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1.
Neurol Sci ; 45(6): 2887-2891, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38589769

RESUMO

INTRODUCTION: Nusinersen was approved for 5q spinal muscular atrophy (SMA), irrespective of age, SMA type or functional status. Nonetheless, long-term data on adults with milder phenotypes are scarce. We aimed to characterize evolution on motor and respiratory function in our cohort of adults with type 3 SMA. METHODS: We conducted a longitudinal retrospective single-center study, including adults (≥18 years) with type 3 SMA under nusinersen for > 22 months. We reported on motor scores and spirometry parameters. RESULTS: Ten patients were included, with a median follow-up of 34 months (range = 22-46). Four patients (40%) were walkers. None used non-invasive ventilation. In Revised Upper Limb Module (RULM) and Expanded Hammersmith Functional Motor Scale (HFMSE), difference of medians increased at 6, 22 and 46 months comparing to baseline (-0.5 vs. + 1.5 vs. + 2.5 in RULM; + 4.0 vs. + 7.5 vs. + 6.0 in HFMSE). Two (50%) walkers presented a clinically meaningful improvement in 6-min walk distance. We did not report any clinically meaningful decrement in motor scores. Spirometry parameters showed an increasing difference of medians in maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) (-3 vs. + 13.4 vs. + 28.7 percentage points of predicted value for MIP; + 11.8 vs. + 13.1 vs. 13.3 percentage points of predicted value for MEP). DISCUSSION: Our cohort supports a sustained benefit of nusinersen in adults with type 3 SMA, in motor and respiratory function. Multicentric studies are still warranted.


Assuntos
Oligonucleotídeos , Atrofias Musculares Espinais da Infância , Humanos , Masculino , Feminino , Oligonucleotídeos/uso terapêutico , Oligonucleotídeos/farmacologia , Adulto , Estudos Retrospectivos , Atrofias Musculares Espinais da Infância/tratamento farmacológico , Atrofias Musculares Espinais da Infância/fisiopatologia , Estudos Longitudinais , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem , Seguimentos
2.
Cureus ; 15(10): e46917, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37954796

RESUMO

Nonmissile penetrating spine injury represents a small percentage of spinal cord injuries (SCIs), estimated at 0.8% in Western countries. This paper presents a detailed case report of a 28-year-old man with a history of substance use who suffered multiple injuries following a violent incident. The patient was found with a knife embedded in his thoracic spine, prompting immediate medical intervention. Computed tomography and postoperative magnetic resonance imaging revealed the extent of spinal cord and anatomical involvement. A thorough physical medicine and rehabilitation evaluation was conducted post-surgery, leading to a diagnosis of Brown-Séquard syndrome with associated sensorimotor deficits. This paper highlights the challenges posed by penetrating SCIs while reviewing the literature.

3.
Pharmaceutics ; 15(1)2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36678788

RESUMO

Copaiba oil has been largely used due to its therapeutic properties. Nanocapsules were revealed to be a great nanosystem to carry natural oils due to their ability to improve the bioaccessibility and the bioavailability of lipophilic compounds. The aim of this study was to produce and characterize copaiba oil nanocapsules (CopNc) and to evaluate their hemocompatibility, cytotoxicity, and genotoxicity. Copaiba oil was chemically characterized by GC-MS and FTIR. CopNc was produced using the nanoprecipitation method. The physicochemical stability, toxicity, and biocompatibility of the systems, in vitro, were then evaluated. Β-bisabolene, cis-α-bergamotene, caryophyllene, and caryophyllene oxide were identified as the major copaiba oil components. CopNc showed a particle size of 215 ± 10 nm, a polydispersity index of 0.15 ± 0.01, and a zeta potential of -18 ± 1. These parameters remained unchanged over 30 days at 25 ± 2 °C. The encapsulation efficiency of CopNc was 54 ± 2%. CopNc neither induced hemolysis in erythrocytes, nor cytotoxic and genotoxic in lung cells at the range of concentrations from 50 to 200 µg·mL-1. In conclusion, CopNc showed suitable stability and physicochemical properties. Moreover, this formulation presented a remarkable safety profile on lung cells. These results may pave the way to further use CopNc for the development of phytotherapeutic medicine intended for pulmonary delivery of copaiba oil.

