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1.
Artículo en Inglés | MEDLINE | ID: mdl-39280995

RESUMEN

Thelazia callipaeda, also known as the "oriental eye worm", is a zoonotic parasitic nematode with a wide range of hosts, particularly wild and domestic carnivores, but also lagomorphs and humans. Currently, ocular thelaziosis presents an expanding distribution range throughout Europe, including Portugal. This study provides an update on T. callipaeda infection reports (30 studies) in European wildlife comprising 54 host-locality records in 10 host species from nine European countries. The prevalence of T. callipaeda varied widely, with ranges from around 1% in red foxes and European hares to almost 50% in red foxes. The lowest mean intensity was 2.7 nematodes/host in European wildcats and the highest was 38.0 nematodes/host in wolves. In addition, a massive infection with T. callipaeda in a juvenile male red fox from eastern-central Portugal is also described, representing the southernmost report in a wild animal in this country. A total of 188 nematodes (139 females and 49 males) were collected from both eyes and were submitted to morphological and molecular characterization. Collected nematodes were morphologically identified as T. callipaeda. Given the endemicity of T. callipaeda in eastern-central Portugal, surveillance system should be implemented to monitor its presence among wild and domestic animals.

2.
Food Res Int ; 193: 114854, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39160045

RESUMEN

In this study, phenolic profile/content was analyzed by high-resolution untargeted metabolomics after short germination (72 h) and seedling growth (144 h), using three sorghum genotypes varying in tannin content (IS 29569, Macia and IS 30400). In vitro antioxidant capacity and phenolic bioaccessibility were determined by microplate-based and INFOGEST methods, respectively. A total of 58 % annotated compounds were found in all genotypes; and phenolic acids and flavonoids represent more than 80 % of sorghum total abundance. PCA analysis showed higher phenolic variability in germination times (72 %) than genotypes (51 %). Germination reduced total ion abundance (-7 %) and free:bound phenolic compounds ratio (2.4-1.1), but antioxidant capacity remained constant. These results indicate the cell matrix-phenolic decomplexation, with the free compounds were quickly consumed after radicle emergence. Germination increased phenolic bioaccessibility (mainly in oral phase) but reduces flavonoids contents in gastric/intestinal digestion steps. This work can stimulate seed germination as a viable option for sorghum-based foods development, with improved nutritional and bioactive properties.


Asunto(s)
Antioxidantes , Germinación , Fenoles , Plantones , Sorghum , Espectrometría de Masas en Tándem , Sorghum/metabolismo , Sorghum/crecimiento & desarrollo , Sorghum/química , Plantones/crecimiento & desarrollo , Plantones/metabolismo , Fenoles/metabolismo , Fenoles/análisis , Cromatografía Líquida de Alta Presión , Espectrometría de Masas en Tándem/métodos , Antioxidantes/metabolismo , Antioxidantes/análisis , Flavonoides/análisis , Flavonoides/metabolismo , Semillas/crecimiento & desarrollo , Semillas/metabolismo , Semillas/química , Disponibilidad Biológica , Metabolómica/métodos , Genotipo , Taninos/análisis , Taninos/metabolismo , Digestión
3.
Micromachines (Basel) ; 15(7)2024 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-39064385

RESUMEN

The evolution in the biomedical engineering field boosts innovative technologies, with microfluidic systems standing out as transformative tools in disease diagnosis, treatment, and monitoring. Numerical simulation has emerged as a tool of increasing importance for better understanding and predicting fluid-flow behavior in microscale devices. This review explores fabrication techniques and common materials of microfluidic devices, focusing on soft lithography and additive manufacturing. Microfluidic systems applications, including nucleic acid amplification and protein synthesis, as well as point-of-care diagnostics, DNA analysis, cell cultures, and organ-on-a-chip models (e.g., lung-, brain-, liver-, and tumor-on-a-chip), are discussed. Recent studies have applied computational tools such as ANSYS Fluent 2024 software to numerically simulate the flow behavior. Outside of the study cases, this work reports fundamental aspects of microfluidic simulations, including fluid flow, mass transport, mixing, and diffusion, and highlights the emergent field of organ-on-a-chip simulations. Additionally, it takes into account the application of geometries to improve the mixing of samples, as well as surface wettability modification. In conclusion, the present review summarizes the most relevant contributions of microfluidic systems and their numerical modeling to biomedical engineering.

