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OBJECTIVE: This study assesses the impact of having a surgical trainee performing a carotid endarterectomy procedure on the post-operative rates of stroke and death. DESIGN: Observational Retrospective study METHODS: Consecutive patients, who underwent carotid endarterectomy between 01/05/2016 and 31/7/2022, were entered into a retrospectively collected database. Patients were stratified into two categories - consultant-led cases and trainees-led cases. Primary outcomes were 30- day stroke rate, and 30-day morbimortality. A sub analysis was performed after grouping the patients in whether there was a neurological event in the previous six months - symptomatic or asymptomatic. RESULTS/CONCLUSIONS: Trainees-led cases had significantly longer clamping times and higher rates of stroke in asymptomatic patients compared with consultant-led cases. Patient's safety should be our top priority. Any practice leading to a significantly increased rate of post-operative stroke must be discontinued. Training protocols and adequate supervision must ensure that trainees possess the necessary skills and knowledge to safely and effectively perform carotid endarterectomy (CEA) procedures, thereby prioritizing patient safety.
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Quistes , Enfermedades Duodenales , Humanos , Masculino , Quistes/diagnóstico por imagen , Quistes/congénito , Quistes/cirugía , Enfermedades Duodenales/diagnóstico por imagen , Enfermedades Duodenales/congénito , Duodeno/anomalías , Duodeno/diagnóstico por imagen , Persona de Mediana EdadRESUMEN
Antibiotics are the main active pharmaceutical ingredients (APIs) for the treatment and prevention (prophylaxis) of bacterial infections, for which they are essential for health preservation. However, depending on the target bacterial strain, an efficient treatment may imply weeks of continuous intake of antibiotics, whose unmetabolized fraction ends up in the wastewater system by human and animal excreta. The presence of these chemical compounds in wastewater is known to damage aquatic ecosystems and cause antibiotic resistance of pathogenic agents, which threatens the future application of these medicines. Aqueous two-phase systems (ATPSs), an emergent extraction technology for biomolecules such as proteins and vitamins, could provide more eco-friendly and cost-effective extractive alternatives given their nontoxicity and low energetic requirements. Moreover, choline-amino acid ([Ch][AA]) ionic liquids (also known as CAAILs or ChAAILs) are considered one of the greenest classes of ionic liquids due to their favorable biocompatibility, biodegradability, and ease of chemical synthesis. In this work, partition studies of amoxicillin were performed in three ATPSs containing dipotassium hydrogen phosphate (K2HPO4) and the CAAILs (cholinium l-alaninate, [Ch][Ala]; cholinium glycinate, [Ch][Gly]; and cholinium serinate, [Ch][Ser]) at 298.15 K and 0.1 MPa. To better characterize the extract and reduce errors in quantification, the effect of pH on the intensity and stability of the UV-vis spectra of amoxicillin was studied prior to the partition studies, and computational chemistry was used to validate the molecular structure of the synthesized ionic liquids. During experimental determinations, it was observed that the extraction of amoxicillin was favored by less polar ionic liquids, achieving maximum partition coefficients (K) and extraction efficiencies (E) of K = (16 ± 6)·101 and E / % = 97 ± 2, respectively, for {[Ch][Gly] (1) + K2HPO4 (2) + Water (3)} in the longest tie-line.
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Endovascular thrombectomy in patients with tandem occlusions can rarely result in the rupture of the internal carotid artery, leading to subarachnoid haemorrhage and death. However, this complication and its causes are rarely reported and discussed in the literature. We describe two cases of internal carotid artery rupture during endovascular thrombectomy in patients with tandem occlusion. It is hypothesised that the primary approach to the distal lesion, before recanalization, creates a blind alley that faces an intraluminal pressure increase upon manual contrast injection, surpassing the vessel's resistance and resulting in arterial wall rupture. To prevent this complication, approaches such as treating the proximal occlusion first, injecting the contrast through a microcatheter or retracting the endovascular support catheter proximally to the stenosis of the cervical internal carotid artery have been suggested and are discussed.
