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1.
Environ Res ; 231(Pt 3): 116280, 2023 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-37257742

RESUMO

This work presents a one-step synthesis methodology for preparing a hydrochar (HC) doped with TiO2 (HC-TiO2) for its application on the degradation of crystal violet (CV) using UV and visible radiation. Byrsonima crassifolia stones were used as precursors along with TiO2 particles. The HC-TiO2 sample was synthesized at 210 °C for 9 h using autogenous pressure. The photocatalyst was characterized to evaluate the TiO2 dispersion, specific surface area, graphitization degree, and band-gap value. Finally, the degradation of CV was investigated by varying the operating conditions of the system, the reuse of the catalyst, and the degradation mechanism. The physicochemical characterization of the HC-TiO2 composite showed good dispersion of TiO2 in the carbonaceous particle. The presence of TiO2 on the hydrochar surface yields a bandgap value of 1.17 eV, enhancing photocatalyst activation with visible radiation. The degradation results evidenced a synergistic effect with both types of radiation due to the hybridized π electrons in the sp2-hybridized structures in the HC surface. The degradation percentages were on average 20% higher using UV radiation than visible radiation under the following conditions: [CV] = 20 mg/L, 1 g/L of photocatalyst load, and pH = 7.0. The reusability experiments demonstrated the feasibility of reusing the HC-TiO2 material up to 5 times with a similar photodegradation percentage. Finally, the results indicated that the HC-TiO2 composite could be considered an efficient material for the photocatalytic treatment of water contaminated with CV.


Assuntos
Violeta Genciana , Raios Ultravioleta , Luz , Titânio/química , Catálise
2.
NPJ Precis Oncol ; 6(1): 7, 2022 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-35087175

RESUMO

Platinum-based neoadjuvant chemotherapy followed by interval debulking surgery is an accepted treatment for patients with stage III or IV epithelial ovarian cancer who are not suitable for primary debulking surgery. The identification of suitable adjuvant treatments in these patients is an unmet need. Here, we explore potential genomic characteristics (mutational and immune-associated expression profiles) in a series of patients undergoing neoadjuvant chemotherapy. Tumor samples from biopsy and interval debulking surgery were analyzed for mutational landscape and immune profiling, together with detailed immunohistochemistry using different immune cell markers, and correlated with clinicopathological characteristics and potential response to neoadjuvant chemotherapy. No major differences in the mutational landscape were observed in paired biopsy and surgery samples. Genomic loss of heterozygosity was found to be higher in patients with total/near-total tumor response. The immune gene expression profile after neoadjuvant chemotherapy revealed activation of several immune regulation-related pathways in patients with no/minimal or partial response. In parallel, neoadjuvant therapy caused a significant increase of tumor-infiltrating lymphocyte population abundance, primarily due to an augmentation of the CD8+ T cell population. Remarkably, these changes occurred irrespective of potential homologous recombination defects, such as those associated with BRCA1/2 mutations. Our study strengthens the use of loss of heterozygosity as a biomarker of homologous repair deficiency. The changes of immune states during neoadjuvant chemotherapy reveal the dynamic nature of tumor-host immune interactions and suggest the potential use of immune checkpoint inhibitors or their combination with poly-ADP polymerase inhibitors in high stage and grade epithelial ovarian cancer patients undergoing neoadjuvant therapy.

3.
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
4.
Rev. med. vet. zoot ; 67(2): 136-148, May-Aug. 2020. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1180950

