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1.
Trop Anim Health Prod ; 55(2): 133, 2023 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-36971860

RESUMEN

Egg storage duration can affect embryo mortality, hatching characteristics, hatching time, and post-hatch chick quality. In order to assess these effects, the impact of storage duration (5 days, 10 days, 15 days) and short incubation period during egg storage (SPIDES) investigated further 18, 900 eggs of broiler breeder (ROSS 308) in 3 × 2 factorial arrangement design. In the SPIDES treatment, the egg shell temperature was raised from its storage temperature (18 °C) and held at 100 °F for 3.5 h. Storage periods could significantly (P < 0.05) influence on embryo mortality (total, early, middle, and late), hatchability of both the total eggs and fertile eggs. The SPIDES treatment had a significant (P < 0.05) impact on a lower embryonic death rate and improved egg hatchability. Eggs stored for 5 days and eggs treated with SPIDES significantly (P < 0.001) shorten hatching time, batch's 90% hatching time (T 90% H), mean hatching time (MHT), maximal hatching period (MHP), and hatching window (HW). Chick quality was also determined, whereas storing eggs for 5 days and using the SPIDES treatment resulted in enhanced (P < 0.001) chick weight relative to egg weight (CW/EW), activity (AC), and chick quality score (CQS). The residual yolk sac weight (RYSW), unhealed navel (UHN %), and dirty feather (DF%) recorded the lowest (P < 0.001) values compared to long storage periods and control group. Finally, stored for 5 days treated by SPIDES positively affected the hatchability characteristics, the shortening hatching time, and the quality of chicks. Regarding the results, it was confirmed that using the SPIDES treatment to prevent the harmful effects of broiler eggs being stored for an extended period of time is a viable option.


Asunto(s)
Crianza de Animales Domésticos , Pollos , Óvulo , Animales , Crianza de Animales Domésticos/métodos , Pollos/fisiología , Óvulo/fisiología , Temperatura , Factores de Tiempo
2.
Folia Morphol (Warsz) ; 80(2): 352-362, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32644186

RESUMEN

BACKGROUND: The objective of this study is to evaluate the influence of carbimazole- induced hypothyroidism on the testes of adult albino rats and the probable protective effect of alpha-lipoic acid (ALA). MATERIALS AND METHODS: The rats were divided into four groups; control group, ALA group, carbimazole, and carbimazole + ALA groups. Rats were exposed to ALA (60 mg/kg body weight) or carbimazole (1.35 mg/kg body weight), or both, administered via gavages for 30 days. RESULTS: Morphometric analysis revealed a significant decrease in tubular diameter, germinal epithelium thickness, and interstitial space as compared to the controls. Also, rats exposed to carbimazole showed a significant decline in testicular weight, sperm motility, and count. Additionally, deterioration of the testicular architecture was observed. ALA supplementation resulted in a significant improvement in the tubular diameter and germinal epithelium thickness, but no significant improvement regarding interstitial space was observed. Another observation was the significant decline in serum testosterone and follicle-stimulating hormone (FSH) in the carbimazole group, indicating reduced steroidogenesis. A significant reduction in reduced glutathione content was detected in the testes of the carbimazole group compared with the controls, while malonaldehyde concentration significantly increased. Conversely, ALA supplementation ameliorated the toxicity induced by hypothyroidism as illustrated by enhanced reproductive organ weights, testosterone, luteinizing hormone, and FSH levels, testicular steroidogenesis, and oxidative stress parameters. CONCLUSIONS: Hypothyroidism altered testicular antioxidant balance and negatively affected spermatogenesis. On the other hand, ALA through its antioxidant properties alleviated testicular toxicity in carbimazole-exposed rats.