4.
Food Chem ; 457: 140206, 2024 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-38936134

RESUMEN

The use of suitable analytical techniques for the detection of adulteration, falsification, deliberate substitution, and mislabeling of foods has great importance in the industrial, scientific, legislative, and public health contexts. This way, this work reports an integrative review with a current analytical approach for food authentication, indicating the main analytical techniques to identify adulteration and perform the traceability of chemical components in processed and non-processed foods, evaluating the authenticity and geographic origin. This work presents results from a systematic search in Science Direct® and Scopus® databases using the keywords "authentication" AND "food", "authentication," AND "beverage", from published papers from 2013 to, 2024. All research and reviews published were employed in the bibliometric analysis, evaluating the advantages and disadvantages of analytical techniques, indicating the perspectives for direct, quick, and simple analysis, guaranteeing the application of quality standards, and ensuring food safety for consumers. Furthermore, this work reports the analysis of natural foods to evaluate the origin (traceability), and industrialized foods to detect adulterations and fraud. A focus on research to detect adulteration in milk and dairy products is presented due to the importance of these products in the nutrition of the world population. All analytical tools discussed have advantages and drawbacks, including sample preparation steps, the need for reference materials, and mathematical treatments. So, the main advances in modern analytical techniques for the identification and quantification of food adulterations, mainly milk and dairy products, were discussed, indicating trends and perspectives on food authentication.


Asunto(s)
Productos Lácteos , Contaminación de Alimentos , Leche , Contaminación de Alimentos/análisis , Leche/química , Productos Lácteos/análisis , Animales , Análisis de los Alimentos/métodos
5.
Eur Urol Focus ; 2024 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-38897871

RESUMEN

BACKGROUND AND OBJECTIVE: Diagnosis of primary and relapsed bladder carcinomas is accomplished by urethrocystoscopy, an invasive procedure, combined with urinary cytology, with limited sensitivity, resulting in a substantial burden. Thus, noninvasive biomarkers have been investigated, among which DNA methylation has shown promise. This systematic review and meta-analysis sought to assess the diagnostic accuracy of DNA methylation biomarkers reported in the literature for bladder cancer detection, pinpointing the most informative one. METHODS: The search for this systematic review and meta-analysis was conducted on PubMed, Scopus, and Cochrane Library for relevant studies published until December 31, 2022. A meta-analysis was performed using a random-effect model, to compute the pooled sensitivity and specificity of the markers. PROSPERO's registration ID for the study is CRD42023397703. KEY FINDINGS AND LIMITATIONS: Out of the 2297 studies retrieved, 68 were included in the final analysis, despite considerable heterogeneity. These involved 12 696 participants, of whom 5557 were diagnosed with bladder cancer. Using diagnostic odds ratio (DOR) as a comparative measure, the five most promising markers (pooled sensitivity, specificity, and DOR) were SALL3 (61%, 97%, and 55.67, respectively), PENK (77%, 93%, and 47.90, respectively), ZNF154 (87%, 90%, and 45.07, respectively), VIM (82%, 90%, and 44.81, respectively), and POU4F2 (81%, 89%, and 34.89, respectively). Urinary cytology identified bladder cancer with 55% sensitivity, 92% specificity, and 14.37 DOR. CONCLUSIONS AND CLINICAL IMPLICATIONS: DNA methylation biomarkers disclose high accuracy for bladder cancer detection in urine. Nonetheless, validation studies in different clinical settings are scarce, hampering clinical use. The identified biomarkers should be prioritized in future validation studies. PATIENT SUMMARY: In this meta-analysis, we include previously published studies that used urine samples of bladder cancer patients' from all around the globe. We were able to compare the diagnostic accuracy of noninvasive markers across different populations. We were able to conclude on the most promising DNA methylation markers to detect bladder cancer using urine.

6.
Healthcare (Basel) ; 12(11)2024 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-38891196

RESUMEN

Health and exercise technology may promote a healthy lifestyle during pregnancy. The objective of this cross-sectional study was to understand and involve the perspective of pregnant women as users in the design of a framework for future e-health and exercise interventions during pregnancy. Pregnant women replied to a questionnaire aimed at understanding their physical activity patterns, needs, and preferences regarding the use of mobile applications (apps). The main results showed that one-third of the women did not practice any type of exercise during pregnancy. Women preferred to exercise in a gym, outdoors, or at home. The majority already had or were currently using a fitness app, but never used any pregnancy-specific app. Most women agreed that it was important to have a specific app for pregnancy to improve knowledge about recommendations on lifestyle, have direct contact with health and exercise professionals, have social interaction with other mothers, and have guidance on preparation for childbirth and postpartum recovery. Understanding and involving the perspective of pregnant women as users will allow researchers to improve the design of a pregnancy-specific app and future e-health and exercise interventions during pregnancy. These preliminary results will lead to the development of the "active pregnancy app" focused on the promotion of an active and healthy lifestyle during pregnancy and postpartum.

