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1.
J Biomed Mater Res B Appl Biomater ; 112(10): e35485, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39324392

RESUMO

The development of new wound dressings made from biomaterials, which offer a better cost-benefit ratio and accelerate the healing process, is increasing nowadays. Various biopolymers can be electrospun to form functional membranes for wound healing. Therefore, in this study, chitosan and nanochitosan membranes with or without hyaluronic acid were prepared using the electrospinning technique, characterized and evaluated in the healing of skin wounds in rats. Chitosan and nanochitosan solutions, with or without hyaluronic acid, were prepared at concentrations of 1%-4% using PEO (polyethylene oxide) and subjected to the electrospinning process to obtain membranes characterized by scanning electron microscopy (SEM), mechanical tests, and antimicrobial activity. The healing effect of the membranes was evaluated by monitoring the area of the lesions, contraction of the wounds, histologic analysis, and induction of pro-inflammatory cytokine (IL-1 α and TNF-α) production in rats. The nanochitosan and nanochitosan membranes with hyaluronic acid achieved greater fiber diameter and uniformity, resistance, elasticity, and thermal stability, in addition to good adhesion to the wound bed and permeation capacity. Despite not presenting antimicrobial activity in vitro, they contributed to the production of pro-inflammatory interleukins in the animals tested, provided physical protection, reduced the wound area more markedly until the seventh day of the evaluation, with an acceleration of the healing process and especially when functionalized with hyaluronic acid. These results indicate that the membranes may be promising for accelerating the healing process of chronic wounds in humans.


Assuntos
Quitosana , Ácido Hialurônico , Membranas Artificiais , Pele , Cicatrização , Quitosana/química , Quitosana/farmacologia , Animais , Ácido Hialurônico/química , Ácido Hialurônico/farmacologia , Cicatrização/efeitos dos fármacos , Ratos , Pele/lesões , Pele/metabolismo , Masculino , Ratos Wistar , Bandagens
2.
Dent J (Basel) ; 12(9)2024 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-39329852

RESUMO

This study aimed to evaluate the effects of sodium hypochlorite (NaOCl), chlorhexidine (CHX), and the glycolic extract of propolis (GEP) as endodontic irrigants and of calcium hydroxide [Ca(OH)2], CHX, or Ca(OH)2 + CHX as intracanal medications on the capacity of the lipoteichoic acid (LTA) of Enterococcus faecalis in macrophages' proinflammatory cytokines production. Freshly extracted 108 human single-rooted teeth were used in this study. The LTA of E. faecalis was standardized in double-distilled pyrogen-free water (250 µg/mL) and inoculated into the specimens subdivided into nine subgroups (n = 12). Cultures of murine macrophages (RAW 264.7) were treated with 30 µL of each sample collected from root canals and incubated (37 °C, 5% CO2) for 24 h. Lastly, anti-TNF-α, anti-IL-6, anti-IP-10, anti-MIP-1α, anti-G-CSF, and anti-IL-1ß DuoSet kits were used to perform an ELISA assay. Data were analyzed using one-way ANOVA and Tukey test (p ≥ 0.05). It was found that 1% NaOCl was the most effective irrigant in reducing the capacity of LTA in cytokines production, followed by 12% GEP and 2% CHX, respectively. Ca(OH)2 + CHX presented the best results when associated with NaOCl or GEP. Thus, NaOCl or GEP associated with Ca(OH)2 + CHX were effective in reducing the capacity of LTA in different macrophages pro-inflammatory cytokines production.

3.
Gerodontology ; 2024 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-39076134

RESUMO

INTRODUCTION: Home care provided by dentists is crucial for ensuring adequate oral care. However, oral health professionals face challenges in delivering treatment at patients' residences due to a lack of resources. Our objective was to explore dentists' perspectives and experiences of dental home care and potential challenges for its implementation. METHODS: The study took a qualitative approach. Guided by a semi-structured interview schedule, data were gathered using recorded interviews with 22 dental professionals. After transcription, data were analysed thematically using the Discourse of the Collective Subject (DCS) method, using Qualiquantisoft. RESULTS: The majority of participants were female (n = 20), aged between 30 and 40 years old, and predominantly specialising in primary care (n = 6) or endodontics (n = 6). All participants provided home care, performing general dental procedures, normally responding to requests from the work team (n = 13) or family (n = 7). Six main categories on to the topic emerged: importance and access to home care, procedures performed during home visits, discussions about post-home care, professional competence and patient-centred care, positive aspects of home care, and negative aspects and challenges faced in this type of care. CONCLUSION: This study highlights the fundamental, yet complex, role of home care in dentistry. Continuity of treatment through adaptability and a patient-centred approach are important.

