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White-lipped peccary (Tayassu pecari) is a neotropical mammal that plays a fundamental role in maintaining the integrity of tropical forest systems. However, due to hunting and deforestation the species is currently classified as vulnerable. As there are reports of difficulties in captive reproduction, it was proposed to use assisted reproduction techniques for later reintroduction into their natural habitat. Therefore, the objective was to describe the physical, chemical, morphological and functional characteristics of its semen. Sixteen adult male, white-lipped peccary, aged between three and seven years old, distributed in three groups, were used in this study. After physical and chemical retainment, semen was collected by electroejaculation from 16 individuals. It was evaluated by computer analysis (CASA). The mean values recorded were as follows: volume 0.5 ± 0.6 ml, pH 7.2 ± 0.3, sperm concentration 967.2 ± 947.3 × 106 spermatozoon/ml and total motility of 75.4 ± 16.2. The average sperm reactive to the hypo-osmotic test was 85.3% ± 21.0%, and 62.4% ± 43.9% of the cells presented intact membranes in the structural integrity test. Additionally, the semen showed milky consistency (80%), yellowish colour (40%) and sui generis odour (100%). The sperm parameters of the white-lipped peccary are within the desirable standards, allowing them to be considered as potentially fertile for the development of assisted reproduction techniques that may contribute to the conservation of the species.
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Artiodáctilos , Análisis de Semen/veterinaria , Animales , MasculinoRESUMEN
BACKGROUND: The impact of MYC proto-oncogene, basic helix-loop-helix (MYC) translocations (with or without additional rearrangements involving the B-cell lymphoma 2 [BCL2] or BCL6 genes) on the response to salvage therapy and survival in patients with diffuse large B-cell lymphoma (DLBCL) who experience primary treatment failure is not well defined. METHODS: This was a multicenter, retrospective study of the impact of MYC, BCL2, and BCL6 rearrangements in patients with DLBCL who failed to achieve complete remission or relapsed within 6 months after they completed upfront chemoimmunotherapy. RESULTS: The authors examined response to salvage therapy, receipt of hematopoietic cell transplantation (HCT), and survival outcomes in MYC-negative (n = 120), MYC-positive single hit (SH) (n = 20), and MYC-positive double hit/triple hit (DH/TH) (n = 35) cohorts. The overall response rate in these cohorts to first salvage therapy (51%, 50%, and 54%, respectively) and receipt of HCT (52%, 40%, and 43%, respectively) were comparable between the 3 cohorts. The 2-year overall survival rate was 29.9% in the MYC-negative cohort, 0% in the MYC-positive SH cohort, and 9.9% in the MYC-positive DH/TH cohort (P < .001), and no difference was observed between the SH and DH/TH cohorts (P = .8). The higher risk of death for patients with MYC-positive SH DLBCL (hazard ratio, 1.70; 95% confidence interval, 0.98-2.96; P = .06) and those with MYC-positive DH/TH DLBCL (hazard ratio, 2.22; 95% confidence interval, 1.41-3.50; P = .001) persisted after adjusting for covariates. For patients who underwent autologous HCT, the 2-year overall survival rate was 55.4% in the MYC-negative cohort, 0% in the MYC-positive SH cohort, and 19.4% in the MYC-positive DH/TH cohort (P < .001). All 4 MYC-positive patients who underwent allogeneic HCT relapsed in <4 months. CONCLUSIONS: Patients with MYC-positive DLBCL who experience primary treatment failure have response rates to similar to those achieved by salvage therapy compared with their MYC-negative counterparts, but their survival is dismal irrespective of additional "hits" and HCT, representing an unmet medical need. Cancer 2017;123:4411-8. © 2017 American Cancer Society.