4.
J Enzyme Inhib Med Chem ; 38(1): 67-83, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36305291

RESUMO

Bacterial infections have become a global concern, stimulating the growing demand for natural and biologically safe therapeutic agents with antibacterial action. This study was evaluated the genotoxicity of the trypsin inhibitor isolated from tamarind seeds (TTI) and the antibacterial effect of TTI theoric model, number 56, and conformation number 287 (TTIp 56/287) and derived peptides in silico. TTI (0.3 and 0.6 mg.mL-1) did not cause genotoxicity in cells (p > 0.05). In silico, a greater interaction of TTIp 56/287 with the Gram-positive membrane (GP) was observed, with an interaction potential energy (IPE) of -1094.97 kcal.mol-1. In the TTIp 56/287-GP interaction, the Arginine, Threonine (Thr), and Lysine residues presented lower IPE. In molecular dynamics (MD), Peptidotrychyme59 (TVSQTPIDIPIGLPVR) showed an IPE of -518.08 kcal.mol-1 with the membrane of GP bacteria, and the Thr and Arginine residues showed the greater IPE. The results highlight new perspectives on TTI and its derived peptides antibacterial activity.


Assuntos
Tamarindus , Inibidores da Tripsina , Inibidores da Tripsina/farmacologia , Tamarindus/química , Peptídeos/química , Sementes/química , Antibacterianos/farmacologia , Antibacterianos/análise , Arginina/análise , Arginina/química
6.
Port J Card Thorac Vasc Surg ; 29(1): 61-63, 2022 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-35471214

RESUMO

The extravasation of doxorubicin, a cytostatic from the anthracycline group, is a rare and feared complication of intravenous chemotherapy due to tissue toxicity of these drugs. We describe a case of a 64-year-old woman with breast cancer undergoing adjuvant chemotherapy with doxorubicin and cyclophosphamide using a tunneled central catheter. After a chemotherapy cycle, the patient developed cough, dyspnoea and chest pain, due to a pleural effusion secondary to cytostatic leakage. A pleural drainage was placed and dexrazoxone was administred with resolution of the condition. The authors wish to highlight that the use of dexrazoxone should be considered after intra-pleural extravasation of anthracyclines given its effectiveness in preventing tissue damage and long-term sequelae in peripheral extravasation.


Assuntos
Antraciclinas , Citostáticos , Antraciclinas/efeitos adversos , Antibióticos Antineoplásicos/efeitos adversos , Doxorrubicina/efeitos adversos , Extravasamento de Materiais Terapêuticos e Diagnósticos , Feminino , Humanos , Pessoa de Meia-Idade
7.
PLoS One ; 17(3): e0265649, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35303021

RESUMO

The present study evaluated the cytotoxicity, antioxidant potential, and antimicrobial effect on the antibiotic activity modulation of gelatin nanoparticles containing buriti oil (OPG). The cytotoxicity analysis was performed on Chinese Hamster Ovary Cells (CHO) using a MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] test. The antioxidant potential of buriti oil and OPG was determined by total antioxidant capacity, reducing power, and the ABTS (2,2'-azinobis-3-ethylbenzothiazoline-6-sulfonic acid) test. The modulating antimicrobial activity was evaluated by determining the minimum inhibitory concentration (MIC) concentration against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, gentamicin and norflaxacillin. The nanoformulation of OPG did not show a cytotoxic effect on CHO cells and had a higher antioxidant potential than free buriti oil (p<0.05). The combination of antibiotics with free buriti oil and OPG was more efficient in inhibiting E. coli and P. aeruginosa than isolated norfloxacillin and gentamicin (p<0.05). Regarding the inhibition of S. aureus, OPG in combination with norfloxacillin reduced MIC by 50%. Nanoencapsulation was a viable alternative to enhance functionality and adding commercial value to buriti oil.


