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1.
Artigo em Inglês | MEDLINE | ID: mdl-37923577

RESUMO

The pathogenesis of recurrent chronic dislocation of the temporomandibular joint has been attributed to multiple factors, such as hyperlaxity of the soft tissues or alterations in the size of the temporal eminence. When there are no bone alterations, the injection of sclerosing solutions is an effective treatment that can be performed using a blind technique or with arthroscopy. This study presents an innovative technique for injecting ethoxysclerol into the posterior ligament through single puncture arthroscopy. This approach offers a safe and effective alternative for surgeons without experience in high-complexity arthroscopy who want to ensure precise injection of the agent into the desired anatomical areas.

2.
Plant Biol (Stuttg) ; 25(3): 468-477, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36652268

RESUMO

In several montane forests around the world, epiphytes coexist in mats, sharing the rhizosphere and forming histosol-type soils rich in nutrients. The role of these epiphytes in the formation of canopy soil and the fitness costs that epiphytes face when cohabiting in these mats are unknown. In a lower montane cloud forest in central Veracruz, Mexico, a 2-year factorial experiment was carried out with the presence/absence of ramets of Phlebodium areolatum (Polypodiaceae), Tillandsia kirchhoffiana, T. multicaulis and T. punctulata (Bromeliaceae). We examined (i) which epiphyte species contribute to the formation of canopy soil, (ii) the role of epiphyte composition in the soil nutrient composition, and (iii) the fitness costs faced by epiphytes when cohabiting. Canopy soil formation highest when P. areolatum is present. Soil nutrient content does not change with epiphyte composition, is influenced by the microbiota, and P content decreases with the presence of epiphytes. The fitness costs show that the species compete, decreasing their survival and growth, but the competitive capacity differs between the species. We conclude that P. areolatum is an ecosystem engineer that promotes the creation of canopy soil but is a poor competitor. The results coincide with the model of succession by facilitation. Canopy soil is a slow-created component whose nutrient content does not depend on the epiphytic flora. In epiphyte mats, the dominant interactions are competitive, but there is also facilitation.


Assuntos
Ecossistema , Solo , Árvores , México , Florestas
3.
Actas Urol Esp (Engl Ed) ; 46(10): 619-628, 2022 12.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36280035

RESUMO

INTRODUCTION: There is no population-based study that accounts for the number of radical prostatectomies (RP) carried out in Spain, nor regarding the morbidity and mortality of this intervention. Our objective is to study the morbidity and mortality of RP in Spain from 2011 to 2015 and to evaluate the geographic variation. MATERIAL AND METHODS: We designed a retrospective observational study of all patients submitted to RP in Spain during five consecutive years (2011-2015). The data was extracted from the «Conjunto Mínimo Básico de Datos¼ (CMBD). We have evaluated geographic variations in terms of morbidity and hospital stay, and the impact of the mean annual surgical volume for each center on these variables. RESULTS: Between 2011-2015, a total of 37,725 RPs were performed in 221 Spanish public hospitals. The mean age of the series was 63.9±3.23 years. Of all RPs, 50% were performed through an open approach, and 43.4% have been operated on in hospitals with <500 beds. We observed an important variability in the distribution of the cases operated on in the different regions. The regions that perform more RPs are Andalusia, Catalonia, Galicia, and Madrid. Our study shows a complication rate of 8.6%, with hemorrhage and the need for transfusion being the most frequent (5.3 and 4%, respectively). There are significant differences in bleeding rates and hospital stay among regions, which are maintained after adjusting for patient characteristics and type of hospital. When studying the annual surgical volume of each hospital, we find that the impact on the rate of hemorrhage or transfusion is linear; however, hospital stay remains stable at around 5 days from 60 RPs/year. CONCLUSIONS: In national terms, morbidity and mortality rates after RP are comparable to those described in the literature. This study reveals a clear dispersion in the hospitals that carry out this intervention, showing clear differences in terms of morbidity and hospital stay between the different regions.


