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1.
Clin Transplant ; 38(5): e15339, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38775413

RESUMEN

Simultaneous pancreas-kidney transplantation (SPKT) is the best treatment for selected individuals with type 1 diabetes mellitus and end-stage renal disease. Despite advances in surgical techniques, donor and recipient selection, and immunosuppressive therapies, SPKT remains a complex procedure with associated surgical complications and adverse consequences. We conducted a retrospective study that included 263 SPKT procedures performed between May 2000, and December 2022. A total of 65 patients (25%) required at least one relaparotomy, resulting in an all-cause relaparotomy rate of 2.04 events per 100 in-hospital days. Lower donor body mass index was identified as an independent factor associated with reoperation (OR .815; 95% CI:  .725-.917, p = .001). Technical failure (TF) occurred in 9.9% of cases, primarily attributed to pancreas graft thrombosis, intra-abdominal infections, bleeding, and anastomotic leaks. Independent predictors of TF at 90 days included donor age above 36 years (HR 2.513; 95% CI 1.162-5.434), previous peritoneal dialysis (HR 2.503; 95% CI 1.149-5.451), and specific pancreas graft reinterventions. The findings highlight the importance of carefully considering donor and recipient factors in SPKT. The incidence of TF in our study population aligns with the recent series. Continuous efforts should focus on identifying and mitigating potential risk factors to enhance SPKT outcomes, thereby reducing post-transplant complications.


Asunto(s)
Diabetes Mellitus Tipo 1 , Supervivencia de Injerto , Fallo Renal Crónico , Trasplante de Riñón , Trasplante de Páncreas , Complicaciones Posoperatorias , Humanos , Femenino , Masculino , Trasplante de Páncreas/efectos adversos , Estudios Retrospectivos , Trasplante de Riñón/efectos adversos , Adulto , Complicaciones Posoperatorias/etiología , Estudios de Seguimiento , Factores de Riesgo , Fallo Renal Crónico/cirugía , Pronóstico , Diabetes Mellitus Tipo 1/cirugía , Diabetes Mellitus Tipo 1/complicaciones , Rechazo de Injerto/etiología , Persona de Mediana Edad , Reoperación/estadística & datos numéricos , Pruebas de Función Renal , Tasa de Supervivencia , Tasa de Filtración Glomerular
2.
Child Care Health Dev ; 50(2): e13246, 2024 03.
Artículo en Inglés | MEDLINE | ID: mdl-38483061

RESUMEN

BACKGROUND: Children with meningomyelocele may require continuous care. Consequently, there is a risk for caregiver burden and impact on family quality of life (QoL), including siblings' QoL. Some studies analysed caregivers' burden and family QoL separately. However, none of these studies evaluated siblings' QoL and the associations between these three dimensions. This study investigated the associations between caregivers' burden, family QoL and siblings' QoL in Brazilian families of children with meningomyelocele and its correlations with sociodemographic, functional and clinical variables. Siblings' QoL was specifically assessed using as a parameter the QoL of typically developed Brazilian children. METHODS: One hundred and fifty families, 150 caregivers and 68 siblings completed the Family Quality of Life Scale, Burden Interview, KIDSCREEN-27 Child and Adolescent Version and Parents Version questionnaires. RESULTS: Most families and caregivers reported a high family QoL and a low caregiver burden. Family QoL was significantly lower as caregivers' burden increased. Caregiver's burden was significantly lower with increasing family QoL levels. Self-reported siblings' QoL was significantly worse than that of typically developed peers. There were no significant differences between self and parent-reported siblings' QoL. Self-reported siblings' QoL was significantly worse as their age increased and better with increasing family QoL levels. Parent-reported siblings' QoL was significantly worse with increasing levels of caregiver's burden and significantly better as family QoL increased. There were no significant associations with functional and clinical variables. CONCLUSIONS: Despite the cross-sectional nature of the available data precludes any statements of causality, our results reinforce the relevance of knowing the factors that influence the QoL of families and siblings of children and adolescents with meningomyelocele and the relevance of actions aimed at reducing caregivers' burden, improving family QoL and meeting siblings' individual needs. Future multicenter studies may validate the generalizability of our findings.


Asunto(s)
Meningomielocele , Calidad de Vida , Niño , Humanos , Adolescente , Hermanos , Estudios Transversales , Cuidadores , Encuestas y Cuestionarios
3.
An Acad Bras Cienc ; 95(3): e20221043, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37909567

RESUMEN

The concept is part of the essence of a mentally represented element. The concept is part of the process of identification, categorization and description, which allows researchers to define and compare themes between two or more different categories. Following this idea, the main objective of this article is to establish a non-exhaustive reflection on the conceptual bases of Geotourism and its sub-segments Celestial Geotourism, Space Geotourism and Astrotourism. The main reason for carrying out this research is because there isn't a one definition yet for the terms. This is perhaps the reason for the conflicts that exist between the themes of this tourism practice and the three categories - Celestial Geotourism, Space Geotourism and Astrotourism. The methodology was developed through secondary sources and based on the results obtained, it was possible to identify and distinguish the most important concepts to establish a univocal operational definition for each term. Finally, it was possible to conclude that although there are conflicts, this happens due to the inadequate interpretative representation of the themes between the categories.

