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1.
Geohealth ; 8(6): e2024GH001067, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38884068

RESUMO

Tourist volcanic caves are in high demand for ecotourism and geotourism lovers, as well as by sun and beach tourists as a complementary activity during their holidays. There are six tourist volcanic caves in the Canary Islands, all of them managed by the local administration of the island. The managers of these caves must ensure the safety of visitors and workers, who are exposed to natural hazards, such as radon, inherent to the environment in which the activity takes place. The methodology for analyzing natural radon radiation is based on the latest studies published by experts in this field and on previous experiences in tourist caves. This article proposes a protocol for the correct management of radon in tourist caves in the Canary Islands, adapted to current regulations, to mitigate effects on the health of visitors and workers.

2.
Arch Cardiol Mex ; 2024 May 16.
Artigo em Espanhol | MEDLINE | ID: mdl-38754126

RESUMO

Objective: The objective is to expose the cardiovascular alterations in patients diagnosed with pediatric inflammatory multisystem syndrome (PIMS) associated with COVID-19 during the SARS-CoV-2 pandemic, in order to understand the disease, its evolution, and optimal management upon diagnosis. Method: Retrospective, observational, cross-sectional analytical study of patients diagnosed with PIMS according to the criteria of the World Health Organization at the National Institute of Pediatrics, from March 2020 to December 2021. Results: During the study period, 77 patients with PIMS were diagnosed. The results showed correlation between the shock state and alteration of laboratory markers (platelets 144217.29 ± 139321.6 µL [p < 0.001], procalcitonin 27.37 ± 38.37 ng/ml [p = 0.05] and ferritin 1937.87 ± 2562.63 [p < 0.001]). The ventricular function in patients with shock was significantly lower compared to those without shock (49.6 ± 9.1% vs. 58.1 ± 8.4 %; t-Student p < 0.001), as well as injury to the left coronary artery (p = 0.02). There is a correlation between NT-proBNP and ventricular dysfunction (Kruskal-Wallis p = 0.007). Statistical significance was found in the association between death, elevation of inflammatory markers and ventricular dysfunction (p < 0.001). Conclusions: The cardiovascular alterations observed, in order of frequency, were pericardial effusion (25.7%), myocarditis (15%), mild ventricular dysfunction (13.5%) and small coronary aneurysm with predominance of the left coronary artery and the anterior descending one.


Objetivo: Exponer las alteraciones cardiovasculares en los pacientes diagnosticados con síndrome inflamatorio multisistémico pediátrico (PIMS) asociado a COVID-19 durante la pandemia por SARS-CoV-2 con el fin de comprender la enfermedad, su evolución y el manejo óptimo al diagnóstico. Método: Estudio retrospectivo, observacional, transversal y analítico de pacientes con diagnóstico de PIMS de acuerdo con los criterios de la Organización Mundial de la Salud en el Instituto Nacional de Pediatría, de marzo de 2020 a diciembre de 2021. Resultados: Durante el periodo de estudio se diagnosticaron 77 pacientes con PIMS. Los resultados demostraron una correlación entre el estado de choque y la alteración de los marcadores de laboratorio (plaquetas 144217.29 ± 139321.6 µl [p < 0.001], procalcitonina 27.37 ± 38.37 ng/ml [p = 0.05] y ferritina 1937.87 ± 2562.63 [p < 0.001]). La función ventricular en los pacientes con choque se registró significativamente menor en comparación con aquellos sin choque (49.6 ± 9.1 % vs. 58.1 ± 8.4 %; t de Student p < 0.001), así como lesión en la arteria coronaria izquierda (p = 0.02). Existe una correlación entre el NT-proBNP y la disfunción ventricular (Kruskal-Wallis p = 0.007). Se encontró significancia estadística en la asociación entre fallecimiento, elevación de los marcadores inflamatorios y disfunción ventricular (p < 0.001). Conclusiones: Las alteraciones cardiovasculares observadas fueron, en orden de frecuencia, derrame pericárdico (25.7%), miocarditis (15%), disfunción ventricular leve (13.5%) y aneurisma pequeño coronario con predominio de la arteria coronaria izquierda y la descendente anterior.

