A Fluorescent Furan-based Probe with Protected Functional Groups for Highly Selective and Non-Toxic Imaging of HT-29 Cancer Cells and 4T1 Tumors.

Most of the previously reported fluorescent organic probes for cancer cell and tumor imaging have significant limitations including chemical toxicity, structural instability, low Stokes shift value, and the inability for selective accumulations in tumors during in vivo imaging. To overcome the mentioned challenges, we synthesized the fluorescent probes with protected polar functional groups to enhance the non-toxicity nature and increase the selectivity toward tumors. In addition, the structural rigidity of the fluorescent probes was increased by embedding aromatic rings in the probe structure. This issue enables us to obtain ultrabright cell images due to enhanced fluorescence quantum yield (ΦFL) values. After synthesis and spectral characterizations, the applicability of two furan-based and imidazole-based fluorescent probes ( abbreviated as DCPEF and DBPPI, respectively) was investigated for ultrabright in vitro and in vivo imaging of cancer cells. The probe DCPEF shows the ΦFL value of 0.946 and the Stocks shift of 86 nm. In addition, probe DBPPI offers the ΦFL value of 0.400 and a Stocks shift of 150 nm. The MTT colorimetric cytotoxicity assay showed that probe DCPEF has minimal effects against HT-29 (cancer) and Vero (normal) cells. The probe DCPEF produced ultrabright fluorescence images from HT-29 cells. In addition, in vivo imaging of cancer cells showed that probe DCPEF selectively accumulates in the 4T1 tumor in mice. The spectral and chemical stability, minimal cytotoxicity, significant Stokes shift, and high degree of selectivity for tumor cells during in vivo imaging make DCPEF an appropriate candidate to be used as a standard probe for cancer cell imaging.

A Bayesian approach for mixed effects state-space models under skewness and heavy tails.

Human immunodeficiency virus (HIV) dynamics have been the focus of epidemiological and biostatistical research during the past decades to understand the progression of acquired immunodeficiency syndrome (AIDS) in the population. Although there are several approaches for modeling HIV dynamics, one of the most popular is based on Gaussian mixed-effects models because of its simplicity from the implementation and interpretation viewpoints. However, in some situations, Gaussian mixed-effects models cannot (a) capture serial correlation existing in longitudinal data, (b) deal with missing observations properly, and (c) accommodate skewness and heavy tails frequently presented in patients' profiles. For those cases, mixed-effects state-space models (MESSM) become a powerful tool for modeling correlated observations, including HIV dynamics, because of their flexibility in modeling the unobserved states and the observations in a simple way. Consequently, our proposal considers an MESSM where the observations' error distribution is a skew-t. This new approach is more flexible and can accommodate data sets exhibiting skewness and heavy tails. Under the Bayesian paradigm, an efficient Markov chain Monte Carlo algorithm is implemented. To evaluate the properties of the proposed models, we carried out some exciting simulation studies, including missing data in the generated data sets. Finally, we illustrate our approach with an application in the AIDS Clinical Trial Group Study 315 (ACTG-315) clinical trial data set.

Prevalence of Toxoplasma gondii in Galapagos birds: Inference of risk factors associated with diet.

Toxoplasma gondii is a zoonotic intracellular parasite of particular concern in the conservation of wildlife due to its ability to infect all homeotherms and potentially cause acute fatal disease in naive species. In the Galapagos (Ecuador), an archipelago composed of more than a hundred islets and islands, the presence of T. gondii can be attributed to human-introduced domestic cats, but little is known about its transmission in wildlife populations. We compared the prevalence of antibodies against T. gondii in sympatric Galapagos wild bird species that differ in diet and contact with oocyst-contaminated soil to determine the relative importance of trophic habits as an exposure factor. Plasma samples were obtained from 163 land birds inhabiting Santa Cruz, one of the cat-inhabited islands, and from 187 seabirds breeding in cat-free surrounding islands (Daphne Major, North Seymour, and South Plaza). These samples were tested for the presence of T. gondii antibodies using the modified agglutination test (MAT ≥ 1:10). All seven species of land birds and 4/6 species of seabirds presented seropositive results. All great frigatebirds (Fregata minor) (N = 25) and swallow-tailed gulls (Creagrus furcatus) (N = 23) were seronegative. Prevalence ranged from 13% in Nazca boobies (Sula granti) to 100% in Galapagos mockingbirds (Mimus parvulus). It decreased from occasional carnivores (63.43%) to granivores-insectivores (26.22%), and strict piscivores (14.62%). These results indicate that the consumption of tissue cysts poses the highest risk of exposure to T. gondii for Galapagos birds, followed by the ingestion of plants and insects contaminated by oocysts as important transmission pathways.

Rapid adaptive radiation of Darwin's finches depends on ancestral genetic modules.