4.
Retina ; 40(7): 1286-1298, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31313717

RESUMEN

PURPOSE: To determine whether internal limiting membrane peeling in primary rhegmatogenous retinal detachment prevents epiretinal membrane (ERM) development. Secondarily, we propose a classification system for postoperative ERMs. METHODS: Retrospective, interventional, comparative case series. Consecutive eyes with primary rhegmatogenous retinal detachment (n = 140) treated by a single surgeon. The presence of postoperative ERMs was assessed with swept-source optical coherence tomography. RESULTS: An ERM was detected in 26 eyes (46.4%) in the nonpeeling group and in one eye (1.8%) in the internal limiting membrane peeling group (P ≤ 0.001). The median visual acuity significantly improved in both groups (P ≤ 0.001). Inner retinal dimples were observed in 41.1% of eyes in the internal limiting membrane peeling group versus 0% in the nonpeeling group (P ≤ 0.001), and they were not correlated with visual acuity (r = 0.011; P = 0.941). Based on swept-source optical coherence tomography findings, we identified three different types of ERMs: 7 (26.9%) were classified as Type 1, 12 (46.1%) as Type 2, and 7 (26.9%) as Type 3. Superficial retinal plexus deformations observed on optical coherence tomography angiography and en face images were detected in 100% of Type 3 ERMs, 41.6% of Type 2, and 0% of Type 1 (χ = 14.3; P = 0.001). Interestingly, all of the patients who presented these alterations also had metamorphopsia. CONCLUSION: Internal limiting membrane peeling in primary rhegmatogenous retinal detachment seems to prevent postoperative ERM development. Swept-source optical coherence tomography analysis is helpful to define and classify different types of ERMs and to establish the surgical indication for their removal.


Asunto(s)
Membrana Basal/cirugía , Membrana Epirretinal/prevención & control , Desprendimiento de Retina/cirugía , Tomografía de Coherencia Óptica/métodos , Agudeza Visual , Vitrectomía/métodos , Membrana Epirretinal/diagnóstico , Membrana Epirretinal/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Desprendimiento de Retina/complicaciones , Desprendimiento de Retina/diagnóstico , Estudios Retrospectivos
5.
Biochim Biophys Acta Proteins Proteom ; 1865(4): 395-403, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28088615

RESUMEN

The cellulases from Glycoside Hydrolyses family 12 (GH12) play an important role in cellulose degradation and plant cell wall deconstruction being widely used in a number of bioindustrial processes. Aiming to contribute toward better comprehension of these class of the enzymes, here we describe a high-yield secretion of a endoglucanase GH12 from Aspegillus terreus (AtGH12), which was cloned and expressed in Aspergillus nidulans strain A773. The purified protein was used for complete biochemical and functional characterization. The optimal temperature and pH of the enzyme were 55°C and 5.0 respectively, which has high activity against ß-glucan and xyloglucan and also is active toward glucomannan and CMC. The enzyme retained activity up to 60°C. AtGH12 is strongly inhibited by Cu2+, Fe2+, Cd2+, Mn2+, Ca2+, Zn2+ and EDTA, whereas K+, Tween, Cs+, DMSO, Triton X-100 and Mg2+ enhanced the enzyme activity. Furthermore, SAXS data reveal that the enzyme has a globular shape and CD analysis demonstrated a prevalence of a ß-strand structure corroborating with typical ß-sheets fold commonly found for other endoglucanases from GH12 family.


Asunto(s)
Aspergillus , Celulasa , Clonación Molecular , Proteínas Fúngicas , Expresión Génica , Aspergillus/enzimología , Aspergillus/genética , Celulasa/biosíntesis , Celulasa/química , Celulasa/genética , Proteínas Fúngicas/biosíntesis , Proteínas Fúngicas/química , Proteínas Fúngicas/genética , Proteínas Recombinantes
6.
Nutr Cancer ; 67(3): 463-71, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25710080