RESUMO

RESUMEN Las enfermedades gastrointestinales equinas tienen una alta incidencia con un pronóstico variable en la práctica clínica. La mayoría de los estudios se limitan a describir lesiones ulcerativas y lesiones inflamatorias. El objetivo de este estudio fue evaluar el potencial diagnóstico complementario de la cromoendoscopia convencional en la mucosa gas-troesofágica y duodenal proximal del equino. El estudio incluyó 20 caballos criollos colombianos de ambos sexos (12 hembras y 8 machos), con edades entre 5 y 20 años, peso entre 250 y 350 kilogramos, condición corporal 4-5/9 y con historial de alteraciones digestivas en los últimos 3 meses; quienes previo a la evaluación por gastroscopia y cromoendoscopia se sometieron a ayuno (sólidos 12h y líquidos 4h) y sedación (xilacina 0,5 mg/kg/iv). Se utilizaron tinciones como rojo fenol, lugol, índigo carmín, azul de metileno y ácido acético y se tomaron biopsias de los segmentos que mostraron reacción. El azul de metileno reveló 52% de las lesiones, el lugol 19%; por su parte, el rojo fenol, el índigo carmín y el ácido acético revelaron el 9,5% restante. El epitelio escamoso fue el más afectado (66,6%), el glandular (19%), antro pilórico (9,5%) y duodeno proximal (4,7%). Los hallazgos histopatológicos fueron hiperplasia, hipertrofia, hiperqueratosis, congestión, degeneración vacuolar, infiltrados celulares, fibrosis, necrosis y atrofia en diferentes grados de severidad. La cromoendoscopia reveló lesiones prematuras, que pasaron desapercibidas con las técnicas convencionales de endoscopia del tracto digestivo. Este es el primer estudio que emplea la cromoendoscopia en equinos; a pesar de que la técnica mejoró la visualización y facilitó la ubicación y descripción de lesiones ulcerativas prematuras a través de la histopatología, se recomiendan mayores estudios controlados y con un número más amplio de muestras.


ABSTRACT Equine gastrointestinal diseases have a high occurrence with a variable prognostic in clinic practice. Most of the studies limits to describe ulcerative and inflammatory lesions. The objective of this study was to evaluate the potential complementary diagnostic of conventional chromoendoscopy on the gastroesophageal and proximal duodenal mucosa of the equine. 20 Colombian creole horses, of both sexes (12 females and 8 males), with ages between 5 and 20 years old, weight between 250 and 350 kilograms, body condition 4-5/9, that had presented digestive alterations in the last 3 months, were subjected to fasting (solids 12h and liquids 4h) and sedated (xylazine 0,5 mg/kg/iv) to be evaluated by gastroscopy and chromoendoscopy, using for stains phenol red, lugol, indigo carmine, methylene blue and acetic acid, taking biopsy samples of the segments that showed reaction. The methylene blue revealed 52%, lugol 19%, and phenol red, indigo carmine and acetic acid revealed only 9,5% of the lesions, being the squamous epithelium the most affected (66,6%), glandular epithelium (19%), pyloric antrum (9,5%) and proximal duodenum (4,7%), where histopathological findings were hyperplasia, hypertrophy, hyperkeratosis, congestion, vacuolar degeneration, cellular infiltrates, fibrosis, necrosis and atrophy in different degrees of severity. Chromoendoscopy revealed lesions premature, which go unnoticed with conventional light endoscopy techniques. This is the first study using chromoscopy in horses to show that the reagents used allow a better visualization of injuries than the conventional technique, helping histopathological studies and molecular biology to understand ulcerative premature injuries and possible pathophysiological pathways. However, larger controlled studies and a larger number of samples are needed.


Assuntos
Animais , Ferimentos e Lesões , Gastroscopia , Corantes , Endoscopia , Cavalos , Atrofia , Vacúolos , Biópsia , Células , Carmim , Jejum , Ácido Acético , Fenol , Duodeno , Epitélio , Distribuição por Idade e Sexo , Junção Esofagogástrica , Hiperplasia , Hipertrofia , Azul de Metileno , Mucosa , Necrose
5.
Arq. bras. med. vet. zootec. (Online) ; 72(4): 1339-1345, July-Aug. 2020. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1131509

RESUMO

Free-range chickens may ingest oocysts of T. gondii present in the environment and consequently harbor virulent strains of this parasite in different tissues, without any clinical signs. Isolation of T. gondii through bioassays on mice and cats from naturally infected chicken tissues has been described in several countries, demonstrating the importance of free-range chickens in the transmission of this parasite. The aim of this study was the genotypic characterization of T. gondii isolates obtained from naturally infected free-range chickens in a rural area of the state of Rio Grande do Sul, Brazil. Brain and heart tissue from 12 chickens seropositive for T. gondii were processed using peptic digestion technique for parasite isolation. From 12 samples subjected to mouse bioassay, nine isolates were obtained. RFLP-PCR genotypic characterization was performed using 11 genetic markers: SAG1, 5'-3'SAG2, alt.SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 and Apico. Genetic characterization of the isolates revealed the presence of five atypical genotypes according to ToxoDB (# 11, # 55, # 64, # 140 and # 163). Our results showed a wide genetic diversity of T. gondii in free-range chickens in this region.(AU)