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Syphilis, a disease caused by the bacteria Treponema pallidum, has a multitude of clinical manifestations and is classified into primary syphilis, secondary syphilis and tertiary syphilis, based on clinical presentations and the time elapsed since the primary infection. The secondary stage of the disease can affect multiple organs and systems, and some of these involvements may be general and non-specific, justifying its name as 'the great imitator'. We present a case of a 30-year-old woman with a history of painful neck lymph nodes with progressive enlargement, persistent headache, weight loss, myalgia and alopecia. During investigations, stomatitis on the dorsal face of the tongue developed. A secondary study showed serum positive for rapid plasma reagin (RPR) and T. pallidum haemagglutination (TPHA), negative RPR in cerebrospinal fluid and normal MRI, thus the diagnosis of secondary syphilis was made. The patient was treated with a single dose of penicillin with complete resolution of symptoms. The case highlights the need for an exhaustive clinical examination, especially in cases presenting with non-specific and general symptoms, and raises awareness for this disease which has increased its prevalence in the last decades. LEARNING POINTS: Syphilis is a resurgent infection with increasing prevalence, and its manifestations in the secondary stage of the disease are general and non-specific, being able to affect every organ system.The oral mucosa may be involved at any stage of the disease and the tongue, often a neglected organ, can be particularly affected and should be routinely observed.The internist, integrating a cornerstone speciality able to manage and diagnose systemic diseases, must be aware of the individual aspects of the physical examination, notably the appreciation and interpretation of each clue and sign found.
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Wine has been utilized as a source for medicinal preparations, combined with various herbs, to treat particular ailments and disorders. By utilizing herb extracts, regular but limited consumption of these herbal wines helps to decrease the need for prescription medications to treat a variety of ailments. The diversity and the composition of the yeast micropopulation significantly contribute to the sensory characteristics of wine. A particular metabolic activity characterizes the growth of each wine yeast species, which determines the concentrations of flavor compounds in the final wine. Numerous herbs, such as tulsi, ginger, aloe vera, tea, amla, lemongrass, and peppermint, are used in the preparation of herbal wines, where either the herb or herbal blends are primarily used as the substrate. The variants provided improved accuracy, increased acceptability, and broader uses for the novel product. Herbal wines pave the way to provide nutraceuticals to consumers and protection against pathogenic microorganisms and inflammation through their richness in antioxidants. The existing herbal wines and their health advantages are discussed in this Review, along with some new directions for the herbal wine business.
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Patient characteristics may influence access and acceptance of Prostate Specific Antigen test, and therefore, the timing of prostate cancer (PCa) diagnosis. A group of 361 patients from a cohort (nâ =â 451) diagnosed with PCa in 2018-2020 at the Portuguese Institute of Oncology of Porto was evaluated before treatment, using a structured interview, the Medical Term Recognition Test, and the EORTC Quality of Life Questionnaire QLQ-PR25. PCa prognostic stages (I, II, III, IV) were attributed according to the American Joint Committee on Cancer eighth edition. Multinomial logistic regression was used to compute the odds ratio and 95% confidence interval (OR [95% CI]), considering PCa stage II, the most frequent, as reference. Older age (ORâ =â 4.21 [2.24-7.93]), living outside the Porto Metropolitan Area while having low income (ORâ =â 6.25 [1.53-25.62]), and erectile dysfunction (ORâ =â 2.22 [0.99-4.99]) were associated with stage III, while urination during the night (ORâ =â 3.02 [1.42-6.41]) was associated with stage IV. Urine leakage was less frequent in stage III (ORâ =â 0.23 [0.08-0.68]), and living with a partner (ORâ =â 0.41 [0.19-0.88]) and family history of cancer (ORâ =â 0.25 [0.07-0.86]) in stage IV. Health literacy was not associated with PCa stage but lower education was less frequent in stage I (ORâ =â 0.27 [0.11-0.69]). Patient sociodemographic and clinical characteristics should be considered as targets to improve PCa early detection and prognosis.