Recent adaptive radiations are models for investigating mechanisms contributing to the evolution of biodiversity. An unresolved question is the relative importance of new mutations, ancestral variants, and introgressive hybridization for phenotypic evolution and speciation. Here, we address this issue using Darwin's finches and investigate the genomic architecture underlying their phenotypic diversity. Admixture mapping for beak and body size in the small, medium, and large ground finches revealed 28 loci showing strong genetic differentiation. These loci represent ancestral haplotype blocks with origins predating speciation events during the Darwin's finch radiation. Genes expressed in the developing beak are overrepresented in these genomic regions. Ancestral haplotypes constitute genetic modules for selection and act as key determinants of the unusual phenotypic diversity of Darwin's finches. Such ancestral haplotype blocks can be critical for how species adapt to environmental variability and change.

Synthesis and application of the fluorescent furan and imidazole probes for selective in vivo and in vitro cancer cell imaging.

Development of imaging probes for identification of tumors in the early stages of growth can significantly reduce the tumor-related health hazards and improve our capacity for treatment of cancer. In this work, three different furan and imidazole fluorescent derivatives abbreviated as Cyclo X, SAC and SNO are introduced for in vivo and in vitro imaging of cancer cells. The fluorescence quantum yield values were 0.226, 0.400 and 0.479 for Cyclo X, SAC and SNO, respectively. The excitation and emission wavelengths of maximum intensity were (360, 452), (350, 428) and (350, 432) nm for Cyclo X, SAC and SNO, respectively. The MTT reduction assay was used to estimate the cytotoxic activity of the proposed derivatives against HT-29 (cancer) and Vero (normal) cell lines. Cyclo X showed no cytotoxic effect, while SAC and SNO showed significantly higher cytotoxicity against the tested cell lines than cisplatin as a well-known anticancer drug. In vitro fluorescence microscopic images obtained using HT-29 cells showed that Cyclo X produced very bright images. The in vivo cancer cell imaging using 4T1 tumor-bearing mice revealed that Cyclo X is selectively accumulated in the tumor without distribution in the mice body organs. The spectral and structural stability, large Stokes shift, non-cytotoxicity and high level of selectivity for in vivo imaging are properties that make Cyclo X a suitable candidate to be used for long-term monitoring of cancer cells.

Effect of a preoperative single-dose steroid on pulmonary function and postoperative symptoms after modified radical mastectomy: results of a randomized clinical trial.

BACKGROUND: Evidence suggests that a preoperative single-dose steroid improves lung function and decreases the incidence of postoperative symptoms; however, this has not been sufficiently proved in modified radical mastectomy for cancer. This study aimed to evaluate the efficacy of preoperative single-dose steroid administration for postoperative lung function and postoperative symptoms in women undergoing modified radical mastectomy for breast cancer. METHODS: In this controlled clinical trial, conducted between June 2014 and October 2018, we examined 81 patients. Patients received a preoperative single dose of 8 mg dexamethasone (n=41; treatment group) or placebo (sterile injectable water; n=40; control group). We obtained data on postoperative nausea and vomiting and pain intensity and performed spirometry 1 h before and 1, 6, 12, and 24 h after surgery. The use of additional analgesic or antiemetic drugs was recorded. We followed up patients 30 days after discharge and recorded any surgical or medical complications. RESULTS: The age distribution and anthropometric variables of the two groups were similar. Almost 50% of the patients in each group also underwent breast reconstruction. In the treatment group, pain intensity was always lower, the incidence of postoperative nausea and vomiting was lower at 6, 12, and 24 h, and additional analgesics or antiemetics were required less frequently (P<0.05 for all). Both treatment and control groups demonstrated a restrictive ventilatory pattern immediately after surgery, which in the treatment group was reversed after 24 h. However, the reconstructed patients had a more intense and prolonged restrictive pattern (P<0.05). Surgical morbidity included one seroma observed in the control group. No infections occurred at the surgical site or at any other level, and no patient developed any metabolic disorder. No mortality was observed in either group. CONCLUSIONS: This study establishes that a single preoperative dose of dexamethasone markedly decreased the incidence of postoperative nausea and vomiting and pain, improved respiratory parameters, and decreased the need for additional postoperative analgesic or antiemetic drugs. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (ID NCT02305173).

HEALTH STATUS AND BASELINE HEMATOLOGY, BIOCHEMISTRY, AND BLOOD GAS VALUES OF GALAPAGOS SHEARWATERS (PUFFINUS SUBALARIS).

The Galápagos shearwater, Puffinus subalaris, is a seabird endemic to the Galápagos archipelago. Hematology, blood chemistry, and general health parameters have not been published for this species. Analyses were run on blood samples drawn from 20 clinically healthy Galápagos shearwaters captured by hand at their nests at Islote Pitt on San Cristóbal Island in July 2016. A portable blood analyzer (iSTAT) was used to obtain near immediate field results for pH, pO2, pCO2, TCO2, HCO3 -, hematocrit, hemoglobin, sodium, potassium, chloride, ionized calcium, creatinine, urea nitrogen, anion gap, and glucose. Blood lactate was measured using a portable Lactate Plus analyzer. The reported results provide baseline data that can be used for comparisons among populations and in detecting changes in health status among Galápagos shearwaters.