Asunto(s)
Hipotiroidismo , Ácido Tióctico , Animales , Hipotiroidismo/inducido químicamente , Hipotiroidismo/tratamiento farmacológico , Masculino , Ratas , Motilidad Espermática , Espermatogénesis , Testículo , Testosterona , Ácido Tióctico/farmacología
3.
Anaesthesia ; 74(12): 1618-1619, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31681991
4.
Anaesthesia ; 74(8): 1047-1056, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31058317

RESUMEN

There are data suggesting that intravenous dexamethasone has an effect on postoperative analgesia when given during single-shot spinal anaesthesia. However, the research literature is equivocal. We performed a systematic literature search followed by conventional meta-analysis (random effects model). We used trial sequential analysis to control for type-1 and -2 statistical errors. We also performed a leave-one-out meta-analysis for our primary outcome, the consumption of intravenous morphine in the first 24 postoperative hours. We applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to rate the level of evidence. We obtained data from 1133 patients, reported in 17 trials. Reporting quality was high, with low risk of bias. Dexamethasone use was associated with a significant reduction in 24-h morphine consumption, the mean difference (95%CI) being -4.01 (-5.01 to -3.01) mg, 6 trials, 326 participants, I2 = 0%. Trial sequential analysis showed that there was firm evidence for the primary outcome, and leave-one-out meta-analysis showed that our result was not driven by one single trial. The GRADE evaluation showed a high level of evidence, suggesting that further studies are unlikely to alter the result. The time to first analgesic request (95%CI) was significantly prolonged by 86.62 (10.62-162.62) min, I2 = 93%, in the dexamethasone group. For other secondary outcomes including number of patients requiring rescue analgesia, or visual analogue scale pain scores, we found no evidence of a significant difference between the treatment arms. We report a high level of evidence that intravenous dexamethasone improves postoperative analgesia after spinal anaesthesia.


Asunto(s)
Anestesia Raquidea , Dexametasona/administración & dosificación , Dolor Postoperatorio/prevención & control , Humanos , Morfina/administración & dosificación
5.
Orthop Traumatol Surg Res ; 104(6): 767-772, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29505820

RESUMEN

BACKGROUND: The aim of this study was to assess the accuracy of patient-specific guided glenoid component implantation in reverse shoulder arthroplasty. MATERIALS AND METHODS: 32 reverse shoulder arthroplasties were done using preoperative 3D planning and 4 patient-specific guides to prepare the glenoid and position the glenoid component. Baseplate version, inclination and entry point as well as angulation of the screws were compared to the preoperative plan measured on CT by independent observers. RESULTS: The mean deviation in baseplate version from the preoperative plan was 4.4°+3.1° (range, 0.3°-13.7°), in baseplate inclination 5.0°+4.2° (range, 0.1° to 14.5°) and in baseplate entry point 2.4mm+1.4mm (range, 0.4° to 6.3°). The average screw superior-inferior angulation deviation for the superior screw was 2.8°+2.6° (range, 0.0°-10.1°) and 2.8+2.6° in the antero-posterior plane (range, 0.1°-11.6°). For the inferior screw the superior-inferior angle deviation was 5.3°+3.8° (range, 0.1°-15.2°); the antero-posterior angle deviation was 4.1°+3.1° (range, 0.0°-9.8°). CONCLUSIONS: Patient-specific instrumentation (PSI) for the glenoid component in reverse shoulder arthroplasty allows the shoulder surgeon to accurately execute the preoperative 3D plan. LEVEL OF EVIDENCE: Level 3.


Asunto(s)
Artroplastía de Reemplazo de Hombro/métodos , Cavidad Glenoidea/cirugía , Articulación del Hombro/diagnóstico por imagen , Anciano , Anciano de 80 o más Años , Artroplastía de Reemplazo de Hombro/instrumentación , Tornillos Óseos , Femenino , Humanos , Imagenología Tridimensional , Masculino , Persona de Mediana Edad , Periodo Preoperatorio , Estudios Prospectivos , Articulación del Hombro/cirugía , Cirugía Asistida por Computador , Tomografía Computarizada por Rayos X
6.
Langmuir ; 32(27): 6967-76, 2016 07 12.
Artículo en Inglés | MEDLINE | ID: mdl-27269182

RESUMEN

This work demonstrates the controlled motion and stopping of individual ferrofluid droplets due to a surface tension gradient and a uniform magnetic field. The surface tension gradients are created by patterning hydrophilic aluminum regions, shaped as wedges, on a hydrophobic copper surface. This pattern facilitates the spontaneous motion of water-based ferrofluid droplets down the length of the wedge toward the more hydrophilic aluminum end due to a net capillarity force created by the underlying surface wettability gradient. We observed that applying a magnetic field parallel to the surface tension gradient direction has little or no effect on the droplet's motion, while a moderate perpendicular magnetic field can stop the motion altogether effectively "pinning" the droplet. In the absence of the surface tension gradient, droplets elongate in the presence of a parallel field but do not travel. This control of the motion of individual droplets might lend itself to some biomedical and lab-on-a-chip applications. The directional dependence of the magnetoviscosity observed in this work is believed to be the consequence of the formation of nanoparticle chains in the fluid due to the existence of a minority of relatively larger magnetic particles.