Assuntos
Hemorragia , Humanos , Pessoa de Meia-Idade , Idoso , Espanha/epidemiologia
4.
Med Phys ; 49(12): 7404-7416, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36217283

RESUMO

BACKGROUND: The Agility multileaf collimator (MLC) mounted in Elekta linear accelerators features some unique design characteristics, such as large leaf thickness, eccentric curvature at the leaf tip, and defocused leaf sides ('tilting'). These characteristics offer several advantages but modeling them in treatment planning systems (TPSs) is challenging. PURPOSE: The goals of this study were to investigate the challenges faced when modeling the Agility in two commercial TPSs (Monaco and RayStation) and to explore how the implemented MLC models could be improved in the future. METHODS: Four linear accelerators equipped with the Agility, located at different centers, were used for the study. Three centers use the RayStation TPS and the other one uses Monaco. For comparison purposes, data from four Varian linear accelerators with the Millennium 120 MLC were also included. Average doses measured with asynchronous sweeping gap tests were used to characterize and compare the characteristics of the Millennium and the Agility MLCs and to assess the MLC model in the TPSs. The FOURL test included in the ExpressQA package, provided by Elekta, was also used to evaluate the tongue-and-groove with radiochromic films. Finally, raytracing was used to investigate the impact of the MLC geometry and to understand the results obtained for each MLC. RESULTS: The geometry of the Agility produces dosimetric effects associated with the rounded leaf end up to a distance 20 mm away from the leaf tip end measured at the isocenter plane. This affects the tongue-and-groove shadowing, which progressively increases along the distance to the tip end. The RayStation and Monaco TPSs did not account for this effect, which made trade-offs in the MLC parameters necessary and greatly varied the final MLC parameters used by different centers. Raytracing showed that these challenging leaf tip effects were directly related to the MLC geometry and that the characteristics mainly responsible for the large leaf tip effects of the Agility were its tilting design and its small source-to-collimator distance. CONCLUSIONS: The MLC models implemented in RayStation and Monaco could not accurately reproduce the leaf tip effects for the Agility. Therefore, trade-offs are needed and the optimal MLC parameters are dependent on the specific characteristics of treatment plans. Refining the MLC models for the Agility to better approximate the measured leaf tip and tongue-and-groove effects would extend the validity of the MLC model, reduce the variability in the MLC parameters used by the community, and facilitate the standardization of the MLC configuration process.


Assuntos
Planejamento da Radioterapia Assistida por Computador , Radioterapia de Intensidade Modulada , Planejamento da Radioterapia Assistida por Computador/métodos , Dosagem Radioterapêutica , Imagens de Fantasmas , Aceleradores de Partículas , Radiometria/métodos , Radioterapia de Intensidade Modulada/métodos
5.
Int J Oral Maxillofac Surg ; 51(12): 1579-1586, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35654642

RESUMO

The aim of this investigation was to evaluate the outcomes of patients with advanced internal derangement of the temporomandibular joint who underwent operative arthroscopy, according to age stratified into two groups: <45 years and ≥45 years. The study included a series of 194 patients. Outcome variables were pain intensity and mandibular mobility. Additionally, the difference in arthroscopic findings in these age groups was studied. The data analysis included the paired t-test, χ2 test, and two-way analysis of variance, with a P-value <0.05 indicating statistical significance. A significant reduction in pain and an improvement in maximum inter-incisal opening (MIO) was observed in both groups starting at 1 month of follow-up (P < 0.01). However, the results for MIO were worse in the ≥45 years group (P=0.036) at 12- and 18-months follow-up. Regarding arthroscopic findings, the study showed a higher prevalence of severe chondromalacia in the ≥45 years group (P = 0.031) and disc displacement without reduction in the <45 years group (P = 0.020). Analysis of variance showed a greater pain reduction if no obliteration of the articular space was observed (P = 0.039). In young and older patients, operative arthroscopy can be useful for short-term treatment in advanced stages of internal derangement of the temporomandibular joint.


Assuntos
Luxações Articulares , Transtornos da Articulação Temporomandibular , Humanos , Pessoa de Meia-Idade , Artroscopia/métodos , Transtornos da Articulação Temporomandibular/cirurgia , Estudos Retrospectivos , Amplitude de Movimento Articular , Articulação Temporomandibular , Dor , Luxações Articulares/cirurgia , Resultado do Tratamento
6.
J Stomatol Oral Maxillofac Surg ; 122(1): 50-55, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32376499

RESUMO

PURPOSE: The aim of this report is to define a modification of the arthroscopic anterior myotomy that avoids disc suturing procedures for the treatment of advanced internal derangement (I D) of the temporomandibular joint (TMJ). SURGICAL TECHNIQUE: The minimally invasive arthroscopic anterior myotomy (MIAAM) is based on a partial resection of the superior belly of the lateral pterygoid muscle performed through a small incision of the articular capsule associated with a scarification of the posterior ligament of the TMJ. The high-frequency wave system, called Coblation, is extremely useful to be able to complete the MIAAM. CONCLUSION: This technique is indicated for patients with ID and Wilkes stages III-IV without response to conservative treatments, and the presence of an integral disc with an appropriate consistency is transcendent for the success of the procedure. Because of the unique characteristics of the MIAAM, it can be considered as an alternative to arthroscopic discopexy procedures.