RESUMEN

Hematological malignancies present abnormal blood cells that may have altered functions. This study aimed to evaluate nutritional status, acute phase proteins, parameters of cell's functionality, and oxidative stress of patients with hematological malignancies, providing a representation of these variables at diagnosis, comparisons between leukemias and lymphomas and establishing correlations. Nutritional status, C-reactive protein (CRP), albumin, phagocytic capacity and superoxide anion production of mononuclear cells, lipid peroxidation and catalase activity in plasma were evaluated in 16 untreated subjects. Main diagnosis was acute leukemia (n = 9) and median body mass index (BMI) indicated overweight (25.6 kg/m(2)). Median albumin was below (3.2 g/dL) and CRP above (37.45 mg/L) the reference values. Albumin was inversely correlated with BMI (r = -0.53). Most patients were overweight before the beginning of treatment and had a high CRP/albumin ratio, which may indicate a nutrition inflammatory risk. BMI values correlated positively with lipid peroxidation and catalase activity. A strong correlation between catalase activity and lipid peroxidation was found (r = 0.75). Besides the elevated BMI, these patients also have elevated CRP values and unexpected relations between nutritional status and albumin, reinforcing the need for nutritional counseling during the course of chemotherapy, especially considering the correlations between oxidative stress parameters and nutritional status evidenced here.


Asunto(s)
Proteínas de Fase Aguda/análisis , Neoplasias Hematológicas/metabolismo , Estado Nutricional , Estrés Oxidativo , Adolescente , Adulto , Anciano , Índice de Masa Corporal , Proteína C-Reactiva/análisis , Femenino , Neoplasias Hematológicas/tratamiento farmacológico , Humanos , Peroxidación de Lípido , Masculino , Persona de Mediana Edad , Albúmina Sérica/análisis
7.
BMC Pulm Med ; 15: 118, 2015 10 12.
Artículo en Inglés | MEDLINE | ID: mdl-26459359

RESUMEN

BACKGROUND: Schistosomiasis associated pulmonary arterial hypertension (Sch-PAH) might represent the most prevalent form of PAH worldwide. In Sch-PAH, the presence of aneurismal dilation of the pulmonary artery has been described, although it is still a matter of debate whether on average the pulmonary artery is more enlarged in Sc-PAH than IPAH. METHODS: We retrospectively evaluated patients with IPAH (n = 25) and Sch-PAH (n = 22) who underwent computed tomography pulmonary angiogram and right heart catheterization. RESULTS: Sch-PAH patients were older and presented less severe hemodynamic profiles. Main pulmonary artery diameter (MPAD) was greater in Sch-PAH than IPAH (4.5 ± 1.8 vs 3.7 ± 1.1 cm, p = 0.018). For the same level of mean pulmonary artery pressure, the MPAD in Sch-PAH was 0.89 cm larger than in IPAH (Covariance model p = 0.02). CONCLUSION: This study demonstrated that pulmonary artery enlargement is more pronounced in Sch-PAH than IPAH, independently of mean pulmonary artery pressure level, suggesting that this is more likely a feature of Sch-PAH.


Asunto(s)
Aneurisma/diagnóstico por imagen , Hipertensión Pulmonar Primaria Familiar/diagnóstico por imagen , Arteria Pulmonar/diagnóstico por imagen , Esquistosomiasis/complicaciones , Adulto , Angiografía , Femenino , Humanos , Hipertensión Pulmonar/diagnóstico por imagen , Hipertensión Pulmonar/etiología , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Estudios Retrospectivos
8.
Histopathology ; 65(5): 606-12, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24807692

RESUMEN

AIM: To describe the clinicopathological and immuno-histochemical features of six tumours that do not fulfil the criteria of any of the currently classified odontogenic tumours. METHODS AND RESULTS: The patients were three males and three females, whose ages ranged from 3 years to 18 years (mean, 11.05 years). In all cases there were well-defined radiolucencies associated with unerupted teeth apparently showing a pericoronal relationship. Microscopically, all tumours were composed of variably cellular loose fibrous tissue with areas similar to dental papilla, entirely surrounded by cuboidal to columnar epithelium resembling the internal epithelium of the enamel organ. Mesenchymal tissue was positive only for vimentin, and Ki67 expression was very low (<2%). The epithelium was positive for CK AE1/AE3, CK5, CK14, and CK19, but negative for CK18 and CK20. All cases showed clear demarcation from the surrounding bone, and were surgically removed, with no recurrences after follow-up ranging from 6 months to 20 years. CONCLUSIONS: These findings differ from those observed in other odontogenic lesions, such as ameloblastic fibroma, odontogenic myxoma, odontogenic fibroma, and hyperplastic dental follicles. The term primordial odontogenic tumour is proposed to describe this novel lesion.