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Genes myc , Linfoma de Células B Grandes Difuso/genética , Linfoma de Células B Grandes Difuso/terapia , Translocación Genética , Adulto , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Resistencia a Antineoplásicos/genética , Femenino , Trasplante de Células Madre Hematopoyéticas , Humanos , Linfoma de Células B Grandes Difuso/mortalidad , Linfoma de Células B Grandes Difuso/patología , Masculino , Persona de Mediana Edad , Proto-Oncogenes Mas , Recurrencia , Estudios Retrospectivos , Terapia Recuperativa , Resultado del Tratamiento , Adulto JovenRESUMEN
The outcomes of patients with DLBCL and primary treatment failure (PTF) in the rituximab era are unclear. We analyzed 331 patients with PTF, defined as primary progression while on upfront chemoimmunotherapy (PP), residual disease at the end of upfront therapy (RD) or relapse < 6 months from end of therapy (early relapse; ER). Median age was 58 years and response to salvage was 41.7%. Two-year OS was 18.5% in PP, 30.6% in RD and 45.5% in ER. The presence of PP, intermediate-high/high NCCN-IPI at time of PTF or MYC translocation predicted 2-year OS of 13.6% constituting ultra-high risk (UHR) features. Among the 132 patients who underwent autologous hematopoietic cell transplantation, 2-year OS was 74.3%, 59.6% and 10.7% for patients with 0,1 and 2-3 UHR features respectively. Patients with PTF and UHR features should be prioritized for clinical trials with newer agents and innovative cellular therapy.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Progresión de la Enfermedad , Trasplante de Células Madre Hematopoyéticas/mortalidad , Linfoma de Células B Grandes Difuso/mortalidad , Linfoma de Células B Grandes Difuso/terapia , Terapia Recuperativa/mortalidad , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Benchmarking , Supervivencia sin Enfermedad , Trasplante de Células Madre Hematopoyéticas/métodos , Trasplante de Células Madre Hematopoyéticas/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Análisis Multivariante , Neoplasia Residual , Recurrencia , Estudios Retrospectivos , Factores de Riesgo , Terapia Recuperativa/métodos , Terapia Recuperativa/estadística & datos numéricos , Trasplante Autólogo , Insuficiencia del TratamientoRESUMEN
STATEMENT OF PROBLEM: The importance of the crest module design in the cortical bone region triggered a need to understand its geometry and its influence on stress management and bone stimulation. PURPOSE: The purpose of this study was to determine the effect of different crest module designs in the cortical bone region in terms of critical stress distribution and bone stimulation. MATERIAL AND METHODS: Several 3-dimensional finite element analyses were conducted of a mandibular cross section with osseointegrated dental implants. For the numerical models, different crest module designs (cylindrical, divergent, convergent, and cup shaped) were analyzed. An average value of a maximum occlusal load of 250 N was applied to each dental implant design, 30 degrees from the top surface. The concentration and distribution patterns of principal and maximum shear stresses and strains were obtained and analyzed. RESULTS: According to the comparative finite element analyses, the most pathologic stress and strain peaks around the implant collar in the cortical bone region were found in divergent crest modules with angles 14 degrees or larger. Nevertheless, the highest physiologic peaks of passive bone stimulation through compression, and the lowest tensile and shear stresses and strains in the cortical bone region were promoted by extended divergent crest module designs. CONCLUSIONS: A slightly divergent and smooth crest module design extended to the cancellous bone increases the surface area available. This results in the dissipation of critical stresses expressed around the collar of the cortical bone region, not only promoting a higher bone-implant contact area and a physiologic bone stimulation but also boosting a healthy and strong bone-implant interface.
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Implantes Dentales , Diseño de Prótesis Dental , Análisis de Elementos Finitos , Imagenología Tridimensional/métodos , Mandíbula/fisiología , Aleaciones , Anatomía Transversal/métodos , Fenómenos Biomecánicos , Fuerza de la Mordida , Interfase Hueso-Implante/fisiología , Hueso Esponjoso/fisiología , Diseño Asistido por Computadora , Hueso Cortical/fisiología , Aleaciones Dentales/química , Humanos , Oseointegración/fisiología , Estrés Mecánico , Propiedades de Superficie , Titanio/químicaRESUMEN
BACKGROUND AND PURPOSE: X-linked adrenoleukodystrophy (X-ALD) is a peroxisomal disorder affecting particularly the nervous tissue and adrenal cortex. Adrenomyeloneuropathy (AMN) is the most frequent phenotype, although adrenal insufficiency is usually the first manifestation in male patients. We set out to describe the clinical and biochemical features, together with the clinical course of X-ALD patients, focusing particularly on endocrine dysfunction. PATIENTS AND METHODS: A retrospective study of 10 male X-ALD patients followed up at the Endocrinology Department. Epidemiologic data, phenotype evolution, endocrine and neurological findings and family history were analysed. RESULTS: All the patients presented with adrenal insufficiency, 4 of them during adulthood, with a mean age of 19.6±17.1 years (6-64 years). Six patients had mineralocorticoid deficiency. At diagnosis, 8 patients had Addison-only phenotype and 2 AMN phenotype. In the course of follow-up (24.9±16.1 years), 4 patients developed AMN about 25.0±7.4 years after the initial diagnosis and 2 patients presented the cerebral adult form 11 and 17 years after the initial diagnosis. Testosterone levels were within the normal range in all patients. There were 7 families, and age of onset and clinical course were similar in 3 of them. CONCLUSIONS: The presentation of X-ALD varied widely, 40% of the patients presented with adrenal insufficiency in adulthood, 60% had mineralocorticoid deficiency, and the onset and progression of neurological manifestations showed no pattern. Nevertheless, some similarities in the clinical course were found in some families. Our findings reinforce the need for screening for X-ALD at any age when approaching adrenal insufficiency and the importance of a multidisciplinary approach between endocrinologists and neurologists.
