutura/efeitos adversos , Técnicas de Fechamento de Ferimentos Abdominais/efeitos adversos , Aneurisma da Aorta Abdominal/complicações , Hérnia Abdominal/diagnóstico , Hérnia Abdominal/etiologia , Humanos , Hérnia Incisional/diagnóstico , Hérnia Incisional/etiologia , Laparotomia/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Seroma/etiologia , Infecção da Ferida Cirúrgica/etiologia , Resultado do Tratamento
11.
12.
Food Res Int ; 123: 771-778, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31285027

RESUMO

The present work details the nutritional and chemical compositions of borage and centaurea, at three flowering stages. Water was the main constituent, followed by total dietary fiber. Both flowers showed statistically different (p < 0.05) nutritional and chemical profiles, although in both, polyunsaturated fatty acids (PUFAs) (mainly linoleic and α-linolenic acids), free sugars (3.9-28.9% dw as fructose, glucose, and sucrose), tocopherols (with the major contribution of α-tocopherol from 1.24 to 2.75 mg/100 g dw), carotenoids (0.2-181.4 mg/100 g dw, mainly as lutein), and organic acids (6.1-14.4 g/100 g dw, mainly malic, succinic, and citric acids) were quantified. Concerning flowering, significant differences (p < 0.05) were found for some components, particularly carotenoids; however, no specific trend was observed in either of the two flower species. Thus, the present study shows that each flower species, as well as their flowering stages, may have different phytochemical and nutritional compositions.


Assuntos
Borago/química , Centaurea/química , Flores/química , Compostos Fitoquímicos/análise , Carotenoides/análise , Fibras na Dieta/análise , Ácidos Graxos Insaturados/análise , Valor Nutritivo , Tocoferóis/análise , alfa-Tocoferol/análise
13.
Br J Surg ; 95(8): 961-7, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18618893

RESUMO

BACKGROUND: Transient recurrent laryngeal nerve palsy affects to 5-10 per cent of patients after extracapsular thyroidectomy. This prospective study assessed the impact of surgical injury and extralaryngeal branching of the inferior laryngeal nerve (ILN) on vocal cord dysfunction (VCD). METHODS: Total thyroidectomy or lobectomy was performed in 188 patients, with 302 ILNs at risk. The anatomy of the ILN and degree of injury to the nerve, based on the Laryngeal Nerve Injury Score (LNIS), were recorded. Fibreoptic laryngoscopy was performed a mean(s.d.) of 10.6(4.1) days after thyroidectomy. RESULTS: Some 37.4 per cent of ILNs showed extralaryngeal branching. In all, 10.9 per cent of patients developed VCD; 4.3 per cent had paresis and 6.6 per cent paralysis. All paretic and all but one paralytic cords recovered fully after 61(17) days. VCD was more frequently associated with branched than non-branched ILNs (15.8 versus 8.1 per cent; P = 0.022). Injuries were more common in branched nerves (mean(s.e.m.) total LNIS 0.94(0.08) versus 0.51(0.05); P < 0.001). Branched nerves were more likely to be associated with VCD (odds ratio 2.2 (95 per cent confidence interval 1.1 to 4.5)). CONCLUSION: Branched ILNs suffer more surgical injuries and are twice as likely to be associated with VCD.


Assuntos
Traumatismos do Nervo Laríngeo Recorrente , Tireoidectomia/efeitos adversos , Paralisia das Pregas Vocais/etiologia , Feminino , Humanos , Complicações Intraoperatórias/etiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Recidiva , Nervo Laríngeo Recorrente/anatomia & histologia , Nervo Laríngeo Recorrente/fisiopatologia , Fatores de Risco , Paralisia das Pregas Vocais/fisiopatologia
14.
Hernia ; 22(6): 921-939, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30178226