Assuntos
Antioxidantes , Arecaceae , Animais , Antibacterianos/farmacologia , Antioxidantes/farmacologia , Células CHO , Carotenoides , Cricetinae , Cricetulus , Escherichia coli , Gelatina , Gentamicinas/farmacologia , Testes de Sensibilidade Microbiana , Óleos de Plantas , Staphylococcus aureus , Suínos
8.
Rev Port Cardiol (Engl Ed) ; 40(10): 741-752, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34857112

RESUMO

INTRODUCTION AND OBJECTIVES: Pulmonary endarterectomy (PEA) is a potentially curative procedure in patients with chronic thromboembolic pulmonary hypertension (CTEPH). This study reports the initial experience of a Portuguese PH center with patients undergoing PEA at an international surgical reference center. METHODS: Prospective observational study of consecutive CTEPH patients followed at a national PH center, who underwent PEA at an international surgical reference center between October 2015 and March 2019. Clinical, functional, laboratory, imaging and hemodynamic parameters were obtained in the 12 months preceding the surgery and repeated between four and six months after PEA. RESULTS: 27 consecutive patients (59% female) with a median age of 60 (49-71) years underwent PEA. During a median follow-up of 34 (21-48) months, there was an improvement in functional class in all patients, with only one cardiac death. From a hemodynamic perspective, there was a reduction in mean pulmonary artery pressure from 48 (42-59) mmHg to 26 (22-38) mmHg, an increase in cardiac output from 3.3 (2.9-4.0) L/min to 4.9 (4.2-5.5) L/min and a reduction in pulmonary vascular resistance from 12.1 (7.2-15.5) uW to 3.5 (2.6-5,2) uW. During the follow-up, 44% (n=12) of patients had no PH criteria, 44% (n=12) had residual PH and 11% (n=3) had PH recurrence. There was a reduction of N-terminal pro-B-type natriureticpeptide from 868 (212-1730) pg/mL to 171 (98-382) pg/mL. Rright ventricular systolic function parameters revealed an improvement in longitudinal systolic excursion and peak velocity of the plane of the tricuspid ring from 14 (13-14) mm and 9 (8-10) cm/s to 17 (16-18) mm and 13 (11-15) cm/s, respectively. Of the 26 patients with preoperative right ventricular dysfunction, 85% (n=22) recovered. The proportion of patients on specific vasodilator therapy decreased from 93% to 44% (p<0.001) and the proportion of those requiring oxygen therapy decreased from 52% to 26% (p=0.003). The six-minute walk test distance increased by about 25% compared to the baseline and only eight patients had significant desaturation during the test. CONCLUSION: Pulmonary endarterectomy performed at an experienced high-volume center is a safe procedure with a very favorable medium-term impact on functional, hemodynamic and right ventricular function parameters in CTEPH patients with operable disease. It is possible for PH centers without PEA differentiation to refer patients safely and effectively to an international surgical center in which air transport is necessary.


Assuntos
Hipertensão Pulmonar , Embolia Pulmonar , Disfunção Ventricular Direita , Idoso , Endarterectomia , Feminino , Humanos , Hipertensão Pulmonar/etiologia , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/complicações , Resistência Vascular
9.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34474956

RESUMO

INTRODUCTION AND OBJECTIVES: Pulmonary endarterectomy (PEA) is a potentially curative procedure in patients with chronic thromboembolic pulmonary hypertension (CTEPH). This study reports the initial experience of a Portuguese PH center with patients undergoing PEA at an international surgical reference center. METHODS: Prospective observational study of consecutive CTEPH patients followed at a national PH center, who underwent PEA at an international surgical reference center between October 2015 and March 2019. Clinical, functional, laboratory, imaging and hemodynamic parameters were obtained in the 12 months preceding the surgery and repeated between four and six months after PEA. RESULTS: 27 consecutive patients (59% female) with a median age of 60 (49-71) years underwent PEA. During a median follow-up of 34 (21-48) months, there was an improvement in functional class in all patients, with only one cardiac death. From a hemodynamic perspective, there was a reduction in mean pulmonary artery pressure from 48 (42-59) mmHg to 26 (22-38) mmHg, an increase in cardiac output from 3.3 (2.9-4.0) L/min to 4.9 (4.2-5.5) L/min and a reduction in pulmonary vascular resistance from 12.1 (7.2-15.5) uW to 3.5 (2.6-5, 2) uW. During the follow-up, 44% (n=12) of patients had no PH criteria, 44% (n=12) had residual PH and 11% (n = 3) had PH recurrence. There was a reduction of N-terminal pro-B-type natriureticpeptide from 868 (212-1730) pg/mL to 171 (98-382) pg/mL. Rright ventricular systolic function parameters revealed an improvement in longitudinal systolic excursion and peak velocity of the plane of the tricuspid ring from 14 (13-14) mm and 9 (8-10) cm/s to 17 (16-18) mm and 13 (11-15) cm/s, respectively. Of the 26 patients with preoperative right ventricular dysfunction, 85% (n=22) recovered. The proportion of patients on specific vasodilator therapy decreased from 93% to 44% (p<0.001) and the proportion of those requiring oxygen therapy decreased from 52% to 26% (p=0.003). The six-minute walk test distance increased by about 25% compared to the baseline and only eight patients had significant desaturation during the test. CONCLUSION: Pulmonary endarterectomy performed at an experienced high-volume center is a safe procedure with a very favorable medium-term impact on functional, hemodynamic and right ventricular function parameters in CTEPH patients with operable disease. It is possible for PH centers without PEA differentiation to refer patients safely and effectively to an international surgical center in which air transport is necessary.