Asunto(s)
Biomarcadores de Tumor/metabolismo , Neoplasias Maxilomandibulares/clasificación , Tumores Odontogénicos/clasificación , Adolescente , Epitelio/patología , Femenino , Humanos , Inmunohistoquímica , Neoplasias Maxilomandibulares/metabolismo , Neoplasias Maxilomandibulares/patología , Neoplasias Maxilomandibulares/terapia , Masculino , Tumores Odontogénicos/metabolismo , Tumores Odontogénicos/patología , Tumores Odontogénicos/terapia
9.
Biotechnol Bioeng ; 111(8): 1494-505, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24578305

RESUMEN

Enzymes that cleave the xyloglucan backbone at unbranched glucose residues have been identified in GH families 5, 7, 12, 16, 44, and 74. Fungi produce enzymes that populate 20 of 22 families that are considered critical for plant biomass deconstruction. We searched for GH12-encoding genes in 27 Eurotiomycetes genomes. After analyzing 50 GH12-related sequences, the conserved variations of the amino acid sequences were examined. Compared to the endoglucanases, the endo-xyloglucanase-associated YSG deletion at the negative subsites of the catalytic cleft with a SST insertion at the reducing end of the substrate-binding crevice is highly conserved. In addition, a highly conserved alanine residue was identified in all xyloglucan-specific enzymes, and this residue is substituted by arginine in more promiscuous glucanases. To understand the basis for the xyloglucan specificity displayed by certain GH12 enzymes, two fungal GH12 endoglucanases were chosen for mutagenesis and functional studies: an endo-xyloglucanase from Aspergillus clavatus (AclaXegA) and an endoglucanase from A. terreus (AtEglD). Comprehensive molecular docking studies and biochemical analyses were performed, revealing that mutations at the entrance of the catalytic cleft in AtEglD result in a wider binding cleft and the alteration of the substrate-cleavage pattern, implying that a trio of residues coordinates the interactions and binding to linear glycans. The loop insertion at the crevice-reducing end of AclaXegA is critical for catalytic efficiency to hydrolyze xyloglucan. The understanding of the structural elements governing endo-xyloglucanase activity on linear and branched glucans will facilitate future enzyme modifications with potential applications in industrial biotechnology.


Asunto(s)
Aspergillus/metabolismo , Celulasa/metabolismo , Proteínas Fúngicas/metabolismo , Glucanos/metabolismo , Glicósido Hidrolasas/metabolismo , Xilanos/metabolismo , Secuencia de Aminoácidos , Aspergillus/química , Aspergillus/genética , Dominio Catalítico , Celulasa/química , Celulasa/genética , Proteínas Fúngicas/química , Proteínas Fúngicas/genética , Glicósido Hidrolasas/química , Glicósido Hidrolasas/genética , Simulación del Acoplamiento Molecular , Datos de Secuencia Molecular , Mutagénesis Sitio-Dirigida , Filogenia , Pliegue de Proteína , Eliminación de Secuencia , Especificidad por Sustrato
10.
Arch Gynecol Obstet ; 289(1): 119-22, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23860693

RESUMEN

OBJECTIVE: The purpose of this study was to further understand interrelationships between insulin resistance in PCOS and elevated diastolic blood pressure. DESIGN: A prospective case control study. PARTICIPANTS: Fifty normal women and 43 PCOS patients, 16 of them with insulin resistance. SETTING: Academic Institution. INTERVENTIONS: Clinical, anthropometric and ultrasonographic features of PCOS were assessed, as were blood levels for luteinizing hormone, follicle-stimulating hormone, androstenedione, DHEAS, and basal insulin. A lipid profile and an oral glucose tolerance test (OGTT) were also performed. MAIN OUTCOME MEASURES: To demonstrate the effect of insulin resistance on blood pressure in patients with PCOS. RESULTS: Patients with PCOS and those with PCOS plus insulin resistance (IR) had significantly elevated levels of plasma androgen but only those with IR showed greater body mass index and waist: hip ratios than PCOS or control. PCOS plus IR differed significantly in their response to OGTT when compared to PCOS or control. Alterations in lipid profile were shown to be atherogenic. Patients with PCOS plus IR demonstrated a significant elevation of diastolic blood pressure when compared to PCOS alone or controls. CONCLUSIONS: We hypothesize that hyperlipidemia and IR may be involved in the pathophysiologic features of the elevated diastolic blood pressure in PCOS patients.