7.
J Biophotonics ; 17(7): e202400095, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38850248

RESUMEN

Prevention and treatment protocols for taste changes observed during hematopoietic cell transplantation (HCT) are not well-established. The purpose of this study was to assess the efficacy of photobiomodulation (PBM) in relieving taste changes and preventing lingual papillae atrophy. HCT patients received PBM (n = 42) on the tongue dorsum using an InGaAIP laser (660 nm, 100 mW, 1.1 W/cm2, 8.8 J/cm2). During the HCT conditioning (T0), severe neutropenia (T1), and after neutrophil engraftment (T2), taste acuity for sweet, bitter, sour, and salty solutions, and clinical appearance of lingual papillae were compared with those of a placebo group (n = 43). PBM significantly reduced hypogeusia, ageusia, and parageusia at T1 and T2, and also successfully prevented papillae atrophy during all the analyzed HCT periods. In conclusion, PBM enhanced taste acuity during HCT. The decrease in papillae atrophy indicated a potential regenerative effect of this therapy on tongue mucosa.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Terapia por Luz de Baja Intensidad , Gusto , Humanos , Femenino , Masculino , Persona de Mediana Edad , Adulto , Gusto/efectos de la radiación , Lengua/efectos de la radiación , Lengua/patología , Atrofia , Trastornos del Gusto/etiología , Adulto Joven , Anciano , Papilas Gustativas/efectos de la radiación
8.
Heliyon ; 10(11): e31608, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38868005

RESUMEN

Doxorubicin (DOX) is an anthracycline used to treat a wide range of tumours. Despite its effectiveness, it is associated with a long range of adverse effects, of which cognitive deficits stand out. The present study aimed to assess the neurologic adverse outcome pathways of two clinically relevant cumulative doses of DOX. Adult male CD-1 mice received biweekly intraperitoneal administrations for 3 weeks until reaching cumulative doses of 9 mg/kg (DOX9) or 18 mg/kg (DOX18). Animals were euthanized one week after the last administration, and biomarkers of oxidative stress and brain metabolism were evaluated in the whole brain. Coronal sections of fixed brains were used for specific determinations of the prefrontal cortex (PFC) and hippocampal formation (HF). In the whole brain, DOX18 tended to disrupt the antioxidant defences, affecting glutathione levels and manganese superoxide dismutase expression. Considering the regional analysis, DOX18 increased the volume of all brain areas evaluated, while GFAP-immunoreactive astrocytes decreased in the dentate gyrus (DG) and increased in the CA3 region of HF, both in a dose-dependent manner. Concerning the apoptosis pathway, whereas Bax increased in the DOX9 group, it decreased in the DOX18 group. Only in the latter group did Bcl-2 levels also decrease. While p53 only increased in the CA3 region of the DOX9 group, AIF increased in the PFC and DG of DOX18. Finally, phosphorylation of Tau decreased with the highest DOX dose in DG and CA3, while TNF-α levels increased in CA1 of DOX18. Our results indicate new pathways not yet described that could be responsible for the cognitive impairments observed in treated patients.

9.
Rev Neurosci ; 2024 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-38843463

RESUMEN

The prevalence of stroke and traumatic brain injury is increasing worldwide. However, current treatments do not fully cure or stop their progression, acting mostly on symptoms. Amphetamine and methylphenidate are stimulants already approved for attention deficit hyperactivity disorder and narcolepsy treatment, with neuroprotective potential and benefits when used in appropriate doses. This review aimed to summarize pre-clinical and clinical trials testing either amphetamine or methylphenidate for the treatment of stroke and traumatic brain injury. We used PubMed as a database and included the following keywords ((methylphenidate) OR (Ritalin) OR (Concerta) OR (Biphentin) OR (amphetamine) OR (Adderall)) AND ((stroke) OR (brain injury) OR (neuroplasticity)). Overall, studies provided inconsistent results regarding cognitive and motor function. Neurite outgrowth, synaptic proteins, dendritic complexity, and synaptic plasticity increases were reported in pre-clinical studies along with function improvement. Clinical trials have demonstrated that, depending on the brain region, there is an increase in motor activity, attention, and memory due to the stimulation of the functionally depressed catecholamine system and the activation of neuronal remodeling proteins. Nevertheless, more clinical trials and pre-clinical studies are needed to understand the drugs' full potential for their use in these brain diseases namely, to ascertain the treatment time window, ideal dosage, long-term effects, and mechanisms, while avoiding their addictive potential.