4.
Front Vet Sci ; 11: 1424960, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39076303

RESUMO

Maternal status during the transition period can significantly impact the health and performance of Holstein dairy calves, with lasting effects on various variables. However, the relationship between maternal late gestation metabolic status, seasonality, and their impact on offspring remains unclear. This study aimed to assess the influence of maternal variables at calving on the performance, metabolism, and immunity of 28 dairy calves during their first month of life. Blood samples were collected from 28 Holstein cows at calving. Median results for maternal variables including non-esterified fatty acids (NEFA), ß-hydroxybutyrate (BHB), glucose, total protein (TP), albumin, triglycerides (TG), total cholesterol (TC), haptoglobin (Hp), body weight (BW), and body condition score (BCS) were determined. These median values served as a basis for categorizing the offspring into two groups based on their dams' high or low degree of each maternal variable. Additionally, calves were categorized by the season of birth (Spring vs. Winter), with 14 in each. Blood samples were collected from the calves at birth and on days 1, 7, 14, and 28 to assess IgG, biochemical parameters, and haptoglobin concentration. Reactive oxygen species (ROS) production by polymorphonuclear cells stimulated by various agents was also evaluated. Clinical assessments were conducted for diarrhea and bovine respiratory disease frequencies. Despite the overall health of the cows, differences were observed in the calves between maternal groups. Heavier cows with high maternal BCS tended to have larger offspring, while high maternal BCS was associated with increased diarrhea prevalence. Low maternal BCS resulted in a stronger innate immune response, indicated by higher ROS production. Calves from cows experiencing metabolic changes during calving displayed elevated Hp concentrations. Spring-born calves were larger but had lower serum IgG concentration and reduced innate immune response compared to winter-born calves. Additionally, spring-born calves exhibited higher Hp and increased diarrhea prevalence on day 28. These findings underscore the importance of the prenatal period in determining neonatal health and suggest further research to elucidate the long-term clinical implications of maternal effects on offspring health and growth. Investigating offspring constituents later in life can provide insight into the persistence of maternal effects over time.

5.
Mol Ecol ; 33(14): e17431, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38877815

RESUMO

The South American Dry Diagonal, also called the Diagonal of Open Formations, is a large region of seasonally dry vegetation extending from northeastern Brazil to northern Argentina, comprising the Caatinga, Cerrado, and Chaco subregions. A growing body of phylogeography literature has determined that a complex history of climatic changes coupled with more ancient geological events has produced a diverse and endemic-rich Dry Diagonal biota. However, the exact drivers are still under investigation, and their relative strengths and effects are controversial. Pleistocene climatic fluctuations structured lineages via vegetation shifts, refugium formation, and corridors between the Amazon and Atlantic forests. In some taxa, older geological events, such as the reconfiguration of the São Francisco River, uplift of the Central Brazilian Plateau, or the Miocene inundation of the Chaco by marine incursions, were more important. Here, we review the Dry Diagonal phylogeography literature, discussing each hypothesized driver of diversification and assessing degree of support. Few studies statistically test these hypotheses, with most support drawn from associating encountered phylogeographic patterns such as population structure with the timing of ancient geoclimatic events. Across statistical studies, most hypotheses are well supported, with the exception of the Pleistocene Arc Hypothesis. However, taxonomic and regional biases persist, such as a proportional overabundance of herpetofauna studies, and the under-representation of Chaco studies. Overall, both Pleistocene climate change and Neogene geological events shaped the evolution of the Dry Diagonal biota, though the precise effects are regionally and taxonomically varied. We encourage further use of model-based analyses to test evolutionary scenarios, as well as interdisciplinary collaborations to progress the field beyond its current focus on the traditional set of geoclimatic hypotheses.