3.
Sci Rep ; 14(1): 11448, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38769370

RESUMO

Most advanced medical imaging techniques, such as positron-emission tomography (PET), require tracers that are produced in conventional particle accelerators. This paper focuses on the evaluation of a potential alternative technology based on laser-driven ion acceleration for the production of radioisotopes for PET imaging. We report for the first time the use of a high-repetition rate, ultra-intense laser system for the production of carbon-11 in multi-shot operation. Proton bunches with energies up to 10-14 MeV were systematically accelerated in long series at pulse rates between 0.1 and 1 Hz using a PW-class laser. These protons were used to activate a boron target via the 11 B(p,n) 11 C nuclear reaction. A peak activity of 234 kBq was obtained in multi-shot operation with laser pulses with an energy of 25 J. Significant carbon-11 production was also achieved for lower pulse energies. The experimental carbon-11 activities measured in this work are comparable to the levels required for preclinical PET, which would be feasible by operating at the repetition rate of current state-of-the-art technology (10 Hz). The scalability of next-generation laser-driven accelerators in terms of this parameter for sustained operation over time could increase these overall levels into the clinical PET range.

4.
Diabetes Metab Syndr Obes ; 17: 1667-1673, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38616987

RESUMO

Purpose: Diabetes is a public health problem that requires strategies to impact glycemic control and reduce the risk of long-term medical complications. Pharmacological management is a necessary treatment for this disease. Therefore, semaglutide is an essential tool to achieve the treatment targets. The present study aimed to evaluate the semaglutide effects on a cohort with type 2 diabetes mellitus (T2DM) in Colombia. Materials and Methods: The cohort included 49 patients with T2DM that have been treated in a specialized care center. Their glycemic outcomes, weight, renal function, and adverse events were evaluated through a 3-, 6- and 12-month follow-up. Results: Significant differences were observed in the outcome evaluation: reduction of glycated hemoglobin levels (MD -2.74 CI -1.95 to -3.52 in 6 months), fasting plasma glucose levels, body weight (MD -7.11 CI -5.97 to -8.24), and the albumin-to-creatinine ratio. The results were maintained throughout the treatment period. The adverse event rate was 16.3%, predominating gastrointestinal events. Conclusion: This real-world evidence shows the efficacy of semaglutide in achieving treatment goals in patients with T2DM.

7.
Comput Methods Programs Biomed ; 248: 108124, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38503070

RESUMO

BACKGROUND AND OBJECTIVE: Many recent studies in virtual reality (VR) have managed the sense of Presence to assess the suitability of their designs, mainly when focused on learning goals that require high user engagement, such as in serious games for psychomotor training. However, the place and plausibility illusions needed to promote Presence are achieved by combining different VR-based design cues, and their individual contribution to preserving the Presence's engagement/involvement component is still unclear. This article explored the single effect of breaking the sense of Presence per VR factor, i.e., removing VR cues related to Social Presence (human interactions), Self-Presence (embodiment), and Physical Presence (Scenario realism). METHODS: Thirty-three participants were asked to play an immersive VR simulation of an arcade game three times by experiencing a stepped Break of Illusion in one of the VR factors, i.e., while two factors were kept high, the remaining one was reduced to a low and null (hypothetical) level. The game difficulty was fixed after assessing each person's skills. RESULTS: Results showed that psychophysiology indicators (heart rate and skin conductance) were not affected by the level of illusion, whereas exercise intensity was significantly higher with low body and social presence-based conditions. Moreover, skin conductance was lower in the Social-presence group, which suggests that perspiration is only affected by breaks in realism (scenario and body representations). Based on the obtained evidence, we proposed some guidelines for adapting the design of immersive virtual environments through Breaks in Presence, mainly by changing the realism of the scenario and body representation depending on the skin conductance or the interaction with virtual humans depending on exercise intensity.