Assuntos
Luxações Articulares , Miotomia , Transtornos da Articulação Temporomandibular , Humanos , Articulação Temporomandibular , Disco da Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/cirurgia
7.
Sci Rep ; 10(1): 18683, 2020 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-33122650

RESUMO

Reactive oxygen and nitrogen species (RONS), e.g. generated by cold physical plasma (CPP) or photodynamic therapy, interfere with redox signaling pathways of mammalian cells, inducing downstream consequences spanning from migratory impairment to apoptotic cell death. However, the more austere impact of RONS on cancer cells remains yet to be clarified. In the present study, a combination of electrochemistry and high-resolution mass spectrometry was developed to investigate the resilience of solid-supported lipid bilayers towards plasma-derived reactive species in dependence of their composition. A 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) lipid bilayer was undisturbed by 200 µM H2O2 (control) but showed full permeability after CPP treatment and space-occupying oxidation products such as PoxnoPC, PAzePC, and POPC hydroperoxide were found. Electron paramagnetic resonance spectroscopy demonstrated the presence of hydroxyl radicals and superoxide anion/hydroperoxyl radicals during the treatment. In contrast, small amounts of the intramembrane antioxidant coenzyme Q10 protected the bilayer to 50% and LysoPC was the only POPC derivative found, confirming the membrane protective effect of Q10. Such, the lipid membrane composition including the presence of antioxidants determines the impact of pro-oxidant signals. Given the differences in membrane composition of cancer and healthy cells, this supports the application of cold physical plasma for cancer treatment. In addition, the developed model using the combination of electrochemistry and mass spectrometry could be a promising method to study the effect of reactive species or mixes thereof generated by chemical or physical sources.


Assuntos
Técnicas Eletroquímicas/métodos , Bicamadas Lipídicas , Espectrometria de Massas/métodos , Espécies Reativas de Nitrogênio/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Eletrodos , Ouro/química , Peróxido de Hidrogênio/química , Microscopia de Força Atômica , Oxirredução , Fosfatidilcolinas/química
8.
Int J Oral Maxillofac Surg ; 49(12): 1525-1534, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32360101

RESUMO

Oral squamous cell carcinoma (OSCC) remains a challenge for head and neck surgeons, with low 5-year survival rates despite improvements in diagnostic techniques and therapies. This retrospective observational study was performed to evaluate the epidemiology and risk factors in a cohort of 666 patients with invasive OSCC over a 39-year period. Risk factors assessed were age, sex, toxic habits, premalignant lesions, tumour location and size, and neck involvement, and pathological factors such as surgical margins, tumour thickness, perineural invasion, and bone invasion. These factors were analysed over time, and their influence on recurrence and survival rates examined. Results were compared with those of current epidemiological studies in the literature. This series showed a tendency to diagnosis at older ages (P<0.001) and decreased differences in sex distribution (P<0.001) over time. Regarding risk factors, tobacco and alcohol drinking increased significantly in females, but remained stable in males. Forty percent of the patients developed recurrences during follow-up; the relapse rate did not improve over time (45.6% in the 1980s to 36.1% in 2010-2017). The 5-year survival rate also remained stable over time, ranging from 62.7% (1980s) to 71.7% (2010-2017). This epidemiological study analysed trends across four decades in a stable cohort, with results that may be extrapolated to the populations of European countries. The results confirmed that recurrence rates and survival rates have not improved over time, despite better surgical treatments and new therapies. Further studies are needed to improve knowledge about genetics and tumour behaviour in oral cancer.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Bucais , Idoso , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/terapia , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Neoplasias Bucais/terapia , Recidiva Local de Neoplasia/epidemiologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco
9.
World J Urol ; 38(12): 3121-3129, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32140768

RESUMO

OBJECTIVE: To investigate the effect of an Enhanced Recovery After Surgery (ERAS) program on complications and length of stay (LOS) after radical cystectomy (RC) and to assess if the number and type of components of ERAS play a key role on the decrease of surgical morbidity. MATERIALS AND METHODS: We analyzed the data of 277 patients prospectively recruited in 11 hospitals undergoing RC initially managed according to local practice (Group I) and later within an ERAS program (Group II). Two main outcomes were defined: 90-day complications rate and LOS. As secondary variables we studied 90-day mortality, 30-day readmission and transfusion rate. RESULTS: Patients in Group II had a higher use of ERAS measures (98.6%) than those in Group I (78.2%) (p < 0.05). Patients in Groups I and II experienced similar complications (70.5% vs. 66%, p = 0.42). LOS was not different between Groups I and II (12.5 and 14 days, respectively, p = 0.59). The risk of having any complication decreases for patients having more than 15 ERAS measures adopted [RR = 0.815; 95% confidence interval (CI) 0.667-0.996; p = 0.045]. Avoidance of transfusion and nasogastric tube, prevention of ileus, early ambulation and a fast uptake of a regular diet are independently associated with the absence of complications. CONCLUSIONS: Complications and LOS after RC were not modified by the introduction of an ERAS program. We hypothesize that at least 15 measures should be applied to maximize the benefit of ERAS.