Assuntos
Filogeografia , Mudança Climática , América do Sul , Biodiversidade , Clima Tropical
6.
Artigo em Inglês | MEDLINE | ID: mdl-38791748

RESUMO

This study investigated the impact of home care, health status, and cognition. A qualitative and quantitative approach was employed through a cross-sectional study with a sample of 60 elderly individuals in need of home care in the municipality of Itatiba, São Paulo, Brazil. The analysis utilized the Discourse of the Collective Subject (DCS), EQ-5D, EQ VAS, and Mini-Mental State Examination (MMSE). The sample consisted of 40.0% male and 60.0% female individuals. The majority (61.6%) received weekly visits, mainly from community health agents, who were responsible for the majority of the care (45%). Positive considerations were highlighted, with 36.6% emphasizing the contribution to treatment continuity. The EQ VAS assessment indicated a moderately good perception of health. The EQ-5D analysis revealed significant differences between genders in personal care (p = 0.04). There were significant differences between clinical characteristics and EQ-5D dimensions, such as neoplasia and reduced mobility (p = 0.04), and arthritis/osteoarthritis/rheumatism and a limitation in common activities (p = 0.01). The presence of anxiety/depression was significant in cases of neoplasia (p = 0.006), arthritis/osteoarthritis/rheumatism (p = 0.01), and stroke (p = 0.04). The logistic regression analysis showed associations between usual activities and arthritis, osteoarthritis, rheumatism (p = 0.034), pain/malaise and arthritis, osteoarthritis, rheumatism (p = 0.038), and anxiety/depression and stroke (p= 0.028). The average MMSE scores (17.52) suggested a mild cognitive impairment, with no statistical differences between genders. Based on these results, it can be concluded that home care can provide a comprehensive approach and continuous assistance, emphasizing the importance of personalized care based on perceived and clinical differences.


Assuntos
Cognição , Serviços de Assistência Domiciliar , Qualidade de Vida , Humanos , Masculino , Feminino , Idoso , Serviços de Assistência Domiciliar/estatística & dados numéricos , Estudos Transversais , Idoso de 80 Anos ou mais , Brasil , Nível de Saúde , Pessoa de Meia-Idade , Percepção
7.
Cell Biol Int ; 48(6): 898-906, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38511230

RESUMO

The limitations of current imaging methods to detect small or superficial endometriotic lesions prompt the search for new molecular targets. TSPO is an 18 KDa protein located in the outer mitochondrial membrane, which can be traced by positron emission tomography (PET) using specific ligands. TSPO is located mostly in neurons and inflammatory sites outside the brain. We hypothesized that it might also be expressed in the human endometrium and endometrial-like tissue, being a target for molecular imaging of endometriosis. This prospective cross-sectional study included 28 women with endometriosis and 11 endometriosis-free controls. Endometriotic lesions (n = 49) and normal peritoneum (n = 13) from endometriosis patients were obtained during laparoscopy, while samples of eutopic endometrium from patients with endometriosis (n = 28) and from control women (n = 11) were collected in the operating room using a flexible device. TSPO mRNA expression was evaluated by quantitative reverse-transcription real-time PCR while protein expression was evaluated by immunohistochemistry with a monoclonal antibody antihuman TSPO. TSPO mRNA expression was detected in an invariable fashion in all tissue types evaluated; however, TSPO protein was found to be more abundant in the glandular epithelium than in the stroma, both in the endometrium and in the endometriotic lesions. Interestingly, hormone therapies did not alter the expression of TSPO, and its presence was mostly negative in tissues adjacent to endometriotic implants. As a proof of concept, the protein expression pattern of TSPO in endometriotic tissue and along the adjacent areas suggests that TSPO-based molecular imaging might be used for noninvasive endometriosis detection.