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Alfabetización en Salud , Neoplasias de la Próstata , Masculino , Humanos , Pronóstico , Calidad de Vida , Conductas Relacionadas con la SaludRESUMEN
Erythrocytes play a fundamental role in oxygen delivery to tissues and binding to inflammatory mediators. Evidences suggest that dysregulated erythrocyte function could contribute to the pathophysiology of several neurodegenerative diseases. We aimed to evaluate changes in morphological, biomechanical, and biophysical properties of erythrocytes from amyotrophic lateral sclerosis (ALS) patients, as new areas of study in this disease. Blood samples were collected from ALS patients, comparing with healthy volunteers. Erythrocytes were assessed using atomic force microscopy (AFM) and zeta potential analysis. The patients' motor and respiratory functions were evaluated using the revised ALS Functional Rating Scale (ALSFRS-R) and percentage of forced vital capacity (%FVC). Patient survival was also assessed. Erythrocyte surface roughness was significantly smoother in ALS patients, and this parameter was a predictor of faster decline in ALSFRS-R scores. ALS patients exhibited higher erythrocyte stiffness, as indicated by reduced AFM tip penetration depth, which predicted a faster ALSFRS-R score and respiratory subscore decay. A lower negative charge on the erythrocyte membrane was predictor of a faster ALSFRS-R and FVC decline. Additionally, a larger erythrocyte surface area was an independent predictor of lower survival. These changes in morphological and biophysical membrane properties of ALS patients' erythrocytes, lead to increased cell stiffness and morphological variations. We speculate that these changes might precipitate motoneurons dysfunction and accelerate disease progression. Further studies should explore the molecular alterations related to these observations. Our findings may contribute to dissect the complex interplay between respiratory function, tissue hypoxia, progression rate, and survival in ALS.
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Esclerosis Amiotrófica Lateral , Eritrocitos , Microscopía de Fuerza Atómica , Humanos , Esclerosis Amiotrófica Lateral/fisiopatología , Esclerosis Amiotrófica Lateral/patología , Esclerosis Amiotrófica Lateral/mortalidad , Esclerosis Amiotrófica Lateral/sangre , Femenino , Persona de Mediana Edad , Masculino , Eritrocitos/metabolismo , Eritrocitos/patología , Anciano , Propiedades de Superficie , Membrana Eritrocítica/metabolismo , Adulto , Capacidad Vital , Progresión de la EnfermedadRESUMEN
Fucoxanthin (Fx) has been proven to exert numerous biological properties, which makes it an interesting molecule with diverse industrial applications. In this study, the kinetic behavior of Fx was studied to optimize three variables: time (t-3 min to 7 days), temperature (T-5 to 85 °C), and concentration of ethanol in water (S-50 to 100%, v/v), in order to obtain the best Fx yield from Undaria pinnatifida using conventional heat extraction. The Fx content (Y1) was found through HPLC-DAD and expressed in µg Fx/g of algae sample dry weight (AS dw). Furthermore, extraction yield (Y2) was also found through dry weight analysis and was expressed in mg extract (E)/g AS dw. The purity of the extracts (Y3) was found and expressed in mg Fx/g E dw. The optimal conditions selected for Y1 were T = 45 °C, S = 70%, and t = 66 min, obtaining ~5.24 mg Fx/g AS; for Y2 were T = 65 °C, S = 60%, and t = ~10 min, obtaining ~450 mg E/g AS; and for Y3 were T = 45 °C, S = 70%, and t = 45 min, obtaining ~12.3 mg Fx/g E. In addition, for the selected optimums, a full screening of pigments was performed by HPLC-DAD, while phenolics and flavonoids were quantified by spectrophotometric techniques and several biological properties were evaluated (namely, antioxidant, antimicrobial, and cholinesterase inhibitory activity). These results could be of interest for future applications in the food, cosmetic, or pharmaceutical industries, as they show the Fx kinetic behavior and could help reduce costs associated with energy and solvent consumption while maximizing the extraction yields.