10.
Food Chem ; 451: 139506, 2024 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-38703733

RESUMEN

This study aimed to characterize and evaluate the in vitro bioactive properties of green banana pulp (GBPF), peel (GBPeF), and mixed pulp/peel flours M1 (90/10) and M2 (80/20). Lipid concentration was higher in GBPeF (7.53%), as were the levels of free and bound phenolics (577 and 653.1 mg GAE/100 g, respectively), whereas the resistant starch content was higher in GBPF (44.11%). Incorporating up to 20% GBPeF into the mixed flour had a minor effect on the starch pasting properties of GBPF. GBPeF featured rutin and trans-ferulic acid as the predominant free and bound phenolic compounds, respectively. GBPF presented different major free phenolics, though it had similar bound phenolics to GBPeF. Both M1 and M2 demonstrated a reduction in intracellular reactive oxygen species (ROS) generation. Consequently, this study validates the potential of green banana mixed flour, containing up to 20% GBPeF, for developing healthy foods and reducing post-harvest losses.


Asunto(s)
Harina , Frutas , Musa , Valor Nutritivo , Fenoles , Musa/química , Harina/análisis , Frutas/química , Fenoles/análisis , Fenoles/química , Extractos Vegetales/química , Extractos Vegetales/análisis , Especies Reactivas de Oxígeno/metabolismo , Almidón/química , Almidón/análisis
11.
J Agric Food Chem ; 72(34): 19197-19218, 2024 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-38803291

RESUMEN

Cereal grains play an important role in human health as a source of macro- and micronutrients, besides phytochemicals. The metabolite diversity was investigated in cereal crops and their milling fractions by untargeted metabolomics ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) of 69 samples: 7 species (barley, oat, pearl millet, rye, sorghum, triticale, and wheat), 23 genotypes, and 4 milling fractions (husk, bran, flour, and wholegrain). Samples were also analyzed by in vitro antioxidant activity. UHPLC-MS/MS signals were processed using XCMS, and metabolite annotation was based on SIRIUS and GNPS libraries. Bran and husk showed the highest antioxidant capacity and phenolic content/diversity. The major metabolite classes were phenolic acids, flavonoids, fatty acyls, and organic acids. Sorghum, millet, barley, and oats showed distinct metabolite profiles, especially related to the bran fraction. Molecular networking and chemometrics provided a comprehensive insight into the metabolic profiling of cereal crops, unveiling the potential of coproducts and super cereals such as sorghum and millet as sources of polyphenols.


Asunto(s)
Antioxidantes , Grano Comestible , Espectrometría de Masas en Tándem , Antioxidantes/metabolismo , Antioxidantes/química , Antioxidantes/análisis , Grano Comestible/química , Grano Comestible/metabolismo , Cromatografía Líquida de Alta Presión , Sorghum/química , Sorghum/metabolismo , Avena/química , Avena/metabolismo , Avena/genética , Triticum/química , Triticum/metabolismo , Triticum/genética , Flavonoides/metabolismo , Flavonoides/análisis , Flavonoides/química , Extractos Vegetales/química , Extractos Vegetales/metabolismo , Mijos/química , Mijos/metabolismo , Mijos/genética , Hordeum/química , Hordeum/metabolismo , Hordeum/genética , Semillas/química , Semillas/metabolismo , Metabolómica , Productos Agrícolas/química , Productos Agrícolas/metabolismo , Productos Agrícolas/genética
13.
Curr Res Toxicol ; 6: 100165, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38562456