RESUMO

PURPOSE: To provide guidelines for all surgical specialists who deal with the open abdomen (OA) or the burst abdomen (BA) in adult patients both on the methods used to close the musculofascial layers of the abdominal wall, and regarding possible materials to be used. METHODS: The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach including publications up to January 2017. When RCTs were available, outcomes of interest were quantitatively synthesized by means of a conventional meta-analysis. When only observational studies were available, a meta-analysis of proportions was done. The guidelines were written using the AGREE II instrument. RESULTS: For many of the Key Questions that were researched, there were no high quality studies available. While some strong recommendations could be made according to GRADE, the guidelines also contain good practice statements and clinical expertise guidance which are distinct from recommendations that have been formally categorized using GRADE. RECOMMENDATIONS: When considering the OA, dynamic closure techniques should be prioritized over the use of static closure techniques (strong recommendation). However, for techniques including suture closure, mesh reinforcement, component separation techniques and skin grafting, only clinical expertise guidance was provided. Considering the BA, a clinical expertise guidance statement was advised for dynamic closure techniques. Additionally, a clinical expertise guidance statement concerning suture closure and a good practice statement concerning mesh reinforcement during fascial closure were proposed. The role of advanced techniques such as component separation or relaxing incisions is questioned. In addition, the role of the abdominal girdle seems limited to very selected patients.


Assuntos
Parede Abdominal/cirurgia , Técnicas de Fechamento de Ferimentos Abdominais , Europa (Continente) , Fasciotomia , Humanos , Tratamento de Ferimentos com Pressão Negativa , Complicações Pós-Operatórias/prevenção & controle , Transplante de Pele , Sociedades Médicas , Telas Cirúrgicas
15.
Urol Oncol ; 36(7): 345, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29880459

RESUMO

BACKGROUND: Carcinoma in situ (CIS) is a poor prognostic finding in urothelial carcinoma. However, its significance in muscle-invasive urothelial carcinoma (MIUC) treated with neoadjuvant chemotherapy (NAC) is uncertain. We assessed the effect of CIS found in pretreatment transurethral resection of bladder tumor (TURBT) biopsies on the pathologic and clinical outcomes. MATERIALS AND METHODS: Subjects with MIUC treated with NAC before cystectomy were identified. The pathologic complete response (pCR) rates stratified by TURBT CIS status were compared. The secondary analyses included tumor response, progression-free survival (PFS), overall survival (OS), and an exploratory post hoc analysis of patients with pathologic CIS only (pTisN0) at cystectomy. RESULTS: A total of 137 patients with MIUC were identified. TURBT CIS was noted in 30.7% of the patients. The absence of TURBT CIS was associated with a significantly increased pCR rate (23.2% vs. 9.5%; odds ratio = 4.08; 95% CI: 1.19-13.98; P = 0.025). Stage pTisN0 disease was observed in 19.0% of the TURBT CIS patients. TURBT CIS status did not significantly affect the PFS or OS outcomes. Post hoc analysis of the pTisN0 patients revealed prolonged median PFS (104.5 vs. 139.9 months; P = 0.055) and OS (104.5 vs. 152.3 months; P = 0.091) outcomes similar to those for the pCR patients. CONCLUSION: The absence of CIS on pretreatment TURBT in patients with MIUC undergoing NAC was associated with increased pCR rates, with no observed differences in PFS or OS. Isolated CIS at cystectomy was frequently observed, with lengthy PFS and OS durations similar to those for pCR patients. Further studies aimed at understanding the biology and clinical effect of CIS in MIUC are warranted.


Assuntos
Carcinoma de Células de Transição/cirurgia , Terapia Neoadjuvante , Carcinoma in Situ , Cistectomia , Humanos , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento , Neoplasias da Bexiga Urinária/cirurgia
16.
Acta Trop ; 103(3): 157-62, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17631264

RESUMO

The authors analysed laboratory samples testing positive for rabies virus collected between 2000 and 2005 from Santa Cruz de la Sierra, Bolivia, to assess the spatial and spatio-temporal distribution of the endemic of canine rabies. According to the results of the spatial analysis, canine rabies was not evenly distributed in the city. Significant spatio-temporal clustering of canine rabies cases showed a trend towards clusters with high incidence rates in two particular areas compared with surrounding areas in the city. Benefits obtained from each of the analytical techniques utilised are described and practical difficulties in conducting and interpreting the results are discussed.