Assessment of the pedal arteries with Duplex Scanning.

Vascular Doppler ultrasound is a noninvasive method that can help in diagnostic and therapeutic planning in case of pedal arterial obstructive disease. The dorsalis pedis artery is the direct continuation of the anterior tibial artery and follows a straight course along the dorsum of the foot, leading medially to the first intermetatarsal space, where it gives off its terminal branches. The posterior tibial artery forks distal to the medial malleolus and gives rise to the lateral plantar and medial plantar arteries. The medial plantar artery has a smaller caliber and runs medially in the sole of the foot, while the lateral plantar artery is of larger caliber, following a lateral course in the plantar region and forming the deep plantar arch, which anastomoses with the dorsalis pedis artery via the deep plantar artery. The arteries of the foot can be assessed noninvasively with Doppler, providing an adequate level of anatomical detail.

Baseline haematology, biochemistry, blood gas values and health status of the Galapagos swallow-tailed gull (Creagrus furcatus).

The swallow-tailed gull, Creagrus furcatus, is a seabird endemic to the Galápagos archipelago. In general health, blood chemistry and haematology, parameters have not been published for this species. Blood analyses were run on samples drawn from 58 clinically healthy swallow-tailed gulls captured at Islote Pitt on San Cristóbal Island in July 2016 (28) and South Plaza Island in June 2017 (30). A point of care blood analyzer (iSTAT) was used in the field to obtain results for HCO3 -, pH, pCO2, pO2, TCO2, anion gap, chloride, creatinine, glucose, haematocrit, haemoglobin, ionized calcium, potassium, sodium and urea nitrogen. A portable Lactate Plus™ analyzer was used to measure lactate. The baseline data reported is valuable for comparisons amongst different populations in the archipelago and to detect changes in health status of Galápagos swallow-tailed gulls.

Inversão total do fluxo em artéria carótida interna direita em paciente com estenose grave do tronco braquiocefálico / Total reversal of internal carotid blood flow in a patient with severe stenosis of the brachiocephalic trunk

RESUMO As estenoses graves e oclusões do tronco braquiocefálico (artéria inominada) são raras, e apresentam uma grande variedade de manifestações clínicas, com alterações relacionadas a isquemia cerebral hemisférica, vertebrobasilar e de membro superior direito. A causa mais comum é a aterosclerose. A ultrassonografia vascular com Doppler pode revelar inversão de fluxo na artéria vertebral direita, hipofluxo na subclávia, e vários tipos de alterações no fluxo da carótida direita, incluindo hipofluxo, inversão parcial do fluxo durante o ciclo cardíaco, e até mesmo inversão completa do fluxo na carótida interna, achado este bastante raro. Os autores descrevem o caso de paciente do sexo feminino, tabagista, com estenose grave do tronco braquiocefálico e crises de lipotimia. Além do roubo de artéria subclávia e do fluxo parcialmente invertido na carótida comum direita, a paciente apresentava exuberante fluxo invertido na carótida interna durante todo o ciclo cardíaco, achado este não encontrado na literatura em tamanha magnitude.

ABSTRACT Occlusions and severe stenoses of the innominate artery (brachiocephalic trunk) are rare and present with a wide variety of clinical manifestations, with hemispheric, vertebrobasilar and right upper limb ischemic symptoms. The most common cause is atherosclerosis. Duplex scanning may show right vertebral artery flow reversal, diminished subclavian flow, and several patterns of right carotid flow disturbance, including slow flow, partial flow reversal during the cardiac cycle and even complete reversal of flow in the internal carotid artery, which is a very uncommon finding. Herein, the authors describe the case of a female patient who was a heavy smoker, had severe stenosis of the brachiocephalic trunk, and had episodes of collapse. Besides the subclavian steal and partial flow reversal in the common carotid artery, duplex scanning also showed high-velocity reversed flow in the internal carotid artery during the entire cardiac cycle, a finding that is not reported in the literature at this magnitude.

Memórias, histórias e linguagens da dor e da luta no ativismo brasileiro de HIV/Aids / Memorias, historias y lenguajes del dolor y de la lucha en el activismo brasileño de VIH/Sida / Memories, stories and languages of pain and struggle in the HIV/Aids Brazilian activism

Resumo Este artigo pretende discutir questões que vêm sendo abordadas e apresentadas publicamente por parte do ativismo social de HIV/Aids no Brasil. As questões de memória e história do movimento social e da sociedade civil estão presentes sempre que o ativismo sofre com dilemas e obstáculos de continuidade social e manutenção institucional. Assim, eventos e comemorações são organizados e expressam uma forte linguagem cultural das emoções, muitas vezes materializados através de objetos, cartazes e fotografias. Por meio de pesquisa antropológica baseada em etnografia e interpretação de documentos, pretendo discutir como se dá uma política de memória, a manutenção de uma tradição de conhecimento ativista e a produção de certos silenciamentos do passado, que encobrem e enquadram de um determinado modo a história das ONGs brasileiras e seus ativismos.