RESUMEN

Full treatment of the second most common neurodegenerative disorder, Parkinson's disease (PD), is still considered an unmet need. As the psychostimulants, amphetamine (AMPH) and methylphenidate (MPH), were shown to be neuroprotective against stroke and other neuronal injury diseases, this study aimed to evaluate their neuroprotective potential against two dopaminergic neurotoxicants, 6-hydroxydopamine (6-OHDA) and paraquat (PQ), in differentiated human dopaminergic SH-SY5Y cells. Neither cytotoxicity nor mitochondrial membrane potential changes were seen following a 24-hour exposure to either therapeutic concentration of AMPH or MPH (0.001-10 µM). On the other hand, a 24-hour exposure to 6-OHDA (31.25-500 µM) or PQ (100-5000 µM) induced concentration-dependent mitochondrial dysfunction, assessed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, and lysosomal damage, evaluated by the neutral red uptake assay. The lethal concentrations 25 and 50 retrieved from the concentration-toxicity curves in the MTT assay were 99.9 µM and 133.6 µM for 6-OHDA, or 422 µM and 585.8 µM for PQ. Both toxicants caused mitochondrial membrane potential depolarization, but only 6-OHDA increased reactive oxygen species (ROS). Most importantly, PQ-induced toxicity was partially prevented by 1 µM of AMPH or MPH. Nonetheless, neither AMPH nor MPH could prevent 6-OHDA toxicity in this experimental model. According to these findings, AMPH and MPH may provide some neuroprotection against PQ-induced neurotoxicity, but further investigation is required to determine the exact mechanism underlying this protection.

14.
Artículo en Inglés | MEDLINE | ID: mdl-38597519

RESUMEN

Sporotrichosis is a neglected mycosis that affects human and animal hosts, including domestic cats. In Brazil, its most frequently diagnosed etiological agent is Sporothrix brasiliensis. Zoonotic transmission of S. brasiliensis occurs via direct contact between an infected cat and a susceptible human host. Notification of confirmed cases of feline sporotrichosis is not mandatory in Brazil. The metropolitan area of Goiania city can be considered a silent area for the occurrence of feline sporotrichosis. In this context, voluntary reporting of feline sporotrichosis cases is recommended for all healthcare professionals. This study aimed to report the first occurrence of S. brasiliensis in a cat from the metropolitan area of Goiania city. Cytopathology, mycology, thermal dimorphism and calmodulin gene amplification tests were performed. The mycological and molecular biological diagnoses corresponded to S. brasiliensis. The etiological agent of zoonotic sporotrichosis was detected in the metropolitan area of Goiania city, and therefore there is a risk of the emergence of new cases of cats infected with S. brasiliensis and the occurrence of zoonotic transmission of this fungus.


Asunto(s)
Enfermedades de los Gatos , Sporothrix , Esporotricosis , Animales , Gatos , Humanos , Esporotricosis/diagnóstico , Esporotricosis/epidemiología , Esporotricosis/veterinaria , Brasil/epidemiología , Sporothrix/genética , Personal de Salud , Enfermedades de los Gatos/epidemiología
15.
Endoscopy ; 2024 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-38684193

RESUMEN

BACKGROUND: The ileocecal valve (ICV) is considered to be one of the most difficult locations for endoscopic submucosal dissection (ESD). The objective of this study was to evaluate the efficacy and safety of traction-assisted ESD in this situation. METHODS: All patients who underwent traction-assisted ESD for an ICV lesion at three centers were identified from a prospective ESD database. En bloc and R0 rates were evaluated. Factors associated with non-R0 resection were explored. RESULTS: 106 patients with an ICV lesion were included. The median lesion size was 50 mm (interquartile range 38-60) and 58.5% (62/106) invaded the terminal ileum. The en bloc and R0 resection rates were 94.3% and 76.4%, respectively. Factors associated with non-R0 resection were lesions covering ≥75% of the ICV (odds ratio [OR] 0.21. 95%CI 0.06-0.76; P=0.02), and involving the anal lip (OR 0.36, 95%CI 0.13-0.99; P=0.04) or more than two sites on the ICV (OR 0.27, 95%CI 0.07-0.99; P=0.03). CONCLUSION: Traction-assisted ESD for treatment of ICV lesions was a safe and feasible option. Large lesions and anal lip involvement appeared to be factors predictive of difficulty.