Assuntos
Doenças do Cão/epidemiologia , Doenças do Cão/virologia , Doenças Endêmicas/veterinária , Raiva/veterinária , Animais , Bolívia/epidemiologia , Cães , Raiva/epidemiologia , Vírus da Raiva/isolamento & purificação
18.
Mar Pollut Bull ; 118(1-2): 403-406, 2017 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-28279503

RESUMO

The Furo of Laura is an economically important river in the Amazon estuary. Thus, in the present study, we evaluated the metal distribution (Al, Cd, Co, Cu, Cr, Fe, Ni, and Mg) in the bottom sediments of this river. The sediments were sampled at four points every 2months for a year with an Ekman-Birge sampler. After microwave acid digestion, the metal levels were determined by optical emission spectrometry with inductively coupled plasma. The particle size and organic matter content influenced the concentration of the metals. The sediments were not enriched by the analyzed metals; the estuary therefore retained the characteristics of an uncontaminated environment, thus serving as a reference environment for comparison.


Assuntos
Monitoramento Ambiental , Estuários , Sedimentos Geológicos/química , Metais Pesados/análise , Poluentes Químicos da Água/análise , Brasil , Tamanho da Partícula , Rios/química
19.
J Clin Neurosci ; 31: 76-80, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27183958

RESUMO

Acute multifocal placoid pigment epitheliopathy (AMPPE) is an autoimmune chorioretinal disease that can be complicated by neurological involvement. There is limited information on this potentially treatable condition in the neurological literature. The objective of this patient series is to describe the neurological complications of AMPPE. We retrospectively identified patients with neurological complications of AMPPE seen at Auckland Hospital between 2008 and 2013 and summarised cases in the literature between 1976 and 2013. We identified five patients with neurological complications of AMPPE at Auckland Hospital and 47 reported patients. These patients demonstrated a spectrum of neurological involvement including isolated headache, stroke or transient ischaemic attack, seizures, venous sinus thrombosis, optic neuritis, sensorineural hearing loss and peripheral vestibular disorder. We propose criteria to define AMPPE with neurological complications. A cerebrospinal fluid (CSF) lymphocytosis in a patient with isolated headache may predict the development of cerebrovascular complications of AMPPE. Patients with cerebrovascular complications of AMPPE have a poor prognosis with high rates of death and neurological disability among survivors. Predictors of poor outcome in those who develop neurological complications of AMPPE are a relapsing course, generalised seizures and multifocal infarction on MRI. All patients with neurological complications of AMPPE, including headache alone, should be investigated with an MRI brain and CSF examination. Patients with focal neurological symptoms should receive intravenous (IV) methylprednisolone followed by a tapering course of oral steroids for at least 3months. Patients with AMPPE and an isolated headache with a CSF pleocytosis should be treated with oral steroids.


Assuntos
Doenças Autoimunes/complicações , Corioidite/complicações , Doenças do Sistema Nervoso/etiologia , Doenças Retinianas/complicações , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética/efeitos adversos , Masculino , Coroidite Multifocal
20.
Meat Sci ; 101: 33-41, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25462380

RESUMO

Morcela de Arroz (MA), a popular Portuguese blood sausage, with high pH and water activity (aw), is traditionally commercialized without preservatives and unpacked. This study evaluated the best packaging solution to extend MA shelf life stored at 4±1°C for 44days: without packaging (WP), vacuum (VP) and modified atmosphere packaging (MAP) (80% CO2; 20% N2). Mesophilic (MTVC), psychrotrophic (PTVC), lactic acid bacteria (LAB), pseudomonads, molds and yeasts, Enterobacteriaceae, Listeria monocytogenes, Salmonella spp., Bacillus cereus, Clostridium perfringens, sensory properties, pH, moisture and aw were studied. Moisture and aw decreased (p<0.05) in WP. pH decreased in WP and MAP during storage. MTVC and PTVC counts increased to values around 7logCFU/g at 44days of storage. LAB and Enterobacteriaceae counts were higher (p<0.05) in VP. Pseudomonads were inhibited (p<0.05) by MAP after 8days of storage. Sensory parameters were affected (p<0.05) by packaging and storage time. Globally, MAP performed better.


Assuntos
Atmosfera , Bactérias/crescimento & desenvolvimento , Culinária , Embalagem de Alimentos/métodos , Conservação de Alimentos/métodos , Produtos da Carne/análise , Animais , Contagem de Colônia Microbiana , Qualidade de Produtos para o Consumidor , Microbiologia de Alimentos , Armazenamento de Alimentos/métodos , Fungos/crescimento & desenvolvimento , Humanos , Concentração de Íons de Hidrogênio , Produtos da Carne/microbiologia , Produtos da Carne/normas , Odorantes , Portugal , Suínos , Paladar , Vácuo , Água
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