Galinhas criadas ao ar livre podem ingerir oocistos de T. gondii presentes no ambiente e, com isso, albergar cepas virulentas desse parasita em diferentes tecidos, sem sinais clínicos. O isolamento de T. gondii por meio de bioensaios em camundongos e gatos, a partir de tecidos de galinhas naturalmente infectadas, tem sido descrito em vários países. Isso demonstra a importância das galinhas caipiras na epidemiologia desse parasita. O objetivo deste trabalho foi caracterizar genotipicamente isolados de T. gondii obtidos de galinhas caipiras naturalmente infectadas em uma área rural do município de Santa Maria, estado do Rio Grande do Sul, Brasil. Fragmentos de cérebro e de coração, de 12 galinhas soropositivas para T. gondii, foram processados pela técnica de digestão péptica para isolamento do parasita. Das 12 amostras submetidas a bioensaio com camundongos, nove isolados foram obtidos. A caracterização genotípica por RFLP-PCR foi realizada utilizando-se 11 marcadores genéticos: SAG1, 5'-3'SAG2, alt.SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 e Apico e revelou a presença de cinco genótipos atípicos de acordo com o ToxoDB (# 11, # 55, # 64, # 140 e # 163). Os resultados mostraram uma ampla diversidade genética de T. gondii em galinhas caipiras nessa região.(AU)


Assuntos
Animais , Camundongos , Toxoplasma , Bioensaio/veterinária , Galinhas/virologia , Toxoplasmose Animal , Técnicas de Genotipagem/veterinária , Zona Rural , Reação em Cadeia da Polimerase/veterinária
6.
Arch Soc Esp Oftalmol (Engl Ed) ; 95(9): 459-462, 2020 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32513417

RESUMO

Cutaneous anaplastic large-cell lymphoma (cALCL) is a condition within CD30 lymphoid proliferations spectrum. Involving the eyelid is unusual and all cases found in the literature are located in the upper eyelid. In this case we report an cALCL atypical presentation. A 39 year-old woman with no significant medical history, presents a fast-growing mass in the medial canthus, with inflamatory-infectious appearance. After a week with antibiotics with no response, an excisional biopsy was practiced. The hystopathology analysis with a negative systemic work up confirmed the diagnosis of a cALCL. After two-year follow up, patient is asymptomatic. cALCL involving the eyelid are rare but potentially life-threatening disorders, so more information about diagnosis, treatment and follow up is needed.

9.
Biochem Pharmacol ; 177: 113937, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32224142

RESUMO

Latent HIV reservoirs are the main obstacle to eradicate HIV infection. One strategy proposes to eliminate these viral reservoirs by pharmacologically reactivating the latently infected T cells. We show here that a 4-deoxyphorbol ester derivative isolated from Euphorbia amygdaloides ssp. semiperfoliata, 4ß-dPE A, reactivates HIV-1 from latency and could potentially contribute to decrease the viral reservoir. 4ß-dPE A shows two effects in the HIV replication cycle, infection inhibition and HIV transactivation, similarly to other phorboids PKC agonists such PMA and prostratin and to other diterpene esters such SJ23B. Our data suggest 4ß-dPE A is non-tumorigenic, unlike the related compound PMA. As the compounds are highly similar, the lack of tumorigenicity by 4ß-dPE A could be due to the lack of a long side lipophilic chain that is present in PMA. 4ß-dPE activates HIV transcription at nanomolar concentrations, lower than the concentration needed by other latency reversing agents (LRAs) such as prostratin and similar to bryostatin. PKCθ/MEK activation is required for the transcriptional activity, and thus, anti-latency activity of 4ß-dPE A. However, CD4, CXCR4 and CCR5 receptors down-regulation effect seems to be independent of PCK/MEK, suggesting the existence of at least two different targets for 4ß-dPE A. Furthermore, NF-κb transcription factor is involved in 4ß-dPE HIV reactivation, as previously shown for other PKCs agonists. We also studied the effects of 4ß-dPE A in combination with other LRAs. When 4ß-dPE A was combined with another PKC agonists such as prostratin an antagonic effect was achieved, while, when combined with an HDAC inhibitor such as vorinostat, a strong synergistic effect was obtained. Interestingly, the latency reversing effect of the combination was synergistically diminishing the EC50 value but also increasing the efficacy showed by the drugs alone. In addition, combinations of 4ß-dPE A with antiretroviral drugs as CCR5 antagonist, NRTIs, NNRTIs and PIs, showed a consistent synergistic effect, suggesting that the combination would not interefer with antiretroviral therapy (ART). Finally, 4ß-dPE A induced latent HIV reactivation in CD4 + T cells of infected patients under ART at similar levels than the tumorigenic phorbol derivative PMA, showing a clear reactivation effect. In summary, we describe here the mechanism of action of a new potent deoxyphorbol derivative as a latency reversing agent candidate to decrease the size of HIV reservoirs.