16.
Diagn Microbiol Infect Dis ; 109(2): 116295, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38579431

RESUMEN

BACKGROUND: Patients colonized with Staphylococcus aureus in their nasal passages have a higher risk of acquiring infection, especially if they are immunocompromised or have comorbidities such as chronic renal failure undergoing hemodialysis (HD). OBJECTIVE: This study aimed to report the prevalence of nasal carriage of S. aureus among HD patients utilizing a seven-week sampling protocol and to assess the susceptibility of these isolates to various antimicrobial agents. METHODS: Over seven consecutive weeks, nasal swab samples were collected from 47 HD patients, resulting in a total of 329 samples. The microorganisms were identified using biochemical methods and subjected to antimicrobial susceptibility testing via disk diffusion and microdilution techniques. RESULTS: Out of all the patients analyzed, 25 individuals (53.19%) were found to be colonized by S. aureus, with 21 of them displaying intermittent colonization. Additionally, 38% showed positive results for S. aureus in only the 6th or 7th week of sampling. Within the 58 isolates, 17.2% (n=10) exhibited methicillin (oxacillin)-resistance and 25.86% (n=15) displayed elevated vancomycin MIC values (2 µg/ml). Based on the results, daptomycin and gentamicin were found to be effective treatment options. However, 31% of the isolates (n=18) exhibited a MIC of 1 µg/ml for daptomycin. CONCLUSION: Over half of the patients were colonized by S. aureus, but mostly on an intermittent basis. The identification of oxacillin resistance and high vancomycin and daptomycin MICs serve as warnings for possible future complications in managing bacteremia caused by S. aureus in these patients.


Asunto(s)
Antibacterianos , Portador Sano , Pruebas de Sensibilidad Microbiana , Diálisis Renal , Infecciones Estafilocócicas , Staphylococcus aureus , Humanos , Diálisis Renal/efectos adversos , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/epidemiología , Staphylococcus aureus/efectos de los fármacos , Staphylococcus aureus/aislamiento & purificación , Masculino , Femenino , Persona de Mediana Edad , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Portador Sano/microbiología , Portador Sano/epidemiología , Anciano , Adulto , Prevalencia , Anciano de 80 o más Años
17.
Rev. Soc. Cardiol. Estado São Paulo, Supl. ; 34(2B): 133-133, abr-jun. 2024.
Artículo en Portugués | CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1561645

RESUMEN

INTRODUÇÃO: A doença cardiovascular continua estabelecida como a principal causa de óbito no Brasil e também em São Paulo, tendo como fator de risco cardinal o crescimento de depósitos gordurosos nas artérias coronárias, as chamadas placas de aterosclerose. O tratamento para doença aterosclerótica coronária (DAC) inclui intervenções bem consolidadas na prática, sendo a cirurgia de revascularização miocárdica (CRM) uma das mais importantes medidas terapêuticas no contexto hospitalar, principalmente em pacientes portadores de lesões triarteriais ou com diabetes associada. Nesse sentido, a CRM vem apresentando importantes avanços em relação à redução da mortalidade e morbidade inerentes ao procedimento cirúrgico, principalmente através das inovações tecnológicas dos últimos anos. Sendo assim, o seguinte trabalho se objetiva a analisar a mortalidade da revascularização miocárdica em pacientes com DAC supracitadas, para uma melhoria da assistência hospitalar e das políticas públicas de saúde, pleiteando uma mortalidade hospitalar cada vez menor. MÉTODOS: Estudo de caráter epidemiológico, descritivo e transversal. Foi realizada coleta de dados através do banco informativo de saúde DATASUS (TABNET), correspondente aos óbitos de pacientes submetidos a revascularização miocárdica entre os anos de 2013 a 2023 no município de São Paulo. As variáveis utilizadas são: raça/cor, sexo e faixa etária. RESULTADOS: Analisando os dados coletados, é notável que o ano de maior incidência de óbitos foi 2014 com 123 óbitos, representando aproximadamente 13,91% do total do período estudado. A raça mais afetada foi a branca, com 65% dos óbitos. Já a faixa etária mais acometida foi entre 65 e 69 anos, totalizando 22,05% dos óbitos. Em relação ao sexo, a prevalência é masculina, caracterizando 58,37% dos óbitos. CONCLUSÕES: Em relação à abordagem terapêutica analisada nos últimos 10 anos no município de São Paulo, foi verificada uma maior mortalidade no sexo masculino, em idades avançadas e na raça branca. Além disso, é importante destacar que houve uma redução significativa nas taxas de desfecho cardiovascular primário nos pacientes submetidos ao procedimento. Esse cenário reforça a projeção da CRM como um tratamento cada vez mais seguro e eficiente no contexto das doenças coronarianas.