Assuntos
Endometriose , Endométrio , Receptores de GABA , Humanos , Endometriose/metabolismo , Endometriose/diagnóstico , Feminino , Receptores de GABA/metabolismo , Receptores de GABA/genética , Endométrio/metabolismo , Adulto , Estudos Transversais , Estudos Prospectivos , Pessoa de Meia-Idade , RNA Mensageiro/metabolismo , RNA Mensageiro/genética , Imuno-Histoquímica , Tomografia por Emissão de Pósitrons
8.
Int J Oral Maxillofac Implants ; 39(1): 50-56, 2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38416000

RESUMO

PURPOSE: To evaluate the effect of supraphysiologic administration of testosterone in an early and late model of implant osseointegration in rat tibiae. MATERIALS AND METHODS: A total of 40 rats were randomly allocated into four groups (n = 10/ group), which were divided according to the type of experiment and time of osseointegration: (1) vehicle (14 days), (2) testosterone (14 days), (3) vehicle (42 days), and (4) testosterone (42 days). Testosterone cypionate (7.5 mg/kg) administration started 4 weeks before implant placement, and the injections were performed daily until euthanasia. Machined-surface titanium implants (2.2 mm in diameter and 4 mm high) were placed bilaterally in the tibia of animals 28 days after the first testosterone injection. At days 14 and 42 after implant placement, euthanasia was performed and the tibiae were harvested to perform biomechanical evaluation and histomorphometric analysis of bone-to-implant contact (BIC%) and bone between the threads (BBT%). RESULTS: There was no statistical difference in the removal torque of the implants between the groups treated with the vehicle (control group) or testosterone (P > .05). At 14 days of osseointegration, the BIC% and BBT% did not differ between vehicle or testosterone groups (P > .05), while at 42 days, both the BIC% and BBT% were significantly reduced by testosterone compared to the vehicle group (P < .05). CONCLUSIONS: Testosterone cypionate in supraphysiologic dose impaired late-phase osseointegration in rat tibiae.


Assuntos
Osseointegração , Testosterona , Masculino , Animais , Ratos , Software , Tíbia/cirurgia , Titânio
9.
Clin Oral Investig ; 28(1): 89, 2024 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-38217802

RESUMO

OBJECTIVE: To evaluate the osseointegration of implants with hydrophobic (HFB) and hydrophilic (HFL) surfaces in a murine model of high-dose bisphosphonates (BPs). MATERIALS AND METHODS: Sixty-four rats were randomly allocated into four groups: control group with HFB implants (CG-HFB), control group with HFL implants (CG-HFL), BP group with HFB implants (BP-HFB), and BP group with HFL implants (BP-HFL). Animals were euthanized after 15 and 45 days (n=8). The dependent variables assessed were the removal torque (biomechanical analysis), the bone volume around the implants (%BV/TV) (microtomographic analysis), the bone-implant contact (%BIC), the bone between the threads (%BBT) (histomorphometric analysis), and the expression of bone metabolism markers (immunohistochemistry analysis). RESULTS: The CG-HFL and BP-HFL groups presented higher removal torque than the CG-HFB and BP-HFB implants. The %BIC of the CG-HFL surfaces was slightly higher than that of the CG-HFB implants. The BP-HFB and BP-HFL groups presented a higher %BIC than that of the CG-HFB and CG-HFL groups (p<0.001). BP therapy also increased the %BBT at both implant surfaces. Higher levels of ALP were observed in the matrix region of bone tissue on the HFL surfaces than on the HFB surfaces. CONCLUSION: Both surfaces enable osseointegration in rats under BP therapy. CLINICAL RELEVANCE: The study demonstrates that hydrophobic (HFB) and hydrophilic (HFL) implant surfaces can promote osseointegration in rats undergoing bisphosphonate therapy. The HFL surfaces exhibited improved biomechanical performance, higher bone-implant contact, and increased bone volume, suggesting their potential clinical relevance for implant success in individuals on bisphosphonate treatment.