Assuntos
Fármacos Anti-HIV/farmacologia , Infecções por HIV/metabolismo , HIV-1/fisiologia , Quinases de Proteína Quinase Ativadas por Mitógeno/metabolismo , Ésteres de Forbol/farmacologia , Proteína Quinase C/metabolismo , Ativação Viral/efeitos dos fármacos , Vorinostat/farmacologia , Briostatinas/farmacologia , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD4-Positivos/virologia , Sobrevivência Celular/efeitos dos fármacos , Sinergismo Farmacológico , Infecções por HIV/patologia , Infecções por HIV/virologia , HIV-1/efeitos dos fármacos , Humanos , Células Jurkat , Transdução de Sinais/efeitos dos fármacos , Latência Viral/efeitos dos fármacos
12.
Sci Rep ; 9(1): 2589, 2019 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-30796344

RESUMO

Cetuximab is a standard-of-care treatment for RAS wild-type metastatic colorectal cancer (mCRC) but not for those harbor a KRAS mutation since MAPK pathway is constitutively activated. Nevertheless, cetuximab also exerts its effect by its immunomodulatory activity despite the presence of RAS mutation. The aim of this study was to determine the impact of polymorphism FcγRIIIa V158F and killer immunoglobulin-like receptor (KIR) genes on the outcome of mCRC patients with KRAS mutations treated with cetuximab. This multicenter Phase II clinical trial included 70 mCRC patients with KRAS mutated. We found KIR2DS4 gene was significantly associated with OS (HR 2.27; 95% CI, 1.08-4.77; P = 0.03). In non-functional receptor homozygotes the median OS was 2.6 months longer than in carriers of one copy of full receptor. Multivariate analysis confirmed KIR2DS4 as a favorable prognostic marker for OS (HR 6.71) in mCRC patients with KRAS mutation treated with cetuximab. These data support the potential therapeutic of cetuximab in KRAS mutated mCRC carrying non-functional receptor KIR2DS4 since these patients significantly prolong their OS even after heavily treatment. KIR2DS4 typing could be used as predictive marker for identifying RAS mutated patients that could benefit from combination approaches of anti-EGFR monoclonal antibodies and other immunotherapies to overcome the resistance mediated by mutation in RAS.


Assuntos
Antineoplásicos Imunológicos/uso terapêutico , Cetuximab/uso terapêutico , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/genética , Resistencia a Medicamentos Antineoplásicos/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Receptores de IgG/genética , Receptores KIR/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/genética , Feminino , Genes MCC , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético , Estudos Prospectivos , Resultado do Tratamento
13.
Nanotoxicology ; 13(6): 812-826, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30776931

RESUMO

Silver nanoparticles are currently one of the most widely used metallic nanoparticles. Due to their antibacterial properties, they are applied in textiles, house-holds items, and medical devices, among many other products. Understanding the potential toxicity associated with silver nanoparticles and the differential effect that nanoparticles of different size might induce is crucial, due to the increasing human and environmental exposure to this type of nanoparticles. In this work, we explored the different biomolecular mechanisms underlying the toxicity of silver nanoparticles in a size-dependent manner. Quantitative proteomic analysis of hepatic cells exposed to 10 and 60 nm silver nanoparticles demonstrated the alteration of a different set of proteins depending on the particle size. We demonstrated that while 10 nm silver nanoparticles induce nucleolar stress and ribosome biogenesis halt, both types of nanoparticles induce DNA damage and oxidative stress but through different pathways. In addition, both types of nanoparticles also affected cell proliferation, disrupted the cell cycle and ultimately, induced apoptosis. The alteration of different cellular mechanisms in a size-dependent manner, have relevant implications not only from a toxicity point of view, but also for the potential applications of silver nanoparticles.