11.
Int J Biol Macromol ; 114: 565-571, 2018 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-29578018

RESUMO

Marine algae are sources of novel bioactive molecules and present a great potential for biotechnological and biomedical applications. Although green algae are the least studied type of seaweed, several of their biological activities have already been described. Here, we investigated the osteogenic potential of Sulfated Polysaccharide (SP)-enriched samples extracted from the green seaweed Caulerpa prolifera on human mesenchymal stem cells isolated from Wharton jelly (hMSC-WJ). In addition, the potential genotoxicity of these SPs was determined by cytokinesis-block micronucleus (CBMN) assay. SP-enriched samples did not show significant cytotoxicity towards hMSCs-WJ at a concentration of up to 10µg/mL, and after 72h of exposure. SP enrichment also significantly increased alkaline phosphatase (ALP) activity, promoting calcium accumulation in the extracellular matrix. Among the SP-enriched samples, the CP0.5 subfraction (at 5µg/mL) presented the most promising results. In this sample, ALP activity was increased approximately by 60%, and calcium accumulation was approximately 6-fold above the negative control, indicating high osteogenic potential. This subfraction also proved to be non-genotoxic, according to the CBMN assay, as it did not induce micronuclei. The results of this study highlight, for the first time, the potential of these SPs for the development of new therapies for bone regeneration.


Assuntos
Caulerpa/química , Diferenciação Celular/efeitos dos fármacos , Dano ao DNA , Células-Tronco Mesenquimais/metabolismo , Osteogênese/efeitos dos fármacos , Polissacarídeos , Animais , Células CHO , Cricetulus , Humanos , Células-Tronco Mesenquimais/citologia , Polissacarídeos/química , Polissacarídeos/isolamento & purificação , Polissacarídeos/farmacologia
12.
Sleep Breath ; 22(1): 211-221, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29247296

RESUMO

INTRODUCTION: Sleep related breathing disorders (SRBD) cause sleep fragmentation, intermittent hypoxia or a combination of both leading to homeostasis perturbations, including in the immune system. We investigated whether SRBD patients with or without intermittent hypoxia show substantial differences in perforin and granzyme-B positive peripheral blood lymphocytes. METHODS: A total of 87 subjects were included and distributed as follows: 24 controls (C), 19 patients with respiratory effort related arousals due to increased upper airway resistance (UAR) without hypoxic events, 24 obese patients with obstructive sleep apnea (OSA) (oOSA), and 20 without obesity (noOSA). After polysomnographic recording, we analyzed in fasting blood samples routine hematologic and biochemical parameters and the percentage of lymphocytes containing the proteins perforin and granzyme-B (GrB). Kruskal-Wallis tests and a posteriori multiple comparisons were applied for statistical analysis of results. RESULTS: Perforin-positive γδ-cells revealed significant differences between groups (p = 0.017), especially between the Control group and the oOSA (p-value = 0.04); the remaining SRBD groups also showed differences from the control (C vs UAR: p = 0.08; C vs noOSA = 0.09), but they did not raise to statistical significance. There were no differences among the SRBD groups. Granzyme-B cells were decreased in SRBD patients, but the differences were not statistically significant. No additional statistical significant result was found in the other investigated lymphocyte subsets. CONCLUSIONS: Obstructive sleep-disordered breathing is associated with a decrease in perforin-positive CD3+γδ-T cells. Although this finding was detected in lean patients without intermittent hypoxia, the reduction was only statistically significant in obese patients with severe OSA. Because CD3+γδ-T cells play an important role in the control of tumor cells, our findings are directly relevant for the study of the association of OSA and cancer.