Assuntos
Cistectomia , Recuperação Pós-Cirúrgica Melhorada , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Cistectomia/métodos , Feminino , Fidelidade a Diretrizes , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Resultado do Tratamento
10.
Int J Oral Maxillofac Surg ; 49(10): 1311-1318, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32217035

RESUMO

The aim of this study was to present the results of a modification of the arthroscopic anterior myotomy for the treatment of internal derangement (ID) of the temporomandibular joint (TMJ): the minimally invasive arthroscopic anterior myotomy (MIAAM). Fifteen joints with Wilkes stages III-IV ID treated with this technique were studied. Clinical data evaluated were pain (visual analogue scale, VAS) and articular movements (preoperatively and at 1, 3, 6, 9, and 12 months postoperative). The position of the disc at 1 year after surgery was compared with the pre-surgical position, using magnetic resonance imaging (MRI). The mean pain level according to the VAS decreased from of 67.8 pre-surgery to 29.0 at the 12-month follow-up (P < 0.001). Functionally, mouth opening increased from a mean 27.8 mm to 36.0 mm (P < 0.001). Evaluation of the MRI images showed statistically significant improvements in disc position in both the closed (P = 0.00002) and open-mouth (P = 0.00001) position. The incidence of re-arthroscopy was 13.3% (2/15). This procedure is an effective method for the improvement of joint function and reduction of pain in patients with ID of the TMJ. However, MIAAM is moderately effective in regards to repositioning of the disc.


Assuntos
Luxações Articulares , Miotomia , Transtornos da Articulação Temporomandibular , Artroscopia , Humanos , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/cirurgia , Imageamento por Ressonância Magnética , Medição da Dor , Amplitude de Movimento Articular , Articulação Temporomandibular , Disco da Articulação Temporomandibular/diagnóstico por imagem , Disco da Articulação Temporomandibular/cirurgia , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/cirurgia , Resultado do Tratamento
11.
Plant Biol (Stuttg) ; 22(3): 541-552, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31834980

RESUMO

Canopy soil (CS) volume reflect epiphyte community maturity, but little is known about the factors that retain CS or species succession within it. Humus fern species (e.g. Phlebodium areolatum) appear capable of retaining CS. In ten Quercus spp. we sampled 987 epiphyte mats to examine the role of the common epiphyte species and crown traits determining CS volume, in order to infer successional stages and identify pioneer and late successional species. Branch traits (height, diameter and slope), CS volume and cover of the epiphyte species were determined for each mat. Nutrient content was determined in CS random samples of 12 epiphyte associations and sizes (one sample from each size quintile). A total of 60% of the mats lack CS. Cover of P. areolatum was the main variable explaining CS volume, and this species was present in 46.8% of those with CS. Epiphyte composition was highly variable, but pioneer (species appearing in monospecific mats, without CS) and late successional species could be identified. Canopy soil nutrient content was similar among the associations of epiphytes. Magnesium, Ca and pH decreased with CS volume, while P and N increased. Phlebodium areolatum is associated with high CS volumes and could act as a key species in its retention. Monospecific mats of pioneer species lack CS or have low volumes, while CS is much higher in mats with late successional species, but the mechanisms of CS formation and nutrient retention in response to interactions between epiphyte species remain to be tested.


Assuntos
Gleiquênias , Nutrientes , Quercus , Solo , Gleiquênias/fisiologia , Nutrientes/metabolismo , Quercus/metabolismo , Solo/química , Árvores
12.
Rev. mex. ing. bioméd ; 40(3): e201910, sep.-dic. 2019. graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1127060

RESUMO

Abstract Medical imaging technologies have become an essential component in different areas related to health care. Volume visualization (VV) of medical data is an invaluable support in tasks such as clinical diagnosis, treatment planning, surgery rehearsal, education, and research. Several algorithms and systems have been developed to enable the visualization and interaction with volumetric data. Slice-based visualization methods dominate the field of medical volumes scanning since they allow more detailed analysis of the data. However, an intensive training is usually required for the user to be able to effectively explore the data. In this paper, we present novel a slice-based methodology which objective is to facilitate the exploration of medical volumetric data. The proposed method consists of the use of augmented reality principles to determine the spatial position and orientation of rigid planar objects within a defined space in the real-world which represents the medical volumetric information. The results obtained by a usability study indicate the feasibility of employing this technique for a natural human-computer interaction with the medical data, having the potential of making the process of medical volume exploration more easy and intuitive.