Resumen Este artículo pretende discutir asuntos que vienen siendo abordados y presentados publicamente por parte del activismo social de VIH/Sida en Brasil. Las cuestiones de memoria e historia del movimiento social y de la sociedad civil están presentes siempre que el activismo sufre con dilemas y obstáculos relativos a su continuidad social y sostenibilidad institucional. De esta forma, eventos y conmemoraciones son organizados y expresan un fuerte lenguaje cultural de las emociones, frecuentemente materializados por el uso de objetos, afiches y fotografías. A través de una investigación antropológica apoyada en etnografía e interpretación de documentos, pretendo discutir cómo se da una política de memoria, el mantenimiento de una tradición de conocimiento activista y la producción de determinados silenciamientos del pasado, que ocultan y encuadran de una determinada forma la historia de las ONGs brasileñas y sus activismos.

Abstract This article discusses issues that are approached and publicly presented by HIV/Aids social activism in Brazil. Questions on memory and history of this social movement and civil society are present when the activism suffers with dilemmas and obstacles related to its social continuity and institutional maintenance. Therefore, events and celebrations have been organized and express a strong cultural language of emotions, materialized by the use of objects, posters, and photographs. Through an anthropological research based on ethnography and the interpretation of documents, I discuss how a politics of memory is created, the maintenance of a tradition of activist knowledge, and the production of some silences regarding the past, which has been somehow occulted and framed by a certain perspective on the history of Brazilian ONGs and their activisms.

Sexuality Among Women Treated for Breast Cancer: A Survey of Three Surgical Procedures.

BACKGROUND: The quality of life of Mexican patients with breast cancer has been studied, but female sexual function has only been explored superficially. The Female Sexual Function Index (FSFI) questionnaire has been validated as a tool to measure sexual function among women with cancer. However, no study in Mexico has been published. PURPOSE: To evaluate and compare female sexuality of breast cancer survivors treated with three surgical procedures. MATERIALS AND METHODS: This is a cross-sectional questionnaire survey applied in patients without active disease and free of any oncologic treatment who underwent conservative mastectomy, and mastectomy with and without reconstruction. Patients included in this study had no evidence of active disease after at least 2 years of postoperative follow-up and agreed to complete the FSFI questionnaire during a surveillance visit. RESULTS: Seventy-four patients were included: 37.8% had undergone conservative mastectomy, 29.7% radical mastectomy, and 32.4% radical mastectomy plus reconstruction. Patients in the radical mastectomy group were older than those in the other groups (p = 0.002). Female sexual dysfunction was observed in 34% of patients, but in patients who underwent radical mastectomy, it was 63% by contrast with 14 and 29% in women treated with conservative mastectomy and radical mastectomy with reconstruction (p = 0.001). CONCLUSIONS: We found a lower prevalence of female sexual dysfunction in patients treated with conservative mastectomy or reconstruction after radical mastectomy. Alternatively, radical mastectomy was offered to older patients, a condition that could contribute together with a loss of female perception to a higher prevalence of sexual dysfunction. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Modelo participativo para el abordaje de la violencia contra las mujeres en La Araucanía, Chile / A participatory model for addressing violence against women in La Araucanía, Chile / Modelo participativo para abordagem da violência contra a mulher em La Araucanía, Chile

RESUMEN La violencia contra la mujer se considera un problema de salud pública que afecta a las mujeres en todo el mundo. Recientemente, el Consejo Directivo de la Organización Panamericana de la Salud declaró sus graves repercusiones sociales y económicas en la Región de las Américas y se comprometió a emprender acciones en los servicios de salud para afrontar el problema. En ese marco, se presentan los pasos de una investigación-acción-participativa (IAP), que se está desarrollando en el territorio wenteche de la región de La Araucanía de Chile, que apuesta por fortalecer los vínculos comunitarios, revalorizar los espacios de diálogo con y entre las personas del territorio, la participación social y la democracia en la generación de conocimientos pertinentes y participativos sobre este problema, y obtener información para diseñar un modelo de intervención que se adecúe a las características locales.(AU)

ABSTRACT Violence against women is considered a public health problem that affects women worldwide. Recently, the Directing Council of the Pan American Health Organization declared its serious socioeconomic impact in the Region of the Americas and committed to undertaking actions in the health services to address this problem. Within that framework, this paper describes the steps of a participatory action research (PAR) approach that is being implemented in the Wenteche Territory of the La Araucanía region of Chile, which aims to strengthen community bonds, rekindle opportunities for dialogue with and among the people of the territory, foster social participation and democracy in the generation of pertinent, participatory knowledge regarding this problem, and obtain information to support design of an intervention model adapted to local characteristics.(AU)