Assuntos
Dano ao DNA , Nanopartículas Metálicas/toxicidade , Estresse Oxidativo/efeitos dos fármacos , Proteoma/metabolismo , Prata/toxicidade , Apoptose/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Células Hep G2 , Humanos , Nanopartículas Metálicas/química , Membrana Nuclear/efeitos dos fármacos , Membrana Nuclear/metabolismo , Membrana Nuclear/ultraestrutura , Estresse Oxidativo/genética , Tamanho da Partícula , Proteoma/genética , Proteômica , Prata/química , Propriedades de Superfície
14.
Clin Transl Oncol ; 21(8): 1044-1051, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30617939

RESUMO

INTRODUCTION: The clinical course in patients with prostate cancer (PCa) after biochemical failure (BF) has received limited attention. This study analyzes survival time from recurrence, patterns of progression, and the efficacy of salvage therapies in patients treated with radical or postoperative radiotherapy (RT). METHODS: This is a multicenter retrospective comparative study of 1135 patients diagnosed with BF and treated with either radical (882) or postoperative (253) RT. Data correspond to the RECAP database. Clinical, tumor, and therapeutic characteristics were collected. Descriptive statistics, survival estimates, and comparisons of survival rates were calculated. RESULTS: Time to BF from initial treatment (RT or surgery) was higher in irradiated patients (51 vs 37 months). At a median follow-up of 102 months (14-254), the 8-year cause-specific survival (CSS) was 80.5%, without significant differences between the radical (80.1%) and postoperative (83.4%) RT groups. The 8-year metastasis-free survival rate was 57%. 173 patients (15%) died of PCa and 29 (2.5%) of a second cancer. No salvage therapy was given in 15% of pts. Only 5.5% of pts who underwent radical RT had local salvage treatment and 71% received androgen deprivation (AD) ± chemotherapy. The worst outcomes were in patients who developed metastases after BF (302 pts; 26.5%) and in cases with a Gleason > 7. CONCLUSIONS: In PCa treated with radiotherapy, median survival after BF is relatively long. In this sample, no differences in survival rates at 8-years have been found, regardless of the time of radiotherapy administered. AD was the most common treatment after BF. Metastases and high Gleason score are adverse variables. To our knowledge, this is the first study to compare outcomes after BF among patients treated with primary RT vs. those treated with postoperative RT and to evaluate recurrence patterns, treatments administered, and causes of death. The results allow avoiding overtreatment, improving quality of life, without negatively affecting survival.


Assuntos
Braquiterapia/mortalidade , Bases de Dados Factuais , Recidiva Local de Neoplasia/mortalidade , Neoplasias da Próstata/mortalidade , Sistema de Registros/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/radioterapia , Prognóstico , Neoplasias da Próstata/patologia , Neoplasias da Próstata/radioterapia , Estudos Retrospectivos , Taxa de Sobrevida
15.
Cir Pediatr ; 31(3): 125-129, 2018 Aug 03.
Artigo em Espanhol | MEDLINE | ID: mdl-30260104

RESUMO

INTRODUCTION: Laparoscopic inguinal hernia and hydrocele repair has become an alternative to the more frequently used inguinal approach. We describe our experience with the laparoscopic technique. MATERIAL AND METHODS: Retrospective study of laparoscopic inguinal hernia and hydrocele repair performed during the period between 2003-2016. We included patients < 14 years, with communicating hydrocele and/or indirect inguinal hernia diagnosis (N = 39). We have studied two cohorts; group A patients with indirect inguinal hernia (N = 31) and group B patients with communicating hydrocele (N = 8). We used intraperitoneal laparoscopic approach, performing herniorrhaphy of the internal inguinal orifice without resection of the hernial sac. The main outcome measurements were surgical indication and postoperative complications. RESULTS: The indication for laparoscopic repair was bilateral defects (46.2%), unilateral defects (28.2%), defects associated with umbilical hernia (23.1%) and associated with another pathology (2.6%). In group A the rate of complications that required new admission was 3.2% and the recurrence rate was 9.7%. In group B, was 12.5% ​​and 12.5% respectively. We have not observed a significant relationship with respect to patient age, laterality or suture used and the rate of complications in any of the groups. CONCLUSIONS: Despite the limitations of our study given the small sample size and retrospective nature, the complication rate (15%) is higher than that published in the literature. This makes us take a step back to reassess our indications and technique, and not forget that the laparoscopic approach is not a technique without risks and requires a learning curve.