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Adrenoleucodistrofia , Masculino , Humanos , Adrenoleucodistrofia/complicaciones , Adrenoleucodistrofia/diagnóstico , Adrenoleucodistrofia/genética , Estudios Retrospectivos , Mineralocorticoides , Fenotipo , Progresión de la EnfermedadRESUMEN
INTRODUCTION: Natural hair curvature and colour are genetically determined human traits, that we intentionally change by applying thermal and chemical treatments to the fibre. Presently, those cosmetic methodologies act externally and their recurrent use is quite detrimental to hair fibre quality and even to our health. OBJECTIVES: This work represents a disruptive concept to modify natural hair colour and curvature. We aim to model the fibre phenotype as it is actively produced in the follicle through the topical delivery of specific bioactive molecules to the scalp. METHODS: Transcriptome differences between curly and straight hairs were identified by microarray. In scalp samples, the most variable transcripts were mapped by in situ hybridization. Then, by using appropriate cellular models, we screened a chemical library of 1200 generic drugs, searching for molecules that could lead to changes in either fibre colour or curvature. A pilot-scale, single-centre, investigator-initiated, prospective, blind, bilateral (split-scalp) placebo-controlled clinical study with the intervention of cosmetics was conducted to obtain a proof of concept (RNEC n.92938). RESULTS: We found 85 genes transcribed significantly different between curly and straight hair, not previously associated with this human trait. Next, we mapped some of the most variable genes to the inner root sheath of follicles, reinforcing the role of this cell layer in fibre shape moulding. From the drug library screening, we selected 3 and 4 hits as modulators of melanin synthesis and gene transcription, respectively, to be further tested in 33 volunteers. The intentional specific hair change occurred: 8 of 14 volunteers exhibited colour changes, and 16 of 19 volunteers presented curvature modifications, by the end of the study. CONCLUSION: The promising results obtained are the first step towards future cosmetics, complementary or alternative to current methodologies, taking hair styling to a new level: changing hair from the inside out.
RESUMEN
Langerhans cell histiocytosis (LCH) is a disease that can involve one or multiple organ systems characterized by an accumulation of CD1a(+) Langerhans-like cells as well as several other myeloid cell types. The precise origin and role of one of these populations, the multinucleated giant cell (MGC), in this disease remains unknown. This work shows that in three different lesional tissues, bone, skin, and lymph node, the MGCs expressed the characteristic osteoclast markers, tartrate-resistant acid phosphatase and vitronectin receptor, as well as the enzymes cathepsin K and matrix metalloproteinase-9. Although, in bone lesions, the osteoclast-like MGCs were only CD68(+), in the nonostotic sites, they coexpressed CD1a. The presence of osteoclast-like MGCs may be explained by the production of osteoclast-inducing cytokines such as receptor activator of nuclear factor kappaB ligand and macrophage colony-stimulating factor by both the CD1a(+) LCH cells and T cells in these lesions. As osteoclast-derived enzymes play a major role in tissue destruction, the osteoclast-like nature of MGCs in all LCH lesions makes them a potential target for the treatment of this disease.
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Huesos/patología , Células Gigantes/patología , Histiocitosis de Células de Langerhans/patología , Osteoclastos/patología , Biomarcadores/análisis , Huesos/metabolismo , Proteínas Portadoras/metabolismo , Diferenciación Celular , Células Gigantes/metabolismo , Histiocitosis de Células de Langerhans/metabolismo , Humanos , Factor Estimulante de Colonias de Macrófagos/metabolismo , Glicoproteínas de Membrana/metabolismo , Organofosfonatos/uso terapéutico , Osteoclastos/metabolismo , Fenotipo , Ligando RANK , Receptor Activador del Factor Nuclear kappa-BRESUMEN
The importance of the hair follicle in the process of cutaneous drug penetration has been established since this skin appendage was recognized as an entry point for topically applied substances. A comprehensive review on the hair follicle as a target per se is here provided, exploring the current knowledge on both targeted regions and delivery systems that take advantage of this permeation route. The follicular penetration is a complex process, whose effectiveness and efficiency strongly depends on a diversity of different factors including follicular density and size, activity status of hair follicles and physicochemical properties of the topically applied substances. Nanocarriers represent a heterogeneous assembly of molecules organized into particles and they have revolutionized drug delivery in several areas of medicine, pharmacology and cosmetics. As they possess an inherent ability to use the follicular route, they are reviewed here having in perspective the hair follicle zones that they are able to reach as reported. In this way, a follicular road map for the different delivery systems was compiled to assist as a guiding tool for those that have interest in the development and/or application of such delivery systems for hair and skin treatment or care.