Resumen Las tecnologías de imagenología médica se han convertido en un componente esencial en diferentes áreas relacionadas con el cuidado de la salud. La visualización de volúmenes médicos, es un apoyo invaluable en tareas como el diagnóstico clínico, la planeación de tratamientos, la realización de cirugías, la educación y la investigación. Los métodos basados en cortes dominan el campo de la exploración de volúmenes médicos debido a que permiten un análisis más detallado de los datos. Sin embargo, una desventaja importante de los sistemas asociados a dichos métodos es que para su manejo usualmente se requiere una etapa de entrenamiento intensivo. En este artículo presentamos una novedosa metodología cuyo objetivo es facilitar la exploración basada en cortes de datos volumétricos de origen médico. Los métodos propuestos incluyen el uso de los principios y algoritmos de la realidad aumentada para determinar la posición y orientación espacial de objetos planares rígidos dentro un espacio definido en el mundo real, el cual representa la información del volumen médico. Los resultados obtenidos mediante un estudio de usabilidad indican la factibilidad de emplear este método para la exploración natural de los datos médicos, teniendo el potencial de hacer el proceso de exploración de datos volumétricos médicos más fácil e intuitiva.

13.
Ophthalmic Genet ; 40(6): 553-557, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31755796

RESUMO

Background: Nance-Horan syndrome (NHS) is an X-linked rare congenital disorder caused by mutations in the NHS gene. Clinical manifestations include congenital cataracts, facial and dental dysmorphism and, in some cases, intellectual disability. The aim of the present work was to identify the genetic cause of this disease in two unrelated Spanish NHS families and to determine the relative involvement of this gene in the pathogenesis.Materials and methods: Four members of a two-generation family, three males and one female (Family 1), and seven members of a three-generation family, two males and five females (Family 2) were recruited and their index cases were screened for mutations in the NHS gene and 26 genes related with ocular congenital anomalies by NGS (Next Generation Sequencing).Results: Two pathogenic variants were found in the NHS gene: a nonsense mutation (p.Arg373X) and a frameshift mutation (p.His669ProfsX5). These mutations were found in the two unrelated NHS families with different clinical manifestations.Conclusions: In the present study, we identified two truncation mutations (one of them novel) in the NHS gene, associated with NHS. Given the wide clinical variability of this syndrome, NHS may be difficult to detect in individuals with subtle clinical manifestations or when congenital cataracts are the primary clinical manifestation which makes us suspect that it can be underdiagnosed. Combination of genetic studies and clinical examinations are essential for the clinical diagnosis optimization.


Assuntos
Catarata/congênito , Doenças Genéticas Ligadas ao Cromossomo X/etiologia , Proteínas de Membrana/genética , Mutação , Anormalidades Dentárias/etiologia , Adulto , Catarata/etiologia , Catarata/patologia , Criança , Feminino , Doenças Genéticas Ligadas ao Cromossomo X/patologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Linhagem , Prognóstico , Anormalidades Dentárias/patologia
14.
Actas Urol Esp (Engl Ed) ; 43(7): 378-383, 2019 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31171379

RESUMO

INTRODUCTION: The world population is ageing, and life expectancy is increasing. This situation will have a great impact on the management of patients with prostate cancer, especially in those of low risk, susceptible to a conservative management under active surveillance (AS). Regarding these patients' profile, it is necessary to answer the following questions: ¿for how long to continue with the AS scheme?, ¿which tests will be required?, ¿is it possible to carry out a transition to observation with oncological safety? The objective of this work is to analyse those patients with prostatic cancer who have been in AS with 75 years of age or more and assess the safety of the observation in an AS series with a long follow-up. MATERIAL AND METHODS: We analysed our prospective cohort of AS patients between the years 1999 and 2018,including those who had been in follow-up with 75 years or more. They were offered treatment with curative intent when there were progression criteria and transition to observation under the urologist's decision. Some intermediate risk patients were included in the analysis. Comorbidity changes were analysed with the Charlson comorbidity index at entry and exit of AS. The progression and mortality of the patients were studied according to the management they received. RESULTS: From 347 AS patients, 90 patients fulfilled the afore mentioned criteria and 15 (16.7%) were intermediate risk. The median follow-up was 6.4 years and 73 (81.1%) had low comorbidity (Charlson<2).There were 40 (44.4%) patients who left AS, 17 (18.9%) of them went to observationand the rest, 21 (23.3%), received curative treatment. There was a significant difference in comorbidity, measured by the Charlson index, at entry and exit of AS (P<.05) among patients receiving active treatment and the ones submitted to observation.No case of cancer-specific death or progression was observed in the observation group. CONCLUSION: The transition from an active surveillance management to observation of prostate cancer elderly patients, as well as the decision to carry out a treatment with curative intent, seems controversial. In our series, this transition in patients older than 75 years does not increase the oncological risk.