Assuntos
Complexo CD3/metabolismo , Perforina/análise , Apneia Obstrutiva do Sono/sangue , Apneia Obstrutiva do Sono/imunologia , Linfócitos T/citologia , Linfócitos T/metabolismo , Adulto , Granzimas/análise , Granzimas/metabolismo , Humanos , Contagem de Linfócitos , Pessoa de Meia-Idade , Perforina/metabolismo , Polissonografia , Adulto Jovem
13.
Stem Cell Res Ther ; 8(1): 269, 2017 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-29179738

RESUMO

BACKGROUND: Titanium surfaces have been modified by various approaches with the aim of improving the stimulation of osseointegration. Laser beam (Yb-YAG) treatment is a controllable and flexible approach to modifying surfaces. It creates a complex surface topography with micro and nano-scaled patterns, and an oxide layer that can improve the osseointegration of implants, increasing their usefulness as bone implant materials. METHODS: Laser beam irradiation at various fluences (132, 210, or 235 J/cm2) was used to treat commercially pure titanium discs to create complex surface topographies. The titanium discs were investigated by scanning electron microscopy, X-ray diffraction, and measurement of contact angles. The surface generated at a fluence of 235 J/cm2 was used in the biological assays. The behavior of mesenchymal stem cells from an umbilical cord vein was evaluated using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, a mineralization assay, and an alkaline phosphatase activity assay and by carrying out a quantitative real-time polymerase chain reaction for osteogenic markers. CHO-k1 cells were also exposed to titanium discs in the MTT assay. RESULTS: The best titanium surface was that produced by laser beam irradiation at 235 J/cm2 fluence. Cell proliferation analysis revealed that the CHO-k1 and mesenchymal stem cells behaved differently. The laser-processed titanium surface increased the proliferation of CHO-k1 cells, reduced the proliferation of mesenchymal stem cells, upregulated the expression of the osteogenic markers, and enhanced alkaline phosphatase activity. CONCLUSIONS: The laser-treated titanium surface modulated cellular behavior depending on the cell type, and stimulated osteogenic differentiation. This evidence supports the potential use of laser-processed titanium surfaces as bone implant materials, and their use in regenerative medicine could promote better outcomes.


Assuntos
Diferenciação Celular/efeitos dos fármacos , Células-Tronco Mesenquimais/efeitos dos fármacos , Osteoblastos/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Titânio/efeitos da radiação , Fosfatase Alcalina/genética , Fosfatase Alcalina/metabolismo , Biomarcadores/metabolismo , Proteína Morfogenética Óssea 2/genética , Proteína Morfogenética Óssea 2/metabolismo , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Expressão Gênica , Humanos , Lasers , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Microscopia Eletrônica de Varredura , Osteoblastos/citologia , Osteoblastos/metabolismo , Osteocalcina/genética , Osteocalcina/metabolismo , Osteogênese/genética , Osteopontina/genética , Osteopontina/metabolismo , Cultura Primária de Células , Próteses e Implantes , Propriedades de Superfície , Titânio/farmacologia , Cordão Umbilical/citologia , Cordão Umbilical/efeitos dos fármacos , Cordão Umbilical/metabolismo
14.
J Bras Pneumol ; 43(2): 101-105, 2017.
Artigo em Inglês, Português | MEDLINE | ID: mdl-28538776