OBJETIVOS: La reparación laparoscópica de la hernia inguinal e hidroceles en la edad pediátrica, se ha convertido en una alternativa a la herniorrafia inguinal clásica. Describimos nuestra experiencia en las intervenciones realizadas con dicha técnica. MATERIAL Y METODOS: Estudio retrospectivo de las reparaciones laparoscópicas de hernia inguinal e hidrocele realizadas en el periodo 2003-2016. Se han incluido pacientes <14 años, diagnosticados de hidrocele comunicante y/o de hernia inguinal indirecta (N=39), divididos en dos cohortes: grupo A pacientes con hernia inguinal indirecta y grupo B pacientes con hidrocele comunicante. Se ha empleado el abordaje laparoscópico intraperitoneal, y anillorrafia del orificio inguinal interno sin resección del saco herniario. Las variables principales estudiadas han sido la indicación quirúrgica y las complicaciones postquirúrgicas. RESULTADOS: Las indicaciones quirúrgicas han sido los defectos bilaterales (46,2%), defectos unilaterales (28,2%), defectos asociados a hernia umbilical (23,1%) y asociados a otra patología (2,6%). En el grupo A la tasa de complicaciones que precisaron de ingreso fue de 3,2% y la tasa de recurrencias fue de 9,7%; mientras que en el B han sido del 12,5% y del 12,5% respectivamente. No hay una relación significativa respecto a la edad, la lateralidad o la sutura utilizada y la tasa de complicaciones en ninguno de los grupos. CONCLUSIONES: A pesar de las limitaciones del estudio, el porcentaje total de complicaciones (15,3%) es más elevado que el publicado en la literatura. Esto nos hace reflexionar y no olvidar que el abordaje laparoscópico no es una técnica exenta de riesgos y requiere de una curva de aprendizaje.


Assuntos
Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Laparoscopia/métodos , Hidrocele Testicular/cirurgia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Doenças Peritoneais/patologia , Doenças Peritoneais/cirurgia , Complicações Pós-Operatórias/epidemiologia , Recidiva , Estudos Retrospectivos , Resultado do Tratamento
16.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29574163

RESUMO

OBJECTIVE: Evaluate the enlargement effect of the tibial tunnel emergence of 2 different of anterior cruciate ligament reconstruction techniques: antero-medial portal (AMP) vs. transtibial (TT) technique. METHODS: A prospective, randomized controlled study was performed in 36 consecutive patients who underwent anterior cruciate ligament reconstruction with autologous hamstring tendon grafts employing the AMP and conventional TT techniques. Lateral and antero-posterior radiographs were obtained for each patient at 6 weeks and 12 months postoperatively. The sclerotic margins of the tibial tunnels were measured at the widest dimension of the tunnel as well as the diameter of the tibial emergence and were compared with the initially drilled tunnel size after correction for radiographic magnification. Statistical analysis was performed to compare the 2 groups by use of the independent-samples t test, with significance set at .05. RESULTS: The mean percentage increase in the diameter of tibial tunnel emergence at 6 weeks after surgery was 8.1%±2.9 for the PAM technique and 21.20%±11.87 for the TT technique on the anteroposterior x-ray view. However, the mean percentage increase in the diameter of the tibial tunnel emergence on the lateral view was 7.1%±4.72 for the medial portal technique and 17.64%±11.48 for the transtibial technique. This difference was statistically significant on both anteroposterior and lateral views. CONCLUSIONS: The diameter of the tibial tunnel emergence for hamstring autologous anterior cruciate ligament reconstructions was significantly lower for the medial portal technique when compared with the conventional TT technique.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior/métodos , Tendões dos Músculos Isquiotibiais/transplante , Tíbia/cirurgia , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Transplante Autólogo , Resultado do Tratamento , Adulto Jovem
17.
Neurogastroenterol Motil ; 30(5): e13264, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29266818