Assuntos
Neoplasias da Próstata/terapia , Conduta Expectante , Fatores Etários , Idoso , Progressão da Doença , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Fatores de Tempo
15.
J Appl Microbiol ; 126(6): 1944-1954, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30884047

RESUMO

AIMS: To evaluate a low-cost water quality test for at-scale drinking water safety estimation in rural India. METHODS AND RESULTS: Within a longitudinal study to characterize variability in household drinking water safety in rural Maharashtra, we piloted a low-cost presence-absence (LCPA) microbial test designed to be used by volunteer residents in rural areas. In comparing the LCPA results with standard laboratory methods for enumeration of Escherichia coli, we found that LCPA tests using modified mTec media were highly sensitive in detecting drinking water of moderate risk (88% of tests were positive at E. coli counts of 11-100 CFU per 100 ml) and high risk (96% of tests were positive at E. coli counts of 101 + CFU per 100 ml). The LCPA tests demonstrated low specificity for E. coli specifically, due to concurrent detection of Klebsiella: 38% of LCPA tests were positive even when E. coli was not detected in a 100 ml sample by membrane filtration, suggesting the test would be conservative in risk estimation. We also found that 47% of participants in rural villages in India were willing to conduct tests and return results after a brief training, with 45% of active participants sending their water testing results via short message service. CONCLUSIONS: Given their low cost (~US$0.50 as piloted) and open-source format, such tests may provide a compelling alternative to standard methods for rapid water quality assessments, especially in resource-limited settings. SIGNIFICANCE AND IMPACT OF THE STUDY: The lack of availability of water quality data constrains efforts to monitor, evaluate and improve the safety of water and sanitation infrastructure in underserved settings. Current water testing methods are not scalable because of laboratory and cost constraints. Our findings indicate the LCPA or similar low-cost microbial tests could be useful in rapid water safety estimation, including via crowdsourcing.


Assuntos
Água Potável/microbiologia , Água Potável/normas , Monitoramento Ambiental/métodos , Técnicas Microbiológicas/métodos , Microbiologia da Água , Abastecimento de Água/normas , Contagem de Colônia Microbiana , Monitoramento Ambiental/economia , Monitoramento Ambiental/normas , Escherichia coli/crescimento & desenvolvimento , Humanos , Índia , Estudos Longitudinais , Técnicas Microbiológicas/economia , Técnicas Microbiológicas/normas
16.
Rev. MVZ Córdoba ; 23(2): 6681-6695, May-Aug. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-957363

RESUMO

Abstract Objectives. The aim of this study is to evaluate the relationship among ovulatory follicle (OF) size, corpus luteum (CL) volume, and progesterone (P4) serum levels with pregnancy success. Materials and methods. Nineteen Holstein cows located in Bogotá, Colombia with a history of 2 to 6 previous calving were used in the study. Following 40 day postpartum, two consecutive phases were evaluated as follows: 1) estrous cycle; 2) early pregnancy or return to estrus after Artificial Insemination (AI). Ultrasound exam was performed twice daily after first sign of estrus to evaluate OF diameter and CL volume, and serum P4 levels were evaluated on days 6, 9, 12 and 15 after ovulation. Cows were inseminated 12 hours post estrus signs and pregnancy was diagnosed 30 days post AI. Results. 47.36% of the cows were diagnosed as pregnant after AI. Pregnant cows had smaller OF diameters (17.85±2.39 mm) than non-pregnant females (21.10±2.86 mm) (p<0.05). Cows with smaller OF were more likely to become pregnant (OR=0.624, IC=95% (0.4-0.9) (p<0.05). There were non significant differences in the CL volume (p=0.10) and P4 serum values (p=0.39) between pregnant and no pregnant cows on days 6, 9, 12 and 15 post ovulation. Serum P4 levels were not correlated to CL size and reproductive status. Conclusions. This study shows that there was not significant difference in serum P4 levels and the CL volume when comparing pregnant with non-pregnant cows. A relationship was found between the OF diameter and the CL volume. Small OF diameter was a factor associated with early pregnancy.