Assuntos
Ilusões , Realidade Virtual , Humanos , Simulação por Computador , Frequência Cardíaca , Aprendizagem
8.
Nutrients ; 16(5)2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38474711

RESUMO

(1) Background: Ultra-endurance exercise involves a high physical impact, resulting in muscle damage, inflammatory response and production of free radicals that alter the body's oxidative state. Supplementation with antioxidants, such as beetroot, may improve recovery in ultra-endurance runners. The aim of this study was to determine whether there is a correlation between beetroot intake and recovery of serum oxidative status, inflammatory response and muscle damage parameters after an ultra-endurance race. (2) Methods: An observational and longitudinal study was conducted by means of surveys and blood samples collected from 32 runners during the IX Penyagolosa Trails CSP®® race and the two following days. The variables C-reactive protein (CRP), lactate dehydrogenase (LDH), creatine kinase (CK), the activity of the antioxidant enzymes glutathione peroxidase (GPx) and glutathione reductase (GR) as well as the oxidative damage markers malondialdehyde (MDA), carbonyl groups (CG) and loss of muscle strength using the squat jump (SJ) test were analyzed to discriminate whether beetroot consumption can modulate the recovery of ultra-trail runners. (3) Results: Significant differences were observed between runners who ingested beetroot and those who did not, in terms of oxidative status, specifically in serum GPx activity at 24 and 48 h, muscle damage variables CK and LDH and regarding the SJ test results at the finish line. Therefore, the intake of supplements containing beetroot positively influences the recovery of serum oxidative status and muscle damage after ultra-endurance running.


Assuntos
Antioxidantes , Estresse Oxidativo , Estudos Longitudinais , Antioxidantes/metabolismo , Oxirredução , Suplementos Nutricionais , Verduras/metabolismo , Músculos/metabolismo , Músculo Esquelético/metabolismo
9.
Poult Sci ; 103(5): 103567, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38417302

RESUMO

Improving productive performance is a daily challenge in the poultry industry. Developing cost-effective additives and strategies that improve performance in antibiotic-free poultry production is critical to maintaining productivity and efficiency. This study evaluates the influence of a commercially available phytogenic feed additive (CA-PFA, that comprises silymarin, betaine and curcumin extracts as main ingredients) and silymarin on commercial broilers' productive performance and liver function with and without carbon tetrachloride (CCl4)-induced liver damage. The experiment was conducted in a completely randomized design, with six treatments, eight replicates, and eight birds per replicate in 18 one-day-old male broilers (Cobb Vantress 500) each; under a 3 × 2 factorial arrangement (3 diets x 2 levels of CCl4, 0 and 1 mL/kg body weight orally). The experimental treatments included 3 diets, commercially recommended doses of CA-PFA (500 mg/kg of feed; this dose provides 70 mg/kg of silymarin, besides the other active ingredients included in the formulation), silymarin (250 mg/kg of feed, containing 28% of active ingredient; this dose provides 70 mg/kg of silymarin as active ingredient) and an additive-free basal diet as a control. A standard commercial silymarin was used as a reference due to its well-known and extensively studied hepatoprotective properties that can mitigate the negative effects of CCl4 in the liver. The data were analyzed as a 2-way ANOVA, and the means showing significant (P ≤ 0.05) differences were then compared using the Post-Hoc Tukey HSD test. No interaction was detected between factors. Exposure to CCl4 had a noticeable detrimental effect on alertness, productive performance, and liver function of broilers without a significant increase in mortality. Including CA-PFA in the diet improved productive performance compared to the basal diet from day 21 to the end of the trial, on day 42. While no influence in feed intake was detected for any treatment, CA-PFA improved body weight gain (BWG) and feed conversion ratio (FCR) significantly (P < 0.05) from day 21 to the end of the trial in healthy and CCl4-exposed birds. The results show that CA-PFA supplementation improves performance parameters in broilers with and without CCl4-induced liver damage, when compared to a basal diet and the addition of a standard commercial silymarin product.


Assuntos
Ração Animal , Tetracloreto de Carbono , Doença Hepática Induzida por Substâncias e Drogas , Galinhas , Dieta , Suplementos Nutricionais , Doenças das Aves Domésticas , Silimarina , Animais , Silimarina/administração & dosagem , Silimarina/farmacologia , Ração Animal/análise , Masculino , Dieta/veterinária , Suplementos Nutricionais/análise , Doenças das Aves Domésticas/induzido quimicamente , Doenças das Aves Domésticas/prevenção & controle , Doença Hepática Induzida por Substâncias e Drogas/veterinária , Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Betaína/administração & dosagem , Betaína/farmacologia , Distribuição Aleatória , Curcumina/administração & dosagem , Curcumina/farmacologia , Fígado/efeitos dos fármacos
10.
Cardiol Young ; 34(1): 120-125, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37231590