RESUMO

OBJECTIVE:: To characterize clinically all of the patients with spontaneous pneumomediastinum (SPM) admitted to an adult pulmonology ward in Lisbon, Portugal. METHODS:: This was a retrospective descriptive study of all adult patients (≥ 18 years of age) diagnosed with SPM between January of 2004 and September of 2015. RESULTS:: At least one predisposing factor was identified in most (88.9%) of the 18 patients who presented with SPM during the study period. With regard to precipitating factors, bouts of cough were present in 50.0% of the patients. Other precipitating factors included a sudden increase in tobacco consumption, inhaled drug use, occupational inhalation of varnish fumes, intense exercise, and vomiting. The most common complaints were dyspnea (in 83.3%) and chest pain (in 77.8%). Other complaints included cough, neck pain, dysphagia, and odynophagia. Subcutaneous emphysema was found in most of the patients. The diagnosis of SPM was based on chest X-ray findings in 61.1% of the patients. CONCLUSIONS:: Although SPM is a rare condition, it should be considered in the differential diagnosis of chest pain and dyspnea. It can develop without a triggering event or conclusive findings on a chest X-ray, which is usually sufficient for diagnosis. OBJETIVO:: Caracterizar clinicamente todos os pacientes com pneumomediastino espontâneo (PME) admitidos em uma enfermaria de pneumologia para adultos em Lisboa, Portugal. MÉTODOS:: Estudo descritivo retrospectivo no qual foram analisados todos os pacientes adultos (≥ 18 anos de idade) com diagnóstico de PME entre janeiro de 2004 e setembro de 2015. RESULTADOS:: Pelo menos um fator predisponente foi identificado na maioria (isto é, em 88,9%) dos 18 pacientes que apresentaram PME durante o período de estudo. No tocante a fatores precipitantes, crises de tosse ocorreram em 50,0% dos pacientes. Outros fatores precipitantes foram um aumento repentino do consumo de tabaco, uso de drogas inalatórias, inalação ocupacional de vapores de vernizes, exercício intenso e vômitos. As queixas mais comuns foram dispneia (em 83,3%) e dor torácica (em 77,8%). Outras queixas foram tosse, cervicalgia, disfagia e odinofagia. Constatou-se a presença de enfisema subcutâneo na maioria dos pacientes. O diagnóstico de PME baseou-se na radiografia de tórax em 61,1% dos pacientes. CONCLUSÕES:: Embora seja uma doença rara, o PME deve ser levado em conta no diagnóstico diferencial de dor torácica e dispneia. O PME pode surgir sem um evento desencadeante e sem achados conclusivos na radiografia de tórax, que é geralmente suficiente para o diagnóstico.


Assuntos
Enfisema Mediastínico/diagnóstico , Enfisema Mediastínico/etiologia , Adolescente , Adulto , Dor no Peito/diagnóstico , Diagnóstico Diferencial , Dispneia/diagnóstico , Feminino , Humanos , Masculino , Enfisema Mediastínico/terapia , Portugal , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo
15.
J. bras. pneumol ; 43(2): 101-105, Mar.-Apr. 2017. tab
Artigo em Inglês | LILACS | ID: biblio-841270

RESUMO

ABSTRACT Objective: To characterize clinically all of the patients with spontaneous pneumomediastinum (SPM) admitted to an adult pulmonology ward in Lisbon, Portugal. Methods: This was a retrospective descriptive study of all adult patients (≥ 18 years of age) diagnosed with SPM between January of 2004 and September of 2015. Results: At least one predisposing factor was identified in most (88.9%) of the 18 patients who presented with SPM during the study period. With regard to precipitating factors, bouts of cough were present in 50.0% of the patients. Other precipitating factors included a sudden increase in tobacco consumption, inhaled drug use, occupational inhalation of varnish fumes, intense exercise, and vomiting. The most common complaints were dyspnea (in 83.3%) and chest pain (in 77.8%). Other complaints included cough, neck pain, dysphagia, and odynophagia. Subcutaneous emphysema was found in most of the patients. The diagnosis of SPM was based on chest X-ray findings in 61.1% of the patients. Conclusions: Although SPM is a rare condition, it should be considered in the differential diagnosis of chest pain and dyspnea. It can develop without a triggering event or conclusive findings on a chest X-ray, which is usually sufficient for diagnosis.


RESUMO Objetivo: Caracterizar clinicamente todos os pacientes com pneumomediastino espontâneo (PME) admitidos em uma enfermaria de pneumologia para adultos em Lisboa, Portugal. Métodos: Estudo descritivo retrospectivo no qual foram analisados todos os pacientes adultos (≥ 18 anos de idade) com diagnóstico de PME entre janeiro de 2004 e setembro de 2015. Resultados: Pelo menos um fator predisponente foi identificado na maioria (isto é, em 88,9%) dos 18 pacientes que apresentaram PME durante o período de estudo. No tocante a fatores precipitantes, crises de tosse ocorreram em 50,0% dos pacientes. Outros fatores precipitantes foram um aumento repentino do consumo de tabaco, uso de drogas inalatórias, inalação ocupacional de vapores de vernizes, exercício intenso e vômitos. As queixas mais comuns foram dispneia (em 83,3%) e dor torácica (em 77,8%). Outras queixas foram tosse, cervicalgia, disfagia e odinofagia. Constatou-se a presença de enfisema subcutâneo na maioria dos pacientes. O diagnóstico de PME baseou-se na radiografia de tórax em 61,1% dos pacientes. Conclusões: Embora seja uma doença rara, o PME deve ser levado em conta no diagnóstico diferencial de dor torácica e dispneia. O PME pode surgir sem um evento desencadeante e sem achados conclusivos na radiografia de tórax, que é geralmente suficiente para o diagnóstico.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Enfisema Mediastínico/diagnóstico , Enfisema Mediastínico/etiologia , Diagnóstico Diferencial , Dispneia/diagnóstico , Enfisema Mediastínico/terapia , Portugal , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo
16.
Case Rep Pulmonol ; 2016: 5092157, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27213070