Resumen Objetivo. Evaluar la relación entre el diámetro del folículo ovulatorio (FO), el volumen del cuerpo lúteo (CL), los niveles séricos de progesterona (P4) con el éxito de la gestación. Materiales y métodos. En 19 vacas Holstein que habían tenido 2 a 6 partos ubicadas en Bogotá, se evaluaron dos fases consecutivas a partir del día 40 postparto, la primera correspondió al ciclo estral y la segunda correspondió a la gestación temprana o repetición de celo. En cada fase se detectó el celo, se realizó ultrasonografía para evaluar el diámetro del FO, confirmar ovulación, y el volumen del CL los días 6, 9, 12 y 15; en estos días también se evaluó los niveles séricos de P4. En la segunda fase se realizó inseminación artificial (IA) y se diagnosticó la gestación 30 días post-IA. Resultados. El 47.36% de las vacas se diagnosticaron como gestantes y el 52.63% como no gestantes. Las gestantes presentaron diámetros de FO menores 17.85±2.39 mm al de las no gestantes (21.10±2.86 mm; p<0.05). Las vacas que presentaron diámetros de FO más pequeños tuvieron mayor posibilidad de quedar gestantes (OR=0.624, IC=95% (0.4-0.9) (p<0.05). Los animales gestantes y no gestantes presentaron similares volúmenes de CL (p=0.10) y niveles séricos de P4 (p=0.39) los días 6, 9, 12 y 15. Conclusiones. No hubo diferencias en los niveles séricos de p4 y el volúmen del CL. Vacas con FO de menor diámetro tuvieron mayor probabilidad de gestación. Otras variables como CL y niveles de P4 no fueron predictivos del éxito de la gestación.


Assuntos
Animais , Ovário , Progesterona , Gravidez , Bovinos , Ciclo Estral , Período Pós-Parto
17.
Actas Urol Esp (Engl Ed) ; 42(7): 442-449, 2018 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29661508

RESUMO

BACKGROUND: Our main objective was to report the current use of active surveillance in Spain and to identify areas for potential improvement. METHODS: A questionnaire generated by the Platform for Multicentre Studies of the Spanish Urology Association (AEU/PIEM/2014/0001, NCT02865330) was sent to all associate researchers from January to March 2016. The questionnaire included 7 domains covering various aspects of active surveillance. RESULTS: Thirty-three of the 41 associate researchers responded to the questionnaire. Active surveillance is mainly controlled by the urology departments (87.9%). There was considerable heterogeneity in the classical clinical-pathological variables as selection criteria. Only 36.4% of the associate researchers used prostate-specific antigen density (PSAd). Multiparametric magnetic resonance imaging (mpMRI) was clearly underused as initial staging (6%). Only 27.3% of the researchers stated that their radiology colleagues had a high level of experience in mpMRI. In terms of the confirmation biopsy, most of the centres used the transrectal pathway, and only 2 out of 33 used the transperineal pathway or fusion software. Half of the researchers interviewed applied active treatment when faced with disease progression to Gleason 7 (3+4). There was no consensus on when to transition to an observation strategy. CONCLUSIONS: The study showed the underutilisation of informed consent and quality-of-life questionnaires. PSAd was not included as a decisive element in the initial strategy for most researchers. There was a lack of confidence in the urologists' mpMRI experience and an underutilisation of the transperineal pathway. There was also no consensus on the follow-up protocols and active treatment criteria, confirming the need for prospective studies to analyse the role of mpMRI and biomarkers.


Assuntos
Neoplasias da Próstata/terapia , Sistema de Registros , Urologia , Conduta Expectante , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Espanha
18.
Rev. MVZ Córdoba ; 23(1): 6500-6513, Jan.-Apr. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-957348

RESUMO

ABSTRACT Objective. The purpose of this study was to characterize the incidence of EM in Ross 308 strain eggs. Materials and methods. A prospective cohort study was performed, through candling and embryodiagnosis, in 4 groups of eggs coming from 4 different age breeders. Other data such as percentage of infertility, malformation, malposition, cracked and contaminated eggs were reported. Results. General EM reached 16.08% IC95% (14.69; 17.60) and was different among the different age-groups (p<0.001), being higher for eggs from 64 week-old breeders with 27.66% IC95%(23.92; 31.99) and lower for the 47 weeks old ones (8.84% IC95%) (6.97; 11.22). In the first week of incubation 57.53% of the embryos died and mortality was at its highiest during days 1 and 3; in the second week EM was 38.42% died, with a maximum of deaths between days 19 and 21. Conclusions. This study allowed confirmation on the biphasic behaviour of EM, although there are variations in the peaks of mortality possibly attributed to differences in production conditions for each enterprise.