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Undaria , Solventes , Etanol , Xantófilas/análisisRESUMEN
Macroalgae are an extensive resource for the obtention of bioactive compounds, mainly phenolic compounds, phlorotannins, and pigments. Fucoxanthin (Fx) is the most abundant pigment present in brown algae and has shown several useful bioactivities that can be used to fortify products in the food and cosmetic industries. Nevertheless, to date, there is still insufficient literature reporting on the extraction yield of Fx from U. pinnatifida species from green technologies. In this regard, the present study aims to optimize the extraction conditions to obtain the highest Fx yield from U. pinnatifida through emerging techniques, namely microwave-assisted extraction (MAE) and ultrasound-assisted extraction (UAE). These methods will be compared with the conventional methodologies of heat-assisted extraction (HAE) and Soxhlet-assisted extraction (SAE). According to our results, even though the extraction yield could be slightly higher when using MAE than UAE, the Fx concentration obtained from the alga was double when using UAE. Thus, the Fx ratio in the final extract reached values of 124.39 mg Fx/g E. However, the optimal conditions should also be considered since UAE needed 30 min to perform the extraction, whereas MAE was able to obtain 58.83 mg Fx/g E in only 3 min and 2 bar, meaning less energy expenditure and minimum cost function. To our knowledge, this study obtains the highest concentrations of Fx ever reported (58.83 mg Fx/g E for MAE and 124.39 mg Fx/g E for UAE), with low energy consumption and short times (3.00 min for MAE and 35.16 min for UAE). Any of these results could be selected for further experiments and proposed for industrial scaling-up.
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Phaeophyceae , Undaria , Microondas , XantófilasRESUMEN
BACKGROUND: Neuromyelitis Optica Spectrum Disorder (NMOSD) is an inflammatory disease of the central nervous system. The study aimed to characterize the neuropsychological profile of NMOSD by comparing them with multiple sclerosis (MS) patients and healthy controls. METHOD: Sixty-four participants were included:19 NMOSD, 27 MS, and 18 healthy controls. The neuropsychological protocol included the Portuguese version of Montreal Cognitive Assessment, the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), Verbal Fluency (phonemic and semantic), the Hospital Anxiety and Depression Scale, and the Expanded Disability Status Scale for clinical groups. RESULTS: NMOSD patients had significant lower cognitive performance when compared to HC mainly in information processing speed, concentration, language processing, and in executive functions (cognitive flexibility, sustained, and divided attention). No significant differences were observed between NMOSD and MS patients. Three predictors for cognitive impairment, according to BICAMS criteria, were found: depression, disease duration, and the level of disability. CONCLUSION: The neuropsychological profile found in the present study for NMOSD is consistent with the previous findings. Information regarding the predictors of cognitive impairment in both diseases and their different associations are important for future research and for guiding interventions more suitable for the neuropsychological needs of affected patients.
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Upper gastrointestinal endoscopy is considered the gold standard for gastric lesions detection and surveillance, but it is still associated with a non-negligible rate of missing conditions. In the Era of Personalized Medicine, biomarkers could be the key to overcome missed lesions or to better predict recurrence, pushing the frontier of endoscopy to functional endoscopy. In the last decade, microbiota in gastric cancer has been extensively explored, with gastric carcinogenesis being associated with progressive dysbiosis. Helicobacter pylori infection has been considered the main causative agent of gastritis due to its interference in disrupting the acidic environment of the stomach through inflammatory mediators. Thus, does inflammation bridge the gap between gastric dysbiosis and the gastric carcinogenesis cascade and could the microbiota-inflammation axis-derived biomarkers be the answer to the unmet challenge of functional upper endoscopy? To address this question, in this review, the available evidence on the role of gastric dysbiosis and chronic inflammation in precancerous conditions of the stomach is summarized, particularly targeting the nuclear factor-κB (NF-κB), toll-like receptors (TLRs) and cyclooxygenase-2 (COX-2) pathways. Additionally, the potential of liquid biopsies as a non-invasive source and the clinical utility of studied biomarkers is also explored. Overall, and although most studies offer a mechanistic perspective linking a strong proinflammatory Th1 cell response associated with, but not limited to, chronic infection with Helicobacter pylori, promising data recently published highlights not only the diagnostic value of microbial biomarkers but also the potential of gastric juice as a liquid biopsy pushing forward the concept of functional endoscopy and personalized care in gastric cancer early diagnosis and surveillance.