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Folículo Piloso , Absorción Cutánea , Administración Cutánea , Sistemas de Liberación de Medicamentos , Folículo Piloso/metabolismo , Piel/metabolismoRESUMEN
The follicular route is an important drug penetration pathway in any topical application, either concerning dermatological and cosmetic skin treatments or any transdermal administration regimen. Efficient transport into follicles will depend on drug inherent properties but also on the chosen vehicle. The main study goal was to compare several systems for the delivery to the hair bulb of two fluorescent molecules of different water affinities: the hydrophobic Nile Red and the quite similar but hydrophilic Nile Blue. Three common nanoparticle types were compared in terms of encapsulation efficiency and stability: liposomes, ethosomes and polymeric nanoparticles. A liquid serum-like formulation was also developed, adjusting the final ethanol amount to the type of dye to be solubilized. Then, this formulation and the nanoparticle systems that successfully passed characterization and stability stages were further studied on their ability to reach the bulb. The serum formulation was able to deliver, both drug models, to deeper follicular regions than nanoparticles. Attending to the envisioned zone target of the follicle, the simplest approach proved to be the best choice from all the systems tested in this work. Nonetheless, nanocarriers and the inherent complexity of their manufacturing processes may be justified under very specific requirements.
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Portadores de Fármacos , Nanopartículas , Administración Cutánea , Sistemas de Liberación de Medicamentos , Folículo Piloso , Interacciones Hidrofóbicas e Hidrofílicas , PielRESUMEN
Langerhans cell histiocytosis (LCH) is characterized by a clonal proliferation and retention of cells with a Langerhans cell (LC)-like phenotype at various sites within the body. The present study set out to elucidate whether aberrant expression of chemokine receptors or dysregulation of chemokine production in LCH lesions could explain abnormal retention of these cells. Immunohistochemical analysis on 13 LCH biopsies of bone, skin, and lymph node all expressed the immature dendritic cell (DC) marker CCR6 on the lesional LCs and absence of the mature DC marker CCR7. Furthermore, regardless of the tissue site, LCH lesions markedly overexpressed CCL20/MIP-3alpha, the ligand for CCR6. The lesional LCs appeared to be the source of this CCL20/MIP-3alpha production as well as other inflammatory chemokines such as CCL5/RANTES and CXCL11/I-TAC. These may explain the recruitment of eosinophils and CD4+CD45RO+ T cells commonly found in LCH lesions. The findings of this study emphasize that, despite abundant TNF-alpha, lesional LCs remain in an immature state and are induced to produce chemokines, which via autocrine and paracrine mechanisms cause not only the retention of the lesional LCs but also the recruitment and retention of other lesional cells. We postulate that the lesional LCs themselves control the persistence and progression of LCH.
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Quimiocinas/biosíntesis , Histiocitosis de Células de Langerhans/etiología , Células de Langerhans/inmunología , Receptores de Quimiocina/análisis , Animales , Antígenos CD1/análisis , Linfocitos T CD4-Positivos/fisiología , Quimiocina CCL20 , Quimiocina CXCL11 , Quimiocinas CC/análisis , Quimiocinas CXC/análisis , Histiocitosis de Células de Langerhans/inmunología , Histiocitosis de Células de Langerhans/patología , Humanos , Proteínas Inflamatorias de Macrófagos/análisis , Ratones , Conejos , Receptores CCR6RESUMEN
The etiology of Langerhans cell histiocytosis (LCH), a disease characterized by uncontrolled proliferation of Langerhans cells, is unknown. Although some believe that LCH is reactive, others support a neoplastic origin. We tested the hypothesis that LCH is neoplastic by investigating potential consistent chromosomal aberrations in LCH cells. We used multiparameter DNA flow cytometry to analyze the DNA ploidy LCH cells in 20 cases, performed karyotype analysis in 31 cases, array-based comparative genomic hybridization (arrayCGH) and single nucleotide polymorphism (SNP) arrays with DNA from flow-sorted CD1a-positive and CD1a-negative cells in 19 cases. Ploidy analysis revealed diploid DNA content in all cases. The karyotype of all patients analyzed was normal, excluding the presence of balanced translocations. ArrayCGH and SNP arrays did not show genome abnormalities. Despite positive TP53 protein immunohistochemical staining, sequencing of exon 5 to 8 of p53 gene showed no alterations in 7 cases. This study strongly suggests that gross chromosomal abnormalities do not cause LCH. Although we cannot exclude cryptic point mutations in as yet unidentified genes, this study of 72 LCH cases shows that LCH may be the result of restricted oligoclonal stimulation rather than unlimited neoplastic proliferation. (c) 2008 Wiley-Liss, Inc.