RESUMO

Pulmonary atresia with an intact ventricular septum is characterised by heterogeneity in right ventricle morphology and coronary anatomy. In some cases, the presence of ventriculocoronary connections may promote coronary artery stenosis or interruption, and aortic diastolic pressure may not be sufficient to drive coronary blood flow. This requires a correct evaluation (currently done by angiography) which depends on whether the patient can be offered decompression of the right ventricle. To date, there is no objective method to do so, so we designed a percutaneous, transitory technique with the purpose of occluding the transtricuspid anterograde flow. The manoeuverer was performed in a 25-day-old female with pulmonary atresia with intact ventricular septum, right ventricle at suprasystemic level, and selective coronarography was not conclusive, the anterior descendant with stenosis in its middle third and from this point, thinner with to-fro flow. Occlusion was performed with a balloon catheter. We re-evaluated the coronary flow and the normalised anterior descendant flow. We hope that with this new method, we can give a more accurate diagnosis and determine the cases in which the coronary circulation is truly not right ventricle dependent to offer a greater number of patients biventricular or 1.5 ventricular repairs and thereby improve their quality of life and survival, the ones that turn out to be right ventricular dependant; offer them an early reference for cardiac transplant or in case it is not available to consider univentricular palliation knowing that this probably would not reduce the risk of ischaemia and/or death over time.


Assuntos
Cardiopatias Congênitas , Atresia Pulmonar , Septo Interventricular , Humanos , Feminino , Atresia Pulmonar/diagnóstico por imagem , Atresia Pulmonar/cirurgia , Septo Interventricular/diagnóstico por imagem , Septo Interventricular/cirurgia , Ventrículos do Coração , Qualidade de Vida , Resultado do Tratamento , Circulação Coronária
11.
Cardiol Young ; 34(2): 314-318, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37403735

RESUMO

The use of prostaglandin E1 is well documented in ductus arteriosus-dependent CHD or in neonatal pulmonary pathologies that cause severe pulmonary hypertension. The intravenous infusion is well established in loading infusion and maintenance with an onset of action of 30 minutes until 2 hours or even more. Our aim is to report three patients with pulmonary atresia that presented hypercyanotic spell due to a ductal spasm during cardiac catheterisation in whom the administration of a bolus of alprostadil reversed the spasm and increased pulmonary flow, immediately stabilising the condition of the patients allowing subsequent successful stent placement with no serious complications or sequelae after the administration of the bolus. More studies are needed to make a recommendation regarding the use of alprostadil in bolus in cases where the ductal spasm might jeopardise the life of the patient.


Assuntos
Permeabilidade do Canal Arterial , Canal Arterial , Cardiopatias Congênitas , Recém-Nascido , Humanos , Alprostadil/uso terapêutico , Permeabilidade do Canal Arterial/tratamento farmacológico , Espasmo
12.
Virus Res ; 339: 199285, 2024 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-38013142

RESUMO

OBJECTIVES: This study aimed to explore the impact of oxidative stress and extracellular matrix integrity on rotavirus infection in various cancer cells, including breast cancer, acute lymphoblastic leukemia, and melanoma. METHODS: We induced oxidative stress using ROS-inducing drugs (cisplatin, metronidazole, melatonin, valproic acid, doxorubicin, losartan, nitrofurantoin, and DHA) and investigated the effects on viral infection in MCF-7, Reh, A375, B16-F1, and SK-MEL-28 cells and the generation of virions from infected cells by harvesting the supernatants every two hours, reinfecting other cells, and analyzing cell viability and DNA fragmentation. FINDINGS: In MCF-7 and Reh cells, rotavirus Wt1-5 infection led to increased ROS generation, virion production, membrane permeability, mitochondrial dysfunction, DNA damage, and cell death. These effects were amplified by ROS-inducing drugs. Conversely, melanoma cells (SK-MEL-28 and A375) with a robust extracellular matrix network showed limited sensitivity to the drugs. Notably, losartan, which modulates the extracellular matrix, enhanced viral infection in melanoma cells (99 %). CONCLUSIONS: Oxidative stress promotes oncolytic rotavirus infection in breast cancer and acute lymphoblastic leukemia cells, suggesting potential utility in combination with radiotherapy or chemotherapy due to their shared induction of intracellular oxidative stress.