Asunto(s)
Presión Sanguínea/fisiología , Resistencia a la Insulina/fisiología , Insulina/sangre , Síndrome del Ovario Poliquístico/fisiopatología , Adulto , Androstenodiona/sangre , Glucemia , Índice de Masa Corporal , Estudios de Casos y Controles , Sulfato de Deshidroepiandrosterona/sangre , Femenino , Hormona Folículo Estimulante/sangre , Prueba de Tolerancia a la Glucosa , Humanos , Hormona Luteinizante/sangre , Síndrome del Ovario Poliquístico/sangre , Estudios Prospectivos
11.
Pharm Dev Technol ; 19(2): 173-80, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23356908

RESUMEN

Ethylcellulose microparticles containing metronidazole and propolis extractive solution were prepared and evaluated in vitro against periodontal pathogens. Scanning electron microscopy, particle size analysis, drug entrapment efficiency and drug release of microparticles were determined. The antimicrobial activity of microparticles was evaluated against microorganisms of periodontal importance (Enterococcus faecalis, Streptococcus pyogenes, Streptococcus mutans, Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli). It was obtained particles with regular morphology, mean diameter of 1.23 µm, and entrapment efficiency for propolis and metronidazole were 91.41% and 22.23%, respectively. In vitro release studies of propolis and metronidazole from microparticles showed prolonged drug release and controlled by Fickian diffusion. Both propolis and metronidazole displayed activity against the tested strains. Moreover, the results showed that the strains of E. faecalis, S. pyogenes and S. mutans were more susceptible to the propolis and E. faecalis to the metronidazole. It was also observed that the amount of metronidazole to inhibit the microorganism strains in the physical mixture with propolis was smaller than in the metronidazole alone, suggesting potentiation effect between propolis and metronidazole. These microparticles would be useful for developing intermediary or eventual dosage form to be administered into the periodontal pocket more easily and safely.


Asunto(s)
Antiinfecciosos/administración & dosificación , Bacterias/efectos de los fármacos , Celulosa/análogos & derivados , Portadores de Fármacos/química , Metronidazol/administración & dosificación , Própolis/administración & dosificación , Antiinfecciosos/farmacología , Infecciones Bacterianas/tratamiento farmacológico , Escherichia coli/efectos de los fármacos , Humanos , Klebsiella pneumoniae/efectos de los fármacos , Metronidazol/farmacología , Pruebas de Sensibilidad Microbiana , Própolis/farmacología , Staphylococcus aureus/efectos de los fármacos , Streptococcus/efectos de los fármacos
12.
J Pediatr (Rio J) ; 2024 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-38663449

RESUMEN

OBJECTIVES: To investigate the associations between caregivers' burden, family quality of life (QoL), and siblings' QoL in Brazilian families of children with cerebral palsy, and to analyze siblings' QoL using as a parameter the QoL of typically developed Brazilian children. METHODS: It was a cross-sectional study. The 212 families, 212 caregivers and 131 siblings completed the Family Quality of Life Scale, Burden Interview, and KIDSCREEN-27 Child and Adolescent Version and Parents Version questionnaires at a neurorehabilitation center in southeast Brazil. Univariable and multivariable models were used. RESULTS: Family QoL significantly worsened as caregivers' burden increased (95 % CI -0.66 to -0.38). Caregivers' burden was significantly lower with increasing family QoL scores (95 % CI -0.52 to -0.30). Self-reported siblings' QoL was significantly worse than that of their typically developed peers (95 % CI -7.6 to -3.6). Self-reported siblings' QoL was significantly lower as siblings' age (95 % CI -2.52 to -0.59) and caregivers' burden (95 % CI -0.35 to -0.05) increased. Parent-reported siblings' QoL was significantly lower with increasing caregivers' burden (95 % CI -0.45 to -0.16) and higher as family QoL increased (95 % CI 0.09 to 0.37). CONCLUSIONS: The cross-sectional nature of these data precludes any statement of causality. Family QoL worsened with higher caregivers' burden levels. Lower caregivers' burden scores were associated with a higher family QoL. Siblings' QoL was impaired as compared to typically developed peers, worse among older siblings, and as caregivers' burden increased and better with higher family QoL levels. Future multicenter studies may validate the generalizability of the present findings.

13.
Transplant Proc ; 2024 Feb 13.
Artículo en Inglés | MEDLINE | ID: mdl-38355372

RESUMEN

Transplant renal artery stenosis (TRAS) is a well-recognized vascular complication after kidney transplantation, with an incidence ranging from 1% to 23%. TRAS often presents with clinical features such as refractory hypertension, de novo hypertension, allograft dysfunction, and the presence of a bruit over the graft. A rare manifestation of TRAS is flash pulmonary edema. Here, we present a case of a 37-year-old male who received a living donor kidney. Four years after the transplant, he presented with acute kidney injury, hypertensive crisis, and flash pulmonary edema. Initially, methylprednisolone pulses were administered due to suspicion of acute rejection, which was later ruled out after a kidney graft biopsy. Computed tomography angiography showed findings suggesting stenosis or thrombus in the renal artery. The patient developed sudden acute pulmonary edema, requiring hemodialysis, with notable clinical improvement. Subsequently, stent placement was performed without complications, resulting in the complete recovery of renal function and effective blood pressure control. The incidence of renal artery stenosis is higher in living donor kidney transplantation, mainly due to technical complexities during surgery. Acute presentations, such as flash edema, are exceptionally rare but can occur years after transplantation. Prompt intervention can lead to favorable outcomes.