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Aberraciones Cromosómicas , Histiocitosis de Células de Langerhans/genética , Adolescente , Adulto , Anciano , Antígenos CD1/genética , Antígenos CD1/metabolismo , Secuencia de Bases , Niño , Preescolar , Hibridación Genómica Comparativa , Análisis Mutacional de ADN , Femenino , Citometría de Flujo , Genes p53 , Histiocitosis de Células de Langerhans/patología , Humanos , Lactante , Cariotipificación , Células de Langerhans/patología , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Análisis de Secuencia por Matrices de Oligonucleótidos , Ploidias , Polimorfismo de Nucleótido SimpleRESUMEN
Background: Research on the interplay between mothers' and children's eating behaviors is needed to better inform sensitive and tailored interventions for treatment-seeking children with overweight/obesity. The present study aimed to identify mothers' eating behavior phenotypes, investigating their associations with problematic eating behaviors of children undergoing weight loss treatment in two central hospitals. Methods: This is a cross-sectional study evaluating 136 mother-child dyads (Mothers: age 39.58 ± 5.40 years; Children: n = 75 female; age 10.13 ± 1.37 years). Mothers' eating behavior (restraint, emotional, and uncontrolled eating) and depression/anxiety, and children's problematic eating attitudes/behaviors were assessed. A cluster analysis (K-means) was performed using mothers' eating behavior dimensions. Multivariate Analysis of Covariance investigated differences between clusters on mothers' and children's sociodemographic, anthropometric, psychological, and eating-related variables. Results: Three clusters emerged: The Disordered Eating group (n = 39) of mothers with the highest scores on emotional eating and uncontrolled eating dimensions, the Restraint Eating group (n = 48), including mothers scoring high in cognitive restraint, and the Low Disordered Eating (n = 49) group where mothers scored low in all eating behavior dimensions. Children of mothers in the Disordered Eating cluster had significantly higher emotional overeating relative to children of mothers in the other two clusters. Conclusions: Distinctive eating behavior profiles of mothers, instead of the presence of single eating behaviors, seem to be associated with specific problematic eating behaviors of children undergoing weight loss treatment. Prospective studies are essential to determine whether these profiles can predict differential weight change trajectories in pediatric obesity treatment.
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Obesidad Infantil , Pérdida de Peso , Adulto , Índice de Masa Corporal , Niño , Análisis por Conglomerados , Estudios Transversales , Conducta Alimentaria , Femenino , Humanos , Conducta Materna , Persona de Mediana Edad , Relaciones Madre-Hijo , Madres , Obesidad Infantil/epidemiología , Obesidad Infantil/terapia , Estudios ProspectivosRESUMEN
PURPOSE: Bendamustine and rituximab (BR) has been established as a superior frontline therapy over R-CHOP in the treatment of follicular lymphoma (FL). Yttrium-90 Ibritumomab tiuxetan (90YIT) is an effective consolidation strategy after chemotherapy induction. This prospective, single-arm, multicenter, phase II trial evaluated the response rate, progression-free survival (PFS), and tolerability of BR followed by consolidation with 90YIT in patients with untreated FL. PATIENTS AND METHODS: The study included grade 1 to 3a FL patients aged ≥18 years, chemotherapy-naïve, and requiring treatment for stage II-IV disease. Study treatment included an initial rituximab treatment, followed by four cycles of BR. Patients were eligible for consolidation with 90YIT, 6 to 12 weeks after BR, if they obtained at least a partial response after induction had adequate count recovery and bone marrow infiltration < 25%. RESULTS: Thirty-nine patients were treated. Eighty-two percent had an intermediate or high-risk Follicular Lymphoma International Prognostic Index score, and 6 of 39 (15%) were grade 3a. The response rate was 94.8%, and the complete response(CR)/CR unconfirmed (CRu) rate was 77% in the intention-to-treat analysis. The conversion rate from PR to CR/Cru after 90YIT was 81%. After median follow-up of 45 months, the PFS was 0.71 (95% confidence interval, 0.57-0.89). CONCLUSIONS: This report demonstrates that four cycles of BR followed by consolidation with 90YIT achieve high response rates that are durable. In addition, consolidation with 90YIT results in a high conversion rate of PR to CR/CRu. A short course of BR followed by 90YIT is a safe and effective regimen for frontline treatment of FL.