RESUMO A violência contra a mulher é um problema de saúde pública que atinge mulheres em todo o mundo. Recentemente, o Conselho Diretor da Organização Pan-Americana da Saúde reconheceu as sérias repercussões socioeconômicas do problema na Região das Américas e se comprometeu a realizar ações nos serviços de saúde para combatê-lo. Como parte deste enquadramento, são apresentadas as etapas de uma pesquisa-ação participativa sendo desenvolvida no território wenteche da região de La Araucanía, no Chile, que visa reforçar os vínculos na comunidade, revalorizar os espaços de diálogo com e entre os habitantes locais, a participação social e a democracia na geração de conhecimento pertinente e participativo sobre esta problemática e obter dados para a elaboração de um modelo de intervenção adequado às características locais.(AU)

Síndrome de burnout en estudiantes de medicina: frecuencia, características y factores asociados / Burnout syndrome in medical students: frequency, characteristics and associated factors

Objetivo: Determinar la frecuencia, características y los factores que están asociados ante el síndrome de burnout (SB) en estudiantes de medicina. Materiales y métodos: estudio transversal analítico. Se encuestaron a 583 estudiantes de medicina que cursaban las ciencias clínicas y realizaban rotaciones hospitalarias en los departamentos de Lima, Ica, Junín, Lambayeque y Ucayali. El SB se evaluó a través del Maslach Burnout Inventory en su versión validada en español así mismo las características sociodemográficas que fueron incluidas en el instrumento Resultados: se encontró que 50,6% eran varones, el 16,5%, 47,7% y 35,3% de los estudiantes indicaron tener agotamiento emocional, despersonalización severa y realización personal baja, respectivamente. Se halló asociación significativa entre tener SB y sobrepeso (razón de prevalencias [RP]= 1,57; intervalo de confianza al 95% [IC95%]= 1,14 - 2,14), ser obeso (RP= 2,68; IC95%= 1,75 - 4,11), padecer una enfermedad crónica (RP= 1,84; IC95%= 1,38 - 2,45), fumar (RP= 1,41; IC95%= 1,76- 2,28) ingerir bebidas alcohólicas (RP= 1,46; IC95%= 1,10 - 1,95) y proceder de una universidad de provincia (RP= 1,20; IC95%= 1,05 - 1,36). Conclusión: el SB se presentó en aquellos quienes padecían de alguna enfermedad crónica, fumaban, ingerían bebidas alcohólicas y procedían de una universidad de provincia.

Objective: To determine the frequency, characteristics and associated factors with the Burnout Syndrome (BS) inmedical students. Material and methods: this is a cross-sectional study. Five-hundred and eighty three (583) medicalstudents doing clinical sciences courses having hospital training periods in Lima, Ica, Jun¡n, Lambayeque and Ucayaliwere surveyed. The presence of BS was determined using the Maslach Burnout Inventory (MBI) in its validated Spanishversion, and also the socio-demographic characteristics included in the instrument. Results: gender distributionwas similar (50.6% were male), also 16.5%, 47.7% and 35.3% of the students reported having emotional exhaustion,severe depersonalization and low personal accomplishments, respectively, as defined by the MBI. Also, a significantassociation was found between BS and being overweight (Prevalence ratio [PR]= 1.57; 95% confidence interval [95% CI]=1.14 to 2.14); obese (PR= 2.68; 95% CI= 1.75 to 4.11), having chronic disease (PR= 1.84; 95% CI= 1.38 to 2.45), smoking(PR= 1.41; 95% CI= 1.76 to 2.28) drinking alcohol (PR= 1.46; 95% CI= 1.10 to 1.95) and studying in a province university(PR= 1.20; 95% CI= 1.05 to 1.36). Conclusion: BS occurs in those who suffer from a chronic illness, smoke, drink alcohol,and study in a province university.

Microfiltración apical in vitro causada por las técnicas de obturación con cono único, System B y condensación lateral clásica / In vitro apical microleakage causade by single-cone, System B and cold lateral condensation obturation techniques

La obtención de un sellado hermético en la obturación del conducto radicular es una etapa coadyuvante del éxito endodóntico. Objetivo: Comparar la microfi ltración apical in vitro, calidad de relleno y presencia de espacios vacíos en conductos radiculares obturados con los métodos de obturación cono único, condensación lateral clásica y System B. Material y métodos: Noventa raíces mesiales de molares inferiores fueron instrumentados con ProTaper a un calibre F3 y asignados aleatoriamente para su obturación a tres grupos (n = 30 raíces), grupo 1: condensación lateral clásica con gutapercha #30.02, grupo 2: cono único con gutapercha F3 y grupo 3: System B con gutapercha #30.02; en todas las técnicas se usó una mezcla de óxido de zinc eugenol como sellador.Obturados los conductos las muestras se sumergieron en azul de metileno al 0.5 por ciento, se centrifugaron a 3,200 rpm durante cinco minutos, se diafanizarony se llevaron al microscopio estereoscópico a 12.5x para la mediciónde microfi ltración apical, calidad de relleno y presencia de espacios vacíospor un observador calibrado. Resultados: No se encontraron diferencias significativas en la microfi ltración apical entre el grupo de condensación lateral clásica y System B (p > 0.05) siendo el cono único la técnica que presenta mayor fi ltración. La técnica que ofrece la menor cantidad de espacios vacíos y mejor calidad de relleno es System B. Conclusiones:El método System B y condensación lateral clásica dejan una baja microfiltración apical y adecuada calidad de relleno comparada con la que sepresenta con cono único utilizando como sellador óxido de zinc eugenol...