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Infecciones por Helicobacter , Helicobacter pylori , Lesiones Precancerosas , Humanos , Infecciones por Helicobacter/complicaciones , Disbiosis/complicaciones , Estómago/patología , Inflamación/complicaciones , Endoscopía Gastrointestinal , Carcinogénesis , Biomarcadores , Lesiones Precancerosas/diagnósticoRESUMEN
Triatoma costalimai and Triatoma jatai are related species, which occur in sympatry in Paranã, Tocantins, Brazil, in rocky outcrops and in peridomicile and intradomicile environments. This study compared morphologic and morphometric aspects of the eggs of these species using optical microscopy (OM) and scanning electron microscopy (SEM). Operculum cells (OP) and egg body (EB) were drawn and photographed, their surfaces were measured, and spots were quantified. Statistical analyses were performed using ANOVA and t-tests. OM showed an egg exochorium with spots in T. costalimai and a predominance of short lines in T. jatai. We found significant differences in egg length and width, which were larger in T. costalimai. SEM analysis showed that the operculum of both species had cells with straight and/or rounded rims, with a smooth aspect, random spots, and predominantly pentagonal shape. In the EB, hexagonal cells were predominant, with indices exceeding 60% in both species. Triatoma costalimai cells were flat, with a discrete definition of the rims, whereas T. jatai cells were smooth with well-defined rims. Statistical tests showed significant differences for EB, where T. costalimai cells were larger and have more spots than T. jatai. The eggs can thus be differentiated, thereby contributing to integrative taxonomy.
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Enfermedad de Chagas , Triatoma , Triatominae , Animales , Simpatría , Microscopía Electrónica de Rastreo , BrasilRESUMEN
Erythrocytes are deformable cells that undergo progressive biophysical and biochemical changes affecting the normal blood flow. Fibrinogen, one of the most abundant plasma proteins, is a primary determinant for changes in haemorheological properties, and a major independent risk factor for cardiovascular diseases. In this study, the adhesion between human erythrocytes is measured by atomic force microscopy (AFM) and its effect observed by micropipette aspiration technique, in the absence and presence of fibrinogen. These experimental data are then used in the development of a mathematical model to examine the biomedical relevant interaction between two erythrocytes. Our designed mathematical model is able to explore the erythrocyte-erythrocyte adhesion forces and changes in erythrocyte morphology. AFM erythrocyte-erythrocyte adhesion data show that the work and detachment force necessary to overcome the adhesion between two erythrocytes increase in the presence of fibrinogen. The changes in erythrocyte morphology, the strong cell-cell adhesion and the slow separation of the two cells are successfully followed in the mathematical simulation. Erythrocyte-erythrocyte adhesion forces and energies are quantified and matched with experimental data. The changes observed on erythrocyte-erythrocyte interactions may give important insights about the pathophysiological relevance of fibrinogen and erythrocyte aggregation in hindering microcirculatory blood flow.
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Eritrocitos , Adhesivo de Tejido de Fibrina , Humanos , Adhesivo de Tejido de Fibrina/metabolismo , Adhesivo de Tejido de Fibrina/farmacología , Microcirculación , Eritrocitos/metabolismo , Fibrinógeno/metabolismo , Modelos TeóricosRESUMEN
Malaria remains a major world public health problem, contributing to poverty and inequality. It is urgent to find new efficacious tools with few adverse effects. Malaria has selected red blood cell (RBC) alterations linked to resistance against infection, and understanding the protective mechanisms involved may be useful for developing host-directed tools to control Plasmodium infection. Pyruvate kinase deficiency has been associated with resistance to malaria. Pyruvate kinase-deficient RBCs display an increased concentration of 2,3-diphosphoglycerate (2,3-DPG). We recently showed that 2,3-DPG impacts in vitro intraerythrocytic parasite growth, induces a shift of the metabolic profile of infected cells (iRBCs), making it closer to that of noninfected ones (niRBCs), and decreases the number of parasite progenies that invade new RBCs. As an increase of 2,3-DPG content may also have an adverse effect on RBC membrane and, consequently, on the parasite invasion, in this study, we explored modifications of the RBC morphology, biomechanical properties, and RBC membrane on Plasmodium falciparum in vitro cultures treated with 2,3-DPG, using atomic force microscopy (AFM)-based force spectroscopy and other experimental approaches. The presence of infection by P. falciparum significantly increased the rigidity of parasitized cells and influenced the morphology of RBCs, as parasitized cells showed a decrease of the area-to-volume ratio. The extracellular addition of 2,3-DPG also slightly affected the stiffness of niRBCs, making it more similar to that of infected cells. It also changed the niRBC height, making the cells appear more elongated. Moreover, 2,3-DPG treatment influenced the cell surface charge, becoming more negative in treated RBCs than in untreated ones. The results indicate that treatment with 2,3-DPG has only a mild effect on RBCs in comparison with the effect of the presence of the parasite on the host cell. 2,3-DPG is an endogenous host metabolite, which may, in the future, originate a new antimalarial tool with few adverse effects on noninfected cells.