Assuntos
Implantes Dentários , Ratos , Camundongos , Animais , Osteogênese , Difosfonatos/farmacologia , Modelos Animais de Doenças , Propriedades de Superfície , Titânio/química , Osseointegração
10.
World Neurosurg ; 181: e94-e106, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37567560

RESUMO

OBJECTIVE: The objective of this study was to analyze the trends in publications on intrathecal baclofen (ITB) therapy. METHODS: We searched Elsevier's Scopus database in February 2022 to find articles focused on ITB therapy. Data extracted included citation count, publication year, author's country and income category, journal and its 5-year impact factor, research type, disease requiring ITB, and target population. RESULTS: The analysis covered 615 articles from 1985 to 2022. The average citation count per article was 27.47 (95% confidence interval 23.75-31.18) and the mean impact factor was 4.54 (95% confidence interval 3.84-5.24). The majority (76.42%) were primary research, with 8.1% being interventional and 91.9% observational. Even so, one half of the top ten most cited were interventional. Secondary research and case reports made up 12.68% and 10.73% respectively, with narrative reviews making up most of the secondary research (79.48%). Only 1 study conducted a meta-analysis. The United States was the most prolific country. High-income countries published 96.42% of articles. CONCLUSIONS: The rising number of ITB articles and citations indicates growing interest and expanding knowledge in this field. However, there's a notable scarcity of research from low- and middle-income countries, particularly those with high prevalence of ITB-treatable diseases. The need for more evidence to overcome potential barriers to ITB implementation is emphasized. Despite an increasing number of publications, a large proportion presented low levels of evidence, such as case reports and narrative reviews, highlighting the need for more rigorous research methods to solidify the evidence base for ITB therapy.


Assuntos
Baclofeno , Bibliometria , Humanos , Estados Unidos , Projetos de Pesquisa , Bases de Dados Factuais
11.
Rev. bras. educ. méd ; 48(3): e069, 2024. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1565255

RESUMO

RESUMO Introdução: A competência dos profissionais de saúde em radiologia não apenas desempenha um papel fundamental no controle de custos, mas também na prevenção de erros médicos decorrentes da inexperiência durante a prática clínica. Objetivo: Este estudo realiza uma revisão sistemática com o objetivo de investigar as estratégias pedagógicas empregadas no ensino de diagnóstico por imagem nas instituições médicas brasileiras, bem como analisar o nível de conhecimento adquirido pelos estudantes de Medicina ao longo de sua graduação. Método: A revisão sistemática da literatura seguiu as diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) e abrangeu as bases de dados PubMed, LILACS/BVS, Scopus, Web of Science, Embase e ScienceDirect. A busca visou identificar artigos que abordassem metodologias e estratégias de disseminação do conhecimento em imagiologia médica. A avaliação do nível de evidência foi conduzida utilizando a abordagem GRADE. Resultado: Dos 152 artigos inicialmente identificados, 13 foram selecionados após a remoção de duplicatas e análise de títulos e resumos. Durante a leitura completa, excluíram-se oito artigos por causa de metodologias inadequadas ou desalinhamento com os objetivos da pesquisa. Os estudos elegíveis envolveram 461 alunos de Medicina em 49 instituições brasileiras, principalmente privadas, caracterizadas por um sistema híbrido de ensino e uma ênfase particular em módulos de radiologia médica. Salas de aula foram destacadas como os principais ambientes de ensino. No contexto do ensino de diagnóstico por imagens, muitos alunos ainda enfrentam dificuldades na avaliação de exames, independentemente do período letivo. O estudo aponta para a falta de uniformidade nos benefícios das políticas governamentais, resultando em segregação regional e financeira no acesso ao ensino. Conclusão: A despadronização do ensino contribui para uma formação deficiente em radiologia, deixando os profissionais despreparados para a interpretação adequada de exames. Diante da escassez de estudos e das disparidades identificadas, torna-se imperativo estabelecer parâmetros mínimos para os currículos em radiologia médica, proporcionando uma base estruturada para as instituições de ensino nacionais e visando à melhoria da qualidade do ensino e da formação profissional.