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Anticuerpos Monoclonales/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Clorhidrato de Bendamustina/administración & dosificación , Linfoma Folicular/tratamiento farmacológico , Rituximab/administración & dosificación , Adulto , Anciano , Anticuerpos Monoclonales/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Clorhidrato de Bendamustina/efectos adversos , Quimioradioterapia/efectos adversos , Quimioradioterapia/métodos , Esquema de Medicación , Femenino , Humanos , Linfoma Folicular/mortalidad , Masculino , Persona de Mediana Edad , Supervivencia sin Progresión , Estudios Prospectivos , Radioinmunoterapia/efectos adversos , Radioinmunoterapia/métodos , Inducción de Remisión/métodos , Rituximab/efectos adversosRESUMEN
BACKGROUND: Acid-base disturbances are frequent in critically ill patients. Arterial blood gas (ABG) is the gold standard in the diagnosis of these disturbances, but it is invasive with potential hazards. For patients with a central venous catheter, venous blood gas (VBG) sampling may be an alternative, less-invasive diagnostic tool. However, the accuracy of a central VBG-based acid-base disorder diagnosis compared to an ABG is unknown. The primary objective of this study was to assess the accuracy of a central VBG-based acid-base disorder diagnosis compared to the "gold standard" ABG in critically ill patients. METHODS: This was a study of adult patients in a medical intensive care unit that had simultaneously drawn ABG and central VBG samples. Expert acid-base diagnosticians, all nephrologists, diagnosed the acid-base disorder(s) in each blood gas sample. The central VBG diagnostic accuracy was assessed with percent agreement, sensitivity, and specificity compared to the ABG-based diagnosis. RESULTS: The study involved 23 participants. Overall, the central VBG had 100% sensitivity for metabolic acidosis, metabolic alkalosis, and respiratory acidosis, and lower sensitivity (71%) for respiratory alkalosis, and high percent agreement, ranging from 75 to 94%. VBG-based diagnoses in vasopressor-dependent patients (n = 13, 56.5%) performed similarly to the entire sample. CONCLUSIONS: In critically ill adult patients, central VBG may be used to detect and diagnose acid-base disturbances with reasonable diagnostic accuracy, even in shock states, compared to the ABG. This study supports the use of central VBG for diagnosis of acid-base disturbances in critically ill patients.
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Equilibrio Ácido-Base , Desequilibrio Ácido-Base/diagnóstico , Análisis de los Gases de la Sangre/métodos , Cuidados Críticos/métodos , Desequilibrio Ácido-Base/sangre , Acidosis/diagnóstico , Adulto , Anciano , Alcalosis/diagnóstico , Cateterismo Venoso Central , Enfermedad Crítica , Estudios Transversales , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
A ocorrência de processos fisiopatológicos que cursam com desidratação da ingesta no trato gastrointestinal dos equinos é comum na rotina clínica. Fatores como diminuição da motilidade intestinal e sobrecarga intraluminal de conteúdo desidratado podem levar a compactação em segmentos como estômago, ceco e cólons. Este estudo objetivou realizar a comparação entre soluções eletrolíticas enterais hipotônica (SeHIPO) e isotônica (SeISO) e a solução Ringer com lactato de sódio (RL IV) sobre o teor de umidade das fezes de equinos submetidos a um período de desidratação experimental (PD). Foram utilizados seis equinos adultos, todas fêmeas com idades entre 10 e 15 anos, média de 440 kg de peso corpóreo. O PD constou de 36 horas de jejum hídrico e alimentar associadas a duas administrações intravenosas de furosemida, sendo a primeira imediatamente no início (T-36) e a segunda 12 horas após o início do PD. Os tratamentos utilizados foram: SeHIPO e SeISO, ambas administradas por via nasogástrica em fluxo contínuo (HETfc), e RL IV administrada pela via intravenosa. Todos os tratamentos foram administrados a uma taxa de infusão contínua de 15mL kg-1 h-1 durante 8 horas consecutivas. O delineamento experimental utilizado foi o crossover6x3, onde cada animal foi submetido, em sistema de rodízio, aos três tratamentos em momentos distintos. As soluções eletrolíticas enterais demonstraram maior eficácia na recomposição do teor de umidade das fezes quando comparadas à terapia RL IV. A hidratação enteral com soluções isotônicas e hipotônicas administrada em fluxo contínuo são eficazes em restaurar o teor de umidade das fezes, podendo ofertar uma opção econômica, segura e eficiente na reidratação de pacientes e nas afecções que cursam como obstruções intraluminais simples.