7.
Int J Pediatr Adolesc Med ; 1(1): 26-30, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32289071

RESUMEN

BACKGROUND AND OBJECTIVES: Metered-dose inhalers plus spacers (MDI-spacer) are as effective as, or better than, nebulizers in aerosol delivery. The selection of aerosol delivery system for hospitalized children can have a significant impact on the utilization of healthcare resources. DESIGN AND SETTING: A quality improvement project to evaluate the impact of conversion to MDI-spacer to administer bronchodilators (BDs) and inhaled corticosteroids (ICSs) to hospitalized children on the utilization of hospital resources. The project was conducted in a tertiary pediatric ward from April to May 2013. MATERIALS AND METHODS: The project was conducted over a six-week period. In the first two weeks, data were gathered from all hospitalized children receiving BDs and/or ICSs by nebulizers. This data collection was followed by a two-week washout period during which training of healthcare providers and operational changes were implemented to enhance the conversion to MDI-spacer. In the last two weeks, data were gathered from hospitalized children after conversion to MDI-spacer. The primary outcomes included the mean time (in minutes) of medication preparation and delivery. Secondary outcomes included the following: need for respiratory therapy assistance, estimated cost of treatment sessions, and patient/caregiver satisfaction. RESULTS: Five hundred seventy-five treatment sessions were enrolled (288 on nebulizers, 287 on MDI-spacer). The nebulizer group had more male predominance and were slightly older compared to the MDI-spacer group (male: 59% vs. 53% and mean age: 52 vs. 40 months respectively). The duration of treatment preparation and delivery was significantly lower in the MDI-spacer group (2 min reduction in preparation time and 5 min reduction in delivery time; p < 0.01). Caregivers mastered MDI-spacer use after an average of two observed sessions, eliminating the need for respiratory therapy assistance during the hospital stay. Medication cost analysis showed savings in favor of MDI-spacer (cost reduction per 100 doses: 50% for albuterol, 30% for ipratropium bromide, and 87% for ICSs). The patient satisfaction survey showed "very good" to "excellent" levels in both groups. CONCLUSIONS: Conversion to MDI-spacer for BDs and ICSs administration in hospitalized children improve hospital resource utilization.

8.
Langmuir ; 29(38): 12043-50, 2013 Sep 24.
Artículo en Inglés | MEDLINE | ID: mdl-23971937

RESUMEN

This paper describes a method for creating a topography-based gradient on a metallic surface to help mitigate problems associated with condensate retention. The gradient was designed to promote water droplet migration toward a specified region on the surface which would serve as the primary conduit for drainage using only the roughness of the surface to facilitate the movement of the droplets. In this work, parallel microchannels having a fixed land width but variable spacing were etched into copper substrates to create a surface tension gradient along the surface of the copper. The surfaces were fabricated using a 355 nm Nd:YVO4 laser system and then characterized using spray testing techniques and water droplet (2-10 µL) injection via microsyringe. The distances that individual droplets traveled on the gradient surface were also measured using a goniometer and CCD camera and were found to be between 0.5 and 1.5 mm for surfaces in a horizontal orientation. Droplet movement was spontaneous and did not require the use of chemical coatings. The theoretical design and construction of surface tension gradients were also explored in this work by calculating the minimum gradient needed for droplet movement on a horizontal surface using Wenzel's model of wetting. The results of this study suggest that microstructural patterning could be used to help reduce condensate retention on metallic fins such as those used in heat exchangers in heating, ventilation, air-conditioning, and refrigeration (HVAC&R) applications.