ABSTRACT Introduction: The competence of healthcare professionals in radiology not only plays a fundamental role in cost control but also in preventing medical errors resulting from inexperience during clinical practice. Objective: This study conducts a systematic review aiming to investigate the pedagogical strategies employed in teaching imaging diagnostics at Brazilian medical institutions, as well as to analyze the level of knowledge acquired by medical students throughout their education. Method: The systematic literature review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and covered the databases PubMed, LILACS/BVS, Scopus, Web of Science, Embase, and ScienceDirect. The search aimed to identify articles that addressed methodologies and strategies for disseminating knowledge in medical imaging. The evaluation of the level of evidence was conducted using the GRADE approach. Results: Of the 152 articles initially identified, 13 were selected after the removal of duplicates and analysis of titles and abstracts. During the full reading, eight articles were excluded due to inadequate methodologies or misalignment with the research objectives. The eligible studies involved 461 medical students across 49 Brazilian institutions, primarily private, characterized by a hybrid teaching system and a particular emphasis on medical radiology modules. Classrooms were highlighted as the main teaching environments. In the context of teaching imaging diagnostics, many students still face difficulties in evaluating exams, regardless of the academic term. The study points to the lack of uniformity in the benefits of government policies, resulting in regional and financial segregation in access to education. Conclusion: The lack of standardization in education contributes to inadequate training in radiology, leaving professionals unprepared for the proper interpretation of exams. Given the scarcity of studies and the identified disparities, it becomes imperative to establish minimum standards for medical radiology curricula, providing a structured foundation for national educational institutions and aiming to improve the quality of education and professional training.

12.
Rev Bras Enferm ; 76(6): e20220786, 2023.
Artigo em Inglês, Português | MEDLINE | ID: mdl-38055481

RESUMO

OBJECTIVE: to discuss undergraduate students' sexual behavior from the perspective of social markers and cross-cultural care proposed by Madeleine Leininger. METHODS: descriptive-exploratory qualitative research, with a theoretical-philosophical foundation in the Transcultural Theory. Convenience sample was composed of 57 young people from two universities in Rio de Janeiro. The focus groups' content were analyzed lexically using the IRAMUTEQ software. RESULTS: four classes emerged: Young people's sexual scripts: between the fear of an unplanned pregnancy and the risk of exposure to sexually transmitted infections; Affective relationships: trust in steady sexual partners, apparent sense of security and disuse of condoms; Sexual practices, gender and cultural determinants: distinction in men's and women's role; Sexual partnerships, negotiation of condom use and vulnerability to sexually transmitted infections. FINAL CONSIDERATIONS: challenges are perceived for the attention to undergraduate students' sexual health, who verbalized risky sexual behaviors due to sociocultural vulnerabilities.


Assuntos
Comparação Transcultural , Infecções Sexualmente Transmissíveis , Masculino , Gravidez , Humanos , Feminino , Adolescente , Brasil , Comportamento Sexual , Infecções Sexualmente Transmissíveis/prevenção & controle , Parceiros Sexuais , Preservativos , Estudantes/psicologia
15.
Femina ; 51(9): 538-542, 20230930.
Artigo em Português | LILACS | ID: biblio-1532483

RESUMO

A mamografia é o método de eleição para o rastreamento do câncer de mama, sendo o único que demonstra redução de mortalidade na população de risco habitual. A periodicidade de realização e a idade de início do rastreamento mamográfico são um tema controverso na literatura. Entretanto, dados no nosso país apontam para uma porção significativa de neoplasia de mamas em mulheres abaixo dos 50 anos. A Federação Brasileira das Associações de Ginecologia e Obstetrícia (Febrasgo), a Sociedade Brasileira de Mastologia (SBM) e o Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR) concordam que o rastreamento mamográfico deveria ser realizado, anualmente, por todas as mulheres a partir de 40 anos de idade. No Brasil, há uma distribuição desigual de mamógrafos nas várias regiões. As políticas de rastreamento devem considerar essa desigualdade. A grande maioria dos serviços no Brasil realiza rastreamento oportunístico para o câncer de mama. A implantação de rastreamento organizado por faixa etária e estratificação de risco pode otimizar os custos do sistema público de saúde. Pacientes de alto risco precisam ser rastreadas de forma diferente das pacientes de risco habitual. Essas pacientes precisam ter acesso à ressonância magnética das mamas e também iniciar seu rastreamento em idade mais precoce. O protocolo abreviado da ressonância magnética para rastreamento de pacientes de alto risco para câncer de mama pode melhorar a adesão e o acesso dessas pacientes ao programa de rastreamento. A ultrassonografia das mamas não é método de rastreamento isoladamente. Entretanto, ela tem seu papel como método complementar à mamografia e à ressonância magnética em cenários específicos, bem como em substituição à ressonância magnética em pacientes com contraindicação ao uso desse método. As mamas densas possuem baixa sensibilidade para o rastreamento por mamografia