Asunto(s)
Revascularización Miocárdica/mortalidad
18.
Endoscopy ; 56(9): 653-662, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38626891

RESUMEN

BACKGROUND: This study evaluated the safety and efficacy of salvage endoscopic submucosal dissection (ESD) for Barrett's neoplasia recurrence after radiofrequency ablation (RFA). METHODS: Data from patients at 16 centers were collected for a multicenter retrospective study. Patients who underwent at least one RFA treatment for Barrett's esophagus and thereafter underwent further esophageal ESD for neoplasia recurrence were included. RESULTS: Data from 56 patients who underwent salvage ESD between April 2014 and November 2022 were collected. Immediate complications included one muscular tear (1.8%) treated with stent (Agree classification: grade IIIa). Two transmural perforations (3.6%; treated with clips) and five muscular tears (8.9%; two treated with clips) had no clinical impact and were not considered as adverse events. Seven patients (12.5%) developed strictures (grade IIIa), which were treated with balloon dilation. Histological analysis showed 36 adenocarcinoma, 17 high grade dysplasia, and 3 low grade dysplasia. En bloc and R0 resection rates were 89.3% and 66.1%, respectively. Resections were curative in 33 patients (58.9%), and noncurative in 22 patients (39.3%), including 11 "local risk" (19.6%) and 11 "high risk" (19.6%) resections. At the end of follow-up with a median time of 14 (0-75) months after salvage ESD, and with further endoscopic treatment if necessary (RFA, argon plasma coagulation, endoscopic mucosal resection, ESD), neoplasia remission ratio was 37/53 (69.8%) and the median remission time was 13 (1-75) months. CONCLUSION: In expert hands, salvage ESD was a safe and effective treatment for recurrence of Barrett's neoplasia after RFA treatment.


Asunto(s)
Esófago de Barrett , Resección Endoscópica de la Mucosa , Neoplasias Esofágicas , Recurrencia Local de Neoplasia , Ablación por Radiofrecuencia , Terapia Recuperativa , Humanos , Esófago de Barrett/cirugía , Esófago de Barrett/patología , Resección Endoscópica de la Mucosa/efectos adversos , Resección Endoscópica de la Mucosa/métodos , Masculino , Femenino , Anciano , Estudios Retrospectivos , Terapia Recuperativa/métodos , Persona de Mediana Edad , Neoplasias Esofágicas/cirugía , Neoplasias Esofágicas/patología , Ablación por Radiofrecuencia/efectos adversos , Ablación por Radiofrecuencia/métodos , Adenocarcinoma/cirugía , Adenocarcinoma/patología , Estenosis Esofágica/etiología , Anciano de 80 o más Años , Resultado del Tratamiento , Esofagoscopía/métodos , Esofagoscopía/efectos adversos
19.
Animals (Basel) ; 14(8)2024 Apr 18.
Artículo en Inglés | MEDLINE | ID: mdl-38672371

RESUMEN

In the last decade, over 40% of bird species in Europe have experienced poor and bad conservation status, with more than 30% of bird species in mainland Portugal threatened with extinction. Along with anthropogenic factors, parasites and pathogens such as avian haemosporidians have been suggested to be responsible for these avian population declines. Wildlife rehabilitation centres play an essential role in species conservation and preservation. Moreover, animals admitted for rehabilitation can provide valuable information regarding transmission and pathogenicity of many diseases that affect wild birds that are rarely sampled in nature. However, reports of haemosporidians in captive birds are still limited. Here, we explored the prevalence and genetic diversity of avian haemosporidians in 89 birds from 29 species admitted to rehabilitation centres in Portugal, showing an overall infection prevalence of 30.3%. The prevalence of infection was higher in Strigiformes and in birds admitted to rehabilitation centres due to debilitating diseases. Remarkably, 30% of the infected bird species have not been found to harbour malaria parasites in preceding studies. We detected 15 different haemosporidian lineages infecting a third of bird species sampled. Notably, 2 out of these 15 detected haemosporidian lineages have not been obtained previously in other studies. Furthermore, we also identified nine new host-parasite interactions representing new host records for these haemosporidian parasites. Finally, our results revealed that birds infected with haemosporidians require longer rehabilitation treatments, which increase the economic costs for rehabilitation and may impair their survival prospects. These findings emphasise the importance of integrating haemosporidian infection considerations into rehabilitation protocols, highlighting the challenges posed by these infections in avian conservation and rehabilitation, including economic and logistical demands.