9.
Int J Nanomedicine ; 6: 311-20, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21383856

RESUMEN

BACKGROUND: Nanosized dry powder inhalers provide higher stability for poorly water-soluble drugs as compared with liquid formulations. However, the respirable particles must have a diameter of 1-5 µm in order to deposit in the lungs. Controlled agglomeration of the nanoparticles increases their geometric particle size so they can deposit easily in the lungs. In the lungs, they fall apart to reform nanoparticles, thus enhancing the dissolution rate of the drugs. Theophylline is a bronchodilator with poor solubility in water. METHODS: Nanosized theophylline colloids were formed using an amphiphilic surfactant and destabilized using dilute sodium chloride solutions to form the agglomerates. RESULTS: The theophylline nanoparticles thus obtained had an average particle size of 290 nm and a zeta potential of -39.5 mV, whereas the agglomerates were 2.47 µm in size with a zeta potential of -28.9 mV. The release profile was found to follow first-order kinetics (r(2) > 0.96). The aerodynamic characteristics of the agglomerated nanoparticles were determined using a cascade impactor. The behavior of the agglomerate was significantly better than unprocessed raw theophylline powder. In addition, the nanoparticles and agglomerates resulted in a significant improvement in the dissolution of theophylline. CONCLUSION: The results obtained lend support to the hypothesis that controlled agglomeration strategies provide an efficient approach for the delivery of poorly water-soluble drugs into the lungs.


Asunto(s)
Broncodilatadores/química , Inhaladores de Polvo Seco/métodos , Nanopartículas/química , Nanotubos/química , Polvos/química , Teofilina/química , Broncodilatadores/administración & dosificación , Rastreo Diferencial de Calorimetría , Sistemas de Liberación de Medicamentos/métodos , Concentración de Iones de Hidrógeno , Cinética , Nanopartículas/ultraestructura , Nanotubos/ultraestructura , Tamaño de la Partícula , Cloruro de Sodio , Teofilina/administración & dosificación
10.
Am J Transplant ; 10(10): 2331-40, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20825384

RESUMEN

Despite continuous improvement in long-term survival, there is no knowledge about risk of bone health impairment and management strategies before and after intestinal transplantation. Therefore, 147 adults were retrospectively studied via chart review; 70 long-term survivors, 53 candidates and 24 recipients with longitudinal follow-up. Evaluation process included measurement of bone mineral density (BMD) and allied biochemical markers. Both long-term survivors and candidates showed low bone mass with lower (p < 0.05) z-scores at hip, femoral neck and spine. Vitamin D deficiency and secondary hyperparathyroidism were observed in both groups. Prevalence of osteoporosis was 44% among long-term survivors and 36% in candidates with age, BMD, duration of parenteral nutrition, type of immunosuppression and rejection being significant risk factors. Fragility fractures occurred at a higher (p = 0.02) rate among long-term survivors (20%) compared to candidates (6%). The longitudinal study documented acceleration (p = 0.025) of bone loss after transplantation with a decline of 13.4% (femoral neck), 12.7% (hip) and 2.1% (spine). Alendronate reduced (p < 0.05) but did not prevent bone loss. In conclusion, intestinal transplant recipients are at risk of osteoporosis secondary to bone loss before and after transplantation. Accordingly, current management includes comprehensive preventive measures with prompt therapeutic intervention utilizing intravenous bisphosphonates or subcutaneous human PTH.


Asunto(s)
Densidad Ósea , Intestinos/trasplante , Trasplante de Hígado , Adulto , Alendronato/uso terapéutico , Biomarcadores/análisis , Femenino , Fracturas Óseas/etiología , Humanos , Hiperparatiroidismo Secundario , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Osteoporosis/epidemiología , Osteoporosis/etiología , Nutrición Parenteral en el Domicilio/efectos adversos , Pennsylvania/epidemiología , Estudios Retrospectivos , Sobrevivientes , Deficiencia de Vitamina D/complicaciones
11.
Am J Transplant ; 10(8): 1940-6, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20636461

RESUMEN

This report describes a new innovative pull-through technique of hindgut reconstruction with en bloc small bowel and colon transplantation in a Crohn's disease patient with irreversible intestinal failure. The approach was intersphincteric and the anastomosis was established between the allograft colon and the recipient anal verge with achievement of full nutritional autonomy and anal continence.