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/prevenção & controle , Mamografia/métodos , Programas de Rastreamento , Espectroscopia de Ressonância Magnética/métodos , Saúde da Mulher , Ultrassonografia/métodos , Detecção Precoce de Câncer/métodos
16.
Adv Radiat Oncol ; 8(5): 101233, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37408678

RESUMO

Purpose: To present the long-term results of intraoperative radiation therapy (IORT) for early breast cancer using a nondedicated linear accelerator. Methods and Materials: The eligibility criteria were biopsy-proven invasive carcinoma, age ≥40 years, tumor size ≤3 cm, and N0M0. We excluded multifocal lesions and sentinel lymph node involvement. All patients had previously undergone breast magnetic resonance imaging. Breast-conserving surgery with margins and sentinel lymph node evaluation using frozen sections were performed in all cases. If there were no margins or involved sentinel lymph nodes, the patient was transferred from the operative suite to the linear accelerator room, where IORT was delivered (21 Gy). Results: A total of 209 patients who were followed up for ≥1.5 years from 2004 to 2019 were included. The median age was 60.3 years (range, 40-88.6), and the mean pT was 1.3 cm (range, 0.2-4). There were 90.5% pN0 cases (7.2% of micrometastases and 1.9% of macrometastases). Ninety-seven percent of the cases were margin free. The rate of lymphovascular invasion was 10.6%. Twelve patients were negative for hormonal receptors, and 28 patients were HER2 positive. The median Ki-67 index was 29% (range, 0.1-85). Intrinsic subtype stratification was as follows: luminal A, 62.7% (n = 131); luminal B, 19.1% (n = 40); HER2 enriched 13.4% (n = 28); and triple negative, 4.8% (n = 10). Within the median follow-up of 145 months (range, 12.8-187.1), the 5-year, 10-year, and 15-year overall survival rates were 98%, 94.7%, and 88%, respectively. The 5-year, 10-year, and 15-year disease-free rates were 96.3%, 90%, and 75.6%, respectively. The 15-year local recurrence-free rate was 76%. Fifteen local recurrences (7.2%) occurred throughout the follow-up period. The mean time to local recurrence was 145 months (range, 12.8-187.1). As a first event, 3 cases of lymph node recurrence, 3 cases of distant metastasis, and 2 cancer-related deaths were recorded. Tumor size >1 cm, grade III, and lymphovascular invasion were identified as risk factors. Conclusions: Despite approximately 7% of recurrences, we may infer that IORT may still be a reasonable option for selected cases. However, these patients require a longer follow-up as recurrences may occur after 10 years.

17.
Clin Implant Dent Relat Res ; 25(5): 919-928, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37309706

RESUMO

OBJECTIVE: The aim of the present study was to evaluate the effect of obesity on the osseointegration of implants with hydrophobic and hydrophilic surfaces. MATERIALS AND METHODS: Sixty-four male rats were distributed among four experimental groups: H-HB (Healthy/Hydrophobic): healthy animals with hydrophobic implants; H-HL (Healthy/Hydrophilic): healthy animals with hydrophilic implants; O-HB (Obese/Hydrophobic): animals with induced obesity and hydrophobic implants; O-HL (Obese/Hydrophilic): animals with induced obesity and hydrophilic implants. One hundred and twenty-eight implants were installed in the tibiae of the animals bilaterally (64 on the left tibiae and 64 on the right one) after 75 days of a specific diet (standard or high-fat diet) and euthanasia was performed in the experimental periods of 15 and 45 days after implant placement. Bone formation was assessed by biomechanical analysis (on the left tibiae of each animal), and microtomographic and histomorphometric analyses (on the right tibiae of each animal). Statistical analysis was performed using the Shapiro-Wilk test for normality and ANOVA followed by Tukey test to observe whether there was a significant difference between groups (p < 0.05); the t-test was used to compare the animals' body weight. RESULTS: The biomechanical analysis showed an increase in the removal torque value of animals after 45 days in comparison to after 15 days, with the exception of O-HB groups. The microtomographic analysis demonstrated no significant differences in the mineralized bone tissue volume between the groups. In the histomorphometric analysis, the H-HL/45 day group/period demonstrated higher bone-implant contact, in comparison to H-HL/15 days and the O-HL/45 day group/period showed an increase in bone area between the implant threads, in comparison to O-HL/15 days. CONCLUSION: In conclusion, obesity does not interfere with the osseointegration of hydrophobic and hydrophilic implants.