14.
Rev Assoc Med Bras (1992) ; 70(5): e20231116, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38775530

RESUMEN

OBJECTIVE: Our study aimed to evaluate the impact of bacillus Calmette-Guérin shortage on recurrence and progression in patients with non-muscle invasive bladder cancer in a Brazilian cohort. METHODS: We retrospectively reviewed the clinicopathological data of 409 patients who had their first transurethral resection of the bladder tumor for intermediate or high-risk non-muscle invasive bladder cancer between June 2014 and May 2021 in a tertiary public hospital in Brazil. Patients included had non-muscle-invasive urothelial carcinoma of the bladder resected completely for the first time, regardless of bacillus Calmette-Guérin use. Low-risk disease patients were excluded from the analysis. Demographic, clinicopathological, and bacillus Calmette-Guérin use data were collected from our database. Recurrence and progression data were obtained from patient records or through telephone interviews. Recurrence-free survival and progression-free survival were calculated from the date of transurethral resection of the bladder tumor until the events of recurrence, progression, last office visit, or phone interview. RESULTS: Within a median follow-up period of 26.7 months, 168 (41.1%) patients experienced a recurrence in a median time of 27 months (95%CI 16.1-38). Bacillus Calmette-Guérin was administered to 57 (13.9%) individuals after transurethral resection of the bladder tumor. Patients with ≥3 lesions (p<0.001), those with lesions >3 cm (p=0.02), and those without bacillus Calmette-Guérin treatment (p<0.001) had shorter recurrence-free survival. According to a Cox multivariate regression model, bacillus Calmette-Guérin use was independently associated with a reduced recurrence rate, with an HR of 0.43 (95%CI 0.25-0.72). Out of the patients studied, 26 (6.4%) experienced progression. T1 stage (p<0.001) and high-grade (p<0.001) were associated with shorter progression-free survival. Bacillus Calmette-Guérin did not influence bladder cancer progression. In the Cox multivariate analysis, high-risk disease was independently associated with progression (p<0.001). CONCLUSION: Our study confirms that non-muscle invasive bladder cancer exhibits a high recurrence rate. The use of adjuvant bacillus Calmette-Guérin in intermediate and high-risk patients significantly reduces this rate. Furthermore, the bacillus Calmette-Guérin shortage could have negatively impacted these patients.


Asunto(s)
Vacuna BCG , Recurrencia Local de Neoplasia , Neoplasias de la Vejiga Urinaria , Humanos , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/cirugía , Masculino , Vacuna BCG/uso terapéutico , Femenino , Estudios Retrospectivos , Brasil/epidemiología , Anciano , Persona de Mediana Edad , Factores de Riesgo , Adyuvantes Inmunológicos/uso terapéutico , Progresión de la Enfermedad , Administración Intravesical , Anciano de 80 o más Años , Carcinoma de Células Transicionales/patología , Carcinoma de Células Transicionales/cirugía
15.
Surg Neurol Int ; 15: 145, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38741988

RESUMEN

Background: Orbital hypertelorism is a rare congenital condition caused by craniofacial malformations. It consists of complete orbital lateralization, characterized by an increase in distance (above the 95th percentile) of the inner canthal (ICD), outer canthal, and interpupillary distances. It can be approached surgically, and the main techniques are box osteotomy and facial bipartition. The surgical procedure is usually performed before the age of 8. We describe here two patients who underwent late surgical correction using the box osteotomy technique. Case Description: Patient 1: A 13-year-old female presenting isolated hypertelorism with 5 cm ICD and left eye amblyopia. Patient 2: A 15-year-old female with orbital hypertelorism, 4.6 cm ICD, and nasal deformity. Both patients underwent orbital translocation surgery and had no neurological disorders. Conclusion: The article reports two cases of isolated hypertelorism treated late with the box osteotomy technique. Both surgeries were successful, with no postoperative complications. It appears that it is possible to obtain good surgical results even in patients who have not been able to undergo surgery previously.