Asunto(s)
Canal Anal/cirugía , Colon/trasplante , Enfermedad de Crohn/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Intestino Delgado/trasplante , Adulto , Anastomosis Quirúrgica , Femenino , Humanos , Persona de Mediana Edad , Complicaciones Posoperatorias/cirugía , Resultado del Tratamiento
12.
Trop Gastroenterol ; 31(4): 279-84, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-21568143

RESUMEN

BACKGROUND: There is scarcity of data concerning the management of bleeding junctional gastroesophageal varices. AIM: Our aim was to compare the efficacy and safety of endoscopic variceal ligation (EVL) with cyanoacrylate injection for the treatment of bleeding junctional varices. METHODS: One hundred fifty patients with bleeding junctional varices were included in the study. Patients were subjected after randomization to either EVL of junctional varices (group 1:75 patients) or cyanoacrylate injection (group 11:75 patients). Endoscopic sessions were continued till obliteration of the varices. Clinical as well as biochemical parameters and severity of liver disease were assessed in all patients. RESULTS: Control of active variceal bleeding was achieved in 61 patients (81%) in group I and in 68 patients (91%) in group II with no significant difference (p = 0.07). Re-bleeding was seen in 12 patients (16%) in group I and 5 patients in group II (6%). Junctional varix obliteration was achieved after one session in 33% of patients in group I and 52% of patients in group II, however after 2 sessions it was achieved in 67% in group I and 93 % in group II. After 3 sessions variceal obliteration was achieved in 99% in group 1. Fever, chest pain and dysphagia were observed more frequently in group II than in group I. Long term complications including spontaneous bacterial peritonitis, hepatic encephalopathy and hepatorenal syndrome were also observed more frequently group II than in group I. CONCLUSION: EVL may be a good alternative to cyanoacrylate injection in treatment of bleeding junctional varices.


Asunto(s)
Cianoacrilatos/administración & dosificación , Endoscopía/métodos , Várices Esofágicas y Gástricas/cirugía , Hemorragia Gastrointestinal/cirugía , Adulto , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intralesiones , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Resultado del Tratamiento , Adulto Joven
13.
Scand J Immunol ; 66(6): 703-10, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18021367

RESUMEN

This study aimed to analyse the association of gene polymorphisms with the outcome of allogeneic haematopoietic stem cell transplantation. We studied 122 donor/recipient pairs who received HLA-identical transplants from siblings at the Universidade Estadual de Campinas, Brazil, between June 1996 and June 2006. Donor/recipient alleles for TNFA-238 and IL2-330/+166 single-nucleotide polymorphisms (SNP) were analysed by PCR-SSP. No association was observed between the risk of acute graft-versus-host disease (GVHD) and these SNP. However, our findings suggest that the polymorphism of promoter gene TNFA-238GA is associated with the occurrence and severity of chronic GVHD. The probability of chronic GVHD in patients with GA genotype at position -238 of TNFA gene is 91.7% in contrast to 59.4% in patients with GG genotype (P = 0.038). In patients with donor GA genotype the probability of chronic GVHD is 90.8%, and 57.9% in patients with donor GG genotype (P = 0.038). The probability of extensive chronic GVHD in patients with TNFA-238GA is 91.7% compared with 46.3% in patients with TNFA-238GG (P = 0.0046). In patients with donor GA genotype at position -238 of the TNFA gene, it is 81.7%, compared with 44.5% in patients with donor GG genotype (P = 0.016). However, further studies with more patients are required to identify cytokine gene polymorphisms and their association with transplant-related complication in Brazil, particularly due to ethnic background, the relatively low power of detection of genetic markers of this study, and the complexity of the MHC region.


Asunto(s)
Enfermedad Injerto contra Huésped/genética , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Interleucina-2/genética , Polimorfismo Genético/genética , Factor de Necrosis Tumoral alfa/genética , Adolescente , Adulto , Brasil , Niño , Femenino , Genotipo , Enfermedad Injerto contra Huésped/inmunología , Humanos , Lactante , Interleucina-2/inmunología , Leucemia/genética , Leucemia/terapia , Masculino , Persona de Mediana Edad , Polimorfismo Genético/inmunología , Hermanos , Donantes de Tejidos , Trasplante Homólogo , Factor de Necrosis Tumoral alfa/inmunología
14.
J Bone Joint Surg Br ; 89(10): 1347-51, 2007 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17957076