RESUMO

BACKGROUND: The intestinal mucosa plays an important role in the mechanical barrier against pathogens. During Toxoplasma gondii infection, however, the parasites invade the epithelial cells of the small intestine and initiate a local immune response. In the submucosal plexus, this response promotes an imbalance of neurotransmitters and induces neuroplasticity, which can change the integrity of the epithelium and its secretory function. This study evaluated the submucosal neurons throughout acute T. gondii infection and the relationship between possible alterations and the epithelial and immune defense cells of the mucosa. METHODS: Forty Wistar rats were randomly assigned to 8 groups (n = 5): 1 control group, uninfected, and 7 groups infected with an inoculation of 5000 sporulated T. gondii oocysts (ME-49 strain, genotype II). Segments of the ileum were collected for standard histological processing, histochemical techniques, and immunofluorescence. KEY RESULTS: The infection caused progressive neuronal loss in the submucosal general population and changed the proportion of VIPergic neurons throughout the infection periods. These changes may be related to the observed reduction in goblet cells that secret sialomucins and increase in intraepithelial lymphocytes after 24 hours, and the increase in immune cells in the lamina propria after 10 days of infection. The submucosa also presented fibrogenesis, characterizing injury and tissue repair. CONCLUSIONS AND INFERENCES: The acute T. gondii infection in the ileum of rats changes the proportion of VIPergic neurons and the epithelial cells, which can compromise the mucosal defense during infection.


Assuntos
Células Caliciformes/metabolismo , Íleo/metabolismo , Linfócitos Intraepiteliais/metabolismo , Neurônios/metabolismo , Toxoplasmose/metabolismo , Peptídeo Intestinal Vasoativo/metabolismo , Animais , Contagem de Células , Morte Celular/fisiologia , Células Caliciformes/microbiologia , Células Caliciformes/patologia , Íleo/microbiologia , Íleo/patologia , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Mucosa Intestinal/patologia , Linfócitos Intraepiteliais/microbiologia , Linfócitos Intraepiteliais/patologia , Masculino , Plexo Mientérico/metabolismo , Plexo Mientérico/microbiologia , Plexo Mientérico/patologia , Neurônios/microbiologia , Neurônios/patologia , Ratos , Ratos Wistar , Toxoplasma , Toxoplasmose/microbiologia , Toxoplasmose/patologia
18.
Braz. j. biol ; 77(4): 724-730, Nov. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-888805

RESUMO

Abstract We evaluated the nesting by Crocodylus moreletii in Lago de Catemaco, Veracruz, southeastern, Mexico. During the nesting and hatching seasons, we searched for nests along the northern margins of the lake and small associated streams. We investigated egg mortality by weekly monitoring each of the nests found, recording sign of predation (tracks and holes dug into the nest) and the effect of water level fluctuations. We not found differences to nest between inland or flooded zones. However, we found that egg size varied among nests. In nests built inland, predation was the major cause of egg mortality whereas flooding resulted in more deaths of eggs in the flooding zone. Flooding killed 25% of eggs monitored in this study. We suggest that to increase nest success in the Morelet's crocodile it is necessary to promote conservation of nesting areas around the lake, recently occupied by urban or tourist developments.


Resumo Nós avaliamos a nidificação numa população de Crocodylus moreletii no Lago de Catemaco, Veracruz, sudeste, México. Durante as temporadas de nidificação e eclosão buscamos ninhos ao longo das margens situadas ao norte do lago e pequenos riachos associados. Estabelecemos a mortalidade de ovos por semana monitorando cada ninho achado, registrando qualquer sinal de predação (rastros e buracos cavados no ninho) e o efeito das flutuações no nível da agua. Não achamos nenhuma preferência para aninhar na terra ou em áreas inundadas. Por outro lado, achamos que o tamanho de ovo foi significativamente diferente entre os tipos de ninho. Em ninhos construídos na terra, a predação foi a principal causa da mortalidade de ovos enquanto que nas áreas inundadas, inundação foi um fator importante na morte dos ovos. Em comparação com depredação, a ruptura acidental e colonização fúngica, as inundações mataram 25% de ovos monitorados. Nós sugerimos que para aumentar o sucesso de aninhamento do crocodilo do Morelet é preciso promover a conservação das áreas de nidificação ao redor do lago, recentemente ocupadas pelo desenvolvimento urbano ou turístico.