Assuntos
Neoplasias da Mama , Melanoma , Leucemia-Linfoma Linfoblástico de Células Precursoras , Infecções por Rotavirus , Rotavirus , Humanos , Feminino , Melanoma/terapia , Rotavirus/genética , Rotavirus/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Losartan/farmacologia , Losartan/uso terapêutico , Linhagem Celular Tumoral , Apoptose , Estresse Oxidativo , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia
14.
Epileptic Disord ; 25(6): 886-889, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37861287

RESUMO

Mutations in the gene encoding syntaxin binding protein 1 (STXBP1) have been implicated in a wide variety of epileptic encephalopathies. Although the recognized phenotypes of patients with STXBP1 encephalopathies have broadened in recent years, no case of reflex seizures, particularly musicogenic seizures, has been reported in the literature. We present an 18-year-old woman with STXBP1 encephalopathy and seizures that are stereotypically reproducible in response to a variety of audible stimuli. An 18-year-old woman with a history of profound intellectual disability, confirmed STXBP1 genetic defect via genetic testing, and seizures beginning as infantile spasms during childhood, who presented to the epilepsy monitoring unit for seizure characterization. Her mother reported reproducible seizures triggered by a particular cell phone ringtone, music from a certain automobile television commercial and certain beeping alarm sounds. In response, the patient had clinically stereotyped seizures associated with staring, behavioral arrest, followed by eye deviation to the left, tonic stiffening in upper and lower extremities, and labored breathing lasting between 30 s and 2 min. These seizures were reliably reproducible within a few seconds of exposure to the auditory stimulus. During hospitalization, mother played one of the cell phone ringtones known to trigger seizures for the patient, which resulted in induction of a seizure characterized by diffuse electrodecrement, subsequent emergence of frontal-predominant theta which was followed by progressive diffuse attenuation and semi-rhythmic slowing over the right posterior quadrant. This is the first case to describe musicogenic or other reflex seizures in a patient with STXBP1 encephalopathy.


Assuntos
Encefalopatias , Epilepsia Reflexa , Espasmos Infantis , Feminino , Humanos , Adolescente , Convulsões , Encefalopatias/genética , Espasmos Infantis/genética , Mutação , Proteínas Munc18/genética , Eletroencefalografia
15.
Eur J Pediatr ; 182(12): 5465-5471, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37773295

RESUMO

The purpose of the study is to test whether NT-proBNP serves as a screening tool for low-risk patent ductus arteriosus and safely avoids routine early echocardiography. This is a prospective observational study in preterm infants ≤32 weeks of gestational age. Infants with ≥5100 pg/ml (positive screening) at 48-72 hours of life received comprehensive echocardiography and were treated according to shunt severity. Infants with NT-proBNP below 5100 pg/ml (negative screening) were managed expectantly. The main outcome was need for ductus treatment within the first 7 days of life. One hundred twenty-five infants were included; 82 had a negative NT-proBNP screening and 43 had a positive NT-proBNP screening. No infant (0%) with a negative screening was treated for ductus while 26 (60.4%) with a positive screening were treated (p < 0.001). NT-proBNP avoided a 65.6% of routine echocardiograms. NT-proBNP had an excellent performance to predict PDA treatment (AUC = 0.967).Conclusion: NT-proBNP at 48-72 hours of life has an excellent performance to detect low risk and avoids unnecessary echocardiograms. This may contribute to optimize PDA management in terms of resource utilization.


Assuntos
Permeabilidade do Canal Arterial , Recém-Nascido Prematuro , Lactente , Recém-Nascido , Humanos , Seguimentos , Biomarcadores , Peptídeo Natriurético Encefálico , Permeabilidade do Canal Arterial/diagnóstico por imagem
16.
J Neuroeng Rehabil ; 20(1): 124, 2023 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-37749566