RESUMO

Pneumomediastinum, the presence of free air in the mediastinum, is described as spontaneous pneumomediastinum when there is no apparent cause such as trauma, surgery, interventional procedures, or intrathoracic infections. Pneumorrhachis is a rare clinical condition, consisting of intraspinal air. The main causes are iatrogenic, traumatic, and nontraumatic. Spontaneous mediastinum is usually associated with subcutaneous emphysema and, occasionally, with pneumothorax; however, its association with pneumorrhachis is extremely rare. Here, we present two rare cases of spontaneous pneumomediastinum associated with pneumorrhachis caused by vigorous coughing.

17.
J Environ Manage ; 135: 36-44, 2014 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-24508845

RESUMO

Different risk evaluation approaches have been used to face oil and hazardous and noxious substances (HNS) spills all over the world. To minimize health risks and mitigate economic losses due to a long term ban on the sale of sea products after a spill, it is essential to preemptively set risk evaluation criteria and standard methodologies based on previous experience and appropriate scientifically sound criteria. Standard methodologies are analyzed and proposed in order to improve the definition of criteria for reintegrating previously contaminated marine marketable resources into the commercialization chain in Europe. The criteria used in former spills for the closing of and lifting of bans on fisheries and harvesting are analyzed. European legislation was identified regarding food sampling, food chemical analysis and maximum levels of contaminants allowed in seafood, which ought to be incorporated in the standard methodologies for the evaluation of the decision criteria defined for oil and HNS spills in Europe. A decision flowchart is proposed that opens the current decision criteria to new material that may be incorporated in the decision process. Decision criteria are discussed and compared among countries and incidents. An a priori definition of risk criteria and an elaboration of action plans are proposed to speed up actions that will lead to prompt final decisions. These decisions, based on the best available scientific data and conducing to lift or ban economic activity, will tend to be better understood and respected by citizens.


Assuntos
Monitoramento Ambiental/métodos , Contaminação de Alimentos/análise , Substâncias Perigosas/análise , Poluição por Petróleo , Alimentos Marinhos/análise , Monitoramento Ambiental/legislação & jurisprudência , Europa (Continente) , Pesqueiros , Análise de Alimentos/legislação & jurisprudência , Contaminação de Alimentos/legislação & jurisprudência , Medição de Risco/métodos
18.
Biotechnol Prog ; 29(1): 17-22, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23125137

RESUMO

Magainin-2 (MAG2) is a polycationic antimicrobial peptide isolated from the skin of the African clawed frog Xenopus laevis. It has a wide spectrum of antimicrobial activities against gram-positive and gram-negative bacteria, fungi, and induces osmotic lysis of protozoa. MAG2 also possesses antiviral and antitumoral properties. These activities make this peptide a promising candidate for therapeutic applications. Recombinant expression systems are necessary for the affordable production of large amounts of the biologically active peptide. In this work, MAG2 has been cloned to the N-terminal of a family III carbohydrate-binding module fused to the linker sequence (LK-CBM3) from Clostridium thermocellum; a formic acid recognition site was introduced between the two modules for chemical cleavage of the peptide. The recombinant protein MAG2-LK-CBM3 was expressed in Escherichia coli BL21 (DE3) and MAG2 was successfully cleaved and purified from the fusion partner LK-CBM3. Its functionality was confirmed by testing its activity against gram-negative bacteria.