Tecnica de instala‡Æo de implantes inclinados na reabilita‡Æo de maxila atr¢fica / Tilted implants technique in the rehabilitation of atrophic maxilla

A atrofia maxilar e a diminui‡Æo de volume ¢sseo do paciente podem exigir maior cautela quanto … reabilita‡Æo com implantes dent rios, assim existe a necessidade de oferecer alternativas para o tratamento, especialmente quando o caso apresenta limita‡ães. A t‚cnica da instala‡Æo de implantes inclinados aparece como uma alternativa vi vel e r pida para atender esses casos. A preferˆncia de implantes mais longos e da instala‡Æo dos mesmos junto … parede do seio maxilar torna o procedimento mais conservador quando comparado …s t‚cnicas convencionais – uso de enxertos ¢sseos ou ancoragem de implantes em osso zigom tico. Os pontos fortes na indica‡Æo desta t‚cnica sÆo o menor tempo de tratamento, a diminui‡Æo da exposi‡Æo do paciente (nÆo ‚ necess rio enxerto ¢sseo), al‚m da diminui‡Æo do custo financeiro. A indica‡Æo da t‚cnica na reabilita‡Æo de maxilas atr¢ficas favorece especialmente aos pacientes idosos, uma vez que evita dois tempos cir£rgicos, al‚m de permitir a instala‡Æo de uma pr¢tese provis¢ria imediata. O estudo relatou um caso cl¡nico onde foram instalados seis implantes inclinados na inten‡Æo de reabilitar a maxila do paciente com uma pr¢tese fixa. O caso em tela reabilitou um paciente de 65 anos que apresentava consider vel atrofia maxilar e usava uma pr¢tese parcial superior. Existiam ainda dentes remanescentes e que se encontravam em prec rias condi‡ães. Os dentes foram extra¡dos e no mesmo tempo cir£rgico foram instalados 6 implantes dent rios, do tipo cone morse, que suportaram uma pr¢tese provis¢ria imediata. O sucesso do caso devolveu autoestima ao paciente al‚m de melhorar a eficiˆncia mastigat¢ria.

Maxillary atrophy and the decrease in bone volume of the patient may demand more caution as rehabilitation with dental implants, therefore there is the need of offering alternatives to treatment, especially when there are limitations. The technique of installing tilted implants can be a viable and fast alternative to deal with these cases. Preference for longer implants as well as for installing them next to the sinus wall makes the procedure more conservative when compared to conventional techniques - use of bone graft or anchorage implants in zygomatic bone. The advantages of the indication of this technique are: shorter treatment time, decreased patient exposure (no requirement for bone graft), in addition to lowering financial cost. The indication of this technique in the rehabilitation of atrophic maxilla encourages especially elderly patients, since it avoids two surgical times and allows the installation of an immediate provisional prosthesis. The study reported a case of a 65 years old patient with considerable jaw atrophy and partial denture. There were still remaining teeth in disrepair. The teeth were extracted, and during the surgical procedure 6 dental implants, cone-morse type, which endured an immediate prosthesis were installed. The success of the case returned to the patient’s self-esteem while improving his masticatory efficiency.

Quality of life among women treated for breast cancer: a survey of three procedures in Mexico.

BACKGROUND: This study aimed to determine the quality of life among patients treated with one of three different types of surgery for breast cancer. METHODS: This cross-sectional study used a questionnaire survey completed by Mexican patients without active disease 1 year after breast cancer surgery. RESULTS: The 139 patients enrolled in the study included 44 (31.6 %) who had undergone mastectomy with reconstruction, 41 (29.5 %) who had undergone a quadrantectomy, and 54 (38.9 %) who had undergone radical mastectomy without reconstruction. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, core version 30 (EORTC QLQ-C30) and EORTC Breast Quality-of-Life Questionnaire (QLQ-BR23) questionnaires were used. These instruments had a reliability greater than 0.82. Global health status (94.30 ± 12.04; p = 0.028) and role functioning (85.16 ± 17.23; p = 0.138) were highest in the quadrantectomy group. The pain score was highest in the group that had received mastectomy with reconstruction (26.13 ± 30.15; p = 0.042). The breast symptom score (22.56 ± 22.30; p = 0.009) and body image perception (85.56 ± 19.72; p = 0.025) were highest in the group that had conservative treatment. The overall health of the patients who had undergone mastectomy without reconstruction was lower (72.61 ± 20.89; p = 0.014) among the women older than 50 years than among the younger women. CONCLUSIONS: The quadrantectomy procedure had better acceptance, but the overall health status did not differ between the groups. The overall health status was lower among the women older than 50 years who had received a mastectomy without reconstruction.