RESUMEN

The generally-accepted treatment for large, displaced fractures of the glenoid associated with traumatic anterior dislocation of the shoulder is operative repair. In this study, 14 consecutive patients with large (> 5 mm), displaced (> 2 mm) anteroinferior glenoid rim fractures were treated non-operatively if post-reduction radiographs showed a centred glenohumeral joint. After a mean follow-up of 5.6 years (2.8 to 8.4), the mean Constant score and subjective shoulder value were 98% (90% to 100%) and 97% (90% to 100%), respectively. There were no redislocations or subluxations, and the apprehension test was negative. All fragments healed with an average intra-articular step of 3.0 mm (0.5 to 11). No patient had symptoms of osteoarthritis, which was mild in two shoulders and moderate in one. Traumatic anterior dislocation of the shoulder, associated with a large displaced glenoid rim fracture can be successfully treated non-operatively, providing the glenohumeral joint is concentrically reduced on the anteroposterior radiograph.


Asunto(s)
Inestabilidad de la Articulación/prevención & control , Luxación del Hombro/etiología , Fracturas del Hombro/terapia , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Prevención Secundaria , Fracturas del Hombro/diagnóstico , Fracturas del Hombro/etiología , Resultado del Tratamiento
15.
J Bone Joint Surg Br ; 88(10): 1394-400, 2006 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17012435

RESUMEN

Systemic factors are believed to be pivotal for the development of heterotopic ossification in severely-injured patients. In this study, cell cultures of putative target cells (human fibroblastic cells, osteoblastic cells (MG-63), and bone-marrow stromal cells (hBM)) were incubated with serum from ten consecutive polytraumatised patients taken from post-traumatic day 1 to day 21 and with serum from 12 healthy control subjects. The serum from the polytraumatised patients significantly stimulated the proliferation of fibroblasts, MG-63 and of hBM cells. The activity of alkaline phosphatase in MG-63 and hBM cells was significantly decreased when exposed to the serum of the severely-injured patient. After three weeks in 3D cell cultures, matrix production and osteogenic gene expression of hBM cells were equal in the patient and control groups. However, the serum from the polytraumatised patients significantly decreased apoptosis of hBM cells compared with the control serum (4.3% vs 19.1%, p = 0.031). Increased proliferation of osteoblastic cells and reduced apoptosis of osteoprogenitors may be responsible for increased osteogenesis in severely-injured patients.


Asunto(s)
Apoptosis/fisiología , Células del Tejido Conectivo/fisiología , Heridas y Lesiones/fisiopatología , Adulto , Fosfatasa Alcalina/metabolismo , Médula Ósea/patología , División Celular/fisiología , Células Cultivadas , Matriz Extracelular/patología , Femenino , Fibroblastos/fisiología , Expresión Génica , Humanos , Puntaje de Gravedad del Traumatismo , Péptidos y Proteínas de Señalización Intercelular/sangre , Masculino , Persona de Mediana Edad , Osificación Heterotópica/patología , Osificación Heterotópica/fisiopatología , Osteoblastos/fisiología , Osteogénesis/fisiología , ARN Mensajero/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Células del Estroma/fisiología , Heridas y Lesiones/sangre , Heridas y Lesiones/patología
16.
J Inherit Metab Dis ; 29(1): 92-8, 2006 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-16601874