16.
Cien Saude Colet ; 28(3): 935-946, 2023 Mar.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-36888875

RESUMEN

This work presents the results of a study that analyzed the processes and communication strategies by the entities represented in the National Health Council (NHC), 2018-2021 administration. The production of alternative communication by civil society constitutes one of the fundamental principles of democratic regimes for an important American institutionalist author (Robert Dahl). The emergence of the Internet and social networks has brought new demands for these organizations to disseminate their ideas and be present in this network society (Castells). Our study aimed to analyze the extent to which these entities are present in the digital media and to verify if there were significant differences in the communication capacity among the segments represented in the NHC. A survey was applied to the communication departments of the 42 NHC entities from September 2019 to February 2020. Thirty-four answers were obtained (81%). The results show the existence of 3 different levels of development in communication within these entities, regardless of the macro-institutional categories. Our article ends by discussing the results in light of the polyarchy and the digital democracy models and highlighting new steps towards effective democratic communication policies and participation.


Apresentamos os resultados de uma pesquisa inédita que analisou os processos e as estratégias de comunicação das entidades titulares do Conselho Nacional de Saúde, gestão 2018-2021. A produção autônoma de comunicação alternativa pela sociedade civil consiste num dos princípios fundamentais dos regimes democráticos para um importante autor norte-americano institucionalista (Robert Dahl). A emergência da Internet e das redes sociais trouxe novas necessidades para essas organizações divulgarem suas ideias e se fazerem presentes na sociedade em rede (Castells). O estudo teve como objetivo analisar em que medida essas entidades estão inseridas no meio digital e verificar se havia diferenças expressivas na capacidade de comunicação entre os segmentos representados no Conselho. Um inquérito foi aplicado às áreas de comunicação de 42 entidades do CNS de setembro de 2019 a fevereiro de 2020. Foram obtidas 34 respostas (81%). Os resultados mostram a existência de 3 níveis de desenvolvimento no trabalho de comunicação entre essas entidades, independentemente das categorias macro institucionais. Ao final, discute-se os resultados à luz dos modelos da poliarquia e da democracia digital, e são apontados novos passos para uma comunicação e participação efetivamente democráticas.


Asunto(s)
Comunicación , Internet , Humanos , Encuestas y Cuestionarios
17.
J Vasc Access ; : 11297298231192125, 2023 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-37574954

RESUMEN

Population aging and prolonged time on dialysis pose challenges to vascular access for nephrologists and vascular surgeons. HeRO grafts are an option used for patients with central venous obstruction and without the possibility of other vascular access on upper limbs. Some long-term complications, namely access thrombosis, infection, and limb ischemia, have already been reported. There are few data on thromboembolic complications associated with this device. We report the first case in the literature of Budd-Chiari Syndrome associated with the HeRO graft.

18.
Dental Press J Orthod ; 27(5): e222199, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36629628

RESUMEN

INTRODUCTION: Research in Orthodontics and Oral Surgery has been relying on three-dimensional (3D) models to evaluate treatment results with displacement color map techniques, even though it has important limitations. OBJECTIVES: This study proposed a method of tracking translational movements of 3D objects to evaluate displacements in surfaces with no shape modification. METHODS: Cone Beam Computed Tomography (CBCT) data of ten patients were imported to the Dolphin software. A hypothetical virtual surgical plan (randomly defined) was developed in the software and afterwards verified using the proposed method. All the procedures were carried out by two evaluators, in two different time-points, with a 15-day interval. ITK-Snap software was used to generate high quality STL models. Centroid points were automatically generated and their coordinates were compared to confirm if they represented the known displacements simulated. The paired t-test and the Bland-Altman plots were used, as well as the intraclass correlation coefficient. RESULTS: Interexaminers and intra-examiner tests showed excellent reliability of the method, with mean displacement measurement error values under 0.1mm. The paired t-test did not show any statistically significant differences. CONCLUSION: The method showed excellent reliability to track the simulated translational displacements of bone segments.


Asunto(s)
Imagenología Tridimensional , Ortodoncia , Imagenología Tridimensional/métodos , Reproducibilidad de los Resultados , Tomografía Computarizada de Haz Cónico/métodos , Programas Informáticos
19.
J Anim Sci ; 100(10)2022 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-36055763