The occurrence of pathophysiological processes that curse with digesta dryness in the gastrointestinal tract of horses is common in clinical routine, factors such as decreased intestinal motility and intraluminal overload of dry content can lead to compaction in segments such as cecum and colon. This study aimed to compare a hypotonic enteral solution (SeHIPO), an isotonic enteral solution (SeISO) and a Ringer with sodium lactate solution (RL IV) over the moisture content of equine feces submitted to an experimental dehydration protocol. Six adult horses were used, all females aged between 10 and 15 years, average body weight of 440 kg. The PD consisted of a 36 hours period of water and food fasting associated with two intravenous administrations of furosemide, the first immediately at the beginning (T-36) and the second 12 hours after the beginning of the PD. The treatments used were: SeHIPO (hypotonic enteral solution administered via nasogastric), SeISO (enteral isotonic solution administered via nasogastric) and RL IV (Ringer's solution with sodium lactate administered intravenously), all treatments were administered by continuous infusion at a rate of 15mL kg-1 h-1 for 8 consecutive hours. The experimental design used was the 6x3 crossover, where each animal is submitted, in a rotation system, to the three treatments at different times. Enteral fluid therapy with isotonic and hypotonic solutions administered in continuous flow are effective in restoring the moisture content of feces, and may offer an economical, safe, and efficient option for rehydrating patients and in conditions that progress as simple intraluminal obstructions.
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Animales , Equilibrio Hidroelectrolítico , Deshidratación/veterinaria , Fluidoterapia/veterinaria , Lactato de Ringer/uso terapéutico , Caballos/metabolismo , Soluciones Hipotónicas/uso terapéutico , Soluciones Isotónicas/uso terapéutico , Tracto Gastrointestinal , Heces , Administración Intravenosa/veterinariaRESUMEN
Purpose Patients with double-hit lymphoma (DHL) rarely achieve long-term survival following disease relapse. Some patients with DHL undergo consolidative autologous stem-cell transplantation (autoSCT) to reduce the risk of relapse, although the benefit of this treatment strategy is unclear. Methods Patients with DHL who achieved first complete remission following completion of front-line therapy with either rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or intensive front-line therapy, and deemed fit for autoSCT, were included. A landmark analysis was performed, with time zero defined as 3 months after completion of front-line therapy. Patients who experienced relapse before or who were not followed until that time were excluded. Results Relapse-free survival (RFS) and overall survival (OS) rates at 3 years were 80% and 87%, respectively, for all patients (n = 159). Three-year RFS and OS rates did not differ significantly for autoSCT (n = 62) versus non-autoSCT patients (n = 97), but 3-year RFS was inferior in patients who received R-CHOP compared with intensive therapy (56% v 88%; P = .002). Three-year RFS and OS did not differ significantly for patients in the R-CHOP or intensive therapy cohorts when analyzed by receipt of autoSCT. The median OS following relapse was 8.6 months. Conclusion In the largest reported series, to our knowledge, of patients with DHL to achieve first complete remission, consolidative autoSCT was not associated with improved 3-year RFS or OS. In addition, patients treated with R-CHOP experienced inferior 3-year RFS compared with those who received intensive front-line therapy. When considered in conjunction with reports of patients with newly diagnosed DHL, which demonstrate lower rates of disease response to R-CHOP compared with intensive front-line therapy, our findings further support the use of intensive front-line therapy for this patient population.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Linfoma de Células B/genética , Linfoma de Células B/terapia , Trasplante de Células Madre , Anticuerpos Monoclonales de Origen Murino/uso terapéutico , Ciclofosfamida/uso terapéutico , Citarabina/administración & dosificación , Citarabina/uso terapéutico , Dexametasona/uso terapéutico , Supervivencia sin Enfermedad , Doxorrubicina/uso terapéutico , Etopósido/uso terapéutico , Femenino , Humanos , Ifosfamida/uso terapéutico , Masculino , Metotrexato/administración & dosificación , Metotrexato/uso terapéutico , Persona de Mediana Edad , Prednisona/uso terapéutico , Proteínas Proto-Oncogénicas c-bcl-2/genética , Proteínas Proto-Oncogénicas c-bcl-6/genética , Proteínas Proto-Oncogénicas c-myc/genética , Recurrencia , Inducción de Remisión , Rituximab , Tasa de Supervivencia , Trasplante Autólogo , Vincristina/uso terapéuticoRESUMEN