Assuntos
Magaininas/genética , Magaininas/isolamento & purificação , Proteínas de Xenopus/genética , Proteínas de Xenopus/isolamento & purificação , Animais , Escherichia coli/genética , Escherichia coli/metabolismo , Proteínas Recombinantes/genética , Proteínas Recombinantes/isolamento & purificação , Xenopus laevis/genética , Xenopus laevis/metabolismo
19.
Biotechnol Prog ; 28(2): 526-32, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22271600

RESUMO

A wide variety of biomaterials and bioactive molecules have been applied as scaffolds in neuronal tissue engineering. However, creating devices that enhance the regeneration of nervous system injuries is still a challenge, due the difficulty in providing an appropriate environment for cell growth and differentiation and active stimulation of nerve regeneration. In recent years, bacterial cellulose (BC) has emerged as a promising biomaterial for biomedical applications because of its properties such as high crystallinity, an ultrafine fiber network, high tensile strength, and biocompatibility. The small signaling peptides found in the proteins of extracellular matrix are described in the literature as promoters of adhesion and proliferation for several cell lineages on different surfaces. In this work, the peptide IKVAV was fused to a carbohydrate-binding module (CBM3) and used to modify BC surfaces, with the goal of promoting neuronal and mesenchymal stem cell (MSC) adhesion. The recombinant proteins IKVAV-CBM3 and (19)IKVAV-CBM3 were successfully expressed in E. coli, purified through affinity chromatography, and stably adsorbed to the BC membranes. The effect of these recombinant proteins, as well as RGD-CBM3, on cell adhesion was evaluated by MTS colorimetric assay. The results showed that the (19)IKVAV-CBM3 was able to significantly improve the adhesion of both neuronal and mesenchymal cells and had no effect on the other cell lineages tested. The MSC neurotrophin expression in cells grown on BC membranes modified with the recombinant proteins was also analyzed.


Assuntos
Celulose/metabolismo , Gluconacetobacter xylinus/metabolismo , Células-Tronco Mesenquimais/citologia , Neurônios/citologia , Engenharia Tecidual/instrumentação , Animais , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Materiais Biocompatíveis/química , Materiais Biocompatíveis/metabolismo , Adesão Celular , Linhagem Celular , Celulose/química , Celulose/genética , Humanos , Células-Tronco Mesenquimais/metabolismo , Fatores de Crescimento Neural/genética , Fatores de Crescimento Neural/metabolismo , Neurônios/metabolismo , Ratos , Proteínas Recombinantes de Fusão/genética , Proteínas Recombinantes de Fusão/metabolismo
20.
J Biomater Sci Polym Ed ; 23(10): 1339-54, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-21722421

RESUMO

The bacterial cellulose (BC) secreted by Gluconacetobacter xylinus is a network of pure cellulose nanofibres which has high crystallinity, wettability and mechanical strength. These characteristics make BC an excellent material for tissue-engineering constructs, noteworthy for artificial vascular grafts. In this work, the in vivo biocompatibility of BC membranes produced by two G. xylinus strains was analyzed through histological analysis of long-term subcutaneous implants in the mice. The BC implants caused a mild and benign inflammatory reaction that decreased along time and did not elicit a foreign body reaction. A tendency to calcify over time, which may be related to the porosity of the BC implants, was observed, especially among the less porous BC-1 implants. In addition, the potential toxicity of BC nanofibres - obtained by chemical-mechanical treatment of BC membranes - subcutaneously implanted in mice was analysed through bone marrow flow cytometry and histological analyses. At 2 and 4 months post-implantation, the nanofibres implants were found to accumulate intracellularly, in subcutaneous foamy macrophages aggregates. Moreover, no differences were observed between the controls and implanted animals in thymocyte populations and in B lymphocyte precursors and myeloid cells in the bone marrow.


Assuntos
Celulose , Gluconacetobacter xylinus , Nanofibras , Animais , Medula Óssea/patologia , Medula Óssea/fisiologia , Calcificação Fisiológica , Celulose/química , Citometria de Fluxo , Gluconacetobacter xylinus/química , Implantes Experimentais/efeitos adversos , Masculino , Teste de Materiais , Membranas Artificiais , Camundongos Endogâmicos BALB C , Microscopia Eletrônica de Varredura , Nanofibras/química , Porosidade , Tela Subcutânea/irrigação sanguínea , Tela Subcutânea/patologia , Tela Subcutânea/fisiologia , Fatores de Tempo
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