Assuntos
Implantes Dentários , Osseointegração , Masculino , Ratos , Animais , Tíbia/cirurgia , Implantes Experimentais , Obesidade/complicações , Propriedades de Superfície , Titânio/química , Torque
18.
Microb Pathog ; 180: 106143, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37146700

RESUMO

Cattle trypanosomiasis negatively impacts animal husbandry due to high morbidity, productivity losses, and mortality rates. Knowledge regarding Trypanosoma evansi infections in locally adapted breeds remains limited. Some cattle breeds exhibit trypanotolerance, requiring the determination of prevalence, as well as related tolerance and resistance characteristics, for disease control programs. This study aimed to determine T. evansi prevalence in Crioula Lageana cattle and associate clinical, hematological, and biochemical aspects with the infection to further research on tolerance in this population. Blood samples from 310 Crioula Lageana cattle were tested using Polymerase Chain Reaction (PCR) and Indirect Immunofluorescence Reaction (IIFR). T. evansi prevalence was 8% (24/310) using PCR and 4% (11/310) using IIFR. Positive animals showed increased ruminal movements, elevated eosinophil counts, and reduced monocyte numbers, but both latter within the reference range for the species. Albumin concentrations were low in positive cases and remained below the reference range limit for both groups. However, triglycerides exceeded the physiological range for the species in both positive and negative groups. Increased gamma-glutamyltransferase (GGT) activity was observed in positive animals. In conclusion, Crioula Lageana cattle exhibited enzootic instability with a low T. evansi infection prevalence when assessed using PCR and IIFR techniques. Furthermore, the animals did not display clinical, hematological, or biochemical alterations attributable to the presence of hemoparasites.


Assuntos
Doenças dos Bovinos , Trypanosoma , Tripanossomíase , Animais , Bovinos , Tripanossomíase/epidemiologia , Tripanossomíase/veterinária , Tripanossomíase/parasitologia , Prevalência , Trypanosoma/genética , Reação em Cadeia da Polimerase/métodos , DNA de Protozoário/genética , Doenças dos Bovinos/epidemiologia
19.
Braz Dent J ; 34(2): 105-112, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37194848

RESUMO

This study aimed to evaluate the effect of nicotine administration on the osseointegration of a superhydrophilic implants surface on rat tibiae. Thirty-two rats were used and divided into 2 groups according to the administration or not of nicotine: HH - Installation of implants with superhydrophilic surfaces in healthy animals; and HN - Installation of implants with superhydrophilic surfaces in animals subjected to nicotine administration. The animals were euthanized 15 and 45 days after implant placement (n = 8). Osseointegration was assessed by means of biomechanical analyses (removal torque), microcomputed tomography (volume of bone around the implants- %BV/TV), and histomorphometry (bone-implant contact -%BIC and the bone area between implant threads -%BBT). The animals subject to the nicotine administration presented lower removal torque than the control animals at the 45-day period (21.88 ± 2.80 Ncm vs. 17.88 ± 2.10 Ncm). The implants placed in the control rats presented higher %BIC (54.26 ± 6.59% vs. 39.25 ± 4.46%) and %BBT (50.57 ± 5.28% vs. 32.25 ± 5.24%) than the implants placed in nicotine animals at 15-day period. The nicotine administration reduces the osseointegration at 15 days, however, the superhydrophilic surface equalized the osseointegration in nicotine-exposed animals compared with healthy animals after 45 days of implant placement.


Assuntos
Implantes Dentários , Nicotina , Ratos , Animais , Nicotina/farmacologia , Osseointegração , Microtomografia por Raio-X , Tíbia , Titânio/farmacologia , Torque , Propriedades de Superfície
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