Correlation of clinical features with the risk of lower limb deep vein thrombosis assessed by duplex ultrasound / Correlação de achados clínicos com o risco de trombose venosa profunda de membros inferiores através do ultrassom vascular

BACKGROUND:Symptoms and clinical signs suggestive of deep vein thrombosis (DVT) are common but may have numerous possible causes. OBJECTIVES: 1) To identify the most frequent clinical symptoms and correlate them with duplex ultrasound scan (DS) findings; 2) to identify high-risk clinical conditions for DVT; and 3) to evaluate time since the onset of symptoms and DS examination. METHODS: A total of 528 patients with a clinical suspicion of DVT were evaluated by DS performed by experienced vascular ultrasonographists. RESULTS: DVT was present in 192 (36.4%) of the patients. The external iliac vein was involved in 53 patients (10.04%), the femoral veins in 110 (20.83%), the popliteal vein in 124 (23.48%), and veins below the knee were involved in 157 (29.73%) of the cases. Limb swelling was present in 359 cases (68%), and 303 (57.4%) complained of pain. Sixty nine patients received a DS due to suspected or proven pulmonary embolism (PE); 79 patients were in postoperative period. In the multivariate analysis, independent risk factors for DVT included age>65 years (OR=1.49; 95% confidence interval [95%CI] 1.01-2.18; p=0.042), edema (OR=2.83; 95%CI 1.72-4.65; p<0.001), pain (OR=1.99; 95%CI 1.3-3.05; p=0.002), cancer (OR=2.32; 95%CI 1.45-3.72; p<0.001), and PE (OR=2.62; 95%CI 1.29-5.32; p=0.008).Time since the onset of symptoms did not differ between the groups. CONCLUSIONS: In the present study, 36.4% of the patients referred to DS had DVT. Age > 65 years, presence of limb swelling, pain, cancer, and suspected or proven PE should be considered as major risk factors for DVT. .

CONTEXTO:Sintomas e sinais clínicos indicativos de trombose venosa profunda (TVP) são comuns mas podem ter inúmeras causas. OBJETIVOS: 1) Identificar os sintomas mais frequentes e correlacioná-los com achados de dúplex scan (DS); 2) identificar condições clínicas de alto risco para TVP; e 3) avaliar o intervalo de tempo decorrido entre o início dos sintomas e o exame do paciente. MÉTODOS: Um total de 528 pacientes com suspeita clínica de TVP foram examinadosvia DS por ultrassonografistas vasculares experientes. RESULTADOS: TVP esteve presente em 192 (36,4%) dos pacientes analisados. A veia ilíaca externa esteve acometida em 53 pacientes (10,04%), as veias femorais em 110 (20,83%), a veia poplítea em 124 (23,48%), e as veias abaixo do joelho em 157 casos (29,73%). Edema de membro esteve presente em 359 casos (68%), e 303 (57,4%) se queixaram de dor. Sessenta e nove pacientes realizaram DS devido a embolia pulmonar (EP) suspeita ou comprovada; 79 pacientes estavam em período pós-operatório. Na análise multivariada, os fatores de risco independentes para TVP incluíram idade >65 anos [OR=1,49; intervalo de confiança de 95% (IC95%) 1,01-2,18; p=0,042], edema (OR=2,83; IC95% 1,72-4,65; p<0,001), dor (OR=1,99; IC95% 1,3-3,05; p=0,002), câncer (OR=2,32; IC95% 1,45-3,72; p<0,001) e EP (OR=2,62; IC95% 1,29-5,32; p=0,008). O tempo decorrido desde o início dos sintomas foi semelhante nos dois grupos. CONCLUSÕES: No presente estudo, 36,4% dos pacientes encaminhados para DS apresentaram TVP. Idade acima de 65 anos, presença de edema de membro, dor, câncer e EP suspeita ou comprovada devem ser considerados fatores de risco maiores para TVP. .

Alteraciones morfológicas en el tracto respiratorio de ratas Wistar inducidas por vapores de la raíz de hierba del zorrillo (Petiveria alliacea) del suroeste de México / Morphologic alterations in the respiratory tract of Wistar rats induced by steams of the root of hierba del zorrillo (Petiveria alliacea) from southwest of Mexico