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Malaria Falciparum , Malaria , Humanos , 2,3-Difosfoglicerato/metabolismo , Piruvato Quinasa/metabolismo , Eritrocitos/metabolismo , Malaria/metabolismo , Malaria Falciparum/parasitología , Plasmodium falciparum , Ácidos Difosfoglicéricos/metabolismoRESUMEN
The knee is one of the most stressed joints of the human body, being susceptible to ligament injuries and degenerative diseases. Due to the rising incidence of knee pathologies, the number of knee X-rays acquired is also increasing. Such X-rays are obtained for the diagnosis of knee injuries, the evaluation of the knee before and after surgery, and the monitoring of the knee joint's stability. These types of diagnosis and monitoring of the knee usually involve radiography under physical stress. This widely used medical tool provides a more objective analysis of the measurement of the knee laxity than a physical examination does, involving knee stress tests, such as valgus, varus, and Lachman. Despite being an improvement to physical examination regarding the physician's bias, stress radiography is still performed manually in a lot of healthcare facilities. To avoid exposing the physician to radiation and to decrease the number of X-ray images rejected due to inadequate positioning of the patient or the presence of artefacts, positioning systems for stress radiography of the knee have been developed. This review analyses knee positioning systems for X-ray environment, concluding that they have improved the objectivity and reproducibility during stress radiographs, but have failed to either be radiolucent or versatile with a simple ergonomic set-up.
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Articulación de la Rodilla , Rodilla , Humanos , Rayos X , Reproducibilidad de los Resultados , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/cirugía , Rodilla/diagnóstico por imagen , RadiografíaRESUMEN
Gastric cancer (GC) screening is arguable in most Western countries. Liquid biopsies are a great promise to answer the unmet need for less invasive diagnostic biomarkers in GC. Thus, we aimed at systematically reviewing the current knowledge on liquid biopsy-based biomarkers in GC screening. A systematic search on PubMed/MEDLINE and Scopus databases was performed on published articles reporting the use of non-blood specimen (saliva, gastric juice [GJ], urine and stool) on GC diagnosis. 3208 records were retrieved by June 2022. After removal of duplicate records, 2379 abstracts were screened, and 84 full texts included in this systematic review. More than 90% of studies were reported on Asian populations. Overall, 9 studies explored stool-, 12 saliva-, and 29 urine-derived biomarkers for GC detection. Additionally, 37 studies, representing the majority, analyzed GJ, focusing on nucleic acid molecules. Several miRNAs and lncRNA molecules have been associated with GC risk, particularly miR-21 (area under the curve [AUC] = 0.97, 95% CI: 0.94-1.00). Considering salivary biomarkers, the best described model in validation sets included the soybean agglutinin and Vicia villosa agglutinin lectins (AUC = 0.89, 95% CI: 0.80-0.99). Most studies in urine carried out metabolomic approaches, with two discriminatory models presenting AUC values superior to 0.97. This systematic review emphasizes the potential role of non-blood-based biomarkers, although further validation, particularly in Western countries, is mandatory, namely for non-invasive screening and/or monitoring, as well as the use of GJ as a tool to enhance upper gastrointestinal endoscopy accuracy.