20.
GE Port J Gastroenterol ; 31(1): 41-47, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38476304

RESUMEN

Introduction: Endoscopic submucosal dissection (ESD) is a well-established resection technique for colorectal superficial tumors, but its role in the treatment of anorectal junction (ARJ) lesions still remains to be determined. With this study, we aimed to evaluate the feasibility, safety, and efficacy of ESD for the resection of ARJ lesions, in comparison to more proximal rectal lesions. Methods: We performed a retrospective analysis of prospectively collected data concerning all consecutive rectal ESD procedures performed in two European centers, from 2015 to 2021. Results: A total of two hundred and fifty-two rectal lesions were included. Sixty (24%) were ARJ lesions, and the remaining 192 (76%) were located proximally. Technical success was achieved in 248 procedures (98%), and its rate was similar in both locations (p = 0.246). Most of the lesions presented high-grade dysplasia/Tis adenocarcinoma (54%); 36 (15%) had submucosal adenocarcinoma, including 20 superficial (sm1) and 16 deeply invasive (>SM1) T1 cancers. We found no differences between ARJ and rectal lesions in regard to en bloc resection rate (100% vs. 96%, p = 0.204), R0 resection rate (76% vs. 75%, p = 0.531), curative resection rate (70% vs. 70%, p = 0.920), procedures' median duration (120 min vs. 90 min, p = 0.072), ESD velocity (14 vs. 12 mm2/min, p = 0.415), histopathology result (p = 0.053), and the need for surgery due to a non-curative ESD (5% vs. 3%, p = 0.739). Also, there was no statistically significant difference that concerns delayed bleeding (7% vs. 8%, p = 0.709), perforation (0% vs. 5%, p = 0.075), or the need for readmission (2% vs. 2%, p = 0.939). Nevertheless, anorectal stenosis (5% vs. 0%, p = 0.003) and anorectal pain (9% vs. 1%, p = 0.002) were significantly more frequent in ARJ lesions. Conclusion: ESD is a safe and efficient resection technique for the treatment of rectal lesions located in the ARJ.


Introdução: A dissecção endoscópica da submucosa (ESD) é uma técnica endoscópica com demonstrada eficácia nas lesões neoplásicas superficiais colorectais. No entanto, a evidência da sua eficácia nas lesões localizadas na junção ano-rectal é escassa. O nosso objectivo foi avaliar a segurança e eficácia da ESD nas lesões da junção anorectal (menos de 2 cm da linha pectínea), em comparação com as lesões mais proximais do recto. Métodos: Análise retrospectiva de registos colhidos prospectivamente de dois centros europeus de referência, entre 2015 e 2021. Resultados: Foram incluídas 252 lesões. Sessenta (24%) localizavam-se na junção ano-rectal, e as restantes 192 noutro local do recto. O sucesso técnico foi de 98% (n = 248) e foi semelhante nas 2 localizações (p = 0.246). A maioria das lesões eram displasias de alto grau/Tis (54%); 36 (15%) tinham adenocarcinoma submucoso, tendo 20 invasão submucosa superficial (sm1) e 16 invasão profunda (>SM1). Não foram encontradas diferenças entre as duas localizações relativamente às taxas de ressecção em bloco (100% vs. 96%, p = 0.204), R0 (76% vs. 75%, p = 0.531), ou curativa (70% vs. 70%, p = 0.920), duração da ESD (mediana 120 min vs. 90 min, p = 0.072), velocidade da ESD (14 vs. 12 mm2/min, p = 0.415) ou resultado histológico (p = 0.053), assim como na necessidade de cirurgia por ESD não curativa (5% vs. 3%, p = 0.739). Além disso, as taxas de hemorragia tardia (7% vs. 8%, p = 0.709), perfuração (0% vs. 5%, p = 0.075) e necessidade de internamento por complicações (2% vs. 2%, p = 0.939) não revelaram diferenças estatisticamente significativas. A estenose ano-rectal (5% vs. 0%, p = 0.003) e a dor ano-rectal (9% vs. 1%, p = 0.002) foram mais frequentes nas lesões da junção ano-rectal. Conclusão: A ESD é uma técnica segura e eficaz no tratamento das lesões do recto localizadas na junção ano-rectal.

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