RESUMO

BACKGROUND: Optic flow-the apparent visual motion experienced while moving-is absent during treadmill walking. With virtual reality (VR), optic flow can be controlled to mediate alterations in human walking. The aim of this study was to investigate (1) the effects of fully immersive VR and optic flow speed manipulation on gait biomechanics, simulator sickness, and enjoyment in people post-stroke and healthy people, and (2) the effects of the level of immersion on optic flow speed and sense of presence. METHODS: Sixteen people post-stroke and 16 healthy controls performed two VR-enhanced treadmill walking sessions: the semi-immersive GRAIL session and fully immersive head-mounted display (HMD) session. Both consisted of five walking trials. After two habituation trials (without and with VR), participants walked three more trials under the following conditions: matched, slow, and fast optic flow. Primary outcome measures were spatiotemporal parameters and lower limb kinematics. Secondary outcomes (simulator sickness, enjoyment, and sense of presence) were assessed with the Simulator Sickness Questionnaire, Visual Analogue Scales, and Igroup Presence Questionnaire. RESULTS: When walking with the immersive HMD, the stroke group walked with a significantly slower cadence (-3.69strides/min, p = 0.006), longer stride time (+ 0.10 s, p = 0.017) and stance time for the unaffected leg (+ 1.47%, p = 0.001) and reduced swing time for the unaffected leg (- 1.47%, p = 0.001). Both groups responded to the optic flow speed manipulation such that people accelerated with a slow optic flow and decelerated with a fast optic flow. Compared to the semi-immersive GRAIL session, manipulating the optic flow speed with the fully immersive HMD had a greater effect on gait biomechanics whilst also eliciting a higher sense of presence. CONCLUSION: Adding fully immersive VR while walking on a self-paced treadmill led to a more cautious gait pattern in people post-stroke. However, walking with the HMD was well tolerated and enjoyable. People post-stroke altered their gait parameters when optic flow speed was manipulated and showed greater alterations with the fully-immersive HMD. Further work is needed to determine the most effective type of optic flow speed manipulation as well as which other principles need to be implemented to positively influence the gait pattern of people post-stroke. TRIAL REGISTRATION NUMBER: The study was pre-registered at ClinicalTrials.gov (NCT04521829).


Assuntos
Fluxo Óptico , Acidente Vascular Cerebral , Realidade Virtual , Humanos , Fenômenos Biomecânicos , Imersão , Marcha , Caminhada , Acidente Vascular Cerebral/complicações
17.
Cir Esp (Engl Ed) ; 101(12): 833-840, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37544607

RESUMO

INTRODUCTION: Robot-assisted thoracic surgery (RATS) is a rapidly expanding technique. In our study, we aimed to analyze the results of the process to adopt robotic surgery in our Department of Thoracic Surgery. METHODS: This is an intention-to-treat analysis of a series of consecutive patients operated on using the RATS approach in our hospital from January 2021 to March 2022. Data were registered for patient characteristics, type of surgery, operative times, conversion rate, chest tube duration, length of hospital stay and complications. The IBM SPSS® statistical software was used for the statistical analysis. A cumulative sum analysis of the operating time was performed to define the learning curve. RESULTS: During the study period, 51 patients underwent robotic surgery, including pulmonary and non-pulmonary interventions. In addition, 15 patients (29.4%) underwent non-pulmonary interventions: one pleural (2%), 2 diaphragmatic (3.9%), and 12 mediastinal (23.5%). Among the mediastinal surgeries, one conversion was necessary (8.3%) for a complex vascular malformation, and 11 were completed by RATS, including 7 (58.3%) thymomas, 3 (25%) pleuro-pericardial cysts, and one (8.3%) neurogenic tumor. Mean operative time was 141 min (104-178), mean chest tube duration was 0.9 days (0-2), and mean length of stay was 1.45 days (1-2). Thirty-six patients underwent lung surgery (70.6%). The complete RATS resections (34; 94.4%) included: 3 wedge resections (11.1%), 2 segmentectomies (3.7%), 28 lobectomies (81.5%), and one sleeve lobectomy (3.7%). Mean surgery time was 194.56 min (141-247), chest tube duration was 3.92 days (1-8), and length of stay was 4.6 days (1-8). Complications occurred in 4 patients (11.1%). No 90-day mortalities were registered. CONCLUSIONS: The implementation of RATS was achieved with good clinical results and operative times for all indications. A rapid learning curve was accomplished in short time. Previous VATS experience, patient selection, team training and program continuity are fundamental to successfully develop a RATS program.