RESUMEN

Two experiments were designed to evaluate the effects of different probiotic combinations on rumen fermentation characteristics, performance, and carcass characteristics of feedlot Bos indicus beef bulls offered a high-concentrate diet. In experiment 1, 30 rumen-fistulated Nellore steers were blocked by initial body weight (BW = 350 ± 35.0 kg) and within blocks (n = 10), animals were randomly assigned to receive: 1) high-concentrate diet without probiotic supplementation (n = 10; CONT), 2) CONT plus 1 g per head of a probiotic mixture containing three strains of Enterococcus faecium and one strain of Saccharomyces cerevisiae (3.5 × 109 CFU/g; n = 10; EFSC), and 3) CONT plus 2 g per head of a probiotic mixture containing Bacillus licheniformis and Bacillus subtilis (3.2 × 109 CFU/g; n = 10; BLBS). The experimental period lasted 35 d, being 28 d of adaptation and 7 d of sampling. From day 34 to day 35 of the experimental period, ruminal fluid and fecal samples were collected every 3 h, starting immediately before feeding (0 h) for rumen fermentation characteristics and apparent nutrient digestibility analysis, respectively. In experiment 2, 240 Nellore bulls were ranked by initial shrunk BW (375 ± 35.1 kg), assigned to pens (n = 4 bulls per pen), and pens randomly assigned to receive the same treatments as in experiment 1 (n = 20 pens per treatment). Regardless of treatment, all bulls received the same step-up and finishing diets throughout the experimental period, which lasted 115 d. In both experiments, data were analyzed as orthogonal contrasts to partition-specific treatment effects: 1) probiotic effect: CONT vs. PROB and 2) probiotic type: EFSC vs. BLBS (SAS Software Inc.). In experiment 1, no contrast effects were observed on nutrient intake, overall nutrient digestibility, and rumen fermentation analyses (P ≥ 0.13). Nonetheless, supplementation of probiotics, regardless of type (P = 0.59), reduced mean acetate:propionate ratio and rumen ammonia-N concentration vs. CONT (P ≤ 0.05). In experiment 2, no significant effects were observed for final BW and dry matter intake (P ≥ 0.12), but average daily gain and feed efficiency tended to improve (P ≤ 0.10) when probiotics were offered to the animals. Probiotic supplementation or type of probiotic did not affect carcass traits (P ≥ 0.22). In summary, supplementation of probiotics containing a mixture of E. faecium and S. cerevisiae or a mixture of B. licheniformis and B. subtilis reduced rumen acetate:propionate ratio and rumen ammonia-N levels and tended to improve the performance of feedlot cattle offered a high-concentrate diet.


Two experiments were designed to evaluate the effects of different probiotic combinations on rumen fermentation characteristics, performance, and carcass characteristics of feedlot Bos indicus beef bulls offered a high-concentrate diet. The two probiotics consisted of a mixture containing three strains of Enterococcus faecium and one strain of Saccharomyces cerevisiae or a mixture of Bacillus licheniformis and Bacillus subtilis. Supplementation of probiotics, regardless of type, reduced acetate:propionate ratio, and mean rumen ammonia-N concentration and tended to improve the performance of feedlot cattle offered a high-concentrate diet, demonstrating the potential of this technology to be used as a feed additive for beef cattle.


Asunto(s)
Alimentación Animal , Probióticos , Bovinos , Animales , Masculino , Alimentación Animal/análisis , Amoníaco/metabolismo , Saccharomyces cerevisiae/metabolismo , Propionatos/farmacología , Rumen/metabolismo , Dieta/veterinaria , Fermentación , Probióticos/farmacología
20.
Front Microbiol ; 13: 951130, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36687575

RESUMEN

Plant diseases caused by phytopathogens result in huge economic losses in agriculture. In addition, the use of chemical products to control such diseases causes many problems to the environment and to human health. However, some bacteria and fungi have a mutualistic relationship with plants in nature, mainly exchanging nutrients and protection. Thus, exploring those beneficial microorganisms has been an interesting and promising alternative for mitigating the use of agrochemicals and, consequently, achieving a more sustainable agriculture. Microorganisms are able to produce and excrete several metabolites, but volatile organic compounds (VOCs) have huge biotechnology potential. Microbial VOCs are small molecules from different chemical classes, such as alkenes, alcohols, ketones, organic acids, terpenes, benzenoids and pyrazines. Interestingly, volatilomes are species-specific and also change according to microbial growth conditions. The interaction of VOCs with other organisms, such as plants, insects, and other bacteria and fungi, can cause a wide range of effects. In this review, we show that a large variety of plant pathogens are inhibited by microbial VOCs with a focus on the in vitro and in vivo inhibition of phytopathogens of greater scientific and economic importance in agriculture, such as Ralstonia solanacearum, Botrytis cinerea, Xanthomonas and Fusarium species. In this scenario, some genera of VOC-producing microorganisms stand out as antagonists, including Bacillus, Pseudomonas, Serratia and Streptomyces. We also highlight the known molecular and physiological mechanisms by which VOCs inhibit the growth of phytopathogens. Microbial VOCs can provoke many changes in these microorganisms, such as vacuolization, fungal hyphal rupture, loss of intracellular components, regulation of metabolism and pathogenicity genes, plus the expression of proteins important in the host response. Furthermore, we demonstrate that there are aspects to investigate by discussing questions that are still not very clear in this research area, especially those that are essential for the future use of such beneficial microorganisms as biocontrol products in field crops. Therefore, we bring to light the great biotechnological potential of VOCs to help make agriculture more sustainable.

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