RESUMEN

BACKGROUND: In Gaucher disease, the infiltration of the bone marrow by glucocerebroside-laden macrophages (Gaucher cells) triggers a diverse pattern of skeletal disease that results in crippling complications. Reliable ascertainment of the severity and pattern of skeletal disease is essential to determine disease status and the response to enzyme replacement therapy (ERT). Although there is ample documentation of reversal of haematological and visceral disease by ERT, there is a paucity of data on skeletal response to ERT in children. AIM: To delineate the pattern of bone disease in children with Gaucher disease in Egypt and to evaluate its response to ERT. METHOD: Twenty-two children with Gaucher disease were treated with ERT. Phenotyping by clinical, laboratory and radiological criteria was performed at baseline and following 11.2 +/- 4 months of ERT. Genotyping for glucocerebrosidase (GBA) mutations was performed by gene sequencing, and genotype-phenotype correlations were performed.Results. Two-thirds of the patients were from consanguineous pedigrees and 14/22 patients were homozygous or compound heterozygous for L444P and D409H mutations. Bone involvement was detected by plain radiology in 11 children (50%) and in 16 (73%) by magnetic resonance imaging (MRI). There was no correlation of severity of bone involvement and GBA genotype. ERT ameliorated bone disease: 10 of the 11 children with abnormal radiographic findings at baseline showed improvement in skeletal lesions; while 9/16 showed improvement of marrow disease by MRI. Radiographic sensitivity and specificity were 62% and 82% compared to MRI for detection of bone involvement in this patient population. At baseline, bone pain was present in 5 patients and ERT resulted in complete symptomatic remission in all of them. ERT was associated with significant improvement in growth parameters and amelioration of haematological and visceral involvement. CONCLUSION: Symptomatic and radiological skeletal disease is common in children with Gaucher disease in Egypt. MRI is the most accurate technique for detecting early skeletal involvement. There was no correlation between severity of skeletal involvement and GBA genotype. ERT was effective in ameliorating radiological manifestations of skeletal disease and achieving complete remission of bone pain.


Asunto(s)
Enfermedad de Gaucher/tratamiento farmacológico , Enfermedad de Gaucher/patología , Glucosilceramidasa/uso terapéutico , Adolescente , Huesos/efectos de los fármacos , Niño , Preescolar , Egipto , Femenino , Genotipo , Glucosilceramidasa/genética , Heterocigoto , Humanos , Lactante , Masculino , Fenotipo , Inducción de Remisión , Factores de Tiempo
17.
Bone Marrow Transplant ; 37(10): 955-9, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16565740

RESUMEN

Salivary gland dysfunction is a common sequela of hematopoietic progenitor cell transplantation (HPCT). The investigation of major salivary gland dysfunction with sodium pertechnetate scintigraphy is a non-invasive method that provides images of the parotid and submandibular glands. In this prospective trial, 20 HPCT patients were submitted to scintigraphic study with 99mTc-pertechenate and 67Ga in order to evaluate the major salivary glands early involvement following HPCT. Major salivary glands were evaluated prior to HCPT as well as at Days +30, +60 and +100 post transplant. Major salivary glands uptake and clearance of 99mTc-pertechenate results did not demonstrate any functional differences between pre- versus post transplant periods. Results of the 67Ga scan revealed inflammatory infiltration following HPCT, primarily in submandibular glands, suggest a persistent involvement of major salivary glands up to Day +100 after HPCT.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas/métodos , Cintigrafía/métodos , Glándulas Salivales/diagnóstico por imagen , Glándulas Salivales/lesiones , Trasplante Homólogo/métodos , Adulto , Femenino , Galio/metabolismo , Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Glándulas Salivales/metabolismo , Glándula Submandibular/metabolismo , Tecnecio/metabolismo , Trasplante Homólogo/efectos adversos , Resultado del Tratamiento , Xerostomía/etiología , Xerostomía/metabolismo
18.
Unfallchirurg ; 108(1): 35-36, 38-42, 2005 Jan.
Artículo en Alemán | MEDLINE | ID: mdl-15674646

RESUMEN

Initial treatment of pelvic ring fractures with involvement of the iliosacral complex is directed at bleeding control and fixation of the pelvic ring. However, long-term outcome is determined by persisting neurological deficits, malunion of the posterior pelvic ring with low back pain, and urological lesions. Between 1991 and 2000, 173 patients with sacral fractures were treated at our institution. Sacral fractures as part of type B2 ("lateral compression") or type C ("vertical shear") pelvic ring fractures were treated conservatively, if dislocation was less than 1 cm. Fractures with a dislocation of more than 1 cm were treated operatively (n=33, 19%). A total of 112 patients were examined after an average of 4.9 years. Of the 39 patients with primary neurological deficits (35%) only 4 showed complete neurological recovery. Chronic low back pain was rarely observed (n=8, 7%) and only in type C injuries. The low incidence of chronic low back pain justifies conservative treatment of minimally (<1 cm) displaced sacral fractures. Long-term outcome is largely determined by neurological deficits, which persist in 30% of all patients with sacral fractures.