Assuntos
Neoplasias Pulmonares , Procedimentos Cirúrgicos Robóticos , Robótica , Cirurgia Torácica , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias Pulmonares/cirurgia , Pneumonectomia/efeitos adversos , Pneumonectomia/métodos
18.
Front Pediatr ; 11: 1200395, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37484769

RESUMO

Endothelial progenitor cells and circulating endothelial cells have been proposed as useful markers of severity and disease progression in certain vascular diseases, including pulmonary arterial hypertension. Our study focused on evaluating the levels of circulating endothelial progenitor cells and circulating endothelial cells in patients with congenital left-to-right shunts and pulmonary hypertension undergoing definitive repair. Endothelial progenitor cells (identified by simultaneous co-expression of CD45dim, CD34 + and KDR2 + surface antibodies) and circulating endothelial cells (identified by simultaneous co-expression of inherent antibodies CD45-, CD31+, CD146 + and CD105+) were prospectively measured in seventy-four children (including children with Down syndrome), median age six years (2.75-10), with clinically significant left-to-right shunts undergoing transcatheter or surgical repair and compared to thirty healthy controls. Endothelial progenitor cells and, particularly, circulating endothelial cells were significantly higher in children with heart disease and pulmonary arterial hypertension when compared to controls. Endothelial progenitor cells showed significant correlation with pulmonary vascular resistance index when measured both systemically (r = 0.259; p = 0.026) and in the superior vena cava (r = 0.302; p = 0.009). Children with Down syndrome showed a stronger correlation between systemic cellularity and pulmonary vascular resistance index (r = 0.829; p = 0.002). Endothelial progenitor cells were reduced along their transit through the lung, whereas circulating endothelial cells did not suffer any modification across the pulmonary circulation. In children with yet to be repaired left-to-right shunts, endothelial progenitor cells and circulating endothelial cell counts are increased compared to healthy subjects.

19.
Front Comput Neurosci ; 17: 1153572, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37485400

RESUMO

Convolutional Neural Networks (CNN) are a class of machine learning models predominately used in computer vision tasks and can achieve human-like performance through learning from experience. Their striking similarities to the structural and functional principles of the primate visual system allow for comparisons between these artificial networks and their biological counterparts, enabling exploration of how visual functions and neural representations may emerge in the real brain from a limited set of computational principles. After considering the basic features of CNNs, we discuss the opportunities and challenges of endorsing CNNs as in silico models of the primate visual system. Specifically, we highlight several emerging notions about the anatomical and physiological properties of the visual system that still need to be systematically integrated into current CNN models. These tenets include the implementation of parallel processing pathways from the early stages of retinal input and the reconsideration of several assumptions concerning the serial progression of information flow. We suggest design choices and architectural constraints that could facilitate a closer alignment with biology provide causal evidence of the predictive link between the artificial and biological visual systems. Adopting this principled perspective could potentially lead to new research questions and applications of CNNs beyond modeling object recognition.

20.
Polymers (Basel) ; 15(13)2023 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-37447444

RESUMO

The meat industry generates a large amount of waste that can be used to create useful products such as bio-implants, which are usually expensive. In this report, we present an economic analysis of a continuous process for large-scale chemically cross-linked collagen scaffold (CCLCS) production in a Mexican context. For this purpose, three production capacities were simulated using SuperPro Designer® v 12.0: 5, 15, and 25 × 103 bovine pericardium units (BPU) per month as process feedstock. Data indicated that these capacities produced 2.5, 7.5, and 12.5 kg of biomesh per batch (per day), respectively. In addition, Net Unit Production Costs (NUPC) of 784.57, 458.94, and 388.26 $USD.kg-1 were obtained, correspondingly, with selling prices of 0.16 ± 0.078 USD.cm-2, 0.086 ± 0.043 USD.cm-2, and 0.069 ± 0.035 USD.cm-2, in the same order. We found that these selling prices were significantly lower than those in the current market in Mexico. Finally, distribution of costs associated with the process followed the order: raw materials > facility-dependent > labor > royalties > quality analysis/quality control (QA/QC) > utilities. The present study showed the feasibility of producing low-cost and highly profitable CCLCS with a relatively small investment. As a result, the circular bioeconomy may be stimulated.

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