BACKGROUND AND AIMS: Differences in the mating systems and the mechanisms of reproductive isolation between Chamaecrista desvauxii var. graminea and C. desvauxii var. latistipula were examined in the Chapada Diamantina, Brazil. These taxa occur sympatrically, and their populations demonstrate marked morphological differences. The objective of the present work was to determine if reproductive isolation mechanisms exist between these two populations of C. desvauxii, and to determine the influence of these putative mechanisms on their genetic differentiation. METHODS: Field observations were made of floral biology, phenology and floral visitation, and experiments on intra- and interpopulation pollination and germination rates of the resultant seeds were performed. A genetic examination of the populations was undertaken using four allozyme loci. KEY RESULTS: The varieties examined demonstrated overlapping of flowering periods during the months of June to September. The main pollinator for both varieties was the bee Bombus brevivillus. Both varieties are self-compatible, and a large number of fruits are formed in cross-pollinations with high seed germination rates. Inter-taxa pollinations result in high levels of fruit production, but no seeds are formed. Two of the four loci examined were diagnostic for the varieties, and exclusive high-frequency alleles were encountered at the other loci, leading to a high genetic distance between the two populations (0.495). CONCLUSIONS: Pre-zygotic barriers were not found between the two varieties, and these remain isolated due to post-zygotic events. The two varieties demonstrate marked differences in their morphology, floral biology, phenology and genetic make-up, all of which indicate that they should be treated as two distinct species. A complete revision involving the other varieties of the C. desvauxii complex will be necessary in order to define these two taxa formally.
Asunto(s)
Chamaecrista/fisiología , Alelos , Brasil , Chamaecrista/anatomía & histología , Chamaecrista/enzimología , Flores/anatomía & histología , Flores/enzimología , Flores/fisiología , Proteínas de Plantas/metabolismo , Polimorfismo Genético , Reproducción/fisiologíaRESUMEN
Transexual é o indivíduo que se identifica como pertencente ao sexo oposto e experimenta grande frustaçao ao tentar se expressar através do seu sexo genético. No presente artigo os autores fazem uma revisao do transexualismo, abordando a sua etiologia, a importância do diagnóstico correto, os tratamentos hormonal e cirúrgico, além de iniciarem discussao sobre seus aspectos éticos, sociais e legais.
Asunto(s)
Humanos , Masculino , Femenino , Transexualidad , Ética Médica , Transexualidad/diagnóstico , Transexualidad/etiología , Transexualidad/terapiaRESUMEN
Investigou-se o efeito do jato de óxido de alumínio e de três substâncias modoficadoras de superfície na resistência adesiva do polímero de vidro Artglass« ao cimento resinoso C&B«. Foram confeccionadas 60 pastilhas de Artglass«, medindo 7,0mm de diâmetro e 5,0mm de altura, e 60 pastilhas medindo 5,0mm de diâmetro e 3,0mm de altura. As pastilhas foram distribuídos em 6 grupos (n=10), e receberam os seguintes tratamentos superficiais: G1- adesivo Alloybond«; G2- agente silano Scotchprimer RelyX« seguido pelo Alloybond«; G3- c&b Liquid«; G4- jato de óxido de alumínio e adesivo Alloybond«; G5- jato e agente silano Scotchprimer« seguido pelo Alloybond«; G6- jato e c&b Liquid«. A cimentação das pastilhas foi realizada com o cimento resinoso C&B« a uma carga de 0,5 kgf. O ensaio de cisalhamento foi realizado em uma Máquina de Ensaio Universal Instron« e após a fratura dos espécimes, as superfícies das pastilhas foram examinadas em lupa com aumento de 20x, para classificação do modo de fratura. Os resultados evidenciaram que os espécimes jateados tiveram os maiores valores de resistência adesiva; e que a apicação do silano Scotchprimer« seguida do Alloybond« gerou valores de resistência adesiva superiores aos outros modoficadores de superfície. Os espécimes não jateados apresentaram 100 por cento de fraturas na interface adesiva, predominando as fraturas no interior do cimento e complexas nos grupos jateados. Conclui-se que o jato , seguido da aplicação do silano Scotchprimer« e do Alloybond«, promoveu a maior resistência adesiva ao cisalhamento entre o Artglass« e o C&B« Cement