RESUMEN Objetivo. El propósito de este estudio fue caracterizar la incidencia de mortalidad embrionaria (ME) en huevos de estirpes Ross 308 en una empresa de Santander, Colombia. Materiales y métodos. Se realizó un estudio de cohorte prospectivo en el cual se siguieron durante la incubación, por medio de ovoscopía y embriodiagnóstico, 4 grupos de huevos provenientes de reproductoras de 4 edades diferentes. Se reporta el porcentaje de infertilidad, de malformaciones, malposición, huevos fisurados y contaminados. Resultados. La ME general alcanzó 16.08% IC95%(14.69; 17.60) y fue diferente entre los grupos de edad (p<0.001); esta fue mayor para los huevos de reproductoras de 64 semanas con 27.66% IC95% (23.92; 31.99) y menor para las de 47 semanas con 8.84% IC95% (6.97; 11.22). En la primera semana de incubación murió el 57.53% de los embriones y se presentó el pico de muerte entre los días 1 y 3; la segunda semana murió el 38.42%, con un máximo de muertes entre el día 19 y 21. Conclusiones. Este estudio, es el primero de su naturaleza para la zona y la estirpe y permitió confirmar el comportamiento bifásico de la ME aunque existen variaciones en los picos de mortalidad atribuidas posiblemente a las diferencias de las condiciones de producción propias de las empresas.

19.
Plant Biol (Stuttg) ; 20(3): 507-515, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29350452

RESUMO

The success of galling insects could be determined by synchronisation with host plant phenology and climate conditions, ensuring suitable oviposition sites for gall induction and food resources for their survival. The anatomical, histochemical and phenological synchronisation strategies between Calophya rubra (Blanchard) (Hemiptera: Psylloidea) and its host, the evergreen plant Schinus polygama (Cav.) (Cabrera) (Anacardiaceae), in the Mediterranean climate of southern Chile was evaluated and compared to that of the congeneric C. cf. duvauae (Scott) from Brazil and closely related host plant S. engleri in a subtropical climate. Anatomical, histometric, histochemical and vegetative phenology studies of the stem and galls were conducted from June 2015 to December 2016. Based on the anatomical, histometric and histochemical analysis, the conical stem gall traits imply gains over the non-galled stem toward the galling insect survival, but the maintenance of phellem, secretory ducts and pith indicate conservative developmental traits that cannot be manipulated by C. rubra. Our results indicate that the conditions of the Mediterranean climate zone limit C. rubra immature activity during unfavourable periods, probably determining a diapause period and a univoltine life cycle, which are peculiarities of the S. polygama- C. rubra system. The synchronisation between development and seasonality confers peculiarities to the S. polygama- C. rubra system in the Mediterranean climate zone.


Assuntos
Anacardiaceae/parasitologia , Hemípteros/fisiologia , Tumores de Planta/parasitologia , Anacardiaceae/anatomia & histologia , Animais , Chile , Estágios do Ciclo de Vida/fisiologia , Caules de Planta/anatomia & histologia , Caules de Planta/parasitologia
20.
J Comp Pathol ; 157(2-3): 193-200, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28942304

RESUMO

Neospora caninum, a tissue cyst-forming parasite, is the causative agent of bovine neosporosis. It is considered to be one of the most important transmissible causes of reproductive failure in cattle; abortion and neonatal mortality result in significant economic losses within the cattle industry worldwide. The balance between acute (mediated by the tachyzoite stage) and persistent (mediated by the bradyzoite stage) phases of the infection is influenced by the immune status of the animal, and for pregnant cows (the intermediate host) immune status is critical for transplacental (i.e. vertical) transmission of the parasite and associated disease outcomes. The horizontal route of transmission from the definitive host, the dog, occurs via ingestion of oocysts containing sporozoites, and plays a minor but important role in transmission of the infection to cattle. Despite the importance of this disease, there is no vaccine or treatment available currently, and at the present the only control measure to reduce the impact of disease is informed management on the farm. The development of vaccines, targeting key biological processes such as invasion and persistent infection, is needed urgently for the control of this widespread parasite.


Assuntos
Doenças dos Bovinos/prevenção & controle , Doenças dos Bovinos/parasitologia , Coccidiose/veterinária , Neospora , Vacinas , Animais , Bovinos , Doenças dos Bovinos/microbiologia
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