Assuntos
Animais , Feminino , Jacarés e Crocodilos/fisiologia , Comportamento de Nidação , Lagos , Rios , México
19.
Rev Calid Asist ; 32(5): 262-268, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-28863965

RESUMO

AIM: To evaluate the differences in COPD patients below the lower limit of normal (LLN) of the fixed ratio FEV1/FVC < 0.70 and those above this limit. PATIENTS AND METHODS: Cross-sectional study. COPD patients between 40 and 85 years old included in primary care clinical record database were randomly selected. Baseline and postbronchodilator spirometries were performed. Two groups of patients were established: FEV1/FVC<0.70 and ≤LIN (group1) and FEV/FVC<0.70 and >LIN (group 2). Sociodemographic, clinical, pulmonary obstruction, quality of life and attendance to health services variables were measured. The results of both groups were compared. RESULTS: 22.3% of the subjects were misdiagnosed FEV1/FVC < 0,70. Patients in group 2 (FEV1/FVC<0.70 y > LLN) are diagnosed at an older age, they have a lower exposure to tobacco and better pulmonary function (FEV1: 74.9% vs 54.6%). 35.5% of those patients belong to stage i of GOLD, vs 8.5%, this patients have an increased comorbidity. Patients in group 1 have more COPD exacerbations, worse quality of life, a higher BODEx index 2,3 (1.8) vs 1.1 (1.5); 55.1% of those patients were high risk patients (GoldC or Gold D). Diagnose before being 56 years old, an increased exposure to tobacco, the FEV>50%, and a lower comorbidity are associated with a greater chance of suffering COPD with LLN criteria. CONCLUSION: We obtain two groups of patients with differentiated clinical characteristics if we use LLN. Subjects with FEV1/FVC<0.7 and >LLN have less obstruction, less severity and more comorbidity, suggesting the possibility of overdiagnosis or misdiagnosis. On the other hand, younger age at the time of diagnosis, higher tobacco consumption and more severe obstruction are related with FEV1/FVC >0.70 and

Assuntos
Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Espirometria , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Broncodilatadores/farmacologia , Broncodilatadores/uso terapêutico , Terapia Combinada , Comorbidade , Estudos Transversais , Erros de Diagnóstico , Feminino , Volume Expiratório Forçado/efeitos dos fármacos , Humanos , Pulmão/fisiopatologia , Masculino , Uso Excessivo dos Serviços de Saúde , Pessoa de Meia-Idade , Oxigenoterapia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/terapia , Qualidade de Vida , Estudos de Amostragem , Fumar/epidemiologia , Fatores Socioeconômicos , Capacidade Vital/efeitos dos fármacos
20.
Rev Clin Esp (Barc) ; 217(8): 454-459, 2017 Nov.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28830616

RESUMO

OBJECTIVES: In recent years, various scientific societies and healthcare organisations have created recommendations aimed at decreasing the use of healthcare interventions that have shown no efficacy or effectiveness. The aim of this study was to assess the impact of an intervention on 12 do-not-do recommendations regarding the laboratory in 7 hospital centres. METHODS: Before-after study conducted in 7 hospital centres of Cordoba and Jaen during 2015 and 2016. Based on the recommendations of existing scientific societies, a consensus was reached on various actions regarding laboratory measurements. We analysed the number and cost of measuring 6 tumour markers (carcinoembryonic antigen, prostate-specific antigen, carbohydrate antigen [CA] 15.3, CA125, CA19.9 and alpha-fetoprotein), thyrotropin, T3, T4, glycated haemoglobin, urea, ferritin and antigliadin antibodies, before and after implementing the consensus. RESULTS: Compared with the previous year, there were 55,902 fewer laboratory measurements (-19%) in 2016, with an overall savings of €82,100. The reduction in the number of measurements occurred mainly in plasma urea (-50.3%) and in the tumour markers CA125 (-16%), CA19.9 (-11.6%) and CA15.3 (-10.5%). The most pronounced savings were achieved in the measurements of urea (-€21,002), thyroid hormones (-€12,716) and thyrotropin (-€7,638). CONCLUSIONS: The adoption and consensus of do-not-do recommendations among healthcare levels resulted in a significant reduction in unnecessary measurements.

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