Petiveria alliacea, es conocida con diferentes nombres según el lugar donde se le encuentre. Estudios con hojas, tallo, raíz o extractos describen múltiples usos medicinales. Sin embargo, son pocos los que describen efectos tóxicos. En este estudio se evaluó el efecto morfológico de los vapores de la raíz de P. alliacea sobre el tracto respiratorio de ratas Wistar. Se emplearon 15 ratas divididas en 5 grupos (n=3): control absoluto, 0, 5, 15 y 30 minutos post-exposición (grupos I-V, respectivamente). Las ratas se sacrificaron y se colectaron muestras representativas del tracto respiratorio que posteriormente se procesaron por la técnica histológica convencional, hasta su inclusión en bloques de parafina. Los cortes histológicos se tiñeron con H-E, tricrómico de Masson y azul de toluidina. En tráquea, bronquiolos y pulmón de las ratas de los grupos I y II se observó una histología normal. En la tráquea de los grupos III, IV y V se identificaron áreas variables de hiperplasia en el epitelio, zonas desprovistas de cilios, signos de aumento en la secreción de las células caliciformes y áreas desprovistas de epitelio que se incrementaron con el tiempo. En la lámina propia se observó congestión vascular e infiltrado mononuclear que incrementó con el tiempo. En los bronquiolos de los grupos III y IV se observó activación de las células de Clara, áreas desprovistas de epitelio, y células mononucleares en la luz bronquiolar. En el grupo V se observaron características histológicas normales. En pulmón de los grupos III y IV se identificó engrosamiento de tabiques alveolares, incremento de las fibras de colágena, congestión y extravasación capilar, además de exudado intralveolar. En el grupo V se observó aparente reversión de algunas alteraciones morfológicas de los grupos previos, aunque otras alteraciones persisten. No se observaron diferencias en el número de las células cebadas.

Petiveria alliacea, is known with different names depending of the place where it is found. Studies with leaves, stem, root or extracts, describe multiple medicinal uses. However, there are few reports that describe toxic effects. This study assessed the morphologic effect induced by steams of the root of P. alliacea on the respiratory tract of Wistar rats. We used 15 rats divided in 5 groups (n= 3): absolute control, 0, 5, 15 and 30 minutes post-exposure (I-V groups, respectively). The rats were sacrificed; representative samples of the respiratory tract were collected, and were processed by conventional histological technique until their inclusion in paraffin blocks. Histological sections were stained with H & E, Masson trichrome and toluidine blue stain. A normal histology was observed in trachea, bronchioles and lungs of rats in groups I and II. In trachea in groups III, IV and V, areas with variable hyperplasia in the epithelium, cells without cilia, increase in the secretion of goblet cells, and areas without epithelium were observed. These morphologic alterations were increased with time. In the lamina propia vascular congestion and mononuclear infiltrate were observed, also increasing with time. In bronchioles in groups III and IV, it was noted activation of Clara cells, areas without epithelium, and mononuclear cells in the bronchiolar light. In group V normal histology was observed. In lung in groups III and IV thickening of interalveolar septa, increase of collagen fibers, capillary congestion, extravasation, and exudates were present. Also was observed an apparent reversion of morphologic alterations of previous groups, but other alterations persist. No difference in mast cells number was observed.

Complicaciones de la capsulotomía posterior por láser de Nd-Yag en el Centro Oftalmológico "Enrique Cabrera" de La Habana / Complications of posterior capsulotomy due to Nd-Yag laser in "Enrique Cabrera" Ophthalmological Center from Havana

Introducción: La opacidad capsular posterior es la complicación más frecuente de la cirugía de catarata y, aunque la capsulotomía con láser de Nd-Yag es un procedimiento muy efectivo para solucionarla, no está exenta de complicaciones.Objetivo: Describir las complicaciones en pacientes expuestos a capsulotomía con láser de Nd-Yag.Métodos: Se realizó un estudio descriptivo y prospectivo de 104 pacientes con opacidad capsular posterior, atendidos en el Centro Oftalmológico "Enrique Cabrera" de la Habana, durante el 2010. Se analizaron las variables frecuencia y tipo de complicaciones, edad, sexo, antecedentes patológicos personales oculares y sistémicos, clasificación de la opacidad capsular, energía utilizada, así como agudeza visual antes y después del tratamiento.Resultados: En la casuística predominaron el aumento de la presión intraocular y el edema macular quístico como las complicaciones más comunes, los pacientes de 56-75 años, el sexo femenino, así como la opacidad capsular fibrótica y la capsulotomía con más de 8,0 MJ.Conclusiones: Más de la mitad de los afectados presentaron complicaciones de carácter transitorio y reversible, las cuales no estuvieron relacionadas con la cantidad de energía empleada; la mejoría visual después del proceder fue notable.

Introduction: The posterior capsular opacity is the most frequent complication in the cataract surgery and, although capsulotomy with Nd-Yag laser is a very effective procedure to solve it, it is not free of complications. Objective: To describe the complications in patients exposed to capsulotomy with Nd-Yag laser.Methods: A descriptive and prospective study of 104 patients with posterior capsular opacity, assisted in "Enrique Cabrera" Ophthalmological Center from Havana, was carried out during the 2010. Variables of frequency and type of complication, age, sex, pathological ocular and systemic medical history, classification of the capsular opacity, energy used, as well as visual acuity before and after the treatment were analyzed.Results: The increase of the intraocular pressure and the cystic macular edema as the most common complications, the 56-75 year-old patients, female sex, as well as the capsular fibrotic opacity and the capsulotomy with more than 8,0 MJ prevailed in the case material.Conclusions: More than half of the patients presented complications of transitory and reversible type, which were not related to the quantity of energy used; the visual improvement after the procedure was remarkable.