Asunto(s)
Fijación de Fractura/estadística & datos numéricos , Fracturas Óseas/epidemiología , Fracturas Óseas/cirugía , Dolor de la Región Lumbar/epidemiología , Huesos Pélvicos/lesiones , Huesos Pélvicos/cirugía , Sacro/lesiones , Sacro/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Comorbilidad , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos/estadística & datos numéricos , Recuperación de la Función , Medición de Riesgo/métodos , Factores de Riesgo , Suiza/epidemiología , Resultado del Tratamiento
19.
Swiss Surg ; 9(2): 87-91, 2003.
Artículo en Alemán | MEDLINE | ID: mdl-12723289

RESUMEN

Computed tomography (CT) of the abdomen is a reliable method for evaluation of spleen injuries and has the potential to exclude further abdominal injuries. Blunt and penetrating injuries of the spleen have to be managed immediately due to a high mortality rate. Two therapeutical options, conservative or operative, are currently available. In general, a hemodynamic stable patient, no further injuries of the abdominal organs or the skull as well as no history of abdominal surgery of the abdomen are prerequisites for a non-surgical therapy. Catheter-based angiography gives the possibility to diagnose and to treat injuries of blood vessels of the spleen, which were seen on the CT scans. Gunshots are relatively rare in Europe, but the mortality of such traumas is high. The present case demonstrates a patient with a penetrating gunshot trauma of the left hemiabdomen with a bleeding injury of the spleen. Due to the stable hemodynamic conditions, absence of further injuries of the abdomen or the skull and, because of previous pancreas surgery a non-surgical therapy was chosen, consisting of proximal embolisation of the splenic artery.


Asunto(s)
Embolización Terapéutica , Bazo/lesiones , Arteria Esplénica/lesiones , Heridas por Arma de Fuego/terapia , Adulto , Angiografía , Humanos , Imagenología Tridimensional , Masculino , Complicaciones Posoperatorias/diagnóstico por imagen , Bazo/diagnóstico por imagen , Arteria Esplénica/diagnóstico por imagen , Tomografía Computarizada Espiral , Heridas por Arma de Fuego/diagnóstico por imagen
20.
Braz J Med Biol Res ; 36(3): 315-21, 2003 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-12640495

RESUMEN

The feasibility of allogeneic bone marrow transplantation (alloBMT) in a developing country has not yet been demonstrated. Many adverse factors including social and economic limitations may reduce the overall results of this complex and expensive procedure. Our objective was to characterize the most important clinical, social and economic features of candidates for transplantation and their potential donors as well as the influence of these factors on overall survival in a retrospective and exploratory analysis at a university hospital. From July 1993 to July 2001, candidates for BMT were referred to the Bone Marrow Transplantation Unit by Hematology and Oncology Centers from several regions of Brazil. A total of 1138 patients were referred to us as candidates for alloBMT. Median age was 25 years (range: 2 months-60 years), 684 (60.1%) were males and 454 (39.9%) were females. The clinical indications were severe aplastic anemia and hematological malignancies. From the total of 1138 patients, 923 had HLA-typing; 497/923 (53.8%) candidates had full match donors; 352/1138 (30.8%) were eligible for alloBMT. Only 235 of 352 (66.7%) were transplanted. Schooling was 1st to 8th grade for 123/235 (52.3%); monthly family income ranged from US$60 (7%) to more than US$400 (36%). Overall survival for patients with chronic myeloid leukemia, severe aplastic anemia and acute myeloid leukemia was 58, 60 and 30%, respectively. Thus, overall survival rates for the most frequent hematological diseases were similar to those reported in the International Registry, except for acute myeloid leukemia. This descriptive and exploratory analysis suggests the feasibility of alloBMT in a developing country like Brazil.


Asunto(s)
Enfermedades de la Médula Ósea/terapia , Trasplante de Médula Ósea/estadística & datos numéricos , Histocompatibilidad , Donadores Vivos/provisión & distribución , Hermanos , Adolescente , Adulto , Enfermedades de la Médula Ósea/mortalidad , Trasplante de Médula Ósea/mortalidad , Brasil/epidemiología , Niño , Preescolar , Escolaridad , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores Socioeconómicos , Tasa de Supervivencia , Trasplante Homólogo
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