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MicroARNs , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patología , Biomarcadores de Tumor , MicroARNs/genética , Biopsia LíquidaRESUMEN
INTRODUCTION: The benefits of the multimodal Enhanced Recovery After Surgery® (ERAS) program have been described all over the world. The adoption of several perioperative strategies translates into an improvement in the quality of the healthcare provided. The aim of this study was to report the results of the implementation of the ERAS® program for colorectal surgery in a tertiary hospital. MATERIAL AND METHODS: In this single-center observational study, 534 patients who underwent colorectal surgery between December 2018 and May 2021 were included. Two groups were considered: before and after the implementation of the ERAS® program. The primary outcome measure was 30-day morbidity. The length of hospital stay, readmission rate, reintervention and mortality among the two groups were also evaluated. RESULTS: The pre-ERAS group included 102 patients and the ERAS group included 432 patients. There was a statistically significant reduction in morbidity at 30 days (37.3% vs 26.5%, p < 0.05), length of stay (7 days vs 5 days, p < 0.001) and readmission rate (12.9% vs 6%, p < 0.05) after the implementation of the ERAS program. CONCLUSION: The ERAS® protocol for colorectal surgery was successfully and safely implemented in our hospital, contributing to an improvement in perioperative care provided to patients.
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Cirugía Colorrectal , Procedimientos Quirúrgicos del Sistema Digestivo , Recuperación Mejorada Después de la Cirugía , Humanos , Tiempo de Internación , Portugal , Complicaciones Posoperatorias/prevención & control , Centros de Atención TerciariaRESUMEN
Prostate cancer (PCa) is the most prevalent among men, and psychological symptoms may affect many patients. This study aims to describe the prevalence of probable anxiety and depression before PCa treatments and after one year and to identify sociodemographic and clinical factors associated with these outcomes. Between February 2018 and March 2020, 292 patients recently diagnosed with PCa were recruited at the Instituto Português de Oncologia-Porto. The Hospital Anxiety and Depression Scale (HADS) was used to define probable anxiety and depression (cutoff = 11). The prevalence of probable anxiety remained stable from baseline to one year (7.8% vs. 8.5%, p = 0.866) while there was an increase in probable depression (3.1% vs. 6.8%, p = 0.012). After one year, probable depression persisted in 55.6% of patients with probable depression at baseline and 47.8% of those with probable anxiety at the first assessment had normal anxiety scores. At baseline, anxiety was more frequent among dwellers in rural areas (adjusted odds ratio-aOR, 95%CI: 2.80, 0.91-8.58) and less frequent in patients with body mass index 25-29.9 kg/m2 (aOR, 95%CI: 0.33, 0.12-0.91) compared to 18.5-24.9 Kg/m2, while those living alone had higher odds of depression (aOR, 95%CI: 6.35, 1.43-28.30). The frequency of anxiety and depression fluctuated during the course of treatment. Monitoring these symptoms would identify the most affected patients, contributing for a better use of mental health services.
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Depresión , Neoplasias de la Próstata , Ansiedad/psicología , Trastornos de Ansiedad , Depresión/psicología , Estudios de Seguimiento , Humanos , Masculino , Prevalencia , Neoplasias de la Próstata/epidemiología , Neoplasias de la Próstata/psicologíaRESUMEN
Brown macroalgae are a potential source of natural pigments. Among them, Undaria pinnatifida is recognized for its high concentration of fucoxanthin (Fx), which is a pigment with a wide range of bioactivities. In this study, three independent parameters were optimized for conventional heat extraction (CHE) to maximize the recovery of Fx from Undaria pinnatifida. Optimal conditions (temperature = 45 °C, solvent = 70%, and time = 61 min) extracted 5.1 mg Fx/g dw. Later, the bioactivities of the Fx-rich extracts (antioxidant, antimicrobial, and neuroprotective) were assessed using in vitro and in silico approaches. In vitro assays indicated that Fx has a strong antioxidant capacity and even stronger antimicrobial activity against gram-positive bacteria. This data was supported in silico where Fx established a high binding affinity to DR, a Staphylococcus aureus protein, through aa ALA-8, LEU-21, and other alkane interactions. Finally, the in vitro enzymatic inhibition of AChE using Fx, was further supported using docking models that displayed Fx as having a high affinity for aa TYR72 and THR 75; therefore, the Fx extraction behavior explored in this work may reduce the costs associated with energy and solvent consumption. Moreover, this paper demonstrates the efficiency of CHE when recovering high amounts of Fx from Undaria pinnatifida. Furthermore, these findings can be applied in different industries.